{
   "doc" : {
      "creator" : [
         "MacPherson, Daniel, Mrs., ca. 1828-1892."
      ],
      "key" : "oocihm.04640",
      "label" : "Notes on nursing : how to treat smallpox - guaranteed to prevent disfiguration and lessen suffering : cure for cholera, cancer, sprains, \u0026c., \u0026c. / by Mrs. Daniel MacPherson.",
      "location" : "http://eco.canadiana.ca/view/oocihm.04640",
      "collection" : [
         "wmh"
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      "lang" : [
         "eng"
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      "note" : [
         "Title from title screen.",
         "19 p. ; 19 cm."
      ],
      "subject" : [
         "Smallpox -- Quebec (Province)",
         "Variole -- Québec (Province)"
      ],
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         "text"
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      "contributor" : "oocihm",
      "text" : [
         "Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliogrqphically unique, which may alter any of theimages in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque E Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur [ Bourid with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans-e texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. Additional comments:/ Commentaires supplémentaires: L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont ut-étre uniques du point de vue bibliographiq u, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiquée ci-dessous. . Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stain4dor foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Includes supplementary material/ Comprend du matériel supplémentaire Only edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. This item is filmed at the reduction ratio checked below/ Ce document est filné au taux de réduction indiqué ci-dessous. 1oXX 14X 18X 22X 26X 30X - 12X 16X 20X 24X 28X 32X",
         "N TES ON NURSING HOW TO TREAT SMALLPOx--;UARANTEED TO PRE\\'ENT DISFIGURATION ANI) LESSEN SUFFERING. CURE FOR CHOLERA, CANCER, SPRAINS, \u0026c , \u0026c. BY MRS9. DANIEL MACPHlERSON. N MONTREAL: PRINTED1 BY JOHN LOVELL \u0026 SON, 1890. j",
         "e ' j. s - v 4. - a. - I.",
         "NOTES ON NUR S IlG HOW TO TREAT SMALLPOX-GUARANTEED TO PREVFT DISFIGURATION AND LESSEN SUFFERING. CURA FOR CHOLERA, CANCER, SPRAINS, \u0026c., \u0026c. BY MRS. DANIEL MACPBER8ON. MONTREAL: PRINTED BY JOHN LOVELL \u0026 SON, 1890.",
         "eo.e* e. . . . . . . . ose 49 04. 4b ** * ** * 60* * 00 lb *",
         "NOTES ON NURSING. THIS pamphlet must necessarily be egotistical, if I am to help others- by my advice and experience. I can only' do so by saying what I did myself and how I came to do it. Well, in the year - , a young son of mine was sitting on the Esplanade, Quebec, watching some exhibition, when he found the party seated beside him was a young girl covered with small- pox. He left quickly, but the harm was done. I forget how many days after he took ill. The late lamented Dr. LaFleur, of Levis, attended him, and from him I learnt the treatment, which enabled me, alone, without nurse or physician, to treat another son. Both were very bad cases, and neither bear the slightest mark of ever having had the disease. I wished to go to the General Hospital in Quebec with my boy. \"What is your object ?\" Dr. LaFleur inquired. \"To prevent giving it to others,\" I answered. \"Well,\" he said, \"as 59058",
         "N07ES ON NURSJNG. you would have to get a carriage, cross in the steamer, and drive some distance, you would probably do your son great harm and risk in- fection to dozens of people before you get there.\" So I remained where I was. We occupied a very large double house; one side- parlor and bedroom was tightly closed off from the rest. All food was carried to me by an old man, hired to sit on a grass-plot-and bring what was required-taking it from the servants, hands and depositing it on the gallery. Every article of furniture was taken and, with carpet, put in the hangard, and there kept three months. I only retained a bed, and I had a small stove, in which I burnt all remains of food, and the plates were thoroughly soaked in disinfectants before being returned to the cook.- All linen and bits of cotton used as pocket handkerchiefs were burnt, and the sheets thrown into tubs of cold water, with disinfectants, and the old man, with a stick, shaking them around several times, before changing the water, and put them out on the grass, in'the hot sun, to dry; thusI could change the bed every day or two, and yet not risk infection to others by having them washed. Dr. LaFleur only came into the house for about a",
         "NQTES ON NURSING. Nveek, he looked at his patient through an open vindow. * I attended him alone for six weeks, and then two tents were erected, in one of which he and I sat and talked to other members of the family in another tent. This was the one solitary case in South Quebec. Thank God no one took it from us. And now for my second case and the treatment: I must premise I pretend to no medical know- ledge. I ne'er gave a pulse or*temperament to a doctor, for my days were the days of Dickens' Sarey Gamp, and to give a drink, or rather not give a drink, of cold water to a fever-stricken and thirst-cd'nsutming patient was the utmost we aimed at in nursing; so that in acting the part of, sole physician, I was driven by stern neces- sity by no desire of my own. , When first the small-pox epidemic appeared in Montreal, there was a regular panic, there was not room in the.Civic. Hospital, and the doctors feared to attend small-pox caîses or account of the fears of their other patients. Thf'swas the position of affairs when I went one morning to my dressnaker, and asked her to make some small repairs to a pair of pants, belonging to my . When I went back for them and for some dresses (fortunately they",
         "NOTES ON NURSING. were calico 1and so washed), I noticed a very peculiar and disgusting odor. - I remarked, \" You can never be healthy in such an atmos- phere as this. Why don't you open your win- dows ?\" \"They have been open.\" The room was in semi-darkness, and a child's cot was in the corner. I believe now the sick child was in that cot. I took my effects and departed. The next day. Mrs. G--, a kind neighbor from that house, said: \"You get your sewing done there? I want some done; but little Jeff, who went to get some milk there, says he is sure that he saw a child ill with small-pox, and refused to take the milk.\" ''\"Can it be possible ! \" It flashed upon me instantly that was really the peculiar disgusting odor of small-pox 1 had smelt. I said so. A doctor was sent to investigate, and it was found to be - the case ; and the criminal neglect of that fanily gave it to ten -arties in that street-one of them my son. A b cther of little Jeff took it also. My patient had started on business and reached Toront, feeling very ill; went to a physician there, who toldt him there was a good deal of low fever about, and he had better lay up in some hospital there. He said, no, he would come home; but, just on arrival, wanted to go to an hospital-",
         "NOTES ON NURSING. 7 beginning to fe3r it was small-pox. But as it was late, and he very much exhausted, I per- suaded· him to stay with us for one night, as he had had no food and could take none.* I gave him some hot bitter ale (an old Englishman had told me it was a good thing to cause an eruption to come out). He slept the sleep of exhaustion that- night, and the next morning he was covered with a rash. We had been such a healthy family. We knew.no doctor in Mont- real; knew none to whom to apply. So (and now the personal pronoun must be used very often if I arm to obtain the desired result from these memories) that by helping any one unexpectedly placed in my position,/unable to procure medical help, I was enablJd to take care of and preserve the life and prevent dis- figurement of a patient, and destroy all danger of infection. I called to Mr..G--, a neighbor, from an upper window, and asked him to send me a doctor. \"What for? \" \"I don't know. \" \"Can it be small-pox ?\" \u003c'It may be.\" So he sent. Dr. Laberge arrived, glanced from a distance, said \"tIll send the doctor of the Civic hospital to- morrow. We'll judge better then.\" There was",
         "NOTES ON IAURSZNG. chloride of lime on a saucer in the passage, through which passed a through draft of air, There was no one in the house except my hus- band, my son and myself. My servant had gone home some days previously. My dear husband would not leave; but I never spoke to him, except from a distance, for six long weeks. He occu- pied a room in the ,lower story, and spent his days walking in the country, and took,his meals out. The next day the civic doctor arrived- he pronounced it an unmistakable case of small- pox. \"Will you have him taken to the Civic hospital ?\" was the next query? \"Can I hire a roon to go with him, and nurse him, if I stay inside all the time.?\" \"No; there is no room to hire. The hospital is crowded. It will be as much as I can do to get your son a bed; then he will remain.\" The two next houses were unoccupied-parties were in the country. Mine was on a corner, next a large vacant lot, opposite a large green field, with an empty school-house. I decided to ask permission to remain. I again sent for Dr. Laberge; he took in the sur- roundings, and said I could, as he saw I was to be trusted. I asked him to attend my patient ; he said he could not, in iis public situation he",
         "NOTES ON NURSING. 9 would risk too much infection to others. \" Well, then,\" I asked, \"can you tell me how to make the salve Dr. Lafleur, of Levis (now deceased), pu-t on the patient's face to prevent disfigure- ment ? Was it black ?\" \"No, grey.\" \"This I can- not tell you; but I know in England they use something with charcogl in it.\" And that was all the medical advi\u0026eI had in the course of this long and very serious illness, for it was a ývery bad· case, and the doctor who had seen my son in Toronto sa4-, from the weakness of ny patient at the time he saw him, he thought that there were no hopes of recovery. I also sent for Dr. P , of Bleury street. He looked in from the door, and said his duty to patients he was then attending would prevent his com- ing, unless in case of inflammation of the lungs or other serious complication. So I prepared for a seige in earnest. I talked from an upper window, and ordered that essence of beef and a bag of ship (not cabin) biscuits, be sent to me. Some canned things for myself, cheese, other crackers, honey, preserved fruit, lemons, oranges, gelatine~and wine for jelly, etc.; and as medical stores an.ounce of flour of sulphur, a bottle of îodine (small one), a jarof mineral water, a few",
         "1o NOTES ON NURSING. 7 ounces best cream oi tartar, a small quantity of powdered charcoal, a box of pure fresh lard, a small new paint brush, a bottle of sweet oil, and a few seidlitz powders. This was all my medical paraphernalia, more preventive than curative, for I pretend to no medical knowledge. OTHER PREPARATIONS. In the outbuildings was a table, with drawers, containing silver money over a cup of chloride of lime, paper, and ,pen and ink. I arranged with a man to place on that table every day, a pound of any kind of fresh meat, some boxes of strawberries, half a gallon of milk, a few fresh eggs, and the,daily papers. My friends were requested after ringing the bell to- look to the parlor window, from whence I said how we were getting on,1and to place between the doors amusing books, papers and letters. Well, with profuse apologies came the men. \"So sorry, but we are obliged to placard you.\" \"So much obliged,\" said I. \"Put it on the outer door where it can be well seen, and then I shall have perfect quiet and not be bothered by visitors.\" Ir",
         "NOTES ON NURSING. Now I think it is time to go back to my patient, whom I have left quietly dosing in the very top story onthe bath room flat. For the first few days he was very weak, his long travel and anxiety to reach home had told upon him, so occasionally I gave him hot ale as nutritive and stimulating, and sailors' biscuits and strawberries. He was delighted with the biscuit. \" How did you come to think of it. I could not have eaten bread.\" 'I know by experience that a person ill can eat'sailors or soda biscuit when they cannot eat anything else; besides, the baker ceased to come, and if the man I had hired to bring me provisions failed me, I was insured against starvation, for none of my family would have been permitted to come near me. I have since learned, that when a house is placarded, you can insist on a policeman calling with eatables every day. As soon as the eruption was fully out, I made a salve of charcoal, perfectly black, with which the patient's face was thickly covered, he only looked like a negro, and as the oldest of everything was brought into use and burnt in a small stove on the same flat, it did not matter much. Old shirts shared the same fate, and for pocket handkerchiefs I used old squares of cotton, 11I",
         "NOTES ON NURSING. and burned them. Then I put into practice.what Dr. LaFleur tajght me. It sounds disgusting, but is not everything about small-pox disgusting, and a few days patience and perseverance protects from disfigurement for life. So I must tell you that every single pustule as soon as it reaches maturity, must be picked with a clean ßi dzeee, and not suffered to eat holes in the skin, for this is what causes disfigurement, by small-pox. Then mix equal parts of cream and iodine, and with a small clean paint brush touch every pustule, don't neglect one, or there will be a mark. This must be done every day for a few days ; if it smarts put more cream, and then every day for about a week, put on all over the face a mixture of cream and glycerine: That is the whole process, very simple in practice, and which not only saves the looks, but gives great relief, by taking away the intolerable itching which small-pox patients suffer from; for sore throat and inability to swallow, gargle with flour of sulphur, and put a little on the tongue. Now for diet. As soon as the eruptior( was fully out, I gave all fruit and milk he asked. I stopped the ale, and never gave a drop of wine or stimulant of any kind during the whole six 12",
         "NOTES ON NURSING. weeks he was in my charge. I may state here that from what I have heard, I attribute the great disfigurement amongst. the French Canadians, particularly 'of the lower class (intelligent people know better), to the great quantity of whiskey and gin given at that time, In fact, I heard a man say in the cars one day, there is only one remedy for small-pox, this about a young child-du gin à force-meaning gin in any quantity, and now mind ask a doctor what diet should be, as I had no doctor. I gave my patient what he asked for tea, coffee, broma, lemonaçie, and when the fever was high lemonade with plenty of cream of tartar, for which this receipt:- Take an ounce of cream of tartar, put it in a good sized jug, cut up a lemon and put it on the cream of tartar with sone white sugar, pour on it some boiling water to extract the juice, then fill up with cold water, and when well settled, give as the patient is thirsty. After the anxiety of the first ten days was over, and my patient began to mend, we had some very pleasant though quiet days. I read aloud amusing books and papers, and at the end of about six weeks I thought my patient well enough to go free, and so called out of 13g 4",
         "NO TES ON NURSING. the window to send for a city doctor to pro- nounce my patient cured. We went into -the hangard, where a nice dinner was cooling on a coal oil stove, passed the day there while the house was being disinfected, and returned next day to freedom, with grateful hearts to rejoice over past danger. If I have been so minute in these details, it is that in times of public calamity, when doctors are overworked and hard to procure, most parties lose their wits, and do not exercise the calm judgment that might otherwise help to save their friends and s themselves. I must note as a singular fact that both the gentlemen I have spoken of as patients had been vaccinated as children, which shows the necessity of revaccination, while I, who attended them, had not been revaccinated, and, after a lapse of fifty years vaccination, never took it, though I attended them both. An - extraoidinary exception, not to be relied upon. The question was asked me, what would you have done if your patients became delirious, as you were alone? They were both at times slightly delirious, but not annoyingly so. Had they shown the slightest._ symptom of becoming 14",
         "NOTES ON NURSING. -, uncontrollable; I should have rolled them in sheets, tied them, and called for help. I had reasoned out all my plans in my own mind. So I give this as a hint to others, and I advise any one else to bathe the feet constantly in sweet oil, as one patient suffered most from his* feet. In cases of yellow fever, I have heard that in the South they apply a salt herring to the sole of the foot, it draws out the fever, becomes black, is burnt, and another put on. I would now try the same on small-pox, taking care the brine did not touclY the skin, the herring- to be well covered. CHOLERA. The first case of cholera I remember of was the case of a servant who was pronounced by two dòctors almost in the state of collapse. A man-I never knew his name-asked to be allowed to try what he could do, as there was pronounced no hope. He tried brandy in good green tea, after a dose of castor diI,-I think a tea-spoonful of best brandy in a small cukof hot green tea. The women recovered, and, 1 e wildfire, the news spread, and old Mr. Tibbits, recently deceased, and Horatio Patton, Esq., i 5",
         "NOTES ON NURSING. both lumber merchants, employing hundreds of hands, used to start out in the morning, on, their rounds, each carrying a bottle of brandy and pail of hot tea in hands, waiting on and saving the lives of hundreds of men, women, and children. The late Brian O'Harý, Esq., a very old. friend of my dear father's, told me that when a merchant in Porto Rico (he was English con- sul there), so many of his blacks died of cholera, that he was obliged to have a large dining room in his house prepared as an hospital, and the ladies of his family to look atter them. Cold water was supposed at that time, in nearly all diseases, especially cholera, to be so. much poison, and the men were, some of them, strapped down to prevent their getting at it.' One powerful fellow, on seeing the men place- water on the verandah, broke his bonds, and. before he could be stopped,-drank more than a. quart ; all expected to see him die, instead,. he began to mend from that moment, and then the others were allowed to use it. None- died after. I had a very young child ill with country- cholera. My father advised rny trying cold",
         "NOTES ON NURSING. 17 water and giving the child ice to suck. My boy is living now. And a young doctor, living near us at Lake St. Charles, refused to try it, think- ing it too hazardous a remedy. His child died. Water poured on chopped raw beef, allowed to soak to extra trength, is also good in cholera for a young-chi d. Now, cholera i uch better understood ; then its treatment was guess work. A physician, now deceased, who had a great deal to do with it (late Dr. Michaud, of Kamouraska), told me, from the first moment of an attac k, if possible one attacked should remain perfectly quiescent. The movement of a hand even being unwise. PRÉVENTION. Mrs. MacDonald, wife of a sergeant in the army (one of Quebec's noted nurses), told me that orl the outbreak of the cholera in India, the doctor of the regiment ordered that every man, woman and child put on and keep on a flannel band, reaching from the waist to the hips, and not one of their regiment died of it. Apropos of cholera, the late Dr. James Sewell told me that when in England, staying with two old lady friends, one became ill. He said",
         "NOTLS ON NURSING. he had -seen so much of it in Quebec he knew it was cholera by the peculiar look in the eye, and advised them to send for their own doctor at once. The learned man came and, after examiniñg the lady, said it was nothing serious, and wanted to see this young prodigy from America who knew so much. The lady was dead before night of Asiatic cholera. The Lon- don physician knew it intheory, Dr. Sewell by practice. But even Dr. Sewell's well tried knowledge failed to save his cherished wife, who died of it after a few hours illness. The first symptoms must be attended to at once ; whereas this lady, seeing her husband so over- worked, failed to acquaint him how ill she felt, and fell a victim in part to her own unselfish- ness. How great was the universal sorrow I need not say. CANCER. The late Dr. Anderson told me he had seen his father, I think it was, cure a woman by thé application of pure lemon-juice. He said the lemon-juice killed the cancer, the bad flesh -fell off, and the woman's shoulder remained per- fectly cured without aid of the knife.",
         "NOTES ON NURSING. 19 SPRAINS. An Indian remedy for sprains is to take salted parsley and bind it on the sprained part, chang- ing it occasionally till it is cured. This I know to be perfectly successful, having seen a party treated. Hot camomile infusive is also good for a sprain. INDIAN REMEDY FOR DROPSY. I was told that a woman who had lived near us some years ago, a farmer's ife, had been cured by a squaw; by covering the whole body with slices of cucumber which drew out the water through the pores, I do not know whether this is true or not, but it was told to me for a fact. For sting of a wasp or bee, wet earth, and put it on, it will take away the pain at once."
      ],
      "type" : "document",
      "title" : [
         "Notes on nursing : how to treat smallpox -guaranteed to prevent disfiguration and lessen suffering : cure for cholera, cancer, sprains, \u0026c., \u0026c."
      ],
      "published" : [
         "[Montreal? : s.n.], 1890 (Montreal : J. Lovell)"
      ],
      "identifier" : [
         "04640"
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      "text" : [
         "Technical Notes / Notes techniques The institute has attempted to obtain the best L'institut s microfilmé le meilleur exemplaire original copy available for filming. Physical qu'il lui à été possible de se procurer. Certains festures of this copy which may alter any of the défauts susceptibles de nuire à la qualité de la images in the reproduction are checked below. reproduction sont notés ci-dessous. Coloured covers/ Coloured page\u0026/ Couvertures de couleur Pages de couleur Coloured nasps/ *Coloured plates/ Cartes géographiques en couleur Planches en couleur Pages discoloured. stained or foxed/ Showi through/ Pages décolorées, tachetées ou piquées Transparence Tight binding (may cause shadows or distortion along interior margin)/ Pages damaged/ Reliure serré (peut causer de l'ombre ou de la distortion le long de la marge intérieure) Additional commenta/ Commentaires supplémentaires Pages endommagées Bibliographic Notes i Notes bibliographiques Only edition available/ Pagination Incorrect/ Seule édition disponible Erreurs de pagination Bound with other material/ Pages missing/ Relié avec d'autres documents Des pages manquent Cover title missing/ Maps missing/ Le titre de couverture manque Des cartes géographiques manquent Plates missing/ Des planches manquent Additional commenta/ Commentaires supplémentaires Tl P of fill T a fi ir w w w E' w",
         "t)) \u0026 i i",
         "p 1. x j' -:,?,~4.",
         "I t t",
         "). si",
         "0 A BRIEF HISTORY O F TNE SMA L{0X EPIDEMIC4 IN MONTREAL FROM 1871 TO l88O AND THE LATE OUTBREAK OF 1885 Mrs. M. GUYOT, AUTHOR OF \"TEE HANISHMENT OF THE tCADIANS,' ETC. CONTA1NING A CONCISE ACCOUNT VOF THE INOCULATION OF ANCIENT TIME, THE DISCOVERY AND ADVANTAGE OF VACCINATION; MORTALITY FROM SMALL POX FRON 1871 TO 1880, TOGETRER WITH A NUMMARY OF THE RECORD OF THE PRINCIPAL EVENTS, WITH STATISTICS OF MORTALITY OF THE LATE OCTBREAK v% 1885. , ~..-*- t (4,",
         "- 1",
         "HISTORY OF THE MONTREAL EPIDEMI-@. INOCULATION AND VACCINATION. So much has the foul disease of smallpox been dreaded, that different nations have, in times past, endeavored to mitigate the severity of the malady, by communicating it artificially. The Brahmins, engrafted the virus, so also did the Turks, and the Chinese who were in the habit of put- ting some of the crusts into the nostrils. The practice of inoculation became more or less general in Europe, and its efficacy in mitigating the severity and the danger of the disease, was considered to be very great. Lady Mary Worthy, wife of the British Am. bassador, while residing in the East, in Belgrade, in 1718, caused her infant son to be inoculated, being the first English person to make the experiment. It proved to be perfectly su'ccessful, and with the hope of alleviating much suffering and even saving many lives, Lady Mary resolved to introduce the practice of inoculation into her own country. It was an arduous and for some years a thankless task, she had to en-",
         "4 counter opposition on every side, who predicted the most desastrous results; but supported firmly by the Princess of Wales she gained many supporters among the nobility and the middle classes. In 1784 four condemned cri minals were inoculated; this test having proved successful, the Princess of Wales had two of her own daughters subjected to the operation, with perfect safety. Some of the nobility followed the example of the Princess and the practice gradually extended to the middle classes, but the fees at first were so expensive as to preclude many from the be- nefit of the new discovery; but the time for smallpox inoculation is now over, as we have a wiser and safer substitute. About eighty years ago, a chance observation was matured into a rational and scientific forni, by a mind deephy imbued with best principles of sound philoso- phy, and a disease mild in form, and safe in character, was substitutbd for the inoculation of the Turks and Chinese. In 1799, the first public. institution for vac- cination was established in London, and the following year it was introduced into Germany and France, and the practice of vaccination has now became general over the whole educated world. Here and there, as might be expected, it has met with opposition, but every objection that was raised by the anti-vaccinator, has been'answered again and again by the leading minds of the. profession. Dr. Robert Thomas, author of the \"Practice of Physic\" which serves as a text",
         "'1 Compare the ravages committed by smallpox before and after this important epoch ; and we may in the first place appeal to general experience, in the words of the National Vaccine Establishment, \"where the rarety of an example of disfigurement by smallpox now to be found in theatres, churches, or any large assembly of the people is adduced in proof of the con- tinued protectiveproperty of the lymph employed.\" It will be interesting to my readers to know how, and what brought about this great triumph of me- dical skill. This was dis¢overed by Edward Jenner, M.D.,F.R., it was tht result, like most important disco- eI W W, 5 book for students apd physicians, after a long and careful analysis, and giving to every objection the most patient consideration, thus sums up, \"the intro- duction of vaccination, notwithstanding all the abate- ments which must be made in the estimate of its powers, is still one of the greatest boons that science ever conferred upon mankind.\"",
         "6 veries of the world, of accident. Jenner, when a young mnan, was studying medecine in the house of a Mr. Ludlow, a surgeon in Sodbury, near Bristol, Jenner was accustomed to be present when his master was treating patients, in order that ight become practically familiar with the treatment of diseases. On a certain day, a young woman in the office of Mr. Ludlow, for treatment, the question of smallpox being discussed, thoughtlessly made the remark1; \"I cannot take smallpox, I have had the cowpox.\" This was the foundation for a discovery which was later on to electrify the world. Jenner was struck by the remark and never missed the opportunity of verify- ing the truth of this carelessly uttered statement. He reasoned thus by \"if cowpox naturally produced does give immunity from smallpox, why will not the same disease artificially developed confer the same protec- tion.\" Although laughed at and rediculed, he was fim in the belief ofithis idea. On the 14th of May 1796 he vaccinated one James Phipps. To his unspeak- able joy, as day by day he watched the result, he witnessed all the different stages of cowpox occur regularly and perfectly, and after being sneered at for a quarter of a century he turned to his confreres with a shout of joy,·\" behold the consummation of my dream.\" He had get however many trials to endure before his theory was accepted, but in 1799 about seventy of the most distinguished physicians and surgeons of London, signed a declaration of their entire confidence and the benefits and advantages of his discovery; all the honors that could be heaped",
         "upon man were bestowed upon him, and he was enrolled among the great men of the world. Vaccination affords protection - from smallpox by producing in the body a constitutional disease which runs a regular course that is similar to smallpox, and possibly identical with smallpox itself, but of a character so mild as to be utterly and entirely harm- less, but which so alters the condition of the blood as to render the development of the disease itself, in its most violent form, almost an impossibility and cer- tainly a very great rarity. It is not my object to dis- cuss the scientific points of vaccination as has been done. in many hundreds of volumes, but the decision of the majority based upon the results are : that vac- cination is the only available means of protection against smallpox and, with due care in the perfor- mance of the operation, no risk need be run of the injurious effect; that before its discovery, the morta- lity by smallpox was forty times greater than it is now, that the death rate is less than one per cent of well vaccinated persons against a rate of the unvacci- nated at thirty five per cent. MONTREAL'S EPIDEMic, FRoM 1871 to f88o. Should any of my readers desire a good illustration of the way in which a large wealthy and comparatively enlightened community, in a position as regards social and material interests ither than sanitary, second to",
         "8 none in this country, can mismanage an epidemic of smallpox, we invite their attention to the history of the epidemic of Montreal in 1871 and prevailed until 188o and broke out with double force in 1885. · Not a month has passed during those nine years without. furnishing its quota of cases with a large aggregate of deaths. The following is the mortality: in 1872 the number of deaths were 897 ; in 1873, 228 deaths; in 1874, 647 deaths ; in 1875, 590 deaths. During these nine years the press contented itself in giving the people the occasional statistics of the disease and the city contented itself in receiving these statistics in silence. Year after year passed by and hundreds died, and hundreds more lived pitted and unsightly. The disease had its 'vil1. But with the late epidemic the public and the press both realized that a great amount of labor was necessary, to stamp out at once and forever this most foul desease and they struck while the iron was hot. The smallpox outbreak is regarded as a calamnity to all Canada; it is curious that in a city which has been not unfrequently visited by the disease, there should be so few precautions taken against the return of the scourge and such little faith in the preventive vaccination, as will be seen in the following pages. Many peopleneglect precaution while others regard it with supreme contempt while even the merchants were at the beginning of this last outbreak, like they were all through the former scourge, quite indignant, and severely resented publicity given it by the local papers; they seem to regard it more as a drawback to com-",
         "r - ~ I 9 T BAT.PGX IN TEE CITY R17 ggTO I8g (INCLUSIVE.) 1876 French Canadians, Other origin...... Total.... 1877 French Canadians Other origin...... Total.... 1878 French Canadian!. Other origin....... Total......... 1879 French Canadians Other origin........ Total......... 1880 French Canadians Other origin........ Total.... 1881 French Canadians Other origin. Total. Total French Canadians. Total other origin. I~ L n 50 60 701 , 134 319 62 15 15 5 2... 1 568 25 46 16 10 9 21 6 2 ... ... 135 159 365 78 25 24 36 11 4... 1 703 78 247 44 13 17 29 ......... 3 ... 431 ,8 25 6 ...... 4 17 ...... ... 4 1 75 96 272 50 13 21 46 ...... ... 7 1 506 134 371 90 9 14 18 2...1....639 16 32 10 2 7 17 5...... ... 89 150 403 100 11 21 35 7 ... 1... 728 84 240 62 11 13 5 2... ... ... 417 7 13 4 3 8 13 33 1 55 91 253 66 14 21 18 5 3 1...472 21 58 22 3 4 3 ....-... .....111 3 9 I...... 1 4 8 4,. 29 24 67 22 4 8 11 4 . 140 1 2 . . ................... ......................I 1 2. 2...... . ......... ... 5 45111235 280 51 63 7Q 9 2 4 12166 52 13601316 67 95 146 27 7 9 2 383 Grand Total....... 52111369 316 951 14d 271 71 ~1 I9F~SA eeI 4r 140 27-- 7-19- 40o 15 20 130 5",
         "Io mercial interest than a warning of danger to their neighbors. They seem to count the cost of an epide- mic in hard cash not to human lives, they forget that a great epidemic stops thousands from working there- by earning wages for themselves and creating capital for business men. The last time it was our visitor, for nine yea'rs it was treated gingerly, the Health office was not anxious for publicity and the press differred to the feelings which existed among the public against alleged \"unnecessary\" ventilation of the facts. But at this last outbreak, although in a few cases the old timed feeling rèmained, still the majority of the busi- ness public knew better and the press responded to the public feeling. DURING THE YEAR 1885. From almost the beginning of the year 1885 the disease struggled for a foothold and let alone by the people it soon became master, and at ti mes it was thought that it would hold that position for some time, as the health officials had not the time or means to conduct a systematic campaign against the pest; it was nothing more than a hand to hand fight, but aided by many of the citizens they at last conquerred. A glance at the gradual and rapid increase will be of interest, beginning'with the month of April, at .which time its appearance began to cause a whisper. The contagion was taken to Boston by the same Pulman car which afterwards brought it to Montreal. The Board of Health of the former city however ac-",
         "II ted so promptly and the people generally were so well protected by vaccination that the disease only spread to six persons, four of whom recovered. The result of the Boston authorities investigation found that, in February a newly married couple, natives of Chicago, returning from their honeymoon which they had spent in Europe, landed in New-York, and travelled in a certain Pullman car to Chicago. On the way the lady fell sick and arriving at their destina- tion was found to be ill with smallpox. The car came back to Boston twelve days later ; the colored man who hbad cleaned the car fell ill with the same disea- se, his wife also took the contagion, and the disease spread to four other persons. Meanwhile the car came to Montreal, and both the conductor and porter developed the disease and were taken to the Hotel-Dieu Hospital, as no hospi- tal for contagious disease was open at the time, a fronir the conductor it spread to the patients of the Hospital and from the patients to the visitors and hence to the whole city. The car then returned to Bos- ton, there all the upholstering was taken out and burned, the car was refitted, repainted,, revarnished, and rechristened, since which time no new cases have developed in it. But in Montreal it left a ghastly record as a memento of its visit. In that month (April) six deaths were reported, all ofwhom were French. During the month of May ten more occur- red, seven being French, while for the month of June, thirteen deaths occurred, ten being French. July it rose to 46 deaths, 37 of which were French.",
         "12 - 0 -1 c\u003e e o .- c\u003e c.. -UAOUx 1 10 Cs_ I i _CI CDI I CD i _ __CID __i= I I_ ____I LI__ _ _ I Il 9 __ I Il I_ __ Il 0 Co *0\u003c E- o fr4 r ~,Q c * o 0o., c s ri co :1.e J-m",
         "13 The mortality was becoming too alarming for the people to remain disinterested, and they begun to take action in several important matters. The ques- tion of obtaining lymph now began to agitate the Board of Health ; that is regarding points that could be guaranteed by responsible authority so that no evil results would arise to strengthen the now great prejudice entertained by the majority of the people; but they decided to accept that furnished by the New England Vaccine Co., of Chelsea, Mass. The 14th showed a great increase of the disease and complaints were constantly brought to Dr. Laberge, the City Health officer, of placards being torn down and cases not reported, while he lamented his want of power. The -Health committee in their special meeting discussed the question of vaccination, and the spread of the d isease ; free vaccination was p roposed, and free disenfectants. Philanthropists were appealed to the necessity of organizing a committee, to relieve the wants of fabilies who were prevented from atten- ding their work through having smallpox among their members. Ald. Roy's proposition, that four medical vaccinators be appointed for three months at a salary of $25 per month to attend to vaccination. three hours per day under the supervision of the board of Hlealth, was accepted; their names and dis- tricts to be as follows ' Dr. G. E. Roy, eastern portion of the city from limits to Papineau road ; Dr. E. La- porte, that section between Paipineau read and St. Lawrent street; Dr. Reed, St. Lawrence ward; and Dr. Kannon St. Ann's ward. On the i8th vaccine points",
         "14 began to be widely distributed, fifty medical men having applied for them at the Health office. The boot and shoe factories employ a larger num- ber of help than any other industry in Montreal The majority of the employees are Fre=ch Cana- dians, which race are the most subject to smallpox and I may had the most indifferent to its dangers.- It is this yery contempt for smallpox which makes the disease so fatal in Montreal.-These were im- mediately notified to get vaccinated, and those who could not produce a doctor's certificate of vaccina- tion within two days, er of course a certificate that they were not fit subjects for vaccination, were dis- missed fromn their employment. The measure was an extremeone, but so also was the danger. This act was followed by all the other manufacture with the most gratifying results. It is a question if a man has a right to inperil his own life by his own igno- rant prejudices, but certainly he has no right to im- peril the lives of other people. About the 2oth, the- number of persons applying at the Health office be- gan to increase every day, and doctors continue de- mand of Dr. Laberge the procuring of more vaccine. The 2ùIt the City Passengers Railway Co., under- took to prevent their servants introducing conta- gion into their cars ; this is practically an igmpssibi- lity, no matter what amount of watchfulness is e4er- cised; people walked out of infected houses straight into the cars; sanitary policemen who had been dis- enfecting rode on them ; probably there were hun- dreds every day who had been in infected houses",
         "15 used these vehicles; the cushions and trimmings of which being excellent mediums for conveying the disease from one person to another, the h#alth de- partment therefore were justified in seeing that the cars were fumigated daily. The managers of this Railway issued orders that -the sanitary police was not to be permitted to ride on these cars. On the 22nd the wholesale clothing trade being fully alive to the prevalence ofsthe disease ; in addition to having all those employed on their premises vaccinated, they at once engaged a doctos to devote the whole of his time in visiting the operatives in théir houses. On the same date the mayor received replies to his two hundred post cards asking the permission of subscribers to the volunteers, to apply-their subscrip- tions to the relief of persons distressed by smallpox. Nolone refused, and many asked his Worship to apply to them-for additional subscriptions,.if neces- sary. About this date, people began to overdo the re- porting business,and were sending the mnedical Health Officers on afl sorts of useless' and foolish errands. It was during this month that the distinguished statesman and scholar Sir Francis Hincks -fell a victim to this scurge and several -misapprehensions respecting his illness and death were made public; two statements in particular were.erroneous ; one was that only a domestic was in attendance during his illness and death ; the other that -no rdligious -servi- ces were held over his grave. Sir Franeis had no one with-him but his housekeeper when he was taken ill, but on the Saturday previous to his death, she,",
         "16 without his consent or knowledge, notified his son- in-law Lt. L. Ready, and his wife immediately came to thity and were with him until the close. It was not now at first what Sir Francis was suff- ering from,.it\u003cas believed to be a bilious attack, but as he grew worse Dr. McDonnell was summoned, and he in his turn called in Dr. Howard and the disease was pronounced smallpox. An excellent English nurse who had been trained in smallpox Hospitals, was secured, but the disease made rapid progress and Sir Francis succombed. In obedience to the law governing such cases, no funeral service was held. As soon as the body was prepared it was removed to the vault in the cemetery until the grave was pre- pared. Col. Ready and the Rev. Mr. Dixon were at the burial and the latter read the funeral service of the church of England over his remains. The month of August closed with the people hav- ing a full determination to stamp out the pest, but the disease was making terrible headway as the mor- talitf1of September shows. On the 5th of this month the mayor called a meet- ing of the citizens in Nordheimers hall, which was largely -attended. In opening the meeting,· he said that in view of the fact that all over the continent it was thought the people of Montreal were dying like sheep in the streets, the calling of a meet- ing of citizens had become necessary. As an instance of the way in which the affliction of Montreal was being spoken of, he read a telegram from Mr. Sho- rey, stating that the Manitoba .\" Free Press \" in its -x 111 '4",
         "47 -0 ce cl Wà -oftl p I e cs *01 MT T[ V",
         "18- last issue advised the merchants of Manitoba to boy- cott Montreal on account of the prevalence there. The same paper placed the number of patients suffer- ing from, smallpox at 2000. With regard to the health department he would say that it was doing its work well and to the full extent of its powers. At the meeting of the Board of Heath, it was de- cided to put the Civic Hospital under the charge of the Grey nuns. A grant of $ioo.oo per year to be paid to each nun acting as nurse. Four of the ladies of this institute were chosen for this special purpose and their number was to be increased if necessary. Their adieux to the mother house were most touch- ing, as they were of course to be entirely secluded from all intercourse with the other members of the community as long as they were attached t the hospital. Althoùgh fully realizing the dangers would encounter, the four generous nuns left their cherished home with a cheerful heart after receiving the blessing of their mother superioress; for, say they, our motto is \"sacrifice.\" No better day would have been chosen for the departure of the nuns on this painful mission, the 14 of september, the feast of the order, of the exaltation of the Holy cross,",
         "19 which was adopted by the founder of the institLion as meaning total abnegation and self sacrifice for the love of God and suffering mankind. A new wing of the hospital was built, and a portion set apart for protestant patients who where cared for by protestant nurses. There were to be seen some very touching scenes at the Healt Office; on the morning of the 15th, there came in a poor but neatly clad woman who meekly asked for her daughter who had been sent to the civic Hospital. Going to the telephone an officer rang up the hospital and learned that the little girl was recovering. When the poor woman heard this, her self control gave way.all at once and she cried. Composing herself somewhat, she explained that the little girl *as her only child. Then she produced a small parcel containing a few blue plums, an apple, several tomatoes and a course lump of maple sugar. These things she wished te have-sent to her daughter. She was told that then was no lack of delicacies at the hospital, but she insisted on having her present sent; she was afraid her daughter might think she had forgotten her if she did not send her something. Dr. Lberge had frequently trouble in obtaining care for little children temporarily orphaned by the di- sease. A Mr. who lived on St. Lawrence street, was t4en to the St. Rock's hospital, a few days later hi wife also was taken there. She left behind her an infant five weeks old who, having been vaccinated, did not contract-the disease from the parent. There was no one to) take charge of",
         "20 the child, Dr. Laberge applied for admittance for it at the protestants infants Home, but was informed that the house was too crowded to accommodate another child. He then applied to the relief com- mittee composed of protestant clergy and the Rev. Mr. Nichols had it cared for. It is a sad but unde- niable fact that a large number of the French popu- lation, encouraged by causes we will not mention, were hostile to vaccination; therefor on the 23rd, vaccination was made compulsory; this had to be done in order te have any control over the disease; every house was visited and summoning every house- keeper to declare whether or not each and every member was vaccinated. To the unvaccinated, the operationswas effered free. Refusal to be vaccinated or misrepresentation made the offender guilty under the law and punishable by a heavy penalty, which' can be repeated until compliance is secured. When that portion of the city learned that compulsory vac- cination was to be enforced, on Monday the 28th, following the advice of a few hot headed demago- gues, they resolved to make a boisterous demonstra- tion. They therefore organized themselves into a mob which at same points must have numbered several thousands; for several hours these people had com- plete possession of the streets. The rioters went where they liked, and did what they liked. War- nings were given of the intention of the mob to return in force and express in a more decided way, their disapproval of the energetic measures taken by the board of Health authorities. The threat was even owâmwàommm\" Dow",
         "4, 21 made to the secretary of the cffice, Mr. Berthelot, that by six o'clock there would be nothing left of the office. The chief, as in previous cases, did not deem the warning of sufficient importance to take any immediate precautions and no arrangments were made for extra police protection. Two hours later the threats had been carried into execution and the mob alter having wrecked the office, started out on a tour of devastation. The rioters were of such pro- portions as to indicate preconcerted arrangements. The wide street of St. Catherine for a distance of a hundred yards, was black with -men and boys. Chief Police Paradis was consequently communicated with, and arriving soon after, telephoned for all men on duty at the East end stations. When these ar- rived, they were not much of an acquisition, and their services were not brought into play until long after they arrived. Sub-Chief Lancey, single handed, cleared the sidewalk in front of the health office and in company of two others cleared the,vhole street in front of the building. This showed at once the crowd was not a very desperate one. Although the street was cleared, the stones continued to rattle through the glass of the office windows. After half an hour of this desultory stone throwing, a large por- tion of the mob broke off from the remainder to demonstrate in other parts of the city. In the dis- orderly processipn, were many respectably dressed young men and these in fact appeared to be the most unruly of the lot. Now and again the uproar wo ke a new turn by the shouting out",
         "22 of some such expressions as: BRAvo RIEL, VIVE LA FRANCE, or /urrah can4diens frangais, such cries in- variably changed singing to cheering, and in this exuberant mood the crowd proceeded throi;gh the city. Panes of glass were brooken at Dr. F. X. Archambault's house, and arriving in front of the dwelling of Dr. Laberge, the medical Heakh officer, the rioters shouted for him swearing they would kill him. Getting no response to their cries, the crowd stoned the house doing considerable damage. On St. Denis street, the mob broke several panes of glass and smashed the blinds of Ald. Grenier's resi- dence. When Mr. Baridon, who keeps a drug store on St. Denis street, saw the crowd descending, he, immediately tore down a notice to the effect that he sold vaccine points, extinguished the lights and clo- sed the doors. Meanwhile the crowd advanced hooting and yelling in front of his store; they then halted and stoned the place. Two large plate glasses and two valuable showcases were destroyed. The anti-vaccinationists then started for the city Health office arriving at a quarter to eight. Here were gathered some ten or dozen constables. These went outside, they attempted to persuade the rioters to move on ; but were soon lost in the growing multi- tude. There-was a lell for a time büt soon the sounds of crashing glass were heard all over the building. At this time, detective Richardson came in and without losing much time in deliberation drew a revolver and commenced firing ever the heads of the crowd through the windows. This 0 II1",
         "I. 23 produced a cessation in the stone thrbwing, and also served as a signal of recall for the police dispersed through the crowd. Thinking the roughs were in the station, these returned not however unnoticed for as the door was opened to allow them to enter, a volley of stones made painful bruises on a number of them. When within the door they formed up in line about twelve men all told. The contrast of their numbers with those they were about to attack seemed to strike every one, and a suggestion was made and adopted that they should use their rifles and bayonets. Armed with these, they were about to march out when the detachment which had gone to the East end office returned with Chief Paradis at / their head. Ten minutes of organized effort ended the whole trouble as far as the city Hall was concer- ned, the crowd melted away. Detachments of police were sent to guard the houses of Ald. Grenier and Dr. Laberge. A call issued by the mayor about mid-day of the 3oth,'brought close on twelve hun- dred volunteers under arms in three or four hours to preserve the city's peace and to guard the exhibition buildings which had to be used as hospitals. The Canadian militia is a force, which the more is seen the more there is to be proud of. In time of quiet it costs little, gives no anxiety and loses no industry to the country. In time of trouble it does all that regular troops could do and even more. The",
         "-m 0 24 E- E- -umou log ao i o 1 - __: I _- Co _ _ _ _ I * t t._ o _ _i i oo ___| c __ _I o I __ _ _c _ _ I l - _ _o o T I I : I __ ___ I oI I __C CDa cmC sqluolui9 Japua C _ 41 \u003e --~ 00 00 Ï e boo@PÈ~ ..-",
         "25 same night, as if invigorated by the spirit of the civic chief, the police did their duty and did it well. The Royal Scots received orders to remain on duty all night, which was passed very quiet and returned to break-fast at six in the morning. There was no reason to predict further trouble than had occured to relieve the monotony of the vigils kept by the guards during the week of October the 7th, but the strictest vigilence was maintained. Until ten o'clock on the night of this day nothing had occurred beyond the relief of sentries, the visits of rounds men and the lusty chorus appreciated by only those who have slept in a military camp, as the watchful sentries passed the assuring \"alls well\" round the lines, but a quarter of an hour later the alarrn was given and the necessity of maintening guard at the Fair buildings was being demonstrated. 2 -~ ~ 's",
         "26 Trumpter Browning, nd Corp. Drysdale were the cavalry videttes on patrol duty outside the grounds; and observed a crowd of eighty or a hundred men approaching noisily across the fields towards Wise- mans corner. *Here they formed a juncturé with another crowd and the whole, numbe-4ng probably some four hundred, proceeded along Mount Royal towards the Exhibition grounds. The troopers advan- ced to the end of their beat, nearest the crowd, and chalenged them, reeeiving in reply the information that the crotvd was on its way to the Côte-des-neiges road. The troopers replied that their orders were to prevent any crowd from passing in front of the Exhi- bition grounds, and added that they could not pass. At this, the crowd with a yell made a rush at the two cavalry men, and stones at the same time were sent whizzing through the air. The patrol was driven back to the gate by sheer weight and both men were wounded by the stones. The sentries at the gates called out the guard at the first appearance of the crowd and as they advanced the detachment off duty fell it. Strict orders were given to the men on no account to load. The support of the cavalry detachment was * also got under arms and mounted and galloped down to the gate in support of their patrol. The detachment was in charge of Sergt. W. Thompson, and as the men were leaving the gate, Major Atkinson threw in his lot with them and formed the eleven troopers up in, Une across the road. A charge was then ordered, and the E",
         "27 mob dispersed with amazing agility before the earnest soldier. Throughout the night of the 8th, perfect quiet rei- gned on and about the Exhibition grounds. At eight o'clock sixty men of the Prince of Wales Battallion under command of Major Butler, relieved the Garri- son Artillery. On their way home the latter marched by St. Lawrence street through the very heart of St. Jean-Baptiste village and not a sign of hostility on the part of the residents was anywhere noticeable. Objections were hereafter unheard of from the 1¢1e- ducated portion of the City, they realized that they must submit to a wiser and stronger power. And so the weary days dragged themselves along; another month passes and we find ourselves in the month of November ; congratulations are the order of the day. 'So much has smallpox -relaxed its grasp on the city of Montreal that now less than half the victims slain every day in October are entered on the bills of mortality. But Montreal will never be free from danger while contagion lingers in its suburbs, nor can weexpect Montreal to revive until they can show a clean bill of health. Among that partion of the city which has accepted the protection of vacci- nation well-nigh perfect immunity from the epidemic has been enjoyed. Here and there stili lingers a reluc- tant ninority who willnot vaccinate, and who there- *fore will, if neglected, keep the pestilence smoulde- ring away indiffinitely. The practitioners whose careless operat'ons in the past years have prejudiced people against vaccination have much to answer for.",
         "28 Co ( I l I i oCL . I IO _ I . I . . 8 i I I E iELLr I I ___I J \"l I __ ____ t I I [ ___ _____I I I. . %A 00 00 : We have been laboriously bailing the water out of our boat instead of stopping the leak, with all the loss ever attending cure as against prevention. Al the costly and enormoysly troublesome means of isolation, the hospitals with their ambulances, the lo o .0 o2 sccqi",
         "?9 guards around infected houses, all these but measure the extent to which safe and certain prevention has been neglected or opposed. Although the disease is checked, there are so many centres of contagion and so many people remaining unvaccinated, that the disease may begin again with renewed violence. A curious fact about the scourge is its absolute restric- tion to unvaccinated portions of the city. This and the facts that from the first its ravages have been lar- gely confined to young children, must impress my readers in addition to the restrictedness ofthe small- pox area and its easy avoidance. While these facts are encouraging they have not lead to any relaxation of effort. Vigilence and energy are being practised now as ever. December finds the city' under controle, and the mortality greatly diminished, in fact the epidemic stopped. Now that it is over, we can look over the situation with the same glasses that other cities see us through. The large employers oflabor in Montreal have struggled manfully with the smallpox difficulty. A few even now talk feebly about the damagewhich publicity has done to trade, but the majority realize that the only way.to minimize the bad effects of that intelligence upon the trade of the city, is by giving equal publicity to the fact that the people of Mon- treal, rich and poor, employers and employees. have' worked actively to stamp out the disease. Perhaps the cost of this epidemic direct and indirect to the business men of Montreal will wake them up to the necessity of sanitary reform in that city, and perhaps",
         "30 umou ItON 00o c', %A~ 00 00 sZ crio o H a large measure of success in fighting the smallpox will encourage them to fight other contagious diseases which are harder to control than that disease. The death rate of Montreal in ordinary seasons proves that there are serious shortcomings somewhere, and at this time it is opportune to find out where they S II -e I : I : I : I : O * I *i. S I ® -1 __ 2 I ®__-_ .repuI \",là Co C4",
         "31 are. A committee composed of the best available men in the city council is needed, which can resolve itself into sub-committees, and take every civic sani- tary shortcoming in hand and remedy it intelligently. The present staff of the Health department is in- adequate for the demands of city like this, with two hundred thousand people and the citÿ in such poor sanitary conditions. The health officer, his two assis- tants, the sanitary inspector, two or three clerks and haif a dozen sanitary policemen, do these even with the assistance of the chairman of the board of health constitute a sufficient staff ? No; and we should not be content with it, they are doing all in theirpower but that is not sufficient ; a reform must and will be had. A case of smallpox in Montreal seems to create almost as much alarm in the city of New-York as a case in that city itself. Dr. J. B. Taylor of the New- York board of Health in speaking to the Tribune reporter said \"Montreal is the hot bed of smallpox in this country,\" and he went on to attribute this to the violent opposition to vaccination met with in that city. We cannot deny the fact that one case of smallpox in Montreal is an infinitely more alarming thing than one case in New-York or London, not- withstanding that in each of those cities there is a large- and more heterogenous population than Mon- treal. Although London has cases of smallpox continually, no one is alarmed, and recently there were as many as ten deaths from smallpox in one week; but in London vaccination is a rule rather than an excseption, and they do not wait for an epide-",
         "32 mic, to commence vaccinating; there the disease is largely under control ; were this most contagious of diseases to meet with the same conditions in the over crowded slums of London that it now meets in Mon- treal, the appearence of a single case in London might well alarm the whole civilized world, might well be regarded as the harbinger of a truely appal- ling disaster. The grandest and most enterprising cities in the world are not exempt from smallpox. Yet other cities point the finger of scorn at Montreal for the reason that this disease is universally recogni- zed as the most preventable of contagious diseases, and outsiders cannot understand why that city should be willing to expose itself to repeated attacks of a deadly foe whom they might control if they would, to expose their trade to crushing desaster, to allow their fair city to be pointed out as the \" hotbed of smallpox.\" All over the continent people has regar- ded Montreal as a place to be avoided and even to be communicated with as little as possible ; the effect of this boycotting is felt upon the trade; had it conti- nued much longer we shudder to think of the result. The cy is paying a heavy penalty, as we know of ships refusing to come to Montreal for fear of being subjected to guarantine regulations on reaching the other side. Of excursions to Montreal abandoned, of Montreal commercial travellers having their sam- ples returned to them unopened. We are aware of the city being discussed all over the continent as a horrible example of sanitary neglect ; we can unders- 4- s ~\u003c 4~~~4\" f4,'",
         "tand the feelings of the good people who nervously- deprecate the \"scare \" that has been created by the epidemic, and stimulated by the. unusual publicity given to the progress of the disease. It is true that Montreal has never been so badly scared by an epi- demic as this. Some say the scare was werse than the disease. My opinion is that this epidemic is one of the best things that could occur to Montreal, who has for years been living in defiance of all natural laws, and now that the inevitable result h come, it would be more than useless to attempt to belittle the penalty Montreal is now paying. Fortunately the sani- tary matters had been placed in better hands or the city would indeed have been in a bad plight. Even when free from epidemics, the city has an extraordi- nary high death rate, but business men agree that it does not scare business, providing it is steady away from the city like an epidemic. It is useless for Montreal to cry over spilt milk, it aught to know by this time that it cannot defy natures laws with impu- nity, and knowing this, the sooner the people com- mence to live in obedience to those laws the better for both commerce and society. This last experien- ce is, we think, sufficient for the commercial men of Montreal. They will labor not only to make epide- mics and \"scares \" impossible for the future, but -to make the city healthy generally. They needed awa- kening upon this subject and if the awakening has been rough it has been thorough. When the small- pox was silently and surely progressing, the city councel did nothing; it was aware of its progress but - - - ~ %'.V",
         "34 paid no heed- to its growing danger; it adjourned for the summer at the time that the danger was such that it could be fairlyunderstood, it remained adjour. ned while the deaths amounted into scores, and until the press was forced to take up the matter. Montreal will come out of this crisis a better and more respec- ted city, with the stain of 1872-1880 and of its late dilatoriness entirely removed. --~ - ~ ~ ~",
         "I r."
      ],
      "published" : [
         "[S.l. : s.n., 1886?]"
      ],
      "identifier" : [
         "05135"
      ],
      "type" : "document",
      "title" : [
         "A brief history of the small pox epidemic in Montreal from 1871 to 1880 and the late outbreak of 1885 : containing a concise account of the inoculation of ancient time, the discovery and advantage of vaccination ..."
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.05135",
      "creator" : [
         "Morel de la Durantaye, Mde."
      ],
      "key" : "oocihm.05135",
      "label" : "A brief history of the small pox epidemic in Montreal from 1871 to 1880 and the late outbreak of 1885 : containing a concise account of the inoculation of ancient time, the discovery and advantage of vaccination ... / by M. Guyot.",
      "media" : [
         "text"
      ],
      "contributor" : "oocihm",
      "collection" : [
         "wmh"
      ],
      "lang" : [
         "eng"
      ],
      "note" : [
         "Written by author of \"The banishment of the Acadians\", i.e. A. Morel de la Durantaye.",
         "Title from title screen.",
         "34 p."
      ],
      "subject" : [
         "Smallpox -- Quebec (Province) -- Montréal -- History -- 19th century.",
         "Smallpox -- Quebec (Province) -- Montréal.",
         "Variole -- Québec (Province) -- Montréal -- Histoire -- 19e siècle.",
         "Variole -- Québec (Province) -- Montréal."
      ]
   },
   "version" : "0.4",
   "request" : "http://eco.canadiana.ca/view/oocihm.05135/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1"
}
{
   "version" : "0.4",
   "request" : "http://eco.canadiana.ca/view/oocihm.49467/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1",
   "doc" : {
      "media" : [
         "text"
      ],
      "contributor" : "oocihm",
      "collection" : [
         "gvp"
      ],
      "lang" : [
         "eng",
         "fra"
      ],
      "subject" : [
         "Lower Canada.Act to encourage and diffuse the practice of vaccine inoculation.",
         "Bas-Canada.Acte pour encourager et répandre l'usage de l'inoculation de la vaccine.",
         "Smallpox vaccine -- Quebec (Province)",
         "Vaccin antivariolique -- Québec (Province)"
      ],
      "note" : [
         "Added t.p. in French: Statut provincial du Bas-Canada, statué par la Très Excellente Majesté du Roi ... : passé dans la trente-unième année du règne de notre souverain seigneur George Trois ...",
         "Short title in English (p. 6): An Act to diffuse the practice of vaccine incoulation (25th March, 1815); and in French (p. 7): Acte pour encourager etrépandre l'usage de l'inoculation de la vaccine (25e. mars, 1815)",
         "Title from title screen.",
         "Vlach and Buono, no. 0075",
         "11 p. ; 29 cm.",
         "Text in English with French translation on opposite pages."
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.49467",
      "key" : "oocihm.49467",
      "label" : "A provincial statute of Lower Canada, enacted by the King's Most Excellent Majesty ... : passed in the thrity-first year of the reign of George the Third ...",
      "published" : [
         "Quebec : Printed under the authority and by command of His Excellency the Governor in Chief; as the act of the provincial Parliament directs, by P.E. Desbarats, law printer to the King's Most Excellent Majesty, 1815."
      ],
      "identifier" : [
         "49467"
      ],
      "type" : "document",
      "title" : [
         "Lower Canada.",
         "A provincial statute of Lower Canada, enacted by the King's Most Excellent Majesty ... : passed in the thrity-first year of the reign of George the Third.",
         "Acte pour encourager et répandre l'usage de l'inoculation de la vaccine",
         "Statut provincial du Bas-Canada, statué par la Très Excellente Majesté du Roi ...",
         "Act to diffuse the practice of vaccine inoculation"
      ],
      "text" : [
         "--Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. ff Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre- de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations-en couleur Bound with other material/ Relié avec d'autres docurments Tight~binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration-apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ I Pages décolorées, tachetées ou piquées Pages detached/ L. Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Includes supplementary material/ Compiend du matériel supplémentaire Only edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par-un-feuillet d'errata, une pelure, etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lox 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "o",
         "A PROVINCIAL STATUTE OF LO W E R -C A N ADA, ENACTED by the KING's most Excellent MAJESTY, by agd with the Advice and Consent of the Legislative Council and As4embly of the said Province, constituted and assembled by virtue ýf and under the Authority of an Act of the Parliament of GREAT BRI- TAIN, passed in the Thirty-first year of the Reign of our Sovereign Lord GEORGE the Third, by the Grace of GOD, of the United Kingdom of Great Britain and Ireland, KING, Defènder of the Faith, \u0026c. Q UEBEC: PRINTED 1UNDER THE.AUTHOILITY AND BY COMMAND Op HIS EXCELLENCY THE GOVERNORt 1: CHIEF; AS THE ACT OF ,THE PROVINCIAL PARLIAMENT DIRECrS, ni P. .E. DESBARATS, LAW PRINTER, TO THE KING'S MIOST EXCELLENT MAJESTT. Anno Domini, 1815.",
         "CIL4",
         "STATUT PROVINCIAL' DU BA S -CA N A DA, STATUE' par la Très Excellente MAJESTE' du ROI, par et de l'Avis et Consentement du Conseil Législatif et Assemblée de la dite Province, constitués et assemblés en vertu et sous l'autorité d'un ACTE du Parlement de la Grande Bretagne, passé dans la Trente unième année du Règne de Notre Souverain Seigneur GEORGÉ TROIS, par la Grace de DIEU, ROI du Royaume Uni de la Grande Bretagne et d'Irlande, Défenseur de la Foi, \u0026c. QUE BEC: IMPRIME' SOUS L'AUTORITEt DU GOUVERNEMENT ET PAR ORDRE DE SON EXCELLENCE LE GOU=- VERNEUR EN CHB?, CONFORMEMENT A L'ACTE DU PARLEMENT PROVINCIAL, PAR P. E. DESBARAi'S, IMPRIMEUR DES LOIX DE LA TRES EXCELLENTE MAJESTE' DU ROI, Anno Dumini 1815.",
         "r~ I 1 tl b",
         "* -*,",
         "A PROVINCIAL. STATUTE OF LOWER-CANADA. Anno Regni GEORGII III. Quinquagesimo Quinto. HIS EXCELLENCY SIR GEORGE PREVOST, Baronet, GOVERNOR IN CHIEF. A' the Provincial Parliament, begun and holden at Quebec the Twenty-firft day of January, d1nno Domini, one thoofand eight hundred ind fifteen, in the Fifty-fifth year of the Reign of Our Sovereign Lord GEORGE the Third, by the Grace of GOD of the United Kingdom of Great Britain and Ireland, KING, \" Defender of the Faith.\" \u0026c. \" Being the Fir Seffion of the Eighth Provincial Parliament of Lower.Canada.\" An A\u0026 to encourage and diffufe the pra\u0026ice of Vaccine Inoculation. (25th March, 1815.) Preamble HEREAS the pra\u0026ice of Vaccine Inoculation has not hitherto obtained in V v this Province a fufficiently extenfive diffuflion, and that it would be necci. fary to provide means for giving a greater extent thereto: Be it therefore enaaed by the King's Moi Excellent Majefty, by and with the advice and confent of the Legiflaive Council and .Aflembly of the Province of Lower-Canada, conftituted and affembled by virtue of and under the authority of an A\u0026 paffed in the Parlia. ment of Great Btatain, intituled, \" An Aà to repeal certain parts of an A\u0026 paffed in the fourteenth Year of His Majefty's Reign, intituled, \" An Aafor making more efe\u0026ual proviion Jor the Government of the Province of Quebec in orith America,\" and to make further provifion for the Governiment of the flid Province.\" And it is hereby enaaed by the authority of the fame, that it flail and may be lawful to and for the Governor, Lieutenant-Governor, or Perfon admininftering the Government of this Province for the tine being, out of the unappropriated Monies in the hands o f",
         "STATUT PROV INCIAL L DU y A S-C A N A D A Anno RegnI GEORGII III. Quinquagestmo Quinto SIlt GEORGE,-PREVOST', Baronet GOUVERNEUR EN CHEF. AU Parlement Provincial, commencé et tenu à Québec le Vingt-unième jour de Janvier, Anno Domini, Mil huit cent quinze, dans l'a Cinquante cinquième 4 Année du Règne de Notre Souverain Seigneur GEORGE Trois; par la Giace de Dieu, ROI du Royaume Uni de la Orande Bretagne et d'Irlande, Défenfeur \" de la Foi,\" \u0026c. Etant la première Sefion du Huitième Parlement Provincial du Bas-Canada. ACTE pour encourager et répandre lufage de l'Inoculation de la Vaccine, (25e. Mars, 815.) T U que l'ufage de l'inoculation de laVaccine n'en pas encore affes généralement répandu dans cette Province, et qu'il feroit nécefairede pourvoir aux moyens d'en répandre plus généalement l'ufage: Qu'il foit donc ftatué par la Très Excel- lente Majeftédu Roi, par et de l'avis et.confentement du Confeil Légilatif et de l'Af- fembrléede la Province du Bal Candascoaitués-etaifemidda en-vetu et Cous l'autorité d'iin Aa fé dar. le Parlement de la Grande Bretagne, intitulé, \u003cAEte qu- ep çerp\" taines parties d'sn Aale paflé dans la giatorzèrre A'iWffil-ègne de Sa MapeRé, intitilé, \"Atte qui pourvoit plus ejicacement pour le Gouvernement de la Province de Québec dans l'Amérique Septen(rionae ;Et qui pourvoit plus amplement pour le Gouverutnemeti de la dite Province.\" Et il en par le préflent ê,atué par la dte autrité, ul fra loidible au Gouverneur, Lieutenant Gouverneur, Làalta Perfon!e aýyajt 1amirîamir WTcüTeïñiinüfe cRte Province, 'por- le",
         "Anno Quinquagesimo Quinto Georgii IIL A. D. 1815. of the R criver Ceneral,to apply the fum of One Thoufand poundx, currency, in the m,,ýjn'anner herein.-after prefcribed to'defray the'e*penfes neceffary foi diffullng the pradice of Vaccine Inoculation, which fum Ihall be diafributed in the feveral parts tion, to bei( tri. of the Province as follows, that is to fay, in the Difiria of Quebec, Three Htn- roBortiong, dred pounds ; in the D'lria of Montreal; Four Hundred pounds in the I)iftria BIree isiricia of Three Rivers, One Hundred pounds; and in the Ditiria of Gafpé, One Sthe iovince n1-ndred pounds or a \u003chI p, a 'i Sr~ a b vi i r in h 94 \u003e LurC H ILAnd bc it further enaà-ed by the authority aforefaid, that frorm and after the paffing of this Ad, it fhall-and may he lawful to and for thâ Governor, Lieotenant Governor or Perfon adminiftering the Government of this? rov'ince for the time being, to apply the faid fum.s in'each of the Diftri\u0026s aforcfai\u0026to-the paynent of one or more Phyficians or Surgeons in each of the faid Difirias, charged with the duty of vifiiing fuch Difuia during the next fummer, -and of perfurming Vaccine Inoculation in the- feveral Pariihes or Townfhips as herein-ater provided, upon every perfon or perfons offered or prelenting themfelves for that*purpofe, without being entitled to any fee, emolument or any confideratiôn whatever, for effeding the lame. II. And be it futther ena\u0026ed by the authority aforefaid, that each of the faid Phylicians or Surgeons nominated and appointed by the Governor, Lieutenant- Governor or Perfon adminiftering the Governm'ent of this Province for the time being, before making his vifit in the Diftri\u0026s Of Quebec, Montreal\"and Three Rivei-s fhail give notice by. au -Advertifément in thë Engifh and French languages, of the times and places, when and where he will, make luch vifit, fifteen days at lhe leaft before- he Ihail perform t-he fame, which adycrufement for the Difirias of Oiebec and Thrce RivereIhall be~giien in the Quebec Gezettetand for the Difria\u0026 ot Montreal, in tic Montr\u003cal Gazette, and fhall indicate the place at which he will refide, and the «nie during-which he will remzin, to perform the Vaccine Inocula- «un as aforefard, Knrd the duration of his Ray lhall not be less than one week for every thr.e Parifhes or Tuwnfhips I V. And lbe it further enaaed by the authority afore[aid, that the Phyficians or Surgeoris Wu appointed to perform Inoculation as aforefaid, fhall at ail vmes keep a corrEi regifler Qf all the perfons whom they fihall have inoculated, their ages frxes, therchrian narnes and furnames, the. narmes of the Par ilhes, Seigneuries or Town* fhipstowhich they play be'ong; they fhail alfo report what Endemic difease prevail in Lhe leveral part. of the Province which they may 'ofit, of whch RegifRers and Re- ports, three copies fignied by the fai I Phyficians or Surgeons refpeátively, (hall be tranfmiutd befre the Iii fu day of )ecemnber next to the Office of the Secrectary of the P ovincc, in order to their being fubmitted to the conflderation of the Legifla- tule, il then in Selllon, or if not, at theu then ncxt Selhon thereof.",
         "A. D. 1815. Anno Qunagesirno Quinto Georgii. III ý?19 le tems d'alors, de prendre fur les deniers .non-appropriés entre les .niains du Re- s ceveur ,Général une Somme de Mille Livres Courant pourêtre employéeén maniere ci-apres mentionnée pourfjubvenir aug. frais -nécefaires pour répand l'ufage de l'Inoculation de la Vaccine; _la elle fimmeferénployée dans les dif- dc- I \u0026VaccWiù fergnes parties de la 'Province, comme, fuit, Svoir : Troii cens -Livres'por pour tre isetri «Difrié de Québec, Quatre cens Livrespour le Dillrict de Montréal, Cent Liv-res tions differeutes pour le Di\u0026ict de8 Trois Rivières, et Cent iÂvrep pour le Diftrict de Gafpé. d cete prin. ce@ - 3I t qu'il foit de plus flatué par l'autorité fufdite, que depuis et après la paffauion de cet Ade, il fora. loifible au Gouverneur, Lieutenant Gouverneur, ou à la Perfonne ayant l'Adminiftration du Gouvernement pour le tems d'alors, d'en. ptOycr.!es dites Sommes dans chacun des dits Diftricts fus-mentiponés, pour payer un ou Vluieurs Médecins ou Chirurgiens dans chacun des dits. Diftricts, chargés d'en faire la vifite dans le cours de l'Eté prochain, et de donner Gratis dans les différentes Paroiffes ou Townthips qu'il fera dit ci-après, l'Inoculation de la Vaccine à toutes les perfonnes qui leur feront préfentées, o. qui fe préfeateort à l'effet de la recevoir,-et fans avoir droit pour ce faire à aucun émolument quelconque, Ill. Et qu'il foit de plus Ratué par l'autorité fufdite, que chà:un des dits Médecins ou Chirurgiens ainfi nommés par le Gouverneur, Lieutenant Gouverneur ou par la Perfonne ayant 'Admjnißration-du Gouvemrmer¢ de cette Province poQr Vet¢ms d'alors, avant de faire la vfire dapela Diaits, deý Qébec, de Montréal et- des Trois Rvieress fera temddoçAqýner uh, Avectiffenent en Langues Anglaifes.et Françoifeb des tems, et lieux où il fera fa vifite,sau - moins quirnze jours àvantde là commencer, le quel avertiffenient ,fera.donné pour le DiIrict de Québec et dés Trois Rivières dans la Gazette de Québec, et pour le Diftrict de Montréal dans la Gazette de Montréal, et indiquera le lieu et le tems auquel il fera fon féjour pour donner comme dit enl l'Inoculation de la Vaccine, lequel tems de féjour ne fera pas moins d'une Semaine pour trois Paroiffes ou Townfhips. IV. Et qu'il foit de plus flatué par l'autorité fufdite, que les Médecins ou Chirurgiens ainri nommrés pour Inoculer comme dit eft feront obligés de tenir un Régiftre éxact de toutes les Perfonnes qu'ils auront ainfi Inoculées, contenant leurs âges, fexe, noms et prénoms, et les noms des Paroiffes, Seigneuries ou Townlhips auxquels ils appartiendront, et feront auffi un rapport dçs Maladies Endémiques dans les différentes parties de la' Province qu'ils vifiteront, defquels Régîtres et Rapport trois copies fignées par les dits Médecins ou Chirurgiens, ou refpe\u0026ive- ment feront tranfînifes, avant le premier Décembre prochain, au Bureau da Sécré. taire de cette Province pour être foumifes à la confidération de la Légiflature qui pout ra fiéger alors, ou à la Seffion alors prochaine, Le Giuverneur autorisé d'eni ployer les dites sommes pour le payement des Chirurg1ens ou Docteurs qui sen ront employeua Devoir de tels Chirurgiens a. vant de fait leur visite- dang les différente dis- tricts. Ils tiendront un aégistre exact des Personnes qu'ils auront inoculé.",
         "drawiog up a s Era cleo 0 this Act, wmtb thi copies oflistrue tions, to be sen bo the persons, entilIed to rsciv the Laws. accounted fôr il lii, Majesty. Axino iiqùa b âwuite ÏâiirheGero, tiltGde,\u0026 at ?itirifil trib-e Sthe GOvecrnmeênt of thsrbl~d ' Ï hi beireî __,\"ta aîp t\u0026j' ftn of býïè1e idred pounds, tutrency, to the -dtaýigàe ,br è6 eihc àutd pifk~ 1r tàh Oei~r or perfonis as iît Iball #iea1ê th'6,'rî5 o rýia ü ceringý ti Gôvetnniefit of 'this' 'Pkracïe 'for ifbe etiie beMgî for atp;ùtet appoimit, a let -or icoIêai-on-bf ihâh'iôb' éùy\u0026~d~iv~~vf ma2y refuit from tbe-praice of Vaccine Inoculation, and the mnerhod of trealment proper to be obterved in confequence of which fet or colleaion of inftruasons, topiîëhl1 f ôrl ý wàýdedè t'aIkfibc:~~ ~d Meibbýrs.of ttîe--leg'ih. tive Bbdiei'ahd Ëetû'.iiê Cbutts- -~ to tbù iûftk\u0026.co His, Maj'%fty's Cotma,tô thel jofficea of- the Peâce, ReEloree Cutatta 'ýhd »Mifttf .,Of, the fevetaîl ReIigioueà P'eifiafionsb end te the s§igneurie Ca~, aptad d*éh--il wrl*r Oficeeof MiIitia2,abôýià that Rank. VI. Afid be it fuïtthr etùaed b:y.h- o uhrt~tfta- tme f extra tCôpiee 0 f thiS AE1î fhà11 be einrùê as- Ifidt as,\"pô1ibte to 16, 1Fàfiu-ted *ithih Scopie\u0026 aof the Inairuajions hercin 1,efore mentioned to the Perrons whoby=t-is-Aa. are entitlcd to receive thlame. - f vil -And beit fah'bste~tilàtib due app1li' cation of-âiI iiôtïîes é-petdèd-i ebüfdr iàyblýthediidaÎÔü Ôf thiis4\u0026, àalibe àt 1Cointed for- tô -Mis Mjah hi'n fué[* hrghh Lord:à Coonti't fiburf His Majtfty's Téfryf t I*n beïig, Mîàfch malnàezvand foita a\u0026 H~ c~~fyhi H~h mdSg~ei rflàfdj~b~7 - ....~.. 0 ~...i ,s).~ * j 4f,-,., ~.., - ~ .~-, ..~- -'f Aý9",
         "A. D. 1815. Anno Quinquagesimo Quinto V. Et qu'il foit de plus flatué par l'autorité .fdite,qu'il fera loiibleau Gouverneur, Lieutenant Gouverneur ou à la Perfonne ayant l'Adminiftration du Gouvernement de cette Province pour le-Yé¥ns d'a!ors, d'emplover Cen Livres courant pour faire dreffer ou compofer et imprimer, par telle pet fonne ou perfonnes qu'il plaira au Gouverneur, Lieutenant Gouverneur ou la Perfonne ayant I'Admiînftration du Gouvernement de cette Province pour le tems d'al.rs, de nommer à cet effet, un mémoire et des infirualions fur les avantages qui peuvent réfulter de l'u(age de l'Inoculation de la Vaccine, les foins et traitemens qu'elle exige, defquels me. moire et inftructions copies feront adrcffées, auflitôt que poflibie, aux Membres des Corps Légilatifs et du Conieil Exécuif, aux Juges et Juges de Pa:x, aux Curés et Minmfltes'des différens Cultes Religieux, aux Seigneurs, aux Capitainrs et aux autres Officiers de Milice au-deffus de ce grade. 41 ;C100 ncrorðder telle personne ' que le Gouver.. netr appointera pour dresser .ou composer un mé- moire et des ino. gractions à ce sujet. Dis copies exIra. ordinairesde cet VI. Et qu'il foit de clus ilatué par l'autorité fafdite u bid e=' spisg-. extraordinaires decet Aae fera imprimé apioiitquepoffrbeþo'r être transmifes tion seront en- avec les Copies-desJituionscirdvant~mentionnées dans le préfent, aux pet. sonnes autorisies fonnes-qui-parctAte ont droit de les recevoir. de recevoir les VII. Et qu'il foit de plus fiatu ê ff l'autorité fufdite, qu'il fera tenu compte I sera rende Sa Majeflé, Ses Héritiers et Suc effeurs, par la voie des Leids Commiffaires du ?°\"Pieà saiý1a Tréfor de Sa Majeflé de la due ap ibcation des Sommes d'argent conformémeut aux jpi c a de dircaîns de cet Aae, en telle manière et forme que Sa Majefiés Ses eii et CC argen Succeffeurs l'ordonneront. Georgii lIT."
      ]
   }
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   "doc" : {
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "\u003c C HEI MAGAZINE LITERARY REVIEW. Edited by GEO. A. BAYNES. M.D.. \u0026c.,\u0026c _NOV~E MBER, 1876. COETETS. ORIG~I COMMUNICATIONS. Page. I'age futi Monahty by hgt;, Natio- Ie Pneumatic Syteni of Sewerage ality, and Wards.......... and its application to the city of Montreal........ . - 33COR PONIC. \\ accination. Address by w Ietter from W. E. Scott, M.. Iington, M D., Mayor of with Editortal renrks. 167 Montreal 141 R..vi.ws. I \u003eîctionary of Hygiene and Public SANITAR\\ REPORT. Healîh..................170 Forci. Iealth Statistics ......161 Kanual for Me6rcal Officer of Mortality of the City and Suburbs Healîh. .........171 of Montreal, for September, Books and Pampletb received. 171 1876.. .... ... .. 162 EDITORIAL. Synois of Meteorological Observ- Public Health in St. jean 1hptiste aons in Septeniber. 1a4 aownd ................... 172 AU Jommuications for eroî, and Books for eitea, emas.t. '. eeed befhee ttn ofh of eac H month. Registered in accordance with the Act oi Parlhament bY Gao. A . BAYNaS, M.D., m the Office cift the Miniser of Agiculure, Ottawa. 1 Price, $2 per Annum, payable in Advance. jfontreal: JOUN DOUGALL \u0026 SON, PRINTERS, ST. JAMES STREET. 1876. k?",
         "PUBLIC HEALTIL MAGAZINE ANI1) LITERARY REVIEW. Vol,. II.] NOVEMBER, 1876. [Nu 5. THE PNEUMATIC SYSTEM OF SEWERAGE AND ITS APPLICATION TO TrE CITY OF MONTREAL. By R. CAR HARRIS, C. E., Associate Member Institute C. E. This article will deal in general terms with the cost of the Pneumatic System. It has been overstated by persons not possessing the necessary data for making an estimate. It is true that the cost of construction at the outset would exceed that of the water carriage system,-just as any engine of advanced civilization vill cost more to build than would the primitive contrivance which it supersedes. To arrive at clearer ideas as to the real cost of the Liernur Pneumatic System, as compared with that of the Water Carriage System, take the case c: dhe whole or a part of a city which is unprovided with any system of sewerage, and consider the elements of cost, both direct and indirect. The two systems will compare.as follows LIERNUR'S SYSTEM INVOLVES : WATER CARRJAGESYSTEM INvOLVFS: (i) Closets in the house of a simple (r) Closets with pans, traps, handles nature, not liable to expensive arrange. and water valves. ments. (2) Soil pipes from closet to street (2) Soil pipes and drains fron closet pipe. to street sewer.",
         "PUllc IIEALTI MdAGAZINE. (3) Alnng cach branch strect toi a single Une of iron pipe, 5 inches diametcr, laid about 5 feet below sur- face of strect. (4) Along cach main street, two lines of 5 inches diameter iron pipes. (5) Iron boxes at the interections of the side streets with the main streets. (6) Air punm engine and station for creating N acuum and receivingfecak, and appliances for making poudrette. (7) Line of drains along ci street for conveyance of storm waters. and factory waste. This is really the item by which the construction cost of this system cxceeds that of the water car- nage system. (8) sale of manure in a dry powder a source of profit to the city. (9) Profit to the nation from the return to the soil of the constituents taken from it by agriculture. (3) A brick or pipe scwcr about 4 feet diameter, laid nn an average 10 fect below surface of strcet. * (4) Along each muin street, one large brick sewcr, say 6 feet 'r 8 feet diameter. (5) Numcrou. wells and nyerflow. Also man lî , which slhould occur about every îoo yards. (6) Pumping engines for raising water vith which to carry the fecale and to flush sewer,. Also, in many cases, pumping works are required in order to provide outfall for the sewerage, also intercepting sewers. (7) Ilidusion of infection, a fruitfl source of expense and \u003euffering. (8) Total slos of this revenue to the city. (9) Entire loss to the soil of the nation of the nutritive results of agri. culture. It is a matter of fact that the City of Montreal is now daily pumping by steam power a quantity of water for use in water closets and for flushing sewers a great many times in excess of the quantity of fecale which the Liernur system would have to to convey by steam power. This indirect item of cost has a considerable influence in swelling the taxes and the general cost of living, and although its expense is always charged to the De- partment of Water Supply, its cost should more properly be charged to the Department of Sewerage. The ivater carriage system performs its work by means of a pumped and otherwise expensive vater supply, and yet many of its advocates say, \" What \" can be simpler than this method of sewerage-by gravitation of course-so cheap-so easy ? \" forgetting that this gravitation must be supplied by expensive pumping and other works. The Liernur system has the merit that al! its cost is directly chargeable to itself-it is not complicated with a distinct other system of works, and iL can be employed in localities and blocks of cities where the other system, if used, would require double * Average depths of City Sewers as follows :-Providence, R. I., xo\u003e2 feet ; Tersey City, 12 feet ; Philadelphia, io feet ; Cleveland, 12 feet ; Chicago, 9 to 12 feet ; Hamburg, Germany, 13 feet ; London, England, 17h feet ; Rugby, io feet; Penzance, 9 feet.",
         "THE PXEUNMArIC SYSTEM OF SEWERAGE. punping-first, to supply the water ror carriage-second, a pump- ing of scwage Io obtain an outfall for the scwers. At Leyden the first cost of the Liernur works was $9 per head of the population served. For Glasgow, Capt. Liernur's estimate of the first cost is $9.5o per head. The cost in Ameri- can cities will of course depend upon the width of the streets, the denseness of the population, and the current price of material and labor. In the judgment of Col. Haywood, the first cost in England would be more than that of the first cost of the water system ; but the latter causes a source of heavy indirect ex- penses from year to year, besides offerng no return by the sale of manture ; whereas the former contemplates, after its operation is established, a clear paying profit on its first cost, besides cover- ing maintenance. The sale of the manure in Holland is an established fact, :nd has paid for the cost of working during three years of its opera- tion in Leyden. The surrounding districts cf those towns in Holland where the system lias been adopted, are flat,-in fact, only marshes dyked and devoted to pasture, requiring little other manure than the droppings of cattle and sheep. in consequence of the low wet nature of the soil, they are unfavorable absorbents of the fecale. The broad upland country around Montreal, al- ready much depleted by hard croppings, would be more suscep- tible to its manurial value. The necessarily limited space of these papers does not ad- mit of full analyses and estirnates of value of the poudrette. Professor Voelcker estimates its value at $42 per ton. Mr. Arthur Angell, Public Analyst for the County of Hlants, at $55 per ton. The following is an analysis of the poudrette prepared from fecale as given by Alfred Silison, F. C. S., a distinguished Eng- lish analyst:- Moisture ............................................ 15.34 * Nitrogenized organic matter and salts of ammonia....... 64.13 f Phosphates and oxide of iron containing phosphoric acid. 5.40 Alkàline salts, \u0026c.................................... 11-33 Insoluble matter....... .....,........................ 3.30 Containing nitrogen, 8.30 100.00 t Equal to ammonia, ro.oS.",
         "136 1'1'IiT,1C III'1TIt MiG71NE. The ferale at Leyden and Amsterdam is not converted into poudrette, as it would bc were the systen fully carried out. At the time these cities adopted the system, doubts existed as to whether the pneumatic plan would succeed. The adlthorities, therefore, decided not then to incur the further expense of the poudrette manufacture and works. Tlhc data available relate only to the sale of the fccale, not to that of poudrette. The latter would command a much higher price. The price paid at first by the fariners in Holland was Sd. per hectolitre, equal to 50 cents per annum per head of population. In 1S74, the orice rose tò 66 cents per head per annum; and for that year the figures for that block of the city of Leyden operated by the system are as follows:- Reccived for fecale........................ $S,3o0 Expended for men, fuel, repair;, c .............. 7,c00 Net profit.....................$1,300 In 1875, the price fell to 13 cents per head, and in 1876 rose again to 17 cents per head. The Commission for Public Works of the city of Leyden have reported in favor of extending the system to the whole city of 40,000 inhabitants, and in their report designate t as \" the system of the future for all large towns.\" The financial com- mission have reported on it in similar ternms. Before leaving this subject of expense, we may state that as regards the effect on city taxatior, the Liernur System would, in our opinion, be cheaper than that by water carriage if the whole question of cost is taken into consideration, but that its first cost would be higher than the first cost of the other. The money outlay, however, is not the only important consideration in coin- paring different systems of sewerage. Colonel Haywood, en- gineer of the city of London sewerage commission, justly re- marks apropos of the Liernur system, that \" If the daily removal of the excreta of a population be of paramount importance-if the absence of effluvium on the public ways and in the interiors of houses be of importance to the public health-if remedy for the pollution of streams must be found, and if in the public in-",
         "11111 I''ir N'1AIt i s l ti t 1 Wi Iw i tA . 137 terest the exrreta of tlic poptulatin ought tg- lie returned to tle earth-this question of cost ouglt surelv to lie a scondary one.\" As regards the ity 'of Montrcal, it night lie an advantage to have an esttimtc made, and the proscpects of the two systems pla ed i learly in juî\\tapoî'sition f.ir the information of the authori- ties. The sytenm need not nccessarily lie apsplied to ti whole town at once. Any part \u003c'f the town ina) be selectel for a trial, es- pecially those parts which, fron their crowded population and lowne, of level. \u003coffer unusual difficulties to the extension of the ordnary systeni. Colonel Haywuod suggests that in London and not of the great English tuin, the systeni could lie tried under favorable conditions. He goes on to say: \" There are existing districts in Edinbîurgh, Glasgow, Dirmingham, and other large towns. where the system might at once be tested ; and at the small towns and villages where the construction of a system of sewers nay now be under consideration, it would be wJel for the local authorities carefully to consider the advantagcs of this Pneunatic System hefore adopting the present Water.carriage System with all its difficulties and objections.\" We vill now contrast the sanitary results of the Liernur Sys- tem, as far as ascertained, with those off the Water-carriage System. It bas been shown that the Pneumatic System makes it im- possible for the germs of diphtheria, dysentery, cholera, diarrhea, typhoid, scarlatina and other zymotic diseascs, to enter a house or escape into the street fron the sewers. There lias not yet been time to get statistics of the positive sanitary results caused by its introduction. The great medical journal of England, the Lancet, says-\" Theoretically, it is perfect.\" The Common Council of Amsterdam, Toth April, 1873, dis- cussing its compulsory application to seven new districts of the city, says, among other things :-\" The results obtained in a sani- tary point of view for Amsterdam are of the utmost importance; and it lias been demonstrated that excreta are removed before noxious gases can develope or escape.\"",
         "In Leyden, that quartcr where the systcm is ilpplicd ws for- merly known for the prevalcnce of enterir fever and typhus. It has licen olbservcd that these maladies havç nearlv \u003ccased sinre the introduction of the Liernur Systei. It\u003c; sanitary lbcnefits may also be remarked by examining the sanitary cvils which it will prevent, and with thi4 oliject wc now draw attention to the history and results of the Water-carriage System. Previous to 1847, water-closets were little knov n in I.ondon, and in English tovns generally; and not very long liefore this date it was illegal to pass fecal matter into a strcam or riv.er. The excreta of the whole population were put nto cesspools, which verc brick pits or wells, the bricks being laid with opaen joints, without mortar or cement; the intention was to facilitate the escape of the liquids into the soil. The ccsspoolS were directly underneath the privy seats. These cesspools required to be emptied at intervals. This was gradually changed into our present water-closet systeni. In 1847, an Art was passed compelling the houses in Lon- don to discharge the excreta directly into the sewers. Other towns copied London, and this led to the general introduction of this system. It is considered by many îigh medical and sanitary authori- tics that the Water-carriage System is the cause of extensive in- fection, and of a great increase in the death rate of Great Britain and America. The Report to the Massachusetts State Board of Hlealth for 1875 --a large Svo. volume, and an exhaustive work-contains reports from a very large number of medical authorities -md commissions upon epidemics and diseases, and nearly all of them ascribe the evil to seiver gas. In case after case, mention is made of the sewer gas playing over the marble wash-basins and in the baths, finding entrance through the overtlow apertures and the discharge pipes which are .used in the best houses where these luxuries are used. It also states that the gas is extremely light, and floats its way into the houses on the highest grounds, and into the warmest roons: and, moreover, much of the most dele- terious gas is without odor. Consider the baleful effect of this ITl!ii.ir ulTAIvrH AGi lN",
         "l'lit'l.'At svrîi mr.i *- WI l %§.y .u lie \"f tliing't in a rit\u003e' thr# e 0'rî w'f llnny îyj.hu.-is -itii paiI*\u003e. t ~icris irc flriwing ilirotîgli tfic ýCWCTs.* 'Ihv fatal e~l rail a]\u003e, Ie %lirèwn liy rrontrasi %vit1î ritlher îhco' -till feffloi the nîethndit rof renîoving tlime excrcnîcnt lail\u003e' in i..îii-, Iby rarts frn the hinscs. The writu.r savw this mretiior in cq.lratiin in sonc of the sti-e.xts nf DiJndcr ciglteen niontlis ag-. It is .ulso ffiilowvcr in Edinlturghi (nid towný ,ide b\u003e' side wîîth (lie wavrrls t nstc whirlh is 1;IiivwLd in Ei'dnbiurgl tnuv tnwn). Ti.\u003ec exactî resîuit fI'dows hiinight li' e\\!,ci' t7d .ittr c\\xarnining the frs-rgc-itîg rctuîrns o'f the RgtrrGencral. It i\u003e fnkind ih.it in the w.iter-lo.setcd tit i f \u003c Ed3in1îrgh, tylohriid and dilplitheria %îe.îdiIv mowv their «smvat- of viî'timis, while dte oid rpart 0i the toivil, lviîh it-. absence of modern convenwences, P\u003er. sfý'-.Lrt, tthCn xV«1ý ne or 111C tA'at t-'. point nlut lîi iercnct' l'eîw-cen tyrl n 'l Itj~. '.îat t l Ji'inlurgh uy lftevcr wa, nnoî (lS3-' t-. IN42)1-4 F'Jrc dit 'u\"'c\" c m M~ ýLm U\" u'. 'lhi, i, c. ntirîuc'l l'y lir. %fturcli.'n in thý .ccl tA'iti\"îî ;' hi, on.r fekvcr., p~g\"443 an- 444, uit l'îhjh. 'thatl typh'-ii'l f'--x'r glit1 n 't \u0026'.\\.,t in E'-lint-iurglh \"unt il the inir-'-. dluctiý-n .1 .t- '.-rîfg. Ile al-, ,i),, IlIt i, rc'n-arkîbIlc thi1 the incr.Lc' t-f i-ntric fcvcr in b-nl nh. U-t'n contcmprar.n:.ou,, %itb thc con-iplution r4 the min draina:,(Ckre. rir. Fcrgu-ý, th' I'rc:i'lunt ', tlhe Iltalth Se'ction of the Glagnv ThI'o.ia Socet'y, point'. oUt the startling- fact that, according 'ô \u003clie retum'. of the Regi'.trar (;efcl'3, thu' deatlu'rate of flritain Era-m choIera, 0ýarrhoe:a anil dly.cntery, which are: rc-',gni/'i'l aL, 'lkea\"u m-e u ari'.ing (rint uxerumental pollution, wa.u nuarly four tvm,.. what it wvas tiiirty-ivc' yeirs iago. The following ara the Registrar Gcneral's returas Deaths p*r million per annum. Nfezn of fiveya, IS3SIO 1842«.. 29S; atthis time watcr.ç!o.et: almo'.tunkcno'vn. IS47 Il 852 ...1, 569 ; including choiera epidcnlic of 1-849. 1b52\" 1856. . 1249 ; du. do. do. of 1854 157\" 186..1,192 #9 tg :C )2z866 ... i,24t ; ircluding partil choiera epidemic 1866. I ci 1867 \" IS1 . 1,282. Probably thie terrible epidemics included in thesc figurcei owed much of their wide spread de;'astation to the wide spread diffusion of the excrement through the semvers. Dr. Fergus makes thie deduction that the cause of the increase was the %vater-carriage system.",
         "140 PUBLIC HEALTH MAGAZINE. and its primitive custons of 1838 to 1842, is almost free fron those and similar diseases.* The writer of this article a few years back considered the water-carriage systemi to be one of the triumphs of modern science. It has taken many facts and thoughts to show him its true character. The sewers of a great city are arteries of cor- ruption infecting the busy family of men dwelling over them- making shorter their already short span of life and health, and bringing suffering and misery to the door of every inhabitant. The occupant of a city mansion would do well to plug up the outlets of his narble baths and wash basins, and seal up his water-closets if his object is health. Better the primitive incon- veniences of our ancestors than the gilded death-traps of our modern cities. As Mr. Simon, the medical officer to the Privy Council, in lts 9th Report, truly says: \" It is to be hoped that as the educa- \"tion of this country advances, this sort of thing will come to \"an end-that so mnuch preventable death will not always be ac- \"cepted as a fate-and that ror a population to be thus poisoned \"by its own excrement will some day be deened ignominious \"and intolerable.\" t * Dr. H-enry Littlejohn, Medical Officer of -tealth for the City of Edinburgh, makes the following statement:- \"The nený town is inhabited by the better classes, and is pre-eminently a water-closet town. The old town consists for the most part of strongly bu:lt tenements, crowded with very poor people, and to this day they m»ake use of pails for the reception of the excreta of those confined to the house-these pails are brought to the street daily, and emptied into carts provided by the authorities. From this state of things, the low norality of the population, the bad ventila- tion, the crowding together and the retention of the filth in the living rooms for the greater part of the day, it might naturally have been imagined that t\u003ephoid fever and diphtheria were endemic in the old town. This is not the case, however, for despite the surrounding circumstances the diseases maypraically be said t be unknown. \"In the new and w%,ater-closetted town, however, the case is different--ypHoid and digp;tleria are neve;r enrire/y absan, and are frequently endemic, and it has been noticed that the ravages of these diseases have been the greatest in the best bouses.\" † Dr. Fergus, in the opening address session, 1873-74, of the sanitary and social econony section of the Glasgow Philosophical Society, says - \" But how are we to account for the slight increase in scarlet fever, the strik- ing increase in the diarrhoeal groups, and the addition to the list of a most deadly zymotic previously almost unknown. What changes have ben made in the habits of thet people vhich could in any wsay lead to so sad a result after all the legislation and patriotic efforts to ameliorate the condition of the people and to lessen the enormous amount of preventable dcath. Certainly the only great change has been the mode by which wve get rid of our excreta and refuse. \" If any one had hinted to me ten er a dozen years ago that our present sys- ten of vater-carriage would prov.e a source of disease, I would have scouted the idea ; and even when I began the study of this great question I had perfect faith in the system, and have only been driven fron it step by step as new light gradually dawned on me, and the question was sifted to the bottom.\"",
         "VACCINATION. VACCINATION. Iis Worship the Mayor delivered the following lecture on vaccination to the Public Vaccinators and other Physicians and Citizens, on Friday, the 2oth October, 1876 :- Gentlemen : It has been suggested to me by some of your body that, in addition to the directions issued by the' Board of Health, for the guidance of vaccinators, something might be said to meet the objections urged by some active but mistaken writers against the practice of vaccination. Had similar articles been written against the practice of setting fractures ; of reducing dislocations; or of removing dead parts from living bodies, I should have thought it useless to reply : for if surgeons contend that a dislocated bone should be reduced, the profession-I speak of its more experienced nembers-is almost equally unanimous in favor of the practice which some so persistently, and so unfortunately, denounce. It is something to array oneself against the general belief. To follow quietly in the footsteps of those who, in all things else, medical, are our guides, brings with it, to the mind, less eclat, than to take up arms in what may be considered a safe warfare-safe, perhaps, to the combatant, but fraught with terrible mischief to those most interested. To prove to the unprejud~ced, that vaccination exerts a protective influence over the economy, would be an easy task, for the writings of thousands, from the time of Jenner to our own day, are before us for the purpose; but to attempt to convince those wvho persistently close their eyes to the over- whelming evidence of almost every country and government in the world, including our own, would be as fruitless as was the effort to convince the disbeliever in matter of the reality of the missile which almost knocked off his too unyielding head. In deference, however, to wishes expressed and suggestions offered at a meeting on Wednesday last, I venture some observations on this disease, now unfortunately too prevalent, and on the means which science has furnished for its prevention. Small-pox has its \"periods of dormancy, and its periods of activity,\" at one",
         "14.2 PUBLIC HEALTIH MAGAZINE. moment overspreading a district, and at another disappearing. It is fatal in direct ratio to its epideniic character. Cases occur- i ing sporadically (here and there in spots), are not so fatal. It is I the most contagious of all diseases; and this is a point on which I wish to insist, for some industriously endeavor to circulate the belief that small-pox drops upon individuals as rain drops from heaven-touching this one and sparing that! It is communicable in every way; \" by inoculation, by breathing a contaminated atmosphere, by the contact or vicinity of fomites.\" It is infectious in the early febrile stage; infectious before and during the eruption; a d infections \" so long as any of the dry scabs result- ing from the original eruption remain Adherenttothe body.' It may be caught, therefore, from the living body ; it may be caught from the dead body; or it may be caught from clothing and furniture near the living or the dead body. So much bas this foul disease been dreaded, that different nations in time past endeavored to mitigate the malady by communicating it artificially. The Brahmins in India engrafted the virus; so also did the Turks; and the Chinese were in the habit of putting some of the crusts into the nostrils. The practice of inoculating with small-pox virus became more or less general in Europe, and \" its efficacy in mitigating the severity and the danger of the disease \" was considered to be very great. While it is estimated 'that one third of those who take the natural small-pox die, not more than three or four in a thousand are destroyed by the ingrafted disease. Curschmann states it to have been about two per cent. But the time for small-pox inoculation is past, as the law has forbidden it. Eighty years ago a chance observation was matured into a rational and scientific form by a mind deeply imbued with the best principles of sound philosophy. A disease, mild in form and safe in character, was substituted for the inoculation of the Greeks and Chinese. In 1798 Jenner published his first important paper. In 1799 the first public institution for vaccination was established in London; and in the following year it was introduced into France and Germany ; and the practice of vaccination bas now become general over the whole educated",
         "VACCINATION. world. Here and there, as might be expected, it has met with opposition; but every objection that has been urged by the anti- vaccinator bas been answered again and again by the leading minds of the profession. So much is this the case that I feel I owe something like an apology to my medical brethren for writing affirmatively of a practice most of them endorse. I spoke a moment ago of Jenner as a discoverer; but Jenner did not discover vaccine any more than Watt discovered steam. He noticed the prevalent belief among the peasantry in the immu- nity from small pox enjoyed by farm servants and milk maids ; and little by little he drew the conclusion which has been so pregnant with benefit to mankind. The belief in the existence of a vaccine virus was not confined to Englanc. Cow-pox and its relations to small-pox had been noticed long before on the continent of Europe; and in France and Germany numerous experiments had been made prior to the time of Jenner to show that persons affected by the natural vaccine virus were not susceptible to the small-pox influence. Jenner's merit con- sisted chiefly inproducing the virus at will, and in diffusing it at pleasure for our advantage. And how slowly and how cautiously he advanced his every sfatement may be gathered from the fact that twenty-two ycars elapsed between his first experiment and the promulgation of his theory. He was assailed then, as his memory is to-day, but with more excuse then than now, for no one having the leisure and the disposition to read, and having access to the records of medical observers, has now the shadow of an excuse for rejecting the theory then advanced, the critical acuteness of which, says Curclimann, may serve as a model. But we do things differently now-a-days, and a harangue in a market place or public square, by gentlemen who may, 'tis true, be authorities in law, but cannot be accepted as such in medicine, is deemed sufficient to initiate the uneducated niasses into a knowledge of one of the most difficult and abstruse subjects in the whole range of medical science. I shall not allude to the members of my own profession who have chosen to so far forget what is due to their own dignity and the dignity of their calling as to select such an arena for the dis-",
         "PUBLIC IIEALTII MAGA/INE. semination of their fatal errors. As the times are as pregnant with niischief, as the air is with the disease, I proceed tu ask and to answer questions asked and answered a thousand times: 1st. Does vaccination confer a certain degree of protection against small-pox ? 2nd. Are the effects of vaccination permanent ? 3rd. Is there risk of lighting up local and inflammatory action ? 4th. Is there risk, when vaccinating, of inoculating the system with scrofula, or other hereditary disease ? 5th. Is there risk of contaminating the system with syphilis. or other acquired disease ? The answer to these questions will, I think, cover the ground gone over by the anti-vaccinists. 1st. A simple assertion that vaccination does confer a certain degree of protection against an attack of small-pox would at once be met by a counter assertion that it does not. The ques- tion, therefore, vill be answered inferentially, and from sources the most reliable, though a desire to economize space prevents me from citing at length. And first for .Enzgland. In the first thirty years of the last century, when inoculation of small-pox was unknown, the mortality in London from that disease was 7.4, and at the close it was 9.5 per cent., inoculation having been introduced in the interval. A committee of the Epidemiological Society have compiled tables to show the ratio of mortality from small-pox in London before and since vaccination was intro- duced, and the following are the results :-For the fifty years, from 1750 to 18oo, the average number of deaths from small-pox out of every 1,ooo deaths from all causes was 96 or nearly ten per cent., while during the first half of the present century (the half century.succeeding the introduction of vaccina- tion) the mortality was 39. In England, according to official returns, the estimated death-rate from small-pox alone at the end of the last century was 3,0oo per million, vhile from the same returns the present death-rate from the same cause is only 200 per million ! An analysis of the latter is most interesting.",
         "VACCINATION. 145 Vaccination has, in Great Britain as elsewhere, had its oppon- ents, but the practice has become more and more general, and the opposition to it Iess and less, till now it is quite general. What is the result ? During the first ten years of the present century, the mortality from small-pox in every thousand deaths from all causes was 64; in the second decade, 42 ; in the third, 31 ; in the fourth, 23; and in the fifth decade it was 16. Let the anti-vaccinators explain this as best they may. Not only bas the average of deaths from small-pox diminished in the above ratio, but epidemics of the disease have become less frequent. Before vaccination it was as 48; during vaccination it was as 14. The inference from all this is thus drawn by Sir Thomas Watson (the ablest medical writer in London): \" Where vaccination is, the contagion of small-pox need never come.\" How is it in WVales ? Dr. Hughes, of Mold, states, \" No child born in the Mold district, and alive at the date of the registration of its birth, lias died of small-pox during fourteen years, yet small-pox has prevailed on various occasions all around it.\" How is it in Ireland, where vaccination has been compulsory for the last fifteen years ? The immunity afforded by vaccina- tion there has been such as to induce a wide-spread belief in its efficacy among the people. Vaccination is practiced generally all over that country, and the children of the soil carry-ng with dbem an entire confidence in the practice, are always the 'most willing to be vaccinated. The results are seen in the following figures, from which it appears, says an official document, that the Irish physicians have banished small-pox from their island, as Saint Patrick is said to have banished the snakes. In the periods 1830-40, 1840-50, and 185o-6o, befdre vaccination was general, the respective annual average mortalities had been 5,8oo, 3,827, and 1,272. In the years 1864, 5, 6, 7, 8, they were 854, 347, 187, 20 and 19, respectively. In the irst half of 1869, the whole number was three ! The remarkable immunity from small- pox conferred by'vaccination, induced a- laxity in the practice, and a few cases occurred subsequently to 1869, but they were upposed to have been imported. In Montreal there are coin-",
         "146 PUBLIC HEAi MAGAZINE. pa-atively few children of Irish parentage unvaccinated, and our tables of mortality-to which I beg to refer-show how very few of that nationality die of small-pox. What is thought in Sco//and of the protective influence of vaccination ? I quote again only our medical teachers-those from whom we are content to receive our medical knowledge. One of the most distinguished medical philosophers that Scot- land-and Scotland is prolific in medical philosophers-has lro- duced ; and one who graced, for a great number of years, the chair of medicine in the University of Edinburgh, writes thus:- \" The first question is whether or not we have, at this time, in the matter of cow-pox, a power at our command capable, if duly employed, of depriving the poison of small-pox of all fatal in- fluence over an immense majority of mankind. And on this subject there has been quite sufficient information collected, since the date of the papers which were held decisive of the question fifty years ago, to show that the sanie inference is still inevitable, and that he who disputes it is equally unreasonable as lie who opposes, in like manner, any proposition in Euclid. Of course, when I say there lias been ample evidence to decide this question statistically, I mean to refer to cases where ve have not only the negative evidence of large nunibers of persons duly vaccinated, having been subsequently, most of them re- peatedly, or for a long time together, exposed to the contagion of small-pox-i. c., placed in the sane circumstances in which unvaccinated people have been generally affected, and many of them died of small-pox; these vaccinated persons have never- theless escaped, most of them without any indication of disease. To show that this is the light in which I have always regarded such collections of facts, I quote one sentence from my own lec- tures, written as long ago as 1820-1821, and repeated almost every winter since then :-\" You will remember that the question is, not how many vaccinated persons never take small-pox, but how many vaccinated persons are fully exposed to the contagion of small-pox and escape without any disease ; and our assertion is that, so far as is yet known, absolute protection of the human constitution is the rule, and the occeurrence of any disease is",
         "VACCINATION. 147 the exception.\" Thnse who have had the advantage, as I have had, of listening to that most profoundly logical and conscien- tious medical teacher well know the care and thought lie gave to his every utterance. Dr. Alison has passed away, and what says Dr. Hughes Bennett, his successor in the professorial chair ?- \"We have no remedy (for small-pox) but vaccination.\" Let us now proceed to the Continent, and what do we find ? In Copenhagen the fatality from small-pox is but an eleventh part of what it was before the introduction of vaccination; \"'in Sweden it is a little over one-thirteenth ; in Berlin, in Prussia, and in large parts of Austria, but a twentieth ; in Westphalia but a twenty-ifth ! !\" In Bohemia, Moravia, and Silesia it has been reduced from 4,000 in every million of deaths to 2Co per million. Not only is it satisfactorily established that vaccination is an effectuai safeguard against small-pox, it is, according to some, more effectuai in preventing small-pox than is small-pox itself. This was thoroughly tested in Hanover, where it vas found that out of a hundred soldiers re-vaccinated, sixty-two per cent failed altogether in producing a vaccine vesicle ; and twenty-seven per cent were only partially successful. Soldiers who had already had small-pox were operated upon in the same way, and with precisely the same result. Such information as I could glean from different sources leads me to the conclusion that an attack of small-pox and vaccination confer the same degree of immunity from an attack of small-pox; but that subsequent fatal small- pox follows more frequently after small-pox than after vaccination. How is the practice of vaccination regarded in the United States? Gentlemen. it would be an endless matter to quote the opinion of every medical observer in the adjoining Union, but I shall introduce the substance of everyone's remarks as furnished to the State. Many of the States of the adjoining Union have their State Board of Health, and each board may be considered to reflect the opinion of the medical minds in the State. The State Board of Health for 1871 says :-\" No amount of disinfectants can cope with this dire disease. The only way to thoroughly drive it from the United States is by a national law, as in England, requiring every parent to duly register his child after",
         "148 PUDLIC IIEALTH MAGA/INE. baving been duly vaccinated.\" The experience of Massachusetts is sunimed up in the report from which I quote : that small-pox has appeared here and there, but where it lias appeared sporadically it has always been in places where vaccination liad been neglected. The town of Holyokc, in the Connecticut valley, was an illustration. One-fifth of all the deaths from small-piox occurring in the whole State took place there. ''he people in Holyoke had not been vaccinated as elsewhere. Dr. Geo. Darby, of Boston, Secretary of the State Board of Health, summarises for his Board as follows (and his summary receives the sanction of the Board): Vaccination \"invests the human body with an armour which may hardly be penetrated by this subtle poison.\" A year later (an epidemi: of snall-pox having passed over the Continent) he writes : The present epidemic is of such intensity, that it is quite common for persons who have had small-pox in former years to now have it again. Such occurrences have been previously rare. Vaccination, whether from the cow or from the human body, \"takes\" readily, and re-vaccinations prove abundantly the extraordinary susceptibility to the vaccine disease now prevailing, and never Afre existing\u003c. In view of these facts, with which physicians and intelligent persons, of whatever calling, are now familiar, let us thank God for Jenner's great discovery, without which our homes would be desolated, and our peace and happiness destroyed. The imagination can hardly picture the horror which would to-day pervade Massachusetts, were the present epidemic unchecked by vaccination.\" A year later (1874), the epidemic being over, the sane authority, and the same Board, report inter alla : One year ago * * * * we were in the midst of an epidemic of small- pox of extraordinary intensity * * * the protective power of vaccine has been proved beyond all question, and the absolute need of careful vaccination is equaliy evident.\" Fron September 6th to the close of the year, not a single death froni small-pox has been reported to us froni the cities of the State.\" I receivcd the last \" State Board of Health \" report, a few days ago, an interesting document of nearly four hundred pages, and so completely lad vaccine done its work that the report contains no",
         "VAcc1NAIOINV. allusion to the dreaderd disease. Thankful for tie immunity afforded, the reporter froii whnm I quote writes \" Vaccination needs no defence from us. Nothing, however beneficent, can escape the criticisn of the times in which we live. But this criticisni of vaccination, often passionate and violent, relates chielly to points whiclh, hîowever interesting they may be, leave the main question unaffected. Let any one read the history of the ravages of small-pox before Jenner's discovery, and compare it with the mortality of Massachusctts from this cause in the present generation, and ask himself - the reason of this change. There can be but one answer. We may speculate about the possibility of the potency of vaccine being exhausted in the human family; we may be surprised to find that people with good vaccne scars sometirmes have small-pox; we may dispute as much as ve please about the average icriod when re-vaccination may be considered a prudent safeguard; we may e'ven conjecture (what no man has proved) that other diseases than that of the cow may be communicated by humanized vaccine ; we may turn the vaccination question with ingenious skill, so that its nany facets shall reflect a multitude of curious lights, and after all we find that we rest in a security against this most horrid pestilence, unknown to former gencrations. The disease is the same now as then, for we sec its effect among barbarous tribes; but bccause Dr. Jenner lived and made the greatest of all discoveries in preventive medicine we are almost completely safe.\" I have quoted fron a public document which received the sanction of a learned deliberative body-and the approval of the Government of the State-the most genern ily intelligent State in the adjoining Union. What says the Ohi: Board of Health ? \" While sister cities in Ohio have been recently afflicted with small-pox, Cleve- land lias enjoyed an exemption far exceeding that of former years. * * * * Our comparative immunity fron this loath- some and terrible disease conclusively demonstrates the prevent- ive power of vaccination, and must impress every thoughtful mind with the munificence of the legacy the immortal Jenner left the hîuman race.\" I have purposely introduced at greater lengtlh from American than from British authorities, because it lias been asserted by a certain few, who have spoken against vaccination",
         "1 go iticI( 11VAi;ri 'MAGA/INt:. at public gatherings in this city, that it was an ' English remed\u003e, and that Englishmen had a pride in engrafting their 'beastly ' virus on the Christian children of fair Canada \"-an argument rellecting but lttle credit upon the heads, and less upon the learts of tlose w ho ad% anced it. But American authorit qui ad the vaccine qu*stion cannot be suspected of partiality. I have singled out no individual writer on the subject, (I might have iuoted a thousand American writers in favour of the practice of %accination) but haie confined myself to State documents con- taining the deliberate expressions of deliberative bodies, rellecting the condensed thoughts of the best medical minds in the United States. I turn with little pleasure to this, my oin country, and especially to this my own city, and I find anti-vaccination 'iews aducated, and disseminated by a small but ceaselessly active section of medical and legal thought. I find from piersonal knovledge a d.:eep rooted prejudice against what the scientific world generally has sanctioned, and I find disfigurenint, disease and death follow% ing in the wake of those teachings ; teachings to the dissemination of which a portion of the daily press lias lent its columns. I readily admit that small-pox has its \" periods of dormancy and its periods of activity,\" and that, \"every now and then, at irregular inter% als, it overspreads a district or country as an epidemic. But why should it press so heavily on this city ; and why should it single out chiefly one nat'onality P Why should it pass so lightly over Quebec ? Dr. Russell, President of the College of Physicians and Surgeons, residing there, gives the reason :-\"We have %ery little small-pox here (Quebec). We are ail vaccinated.\" The table pre,\u003eared by the skilled House Sur- geod of the Marine and Emigrant Hospital, of Quebec, Dr. Catellier, is a crushing and unanswerable argument against the anti-vaccinators. Tiere were 131 cases admitted into the estab- lishment between the months of May, 1874, and july, 1875, and of these the vaccinated numbered 54, one alone died. In 69 cases of unvaccinated patients 32 were discharged cured, but somewhat disfigured, and 37 died. In 8 cases where it was doubtful if vaccination had or had not been performed, 6 were cured and 2 died. These computations afford us flie following startling percent-",
         "VACcINAT1IN. 151 ages, whi h e cry mau and wonan valuing the hcalthy future of their progeny ought to carefully note. The death rate in rýcci- nated cases, is only i.8 lier cent.; in unzaccinated 53.6 per #ent.; in doubtfull cases 25 per cent. Can anything tend to expose and conform the clainf of tpis grar tire upon the people Ltter than these dates ? Why does it pass so lightly over Three Rivers ? Dr. Badeau, the Doyen of the profession there, explains - \" On n'a pas de Pici//r ici. On sc fait racciner.\" The same for Toronto. And why does it % isit in Montreal, most severely those of a particular nationality ? We nurse it. In Quelbec, Tlhrec Rivers and Toronto no one writes against or attacks the principle of vaccination-the only prophylactic for small-pox. That the con- verse is truc in Montreal is evident from the circumstance that the mortality is immensely greater among that nationality whose beautiful language has been made to serve as a vehicle for the dissemination of a most fatal error. Dr. Osler-whose every statemenîn has the accuracy of a patlologist-furnishes me with the records of the Small-pox )cpartment of the General Hospital from Dec. 14, 1873, to July 21, 1875, the p\u003eeriod during which it was under the charge of Dr. Simpson and himself There were adnitted during that period 261 cases, and there were 73 deaths. But how was those death-rates distributed ? In the unvaccinated, 58.8 per cent.; in the vaccinated, 17.09 per cent. We have now two civic hospitals in Montreal for small-pox, one presided over by the Sisters of Pros idence; the other by Miss Chambers. What is the experience of these ladies ? I give the fluestion putto the ladies of both establihîments and their answers :-\" Have you noticed any difference between the vaccinatcd and non-vaccinated inmates of the hospital ?\" Sister Nativity states, in French :-\" There is no comparision between the effects of small-pox on the vaccinated and non-vaccinated ; the vaccinated, as a rule, are not affected, and when they are they have it shlghtly; the deaths are among the unvaccinated.\" Miss Chambers' is precisely to the same effect. What more convincing evidence than this, coming, as it does, from sources whose reliability is beyond doubt or question. I do not quote from the physicians of the city, who, vith a very small exception, have again and again expressed their entire belief in the prophylactic power of vaccine. Volume after volume lias",
         "13ý2 1T1itir Ili'. U. li iA /INE been written tu establish the power of vrrine, andt mv t.ble, as 1 write, is rovered with dcumentary evidence, the magnitude of which alonc prevents my introducing it here. Suffirient, however, ha, been aidurced to warrant an answcr to the first qucstion in the afflirmative, \" that varrination confers a greater or less degrec of protection against small.pox. 2fld. A/IC flic ffcs if vaccin'aftio7n trrmaneft 1 As a ruie the answer may le yes ; but the exceptions are so nuncrous that I niust admit the partial truth of what is claincd by some writers, \" that the rotecrtion whirh vaccination affords againi small-pto\\ is only of limited duration.\" During what time i, there absolute imninity? This varies in different indi- viduals ; but I have long been of opinion, and that opinion is shared liv those who have given attention to the matter, that the manner in which vaccination has been donc in the first instance has much to di, with the degrec and period of that immunity. Although ten or twelve years are said to le the average period, the thoroughly vaccinated have an immunity of much greater duration. In a large, a very large nunber, unfortunately, vac- cination is not performned with anything like approximate thoroughness. This has been noticed in the Snall-pox Hospital here, where a e.amination of the arms of the inmates bas rare/y discovered marks of a true Jennerian vesicle. But if there is doubt as to the conued inmmunity afforded by varcination, there can be none when properly performed e sec nd time. Re- vaccination, when successful, affords entire imm inity, and in proof of this assertion I shail cite but one proof from among a thousand. It bas been an imperative rule for the last thirty-four years at the London Small-pox Hospital that every nurse and other servant of the Hospital should, on entering the service, be vaccinated. In their case it is generally re-vaccination ; and it is never afterwards repeated. These nurses live in the closest daily and! nightly atttndance upon small-pox patients; and the other sers ants are constantly exposed to the profuse contagion; yet in no single instance, during these thirty-four years, lias any one of these servants and nurses been affected with small-pox. Surely n tronger proof than thib can be imagined, that re- vaci.nation in the adalt is a i ý.bolute protection against small-",
         "VACCINATION,. pox, and necd not be rcpeated. Up to the age of puelcrt. -a rhild profer/r' vaccinated may be considered saf,-hut *o many of thosc vaccinated have cicatrice% deficient in number and of a character not strikingly good that re-vacrination should be re- sortcd to where there is more than usual exposure to small-pox. I have instanced the London Small-pox Hospital a% eviden;c of the advantages of rc-vaccination, and shall cite fron official %ources cu Sdence of the immunity conferrcd hy it on soite of thc continental armici of Europe. In five years, says Scaton. there occurred in 14,.34 re-vac inated soldier% in Wurtemburg only onr instance of varioloid ; and among 30,ou0 rc-saccinnated per- sons in cival )ractice only two \u003cases of varioloid ione of whi\u003c h was probably really a case of rhi ken-poN), though during ta\"se ycars mail-pox had prevailed in 144 locahîties, producing 1,674 ti es of modified or unmnodificd ,mal -pox among the not re-vaccin- ated, and in part not vaccnated, population of 363,-) p\u003eerons in those places in which it had pr:va:Ied. In the Prussian army, since the introduction of systenatiît re-vacrenation in 1834, the cases .eported as \" varioloid,\" and still more those called \"variola,\" have been, nearly al] of them, aniong that portion of recrîlîts whose term fo: re-vaccination had not corne, or whose re-vaccinations had not been successful, or who were incubating small-pux when they were re-vaccinated ; in the 20 years which immediately succeeded the adoption of this system there oc- cuired altogether but forty deaths from small-pox in this large army-(or an average of two deaths per annum)-only four of the entire forty being in persons who, it is said, had been suc- cessfully re-vaccinated. So also in the Bavarian army, in which there had been compulsory re-saccination since 1843, there had not, from that date up to the time of a report made by the Minister of War in 1855, been a single case of unmodified small- pox; and only a very few cases of modified small-pox, without any deaths. While, therefore, I answer the second question in the negative, as to the permanency of primary vaccination, the statistics quoted from official sources, with the almost universal collateral concurrence of medical practitioners, warrant the statzment that \" after successful re-vaccination, small-pox, even of the most slight or modified kind, is rardy met with, and that",
         "154. PUBDIC IHEALTH MAGAZINE. wlen post-vaccinal small-pox is met with of a somewhat severe character it is due to the want of care in the performance of vaccin.aion in the first instance, or to want of preparedness in the systern when primary vaccination had been performed. Froi what lias been said, a question of vast moment to adults neces- sarily presents itself. As all those who have been vacci, ated but once run more or less risk of cont:acting the disease, and as it is admitted that re-vaccination renews, or adds to, the security against small-pox, common prudence would suggest the course to be pursued by those who wish to guard against this nalady. Although it forms no part of my present subject, yet, as an impression prevails vith some that persons exposed to small-pox contagion incur additional tisk by being vaccinated, and by hav- ing one discase engrafted on another, it is well to state that such a view is entirely erroneous. If vaccination is performed suffi- ciently early, so that the areola may have time to form, it will prevent small-pox; if later, it will modify that disease. Mr. March illustrates this rule thus:-\" Suppose an unvaccinated person to inhale the germ of variola on a Monday, if lie be vaccinated as late as on the following Tuesday, the vaccination will be in time to prevent small-pox from being developed. If it be put off till Thursday, the small-pox will appear, but will be modified. If the vaccination be delayed till Friday it will be of no use.\" Sir John Watson, p. 888, adds:--' Should tne person have been formerly vaccinated, revaccination will be effectual two days later than this, because in revaccinated persons the stage of areola is reached two or three days sooner than in persons vaccinated for the first time.\" 3rd.-s there risk of vaccination lighting up local inlam- matory action? When we consider the disposition, the temper- ment. the c ondition of health, of those vaccinted, and the per- iod of life at which vaccination is usually-and the petiod of'the year at which it is sometimes-prformed, it is a matter of sur- prise that local irritation, or erysipelatous action, is not more frequently lit up. At certain seasons of certain years any abra- sure of the skin, however slight, even without vaccine lymph, is apt to cause erysipelatous inflammation. What medical nrem lias not sometimes seen crysipelas to follow a slight bruise, or the",
         "VACCINATION. 155 scratch of a needle or a thorn? The accidents of this kind fol- lowingvaccination are very few-not by any means as many as I have scen to follow the pulling of a tooth. Yet who ever ad- vised that an aching tooth should be left alone because it had happened sometime, somewhere, and in the hands of sone one, that hemorrhage from the tooth socket' had taken place; that erysipelas-fatal erysipelas-had sometimes followed; or that the bones of the jaw had been splintered? These are the acci- dlents-and so rare are they that they should not enter into one's calculations. So convinced am I of the safety of vaccination, that I have no hesitation in saying that a vaccinator. who knew his business, would vaccinate -. thousand children with fewer un- pleasant results than a competent dentist would have in extract- ing the same number of teeth. There are, 'tis true, precautions to be taken, just as there are common sense precautions to be used by every one in eating, in drinking, in travelling. But these occurrences would be rare indeed if vaccinators exercised care and judgment in the selection of the lymph (which should be pure, taken at the proper time, and without admixture either of decaved epithelum or of pus) and in the selection of their subjects (who should neither be too young, too feeble, nor too sickly) ; and with these precautions, severe local inflammation would be rare indeed. But it is not to be expected that some degree of irritation will not be produced. To prove this, child- ren, vaccinated with the purest lymph, will manifest, during the few days that the pustules are at the highest development, cer- tain febrile disturbances of the general system, during which the temperature of the body sometimes reaches 104° F. But in cer- tain constitutions, and in certain states of the atmosphere, and especially when the crust is brittle, and with it there happens to be, either through carelessness or ignorance, decayed epitheliun or dried pus, or even the purest lymph with an unclean instru- ment, the constitutional disturbance above alluded to, and which was till now within the range of health, assumes a morbid char- acter, and more or less severe local or constitutional disturbance is the result. The third question, therefore, may be answered thus: Moderate local inflammatory action may sometimes be lit up, but tie severer forms are, as a rule, due to want of care in",
         "PUBLIC HEALTH MAGAZINE. ti selection of the crust ; inattention to the age or hcalth of the subject; to carelessness in the use of the scrificator ; or to at- mospheric influence ; or to all combined. 4th-s there risk when vaccinating,of inoculating the system wit scrofula, or other hereditary disease ? If my answers to the previous questions were necessarily qualified, this one is not, and I cmxûbatically answer no. It would be an utter waste of time t' d to discuss what has already been disposed of, to the s .ction of every unprejudiced mind. That vaccination induces scrofula or other new disease is an absurdity, notwith- standing the wonderful tales of a verde de lisle, that it lias caused mental and physical degeneration of the hunian species, diminishing men's stature, incapacitating then for the fatigues of military service, or even the exercise of dancing.\" One word as to the first: the tallest, strongest, and heaviest men in Europe, according to Professor G. D. Forbes, are the Irish: yet Ireland is one of the, if not the, most thoroughly vaccinated countries in the world. 5th.-s there rzsk when vaccinating, of inoculating with syphilis or other acquired diseases ? The allega- tion bas been made by some in the affirmative; but when it is borne in mind the strong \".temptations to employ false pre- texts,\" it is a matter of surprise that vaccination lias not been more generally 4 pitched upon by persons in search of an apolo.. gy for their syphilitic chddren.\" For my own part, not only have I never seen a case of invaccination of syphilis, but have never met a medical piactitioner who had seen a case, either in his own practice or in that of another. We all know how the sligbtest scratch or cut is apt to develope tractable ulceration in a child having latent syphilis, and the ulceration thus produced requires the local and constitutional treatment of a syphilitic sore. A slight scratch, required for vaccination, with the purest lymph, nay assume a specific character, but conjugal infidelity, and nrt inei vaccination, is the true cause. That vaccine lymph does iot carry vith it the syphilitic virus, even in cases of un- doubted syphilis, may be fairly infeired fron the experiments which have been performed on a large scale on the continent of With well attested experiments like the above standing on",
         "VACCINATION. 157 on record, we are obliged to doubt whether vaccination (i.c. genti- ine and simple inoculation with vaccine lymph) from however syphilitic a subject can possibly communicate syphilis ; or, at the very least, whether some stage of the vaccine vesicle more ad- vanced than vaccination rules allow to be proper for lymph supply, or some admixture, which fastidious vaccinators never permit, of blood with the vaccine lymph, must not be a condition for such possibility. That some ignorant quack salver, pretend- ing to vaccinate, but neither knowing the aspects of a vaccine vesicle, nor caring from what sort of body he draws his supposed lymph, may take as his \" healthy source for lymph supply \" an infant all maculated or ulcered with siphilitic skin disease, àind may from its spots or sores tranfer infective material to some victim of his mis-called vaccination, is of course evident; for syphilis does not cease to be syphilis because noodie or knave calls it vaccinia; but facts of this kind cannot in any reasonable sense be counted against vaccination, any more than we should count it a fact against Quinine that some grocer had dispensed Strychnine in mistake for it. Finally, too, I permit myself this general remark : that, in proportion as any alleged fact contra- dicts an otherwise universal experience, the individual witness must be regarded as making larger and larger demands on us for belief; and that in matters like the present, where sources of fallacy are so abundant, the witness's accuracy of observation requires to be most thoroughly guaranteed. The cases of supposed inoculation of syphilis with the vaccine virus are not many, and an analysis reduces them to very few- and those few are still further reduced by the fact that the grossest ignorance and misconduct vere imputed to the vaccin- ators. The few cases that have been published in the past seventy years, chiefly frcn Continer.tal -sources, are utterly insignificant in nuimb.ers and importance, and lead us to ask the same questirn as Mv. Simon : \"If our ordinary current vaccination propagates syphilis, where is the syphilis that it propagates ? Who sees it ?\" The experience of the department is an entire blank on the subject. For the last ten years we have been in incessant intiinate communication with the different parts of England on details of public vaccination, and during these",
         "158 PUBLIC HEALTHl MAGAZINE. years every one of the about 350 vaccination districts into which England is divided bas been visited three or four times by an inspector specially charged with the duty of minutely invest- igating the local practice of vaccination; yet from this systematic and extremely detailed search for all that has to be said on the subject of vaccination in England, no inspector has ever repurted any local accusation or suspicion that a vaccinator had coin- municated syphilis. Again, our national vaccine establishment has been in existence for more than 6o years, vaccinating at its own stations every year several thousands of applicants, and transmitting to other stations supplies of lymph, with which every year very many (at present 5o or 6o) other thousands are vaccinated, who in their turn, become sources of vaccination to others ; but this vast experience does not, so far as I can ascertain, include knowledge of even one solitary case in which it has been alleged that that the lymph has communicated syphilis. Is it conceivable that these negative experiences could be adduced if the vaccine lymph of children with latent heredit- ary syphilis were an appreciable danger to the public health ? Thirteen years years ago it devolved upon me (as medical officer of the Board of Health), to make the widest possible enquiries, both of scores of public departments and institutions, and also of many hundreds of individual practitioners, in our own country and on the continent of Europe, with a view to elicit all existing experience on the validity of objections which had been alleged against vaccination; and on that occasion I, of course, gave great prominence to the point which is here raised. One of the four questions which I circulated was the following :-\" Have you any reason to believe that lymph from a true Jennerian vesicle, has ever been a vehicle of syphilitic, scrofulous or other constitu- tional affection to the -vaccinated person; or that unintentional inoculation with some other disease, instead of the proposed vaccination, has occurred in the hands of a duly educated medical practitioner ?\" The answers which I received on this, as on each of my other points, from 542 members of my profession, are as regards syphilitic inoculation, only just short of being an absolutely unifori \" No.\" The alleged cases (of inoculation) were thrown into real insignificance by their relation to the main",
         "VACCINATION. 15q body of testimony. Men of the oldest and largest consulting practice in the United Kingdom, men who were believed to have seen every variety of disease and accident to which the human body is liable, our leaders who had taught medicine and surgery to the mass of the profession, physicians and surgeons of our largest metropolitan and provincial hospitals, in England and Scotland and Ireland, physicians who had specially studied the discases of infancy, surgeons who had specially studied the ino- culative diseases, pathologists of distinguished insight and learn- ing,-men of all thes2 sorts, score on scores of them, had never in their experience \"had reason to believe or suspect any slich occurrence as my question described.\" In the alphabetical series to which I have referred there may be read all the most eminent British names of thirty years ago, certifyirng to such negative experiences ; there may be read too that equally negative in Paris had been the vast experience of Chomel and Moi eau, Royer, and Ricord, and Rostan, and Velpeau; equally negative at Vienna that of Hebra and Oppolzer, and Sigmund. And in here recurring to that very remarable mass of testimony, I may repeat the remark which my former review of it sug- gested to me: \" Obversely one at least of two conclusions is inevitable ; either it is that with reprehensible carelessness as to the source of lymph, vaccination (so long as in any sense of the word it is vaccination) cannot be the means of communi- cating any second infection ; or else it is the case that in the world of vaccinators care is almost universally taken to exclude that possibility of danger.\" To the public, perhaps, it matters little which of these conclusions is true. Though it would be the merest idleness to take again now the sort of formal census of medical opinion which I took thirteen years ago, I may state that ever since that time I have felt it among my strictest duties to be generally watchful and interrogative on the present subject ; all the more so as the period has been one of extraordnary pathological progress, and especially has brought to light very important new knowledge concerning syphilis; and I have every reason to believe that a present census of personal experience in this \u003c ountry would give just the same practical results as those which accrued from the formei enquiry. Indeed,",
         "100 11Im.C HEALTH I AA,1E in a few very important directions I an satisfied iyself that it does so. I may mention for instance that the Army Mediral Departnient has, during the last eleven years, had cognizance of 151,316 (adult) vaccinations and re-vaccinations performed on the soldiers and recruits of Her Majesty's service, where from the nature of the case the subjects of the proceedings are per- sons who aftervards permanently remain under medical obser- vation, and in whom, therefore, no syphilitic consequences of vaccination could possibly escape notice; where, moreover, the chances of latent constitutional syphilis in subjects furnishing the lymph nust be about the same as among our civil popula- tion, but ir. all this vast and critical experience, so far as is known to Dr. Balfour (the eminent and laborious reporter on the diseases of the British army) no single case has ever been al- leged of a soldier syphilized by vaccination. Indisputable cer- tainties, which any one can verify for himself, are:-First, that year by year millions of vacinations are performed in Europe with scarcely a solitary accusation transpiring that syphilis lias been communicated by any of them ; and secondly, that physi- cians and surgeons who could not fail to see such cases in abun- dance, if such abundance were a reality, concur with the almost absolute uniformity, hundreds of theni together, in declaring that they had never in their experience seen even a single case of the kind. One terse observation from the Board of Health Report of Ohio, and I have done : \" WV/en properly vaccinated by an intelligent physician, no disease could be produced by inoculation other than vaccinia, the one to be desired.\" Surely, for every practical purpose, certainties like these are our best guides, and with such certainties in our know- ledge it would be the merest pedantry to insist on infinitesimal speculative uncertainties. It may be some satisfaction to the learned and laborious writer\u003e, from whom I have quoted above, to learn that their views are fully coincided in by most of the lead- ing minds of the profession in Montreal. On Friday of last , week I submitted the following questions to the members of the Medico-Chirurgical Society of this city. Doctors are said to differ, and knowing, as I do, the difference of opinion of the members, on almost every medical subject, the unanimity of",
         "FoRLIU E1 LTH STATIStICs. 16f opinion on the following was most noteworthy. The meeting was an unusually large one, and the Secretary (Dr. Dcli) has kindly furnished me with the accompanying minute, with the permission of the Society for its publication : Moved by Dr. HmosToN, seconded by Dr. R. P. Howanix -ist. TIt vaccination confers a certain degree of immunity from sinall-pox, by cither pre% enting or modifying that disease. and. That that immunity is not always permanent but may be rendered so by re-vaccination. 3rd. That vaccination may produce in some instances a certain degree of inflammatory action, which nay be modified, increased or diminished by the age, constitution or condition of the patient, or by the state of the atmosphere. 4th. That vaccination does not, in any instance, produce scrofula or other hereditary diseases. 5th. That neither the evidence hitherto furnished, nor the experience of the members of this Society, is of a character to lead to the con- clusion that syphilis is ever inoculated with vaccine lymph. Carried. Members of the Medico-Chirurgical Society, present at the meeting on the 13th Of October, 1S76, all of whom supported the above resolutions:- Drs. T. J. Alloway, Wm. E. Bessey, John Bell, A. A. Browne, G. E. Fenwick, Wm. Fuller, R. E. Godfrey, R. T. Godfrey, Wm. H. Hingston, R. P. Howard, H. Howard, Wm. H. Mondelet, J. B. McConnell, Wolfred Nelson, Wm. Osler, Jos Perrigo, Alex. Proudfoot, John Reddy, Thos. G. Roddick, Geo. Ross, G. B. Schmidt, F. J. Shepherd, E. H. Trenholme. 0 FOREIGN HEALTH STATISTICS. United Kingdom of Great Britain, during four weeks, ending August 5th, 22,403 births and 15,211 deaths were registered in London and twenty-two other large towns. The natural ncrease of the population was 4,196. The mortality from all causes was at the average rate of 24.50 deaths annually in every 1,oon persnns living. Other foreign cities at most recer-t dates, annual ratio of mor- tality per 1,000: Calcutta, 23; Bonbay, 28 ; Pari,, 27; Brussels, 30; n- sterdaml, 24; Rotterdam, 27 ; The Hague, 36 ; Copenhagen, 24; Stockholm, 31 : Christiana, 30 ; Berlin, 46; Hamburg, 21 ; Breslau, 35 ; Munich, 36 Vienna, 24; Buda-\u003eesth, 4S ; Roume, 25 ; Naples, 3o ; Turin, 26 ; Alexandria, 49.-The Sanitaian.",
         "2 IT',IIt* AI.TII MAI GA/INf. MORTALITY OF THE CITY AND SUBURßS OF MONTREAL, FOR SEPTEM1mR, 1876. I IsI:A-i.. 2. Sm.al. k............................ 3 ..c rlatina........................ 4. Iiphthlierii ...............,...... 4- (I.i1ht.y...'........................ .. 7. W h piti ng .. h. .. .................. s. T\u003e p.h.i Fever (Infantile~ Re.mittent Fever) 9. T\u003e phu, an hantuile Fever......... to. Relapingi. Feveî........,........... . FIer............................. 72. Eryipla....................... 3. MetriaI, (Puerp.ral Fver) ............. 14. ta rb ..mee..... ..................... 15. ItIhuenza............... .......... 13. I 1tcry .... ............ 17 4 \u003e rc w . . . .. . .. . . ... . . .. . . . .. ... . . 17. P \u003ewia ........................... . I 17. 1'.eui..... ................ ...».i 19. 9 holera Infantum .................. 20. c holer............................ . 21. Aguie........... ............. .... 22. I.emaitteint FeNer ..................... 23. Cerebro.Spinal Meningiti............. I. Syphils............. ............... 2. HydropLoubia...................... 3. Glander......,.................... 1. P'riatiun........................ 2. Purpura and Scurvy ..................( 3. I Dchrium Tremnatis . 4- Alcoholism ..c ..,... 4. Intemfpe'ranIce.... ) . hl rush ....................... .... 2. \\orns, \u0026c................... .... . Gout ...........................à 2. kihunatim....................... 3. 1\u003eropsy and An:enmia............... 4. Cancer.. ...'..................... 5Noma (or Cank,r) ......... ... ........ 6' Mortification. . . ... . ... ... ... Scrofula .......................... 2' Tabrs Mescncterica................ 3 'Phthiis (Cûn. ofLun.gs)..............- H I-Iydrocephalus..... ................. 5 u. \u003eercular Meningitis................ Cazrredforward............ .. . Six..1 . 64 4N 112 3 2 5 1 I 4 2 b 3 r 4 2 2 1 1 16 20 3b 2 I 3 3 1 4 161 132 293 IV -l'a rai.I",
         "Mu 'k l \\l .111 RI'I URNs. I (s Ru r.\\uîrvTuv rFTl 'ITy ANI 0 sI'hÏU 1,1: \\fiM iu:A. -n. S. I . 2. 3. 4. 5. S2. 37. 1. 12. 3. I4. 1 O 3. 7. 8. Organs 2. VIT. Or- I. gans of 2 mDoti0n. Tréotal 1'y Sex. lethIl Sexe. Maie. Fernalo. 1101 132 293 4 2 fi 1 4 5 3 3 w| r ,n ./el jz art .................. p a i . .... ............ ........ .... Ap p e y .. ............... ....... . laralyi ... . . ................. . S b r .......,....................... E.i i ... . .................. .. ... Tea u ............ .................. Convul,i n........................ I trihti, l'eriardiis and Elndzcakditi.... Other liart di case ..c . .... ... . rnt tand T ... . n ................ ::::: ..... I'leuiri.. ............................. lnturnoial .... ... ........... . .. AsthmaW .... .. ............ . . . . uther l.ung d , ............... I astr ts ............ ............... Enteritiî ........ ............ ....... lritoniiti,. . ..... ..... . .. . . -..........- Ascite, .. .... ........ .. ....... ..... .. Ulceration of Intestine, ................ Ilernia .............................. lieus n Intuss ............. Stricture In t.................. Fistula .................. ............ I iease of Stornacli and Intestines, \u0026c.. l'ancreas isass, \u0026C ................. H etpatiti ..................... . . Jaunldice .......... .....I. ..... Liver Disease, \u0026c..................... Spleen iease, \u0026................. N e p ittriti................ . Isc iuria ............ Nephiria (Bright's I)isease) ............ Diabetes.... .... ........I............ Calculus, (Gravel, \u0026c)............ Cystitis and Cyatorrhoa ....... ..... Stricture ....................I........ Kidney i)isease, \u0026c................... Ovarian isea e ...................... D)isease of Uterus, \u0026c......c.. . A rthritis .... ................ ....... Joint Disease, \u0026c.....................3 I i t t Carried over..................... 212 168 380 5 3 1x 4 7 i 2 2 6\u003e 2 5 - 6 I 2 4 5 2 2 2 6 I 2 2 I i",
         "114 PUl1LIC H1FALTH1 MAGAZINE. MORT \\LITY OF TIIE CITY AND\u003e SUB1URBS OF MONTREAL.-(Cen. TTaltalic Total by S ex. . Q\u003e O Male. Female. ru // r....................... ... 212 1 68 38o l ce........................... Ilcer......................... Skinl Disease , \u0026c................ Stillborn....................... I'renafure Birth....................| Infantile Debility............................. Cyanosi\u003c......................... Spina Bilida and other falformation.... During Dentition.................... l'aramlenia.......................... Chilllirth .......................... Old Age .. ........................ Atrophy and Debility. ............... Fractures, Contusions, Wounds......... Burns and Scalds..................... POison... ... ........ .. I\u003erowning....................... Otherwie........................ Murder, Manslaughter........... Execution........................ Wouînd........................ P'oison........................... Drowning..................... .... Othenvise......................... Chirurgici........................... Not known.......................... Infection purulente................... Emesis............................. Lock Jaw.......................... S 2 10 I I 2 10 2 12 40 25 65 I 1 15 14 29 1 4 5 3 3 6 I I I I 3 2 5 Total..................... 295 222 5M7 o SYNOPSIS OF METEOROLOGICAL OBSERVATIONS IN SEPTEM.- BER FROM McGILL COLLEGE OBSERVATORY. Barometer readings reduced to sea-level and temperature of 320 Fahr. t Pressure of vapor in inches mercury. : Humidiy, re.ative Saturation, roo °Ten inches of snow is taken as equal to one inch of water. Mean temperature of montb, 55.965. Mean of mean maxima and minima temperatures, 56.3S. Greatest heat was 81.7 on the îst; greatest cold was 40.5 on the 2Sth,--giving a range of temperature for the month of 41.2 degrees. Greatest range of the thermomneter in one day was 21.4, on the 3rd and I th; least range was 4.4 degrees on the 19th. Mean range for the month was 13.or degrees. Mean height of the baromete· was 22.92 4. Highest reading was 30.426 on the i6th ; lowest reading was 29.453, on the 27th, giving a range of 0.973 inches. Mean elastic force of vapor in the atmnosphere was equal to .3633 ilches of nercury. Mean relative humidity was Si. iS. Maximum relative humidity was 99 on the Sth. Minimum relative humidity was 50 on the 13th. Mean velocity of the wind was 9.o miles per hour; greatest mileage in one hour was 25 on the 2nd. Mean direction of the wind, N. Mean of sky clouded was 69 per cent. Rain fell on 13 days. Total rainfall, 5.51 inches. Integ 2 I Dfi'I o *' 1 r I. 2. 3. 4. 5. 6. 2Chîid ren. . I. Of I Worn'n Si IIIold I People. -- Iv. of lion. I. 0",
         "MORTALITY RETURNS. 165 TOTAL MORTALITY BY AGFS. Under t ycar................. ............................ 04 From i tri 5 ycar,........ ....................................;63 S5 t 10 \". ........... . . . . . ....24 \" 10 t) 15 \" .. . .. . . . .. ... \" 15 to2 \"..... . . . .9 \" 20 to 40 \" .............. .. \"40 tio..0\".................................................... 2c4 to7 ... ......................................... :6 ......... . ..... . ............................. ............. 4 d90 t.uId.................................................... 4 100 yeair, l anover.. ........................................... Not knowo \"................................................. 6 Total. o................... 517 TOTAiL M1ORTALITY 13Y NA.;4*TIONA.LLITY. Frvnchi Canadian,........................................... ----358 Britis .................................................. 112 I \" .... .oo . ................................................... 22 0 erglisi a....... .............................................. i Scotchn w .. ................... .................................. 6 Other Countrin................................................ 6 Not known.. ................................................. 2 Total ..................... 517 TOTAL BY WARDS. St. Ann's W ard......... ......................................... 69 S t. An .in. . . ... ............................................. 6 St. Lawrencei ................................................... 53 St. Jak es . .................................................. 33 St.tMar.----.-**.--..... 1 st. ans W d. ......... ......................................... 69 Centre..n \"..................................................xo ESt..o.:. ...................................................63 Not known...... ................................................... I 494 City Hospital..... ................................................. 2 H otel Dieu ..... ................................................... 6 Montreal General Hospital............ .......................... Il Other Institutions...............................................4 Foundlings ...................................................... Outside City Limits ................................... ............ ... Total -.................... 517 N. B.-The foundlings and deaths outside city limits are not included in classification of diseases, ages or n.atonalities.",
         "166 x',111Uiu ULALTII M4/Nl il 1 14 -4 Cil I ~ wq tpJE1 -P rI sz th Il*jplJj1(.. ;3.. j'E: -__ ___ _ ri IlC O ,Ei . ý1 C, '. \u003e c .= . ;\u003c I\", 0 ~ Z~- .7t E o co",
         "GEn. A. BAYNEs, E M.D., Edifor I'10lir alh Maga:ine. I)VFAR SIR :-M attention has just been directed to an article that appeared in the last number of the PUBLIC HEALT MAGAZINE, of which you are said to be the Elitor, containing impertinent, unralled for, and %ery questionable remarks with reference to the Medical Faculty of McGill University, in con- sequence of which I shall feel thankful if you vill remove my name fron the list of subscribels, and let me know what I owe for the three numî.,ers of the second volume. If you, upcn reflection, consider that the ill-advised course you have aaopted, in endea·:oring to injure your \" Alma Mater \"- which most certainly has not been ungenerous to your family- is creditable, I most certainly do not envy you all the honor obtainable from it. Yours, \u0026c., W. E. iSCOTT, M.D. Afontreal, Oct. 4th, 18-6. The above letter which has been addressed to the Editor of PUBLIC HEALTIH MAGAZINE, calls not only for its insertion in our earliest number, but for a protest against such a misconstruc- tion of our best intentions towards our \" Alma Mater \" in the article to which it alludes. In the September number of Pu6LIC HEALTH MAGAZINE, we contrasted the Calendars of McGill University and Bishop's College, Lennoxville, in the curriculum given by the two Medi- cal Faculties; and we regretted that such meagre notice was",
         "Iob CORREMPONDENCE. given to the subjects of such able Professors as M cGill possessed, while, on the other hand, Lennoxville had given a full page to each professor in lier Medical Faculty, detailing the various branches that each subject treated of, and fully explaining the extent of the course to be lectured upon. Our attention, then, being drawn to the fact that Hygiene, as a study, in the Bishop's Colleg- programme, was brought to the front on equal terms and lonor with the other subjects of the Medical course, and was to be a compulsory subject for the degree, we naturally enough pleaded with McGill to give the same prominence in her course, asserting that her friends had every right to expect it, from the fact that she had, in the last year, raised the subject to a chair in the University, and called an eminent man from an important chair in Lennox- ville to fill it. We certainly gave a free opinion on op- tional subjects, based upon our own observation of them; and it was because the importance of the subject for the well-being of the student and his future usefulness is thoroughly acknowledged on all sides, that we pleaded hard to have it made compulsory; and one of these days it as- suredly will be. Now we are accused, -while urging this most reasonable view, of having used \"impertinent, uncalled for, and very questionable remarks with reference to the Medical Faculty of McGill University.\" We protest against such language as being reitherfair nor true. First; taking the term imperti- nent as alluding to the subject-for it is scarcely credible that a gentleman would use it personally-we, maintain that it is exceed- ingly pertinent, and of great weight and importance, and has a full bearing on the subject in hand, and we shall not cease to urge on our Medical Faculty the full adoption of the sub- ject into lier required course. Next, as to \"uncalled for \"; if Hygiene, as the foundation of all sanitary progress, does not confessedly stand at the head of curative science, then to urge the University to adopt it with energy and zeal was \"un- called for \"; but if, on the contrary, there was a manifest slight shown to the subject by shelving it as optional, when every man of intelligence is studying it in self-defence and for the good of the public at large, then it was not \" uncalled for.\"",
         "PUBLIC HEALTI MAGAZINE. Lastly, that they were \" very questionable remarks with reference to the Medical Faculty,\" we utterly deny, and appeal to the article itself, in which, as plainly as language can speak, we spoke in the highest terms of the ability of the Professors, and complained only that they were not as fairly advertised as they ought to have been. That the Professor himself who holds the chair of Hygiene did not think we were using \" very ques- tionable remarks,\" is evident from the fact that the first time we met after the publication of the article, he thanked us for the manner in which the subject had been treated. And here we should drop the matter, but Dr. Scott volunteers a statement which so truly comes under the category of \" very questionable,\" that we are bound to notice it. After bidding us reflect on the ill- advised course adopted in endeavoring to injure our Alma Mater-to which we boldly say \" Not Guilty,\" and call for a verdict of acquittal from every /onest man-he adds that \" our Alma Mater \" \" most certainly has not been ungenerous to your family.\" We really do not understand where the generosity of the McGill Medical School has been displayed more to ns than to any other students, for in the education of our family, the same fees paid by all students to all Professors were paid by our- selves, and we are therefore at a loss to conceive where the gen- erosity has been exhibited. But enough ; the name is removed from the list of subscribers, and we can only add that if an honest, friendly article, like the one in question, is a righteous cause to desert our effort for the public good, then the sooner we hand over the publication to a more time-serving and obseguious editor the better.-(ED. PUBLIc HEALTH MAGAZINE.) COMMUNICATION received from N. E. B.-\" Muffs versus Mitts.\"",
         "DICTIONARY OF HYGIENE AND Puntic HEALTH, comprising Sanitary Chemistry, Engineering, and Legislation, the Dietetic Value of Foods, \u0026c., \u0026c., on the plan of the \" Dictionnaire D'Hygiéne Publique \" of Prof. Ambroise Jardien. By Alex. Wynter Blyth, M.R.C.S, F.C.S., \u0026c., \u0026c. (Chas. Griffin \u0026 Co., London). The work now offered to the public aims at Iilling a vacant place in English sanitary literature, namely, that of a book of reference, which, in one volume of convenient size, shall contain the information on sanitary topics at present only to be gathered from the perusal of many separate and distinct treati ;es. It is not intended solely and entirely for any particular class. Sani- tation is universal-it concerns every living unit of the State, and is of equal value to all; therefore, although the special wants of the practical hygienist, and medical officer of health and public analyst, have naturally claimed the first place, and received the attention which their importance demands, Dr. Blyth lias throughout endeavored tu render intelligible to non-professional readers also, every subject susceptible of such treatment. A special feature of the present w ork is that it contains, in a forrm admitting of easy and rapid reference, the vhole of the Public Health Act of 1875, as well as sections and portions of the sanitary statistics without alteration or abridgement, save in a few unimportant instances. It contains numerous and well exe- cuted illustrations, besides charts, and a map of the geographical distribution of health and disease, (by permission from Keith Johnston's Physical Atlas). The value of an undertaking of this kind must always be in exact proportion to its accuracy and completeness, and, bearing these conditions in mind, the author has spared no pains to fulfil both of them. We venture to pre- dict that although there are a few shortcomings, it will prove a useful work. It fi1s a want long felt, and as such will find a place on the library shelves of those interested in sanitary progress.",
         "REVIEWS. 171I MANUAI. FOR MEDICAL OFFIcERS oF HEALTH. By Edward Smith. M.D., LL.B. (Lond.) F.R.S., Fellow of the Royal Collegre of Physicians, \u0026c., \u0026c. (Knight \u0026 Co., London) Second edition. The absence of any well established scheme of action on the part of our governments, necessitates the action of local corpo- rations. But our Board of Health, having less experience than those in England, we of course naturally look for information abroad ; besides, the experience of the English Boards is far be- fore that of any other nation, so we cannot do better than endeavor to follow out the advice given by those wlho have made Sanitary Science a life long study. We commend to our Health Officers the many new and valable suggestions to be found in Dr. Smith's manual. The science in some of its aspects will be comparatively new to the Medical Oficers and Inspector; and newer still to the members of the Board. It embraces much that is not included in medical education, and which can be acquired by special study only. The author has taken a wide range, and offers a variety of information on the nost important parts of the subject, It is difti.:ult to lay down special duties to be performed by all health officers, as in every district circumstances alter cases ; but there are general principles which must be understood and acted upon at the discretion of the health officer,-these are laid down very distinctly by the author. We would suggest that our Board begin by forming a library of reference upon sanitary science) and supply our officers with all the perfected information that is available Such money would be well invested, and repay in the end every dollar of outlay a thousand fold. Dr. Smith', work should be one of the first purchases. CID \" On Personal Care of Health,\" by B. A. Parkes, M.D., F.R.S. \" Industrial Canada,\" bv A. Baumgarten, Ph. D. \" Address of the Preside t of the KuZos Club.\" \" Physicians' Combined all Book and Tablet,\" by Ralph Walsh, M.D. (Second Edition).",
         "PUBL1C HEALTHI MAGAZINE AXD L1TERARY REVIEW. NOVEMBER, t876. PUBLIC REALTI IN ST. JEAN BAPTISTE TOWN. Sometime ago. the Cure of St. Jean Baptiste Town ap- plied to the Board of lealth. in this city, for permission to send five patients froi the municipality to the Civic hospital. This involved the question of expense, which was promptly met by the kind-hearted priest, who believed the municipality would be only too happy to pay the small sum of half a dollar for each patient; and added, \" if they refused, rather than sep these poor parishioners of mine suffer, I will pay it myself.\" Mr. Radford promised to sec the Mayor, and upon this understand- ing the patients were admitted. On Wednesday last, Mr. Radford reported to the Board of Health \" that he had, along with Dr. LaRocque, seen his Worship, of St. Jean Baptiste, who informed him that the Corporation had declined paying for such cases, the reason given being that they were too poor. On examining the mortuary returns for the last eight weeks, it was found that sixteen deaths had taken place from smnall- poe. Now, assuming that St. Jean Baptiste had a population of 7,000, and Montreal 12ò,000, and that in the latter the death-rate from this disease was equal to that in the former, we should have 194 deaths per month, or 54 in excess of what it really is. \" During the sanie period, three deaths had occurred in thz town from Typhoid ; if the same ratio existed within the citv limits, we should have 348 per annum fron this disease, whereas 122 deaths from this cause occurred. It will therefore be seen at a glance that the outlying municipalities cannot be allowel to remain as they are, if St. Jean Baptiste is a true specinen of the rest.\" Instead of being a healthy retreat for our citizens, it is clear that this suburb is in a most unsatisfactory condition, and that with all the energy and effort that is being used in Montreal, we eau never hope to be in a good hygienic condition, so long as no means exist compelling the authorities to exert themselves in putting down the wide-spread disease which flourishes under their present rule."
      ],
      "identifier" : [
         "8_05170_17"
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      "published" : [
         "[Montréal? : s.n., 1876]"
      ],
      "title" : [
         "Public health magazine [Vol. 2, no. 5 (Nov. 1876)]"
      ],
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      "pkey" : "oocihm.8_05170",
      "label" : "[Vol. 2, no. 5 (Nov. 1876)]",
      "key" : "oocihm.8_05170_17",
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         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine"
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         "text"
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      "lang" : [
         "eng"
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      "note" : [
         "Monthly."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Covers restored and/or laminated/ Couverture restaurée et/ou pellic'ilée Cover title missing/ Le titre de couverture manque Coloured maps/ Cai tes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured. stained or foxed/ Pages décolorées, tachetées ou piquées D Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison D Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "\u003c1MEDIGAL GRITICISMIX No. /8-December 801h, 1882, A Weekly Sheet, b\u003e' DAVID 'ED\\ARDS, pub/lhsed om Sa? urday-, and so1l? at Iavlkis \u0026 (-o'\u003e 67 Yonge Street, Toron/to. PRICE 50 CENTS -Copies oi any single number can be had, in quu.ntitics, at 15c. per dogon. FEVER. A physician of this city gives the followinig illustration of the nature of fever,-A mnai rushes along the street, crying \"cFire ! The threatened. destruction of his property incites him to do so ; his strength is the propeZing cause of the disturbance; the loudness of the alarm will correspond to the strength of his lungs. There are three ways by which the disturbance may be quelled ; L_(1) reduce the mian's strength, bleed him, starve him, administer poisons to him : and his crie-s and excitement wvill abate by degrees ; (2) sustain the systemn; give him milk and eggs, brandy and quinine, and then tell him to extinguish the fire : (3)~ lend a hand at once ; aîd hlm to remove the excdling cause of his trouble. and he will soon recover from the exhnustion entailed by the vigorous exercise of his lungs. The excî2ing causes of fever are as numerous as are the modes of prevent- ing the healthy action of every organ and tissue of the body. Another illustration the doctor presents in the following form- Floodwood blocks un a watercourse, the water cons,,iqteiitly, overflows the meadow ; the flo-odwood is the excdting cause; the overflow of water resuits in an inundation ; similarly obstructions to the ree action of nerves and bloodvessals are the excjling causes of fever- and inflamu:nation; but the propelling- cause of the fever, \u0026c.. is the vital force. STORIES ANCIENT AND -MODERN. A«nd there ran a young man. and told Moses. and saifl. Eklad and Medad do prophesy i-n the camp. And Joshua. the son of L'Çun, the servant of Moses, 'one of his young men, answered and said,.iMy% lord Moses, forbid themn.- And Moses said unto hirn, Enviest thou f'or my sake ? would God that all Jehovahi's people were prophets. and tha.t Jehovahi would put his spirit on them -N\\um. xi. 2Î-29. And John answered hlm. saying, Master. we -saw\\ onie castig ont devils in thy name. and he folloveth not Us .and Nwe forbade hirn. because he followeth not us.-Mark ix. 38. The Reverend Johni Wesley, on hearingy a complaint of a per- son having practised the healing art, and effected cures, wvithout hav- ing received'a diplom-a, observed that L-he who heals is a physician\" (What are they wvho do not heal1?) IThose however who, having been residents in Ontario, and (having) begun their medical studies here have sought Registration elsewhere. must not expect that by such kegistration, nor by having passed any examinations abroad, ?howeyer s1ringen, that they wvill be allowed to register and to practise here, and thus evade the exam- inations estaldished by the CouncA. of thie College of Physicians and 6f Ontario. \"-Onlariaiz .?edicaZ Regisler.",
         "2 D1ARRHRLA AND D-£SENTERY. Strong's Choiera-Mixture, according to an East; Jndia Army-phy- sician's prescription. We understand, t hat the above mixture is Pro- curable at Gait, and we are assured on excellent authority, that it has been used in multitudes of cases, and has neyer been known to fail. VACCINATION. The subjoined letter lias crossed the Atlantic twice; it was ad- dressed by the physician ivhose name it bears, to Professor J. Dobsori. M.D., of Fairfleld, Coun., in Nýovember last, and appeared in Nije .Eczo, of London, on the àth inst. \" 3 Woodlawn-street, Lynn (Mass.\u003e. Nov. 18, 8. \"Profçssor Dobson,-Dear Sir,-My mother had a bad arm, caused by vaccination, by Dr. Woodman Home, of Lynn. Mrs. Elleri Moulton, who lived in the viciniity of Blakeley's Brickyard, Lower- hili, Lynn, died frorn vaccination. Jerry Feelows, of'Salem, died from small-pox, after having been vaccinated near a dozen times. I arn told he had small-pox three times, and died with it. Frank Alley, of this city, has hiad small-pox twice ; he wvas vac.cinated. . . Mr'. Fred. Stodard, Ally-street, Lynn; two children very b-ad from vacci- nation. Mr. Lucien Newhal's stepson, bad arru; Johin Dillon. of Commercial-street, Lynn; Dr. Rogers, of Western-ave. and Fra.nklin- street, very bad case of vaccination, wvas vaccinated by Professor Morrili 'Weyman, Cambridge; Webster Blrown and -%vife both hiad small-pox af ter vaccination; they live in Shephard-street. Dr. Abbott, of Wakefield, Mass., hired a cow in Sangus. and inoculated her with small-pox matter from patient. Hie tolld the owner of the cow that it -%rould be ail riglit to seil the milk, which, was done. to a milkman, and the case came to the notice of A. A. Carleton, nilk in- spector, -%vho gave me the facts. James Ed. Potter. 4!) Lake-street. Glenmere, Lynn, twvo chiîdren and self (vaccinated); one cliild died from vaccination ; the other is a cripple for life. Hfe was taken to, the City Hospital, Boston, and a verdict of poisoing by impure virus was rendered. M.JP.Esm ,ofBston, MINass., poisoned by vaccination. 1 could find five hundred such cases in a month. if - 1 were paid for my timne to look thern up. Dr. Noyes can testify to the truth of this statement. I know of others, but 1 have not their names at present. 1 cani testify before any Court or elsewhere as to ail the statements I i-ake.-Hastily and respectfully yours, (Signed) \"J. E. FROTHINGHAM N, M.D.\" Jýý In the event of any irregularity occurring in the delivery of this publication, the Editor requests that lie may be addressed respecting it. The price of \" MEDICAL CRITICIS' * for 1883 (the size being \"PULPrrITICS by the sane author. solda-t HAWKINS \u0026 CoA'. 67 Vong-e Street- Price $z.oo per annuin."
      ],
      "published" : [
         "Toronto : [s.n., 1882]"
      ],
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         "8_05107_19"
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      "type" : "document",
      "title" : [
         "Medical criticism [No. 18 (Dec. 30, 1882)]"
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      "source" : [
         "University of Western Ontario, D.B. Weldon Library, London."
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         "text"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur Covers damaged / Couverture endommagée Covers restored and/or laminated I Couverture restaurée et/ou pelliculée Cover title missing / Le titre de couverture manque Coloured maps / Cartes géographiques en couleur Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible IJ Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. ri ri Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées w w Et' Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning I Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE SANITARY JOURNAL. VOL. V.] JUNE I5TH, 1883. [No. 9. IS VACCINATION AS IMPORTANT A PREVENTIVE OF SMALL- POX AS IT IS COMMONLY BELIEVED TO BE? BY THE EDITOR, EDWARD PLAYTER, M.D. At the present time there is no question pertaining to the preven- tion of disease of more importance, or receiving more attention, than that of vaccination. The recent experiments of Basteur have in- creased the interest taken in it. The whole question is one of the utmost importance in relation to the public health. To what extent will vaccination prevent small-pox, and are the advantages of the practice sufficiently great to outweigh the disadvantages, are ques- tions asked by those who feel the deepest interest in the subject. That there are disadvantages, in the form of serious consequences following vaccination, is unquestionable. Of late these serious con- sequences seem to have been of more frequent occurrence, or to have attracted more attention than formerly, and wide-spread opposi- tion to the operation, and especially'to the principle of compulsory vaccination, has been thereby created. If the practice has, of itself, been so far instrumental in preventing small-pox, as its strongest advocates assert that it has been, it is probable that the serious con- sequences referred to which have followed it on occasions, have not been of such importance as to warrant its discontinuance. The cases in which death has seemingly directly followed, or been caused through, or by means of the operation, on the whole, have been numerous. I will only here allude to the possible evil consequences, other than death, consequences upon future geneiations,-upon the race, which may be vastly more far-reaching than death itself, which, even though we have no direct evidence of it, it is not difficult to conceive, may follow the introduction into the human body of the vaccine poison. I desire not to be regarded as one opposed to the practice of",
         "THE SANITARY JOURNAL. vaccination, but rather as one who, in view of the many evils re- ported to have followed it, and other possible evils just referred to, has become somewhat sceptical and critical, and who would most carefully and fully, and in every light, examine all evidence relating thereto, favorable or otherwise. It is difficult, on first view, to believe, from the statistics which have been brought forward by those who are favorible to it, that it has not in the past, with less perfect knowledge of the value of other sanitary measures, been of value, a necessary precaution, and a pre- ventive of the spread of, and mortality from, this most loathsome dis- ease, smali-pox; and it is just possible that it will be best to continue it, for some time to come, at least. But I desire to say here at the outset that, after carefully examining and sifting all the obtainable evidence, pro and con, in regard to the measure, I fear that it has been and is too much extolled, and too much relied upon, to the comparative neglect of other, and, it appears me, more strictly scien- tific preventive measures, and that it is opposed and repulsive to nature. It is said that figures cannot and do not lie, but unques- tionably they may, if they are not carefully weighed and investigated in all their relations and bearings, greatly mislead. I propose, therefore, to bring forward the strongest evidence that has been advanced on behalf of the practice of vaccination as a preventive of small-pox, and to examine its value so far as space and time will permit; then to notice, very briefly, some of the evils which have been the consequence of the practice ; and, finally, the methods of checking the progress of small-pox without vaccination. Before proceeding to this, however, I desire to drawv attention to a few points relating to the history of vaccination which will be of interest, and which will bear more or less strongly upon- the evidence. In the original essay of Dr. Jenner, published in 1798, entitled, \"An Enquiry into the Causes and Effects of the Variole Vacciner a Disease discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the name of Cow-pox,\" the author gives it as his belief that the disorder does not originate with the cow, but is communicated to that animal from the horse, where it appears on the heels, and is known by the name of the grease. Later observations have established the identity of the twO disorders, cow-pox and grease, and equination (the communicatiol of the disease from the horse direct to man) has been practised ont 228",
         "THE SANITARY JOURNAL. the Continent of Europe and in India. Jenner next suggested that the small-pox itself may have been originally morbid matter of the same mild kind, changed by accidental circumstances into that con- tîgious and malignant form with which we are now too familiar. More recently it has been shown, by experiments, that the cow may be inoculated with the small-pox virus, and that by passing through the animal it is converted from snall-pox into vaccine. Jenner next stated his conviction, and four years later, in his petition to Parlia- ment, confidently ainounced, that the cow-pox, when it has once passed through the human body, renders through life the person inoculated with it perfectly secure from the infection of small-pox. How far from what time has proved to be the fact is this last sweep- ing assertion we all know. In his earliest statements Dr. Jenner led t the belief that the cow-pox in the cow was generally a local disorder confined to the udder. But more recent observations have shown that it is a constitutional febrile disease, accompanied with eruption, sometimes very severe and frequently fatal. The animals in severe cases, after appearing dull and stupid for a day or two, are seized with distressing cough, accumulation of phlegm in the mouth and fauces, and loss of appetite. On the fifth or sixth day pustules make their appearance all over the body, but especially on the abdomen, accompanied with much general distress and fever. The pustules go on to ulceration, the hair falling off wherever a pustule runs its course. The mouth and fauces in bad cases become one mass of ulceration, and mastication is so impeded that death seems to follow from inanition. An epizootic has been reported as occur- ring in India in which the mortality was estimated as being from i5 to 20 per cent EVIDENCE IN FAVOR OF VACCINATION EXAMINED. We have tolerably reliable statistics which show that there was a gradual increase in the proportion of deaths from small-pox in London, England, from about the year 1630 to 1765, or during a period of about 135 years. Since about the year 1765 down to about 1865, there was a gradual decline in the mortality from this disease. The rise and fall was not, of course, gradual, but subject to great fluctuations. The decline, it must be observed, commenced over a quarter of a century before vaccination was practiced, though the mortality appears to have fallen more rapidly after this. Figures, seemingly reliable, show that there has been, on the whole, a greatly reduced mortality from this disease during the present century as 229",
         "THE SANITARY JOURNAL. compared with the 18th century, though there have been some especially severe epidemics. There was one epidemic in 1805, not long after vaccination was discovered; another in 1825. Dr. Barron, the friend and biographer of Jenner, says the disease was nearly as prevalent in London in this year (1825) as during any of the three great epidemics of the preceeding century. In 1838, '39, '40, in spite of vaccination, which had become very general, small- pox killed in England and Wales, 35,833 persons. In 1870, '71, '72, '73, the worst epidemic, it appears, of the century prevailed, reaching its climax in 1871. In it the mortality appears to have been, proportionately, almost as great as in any of those of the 18th century. Regarding this one, D. Manson Fraser, M.A., M.D., F..S., a strong advocate of vaccination, gives us a valuable but sort of apolegetic paper in the Sanitary Record of April last. A large part of his argument goes to show that whilst, as he himself has it, \" in the epidemics of small-pox which occurred before the introduc- tion of vaccination, the mortality caused by the disease was almost exclusively amongst the very young,\" (from 8o to 90 per cent. of the deaths being of children under r years of age), from his figures, it \" appears that in the epidemic of 1870 to 1873, the number of deaths from small-pox amongst children under 5, as compared with the total number of all ages, was very much less than it was in the 18th century.\" Again he writes : \" It is held, and the opinion is based on wide clinical observation, that while vaccination cannot, under any circumstances, be called an absolute protection against att'ack of or death by small-pox, it is, when efficiently performed. an almost absolute protection against attack of and especially death by that disease during the earlier years of life ; and when followed by efficient re-vaccination, the protection is renewed for a further period of years.\" Observe, what a backing down is this from the strong language used in the time of Jenner, as regards the preventive influ- ence and the permanency of vaccination. Near the commencement of his paper Dr. Manson writes that the occurrence of the epidemic \" was fully expected,\" from a certain tolerably definite law of periodi- city ; but \" wholly unexpected, however,\" he adds, \" was the extrene intensity which the disease assumed all over the country.\" The prevaleney of the disease had so diminished that in many quarters, he says, \"extravagant hopes had been formed as to the efficacy of vaccination as a protection against small-pox. The great extent, therefore, and the extreme virulence of the epidemic came as a conm- 230",
         "THE SANITARY JOURNAL. plete surprise.\" So writes one of the strongest and most able advo- cates of vaccination. In Bavaria vaccination has been enforced over three-quarters of a century, with, apparently, very unsatisfactory results ; the govern- ment since 187 1 have issued a series of questions to local authorities and public vaccinators, constituting a sort of investigation (Fried- reich's Blatterfur Gerichtliche Medicin). In the 22 years, 186o-81, inclusive, there were in the kingdom, which comprises a population of about 5,000,000, 79,534 cases of small-pox, with 1,3oo deaths ; or a yearly average of 3,615 cases and 513 deaths-a mortality of 14.2 per cent., or about i in 7. During a ten years' epidemic period of this time, 1865-74, the yearly average was 8,543 cases, and 1,093 deaths ; and in 1871, 30,742 persons were attacked, 4,784 of whom died. And, somewhat strange, if vaccination is of much value, 29,429 of these, or 95.7 per cent., had been vaccinated. Now, how far does all this go towards proving that vaccination exerted any particular influence in reducing the death-rate from small-pox ? What evidence have we of any causal relation between the decrease in the mortality from small-pox and the diffusion of the practice of this discovery of Jenner ? The statistics of that great statistician, Dr. Farr, show us that small-pox began to be much less fatal, as I have stated, during a period of more than a quarter of a century, or about 30 years, before vaccination was discovered. It began to decline soon after the great rise following the practice of inoculation, and the discontinu- ance of this practice. It appears that we have these great waves or curves-rises and falls-made up as it were of smaller waves, and extending along for generations and even perhaps centuries, in the mortality from, or pre- valence of, epidemic diseases, the cause or causes of which we are unable to explain. It appears that it may be that the particular disease becomes so prevalent and universal that it eventually gives rise in the constitution to a sort of hereditary insusceptibility to itself, for a few generations, when it commences to recede and be- come at once less frequent and less fatal. Again, it seems probable that the influence or effect upon the system of any one of the epide- mic diseases may tend strongly to prevent for a time, long or short according to circumstances, the same organism becoming the sub- ject of small-pox, or indeed of any other of the epidemic diseases. It is now admitted that the cow-pox only protects for a season, as it 23I",
         "THE SANITARY JOURNAL. were. The period of protection may be becoming shorter and shorter, however long seemingly at first it may have been, and the hereditary insusceptibility to its protective influence may be gradu- ally increasing. It was at first believed, as Jenner declared, that this influence would be continuous, and would render the constitution for ever after secure from the infection of small-pox. We know now that this is very far from being the case. It is very well known that the effect upon the system of many diseases, or rather probably of their accompaniments-the treatment, the hygiene of convalescence, the rest, is of a renovating or protective character, and that the sub- jects of them frequently experience greater vigor and freedom from disease for a long time thereafter than they had previously experi- enced. The fact, as appears, that while small-pox has decreased, measles and hooping-cough have increased, is brought forward as an argument in favor of vaccination. It appears probable that enteric fever and diphtheria have also increased in frequency during the pre- sent century. May not the increase in the frequency of these dis- eases have contributed to the decrease in the frequency of small-pox ? The improved general sanitary condition of the large cities, such as London, when the present century is compared with the 18th, is be- lieved to have had a marked effect in preventing the spread of, and reducing the mortality from, small-pox, and it cannot be doubted that the improvement in this regard, together with disinfection, isolation in hospital, and the greatly improved methods of treat- ment of cases of the disease, have contributed very largely to the reduction in the death-rate from it. We have the best of evi- dence, theoretical and practical, that outbreaks of the disease may be invariably stamped out at once, irrespective of vaccination, as I shall refer to more directly further on ; and if all outbreaks were thus stamped out as they occur, we should soon be free from the disease, without this questionable practice. The fact that in spite of com- pulsory vaccination a most severe epidemic of small-pox prevailed in Great Britain in 1871, the percentage of deaths from which, com- pared with the total number of deaths from all causes, being, it ap- pears, from a chart by that veteran Sanitarian, Dr. Guy, I think, nearly as high as that in the epidemics of last century, with the'fact that the epidemic was soon checked, not by vaccination alone, cer- tainly, but by isolation, quarantine and disinfection, affords evidence, that we may rely too much on vaccination as a prophylactic in small-pox. 232",
         "THE SANITARY JOURNAL. Moreover, the disease under consideration is of such a loathsome character and withal.so fatal, that since preventive -measures have become known 'and their practical value understood, they have been and are applied to the stamping out of small-pox with probably tenfold more vigor than they are applied to the stamping out of any other disease, or especially of the milder and vastly less terrifying ones, such as measles and whooping.cough. The cholera, an exotic disease it is true, has been, without the application of any such prophylactic as vaccination, but by other, and I must say, more rational and scientific sanitary measures, bereft of its terrors, and is now almost unknown in Europe. Now let us notice different, but perhaps somewhat stronger, evi- dence in favor of vaccination. During the period between the institution of the first civil registra. tion act in Great Britain (1836) and the passing of the first compulsory vaccination act in 1854, a period of 18 years, the annual average death rate from small-pox in England and Wales was 420 per mil- lion, while in the following 28 years of compulsory vaccination, it fell to 196 per million, or to considerably less than hall. This is re- garded as a strong point ; but we must bear in mind that the first of these periods was comparatively a short one, and if a few years of absence from epidemics of the disease were added to it, a greatly reduced mortality in it would be shown. In fact, the reduced mor- tality in the latter period, in view of the great fluctuations in the mortality from the disease, during the last two hundred and fifty years, does not prove anything. Again, in view of the recent proposed motion for the repeal of the compulsory clauses of the Vaccination Acts in the Parliament of Great Britain, Dr. W. B. Carpenter has addressed a letter to the Rt. Hon. Lyon Playfair against the motion. He points out that great reduction in the mortality from small-pox followed the two principal legislative measures for the promotion of vaccination. But he did not state that these two principal legislative measures were enacted on the decline of two great epidemic periods ; such periods being invariably followed by a decline in the mortality. It appears, on the other hand, from the Annual Summary of the Registrar-Gen- eral for 188o, that there has been a great increase in the number of deaths from this disease since the commencement of compulsory vaccination. In London, probably the best vaccinated city in the world, in the decenniad between 1851 and 186o, there were 7,150 233",
         "THE SANITARY JOURNAL. deaths from small-pox; in the next decenniad there were 8,547 deaths; and in the last, 1871-80, there were 15,543, or much more than double the number of 20 years before, while the mean popula- tion had increased less than 40 per cent. in that period. Hence, though the mortality has been from this disease much less since compulsory vaccination than it was before, it has greatly increased since the practice was first made compulsory. So it is that figures may mislead unless carefully considered in all their bearings. THE STRONGEST EVIDENCE. We now come to what is regarded as the strongest evidence in favor of vaccination : the relative mortality amongst vaccinated and unvaccinated persons in hospitals. During the eight years, 1871 to 1878, there were admitted into the small-pox hospital at Homerton, 6,553 cases. Of these, 1,626 bore one or more good marks ; 2,657 had only imperfect marks ; in 793 persons there was no evidence of vaccination, although the patients stated that they had been vacci- nated ; while 1,477 never had been vaccinated. It is estimated that there was only five per cent. of the population who had not been vaccinated, or had not had small-pox, whilst the proportion of unvaccinated persons admitted in hospital was about 22 per cent. of the whole. It is argued from this, taking into consideration the number from whom the univaccinated were drawn (5 per cent. of the whole), that unvaccinated persons must be far more susceptible to the disease than the vaccinated. The death rates of those admitted are considered to furnish the most reliable or least doubtful evidence of al], on behalf of vaccina- tion. Amongst those having good marks, the death-rate was only 3.32 per cent. ; amongst those having indifferent marks, the death- rate was L 1.10 per cent. ; while amongst those on whom no mark could be found, but who stated that they had been vaccinated, the death-rate was 27.23 per cent. ; and amongst the unvaccinated it was 45.76 per cent. The experience of this hospital was borne out by that of other hospitals. In Bavaria, too, the investigations which have been made in the last decade, furnish results similar to those in England. Furthermore, it appears that nurses and attendants in small-pox hospitals who have been re-vaccinated, very rarely take the disease.. But the above figures may greatly mislead, unless certain points relating to them are carefully scrutinized. Before conceding that the fact that the 5 per cent. of unvaccinated persons outside of the 234",
         "THE SANITARY JOURNAL. hospitals, who furnished 22 per cent. of the unvaccinated suffering from small-pox in the hospitals, is nearly as strong evidence in favor of vaccination as it appears in the abstract to be, we must know something more about these 5 per cent. of unvaccinated persons outside who contributed the 22 per cent. of unvaccinated patients. Were they not of the poorer, or indeed of the poorest classes ? Were they those most exposed to the disease, and who from their general habits and environments were most likely to take small-pox, or any other prevailing epidemic ? Who are they who usually es- cape vaccination ? What is their character ? Comparatively few were so strongly opposed to the practice as to refuse to undergo the operation, and it is probable that most of the 5 per cent. of unvac- cinated persons referred to were the very ones who of all others, in a large city-the improvident, the unsettled-who would be most exposed to, and from their habits, prone to take the disease. Fur- thermore, the very ones amongst whom by far the greatest mortality would most certainly take place in hospital, or anywhere. We have no figures or other evidence to prove that it is chiefly persons such as I refer to who do not get vaccinated, but it is, I think, a fair and reasonable conclusion. Again, as a rule, I think we find that those persons who pos- sess the best general constitutions, develope the most perfect vacci- nal mark, and small-pox in such persons is least likely to prove fatal, the ratio of mortality amongst such being doubtless the minimum. I do not wish it to be understood that I believe that the differ- ences in the mortality in the different classes of patients in hospital, as shown by the figures above given, can be accounted for in the way I have just indicated, but I am persuaded that these differences may be in a measure, or to a certain extent, accounted for in that way, and that the protective influence of vaccination is not, to say the least, quite so great as the hospital returns would, on first view, lead us to suppose. There can be no reasonable doubt that the passing through the human body of the disease called the cow-pox, affords to that body for a period of time, probably of a few years' dura- tion, a certain amount of protection from small-pox-even greater pro- tection than would be afforded by an attack of scarlet fever or measles. Since writing the above, I observe that the Medical Times and Gazette (London, Eng.) of May 12, 1883, after noticing similar evidence, states that \" there is no other way of accounting for this fact than by allowing that vaccination affords some protection, which may in time wear out.\" This is not saying much. 23",
         "THE SANITARY JOURNAL. THE EVILS SOMETIM ES FOLLOWING VACCINATION. Now as to the evils which may and as we know do result directly from vaccination, I will be very brief and refer to only one fact. A Parliamentary return, Great Britain, 188o, gives the following statis- tics of deaths resulting from inoculable, and therefore vaccinal, dis- eases, for a period of about thirty years, just previous, comprising the period of compulsory vaccination :-The deaths from syphilis, of those under one year of age, had increased during that period, according to the return, from 564 to 1738, per million births-ob- serve, having no relation to the population, or increase thereof; the deaths from skin diseases had increased from 183 to 343 ; from scrofula, from 351 to 908 ; and from mesenteric disease, from 2981 to 4373. We do not know that the great increase in the proportion of deaths from these causes was the consequence of vaccination, any more than we know that vaccination will prevent small-pox. We have the facts and can only draw our own inferences. I will but just allude to the possibility that, in view of the contagiousness of tubercular disease and its frequency in the cow, vaccination with animal virus may prove as dangerous as arm to arm vaccination. VALUE OF ISOLATION, QUARANTINE AND DISINFECTION. Before concluding, I desire to draw attention to preventive mea- sures, other than vaccination, for the suppression of outbreaks of small-pox. As an illustration of their value and practicability, I shall refer to their application in one city, only. In Leicester, England, a city of about 130,000 inhabitants, an experiment of a most valuable and interesting character for the limitation and stamp- ing out of this disease has been tried and with the greatest success. Leicester is said to be the worst vaccinated city in the kingdom. In 188o-8i the number of children vaccinated did not much exceed half the number of births, and there have been there more prosecu- tions for breaches of the Compulsory Vaccination Acts than in all the other large cities of the kiigdom put together. During the first six months of last year there were 29 cases of small-pox admitted into the small-pox hospital, representing 19 distinct importations or outbreaks of the disease. Many of these outbreaks were at the lowest lodging houses, where under ordinary conditions the disease would be most likely to spread. The practice of compulsory notifi- cation to the health authorities of cases of infectious diseases is carried out there, and each case, immediately on being known, was promptly reported, and health officers at once visited the premises 236",
         "THE SANITARY JOURNAL. where the outbreak occurred and removed the patient and all in the house, together with all who had come in contact with the patient, to the hospital. Those not affected, were placed in quarantine, where they were given a bath, and where they remained till their clothes, and the house from which they had been removed, had been thoroughly disinfected. They were then allowed to go home, but the house was kept under the supervision of the sanitary inspec- tors until all danger of a further spread of the disease was at an end. In every one of the 19 instances the method was completely suc- cessful and each outbreak was at once and effectually stamped out. SUMMARY OF CONCLUSIONS. That while it appears evident that vaccination affords a certain amount of protection against small-pox, the evidence which has been advanced in support of its protective value, on careful examination, does not prove that the practice is nearly so great a preventive of the disease as many have been led to believe, and therefore that it has been too much relied upon to the disregard and neglect of other more rational preventive measures, such as isolation, disinfection and quarantine, which experience has proved are alone adequate for the prompt and complete suppression and stamping out of outbreaks of small-pox ; that the practice of vaccination is certainly not free from danger, and that it therefore becomes a question for serious consideration whether we shall or shall not continue to introduce into the human body, from man or beast, the poison of a contagious disease, however generally mild in character, with the view that it may prevent a possible attack of a possibly more serious disease ; and this when we are, as now, enabled, from our knowledge of con- tagious diseases, to practically carry out other more certain, prompt and efficient, as weil as more rational and more truly scientific pre- ventive measures. MODERN SANITARY SCIENCE. Below is an abstract, from the Sanitary Engineer, of the very, able address delivered before the Sanitary Institute of Great Britain by Prof. F, S. B. F. de Chaumont on \" Modern Sanitary Science.\" OBJECTS OF SANITARY SCIENCE. Replying to the question, \" What are the Objects of Sanitary Science ?\" Prof. de Chaumont sums them up in a word, as \"seeking to diminish the inordinate waste of life now continually going on.\" 237/",
         "THE SANITARY JOURNAL. One-half of the population dying in childhood is .throughout its existence absolutely unproductive. The average age at death throughout the United Kingdom is only 39, of which barely one- half has been productive. On the other hand, the average in our great cities has been shown by Dr. Farr to be much lower, as low as 26 in Liverpool, so that there is hardly one-third of this productive. This evil if left to itself tends to increase from the continuai removal of the populace from the country into the town and the consequent multiplication of insanitary influences. Sanitary science also pro- poses to preserve these lives in their best circumstances for adding to the wealth of the community. It is based on the knowledge obtained through other branches of science ; geology, mineralogy, etc., give information as to the nature of the ground we live on ; through chemistry and physics we ascertain the character and move- ments of the water and air in the ground and in the atmosphere, their normal constituents and occasional deviations ; from medicine we get knowledge of disease, and the methods of its communication from individual to individual. CONDITIONS FAVORABLE TO DISEASE. On this basis of scientific fact certain points have been ascertained which make the science practically a matter of certainty. Some diseases have been actually traced to active causes, or at least the possibility of communicating them with certainty has been so well demonstrated as to limit the area of search. Others still remain more or less unsolved problems, although we have made some pro- gress in ascertaining the conditions favoring their propagation. We are pretty certain of this, that diseases do not arise indifferently, but are due to certain causes, which we hope will admit hereafter of being traced out and analyzed. Recently researches by various inquirers have held out hopes of still further progress being made, so that not only the real causes of individual maladies may be dem- onstrated, but even that it may be possible so to treat and, as it were, cultivate those verae causae, as to produce a benign agent which shall protect from the severer form, just as vaccine virus does from small-pox. We have ascertained that certain conditions of existence are favorable to the development of certain diseases ; that the living on a wet and contaminated soil, the drinking of polluted water, the breathing of a vitiated atmoéphere, the crowding together of human beings, all have their own powerful influence in favoring the spread of disease.",
         "THE SANITARY JOURNAL. MATTER IN THE WRONG PLACE. We have come to a geneial opinion of some importance, that human ills in a sanitary point of view arise from the presence of matter in the wrong place. What we require is a continual redistribution of matter, an unremitting attention to the great problem of how matter is to be taken to its proper place in the world, where it shall expend its potential energy in useful productive work, and not in effecting the destruction, rapid or gradual, of the human race. This principle is best carried out by finding the appropriate place for all kinds of matter, and allowing matter, particularly organic, to remain nowhere where it is likely to expend its energy in the propa- gation of such low forins of life as are believed to be inimical to human economy. We must adopt such means of removal as will carry away from our dwellings at once all refuse and excrera, pre- vent effluvia from drains or emanations from the soil on which the house is situated from entering our dwellings; we must cause a con- tinuous change of air in sleeping and living rooms, and cease to pollute the soil and the water courses with organic filth, using such material for cultivation, or throwirg it into the sea. We must pro- cure wholesome drinking water under such conditions as to render contamination impossible. Rigid personal cleanliness must be prac- tised, and we must scatter our town population, by attempting to provide better dwellings and more open spaces to form lungs of towns. The advantages of this last principle are very considerable, and have been dwelt upon by many writers. INFLUENCE OF OVER-CROWDING. London is undoubtedly the healthiest of the great cities of the world, and it compares favorably in point of space with most others. Paris is computed to have 40 square metres per head, whereas Lon- don has more than double that. Dr. Farr has shown that the death- rate in England corresponds very markedly with the degree of prox- imity of the population. Liverpool, where the average distance from person to person is only 7 yards, loses annually i person out of 26, and the mean duration of life is only 26 years. Manchester, where the people are 17 yards apart, loses only i in 31, and has 3 years more of life-9 districts, 28 yards apart, lose i in 36, and have an average duration of 32 years., and they proceed thus:- 74 districts, 46 yards apart, lose i in 40, and live 35 years. 137 n 97 il il 46, fi 40 il 345 \" 139 \"i 53, 45 53 n 147 \" \" 6o, n 51 n 239",
         "240 THE SANITARY JOURNAL. These numbers show the influence which crowding exercises on the health of the community. Tn particular instances it has been recog- nized as one of the most disastrous factors in the propagation of typhus, plague, small-pox, and many other fatal diseases. ACHIEVEMENTS OF SANITARY SCIENCE. As to the achievements of sanitary science, the returns of the last census have shown that the death-rate was smaller than was expected during the last ten years. Had the rate continued between 1871 and 1881 the same as between 1861 and 1871, there would have died in England and Wales alone nearly 3oo,ooo persons who are now living, a convincing proof that, as Lord Carrington told the House of Lords recently, \"Modern Sanitary legislation had pro- duced useful and important effects.\" This is a diminution of 5 per cent. on the death-rate, or an addition of more than a year to the mean age of the community. The population of Great Britain has doubled in about 6o years in this century, and there is every proba- bility of its doing so in about 50 years, or perhaps even less in the next period. In the last century it took nearly 100 years to double the population. It is not easy to calculate out the details of a case when so much is wanting, but if the birth-rate had been the same as at present, this would argue a death-rate of at least 28 per rooo, and a mean age at death of only 33 years. Previous to 1700 the doub- ling of the population must have been very slow, and what with wars, famines, and visits of plagues and pestilences, there was pro- bably a diminution at times of population rather than an increase. Immunity from general pestilence due to gradual adoption of rules of hygiene-increased cleanliness in person and dwellings and im- provement in character and quality of food, mark off the modern from the older time. If, however, we turn to groups of the commu- nity more directly under control, we may perhaps better appreciate what has been accomplished. Our army and our prisons are two good examples. The former has been especially valuable as fur- nishing instances, first of the evil effects of insanitary conditions, and secondly, of the excellent results of careful sanitation. Our prisons tell a similar story; from being mere pest-houses in former times, they are now among the healthiest places in the kingdom. THE PROSPECTS FOR THE FUTURE Are regarded as encouraging. The number of writings and discus- sions on sanitary matters, the impetus given to the production of improved appliances, the sanitary societies, testify to the deep hold",
         "THE SANITARY JOURNAL. the subject has on the popular mind, and the recent legislation has been on the whole encouraging. There is one point on which we ought to insist, and that is more extended means of instruction for all classes, and the exaction of certificates of competency from all who are officially charged with sanitary duties, Medical Officers of Health, Borough and District Surveyors, and Inspectors of Nuisance. At present such certificates are entirely voluntary, and taken by few. CONTAGIOUSNESS OF PULMONARY PHTHISIS. The following valuable conclusions bearing upon this question will be of interest. They are from a paper on the \" Contagion of Pulmonary Phthisis from the point of view of History and Public Hygiene,\" read by Prof. A. Corradi, of Pavia, at the meeting of the International Congress of Hygiene and Demography in Geneva, a few months ago. (Translated by Dr. O. H. Wright, Health Officer of Detroit, Mich. From The Detroit Clinic). . i. Belief in the contagion of phthisis or tubercular consumption dates from remotest antiquity. It has been maintained in every age, not only as an opinion among the people, but also as a scientific doctrine. 2. In the second half of the last century, this belief culminated; probably because the disease became more frequent than ever be- fore. The State, in several countries, was compelled to interfere and to take measures in the interest of public health, for the pur- pose of preventing the spread of contagious phthisis. 3. On the other hand, in the first half of our century, the doc- trine of contagiousness lost ground, anatomico-pathological investi- gations having taken the lead in etiological questions. 4. Only recently experimental pathology has resumed the ques- tion, and undertaken to give the doctrine of contagion the support of the results of inoculation with tuberculous products. Still further, ability to demonstrate that the virulent principle of the disease is represented by a mycrophyte, a bacillus has been claimed. 5. Clinical observation must determine the question which experimentation has so definitely propounded ; pathology has to settle many other questions raised by the doctrine of the parasitic nature of tuberculosis, and to reconcile this doctrine with the fact of predisposition and heredity. 6. If 'contagion or transmission is possible, the conditions there- of still remain to be determined. 247",
         "THE SANITARY JOURNAL. 7. Meanwhile, hygiene must regard phthisis as a suspected disease, that is, as a disease which may be communicated or trans- mitted under certain conditions. 8. Attention must especially be paid to the relations established by cohabitation; by making such relations less intimate and contin- uous, the sources of infection will be weakened, if not destroyed ; and at the same time those exhalations will be removed, which aside from any specific action, enfeeble the organization and predispose the phthisis. 9. Although it cannot be certainly demonstrated that food com- municates tuberculosis, nevertheless it will be prudent to abstain from the flesh and milk of phthisical animals. 10. Especial care should be taken in the selection of lymph, bovine or humanized, for vaccination. i i. The institution of exclusive hospitals, at least of separate pavilions, for phthisical patients is earnestly recommended. 12. The results of recent studies and investigations arrived at, determining under what conditions and by what ways tuberculosis is transmitted, indicate the especial prophylactic measures to be adopted. 13. Whatever opinion may be entertained on the subject of the nature of pulmonary phthisis, no one doubts the advantages in the struggle which organic resistance affords ; for this reason one of the most potent barriers to the diffusion of this plague of civilization must be erected by the practical hygiene which secures the physical -and moral well-being of the people. MEAT AND TUBERCULOsIs.-The Live Stock Yournal says the remarks of the Secretary of the Royal Agricultural Society on - English Meat and Tuberculosis\" are not exactly pleasant reading, unless we are vegetarians. When at Hanover, Mr. Jenkins visited the new cattle market and slaughter-houses, where he found that every carcase was submitted to a microscopical examination by experts before being allowed to be sold. In one month, out of 637 head of cattle thus inspected, sixteen, or 2 / per cent., proved to be more or less affected with tuberculosis or consumption, and were instantly condemned, the disease being held to be communicable tO human beings through meat taken as food. In London no such provision'is exercised, and if the proportion of affected animals is the same as at Hanover, it follows that 75oo head of cattle which have suffered from the disorder are eaten in the metropolis every year. How many in Canada?",
         "THE SANITARY JOURNAL. HINTS TO HEALTH OFFICERS. It may be stated as a broad fact that most diseases, for the pre- vention of which a medical health officer, especially in a city or town, may be called upon to exercise his skill, have their origin in or through excrete matters, more particularlyhuman excreta, finding their way into the human body along with the air, or water, or even sometimes the food consumed. There are three principal causes of disease with which a health officer may practically and profitably deal: (a) Foul air from collec- tions of excreta or filth of various sorts ; (b) foul water from wells ; and (c) patients suffering from contagious diseases, as centres from each of which hundreds and even thousands of cases may arise. In the largest cities even in Canada, there are some crowded tenement houses and cheap boarding houses which cannot fail in various and obvious ways, to give rise to disease, and to the spread of epidemics, and which demand the attention of the health officer and authorities. If these are not better looked after, we shall soon have in this country, as in the older countries, outbreaks of true typhus. There are such places'in Toronto, furnishing the very soil and conditions where typhus would doubtless develop and spread, were the germs once present-or, if it be possible that such diseases ever arise spontaneously (which we doubt), develop without the germs. All cesspools and privy vaults, when not far removed from all dwellings and wells of water-supply are, in the light of our present knowledge of sanitary science, truly nuisances, and we do not see why, without a special municipal by-law, they cannot be dealt with- removed under the provisions of the present public health Act (36 Vic., cap. 43). This provides that health officers may, in the day time, as often as they think necessary, enter into and upon any premises within their jurisdiction and examine the same, and \"if upon such examinatton, they find that the premises are in a filthy or unclean state, or that any matter or thing is there which, in their opinion, may endanger the public health, they or any two of them, may order the proprietor or occupant of the premises to cleanse the same, and to remove what is so found there.' There being further provision, in case of neglect or refusal of the proprietor or occupier to remove the same, by which the officers may have it done forth- with, and the proprietor or occupier will be compelled to pay for it. We should like to see this matter tested in the courts. And why could not foul wells, too, be deait with in. like manner. 243",
         "THE SANITARY JOURNAL. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. Medical journals in Great Britain agree that it is indisputable that the \" compulsory notification of infectious diseases,\" with all it may involve, has become one of the most \" burning \" questions of the day. There the profession are almost a unit in their opposition to making the duty and responsibility of notification incumbent upon medical men, though, for the most part, they are favorable to the principle of notification, but think the duty should be imposed upon the householder, custodian or guardian of the patient. In this we are disposed to agree with them. Unquestionably, in the interests of the public health, prompt notification should be given to the health authorities, in order that means may be at once employed for pre- venting the spread of the disease, but we can see no good reason why the medical attendant should be compelled to perform the duty when it can be just as effectually done by those who engage the physician. In the few cases amongst the poorest class (very few in this country), in which there would be indifference and irresponsi- bility, we are convinced the medical attendant would invariably, without compulsion, give the necessary intimation. Dr. Carter, of Liverpool, Eng., has founded an association for opposing the compulsory notification by medical men, and according to the Medical 7imes and 'Gazette, it has \"rapidly become a numer- ous and powerful society, with branches in many of the large towns.\" As regards the United States, competent lawyers there assert that such a compulsory measure would be unconstitutional. While we heartily approve of the plan of compulsory notification- have advocated it years ago in this JOURNAL, and were the first, SO far as we have any knowledge, to advocate such a measure in this country, we do not think it wise to place the responsibility on medi- cal men. It will tend to create opposition to the principle of notifi- cation, and disturb the harmonious relations existing between medical practitioners and medical health oficers. In some cities in Great Britain, a fee of fifty cents is paid physi- cians for notification, and the plan has been found to work well. But we cannot see that the fact of paying a fee, small or large, does away with the objection to compulsory notification. THE Citizen states that at the vegetarian restaurants in the city of London, Eng., the dinners daily served average 1,550. 244",
         "THE SANITARY JOURNAL. DRAIN TRAPS AND SEWER GASES. Too great precautions cannot be taken in order to prevent the deadly influences of sewer gases in our dwellings. The only safe rule is, Io have the house drains and soil pipes kept always free from sewer gas, by means of traps between the drain and the sewer and by free ventilation of the drains and soil pipes. The greatest'diffi- culties we have to contend with is in the sewers themselves. In defective construction of these, in want of free ventilation of them, and in the altered conditions of their contents from storm water, winds, etc., the chief troubles are to be found. A double trap between the sewer and house drain must afford bettèr protection than a single trap. A plan recently proposed by Mr. H. Masters, in the Sanitary Record for April, illustrated in the following figure, appears to have many advantages, especially in providing for unusual pressure from storm water in the sewers. In the section of sewer, s, the space a represents the average amount of sewage flowing in it. When a storm' occurs, as a heavy shower of C rain,the water poured in from the street gullies quickly in- creases the quantity of sew-\\ age and it rises into the space b,compressing the air or gases into that of c. Now, although \\ there may be, at intervals, street openings for the escape of the con- pressed gases, a certain amount of these gases will be forced through the first trap at t, as shown in the figure. With an escape pipe, as at e, of the same area as the drain itself, and a second trap between it and the house drain, as at t, the greatest amount of safety is ob- tained. The soil pipe, p, as in all cases, should be carried up full bore above the roof of the house ; and there should always be an inlet for fresh pure air, as at i, by which the drain, d, and the soil pipe will be kept free from foul air. The distant opening of the inlet may be, according to circunstances, either in the yard, when this is large, or the pipe may be carried up above the roof. THERE MUST SOON be hundreds of medical health officers appoint- ed in Canada. Physicians should keep \" posted\" by subscribing foi this JOURNAL. 245",
         "THE SANITARY JOURNAL. THE REAL \"PUBLIC HEALTH\" WORK OF TIHE ONTARIO MEDICAL ASSOCIATION. The recent meeting of this Association was not marked by a large proportion of work specially relating to the public health ; not so much indeed as the meeting of last year, or as those of late years of the Canada Medical Association. We regret this, and trust there will be more at next year's meeting. A valuable paper bearing closely upon it-\" Bacilli of Phthisis,\" by Dr. Graham, was read, and discussed at great length. Dr. Cassidy read a paper upon \" Typhoid Fever,\" referring to special cases. One by Dr. Covern- ton, a \" Trqnslation on the New Microbes \" was, unfortunately, passed over in some way ; and it is to be regretted that the one on the important subject of vaccination, published in another part of this JOURNAL, was not read for the purpose of discussion, and getting the feeling of members upon this prophylactic. Indeed, we must say that the programme of papers at the meeting of this Association has not been usually carried out in a fair, and the customary way. The report on public health, for the preparation of which credit is due chiefly to Dr. Oldright, drew attention to the work of the past year, and urged the importance of municipal boards, and of teaching hygiene more generally in the public schools, in place of other less important subjects. The report included a paper on local boards, by Dr. Oldright, which was read by him. the report proper being read by the Chairman, Dr. Playter. It referred specially to the success of the health delegation at Ottawa in December, and to the cordial recep- tion accorded by Sir Charles, and Hon. Mr. Pope, and to the most agreeable private reception given by the latter honorable gentleman to the delegates after the meeting. Some questions on the use of alcoholic liquors, submitted to the Association by the \" Ontario Women's Christian Association,\" who desired an expression of collective medical opinion thereon, and which had been referred to the public health committee, were re- ferred, owing to want of time, to a special committee afterwards appointed, consisting of Drs. Burritt, Buchan, Workman, Geo. Wright, and Playter, who were desired to consider and report upon the same at the next meeting. THERE are now twenty-three towns in Great Britain in which the notification of infectious diseases has been made compulsory.",
         "THE SANITARY JOURNAL. \" WANTED \"-MUNICIPAL BOARDS OF HEALTH. Almost ever since the commencement of this Journal, we have through it urged the desirability of having municipal boards of health formed,-one indeed in every city, town, village and township in Ontario. Personally, too, we have urged upon the Attorney-General and the Provincial Secretary, the great importance of these, and in pressing for the Provincial Board, it was in order that it might serve as a centre for the municipal boards. In fact that is, or ought to be, the chief function of the Provincial Board, the organizing and keep- ing in working order of local bodies, which can best, by all odds, do practical sanitary work. It was much regretted that provision was not made for the formation of these two sessions ago ; yet another session of the Legislature has been allowed to pass without action in this behalf. The stand taken by Dr. Carney, of Windsor, is highly commendable, and if numerous other medical practitioners would do likewise, it would aid greatly in bringing about the desired legis- lation. We trust all will assist, in accordance with the resolution passed at the recent meeting of the Ontario Medical Association, by using their individual influence in urging the importance of it upon individual members of the Legislature. THE HAPPY MEDIUM. Greatly blessed are they who are so constituted, either by inherit- ance or education, as to be able to strike in all things the happy medium. Many persons of both sexes there are who are extreme in their views and actions in everything; and there are those, not small in number, who go to extremes in some things, though they are moderate in others. But there are not very many who can take the medium course in everything. In nothing is a judicious moderation of greater importance than in matters relating to health. Those are healthiest, for example, in body and mind, who, in eating and drinking partake in moderation, perhaps in great moderation, of most of the many and various good things which a wise Providence has provided for mankind, and who do not subsist almost wholly upon coarse bread, vegetables and water; who, without over-work or over-play, .take abundance of regular out-door exercise; who bathe for cleanliness, without soak- ing themselves too constantly in water; and who clothe moderately and sleep not too little nor too much.",
         "THE SANITARY JOURNAL. Again, changes from one extreme to another are most injurious. Some who have always been large, perhaps inordinate eaters, will, on learning that they are eating too much, or that abstinence is good, possess enough resolution to go to the other extreme and henceforth eat too little. Lacking the judgment to discern and pursue the happy nmedium, they perhaps give rise to more serious harm by not supplying the system with sufficient nutriment for health, than they had done in eating too much. They may take enough probably after the change if it were all thoroughly digested, but the stomach having been accustomed for many years to digest only a portion of what had been eaten, will not now digest com- pletely the much smaller quantity which it receives. The change from even over-eating, when made, should be gradually made-a little and a little less eaten from day to day and from week to week -rather than suddenly, except it be for a meal or two, or a day or two, with some individuals. So in exercise : one has long been of sedentary habits and learns that he should take exercise, perhaps a good deal of exercise. He is very liable to commence at once to take too much-to walk or to row too far or to play too hard at some game, and he is rather injured than benefited. He should have commenced the exercise by taking only a little at first, increasing the amount, short of great fatigue, from day to day. So, in like manner, in all other things connected with health ; all should pursue the happy medium. SEWER VENTILATION.-Many methods have been proposed for the ventilation of sewers. The latest, perhaps, is that of forcing fresh air into them. We do not believe in the principle of this method, and cannot see how it can be put into practice without increasing the tendency to the unsealing of traps from pressure. Nor do we approve of the practice of ventilating by, carrying pipes from the drains on the sewer-side of the drain-trap up the side of the houses. The correct principle, as seems so manifest, is that of drawing of the sewer gases towards the sewer outlets, and keeping up a constant current from the houses, rather than toward them, regardless of gravity, which is readily overcome. This may be accomplished by means of furnaces with tall chimneys, or pneuma- tic pumps. This last method has been carried out, it appears, most successfully in Paris. We purpose to soon deal with this subject at greater length. 248",
         "THE SANITARY JOURNAL. SUMMER CARE OF INFANTS.-During the hot weather in summer many infants and young children suffer from intestinal disease, and the mortality therefrom, especially in the cities, is usually great. This is chiefly owing to organic impurities in the air-the germs or seeds which give rise to moulds and bacteria-finding their way into the food. The most scrupulous cleanliness should be observed in regard to vessels used with milk and other foods. The feeding bot- tie, which is a sort of necessary abomination, is very difficult to keep clean and sweet, and the nipple is frequently a hot-bed for the rapid growth of microscopic vegetation, of a very poisonous nature. The Medical Times and Gazelle suggests that pictures of the \" world \" found in a drop of sour milk from a dirty feeding bottle be hung up in every nursery. Keep the children out in the fresh air in the parks and such places and away from close, dirty yards and badly venti- lated rooms. Keep the skin clean, and clothe so that the limbs may have full play. Let them have what pure cold waler they like to take, offering it frequently to those too young to ask for it, and they will then not be likely to take more milk or other liquid food than they require or can digest. Food suited to the age and powers of digestion must be provided. As Sir William Jenner says, proper food, pure air and cleanliness, are the three great essentials. WATER IMPURITEs.-Amongst the results of the experiments on water analysis by the National Board of Health, U.S., are the fol- lowing (Med. Times and Gaz., June 2-83) : That it is not so much the quantity of organic matter as the presence of organisms which renders certain waters unwholesome. Waters containing large amounts of nitrates and nitrites were found to exert specially inju- rious effects on the rabbits experimented on ; and these results, together with medical testimony as to the unwholesomeness of the same waters, suggest that these salts indicate not merely \" previous sewage contamination,\" but the presence of noxious organisms- probably those to which the very process of nitrification has recent- ly been attributed,-thus attaching special importance to these salts in water analysis. So far as the results of observation on concentrated waters go, they tend to show that in some cases at least, contrary to the usual belief, vegetable impurities, particularly those derived from decaying woody fibre, were even more dangerous than those of animal origin, and in those found to be most pernicious the amount of organic carbon was relatively higher than that of organic nitrogen. 249",
         "250 THE SANITARY JOURNAL. MANKIND'S MISTAKEs.-(From an exchange). It is a mistake to labor when you are not in a fit condition to do so. To think that the more a person eats the healthier and stronger he will become. To go to bed at midnight and rise at daybreak and imagine that every hour taken from sleep is an hour gained. To imagine that if a little work or exercise is good, violent or prolonged exercise is better. To conclude that the smallest room in the house is large enough to sleep in. To eat as if you had only a minute to finish the meal in, or to eat without an appetite, or continue after it has been satisfied, merely to satisfy the taste. To believe that children can do as much work as grown people, and that the more hours they study the more they learn. To imagine that whatever remedy causes one to feel immediately better (as alcoholic stimulants) is good for the system, without regard to the after effects. DR. TACHE'S INVESTIGATION ON CENTENARIANISM.-The careful investigation of the Deputy Minister of Agriculture and Statistics at Ottawa, Dr. Tache, into the records relating to the actual age of so-called centenarians in Canada, is of much importance, bearing as it does so directly upon the longevity of Canadians. In only 82 cases out of 421 reported to have survived the age of roo years, could authentic documents be obtained, it appears, for close exami- nation, and out of these 82 alleged centenarians, it was fouud that only 9 (5 men and 4 women) were really ioo years old or over. The greatest number of errors were committed in good faith, and the age of several seemed based on authentic records. We shall pro- bably refer to this subject on another occasion. WOODEN-BLOCK STREET PAVEMENT.-We have many times been asked our views on the probable effect on the public health of the cedar block pavement which is coming into such general use. In the next number of this Journal we purpose giving the latest views obtainable on this question. In the meantime it may be stated that any future ill effects on health from the wooden pavements will proceed more from the manner of construction and after maiage- ment than from the pavement, per se. It shoula be laid on a well constructed, thoroughly under-drained bed, be kept well cleaned afterwards, and all sunken spots be repaired at once as they appear.",
         "THE SANITARY JOURNAL. CANADIAN SANITARY ASSOCIATION.-The movement to form an association of this kind in Canada ought to be successful, and we trust all our readers will join in.promoting it. We have repeatedly, in this JOURNAL, urged the desirability of organizations of this kind, and have, on several occasions, at the meetings of the Medical Associations, personally suggested that one be formed for the Dom- inion. The credit of suggesting to take advantage of the meeting of the delegates on health and vital statistics at Ottawa in December, in order to make a commencement-appoint a committee, etc., belongs to Mr. F. N. Boxer, C.E., of Montreal. He was warmly supported, and has taken a good deal of trouble in the preliminary work of organization, and the prospectus will soon be issued. MANAGEMENT OF CONSUMPTION.-Dr. Satterthwaite, Pathologist St. Luke's and Presbyterian Hospital, New York, terminates an elaborate paper on \" The Origin and Natural History of Tubercu- losis,\" with the following conclusion : \" As a natural deduction from the above views, attention should be chiefly directed, in prophylaxis and treatment, to the vicious constitution which is conceded to be an essential prerequisite of the disease, rather than to a contagium that at the best plays only a comparatively infrequent and subordi- nate rôle.\" BAD PLUMBING-JUSTICE.-An action was brought by a plumber in the Croydon County Court against a civil engineer for upwards of £30, for the erection of a lavatory. The defendant made a counter- claim of £120 on the ground that, the work being improperly done, sewer-air escaped into the house and caused the illness of six mem- bers of his household and the death of his son. He therefore claimed the doctor's bill and other expenses. The judge disallowed the plaintiff's claim and gave judgment for the defendant. COMPULSORY VACCINATION, SWITZERLAND. - A correspondent (Med. Times and Gaz.) writes : \"I have just received information that the city of Basle, after six months' agitation, and the most vigorous efforts on the part of the medical faculty, voted, on Sunday, the 17th ult., in favor of the suppression of compulsory vaccination by a majority of 3539 against 716, or five to one, being about the same proportionate excess that made an end of the despotic Federal Vaccination Bill on July 30 last.\" INDOLENCE AND LONGEVITY.-No instance can be found of an idler having attained to a remarkably great age.",
         "252 THE SANITARY JOURNAL. LITERARY AND SCIENTIFIC. THOUGHT-READING. A leading London medical journal (Med. Times and Gaz.) has \u003cdiscussed the subject of thought-reading. From it, it appears that Mr. Bishop's so-called thought-reading \"resolved itself simply into the interpretation of the involuntary and unconscious muscular movements of persons whose attention was fixed on some particular object. Similar results have been obtained by Mr. Stuart Cumber- land, who entirely disclaims the possession of any peculiar power, and avows that he works simply by the means of the communication we have stated.\" The children of a clergyman in Derbyshire, of unblernished cha- racter and tried integrity, had been accustomed to amuse themselves with the \" willing\" game-i. e., one of them would leave the room and in her absence the others would think of some object, and the absent one on being re-called would try to guess the object thought of. The children attained such great skill in \"guessing\" as to sur- prise their father, who in consequence gave to their proceedings more than usual attention. It seemed to him so wonderful, that he invited members of a neighboring family to join them, and the fame of the family spread. The presence of the father seemed to increase the sùccesses. On one day, when there was ill-success, it was attri- buted by the children to inertness after an early dinner. The family are convinced that when mistakes are made the fault rests, for the most part, with the thinkers, rather than with the thought-readers. Dull and undemonstrative people make success difficult. The Ga- zette concludes:-\" It seems that in some organizations thought can be communicated by means apart from the generally recognized modes of perception. How such communication takes place-whe- ther it depends upon some peculiar power, or whether it is simply that some quick children have so trained their perceptive powers that they notice indications of thought, ordinary in kind, but so slight in degree that less skilful observers are not aware of their existence,-we will express no opinion.\" UTOPIAN. LEAVES FROM THE DIARY OF A CENTENARIAN. JUNE---1983.-To-day I went in the \"Sky Fly,\" high up over the beautiful fields and houses and trees, to the great city of Hygieao- polis, to see the enormous balloon and other preparations for the proposed expedition to the moon. I hope this, the third expe-",
         "THE SANITARY JOURNAL. dition, may be successful, and also that I may live to read the report of this ex-terrestrial trip and speak with a man who has stood on the moon. What a huge gas chamber when compared with those I remember in my boyhood, and what wonderfully deli- cate propellers. And all must be made so very light to float in the ethereal space beyond the earth's atmosphere. They are surely taking enough condensed foods to supply them for many years, and the improvements for preparing water and oxygen from condensed hydrogen, will prevent the possibility of a failure in the supply of these essentials of life. What a happy discovery, that of Platina, that everything in the universe is made up of multiple equivalents of hydrogen gas, which pervades all space. The late improvements for utilizing for heating purposes the rays of the sun beyond the earth's atmosphere, will also give this expedition an advantage over the others. I could not help dwelling mentally on the wonderful change in the appearances in the streets of the city since I was young. Now, no dust nor dirt of any sort; no dirty, untidy men nor women ; no \"smokers\"; no dogs nor horses. How did men so long endure to associate with animals? And the saloons and showy shop windows, tempting men to spend their substance in drinks and in articles of \" merchandize\" they did not need, all disappeared. Had these not been done away with, the artizans could not now have so much time for recreation, and for improving individually their mind and body and their home. EDUCATION AND CRIME.-The French court records show (De- troit Lancet), that the increase of education increases the amount of crime specifically. (i) That 25,ooo persons wholly illiterate furnish five criminals. (2) That 25,000 of the class able to read and write furnish six criminals. (3) That 25,ooo of the class of superior edu- cation furnish more than fifteen criminals. (4) That the degree of perversity in crime is in direct ratio with the amount of instruction received. (5) That in the departments in which instruction is most general, crime is greatly more prevalent-in other words, that mor- ality is in an inverse ratio with instruction. (6) That relapse into crime is much greater among the instructed than the non-instructed portion of the community. YOU MAY PROFIT much by reading the advertisements in this JOURNAL; only reliable ones are accepted. 253",
         "THE SANITARY JOURNAL. WEATHER AND HEALTH.-Sydenham, after bestowing much time and consideration on this subject, concluded that his time and trouble had been lost. Van Swieten, after keeping a record of barometrical and thermometrical readings for ten years, arrived at the conclusion that he was no wiser as to the effects of atmospheric variations on epidemic diseases than when he began. Ramazzini, after devoting considerable time and labour to the matter, said that he could see no constant relations between the changes of the atmos- phere and disease, and was as ignorant as ever at the termination of his work. And the same may be said as to the investigations of Huxham and many others. BACTERIA OF WHoOPING-COUGH. - Dr. Karl Burger, of Bonn, who claims t.o have discovered the bacterium of whooping-cough, regards these as being the cause of the disease, \" because-(i) he does not find the bacteria in other sputa ; (2) they exist in such pro- portion in the expectoration of pertussis that their influence cannot be doubted ; (3) their number is directly proportionate to the intensity of the illness, whether in the course of the same or differ- ent individuals ; (4) the symptoms and progress of the disease may be best explained by the development of the bacteria.\" PASTEUR'S \"VACCINATIONS\" A FAILURE.-The Medical Times and Gazette, May 12, '83, in discussing the experiments of Koch and Pasteur, states that the latter has utterly failed, on the scanty basis of his partial successes in the case of two diseases-fowl-cholera and splenic fever-to establish any law of immunity, still less has he made any progress towards realizing his dream of extending its application to the prevention of every infectious disease to which man or beast is heir. His operations are more akin to small-poX inoculation than to vaccination. RELIGION AND STATE MEDICINE.-In France, the editor of the Medical Gazette remarks that true religion is the needful thing to prevent suicides. \" Society demands religion. It constitutes an essential part of state medicine, without which individuals and communities tend to a condition of reckless irresponsibility, which ends in most cases in a species of mental and social anarchy. In our opinion, therefore, whoever attempts to loosen this anchor is ail enemy to his own race.\" 254",
         "THE SANITARY JOURNAL. NOTICES OF BOOKS, ETC., RECEIVED. FIRST ANNUAL REPORT of the Provincial Board of Health of Onta- rio, for the year 1882. TENTH ANNUAL REPORT of the eecretary of the State Board of Health of Michigan, U. S., for 1882. FOURTH ANNUAL REPORT of the State Board of Health of Illinois, U. S., for 1882. SIXTH ANNUAL REPORT of the Board of Health of New Jersey, U. S., for 1882. SIXTH ANNUAL REPORT of the State Board of Health of Wisconsin, U. S., for 1882. FoRTIETH REPORT OF BIRTHS, MARRIAGES AND DEATHS of the State of Massachusetts, U. S., 1882. ANNUAL REPORT OF THE NATIONAL BOARD OF HEALTH of the United States for 1882. THE CANADIAN GAZETTE, a weekly journal of information and com- ment upon matters of use and interest to those concerned in Canada. London, Eng. HEALTH AND HEALTHY HOMES IN CANADA, by Dr. Robert Sproule, B.A., Peterboro'; a little work containing much valuable informa- tion for lay and other readers. THE \"ORIGINAL CHATTERBOX,\" an admirable magazine for the young, handsomely illustrated ; unrivalled indeed in its field. Boston: Estes \u0026 Lauriat. OUR LITTLE ONES AND THE NURSERY, Oliver Optic, editor. Bos- ton: Russell Publishing Co. \"A more beautiful magazine for the little ones we have never seen.\"-Evangel. Messen. A MANUAL OF GYNÆCOLOGY, by Dr. Berry Hart, M.D., F R.C.P.E., Lecturer on the subject, School of Med., Edinburgh, and A. H. Barbour, M.A.B.Sc., M.B. Vol. 1, with 8 plates and 192 wood- cuts. New York: Wm. Wood \u0026 Co. A new work, which has been very well received by the press and profession. LEGAL MEDICINE, vols. I and II, by Charles Meymott Tidy, M.B., F.C.S., Prof. Chem., Forensic Med. and Public Health, London Hospital, etc. New York: Wm. Wood \u0026 Co. It is enough to state that the reviewer in the Medical Times and Gazette of London, Eng., believes it \" will become the standard work on the subject\" in that country. DR. O. W. HOLMES says he has known a practitioner-perhaps more than one-who was as much under the dormant influence of the last article he had read in his favorite medical journal as a milli- ner is under the sway of the last fashion plate.",
         "THE SANITARY JOURNAL. THE PUBLIC HEALTH IN TORONTO.-The city health officer states there is no special epidemic prevailing, though a good many cases of puerperal fever have been reported. In this connection we would draw attention to the fact that the powers conferred upon the health officer are very limited, he being rather an advisory than an execu- tive officer, and his hands are in a large measure tied. In the cities in the United States much more power is conferred upon such func- tionaries. A change in this regard here is desirable. NUMEROUS DEATHS FROM VIOLENT GAMES are chronicled, espe- cially from playing foot-ball, and the practice is being condemned by medical journals. The Detroit Lancet says, \" Physicians should use what influence they possess in their several communities to teach the true principles of physical development in opposition to the false ones now so universally prevalent.\" THE SUGGESTION OF DR. GRANT, of Ottawa, at the Medical Council meeting this week, that Government levy a tax on every patent medicine advertisement, was a healthful one. Everything tending to suppress the sale of these nostrums will promote the public health. THE TORONTO GENERAL HOSPITAL has the reputation, and doubt- less deserves it, of being one of the cleanliest, sweetest and best kept hospitals on this continent. The great difference in the character of the atmosphere in it now, as compared with that of twenty years ago, is surprising. FUTURITIAL.-The next number of this JOURNAL will contain articles on the following subjects :-Must we always follow nature? Mistakes in education ; The diet makes the man and the nation; Midde men ; Block pavements; Bacilli ; and many other topics. FROM OTHER CITIES we arc preparing to obtain regulàr, monthly health reports, which will be published in the JOURNAL from month to month, commencing with next number. A SANITARY ASSOCIATION ought to be formed in Toronto. It would interest the citizens in sanitary work and aid the health offi- cer. Who will move for it ? ONE COW's MILK.-A child fed on one cow's milk recently died of tuberculosis, and the cow died a few months later of tubercular disease."
      ],
      "identifier" : [
         "8_05173_51"
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      "published" : [
         "[Toronto? : s.n., 1883]"
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      "title" : [
         "The sanitary journal [Vol. 5, no. 9 (June 15th, 1883)]"
      ],
      "type" : "document",
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05173_51",
      "pkey" : "oocihm.8_05173",
      "label" : "[Vol. 5, no. 9 (June 15th, 1883)]",
      "key" : "oocihm.8_05173_51",
      "source" : [
         "Library and Archives Canada."
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      "contributor" : "oocihm",
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         "text"
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      "note" : [
         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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         "eng"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE CANADA LANCET VOL. XXXIV. TORONTO, APRIL, 1901. No. 7. ORIGINAL ARTICLES. NOTES ON HYDROCHLORIC SUPERACIDITY, WITH REPORTS OF CASES. BY GRAHAM CHAMBERS, B.A., M.8. Physician to St. Michael's Hospital ; Abistant Physioian to Toronto General Hospital. According to my experience excess of hydrochloric acid is a very common functional sign in cases of gastric indigestion. This acid is no doubt the secretion of the border or oxyntic cells of the peptic glands- The size of these cells varies with their activity. When quiescent they are smaller than when their secretory function is active. In cases of hydrochloric hyperacidity, where the secretory function of these glands bas been norbidly active for a 1 rolonged period, proliferation of both the border and chief cells can be frequently demonstrated in some parts of the mucous membrane of the stomach. This fact should be kept in mmd, as the greater the proliferation of the glandular elements the more diffi- culty will be experienced in affecting a cure. As stated above, hydrochloric superacidity is a common result in analyses of gastric contents. It may be present in hyperchlorhydria, hypersthenic gastritis, hypersecretion, ulcer, carcinoma, gastroptosis, atony, as well as in some of the neuroses other than those mentioned in the foregoing list of diseases. It is quite evident therefore that this functional sign alone is of little value in differentiating the above diseases. But it is a sign that must be considered in the treatment of every one of them. Let us now consider the etiology of excess of hydrochloric acid As far as known at the present date, the causative agents may be conveni- ently described under two heads:- (a) Local irritation. (b) Mental disturbances. However, in many cases both of these conditions are important factors in the developement of the morbid condition. The stomach may be over-stimulated in several ways. Stagnation of food may affect it. I ascribe the hyperacidity which is frequently found in gastroptosis and atony to this cause. Again, too. rapid eating may bring about the same result. The stomach is not a gizzard and [ 393 I",
         "[ APRIL CHAMBERS: HYDROCHLORIC SUPERACIDITY. should receive the food in a thoroughly masticated condition. If, in place of this, the food is gulped, then excessive stimulation of the glands of the stomach must necessarily follow. Hyperacidity is also a frequent result of eating excessively of foods which are known to markedly stimulate the secretion of hydrochloric acid. Acid, meats, salt, fruits, pickles, spices, spirits, sugars and coarse vege- tables are believed to be the most potent in this particular, whereas bread. milk, well-cooked cereals, tender vegetables, etc., are only mild stimulants. That meat is an active stimulant of secretion of hydrochloric acid is supported by the fact that the gastric juice of carnivorous animals is always highly acid and that the glandular elements of their stomachs are always very highly developed. Fruit is also apt to cause excessive secretion. I believe that more cases of hydrochloric superacidity are due to uncooked fruit than to any other form of food. Mental and moral causes also take an important part in the develop- ment of many cases of this condition. I have met several cases in which the commencement of the trouble appeared to date from a disappoint- ment, excessive mental work, etc. The symptoms of hydrochloric cuperacidity will vary with the disease of which the excess of acid is only a functional sign. Neverthe- less there are certain symptoms which are usually present, and of these pain half an hour to three hours after eating, relieved by eating, or by an antacid, is the one which is most frequently complained of. The reason why the pain appears at this time is readily understood. As soon as food is taken in the stomach hydrochloric acid begins to be secreted, but it is immediately fixed by the proteids of the food, forming an acid albumen. As soon as all proteids are satisfied then the acid remains free in the stomach. This usually happens about three-quarters of an hour after eating an average-sized meal. In cases of hyperacidity the acid is secreted more rapidly than normal and as a result free hydrochloiic appears earlier during digestion. As soonas the acid accumulates above a normal proportion it is apt to cause pain by irritating the mucous membrane of the stomach. When albuminous food or an antacid is taken the acid becomes fixed and the pain is for a time relieved. The treatment of byperacidity will depend to a certain extent upon the disease in which it occurs as a sign. Thus the treatment of ulcer would be quite different from that of the neurosis, hyperchlorhydria. Nevertheless there are certain general rules which one should follow in ail cases of exce- sive secretion, and it is to these alone I wish to refer in these notes. The diet should always be of a bland, unirritating nature. Some advise the use of meats alone in cases of hyperacidity. They maintain that the albuminous food will fix the free hydrochloric acid and thus prevent it irritating the stomach. But we know that meat is a most potent agent in stimulating the secretion of hydrochloric acid and thus would be detrimental in affect- ing a cure. About three years ago I frequently used a meat diet in the treatment of this condition, and I found that it was unsuccessful in many cases. A mixed diet of very tender meats, milk, bread, butter, cereals, etc., appears to me td be more rational. This form of diet fixes the free acid and at the same time will not stimulate the secretion of hydrochlorie 394",
         "1901.] 395 CHAMBERS: HYDROCHLORC SUPERACIDITY. acid to the same extent that a meat diet will. Fruit, pickles, coarse vegetables, sugars, and spirits should not as a rule be allowed. The medicinal treatment is more or less alike in all cases of hyper- aciditv. Ext. belladonae, ext. cannabis indicaa, bismuth carbonat, ext. cocæ, are all useful sedatives to the mucous membrane of tbe stomach. Taka diastase may be used with advantage in many cases as it assists in the digestion of starchy foods. Sodium bicarbonate and calcined magnesia are generally required to neutralize the excess oi acid. Strychnine and hydrastine are the drugs to be depended upon in cases of atony. Con- hein, of Berlin, recommends the administration of olive oil in cases of spasm and obstruction of pylorus. I have used it in two cases with apparent advantage in chronic ulceration with symptons of pyloric onstruction. Bitters, acids, pepsine and irritating catharties are contra- indicated. CASE 1, HYPERCHLORHYDRIA.-A. T., aged 22, female, single, con- sulted me in August, 1900, on account of pain after eating. She stated that she had suffered for three weeks, and previous to that date had always good health. She had always been very regular with her ineals and as a rule had eaten plain food. She was very fond of fruit and had eanten freely of it during the summer months. The pain for which she a)Uht advice began about an hour after eating and lasted as a rule from oneuto tour hours. OccasionallY the pain would continue to the following neal, when it would be relieved for a time. She stated that baking soda would abways relieve it for a short time. Her appetite was good and her bowels were constipted. She did not co uplain of belchig, heartburn, lutulency, nausea or voniting. I gave her a test breakfast and analysed the gastric contents with the following reslt quatity, one ounce ; mucus, about normal ; total free HCI, 34; total acidity, 78. Lugol's solu- tion gave marked violet color. The position of the stomach was found to be normal. DIAGNOSIS:-Hyperchlorhydria. TREATMENT :-Diet: white bread, butter, . ilk, straued gruels, well cooked cereals, scraped meat, tender meats. Fruits, pickles, coarse veget- ables were strictly prohibited. Metlicinal treatment consisted in the administration on a large dose of bismuth subnitrate every morning, a capsule containing ext. bella- donae, et. cannabis indicae, ext. cocae and taka diastase during each meal tnd two teaspoonfuls of c dcined inagnesia an hour after each meal. The lowels were regulated by solid ext. cascara. Under this treatment she rapidly improveand in a fortnight was able to digest an ordinary iiieal withtout discomfort. In this case it was quite cleard that the excessive secretion was due to increased functional a-tivity of glands, and that there was probably no proliferation of the glandular elemenis. CASE, 2, GASTROPTOSSi W1TH LlYlROCHLORLC SU1\u003eERtACII\u003eITY.--- Mrs. K., a Sed 3, motier of one cwhild, consulted me on Feb. Ist, 1900, on ac. K.ngd3,mte foecid os Her health bad been poor for count of pai after eating, and wveakness. Le ~at a enpo o about eight years. Sie had veen treated for prolapse of the uterus, infla- nmation of the ovaties, and haemmorrhoids. About the beginning of this",
         "CHAMBERS: HYDROdHLORIC SUPERACIDITY. year she began to suffer from pain after eating. The pain would usually come on about 4 p.m., and would continue until she ate her tea, when it would be relieved for about two hours. It would then commence again and continue until midnight. The pain was very severe at times. There was neither nausea nor vomiting, but if she could make herself vomit the pain would stop. The patient also complained of flatulency, belching, heartburn and constipation. The tongue was slightly furred. The appetite was fair. I gave ber a test breakfast and analyzed the gastrie contents with results as follows: quantity expressed, three ounces; mucus about norm- al ; total free HCi, 42 ; total acidity, 78. On inflating the stomach with air the lesser curvature was found to be lower than normal, and the greater curvature passed across the abdomen about two inches below the umbilicus. TREATMENT :-Abdominal bandage ; bland diet, such as recomniended in hyperchlorhydria, to be taken in three meals a day as far apart as possible ; a mixture of bismuth carb., tinct. belladonae, tinct. nux. vom. and arom, fl. ext. cascara sagrad. before meals. Under this treatment the patient rapidly improved and at the present date is quite free from pain after meals. In this case I believe that the hyperacidity was due to the stagnation of food. The application of the bandage was no doubt the principal factor in affecting a cure. CASE 3. Ulcer of Stomach preceded by symptoms which usually indicate hyperacidity.-M. C., aged 24, female, patient of Dr. Geo. Balmer, Toronto. I saw her in consultation on Feb. lst, 1901. Patient had measles in childhood, otherwise had good health until she was 14 years of age. During the following year she began to eat cloves, and suffered a good deal of pain in the stomach while doing so. After two months the pain became so severe that she gave up the habit, and her stomach gave her no further trouble for some years. At the age of 19 years she began to suffer from hiccoughs and eructations of gas, which would come on about an hour after eating, and last as a rule about half an hour. These symptoms continued for about two years, when she began to have pain in the region of the stomach after eating. The pain would usually come on about an bour after eat- ing and continue an hour. It would frequently radiate to the leit shoulder. The pain was always worse after eating salt pork, tough beef, pickles, onions, etc. She did not suffer nearly so much after eating farinaceous foods such as bread, porridge, etc. She did not vomit until Jan., 1900. During that month she was travelling to Winnipeg and vomited and retched for five days. Since then she had no further vomiting until hemorrhage took place on Jan. 26th, 1901, but she sùffered more or less from pain after eating. On Jan. 23rd, 1901, the epigastric pain became much more severe, and on the 26th Jan. she vomited blood. The hemorrhage recurred on the 29th Jan. and again on the 2nd Feb. Since the last hemorrhage the patient bas gradually improved. TREATMENT.-Dr. Balmer saw the patient for the first time on Jan. 26th, and ordered her a hypodermic of morphine salphate, a mixture of [ APRIL 396",
         "CHAMBERS: HYDROCHLOR1C SUPERACIDITY. bismuth subnitrate and codeine phosphate, an icebag to be applied to the epigastrium, and to be nouirished by nutrient enemata. After the hemorrh- age on the 29th Jan. the bismuth mixture was discontinued and when the haematemesis again recurred on 2nd Feb.everything was withheld from the stomach. This form of treatment was continued for one week when she was allowed a teaspoonful of peptonized milk every two hours by the mouth. The food-peptonized milk, Wemalta and Allenbury's No. 3-- by the mouth was gradually increased and a corresponding decrease was made in the nutrient enemata and finally all the nourishment was given by the mouth on Feb. 20th. The patient has at present (March Tst) no gastric distress and only slight eructations of gas. Gastrie ulcer is usually complicated by hyperacidity. In this case the hyperacidity appeared to have preceded the ulcer, but in many cases no such history is obtaned. CASE 4.-J. J., aged 2:f, consulted me on Feb. 1 th, 1901, on account of heaviness and pain after eating, headache, and general lassitude. Family history negative. Patient had good health until 20 years of age, when he suffered for six months from the sane symptoms on account of which he now sought ad-ice. He recovered from this attack and had good health until last summer, when he bègan again to suffer from the same symptoms. The subjective symptoms are flatulency, heaviness after eating, headache, constipation, and occasionally pain after eating. The symptoms are always more marked after a large meal. The headache was always more marked after a large meal or after eating fruit. The appetite was good. Analysis of the gastric contents after a test breakfast gave the fol- lowing result :-Quantity 4 ounces; mucus normal; total free HC1 32; total acidity, 70. The stomach was distended with air and foind to be dilated. The water test showed diminished motilitv, and the splashing sound was readily made out beyond the normal limits. DIAGNosIs.-Atonic dilitation with hydrochloric superacidity. TREATMENT.-A capsule containing ext. nux. vom., ext. belladonae., ext. cascara sag. and resorcin before each meal and a bland con- centrated diet. The meals were to be taken as far apart as poqsible. The patient found that he was able to digest his food best when he ate a very light lunch. Under this treatment the distress after eating quickly disappeared, but he still occasionally suffers from the pain in the head. 397 1901.]",
         "GRANT: LATENT APPENDICITIS. LATENT APPENDICITIS* By .1. A. GRANT, Jr., M.D. St. Luke's Hospital, Ottawa. I wish to use the title of my paper in a restricted as well as in its fullest sense, that is inferring fron the clinical data there is a latency of the absolute conditions present: a grave condition, impossible of aiag- nosis, as well as an absolutely latent appendicitis, which may be diagnos- ed only after operation. Not only may the attack be latent, the symptoms of such slight nature that a physician is not consulted, nor even bas the patient any symptoms referable to the appendix, but also the gravity of the condition may be latent, the symptoms so slight that many a man would be inclined to treat the case medicinally and await developments, thus greatly reducing the patient's chance of recovery. Case 1.--I was called to see M. S, a yonng girl aged 11, suffering from severe pains in the right iliac region. The patient bas had the usual diseases of childhood, and with the exception of these has always enjoyed good health. She had suffered at tiimes from colicky pains in the intestines, but bas never had te lay up or leave school. On the morning of May 24th she was suddenly siezed with pain over the appen- dix,accompanied by vomiting. I removed ber to the hospital at once,and on admission found her temperature at 100, pulse, 90, marked tenderness over the region of the appendix; no dulness, but considerable rigidity of the abdominal wall. As the symptoms became more aggravated, I operated the following morning. On exanination numerous firm old adhesions were found in the neighborhood of the appendix, binding the caecum firmly to the abdominal walls in many directions. These adhesions were broken down after considerable difficulty, and on bringing the appendix to the surface, it was found acutely inflamed and covered with recent lymph. It was removed and the patient made an uneventful recovery. The fact that this was the first attack that the patient bad bad to her knowledge, coupled with the presence of numerous old firm adhesions matting the appendix, caecum, and and abdominal wall together, shows that there must have been repeated attacks of inflammation in the neigh- borhood of the appendix that had not caused sufficient syiptoms to in- terfere with the ordinary routine of her life. Case II.-A. S., aged 26, was admitted June 10th, 1900. Patient was seized three days ago with pain in the right iliac region, and stated he had never had a previous attack. On admission to hospital there was distinct dulness over McBurney's point, nausea, temperature 100, pulse 84. He bad had a good night, slight pains at times; slept about five hours. Next morning his temperature was 00, pulse 78, pain very slight, dulness, no nausea or vomiting. He was removed to the operating room, and on making an incision I found the appendix twisted on itself, rup- *Read before the Medical Society of Ottawa, Feb, 1901. 398 [ APRIL",
         "GRANT : LATENT APPENDICITIS. :399 tured at the angle and gangrenous. Many adhesions were present, hind- ing the appendix to the surrounding tissues. Tuie caecal wall in the neighborhood of the adhesions was highly inflamed and almost purple in colour; considerable pus was present. The appendix was removed, parts dusted with iodoform, and a large iodoform gauze drain packed around the caecum. Patient was discharged July 5th, having quite recovered. In this case the illness dated from three days previously,the pain was localized, but not severe, and even intermittent. There was no vomiting, but simply a feeling of nausea. The temperature, while under observation, was only a fraction over 100, and the pulse ranging between 78 and 90. There was distinct dulness over the appendix. Thus the slightness of the symptoms, and short duration of the attack, would hardly lead one to expect to find such a grave condition of affairs, a gangrenous appendix, perforated, and a caecal wall acutely inflamed. Case IIl.-Mr. T., aged 29, was admitted to hospital, June 12th, suffer- ing from pain in the iliac region. For some.years he had been subject to similar attacks of pain, which passed away in a few days under house- hold measures. The present attack failed to do so, and for the first time a doctor was called in. Two days before he was suddenly seized with pain and severe vomiting, since which time the pàin had been constant. On admission to hospitil he had a temperature of 102, pulse 98, com- plaining of weakness and nausea, but no pain The following day his temperature was 98 3-5, pulse 76, occasionally attempts at voniting, pain and tenderness in the right iliac region, and some slight distention of the abdomen. At 12 o'clock that day, 3rd, he was operated on, and on open- ing the abdomen, commencing general peritonitis was found, pus having oozed through the peritoneum as soon as it was incised. There were numerous recent adhesions and some old ones in the region of the appen- dix. The appendix itself was gangrenous and the colon in its neighbor- hood was fast becoming so The appendix was removed, parts carefully dried and dusted with iodofurm, iodoform gauze packed freely around the stump, and a large gauze drainage left in the wound. The patient, contrary to my expectation, inade an uneventfui recovery, and was dis- charged cured 23 days afterwards. This case was more serious in its aspect, but certainly the man's condition would hardly have led one to suspect general peritonitis and a gangerous appendix. Case IV.-Mrs. B., aged 24, had several slight attacks of appendicitis which always yielded to hot fomentations. The - present attack began Monday, December 12th, with acute pain over the appendix, tenderness and vomiting. On the 14th she was removed to hospital, and on admis- sion her temperature was 99 2-5, pulse, 100, nausea was present and she had tenderness over the appendix. I operated that day, and found numerous adhesions, the appendix almost gangrenous, distended with pus, and on examining it later it was found that it was on the point of rupturing. Case V.-Miss E., aged 24, had always enjoyed good health up to one year ago, when she had her first attack of appendicitis. Three mnonths later she had ber second. Both attacks were slight. Since then she has been almost an invalid, unable to stand exertion, more or less abdominal 1901.]",
         "GRANT: LATENT APPENDICITIS. pain present, intestinål indigestion, abdominal fulness and distress, bowels very irregular, general debility and indisposition to work. These symp- toms kept on until July last, and, as she was rapidly losing ground, I re- moved her to hospital. Her temperature on admission was 99, pulse 88, there was slight tenderness and pain over the appendix, which on operation was found to be markedly congested and distended with fluid and adherent to the colon. On removal it was found that a stricture was present at its proximal end, and the appendix was filled with a purulent looking material. Recovery was uneventful. There is no doubt that her impoverished condition during the preceding six months was due to the absorption of fecal toxins from the appendix, as having had her under observation ever since the opera- tion in July last her condition has been one of perfect health, never having felt better in her life. The case was rather chronie, but the symp- toms up to the time of the operation were very indefinite, and it was only the fact of former attacks having occurred made me decide to oper- ate, and the operation proved that the constant absorption of the poison- ous contents of the appendix was fast undermining her health, and might at any time have assumed an acute aspect. Case VI.-S. McF., aged 25, was admitted to hospital January 21st, complaining of pain in the right iliac region. Two days ago she was siddenly seized with a sharp pain in the epigastrie region, which lasted till the following day. There were periods of relief, lasting about an hour or more. On the second day the pain shifted to the right iliac region, and has been continuous in character. She vomited four times on the second day of the attack. No history of former attack. On ad- mission January 21st, her temperature was 100, pulse 94. She com- plained of pain in the right iliac region, some tenderness, well marked dulness, no rigidity or tympanItes. She was kept under observation for 36 hours, during which time there was no material change in her condi- tion, the marked dulness being the most characteristic condition found. There had been no vomiting since her admission, her temperature had fallen to normal, her pulse 80, but marked dulness, some tenderness, and pain over McBurney's point. 'On examination in the region of the ap- pendix, the finger detected a large mass apparently the size of an egg, and on bringing this to view the appendix was found pointing back- wards, and the base for one-quarter of its length apparently healthy : the outer three-fourths of the appendix was imbedded in a large mass of in- flammatory material, binding it firmly to the posterior surface of the caecum ; the whole mass was almost purple in colour, and felt as if there might be some pus towards the centre of this rapidly becoming necrotic mass. On breaking down the adhesions, which were so firm as to require ligature in several places, it was found that pus had not yet formed, nor had the appendix ruptured. The remaining adhesions were tied, the ap- pendix liberated anc removed. From the amount of inflammatory exuda- tion and its deep purple colour there is little doubt that this mass would have suppurated or become gangrenous in a short time. My first inten- tion was simply to free any pus that was present, clean out the abcess cavity, and treat the case by drainage. Having entered the mass and [ APRIL 400",
         "GRANT: LATENT APPENDICITIS. found no pus, and having disturbed the adhesions considerably, I thought it wise to remove the offending member, although the appendix was still buried in inflammatory exudation. By ligaturing this mass in sections, the appendix was liberated and removed with very slight hemorrhage. Considering this was a first attack, and only dated since the Saturday previous, five days, no vomiting, temperature normal, pulse 80, and only marked dulness with some pain, one would scarcelv expect to find such a large mass of firm vascular inflammatory exudation well advanced towards gangrene. Mansell Moullin in a paper on \" Early Operation on Appendicitis\" read hefore the Harveian Society of London last October, stated that of the symptoms by which cases which would recover of themselves might be distinguished from those that would require operation, the pulse was the most reliable guide. If at the end of 36 hours, while the patient was lying in bed, it was over a hundred a minute, or if in the course of the last few hours it had increased much in frequency, there was no doubt that the attack was a severe one, and that operation would be re- quired. The temperature was no certain guide unless it continued to rise. The intensity of the pain was of great significance, and so were also, but perhaps in less degree, local tenderness, muscular resistance, and a sense of fulness in the right iliac fosso. Vomiting, constipation and other symptoms usually present could not be relied upon in the same measure. Great stress was laid upon the absence of any individual symptom being of no account, and that operations should be performed in any case in which the pulse was very rapid, even if other symptoms did not point to any great degree of intensity. Here, there is an attempt to estimate the importance of individual symptoms, but so far it must be acknowledged that we are unable to tell with any great degree of certainty what is the actual condition of affairs present. I have pur- posely given notes of some of my cases where the condition of affairs was much more severe than the clinical symptoms have indicated. It is our goal to be able to diagnose accurately the pathological conditions present, and to estimate the importance of each individual symptom, or rather the importance of the individual symptoms present, as we so often find so many cardinal symptoms absent. It is this very fact of the latency of the conditions present which has such great bearing on the question of operation, Moreover, very rapid pathological changes are liable to take place in any case and at any time, so that no one can state in any given case, no matter how simple to-day, what the conditions will be to-morrow. Our inability to estimate individual symptoms, the grave latent conditions, associated with apparently innocent clinical symptoms, the rapid changes that are liable to take place for the worse in any case, our improved operative technique and aseptic surroundings, together with the percentage of recoveries that we can boast of, all have an im- portant bearing on the future treatment of this disease, and lead me to think that appendicitis is a surgical disease, and the time to operate is as soon as the condition is diagnosed. 1901.] 401",
         "EMORY: UMBILICAL HERNIA. RADICAL CURE OF LARGE UMBILICAL HERNIA By DR. W. J. HUNTER EMORY. Surgeon to Grace Hospital, Toronto. On the 18th day of January, 1898, Mrs. C. was admitted to Grace Hospital, seeking relief from a very painful condition caused by exten- sive ulceration in the skin and subcutaneous tissues, covering a large umbilical hernia of long standing. Patient fifty years of age. First noticed protrusion twenty years before. Nine years before, when hernial protrusion was the size of a large orange, she stated that she had consulted Dr. Bull, of New York, who advised against operative interference on the grounds that the extreme corpulency of the patient would render an opera- tion not only very hazardous, but unlikely to resuilt in permanent success. The photograph accompanying was taken just before the operation, after the patient had been three weeks in bed on a restricted diet, with active catharsis, which had reduced the size of the hernial protrusion by at least one half. When first admitted the coverings of the hernia vere tense, with numerous ulcers over the surface varying from the size of a pea to that of a half dollar, due to pressure. These healed readily under treatment, and on the 27th day of January the following operation was performed for the radical cure of the hernia,assisted by Dr. G. P. Sylvester. Iland Grasping lernia. An incision was made over the central portion of the mass, opEning peritoneal covering. The omentum was found densely adherent to the peritoneum throughout the entire surface, and was separated with great ditliculty, being also intimately adhe ent to the intestines, colon, and stomach, as well as to the parietal peritoneum. When the omentum was 402 [ APRIL",
         "EMORY: UMBILICAL HERNIA. completely separated, a large mass of it, being ragged and torn, was liga- tured in Eections with catgut, and excised. The adhesions between the various coils of the jejunum, about ten feet of which occupied the hernial sac, and the tranverse colon, the major portion of which also occupied the hernial sac, and the stomach, which was entirely protruded through the hernial ring. were gradually separated with great difficulty, and the hernial opening had to be enlarged before the stomach coul-1 be returned to the abdominal cavitv. Wheii all the contents had been returned to the abdominal cavity the entire hernial sac was excised, including the peritoneal sac and the integumentary structures forming the covering. The peritoneum was then closed by continuous c\u003etgut suture; the fibrous structures which unite to form the \" linea alba,\" were firmly united by mattress sutures of silver wire, the remaining layers being closed separ- ately hy continuous catgut sutures. The patient suffered considerably from symptoms of shock during the first few hours, but by the end of twelve hours had reacted nicely, and the convalescence was normal up to the tifth day, when, from some cause, suppuration occurred in the abdominal wound. This, however, was not to be wondered at, considering the very great amount of adipose tis- sue present. The suppurative process continued for about ten days-the wound eventually healing, and a very firm cicatrix resulting, and at the date of writing no recurrence has taken place, though over three years have intervened. 1901.] 403",
         "SMALL-POX AND VACCINATION SELECTED ARTICLES. FACTS ABOUT SMALL-POX AND VACCINATION. Issued by the Council of the British Medical Assoeiation, January l9th, 1898. 1 The Mortality from small-pox is much less now than in prevaccination times. Bernouilli, the famous mathematician, calculated that no fewer than 15,000,000 of human beings in the last century died of it every 25 years. Süssmilch, an eminent statistician of the timne of Frederick I, estimated that nearly everyone had small-pox, and that it carried off a twelfth part of mankind. In London in 1660-79, of every 80,000 deaths, 4,170 were from small-pox. In Iceland in 1707-9, it killed 18,000 persons in a popu- lation of 50,000. In Glasgow, a lîrge and very insanitary town, in 1783-1800, of 31,088, deaths or burials fron all causes, 5,959 were due to small-pox. Chester. wh ch on the other hand was dt scribed by an eminent authority of the time as a town of \" almost incredible \" healthi- ness, had fewer than 15,000 inhabitants and contained in the year 1775 only 1,060 persons, or one in 14, who had not had small-pox. In Kil- marnock, with 4,000 or 5,000 inhabitints in 172S-64, of every 1,000 children born alive 161 died of small-pox. in the village of Ware, in Hertfordshire, after an epidemic in 1722, only 302 persons in a population of 2,515 had never had the small-pox. Such examples could easily be added to. Great diminution of smnall-pox mortality occurred *after the introduction of vaccination where small-pox inoculation never prevaled, and also in places where small-pox inoculation had prevailed. 2. The greatest diminution in the small-pox mortality is found in the early years of life, in which there is most vaccination In Geneva in the per'od 1580-1760, during which there were 25,349 small-pox deaths, 961 - f every 1,000 were under 10 years of age. In Kilmarnock in 1728-64, of every 1,000 small-pox deaths, 988 were under 10 years of age. In a total of 36,755 deaths from small-pox at all ages occurring in Kilmarnock, Edinburgh, Manchester, Warrington, Chester, Geneva, and the Bague in vrious prevaccination periods from 1580 on- wards, 17,252 were under 2 years of age. In the present day, on the other hand, vaccination being performed in infancy and having its greatest protective influence in the earlier years of life, small-pox has to a great extent departed fron children and tran-ferred itself to later and less protected ages. In London in 1884, of 1,000 small-pox deaths, only 343 were under ten years old. But this calcu'ation includes both vaccinated and unvaccinated person ý. In the vaccinated community the corresponding figures were not 343, but 86; and in the unvaccinated, not 343, but 312. Among the unvaccinated the 612 is better than the Geneva 404 [ APRIL",
         "SMALL-POx AND VACCINAIION. 961, and the Kilmarnock 988 of prevaccination times. Vaccination, by lessening the opportunities for infection, and increasing the intervals between epidemics, has helped even the unvaccinat-cd. Yet anong the unvaccinated in London, Leicester, Dewsbury, and Gloucester, small-pox is still to a great extent a disease of childhood. In prevaccination times, small-pox, measles and whooping cough were diseases of childhood. Mea,4es and whoopi, g cough are still di-eases of childhood, but small-pox, and especially fatal small-pox, has been to a very remarkable extent driven from vaccinated childhood by means of vaccination. In the same way, what still remains of it can be driven from later priods of life by means of revaccination. The manner in which small-pox·differ ntiates between the vaccinated and unvaccinated is seen in the incidence of the disease -n towns where it has recently prevailed. In Gloucester, for example, there had been extreme neglect of infantile vaccination, and the disease attacked a school and spread there, the scholars being chiliren. In Leicester the infection was accidentally introduced into the scarlet fever hospital and the child- ren being unvaccinated the disease began to spreai there. The hespital was then emptied of scarlet fever and no more cases were admitted, and in the town of Leicester scarlet fever cases increased to thou.-ands. In Warrington on the other hand, infantile vaccination had been well car- ried ont, but there was a want of aidult revaccination and the disease fastened on the workmen in a large ironworks. Then the workn en's committee in charge of the sick fund resolved \"that any member who remains unrevaccinated after Monday, November 2'st, 1892, shall not be entitled to any sick benefit should he be afflicted with small-pox; \" and in consequence over 1,400 men were revaccinated by the works' doctor, and many others privately. The result was that after the middle of December there were only 12 cases among the employees, and the health officer of Warrington reported that these were among men who had re- fused revaccinatioi or joinei the works subsequently. . The following table teaches a lesson that cannot easily be misread. Percentage of total small-pox deaths borne by ch ildren under 10 years of age in recent outbreaks. Percentage of total Vaccination Default sinall-pox deaths in antecedent years. borne by children under 10 years of age. W arrington ......Very slight........................22.5 Sheffield . ........Very slight........................25.6 London ..........In 1883-91,10 per cent. ...........36.8 Dewsbury ........ In 1882.92, 32.3 per cent............. 51.8 Gloucester ....... . In 1885-94, 10.6 to 85.1 per cent. . . . . .64.5 Leiceter ........In 1883-92, 43.8 to 80.1 per cent .....71.4* *Or 66.6. The ditference depends on the exclusion or inclusion of three deaths which occurred owing to the attack of several children in a scarlet fever ward through proximity to the small-pox hospital. 1901.] 405",
         "SMALL-POX AND VACCINATION. 3. In countries where there is much vaccination and re-vaccination relative- ly to the population, there is little small-pox. In Prussia both vaccination and revaccinati n are compulsory, and snall-pox mortality is almost abolished.* Beginning with the year 1816, it is found that in that country previous to the law of 1874 the snall-pox death-rate was 309 per annum per million of population. Since then, ending with 1892, it has been 15, and in the last ten years of the period only 7. Voreover, the compulsory vaccinat:on age is the second vear of life, and investigation showed that in 1886-90 more than two-fifths of the few deaths that occurred from small-pox were under two years of age. In Austria where vaccination is not compulsory, the rate instead of being 7 per million as in Prussia, was 458 in the same period. In Belgium also vaccination is not conpulsory, and in 1875-84 it had a rate of 441 per million as compared with Prussia's 22 in the same period. In Italy since 1888 vaccination of infants has been compulsory, as has revaccination of children attending public schools. Already a great im- provernent is indicated. In 1881-90 the small-pox death rate was 355 per million per annum, and in 1891-94 it was only 65. At the time of the European epidemic of 1870-7.i Scotiand, England, Sweden and Ba- varia had a conpulsory vaccination law, and their small-pox rates per million in the worst years were 1,470, 1,830, 1,660 and 1,660 respectively. Prussia, Holland and Austria had no general compulsory vaccination,and their rates in the worst years were 5,060, 5,490, and 6,180. Coming to 1877-86, with vaccination not compulsory in Austria, with only infantile vaccination compulsory in England, and with vaccination and revaccina- tion compulsory in Prussia. the average death rate per million from sinall- pox in the capitals of these three countries was in Vienna 670, in London 250, and in Berlin 10. In London the rate w ould have been less but for the disease spreading from the small-pox hospitals that it then contained. 4. In classes among which there is much vaccination and re-vaccination there is little small-pox. In epidemics, as in London, Sheffield, and Warrington, re vaccinat- ed postman and policemen renained safe in the midst of exposure to in- fection. Sir Charles Dilke stated in 1883 that the average strength of the permanent postal service in London was 10,504 in 1870-80, and yet during all that period. including the great epidemic, there was not a single death from simall pox, and only ten slight cses. In 1891-94, the employees of the General Post Office were over 55,000, yet there was onlv 17 cases of small-pox and one death, though postmen owing to the nature of their duties are specially exposed to infection. In the Army and Navy, where a large inajority of the men are suc- cessfully revaccinated, there is very little emall-pox-very much lessthan before revaccination become so prevalent. No persons are so terribly exposed to infectious diseases as are the nurses in fever and small-pox hospitals. As regards fever nurses, Dr. *As regards the Prussian vaccination laws see BRIT. MED. -JOUR., 1894,,vol.*ii, p. 1213 and Dr. Edwards in The Practîtioner of May, 1896 406 [ APRIL",
         "SMALL-POX AND VACCINATION. Collie, Medical Superintendent of Homerton Hospital, declared that \"the only way in which nurses become seasoned against lever is by taking the disease.\" At Homerton, Stockwell, and Liverpool Road Fever Hospitals, in the ten years ending 1881, 133 of the staff were attacked by various fevers, and 25 died. The Gateshead Medical Officer wrote: \" Every nurse who has been more than a fortnight in the typhus wards has suff- ered from typhus.\" lu Newcastle in 1882 only 5 out of 14 nurses escaped typhus,and among the 9 attacks there were two deaths. In the Hospitals of the Metropolitan Asylums Board in 1487-95, no fewer than 704 of the attendants contracted scarlet fever, diphtheria, or enteric fever. low is it as regards small-pox? At Homerton Hospital in 1871-77 366 persons were employed. Al but one was revaccinated and she was the only one who took small-pox. In the Highgate Hospital the Royal Commission found that since May, 1883, of 137 nurses and attendants 30 had had small-pox before entering the service. Of the other 107 all ex- cept the gardener were revaccinated, and the gardener was the only one who took small-pox. In the Sheffield hospitals, in the year ending 31st March, 1888, there were treated 1,798 small-pox patients. The total number of atteudants, etc., was 161. Of these 18 had had small-pox pre viously and escaped attack ; 63 had been vaccinated in infancy, of whom six were attacked and one died ; the other 80 were successfully revaccin- ated, and not one contracted small-pox. In Leicester, however, where vaccination is neglected, some of the nurses refused revaccination In the outbreak there the total hospital staff consisted of 40 persons. Of these 14 had either had small-pox or had been revaccinated before the out- break, and 20 were vaccinated owing to the outbreak. Among these 34 (14 and 20) one mild case occurred in a nurse whose revaccination was ten years old. Six of the 40 nurses appear to have been imbued with anti-vaccination opinions, and refused revaccination. Only one of the six now needs any protection against snall pox. Five of thern took it and one died. 5. In places where small-pox prevails it attacks a much greater proportion o. the unvaccinated than of the vaccinated, especially where the vac- cinations are comparatively recent. In the Homerton Small-pox Hospital in over 10,000 cases treated by Dr. Gayton nearly 21 per cent. were unvaccinated, and among children under 10 the unvaccinated were no less than 47.6 per cent. The unvac- cinated at this time (1873-84) in the population fron which the cases were drawn did not ainount nearly to 21 per cent. much less to 47 per cent. On the other hand, there is one hospital (Highgate) which does not admit children under seven and which draws its patients from a more universally vaccinated section of the population, and this hospital differ- ed from others in London in that the percentage of unvaccinated patients was found to be much less, the difference being due to the difference, in the ages of admitted cases, and the difference in the prevalence of vaccin- ation in the population from which cases came. 190 1.] 407",
         "SMALL-POX AND VACCINATION. 6. In houses invaded by small-pox in the course of an out-break not near- ly so many of the vaccinated inmates are attacked as of the unvac- cinated in proportion to their pumbers. Taking chiidren under 10 years old, in infected houses in Dewsbury, 10.2 per cent. of the vaccinated were attacked, and 50.8 per cent. of the unvaccinated; in Leicester. 2.5 per cent. of the vaccinated, and 35 per cent. of the unvaccinated; in Gloucester 8.8 per cent. of the vaccinated, and 46.3 per cent. of the unvaccinated, These places are selected here because they are centres of antivaccination, as to which it cannot be truthfully alleged that the unvaccinated are weakly children whose vac- cination has been postponed by medical certificate, or that the vaccinated and unvaccinated children belong to different classes especially when they are compared in tie households actually invadel by the disease. It is urged by antivaccinationists that vaccination does not protect against small-pox, but on the contrary tends to weaken the system against all disease. Yet the vaccinated were attacked in much less pioportion than the unvaccinated. 7. The fatality rate among persons attacked by. smallpox is much greater. age for age, among the unvaccinated than among vaccinated Taking the 10,403 cases treated in Homerton Hospital in 1 s73-84, the deaths among the vaccinated 8,234 were 869, or 10.5 per cent., and among the unvaccinated 2,169, were 938, or 43.4 per cent. We shall see shortly that the deaths among the well vaccinated were on'y 3 per cent. Taking the epidemics in three towns, Dewslurv, Leicester and Gloucester, where vaccination has been neglected, we find that under 10 years of age, among 72 vaccinated children attacked, two died, or 2.7 per cent., but among 961 unvaccinated children attacked 350 died, or 37.3 per cent. Taking persons over 10 years old, among 1,959 vaccinated persons attacked, there were 136 deaths or 6.9 per cent., and amorg :ý31 unvaccinated persons tiere were 75 deaths, or 22.6per cent. Again it is to be noted that as vaccination was practically optional in these towns, the unvaccinated children, according to anti-vaccination theories, should have been more able to resist death by smallpox than those who had been subjected to an operation which is alleged to weaken the system and render it more liable to disease and death. 8. It cannot be truthfully alleged that independently of vaccination smallpox is a milder disease now than in former centuries. If it were the case, as is sometimes argued by anti-vaccinationists, that the smallpox fatality rate in last century was about 18 per cent.* of persons attacked, then the much higher rate now occurring among the un-vaccinated would showthe disease to be much more severe now thait then. But in the last century, as in the present, century, the fatality varied greatly in different outbreaks, as does the fatality of scarlet fever, * This rate is based mainly on a prevalance of the disease in certain towns in the We t Riding of Ylrkshire in certain years between 1720 and 1730, but no average, either for a century or for a country can be calculated on such limited data. (Vaccination Vindicated, pp, 57-59.) [ A PRIL 408",
         "SMALL-POX AND VACCINATION. diphtheria, measles, etc., in the present century. And in epidemics in the present century, whether they be mild or severe, whether the fatali- ties be few or many, and whether there be much or little vaccination in the community, it is found that both the attack rate and the fatality rate are much greater in the unvaccinated than in the vaccinated in pro- portion to their numbers. 9. The degree of protection conferred by vaccination corresponds to the thoroughness with which the operation has been performed, three or four marks being much better than one or two, and a large mark much better than a small one. In Dr. Glayton's 10,403 cases at the Homerton Hospital, 2,085 had good marks, and the fatalitv rate was 3 per cent.; 4,854 had indifferent marks, and the fatality rate was 9 per cent.; 1,295 were alleged to be vaccinated, but had no marks, and the fatality rate was 27 per cent; and, 2,169 were unvaccinated and the fatality rate was 43 per cent. Taking \"good \" marks only, and attending to their numbers, Dr. Gayton found that with one mark the fatality rate was 4.1 per cent.; with two marks, 3.3 per cent.; with three marks, 2.3 per cent.; with four or more marks, 1.5 per cent The cases on which these percentages are founded were 529, 649, 518 and 389 respectively. Taking nearly 7,000 cases observed in recent years, the Royal Commission found that the smallpox fatality rate in persons with one mark was 6.2 per cent.; with two marks, 5.8 per cent.; with three marks, 3.7 per cent.; and with four marks, 2.2 per cent. It is comparatively seldom that cases come to hospital with the smallpox eruption so far advanced and profuse as to obscure the vaccina- tion marks, but in hospital statistics in this country a column is provided for \"doubt.ful \" cases, and if the figures for any large hospital be ex- amined it will be seen that the inclusion of such cases either as \" vaccin- ated \" or 'unvaccinated \" does not alter the lesson taught by the statis- tics. 10. Sanitation cannot account for the facts above set forth. Whooping cough and measles deaths still belong to childhood as in the last century, while snallpox deaths have been removed from child- hood to later periods of life. How could sanitation account for this differentiation ? If it be suggested that because sanitation confers . a special benefil on children it may have altered the age incidence of small- pox, the answer is got by looking at facts. In Germany. as we have seen, vaccination is not compulsory till the second year, and over 40 per cent. of all the smallpox deaths occur under two years of age. In Scot- land the vaccination age is six months, and children under six months make just about the same contribution (138 deaths per 1,000 deaths) to the total sinallpox deaths as they did (139 deaths per 1,000) before the vaccination law was passed. But in the next half-year of life-the half- year of vaccination-the contribution has fallen from 153 to 47. Surely this is vaccination and not sanitation. In a community attacked by 1901.] 409",
         "SMALL POX AND VACCINATION. smallpox, how could sanitation at home protect postmen going from door to door day after day in the infected districts? In Leicester, how could sanitation account for the revaccinated nurses escaping smallpox, and the nurses who had refused revaccination taking smallpox ? How could sanitation cause smallpox to pass over vaccinated children and seize on unvaccinated children in bouses invaded by smiallpox in Dewsbury and Leicester and Gloucester ? How can sanitation have caused the fatality of smallpox cases to be nuch less among the vaccinated than among the unvaccinated in these towns, especially if vaccination weakens the system and makes it less resistent to disease as is alleged by anti-vacci- nationists ? How could sanitation cause chiliren with three or four vaccination marks to have a less fatality from smallpox than children with one or two vaccination marks ? In Glasgow, while sanitation was going fromi bad to worse in the early part of the century, vaccination was introduced and smallpox underwent an enormous diminution, though hospit ais and isolation and disinfection were entirely out of the question- In Gloucester vaccination had been neglected and in 1891 the secretary to the anti-vaccination league declared to the Royal Commission that Gloucester was a very clean town and liad always been well abreast of sanitary improvements, and that its death-rate wvas very low. The Board of Guardians also wrote to the Commission on the sanie lines. But smallpox came, and the town suflered from a terrible epidemic, and ever since then the anti-vaccinationists have been declaring that there was a great want of sanitation in Gloucester. What was wanting was vaccination. For convenience the Registrar-General many years ago grouped together places whose death-rate was low and classitied them as \" healthy districts.\" They were nearly all found to be sparely populated rural districts where, though bouses may be damp and overcrowded and other insanitary conditions prevail, there is little opporturity for infection. In such places, in spite of bad sanitation, there is a lower death-rate than in towns, because, independently of sanitary effort, the atmosphere is purer. Also there is less sinall-pox, and it comes at a later average age, because there is less facilitv for spread of infection on account of the sinallness of the population and the distance of house fron house and village from village. In such circum4tances, though there is little sanitary effort there is little small po. , and unvaccinated per.ons have a better chance of escap- ing small pox attack than they have in large towns where sanitary arrangements are more elaborate. 11. Though isolation of small-pox cases in hospitals is a useful auxiliary to vaccination it is no substitute for it. In an unvaccinated n4tion it would be utterly impracticable to pro- vide sufficient small-pox hospitals. For whooping cough and measles hospital accommodation bas iot been seriously attenpted, though these disea-es cause an enorrnous imiortality. Where, owing to vaccination lia- bility to small-pox is limited, hospitals are very useful and help to give time for general revaccination. But in an unprotected community their almost certain breakdown is obvious. Who would have attended to the 410 [ APRIL",
         "SMALL-POX AND VACCINATION. sick in Leicester if ail nurses had had the same experience as the nurses who refused revacccination ? In an unprotected community, instead of snallpox being limited, it would spread in rapidly widening circles. Where a person protects himself by vaccination and revaccination he can defy smallpox. le carries his protection with him wherever he goes and a father can obtain protection both for himself and his family. Even if isolation in hospitals were made more stringently compulsory than vaccination has ever be'rn in this country there could be no complete security. The protection of the individual might fail at any moment. It would depend not on himself but oo other people. His cordon of pro- tection would be a chain, the measure of whose strength would be its feeblest link, and over not orie link would he have efficient control. Failure of parents to observe the symptoms of illness ; failure to call in a doctor; failure of the doctor to recognize smallp x ; failure in prompti- tude of removal ; inadequacy of hospital accommodation; insufficiency of disinfection of persons and things-these would be among the risks to whieh even a law of compulsory isolation would leave him exposed. Ob- viously the risk of collapse of voluntary isolation would be much greater. 12. Vaccination is very safe. Nothing done by human beings is entirely without risk, but the risks of vaccination have been grossly exaggerated. Some of the earliest anti- vaccinationists held that the countenance of a vaccinated child might be transformed so as to assume \"the visage of a cow.\" Later on, in the 'fifties, vaccination was accused of making people bald-headed, short- sighted, lazy, and of causing degeneracy in music, painting, oratory, poetry, etc. Still later, the habit has been to get statistical returns of increasing and decreasing diseases froi the Registrar-General, and to attribute the increasing diseases to vaccination, and to use the decreasing diseases to illustrate the view that smallpox also might decrease without vaccination. But a disease may be increasing at one time and decreasing at another. Thus at one time cholera and enteric fever and scarlet fever were blamed on vaccination, but when these diseases began to decrease, their decrease was, and still is, held to show the needlessness of vaccination. One foul disease in particular has been blamed on vaccination. It happens that since Leicester gave up vaccination that disease has increased there much more rapidly among infants than in the rest of England. So also erysipelas, while it decreased in England by 16 per cent., increased in Leicester by 41 per cent. Similarly, diarrhea, dysentery and bron- chitis, all of which have been blamed to vaccination, increased much more in Leicester than in England. The periods under comparison are 1863- 67 and 1883-87. It is not to be supposed that the increase in these diseases is due to want of vaccination, but if instead of increasing they had diminished in Leicester, it is undeniable that their diminution. would have been attributed by antivaccinationists to diminution in vaccination, just as increase of many sorts of dibease has been attributed by them to vac- cination where vaccination is not neglected as in Leicester. The Royal Commission made most careful search for injuries resulting from vaccin- 1901.] 411",
         "412 SMALL-POX AND VACCINATION. [ APRIL ation, and, after the fallest consideration, arrived at the deliberate conclus- ion that such injuries are \"insignificant\" and \"diminishing\" andcan be still further diminished. So insignificant are they that vaccination is nowhere more nearly universal than in the families of medical men, who love their children as other men do, and who know much better than other men can do, the exceeding safety of vaccination. 13. Calf lymph is now available to Boards of Guardians, etc., for the vac- cination of every child in the country. Reverting to the foul disease which has formed the principal allega- tion by antivaccinationists, it is to be noted that the use of calf lynph makes its occurrence through vaccination an absolute impossibility, as calves are not subject to that disease.",
         "TREATMENT OF INFLUENZA. SOME FACTS IN REGARD TO THE TREATMENT OF INFLUENZA. There are very few diseases Nhich in their early stages produce such mild symptoms, and which on the other hand are capable of being so rapidly fatal in their results, as influenza. There is probably no malady in which careful nursing and the avoidance of exposure will so certainly produce recovery in the ordinary individual as this disease; and con- versely, there is no illness which if subjected to poor nursing associated with exposure is capable of producing more serious consequences. While the patient may feel generally wretched in the early stages of invasion, he often does not feel sufficiently ill to force him to his bed. His fever is often moderate, and strength at this period is not sufficiently decreased to impress upon his mind the necessity of its preservation by absolute rest. The result is that very frequently the patient keeps on his feet, as does a case of walking typhoid fever, until his vital energies are so sapped that he becomes not only bed-ridden but in desperate straits, and then it is that the physician is called upon with the expectation that he will give speedy relief. Unfortunately, in many of these cases, consolidation of the lung, feebleness of the heart muscle, or renal complications are important factors in the case which cannot be speedily dissipated, and which otten resist all our efforts at betterment. Undoubtedly much more can be done in the way of prophylaxis when a person is taken ill with influenza than can be accomplished by active medicinal interference, and the prospects of rapid recovery are always in direct proportion to the willingness of the patient to lie by for a few days when he is first taken ill. Ever since the great epidemic of influenza which swept over the country in 1889 and 1890 and thereabouts, physicians have constantly met with cases of cardiac disease which have dated their illness from the attack of grippe suffered at that time. Many of these patients previous to that epidemie were already sufferers from valvular affections of the heart, but were unconscious of the valvular defect until the influenzal poison so sapped the strength of their heart muscle that a rupture of compensation occurred. In other instances persons who had previous to that illness perfectly healthy hearts have now apparently perfect valves, but nevertheless suffer from evidence of heart feebleness, continuously or upon marked exertion. In these cases the inluenzal poison seems to have expended its energy solely upon the heart muscle and produced a cardiac asthenia which it is often impossible to overcome. Many of these cases of cardiac asthenia depend upon the patient having disregarded his physician's advice and insisted upon get- ting out of bed before the heart muscle had time to recover from the disease. Every patient should be told when taken il] with influenza that the surest way to reach perfect recovery is to call upon all the vital fune- tions of his body to the least possible extent during his illness, resting 1901.] 413",
         "TREATMENT OF INFLUENZA. assured that the old motto of \" Make haste slowly \" holds true most emphatically in this disease. In many instances no other treatment than this advice is really needed, although in many of them it is advisable from the very beginning of the illness to administer some mild alkaline diuretic, which is perhaps best represented by the following prescription: I Potassii citratis, à ij; Spiritus æetheris nitrosi, f 5 j Aquæ dest., q s. ad f 3 iv. M. S.: Dessertspoonful every four hours. This prescription will maintain urinary flow, be slightly antipy'etic in its influence, will perhaps aid in the destruction of the toxic materials, and certainly will aid in their elimination by the kidneys; and it cannot be doubted that free diuresis for the purpose of eliminating the impurities of the body is an important part of the treatment of all infecticus diseases. For the muscular and bone pains of influenza the application of a hot- water bag or hot brick to the part of the body which is in greatest suffer- ing will often be efficacious, and is much better than the administration of coal-tar products, whieh are apt to help produce cyanosis and nervous depression, and which give the kidneys additional work in elimination. But if these symptoms are 'marked, 9cetanilid in what is well known as the migraine tablet, which contains two grains of acetanilid, half a grain of citrated caffeine, and one grain of monobromated camphor, may be administered several times a day ; or in its place phenacetine and salol, as these preparations seem to depress the circulation less than some of the other coal-tar combinations. If an irritable cough, unassociated with distinct bronchial or pulmon- ary trouble, annoys the patient, doses of codeine, say one-tenth to one- fifth of a grain, may be administered several tiines a day with advantage; and if'headache is marked and of a congestive type, with cold in the head and frontal fulness, a hot mustard foot-bath repeated several times a day will often give relief, and is a much better mthod of treatment than the administration of drugs. In some cases of influenza the heart seems to be considerably de- pressed by the action of the disease, and it is necessary to administer stimulants. But in the great majority of instances, if the patient will remain flat on his back in bed the use of stimulants is unnecessary, and if they can be avoided it is best not to administer them. If they are given, moderate doses of the alcoholic stimulants are probably best, par- ticularly if whiskey or brandy is administered, in the form of hot lemon- ade, which, while acting as a stimulant to the circulatory system, will also increase the activity of the skin and kidneys in eliminating toxic materials. We do not think that the fever ought ever to be lowered by coal-tar products, but always by sponging with tepid water; or, if the temperature is very high, by the use of the su-called sponging or rubbing of the body with a small piece of ice, using active friction with the other hand, and keeping cold applied to the head so as to avoid cerebral con- gestion during the sponging. W here patients object to the use of cold 414 [ APRIL",
         "1901.] TREATMENT OF INFLUENZA. 415 water or ice, alcohol and water, half and half, may be employed, and in other instances a mixture of equal parts of warm vinegar, warm water, and alcohol may be used with advantage, in that sponging with this liquid not only cools the skin but opens the pores, washes off effete ma- terials, soothes the peripheral sensory nerves, and by so doing tends to produce sleep. Another drug which is of value because of its influence in increasing secretion of the skin, and because it relieves pain in the muscles and bones, is Dover's powder. But this substance often seems to produce secondary depression in blond, sanguine persons, and because of the opium it contains is liable to increase constipation, which should not be encour- aged in the presence of a condition where it is desirable to aid in elimina- tion as much as possible.-Therapeutic Gazette.",
         "ENEMAS. ENEMAS. The position has much to do with the comfort of the patient and more so with the effect of the enema. The following positions are most used - Sims's or left lateral, in any cases where the patient can be placed without discomfort or danger ortearing stiches, as in a recent laparotomy. Dorsal in any case where patient cannot be turned on the side, and in oiving rectal irrigations. Right lateral when complete laceration of perineum exists. Genu-pectoral, or knee-chest, position when giving rectal irrigations or when giving medicated enemas, as in cases of dysentery, etc. Trendelenburg's position immediately after an operation when sti- mulating or saline enemas are given, especially if the sphineter-muscles are relaxed. An evacuant enema consists of either pure water to which is added a little salt or soap-suds. This enema should not be very large, 1 to 2 pints being a sufficient amount. It can be given either high or low, but the latter is most commonly used. A purgative enema is given when an increased peristaltic action is desired, and consists generally of somne irritating medicine mixed with water, salt solution, or soap-suds. The follow ing precriptions have pro- ved very efficient:- 1 Turpentine, 4 ounce. Mag. sulph., 1 ounce. Castor-oil, 1 ounce. Warm water, 1 pint. 1W Ox-gall, 15 grains. Turpentine, J ounce. Glycerin, 1 ounce. Castor-oil, 1 ounce. Soap-suds, 1 pint. The ox-gall should first be dissolved in a little warm water. In cases of severe constipation, when the fæces are clogged in the lower bowels, it will often be necessary to remove them with the fingers, then inject 5 to 8 ounces of warm olive-oil, which should be retained for one hour, followed by an evacuant enema. In cases of operation upon the perineum, rectum, etc., the bowels should never be allowed to be moved the first time after the operation without an oil enema; this will prevent much pain and irritation to parts surrounding the stiches. An antispasmodic enema is given in cases of colic either in adult or child. This enema gives great relief to patient in cases of tympanites. It is beýst given in Sims's positions. If the flatulence is caused by fer- [ APRIL 416",
         "mented food, a purgative should be given by mouth, and an enema con- sisting of W Mag. sulph.. 1 ounce. Turpentine, i ounce. Hot water, i ounce. given high will often give great relief. Flatulence that occurs in preg- nancy is relieved by injecting through a hard-rubber syringe the fol- lowing: IU Yelk of an egg; Turpentine, i ounce. well beaten together. An astringent enema is given to reduce chronic inflammation: to check diarrhœa and hæmorrhages f rom the bowels. It consists generally of starch and opium and some astringent: 1 Tannic acid, 10 grains; Tinet. opii, 15 grains; Mucilage of starch, 2 ounce, injected cold after each defecation- In cases of bleeding and irritating ulcers in the rectum:- 1 Nitrate of silver, 5 grains; Water, 1 ounce, injected cold once or twice, and is very effectual. A stimulating enema is given in cases of low vitality. A stimulating enema should always contain some salt, should be hot, and given high in large or small quantities depending on the circumstances. It consists of some kind of alcoholic fluid, such as whisky, brandy, or pure alcohol. The pure alcohol should only be given one-half dose. W Whisky or brandy, j to 2 ounces. Normal salt sol., 1 to 4 pints. Strong coffee with whisky is very good stimulating enema in cases of morphine poisoning, and is given in quantities, as j pint to 2 ounces. A nutrient enema is given to nourish the system through the bowels when nothing can be retained on the stomach. All food given through the rectum should be predigested or peptonized, should contain salt, and be warm. The quantity should be small, but repeated often. The bowels should first be well cleansed, then quieted, if necessary, by aid of tinct. opii, 15 minims, or cocaine, 1 grain, in solution injected through a small glass syringe. The enema is always given high, and between each enema the bowels should be well flushed with normal salt solution to remove all irritating remains. A nutrient enema is best given through a funnel and tube, but a Davidson syringe can be used if the nurse is gentle and careful. The patient should be placed in either Sims's, dorsol, or Trendelenburg's position, according to circumstances. To peptonize milk, chicken-broth or soup, beef-tea, oyster-broth or soup, or clam-broth or soup, one may use 15 grains of bicarbonate of soda and 5 grains of pancreatin to each pint of fluid used. The powder is disolvetl in a little water; then the fluid, which should be tepid, is added, and the vessel containing this preparation is placed in a large vessel con- taining water at a temperature of 90 F. The water must reach the 1901.] ENEMAS. 41'7",
         "margin of the food to be peptonized, which should remain in the water for exactly twenty minutes. If it remains longer or at a higher tempera- ture it curdles and is unfit for use. After the food is peptonized it should be placed on ice and reheated when needed. Leibig's beef-extract and Wyeth's beef-j uice are very good agents, and do not need to be peptonized. The following prescriptions are valuable:- 1E Either Milk, Chicken-broth, Beef-tea, Oyster-broth, Clam-broth, 8 ounces. 1W Liebig's beef-extract 1 ounce. Hot water, 4 ounces. Whisky, i ounce, Sodium chloride, 15 grains. 13 Wyeth's beef-juice 1 ounce. Tepid water, 1 ounce. This nourishment should be repeated every three or four hours as needed. A forced enema is given in cases of obstruction of the bowels and small tumors of the bowels in children. It consists of large quuatities of plain tepid water or oxygen. The rectum should be emptied, then plu- gged with a rubber cork, through which the nozzle of the syringe is in- troduced, and the anus should be strongly supported to prevent explusion of the enema. This treatment is very painful, but is sometimes very successfully administered. Hanna Kindbom (trained nurse and Hospital Review).-Monthly Cyclopaedia. [ APRIL 418 ENEMAS.",
         "SOCIETY REPORTS. SOCIETY REPORTS. TORONTO CLINICAL SOCIETY, Stated meeting March 6th, 1901. Dr. George A. Peters, the vice-president, in the chair. Visitors present:-Dr. Clarence Starr, and Dr. Ryerson of the Sick Children's Hospital. Case of Convulsive Tic. Dr. R. D. Rudolf presented the patient and read notes of the case. This condition of tic really means a jerk or twitch or spasm. He referred to an exceedingly good article on the subject in Clifford Allbutt's System of Medicine by Dr. Russell, who divides it into four different classes. Dr. Rudolf thought that the first class that of simple tic, which is sometimes called habit spasm, was very badly named because it was not always due to habit. The other part of the name is also wrong ; it is note on- vulsive; it is simple because the patient utters no ejaculations. J. B., aged fifty-seven years, who came corrplaining of twitching of the muscles of the face and neck, and the duration of whose illness was then about tifteen months. He had been married seven years; no chil- dren. There was no history of spasms of any kind in any of the mem- bers of his family. His previous history showed that he had always been strong; and there was no history of venereal disease. Outside of his present trouble he was strong and healthy. The present attacks be- gan six months ago; began by a gre'at deal of twitching of both eyes; and much worse when walking about. When he was sitting still he was not troubled with it at all. Dr. Rudolf saw him first in March of last year; that was six months after the commencement of his illness. He suffered then from spasms of the eyelids, coming on at irregular intervals. The patient occasionally assumed a condition of risus sardonicus. He was decidedly worse in December. It involved the facial muscles as well as the orbicularis palpsbrarum. This almost makes- him blind. There is nothing abnormal in any of the muscles of the neck. When sitting quietly he is pretty steady. The twitchings are rapid-about one hun- dred and twenty to the minute. When he tries to open the eyes, he momentarily succeeds, but spasm in face and neck sets in. His forehead wrinkles up and relaxes; and he assumes the risus sardonicus condition. The strands of the platysma stand out like cords. The sterno-mastoid alsq involved. The head is occasionally drawn forward and to the right side. If the eyelids are forcibly opened, the condition is found to involve the external muscles of the eyes so that the eyes are rolled about.' The tongue does not seem to be affected; and speech is unaffected. When he stands the spasms are worse and so close his eyes that he is partially blind. His head rotates from side to side and he endeavors to hold it with both hands. Saliva increases in the mouth, and a peculiar snuffing 1901.] 419",
         "SOCIETY REPORTS. [ APRIL induced. These are very constant in the disease. The eyes were ex- amined by Dr. Reeve, who found them practically normal beyond a little presbyopia. There is a good deal of watering of the eyes. Romberg's symptom is absent. The knee jerks are absolutelv gone, when tried a few weeks ago. There is no hearlache, but occasionally pain about the muscles of the neck when the spasms are on. There are no abnormal sensations anywhere The spasins are ail gone when he is asleep. He is almost, if not quite, as bad when sitting in the dark as when sitting in the lighit. He can sit or lie in bed with his eyes closed and be pretty free froin the spasrn, but if he opens them the spasms begin at once. The act of opening them brings on the spasms-in the light. When the spasms are very bad, he puts his hands to his head and neck, and by pressure he slightly controls them. It is quite evident that this case belongs to the first class of Dr. Russell, viz., simple tic. le bas not any of the verbal ejaculations, except under sufficient provocation. It is certainly not psychycical. As regards the cause of this condition. There have been numerus causes mentioned. It is frequently habit. Blephorospasm from conjunc- tivitis, and lasting long years after the irritation bas gone. Habit spasm is a bad naine because it is not present in all cases. It is not heredit ary in this case. The age : most commonly it coimmences in youth, but occasion- ally, as in this man, who was fifty-five or fifty seven when it comnenced. Irritation from sonie scar is another cause, but there is no such cause to be found in this case. The most common cause, or associated condition, seems to be somue error in accommodation. Dr. Sinclair found error of accommo- dation in forty-one out of forty-nine cases,-quoted by Dr. Russell. There is very little wrong with the eyes in this case. The case is a typical one. Dr. Osler mentions that a dozen of these cases may be attending any clinie. Dr. Rudolf does not think them so common. He came across a very slight case this winter. In the treatment he has tried various remedies. Bromides had no effect at all. Nitro glycerine absolutely had no effect here. At present the patient is taking liquor arsenicalis-five minims three times a day. Dr. Rudolf thinks he is slightly better than he was at first. The patient was examined by the Fellows present and it was found that the man had a large right scrotal hernia. Dr. Oldright asked whether the zinc salts were of any worth in these cases. Dr. Primrose referred to scars as a caune of tic; and asked whether it is common to have a unilateral condition in these cases, or common to have both sides involved, or one side only. Dr. Peters asked if Dr. Rudolf had discovered any reflex exciting cause excepting the hernia, which he has had a great many years; for instance, anything in the Schneiderian membrane, and if stuttering bas any relation to this disease. He also referred to the case of a bandsman in one of the city bands, who stutters very badly, who jerks his head to the side frequently and utters ejaculations. Dr. Peters bas noticed quite recently that someone bas been operating on these cases by cutting the seventh nerve and transplanting the spinal accessory into its distal end. He claims in that way to have got rid of the spasms, without having 420",
         "1901.] SOCIETY REPORTS. 421 complete paralysis. This operation had done it in two or three cases with beneticial results. Possibly. taking out a section of the orbicularis muscle might relieve the intensity of the eye spasm. Dr. Rulolf in reply: He thought that stuttering would come under the heading of the co-ordinated form of tic, not this unco-ordinated forin. He has seen cases of that kind,-inspiratory form of stuttering. Cutting the facial nerve and joining it to the spinal accessory might do in a unilateral case, but does not see what good it could do in this case where the condition is generalized. Dividing of the orbicularis muscle on both sides might possibly do some good. The prognosis at the present is very poor indeed. Regarding Dr. Primrose's question, if due to a scar, would it be unilateral,-he does not think so always. Dr. Reeve strongly suspected there would be a scar somewhere. Dr..Rudolf bas not tried the zinc salts. The prognosis is exceedingly poor, and Dr. Rudolf stated he was glad of the sugestion of operation on the orbicularis pal- pebrarum. The condition now, practically makes the patient blind. The inan has had right inguinal complete hernia for forty years. Tendon Transplanting in Paralytic Deformities. Dr. Clarence L. Starr by invitation presented this paper with the histories of four cases. The treatment of paralytic deformities has been until recently by means of mechanical support, and where operative treatment had been added, it was in long-standing deformnities, and in these a simple operation bas been done and the necessary mechanical support applied afterwards to prevent relapse. The outlook for that bas not been bright. Within the past few years other attempts have been made to prevent or correct deformity. In 1881, transplanting of the peroneal tendon into the tendo-Achillis was first performed. One cannot claim that the operation will cure or is applicable in the large numbe- of cases of deformities. Some are, however, completely cured. Operation is clearly indicated where a group of muscles are left unimpaired while others are paralyzed. Better results may be looked for here than else- where. Dr. Scarr then reported the following four cases in detail. Case 1. A boy five years of age, who had had acute infantile spinal paralysis with complete paralysis of the right limb. The peronei muscles remained inactive. The patient walked on the outer border of the foot entirely. The tendon of the peroneus longus was isolated; a second incision made above the ankle joint, and the tendon of the tibial is anticus exposed. These tendons were united. The foot is now perfectly flat. Case 2. A young girl fourteen years of age. Perfect valgus was present in this case-equino-valgus, the calf muscles being paralyzed as well. It was desirable to get a firm base of support in the right leg. An oblique incision was made from above the outer malleolus downwards and inwards so as to expose the peronei tendons and the tendo-Achillis. The brevis was divided and carried underneath the tendo-Achillis and attached to a slip of the flexor longus hallucis. The peroneus longus was then divided and attached in the same way to the tendo-Achillis. The",
         "wound was closed and splints applied. Passive motion was commenced in three weeks; and in six weeks the patient was able to bear her weight upon it, and she is now able to walk. Case 3. A young lad aged 18 years with marked valgus deformity resulting from infantile paralysis. He walked with a stiff and awkward gait. An oblique incision was made over the extensor tendons The extensor longus digitorum was isolated. This patien. was allowed to walk in six weeks; and his gait was very much improved. Case 4. This patient, a boy aged five years, was presented to the Fellows. He had had an acute attack of paralysis in July '99, which involved both lower extremities. The right gradually improved and is now apparently totally recovered; the left, only partially defornied, showed the regular typical club foot. In January 1901, the peronei and extensor mu-cles were permanently paralyzed, giving no response to the faradic current. The boy walked altogether on the upper surface and dorsum of the foot. Walked distinctly on the outer side, the plantar surface being turned inward and backward towards the opposite foot. There was narked toe drop except in the great toe. The boy was oper- ated on January 23rd when a curved incision was made exposing both peronei and the tendo-Achillis. The wound healed by primary union were removed only a few days before his being presented to the society. There is noted narked improvement in the position and stability of the foot. The plantar surface comes in contact with the floor at every step. A great deal may be done for these otherwise helpless class of de- formities, and it is essential that primary healing be secured or the oper- ation will prove useless latterly. Kangaroo tendon should be used in these operations; silk is likely to corne out later on. Motion should not be allowed until four or five weeks, as tendons unite very slowly. In this case the extensor comnumis digitorum was attached to the tibialis anticus. It is absolutely necessary if you use a mechanical support of any kind to replace it by a larger one so that the patients are thoroughly disgusted when they arrive at adult life. Dr. Primrose has suggested the possibility of nerve grafting; but Dr. Starr did not remember ever hear- ing of any case where that had been attempted. lie had heard it dis- cussed in the American Orthopedic Association. Unusual Dilatation of Bladder. Dr. William Britton presented these pathological specimens and de- scribed the conditions present in each patient. The first occurred in a gentleman, 75 years of age, who has always lived a careful life. He had come to Dr. Britton last winter complaining of difficulty in voiding his urine. He had to use more force than was natural. Dr. Britton ex- amined him and found what appeared to be a tremendous cyst of some character extending up as far a; the lower margin of the ribs on the left side, the greater part of the tumor appearing to be to the left of the median line. The doctor used the catheter the following day and drew off seventy or eighty ounces of urine. The character of the urine was [ APRIL 422 SOCIETY REPORTS.",
         "SOCIETY REPORTS. the same as was found subsequently at post mortem. After a few days he was seized with coma and died in this comatose condition after seventy-two hours. A post mortem examination was made by Dr. H. B. Anderson. Found prostate very much enlarged; ureters much dilated; kidneys about normal in ize, but evidence of hydro nephrosis. Bladder was full with about seventy or eighty ounces. The urine was limpid, almost as clear as water. Dr. Britton did not know the exact quantity of urine he was voiding prior to his coming to see him. The sp. gr was 1,008. Bladder was a great deal hypertrophied. The walls were thick- ened, and there were very small extravasations beneath the mucous membrane. Cancer of Stomach. The case of cancer of the stomach occurred in a man who in ordin- ary health weighed 196 lbs., a machinist by occupation. He had always lived the life of an old country Englishman, that is, he ate as much as lie wanted to. He was very robust, and Dr. Britton had know i him for ten years. Last fall he began to become emaciated. He was reduced from his former weight of 196 pounds to 117 pounds. That would seem to be almost beyond belief. He had been suffering about a year and one half with the ordinary symptoms of cancer, except that he suffered from no pain from first to last. In the first instance, one and one half years before lie was seen by Dr. Britton, lie had discomfort in the stomach which would continue for two or three days when he would vomit large quantities of undigested food, and would be relieved by drinking large quantities of water. The intervals of relief became shorter and shorter. Dr. Britton was not able to find any tumor and nothing but positive evidence of closure of pylorus. He was fed per rectum for two weeks during which time lie gained seven pounds in weight. He was seen by Mr. Cameron who performed gastro-duodenostomy. He died a short time afterwards. On opening the stomach it was found to be very much eularged, the walls being very much thickened. At the pyloric extremity there was a soft cancer attached to the walls all round, but there was sufficient opening so that the doctor could pass his finger eas- ily through the pylorus. When food entered the stomach, the cancer was pressed down and acted as a sort of ball valve. There was no exit from the stomach to the intestines. Before the operation, Dr. Anderson made an examination of the contents of the stomach, and the details of the report pointed towards the existence of cancer. HCI was not present. No lympnatic glands were affected at all. The cancer was a very small one, and it was extraordinary that it should have caused death by starvation. The lungs were in a perfectly normal condition, and the other organs of the body as well; no metastasis. Dr. Fotheringham asked if a microscopical examination had been made as to the exact character of the new growth. Dr. Rodolf asked the composition of the nutrient enemata which produced the large gain in weight. Dr. Peters thought it a remarkable feature of the case, the pro- nounced loss in weight with so small a growth; and the fact that the 1901.] 423",
         "cancer had evidently produced death in the end was one which would appear to have been amenable to treatment by pylorectony, there being no enlargement of glands and no metastasis of the liver He considered it a rare condition to find cancer as old as this without these conditions being present. Most cases when discovered are so far advanced that you cannot remove the pyloric end of the stoinach on account of metastasis etc. Symptoms of cancer of the pylorus are very slight in character for a long time, and by the time a positive diagnosis has been made it has gone past the reach of the surgeon. Gastro-enterostomy was the proper operation had the patient been strong enough to stand it. Dr. Primurose began the discussion on the bladder case. A question which has occurred to hiin in connection with a case recently under his care-whether it is wise to interfere at all with a greatly distended blad- der, or whether is it not wiser to open abdomen and establish drainage. He further referred to several cases in his own practice. Dr. Silverhorn asked whether Dr. Britton had any difficulty in pass- ing a uatheter. Dr. Oldright mentioned a case where a man had not passed urine for 36 hours, he drew off 60 ounces of urine. What does Dr. Britton consider was the cause of death in his case? Dr. Britton stated he did not look upon it aý a case of sepsis. Dr. Peters had stated there must be somnething else than that. Dr. Britton in reply stated that a microscopic exanination had been made of the stomach and the report was cancer. The enemata consisted of thoroughly peptonized milk. As to the bladder case, he had not been able to assign the ciuse. GEORGE ELLIOTT, Recording Secretary. MISCELLANEOUS. EMERGENCY HOSPITAL AT THE PAN-AMERICAN. By HERBERT SHEARER. A very pretty hospital building stands near the west end of the Mall. Floor area rather than elevation is a prominent feature in the con- struction of this important adjunct to the exposition. Utility, first, last and all the time is the prime consideration in this design though it is by no means a case of utility unadorned. In conformity with the general Exposition plan the free Spanish renaissance has been treated, in this in- stance, with a strong leaning towards the old mission interpretation. [ APRIL 424 SOCIETY REPORTS.",
         "MISCELLANEOUS. 425 Having a frontage of 90 feet on the Mail : the main wing has a depth of :8 feet with a height of but one story, except in the center, where it assumes the formi of a square tower with a rounded top. This tower attains to the pretentious height of two stories surmounted with two flagstaffs. One staff supports the Exposition flag and from the other waves the well known red cross banner, the only universal international eniblein that is recognized and reverenced in all couitries. A rear wing one story higli runs back fron the center portion a dis- tance of 56 fet with a width of 32 feet. 1 his forin of construction lends itself readily to this pictureque reminder of the early struggles of our first missionaries. Color, here as everywhere throughout the grounds, adds its mantle of beauty to the odd and in nany cases obsolete nethods of construction, penetrating, rather than clothing the building in the warm changing HosPTA. ON TE ROUN v Go' PAN-AMERICAN EXPOSITION. tints of the sunset. A low wandering adobe mission house covered with heavy red tiling, its weather stains retouched by the gorgeous rays of the departing sun, may be readily imagined while looking at this rehabilita- tion of the past. Any antequated illusion that may be conveyed by the outside appearance of this building is, however, at once dispelled by a visit to the interior. Modern arrangements that are both convenient and sanitary mark every feature. Approved medical and surgical appliances have been carefully selected in regard especially for their adaptability to emergency work and the exigencies that are likely to arise. The main hospital entrance is from the Mail opening directly into a handsome rotunda decorated with tropical plants and suitable hangings of pictures, drapery, etc. The main office is situated at the farther left hand corner ofthis ro- tunda where it is carefully tucked away under the staircase forming an irregular alcove. It contains telephone and electrical annunciator, and messenger call service, with other modern and necessary appurtenances. 1901.]",
         "As this is lighted from above and encircled by a round gallery opening through the upper story the effect is very pleasant and agreeable. The first floor front contains in the extreme western wing, two male wards with seven cots each, a bath room, physician's office, a morgue and a linen chest. The eastern wing contains a woman's ward, large enough to hold a dozen cots, with direct communication to the woman's bath room. This wing also contains an ottice for the superintendent of nurses, private physician's office, a linen closet and other conveniences. The upper story is intended for the use of the resident physicians and the necessary attendants. It is fitted up with four pleasant, com- fortable bedrooms and a bathroom. The rear wing extending back from the main entrance, contains the operating room, sterilizing department and instrument cases. Immediately across the hall is the emergency bathroom and patients' waiting-room. Still farther down the corridor is located the kitchen, pantry and dining-room, which is intended for the use of patients only, as the staff have their culinary department in the service building situated but a few yards distant. In the extreme southern end of this wing is the storage room for electrical ambulances; this room also contains a station for recharging the batteries ; electricity for this purpose being brought from an electric circuit provided for the electric launches on the Grand Canal. In addition to the two electrical ambulances, a steam or gasoline motor ambulance will be provided to be ready in case of a possible failure of the electrical current. The building is provided with natural gas for hea.ting purposes and for cooking when necessary for the patients. Water, gas and electricity is carried to every part of the hospital in the most approved manner. The building is plastered throughout and rendered sanitary and germ proof so far as possible, in every instance. The staff in attendance are uniformed to grade according to universal custom. In the matter of equipment and applianees, everything is of the newest and best. A new litter attracts considerable attention; it is care- fully balanced and so arranged that one attendant can operate it easily and noiselessly as it runs on two wheels about 20 inches in diamneter which are fitted with large inflated rubber tires. Sterilizing apparatus with an appartment for instruments and another for towels and linen, is another necessary arrangement. Roswell Park, M.D , is the Director, Vertner Kenerson, M.D., Deputv Director and Dr. Alexander Allen, is the resident physician, a staff which will at once inspire confidence in all who are acquainted with these gentlemen or their work. The efficiency of this department is an illus- tration of the manner in which the Exposition is designed and executed in all its departments. Everything has been carefully arranged accord- ing to a great cômprehensive plan, the details of which have been worked out in every instance with careful conscientious precisiun. In regard to the importance of this adjunct to the Exposition it may be said that up to the first of March five hundred and four cases have been treated on the grounds, only one of which proved fatal. These ii- clude all forms of sickness and accidents to workmen employed upon the [ APRIL 426 MISCELLANEOUS.",
         "MISCELLANEOUS. construction work. In this connection it is well to note that the number of cases treated at the Omaha Exposition was about three thousand while the history of the hospital at the World's Fair in Chicago gives a total of 11,602 medical and surgical cases treated, resulting in 69 deaths. It is hoped to have less use than this for the hospital at the Pan- American though in the immense crowds who will attend, no doubt, many individuals will have occasion to appreciate the provision that has been made in this direction. THREE DANGEROUS OPERATIONS.-J. B. Deaver, (Philadelphia Med- ical Journal) protests vigorously against the abuse of three common operations in gynecology. First of these is repair of lacerated cervix. The condition is so common that it is more normal than pathological. In the absence of special indications, such as the cancerous diathesis, it had better he left alone. Salpingitis, pyosalpinx and adhesions strongly con- traindicate, and endometritis should be previously corrected. Curette- ment of the uterus is a dangerous operation and calls for a rigid observ- ance of aseptic and anti-septic details. In acute endometritis, the possi- bility of perforation and in chronic endometritis, the possibility of light- ing up a latent salpingitis must be borne in mind. The presence of gonococci positively contraindicates curettement. Divulsion of the cervix should never oe done except under anesthesia and with complete cleanli- ness. It ought never to be done in the office. It is unsatisfactory in cervical stenosis and a failure for the correction of flexions.-St. Loui8 Medical Review. ORGANO-THERAPY IN GYNECOLOGICAL THERAPEUTICS. Harvey P. Jack (InternationAl Jour. of Surg.) says that there has been more ad- vance along the line of organo-therapy than in any other department of experimental therapeutics. The use of thyroid extract in cretinism and myxœdema is well known, but medication almost as specific, and results almost as striking, are to be obtained by the use of this and the parotid, mammary and ovarian gland extracts in gynecological therapeutics. Thyroid extract is one of the most reliable vaso-constrictors, and in gynecology its use is indicated in hemorrhagic affections of the uterus and in various forms of pelvic congestion; the best results are to be ex- pected in tibromas and pathologic conditions of recent development. Polk has noted also an increase in nervous and muscular energy, improved nutrition and lessening of pain. Shober bas obtained equally good re- sults in fibromas from the administration of mammary gland extract, and it is not followed by the symptoms of thyroidism. It controls the hemorr- hages, reduces the size of the tumors, and in some cases causes their dis- appearance. It does not seem to have any effect on the hemorrhages of inoperable cervical cancer, as does thyroid extract. This may bç ex- plained by the fact that thyroid extract has a special catalytie action upon the epithelial elements of the endometrium. In two cases of in- operable cancer of the uterus in the writer's practice, thyroid extract controlled the hemorrhage, and in one case the pain. Parotid extract is the best remedy for dysmenorrhea and ovaritis. Pelvic exudates soften and are often absorbed. Menstr 'ation becomes regular, less in amount 1901.] 427",
         "and shorter in duration, while the headaches and nervous symptoma so often accompanying the monthly period are, as a rule, cured. The ovarian extract is indicated in all cases of nervous trouble at the menopause, and also where it is desirablie to increase the flow from the uterus. The ovary has, besides its function of ovulation, another almost as important, that of internal secretion, and, like the thyroid, secretes an active oxidizing agent, spermin, that aids in the metabolism of the blood. Parotid extract is the best ovarian sedative, and ovarian extract the best ovarian stimulant. It is probable that as we learn more of the dif- ferent physiological effects of each gland, as ý tudied alone and in com- bination, more exact therapeutic application may be deduced and gland therapy may take thé- place, in a large measure, of surgical procedures. -Am. Gyn. and Obst. Jour. SURGICAL HINTs. Never minimize to a patient the importance of any operation. They all offer certain dangers, and no branch of your art may be consiiered as of a trivial nature. If you are compelled to put on a bandage rather tightly, it is well to warn the patient that it must not be removed, but that, if it becomes painful, a few snips of the scissors will give relief. No operation about the mouth, such as removal of the tongue, or about any of the orifices of the body, ought to be undertaken without previous methodical disinfection continued for several days. Never be in a hurry to amputate in wounds of the fingers or hand. Observation under treatment by antiseptics will often result in saving important parts, which at first seemed quite hopeless. In small abscesses,occurring in infected wounds, whether they involve the whole or only a portion of the wound, there is no better treatment than the removal of stitches, washing out with peroxide of hydrogen, and thoroughly painting the pyogenic surfaces with tincture of iodine. It is a fault of many operators that they are constantly asking ques- tions of the anaesthetist during operations. Only employ a man you can trust, and then leave him alone to bear the sole responsibility of his share in the operation. He may have a hard enough time in coping with a patient who takes the anaesthetic badly without being disturbed by con- stant admonitions. INDIGEsTION. T. Lauder Brunton lays down the following rules for the treatment of chronic function in dyspepsia: The first rule is to eat slowly, masticate thoroughly, and insalivate completely; three things which are by no means always the same. The next rule is to take solids and liquids separately, the latter in the shape of hot water on rising in the morning, between eleven and twelve in the forenoon, about four or five in the afternoon, and at night before going to bed. When these rules do not suffice to remove the dyspepsia, the patient must take his farinaceous and proteid foods at different meals alternately, a farinaceous meal at breakfast-time and again at five o'clock, and meat or fish meals at mid- night and at eight o'clock. In some cases it will be found advanta- geous to supplement the gastric juice with a little acid and pepsin. A little alkali with calumba may be given before meals, or if there is gastric [ APRIL MIsCELLANEOUS. 428",
         "catarrh some substance containing tannin, such as infusion of gentian, may be preferable. In cases with tlabby tongue perchloride of iron with quassia will probably be of more service. When there is gastric dilata- tion which will not yield to the measures above mentioned, it may be necessary to wash out the stomach in the morning or at night.-The Clinical Journal. TREATMENT OF THE GRIPPE.-Knowing that influenza, as rheuma- tism, is particularly frequent during the cold and wet season, and has for the mucous membrane a predilection analogous to that of rheumatism for the serous membranes, Dr. Bourget. Professor Medical Clinique, has been experimenting on the effects of a treatment similar to that of rheu- matism. His liniment is composed as follows:- Salicylie acid, -j; Salicylate of methyle, 5ijss; Essence of eucalyptus, Sj Camphorated oil, ýj; Spirit of juniper, äiv. A portion of this mixture is rubbed strongly over the chest and the back of the patient, who is then closely covered up to the chin with the bedclothes. The heat of the bed caused evaporation of the aromatic essences, and favours the absorption of the salicylic acid, and the patient experiences a sensation of bien eêtre. Not only for influenza has Prof. Bourget used this liniment with success, but also in several aflections of the respiratory organs. -Medical Press and Circular. ' AN OINTMENT FOR CHRONIC BLEPHARITIS.- 1 Binoxide of mercury .......... 1 grains; Lead water.... ............... 10 drops; Petrolatum .................. 5 drachms. M. To be applied night and morning to the free edges of the lids.-N. Y. Medical Journal. HEMORRHOIDS.-In the Richmond Journal of Practice for January, John G. Rennie gives a plan of treatment in painful hemorrhoids. His method of treatment includes rest in bed with elevation of hips, light diet, contents of bowels soluble, and cleanliness. To avoid consti- pation he uses cascara, 20 to 30 minims of the fluid extract once or twice daily. He uses the following prescription locally: 1 Acid carbol. Menthol .......... ...... ... .a.a. gr. xii Cocaine hydrochlorate .......... gr. xiv Acid Tannic..... ............. gr. xvi Vaselin alb. ................\u003cq.S. 1i M. Sig. For local use. -Charlotte Medical Journal. 1901.] 429 M1sCELLANEOUS.",
         "430 Infuse in: Boiling water Filter and add: Asafetida . ... Yellow of egg S. For rectal use. ................ 250 gm. ................ 4 gm . ................ N o. i. ANTINEURALGIC PILL.- R Zinci valerianat................. Quinin valerianat ............ Ext. opii ...................... Ext. bellad ................... For one pill. S. Two to six daily. 0.05 0.10 0.01 0.05 egm. cgm. egm. egm. -YVON. SWEATING IN PHTHISIS.- R Scopoliæ (alkaloid) .......... 0.015 mgm. Spt. vini reet .. ............. 6. Ij igm. M. S. Gtt. x. three times daily. i -DUcKWORT AND DUNSTANT.-N. Y. Medical Record. MISCELLANEOUS. [ APRI LUMBAGO AND MUSCULAR RHEUMATISM.- Menthol .........................20 gr. Salicylic acid .......... ........... 15 Chloral hydrate..................... Camphor........................aa 40 gr. Powd. capsicum ....................90 gr. Croton oil ........................5 gtt. Petrolatum ........................ 2 3 Rub in vigorously, a small quantity at a time.-Med. Fortnightly. CHRONIc ECZEMA AND PSORIASIS.- R Creolin ........................... 5 ss. Hydrarg. ammon .................. gr. x. Petrolati ............ . ........... 1. -DAVID WALSH.-Medical Record. L",
         "The Canada Lancet A MONTHLY JOURNAL OF MEDICAL AND SURGICAL SCIENCE, CRITICISM AND NEWS. The Oldest Medical Journal in the Dominion: Established 1867. Editor :-H. B. ANDERSON, M.D. ASSOCIATE EDITORS: W. B. Geikie, M.D. F. Le M. Grasett, M.D. G. Sterling Ryerson, M.D. John L. Davison, M.D. Geo. A. Bingham, M.D. N. A. Powell, M.D. D. Gilbert Gordon, M.D. Allan Baines, M.D. D. J. G. Wishart, M.D. J. T. Fotheringham, M.D. D. C. Meyers, M.D. C. A. Temple, M.D. F. Fenton, M.D. H. C. Parsons, M.D. Chas. Trow, M.D. Chas. B. Shuttleworth. COLLABORATORS: A. H. Ferguson, M.D., Chicago. Ernest Hall, M.D., Victoria, B.C. Hadley Williams, London. J. Coplin Stinson, San Francisco. All Communications in reference to the Literary part of the Journal, articles for publica- tion, etc., address The Editor, 241 Wellesley Street, Toronto. Articles on subjects of Medi- cal, Surgical or general interest to the profession solicited for publication. Correspondence in reference to Advertising, Subscriptions, Publishers Department, etc., address Dr. G. P. Sylvester, Business Manager. Make Cheques and Drafts payable to the Business Manager. EDITORIAL. MEDICAL AMALGAMATION IN TORONTO. As the L INCET by an editorial in April last inaugurated the move- ment for a friendly approach between the two medical teaching bodies in Toronto, it may be not out of place to detail the course of the negotiations with that end in view now brought to a close by the refusal of the Cor- poration of Trinity Medical College to assent to the terms formulated by the joint committee. While negotiations were pending we refrained from any comment which might be a breach of confidence or which might tend to make more difficult the delicate adjustments necessary in such an undertaking. Now that the joint committee which has had the matter in hand is dissolved, a statement of the sequence of events in the negotiations is permissable, and is, moreover, due to the profession at large. After the failure to secure by the \" McKay Bill,\" at the last session of the Legislature, better relations between Trinity Medical College and the Provincial University, many prominent members of the two medical teach- ing bodies in Toronto thought it to be an opportune time for the burying of old 'ifferences and for uniting in a scheme for placing medical education [ 431 ]",
         "in Ontario on a more satisfactory basis. At their instance the Senate of Toronto University appointed a committee to act as a joint committee with one appointed at the same time by the Corporation of Trinity Medical College. The personnel of this joint committee was as follows: From the Senate of Toronto University-Rev. Principal Caven, Chair- man, with Sir Wm. R. Meredith, Chancellor, Mr. Justice Moss, Vice- Chancellor, Sir John Boyd, Hon. S. H. Blake, Drs. 1. H. Cameron, A. H. Wright and A. B. McCallum. From Trinity College there were Drs. W. B. Geikie, Dean of the Faculty; J. A. Temple, F. Le M. Grasett, Chas. Sheard, J. L. Davison, N. A. Powell, G. A. Bingham and J. T. Fotheringham, with Dr. D. J. G. Wishart, the Secretary of the Corporation. This joint committee met before the summer vaca- tion and appointed a sub-committee, composed of Dr. Cameron, Chair- man, with Drs. Wright and McCailum, and Drs. Temple, Powell and Davison, to confer as to the general principle of amalgamation and its feasibility. This sub-committee's report was brought in, received and adopted by the joint committee in June, 1900, and was to the effect that amalgamation was desirable, and that no insuperable obstacles to its accomplishment presented themselves. In October the sub-committee was enlarged by the addition of Drs. Charles Sheard and R. A. Reeve, Dean of the Faculty of Toronto University, with Dr. Sheard as Chairman, and was instructed to prepare a statement of appointments, emoluments and other details as a tentative basis for the formation of a new joint Faculty. This they did after many laborious sederunts, and submitted their report to the joint committee shortly after the New Year. The joint committee received this report and, prior to laying it before the Senate of Toronto University and the Corporation of Trinity Medical College, the bodies from whom it had its origin, thought it wise to transmit it to the two Medical Faculties concerned, for an expression of their opinion as to the details proposed, and for further suggestions and amendments. The Toronto University Medical Faculty made no response to the request of the joint committee for an expression of their opinion, and the reply received from the Corporation 3f Trin- ity Medical College dealt rather with a proposal in favour of \"federation upon broad lines,\" with retention of their identity as a teaching body, than with amalgamation and the conditions proposed by the sub-committee. This being submitted as Trinity's final statement in the matter, the joint committee, having no further purpose to serve, dissolved, and the negotiations may be held to be at an end. Other facts that appeared during the negotiations may be mentioned. 432 EÉ)ITORIAL. [ APRIL",
         "The scheme, so far as the general principle at any rate was concerned, met with favour and support; firstly,- from the Senate of Toronto University, particularly its lay members; secondly, from the Government, which unofficially but plainly announced its sympathy with the project; thirdly, we believe from a majority of the members of both medical facul- ties. There seems to have been uncompromising opposition to amalgamation by certain members of both medical faculties for reasons that do not appear on the surface, and this minority was able to prevent the consummation of a project which we believe met with very general endorsation by both the profession and the public. Not withstanding that the episode seems closed, we venture to reiterate the opinion expressed a year ago-that an amalgamation would have been the best, if not the only means of settling present difficulties and dis- agreements, and laying the foundation for a permanently satisfactory system of medical education in the Province. It must appear to the most casual observer tnat, while undergraduate teaching in this city is well up to the standard at present prevailing in other centres, we have not arisen to the fulness of our undoubted opportunities in the matter of medical research and direct contributions to scientific medical literature, and we feel assured that these most desirable ends would be greatly advanced by -uniting all our resources and energy to further them. AUTOINTOXICATION IN RELATION TO INSANITY. As a result of the excellent research work that bas been carried on during the past few years in the asylums for the insane in Europe and America, much knowledge has been gained of the etiology of insanity, which brings the treatment of many cases within the range of practical therapeutics, where hitherto little hope of cure would have been held out. Both as regards prevention and cure the study of insanity has thus assumed a position of much greater importance to the general prac- titioner, who can no longer afford to disregard derangements or diseases of such moment to the afflicted individual and his friends, nor to think that his duty as aphysician is done when the unfortunate has been relegated to a place of confinement. In no class of disease has progress been so much retarded by reason of their being too often regarded as outside the realm of pathology, as if insanity were due to supernatural agencies rather than the result of gross or minute structural lesions in the brain. Fortunately more rational ideas now prevail and the relationship of mind and matter are better understood. Hazy, indefinite, almost superstitious, ideas, pre- viously held. have given place to more rational conceptions and the basis 1901.] EDITORIA L. 433",
         "of a definite pathology has been laid, with a more or less satisfac- tory classification based on etiology, or on structural changes in the brain itself. The result has been to create a new interest in a field hitherto much neglected. One need only mention the good work that has follow- ed upon more attention to surgical treatment in the insane, even though at times certain individuals may hee allowed their enthusiasm to carry them to extremes in reference to it. The more careful study of the influence of morphine, cocaine, alcohol and other poisons in producing mental disease, as well as of the bacterial toxines in causing the delirium and other psychoses so of ten seen in the acute infective diseases, has thrown a flood of light upon. the etiology of insanity in general, productive of excellent practical results. The rela- tionship of the brain and its functions to the general nutrition is also more clearly understood, thus explaining the effect of chronic diseases of the liver, kidneys, bowels, etc.,-conditions assoiated with auto-intoxica- tion-in upsetting the mental equilibrium of susceptible persons. Hamilton, Berkeley and others have particularly called attention to this matter and insisted on its importance. Many instances have been quoted where removal of the source of toxæmia-as constipation or obstipation, has been followed by a prompt cure. The treatment is so simple and rational that such a possible cause should always be borne in mind. A careful inquiry into the etiology of all cases of insanity coming under the physician's notice would not infre- quently discover conditions amenable to treatment and restoration to health from a condition otherwise hopeless. In view of the fact that other countries are doingso much to assist the scientific study of insanity and whereas the increase of cases in Ontario is continually calling for more accommodation for confining these unfortu- nates at a great expense to the country, it seems a pity that our local legislature does absolutely nothing towards establishing facilities for re- search work in this direction, with a view to preventive measures. THE PROPOSED BILL FOR THE TREATMENT OF INEBRIATES. In the January number of THE LANCET we gave an abstract of the proposed bill for the treatment of inebriates. This bill, it will be remem- bered, was drafted by the Public Health Committee of the Ontario Medi- cal Association and a committee of the Prisoners' Aid Association, and was ratified by the Ontario Medical Association, in June last. The principle of that bill, it will also be remembered, has been endorsed 434 [ APRIL EDITORIAL.",
         "by the Canadian Medical Association and by the Toronto Medical Society, The bill was drafted a year ago at the request of the Premier of Ontario, was endorsed by the medical members of the Legislature, so that it was fully expected that the bill would have been introduced last session. We now learn, we must confess, to our surprise, that it is quite possible that it may not even be brought down this session. At an interview with the Provincial Secretary a few weeks ago, he stated that although the members of the Government and the inspectors of prisons were in full accord with the provisions of the bill he could not state when it would be introduced. Failing to introduce the bill last session-from whatever cause-we took it for granted that it would be brought down without fail this session, and we expected that reference would be made thereto at the opening of the legislature. While we cannot conceal our disappointment at this set back, possibly no good would result from denouncing the Gov- ernment for its reprehensible tardiness in dealing with so important a question. Having failed to move the Government by deputations and direct application, it now remains to be seen what may be accomplished by an appeal to the individual members of the legislature. We doubt that one member in ten really understands the question. If the members once understood the question we believe the bill would be introduced and passed without difficulty this session. Here is an opportunity for mis- sionary work on the part of each member of the profession throughout the Province. Copies of the proposed bill will be furnished members of the Medical Council from whom they may be obtained. If each member of the profession would procure a copy and would bring the question personally to the attention of his representative in the Ontario Legisla- ture, the whole question, we feel assured, would be settled in short order. Let each member of the profession realize his responsibility in this important matter and act accordingly. Copies of the bill may also be obtained of Dr. Rosebrugh, Confedera- tion Building, or to Dr. Gilbert Gordon, 646 Spadina Avenue, Toronto. THE MALPRACTICE SUIT AGAINST DR. CONERTY. We have previously called the attention of the readers of THE LANCET to the genuine hardship inflicted upon Dr. J. M. Conerty of Smith's Falls in having to defend a suit for malpractice that bas been drag- ging througb the courts for the past five years. In fighting this case Dr. Conerty bas not only been upholding his own rights and honor but those of the profession. The prolonged litigation has almost ruined him finan- 1901.] 435 EDITORIAL.",
         "cially and in the absence of any medical defence union, this is a case where his medical brethren should show their sympathy and apprecia- tion by coming to his assistance. We cannot do better than quote from a circular issued to the members of the profession in No. 17 medical dis- trict by their representative, Dr. R. W. Powell, of Ottawa. \"The annoyance, indignity and financial loss involved in the defence of such an action-particularly when the plaintiff is penniless-is a bard- ship which should arouse our sympathies. Dr. Conerty has made a good fight and is determined to do so to the end. His interests in the case are largely our own. It is in the absence of any medical protective or defence association that I am compelled to make this appeal and I hope that every physician in this division will do bonor to himself and his profession by contributing whatever sum he may feel disposed to in order that the professional standing of a brother practitioner may be vindicated. A moderate subscription from each one of us would be greatly appreciated by Dr. Conerty-with whose consent I am making this appeal. Any subscriptions to me will be acknowledged and forwarded.\" We hope the appeal made by Dr. Powell may meet with a ready response by the profession throughout the Dominion. THE LANCET will be pleased to receive and acknowledge subscriptions to enable Dr. Con- erty to bring the case to a satisfactory termination. The final hearing has been set for April 29th. Besides individual subscriptions, vari- ous local medical societies could greatly assist by following the example of the Medico-Chirurgical Society of Montreal in voting a sum for the defence of a case in which all are interested. THE ONTARIO MEDICAL ASSOCIATION. The annual meeting of the Association will be held in Toronto on June 19th and 20th. The committees have been at work for the past two months and the arrangements are now well under way. The Com- mittee on Papers, under the guidance of Dr. Machell, have arranged for discussions on the following subjects, which it is thought will be of interest from medical, surgical and pathological aspects alike,-Gastric Ulcer and Empyema. The discussions will be opened in each case by a physician and a surgeon by short papers,and general discussion will follow. There will also be a discussion on Extra-uterine Pregnancy. As this Association is the Provincial medical body, it is hoped that all parts of the Province will be well and fully represented, not alone by the presence of members or those intending to become such, but in the active interest in the proceedings, of which it is the privilege of all to partake. 436 EDITORIA L. [ APRIL",
         "1901.] EDITORIAL. In the course of a few days cards of notice will be sent to all mem- bers informing them of the date of meeting, and asking for titles of papers or reports of cases to be presented. It will assist the committee in their work if the titles of papers be sent to the secretary at an early date. POST HOC ERGO PROPTER HOC. The following delightful document was recently handed in anony- mously at the door of a house in Toronto which bore the yellow placard of diphtheria. The nâivete and childlike faith of the writer of it, his absolute disregard of cause and effect, his evident kindliness of intention find their full and adequate explanation in the legend inscribed at the foot of the manuscript :-\" Receipt from Ireland.\" The medical man who was in charge of the case, and who is so ungrudgingly credited with sufficient capacity to \" easily treat the boil,\" need not be much of a philosopher in order to keep his temper, and, instead of resenting too violently the attempted interference with his management of the case, to ruminate upon the extraordinary persistence of the Galenian theory of humowurs in the public mind in general, and the perennial fount of humour, usually as here, unconscious in the Hibernian mind in particular:- \" SURE CURE FOR DIPHTHERIA. Lately given to one after we have lost one child--we wish we had known of it before. Get 4 salt herrings right in the brine. Slice them in thin long strips. Wrap them thickly all round the throat. Bind them round with cotton strips, and flannel afterwards. Let them be on all night. In the morn- ing a boil will be raised through which the badness will come instead of going into the system. Of course the doctor can easily treat the boil. R FROM A SYMPATHIZER.\" Receipt from Ireland. 437",
         "EDITORIAL NOTES. EDITORIAL NOTES. The Medical Act of British Columbia. An attempt is being made at the present session of the Provincial Legislature of British Columbia to get an amendment to the Medical Act so as to allow all graduates of recognized colleges or licentiates from any part of Great Britain or her colonies to practice there without further examination. Colonial Doctors in the Imperial Service. Legislation is being procured at the present session of the Imperial Parliament which will qualify graduates of colonial colleges for appoint- ment on the Royal Armv Medical Staff. It was felt by many that an unjust slight was placed upon colonial medical officers during the South African campaign in this matter. When Did They Happen? Several deaths among children in Toronto, Canada, have been traced to eating ice-cream which had been re-frozen.-The Medicus. PERSONAL. Dr. J. F. W. Ross has returned to Toronto after a two months holiday in the West Indies. Dr. Samuel Lavine (Trinity '99) is opening an office on John street, Toronto. Dr. Harry Watson (Trinity '97) is assistant surgeon with the American forces at Manilla. We are pleased to learn that Dr. Price Brown, of Carlton street, has returned from the south greatly improved in health. Dr. Nattress, we are glad to know, has returned from The Welland, St. Catharines, much improved in health. Dr. W. T. Rush (Trinity '97) has returned to Toronto from mission work in British Columbia. Dr. John M. Macdonald (Trin. '97) has been appointed associate coroner for the county of Halton. Dr. G. A. Peters has been given command of the new corps of Mounted Infantry being raised in Toronto, with the rank of major. 438 [ APRIL",
         "Drs. A. H. Wright, W. P. Caven and Crawford Scadding sail for Europe in April, where they will spend some months. Dr. Hugh A. McCallum, of London, Ont., has passed the examinations for the M. R. C. P. of London. The engagement of Dr. Victor McWilliams, of Peterborough, to Miss Sheppard, daughter of 0. B. Sheppard, Esq., of Toronto, is announced. Dr. F. S. Pope (Trin. '98) of Victoria, B. C., is doing past graduate work in London, England; as also is Dr. A. R. Perry (Trin.'97). Dr. D. A. McGillvrav has returned from Europe and will take Dr. Fotheringham's practice during his absence in England. Dr. Wm. McCallum, of Jarvig street, will have the sympathy of the profession in the death of his brother from appendicitis. Dr. Fotheringham sails for England in a few weeks, where he will devote his attention to diseases of the skin and nervous system for some months. Dr D. M. Anderson (Trin. '98) for the' past two and a half years surgeon on the \" Empress of India,\" has returned to Toronto after a trip to Australia, South Africa and England. Dr. G. B. Smith, of College St., Toronto, will have the deepest sym- pathy of the profession in the death of his wife on Mar. 17th, after a short illness. Dr. T. H. Prust (Trin. '99) of Eastern Mich., was married on March 20th to Miss Vina Belleghem, daughter of D. Belleghem, Esq., of Peter- boro'. THE LANCET offers congEatulations. Dr. E. C. Ashton (Trinity '98), formerly house surgeon in the Hospi- tal for Sick Children and afterwards medical superintendent of the Gravenhurst Sanitarium, is beginning practice in Brantford. Dr. G. Sterling Ryerson is to be congratulated on being one of the new Knights of Grace of the Order of St. John of Jerusalem, an honor conferred at the same time upon Mr. Frederick Treves and Mr. A. D. Fripp. Capt. Frederick Fenton, A.M.S., has just completed a course of ten lectures to No. 4 Bearer Company. Under the popular commanding officer, Major Fotheringham, this unit is one of the smartest and most admired in the Toronto garrison. Dr. Robert Kippen, of St. Thomas, was recently bequeathed $78,000 by a grateful patient in Sault Ste. Marie, who died a short time ago. The doctor had attended her free of charge in the days of her poverty, and in prosperity she did not forget his kindness. 1901.] PERSONAL. 439",
         "OBITUARY. OBITUARY. Dr. C. E. Martin. We regret to announce the death at Whatcom, Washington Territory, on March 1lth, of Dr. C. E. Martin of Toronto. Dr. Martin was 69 years of age at the time of his death. He was a graduate of the Rolph School of Medicine, began practice in Lindsay, afterwards removed to Oshawa and finally took up his residence in Toronto some 25 years ago, where he continued in active practice until a few months ago. During the Ameri- can war Dr. Martin served in General Sheridan's cavalry. The deceased was well known and highly esteemed by both the public and the pro- fession in Toron o who will deeply regret his death. He was a Liberal in politics and a member of the Anglican church. Two sons, graduates of Trinity Medical College, are practicing in the western States and Mrs. (Dr.) Norman Allan, of Toronto, is a daughter. Mr William R. Warner. It is with feelings of profound sorrow that we announce the death of Mr. William R. Warner, which occurred on the morning of Wednesday, April the 3rd, 1901. His business career, covering a half century, was not only long, but honorable, and his impulses as a man were kindly and generous. We feel that his loss will be shared by all who came in contact with him in either trade or social circles. CORRESPONDENCE. Toronto, March, 1901. DEcAR SIR,-I beg to announce that I have just returned from the United States where I have been perfecting myself in the science of correcting visual defects with glasses. I have studied under some of the most efficient masters of this science in New York, Philadelphia, Boston and Detroit. I have fitted my apartments with the most modern appliances for detecting and measuring defects of sight. I make no charge for consultation. I recommend glasses only when absolutely beneficial. I guarantee my fitting to be satisfactory in every particular, and prices reasonable. Trusting I may have a share of your patronage. DEAR MR. EDITOR,-Perhaps you may think it worth your while to comment upon the amazing thickness of the skin of the gentleman who returns from the land of freedom from the exigencies of professional decency, and \" circularizes \" us as above. The rampant commercialism which announces that his professional training is of no value and there- fore is given free, has as its necessary corollary the next announcement in his precious circular that he will not sell glasses when they are not 440 [ APRIL",
         "needed. This is on a par with the notice which calls upon men of breeding not to expectorate upon the parlor carpet. The only way by which the optician, fully fledged after a two weeks' course, can be met, is by imposing a similar course upon all students in medicine, a very slight addition to the present curriculum, and one which would at once retain such work in medical hands, and give the public much better service. I would suggest that the Council make this a part of the course in the 5th year of study now exacted. Yours faithfully, J. T. FOTHERINGHAM. BOOK REVIEWS. THE JOHNS HOPKINS HOSPITAL REPORTS, VOLUME VIIL NOS. 3-9. The volume deals with typhoid fever in its various phases, and is a compilation of valuable monographs, contaning elaborate statistics and observations on many new points. The surgical treatment of perforating typhoid ulcer is taken up by Drs. Finney and Cushing. I. Dr. Finney gives an historical review of the operation, classifies 112 cases collected from literature, with his own cases, gives valuable hints as to signs of perforation, indications for opera- tion, technique, the value of blood examination as an aid in diagnosis, etc. IL. Dr. Cushing records 3 cases operated upon by himself and refers to the same points as to signs, etc., as in the former paper. III. Dr. Simon Flexner's article on \"Unusual Forms of Infection in typhoid fever,\" and \" Typhoid Fever without Intestinal Lesions,\" is ex- haustive and most valuable. IV. Dr I. P. Lyon, takes up the subject of coincident typhoid and malarial infection. V. Dr. J. F. Mitchell records 8 cases of oesophageal complications, some from literature, others from personal observations. The paper treats of olesophagitis, ulcer, stricture, with symptoms and pathological anatomy. VI. Haemorrhagic typhoid by Dr. L S. Hambruger. VII. Puerperal infection with bacillus typhosus by Dr. George Dobbin, is an historical review and report of a carefully studied case. VIII. Gall-bladder complications, by Dr. Charles Camac, includes cholecystitis, cholelithiasis and such conditions IX. Dr. Osler, hemiplegia in typhoid, with record of 4 cases. X. Hepatic complications by Dr. Osler, includes a comprehensive review of such conditions as, (a) focal necroses as described by Reed, (b) 6 cases of jaundice arising from catarrhal states, toxic abscess, gall-stones, cholangitis and pylephlebitis, (c) abscess. XI. The results of Widal's reaction are reviewed by Dr. Norman Gwyn. In 265 cases of typhoid positive reactions were obtained in 99.60%. A short article is given by the same writer on the \" Disinfection of infected typhoid urine.\" 1901.] BOOK REVIEWS. 441",
         "XII. A case of early oculo motor paresis in typhoid fever is re- ported by Dr. Charles P. Emerson. XIII. Dr. Hugh H. Young's paper on chronic cystitis due to the typhoid bacillus is something new and instructive. XIV. Dr. Osler gives a summary of the cases of typhoid under. observation from 1889 to 1899 This is most complete and exhaustive. XV. The special features, symptoms and complications taken up in the same manner are embodied in another article. XVI. The last paper is on \" Observations on the blood in typhoid fever.\" The technique is described at length. The blood of uncompli- cated cases is first dealt with and later the blood changes occuring with the advent of complications. Such a series of carefully recorded observations is a valuable contri- bution to medical literature. H. 0. P. A SYSTEM OF PRACTICAL THERAPEUTICS. By Eminent American and Foreign Authorities. Edited by Hobart Amory Hare, M.D., Professor of Therapeutics, Jefferson Medical Col- lege ; Physician to Jefferson College Hospital, etc. Philadelphia. New (2nd) edition thoroughly revised. In three very handsome octavo volumes, containing 2593 pages, with 427 engravings and 26 full-page colored plates. Per volume, cloth $5.00, net: leather, $6.00, net ; half morocco, $7.00, net. Lea Brothers \u0026 Co., Publishers, Philadelphia and New York. Volume II of Hare's system of Practical Therapeutics deals with the treatment of fevers and of diseases of the respiratory, circulatory, diges- tive, renal and nervous systems and of the skin The opening éhapter on typhoid fever is contributed by the editor, Dr. Hare. The author clearly outlines the power possessed by the physician in dealing with the disease, and its limitations and then proceeds to discuss prophylaxis and the treatment to be adopted in guiding the patient through his illness. Dr. Hare does not think that antityphoid inoculations are likely to give results at all comparable to those obtained in vaccination for smallpox -an opinion with which most authorities will agree. In discussing therapeutic measures in general he gives a qualified approval of the cold bath in selected cases but condemns the use of the coal tar antipyretics. Altogether the chapter deals with the matter under discussion in the most careful and conservative manner and represents the safest teaching at the present day. Dr. J. M. Anders writes a very satisfactory chapter on the treatment of malarial fevers. . Acute tonsillitis, influenza and acute articular rheumatism are dealt with by Dr. F. A. Packard in three unpretentious chapters In a system of therapeutics we think the use of guiacum in acute tonsillitis might have been mentioned. 442 BOOK REVIEwS. [ APRIL",
         "BOOK REVIEWS. 443 In discussing the treatment of diphtheria Dr. Floyd M. Crandall strongly approves of antitoxin. The same author deals very satisfactorily with spasmodie croup and rickets and diseases of the mucous membrane of the mouth. The articles croupus and catarrhal pneumonia are contributed by the editor and are up to the high standard one would expect. Diseases of the heart and vessels are dealt with by Dr. W. H. Thompson of New York, Dr. F. C. Shattuck, of Boston and Sir Lauder Brunton, authorities well qualified for the task, which has been satisfac - torily performed. We can scarcely agree with Dr. Thompson that digitalis can only benefit the heart as a nervine and is theiefore a tem- porary makeshift. By stimulating muscular contraction and thus filling the coronary vessels better it muRt improve the nutrition of the heart muscle, Dr. Thomas G. Ashton contributes the chapters on diseases of the stomach The articles are excellent, though possibly too short to be exhaustive. A most complete practical and altogether commendable chapter is that by Dr. Wharton Sinkler on headaches and neuralgia. Dr. J. H. Musser contributes the article on diseases of the liver and spleen. Dr. N. S. Davis those on diseases of the kidney. The treatment of diseases of the nervous system, including insanity is fully discussed by Allen M. Starr, Chas. K. Miils, F. H. Dercum, H. M. Bannister, Joseph Collins, Ed. N. Brush, and Hugh T. Patrick and the volume concludes with a number of short, concise, but thoroughly satisfactory monographs on the treatment of skin diseases by Henry N. Stelwagon. A perusal of this volume discloses much for praise and little for ad- verse criticism. The various articles are concise, practical and up to date and represent the best teaching and practice of the present day. The volume will be found most satisfactory and no medical library should be without it.--H. B. A. Clinical Examination of the Urine and Urinary Diagnosis. A Clinical Guide for the Use of Practitioners and Students of Medicine and Surgery. By J. Bergen Ogden, M.D., Instructor in Chemistry, Har- vard Medical School; Assistant in Clinical Pathology, Boston City Hospital; Medical Chemist to the Carney Hospital; Visiting Che- mist to the Long Island Hospital, Boston. 416 Pages Illustrated. Philadelphia, W. B. Saunders \u0026 Company, 1900. Canadian Agents, J. A. Carveth \u0026 Co., Toronto, Ont. Price $3.00. This work presents in a clear and concise manner the chemistry of the urine, giving detailed methods of analysis, both qualitative and quan- titative. Many illustrations and a number of colored plates are intro- duced, showing normal and abnormal ingredients of urine. The latter half of the work is devoted to the diagnosis of disturb- ances and diseases of the kidneys and urinary passages. The clinical symptoms of each disease is given in brief with the peculiarities of the urine in each affection and also in certain general diseases of the body. 1901.]",
         "The colored plates and illustrations are heautifully executed and add much to the value and appearance of the book. The text, paper and binding are creditable to the publishers. From a chemical standpoint this publication is wonderfully complete in detail and a careful perusal of its pages shows that all the standard authorities on the subject have been freely drawn upon and all recent methods of examination of urine have been embodied in this volume. We can recommend the work to the student of medicine as a full and concise treatise on the clinical examination of urine. To the busy practitioner, who has neither the time nor opportunity to consult the literature on medical and surgical diseases of the urinary organs, this work will prove invaluable.-C. B. S. SAUNDERS' MEDICAL HAND-ATLASES Atlas and Epitome of Diseases Caused by Accidents. By Dr. Ed. Golebie- wski, of Berlin. Translated and edited with additions by Pearce Bailey, M.D., Attending Physician to the Department of Corrections and to the Almshouse and Incurable Hospitals, New York. With 40 colored plates, 143 text-illustrations, and 600 pages of text. Cloth, $4.00 net. W. B. Saunders \u0026 Co., Philadelphia. J. A. Carveth \u0026 Co., Toronto, Canadian agents. This work contains the first systematic description ever published of the injuries produced by accident and the consequences and sequels resulting therefrom. It represents a full and scientific treatment of the subject of accident injury; the functional disability caused thereby ; the medico-legal questions involved, and the amount of indemnity justified in given cases. The text of the book is extremely complete, especially in its descriptions of functional disorders. The subject lends itself par- ticularly well to illustration, and the illustrations have been chosen with discrimination and executed with skill. The beautiful lithographic plates are models of artistic and lifelike representation. The subject is one of the utinost importance in these days of expert evidence in personal injury cases. The work is indispensible to every physician who sees cases of injury due to accidents, to advanced students, to surgeons, and on account of its illustrations and statistical data, it is none the less useful to accident insurance organizations. Canadian agents, J. A. Carveth \u0026 Co., Toronto, Ont.-G. A. B. ENCYCLOPAEDIA MEDICA.-VOL II,-BRACHIAL PLEXUS TO DIGESTION. Under the general Editorship of Chalmers Watson, M.B. Published by Wm. Green \u0026 Sons, Edinburg. Canadian Agents, J. A. Car- veth \u0026 Co., Toronto, Ont. Price $5.00 per volume. In the second volume, the excellencies which characterized the first volume are fully maintained. The articles on Burns, Climate, Cornea, 444 BOOK REVIEWS. [ APRIL",
         "Digestion and Metabolism are especially to be commended. The brain is treated in a series of five articles contributed by Bruce, Taylor, Rissien Russell, Fleming and Cotterill. In all some fifty-six subjects received treatment. Among the more important writers in these being Saundby, Habershon, Mansell Monllin, Julu and Allingham. The work is certainly up-to-date, and of good valhe. The articles are not too long. The treatment which each subject receives is original, and such as makes it appear before the reader as something entirely new and fresh. This is the best encyclopædia in the market.-D. J. G. W. SAUNDER'S MEDICAL HAND ATLAS SERIES. An authorized translation from the German of the revised and enlarged edition of the atlas and epitome of Gynecology by Dr. Oskar Schoffer, obstetrician and gynecologist, in the University of Heidelburg, and edited by Richard C. Norris, A.M., M.D., of Philadelphia, with 90 colored plates, 65 text illustrations and 308 pages of text ; price $3.50. W. B. Saunders \u0026 Co., Philadelphia and New York. The water color plates are really excellent, the artistic effects striking and the representations true. The clinical notes explanatory of the draw- ings are concise and the suggestions as to treatment are good. The method of teaching by appealing to the eye as well as to the ear is most valuable and is of the greatest assistance to the student in acquiring a minute and easy grasp of the conditions described. The drawings illus- trating the different normal positions of the uterus, as well as those show- ing the presence of abnormal growths in the pelvis, are especially instructive. The book on the whole is a valuable one. The Canadian agents are J. A. Carveth \u0026 Co. Toronto.-D. G. G. FRACTURES. Carl Beck, Surgeon to St. Mark's Hospital and the New York German Poliklink, 255 pages and 70 illustrations. Price $3.50. W. B. Saunders \u0026 Co., 1900, Philadelphia. J. A. Carveth \u0026 Co., Toronto. There are but few works that deal exclusively with fractures. The present one combines excellent arrangement with the latest useful- ness of Röntgen rays in such cases. By practically exposing the fracture to view, it enables the surgeon to verify or not his anatomical opinion in any given case. The old difficulty of wrestling with an obscure fracture in the vicinity of a large joint, endeavoring to determine whether there was fracture alone or fracture-dislocation is done away with in a large measure. Many excellent photographs illustrate special points in this con- nection. Recognizing that after all this is but an aid and corrective to the right appreciation of the diagnosis and treatment of fractures-the author in this work very clearly and systematically deals in two parts with the subject. In the first, \"Fractures in General,\" and in the second, \" Frac- tures of Special Regions.\" We like the style of the whole work and its 1901.] BOOK REVIEWS. 445",
         "BOOK REVIEWS. [ APRIL general get-up. It is not over-burdened with details, yet the descriptions are sufficiently clear, the plates are good, the printing unusually clear and easy to read. It is well worthy of a place in medical libraries. F.Le.M.G. A TEXT BOOK ON PRACTICAL OBSTETRICS. By Egbert H. Grandin, M.D., New York, Gynecologist to the Columbus Hospital, and George W. Jarmin, M.D., Instructor in Gynecology in Columbia University, is just entering upon its third edition, \"revised and enlarged.\" F. A. Davis \u0026 Co, Philadelphia. This is a book of 500 pages,tastefully gotten up, with a very attractive external appearance. The print is plain and easily read. The plates are particularly good and instructive, especially those in Part Il. These are artistic in character and of great assistance to the student in under- standing the text. The work is preeminently a \" practical \" one, and while it avoids the mistake of leading its readers into a maze by too voluminous descriptions, it perhaps goes to the other extreme of condensing over much, especially the theoretical side, thus making the book a little more difficult to read. Chapter IV., \"l The Diagnosis of the Presentation and of the Position of the Fætus \" is especially good and shows evidence of being care- fully prepared; likewise chapters VII and X. \" The management of normal and abnormal Labor,\" and the \" Pathological Puerperium.\" The teach- ings on the whole as to treatment are safe, and the book an excellent one and should be of the greatest value to the practitioner, as well as to the student.-D. G. G. THE INTERNATIONAL TEXT-BOOK OF SURGERY. By American and British Authors. Edited by J. Collens Warren, M D , LL.D., Professor of Surgery at Harvard Medical School, Surgeon to the General Hospital, Massachusetts, and A. Pearce Gould, M.S., F R.C S., Surgeon to Middlesex Hospital, etc. In two volumes Cloth, $5; sheep or half Morocco, $6. W. B Saunders \u0026 Co., Philadelphia. Canadian Agents, J A. Carveth \u0026 Co., Toronto, Ont. The second volume of this new work on surgery is now before us. This volume, devoted to regional surgery, confirms still more thoroughly the wisdom of the editors as shown in the former volume. With its 471 illustrations and eight full page plates in colors, in addition to its splendid text, the subject is made very plain and is presented in a highly practical kay. The conciseness of the text is very marked, nothing being admitted for the sake of \" padding.\" Where there is so much that is really excellent, it is perhaps unwise to particularize, but the chapters on \" The Diagnosis of Abdominal Diseases,\" by Mayo Robson, is in our estimation one of the very best things that bas been writteL on the subject. W. B. Saunders \u0026 Company (Philadelphia), are certainly to be con- gratulated upon the general appearance of the volume.-GEO. A. B. 446",
         "PUBLISHERS' DEPARTMENT. PUBLISHERS' DEPARTMENT. FEMALE NEUROTICS-THEIR TREATMENT. Prof. Chas. J. Vaughan, Chair of Gynaecology, Atlanta College of Physicians and Surgeons, writes: \" Cerebro-nervous affections peculiar to women associated with pathological disturbances of the reproductive organs are legion, and most trying to physician and patient. Physicians are aware of the wide prevalence of these nervous disorders, for com- paratively few women are entirely free from some phase of the ailment. Neurasthenia, neuralgia and other manifestations, either of an active or passive character, are common and are always peculiarly rebellious to treatment. Neuralgia constitutes the great cause of danger from the employment of hypnotics and narcotics, which only afford relief by numb- ing, but effect no cure. On the other hand, the formation of a drug habit rather aggravates the condition from which relief was originally sought. I have found nothing so well suited to these cases as five-grain antikam- nia tablets, administered in doses of from one to three tablets and re- peated every one,two or three hours according to the attendant's judg- ment. These tablets not only afford complete relief without fosterlng a drug habit, but they do not endanger weakened hearts. Their exhibition is attended with no unpleasant after effects. I use them in preference to any other prepàration in the treatment of female neurotics and experience demonstrates that they are safest and best.\" DECEIVING THE PALATE. In a recent issue of a medical journal appeared the following item:- \" A somewhat clever ruse, practised for the purpose of administering cod-liver oil to those who object to it, is described as breaking up a con- spiracy among the patient's olfactory, optic, and pneumo-gastric nerves. The patient probably confesses he likes sardines so without his becoming aware of the trick, the preservative cotton-seed oil is emptied away and the sardine box is filled with fresh cod-liver oil, of which every day the patient unconsciously takes a substantial amount.\" About the same time that the above appeared in print another authority vouchsafed the information that \"a ferruginous water, prepared by keeping a few iron nails in contact with water for a few days, serves to fully prevent the odor and taste of cod liver oil from being noticed. The mouth is to be rinsed with the water both before and after taking the oil.,' 1901.] 44'7",
         "448 PUBLISHERS' DEPARTMENT. [ APRIL. These articles take one back to the' days of the stage-coach, the hand-press, the tread-mill and the spinning-wheel, and the conviction is forced home that many people do not progress with Che age in which they live. Physicians of the modern school have come to the realization that plain cod-liver oil is too violent in its action to be safely adminis- tered to patients whose stomachs are in a weakened condition. But in order that the full strength of cod-liver oil may be secured, and at the same time additional benefits derived from other valuable bone-building and blood-enriching properties, the careful practitioner prescribes Scott's Emulsion of cod-liver oil. He gives this the preference over all others because during the twenty-six years of its existence it has proved invaluable in the treatment of all cases requiring cod-liver oil combined with hypopho.phites of lime and soda and glycerine. It is not necessary to resort to such subterfuges as above cited in order to get the emulsion into the system. Grown folks take it without the slightest hesi- tancy, while children, however young, become really fond of Scott's Emulsion."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "MAGAZINE T E R A R Y R E V I E W. by GEO. A. BAYNES. M.D.. \u0026c., \u0026c. JA NUARY 87 CO]TT I2 E rISI'T s. ORio tr.t'osiftae.tros.agre. On Toba..in Smoking. 1î t. On Trac tnom, especially in rela- Jr dti, \\L i., 1. R. . 1.. tin tiseases of he Tracha. 226 1.i.e .. . . . . . .. 205 11\"-s1an Pamlets eevd. . 227 \\lohoi. L.:cture by George .. En A. ?il.I. 212 . small Po,\\..................... 22S Tobtaccu: Itz Eifects. ......... 23o Sistri y Ri.o is.t-CgiC I.ibra. .. . . . .. . 2.31 l.atyof the city and Subuîrb\u003e..1.ataN.Eros \\If tontreal, ftr Novenuber, Sanitar Eluctilon.............. 232 i776.. 221 Ventilation ofHer Majety'Ship,. 2 Foreign H-ealth Saistic ....... 223 A Ver\u003ey Remarkale Ca2e ....... 235 Tuta Mortality b% .\\ge., Nation- EditoriaL Notes anid .\\nwers tu ality, and ard.......... 22. Curre \u003eondenL .......... 236 Publi, ieaith in th.. Unitedi Statu\u003e. -2r, Snopsis f Meterlogica i - vai ...... ............. 236 -111 Commutncationaq for in-erfo, a:d Books for .RLtviw, mutst be received beforo the 10th of each mont_. Price, $2 per Annum, payable in Advance. JOHN DOUGALL \u0026 SON, PRINTERS, ST'. JAMES STREET. 1877. Regit'ert d 'n accord.nc withà the A\u003c.t of Partil .u bo Gau. A. BAt:as, M.D., n Le Offie of the Minister ni Agricuilture, Ottawa.",
         "PUBLIC HEALTHI MAGAZINE AND LITERARY REVIEW. Vot.. I.] JANUARY, 1877. [No. 7. ON TOBACCO SMOKING. By C. R. DRYSD \u0026LE, M.D., M.R.C.P. London, F.R.C.S., England, Senior Physician to the Metropolitan Frec Hospital, and Phy- sician to the North London Hospital for Consumption and Discases of the Chest. THE late \"whiskcy war'\" waged in the United States by some earnest women who had doubtless suffered either in their own families, or had seen much suffering among their friends, caused by tha.t terrible foc to human happiness, drinking, bas tempted me to reflect that a great deal which lias been so justly urged against the drinking habits of men and women might also be urged against a vice nearly entirely confined to the male sex, to- bacco smoking. I do not mean, of course, for a moment to say that I have seen anything like the same amount of acute and chronic disease, or so many deaths, which could be set down to smoking as I have witnessed from the deplorable habits of intemperance, which seem now so diffused throughout society, and which, I agree with Dr. Murchison, in a recent lecture delivered at the College of Physicians in London, have been not a little brought into vogue by some medical fashions in England and Ireland with regard to treatment.",
         ":06 PUBI.C EAiM.T{ MAtA2INE. But tobacco, in my own experience, is guilty of causing a very great amount of suffering, and I wish I could sec a crusade arise against this extraordinary vice of modern days, which is, unlikc alcohol, never necessary las far as I know) in any way, cither in health or in disease, and which, I am certain, is very seriously undermining the stamina of modern civilized nations, and espe- cially of the Males of England, France, and the United States of America, wherc the strongest kinds cf tobacco are in fashion. In England, too, cities are so large nowadays, and life indoors is so frequent among men of ail classes, as well as among wornen, that a narcotic poison, such as tobacco, is especially debilitating, and its use ought to be loudly inveighed against. Smokers who are not \" made of iron \" arc not long in expe- riencing some of the m':.y evil effects of this poison; sometimes these are rather rapid. Thus, I lately saw a young fellowv of twenty-three who had nearly entirely lost his eyesight from chew- ing and smoking half an ounce of tobacco (Virginia) daily; and another case was published by myself lately in a rnedical journal of a man of twenty-seven similarly blind from smoking, for some years, an ounce of shag daily. When quite a young man, I remember a case of an extravagant smoker, a gentleman related to myself, who died suddenly after smoking a great number of strong cigars; and of late I have noticed that coroners have, in more than one instance, given ver- dicts in this direction. Palpitation of the heart is often bitterly complained of by smokers, and dyspepsia of ail degrees, accompanied by constipa- tion or diarrhoea. The injury donc to the teeth by the use of tobacco, is best seen among men ot the operative classes, who sometimes loose every tooth in their head before the age of thirty, from the filthy state in which the mouth is kept by continually smoking or chewing. How would such men like their young wives to be so careless of their looks ? Women ought, I contend, to dislike tobacco-smoking exceed- ingly. This habit annoys non-smokers, and the gentler sex is not as yet permitted to smoke by one of the unwritten laws of Eng- lish society. It withdraws men from the society of women, and",
         "Ou TÔ3ACCO $OKWNG. 207 tends to lower thcir habits of cleanliness, whilst smoking in the little rooms of cottages is often.very injurious to both wives and children. Paralysis of various kinds is, in my view, oftcn caused by smoking or chewing, and with especi;l rapidity by the latter habit. Indeed, amaurosis is only one of the many kinds of nervc destruction caused by the use of tobacco, Gencral paralysis and insanity arc, therefore, perhaps rightly attributed to the use of tobacco, especially in France, where the amount of smoking is tcrribly on the increase. Youths and boys are continually damaged in health, almos, irretrievably, by taking to tobacco in imitation of their fathcrs and tutors; and it is a great pity that smoking cannot be kept out of European courts, since the habits of royalty are so apt to become fashionable- \" Dclirant regc, plectunturAchivi.\" Sir William Jenner used to teach that smoking tended to pro- duce palpitation of the heart, prolapse of the lower bowel, and impotence; whilst Sir B. Brodie denounced tobacco as the most enervating of all modern practices, and ascribed the degeneration of the modern Turks to the national habit of great tobacco.. smoking. My main object in this letter is to introduce to English readers an article on tobacco from the pen of Professor Mantegazza, of Florence, a gentleman of European fame. The following facts are taken from an admirable work by that learned author, entitled \"Elementi di Igiene,\" and wvhat he there says may tend to prove that the re are in Italy, as in England, France, and Germany, many medical men who are foes to tobacco:- Johnston (says Mantegazza) has calculated that Soo,ooo,ooo people use tobacco. Tobacco, introduced into Europe not many centuries ago,.has an ample history, and figures as one of the principal sources of the revenues of European governments. In 1496 Pietro Pane, one of the companions of Columbus, gave the ñirst notice to Europeans about tobacco, which he called cohoba. In 1519 tobacco was discovered by the Spaniards near Tabasco.",
         "ao8 'LTILIC IEALTl MAZINE. In 1531 the ncgrocs cultivatcd it in the plantations, and iL was uscd in Canada. In 1559 it was introduced into Europe by Hcri1ande.z of Toledo. Nirot, French Ambassador at Lisbon, sent some sceds of tobaccn ta Paris. In 1565 Gesncr was acquainted with tobarco; Hawkins btrought it into Europe from Florida. 1In 1570 it was smoked in lolland in tubes made of the leaves of the miln-tre.?. In 1574 it was cultivated in Tusrany. In 1575 there is a drawing of the plant in the Cosmûografia of Andrea Thevot. In i585 the first clay pipes were made in Europe. In 159o Schah Albas forbade the use of tobacco in Persia. In 16or tobacco was introduced into Java, and smoking com- nienced in Egypt. In 16oi James I. of England imposcd enormous taxes on tobacco. In i6io smoking began in Constantinople. In 1615 tobacco wa, planted at Amersford, in Holland. In 16x6 the colorists cultivated tobacco in Virginia. In 1619 James I. wrote his counterblasi. In 162o nincty young men wcre sent from England to Amerira, and were sold to the tobacco-planters for 2,ooo livres each. In 1622 the annual importation of tobacco from America to England was 142,o35/. sterling. In 1624 the Pope excommunicatcd all who took snuff in Church. King James restricted the culture of tobacco in Vir- ginia. In 1631 tobacco was smoked in Misnia. In 1634 a court was e.stablished in Moscow to punsi smokers. In 1639 the Assembly in Virginia ordered that all the tobacco planted that year should be destroyed, as well as that to be planted in the two following years. In 1653 smoking began in Switzerland, at Appezell. In 1661 smoking was forbidden in Berne, adding an eleventh commandment to the decalogue: \"7Thou sha/t notsnoke.\"",
         "ON TO2DACCO SMOXt\u003cNG. 209 In 1659 adultery and fornication wcre punished in Virginia Ly a fine of Sco to oco pounds of toba-co. In 167o smokers in Glarus wcre flned. lIn î676 tic duty on tobacco from Virginia into Enland was £12o,oo sterling.Two Jews tricd ta cultivate it in Bradenburg. In 11i91 Ponpc Innocent Xil. exconnanicated all who u.cd te'lwco in St. Peter's. In 1697 the palatinate of He:,sc prodluccd a great quantity of In 1709 there were exported from An-erica 28,858,666 pounds of tobacco. L 1719 the senate of Strasburg proiibited the culture of toibacco. Ira 1724 Pope Benedict XIV. revoked the bill of excommuni- c2tion of Pope Innocent. In 1747 there wcre cxported froni America ta England 4ci,cro,000 pounds of tobacco. In 1753 the revenue of tobaccoi of the King ofSpain was about 31,000,00c francs. ID 1759, in Denmark, the duty on tobaccoamout.ied to £8,coo sterling. In 1773 the revenue of the kingdom of Naples fron tobacco was about £8,ooo sterling. In 1775 the United States exported during the year i,ooo,ooo pounds of tobacco. In 1780 the King of France had a revenue of £t,5oi,ooo sterling froni tobacco. In 1782 the annual exportation of tobacco from America in the seven years of the revolutionary war, was 12,378,504 pounds. In 1787 the tobacco imported into Ireland was 1,877,579 pounds. In 1789 there were exported from the United States 9o,ooo,0 pounds of tobacco. In 1820 were cultivated in France. 32,887,560 pounds of tobacco. In 1830 England had a revenue fron tobacco of £2,250,000 sterling.",
         "210 PUBLIC IHEALTH MAGAZINE. In 1834 the value of the tobacco consumed in the United States was calculated at £3,ooo,ooo sterling. In 1838 the annual consumption of tobacco in the United States was oo,ooo,ooo pounds. In 1840 it was found that, in the United States. there were employed about 1,5oo,ooo persons in the cultivation and manufac- ture of tobacco. In 1854, Louis de Baudicourt pul'iished an essay on the pro- duction and consumption of tobacco in Europe, which is, perhaps, amocg the best on the statistics of tobacco. He mentions that in England there ace consumed annually some 15,ooo,ooo of kilograms of tobacco ; in Austria, 40,000,000 ; in France, 21,ooo,ooo; in Russia, 13,ooo,ooo; in Turkey, 14,000,000 ; in Belgium, 7,000,000; in Italy, 12,000,000; in Europe, about zo3,ooo,ooo. ' From the commencemeit of the century until now the consumption of tobacco has not followed a constant progress. In France, from 1811 to 1820, the average consum- tion of tobacco was 400 grans per head. From 1821 to 1825, it fell to 390 grams, and to 350 from 1826 to 183o. It commenced to rise to 351 from the year 1831 to 1835; then to 470 from 1836 to 1841. From this time forward the consumption of tobacco has constantly increased to 5oo,600,750 grams per head, and everything appears to indicate that it will not stop at this limit. France consumes every year abuut 6o,ooo,ooo pounds of tobacco, the sale of which is entrusted to So,ooo tobacconists, each paying from 5o to i,5oo francs.\" \" The abuse of tobacco weakens the muscles, the stomach, and the genital organs, and, in this point of view, rich lords of harems in Turkey are quite right in hating it. At Oxford and Cambiidge, the powerful boating-men, who train for the races, are not allowed to smoke. \" It has been fouid, by examining the statistics of a great number of years in the Polytechnic School of Paris, that the young men who did not smoke passed the niostbrilliant examina- tions. According to Fenn, the use of tobacco is especially dangerous during an epidemic of typhoid fever, since it relaxes the mucous membrane, and 'diminishes the vital force,\"",
         "ON TOBACCO SMOK-fNG.- 2:1t \"Siebert also believes that many nervous diseases of men are caused by the use of ti e cigar, with which the smoker gradually swallows small quantities of nicotine, fcr which reasons he would advise the pipe. Some great smokers suffer from a true spinal irritacion, they feel as if strangled, they have bronchial spasm, palpitation, pain in the chest, vomiting, and pain in the abdomen.\" Sichel and Wordsworth have accused tobacco of producing blindness, and call one kind of amaurosis by the name of tobacco- anaurosis, \"Bean asserts that smoking may produce angina pectoris. Smoking has next, the grave inconvenience of being one of thé most selfish pleasures in the world, since it annoys and drives away people who do not share this taste.\" Professor Mantegazza concludes that \"tobacco is never neces- sary ; it is always hurtful to boys and young men, to weak people and those disposed to consumption.\" He adds that \" all ought to try to put a stop to the general invasion of tobacco, which threatens to involve the whole of Europe in a dense cloud of smoke, which poisons even those who do not smoke.\" It is a pleasure to see that men of eminence, such as .)enner, Critchett, Brodie, Copland, Mantegazza, and so many more at the present day are striving to set themselves against that mad race after this injurious physical pleasure of smoking, which is doing so much harm. The end of all science is to secure long life and health to the ¡ndividual and the race; and it ought, I believe, to be a part of the rational creed of every good man and woman to abjure the use of tobacco, and keep others from falling into the vice of smoking.",
         "PUBLIC HEALTH MAGAZINE. ALCOHOL. A LECTURE DELIVERED DEC. 7TK TO THE ST. GEORGE'S TEM- PERANCE SOCIETY, BY DR. GEO. A. BAY2NS. MR. CHAIRMAN AND GENTLEMEN:- According to Bartholomew Parr, one of our most learned scientific classics, the word alcohol was derived from the Arabic A'l-ka-hol, to designate a subtle essence or impalpable powder with which Eastern women used to tinge the hair and margins of the eyelids. As this powder (namely, the ore of lead) was impalpable, the same name was given to other subtie powders, and then to the Spirit of Wine in its highest purity and perfection as a subtle essence. The word employed in this sense merely tells us of a refined fluid substance, obtained by a subtle process of separation. But it was not applied to the special fluid now under consideration, until long after that fluid had actually been separated. I shall not enter more minutely into this separation than to say that Alcohol is an inflammable liquor, lighter than water, of a warm, acrid taste, colorless, transparent and of a pungent, aroma- tic smell. It is the product of the distillation of vinous liquors. The practice of exciting fermentation, and of obtaining this coveted fermented liquor, once known, the knowledge soon extended, until from various vegetable substances, wine became a product of manufacture. The use of the expressed juice of the grape, and other juicy fruits-such as the mulberry, the apple, the pear, and the peach- led to those juices which exude from trees ; and from these to other substances, such as manna and honey; and from fruits the transition was easy to seeds; and from the seeds that were soft and succulent, to seeds that were hard and of the character of what we call grain. This fluid was called wine, and was worshipped by the",
         "ALCÔHOL. ancients. rhe discovery was an epoch surpassed by none other and the heathen shoved their wonder at it in their Mythology. Egypt claims the invention for ber God Osiris, Greece for Bacchus, and Rome for Saturn. The Greeks assert that the very name belongs to them, for the drink was first discovered in £tolia, by Orestheus, the son of Deucalion, whose grandson Oeneus was so called from Oinos, which was the old name of the vine. Thus Oinos, oinon, vinum, wine. Then, by these nations, the praises of wine and of the vine gods, one and all, were sung in the later times. It is not to the savage a mortal thing at all. It lifts the man who takes it into a higher sphere of life, or it degrades him to the lowest. It introduces him, as it were, to a nev human organization, that is not to be a passing phenomenon, but for good or ev'l is to remain through ages. Much more might be said of the praises devoted to it by the ancients, but this will suffice to show with what reverence they held it. We will, for a time, leave the consideration of wine and alcohol as drinks, and dwell briefly on the uses to which these fluids have been applied in other purposes. The study is peculiarly interesting, and I could easily carry you on for a whole hour with the narration of it. I shall refer only to the salient points, and to a few only of these. From the very first its preservative and antiseptic qualities were known, and it was used for preserving animal and vegetable substances. The Roman butchers had their fresh and salt meats (as we moderns), curing the latter by pouring sweet wine over the flesh they wished to preserve. The Egyptians used it in their most costly processes of embalming the bodies of the dead, and we in our day preserve our specimens in our museuns in a moist state by immersion in spirir. It was also used for extracting the active principles from plants and other substances possessing medicinal virtues. Dioscorides, one of the fathers of medicine, made a vinous tincture from the mandragora, which lias a ronantic history. In the Isles of Greece there bas grown for ages a plant, called mandrake, of the same family as Belladonna, or deadly-nightshade. From the root of this plant the Greeks extract, by the means of wine, a narcotic possessing strong anesthetic power.",
         "z 14 PUBLIC HEALTH- MAGAZINE. Dioscorides, in speaking of this preparation of the mandra- gora, says-\" Those in want of sleep may take one cyath (a wineglassful) of the decoction ;\" also, he says that threc cyathus of this are given to those who are cut or cauterized, when, being thrown into a deep sleep, they do not feel any pain.\" Again, he speaks of a preparation of mandragora called morion, which causes infatuation and takes away reason. Under the influence of this agent, the person who takes it, sleeps, without sense, in the attitude in which lie took it, for three or four hours after- wards. Pliny, the Roman historian, bears evidence to the same fact, and adds that persons seek sleep frorn the smell of this medicine. And again, Lucius Apuleius, (the tuthor of the book called the \" Golden Ass \"), vho lived about 16o A. D., says that if a man has to have a limb mutilated, sawn, or burnt, he nay take an ounce of mandragora in wine, and while lie sleeps the member may be cut off without pain or sense. It is to this vine, undoubtedly, that Shakespeare refers in his half-imaginary, half-legendary, middle-age history. This is the wine of that insane root, which, says Macbeth, \" takes the reason prisoner.\" This is the wine that Juliet drinks, and the action of which Friar Lawrence describes:- \"Through all thy veins shall run A cold and drowsy humour, which shall seize Each vital spirit.\" And further on, he says:- \"And in this borrow'd likeness of shrunk death, Thou shalt remain full two and forty hours, And then awake as from a pleasant sleep.\" You will perceive that our great modern advance of removing pain during surgical operations, is, if not as old as the hills, as old almost as wine. Thus, the first use of wine to man was amongst the most noble and beneficent of blessings, and if it had been used only in this way, and in nothing worse, Pater Leneus might have retained his supremacy in the good opinion of all the world. After the distillation of wine was discovered, the niddle-age chemists kept this new spirit long a secret. They found in it a solvent for many things that before were insoluble-such as oils, resins, gum-resins, balsams, \u0026c. The commander's balsam, or balsam for wounds, or better known as Friar's balsam, was soon the reputed healer of every injury.",
         "ALCOHOL. Z15 Beauty was next remembered. Alas for the fenale face divine ! cosmetics and the subtle washes that should veritably make young faces old, and assumably old faces young, were soon in process in the laboratory of the adepts who made wine. The artist came in for a share of the discovery-the once in- soluble and useless resins were dissolved for his brush, and gave him preservative coatings and washings. Then the spirit-lamp in due time was invented-a trifle, say you ? nay ! it was as great an advance to the chemist who first used it, as the gas in the Bunson burner is to us. Adepts soon attacked the mineral world-the green stone crystal found in the earth, snd called green vitriol, was submitted to distillation, and yielded in the retort a heavy, oily, corrosive fluid called sulphuric acid. In the course of time they began to com- bine other fluids with the corrosive sulphuric oil, in the hopes of discovering something new. The experiment did not deceive them; it gave a usefui and most wonderful liquid that floated on water and floated on spirit. They poured it on the hand-it boiled there; it escaped from them into an invisible air before they could well bott'e it. It burned and exploded, and caused after evaporation from the body intense cold. Many other things this infinite marvel was able to accomplish. It was the lightest thing known they called it Ether. We all know the use of this magic fluid in suspending sensa- tion and sensibility after being inhaled by the lungs. Professor Benjamin W. Richardson has invented the e/lier spray, by which you can benumb the body in part, and so operate without des- troying consciousness. To the photographer it is invaluable as the volatile solvent of collodion, and in other branches of refined and useful art it is equally serviceable. But I have already dwelt too long upon this part of my subject, and shall proceed to the description of the actions of some of the different alcohols:- First, then, the action of methylic alcohol, pyroxylic spirit or wood spirit. You can use this alcohol in the usual way, hot or cold,-in fact, some say it is more pleasant than the ordinary alco- hol when made into toddy with sugar, and while it is as pleasant to take as an ordinary drink, it is less injurious.",
         "PUDLIC HEALTH MAGAZINE. This being adnitted by the profession, it is prescribed in pre- ference to the heavier or ethylic spirit, and with better results Without doubt, the ligliter the alcohol, the less injurious the action ; methylic alcohol being the lightest, we can put it down as the safest for administration. But it is not without potency, as the phenomena it produces will sufficiently demonstrate. They are developed in four distinct stages:-Excitement of the nervous organization inaugurates the first stage ; the pulse and breathing are quickened, the surface is flushed, the pupils dilated, and then ensues a sense of languor, the muscles falling prostrate, the movements being irregular. The second stage is ushered in by increased muscular pros- tration, respiration labored, accompanied by a sighing movement, followed by increased prostration, rolling over of the body, and other signs of intoxication. The third stage is demonstrated by entire intoxication, insen- sibility to pain, unconsciousness, voluntary muscular poyer being entirely absent. The breathing is embarrassed and bloving, but the heart and lungs retain their functions, and therefore recovery will take place if the conditions are favorable to it. Reflex action ii still present. The only phenomena vhich is very marked, is the reduction of the animal temperature, which begins in the first stage, till in the third the loss of heat becomes actually dangerous. Considering that the third degree is reached, and the adminis- tration continued, the last stage is ushered in by death. The action of this spirit somewhat resembles chloroform and ether in its ultimate action, but the recovery from the two last is much more rapid. Butylic alcohol is one of the heavier substances of this group. Applied to the lips and tongue in a pure state, it creates a burning sensation of great intensity, followed by a nurnbness of the part where the fluid is applied. The knowledge of this latUer effect has given rise to its use for the relief of pain. There are four distinct stages of action of butylic alcohol, but the period required for producing these stages is greatly pro- longed. They are similar to those.of methylic spirit. But in the 2126",
         "ALcoiôt. 217 third stage after the depression of the temperature, butylic alco- hol produces distinct tremors, which we clesignate as delirium tremens. The nature of these muscular movements, and what relationship it has between the nervous system, muscles and blnod are still unsolved questions. RCcovery rests entirely on the maintenance of the organic nervous power, so that a body must be sustained by external heat and by internal nourishment. The appearance after death I w!ll speak of further on. Amylic alcohol is obtained by the fermentation of potato- starch. It is believed to be largely in use for the adulteration of wines and spirits. Its action on the human body is the same as butylic alcohol. The alcohols of sodium and potassium are not much in use, but they act on the body as caustics, and will be found of great service in surgery. Mercarptan or sulphur alcohol. The vapor of this produces somewhat similar effects when inhaled. It is not irritating to the breath. It soon produces a desire for sleep, with a strange, unhappy sensation, as if some impending trouble were at hand. This is succeeded by an extreme sensation of muscular fatigue. There is still a sensibilhty to pain, and no intoxication. The pulse is feeble and slow; recovery is rapid, especially in the open air. We will now proceed to examine the influence of common or ethylic alcohol on animal life. Alcohol may be made to enter the body by many channels. It can be introduced by injection cither under the skin or into a vein. Exalted by heat into a form of vapor, it may be inhaled by man or animal, when it will penetrate into the lungs, will dif- fuse itself through the bronchial tubes, will pass into the minute air vesicles of the lungs, thence into the arterial canals, and so throughout the body. Or, again, the spirit can be taken by the more ordinary channel, the stomach. Through this latter chan- nel it finds its way into the circulation by two modes. The greater portion is absorbed direct by the veins of the alimentary surface, finds its way straight into the larger veins, to the heart and onwards with the course of the blood. The other portion is",
         "218 PT'UIC IEALTH MAGAZINE. picked up by thoc small structures called vi//i, which procced from bclow the imicous surface of the stomach. Thus we see that which ever way the alcohol is introduccd, it enters the blood. As aIl the modes of introduction, e:ccpt the latter, are only used experimentally, we will not consider them more fully but proceed to exemplify the cffects upon the system when taken as a fluid by the mouth. As it enters the blood it becomes mixed with the water, which it readily diffuses through it, then cornes in contact with the other constituent parts ; with the fibrine, that substance which clots or coagulates when blood is drawn; with the albumen, the salts, the fatty matters, and lastly vith those minute round bodies called corpuscles or blood globules-of which there are two kinds, red and white. The red give the color to the blood and occupy the centre of the stream; the white are near the out- side of the vessels and move less quickly. The red perforn the most important functions in the economy -they absorb the oxygen which we inhale and carry it to the extreme tissues of the body; they also absorb the carbonic acid gas on the extreme tissues, and bring the gas back to the lungs to be exchanged for oxygen,-in fact they are the vital instru- ments of the circulation. Alcohol, when in contact with these corpuscles or cells, cause them to run too closely together, and to adhere in rolls; it may modify their outline, mak'ng the smooth, defined edge irregular or crenate, or even starlike ; it may make it oval or truncated in form, in fact hardly recognizable. All these changes are d.e to the action of the spirit on the water in the corpuscles. Dur- ing every stage of modification of the corpuscles their function to absorb the fixed gases is impaired, and when the aggregation of the cells in masses is great, other difficulties arise-for the cells unite together and pass less easily through the minute blood vessels of the lungs and general circulation, and impede the cur- rent, bywhich local injury is produced. This is the only point that we have time to touch upon in respect to the physical action of alcohol upon the blood, and shall nov proceed to describe the different stages of the action of alcohol up to the poisoning point.",
         "AtCooL. 219 If you attend a large dinner party, you will observe after the first fcw courses, whcn the wine begins to circulate, a progressive change in sonie of those about you vho have taken wine. The face begins to get ilushed, the zye brightens, and the mutrnur of conversation becomes loud. What is the reason of that flushing of the countenance ? It is the same as the flush froni blushing, or froni the reaction of cold. It is the dilation of vessels fol- lowing upon the reduction of nervous control, which reduction has been induced by the alcohol. In a word, the first stage, the stage of vascular excitement from alcohol, lias been established. The action of alcohol extending sa far does not stop with the disturbance of power in the extrene vessels; more disturbance is set up in other organs, and the first that shares in it is the heart. With each beat of the heart a certain degree of resistance is offered by the vessels when their nervous supply is perfect, and the stroke of the heart is moderated in respect both to ten- sion and to time. But when the vessels are rendered relaxed, the resistance is removed, the heart begins to run quicker, like a watch froi which the pallets have been rernoved, and the heart.. stroke losing nothing in force, is greatly increased in frequency, with a weaker recoil stroke. It is eas\u003e to account in this manner for the quickened heart and pulse which acconpany the first stage of deranged action from alcohol. There are four stages of alcoholic action in the primary form. ist. A stage of vascular excitement or exhaustion. 2nd. A stage of excitement and exhaustion of the spinal cord with muscular perturbation. 3rd. A stage of unbalanced reasoning pover and of volition. 4th. A stage of complete collapse of nervous function. The first stage, or that of vascular excitement, lasts for some time, but at last the heart flags from over-exertion, and requires more stimulus to carry on its work. This stage can be seen from the flushed appearance, as described before, and let me remnd you that this injected appearance is not confined to the parts seen only, but to the lungs, brain, spinal cord, stomach, liver, spleen and kidneys; this vascular engorgement is manifested in every organ. This has been preved by Dr. Richardson, who",
         "220 PtnLIC HEALTI MAGAZtNE. once had the opportunity of examining the brain of a man who had committed suicide while suffering from vascular excitcment, by being dccapitated by a railway train running over him. The brain cxhaled the odor of spirit, and its appearanre was as if it had been injected with vermilion; this appearance was complete through the whole brain, in both hemispheres. The action of alcohol carried further, brings us to the secrond stagr, or that of excitement and exhaustion of the spinal cord. Through the nerve power of the cord we arc enabled to carry on the ordinary automatic acts of a mechanical kind. Under alcohol thcse acts cease to be carried on correctly. The higher intellectual centres must be invoked to make the procceding secure, for the hand to reach an object, or the foot to be correctly planted. Then follows quickly upon this, a deficient pover of co-ordination of muscular movement. The nervous control of certain of the muscles is lost, and the nervous stimulus is more or less enfeebled, and if the adminiN- tration bc continued, the third stage, or that of unbalanced reasoning power and of volition, is soon reached. As these centres are unbalanced and thrown into chaos, the rational part of man gives way to the emotional, passional, or organic. The reason is now off duty, and \"In vino veri/as \" expresses the truc condition, the coward is more craven, the braggart is more boasitful, the cruel is more merciless, the untruthful more false the carnal more degraded. Finally, the action of alcohol still extending, the superior brain centres are over-powered, sensibility is lost, and the body lies a mere log, dead by all but 1, on which alone, life depends. But the heart still remains true to its duty, and while it yet lives, it feeds the breathing power. It is happy for the inebriate that, as a rule, the brain fails so long before the heart, that lie bas neither the power nor the sense to continue his process of destruction up to the act of the death of his circulation. There- fore he lives to die another day.",
         "MORT.LTY Il ETL'IMNS. MORTALITY OF THE CITY AND SUBURBS OF MONTREAL, FOR OCTOBER, 1-S76. 4, - C S. 2. 3. 4.- 5. 17. 2. 1o. 1. 12. 13. S 4. rg. î6. I 17. 18. N 19. 20. 21. 22. 23. 2 i 1 3 4 V -Pa rsitte. 2 Î 3 4 Total býy Tontal Scx. Isoth Scxes. ale. Femalo. 57 52 10q I 1 o 8 17 2 3 1o 2 2 4 6 10 )lîli îcra................. M e sin ..y ......... . ...... Cr. up.............................. Whooine ong .................. . TIyphcidFe~'ver, (InfantUieitenicnFev er) 'ly phus, an\u003cl Infantile Fcver......... 1.lap,isg Fever....... . .... lFe,6er.- ............... . . . . . Er i e. ...... .......... ..... . . . Metria, Fver). . Influenzai........................... Dyentery ....... ...................i DiarrhSi ........................ Pyremia .....................,..... Cholera Infantum ................... Cholera........................... Ague............................. Remittent Fever ..................... Cerebro.Spinal Meningiti,............. syphilii ............................. . lydrophobia....................... GIander .......................... Privation.......................... Purpura andi Scurvy ................f Delirium Tremens Alcoholism . ' rur. ......................... Worms, \u0026c ...................... . Gout............................. Rheumatismn...-............... .... Dropsy and Anicaiia ............. ... Cancer.......................... Noma (or Canker).................I Mortification.......................J Scrofuia .......................... Tabes M esen terica.................. Plithisis (Cons. of Lungs)............ Ilydroce phalus .................... Tubercular Meningitis ............ .. 2 4 I 1 2 13 23 36 r r r Carriedforward..................... 101 rio 211 2 3 I",
         "PUBLIC HEALTH MAGAZINE. MORT LITY 0~ 3 1. S 2. 3. 4.- g5. * 6. ji 7. * 8. 9. 3. 2. 3. 7. 2. s .3. 5. 7.- g. 12. 3. 14. 2. S7. e-8. 9. E 1o. 7» '. it. 12. Sr3. 14. 15. Loc 2. ¿oS3. b 4. S5. S6. S7. 8. VI.C.en . erauve organs 2. v11.or- i. oan.f 2. ,motin OF TUE CITY .rND SUtliUR1S 0F MON 'REAL-(Cos. Total Total by \"ex. l-th bSets. Broa,At jotwa i................. Cephalitis ...... ......... ... .. ···. AIopIexy.................... ....... Paralyis..................... ...... Inamity.............................. chorca......................-. Epilepsy .. ....... .............. Tetanus......................... .... Convulsions..................... .... Other Braiti sease\" \u0026c.............. Carditis, Pericarditis and Enducarditis. . Aneursm...................... ... Other leart dieases, \u0026c ............ Ep.i.taxi%........................ . I I.arvngiti% and Trachit: s........ . lhon.hitis ...................... 1\"eu isy................. ...... P cumnoma ..................... Asthia ...... .................. Other I.ung das, \u0026c............ G: stritis .... ... ....... En ertis .......... ............. Ier.tonitis............... .......... .. Ascites..............·· .· LIctration of Intestines ....... Herlia ................... lleus and intussuý(eption. ....... Stricture of Intestmtsn................ F s u a .............. .. . . . . is)eases of Stomîch and (nt -s, \u0026c P\u003eancreas i)eases, \u0026c.............. HIepaititi' ................. ...... jautublce ........................ Li.:r Disease, \u0026c. ............... Spleen JJseae, \u0026 ................ :1rIi...................... 1,ciiriai................... Nephuta ý1lrght's Ia ........... I ete............... ....... calculus, (Gravel, ................ Cystitis and Cystorrha ............. Stricture.......................... Kidney Disease, t c................... Ovarian Uisease................... Disease of terus, \u0026............... Arthriti ..... ........ Joint Diseaw-, \u0026c.............. 1 Carried 4-vtr............ * Male. elmais. toi 110 1 7 1 I I 6 1o 2 2 6 8 14 4 5 4 3 3 I 2 2 2 4 2 2 I 1 I I 135 î6o 295 22a ly 1 SEr A, r , .",
         "MORTALTT xETU\u003cNs. 223 MORTALITY OF THE CITY AND SUBURBS OF MONTREAL.--(Con). 1,; d DistAsts. (J 0 2r u i Cv r -............. ... . Vit A 1 - S % 1 1.. . . . 2 Z 2.rCMatUre Ilirth C..d..2. A 3. Infantile LecbiliY ... . ...... . I re . yn.i f - 5. .............. 1. it, r.................. S. $ .im iilda,i ........ .. .... .... 4 IoI2. ChzIl1h......................... I'eople . 01 Age............ ....... IV. of w N(tn. 2. A1rOI-hy ardrltlril.\"y.............. tio. ~ i. Fracture,,cr.ui~rs Wç,unls .... 2. iiUrS and Seall.................. 3* 21 . Iunin... ... ................. m aj r. MreMrsaihc....... . . \" î:rd .. 3.... .... 2. eXC .uin.......................... 1. Wounds .......................... 2. Ioin ........ ................. 3 lbr. nng.......................... 4 0threvi ....................... . Chirurgici .. ...... ..... ......... yaknown...... ............... Infection purulente ................. Eamc ia,. ......................... Lock jaw .......................... Total ... ................ r. Total 'otal by Sex. both Scxcs. Mate. Femate. 135 160 295 7 14 r 7 7 21 4 4 3 3 6 I 2 3 1 5 1 1 I 2 3 174 1S7 361 FOREIGN HEALTH STATISTICS. United Kingdom of Great Britain, during four weeks, ending October 2rst, 22,851 births and 12,oo deaths wee registered in London and tw.-nty other large towns, and the natural increasc of the population was o,751. The mortality (rom all causes was, per i,ooo. in London, 1.25 ; Edinburgh, r5.5o; Glasgow, 20.75 ; Dublin, 20.25 ; Ports.mouth, 19.25; Norwich, 22.25; Wolverhampton: 21.15 ; Sunderland, 17.50 ; Sheffield, 21.75; Birmingham, 19.75 ; Bristol. 19.75 ; Liverpool, 22.25 ; Salford, 27.50; O1dham, 26.75 ; Bradford, 18; Lceds, 20.75 ; Hull, 18.50; Ncwcastle-upon-Tyne, 16.25.; LCicester, 22; Manchestcr, 24; Nottingham, 17.5.-Other foreign tities at most recent dates, per r,ooo, Paris, 22 ; Rome, 23 ; Vienna, 23; Brussels, 19 ; Berlin, 22; Hamburg, 23; Calcutta, 27; Bombay, 24; Madras, 42; Amsterdam, 19; Rotterdam, 23; TI:c Hague, 26 ; Christiana, 20 ; Breslau, 22; Buda-Pesth, 27 ; Turin, 23 ; Ale - andria, 59; Copenhagen, 21; Munich, 30; Naples, 22.-The ani/aian.",
         "224 PUBLIC HEALTH MAGAZINE. TOTAL MORTALITY BY AGES. der i y ....................................................... 89 From 1 to years ............. ........................... 5 t 1 ................................................... 3 \" cl to o 4 ................................................ . 12 15 to1 20 ................................................... 1 2t to 40 .................2.. 5 40 to 6o ................................................... 26 0 0 .................................................. 1 \" t600 to .................. I '. 7o to go \" ................. .............................,... ro aoo0 years and over............................................... Not kno n. .. ...... ............................................ Total...................... 361 TOTAL MORTALITY BY NATIONALITY. French Canadians .................................................. 219 British Canadians .......... .................................. 98 irish .............................................................. 29 Einglish ............................................................ 5 Scotch............................................................. 6 O ther Countries .................................................... 4 Not known ...................................................... .. Total...................... 36r TOTAL BY WARDS. St. Ann's 'ard................................................... 50 St. Antoine ................................................... 67 St. Lawrence ............................................... . 30 St. Louis \"t ................................................ . 29 St. James \"t ................................................ . 73 St. Mary .................................................. St 'est.............................................................. ... Centre............................................................. 3 E ast .............................................................. 5 Not known........................................................ 338 City lospital ..................................................... I H otel D ieu ........................................................ Il Montreal General Hospital......... ............................ 8 O ther Institutions................................................... 3 Foundlings................. . ..................................... 34 Outside City Limits .................. ............................. 85 Total...................... 480 N. B.-Tle foundlings and deatls outside city limuits are not included in classification of diseases, ages or nationalities.",
         "PUBLIC HEALTH IN THL UNITED STATES. 2 *uloramnonoa Qýteý -e\" u .iioq ouQuogia9ni. -- -4 c ~~iî2no3~' 2uoqZ q -j.L--c~ -. . .4 4l M càuaa cit j *xo.jpci O~O-c'l~lC ~l C'l o3ci--..- ~oauutOjcj.ci ^oooio\".Qr M Q M mmmn CltC.4....cDe-t--ecDmCClcIC C1O- CqCC -scoffl \".bou 1iWrjC Mmma O *1imi '-4D .zt0 -' c cr .~4 . . . . . . - f : C . 'i: ô O - :--' op Q O C",
         "ON TRACHEOTOMY, ESPECIALLY iN RELATION TO DISEASES OF THE LARYNX AND TRACHEA. By W. Pugin Thornton, Surg% on to the Hospital for Diseases of the Throat and to the Marylebone General Dispensary. J. \u0026 A. Churchill, New Burlington, Eng. We have perused with a great deal of pleasure this neat little work, which is of a thoroughly practical character, and a careful study of which will repay the reader. In the introdictory part the author gives reasons for preferring tracheotomy to the simpler and safer operaticn of laryngotomy, and pays a tribute to the valuable aid afforded by the laryngoscope in recognizing with precision conditions of the larynx interfering with respiration. Contrary to most other writers and authorities on the subject, he avoids the use of anæsthetics, and prefers freezing the part by means of the ether spray. Even in the case of children he does not use chloroform, but has the patient wrapped up in a sheet and held down. After a short resumé of the anatomy of the trachea, the subject of instruments and apparatus is taken up, and here we get much useful information ; the right-angled, or Durham's Canula, being the one most recommended owing to the ease with which its length is regulated. In the operation itself the author recommends, after making the primary incision through the skin, that most of the subsequent dissection should be done with the handle of the scalpel, the operator always re- mniembering not to make the wound \" funnel shaped,\" i. e. that it should be of a uniform length from the skin down to the rings of the trachea. The after treatment is carefully dwelt upon, and much practical information is given upon this, perhaps the most important part of the whole subject. In referring to dangers during and after tracheotomy, the risk eutailed by the passage of blood down the trachea and into the bronchial tubes is fully re- cognized, and in common with most other writers on this subject,",
         "REVIEWS. 227 the author insists that, unless it is absolutely necessary from the state of the patient, the trachea should not be opened while bleeding is going on to ary extent, In the management of those cases where hemorrhage occurs after the insertion of the canula, a simple and very effectual mode of withdrawing the blood is by the introduction of an elastic catheter, through which the blood may be sucked out, and we think this means might have been mentioned, and a suitable catheter added to the list of instru- ments enumerated. Other complications are alluded to, and their management -clearly indicated, not the least of which is the breaking off a portion of the inner canula. A photograph is given of such a case where the tube broke away from the shield and falling down the trachea lodged in the right bronchus. The book finishes with an account of iseases and injuries re- quiring tracheotomy, and includes several very interesting cases, especially some in which tracheotomy was performed on account ,of syphilitic webs in the larynx. The woodcuts are good, and there are three photographs which are better than most photographs that we have seen of morbid specimens, and altogether the work will prove a useful one to the student and to the busy practitioner, to whom we vould cordially recommend it. We would suggest that in a -future edition the author should include some results of the operation in a tabular form for reference, knowing the many ex- cellent opportunities he has for so doing. :0: \"Twenty-first Annual Report upon the Births, Marriages, and Deaths in the City of Providence for the year 1875.\" By Edward M. Snow, M. D., Superintendent of Health and City Registrar. \"Vennor's Almanac for the Year 1877.\" By H. G. Vennor, C. E., F. G. S., \u0026c., \u0026c., Author of the \" Birds of Prey of -Canada.\"",
         ". PUBLIC IIEALTH MAGAZINE LITERARY REVIEW. JANUARY, T177. SMALL-POX. By request we reproduce His Worship's lecture on vaccination, much having been added to it. It will pay our readers to reperuse itr as there is much evidence brought out that before was omitted' As this formidable disease is now so prevalent, and much discus- sion has been held upon the subject of small-pox, we think a short history of the disease itself, and the means used for its prevention up to the period of vaccination, will be of interest. Without doubt, small-pox is one of the most ancient, as it is one of the most frightful diseases which ever afflicted humanity. Ancient Chinese and Brahmin manuscripts 3366 years old, are said to refer distinctly to epidemics of small-pox. The Chinese- call it the \" bean disease,\" and trace it to the reign of the first Emperor of the (eastern) Han dynasty, Kwang Wu, who reigned A. D., 25-28. It is said to have been imported from some portion of Central Asia, or from some part of South Western China, by some Chinese troops returning from a foreign campaign. The earliest Chinese work on small-pox is a treatise called \" Wan-jin-shi-tau-chin-lun,\" published in 1323, from which it appears that they had practised inoculation more than a thousand years. Allowing that it entered Europe from the East, the exact date of its introduction is unknown, but it is certain that the Arabian army was attacked by it at the siege of Mecca in A. D. 569, and that in 570 it was both in France and Italy. In the eighth century all Europe wâ infected with it, the virus having,",
         "SMALL-POX. 229' been in many cases disseminated by the Saracens; and in the same century it was introduced into brngland, where it soon became naturalized. The history of small-pox in England, naturally divides itself into three parts, viz., the first period from the cleventh and twelfth centuries to 1721, in which period it was altogether unchecked; the second epoch, from 1721 to 1802, during which, it was palliated by inoculation ; and the last, fron 1802 to the- present time, during which it has been partly prevented by vaccination. The irst period was one of the utmost severity; it raged from time to time throughout England, in a horrible manner, the most fatal of all contagious disorders. Sir Gilbert Blane estimated that small-pox destroyed too for every one that perished by the plague; and Dr. Black estimated the annual mortality from small-pox during this period, in Europe, to, be 494,000. In the second period, inoculation was introduced fron Con- stantinople, by Lady Wortley Montague (1721). This operation had, as we have men'tioned, been practised from a very remote perio'd, by the Chinese, who inserted a small-pox scab, or crust, in the nose. It had also been practised xoo years before this date, in Wales, the method there being known as that of \"buy'ng the small-pox.\" The effect of inoculation was to induce a milder disease, the mortality from naturai small-pox in those times being one in five ; in inoculated small-pox first one in fifty, and then, when greater care was taken, and operators became more skilful, one in five hundred. Its value as a sanitary measure, in those times, was great, and this, Dr. Guy proves, by taking the ratio of deaths reduced to the common st ndard of a million for three decades- one ending 1719, in which no inoculation was practiced; a second decade ending 1749 of partial inoculation ; a third, ending 1799, of general inoculation. For the first, the figures are 3r,416 ; for the second, 28,282; and for the third, 22,863. In 18oi Dr. Jenner's discovery of the prophylactic properties of vaccination began to be widely known (vaccination was actually introduced in 1797, and Jenner published the results of",
         "230 PUBLIC IIEALTH MAGAZINE. his experiments in 1798), but it was not practised to anything like a general extent for a few years. The actual number of the vaccinated in i8oi is said to have been about 6,ooo; but its marvellous power was soon felt, and is imperishable in the records of humanity. Dividing the last forty unvaccinated years of the eighteenth century into four decades, and takiing six decades of the vaccinated nineteenth century, up to S6o, by calculating the ratio of deaths from small-pox to deaths from all other causes we get the following remarkable series . For the four unvaccina- ted decades 108, 98, 87, 88 ; for the six vaccinated decades, 64P 42, 32, 23, 16, 11. These figures alone, show what vaccination can do. That vaccination properly carried out,. all over the world, would actually extinguish the disease, there can be little doubt; but on the jther hand, that vaccination slovenly perform- cd (and that only once) imperfectly protects a nation, is proved by the recent epidemics in England, Europe, and America. :o: TOBACCO-ITS EFFECTS. We give this month, a paper on tobacco,'from Dr. Drysdale, but as his conclusions are entirely too sweeping, we cannot forbear giving counter authority. Not that we wish the use of it to increase, for as a habit, it is, to say the least, a selfish one and unnecessary. But in justice to the plant, we must give our readers both sides, and then let them choose for thernselves, either its disuse or use. First of all, we may add to the other evidences that Dr. Drysdale lias cited one from M. Decroix, recently published in the \" Bulletin de l'Association Française contre l'Abus du Tabac et des Boissons Alcoholiques,\" a paper in which he enumerates no fewer than 16 diseases-the list commenc- ing with cancer of the tongue,*and ending with idiocy and pre- mature old age, as resulting from the use of tobacco. A fact that goes far to show the error of so extreme a view, may be deduced from the careful observations of Thackrah, Parent-Duchftelet, and D'Arcet. We learn from them that workers in tobacco facto-;es-men who are us aally great s nokers",
         "GEORGIC LTBWARY. 231 -arc exceptionally healthy, and suifer less from contagious discases than other v-orkers whose hygienic conditions arc similar. Looking impartially at the little reliable evidence we have on the effects produred by tobacco smoking, we may c.onclude that juvenile smoking is in al cases, and under ail circurnstances, bad, the effects produced being tobacco amaurosis, impaired eye- sight, thinning of the hair, and other symptoms of excessive draughts on the tropic nerve centres ; that to ail constitutions it is hurtful in excess, and to many, pernicious in any degree, how- ever small, inducing dyspepsia, muscular tremors, and nervous palpitation, and that it is, in nany instances as we said before, a selfish indulgcnce, and one likely to produce habits of dreamy, listless indolence; but that, on the other hand, to the poor man, living and working hard, to the soldier ill-fed during a campaign, to the !i'erary man, the artist, and others whose occupations demand great mental effort (more especially if the individual possesses a highly excitable nervous organization), tobacco is useful, soothing, and conforting. That tobacco in moderation is a brain-destroying agent, is sufficiently disproved by the fact that many of our most eminent writers have been votaries of the pipe. and some of the most acute statesmen, confirmed smokers. :o: GEORGIC LIBRARY. Among the free libraries of this State one of the most useful and valuable is the \" Georgic Library,\" founded by Dr. T. A. Cheney, at Starkey, in Yates County, not far from the famous Watkins Glen. The Hon. H. Boardman Smith, of Elnira, in a memoir of Dr. Cheney, says of him : \" He accomplished his prc- posed studies at Oberlin, and in 1849 returned to Leon, where lie soon after established the 'Georgic Society'-composed mainly of graduates of academies who proposed to pursue the higher studies-of vhich he was President. This society insti- tuted the 'Georgic Library,' which is now established upon a permanent basis, and has become, particularly in its rare collet - tions of historical and scientific works, one of the most valuable free libraries in Western or Central New York.\" Its establish- ment is highly creditable to the public spirit of Dr. Cheney and his friends.-W. C. BRYANT, [We hope it will not be loag before Montreal may boast of a similar institution.-ED. P. H. M.]",
         "5istefItiltm SJIediglis. SANITARY EDUCATION.* Public Sanitation in this country is in the paradoxical condi- tion of being in strong manhood and infancy at the sarne time. The feeling of insecurity caused by the warnings of Southwood Smith, Chadwick, Acland, and other;, lias created a schooil of men who have made Public Hygiene, Conservative Medicine, and Sanitary Engineering sciences which have reduced vague theories to substantial practicalities, which have a literature bristling with maxims hewn from common sense; and it may be safely stated, that thougli a vast amount of knowledge lias yet to be attained on each of these subjects, we are in possession of certain reliable facts which. if acted upon, would do a great deal to reduce the death-rate and disease-rate, and raise the living humanity of poverty from the low state of vitality it has fallen into in all large cities to a much higlier standard. We see how sorne of these, the teachings of sanitarians, have in some degrec stayed the hand of pestilence. and there is every reason to believe if the advice thus given had been acted on thoroughly, and with- out regard to trouble or money cost, we should have had a diminu- tion in the death-rate of all towns over 40,000 souls during the past quarter of a century, instead of an increase, as we have- while, however, there is this clas. of professionail sanitarians earnestly endeavoring, day by day and hour by hour, to awake the authorities to a due sense of their heavy responsibilities-a class, we may say, in advance of its times, and fully capable of dealng with the question. We have populations crowdiig together thick, and thicker every year, so avowedly ignorant of the elements of healthy con- On the Education of the People with reference to Sanitation.\" A paper read in the Health Section, Social Science Congress, Liverpool, October, 1876, by E. B. Ellice-Clark, Assoc. Inst. C.E.",
         "SMNITARY EDUICATION. 233 ditions that they arc \"cten worse than the brute beasts of the open fields: only those who arc brought into personal contact with the very and refuse poor, know to what an extent this ignorance pre- vails; and it is not with the poor alone; the middle and coni- mercial classes, the aristocratic and wealthy, arc as badly off for instruction or information. It commences with the peasant town-housed Irishwoman, who never washes the head of lier infant offbpring, leaving a scalp of dirt to prevent cold, and runs through the professional and commercial classes whose educa. tion does not embrace one single clement of sanilation excel t personal cleanliness; finally reaching the aristocracy, wlio, with few exceptions, look upon the question as filthy, and too disgusting to be tolerated for conversation, much less to discuss openly, as the first great principle of existence. A personal examination of the dwellings of all classes, in nearly every large town in the country, lias convinced us, that unless something is donc by way of educating the masses of the people in sanitary matters, all the scientific research and practical teachings of experts will be valueless. Sanitarians ixjay labor fur ever with little result for good with- out the assistance of the peuple. Individual responsibility should be in.,isted on. Little can be effected with the adult populations; but through the School Board there is an opportunity of incul- cating knowledge at an age when it is never forgotten. Contro- ,ersy, loudand deep, has been heard througlout the country as to teac.hing religion in schools, but there can be no question of doubt here for Churchman or Nonconformist. The author would insist on classes being formed to teach children the use of the wvater-closet-the necessity of daily washing--how filth is re- noved from towns, and why-what is the use of pure air and water-the objects of the scavenger's cart, the dustbin and aslpit -why the streets are paved, swept, and watered-the reason there are drain-traps in the court-that the refuse of our food becomes unwholesome, and mu;t be removed from the air we breathe-the responsibility of the individual, and inany other such matters. There need be no technical language or long",
         "234. PUBLIC H1EALTH MAGAZIN words; let them bc in short, casy phrases, and if in rhyme and sung by the children the better; impress thcse in carly youth; thcy will not in all cases be actcd upon, but they will cxpand the minds of those for whom sanitary laws were madc; and sanitar- ians arc working, and must assist in such work. Indccd, without it, build up a sanitary edifice by Parliamentary standard ever so, ye will labor in vain that build it unless you insist on fixing on individuals the responsibilities that individual5 produce. -.:o0r THE VENTILATION OF HER MAJESTY'S SHIPS. The Construction Department of the Admiralty nust bc having just now :ather a bad time of it. A very protracted enquiry, commenced more than a year ago, and the reults of which are but just published, goes to show that, as sanitary science afloat is understood at Whitehall, the proper ventilation of a ship is utterly incompatible with her safety. H.M.S. \"Vanguard,\" supposed to be one of the most perfect ironclads in existence, seems, from the report now before us, to have been put hopelessly under the sea because the entirety of l'er water-tight bulkheads had been des- troyed by some officer in the Controller's Depariment at Devon- port, who conceived the (to their Lordships apparently insane\u003e notion that comparative health at sea was, generally speaking, preferable to absolute safety, and so incautiously ordered ventil- ating openings to be cut through certain of these bulkheads. In this particular case the ship now practically ceases to exist; and it is perhaps immaterial to discuss whether, if she had not gone down in consequence of the imperfect state of her compartments, she might not have gone up from a gaseous explosion, the result of imperfect ventilation of the coal-boxes. But, as it appears. that this piercing of bulkheads to promote ventilation (not to. increase the risk of sinking) bas been going on in no fewer than fourteen ships of the Royal Navy, it is incumbent upon us to ask on whom the responsibility rests of advising and seeing as to the sanitary condition of ships that are being continually planned onstructed, and launched, at a vast cost to the nation. We as k",
         "A VERY REMARLAI.E CASE. 232 the question, but can answcr it very promptly indeed. There is no sanitary officer in the Corsstructor's Ofice at Whitchall. The Medical Department of the Navy is nover, and has never been, consulted as to the sanitary requirements of a ship, until she bas been commissioncd for some time, and her gross unhealthiness is demonstrated by some sort of epidemir. The sickness (quite irrespective of the mortality) caused by culpable carelessness in this matter is very large and wholly inexcusable. We have here, in this case of the \"Vanguard,\" a notorious instance of a Quecn's ship, constructed most expensively, but with an entire disregard of all sanitary principles. A lame attempt is made to obviate the inevitable and evil resui:, which attempt, as wc glcan from the official report, causes the destruction of the ship. We remarked some months ago, for the third or fourth time, that these expensive events will continue ti occur until a skilled officer from the MedicalD;rctur-General's Department is attached to the Cunstructor's Office at Whitehall, whose duty it shall be when the lines of a sh'2 are drawn, to show in detail how each and every part of that vessel ought to be veitilated.-The Lancet : : A VERY REMARKABLE CASE. The New York papers contain an account of a strange ca;w of convulsive seizure vhich bas baffled the skill of more than sixty medical men of high standing. The subject of the attack, a well-to-do farmer residing at Springfield, was suddenly taken on the 15th November, 1858, with convulsions, which lasted until the 2Sth. Every year, for eighteen years, he bas been similarly attacked. Medicines are of no avail whatever. He is as healthy and strong as ever, and entirely well, except for these attacks. His convulsions are terrible to witness. He experiences no pain while they are upon him, and is perfectly conscious all the time. His violence is s'uch that it requires the united strength of five men to hold him. His contortions are described as simply hor- rible-every muscle in his body seems to writhe and twist, his *hmbs and arms are flung about convulsively, bis face is contorted",
         "2,6 11Mue uratti 11. iNr.IÎ to a hideous degrce, ar.d, as one informant said, he \" would as- sume all manner of shapcs, actually tying himself into a knot, iintil it seemed as though cvery bone in his body must break.\" The superstitious attribute it to the devil's marhinations, and belicve that the man is veritably \"possessed.\" The people of Springfield' and nimerfîus oither pcrsons have witnessed the patient's rontortions whetin the \"spirit was at work.\"-(AfMe'üal Exilxaminer.) ËbildtiR 0olts aub lisiuris lu Gorrt5LoùtiS. [To thlie'litrr, Pi urC HirT; r N MA.ZriNL] DrAt SuR,- The enclo,iure i from the inside band of my felt hat, and I am under the impression that poison is in the leather, frnn the fact nf my forchcad, which is always clear, being covered with pimples. Sinre the enclosure was ctt out, the pimples have been dibappearing. Look into this matter, please, and if you think it \u003c,f sufflcicr.t importance, take notice of it in your PUnLIC HFALTI MAGA7tU., which 1 vill see. MONTREAL, 28th October, x876. ETNA. [We have examined the enclosed hat-band, and find that it bas been colored by a poisonous aniline dye. It is not an .încommon occurrence, as may be seen from the fact that many ,of our professional journals have reported cases similar; some persons, in fact, having suffered very severely from its effects. -EntToR P. H. M.] :o: SYNOPSIS OF METEOROLOGICAL OBSERVATIONS IN NOVEM BER FROM McGILL COLLEGE OBSERVATORY. Mean temperature of month, 34.146. Mean of maximum and minimum tem. peratures, 34.48. Greate\u003et heat was 54.o on the 3rd; greatest cold vas 7.7 un the 3oth,-giving a range of temperature for the month of 46.3 degrees. Greatest range of the thermometer in one day was 17.4, on the 3rd; lcast range was 1.2 degrees on the 2nd. Mean rang: for the month was 8.5r degrees. Mean height or the barometer was 29.9632. Highest reading was 30-400 on the x8th; lowest reading WaS 29.373, on the 3rd, giving a range of 1.027 inches. Mean elastic force of vapor in the atmosphere was equal to .1725 inches or -mercury. Mean relative humidity vas 83.4. Maximum relative humidity was 1oo on the 2nd and 8th. Minimum relative humidity was 51, on the 29th. Mean velocity of the wind was 10.76 miles per hour; greatest milcage in one hour was 30 on the 3rd. Mean direction of the wind, N.V. Mean of sky clouded was 73.0 per cent. Rain fell on r2 days. Snow fell on 5 days. Total rainfal/ 1.76 in. Rain or snow on 16 days. Total snîowfall 0.07 in. Total precipitation, in inches of water was 1.83.",
         "REMARKS ON VACCINATION BY WM. H. HINGSTON. M.D., D.C., L.R.C.S. EDINR. liember of the ImIcriial Leopold A cadney ; Société 31édicale Ail. of Paris; Pollichia of Bavaria; lion. Mim. Gynecological Society of Boston. âc, \u0026c., Surgeon to lHotel-DIou lospital; Consulting Surgeon to Woman's Hospital and Montreal Dispensary; Jlreaideiit Canadian Mcdical Association; V.-P. Intornat. Medlical Congress. Chainnm ofthie Board rf Health. MONTREAL: PRINTED BY LOUIS PERRAULT \u0026 CO. 87 ST. JAMES STREET. ,.1876.",
         "VACCINATION. Address by His Worship the Mayor, Wm. H. Hlingston, M.D., Chairman of the Board of Health, to the Public Vaccinators, a.# other Physicians and Citizens, on Friday the 20th October, 1876: Gentlemen: The prevalence of small-pox in this city, disturbing its tables of mortality ; affecting its reputation; and injuring its trade; has rendered it necessary that more than usutal efforts should be made to eliminate it from our midst. Large and airy hospi- tals are established, where every care and attention are secured to those who are admitted. It is hoped personal and selfish,(if not pati iotic motives alone) will induce those afflicted with the disease to isolate them- selves, and seek comfort and alleviation within their portals; and not continue to be sources of danger to others. But such isolation as can be secured is un- equal to arrest the progress of the malady without the prophylactic means which science has secured to us. Your services, gentlemen, have been invited for that purpose, and to you is entrusted the important task of vaccinating throughout the city generally. While having every confidence in your thorough fitness for the important work; that you may pursue a commion course of action I have prepared a few rules for your guidance. They have received the sanction of the Board of Health to which I sub- mitted them at our meeting two days ago; and will, I venture to hope, be found sufficiently clear and distinct for the purpose for which they are intended,",
         "B3OARD 0F F[EALT1. INSTRUCTIONS TO VACCINATOftS. 1. Do not act by deputr, but vaccinate, eithtr hy yourself, or by sone fully qualified medical practitioner as your substitute. 2. Vaccinate only subjects who are in good health, vith prima via in good order i and with no cruption behind the ears, or elsewhere on the skin; nor any febrile state. 3. Do not vaccinate a subject to whom, fron the state of health, vaccination may prove injurious. 4. The Board is responsible forthe purity of the lymph furnished in the first instance; but as you are strictly responsible for the quality of whatever lymph you gather for further vaccination, be careful to take it only fron subjects who are in god health, and free from cruptions on the skin. N.B.-Good lympn is liquid, clear, limpid, translucent, sometime, slightly yellow, and moderately viscid, and should flow slowly from the punctured vesicle as a syrup, and collect into a globule. 5. Take lymph only foin well characterised uninjured vesicles, and not from cases of re vaccination. t. Take it when the ve.icles are plump,'(this is usually on the 8th day) and within twenty.four hours after the arcola lias begun to form. 7. Avoid drain.ing any vesicle which is punctured. 8. If any undue local irritation arises in more than one case vacei- nîated fron the same lymph, desist froin employing it any further. 9. If the supply of lymph ceases or becomes unsuitable, procure a new supply from the cases already vaccinated, or fron the Board of 11ealth. 10. Vaccinate fron arm to arm when practicable. il. If the crust be used, it should not be taken from the arn before the 21st day : or better still, wait till it is quite loose. N.B.-The crust should be of a dark amber color, and semi- transparent. It should n'ot be too thin nor brittle, but should cut easily, and without fracture, and be the product of an undrained or uminjured vesicle.",
         "12. The Lancet used for vaccinating must not bc employed for any other surgical operation. 13. Note particularly, in eaci vase, the source from which vaccina- tion is done. 14. The systein should be throughly prctected by the production of at least four vaccine vesicles. 15. Carefully fill up the blank Certificate furnished, of those vaccina- ted ; or furnish a card to be forivarded to the Health Office for those «%illing to be vaccinatcd, but wvho prefer their family Physician; or note name and address for the information of the Board'of those unwilling to be vaccinated by any one. WM. I. HINGSTON, M.D., Chairman. I. C. RADFORD, Secretary.",
         "6 It has been suggested to me by some of your body, that, in addition to the above, something mightbe said to noet the ol)jectionls urged by those active. but mis- taken writers, agaiit th paeinactiee of vaccination. lad similar articles beein % ritten agnains t thepractice ofset- ting fractures :of reducing dislucations , or of renov- ing dead parts from living bodies, I should have thought it useless tu reply : fur if surgeonp contend that a dislocateld bone should be reduced, the profession -I speak of its more experienced inembers-is almost equally unanimous in favor of the practice whi.h some so persistently, and so unfortuiiately, denounce. It is something to array oneself against the general belief. To follow quietly in the footsteps of those who, in all things ele, medical, are our guides, brings with it, to the mind, less éclat, than to take up arms in what may be considered a safe warfare-safe, perhaps, to the combatant, but fraught with terrible mischief to those most interested. To prove to the unprejudiced that vaccination exerts a protective influence over the economy would be an easy task, for the writings of thousands, from the time of Jenner to our own day, are before us for the purpose ; but to attempt to conv'ice those who persistently close their eyes to the overwhelming evidence of almost every country and government in the world, includ- ing our own, would be as fruitless as w as the effort to convince the disbeliever in matter of the reality of the missile which almost knocked off his too unyield- ing head. In deference, however, to wishes expressed, and suggestions offered at a meeting on Wednesday last, I venture some observations on this disease, now unhappiely too prevalent, and on the means which science has furnished for its prevention. Small-pox has its periods of dormancy, and ite",
         "periods of activity, at one moment overspreading a district, and at another disappearing. It is fatal in direct ratio to its epidemic character. Cases occuring sporadically (here and there iii spots), are not so fatal. It is the mot contagions of all diseases; and. this is a point on which I wish to insist; for some industriously endeavor to circulate the belief that small-pox drops upon individuals as rain drops from heaven-touch- ing this one and spàring that! It is communicable in every way by inoculation, by breathing a contaminated atmosphere, by the contact or vicinity of fomites. ] t is infections in the early febrile stage; infections before and during the eruption; and infec- tions \"so long as any of the dry scrabs resulting from the original eruption remain adherent to the body \" It may be caught, therefore, from the living body; it may be caught from the dead body; or it may be caught from clothing and furniture near the living or the dead body. So much has this foul disease been dreaded, that different nations in times past endeavored to mitigate.the malady by communi- cating it artiticially. The Brahmins in India en- grafted the virus; so also did the Turks; and the Chinese were in the habit of putting some of the crusts into the nostrils. The practice of inoculating with small-pox virus became more or less general in Europe; and its efficacy iii mitigating the severity and the danger of the disease was considered to be very great. While it is estimated that one third of those who take the natural small-pox die, not more than three or four in a thousand are destroyed by the ingrafted disease. (Carschman states it co have been about two per cent.) But the time for small-pox in- go nlation is past, tht law raying wisely frbidd4 it,",
         "Eighty ytars ago a chaine obswrvation was ma- tured into a ratioil aid kcieiitific forin by a mind deeply imbued w ith the 3 bet principles of sound philoisophy ; and a disaw, iiild n firim, aid safe' in charneter, u% as subs.)tiutel 1r th. inoculation of the Turks and Chine. In 179, Jleniier published lis first important paper. In1 1I9 the first public insti- tution rn u..s stablished iii London ; ia the followî inw yvar it w n intro-luced into Franev and Gernaiv , and the practice of »% aceina- tion has non become gen-rai oî er the whole educated vorld. lere aid there, as mnight be expected, it has met with opposition ; but every objection that has been urged by the auti-vacciiiator hus ben-ii answered again and aLraii Iv the leading minds of the profes- sion. So much is this the case that I feel I owe somethmig like an apology to my mîedical brethren for writing ailirmati ely of a practice whlich most of them eidorse. I spoke a maomenit ago of Jenner as a discoverer ; but Teinier did not disco% er vaccine any more than Watt discovered stearn. ie noticed the prevaleit belief arnong the peasantry in the immu- nity froni small-pox enjoyed by fitrm se*rv ants and inik mnaids ; and little bv little he drew the conclusion which has been so pregnait w ith benefit to mankind. The belief in the existence of a vacc ine virus was not confined to England. Cow-pox and its relations to small-pox had been ioticed long befbre on the con- tinent of Europe ; * and in France and Germany nu- merous experiments had been made, prior to the lime of Jenner, to show that persons affected by natural fDoctor Michea publirhed an article borme yearb ago provi.ng tliat Vaccination was known to, and practised by the Hindoo physicians; and gave an extract from the Satega Grantham (a sacred boôk attributed to Dhanwantari) in support of bis assertion.",
         "vaccine virus w ere not suceptible to the siall-pox influence. Tenner's merit conistd chi.fly ini prolui in- the virus at wiII, and in diffnsing if, ot pleasure, for our advantag' And how slowly and how cau- tionsly ho advanced his ev.erv statoim -nt, i -y be gahithred fromn the faut that twvinty two years elapsed betn% een his first experiniont and the promulgation of his theury. Hei was as iiled tI»en, as hi menmory is to day ; but with more excusq theu than now, for nio one having thw leisure and the disposition to rend, and having access to thie ree Irds of medical observers, has no'v t he shadow of ai excuse lor rejectmg the the- orV [hen alvanceed, the critical acuteness of which, s.tys Curse'im tn, m îy serv'e as a miel But we do things differently now a days, and a harangue in a mnarket place or public square., by gentlemen who may, 'tis true, bei anthorities in /bnn, but cannot be accepted as such iii iedicine, is deemed suflicient to introduce the uninitiated to a knowledge of one of the most diflicult and abstruse subjects in the whole range of medical science. I shall not allude to the members of my own profession who have choseni so far to forget what is due to their own dignity, and the dignity of their calling, as to select such an arena for the dissemination of their fatal errors. As the times are as pregnant with mischief, as the air is with the disease, I proceed to ask and to answer questions asked and answered a thousaid times: Ist. Does vaccination confer a certain degree of protection against small-pox ? 2nd. Are the effects of vaccination permanent? 3rd. Isithere risk of lighting up local inflam natory action ?",
         "4th. Is there risk, vhen vaccinating, of inocul- aung the system with scrofula. or other hereditary disease ? 5th. Is there risk of contaminiating the systein with syphilis, or other acquired disease ? T'he answers to these questions vill, I think, cover the ground gone over by the anti-vaccinists. 1it. A simple assertion that vaccination dues confer a certain degree of protection against au attack of sinall-pox wouli at once be met by a counter assertion that it doe's not. The question, therefore, will be answered inferenLtially, and from authors the most trustworthy, though a desire to economize space prevents me from citing them at length. And first for England. In the first thirty years of the last century, when inoculation of small-pox was unknowni, the mortality iii London from that digease was 7.4, and at the close it was ..5 per cent, inoculation having been introduced iii the interval. A Comnittee of the Epidemiological Society have conpiled tables to show the ratio of mortality from small-pox in London before and silice vaccination was introduced, and the following are the results: For the lifty years, from 1750 to 1800, the. average number of deaths from small-pox, out of every 1,.00 deaths from all causes, w as 96 or nearly ten per cen t; while during the hrst half of the present century (the halfcentury succreeding the introduction of vaccination) the mortal ty was 39. ln the whole )f England, accord ing to official returns, the estimated death rate from small-pox alonae at the end of the last century was 3,000 per million, while from the same returus the present decath -rate from the sane cause is oily 200 per million! An analysis of the latter is most interesting. Vacci- ption has, in Great Brilffin gs elsewhere, had it§",
         "fippoients, but the practice las becomie more. and more general, (and the opposition tu it less and less,) till now it is quite general. What is the result? During the first Lien vars of the prese-nt century, the mortality froin sm:di-px in every thouaiand deaths froin ail caus.e.s was 14; in the seconld decade, 42; in the third, .12; in the' lburth, 23; and in the iifth decade it was l. Let the anti vaccinators ex- plain this as be.st thv way. Not unly has the aver age of deaths froi sinall pox diminiished in the above ratio, bat .pIdeies of the disease have become less frequent. DIefbrv accination it was as 4-; during vaccination it was as 14. The inference from all this i, thus drawn by Sir Tiomas Watson (the ablest medical writer in London): \" Where vaccination is, the contagion of smnall-pux need never come.\" Dr. Robert Thonas, author of the \"Practice or Physie,\" which serves as a text book for students and physicians, after a long and careful analysis of the vaccine question, and giving to every objection the most patient consideration, thus sums up: \" the intro- duction of vaccination, nutwithstaudinig all the abate. ments which must be made in the estimate of its power!, is still one of the greatest boons that science ever conferred upon mankind. Compare the ravages committed by small pox, before and after this impor- tant epoch; and we may in the first place, appeal to general experience in the words of the Report of the National Vaccine Establishment, where the rarity of an example of disiigurement by small pox now to be found in theatres, in churches, or any large as- sembly of the people, is adduced in proof of the con- tinued protective property of the lymph employed.\" After a long and laborious analysis of the bills of mortality, and of t1e observations of Christian of",
         "Liverpool, Percivall of Manchester, Monro, (J'cely, (Gregory, Thonson, Curtis and others, he says: \"if these conclusions, derived as they are from somewhat extensive data, b1' at ail near the truth, they will go far tio prove Mr. Curtis's assertion, where lie says of vaccination, that its value is much greater than that Of any know n remedy for any known disease at ail compitrable to small pox in nischief to the human race. H.w is it in i'a/cs ? Dr. Huglies, o' Mold, states no chid born in the Mold district, and alive at the date of the registratiot of its biirth, has died ou small- pox during fourteen y ears, yet snalt-pox has prevailed 01n various occasions all arounîd it.\" How is it iii Ire/and, where i accination has beeu compulsory for the last lifteen years ? The innunity alforded by % accination there bas been such, as tu in- duce a % ide-,pread belief in its eflicacy among the people. Vaccination is practiced generally ail over that cunitry, and the children of the soil carrying with thein an entire confidence in the practice, aie alw a3 s the most willing to be vaccinated. The results are seen in the folloning ligures, from which it ap pears, says an official document, that the Irish physi- clans have baniishîed small-pox from thyir island, as Saint Patrick is said to have banished the snakes. In the periods 1830 40, 1840-50 and 1850-60, before vac- cination w as general, the respective annual average mortalities had been 5,800, 3,827, and 1,272. In the years 1864, 5, 6, 7, 8, they were 854, 347, 187, 20 and 19, respectively. In the first half of 1869, the whole number vas three ! The remarkable immunity from small-pox conferred by vaccination, induced a laxity in the piactice, and a few cases occurred subsequent ly to 1869, but they were supposed to have been im ported. In Montreal there are comparatively few",
         "children of Irish parentage unvaccinated, and our tables of inortality-to which I beg to refer-show how very few of that nationality die or sm all-pox. What is thonght in Snland of the protective influence of varcination ? f quote again only ou- ni- licai teachers-those frorm whon we are content to receive our me dical knowledge. 01ne. of th. most di tinguished modical philosophers that 8eo liand.1- and nd is prolifie in medical philosoplhers -has producei ; and one who graced, fIr a great number of years, the chair of medecine in the Uni- velsity of Edinburgh, writes thus \" The first que. - tion is wheithe'r or not we have, at this time, in the matter of cow pox, a power at our command capable, if duly employed, of de-priving the poison of small- pox of ail fatal influence over an imnmen'sel majoriny of mankind. And on this subject there has been quite sufficient information collected, since the date of the papers % hich were held decisive of the question lifty years ago, to show that the same inference is still inevitable, and that he who disputes it is equally un- reasonable as he who opposes, in like manner, any pro- position in Euclid. Of course, when I say there has heen ample evidence to decide this question statistical- ly, I mean to refer to cases where we have not only the negative evidence of large numbers of persons duly vaccinated, having been subsequently, most of them repeatedly, or for a long time together, exposed to the contagion of snall-pox --i. e., placed in the same cir- cumstances in which unvaccinated people have been generally affected, and many of themi died of small- pox ; these vaccinated persons have nevertheless escaped, most of thenm without any indication of disease. To show that this is the light in which I have alwa, s regarded such collections of facts, I quote",
         "one sevntene'm fruma my m n leetnres, written as long igo as 18,20-1821. and re'pe'aLtd almost very wintor since' theni .-- You will rememblr that thle question is, nt how nany vaccintited pe'rsons ne'ver take small-pox, bu hemany % accinaited- pe-r.sons are, fully exprsid to the con.utagionu of simalli pox and e.scape without any dis.ase, and our a-rtion is that, me far as is vot knuowvn, asolat-- proute'tion f' the human Constitutiini is tii rule, and1 the \u003cow urencre of an% distaso is thé exption.\" Ti;s' w ho,, lik mi', have had the advantage' oi' listiniuug to that most pro- foundlIy logical and conscienutious ne'dical teacher, well know the care and thoughlt hi- gave to his every uztterance. Dr. Alisonr hlas passd away, and what says Dr I. Hugh.s Bîenne*tt, his successor in the pro- fessorial chair ? \" WV have- n re'me'dy (fbr small-pox) but vaccination Let us now proceed to the Continent, and what do we find ? And first to France- eve:r f'oremost in all researches having science for their foundation. M. Bousquet, in his Traité de la Varrine, gives nost accurate and interesting details of* an Epidemic of Small-Pox which visited Marseilles in 1825 The population of Marseilles amounting to 40,000, might be divided into three classes, of which the respective numbers stood thus: 00,000 vaccinated ; 8,000 neither vaccinated nor variolated ; and 2,000 variolated-ihat is who had the small pox either naturally or by ino- culation. Of the 00,00) vaccinated, about 2,000 were seized with the prevalent small pox epidemie, of which number 20 died or 1 for every 100 affected. Of the 2,000 % ariolated, 20 n ere attacked and 4 died , or 1 in every five cases. Of the 8,000 non-vaccinated, 4,000 were affected, e.nd of this number 1,000 died or 1 out of every 4 cases. From this it follows",
         "that nieé-half of tie non vaccinte'd, 1-15th of the vaccinated and only 1-l10th of the vnriolated took the disease. But such was the, diflferice in thé compa- rative' setverity rf the attack in the vaccinated and variolated, that w hile the- variolated part of the' popu- lation were- cut off in the propirtion of 1 out of overy .)Of), the vaccinated part oi Ihe population only lost 1 ont of every 15011 , or in othe'r words, af an equal number of variolatel and vaccinated cases, : vario- lated diel from th second attack, for every one who died of the disease after vaccination ! Gaultier de Glaubrv states-and his statenvint is confirmed by othtrs-that vhile, in 1841, small-pox in France carried oif inore than a saiventh of those attacked by it who had not been vaccinated, the mortality was only one in a hundred amtiong those' who had contracted the disease after having been vaccinated. La vaccination peut étre pratiquée avec succes, says Bouvier, en toute saison, en tout temps d'épi- démie on doit vacciner les enfants le plus tôt possible après leur naissance , les re-vaccinations sont néces- saires pour mettre à l'abri dle la petite vérole ; elles sont sans danger et particulièrement utiles pendant la durée d'une épidémie quelle que soit l'époque de la précédente inoculation du vaccin. There are, in every country, men who stand out in bold relief even among their compeers; and high among the ablest medical writers of France, or of the vorld, is the name of Grisolle-celte aie à la vieille marque. There are some so bold,-and I am one of them-as to place his \" Pathologie Interne,\" among the greatest productions of genius-a work in which no unstable theories however brilliant--no baseless spe- çulations, however fascinating-find place-a work",
         "which reached its 9th edition in about twice as many years, and which, during that period was, and still is, the standard authority upon a most important de- partment of mediciue. M. Grisolle says . \" Les recher- ches de .lenier lui ont assignué une place éminente parmi les iplus grands bienfaiteurs de l'humanité. La vaccino a donné lien en France à des travaux importants. Ont peut vacciner dans toutes les sai- sons et à tout âge. On attend généralemeint que les enfintîs soient agés de deux ou trois mois pour les inoculer ; mais; cette pratique, que rien ne jusl;ie, n'a aucun avantage ; ce retard a été cause que beaucoup ont en une variole presque toujours mortelle, et qu'on aurait pu leur épargner. J'ai inoculé mues deux filles dès la fin le leur première semaine. C'est ainsi que nous devons agir pour nos enfants, plus exposés sans nul doute que les autres à la contagion médiate. On devrait même inoculer aussitôt après la naissance, si l'on était on temps d'épidémie varioleuse, ou si les individus vivaie)4 dans un milieu infecté; c'est ce que j'ai fait maintes fois à l'hôpital sans aucune espèce d'inconîvénient. Il n'y a aucune préparation à laire subir aux sujets qu'on doit vacciner. L'opération de la vaccine est fort simple. Il est certain, en effet, que la plupart des vaccinés sont définitiveieit à l'abii d'une atteinte de variole. Il est certain du moins que la vaccine rend la variole bénigne que la mort en est rarement le résultat.\" I have quoted at length from Grissolle ; as he may be said to bear the relationship to medicine, in France, that Blackstone does to law in England. Ii Copehagen, the fatality from smalt-pox is but an eleventh par.t of vhat it was before the introduction of vaccination , \"in Sweden it is a little over one- thirteenth; in Berlin, in Prussia, and in large parts",
         "of Austria, but a twentieth ; in Westpitalia but a twenty-lifth ! !\" Ini Bohenia, Moravia, and Silesia it has been reduced from 4,000 in every million of deaths to 200 per million ! Not only is it satisfactorily established that vaccination is an effectual safeguard against small-pox, it is, according to some, more effec- tual in preventing small-pox thai is small-pox itself. This vas thoroughly tested in Hanover, where it was found that out of a hundred soldiers re-vaccinated, sixty-two per cent failed altogether in producing a vaccine vesicle; and twenty-seven per cent were only partly successful. Soldiers who had already had small-pox were operated upon in the same way, and with precisely the same result. Taking Europe as a whole, the conclusion arrived at by Berard and DeLavit, of Montpelier; Hodenpyl, of Rotterdam; and Thompson, of Edinburgh, after a close observation, and especially of the epidemic of small-pox in 1816, 17 and 18, in (1) the vaccinated; in (2) the variolated; and in (3) those who had neither been vaccinated nor had small-pox was, according to Dr. Stark, thus: Of those who had neither had cow- pox nor small-pox, one out of every four who were seized with the disease, died ; of those who had small pox naturally, or by inoculation, one of every twenty- five to one in seventy-five died; while of those who had been vaccinefted, and were afterwards seized with small-pox, not more than one in three hundred and thirty cases died; thus showing the great superiority of vaccination, even to the small pox itself, in protect- ing the system from the fatal effects of a second attack. Such information as I could glean from different sources leads me to the conclusion that an attack of small-pox and vaccination confer the same degree of 13",
         "18 immunity from an attack of snall-pox ; but that subsequent.fatal small-pox follows more frequently after small-pox than alter vaccination. low is the practice of vaccination rep·arded in the Uniied $Iates? (Gentlemen : it would be an end- less matter to quote the opinions of the many medical observers in the adjoiiig Union, but I shall introduce the substance of everyone's reinarks as furnished to the State. Several of the States of the adjoining Repub- lic have their Statc Board of Health; and each Board may be considered to reflect the opinion of the medical minds in the State. The State Board of Health for 1871 says :-\" No anount of disinfectants can cope with this dire disease. The only way to thoroughly drive it from the United States is by a national law, as in England, requiring every parent to duly register his child after having been duly vaccinated.\" The experience of Massechusetts is sumned up in the report from which I quote: that small-pox has appear- ed here and there, Wut where it has appeared spora. dically it has always been in places where vaccination had been necglected. The town of Holyoke, in he Connecticut valley, was an illustration. One-fifth of all the deaths from small-pox occuring in the whole State took place there. The people in Holyoke had iot been vaccinated as elsewhere. Dr. Geo. Darby, of Boston, Secretary of the State Board of Health, summarises for his .Board as follows (and his summary receives the sanction of the Board) ; vaccinatiJn \" invests the human body with an armour which may hardly be penetrated by this subtle poison.\" A year later (an epidemie of small-pox having passed over Connecti- cut) he writes : The present epidemic is of such intensity, that it is quite common for persons who have had small-pox in former years to now have it",
         "again. Such occurrences have beein previous!y rare. Vaccination, wliether from the cow or from the hu- mian body, \"takes\" rt-tdilv and re-vareinations prove abundantlv th. extraordinar.y suseeptibiIity to the vaccme udiease now prevailing, and never before t., zsig. il view iof these fhcts, with which physi- eians and intelligent persons, of whatever calling, are now familiar, let us thank 4God fbr Jenner's great discovery, w ithout which our homes would be desola- ted, and our peace and happine:s destroyed. The imagination ean hardly picture the horror which would to day pervade Massachusetts, were the present epidemie uinchecked by vaccination.\" A vear later (1874)the epidemic being over, the same authority, and the saine Board, report inter alla : une year ago * we were in the midst of an epidemie of small-pox of extraordinary intensity :' the protective power o vaccine has been proved beyond all question, and the absolute need of caref/ raceition is equally evi- dent. From eptember th to the close of the, year, not a single death from small-pox has been reported to us fron the cities or state.\" I received the last \" State Board of Health \" report, a few days ago, an interesting document of nearly four hundred pages, and so complnjetely had vaccine done its work that the report contains no allusion ta the dreaded disease. Thankful for the immunity afforded, the reporter from whom I quote writes : \" Vaccination needs no defence from us. Nothing, however beneficent, can escape the criticism of the times in which ve live. But this critici i aof vaccination, often passionate and violent, relates \u003ciefly to points which, however in- teresting they may be, leave the main question un- affected. Let any one read the history of the ravages of small-pox before Jenner's discovery, and compa-",
         "it vth th.v iortality il IasIîîtf frîîîî thhisîuî in t]i' r*î2tgý-raiui:i\u003c ikljnîftî rozison of this eliangv~. 'Iiii- i' i lie but toiv Waî\\ir va mnay spicnI:tfaaîiif1 pîiii i 11-ai iailil prî w'avî ivay a ', liixîn.\\-.t' I i lte iiat î bîinl Létl rios' wli'sui î tri Ihîl IV lîi peîîl 1 r'iu blCiflî 1%,r s(i i vi't g-vive ihIl-iI i in of eutî' us linnh\u003e ... i'îi aldat- d efiflt.itw YXêia( i-- cio\u003c seuxvîan il v'ait\u003c thI I'flll 1'aîuIsjia i fI t-1))-10%il- dctsalxr ther %vi iv araoni gx jitroro(w trt un butn heasq i.vid haL.livrI ad es th,î t l u af li asnill, o ihaptt I. I~aî fuat aialIi'ic a pubtituc docurin i-tghîs. aîxd le 'lI iŽ iîdt foi' yc, t m ecnt of tiestathiorrtlii 'ia 111 .s tIi.îîcî' n kxîo tt ini~ the uaicns. Ui ht i. 'use i th(-arî IOii Da- th f» felt ?w ' secits ehIî't r eli\u003e ùrh ous trae I)Ut ba'cently flJic Tiiiii ld \\%ail tt Cllai ~a';i eo ail exvOemio lhr 1 erevdîi11, thai t Of.' I*\\e r docrneî * :X, i*-jiv' i\u003e 0111- su ait i ri ii'ni'd delin hisatiehdx - anid teib' le\u003cvî diii' ita c onhsveru- deottate the djouiîî xiven.we oiaa svacith.Oio ban musetl afflicta' ever thuhfmith thei-ox lwvln a munificence of the legacy the immoî'tal JTenner left t4e human race.\"",
         "1 hav*' piirpfosei -y .iitt, -c' t gr.'aîtr ligrtli fronn ('tiit in.nt i t hai Brm ]ritisI luthorities, ho.cause- it ha. I,.'.ii by.r.'lh a certain orator inv'i~'4 i.vilI l ~veinatioli a t publie g~h' in i thi\u003e vii y, tit-.t it Nvasin 1, bîîglishil rem- dy, alucd t1l.at EI.Ihî,îlhad a prids l i gatu thu'ir xrwîs l -fts ii the iiro iî thildIr.i oi'fiair Up)oit ihlitd. and l., itp.it th,- hoart ot'tiia' ont'h itdvztiue.-Il il. 1.4t t înîI ula itt quu ,u thte- have's ~h -io ti n'mut.1uîI rit. r un the siuiiet? (I inivlit Ii xo.'1a . un iivràîîîeiî xritc'rs iii i otx \u003cju'Ic lbl*.ïi'ti'.'\u003e tel' vî'iît. leut have coil.iuu-d 111 \\-I sel t Stat.' d ..ui eîîsontaiiimîa the tilt coîîdeiiîs.d 1 tuhî . the Jn'st iîcdical îinids in the? Ullîted Stjttt'. 1 tuitr with uitle pivasure to this rny owu. Country, aniti clp..Ciilyl t thi's ily onCity, and I id anti v'accinîaion view's*ý advouated, andi dis- seminzated by a sýriiiil but ceastIts.sly tictive ýsection of medical and lega I thought. 1 Iind l'romn ptrsonal knowedgea deeply ruoted prejudice against xvhat the scientilic wvoric1 generally lias -janctioned; and I lind diseazie, dislig-tre iinît, anîd deathlloin ini the wake of those teac'hings ; teachings to the disse- mination - 1' which a, portion or the daily 1)rCsb las lent iLs colurnais. I readily admit that sriiull1-pox lias itLs periods of' dorinancy and its periods of activity, and that, everv iow aiîd then, ut irr'ega-lar intervals, it overspreads a district or countîry as ià epideinic, but -wvhv should iL presb :so lighty elsewhere? D)r. IR'us'sell, President of the College oi'Physiciails and Sureos, residing in Q.uebecý -ives the -reason ccVe have ve y htale small-pox here. XVe are al vaccina-,ted.\" Te table prepared by the skillcd alouse",
         "Surgeon of the. Niariiie andl Eni.ran H pil l f Queb'c, Dr. Cateillier. is : erus1in amdl mus'r.. ble argiiiiiiit rinst the anti-vavciuato-r.ý. lei vere 1:11 cases admitted iiio the est ashu n be- tweei the- months of N31ay, 181, ai .Julv. 1-7à. anil #f these, the vaccinatd niuiibiered -, 1, \u003c'/ : /i iIid. In 69 caises #of u-acntdptin sueed:caee cured, but somnewhat di-figurd, ani ::7 died. In S cases where it was douitil1 if vacriin.diatii liad --r had1 not been prforined, . wfr; Cureil anil ' died. These corputatxions allord is! the.. 1Iovlowineî st.rt- linig percenitagcs, whicl i-very man iul womîan valuing the healthy futurc o f their pro.eny ouglt to carefully note. The dceath-rat' iii rorrimiatd :eass, is only 1.8 per cent. ; iii unrarrimfnf d 53. peir cent. in doubtful crises 2.5 per cent. Can aînvthingi tend tco expose andl conlirm the claimlis of this pctice uponl1 the people better than thesec data ! Why loe's srnal- pox pass so lightly over Three Rivers ? Dr. Badeau, the Doyen of the professioi ther,. explains:-\" On -n'a pas de picole ici. On ee fait vaciner,\" The same may be said for Toronto. And why does the dis'ease Visit Montreal so severely? We nuise if. In Quebec,Three- Rivers and Toronto no one writes against, or attac'ks the principles or vacciautioi-the only pruphylactic for small-pox. That the converse is true iii Montreal is evident from the circumstance that the mortality is immensely greater among that nationality whose beau- tiful language has been made to serve as a vehicle for the dissemination of a most fatal error. Dr. Osler has kindly handed me the records of the Small- pox Department of the General Hospital from Dec. 14, 1873, to July 21, 1875, the period during which it was under the charge of Dr. Simpson and himself There were admitted during that period 261 cases,",
         "and there were- 7î death. Ilut how vas the death-rate distribute'd? lu the unvaccinated, 58.8 per cent. ; in the* vaccinateid 17.09 per cent. ! Dr. Simpson furnished the following additional lacts: \" Al the unvaccinated small-pox patients, except two, had the confluent formu i. o. the' serious forrn of the disease. Of the whol number of the vaccinateel admitted with small pox onfly two lad more than two good vaccination marks upon the arm, and only two liad been successfilly re-vaccinated. These latter two were so sligtly alBrtod by th disease, that except as a priecautionary measure, they mighthave continued to u follow thecir daily occupations.\" We have nlow two Civie hospitals in Mlontreal lor smaall- pox; one presided over by the Sisters of Providence; the other by Miss Chambers. What is the experience of these ladies? I give the questions put to the ma- trons of both establi:hreints, and their aniswers:- \" Have you noticed muy difference between the vac- cinated and non-vaccinated inroates of the hospital 9\" Sister Nativity states, in French :-\" There is no comparison between the effects of small-pox ou the vaccinated anîd non.vaccinated. the vaccinated, as a rule, are not affected; and when they are they have it slightly; the deaths are anong the unvaccinated.\" Miss Chambers' experience is precisely to the same effect. What more convincing evidence than this, coming, as it does, from sources vshose trustworthiness is beyond doubt or question. But the register of the. Civie Hospital, (and for the accuracy of which I can vouch) is even more painfully eloquent;",
         "Patienlts admitted froim 7th Novlnta-r 1st Novembr 1-i-.' 514. )f these wer....... ...... ..... l Of the above, recove-r'd. ....... 1:24 died ................ :,4 The deaths anrlg non-rcinated... :35 with 1 vaccine mark.... \" \" 3or 4 t .... \u003c 1871 ~. I .d)~..Ip 2';\" 127 Total,.......... 34 1:L7 Of the patients who had three, fiur or five vaccine marks (and there were many in each institu- tion) not one died in either! ! Dr. Larocque obligingly anialyed the above for me, and gives the following a.s the percentage of deaths ki the varions divibions. DEATH RATE PER CENT. PROTESTANTS. Total received 108. Died Unvaccinated \" 54, \" Vaccinated \" 114, \"c 34 or 20-23 per cent. 25 or 46-29 9 or 7-89 CATHOLICS. Total received 396, Died Unvaccinated \" 165, \". Vaccinated \" 231, \" 127 or 32-07 per cent. 89 or 53-93 \" 38 or 16-45 I",
         "I N 119 1111 1 I 1T. 17 LA 1- Vacilavi:1., .. 17 ''rI :ua th. lasv' thvir -'uîtir,.I.i'fl ih'tr alî'i'pie a vaccinatio,j V4l,111 alier lviiai %%1 b' riti-.n wvrirt-, i's c-\u003cvori-iI wit h .1,\"îî.îlr 'il*î thi- inagîu)it.ul. oi, w'hi.h .d .u.peeî t Is i]r'diuî hierc.è fhiih.h. 'elas% I.eIad.Llt8 ,warrant aliaswr t., t fir-t tliLt-'tii iii tht' adlir- inativi, : I hat vdC\u003ci1Iatit.)1L eainIs'rsý a --,ricator co \u003c'r 2n)id. 1.''/Arr Ille, I \u003cqril i'OlLtfl let l'uiifli As a nb., thii. aîwer wuav bol : 'gt.-; but the except- icixîs areci ii0 nunrous, flat I inust admit the partial trutth. tion wvhichî . nio f'rsaaîs :siiîi-zlox i.s offly of fiùnited duration.\" I)uring what thus i;s tiiere absolute iuiiuiity ? This %-;ries lit dilloreit, indi- x'iduals ; but 1 have long bi'eil ol' opinion, and that opinion is shar.'d by those who have given atteîii1 to the matter, that the iaiîner in which vaccinaion has beeuî donle in the firsi instanue has much te, do with thie dogree and period of thât iirumuîîiity. AI- though tell. or twI Ive years are said to be the aver- agxe period, the ( horoughly x'ac'cinutvd hin e ait immuin- iiity otf much greater duration. In a large, a verîy large niumber, unfolirtninately, Vaccination is net pï Jfrmed with itnything likec a.pproximate thoroughness.",
         "This has heen noticed in the Snail-pox Hospital here, where an examination of the arms of the inmates has rareyi discovered marks of a true .ennerian vesicle. But if there is doubt as to the continued immunity afforded by vaccination, there can he none when it has been Proper/y perforined a second time. Re- vaccination, when successful, affords entire immu- nity, and in support of this assertion I shall cite but one or two proofs from among a thousand. It has been an imperative rule for the last thirty-five years at the London Snall-pox Hospital that every nurse and other servant of the Hospital should, on entering the service, he vaccinated. In their case it is generally re-vaccination ; and it is never afterwards repeated. These nurses live in the closest daily and nightly atten- dance upon small-pox patients; and the other servants are constantly exposed to the profuse contagion: yet in no single instance, during these thirty-five years, has any one of these servants and nurses been affected with small-pox. Surely no, stronger proof than this can be imagined, that re-vaccination, in the adult, is an absolute protection against small-pox, and need not be repeated. Up to the age of puberty. a child properly vaccinated may be considered safe,-but so many of those vaccinated have cicatrices deficient in number, and of a character not strikingly good, that re-vaccination should be resorted to where there is more than usual exposure to small-pox. I have instanced the London Small-pox Hospital as evidence, ofthe advantages ofre-vaccination, and shall cite from official sources evidence of the imnmunity conferred by it on some of the continental armies of Europ,. In five years, says Seaton, there occurred in 14,884 re-vaccinated soldiers in Wurtemburg, only one inst- ance of varioloid; 'and among 30,000 re-vaccinated",
         "Persois in civil prautice only two cases of varioloid (one of which was probably really a case of chicken- pox), thongh during these years small-por had pre- vailed in 844 localities, producing 1,674 crises of mo- dified or unmodified srnall-pox among the not re- vaccinated. and in part not vaccinated, population of 363,298 persons, in those places in which it had prevailed. In the Prussian army, since the introd- uction of systematic re-vaccination in 1834, the cases reported as \" varioloid,\" and still more those called \" variola,\" have been, nearly ail of thern, among that portion of recruits whose term for re-vaccination had not come, or whose re-vaccination had not been successfni, or who were incubating small-pox when they were re-vaccinated. In the 20 years which immediately succeeded the adoption of this system there oc'urred altogether but forty deaths from small pox in this large army-(or an average of two deaths per annum)-only four of the entire forty being in per- sons,whoit is said,bad been successfully re-vaccinated. So also in the Bavarian army, in which there had been compulsory re-vaccination since 1843, there had not, from that date up to the time of a report made by the Minister of War in 1855, been a single case of unmo- dified small-pox; and only a very few cases of modi lied small-pox, without any deaths. While, therefore, I answer the second question in the negative, as to th einvariable permanency of primary vaccination, the statistics quoted from official sources, with the almost universal collateral concurrence of medical practitio- ners,warrant the statement that, after successful re-vac cination, small-pox, even of the most shght or modi- fied kind, is rarely met with; and that when the post vaccinal small-pox is met with, of a severe character, it is due to the want of care in the performance of",
         "vaccination in the first instance ; or to wnt of prepar- edness in the systen wlhen primary vaccination had been performed. Froin h.t lias bee said, a question of vast moment to adults iecesarily preseits itself. As all those wl'ho have been i accinated but once ra more or less risk of contractin the disease and as it is admittel that re-vaceimai\u003ea ren\\, 1r adds to, the secnrity against small-pox, eomo mon prudence would sugest the cours to be pursud by tlo.se who wish to guard against tlis nmlad (:risolle, ini advising e aicunation, says La pratique des re-vaccinations est généralement adoptée dans les pays du Nord: elle tend aussi à se répandre en France. On peut invoquer en sa faveur qu'une foule d'épidémies de variole, séVissuant chez des vaccinés, se sont tout à coup arrêtées dès qu'on eut soumis à la re-vaccination les individus exposés à la contagion. Ces faits sont désormais acquis à la science. C'est à faide de la re-vaccnation, appliquée comme méthode générale, qu'on a presque, complète- ment éteint la variole dans les armées Prussienne et Wurtembergeoise.\" * Although it forns no part of muy present subject, yet, cs an impression prevails with some, that persons exposed to small-pox contagion incur additional risk in being vaccinated, and of ha -g one disease en- grafted on another, it is well to state that such a view * Dr. Cuignet recently inade the following statemvnt at the Société des Medeius du Dipartuent du Nord. · With lugard to the influence of revaccination a,, a preservative against snaill-pox, I vii direct your attention to the quite special condition in which the soldiers of the iuard of Paiiz are plat d in this itspeitt. Tiere is not a corps ;n the entire army in which revaccinations have been so fre- quently and so carefully perforned ; and during ses eunty years no case of variola has bet i met with ant.ig tlçum, in spitc of the cpidt inhi, vhich have on zevemi occasions Iecinated the populou quariers of earis.\"",
         "29 is entirely erroneous. Il vaccination is perforrned sufficiently early, so that the zireola miay bave time to form, it vill prevent smrall-pox ; if later, it will modi- fv that disease. M. March illustrates this rule thus: - \";suppose an nvaceinated person to inhale the germ of variola on a Monday, if lie be vaccinated as late as on the followinig Tuesday, the vaceination will be in time to prevent smallpox fromn being developed If it be put off' till Thursday, the snall-pox will appear, but will be modified. 1f the vaccination be delayed till Friday it will be of no use.\" Sir John Watson, p- SSS, adds :-\" Should the person have been for- merly vaccinated, re-vaccination will be effectual two days later than this, because, in re-vaccinated persons the stage of areola is reached two or three days sooner than in persons vaccinated fbr the first time. 3rd. is ihere risk of r\u003cnriialion / ightg up local inflainrialory ac/ion , - When wve consider the disposition, the tempe- rament, the condition of health, of those vacci- nated ; and the period of life at which vaccination is usually-and the period of the year at which it, is sometimes-peronnd, it is a natter of surprise that loeal irritation, or erysipelatous action, is not more frequently lit up. At certain seasons of cer- tain years any abrasure of the skin, however slight even without vaccine lymph, is apt to cause erysipel- atous inflammation. What medical man has not sometimes seen erysipelas to follow a slight bruise, or the scratch of a needle or of a thorn 2 The accidents of this kind following vaccination are very few- not by any means as many as have been seen to follov the pulling of a tooth. Yet who ever advised that an aching tooth should be left alone because it had happened sometime, somewhere, and in the hands",
         "of some one, that hemorrhage from the tooth socket had taken place ; that erysipelas-fatal erysipelas- had sonetimes followed ; or that the bones of the jaw had been splintered ? These are accidental ; and so rare are they that they should not enter into one's calenlations. So convinced ara I of the safety of vaccination, that I have no hesitation in saying that a vaccinator, wrho kIows his business, would vacciiate a thousanid children with fewer unpleasant results, than a competent deatist would have in ex- tracting the saine nuraber of teeth * There are, 'tis true, precatations to be takenjust as there are common sense precautions to be used by every one in eating, in drinking, in travelling. But these occurrences would be rare indeed if vaccinators exercised care and judg- ment in the selection of the lymiph (which should be pure, taken at the proper time, and without admit- ture either of decayed epidermis or of pus) and in the selection of their subjects (who should be neither too young, too feeble nor too sickly); and with these precautions, se vere local inflammation would be rare indeed. But it is not to be expected that some degree of irritation will not be produced. On the contrary, children vaccinated with the parest lymph will manifest, during the few days that the pustules are et the highest development, a certain febrile distur bance of the general systtm, during which the tem- perature of the body sometimes reaches 1040 F. But As this is passing through the press sone time after its actual delivery, I have the satisfaction of stating in illustration, that upwards of 6000 children have been vaccinated in this City within the past few weeks by the gentlemen named by the .Board of Health ; and that the alleged caseb of se tre irritation following, were only two, in that large number. They were both seen by me and presented nothing unusual- the children being now quite well. Emphlysis coniformis occurred in one house where vactination had recently been performed, and all the chjldren had it , but %accination had nothing, whatever, to do with it,",
         "in certain constitutions, and in certain states of the atmosphere, and especially when the crust is decayed and with it there happens to be, either through care lessness or ignorancet, decayed epitheliun or dried pus or both; or even the purest lymph with an iuiclean instrument, the consi itutioiial derangement above allu- ded to, and which was still withinthe range of health, assumes a morbid chavacter, and more or less severe local or ocustitutional disturbanee is the result. The third question, therefore, iaay be answered thus : moderate local inflammaatory action may sometimes be lit up, but the severer forms are, as a rule, due to want of care in the selection of the crust; to inatten. tion to the age or health of the subject; to careless- ness in the use of the sacrilicator : or to atmospheric influence; or to all combined. 4th. Is there ilsk, when varenating, of inovultling the system wtith scrofila, or other hieditary disease ?- If my answers to the previons questions were neces- sarily qualified, this one is not, and I emphatically answer: no. It would be an utter x aste of time to proceed to discuss what has already been disposed of to the satisfaction of every unprejudiced mnd. That vaccination induces scrofula, or other new disease, is an absurdity, notwithstanding the w'onderful tales of a Verde de Lisle, that it has caused mental and phy- sical degeneration of the human species ; diminish- ing men's stature; incapacitating them for the fatigue of military service; or even of the exercise of dancing. One word as to the first: the tallest, strongest and hcaviest men in Europe, according to Professor J. D. Forbes, are the Irish; yet Ireland is one of the, if not the, most thoroughly vaccinated countries in the world. And as to the second, if vaccination induces dis- ease, where are the results of those diseases ?",
         "Instead of vaccination inducing scrofula or other hereditary disorder, it is claimed to diminish ihat ten- deney. Uuiversal death, it is not denid, is the law of our nature. Thongh we maust all die, yet life may be prolonged in pirticular instances ; and particutar instances go to make up hie general resuilt. The tables of mortalif y of a country are the data on which Life Assurance is built It is upon a knowledge of these f ables that the premium rate or percentage to b, charged in dliffreit countries is regulated. Mr. BabbagyO in his work on Life Assurance, says \" it has been shown by Mr. Davillard, (a french writer) that the introduction of vaccination ias increased the mean duration of huinan life hv about three years and a half.\" And the prernium. rates are influenced accor- dingly. At the end of the last century the rate ofmor- tality in London was one in every thirty.-One half century later, and the rate of nortality was one in forty-one ! Yet during that interval vaccination had been introduced, and the practice had become general. It greatly strengthens, says Thomas, our argument in favour of vaccination, to find that the general mortali- ty, in comparison with which that from small-pox has undergone so m arked a diminution, has itself also nota- bly decreased iii proportion to the existing population. In this connection I am happy to be able to cite Dr. Henri Cotin, author of the Guide iMledical, who says : \" On se préoccupe beaucoup dans le monde de l'idée que le vaccin pris sur des enfants malsains peut communiquer la maladie de l'individu. Cette idée est complètement erronée ; jamais aucune maladie n'a eté inoeulé at'ec le vaccin, et ce dernier pris sur l'en- fant le plus malingre, pourvu qu'il ait les qualités physiques que nous avons indiquées, est tout aussi bon que celui qui provient du plus bel enfan.\"",
         "I shall iot do more than allude to that absurd paradox advanced by a nathematician, and suppor- ted by two or three physicians as paradoxical as him self, that vaccination htas transformed small-pox into typhoid lever! and that, in causing the disappearance of the lormer, it had increased the frequency and viru- lence of the latter ! There may be an excuse for a mathematician-knowing nothing of medicine-to hold such a view; but there can be none for phy- sicians, as it could only be the oftspring of profound ignorance of the merest elenentary literature of the profession. Every physician should know that typhoid fever is not a recent disease- but that for centuries before the introduction of vaccine it had the same hideousness it has now-and will have so long as sanitary laws are set at defiance. 511.-Is there risk, when 'accinating, of inoculating with syphilis or other acquired diseases ? The allegation has been rrade by some in the affirmative; but when it is borne in mind the strong temptations to employ false pretexts, it is a matte of srirjrise that vaccina- tion has not been more generally \" pitched upon by persons in search of an apology for their syphilitic children.\" For my own p.-t, not only have I. never seen a case of vaccination of syphilis, but have never met a medical practitionir who had seen a case, either in his own practice or in that ofanother. We all know how the slightest scratch or cut is apt to develop n- tractable ulceration in a child having latent syphilis; and how the ulceration thus produced requires the local and constitutional treatment of a syphilitic sore. A slight scratch, required for vacination, may assume a specific character with the purest lymph, when conjugal infidelity, and not the vaccination, is the cause. Sores somewhat resembling syphilitic sores",
         "have occasionally appeared alter vaccination, and even in this city have been taken for syphilis. But their early healinxg without specific treatment, apart. from their appearance,forbids the assumption that they were syphilitie sores These are n hat are called by Rayer, Auzias Turenne and others rarrinel/e or rar rinoïde, and may arime from : lst the vaccination of a syphilitic child, or 2nd the vaccination of a child who had already been vaccinated, or who had had small pox or who manifested an inaptitude lor the vaccine influence That vaccine Iymph does int carry vith it the syphihtic virus, even i cases of undoubted sy- philis, mav be fairly inferred from the experiments which have been performed on a large scale on the continent of Europe, where, n not mne ot those expe- riments, has anything like syphilis resulted. The British Public Health Report published by authority of Government, and presented pursuant to act of Par- liament is so germane to this part of my subject that I shall quote from it at considerable length. M. Taupin, of the Children's Hospital in Paris, iii order to settle such questions as these, had, in a large number of cases, deliberately vaccinated from the arms of chil- dren who (while under vaccination) were sick with all other sorts of communicable diseases, including syphilis; but had never, on any occasion, seen any of these affections communicated in his vaccinations: \" dans aucun cas, nous y insistons à dessein, le virus n'a rien communiqué que la vaccine toute seule.\" Dr. Schreier of Ratisbon had similarly, on two occasions, experi- mented with vaccine lymph from syphiltic children and, like M. Taupin, had got no syphilitic results. Professor Heim of the Wirtemberg military service, had done similar experiments, with similarly negative results. Dr Heymann had, as seen the habitual",
         "practice in Java, that children having scrcfula, syphi- lI, itch, the endemic frambosia, and other com- plaints, were used mndifferently with others as sources of vaccine lymph , and that no evidence ever appeared of any of the complaints being so communicated. And to this former nwgative tetimony, from several independent experimenters, I nay now add the simi- lar testimouy of' Professor lBeck of Christiania; testi- rnony which has peculiar value because of Dr. Boeck's very emnent relation to contemporary studies of syphilh. Dr. Irck reports that, having under his observation two men affected with elephantiasis, two men who had never had syphilis, and whom their elephantiasis of course would not have rendered in- susceptible of it, he, on three different occasions far apart, vaccinated these two inen from children having well developed hereditary syphilis, that in one of the six vaccinations, live normal vesicles resulted, but in the others, none, nor any other local change; that \"these two patients were observed daily during three years, and never presented a single symptom of sy- philis.\" With well attested experiments like the above standing on record, we are obliged to doubt whether vaccination (i.e. genuine and simple inoculation with vaccine lymph) from however syphilitic a subject, can, possibly communicate syphilis; or, at the very least whether some stage of the vaccine vesicle more ad- vanced than vaccination rules allow to be proper for lymph supply, or some admixture, which fastidious vaccinators never permit, of blood with the vaccine lymph, must not be a condition for such possibility. That some ignorant quack salver, pretending to vac- cinate, but neither knowing the aspects of a vaccine vesicle, nor caring from what sort of body ho drawe",
         "his supposed lym ph, may take as his \"huealtliy source for lymph supply\" an inf.nt all maculated or uleered with syJhilitie skii disease, aind may fron its spols or sores transfer infoctive imaterial to some victiin of his mis-called vaccination, is of coursc evident; for syphilis does not cease to be syphilis because noodle or knave calls it vaccinia; but lcts of this kind can- not in any reasonable sense be counted against vac cination, any more than we should count it a fact, against Quinine that tome grocer had dispensed Strychnine in mistake lhr it. Finally, too, I permit myself this general remark : that, in iroportin as any alleged fact contradicts an othern ise universal expe- rience, the indivitdual witness nust be regarded as making larger and larger demands on us for belief; and that in matters like the preseit, where sources of fallacy areso abundant, thewitness's accuracyofobser- vation requires to be most thoroughly guaranteed. Dans le monde, says Grisolle, les parents se pré- occupent beaucoup de l'idée que leurs enfants pour- raient être vaccinés avec du mauvais vaccin, c'est-à- dire provenant de sujets malsains. Quoiqu'il n'y ait pas plusieurs qualités de vaccin, quoique le virus qu'on retire d'un enfant fort ou faible, d'un individu ayant le syphilis, les scrofules, etc., ait en général la même efficacité, cependant il y a toujours intérêt à prendre du vaccin chez des sujets vigoureux, attendu- que, chez les individus faibles, on voit le virus dégé- nérer promptement ...... ......... .. ......... Relativement à la syphilis, il est certain aussi que le vaccin fourni par un vérolé ne peut transmettre que la vaccine lorsqu'il est pur, c'est-à dire sans mélange de sang: il n'en est plus de même lorsque la pointe de la lancette qui est chargée du vaccin, est salie par la plus minime quantité de sang.",
         "The cases cf supposed inoculation of syphilis with the vaccine virus are not many, and an analysis reduces them tr. very few-and those few are still further reduced lby the fict thùt the groassest ignor- ance and misconduct w , in orae instances at least, imputed to the vaccinators. The few cases thathave been publishetd in the past beventy years, chiefly from. Continntal sources, are utterly insignificant in nlum- bers and importance, and lead us to ask the same question as Mr. Simon: \"if our ordinary current vaccination propagates syphilis, where is the syphilis that it propagates ? Who sees if ? '. ho experience of the departrmlent is an entire blank on the subject. For the last ten years we have been in incessant inti- mate communication with the different parts of Eng- iand on details of public vaccination, and during these years, every one of the about 350 vaccination districts into which England is divided has been visited threo or four times by an inspector specially charged with the duty of minutely investigating the local practice of vaccination; yet from this systematic and extreme- ly detailed search for all that has to be said on the subject of vaccination in England, no inspector has ever reportei any local accusation or suspicion that a vaccinator had communicated syphilis. Again, our national vaccine establishment has been in existence for more than 60 years, vaccinating at its own stations every year several thousands of applicants, and trans- mitting to other stations supplies of lymph, with which every year very many (at present 50 or 60) other thousands are vaccinated, who in their turn, become sources of vaccination to others; but this vast experience does not, so Jar as I can ascertain, include knowledge of even one solitary case in which it has been alleged that the lymph has communicated",
         "38 syphilis. Is it conceivable that these Tegafive expe- rienes could he adduced if the vaccine lymph of children with latent hereditary syphilis were au ap- preciable danger to the public health ? Thirteen years ago it devolved upon me (as medical officer of the Board of Health), to\u003c make' the widest possible en- quiries, both of scores of public departments and institutions, and also of raanv hundreds of individual practitioners, iii our own co-untry and on the conti- nent of Europe, with a view to elicit all existing ex- perience on the validity of objections which had been alleged against vaccination; and on that occasion I, of course, gave great proninence tu the point which is here raised. One of the four questions which I circulated was the following:-\" Have yon any rea- son to believe that lymph frorm a true Jenns.rian ve- sicle, has ever been a vehicle of syphilitic, scrofulous, or other constitutional affection, to the vaccinated person; or that unintentional inoculation with some vther disease, instead of the proposed vaccination, has occurred in the hands of a duly educated medical practitioner ?'* The answers which I received on this, as on each of my other points, fromn 542 muem- bers of my profession, are, as regards syphilitic inocu- lation, only just short of being an absolutely uniform \"1 o.\" The alleged cases (of inoculation) were thrown into real insignificance by their relation to the main body of testimony. Men of the oldest and largest consulting pratice in the United Kingdom; men who were believed to have seen every variéty of disease and accident to which the human body is liable; our leaders who had taught medicine and surgery to the mass of the profession; physicians and surgeons of our largest metropolitan and provincial hospitals, in England and Scotland and Ireland ; physicians who",
         "8pecially studirl the- disoastes of infancy ; surgeons who hand rp-ciatlly ;tiliedl the incieulative dliseases;- patolgiss f distiHnàniçed insight and learingi!,- mna of all thons\"rt\u003c, scres cn scores of them, hud n-ver in their -p.riee. \" hid rrjson to believe or suspet ainy such 1ee5rn'e as my question des. erih*d.\" Iii th alphahatical series toi wvhich i have re-ferred there mav b.e rread all the most emrainent liritish naris of thirty years ago, certifying to such negative experienhlces: the're may bo read, ton, that equally negativ in PIris hadr ben the vast experience of Chomrel and Moreau, Raye-r and Ricord, and Ros- tan and Velptuan; -qnally negativo at Vienna that of Hebra and Oppolz-r, and Sigmund. And in here recurrincg to that very rerarkable mass of testimony. I may repeat the remark which my former review of it suggested to me: \" Obviousely one at least of two conclisions is inevitable; either it is that with repre- hensible carelessness as to the source of lymph, vaccination (so long as in any sense of the word it is vaccination) cannot be the means of communicating any s-econd infection ; or else it is the case that in the world of vaccinators *care is almost universally taken to excude that possibility of danger. To the public, perhaps, it matters little which of these con- clusions is true. Though it would be the merest idleness to take again, now, the sort of formal census of medical opinion which I took thirteen years ago, I may state that ever since that time I have felt it among my strictest duties to be generally watchful and interrogative on the present subject; all the more so as the period has been one of extraordinary pathological progress, and especially has brought to light very important new knowledge concerning syphilis; and I have every reason to believe that a",
         "ripst-it ra'nsus ofjaarsoaîîl a'Ja' irîc'li LIi% vouittry wvhich iiecrua'd ru ' I lit 1 arlnl-r s-itltuirv.Iî1.ad iii a fa.-v va'ry îyljrarit \u003ctiraI1 I ant I'iltaIXi sa'.lf that it doos s. I rù;tv ll'îIin.l r istc that the' Ariny -I'Ic:lIIQXTAi'\u0026 hs 1rii- th-- Lt: itavsýii vvaj.ha *rsî;îa''a.'I.a ' \u003caut 11111iansaart-s'i:jan.aarri.Ja» la hI irsailrvta'rnits flarMaasy' r. h'o fron-1th liatll.iI't .a th ýth. snl .Ir I'f th5' parit ceaedings art'jo.an la al't o riarals 'ii uauomiiiýtly rt'maiîî unldi-r îua'-di--I abz 'vai au. al iii wrm thert-'nra. il(, syrthiitic u'asqsîrof( vatvifitioii could possibly aesua utcaticta' w'hL'rl, mc-o\u003cver, thoc chances of late.nt coxistituti:îil syphilàýisu îbjects Iurnishiiîîg the lyrnph jnu\u003et lie, asaut the.. samne as amoiig cur civil Pppulatiqan, bat in ail this v~ast and c.ritical expat.rieîcv., S.-, far tus is kncown. to Dr. b'alfour (the eminenît aîid laboricaus repoarter on the dliseases ofl' the British amry) m, i±'l'îa has errr bren azli'.-cd \u003e1f a çoldier s1pii'lb!,,riuijia IndiNputabh* certainties, %whieli aiy mie' caul verify foar himseif, are :-first, that year bvy ear millîiiong\u003co1 vueC-ilations are perfbrrnted iii Europe wvith scarca'lv a solitary ac cusation transpiring that syphilis has been comamu- nicateci by anly of thert; and, secondly, that physiciails and surgecns who could flot fait tco seo sutuh cases iii abDundance, if such abundauce wure a reality, coucur with almost absolute uiliormity, hiundreds of thein together, in. declarinrg that they had \" never iii their experience ,;eeil even a isingle ca:se of the kind.\" ýSurely for every practical purpôs,-e,' certainties like these are our best guides ; and writh such certainties in our knowledge it would ho the merest pedantry to insist on infinitesixnaa speculative uncertainties.\"",
         "Oie terne observatioi froin the' flroard of Health of Ohio, and I have doni ; \" Wie priprly varrinated hy an intelligent phybician, no disease could be pro- duced by inoculation nthe.r than vaccinia, the one to It may 1e soiie satisfactinn to the learned and laborioaus wri'rs, from whom I have quoted above, to learn that their views are fully coincided in hy nost of the leading minds of the profession in Montreal. On Friday, of last week, I submitted the following questions to the members of the Medico- Chirurgical Society of this city. Doctors are said to differ, but th1 unanimity of view on the follow- ing vas most niteworthy. The meeting vas an unustually large one, called for another purpose, and the secretary (Dr. Bell) has kindly furnished me with the accompanying extract from the minutes, with the permission of the ' Society for its publication : Meeting of th Mr db '-f:nirg a: S\u003e iety of Montreal, f'il the lath Octube-r, 1.7G. Tweity thtec inetabira resent. Moved by Dr. H1 osi\u003c, cuUd'd by Dr. IL. P. HoWnn.-Ist. That vaccination confers a certdui degrcc of immuntity from small-pox, b-y either pruv\u003c.nting or rodifyinig that disease. .n-'.-That suclh imiunity is u.t always rmianent, but may be rendered su by re-vaccination. :3îd.-That vaccination may produce, in soie': instances, a certain degree of inflammatory action, which may be modified, incrcased, or diminisbed, by the age, constitution or condition of the patient, or ly the state of the atmosplhere. 4th.-That vaccination du',q no\"t, i any iistance, produce scrofula or other hereditary disease. 5th.-That nelther the vvidence hithertu furnished to, nor the experience of, the mnembers oi this Society, is of a character to lead toi the conclusion that syphilis is ever inoculated witb vaccine lymph. Carried unanimously.",
         "In concluding 1 may add: As it will be some- what difficult for you to obtain a sufficient supply of lymph to continue your vaccinations, owing to the circumstance that icany mothers, while solicitous regarding the physicai condition of the child who has the honour of furnishing vaccine lymph to tieir chil- dren, refuse, in turn, to render the same service to others, under a pretext that it disturbs or fatigues their precious offspring. Explain to such mothers, please, that they do an act of injustice; that as they received immunity on the one hand, they are obliged, in justice, to dispense it on the other; that had other mothers acted as selfishly, the supply could not have been kept up for their advantage. Some mothers refuse, under the belief that puncturing a vaccine vesicle, and receiving a portion of its contents, will diminish the protective influence intended to be gained by the vaccination in the first instance. But this is an error, and should not be permitted as an excuse to those who are slow to do for others what has been done for them. A mother should never hesitate to permit her child to be the source of safety to other children, not less dear to their mothers. You can assure them more- over, with confidence: that the removal of a portion, or even of the whole-(which is never done-see Clause 7 of instructions) of a vaccine vesicle, in no way impairs the protective influence, or produces any, even the slightest inconvenien ce or suffering Gentlemen: i have detained you much longer than I intended, and beg to thank you, and mymany medicalfriends andfellow citizens who have honoured me with their presence this afternoon, for their and your most patient attention.",
         "APPEiNDIX. Since the foregoing was delivered, many of my medical friends, some not members of the Medico-Ohi- rurgicaI Society of Montreal, and some not present at the meeting in question, expressed a desire to have an opportunity afforded them of recording their opinion on the questions submitted to, and una- nimously adopted by that Society on the 13th October last, and referred to on page 42. 1 willingiy acceded to their request, and have been fuirnished with the follow- ing list, not at all complete, 1 am informed, of medical gentlemen practising in this City supporting those resolutions. Their names are published in exienso, as it has been industriously circulated that those who practice vaccination are unsustained by medi- cal opinion here. The reader will perceive the re- markable unanimity of thought, as expressed by the very large number, on a matter of such vital mo- ment ; and will recognize among that number our most distinguished physicians-French and English; nearly all the physicians at our hospitals; nearly all the physicians at our dispensaries; nearly all the professors in our medical schools and colleges; nearly all our oldest and ablest men in private practice, with a life long experience to appeal to, and without motive to mislead ; nearly all our middle aged practitioners engaged in large and lucrative practice; nearly all our young men fresh from their studies, and familiar with the most advanced views cf trans-atlantic medi- cal minds-some of them just returned from Europe where they have had opportunities of learning the thoughts and opinions of the most eminent in our",
         "profession there; noi, perhaps, the views of such men as might well be astonished to find themselves quoted as authorities thrce thousand miles away. I thank my medical friends for their readiness in cx- pressing their opinion on this important question; and much doubt if there is any other topic or point in controversy on medicine, surgery or pathology upon which so unainiimous an expression of medical thought could be obtained in this city. In matters of laib, judges differ; but the decision of the majority is, after all, the decision of the court, and litigants must abide by it. Respect for a majority, so well pro- nounced, of competent medical judges will, in this in- stance, I hope -considering the contingency in events -lead to a cessation of those ill timed attempts ta interfere with the efforts that are now being made to check a loathsome disease by the only prophylactic which science has yet discovered Pronunciamento of Pzysicians of Montrea4 in favour of Vaccination. G. M. Abbott, T. J. Alloway, P. A. Allard, G. Archambault, P. Beaubien, J. Bell, F. Barnes, D. Baynes, G. A. Baynes, J. E. Berthelot, J. G. Bibaud, A. Bondy, I\\I.D. S. Lachapelle, L. Laberge, Jos. Leduc, B. H. Leblanc, A. Lamarche, H. Lemery, J. A. A. Léonard, J. L. Leprohon, D. C. MacCallum, A. C. Macdonnell, W. Macdonald, D. McCallum, MU.D. \"t \"t \"4 \"e \"i te",
         "r. Brodeur, M.D. F. Buller, G. O. Beaudry, . W. E. Bessey, A. A. Browne, Q. A. S. Brunelle, E. J. Bourque, W. I. Burland, W. B. Burland, G. W. Campbell, F. W. Campbell, P. F. (asgrain, J. C. Cameron, R. Craik, A. Chamberland, J. D. Cline, J. O. Coutu, A. . David, F. Demers, S. Duval, J. J. Dugdale, P. L. J.Desrosiers, G. H1. Desjardins, A. A. Duhamel, L. A. E. Desjardins, Th. E. D'Orsonnens,\" J. M. Drake, \" A. Deschamps, \" W. A. Duckett, \" Chas. Dansereau, \" J. Il. A. Matte, L. J. A. MeMillan, W. H. Mondelet, E. P. Mount, F, Müller, R. L. Macdonnell, J. B. McConnell, G. W. Major, A. W. Marston, A. Mathieu, I, H. Merrill. H. Merrill, A. Meunier, P. B. Migiiault, W. A. Molson, C. J. Morse, J. W. Mount, W. Nelson, S. Nichol,, P. O'Leary, W. Osler, H. Peltier, E. A. Paquet, Sas. Perrigo, A. Piché,) Sos. C. Poitevin, E. K. Patton, P. E. Picault, P. E. Plante, Alex. Proudfoot, M.D. 9' \"' \" \"' \"' \"'",
         "hs. Dansereau, Jr. M.D). C. Dubue, 0. 0. Edwards, J. Eneas, \" O. P. Etu, \" E. G. Fenwick, J. T. Finnie, W. Fuller, \" A. Fisher, R. T. Godfrey, \" G. P. Girdwood, ' J. Gagnon, \" W. Gardner, \" F. L. Génand, \"4 R. F. Godfrey, \"\u0026 F. H. Girard, Thos. E. Hayes, R. P. Howard, T. Hughes, W. H. Hingston, H Howard, E. H. ilurtubise, R. Kennedy, W. J. Kearney, A. H Kollmyer, A. B. Larocque, \" J. A. Laramée, \"c A. Latour, \"i H. T. Latour, \" N. Loverin, \"i P. E. Lachapelle, \" J. P. Rottot, J. Reddy, A. Ricard, T. H. Richelieu, T. G. Roddick, T. D. Reed, Ed. Robillard, N. lobillard, Thos. A. Rodger, G. Ross, F. Rourk, G. F. Slack, S. B. Schmidt, F. J. Shepherd, T. Simpson, W. P. Smith, G. B. Shaw, W. E. Scott, E. H. Trudel, F. X. Trudel, F. Z. Tassé, R. Thompson, E. H. Trenholme, Ls. Turgeon, J. R. Wanless, J. Wanless, los. T. S. Webb, M. O'B. Ward, Th. Wheeler, Geo. Wilkins, W. Wright, M.D. tg tg g \"g \"g \"' \"' \"g \"' \"c \"g \"' \"' \"g"
      ]
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   "doc" : {
      "identifier" : [
         "8_04844_410"
      ],
      "published" : [
         "[Montréal : Gazette Print. Co., 1885]"
      ],
      "title" : [
         "The legal news [Vol. 8, no. 46 (Nov. 14, 1885)]"
      ],
      "type" : "document",
      "text" : [
         "TillE LEGÂL NEWS. 361 .he jegzl jNws. Vo\" \\VIII. NOVEMBER 14, 1885. No. 46. In the case of Read v. Anderson (7 Leg. News, p. 296), it was decided that a com- mission agent, who has lest a bet made according te agreement with his principal in the agent's own name, can recever it from the principal, although the latter directed him net te pay it. That is te, say, the agent has an action against his principal for a debt arising from a betting transaction, and it seemed te, follow that the principal should have a similar action against the agent, i.e., where the agent has won a bet for a client, and has recoived the money, lie should be beund te pay it over te the princi- pal. But against this there was the author- rity of Beyer v. Adana, 26 L J. 841, Ch. Reoently, however, the English Court of Appeal in Bridger v. Savage, 54 L J. Rep. 0,B. 464, decided in July last, has overruled Beyer v. Adarna, and holds that a botter may Fecover from a commission agent money won by hlm for the botter. This ruling appears te be opposed te the jurisprudence in the Ilnited States, and te, several decisions of our Superior Court. But the case of Macdougall \u0026 bernera, which was heard before the Court of Appeal in September, will probably throw additional light upon the question. The Montreal Law Reports, Queen's Bench Series, for September - Octeber, comprise Pages 369--432. Among the cases reported ia that of PLllow \u0026 C'ity of Montreal, in which an important constitutional question wais decided. The case of ffier \u0026 Evans fur- iishes a precedent in the Iaw relating te servitudes. The decision in Starnea \u0026 Maison is eof great importance in expropriation pro- ceedings. The case of McMillan \u0026 Hedge Presented an interesting question of law conoerning the aggravation of a servitude in the nature of a right ef way. Macma8ter \u0026 Mfoffatt was a case decided in the Court bolow upon the question whether an agree- Mrent was complied with in due time. In ftppeal, the judgment was reversed upon a different ground. NEW PUBLICATIONS. PR)INCIPLU or CANADiAN RAILwAY LA\u0026w, with the Canadian Jurisprudence and the leading English and American Case. By Chas. M. Holt, LLTL., Advocate. Montreal: A. Periard. This is a work which will be found useful by those who have occasion te examine questions cennected with railways and rail- way companies. It begins with a statement of principles based upon decisions of the Canadian Courts and the works of the lead- ing writers upon this branch of the law. The text of the Dominion Raiîway Act, with the amendments up te the present date, is appended. The whole is accompanied by forms of proceedings in expropriation in [Quebec and Ontario. A copious index is aise firnisbed. The work is well printed and beund, and will form a desirable addi- tien te the library of cone throughout the Dominion. COURT 0F QUEEN'S BENCH.- MONTREAL.* Contract-Tirne forvfiiment. M., against whom acapia8 had issued, de- poeited a choque in the hands of appellants, the agreement being that if he appeared with his bail at their office at eleven o'clock on the following morning the cheque was te be returned ; if he did not appear, the choque was te be applied te the payment of debt and ceets. There was a confiet of evidencO as te whether M. appeared at eleven or a few minutes after, and (as the majoritY of the Court viewed the evidence) one of the bonds- men agreed upon was net preselnt. fiHxLD (by the whole Court):- That a difference of a few minutes in a contract of this nature was tee slight te, be material, and would net have justified the application ef the cheque te the payment of the debt and coots, if 3L had appeared with hîs bail as agreed; but Med by the majority of the Court, the absence of one of the bondsmen was a non-compliance with the agreement which, justified the application of the choque te the payment of the debt and ces. Mac- miater et al. \u0026 Moffait, Dorien, C. J., Monk, Ramnsay, Cross, Baby, JJ. (Dorien, C. J., and Cross, J. dise.), May ?6, 1885. * To appea in fuil in Montreal Law Reporta, 1 Q. B. 361 THE LEGAL NEWS.",
         "THE LEGAL NEWS. Audition par privilége-Procédés sommaires- Evocation. JUGÊ:-Qu'un appel d'un jugement de la Cour Supérieure décidant préalablement de la validité d'une évocation de la Cour de Cir- cuit à la Cour Supérieure, peut être entendu par privilége, la règle étant que toute cause qui doit être jugée sommairement en Cour Supérieure, peut l'être également en appel.- Coursol et-al. \u0026 Les Syndics de la Paroisse de Ste. Cunégonde, Dorion, J.C., Monk, Ramsay, Cross, JJ., 15 septembre 1885. COUR SUPERIEURE. FRABERVILLE, Dist. de Kamouraska, 18 octobre 1885. Coram H. T. TASCHERBAU, J. BEAULiEU, requérant v. LEBEL et al., intimés. La Loi des Licences de Québec de 1878-Tribu- nal compétent. JUoà:-Qu'une poursuite pour contravention d \" La loi des Licences de Québec de 1878 \" ne pet être entendue et jugée par trois juges de paix; et sur un br6f de Prohibition, la sen- tence ou conviction rendue par trois juges de paix sera annulée et mise d néant. Le percepteur du revenu, pour le district de Kamouraska, fit émaner le 31 août der- nier, un bref de sommation, enjoignant au requérant de comparaitre, le 4 septembre dernier, devant Joseph Sirois et Jean Daniel Schmouth, deux juges de paix de Sa Majesté, pour le district de Kamouraska, résidants en la paroisse de Ste-Anne Lapocatière, pour répondre à la plainte du percepteur du revenu, LeBel, qui accusait le requérant d'avoir en- freint les dispositions de \" La loi des Licences de Québec de 1878 \" et demandait qu'il fût condamné à payer une amende de $100 pour récidive. Le 4 septembre dernier, le requérant com- parut par son procureur, mais au lieu de deux magistrats ainsi que prescrit par la sec. 196 du dit acte, le tribunal était alors composé de trois juges de paix. Les deux juges de paix ci-dessus nommés s'étaient adjoints un troi- sième, savoir: Joseph Dionne. * Le percepteur du revenu procéda à faire sa preuve devant ces trois juges de paix et le requérant fut condamné, par le dit tribunal, composé comme ci-dessus mentionné, à payer une amende de $100 et les frais, ou à être emprisonné, à défaut de paiement immédiat, pour l'espace de six mois. Le procureur du requérant fit immédiate- ment application à l'honorable juge Tasche- reau, à Fraserville, pour obtenir un writ de prohibition, afin de faire annuler cette con- viction, vu qu'elle avait été rendue par un tribunal qui n'était pas légalement constitué et qui n'avait pas de juridiction pour entendre et juger cette plainte. Le dit bref lui fut accordé et après avoir entendu les plaidoiries des avocats de chaque partie la cour rendit le jugement dont voici un extrait : \" Considérant l'illégalité de la sentence ou conviction prononcée le quatre septembre 1885 à Ste-Anne Lapocatière, par les dite in- timés Joseph Dionne, Joseph Sirois et Jean Daniel Schmouth, juges de paix pour le dis- trict de Kamouraska, condamnant le requé- rant à raison de ce qu'il aurait vendu des liqueurs enivrantes sans licence, contraire- ment aux dispositions du statut dans tel cas fait et pourvu, à payer à l'intimé LeBel, per- cepteur du revenu pour le district de Kamou- raska, la somme de $100 comme amende pour récidive en vertu de la section 223 de la loi des licences de Québec de 1878, plus $16.25 pour frais, ordonnant le prélèvement des dites sommes par voie de saisie et vente des biens et effets du requérant, et dans le cas de défaut ou insuffisance des dits biens et effets, ordon- nant l'emprisonnement du requérant pour une période de six mois dans la prison com- mune du district de Kamouraska; \" Considérant que la plainte portée contre le requérant par le dit intimé LeBel ne pou- vait être entendue et jugée que par les tribu- naux indiqués par la loi des licences de Qué- bec et ses amendements, et que par les dis- positions législatives susdites, trois juges de paix ne forment pas un tribunal compétent et ayant juridiction pour entendre et juger semblable plainte; \" Considérant que les dits intimés Dionne, Sirois et Schmouth n'avaient en conséquence aucune juridiction pour rendre et prononcer la dite sentence de conviction; qu'ils excè- dent encore leur juridiction en menaçant par 362",
         "THE tEGAL NEWS. 363 leur dite sentence le dit requérant de la saisie et vente de ses biens, et même de l'emprison- nement de sa personne; \"'Considérant que le défaut de juridiction est suffisamment allégué et démontré dans la dite requête libellée, et que conséquemment la défense en droit du dit intimé LeBel n'est aucunement fondée; \" Rejette la défense en droit et les autres plaidoyers de l'intimé LeBel, maintient la requête libellée du requérant, déclare illégale et nulle, et met à néant la dite sentence ou conviction, enjoint et ordonne aux dits inti- més LeBel, Dionne, Sirois et Schmouth de cesser tous procédés déjà commencés en vertu de la dite sentence ou conviction, et leur dé- fend tous procédés ultérieurs en vertu d'icelle, le tout avec dépens personnellement contre le dit intimé LeBel qui seul a contesté la demande, distraits, etc.\" Charles Pacaud, procureur du requérant. Taché \u0026 Taché, procureurs des intimés. Autorités citées par le procureur du requé- rant: \" La loi des licences de Québec de 1878,\" secs. 196, 220, 221; Paige v. Grifith, 18 L. C. J. 119; Statuts de Québec, 34 Vict., c. 2, sec. 153, 37 Vict., c. 3, sec. 14. SUPERIOR COURT. Mon\"raL, October 3, 1885. Before DOHERTY, J. THoMPsON v. THs MoLsoNs BAN. Action-Creditor claiming account of moneys collected for insclvent debtor-Demurrer. The plaintiff in this cause sued, setting up that he was a creditor of the insolvent firm of Haldane, Haswell \u0026 Co., and alleging that the defendants had in their possession large sums arising from the sale of collateral security deposited with them for paper dis- counted for that firm before its insolvency, and which was not met at maturity; that the firm of Haldane, Haswell \u0026 Co. had be- come insolvent and had assigned in trust ail its rights and assets to one Stevenson, in which assignment the plaintiff and defend- ants had acquiesced, and plaintiff prayed that au account might be rendered to him or the.aasignee, and the balance due Haldane, Haswell \u0026 Co.'s estate paid in for the benefit of the creditors as the gage commun. TRE tEGAL e-ËWS. 363 The defendants demurred to this declara- tion on the grounds that no privity of con- tract between plaintiff and defendants wa alleged; that the only party entitled to sue was the firm of Haldane, Haswell \u0026 Co. or their legal representative, it not being alleged that plaintiff was such; that the alleged in- solvency and assignment did not prevent the firm of Haldane, Haswell \u0026 Co. or the assignee bringing suit; nor did the assign- ment give plaintiff any greater rights than he would have had otherwise; that there was no fraud alleged, and that therefore no grounds or rights of action on plaintiff's be- half were disclosed. At the argument it was submitted on be- half of the defendants that the plaintiff muet either sue in hie own right or as representing his debtors, Haldane, Haswell \u0026 Co. As to hie own rights he had none as against defen- dants, between whom and himself there was no privity or lien de droit. The rights of Hal- dane, Haswell \u0026 Co., he did not pretend to be subrogated in, and moreover he expressly alleged that they were all vested in the assignee. C.C. 1031 differs from the Code Napoléon Article 1166, the last paragraph of which does not include the words, \"Lorsque à leur préjudice il refuse ou neglige de le faire.\" The essentiality of allegations of the debtor's neglecting or refusing to exercise his rights to creditor's prejudice was a question even in France under the Code Napoléon as it stands: and no doubt can exist in Quebec inasmuch as our Code expressly lays it down. If it were possible for plaintiff to obtain the money or an account without pretending that he was exercising Haldane, Haswell \u0026 Co.'s rights it could only be done by saisie-arret. Authorities in support of these positions are found under Art. 1031 C.C. The plaintiff's counsel in reply urged that he was exercising hie own rights, privity being entirely unnecessary. Article 1981 of the Civil Code provides that the goods of a debtor are the common pledge of hie credi- tors, and plaintiff was exercising hie rights in this respect. That defendants had got",
         "THE LEGAL NEWS. into their possession property of the firm of Palade ayant constitué avoué sur la demande Haldane, Haswell \u0026 Co., in which plaintiff en validité a suivi l'audience, et conclu à ce was entitled to share as creditor, and that in qu'il plût au tribunal l'autoriser moyennant their refusal to recognise his rights he was le dépôt à la Caisse des Dépôts et Consigna- entitled to bring an action against them to tions de telle somme complémentaire que le compel them to do so.-CC. 1981, 7 L.N. tribunal fixerait avec affectation spéciale aux 274, Boisseau \u0026 Thibaudeau. éventualités de la créance de Dubreuil, à The Court after briefly stating the allega- toucher des mains de ses locataires les loyers tions of the declaration did not think the de ses maisons, et ce, nonobstant les opposi- declaration demurrable. tions de Dubreuil et toutes autres qu'il pour- Demurrer dismissed. rait former ultérieurement ; Robertson, Ritchie, Fleet \u0026 Falconer, Attor- Considérant que Dubreuil, loin d'adhérer neys for plaintiff. à cette demande, a conclu à te qu'il plût au Abbott, Tait \u0026 Abbotts, Attorneys for defen- tribunal déclarer Palade purement et simple- dants. ment non recevable, en tous cas mal fondé (c.s.c.) en sa demande incidente, et l'en débouter ; Considérant que c'est dans cet état de la COUR D'APPEL DE PARIS (FRANCE). procédure qu'est intervenu le jugement dont est appel ; 22 avril 1885. Considérant que c'est à tort que les pre- M. ROUSSELLE, Président. miers juges ont, malgré la résistance de Du- breuil, autorisé Palade moyennant le dépôt LEFÈVRE et PALA DE. d'une somme de 20,000 francs avec affectation Saisie-arrét-Dépdt en cour-Droit du saisissant. spéciale aux éventualités de la créance de JUGÉ:-lo. Que la Cour ne peut, sans le congen. Dubreuil, à toucher des mains des tiers saisis tement du créancier saisissant, autoriser le les sommes arrêtées ; débiteur à toucher des mains des tiers-saisis Considérant en effet qu'ils n'ont pas pu, les sommes d'argent saisies-arretées, lors sans le consentement de Dubreuil, affecter même que le défendeur ofrirait de déposer spécialement à sa créance ls sommes qui en Cour le montant sufisant pour désinté- seraient déposées, et créer à son profit un resser le créancier saisissant, ce dépôt ne privilége sur lesdites sommes ; pouvant offrir à celui-ci les mêmes adretés, Considérant qu'aux termes de l'article 2095 ni produire les mêmes effets que la saisie- du Code civil, le privilège est un droit qui arrêt. résulte de la qualité de la créance; que les 2o. Que le privilège est un droit qui résulte de la privilèges sont énoncés limitativement dans qualité de la créance, et qu'un tribunal ne les articles 2100 et suivants du Code, et que peut étendre les privilèges créés par la loi. les juges n'ont pas le droit d'en créer; Considérant que si Dubreuil avait consenti Le jugement suivant de la Cour d'Appel à accepter l'affectation spéciale à lui proposée, renferme tous les faits de la cause: il serait intervenu entre les parties un contrat La Cour.... judiciaire, que la somme déposée se serait Donne acte à Lefèvre, cessionnaire de Du- trouvée affectée spécialement à la créance de breuil de sa reprise d'instance; Dubreuil, soit comme formant l'objet d'un Au fond: transport conditionnel, Dubreuil étant saisi Considérant qu'en vertu d'un, jugement en conformité de l'article 1690, par la signi- rendu par défaut à son profit contre Palade fication du transport, faite à la Caisse des par le tribunal de commerce de la Seine le 12 Consignations dépositaire, et par suite débi- janvier 1884, Dubreuil a formé des saisies- trice de la somme cédée conditionnellement, arrêts sur ledit Palade entre les mains des soit à un autre point de vue, comme consti- locataires d'immeubles appartenant à celui-ci; tuant un gage déposé conformément à l'art. que lesdites saisies-arrêts ont été régulière- 2076 en la possession de la Caisse des Con-, ment dénoncées et contre dénoncées ; que signations, tiers convenu entre les parties; 364",
         "THE LEGAL NeWS. Considérant que le consentement des deux parties est nécessaire pour la constitution soit du contrat de cession de créance, soit du con- trat de gage ; que le consentement de Du- breuil faisant défaut, il n'y a ni transport conditionnel, ni constitution du gage, ni par suite affectation spéciale à la créance de Du- breuil des sommes consignées; que le tribu- nal n'a pu, de sa propre autorité, constituer et établir au profit de Dubreuil un privilège qui n'est écrit nulle part dans la loi; que par suite les oppositions qui surviendraient ulté- rieurement sur Palade, frapperaient utile- ment la somme déposée par Palade et ses locataires; que Dubreuil, au cas où une con- tribution viendrait à être ouverte sur ladite somme ne pourrait prétendre à une colloca- tion privilégiée, et serait tenu de venir au marc le franc avec les créanciers postérieurs de Palade; Par ces motifs, Infirme, Et statuant à nouveau, Déclare Palade mal fondé dans sa demande. (J. J. B.) REG ULATIONS OF THE CENTRAL BOARD OF HEALTH. In an Extra of the Quebec Officiai Gazette, 7th Nov., 1885, the following by-laws passed at Montreal by the Central Board of Health, P.Q., 31st Oct., 1885, are promulgated:- Duty of Municipal Councils. 1. Every city or town council, and every local municipal council within the province of Quebec, shall appoint immediately, if none has yet been appointed, a local board of health for its municipality, in conformity with the provisions of chap. 38, of the Con- solidated Statutes of Canada. Duties of Municipal Corporations. 2. Every city, town or other local muni- cipal corporation within the province of Quebec, shall:- A.-Establish and provide without delay an hospital or a suitable house, in an isolated place, to receive therein patients affected with small-pox in the municipality. B.-Establish and provide, upon being required thereto by the local board of health, in the municipality, suitable houses to re- ceive patients suspected of suffering with small-pox, until the nature of the disease has been ascertained, and other suitable houses to receive persons compelled to vacate their lodgings, pending the disinfection of the same. C.-Supply the local board of health with suitable vehicles for the transportation of small-pox patients, and of the bodies of those who have died of small-pox. D.-To cause all public places, streets, lanes, public and private property, and all buildings and appurtenances situate within the municipality to be cleansed, and kept in a suitable state of cleanliness. E.-To aid as much as in their power lies the local board of health, and the officers thereof, in the execution of their duties. Duties andpowers of Local Board8 of Health. 3. Every Local Board of Health shall:- A.-Conform to the instructions of the Cen- tral Board of Health. B.-Execute and cause to be executed with care and diligence the regulations of the central board of health. C.-Fulfil any of the obligations imposed upon municipal corporations by article 2, sections A. B. C. D., of these regulations, upon refusal or negligence by the said muni- cipal corporations of fulfilling the same. D.-Cause to be posted on churches, public markets and the town-hall, the regulations of the central board of health at one or more conspicuous places, where they can easily be read. E.-Visit and cause to be visited by its officers, at reasonable times, during the day, all houses and buildings, and public and pri- vate property, situate within the municipa- lity, in order to ascertain whether such houses, buildings and property are kept in a suitable state of cleanliness and whether any case of small-pox exista therein, and in order to execute and cause the regulations of the central board of health to be executed. F.-Cause to be isolated and to be kept isolated at the domicile, every patient suf- fering, or suspected of suffering from emall- pox, if such isolation is practicable in the opinion of its officer, so long as the disease and the danger of contagion exist.",
         "366 TIE LEGÂL KEWS. G.-Cause the front of the house or lodging ini which a case of small-pox existe, to ho placarded and kept placarded, according to articles 16, 17 and 18 of these regulations, and supply such placards gratuitously to peisons asking for them. H.-Cause the body of any person who has died of smail-pox to ho buried according to the provisions contained in the present regulatiozis Nos. 28, 29, 30, 31 and 32. I.-Cause to ho disinfected every house or building where smail-pox ha existed, and every vehicle in which a small-pox patient has been conveyed, and ail things and effeets which may have been used by or for such patient. J.-Provide pure vaccine lymph, the source of which shall have been approved by the central board of health, and offer free vac- cination to ail who have flot already been vaccinated, as well as to ail who muet ho re- vaccinated. K.-Compei every person to ho vaccinated in conformity with articles 7, 8, 9, 10 and il of those regulations. L-Grant oertificates of vaccination gratui- tously, whenever required, to every person entitled thereto. M.-Report to the central board of health ail cases of amail-pox as soon as asoertained. 4. Every local board of health may: A.--Cause to ho removed to the houses set apart for such purpose any porson suspected of suffering from smaîl-pox, and to the small- pox hospital any person suffering therefrom, if in the opinion of the health officers, isola- tion at the domicile is not practicable, or if the health officers are prevented from effect- ing such isolation, or if the persons having the care of the patient refuse or neglect to foilow their instructions. 1B.-Order the closing of any shop, office, saloon, work shop, or other place of business situate ini a hous in which a case of smail- pox exists, and order the same to romain closed until the danger of contagion shail have passed, and the hous has been disin- fected. - C-Compel the occupants to vacate any hous or building where there is 'or has been a case of amail-pox, in order that it b. dis- D.-Prevent, when smail-pox existe in a municipality, fromn being carried on within the whole or part of the same, any trade or business by which, the disease may be spread. 5. Ail the powers conferred upon the local board of health may ho exercised, and the duties imposed by the same may ho per- formed by auy officer thereto authorized by the same. Dutie8 of proprietors of (Jemetere. 6. Proprietors and managers of ail oeme- tories for any municipality, shahl cause the body of auy person who has died from small- pox, within the limita of such municipality, to ho buried under ground, and they are forbidden to ailow the body of any person whatever wbo hua died from small-pox to ho placed in their vanît. Vaccination and revaccination certificates. 7. Every person who hua not hoon vaccin- ated shaîl ho vaccinated witbin eight days from the promulgation of these regulations. 8. Every person who has not hoon vaccin- ated successfully within five yoars, shail ho vaccinated within a deiay of eight dayp from the promulgation of these regulations. Dweling House to, be kepi dean. 9. Every porson having the caro of a child in any capacity whatever, shaîl cause it to bo vaccinated, if it ha not already been sucoessfuily vaccinated, within the same dlay of eight, days. 10. After the expiration of such delay, every porion mentioned in articles 7, 8 and 9 of these rogulations shall exhibit, te any health officer requesting it, a oertificate of such vaccination or revaccination, but the said health officer shaîl have the right ta examine evory person ta ascertain that the same hua taken place. 11. Any person going ta or coming, from a locality where small-pox exista muet produce a certificate of vaccination, and aiso a certi- ficate attesting that ho has not been exposed ta the contagion within the lat lifteen days preceding; failing oither of which it wiil ho the right of the officer of the municipality ta foirbid such, porion to enter or depart as the cas may ho.",
         "-TIE LEGÂL NEWS. 6 Keeping lodging8 dean. 12. Every proprietor who occupies a bouse, eyvery tenant and every occupant of a house, is bound te maintain the saine, and the appurtenances thereof in a suitable etate of cleanliness, to the satisfaction of the local board of health. 13. No person shall oppose any visit made at reasonable times, diiring the day, by the health officers, under the regulatione of the- central board of health. Obligation Io report small-pox cases. 14. The head of a family in which a case of smail-pox bas broken out shall be bound te give notice thereof te the local board of health as eoon as it may corne te hie or her knowledge. 15. Every physician muet give notice te the local board of health of any case of emali- pox te which he has been called profees- ionally. Placards. 16. The placards which must ho posted as aforesaid, ehall ho printed in lotters not less than four inches in longth, the placard iteelf being at least two feet long and one foot six inches wide. 17. Every head of a family occupying the bouse shall be responsiblo for the placard in- asmuch as he muet replace the same every time it is deetroyed or dofaced. 18. Every placard muet remain posted un- til after the dieinfection of the houso to the satisfaction of the local board of health. I8olation-\u0026hools. 19. Evory person having the care of a small-pox patient, muet koep him isolated according te, the instructions received from the health officer. 20. No poison euffering from small-pox shaîl expose himef in any street, church, school, chapel, theatre or other public place, or in any omnibus or any other public con- voyance, and any person in charge of any one so suifering from emali-pox who exposes the sufforer in any place above mhentioned, shahl ho liable te the penalties imposed by law upon any poison contravoning to the present regulations. 21. No person residing i a house wherein email-pox exista shail take part ini any public or private gathering, for shall exorcise any profession or trade which shall place him in contact with others. 22. Parents and guardians mnuat pravent their children or pupils fromn attending echools or other gathering places when smail- pox exista in the house where such pupils reside, uintil after fifteen days following the disinfection of the bouse. 23. The directors and professore of educa- tional establishments shall exact fromn time to, time from the parents or guardians of their pupile, a certificate countersigned by a physician that no emall-pox existe in the house where such pupils reside, and sucli certificate shall be kept for the inspection of the health officer. 24. The directors and professors of any educational establishment shall refuse ad- mission into it of any pupil residin,- i a house where email-pox exista until after fifteen days following the disinfection of the same. 25. The directors and professors of any educati onal establishment shall refuse ad- mission into it during a period of fifteen days of any pupil who shall have visited a bouse in which smail-pox exista, or shall have attended the funeral of a pereon who bas died from smail-pox. Conveyanoe of small-pox patienti. 26. The conveyance of any person suffering from email-pox shall be Made exclusiVely i vehicles specially for that purpose and ap- proved of by the local board of health. 27. No email-pox patient shall be con- veyed from one municipality into another, witbout the permission of the local board of bealth of the municipality to which the patient is being conveyed. 28. The central board of health may give eolih permission. Intermenti of persons tvho have dieci of amaaipox. 29. The bodies of thoso who have died from gmail-pox shail bo buriod underground i the cemetery of the municipality witbin which they have died. 30. The bodies of ail poisons who have died from smail-pox shall bo buried under grou'd within twelvo hours of their doath. 367",
         "âb ~ THE LEGAL NEWS. 31. The bodies shall ho taken directly tx the oemetery and the funeral shail ho strictI3 private. 32. The conveyanoe of the bodies of ai] porions who bave died froms mali-pox, shail ho made exclusively in vehicles specially sel apart for that purpose, and approved of by the local board of health. JYsinfection. 33. E-verv person is bound to allow his residence to be disinfected by the offioer of the local board of healtb, and to vacate the saine for the purpose if required thereto. 34. No person shall rent a house or tene- nment wherein small-pox shail have existed witbout causing it to ho disinfected to the satisfaction of the local board of bealth. 35. No article which bas been in imme- diate or mediate contact with a patient suf- fering froni 8mali-pox shall ho removed hofore it has heen disinfected. Sales, \u0026c., of artidlea infected prohibied. 36. No porion shail give or soul any arti- cles, nierchandise, prozlucts, milk, biread, pro- visions, \u0026c., if such are côïming froni a house or proporty in which smail-pox exists or if they are liable to convey the disease. Power of Central Board o] Health Io inspeci. 37. The Central Board of Health, by any of ils menihors or a porion authorised tbereto, niay, at reaionable rimes, during the day, visit ail public or private proporty and al bouses, tenements and appurtenanoes within the Province, to ascertain the state of the public health and that its regulations are duly executed. Penalties. 38. Whosoever refuses or neglecta to con- forin to any of the aforesaid regulations or willingly ohstructs any porion in the execu- tion of any of theni, or willing]y contravenes any of the saie shail incur the penalty in- posed by cap. 38, of the consolidated statutes of Canada. .Previotu rules and regulations abrogated. 39. Ail regulations paaîed by the central 4)oard of health hofore this date are repealed, exoept those which concern theimposition and recovery of penalties incurred until this date. Innkeqpe - Suit for Accommodation and Board-Gue8t's dlothing stolen.-In an action by an innkeepor against a guest to recover for board and accommodation, the defend- ant may recoup his daniages for the value of clothing stolen froni bis rooin. It appeared that before the theft, the following printed regulation was postod in the rons of the inn: \"Lock the door wben going ont and leave the key at the office \"; defendant, knew of the regulation, and on the occasion when bis clothing ivas stolen, failed te leave his key at the office. The court ruled as matter of law, that defendant having fa.iled te beave bis key at the office on the occasion in ques- tion, was not entitled te recoup the value of the clothing stolen. Held erroneous; that in the absence of any express contract, an inn- holder is relieved fromn liability for loi, only when, in the words of the statute, such los is attributable to the non-compliance with the regulation. At common law innholders, like common carriers, are regarded as insur- ers of the property committed to their care, and are liable for any lois not caused by the act of God, or of a public enemy, or by the neglect or fauît of the guest. Afa8on v. Thompson, 9 Pick. 280; Berlehire Woollen Co. v. -Proctor, 7 Cush. 417. Our statutos have in some respects limited this extreme liability. Pub. Stat., ch. 102, êê 12-16. The statute ex- onerates an innholder fromn bis common-law liability for a loss.sustained by a guest, who has knowingly failed te comply with a rea- sonablo regulation of the inn, if the loss is attributable te such non-compliance. The rulling of the Superior Court went further and held tbat an innholder 18 exonerated, by the fact of non-compliance, without any in- quiry into the question whether the lois was attributable to the non-compliance. The law wiil not imply a contract against the gnest more extensive than the ternis of the statuts, and in a case like the one hofore us, in the absence of any express contract, an innholder is relieved froin liability for lois, only when, in the words of the statuts, such lo is attri- butable te the non-compliance with the regu- lations of tbe inn. Burbanc v. Chapin. Maine. Supreme Judicial Court. Opinion by Morten, C. J. (Sept 21, 1885.) RECENT U. S. DECISIONS."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "MONTREAL, JANUARY, 1879. C O N T E N T S. -ORIGINAL COMMUNICATIONS. Animal Vaccination. By W. E. Bessey, M.D. (Read before the Medico-Chirurgical Society, Mon- treal, Dec. 27, 1878)...... ....85 TROGRESS OF MEDICAL SCIENCE. PAGE 'Treatment of Obstinate Vomiting during Pregnanicy by Dilation of the Cervix Uteri, 96. Pyrogallic Acid in Psoriasis, Dr. A.' Juriscli 96. Poultices, 97. Dislocation of Muscles and their Treatment, 97. The Treatment of Sea-Sickness, 97. Treatment of Obstinate Scia- tica by Subcutaneous Injections of Nitrate of Silver, 97. Spinal Irritation, from Dr. McCall An- derson's \" Clinical Medicine,\" 98. Examination of the Throat and Posterior Nares, 98. Chinese Medi- eine and Surgery, 99. The Res- pirator as a Preventive of Coughs and Colds, 100. Table Salt in Milk for Children, 100. To stop the Nose-Blecd, 100. Intestinal Ob- struction, 101. Treatment of Obe- sity by Arsenic, 101. Some Reme- dies to Ease the Pain of Uterine Cancer, 102. Post-Partu m Hem- orrhage, 102. The Urine of the Insane, 102. On the Employment of Lister's Metbod in the Treat- ment of Burns, 102. Dr. Seaton on Re-vaccination, 102. For Mos- quito Bites, 102. Chronic Vari- cose Ulcers, 102. Sclerotomy in Glaucoma, 103. On the use of Arsenic as a Blood and Cardiac Tonic, 103. Mnriate of Calcium as , a Therapeutic Agent, 103. Treatment of Asthma by lodide- of-Potassium Spray, 104. Thumb- Sucking and Irregular Teeth, 104. Epilepsy, 104. The Pith of Dried Corn Stalk as a UterineTent,'104. Oxide of Zinc in Diarrhœa, 104. Iodoform in Eye Diseases, 105. Treatmnent of Obstinate Hiccough by Pilocaipine, 105. Removal of Moles upon the Face................ 105 EDITORIAL. To Subscribers, 105. The Specimen Copy Nuisance, 105. Canada Vine Growers' Association, 105. Wo- men's Hospital, Montreal, 105. Personal, 106. Obituary, 106. Extract of Malt, 106. Current Literature, 107. Medical Alumni Association of Bishop's College, 107. Lunatic Asylums in the Pro- vince of Quebec, 108. Curious if Truc,108. Phthisis in Australia, 108. Births and Deaths............108 PHARMACEUTICAL DEPARTMENT. Animai Faccination. By W. E. BESSEY, M.D. (Read before the Medico-Chirurgical Society, Montreal, Dec. 27, 1878.) 31R. PRESIDENT AND GENTLEMEN,-ThIe vast importance of the subject of vaccination as a prophylactic measure against the contagion of smnall- pox must be iny apology for troubling you with a paper upon snch an old and familiar, yet far frorm :threadbare subject. A full discussion of the subject -of animal vaccination would involve a consideration -or retrospect of the whole history of vaccination. This I shall not attempt to do. Neither have I set my- self the task of producing a mere technical paper on the vaccination of animals; but I intend to lay before you some considerations iu favor of animal vaccination in contrast with hmnzed vaccina- .tion, or, in other words, to advocate the performance of all vaccinations with virus obtained by direct transmission from ieifer to heifer, for reasons that are sufficiently weighty to deserve the cordial. consideration of the profession. We are, in this city, brougbt face- to face with an influential and wily antagonist to the practice of vaccination, as a prophy- lactic aginst smal-pox, and I am soiry to be obliged tosay, (bat-ia my humble opinion the profession are much to blame, by the indifferent manner in which much ofthis work bas been donc in the past, for the accidents and'arguments which have been placcd at the disposal of those opposed to the praictice. These accidents I may enumerate as follows:IFirst, the frequent occurrence of erysipelas as the imme- diate sequel of the, operation, sometimes ending iu deith The frequency with which skin eruptions of a doubtful character have succeeded the use of human-, ized virus. The frequency with which small-pox has followed vaccination by long humanized virus, indeed to such an extent a to have etused certain portions of the community to regard it as no preven- tive whatever. The popular belief is latent con- stitutional disepses or tendencies, such as scrofula, \u0026c., have been aroused into action, and enfeebled health lias too often resulted, fromii careless vaccina- tion althoughi I think this danger has been much over- rated. The positiwe proofs however of the transmis- sion of syphilis by this means, are among some of the considerations which require that we should pause and consider, what have been the defects in the practice which could have occasioned such untoward events ; and, whether, the principle of the antagconism of a specific contagion against subsequent incursions of a like, contagion in the animal organism for the rest of life, supposed to have been well established in pathological science, should be reconsidered. The medical philosopher, Jenner, in contemplat- ing the fact that the modifications which the systeni undergoes in the reception of measles, scarlatina, and other contagious fevers, is protective of the individual against these several specific contagions for tlhe rest of life; in conjunction with the well-known immu- nity from the contagion of small-pox conferred by the spontaneous vaccination upon the hands of the, servants engaged in mnilking animals affected with the cow-pox,--led him to perceive in cow-pox, small- pox in its mildest possible form, or in other words that pox was pox, one and the same, no matter upon what animal it might make its, appearance, and only modified in character and severity by the animal through which *it happened to be transmitted. -'This, gentlemen, , neéd lardly add, is the patho-",
         "86 THE CANADA MEDICAL RECORD. logical creed to which I hold. A century bas almost passed away since Jenner in 1798 first pub- lished bis discovery, and the medical profession is seen engaged in considering the imperfections of our present means of defence against simall-pox. It is scen that the general principle already announced, that \" the invasion of a contagious disease is protec- tion against subsequent attacks of the saine disease,\" is quite correct, yet that from some imperfection in the application of the prophylactic, or from some peculiar idiosyncrasies of the system in individuals, secondary attacks of small-pox do occur, and attacks of small-pox subsequent to vaccination arc very uncomfortably frequent. This latter bas led to the supposition that vaccination gradually loses its pro- tective influence over the system, hence as a remedy, re-vaccination bas been wisely recommended. Instead, however, of going back to the position of admitting the imperfection of the principle upon which the practice is based, naniely, the fact that \" it bas been found impossible to infect with small-pox virus per- sons who have spontaneously contracted the vaccinia disease upon their bands in milkiag, or who have been artificially impregnated with the vaccine virus of the-cow or horse ;\" the question bas occurred to my mind whether, as \" a thing balf donc is never donc,\" and that \" whatever is worth doing at all is worth doing well,\" it would not be better to use every means to render our practice of vaccination perfect, and in this way confer a degree of protection coin- mensurate with the exigencies of the case 'and in pro- portion to the confidence placed in it. It is hardly necessary for me to say that I am an implicit believer in the perfect protection afforded by pe7fect vacci- nation.\" I may quote the much respected and vuorthy Dean of McGill College, Dr. Campbell, as entertaining the same view. His statement tome was in thèse words: \"I have been vaccinating for over forty years, and I have never had an accident ; and I have yet to learn of a single person whom I have vaccinated having taken small-pox afterwards.\" Also Dr. Trudel, the worthy Dean of Victoria College, said to me: \"I have been using the stock of vaccine wbich I'possess for the last forty years, and I have never had an accident of any kind ; nor am I aware of an individual having taken small-pox whom I bad vaccinated. I collect and preserve my own vaccine.,; What original source this lymph is from I have been unable to ascertain. The experience just narrated of Drs. Campbell and Trudel, show, in my opinion, what results may be expected from properly performed vaceination, with carefully selected virus. If we go back to the original statemrents of Dr Jenner, in 1798, we may find a clue to many of the defects which have been observed to resultfrom vac- cination since his time. In my researches of the lit, terature on the subject, which is most voluminous, I find the earliest notice of the cow-poX, and its sup posed powers in preventing the infection of small pox, was found by Mr. Steinbeek to exist in a pe riodical work published at Gottingen in the ycar 1769 By this it appears the people of that eountry who had received the cow-pox, flattered themselves, that thereby they were secured against the infection of snall-pox-a circumstance that does not appear to have arrestcd the attention of the physicians of Ger many. It has also been asserted by a Dr. Barry cf, Cork that the cow-pox bas been known in Ireland from time immemorial; and in the neighborhood o Cork it has been called skieMch, a term belobngi t the ancient language of the country, whieh bas bee- applied to the disease as far back as oral testimony' can be carried. The cow-Pox DIsEAsE,-which the weight of evi- dence, including numerous experiments and observa4 tions, goes to prove is identical with and only a mod-, ified form ofsmall-pox-appears to have been familia to the rural population of most counties in Enland long prior to Jenner's first experiments with it, par ticularly in Dorsetshire and Gloucestershire Aid there, as from my own personal knowledge among the rural populations of Ontario, my native Provine of Canada, the people reposed the fullest confidence, in the presumption, that those who had been sponta neously or accidentally affected with cow-pox, wer thereby rendered proof against any future attack o small-pox. I find a statement on record, also, to the effect tha twenty years previous to Jenner's experimentsoa Benjamin Jesty, of Downshay, Dorsetshire, had made the experiment of vaccination upon bis wife and tWON sons with virus from a cow affected with cow-poX, in 1774. This record is taken from a memori tablet of the gentleman, wbo was a layrnan, in th churchyard of the village of Worth, which, amoïuge other things, states that he was \" particularly noted; for baving been the first known person that bad î troduced the cow-pox by inoculation.\" The voxpopli in this matter seems to bave been taken by Jenner) (then resident at Berkley in Gloucestershire) to hai- been the vox Dei, as it has often been in other thinge,' and, catching the inspiration, he was led te-ma",
         "THE .CANADA MEDICAL RECORD. ome experiments with the matter of the cow-pox, the results of which he published in 1798. The morning of the 14th of May, 1796, was a eglorious one for preventive medicine, for that may [,e taken to bave been the birth-day of vaccination. On that day virus was taken from the band of a milk- maid named Sarah Nelmes, who had been in- fected while milking her master's cows, and inserted by two superficial incisions into.the arms of a boy named James Phipps or Philips, aged about 8 years. He went through the disease in a regular and satis- ,,factory manner. The most agitating part of the trial still remained to be performed, for the point of great- est moment to Dr. Jenner was to ascertain whetber he was free from the influence of the contagion of small-pox, which was put fairly to the issue on the lst of the following July, or nearly three months later. Small-pox virus, taken immediately and direct [ from a small-pox pustule, was carefully inserted by several incisions, without producing infection. By ! this one experiment a law was establisbed, which the experience of millions upon millions of the buman family in subsequent generations bas only served to strengthen. And yet, notwithstanding that these ex- periments bave since been repeated upon about 4,000 vaccinated individuals by Dr. Woodville, and upon about sixty by Dr. Pearson in England, and on a smaller scale by Dr. Duncan Stewart in India; by M. Chaussier, Pinel, Hasson, Salmade, Jadelot, and 1.others in France, with the same negative results, in every instance, tbat were originally obtained by Jen- ner; there are those among our French compatriots, and in our profession, who affect to disbelieve, or fail altogether to sec, the trutb, simplicity and beauty of that beneficent pathological law. But,as bas been said, \" There's none so blind as those who will not sec.\" The special advantages of cow-pox over small-pox: miocuiation claimed by Jenner were: Pirst. Its uni- lform mildness, \" that, out of two thousand vacci- I.nated with the cow-pox, not one died, and therefore ý might be practiced in all ages with safety. econd.It is not communicable by effluvia. There- fore any part of the family may be infected with- eut affecting the rest. Third. It does not disfigure the skin ; and ourth. Requiring no medical attendance, it may be practised by any intelligent person--advantages f great value as compared with the dangers attend- nt-upon the old practice of inoculation. Jenner as very explicit in directing that special care should be used in the details of the operation in order to nsure success details it would be well if many modern practitioners would take tbe pains to follow. He says, for instance, \" Care should be taken that matter be collected from genuine cow-poxpustules only, and before it begins to scab, or the matter be- comes opaque and thick and the system be affected; for, if the matter does not enter tbe system, thepaa tient will be liable to small-pox-,\" a result which I have little doubt frequently follows. In such cases there is little or no constitutional disturbance or fever, and the vesicle exhibits an imperfectly devel- oped or abortive character. \" From inattention to these particulars,\" observes Jenner, I ithas been suspected that the reports ofthe small-pox succeeding the cow-pox inoculation have arisen ; for, unless the matter be genuine and the constitution be infected, the person cannot bc secured against the small-pox contagion. It may happoe that the inflammation excited by the inoculation with genuine cow-pox matter nay remain local, i. e., the inflammation may go on so as to form a pustule,with- out any portion of the matter being taken up into the system, when, of course, the subject must stili be liable to small-pox infection. The same may occur froin inoculation with small-pox matter.\" The whole subject resolves itself under three pertinent queries:- First.-Has vaccination, as a protectivo measare against small-pox, established a claim to confidence ? Second.-Is it an operation so harmless as to commend itself to our acceptance, or is it encom- passed with dangers? Third.-Have we any means that will guard us against tbe 'dangers attended upon vaccination, or secure to our patients the fullest measure of the prophylactic power conferred by it, equal or superior to a resort to the exclusive use of vaccine lymph obtained by direct transmission of spontaneously occurring cow-pox from heifer to heifer, or in other words by animal vaccination ? The best reply at our disposal to give to the first question is an appeal to facts, and the experienceof the profession for the past 75 years. The 539 replies received by Mr. Simon in 1856, including the names of the most eminent men of the day, as to the general value of vaccination, are sùficient to establish the favorable opinion enter- tained by the profession on this subject. The bare fact alone, that confidence is generally im- posed in vaccination by the Most enlightened, the best educated,and best informed classes and communities ; people whose faculty of observation is too astute to allow of their being misled by sophistry, or deceived",
         "T1E CMIADA MEDICAL RECORD. by false assuaption, is ir itself primna facie evid- recent remove fron the animal, has been used, and ence that it has been fairly earned, and lias not been the patient bas gone rcgularly through the several misplaced. This is a scientific period in whieh fact and experience reign supreme, and dogma and opinion take second place. The sanguine hopes of Dr. Jenner, that \" the annihilation of small-pox, the most dreadful scourge of the human species, must be the final result of the practice of vaccination,\" bas not, and is not likely to be realized. But, that the practice of vaccination is worthy of confidence as a protection against small- pox; while the fact that the protection it affords is neither unconditional nor unlimited ; but, that many of the conditions upon which it depends are under the control of ourselves; are self-evident propositions. The first and most conclusive proof, in fact the only unexceptionable test which can be applied to an individual to show the degree of protection afforded by their having undergone the vaccine disease, is the \"I inoculatiion test \" applied by Jenner himself and bis *early followers. Wlhat test could have been devised, more satisfactory, and more free from excep- tion, than the direct introduction of small-pox virus, one cannot conceive; as no question can arise as to .whether or not the vaccinated individual has been subjected to exposure to the influence of the con- tagion. I learn from the records of the early vaccina- tors that they were in the habit of taking great pains to give small-pox by contagion to persons who had recently been vaccinated ; but invariably without success. Dr. Woodville, physician to the Small-Pox and Inoculation Hospital in 1799, finding a milkmaid who had become infected with cow-pox in a dairy in Gray's-Inn, inoculated seven persons by a single puncture from the teat of the cow, and subsequently endeavored fruitlessly to impart small-pox to them, both by inoculating the virus and by exposing them freely to the contagion. And, within two years, he transmitted the disease to 7,500 persons successively, One half of whom were subsequently inoculated with variolous matter without success. Dr. Pearson's experiments werc upon sixty vaccinated individuals in 1804, but without imparting the disease; and in France, several physicians applied the inoculation test unsuccessfuly. In India, also, I find that in 1841 ,Assistant Surgeon Russel inoculated with small-pox six natives who had been previously vaccinated, with- out success. This test bas always been regarded as the experinentun crucis, and may safely be under- taken in any case where animal virus, or virus of a stages cf the disease. Moreover, I believe it to be the duty of the profession to invite this trial, as the surest possible way of overturning the antagonism of the anti-vaccinationists, and restoring confidence among the public. This bas been disturbed on two points : first, as to the protective power of vaccination; aad second, as to the purity of the lymrph in use; and the danger arising from erysipelas, syphilis, \u0026c., from which it does appear, that the second query de- mands a reply in the affirmative. This danger eau be effectually provided against by the use of animal virus in preference to the humanized, and the former difficulty can be got over by the prompt application of the inoculatiou test, which should satisfy the most sceptical. That there is no means open to us, whereby we may so effectually guard vaccine lymph against de- generation, and the possible contamination with blood taints of constitutional diseases, as by animal trans- mission, is net onlyprimafacie self evident, but this view is endorsed by some of the finest minds in the profession. UPON )VIIAT UYPOTHESIS CAN POST-VACCINAL CASES OF SMALL-POX BE EXPLAINED. Vaccinia is but one member of a group of exan- thems among which non-recurrence is the rule, and a second attack in the life-time the exception; and another is snall-pox; with which vaccinia, as one of the varioloid maladies, bas the very closest relation- ships ; so close, that the vaccine disease, when under- gone destroys that in the human systei which im- parts to it the capability of developing vaccinia. Now, the rule is that small-pox only occurs once in a life-time, yet secondary attacks are frequently met with in every recurring epideinic. The rule is that one attack of small-pox destroys for a life-time the receptivity of the system for the saine disease, but not always. Dr. Jenner mentions a Mrs. Grinnet as baving had the small-pox five timez. Dr. Baron mentions a surgeon who was so susceptible that lie could not attend a case of small-pox without taking the disease. Mr. Simon narrates a case on the authority of Mr. Baker that was severely pitted in two attacks, and a Mr. Inhausen gives a narrative of a lady who was pitted and scarred up in thrce successive attacks; also two years ago I lost a patient sent to Small-Pox",
         "TII CANADA MEDICAL RECORD Ilospital with a second attaek; and I have heard of several other cases. If,then, says BallaHd, an attack of small-pox-which is a disease naturai to man -does not always,even when severe, destroy forever the receptivity of the indivi- dual suffering it; it can surely be no natter of sur- prise, that, in occasional instances, vaccinia-a disease foreign te men-should fail to effect that which an attack of smnall-pox, itself, does net always accomplish. But, it is asserted that if vaccination does net invariably confer immunity from an attack of suall- pox, it renders it less severe, by exercising a most marked modifying influence over the progress and] issue of the disorder. But, again, there are some conditions on which the protective power of vaccination depends which are- under our own control; then, what are these ? First, then, it is within our own power to secure perfect vaccination, in other words, te secure the fillest protective power of the vaccine disease, and this depends upon the perfection of its development as an exanthematous disease; upon the closeness of the similarity it exhibits te small-pox in its process of developient, in truth, upon the perfection of the substitution. The production of a perfect veside is alone in- sufficient without the constitutional disturbance, both are equally important, because both are patho- logically associated. The areola indicates the in- capability of the system te undergo further impres- sion, and the development of the vaccinalfever and areola indicate that the system bas becoie fortified against the receptivity of small-pox virus, even by inoculation, at any future time. As te the local phenomena, the fulness of the eruption and the number and character of the vaccine Tesicles are te be considered. The degree in which protection from small-pox de-, pends upon the character of the vesicle produced by vaccination is very considerable ; as imperfectly de- veloped or abortive vesicles are a sure indication of some defect either on the part of the virus used or the patient's constitution, and demands an application of Bryce's test of re-vaccination upon the other arm on the fifth day. A well-developed vesicle,with a well marked areola, which usually appears on the eighth, sometimes not until later (I have had it appear on the lth, and, in one case, no appearance of the arm taking appeared until the 12th day, which caused the appearance of the areola te be deferred until the 1 5th day, but these cases, are.exceptional) and a profound vaccinal fever, are the'best indications of a successful vaccination. About the fifth or sixth day, usually, (sometirnies later with Longue Pointe virus) a red pimple may be fet at the point of vaccination, which gradually increases in size and prominence until the eighth day, -wlien it is fully developed, and usually presents the appear- ance of a small-sized bead of pearl set in the skin. After the areola bas developed it answers very well to the description of a bead ofpearl upon a rose leaf, The nearer the animal, the smaller, more circum- scribed, harder, more elevated and firm the vesieles appear. Generally there arc a number of them ; corresponding to the number of points of infection, which usually coalesce and, running together, form a larger scab, of a brownish mahogony'colour, thick and elevated, and, when held up te the light, trans- lucent in appearance. I have never had any suppu- ration or ulceration as yet in any case from this virus; Good, well-filled vesicles, always leave good welL marked circular scars; which may be seen plaiif' a a distance. They are very distinct, sunk beneath thi level of the surrounding skin, having a rather well marked edge, and foveated or dotted with minute indentations, in a few cases striated, the fovea being most numerous near the outer circle of the depres- sion. In every case, where the vesicles are net well developed and full, I have taken the precaution te re-vaccinate upon the other arm, in which case the second scems to add intensity te the first, both mature, and the crusts fall off at about the same period, or from the sixteenth te the twentieth day. There are three tests recommended as applicable in judging respecting the amount of protection any case of vaccination bas afforded:-st. The subse- quent inoculation of small-pox virus, or Jenner's test already spoken of; 2nd. The result of casual exposure te contagion; and, 3rd. An attempt to reproduce the disease by re-vaccination, or Bryce's test. As te the -value of the first there can be no question whatever; as te the second, the length of time after vaccination and the degree of exposure will determine the result. All other things being equal those persons having good scars on their arms are less frequently attacked with small-pox than people with bad scars. But all persons are net equally exposed, and this mode of reasoning is falla- cious, for one good mark with strong fresh virus would be more protective than several marks with old deteriorated virus, as I will presently shew. Drs. Jenner and Woodville's original tests with small-pox, were ail made upon persons upon whoma the animal virus had been used in one point only,",
         "THE CANADA MEDICAL RECORD. direct from the teat of the animal ; and yet we bave statements made by Dr. 3Marson, of the London Small-Pox Hospital, that out of 2787 patients with cicatrices on their arms 486-9 per 1000 lad one mark, 318·6 per 1000 had two, 98-3 per 1000 had .4hree, and 96·2 per 1000 lad four marks or up- wards. Dr. Roddick, also, in a paper read before this Society, gave ample proof of the greater protection afforded by a large or a smail number of marks shewing that twvo vesicles is more than twice as pro- tective as one, and the production of three or more nearly four times as protective against the casual contagion of small-pox. And yet small-pox does not always spare in its attacks persons who have multiple scars of vaccine upon their arms ; while, on the other hand, a single vesicle lias in innumer- able instances served as a protection, both against the inoculated virus and against the influence of casual contagion. In fact, it was upon the protective operation of single vaccine vesicles, that the reputa- tion of vaccination, as performed by Jenner and the earlier vaccinators, was built up ; a most conclusive proof that more depends upon the quality of lympli used than the number of marks. Pcfect vaccination having been secured; which, in my opinion, entirely depends upon the production of perfect vesicles, with areola and constitutional fever, and not mere vaccinal scars; the next question which naturally arises is, how long does the protei- tion against small-pox afforded by vaccination conti- nue ? Is it limited in duration ? I do not sec any reason why it should not be equally enduring with that afforded by a previous attack of small-pox. I think perfect vesicles, secured with fresh animal virus; or a first or even fifth remove, if procured from perfectly developed vesicles at the proper period ; should afford protection that would last during the remainder of life. I look upon re-vaccin- ation as a most prudent precaution against im- perfect primary vaccination, but a precaution that in most instances will prove to have been uncalled for where the work bas been thoroughly donc with active virus in the first instance. Re-vaccination is Bryce's test of perfect vaccination reduced to a general rule in practice, and which seldom results in producing a peîfect cow-pox pustule, but merely a vaccinal sore, which illustrates the fact that the pabulum in the blood upon which it feeds lias been too much exhausted in a previous attack to enable it to produce a perfect result a second time. Now, have I any authority for such a statement ? We shall sec. Jenner and Woodville entertained this view, but their experience was limited to their own personal observations. But Ballard says: \" In the large majority of vaccinated persons the protection against casual small-pox obtained by the time that the vaccine disease has completed its course lastsfor the whole renainder of life.\" That, except in a small number of persons, vaccination is a life-long protection against all ordinary and even against extraordinary chances of contagion. This point being established, I proceed to the question, Does vaccine virus in its transmission through successive human generations lose any of its activity, or become less effectual when developed in the system as a protection against small-pox ? My answer is, it does, and I shall adduce ample evidence to establish this view. The first thing that suggests itself here is that the vaccine disease being unnatural to man-a dis- ease of an animal ilower in the scale of organiza- tion, implanted upon man by art-it is not impro- bable that some careful cultivation would be neces- sary to prevent its degeneration. Experience has demonstrated that the disease (vaccinia), when im- parted to certain subjects, produces in them an imperfect or modified clevelopment; and that lymph taken from such pocks, or from vesicles which are too old or damaged, lias so far lost its character as to give rise, when introduced into the system, to an imperfect vaccine disease. This then is one proof that in vaccinia, degeneration of virus does take place under certain circumstances ; while that in succeeding generations the quality of the virus may not recover itself, although that of modified small-pox may do so, is quite explicable by the fact that small- pox is in its native soil in man, while vaccinia is in a foreign soi, having been transplanted from a lower animal. This, however, is not all that is meant by degencration of vaccine virus. On this point Ballard says:-' It is said that the virus degenerates by successive human generations, even wheû the utmost care is taken in the selection of the vaccinifer, and in taking lymph froma pocks of the proper age. Is this so ? I believe it is.\" Probably with this danger in view, Jenner, fron an early period, recmmended that recourse should be lad anew to the cow, as a source of vaccine lymph, as frequently as possible.* * Norm.-Itmay be important to sa.y here that a current statement among anti-vaccinators. (and made use of by Dr. Coderre, of Montreal, (on the authority of Baron) that \"Spontaneous cow-pox is not protective against small pox \" is not founded on fact, but is the result of a clear perversion of a statement of Jenner in which he guards his followers against mistakes by pointing out the exist-",
         "TEE CANADA MEDICAL RECORD. In 1814, the opinion that the vaccine lymph gradually lost its power by successive human trans- missions was put forward by Dr. Kinglake, who recommended that fresh lymph should be taken as often as possible from the cow. In 1818, the Government of Wurtemburg, in deference to this opinion, endeavored to provide for a renewal of the virus from animal vaccinalion by directing that a certain number of cows should be vaccinated annually. M. Brisset of France and Dr. Gregory of Eng- land endorsed this view in 1823. In 1836, Dr. Gregory wrote as follows: \" The lymph in use at this Small-Pox Hospital, (London) bas been 'pre- served in uninterrupted descent for a very long period of time; but for three or four years past I have noticed that its intensity was diminished, and that eight or ten incisions produced not more irritation than the three to which I was accustomed fifteen years ago. In March last (1836) the resident surgeon obtained lymph from a new source. This new lymph was found to be more intense and active than the old. Three or four incisions are now found amply sufficient, and so satisfied was I of the supe- rior quality of this new lymph, that, after a careful trial of about two months, the old (Jennerian) lymph bas been suffered to die out, and for the last six months we have vaccinated exclusively from the new stock. These facts have convinced me that vaccine lymph, in passing through the bodies of many persons, loses in process of time some essential por- tion of its activity. It follows froi this, that an occasional resort to primary lymph from the cow ence of two distinct diseases which occur on the teats of the cow. One, the genuine cow-pox pustule, of rare occur- rence, and one of more common occurrence, namely, sup- purative sores from wounds, stings of insects, cracks, \u0026c. Jenner says: \" Pustulous sores (he does not say pocks) frequently appear spontaneously on the nipples of the cow and instances have occurred, though very rarely, of the hands of the servants employed in milking being affected with sores in consequence, and even of their feeling an indisposition from absorption. These pustules are of a much milder nature than those which arise from that contagion which constitutes the truc cow-pox......They are always free from the bluish or livid tint so conspicuous in the pustules in that disease. No erysipelas attends them. This disease is not to be considered as similar in any re- spect to that of which I am treating, as it is incapable of producing any specific effects upon the human constitu- tion. It is of the greatest consequence to point it out here lest the want of discrinination should oecasion an idea Of security from the infection of small-pox which milght prove delusive.\" Thus clearly discriminating between two distinct affections occurring on the cow. becomes a matter of the greatest importance, per- haps even of indispensable necessity.\" In the sanie year comparative experiments were made in France by the Vaccine Committee of the French Academy, which led to a complete abandon- ment of the opposite view which had been strenu- oisly maintained by M. fBousquet and others, and gave a solid basis to the opinion. In 1838, Dr. Estlin of Bristol wrote as follows, speaking of the old or Jennerian stock: \"On the diminished anti-variolous powers of the present stock of vaccine matter I need make no remark, the public are too painfully aware of the fact.\" This remark is applicable to Montreal. In Germany Drs. 3Medieus and Orgy noted the gradual changes in the cicatrices following vaccina- tion as being less perfect. In 1839 Dr. Stewart compared results in India with old and new virus, giving in detail his observa- tions as follows: \" The period of latency was much longer. 2nd. The vesicles are larger and have globular disc more exact and circular, contain clearer lymph and more of it, and bave a central depression from outset. Third. The areola is more decided and larger, the color and formula strictly Jennerian. Fourth. The constitutional fever is well marked. Fifth. The course of the disease is slower and more deliberate. A Dr. Straub, of Germany, is stated to have vac- cinated successfully two children. The lymph fur- nished by the one produced very fine vesicles, that furaished by the other produced normal vesicles in the first generation, but could not be propagated at all beyond the second remove. A similar experience occurred to myself not long since. On October 26th I took from a calf atLogan's farm a number of points, with which I vaccinated successfully the child of iMrs. E , 411 Seig- neurs street, from which I collected, on November 5tb, a quantity of excellent lympb, all of which gave splendid results, no failures. With the same source of lymph I vaccinated a child of Mr. J- L.-- , 121 Canning street, from which I obtained first-class crusts, which gave every satisfaction in further transmission by those to whom sent. I also vaccinated the child of myfriend Dr. l -- from this source with excellent results, and from whicb, on November 11th, I charged about fifteen points which were forwarded on sane day to two widely separated points of the country. From both medical men the envelope was returned as unsuccess- ful. I bave not been able to explain the circum-",
         "THE CANADA MEDICAL RECORD. stance, as the vesicles upon Master H. were most superb, and the lymph, when taken, clear and beautiful, but it did not propagate itself. The growing frequency with which varioloid disease and true small-pox are observed in vaccinated persons bas been adduced as an argument by some writers. The greater success attendant upon re-vaccination of adult subjects than formerly is another argument -fewer failures and better results. The experience of re-vaccination in the Prussian Army bas been appealed to. This extends to 45,000 operations annually. The statistical results are given from 1833, -when the proportion of successful results was 33 per cent. and afterwards gradually increased as follows: 39, 42, 46, 49, 50, 51, 54, 57, 58, 57, 57, 58, 60, 64, 64, 64, 61, 64, 69, 69, 69, 69, 70 The last proportion of success being more than double the first of the series. Dr. Ballard, referring to these statistics, says : \" There can be only two explanations of this remarkable fact, the one, that the virus bas degenerated in its protective power, as the result of frequent human transmissions; the other, that there has been a steadily progressive carelessness in the mode in which the primary vac- cinations have been performed, and that this care- lessness bas resulted, as I have shown it may result, in a deterioration of the virus.\" He gives as the best evidence of the deterioration which vaccine virus undergoes in the course of frequent human trans- missions that obtained \" by comparing the effects produced by selected lymph which bas undergone numerous human transmissions with that produc.d by lymph recently derived~ anew from the cow, or after having passed through only a small number of human generations,\" and gives a number of coin- parisons that should convince the most skeptical. My own observations witl Longue Pointe lympli in this regard bas been this: The period of latency is greater ; no sign of taking is seen before the 6th day, in some cases not before the Sth, and I have fiad it as late as the twelth day. The vesicles are small, circulai, firm, well elevated, having from first a depression in centre, very distinct, but, where a number appear together, will coalesce, retaining their distinctive outline throughout. They mature usually on eighth day, in the later part of whieh the areola usually begins to appear, and is well formed by the 9th. There is a good deal of rest- lessness and fever after the appearance of the areola, which is at its height on the tenth day, after which it and the areola decline together and are Usually gone on the 12th day. From this tinie the pustule, which on the eighth day is full, tense, white and shining, and if pricked yields abundant lymph, clear as water, begins to dry and look dull, a brown- ish crust takes the place of the bluish central deprès- sion, and by the 18th to 21st day a thiek circular, somewbat conical, mahogany colored, well defined crust falls off, leaving a depressed cicatrix full of fovea or pin-pointed depressions. I bave observed after a few removes from the animal that the whole progress becomes more rapid, the crusts more spread out, flat and irregular, so that I say when the crust begins to be as large as a pants button it is time to go back to the animal virus, which gives you again the small circular elevated vesicle, resembling a bead of pearl upon a ground of rose pink colour. Taking the possible degeneracy of vaccine by human transmission to be proven, it is necessary that this degeneracy should be prevented as much as possible by care on the part of the propagator in the selection of the vaccinifer (wbich sbould be the young bovine animal) and the pock. On this point Dr. Ballard says:-\" The vaccinifer (if human) should be \" robust, not cacbectic, the pock selected should be \"perfect in character, and the lymph should be \"taken at a period prior to the appearance of the areola. The principal causes of bad and un- \"protective vaccination are the use of lymph taken \"at too late a period in the course of the disease, \"taking lymph from vesicles badly developed or \"imperfect in character, the use of dry lymph or \"scab instead of limpid lymph. The lymph for \"vaccination,\" he continues, \"should never be taken \" after the areola is formed. Wthen the areola is \"formed the lymph ceases to be limpid, is imper- \"feet in power, and apt to give rise to imperfect or modified pustules. According to Sacco and Eichorn \"the lymph is distinguisbed for energy on the fifth or sixth day, or while the nascent vesicle is still \"undeveloped. When the vesicles on the vaccinifer \"are small and poor they are apt to reproduce their \"kind, and in tbis way a supply of lymph may degenerate in quality.\" In producing humanised vaccine, direct from animal lymph, I select the most scrupulously healthy children, of robust, healthy parents having perfectly developed vesicles. Froin these I prefer to take the lymph when it bas attained its greatest perfection, which one bas to be on the qui vive for, and always before the areola bas appeared ; after this the lymph becomes purulent and opaque, and is very subject to oxydation and decomposition, as Schonbein lias shown, probably more rapidly in some conditions of the atmosphere",
         ".THE CANADA MEDICAL RECORD.' U9 than others, as it readily decomposes the peroxide of hydrogen, and is subject to the ordinary decomposi- tion which animal substances undergo when exposed to heat and moisture, and to the generation within it of organized beings or animalcule as in other decomposing animal fluids. For these reasons I believe the occurrence of erysipelas or septie inocula- tion bas frequently followed the use ofputrid lymph; as I an certain it frequently bas the use of crusts imbued with pus; the result of excessive local inflammation and consequent suppuration in persons of a strumous habit of body. In this matter, as else- where, we reap what we sow. If vaccine, then only vaccine; if pus, septic poisoning, suppuration, inflam- mation. On this point Dr. Martin, of Boston, says: I Before the appearance of the areola there is no pus in or around the vesicle ; afterward there is no security from its admixture with the lympb.\" The knowledge of the exact period at which to obtain perfect virus is the one great and essential item of knowledge necessary to success in the specialty of animal vaccination. During my own experience I have frequently eschewed very reluctantly the most splendid vesicles where my visit bad 'been antici- pated by the areolae. Il Having shewn that under the best possible secle- tion, and with the utmost care in cultivation,\" writes Dr. Ballard, \" the vaccine virus loses energy as its human transmissions become more and more numer- ous, so it fbllows that, fron time to time, it is desir- able that new sources of primary supply should be sought for and opened,\" which, he says, involves two questions: lst, the frequency with which natu- ral or spontaneous cow-pox is met with on the cow as a source of renewal of supply ; and, 2nd, whether tbe object can be attained equally well by any other neans, and concludes by recomnending a recurrence to natural cow-pox as a source of lymph, which he is particular to state bas one practical drawback, which is, \"the rapid passage of the cruption on the cow's teat through the stage at which it is most energetic, and which is said sometimes to be over in fromn twelve to twenty-fbur hours,\" a fact which my limited ex- perience bas fully attested, and which adds very much to the risk of failure in the use of animal virus. If it could be ascertained at what human remove from the cow permanent protective power first be- comes impaired to an important degree, and if such virus could be fully insured from syphilitic contam- ination and liability to erysipelas, etc., all rational objections to the use of early human removes would be ended. Suclh knowledge and security are not attainable, and, therefore, the only absolutely safe course is to use cither virus of origiual cow-pox, or that transmitted through a series of selected bovine- animals.* IRETRO VACCINATION OF ANIMALS WITII HT- MANIZED VIRUS. This lias been donc successfully by Bosquet in France, Babcock and Ceely in England, Goldwin in Venetia and many others, but without any par- ticular advantage to the lymph in the way of improvement. ANIMAL VACCINATION, direct froni heifer to heifer, in unbroken succession froin original cases is the one thing needful to preserve a continuous supply of undegenerated lymph for the purposes of human vaccination, as by this means a far more perfect development of vaccinia is obtained than from long humanized virus. Through the kindness of my friend Dr. F. W. Campbell I am enabled to illus- trate the appearance offered by spontaneous cow-pox on the cow's teats and udder in two stages by Ceely's admirable plates, also the appearance of artificial inoculation of cow-pox and small-pox, and the effects exbibited on the animal by retro-vaccination. I have also Willan's illustrations of Roseola Vaccina and Variolosa, and a number of paintings illustrative of first removes froin animal virus of the Longue Pointe stock. Troga of Naples was the first to conceive the idea of taking the virus from a vaccinated cow for the purpose, and the practice was pursued by him and bis successors for many years for the benefit of the upper classes of society. Galbatia continued it, and M. Negri followed at first in their steps in propagating virus obtained by a primary retro- vaccination, but obtaining three different times a fresh supply of virus direct from cases of natural pox, he maintained a supply by an uniuterrupted succession of inoculations froi animal to animal, sò that to M. Negri we owe our knowledge of the practice of animal vaccination as it is now under- stood. Dr. George Wyld, London, Eng., a most prominent apostle of vaccination direct from the calf, is now engaged in providing London with a supply of pure lymph by in- oculation from heifer to heifer, and calf to calf. He pur- poses to \"multiply spontaneous cases by passing it through a series of calves ad infinifum, ifnecessary,\" and claims that \" a government which renders vaccination compulsory is in duty bound to supply a lymph with total freedom fromi syphilis.\"",
         "94~ THE CANADA MEDICAL RECORD. I must now pass over Janoix to refer to Professor Depaul of the French Academy, wlho announced in May, 1866, now twelve years ago, that cow-pox had been discovered at Beaugency, France, and that it had not only been used as a new source for huinan transmissions, but also for transmissions, by animal vaccination, from heifer to heifer. Several advan- tages werc also urgced in favor of animal transmitted lymph: 1st. The advantage of being able to renew at will a stock of vaccine by return to the animal. 2nd. Freedom froma all possible syphilitic contamin- ation. 3rd. The ability to furnislh large amounts of virus regularly and at short notice, avoiding the necessity for a vaccine famine. 4th. That it avoids the necessity of interference with the process of development of human vesicles by tapping, which some fancy interferes with the protection afforded. Jenner, on this point, counselled the development of one vesicle at least without interruption. 5th. The importance of being able to obtain virus from a reliable source. 6th. The immunity of animal virus from erysipelas. 7th. The more perfect scar it pro- duces. The results of animal vaccination as pur- sued in Paris by M. Chambon, under the direction of Professor Depaul ; and at Brookline, Boston, by the younger Dr. Martin, under the supervision of the elder (who has a large experience) ; corresponds in al important particulars witb those obtained from the use of animal virus or the early removes of it, propagated up to the present by myself from the spontaneous cases of natural pox found at Longue Pointe, Island of Montreal, November, 1877. In all cases wilth animal virus there is an absence of all undue irritation ; there is a renarkably slow and deliberate growth or evolution (in this respect dif- fering greatly from the humanized) the pock is distinct, circular, cupped, elevated and firm, and the areola is comparatively late in appearing; the lymph remains longer limpid, the decline and incrustation is slower or more graduai, and the crust is tardv in falling. At first the dificulty attendant upon the vaccina- tion and collection of lynph from the animal I found, owing to inexperience, to be very considerable, but, by persistent perseverance, the difficulties have been gradually overcome. I now adopt Depaul's plan of having a table with a swinging cover or flap similar to those used in handling plate glass. Its lower edge is eut out with a triangular notch, leaving an extension before and behind to correspond with the extension of the animal's limbs. It is a strong wood- en frame, and is firmly fastened down to the foor, so as to be immoveable. The flap being let down, the calf or heifer (only animals of the female sex and from six months to two years old are used) is placed with its left side against it, and securely fastened by a waist belt and a belt around the flanks; (the formeri just bchind the forelegs, the latter just in front of the hind legs); the flap or table leaf is now turned up hoeizontally, and the head and feet having been secured by extra straps, the animal lies helpless and unable to struggle. The belly is then shaved with a dry razor ; a strip about 18 inches long and 9 wide on cach side of the udder , also the inside of the hip behind, or where the skin is most delicate, in strips about 9 or 10 inches wide. Over these sur- faces a number of abrasions are made, and the virus (contained in glycerine usually) well rubbed in. I hope soon to be able to vaccinate so frequently as to take the lymph froin the animal and apply it to another at the same moment, without an interval of some days, as lias been the case witlh me heretofore, In this way I would have a greater percentage of success, and obtain more lymph from each animal, My success lias been limited only by want qffudls, which lias been a great obstacle to my progress with this enterprise. The animal has to be so secured in a stable with clean straw, etc., as to prevent subse- quent injury to the pocks by licking or biting, and the destruction of lymplh by lying in its own mnanure. Frion the fourth to sixth day lyniph mnust be taken for the vaccination of children,-lymph taken at this stage of the disease is nearly always successful, -but for propagation upon the animals a day later will do, or just before the pocks begin to decline and forin scabs. The lynpi is thought to be more perfectly developed by the seventh day, but is too thick in consistence to be possible of absorption by the lunan absorbents. If not taken until too late in the disease the lynipli will not take on the huiman subjeet. The animals recover in a f»rtnight, and are quite uninjured by the process,but are protecteci against any future attempts at inocula- tion. In all my experiments on animals I have had an encouraging degree, but not always the same success. Out of seventy points of abrasion I may get fromsix- teen to twenty pocks, which are sometimies distinct, sometimes conflucnt,and attain the size of large human poeks or about the size of a pea, and arc filled witha white milky (or clear watery fluid when it exudes) of the consistency of the albumen or white of egg. The central depression has a peculiar slate blue or grey appearance. Cleanliness is the great difficulty to secure, without which disappointient in degree of",
         "THE CANADA MEDICAL RECORD. ,success is met with. When the vesicles have a bluish-white, shining appearance they are at their fullest degree of perfection. I trust a Government allowance may yet be granted to enable ample pro- vision toe hi made for carrying out successfully the details of this process of production of animal lynmph, and that the profession will avail themselves fully of its unquestionable advantages offered. Animal vaccination is the national method in France and Belgium, and lias been introduced in Berlin, Vienna and St. Petersburg in Europe; and for some time past in Boston, New York, and Phila- delphia, in Amlerica;--an adoption in a number of -videly separate and influential points difficult to account for on other than the real advantages which attach to it. The two most prominent of these seem te be: ist, the absolute security which it affords against al kinds of human blood containinations; avoiding all possibility of sypiilization, that standing menace of every vaccinator who ventures the use of huianized virus; and, 2nd, the greater decgree of protection which it affords as a prophylactic against the contagion of variola; respecting which M. La- noix says: \" For twenty years past epidemies of smnall-pox in Naples have never acquired any great severity; and it is an opinion held by the inhabi- tants that persons vaccinated with animal virus are not now exposed to danger from small-pox, like those -who in their infancy were vaccinated froni.arni to I confess I should be glad to sec animal vaccina- tion established on a firm basis in this country,- where wc have the reputation of nursing siall-pox, as Cleopatra did the serpent, in our bosoins, in order 1hat it may have a fair opportunity of striking its deathly infection into our very vitals or those of our -children,-as a preventive against snall-pox. I am convineed there is none equal to it; and I believe that such good would flow from it that practitioners desirous of imparting the fullest protection to their patients could have recourse to the vacc;nated heifer for their supply. If the public and private vaccination of the City of Montreal were donc with animal vaccine only for a few years, I believe the insusceptibility that would be created would result, in the effectual riddance if the city of this foui pestilence altogether; for it is my implicit belief that the great susceptibility of our population to small- poe, shewn during the past few years, can only be justly attributed to the insufficient protection afiorded by the long humanized and deteriorated vaccine znatter, which has been used for so many years ; and whieh, by repeated transmission through tbousands of systems, had become enfeebled and virtually worthless as a prophylactie agent. Having obtained lympli from the animal, it is well to understand its pecu- liarities and wherein it differs from humanized lym\u003epli, or the lymph from the human subject, to the end that we may have an intelligent appreciation of the precautions necessary to ensure successful results in its use. It is more pdastic than the Iuman ; in fact, animal vaccine is contained in animal albumen, or is so mixed with it as to give a viscid glairy fluid which dries uponi the ivory point as a thin film or varnish like isinglass ; which is not readily soluble in the serum or blood which exudes upon the arm in vaccinating ; but requires that the precaution be observed to dip ie point in cold water previous to use, to soften the albuminous film thereon ; after whiclh, it may be rubbed thoroughly over the scratches with the certainty that it will be rubbed into the wounds, that the wounds will be infected thereby, and the infection become absorbed into the system and produce its characteristic results. 80 per cent. is a good proportion of success with this lymph. Humanized lymph is more readily soluble, hence fewer failures follow its use in general practice. Success here should not be less than 90 per cent., but the diffirence in the character of the lympli being known, I am satisfied my colleagues will become as successful in its use as clsewbere. The carlier any lymph is used, the more certain the results and the more satisfactory. Failure with properly collected animal virus of a proper degree of freshness is a very rare circumstance indeed; always supposing it is used properly and with due care. Hlerein all the nerit lies ; the fault is not with the animal virus, but with the men tlat use it, and the munner qf its use. Although a lack of know- ledge on the part of a propagator of the peculiar state of the vesicle in the heifer, and period at which virus exists in its most perfect condition, lias no doubt caused the issue of virus at times which did not possess the necessary degree of activity ; this defeet a propagator will very soon become painfully aware of by having his lympli returned as inert. One word in reference to the Longue Pointe stock of vaccine virus and I have done. Owing to Professor McEaehran's prognostication, that an epidemie of cow-pox would probably follow that on the horses in the spring of' 1877, I was on the lookout for it, and made known my object to some of my colleagues, among others Dr. IIingston. Learning from Mrs. Leney of Longue Pointe of",
         "TBE CANADA. MEDICAL RECORD. the existence of the disease among her husband's tions will b cows, ho made known the factto me, and early on the the only p following morning, Nov. 6th, 1877, Ivisited the farm, degeneracy in company with a colleague, and finding six cows kindness of affected in various stages of the disease I procured public vacci a large number of crusts and some lympli in a rather cow-pox; sp advanced stage. With this stock I at once began cination and operations, vaccinating ten children during the next ference to w day or two, and using every possible care to liquefy cannot close the vaccine as much as possible before using. In to Dr. H. M nine of these no result was obtained, but in one I able practic had a single vesicle of perfect characteristics. The Thankino progress was very deliberate, but tardy in comparison apologizing with my former experience with humanized lymph. in which I It was vaccinated on the 7th, and on the 17th it was cons of the seen by Drs. Ringston and Larocque. In the om- ample proof pany of the latter I procured about 100 points of pp. 150. I clear beautiful lymph. Some of these I distributed to cination,\" a members of the profession, and with the balance I am obliged ôbtained a number of splendid results of the 2nd finished, in i generation, giving more plunp and otherwise char- ties nay yel acteristic vesicles. From one of these second re- points invol moves, the child of a Mrs. Reaves, No. 30 St. Urbain street, I obtained a large number of points, with which I furnisbed a supply to the various public vaccinators, charging 150 points for the IHealth Office. On visiting the Lency Farm a week luter I was fortunate en ough to procure more lymph, TREATMEN in better condition, and with this I succeeded in PREGNAŽ vaccinating a child of a Mr. Leprees, after a second trial (residing in 504 St. Joseph street). From this Dr. Mur case I was able to charge in company with Mr. commende McEachran, medical student, a large number of ie introd as the inte: ivory points. From this time forward I had no the cervix difficulty in keeping up a liberal supply of lymph by at interval successive transmissions through healtby children, gircn to p from none of which have I bad any complaint. Fee!- desired eff ing desirous of trying its effects on the animal and provement n perfet c having a great quantity of my original virus carefully Reod put away, I obtained, as best I could, the consent of milkmien to vaccinate an animal with the virus. In every case I was more or less successful ; on two or three occasions too much so, as it communicated to other animals and interfered with the operations of milking. During the past summer and autumn I have transmitted it through about 30 animals on Logas' .farm amply sufficient to keep up the activity of the made witl --virus. This I find keeps best in glycerine in a cold chrYSOPha and dark place. I trust the results of animal vaccin- new repor ation may yet prove so satisfactory to the profession ment ef t of Montreal, and the Dominion of Canada-as to be- per ce corne eventually'the onlý source frein which vaccina- 'ourid te p e performed ; as I am convinced it is» erfect safeguard against impurity and of the lymph. I am indebted to the great my friend, Dr. F. W. Campbell (an olda nator), for Ceely's plates, illustrative of ontaneous and artificial ; also Retro-vac. Snall-Pox Inoculation in Animals; a re. Lich inay not prove uninteresting ; and I without acknowledging my indebtedness artin, Boston Highlands, for much valu. il information on the subject. you for your patient hearing, and for the undue length of my paper,, have been unable to discuss the pros or question of the transmission of syphilis; of wbich is given in Tanner's Practice, utchison's Plates, Martin's \"Animal Vac- nd other authors ancient and modern. I to leave the matter with you thus un- the hope however, that other opportuni be afforded for discussing the several ved in the subject, seriatum. T OF OBSTINATE VOMITING DURING NCY BY DILATION OF THE CERVIX UTERI. illo resorted le this remedy, as re- d by Dr. Copement, of Norwic. uced the finger into the-cervix as far, rnal os, kept it there for two minutes; was thus dilated four different times, ls of one or two days, and morphia roduce slecp, which did not have the ect. At the end of one week the ii- was marked, and in eleven days a ire was effected. -London Medica ROGALLIC ACID IN PSORIASIS. (DR. A. JURISCIL) e alrcadv in our July number, on given a resurne of some experimente-. h pyrogallie acid as a substitute for, nie' acid in psoriasis. The authoie ts his complete success in the treat- his affection by the agent indicatedL used an ointment containing twenty f pyrogallic acid; this- was, however, roduce excoriations. Hence, lie has",
         "THE CANADA MEDIOAL RECORD. 9 reduced the ointment, as ordinarily used,'to the strength of ten per cent., and in some cases he uses it only of five per cent. If spread on muslin, and then applied, it must be still further diluted, otherwise it acts as an irritant. Aque- ous solutions should contain about--one per cent. Pyrogallic acid acts not as :rapidly as chrysophanic acid, but is equally certain in its results. POULTICES. 'The common practice in making poultices of -mixing the linseed-meal with bot water, and' .applying them directly to the skin, is quite wrong, because, if we do not wish to burn the patient, we must wait until a great portion of the heat has been lost. The proper method is to take a flannel bag (the size of the poultice required), to fill this with the linseed poultice as hot as it can possibly be made, and to put between this and the skin a second piece of flannel, so that there sball be at least two thick- nesses of flannel between the skin and the poultice itself. Above the poultice should be placed more flannel, or a piece of cotton wool, to prevent it from getting cold. By this method ve are able to apply the linseed-meal boiling hot, without burning the patient, and the heat, :gradually diffusing through the flannel, affords a grateful sense of relief which cannot be obtained by other means. There arefew ways in which such marked relief is given to ab- ,dominal pain as by the application of a poultice in this manner.-Dr. T. Lauder Brunton, in Brain. 3ISLOCATIONS OF MUSCLES AND THEIR TREAT- MENT. British .Med. Jour : Mr. Callender remarks that but littlie attention bas been paid to tbis -Class of injury, though they are followed by considerable inconvenience, by pain often of long continuance, and by interference with the very amusement or occupation in the practice ýof which they have been sustained. Mr. Cal- lender refers to various cases of displaced ten- ýdon, as of the biceps, the tendons about the wrist, and the peronei, in all of which, while the reposition of the tendon is not very difficult, the -unsatisfactory feature of the treatment is the impossibility of preventing in many instances the recurrence of the displacement. , He then proceeds to consider dislocations of the muscles themselves, and -the following may be taken as a typical case: A man, aged forty-six, was playing at lawn-tennis, when he felt a sudden movement, with intense pain, in the right fore- arm. He rested the arm, had advice, but the pam persisted. When the accident bappened the fore-arm was suddenly thrown into the extreme of pronation while he was making. a back-stroke. - On examining the arm Mr. Cal- lender found there was tenderness along the course of the pronator radii teres, and the pain in the fore-arm was severe when the hand was moved in pronation. The hand was brought into pronation, and with a pad fitted to aud applied over the course of the pronator firm pressure was made upon the muscle, while the hand was carried to the extreme of supination. The pressure, the patient said, gave relief, and on removing it the pain had ceased; the fore- arm could now be freely moved. The parts were rested in a sling, and lie was told to keep the arin quiet. In two days' time he again tried the muscle at lawn-tennis, and again the pain recurred. The muscle was again returned to its place, and this time the arm was so fixed that the muscle was secured against further dislocation, and, as no movements have since been made which would cause its displacement, the patient bas remained well. As general rules for reducing dislocation of muscles, Mr. Callender recommends that an accurate diag- nosis should first be made of the muscle dis- located ; secondly, the muscle should be relaxed as far as possible ; thirdly, by firm manipula- tion, such as the rubbing with the hand, or by kneading with the thumb, an endeavor should be made to replace it; and, lastly, pressure should be made whiie the muscle is on the stretch. THE TREATMENT OF SEA-SICKNESS. C. J. S. Digges, M.R.C.S.E. (of St. Louis, Mo.), recommends hypodermic injections of morphia over the epigastric region in sea-sick- ness. In 200 passengers experimented upon, the majority were completely and permanently relieved-; in the others, relief for twelve to forty- eight bours followed, allowing the partaking of food during the interval. TREATMENT OF OBSTINATE SCIATICA BY SUBCU- TANEOUS INJECTIONS OF NITRATE 0F SILVER. Dr. Dureau has-collated the cases of obstinate sciatica treated in the Parisian hospitals by Damaschino and Guérin-Rose, on Luton's plan, and bas deduced from them the following con- clusions: , 1. The subeutaneous injections of nitrate of silver are to be recommended in cases of inveter- ate sciatica. 2. These injections, though irritating to the, tissues, may be undertaken without any fear of evil consequences. 3. The method renders it possible to reach the'diseased spot and to insure the action of the remedy. 4. improvement and recovery take place rapidly under this treatment. 5. The subcutaneous injections oflunar caustie are more active and less dangerous -than the",
         "-THE CANADA MEDICAL RECORD. actual cutting, which is so fr.eguently recom- situation, that is, the usual remedies for local c Imended for sciatica. gestion, are the most efficacious means of cure. Luton employed a ten per cent. solution of the The most characteristic symptorn of spinal irrita. nitrate of silver, and injected fromn. twenty to tion is tenderness of the spine, whieh may implicate twenty-four drops, but Guérin-Rose uses a it in its whole length, but much more frequently a, fifteen per cent. solution, and injects fifteen one or several parts, and the symptoms of functional drops, and Damaschino takes one of only four derangement of internal organs, and the pain so per cent., and injects only five drops. Of twelve often complained of, generally bear some relation tw cases treated by Guérin-Rose, most were cured, the seat of the tenderness. In a large proportion of, a few were improveci, and a few were not cases the patient makes no complaint of uneasiness affected at all. No unfavorable consequences in the region of the spine, and when asked if he has. were observed in any of the cases. Dr. Dureau any pain in the back, answers as often in the nega- advises that the needle be introduced deeply, so tive as in the affirmative, so that, unless this symp- as almost to reach the nerve.-Allg. 3fed. Cent. tom is specially looked for, and the spine carefully Zeit. exarnined, the tenderness is exceedingly apt to be overlooked. For this reason, and because there is hardly a single disease in the whole category of ail- SPINAL IRRITATION. ments which may not be more or less accurately. [From Da. McCALL ANDERSON' SC linical MediCIDe.\"] sinulated by it, errors of diagnosis are of every-day ocoîrrence. The following points, all of which, with In the year 1828 the late Dr. Brown, of Glasgow, the exception of the last, perbaps, I can verify from directed attention to a class of cases illustrative of my own experience, are specially insisted upon by, disorder of the spinal cord, to which he gave the the Messrs. Grifflin as aids to the diagnosis: name of spinal irritation. This affection had pre- \"1. The pain or dis order of any particular organ viously been alluded to by Mr. Player, of Malmes- being altogether out of proportion to the constitu- bury, in an article in the Quarterly Journal of tional disturbance. Science for January, 1822, and a good many years \"2. The complaints, whatever they may be, are afterward it formed the subject of important con- usually relieved by the recumbent position, always tributions to our knowledge of it as a distinct affec- increased by lifting weights, bending, stooping, or tion from the pen of the late Mr. Teale, of Leeds, twisting the spine; and among the poorer classes. and a few years later from the Messrs. Griffin, of often consequent to the labor of carrying heavy -Limerick. To these gentlemen we owe almost all 1oads, as in drawing water, etc. that we know of it at the present day. \"3. The existence of tenderness at that part of It is especially apt to occur in debilitated, ner- the spine which corresponds with the disordered vous, and hysterical subjects, and, although it is organ, and the increase of pain in that organ by sometimes met with in males, it is, par excellence, pressure on the corresponding region of the spine. a disease of the female sex. This is well shown by \"4. The disposition to a sudden transference of the statisties of the Messrs. Griffin, for, of one the diseased action from one organ or part to another, hundred and forty-eight cases, twenty-six occurred or the occurrence of hysterical symptoms in- affec- in males, forty-nine in married-women, and seventy- tions apparently acute. tbree in girls. According to Radcliffe, a strain or \"5. Perhaps we may mention the occurrence oft blow upon the back is apt to prove its starting point, continued fits of yawning or sneczing. They are, although I can not say that I have noticed such a not very common symptoms; but as scarcply ever connection, and it is the opinion of some that it is at occurring in acute or organic diseases, they may times hereditary. generally be considered as characteristic of nervous ,The truc nature of this morbid state is much irritation.\" disputed, and as the disease is one which is seldom, if ever, fatal, it is somewhat difficult to place its pathology upon a reliable basis. According to Brown, \" the iminediate cause ...... is spasm of one or other of, the muscles arranged along the spine, altering tho position of the veîrtebrS, or otherwise compressing the nerves as they issue from the spinal marrow.\" Teale, on the other hand, attributed it to congestion, which by continuance and repetition may so far impair the tono of the capillaries as to produce a state of actual inflammation ; while Radcliffe seems of opinion that the opposite condition, namely, capillary contraction and bloodlessness, is nearer the truth. But whatever the correct interpretation may be, certain it is that the abstraction of blood by leeches or cupping-glasses, applied over the tender spine, and the application of blisters in the sanie EXAMINATION OF THE TJROAT AND POSTERIOR NARES. To examine the throat well, the nose should b held so as to compel breathing through the mouth. Thus the soft palate will be raised, the palatine arches widened, and the tonsils and the back of the pharynx fairly exposed. Pressing the tongue down- ward, provided it be donc very gently, is also of advant:îge. Rude treatment the tongue would resist. The forefinger eau be passed into the throat as low as the bottom of the cricoid cartilage, and thus search the pharynx down to the top of the esophagus, and the hyoid space (on each side) where foreign bodies are so apt to lodge. In introducing a stomach pump, the finger should keep the instrument well",
         "THE CANADA MEDICALOECORD. against the back of the pharynx so as to prevent its slipping into the larynx. Put the:finger into the moutb, and feel the ante- rior border of the coronoid process of the jaw. On the inner side of this process, between it and the tuberosity of the upper jaw, is a recess, -where a deeply-seated temporal abscess might burst, or might be opened. Behind the last molar tooth of the upper jaw we can distinctly feel the hamular process of the sphenoid bone; also the lower part of the pterygoid fossa, and the internal pterygoid plate. Behind, and on the outer side of the last molar, can be felt part of the back of the antrum, and of the lower part of the external pterygoid plate. On the roof of the mouth we can feel the pulsation of the posterior -palatine artery. Hemorrhage from this vessel can be arrested by plugging the orifice of the canal, which lies (not far from, the surface) on the inner side of the last molar, about one-third Of an inch in front of the hamular processs. When the mouth is wide open, the pterygo-maxil- lary ligament forms a prominent fold readily seen and felt beneath the mucous membrane, behind the last molar teeth. A little below the attachment of this ligament to the lower jaw we can easily feel the gustatory nerve, as it runs close to the bone below the last molar tooth. The exact position of the nerve can be ascertained in one's own person by the acute pain on pressure. A division of the nerve, easily effected by a small incision in the right place, gives much temporary relief in cases of advanced car- cinoma Of the tongue. To feed a patient in spasmodie closure of the jaw, it is well to know that there exists behind the last molar teeth a space sufficient for the passage of a small tube. A surgcen's finger should be familiar with the feel of the posterior nares, and of ail that is within reach behind the soft palate. This is important in relation to the attachment of polypi, to plugging the nostrils, and the proper size of the plug. In the examination of this part of the back of the throat it is necessary to throw the head well baek, because, in this position nearly all the pharynx in front of the basilar process cornes down below the level of the liard palate, and can be seen as well as felt. But when the ,skull is horizontal, i. e., at a right angle with the spine, the bard palate is on a level with the margin of the fora- men magnum, and the parts covering the basilar pro- cess are concealed from view. The head, then, being well back, introduce the forefinger behind the soft palate, and turn it up toward the base of the skulì. You feel the strong grip of the superior constrictor. Hlooking the finger well forward, you can feel the contour of the poste- nor nares. Their size depcnds upon the anterior, but rarely exceeds a small inch in the long diameter, and a small half-ineh in the short. The plug for the posterior nares should not be larger than this. Their plane is not perpendicular, but slopes a little forward. You can feel the septum formed by tLe vomer, and also the posterior end of the inferior spongy bone in each nostril. - Before taking leave of the throat, look well at the: position of the tonsils between the anterior and pos-., terior half arches of the' palate. In a healtby state they should not project beyond the -level of these arches. In all operations upon the tonsils, we should remember the close proximity of the internal caroticl artery to their outer side. Nothing intervenes but the pharyngeal aponeurosis, and the superior con- strictor of the pharynx. Hence the rule in operating- on the tonsils always to keep the point of the knife- inward. In troublesome hemorrhage from the tonsils, after an incision or removal, it is well to know that they are'accessible to pressure if necessary by means of a padded stick, or even a finger.-From Holden',s Landmarks. CHINESE MEDICINE AND SURGERY. A correspondent of the New York -Evening Post, now travelling in China, gives an entertaining ac- count of mcdical and surgical matters in the Celes- tial Empire, from which we cull a few paragraphs.. The list of materia medica includes not a few arti- cles which would have found favor in Europe in the olden time, though out of fashion now-a-days, as the following enumeration will show The larvæ of beetles and other insects are used medicinally to give strength to feeble children ; dried toads are taken to give tone to the system; cater- pillar syrup is a specific for bronchitis; and for small-pox the skins of snakes and scorpions, dried and powdered, are considered efficient remedies. The horns of the rhinoceros, the bones of tigers, the- paws of bears, and the wings of bats all have a place in the Chiriese pharmacopia. The body of the bat eaten is said to prolong life ; to partake of the white bat-is believed to be to protract one's existence be- yond that of the aged Mthuselah. A simple remedy, containing well-known ingredients, is nothing thought of by a patient, and the doctors seem to be. quite of the same mind. Orange peel, dried, is used in enormous quanti.- ties, and seems to be considered a real panacea. Ginseng ranks next in importance, and licorice and rhubarb are highly esteemed in Chinese pharmacy. The water in which the precious metals have becen hastily boiled is a popular remedy for emergencies in a household, such as sudden faintness or slight illnesses. It seems to take the placé of the brandy and camphor so frequently given in foreign bouse- holds, when a sudden exigency arises. The orna- ments and pins, of gold and silver, which adorn a Chinese lady's head, are often brought into requisi- tion in preparing this medicinal drink. The Chi- nese nedical men are exceedingly given to the use of caustic medicines and plasters. The blossoms of a certain plant are sometimes placed on the skin and set fire to in order to blister the surface. In rheunatism of the joints, a thin slice of ginger-root is laid on the joint, and a piece of burning moss placed on the ginger to cause irritation of the skin.",
         "UU 'THE CANADA MEDICAL RECORD. A trifiing sore is frequently so doctored with these caustics that much of the tissue is destroyed, and the patient suffers long and seriously. Of the Celestial surgery the following account of setting a dislocated brain will suffice as a sample:- The Chinese surgeon, although unskilled in the art of setting a broken leg, seems to be at no loss what to do in \"setting the brain,\" as he styles the process. A Roman Catholic missionary having fallen from bis horse and been taken up in a criti- ical condition, a native doctor was summoned, who ýdeclared that the brain of the sufferer had been -displaced by the fall, and must be \" set.\" There- capon he tied a stout eloth about the head of the priest, giving the ends of the cloth into the hands of two men, who drew the bandage as tightly as possible, while the physician beat the patient's head with a stick. This operation, although giving the poor priest's head a violent shaking and causing severe pain, proved highly successful, in the sur- :geon's opinion, the brain having thereby at once re- gained its normal position. One of the priest's ribs baving been dislocated by bis fall, the doctor half suffocated the poor man by fastening a handker- chief or soneting cf the sort over bis mouth and nose, doing so with the expectation that the pa- tient, by dint of making violent and spasmodie :struggles to get bis breath, would cause the rib to, spring of itself back into its place. THE RESPIRATOR AS A PREVENTIVE OF COTGHS AND COLDS. -Dr. J. Milner Fothergill, of London, sends to the Philadelphia Medical Timnes a long and inter- -esting letter on the treatment of coughs and colds. Among preventive measures he lays great stress on the respirator, which is much more commonly used .abroad than bore, and is undoubtedly a good thing for persons with sensitive lungs, if they cannot or -will not keep their mouths shut when out of doors in cold weather. On this subject Dr. Fothergill says:- The mucous rheum which calls out the morning cough is due to the changes of temperature to which the lining membrane of the air-passages is exposed in cold weather. People pass rapidly from in-door temperatures of 60° Fahr. to out-door temperatures varying from 40° to 32°, and far below that very oft- en, and then changes in the vascular supply of the mucous membrane of the air-passages are set up. If everybody at all times only breathed through the nose, the inspired air would be warmed by passing over the coils of blood-heated plates which exist in the nose for that purpose, and would not affect the air-passages placed behind the turbinated bones. But such is not the case; they probably commence to talk, and in doing so draw in by the mouth cold air, which, on mixing with the residual air in the ýchest, lowers its temperature, and then a fluxionary byperomia follows, and after it, in its train, a mu- cous rheum. The best plan for persons who thus catch their winter cough to adopt is to keep their mouths closed ; but then humanity is not generally prepared for such -self-denial, and the respirator suggests itself as the agent required. A respirator is Éiot an ornamental thing, and its appearance is not in its favor. Its use subjects you to the remarks of inconsiderate and unreflecting friends and acquaint ances, who point significantly to the unsightly con. trivance, and express their regret that you should be compelled to wear such a thing ; and the insur. ance agent, when you call to pay the premium on your policy, looks excited and nervous. Having worn a respirator for eight winters now, and know. ing how little I have been troubled with bronchitis since, which previous to then for some years had made winter a very uncomfortable season, I am very little perturbed by such incidents, and reply that \"I don't wear a respirator because I am il], but because I don't wish to be ill.\" And a wonderfully comfort- able thing it is 1 It keeps the cold wind from blowing into the mouth when facing it ; and surely it is as natural to cover the orifice of the mouth in winter as it is to shut the front door to prevent a cold draught pervading the bouse. Ladies who take carriage-drives wrapped in furs copiously and pro. vided with foot-warmers in their carriages and flasks of hot water in their muffs often catch cold when out. If they would further conserve and economize their body heat by the use of respirators, which take up some of the heat of the warm expired air and, give it off again to the cold inspired air, then they would not only be more comfortable, but they would escape many a catarrh and much coughing. Whether it is inconsistent with the interests of the 'profession thus to instruct the public how to keep themselves welli, or not, may not be affirmed. The respirator in some forn has a great future before it. TABLE SALT IN MILK FOR CHILDREN. Dr. Q. C. Smith, in the Pacific Medical Journal, gives the following useful hint, which, by the way, is confirmed by other excellent authority: \"When cow's milk is found to disagree with band-fed babies or small children it may in many cases be rendered entirely wholesome to them by adding to it a small portion of table salt, just enough to be perceptible to the taste. I have for years directed the practice of this expedient among our people, and know it to be of real value.\" TO STOP THE NOSE-BLEED. A recent writer says that the best remedy for bleeding at the nose consists in the vigorous motia of the jaws, as in the act of mastication. In the case of a child a wad of paper should be placed ii its mouth, and the child should be instructed to cher it bard.",
         "THE CANADA MEDICAL RECORD. INTESTINAL OBSTRUCTION. Its Diagnosis.-When a child becomes suddenly the subject of symptoms of bowel obstruction it is probably either intussusception or peritonitis. When an elderly person is the patient, the diagnosis will generally rest between impaction ofintestinal contents and malignant disease. In middle age the causes of obstruction may be various; but intussusception and malignant disease, both of them common at the extremes, are now very unusual. Intussusceptious cases may be known by the frequent straining, the passage of blood and mucus, the incompleteness of the constipation and the discovery pf a sausage-like tumor, either by examination per anum or through the abdominal walls. In intussusception the parietes usually remain lax, and there being but little tym- panites it is almost alwiays possible without much diffliculty to discover the lump by manipulation under ether. Malignant stricture may be suspected, when in an old person continued abdominal uneasi- ness and repeated attacks of temporary constipation have preceded the illness. It is also to be noted that the constipation is often not complete. If a tumor be present and pressing on the bowel it ought to be discoverable by palpitation under ether through the abdominal walls, or by the examination by the anus or vagina, great care being taken not to be misled by scybalous masses. If repeated attacks of dangerous obstruction have occurred with long intervals of perfect health, it may be suspected that the patient is the subject of a congenital diverticu- luni, or bas bands of adhesion, or that some part of the intestine is pouched and liable to twist. If, in the early part of a case, the abdomen becomes dis- tended and hard, it is almost certain that there is peritonitis. If the intestines continue to roll about visibly, it is almost certain that there is no perito- ntis. This symptom occurs chiefly in emaciated subjects, vith obstruction in the colon of long dura- tion. The tendency to vomit will usually be relative with three conditions and proportionate to them. These are, (1) the nearness of the impediment to the stomach ; (2) the tightness of the constriction, and (3) the pérsistence or otherwise with which food and medicine bave been given by the mouth. In cases of obstruction im the colon or rectum, sickness is often wholly absent. Violent retching and bile. vomiting are often more troublesome in cases of gal stones or renal caliculus simulating obstruction, than in truc conditions of the latter. Fecal vomiting can ,occur only when the obstruction is modcrately low down. If it happens early in the case, it is a most serious symptom, as implying tightness of constrie- tion. The introduction of the hand into the rectum, as recommended by Simon, of Heidelberg, may often furnish useful information. As Treatment.-(1) In all early stages, and in all acute cases, abstain entirely from giving either food or medicine by the mouth. (2) Use anoesthetics promptly. Under their full influence examine the abdomen and rectum carefully before tympanites ias concealed the conditions. Administer large enemata in the inverted position of the body. If 10r advisable, practice abdominal taxis. If you do not. at first succeed, do it repeatedly. (3) Copious ene- mata, aided perhaps by the long tube, are advisable- in almost all cases, and in most should be frequently- rcpeated. (4) Fluid injections may be sometimes- replaced by insufflation of air in cases of invagination; since air finds its way upward better and is more easily retained. It is, however, somewhat dangerousr and bas perhaps no advantages over injections with. the trunk inverted. (5) Insufflation is to be avoided, in all cases of suspected stricture, since the air may- be forced above the stricture and there retained. (6) Saline laxatives are admissible in certain cases where impaction of feces is suspected, and in cases, of stricture where fluidity of feces is advisable. (7). Opium must be used in proportion to the pain which the patient suffers. It should be administered hypodermically or by the rectum, and should be-, combined with belladonna. If there be not mnuch pain or shock it is better avoided, since it increaset constipation and may mask the symptoms. (8) A full dose of opium, administered hypodermi. cally, will put a patient in a favorable condition. for bearing a prolonged examination under ether- and attempts at abdominal taxis: ¯ (9) In cases of uncertain diagnosis it is better to trust to the chance of spontaneous cure, or relief by repeated abdominal taxis, than to resort to exploratory opera- tion ; or in desperate cases iliac enterotomy should, be donc. Operations for the formation of artificial' anus in the right or left loin may be resorted to whenever the diagnosis of incurable obstructive dis- case in the lower bowel is made. (10) The opera- tion for the formation of an artificial anus througha the anterior part of the abdominal wall and into the- small intestines should be resorted to only in certain, cases of insuperable obstruction in which the seat of disease is believed to be above the cecum. (11) In all cases in which the precise seat of the disease is doubtful, but the large intestine is suspected, the right loin should be preferred. If the colon here be found to be empty, the peritoneum may be cau- tiously opened and a coil of distended small intestine brought into the wound. (12) Cases of intestinal obstruction are strictly surgical, and not medical cases.-Dr. Jonathan Hu tcainson, British lfedicat Journal. TREATMENT OF OBESITY BY ARSENIC. Dr. J. T. Whittaker states that he bas employed arsenic with success in the treatment of four cases of obesity. One case iwas so severe that the patient fainted on the slightest movement; he had gained forty pounds in three months. 1Hle had no valvular- lesions and had never had rheumatisi. After the- failure of all other methods of treatment, he was put on five drops of Fowler's solution thrce times a day. In two months he was restored to health, could walk well, and had lost much of bis embonpoint. In the three other cases, two of which were complicated with asthma, the effect was also decisive but less rapid.-Cincinnati Lancet.",
         "THE CANA.DA MEDICAL RECORD. SOME REMEDIES TO EASE THE PAIN OF UTER- INE CANCER. Dr. Aus-Lawrence has compared the effect of various remedies easing the pain of uterine canicer. The result of his investigations sbowed that ergot given in 30 minim doses every 6 hours re- lieved the pain botter than any of the other ordi- nary medicines. This remedy acts probably by diminishing the hyperSmia of the uterus. The hydrate of croton chloral is also of good effect in these cases, but it is of use more parti- cularly for the radiating pains which are present in the side, thighs and back. As a local remedy the author gives the prefer- ence to carbolic acid, of whieh ho applies a con- centrated solution by means of a wad of lint upon the diseased part. In addition to that the patient takes night and morning an injection of carbolized glycerine, and small blisters applied. to the lumbar region are sometimes of service. These may be dressed by the application of an ointment containing a little morphine.-Jow'- 2ial de Tlerapeutique.-Lyon M.7edicale. POST-PARTUM HEMORRHAGE. Mr. Tyson, F.R.C.S., read a paper before the Kent Medical Society, detailing thrce cases of post-partum hemorrhage, in each of which perchloride of iron was injected into the uterus wvith good effect. The cases were adherent placenta, hour-glass contraction, and the last mainly one of inertia. In all, ergot, cold .external and internal pressure were fairly tried. The strength of the iron solution was one of the strong liquor of the B. P. to ten of' water. Stress was laid on the importance of syringing out the uterus for a few days after the labor ; mention was likewise made of the .good effect of the subcutaneous injection of the liquid extract of ergot, being apparently as :useful, although a large quantity was required, as ergotin-the latter remark referring to those cases in whieh the stomach rejects every thing put into it.-British Medical Journal. TEE URINE OF THE INSANE. M. Albert Robin (Société de Biologie, June 24) hbad occasion to examine the urine ofa madman who died at the Hospital Beaujon, and communi- cates the very interesting results of his re- searches. The quantity of the urine was diminished to three hundred grams in twenty- four hours ; the specific gravity was 1030 ; the reaction acid, remaining so after exposure to the air for eight days. The amount of solids was twenty-five grans in twenty-four hours, that of the urea only 10.22 grams, but urie acid, on the con trary, was present in large propoi:tions. The chlorides were diminished, the phosphates nor- mal; sugar and albumen were not present.: the sediment, after evaporation, he found crystals of the hippurate of calcium, margaui acid, leucine, and an enormous quantity of uri acid. Many bacteria of a special nature wee found on microscopical examination. M. Robid asks whether it miglit be possible to inoculagf madness by means of urine.-British Rede Journal. ON TEE EMPLOYMENT OF LISTER'S METHOD W THE TREATMENT OF BURNS. The burned part is to be carefully disinfected, and then covered with a piece of linen spread witß Lister's boracie acid. Then follows the envelopiueq with carbolized gauze or salicylie cotton. Accordind to H. Busch of Bonn, under this dressing tk necrosed parts are separated, move gradually anl easily, and the granulations never become exuberat The most striking results, however, are seen in tbd cicatrix. Instead of the usual extensive cicatricid! bridles which project above the surface and cxer traction on the neighboring tissues, an almost'smooùti' cicatrix forms, which remains elastic and extensivj and does not cause contracture.-Gentrait\u003elattf. Afed. issen DR. SEATON ON RE-VACCINATION. Generally speaking, the best time of life for rcj vaccination is about the time when growth is com pleting itself, say from fifteen to eighteen yeaz of age; and persons in that period of life ought not to delay their re-vaccination till times wheî there shall be a special alarn of small-pox. E! are strongly of opinion that there would be î1 great deal more re-vaccination if the family mnedicffl ran always made a point of drawing the attea tion of parents to the necessity of their adulk children being re-vaccinated. We feel certain thait as a rule medical men neglect to do this, little thid img how, by insisting on the repetition of tbei operation, they have it in their power to starve, acid therefore to wcaken the force of any future epide- mic of smrall-pox.-Report to the Local Gov. Boaid FOR MOSQUITO BITES. Rub on the bite a little soap (toilet), then allie a stream of cold water to run upon the part fo three or four minutes. The itching is at ouc relieved and no further annoyance results.-C. J.*S DIGGES, in Lancet. CRONIC VARICOSE ULCERS. Wash with an eight per cent. sol. of zinc chloride, then cover with wet borax lint, and over the latter spread gutta-percha tissues. W.hen healtlhy gran- lations appear, cover the surface with dry bora lint, without the impermeable covering. This is said to give excellent results.-N. Y. Medical Record. 102",
         "TRE CANADA MEDICAL RECORD. 103 SCLEROTOMY IN GLAUCOMA- results obtained by him in the administration of arsenic in certain cases of anomaia, and those cases in Professor L. Mauthner, of Vienna, (in the Wie- which iron and good food had failed to produce any ener 3edizin TVochensclhift, for July, 1877,) has a benefit. lis attention was first directed to the eon communication on the advantage of selerotomy power of arsenic in this respect by a paper published \"in glaucoma over iridectomy. Hie considers that by Dr. Byrom Bramwell, of Newcastle, in which he the essential part of the operation of iridectomy is narrated several cases of essential or progressive the division of the selerotic at the margin of the pernicious an cmia, where remarkable benefit ac- J~pr andnja where retrhel benefit oftene-tindee J cornea, and that the success cf the operation depends crued from the administration of this drug. Whether Upon the extent of the sclerotic divided; he thinks, it really has the power of curing this disease-a therefore, that the above operation 1s more certain discase which bas hitherto bafled the resources cf than iridectomy, as the extent of the scleral wound our art, and the good results apparently promised by -is greater. le relates that he as found many cases phosphorus in the hands cf Dr. Broadbent not in which the large opening after iridectomy inter- having been obtained, te any extent at ail events, by fores seriously with the funetions cf the oye, and other observers-remains for the future to determine. that he finds the removal of a segment of the iris to Certain it is that in cases of anamia approaching in be quite an unnecessary proceedig; aise, that n ravity the so-called essential or pernicious eanmia cases iii which the segment of the iris has been in- it is capable cf producing great benefit. In support completely renoved, the tension bas been reduced as cf this statoment Dr. Loekie reports several strikin wvell as in those in which no such failure bas occur- cases red; and that, when selerotomy bas been performed _ in the manner in whicl be describes the operation, the results have been more successful than those MURIATE OF CALCIUM AS A THERAPEUTIC after Von Graefe's operation. AGENT- The following are his directions for the perform- -ance of the operation : Before the operation, a drop aneecf licopeatio: ]clbe te epratena d o f tbis drug, scys, Il Cieoride cf calcium possesses a of a one per cent. solution of the sulphate of eserin t is to be applied, when the pupil will undergo con- traction, unless there is atrophy of the iris. If there be atrophy, lie reiarks that it is exceedingly diffi- experienee Ilbave found ne 'emedy on whieh se cult to avoid prolapse. In adults the operation should be performed without anæsthetics. The di- Vision of the selerotic should be performed upwards been es te the westing diseases cf chîldren. It bas in case it is necessary to perform irideetomny on ac- four mest exteesively used by ne during the past count of accidental prolapse of the iris, this is thef r yers, and vith the niost gratifying resuits. nies faorale psiton e dese.A Yn Grefe I avi ng prescribed it in cvery forai cf tu'bercular most favorable position to do so. A Von Graefe's cataaetkeie i ne teho ntced milimterho-disease that bias cerne hefore nie duriag this period, cataract kçnife is now to be entered a millimeter be- perbeps a short accunt cf my observations on the hind the edge of the cornea, and carried through as if to form a scleral flap by Wccker's method. After c t transfixion, h prte scmltdb ase conditions wbichi indicate the probable uscfuiness cf' trnfxothe operation is completed by causing the knife to eut its way out very slowly, so that the y sf aqueous humor muay escape very gradually ; it is in this manner that the prolapse of the iris is prevented i the fiap is not, however, to be completed, but a small ho hecomes more attenuated every day, bois ianguid, bridge is to be left at its upper part. The knife oft-times sleepiess, acd the pupîls are always very should not be withdrawn from the cye until just as the last of the aqueous humor has escaped ; as it is patient frcquetly starts up in a frigbtgrinds his withdrawn, its flat side is very gently pressed upon c tie muscular the iris. A drop of the solution of eserin is then system will ofte ho observed,- these symptems applied, and the eye is dressed with the usual pad being evidently due te a large ameunt cf undigested and bandage. This dressing is to be renewed afterr fe her, e for stimulants, and a niost extraordinary iiking fer a few hours, and another drop of the solution ofc eserin applied. The patient should be kept in bed pot'tef for forty-eigit hours. If the iris prolapse, it mnay be ameunt cf stareh. If the motier is questioned, the returned, or the operation fb made that the child takes bis ,i aieio~ or e reuits ofro iiýthi efo food se weil «-s te inaeke it quite heyoed ber power te e also hopes for good results from this operation iunderstand how lie dees net tirive but on the contraîy, is fciling off overy day. Wbou we coe te examine the patient, the face ay appear te ho ON TRE USE 0F ARSENIC AS A BLOOD AND ptitty plugp, but the lrms cad legs are miserably CARDIAC TONIC. tin, soft and fabby, whil tc abdomen is greatly distended, iaving te cutaneous veins very mco tur nred. Thbeova lations s turld always as ex- wa?, Dr. Loekie oeils attention te the remarkebie axeined wen it will h easervsd that they are murk",
         "uiN THE CANADA MEDICAL RECORD. greater in quantity than they ought to be, that undigested food can be largely traced in them, and that their fetor is excessive. Such a state of thbigs distinctly points to great defect in the powers of digestion and assimilation. In fact, none of the food appears to have entered the child as nourish- ment, it having seemed to pass away in a state of putrid fermentation, while the body bas been previngr on its own tissues. It is in circumstances such as these that the beneficial effects of the muriate of calcium can be appreciated. Is powers in arresting such symptoms, in my opinion, are superior to cod- liver oil or iron ; and, wbat is of no little advantage, very young children soon get to take it quite readily. Of course, when one is prescribing in disease of this kind, it is absolutely necessary to observe strict dietetic rules. In addition to the internal remedies, it will be of immense service if the abdomen of the patient is gently rubbed, night and morning, with olive oil, and afterwards a flannel bandage applied. With reference to diet, I insist upon a large quan- tity of milk, and the avoidance of starchy food and sweets. The medicine requires to be perseveringly used. Let me urge on my professional bretiren to give it a lengthened trial, and not to be discouraged by an apparent failure. iMuriate of calcium can do no possible injury to the economy, while in properly selected cases it will be of incalculable service.\" The dose for the adult of muriate of calcium is twenty grains, repeated three times a day after meals; diminish the dose to suit the age of the child ý from three to five grains may be given to an infant. TREATMEÑT oF ASTHMA BY IODIDE-OF-POTASSIUM SPRAY. Dr. Evrard, of Orsennes, lias obtained very satisfactory results, in a severe case of asthma, from the use of a spray of idodide of potassium. The patient, a man thirty years of age, had suffered for eight months from daily attncks of asthma, and had also been subject to chronie bronchitis for five years. At the time the treatment was begun he had three or four attacks a day, and was reduced to a pitiable condition. After assiduous use of the spray for eight days the asthmatic attacks had almost entirely ceased. Eighteen months have clapsed since thon, but. the patient continues to use the pray, and the attacks have not rccurred. The strength of the solu- tion used was one to twentv. The periods of inha- lation were bort, but frequeutly repeated.-Boston Jour, fOhenG. TIIUMB-SUOKING AND IRREGULAR TEETI. EPILEPSY. Dr. Mordouéh, of Platbush, highly recommends the hypodermie use of veratrum viride in recurring epileptic attacks ; that is, in a series of attacks with an interval of only a fev moments. His formula is: Morph. sulph., gr. ijss; tinet. verat. verid., aquoe, aa ss. M. S. Use twenty minims of the solution, representing ten minims of the U.'S. P. tinet., and about a tenth of a grain of morphia.- Phila. .Drg9. and Glicin. THE PITE OF DRIED CORN STALK AS A UTERINK TENT. W. T. Goldsmith, M.D. (Southern Medical Record, September 20tb, 1878), says that he Las used the dried pith of the corn stalk as a uterine tent for the last seven years, and finds them (the tents) to possess decided advantages over sponge tenis. During the seven years the doctor bas used these tents he bas not had a single accident attributable to their use. The tents are easily shaped of the proper size to which the dilatation is to be carried, and thon the tent can easily be compressed to one- fifth its original size. The tent can be inserted without exposure of the patient, but not s6 readily. Among the advantages of the corn-pith tent are the following: It dilates effectually, but not too rapidly. It is smooth, soft, and can be removed with- out force. It produces no lacerations, abrasions, or irri- tation of the mucous membrane. It can be medicated with any substance as easily as the sponge or cloth tent. It is of vegetable origin, and hence does nol become putrid and poisonous to the patient. It may be retaned non-compressed for days without injurious results, if no pain occurs. A number of small tents, filling up the cer- vical canal, may be used for more rapid expan- sion. It can be prepared in a few minutes, of any desired curve, size and length. Any degrec of compression may be given to it, or it may be used without compression. It .may be perfor-ated like the sea-tangle, and its powcr of absorption increased by pricking is surface. it suill not break upon introduction in the cervical canal, and cari be bent without break- ing on removal. OXIDE OF ZINC IN DIARRHRA. Dr. Chandler, in a paper published in the Boston Journal, August 15th, states that there is no cause Dr. Jacquier, in the service of Dr. Bonamy, at so productive of malformation of the bones of the Nantes, has noted the excellent effects of the follow- mouth and irregularity of the teeth as the habit of ing formula: Zinc oxide, gr. liv.; soda bicarbonate, thumb-sucking during infancy, the different positions gr. vijss. M. Divid. in pulv. iv. Sig.-One every of thé thumb giving rise to different kinds of six hours. In all cases the zinc produced rapid. deformity. cures, even in chronie cases.",
         "THE CANA.JA MEDICAI RECORD. IODOFORM IN EYE DISEASES. Mr. Patrick J. Hayes, of Dublin, calls attention (Med. Tines \u0026 Gaz.) to the value of iodoforn as a therapeutie agent in the treatment of certain sub- acute and chronic diseases affecting the eyes and eye- lids. Many practitioners are of course aware that for a considerable time iodoforin bas been used as an ap- plication in cases of trachoma or granular lids, rmd reports have been published, in America and else- where, illustrative of the good results whieh frequent- ly ensue upon its employment. M1fr. Hayes bas not, however, seen any recomendation of it for such cases as phlyctenular and pustular ophthalmia, cor- neal ulceration, obstinate keratitis, ciliary blepbaritis, ,etc., hence, as he has found it to benefit several patients so affected, he ventures to invite for it a trial at the hands of his confrères. With respect to -the method of application, it is his custoni to crush the crystals until they become reduced to a very fine powder, and then, with a delicate camel's hair pencil, the powder is freely dusted ever the affected surface. For use upon the eyelids such an ointmîent as the following will be found convenient: Iodoform 1 part, vaseline 4 parts; mix. Iodoform, when brought into contact with the eye \u003cdoes not give rise to pain, and children who have once experienced its effect 'will readily tolerate sub- sequent applications. Mr. Hayes adds that it is not suitable for and ought not to be used during the early or acute stage of conjunctivitis. TREATMENT OF OBSTINATE HICCOUGE BY P[LOCARPINE. Dr. ORTILLE, of Lille (Bull. Général de Ttérap.' 1878), gives an account of a case of obstinate hiccough in which. after trying all the usual remedies, he had recourse to electricity. For a few hours the application appeared to prove successful; but the hiccough returned. Re- membering what be had read of the action of pilocarpine upon the phrenic nerves and of the vomiting which often follows its use, he injected two-fifths of a grain of pilocarpine under the skin. The effect vas almost instantancous. A quarter of an hour after the injection the patient was covered with sweat, salivation was established, and the hiccougli h-ad definitely ceased.-London JMfed. Record, Oct. 15, 1878. REMOVAL OF MOLES UPON THE FACE. Dr. Llewlen Thomas advises (British 3edical Journal) the use of the acid nitrate of mercury for the removal of moles upon the face. No pain attends the application, if care be takento prevent touching the surrounding skin. The growth gradually shrivels away; the slough falls off in about a week, leaving only a very faint depression like a very indistinct emall-pox mark. THE CANADA MEDICAL RECORD, fficoni)IE iuritl of Werbirtíne Et 3)rã EIDITZOR: : FRANCIS W. CAMPBELL, M.A., M.D.L.R..., LOND. SUBSCRIPTION TWO DOLLARS PER ANNUM. All communications and Exchanges must be addressed to the Editor, frawer 356, Post Ogice, Miontreal. MONTREAL, JANUARY, 1878. TO SUBSCRIBERS. Please look at your address labels. If you are in arrears, and the dates will show, please remit at once. THE SPECIMEN COPY NUISANCE. We had thought that the remarks which appeared about a year ago in a number of medical journals throughout the country, our own included, had struck a death-blow at this contemptible swindle. It seemed so,for atleast a time we did not receive the usual postal card, written in the usual complimentary style; but a revival is again coming around; if crushed they bave not been killed. During the past month we have received six such requests for specimen'copies, and, what is somewhat singu- lar, is the fact that two of these have been from places where about a year ago we received similar requests. The handwriting of the cards is identical with that received a year or so ago, although the names signed are different. We send ,specinen copies only on receipt of twenty cents. CANADA VINE GROWERS' ASSOCIATION. Messre. McGibbon \u0026 Baird, of Montreai, keep the Wines of Canada Vine G rowers' Association for sale, cither in wood or bottle. WOMEN'S HOSPITAL, MONTREAL. We direct the attention of our readers to the advertisement of this institution, which bas now been in operation some five years. It contains a general department for diseases peculiar to women, and a ]ying-in departnent, where patients can receive every attention. Poor patients are received from a distance, at a purely nominal figure, while private rooms and attendance can be had at rates according to ac- commodation and attendance. Applications to directed to the Matron. 105",
         "106 THE CANADA ME PERSONAL. Dr. George F. Slack bas resigned bis position as one of the attending physicians to the Mon- treal Dispensary. Dr. Alexander Blackader bas been electcd as one of the attending physicians to the Mon- treal Dispensary, in place of Dr. Slack resigned. Dr. Bergin, M.P. for Cornwall, Ont., delivered an address before the St. Patrick's Society of Montreal. The address was worthy of the doctor's reputation as an orator, and was patriotie both as regards Ireland and Canada. Dr. A. Lapthorn Smith, (M.D., Laval Uni- versity), bas commenced practice in Montreal, Dr. Smith is a son of the respected Deputy Minister of Marine and Fisheries. Dr. Tunstall, (M.D., McGill University, 1875, and gold medallist), has commenced practice in Montreal. OBITUARY. Among our obituary notices will be found the name of Dr. iHierbert C. Fuller, who died in Montreal on the lOth day of January. Dr. Fuller was a brother of Dr. William Fuller, who, for many years, was so well and s, favorably known in our city, and who only left us a few nonths ago to take up bis abode in the West. Dr. Herbert C. Fuller began his studios at McGill University, but passed bis last two years at Bishop's University, at which ho graduated in the Spring of 1878, baving during bis atten- dance at this school filled most acceptably the position of Curator of the Museum. Ie was distinguished for bis love of, and special adaptedness for, the study ofAnatomy, in which branch of modical science ho promised to take a most distinguished position had bis life been spared. A year before bo graduated, however, phthisis began to develope itself and, although he nanfully fought against his malady, ho finally succumbed. Ris fellow-studonts will mourn bis early decease. Dr. Thomas Edward Hayes, whose name is also among our obituary notices, died in Ireland in November. He vas possessed of several Irish medical qualifications, occupying for some seven or eight years the position of Resident Surgeon to the Richmond Lunatie Asylum, Dublin. He came to Canada some threo years DICAL RECORD. ago, and, after attending Bishop's University for a session, graduated in the spring of 1877, Although, from bis physical conformation, almost the last person in whom the develop. ment of phthisical disease would be looked for, ho was predisposed to it from bis family his tory. About eighteen months ago he was pros trated by an attack of bmoptysis, and the disease made rapid progress. Last summer ne left bis family in Montreal and took a trp across the Atlantic, in the hope of receiving 5 benefit. He had bardly reached the other side when he was again prostrated, and, although he rallied to some extent, he was never able to re-cross the Atlantic. Although he died away from bis family, bis last moments vere soothed by the kind attention and warm devotion of a sister. EXTRACT OF MALT. Testimony as to the value of this medicinal agent is being steadily and increasingly brouglt to our notice in the European and American press. Nie. meyer, Oppolzer, Werber, Bock, Hoppe-Seyler, Heinerdinger, Juergensen, Shroder and Ziem sen, in Germany; Trousseau, Gosselin, Hardy, Mauduit and Pillois in France ; Ramagalia, Testa and Tar- taglia, in Italy; Aitken, Anstie, Richardson, Chambers and Thompson, in England, are among the forcign writers who speak in favorable terms of its use. In America the testimony is to the same effect. In Canada, where its introduction is of comparatively recent date, it has grown so rapidlyin favor that there are few practitioners-in this'vii- nity ,t lcast-who do not regularly prescribe it. The range of its application is so wide that abundant 1 opportun ities present tbemselves for every one to de- termine its merits. It is officinal in Germany, where it is fixed in the front rank of therapeutic agents. Dr. Niemeyer says: \" The class of diseases in whiclh the chief, if indeed not the only, task of the physician is to maintain or restore the strength and nutrition of the patient is very large. For several years past, to neet these indications, instead of prescribing Cod Liver Oil, which I was formerly .i the habit of doing, I have employed, almost exclu- sively, Malt Extract, and with the very best effet.\" According to Prof. Douglas, 1000 parts of the Trommer Extract of Malt (which is the standard. American preparation) contains: Malt sugar, 461; dextrine, hop bitter, extractive matr, 23.6; dias",
         "tase, 2.469;- ash-phosphates, 1.712 ; alkalies, .377; teemed. Address: P. O. Box 724, Montreal. He water, 25.7. In comparing the above analysis will also be glad to answer any enquiries, and ith that of the Extract of Malt of the Germýan to furnish samples on application. pharmacopoeia, as given by Hager, he finds it to substantially agree with that article. IMalt Extract, with its combinations, has been re- CURRENT LETERATURE. commended and deserves a trial in the following New Books published in Decenber, 1878. diseases : anomeia, chlorosis, marasmus, dyspepsia, neuralgia, insomnia, pulmonary and bronchial affections, dysentery, constipation, serofula, con- Posture, The Influence of, on Women in Gynecie -valescence from exhausting diseases, etc. We give and Obstetric Practice J. H. Aveling, M.D. 111 the formulx of the various combinations prepared 8vo, 182 pp., $2. Lindsay \u0026 Blakiston by the Trommer Extract of Malt Company, whose Progressive Locomotor Ataxia, Diagnosis of. E. C high standing is sufficient endorsement of their Segain, MM. Svo, 25 pp., sewed, 25c. guarantee as to the prime quality and absolute reli- G. P. Putnam's Sons ability of their preparations:- Pumonary Cosumption, The Treatment of, b Ext. of Malt with flops, (Plain,) Jlygiene, Climate, and Medicine. James Renrj Each Tablespoonful contains- lops. .......................................... 6 grains. ]kt. of .M alt (Ferrated,) $2.50. Lindsay \u0026 Blaldston Each Tablespoonlul contains- Pyrophosphate of Iron.................... .... 4 grains. 31ontin ISKt. of Malt with Cod Liver Oil, Sctions for the Microscope. Dr. Sylveste Each Tablespoonftul contains- Extract of ialt.................'''''rt Cod Liver 0i .....................Equal parLinsay \u0026 Blaston Ext. of Malt with Cod Liver Oil and Iodide of Commoncing with the first of 1879, the Archive Iron. Each Tablespoonful contains- of Dermatology will bepublished by J. B. Lip Extract of Malt ..........,....... Codtract 01 Mat................. Equal parts. ict \u0026 Co., ofPiaephia. The editorshil Cod Liver Oil................................ pincEqualf parts. lodide of Iron .. .....,............ .... .... 1 grain. lodie o ho.................1 gain will be unaltered, but we understand that th( Ext. of Malt with Cod Liver Oil and Phosphorus. Each Tabiespoonful contains- Extract of Malt ................... .. i n Cod Liver 01..,.................... Equal Parts. every repu Phosphorus ................................ 1-100 grain. t tion. Ext. of Malt with Pepsin, Each Tablespoonful contains- Pepsin.......... ..................61 grains. Hydrochloric Acid................. .......2à minims. Ext. of Malt with Alteratives. the series o? Illustrated lymns in course c Each Tablespoonful contains- Chloride of Calcium ........................ 10 grains. the well-known IPotassium .................... c f \" Magnesium...................5 lodide \" Calcium........................... e \" Iron ...............................b Bromide\" Sodium............................2 \" my God to ice, \" and \"Rock of Ages Ext. of Malt with Hypophosphites.e tt Each Tablespoonful contains- Hlypophosphite of Lime ..... .. ... ............. . 2 grains. Iiyopospî od .Lim ...................2 rins of Christian harmony, these exquisite hymn \" \"Soda.................... 1 \" \" Potassa ..................... 1 ac \"( \" Iron ...................... 1 Ext. of Malt with Citrate of Iron and Qui.nia. they are, by illustrations which, to quote fro Each Tablespoonful contains- Citrate of Iron and Quinia..................... 4 grains. ontemporary, spirit prayer. Ext. of Malt with Iodides. For sale by Dawson Bros. Each Tablespoonful contains- lodide ofManganese.... ................. 1 grain. C IlIron........................ .. 1 C Gibson, agent for tc Trommer Extract of MEDICAL ALUMINI ASSOCIATION 0F THE 1NIVED Malt Company, is at present visiting tc Physicians SITY 0F ISIIOPS COLLenGE. in the cities ofa this Province, and we have no At the last regular meeting, hgld Januar doubt will be cordially received. 1e is desirous of P9th, Mr. eson read a paper on osAntisepti securing reports frou physiciaPs of their experience Surgery Athe next meeting, to be held Feb r e f r y s S . - 1- in the use of these preparations, and requests us to ruary 3rd, Mr. Houston bas promised to give a say that such courtesy would be very highly es- paper on \"Gon6rrhoeal Rheumatism,\" and DPr. M0 THE CANADA MEDICAL RECORD.",
         "108 IÈÉ CANADA 2jEDICAL RECORD, Wolfred NKelson one on \"Purpura Hemorr- GURIQUS, IF TRUE. hagica.\" The following officers wee 'elected The Chicago lLedic£l Timea (Eol e for the ensuing ycar: Presiden Dr. Wm. 3Mac- narvelous case of a woman who Iived lour Yea! donald, Montreal, re-clected ; lst Vice-President and three montbs without the Ieast diseharge from Dr. Wolfred Nelson, Montréal; 2nd Vice-Presi, the bowels. The urine was evacuated by t« y à dent, Dr. J. T. Davis, Amsterdam, British Guiana; 3rd Vice-President, Dr. Wm. Young, Hong Kong, China; 4th Vice-President, Dr. Lanouette, Gentilly, Que., re-elected. Council, Dr. Graveley, Cornwall, Ont.; Dr. Costigan, In- dianopolis, Ind., U. S., and Dr. A. Kerry, Mon- treal. Honorary Treasurer, Dr. Iart, Bedford, Que., re-elected. Sccretary, Dr. C. A. Wood, IMontreal. It was moved and seconded, and unanimously resolved that, \"b aving learned with the deep- est regret of the death of three members of this Association, viz., Dr. H. N. Curtis, of Dunham, Que., Dr. T. E. Hayes, of Montreal, and Dr. H. C. Fuller, of Point St. Charles, we desire to place on record our deep sense of the loss that we, and the profession generally, have sus- tained thereby, and to express our heartfelt sympathy with the bereaved families; and be it further resolved, that a copy of this reso- lution be forwarded to the wives of the de- ceased, and to the public press. C. A. WOOD, M.D., Secretary. catheter, but sometimes ouly once in three week She took nourishment, but voinited afterward. post-norten. PHTHISIS IN AUSTRALIA. A valuable report bas been issued by committee of the Medical Society of Victori It winds up with the following conclusin based upon carefully collated data. lst. The mortality froin phthisis in Victorid is little more than balf of that in Engiand. 2nd. The rate of mortality from phthisisit Victoria has been perceptibly less of late year. ý 3rd. That rate is especially low among per, sons under 15 or 20 years of age, and bas beet very greatly reduced between 1861 and 1871. 4th. The reduction of the mortality amog, young persons is to be explained by a compar tive immunity among those born in the colony 5th. The apparent increase of mortality amog'3 young adults is due to the influx of phthisicel persons from abroad. 6th~UU The unif mit in h a Ufal LUNATIO ASYLUMS IN THE PROVINCE OF over the whole colony for a good many yeaa QUEBEC. QUEBEC.is owing te certain insanitary conditioins opera To the Editor of T HE CANADA MEDICAL RECORD. ting especially in. Melbourne, since for the ref DEAR SIR,-Your readers being very inter- of the colony the rate vas reduced by abou ested parties as to the mode of procedure to one-third between 1861 and 1871. obtain orders for the admission of patients into either of these Asylums, I beg to inform them that, by virtue of an Order in Council, passed BIRTHS. in the mronth of November, 1878, at the In Barrie, on the 18th December, the wife of Dr. Olive suggestion of the Honorable Provincial Secre- of a son. tary, Mr. Marchand, under no circunstances At Galt, on the 22nd November, the wife of D whatever can any non-paying patient be admit- Sylvester cf a daughter. ted inte either of these asylums without a At Toronto, on the SOth November, the wife of I. E Cameron, M.B., of a son. Government order, and this order can only be At Hawksville, on the 12th December, the wife i obtained by making an application for it to the Dr. T. W. Vardon of a daughter. Honorable Provincial Secretary, Quebcc. When At Montreal, on the 21st of January, the wife cf of application is made to him, the applicant at Molson, M.D., of a daughter. once receives all necessary information. DIED. Truly yours, At Montreal, on the loth of January, Herbert 00?p H. HoWARD, M.D., Fuller, C.M., M.D. Governient Medical Attendant, Lunatie Asyluma, At Annagarra House, Ballin1anders, Knooklong, le5 Longue Point, (P. Q.) B lontreal 26 Berri Street, Dublin, Ireland, en the 29th November, 1878, Thomas December 24, 1878. ward Hayes, C.M., M.D., of Montreal, aged 4L. p",
         "THE CANADA MEDICAL RECORD. l\u003e A. H. KOLLXYER, M.A., M.D, Editor. MONTREAL, Jan. 16, 1879. To the Editor MEDICAL RECoRD. May I draw your attention to the fact that, not- withstanding the British PharmacoSoia is the sole authority in this Dominion for naking tinctures, extracts, pills and all other pharmaceutical prepara- tions, the students and graduates of the French School of Medicine in Montreal do not seem to know the book, and nany of them (most of theini) have never seen it. This seems very strange, and is a great injustice donc to these students, for how can tbey intelligently prescribe medicine if they do not know the formula by which it is made ? A physi- cian, graduate of this school, who keeps a drug store, applied to me for a preparation, saying he could rot find mention of it any where. I asked him if he had looked into the British Pharmacopæia, and he admitted he did not possess the book, but had re- ferred to the U. S. Dispensatory, 13th edition. and to the Matière Medicale des Sours de la Providence. Now the 4 additions \" to the British Pharmacopia, publisbed since le 13th edition of the i. S. Dis- pensatory and the Nuns' book, he had never heard of. Now, sir, I am quite willing to grant a great deal to national sentiment, but national sentiment wont go far towards building up a practice, espe- cially if these young mon emigrate to Ontario, and request the druggists there to refer to the \" Matière Medicale des Soeurs de la Providence.\" Yours truly, \" CANADIAN.\" MILK AS A PREVENTIVE OF WHITE LEAD POISONING. - A singular fact is given in the Journal de Médecine of the effect of the habitual use of milk in white lead works. In some Prench lead mills it was observed that in a large working population two men who drank nuch milk daily were not affected by lead. On the general use of milk throughout the works the colie vanished entircly. Each opera- tive was given enough extra pay to buy a quart of milk a day. From 1868 to 1871 no cases of colic h ad occurred.-Sanitary Record. IRULES FOR LIVING.-The Burlington Hack- eye gives the following directions to chose who desire to live a long life. They are compiled from eleven different health journals, hence we ean cheerfully commend them : 1. Rise with the sun. 2. Never rise before seven o'clock, 3. Drink a glass of cold water before breakfast. 4. Never drink until you are through eating. 5. Eat nothing but Graham bread and vegeta- bles. 6. Eat plenty of roast beef and mutton well done. 7. Bathe every day. 8. Never bathe oftener than twice a week. 9. Always sleep in a cold room. 10. Never sleep in a. room with the temperature lower than 45 degrees. 11. -Drink nothing but water. 12. Drink nothing but milk. OXIDE OF 'IN is recommended as a specifie for the tremor of chronic alcoholism.-Cincin- nati Lancet. NEw PHYSIOLOGICAL PROPERTY OF STRYOE- NIA.-It iS asserted that strychnia, by increasing the arterial pressure, increases the secretion of the maimmary glands in sone cases as much as fifteen-fold .-Druggists' Circular. EXTRACT OF PIMENTO AS A REVULSIVE. (DR. ED. CoUTURlER.)-Ih cases where the persistent and blistering properties of cantharides would produce too great an effect, and where the ordi- nary rubefacients, as tartar eietic, croton oi, and thapsia, are not active enough, the extract of pimento may be used, which produces in- tense rubefaction within tern to thirty minutes, Particular care must be taken to clean the hands after handling it, so as not to get any into the eyes, nose, or mouth PDIENTO AS A REVULsIVE.-To the list of revulsives and local irritants, M. Lardy adds the extract of pimento. The color of the ex- tract, like that of the fruit, is a beautiful red. By being incorporated witb a plaster, it may be spread upon cloth or paper, and adheres to the surface of the skin without warming. It acts rapidly, ten to twenty minutes being the usual limit, according to the point of applica- tion and sensitiveness of the skin. From the outset it causes heat, redness and slight smart- ing. These phenomena increase in degree for about three hours, and then remain stationary. Neither the heat nor snarting are painful, and do not hinder the patient continuing his occupa- tion. Tbere is no itching, and the effect re. mains localized. Conpared with mustard, it is of about half the strength of the latter. EsSENTIAL OLs.-Tunis is justly celebrated for its essences, such as ottar of roses, jasmine, cassie, quince, narcissus, henna, aloes, apple, orange, lemon (both acid and sweet), scented poplar, sambak, or double jasinine of Arabia. These ottars arc held in great esteen on account of the delicacy of their perfume, but, owing to their high price, a very siall quantity is export- ed, and they only serve for local consumption. The price per metical (4ï grains) of these ottars or essences is-roses, cassie, henna, quince, 9s. 7d., for jasmine, £1, double jasmine, 31s. 8d., or- ange and lemon, 4s. 9-d. A very large quan- tity of rose, orange flower water, and nmut water is likewise distilled, with which the natives per- fume their sherbets and sveetmeats. ADULTERATION OF CREAM oF TARTAR.--Dr. Squibb, of Brooklyn, at a recent society meet- ing, gave some interesting statisties as to his experiments on the purity of this drug, in which he had found samples as offered for sale to vary",
         "110 THE CANADA MEDICAL RECORD. from 10 to 12 per cent. of pure cream tartar, the adulterations consisting of tartrate of lime and terra alba. He also told how one could go to stores in New York, where he would be taken into a room in which a sample table is set with different grades of terra alba. One, you are told, will make a beautiful, brigbt cream tartar, another a dull one, and so on, from one end of the table to the other, each having a particular use.-Med. and Burg. Rep. CASTOR 01 BEANs are now grown as a crop in the United States. In one western county alone 2,773 acres were laid down in it last year, the average crop being 12 to 15 bushels per acre. A bushel of good seed is said to yield there about 2½- gallons of oil. A NEw STIMULANT.-The Britith Medical Journal gives a long account of a new stimulant whicb bas lately been described by the papers of Australia. It is called piteherine by the natives, and is used by then as we use tobacco, both for smoking and chewing. Its effect is that of a pleasant exhilaration; when long con- tinued, intense and continuous excitement fol- lows. It is used when on long foot journeys to' invigorate and keep up the strength, or excite them to courage in battie; large doses are said to infuriate all the passions. Some of the natives make a plaster of the plant and place it back of the ears, believing tbey are influenced by it. THE KoRONIco PLANT.-John Arthur Fran- eis indorses statements recently made in an English journal with regard to the value of the koronico plant of New Zealand (a species of - broom) as an astringent, and the value of its employment in appropriate cases of diarrhea. He says that it is an old and well-known remedy among the Maories and up-country shepherds, especially for intestinal disturbances arising from drinking stagnant swamp-water in dry seasons. The usual mode of using it is by mak- ing a strong infusion of the young leaves. ENGLIsH EARTH is the name given in America to terra alba or plaster of Paris, of which, accord- ing to an exchange, \"tons upon tons are im- ported for the express purpose of adulterating white powders of various kinds, notably cream of tartar.\" THE EUCALYPTUS IN ALGERIA.-Consul-Ge . eral Playfair writes: \" Formerly it was impos sible for the workmen at the great iron mines of Moklta-el-Iadid to remain there during the surn. mer; those v ho attempted to do so died, and, the company was obliged to take the laborerstoj and from the jamines every morning and eveningj 33 kilos each way. From 1868 to 1870 the company planted more than 100,000 Eucalyptsi trees, and now the workmen are able to live all the year through at the scone of their labors. POISONING 3Y SALICYLLC ACID.-A case is' reported from Wreschcn, in Prassia, where à patient suffering from acute rheumatism was poisoned by impure and partially decomposdi salicylic acid. After the first dose of aboutlij grains le began to perspire very freely; tho perspiration inerased with two more suceed] ing doses, and after the fourth dose violent head ache and vomiting supervened, followed by cona and death.-Vew Remedies. IOMEoPATI1 CURE FOR THE OPIUM HABIT- Dr. J. H. Haynes, M.D., of Pittsburg, Pa., has published his method of cure in the AmeriM Homœopatlist, in an article reprinted in the 3/onthly Jfomœoopathic Review. The case, givea in details is of a woman who had taken morphil for fifteen years, during the last five of which her daily dose had been two grains. ler treat- ment was as follows: Morphine was strictly forbidden. Ipecac tincture, 30 m., vas mixed with one-half glass of water, and a teaspoonful was ordered to be taken every hour, or less fre. quently if it should nauseate. Three days after the commencement of the treatment the patient would bardly take morphia, even ifallowed, and since that time, now five years ago, the desin for it bas never once roturned. Dr. Iuaynes says that he has treated forty cases in the sara way, giving 1-5 for each grain of morphine, or its equivalent of opiun in the daily dose. la two cases only bas he failed, in both of which his patients continued to take the drug secretll while under treatment. TEMPERATURE oF FLAMEs.-F. Rosetti finds the temperatures of the flame of the Bunsenl, burner to b: In the external envelope, 1,350°; in the violet portion, 1,250°; in the bie, 1,200e. ADULTERATED SoDA.-Mr. J. Il. Swindells .MATE AS A SUBSTITUTE FoR TEA AND CoFFEE.- writes to the Chiemical News to say that ho bas Mr. O'Oonor, of the British Legation in Brazi found all the samples of Scotch or bastard soda calls attention, in a recent official report, to yer- or washing soda which he has examined to be ba maté, an article largely cultivated in tha nothing more than sulphate of soda. province of Parana, and exported to neighbor- ing South American countries, but hitherto not EssENCE LEMrINE-Watchmakers' oil- is on the list of exports. Ie says it is more made by distilling from a water bath a mixture fortifying and alimentary than either tea or of 200 parts coal-tar benzin, 10 parts lavender coffee, and much more wholesome, antd can be oil, 5 parts bergamot oil. It must be carefully sold at a price so moderato as to place it withW protected from air and sun-light. Our watch. the reach of all classes. He states that the makers use the benzine of commerce.-llager. Minister of Agriculture has appropriatedti",
         "THE CANADA MEDIÔAL RECORD. small sum for the purpose of mraking this ex- cellent plant known in Europe. SULPHUR ihas been discovered in immense quantities at Chillan, Chili. The quality is so fine that it only needs grinding and sifting to be fit for market. TnE MAsSACHUSETTs COLLEGE OF PIARMAY has moved into the \"Old Franklin School House,\" on Washington Street, near Dover, in Boston, where its usual winter course has already opened under favorable auspices. The library and laboratory possessed by the sohool are among the best in the country, and the graded two years course, with corpulsory and free laboratory instruction, are among the features which commènd this school te students. THE PITTSBURG COLLEGE OF PIAR31ACY enter- ed upon its first session on the 1st inst., with Francis C. Phillips as Professor of Chemistry ; W. O. Reiter, M.D., as Professor of iMateria Medica and Botany; and S. Henry Stevens, M.D., as Professer of Pharmacy. Six lectures weekly for 20 weeks will constitute the course. A. J. Rankin is Corresponding Secretary, aid may be addressed at the corner of Fourth and Ferry Streets.-.New Renedies. TRIMETH1YLAMIA or Pseudo-propylamia is now man ufactured in large quantities from beet-root mash. The dealers in chemicals in Europe sell tle article promiscuously under the names Propylandne or Trimethylamine. NITRITE OF A31YL IN SEA-SICKNEss.-Dr. Crochley Clapham, of Surbiton, has recommend- ed in the Laitett the inhalation of nitrate of amyl as a proventive of sea-sickness. He re- commends some capsules containing the drug manufactur'ed by Allen \u0026 Han bury, une of which can be broken as rcquired. A handkerchief is moistened with the liquid, and applied to the mouth and nostrils. Dr. Clapham's experience with this drug has been confirmed by other physicians. The theory is that sea-sickness being due te a pressure of blood on the brain, the nitrite acts by relieving the congestion. LIQUID DENTIFRIE.-A formula is given in our 1877 Diary, thus:- Fine potash soap......... . 3eozs. Cream tartar .................. 1 drachm. Alcohol sp. gr. -910 ..........18 ozs. Distilled perfumed water ... 6 ozs. You can flavor or color this to fancy. To RE31OVE RUST FROM STEEL.-Steel which has rusted can be cleaned by brushing with a paste composed of l oz. cyanide potassium, j oz, Castile soap, 1 oz. hwiting, and water sufficient to form a paste. The steel should first be washed with a solution of . oz. cyanide potas- siunm in 2 ozs. water. To preservo steel from rusting, a good method is to paint it with melted caoutchouc, to which some oil Las been added. The caoutchouc must be melted in a close vessel, te prevent its burning, and should be frequent- ly stirred. It is aiso said that dipping the steel in a solution of common soda (about 1 in 4\u003e will preserve it froin rusting, GOLD SoLUTIoN.-To a drachm of solution of torchloride of gold add two ounces of ether, and shako together. Polished steel articles im- morsed in this elear liquor will become covored with a thin filin of gold. POSTAGE-STAMP MUCILAoE.-ThO following is said to be the formula for the mucilage used on the United States postage stamps:- Dextrine ........................ 2 ounces. Acetie acid ...................... 1 ounce. W ater ............................ 5 ounces. Alcohol ......................... 1 ounce. Add the alcohol te the other ingredients, when the dextrine is complotely dissolved. MILK A SOLVUINT OF QUININE.-Attention bas- recently been called to the fact, not generally known, that milk not only acts as a solvent of quinine, but also to a certain extent disguises its bitterness. It is stated that if one grain of the sulphate be dissolved in an ounce of milk, the bitterness of the sait is scarcely perceptible, while even two grains of the same quantity of solvent do not inake it bitter to a marked de- grec. Five grains nay be taken in two ounces of milk without rendering it particularly dis- agreeable, and if this be added to a tumblerful of milk, nearly ail the bitterness disappears. The resident surgeon of the Birmingham Gene. ral Dispensary recommends the use of a solution of quinine, in glycerine, in the proportion of one grain to one drachm, the dose being admin- istered in a wine-glassfual of milk. The method, would seem to present special advantages in the administration of quinine to children.-Nw Renedics. The Mledical Times tells a humorous story of the late Sir Charles Locock, as an evidence of his powers of repartee. His great repute had induced certain vendors of quack medicine to advertise cough lozenges under the title of Locock's Pulmonie Wafers,\" or \" Locock's Cough Lozenges.\" This, of course, caused him some annoyance. One morning he met the Duke of Wellington in Hyde Park, who said, \"Locock, I have a bad headache from taking your damned lozenges.\" \"Well,\" said Sir Charles, \"I might as well say that I am lamed by wearing your damned boots, for I wear Wellington boots.\" We may add that there are gentlemen in London quite prepared to supply anecdotes of this kind at a moderate price per score. To MAKE DREssEs INCOMBUSTIBLE.-A serious. accident in a factory led one of the owners to experiment as to the cheapest and best sub- Ilit",
         "112 THE CANADA MEDICAL RECORD -stances for making dresses incombustible. He found that a 5-per-cent solution of animonium phosphate accomplished this purpose. ONE FOR THE DoCToRs.-The following bon-mot is of Frencli origin. A lady in delicate health asks a cynical friend whether she shall consult an allopa- thie or homoopathie practitioner. \" It matters but little,\" is the reply. \" The first will kill you, the second Vill let you die.\" HoroeROPATrInc TREATMi ENT oF TAPE-WORM.- Every one is acquainted with the fact that a snalke is charmcd by the sound of soft inusie; but it remained for a German homoeopath to discover that the tape-worm is susceptible of the -same influence. So, at least, we are informed by our contemporary, the Vienna Medical Press. The inferior orifice of the patient's intestinal ,canal is placed in communication with a music- al box, which is set a-playing. \" We have not, long to wait,\" the honieopathic doctor naively remarks. The tape-worm quickly makes his appearance head forenost, and winds himself along the connecting link toward the instru- ment. The latter is soon embraced in its turn, d the cure complete, for the parasite has, so to say, abstracted himself. -Jedical Examiner. CROTON OIL PENCIL.-For the local applica- tion of croton oil, M. Limousin recommends, (Répert de Pharm., 1877) the use of pencils made according to the following formula :-Two parts of croton oil are added to one of cacao butter and one of white wax, melted over the water- bath. When the mixture begins to cool, it is poured into cylindrical noulds, in which it soon solidifies. Althongh the pencil only contains 50 per cent. of oil, yet, owing to the avoidance -of all loss through volatilisation, the revulsive action of the drug is found to be even more powerful in this form than in its natural condi- tion, and it bas been successfully employed with the view of obtaining this action by Dr. Jules .Simon, at the Hopitals des Enfants Malades. Dr. Failler has used these pencils in the treat- ment of tinca tonsurans. The pencils retain their properties for several months. Shampoo Lather.-Cut 2 lbs. best oil-soap into dice; place thcm in an earthen pot with water and a little crystallized soda. Boil over a slow fire. After skimming, the soapy mass may be perfumed and colored to suit the-ideas and taste of those concerned.- The Perfumer's and Blairdresser's Gazette. FATAL EXPLOSION OF AN OXYGEN RETORT.- On Oct. 16 Mr. Edward John Wrench, son of Mr. Wrench, the well-known optician, of Holborn, was engaged in making oxygen at his residence, in 39 Gray's Inn Road, when the retort exploded, smash- ing the fire-grate, blowing the windows out of the sashes, and filling the rooms with dense smoke. Mr. Wrench was fearfully injured ; he had sustained a -cut 6 inches long in the chest, which exposed the lungs, and a jagged wound on the left side of th neck, exposing the muscles and veins. Mr. Regin ald Taylor, surgeon, was called in, but the suffereî died within half-an-hour from collapse and hemoi- rhage. Mrs. Elizabeth Gibson was also fearfully burned about the face. The details given in thé publie reports do not account for the explosion. I does not, however, stand alone. At least two other fatal explosions have occurred, within recent years, duritg the manufacture of oxygen. In both cf these binoxide of manganese was used as the source of the gas, and it was afterwards discovered tha the oxide was adultcrated in one case with soot, and in the ofher with autimony sulphide. Thee mixtures are as dangerous as gunpowder when placed under the conditions required for the manu- facture of oxygen, and it is always wise to test be- forehand the material about to be used. INCOMPATIBILITY OF CALOMEL WITH CERTAIN BRoMIDEs.- Mr. Norman A. Kuhn bas. studied' the action of calomel with the bromides of potas- sium, sodium, ammonium, and zinc, and finds tha, a portion of the calomel is converted into a soluble mercuric salt, a considerable portion of the calomel;' under sonie circumstances, being ths changed This new-fornied sait is poisonous, a kitten liaving been killed by sorte of it in the course cf an heur, and a half. \" A SHORT CUT TO THE TINCTURES OF THE BRITIsH PHARMACOPæIA.\"-By Ilenry Judd. , mnemonic, showing how an accurate knowledge; of the proportion, preparation, time, dose, \u0026c.11 of the sixty-eight tinctures may be easily and permanently remembered in two hours. Lon- don: Printed for the Author. Price one shil ling. We can add nothing to the title; the mnemonic for tint. cinchonæ co. is a sample of the treatment the tinctures undergo:- Six ingredients, yon must know, Make the tinct. .cinchone co.; Serpetary, bark, and peel, Spirit, saffron, cochineal. All rights are reserved,\" so that we must \" quote no more.\"-(Chemist and Druggist.) A very curious case is reported from Spalding. A firma of chemists being suammoned for not fully entering into the \" Poison-book a sale of vermin killer, the date of sale (it was alleged) having beeni omitted. the solicitor for the defence contended withl much skilful argument that the chemists were not, required to produce their books. The law, he said required them to make the entry, but they mightj destroy the sanie the next minute if they so pleased. Tie magistrates were evidently fogged, and they consequently faced both ways-over-ruling the soql citor's objections, but dismissing the summons.-7 Chemist and Druggist. ENGLIsH PATENT WASIIING CRYSTALS.-S parts soluble glass, 29 parts anhydrous washung soda, 60 parts bicarbonate of soda, 5 parts water.-'y Biager. The capital of Turkey is like a whimsical patieut because it's coistant-to-no-pill.-Ex."
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      "label" : "Dominion of Canada quarantine regulations : by Order in Council dated 20th June, 1893, in virtue of Chapter 68, Revised Statutes, intituled\"An act respecting quarantine\"",
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         "Rev. ed.",
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         "\"Printed by order of the Minister of Agriculture.\"",
         "14 p. ; 22 cm."
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         "Quarantine -- Law and legislation -- Canada.",
         "Public health laws -- Canada.",
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming are checked below. Coloured covers/ Couverture de couleur D Covers damaged / Couverture endommagée O Covers restored and/or laminated I Couverture restaurée et/ou pelliculée Cover title missing / Le titre de couverture manque Coloured maps / Cartes géographiques en couleur C Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) C Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents D Only edition available / Seule édition disponible D Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from filming / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exem- plaire qui sont peut-être uniques du point de vue bibli- ographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la métho- de normale de filmage sont indiqués ci-dessous. Coloured pages! Pages de couleur Pages damaged I Pages endommagées D Pages restored and/or laminated / Pages restaurées et/ou pelliculées ' Pages discoloured, stained or foxed / Pages décolorées, tachetées ou piquées w-- Pages detached / Pages détachées Showthrough / Transparence Quality of print varies/ Qualité inégale de l'impression D Includes supplementary material I Comprend du matériel supplémentaire D Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image / Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. D Opposing pages with varying colouration or discolourations are filmed twice to ensure the best possible image / Les pages s'opposant ayant des colorations variables ou des décolorations sont filmées deux fois afin d'obtenir la meilleure image possible. D Additional comments / Commentaires supplémentaires: This item is filmed at the reduction ratio checked below / Ce document est filmé au taux de réduction indiqué ci-dessous. lOx 14x 18x 22x 26x 30x 12x 16x 20x 24x 28x 32x",
         "DOMINION OF CANADA. QUARANTINE REGULATIONS, BY ORDER IN COUNCIL DATED 20TH JUNE, 1893, IN VIRTUE OF CHIAPTER 68, REVISED STATUTES, INTITULED AN ACT RESPECTING QUARANTINE.\" PRIATED BY ORDER OF THE MINISTER OF AGRICULTURE. (REVISED EDITION.) OTTAWA PRINTED BY S. E. DAWSON, PRINTER TO THE QUEEN'S MOST EXCELLENT MAJESTY 1893",
         "DOMINION OF CANADA. QUARANTINE REGULATIONS, BY ORDER IN COUNCIL DATED 2OTH JUNE, 1893, IN VIRTUE OF CHAPTER 68, REVISED STATUTES, INTITULED AN ACT RESPECTING QUARANTINE.\" PRITED BY ORDER OF THE MINISTER OF AGRICULTURE. (REVISED EDITION.) OTTAWA PRINTED BY S. E. DAWSON, PRINTER TO THE QUEEN'S MOST EXCELLENT MAJESTY 1893",
         "CANADIAN QUARANTINE REGULATIONS. THE QUARANTINE STATIONS. 1. The Quarantine Stations of Canada at the Atlantic Maritime Ports, are:- (a.) Grosse Isle, in the River St. Lawrence, with Rimouski, the Louise Embankment and the Grand Trunk Wharf at Lévis, as sub- stations, province of Quebec; (b.) Halifax, the harbour and Lawlor's Island, in the province of Nova Scotia; (c.) St. John, the harbour and Patridge Island, in the province of New Brunswick; (à.) Sydney, Cape Breton, in the province of Nova Scotia; (e.) -Pictou, in the province of Nova Scotia; (f.) Hawkesbury, in the province of Nova Scotia; (g.) Chatham, in the province of New Brunswick; (h.) Charlottetown, in the province of Prince Edward Island; 2. On the Pacific Coast:- (a.) Williams Head, including Albert Head, in the Strait of Fuca, province of British Columbia, and also including as a sub-station the poirT of Victoria; and, 3. Every other port, on both oceans, at each of wbich the Collector of Customs is the quarantine officer, such port being designated an unorganized quarantine station; * 4. And every inland Customs port on the Canadian frontier, between the Pacifie and Atlantic Oceans, each such port being designated an unorganized inland quarantine station. GENERAL PROVIsIONs. 5. Every quarantine officer at a quarantine station in Canada, and every customs collector in his quality of quar~antine officer, shall for the purpose of these regulations be ajustice of the peace in virtue of the provisions of Sec. 5 of the Act respecting Quarantine, Chap. 68, Revised Statutes. 6. Within the meaning of these regulations an infected port or country is a port or country where Asiatic cholera or other epidemie disease bas been communicated to one or more persons through the medium of an infected person, personal effects or otherwise. A poi-t or country is not considered infected when a single case or a small number of cases has been imported and the disease has not been communicated from such cases.",
         "7. Any of Her Majesty's ships of war or any transport having the Queen's troops on board, accompanied by a medical officer, and in a healthy state, is exempt from quarantine inspection and detention. 8. Every vessel from any port outside of Canada requiring qua- rantine inspection shall, on airrival at any port in Canada, display a yellow flag at the fore, for a distinctive quarantine signal, in order to inform the quarantine oflicer that his services are required, and any vessel arriving by night shall display a red light at the fore for such signal. 9. Coasting vessels from Newfoundland and from ports in the United States contignous to Canada and free from infectious disease may, from time to time, be excepted from these regulations by order of the Minister of Agriculture. 10. Every vessel arriving from any port outside of Canada (liable to quarantine) shall be inspected by a duly appointed quarantine officer and shall not be allowed to make customs entry at any port in Canada until it has received a clean bill of health. 11. No person shall be allowed to land from any vessel until such person shall have been declared by a quarantine officer free from infectious disease, and until, in the judgment of such officer, such landing can be effected without danger to the public health. QUARANTINE DETENTION. 12. Every quarantine officer shall satisfy himself as to the presence or absence of infectious disease by the personal inspection of those on board or by the sworn statement of the captain or sur- geon, in the form hereto annexed, or by both; (a.) A vessel may be detained at quarantine for disinfection. during the time necessary for that purpose; (b.) The time during which a vessel may be detained for quaran. tine of observation is the accepted period of the incubation of the disease quarantined against from the ascertained date of last possible exposure. 13. Every vessel with infectious disease on board, or coming f rom an infected port or country. shall be liable to be detained at a qua- rantine station f r disinfection, together with its passengers, crew and pilot, and passengers' luggage and cargo. 14. Any vessel so detained by order of the quarantine officer shall forthwith be anchored or moored in such position as the quarantine officer shall direct. 15. And whilst such ship is so detained no person shall leave the same, nor shall communication be allowed with such vessel, without permission from the quarantine officer. 16. The quarantine officer detaining any ship as aforesaid shall immediately notify the Minister of Agriculture, stating the cause of such detention.",
         "HoURS OF INSPECTION-PUTTING BACI-CoSTS.. 17. Every vessel may be inspected during any hour of the twenty- four.; (a.) With the exception that in times of epidemic the Minister of Agriculture may direct that inspection shall only take place during the hours of daylight. 18. Any vessel shall have the right before breaking bulk to put- to sea in preference to being quarantined, as provided by Section 9 of the Act intitnled \"An Aet respecting Quarantine,\" chap. 68, Revised Statutes. 19. All costs incurred in the maintenance of healthy persons who may have been exposed to infection detained for quarantaine of observation are to be at the charge of the vessel; (a.) And the master of a vessel may make arrangements with the quarantaine officer for the landing of the necessary provisions and attendants or stewards for serving them; (b.) Persons actually sick will be treated and taken care of in the quarantine hospitals, at the charge of the Government; (c.) In the event of a vessel being allowed to proceed and leaving its passengers in quarantine, the subsequent transfer of such pass- engers from quarantine to the port of destination shall be at the charge of the vessel QUARANTINABLE -DISEASES. 20. The graver quarantinable diseases are: Asiatic cholera, small- pox, typhus fever, yellow fever and the plague. The minor: scarlet fever, enteric fever, (typhoid), diphtheria, measles and chicken-pox ; (a.) In addition to the above recital, it is the duty of every quarantine officer to satisfy himself as to the presence or absence of any other contagious or infectious disease; (b.) And with respect to ieprosy it is the duty of every quaran- tine officer, and particularly on the Pacific Coast, to satisfy himself as to the fact of the presence or absence of such disease among the passengers, and in the event of any case of such disease being found the person affected shall not be allowed to land, but must be taken back by the vessel to the place whence be or she came. PILoTs FURNIsH REGUOLATIoNs. 21. It shall be the duty of every pilot to furnish the master of every vessel arriving at any port in Canada with a copy of these regulations under the penalty hereinafter prescribed. RELATING TO VACCINATION. 22. Every passeuger shall be required to furnish evidence to the satisfaction of a quarantine officer of having been vaccinated, or having had the small-pox.",
         "23. The production of a certificate by a ship's surgeon, called \" a protection card,\" and his testimony under oath verifying the truth of such certificate, may be taken by a quarantine officer as evidence of such vaccination and protection. Such quarantine officer shall, however, from time to tiine, make personal examination of holders of such certificates to satisfy himself of the manner in which they have been issued. 24. Any person not baving shown satisfactory evidence of baviing been vaccinated, or of having had small-pox, shall be vaccinated by a quarantine officer ; or in the event of refusal shall be landed at the quarantine station, subject to detention for observation, and the expense of the maintenance of such person during such detention shall be a charge against the vessel; (a.) A vessel arriving at any quarantine station in Canada will be less liable to detention if the vaccination of all steerage passen- gers not showing proof of vaccination within seven years is insisted on beforc embarkation. The ship's surgeon should satisfy himself of such fact in the case of every passenger early during the voyage, or at the lime of embarkation if possible, in order to be able to answer the questions put to him by the quarantine officer. 25. In the event of small-pox having occurred on any vessel every person on board not showing satisfactory evidence of having been vaccinated within 7 previous years, or of' having had the small-pox within that period, shall be vaccinated by or under the supervision of the quarantine officer; or in the event of refusal, shall be landed at the quarantine station, subject to detention for observation, and the expense of maintenance of snch person or persons during such detention shall be a charge against the vessel. EXAMINATION. 26. The quarantine officer shall examine the surgeon or any officer of any vessel, ander oath, touching the state of health of such vessel and of every person on board, in the form of the ques- tions appended to these regulations. ISOLATION. 27. Every vessel provided with an isolated hospital for men, and another for women, on the upper deck, ventilated from above and not by the door only, shall, in the case of minor quarantinable disease, if the quarantine officer is furnished with satisfactory evidence that such hospital accommodation has been promptly and intelligently made use of, be allowed to proceed after the landing of the sick and the disinfection of such hospital as has been used; any vessel, however, arriving with any infectious disease, without having such special isolated and ventilated hospital accommodation, or if having it, without satisfactory evidence tbat it has been promptly and intelligently made use of, shall be liable to be detained for disinfection at a quarantine station.",
         "MAILS AT RIMoUSKI. 28. In the case of a vessel carrying Her Majesty's Mails and arriving by the St. Lawrence, clearance certificate shall be from a quarantine officer at Rimouski or Grosse Isle, and in the case of every other vessel frorn Grosse Isle only; (a.) With the exception that during a time of cholera or other epidemic, the permission to a mail steamer from an infected port or country to land passengers at Rimouski may be suspended by direction of the Minister of Agriculture; (b.) And in such conditions the mails only to be landed at ]Rimouski, the vessel to proceed to Grosse Isle for inspection; (c.) In the event of cholera having occurred on board of such vessel during the voyage, the outer bags containing the mail matter to be left on board the steamship for disinfection at Grosse Isle. DIsINFECTION OF LUGGAGE. 29. Daring a time of cholera epidemic the luggage of immigrants by every vessel arriving by way of the St. Lawrence, not disinfected at Grosse Isle, whetherfrom an infected or healthy port or country, may by direction of the Minister of Agriculture be disinfected at the Louise Embankment, Quebec, with the exception that the luggage of those immigrants booked by the Grand Trunk Railway may be disinfected at the Grand Trunk wharf at Lévis. (a.) The clearance granted by the quarantine officer shall be conditional on the landing of immigrants and their luggage for dis- infection at the Louise embankment or Lévis. (b.) The supervising officer of such disinfection to count the im- migrants as they land, and if he finds the number tallies with that marked on the clearance of the quarantine officer and has satis- factory evidence that ail their luggage has been landed with them, he shall punch the clearance at the place marked for that purpose, which shall then become valid for Customs entry. PASSENGERS CERTIFICATES. 30. Every maritime quarantine officer shall punch each immi- grant \" International passenger certificate \" where such are in use, in such manner as to convey to inland health officers the result of the quarantine inspection, as provided by such card or certificate. (a.) Every maritime quarantine officer shall punch the schedule list of immigrants by destination, Province or State (if destined for the United States) where such is in use, which shall be furnished by the ship's surgeon on forms supplied by the Government, and shall forward such lists forthwith to the Secretary of the Board of Health in the Province or State to which such immigrants are destined.",
         "UNORGANIZED QUARANTINE STATIONS. 31. At every port at which there is no regular quarantine station the Collector of Customs at each port shall be the quarantine officer for the purposes of these regulations; and every such port shall be designated an Unorganized Quarantine Station. 32. Every vessel arriving at an unorganized station from an in- fected port, or on board of which any death from infectious disease or outbreak of infections disease has occurred during the voyage, shal remain outside until it receives permission to enter from the quarantine officer. 33. Al the regulations applicable to regularly organized quaran- tine stations shall also apply to everyunorganized quarantine station in so far as circumstances will admit, and particularly the provisions relating to inspection, anchoring or mooring, disinfecting, customs clearance, putting back to sea before breaking bulk, questions to ship's surgeon or officers, and penalties. 34. In the event of a vessel arriving at an unorganized station -with quarantinable sickness on board, the master shall pay a fee of $4 for each medical inspection ordered by the quarantine officer and such fee or fees must be paid before customs clearance isgranted. (a.) If no sickness is found on board a vessel arriving at an un- organized quarantine station and ordered to be inspected by the quarantine officer, the cost of such inspection shall not be a charge against the vessel, but will be defrayed by the G;overnment. STEAM TUGs. 35. Any steam tug or other vessel which shall have towed or otherwise communicated with any vessel of the class of vessels sub. ject to quarantine or quarantine inspection shall thereby be held to the same regulations and requirements as apply to the vessel com- municated with; (a.) If the communication between the vessel and the steam tug is confined to attachment of a rope, afterwards loosed, the quaran- tine officer may decide to release such tug from quarantine detention. RAGS. 36. Rags coming from a port or country in which infectious disease prevails, shall be prohibited, and the name of any port or country so infected shall, from time to time, be published in the Canada Gazette: (a.) Rags arriving from prohibited ports at a quarantine station shall be liable to be burnt or otherwise treated on the order of the Minister of Agriculture based on a report of the quarantine officer, NEW MERCHANDISE. 37. New merchandise in general may be accepted without ques- tion.",
         "IN TIMES oF EPIDEMICS. 38. Passengers during a period of epidemic disease should be notified by steamship agents to dispense as far as possible with luggage that may be injured by wetting, in case of having to undergo disinfection-such as fabrics, of which the dyes are likely to run, as the owners will be compelled to assume all risks of injury. 39. Vessels during a period of epidemic disease should dispense as far as possible with woollien hangings, curtains, carpets and upholstering, substituting non-absorbingr coverings. 40. Every vessel carrying cargo, and liable to be disinfected, should have provided a plain frame shaft allowing a clear inside space of 12 inches each way, placad in the main hatch, in a sailing vessel; and one in each hatch of a steam-ship, divided by bulkheads. The frame work in this shaft to be set before loading and to extend from the hatchway to the bottom of the vessel. This simple arran- gement would receive the fumigating pipe and avoid shifting cargo. PXsSENGERS. 41. Passengers, for the purpose of these regulations are divided into two classes, cabin and steerage. Steerage passengers are those occupying compartments other than those of first and second cabin. METHoDS oF DIsINFECTIoN. 42. The methods of disinfection at the Quarantine Stations of Canada shall be as follow:- (a.) Exposure to steam not less than 30 minutes, steam to be of the temperature of not less than 100° Centigrade (212° Fahrenheit) nor greater than 1150 Centigrade (239° Fahrenheit) ; (b.) Articles that would be destroyed by the above method to be disinfected by thoroughly wetting with a solution of mercurie chloride, of one part to one théusand, or approximately one drachm to one gallon, wine measure, applied by means of a brush, or by drenching, or by immersion.; (c.) Where sulphur dioxide is used it is to be provided by burning not less than 3 pounds of rolled sulphur per 1000 cubic feet of space, or if it is used in liquid form in the same proportionate strength, and the périod of exposure to be not less than 6 hours. 43. The disinfection of iron vessels shall be as follows, as may be required: (a.) Holds-After mechanical cleansing, the hold to be thoroughly washed with an acid solution of mercuric chloride, 1 to 800 (mercuric chloride 1 part, hydrochloric acid 2 parts, water 800 parts), applied to ail surfaces by means of a hose. If danger is apprehended from the poisonous effects of the mercury deposited on the surfaces, it can be subsequently washed down with clean water;",
         "10 (b.) Steerage-The same treatment should be given the steerage as to the hold, but when there is a steam-pipe provided for each compartment (for the prevention of fire), steam disinfection of the steerage should be practised. The temperature in all parts of each compartment to be not less than 1000 C. (2120 Fahr.); (c.) The forecastle or apartment for crew-After mechanical cleausing the application of mercuric chloride in the manner herein- before prescribed, or sulphurous fumes, or steam disinfection, if facilities are provided for the same; (d.) Officer's quarters, cabin, staterooms, etc.-Each compartment to receive the same treatment, under the same conditions as herein- before specified, it being borne in mind that the decorative metal worlk in cabins, saloons, \u0026c., would be injured by the use of the mercuric chloride solution, and therefore in such cases other forms of disinfection areto be used as determined by theQuarantine Officer. 44. The disinfection of wooden vessels shall be as follows, as may be required:- (a.) Fumigation by sulphur dioxide made by burning not less than 3 pounds of rolled sulphur to each 1,000 cubic feet of space; or by the use of liquid sulphur dioxide in the same proportionate strength; and the period of exposure to be not less than 24 hours. (b.) Washing or flushing with acid solution of mercuric chloride (1 to 800). Cabins, forecastle and other apartments to be thoroughly washed with bichloride solution and all clothing, becding, curtains, etc., to be subjected to steani for 30 minutes at from 1000 C. (212\u003e Fahr.) to 115° C. (239 Fahr.) 45. In all classes of vessels the bilges to be first flushed with sea or river water, pumped out, and then treafed with acid solution of mercuric chloride in large quantity, and allowed to xemain in long contact. UNORGANIZED INLAND QUARANTINE STATIONS. 46. Every inland port on the frontier a Canada between the Atlantic and the Pacific Oceans, at which there is a Collector or a Sub-Collector of Customs shall, for the purpose of these regulations, be constituted un Unorganized Inland Quarantine Station. 47. Every Collector or Sub-Collector of Customs at every such inland frontier port shall be the Quarantine Officer. 48. Any Collector or Sub-Collector of Customs in his quality of quarantine officer at any inland unorganized quarantine station in Canada, if he is informed of or has reason to suspect the presence of any of the graver quarantinable diseases recited in section 20 of these regulations shall, in time of cholera or other epidemic disease, order a medical inspection to be made of the car, carriage, vehicle, boat or thing bringing such disease; (a.) And such quarantine officer is empowered to detain such, car, carriage, vehicil., boat or thing, until such medical inspection shall have been made to his satisfaction;",
         "il (b.) A medical man making such inspection by order of the quarantine officer shal, while engaged in such service, be the Quar- antine Medical officer. 49. The fee payable to such quarantine medical officer for each such inspection shall not exceed the sum of $4, and in the event of any quarantinable disease being found, such fee shall be payable by the company or owner of the car, carriage, vehicle, boat or thing, bringing such disease. 50. The Customs Collector or Sub-Collector in his quality of qua- rantine officer shall, on the report of the medical quarantine officer, in a time of epidemic disease,-in the event of any of the graver quarantinable diseases being found, cause the detention of the car, carriage, vehicle, boat or thing, bringing any person ill with such infections disease until the requirements of these regulations are in his judgment satisfied; (a.) Any such sick person shall not be allowed to enter Canada until in the opinion of the medical quarantine officer he or she can safely do so; (b.) Any car, carriage, vehicle, boat or thing, bringing such sick person to the frontier shall have the option of returning as an alter- native to quarantine detention; or , (c.) The Customs Collector or Sub-Collector in his quality of quarantine officer shall in his discretion, on the report of the quar- antine medical officer'. cause the removal and isolation of snch sick person in any car or boat, set apart for that purpose, or in any suitable building sufficiently separated from other buildings to pre- vent contact; (d.) And such quarantine officer may cause the disinfection of the car, carriage, vehicle, boat or thing bringing such sick person, by means of sulphurous fumes, or any other mode of disinfection prescribed in these regulations adapted to the circumstances of the particular case. 51. In the event of cholera or other epidemic disease prevailing in any part of the United States through which a railway crossing the frontier of Canada ruans, the Governor in Council may, on an order published in the Canada Gazette or in an extra of the Canada Gazette, made on a report of the Minister of Agriculture, and where there may not happen to be at that point of the frontier any ade- quate quarantine arrangements and apparatus to cope with an in- road of such epidemie disease, direct the nomplete cessation of pas- senger traffic at such point; or such restriction thereof, as may in the circumstances be deemed advisable. QUARANTINE OFFIcERS GIVE ALL .EcEssARY ORDERs-PROI1BITED FRoM RECEIVING FERs OR GRATUITIES. 52. Every quarantine officer is empowered to give any necessary order, or do any necessary act, to enforce these regulations, and it is",
         "12 bis duty to report any breach of them, or any attempted breach, immediately to the Minister of Agriculture; (a.) No quarantine officer nor other person employed in the qua- rantine service of Canada shall directly or indirectly receive or take any fee or private gratuity or reward for any service rendered to any company, or owner, master, or crew, passenger, or other person at or detained in any quarantine, Maritime or Inland. Every person to whom the knowledge of any breach of these regu.. lations may come should forthwith report the same to the Minister of Agriculture. Penalties for customs officers, pilots, masters, surgeons and officers of vessels, \u0026c. 53. Every pilot shall be furnished witb printed copies of these regulations, one of which it shall be bis duty to hand to the Master of every vessel coming from a port outside of Canada, immediately on boarding such vessel, under a penalty of $50. 54. Every Collector of Castoms or customs officer shall be liable to a penalty of $400, and imprisonment for 6 months, for allowing customis entry of any vessel in the absence of production of a Qua- rantine Clearance, in accordance with the requirements of these regulations. 55. Every master of a vessel shall be liable to a penalty of $400 and imprisonment fbr 6 months, for any contravention of any of the foregoing regulations. The vessel shall be held liable for any pecu- niary penalty imposed on the master. 56. Every ship's surgeon or other officer not answering with exact truth any of the questions contained in the form hereunto appended shall be liable to a penalty of $400, and imprisonment for six months. 57. Every breach of sub-section a of section 52 of these regula- tions shall be beld to be a malfeasance of office, an offence punish- able with dismissal, fine or imprisonment. Questions to be answered under oath to quarantine officers by masters' surgeons or officers of vessels. Date 189. 1. What is your vessel's name and your name ? 2. From what port and at what date did your vessel sail ?",
         "13 3. What is your cargo and whence taken on board? 4. Are there any rags in such cargo ? 5. Has your vessel touched at any place or places on her voyage ? 6. Was such place or places, or any of them, to your knowledge, infected with cholera, small-pox, plague or any pestilential fever or disease ? 7. How many persons were on board when the vessel sailed ? Cabin passengers ; intermediate ; steerage cattlemen ; crew . Total 8. State whether any person on board during the voyage bas been, or is now, ill with any of the diseases above referred to, and if so, how many? 9. Has any person died on board during the present voyage, and if so, state all particulars ? 10. las each of the steerage passengers on board been vaccinated or hadi the small-pox ? 11. Did the vaccination of steerage passengers take place at time or before embarking? 12. How many have you vaccinated on your present voyage.? 13. (Question to be asked, in the event of small-pox having occurred during the voyage, of ship's surgeon, if such is on board).-Have you personally during the present voyage, examined each one of the passengers and crew for proof of vaccination within seven years or of having had the small-pox in that period ?",
         "14 14. Did you or any of the crew or passengers, within your know- ledge, land at any place or places within Canada during the present voyage ? 15. Is there any person on board lunatie, idiotie, deaf and dumb, blind or infirrm, and if so, is such person accompanied by relatives or guardians? 16. Have you an isolated hospital for men, and another for women, ventilated from above and not from the passage? 17. Were such hospitals, or one of them, immediately made use of on the occurrence of disease ? 18. Are there any other facts which, in your opinion, should be communicated? (Signature) Master. (Signature) Surgeon. I, Master, Surgeon, (here state whether ship's master, or occupying another position on board) do solemnly and sincerely swear to the exactness and truth of the an- swers to the above questions signed by me. So IHELP ME GOD. Master. Surgeon. SWoRN before me at this day 189 Quarantine Oficer and Justice of the Peace, authorized by Order in Council in virtue of chap. 68 Revised Statutes, intituled \" An Act respecting Quarantine.\""
      ],
      "title" : [
         "Canada. Dept. of Agriculture.",
         "Dominion of Canada quarantine regulations : by Order in Council dated 20th June, 1893, in virtue of Chapter 68, Revised Statutes, intituled: \"An act respecting quarantine\".",
         "Quarantine regulations, by Order in Council dated 20th June, 1893, in virtue of Chapter 68, Revised Statutes, intituled: \"An act respecting quarantine\""
      ],
      "type" : "document",
      "identifier" : [
         "9_01955"
      ],
      "published" : [
         "Ottawa : S.E. Dawson, 1893."
      ]
   },
   "request" : "http://eco.canadiana.ca/view/oocihm.9_01955/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1",
   "version" : "0.4"
}
{
   "doc" : {
      "title" : [
         "Medical criticism [No. 15 (Dec. 9, 1882)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_05107_16"
      ],
      "published" : [
         "Toronto : [s.n., 1882]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Car tes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées [ Pages discoloured. stained or foxed/ L Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. 1OX 14X 18X 22X 26X 30X 12 , [. 2 2 12X 16X 20X 24X 28X 32X",
         "«IMIEDICALCRITICIS-MfrP\u003e No. 15.-DECEMBER 9th, 1882. A Weky Sheet, b)' DAviYD EDWARDS, publiszea on Saturda.y, and' soUi at HZawkins \u0026 Go.'s, 67 Yo\u003eý,«e Street, Toronto. PRIOE 50 CENTS-Copies or any qingle tiumber cn be bnd, in quantities, at 15c. per d mon. COMPARISONS \" ODJOUS\" OR OTHERW ISE. Dr. Stahi \"1attributes the frequency of consumnption to the introduction of Peruviari bark.\" Dr. Reed ascribes \"the frequency oi the disease to the use of rnercury.\" Dr. Rush says \"that consumption is an inflarnmatory disease, and should be treated iby bleeding, purging, cooling medicines, and starvation.\" Galen recomnrended \"vinegar as the best preventive of consumption.\" Dr. Beddoes recommends \"foxglove (a deadly poison) as a specific in con- sumption.\" Dr. Morton \"considers the bark an effectuai cure for the disease.\" Dr. Brillonett asserts \"that it is only curable by mei-cury.\" Saivadori says, \"1consumption is a disease of debility, and should be treat- ed by toriics, stirnulating remedies, and a generous diet. Dessault and otiiers assert that \"'con- sumption is often brought on by a coin- mon practice of young people takirxg vinegar to prevent obesity.\" Dr. Parr found \"foxg!love more injuri- ous in bis practice than beneficial.\" Hf we allow twvo hundred patients as an average number for each ofl the, above-named gentlemen to have experimented on, that will give us two thousand sufferers from one- di.-order-, -%vhlorn they hiave unitedly hcelped on their way. A inedical man bnce told one of his characters Ii're t.oo wound: truc. replied Voltaire. not a/iended 4\u003e' a pizysician. Voltaire that lie (Voltaire) liad miade long after lie hiad rcived a certain b)ut you maust rerneniber that lie was PORK. Sucli rniercifiil mon- as arce.ciull disposedf t1owards. anii- matc(1 nature generally, 'viii be. glaid to 1rîtl tedecrepit hr'e wvhose 17ltimate dle.stiniatioli it is to furnish eatsfoi, pigs, pi -.I to hirrea.ching the goal of thiei.r career, care intro\u003clueed to ani equmne paradise, at thie pig-feeders' expjesco, i.e. they are led to ,Ucli'p- ture5s f,-ir\" as resuit in t.hý'ir once agrain bec.,inig fat whe the\"i 1-1 height of their bishas been attained, thiey are swviftly epted ini order to enhanco the hazppinie.,s (and the fans)of the igon the principle of -simzYia simifi'z, c;razzi.",
         "When some one said inadvertently that a certain person had died \"without the aid of a physician,\" he saw at once that he had dcne injustice to \"la noble profession.\" and added, \"lbut sucL instances are of very :rare occurrence.\" iREV. JOHN WESLEY, ON HEALTU. (EXTRACT NO. 3). 7. We may strengthen any weak part of the body by constant exercise ; the lungs may be strengthened by loud speaking, or walk- ing Up an easy ascent .,digestion and the nerves by riding ; (as ev'ery- body doesn't possess a horse, and Most persons might saw a stick of wood for themselves or others, wve may venture to suggest that wood-sawing, in the majority of cases, might advantageously be sub- stituted for equestrian exericise) the arms and legs, by strongly rubbing them daily. 8. The studions ouglit to have stated times for exercise, at least two or three hours a day ; one hiaif of this before dinner, the other before going to bed. .9. The fewer clothes any one uses, by day or nighit, the hardier he will be. 10. The fiesh-brush is Most useful, especially to strengthen any part that is weak. VACCINATION. The people find that Small-pox 13 flot to be got rid of by mnixing Cow-pox with the blood, but by making homes healthy. The Doctors pretend to have foumd to the contrary The people are discovering that defective .drainage, overcrowding, badly-con- structed dwellings, ili ventilation, unwholesome food, and deficient water supply, are the exciting causes of Small-pox epidernics. The Doctors mnust be compelled to m\u0026ke the same discovery. Any inedical theory which ignores the laws of health, and teaches that the SPREADING of dise:aSe, wvheffhcr natural or artificial, is or can be advantageous to the cornmunity, is mible.ading, rnischievous, and opposed to common sense; and any teacher, whlate,,,er bis abssum-ption of authority, title, or degree, who inculcates such a doctrine, iS AN ENEMV 0F THE HUMAN RACE. The first duty of a parent is TO PROTECT HIS OFFSPRING, and to resist e.rery attack on their health at any cost, no matter from what quarter it may corne. How long will Canadians submit to have their clildren's blood poisoned, and their health and future happiness jeopardised. in order that MEDICAL THEORIES MAY PREVAIL, and mrI.-DI. DOM.\\INATION. BE M'AIN- TAINET)? 'PULPIT CRITICJSM.\"2' by the same author. Sold at HAWVKISS \u0026 CO.%'. 67 Vonge Strcet. Price $i.oo per aurnum."
      ],
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      "label" : "[No. 15 (Dec. 9, 1882)]",
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         "University of Western Ontario, D.B. Weldon Library, London."
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      "key" : "oocihm.8_05107_10",
      "source" : [
         "University of Western Ontario, D.B. Weldon Library, London."
      ],
      "label" : "[No. 9 (Oct. 28, 1882)]",
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The institute has attempted to obtain the best Qriginal copy available for film ing. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ i Pages de couleur Pages damaged/ Pages endommagées Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (ie. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur D Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées iors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées 5 Pages discoloured. stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ i Pages détachées Showthrough/ 1 Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken f rom:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Di Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "No. 9.-OCTOBER 28th, 1882. A W«ek/y Sheet, by DAviiD EuDvARDS, publishied on Saturday, and sod ai Hawkins \u0026 67 Yonge S9treet, Toronto. PRICE 50 CENTS-Coffies oi any single tumber can ho bad, in quantities, at 15c. ver doten. MVR. PESTLE'S OBSERVATIONS. Mr. Pestie, the druggist, is one of the few who are teachable. and live to learn ; one of t he lessons Mr. P. lias already learned is, that Doctors like thurMy per cent, on their prescriptions, when they eau obtain it. Mr. P. lias also learned that his medical patrons like showy houses, etc. Lady Gullible casuaily informed Mr. Pestie that she lad just defrayed a bill of $180.00,- under the comprehiensive des- cription of 1'medical attendance ;\" as Lady G. habitually purchases herdentifrice, lier paint, and lier powder at Mr. Pestle's store, Mr. P. bethinks him that his own future bis shahl aiso be comprehensive; they will therefore be duly delivered under the general head of \"Chymical attendance for six months, $80. 00.\" T\"he Ionorary Registrar-6Genera? begs leave to submit to the Honorable Members of the Legisiative Assembly, the fact that there is one physician in Toronto, who in twenty-two years' practice, lias nôt host a case of typhoid fever, lias Iost but one case of scariet fever, no cases of diplitheria, and but three of twenty-seven cases of caneer, the majority of which had not broken. GOLDEN OPPORTUNIT Y. There is one inedicai man in Toronto, ivhose belief in a minerai lias manifested itself in the following fashion-Mr. A., the druggist, con- sented to give him twenty per cent. on ail prescriptions, the Dr. m;ight send to him; but unfortunateiy for Mr. A., Mr. B., of the same vocation, offered twenty-five per cent., and of course secured the prescriptions; tlie astute Mr. B., alas ! in due time had to bewail the evanescense o the said prescriptions, for Mr. C. had turned up witli an offer of thirty per cent. If there be a druggist who considers hie customers suffi- ,Ciently verdant to submit to t h imposition of the screw to the extent- of thirt-y-fi-ve per cent., and is prepared to negociate with our medical friend, we shahl be hiappy to introduce him to the Doctor,. for a cortJder- WHrY do people for the most part die? Becau\u003e;e they have flot learned to live.",
         "BIRTH OF HIMCEE0PATIIY. .The qubjoined narrative may be said to be that of thé birth of homoeSopathy '--\" For the sake of experiment,\" says flahnemann, I took for sevoral days four quenchen of good cinchona twice a day ; my feet, the tipà of my fingers, etc., first became cold, and I felt tired and sleepy, then mny hieart begaii to beat, iny pulse became hard and quick ; I had an insufferable feeling of uneasiness, a tret1ibling (but without chili), a weariness in ail my limibs ; then a beating in my head, redness of the cheeks, thirst, in short, ail the oid symptoms with which I was faniiiar in. ague appeared one after anothér, yet without any actual chili or rigor. In brief, also those particuiariy characteristic symptoms such as I was wvont to observe in agues, obtuseness of the senses, the kind of stiffness in ail the limbs, but especially that dull disagreeabie feel ' ig which seems to have its seat in the periosteum of ail the bones of the body-they ail put in an ap- pearànce. This paroxysmi lasted each time two or three hours, and camne again afre-,J± whenever I repeated the dose, but flot otherwise, I left off, and became weil.\"-Ecce Mediaus, pp. 107, 108. NOT SO VERDANT. A physician ln Toronto, whose license to practise is based on a bogus degree,. produced a reai degree witli much seif-complacency, while conversing with thle editor of \"' Medical Criticism \" recently. The. real degree %as been sent hlm lateiy from Chicago, \"honorés causa;,\" as he made the second 'o\" short in prou ouincing it, we may presume that classicai proficiency was not inciuded iu the \"honoris causa.\" 'VACCINATION. Dr. Edward Jenner discovered that Vaccination once performed with one mark, prevented Smnall-pox for life. The People found that it did not. Doctors then discovered that Vaccination, with four good marks prevented Smail-pox for life. The -People find that it does not. The Doctors next discovered that Vaccination, if properiy doue, métigated Small-pox. The People fixd that it does not. The Doctors afterward discovered that re-vaccination would pre- vent Small-pox, if efficientiy or successfully performed. The People find that it does not. The Doctors then discovered that efficient Vaccination in infancy and succesaful re-vaccination at the age of fourteen, prevented dca/lis from Smaii-pox. The People find it otherwise."
      ],
      "type" : "document",
      "title" : [
         "Medical criticism [No. 9 (Oct. 28, 1882)]"
      ],
      "published" : [
         "Toronto : [s.n., 1882]"
      ],
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         "8_05107_10"
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur D Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured. stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ iJ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken f rom:/ Le titre de l'en-tête provient: D Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. 1oX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "MEDICAL CRITIcIsM. NO- 3. JANUARV 27, 188-. 2NID SERIES. A lleekly Shteet, by DAVID îEDWARfiS, 7publis/ied on Satnirday, and sold at Patterson \u0026 (Jo.'s No. 4 Adelaide Street lVesït, Torointo. PRICE, $1.50--Copics of anY single numnber can ba had, in quantities, at 15c. per dozoli. We gather from the Report of the Hospitals of Ontario for 1882, that the average stay of each patient, including infants, in the Mattawa Hospital (wvhich enjoys the unique privilege of flot having a doctor within a hundred miles of it\u003e, is fourteen days, w~hi1e the average days' stay of siiiar patients in the hospitals of Ottawa, Toronto, and Hamilton respectively is forty-two at the Ottawa General Prostestant H-ospital, twenty-six at the Roman Catholic H-ospital, Ottawa, and thirty-three at thý hospitals of Toronto and Hamilton respectively. The Mattawa Hospital is mianaged entirely by Sisters of Charity ; the average days? stay of its inniates is less than hialf the number shown by nine out of the thirteen hospitals which are aided by Provincial funds. THE TORONTO HOSPITAL. A wvoman who was -eceived into the hospital lately, was suffering intense pain for thirty-one Iîours (low muchi longer we are unable to say\u003e and no doctor had then been near lier. Typhoid fever is supposed to be infectiouý; possibly it is not so, whien the sufferers are in hospital ; for in the To ronto H-ospital, visitors find themselves with a fever patient on one side of them, and a consuiptive patient on the other. Christmas decorations appeal to sentiment, but when they adorn an hospital, they involve an amount of hammering and confusion which lead the patients to coniclude that the practice wotùd be more honored in the breachi than the observance. CONGESTION OF THE LUNGS. The havoc which disease, doctors, and death have wrought of late among our fellow-citizens lias induced the Editor to ask a representative of the Physio-Medical School of Doctors to give him the beniefit of his sentiments on the subject ; to this request, lie lias kindly responded, and the result is subjoined : Pneumonia, or inflammation of the lungs, which in fatal cases, is styled by the faculty 1' congestion of the lîtnqs,\" is. in fact, only \" the first stage \" of the disorder ; there are few who die frot itis derangernent alone; the treatment of the disorder stili remains-what the faculty please to style a '- quoestio vexata,\" -.e., a disputed question ; it may be weIl that ail of us, who are liable to be the objects of profes- sionpl experiments, should have some idea of the fornis which they may assumie; a recent writer says of the treatment bv bleeding: \"Probably five cases out of six would recover without bleeding; the sixth mighit die froin the lack of it; he is of opinion that mortality has increased since the adoption of the practice of bleeding ; he descants on the supposed virtues of tartar emetic, passes froni that to antimony, and thence to veratruni viridi ; in re-",
         "gard to the latter he .speaks of \" watching its effects,\" i.e. its tendency to kill ; another comforting suggestion -which he offers is \" cupping between the shoulders,\" or as an alternative, \"a vigorous dose of Epsom salts.\" Another witness (so to speak), Dr. Chalmrers, of St. Mary's and the Locke Hospitals, says-\" Consider antimony, mercury (blue mass, calomel) and purgatives as poisons in pneumonia.\" A third witness, Dr. Hunter, states that'-' blood-letting is one of the greatest weakeners,\" and naively adds \" as we can kill thereby.\" A fourth witness, Prof. Lobstein, says, \" Without blood, there is no heat, no movement in the system ; in the blood is the life; he who takes blood from the patient removes not only an organ (sic) of life, but a part of life itself.\" An essay appeared in the Canada Lancel, of August, 1882, which had been read before the Medical Association of Ontario, in which the writer maintains that bleed- ing is correct practice especially in pneunonia, or inflammation of the lungs; the writer cites cases, in which he claims to have performed wonderful cures of that too frequently fatal malady. * A sixth witness, Dr. Bennett, of Edinburgh, declares that \"Any weakening remedies not only materially extend the period of the disease, but especially prolong the state of convalescence; \" \" it is easily understood therefore,\" he adds, \" how it happened that the antiphlogistic t treatment (bleeding, prostrating, poisoning) of former days proved so fatal.\" An all but infallible course of treatment of pneumonia is propounded in the Canada Lancet, of Sept. 1881 ; Prof. Alfred L. Loomis (quoted from the New York Medical Record enquires in the accustomed style \" What shall we do? and proceeds to assume that pneumonia is caused by-poison; (other authorities are content to acknowledge that it is traceable to \" taking dold \") the Professor discloses the great secret tha: opium furnishes the antidote for it ! he enlightens us further as to his mode of applying '·he drug, and says that bis rule for the past year bas been \" to bring bis patient under the full influence of it at the outset of the inflammation, and to keep him in that state usually for the first four days of the disorder ; \" it is not surprising that the Professor should further say-\" After this period, the greatest care must be exercised in its use (the use of opium), for now a neýv danger threatens viz. :-paralysis of the bronchi, and consequent accumulation of secretion in the bronchial tubes, which will greatly increase the difficulty of breathing !\" Let no pneumatic sufferer despair, for there is still \" balm in Gilead \" and possibly a \" physician there ; \" \" the learned Professor \" administers \" morphia hypodermi- cally \" (under the skin) \" during the developing period of the disease.\" As we cannot suppose that our readers will be able toreduce the discordant testimony of these witnesses to harmony, we hope to present them with something so uncommon as common-sense views of this subject in our next number : in the meantime they may possibly reflect that death from \"congestion of the lungs \"- according to the registered cause of death-is less surprising than at first it may appear to be. Possibly it might be instructive to enquire which of the above approved modes of treatment was adopted in the one hundred and fifteen cases which have succumbed to the disorder, or the treatment in the hospitals of Ontario. during the past year; it may be satisfactory to enquirers to observe that the disorder is learnedly described as taking the several forms of \"pleuro \"-\" typho \"-and \"bronch\u003e-pneumonia\" * As both the Editor of the Lancet and the several members of the Medical Asso- ciation h; ee hitherto yielded the assent involved by maintaining silence on this subject, we may v tnture to suggest that the cures were probably of such a nature as to result in mourners going about the streets. - † Inflated words are congenial to inflated persons.",
         "3 EXTRACIS FROM A TRACT ENTITLED REMARKS ON \"THE IMISTAKES 0F MOSES.\" By Il. L. Nastiugs. I recollect hearing Lord Shaftesbury speak in London, of attending a Coster- n2onger's Exhibition of the donkeys ivith which they drag about their barrows of provisions and merchandise. H-e said there were fifty donkeys exhibited, looking as sleek and beautiful as if they had corne out of the Queen's stables; and the mnen told him that every, one of the donkeys hiad each week, twerity-four consecutive h ours of rest, and, as a consequence, they could travel thirty miles a day, withi their lcads, for six days a week, while donkeys whichi iere driven seven days in the week, could flot travel more thin fifteen miles a day. 0f course a skeptic would sneer at the idea that divine revelation had anything to do with donkeys; or that donkeys wvere considered iii the lawv of God. But th e Creator knew what was good for a donkey, and so he named the donkey in the conunandment: \"The seventh day is the sabbath of the Lord thy God: in it thou shait flot do any work, thou, nor thy son, nor thy daulghter, nor thy man-servant, nor thy maid-servant, nor thine ox, nor thine ass, nor any of thy cattie, nor thy stranger that is within thy gates.\" Deut. v. 14. The Lord well knew that a donkey would do more work in a iveek if he worked six days, than he would if lie worked seven. He tberefore made provision that the donkey should have his weekly rest. Whatever opinion men rnay hold concerning the perpettuty of sabbatic laws in the change of dispensations, mnan's physical constitution rernains unchanged; and every law which has its foundation in the nature of things, is worthy of the most reverent consideration. They who violate the laws of existence must accept the penalties. It is a curious fact~ that after muan has cverworked himself, and becorne exhausted, fromi neglect of the appointed times of rest, when he is sinking under disease, and the frantic struggles of nature take the formn of fever, this same law of sevens inanifests itself in the process of restoration. His fever runs seven days, and then turns; or if nature be not able to recover herseif at that point, the struggle goes on for another seven days; and if the fever does flot then turn, it must again mun seven days. Fevers do flot turn on the fourth, fiftli or sixth day. Ail the doctors in creation cannot make fevers turfi, as a rule, except at the seventh day. This shows that the law of sevens is so wrought into the constitution of man, that he cannot escape its control. It is a part of himself; and wvhether hie believes it or not, hie is still bound by this universal law. The human constitution is like an eight day dlock. It needs to be -wound up once a week, and the day of rest affords an opportunity of so doing. Any one who wilI study the constitution of man, will find that this law, dividing human life into periods of one, two, three and four sevens of days, is an universal law\u003e controlling human existence from, beginning to, end. It may be well to notice in this connection, that fi re modes of measuring time by seven occur in two chapters of the book of Leviticus; in the twventy-third chap- ter, ive have a weEk of days (v. .ý\u003e, a week of weeks (v. 15), and a week of months (V. 24); in the twenty-fifth, we have a week of years (v. 4), aud a week of sevens, \"seven times seven years \" (v. 8); a sixth mode of reckoning time by seven is found in the seventy years' captivity, and in the seventy weeks of Daniel; see also Is. xxiii. --5, 17 ; and a seventh mode of reckoning time in periods of seventy times seven (to wvhich the Lord alludes in his conversation with Peter, Matt. xviii. 22), is illustrated by the charts of Sir Edward Denny; seventy times seven, or four hundred and ninety, with the addition of the jubilee years during that period, make up the spans of five hiundred years, twelve of wvhichi have nearly elapsed since the period knowîi as the creation.",
         "HOW VACÇINAT10N HAS \"ISTAMPED OUT\" SMALLPOX, IN ENGÎ.AND-.Vaccination ivas made compulsory il. 185., with the folloiving resuit: Deaths frôm Smallpox ini the first decade after the eriforcement of vaccination, 1854 to 1863........ --.......... ....33,515 In the second decade, 1864 to 1873 ... ... ............70,458 IN LONDON-Th c Registrar-General in his Annual Summary for the year i88o, tabulates the smallpox mnortality of London for the last 30 years as follows: Dorades Estiîated Mean PopulatiGn. Smallpox Dcatlis. 185 i-6-o.... ... ..........2,570,489...................7,150 1861-70.................3,018,193.....................8,347 1871-80.............3,466,486.... ...............15S,551 IN SCOTLAND AND) IRELAND- SMALLPOX DEATHS. scotlanld. Irelntl. 1870.......................114...................32 1871......................1,442......................665 1872.................... ......2,446....................3,249 1873.............. .... ..1,126......................4 1874 .. . . .... 1,246.............. .. 569 IN SWEDEN-Quoted as the best vaccinzted country in the world, there died Of SmallPOx il' 1874-'7--6,082, out of a pôpulation of four millions. IN BAVARIA-FaMOUS for compulsion-of 30,742, officially recorded cases' of SnîallPOx ;1n 1871, 29,429 were supplied b\u003e' the vaccinated. 1I anm strong\u003e' oj)posed to Conipulsory Vaccination.\"- Hr-RBER' SPENCER. AGUE. We learn, on good authority, thàt ague lias in many cases been cured by what is known and advertised as Indian Blood, Syrup. The nman who lias been sitting b\u003e' a corpse, on the assumption that the deceased was in a trance, is more of a knave than a fool; hie however possesses the negative menit of flot slaying one iii a litnclred of those who are killed according to lawv and ignorant tradition. Dr. Foote's IIcatth Monih/vi say.,:-\"l Sonie of the surgical instruments fouand in the biiried ruins of the ancient cit\u003e' of Pompeil, now in the collection of antiqui- ties in the museuni cf Na pies, showv that the surgeons of that tinie were l)rovided with many of the niost important instruments now in use.\" The Lancdt remarks that the number of instruments found in one house, there will bear comparison with those possessed by the average practitioner of the present time. 1ýe In the event of an\u003e' irregularities occurring in the delivery of this publica- tion, the Editor requests that lie inay be addressed respecting it. \" PUîPIT CnîTîCxS, 2\\,\" by the same author, sold at PA\u0026-TERSON \u0026 Co.'s, 4 Adelaide Street West. Price ,$k.so per annum."
      ],
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         "Medical criticism [2nd ser. no. 3 (Jan. 27, 1883)]"
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         "University of Western Ontario, D.B. Weldon Library, London."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNA L IGrig4inal 8ùmmunnicatio~ns. THE INITIAL RASHES OF SMALL-POX, BY WILLAM OSLER, M D., L. R.C.P., LOND., Fellow of the Royal Microscopical Society, London, late Physician to the Sinall-pox Dcpartment of the Montreal General Hospital, and Professor of the Institutes of Medicine, McGill Univeursity. In the abundant literature of small-pox, contained in the standard text-books, and scattered through the various periodi- cals, mention is occasionally made of rashes occurring in the initial stage of the disease. The reference to them in the ordinary English works on the Practice of Medicine is usually limited t two or three lines, stating that the eruption is sometimes pre- ceded by an erytheiatous or erysipelatous ra-sh, (see text books of Aitken, Wood, Watson, Niemeyer, Barlow.) Many make no mention wliatever of them. (Bennett, Tanner). Even ii the special wôrlks on the subject the notice is scarcely more 4xended. Thonpson* refers to a roseolons rash as a common precursor o0f varioloid. Munrot speaks of a \"rosy efflorescence as in measles pre- ceding the eruption in malignant small-pox.\" Gregory‡ makes no mention of them, but refers to a scarla- tina-:Iike rash in the progress of the secondary fever. * On Varioloid Diseases, pp. 35-151, † On Snall-pox, p. 97. On Eruptive Fevers, p. 49.",
         "242 CANADA MEDICAL AND SURGICAL JOURNAL. Marson* states, that in varioloiid the eruption \"is very often preceded by roscola, which lasts two or three days-the r. exanthematica.\" Foreign Physicians appear to have paid more attention to them, and very good accounts are to be found lin some of the recently translated works † Many of the older authors believed them to be indepeident aflections, and, according as the eruption was diffuse or mottled, spoke of scarlatina or measles occurring simultaneously with small-pox. Sydenham was evidently acquainted with them, and1 refers to the diffilculty they may cause in the diagnosis. \"The afore- said small-pox,\" speaking of the discrete form, \"\u003cbreaks out some- times after the fashion of erysipelas, sometimes like measles. From these they are difficult to be distinguished even by the practised physician, provided that ho goes by the external appearance only. In some of the cases collected by Murchison§ of the sup- posed coincidence of two fevers at the same time, the mistake has been made of confounding the initial 'rashes with indepen- dent diseases.-(Illustrations, 3, 4, 5, 6, 7, 8, 9, 10.) Our definite information on the subject dates from the publiia- tion by Dr. Theodor Simon of Iamburg (whose premature death last vear was a severe loss to the profession in Germany), of a series of articles in the Archives f. Dermatologie und Syphilis, Bds II, II, \u0026 IV, on the \"Prodromal Exanthems of Small-pox.\" Other papers on the subject appeared in the saine journal from the pens of Drs. Knecht and Scheby-Buch, and less important observations have been published in several of the German period- icals within the past four years. The probable reason why sucli scanty rcference to then h found in the records of the older epidemies is that they appear * Reynolds' System.-Article Small-pox. t Trousseau.-Clinical Medicine (Sydenham Society)) Vol. 2. Hebra. Skin Discases, (Sydenham Society) vol. 1. Zienssen's Encyclopedia, Curschmann. Art. Small-pox. ‡ Works of Sydenham (Sydenham -Society) Vol. 1, page 127. § Med. Chirurgical Review, 185G.",
         "INITIAL RASUES OF SMALL-POX.--BY DR. OSLER. with great irregularity, sone epidemics, as ie one now subsia- ing, affording numerous instances, others very few. Two forms of these rashes are to be distinguished, the diffuse scarlatiniform, and the macular or measly, cither of which may be accompanied by petechie, and occupy a variable extent of the cutaneous surface. In some instances they are general, covering the whole body; as a rule, however, they are limited ai show a decided preference for certain localities. This holds good especially for the purpuric rashes, -which occur with great- est frequence in the abdominal region, occupying a triangle the base of which is formed by a line drawn from one anterior superior spinous proc'ess of the ilium to the other, the sides by Poupart's ligaments, the apex corresponding to the pubis. Another favorite situation is the inner surfaces of the thighs, (the crural triangle of Simon). A third is the lateral thoracic region, in a strip extending towards the navel, along the margins of the ribs. The above are the usual sites for the purpurie rashes, and in the majority of cases they occur in one or all of them. The simple erythematous and macular rashes, unaccompanied by petechke, are often much more extensive, spreading over larger areas. When limited, in which case the presence of purpura is common, they occur in the above-named situations, and also, according to Simon, \" in the axillary regions, (axillary triangle) the extensor surfaces of the extremities, especially in the neigh- borhood of the knees and elbows, the backs of the hands and feet, on the genitals, and lastly, as a streak extending from the ankle along the skin over the extensor hallucis longus.\" . My experience has been that they are chiefly purpuric ; in the limited number of cases which I have observed, only two, were unaccompanied by pctechio. In very many of the cases reported by Simon and Knecht no mention is made of the pre- sence or absence of cutaneous extravasations. Scheby-P\u003euch, On the other liand, believes them to be, in most instances, of an hinorrhagic nature, i. e., numerous petechie occur upon an erythematous base. The following cases will give a good idea of the nature and extent of these initial rashes. CASE I,--D. R., ict. 14. Adimtted November 28th. Vac- 2 -1",
         "CANADA MEDICAL AND SUBGICAL JOURNAL cinated, one good mark. Revaccinated 8 days before admission, three points, -which had taken, were just passing into the 1;ustu- lar stage. A diffuse erythematous rash of a dark-red hue existed over the abdominal region, extending upwards in the lateral thoracic areas, and downwards uppn the thighs. Face much suffused, extremities unaffected. 'On pressing with the finger upon the skin of the abdomen, numerous petechiw were evident, most abundant in the groins, and inner surfaces of the thighs. Temp. 101n. Slight delirium. A papular eruption over face and arms. 29th.-Erythema lias disappeared, leaving the ecchymoses visible as small, dark, punctiform spots, closely set together in the groin, and more scattered towards the navel. The largest existed in the lateral thoracie regions, over the serrati muscles. A few were also noticed on the legs about the inner surfaces of the tibii. Course of the Disease.-Eruption became confluent on the face, discrete on the extremities and trunk. Not more than eight pocks appeared on the sites of the erythema. Instead of proceeding to maturation, the majority of the pustules aborted, and on the 11th diy of the disease desiccation had begun. CASE IL.-J. C., æt. 23, medical student.' Vaccinated, one good mark. Admitted, December 15th, 1874. Initial symptoms, according to his own statements, had been tolerably severe. Papular eruption present on the face and arns. On examiuing the trunk a fading erythema was noticed over the thorax and abdomen. A diffuse ecchymosis existed over the anterior sur- faces of both shoulder joints, extending above over the acromion processes, and internally over the outer half of the clavicles. Continuing into the axillS, it involved the greater part of the skin in these fosso-, terminating below at the level of the fifth rib. A considerable amount of hyperamia was present, and pressure with the finger revealed the fact that the ecchymiosis vas not uniform, but here and there left portions of the skin unaffected. Numerous purpurm in the groins and lateral thoracic regions, 244",
         "INITIAL BASHES 0F s]ALL-PoX.--BY DR. OSLRR, some of which were of considerable size ; none on the e dremi- tics, or inner surfaces of the thiglhs. Temp. 100.50. General symptoms good. Pulse firm and strong. Course bf Disease.-Pocks numerous but discrete, and pro ceeded regularly to pustulation. Ecchymoses faded gradually leaving a yellowish-green discolouration of the skin over the shoulders, and in the axilloe. Desiecation early. Rapid recovery. No complications. The first case affords an excellent example of the condition under consideration. The exanthem occupied the most usual situations, viz, the anterior abdominal and lateral thoracie regions, together with the inner surfaces of the thighs. On superficial examination the ecchymoses were not at first evident, becoming so, however, on the following day, when thé erythema had faded. The second case presents several points of interest. The initial symptoms were so severe, and such was the intensity of the prodromal exanthem, and extent of the~ cutaneous extrava- sitions, that the gentlem-n who attended the case, though poss- essed of considerable experience in small-pox, believed it to bc of the true hæmorrhagic variety. On first seeing it I expressed a similar opinion. The remarkable extent of the ecchymoses in the neiglborhood of the axilloæ was certainly very misleading, more especially, as it was accompanied by an eruption of pur- pura in the thoracie and lower abdominal regions. Indeed, in such a case, within the first 48 hours, it might be almost impos- sible to decide defìnitely, whether we had to deal with a simple prodromal exanthem, or with the initial symptoms of genuirie hmorrhagic small-pox. In the latter the exanthem would pro- bably be more generai, of a deeper hue, and present a greater number of petechie, and even on the second day hitmorrhage mighttake place from the mucous membranes. The two following casss are the only instances which have coma under my noticu of a simple erythemitous rash unaccom- panied by'petechio. Oldly enough, both subsequently became hemorrhagic ; in one the extravasations were limited to the Pocks upon the legs, and a good recovery was made ; the other proved to be of the true hSmorrhagic variety. 245",
         "CANADA NEDICAL AND SURG1CAL JOURNAL. CASE III.-J. M., oet. 25. Vaccinated, one good mark. Ad- initted, January 28th. Initial symptoms not severe. A diffuse erythematous rash existed over abdominal and thoracie regions. According to patient's statements, it had been brighter. and vas fading at time of admission. it was unaccompanied by any purpuric spots, either in the regions affected, or in other parts of the body. Eruption discrete, papular, very scanty upon the abdomen. Course of .Disease.-Pogressed favorably, but presented peculiar characters, inasmuch as extravasation took place about the pustules on the legs on the 5th day, and -was followed by a subsidence and rapid desiccation of the eruptiqn. CAsE IV.-A. McR., it. 19, a strong Scotch girl. Unvac- cinated. Admitted January 3lst, from the general wards, vhere she had been under treatment during two wceks for some ill-defined affection. Initial symptoms very severe. There was on admission a deep crythematous rash over the whole body, most intense on the abdomen and thorax, and unaccompanied by ecchymoses. Face and arms of a deep red colour. Papules very general. Temperature 103.39. Pulse, 116. Respira- tions, 221. Feb. 1st, erythema fading on the trunk. Course of Disease.-This case proved to be of the hæomorr- hagic form, and is interesting from the fact, that a sinple crythematous rash was among the initial symptoms, the extra- vasation into the skin not occurring until the third day of the eruption, when the erythema had disappeared. Patients are usually sbnt to hospital on the third or fourth day of the disease. The initial rashes are often among the earliest symptoms, and may, if of the simple erythematous variety have disappeared, whereas, if purpuric in character traces of them will remain for days. In some instances, a fading erythema vas noticed on admission ; in others, no history of any could be obtained, though the petechim were present. The following cases illustrate this CASE V.-M. C., æt. 15. Vaccinated, one good nark. Ad- nitted Jan. 18th. Initial symptoms severe, well-marked rigor. Temp. 102 2°. Pulse 102. Resp. 24. Only a few papules",
         "INITIAL RASHES Op SMA-PoX -nY DR. OSLER. wisible on the face and about the vrists, PctechiS on back, sides, groin, and legs. Those upon the back were scattered and small, on the abdomen they were thickly set and large, especially in the hypogastric region. On the lower limbs they existed as smnall circular spots of dark red colour on the inner surface Of thethighs and the extensor surfaces of the legs. In this case I could obtain no history of an erytiiematous rash. Course of .isease.-Favorable. Eruption discrete desic- cation early; recovery rapid. CAsE VI.-T. C., St. 20. Vaccinated, one good mark. Ad- mitted Feb. 10th. Initial symptons moderate. Eruption discrete, in tlic papular stage. ' Abundant petechiai in the lower abdom- inal regon, and in the groins; also a few over the serrati magni muscles. None upon the thighs, or legs. No trace of an erythematous rash, nor could it be gathered fron the statements of lie patient that one had existed. Curse of' Discase. General syinptoms good; pustules formed normally. Purpura faded within the first week. CAsE VII.-T. B., ait. 22. Vaccinated, one good mark. Admitted December 3lst. Eruption discrete and in the vesicular stage. Temperature 98.4.0 Ill since the 27th. Initial symptoms mild. Nuinerous snall purpuric spots in the groins, arranged chiefly parallel to Poupart's ligaments, and extending internally over the recti muscles. Similar spots, though some what larger, existed in a line with the lower ribs, extending towards the navel, According to the statements of the patient, on the second and third day of his illness, there was a rash on the lower abdominal region. Course of Disease.-Pustules few in number. Recovery rapid. CASE VIII.-R. W., ait. 20. Vaccinated, one indifferent mark. Admitted Jan. 10th. Initial symptoms mild. A plentiful eruption on face, buttocks, and arms. A diffuse erythema pre- Sent \u003eover the whole trunk, and, in a limited degree, over both elbows. Accompanying this were abundant petechi, espe- eially numerous in the groins, the lumbar region behind, and '2 7",
         "CANADA MEDICAL AND SURGICAL JOURNAL. the posterior surfaces of the the thighs. Jan. 11th. Erythema had disappeared entirely. On the buttocks, back, and extensor surfaces of the arms and thighs, the pustules were collected into small groups. Course of Disease.-Pustules did not maturate fully; des- iccation early. Recovery rapid. This ,was the only instance in which the initial rash was present on the extensor surfaces of the joints. Occasionally the initial rash is late in appearing, and may follow rather than precede or accompany the eruption. CASE IX.-H. A., -et. 28. Vaccinated, five good marks. Admitted April 3rd, with a disscminated papular cruption. Initial symptoms.had been tolerably severe. April 4th. At morning visit an crythernatous rash, accom- panied by numerous petechiie existed over the lower abdominal regions, and groins. Erythema not intense, petechiS small, and closely set together. April 5th.-Rash had disappeared. Course of Disease. Pustules developed well. General symptoms good. Purpura had faded by the seventh dày, leaving light brown discolourations to mark the places where they had existed.. The initial rashes in the foregoing cases, with one exception, (case IV), occurred in the discrete form of variola, and though recovery, as a rule, was rapid, none of the cases could properly (unless, perhaps, case VII), be classed as varioloid. One of the last patients admitted into. the Hospital afforded an instance of an initial purpuric rash in the mildest possible forrm of small-pox. CASE X. W. A., vet. 17. Vaccinated, two good marks. Admitted June 2nd. Eruption scattered, pustules few in num- ber, not more than 30. On admission an abundant purpuric eruption, accompanied by a slight degree of erythema, existed over the lateral thoracie regions, the abdomen, and inner surfaces of the thighs. Between the navel and the pubis was a large superficial ecchymosis, about half the size of the hand, extending in a somewhat semi-lunar form. The purpuric spots",
         "INITIAL RASHES OF SMALL-POX.-BY DR. OSLER. in the groins were of large size, and arranged chiefly parallel to Poupart's ligaments, at a distance frc n '-1\"above them. A few isolated ones extended over them to the anterior region of the thighs,while others existed on the upper third of the inner surfaces. Course of Disease.-Up on thc 5th day. The last case observed is interesting from the fact that the initial rash took the form of an extensive urticaria. CASE XI.-A. E., 'St. 29. Vaccinated, one bad mark. Admitted April 7th. Initial symptoms had been moderate. On examination an eruption was found upon the trunk and extremi- tics which presented the usual characters of urticaria, viz, eclevated reddened patehes of unequal size, in some places arrang ged lincarly, in others forming broad areas, light in the centre, deep red at the periphery. On the trunk they were chiefly grouped together, being most abundant on the anterior surface, while on the extremities they were arranged in raised lines, the typical whealis of the affection. In the neighbourhood of the ankles and back of the feet they were of large size, and showed better than anywhere else the characteristic features of the eruption. The patient complained of sensations of heat and itching, and wherever lie scratclied violently a fresh outbreak occurred. A few papules of variola were noticed on the face, and about the wrists. April 8th --Urticaria persists, though not so marked on the trunk. April 9th.--Has disappeared from the trunk, and greater part of the extremities ; a few only remain about the ankles. At the evening visit no trace of. urticaria could be found. Pocks few in number, not more than 60. Patient got up on the 10th, and rdinained in the hospital twelvi days. Simon* expresses hinself as somewhat skeptical about the occurrence -of genuine urticaria as a prodromal exanthem in Small-pox, believing that most of the cases described as such should be referred to the macular or measly rashes. I think there can be no doubt about this case, the wheals were- * Loc. cit. 21:9.",
         "250 CANADA MEDICAL AND SURGICAL JOURNAL. too characteristic to allow of mistake. A genuine case is also .reported by Starck, (Arch. d3r Heilkunde, Vol. iv.) in which the urticaria appeared and disappeared in different parts of the body in the course of the disease. Simon calls attention to the fact that the simple macular and diff'ise rashes are not unfrequently accompanied by sensations of heat and itching, which in the case of the former might cause them to be confounded with urticaria. The frequeuîcy with wiicli the prodromal exanthcms occur is apparently subject to considerable variations, depending, perhaps, on the type of epidemic, which lias exhibited marked changes within the present century. The epidemic which lias ragetd in so mnany parts of the world since 1870 lias been of an unexampled severity, owing, in great part, to the large proportion of hæmorr- ,hagic cases, and lias been further narked by the very general prevaience of the pradromal exanthems. That no reference is made to then by so many of the old authors, and that such scauty notice is found in the more modern works, can only be explained on the supposition of their infrequence in former epidemics. In 1088 cases of smail-pox obscrved by Kniecht, (Arch. f. Dern. u. Syph. iv), prodromal exantheins occurred in 104 or about 10 per cent. In 1413 cases of Scheby-Buch there were 237 instances of these rashes, or 161: per cent. In 81 cases under my care there were 11 instances, . e., about 13 per cent. Simon does not give the percentage in his cases, but fron the number recorded in his series of articles on the .subject it must have been large. The localities most commonly affectedi are the anterior abdom- inal surface, and the inner surfaces of the thighs. Thus iu Scheby-Buch's 2:37 cases these regions were affected in 190 instances. In the few instances which have cone under iiy notice, the lateral thoracie areas were more frequently the seat o fie exanthem than the inner surfaces of the thigih ; nor did I observe any cases in which the rash was absent from the -interior abdominal regions. Many cases are recorded in whicl the exantlem remained limitedl to the regions of the joints,",
         "NMA. RASHES (F S.ALL-POX-nY DR. OSLERZ. 251 (ebows and knees), or the backs of the hands, the axilhe or the inner surfaces of the thiglhs, without the smnultancous affection of the abdominal surfaces. When confined to the extremities, bo:h upper and unelr are inplicated as a rule, the rash is rarcly li:n-d to either alon2. Occasionallv thev are unilateral, iii case thev are always of snal. extent. The gencral crvthenatous rashes are rare in Scheby-Buch 217 cases therc were only 14 instances. Neithcr of the above mentioned authors s:a:e th pro rio etween the simple erythernatous rashes i those a2c\u003eyi ed by purpurie spots. In1eed, in the reports nimanV of Simîons cases no mention is made of their reseice or abence. LI the Il cases which have come under my notice the latter greatly exceeded the former, the proporton bueing 8:. A consideration of the dia«nostic ani prognostic value of the itial raShles is of great initerest : for. of course, thc worth of a symptom is iii direct ratio to the amount of knowledge it gives us ,i deciding5. upon the nature of a case. andl forming an opinion as to its probable issue. From the faet tiat a patient is rarely or never sent to Hospi- tal untl the characteristic eruptioi has niade its appearance, i. e., on or about the fouith day of the disease, none of the above cases were of any service to Ie in foriing a diagnosis ; that had already been made. l any case the value of the initial rash depeis greatly on the date of its outbreak, which extends from 1 to 5 days before the appearance of tlie cruption. In the majority of cases it cones out on ti second day, and if of noticeable extent would consequently be of diagnostic importance, mors especially if accompanied by petechioe. Indeed, Curseli- mnann* states that in the initial stage of the disease there is only (o pathogorno nic symptoI, and that is, the hæmIorrliagic exanth.em situated in the triangle of the thigh. The petechial rash is of nuch greater diagnostic value than tle simple erythematous, and a case of fever presenting an eruption of purpura in aiy of the above oft-named localities on the scco'nd or third day should be looked upon with grave suspicion. Simon iaintained that even before the onset of the fever, and prior to Loc. Cit.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. the general disturbance of the system, the diagnosis could be determined by the appearance of the characteristic prodromal exanthem. This is going very far; still, he bas recorded two such cases, and quotes two others. In bis 38th case there was an initial rasb in the inguinal regions, and about the anus, for the greater part of a day before the onset of the fever and constitutional disturbance. The former set in with a rigor, and was followed by a great extension of the exanthen. It is to be remembered that prodromal rashes are not peculiar to smail-pox, though, no doubt, they occur .with much greater frequence in this disease than in any other. Scheby-Buch states .that he lias met witli simple erythematous rashes in the initial stage of tonsillitis, typhoid fever, and measles, presenting the same dis- tribution, and differing only from those of small-pox in intensity and extent. Purpuric rashes, however, are excessively rare, if they occur at ail, in the first stage of the ordinary febrile affec- tions ; so that they are of chief moment among the prodromal exanthems of small-pox, and may be regarded as affording a tolerably certain basis for diagnosis. The general erythema, which is met with in a limited number of cases, is usually of the diffr.se form, and, occurring on the second or third day, might be coný,banded with scarlatina. The points to be attended to in the diagnsis would be, the mode 'of. attack, which in the two affec- tions presents certain differences; the colour and extent of the exanthem, vhich is brighter in scarlet fever, and, as a rule, much more extensive ; and lastly, the presence of minute pete-. chiS in the inguinal regions would be in favor of small-pox. The diffuse crythema accompanied by numerous petechiâe which occurs on the second or third day in cases of malignant small-pox, could not be distinguished from the similar condi- tion met with in those rare cases of hæmorrhagic scarlatina. The presence of an epidemic of one or other disease would be the only means of deciding the nature of the case. Simon regards the prodromal exanthems as eminently charac- teristic of small-pox,and among bis cases, which are ail of great interest, we met with some of special significance. Thus in the case of a girl who had had a rigor, fever, pains in the back and 252",
         "INITIAL RASHES OF SMALL-FX.-BY DR. OSLER. 253 head, and initial rashes in several places on the extremities, though no eruption followed, the diagnosis of Emall-pox was made, and confirmed by the fact that the sister, who had acted as nurse, took the disease badly. le also records cases in which, with the outbreak of the prodromal exanthem, the temperature sank and the general symptoms subsided, coming on again with the appear- ance of the eruption, and finally subsiding on its completion. Whether from a diagnostic point of view we agree with this author's estimate of the value of these initial rashes or not, there can be very little doubt that in a limited number of instances they may be of considerable service, in enabling us to decido upon the nature of a case; and therefore take early precàutionary measures for the isolation of the patient. Of the value of the initial exanthem in the prognosis of the disease the opinions of authors differ. Simon makes the general statement, that, \" among the severe and fatal cases of variola just as many were accompanied with prodromal exanthems as those without,\" and ho regards their prognostic significance as nil. It struck me, however, in reading over his cases that the number of deaths was comparatively small. Knecht in 115 fatal cases of small-pox met with the initial rashes only 15 times, and as this observer noted 104 instances his experience supports the view that they are, on the whole, of favorable significance. He states that up to the 30th year they are of no prognostic value, but after this age they indicate a severe course, while in old age they are almost invariably of evil omei. 'Of Scheby-Buch's 237 cases. 37 died ; i. e., about 15 per cent. Ilis experience dGes not bear out Knecht's supposition, that after the age of 30 the prodromal exanthems are of serious import. Curschmann believes that the simple' macular and erythematous rashes almost invariably precede varioloid, and states, thatý in many instaices the number of pustules was in inverse ratio to the extent of the initial rash. On the other hand, the purpuric rashes, in his experience, especially those in the regions of the groin, are almost always followed by variola vera. The il cases above reported do not support the view ; the only",
         "254 canaA mEDICAL AN) SUBGICAn JOrA. fatal case among them was preceded by a simple erythema:cus rash Of considerable extent and the other instance of an erythe- matous rash was not followed by varioloid. Not one of the eight instances of initial purpuric exanthem proved to be variola vera thev were all followed by the milider forms of the disease. tuo of them being varioloid. Trousseau' states that while in natural small-iox the scarla- tiniform rashes accompanied with rur.iia ecnstitute aia1mirr symptoms, they do not lead to an unfavorable prognosis in the modified form. Professor See† believes that the scarlatiniform and rubeclic rashes precede as a rule benign cases, the hemorrhagic variety the severe. Hebrat holds that the appearance of the rash upon the abdomen is not-\" necessarily to be regarded as an unfavorable sign. These cases do, however, more often terminate badly than in recovery, and particularly when the affection passes beyond mere hyperæemia into hîcmorrhage, when, in fact, a purpura rather than an erythema shows itself on the abdomen and on the thighs.\" On the whole the presence of initial rashes in the majority of cases indicates a favorable termination, but it is evident from the foregoing statements that we cannot t.s yet lay down definite' rules with reference to their prognostic value. In forming an opinion we must not rely on the nature and extent of the exan- them alone, but take into account the general symptoms, notas Sydenham says \" go by the external appearance only.\" The prodromal exanthems it may be remarked occur with much gréater relative frequence in men than in women. A debated point has been, whether the small-pox eruption ever appears on the regions wliich have been affected with the initial rashes. In very many instances these parts present an entire immunitv, which may be owing' tô the fact that the rashes occupy just those regions most commonly spared by the smsall- Loc. Cit., Vol. il, p. 71. † Journal (le Medicin, Juin, 1875. ‡ Skin Diseases, Vol. 1. p. 58.",
         "HOSPITAL REPORTS pox pustules. The lower abdominal and inguinal regions are rarely the scats of an abundant eruption, and often remain free,. while the rest of the surface is involved to a considerable extent. I have several times seen isolated pustules develop in the hypo- gastrie region after an initial rash. Most authors refer the phenomena in question to disturbances in the vaso-motor nerves, caused, Sinon supposes, by hyper\u0026- mia of the cord, which affects injuriously t.e vascular nerves, passing down from the modulla. If,\" in his own words, \" the- affection of these nerves is wide-spreal an erythema universale follows, while if limited to certain groups we notice. circumscribed erythemas; and, as the chief site of the affection (hyperomia ?) of the spinal cord is in the lower dorsal and lumbar regions we have in the majority of cases the erythema confined to the lower parts of the trunk.\" ~ospital Seports. MEDICAL AND SURGICAL CASES OCCURRING IN THE PRACTICE OF THE- MONTREAL GENERAL HOSPITAL. Case of Acute Beumatisn treated witl Salicylic Acid.- Under DR. Ross. R.eported by Mr. I-. N. VINEBERG. The following case illustrates well the effect of the great new remedy for rheumatism. The case was certainly quite severe,, but the relief to the pain was very rapid. As the temperature was almost normal on the 19th inst., and there was perfect free- dom from pai'n, the acid was stopped, as some complaint had been made of burning in the stomach from it. The result of this, it- will be observed, was the immediate return of all the febrile and painftil phenomena. A return to the remedy again very soon removed them, and produced a rapid cure. It seems quite necessary to continue the acid for a few days after the patient is completely relieved. L. P., St. 22, was admitted into the Montreal General lospital on the 14th of September, 1876, under the care cf Dr. Ross, with Acute Rheumatism. No history of rheumatism.",
         "25 CANADA MEDICAL AND SURGICAL JOURNAL. in the family. She never had rheunatism herself before. IHad typhoid fever last summer. Has been frequently exposed to drauglits, and sleeps witli the windows of her bed-room open. Eight days ago first began to experience slight pain in both limbs. The pain came on during the day-time. The following day she was comparatively free from pain, but on the second day was seized with a severe pain in both shoulders. It soon left the shoulders and went to the hips, where it remained for some three days, and then migrated to both ,-nee-joint,. ankles and toes. Condition on admission-Severe pain in the shoulders, elbows and wrists. The joints are slightly swollen, very hot and tender. Also has some pain in both knee-joints, the right knee being somewhat swollen, tender and hot. Tongue consid- erably furred, with a red border. Anorexia. Bowels regular, very copious pQrspiration ; whole body is covered with sweat, which is very acid ; urine very higi coloured and acid, and with a higi deposit of lithates. Temperature 1020 ; Pulse 120, full and compressible. Hleart sounds normal. Ordered milk, and to take gr. v. of salicylie acid every hour. Sept. 15th.-Pains much better to-day. Perspires v'ery freely. Saliva distinctly acid. Sept. 16th.-Slept well last nigit. Pains all gone from the joints, with the exception of the left shoulder. The other joints feel stiff. To take medicine only every two hours. Urine feebly acid. Saliva and perspiration very acid. Still perspiring very much. Sept. 17th.-No pains whatever to-day. Joints still feel some- what stiff. Rested very well last niglit. Perspires considerably still. Tongue heavily coated. Bowels not moved since admitted. Sept. 18th.-No recurrence of the pains. Had three attacks of epistaxis during the last 36 hours. Heart sounds normal. Says medicine makesi her sick at the stomach, causing some uneasiness, and a burning sensation, Only to take it every sL( hours in the future. Spt 10th.-To discontinue the salicylic acid, and the follow- ing mixture was ordered. Quinæ sulph, gr. xii; acid nitro' muriat. dil. 3ii ; aquS ad Svi; a table spoonful three times a day.",
         "Sept 20th.-Ie urreice of pain in both shoulders. There is a sligh t roughening with the first sound of the heart, heard over the O3rd caitilage. To have gr. x. of salicylic acid every two hours, and to discontinue quinine mixture. Sept. 21st.-Had a verv poor nigjit. Pain in both wrists to-day, none in the slouliders. las a ptin betweeh the shoulders behind, wlhich shoots to. the left wrist. Bowels moved freely last night by medicine. Owing to some error did not get the salicylic acid till late in the evening. ioughness with first sound pronoiunced. Sept. 22nd-Pains all gone to.day. Wrists a little stiff ouly. No chanîge in s'ounds of heart. 8-pt. 23rd.-Condition about the same as yesterday. To have gr. v. of the acid every four hours. Sept. 24th -Sleeps very much. Says ndicine makes ber sleep. Tongue coated. The roughuess with first sound has become a distinct, but soft, blowing murmur, with maximum of intensity at the junction of the 5th cartilage with the sternum. To have medicine only four times a day. Sept. 29th.-Has had no recurrence of the pains. The murmur, for the last four days, lias been becoming less distinct every day, and to-day it cannot be detected at ail. Feels quite well, asking for food. Still taking five grains of the acid forr times a day. late 14. 15. 16. 17. 18, 19. 20. 21. 22. 23, 24. 25. 21. 27. 28. 29, aE lu, CRE iliEmM ?PIse 120 115 .110 100 83 78 8 108 96 96 100 96 88 80 76 76 76 Oct. 1st.-Up and doing well. Joints as well as ever, Qrdered laif diet, and a tonic mixture. Continuing quinine and nitro-muriatic acid.",
         "258 CANADA MED1CAL AND $URG!IAL JOC:NAL. Case of Tubercudar Minqiti. Under Dr. Ross. Reported by Mr. C. L. CoLoN. E. H., îet. 21, was admittel into the Montreal GencralI Hos- pital on the 27th October. 187G, under Dr. Ross, and wvas said to have typhoid fever. Hlistory.-Has formerlv bcen troubled a g(Od Ldeal with headaches. Last winter she had swelling of. lier legs, for the greater part of the winter, accompanied by a constant head- ache. Father died two years ago. Cause not kn\u003ewn. Mother living. Catamenia always regular. She has been sick for the last fortnight, the predominant symptoms have been a constant severe headacie, vointing and constipation. Oct. 29th.-Patient lias been delirious since ciglit o'clock last night. Delirium of an active, talkative, singing kind. Hands are constantly moving about the head. She is constantly rub- bing her nose as if it irritated ber. She is perfectly unconscious. Muttering, and talking is continuons. Vomited often during the- night. Was given an enema which operated freely. Some· apparent tenderness over the abdomen. Pupils are dilated. They oscillate when expose. to liglit and do not fully contract. The nail drawn across the skin of the abdomen leaves a deep red mark, which is persistent for some time, (Tache cerebrale of Trousseau). Pulse 88, small and weak. Respirations 18. Lips parched and dry. Temperature 101O Fah. Urine contains 25 per cent. of albumen. Heart and lungs examined and found normal in every respect. Ordered a purgative of calomel and black drauglit. Sinapisms to back of neck, and pot. brom. gr. x. pot. iod. gr. v. three times a day. Oct. 30th.-Was delirious all night, but the delirium has subsided, and she now lies in a half stupid condition. Dull expression. Can answer questions slowly. Tongue coated with a heavy white fur. Pupils still dilated, and do not act well to light. About 25 per cent, albumen In. urine. Sp. gr. 1030. Abdomen not so tender on pressure.: HIad an enema last nigit which moved her bowels very freely. Oct. 31st.-She is rather more dull to-day. It is with great - Oct. 5th.-Discharged well.",
         "H1(iTAL lR-PORTS. difficulty that sie answers questions. Urine still albuminous. Complains of a severe fr-ontal headache. Som tenderness over abdomen. Pupils dilated and oscillating. Tongue very heavily coated with a white fur, moist. Bowels not -moved. Nr. 1t.-Mental faculties more stupid to-day. A very severe headache. Tongue dry and dirty brown. Pupils dilated, the left more t1han the right. She oomplains of a pain in the chest, and a very severe pain at thte backc of the necc. and also some pain in thte bacle. She is constantly moaning. Urine 20 oz. Very turbid and a heavy deposit of lithates, 25 per cent. of albumen. Had a purgative of calomel and black draught last night, and an enema this morniig but lier bowels have not mnved. Same condition of skin, but not quite so marked. Mov. 2nd.-Same dull condition of mind. Sie answers questions slowly, and does not always seem to understand their meaning. Face flushed. Pupils dilated. The left more than the right and oscillating. Co'nplains of the light hurting her eyes. Internal strabisinus of right eve evidently caused by paralysis of external rectus of left eye, Frontal headache. Pulse, 100, weak but regular. An apathetic expression of couatenance, the mouth wide open and eyes nearly closed. The peculiar condition of skin which. was noticed at first is still pre- sent, but not quite so marked. Urine still albuminous. Dr. Ross discovered slight traces of sugar. Had an enema last night which moved lier bowels very freely. Ophthalmoscopic eýxaminatio1i of eyes by Dr. Buller. Margins of optic nerve, specially upwards and inwards, are not well defined. Retina slightly hazy. Optic disc rather paler than usual at her age. Nov. 3rd. -Still in the dull condition. Pupils dilated. Equal in size. Internal strabismus of right eye continues. Sordes on lips. Face covered with a profuse perspiration. Bowels not moved. Nov. 4th.-Passed her evacuations under her unconsciously. She had 01. Crotonis vii, last night which operated very freely. She is in a much more stupid condition to-day. Cannot answer questions. Eyes closed, and the light seens to pain her. Con- f. à9",
         "CANADA 'JEDflAL AN1\u003e sURGICAL JOURNAL junctiva of righ t eye sonewhat injected. Pupils dilated, but not to quite so great a degree as heretofore-of equal size. Strabismus not quite so mucli marked. Tougue coated with a heavy' brown ftr and dry. Same peculiar condition of the skin present. Urine albuminous. Pulse, 120. A red rasli on back of both forearms. Cheeks are flushed. Died at 10.15 P.M. AUTOPSY 17 HOURS AFTER DEATH, BY DR. OSLE.R: General Appearance.-3ody, that of a tolerably well nour- ished young girl. Rigor mortis present in a slight degree. Post mortem discolouration in the dependent parts. Thin layer of panniculus adiposus. Muscles normal in colour. Brain.-1270 grammes. Parts about optic nerves matted together, arachnoid thickened. Pia mater very adherent. No lymph nor inflammatory products present. No miliary tuber- cles discoverable on superficial inspection, but on spreading out the middle cerebral arteries under water, many of them were observed about the smaller arteries, chiefly as fusiform thickening. Cortex ; veins moderately distended. Convolutions slightly flattened. Small veins over convolutions also full. On section white substance pale. Puncta vasculosa indistinct. Lateral ventricles distended, and contain one ounce of fluid. Lining membrane of the ventricles slightly granular. Surface of optic thalami soft. Fornix and septum lucidum exceed- ingly soft and tore in the removal. Spinal Cord.-Much blood oozed from the vessels about the dura mater, and a thick layer of fat exists between the laminoc and this membrane in the dorsal region. Arachnoid looks a little opaque in the upper part of the cord. In the lower three-fourths this membrane was covered with numerous small cartiliginous plates irregular in outline, flexible, and of the usual glistening whiteness of these bodies. Veins of pia mater full posteriorly. No trace of miliary tubercle. - Substance appeared in section quite natural. Thorax and Abdomen.-Position of thoracie viscera normal. Sigmoid flexure very lon, 16 inches. and passes across from le 260",
         "HOSPITAL REPORTS. to right, just above the symphysis pubis. Rectum descends on right side. Pericardium appears distended, and a small amount of fat exists upon it, and it contains 6 oz. of slightly turbid fluid. Ileart. Weight, 300 grammes. No clots. Considerable amount of blood in the cavities. Valves of right side healthy. Walls of left ventricle appear slightly thickened, valves normal. Endocardiuin on the septum. immediately below aortic valves, a little opaque. Ruiht Lung.-A large ainount of blood flowed out from the puhnouary veins on removal. Whole of the lower lobe dark in colour, ieavy. On section surface bathed witli bloody serum. No crejitation can be felt. Small portions of the organ from superficial parts float in water, from the deeper parts they sink. Deeper part of the middle lobe of the lung is in a similar condi- tion, and also the anterior part of the upper lobe below. A few miliary granulations seen in the substance of this lung. Left L'ung.-On careful inspection a few small miliary gra- nulations seen on the visceral layer of the pleura, and on section a few are also evident in the substance. The lung is crepitant throughout, and contains an average anount of blood. Bron- chial glands enlarged, and one presents several caseous masses. Small miliary tubercles are also evident throughout them. Spleen.-Capsule slightly opaque, and covered with a few small fibroid thickenings. A small supernumerary spleen, about the size of a walnut, is situated just below the tail of the pancreas. Anterior border of the organ presents three, posterior border two, fissures. .No tubercles evident on the capsule or in, the substance. 'On section the organ is soft and dark in colour. -Rigt Kidney.--180 grammes. Capsule easily detached. Surface smooth. Venae stellatac evident. On section two small tubercles noticed in the cortical portion. Cortex presents a series of alternating red and White lines. Pyramids slightly congested, and a good deal of blood oozes from the vessels at their bases. Left Idney.-160 grammes. Appearances similar to those in the right. No tubercles evident. Somach.-Slight post-mortem softening in the dependent 261",
         "fANAVA SNc'C.]..N ~.I JHA. part frcm -post imortezm di.estion. SuilL ainiiut oicus over the surface. J)odom.--H~ai P. Bile IIfows fron the punem Liliaria on pressini.g ie galla ladier. slands solitary n ate in the reion of the ilium very distinct. Otherwise niormal. Liver-1235 grammes. Firm. On section, of a uniform reddish coIour. I.ubules indistinct. A. good deal of bLod flows out from the cut on section of the veins. Uter's and Oraris - A recent corpus luteum found in right ovary, presenting a yellowish rim, enclosing a firm reddish clot. Thme inucous membrane of the uterus pale, a few of the larger vessels onlv being visible. On examination the uterine g zamìi and epithelimin are present, ani appear normal. '$cuiews aid 1floficcs of Boohs. A Prachtcal Treatise on i ciedica and T4icrapeutics. By Ronans BAnTrOLOW, M. A., M. D., Professor of the Theory and Practice of Medicine and of Clinical MeLdicine, in the Medical College of Ohio etc.. etc. New York : 1). A ppleton \u0026 Company, 1 876. Bartholow's Materia ieicdica is, we beleve, the Latest work upon that highly important department of Medical Science that lias issued from the American press. In many respects it is (eserving23 of coniendation at the hands of the Reviewer. It is'neither too pondcrous nor too diminutive. Its sizo does not iill one with the awe felt by the siglit of the three large tomes of Pereira's Elements,-nor does it cause a sigh for more, as when one turns over the pages of the notorious IIunter Lane. Bu lina happy mean in an 8vo. of 537 pages, the author lias comprised just wvhat is likely to be or practical utility to the physician upon the subjects taken up. Dr. Bartholow entered upon his task with several advantages, and lie brouglit to il) the claims not merely of the plodding book compiler, but far bigher, those of the independent original observer. le was",
         "EVIEwM AND NOTICES OF nOOKS. for several years a teaclier of Materia Medica and Therapeutics, lie pursued a number of rescarches bcaring upon them, and has supplemented the knowledge thus gained by a clinical experience of 2 years' length. The outcone of all thiis in the work before us, is a good digest, not only of the inlforiation to be found in the older works, but also of tiat whichî las accumulated, since their date and is chiefly confined to the'serials or periodicals in which it first appeared. Oné cannot live alone in the past in Materia Medica any more than in anything else. iNew remedies are steadily being aded to our former store.--and some of them are of the greatest worth, to wit, Nitrite of Amyl and Salicylic Acid. All such are fully treated of in this volume in a clear, Conlcise and able manner. The author's classification of nedicines is both novel and interesting. It includes the following divisions: Remedies used I. To promote constructive metamorphosis ; II. To promote destructive metamoiplosis ; III. To nodify the functions of the iervous systCm, by (a) exciting functional iactivity ; (b) depress: ing or suspending functional activity ; (IV) To cause some evacuation from the body, such as Cathartics, Enetics, \u0026c., and (V) To act topically. Simple thongli this be, we think a still simpler arrangement will be found to gatler in the actual ten- dencies of all remedies. Tlhey nearly ail tend to excite or urge on functions. They nearly all are stimuants,-either general or local,-acting upon cither one function alone, or upon several functions. The exceptions to these operations are very few. Upon these few facts Lhe whole materia medica might be made to inplude medicines, which I. tend to stimilate, and If. do not tend to stinulate. The first to include stimulants proper, and besides them narcotics, ai evacuants, and counter-irritants, \u0026c. The last to include such agents as sedatives. demulcents, \u0026c. Such an arrangement may snmck of the old Brunonian fincics,-but it is one the worth of which in its practical bearings will be easily appreciated by the practitioner. While upon the benefits to be had -from i-eduicing things down to the simplesi comprehension we may here also express the wisl that writers upon Therapeu- ties would draw a line of distinction between Absolute and",
         "264 CANADA 3IEDICAI ANI) SURGic.L JOURN.. Relative remedies. As disease is now treated, the latter occupy a far more prominent and frequent place than the former. Who ever thinks of prescribing for Amenorrhoa any of the reputed absolute emmenagogues ? Is not the usual course to treat the disorder by removmg the condition upon which the suppres-- sion depends ? We notice a useful introduction in the work before us, which seems worth mentioning. It is a paragraph under most of the articles to naine the \" Synergists ;\" that is to say, the medicines that act in the saine way with the one under examination. For example, under Chloroform we find \" Synergists, Anæcstlictic agents, opium, chloral, alcohol, etc., promote the action of chloroform :\" under colchicuin we find \" Synergists, such alka- loids as produce gastro-intestinal irritation, and depress the action of the heart, e. g. veratria, aconitia, etc., arc synergistic. Tiher- peutically considered emetics, purgatives, alkalies, promote the activity of colchicum :\" and so on under the majority of the articles discussed. Lastly, we would remark, that this excellent work has been written rather for the physician, than the druggist. Accordingly the mode of preparing drugs, and the formulh of the officinal compouids are purposely omitted. The aim bas been steadily. kept in view to produce a-treatise more therapeutical than phar- maceutical in character. To all in need of such a book ;-and who is not in need of the latest instruction upon the weapons of his warfare ? w'ho in busy practice is.not desirous to have that information in the most condensed, and at the same time most easily accessible form ? To all such we heartily commend this book. We feel sure those vho study it best, will thank us Most for having brought it to their notice. A Practical reatise on Diseases of the Eye. By ROBET BRUDENELL CARTER, F.R.C.S., Ophthalmic Surgeon to St. George's Hospital, \u0026c., \u0026c. American Edition edited by John Green, M.D., of St. Louis; with 124 illustrations;: 8vo., pp. 505. llenry C. Lea, Philadelphia, 1876. The enormous stridces mnade in. the science of Ophthalmology -within the last quarter of a century can only be dimly discerned:",
         "REVIEWS AND NOTICES o BOF s. througlh the flood of literature which, up to the present time, continues to be poured in upon the reading world ; and perhaps nq one can fuly appreciate the full extent and breadth of the subject, who has not attempted to collate from and embody in a single treatise the leading facts containcd in this vast bulk of material. For such an undertaking, if the tréatise is to be a readable one, soiething more thaln mere plodding industry is requisite the author should have a perfect command of the language in which he writes, and, what is almost equally important, be should bc a perfect master of bis subject. Given, then the capacity for labor, together with the two last mentioned quali- fications, and it will be safe to predict that such an author will produce a high classed work on any subject he may choose to treat of. The work under review bas emanated from the pen of a gen- tleman who bas attained a high reputation as a writer, apart from the speciality of which he is one of -the brigltest orna- ments., Although containing much that nay be found in any other treatise on Ophthalmology, the whole work smacks of ori- ginality, botl in its arrangement and il the freedom·with which the author expresses his own views, though without entering into lengthy discussions such as are to be found in some of the more ponderous volumes of a similar kind written within the last few years. Thus it happens that many of the dry details to be found in \" undigested compilations \" are left out ; neverthe- less, there is a very great deal of information contained within a comparativelysmall compass-though nothing of importanee seems to have been oinitted for the sake of originality. From the specialist's point of view, the book might justly be styled incomplete, but it is none the less well adapted to supply the wants of the miuch larger class of readers w-ho cannot be expected to acquire a thorougli kowledge of other than the COmumon forms of diseases of the eye. After discussing the anatony and physiology of the eye suf- ficiently to enable the reader to refresh bis memory on all strictly practical points connected with this division of the sub- 265",
         "nCANA DA M a siCAL A SU ICA JOURNAi. ject, a very clear and concise description is given of the way in' which a inethodical examination of the or gan is to be conducted in order that no departure from the normal state shall escape observation. Tais includes, of course, a description of the ophthalmoscope and its uses. Hiere we do not find as much attention given to the art of determining the state of refraction, by the aid of the ophthalmoscope, as might be desired by any one aiming at proficiency in its use. Some five pages are devoted to the description of a demonstrating ophthalmoscope invented by the author, who seems to have forgotten the cir- cumstance wlien lie states, furtber on, that \" the safest man is he who never invented an instrument in his life, but whose daily practice affords evidence that lie can use those which have been invented for him by others.\" We now cone to the chief feature ini the arraingement of the work, and which, so lr as we have seen, dîstinguishes it from all other recent treatises on Ophthalmology, and that is the introduction of two long chapters on \" The Principles of Oph- thalmic Therapeutics and Ophthalmic Surgcry,\" before proceed- ing to treat of diseases of the eye in specie. Both of these chapters are exceedingly welli written, and will amply repay a careful perusal, as they contain many valuable hirits of an cmi- nently practical character, together with a description of the ordinary instruments required in operating upon the eye; and instructions for, their use are given in detail worthy of the importance attacling to this department of Ophthalmology. The chapter which treats of diseases of the conjunetiva is, perhaps, a little deficient in the inatter of classification of the diseases of tihis structure, but the deficiency lias been pointed out, and to some extent remedied by the American editor, who has also cloue good service in making soine additions to the text, and in supp!ying foot-notes, in relation to some points which have seened to him to require further elucidation or call for criticisml. It would be difficult to find a better essay on iritis and its sequels than that contained in this book and the remainder of the wyork, which treats of cataract, glaucoma, the diseases of the fundus oculi, wounds and injuries of the eye, affections of the ocular ,206",
         "REVIEWS AN) NOTICES OP BOOKS. muscles. acéonimodation and refraction, and the uses and selec- tion of spectacles is fuilly up to the present state of knowledge concerning these things as far as can be comnrised in a work of this size. - He who wishes to study the pathology of diseases of the ove will find but meagre satisfaction fron this treatise, but for tne busy practitioner who desires to keep up his know- ledge of ophthalnic medicine and surgery with the least possible amount of labour, there-is probably no botter text-book in the English language, and for the student who hesitates bofore taking up any new and extensive study, and who recoils at the sight of huge volumes r-zeking. with optical puzzles and algebraical formulb, there can be no more welcome boon. A Contribution, to he Treatment of Uterine 1ersions and Flexions. 13y EPrnAIM CUTTER, A.M., M.D. Second Edition, entirely re-written, with 29 illustrations on wood. 8vo. pp. 216. Boston: JAærEs CAPBELT, publisher, 1876. This litle work lias issued froin the press, as the author expresses it, not as \"a piece of fine writing,\" but rather as a contribution from the po of one who believes it the duty of cvery mari to botter the profession of hlis choice if he can. So far as uterine flexures and their uechanical treatnent is con- cerned, we mwust admit that Dr. Cutter bas in a measure donc his part. The object the author las in view is principally to extol a uterine pcssary wbich goes by his naie, and which seems to bc an excellen~t article of its kind. In neariv all worlks on the subject of uterine discases, imarginiry drawings are given showing the excellent results of the introduction of some forni of Meclianical support for the relief of uterine displacements. Thesè are remarkably satisfiactory as far as a book illustration goes. We sec the uterus which otherwise, is bont or twisted, fiexed or hanging down, set up in its right and proper position, and therc retained, as thoughi it ivere fresh from the hand of Dame Nature. The practical man, however, is sorely perplexod and s'mewhat disgusted whcn on the use of any of these sup- 267",
         "CANADA MEDICAL AND SURGMCAL JOURNAL. ports he finds that they do not correct the difflculty ior remedy the displacement. In making these remarks we do iiot desire to run a tilt against ail pessaries, but we are forced to the con- clusion, after our own limitecd experience, that of all the patented and non-patented contrivances the perfect coning pessary lias not yet seen the light of day. Dr. Cutter in his introduction gives a very lucid description of the mcthods of uterine dis- placements, and he concludes his argument by stating that the principles of treatment consist in, lst restoration of the displace. ment by the uterine sound, and 2nd, the retention of the parts in their proper position through means mechanically adapted to the parts. This is the gist of the whole matter, and it is this difficulty of mechanical adaptability which meets us in many if not the majority of cases. The author next proceeds to the consideration of Retroversion of the uterus, and thon considers separately Retroflexion, and subsequently both these conditions combined. Retroversion as figured at page 11 is a condition which we have never met with, and fear it is a slight exaggeration on the part of the artist,the anteror and posterior cul-de-sac in both instances, is mad to reach as higlh as the fundus of the uterus. For this condition of retroversion the author advises two forms of pessary, the lôp and the T. For the purpose of accuracy the author advises after reduction of the deformity by the uterine sound, to measure the distance from the full depth of the posterior cul-de-sac to flie edge of the perineum at the outlet, or in other words the len't!h of the posterior vaginal wall, when a loop pessary, one half ich longer than the measurement, and with the curve in the loop corresponding to the cervix will be found to fit accurately. The peculiar feature in Dr. Cutter's pessary is the hook-shaped stem which curves backwards over the perineum, and which is held in position by an elastie band, which passes between the nates and is fastened to a waist-belt opposite the sacrum. specific directions are given for the application of these pessarics, and furthermore, directions are given how to properly retain the pessary in position at all times. From pages 42 to 47 there is a liberal amount of -what is known as printer's fat, in wlhich the 268",
         "nRITISII AN) FOILE1GN JOURNALS. author gives an extended list of what to cat and wliat to avoid. This looks odd and somewhat mars the appearance of the book. We next have chapters on Anteversion, Anteflexion, and the conbination of these two conditions. The author adapts his loop and T pessary for these conditions, and in some cases finds it necessary to introduce a stem. In the iùtroduction and wearing of the pessary, the necessity for perfect and absolute comfort to the patient is pointed out, without this, the surgeon should seek to remedy the difficulty or change the instrument. After a few words on lateral displacement the autior discusses prolapsus, for which condition lie employs a cup-slaped support. The author next considers thé prevnlence of versions and filcxions in the un- impregnated state, and lie accounts for this prevalence from a variety of circumstances such as dress, poor food, over-work, much standing, going up and down stairs, non-observance of rest during the menstrual period, indolent indulgence or under work. He also points out the danger of neglecting to treat early uterine diseases, and displacements, and after showing how essential woman is to the sterner sex, lie concludes with cases which have come under his own observation. In the preface the aauthor protests against some forms of pessary which are called by his name, and in which the essential feature of bis invention has been left out. And lie states that Messrs. Codman \u0026 Shurtleff of Boston, who are his instrument makers, can supply these pessaries. We have read this little book with a good deal of satisfaction, and we can commend it for its thoroughly practical instructions. Walsk's Physicians' Combined Call-book anc llet.-Fron .18 to 18. For sale by J. B. Lippincott \u0026 Co., Phila- delphia, and Booksellers generally. We have received from Dr. R. Walsh, of £27, 4½- street. Washington, D.C., a copy of this book. It is to supply a want that\u003ei3 supposed to exist, althougli iwe think that the Physician's Visiting List, published by Lindsay \u0026 Blakiston, which lias 'been in use for over 25 years is fully up to the mark. This '2 G i",
         "270 CANanA ME:IQMo AND\u003e smUOCA JoItiNAL. opinion, lionestly expressed, may be regarded as biased, for we confess to the use of the latter work ever since it first made its appearance. In saying this w'e do not desire to detract from the usefulness and worth of the Call-book and Tablet. It is an exceedingly neat visiting list, and possesses an advantage in that the date is not filled in, so that it can extend over many monthà or years, according to the amount of work which the Physician lias to perform. The' contents consist of an erasible tablet on the inside front cover, a calendar for 1877 and 1878, a table of signs, a table of drops to the luid drachm, a graduated table for the administration of tr. opii, according to the age of the patient, a table to regulate the doses of medicine for children, a list of abbreviations, poisons and their antidotes, formule and doses of medicines for hypodermie injections, the doses of medicines for inhalation, formulS for suppositories and medicated pessaries, table to ascertain the duration of pregnancy, maximum doses of poison- ous medicines, disinfectants, relation of weights and measures, the diagnostic examination-of urine, directions for making post mortem examinations, treatment of asphyxia from drowning, \u0026c., list of incompatibles, list of doses of medicines, blanks for visiting patients, giving the name of patients, name of street with number of house and space for one week's attendance; obstetrical engagements, vaccination engagements, nurses' addresses, and blanks for cash receipts. There is a pocket for bills or prescription blanks. The size of the book is somewhat diflerent to tiose already in use, being longer, about the usual yidth, and more compact. Altogether it is a useful visiting list; and contains one feature of importance, blank leaves whereon short notes of cases can be added at pleasure. We freely commend its use to the profession. It is to be had in this city, at the book-store of C. Hill, No. 66 Dorchester street.",
         ":Fiatra s fro Eiriti an d Voreign 'Curnais. Unless L:h i it : trailslations ae mna le 'oi for this Jounuîi. Hypodermic Ijection of Corrosive Sublimate in Syphilis. - In the Viener IMfed. Wochenschirift, No. 11. 1876, Von Bainberger states bis expe- rience in the treatmaentr of syphilis by the hypodermic injection of corrosive sublimate, and lie raises certain objections to this plan of treatment, the chief of which are that the injections are apt to cause intense pain or even give rise to the formation of abscesses. Dr. Lewin,.who claims to have originated the method again comes to the fore in its defence. le says: \" During the last 11 years, nearly all the patients suffering from constitutional syphilis, that have come under my care, have been treated by the subcutaneous injection of cor- rosive sublimate. The average number was about 1,200 or 1,300 per annum, the total for the 11 years being about 1,4000. The average number of injections required was about 25. Of ·these some 20 suffered froi abscess, iii consequence of the injections. These abscesses were never sufliciently serious to confine the patient to bed. The abscesses will not occur if proper precautions are taken by the person who makes the injection. tr must be admitted the injections are liable to cause violent pain, but this occurs so rarely that it cannot. be advanced as a wpighty argument against the method. On the other hand, the results of this mode of treatment are, ou the whole, so favorable that I do not hesitate to recommend it in all cases. Bamberger himself concedes that their curative effect is surprisingly rapid, and that such is the case the following statistics will abundantly show. These statistics are based upon the reports of the Charit6 Hospital, and they afford a tolerably correct indication of the ameunt 6f syphilis which exists in a certain class of the popu- lation of Berlin, and we have been able to observe its course and progress during lengthened periods of time ; because the Charité is the only hospital in the city which treats syphilitie Mil-nsn1 A FR:MUN .OU-ALSs.",
         "272 CANADA MED1AL AND SURGICIL JOURNAL. prostitutes, and in addition to this the police regulations are such that prostitutes are seldom treated for any length of time by private practitioners. In order to form a just estimate of the resuits of my method of treatment, I have compared the number of syphilitic prosti- tutes treated in my department since I commenced using the mercurial injection in 1865, up to the present time, with three treated in other ways during a like period before 1865. The comparison shows not only that the duration of treatment is lessened by the corrosive sublimate injection, but also that relapses (i. e , manifestation of constitutional syphilis) are muel less frequent. From 1855 b 1865, the average time spent by eaci patient in the Hospital was 10 weeks, since 1865 it bas only been four weeks. The number of relapses under the old system was about 80 per cent, under the injection plan it was about 40 per cent: These results also compared exactly with the difference in the number of patients treated in my department before and after the year 1875. In the year 1855, the inhabitants of Berlin numbered betweein five and six hundred thousand. The number of syphilitic patients treated daily in the Charité was then 150 to 170. There is now a daily attendance of 100 to 120. If the increase had been in proportion to that of the population the daily attendance would now be about three hundred. The severity of the relapses is also much diminished, inasmuch' as I have not seen a severe case of constitutional syphilis in a prostitute for a long time, and as far as I can learn from my hospital colleagues there have been no cases of visceral syphilis after the treatment by mercurial subeutaneous injection. It must not, however, be forgotten, that one course of treatment even when continued for many weeks will not secure immunity from relapses, to this end the treatment must be renewed from time to time for one year at least. Neglect of this precaution is apt to be punished after several years have elapsed by an ont- break of severe constitutional syphilis.-Prof. G. LEwt- (Berliner Elinische WYochenschrift, No. 45, 1816.)",
         "BRITISH AND FOREIGN JOURNALS. Treatment of Acute Rheumatism by Salicin,-Before the oset of winter I would again draw the attention of the profession tO the beneficial result of saliciri in acute rliCunatism. In mny original paper on the subject th- following conclusions were given as the result of iy thiu eperienco of the remedy: -\" 1. We have in salicia a valuable remnedy in the treatment. of acute rheunatismi. \"2. 'ic more acute the case, tie more marked the benclit produced. 3. In acute cases, its beneficial* action is gencrally apparent withia twenty-four, always witbin f\u003erty-cight, hours of its administration in sufficient doses. 4. Given thus at the connencemenît of the attack, it scems to arrest the course of the malady as cffûctuially as quinine cures au ague or ipecacuanha a dysentery. 5. The relief of pain is always one of the earliest effects produced. 6. In acute cases, relief of pain and a fail of temperaturc generally occur simultaneously. 7. In sub-acute cases, the pain is sometimes decidedly relieved before the temperature begins to fall; as is frequently observed in those of nervous temperament, the pain is proportionately greater than the abnorial rise of temperature. S. In chronie rheumatism, salicin sometimes does good where other remedies. fail; but it also sonietimes fails where others do good.\" A further experience of the remedy bas confirmed me in the accuracy of these conclusions. In not one case of acute rhen- inatisn have I found salina fail to produce a speedy cure of the fisease. I have therefore nothing to add to, nothing to detract from, the conchsion-\" tiat, given - in sufficient dose at the commencement of the attack, salicin scems to arrest the course. of acute rheumatisn as effectually as quinine cures an ague, or ipecacualia a dysentery.\" Te points te which, in this communication, I would direct. special attention are : first, the dose which should be given; and, second, the action of the remedy on the cardiac complica- tions of acute rheumatism. I: 2te dose.-What I said on this point.in my former paper Was as follows:-Tlhe dose of salicin is from ten. to tbirty grains, every two, three, or four hours, according to the severity of the, 0 19' 273",
         "CANADA MEDICAL AND SURGTCAL JOURNAL case. Fifteen grains every three hour3 is a medium dose for an acute case. It is very possible that less might suffice ; for I hve not tried to frnd the minimum dose. It is very éertain that a much larger dose may IC 'given without producing discomnfort.\" Further experience bas led me to the conclusion that it is well to give the larger dose; and that the best way to get the full and speedy benefit of the rcmedy is to saturate the system with it as quickly a possible. The more speedily this is done, the more speedily are lthe fever and pails subducd. I now, therefore, give the salicin to adults in a dose of twenty to thirty grains every two hours; in very acute cases I give that quan- tity every hour till pain is relieved. With relief of pain, slecep returns, and the hourly dose cannot be adhered to. Eut it is well to give twenty grains, at least, cvery two hours during the day, till the temperature is down to the normal. For a week afterwards the same dose should be given four times a day. Salicin is an excellent bitter tonic-in my experience as good as quinine, and not apt to disagree as the latter is. I have always found cases of acute rheumatism treated by it convalesce very rapidly ; treated in the old way, convalescence from that- disease is a slow and tedious process. I am specially anxious to call attention to the necessity for giving salicin in large and frequently repeated doses, because, in some of the cases which have been reported in the journals since my original paper was published, the dose given wvas toe small to produce benefit. To give \" from thirty to sixty grains per day \" is to do justice neither to the patientnor the remedy; and to report a case in which such a dose was given as one indicating \" the inability of salicin to arrest the disease,\" is to draw an inference which is unwarranted by the facts, and which tends to throw unmerited discredit on a remedy whose ability to arrest the progress of acute rhoumatism has aiready been demonstrated in numerous cases. A case of acnte rheumatism which gets from thirty to sixty grains in twenty four hours-.e. an average of less than two grains in the hour-reoceives prac- tically no treatment, and is of no value as evidence cither-for or against salicin. -Dr. McLagan., Lancet Oct. 28tA.",
         "BRITISH AND FOREIGN JOURNALS. Post Partum Eoemorrhage-Dr. Osterloh. Ætiology.-The great cause of this hmnorrhage is the incom- plete contraction of the uterus. After labour the uterus feels soft and large instead of bard and round. Among 289 cases of inconplete contraction of the uterus, 150 occurred in primaiparS. The age of the primipara has no offect in the hæmorrhagc. Injury or tearing of the uterus is observed mure in the abnor- mally rapid, or very protracted labour, in cases where the liquor amnii is deficient, and where the child is large. Sometimes the contraction of the uterus is retarded by some of the membranes, or part of the placenta remaining in the uterus, contraction may b aiso hindered by a full bladder ; in these cases the removal of the causes produces coniraction and :essation of the bleeding. In 69 of these 289 cases the labours were of long duration. Forceps were applied in 8.6 per cent. The second great cause of hæmorrhage is due to injury of the soft parts froin rigidity of the passages, \u0026c., or as the result of an operation. In 20 cases hæmorrhage due to injury was -observed, one case of rupture of the walls of the uterus, one case \u003cf tearing of the cervix, four cases of tearing of the vagina, and fourteen cases of tearing of the vulva. There were 353 cases -of late bleeding froim the first to the eighth day or later, due te tardy involution of the uterus. Several of the cases were due to previous severe flooding, and slight after contraction of the uterus; in other cases, it ivas due indirectly to retention of membranes, or part of placenta, inflammation of the mucous membrane of the uterus, \u0026c. In many cases the reason of the bleeding was not apparent. Symptoms.-Among the local symptoms the condition of the Uterus is most important. If the uterus the day after labour is Dainful on moveinent aud very hard to the fecl, this condition 1i proba'\u003ely due te blood clot or retained membranes. The Diagnosis 's not so difficult if one carefully examines the body and passages. If blood comes from the uterus it would of coùrse be On the plug, and by mens of the speculum the blecd- ilg point may be casily made out. The Prognosis of h -morrhage is generally favorable, only in One case did death occur, and this on the cleventh day ; it was 275",
         "276 caAND MEDICAL AN] SUnGICAL oJBNAL. due to ruptured uterus. In 57 cases out of 307, where the hæ-morrhage had ceased, other diseases remained ; 13 had para- metritis, and 37 endometritis. They all recovered. Treatment.-In most cases where there is rupture of the vulva, vagina or external orifice, a plug soaked in vinegar and water was found sufficient to stop the hænorrhage. In one case of tearing of the neck of the womb, a tampon soaked in liquor ferri perchloridi was used. One niust endeavour always to prevent the possibility of bieeding, (a) by avoiding terminating labour by artificial means, esp:ecially in simple cases of labour; (b) by complete removal of placenta by the method of expression ; (c) by using ergotin hypodermically in cases of cxhausted uterus or inertia of the uterus ; salicylic acid (1 to 400) has also been found usefui hypodermically. If bleeding continues after empty- ing the bladder, taking away clots, \u0026c., and using pressure or the uterus, then use subcutaneous injections of ergotin. Ergotin was injected in 230 cases of this kind with favorable results. WVhen ergotin bas no effect inject vinegar and water in a strorg stream into the uterus. In cases wherc ergotin had no effect, (50) liquor ferri perchl. and water (equal parts) were injected into the uterus. Dr. Osterloh says no ill effecte follow the use of the liquor ferri perchl., and that lie can recommend it as an injection. Injection of chloride of lime mas employed in 10 caseS, hypermanganate of potash in 74, and salicylic acid in 12. dar- bolic acid and benzoic acid were also used, and all with good effect. In cases of late homorrhage the cold douche and astringents were used, also hypermanganate of potash, later salicylie acid, (1 to 600), and in severe cases, liq. ferri perchl. was used; where there were placental polyps, these were immediately removed In cases of threatening anæemia, the subcutaneous injection of sulphuric ether is recommended. If there is a high puls- after hæcmorrhage use digitalin subcutaneously (1 mgrmm.) two or thrce times. Every obstetrician should carry with himn' solution of ergotin, a hypodermie syringe, liquor ferri perchl4 and a Winckel ball-syringe.-(Deutscbe Ztschi-. f. pr. Med; 11. p. 119, 1876. quoted in Schmidt'3 Jahrbicher, band 170, Hft.8.)",
         "BRITIS11 AND FOREtiuN JOURNALS. Poisoning by Digitalis.-Two young mon wish- ing.to escape conscription, obtained a large number of pills from a person who professed to be able to exempt recruits from military :service, with instructions to take 2 to 4 pills daily for eight or ton days before their enrohnent. One of them reportedI himself ill three days after entering the sexivice, six days later ho was sont to hospital, whcre he died quite suddenly and uCxpcctedly after three weeks' illness. A careful inve.t'gation of the case clicited the following facts: The post iorteai revealed no pathological change suficient to account for death. The blood was thinî and fluid, of a cherry- rcd colour, and without a trace of coagulurn. Thore were cclîynoses in the coats of the stomach and intestines, and the brain was anminic. A chenical examination of portions of the osophagus .etomach, duodenui, and liver, gave the roaction of digitalin most decidedly ; that of the blood contained in the right von- tric'e was negative. The pilils were found to contain puiv. fol. digit. purp. gr :i\u003e in each. It appeared that the unfortunate young man had talen 131 pills, or upwards of 200 grains of digitalis within five weeks, and lie probably died in consequence of the cumulative action of the drug. The symptois presented during life were pains inii the stomach, loss of appetito, nausca, constipation, pain in the hcad and gid- diness. The patient, morever, looled very ill. The pulse was 50 to 52 per minute, the tenperature normal. The odour ofthe :breath wvas peculiar, and on one occasion sone grcenish muaterial wYas vomited. In addition to this thore was dimness of vision, tinnitus, and great debility. The pupils were alike and acted well. The Fkin.was pale and sallow. rDeath occurred suddenly whilst the patient was being raised up in bed by one of the attendants. The day before he had.a Aualen and severe attack of syncope. The other recruit suffered ,.Q a.sirnilar mnanner, but recovered, having. taken only 75 pills n the four, orfive weeks.-(Dr. Könrad Kühnhorn, Vierteljahr schrift f. ger:chtl. Medizin, April, 1876. 277",
         "CANADA MEDICAL AND SURoICAL JOURNAL Ergot ina Purpura.-The following su-mmary la given by Dr. Buckley in a ral er on the subject in the last number of the Practitioner, (Nov) I. The treatment of purpura, as advised in the books, ià ineffective and tedious in lighter cases, and insullicient to savo. life in many of the severer or homorrhagic cases. IL Ergot possesses a very decided power in contracting tho involuntary mî'scular fibres, causes divided arteries to contract, acts upon the smaller arteries and capillaries, and has been proved a valuable arrester of hoemorrhage in many affections. III Li purpura the action of ergot is very manifest, causing, when given in sufflicient doses. an almost, if not quite, immediate cessation of the cutaneous and other liæmorrhagcs. 1V. The most effective method of administration of ergot is. by hypodermie injection, and this means renders it îcculiarly valuable in purpura lhomorrhagica, ihere there is hæimatcmesis, so that its administration by hie mouti would be impossible, or in cases where ihe stomach would not tolerate it. V. While ergotii, a purificd watery extract, has been advised by many, and bas been found to act cliciently in many cases, its action is liable to be uncertain by reason of age or faulty preparation, and after dilution witl water it soon becomes inert. VI. Fluid extract of ergot may be administered hypodermi- cally, undiluted, and vithout local accident, as abscess or inflammation, if care be exercised ; and its effect is very prompt and certain. VII. Ergot may bc 1hrown under the skin in any part of the body; the gluteal and shoulder regions answer well, but thO places to be preferred are about the rectoral muscles or at the sides of the chest, about balf way down. VIII. evcre cases cf purpura require the frequent repetition, even of very large doses, -ihether by. the mouth or by hypoder- mie injection ; bothl metlods may be combined. IX. Generally one or two grains of ergotin or from ten to fifteen mnimiims of the fluid extract, bylodeimically, once Or twice a day arc suficient, but the former may safely he increaseò-",
         "BaITISI AND FOREIGN JoURNALS. tu five grains, and the latter to twenty or thirty minims, and repeated as often as every hour and a half. X. Larger doses relatively are required when given by the mouth, and thcir action thus given, is more slow. XL. No fear need be entertained of any untoward effects; an ounce of fluid extract by the mouth, zind seven grains of ergotin, hypodermically, have failed to give rise to any un- pleasant symptoms ; and from lialf a drachrn to a drachm and a if of the tincture or fluid extract have been continued for several months without producing ergotism. XI . Other preparations of ergot may be employed internally, -as the powder, solid extract, wine--or infusion, the dose veing proportioned to the efect required and produced. 'Vovulxus and Ileus - Cured by Eftervescing Clysters.-A servant girl, St. 22, was suddenly seized with an abdominal aTfetion which presented the usual symptoms of internal incarceration, and in the right hypochondrium, a short distance above the crest of the ilium, a movable tumour about 3 inches long, and 11 inches wide, could be easily detected by palpation. After several unsuccessful attempts lad been made to move the bowels with purgative medicines, eight effer- vescing enemata were administered at short intervals; each consisted of lialf an ounce of bicarbonate of soda dissolved in a pint of water, -followed immediately by three drachms of tartarie 'acid in an equal quantity of water. It is not stated ihether any of the fluid of each injection, or of the gas generated by the soda and tartarie acid, escaped per rectu:n during the short intervals mentioned, if not the patient's Condition must have been somewlat precarious; for after the first clyster, she is said to have felt as if something had burst in the abdomen. The eighth injection was followed by several Copious and offensive stools, and the symptoms of incarceration Yaniished.-(Dr. S. Adier, Med. Chirurg. Ccntralblatt, 15. 1876). 279",
         "oANADA MEDICAL AIND SURGICAL JOURNAL. NumbSr .of Wite Blood Globules.-M. Grancher communicated the results of his researches into-the physiological number of the white globules in the alult to the Sociét6 de Biologie (Le MLvemnt Médical). The results he obtained differ from wbat have been given up to the present time. Almost alil physiologists say there is ene white to every four or five hundred red globales; but M. Grancher finds that the proportion is much lower, one to every fifteen or eighteen hundrod. HE alsD found, contrary to what is generally accepted that food does not augment the number of white globules, but that their number remains much the sanie during the entire day. The normal oscillations are much greater for white 'n red globules, so that the number of red globules in different healthy persons varies between five and six millions, and the number ef white globules between three and nine thousand. M. Malassez's researches led him to find a snaller proportion of white globules than what is usually accepted, but noverthelcss greater than that found by M. Grancher.--Doctor. The Magnet in cases of Broke Need- les.-A son of Sir B. Brodie broke a needle in bis calf. The magnet was employed, and it was easy to show its position. It did not make any change of position. It boing resolved not!to disturb it, the lad ran about, and in time the needle passed, to th- other side of the leg, its travels being shown by the magnet. At lcngth it came cloze under the skin and was extracted. This case being reported, Mr. B. Carter referred to Dr. Mo- Keown's paper on the diagnosis of picces of iron in the eye, and said that in one case a fragment vas removed by the power of the magnet. Eir J. Paget had heard of powerful inagnets being kept in 'arge foundries for this very purpose; and ,Mr. Savory said Mr. Smee published a paper on the detection. of the presence of needles by the magnet more than thirty years ago. This secms likely, for the practice -is really very. old. Indeed, at the meeting it was remarked that Fabricius Hildnu' alluded to i.-Royal Mied. Chir. Society. Doctor.",
         "BnITISIl ANI) FOREIGN JOURNALS. Enterie Fever.-Beef Tea v. Milk: iemorrhage.- \"In a case, now at the fourteenth day, there is looseness of the bowels. On examining the stuol, .1 find a separate undi- gested curd of milk. This curd bas acted as an irritant and in duced the diarrhoiS, therefore you must thin the milk, and replace it more or less by beef-tea. - It bas been too much the fashion to give much piilk without due regard to its digestion As remedies, you may give some starch with bismuth in enema.\" At the next visit, soie hmorrhage (of which the patient was kept in ignorance) was reported by the nuirse. On inspection, it was found to be about half a pint of dark fluid blood, \" Now, the mo3t important p6int is, that this patient did not sit up for ary purpose. A casa which occurred during my student days imupres3Žd nc very much. IIe had hlmorrhage ike this, but .:did not secem very bad ; his pulse was 84 ; his miud clear ; he was allowed to rise to the night-stool: the h2mnrrhage reurred, and ended fatilly in a few minutes. A mesenteri artery had ben opened. You must then by po3ition, take of the weight of the blooa-coluina. O.nit milk altogether, the cutd night irritate ; give bee-tea and arrowroot ; a littla softened bread; a little bran-ly, two drachm; every three or four hours, to improve the nerve-toii ; giva hiin three grains of the acetate of lead with acbic acid overv four hours, and an opiate enema night and mcrning. Observe there is n) great distension of abdomen, and there is no tram\u003er. I conelade the uleeration is not deep. .Iyhenb treor is disîprprtirtt t other nerve symptOMS, it 'indicatcs more dep\u003cti of ulceration. The patient did well.- Bif W. JENNER, BART., in British ledical dournal, Oct, 28. rson al. A..D. l3ackader, B A., M.D., ('71), bas been appointed one of the resident Cliaical Assistants at the Consumption Hospital, Brompton, London. W. T. Ward, M.D., ('73), and R. L. Macdonnell, M.D., ('76), hayepassedî the primary exainination at the Royal College of Iurgons, England. F. S. Snoider, M.D., ('7U), bas commenced practice in imcoe, Ont.",
         "CANADA MONTREAL, DEcENnEB, 1876. SMALL-POX AND VACCINATION. A very excellent and carefully propared paper was on a recent occasion read before the Board of 1eIalch of the city of Montreal, by ls Worship the Mayor, Dr. Ilingston, and some very prac- tical suggestions vere made touching the subject of vaccination, and also refuting the very dangerou: and distorted statenents which have been so freely and unblùshingly circulated by the anti-vaccinators, of' whon there are anongst us a goodly num- ber. Interesting and practical lessons are to be learnt by a careful comparison of the statistics of the disease small-pox, one year with another, and one period of epidemic of that disease with another. These practical points are brought out with greater prominence in -thosa countries where accurate and reliable statistics are obtainable. In the report of Dr. Seaton, the. Medical Officer of the Lcal Government Board of London, England, which appears in Mr. Simon's Annual Report for 1874, some very instructive facts are brought out, which demand careful scrutiny. From this report it would appear that the epilemic of smdli-pox dnring the years 187 t and 1872, wasa general and wide-spread epidarnie of that dis2as-. It vas nOt confined to the continent of Europe and the British Isles,bu was largely diffused, and we can cati to mind the virulence and intensity, th, maiignancy anu fatality of that epidemic in our own country. The disease attacked in:liscriminately thosO Nh' were supposed to b. protected against it by vaccination as well as the absolutely unprotected. These fcts very seriouly",
         "S.u.AmL-PX A NO VACCINMrtIo. 2 affected the gcenerally admitted protective influence of vaccina- tion, and gave risc to popular clamour against the practice of vaccination, confined, however, to that pcrtion of the community who are always willing to endorse the views of a few leaders amongst them. Furthermore, there are with us, as well as in other countries, a sect of peculiar people, fearless as to results, who will expose thcmse.lves, their children and the community generally to the spread of the contagion of the disease sinall- pox. We have known of instances where parents have taken their children to a neiglibour's house, where a mild case of small- pox existed, and have even placed their children to sleep in the same bed with the sick patient if peradventure they may be equally fortunate and pass through the disease in a mnodified forn. Of course the absurdity of this practice needs no eluci- dation at our hands. The fear of the disease does not exist in a large proportion of our community. Referring again to the report of Dr. Seaton as touching the efficacy of vaccination, he shows that in the metropolis the anuali mortality of small-pox before the introduction of vaccination ranged from 400*to 500 per 100,000 of the inhabitants. Since the introduction of va£- eination the mortality froin small-pox has greatly diminished, taking a period of twenty years from 1854 to 1873, which includes the epidemie of 1871 and 1872, the annual death-rate was reduced to decimal 24 per 1000, or in other words that out of every 100,000 inhabitants 24 persons only died of the disease. This ditrerence in the mortality was so very remarkable, that there were thosewlio suggested that the diminution depended net soiely on the protective influence of vaccination, but on a graduai lessening in intensity of the disease, as also a lessening of its *diffusion. This however bas been proved to be erroneous, the exPerience of 1871 and 1872 showed conclusively that small- Pox had lost none of its intensity and fataliby. But although the epidemie was acknowledged to be unusually severe, the .nurlmber of deaths amounted to 148 per 100,000 of the iühabitants. Thus under 'many most unfavorable circumstances, the death-rate from small-pox, during the most severe epidemie of this century, rose to less than oae half of what it yielded 283",
         "CANADA MEDICAL AND SURGICAL JOURNAL prior to the introduction of vaccination. There must be some good reason for this difference, and to the protective of influence of vaccination with the enforcement of vise laws for isolation of the infected, can alone, this remarkable difference be attributed. This practical lesson, therefore, is tanght by the epedimie of small-pox which visited London daring the years 1871 and 1872. But other most reuarkable facts arc elucidated in con- nection with that epidemic. Persons in constant attendance on the sick, at the snall-pox hospitalis, were, as a rule, re-vaccinated, and in no siigle instance did the disease attack those who had been efficicntly re-vaccinated, althougli the number exposed were somle 300. înd they were in constant association with the sick. Tiis observation can be easily confirmed, as there is hardly a medical mian of any experience in this country, or any othet country, who could not bear similar testimony. Now this lcads to the admission of the valuc of re-vaccination more especially during the prevalence of epidenie small-pox. Re-vacination was very generally practised in London during the epidemic of 1871 and 1872, and as a result the disease in the metropoli was absolutely stanped out. This salutary effeoct followedt isolation, enlarged hospital provision, and a very gencral adutt re-vaccination . Thesc lessons therefore, we can with proprietY apply in the present instance in this country wherein sinall-pox is epidemic. Carefi, energetic and general re vaccination should be practised, and very serious responsibility rests on the IIealth Authorities in this particular. From the published reports of Dr. Buchanan, taking the experience of Londot,* irmninghan, and other large towns in England it would appear, that large hospital accommodation affording the means-of isolating cases of the disease at the commencement of a4 outbreak, exerts a most important influence on the subsequeO course and spread of the disease. If, as a community, we are desirous of improving our sanitarY state as regards this disease ; if ive are earnest in wishing it9 stamp out this disease since its existence amongst us has suÇhW baneful effect on our trade ; if it is deemed advisable to ri4 ourselves of the injurious character of a plague-stricken cityg 284",
         "PRODROMIC RAsES OF S31ALL-POX. then should we take advantage of the experience to be gained from observations in other large cities, and adopt comrnon- sense measures. Liberal and ami.le hospital accommodation will afford means for isolation of those, alrcady suffering from the disease, and again, a thorough system of aduit and infiant vaccination will act as a protection against the invasion of the disease. We are awarc. that the city bas gone tomneh expense in providing hospital accommodation ; and furthermore that public vaccinators are at work engaged in a gencral system of vaccination and re-vaccination, and we niay wi thout hesitation. predict that if isolation is thoroughly practised. and vaccination carefu)ly and efficiently performed, there will be noticed a marked subsidence of the prcsent epidemic if not its total extinction. PRODROMIC RASIIES OF SMALL.POX. We publish in our present nmnber a very good article by Dr. Oiler of McGill University, upon the Prodromie Rashes of Smnall-pox. Tbe writer bas had peculiar advantages for the observation of numerous examples of these eruptions owing to his having held for some time the position of visiting physician to the small-pox wards of the Montreal General Hospital during a period of epidemic visitation· of the disease in this city. Although, unfortunately for science, not now -possessing any similar advantages, owing to the transference of all these patients to the care of the city and its public officers, yet Dr. Oslei appears to have made such good use of his time that lie is enabled to present us with the records of several cases serving to illustrate antecedent or prodromie rashes. It is remarkable how àlmost entirely descriptions of these eruptions preceding the development of the papules proper of variola are wanting from our ordinary English text-books and standard works of reference. * The natural result of this is that a great deal of misapprehension bas existed, and does indeed still exist with Iany as regards the diagnostic value and prognostie significance Ôfthese appearances. We have several times known the devel- 235",
         "286 CANADA MEDICAL AND SURGICAL JOURNAL. opment of a purpuric rash during the primary fever.of an attack, of variola lead the practitioner to give expression to most grave apprehensions as to the expected severity of the subsequent. attack, which have happily been entirely dissipated by the favorable course the case bas followed tirougiout. We have .ourselves been fortunate enough to have observed a very large number of snall-pox cases during several epîidenics of lateycars and through exporience (and by that meansalone,)hbad already learned the truti of scveral of the statements advanced by the writer of this paper. But we must remember that a very large proportion of our medical men (fortunately indeed for the country), see very few cases of snall pox; in fact often pass years without seeing a single one, so that anything which they may learn from others which is of practical value in under standing the disease becomes doubly useful The same is equally true with reference to students. Frcm the nature of the case it iA hardly ever possible for auy of them to study small-pox as they do every other disease in the hospital wards. Thus-many are obligcd to go into practice at first without ever having seen a case of small-pox If thon he trust to the ordi- nary description to guide him to a correct diagnosis, lie will certainly soon experience annoying trouble from the casual occurrence of someo of these (unless known) very puzzling pro- dromic rashes. We have several times been consulted by young practitioners under these circumstances and besides have occasionally been the means of entirely modifying the diagnosis of other and older men by referring to. the facts known of the significance of these rashes. Wc have been pleased to know that Dr. Osier bas promised to contribute another article on the bmorrhagic varieties of small-pox before the Medico-Chirurgical. Society at another nectiiig. Wc are pleased to sec in the Ediniburgli Medical Journal for October, a short article upon Litholysis by our friend Dr. George C. Duncan. It is a subject which first engaged the attention of his brother, Dr. John Duncan, who graduatcd at",
         "EDITORIAL ITEMS. Mc(Gill Uaivrersity in 1871, and who, unfor'unt ly, died before hg orald cairry oa is pan3 . Dr. Dan ai poseIS3S, we are 'sure, th- n3cssnry ingenuity and m3chanical skill for the accomplishm\u003ent ofhis t:3k, for ve remember wi.h p!easure the ingnioasly contrived Sphymmg-aph--:nide altogether by himself and without a. model-which accomnpanied his graduation Thesis on the subject. Dotails are promised shortly, when ive hope te lay them before our readers. Two Private Medical Sclîols have been started in London this autumn session, one by Mr Cooke, a well knovn teacher, and author of the \"Tablets of Anatomy,\" and \" Physiology,\" tie other by Mr. Pearson. The former professes to be largely preparatorv in character, a school where a beghiner mnay spend three months working at Anatomy and Physziology beforo -ttaching himself to one of the larger Colleges, and, in this way, obtain some knowledge of redical work, and judge of hisfitness for the Profession. If this could be carried out in the case of eacli student it would be an admirable plan. Both of these sehools will be taken aivantage of b the large class of students io fiud a few months before the examinations that something more than mere attendance at lectures is needed to master the necessary requirements, and to whom the Tutorial personal in- rdruction will bo invaluable. ,Pr. McKendelCk, formerly the late Dr. ennett's Physiolog- ical assistant, has been appointed to the chair of Physiology in ilasgow Uiiversity. Dr. Andrew Smart succeeds Iim as Lurer on ilogy in thi extra-mural school of Edinburghî. Vie Chair of Medicne in Edinburgh Lniversity, vacated by the death of Dr. Laycoclk, lias been filled by the appointment of Dr. Graizger Stewart, ene of the Physicians to the Royal IIffirarvand Lecturer on Clinical MdIcine. The a.ppointment 13 one whlich will give great satisfaction in Edinburgh, more so than to the Profession at large, with whom Dr. Gairdner of Gelsgow, one e the candi lates, was deservcdly the favorite. 287",
         "288 CANADA MEDICAL AND SUROICAL JOURNAL. We have just received from the Queen's Printer, Quebec, as we go to pless (29th November) a number of copies of the Bil1 of Aiendments to the present act as adopted, by the Board of Governors of the College of Physicians and Surgeons, L.C.\u003e at the last semi-annual meeting of that body held in the city of Qtuebec, on Wednesday the 27th day of September uilt. These shall, without further delay, be circiated amongst the profes- sion, and we must in explanation observe that the delay has been entirely the fuilt of the printer. The. profession should be informned that there are two bills before the Legislature, one the expression of the Medical Society, Montreal. That body lias, without reference to the College, and abslutely ignoring its existen)ce, jepared a Lill mlih his 1 ecn int)dud into the Local Legis!ature by the Hon. Mr. Clhapleau. Tie College bill, which 1.ossesses at least the meit of hiailing from a recog- nized body, one in the possession of corporate rites is the bill which we reflerto above. A petition to the Legislature is in course of signature. printed copies of which have been very gen- erally circulated. The object of this petition is to strengthen the Board of Governors of the College in its demand for legislative amendment to the act under which it is governed. Those of our friends who have not already replied to the circular letter addressed to them with a copy of the 1:etition enclosed, are earnestly requested to do so without delay. We have received from Aldrman MeCord the folloving interesting figures with reference to the death-rate at the Civis Small-pox Hospitals from Nov. 7th, 1874 to Nov. lst, 1876. Protestant Jlospital.-Total number received, 168. Died, 34. = 20.23 per cent. There were 54 unvaccinated, and of these 25 died : = 4(.29 per cent., There were 114 vaccinated, of these 9 died : = 7.89 per cent. Catholie H\u003espital.-Total number received 396. Died 127: = 32.07 per cent. There were 165 unvaccinated, of these 89 died : = 5:t.93 per cent. There 231 vaccinated, of these 88 died : = 16.45 per cent. In both ILospitals, 564 Received. Died, 161,28=.54 per et. Unvaccinated, received 219, Died, 117 : = 53.42 per cent. Vaccinated, received 345. Died 47 = 13.62 per cent. PeISoNAL -Dr. Edmund Robillard of Montreal sailed for Europe via New York on the 15th of November, ult. We believe it is the intention of Dr. Robillard to pass the winter on the cont'nent, between Paris and Vienna, and he expects to return to Canada towards the end of next summer."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. The Small-pox Epideriie in Si. John, N. B., in 1871. By L. C. ALLIsoN, M.B. Read before the New Brunswick Medical Society, 3rd April, 1872. NMR. PRESIDENT AND GENTLE3fEN,-There. are no phenomena for which we find it harder to account than for the variations that constantly occur in the. types of infectious diseases. One year a disease will appear in a particular locality, diffusing itself widely but causingfew deaths and comparatively little suffering among those whom it attacks. ý It disappears-that is, it travels away to act in 'other places, for the infecting principle of such a disease being constantly transmitted from one person to another never dies out to be regenerated de novo, but merely alters its neighbor- hood and the area of its action. After a second interval it re-vkits its former locality, in a form so changed that it hardly seens to be the same thing. A large proportion of those who are attacked by it die, and many others. escape only after a protracted and dan- gerous illness. The sanitary condition of the community and the general healthfulness of its inhabitants are no worse than they were before-perhaps they are better, and the-infection is or ought to be the same, but the disease is very different. Last year it was not severe anywhere. This year, in every site or commu- nity it reachest in every climate, hot or cold, moist ,or dry; in every neighbourhood, crowded or scattered, it exhibits the char- acters of intense malignity. Whence does it derive these char- acters? How~is it that the same factors give a product in one year of four and in another, of forty ? We cannot tell. The question puzzles thé mnost modern nosologists as hopelessly as it puzzled Sydenham. The small pox of 1871 is one of these anomalous epidemics. I am not aware that, its origin has, as yet, been definitely investi- gated; but,, when this is done, I think it will be found that its EE",
         "CANADA MEDICAL JOURNAL. starting point was either in the beleaguered, City of Paris or in the camp of the besieging army. Such epidemics are often trace: able to the massing of large bodies of troops in field or in camp, and their appearance often follows at a short interval after the tidings of battles and sieges. It is probable that the small-pox of 1871 will prove to have been connected with the FrancoGerman campaign in the same manner in which the typhus epidemica of the early years of this century were connected with the wars that followed the French Revlution. But whether the disease acquired its virulence from germs of infection imported from beyond the channel or developed it by maturation at home, this much is cer- tain, that during the last ten or twelve weeks of 1870, small-pox, of an unprecedently malignant type, began to show itself in London. It increased there, the deaths gradually rising from forty or fifty to two or three hundred per week, and gradually spread to some seventeen of the principal cities of the kingdom, in 'hiýh, during the course' of last year, it destroyed more than 13,000 people, and nearly 8,000 of them in London alone. Early in 1871 it spread westward along the principal commercial high- ways to New York and other new centres in North America. from which it extended itself,-always travelling with the sun, until at the present date few of the larger cities of Canada and the United States are free from it. In England it seems now to be upon the decline, but a month or two ago it entered Scotland and became epidemic in Edinburgh. It will probably visit all the remaining' sections of the United Kingdom before it takes its departure. Upon our side of the Atlantic it bids fair to extend across the whole breadth of the continent and ronew in California the havoc of 1868. Such is a brief sketch of its geographical diffusion. There are three points connected with the appearance of the disease in St. John to which I would like to call your attention, and these are: First, the pecular circumstances under which the disease was introduced; secondly, the measures that were employed to check its spread; and thirdly, the peculiar character of type that it presented. ý And first, with regard to the ORIGIN OF THE EPIDEMIC. On the last day of the year 1870 a man named John W - , came to 'St. John fiom Portland, Me., his history, so far as then known, being that of asailorjust landed and paid off from a long sea v6yage, and wishing to spend a few days in diversion upon his wayhome to his friends upon,-the North Shore. He took lodgings in a small bouse near the end of Erin.street, and.within a stone's' throw of the Marsh'Bridge, where he remained about a",
         "SMAL-POX EPIDEMIC. fortnight, \" spreeing,\" as the phrase goes, among the ship car- penters and other pleasure-loving folks in whom the neighbour- hood abounds. On the 14th January le felt indisposed, but not very severely, and kept to the, house, trusting that the uneasy sensation would pass away. As le felt much worse next day medical assistancewas sought from a physician who has kindly supplied me with the following particulars of the case: Case I.-The messenger asked for medicine for a man who had lately been drinking and, was then suffering from the symptoms that usually follow excesses of this kind, but chiefly complained of the vomiting. Bismuth was then prescribed, with milk and- lime water, but no improvement having taken place, the doctor saw him on the following day(16th) and found him presenting the symptoms of a smart febricular attack, witl incessant vomiting and pain relerrec to the epigastrium. Headache was present, but not very severe. All these symaptoms were in perfect accordance with the previous history, and supported the diagnosis of an excess in drinking. The milk and bismuth were continued with the addition of a mustard poultice to the epigastrium. On the 17th the vomiting was relieved and the headache had gone, but a new and strange symptom had appeared-bleeding from the gums .and. from the respiratory mucous membrane. The blood expecto- rated was fresh and there was no physical sign of anything being wrong with the lung. A careful examination failed to elicit any- thing that could account for the mucous hSmorrhage except that during his maritime experience, which included a voyage of seven- teen months' duration, the patient had suffered from a scorbutie attack. Constipation, which had previously existed, was checked by a purgative. So far there had been nothing to excite apprelension or fore- shadow the rapidly approaching catastrophe. But on the 17th January a startling change had taken place in the patient's con- dition. He was passing blood freely fiom all the mucous mem- branes, from two old cicatrices now broken down. from a recent scratch upon the face, und from one ear, the cuticle of which had begun topeel off in consequence of a recent frost-bite. The surface of the body was covered with ecclymotie spots, which were largest and best narked upon the limbs;, those on the body being smaller and brighter in color. On the tongue these spots assumed the appearance of blood-blisters, which constituted the only elevation of surface that could be seen anywhere. The pulse was rapid, very soft and feeble, and the whole appearance was that of a man rapidly sinking from some form of malignant blood- poisoning. A consultation svas held. Beef-tea and brandy were",
         "CANADA MEDICAL JOURNAL freely administered, with the effect of somewhat raising the sink- ing pulse, but the improvement was slight and transitory, and between 9 and 10 p.m. the patient died. During the last hours of the illness some facts came out that had previously been kept secret. After landing from his seven- teen months' voyage, and being paid off at Queenstown, he had come out to Portland in the Allan st'eamship \"Moravian,\" arriving on the 2d December. Four or five days previous to her arrival small-pox had broken out among the passengers, and the vessel had, in consequence, beei quarantined and fumigated after the sick had been removed fron her. One important part of the fumigation had been omitted, as I shall soon show, but this last fact was not known then. In the meantime there was nothfng to attract much attention to the account or to lead the gentlemen- concerned to'suspect, for one moment, the nature of the-horrible case'they had just witnessed. The story did not appear to throw much light upon it. The vessel had been duly quarantined and fumigated, and the man had been more than three weeks away from ber, leading all the while an active and vigorous-life in the .open air. Neither the symptoms of the illness nor the antecedent history favored the diagnosis of small-pox; but, taken togéther they appeared to preclude it. Small pox, withput eruption, can be demonstrated only by tracing it to the infection of small-pox, -or by tracing the infection of small-pox to it, and in this câse the antecedent proof seemed to fail. From the 23d December, the day on which W- left the a Moravian,\" to the 14th January, when he fell sick, twenty-three full days had elapsed, or more than three weeks. Now, of all zymotic diseases, small-pox is that which is most regular in the length of its period of incubation, which is never many hours less .or more than thirteen days.' In W-'s case we must suppose either that we have the incubation lengthened by fully nine or ten days-an observation such as has never previously been xecorded-or that he contracted the infection from his own clothes. We inust inevitably come to the latter conclusion, for it is quite evident that the clothes of the \" Moravian's \" passengers were not thoroughly disinfected. Those which W- brought with him froni the steamer retained the creases and the peculiar sea- smell in which they had been packed. The invariable period of incubation just mentioned will lead us to the day of lis landing in St. John, as that upon which he received the infection. On that * Marson in 'Reynold's System of Medicine,\" i, p. 4.34-5. Barensprnig in \"Amalen des Charite Kranken,\" xix, p. 103. Tne eleven cases inrected by W:-- followed this rule exactly.",
         "SMALL-POX EPIDEMIC day, his long voyage being at an end, he must have taken*off Lis sea-clothes, put on others which he took out of the trunk, and received the infection from the latter. Thus by a series of little circumstances, all perfectly natural if you will, but all beyond recognition by any human knowledge at the time of their occur- rence, a disease of great malignity and infecting poiver obtained a footing in a neighborhood highly calculated to encourage its spread. It could not but spread. The people who live about the Marsh Bridge are very sociable and gregarious in their habits, and at the time of which I speak very few of them were vaccinated. Tie family with whom W-- lodged had their own visitors, and there were others who came to see the sick man. Punctually at the fortnight's end, the Board \u003c f Health were disagreeably surprised by being notified of the simultaneous appearance of eleven cases of small-pox, all situated within a few hundred yards of the unlucky house, and having a traceable connection with it. The infection was evidently virulent. -Six of the cases were confluent, one copious, and only three discreet. The remaining case vas hiemorrhagic, and as I have never seen a clinical description of this form of small-pox in print, I shall give the notes which were kindly furnished to me by the physician who attended it. Case IL--29th January, 1871. In the morning I was asked to see John McE-, who was said to be suffering from febrile symptoms. Being engaged at the time I could not go, but sent bim a febrifuge mixture. As he grew worse they sent for me again and I saw him. ls skin was dry and hot; his pulse 84, ful and bounding. There was intense pain in the back, and pain also in the forehead. He wasvery despondent and kept saying that he was going to have the saine disease that W - had had, and te die in the saine manner.* The bowels were constipated, the urine simoky and scanty. There was incessant vomiting and pre- cordial pain. Gave him a dose of calomel and potash, and con- tinued the febrifuge, which contained a diuretic and a diaphoretic, increasing the former ingredient. Ordered ice to be sucked to relieve the thirst, and a mustard poultice to be applied to the epigastrium and back. After the bowels had been relieved he was to take gr. xx of Dover's powder. He did so and passed a toler- ably easy night. The vomiting ceased, but the thirst remained, and he still had great fear and depression. 28th January, A.M., pulse 84; skin mnoist; urine increased to perhaps x1, but still * This poor fellow had been an intimate friend of W-'s, and had attended closely on him during his illness. The attending physician had not seen or heard anything of W--'s case. 485ý",
         "CANADA MED1CAL JOURNAL. dark colored, and looking as if it contained blood derived from the kidneys. On the back a mahogany-like discoloration, sprinkled with black spots, varying in size from that of a bean to that of a ten cent piece. There was no elevation of the cuticle, and I supposed the discoloration to be the effect of the mustard applied to a congested skin. Two o'clock-Continued the ice. Evening- The niahogany discoloration had spread over the whole surface of the body, still mixed with purpuric spots, larger in size, and. if anything, deeper in colour than those which had been previously observed. Urine decidedly bloody ; pulse soft, quick and feeble. le continued despondent ar.d comparing his case to W-*s. 30th January, at 7 A.M., he died. In comparing his case with W 's, you will notice in each the sthenic symptoms speedily repladed by those of depression, the purpuric blotches and mnucous hemorrhage following upon the cessation of the vomiting and epigastric pain, and the total absence of papules or of any attempt at eruption. Lumbar pain was present in one case but not in the other. I shall next speak of the progress of the epidemic and of the measures that were adopted to check its spread. The measures which the Board of Health adopted -upon the appearance of the disease were as follows: The doors of the infected houses were placarded, and all coi- munication with the inmates was forbidden, save the visits of the medical attendant, of those whose own houses were infected, and of those appointed to bring the necessary provisions. These last were supplied at the public expense to such families as had not the means or credit t- supply themselves. At a meeting of this Society, held upon the 31st January, it had been resolved to recommend that the Board of lealth should appoint a physician to visit the sick. and should procure a temporary hospital. to accom- modate such as required it. Both these recommendations were forwarded to the Board of Health and attended to by that body. A physician was easily found, but in spite of what could be done nearly three weeks elapsed before a hospital could be obtained, during which interval the cases had increased to the number of about sixty, and the fright and clamor had 'arisen to a very dis- creditable pitch indeed. Small-pox at all times makes more or less stir in the comnmnity, but on this occasion the malignant type and high mortality of the disease, so diflerent from what had been observed during any ýrevious epidemic, excited the liveliest alarm, and the accidental circumstance of the physician first employed having been infected before he entered upon his duties, and coiisequently attacked before he had been long engaged in",
         "SMALL-POX EPIDEMIC. them, added, in some measure, to the panic. I cannot say that the tone adopted by the publie press made matters any better. From an early period our editorial friends had made up their minds to insist upon three demands, which the authorities con- cerned, as I think, with very proper firmness refused to grant. These were : first, that the names and residences of the sick should be published; secondly, that the Board of Ilealth should submit the details of its proceedings for publie criticism and thirdly, that the patients in the City Hospital should be removed to the Alms House, and the former building converted, for the occasion. into a small-pox hospital; or, according to the elegant phrase then current, a \"pest house.\" These demands were steadily resisted. The first concession would have increased concealments, and so helped to spread the disease for the mere gratification of an idle curiosity. The second would have subjected the Board of Health to the dictation of the public, which is exactly the reverse of what the mutual relations of these two ought to be, if such a Board is to be of any use. With regard to'the dispute between the'public press and the Hospital Commissioners, I think that the press was decidely wrong upon that point also. No unprejudiced person, who knows anything of the matters referred to, can doubt the propriety of providing separate hospital accommodation for infectious and non-infectious ailments, or suppose that a costly institution, supported by a permanent tax, was set up for the accommodation of diseases which do not appear amongst us as often as once in ten years. Those who wish to see a full statement of the reasons upon which the Hospital Commissioners grounded their refusal to admit the small-pox cases, will find it in an able report which these gentlemen presented to the County Sessions on the 15th of last April. It will be sufficient here to say that an arrangement was finally made with the Directors of the Female RBeform Society, by which the Board of Health obtained the tema- porary use of their building for a small-pox hospital. Possession was given upon the 20th February. It was generally believed at the time that if the first set of cases reported had been.removed into a hospital at once, the disease would have been stayed. I am quite confident that it would not. There were then four-and-twenty other cases in pro- gress of incubation, and had the course recommended been followed, nearly all these cases would have been concealed, and the cases infected by them would also have been hidden until the number of the sick had become so greàt that no hospital would hold, them. It would be far better to let isolation take care of itself altogether than, by a series of indiscriminate removals, to",
         "CANADA MEDICAL JOURNAL. bring about such a state of muatters as this. A state of waràre between the infected families and the rest of the public. At that time, however, tLe public mind was possessed by exaggeráted ideas of the extent to which a hospital could be made useful, as a mneans of checking the spread of smali-pox. Of course we all know that there is but one certain method of effecting this desir- able end, and that is vaccination. Attend to it carefully and you will arrest the diffusion of the disease, no matter how numerous and widely scattered the centres of infection may be. Neglect it, and two or three cases will be sufficient to poison a whole Commu- nity with infection, in spite of every other sanitary precaution. thatyou can adopt. The popular theory seenis to be that, having once obtained an hospital, you, can easily put an end to your epide.mie by removing to it-ti et arrnis, if necessary-every case- of the disease that shows itself. I need scarcely say that this is a fallacy, and that any attempt to stop an epidemic after this fashion, will only lead to worse mischief. You will never be able to collect all the infection within the walls of your hospital; but, this is not the chief objection to the plan. Once let the people thoroughly understand what you mean to do, and every case will be hidden, until it has done mischief enough to render its removal a matter- of comparatively little moment. It must not be forgotten that the chief object of hospitals for infectious diseases is not to pro- tect healthy people, but to accommodate a certain class of the- sick, whom it would be impossible, or very inconvenient, to take care of elsewhere. A servant in a family; a lodger in a boarding house; any person who cannot get friends to take proper cnre and keep proper quarantine of him where be lives, if attacked by such a disease, must go to an hospital, and there certainly ought to be an hospital (and a separate hospital) for him to go to. There- are' also cases in which it is very advisable that a member of a family should go. A poor man who, even under ordinary circui- stances, lives pretty rear the edge of his income, cannot keep a case of smalLpox in his family without making up his nind to- undergo much hardship and suffering. He has no .money, but lie- must give up all his employment. - His neighbors are not always charitably inclined, but if they should be so, they cannot visit him to relieve his necessities. His house is small and he cannot isolate- the sick person or prevent the disease from more or less endanger- ing every member of his family. Some persons will prefer facing: all -these hardships and others, gyu nunc lingue, to parting with their relatives; but, they should never be able to say that such a terrible situation was thrust upon themby the negligence of the- authorities. Moreover, under some circumstances we are justified",
         "sMALL-POX EPIDEMIC. in resorting to rmoval, irrespective of personal considerations. When a solitary case appears, surrounded by a crowded, uncleanly, unvaccinated and ignorant population, it is wise and proper to remove that case and whatever may follow it, as long as by so doing you can 'keep tie neighborhood clehr of infection. By following thisrule during the last epidemic the northern, southern and south-eastern portions of the city were kept clear of the disease until sufficient time had been gained to allow the vaccin- ators to go over the whole community. After this had been done no further forcible removals were made, for the only circumstances that would justify therm had ceased to exist. It is highly neces- sary that the authorities should have the power of forcible removal, but the useful and necessary power must not be employed indiscriminately or it will become, to the public, a source of danger instead of an instrument of safety. In all cases where people (after thoroughly understanding what the conse- quences will be) prefer to keep their relatives with them, it is both cruel and unwise to force them away, unless you feel satisfied that the disease will spread beyond the family if they remain, and disappear altogether from the neighborhood if they go. I trust, gentlemen, that you will not consider these few remarks upon the function of smal-pox hospitals Misplaced or superfiuous. Very different views from those which I have just been stating, found favor with the public last year. They were loudly pressed upon the authorities by some of the public prints, and claimed to- be supported, to a certain extent, by medical opinion. The measures which the Board of Health adopted for quaran- tining anddisinfecting the infected houses have often been sneered at;as inadequate. They are not perfectly protective, and, indeed, no human measure can be, yet they evidently produced some good-effect. The district in which the disease first appeared, and to which it was kept chiefly confined, is bounded by Brunswick street and by portions of Brin and Brussells streets. It presents nany obstacles to the enforcement of any kind of sanitary regu- lations, and contains, for its size, a good many inhabitants, very few of whom, at that time, either were vaccinated or wished to be. Up to the middle of Maich I kept finding unvaccinated;peopIe in it who had been living, week after week, iwithin a very short dist- ance of the infection, before it found an entrance into their houses. Notwithstanding all sorts of local furtherances, the dIs- ease, even in this infected district spread but very slowly from on\u0026 bouse to another, and never became localized anywhere else, although solitary cases appeared at intervals in alimost every part of the city. Clearly, McBurns, with his placards and fumigations,",
         "CANADA MEDICAL JOURNAL. playe-i no contemptible part in suppressing the epidemic. But, the Most careful attention paid to infected houses, coupled with the most judicious series of removals to hospital, could not have eradicated the disease, had it not been for the district vaccinators. As early as the 2nd February, the Chairman of the Board of lealth had written to the editor of the Xorning T egraph, a letter, in which he dwelt upon the impossibility of using the public infirmary as a small-pox hospital; the bopelessness of expecting to extirpate the disease through the medium of any hospital, and the pressing necessity of attending to private vaccination. This last piece of advice was much needed, for, as it afterwards turned out, there were then in the city more than 6,000 unprotected people, or about one.fifth of the entire population.* The neces- sity for a public vaccination soon became apparent and pressing. ,Owing to various causes, the chief of which was the absence of a compulsory vaccination law-a defect which, I regret to say, still remains unremedied-there was a great scarcity of lymph in the city. Moreover, there are, in every large community, a certain class of the people who will not look after their own protection as they are influenced by a dread of vaccination, the combined result of ignorance and quackery, which nothing short of the fear of imminent death can overcome. Lastly, the poorer people, who need vaccination mnost of all, can never be properly attended to by private practitioners. In view of all these considerations a public ,accination was instituted, and to this wise and prudent ineasure we owe the speedy extinction of the disease that followed. With- out it we might have been, at this present moment, sharing the fate of many large citi-s of Europe and America, which have had the disease domesticated among tbem for many nonths, with lamentable waste both of life and public and private expenditure. The city was divided into ten districts, andto each of these was appointed a physician to inspect its inhabitants and vaccinate or re-vaccinate such of them as ho might find unprotected. The undertaking was commenced upon the 3rd March, and completed in the course of a few weeks, 5,379 people being vaccinated, or re-vaccinated, at a cost to the public of a little over sixteen hun- dred dollars. Never was public money better invested. The new cases which, in February and March, had been occur- ring at the rate of two or three a day, declined, in April, to three or four a week, and by the third week in May the disease had *Between 10th February and 19th May there were vaccinated or re-vaccinated: By the District Vaccinators, 5,379; at the Board of Heaith office, 875. Total- 6,254. Besides what was done in private practice. aud what Dr. Boidea and tnyself did among the infected famihes and their neighbors.",
         "SMALL-POX EPIDEMIC. almost disappeared from the city, but at that date it received, from three concealed cases, an impetus that one might call a second epidemic. Eighteen or twenty new cases appeared, nearlv all unvaccinated peole. who had either lately arrived from the country or been accidentally overlooked in the district visitatio)ns. The disease had lost none cf its rnalignancy. Two of the cases were hæemorrhagic and two petechial, and seven, or more than a third cf the whole number, died. The fact that all this mischief arose from three concealments shows what a dangerous thing con- cealment is, and how strenuously we ought to avoid anythirg that may tend to encourage it. The new outbreak thoroughly tested the efficacy of the district vaccinations, for I believe it infected every unprotected person that was to be found within a large radius froin the site of its appearance. It was dealt with in the manner that I have already described. By the end of June the city was clear of smnall-pox and it has since remained so. I may here say a word or two upon the subject of THE SMALL-POX HOSPITAL. Irrespective of other recompense, the public owes itb thanks tc the Directors of the Female Reform Society for affording it the use of the Home, which, as regards site and internal convenience, is, I believe, the best building in the city that could have been procured for the purposes desired. 1 make this acknowledgement all the more cheerfully because, at the time when we most needed co-operation and good wiill, it was almost impossible to hire any- thing for the use of the sick. Whatever we wanted we could only have by buying it altogether, and, cramped as we were for funds. this was a serious inconvenience. I have already mentioned that there was some unavoidable delay in getting possession of the building, but when it was finally handed over to me in a very unfurnished state, the cordial co-operation of Dr. Bayard and the Hospital Commissioners enabled me, in the course of a few hours, to fit it up for the accommodation of some eight or ten patients who were all that then required removal. We were soon ready to receive about eighteen more, or eight and twenty in all, had cir- cumstances required it, but the actual number in hospital at one time never exceeded fourteen. exclusive of a matron, two men servants, and a female nuise, all pernanently employed by the Board of Healtb. Besides these we had other assistance. Certain relatives of the sick who were properly protected, were allowed to enter the hospital and attend upon them if they wished it, on condition of assisting, if required, to look after the other patients, without demanding any wages beyond their board and lodging,",
         "492 CANADA MEDICAL JOURNAL. ,and leaving the hospital with the patients that they had accom- paniedthither. The plan seemed to work very well, and we had always one or two of these volunteer nurses on hand. If I thought it would please any of them to: have their names xnentioned I could do so, and commend their kindness ind diligence as well. Neither were the permanent -servants wanting in these respects. The food and all the other supplies were good, and to shorten a long story, if I had been taken sick I would have gone there myself. I mention all these, things because within three days after the hospital had been opened it was asserted in public print, not only that the place was ill-provided and ill-managed, but that the sick.within its walls were treated with gross inhumanity. I contradicted these statements at once, but they produced a bad effect. Up to the 23rd February, the date at which they were published,; I had not met with a single concealment. in the course of the week immediately following I found nine. All this shows how careful the press ought to be in seasons of public panic, and furnishes an excellent commentary upon the popular notion of combating the disease through the medium of the hospitals. i have now, gentlemen, explained to you the plan which was adopted in dealing with the disease, and the results which followed it. The plan, I think, was sound and the result good, but, I leave them both to your criticism. I hope that the details have not beentedious. I have judged it necessary to go into them because their, expediency was much questioned at .the time, and may, perhaps,, be -doubted still, a fact which, at least, ought not to be due ,to a want of proper explanation. That explanation, which for obvious reasons could net begiven then, I think it, only right to give.now. And before leaving this part of the subject, I shall not be .deterred, by anyfear. of, misconstruction, -from offering a small tribute of.approbation te ourworthy ex-President of, the Boardof lealth. I have no-private interests te, serve with that gentleman. I have.not even acquainted him with the fact that I intended, upon thisoccasion, to make use of bis name,,lest his modesty-should have shrunk from -even this small acknowledge- ment .of the very great services for whichthe public is ,indebted' to him. I amnnot.about toallude ,tohis.reritsas a privae gentle man ,oras. amedical practitioner,,which have long been recog- nizedboth in the profession and outside of it. It is only of his public.actions that I am.free te speak; of valuable services long .and cheerfully rendered to.the public, in pqsts whose only sala'y,: isthe consciousness of .being.useful, in the face of ail manner.of 'perscnal annoyances, -both great and paltry; of; an -hospitl'",
         "SMALL-POX EPIDEMIC. established for the poor, and defended for them against the clumsy manipulations of shallow municipal economist-; of the lives of citizens preserved; of a man's duty manfully done, with the sacrifice of all personal and selfish considerations, and in despite of that great modern bugbear of popular clamour which has so often driven incompetent officials to mischief. It is an invidious action for a junior practitioner to pass an opinion upon the conduct of a senior, but the fear of personal misrepresenta- tion shall never deter me from doing an act of justice. CHARACTER OF THE EPIDEMIC. I have now' to lay before you some of the satistics of the epidemic. The cases, so far as made- known to the Board of lealth, were 205 in all; 98 males and 107 females. Of these, 32 males and 39 females died; 71 in all, or nearly 34 per cent. of the whole number attacked. This heavy mortality was chiefly dueý to three circumstances, each of which claims a word or two' for itself. lst, The noglect of vaccination; 2nd, The large propor- tion of those who were attacked during the early months of life; and 3rd, The great malignity which has everywhere characterised the epidemic of 1871. lst. Neglect of Maccina/ion in every small-pox epidemic is the chief cause' of boththe extension of the disease and its fatality. I need not waste time in dwelling upon truths which have been ten thousand times told, and fifty thousand times demonstrated during the past eighty years, although it scems that there are some people who can never be induced to realize them. No epidemio could confirm then more forcibly than that of which I am now speaking. Of 138 unvaccinated peopie who took the disease here last year, only one escaped with a varioloid attack, and 69, or just half of thema, died; twenty-five, or not far from half of these, again, had either hSmorrhagic small-pox, which is invariably and spoedily fatal, or the petechial form, which, though a little more protracted in duration, is hardly less deadly. All the rest, except some eight or nine, had corfluent or copious 4ruptions which, even in epidemics of the ordinary type, prove fatal to a full third of those who exhibit them. On the other hand, 67 vaccinated people took the disease, and 30, or nearly half of them got off with varioloid attacks; Only two of them died, or about 3 per cent., which is just the usual mortality of Braall-pox after vaccination. This furnishes us with an important ddition to the argument in favour of vaccination, which I have nt found dwelt upon as strongly as it deserves to be by a11y'of -ur authorities, i.e., that the malignancy of the epidemic does not 493",
         "CANADA MEDICAL JOULRNAL. raise the percentage of mortality aiongst the raccincted. While the mortalityfrom the natural disease, neier lower than 12 or 15 per cent , nay be swelled to 50per cent. and upwards, by an increase of nalignity in the type of the epidemic; -snall-pox, after vaccination, is, on the con- trary, an unifornly mild disease, and attended witlh an uniformly low rate ofmortalitU, whatever the type of the epidemnic may be. I have already shown ydu how the district vaccinations extinguished the disease among us in less than three months. I wish that these facts could be carefully considered by all who have any lingering doubt in their minds that there is but one method, and that, hap- pily, an infallible method, of dealing with that formidable and loathsome disease ; or, who think that any amount of squabbling about \"isolation \" and \" the liberty of the subject \" will enable us to avoid the necessity for a stringent Vaccination Act. I have seen people, protected by vaccination only. come out unharmed, after living for weeks together in atmospheres of which the inha- latïon by the unprotected was certain infection and probable death. I have known vaccination resist all these influences, and that of accidental inoculations as well. - In the face of all that I could tell you upon this point, and all that you know yourselves, it does seem a most reprehensible thing that our Legislature should have burked the Vaccination Act that we sent them last year, because they could not decide whether the vaccinators ought to have five cents or fifty cents per head for their va.ccin- ations, or whether they ought to be ordered to perform them for nothing. I hope that this matter will be kept before the public, and not suffered to fall into oblivion until another epidemic calls attention to it in the same melancholy manner as that of last year. With regard to the Ages of the Patients, thirty-five, or rather more than one-sixth of those attacked, were under five years of age, and only three were less than a year old-a circunstance which could not fail to add to the mortality. In treating these little people we thought ourselves uncommonly fortunate to save three out of the nine and sixteen out of the thirty-five. The youngest patient was the child of an infected mother, at the full, time, and was born jaundiced. It, was vaccinated at once, but seven days after birth it showed the eruption of confluent small- pox, and died five days afterwards. Another female infant showed a copious eruption on the tenth day after birth, in spite of an ineffectual attempt that had been made to save it by vaccination. The vaccine vesicles, two in number, ran their course ilong wit- the, eruption, and, though they did not modify its maturation, I am inclined to think that they may have lessened its amount and 494",
         "SMALL-POX EPIDE3IIC. in some measure mitigated the secondary fever, for this infant lived longer than any other fatal case, and at one time I almost indulged the hope that it would recover. It died on the twentieth day exhausted and with paralysis of the soft palate and îeso- phagus, A child, four years of age, was apparently well and hearty two days after small-pox had appeared in the family. On the third day, about six p.m., it suddenly sickened, complaining of pains which it could not precisely localize, and laid down. It sank rapidly and died in about four hours. I could not get down to see it during life. The body presented no characteristic external appearances, and I had not then time to make a post- mortem examination, nor do I think that the parents would have permitted one. In such a case the cause of death must remain an open question, but I returned it as a death from small-pox, having little doubt that the infection had proved sufliciently powerful to cut off the child before anyspecial symptoms could be developed. If this were so it is the most rapidly fatal case upon my list. The youngest patient that recovered was two and a half maonths old, and , had varioloid; but another maie infant, aged fourteen months, recovered from a confluent attack, followed by an abscess in the zygomatic fossa, which retarded his convalescence by several days. It is seldom that we have to record such a fact, or notice the appearance of small-pox pits upon so young a face. The two oldest patients attacked were two men, aged respect- ively sixty and sixty-seven; both of whom had the hoemorrhagic form and died within three days. Three women, aged sixty, sixty-five, and fifty-seven, recovered; the fIrst two from varioloid and the third from the form called \"horn-pox,\" the only case that I have ever seen. The eruption remained papular and took nearly forty days to disappear. The accompanying fever was quite moderate. To conclude with regard to age, you will see by the accompany- ing table,* that the lowest death rate-29 per cent. -was met with between the ages of five and twenty. 3rd. The .Mazgnity of the .Epidemic las been noted during the Last two years in every locality whero the epidemic has shown itself. It is evinced in the large number of h:emorrhagic and petechial cases, both of which are usually great rarities: in the copious amount and unfavorable character of the eruptions, and tlie comparatively unfrequent occurrence of the tuilder forn of smaall-pox among the unvaccinated ; in the severity of both the initiatory' and suppurative fevers; the large number of deaths, [This will appear in the next number of the .iurnal.-Ede. C. JI, .] 495",
         "CANADA MEDICAL JOURNAL. and the early period at which they occur. This last point is worthy, of special notice. Gregory, averaging from a very large experience, found the eighth or'ninth day after the eruption, i.e., the eleventh or twelfth day of the disease, to be the most fatal, and Wood says that most deaths occur between the twelfth and eighteenth days, or, roughly speaking, within the third week of the disease. By the- accompanying table of theý duration of the fatal cases that occurred here last year you will see that twenty- six, or more than a third, died before the fifth day, only seventeen survived the tenth, only one lived beyond the ineteenth, and that the average duration of the whole seventy-one cases was but seven days and a fraction. The same virulence- has characterized the disease in other places. Last year, in England, where they have a Vaccination Act which, however imperfect, protects thousands of the popula- tion, smail-pox destroyed, in: seventeen large towns, 13,174 people, including 7,876 in London alone; while the average mortality among· the unprotected has varied from about 40 per cent. to -more than two-thirds. It has sometimes been observed that the virulence of small-pox epidemics abates after the first month or two. In our half year there was no such abatement, the virulence remained unaltered to the last. The last who were attacked suffered as severely as the first, and of the last six deaths recorded, one died on the second, another on the third and two on the fifth days. I have to add a few remarks upon the d.àèrent forms of small- pox that were observed, and their treatment. HÆEMORRHAGIC SMALL-POX. I have failed to find an exact descrption of this form of the disease in any of our standard authorities. Aitken.says nothing of it. Trousseau speaks of two patients 'l whose bodies looked as \"though they had b neen rubbed over with the juice of mulberries or the dregs -of port wine.\" Sydenhan, whose opportunities for observation of the malignant varieties of small-pox were ample and well used, gives a very good description of the petechial ,form, noticing its frequent association with the synptons of bloody urine, but is not explicit âýs to true hemorrhagic small-pox. The only good accounts of the latter that I have found are those of Gregory and Marson, who describe the mucous hSmorrhages and vibices, and mention the fact, the importance of which we have already seen illustrated, that even in the adult this fori may give rise to uncertainty in the diagnosis by proving fatal before the eruption has had, time to appear. But they agree in stating that it generally proves fatal upon the fifth day of the eruption-",
         "SMALL-POX EPIDEMIC. i.e., the seventh or eighth day of the disease. I do not know from what number of cases they took this average, but the eleven cases that we saw here were closely alike in their symptoins, and not one of them presented anything that could be called an erup- tion at all, while in only one of them, and that a peculiar one (of which I shall shortly speak again), was death deferred beyond the third day. In short, as I have already said, this form of small-pox has no symptom in common with any other, and its identity can be shown only by tracing the cause which produced it and the effects which it produces. From the observations of these ten cases I would describe it as follows: It results from the action of a very malignant virus working upon an unprotected subject, and seems to require, also, the pre- existence of some debilitated state of the constitution. It com- mences with a smart febricular attask. Mental depression iay or may not be present from the beginning, but the first symptoms are always of a sthenie kind. The pulse is hard and quick. The most distressing symptoms are headache and vomiting. The for- mer is frontal and usually very severe; it is rarely relieved before the first symptoms of sinking appear, and always lasts longer than the vomiting. The latter is severe-sometimes almost continuous, always frequent and associated with epigastric pain, almost as if some irritant poison had been received into the stomach. The heat of the surface at this time will attract special attention; it is, I believe, greater than that which attends on the commence- ment of any other disease. I regret that I had not an opportunity of instituting a proper set of thermometrical observations upon this point, but, judging roughly from the sensation communicated to the hand, I would estimate it at not less than 108° or IOQ. On the second day these sthenic symptoms subside into those of great mental and physical depression. The vomiiting stops and is at once succeeded by the formidable and, I would say, fatal symp. tom of mucous and subcutaneous htemorrhages. In the cases which I saw these extravasations occurred first in the conjunctiva and in the urinary and intestinal mucous membranes; these soon give way and exude blood which is dark coloured and forms but a loose and scanty coagulum. The natural secretions of the mem- branes first become tinged and then deeply coloured by this dark blood, and finally almost wholly replaced by it. Superficially the extravasations take place in the subcutaneous cellular tissue, and are also infiltrated into the substance of the derma,giving rise to the appearance of the dark-red patches and blotches which Trousseau has likened in colour to the lees of port wine. These patches may be'associated with large and numerous petechi, but the cutaneous FF 497",
         "CANADA MEDICAL JOURNAL appearances are not invariable; either patches or petechie may be present alone, or the skin may merely present a diffuse, brawny swelling, somewhat heightened from the natural colour. An ulcer is sure to become the seat of liinorrhage; a cicatrix or a recent scratch will probable bleed also. Anything that renders the capil- lary circulation especially active, at a particular point, tends to cause himorrhage from it. The patient sinks on the third day. There is another forin of small-pox closely related to this, but attended by an eruption, and differing somewhat in the intensity and duration of its syrnptoms-the PETECHIAL S3MALL-POX. Ilere the premonitory fever is of an asthenic type froi the first, and on the second and third days there is a strong tendency to mucous hoemorrhage, especially from the gurus and kidneys. Numerous petechif appear, and are soon followed by the eruption, wbose papules, instead of being small and acuminated, are large, broad and flat, and of a dark purplishi-red colour. If the patient survives long enough they become flat, confluent vesicles, irregu- larly shaped and dotted with snall black umbilici, as in the bad, confluent forms of which, indeed, this is the worst kind, the patient usually dying on the fifth or seventh day of the eruption. Sydenhan dwells upon the prognostic value of colour in small-pox eruptions, a point which modern authorities have disregarded, I don't know why. In this respect the favourable eruption differs most markedly from the nialignant one at every stage. In the former; the papules are bright red, the vesicles pearly and trans- lucent. the pustules yellowish white or bright yellow, and the crusts a decidedly reddish brown. In the latter, the papules are purple or claret-coloured, the vesicles an opaque, dirty white, the pustules dark brown, and the crusts (if the patient lives long enough to form ther) almost black. The petechial small-pox is closely related to the hwmorrhagic forminvwhiuch I have just described, but as the latter has well-marked characters of its own, especial!y that of being a essentially non-eruptive form, i would class the former with confluent small-pox. between which and the haumorrhagic variety it forms a sort of connecting link. Petechiw and bloodyvesi- cles are not absolute criteria, but only indices of malignity. When the type of the epidemie is virulent we may see them sometimes present in small size and nunber even in the company of discrete or moderate eruptions. Their value in diagnosis and prognosis is not absolute but comparative. Yet, when they are at all numerous or large, and precede a dark.coloured flat eruption, attended by vibices, hremorrhage from the gums, or bloody urine, the case will almost certainly prove fatal, and when the vibices are large and the",
         "MEDICO-CH{IRURGICAL SOCIETY OF MONTREAL. 499 hemorrhages free. the result will seldom be delayed beyond the third or fourth day from the commencement of the attack. When the petechiS are less numerous, the papules somewhat larger, and the homorrhage not so free, the case may last a few days longer, and the eruption advance through some of its stages before death occurs. To sum up with regard to malignant small-pox: There are two distinct forms; one characterized by himorrhages with- out eruption, the other by petechiim with a dark-coloured eruption which tends to become confluent if developed; but these two forms are closely related to each other, and may, in individual cases, be found, to a certain extent, combined-the homorrhages associated with a certain number of petechiæ, or the petechial eruption with a certain amount of mucous hamorrhage. Both are, so far as I know, inevitably fatal. I saw one homorrhagic case in which life was prolonged for ten days, and in one very ano- malous case of smaall-pox, after vaccination, which recovered easily and quickly, there were scarcely any symptoms beside the erup- tion, which consisted of varioloid papules associated with numerous and well-marked petechi on the legs and arms. But such cases must be very exceptional, (To be coniinued.) MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. MEETING IIELD APRIL 20THR 1872. The Society met in their rooms, the President, Hector Peltier. Esq., M.D.Ed., in the chair. After preliminary business, E. H. TRENHOLME, M.D., read the following paper on Irregular Uterine Contraction. The subject of this paper is of such practical importance that I have thought it might-not be uninteresting to briefly bring it before you. Observation alone can satisfy each one as to the accu. racy of what is stated, and now that the subject is taken up I hope that it will be thoroughly and impartially investigated by you all. Spasmodic contraction of the uterus is naturally divided into irregular contraction during the birth of the child, and irregular contraction during the delivery of the placenta. lst. Irregular contraction of the uterus, during the expulsion of the foetus, is known by short partial spasms of the uterine walls, which acconplishbut little in the way of dilating the os or advane- ing labor.",
         "CANADA MEDICAL JOURNAL. These contractions do not occur regularly, either in respect to the space of time intervening between their return or their dura- tion. By placing the hand upon the abdomen, over the iiterus, we can frequently detect irregular and partial contraction of the organ. These pains are of a short, sharp and painful character, and usually cause intense anxiety and distress to the patient. Upon making a vaginal examination you will detect but slight bulging of the membranes during the pains; also, not unfre- quently an unequal dilatation of the muscular layers of the os or cervix uteri. The internal layer is the least dilated; sometimes to not more than half the extent of the external layer. By the way, I may say that the diagnosis of this condition is not so easy as one would naturally suppose, as the internal layer of muscular fibres is thin and might be mistaken for a thickened decidua. When the finger lias reached the os and is attempted to be passed between the neck and the membranes, we encounter adhesions more or less firm and extensive between the internal surface of the muscles and the decidua. When the adhesions are on one side the os is drawn away froni the median Une and toward that side to which the decidua adheres. As a necessary consequence of such a condition of things, there are obliquity of the womb and irregular oblique pre- sentation of the presenting part at the brim of the pelvis, and retarded engagement and its consequent results. The existence of these adhesions are ascertained with little diffi. ·culty, for, in addition to the facts already mentioned, we have palpable and ocular demonstration of the attachment of shreds of muscular fibre to the decidua. In these cases the membranes are felt to be thickened, and with a little attention this thickening is recognized as due to shreds of muscular fibre adhering to the surface. I have on several occasions removed, by my finger nails, portions of these shreds from the decidua, both during the dilatation of the os and after the removal of the placenta, and found them composed ,of fibrillae of unstriped muscular tissue. (See plate.) The adhesions are also recognised by this additional fact, that after such adhesions have been broken up by the finger, the protrud- ing portion of the membranes rapidly increases in size; the uterus, which was before oblique, soon returns to its central position; the presenting part engages; the irregular, ineffective, spasmodic contractions become regular and powerfully expulsive; and a tedious, lingering labor becomes a normal one, and is speedily brought to a satisfactory conclusion. I have but little doubt more correct and extensive observation will demonstrate that the great 500",
         "MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. 501 majority of oblique presentations will be found to be due to this cause. The manner in which these abnormal adhesions are produced, and their inodus operandi in causing irregular spasmodic contrac. tions of the uterus, and its consequent results, will now be con- sidered. In speaking of this matter we can arrive at probable conclusions only, and I shall therefore submit that these adhesions may be due to: Ist. A pathological condition of the inner surface of the uterus, existing previous to gestation; or, 2nd. To injuries received during gestation; or, 3rd. Result from partial, instead of complete separation of the decidua having taken place before term, i.e., that the ripening of the decidua has not been uniform ; or, 4th. To a combination of two or more of these causes. We will now consider the value of these different hypotheses. lst. In favour of the idea that these adhesions may be due te a diseased state of the internal surface of the uterus, existing pre- vious to gestation, we have the well-established fact, that a part or tissue once the seat of disease or injury, seldomu or never regains its orignal state of perfect health, and is liable to subse- quent diseased action. Experience teaches us to be careful in effecting the delivery of the placenta in those cases where we have encountered strong adhesions in a previous labour, as we know that those who have been troubled with such adhesions are obnoxious to them on subsequent occasions. 2nd. Adhesions may occur during gestation as a result of local extravasation of blood, or liq-sanguinis; either from shoek; a plethoric state of the system in general, and the uterus in parti- cular; or, by direct violence applied over the parts affected, as by a blow upon the abdomen; or, possibly, by injury to some part of the neck or lower segment of the uterus, upon the brin of the upper strait of the pelvis. Such an injury as this might be caused by a false step, jump, or fall. For rny own part, 1 an of opinion that this is a not uncommon cause of such adhesions. This view is confirmed by the fact that in most of the cases of retarded labour, due to irregular uterine contraction, that I have met with, the adhesions were situated within a short distance of the os. 3rd. The adhesions may be due to partial ripening or want of tha't cell maturation, by neans of which the decidua is separated from the internal surface of the womb at terni in natural labour, and which, by the way, is, in all probability, the determining cause of",
         "CANADA MEDICAL JOURNAL. labour, as lately suggested by the present Professor of Midwifery in Edinburgh-Dr. Alexander Simpson. The strength of the attachment will det6rmine the extent of the irregular contractions, and consequent delay, \u0026c., in parturition. The induction of labor at all, where adhesions exist, is probably due to the separation already spoken of having taken place, to a sufficient extent to produce uterine irritation and subsequent muscular contraction of the uterus. In this class of cases we need not look for, or suppose a pathological state of the men- branes or uterine surface, but regard it simply as due to a lack of that perfected developement of the mucous membrane of the uterus, which is usually accomplished about the end of the ninth month. 4th. Lastly, these adhe-ions may be the result of two or more of the foregoing causes. There nay be a predisposing plethoa of the vascular system, accompanied ly shoek or blows; or, a weak- ened state of the uterine walls, the resuilt of former diseaso or injury. and this. by a subsequent injury. may be the cause of local inflammation, effusion of plastic lymuph, and subsequent adhesions. The causes of these adhesions having been spoken of, we will now look at the manner in which they probably cause irregular spasmodic contractions of the uterus and retard labour. The fault may be in the nerves or in the inuscular structure. 1st. The nerves may be at fault, i.e., there may be hypersthesia of some branches of rerves, thus inducing hasty, irregular action; or, there may be paralysis of some of the nerves which supply to the parts, and thus occasion irregular muscular action; or, 2nd. The cause of the spasm may lie in sone abnormal condition of the muscular tissue, apart from any fault in the nerves; or, 3rd. The cause may be adhesions between the decidua and the uterus. Thus the decidua, being closely applied to the muscular surface and the adhesions preventing the membranes from pro- truding, might act in a mechanical way and thereby check the shortening of the muscular fibre, the attempt at contrac- tion being met by the counter extension of the decidua; or, pehaps, the muscular structure. connected at the points of adhesion, may, by being lacerated or irritated during the pains, cause unequal and undue tension of some muscular fibres, the parts injured acting as direct excitants, and in this manner causing that unequal, short, spasmodic forni of uterine contraction which characterizes tedious labour. Of these hypotheses I am inclined to think that the last is most probably the correct one. I suppose it ivill be conceded by every one that the whole uterus responds equally and iegularly to the stimulus that induces labour,",
         "MEDICO-CHIRURZGICAL SOCIETY OF MONTREAL. 503 unless there is some abnormal condition of the organ, such as defective innervation, excessive innervation, or muscular change of some part of the organ, as already mentioned. As to defective innervation I shall not speak. The fact that these kinds of labour occur with women who both before and after- ward have natural labour, shows that it cannot be due to disease of the nerves or muscles of the uterus. Where one good and sufficient cause for the production of any phenomenon is known to exist there is no need to go beyond it, and recognized tension and laceration of the inner layer of muscular fibres, at the points of adhesion, are enougli to account for irregular action of the uterus. The effect of these adhesions when they exist, say on the right side and near to the os. is to interfere with the regular action of the muscular con- tractions. for the reasons already mentioned, and at the same time cause a very incomplete and iuperfect expulsive effort. The steady, protracted bearing-down pains, so desiderted, are wanting, and grinding pains take their place. We all know that the decidua, with its contents must be elongated, in order to adapt itself to the diminished capacity of the uterine cavity during the spasm, that the waters must escape, or the membranes be protruded throtgh the os and a pouch of fluid occupy the vagina before any progress is made toward the delivery of the child. This being the case, lateral adhesions must interfere with the descent of the membranes and cause that the bag of waters be formed at the expense of ihe membranes which slip down froin the side where there are no adhesions. The formation of this pouch in this mianner, in its turn, necessarily, carries the lower segment of the uterus witli the os, toward the side on which the adhesions exist. Thus in a first vertex or breecli presentation of this kind the left side of the presenting part would be driven into the cavity of the pelvis and made to occupy a lower level than the corresponding parts on the opposite side. The expulsive force of the uterine effort is lost to a great extent, on account of the fœtus not being made to engage in the axis of the brim of the pelvis. When we consider the irregularity of the contractions, and the great disadvantages under which the expulsion of the foetus has to take place, we find abundant c not only for the prolongation of the labour, but also for the anxious and exhausted state of the patient lierself, The labour pains in these cases are most severe, and thie, in my opinion, is due to the muscles acting contrary to erah other and tearing themselves",
         "CANADA MEDICÀL JOURNAL. asunder, as has been already mentioned, when speaking of the unequal dilatation of the os. It is this form of pains that most authors recommend to be treated by bleeding, when the patient is plethoric, and when weak and nervous by tepid baths, warm inj3etions, sedatives, opium, Belladonna, \u0026c. The irregularity of the contractions continue tÀll the adhesions are separated; or the dilatation of the neck has been slowly and painfully accomplished by the inoperative contractions of the organ; or until the membranes have been ruptured, so as to per- mit the child to glide over the membranes, seeing the membranes will not glide over the surface of the uterus, as they should do, to allow the child to be born. To break up the adhesions is an easy matter in those cases where they are situated near the os. The finger gently introduced around the neck, between the membranes and the uterus, readily accomplishes the desired result. Where the adhesions are beyond the reach of the finger I do not think it advisable to attempt the separation by instrumental means, but rather to rupture the membranes at once, as by this means we effect the chief thing to be desired, viz., the supervention of normal labour. In some cases, after you have broken up the adhesions as far as the finger will reach, you ivili often find that the os will rapidly dilate, and in a few minutes the finger can be still further introduced and the detachment completed. I give the following case-one out of many-by way of illus- trating what has been said : Mrs. L. aged 20, first pregnancy; has been in labour last four and a half hours; pains irregular and spasmodic, and aecompanied with intense suffering. On examination found os dilated to the size of a twenty-cent piece; membranes adhe- rent on the right side, and neck of uterus turned that way. A somewhat thick layer of muscular fibres, covered the mem- branes, spread over the dilated part of the os. As I could not reach all the adhesions the membranes were ruptured, after which the pains became regular and powerfully expulsive, the os dilated rapidly, and the child was born in less than two hours. By way of illustrating another class of adhesions I may state that during the past week I attended a Mrs. R., aged 21, in her first confinement. 9Jn examination found womb alnost upon the floor of the pelvis, and os dilated to the size of a twenty-cent piece; las bad, grinding pains; little expulsive power for last eight hours. On introducing the finger could feel no adhesions between the mucous membrane and uterus. Being somewhat in",
         "MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. 505 doubt as to the cause of the irregular coutractions, I examined more carefully, and then found that there were tolerably strong adhesions between the posterior part of the neck of the uterus and vagina. The adhesions did not exist over the anterior third of the neck. The separation of the parts was easily accomplished, when the expul- sive power of the pains was greatly increased, the o? dilated more rapidly, but the membranes did not protrude. With the dilatation of the os the womb descended more upon the perineum, and I then found fadhesions between the mucous membrane and the uterine surface, which, when broken up, the labour progressed more rapid]y, but I finally was obliged to deliver by the forceps, as the head presented in the third position, and the woman was too weak to complete the labour alone. This case is mentioned not only on account of its unusual character, but also beeause it shows that external adhesions may interfere with labour as well as adhesions between the mucous. membrane and the inner surface of the womb. Before leaving the subject it might not be amiss to say that the cause of gestation being of shorter duration in first pregiancies 1s probably due 'to a more rapid maturation of the decidua, com- bined with a very sensitive state of the muscular surface of the uterine cavity, which favolurs the induction of muscular contrac- tion before the decidua is thoroughly detached. It also explains why we have trouble in delivering the placenta in many instrumental cases. The adhesions render the contrac- tions abnormal and inefficient, and this condition ienders the forceps necessary to complete the delivery, while the adhesions remain, as before stated, to give us further trouble. The effects of adhe3ions upon the delivery of the placenta deserve some consideration, but as I have not had any cases illus- trating my views upon the subject, 1 shall not longer occupy your attention. We would have no difficulty in attributing hour-glass and spasmodic contractions of parts of the uterus upon the placenta to the same cause that induced such contractions during the first and second stages of labour. In addition to the cause of such con- tractions, which have been spoken of already, there is the possible irritating effect of the placenta when adherent to the uterus. The mass of the placenta being somewhat firn, and the uterus contracting upon it, might easily cause laceration of some muscular libres. and thus originate the hour-glass contractions. Also, the contractions might be due to the effect of lacerations of the tissue- of the surface during labor, whicl had left the parts irritable an4 ready to contract as soon as opportunity olfeired.",
         "CANADA MEDICAL JOURNAL. * As to treatment of retained placenta'I have nothing special to say. We should follow the reco'gnized mode of dealing with such cases, and, when possible, effect the detachment and removal of the entire mass, with its membranes. VICTORIA SQUARE, Montreal, 19th April, 1872. OBSERVATIONS ON SEA-SICKNESS, AND ON SOME OF THE MEANS OF PREVENTINGr IT. By SiR JAMES ALDERsoN, M.D., D.C.L, F.R.S., Consultinig Physician to St. Mary's Hospital. Some remarks which 1 published lately through the mediui of the Journal were not intended to be an exhaustive statement of ny views on the subject of sea-sickness. I propose, therefore, to consider a few points which I intentionally postponed for a future occasion; and I may at the same time briefly allude to certain objections which, though courteously offered, have, as I believe, been made without a sufficient apprehension of my view of the subject, and of the scientific basis on which it is founded. The chief points which I omitted to consider are, the immunity of cerain individuals from sea-sickness, and the relief which is usually experienced after a certain time spent at sea. But, before entering on these special topics, I wish to enlarge a little further on the connection of sickness and vomiting with brain.disturb- ance. It is well known to pathologists that, of all the causes which act sympathetically to induce voniting, affections of the head are the most common; nothing can affect the sensorial functions without in sôme way disturbiig the stomach. The expe- rience of all practical men testifies constantly to this; -but if reference to published authority be desired, I may quote undeni- able testimony in a valuable paper in the Transactions of the Royal Medical and Chirurgical Society, by Sir Benjamin Brodie (vol. xiv., p. 339). In treating of concussion of the brain, he says, that \"sickness and vomiting, for the most part, are early symptoms.\" Now there can be no doubt that the effect on the brain produced by the blood during the cescent of the ship is of the character of a slight concussion. It is in the less severe forns of concussion that sickness and vomiting most certainly occur. In the graver forms of head affection, such as apoplexy, it is not so often found, because it requires a certain degree of excitability of the brain to",
         "OBSERVATIONS ON SEA-SICKNESS induce the act of vomiting, and that excitability has been destroyed by extreme pressure. I pass now to the immunity of certain individuals froin attacks of sea-sickness. This, at first sight, seems an anomaly, and pre- sents a difficulty in accepting the theory which I propose, as well as every other theory which may be brought forward. I can only suggest, as a solution of the difficulty, that there are constitutions so formed as to be very slightly Eubject to sensorial impressions. The same inequalitysubsists between different individualsii their capacity of being enotionally affected; some are unmoved by the most distressing subjects; some have their feelings easily excited. It inust be borne in mind that the argument as to exceptional iimunity is equally applicable to all methods of explaining the existence and causes of sea-sickness. In regard to the recovery from sei-sickness, there is much to be said without abandoning the theory of the original cause. A wonderful and instinctive pover of accommodation to circuni- stances is possessed by the human frame. In the course of time, the sensorium is able to aclapt itself to unusual circumstances; and on this point again we may refer to the same paper by Sir Benjamin Brodie, who, to his statenent, \"that sickness and vomiting are early symptoms,\" adds \"that they seldom. continue after the patient lias recovered from the iinst shock of the acci- dent.\" I may add to this, that, when organic change has taken place in the brain, as in the presence of a clot of blood, from the rupture of a vessel, there is, on reaction taking place, a cessation from sickness and vomiting. That brain has an extraordinary power of adaptation to circum- stances, is evidenced by recovery from hemiplegia, as well as by numerous recorded instances of foreign bodies, such as bullets, etc., being lodged in the brain with subsequent recovery. As an auxiliary to the power of the brain to accommodate itself to the motion of a ship at sea, I must refer to the instinctive act of inspiration, of which I have already spoken, as a great adjunct to relieve the brain fr-onm an undue supply of blood. It must be remembered that recovery from sea-sickness during a voyage, in most cases, takes place after one or two days; by which time the sufferers, now convalescent, have exchanged the short choppy waves of the English channel for le totally different seas of the Atlantic Ocean or North Sea. Having myself several times crossed the Bay of Biscay. and having been once three months on board a sailing vessel, I am quite aware of the entirely. different kind\u0026of sea to be met with outside the (Channel. and f can conjecture that any relief which took place in the broad swelling",
         "CANADAM IEDICAL JOURNAL. waves of the Atlantic would not have been experienced if I had been still pitching about between England and France. As to my suggestion, I must remark that it was intended to prevent sea-sickness, and not as a remedy to relieve it after it has been once set up. It is offered as a means whereby the action on the sensoriumn shall never be induced. After that has once taken place, the effect cannot be expected to subside immediately from the mere avoidance of further exciting cause. I am afraid that some misunderstanding may have arisen from the use of the word \"towards\" instead of \"in the direction of\" the bows of the vessel. I could not have meant to indicate the forward part of the vessel as desirable for the recumbent position; because, the centre of oscillation of a ship being the point about which all its parts may be supposed to oscillate, whether in pitching or rolling, it will be in the midships that the least motion will exist; and it is obvious that there, or as near as may be, the berths or sofas should be placed, especially those for the ladies, who, from delicacy of organisation, are the iost easily affected. I must just allude to a suggestion th-at I precaution as to diet\" is of great importance in preventing sea-sickness. Of course, before going on board, any excess or change of usual habits would be obviously inexpedient; but no rules for a particular diet before going on boa2d can possibly be suited to all habits and constitu- tions: that which would be suitable for strong men would be very ill.adanted for delicate constitutions. There is evidence that the contents of the stomach have very little to do with the sickness, which is secondary only to a disturbance of the sensorium. Vomiting and retching equally take place after the stomack has wholly emptied itself; and this is a distinctive difference between vomiting which arises as a consequence of cerebral disturbance and that from disordered stomach.-British Nedica/ Journal. ON THE \"CARBON CLOSET SYSTEM.\" BY E. c. O. sTANFORD, P.C.s. I am induced to bring this subject specially before this Section because I consider its merits have never been properly brought under your notice and fully discussed. It has been so fashionable Read before the Mechanical Section of the Britieh Association at the Edin- burgh Meeting.",
         "ON THE \"CARBON CLOSET SYSTEM.\" to consider the water-closet system as the perfection of sanitary skill, particularly among engineers, who generally look upon it as the onlyfeasible means of house excreta removal, that it requires soine hardihood for a chemist to urge here a totally opposite opin ion. The fact is, however, that by putting this noxious and yet valuable materiable in the sewers the engineers have removed it from the power of the chemist to bring his science to bear on it. All proposals to deal chemically with the enormous dilution of town sewage have hitherto failed; nor, as far as we know, is there the least probability that anything effectual or profitable can be done in this direction. Now I have always held that if we are to do anything to assist sanitary science we must begin with the noxious material at an earlier stage of excreta removal than as town sewage. Moreover. I consider that the system by water carriage is founded on error. To accomplish the required result and enormous proportion of water is necessary i no doubt it was at first supposed that this large pro- portion of water would oxidise and render innoxious the poisonous matter, but the contrary is now admitted to be the case-decom. position is rýapidly increased and promoted. Moreover the poison germs, so far from being destroyed, are diffused broadeast with appalling rapidity. In times of danger this becomes painfully evident; hence the Times, in a recent article on the expected cholera epidemie, raises an alarm in the following terms: \" In the first place, the destruction of the excreta from cholera patients must be insisted on under the heaviest penalties, and a systen of inspection adequate to enforce this provision must be organised. Without these preliminary safeguards we cannot hope to resist the enemy with any success. So long as the germs of the disease are allowed to pass through the sewers into the rivers, to be washed up by the tide against our seaside villages, to be wafted about our streets in the form of an impalpable dust, we cannot hope for any good results from sanitary measures of the ordinary kind. Cleanliness, ventilation-above all a pure water supply, are advantages which cannot be over-valued. But until the germs of disease are systematically destroyed and excluded from any chance of mingling with the air we breathe and the water we drink, nothing will control the ravages of cholera. Every other precau- tion is subordinate to the main preventative measure, which it will need special powers to carry into effect-the destruction of the cholera germs before their diffusion.\" The 4 sanitary deadlock\" is sufficiettly perplexing without this further complication; one authority obliging the distracted mem- bers of town couñcils to drain somewhere, another interdicting the 509",
         "CANADA MEDICAL JOURNAL. drains from fiowing almost anyiwhere; but none telling them where or kow to dispose of their refuse. Now, however, the sewage question is to undergo another complication. The citizens of London, after paying so very handsomely for their grand experiment on main drainage, are to be told that, just when they most require it to purge their houses of poison and pollution, the mighty engine bas broken down, and they must fall back on their own resources. There can '- no doubt the Times is quite right: the prohibition is absolutely necessary if the plague is to be stayed: but admit this, and the water-carriage system goes by the board, it must be condemned as unable to cope with the removal under all circum- stances of bouse excreta. In Glasgow, the Sanitary Section of the Philosophical Society, after two years' discussion, on which most of the members entered with strongly preconceived prejudices in favour of water carriage, a unanimous resolution was passed strongly condemning it, and insisting that in the perfect system of the future all focal matters must be rigidly kept ont of the public sewers. It is a compliment to the intelligence of that resolution to find that public opinion is gradually working round in the same direc- tion'. The city of Glasgow may not have been so far wrong after all in watching and waiting the experience of the great city before committing herself to a proportionately costly scheme. At the time the resolution I refer to was passed, the water-closet at one end and irrigation at the other were generally considered the two necessaries to all civilization. We have lived to see that neither of these are necessaries, and that neither are generally applicable or advantageous. We are told now that successful irrigation must be accompanied by processes of deposition or filtration. The British Association Committee even recommend two separate systems of drainage, and this partly concedes what the resolution referred to demands. I would, bowever, go further, and treat the house excreta as a material the removal of which should have no con- nection whatever with the sewers and should never be mixed with wa'ter; in fact, that the sewage system should not be complicated by this, the main source of the worst pollution. Now I affirmu that in the most populous cities the general use of the carbon closet systen is perfectly prncticable, and that it must be by far the most healthful and by far the most profitable means of getting rid of the nuisance. In this Sectioi last year I heard a gentleman say that \"no sca- venger should ever visit bis house.\" Now I should like to have asked how that gentleman disposed of his bouse ashes, because either he allowed the scavenger to call for them, which disproved",
         "ON THE \" CARBON CLOSET SYSTEM.\" his assertion, or he put these into the sewers, in which case some other local authority ought to look after him. This, however, is not an uncommon feeling of repugnance on the part of the house- holder, and must be duly respected; yet the maost prominent advocate of water carriage must draw the sewage line somewhere, and all would draw it outside of house ashes. These must not in any case find their way into the sewers. But in the more noxious and more valuable material we actually have much less to remove, and the removal can be made equally inoffensive. I admit that any system to be generally adopted must require no attention from within and must be quite as automatic as the water-closet. This, however, is easily arranged, and if one tithe of the talent and ingenuity had been spent on the dry system that has been lavished on the wet, it would, I believe, have long ago superseded it in this country. There is no more necessity for a scavenger to enter a house properly arranged on the dry system than on the other. . Let us consider, in the first place, what is the actual total amount of excreta per head to remove; and I wish to premise that I would advocate no system that was not intended to cope with the whole of the house exereta, solid and liquid, leaving only the wash-waters to enter the ordinary drains. I have published a table, taken from various authorities, show- ing the estimated amount of this material to be removed per head, with its value.* The last table are the figures employed by Her Majesty's Cormissioners on the Pollution of Rivers in their reports, and as they niake no allowance for loss, for absence from home\u003e \u0026c., I think the average of 8 cwts. (including only about i cwt. solid excreta) per head may be fairly taken; so that in a large household of ten persons it would amount to 80 cwts. (about 8 cwts. solid), and its chenical value would be about 80s., or 's. pet head. The same household would use at least 20 tons of coals, and probably send away four tons of ashes. The total annual quantity of charcoal required therefore could not exceed 4 tons, would probably be much less, and the whole removal, allowing for the drying action of the charcoal in the vault, would be about 5 to 6 tons weight. Eight cwts., then, is the total quantity to be annually removed per head, and it is now generally effected by mixing it with 1,200 tonsý of pure water, all of which it renders highly offbnsive, and its value, however it may be extracted, if that be indeed possible, is reduced to very much less than this, over and above the dilu- tion, in inverse proportion. C\"eicad Nevrre, vol. rxii., p. 302.",
         "CANADA MEDICAL JOURNAL. It is scarcely necessary to reiterate the disadvantages of this method of removal. We know that the closets are costly in erec- tion and in repairs, that they consume and foul a large portion of our water supply, and that they have hitherto wasted the whole of the material. We first tried to confine the polluted water in cess- pools, then we converted these into a network of deep laid sewers. thereby connecting all the houses and ensuring the spread of a cholera or typhoid fever epidemic. We do not know yet how to deal with the sewer gases, and have discovered no certainly perfect method of getting rid of the pollution. Now it does appear to me that we have mistaken the application of water ; we do not require such a gigantic carrier and diffuser. Knowing how possibly dan- gerous the excreta may become, we ought to seek a disinfectant which will add as little as possible to its bulk and increase its manurial value. Therefore I would at once add that precisely the same objection maay be urged against the use of earth, which would require three and a half to four times the quantity of the material removed, and reduce the value of the manure to even less than this in inverse proportion. The analyses of earth-closet soil by Dr. Gilbert confirm my views as to the poverty of the manure. The same applies more forcibly to the use of ashes, of which even more are required. These two materials act only a\u003e deodorisers so long as they are dryers ; let the mixture become damp, and it at once becomes offensive. The use of earth in large cities must be impracticable and will always be expensive. Ashes can generally be provided in the bouses, but these are not so good as earth, and the manure is scarcely worth removing. In all the tons referred to in the British Association Committee's reports where this system is adopted the price obtained is merely nominal. In discussing the merits of a dry system, we have always this advantage over the advocates of the wet system, that, while they are limited to the use of water, we have a large choice of dry deodorisers. That which promises the greatest success is charcoal, and this is now being made the subject of experiment on a pretty large scale. There is no greater difficulty than to provide closets for workmen which shall always be perfectly inoffensive and shall not get out of order. I can point out one work where the system I advocate has been in use for three years by 150 men, and the closets have never got out of order. We have never worked with more than a fourth the quantity as compared to earth, and 1 am convinced that we may reduce the amount required even to one- eighth. I have assumed, however, that we use a weight equal to",
         "ON THE \"CARBON CLO:SET SYSTEM.\" the material to be removed.* The house may have a closet on each floor-say three, or even four; these are arranged one over the other. Each draws on the same supply of charcoal at the top of the house; the contents of the closet are allowed to fall through a 12-inch thin galvanised iron pipe into a water-tight cemented cesspit in the basement of the house. The charcoal reservoir is filled and the cesspit emptied by the scavenger once a year, the whole process being quite external to the house. The urine is emptied into a simple earthenware urinal in the closet on each fluor, and it falls through a lead pipe direct into the pit, where there is always sufficient excess of charcoal to perfectly absorb it. The total absence of all odour is most remarkable. No water-closet can be compared to it. The quantity to be removed is reduced to less than twice tb weight of the total excreta, and when removed an ordinary obseiver would scarcely know it from the original charcoal employed. The next step in the process is to remove it to the chemical works, where it is re- burned in iron retorts, the amîmonia distilled off, and the charcoal returned to the householder. In small villages one of the retorts at the gas works will get through a large quantity, and the ammo- nia will add to the value of the gas liquor. There is a constant increase of charcoal obtained from the excreta itself; this is an animal charcoal similar to that from bones; it contains the whole of the phosphates and the potash, and with the ammonia is avail- able for manure. The chemistry of the process has been so fully gone into before, on a former occasion, in another section, that I deem it unneces- sary to refer further to it here; it will be found very fully described in several papers already published in the Chenical News.* I wish here to show how capable the process is of general extension. It is scarcely necessary to assure you that the cholera germs cannot survive the ordeal by fire which they suffer in this treatment. If, however, in case of cholera, further disinfection be desired, it can be easily effected when the whole excreta of the house is in a small pit, and in any case it is removed from our neighbour's con- tamination. A renarkable proof of the wonderful freedom fronm odour is described in a former paper.† The process is now being worked by a small company, called the *The reznarkablo drying action of the charcoal before alluded to was singularly shown in one house, where the contents of a wash-basin had been daily emptied into the urinal and found its way into the vault for twelve inonths before it was accidentally discovered. The manure, when removed from the vault, was appa- rently quite dry. * Clietical News, vol. xix., pp. 253, 269, 291; vol. xx., p. 196, and vol. xxii., Pp. 289 and 30]. t Uhemical Eew. vol. xxii., P. 303. GG",
         "CANADA MEDICAL JOURNAL. Nitro-Carbon Manure Company, Limited, established by a few gentlemen to show that the process. even on a comparatively smali scale, can be made a commercial success: al are satisfied as to its perfectly fulfilling all sanitary requirements. Several of the principal shipbuilders on the Clyde are erecting the necessary closets and urinals in their yards, and in a few weeks these will be used byabout 10.000 men, In re-burning the material the retorts to be employed will be Normr:an'- patent twin rotaîy retorts, now much used in the principal sugar houses in Glasgow. An arrange- ment has been made with the shipbuilders to allot thein shares in the Company to the value of the closets erected, and thus these employers of labour will share in any profit which may be made. If the process pays as well as we expect, it must rapidly extend: but as I know you will deem it your duty to examine every pos- sible solution of the sewage difficulty, I make no apology for bringing it under your notice at this stage. Now, in estimating the profits of any chemical process as compared with irrigation, it is quite proper to value the manure produced only by chemical analysis. ler Majesty's Commissioners adopt this course; they attach little importance to farmer's certificates, but value entirely by chemieal analysis. This is the only fair way, because it shows exactly what it is worth in open market; and, valued in this way, all the manures produced by the several sewage companies are comparatively worthless. Yet, although this as been abundantly proved, why are the shares at such a premium ? But in comparing the value of irrigation with that of any chemical process dealing with sewage, they bring in another and, I submit, an improper element, i.e., the total profit of the farmer. This is unfair: the farmer buys bis manure-say, made from bones; or, say, from excreta-,by analysis at its market value, and his living is made out of what that investnent produces from the land. The 'irriga- tionists have no right to put themselves in his place, reap his profits, charge themselves nothing for the sewage, and call that \"making it pay.\" In one of the accounts quoted in lier Majesty's Commissioners' Report, the I right of shooting over the farm\" is actually entered as an irrigation profit! We have hitherto used the ordinary earth.closets of Moule's patent, simply throwing smaller charges of charcoal in coarse lumps; these have been wonderfully successful, but in order to use fine granulated chaacoal, and to considerably lessen the quan. tity required, it was necessary to invent a closet for this special application. I applied to my friends, Messrs. Pollock and Pollock. engineers, of Leeds, and the closet exhibited is the result of their 514",
         "SUGAR IN URINE. ingenuity.* It delivers a minimuni, but accurately measured quantity, and places it exactly where it is required; and it is remarkable what a small quantity of the deodoriser is sufficient to keep the deposit perfectly free from odour. I exhiiit also the plans for workmen's closets; and when I add that in all the yards where thebe are being erected they are to supersede large and expensive ranges of iron buildings and water- closets, you will understand that their great disadvantages have been already proved to the satisfaction of those pioneers of suc- cessful engineering, the shipbuilders on the Clyde. The impossi- bility of stopping their action and rendering them offensive is highly important. An instance of the extremne dificulty of dealing with factories is mentioned in a former paper.t The almost uni- versal experience is that the water-closet is unsuitable for factories. The owne.-s of private houses are beginning to think in the same direction, or why do we so constantly find disinfectants still employed? If the water system is or can be made perfect, why should such agents ever -e required? These disinfectants have all, more or less, a disagreeable odour, are all expensive, add nothing to the value of the product, and confess the weakness of the water-closet system. I think, therefore, the method of the future must be sorne such modification of the dry process as that now referred to as the Carbon Closet System.-Chemical News. ON A MEFiHOD OF DETECTING SMALL QUAlTITIES OF SUGAR IN URINE. By J. SEEGEN, M.D., professor in the University of Vienna, Trommer's is the nost reliable and delicate test for sugar. With its aid, I am able with certainty to make out 0.3 milligramme (0.0046 grain) of sugar dissolved in 10,000 times the amount of fluid. This great delicacy of the test, however, only holds good as long as we have to do with a watery solution of sugar. If, on the contrary, small quantities of sugar are to be detected in urine, Trommer's test is neither delicate enough nor reliable, for two reasons. 1. Urine contains certain substances (colouring matters, creatine) which prevent the suboxide of copper when formed from being precipitated; no separation of the reduced suboxide of copper, therefore, takes place, the blue fluid only becoming yellow or yellowish-brown, or presenting a turbid discoloration. This closet can be obtained at the Carbon-Cloet Company, 46 Naymnoun t Ftreet, Leeds. It was figured in the Engineer for August 5, 18-i. t Chenic«I Neter, vol. xxii., p. 302. 515",
         "CANADA MEDICAL JOURNAL. 2. The same processes of reduction are also brought about by uric acid; and urine, containing a considerable amount of uric acid, acts on Fehling's test-fluid exactly in the same manner as urine containing 0.1 to 0.2 per cent. of sugar. The method devised by me has for its object the exclusion of tho'e other contituents of urine which would disturb the proper action of the test, and the transformation, as it were, of the saccharine urine into a watery solution of sugar. Animal charcoal has the property of retaining most of the constituents of urine, more especially the colouring matters and uric acid. After filtering a watery solution of uric acid through animal charcoal I could (provided the charcoal had been good), after repeated filtrations, not find a trace of uric acid in the filtered fluid. Now, in order to detect small quantities of sugar in urine, I proceed in the following manner : I filter one or two ounces of the urine several times through ,good animal charcoal unitil the urine is completely colourless. This operation only takes a few minutes. Then I wash the -charcoal on the filter with a little distilled water, and to thi\u0026 -water, when filtered off, I apply Trommer's test. The water with -which the charcoal- has been washed is almost as sensitive to Trommer's test as a watery solution of sugar, and in it I could ,detect even 0.01 per cent. of sugar by a beautiful red precipitate of suboxide of copper, whilst the original saccharine urine, when eot filtered, only produces a yellow discoloration of Fehling's test-mluid. With urine contaming a little more sugar-say, 0.1 to 0.2 per cent.-the water flowing off from the second and third washing acts even more energetically upon the test-fiuid than that of the first washing, producing and even purer deposit of s8uboxide of copper. The water obtained by the subsequent ýwas1ings thus evidently contains the sugar in a purer from. With normal urine, the water obtained by the above process is either ,entirely inactive towards Fehling's test-fluid, which remains blue, .or it assumes only after' a while a slight dichroid (varying colour .according as the light falls on or passes through) turbidity. The water obtained by a second and third washing always remains without any effect. When the quantity of sugar has to be deter- pined, the urine must not be filtered through charcoal, as the iatter always retains a certain quantity of the sugar which cannot be removed again by washing.-Brfsh Medical Jou2rnal.",
         "M!ONTREAL, MAY, 1872. THE CORONER'S COURT. One of the relies of barbarity is the Coroner's Court. \" Crowner's quests \" have from time immemorial been the subject of ribald jests and sarcastie merriment. We should imagine that the lack of dignity, or the absence of all the paraphernalia whîch constitute a well-ordered court of law has led to this generally entertained opinion; but. more than this, the absurd and irrelevant verdicts rendered have been seized upon by minds like those of Goldsmith and Dickens, and have served to bring into discredit and ridicule a process in our criminal jurisdiction unfitting the solemnity of the occasion. Investigations touching the death of a human being should, from the very nature of the inquiry, lead to serious thought, patient search for the actual cause of death, and a truth ful and straightforward verdict. No peroual consideitions should be allowed to weigh a hair's breadth. J ustice should be admin- istered eveu.handed, and if a gross wrong has been done it should not be smothered by a verdict of death by the visitation of God. These reflection: have been forced upon us by the hurried and unseemly manner in which, on several occasions within the past few months, cases have been disposed of in this city, so that the office of Coroner appears to have become a useless appendage to our criminal administration; nay, worse, in some cases to which we will allude the whole proceedings were a cruel mockery. If we must have a Coroner-we do not seek to a bolish that office-let us have a learned and independent member of the legal profession. It was at one time held in England that the office of Coroner should be filled by a medical man; these views have lately beei modified, and it is now believed tbat physicians do not make the nost efficient coroners. Some years ago, whei Montreal was half the size it is et present, there were two coroners. The process of investiga- tion in that day was performed with greater satisfaction to the public than at present. 'We do not think it necessary to multiply the office of Coroner. but we do think it a reflection on our judicial system to have an office of sich gravity and quai importance filled inefficiently.",
         "CANADA MEDICAL JOURNAL. But, to return to the subject under discussion, we have stated that several cases have been summarily disposed of, and that the verdicts did not give satisfaction to those who thought on the subject. One, the case of a man called Iarry Lewis, who died with ail the symptoms of poisoning by opium, or of some of its preparations, or salts. It was testified to, under oath, that the man, the evening before his death, had procured morphia in quantity from a drug store in this city. Fur- thermore, he h'id been seen to -wnllow a white powder. A lengthened investigation took place; the vî.cera of the chest and abdomen were exanined, and their condition tallied with what is generally observed in cases of poisoning by opium. No chemical examination was ordered: no attempt to decide the question \u003cf opium poisoning was made; the jury were instructed to bring in a verdict of cleatli from congection of the lungs from natural causes, and here the case eided. Now it hap- pens that the public are deeply concerned in this very case, because it is contirary to law for any druggist or apothecary to sel any noxious thing or poison without the order of a physician, and it did not appear in evidence that the druggist who sold IIarry Lewis the morphia was justified in so doing, at least he was not protected from censure or criminal prosecution by holding an order from a recognised practitioner for the dispensing of morphia. It is quite possible that the man did die from natural causes; nevertheless it remains unproven, and if the crown were to insti- tute criminal proceedings again,,t the druggist, one essential element of his deftnse is wanting. Again, another case is brought before the Coroner, somewhat of a diflerent character, but which is disposed of with equal dissatis- faction. A man comiplains of a stomach-ache and resorts to a druggist, who not only prescribes but actually dispenses his own remedy. The next we hear of the man is that he is found dead in a hayloft. A jury is sunmoned, evidence is taken, and deatli by the visitation of God the verdict rendered. iIere, again, society is deeply interested in this case and its results. The law of the land permits alone persons holding the license of the College of Physicians and Surgeons to prescribe medicines or to exercise the functions and privileges of a physician in the Province of Quebec. The ca-e remains in doubt, and som e charitably-disposed persons would naturally and very reasonably believe that the druggist had given the man an over-dose of some drug, which had caused his death. Inquiry is thus burked, and injury is sustained by the druggist who, in all likelihood, gave the man a harmless dose of medicine; but a doubt remains as it is uniproven.",
         "THE CORONE:RS COURT. * Again, we read of a wonan who dies and an inquest is held on her body. The iedical men who are in attendance at'the Coro- ier's Court find a whitish powder about the premises which they allege to be strychnine, and hence, without further inquiry, a verdict of death from taking an over.dose of strychnine is rendered, Since then we believe the Attorney-General has ordered the bcdy to be exhumed, and a chernical analysis to be made to prove the presence or absence of ihe poison. A question natuirally arises, with whit ulterior object is this chemicail analvsi ordered to be znde? Is It to decide the question of the nctual cause of death ? The Coroner and jury have decided, on what we deem to be insuñicient data. thit the death was caused by strychnine; thus bringing into ridicule the whole proceedings. Another case is on record. A ian named Bryson was. in May, - l4\u003e, found dead with bis throat eut. The dectased lived in a house in St. Dommiique street, and it was alleged that early in the morning, between four and five o'clock, lie rose fron his bed and commiitted tLe act of \u003eelf-destruction. A imanwhose namue is not given, was present in the bouse, if not in the room, at the time of the occurrence, but his evidence was iot produced before the jury. The medical gentleman who examined the case noticed that blood, in considerable quantity, was on the side of the bed and on the floor by the bedside. This did not quite agree with the account of the occurrence given by the inmates,. as it was stated that be had risen froi his bed and had committed the act while groping about the room. The neighbours had heard a noise as though a scuffle was going on, followed by groan\u003e. This case, at the time, called forth some very sensible and pertinent comments by the daily press. No searching or critical investigation appears to have been made: the inquest was hurried through; the man who had slept in the house, but wh iwas not an inmate of the prenises, was not examined, and the verdict rendered was one offelo de se; the body was buried and the whole circum\u003ctances consigned to oblivion. .But another case cornes before us, and one in which, through the stupidity of the police, a body is found drowned and is dis- posed of in the comi se of a few hours, we believe somewhat under four. The inque.st is held, and the man, who was a Protestant, and who had been missing since lat December, was buricd in the Roman Catholic Cemetery; whether in the ceinsecrated ground or not we cannot say; in this case th frienîds of the decePsed, had not only notified the police but had publicly advertised the cir- ·cumstances of bis disappearance and after considerable running",
         "CANADA MEDICAL JOURNAL. about and some expense, they had the body exhumed. recognised it, and had it removed to the Protestant Cemetery. Again, we have the case of the man Jones who shot himself. In this case, aspersion of a serious and damaging charactor was pub- lished by a city paper, reflecting on the conduct of the professional gentleman who attended the case. This attack was so gross as to lose in the telling of the story. But who is to blame that the public are as much in the dark, after the inquest, as to the cause of Jones' death, as they were before the investigation ? Al1 we know is that the country is saddled with the expense of a useless trial and inquiry which is allowed to drop for lack of a post-mortem examination of the head of deceased. These cases point either to the lack of judgment or the want of knowledge of the presiding officer. We will not impugn his honesty in the matter. We have heard of instances in which the Coroner has taken upon himself to carry on an inquest without any medical evidence what- ever. Now, this is decidedly wrong, because medical testimony is the only evidence upon which a jury can arrive at an accurate knowledge of the cause of death. It were better to have no inquests at all, than that they should be conducted in a manner to bring discredit on all connected with the Coroner's Court. Medical evidence should not he suppressed, nor should it be lightly passed over. Nor, again, should the Coroner or jury have the power cf deciding the question as to the expediency of post-mortema exam- ination. This is peculiarly the province of the physician., and where he is unable to assert positively the actual cause of death, then should he be required to examine the body po.t morem, inspecting the condition of the various viscera to decide this point. We must state that the present system of conducting Coroner's inquests, not only in this city but generally throughout the country, is, as a rule, unsatisfactory, and it is high time to make some change, or abolish altogether the office of Coroner. substituting a more search- ing, impartial and, in consequence, more reli-ible tribunal. UNIVERSITY OF BI8IOP'S COLLEGE-MEDICAL FACULTY. The first convocation for the conferring of degrees in Medicine, in the new Medical Faculty of the University, took place in the the College, Lennoxville, on Thursday, the 4th April. The chair was occupied by the Hon. Edward Hale, Chancellor. having on his right H is Lordship, the Bishop of Quehec, President of the University. Dr. David. Dean of the Faculty, presented tl-e following eandi-",
         "PROFESSIONAL EXAMINATION. dates for graduation. Having taken the usual oath they severally received, at the bands of the Chancellor, the degree of C.M., M.D.. André Latour, Lachine; Wolfred D.: E. Nelson, Montreal; Henry S. Cunningham, St. Catherines, Ont.; Philipe Deselets. Three Rivers j Joseph E. A. Lanouette, Champlain; Richard N. Webber, Richmond. The Dean also made the following announcements: The number of students in attendance during the session was twenty-five. The following gentlemen passed their Primary Examination: Mr. Godfroi Dubuc, Chambly: Rodolphe Sicotte, St. Hyacinthe; Valmore St. Germain, St. Hyacinthe; E. A. Duclos. Montreal, Jereniali Eneas, Montreal; Isaac Fontaine, St. Barnabé; Wm.. MacDonald. Montreal. The prize for the best Final Examination was awarded to Mr. André Latour. of Lachine; that for the best Primary Examination to Mr. Godfroi Dubuc, of Chambly, who also took the prize in the Senior Class of Practical Anatomy. The prize in the Junior Class of Practical Anatorny was awarded to Mr. Robert Costigan, of Montreal, Mr. John Ahern, of Quebec, receiving honourable men- tion. The two prizes offered to the students of the Senior and Junior Class of Physiology, who obtained the highest number of marks at the written examinations during the session, were awarded to Mr. Godfroi Dubuc (Senior Class) and Mr. Robert Cos- tigan (Junior Class), Mr. Rienond Spencer and Mr. John Ahern (Junior Class) receiving honourable mention for the excellency of their papers. The graduates were subsequently addressed by Dr. David. is Lordship, the Bishop of Quebec, and the Rev. Dr. Nicolls also addressed theConvocation. In the evening a conversazione was held, which was very largely attended. We give below the examination papers of the College of Physi. cians and Surgeons of Ontario for which we are indebted to our cotemporary the Canada Lancet. COLLEGE OF PHYSICIANS AND SURGEONS, ONTARIO.. PROFESSIONAL EXAMINATION, 1872. DEscarrrTîv Ax,\u0026Tox-y-Di. SULLIVAN. The brain being sliced to a level with the corpus callosum, how would you expose the third ventricle? Name 'the structures- livided, and the boundaries of the ventricle. 5'21",
         "CANADA MEDICAU JOURNAL. Describe the arch of the aortU, its course, divisions, liints and relations. Give the exact position of the pancreas, its structure, and the vessels and nerves that supply it. What ducts convey secretions into the mouth, and at what points o they terminate? Define the teri fascia. Name the varieties, and describe the fascia lata. The integument being removed, how would you expose the parts passing through the great sacro sciatic notch ? Name thema in order, and mention generally their destination. What structures would it be necessary to divide to expose the median nerve from the axilla to its termination in the digital branches? 1 What class of articulations does the ankle belong to? Describe its ligaments, and name the tendons contiguous to it. SurIcAL ANATOMY-Dr. SULLIvAN. Describe the mode in which you would expose the several cavi- ties in making a post mortem, and state how you would remove the brain entire ? Name the muscles contracted in tulipes varus and valgus, and any danger likely to occur in their division. Give the exact course and relations of the external iliac, and mode of ligating it. Give the boundaries and contents of th- space in front of the elbow. Describe the Lachrymal duct and Eustacîhian tube, and mode of catheterizing them. MrDlcZxE--DR. WRIGHT. Give the symptoms of Epilepsy in its two principal forms- Mitior and Gravior. Profiposit in each form, courte, termination, and treatinent. Give the symptons and signs of acute Pleurisy, distiniguishing between symptonis and signs, the several stages, prognosis, course and treatment. Give the symptons of Dysentery in its Sporadic and Epidemic forins, nd definition of the terms. What forms of febrile dis- turbance are liable to occur in each ? What are the assigned causes of the diseuse? What the complications, prognosai, and full, and explicit directions for treatment? Give the definition of the. tern Exanthem. Give symptorns of",
         "PIOFESSIONAL EX:AMINATION the preuonitory stage in each, the phenomena of the second stage, and the average duration of each. Enumerate the most frequent complications. Give the appearance of Vaccine disease. Enumerate the causes which may change the shape of the chest, either increasing or decreasing its size, and means by which you may distinguish them. MEDIcAL PATIIOLOGY-Dp. WRIoT. Give the definition. causes and results of Passive Congestion. Give the definition, causes and results of Active Congestion or determination of blood. What is the condition of the blood in Rheunatism, Anremia and Plethora? Give the Pathological Anatony of Enteric or Typhoid Fever. MEDmeAi, DIANOsiss-Du. DEwAR. Enumerate the Diagnostic points between Pulmonary abscess and the cavity of Tuberculocis. lescribe the symptoms of acute Bright's disease. Naine and differentially diagnose the diseases likely to be confounded with it. What is Enteritis? Describe its symptoms. Diagnose Gout. How would you distinguish between Spinal Meningitis and Myelitis? For what other diseases inght the former be mistaken, and how would you recognise it froi them? SURGERY-DR. LîZARs. Describe the difference between Osteo-Sarcona and Osteo- Cephaloma. Describe the varieties of Henmorrhoids. What is commonly known as White Swelling of the Knee? Describe the Pathological changes that take place in its produc- tion. Describe the difference between Concussion and Compression of the Brain. Give the diflèrent varieties of Erysip\u003eelas, the distinguishinig characteristics of each formn, and their appropriate treatment. 0PERARIVE SUJRGERY--DR. LIZA llS. Describe the operations for Resection of, the Shoulder Joint, State which you prefer, and your reasons for that preference.",
         "CANADA MEDICAL JOURNAL. Describe the operation of Paracentesis Thoracis, its site and dangers. Describe the operation for removal of Superior Maxilla. Describe the various Dislocations of the H1ip Joint. Describe the various methods of treating Fracture of the Patella. SURGIcAL PAuHLoGy-DR. FELD. Describe the Phenomena of Inflammation and the transitions to it from Normal Nutrition. Give the Degeneration of the Fibrinous. and also of the Corpus- cular portion of Inflammatory Lymph. Name the five inodes by which the healing of open wounds are accomplished; and describe the process of repair of open wounds. Show the points of resemblance between a Mammary Glandular Tumor and Scirrhus of the Breast; also their distinguishing char- acteristics. Give the distinctions between Innocent and Malignant Tumors as regards Structure, Growth, Ulceration and Propagation. MATERIA MEDICA-DR. TUcK. Explain and illustrate by example the Specific Operations and the Elective Action of Medicine. Give the Description, Action, Use and Dose of the following: Creasont, Santonine, Chloral Hydrate and Tartar Emetic. Give the British Pharnacopoeal namaes and differential characters of Calomel, Corrosive Sublimate and White Precipitate, with their respective Uses, Doses, and Modes of Administration. For a case of general Dropsy, write a prescription in full,. and state the reasons for the introduction of each ingredient used. WIDWIFERY-DR. BERGIN. What are the sigus of Pregnancy at the second, fourth and eighth ronth of Utero Gestation? Is it always possible to pro- nounce positively at these periods as to the existence of Preg- nancy? Why does the occurrence of rigor in the child-bed excite the fears of the medical attendant? How are Puerperal Convulsions to be distinguished from Con- vulsions that are Hysterical, Epileptic or Apoplectie? Name the different varieties of Uterine H{emorrhage. OPERATIVE MIDWIFERY-DR. BRGIN. ýWhat circumstances and conditions justify and necessitate the use of the forceps, and distinguish the cases calling for the employ- ment of the long forceps from those that require the short?",
         "PROFESSIONAL EXAMINATION What precautions should be taken before, during, and after the application of the forceps? Is there more than one mode of Version? If so, describe such modes, and the reasons that compel the operation. Why should labor be induced prernaturely? And if resolved upon, at what period of Gestation, and how should it be accom- plished ? When should the Cesarian section be preferred to Craniotomy ? When is Craniotomy performed, and name the necessary instru- ments to perform the operation? ParsioLoor-Dn. Describe the Nerve-Tissue, its varieties, and its several Fune. tions. Describe the Functions of the Pneumogastric and Sympathetic Nerves. What are the forces which carry on the Circulation of the Blood? What theories have been proposed to explain the generation of Animal Hleat, and what are the objections to them? What are the Changes in the Blood in the Placenta, and how are they effected? Describe the Nervous and Muscular forces by which Respiration is effected. What are the Constituents of the Blood, and how is it formed, tracing it from the Chyme inwards ? Describe the Functions of the Skm. Describe the Functions of the several portions of the Alimentary Canal. CaRàtsTaRY-Dp. SANGSTJR. Give briefly the two theories as to the nature of Electricity. Describe the Composition, Preparation, and Properties of the -compounds of Nitrogen with Oxygen, specially pointing out the relation between NI 05 and the Nitrates, and N2 20 and Nitrites, Give Composition and Properties of Cyanogen and its Com- pounds. Express by symbols the composition of the following Coi- .pounds: Tartaric, Acetic, Nitric and Benzoic Acid, Grape Sugar, and Chloroform. Describe the Chemical character and composition of the Fats, explaining briefly how they may be decomposed into their proxi- -mate constituents. Give general Formula for the so-called Fatty Acids. 525",
         "CANADA MEDICAL JOURNAL. Describe the Chemiîcal relations and characteristics of Urea and Urie Acid, and explain how they may be separated from Urine. Give a brief synopsis of the Chemistry of the Vegetable Alka- loids. PRACTiCAL CHEMISTRY-DR. SANGSTER. Describe the mode of preparing Pot Iodate, Absolute Alcohol, and Pure HCL. - Give the group tests for bases, mentioning the principal Metals in each Group. Givethe distinguishing reactions by which you would recognise Salts of Copper, Lead and Mercury. What special reactions characterize Opium and Morphine, -respectively? What impurities are more or less frequently met with in Com- rercial Potassium Iodide, Sulphate of Quinine, and Chloroform, and how would you detect their presence? MEDIoCAL JURISPRUDENcE-DR. CAMPBELL. Describe the appearances in Death by Drowning, and note the difference presented by the body entering the water before and after death. Name several conditions attended with Insensibility, with brief characteristics of each. State in days the average length of Pregnancy, the shortest, period of Gestation compatible with Viability of Infant, and the most protracted with Legitimacy. Distinguish between Live Birth as understood in Civil and in Criminal Law. Give the Signs in the Living and in the Dead of recent Abortion. at the Fourthi Month. Enumerate in their order the Personal Peculiarities most to be- depended upon in cases of Disputed Identity. Define Hallucination, Illusion and Delusion, and under what circunstances they would warrant a Physician in signing a certifi- cate for coemmittal. ToxicoLogy-Dit. TEMPLE. How are Poisons Classified? Give a few exauples belonging to, each class. What are the Symptoms ofPoisoning by Oxalie Acid? Give Treatment and Tests. What are the Symptoms of Poisoning by Strychnine, and give Treatinent? ,",
         "MEDICAL NEWS. What are the Symptoms of Poisoning by Opium, and give Treatment? Describe the Symptoms and Treatment of Chronie Lead Poison. ing? SANsiTARY ScizcE-Dp. CAnsoN. What is the Annual Average of Death per Thousand in a Healthy Community? What Diseases are likely to arise from Imperfect Drainage, from Deficient Nourishment, or Over-crowding? What Cubie Space of Air should be allowed to each bed -in a Hospital, and state the Diseases likely to be caused or greatly aggravated by Deficient Space? Distinguish between Infectious and Contagious Diseases, with examples. Describe Ozone, its nature, the modes of ascertaining the pro- portion in the Atmosphere, with the supposed effects of an excess or deficiency of it. Defmne the term Endemic, Epidemic, and Enthetie, as applied to Diseases, with examples. What kind of Impurities will Filtering remove from Water, and what remain unaffected by that process ? BonrN-N-Da. ConstL. Why is Physiological Botany the most essential department of the Science of Botany, for the Medical Student to understand? What is the Organized Fabric or Tissue of Plants? And how is Vegetable Growth effected? , Describe the Minute Anatomy of the Leaf, the cause of Death, and Fall. To what extent is the Plant covered by Epidermis ? What is Phyllotaxis; and how do you use the term ? Describe Infloresence, both Definite and Indefinite. Describe minutely, the Food, Nutrition, and Elementary Com- position of Plants. EXTRACTION OF ARTIFICIAL TEETIH FROM TH1E eSO- PHAQUS. Early on the morning of April 25th, I was aroused by the house- maid, who said she had something in her throat, and that she 527",
         "CANADA MEDICAL JOURNAL. feared she had swallowed her artificial teeth during her sleep. She was much distressed, and made constant efforts at deglutition. I passed my finger down the throat; but, although I could reach below the cricoid cartilage, there was nothing abnormal to be felt. I then passed a long oesophagus-forceps, guided by my finger, down the \"throat, and about four inches beyond the point where miy finger reached, the' forceps struck against a foreign substance, which I seized and gently withdrew. This proved to be a metal plate holding two teeth, and from which projected two ugly-look- ing hooks for its attachment to the adjoining teeth. The young woman complained of soreness while swallowing for a day or two afterwards, but is now quite well. ARTITuR BRACEY, Surgeon to the Birmingham Eye Hospital. INJECTION OF TINCTURE OF IODINE AND UF ALCOHOL IN BRONCHOCELE. Dr. Carl Schwalbe (Vichow's Archiv, Band 54,) speaks of injec- tion of tincture of iodine and of alcohol in the treatment of thyroid tumours. Those in which it succeeds best are the soft and cystic enlargements; in hard fibrous tumours no result is obtained; and in vascular swellings there is danger of the production of embolism, unless the vessels have been partially contracted and the tumour diminished by theý internal use of iodine and by elec- trolysis. If blood escape in a strean on the introduction of a cannula, the injection must not be made; in any other case it may be done with safety. About ten or twenty drops are injected as neaily as posbible in the middle line of the neck, over the tumour, by means of a syringe fitted with a cannula having a short point. If no blood flow on the introduction of the cannula, the fluid is forced in ; and before renoving the instrument, the operator waits for a short time in order that the injection may not again flow out. The operatioù is sometimes followed by transient pain in the course of the nervus ~auricularis magnus, cough, gastrie oppression, vomiting, and in weak subjects by fainting. One woman, who was subject to epilepsy, was seized with symptoms of hemiplegia soon after the injection, and died in convulsions. Schwalbe prefers alcohol for the injection, a drachr of iodide of potassium being at the sane time taken daily. The injection may berepeated at weekly intervals. No confinement is required dur- ing the treatment; the average duration of which is two or three -months.- Wiener Medizin,ý Wochenschr., March 16th 1872.- British Medical Journal."
      ],
      "title" : [
         "Canada medical journal [Vol. 8, no. 11 (May 1872)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_05176_95"
      ],
      "published" : [
         "[Montréal : Dawson Bros., 1872]"
      ]
   }
}
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   "request" : "http://eco.canadiana.ca/view/oocihm.8_05179_14/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1",
   "doc" : {
      "published" : [
         "Montreal : Lovell \u0026 Gibson, [1845]"
      ],
      "identifier" : [
         "8_05179_14"
      ],
      "type" : "document",
      "title" : [
         "The Montreal medical gazette [Vol. 2, no. 2 (May 1, 1845)]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur Covers damaged / Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. ri ri Coloured pages / Pages de couleur Pages damaged / Pages endommagées D Pages restored and/or laminated / Pages restaurées et/ou pelliculées w W w Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. This copy is a photoreproduction. Continuous pagination.",
         "THIE MONTREAL MEDICAL GAZETTE, BEINO À MONTHLY JOURNAL OF MEDICINE, AND THE COLLATERAL SCIENCES. 16tU by fraurid lîa'girn, SU. M., une E\u0026illiam tttrlan*, fa. i. VOL. I. MONTREAL, MAY 1, 1845. No. 2. DR. F. C. T. ARNOLDI ON CHRONIC RHEUMATISM. It lias often occured to me in eariy practice, to observe that the tern Rheu- matismwas frequently applied to a chronic painful affection ofthe extremities, and in several instances, to parts of the body, which really did not merit that mild term. I say mild term, because the inveteracy as well as seve- rity of such cases appeared to me to exhibit characters which totally dif- fered from what I conceived to be strictly speaking Rheumatism. Rheu- matism in its active form is easily known, especially when of the articular character, so also is it easy to distinguish it when seated among the muscles; but when these parts, especially the latter, become affected with chronic severe pains, accompanied with great nervous irritability of mind, insom- nia, and general derangement of the digestive functions, I then suspect that much as the case may resemble Chronic Rheumatism, it is more correctly to be referred to Neuralgia, or a spinal affection. In cases of Chronic Rheumatism it is not so easy to trace cause and effect; I meano to say, you cannot so easily perceive the pains to depend on a disordered condition of the digestive apparatus, whereas the cases I now particularly refer to, can on almost ail occasions be referred to that cause. In Rheu- matism, the barometric state of the atmosphere has almost invariably great influence in increasing or mitigating the pains, whereas in the cases I now refer to, such changes produce little or no influence; consequently, fronm these remarks it is easy to perceive that some, if not a great modifi- cation, brecomes essential in the treatment; and for the better elucidation of that, I shall give a general sketch of four well marked cases which came under my care. 1. Mr. C. R. about thirty-five years of age, had been for several years a martyr to what was styled chronic rheumatism. He had been pre- viously attended by every physician of note in this city, and by some of the first standing in London. His case had assumed such a malignant character as to be deemed hopeless: His friends despaired of his com- mercial prospects ;-what rendered bis case still more distressing, his legs were affected with phagedonic ulcerations, and these also took on the pain- fui as well as angry character. At first my plan of treatment consisted c",
         "34 DR. ARNOLDI ON CHRONXIC RHUXATISM. in the usual remedies, which I thought, would tend to allay irritation and assist the digestive organs. This continued for months without effect, and I could not at last forbear concluding, that the symptoms depended more on a neuralgic condition, reflected from the spinal chord, than on ordinary chronic rheumatism. There was no swelling, nor local heat,-but great pain, somewhat intermittent, but never followed by diaphoresis. I then thought of a different plan of treatment, based upon a suggestion thrown out by the late Dr. Robertson, viz. the use of the hydriodate of potass:- I say, based upon his suggestion, because he merely made mention of that medicine having of late been reeommended in cases of chronic rheuma- tism, in quarter grain doses, repéated tiree or four times a day. On re- flection, I considered this as a inedicine likely to take the place of calomel in many instances, and this seemed to me to be one of a very well marked character; but, like calomel in one respect, I inferred it could only be advantageous in this instance, by being administered in sedative quantities. It is very well kncwn that calomel in very small doses, fre- quently repeated, especially if combined with minute doses of opium, will generally counteract the rheumatic condition ; but my experience has taught me, it will not so act in neuralgic affections. Again, we know, that calomel in very large doses, acts almost immediately as a sedative, and thereby may frequently allay the most excruciating rheumatism or even neuralgic pains; but calomel is a medicine which cannot be safely repeated in such doses,-not so with the hydriodate of potass; I therefore concluded, that, if the hydriodate of potass was to be of any use at al, it must be in sedative doses. I therefore determined on trying the experi- ment with Mr. C. R.; but fearing it might act too powerfully on the nervous system, I cautiously added full doses of hyoscyamus. The result was truly miraculous. Mr. C. R. had by this time, been for years, almost uninterruptedly afflicted, and by the third day his pains ceased. His spirits returned, and daily he regained his strength in a most conspicuous manner;-in short, lie has since become corpulent, and never from that moment, (June 1841) has he ever complained of the least menace of his old disorder. . The form in which I prescribed the hydriodate was as follows:- Rp. hydriod. potass. dr. i. aquae pur. oz. viii. tinct. hyoscy. oz. 1 mix. Of this, one-third was taken every six hours, and for three days in succession. The next case which came under my observation, was that of a poor Canadian man, named Labelle, to whom I was called by his neighbours, in consequence of his long continued suffering, and inability to move hand or foot. He had been for three months unable to convey either hand to his mouth. At first, I tried the usual remedies, viz. purgatives, altera- tives, sudorifics, opiates, \u0026c., but to no purpose. Then I prescribed the hydriodate, as in the case of Mr. C. R., and by the third day his pains left him, his sleep returned, and very shortly after, he was enabled to dress himself, and go about. This case is valuable in one respect, as proving the efficacy of the hy- driodate, in as much as it was administered, if possible, under the most disadvantageous circumstances,-at any rate, under circumstances in",
         "DLn ARNOLDI ON CHRONIC RHUMATISM. 35 every respect opposite to those in which Mr. C. R. was placed, save the severity of symptoms. This man lived in a wretched hovel, through the timbers of which the wind entered with sufficient force to extinguish the candle. He was miserably poor, and often had not a morsel to eat; and by way of a climax, this occurred in the depth of winter. From the time the hydriodate relieved him in February, 1842, to this day, he too has continued in the enjoyment of good health, and has become some- what corpulent. His occupation as a fruit and oyster huckster has ex- posed him to all vicissitudes of weather, but with impunity. The third case, was that of a Scotchman, whose circumstances were intermediate between those of the two former; but whose case was not sufficiently severe, though very chronic, to prevent him attending, more or less regularly to his avocation, which was of itself sufficiently well cal- culated to counteract any remedial means, lie being overseer and engineer at a tobacco mill, where, in one apartment he was enveloped in steam, and in the other, in minute snuff dust. After a dose or two of purgative medicine, which produced no alleviation of pain, aithough it improved the tongue, lie took the hydriodate, and experienced the most happy effects. But he soon again suffered another attack, and of his own accord applied, as he styled it, \"for the medicine which cured the pains.\" Again, lie derived the same benefit as before; but being convinced that lie would continue to relapse so long as lie remained in the same situation, lie pro- fited by his improved health and returned to Scotland. The fourth case was Mr. J. G., whose sufferings were almost of as protracted a nature as those of Mr. C. R., and affected his head, arms, and legs, especially towards evening, in a most excruciating manner. Medicines of every description had been tried, and all literally in vain. Not only his mind, but all the organs of digestion became exceedingly irritable. Sometimes his evacuations would appear highly charged with bile, at others, they would be just like mortar. His renal secretions al- ternated from scantiness to abundance, and from high to very pale colour. His appetite was at all times capricious; in short, in addition to his great sufferings of mind and body, lie had superadded dyspepsia, in a very com- plete form. I resolved, in the summer of 1843, to try the hydriodate with him, but feared the irritability of his stomach ; however, after explaining to him how it had acted in other cases, he consented to give it a fair trial, notwithstanding its horrible taste. The consequences were truly astonish- ing; as much so as they had been upon Mr. C. R. Ail symptoms of pain and dyspepsia dissappeared. His spirits immediately returned. and very rapidly followed the restoration of strength and flesh. This favora- ble chang3 lasted for nearly a year, since which he has been occasionally menaced with a return of all his sufferings ; but the occasional use of the hydriodate always keeps them in check. However, Mr. J. G. resides some distance in the country,-he may consequently suffèr more from not knowing under what circumstances lie should have recourse to the medicine, as I do not think it would meet with justice if given indiscri- minately in all cases of severe pains, from whatever cause arising. F. C. T. ARNOLDI, M. D. April 17, 1845.",
         "36 DR. SPIER'S SPECIAL REPORT. MAnCH 17th, 1843. SIR,-You will pardon the liberty I take in addressing you somewhat at large on the subject of the Medical treatment of the patients in the Lunatie Asylum at Toronto. It seems to me, with all deference, that the method of enquiry into the Medical treatment must chiefly turn on a comparison of the num- ber of cures per cent. and of deaths in the Toronto and other Lunatic Asylums. A mere question of numbers to be made and appreciated by any one, could not, in my humble opinion, be made a report worth having, wien founded on a few visits to the patients in an Asylum; in all probability most of whom would be, as at present in the Toronto Asylum, convalescent, and it is impossible in the con- valescent form of Mania to determine what the symptoms were when it was acute. A Physician might find the remains of bleeding and blis- tering in patients perfectly tranquil, and be altogether at fault were he asked to point out from their present state, the former requirements of treatment. I have been round the wards of the Toronto Lunatic Asylum sever- al times, and I then understood froin Dr. Rees, that the antiphlogistie treatment as it is termned, is carried to its full extent, (exceptions ex- cepted,) the recent case 1 saw when admitted and the relief occasioned by copious bleeding was manifest, immediateand durable ; in another case I assisted with my friend Mr. Beaumont at a post mortem.;. we found the vessels of the ipner membranes of the brain, and also of its substance highly injected, and much serum effused ; appearances gen- erally considered to be the result of active inflammation. We found also in the same brain another and further result of iuflammation, viz : a complete disorganization of its substance to the extent of about an inch and a half superficial diameter, and abouî half an inch in depth.- These appearances which of course can only be appreciated after death strongly corroborate the opinion of those physicians, who extol reiter- ated blood letting, local or general, above all other remedies in cases of recent mania. I have read the particulars handed to me by Dr. Rees of eleven oth- er post mortems made on those who had been patients in the Asylum, and all of them, (minute differences excepted,) tallied with the case above detailed. If we refer to Physicians of great experience and re- pute we find that their testimony coincides with the foregoing. Brous- sais, in bis work ' Sur la Folie,' writes \" on a trouvé apres les morts survenues au milieu des transports de la fureur la substance cerebrale fort injectée de sang, \u0026c. We deduce, says Dr. Hawkins (see Medical statisties) from the Statistical report of the deaths in the Lunatie Hos- pitals of Paris, during three years the following. 30 in 100 died from disease of the brain or membranee. 17 in 100 \" \" \" of the Thoracic organs. 20 in 100 \" \" \" of the abdominal \" 10 in 100 \" \" \" of Cachexia \" 4 in 100 \" ', \"from Surgical diseases. i. e. 83 per cent. in ail probability indicating in some period of the dis- order the antiplogistic treatment.",
         "DR. SPISR S RIPORT ON TIE TORONTO LUNATiC ASYLUM. 37 Concerning the advantage of bleeding in Mania most Physicians are agreed. Dr. Sydenham, I believe, was the first who noticed a sort of mania very uncommon, which proceeded from weakness, and whieh for the most part attacked patients who had for a long time suffered under autumnal intermittents, which if treated, says he, in the ordinary way by bleeding, brought on incurable idiotcy or death ; but which was ea- sily cured by wine and tonics. But in general mania is an inflammato- ry disorder, jnst as much so as pleurisy ; you see it often under the form of Phrenitis or of delirium combined with fever, again it is seen as Broassais well observes, with an inflammation of the stomach, for which he was accustomed to bleed till the symptoms changed and to use lis own language with the happiest effects. Again you find a very frequent metastasis of pneumonia to the brain occasioning madness and also very niany examples of mania proceding from the closure of vari- cose and for a long period bleeding hemorrhoidal vessels all requiring blood lettingjust as much so as any disorder whatsoever. Dr. Rush, Professor of Medicine and Clinique in the University of Pennsylvania, and Physician to the Lunatie Asylumthere, whose work on Insanity is held in great estimation in Europe, says \" Blood letting is indicated in mania by the occasional cures that have followed the loss of large quantities of blood. Many mad men, who have at- tempted to destroy themselves by cutting their throats have been cured by the profuse hSmorrhages whieh have succeeded; of this several in- stances have occurred within my knowledge. The bleeding on the first attack of the madness should be copious, twenty to forty ounces. The effect, continues Dr. Rush are wonder- ful, it sometimes cures in a few hours. This treatment to be continued if the symptoms require. The quantity of blood drawn should be greater than in any other organie disease. From among many cases of the successful issue of profuse bleeding in madness, I shall select but two ; one Mr. - 68 years of age, from whom I drew nearly two hundred ounces of blood in less than two months, the other Mr. of New York, who lost by order four hundred and seventy ounces of blood by forty seven bleedings in less than one year; were it necessary, I could add several other cases communicated to me by mny students.\" Mr. Haslam has recorded two hundred cases in the Bethlehem Hospi- tal in all of which he bled. Esquirol strongly recommends bleeding in mania where severe headache exists. Broussais, not only recommends bleeding, but affirms that bleeding, especially by leeches applied during several days have cut short incipient mania, and restored the patient to reason as quickly as we are accustomed to see pneumonia or gastro enteritis removed by blood letting. Dr. Burrows, whose testimony on this subject, before all other Physicians ought to have weight, seeing that his cures of recent cases of Insanity amounted to 90.32 per cent nearly 3 per cent more of cures than any other known Asylum can boast of, declares, that lie cannot recollect a single case of mania, of what sort soever, in which the abstraction of blood either from the head or neighi5ouring parts has not been distinctly indicated ; and he repeats it without hesitation so long as excitement continues, even though it be requisite to give tonics at the same time. In fine if the cure of disease (where it can be obtained) be the great end of all treatment, then in any given number of cases, that Physician",
         "DR. SPIERS REPORT ON THE TORONTO LUNATIC ASTLUE. who cures the greatest number, must be allowed, ceteris paribus, to ad- opt the best nethod of treatment. - Dr. Burrows, who always bleeds in ca es of mania cures 91.32 per cent of recent cases and 3,5.18 per cent of old cases. Dr. Rees 49 per cent of all cases, but 31 of the 161 patients were when admitted into the Toronto Asylum incurable, deducting these we have 60 per cent of cures. Further, many of these cases were not recent, and the chronic form of mania is by no means so easily removed as the recent. Now if from the statement of Dr. Burrowswe take the mean between the cures recent 91.32 and the old cases 35.18, we have a little over 63 per cent of cures of all cases, which number is about 14 per cent above the curesperformed at the Toronto Asylum. The Connectîcut Asylum when under the able Dr. Todd sent out cured of recent cases 88.66 per cent, of old cases, 14.14 per cent, which gives a mean of all cases cured of 51-40 per cent or 2.40 per cent only above the cures of the Toronto Asylum. The returns from the Principal Asylums in England and France give the mean of cures in France 42. In England 32 per cent. The mortality in the Toronto Asylum is 7.5 per cent of all cases. The mortality in the Connecticut is 2.1 nearly per cent of recentcases, and 7.2 per cent of chronie cases. The mean 4.4 per cent less than the mortality in the Toronto Lunatie Asylum. The mortality in the Par- is Lunatic Asylum is 1 in 13 or 7.7 per cent of all cases or 0.2 more than in the Toronto Asylum. Again, I have stated that recent cases of Insanity are more easily cured than those which are chronie. Esquirol has published a table of 269 cases cured at the Salpetriere from which it appears that 151 cases were cured within the first six months ; in the next four months sixty-five cases were cured or a fewer number in proportion of time by fifty-two at least; after and between one year and two yeàrs, twenty- three cures ; shewing, when reduced as near as can be to equal times, a decreasing progression in cures, in equal increments of time from the first attack of 50.32.4, nearly answerieg to the first, second ,and third six months. According to this table, the chances of recovery decrease between the first and second six monts 36 per cent, and between the second and third six months 88 per cent (thisbeing premised) according to Desportes the medium time of cure under the antiphlogistic treat- ment is 55 days, while according to Broussais under the non-antiphlo- gistic treatment, the time of cure extends to 137 days. The antiphlo- gistic treatment, being successful under two months ; the non-anti- phlogistic treatment being successful in between four and five months. The difference between these two methods as regards the number of cures, cannot on account of the very insufficient data be calculated, but the difference in the duration of the disorder is evident, or as five to two in four of the antiplogistic treatment. Dr. Rees has been accusedby some disingenuous person of salivating his patients in cases of mania. Dr. Rees has assured me that he nev- er salivated a patient in the Asylum. But what if he had ? \"Too much\"writes Dr.Rush, \"cannot be said in favor of salivation in general madness. \"I once advised Mercury'' says Dr. Rush, \" in a case of madness in a female, after parturition, who had conceived an aversion for ber infant, on the day that she felt the Mercury in ber mouth, she",
         "APPENDII To DR. REES' REPORT. 39 asked for her infant and pressed it to her bosom.\" \"I have seen\" continues Dr. Rush, \" two instances in our Asylum, in which a taci- turnity of a years continuance was removed by it ; speech was exci- ted in one of then on the very day in which the Mercury affected the mouth, and the use of reason followed a few days after.\" This is just what might be expected, for Mercury diminishes arterial action, and equalizes the circulation in the body ; for this reason it is given in pericarditis, in lydrocephalus, acute inflammation of the larynx, tra- chea, liver, \u0026c. In conclusion, I cannot help expressing a hope that this persecution may redound to the great benefit of Dr. Rees, who lias by his exertions, and his medical and moral treatment, raised the Toronto Lunatic Asylum, with all its disadvantages, to nearly a level, with all the most favored of similar institutions. I have the honor to be, Sir, Your very obedient servant, (Signed) ROBERT SPIERS, B. M. L. M. Cantab, member of the Royal College of Physicians, London. To the Honorable Vice Chancellor, Chief Commissioner of the Toronto Lunatic Asylum. APPENDIX. To thte Report of the Provincial Temporary Lunatic Asylum, ai Toronto, 1st September, 1844, by Dr. Rees. As connected with the considerations which appear at the latter part of this Report, I subjoin the substance contained in Jacobi's recent and highly approved work \" On the construction and management of Hospi.. tals for the Insane,\" also the views, on the same subject, of other writers of eminence. After alluding to the preliminary arrangements necessary in such insti- tutions, Dr. Jacobi observes \" That as the second grand feature in the character of the establishment, we must specify that energy in the appli- cation of medical means for the restoration of the patients, which seizes and applies all those auxiliaries which have an influence on the various kinds of mental derangement, according as they are indicated by the re- sults of scientific experience to be applicable to each individual case; no proof need be adduced to shew how indispensable it is that these medical operations should be characterized by the utmost indulgence of purpose, tnd that they should bear testimony to the same spirit prevading and em- bracing the whole. For as we have already remarked at the commence- ment of this work, the entire arrangements of the establishment in all its separate parts should bear the stamp of the idea from which it sprang, so that the medical spirit which suggested its grand outline should be plainly 'recognized in it. So, also, there can be no doubt that the same concentrated spirit should likewise be manifested in the vigorous applica- lion of the particular means which it has provided to every case that comes under its care.\" The -activity and energv displayed in the establishment, as we have",
         "40 APPENDIX TO DR. REES' REPORT. now depicted it, and which stands in the most immediate relations with the treatment of the patients, is also clearly connected with that depart- ment which relates to the domestic care, and that of the remaining mem- bers of the family. To the repairs and replacing the furniture of the establishment, the procuring and distributing of ail articles of consumption, the management ofthe receipts and expenditure, the keeping of the books and other offices, as every operation in this department, also must concur with the rest in promoting the ultimate object of the establishment ; and as the most perfect unity of purpose and unimpeded activity nust charac- terize ail the exertions made to this end, so, it is here again evident, that the supreme direction and control of all the officers and servants, without cxception, employed in this department, must likewise be concentrated in the directing physician. That this position is the only just one, and the most likely to advance the interests of the establishment, will, I think, be fully acknowledged from what I have said above in reference to the cha- racter of such an institution. It is also very easy to perceive, and expe- rience has invariably attested the fact, that in all those establishments where the opposite relations subsist, and the medical influence is placed on an equality with the domestic stewardship or subordinate to it, there is always an invariable ivant of harmony and singleness of purpose, so that the highest interests of the institution have not been realized to the extent that would be possible; for so soon as the farming and household econc\u003e- my cease to be a simple instrument towards the cure of the patients, so soon will the character of the institution sink into that of a mere nursery establishment in which the economical principle predominates, and the medical influence is subject to it; and though there be many gradations from a tolerable degree of medical independence and eflicacy, yet the system itself leads necessarily to a state of subordination and restriction, in which the physicians are utterly deprived of ail fezdom in their exer- oions, and the steward will issue from his account-desk, his peremptory mandates as to everything that shall be done or left undone.\" \" Let us compare the state of such an establishment with that of one conducted undei the arrangements which I have just advocated. Let us conceive the situation of a physician and philanthropist, whose whole soul is wrapped up in the cause he has espoused, in such a state of subordi- nation. Let us imagine what would be the feelings of a Reil, a Langer- man, of a Willis, a Pinel, or an Esquirol, thus fettered and clogged in their exertions. Let us read Horne's vindication, and then take a glimpse into the interior of almost all the other establishments of Germany as well as foreiga, and we shall be immediately struck with the. conviction, that, the realization of that unity in the direction of these institutions which I hve recomended, can alone be in harmony witb their true interests. Hence, it follows, as a necessary consequence, that one man must be placed at the head of the establishment,-such an one as it has been in- debted to for its origin and existing rules. A kindred spirit must animate him in order to insure the constant application of the means which the institution affords, in strict accordance with the purposes of its foundation. His mind must prevade the whole establishment; every auxiliary means which the science of medicine and moral influence affords must be at his command and disposal; but for these objects he will not oniy require ail the assistance which the mere arrangements of the establishment may confer, but also the help of kindred minds, who, deeply impressed like",
         "APPENDIX TO DR. REES REPORT. 41 hirmself, with the spirit of the idea which is here to be realized, may, as his organs, constitute with himself, a firmly compact, harmonious whole, and may strengthen and diversify, and complete his powers and efficacy.\" . \"Thus, is a sphere of exertion, even as relates to the physical depart- ment alone, far too extensive for the energies of a single physician; he stands in need of the aid and support of a man, who associated in the closest union with him, and partaking in all his views, may in common with himself, engage in the treatment of the patients as his \" aller ego;\" and when sickness or absence withdraws him from his office, may be confidentially entrusted with the discharge of his duties.\" \"There should be at least two resident medical officers, who though not equal in authority, should be united in the consideration of the plan of treatment. I do not, however, see that according to what appears from practice to be the general view of the profession in regard to the usè of phamaceutic means in cases of insanity, the plan generally adopted, of having a resident medical officer, and a non-resident physician who attends twice or thrice a week, is incompatible with the efficient carrying out of the present views of medical treatment in such cases.\" \" In addition to such an officer, he must also be supported by another well informed and skilful medical assistant, who may undertake the more subordinate, and especially the surgical duties of his profession, besides rendering all sorts of assistance in the prosecution of his various plans of observation and research, and particularly in the posi mortem examinations of deceased patients.\" \"It is absolutely necessary that a judicious ar- rangement of authority and subordination be established, and that the phy- sician should be superior to all in respect of every thing that concerns the patients. The greatest importance is attached to the selection of inspec- tors and attendants.\" \" Active and incessant inspection of both patients and attendants is im- peratively required, whilst the moral treatment requires the greatest judg- ment and determination in all its relations.\" On the external government of Lunatic Asylums, it is observed, that, \" the County Asylums of England are entirely under the government of the Magistrates in Quarter Sessions, who appoint visitors from their own body to inspect, from tune to time, into the condition of the establishment, and who meet at stated periods for the direction of these affairs.\" The general character of English magistrates, it is remarked, render this system of peculiar value, and it is asked \"is there any other local class of persons who can be so depended on for this duty ?\" This plan of visitation carries force of sound public opinion into these places, and their business should be to collect and communicate information, to advise and report to the government. OF THE POWERS AND DUTIES OF TUE BOARD OF COMiMISSIoNERS. 1st. The superior or primary direction of every part of the economy of the establishment. 2nd. Inspection of the general management of the funds, and exami- nation of the several amounts of receipts and disbursements. They are expected to render all accounts of the expenditure quarterly, tccording to prescribed forms, or as they see occasion. The statements of receipts and expenditure must undergo revision by the Director, previous to their being laid before the Board.",
         "42 DR. CONNOLLY'S REPORT OF CASES IN THE BICETRE. 3rd. To make an annual examination of the property of the Institu- tion, and to report on its general condition and requirements, its finances, \u0026c. DUTIES OF THE DIRECTING MEDICAL SUPERINTENDENT. The Medical Superintendent or Directing Physician \" is the organ of the Goverement in the management of the Institution, and is responsible to it for the right conduct of every department,-in regard to the manage- ment of the patients, the general direction of the concerns of the Estab- lishment, and of the functionaries to whom the carrying out of the rules and orders are intrusted. To him, in ail affairs of the Institution, the whole jurisdiction is committed; ail orders and instructions of the Go- vernment are addressed, and the amounts and reports of the various Officers rendered. Ail the Officers of the Establishment, Medical, Cleri- cal, and Economical, are under his control, and they are in no respect which concern the Institution, to contravene his instructions.\" The Assistants of lower rank in the Establishment, of whatever class, are of course, still more decidedly subject to the authority of the Director; and ail of them, fromi the upper male and female Attendants downwards, are appointed and discharged by him. He is limited as to the rate of wages, but can promote the most deserv- ing to places which yield the highest rate of remuneration. He is required to report each year respecting those who are unfit for the service. The weightiest duties of the Director are those which regard his own numer- ous cares in' the management of the patients. The administration of ail measures which can contribute to their cure marks the limit to his me- dical duties. The studies of the Director are principally directed to the treatment of the insane. He is to take care that the written document, which is given in with each patient, relative to the symptoms of the disease, and the mode of treatment which has been adopted be entered along with the result of every subsequent consultation in the patient's case. As complete a history as possible must be obtained of each case admitted within the Hospital. The Director is expected to furnish every patient, who is discharged cured, with full instructions as to his future medical treatment. The Director has to determine the period of the discharge of patients, whether with reference to the stage of convalesence in which it may be safe for them to leave the Institution,or as regards the probability of bene- fit to be derived by those who are not recovered by any longer detention; and although two years' continuance of disease may be considered as a general indication of permanency, the Directing Physician believesthat the hope of recovery should by no means be confined to that period ; there are therefore, no absolute rules laid down in reference to this matter. The particular medical, moral, and dietetic management of the patients is also the exclusive business of the Director of the Establishment. INTEREST1NG CASE OF CONGENITAL IDIOCY. [Dn. CONOLLY, in the last No. of the British and Foreign Medical Review, gives an interesting account of the Lunatic Asylums of Paris. Perhaps no part of it is more valuable than that which relates to the de- patment of thii Bicêtre Hospital, appropriated to epileptic and idiotic",
         "DRL CONOLLY% REPORT OF CASES IN THE BICETRE. 43 patients, and to the wonderful improvement in one of these patients. This portion of hie account is given below.) I was accompanied round this Asylum by M. Battelle, and by M. Mal- lon, the Director, and had afterwards an opportunity of hearing from him- self, the exposition of the views of one of its able Physicians, M. Voisin, whose singular zeal in the cause of the idiotic class of patients has caused difficulties to be overcome, which appeared at first to be insurmountable. The firet part of the Bicétre to which I was conducted, was a school ex- clusively established for the improvement of these cases and of the epilep- tie, and nothing more extraordinary can well be imagined. No fewer than forty of these patients were assembled in a moderate sized school room, receiving various lessons and performing various evolutions under the, di- rection of a very able school-master, M. Seguin, himself a pupil of the celebrated Itard, and endowed with that enthusiasm respecting his occu- pation before which difficulties vanish. His pupils hadbeen ail taught to sing to music ; and the little band of violins and other instruments, by which they were accompanied, was formed of the old almsmen of the Hospital. But ail the idiotic part of this remarkable class also sung without any musical accompaniment, and kept excellent time and tune. They sung several compositions, and among others a very pretty song, written for them by M. Battelle, and sung by them on entering the class- room. Both the epileptic and idiotic were taught to write, and their copy- books would have done credit to any writing school for young persons. Numerous exercises were gone through, of a kind of military character, with perfect correctness and precision. The youngest of the class was a little idiot boy of five years old, and it was interesting to see him follow- ing the rest, and imitating their actions, holding out his right arm, left arm, both arms, marching to the rig'it and left, at the word of command, and to the sound of a drum, beaten with ail the lively skill of a French drum- mer, by another idiot, who was gratified by wearing a demi-military uni- form. Ail these exercises were gone throrgh by a collectiou of beings offering the smallest degree of intellectual promise, and usually left, in ail Asylums, in total indolence and apathy. Among them was one youth whose intellectual defleiency was marked in every look, geisture, and feature. I think a more particular account of this poor boy's progress deserving of record, as an inducement to the philanthropist to enter on a new field of instruction, presenting many difficulties, but yet not unproductive of results. In the school for idiots µnd epileptics, at the Bicétre, a careful register is kept of the psychological condition of each pupil, according to a printed form, for the examination of their instinctive, moral, intellectual, and per- ceptive state. I was obligingly furnished with a copy of the register relative to the subject of my immediate observations, Charlés Emile, and also with a copy of the résumé, or summary of his case, made by M. Voisin himself. The age of Charles Emile is fifteen ; he was admitted to the school in June, 1843. He is described as being of a nervous and sanguine tempera- ment, and in an almost complete state of idiocy ; the faculties which re- main being in a state of extraordinary activity. and rendering him dangerous to himself and to others; but still idiot in hie inclinations, sentiments, per-",
         "44 DR. CONOLLY'S REPORT OF CASES IN TIE BICETRE. ceptions, faculties of perception and nnderstanding, and also of bis senses, of which some were obtuse, and others too excitable. He was conse- quently unfit, to use the words of M. Voisin, \"to harmonize with the vorld ivithout.\" As régards his inclinations, he was signalized by a ferocious, indiscriminate, gluttonous appetite, un érotisme hideux, and a blind and terrible instinct ofdestruction. He was wholly an animal. He was without attachment; overturned everything in his way, but without courage or intent; possessed no tact, intelligence, power of dissimulation, or sense of property; and was awkward to excess. His moral senti- ments are described null, except the love of approbation, and a noisy, in- stinctive gaiety, independent of the external world. As to his senses, his eyes were never fixed, and seemed to act without his ivill; his taste was depraved; his touch obtuse ; his ear recognized sounds, but wus not at- tracted by any sound in particular; and he scarcely seemed to be possessed of the sense of smell. Devouring everything, however disgusting ; brutally sensual; passionate-breaking, tearing, and burning whatever he could lay his hands upon, and if prevented from doing so, pinching, biting, scratching, and tearing himself, until lie was covered with blood. He had the particularity of being so attracted by the eyes of his brothers, sisters, and playfellows, as to make the most persevering efforts to push them out with his fingers. He walked very imperfectly, and could neither run, leap, nor exert the act of throiving; sometimes lie sprang like a leopard; and his deliglht was to strike one sonorous body against another. When any atteimpt wvas inade to associate him i-th the other patients, he would start away with a sharp cry, and then come back to them hastily. M. Voisii's description concludes with these expressions:-\" All the faculties of perception in this youth are in a rudimental state; and if I may venture so to express myself, it is incredibly ditlicult to draw him out of his indi- viduality, to place him before exterior objects, and to make hini take any notice of theni. It would not be far fron the truth to say, that for him all nature is alrmost completely veiled.\" This description not only exemplifies M. Voisin's careful mode of ob- servation, but shows that an example of idiocy less favorable to culture could scarcely have been presented to the instructor. This same poor idiot boy is now docile in his manners, decent in bis habits, and capable, thougli iot without some visible effort, of directing his vague senses and wandering attention, so as to have developed his memory, to have acquired a limited instruction concerning various objects, and to have be- corne affectionately conscious of the presence ofhis instructorý and friends. His general appearance is still that of an idiot. Hlis countenance, his mode of walking, all that lie does, declare his very limited faculties. Na- ture has placed limits to the exercise of his powers which no art can re- move. But le is redeened fron the constant dominion of the lowest animal propensities; several of his intellectual faculties are cultivated, sone have even leen called into life, and his better feelings have acquired sone objects and sone exercise. In such a case as this we are not so much to regird what is merely accomplished for the individual. A great principle is established by it in favor of thousands of defective organiza- tions. After vitnessing the general effects of this school on the most imbe- cile human beings, and hearing the particulars of Charles Emile's history, it was really affecting to see hia come forward when called, and to essay to sing a little solo when requested; his attempt at first not being cuite",
         "DR. CONoLLY'S REPORT OF CASES IN TUE BICETRE. 45 successful, but amended by his attention being more roused to it. His copy-book was then shown to me, and his writing was steady, and as good as that of most youths in his station of life. The schoolmaster, who seem- ed to take great pleasure in the improvement of this poor fellow, then showed us how he had taught Charles to count, by means of marbles and small pieces of wood, or marks made on a board, arranged in lines, the first containing an 0, the second 00, the third 000, and so on. Charles was sometimes out in his first calclations, but then made an effort and rectified himself. He distinguished one figure from another, naming their value. Large pieces of strong card, of various shapes, were placed in succession in his hands; and lie named the figure of each, as square, triangle, \u0026c., and afterwards drew their outlines with chalk on a black board, and according to the desire of M. Seguin, drew a perpendicular, or horizontal, or oblique line; so effectually atten'ding to what lie was doing, that if any line was drawn incorrectly he rubbed it out and began anew. He also wrote several words on the board, and the name of the iDirector of the Bicêtre, without the name being spoken to bim. This case was altogether the most interesting of those which I saw ; but there was one poor idiot standing a great part of the time in a corner, to all appearance de very despair of art: even this poor creature, however, upon being noticed and brought to the table, proved capable of distinguish- ing the letters of the alphabet. Most of the others had received as much instruction as bas been described, and could count, draw lines and figures, write, perform various exercises, and point to different parts of the body, as the head, the eyes, the arms, the feet, \u0026c., when named to them. In all these cases, and pre-eminently in that of Charles Emile, the crowning glory of the attempt is, that whilst the senses, the muscular powers, and the intellect, have received some cultivation, the habits have been im- proved, the propensities regulated, and some play has been given to the affections; so that a wild, ungovernable animal, calculated to excite fear, aversion, or disgust, lias been transformed into the likeness and manners of a man. It is difficult to avoid falling into the languag- of enthusiasmi on beholding such an apparent miracle ; but the means of its performance are simple, demanding only that rare perseverance without which nothing good or great is eveoijfected; and suitable space, and local arrangements adapted to the conservation of the health and safety of the pupils ; to the establishment of cleanly habits ; to presenting them with objects for the exercise of their faculties of sense, motion, and intellect; and to the pro- motion of good feelings and a cheerful disposition. The idiot wh9 is ca- pable of playing and amusing himself is already, as M. Seguin observes, somewhat improved. I can but regret that I had not time to watch the progress of this interesting school fron day to day, and to trace the growth of knowledge in the different pupils; as of the first ideas of forn and color, in writing and drawing; the developement of articulation aud the power of verbal expression; the extension of memory to calculation; the subsidence of gross propensities, and the springing forth and flourishing of virtuous emotions in a soil where, if even under the best circumstances the blossoms and fruits are few, but for philanthropic culture all would be noxious or utterly barren.",
         "STATISTICS. STATISTICS OF CANADA. According to the Report made by the Select Committee, of the Legis- ative Council on the Census returns of Lower Canada, there are of Males. Females. Total. Deaf and Dumb, ..... 447 278 725 Blind, . . . . . . . . 273 250 523 Idiots, . . . . . . . . 478 472 950 Lunatics, . . . . . . . 156 152 308 Total afflicted, .... 1354 1152 2506 N. B. Dr. Bell in his work on Regimen and Longevity, gives the following as showing the absolute iortality within the last twenty years of the inhabi- tants of different countries. Russians, . . 1 in 27 English, . . 1 in 43 7 Prussians, . . 1 in 36 2 Sicilians, . . 1 in 32 French, . . 1 in 39 27 Greeks, . . 1 in 30 Dntch, . . . 1 in 38 Pliladelphians, 1 in 42 3 Belgians, . . 1 in 43 1 New-Yorkers, 1 in 37 83 Bostonians, . . 1 in 45. According to the census of 1841, there are of Physicians in the United Kingdom, 1,476; of Surgeons, Apothecaries, Medical Students, Cuppers and Dentists 18,658. Midwives are included underthe head of the Med- ical Profession, aud amount to 676 in England and 641 in Scotland. L'Almanach de Médecine pour 1845 publie la statisque suivante sur le personnel médical de Paris: Le chiffre des docteurs qui y sont établis au 1er janvier 1845 s'élève à 1,430; il était en 1843 de 1,423 ; en 1841 de 1,36e; en 1839 de 1,310; en 1836 de 1,220; en 1833 de 1,090. Sur ce nombre de 1 430, 1,323 ont été reçus à la Faculté de Paris, 50 à celle de Montpellier, 31 à celle de Strasbourg, 26 dans les Universités étrangères et exercent en France en vertu d'ordonnances royales. Dix de ces docteurs se livrent excluslvement à l'art du dentiste, 14 au traitement spécial des maladies des yeux, 16 à la médecine homepathique, et 4 au magnétisme. Sur les 1430 docteurs résidant à Paris, il y a 320 membres de la Légion d'Honneur, dont 4 commandeurs, 50 officiers et 266 légionnaires. Paris renferme en outre 168 officiers de santé, 326 pharmaciens et 450 sages-femmes. The average cost of the inmates in the Temporary Asylnm at Toronto, during the year 1843 was 17s. 2id. per week ; this has been reduced dur- ing the last year, to 14s. per week ; we have not seen the statement ofex- penses incurred during the last year in our Lunatic Cage, but in that ter-",
         "STATISTICAL DEPARTMENT. 47 rinating on the 31st Dec. 1843, stating the average numberof inmates at 45, their cost was rather more than 10s. 6d. each per week ; but rent does not form an item in the expenditure, the .Asylum being in the City Gaol. By a statistical table published in the annals of Medicine of Ghent, and remarked upon in the Parisian Journal of Medicine and Surgary of Janua- ry last, we learn, that within the last 20 years, the number of persons af- fected with Insanity iu Great Britain, has more than trebled. Their total number is 12,549, of whom are lunatics 6,808 and idiots 5,741 giving an average of 1 in 1000. In Scotland there are 3,652 lunatics, or about 1 in 700, and in Ireland their number exceeds 8,000. Tables exhibiting the causes of the disease, the trade or occupation, the ieligious denomInation, and the place of birth of such of the Patients as could be ascertained in the Toi onto Asylum. No. 1. Chagrin and Disappointment,........... Cer,-bral Disease,.... .............. Diseaae of the Digestive Organs ..... ... Irregularities and Exposure,....... ... ... Cold, while under the influence of Mercury,.. Reverses in Life,..... ... ... ... ... Disappointment in love,.... ... ... ... Intemperance, ... ... ... ... ... Inordinate Mental Exertion,....... ... ... Fright,. ... ... ... ........... Domestic Affliction,. ... ... ...... Fanataeism .... ... ... ... ... ... Gambling, \u0026c., ... ... ... ...... External injury of the head, ... ...... Jealousy, ... ... ... ... ... ... Uterine Disease. ... ........... ... Church of England, . Roman Catholics,.... ... ... Fresbyterians, ... ...... Methodista, ... .......... Baptists,.... ........ ... Menoniats, ... ........... Jews, ... ... ... ... ... Natives of England, ... Ireland ... scotland ... ... Canadians, ... ... ... ... French Canadians,.......... Germans, ... ... ... ... Americans, ... .......... Carpenters, ... ... ... ... Blacksmiths,.. ....... 7. Bricklayers and Builders,. Tinamiths, ....... ....... Tailors, ... .......... Shoemakers,... ........ W eavers, ... ... ... ... Tavern-keepers, ... ... ... Pedlare, ... ... ... ... Dyers, ... ... Sawyers, Butchers, ... ... ... 8oldiers, (Milatary Pensioners,)... Plumbers, ... ... ... ... Tannera, ... ... Mercantile, ... ... Printers, ... ... ... ... Schoolmasters, Labourers, ... ... ..... 3eamstrees, . ... ... ervants, ... ... ... Males. Females. Total. 2 2 4 17 15 32 26 12 38 25 15 40 1 0 1 9 7 16 1 2 3 29 15 44 1 0 1 5 4 9 4 7 il 9 7 16 3 1 3 6 1 7 2 1 3 0 3 3 No. 2. No. 3. No. 4.",
         "48 STATISTICAL DEPARTMENT. No. 5. Return of the Districtsfrom whence the several Patients have been st t0 th1 As luJr DistrEis. Home, ... ... ... ... ... ... ... Gore, ... ... ... ... ... ... ... ... . Newcastle, ... ... ... ... ... ... ... ... ... Niagara, ... ... ... ... ... ... ... ... ... M idland, ... ... ... ... .,. ... ... ... ... W ellington, ... ... ... ... ... ... Johnstown, ... ... ... ... ... ... .... B rock, ... ... ... ... ... ... ... ... Huron, ... ... ... .... T albot, ... ... ... ... ... ... ... Simcoe, ... ... ... ... ... ... ... ... ... W estern, ... ... ... ... ... ... ... .... ... London, ... ... ... ... ... ... ... ... ... Eastern, ... ... ... ... ... ... ... ... ... Dalhousie, ... ... ... ... ... ... ... ... ... Bathurst, ... ... ... ... ... ... ... V ictoria, ... ... ... ... ... ... ... ... ... Colborne, ... ... ... ... ... ... ... ... ... City of Toronto, . ....... ... ........ ... . ... Canada East, ... ........ ... ... ... Strangers, .. .. ........ ... ... ... No information obtained respecting the remainder. O 0 Males. Femuales. Total. C Males.c Females. Total. I . iMales. 's r S o Females. o w 0Total. w Males. Females. Total. - Males. Females. E Total. Iales. Fe:nles. E Total. \" cs as - oe\" No. 56 17 14 13 7 7 3 3 2 4 4 3 2 5 2 62 13",
         "CHARITABLE INSTITUTIONS IN BERLIN. 49 Toal c i i bo b 4 Females. Total.\" I ao Females. b-0 liMales. Females. # . Total. males. Jk bo FeMles : 1 *** o, o. Toal - ut Ilul Malus. Females. Total. eb ' ~. \u003e-à ; Males. Females. Total. c ~ I ~ Fmales. CHARITABLE INSTITUTIONS IN BERLIN. One of the most interesting institutions of Berlin, is that for the in- struction of the deaf and dumb, at which the new method is pursued of teaching them articulation. The success with which it is attended is certainly very astonishing, and, to an inexperienced observer like myself, quite satisfactory. The pupils converse with the instructors and with each other, so as to be intelligible to an ear as little practised as mine in the German language. The older ones can also read aloud",
         "50 NEW ANAToMY LAW IN MASSACHUSETTS. and with a distinet enunciation, from an octavo volume pf reading les- sons, any passage that may be selected. But notwithstanding that by a patient imitation of the movements of the lips, tongue, larynx, and chest involved in articulation, this system seems to have achieved an impossibility ; its expediency, as a general system of education for deaf mutes, is doubted by many practical observers, wlio say that the great length of time necessarily devoted by those who possess only or- dinary imitative faculties, to the mere acquirement of an articulation, leaves not enough for more direct and important mental culture. A gentleman from New York is now here for the express purpose of in- vestigating the method and. merits of the system, and bis report will undoubtedly be of great value to those interested in the subject But whether it be destined to supersede the alder plan or pot, it must be considered a very noticeable example of the ingenuity and perseve- rance of German teachers. This is, I believe, the largest institution of the sort in Germany; th*t at Leipsic, the oldest. The schools for the instruction of the blind are here, and in the other cities which I have visited, less extensive than the one in Boston, which enjoys here a very high reputation. The education of the two blind mutes is spoken of in the strongest terms of admiration. and re- garded as a much greater achievement than the teachiqg of the dumb to speak. Attached to the Deaf and Dumb Institutç, is a class of idiots, in the instruction of: whom great pains are talten, and a good deal accomplished.-Corrrspondent of the Boston Medical Journal. TUE NEW ANATOMY LAW IN MASSACHUSETS. The following Act which is officially styled \" An Act concerning the Study of Medicine,\" waa passed during the last month by our Le- gislature, being a modification of the Act passed in 1831 \" to legalize the study of Anatomy in certain cases.\" SECT. 1. The overseers of the poor of any town, Q»d the mayor and aldermen of any City ià the Commonwealth, shall, uporn request, give permission to any regular physician, duly qualifie4 accýrding to law, to take the dead bodies of such persons as are requiredtobeburied at the public expense, within their respective towns, or, cities, to be by him used withinithis Comnaonwealth for the advancement of anatomi- cal science, preforence beirig always given to medicalischools by law establhshed in this State, for their use in the instruction of students ; and it shall be the duty of ill persons having charge ofýany poor-house, work-house, or house of industry, in which any person required to be buried at the 'public expense, shall die, immediately to give notice thereof to the overseers of the poor of the town, or the mayor and alder- men of the city in which such death shall occur, au-d the dead body of such person shall not, except in cases of necessity, be buried, nor hall the same be dissected or mutilatcd until such- notice shall hye betn given, and permission therefor granted, by said overseers or n)ayor or. aldermen. SEOT. 2. \" No such body shall in any case'be surrendered, f the deceased person, during his last sickness, of his own accord, reqnested to be buried, or if within twenty-four hours after bis death, any- person",
         "ALCOHOLIC. DRINKS. claiming to be of kindred or a friend to the deceased, and satisfying the proper authority thereof, shall require to have the.body buried, or if suçh decçased person was a stranger or traveller who suddenly died; but the dead body shall, in all such cases, be buried, and no body shall be surrendered until the physician requesting the same shall give to the board, by whose order the same is to be surrendered, the bond required by the twelfth section of the twenty-second chapter of the Re- vised Stgtutes. SECT. 3. The tenth and eleventh sections of the twenty-second chapte- of the Revised Statutes, are hereby repealed. SECT. 4. ThiA Àct shdll take effect from and after its passage.\" The \u0026natomy Bill passed in the session of our Legislature of 1843 would be much improved by the adoption of some of the provisions contained in the above.-Eds. M. M. G. ALCOHOLIC DRINKS. The following certificate bas been signed by 120 highly respectable niedical men in England. It is thought that it will yet be much more InMUqrpuSly signed, though it bas been found very difficult, thus far, to draw up a paper which in style, language and phrase will suit aUl mindas. \" We are of opinion that there is no principle of strength or nou- rishment for the human frame in alcohol, or generally in drinks of wbich it forms a part, such as ardent spirits, fermented wines, eider, e4 beer, porter, and others ; that any trifling portion of nourishment contiined in the last three is greatly exceeded by that of barley water, poriidge, or gruel, mad, from an equal quantity of grain,; that alcoho- lie beverages gçnerate ultimate weakness instead of strength ; that al- cohol never entirely assimilates with the corporeal system ; that intoxi- cating fluids are in no wise necessary to persons in ordinary health, nor are they required for any particular constitution : that the daily or habitual use çf apy portion of them (much more what has beeu gene- rally, but: erroneously,. thonght a moderate portion) is prejudicial to haath ; that the excitçment or. cordial feeling they create is mere stiimulation, which departs in a short time, and is. unproductive of any element of strength ; an4 that, contrary to ordinary opinion, the health would be greatly promoted by their entire disuse as beverages.\" We have read over the names and are perfectly acquainted with se- .eral of the.iidividuals whose signatures appear, at the foot of this cqrtificate. Blutw would strongly suggest to them the propriety of inherting in a seQnd edition of the above, after the words \"porter and others,\" the following, nor should people at any time except un- der the authority of inedical attendants make use of an'y medicine, eom- peoUQ ed of' alcohol, as oether, laudanum, or spiris ammoniS aromat: Ne were informqd soqç îe4'rs ag by a most inteligent druggist living in our, immediate neighbourhood, not many miles frgm At. George's I4ospital, Hyde Park'Corner, that bis sales of the three above articles",
         "52 DR. G. GREGORY ON VACCINATION AND INOCULAT1ON. had been increased nearly tenfold, since bis residence, (not 2 years) in. that locality, a neighbourhood be it remarked, in which the disciples of total abstinence were daily augmenting in number in an extraordi- nary manner.-Eds. M. M. G. VACCINATION AND INOCULATION. At a meeting of the Royal Medical and Chirurgical Society, in London, Jan. 28, Dr. George Gregory, Physician to the Smallpox Hospital, gave some accoount of the variolous epidemic of 1844, and also made some very important suggestions in regard to the methods of prevent- ing the liability to contract the disease. The following is from the Lancet.] After noticing the remarkable freedom from smallpox which the metropolis enjoyed during the years 1842-3, the author adverted to the rise of the present epideiic, which lie dates from the 21st March, 1844, when thte weekly deaths by sinallpox suddenly rose from twenty to thirty, and have continued progressing (with some irregularities) from that period to the present. The admissions into the Smallpox Hospital, in 1844, amounted to 6î7, and exceeded by one the admissions in the great epidemie of 1781, being, with the exception of 1838 (when the epidemie raged through- out the entire year,) the greatest number ever received into the Hos- pital since its foundation in 1746. The character of the disease was. severe. The deaths amounted to 151, being at the rate of twenty- three and a half per cent. la 1781, when the same -number of pa- tients was admitted, the deaths were 257, being at the rate of forty per cent. Of the total admitted, 312 were reported to have been vaccinated, and have cognizable cicatrices ; 22 professed to have been vac- cinated, but no scars were detected ; two alleged, but on unsatis- factory grounds, that they had been inoculated for smallpox in early life. Among the 312 vaccinated, 100 had the disease in the very mild form usually called the varioloid ; in a certain number no mitigation was observed ; of the whole number, 24 died, being at the rate ofnéar- ly eight per cent. On this section of the admissions, many of the cases received during the year displayed features of individual interest. A variety of them were stated in detail. A remarkable feature in the history of the past year was the in- creasing desire on the part of the public for re-vaccination. Founding bis views on the now indisputable fact that smallpor spreads as widely without as with accompanying inoculation, and on the now equally establislied fact, that smallpox nfter vaccination proves fatal at the rate of seven per cent., while inoculated smallpox is fatal only at the rate of one fifth, or one in 500, the author proceeded to argue that it is unwise to prevent variolous inoculation in toto. Per- sons verging on puberty might, he said, with great prospect of advan- tage, be inoculated after vaccination in early lite. If, as happened in the case of bis own son, the inoculation failed to produce constitution; al symptoms, the permanent security of the party was fully establish-",
         "DR. G. GREGOGY ON VACCINATION AND INNOCULATION. M3 ed ; on the other hand, if febrile symptoms followed, the disease would probably be mild ; and at all events, would be undergone under the watchful eye and care of parents. As it is, the disease is often receiv- ed at a period of life the most distressing-as by young women on the eve of marriage, by mothers in confinement, or by young men just em- barking for India. The author instanced a variety 'of other important objects which might be gained by a repeal of that part of the \" Vaccination Exten- sion Act\" of 1840, which prohibits qualified medical practitioners from inoculating in England and Ireland, and he concluded by recommend- ing to the legislature sucli a measure ; and to the medical profession (where such permission may be granted,) the establishment of a system of infantile vaccination, strengthened and made doubly sure by adult inoculation. The practice of inoculation might usefully be restricted from the period of life extending from the age of 10 to 20. Dr. Webster thought the Society and the profession were much obliged to Dr. Gregory for the excellent paper just read, which con- tained so many important facts and statistical details upon a subjectof great interest. He did not at present intend to enter upon the vari- ous points alluded to by the author; indeed,. it would be diffiçult to controvert many of the conclusions come to by Dr. Gregory, who had Such ample opportunities, and was so well qualified, to form correct opinions respecting vaccination. However, there was one important inference which he (Dr. W.) drew from the paper, namely, that the public, notwithstanding the doubts of some on the subject, now appear- ed to have greater confidence than previously in the protective influ- ence of the cowpox, as shown by the larger number of applications for re-vaccinatiou at the SmaUpox Hospital, during the past than any pre- vious year. 'This was very satisfactory, and induced him to ask the author, whether many cases of smallpox occurring after re-vaccination had come under his own notice, as that would prove the efficacy of re- vaccination, from rendering the individual less susceptible of smallpox than previously. He (Dr. W.) was most unwilling to disbelieve in the protective influence of vaccination,,when properly performed ; and, in proof of its efficacy, he would mention a strong. instance which lately came under his immediate observation in a large establishment ho fre- qnently.visits. In March last, one of the criminal lunatics confined in Bethlehem Hospital was attacked with symptoms of variola, but hav- ing been previously vaccinated, the disease assumed a mild form. One or two other inmates were then affected, and the complaint subsequently extended to the other wards. Of the patients attacked, unfortunately one had never been vaccinated. In this case the disease assumed a most virulent form, and te'rminated fatally in a few days. This was the only death met with ; and although five or six other instances occurred, despite the strictest surveillance and seclusion of the patients, the ma- lady did not spread further, whieh would have been a most serious matter in an institition like Bethlehem Hospital, having a population of about 700, including the lunatics and the residents of the house and occupancies. How the amallpox was first introduced into the criminal wing it is difficult to determine ; for although every inquiry was made, it was impossible to trace its origin. The person first attacked had",
         "54 DR. G. GREGORY ON VACCINATION AND INOCULATION. held no communication beyond the walls of his own division of the es- tablishment, excepting by a letter he received from a distant part of the country ; but this could not have produced the disease. It is, how- ever, right to mention, that smallpox then prevailed at a little distance from the Hospital, in South Lambeth, and as westerly winds prevailed much at the time, perhaps the infection might have been wafted in this way to the prisoner. He would li'ke to ask Pr. Gregory's opinion. on this subject. Respecting the important proposition of the author to resume the old and now illegal practice of inoculation, that was a very grave subject, and required most mature deliberation. He (Dr. W.) acknowledged, although disposed to pay every respect to an act of the legislature, that he did not consider parliament to be the best tribunal to settle disputed points in medical practice ; cases might arise, when inoculation might be advisable ; of course, only qualified persons should be allowed to perform such an operation, whilst the greatest care and precautions were always taken to prevent the dissemination of so virulent a disease as smallpox sometimes appears, even when arti- ficially produced. Dr. Gregory, in reference to one of the questions of Dr. Webster, remarked that the paper contained the case of a girl named Eagle, which in itsçlf was an answer to the query. This girl had been vaccinated in infancy, aud subsequently re-vacciuated with great care; she neverthe- less became a patient of the Smallpox Hospital. These cases were not uncommon. It miglit be urged against the validity of these cases, that neither vaccination nor re-vaccination had been properly performed. These objections were easily made and difficult to contradict. With respect to the mode of introduction of the snallpox into Bethlehem Hospital, as mentioned by Dr. Webster, he thought it hardly probable, though it might bc possible. Mr. Davis (Hampstead) had, in 1798, received orders to inoculate every man in his regiment, in whom there was not some unequivocal mark of the smallpox. Two of the soldiers informed him that they had had the cowpox, having been employed in Yorkshire as cow.boys, and that therefoie it was useless to inoculate them. Neither of these men took smallpox, although he i.noculated them a great number qf times. He attributed the failure of vaccination either to the carelesa mode in which it was performed, or to the carelessness of parents in failing to give the surgeon an opportunity of verifying the success of the operation. H1e related a case in which he had vaccinated an in- fant sucking at the breast of its mother, who was suffering from small- pox ; the infant did not contract the disease, though it continued .at the breast ; .the mother died from the attack. He related an instance to show the importance of vaccinating from a proper vesicle. He had vaccinated several members of a family, and re-vaccinated them a few days after. le was subsequently requested to vaccinate other children from an arm, the appearance of which he did not approve of, and de- clined to operate. The children were subsequently vaccinated from this arm by another practitioner, and every one of these suffered after- wards from smallpox, whilst those he (Mr. D.) vaccinated all escaped. Mr. Streeter inquired the experience of Dr. Gregory in reference to the occurrence of smallpox during pregnancy. He had seen two cases",
         "DR. G. GREGORY ON VACCINATION AND INNOCULATION. 55 of the kind--one in 1838, and one since ; the patients were six months advanced in pregnancy, and recovered. Dr. Gregory had met with cases of smallpox occurring during preg- naney on more than one ocçasip. The violence of the disease, since the prevalence of vaccination,, had fallen on the parents and adulte generally, rather than on the children. He did not agree with Dr. Williams as to the i4entity between sinallpox and vaccinia, and thought that that gentleman had conmitted two main errors in his pathology. Natural and inoculated variola were in no degree different in their power, as had beeti frequently proved in casea of consecutive sInallpox after the natural or inoculated disease. He believed that there was onfly «,n approach to identity between smallpox and vaccinia, but not more than between measles and scarlet fever. He related a case in which an aged couple were vaccinated to preserve them from smallpox, although in early life they had been inoculated. Perfect vaccine vesi- cleasweee produced on their arms. If vaccination were thus successful at an advanced age, and subsequent to inoculation, he thought it a' strong proof of the non-identity of smallpox and vaccinia. Many facts, indeed, might be adduced in support of this non-identity. Dr, Williams alluded, to the. epqriments of Mr. Ceely, as conclusive evidence in favor of the identity of the two diseases. The cases re- lated by Dr. Gregory did not militate against this identity, any more than did the occurrence of smallpox after vaccination. Dr. A. P. Stewart made reference to a number of cases which had occurred in his practice, all tending to prove that vaccination was a sufficient preventive to suallpox, when it was properly and efficient- ly performed. When it failed, it had not been properly applied. In confirmation of this view, he referred to the lately-published report of the Royal Jennerian Institution. His experience at the Glasgow In- firnary enabled him to confirm a statement of Dr. Cowan, that small- pox in that city was perpetuated chiefly by the unvaocinated Highland population. M. Chomel had well said, that we \" could npt expect more from vaccination than from smallpox itself,\" for in many cases small- pox, and that of the worst kind, had attacked the same person twice or thrice, and terruinated fatally. Dr.- Gregory remarked, that, even if his plan were fully carried out, still nearly one half of mankind would be under the proteetioi of Jen- ner's .discovery, for one half of t.he children born in Liverpool died be- fore puberty, and 300 out of every 1000 bora in London id not reach adult age. Thç remaining portion only would be subjected to inocu- lation. We hare tra»Acribed the above article entire as well as the remarks made on the discussion of the paper. Our reasops for doing so are, because opinions offered on this subject by Dr. Gregory cannot but be received as.authority,;not only from his having the charge of so large an Institution as the.smalpox Hospital of Londn. affording as it does, such ample scope for observation, but alsq from bis being possessed of such extensive knowledge of the diseuse of which he treats--for it is far from being always tl4e case, that men the bqst informcd in the pa-",
         "56 EDITORIAL NCTICES. thology and treatment of particular classes of disoases, are those ln. trusted with their management. We entirely agree in opinion with the learned writer of the above paper; as to the propriety of inoculation after early vaccinatiou, our con- fidence in the perfect immunity from smallpox by vaccination only, having received a shock seven years since in England, from which we have notrecovered. While remarkingon this subject we maybe permitted to.observe, that in our opinion, the use of the liquified crust, so univer- sally employed in Canada for vaccination, appears to us to be avery ques- tionable means of securing the individual from an attack of smallpox. We have heard of several cases of smallpox in this town occurring after vaccination performed in this way, and of which more than one assumed the type of confluent variola, and more than one also proved fatal.- Ens. M. M. G. THE MONTREAL MEDICAL GAZETTE. Omnes artes, que ad humanitatem pertinent, habent quoddam commune vinculum, et quasi cognatione quadam inter se continentur.-Cicero. MONTIEAL, MAY 1, 1845. Ouu readers will doubtless be surprised, when we inform them, that the present is the last Number of the Montreal Medical Gazette that will issue under our management. -Many and various surmises will no doubt be entertained by indivi- duals, as to the real causes which have induced us thus suddenly to relinquish an undertaking, upon which we entered only some fifteen months since, and more especially, after having secured for our bantling, a subscription list, not only adequate to meet all the necessary ex- penses attendant on its publication, but promising moreover, for our- selves, a certain and increasing remuneration for the outlay of capital in the way of time and trouble ; this, witli some men, would certainly have acted as a strong inducement for the continuance of the work; to ourselves, strange as it may seem, it holds out no such alluring charms. The circumstances which prompted us to originate a Medical Perio- dical at our own private cost, and subject to all the loss which its failure of success must inevitably have entailed upon us, were these :-lst. A feeling of deep astonishment, that, in a country over whose surface upwards of six hundred Medical men were scattered, there was not to be found any other channel for the interchange of ideas on professional",
         "EDIT)RIAL NoTICES. 57 topics, the cormunicition of anomalous or interesting cases occuring in practice, or the exposition of original views in reference to disease, as influenced by peculiarity of climate, than the daily Journals. 2nd. Our being informed that such a Journal was not needed here, that as there was nothing new under the sun, so there could arisé nothing in this wilderness of ours, worthy of being submitted to the profes- sional world's eye, and that a mere unit of these six hundred men would be found willing to contribute to it, seeing that the greater number of them were totally unable to do so. 3rd. That it would never pay its expenses, because the country Practitioners would never be tempted to become reading men; they would never therefore subscribe to it; and the consequence would be, that the scheme must involve its pro- jectors in heavy loss. Feeling convinced that the assertions contained in the two last heads of our reasons were totally unfounded, and that a libel had been pronounced upon many men fully as well educat- ed, and as able to furnish contributions as those who gave utterance to the sentiments, (provided opportunities were afforded to them,) we resolved alone to run the risk and put their conjectures to the test. And what has been the result ? That the opinions which we formed on the subject have been fully confirmed; that country Medical men will read, and moreover, that they will pay for their reading! Our subscrip- tion list has very much exceeded our most sanguine expectations. In our first Number, we stated, that in undertaking the duties which we had assumed to ourselves, we looked not for profit, nor did we seek notoriety; but that we sought \"that higher reçompense resulting from our having been the humble means of elevating the character of our profession, by the dissemination of more extended observation and knowledge.\" This we already feel has fallen to our share; the Montreal Medical Gazette \"ulterly contemptible\" as it was, has begotten in many men, who, but for it, would have remained in the same state of hybernation with the ma- jority, a taste for knowing what is going in the Medical world,-it las had the effect of proving, that not only can one Medical Journal be supported in Canada, but that even two may,-it has roused into action the energies of men with regard to their profession's status in this colony, which would never otherwise have beeni dreant of,-and lastly, it has called into ex- istence a determination on the part of many men in different portions of the Province, to place the Medical Profession of Canada on that footing to which it is so justly entitled, by raising the standard of qualification in its members, by increasing the facilities ofeducation, and by insisting on a more liberal, and less exclusive mode of electing to offices. The Montreal Medical Gazette has effected all this, and our object in originating it las now been fully attained. May our successor effect as much! We fuel perfectly happy In having acted asjioneers in the work. Had a Journal",
         "58 EDIToiAL NOTICES. been originated in Toronto, or in Quebec, at any period since ours saw the light, we would willingly have withdrawn it, (and this we have re- peatedly stated,) for it was not ambition that caused us to undertake the Editorial chair,-it was a desire to have a Medical Journal in Canada. To the Editor of the British A1merican Journal of Medicing, \u0026c. we offer our best wishes for success; and however opposed his opinions may have been to ours in some matters, he shall not have reason to complain of our attempting to thwart bim in firmly establishing a Periodical of Medieal Literature in Montreal. A parting word to our own friends, our subscribers, and supporters. To all those who have forward4 their subscriptions for the past year, we offer our heartfelt thanks, for having enabled us to carry on our G«zette withqut the risk of being half yearly called upon by onr Publiskern to draw upon our own; private resources for work done ; to such as have not yet done sg we would take the liberty of suggesting, that, as all the demands against us are not yet liquidated, and as they may have derived some profit or amusement from the labour devoted by us in catering for them, we trust, that they will soon give us substantial proof of their appreciation of ouc endeavours, by remitting. For the two Numbers of the new Series it «s not our intention to make any charge. Those of our subscribers who have forwarded their 'subscriptions for the current year, will please inform us of their wishes,-wé shall be most happy to hand the anount over to the Publisher of the British American Journal, and this, we trust, will be the instruction of most of those to whom we allude ; or we will return them by post, deducting only unpaid postage of letters. To the Editors of the valuable Journals which we have been in the habit of receiving in exchangp from England, Scotland, and the United States, we tender our most sigcere thanks, for we are fully sensible how much the advantage has been on our side.- To all we say,-Valete. We beg to direct the particular attention of our readers to the valuable Articles in our present Number by Drs. Rees and Spiers, on the subject of Lunatic Asylums generàlly, and of that in Toronto in particular. When we remember, that provision is not furnished for one-eight part of that afilicted portion of the community in this division of the Province, and the presumption is, that the same ratio obtains in the sister division ; when we think, that another session of the Legislature is past, and that no individual Member of either House rose in his place to take action on that part of our noble minded Governor's speech, which recommended the earnest atten- tion of our country's representatives to the subject; when we see further, that in other civilized countries, unwearied efforts are being made for the amielioration of the condition of the mWt miserable class of that sympathy",
         "EDITORIAL NOTICES. 59 Ieliraing!family, (idiots);s ei4Q»ced in Dr. Çoqlly's graphic account of the case 4f; Charles Emile,,ipg, te Bicetre of Paris,-that Bicetre,be it nunsmbered, where the clankin\u003eg chain, the thonged whip, and.the festering claqp..were first struck off and dispensed with by the immortal Pinel; when we think of all these things, we 'repeat, what ought to be our feeling of humiliation, as a body, that petitions without number have not been laid upon the table of the House, to shew that we have hearts attuned to -others' woes. As a parting legacy, we commend this subject to the Pro- fession, espeeially to the General Association about to be formed in this Province. h e rsit Number of the British American Journal of Medical and Physical Science,. edited by Dr. Hall, was. eireulated in town on Satur. day the 19th instant. It contains four original Medical communica- lions -an excellently written Geological -article, by the Rev. Mr. Leach, of- this ciy ; a Meteorologioal Table for portions of this and the last twi years, by -Staff-Surgeon Smith, of Kingston; and the residue is nahdô up of Extracts from other Journals, and Editorial remarks. It is published in the form of the London Lancet. This, we consider a pity, for on bindiigit, it will neither form an octavo nor quarto volume. ,We may also be permitted to suggest to the publisher, the use of types of a more uniform character. It looks too much as if it were made up of odds and ends. \"WHAT IS HOMROPATHY ?\" Since our last issue, a brochure consisting of thirty-two pages, bear- ing this title, and stitched in a gamboge-coloured cover, has reached us. Thirteen pages are taken up with the absurd attempt at defining what is Homeopathy, alias Humbug, with which the world, or rather the Cheesemongers of London', were favored, in 1838, by John Epps, M. D. Allopathist, Antipathist, Phrenologist, and Homoeopathist. We could fnot refrain from again looking over, with Reviewers' eyes, this tissue of words strung together like beads, and we did so to refresh our memory on certain events connected with the reading of passages inithe Pamphlet at the date of its publication. Five pages are occu- pied with microscopic observations of Dr. Mayerhoffer on Homeopa- thic Triturations. These are, no doubt, all correct; but the infinitesi- mal results of trituration at which he arrives, are quite beyond the powers of our finite speculations, as regards their efficiency as reme- dies. The Homeopathic practitioner of Montreal introduces a Preface of twelve pages, in which, while with one hand he deals heavy blows ag\"iist the prescribers of Calomel, \u0026c.,.and indeed, against all the preseribers of medicines for internal complaints, because, forsooth,",
         "60 EDITOIAL NOTICES. they prescribe in the dark ; lie, as a matter of course, defeends witlk very strong language, the arguments on which Hahnemann based his: Bystem of invisible agents and imperceivable results. We regret to. be obliged to say, in our capacity of Reviewers, that we consider this Pamphlet got up purely with a view ad captandum vulgus,-in the ver- nacular, as a catchpenny. \" A trial is worth a thousand pages of argument.\"-ROSENSTEIN. MEDICAL« MISCELLANY. Two new metals are reported to have been discovered in Bavaria, by Professor Rose, of Berlin, for which ho proposes the names of Pelopinm and Niobium. Dr. Schreiber states, that lie has found lodine, internally administered, a preventive against the infection of small-pox ; with this view, lie orders a teaspoonful of the following mixture to be taken morn- ing and evening,-Rp. Hydriodate Potass, gr. viij. Tincture Igdine, git. xvi. Aq. font. oz. i. M. The best method of emptying Leeches after their removal from a part, according to Dr. Boyce, is, by immersing them in a little mistura Camphora,-having remained in this for a few minutes and discharged their contents, they are to be put into clear water. Professor Ghrenberg has just made some new discoveries of infusoria, more wqn, derful, according to Baron Hunboldt,than any hitherto announced by him. Two new systeins of medical practice are starting up in Germany-one is called the Trauban cur, (grape cure) consistirg, as the name indicates, in living chiefly on grapes, of which several pounds are to be eaten daily. The other goes under the name of Aeropathy, consisting in alternate per- spirations and exposures to currents of cold air.\" Thîs is, to our mind, only a modification of Hydropathy ; and although the former is said at this moment to be the more popular in Germany, as it is in a modified forn ini every country where total abstinence doe's not obtain, yet the tern seems to claim from the profession more consideration, in. as much as it is open to more speculation. There are in Havana, eighty-five Medico- Chrurgians, twenty Physicians, ninety Surgeons, and fifty-seven Sub- Surgeons, who in urgent cases, are perinitted to render assistence to the wounded or sick, until a Surgeon or Physician can be brought. There are eighty-eight Barbers, who are regularly licensed to bleed, cup, leech, draw teeth, and apply blisters and setons. CONSULTATION SUR UN CAS DE MORT VIOLENTE. Il arrive souvent dans les enquêtes judiciaires que les experts confon- dent avec des altérations purement cadavériques des lésions faites pendant la vie et réciproquement. Nous trouvons dans les Adnnales d'Hygiène et de Médecine légale, une consultation de MM. Foullioy et Ollivier (d'An-",
         "EXTRACTS. . 6 gars), qui fournit un nouvel exemple de cette confusion déplorable et prouve combien il importe de connaître avec exactitude tous les phéno- mnènes produits par la putréfaction. Le nommé Piriou était disparu depuis vingt et un jours, quand son corps fut rejeté sur le rivage de Penhors, canton de Plogastel (Finistère). il resta ensuite exposé à l'air libre pendant trente heures environ. A cette époque le soleil était vif, et la température notablement élevée. Des ex- perts furent appelés et constatèrent ce qui suit: Le cadavre encore couvert de ses vetements était dans un état de dé- compositidn putride très-avancée, surtout à la tête, au cou et au ventre. Les parties molles avaient été rongées, détruites sur divers points de la. surface du corps. Les arcades alvéolaires étaient dépourvues de dents et laissaient passer dans leur intervalle la langùe qui était brune et d'un vo- lume' 4norme. Cet organe dépassait les mâchoires au delà de l'insertion du frein, et par suite de son renversement en haut, s'appliquait sur l'orifice antérieur des fosses nasales dont il obstruait le tiers inférieur. Aucune trace de blessures ni de constriction du cou par un lien n'était apparente. Le cerveau était putréfié sans signe de congestion sanguine dans son tissu au uoment de la mort; les os du crâne étaient intacts. La membrane muqueuse de la trachée et des bronches avait une couleur lie de vin. Les umons étaient emphysémateux, remplibsaient exactement la poitrine. s cavités droites du c\u003ceur étaient gorgées de sang noir demi-fluide. L'estomac était vide et la couleur de sa muqueuse lie de vin rouge. De ces faits, les experts concluaient que Piriou était mort probablement sirangulé, appuyant leur opinion, 1° sur lusortie excessive de la langue; 2° sur la vacuité complète de l'estomac, rien d'ailleurs, suivant eux, n'au- torisant à penser qu'ici la mort fût le résultat de l'asphyxie par immer- sion. C'e à Poccasion de ces conclusions et des circonstances qui précèdent que MM. Foullioy et Ollivier ont reçu l'invitation de donner leur avis. 'Une courte discussion imr la signification des faits précités a suffi à ces médecins pour établir que les conclusions dont il s'agit n'étaient pas fondées. Ainsi, par exemple, un phénomène exclusivement cadavérique est devenu pour les experts un des faits qu'ils invoquent pour admettre la strangulation : c'est la saillie excessive de la langue hors de la bouche. Mais, selon MM. Foullioy et Ollivier, il est évident que cette saillie est le résultat constant de la tuméfaction produite par les gaz chez les individus qui, ayant séjourné un certain temps dans l'eau, ont été exposés ensuite à Pair libre, et sont dans un état de décomposition avancé. Or, c'était là le cas dans lequel était le corps de Piriou, et chez lui la putréfaction avait encore été hâtée par les nombreuses solutions de continuité des parties molles. Cette circonstance seule expliquerait donc la saillie de la langue, si l'absence complète des dents ne venait pas faire comprendre que son expulsion a dû être d'autant plus facile qu'il y avait moins d'obstacles op- posés à sa sortie. Qu'on ajoute à cela l'absence de traces de constriction du cou par un lien, l'absence d'une mobilité insolite de la tête sur le tronc, l'absence d1e congestion sanguine dans le cerveau, et il y aura lieu de conclure que la saillie de la langue n'a pas été le résultat de la strangulation. En second lieu, les experts, regardant la vacuité complète de l'estomac comme un fait qui infirme la submersion pendant la vie, ont émis une opi-",
         "62 EXTRACTs. nion qui n'est pas vraie d'une manière absolue. If n'est pas douteuxque la présence d'une quantité plus ou moins considérable d'eau dans l'esto- mac, ne soit, en général, une preuve qui concourt à établir la réalité d'une asphyxie par submersion, et qu'un expert doive toujours la prendre en grande considération quand il est appelé à rechercher les causes de la mort d'un individu dont le corps a été retiré de l'eau; mais c'est encore ici qu'il faut savoir tenir compte des exceptions assez nombreuses que l'expé- rience a constatées. On pôurrait, en effet, citer beaucoup d'exemples de. suicides incontestables, dus à l'asphyxie par submersion, dans lesquels l'ou- verture du cadavre n'a fait découvrir aucune trace appréciable de liquide dans l'estomac. Si l'on remarqùe, en outre, que dans l'espèce le corps avait séjourné vingt et un jours dans l'eau, n'est-il pas possible, ainsi qu'on l'a vu dans quelques circonstances bien déterminées, que le peu de liquide' avalé au moment de la mort ait pu disparaître par le fait d'une imbibitiorn cadavérique? Et d'ailleurs, n'est-il pas. constaté dans la science que, dans certains cas, l'individu peut éprouver, au moment de la submersiop, tne perte de connaissance qui paralyse alors tous les mouvements de dégluti- tion et de respiration, de telle sorte que la mort est due à une asphyxie par suffocation - Ce qui prouve, du reste, que Piriou a pu succomber à l'asphyxie par submersion, c'est la quantité abondante de sang noir fluide qui remplIssait exclusivement les cavités droites du cour, et la couleur rouge lie dé vin de la membrane muqueuse de la trachée et des bronches. Par tous ces: motifs, MM. Foullioy et Ollivier se croient autorisés à penser: 1° qe- rien, dans l'état du cadavre de Piriou, n'indique qu'il était mort au nomebt de la submersion; 2° qu'il n'existe aucune preuve que la mort ait été le résultat de la strangulation; 3° que les circonstances dans lesquelles le corps a été retrouvé, et les obseçvations faites sur le cadavre au mofwent de l'autopsie, concourent plutôt à établir que la mort a été le résultat de l'asphyxie par submersion.-Journal de Méd. et Cdir., Février, 1845. ACADEMIE DES SCIENCES. -M. Nathalis Guillot a adressé une note sur le charbon qui se pro- duit dans les poumons de l'homme, pendant l'âga mûr et la vieillesse. En voici les conclusions: 6 Il se produit et s'accumule continuellement dans les organes respira- toires de l'espèce humaine pendant la durée de l'âge mûr, et principale- ment dans la vieillesse, du charbon en nature dans un état excessif de division. Ce fait est général sur tous les hommes quelle qu'ait été leur profession. \" Ce charbon, déposé dans l'épaisseur même des tissus, P provient pas de l'extérieur. \"Partout où cette matière existe en quantité suffiante pour former des amas de 1 millimètre de côté au moins, les canaux aériens, les conduits sanguins artériels et veineux sont oblitérés en vertu de sa présence, et les tissus pulmonaires sont alors transformés en une substance colOrée ei noir qui peut occuper jusque plus de la moitié des organes. '. La respiration ne s'opére plus dans ces parties qui servent de gangue au charbon ; les phénomènes de la circulation ne s'y produisent plus et dans l'état pathologique les phénomènes inflammatoires ne' s'y dévefop- pent point.",
         "EXTIACT94 63 - L'ac.umulation successive de ce charbon au delà d'un certain terme cause la. mort des vieillards., L'excès de ce. Gharbon produit la mort en trendaat, le poupon imperméable. '4 La présence constante, de ce produit chez tous les vieillards, rend souvent fatale la terminaison des inflammation, .et des congestions san- guiçes de lorganespiratpire. L'oblitération psr des molécules charbon- neuses des canaux aériens et sanguins, explique la fréquence de l'asphyxie rapide dans les, maladies de poitrine pendant la dernière époque de la vie. \" Ces molécules de charbon paraissent avoir une grande influence sur les phénomènes qui se succèden dans l'épaisseur et autour des masses tuberculeuses. .Lorsque des tubercules se produisent dans les poumons et que. W charbon se dkpose abondamment autour d'eux, ils ne subisspot point les changements successifs propres à la phthisie, lorsque cette maladie suit régulièrement son cours. \"Ces tubercles deviennent calcaires, sont privés de graisse, et »e s'ac- croissent. point. Aucun vaisseau de formation nouvelle ne se développe autour d'eux, ou bien lorsque ces vaisseaux ont déjà pris de l'accroissement, avant le dépôt des. molécules de charbçn, ils s'oblitèrent par suite de ce dépôt, et les progrès de la phthisiç s'arrêtent. \" La production du charbon dans les poumons humains, indépendante de la profe,on et nerégg4tntque. de l'âge, et très probablement de. la nourriture des individus, est un fait qui doit être étudié sous le. point de vue.physiologique, et qui mérite également d'être considéré au point de vue de la pathologie, puisque s'il peut en ré,sulter l'aggravation des affeç- tions les plus communes çlîez les vieillards 4ont les poumons ne peuvent plus fonctionner complétement, il paraît aussi que Papparition de cette ria- tière dans les tissus pulmonaires en enveloppant les tubercules, en les iso- lant du reste de l'organe, arrête complètement la marche de la phthisie tu- berculeuse.\"l Dans un travail annexé à cette note, l'auteur rend compte des analyses exactes qu'il a faites, et qui prouvent en effet la réalité de la présence du charbon. - M. Amussat a présenté un second Mémoire 'sur les blesures des vaisseaux sanguins, qui se -termine par les conclusions suivantes: \"1°. Lorsque les deux artères carotides sont coupées en même temps dans une grande plaietraversale du coula mort n'est pas instantanée comme on le pense généralement:; l'hémorrhagie dure plusieurs minutes, pendant lesquelles Panimal conserve toutes ses facultés. \"l2° Les artères carotides ne restent pas béantes après leur division ainsi qu'on pourrait le croire ; et malgré le volume de ces vaisseaux, il se forme des caillotsobtVrateurs comme après la division d'une seulp cçiro- tide. - . \" En examinant les planches qui représentent des artères de chiens, et surtoutdes artères carotides de boufs sacrifiés d'après la méthode juive, on voit que l'organisation du caillot est la même que celle indiquée dari mon premier Mdémoire. 1 3° La section simultanée ou à court intervalle des nerfs de la huitième paire et des deux artères carotides, faite au milieu du cou., n'exerce aucune influence'-irnédiate sur a coloi atioý du jet du sang, ni sur la formation des caillt t ou boucòiôns obtura rs des artèrei carotides cou- pées complèteme'nt eWiraveîs.",
         "f4 Lcaillot spontané formé aux extrémités des artères divisées se compose de deux caillots, l'un extérieur, déjà décrit dans mon premier Mémoire; l'autre intérieur, qui n'est autre chose qu'un coagulum organisé absolument comme celui qui se forme après tous les les moyens artificiels d'obturation, compression, cautérisation, ligature ou torsion. 115° La rétraction des membranes interne et moyenne, qui est le pro- duit des trois propriétés artérielles si bien décrites par M. Flourens, per- met d'expliquer la formation du caillot et la difficulté de le retrouver au milieu des tissus dans lesquels il a été entraîné. , \"6° Le caillot spontané obturateur est souvent fort difficile à reconnaître Pour le retrouver, il faut se rappeler la disposition anatomique de l'artère divisée, et observer les pulsations à l'extrémité du vaisseau. En outre, on peut reconnaître, par le toucher, la petite masse sanguine qui constitue le caillot. \"7° Enfin, je crois avoir suffisamment démontré que c'est bien toujours par un caillot, ou bouchon obturateur, que les hémorrhagies s'arrêtent spon- tanément, soit que l'animal meure ou qu'il résiste à l'héinorrhagie. \"Ainsi, la doctrine du caillot spontané extérieur et intérieur, comme, obstacle à la sortie du sang des.artères complètement divisées, est la seule véritable: et, contrairement à l'opinion de Jones et de Béchard, l'ar- tèie seule peut suffire à elle-même. . LSans doute le fait établi dans mon Mémoire n'est qu'une bien petité addition à la théorie de T. L. Petit, considérée au point de vue physiolo- gique; mais au point de vue de la chirurgie pratique, il 'est d'une grande' importance; comme le prouvent toutes les héinorrhags graves, et même funestes, qui ont eu lie% parce qu'on n'a pas pu trouver l'artère défigurée et masquée par un caRflot.\" CROTON OIL IN DROPSY. Dr. Fife has narrated in the Provincial '3ecical Jourl, severai cases of ascites, originating from or complicated with, organic le- sions, in treating which he derived great benefit from the sustained exhibition of croton oil, which, he observes, possesses one very decided advantage over Elaterium, that even when its extreme action is mani- fested, it is not followed by the depression inseparable from the effec- tive action of the latter ; but that where the greater vis inertie has prevailed, accompanied by absolute incapacity for exertion, a sen- sible amelioration in these respects has followed its continued exhi bition. THE MONTREAL MEDICAL GAZETTE\u003e 18 PUBLIEHED MONTHLY. SUBSCRIPTION, FIFTEEN SHTLLINGS PER ANNUJM. Correspondents are requested to address the Ed ,tors, and in every instance prepay their communications. . PRINTED AND PUBLISHED' Y. LOVELL \u0026' GY3SON\u003e AT THEIR BOOK AND JOB rRiNTINGr OFFICE. 6 4' . arrasc18; -"
      ],
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      "pkey" : "oocihm.8_05179",
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05179_14",
      "source" : [
         "Bibliothèque nationale du Québec, Montréal."
      ],
      "key" : "oocihm.8_05179_14",
      "label" : "[Vol. 2, no. 2 (May 1, 1845)]"
   }
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   "doc" : {
      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 3, no. 1 (May 1877)]"
      ],
      "published" : [
         "[Toronto? : s.n., 1877]"
      ],
      "identifier" : [
         "8_05173_25"
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available I Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w w Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored and/or laminated / Pages restaurées et/ou pelliculées w2 Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Additional comments / Commentaires supplémentaires:",
         "T H E SANITARY JOURNAL. DEVOTED To PUBLIC HEALTH. EDITED BY EDWARD PLAYTER, M.D. VOLUME III. 1877-8. SALUS POPULI SUPREMA TORONTO: DUDLEY \u0026 BURNS, PRINTERS EST. LEX.",
         "T H E SANITARY JOURNAL. DEVOTED TO PUBLIC HEALTH. VOL. III.] MAY, 1877. [No. i. oriignal Exaper. THE VENTILATION OF HOUSE DRAINS. It is truly remarkable that it is such a very difficult and tedious muatter as it proves on trial to be, to instil into the public mind the reality of the existence of imminent dangers, of a most subtle and stealthy nature, which lurk within many households, especially in Cities, from defective drainage, particularly as regards soil and waste- pipes. That there are such dangers, dangers almost wholly pre- ventible, if they could but be recognized as such by the general public, that annually destroy thousands of lives-not unfrequently those most valuable, is alas! but too well attested. In cold weather, when the temperature of rooms is for the most part much increased, and is much above that of the outer air or that Of the sewers, and with windows and doors carefully closed, dwel- lings stand in the position of exhausted receivers placed over pro- longations of the sewers, for such, in fact, disconnected soil and waste-pipes really are. Ordinary water-traps are utterly powerless in resisting the suction forces thus set up ; and yet it seems almost im- possible to shake the abiding faith in these yielding contrivances. Many question the value of water-closets and sewers. They are great mechanical improvements, while they are, as at present con- structed, undoubtedly great carriers of disease. W. C. Merrifield, F. R. S. \u0026c., in a paper read not very long ago at the annual meet- ing Of the British Association, said:--\" As applied to the particular problen of getting rid of waste products, especially solid products, I do not think they were any improvement at all on much that we already had. In many towns in Great Britain, where there pre- viously existed a well understood and well carried out scavenging System, I think they have done more in saving trouble than in con- ducing to health.\" This is putting it mildly enough. It is urged that the fault is not in the system, but in improper and defective construction, and in want of proper ventilation in con- nection with the system. In this there is much truth, yet probably the time will never come when there will not be a good deal of danger from bad material and bad workmanship.",
         "THE SANITARY JOURNAL. Our only real safety seems to be in carefully attending to the four following particulars:-ist. The entire disconnection of our houses from the sewers. 2nd. The construction of the bouse drains in such a manner that impurities formed therein, or entering from without, can not get into the bouses. 3rd. The thorough venti- lation of the sewers at numerous points ; and 4th. The frequent flushing of these so that no excrement can be retained in thern for more than about two days ; as there seems to be little danger from the decomposition of faceal natter until it has been exposed two or three days at least there is much less danger from fresh sewerage. Dr. John Spear, medical officer of health for South Shields, Jar- row, and Hesburn, Eng., lays down in the Sanitary Record, the following rule Soil Pije.-i. The soil-pipe must be disconnected from all other house-drains, receiving only the discharge from the pan of the water- closet. 2. In addition to the usual trap at its commencement, this drain should have a trapping bend in the horizontal part of its course, as it runs towards the sewer; thus cutting off air-communication with the common sewer system. 3. From the house side of this additional trap a ventilator should proceed directly to the surface, opening at the surface in a conveni- ent spot in the yard or premises. 4. The soil-pipe should be carried up, full calibre, as a ventilat- ing shaft, to the roof. Discharge Pipes from Baths, Sinks, Urinais, etc.-i. These may be connected with one common drain, which should always dis- charge in the open air, above a trapped gully. 2. If the drain be a long one, leading from upper stories, it, too, should be carried for the purposes of ventilation to the roof, thus being open at both ends. The inlets from the bouse should be trapped. In reference to the enclosed sketches, [see next page] :-A, illus- trates the method of disconnecting slop-water and sub-soil drains from the sewer ; B, that of trapping and ventilating water-closets. They are slight modifications of the mode advocated by Mr. Buchan and Dr. Spear, and also by Dr. Buchanan (in app'x to Report on outbreak of typhoid at Croyden.) The bath is shown at b ; s, sink ; w w, water-closets; y, yard. The advantage of the ventilating tube leading from the upper part of the bend near the trap of the closet is obvious. It has been argued that the ventilator at the yard level is unsafe, but it bas not been found to be so in practice. In accordance with the natural laws of the movements of gases, a constant current of pure air will pass through the soil-pipe, the inlet being the yard ventilator, and the outlet the opening at the roof. If foul air chances to escape into the yard, it will probably be because the pipe has be- come choked at the bend, or the trap has been forced by the gases",
         "THE VENTILATION OF HOUSE DRAINS. of the main sewer. And it is better that this last should escape into the yard than enter the soil-pipe in close contact with the building, whence it may readily find its way into the house through defective or weak traps or flaws in the pipe. I will conclude this paper with the following remarks on this point from Mr. Buchan. He says:-\"To go back in regard to ventilating soil-pipes with an air inlet at the ground and an outlet above the roof, I may mention that in June, 1866, I altered the drains and soil-pipes of Mr. Browne's house, 7, Queen's Terrace, Glasgow, and a perforated grating was there placed three feet from the back door, which allowed a current of air to enter and pass up the soil-pipe and out above the roof. Owing to the lower opening being so near the back door, I watched for long after to see if there was any cause of complaint, but although parties for the last ten years have been constantly walking across the grat- ing, I have never heard any complaint as yet in answer to my in- quiries. C. E. U",
         "THE SANITARY JOURNAL. ON THE AIR WE BREATHE. EXTRACTS FROM A PAPER READ AT THE MEETING OF THE CANADIAN INSTI- TUTE, TORONTO, MARCH 31, 1877, BY EDWARD PLAYTER, M.D. In the entire range of physical science there is no subject which demands more close investigation than the atmosphere we breathe. It is the first essential of life, and of all causes of disease it is the most constant and important factor, for in whatever condition we find it we must necessarily inhale it. And statistical inquiries on mortal- ity prove beyond a doubt, that of the causes of death which usually are in action, impurity of the air is the most important. It has been noticed that, without exception, a highgeneral death-rate occuning in towns and cities indicates a foul condition of the atmos- phere; whereas, sudden outbreaks of disease are usually referrable to the water supply; or as has frequently been the case in Great Britain, immediately to the milk supply * * * * Besides these normal constituents of the atmosphere a great num- ber of substances find their way into it. The works and habitations of men however furnish the most important impurities. In addition to the solid particles from the soil, and the debris of vegetation and of dead animals which had lived in the air, and the numerous and varied substances arising from manufactories and workshops, there are the vapors and gases arising from the decomposition of organic matter, numerous living creatures, the contagiums of specific diseases, and, especially in enclosed spaces, as inhabited rooms, the products of respiration and exhalations from the human body.\" AI- though the impurities arising from the occupations of men are highly important, I shall on this occasion only draw attention to those arising from the decomposition of fæcal matterto the productsof res- piration, and to living organisms and specific contagiums * * * Having referred to the vapors and gases arising from the decom- position of excrement and in connection with respiration, I will now notice living organisms and contagiums. When external air is examined either by means of an aeroscope of some kind, or by drawing it through previously heated glass tubes, surounded by a freezing mixture, living organisms can be found. Dr. Angus Smith indirectly calculated the amount of these from the ammonia in the air, which appears to be derived from organic matter, and supposed that their might be over half a- million germs in one cubic foot of the air of a city. Ehrenberg has discovered at least 200 forms of living creatures-rhizopods, tardigrades, and anguillulo; some lifted from the ground, others growing in the air. These can be dried, and will then retain their vitality for months and even years. There are found extremely small, round and oval cells, sometimes presenting an appearance like the figure of 8, and which are sup- posed to increase rapidly by cleavage. These require a magnifying power of about ooo diameters to see them properly. They are",
         "ON THE AIR WE BREATHE. 5 s id to grow faster when sulphurated hydrogen is in the air. To this same class Parkes thinks the bacteria and monads may perhaps be assigned. Spores of fungi are not unfrequently found (most commonly in July and August) probably from some form of smut Dr. Smith found innumerable spores in water through which the air of Manchester had been drawn, and it was calculated that one drop of the water contained 250,000 of them, as well as mycelium of fungus. Now as to the germs or contagia of speciflc diseases. The theory that zymotic diseases are caused by the invasion of the human body by microphytes -by some of the lower forms of vegetable life-is to say the least making great progress. Indeed, as regards cholera, small-pox, diphtheria, typhoid and the like, nany regard the germ theory, not as an hypothesis, but as a doctrine, as something true. That these germs in many cases reach the person through the medium of air, as well in others through water or food, cannot be doubted. Moreover, while the living germs grow and multiply in the body of a susceptible person, it is more than probable that they may find nourishment and grow, though probably in a modified form, in the air, especially in that containing certain vapors and gases. Some forms of mycrozymes, as I have stated, have been found to grow faster when sulphratted hydrogen (one of the sewer gases) is in the air ; and as is well known, the peculiar carbo-ammon- iacal vapor emanating from focal matter favors the growth of fungi, and hence the dissemination of spores and mycelium. Many years ago, several experimenters, found in the air of cholera wards spores and mycelium of some species of fungi. Staff- Surgeon Norbury, R. N., of H. M. S. Juno, has contributed a paper to the last and recent official Report on the Health of the Navy, on the subject of Tonsillitis and Atmospheric fungi. He found, through the aid of the microscope, in the air of the ship when she was in and on the other side of the Suez Canal, numerous well defined globose spores of fungi. These spores corresponded exactly, he states, with many found on yellowish-white elevations that appeared on the tonsils of twelve men suffering at the time in the ship from all ordinary symptoms of acute inflammation of the tonsils. The eleva- tions seetningly resembling those of diphtheria. No case of this disease was seen prior to the appearance of the spores. A paper by Dr. Koch has quite recently appeared, and was noticed in the Lon- don Lancet last month, on the Etiolgy of Splenic Fever. The writer has found a species of Bacilli, apparently similar to those,of hay in- fusions noticed by Tindal. When the rninutest drop of a fluid con- taining these was injected into a living animal, as a mouse, the organisms increased with enormous rapidity (in the blood and fluids of the animal) by developing in length and dividing transeversely. In reference to small-pox, Dr. Klein, in experimenting upon sheep With this disease, within the last two years, or thereabout, has demon- stratd the deveilopment of an organism in the fluids and tisrues of",
         "THE SANITARY JOURNAL. the animal going hand in hand with the developement of the lesions characteristic of the disease. And Dr. Weigert, of Breslau, has been experimenting upon man with the same disease, and though his ac- count is not so complete as that of Klien, it strongly corroborates it. Again, in reference to vaccinia. On the 6th of the present month Dr. Godlee read a paper before the Pathological Society, of London, (Eng.) on the \" Cultivation of Micro-Organisms found in Vaccine Lymph.\" He has found that in inocculating vaccine lymph into milk, turnip infusion, \u0026c., and keeping at a temperature of 90° to ioo, an \" organism will generally be developed of perfectly char- acteristic appearance, and closely resembling that seen in the lymph.\" He found the organism grow most vigorously in turnip infusion. Within the last year or so, Klien has also demonstrated the existence in typhoid fever of low vegetable forms, in the fluids and tissues of patients affected with this disease. Typhoid fever being a common endemic disease here I will enter a little more fully into the history of this supposed typhoid plant. The lesions of this disease being found in the alimentary canal, here also Klien found most abundant- ly the vegetable parasite. He says the fungus possesses mycelium threads, the contents of which in some parts split up into microgon- idia, the gonidia become discharged from the thread breaking, and these gonidia end in microcococci. The changes produced in the human system by this invader are apparently similar to those pro- duced in other organism by the attact of fungi. There is, says Klien, a deposition of a peculiar dark colored material (probably micro- cocci), in connection with and around which the tissue undergoes the necrotic changes, is, in short, destroyed. The condition of a typhoid fever patient is said to be parallel to that of a potato affected with the rot. Both are the victims of a fungus which feeds and multiplies at their expense. This vegetation of Klien corresponds closely with one (the crenothrix polyspora) found by Cohn in some well-water at Breslau, famous for typhoid fever. It is argued that the gonidia mentioned by Klien, and their de- scendants, are modified representatives of the sporules of some mould. To establish the claim of this fungus to be the specific cause of typhoid, it is absolutely necessary to connect it with ærial typhoid poison. It is well established that persons who contract this disease by way of water may communicate it through the medium of air. While the converse of this is common. Whatever the typhoid poison is, then, it is evident that under certain conditions, it must be con- vertible from an air poison to a water poison. And the same may be said of the poison of small-pox, cholera, diphtheria, \u0026c. Most of these low terrestrial organisms, it appears, will not only sustain themselves when immersed in fluiids containing nitrogenous matter, but will mul- tiply rapidly in the probably abnormal medium, owing to the facility with which their organs of fructification adapt themselves to it. A writer in the Medical Times d- Gazette last year, thinks that most Phytologists would infer frorm the description of, and from the draw-",
         "ON THE AIR WE BREATHE. 7 ings of the vegetation figured by, Dr. Klien, that it is the water phase of the plant, and that by proper cultivation on the surface of a fit sub- strate, it would revert to its original or mildew form. It is, he says, a warrantable scientific inference that the vegetation in the typhoid tis- sues is a casual and degenerate state of its existence, and that its true or highest, or original form is that of a mildew, growing on a free sub- strate. And that the one great substrate,which has supplied the typhoid mildew in all ages and in all countries, is fœcal matter. Granted the rnildew, and the conclusion that fœcal matter is the principal substrate on which it flourishes itymediately before its reception into the human organism is well nigh forced. Other animal and vegetable matter, as decomposing refuse, may be over-run with this specific typhoid mildew, and may thus cause the surrounding air to be charged with particles of the poison, but the toxical properties of these particles may be modified by the qualities of the substrate, and if imbibed, they will probably cause some one or more of the typical symptoms and lesions of Typhoid. Hence, probably, febriculoe, and bastard or obscure forms of typhoid. The writer believes that a mildew grown on fæcal matter is the only possible exegegis of typhoid causation. It certainly does seem that by this hypothesis all the phenomena which have been observed in epidemics of typhoid, and in isolated cases of the disease, may be clearly inter- preted. It readily explains its de novo or spontaneous origin in many cases. It is strongly supported too by many facts, which, as Parkes says, decidedly show a connection between the effluvia from sewers and excretia and typhoid fever ; facts which prove that the prevalency of typhoid stands in a close relation to the imperfection with which sewerage matters are removed. It has occurred to me that, the fact that these organisms are found most numerously in,-seeminngly seeking as it were, the lower part of the alimentary canal, where 'the undigested portions of the food eaten is fast assuming the character of fæcal matter, may be regarded as evidence in support of this hypothei1, that fæcial matter is the nat- ural substrate of their higher or original form of existence. Now if it is true that the typhoid vegetation is a modified repre- sentative of the sporules of some mould, the same is likely to be true of the special organisms of small-pox, cholera, and kindred diseases ; each having their favorite or natural nidus or substrate, which may be mn all cases some form of refuse organic matter. Now how far can any of these facts be practically applied to our- selves here in Toronto. There is a large amount of organic refuse in the back yards and lanes of the city; though last year it appears, owing to more vigorous sanitary administration, they were kept in a considerably less objectionable condition than formerly. In winter, house and stable refuse accumulate, and with the warm weather de- composition commences, and with the spring rains the soil becomes more or less saturated with organic matter. There are, too, in Toron- to probably not less than o,ooo privies unconnected with sewers,",
         "THE SANITARY JOURNAL. and in the vaults or pits of which are the accumulated excreta of years, in all states and stages of decomposition. We are positively surrounded, divided and beset on every hand with hoarded festering masses of fæcal matter. These and the lanes and back yards, con- stitute hot-beds for the development of those most unwholesome vapors and gaspes which have been enumerated, and for supplying food for the multiplication of microzmes and mycrophytes, while they probably also constitute substrate for the growth of the typhoid and other poisonous plants, whatever the exact nature of these may be. In a calm, warm day, when there is no perflation or hardly any move- ment of the air any whe- e, when the fecal emanations reach great rapidity of evolution, what must be the nature and composition of the air around us, which we of necessity inhale? I desire not to 'overdraw' in this matter, but it seems to me we may be regarded as calmly preparing for the invitation of some direful pestilence. It was said of Over Darwin-a town in England of 25,000 inhabi- tants, over 2,000 of whom were attacked within a brief period, a little over two years ago, with typhoid fever, and rmany died-that the peo- ple tat amidst, walked in, and breathed, and drank their own excre- ta. This would seem a hard thing to say of Toronto. But some of us here to-night heard not long ago in this room some facts related by Professor Ellis regarding the well water used by a large number of the people in the city, which was shown to be no better than largely diluted sewerage. Toronto is probably not, however, in a worse sanitary condition than most other cities and towns in Canada, where little or nothing is done to improve their condition in this respect. We have nothing to lead us to suppose they are in a better. Punch's parody on Mrs. Hemans' \" Homes of England,\" is not inapplicable to thousands of homes in this fair Dominion. He s iys \"The cottage homes of England, Alas ! how strong they smell; There's fever in the cess-pool, And sewerage in the well.\" Let us see what figures divulge ? That la~st year there were buried in the three principal burying places of this city, 1,95 7 human bodies, besides a number, I do not know how many, in the new Mount Pleasant Cemetery. Nearly 2,ooo deaths in one year, in a population, according to the estimates at the last assessment, of less than 68,ooo. A death-rate little short of 30 per 1,ooo living. In 1875 the same sources show x,815 deaths in Toronto, and in 1874, 1,818 deaths. The population being somewhat less in those years, the death-rate was about ý6 or 27 per t,ooo. So as regards last year at least the death-rate is \" working up.\" The death-rate of London, (Eng.) averages about 22 per 1,ooo. In very few cities indeed, so far as known, on this continent or in Great Britain, is there su high a death-rate as here; in a large number it is much lower. There has not been any sudden outbreaks of disease worthy of",
         "ON THE AIR WE BREATHE. note, and as I have said, it has been found that, without exception, a high general death-rate indicates a foul condition of the air. Again, young children are known to be much more susceptible to the influences of foul air, they are better indices of its purity, than adults. Last year in Toronto there died over 400, less than one year old, in a total of less than 2,ooo deaths. In 1875, 630 of the total r,815 deaths were of children under one year; considerably over one-third. It seems, according to Parkes, as I have stated, the breath- ing of air contaminated with emanations from fœcel matter, gives rise to diseases of the alimentary canal rather than of the pulmonary organs. Last year there died, according to the returns from the cem- etries-which I admit are not very satisfactory, but which are as likely to afford antagonistie evidence as any other, there died 135 from diarrhœa ; and all, except 12, died in July, August, and Sep- tember. In 1875, diarrhœa carried off 16o, chiefly in the same months. 204 died last year, and 209 in 1875, from what was certi- fied as debility, and nearly the half of these during the warmest months, and it is more than likely that in most of these, the debility was caused by diseases of the alimentary canal, or digestive organs. It rnust be borne in mind that 665 of the deaths of last year were unclassified ; the causes not given. This is important in noticing the proportion of deaths from any one cause. Excepting inflamma- tion of the lungs, causing 137 deaths, and consumption 171; diarrhœa caused more deaths than any other disease named Considering the large number dying during the very warm weather from debility, it is more than probable that diarrhoa and its complications caused more deaths than any other disease. Again, there died in July a total of 212, and in August of 228, while the next most fatal month, April, a total of 181 died. In January, when it is said most old people die, there were 107 deaths, in February 134, and in Decem- ber, 151. All indicating a condition favorable to infant mortality. As further evidence of this, I may be permitted to refer to something coming within my own personal obsereation, and I suppose every niedical man in Toronto could furnish like testimony. I refer to sending little patients to the country in summer. The good effects of which remedy is often most marked. One little child last year I sent three times out of town in order to save its life ; each time it improved, rapidly in the country, and was soon apparently well ; but on returning to the city it would in a few days again fail fast in health, manifest symptoms of derangement of the digestive func- tions, and it was necessary to take it to the country again. This child ived in a part of the city seemingly as healthy as any other part, and was fed entirely on condensed milk, both in the country and city. So that the improvement was not in any degree owing to change in diet. When in the city it was a good deal with its nurse in the open air. The' water used with the milk constituting this child's food, was that of a well, but it was always very carefully filtered. With the cold weather, this child contrived to live in",
         "10 THE SANITARY JOURNAL. Toronto. Thus much then as regards the death-rate. Now it is very well known that the death-ratc in a locality does not bear an approximate ratio to the amount of sickness there. There may be a high death-rate and a low sickness-rate, or there may be a much larger proportion of sickness than even a high death-rate would indi- cate. At the present time there is no system of registration of diseases, and no means of knowing the amount of sickness in any locality, but it is believed by some to be very large in Toronto. It is strong circumstantial evidence of this, the fact that there are an unusually large proportion of medical men in the city, and it may be assumed that did they not find business with them tolerably good there would soon be a smaller,number. Now, in reference to the air in our dwellings and places of busi- ness. If the outer air is not pure, the air cannot be pure within ; rather it must necessarily be rendered still more foul by the products of respiration especially, and by many other substances. To the highly poisonous nature of the-organic matter in expired air I have already referred. Upon those extreme cases of poisoning by it, I need hardlv dwell. * * Dr. McCormac has insisted on this mode of origin of consump- tion; and Dr. Greenhow, in his \" Report on the Health of the People of England,\" enumerates this as a prominate cause of this disease. The well-known fact of the great prevalence of consump- tion not long ago in the armies of England, France, Prussia, 'Russia and Belgium, can scarcely be accounted for, Parkes says, in any other way than by supposing the vitiated atmosphere of the barrack room to be chiefly at fault. This was indeed the conclusion of the Sanitary Commissioners, in a very celebrated report. Finally, on this point, Dr. Parkes, whom I have so often quoted, and who was probably the greatest Sanitarian of this or any other age, ob- serves, \" Not only may phthisis be reasonably considered to have one of its modes of origin in the breathing of an atmosphere con- taminated by respiration, but other lung diseases, bronchites, and pneumonia (inflamation ot the lungs) appear also to be more com- common in such circumstances.\" He adds, furthermore, that in addition to a generally impaired state of health, and lung affections, it has long been considered, and apparently quite correctly, that such an atmosphere causes a more rapid spread of the specific diseases; as small-pox, scarlet-fever and the like. Again, as regards ourselves, when we consider that there is an almost utter want in all our buildings of any means or system of ventilation, or of changing the air in our homes and shops, and that, according to the death returns before alluded to, there died in Toronto last year from the effects of the three chief lung diseases, consumption, pneumonia and bronchitis, 37o human beings ; ex- cluding the 665 deaths, the causes of which are not given, we have considerably over one-fourth of the remainder of the deaths attri- buted to those diseases,-that in 1875, exactly the same number",
         "BIBLE HYGIENE, died, 370, out of a total of less, by about 15o, than last year ; I say when we consider these facts, can we doubt that as a people we suffer very greatly from breathing air contaminated by emanations from fæcal matter as well as air poisoned by respiration-poisoned in our lungs, or in those of our neighbors. BIBLE HYGIENE-OR THE MOSAIC MODE OF SANITATION. EXTRACTS FROM A LETTER LELIVERED BEFORE THE JEWISH CLUB AND INSTI TUTE BY ERNEST HART.-(SANITARY RECORD.) * * *Now, although I propose to consider the Mosaic ordin- ances in their relation to modern sanitary knowledge and law, I wish very carefully to guard myself against being supposed to assert that that was the sole or indeed the chief object with which many of these ordinances were laid down. As a whole, and viewed solely from the sanitaty standpoint, they form the most remarkable body of public health law of which we have any knowledge in ancient or modern times. They created at once a standard to which no modern Comrnunity has yet succeeded in attaining, and to which the Jews of our time are prevented from adhering by the conditions of life of the society amongst whom they dwell. They established principles of which the full force is not yet recognized in all the countries even of civilized Europe, and which at this moment the enthusiasts of sanitation are urging upon an inert and somewhat scoffing public with a view to establishing a hygieian Utopia. If the modern sanitarian were asked to state the basis of Public Health under a few simple divisions, he would probably say that they might be conveniently classified under the following heads : 1. Purity of air, soil, and water. 2. Isolation of infectious disease and disinfection. 3. Thorough personal hygiene. I do not at all mean to say that this is a complete or scientific classification of a sanitary code, but it is perhaps sufficiently simple and comprehen- sive for our purpose to-night. At any rate, these are the main objects of modern sanitary legislation, and it is to attain these ends that a great body of Public Health law has been created in this country. Let us look at the Mosaic law to see what provision was made for these necessities, in order to ensure the first group of conditions men- tioned. To ensure purity of air, soil, and water, very strict condi- tions were enjoined by Moses and were observed by the Jews in the great city of Jerusalem. There are two prime causes of contamina- tion of earth, air, and water-dead matter and excrementitious matter. In respect to both of these, the Hebrew ordinances were most stringent, nay fastidious, and there observance was hedged round with so much traditional importance that they were very rarely infringed, even in the slightest particulars. Conservancy of Soil, Air and Water.-In Deuteronomy, xxiii. 12,",
         "THE SANITARY JOURNAL. 13 and 14, there is laid down for all camps, villages, and communi- ties dwelling in tents, a system of conservancy which modern science now accepts as the perfection of human reason, and details of prac- tice which the Rev. Mr. Moule has since patented. The rain to the river and the sewage to the soil, is an axiom which modern en- gineers esteem as the summary of some centuries of fatal experience during which millions of lives have been sacrificed to the disregard of this rule. The polluted rivers of modern England, the middens which breed wide-spreading disease in the cities and towns of the North, are the evidences of a fatal infringement of the Mosaic law. ' For the Lord thy God walketh in the midst of thy camp to deliver thee, therefore shall thy camp be holy that He see no unclean thing in thee and turn away from thee.' The details of this ordinance I need not here discuss, but we know from the Talmudic statements that it was amply carried out, even in the City of Jerusalem, and, that the Sanitary police allowed no offensive matters to be retained within the city, but required them to be removed outside the city bounds were they were to be dug into the earth. Had the same rules been observed in modern Europe in our cities, it is probable that some forms of disease which are now most fatal, and are endem- ically rooted in the soil would be altogether unknown or capable of easy extinction. Great Britain pays an annual toll of between eight and nine thousand deaths from typhoid fever alone to the neglect of this one Mosaic ordinance; cholera knows no other origin and spreads by no other agency than the pollution, first of water, then of soil and air. Both are known euphemistically as pythogenic diseases. Mr. J. Simon has given them the more outspoken Saxon title of 'filth diseases. The same rigid observance of hygienic precaution strengthened and emphasized by the same solemn sanctions provided for the sanitary care of the dead bodies whether of the people or the ani- mals of the community. Whilst the sanctity of the dead was guarded by religious observances which surrounded them with solemn and tender reverence; physically and in its hygienic relation to the community, the dead body becarne an unclean thing, to be isolated from the living, to be set apart in its own chamber, so that while still cherished and reverenced as the symbol and former dwel- ling-place of a living spirit, it was in itself a thing which no man might touch without becoming unclean. He must thereafter cleanse himself with water, and the linen with which the body came in con- tact must be submitted to prescribed purification, whilst open vessels within the room in which the body lay were also unclean. Numbers xix. i i.-' He that toucheth the dead body of any man shall be un- clean. seven days.-1 2. He shall purify himself with it on the third day, and on the seventh day he shall be clean ; but if he purify him- self not the third day, then the seventh day he shall not be clean.- 14. This is the law when a man dieth in a tent: all that come into the tent, and all that is in the tent shall be unclean seven days.-15.",
         "BIBLE HYGIENE. 13 And every open vessel which has no covering bound upon it is un- clean.-17. And for an unclean person they, shall take of the ashes of the burnt heifer of purification for sin, and running water shall be put thereto in a vessel.-i8. And a clean person shall take hyssop, and dip it in the water, and sprinkle it upon the tent, and upon all the vessels, and upon the persons that were there, and upon him that touched a bone, or one slain, or one dead or a grave.-19. And the clean person shall sprinkle upon the unclean on the third day and on the seventh day: and on the seventh day he shall purify himself, and wash his clothes and bathe himself in water and shall be clean at even.' Interments.-Jewish interments were always extramural. Dr. Joseph Perles, in his notes on interment of the dead, published by the American Jewish Publication Society, points out that between death and interment there was but a short interval amongst the Jews. It was part of the sanitary system of the City of Jerusalem that no corpse was permitted to pass a night within its walls ; he adds that the cruelty of such interments was more apparent than real, for it was mitigated by the circumstance that the corpse was deposited in an open grave, and carefully inspected for several days, until the signs of dissolution were unmistakably present. The public ceme- tery was usually situated at least 15o yards from the city boundaries. In selecting its site, care was taken that the ground should be rocky and well drained. Those who are at all familiar with the frightful injuries to health and insufferable nuisances created by the intramural system of interment, Which until recently prevailed in this city, will fully appreciate the Jewish ordinance of extramural interment based on the Mosaic law. Isolation of Infections Disease.-We may fairly presume that such regulations as these must have preserved the Jewish people from many of the epidemic diseases now prevalent and most deadly. The importance of isolating cases of prevailing infectious diseases is very fully recognized in the Scriptural system of sanitation. The type of contagious disease which the code selects is leprosy. Isolation is recognized by modern sanitarians as the great principle of action in dealing with infectious disease. The last consolidated Public Health Act, passed by the Health minister par excellence, Mr. Disraeli, two years since, contains a number of clauses intended to give to urban and rural sanitary anthorities those powers for isolating infectious eruptive diseases, which the sanitary ordinances of Moses not only Conferred but compelled the authorities to carry out. The almost topian proposition of Sir James Simpson for stamping out scarlet fever by isolation, and the 'sentinel system' of Mr. Clark, are modern adaptations of the hygiene of the ancient Hebrews. 'All the time that the plague is on himi,' we read in Leviticus xiii. 45, ihe shail be unclean. He is unclean, he shall dwell apart; without the camp shall his habitation be.' Numbers v. 2. ' Command the children of Israel that they put out of the camp every leper and",
         "THE SANITARY JOURNAL. everyone that hath an issue, and every one that is defiled. How vainly are our medical officers of health daily pleading with boards of guardians and with sanitary authorities, that this old Levitical precept, given in the wilderness 4,000 years ago, shall not be altoge- ther forgotten or disregarded in this country, and at this time. If Dr. Brewer were a Rabbi, and Limehouse were within the bounds of Jerusalem, we should have had no procession through the princi- pal streets of the city to protest against the establishment of a small- pox hospital in the midst of it; nor would the board over which he presides be still labouring to elaborate a system of isolatio'n for in- fectious eruptive diseases, in which it is constantly baffled by the prejudices of the population and the inertness of local vestries. During the present epidemic of small-pox in London less than half the deaths from this disease have occurred in hospitals, and there- fore more than half the cases, occurring for the most part under cir- cumstances where home isolation is impossible, have not received hospital isolation. Hence the epidemic has been left to run its natural course. The isolation of infectious diseases was, under the Mosaic rule, invested with all the dignity and force of a religious ordinance, and the establishment of houses of isolation was recog- nised as a public duty of the most urgent importance. The medical officers of health throughout the country are at this moment pro- claiming their powerlessness to stop infectious disease for want of notice of its occurrence. The Mosaic ordinance gave that which the law of England must shortly give, and which Mr. Sclater-Booth a few weeks since acknowledged to be necessary; but feared to pro- pose to Parliament as being in advance of public opinion. Disinfection.-As to the means of disinfection, strangely enough we are returning also to the Mosaic standard. The means of purifi- cation employed by the Hebrews in minor cases of uncleanness such as arose from the touching of unclean things or dead bodies varied with the degree of defilement. Thus, in some cases, the unclean- ness ceased in a few hours without ceremony, in others by bathing the body in water or by the washing of garments, in others by sprinkling and washing with animal charcoal, according to the direc- tions given in Numbers xix. 5, which directs the ceremonial prepar- ation of an animal charcoal for the purposes of purification. Finally, in the more extreme cases the walls are to be scraped or the stones destroyed, and the garments are to be burnt with fire. Leviticus xiii. 32-' And they shall burn the garment or the cloth or the stuff of wool or linen or any utensil of skin wherein the plague is.' I should like, with your permission, to refer you to the best chapter on disinfection with which I am acquainted, that which was written by Mr. Wanklyn, the well-known chemist, in the 'Manual of Public Health,' published by Smith, Elder \u0026 Co. You will find, after reciting the various means of aerial disinfection so-called, and enumerating the ordinary means in use, he concludes that scraping the walls and thorough washing are the best means of disinfection in",
         "BIBLE HYGIENE. 15 the slighter cases, and that in the worst cases fire is the only agent that can be relied on. Personal Hygiene : Cleanliness.-Not long since there was a news- Pàper controversy as to the scriptural origin of the dogma of 'Clean- iness is a part of godliness.' The traces of the laws of personal cleanliness, to which Moses gave a religious sanction, are to be found in the earliest chapters of the Biblical history of the Jews-Genesis Xviii. 4 : ' Let a little water, I pray you, be fetched and wash your feet,' and Genesis xix. 2: And, he said, behold now, my lord turn in, I pray you, into your servant's house, and tarry all night and wash your feet.' Ablution before meals was so invariably performed that, according to Dr. Kalisch, it became a common metaphor or emblem for declaring freedom from guilt or violence. The laws of ablution and purification have of course relations to religious and spiritual conceptions. And once again I would say that if I do not at all dwell upon or even allude to this relation of these laws, it is because we are considering them to-night solely from the sanitary stand-point. The priests on entering upon their office, as well as before and dur- ing their duties in the Temple, were obliged to wash and bathe themselves; and many passages in the Talmud refer to cleanliness as an ornament and a necessity. Among the later Israelites, the Pharisees and the Essenes were most distinguished for their strict- ness in ablutions. Running water plays a great part in the Mosaic system of ablutions, and the strictest ideas of cleanliness are hardly compatible with any other method of attaining complete cleanliness, as may be illustrated for any one who chooses to visit the Hammam in Jermyn Street, and indoctrinate himself with the lessons on wash- ng of Mr. Urquhart, which are based on the Mosaic precedents still observed in the rites of our religious services. According to Wunderbar, the later Israelites bathed not only in rivers, but also in baths, the houses of prosperous people always en- closing a bath in the forecourt (2 Samuel ii. 2 ; Susannah xv.) Turkish baths, as we now call them, are really Jewish baths, and were common in Jerusalem under the name of perspiration baths. After coming out of the bath the body was oiled and perfumed, and there was a favourite beverage, which seems to have been a mixture of wine, oil and water, and was considered to possess most agree- able and strengthening qualities. According to Talmudic authori- ties, the favourite ablution of the ancient Hebrew much resembled the tubbing custom of which the modern Briton is justly proud, and which excites the mingled horror and admiration of the Gaul and the Teuton. It was the custom after finishing with the warm bath to dip into the cold one, or to pour cold water over the body, a method which constitutes the acme of healthful luxury in the daily bath of the modern Englishman. Laws of purification by bathing were established in great detail for women generally (Leviticus xv. 19-22). For women after child- birth strict laws are also laid down (Leviticus xii. 2), prescribing days",
         "Io THE SANITARY JOURNAL. of hygieni c precaution, such as must haverendered almost impossi- ble the forms of puerperal fever, which are now among the chief sources of mortality from child-birth among the European communi- ties. They are such as we are at this moment endeavouring to en- force in connection with our lying-in hospitals, and on this subject we can only say that if these Mosaic ordinances were universally ob- served, puerperal mortality would fall considerably in all great cities of the world. I had lately an opportunity of visiting in Paris the great Maternité Hospital, directed by M. Tarnier, and there I ob- served that in one single cottage, situated in the grounds of the hos- pital, strictly Mosaic rules of purification were observed; it is the only corner of any public institution with which I am acquainted, in which they are fully and conscientiously carried out; this little cottage contains only four beds, but it is the admiration of the ob- stetricians of Europe, and its hygienic regulations are almost as per- fect and almost as religiously observed as if this hospital were situ- ated in Jerusalem and guided by Hebrew physicians, practising upwards of 2,000 years ago. (To be Continued.) NOTES AND EXTRACTS ON VACCINATION. DANGER OF COMMUNICATING SYPHILIS-ANIMAL VACCINATION- RE-VAcCINATION. On ' Safeguards against Small-pox' and the risk of syphilitic con- tamination the Medical Times \u0026* Gazette says :-\" When vaccination was made compulsory on all, its merits had been so well tested that the promoters of public vaccination were, through their great anxiety to see it universal, induced, perhaps to look at the process and its results through too rosy spectacles. They saw only one side of the shield ; they looked only on the lives saved and the faces unscarred by the ravages of the small-pox. They forgot, or did not believe, that, without the greatest precautions, the practice of vaccination might possibly give rise to disorders almost as serious as, if not more so than, small-pox itself. Hence the stringency of the laws. But since that time it has been proved aimost indubitably, by Mr. Jona- than Hutchinson and others, that Syphilis may be inocculated into the system along with, or instead of, the true vaccine virus. And this is no longer among the things which are doubtful; it has been absolutely and to the satisfaction of all who have seen the cases irre- fragably proved. In Dr. Seaton's \" Hand-book on Vaccination \" we do not think the possbility of such a thing is ever hinted at, certainly not admitted ; and as Dr. Seaton has been the authority consulted, directly or indirectly, by the Government authorities, we can hardly blame offici; I for refusing to take any steps to remedy an evil tt a: was evidently deemed ch merical. That the risk is not chimerical,",
         "EXTRACTS ON VACCINATION. 17 but that the danger is real, and likely at a time such as the present to become serious, has now been sufficiently shown, and it will become the duty of the members of our profession, as well as of the public at large, to enforce the prominence of this danger on the notice of the Government authorities, as well as to insist on the fulfilment of de- mands which are in themselves r easonable. That the risk of'syphilitic contamination by means of vaccine fluid was not long ago known seems to depend, as Mr. Hutchinson has pointed out, on the fact that the subjects of vaccination are only, as a rule, seen twice by the vaccinator-once when vaccinated, and again a week after when they come up for examination. Now in the case of children, we all know that at or about the usual period of vaccination they may look fat, plump and in fine condition, whereas seen later they may present all the well-known and unmistakable signs Of congenital syphilis. Healthiness of appearance, therefore, as far as the vaccinifer is concerned, cannot be taken as an absolute test Of the purity of the vaccine lymph. Neither is it until those infected with syphilis by vaccination are followed to their homes, and the sub- sequent history studied, or it may be that some accident brings such patients again under the eye of the surgeon, that the true history of the results of impure vaccination or revaccination is to be discovered. Arm-to-vaccination is undoubtedly the best ; but except the whole history of either subject (especially of the vaccinifer) be known. it is also, as far as risk of syphilitic contamination goes, by far the most dangerous. Dr. Charles R. Drysdale, M.R.C.P.L., \u0026c., \u0026c., in a communica- tion to the above journal, writes on the subject of animal vaccination inBelgium, as follows:-That vaccination is the most splendid triumph of preventive medicine possessed by science is, I suppose, admitted on all hands by persons with capacity for estimating evidence. There are, however, I believe, two objections, against vaccination from arm to arm, or to humanized lymph. Firstly some diseases may be conveyed by such lymph; and, secondly, there is apt to be a great paucity of vaccine lymph just when it is most needed. Both of these objections must, I think, be admitted to have a certain weight; for that syphilis is now and then communicated from an infant that is apparently perfectly healthy to other healthy children, by vaccination, 's now admitted by ail * The practice of animal vaccination is now very successfully carried on in Belgium, and also in the State of Massachusetts, U. S. ; and it seems to me that it deserves our most close and sympathetic at- tention. At the Belgian \" Institut Vaccinal de l'Etat,\" we are informed by Dr. Warlomont that animal vaccination is rapidly superseding human- ized lymph. Thus of 2ooo practitioners in Belgium, some iooo gentlemen practise vaccination; and of these I find, from a pamph- let I lately translated at the request of Dr. Warlomont, that 768 ap- plied to the State Vaccinal Institute for animal vaccine points in",
         "18 THE SANITARY JOURNAL. 1873-showing that the whole of Belgium is rapidly taking up the idea that animal vaccine ought alone to be relied on, as being supe- rior to that from arm to arm .It appears, too, that vaccinations made with ivory points of animal vaccine matter, delivered by the Institute, succeeded in 96 per cent. of the cases vaccinated ; and that in revac- cinations, as many as 62 per cent. were successfully inocculated by it. And it is alleged that, out of io,ooo children vaccinated at Brus- sels by animal vaccine from 1865 to 1870, passing through the great epidemic of small-pox of 1870-71 not a single child was attacked by variola, whilst the same immunity was noticed in ail persons who were successfully revaccinated by animal vaccine-a far greater number, of course, than xo,ooo. In the time of the epidemic in belgium, the State Institute of Brussels furnished animal vaccine for more than 5oo vaccinations daily, and sent off a great deal of lymph to foreign countries. And if 5,ooo vaccinations a day had been needed, ail that the Institute would have required would have been to hire a greater number of young calves. The calves are lent by a butcher to the establishment for a week, and then removed in perfect health and undiminished value. In reference to this subject we find, in a Report on Vaccination, read before the Ohio State Medical Society last year, and which is called an inquiry concerning Human Vaccine, Vaccino-Syphilis, and Animal Vaccine, with an Appendix containing letters from Hebra, Sigmund, Seaton, M. Guerin, Zeissl, Neuman, and Widerhofer, by William B. Davis, A.M., M.D., etc., the following conclusions : Syphillis cannot be transmitted by humanized vaccine lymph, unless syphilitic pus, tissues, or blood, be mixed with the vaccine lymph. Whenever proper precautions are used, such contaminations can be avoided. Animal vaccine-particularly cow-pox lymph and regenerated cow-pox lymph-is very difficult to take, unduly severe in its action when it does take, will not bear transportation or preser- vation with any degree of certainty, and does not afford the same de- gree of protection against small-pox as humanized vaccine lymph. While it may not transmit syphilis, it has transmitted carbon and typhus, which are more dangerous to life than syphilis. Again, Dr. W. C. Chapman, in a pamphlet on vaccination as a pre- ventative of small-pox, holds that, while it may be that syphilis is conveyed during vaccination by the admixture of either blood, pus, or tissues, with the lymph, yet it is not always certain that the admix- ture can be avoided. Hence he holds that the vaccinifer should always be a healthy subject. As regards the protective influence of bovine virus, he is of opinion that, while it acts more severely it takes quite as readily and protects just as perfectly as human- ized lymph. REvAccINATION.-In reference to revaccination, and the neces- sity for it, we find the following in a late number of the London Lan- cet : Is it necessary to revaccinate every seven years ? Is there such",
         "EXTRACTS ON RE-VACCINATION. 19 a thing as \" experimental testing \" of susceptibility or non-suscepti- bility of the system to small-pox by revaccination ? Does the failure of revaccination signify that the person in whom the operation has failed is insusceptible to small-pox ? Such is a sample of questions which have of late been sent us from various sources-questions which, judging from the columns of several of our contemporaries of the daily press, would appear to exercise at the present moment certain of the general public as well as of the profession. It is not quite easy to understand how any doubt should exist on the several rnatters to which these questions refer, seeing the abundant and ready sources of authoritative information (notably Dr. Seaton's \" Hand-Book of Vaccination \") accessible with regard to them. The fact remains, however, and we proceed to answer the questions cate- gorically. First, there is no evidence to show that revaccination, once efficiently performed at or after puberty, need ever be repeated. On the other hand, the frequent repetition of revaccination, which has become common during alarms of small-pox, is distinctly to be deprecated. Such repetitions are, as a rule, futile ; they are waste- ful of vaccine lymph when lymph is most precious ; they tend to unsettle the minds of people regarding some of the best established facts as to the preservative power of vaccination; and (which ought to be all sufficient for the profession) they are unnecessary. The official memorandum of the Local Government Board on revaccina- tion says: \" Revaccination once properly and successfully per- formed does not ajppear ever to require repetition.\" The nurses and other servants of the London Small-pox Hospital, when they enter the service (unless it be certain that they have already had small- pox), are invariably submitted to vaccination, which in their case generally is revaccination, and is never afterwards repeated ; and so perfect is the protection that, though the nurses live in the closest and most constant attendance on small-pox patients, and though also the other servants are in varous ways exposed to special chances of infection, the resident surgeon of the hospital, during his forty-one years of office there, has never known siall-pox affect any one of these nurses or servants. Some thoughtful practitioners are of opin- ion that the occurrence of severe generai diseases after revaccination, such as enteric fever, may weaken the protective influence of revac- cmation, and that where this has happened, and generally whert., long after revaccination, a person is brought into immediate contact with small-pox, a second revaccination is desirable. This, is, how- ever a very different thing from the promiscuous revaccination which has corne into fashion in periods of epidemic small-pox; and, although probably an unnecessary precaution, it need not be dis- couraged. Next, as to the success or non-success of revaccination as a means of determining the susceptibility of an individual to small-pox, the notion is wholly fallacious. Revaccination succeeds equally well",
         "THE SANITARY JOURNAL. upon the well-vaccinated as upon the ill-vaccinated, and vaccination is as successful after small-pox as revaccination after primary vacci- nation. The local effects of revaccination may be produced again and again in the same individual. Dr. Seaton says on this subject, ' The local results obtained by the revaccination of any individual give us absolutely no information whatever as to the constitutional condition in which the revaccinatedperson was with regard to liability to contract sma/l-pox. It has frequently been argued, and is indeed often to be heard said now, that if a revaccination cannot be made to take, or if it take only in a modified way, it is evident that the constitu- tion would not at the time take small-pox ; whereas, if a complete local result follows, it may be assumed that the protection of the primary vaccination had worn out, and that the person was in danger or at all events in more danger than in the former case, of taking variolous infection.\" The erroneousness of this view is proved by certain facts derived from revaccinations in the Wurtemburg and our own army, and which show, if the view had been correct, that 319 out of every thousand persons who had had small-pox, 310 out of every thousand who had been well vaccinated, but only 281 out of every thousand who had been ill-vaccinated, were in present danger of small-pox ; and of the soldiers (not recruits) in our own army, 451, 485, and 237 would represent the ratios in the three classes respectively, which is clearly a reducio ad absurdum. Our know- ledge that revaccination exhausts the exceedingly limited liability to small-pox that may exist, or may recur, after primary vaccination, rests upon a broad basis of observation, but we are unable in any given case to judge of the existence of this liability from the effects or non-effects of the operation. NOTES AND EXTRACTS ON DISPOSAL OF SEWAGE. HIGHLY IMPORTANT REPORT-SEWAGE FARMING. The removal and disposal of excrement is really the great question of the day. On it depends very largely the purity or impurity of the air and water supply. Heretofore all methods for manufacturing portable manure from sewage seem to have utterly failed, from one cause or another, and the advantage of sewage farming-land irriga- tion, is certainly in the ascendancy with those most interested, and who have paid most attention to the subject. Some time since, the President of the Local Government Board (Med. Times d- Gaz.) appointed a Commission, consisting of Mr. Robert Rawlinson, C.E., Mr. Clare S. Read, M.P., and Mr. Smith as an assistant, to inquire as to the great difficulties of devising. means for the disposal of sewage, and also as to the practical effi- ciency of the chief systems then (1875) in operation, by sewage farms, land filtration, and by precipitation or chemical prucesses.",
         "DISPOSAL OF SEWAGE. 21 The report of the Commissioners, the chief recommendations of which have been known for some time, was made public last week. The Commissioners visited Edinburgh, Wroxham, Chorley, Black- burn, Doncaster, Harrogate Wolverhampton, Leamington, Warwick, Rugby, Banbu-y, Bedford, Croydon, Norwood, Reigate, Worthing, Aldershot, Romford, Tunbridge Wells, Cheltenham, Merthyr Tydfil, Barking, Norwich, and Enfield; Kendal, where the downward inter- mittent principle is carried out; Leeds, Bolton, Coventry, Totten- ham, Edmonton, and Hertford, where sewage is treated by a chemical process; Bradford, Birmingham, and Luton, where sewage- sludge is precipitated by the addition of lime; and Halifax, Rochdale, Salford, and Manchester, where the pail system is partially used for dealing with excreta. They also visited Leyden and Amsterdam, where the pneumatic system is partially in operition : Paris, where only a portion of the sewage is used in irrigation; and Brussels and Berlin, where the sewage is about to be disposed of in irrigation. The Commissioners are of opinion that the retention for any length- ened period of refuse and excreta in cesspits or cesspools, or at stables, cow-sheds, slaughter-houses, or other places in the midst of towns, must be utterly condemned ; and that none of the (so-called) dry earth or pail systems can be approved. The sewering of towns and the draining of houses must be considered a prime necessity un- der all conditions and circumstances, so that the subsoil water may be lowered in wet districts, and may be preserved from pollution. That most rivers and streams are polluted by a discharge into them of crude sewage, which practice is highly objectionable That, as far as they have been able to ascertain, none of the existing modes of treating town sewage by deposition and by chemicals in tanks appear to affect much change beyond the separation of the solids and the clarification of the liquid. That, so far as their examinations extend, none of the manufactured manures made by manipulating town's refuse, with or without chemicals, pay the contingent costs of such modes of treatment ; neither has any mode of dealing separately with excreta so as to defray the cost of collection and preparation by a sale of the manure been brought under notice. That town sewage can best and most cheaply be disposed of and purified by the pro- cess of land irrigation for agricultural purposes. That land irrigation is not practicable in all cases. That towns situate on the sea- coast or on tidal estuaries may be allowed to turn sewage into the sea or estuary below the line of low water, provided no nuisance is thereby caused. According to the Sanitary Record the town council of Bedford, Eng., have managed to solve the question of sewage disposal by a yearly outlay of the ratepayers' money amounting to £371, or id. in the pound on the rateable value. The population of Bedford is stated to be i8,ooo souls, and its rateable value £65,ooo. The council cultivate a sewage farm of about i8o acres at Newnham, which is about a mile from the town. The soil is 'a rich loom with",
         "THE SANITARY JOURNAL. a gravelly subsoil, well adapted for the purpose to which it is devoted, and the surface has been specially laid out for irrigation.' The volume of sewage delivered every twenty-four hours averages 700,000 gallons, inclusive of 3oo,ooo of sub-soil water. It flows by gravita- tion into a sewage well, and is thence pumped over the land. The profit and loss account for the year 1875 was this in brief :- £ s. d. Yearly instalment on cost of works, farm rent, labor, etc., etc.................... 3,832 7 8 Realized by sale of stock and crops----....... 3.461 6 o Ultimate cost to ratepayers-***........... 371 1 8 The crops were various, consisting of Italian rye grass, potatoes, mangolds, onions, carrots, cucumbers, vegetable marrows, asparagus, rhubarb, cabbage, cauliflowers, oats, wheat, permanent pasture. Below is an abstract of a financial statement by Dr. Carpenter of the Beddington sewage farm for the year ending September 29, 1876. This fine farm has been noticed several times, and its his- tory has been given, in this JOURNAL. There is an increase in the value of stock and crops on the farm of 7466 5s. 5d. The total receipts during the year have been £7,384 3s. 5d The total payments, rent, taxes, wages, etc., £8,890 is. 7d. The cost of the farm to be paid during the year, about £1,500, was less than a penny rate, notwithstanding enormous rent paid. Dr. Carpenter thinks, if the farm had been managed by a farmer for his own benefit, it would have paid handsomely at a reasonable rent. MODERATE DRINKING. On the 7th uit. a special public meeting of the National Tem- perance League was held in Exeter Hall, to discuss the subject of moderate drinking. Sir Henry Thompson, F.R.C.S., presided, and said they were met together that evening because they believed there was a great deal of erroneous opinion current in society as to the use of alcoholic liquor in dietary, and to declare to what extent it was desirable to have alcoholic liquor at all. Raised a few years ago, such a question would have created, and did create, the greatest opposition, but now the attitude of the public was very largely changed, and they no longer found hosts expecting their guests to get drunk at their tables. They had nothing that night to say to drunkards or to people who sometimes got the worse for liquor without getting drunk, nor to the people who drank good wine daily, appreciating its bouquet and flavour; for as to the former, the case was already settled, while the latter adrnitted that by the daily con- sumption of wine they shortened their lives. Their controversy",
         "MODERATE DRINKING. was with the great mass of people who believed that alcoholic liquors were good and necessary articles of diet, and to convince them two arguments must be employed. The first must be the phy- siological one, and as to that he should maintain that alcohol was of a certain value under certain very exceptional circumstances. When a man had lost his nervous pluck, when the nervous system, and fnot the muscular one, had come to grief, then a stimulant was useful. By giving alcohol when a man had lost all desire to live, he had saved life, and he would ask them not to talk nonsense about putting anything out of their reach if they could ever do any good with it. But that made his argument all the stronger that this alcohol should not be taken daily by healthy people. His second argument was based on experience, but he must remind them that alcohol varied enormously in its effects, and that they could not dogmatise and lay down absolute rules on the subject. The people who could not stand alcohol were the brain-workers, a daily increasing class, whose nervous systems were more susceptible and irritable than those of their forefathers. He had often had the old men, hard drinkers, who lived to seventy or eighty used against him in argument, but they were told nothing of the thousands of men who had gone down, and nothing of the different position of men in those days and these. Those who envied the habits of living and the drinking customs of old he would advise to go and live as they did, if they could. Dr. Richardson, who was very warmly received, said moderate drinking was the moral mainspring of all the drunkenness and all the crime in the world. Defining alcohol as the devil in solution, he maintained that it did not warm the body, did not give muscular power, increased the action of the heart but weakened its strength, built up no tissue except useless fat, and was of no good whatever. By experiment on himself he found that he could do more work, more varied work, and never worked with such facility, or with such a sense of freedom from anxiety, as when abstaining. Observing that the difficulty of dealing with moderate drinking was that nobody could agree what it was, he proceeded to point out the effects of what certainly must be considered 4moderate drinking. A. drank daily a pint of mild liquor, half-pint of wine, and one or two glasses of whiskey at bedtime; this was equal to six ounces of alcohol, made the heart beat 30,000 times faster in the day, and was equal to rais- ing nîneteen tons a foot. B. took a pint of cooper, one brandy-and- soda, and a pint of claret, equal to four ounces of alcohol, to 12,000 extra beats, and to fourteen foot-tons. C. drank two glasses of port or sherry, and a pint of claret, which was equal to three ounces of alcohol, to o,ooo extra beats, or to nine foot-tons. From such figures they might judge of the harm done to the heart by the use of alcoholic liquors. From the amoba floating unperceived in liquid Up to the highest type of animal, Nature built up the constitution of each with water alone, and on this fact Dr. Richardson based a tel- ling appeal to his audience in favour of total abstinence.",
         "24 THE SANITARY JOURNAL. Vice-Admiral Sir B. James Sullivan gave several remarkable in- stances of the value of total abstinence in Arctic expeditions.- Sanitapy Record. SEWER VENTILATION. In reply to questions sent by the surveyor of Carlisle, Mr. Morley, to a great many co-professionals in England, the following valuable and interesting information had been obtained. The system adopted by Mr. Morley had been to send-out circulars making inquiries as to population, acreage, length of main sewer, average distances between manholes, number of manholes, whether ventilated and how, general system of ventilation, whether tall chimneys and rain-water spouts are utilized for ventilation, average extent of daily supply of water per head, the number of water-closets, private house drainage, me.hod of flushing sewers, disposai of sewage, and velocity of travel of the sewage. Dr. Yield, Sunderland, had stated that in that town there are i,ooo open ventilators placed forty yards apart, and that no inconvenience results from them. At Smethwick, near Birming- ham, at Walsall Lincoln, Tipton, Dudley, and many other places there is not yet any system of main drainage in operation ; and that is the case even at Bradford, where the authorities are about to apply for borrowing powers. At Doncaster, with an estimated po- pulation of 20,000 and an acreage of 1,690 (rather more than that of Carlisle) the length of the main sewer is 9 miles, average distance between manholes about ioo yards, all manholes ventilated, no charcoal used in the cylinders, and in addition to the manholes there are metal shafts used for ventilators. There are very few water- closets compared with the size of the place. At Bilston the man- holes are all ventilated in direct communication with the streets, and no effluvia rises. The same is done at Wolverampton (population 72,000) where tall chimneys are not used for ventilation, where a hose is kept for flushing sewers when required, and where the water- supply is 18½ gallons per head per day. At Rochdale (population 70,000, length of main sewer 1o miles) a manhole is placed at every change of line or gradient and at every junction of streets. All the manholes now put in are ventilated, but some of the old ones are not. No charcoal boxes or side chambers are used, and no inconvenience is felt. All new private drains are ventilated. The rate at which sewage travelled there is 3 to 12 feet per second, and the water sup- ply is 13 gallons per head per day. At Kendal, with a population of 14,200, acreage 2,621, though the town proper only covers 450 acres, the main sewers are 71 miles in length, and the average dis- tance of manholes is 170 to 5oo feet. All the manholes are ven- tilated, and side chambers but no charcoal used. Tall chimneys and rain-water spouts are not utilised. Velocity of the sewage, 128 feet per second; water.supply 25 gallons per head per day. At Kidderminster the ventilation is by open gratings over the manholes",
         "PEROXIDE OF HYDROGEN. 25 in the centre of the streets. At Henley the same system has been .adopted, with cans suspended to catch the rubbish that falls through instead of side chambers, which are thought to interfere with venti- lation and certainly add to the cost. These are specimens of one class of replies received, but many contained no information of any value to the Carlisle authority, others had no sewer system, others a sewer system but no means of ventilation, others just beginning to ventilate by putting open grids on new manholes, and so on. A *few reported that they ventilate by means of metal shafts run up above the gables of houses, a few use rain-water spouts where they do not come within a certain distance of windows. The supplies of water vary from about 13 gallons per head per day at Rochdale to 48 gallons at Salisbury and 5o at Wakefield. On this point Mr. Milburn suggested that probably a brook ran through each of the towns and the authorities reckoned the whole of that water as a Supply. At Croydon, with a population of 63,000, 9oo manholes about 150 yards apart, open grides without charcoal are used and no inconvenience arises. The water-supply is 45 gallons, and the rate of mortality rarely exceeds 18 per 1,ooo per annum. At Over Darwen only one manhole at the highest point is ventilated. We have given these returns in some detail, affording as they do some Of the latest information as to these places.-Sanitary Record. PEROXIDE OF HYDROGEN, FOR THE PREVENTION OF THE sPREAD OF SCARLET FEVER AND SMALL-POX. BY JOHN DAY, M.D., OF GEELONG, AUSTRALIA. In October, 1875, by request of the Mayor of Melbourne, I drew up a report which was subsequently published by order of the local Board of Health, on fifty-one cases of scarlet fever which had been treated by me between April, 1873, and April, 1875. These com- prised all the cases of scarlet fever which had come under my charge during that period. They were all treated in a similar manner. Each patient was freely rubbed over the whole surface of the body three times a day with a preparation composed of one part of ethereal solution of peroxide of hydrogen (erronously called ozonic ether) and seven parts pure lard, well incorporated with the aid of heat. The inunctions were continued for about three weeks. No other remedies were prescribed, except in a few cases where the throat symptoms were severe, when a gargle composed of two drachms of Ozonic ether in eight ounces of water, was ordered to be used every second hour. These fifty-one cases occurred in thirty-eight different houses, and in four houises only was there any extension of the disease. There were no deaths. Since the above-named period I have attended sixty-four cases, occurring in fifty different houses, and in three houses",
         "SANITARY JOURNAL. only was there any extension of the disease after I had commenced my treatment. I have been less fortunate, however, in my results, having had six deaths. Peroxide of hydrogen contains a larger amount of oxygen than any other known substance, and moreover, one half of its oxygen is loosely combined and in a highly active condition, ready to combine with any organic matter with which it may be brought in contact ; so that it would appear to be an agent specially suited for the de- struction of the poison-germs of scarlet fever, small-pox and other epidemic diseases. Dr. William Squire, in an excellent paper \" On Sanitary Precautions against the Infectious Eruptive Diseases,\" read before the National Association for the Promotion of Social Science, says-\" It [infection] cannot be carried far in the air, for fresh air oxidates and destroys it, so that for the most subtle disease the in- fecting distance is small.\" Now, the loosely combined atom of oxygen in each molecule of peroxide of hydrogen is infinitely more potent as an oxdiser than the oxygen of the atmosphere ; conse- quently I think it is reasonable to infer that by coating the body of a person suffering from scarlet fever or small-pox-diseases in which most of the poison is eliminated by the skin-with peroxide of hy- drogen in combination with lard, cocoa butter, cold cream, or any other substance which will conveniently retain it, we are reducing the danger of infection to a minimum. I have recently slightly modified my formula for the external application, and now generally prescribe it as follows : Ozonic ether, four drachms ; pure lard, four ounces ; benzoic acid, twenty grains ; otto of roses, four drops ; to be carefully mixed without the aid of heat. The benzoic acid, in addition to its being a powerful antiseptic, possesses the property of allaying cutaneous irritation, a symptom often very distressing to scarlet fever patients. The otto of roses gives an agreeable odour to the preparation. I now also prescribe, throughout the whole course of the disease, a mixture composed of two or three drachms of ozonic ether in a half a pint of water ; the dose ranging from a teaspoonful for a child twelve months old, to a tablespoonful for an adult, to be taken every second hour. This is used for the double purpose of benefiting the throat symptoms, and disinfecting the breath. I have so much faith in the disinfecting properties of peroxide of hydrogen that I recommend all my friends and patients who are in a position to afford it to use freely, that which for want of a better name, I call oxygenated perfumery. It is made by adding ozonic ether, in the proportion of about a drachm to the ounce, to any kind of perfume, according to individual taste. I give the preference either to Rimmel's toilet vinegar or Eau de Cologne. Letters, news- papers, and articles of clothing may be disinfected by sprinkling them over with oxygenated Eau de Cologne, or with any other oxygenated perfume. With regard to any power that peroxide of hydrogen may possess",
         "THE GERM THEORY. 27 of destroying the poison germs of small-pox, I must confess myself to be merely a theorist, for we have not yet had small-pox in its epidemic form in Australia. In 1871 a vessel arrived at Melbourne with small-pox on board, and shortly after the passengers were landed a few cases broke out in different parts of the colony ; but through the energetic measures adopted by Dr. McCrea, our Chief Medical officer, the disease was soon stamped out. At that time, however, it first occurred to me that it might be possible, by a process of oxidation to destroy the poison-germs of small-pox as rapidly as they are given off from the body, and in a paper \" On a Means of Arrest- ing the Spread of Small-pox,\" read before the Medical Society of Victoria, July, 1871, I suggested the use of peroxide of hydrogen for that purpose. From a theoretical point of view it might be supposed that per- oxide of hydrogen would act more powerfully as a disinfectant in small-pox than in scarlet fever, in consequence of the curious pro- perty that pus cells possess of exalting its chemical activity and giving it the oxidising powers of ozone.-Medical limes and Gazette. THE GERM THEORY APPLIED TO THE EXPLANATION OF THE PHENOMENA OF DISEASE. A book upon this subject has been written by Dr. Maclagan, and in reviewing it, the Lancet observes : We must pass over the arguments upon which Dr. Maclagan claims support for the theory of a contagium vivum. They have been ably propounded by Dr. Sanderson, and are familiar to most of our readers. The application of this theory to the actual diseases them- selves is of more extended interest, and it is to this part of the work that we desire especially to call attention. The characters common to all the eruptive fevers, their incubation periods, the febrile state, their characteristic local lesions, definite duration, and the frequency with which immunity is conferred upon the individual from a second attack, are held to be best accounted for on the hypothesis that each fever is represented by its own specific organism, which from the moment of its entrance into the systei to the time at which the first symptoms of the disease appear, is growing and multiplying. That the growth and nutrition of the organsm, which lives parasite-like in the body, requires water and nitrogen, the deprival of which from the body constitutes the chief feature incidental to pyrexia ; that, in accordance with its parasite nature, it seeks and obtains a special nidus for its development in particular regions of the body, and thus gives ise to the \"local lesions \"; that the definite durationi of the disease is consistent with the exhaustion of the material for die sus- tenance of the organism, an exhaustion upon which can also be ex- plained the protection of the individual from further attacks-these are the broad statements upon which are grounded the arguments contained in the work.",
         "28 THE SANITARY JOURNAL. In the simplicity of the germ theory of contagious fevers lies its great merit. Once grant the existence of the living contagium, and it is not difficult to see how the wasting of nitrogenous tissues that occurs in the pyrexia can be explained on the view that the con- tagium itself appropriates the nutriment destined for the repair of the tissues. A like appropriation of water by the contagium accounts for many of the febrile phenomena, as well as for.the decreased elimina- tion of urea sometimes noticed. In like manner it is owing to the activity of the processes by which the living contagium appropriates materials destined for the tissues that the increased activity of the circulation occurs, and, pari passu, the increased body heat. The varied nervous symptoms of fever, rigors, headache, convulsions, coma, \u0026c.-the typhoid state itself-are reduced to the denutritive changes undergone by the nervous centres by the same property of growth at the expense of the tissues that the contagious organism exhibits. HYGIENE OF THE EYES IN CHILDREN. Dr. Galezowiski recently read a paper at the Société Médicale d'Emulation (Union Med. April 7 ; Med. Times \u0026 Gaz., April 14), entitled \" Some consideration concerning the Hygiene of Sight in Children,\" of which the following is an abstract: With respect to children in early infancy the following rules should be observed :--i. The bed of the infant should be so placed that on waking it does not have its face towards the light. It is after sleep that the eyes are most sensitive and delicate, and if the light strikes them at that time it often induces contraction of the internal muscles which may become permanent. In fact, according to Cuignet, the photophobia which in young infants accompanies either hypermetropia or inflammatory affections of the eyes is one of the principle causes of convergent strabismus. 2. When the infant is taken out in the air it should have its face protected from the sun by a blue or green vail, and not-contrary to the usual practice-by a white one. The light which traverses a white vail is very dazzling, and greatly tires the eyes. 3. The nurse of the infant should accustom herself to carry it sometimes on one arm and sometimes on another, for the child is constanty trying to look at its nurse, and rnay insen- sibly acquire the habit of looking only to the left or right, whence may arise strabismus. 4. In choosing nurses we should reject those who have bad eyes or who squint. The disposition to imitation is carried in infants even of the earliest age, to such a height that they may sometipes be seen almost uninterruptedly winking, because their nurse having bad eyes, are obliged to keep them half closed in the li ht of day. The importance of ohserving the hygiene of the eyes is much more important with regird to children going to school or entering",
         "YORKSHIRE ASSOCIATION OF MEDICAL OFFICERS. upon apprenticeship ; and in order that their vision be not prema- turely danaged, it is necessary that the occupations which they are called to should be carried on under the best hygienic conditions, and especially that the school-rooms and workshops be properly lighted. In regard to the illumination of school-rooms, daylight should always come from the left side in relation to the students, and never from the right or the front. This direction of the light is especially favorable for writing, as the hand does not then project its shadow on the copy-book. Benches should not be placed opposite windows, for too muci light is very prejudicial; nor should the classes ever be ranged towards the south, working being very fatiguing with the sun on the windows. Photographers and painters so well under- stand the inconvenience of this, that they always choose their studios with a northern or eastern aspect. YORKSHIRE ASSOCIATION OF MEDICAL OFFICERS. At the recent annual conference of the Yorkshire Association of Medical Officers of Health some interesting papers were read. Dr. Britton stated that in a village near to Halifax, a child, living in a cottage at the top of a steep hill, was taken ill, the diagnosis being that she was suffering from acute tuberculosis. She died, and ber funeral was attended by some children, amongst whom, eighteen days afterwards, typhoid fever broke out. Dr. Britton was then called in, and he advised that the excreta from these fever patients should be buried. Instead, however of this being done, it was sim- ply emptied over a wall into a field about 120 yards from the village. Half way down the hill was a small open pool of water out of which cattle drank, and the overflow from which ran into a well which sup- plied half the village with water. At the time when this was done the weather was very dry, but shortly afterwards a great rain came down which washed the dry excreta into the pool, from whence it was carried on into the well which supplied half the village. On June 30-six days after the rain-two cases of typhoid fever broke out, and within a week there were twelve cases, and the number was ultimately increased to thirty-nine, out of which were five deaths. Al these thirty-nine cases could be directly traced to the first twelve. This history showed the absolute necessity of a little education on the part of the public. Dr. Goldie confined himself to the statistical evidences of deaths caused by preventable diseases during the last ten years. For the purpose of comparison, he divided the ten years into two equal periods. The statistics referring to scarlatina went far to prove that scarlatina seems to possess some inherent quality in its epidemic character which resuits in an epidemic wave, enlarging for three years as it rolis on to exhaust itself; then comes a period of rest or de-",
         "THE SANITARY JOURNAL. crease for two years, and so on repeating its supremacy. It was well known to medical officers of health that sickly children were found in public and private schools, and he was of opinion that the unmanageable character of the late scarlet fever epidemics was largely dependent upon this mode of spreading it. A single infected child in a large congregation of school children would prove a most dan- gerous coipanion. Scarlet fever had a peculiar advantage of infect- ing school children-that is, that the favourite age of attack is exactly the school-going age ; and this is one reason why we find it spreading from schools, and a reason why it is far more intractible than some other of the zymotics-say small-pox, for exaniple. Then again it is a disease (an exanthema) not always diagnosed by the rash; some of the worst cases are those which either never show a rash, or, if they do, it is for so few hours that neither the parents nor the school-teachers can detect persons who are actually suffering from it. Hence children are admitted to schools infected. Dr. Parsons read a paper \" On the Reduction of Mortality effected by Sanitary Improvements in Selby.\" By the provision of efficient sewerage and a pure water-supply, and other sanitary improvements, the average annual death-rate of Selby had in thirty years been re- duced fron 29·3 to 21 per 1,ooo. The scavenging had of late been carried out by the Local Board with their own carts and men with great success, the proceeds of the sale of manure leaving a small balance in hand after the payment of working expenses. THE CRUSADE AGAINST DRUNKENNESS. There can be no doubt that the efforts now being made by all classes in the country to repress what we fear must be called our national vice are as earnest as they are wide-spread. There is one aspect of the question, however, which has hitherto received but slight attention, although worthy of much. It is necessary, so it seems to us, to teach people not only what not to drink, but what they may drink and ought to drink. A religious missionary not only tries to wean the savage from the barbarous superstitions be- queathed to him by his ancestors, but offers him something better in exchange. The missionaries of temperance in this country have hitherto con- tented themselves by preaching \" Thou shalt not drink alcohol,\" and with this exhortation to a negation they have rested content. Surely there is mtch to be done in a positive way, and our belief is that more good will be effected by alluring the public towards pleas- ant and wholesome non-alcoholic beverages than by merely inveigh- ing against the beverages which exist. Why should not coffee, the very prince of all beverages, be as good in England as in France? The Government and the public are too prone, we think, to look upon a \"public house \" only as a",
         "TYPHOID FEVER AND DRINKING-WATER. 31 place for the sale of intoxicating drinks, and too little is done to en- courage publicans to deal in non-alcoholic drinks, although we be- lieve the profit arising from the sale of the latter to be scarcely less than that which belongs to the ordinary \" liquor traffic.\" Would it not, for example, be a good plan to allow the public-houses in Ire- land and Scotland to be open on a Sunday for the sale of non-intoxi- cating drinks ? In this way, perhaps, the publicans would learn that their trade profits are not limited to alcohol, and the public would be tempted during their Sunday rambles to learn a lesson which might serve them on a week-day too. It has been the custom in country districts to offer a small prize occasionally to the woman who can produce the best loaf of bread or the best sample of potatoes boiled ready for the table, but we have never yet heard of a prize for the best cup of coffee, and we throw this out as a hint to country gentlemen interested in the temperance cause. When the labouring classes can procure a decent cup of tea or coffee with the same facility that they can now get a decent glass of beer, we may expect to see a genuine growth of temperate habits, and the temperance agitators must bear in mind that it is not only necessary to take away our beer, but stili more necessary to give us Something in return.-Lancet. TYPHOID FEVER AND DRINKING-WATER. Julius A. Post, M. D., Rochester, N. Y., sends to the N. Y. Medical Record the history of an outbreak of typhoid, of which the following is an abstract :-Some time during the early part of Sep- tember last it was noticed that typhoid fever was confined to a par- ticular part of the city (Rochester). The Board of Health took the natter in hand, and proceeded to investigate, with the following results : Most of the persons who were sick used water from a well which was located at a four-corners, and situated directly in front of a grocery and lager-bier saloon. This well was a famous watering- place for farmers and teamsters, who allowed their teams to stand near the well. In this way the well received washings, from small cesspools of urine, manure, and filth, which had accumulated around it. The Board of Health caused the well to be closed. This action caused much excitement among those who used the water. Prof. Lat- timore, of Rochester University, analyzed some of the water. His report showed nothing which would be injurious to health. The Board of Health determined to make a house-to-house inspection, as it was evident that science and hygienic laws were at variance sonewhere. Each house in the neighborhood was visited, as far as any persons could be found who used the water. The resuits of ispection were as follows: There were forty families who used the",
         "THE SANITARY JOURNAL. water from this well; these forty families contained two hundred and ninteen persons; in these forty families there had been, during the past season, twenty-three cases of typhoid fever, and one case of consumption-in all, tweny-four cases of sickness. In the district inspected there were forty-seven families, who used water from wells in their own or their neighbors' yards ; these forty-seven families contained two hundred and seventy-one persons ; in these forty- seven families there had been, during the past season, one case of dysentery, two of typhoid, one of pneumonia, one of whooping- cough, one of disease of the kidneys, and two sick for a few days, but did not call a physician-in all, eight cases of sickness. Alter closing the well there were no more cases of typhoid in that neigh- borhood than in any other part of the city. SANITATION IN NORWAY.-Though so much has been done in England in sanitary matters, Norway is not behind. The Lancet says : Unless public health organization and legislation soon enter on a new phase here, we shall before long be left far behind by our continental neighbours in matters appertaining to sanitation. We have received a copy of the first of a new series of weekly returns for the city of Christiania, which bears unmistakeable evidence that the capital of Norway is considerably in advance of the capital of England in the organization of its public hygiene. Chris- tiania is a city with an estimated population not exceeding 79,000 persons. The weekly return in question records, however, the num- ber of living and still-births, distinguishing the legitimate and illegiti- mate, and, as regards the deaths, shows the ages of the deceased in eight groups, and the diseases under sixteen headings. Beyond this the return records the number of new cases of epidemic disease reported by the medical practitioners during the week, and a note appended to these figures states that it is compulsory upon a medi- cal practitioner to report to a sanitary authority all cases of infectious diseases coming under his notice. GLAss-WOOL.-A French journal states that M. Limousin laid betore the Paris Therapeutical Society a specimen of \"glass-wool,\" or Glaswolle, which is much used in Germany, and especially in Austria, for the purpose ot filtration, in laboratories. It exactly resembles wadding, but is a little more silky, and slightly crepitates when held near the ear. Bohemian glass is the only kind from which it can be produced, being drawn out, at the moment of fusion into threads of an extreme tenuity. Under the microscope these fibrilkæ are as delicate as those of cotton, and quite as supple. The Glaswolle neither produces any alteration in the filtered substances, nor does it undergo any alteration from them. It may be also con- veniently used for painting parts with chromic acid, nitrate of silver tincture of iodine, etc.-Med. \u0026 Sur. Rdport.",
         "RAW MEAT DIET. THE PARIs ATMOSPHERIC ORGANISMS.-The Paris Municipality recently established at the Meteorological Observatory at Montsouris a service, with the object of investigating the conditions of the clima- tology in relation to hygiene in different parts of the metropolis, com- prising among other things the microscopical examination of the or- ganic dust held in suspension in the air. The service, which since January 1, has been in the hands of one of the most distinguished micrographists, M. Miquel, has already yielded some important re- sults, which show that the almosphere of Paris is loaded with micro- SCopic organisms, the proportions of which vary greatly in the differ- ent quarters-the more healthy parts of the town, as the Park of Montsouris, containing the fewest. The soil of Paris also containing a notable number, and they are found to abound in houses undergo- ing demolition for making new streets. An epidemic of typhoid having caused the evacuation of the barracks at Château d'Eau, M. Miquel detected in the air collected from the rooms of these multi- tudes of alge, vibriones, bacteria, monads, etc., and this organic dust mixed with food and drink may very well have contributed to the production and extension of the epidemic.- Union Méd., Feb. i. THE DURATION OF LIFE.-Dr. William Farr, F. R.S., in his letter to the Registrar-General on the moi tality in England and Wales dur- ing the ten years 1861-70, states that the annual mortality in the city of London was at the rate of 8o per 00o in the later half of the seven- teenth century, and 50 in the eighteenth century, against 24 in the present day. This implies that the mean duration of life in London, was more than twelve in the seventeenth century, was about twenty in the eighteenth century, whereas it is now about forty years. The mean duration of life depends upon the death rate at various ages, which show the widest range in different parts of the country, depen- dant upon their sanitary condition--Med. \u0026 Surg. Reporter. DANGER OF RAW MEAT DIET.-Dr. Brochard, who has done so much in France for improvementlin the hygienic treatment of infants in his Almanach Illustré laljeune Mere cautions mothers against the great abuse of raw meat which now takes place in France in the treatment of the ailments of infancy; and to which he attributed the great increase of verminous disease, and especially tænia. As long as the child has no teeth, good cow's milk, mixed or alternating with broth, forms the best diet; and when meat is commenced it should always be well cooked. If good milk is not procurable, the Swiss condensed milk, diluted with tepid water, will succeed well.-Revue Med., Feb. 5. THE MATHEMATICS OF RHEUMATISM.-An English observer, Mr. Mackereath, bas found that rheumatism occurs when the barometer and hygrometer show great changes; and that by multiplying the norning barometer b'y the difference between the wet and dry bulbs in the morning, by doing the same with the evening records, and",
         "THE SANITARY JOURNAL. subtracting the one from the other, he would get a result which when varying greatly from day to day, would indicate when rheumatism would prevail ; and when the numbers were nearly the same from day to day, rheumatism would disappear.-Md. \u0026 Surg. Rerorter. ON PREVENTING INFANTILE DEATHS. To the Editor of the SANITARY JOURNAL. DEAR EDIToR,-If you would not think it presumption in me, I should like to say a few words to you about something which bas been on my mind for months, and which likely enough you and others have thought of, but to which I have not observed that any attempt bas been made to draw public attention. When I think of the very large number of little children who die every year in Toronto, and of the very much larger number who suffer days, and often weeks from sickness, which is so very trying to the poor little ones, and expensive to their parents, and think of the Dispensaries for providing medicine for curing the sick, and of the great and noble efforts made by ladies to establish and carry on successfully the Hospital for Sick Children, the dearest (I don't mean expensive) institution I know of; and then think, on the other hand, of the old familiar saying, in the truth of which every one seems to believe, that \" Prevention is better than Cure,\" and think again that so far as I can learn, not anything is being done to pre- vent so appalling a number of deaths, and so much trying and troublesome sickness, for 1 hear many say a large proportion of both might be prevented, I am completely at a loss to account for what is certainly to me, in my girlish simplicity, a most unaccountable inconsistency. I am told that in some other cities, as Philadelphia, there are societies for the prevention of cruelty to young children, and sani- tary missions for making efforts to prevent sickness and death, and places provided in the delightful country, where the children of the poor may be sent during the very warm weather, at which time the greatest number die in the city. And it is, Sir, to these I wish to draw attention, and to ask and beg that something may be done in Toronto in this way, to prevent so very many little ones dying, which could not have been the will of our Creator, although He bas permitted it. Will you please, sir, try and stir up some one to \"lead off,\" when it seems to me many other might follow, and much might be done here as well as in other cities. Yours, \u0026c., April, 21St, 1877. A SCHOOL GIRL.",
         "THE SANITARY JOURNAL. Communications solicited from Medical Men and others on all subjects pertaining to Public Health. VOL. Ill. TORONTO, MAY 1, 1877. No. i. ON THE RELATIONS OF MEDICAL MEN TO THE PUBLIC. In no subject effecting the profession of medicine do we feel a deeper interest than in the one above named. Because we believe that no other is of greater general importance ; and that the well- being of the public depends very largely upon it. We have often quoted the words of Sir William Jenner, a physician whom every medical man must highly respect and esteem, that \" to prevent disease is the most important aim of the science and art of medicine.\" They cannot be too often repeated. Is there a medical man who will say that such should not be \" the most important aim \" of the medical science and art, yet, how many practice in accordance with these words ? The entire practice, almost the entire teaching of the schools, is in curing disease, instead of preventing it, the highest aim. The physician is universally associated in the public mind with dis- ease and nauseous doses, rather than with health,-the goddess Hygiea. This ought not to be. He stands as it were on the wrong side of that turning point between health and disease. The science of cure is but a small and a secondary part of the whole science of medicine. A few recognize this fact to the full, and many now place less faith than formerly in the science of cure, as at present understood, and in drug remedies. Dr. Samuel Wilks, F. R. S., \u0026c., Physician and Lecturer on Medi- cine, Guy's Hospital, London, in a paper read before the National Health Society, in June of last year, observed :-' The idea of cure lies at the bottom of all quack systems. They are all alike in this, that they do nothing else, and profess to do nothing else, than cure existing ailments.'' 'Now, as the tendency to quackery is in propor- tion to ignorance, it is clear that the idea of ' cure' is low-born and common-place, whereas the sentiment expressed in the motto, Pre- vention is better than cure, is significant of a higher intellectual ad- vancement.' Many physicians, however, rise little above the",
         "THE SANITARY JOURNAL. pharmacopœia in the.ir daily or semi-daily rounds, and prescribe long lists of drugs, the effects of which upon the system are too far from being even fairly understood. We hope to see the time when it will be the rule, instead of the exception, as now, for physicians to attend patients and families more or less when in health, being employed for this purpose by the year, and endeavor to keep them well. We have long advocated this method of practice, and though a long time may elapse before it is generally adopted, it is certain to be sooner or later. It was with no small degree of surprise that we observed in a re- cent number of the Paafc Medical and Surgical 'fournal, that at a pieeting of the San Francisco Medical Society, one of the members introduced a series of most illiberal resolutions condemnatory of this sort of practice, and proposing to exclude those who engaged in it from membership and professional association. Though many seemingly approved of the measure, it was urged that it would drive off many members and prevent others entering, and it was concluded, wisely no doubt, to defer the question till after the meeting of the State Medical Society. Quite different from this seems to be the feeling in England. At a meeting of the Birmingham and Midland Association of Medi- cal Officers of Health, held early, this year in Birmingham, Dr. Wilson, the President, delivered an address on the Relations of General Medical Practice to Preventive Medicine. He dwelt on the vast saving of life and health which may be achieved by well- directed efforts to prevent disease, much of which medicine is powerless to cure. He described how, in his opinion, curative and preventive medicine should be made to go hand in hand for the- promotion of the public health. All that is required in bringing about the change in practice, he contended, is that the ordinary medical attendant should be paid by an annual stipend, and not ac- cording to the number of visits he may make during illness. The advantages of this system were thus enumerated : In the first place, the practioner would advise his patients concerning the sanitary condition of their houses ; in the second place, he would advise them against any bad habits or agaimst errors in diet and clothing injurious to health ; thirdly, he would make it his duty to call from time to time without being sent for, and would thus be able to de- tect \" ailments in the bud \"; and, lastly, he would take every need- ful precautionary measure in cases of infectious disease, and would.",
         "OMNIVOROUS MAN. 37 have no scruples in giving timely information to the officers of the sanitary aethorities. The Lancet in referring to this system says, it has much theoretically to recommend it, but we do not think there is any likelihood of its speedy adoption. Th\u0026 British public would require a good deal of preparatory education before the \" merits of the system\" could be made apparent to and be appreciated by them. OMNIVOROUS MAN. On several occasions we have been asked for our opinion on Vegetarianijsm. It is one of those subjects upon which one need not hesitate to give an opinion. It seems hardly to admit of discussion, and it is somewhat strange that there should be two opinions upon it. For those few vegetarians-those who strongly advocate the doctrine, that man for his perfect corporeal and mental development ought to subsist entirely on the direct products of the vegetable king- dom, we have the utmost respect and for their sincerity of purpose, but we cannot fully comprehend why they are vegetarians, in this sense. It seems probable that primeval man did subsist upon vege- table foods alone, and, when in his primitive state, when but little effort, physical or mental, was demanded of him, even fruits may have been sufficient for his sus tenance. And doubtless most, if not all men may now, especially in warm climates, live in good health and to advanced ag'e, and perform a large amount of labor, upon an ,exclusively vegetable diet; and a few who, from heredity or habit, have become subjects of diseased or disordered (if there is a dis- tinction) functions, may be benefited or best served by such a diet. Notwithstanding all this, or anythmig more which has been eloquent ly and ably brought forward in advocacy of such a mode of living, the experience of centuries proves that, in temperate climates, at least, those nations who use foods fron both kingdoms, properly proportioned, manifest the highes t degree of vigor, physically and in- tellectu ally ; while those individuals who have attained the greatest age have been in the habit of consuming a moderate quantity of flesh. Again, comparative anatomy affords very strong evidence that man was created, and is, an omnivorous animal. The formation of his teeth, and the extent of his alimentary canal, which is less than that of vegetable feeders and greater than that of the carnivora, show this and one would suppose would place the matter beyond controversy.",
         "THE SANITARY JOURNAL. Furthermore, taste and appetite are instinctive provisions for the se- lection of food; and the taste for animal food in young children is almost universal. The flesh of animals, too, is as a rule, more readily digested and assimilated than vegetable foods ; it is, as it were, vege- table food already once digested. Less force is therefore required for the digestion of flesh ; and the conservation of force is of the first importance in the economy of the human body. Finally, man being at the head of all created things, all other things created seem de- signed for his use,-for aiding in, and contributing to, his physical and intellectual development, improvement and progress. It is not easy to conceive of any other purpose for which many animals could have been designed, except as food for men. Man, at the head of created beings, seems at liberty to use for his food, anything his appetite guided by his reason may select. Va- riety is almost unlimited, boundless. But the great trouble, the evil effects, seem to arise not from the sort of foods, but from the quality, and the quantity consumed. ' Made strong to stand, But free to fall,' Man too often permits his appetite and taste to get the better of his reason, and to indulge in more than is for his good. This is the case as well with foods as with drinks. It is most probable that in those cases where a change from an animal to a vegetable diet has been found beneficial, too much, too large a proportion of anima food had been eaten. This being a more concentrated food, no, doubt the temptation to excess in it is greater than in vegetable food, but this cannot be fairly used as an argument against the moderate· use of an agreeable, nutritious, easily digested article of diet. It appears most vegetarians use milk, which is properly an animal food, certainly not a vegetable, and without which their diet would probably sometimes prove defective. THE USE OF TOBACCO. Against the use of this repulsive poisonous weed, which can hardly lay claim to a single virtue, we have from the first number of this JOURNAL repeatedly given space to articles. We have been tempted to reflect that much which is now being urged by \" tem- perance\" people against alcoholic beverages might also be urged against tobacco. They are twin evils which ought not to be separ-",
         "THE USE OF TOBACCO. 39 ated by acts of Parliament-casting out the one and retaining the other; with this exception, some forms of alcoholic liquors can not be safely dispensed with, while not anything approaching this can be said of tobacco. Excepting the moral or mental effects of alcohol-the tendency its use has to stimulate to crime, it is pro- bable the effects of tobacco at the present time (upon the physical man) are more injurious than those of alcohol. About two years ago, a committee of the Virginia State Medical Society on tobacco, reported, among other things, that its use was \" more revolting and obnoxious to the natural physical man than the use of alcohol.\" Moreover, by reason of the relaxing and debilitating effects of to- bacco, the use of which by the young frequently trecedes the use of sPirits, the temptation to indulge in the latter is increased, while the power to resist the temptation to excess in them is greatly lessened ; and hence, the use of tobacco directly leads to and favors intem- perance. We have no doubt whatever of this. It is well known that the use of tobacco diminishes the vital force. The boating- men who train for the races at Oxford and Cambridge are not allowed to indulge in its use Sir Benjamin Brodie denounced the use of it as the most enervating of all modern practices. Mr. Solly, an eminent surgeon of St. Thomas' Hospital, whom we have fre- quently quoted before, and who gives much attention to the tobacco question, wrote: \"I know no single vice which does so much harm as smoking. It soothes the excited nervous system at first, to render it more irritable andfeeble in the end.\" Its depressing effect upon the natural recuperative powers are well-known in hospital practice, and that it is hardly possible to cure some diseases while the habit of smoking is continued by the patients. Those waging war against alcohol are not striking at the root of the evil. The Canada Lancet for February, we are pleased to see, speaks Out strongly against tobacco, and calls upon medical men to use their influence against its use. It says : \" the smallest amount of consideration, or investigation of the effects of tobacco on the human System, Must have convinced them of its seriously detri- mental character.\" Among the numerous and varied effects of its use, it enumerates the following :-giddiness, nausea, vonmiting dys- pepsia, heartburn, vitiated taste in the mouth, loose bowels, diseased liver, distorted vision, headache, diseased brain and spinal cord, congestion of the brain, apoplexy, palsy, mania, loss of memory, amaurosis, deafness, nervousness, emasculation, timidity, and cowardice.",
         "THE SANITARY JOURNAL. THE REPORT ON VITAL STATISTICS AND PUBLIC HEALTH. Dr. Brouse has favored us with a copy of the Report of the Select Committee of the House of Commons, to enquire into the expedi- ency of legislating in the matter of Sanitary Reform. Dr. Brouse will not allow this matter to drop, we feel sure, until something use- ful to the country comes of it, but how long it will be necessary for him to keep agitating it is quite uncertian. The Report sets forth the great necessity for legislation on sanitary matters, if we are to make any progress against the continual inroads of epidemics and preventable diseases, and also sets forth the benefits that have re- sulted in other countries by enforcing sanitary laws. The Report says :-\" A careful legislation on the part of the Government would place the population of the Dominion in a far more secure condition than they are now in. A striking illustration of this fact was the ter- rible epidemic in the North- West, which ravaged the Icelandic pop- ulation and then spread to the Indians and other inhabitants of that territory, thus showing the want of a proper means of arresting and stamping out contagious diseases. Here the Government found the outlay attendant upon sending medical and other aid far greater than if a regular system of sanitary law had been adopted, besides terrible /oss of hfe, which might otherwise have been avoided. Were a greater in- terest shown by the Government in the sanitary condition of the Do- minion, and did a more perfect code of laws exist regarding public health the population of the country would greatly increase and Im- migration would be greatly facilitated. This has been peculiarly shown some years ago in the State of Colorado. That State by ad- dressing circulars to all the leading medical men of the UnitedStates and Canada, embodying a set of sanitary queries, and showing the comparative advantage of that territory for healthy settlement, suc- ceeded in attracting settlers from all parts of the country, including Canada, peopeling their territory to the detriment and cost of ours.\" It further urges that, as an apparent conflict of jurisdiction exists between the Provincial Government and that of the Dominion as re- gards legislation in this matter, some arrangement should be speedily effected in the matter of jurisdiction. This last is just what we drew attention to and urged exactly two years ago, in this JOURNAL. In view of this rather 'pressing ' nature of the report thus far, the last sentence of it certainly reads rather strangely :-\"The Committee further urge that the Government, as soon as thepublic interest will ai- low, should legislate for the health of the people.\" Could they not have urged, especially after what had just before been stated, that the public interest would not allow of legislation for the health of the people being deferred from session to session while most other countries have been grappling with the matter for years to the great saving of life. We regret that this was not put in a much stronger way.",
         "STATE BOARD OF HEALTH. MICHIGAN STATE BOARD OF HEALTH. This Active Board must be conferring vast benefits upon the State. At the regular Quarterly Meeting held in Lansing, on the 9th January, a paper entitled \" The Location of Healthy Homes,\" was read by Dr. Henry F. Lyster, of Detroit. The con- dition of the homes of the people, he said, may be regarded as an index of their civilization. A complete, healthful, and beautiful home indicates health, intelligence and refinement in its occupant. He dwelt upon the various insanitary conditions most common to our modern homes. Those most strongly touched upon were, de- fective disposai of sewage, unwholesomeness of water-supply, un- favorableness of location, too complete exclusion of sun-liglit and air, resulting from excessive shade, lack of proper drainage, etc. Prof. R. C. Kedzie reported on Illuminating Oils. He thinks the people of Michigan are to be congratulated upon the present con- dition of their illuminating oils so far as exemption from injury to life and property are concerned. The public prints are not now filled with recitals of deplorable accidents from the use of kerosene. Dr. H. O. Hitchcock, submitted a report asking that a commis- sion be appointed to investigate and report in two years concerning the influence of the liquor trafic upon the life and health of the peo- ple of the State, to ascertain, as far as possible, the value to the State of the traffic in alcoholic drinks, and the losses to the State fairly chargeable to the use of intoxicants, \u0026c., \u0026c. Rev. Mr. Brigham reported upon the sanitary influence of the Eucalybptus Globulus, or blue gum tree. Dr. Lyster said the trees were growing in Detroit, that by being cut back they had become somewhat hardened. He recounted instances in which the tree had been planted in Africa where they had a remarkably beneficial sanitary influence. Dr. O. Marshall presented a communication on Opium and Mor- phine eating. He gave facts concerning twenty-five cases which had Come under his observation. He thought the evil was increasing and that measures should be taken not only to assist those who are already victims, but to prevent others from acquiring the habit. He especially urged the prohibition of the sale of soothing syrups, cordials and anodynes, which create in the infant a predisposition to the opium habit in the adult. THE ANNUAL MEETING of the Board was held April 1o, 1877. Rev. C. H. Brigham read an essay on \" Recreations in their In- fluence on Health.\" He said \" that the best recreation is that which gives the most exhilaration of mind and body, with the greatest economy of time and strength, and the least danger to life and limb.\" Dr. Barker submitted a proposed circular of information on the Restriction and Prevention of Scarlet Fever.\" It embodied care- fully framed rules for the prevention of this dreaded disease, and directions for different methods of disinfection, \u0026c. The subject",
         "THE SANITARY JOURNAL. had been a year under consideration. The document was adopted and 2o,ooo copies were ordered to be printed in pamphlet form, for distribution in the State. The subject of illuminating oils was discussed, and there was a unanimous feeling that in the interests of public safety, the present flash test of 140° Fahrenheit, should be maintained. The Secretary submitted his quarterly report. About 1,6oo copies of the last Annual Report had been distributed during the quarter. DRY CLOSETS.-In reference to the use of these the Sanitary Re- cord says :-\" At one time the term dry closets was only applied to earth closets, now it has come to be the designation of almost every kind of closet in which the receptacle is movable, or in which an at- tempt is made at deodorisation, disinfection, absorption, or separa- tion. The passing of the Rivers Pollution Bill has given dry closets a fresh impetus, and now we find sanitary authorities pretty general- ly considering whether they cannot escape their sewage difficulties by falling back upon some one or other of the numerous so-called dry systems of conservancy. This feeling is not confined, as might be expected, to small towns and rural populations. but towns of the size and importance of Manchester, Birmingham, Salford, Halifax,, Rochdale, etc., are busily engaged in extending the use of dry closets and in opposing by all legal and moral means in their power in the further introduction of water-closets. It seems, indeed, as though the old midden, at all events was doomed, and that is a consummation devoutly wished for by all sanitarians, but. how far the sewage problem or difficulty will be solved or assisted remains to be seen. INFANT DIET. In the course of an inquest recently held at Plumstead on the body of a child aged four months, it transpired that the deceased, who had been put out to nurse, had been mainly fed on corn flour and water. On such a diet the child would sooner or later perish. Corn flour contains little else than the granules of starch, and, although producing a certain amount of heat-producing force, is in no sense a flesh-former. When employed it should always be given with milk, as mixed with water only it is useless. When an infant is deprived of its natural supply of milk, its food should be as- similated as much as possible to that provided by a mother. Hence on the excellent substitute found in the cow's milk (always diluted with water be it understood) the most delicate offspring can be suc- cessfully reared. Generally speaking, the diet should be exclusively a milk one until the'age of one year is reached, and for some time after that broth or beef-tea should be very sparingly given. Meat and",
         "ANNOTATIONS. 43 Potatoes should be carefully eschewed, and we are convinced that the reckless use of these is responsible for many of the formidable evils which beset childhood. THE TWIN SANITARY DOOR.-The Sanitary Record draws atten- tion to an invention designed to achieve the isolation of water-closets and apartments in dwelling-houses, and the other buildings from the other parts of them so far as regards air, effluvium, and sound by mfeans of twin doors. Suitable mechanism is introduced in such a mTanner that these doors will close or open simultaneously. When such doors are closed an automatic contrivance immediately opens a valve and allows a free circulation of air to pass-by means of a suitable channel provided for that purpose-from the outside of the building between the doors. In the case of infected air, or germs of disease being supposed to be present, the valve is employed for the admission of fumes, vapours, or gases of a disinfecting nature. The doors thus employed are kept at a suitable distance from each other, and the inlet valves are inserted in the upright linings or jambs, an outlet ventilator being placed in the upper part under the lintel In order to create the requisite current of air. BLUE GLASS. It was said by.DeMorgan that certain men appear occasionally to play the part of \" foolometers,\" i.e., to measure the number and quality of the fools in society. Pleasonton may be regarded as play- 1ng that part about the present time. Numerous and marvellous cures, however, are reported by the press as having been effected by blue-glass. One is mentioned worthy of note. It is that of a young lady who had suffered for .a long time from a wart on her nose. Her society was, consequently, little courted, and her admirers were few ; but she tried blue glass, and thanks to that wonderful discovery the wart has disappeared, and she has had a dozen offers of marriage. Under the spectroscope, sunlight through blue glass is nothing more than sunlight diminished 90 Per cent. in intensity. The Academy of Science of Kentucky reported that blue light \"increases the anount of carbon dioxide produced in animals,\" and says that blue light \"riay possibly prove useful in some diseases and injurious in others., Dr. Javal, of Paris, remarking on the general preference noW existmng for blue glasses over green as protectives, observed that It was not certain whether particular colors are deleterous, and hether there is any advantage in extinguishing certain colored rays. The arguments, he says, on which the use of blue glasses are founded are valueless, and the whole question needs to be reconsidered. DR. WM. OSLER, Professor of Physiology, McGill University, Montreal, has been the recipient of a complimentary address, and a Purse of $100, to aid him in scientific research, as a token of the high esteern in which he is held by his colleagues and students.",
         "44 THE SANITARY JOURNAL. CONSUMPTION A PREVENTABLE DISEASE.-In the first Annual Report of the State Board of Health of Colorado, Dr. Bancroft, President, advances the suggestion that phthisis properly belongs to the class of \" filth diseases,\" and can be controlled and prevented by attention to cleanliness. He supports this view by the fact that tubercle is inoculable, and may enter the body through con- taminated drinking water. In Colorada phthisis was practically un- known until cases from other States brought it there. Now it is found among the native population. This view is strongly supported by the inquiries of Drs. Greenlow, Parkes, Farry, Morgan, and others; especially that the disease is connected in some way with decomposing, purifying organic matter, particularly of that of respiration. The great physician Bandeloque regards this last as the sole cause. And Sir James Clarke regarded the respiration of a deterioated atmosphere as one of the most powerfnl causes of this disease. A late member of the Medical and .Surgical Reporter says too, this view receives very strong support from the history of health resorts in Europe. The time was when phthisis was practically unknown in Maderia, in Naples, in Malta, along the Rivera and the Upper Nile. Consumptives flocked there in crowds, and now in all those districts the native population succumb to the disease in quite as large proportion as elsewhese. The practical lesson is that equal care about disinfection and sanita- tion should be exercised in regard to consumption, as in regard to typhoid or scarlet fever. MILK AGAIN.-The 'milk of human kindness' is sometimes spoken of. In Toronto they get the milk of human trickery, it would seem, according to the report of the public analyst. But possibly the cows have 'water on the brain,' as a milkman pleaded before a magistrate recently in England. The plea did not serve him there, however, and he was heavily fined. Hardly a week passes that we do not observe in our English exchanges notice of one or more outbreaks of typhoid traced directly and unmistakeably to the milk supply. In Canada, having no inspection, or sanitary machin- ery whereby such outbreaks or cases of disease can be traced, the people are in blissful ignorance of the number of cases of disease and death, the germs of which are secretly conveyed to them in the milk- can, possibly from some barnyard pump. When shall there be a system of milk and cow inspection here to afford the people some pro- tection? ALCOHOL AND COLD.-At a meeting given to the Good Templars of the English Arctic expedition, Mr. William Malley, of the Alert, in relating his experiences, said that among the few men who escaped scurvy, and did any sledging worthy of notice, were four teetotallers, who enjoyed perfect immunity from all sickness, establishing beyond the shadow of doubt that the intense cold of the Polar regions could be well endured without the aid of stimulants.",
         "ANNOTATIONS. 45 BOARDS OF HEALTH.-The committee appointed by the Ameri- can Medical Association for the State of West Virginia, for the pur- Pose, has memorialized the Legislature to create a State Board of Health. The petition states, twelve States have seen the wisdom of such Boards, and are now reaping the golden fruits matured from Such efforts. That we may keep pace with our sister States, we mfust call to our aid sanitary knowledge. Competent men, members of Legislatures, who have been as such, desirous of great economy in disbursing the public funds, have, from their own experience, acknowledged that funds so voted by the State authorities for such support have been more than repaid by the reforms brought about in various villages and towns, which reforms have mitigated or prevented diseases previously existing at periods Of the year. AERATED BREAD.-On the important subject of tread, the Sani- tary Record observes: The manufacture of aerated bread has now stood the test of fifteen years' experiment with progressively increas- ing success. Nor is this result to be wondered at when we consider the differences in the process of manufacture. The abomination of the bread-making process, as carried on in ordinary bakehouses, and revealed in reports on the subject, are enough to upset the strongest stomach, and make one wonder that aerated bread is not even more universally used than it is at the present time. Readers of this JOURNAL and others may obtain aerated bread of excellent quality, at Mr. J. Nasmith's, Adelaide St., the only manufacturer of aerated bread in Ontario. To OUR READERS AND FRIENDS.-We again commence our .monthly visits and shall make great efforts to render them interest- ing and instructive. We dislike to talk again of money, but we shall require much of it now to continue the enlarged, improved form of the JOURNAL we have adopted; giving about 50 per cent. more reading matter for the sane money. Two DOLLARS NOW may do as much good as $3 some time hence, and we sincerely hope our friends will not put us to the expense and trouble of sending bills, but will remit without any delay, now, in ad- vance. To those in arrears now, we shall send bills with our next, if they will not be so kind as to save us the trouble by soon remitting the amount, as marked on outsike of cover, first page, above. Please attend to this and oblige ; or, if they would only let us hear fron them by Post Card, fixing a date on which to pay, as a few have done IN THE NEXT NUMBER of the JOURNAL there will be an article on the Public School Houses in Toronto, the Hygienic Experiences of an, Invalid, and on Women's Dress. Some book-notices of books received have been crowded out, but will appear in the next.",
         "THE SANITARY JOURNAL. FOURTH ANNUAL REPORT of the Secretary of the State Board of Health of Michigan. Lansing: George \u0026 Co. t,- This is a volume of nearly 200 pages, full of highly instructive matter, on such subjects as the Achievements of Hygienic Science and Art ; Vaccination ; Criminal Abortion ; Sanitary Improvements in Schools ; Methods of collecting Vital Statistics, \u0026c. About i,6oo copies of the Report have been distributed, which cannot fail to be of great service in educating the people in sanitary matters. THE CANADIAN MONTHLY and National Review. Toronto: Hart \u0026 Rawlinson. The May number of this thoroughly Canadian periodical is before us. It is not too little to say that under its new proprie- tary it seems not to lose in interest ; and we wish it every possible success. The number contains an able article on the \" Evolution of Morality,\" by J. A. Allen; \" Our noblest end is health and vigor of mind and body.\" \" As civilized men we are yet only in the transition stage of our moral life.\"' \" But the process is going on and the result is certain ;\" undoubtedly, though it be a \"thousand millenniums \" hence. We have, among other good things, perhaps most worthy of note, the conclusion, seemingly, of Louisa Murray's 'Swift andThe Women who Loved Him,\"full of interest; and a poem, \"bpring Birds,\" genuine poetry; concluding with Current Events, Reviews, Music and the Drama, worth the price of the Monthly. BELFORD'S MONTHLY MAGAZINE. Toronto: Belford Bros. This new magazine, the sixth number of which we have received, was started with the belief that there was room in the Dominion for a magazine of a \" popular character,\" without being inferior as a literary work. It has been well received, and we hope it will be a success. Its illustrations will compare very favourably with those of English monthlies. The principal story, a serial, receives its name from its principal character, \" Nicholas Minturn,\" a truly original \"hero.\" This is written by J. G. Holland, a well-known and able author, and must command interest. The May number contains a strange, interesting, phychological story, \" The Gerrard Street Mys- tery,\" in which old Toronto characters are the actors. The \" Cur- rent literature\" is interesting and instructive. WE SINCERELY THANK all those who have kindly exchanged journals with us for yet more kindly continuing to send their journals during the suspension of ours. We have received ALL with remark- able regularity, and our friends must not entertain a doubt of our full appreciation of their goodness. ERRATA.-The illustrations on page 3 ought to show a trap between the sewers and yard ventilators. It is mentioned, however, in the text. At page i i for Mosaic Mode read Mosaic Code."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. D Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continu -ý Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison D Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "CANADA HEALTH JOURNAL A Monthly Review and Record of SANITARY PROGRESS [-EDITED BY- Public Health and National Strength and Wealth. For Contents see next page. Subscription Price, $i a year ; Single Copy, io Cents Address \"CANADA HEALTH JOURNAL,\" Ottawa, Can. VOL. XIII. SEPTEMBER, 1891. No. 9. U stric Deral cjnrtnls. HORSFORD.'S ACID PHOSPHATE Unlike all other forms of phosphorus in combination, such as dilute phosphoric acid, glacial phosphoric acid, neutral phosphate of linie, hypophosphites, etc., the phosphates in this product are in solution, and readily assimilative, by the system, and it not only causes no trouble with the digestive organs, but promotes in a marked dexree their healthful action. In certain forms of dyspepsia it acts as a specific. Dr. H. R. MERVILLE, Milwaukee, Wis., says: \"I regard it as valuable in the treatment of gastric derangements affecting digestion.\" Send for descriptive circular. Physicians who wish to test it will be furnished a boule on application, without expense, except express charges. Prcpared under the direction of Prof E. N. I-/oRsioRD, by the Rumford Chemical Works, Providence, R.I BEWARE OF SUBSTITUTES AND IMITATIONS. CAUTION :-Be sure the w\u003c rd \" IIORSFORD'S \" is Pr,,\"\"u, on the label. All others are spurious. Never sold in bulk. M.",
         "Small-pox stamped out by disinfection-a valuable report ... . .. ..... .. The question of Quarantine....... .......... ....... .................. The two lines in Public Health work..... .................... ........ Coercion and Education in Public Health work ........... ... .......... Notes on the Health Officers' Meeting at Trenton. .......... . ...... Notes from Health Officers' Reports, which teach lessons ... .. .......... Miscellaneous Notes and Extracts....................................... Editorial N otes................. ....................................... Notes on Current Literature. .... ... ......................... Johnston's Fluid Beef The Great Strength-giver The most perfect form of Concentrated Nourishment. STIMULATING, STRENGTHENING, INVIGORATING INVALUABLE TO THE SICK. BENEFICIAL TO THE HEALTHY. 14 and 16 Phillip's Square, Montreal. -IMPORTERS AND MANUFACTURERS OF ALL KINDS OF- ANTIBEPTIC DR ESSIN GS, Carbolic, Naphtalin Washed and Sublimated Jute, Carbolic, Iodoform, Eucalyptal, Absorbent S.blimated and Naphtalin Gauze. PEAT, GAMGEE'S AND ANTISEPTIC SPONGES Silk, White and tron-Dyed, Celluloid Oro-Nasal Inhalers. 151 153 155 156 157 158 160 163 166 .",
         "CANADA HEALTH JOURNAL. A iMouataIy RcCO'or of Masita.r Pr\u003eïogress. VOL. XII. SfPTEM lGER, 1891. No. 9 SMA.LL-POX STAMPED OUT BY DIS-INFECTION-A VALUABLE REPOE.T. IGHlT years ago, the London Senitary Record was severe on the CANADA HEALTH JOURNAL because the lat- ter gave expression to views throwing doubt on the great value of vaccination as a preventive of stuall-pox to the exclu- sion of other important measu.res, such as the strictest isolationdisinfection etc. But this being a progressive world, and this a progressive age (this JOURNAL being some- tines only a little ahead of the tinies), the Senitary Record, not now disposed to be far behind, gives in its last month's issue a paper by Conway Scott, C. E., of Bel- fast, showing how a sinall-pox epidemie Vas successfully and quickly suppressed by disinfection, as follows: In the year 1881 a sailor landed in Bel- fast with small-pox; the disease spread over the city, although every effort was nade to stamp it out; the patients were promptly renoved to hospital, the infect- ed bedding and clothing burned, the houses thoroughly disinfected and cleans- ed, and re-vaccination was most exten- sively carried out : but the epidenic spread and lasted for two years, vith about one hundred and twenty deaths, and having caused great alarm and seri- ous loss to trade and commerce. lu the year 1801 a sailor landed in Bel- fast vith small-pox ; the disease spread .partially, but was promptly checlked, and 'the entire epidemic was over in May, hav- ing lasted three months, with twenty- three cases and three deaths. The satis- factory difference in the results of these very similar epidemies was caused by tvo improvenents in the methods of disinfect- ing. (1) In 1881 the disinfectant used was sulphurous acid vapour. In 1891 the Pisinfectant used was carbolic acid vapour. (2) In 1881 personal disinfection was not used. In 1891 personal disinfection was carried out in every case on a most exten- sive scale. Personal disinfection consists in disin- fecting persons, who, although they muay not have an epidenic disease, yet have been in contact with it, and whose cloth- ing must have some disease organisis clinging to then, by means of which epidemie disease is only too often spread. It is best done by sealing up any smnall roonm or chamber, and then filling it with the strongest carbolic acid vapour. The person is then put into this room for ten or fifteen minutes, or until his entire clothing and systen is saturated vith car- bolic vapour. The carbolic vapour is gen- erated by pouring the liquid acid undilut- ed into a small iron vessel heated to near redness ; by using several of these vessels, as nuch as a gallon of the acid can be vaporised in a few hours. HISTORY OF THE CASES. No. 1-On February 4th, three young women were removed to the hospital with sniall-pox froni the house where the sailor boarded; the house and everything in it vas disinfected and cleansed and the bed- ding burned. The sailor and every other person known to have been in contact with the disease were thoroughly disin- fected, and the houses where these people resided and everything in them were also disinfected, and althougb all these people went about their daily business as usual, no case of sickness occurred among them or at their homes, or in their vicinities, or in the works vhere they vere employed. It was afterwards found, however, that a young man who had been in contact vith the disease had escaped notice, and al- il ~:.1 ~",
         "- 152 - though lie did not take the disease, lie passed it on to a young girl who..brought it home and gave it to lier family. No. 2.-On February 14th three younîg women were removed to hospital with siall-pox from a house about a mile fromn No. 1, where the said young girl lived i two more cases were removed on the fol- lowing day, making five cases out of a family consisting in all of about fifteen persons, many of them children. Every- thing in the house was disinfected and the bedding burned, ançi every person about the house was thoroughly disinfect- ed, and although the head of the house went to his work as usual, and the child- ren could not be kept within doors, no f urther cases of the disease occurred in the neighborhood. In fact the carbolic vapour must have exterminated the small-pox organisins, for a few weeks afterwardsra child was bo/ln in the house and neither mother nor child were affect- ed with the disease in any way. Unfor- tunately one of tiese girls, before she knew what was wrong with lier, gave the disease to a police constable, who brouglit it to his barracks and gave it to seven of his comrades. No. 3.-On February 16 and 17 seven constables were removed to hospital with small-pox from this barracks, -that of the Royal Irish Constabulary, and another case wcas removed about ten days after- wards, naking a total of eiglit cases out of forty men belonging to the barracks. This barracks and everything in it was thoroughly disinfected and vacated, and the infected bedding and clothing burned, and every constable about the place was disinfected, and so anxious were they to escape the contagion that they continued to disinfect one another for weeks after- wards. Not another case of the disease occurred among these men, or among any of the men with whom they came in con- tact. Tlius within a few days twelve cases of siall-pox were removed fromn No. 2 and No. 3, a state of affairs that caused great alari, and it was feared that the disease would spread over' the city, but the liberal use of the carbolic vapour aud the personal disinfection completely check- ed the disease, and for all practical pur- poses the epidemic was over. No. 4.-On February 27 a laborer living near the sniall-pox hospital and employed in the vicinity took snall-pox and vas removed to hospital. He iad a wife and flve small children; the house and every- thing in it and the inmates were all dis- infected, and no further case occurred in this house or in the streets adjoining, al- though in former epidemics these streets were perfect hotbeds of the disease. No. 5. -On March 30 a constable froni a barracks near to the small-pox hospital vas removed to hospital with small-pox. Two other constables lad slept in the bed of the patient. The house vas disinfect- ed and the bedding burned as usual. and every constable on the premises w-as thoroughly disinfected, and the barracks vacated. No further cases of the disease occurred among these men, although two of them lad been exposed in a most mark- ed nianner. No. 6.-Ou A pril 4 a man was removed to hospital with snall-pox froin the op- posite end of th'e city. He was a coal heaver, and lad been on a spree for some time previous, and nothing could be as- certained as to the source of infection. He lived in a densely populated and filthy locality; the same course of treatment was adopted. and no further cases of the disease occurred in this neighborhood. No. 7,-On May 2 a young man residing near the snall-pox hospital was removed with small-pox ; a similar course of pro- cedure was adopted, and no further caseb occurred. No. 8.-On May 2 a girl was renoved with siall-pox from a common lodging house in one of the worst portions of the city. The house and everything in it. and all the persons lodging in the house were disinfected, and no further cases of the disease occurred in the city. One case occurred in the hospital, and there was one private case not returned, making a total in all of twenty-three out",
         "- 153 - of which there vere three deaths. It is but right to state that two of these had not been vaccinated. Thus ended an epidemic which under ordinary circumstances might have lasted for years, disorganized business, and cost many valuable lives, but, by the use of carbolic vapour in large quantities, and by disinfecting every person known to have heen in contact with the disease, the epi- demic was stamujped out in three months, with a comnparatively small loss of life. Soine years ago a child in a children's hospital for non-infectious diseases was found to have sinall-pox. This caused alarm, as the disease would be nearly sure to spread among these diseased and delicate children. The child vas remov- ed to hospital, the large ward was filled to suffocation with carbolic vapour, and closed up for twelve hours ; nothing iii this cas e, was burnt, no further :case oc- curred, the disease organisns being des- troyed by the dense fumes of the carbolic vapour. OTHER DISEASES. A short time ago scarlatina broke out in a large public institution ; the services of the sanitary staff were offered, but politely declined. After sixteen cases of scarlatina had been removed to hospital, they were requested to act. The entire establishment was filled with carbolic vapour ; all the disease organisms were poisoned, and no further cases occurred. Exactly similar results have been obtain- ed in typhus fever and diphtheria; in fact, the sane system which stamps out one epidemic disease will be equally ap- plicable to all epidemics, that is, to kill off all the disease organisms as expeditiously as possible. TEE QUESTION OF QUARANTINE. HE views of this journal in respect to quarantines, as long ago indicated, are sonievhat as they are in respect to vaccination, - perhaps rather \" ad- vanced \" for nany sanitarians. To be sure, we are not opposed to all forns of quarantine, nor do weo regard then, as some do, as \"useless measures,\" and a \" survival of ignorance.\" Like vaccination quarantine has served a purpose, and in certain circumstances will continue for a time. yet, to do so ; but all such sanitary cordons are of secondary importance, as compared with other measures, not to bay anything of their great inconvenience and drawbacks in many respects. Absolute clcanliness, including pure air and water, with prompt notification, strict isolation and such measures will do vastly more good than will quarantine, upon which, when adopted, the people are disposed to rely too much, to the neglect of the more important measures ; while, when it fails, as it often does in spite of the utmost care, the infections ot disease will find soil for developruent everywhere, whence then come explosions or sudden outbreaks of epidentiics most difficult of suppression. That most able, advanced and trustworthy periodical, the British Medical Journal, in an editorial on this question in a recent issue (Sept. 12th, inst.) said : The incessant failure of quarantine re- strictions to restrain the diffusion of disease, says that journal. was only one of the points which many years ago led to a reconsideration of this subject in England. \" Foremost amongst the objections to it was the obvious fact that the countries which clung to it most tenaciously wre the most neglected countries from a sani- tary point of view, those in whichi sanitary progress was all but unknown, and those which suffered most fron cholera. And it suon became evident that nations which had to subject themuselves to the disabili- ties and drawbacks of quarantine, were not inclined at the sanie time to spend money on sanitary measurcs. The fact, indeed. of being promised protection against disease by means of quarantine seems a reasoiable objection to incurring the expense of works of sanitation; and the more ignorant the population, the .~ft I LIV",
         "- 154 - more they preferred the risk of the draw- backs of quarantine to the certainty of laving to pay for improved water supply, drainage and removal of town refuse. In this country we learnt by bitter experi- ence that just as these improvements were needed, so did cholera prevail in ovr nidst ; and at last it was decided that quarantine, sanitary cordons. and the like should no longer be inposed ; and that, if the people wished to cope with cholera, tlhey imust do so by neans of a proper sanitary administration.\" Of the results achieved in this direction..., see the testi- mony borne in a recent work by M. Monod, Director of the Departinent of Public Hygiene of France. M. Monod shows how vast lias been the. saving of life in England, not alone from cholera, but also froi a large number of other preventable diseases, in consequence of the action there taken and maintained. He urges \" before everything else that his compatriots should foilow England's exaiple.\" In one sense some progress in the direction here advocated has been made throughout the greater portion of Western Europe. None of the nations now like the imposition of quarantine in their own countries. We have elected to work in the \"direc- tion of removing from our midst the conditions under wlhich alone cholera can diffuse itself,\" the journal continues. It is admitted that \" with the exception of Naples, the Mediterranean ports of quar- antining countiies from east to west re- main as neglected and as prepared to re- ceive cholera as ever.\". ...\"It is a ques- tion whether the cart is to be put before the horse or the reverse. We have elected to put the horse in the shafts, and have given priority to the only trustworthy measure of prevention against cholera.\" The experience of Australia in relation to siall-pox was referred to at the recent Congress, and it was urged that rules whiclh might well apply to England did not, in the sane way. apply to the Austral. asian colony. \" But in the sense just in- dicated there is no material difference be- tween the two countries. Australian re- ports often deplore the lax views enter- tained by the population of that continent as regards vaccination. But so long as the inhabitants are tauglt that, on the suspicion of small-pox whole shiploads of people, healthy or not, will, irrespective of the consequences to them, be detained in quarantine with a view of protecting the colonists,\" why slould these latter subject ihenselves to the inconvenience of adopting other nieasures ? \"Sanitary administration in relation to cholera stands in precisely the saie position as vaccination does towards small-pox, and quarantine measures appiied to one or the other disease constitute a distinct hiind- rance to the adoption of the only true measures of prevention. In Canada, the Federal Governent prides itself, and naturally and properly, on the conpleteness and efficiency of the Cana'dian quarantine system. ' But the Governnent does nothing more in the way of protecting human lire, and we fear the people rely too nuche on the quar- antines, througlh whicli, notwithstanding their well-known efficiency, infections have occasionally passed and ever will pass. We would here asi : Is this a satis- factory, wise or profitable position for the Governient to continue ?-To simply. use and control ineasures-measures, in principle in themselves questionable, often terribly inconvenient and liable to failu:e in the nost critical time-for preventing the entrance of infectious germs into the Dominion, and when the quarantine vigil- ance fails of complete success, and the infectious gain access into one or more of the provinces, to leave the provinces to look after theniselves, whether they vill do so properly or not ? This is an important national question, and mnust soon be taken into serious con sideration by the Federal Government. We contend that its consideration should not be delayed and that much broader preventive measures should soon be pro- vided for, if Canala is to take a respect- able position among the nations. Besides provision for cbtaining, internationally, information relative to the sanitary con- dition of vencls leaving foreign ports, and for better ship sanitation generally, some- thing should be done to promote more active and unifori provincial or inter- provincial sanitation, and for the exercise of more federal or central infInence, if not powers, for the better protection and pre- servation of human life in Canada.",
         "-I -I. 1? - 155 - THE TWO LINES IN PUBLIC HEALTH WORK. T would not be wise to predict where in course of time the limit will be in coerceive legal enactments for the prevention of disease. Legislation is now mainly limited to measures for the preven- tion or removal of accumulations of the ex- cremental and other refuse of life,and damp ness of soil, to care of cases of infectious disease, and some restricticns in reference to water pollution. In other words, near- ly all public health effort is atc the present time confined to the prevention or suppres- sion of infectious or epidemic;diseases. It is true this limited promotion of cleanli- ness aids in the prevention of other diseases too; still the great aim of all hygienic effort now is for the prevention of the com- municable or zymotic diseases. Now all tht zymotic or infectious diseases together, even .including tuberculosis, cause much less than half the deaths-even of the pre- mature deaths, which are indeed gl practically preventable. The long list of ''local\" diseases,-of the kidneys, the lungs, the brain, the heart, intestines, skin, liver and other organs, destroy many more lives than do the zymotic diseases. The last named are no more the resuilt of un- healthy habits and practices than are the zymotics. And moreover,besides this, the unhealthy habits which give rise to the local diseases strongly favor the develop- ment of infectious diseases as well. As in the development of all infectious diseases there are at least two factors, one, the specific germ, the other, the suitable soil -the favorable, unresisting body-the latter being hardly second in importance to the former, in all efforts to prevent or suppress the epidemie diseases,therefore, it is always, if not quite, as essential to use means for improving personal habits, as for removing nuisances and destroying the gerns. Yet all public health efforts as we have said is to make war upon the germs, to the ahnost entire neglect of the -other factor-the soil or unresisting body. There is no reason why we should not, in all our hygienie efforts, go further and endeavor to correct unhygienic personal habits. Some, or many, of these, it is true, vould not be easily reached, although others cculd be. Any at- tempts made of a coercive character to correct such habits and so prevent local diseases, would now be met at once with successful opposition on the ground of their interference vith personal rights and liberties. But this JOUiNAL has always contended that in any case more can be done in public health promotion, better progress can be made, by instruction or education of the public in the rules or requirements of health than by coercion,- this even in the prevention of epidemic or infectious diseases. It is only the few who cannot be induced with pioper in- struction, withont coercion,to attend to all ordinary and even extraordinary, as now understood, sanitary requirements and demands. More general instruction,there- fore, in relation to personal habits would not only aid greatly in the suppression of diplitheria and typhoid, and all other like diseases, which now destroy so riany lives, but wvould also lessen the nunber of deaths froin all other diseases. We would therefore urge upon local boards of health, generally, to put into regular practice, some means for instructing the masses of the people in relation to bathing, clothing, diet \u0026c., and more than all, in relation to the ventilation of their dwellings,-their bed roois and living roons. Not only is this essential in the schools, along with physical culture, but it is nost desirable outside the schools for the benefit of the present generation. This work is perhaps more essential in rural than in urban local- ities ; for in the former there are probably fewer people who would not be favorably influenced by such instruction. All local boards of health have therefore a broad field for constant cultivation. i If 'I q '1 t~",
         "- 156 - COERCION AND EDUCATION IN PUBLIC HEALTII WORK. IN England Sanitarians have learned, but only apparently in quite recent years, that by ceercion alone in mat- ters relating to public health proceedings, but very slow progress can be made. Very little in the Iine of educating the public, as distinct from carrying out compulsory measures, in relation to public hygiene had been donc there previous to the last de- cade. And, as everybody knows, the sani- tary progress made vas far froi great,not only in'England but in all Europe, where the work was in a siniilar line, until quite recent years ; although it is truc on the whole a great deal had been donc in pre- vious decades. With mankind it is the sanie in relation to the general causes of disease, to filthy habits, for exaniple, as it is in relation to 1 intemperance \" and other like evils. The niasses must be educated up to a compre- liension of the advantages to be obtained froi a change in their habits-froni filth to cleanlines, fron intemxperance to tei- perance. They must be so enlightened as to sec the benefits of change and inprove- ment or very slow progress will be made. This principle lias been recognized to perhaps a greater extent on this continent, but still even here the great weight or force of action for promoting the pnblic health has been in legislation for coercing the people into habits of cleanliness, etc., and the practice of educating first lias unot been nearly as general as it should have been. From the state and provincial boards to the village and township boards it has been nearly all in the line of \"Acts \" and \" By-Laws.\" In Canada no systematic effort lias been made to instruct or guide even tle local boards viicl are usually made up of men wlio have lad no oppor- tunity to get correct and useful knowledge on the subject in the interests of whicli they are required or expected to act. It is not the number of organized local boards that can be counted up by which we can estimate sanitary progress, as seeis to be supposed by some in authority, but it is the number doing active, useful work. If some special means had been provided years ago for the instruction and guidance of those who constitute the various local boards of hsalth, as well as the public generally througlhout Ontario, for ex- ample, as lad been then mapped out by this JOURNAL, doubtless much greater progress would have been made than has been made in suppressing the prevalency of dipltheria, typhoid and other fevers, measles, etc., which are so coimon and fatal in the province. It alnost seems as if in some localities the people tliiunk that so long as there is no case of small-pox in the place the public health is \" fairly good.\" HRad there been some such means for guidance as indicated, wive should niot now sec in so many of the reports from the local boards suci as the following: \"The board of health is properly organized, and no complaints requiring official action have coine before it during the year \"; or \" It lias not been necessary to call the board together during the year \"; or - An aggressive policy which the board intended to adopt... was, ... owing persumably to, there being very little sickness and no epi- demie..,. during the year, not put in force ;\" or \" Our board lias never been called into action, except on one occa- sion some years since, wlen scarlet fever vas introduced here by a non-resident Tiere is always work in every munici- pality for the prveention of disease; yet for want of knowledge, boards frequently do nothing until the public,who know stiil less about the causes of disease and the re- quireients, mîake complaints. And so: no wonder that disease is everywhere pre- valent and fatal.",
         "- 157 - NOTES OF THE HEALTII OFFICERS MEETING AT TRENTON. HE annual meeting last month at Trenton of the health officers of Ontario seens to have been a fairlY successful one. Below are a few notes bearing on the work of the meeting which appears to have been of inost practical value and interest. Dr. Coventry, of Windsor, in a sug- gestive paper on \" Auxiliaries to the Health Office,\" advocated the general introduction and encouragement of gym- nasia. Gymnastics, lie believed, were destined to rescue the youth of the land, now being emasculated by the high- pressure system of education. It was to be hoped that within the next ten years gymnasiums would be erected in every city and town of 5,000 inhabitants and up- wards. Women also, as the mothers of the race. should be educated in laws of health. Monthly forme should be re- quired from all medical health officers, and it should be made a statutory obligation for the medical health officer to deliver at least four lectures or readings on sanitary subjects in his municipality during the year. Dr. Coventry had recently addressed a circular to 35 cities and towns in the Dominion having a population of 5,900 and upwards. Replies from 27 of these gave medical officers' salaries varying from zero to $3,000. Seven towns pay nothing, while twelve pay less than $300 per annum; and such small pay should make the people of Canada blush for shame. He believed that the Dominion Government ought to make a special grant for the mainte- nance of general health work. Public water supplies was the subject of an interesting paper -by Mr. W. Chip- man, C. E., of Brockville. He said, the first public water supply known of in Canada was introduced by a company in Montreal in. 1801jthe city purchasing it in 1845. The next was at St. John's N. B., in 1836, sold to the city in 1855, The third was established by a company in Toronto in 1841, and was purchased by the city in 1893 for $200;000. In 1880 there were 33 towns or cities in Canada having a water system, and in the present year the num- ber was about 100. Of these works about 60 per !Ant. are owned by the municipal corporations and 40 per cent. by private companies, but the populationi served by the private companies was probably not over 30 për cent. of the total population served by a public water supply. The average total family rate in Ontario is about $20 per annum in works owned by municipal corporations and $25 where owned by companies. In Ontario the first cost of private works is 35 per cent. less per family, and they charge 20 per cent. more that the municipal works. Of 40 works built by municipal corpor- ations thirteen werebuilt forfire protection only. In many of these cases an expendi- ture of a small extra amount vould have secured a domestic supply of pure water. Of the remaining 27 works the following can claim to have supplies above suspicion: -Brantford, Dundas, London, New- market, Morrisburg, Niagara Falls, Owen Sound, Paris,'Sarnia, Woodstock, Galt and Walkertown. Those water supplies which are now of sufficient purity, but liable to pollution and therëfore placed in the second class, are Collingwood, Guelph, Hamilton, Brampton, Merritton, Ottawa, St. Catherines, Tilbury Centre, Toronto, Welland, Windsor and Niagara-on-the- Lake. Those classed as suspicious were Kingston, Picton, St. Thomas and Toronto Junction. Those controlled by private companies and condemned by the spëaker were Berlin and Belleville. In a lengthy discussion which followed, Mr. Ball, C.E., stated that Berlin had re- cently cleaned out its water pond, greatly improving the quality of the water. Dr. Griffin, of Brantford,said that that city had purchased the system at a cost of $215,000, and lie had no doubt but that $100,000 had been saved by it. Dr. Herod, of Kingston, said the water works of that city had been purchased from a private company for $120,000 and $175,000 had-been expended since in improvingit; and they had recently decided to extend the intake pipe fartheir",
         "-158- out into the St. Lawrence so as to avoid any danger of sowage contamination. The place of meeting was converted into a sort of laboratory, and Mr. McGill, of the Department of Inland Revenue, gave the members . ome simple netlhods for testing the purity of water. The special committee on disposal of sewage reported through Dr. Coventry, h'..ving held a meeting in April at Toronto. They recommend that the use of privy pits be entirely abandoned everywhere, being higlhly objectionable on all grounds. The dry-earth system now in use in Brant- ford was recommended for the favorable consideration of municipalities. The Coi- mittec recommended that the separate systein of sewerage be adopted wlierever practicable ; and that the most desirable method of disposing of sewage is by land irrigation, wherever this is practicable. This method is especially important for cities and towns situated inland, or on such rivers or streams as are or may be used for public water supplies. Some further details were given, and the soils best suited for sowage farms were named, as follows :-Coarse gravels of a calcare- ous character; coarse sharp sand, more or less calcareous; gravelly loams with gravel subsoils ; black loams, with gravelly subsoils, vhen sewage has been treated with lime as a precipitation. Burnt clays have been used, but solely as filtration beds. NOTES FROM HEALTH OFFICERS' REPORTS, WHICH TEACH LESSONS. R. BROAD reports that diphtheria broke out in two families in Cobo- conk, Co. Victoria, one case of which was fatal. The cases were traced to Markham village. The disease broke out in a family there, and a little girl who was just recovering from supposed tonsilitis, but really diphtheria, was sent to friends in Coboconk to get lier out of the way of the disease. She was, unfortunately, sent to school there. The result was that the disease broke out in the family she came to visit, and in another, one of the little girls of whicli had played with her. Dr. Sproule (M.P.) reports that, about the time la grippe was dying out a rather severe type of measles set in in the soutli- west corner of Euphrasia township. They were especially severe on the 11th line, whence they spread. The origin of the epidemic I was able to trace distinctly. It was brought in by a lady who came from Toronto on Christmas day. She was ill at the time, and a physician pronounced the disease measles It rapidly radiated in all directions until it became prevalent in many townships - Eiphrasia, Glenelg Artemesia, etc. On 25tli of February, Dr. Sproule continues, my partner, Dr. Ego, vas called to see a boy suffering fron diplitheria. He reported it. The house was placarded and other means taken to prevent its spread. There were two cases in this house, both of which recovered. On making enquiries it was found that one meniber of the household who had just come home had had a very severe sore throat in Toronto, though a physician there liad told him it was not diphtieria. I have no doubt in my own mind that this was the source of the outbreak. After these two cases it seemed to smoulder for about a month, w lien it reappeared in the family of the next neighbor. There were three or four cases in this house, one proving fatal. The fatal case seemed to add great empliasis to the instructions of the Medical Health Officer, and hence I think the precautions in shape of isolation and disinfection were much more care- f ully carried out in the second outbreak, with the result that there have been no cases since. Dr. Howland, of Chaffey twp,, writes: In the latter part of spring an outbreak of enteric fever began its ravages in the boarding-house of J. Brennan \u0026 Son, lumbermen. Between twenty and thirty employès lodged in this boarding-house. Twenty cases of typlioid fever, mostly of",
         "T ~- 159- - t a severe type, followed with a death rate of twenty per cent. The cause was the result of the grossest violation of health laws. The yard and outhouses vere any- thing but clean. The well vhere the drinking water was obtaineO was ten or twelve feet on declining ground from the kitchen window, through which for two or three years kitchen refuse was thrown, and had accumulated to the depth of three feet immediately at the mouth of the well. It is needless to say that the water was bad and offensive te both taste and smell. Dr. Algie, of Caledon, writes: During the months of September and October the village of Bellefountain suffered froi a severe local epidemic of typhoid fever. On making enquiry I found that, with the exception of three wells, the whole village vas supplied by drirking water froi a streai which rises froin a large spring about half a mile to the west and running down through the village empties into one of the branches of ,the Credit River. During its course through the village several small ponds have been built on the private properties through which the stream runs, and froi these ponds the drinking water is taken. The streani erosses three different streets, passes through several gardens, runs within five feet of a 4arnyard full of manure, passes an occasional privy, runs through beneath the floor of a general blacksmith shop, and finally before discharging'into the Çredit it fills a tank at the lower end of the .illage, and from this tank several fanilies are supplied by underground pipes. Com- plaints were sent that the water was pol- luted too, by a pond on the farm where the stream arises, by geese. I found no special signs of pollution here, although the oc- cupant of the property admitted that his geese had been previously allowed free ac- cess to the stream. This in itself would have been bad enough, but at the first street crossing I saw two pigs wallowing in the stream, and the roadway is so built that the ditch at the roadside drained into the stream. At the second street crossing I saw a cow standing in the stream drink- ing from it. Just below this was a well manured potatoe patch froin which the streai received not only the manure soak- age, but an occasional spicing with Paris green. The worst feature of the streai was the barnyard, containing at least a dozen waggon loads of manure, soaking and oozing into it. Three samples of water were taken. \" The first from near the head of the streai we found to be fairly good and might be pronounced safe drinking water. The second sample taken fron below the first street crossing was bad and contained a large amount of or- ganic matter and salines. The third, taken below the manure heap and blacksnith shop frein the tank at the lower end of the village was simply poisonous, being loaded with organic matter and salines, in fact this sample was so bad that it had an offensive smell in less than 24 hours.\" Dr. James Saison, of Rondeau, reports that in Harwich, a number of cases of diplitheria and scarlet and typhoid fevers had been reported, the last named assum- ing a very serious fori. \" The teacher of school section 13 is dangerously ill with this disease and on enquiry I find that there is no water supply for the school, that there are very few wells in the neigh- borhood of the school and none of these good, and that oftentimes in the autumn the children have to go to a half-dozen houses to secure a pail of very poor water. A fortnight ago diptheria was found in school section 4 in an especially vell regu- lated home with nothing suspiciousaround it. The water at the school was found to be absolutely unfit for human use, many of the pupils vere carrying ývater from their homes and the balance were drink- ing from a ditch, which after all contained much better water than the well. Two or three months ago diphtheria, was reported in the guilds section. It broke out again a month ago in a number of houses, result- ing in the loss of one life. The water was loaded with organic matter. Friom Watfort, the secretary, Mr. Reid, writes. An effort was made here to have all privy vaults cleaned out and the con- tents removed outside the municipality, this measure was readily complied with by s",
         "- 160 - a numiber of the inhabitants, but a large majority rebelled, and even threatened the authorities if compulsion was a'dopted. The Board felt disposed to let them down easy. It is a difficult matter to enforce law here. A BRIGHTER SIDE, TO A SMALL EXTENT. Dr. Hamilton, of Elma, a fiat township' with loany soil, reports : With reference to diphtheria, about which I have already spoken, I amn happy to say that the very efficient drainage lias proved a very great benefit in the wa.y of helping to stanl) out this disease which was once very prevalent liere. I don't think ve have one case for every ten of former years, which goes to show that the noist soil and atmosphere were favorable to the spread of the diph- theritic microbe. Dr. Lake, Ridgetown, says. Great im- provements have been made in regard to the drainage of certain parts of the town. The dry earth system in regard to privies has been made universal, this combined with drainage and properly enforced will, I have no doubt, render our town one of the healthiest in the Province. Up to the end of the year the town lias been in a re- markably healthy condition. MISCELLANEOUS NOTES ANI) EXTRACTS. REMARKABLE COLLECTIONS OF BACTERIA. In the bacteriological museum in con- nection with the recent Congress of Hy- giene in London the following collections of bacteria were exhibited :-The Bacterio- logical Laboratory of Oxford showed sixty different species of bacteria, some of them harmless, and some of dangerous varie- ties, among the latter being the germ of Asiatic cholera. Sir Henry Boscoe and Mr.Josepli Lunt showed bacteria cultivat- ed froi sewage, most of which presented pleasing hues when viewed under the microscope The germ which produces disteniper in dogs was shown by Mr. Millais; while M. Nocard enabled one to compare the bacilli of tuberculosis in man, the horse, pig, pheasant, and pigeon. Professor Kral. of Prague, lad a collec- tion of all the microbes at present known, cultivated, according to character, on potato, agar, or turnip. The bacillus producing decay in teeth was shown by Mr. Sewell, in the process of causing the sane effect on sound teeth on whicl it had been cultivated. Dr. Vashbourne, of Guy's Hospital showed the microbes of anthrax, pneumonia, and tuberculosis in various stages of existence. Mr. Hunter exhibited chemical poisons of ptomaines produced by germs. Mr. Sheridan Dele- pine had a collection of sections of skin displaying the bacteria of leprosy. It is found that bacteria thrive best-and they do thrive so as to multiply in a very short space of time by the millionfold-on agar, a jelly formed by boiling an Indian weed. THE COMMUNICABILITY OF TUDERCULOSIS FROM ANIMALS TO MAN. The following is a very short abstract of the discussion on this subject at the July animal meeting of the British Medical As- sociation, as reported in the British Medical Journal : Dr. G. S. Woodhead said, that f rom the results obtained by all observers, there could be little doubt that the milk ob- tained from tuberculous animals might be instrumental in communicating the disease from animals to man, and that there was great necessity for legislation on this question. The first thing to be 'done was to insist that a regular staff of veterinary inspectors, well trained for this special work, should be appointed whose duty it should be (1) to examine fortnightly al] cattle giving a milk supply, and who should have the pover to order isolation of all cattle in which the presence of tub- erculosis was suspected; (2) that it should be penal for any dairy farmer to throw into his milk supply the milk from any cattle which had been isolated by the vet- erinary inspectors; (3) moreover, no phth- isical patient should be allowed to have charge of any department in a dairy. With respect to ineat the question was much more difficult, for after most care- ful experimentation it liad been found that in only a certain proportion of cattle affected with tuberculosis did there seem to be any great danger to be anticipated from the ingestion of the flesh, but it must be remembered that tuberculosis in cattle was nuch more common than was 1 __ ýMw ý",
         "- 161 - usually supposed, and that if the meat from only 1 per cent. of actually tuber- culous animais could produce tuberculosis, the risk would be three or four times as great as the older statistics might lead one to expect, for it was found that the more perfect the inspection of meat in any country, the higher rose the tubercle stat- istics...and it was evident from bwhat had been observed, both in this country and abroad, that tuberculous carcasses were disposed of for consumption in the uninspected areas, and were thus never heard of. The first thing to institute in connection vith the stanhping out of tub- erculosis was thorough conipulsory in- spection, in order that data on which to carry on further work might be obtained that all private slaughter-houses should be gradually abolished. No animal In which tuberculosis was diagnosed and in which it extended to more than onle organ, and to serous surfaces should be exposed for sale; and those anirmas in which tuberculosis was present in a single organ should only h)e sold tothe consumer on the unîderstanding that it was to be specially well cooked. Such temporary measures might be made more severe or they might have to be relaxed, according. as further experiments proved that they were too stringent or were not adequate for the purpose for which they were drawn up. He could scarcely express his sense of the public indebtedness to experts such as Dr. Woodhead. Dr. Ridge called attention to the comparative iuimunity of Jews from tuberculous disease. It would be interesting if the existence of tubercul- osis in vegetarians could be determined. Personally lie could not recall any such case. Dr. Franklin Parsons said, veget- arians were continually bringing forward the risks attending the use of animal food, and they had made out their case so far as the actual food supply vas concerned; but there was no reason why this should be the case if sanitation in the byres pro- vided for cows was insisted on, and in- spection of the animals themselves proper- ly carried out. Dr. Thresh pointed out the iesirability of medical officers of health attempting to educate the public with reference to the organ and modes of propagation of tuberculous diseases, and the methods by which tuberculous infec- tion could be best prevented. As this education proceeded the difficulties in the way of obtaining efficient legislation woiild be diminished, and probably this would be the best way in whiclh medical officers of health could at present benefit the public and render such legislation piossible. Dr. Willoughby said that iii Italy, under the new Public Iealth Act, veterinary surgeons, exercising fune4iQus co-ordinate with those of the meqcqc of7ì- cers of health, were appointed in eachi province, whose duty it was to superviqe the health and sanitary condition of ai cattle within their jurisdiction. A NEW SCHEME FOR THE MANAGEMENr Op CONSUMPTION. Dr. Sajous, a physician and writer of eminence, of Philadelphia, Pa., (1632Chest- nut St.,) bas organized a company for giving to all consumptives, early in the course of the disease, the benefit of treat- ment, hygienic, climatic, and medicinal, sinultaneously. Existing sanitaria for these cases make provision only for the rich or the poor; the great middle class being inprovided for. For this class the company is projected, in which every par- ticipant would receive a dividend. The plan is so arranged that each person can regulate his expenses accordng to his means. It calls for the erection of villages in different parts of the country, built and conducted under medical supervision, con- ducive to the recovery of consumptives. Each cottage will be separated from is fellow, under constant medical surveil- lance, and all portions of the ho.ise and surroindings kept in a state of perfect asepsis. The rent of cottages completely furnishled varies from twenty to sixfy dol- lars per month. Provisions will be fur- nished at less than rates prevailing in the neighborhood. Trained servants are pro- vided by the company. A special fund has been provided to meet the needs 4f those vho have not the ready money fdr their immediate needs. The first of thé series of villages is to be located at New Florence, near the Gulf of Mexico. on ele- vated pine-covered lands, a beautiful spot, free from malaria, and remarkable in its effect upon consumptives. Later another, village will be established farther no*th. In these villages every case will be caré- fully studied and the results given to thg profession. It is requested of every phy- sician who approves of the plan, that he send the number of patients that he might send yearly to such a sanataria, in order. that the company may form some idea of the number they may be called upon fô provide for. SHOULD MANKIND EAT SALT ? Most vegetable feeding animals have a natural desire for \"salt licks.\" Man can- not always be guided by such facts, but. rather by experience and reason. Some 't I I., ~ '*1 'IMM misillmoi _ý w _ýffl __",
         "- 162- bêliete he does hot require, and is better without salt, except what forms q natural constituent of his food. Observations and investigations should and probably will in course of time decide this. A writer in the Provincial Medical Journal says : \"I am sure we all take too much of this con- diment, and then are driven to drink abnormally in order to wash it out of the sytsem. Vegetarians need salt in order to give savor to their diet, mixed eaters much less, pure flesh eaters-like the South American Guachos, and, when they can get enough of it, the Australian Aborigines-none at all, for all the salt we should decompose in order to digest flesh exists in it already. It was one of the most touching, the most pathetic sorrows of the then recently discovered New Zea- lander, in those vanished days when we believed that the noble savage was all our fancy and Fenimore Cooper painted him, that the missionaries we sent out were too salt, really too savory, for their unso- phisticated taste. Iudeed, one of those guileless children .of nature assured a cousin of mine, witlh the frankest sincerity and with many apologies, that he would rather not eat him. And this explains much of the endurance of fatigue, or rather its retarded induction, exhibited by the savages. An Australian \"boy\" will eat a fair sized leg of mutton, and run like the prophet of old with his loins rather scantly girded up, hour after hour, with untired speed. A white man trained into as good condition breaks down, not from exhaustion, but thirst, in an hour's time. He has only to loose a fev ounces of the water of his blood by perspiration, to render it so salt that its function as an oxygenator, from the contracted red cells, can no longer be carried on ; lie pants for breath, not because his lungs are over- taxed ; lie sinks dead-beat, not because his musclea are overwearied, but because his blood has become unfit for its must impor- tant duty, and the muscles, for want of oxygen, are narcotized into helplessness.\" HOW TO STAMP OUT AN EPIDEMIC. BY CONWAY SCOTT, C. E., OF BELFAST To stamp out an epidemic simply means to kill the organisms which produce the disease, and this can be effected by burn- ing them, boiling them, or poisoning them, the latter being the casiest method under ordinary circunstances, and can be best done by perchloride of mercury or car- bolie acid. As the mercury can only be used in the liquid form, the best orial disinfectant is carbolic acid vapour. In fact, to stamup out an epidemiic, and to kill bugs or other vernin, is very near- ly the same process; the whole thing is to kill them entirely and allow none of them to escape, and this is best done by dense fumes of carbolic acid vapour, as can be proved by long practical experience. I con- sider that skill, promptness, and energy will stamp out any epidemic that can arise among human beings, and it would be a question worthy of extensive experi- ments,--would not the sanie principle stamp ont epidemics among animals, ? thereby increasing our food supply and saving a large loss of capital. When the small-pox organism lias been destroyed in any city or district or country, it can neve lie generated again there (it must be inported de novo), any more than dogs or cats, after being destroyed in any district, could be spontaneously generated ; even filth itself cannot generate an epidemuic disease. There is no great practical diffi- culty in exterminating the smnall-pox or- ganism from Great Britain and Ireland; there are short periods when this lias been effected, and small-pox can never occur again unless imported from abroad. There should also be no great difficulty in exter- minating the small-pox organism fron France, Germany, Italy, Spain, the United States, and all other civilized countries, never to occur again unless imported. There would probably be difficulty but not insurmîountable , in exterminating the small-pox organisni in Russia, Turkey, and in eastern countries, but by a united effort of all the civilized governments of the world the snall-pox organism could be exterminated from the very globe it- self, never to occur again for all time. The great difficulty is in our own minds. We have never been able to realize that small-pox is an organisn as inuch as a cat or a dog is, and can be exterminated never again to re-appear. When public opinion fully grasps the idea that small-pox is an organism that can be annihilated, then, and not until then, will society cease to be plagued vith this terrible pest, which for the last ten centuries lias ravaged lui- mianity. All the lions, tigers, wolves, and hyenas that ever existed have not destroy- c(1 one-thousandth part of the human be- ings that have been destroyed by the smnall-pox organismx, and yet society wages an exteriminating warfare against them, but old superstitious feeling protects the more deadly small-pox organisn.",
         "EDITORIAL NOTES. DisC.uSING RFrORIS sometimnes come to us fron the semi-civilized East, which tell us of the foulness of the water the people there drink, as from the bathing tanks, for examiple,in which the choiera hacillus breeds in abundance, but who would have suppose'l that ir. Ontario, with its \" boasted civilization \" and its Provincial board, and seven hundred local boards, of health, any of the people could drink such water as that drank by the people of Bellefountaine, a village in Caledon township, as reported by Dr. Algie, given on another page of this JOuRNAL.. Nearly the whole village drank front snall ponds made by daning a streani which flowed through the village, and which Di. Algie found passed within five feet of a \" barn yard full of manure,\" near an ' occasional privy, under the floor of a general blacksmith shop,\" and near a \" well-nanured potatoe patch,\" fron which it \"received not only the manure soakage, but an occasional spicing of Paris-green \" [which per- haps acted the part of a bacillicide]: geese had been \" allowed frec access \" to the stream, and the doctor founud two pigs wallowing \" in it, a cow standing in and drinking from it, and the \" ditch at the roadside\" draining into it. Water taken from the lower pond was \"simply poisonous,\" loaded with organic matter, and in \" less than twenty-four hours had an offensive smell.\" It need hardly be said that \" the vil- lage suffered fron a scvere epidemic uf typhoid fever.\" Alas ! beautifully, but very inappro- priately, named, Bellefountaine ; was there no one to look after your health interests. IUCH THE SAME it is in the county of Kent. Dr. Samson, of Rondeau, says a teacher there is dangerously ill with typhoid fever, there was \"no water supply for the school,\" no good Wells in the neighborhood, andI \"oftentimes\" the children had to \" go to half a dozen houses to secure a pail of very impure water.\" In another school section, the doctor continues, in which there was diphtheria, the water at the school was \" absolutely unfit for human use \"; pupils \" were drinking from a ditch, which after aIl contained much better water than the well.\" In yet another section, with diphtheria in a \"number of houses,\" the water \" was loaded with organic matter and unfit for use.\" Dr. Samsoi did not report what the pupils in these schools of our \" boasted 'school system \" were being taught ;-probably drawing, music, and numerous other \" fine arts.\" Besides diphtheria, scarlet and typhoid fevers had been reported in the locality, the last nameid \"assuming a very serious form.\" No one will wonder. A coNTRAsr is presented in the following fron Dr. Bruce Smith, from the. township of McKillop : In the erection of new school- houses in the township every care has been taken by the trustees to provide healthy and cheerful school roomns with vemilation sufficient to provide an abundance of pure air for each pupil. To build up a healthy nation too much attention cannot be paid to the physical well- being of those who are now receiving tieir intellectual equipment for life's duties in the future. School-room headaches will soon be- come a thing of the past if the class-roons are kept properly ventilated. I have to commend the action of our board in appointing different members to visit the several schools of the township and ascertain that the premises were in a thoroughly sanitary condition, and that the water supply was in every case pure and un- contaminated. Sone \" outside \" influence is required to bring ail municipalities up to a like condition. ViND)soR affords an example uf another sort, which cannot be very well defined until it be show, whether or not Ontario health laws can be enforced ; or so it appears. In April last the secretary of the provincial board of health re- ported that the Walkerville sewer was emptying probably from three to four millions of gallons of sewage \"giving off the characteristic snell· of cowv manure\" every day into the river about half a mile above the intake of the Windsor water supply pipe, and that the brown stream. of sewage \" was visible for two thirds \" of thë half mile, in its flow towards the pipe. It is. surprising that the enlightened people of thaï enterprising town could tolerate such a state of matters for a single week. We have known injunctions in Chancery obtained for staying. less objectionable and deadly nuisances. Yet there is one person there, who writes editorials for an evening Windsor paper, who contends virtually for some unaccountable reason or object, that the water is good,- better indeed. :1",
         "-164- than that above the sewage inflow, and who, oreover, rudely, indeed in a bullying style, attacks this JOURNAL because we mentioned the conaition of the water supply source in our lasi issue. Fortunately sanitarians in Ontario in their efforts to pronòte the public health rarcly eti ývith-such persons. We have no tinie nor space-to contend with such. The fact may be here noted that the record of deaths in Wind- *sor dïtring the last thrce years, ending with the 3Ist August, 1891, is, 119, 138 and 159, respect- ively; giving a mortality rate of about 13, 14'5 ;mnd 16 for the respective years, for eaci ooo of population, an increase of about 23 p.c. in the three years. THE QUALI'TY of the immigrants coming into iscountry should receive serious consideration. Canadians are apt to look only to the num- bers which coie in to occupy the broad fields of Canada, and are somewhat discouraged because t.he population has not increased to the extent which had been hoped for. A leading medi- cal weekly in the States, referring to the influx of immigrants there, says It scarcely needs comment to show the enormous influence that such im-igration bas upon the health, welfare ànd:prosperity of this country. It is a notorious fact that the quality of this stream of humanity has diminished within the last decade, and in just about geometrical ratio with its increase in numbers. What a change from the days when inen set out across the seas to escape persecution or to secure wider civil and religious liberty, to the time of \"assisted \" imniigration, when nien lèave their country not for their own good, but the good of their neighbors. Can we estimate the amount of crime, ignorance and insanity that ivill be inflicted upon this country in the defect- ive descendants of these wretched beings. ToRowro CrrY papers sometimes congratu- late the citizens because their death rate is not véry.high notwithstanding all their defects of sanitation ; although since the census returns it is. found that the mortality was cons.iderably higher than, had been estimated. Now as we have before pointed out, the death rate affords little: or no indication of the sickness rate- There may be a great deal of sickness, diseases, even- zymotics, but particularly local diseases, may be very prevalent, and but comparatively few deaths take place. Toronto it appears supports a much larger proportion of practising physicians than any other city in Canada. And although it is best to save life, or to prevent pre- mature death, so Jar as possible, çonetimes one might'as well die as to suffer with lingering, and eventually:fatal illness. Besidès, sickness with the unsanitary conditions which give. rise to it, depreciates the stamina of the people, not to say anything of the pains, anxieties and costs in time and money which invariably accompany it. THEa MoRTALITY in Quebec, now that the alnost phenomenal birthrate is shown by the re- cently published vital andi mortuary statistics of the Catholic population of the province for 1889-90, appears not very much greater propor- tionately than in Ontario. In Ontario the chief cities return a birthrate, of about 27 per thou- sand of population ; in Quebec, about 47 per thousand. In Ontario, but little short of one- fourth of those born die before completing their first year of life. If ve allow that the same proportion die in Quebec under one year, and deduct this from the total mortality, it makes a very niaterial difference in the death-rate of those above one year as compared with the total death rate. Furthermore, of the three- fourths and over who in Ontario survive the first year of life, one-tenth die under five years ; although much less than half this proportion die between five and ten years. Ve must expect at least the sane pruportion to die tinder five years in Quebec, and this makes a further material difTerence in the mortality after the tifth year as compared with the total nortality. Certainly sonie special effort should be made to lessen the high rate of infant mortaility everywhere. ON DiPHTIIERIA, Dr. Alfred Carpenter, at the recent annual meeting of theBritish Medical Association, said : It was shown that fifty years ago the disease was unknown in this country, but for the last thirty-five years cases had heen under his personal observation in country places. Between 186o and 1870 cases were coinmon in rural districts. and between 1870 and tS8o the towns became affected. The difference between the two cases was that in the rural districts the outbreaks were limited to one or two, whereas in the towns the nunber was more widespread. Some cases were caused by the distribution of infected milk, some by con- tagion in schools ; while in some cases, when cesspoois were cleared away and the basements of bouses rendered dry and damp-proof the disease had disappeared. Warmth, moisture and absence of.light were necessary agents for the propagation of dipitheria. Dr. Butterfield stated as his experience that diphtheria followed the conveyance of manure in the hop fields. It was possible that it existed in a latent condition in many districts in a smoulderingform and was brought out by heat and damp. A CASE of resuscitation extraordinary is men- tioned in the New York Times of the current month. In Paris, a doctor was called to a woman who, with her child, had been suffocatz cd. \" They are both dead,\"he remarked,. \"we",
         "-. - 165 - can do nothing.' The unfortunates were re- Ioved to :he hospital St Louis, where thesaie stateient was made. The house-doctor, how- ever, asked permission to try artificial respiration withinsufflationsof oxygen, alternated with hypo- dermic injections of ether. Four receivers of oxygen were %.ed, and the young doctor worked over lis patients for three hours before a sign of life was perceptible. He finally succeeded in saving both. \"l Moral:\" kee' on trying, in all eflorts to resuscitate. A VANGEROUS practice is brought :o notice by thle secretary of 'he bo-ard of lealîth of To- ronto township. There was a case of diphtlheria in a hotel at the Streetsville junction of the C.P. Raihvay, of a malignatit kind, which caused one deati. ' The doctor and I ordered the clothes to be buried, which was doue by a very stout voung man who died of the sanie complaint .con after.\" Might not the free use of a proper disîtfectant at ain early peariod have saved the young mîan's life ? TIN in Canned Goods was the subjert of a recent paper, read in the American Chîemnical Society by Prof. 1-. A. Weber. He related a case of poisoning fromî eating pumpkin pie made from canned pumpkin, in the investigation of which lie lad found as much as seven mîaximîum or fifty or more minimum doses of lin saîts in a pouînd of canned punpkin. He also found large traces of titi in canned fruits and toiatocs OF FRUITS, Dr. Fathergill says, a great amount of themn that would have been of inestiai- able value in our dietary, has been spoiled by incorporating them in the cooking process with cane sugar. MaNiy stomachs can take mildly acid fruits and be benefitted by tliei, but wîen taken along with cugar they occasion distress. One or two raw apples, taken with a meal and thoroughly masticated, will often be fouind an aid to the stoinach in (figestion. DRs Louis and Gustav Lancry publish (L'Un. Med.) the resulhs of ihueir investigationts on the effect on offlspring of consanguineous iarriages. Their conclusions. based on a study of sixty- three consanguineous marriages, are that the marriage of blood relations tends to tIe dimninu- tion of the birth-rate. but that it lias no preju- dicial influence upon children born of such uniot BRAZI L ias, it is said, a law for the mnedical examination of persons about to marry to deter- mine ilieir fitness. It is a sanitary lieasure that was fouînd to be necessary to stop the transmis- sion of scroula, whichi at one time tireatened to destroy the strength of the people. ON TuE \" Substitution \" evil leading papers ail over this continent have been writing long editorials and sending out marked copies, with many of which we have been nmuch pe.tered. We looked upon it as an advertising dodge, and as the Sanitary News says, \"We are uni in that kind of business, nor that kind of market. There is one of two things about it. The news- papers have been handsumely paid foi ,tch, work, or they have been woefully duped.\" ITý is claimed by those I whorking he \" substitution \" editorials, that when a lierrtn goes to a drug store and asks for sonie of the \" dead-wall, plank-fence, hig.-rock and Lircus- bill advertised nostrums, the druggist suggests that he has soniething better for less nioney, etc.\" The chances are that if the druggist has anything harmnless to offer lie has somcthing infinitely better. He can say this and tel] the truti in nine cases out of ter, and is doing the poîchaser a good turn. RELATING to Asiatic Cholera: Under Ile date of August i t last, the United States Con- sular Agent at Aleppo reports the departure. on the 6th of August. of the Italian bark Uliva Specioso, froi Ale.xandretta, loaded w ith liquorice root, destined for New York. Alex- andretta is a cholera-infEcted port . The health officer at New York lias been notified. Ile also reports 133 deaths from cholera in .\\LppO during the week ended August 19, 1891. UNiER date of August 2o the United States Consul at Beirut reports the departure, on the 19th1 of August, of the Englisbh steamîship Drew- ton fromn Alexandretta, wvhere sie took vi 68. bales of unwashed wool bound for New York. BosTON, Sept. 22.-Reports from Asiatic Turkey are to the effect that cholera is spread- ing in the stricken districts. On July 21, 405 deatlhs occurred in Mecca aind Mina alone. The English steamer Drewtzon recently took on a lot of unwashed wool from infected ports. she is said to be bouînd for some port in Aeniarca, probably New Vork. LONDON, Sept. 22.-The lcalth authorities. at Kilburi, a suburb of London, are investiga;- ing the sudden death of a mian who is supposed to have died froni cholera. TuE Medical Officer of iealth, Dr. Seaton, strongly urged in a paper on the Evolution of Local Sanitary Administration, at the last mteet- ing of the Britishi Medical Association, is \"the Keystone of the administrative arch,\" and \" in order to attract competent men this position should be one of independence and dignity and so fairly paid. SIR ANDREW CLARK, the celebrated Lon- don physician said : \" I worked tvelve years for bread, twelve for butter and twelve more for the luxuries of life.\" e' : i J'-",
         "- 166 - NOTES ON CURRENT LITERATURE. THE ILLUSTRAITED NEWS OF THE WORLD (Loerinn News-Am. Edition), has given dur- ing the past few weeks an enormous nuniber of illustiations of scenes in many quarters of the globe, many of them of exciting interest, many ver) pretty. \" The Tinte of Roses \" and *The. Old Pilot \" are very attractive full page pictures; Shipmnate,\" \"The King of the Castle \" and Piiscilla,\" aill full paee, are but little less so, One Too Nany \" and \" A Summer Idyl \"- full page, are pretty and amusing. \" Cardiff,\" gives a most excellent birds-eye view of that city. \" The French Squadron off Portsmouth\" and \" Indian Jugglers' are anong the double page illustrations. \" The Scapegoat, a romance by Hall Caine,\" is thrilling and profusely illus- trated. THw DOMINIoN ILLUS'IRA'IED is another adrnralle weekly w hich every Canadian should end.avour to patronize. It has taken a long stride forward during the last ) car, both in slec- lions and execution of subjects. It is purely Ca- nadian in intellect, art and workmanship. Late numbers have git-en two fine double page illus- trations-' Views of Fort WVellington,\" Pres- cott. Ont., and of \" Ste. Anne's,\" P. Q. Amung other attractive illustrations are \" Views of Banff,\" N. W. T., \" Camping near Picton,\" Ont.,. and, four in aIll of the camps. butts, garden party, \u0026c.. of the late meeting of the Dominion Rifle Association in Ottawa, TiF Ga.lrIc of Chic.Igo is another goud weeMly, not second tu any published in the United States The illustrations are excellent, clear, on guud papai, aud many of them of sub- jects of much interest to all cultivated people. IN THE COSMîoPoî.I'AN for October, Amelie Rives' striking story \" According to St. John \" is brought to a dranatic close. No other piece of current fiction by an American author, it is said, has attracted so wide attention a3 this tale of Parisian life. A new and capital feattire of this attractive monthly and one which is origi- nal with the magazine, is the publication each month, in the forms of foot notes, of a numiber of little portraits with brief biographies, of the writers of the various articles. HIowever widely read one may be, there is apt to be something of information lacking regarding the vast number of writ'-rs who appear in the peiiodicals of the pre- sent day. Is n s Noember number the Cosmopulitan will publish a series of letters written by Gen. W. T. Sherman to one of his young daughters, Letuecn the years 1859 and1 S65 and covering v of the mimp rtant events of the war of s.ces- sion. These letters lresent graphic pictures of a great soldier amid sopc of the stirring scenies in which he was a giant'figure. ST. NICHOLAS seldom publishes a number without some clecided novelty. In the October, issue ive find an account by Margaret Bisland of \" A Curious Relic,\" part of the figurehead of the old frigate \" Constitution.\" Andrew Jack. son was the figure chosen by soume of his ad- mirers, and one of his opponents stole the head from the bow of the ship. lts after adventures were curious. \" Black Art \" is a sketch designed to revive the delights and suggest the possibili- ies of that very antique device, the silhouette. The author, Jack Bennett, protests against the disuse of the art, and presents his stiongest arguments in the very humorous black pictures. St. Nicho'as is always ahead in interesting youîng people. THE CENTURY for October aniong other things will contain the following: Portrait of Rudyard Kipling, Frontispiece ; My Last Days in Siberia, by George Kennan, with pictures by Frust, Sandham and Wiles: Was i an Excep- tional Case ? Aerial Navigation; The Power Re. quired ; Beseiged by the Utes ; The Massacre of 1879 ; A Water Tournament (Playin Provence); In Answer to a Question ; The Press and Pub- lic Men ; An Escapade in Ccrdova ; The Story of a Story, by Brander Matthews, with Decora- tions ; Who was El Dorado, vith twenty-six illustrations fron the Ruz-Randall collection and Italian Old Masters. A BEAU riFUL SQUVRENi-Splendid illustra- tions, supplements, literary features and artistic arrangement ; beautiful engravintgs, charming sturies, shetches and poems, uit and humor, im delightful coibination are promtised in the Christmas nuntber of the Dominion Illustrated for 1891. No expense will he spared to make it the most magnificent holiday souvenir ever issued in Canada. Published by the Sabiston Litho. \u0026 Pub. Co., Montreal. DR. WEIR MITCHELL, of Philadelphia,.has put into narrative form the ripest results of a lifetine of specially trained observations of human nature. I-le calls his story -Character- istics,\" and The Century has secured it for the coming year. The editois consider it \"'more than a novel,\" made up as it is of science, poetry and the author's self. THE nell.known humorist Eugar Wilson Nye better known as \" Bill Nye,\" will contribute to The Century during the coming year a series of articles descriptive of his experience in different parts of America and in various capacities, His \" Autobiographies,\" the first one \"l The Auto- biography of a Justice of the Peace,\" vill ap- pear in the November Century. RiYUnnn Kîrtiss new novel, written in collaboration vith %% ulcott Balestier for the Century, \"The Nauilahka, a Tale of West and East,\" a story of America and India, will com- mence with the November Century."
      ],
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         "Ottawa : Canada Health Journal, [1891]"
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         "Canada health journal [Vol. 13, no. 9 (Sept. 1891)]"
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      "label" : "[Extra sheet (Oct. 7, 1882)]",
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         "Toronto : [s.n., 1882]"
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      "title" : [
         "Medical criticism [Extra sheet (Oct. 7, 1882)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images mn the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. | Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées D Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Car tes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured. stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. loX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "EXTRA:, SHIEET. OKJMEIGJAL GRITIISM»\u003e O(CTOBER 7th, 1882. A Weckly Sheet, by DAVI D EDWAR oS, pzeb/zs/ie'd ou .Scz/urdaey, anid sol\u003cl ai/ Hawkizs C o.'s, 67 Vonii' Street, Toronto. PPJCE 50 CENTS-Colpics, oi :Illy illgle numiber can bc had, in quantities, at 15c. per dozen. TESTIMONY RELATING TO VACCINATION. REGISTRAR-GENERAL'S RETUR.N.-Since the passage of the original Compulsory Vaccination Act in- England, there have been three epi- demics, with the following resuits : ist.-S57-59, there wvere 12.2.4 deaths. 2nd.-1863-65, there were 20,059 deaths. \"'rd. -802,there were 44.840 deaths. Allowing for increase of popuilation at 7 pi-r cent. from the first to the second epidemie, there is an increase of small-pox in the saine period of 44 per cent.; and allowing for an increase of population between the second and third epidemies of 10 per cent.. there is shown an in- crease of smnall-pox of 120 per cent.!! ln thîs remarkable fashion lias the Jennerian nostrum stamped out smnall-pox. W. J. COLLINS, M. D., London.-After occupying the position of Public Vaccinator for twent3 years in one of the most populous me- tropolitan parishes, and having devoted twenty-five years to close study of the question, I have relinquishied the practice of vaccination, with its emoluments, on the grounci, that while it afforded no protec- tiorL against the small-pox, it xvas the frequent cause of dangerous and ftal diseases: and my investigations into and experience of calf-lymph or bovine vacciAnation (advocatecl by Dr. H. A. Martin, of Boston, ,U.S., and Dr. Xarlomorit, of Brussels); has only confirmedmy opinion on both tliese issues. TiîE RiGHTr HON. W. E. GLJADSTONE. M.R.-I regard compulsory and penal provisions, such as those of the Vaccination A ct, with mis- trust and miisgiving, and were i engaged on an inquiry, 1 should re- quire very clear proof of their nccessity before giving them my ap- proval. è Time RiGHT HON. JOHN BRizGHTr, M.P.-The law which infliets. penalty after penalty on a parent whio is unwillino- to have his chiid vaccinated is monstrous, and ought te be repeaIeâ. Miss FLORENCE, NLGHTINGAL.-EVery one who knows a-nythin~ of public-health questions, and the practical unity of epidemics, ani their determining causes, wilI agree that exemption. from ail alike must be souglit, not by any one thing. such as vaccination, but by removing the causes of epidemic-susceptibili-ty genemlaly. *LANCET,\" (June 2.2nd, 187S).-The notion that animal lymph would be frce from chances of sypliilitic contamination is so f alla- cious, that -%ve are surprised to se Dr. Martin (of Boston, 13. S.) repro- ducing it.",
         ". SIR ROBERT PEEL, BAR~T. (1849.-To inake vaccination cpnxupul- sory, as in sorne despotic countries, would be so opposite to the meýin- tal habits of the British people, ai-d the freedorn of opinion wherein they rightly glory, that I neyer could bo a party to such compulsion. How much ionger will the docile people of Ontario be content to be hoodwinked by th e doctors ? OVERTIIROW 0F COMPULSORY VACCINATION IN SWITZER- LAND. The people of Switzerland have been greatly stirred by the at- tempt to force upon themn a vaccination law of more than ordinary stringency. This projet de loi, known as the epidemien gesetz. which rendered vaccination compulsory in 22 cantons, was passed'by the Federal Chambers on January 3lst last, and was the outcome of united action on the part of the Swviss Medical Commission, which had ascertained L~y a post card inquiry thiat out of 1,168 members of the profession, 1,122 we-re favorable to vaccination. The. law was promulgated on February 14th'k, whien, its oppressive character becom- ing known (the penalties being f rom 5 to 2,000 francs, or one yeà'r's imprisonment, according to the gravity 'of the offence),, the people decided at once to exerci:se thie rigTit of a referendum, or appeal from the decisioiis of th.e Chambers to the suffrages of the people. This Constitutional right can only bc utilized provided 30,000 signatures are obtained within 90 days. So great, hiowever, was the public inter- est, and so pronounced the (letermination to throw off this .yoke,. that within the period prescribed upwards of 80,000 signatures were laid b.efore the ?resident of the Republie. The popular and final vote was taken on the 3Othi July, and iii a despatch froin Professor Vogt, of Berne University, I lcarn that notwithstanding the most vigorous efforts on thie part of the medicai faculty and their friends, who spared neither trouble nior expeiise in circulating their appeals, the law has been rejected by a majority of 253,96S votes, or about four for every one who voted in the affirmative, only onc canton .(Neuchatel) having a majority in favor- or' the law. The resuit has given a fresh impulse to the international movement against compulsory yacciila- tion in Holiand, Belgium, and Germnany, and the leaders of the agi- tation in the latter couintry are confident thàt the Reichstag will f oi- Iow the example of Switzeriand, and repeal the German Vaccination Law at the néxt session. In order to co-operate in this important under- takiing, the executive committee of the International Anti-Vaccina- tion Leaguc lias just decided to liold the third International Anti- Vaccination 0Cong ress at B3erlin in January next, and arrangements will be made to si, juire ilhe representation of ail countries where this medical prcscript 011i is enforced by municipal or Imperial statutes.- Yours faitbfuOly, W'ILLIAMi TiiB, 114 Victoria Street, Westminster, August iotii. (ý fi. TEBB is the Ilonorary Secretary for the Anti- Compuisory Vaccination'Society.) \"PULPIT CRITICISM,'! hy the samc author, SOid 3t HI-ICINS \u0026 Co.'s, 67 Vonge Street. 1'rice $i.oo per annumn."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur W Covers damaged / Couverture endommagée El Covers restored and/or laminated I Couverture restaurée et/ou pelliculée El Cover title missing / Le titre de couverture manque El Coloured maps / Cartes géographiques en couleur E Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) E Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. El El Coloured pages I Pages de couleur Pages damaged / Pages endommagées El Pages restored and/or laminated / Pages restaurées et/ou pelliculées 12 Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough I Transparence Quality of print varies / Qualité inégale de l'impression E Includes supplementary materials / Comprend du matériel supplémentaire Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination. El 1",
         "THE SANITARY JOURNAL. VOL. V.] SEPTEMBER i5TH, 1883. [No. 12. THE COMPULSORY NOTIFICATION OF INFECTIOUS DISEASE TO LOCAL AUTHORITIES. The question of the compulsory notification of infectious diseases to local authorities is one which is becoming of much interest to sanitarians in this country, and the following extracts from a paper on it by A. M. Anderson, M.D., medical officer of health for the burgh of Dundee, Scotland, will be interesting and useful. The writer says :-I propose, in this paper, to place before you the history and development of the question, without exaggeration or suppression, and to give a brief account of our experienee of the system which is now law in Dundee. I believe this question began to be publicly discussed in 1876. Local Authorities experienced great difficulty in dealing with epidemics of the chief infectious diseases, and this general experience led to suggestions which it was hoped might overcome the difficulty. At first, attention was mainly directed to the householder, or person in charge of the infected patient, and, either by Police Bye-laws or otherwise, powers were obtained in several districts to compel the householder to notify. A little experience soon convinced the authorities that the object aitaed at-viz., early and accurate information as to the presence and locality of infection, could not be satisfactorily obtained in every instance by this method. For,. while the more intelligent portion of the public generally reported, the very poor and destitute, small shopkeepers and others, delayed or evaded reporting. In Greenock, during a period of four years and four months, the total number of cases known to the authority was 4 423, and of these the householders reported only a percentage- of 55-52 The medical practitioners agreed to report voluntarily,. at the total number so reported amounted to zo6.",
         "IV6 THE SANITARY JOURNAL. As a matter of fact, a considerable proportion of the public are extremely careless, not to say reckless, as to the danger of spreading infection amongst their neighbors, and, even when vigilantly watched and compelled by the law, it is not possible to obtain from every householder information as to infectious disease which shall be early, accurate, and complete. Owing to this experience, Local Authorities have sought in recent years to impose the duty of notification on the medical attendant, and in a number of towns they have succeeded. In 1878 the attention of the Local Goverment Board was directed to this subject, and that Board framed and passed through Parliament the now well known Manchester Provisional Order Act, 1878. As its provisions have been generally adopted. it may be desirable to mention details. It provides for the compulsory notification of infectious disease by the householder and the medical attendant, direct to the Local Authority, and the penalty attached is \"a sum not exceeding forty shillings.\" The term \" infectious disease \" me.ans and includes small-pox, cholera, typhus, typhoid, scarlet, relapsing, continued and puerperal fever, scarlatina and diphtheria, \" and such other diseases as the Corporation, under the provisions and for the purposes of this act, may from time to time declare to be infectious.\" The fees payable are 2s. 6d. for each certificate, and is. for cases occuring in practice as medical officer to any public body or institution. In 1881 a Royal Commission was appointed to inquire respecting small-pox and fever hospitals, and in their report the commissioners deal with the notification and isolation of disease. They state as follows :-\" In effect, it is only by the medical attendant, if any, that the disease can be intelligently notified, since it is ònly he who can be presumed to know what it is, and who has no interest in concealing it. But it is represented that to impose this duty upon him directly and unreservedly, would intefere with the relations which ought to exist between him and his patient, and might prevent the aid of a medical attendant being sought at all. If this be so, it may be sufficient that the medical attendant should be required by law to furnish a certificate to the householder, who should be bound to forward it to the authorities.\" This report has been frequently cited as recommending compulsary notification by the householder, and nbt directly by the medical attendant. Its terms, however are cautious and qualified, the phrase, \"if this be so, it may be sufficient,\" leaving the whole question open.",
         "THE SANITARY JOURNAL. Last year eight local bills for police and sanitary purposes were presented to Parliament, and in March the House of Commons appointed a select committee to consider those bills and to report on police and sanitary regulations. At the instance of the committee, the Local Goverment Board obtained information from the authorities of the twenty-three urban districts in which, up to date, legislation on compulsory notification had been embodied in private or local Acts. This information is published in Parliamentary Paper 164 (1882), and this paper, along with the report of the Select Committee, I have carefully considered. The urban districts referred to are Barrow-in-Furness, Birkenhead, Blackburn, Blackpool, Bolton, Brad- ford (Yorkshire), Burton-on-Trent, Derby, Huddersfield, Jarrow, Lancaster, Leicester, Llandudno, Manchester, Norwich, Nottingham, Oldham, Preston, Reading, Rotherham, Stafford, Stalybridge, and Warrington, and the total number of their population amounts to 1,997,249 ; medical men, 932. In addition, there are reports froni Edinburgh and Greenock, atitd the total population of the thirty-one -cities and towns in which compulsory notification now exists may be roughly estimated at two millions and three-fourths, and the total number of resident medical men is 1,417. The reports of the local authorities state that the experience of notification gained under the local Acts has been satisfactory, and that it has enabled the authorities in many instances to prevent the spread of infectious disease. There is some difference in the methods of notification, and also in the number of infectious diseases included. Thus, there are thirty towns in which the medical attendant has to notify either directly or to the householder ; seven towns in which, when there is a medical man in attendance, it is not the duty of the occupier to notify ; twenty-two towns in which the duty to notify devolves upon the occupiers, whether there is a medical man in attendance or not ; and twenty-three towns in which, when there is no medical man in attendance, it is the duty of occupiers to notify. The fees paid to medical men for each certificate vary : In twenty-five towns the sum iS 2s. 6d. for each certificate, in four towns is. each, and in one town 1s. 6d. each. The amount of the penalty also varies : In twelve towns it is 40S., in ten towns £5, in eight towns £1o for each offence, and in four towns there is an increased penalty for a second offence. The collective opinion of these thirty-one cities and towns is to the effect that the system of compulsory notification has proved beneficial to the health, and greatly assisted in preventing epidemics. 317",
         "THE SANITARY JOURNAL. Mr. Hasting's Bill, to apply to England and Scotland, as introduced last session, proposed to place the duty of notification primarily on the medical attendant, the occupier being bound to give notice in the event of no medical man being called in. In his Bill as brought in this session, he adopts the dual system of notification, that is, the householder and the medical attendant are- to notify direct to the local authority. The diseases included, the fees payable to medical men, and the penalty attached are similar to those of the Local Goverment Board. [This Bill was shelved by a count out since the above date.] * * * The British Medical Association now numbers about ro,ooo ihembers, and its Yourna, as edited by Mr. Hart, fairly represents the views, opinions, and feelings of a very large proportion of the profession. Mr. Hart is Chairman of the Parliamentary Bills Committee of the Association, and by his ability, personal character, and special experience in medico-legal affairs, he bas obtained the confidence of the profession, and his views may be taken as fairly representative. In 1876 the Registration of Disease Committee recommended compulsory notification on the houseiolder, and not upon the medical attendant, in the first instance ; and again in 1879, 188o, and 1881, Mr. Hart submitted to the Parliamentary Bills Committee very interesting and exhaustive reports on the subject. In 1879 the Committee resolved in favor of the now well known \" Hart's Model Clause.\" This provides compulsory notification on the householder, the medical attendant being bound to furnish a properly filled up certificate to the householder, who is bound under penalty to forward it forthwith to the Local Authority. The fee to the medical attendant is as. 6d. for each certificate, with a limitation as to cases of the same disease occuring in the same building within thirty days of the date of the first certificate. There is no penalty attached to the medical, attendant's obligations. * * * Mr. Hart, in bis reports, admits that his model clause has not found favor with Local Authorities, or with the Local Government Board. It bas been adopted to some extent in Nottingham, Norwich, and Bradford, but nowhere else. The public authorities and Committees of the House of Commons have evinced a decided preference for the scheme of the Local Goverment Board. The reasons are obvious. Parliament apparently insists that a penalty shall attach to the legal obligation to notify, and this with the view of controlling any \" black sheep \" who may be in the profession ; and local authorities seem to be gentrally of opinion that the house- holder, if left to transmit the certificate, would, in many instances, cause dangerous and unnecessary delay, and, probably where his interest was involved, be might attempt to evade bis responsibility The \"If art Model Clause\" may be taken as the system of notification put forward by the medical profession as a body. 318",
         "THE SANITARY JOURNAL. Numerous branches of the Medical Association have discussed and adopted resolutions in favor of its princtple. The Lancashire and Cheshire Branch, the Metropolitan Counties Branch, the South-Wes- tern Branch, the Worcestershire Herefordshire Branch, and others have done so. It was aLo adopted by the London Society of Med- ical Officers of Healtb, and finally at the annual meeting of the Association held at Worcester in 188z, an amendment in favor of compulsory notification on the householder, and not upon the doctor,. was on a division carried, and it was also carried as a substantive motion. In several districts, notably Liverpool and Glasgow, the Local Authorities have recently drafted bills which provide compulsory notification on the system framed by the Local Goverment Board. The proposal caused considerable agitation amongst the medical practioners resident in those districts, and they vehemently resisted the granting of such powers to the sanitary authorities. The oppo- sition was so strong, and the medical profession so united, that the corporations delayed proceeding with their bills. It may be ques- tioned whether the position taken up by the profession in those districts is tenable for any length of time, more especially in view of the recommendations of the Select Committee, and the fact that the serious dangers anticipated have not, on actual trial of the system, been realized, while the counter schemes and suggestions offered by the profession fail to meet the difficulties of the case. In Liverpool the dpposition of the medical profession was very keen, and the resident medical men were almost unanimous-of a total number of about 310, nearly four-fifths were opponents. The objections usually raised to direct compulsory notification by the medical attendant, under a penalty, with the answers put forward by supporters of the system, may be briefly summarised as follows :- i. The State acting for the public interest, exacted, under legal compulsion, certificates as to the cause of death, and vaccination certificates, without payment; and we positively decline to render the State further gratuitous services. Answer.-Admitted, but on this occasion the State proposes to give a fair remuneration. 2. The system is repugnant to the unwritten law of professional honour, as it compels medical men, under a penalty, to divulge to the authorities knowledge acquired in professional confidence. Answer.-It is admitted that the duty is disagreeable to a large proportion of the medical profession, but it is urged (a) that it is unavoidable in the public interest, no other method hitherto sug- gested being adequate to serve the purpose in a complete and satis- factory manner ; (b) that by making compulsion under penalties apply to the householder as well, and exacting his compliance in .every instance, he cannot complain of his medical attendant con- 3I9",
         "THE SANITARY JOURNAL. forming to the law ; (c) that the penalty attached is necessary, as, if no penalty were attached to the obligation, those who did not com- ply with it would be subject to an indictment at common law in- volving expense and trouble; and (d) that where the system has been tried it has proved uniformly satisfactory. 3. That it causes concealment of infectious disease, and avoidance of or delay in seeking medical aid, which must spread disease and endanger life. Amwer.-Notification being made compulsory is not the cause of concealment, which is chiefly caused either by the ignorance of the poor, or the deliberate and selfish carelessness of bad citizens. It existed in large measure prior to notification being made law,. only the fact was not so well ascertained until by notification the extent to which infectious disease prevailed in a district' revealed the extent and serious nature of the danger. The evidence as to concealment in towns where notification is law, shows that it pre- vails to a sinall extent, and with time tends to diminish ; but oppo-- nents wholly ignore its existence prior to notification, and greatly exaggerate its extent since. The law as to vaccination leads to con- cealment, and many persons evade vaccination to the danger of human life and the peril of the whole community ; but the law re- mains on the Statute Book, and its provisions are enforced under penalties, with the sanction of the public. 4. It is the first step towards removal to hospital, which, fre- quently, is badly planned, badly constructed, and indifferently ad- ministered ; and such removal is objected to by the patient's friends, and, in the case of children, causes distress to parents. Answer.-It is admitted that, when proper isolation at home is- not attainable, compulsory removal to hospital is the necessary com- plement of compulsory notification. It cannot be denied either that the presently existing hospital provision for infectious disease throughout the country is not, in point of accommodation, one-tenth of what is necessary; and in regard to the plans, material, and con- struction of the buildings, great improvement is absolutely required.. Befre powers of compulsory removal are granted to Local Authori- ties, care should be taken to make the provision of properly con- structed and well administered fever hospitals free to all infected persons, and supported out of the public assessment, compulsory on the Local Authorities. There is abundant evidence to show that where notification becomes law, it is quickly followed by in- creased hospital accommodation, greatly improved in construction and administration. Generally the public will gladly enter a good hospital. 5. The system frequently leads to collisions between the sanitary authorities and the medical attendant, and to disturbance of the de- licate relationship subsisting between the latter and his patient, and consequently to medical opposition. 320",
         "THE SANITARY JOURNAL. Answer.-With wrong headed people anything may lead to colli- sions, but with a little good sense and good feeling all tension and strife can be easily avoided. In Edinburgh, Dundee, Aberdeen,. and other towns there have been no such collisions or disturbance. Mr. Hamilton, in his pamphlet, magnifies every littie breeze of irri- tation into a hurricane, but lie and other opponents omit to mention that there is abundant evidence to show that medical men who were either neutral, doubtful, or actually hostile to notification, have be- come, after a brief experience of the system, reconciled to it, and even to admit its public benefit. I am not aware that any medical supporter of the system has, after experience of it, withdrawn his approval. In the districts where it is in operation, the total number of resident medical men is about 1,417, and opponents of the mea- sure have endeavoured to elicit from them an adverse opinion. The Opposition Association of Liverpool has not, I believe, published the replies received, and until that is done, it is fair to infer that the replies were not encouraging to the Opposition. All Mr. Hamilton has hitherto given to the public is an extract or two from several private letters, with the limitation not to publish the writers'names , if this represents all the medical opposition in thirty-one cities and towns, having a total number of 1,417 resident medical men, it is fair and reasonable to describe it as of no serious moment. 6. The public opinion of these districts is said to be opposed to- the local Acts, on the ground of the vexatious interference with indi- vidual liberty, and the hardship and loss entailed on small shop- keepers and others. Answ-r.-The Local Authorities concerned have officially de- clared to the Government that public feeling is in favour of the Acts, and if dissatisfaction exists to any considerable extent, it is a sin- gular circumstance that it finds so little expression by the usual channels-petitions to Town Councils and to Parliament, public meetings of citizens, and the local press. As to the hardship and loss entailed on shopkeepers and others, calamities come to us all,. and eaclh man has to bear his own portion. Mr. Hamilton's claim to permit these peuple the liberty of spreading disease and death among their customers, rather than remove the infected person to. hospital, or isolate him at home, is wholly preposterous. On the other hand, it is easy to prove, and has been conclusively proved hundreds of times, that sanitary measures are, in a special manner, a protection and benefit to shopkeepers and others who depend upon, public custom. 7. The dual system of notification can never be successfully car- ried out in face of the open or covert hostility of the medical profes- sion; Why, then, not adopt the system favoured by the profession- viz., \"Hart's Model Clause ? Answer.-Without the cordial co-operation of the profession it is perfectly hopeless for any local authority to deal effectively with infectious disease. -But the profession is open to conviction 321",
         "322 THE SANITARY JOURNAL. by reasonable argument, and by facts which tend to demonstrate that the dual system will benefit the public health in larger mea- sure than the system known as \" Hart's Model Clause.\" The latter leaves an open door for delay and evasion, which would, to some extent, defeat the object aimed at, and render the trouble and expense of it comparatively useless. Moreover, to prove the case against an offending householder, his medical attendant would have to be called as a witness against him-not a pleasant thing to do. 8. Where the duty of notification is placed directly on the medical attendant, the people delay or avoid seeking medical aid, and this is followed by a higher death-rate from infectious disease. Answer.-The fact is stoutly denied by the Local Authorities of the several districts, who are unanimously of opinion that notification is as their right arm in combating infectious disease, and that by its timely aid they have prevented what might otherwise have developed into costly and fatal epidemics. Speaking in the presence of my medical brethren from Dundee, I believe I am justified in stating that the working of the system has not caused any disturbauce of the relationship subsisting between them and their patients. There has been no difficulty as between the sanitary authorities on the one hand, and the medical practi- tioners and the householders on the other. The public generally appear satisfied with the working of the system, and I have not yet heard of any person complaining of it, or expressing a desire to have it abrogated. THE \"PUBLIC HEALTH\" OR DISEASE REPORTS. In connection with anything like a complete public health system it is essential that the Government of a country and through it the public, should from time to time or as often as possible, be made acquainted with the condition of the public health throughout the country-the amount or proportion of disease prevailing, and the rise, progress and fall of epidemics of any of the infectious diseases. As the mortality in any locality affords but an imperfect index of the general state of the health of the people or the amount of dis- ease in such locality, it is somewhat strange that, in countries espe- cially where much attention has long ago been given to public health matters, measures have not yet been adopted for obtaining rçgular and reliable statements relating to the public health-to the amount of prevailing disease, from week to week or from month to month, in the various parts of the country. Through such state- ments or reports the health authorities may best become thoroughly",
         "THE SANITARY JOURNAL. cognizant of the sanitary condition of such localities, and hence be in a position to direct remedies-remove causes and prevent sick- ness. There is no effect without a cause. When the general sickness- rate is high, or when zymotic diseases are common and epidemics prevail, it is a sure indication of insanitary conditions and of want of proper sanitary administration. Where rheumatisms, neuralgia, malarial fevers and acute inflammations are common, it indicates a want of good drainage. And where the more chronic diseases- such as those of the kidneys and liver and heart, are prevalert, it will be found that the general hygienic habits of the people are not what they should be. In this country as in most others the zymotic diseases are consid- ered the most preventable, and therefore a knowledge as to their prevalency is regarded as of the most practical importance; hence reports concerning these should receive first attention. Next in practical importance come those diseases attributable to want ,of drainage, and reports as to the prevalency of these are desirable ; while as the system of disease reporting reaches greater and greater perfection and is better understood and appreciated by the people, it would be desirable to have included in the reports the more chronic diseases-such as those of the kidneys, liver, heart, etc. In view of the necessity for some knowledge of the general preva- lency of zymotic and infectious diseases especially, and of the course and extent of our ordinary epidemics, the Editor of this Journal last year proposed a plan for obtaining from ail parts of the Domin- ion reports or statements relating to these, or any other diseases. The plan provided for the appointment by the Federal Government of 144 reporters throughout the Dominion-physicians in good practice and residents of the cities, towns and principal villages, which places are usually the starting points and centres of epidem- ics. Blank forms to be provided for these official reporters, one of which each reporter wouhl fill in every fortnight and mail at once to Ottawa. The small fee of one dollar to be paid for each report, to commence with. There would be no postage to pay, nor r-her expense of any sort. The collected reports to be studied and compiled in Ottawa by a proper official, and a fortnightly report or bulletin to be prepared therefrom and copies to be freely distributed through- out the Dominion, along with any other sanitary information for the public thought desirable. The total cost would not exceed $ro,ooo 323",
         "THE SANITARY JOURNAL. This plan met with general approval by the medical profession, especially in Ontario, the medical journals commended it, and the Ontario Medical Council passed a resolution recommending it. It was laid before the Minister of Agriculture and the Government afterward passed an Order in Council making each electoral district or constituency of the Dominion a distinct district for the collection of health statistics, after the proposed plan. But the other provinces had not, like Ontario has, any system for the collection of vital or mortuary statistics, and it was afterward decided to suspend the order above mentioned, for carrying into practice the plan for col- lecting statements of disease alone, and adopt the present plan of collecting statistics of deaths along with certain monthly or quarterly disease reports from the principal cities only, for the present. Considering the comparatively small cost of obtaining from the two hundred and odd electoral districts of the Dominion of a fort- nightly statement of the condition of the public health in each of the districts, and the great advantages such statsnients would un- doubtedly give in the interests of the public health, the medical profession ought to unite in using the influence' of its members, collectivcly and individually, in order that some such plan as pro- posed last year may be adopted and carried into practice at an early day-for the collection and utilization of disease reports from all parts of the Dominion. These being defined as to locality, wQuld add to the good results of the present health reports of the Ontario health board. The official reporter in each district should reside in the most central or principal town in the district, and while relying chiefly on the knowledge obtained in his own practice and by direct observa- tion, in making up the reports, he could easily by a little enquiry during the fortnight obtain a good deal of reliable information as to the prevalency of disease throughout the entire district. As before intimated, the condition of the public health, especially as relating to infectious diseases, in the most central town itself and neighbor- hood would be a fair index of that throughout the district. While the plan would not give a complete knowledge of all prevailing dis- eases-which indeed it will hardly ever be possible to obtain, it would give such a knowledge of the general condition of the public health, and of the ourse and spread of epidemics, as would prove of immense value to the country, and at once and in a practical way. In large or irregularly outlined districts more reporters could be appointed from time to time as circumstances required. For the 324",
         "THE SANITARY JOURNAL. 325 few minutes of time necessary for filling in each of the simple blanks provided, even including a few other minutes occupied in making observations and enquiries, we believe one dollar would be regarded as satisfactory remuneration to make a commencement with. This would make the cost for 26 returns per year in 208 districts, $5,408. The cost of the work at the central office in Ottawa and the publica- tion of a sufficient number of fortnightly reports or bulletins for distribution need not exceed $4,500 ; and the whole cost would therefore be less than $ro,ooo per year. So soon as the Government felt itself to be in a position to extend the present system, commenced this year, for the collection of com- plete mortuary statistics, the number of burials in every cemetery or burial place of any kind in each district-say in every township in each district-could be obtained through these district reporting officers, and as we show elsewhere, at less expense than has been by some thought to be necessary. Hence in this way could soon be constituted a complete system of vital statistics with regular state- ments of disease. VALUE OF VACCINATION-AGAIN. Our most welcome exchange and cotemporary, the Sanitary Record (London, Eng.), has been tasking us somewhat severely on account of the paper in the June number of this JOURNAL relating to the value of vaccination. While we feel rather complimented by the statement (it being incorrect) that the paper is \"calculated to do an immensity of harm,\" we are quite sure that the Record is mistaken and believe that the paper will do an immensity of good. No good measure in this enlightened age can be injured by discus- sion and the light of truth. The Record is in error too when refer- ring to the paper as \"an attemupt to minimise as much as possible the value of vaccination.\" The prime object in preparing the paper was to induce las reliance to be placed upon vaccination and more upmon the strictest isolation and non-intercourse. When people rely so implicitly upon vaccination they are often not careful enough about avoiding exposure to cases of smallpox. In the paper are two excellent reasons for its publica- tion, briefly these: On the one hand we find that in Bavaria, in one year (1871), 30,742 persons were attacked with smallpox, of whom 4,784 died, though over 95 per cent. of them had been vac- cinated. On the other, we find, and as reported in the Record",
         "THE SANITARY JOURNAL. itself, that last year in Leicester, said to be the \" worst vaccinated city\" in England, 19 distinct importations of cases of smallpoxP representing so many centres or outbreaks of the disease, were so managed, by isolation, quarantine and disinfection that there were only 29 cases in ail, or io more than the importations-every out- break being at once thus stamped out. Would vaccination have done this ? No. Yet our friend of the Record trusts that our paper \"will not induce the good people of Toronto to cast aside the only efective protection against\" smallpox-vaccination. We marvel at this, after all the good things which have appeared in the Record bearing upon other most effective and rational prophylactics. All who scrupulously keep or are kept a safe distance away from every case of smallpox will escape the disease, but all who are vac- cinated do not escape it. And with proper sanitary administration -isolation and disinfection, with quarantine of any recently exposed, and with suitable dress, and respirators for attendants, the spread of smallpox or indeed of any other infectious disease may be completely prevented, and the disease soon wholly stamped out. While we cannot command this perfect sanitary administration it may be best to continue the practice of vaccination, as we stated in the paper ; when we can command such administration it will not be necessary to give rise to a disease in the human body in order to prevent a more serious one, either of the same character or another. . If our cotemporary will kindly bring forward some evidence against the \" strange hypothesis evolved out\" of our \"inner consciousness,\" that one epidemic disease may tend to prevent attack from another epidemic disease, we shall be glad to refer to that point again ; meantime we must confess we cannot now \"evolve\" out of our \"inner consciousness\" any way in which the increase in registered deaths from syphilis, skin diseases, etc., can be explained by \" the advance in knowledge\" of diagnosis. Had there been no advance in knowledge of diagnosis it is possible the number of registered deaths from such causes might now be still greater than they are. We would feel obliged if the Record would better explain our position to its readers. It was not so much our aim to minimise tne value of vaccination as to magnify the value of other preventives too much neglected. We have had no intention, nor do we intend, to really oppose the practice of vaccination. It will probably be best to con- tinue it for some time to come, at least. It affords a certain amount of protection, and although many who have been vaccinated take smallpox, death is less hikely to result from the attack. 3-6",
         "THE SANITARY JOURNAL. MARRIAGE FROM A MEDICAL STAND-POINT. Under this head our valuable cotemporary the Philadelphia Medical Times (Aug. 25) gives its readers the following very sensible and timely suggestions :-The venerable editor of the Yournal of the American Medical Association, in a recent issue, propounds the start- ling query, \" Do moral principles change? Are they subject to the Darwinian law of evolution ?» Although this important question is unanswered, it is left to be inferred, since it was raised in connection with our Code of Ethics, that it is not within the province of any State medical society to invalidate the Decalogue or to rescind the moral law as it applies to the relations existing between members of the profession or between the profession and the public. Since this point has been satisfactorily settled, it may be as well for a moment to extend the application of the query,-Do moral principles change ? Is there one code of morals for physicians, for instance, and another for surgeons, or, let us say, one for general practitioners and another for specialists ? Take gynæcology for example. A writer in the American Yournal of Obstetrics, in discussing a case of chronic invalidism in a neurotic and hysterical young girl, weak in body and mind, concludes, after consultation, that the only remedy that remains is-marriage ! As all others have failed, this must be the panacea. Without a word of sympathy for the unfortunate individual who is to take this forced card to the hymeneal lottery, or without apparently a thought as to the possible unfitness of such a mental and physical wreck for undertaking the duties of wife and mother, the recommendation is given, and marriage is to be tried like any other therapeutic expedient. Failure may mean domestic misery and unfaithfulness for the husband, but marriage from a medical stand-point has consideration only for the patient: the husband is left entirely out of the question. We think, however, that in such a case, unless moral principles have changed, the physician has incur- red a grave responsibility. Would he willingly consent to have his own son unite his life with such wretchedness? Let us take a sur- gical illustration. A young man acquires syphilis. Coming into skilful hands for treatment, one of the questions he is sure to ask is, \" How soon can I safely marry ?\" It is not proposed that the young wife or her family should be informed that the husband has a syphi- litic taint. Not at all. That would violate professional confidence. It is equally useless to suggest that the patient find some young, 32y",
         "328 THE SANITARY JOURNAL. woman who has been affiicted in like manner with himself, with whom he could unite on equal terms. No ; that is not at all his idea; he wishes to marry in his own set, perhaps some bright and pure young girl, respected and loved by all who know her, because a reformed rake is said to be very particular in this respect. What is the duty of the physician? Shall he give his consent to such an unequal marriage, even if two years of penance under mercury have been offered to atone for previous excesses under Aphrodite? Un- less moral principles have greatly changed, he cannot recommend any such union. His own daughter he would shield from such a marriage. Can he consistently sacrifice another on such an altar ? A DOMINION BUREAU OR DEPARTMENT OF HEALTH. At the present time when sanitary matters are attracting so much public attention in most countries, there is probably not any one thing that would, in proportion to the small expense involved, help more to make Canada popular abroad and regarded as a desirable country to live-in than the organization, in connection with one of the departments of the Federal Government at Ottawa, of a sub- department or bureau of health, including vital statistics. It should consist of a head, say a deputy minister of public health, and in connection with the department of agriculture, and of a council, consisting of at least four or five distinguished physicians, a member of the legal profession and an engineer, and perhaps a veterinary surgeon. The duty of the chief officer would be for the present to superintend the mortuary statistics and the disease reports and to utilize these and all other available means for educating the public in all matters pertaining to the health of the people. With future improvements in sanitary legislation his duties would be much enlarged. He should of course give his whole time to the work of the office and receive a liberal salary. The council should meet at least three or four times a year and consider all matters concerning the public health-vital statistics, health legislation, etc. The posi- tion of the council would be chiefly honorary, but all the expenses at least of the members should be paid with a liberal allowance for time occupied in the work of the department. For many years this JOURNAL has urged the formation of a centre of this sort, and the same has been strongly advocated by several of the presidents of the Canada Medical Association in their address during the past three or four years. It is time more definite and decisive action were taken. There can be no question but it would in the prevention of sickness save the county many-fold the cost incurred.",
         "THE SANITARY JOURNAL. VALUE OF MORTUARY STATISTICS. The number of deaths that occur at the early ages of life is very significant as to the vitality of any particular community. While the number for a single year may depend on some local epidemic, the average through a series of years is a very correct record of the vigor of the population. So the ultimate capacity of a nation can quite accurately be foretold by a close study of its vital statistics through a series of years. Forewarned is forearmed, not less to society than to individuals. Through such records States must study their tendencies to decadence, and so check the progress or interpose compensating influences. It is the misfortune of insanitary conditions not only to kill multitudes at an untimely age, but so to enfeeble or reduce race- vitality as to lower the health standard of those that live. Thus the deaths measure the entailments to the living and to their ancestry. An accurate knowledge of the relation of the death-rate to local conditions, aids very much in the diagnosis, the treatment and the prevention of illness. Physicians are now watching, also, more closely the types of dis- ease as they are modified by earth structure, topography, climate or by insanitary conditions in the person. We now fail not so much from deficiency in the aggregate of available and life.preserving knowledge, but in our personal possession of such knowledge, and not less in our ability to enforce what we do know upon the popular mind. We sliall never attain perfect corr,.ctness of methods, but the two most forward steps thereto are to know what is correct and to obtain so far as State, municipal and other local governments are concerned, a power to execute so far as is feasible. The success which has attended other governments and States in this direction is the guaranty that our efforts in the same direction will be of service. We are forced to study not only the vital but the social conditions of our population by the light afforded through the study of the forces which affect health and life. It is essential, if in one section of the State the population is dying at the rate of thirty to thirty-five per thousand and in another at oily sixteen or seventeen per thou- sand, that we ascertain the causes of the difference. Especially as so many of these causes are to be found within the reach and duty of control. All the moue because the epidemic originated or fos- tered by private or public filth does not stop amid its degraded beginnings, but invades the homes and the persons of those who have been personally careful. It is for this reason that no health administration is permanently effective which does not secure the numerical statement of marriages, of births and of deaths, in order that it may have them as the record of actual results, as the guides to observation and as the indices of those preventive methods which limit or abrte such devitalizing influences as enfeeble, demoralize and destroy the people. 329",
         "THE SANITARY JOURNAL. MORTUARY STATISTICS IN CANADA, AND THE COST OF THEM. Although it is very desirable that we should have at least approxi- mate reports at short intervals of the amount or proportion of disease prevailing, we cannot hope to obtain accurate returns of all the cases of sickness in a locality ; but as there are providentially only few deaths as compared with the total number of cases of sickness, and as death is an event of such a serious and marked character, it ought to be possible to obtain a record of every death which takes place in a community. The great value of a perfect record of deaths need not be dwelt upon ; it is universally conceded. It required many years in Great Britain to reach the present almost absolutely com- plete returns of vital statistics which they obtain there. In this country, with a much more scattered population, it is a much more difficult matter than it has been in Great Britain to obtain a perfect record. In Ontario, a system for the registration of births, marriages and deaths, similar to that of Great Britain, has been in force many years, and has been, especially of late years, vigilantly and vigorously administered, yet the records, especially of deaths, are far from per. fect. A plan has been this year put in operation in connection with the Department of Agriculture and Statistics at Ottawa for the pur- pose of obtaining a more perfect record. In this the number of burials is to be obtained from the cemeteries, and can hardly fail to reach all deaths which take place. It has been commenced in only eleven of the principal cities of the Dominion, with the view of ex- tending it as circumstances make this desirable. We propose to show that the cost of extending it to the whole Dominion would not be so great as soine have been led to suppose. There are probably not more than about 8o,ooo deaths in the Dominion every year, or, in round numbers, 20 deaths per 1,ooo of population, of 4,000,000 of inhabitants. We believe a perfect record of these could be obtained from the cemeteries and burial places for a sum not exceeding 25C. for each death, and that the total sum for collecting the whole would not exceed $29,oo. The sum of 15c. is now paid the caretakers of the cemeteries for a record of each death, which sum is ample enough. This part involves the principal pait of the work. They could be received from the caretakers of the different places of burial by a sanitary official in each electoral district, who could also make fortnightly reports of prevailing dis- eases. This official could receive them direct from the burial places, or perhaps more surely and completely, with but little extra expense, from the municipal clerk of each municipality. The plan ought soon to be extended throughout the whole Dominion. 330",
         "THE SANITARY JOURNAL. ON THE CAUSES AND PREVENTION OF EPIDEMICS. By J. W. MACDONALD, M.D., L.R.C.S.E., Medical Officer of Londonderry Iron Works, Nova Scotia. While the general sanitary dondition of the country and the preven- tion of widespread epidemics can onfly be secured by such systematic supervision as only a government can provide for, I wish particularly to draw attention to what can be done by individuals in preventing and checking local outbreaks of the epidemics which are constantly ravaging this country. I refer particularly to diphtheria, scarlet fever, typhoid and typhus. Four years ago I travelled over the greater part of Nova Scotia, examined the sanitary condition of its towns and villages and the influences which appeared to affect the origin and spread of the infectious diseases. In all cases it was found that the prevalence of these bore an exact relation to the want of cleanliness of the locality,. the impurity of drinking water and the carelessness of the people in allowing the infection to be carried from house to house. Many persons are fond of saying that our forefathers paid less regard to cleanliness than we do, and yet they were free from many of the epidemics which now affiict us. Such people forget that filth accumulates around dwellings year after year; that as people collect together in villages and towns the soil in the neighborhood of them becomes more and more saturated with filth, contaminating the air and drinking water, thus producing two of the most fruitful sources of disease-foul air and impure water. Many savage and nomadic tribes finding their village or encamp- ment after a time become unhealthy, ascribe their diseases to the displeasure or departure of their tutelar deity and remove their habi- tations to some distant and uncontaminated spot. What the savage found by experience we find true to-day, and what he attributes to the departure of his protecting deity we know to be the resuit of our own neglect. The whole subject of the prevention of disease can be summed up in one word-cleanliness. Not cleanliness of indi- viduals only, but purity of the person, purity of the air, purity of the dwelling, purity of the water, purity of all that surrounds the family. After all we are brought back to the simple faith of the Jews, that demons, evil spirits, call them what you will, diphtheria, typhoid, scarlet fever, are connected with foul places, and the remedy lies in the old and simple words-\" wash and be clean.\" A 2 331",
         "THE SANITARY JOURNAL. Let nie give an instance or two of the results which follow when an atmosphere is polluted with emanations from filth. In an eastern county of Nova Scotia a lobster canning establishment commenced operations in 1878, and in the month of July farmers carted the refuse and shells upon the fields. The air was filled with the stench of these decomposing heaps, and although there was no evidence of the disease being brought from outside, within a few weeks thirty- four cases of diphtheria occurred in the immediate neighborhood. Take another case, related to me by an old and very reliable physician. In a village near the shore of the Bay of Fundy the people were in the habit of drawing large quantities of fish from their boats to the neighborhood of their houses to be cleaned. One man brought his fish to a spot near his well and directly in front of his house. The dwelling was old and dilapidated. Slops and kitchen waters were thrown out the door and ran down the hill toward the well. The fish cleaning began in July, and by the first of August the stench of the combined fish refuse and slops was beyond endurance. Here is the record of the health of the man's family taken from the doctor's books : In August, 1854, they had \"putrid sore throat.\" In August, 1857, they had \"putrid sore throat.\" In August, 1858, diphtheria broke out and one child died. In August and September, i86o, they had diphtheria. In August, 1861, they had diphtheria. Here their dismal story ends, for the remaining three of the family died, and one daughter who had previously married and gone to a distant county, alone escaped. Where can we look for the cause of these frequent visitations occurring with such regularity, but in the filthy surroundings. The disease broke out each year at the time when the temperature of the atmosphere permitted the freest decom- position. Foul air not only gcts as a powerful agent in favoring the outbreak of disease, but its effects upon the course of disease already produced can be observed and measured. In one of the towns which I visited, an open sewer receiving the drainage from sinks, privies and stables passed directly under the kitchen floor of a house. Emerging be- neath the threshold of the door it passed through the yard covered by loose boards, and in its further course to the waters of the harbor, a distance of about one hundred yards, it served as a receptacle for eight or ten privies. The odor from this sewer was most offensive, 332",
         "THE SANITARY JOURNAL. and when the wind was westerly it was driven into the kitchen. Under these circumstances we cannot wonder that typhoid broke out iii the house. A woman, aged 30, was the victim. She had always enjoyed good health, but since coming to live in this house had gradually been failing: On the 2oth of August, 1879, Dr. Perrin, to whom I am indebted for notes of the case, was called to see her and found ber suffering from typhoid. The chart which I show you exhibits the temperature and pulse during the course of the disease. For the first two days the wind is easterly, blowing the sewer gas away from the house, and t'ne temperature of the patient ranges from 102 to 103. With a change of wind to the westward, the temperature goes up and con- tinues rising as long as the wind is from that quarter. On the sixth day the wind is easterly, and the improvement in temperature and pulse is very marked,-the pulse falling to 90 and the temperature to 102. On the ninth day the temperature flies up to 107, all the symptoms get worse, for the wind is again driving the poisoned air into the house. On the thirteenth day there is a lull, and by the fifteenth the pulse is down to go and the temperature to 1o1. But on the sixteenth the wind is back to the west, and up goes the tem- perature to 107, the pulse to 13o, and all the other symptoms aggravated, until from the twentieth to the twenty-third, a kindlier breeze brings down the temperature to 103, then 102, and at last to îoo. The west wind returns on the twenty-fourth, and at once the thermometer marks 107 and the pulse 130, to fall again to 101 and 9o respectively as soon as the wind changes. On the thirty-second day the temperature is down to 99, the pulse to roo, and convales- cence has begun. In the prevention of epidemics our efforts must be directed to three great points : i. To ensure perfect purity in all that surrounds the dwelling. 2. To keep the water supply free from impurity. 3. To isolate every case of infection at the earliest possible mo- ment, and thoroughly cleanse and disinfect every article exposed to the infection. When I assumed the duties of medical officer at the Londonderry Iron Works in January, 188o, I found that the neighborhood, num- bering about 3000 of a population, had for several years previously enjoyed a most unenviable reputation as a hotbed of diphtheria, typhoid and other infectious diseases. In the first fortnight I paid 333",
         "THE SANITARY JOURNAL. upwargs of 400 professional visits, nearly all of which were to per- sons suffering from infectious diseases. In the first -three-quarters ot the year 82 cases of diphtheria occurred ; scarlet fever, measles, typhoid fever and diarrhœa were also prevalent. Up to this time little or nothing had been done to check the progress of these dis- eases; people freely visited infected houses; dwellings were sur- rounded by heaps of filth ; many of the dwellings were built on swampy ground with badly drained cellars, and outhouses were neg- lected, and altogether the same unsanitary conditions prevailed which, alas! are too common all over the country. In September, i88o, a Board of Health was appointed, of which I have the honor of being chairman. Immediately after our appoint- ment we called a public meeting and laid before the people the plans we proposed to adopt, and I am happy to say that from that time to the present we have received the hearty support of the community. Notices were issued to householders to have ash-heaps and other refuse removed, to have cellars cleaned and bad drains and other nuisances attended to. At the same time every house in which diphtheria broke out was put under strict quarantine. This was done by first ensuring efficient nursing for the sufferers, and then preventing all intercourse between the inmates and the rest of the community. In the case of a death no funeral procession was permitted. The Board of Health took charge of the burial and made sure that the infection had no chance to spread. The result of our labors was soon apparent, for while we had 82 cases in the first three-quarters of the year, in the last quarter there were only 8, and from that time to the present, nearly three years, we have not had a single case. Diphtheria was stamped out. In the following spring arrangements were made for having the town cleaned up, and a thorough inspection was made from house to house. The neighborhood is not yet what it should be, but the most satisfactory results have followed the measures adopted, as will be seen by the following figures. In the first three-quarters of i88o there were 83 cases of diphtheria and 23 deaths. In 1881, not a single case. The cost of the 83 cases, for nursing, loss of labor, funeral expenses, etc., was at the lowest calculation $i8oo. That amount was saved in 188 [, and every year since. In i88o we had 20 cases of scarlet fever, which I traced to a bad well. The closing of this well and isolation of the sick prevented the disease from spreading further. In 1881 not a single case of scarlet fever 334",
         "THE SANITARY JOURNAL. occurred. Six cases of typhoid, one of which was fatal, occurred in i88o. In the following year, one very mild case. Altogether, we may infer that the means adopted prevented 163 cases of tedious and painful illness, saved the lives Of 29 people, and effected a money saving of at least $25oo; and all this in a population of less than 3ooo. But this was not all ; the general health of the commu- nity was greatly improved. In 188o my visiting list showed 6ooo professional visits ; in 1881, only 32oo, and it has remained at about that number every year since. \"SAVE THE CHILDREN.\" By all means. In the Toronto Globe of September 8th there is a suggestive and useful article under this head, with which we agree, excepting one sentence, this :-\" th'at the medical profession is not wholly free from blame\" in that there is so large a mortality amongst children. \"The medical profession could do much,\" it is stated, \" in enlightening mothers,\" etc. The profession could, and do, do much. They are more than blameless. As stated by the chairman, the Editor of this JOURNAL, at the meeting at Kingston last week, at which a Sanitary Association for the Dominion was organized, the history of the world has not afforded another exhibition at once so singular, so philanthropic, and so unselfish as those, which have of late years frequently taken place, of medical practitioners (who in this country earn a livelihood solely, with less than half a dozen exceptions, by attending to the sick) consulting together, puzzling their brains, spending their time and money, in devising ways and means for preventing the development of disease. As the Globe admits, \"many physicians are in the habit of giving valuable and timely advice,\" for which indeed we add they are never remunerated, and rarely is it appreciated. If every physician in Canada were to advise the mothers with whom they come in contact to invest a dollar or even twenty-five cents in a book on the management of children and to study it, how nany mothers would act upon this advice ? probably not one in a hundred. No, the public alone are to blame. They must learn to place more value upon preventive measures-less upon curative. The medical profession are already doing more, much more, than ought to be expected of its members. FRoM DR. JAMES, OF BELLEVILLE, we have received an interesting but lengthy paper on the analysis of the air in certain places in that city. We purpose giving some extracts from it in another number of this JOURNAL. 335",
         "THE SANITARY JOURNAL. CORRESPONDENCE. SANITATION, A SCIENTIFIC PREVENTION FOR SMALLPOX. (To the Editor of the SÂKiTARY JOURNAL, Toronto, Canada). SIR,-The impartial manner in which all matters relating to the public health are discussed in your ably conducted JOURNAL, encou- rages me to ask permission to place before your readers some facts relating to the above important subject. An interesting demonstra- tion of the value of sanitation in affording immunity against small- pox, even when surrounded by a pestilential atmosphere, is afforded by the associations in London which have devoted their attention to improving tle dwellings of the poor. A wholesome habitation in a crowded district is shown to dimin- ish the death-rate by a third or half, as compared with the occupiers of old houses in the same locality. I have a ieport of the thirty- sixth half-yearly meeting of the Improved Industrial Dwellings Company, held at the Mansion House, London, August 5th, 1881. This association controls 3,681 tenements or habitations (with a population of 18,ooo persons), nearly all of which are situated in the dense parts of the Metropolis, and the mortality is only 16.7 per thousand, while the death-rate from the adjoining houses is 30 to 35. Although the report is for a year when there was a severe epi- demic of smallpox, the secretary, Mr. James Moore, states that only one death from that disease occurred. , Again, the thirty-seventh report of the Metropolitan Association for Improving the Dwellings of the Industrial Classes, read by the secretary, June 6th, 1881, gives the death-rate of an average popula- tion of 5,675 at 15.5 per thousand. And as the average mortality of the entire Metropolis is 23 per thousand, there has been a saving of life of seven or eight per thousand. In the last-named associa- tion there has not been one death from smallpox during the past ten years, while the surrounding habitations have often been the hotbeds of variolous contagion. An equally satisfactory result has been achieved by the Victoria Dwellings Association, which has been in existence eight years. Their buildings are situated at King's Cross, a crowded centre of the Metropolis, and at Battersea, one of the outlying suburbs. The average population has been 2,5oo, out of whicli only twenty-four deaths occurred during the past twelve months, or less than half the Metropolitan death-rate, and not a single death from smallpox since he Association was formed. 336",
         "THE SANITARY JOURNAL. These prove that sanitation is sufficient to prevent and stamp out all zynotic diseases, including smallpox. Earl Spencer, in opening the Sanitary Exhibition in London, July, 1881, said that already in Great Britain the death-rate had been so much diminished during the past ten years, that 6oo,ooo lives have been saved, as compared with the previous decade, and this was due to improved sanitation. An official report on the sanitary condition of England for 1881, says that more than three fourths of the reduction is due to the decrease of severe zymotic diseases, the product of filth, which good sanitation can remove. Sir Lyon Playfair, the Parliamentary cham- pion of vaccination, said some years ago that \"no epidemic could withstand thorough cleanliness.\" I am, Sir, yours faithfully, WILLIAM TEBB, F.B.G.S. Devonshire Club, St. James's, London, England, August 28th, 1883. THE BY-LAWS SUGGESTED BY THE PROVINCIAL BOARD OF HEALTH. -It was a good thing to issue copies of proposed by-laws and rules and regulations for the guidance of municipal councils in establish- ing local boards of health throughout the province, as the Provincial Board of Health has recently done. It will promote desirable uni- formity in the various municipalities. The proposed by-laws, etc., comprise about all that the public would bear to have enforced at the present time. In reference to rule one, we would suggest that all privy vaults, cesspools and anything of that sort be one hundred feet at least from any dwelling house, shop or other inhabited place, as well as that diatance from the water-supply. When will the time come when such collections of filth will be entirely prevented, and no one permitted to keep such excrement on his premises more than twenty-four hours without being mingled with abundance of earth or ashes ? There is nothing about vaccination. The board it would seem rightly regard it as secondary to general sanitation. DR. LAROCQUE of Montreal, at the meeting of the Medical Association in Kingston last week, as chairman of the committee on public health, read an exhaustive and interesting report which he had prepared and which must have involved a good deal of labor. It gave in detail an account of the progress of public health work in Canada during the past few years and more especially of the last year. The report was well received. 337",
         "THE SANITARY JOURNAL. THE DOMINION SANITARY AsSOCIATIoN.-Inmediately after the adjournment of the meeting of the Medical Association in Kingston on Friday, 7th inst., a meeting took place for the formation of a Dominion Sanitary Association ; most of the medical men remaining. Dr. Playter, chairman of the committee of representatives from the different provinces appointed last December in Ottawa for organiz- ing the association, called the meeting to order, and briefly stated the objects of the meeting, which were chiefly to enlist the co-oper- ation, with medical men, of all others who feel an interest in public health work in Canada in the education of the people in all matters pertaining to health. There was only time for the election of the principal officers, forming the executive committee. Dr. Macdonald, of Londonderry, N. S., moved the inauguration of the society. He regarded with envy Ontario people, for whom good public health laws had been enacted. He alluded to the want of public health legislation in the lower provinces. Dr. Oldright seconded the resolution. The following officers were then elected : President, Dr. Sweetland, Ottawa ; Secretary-Treasurer, Mr. F. N. Boxer, Montreal; Vice-Presidents, Ontario, Dr. Covernton, Toronto; Quebec, Dr. Roy, Que.; New Brunswick, Dr. Bottsford, St. John; Nova Scotia, Dr. Macdonald, Londonderry; P. E. Island, Dr. Con- roy, Charlottetown; Manitoba, Dr. Lynch, Winnipeg ; Executive Committee for Ontario, Prof Galbraith, Prof. O. Harris, Dr. Mc- Canmon, Dr. Oldright. For Quebec, Dr. Rinfret, Que.; Dr. La- rocque, Ald. Fairbairn, Mr. Hughes, Montreal; Nova Scotia, Hon. Dr. Parker, Halifax; T. Slewen, C.E.; New Brunswick, Dr. Hard- ing ; the other members to be appointed by the Executive Commit- tee itself. THE AMERICAN PUBLIC HEALTH ASSOCIATION vIl meet in Detroit on the i3th, to 16th of November. The special subjects chosen for consideration are :-ist Malaria, 2nd Foods, 3rd Vital Statis- tics, 4th Control and removal of all decomposable material from households. Physical education and drill in the school-room and other topics will be discussed. Enquiries may be addressed to Dr. Wm. Brodie of Detroit. THE THIRD INTERNATIONAL CONGRESS of opponents to compui- sory vaccination will be held at Berne, Switzerland, Sept. 27, 28 and 29, when all European States where vaccination is enforced have been invited to send delegates. At the last Congress held at Co- logne, 40 delegates, representing 8 States, were present. Invita- tions it appears have been sent both to Canada and the United States. 338",
         "ORDEUS BY MAIL. W E furnish Samples free upon request; but as a single Season's Stock usually embraces more than One Thousand Different Lots of Clothing, it it obvious that only a fractional part of Goods on hand can be represented by Sample. An indefinite request gives us ne clue to your wants, and a Catalogue is sent to enable you to determine with precision what is desired. We should know the style of garment and the kind and color of material preferred, and whether the clothing is for Dress or ordinary wear, also about the Price you wish to pay. If Boy's clothing is desired, we should by all means have the boy's age. And even for Adults, it is an advantage to know whether the person ordering is a young or an old Gentleman, that we may be governed in our choice of grave or gay Patterns. If the person is an extra large size (over 42 inches Breast measure), it should also be mentioned. If you cannot wait for the return of Samples and are willing to trust the selec- tion of Garments to us, we will undertake to please you, with the understanding that goods not Satisfactory are returnable at our expense. P. JAMIESON, THE CLOTHIER, PALACE CLOTHING HOUSE, Cor. Yonge and Queen Sts., Toronto.",
         "PETLEY \u0026 PETLEY, (LIMITED) Wholoae1 Importers -AND- MANUFACTURERS. DEALER.S IN Dry Goods, Millinery, Silks and Carpets. Fine Ordered and READY MADE CLOTHING. 128 to 132 KING ST. EAST, Nearly opposite St. Lawrence Hall, Toronto.",
         "THE SANITARY JOURNAL. SOME CITY GRIEVANCEs.-The drivers of vehicles, especially of the heavier sort, are usually exceedingly indifferent as to who are on the crossings of the streets in cities when they drive their great horses and waggons across, and some of them ought to be taught a lesson which would prove a warning to all. It is suprising severe accidents do not occur from their indifference and such probably.wiil if more care be not observed. THosE WHO SWEEP THE SIDEWALKS in front of their shops should be required to sprinkle the parts first with water, in order to avoid a disagreeable and often very unwholesome dust for pedestrians to breathe This is a very common and easily remedied grievance. SMOKING ON THE SIDEWALKS is a practice which no gentleman indulges in, but it is nevertheless very common and very disgusting, especially when accompapied with careless spitting. It has been urged in this JOURNAL long ago that smoking on the sidewalks be prohibited, and it is gratifying to many to have observed that the question has been recently agitated in the Tovnto World. It may be safely predicted that the time is not far distant when the localities for indulging in this vile habit will be very limited, unless the smokers take to the fields. THE KINGSTON MEETING of the Canada Medical Association last week was one long to be remembered. The people of Kingston owe much to the medical men there for producing upon the profession throughout Canada such a favorable impression in relation to that clean, pretty city, with its fine parks, good buildings and beautiful scenery. The reception to the profession was a \"right royal\" one, and the delightful excursion with the charms of so many ladies, and dinner on the boat, seemed too much for a city of that size-but it has a large heart. The meeting was a good and profitable one. ON CHOLERA INFANiUM, the Canada Lancet gives its readers a practical article. Two sentences of it contain a great deal : \" If medicine furnishes no certain cure, it is satisfactory to know that the disease may be in a large measure prevented. Due regard to diet, clothing, cleanliness and purity of air is a pretty efficient safeguard.\" A DEATH has just been reported in Philadelphia (Science and Health) of a child, from eating candy loaded with \" Georgia clay.\" There seems no use warning parents against candies, frequently made of clay, arsenic and glucose; nothing but death in the cheap candies now in the American market. THE PEPTONOID BEEF of Reid and Carnick has proved in our hands to be a most valuable nutrient. A little of it added to ordi- nary vegetable soup gives this a \" body\" and renders it highly nutritious. We advise physicians, and cooks also, to give it a trial. AsK EVERY CLERGYMAN in your vicinity to preach one sermon on public health and rural improvement each year, says \" Indoors and outdoors.\" 339",
         "340 THE SANITARY JOURNAL. EDUCATION AND CRIME.-We are glad to observe that the St. Croix Courier (N. B.) bas been discussing this important question. Some time ago statistics were published in the Detroit Lancet show- ing that crime has been proportionately much more prevalent in the New England States (U. S. A.), where education bas been so gene- ral, than in the Southern States, with much more limited \" educa- tional advantages\" (?) We shall endeavor to obtain these statistics and refer to them again. SMALLPOX STAMPED OUT By GENERAL SANITATION.-In Wednes- bury (Med. Times and Gaz.) the Sanitary Authority has succeeded in stamping out smallpox in the district, where it bas prevailed for two years. The disease was brought into the town, and seven hun- dred cases have occurred, resulting in fifty deaths. A thorough sys- tem of isolation was carried out, and the authorities erected marquees in a field, to which affected persons were immediately removed. THE PUBLIC HEALTH COMMITTEE of the Canada Medical Asso- ciation for the ensuing year consists of Drs. Canniff, Oldright, Robil- lard, Yeomans, Harding, Larocque, Playter, Bottsford, Worthington, Wickwire, Covernton and Bryce. THE BACILLUS OF CONSUMPTION has been discovered by R. Ran- some in the vapor of the breath of persons in an advanced stage of this disease. \" Moral,\" don't re-breathe the breath of one affected with consumption. OYSTER SEASON AGAIN.--The raw or merely warmed oyster is almost self-digestive. Much heat destroys a natural digestive prin- ciple it contains. When cooked it must be digested like other animal foods. THE MICROCOCCUS OF CEREBRO-SPINAL MENINGITIS - Herr Leyden bas demonstrated this organism before the Berlin Society of Medicine. CURED HIMSELF.-Mark Twain clainis that last year, by chopping wood, he cured himself of thirteen different and distinct diseases. BOOK NOTICES. TRANSACTIONS OF THE MICHIGAN STATE MEDICAL SOCIETY for the year 1883. Lansing, Mich. : W. S. George \u0026 Co. REPORT ON DISEASES OF WOMEN FROM THE FIRsT CONGRESSIONAL DISTRICT. By R. J. Nunn, M.D., Savannah, Ga. Reprint from the Transactions of the Medical Association of Georgia. REPORT OF THE DEPARTMENT OF AGRICULTURE ANI) STATISTICs, Province of Manitoba, for the year 1882, a book of over 300 pp., with an unusually large proportion of solid reading matter relating to the crops (fruits, grasses, grains), stock, manufactures, railways, and to the vital statistics of the province. It contains an interesting report of the Provincial Medical health officer, James Kerr, M.D., on smallpox there, and on typhoid fever and the water supply.",
         "THE SANITARY JOURNAL. PHILADELPHIA MED1CAL TIMES, a bi-weekly Journal of Medical and Surgical Science, edited by Horatio C. Wood, M.D., assisted by Frank Woodbury, M.D. This is a very practical fortnightly journal. Subscription price $4 per year. THE MICROSCOPE AND ITS REVELATIONS. By Wm. B. Carpenter, C.B., M.D., LL.D. Sixth edition, with 26 plates and 500 woodcuts. Vol. ii. New York : Wm. Wood \u0026 Co. Toronto : Willing \u0026 Williamson. For May, '83. Pp. 354, cloth. For sale only by subscription, in monthly volumes at $15 per year. For the microscopist this work of Carpenter's is doubtless the best treatise published. This volume treats microscopically of the various forms of animal life, from the protozoa to vertebrata, and for both instruction and entertainment it is a storehouse of great value. It is well illustrated, showing some beautiful specimens of microscopic animals and of tissue structure, and also of geological formations and metallic crystalizations. HAND-BOOK OF ELECTRO-THERAPEUTICS. By Dr. Wilhelm Erb, Prof. in the University of Leipzig. Translated by L. Putzel, M.D., Neurologist to Ran- dall's Island Hospital, and Physician to the Clinic for Nervous Diseases, Bellevue out-door department, etc.; with 39 woodcuts ; pp. 366. New York: Wm. Wood \u0026 Co. Toronto : Willing \u0026 Williamsori. For June, '83. This is a concise and complete treatise on this important subject, in many respects superior to any other work of the kind published. Part I, the electrical apparatus and governing laws. Part II, the physiological effects of electro-the- rapeutics. Part III, methods of electrical examination and electro-diagnosis. Part IV, general electro-therapeutics. Part V, special electro-therapeutics. Besides an appendix on electro-therapeutics of the psychoses ; diseases of spinal cord ; of peripheral nerves ; paralysis and atrophy ; pain, neuralgia ; anæesthe- sia ; general neuroses, etc. THE PUBLIC HEALTH IN ONTARIO FOR AUGUST. HAMILTON-From Dr. Ryal's report the public health there was generally good during August. A good many cases of diarrhoa andsome of cholera infan. tum (nearly twice a, many deaths from the former as from the latter); a few cases of diphtheria and dysentery, and more of typhoid fever. LONDON-Dr. Edwards reports no epidemic of any sort there. A large pro- portion of diarrhœa and some cholera infantum, both on the decline; a few isolated cases of diphtheria and scarlet fever ; little of typhoid, whooping-cough or measles ; malarial fevers on the increase. On the whole, health remarkably good, mortality low. CHATHAM-Dr. Bray reports \"no epidemic of any kind.\" A good deal of diarrhœa and some cholera infantum-increasing; no diphtheria nor whooping- cough, mea-les about disappeared ; some scarlet fever-decreasing; more typhoid -increasing. On the whole, an unusually bealthy August. Less malarial fevers than usual though a good deal of ague reported. General mortality low. GLELPH-Dr. Brock reports the public health of that city as having been very good during last month. Some cholera infantum, more diarrhœa, and a few cases of diphtheria and whooping-cough. No epidemic of any kind. Mortality low. PORT HOPE-Dr. Hamilton reports some cases of cholera infantum, dysentery and diphtheria ; more diarrhœa ; no measles, scarlet fever nor typhoid ; whoop- ing-cough still epidemic-increasing ; cases of mild remittent fever and rheuma- tism. \" Funerals numerous enough, but deaths due to very various causes.\" 341",
         "THE SANITARY JOURNAL. BELLEVILLE-Dr. H. James reports many cases of cholera infantum and less diarrhœa ; with considerable dysentery ; cases of diphtheria, more scarlet fever, and a good deal of whooping-cough, lung affections and malarial fevers, with high mortality from lung disease. All except lung diseases of a mild type. BROCKVILLE-Dr. V. H. Moore reports many cases of diarrhœa-increasing, also of cholera infantum and dysentery-increasing, too ; some diphtheria and typhoid-decreasing; whooping-cough, epidemic in July, decreasing ; no mea- sles nor scarlet fever ; increase in lung affections. In consequence of cool wea- ther intestinal diseases of children less than usual for August. \" The town and surrounding country can be said to be in a very healthy condition.\" Mortality low. BAR RIE-Dr. McCarthy reports about the usual proportion of cholera infan- tum and diarrhœa, and some dysentery ; no diphtheria, nor typhoid, but some scarlet fever. Measles and whooping-cough, epidemic in June, decreased in July, had about disappeared. \" Health of town and neighborhood remarkably good. Mortality low. ST. CATHARINES-Dr. Greenwood reports that, unlike July, in August there was a great deal of sickness there, but only few deaths. No epidemic, but cases of cholera infantum, diarrhœa, dysentery, typhoid fever, a good deal of bronchi- tis, with considerable malarial fever and rheumatism. Most diseases on the increase. TORONTO-There is no particular epidemic here, but about the usual number of cases of infantile summer diseases ; a number of the principal practitioners report the month as unusually healthy on the whole. Now that the cholera scare is about over for the present, we hear less about cleaning up ; still it appears the work of improvement in this regard in going on fairly. THE CHOLERA.-Dr. John Roche, an English physician who has had remarkable experiences, says the Scientific American, gives as his conclusion that cholera is purely and simply a specific fever, only inferior in its.ravages to yellow fever, and closely allied to it. Cholera has a period of incubation varying from two to fourteen days: prone to attack the enervated and those subject to depression from any cause. It is contagious, and liable to occur periodically about every ten years in some parts of India. It seems to have visited the British Isles about every sixteen years, and as that period has elapsed since the last outbreak, it is more than like y to occur this year. Those persons who indulge in no enervating habits, and take nothing internally which would arrest the secretions nor too drastically stimulate them, and partake of nothing which is highly fermentable, may safely feel that they are cholera-proof during an epidemic. DEATH FROM A CARBUNCLE.-Dr. Frank L. Rea, of Chicago, died August 3, of malignant facial carbuncle. His death attracted a great of attention from medical men in the city. On Tuesday, July 31, he applied to a druggist to pull a hair from his moustache. The hair was pulled and examined by Dr. Rea, who said that the condi- tion of the hair root showed the beginning of a carbuncle. He died in five days. 342"
      ],
      "published" : [
         "[Toronto? : s.n., 1883]"
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         "8_05173_54"
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      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 5, no. 12 (Sept. 15th, 1883)]"
      ]
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   "doc" : {
      "type" : "document",
      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 3, no. 5] (Nov. 1874)]"
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      "published" : [
         "[Montréal : \"Gazette\" Print. House, 1874]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIQINAL COMMUNICATIONS. 7hi-ce cases of well marked Moral fisanity, .witi emarks; reportecd for the Canada Medical and Surgical Youymial. By HENRY HOWARD M.D., Medical Superintendent, of the Provincial Lunatic Asylum, St. Johns, P. Q. It is now a recognized fact, by aIl scientific medical men that there can be no case of Insanity, from any exciting cause whatever, if there does not exist already, an insane neurosis, that is a predisposition, in either, or both, of the intellectual and moral faculties, or more properly speaking the intellectual and moral organization, from which these faculties come. Of course there is the exception, where there is organic disease, such as apoplexy, and softening of the brain, or a disorganised state of the brain from direct injury. The next well established fact is, that all cases of Insanity,whether it be intellectual or moral, or a combination of both, is produced by physical causes. Some physical dis- ease of the nervous centre must exist, consequently insanity to be treated, on scientific principles, must be treated both physically and morally. There is not much difficulty in diag- nosing a case of insanity depending upon direct organic dis- ease, but it is not always very easy, to diagnose a case of in- sanity, particularly if it is moral insanity, frorm functional derangement. It is so very easy to confound moral insanity, with moral depravity, or what we call wickedness. The fol- lowing quotation is from Maudsley on \" Responsibility in Mental Diseases.\"",
         "194 CANADA MEDIoAL AND SURGICAL JOURNAL. \" This is a form of mental alienation which has so much the look of vice or crime that many persons regard it as an unfounded medical invention. Much indignation therefore has been stirred up where it has been pleaded to shelter a .supposed criminal. from the penal consequences of his offences ; and judges have repeatedly denounced it from the bench as 'a most dangerous medical doctrine' 'a dan- gerous innovation' which in the interest.of.society should be reprobated. The doctrine has no doubt been sometimes used improperly to shelter ân bfrocious criminal, but of the actual existence of such a form of disease no one who bas made a practical study of insanity entertains a doubt.\" \"Notwithstanding prejudices to the contrary, there is a disorder of mind in which, without illusion, delusion, or hallucination, the symptoms are miainly exhibited in a per- version of those mental facultiës, which are usually called the active and moral powers, the feelings, affections, propen- sities, temper, habits, and conduct. The affective life of the individual is profoundly deranged, and his derangement shows itself in wvhathe feels, desires, and docs. He has no capacity of true moral feeling, all his impulses and desires, to which he yields withou't check, are egoistic ; his conduct appears to be governed by immoral motives. which are obeyed without any evidcnt desire to resist them. There is an amazing moral insensibilifty. The intelligence is often acute enough, being not affected otherwise than in béing tainted by the in orbid feelings m:der the influence of which the persons thilnk d t Trdeedltey ofefeïdifSiáÿ 1an éxtraordinary ingénuity*in explaining, excusing, orjustifying their behaviour, exaggerating this, arid ignoring thàt, and so colouring the whole as to'make themséles appear the vie- tims of risepresentation and persecutiori. \"Their mèntal resources sér to be greater sornetinme( tianwhen they were veýlfidý INéy reason rnostacufèl, a#fparéhtlyibeendse ail'their ifitéll5t iaffacultiés are aplied t 0fle justification, anl gratifi à'àti of their selfish desires. Every medical superintendent of Lunatic aylums sees",
         "MORAL INSANITY-IIENRY IIOWARD, M.D. these cases of moral insanity, some of therm, however, more marked than others. The three following cases at present under my charge, are particularly well marked. Case 311 on the Register, young man aged 24, admitted January 1873. History as given by his father. Was a well educated, classical scholar, had always been a good, obedient son, and of good moral conduct. Threce months previous had some words.with his employer and left bis employment, became depressed in spirits, gradually becarne slovenly in bis person, and morose in his manners, and bis whole nature seemed to change. Fie became immodcest in bis actions, and would expose hiniself before bis mother and sisters, endeavoring to justify bis conduct by argument. His intel- lect appeared as clear as ever it was. His sisters feared to have him in the bouse, consequently his father brought him to the asylum. He has been with me now for nearly two years, bis in- tellectual faculties have never given. way, his moral conduct is iniproved, yet poor fellow he is guilty of that which I fear if continued, will in time dest;roy all bis faculties. Case 344 on the Register. Young man aged 20. Ex- actly a similar case to the first, history the same, conduct in asylum the same, with this difference, only, that the latter for a time,.was under the impression that bis father, and everyone else, wanted;to poison him. Case 358 on tbe. Register, a case of Dzpsovzania. A.girl aged 25. admitted May 12, 1874 . History ; has been i1 jaiI 63 times in 12 years, once in the peiitentiary, four times in Beauport Lunatic As' lum, is blind of an eye, having gouged it. out herself with her thumb. After being with me, for a couple of weeks she beçame perfectly well; she is perfectly well now, ber conduct il the asylum is irreproachable and she speaks as intelligentlyas any one can. :She tells me that when thefitcomesn ,ler for strong drink, she réusthave.it, no matter what is t4e consequence, shex yill have it, though she-knows it:sets be, not drunk, butý Mad, and, she would take.it though she knew it would cost her, her life, and she 195",
         "196 CANADA MEDICAL AND SURGICAL JOURNAL. would commit any crime to obtain it. Poor thing; I will take care that it will be a long time before she gets the chance. This is not the only case of this sort I have had under my charge, I have in my mind now,- the most thorough gentleman I ever knew, one of the most lovable men I ever met, so good, so kind, so full of the milk of human kindness, yet poor fellow, when this thirst for drink comes on, he gets just as'mad as the girl whose case I have given. His case is hereditary. It will be at once assumed that I have an object in view in writing to prove that there is such a disease as moral insanity. Most assuredly I have, one is to draw public attention to the fact, that there is such a disease and that the public should know it, and when they hear of an extraor- dinary, and an unaccountable crime being committed, before they enter into judgment, and condemnation, upon the per- petrator, they will in charity, wait, and see if he is not a victim of moral insanity. And this brings to my recollection that some time since there was a man, I think by the name of Bowen, condemned in Napanee, Ont., to four months imprisonment, and to be flogged twice, for having attempted to rape his own child. When we hear of such an unnatural crime, we naturally look for a case of moral insanity, and I beg that you will, through your Journal ask some of our confreres in that part of the country to give a report of the history of that man, his parentage, and, if possible, the history of his grand parents. Such a hi3tory may throw some light upon the case, that wouldbe useful in a scientific point of view. In conclusion, as man's intellectual and moral sensibili- ties are dependent upon his intellectual and moral organi- zation, and as these organizations, particularly in childhood, can be improved by a proper physical and moral education, should there not be great caution used on the part of parents and teachers, in the training of children? Have parents and teachers been cautious enough in this particular? Have they seen the necessity, that if they would have a strong",
         "REVIEWS AND NOTICES OF BOOKS. 197 mind, they must have a strong and healthy, body? Have they discriminated between the child of high mental or- ganization, and the child of low ? Have they discovered the fact, that the treatinent, which is good for one, is destructive of the other ? I fear not,I fear these thingshave not been properly attended to, I fear that pride and ambition, have taken the place of prudence and justice, and that because of this, we find in'sanity so much upon the increase all over the world, more particularly in Christendon. If -such is not the case, it will be very hard to say what is the cause, for certainly for the last century there have been fewer marriages of consanguinity than in any previous century, and moreover, I believe, bad as we are, less of drunkenness and general immorality. The Pliysician's Visiting List for 1875. Twenty-fourth year of its publication. Philadelphia: LINDSAY \u0026 BLAKISTON. We are indebted to Messrs. Lindsay \u0026 Blakiston of Philadelphia, for a Physician's visiting list for twenty-five patients per week, for the year 1875. This is the twenty- fourth year of the publication of this little book, and in common with many others we can testify to its usefulness, simplicity and general completeness. It contains among other things, an almanac for the year 1875; Marshall Hall's Ready Method in Asphyxia; Poisons and their antidotes: Table for calculating the period of Utero-gestation ; blank leaves for visiting list ; blank leaves for monthly memoranda, for obstetric engagements, for a record of births and deaths, and for general memoranda \u0026c. \u0026c. It is of a very convenient size for carrying in the pocket, and we can recommend it as the most compact and handy visiting list which we have yet seen.",
         "198 C-NADA MEDICAL AND SURGICAL JOURNAL Ectro-T/herapeutics; A Condensed iJanual of iMedical Electriciy. By D. F. LINCOLN, M.D., 8 vo. pp: 186. Philadelphia: Henry C. Lea, 1874. We have herg, in a small compass, a great deal of valuable information upon the subject of Medical Electricity. The author appears to have consulted almost all the recent writcrs on the subject, and his own experience in the treat- ment of nervous diseases by electricity seems to have been extensive. In chapters I. II. and III., we have a preli- minavy statement of the Physical laws, relating to or gov- ernin g electricity ; a short account of the various modes of gencrating it, and of its Physiological actions. Chapter IV. treats of Electricity as a means of diagnosis, and is, although short, verv suggestive. \" The main value of elec- tricity,\" says Dr. Lincoln, \"as an aid to diagnosis, lies in the indications its reactions furnish with respect to the seat of a motor lesion.\" If the lesion be central, the paralyzed motor nerve will still respond to electricity, but if the lesion be peripheral, the nerve loses wholly or in part its power of responding to electric stimuli. Of course the two lesions may coexist. in Chapter V. the methods of applying clectricity are described, and diagrams are given, showing the \"points d'election,\" which are the points most advantageous for producing given muscular contractions. These points correspond exactly to the places where the motor nerves enter the inuscular tissue. Chapter VI. is devoted to the Therapeutics of Electricity, and describes its use in the treatment of both medical and surgical diseases. This is a thoroughly practical chapter and is the most in- structive part of the book. Chapters VIL and VIII. are short; and are devoted, to cautions in the use. of electric batteries and hints regarding apparatus. A study of this little book will be very useful to the general practitioner, who has not time to devote to reading larger wôrks on the subject, 'and who wishes to employ what is now recognised as a valuable, thérapeutic agent. *",
         "REVIEWS AND NOTICES OF BOOKS. Lectures on the Clinical Uses of Eleciricity.-Delivered in University College Hospital. By J. RUSSELL REYNOLDS, K.D., F.R.C.P., Professor of the Principles and Practice of Medicine i-n University College, \u0026c., \u0026c. Second Edition. 8vo. pp. îi8. Philadelphia, LINDSAY \u0026 BLAKI- STON, 1874. We learn from the preface that these lectures, forming a special course, ivere delivered by Dr. Reynolds during the summer of 1870, in University College Hospital. A short- hand report by Dr. Gowers appeared at the time in the columns of the London Lancet. Subsequently, at the request of many of his pupils, Dr. Reynolds publishedl a revised edition of the lectures vith such additions and emendations as appeared to be dcsirable. The author wishing to render the work strictly practical has avoided all debatable ground, confining his remarks as closely as possible to ascertained facts as bearing on the clinical uses of electricity in the diagnosis and treatment of disease. The opening chapter consists in general remarks on the clinical uses of electricity, and here the author points out in what cases this agent can be rendered efficient in determining the presence or absence of disease. For instance in alleged paralysis of one limb, the application of the electric current will detect a difference between the two should such a state of things really exist, so that this agent is most valuable in the discovery of a condition known to exist, and which will occasionally give much trouble and perplexity,-ve allude to \"sham ;\" but,\"again, the necessity of caution is recommend- ed, as it is not always advisable or just to acquie'a patient of \" humbug,\" or malingering, simply becausewe are unable to detect an eléctric difference between two imbs, one of which the sufferer states he cannot move. There are other conditions, however, in whÎch electricity acts as a therap,eutic agent of great value-cases in which its use will apparently effect an instantaneous cure. W say apparently, because although a change arked and 1991",
         "200 CANADA MEDICAL AND SURGICAL JoURNAL. permanent is the result of a single application, yet the exist- ence of any actual morbid condition has been ivanting. It is precisely this class of patients that the charlatan delights to secure. By the use of his wonderful battery aperson who has been suffering, perhaps for months, from hysterical aphonia, will by a single application regain her voice. Again, there are other conditions which are relieved by the applications of this therapeutic agent. Pain .may be assuaged, spasms relieved, and paralysis ultimately removed. A third group of cases there are in which electricity will fail to cure, but in which the progress of the disease vill be arrested ; and lastly, there is a class of cases in which the application of electricity can do no good, but on the con- trary much harrn may follow its use. The author observes, \" The general facts which I wish you therefore to bear in \"mind with regard to the two nain directions in which \"electricity is useful are these : That like other modes of \"examination or treatment, this one bas its limits, and that \"only by its appropriate employment within these limits \"can it be of any real service in either diagnosis or thera- peutics.\" We have next a description of the various forms of electricity in clinical use : as first, the Franklinic, static or friction electricity ; under this head is included the electric bath, the shock, the application of sparks and the use of the Leyden vial. Secondly, Galvanic electri- city, either the constant or the interrupted current. The meaning of the termsý direct and inverse are explained, and other practical observations are noted. Thirdly, that form of electricity known as faradization, or \" that parti- cular kind of which Faraday was the exponent.\" This is of very high tension, and resembles Franklinic electricity more closely than it does the galvanic current. This form of electricity has been known or distinguished by the several terms, \" induced electricity,\" \" magneto-electric,\" \"voltao-magnetic,\" and \" voltao-dynamic.' With regard to this form, \" there are two terms commonly used about it,",
         "REVIEWS AND NOTICES OF -BooKS. primary and secondary,-this for clinical purposes is almost a useless distinction.\" The word 'primary\" appears to be an improper use of that ter m, \" for the current so named is not a primary currentin the sense of being a simple battery current :\" it is a battery current strengthened by induction. The secondary current is when you have an induction from an induction, and is therefore secondarily induced, the differ- ence between them clinically is mainly one of intensity, the secondary possessing greater intensity than the primary. The author next proceeds to review the various clinical effects of electricity when applied. These he divides into, first, its chemical effects, such as the production of blister, coagulation of the blood, its effect as a cautery, and its use in dissolving calculi; and secondly, its vital effects, as its action on the nerves, cither calling into play nervous action which has been partially lost, or in diminishing the activity of a nerve when in excess. On muscles, electricity may with advantage be applied either in cases where there exists morbid inactivity or where there is a state of spasm either tonic or clonic. Electricity, from whatever source, may be applied to any one muscle or group of muscles through the skin or through the nerve trunks which supply the muscles. On the skin, it will increase the activity of the capillary circulation, in cases of partial paralysis, or in cases of languid circulation. All the forms of electricity are of benefit in these cases. The continuous current will moreover have a decided effect on the deeper tissues of a limb, so that the nutrition of the muscles and most probably of the nerves may be improved. Another beneficial effect that will undoubtedly result from the use of electricity is the general improvement of the nutrition of the part to which it is applied. The bulk of a wasted muscle may by this méans be increased, whether the wast- ing has been due to degeneration of the muscular tissue,- disease or accidental.division of its nerve, blood poisoning, disease of the spinal cord or .brain, or disuse., as in long- existing palsy. We next have a chapter on the diagnostic 201",
         "CANADA MEDICAL AND SURGICAL JOURNAL. uses of electricity, and another on the clinical uses of elec- tricity, and an appendix in which is described the require- ments of an electrical room We have perused this little book with much interest and can heartily recommend it for its practical value. Not only will the reader, in its pages ascertain what diseases or conditions of the system are benefitted by the use of electricity, but he will here see what form of electricity will be most advantageously employed. A Cinmical History of the M1édical and Siurgical Discases of IWomen. By ROBERT BARNES, Mi\\I. D., London. Fellow \u0026 Lumleian lecturer (1873), Royal College of Physicians ; Examiner in Obstetrics and the diseases of wornen at the University of London and the Royal College of Surgeons: Obstetric Physician and Lec- turer on Obstetrics and the diseases of women to St. Thomas's Hospital. With one hundred and sixty- nine illustrations, 8 vo. pp., 791. Philadelphia, Henry C. Lea, 1874. This subject, as Dr. Barnes remarks, is indecd wicle and important, not only in its direct application -to the relief of the special diseases it embraces, but also in its endless and interesting relations to the physiological and pathological history of women. \"A physician cannot possibly under- stand many of· the disorders of the organs of assimilation, of respiration, of circulation, and especially of the nervous system, without a careful investigation of the condition of the reproductive organs.\" : How very frequently, indeed, do we see disturbances in remote parts treated as arising from a variety of suspected local disorders, when in fact they are: entirely Qriginated from someý trouble,, cither functional or organic in the gererative organs: Admitting this, as we think every onemust do, we recognize the para- mount importance to the:practical physician of possessing a, sufficient . and satisfactory. knowledge .of the. various affections to which these organs' are liable, in order to be 20 2",
         "REVIEWS AND NOTICES -OF BOOKS. able to assure himself of the presence or absence of any of them in any given case. . Now, although we have a goodly number of treatises upon diseases of women, yet this branch bas justly been denominated by*the author \"one of the less generally cultivated departments of medicine \"-and therefore it is that there yet remain in it so 1many points of unsettled pathology and undecided questions of treatnent. Dr. Barnes, in this book, brings to us the results of his extended researches towards ex- plaining matters appertaining to pathology, and of his immense experience towards determining the value of various lines of treatment. An introductory ground work is laid in the commencing chapters by a most careful des- cription of the general and minute anatomy of the whole of the generative organs, and then all the known functional and organic derangrements of these organs are treated of seriatim. It is called a Clinical history and, although the arrangement of the volume is systematic, yet the great mass of the author's reiarks cone to us as though made (as indeed they have been) from observations of his own and, thus possess all the force of bedside teaching by a master of bis art. Hardly a subject but is illustrated by the recital of original cases from the author's'own notes, each tending to bear out the point to be impressed. The functional disorders, Amenorrhea, Dysmenorrhoea y Men- orrhagia,'\u0026c., are first treated of in the most exhaustive manner, including special and practical notices of such other affections as vaginismus, dyspareunia, \u0026c., together with the signifiance to be attached to each of these. Special chapters are- also devoted to \"the menstrual irregularities of the climacteric epoch\"-'' the influences of ovulation and menstruation in evoking morbid influences\" -L\"the disorder- of senility or dlecrepitude.\" Eight chapters are then devoted to a description of the abnormal conditions and organic diseases of the ovary-special attention being given to. the diagnosis and treatnient of \u0026vàrian.'cystic disease undeï every pdssible variety of cir- 203",
         "204 CANADA MEDICAL AND SURGICAL JOURNAL. cumstances. Now that ovariotomy is one of our recog- nised operations and it is so frequently performed, it be- hoves every surgeon to be freely acquainted with all the difficulties which may surround the diagnosis of a difficult case and the dangers to be met with in the performance of the operation. Much can here be learnt to assist him in forming an accurate and confident opinion of the exact nature of the abdominal contents and in avoiding those perils which are likely to beset his path. Next we have treated of, the organic disorders of the Uteru s and Uterine ligaments-inflammatory, develop- mental and mechanical, Perhaps one of the most valuable and complete of these chapters is that upon pelvic hæma- tocele, the frequency of which is not even yet generally admitted, but which, through greater care and minuter ex- aminations is being more and more frequently recognized. Numbers of cases, presenting a variety of phases, are alluded to in the text. All the displacements and the different modes of managing each, are succesively described, and then the Tumors of the Uterus are taken up and chap- ters subsequently devoted to Cancer and Tubercle of the Uterus. Finally we have a section describing the diseases of the Vagina and of the Vulva. Dr. Barnes deserves the thanks of the entire medical community for the production of this treatise through which every physician interested in Gynœcology is at once put in possession of the fruits of the immense toil and vast experience of one who has done so much to enrich this particular branch of medical science. The book is extremely well printed and the illustrations are original and very valuable. The Physician's Dose and Symptom Book. By JoSEPH H. WYTHES, A.M., M.D., Author of the \" Microscopist \" \u0026c.-Eleventh Edition, 8 vo., pp., 236 ;-Philadelphia, Lindsay and Blakiston, 1874. - We have here the eleventh edition of this little book, which",
         "BOOKS RECEIVED FOR REVIEW. appears to have been received with great favour by our Ame- rican professional brethren. In this edition the same arrange- ment has been followed as in the last, but it has been revised and compared with the U. S. Dispensatory \u0026c., and the author has endeavoured, as he tells us, \"to embody the recent additions to the Materia Medica, as well as every article likely to be useful.\" In this comprehensive undertaking, he appears to have met vith a limited amount of success, and we have no doubt that many a hard worked practitioner will find it a useful little work to have on his study table. In Section V. ,we have an Index of Diseases and Treatment, after Tanner. In the next section we have an Alphabetical List of Medicines with their uses, doses \u0026c., and in section VII. a Pharmaceutical Arrangement of the Materia Medica. At this point we think that the author vould have been wise to have stopped. The remainder of the work is occupied with a Table of Symptomatology and with Outlines of General Pathology and Therapeutics. These we think should be systematically studied in more comprehensive works, and elucidated by careful clin'cal observation. We think that this part of the work so far from being useful, may become positively injurious, by inducing carelessness, and a slip shod mode of practice. We are far from claiming for Medicine the honours of an exact science, but we would gladly sec the Practice of Medicine followed in a scientific spirit. This end is not to be attained by the constant use of manuals like the present, although we should not like to sec this one consigned to the limbo which to our mind is the just portion of the whole tribe of \" Remembrancers.\" Tlherapeutics and Materia Medica.-A Systematic Treat- ise of the action and uses of Medicinal agents including their description and history. By ALFRED STILLE, M.D., Professor of Theoryand Practice of Medicine andof Clinir1 205",
         "206 CANADA 3IEDICAL AND SURGICAL JOURNAL. Medicine in the University of Pennsylvania \u0026c., \u0026c., \u0026c. Fourth Edition thoroughly revised and *enlarged. In two volumes 8 vo: vol. 1, pp. 968; vol. 2, pp: 976. Phila- delphia: Henry C. Lea, 1874. Essentials of the Priniciples and Prectice of iMedicine; a hand book for students and practitioners. By HENRY HARTSHORNE, A.M., M.D., Professor of Hygiene in the University of Pennsylvania, '\u0026c., \u0026c. Fourth Edition: thoroughly revised, with one hundred illustrations. S vo. pp: 548. Philadelphia: Henry C. Lea, 1874. Clinical Lectures on Tariois Inportant Discases,; being a collection of the Clinical Lectures delivered in the Medical ward of Mercy Hospital, Chicago. By MATTIIEW S. DAv1s, A.M., M.D., Prof. Principles and Practice of Medicine and Clinical Medicine in Chicago Medical College. Edited by Frank H. Davis, M.D., second Edition 8 vo. pp: 287. Philadelphia: Henry C. Lea, 1874. SURGERY. Nasal Catarrl; its Patlhology anti Trealment. By EDWARD C. MANN, M.D., New York. As the nasal niucous membrane is especially liable to become involvéd in the nutritive and fuictional disorders characteristic of catarrh; it is propr .to look briefly at the anatomy'of the region, the diseased condition of which we propose to treat. The pituitary or Schneiderian mucous membrane, which lines the nasàl'càvities, is èontinuousexternallywith the skin, through the anterior nares, and with the mucous membrane of.the pharynx through the posterior nares., P From the. nasal fossie tit is continuous vi.th, the:cpnjunctiva proceeding through the nasal du.ct and lachrymal canals.: It may also be traced, proceeding -through the Eustachian tube, being",
         "NASAL CATAIRRH-E. C. 3ANN, 31.D. continuous with the lining membrane of the tynpanum and mastoid cells. It is also continios with the frontal, ethmoidal, and sphenoidal sinuses, and antrum maxillare, through the opening irÇ the meatuses. The nasal mucous membrane is thickest and most vascular over the turbinated bones and septum, and is verv thin where it lines the in- tervals between the spongy boncs, and also on the floor of the nasal f\u003essa. At the upper part of the nasal fossoe the mucous membrane is covered with tessellated cpithelium corresponding with the distribution of the olfactory nerve, but the remainder of it is covered with ciliated epithelium, except at the entrance to the nares. The nasal mucous membrane is abundantly supplicd with mucous glands, the ducts of which open upon its surface. The arteries supply- ing the nasal fosso are the anterior and posterior ethnoidal, from the ophthalmic, which supply the ethmoiclal cells, frontal sinuses, and roof of the nose ; the spheno-palatine, which proceeds from the internal maxillary artery, and supplies the mucous membrane covering the spongy bones, thc meatuses, and septum ; and, lastly, the alveolar branch cf the internal maxillary artery, which supplies the iining membrane of the antrum. The olfactory nerves, which preside over the sense of smell, break up into bundles of primitive fibres, which bundles are contained in nucleated sheaths, and are conposed of the flnest fibrillæe, which are held together by finely granular natter. These bundles of nerve-fibres penetrate into the epithelial layer, pass outward between the epithelial cells, and probably.terminate by free extremities. The finest fibrillæ of the olfactory nerves, after penetrating to the epithelial layer, are supposed to surround the epithelial cells. on all sides, and with them reach the surface ôf the epithelial layer. The large epi- thelial cells are seen by the microscope to be covered with fine lorigituidinal-striæé over their entire length,':which are supposed to be the terminal extremities of these fibrillkeof the elfactoÉy herves. Nasal catarrh may be de fined'as an acute catarrhal in-",
         "208 CANADA MEDICAL AND SURGICAL JOURNAL. flammation of the mucous membrane which lines the nasal cavities, beginning with hyperæemia of the mucous mem- brane, followed by swelling, accompanied at first by exces- sive dryness of the mucous membrane, and afterward by-a secretion, which is at first thin and watery in character, and afterward, if the discase progress to any extent, becomes muco-purulent or even purulent in character, giving rise to ozoena, which term is used to denote any chronic discharge of a fetid character from the nasal cavities. At the outset of an attack of acute nasal catarrh, the capillary vessels of the nasal mucous membrane are dis- tended with blood, the tissues are infiltrated, and from the mucous membrane, swollen by congestion and œdema, is discharged a thin, colorless saline secretion. -After the primary swelling and congestion have subsided, this secre- tion becomes thickened from the addition of young cells. If the disease runs into the chronic form we shall find the nasal mucous membrane considerably thickened, especially the mucous membrane covering the turbinated bones. The swellings of the nasal mucous membrane do, not have their seat in the mucosa, but are œdematous infiltrations of the sub-mucous connective tissue. The swelling is dependent upon the amount of hyperæmia, so far as depends upon the increase of volume of the vessels and upon a more abundant saturation of the mucous membrane with serum. After this condition, which characterizes acute catarrh, the mucous membrane may return completely to its normal condition, but it is liable, upon very slight irritation, to again take on catarrhal inflammation,; and such relapses are much more difficult to treat than was the primary disease. Each relapse increases the proliferation of cells in the sub-mucous con- nective tissue. The epithelium and mucous glands grad- ually enlarge, and the mucous membrane passes into an hypertrophied condition. In chronic nasal catarrh we find in many instances catarrhal ulcers, superficial as a rule, but which in scrofulous and cachectic patients may. penetrate more deeply, destroying the perichondrium and periosteum,",
         "NASAL CATARRH-E. C. MANN, M.D. and giving rise to caries and necrosis of the cartilages and bones of the nose. In these cases, the secretion from the nasal passages is extremely offensive, requiring the use of deodorizing solutions of chloride of lime, or permanganate of potassa, which may be used with the posterior nasal syringe or nasal douche. A solution of glycerine containirig iodine and iodide of potassium has rendered us great service in these scrofulous conditions, by aiding in the detachment of thick crusts, exfoliating bone, etc. In cases where the mucous membrane is much thickened, applications of ni- trate of silver will often afford relief; but where there is relaxation of the mucous membrane, or where it has assumed the condition of mucoid polypous outgrowths, which block up the nasal passages, the best plan will be to remove such growths, either by twisting them off by forceps, or enCir- cling them with a wire snare, and then cutting them off by drawing the loop tight, after which the remaining portions may be cauterized with nitrate of silver. The senses of smell and taste are perverted, and in chronic cases it is not uncommon to find complete anosmia resulting from the effect produced bythe long-continued inflammatory pi ocess upon the terminal distribution of the olfactory nerves. The symptoms are very varied in chafacter, affecting some persons but slightly, while others suffer intensely from the severity and rapid recurrence of these attacks. The symptoms at the outset are a sense of dryness, irritability and obstruction ii the nostrils, with difficulty in nasal res piration. There is also very severe pain in the region of the frontál sinuses, and, if the inflammation has extended to the Eustàcliián tube, the patient will cornplaiîi of ýraring noises in the auditorcanâl, with ome pain and duhriess of-heâiing. TheréKvill be also a constant dispositionio sneežé, which' is kCpt up :by the irrifation of the inflanied mucous membrane bthe saline secretion. This irria tinjb prop'erty of the wávtei Necretioih is due to the qûantitý 6df amnoniaèontain d i n itahd annéiyften itcaises ex orationi of the upper lip as it flows over i't 14 209",
         "210 cANADA MEDICAL AND SURGIcAL JOURNAL. In chronic nasal catarrh the symptoms differ entirely, the prickling sensation in the nose, sneezing, frontal pains, and febrile action, being generally absent, while in their place we find obstruction of the nasal passages, owing to the mucous membrane being relaxed, and the membrane cover- ing the turbinated bones hypertrophied and thickened. There will also be found accumulations of thickened crusts of inspissated mucus at the entrance to the posterior nares. The secretion of chronic catarrh is of a muccus, muco- purulent, and (in cases of ulceration of mucous membrane) purulent character. In cases where there is no ulceration of the mucous membrane there is generally no fetor attend- ing the discharge from the nasal passages ; while in scro- fulous or syphilitic cases, attended with caries, or necrosis, or even ulceration, we generally perceive it, even at quite a little distanice from the patient. The length of an attack of acute nasal catarrh varies from two or three days to a week or two ; while the chronic form of nasal catarrh is an ex- ceedingly obstinate disease, lasting sometimes for years. In view of the predisposition of nasal catarrh to assume a chronic form, andof the difficulty experienced in eradicating it when it has lasted for some months, it becomes a matter of great interest to those interesfed in diseases of the throat and respiratory organs. By means of rhinoscopic examin- ations we are enabled, much more accurately than formerly, to determine the seat and progress of nasal catarrh, and to make local applications to the mucous membrane covering the turbinated bones and septum, which are the parts especially liable to take on ulceration'; and it is here also that we find the greatest thickening and hypertrophy of the mucous membrane, resulting sometimes in the pro- duction of mucoid polypi, These polypi owe their pro- duction to a circumscribed hypertrophy of the mucous membrane, which is especially concentrated upon the glands. The principal mass of the tumor is formed by hypertrophic glands, and it is attached to the mucous maembrane by a more or less distinct pedicle.",
         "NASAL -CATARRH--E. C. MANN M.D. The treatm ent of nasal catarrh heretofore has consisted in the application of nitrate of silver,,and in the use of as- tringent injections, together with the employnent ofvarious snuffs containing merc-urials, tannin, alum, zinc, lead, etc., all of which have signally failed to accomplish radical cures. The first indication evidently in all cases is to build up the patient's system, and, for this purpose, prepa rations of iron and, quinine, with the use of cod-liver oil, combined with iodine in scrofulous cases, will generally suffice, toning up the system and aiding materially the local treatrnent. The first thing to be accomplished in the local treatment is, to clear out the nasal passages, anteriorly and posteriorly, in orderto prepare the nasal mucous membrane for medication; and to this end, Thudlicuni's nasal douche, or the posterior nasal syringC, mav be used with a warm saline solution, containing sixty grains of the chloride of sodium to the pint of water. This operation villi have the cffect of clearing the nasal cavities of the accumulations of crusts, and will leave the surface of the mucous membrane clear and free for the local applications. After the nasal mucous mem- brane has been thus preparedl for the reception of medi- cation, a solution of nitrate of silver may be applied thoroughly to the entire surface of the nasal cavity, which will have the effect of diminishing the thickening and con- gestion of the mucous membrane. This application is recommended to be followed by the propulsion of the vapor of iodine into the nasal passages anteriorly, by means of an instrument similar to that devised by Dr. Roosa, of this city. The instrument used by the writer is made of hard rubber, having a cavity filled with sponge which is medicated with the tincture of iodine. Upon one end of this hard-rubber apparatus is attached a nasal tube fitting into the nostril, while to the other extremity is attached a soft-rubber bulb with a flexible tube. By compressing the bulb, atmospheric air, or steam if desired, is forced through the hard-rubber apparatus containing the sponge saturated with iodine, and difluses the vapor of iodine throughout the entire extent of 211",
         "212 CANADA MEDICAL AND SURGICAL JOURNAL. the nasal cavities, exerting a powerful alterative and curative effect upon the mucous membrane of the nasal cavities and Eustachian tubes ; and especially in cases of swelling and hypertrophic thickening of the mucous membrane covering the turbinated bones' and septum. After a very few ap- plications have been made, a very free flow of scrurn will be induced, and the sub-mucous infiltration will be much lessened. The sense of hearing, which is often impaired by the extension of the catarrhal inflammation to the Eus- tachian tubes, xwill often be restored by these applications, after the flow of serum has relieved the congestion and swelling of the mucous membrane. The sense of smell, which in chronic catarrh is often entirely obliterated, is also restored as the mucous membrane returns to its normal con- dition. These applications can be more or less prolonged as the cases are more or less advanced in character ; fifteen minutes, however, being considered by the writer a sufficient length of time, if the applications are properly made. The use of the nasal',douche should precedce each application. A snuff, composed of equal parts of finely-pulverized cam- phor and 'White powdered sugar, is also given to the patient, with instructions to use it ad libitum; and patients are unanimous in their expressions of relief subsequent to its use. The preceding, together with the use of injections, and sprays of sulphate of zinc or copper, constitutes the writes treatment for nasal catarrh in the acute and chronic forms, and it, has proved equal to the cure of several very obstinate cases which had been considered incurable. The following cases serve to illustrate the success of the plan of treatment recommended. William C., fourteen years ; occupation, school. Duration of disease. three years. Previous treatment consisted. in applications of various catarrh-snuffs, which had done no good. There were complete anosmia ànd partial deafness, owing to the linirig'rnerhbrine of thé' Eustâhich sibes Ifiàvin'g become affected by the e're'n'sion of-e inflammatin Mò-then. Erilaged veincsôbuld %b sée h ' po*teidr",
         "NASAL CATARRH-E. C. MANN, M.D. pharyngeal wall. Examination anteriorly with nasal specu- lum revealed a congested and swollen condition of the mucous membrane, with considerable infiltration. At the posterior part of the right nostril. could be seen, projecting into the nasal cavity, a small mucoid polypus, which oc- cluded the nasal pa-ssage considerably, preventing the free nasal respiration which should take place. Rhinoscopic examination revealed a very red and thickened appearance of the mucous membrane covering the turbinated bones, particularly the miçddle and lower ones, and also the septum. The secretion from the nasal passages vas conposed of mucus, and at times was muco-purulent in character. The patient had lost all power of distinguishing different odors, and'his voice had acquired a strong nasal twang. He was obliged to keep the mouth open during respiration, owing to the partial occlusion of the nostrils by the hypertrophic thickening of the nasal mucous membrane, and the presence of the small polypus before ailuded to. The treatment w as commenced by a very thorough use of Thudicum's nasal douche, with a warm saline solution. This resulted in the detachment and expulsion of a large occumulation of crusts of inspissated mucus. After this operation the mucous membrane of the nasal cavities was painted over with a solution of nitrate of silver in glycerine, sixty grains to the ounce. On the following day the nasal douche was again used, and the operation followed by the propulsion of the vapor of iodine by means of the istrument pteviously clescribed. After.this appli cation the patient complained of a slight burning sensation,; which soon passed away After the fourth application of this character, there was a very.free flow\u003cof serum induced, Mhich relieved the patient greatly, diminishing the swelling of the mnucòus menbrane. The patient ivas givena snu, ýomposed of equal parts of. pulverized camphor, and powdered sugarto be used by him ad.libitum; and h successive boxes were- givenhim, as he.seemed tobe so ch :ieheed by its use. The small mucoid - polypus was 213",
         "214 CANADA MEDICAL AND SURGICAL JOURNAL. twisted off, and the attachment of the mucous membrane cauterized with the nitrate of silver. Upon microscopical examination this tumor was found to consist principally of enlarged glands, the remainder being mucous tissue. The above-mentioned treatmient was persisted in for three months, the use of the nasal douche preceding each.appli- cation of the iodine. At the end of that time the swelling' of the mucous nembrane, together with the discharge from the nasal passages, had entirely disappeared. Nasal res- piration was re-established, the partially-obliterated sense of hearing reappeared, and the sense of smell at the termi- nation of treatment was normally acute. Elizabeth G., eleven years of age; duration of disease, eight months. Rhinoscopic examination revealed conges- tion and swelling of the mucous membrane of turbinated bones and naso-pharyngeal cavity, but no apparent thicken- ing. There was excessive secretion of mucus, and partial loss of smell. The nasal douche was used, and the nasal cavity painted over with the following* R. Iodini, gr. vj. Potass. iodid., gr. xij. Glycerin., oz. ij. M. This was followed by the propulsion of the vapor of iodine, applications being made every other day, and in a little less than three weeks the disease had yielded completely to treat- ment, and the patient was discharged. During the treat- ment of the above-mentioned case, the patient, being insuffi- ciently nourished, was put upon a mixture of cod-liver oil and syrup of the iodide of iron. The camphorated snuff was also given her to use. Another case, in a.boy sixteen years old, vas complicated with glandular enlargements at the vault of the phariynx, to which the writer's attention was drawn from the patient's complaint of the constant dropping of mucus from \"the roof of his mouth,\" as le expressed it. Upon rhinoscopi\u0026 examination there wvas seen to be; in the naso-pharyngeal cavity,'lying betweén the orifices of the Eustachian tubes",
         "DISEASE OF CARPENTERS-P. EADE, 3.D., F.R.C.P. an irregular eniain of highly-congested glands, whose free extremities depended from the vault'of the pharynx. These vegetations were covered with a copious secretion of mucus, which kept dropping constantly into the back part of the throat, and were expectorated by the mouth. Upon re- moving the adherent élumps of mucus with a sponge, a few small drops of blood exudedfrom the fungoid mass, showing that it was veryvascular, These growths encroached some- what upon the orifices of the Eustachian tubes giving rise to a considerable deafness. As the growths were too small to be crushed, or torn off by forceps, as is'recommended by Cohen, Meyer, and others, they were cauterized by means of nitrate of silver, and daily injections of sulphate of copper (3 ij. ad aque oz. j) were employed, which caused their destruction and disappearance. The patient was then treated in the usual way for his nasal catarrh, which soon disappeared, the principal difficulty residing in the glandular hypertrophy. Many cases of simple acute catarrh have been treated at the outset by the simple propulsion of the vapor of iodine, and the administration of a full dose of some diffusive stimu- lant, such as muriate of ammonia, opium, hot punch, etc., at bed-time, with the result of abating the attack in two or three days. According to the writer's experience, if cases can be seen at the outset, or before thickening of the mucous membrane bas taken place, they can be easily cured, while cases of long standing invariably require protracted treatment for the -ac- complishment of a thorough cure.-New York Medical On the disease of Carpeniters. By PETER EADE, M.D., F.R.C.P., Physician to the Norfolk and Norwich Ios7; pital. (Read before the 3edical Sectionat the Annual Meeting of the British Medical Asociation i, Norwch, August, 1864.) The present communication will be a short one; but I have thought it worthy of production on the present'occa- 215",
         "216. CANADA MEDICAL AND SURGICAL JOURNAL. sion, because I believe it to describe an affection quite distinct in itself, though hitherto unnoticed by writers, or at all events, not separated by them from kindred or allied disorders. It is well known that undue or too prolonged exertion of any part of the body is apt to be followed by an exha.usted or more or less paralytic condition of the overworked part; and also that this precise condition may vary in every degree from simple weakness to a more or less complete loss of the function of the affected part. It is also familiar to us that the affects of such an exhausting or paralysing cause may be produced not alone at the special -part itself, or even at the central-point of implantation of the nerves passing from it, but also, and still more, by reflected action at other points, either contagious to the affected centre or at the periphery of nerves afferent from these adjoining parts or their con- nections. Carpenters, it is well known, in a certain class of their, work, use their hands and arms pretty continuously ; and not only so, but in a very monotonous way-as, e. g., in planing an hand-sawing ; so that the same set or sets of muscles are often constantly and continuously called into action. have ascertained that, in an ordinary way, they do not suffer from their peculiar work-probably because it is commonly much varied; .and I therefore conclude that special circumstances or conditions are necessary to induce. such evil results. - R N., aged 52, married, a carpenter, firstcame under ob- servation in March, I879. He had enjoyed excellent health until about five months before this, with the exception that,, in November of the previous year, he had suffered for a shor ilme, and -vith6utý.known cause, frorn slight weakness andiremors of the muscles of the face and tongue'. These symptoms, however, quickly passed off, and he remained quite well until October 1869. At:this time, he began·to comrJainp pnand umbness:o t1e fingegs ancthandson bQth sides, extending as -high as, he 1vrists ; and, n t. long-",
         "DISEASE OF CARPENTERS-P. EADE, M.D., F.R.C.P. after this, he began to be troubled with shortness of breath, made worse by any exertion ; and this was soon followed by a slight cough and expectoration, the latter once.or twice tinged with blood. He also said that he feltgenerally weak, and was unsteady about the knees on standing or walking. At the time of his àdmission to the hospital, the numb- ness and aching of the hands and the shortness of breath were his principal symptoms- But he still had some trifling cough and spitting; and, though his body-was well nourish- ed, he was evidently weak in all his limbs, and had a fidgcety nervous manner. The respiratory murmur wras found to be weaker on the right than on the left side of the chest; but no. other abnormality of the lungs, and none of the heart, could be detected. There was no disease or disorder of any other viscus. I ascertained that he was a quiet steady living man, perfectly temperate, not a great smoker, and free from any suspicion either of venereal disease or of lead-poisoning. His temperature was not above normal; and he had previously been very healthy and strong, and by no means of iervous temperament. The only probable explanation of his symptoms appeared. to be this. He was a carpenter in-a small vay of business, with a family dependent upon him, and of an anxious turn ofmind. As such,.he had been accustomed to work long and, extra hours, to save~thecost of hiring assistants, .nd in consequence had greatly fatigued himself in his various kinds of manual labour. I shall not detain you with any lengthenedhistory of- this case, but will merely say that this patient has been under My observation from 1870 until the present time, a period of-nearly four years. During this time, he has very slowly, improvéd,,and is now so much bepter that almost the on1ýi remaining symptom is shortness ofbreath,; and he hasbeeu, \u003ele, to resume his occupation so far as to do some, of .the ligter workof his trade... $on,afterthis case-came!undei my obseryation,,aneo@I apd similar one, Aso in a carpente, occurred to-me ;g 217",
         "218 CANADA MEDICAL AND SURGICAL JOURNAL. still later, a third case, with almost identical symptoms, presented itself in the person of a labourer who had over- worked his upper extremities by prolonged digging. Of all three, I may say shortly, that they all presented very similar and closely allied symptoms, one of the most prominent of these being the free secretion of a whitish mucus, apparently from the mouth, the throat, and the air-tubes, but without much cough, and without any distinct chest disease. Other symptoms have been, shortness of breath ; vague pains and discomforts in and across the chest, éither limited to this part or extending upwards to the neck and face and head ; sensations of dorsal chilliness or tremor, but scarcely any distinct spinal tenderness ; and in all a peculiar nervousness and fidgetiness of manner. I would now add that since this paper was announced, a fourth case, evidently of the same class, bas come under my care. This man, like the last, was not a carpenter, but had worked as a \"navvy\", in which capacity lie had of late strained his arms severely-first in throwing earth into railway-waggons, and afterwards in barrowing heavy loads of soil all day-the effect of which at the time was to cause much numbness and aching weakness ia and all along his arms. It will be seen from this history that, of my four cases, only two were carpenters. The title, therefore, of this paper, is plainlynot sufficiently'comprehensive, seeing that other workers besides carpenters are liable to it.- But, as my first and most typical casé, and the one which is the foundation of this communication, occurred in a carpenter, and as the work in which carpenters are engaged-is so es- pecially arm-work, I have not thought it necessaryat the last moment to alter it, believing that this term nfot inaptly expresses the nature:of the disorder from which they have ail suffered. No doubt-its exact nature is irritation, followed by exhaustion, of those portions · the spiiai cord -froni which the nerves of -the -brachial lIexus- arise; in other wo-ds, it is an erethism'of thisplexús and' of its related- cer-",
         "DISEASE OF CARPENTERS-P. EADE, M.D., F.R.C.P. vical ganglia, with reflex disturbed action of other parts whose nerves are in conncction with thesc cervico-dorsal nerves. I believe that it has been noticed that sawyers working long hours in sawpits are liable to get a weak or semipara- lysed condition of the muscles of the upper extremities. It is also well known that cramp and a species of palsy are apt to follow continued over-exertion of the limbs in several classes of workers, as in the writers' cramp of clerks, the thumb and|forefingers of writers, and the arm-cramp of smiths (described by Romberg, Russell Reynolds, and others); but I think that, although these affections are more or less allied in their nature, there is an essential difference between thern and the one I an describing, in that in writers' cramp the muscles of the arm are the parts chifly affected, whereas in these cases, beyond the trifling initial weakness and pain of the hands and arms, the effects are produced in parts distinct from the limbs, and are such as show that the ganglionic system is the one specially affected. An analysis of the symptorns shows that they extend over a considerable distance-indeed, from the head above, through the cervical and dorsal regions, as low as the level of the epigastrium ; and that, though the greatest amount of effect is produced at the level of the upper part of the thorax, yet that the discomforts elsewhere felt are by no means insignificant. In some degree, the peculiar nervous- ness and sensitive condition approximate to what is seen after concussion of the spine, and are not very unlike what I have witnessed as following a railway accident. It is, I think, probable that the effect of such work as carpenters and navvies sometimes perform may be some- what akin in its jar and concussion to that of a blow or in- jury to the spine ; and that, although in the one caae the shock is less in amount and more prolonged, instead of, as in the other, sudden and violent, yet the eventual effect may De the same in kind in the two cases ; viz., the produc- 219",
         "ZZU CANADA MEDICAL AND SURGICAL JOURNAL. tion of a condition of weakness, hyperæsthesia, and loss of functional power. Perhaps in some slight degree, also,, this affection may be likened to that produced in women by excessive use of the foot sewing-machine, in whom it is well known that irritability of the spine and pelvic irritation are frequently set up by its enployment. A curious fact bas been announced by Dr. B. W. Rich- ardson ; namely, that a subclavian murmur is almost universally present in carpenters and in men who work as they do. In one of the patients above alluded to, it was very distinct ; and it would probably be due to the same class of cause as the affection I arn describing. As to treatment, I have tried very various forms of rem- edies-tonics, bromides, ice to the spine, faradic and galvanic electricity; but nothing except prolonged rest bas appeared to be of any material value.-British Medical 7outrnal. Rigor Mritis in an Infant ai Birth. By W. C. GRIcG, M.D. Assistant Obstetric Physician to the Westminster Hospithal. ,The following case appears to me to. be not without interest in relation .to the etiology of rigor mortis. On the evening ofAugust i6th, I was sent for by one of the mid-wives of Queen Charlott's Lying-in- Hospital to see a woman .(a muftipara) vith placenta præcvia. Labour began at 6 P.M. with a iischarge, which continued with each pain. On the arriva, -of· the midwife, the os was found about the size of a sixpense,,but the presentaion could not bç distinctly deterxnined. - At 9.30,:severe floodjng set in, which lasted about half an hour. The os vas now dilated to. ;te size of a half-crown açross the anterior portion, a soft thicksubstance yas elt.; Wen I reached the woman, a little7before eleven,.the hæenmorrhage had pearly ceased; theos was fully dilated, ând the-mass was clearly a portion of the. placenta. As thé, membranes were itact, they were",
         "RIGOR MORTIS-W. C. GRIGG, M.D. ruptured'; and in a few minutes the child was born. The after-birth came easily away five minutes afterwards, and with it some clots, so firm that theyLfelt like pieces of flesh, requiring some force to break them down. There was slight post partu heriorrhage. The child was quite livid; the arms were folded on the cliest, and the thighs fiexed on the abdomen. The jaw Wvas firmly fixed ; so was the head and the extremities. The abdominal walls were flaccid, but the back was partially set. It was with the greatest diffi- culty I could get my finger into the mouth ; and in order to extend the extremities, the body of the child had to be firmly held. The woman stated she received a severe fright the pre- vious evening, but believed she was at her full time. The movements of the fcetus were so troublesome that she slept little that night. It was last noticed at about 4 .Mi., two hours beforelabour set in. The hæmorrhage was nothing to speak of until about 9.30, when it became very severe, but only lasted about half an hour. She was confined shortly after 1i P.M. When seen, she did not present the appearance of having lost much blood, No ergot had been given. I think it may be fairly presumed that dcath of the fotus took place during the excessive loss of blood-i. e., about an hour and a half before its birth. It has been my misfortune to have been present at the birth of many still- born children, whose deaths have varied fron minutes to days before birth, but I bave never before seen a fœtus with rigor mortis at birth. It would be interesting to know if any other practitioners have met with a like case, and if so, what were the circumstances attending cach case. Here the woman had received, on the previous eveniii'a seveie shock; there were partial placenta prævia, sev~re floodin'g only for about thirty minutes, delivery in an 'hotr afterwards, and the-blood coagulating rapidly and very firmly.-Bl'iislz Medical %oumal. 991",
         "222 CANADA MEDICAL AND SURGICAL JOURNAL. Coal Gas Poisoning. Although cases of poisoning have from time to time occurred such as those related in the pamphlet before us, veryfew of them have been carefully recorded. It is some- what singular that the July number of the Edinbui g/h Mcdi- cal yournal for this year, and the first number for July of the Beräiner Klinische Wochenschrift should simultane- ously contain articles on this subject. The latter will be found'by English readers in- a condensed form in the Lou- don Medical Record for August 5th, (No. 83, vol. 2). the former is reprinted with some additions, forming the pam- phlet now before us. Dr. Taylor first relates the case of a Canadian, between 50 and 6o, who vas found livid and insensible in a bedroom in one of the Edinburgh hotels. [t appeared that lie had blozvn out fhe gas instead of turning it off,-and had thus inspired a mixture of gas and air, which amounted to some three per cent. only, or abrut i in 33. Efforts to resuscitate him were so far successful that lie survived nearly two days. Unfortunately no post mortem examination was allowed. The pamphlet is not confin d to a very careful record of the symptomns in this case, but contains accouits of several. others, and more particularly of the suffocation of a whole family (a foundry labourer, bis wife, vho was: enceinte, a ;rl aged two, and a boy aged 8 years), at Dundee. Bsides this there is an abstract of the Strasburg case, in which six persons-father, mother, two sons, a daughter and a servant, were exposed for nearly forty hours to the deletérious effects of a gas containing unusual quantities of carbonic oxide. Of these, four were found dead, and, after 19 hours, one only, the : mother, sur- vived. - The original account of these cases is in French (Relation Médicale des Asphyxies Occasion6es à Strasbourg par.le Gaz de l'éclairage, par G. Tourdes, Professeur de Médicine Legale ýà le Faculte de Strasbourg), and'is litte known in this country. Dr. Taylor has\u003c thereforegdone well in giving an abstract of its chief points of interest. I",
         "COAL GAS POISONING. appears that the woman who recovered was insensible. forty hours. She had hemiplegia on the*right side. Her recov- ery was very tedious. The principal post mortem appear- ances in the four fatal cases were as follows :-Brain anl its membranes highly congested. Intense redness of sur- face. Air passages also strongly injected, filled with whit- ish, viscid, frothy foam, with sanguineous streaks. Lungs: in ail the cases intensely red thrdughout their parenchyma. H]eart: blood clotted, especially in right auricle. Liver: blood very red. Bladdr: distended, with an enormous quantity of limpid urine. The morbid phenomena are thus classified : ist, insidious invasion. 2nd, headache and ver- tigo. 3rd, nausea and vomiting. 4th, absolute loss of consciousness (and an sthcsia]. 5th, general debility, prostration of strength, partial paralysis, and convulsions, 6th, phenomena of asphyxia appearing slowly, but complete and predominant during last moments of life. Dr. Taylor's recommenclation to turn off the gass at the main, or at all events, at the meter during all the hours of daylight, scarce- ly strikes us as practical or practicable in large cities. His advice to avoid all flexible fittings, to discontinue the use of gas in bedrooms, and to take care of due ventilation wherever it is burnt, is more easily carried out. It strikes us that the thorough purification of coal-gas is of more moment, for carbonic oxide in these cases, and sulphuretted hydrogen in some others appear to Us to have been the chief causes of the fatal results. But the discovery of some sufficiently cheap and brilliant substitute for coal-gas is the real desideratum, and this we fully believe we shal some day obtain by some rnodification of the present electric light. As most of our manuals òf medical jurisprudence and-toxi- cology make little or no mention of the subject, we strongly advise students who intend going in for honours in this subject to procure Dr. Taylor's little pamphlet.-Studenzs' .7urual. 2-2a",
         "224 CANADA MEDICAL AND SURGIcAL JOURNAL. Dr. Sée on Belladonna and Nicotine. Dr. Sée, in a lecture at the Hospital de la Charité, says that atropine is the most complete antagonist of mus- carine, that cardiac medicine spoken of by O. Schmiedeberg in 1869. Six or seven years ago, Meuriot, one of Dr. Sée's pupils, noticed that atropine caused acceleration of the movement of the heart. -The ganglia which terminate the pneumogastric nerve are paralysed. If muscarine and atro- pine are successively employed, we notice that the.heart, arrested by the effect of the muscarine, begins to palpitate with atropine; but muscarine cannot arrest the palpitation of an atropised heart. The paralysing action of atropine on the pneumogastric is, then, very energetic. Atropia has besides the power of exerting the blood-vessels and making them contract rhythmically. To this commencing con- traction of the vessels let us add the most remarkable effect of this drug, the dilatation of the pupil, which takes place from contraction of the dilating muscle, excited by the sympathetic. There is also paralysis of the sphincters, of the pharynx and larynx, and of the voluntary muscles, with impaired sensibility. Nicotine is the neutral principle of tobacco, and is a vas- cular poison above all, bût also a cardiac poison. If a small dose of nicotine be injected into an animal, we notice first a retardation of the heart's action, and next, augmented pressure in the vessels. If the animal be opened, the ves- sels are found cont'racted.. There is, in a word, enlargement of the vaso-motor nerves, and of the vesséls, and also tetàn ic-rigidity. When there is a strong dose of nicotine, wë nlotje2the ihverse.;: the heart'á action becomes acéelerated because, then:nicotine acts.like atropine, by paralysing some part of the suspending system.. Ordinary smokers. have ýl pitationsor-slov pulse sométimes, 48 pulses per minute, Withiñt.r cëï;\"extravagant smokérs speak of palpi- tatio'n§ ith 'pid \"ulse--130, 140 -150 pulsations per min- ute. Roux, an old professor of the Faculté de Médecine, con- sidered that smokers were \"gredins;\" but that was forty years ago. Muscarine, when injected, will lower the pulsa- tion caused by nicotine.-The Doctor.",
         "IDIOPATHIC RUPTURE OF SPLEEN-E. ATKINsON, M.D. 225 Death from Idiopatzic Rupture of Spleen. By EDWARD ATKINSON EsQ., Surgeon to the Leeds General Infir- mary. A lady, aged 35, of middle height, stout, married only five months, highly hysferical, had never been quite well since her marriage. She had menstruated regularly, but had irritable stomach, with frequent attacks of vomiting, and sometimes suffered considerable pain in the gastric region. She had been under the treatment of my friend Dr. Young for four or five weeks for these symptoms, which had been alleviated, and she was considered to be conval- escent. She never had enteric fever. On the evening of August 5th, 1873, she was suddenly taken ill after eating herring, and was attended by Dr. Frobisher. Violent retching continued from'9 P.,. till noon next day, and was followed, after the first hour or two of sickness, by acute pain in the left side, which rapidly spread over thé whole abdomen. At noon she sank into a state of collapse. When I saw her at 4 r.m. with Dr. Frobisher, she presented the appearance of a person in the last stage of Asiatic cholera-cold, restless,pallid, blue lips, pulseless at the wrist, whispering voice, clammy sweat, but no diarrhœa. Was it 'gall-stone, intussusception, internal strangulation, or rupture of an aneurism ? One thing was evident-that death was inevitable. She died at 5 o'clock, twenty hours from the commencement. With great- difficulty, a necropsy was obtained, and was made two days after death by myself in conjunction with Drs: Young and Frobisher. The body was very fat. There were two inches of fat in the parietes, besides a thick subperitoneal layer.* The 'abdominal viscera were bloodless. A large clot, several pounds iw weight, overlapped the lower edge of the great omentum and filled the left side of the abdomen; beside which, there was a. large. quantity of dark fluid blood.e There were no adhe- sions, or signs of effused lymph, or 6f peritoneal inflamma- tion anywhere. On tracing up the blood to its source, it was found to-issue from a rent in the gastrosplenic omentum 15",
         "226 OANADA -MEDICAL AND SURGICAL JOURNAL. which was distended into a large pouch. On enlarging the opening, more clot and fluid blood escaped, and then the spleen was seen, shrunken, pale, flabby, and its lower por- tion disintegrated and in a state of muddy pulp. The stomach and duodenum confained no ulcer or other unheal- thy appearance. The liver was pale, flabby, and very friable. The kidneys were healthy. The gall-bladder and duct were devoid of calculi. The thorax was not opened. The only similar case of which I ever heard, or of which I have been able to find record, is one which my friend Dr. Deville of Harrogate communicated to the Branch meeting at Scar- borough last year.-Britisht Medical Yournal. Sliglit Ijur'y to Leg ; Sudden Deathk; Tlirombi in Right Ventricle fron Popliteal Yein. By A. B. SIHEPHERD M. A., M B., Assistant-Physician to St. Mary's Hos- pital, etc. -The following case presents many points of similarity to those lately published in THE LANCET by Surgeon Thomas Browne, M. D. June 27th, 1874, p. 901), and Mr. Geo. G. Gascoyen (Aug. 8th, p. 189). For the life-history I am indebted to Dr. Stewart, of Southwick-street ; for the post- mortem notes I am entirely responsible. R. G.-, aged forty-nine, a healthy, spare, though largely-made man, of active and temperate habits, slipped, on. June 1st, 1874, through the rounds of a .ladder, and abraded his left shin. Under ordinary treatment the wounds so caused almost entirely healed. On the twenty- first day after the accident, while,going up stairs, he fainted .and fell, withoutsuffering any. apparent injury. Three days later he had\u0026arrigor, followed by well-marked signs of simple pleurisy on the right-side, the diagnosis being con- firmed by Dr. Walshe, who saw him whilst suffering fro.n the attack- On the thirtieth day after the accident, he fell down while dressing, and died.",
         "INJURY TO LEG-A. B. SHEPHERD, M.A., M.B. The autopsy was. made forty-eight hours after death. There was most extensive decomposition of the head, neck, 2rd upper extremities, the superficial veins being much dis- coloured. There was no great decomposition of the body externally below the level ôfthe diaphragm.. All the organs were healthy, but very much decomposed. The blood -throughout the body, with the exceptions noticed below, was fluid. Coiled up in the apex of the right ventricle were three moulded clots, one showing most beautifully the impression of vein-valves. Two of these clots exceeded 71 in. in length each. Only one very small clot, soft and recent, was found in a branch of the pulmonary artery. The subclavian, jugular, iliac, and femoral veins, and the cava were carefully examined. The left internal saphena was removed from two inches below the original wound to its entrance into the femoral, and the latter itself to below the popliteal, vein. On slitting up the saphena, the coats- of the vein below the region of the wound were found to be perfectly normal, semi-transparent, and drying rapidly on exposure to the air. Nearer the wound its coats cut more rottenly, and where the smaller veins from the wound entered it, it was dilated. From this point upwards. its internal coat, as well as that of the veins from the wound, and of those dipping down to the deeper vessels, wvas in- tensely red, more than bloodstained, swollen, and moist, even after long exposure to the air. The same was the case with the femoral and popliteal veins ; the coats of thé latter were gréatly swollen, and injected a dark, black- currant colour: and in the popliteal vein itself lay. the debris of a clot, non-adherent to the vessel-wall, and ex- tending for more than three inches from above to below a pair of valves,, the same, in 'all probability, which had left their impression on the clot in the right ventricle. The heart-clots, together with the veins engaged in the morbid process, are preserved in the Museum of St. Mary's Hospital, 'Remarks.-Itis impossible to add much to the simple in- 227",
         "228 CANADA MEDICAL AND SURGICAL JOURNAL. terest'of this case. The'very slight injury to the leg.; 'the consequent thrombosis occurring in the vessels running* from the wound, unacompanied by obstruction, œdema, or, pain in the limb ; the dislodgment of the clots and of portions of them ; the fainting-fit, due either to. pulmonary embolism, of which, however, no sign was found, or to the presence only in the ventricle of a clot or clots; the pleurisy, also probably embolic; the sudden death, due to the thrombi in the heart; such was the succession. of events. The first seat of the original thrombus must remain a matter of speculation. One of the clots removed from the heart shows, by its concentrically deposited layers at one end, that it is a prolonged thrombus, much increased in size since it commenced to travel, and the marked signs of, morbid action throughout the course of the saphena, popliteal, and femoral veins, make the original starting- point more .doubtful still. Most. noteworthy is the agree- ment of the valve-impressed thrombus in the heart with the position of the less firm clot found in the vessel. The Lancet. Two Cases of Diastasis in Adolescents. By CLEMENT DUKES, M.B., B.S. Lond., .Medical Officer to Rugby School. Case i.-Mr. X., aged 18, on December ioth 1872,.while playing in the close at the school, was pushed on the outer side-of his right leg while his legs were extended laterally from th.e median line, when he suddenly felt acute pain above the knee, and fell down ; and the limb was powerless. On examination, the knee-joint was not swollen. 'No distortion was perceptible to the eye. The leg lay power- less on the bed. - The foot was neither twisted nor everted. The limb was slightly shortened on measurement. On taking; hold of. the limb, no crepitus could be elicited, nor any movement, though pain was felt, whichever way it was moved. On slightly flexing the leg, a rapid movement in the lirnb was felt, like two smooth surfaces passing quickly",
         "DIASTASIS IN ADOLESCENTS-C. DUKES, M.B., B.S. 229 one over the. other. The situation of this rub was found by a slight depression being felt about two inches above the knee ; and the lower bone could be felt slightly prominent posteriorly on the upper part of the popliteal space, being rotated a little backwards by the gastrocnemius. The diag- nosis was made of diastasis, or separation of the condyles. from the shaft of the femur. This epiphysis is the last to unite-viz., at twenty years. Treatment.-The difficulty was to keep the surfaces of the bone accurately together, owing to their slippery nature: i. A suspending thigh-splint with pulleys was first tried, but wvithout success. 2. The straight \"'long outside\" splint, with perineal ex- tenders, was then applied with better success, but not com- plete. 3. To the '\"long outside\" was added a small straight back-splint with a pad sewn on it, to keep the lower end fromn slipping backwards. The perineal band was moved, and extension kept up by a weight passing over a pulley at fot of bed. By this means, a firm union was obtained at the end of ,six weeks: the limb was of full length; and he was allowed to get up. On examining the limb, no one could have told that there had been a disunion; for there was fnot the slightestthicken- ing at the seat of injury; noprovisional callus being tirown out as in fracture, union being effected in the cartilagé. Fearing lest this should not be strong enough at the end of six weeks to support a tall strongly-built youth, I made a leather case, which he wore for a week or two. - case ji. Mr. T., aged 16. on July 4th, 1874, for three months had had a little pain at the inner side of the arm at the elbow, when exercising in the gymnasium. This cul- minated in an injury there, through a fall from the horizon- tal bar while performing the exercise called \"back away \". His account is, that he kept hold of the bar with his hands",
         "230 CANADA MEDICAL AND SURGICAL JOURNAL. too long, so that in the turn, instead of alighting on his feet as usual, he fell on \" all fours\", with his arms extended ; but the force was sufficient to make the left arm suddenly flex outwards. He felt something: crack, and cause him pain at the elbow and a-feeling of faintness. On inspection, the arm was held stiff, neither flexed nor extended. There vas a swelling over the internal condyle of the humerus, like a swelled bursa, making the condyle appear very prominent. Immediately below this, instead of the usual convex contour on the inner as well as the outér side of the forearm, there was a considerable hollow or con- cave outline, with slight extra thickness of the muscles of the forearm antero-posteriorly. Owing tothis the outer con- tour of the forearm seemed increased in convexity, but was in reality normal when the two arms were compared ; thus dispelling the idea of a dislocation of the radius and ulna outwards, which it resembled at first, from the prominent inner condyle with the depression below. On manipulation, flexion and. extension were perfect and almost painless; also rotation internally and externally; but, when the palm of the left hand was placed over the inner condyle, and the arm moved, great pain was elicited. On manipulating over the inner condyle more minutely, a morsel of bone could be felt, freely movable when laid hold of with the fingers, causing no crepitus, but moving easily and smoothly, and distinctly external to the joint; being a separation of the internal epicondyle from the humerus, caused by muscular action through the forcible flexion.of the forearmon the arm. There was no injury of the ulnar nerve. The inner condyle of the humerus unites at the age of eighteen. Treatment.-A rectangular splint was applied, and a figure-of-eight bandage and a pad on the elbow. Position and union ivere effected well.--Britis Medical Nurnal.",
         "CANADA MONTREAL, NOVEMBER, 1374. THE MONTREAL GENERAL HOSPITAL AND ITS .SMALL POX WARDS. We have on a former occasion called attention to the danger which arises to the inmates of General Hospitals by having an attached building for the treatment of small- pox. With regard to our own hospital we have reported on several occasions the spread of small-pox into the gen- eral wards and we have repeatedly advised the governing body of our hospital to close their snall-pox wards and refuse to admit patients suffering from that disease When- ever we have suggested this desirable change, we have been met by the statement that it is contrary to the Act or Statute regulating General Hospitals, and therefore until an amend- ment to that Statute is effected the small-pox wards of the Montreal General Hospital must remain where they are. We would cal! upon our Local Parliament at its next Session to consider the advisability of amending the first clause of the Act bearing on this subject. It is to be found in the Statutes of Canada for the year 1861, being the 24, Victoria Cap 24, and assented to the 18th May 1861, it reads as fol- lows:- \" No warrant shall hereafter issue for the payment of any \" sum of money granted by the Legislature .to any hospital, \" unless, nor until a certificate signed by a medical officer \"of such hospital, to the effect-that there is in such hospi- \"tal a distinct and separate ward set apart for the exclusive· \"accommodation of patients afflicted with small-pox, has been filed with the clerk of the Executive Council.\" We will not refer to the time when this clause was enacted, but merely observe that if the legislators of that day desired",
         "232 eANADA MEDICAL AND SURGICAL JOURNAL. by the introduction of such a clause, to prevent the spread of small-pox, that the experiment has been tried and has signally failed ; the disease is not thereby.prevented from spreading among the people at large, nor is the isolation sufficient, at least in the case of the Montreal General Hos- pital, to prevent .its spreading into the general» wards. No person can speak more positively on this subject than the writer. He is one of the attending medical staff of the Montreal General Hospital and since the year 1867 has, performed his duty during the first winter quaiter, that is, during the months of November, December and January up to the year 1870 when a change took place and his months of attendance have been since that period October, November and December in each year. During his attend- ance lie can call to mind the occurrence of small-pox in patients under his charge suffering from some minor com- plaints and in many instances the sufferers have paid the forfeit of their lives. It will thus be observed that the use- fulness of a noble charity is to a certain extent marred, a gross wrong done to those seeking its benefits, the attending surgeons and physicians seriously interfered with 'in their work of philanthrophy and the spread of a highly contagious disease permitted to go on unchecked. In a recent visit abroad, we ascertained the practice fol- lowed in other countries. In Scotlandwe found that small- pox when it occurs is not admitted into any generalinfirmary. A separate and distinct building, apart and entirely isolated, is allotted to such a class of disease. In the Glasgow Infirm- arywhat was once .used as a Fever Hospital is at present, or at the time we visited.it in August last, devoted exclusively to surgical cases. We were informed by the attending sur- gèon that a separate.. and distinct building in another quarter of.the city is devoted to the exclusive use of small-pox and other highly contagious maladies.. The same may be said of Edinburgh .and London. In the latter city there is a separate and distinct small-pox hospital; we, believe there are eight, or rather thateight separate buildings were used",
         "THE MONTREAL GENERAL HOSPITAL. exclusively for small-pox during the recent epidemic of 1870 and 71. What is the result of such precautionary measures? We find that duringthe first three months of the epidemic of 1870 and 71, London suffered amortality from small-pox alone of over three thousand persons. By persistent efforts at isolation, by vaccination, and the strict enforcement of sanitary regulations there is\"not at the present day a single case of small-pox reported as occurring im the Metropolis, nor has there been a single death from small-pox in London for several weeks past. This is a surprising fact when it is considered that London possesses constantly a large rolling population of strangers who hail from all countries in the world, whose residence is brief, who come and go and their place is filled by others as rapidly as they leave. In the name of common sense then, why should we in Canada, and in this large city permit a state of things to exist amongst us which should bring a blush of shame to any civilized community. It would be well for our Local Legislature to consider and deal with this subject. By a verbal alteration in the clause above referred to the govern- ing bodies of general Hospitals would not be forced to keep attached to their institutions, wards for the '\"exclusive accommodation of patients afflicted with small pox,\" and in our own city we should be glad to sec the small pox wards of both our general hospitals done away with. We have heard much about a fifty thousand dollar grant munificently made by our city corporation, but there the thing ends. It does :appear that the insanity of folly has fallen on our civic authorities, admitting the want of a'smail pox hospital, they voted $50,ooo. Then, for fear that some imaginary citizen should make a fortune out of this -grant they determine to divide the amount so as to give the city of' Montreal two sectarian institutions. for the treatment ôf small pox. This not proving acceptable to the citizens, in their wisdom, the city corporation has decided to leave us without any hospital for the treatment of small pox. : We think that in the present emrergency the Government might",
         "CANADA MEDICAL AND SURGICAL JOURNAL. order the Corporation of our city to provide the necessary accommodation within a stated time, failing which, it should be done at its cost and charges. It is only by some prompt action of this nature that our Corporation will be roused to a sense of its duty. SANITARY AUTHORITY. In a recent speech at Manchester the British Premier, Mr. Disreali, is reported to have said \" I think public atten- tion should be concentrated on sanitary legislation. I cannot impress upon you too strongly my conviction of the importance of the Legislature and Society uniting together in favour of those important results. After all, the first consideration of a minister should be the Health of the people.\" Surely, if this applies in England, how much more in Canada. In England for many years past much ex- tended and thoughtful legislation has been inaugurated bearing upon the enforcement ofsanitary regulations, whilst here we yet await the laying of the very foundation upon which to rest any legal enactments to provide for the Sanitary Government of the country. Do we Canadians really and truly appreciate the great, the overwheilming, importance of this subject ? We find the head of the British Government openly saying with all the emphasis of which he is capable that public attention should be concen- trated on sanitary legislation. We should be only too glad to hear such words* coming from the lips of some leading member of our present Executive at Ottawa. Nothing less than this should satisfy the Canadian public, they should not rest content simply with insisting that sanitary matters should receive a certain share of attention at the next ses- \"sion of our Parliament, but by concentrating their attention upon these matters and constantly keeping tfiem agitated through the press and by every other available means, they would ultimately succeed in forcing measures relating to -the public health into that prominence which they unques- 234",
         "SANITARY \u0026UTHORITY. tionably deserve. Let us take as an example our own un- fortunate city, which, we are sorry to have to confess, has been branded by the daily press, as the \" most unhealthy city in the world.\" With such a climate as we enjoy, with such great natural advantages as regards site, water-supply, \u0026c., as we possess, is it not a crying shame that such a dis- graceful stigma should be allowed to go uncontradicted ? And, to our disgrace be it said, it cannot be contradicted. For, according to the report of the Health officers received for the month of August, it appears that there were 346 deaths out of a total of 785, (nearly one half) from Zymotic diseases-the most prominent being small-pox, scarlatina, typhoid fever and whooping cough. Now, what means are being taken to put a stop to this outrageous and inexcusable mortality from preventible causes ? Let us say at once none. We boast a Board of Health, salaried Health officers, and paid Health constables-but of what earthly use are all these when we are plainly told by them that they receive no information concerning the commencement, rise and spread of infectious diseases, and that they have no power to inspect premises, order removals, make improvements, or otherwise interfere to preserve the health of any place or district. The sooner we distinctly understand that there is no legal sanitary authority in our midst the better, for the more wedwell upon this idea, the more we will be impressed with the importance of concentrating our energies towards establishing such authority for the benefit of the whole com- munity. We learn that one of our city advocates, has in course of preparation a code of sanitary legislation for the city which it is proposéd to sùbmit to the City Council. to be by them sanctioned and then made law by Parliament. Of course to prepare such a digest must take some time but we heard of this subject having been submit- ted to the city attorney for his opinion some months ago, and we w ould protest against any-the léast-unnecessary délay in laying this report before the Conncil, and we do ftrst that, in the interests of humanity, the Health Corn- 235",
         "236 CANADA MEDICAL AND SURGICAL JOURNAL. mittee will see to it that the proposed by-laws are at once brought forward for public discussion. SMALL POX. With the advance of our cold season the disease small- pox appears to have taken fresh root, and'is breaking out-iin all quarters of the city. This increase in the number of cases is due to several causes, Éhe principal amongst which is our own neglect of known sanitary laws, and we might add the reckless, criminal, and trifling incompetence of our civic authorities, in not providing the necessary means for isolating the disease by.the establishment of a proper small- pox hospital. Quite recently a patient left the small-pox wards of the Montreal Generai Hospital and. was taken to orie of the charitable homes of this city. We have not heard that the infection has spread in the institution .alluded to, but we should not be surprised if such an event were to follow. It may be asked why,? Simply because there is no means in our hospital wherebya patient who has recovered from small-pox can be so isolated for a time, and cleansed; as to insure the public. against infection... There are no interrie- diate wards no convalescent wards. The patient who has recovered froni small-poxand is lt to be discharged from hos- pital is sent out directly from the room or ward in which he hbas. gone through hisillnéss. His clothës are brought to him:and he has to,.dress in his.ward or in sonie contiguous r oom, and he, leaves, the building carrying with him the germs of this loathsome:disease in his clothes, it±nay be in his .breath. This is no exaggerated picture, it is a fact and recent events;ib the breaking out of the disease in familiés who'suffered nô-apparënt,.direct, ëxposure attest the fact. .We will mention a few ôther:sources,from which the disease spreads. : Aweek oritwo since à.brother practitioner-enter- ed one of the many public: donveyancesto be fouind in this city, he had scàrcely -taken:lhis seat-befôre he r*cognised in",
         "one of the passengers a respectably dressed woman the mother of a large family three of whom were lying danger- ously ill at her house with small-pox, she came fresh from this house and entered a public conveyance- carrying with her we do not doubt the germs of thedisease in her clothes to be spread about and dropt in every quarter. Not long since another medical gentleman was called to a case of small pox in a child of a highly respectable citizen. No known exposure could be traced by the parents. Our pro- fessional friend, however, ascertained that this little girl went to a school in the neighborhood where there were à large number of children about her own age. One of these children came from a house in which several cases of small-pox existed, and, although she did not suffer from the disease, yet she carried the disease in her clothes and thirteen of her little playmates were struck down by small- pox while she remained' exempt. We could rmention a num- ber of cases of a similar nature if it were necessary, all pointing to the fact of direct communication as the origin of the attack. Are the citizens of Montreal sincere in their, desire to stamp ouf small-pox ? if so, it can only be done by perfect and determined isolation and general vaccination. Vacci- nation is not in itself an absolute preventive, but where it is strictly enforced and rigorously carried out the dis- ease will,- if it does attack the person so -vaccinated, ap- pear in a milder form. Isolation will- stanp out the disease to such an extent that no single case wil occur. If by way of allegory we suppose that persons were in the habit of go- ing about the citywith lighted torches so constructed that they left behind them a train of sparks and that in conse- quence large and destructive fires .constantly occurred. What a frenzy of excitement would be produced, Mayors, Aldermen, Recorders, and all the lesser officials of state would be on the alert. - These insane persons would be regarded as a public nuisance and they would be sumarily ordered to quench their fire brands or suffer the penalty 237 SMALL FOX.",
         "238 CANADA MEDICAL AND SURGICAL JOURNAL. that the law prescribes. Is property of greater consequence than human life? Would it notbe better to provide in the present emer- gency a public hospital to which all cases ofsmall-pox should be sent, but if persons elect to keep their friends at home they should do so with the known alternative of public iso- lation. Provide for persons afflicted with this horrible disease a fit and proper place where rich and poor alike can be accommodated with all the care or luxury needed or that can be procured, but if they decide on remaining -in their own homes let the fact be intimated by a placard placed on the house, under police authority, simply the word Small-Pox in large andlegible letters so that thoseiwho run may read, and thus give warning to the whole community that such a house is infected with the plague. If this is done and perfectly and absolutely carried out so that no unneces- sary communication shall be held with such a house, then we will guarantee that within six months from this date probably within three there will not be left a single case of small-pox to record as occurring in the city of Montreal. A small-pox Hospital is first to be provided, the City Council have proved themselves silly idlers, it would be well for the citizens to buy a few bags of marbles or spinning tops or any other toy of childish amusement for the foolish incompetents of the City Hall to wile away-their time, but as to building a City Hospital for small-pox, the thing is absolutelybeyond their ken. If a small-pox hospital is to be built or suitable premises secured to act as a temporary hospital, it will have .to be done by the citizens them- selves. If this is undertaken at aUl, it should be. done without further: delay. A spirit of earnestness and -self preservation stiould guide those concerned in carrying out this work. Valuable lives have been already sacrificed, and others:will follow unless some sensible honest and imme- diate action is taken in the premises.",
         "TRAINING SCHOOL FOR NURSES. THE TRAINING SCHOOL FOR NURSES AT ST. CATHARINES, ONT. About one year ago a young lady entered into an agree- ment with Dr. Mack:to go to England and to return in the spring with a suffi.cient number of trained nurses and of others who were willing to serve as- probationers, to estab- lish;in St. Catharines one of those institutions now grow- ing up in all centres of population in Europe and America. In the month of April, Miss Money, the young lady referred to, returried with four nurses whom she had care- fully selected from applicants during the winter. Dr. Mack having also during her absence fitted up and rented a proper abode for them with funds collected from visitors at Springbank and from the ladies of the town, and upon the ist May the whole undertaking commenced active operations with a staff of five nurses, one being a Canadian, and Miss Money as superintendent, under the designation of \" The Gasparin Training School and Nurses' House.\" A small hospital of about twenty beds was placed in the hands of the sister superintendent, and the work of training commenced. At Springbank, also, a large hotel sanitorium and bathing house wvas established. Two of the nurses went on duty every second week, and thus two valuable elements of training were combined, viz., the care of the affluent and the care of the poor, home nursing and hospital nursing, while two of the number were left ready for serving as monthly nurses if required. , The cottage hospital being wholly inadequate to its requirements as a \"General and Marine Hospital,\" the Dominion Government, by the strenuous exertiors of Mr. Norris, the Member for this County, were induced to make a small grant in aid¯of the Marine. department, and this, with other contributions enabled the Trustees to erect a commodious addition, admitting of about 4o beds in all, and now under the present able management the Charity bids fair to become a perfect \"bijou \" in the hospital way. The plan of management of the Nurses' Home is as 239",
         "240 CANADA \"3EDICAL AND SUROICAL JOURNAL. follows : each nurse binds herself to serve three years, the first six months free, and after that to receive ten dollars per month and-two suits of uniform annually, and. comfort- able board and lodging at the \" Home \" when unemployed. The expenses so far have been very small, and have been met by private contribution, two gentlemen, Mr. Fred. Merritt of St. Catharines, and Mr. P. P. Pratt of Buffalo, making the handsome donation of $ ioo each. Miss Money gives her services entirely free, and having purchased the property where the \"Home \"now is out of her private means, she gives it up for the purpose at a small rent. This lady was trained by the Countess Gasparin, in honour of whom she has given the name to the Institution. and she is well competent to instruct, having had a large experience during the Franco-Prussian war. Instructions in the principles of Physiology and in General Anatomy will be also given by the Medical Attendants at the Hospital during the winter months. The monthly and other nurses are in constant requisition, and the want is felt of more nurses, but not of employment for them. It is barely self sustaining now, and by careful management and a little outside assistance there seems to be. no doubt that this, the first.enterprise of the kind in Canada, will ultinately be crowned with success. No distinction of'religious sect is recognized, the women are only required to be Christian in character and conduct and to comply rigidly with the rules and regulations both of the Hospital and of the \"Home.\" The canal at present being cut, and the navigation of the old canal give a large number of serious surgical cases, and afford ample scope for the- exercise of those desirous to learn.-Commnnicated. The Laie Dr. Anstie.-A committee bas been formed, which comprises many of the most eminent men in the medical profession, for the purpose of taking stepsjto raise a fund to be applied in perpetuation of the memory of the late Dr. Anstie. Ris former pupils will, there is no doubt,.assist the movement to the utmost, and we trust that it will be as well supported generally as was the \" Web Fund,\" the total of which amounted to ;,2,674 Is. 6d. It is report- cd that Dr. Lauder Brunton will succeed Dr. Anstie as Editor of the Praciioner.-Stu~dentf' 7ourna?."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICA L \u0026 SURGICAL JOURNAL Griginal fSoinmtiications. ILEMORRHAGIC SMALL-POX. I WILLA OSLER, M.D., L.R.C.P., LoŽN. Fellow of the Royal Microscopical Society, London, late Physician to the Small-pox Department of the Montreal General Hospital, and Professor of the Institutes o' Medicine, McGill University. True hoemorrhagic small-pox occurs under two conditions; in one the characteristic symptoms come on early, either with or following close upon the prodromata; there are extensive cutaneous extravasations, with hwmorrhages from the mucous surfaces, and death ensues with a terrible certainty in from two to six days. This is the purpura variolosa of authors, the petechial, malignant, or black small-pox. In the other, the case progresses as one of variola vera, and it is not until the vesicu- lar or pustalar stage that hSmorrhage takes place into the pocks, and in some cases from the mucous membranes. This, which is almost as invariably fatal as the former, lias been called by some writers, variola hoemorrhagica pustulosa, indicating that the hoenîorrhages occur at a later period of the disease. The epidemic which has raged in this city for the past five years lias been remarkable for the prevalence of this variety of the disease ; and the present paper is based on 27 cases, 14 of which came under my own observation, chiefly at the General Hlospital, while the remaining 13 were under the care of my predecessor, Dr. Simpson, to whose kindness I am indebted for 19",
         "cANADA MEDICAL AND SURGICAL JOURNAL. permission to utilize them. The clinical history of the disease- is well exemplified in the reports of the following cases. I.-A. T., aged 6-, unvaccinated. Admitted at 2 p.ni., July 14th. Iad been ill since the afternoon of Monday, the loth,. with fever, severe pains in the back and head, and vomiting. Patient seen at 8.40 p.m. Pulse 144, tolerably firm ; tem- perature 105- ; respirations 26, the rhythm broken by an. occasional deep inspiration, or a series of shorter ones. Pupils. dilated. Slight delirium. Tongue thickly coated, white, edges. red. Generai cutaneous surface of a dusky red colour, especially marked in the face, and by careful inspection an exceedingly fine papular eruption was discovered, nost evident on the face, less so in other parts. Scattered over the whole skin were numerous ecchymoses, from 1 to 3 lines in diameter, and of a, dark red colour. They were most abundant about the neck, in. the submaxillary regions, scattered on the extremities. A thickly- set group existed over the left biceps. Ordered quinine gr. x, at 9.30. Very restless all night, raving and shouting ; tem- pèrature at 3 a.m., 104.1°, and at this time lie had a second ten grains of quinine, shortly after the administration of which he vonited a little blood. 15t.-9.15 a.m. Pulse 140, not so full; temperature 104Q; respirations 18, and still irregular. Is sensible, but will not take- nourishment. Ordered a cold pack. At 12 a.m., temperature- 103Q. 5.30 p.m.,Pulse 144 ; temperature 104.2 ; respirationsý a2. On the back are many elevated wheals, and on the- sumuit of these small groups of vesicles exist. The fein punctiform, extravasations are almost universal on the skin of the trunk. Lips- dry and cracked. Tongue darkly coated. Does not complain of his throat. Ordered a cold pack at 6 p.m., and quinine- gr. x, at 9 p.m. To have morphia if sleepless. 16th.-Has been very restiess all night, in spite of two draughts of morphia (- gr. each). Pulse 140, weak but regular; temperature 103.2 ; respirations 18, more regular Great restlessness and jactitation. The scattered papules are uniformly hoemorrhagic, and the wheals on the back and side, 2Q90",
         "Hl YfORRHAGO rosMALL-Pox .--Y DR. osLER. - 291- which yesterday were only hyperSmic, are now purpuric. At least one half of the cutaneous surface is the seat of extra- vasation and the free. portions are of a dusky-red colour. Purpuric spots numerous about the face, and a few exist beneath the conjunctiva. The urine passed through the night is clear, though scanty. Has passed a considerable amount of blood per rectum, .and also a small quantity of bloody urine. Surface of body darker, extravasations appear deeper and more abundant; on exposing the trunk, nothing is noticeable en the skin but the deep plun colour. Restlessness extrenie, and slight delirium. According to the nurse he became easier after 3 p.m., passed more blood from the bowels and bladder, and died at 5.30 p.., having been in hospital a little over two days. Duration of illness about six days. The above may be taken as a fair example of the disease in question, but it may occur in a more aggravated form, killing in from thrce to four days, and before the eruption bas become at all evident. One of the worst cases whiclh came under my notice was of this description, and, as I saw it very frequently fron the begining to the close, I ivill give a short account of it. IL. On the evening of Tlursday, Oct. 24th, 1874, I was sent for to see A. N., aged 22, a stout, well-built, young Englishman. I found him in a high fever, complaining of intense pain in the. lumbar and precordial regions, and incessant vomiting. Hle. stated that lie had been to the theatre the previous night feeling- in his usual health, but that on awaking this morning lie felt: unwell, had a licadache and nausea, and was unable to attend to lfis business. Ie believed it to be biliousness, to attacks of which le was, at times, subject. On the left arra were two, scars of an old vaccination. 25th, 9 a.n. - Found him in the sanie condition, having, passed a very bad night. The vomiting and pains continue. Temperature 1014 ; pulse 116, full and strong ; face flushed, $kin of chest erythematous. The præcordial. pain was.specially",
         "CANADA 31EDICAe, AN) SURGICAL JOURNAL. grievous, and I gave him an injection of i a gr, of morphia in this region. 12 a.m. - Is a little easier, but the retching continues. 4. 15, p m.-Skin of the trunk very hyperemie, and a few isolated ecchvmoses were noticed along the lower margins of the chest. 9. p.m.-Scattered spots of purpura exist also in ithe groins. Condition much the same, retching not quite so frequent. Pulse 112 ; temperature 102.4°. 26th.-Passed a restless, uneasy, night. Skin of trunk much congested, that of extremities less so. Ecchymoses have extended, and are more numerous. In consultation with Dr. Howard in the afternoon, ny suspicions were confirmed, and the diagnosis of smail-pox nade. On careful inspection a few small papules vere discovered upon the 'wrists and forehead, near the roots of the hair. Still complains of the dull, aching pain in the back, and the vomiting continues every 15 or 20 minutes. In the evening lie was removed to the small-pox wards of the General Ilospital, and placed under the care of Dr. Simpson. Shortly after arriving there lie vomited a little blood. 9. p..-The skin of the trunk is now almost univer- sally purpurie, and the extravasations are extending on the extremities. Pulse 124, soft and compressible ; respirations 26, interrupted, every fifth or sixth inspiration deeper than the. others. Complains a little of his throat ; soreness due probably. to the constant retching. Still complains of the dorsal pains. A hypodermie injection of morplia was given in the lumbar region. 27th.-Passed a restless night. Hoematuria and mehena towards morning. lrematemesis at intervals. Considerable -oozing took place from the puncture of the hypodermic needle. General symptoms a little improved. The lumbar Tpains much relieved. Cutaneous hSmorrhages are extending on the extremities. Pulse 140, and small; respirations 34; temperature 100.2f. Imorrhages from the bowels, sto- -mach, and urinary passages continued through the day, and. the symptoms became aggravated. 6 p m.-Pulse 140, and :2 93",
         "IAEMoRRIAGIC SMALL-POX.--BY DR. OSLER. almost \"imperceptible ; respirations between 40 and 50, and interrupted. The mind, which up to this time had remained clear, now began to wander. The greater part of the skin of the body is ecchymotic. The face is somewhat swollen, dark purplish red in colour, and on pressing with the finger it is seen that colouration is due ciiefly to the extravasations, which have also occurred round fh orbits. The conjunctivS are swollen and blaek, hæmorrhage having taken place beneath them ; the cornemc appear sunk in dark red pits, giving to t.e patient a frightful appearance. The whole trunk is of a deep plum colour, hardly a trace of clear cuticle remains, The purpuric spots are. thicekly set, and between them are fine punctiforn extravasations. On the extremities the petechial cruption is more scattered ; still, even here, more than two- thirds of tho cutancous surface is the seat of læmorrhage, and the whole skin is hyperiemic. The most careful inspec- tion fails to detect any papules, even about the wrists or for- head, where on Friday evening they weré appearing. Just after midnight the respirations became more prolged, pulse quite imperceptible, extremities cold, and deatt took place at 12.45 a.m.,on Monday morning. The whole illness lasted hardly four days. With the exception of two, all the cases of homorrhagie small-pox which I have observed were of the above type-the patients died before the characteristie eruption developed, or the cutaneous ecchymoses completely cloaked it. In two instances the extravasations did not cone on in the initial stage, but dur- 'ing the development of the pocks.- 1 cemorragicapustulosa. The following is a brief history of one of these cases: -III. A. McR., aged 19, a well-built Scotch girl, unvaccinated. Admitted January 31st, 1875, from the general wards, where she had been under treatment during two weeks for some ill. defined affection. Only six weeks previous to this she had been, discharged from the Ilospital convalescent from typhoid fever. In the general wards she Iad suffered with the usual initial, symptoms of the disease. On admission, temperature 103..3 ;",
         "CANADA MEDICAL AND SURGICAL ,0tJRNAL. pulse 116 ; respirations 22. A deep erythematous rash exists over the whole body, most intense on the abdomen and thorax, unaccompanied by ecchymoses. A papular eruption is present on the face, thorax, and arms, and is just appearing on the legs. Patient dull, heavy, and ctoes not respond to questions. Feb. 18t.-9 a.m.-Temperature 102e; pulse 110; respira- tions 26. Has passed a restless night ; delirious at times, vomiting continues at intervals. . Erythema persists. 6. p.m. Pulse 112 ; respirations 32; temperature 103.40. Towards the afternoon the nurse states that a small amount of blood was vomited, and she also passed a little from the-bladder and bÔwels. The eruption bas extended, many of the papuies have now vesi- cular tops. The erythema is not nearly so bright. 2nd., 9 a.m. - Temperature 102.30 ; pulse 100 ; respir- ations 26. The bematemesis bas continued at intervals through the night. Slight hæmaturia. The bright erythematous rash bas gone, the skin is now of a dusky livid hue. 6. p.m. Tem- perature 103.40 ; pulse 60, and intermittent every fourth beat, but is tolerably full; respirations 28. Cutaneous extravasations noticed for the first time, chiefly about the vesicles on the upper part of the chest, and on the legs. In many the hæmorrhage bas occurred into the vesicles. The hæmorrhages from the mucous membranes have continued at intervals. 3rd, 8.30 a.m.-Temperature, 1010 ; pulse, 112 ; respira- tions, 24. Most of the vesicles on the legs are now homorr- hagie, and the ecchymoses have extended in the abdominal region. The vomiting is still a very troublesome symptom. 5.30 p.m.-Pulse, 120, not irregular; temperature, 1020; respirations, 24. On the face and arms the pocks are develop- ing slowly, and only a few in these parts are hoemorrhagic; melæna, hSnaturia and metrorrhagia (slight). Takes nourish- ment well; 4th, 9. a.m.-Pulse, 120 ; temperature, 101.20 ; respirations' 28 ; says she feels better ; vouiting bas stopped. Blood in the urine passed through the niglit. Pocks are not developing, look dark, and the majority of them are hkemorrhagic. '294",
         "295i ILE.oRHIAGIc SMALLPOX.-Y IR. OSLER. 6. p.m.-Puse, 124 ; temperature, 1020 ; respirations, 36. 'The peculiar variolous odour very evident this evening. 5th, 8.30 a.m.-Pulse 116 ; temperature, 1000; respirations, 18. Slept well, and says she feels much better. Meloena and 'haiaturia through the night. Peceks much flattened at the -top, and of a, dark colour; skin between them livid, and -covered with minute extravasations. 6 p.m. Pulse, 112, very weak and interinits every tenth beat ; temperature, 1010. Is .very dull and heavy, and does not care to take nourishment. Not 'much change noticed in the eruption, the majority of the pochs look like elevated hemorrhagic papules, no umbilication i any ,of them. Througlh the evening she lost a good deal of blood from the vagina, got .much worse towards morning, and died at 7 a.m., on the 9th day of the disease. The details of the above cases furnish a tolerably accurate picture of the clinical features of this truly terrible disease, and I shall now proceed to make some geneiral remarks upon its synptoms, diagnosis, etiology and pathology. \u003eSnptos-Satisfactory evidence is wanting as to the period ,of incubation in hoernorrhagic small-pox. IMost. writers state that it is the same as in the ordinary form, i. e., 12 to 14 days. ZuIlzer,* however, states that it is shorter, having determined it in 9 cases to be from 6 to 8 days. In the majority of instances it is unaccompanied by any symptoms-perhaps slight languor and malaise-the disease breaking out suddenly in all its vio- lence. So it .was in the case above reported of the young Englishman. The day before the attack he had walked round .the mountain, (5 miles). The symptomns of the initial stage are those of the pustular for.m; indeed, the disease mav be regarded as an intensified and prolonged initial stage, combined with a remarkable tendency to cutaneous and mucous hSmorrhages. The fever, pain in the back, and vomiting-that triple com- bation, which we look upon as almost pathognomonie of small- px-are the prominent symptoms throughout, even after the tearacteristie extravasations appear. Berliner klinische Woclicnschrift, 1872.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. The fever is usually moderate, varying from 1010 to 1030; only once did I observe a temperature of 105\u003e. It is frequently ushered in with a rigor, or series of chills. The pain in the back is perhaps the most distressing symptom to the patient, and persists longer, and is more constant, in this than in the pustul- ar form of the disease, continuing, in some instances to -within 12 hours of death. All of my patients complained of it, and -when asked to localize it placed the hand~ over the sacrum. Procordial pain was also common, in one or two cases much more. severe than the dorsal. Headache is rarely absent during the- first days of the ever. Vomiting constitutes a very troublesome symptom, and, in my experience, proves exceedingly obstinate, much more so than ià ordinary small-pox. It was very unusual for patients with the latter disease to vomit after the appearance of the eruption, while, in cases of the hcmorrhagic form, it continued for 3, 4.. and 5 days. Dry retching was frequcntly combined with it, and seemed particularly distressing. Early on the second day, or even in the most severe cases on the evening of the first, a bright scarlatiniform redness spreads over the skin of the trunk, sometimes extending to the extremi- ties, but not often involving the face. In some instances this is not universal, but confined to the lower abdomnial or lateral thoracic regions. It is difficult, or even impossible, to dis- tinguish this general or localized erythema preceding'hemorr- hagie small-pox froin the similar condition which, as an initial rash, so frequently ushers in the ordinary or modified forms of the disease. For a time simply hyperSmic and. disappearing on pres- sure, the character of the rash quickly alters by the occurrence of numerous extravasations, vhich begin commonly in the groins- and lateral thoracic areas. At first punctiform or macular, and concealed by the generali redness, they soon increase in size, and on the trunk form irregular patelies, ranging in size from a six-pence to a penny, -while on the extremities and face they remain discrete. l 36 hours the ecchymoses may have devel-: oped to such an extent a s to involve fully two-thirds off cutaneous surface. The skin of the trunk is now of a rich pla 296",
         "IHEMORRHAGIc sMALL-POX.-BY DR. OSLER colour, and by pressure very slight difference is made in the intensity. Homorrhage into the tissue of the eyelids and beneath the conjunctiv is common, and adds greatly to the dis- figuremen: of the face, already puffed and swollen. The extra- vasations deepen until the end, forming throughout the most distinguishing feature, and the one which has so justly given the· name of black small-pox to this variety of the disease. True papules of variola may nearly always be discovered, if carefully looked for upon the forehead and vrists at the end of the second or upon the third day. They were present in all the cases which came under my own observation. In the most malignant form--purpura variolosa -the rapidly extending ecchymoses soon hide them, and it may be difficuli or impossible even to feel them ; indeed, in several instances, I could not, post mortein, convince myself of their presence. In the other variety, v. hæemorrlhagica pustulosa, the eruption comes out as usual, the extravasations occurring eitherin the vesicular or pus- tular stage. Homorrhage fron the mucous membranes takes place in the- majority of cases, and constitutes one of the most prominent symptoms. Epistaxis is common, especially in the early stage of the- disease. Henaternesis occurs in more than half of the cases. In'my experience it is not copious, but the blood is mixed with the thick mucus brought up in the constant attacks of vomiting. Melna was noticed in about one-third of the cases ; the blood in three was tolerably fresh and -bright ; as a rule, howevei, it was dark, and mixed with the mucous discharges. Homorrhage from the urinary passages occurred in a large proportion of the cases. and was often profuse, the blood coagula- tmg in the chamber-pot. .etrorrhagia is stated to be exceedingly common in women. It.was only noticed in one out of six females. Wom)l9ptysis occurred in five cases, in one it was profuse and arterial. The sputa hawked up are frequently streaked with blood from the bronchial tubes and fauces. These hæimorrhages from the mucous membrancs d not 297*",
         "C CANADA MEDICAL AND SURGICAL JOURNAL always occur. In five of my own cases (Nos. 16, 18, 20, 22, 23,) they were absent, and yet these were among the most severe and rapidly fatal cases of the disease, death ensuing on the 5th, 5th, 6th, 7th and 4th days respectively. In two, (Nos. 22, 23) post mortem examination revealed extensive hemorrhages into the mucous membrane of the stomach, intes- tines, and urinary tract. The pulse in the first days of the disease ranges from 110 to 120 beats in the minute, and is full and compressible. Gradually the arterial tension is increased, the pulse becomes more rapid, '120 to 140, small, hard, and irregular, and at last uncountable 'or imperceptible. The respirations are unusually increased in frequence in the early stage, without any discoverable disorder in the lungs, and are out of proportion to the intensity of the fever. In the case of a negro whose respirations the morning after admission were 32, and the temperature 101.0, after examining the lungs and finding nothing to account for the acceleration, my suspicions ivere aroused, and on careful inspection I was able, even on the dark skin, to detect the hæmorrhagic condition in and about the papules. This symptom alone directed my attention to his dan- gerous condition, which might otherwise have escaped observa- tion, as there were no hæmorrhages from the mucous membranes. An interesting, and by no means unfrequent phenomenon,was the disturbance in the respiratory rhythm, first drawn attention to by Drs. Cheyne and Stokes, consisting in a series of superficial respirations, sometimes almost imperceptible, followed by a deep inspiration. This vas noticed chiefly during the last 24 or 36 .hours of life. A short hacking cough was not an uncommon symptom. Many of the patients complained of sore throat, which, in soce instances, appeared to be due to the constant gagging and voM' ting, in others to a foul, horribly fotid, diphtheritic pharyngitis.' Consciousness is commonly retained until near the end. In ,only six cases was delirium a prominent symptom. A hyperos- thetic condition of the skin, mentioned by Zulzer* as common, was not noticed in any of the cases. Loc. Cit. '298",
         "TLEMORaIIAOIO SMALL-I'OX.-ny DII. 0~LEB. 29~ In the true petechial form the patients seldom outlive the sixth ,or seventh day ; where the hbamorrhages do not corne on until the vesicular stage, they of course last longer. The cases upon which this paper is based died on the following days: 1 on the 3rd day ; 2 on the 4th day ; 5 on the 5th day; 6 on the 6th day ; 5 on the 7th day; 4- on, the 8th day; 4 on the 9th day. The disease, in both its forms, is spoken of as invariably fatal, and such has been our experience in the snall-pox department ,of the General Hospital. Diagnosis.-In an epidernic of siall-pox cliaracterized by the presence of horrhagic varieties, there is rarely any doubt of the nature of a case of fever presenting extensive cutaneous -extravasations, and, perhaps. mucous hmmorrhages. Givei, however, an individual case, when no epidemic was raging, and the matter would not be so easy. We mist be careful, in the first place, to remnember that the initial rashes, which so often precede the milder forms of the disease, may be general and purpuric, closely resembling, or identical in appearance with, those aeconpanying the truc pote- chial variety. It might be impossible to decide definlitely for 24 hours on the nature of a case of this kind, In the latter the erythema would probably be more intense, the ecchymoses more extensive, and the general symptons more aggravated. In nany instances the progress of the case would alone deter- mine its nature. The bright, rôsy-red, rash appearing on the second day might e' Mistaken for the eruption of searlet fever, unless the mode Of Onset of the disease had been carefully watched. The diagnosis between hrmorrhagic scarlatina-fortunately a rare diease-and petechial small-pox offers still greater difficulties. Close inspection might discover in the. latter papules about the forehead or wrists, and, I think, the characteristie odour of small-pox,-which is well developed in this variety, would aid in riving at a conclusion. Cerebro-spinal ineningitis is another disease which, il some of its forrs, is apt to be confounded vith purpuric variola. The pains in the head and back in the latter simulate those of 299",
         "300 CANADA MEDICAL AND SURoICAL JOURNAL meningitis, in which disease also cutanceous ecchymoses not unfrequently occur. Indeed, I have the permission of the phy- sician in charge to state that in case 25 on the list the eri'or in diagnosis was made. I remarked to hin at the post mnorten examination upon the similarity of the pathological changes to those in hætmorrhagic variola. The mother, who had nursed the child, a short time subsequently took small-pox, and died. With truc Purpojra hæmorrhagica -the zlorbus maculosve lVerlltoffii,-this variety of small-pox has many points in com- mon. In both there are cutaneous and muacous hmniorrhages, but in the former the extravasations begin on the lower extreinities, the skin is not so hyperoemic, the fever not se high, and there may be cdema about the joints, diarrhea, and ascites. Etiolog.--rom the table subjoined some interesting facts with reference to the general etiology of the disease may be drawn. It is most common between the ages of 1.5 and 30.: Thus of the cases there were- Under 10 years, 3 ; between 15 aid 20, 4; between 20 and 25, 9 ; btween 25 and 35, 6; between 35 and 45, 3; above 50,1. Young, vigorous, muscular persons form the majority of the victims, aud this remarkable fact -was noticed also in the late epidemic in Germany. (Zulzer, Ponfick). Several of my patients were above the average muscular development, most of them belonging to the artizan class. The predisposing causes mentioned by Aikman,* viz., sudden change of residence, debilitating ner- vous influences, unhealthy dwellings, were not speciallyobserved. Men appear to be more frequently attacked than women. With regard to vaccination the table shows that 14 were ure vaccinated, while 13 showed marks of a by-gone vaccination. In none was there a history of re-vaccination. That is, the whole of these cases were unprotected, for I hold that we have no right whatever to say that a man is vaccinated because lie has cicatrices on his arm. The proof that these 13 were not vac- cinated lies in the fact that they died of the worst form of sinall- pox. No properly vaccinated person, one in whose tissues the impress of vaccina persists, can, I maintain, take small-pox. Similarly Zulzer's† cases, 35 in number, all showed scars, - Olagoi, edical Journal, 1871, p. 60. t Loc. Cit.",
         "UL2EMoftRHAGCl sMALL-POX.--BY Dit. OSLER. but none of themn had been re-vaccinated. Other observers state that persons without cicatrices of a former vaccination form the majority, or even all of the number attacked. The proportion of hiemorrhagic cases bas been unusually large in this epidemic, not only here but in other parts of the world ; indeed, it bas been the most virulent type of small-pox known since the beginni.ng of the century. In the small-pox department of the Montreal General IIospital there were admitted from Dec. 14th 1873, to July 21st 1875, one year and seven months, 260 cases. Of these 24 died of the variety under consideration, or 9.23 per cent. Age. Sex. Una. 27 F. ...... 28 F. 29 M. Un'. 53 M. ...... 20 F. Unv. 19 M. ..... 35 M. ...... 20 m. ...... 39 M. Unri. Vac. ofy Death. V: 8th V2 6th .. . 8th V. 3rd 6th VI 7th V2 9th V. 6th .... 7th 10 24 M. Unr. ....8th il 25 M. Uny. 9th 12 .. F. ...... V2 8th 13 23 M. ...... 7th 14 22 M. ......V2 4th 15 20 M. ......V2 9th 16 21 M.- ...... VI 5th V 19 F. Unv.. . 9th 18 44 M. Univ. . 5th 19 24 M. Unv. . 5th -20 36 M. ......VI 6th -21 6 M. Unv. .... 4th 22 35 M. ....... V. 7th 23. 16 M. Un.. 4th 24, 30 M. Un'. . 7th 25 4 F. Unv. Gth 26 36 M. Unli. 6th 27 6 M. Unv. 5th 'The figures indicate the number ofscars. icut-lnleous extravasations occurred in ail. REMARlKS.t Delirium. UmmenatemieSiA. EpýIistaxis.Mfelmna.RoSmoptysis;. Delirium. Melena. No papules evident. Died 3j hours after admission. Epistaxis two days before. Slight convulsions. R oematuria. Much Delirium. var. hSm. pust. No mucous hSmorrhages. Delirium. Meliena, frequent. loemateinesis. MelSna. Epistaxis.MelSna. Iloematemesis. Var. huum. pustulosa. flmop- tysis. Old lung disease. iloinaturia.Melæna.Homoptysis. Epistaxis. iHoenioptysis. H enaturia.Iomoptysis. Meloena. V. hoem. pustulosa. Hlomaturia. ]IUmatemesis. No i3ucous heiorrhages. V. hni. pustulosa. i wmlaturi' l emnateimesis. No inucous hniorrhages. liumaturia. Metrorrbagia. Delirium. No mucous hemorr- hagres. Hiniaturia. JSmatemesis Met- oena. Delirium. No inucous hiemorr- hages. No inucous homorrhages. Hl naturia. llniatemesis.He- moptysis, Roamatemesis. Emmaturia. MelSua HSmaturia. Roematemesis. Case. *a%01",
         "3 ëA'2An A1 MEDica AND SUOICAL JOURNAL. Pathology-The condition of the internal organs in th disease lias received a good deal of attention within the past fe, years. The remarks which I shall bere inake are based upo seven carefully performed autopsies. The prominent characteristics in all were the haænorrhage into the various tissues and organs. The blood during life vas carefully exanined iii six cases, bu no change of importance noticed in the corpuscles. Post morten it was dark in colour and generally fluid. In the 7eninges of the brain scattered ecchymoses wer noticed in five instances. The venous sinuses of the dura matei and the vessels of the pia mater were full In cases 21 and 2e thin coagula of blood existed on the surface of the pia mater. The brain appeared normal, the consistence renarkably good. In case 22 there was a small clot in the right ventricle. Tite spinal cord was examined in one instance, when nothingabnormal was found. On the pericardium nmacuke were present, often quite large on the visceral layer along the tract of the coronary vessels. The heart substance was firm, dark in colour ; in several. instances minute ecchymoses were observed on the endocardium, anc in the muscular walls. Both visceral and parietal layers of the pleura contained. ecchymoses in 6 cases. Tite lungs were crepitant, and contained much blood in the posterior parts. In case 23 there was a patch of catarrlal pneunonia. in five instances apoplectic spots were found, none of them larger than a walnut. The spleen in ail was firm, about the natural size, in two a little enlarged. On section the substance was compact, smooth, of a dirty-purplish red colour, and in six of the cases the Mal- pighian corpuscles were remarkably enlarged, appearing a3 round white bodies on the dark background of the pulp. The kidneys appeared of normal size. Ecchymoses on the capsule common ; in one instance a thin clot existed upon the organ. The consistence of parenchyma vas good. In three cases minute liernorrhages had taken place into the substance. The vessels as a rule were full. The pelves of the kidneysiR * For two of these I have to thank Sister tosalie, apothecary at the R. C. Clivi' Small-pox Hospital, who kindly informed me when any of these cases occurred.",
         "HLEMORRUAoc SMALL-POX.-BY DR. OsLER. 303 four instances were plugged with dark clots, which extended u4p into the calyces, and down the ureters. Ia all ecchymoses were present on the mucous membrane. In the mucous membrane of the bladdei- small hmorrhages were met with on five occasions. In case 21 the walls of the whole org§ n were uniformly infiltra- ted with blooi, not a trace of normal. tissue could be seen on section. Tie liver in five cases was of normal size, unusually dense and firm, lobules moderately distinct, of natural colour, and con- tained a good deal of blood. In two cases it was large, pale in colour, very friable, and on examination proved fatty. The gen eral condition in both these cases accounted for the state of the liver, one had suffered from chronie disease of the leg, the other was a drunkard. Ecchymoses upon the capsule were common. The mucous membrane of the stomach in all the cases showed an enormous number of extravasations, some small and capillary, others as large as a bean, and projecting on the surface. Similar appearances were foun. in the snall intestines ; in two instances the ecchymoses were .nost abundant in the ileum, in the others the upper region of tic bowel was most affected. Peyer's glands were swollen and prominent in four instances. In the large bowel the extravasations were only noticed in three cases. In two instances the wesenterie glands were uniformly infiltra- ted with blood, looking like dark-purple grapes. Extravasations occurred in ail the cases in the retro-peritoneal tissues, about, the aorta, along the iliac arteries, and about the lumbar nerves. In most they, were small and confned to the adventitia and parts about the vessels, in one, however, quite a large suggillate was found in the region of the right psoas muscle. Similar appearances vere noticed twice about the thoracic aorta. Such, are the chief pathological changes in the internal organs, and they correspond pretty closely to those described by Ponfick* in the Berlin epidemic. In addition to the hæmorrhages, the firm, dense condition of the heart and abdominal glands seems pecuiar, and stands in marked contrast to the appearances of these organs in variola vera, in which they are swollen, soft Berliner klinische Wocheischrift, 1872.",
         "304 CANADA 31EDICAL AND SURGICAL JOURNAL. and friable, and in that state of cloudy swelling common to pro- longed fever. So impressed is Ponfick -with the pathological and .clinical differences between these extremes of small-pox, that he is inclined to group them as distinct diseases. But, just as transitions are met with clinically between the macularhmmorr- hagic form and that in which extravasations take place in the vesicular and pustular stages, so also, I think, in a more extended series of post mortems appearances would be found intermediate between the extremes, and where the disease had lasted any time the same pyrexial changes would occur. Indeed, Cursch- mann* states that he has noticed them in variola hlæomorrhagica pustulosa. On the intirnate pathology of this disease I can offer no sug- gestion. We are, as yet, profoundly ignorant of the conditions .of its genesis, and do not know whether it de pends on the in- tensity of the poison or the extreme susceptibility of the patient. Most histologists are agreed that in these purpuric disorders the red corpuscles pass through altered or thinned and not ruptured vessels, but as to the causes of this general diapedesis, as the process is called, we have no data upon which to form .a judg-ment. The treatment of the disease is eminently unsatisfactory, the patients almost invariably die. A few instances are recorded of recovery from variola hmorrhagica pustulosa. All the usual medicines indie'ated under these circumstances were tried, gallie acid, ergot, turpentirie, acetate of lead, \u0026c., without the slightest benefit. Quinine was used in large doses, and in three cases I used the cold pauk. Since the closure of the wards I have met with an article in the' Glasgow Medical Journal by Mr Aikman, forinerly assistant mjedical officer at the Hampstead Small-pox Hospital, in which lie recomnends strychnia in large doses, and states that under this treatm3nt many of these cases recovered. He gives as much as a draclim ind a half of the liquor strychnie in the twenty-four hours ic severe cases, combined with iron and -quassla. * Ziemssen's Ency, , , V' 1I., A n. Sm pox. p. 387. t Loc. Cit",
         "UsJE ô' THE CLINICAL THERMoETER-BY mi. sliiUIRFF. 305 TIE EARLY USE OF T[E CLINfCAL THERMOMETER. Ey W. F. SImRiiIFF, M.D., L.R.C.S., Es;i., IIUNTINGDON, QUE. I do not renember the history of the clinical thermometer, but until lately I supposed it was a éomparatively recent inven- tion. I have a copy of the fourth edition of Dr. James Currie's Medical Reports, printed in 1805, on the effects of water cold and warm as a remedy in fever, and other diseases. Some time ago I was looking over the lst volume and was nuch surprised to find a theriometer described almost identical with those at presenrin use. Dr. Currie strongly advocates the use of the coll afftusion in fevers, but only when the temperature of the body is considerably above the natural liet. On pages 3.5 and 36, lie says: \".In taking the heat of the patient, I have gncerally used a small mercurial thermometer of great sensibility, with movable scales. made for me by Mr. Ramsden, after a form invented by the late Mr. Hlunter, and used by him in his experiment on the heat of animals, and I have introduced the bulb under the tongue, with the lips close, or under the axilla, indifferently : having proved by repeated experiments that the heat in these two places corresponds exactly, and gives a just indication of the lieat of the surface of' the body, where shel- tered by the nccessary teguments fron the contact of the exter- nal air. Finding, however, considerable risque in using the straight-tubed thermomete in contagious diseases, I got some instruments of this kind made with a smuall balb and curred it the end. The bulb bcing introduced under the tongue or axilla, the observer eau stand behind tle patient, and nrrk the rise of the mercury. without cominig into the imumediate sphere of his respiration. Though no irjury lias iii any case incurred from the use of the thermometer, yet a further improvemient lias sug- gested itself. 13y introducing a small piece of air into the tube after the manner of Mr. Six, a permanent indication of the greatest heat is obtained, and the approach of the observer towards the patient during the experiment is rendered unneces- sary.\" On pa)ge 21 lie describes a case, dated Ist January, 20",
         "306 CANADA MEDICAL AND SURGICAL JOURNAL. 1790. I -will transcribe it as it is interesting. He says: \"a nurse in the fever ward of the Infirmary having several patients under her care, caught the infection. She was seized with violent rigors, chilliness and vandering pains, succeeded by great heat, thirst, and headache. Sixteen hours after the first attack her heat at the axilla was 103\" Fahr., her pulse 112 in the minute and strong, her thirst great, her tongue furred, and her skin dry. Five gallons of salt water, of the temperature of 44o were poured over her naked body, at 5 o'clock in the afternoon, and after being hastily dried with a towel she was replaced in bed; when the agitation and sobbing had subsided, her pulse was found to be at the rate of 96 strokes in the minute,. and in half an hour afterwards it had fallen to 80. The heat was reduced to 98) by the affusion, and half an hour afterwards it remained stationary. The sense of hcat and headache were gone and the thirst nearly gone. Six hours after she was found perfectly free of fever, but a good deal of debility remained. Small doses of colombo were ordered with a liglit nourishing diet, and for several days the cold affusion was repeated at he same hour of the day. As at first the fever never returned.\" As this case is dated lst January, 1790. the clinical thernom-- eter must bave been in use sonmte tine beïore. Sauctorius who was a teacher of medicine in 1adua froin 1602 to the time of his death, in 1636. used a theriometer of bis own invention to determine the tenperature of the body in disease. Subsequently Boerhave and van Swieten Iollowed up the practice, and Dei laen mnade extensive use of the thermometer, apparcntiy using Fahrenheit's .instrument, which was invented about the ycar 1726. DeHaen was fuilly impressed with the in- portance of the clinical use of the thernionieter, and not only employed it in his own practice but taught its use to his class; bis observations on ther- mometry are to be found in his works entitled Ratio Medondi. John Hunter niade inynv observations on the temperature of the body, and he recorded local elevation of tenperature, in the inflamination whicl followed surgical operations. Dr. James Currie firit published his medical reports in 1797. These went tbrough several editions but they did not ap- pear to be of practical valie, and therefore were negiected. Since that timle many observations have been carefully recorded by various observers, English and Continental. But thernonietry did not assume the imaportant position it holds at the present day natil'after the declaration of the doc- trine of the unitv and ecorrelation of forces. This produced a new train of reasoning since it was apparent that the teniperature of the body wals a convertible force subject to, set laws. Birensprung, Traube, Wunderlieb, Aitkin, -who gave to us the invention of the self-registering therniometer, and a host of other workers, have all erstributed to render the thern3ometer a mnost important auNxiliary in the treatment of disease.-ED.",
         "REVIEWS ANI NOTICES OF BOOKS. 307 geviews and notices of Boelhs. linhalatiQn in the Treatment of .Disease ; its Therapeutics and Practice.-A treatise on the inhalation of gases, vapours, fumes, eompressed and rarefied air, nebulized fluids, and powders. By J. SOuS CoHiEN, M.D., Lecturer on Laryn- goscopy and Discases of the Throat and Chest in Jefferson Medical College; one of the physicians to the German Hospital of Philadelphia, \u0026c. Second edition, revised and enlarged with many new illustrations, 8vo. pp. 392: Philadelphia, Lindsay \u0026 Blakiston, 1876. Enthusiasts in favor of the treatment of pulmonary complaints by means of local applications claim for this topical medication a great superiority over the ordinary methods by the internal administration of medicines. We are not prepared to go with theIn so far as this, insomuch that if we were compelled to make a choice between inhalation and internal dosage we should cer- tainly retain the latter. Take, for instance, the case of softened tubercle. The most favorable result which we can possibly hope for in these cases consists in the absorption of the fluid parts and the obsolescence of the semi-solid remainder, i. e., its con- version into a calcarcous and inert mass, whilst at the saine time the process of deposition is arrested, and consequently no new tubercle is formed elsewhere. Now this involves the extinction of what we cal] the tuberculous crasis, and nust, we think, be inti- mately connected with the general condition of the nutritive func- tipns. If this view be correct local applications can have but little to do with effecting the desired resalt. In saying this much, we do not for a moment desire to be understood to be decrying the nsefulness of inhalation and the breathing of atomized fluids, \u0026c., because we have a high opinion of their utility, but we wish merely to dissent fron the views of those who, we think, ride this hobby rather too severely, and perhaps to the exclusion of more berieficial, general, and hygienic measures. The great assistance to be derived from the use of medicated steam and atomized fluids is at present undoubted, and it behoves every",
         "CANADA MEDICAL AND SUROlCAL JOURNAL. practitioner to have a fair knowledge of the proper means of applying these, and of the various drugs which are suitable for use in different cases. The little work of Dr. Cohen is very well suited to serve this purpose, being very complete in its men- tion of all the substances which may be beneficially employed in this way, and in illustrating and describing all the appliances which are requisite for the several procedures. Much of the success of these very valnable auxiliaries will depend upon the care with which the thoroughness of their application is attended to by the practitioner himself, and no doubt it is the time and trouble thus involved which prevents their being universally adopted. Part I. includes the inhalation of airs, gases, vapours and fumes. Here we have short notices of almost all known substances which have been thus employed, together with their therapeutical applications and modes of usage. The sections on ccndensed and rarefied air are interesting, as some rather extensive experiments on this treatment have recently been made in Paris and elsewhere on the continent. Some of the most recently discovered and most valuable drugs are, we think, treated rather hurriedly, and. without the consideration that their importance and their novelty demand. For instance, Nitrite qf Amyl has but a short notice awarded it and its main indications for employment pointed out. It seems to us that a good deal more detail on this subject would have been very acceptable to the readers. Part IL On the inhalation of nebulized fluids or sprays is made interesting by numerous experiments and arguments as to the penetration of these fluids into the respiratory passages, together with observations on all articles of the materia medica which are suitable for this mode of administration. Part III, considers the inhalation of powders, and Part IV is a short chapter on medicated atmospheres. There are a number of illustrations which also will be found very useful in explaining the text. 308",
         "REVIEWS AND NOTICES OF BOOKS. Uyclopoedia of the Practice of lfedi\u003c:inc. Edited by Dr. H. voN ZIEMSSEN, Professor of Clinical Medicine in Munich, Bava- ria. Vol. XI. Diseases of the Peripheral Cerebro-Spinal Nerves. B3y Prof. Wilhelm Heinrich Erb, of Heidelberg, Baden. Translated by Mr. Henry Power, of London, England. Albert IL. Buck, MD., New York, Editor of American Edition; 8vo. pp. 623. New York: William Wood \u0026 Co., 27 Great Jones street, 1876. Considerable progress bas been made, during the last few years, in the pathology of the nervous systerm. This bas very materially extended.our acquaintance with the diseases of the peripheral nerves, although the knowledge thus gained may be considered small and unsatisfactory, when compared with advances which have been· made in pathological research in other departments. The division of all nervous diseases into functional and organic is usually adopted. From being unable to recognise organic changes which may -possibly exist, or have existed during life, we have no alternative but to adopt the sig- nification of disturbed function. Pair is the essential feature of all neuralgia ; it is the most commonly observed sensation, and may be produced in all sensory organs. It may have as its factor some anatomical lesion, or it may appear to be destitute of any special and well-mark-ed cause. Erb holds, in regard to pain in neuralgia, that \" a nerve may be at one moment in a state of the most violent excitation, whilst at tho: very next instant it nay be performing ,its functions ni a perfectly normal manne,-ancd since a perfect internission of the painful phenomena may thus occur, it cannot have undergone any notable anatomical changes; every such change would be accompanied by considerable interference with the functions of the nerves, that is to say with a high degree of, anæsthesia.\" Anstie states that anatomical changes, where tlley do exist, are simply accidental, and that they rarely act as factors in the production of neuralgia. The occasional anatomical lesions found in the nerve centres, or in the course of the nerves themselves, unaccompanied by pain of any kind, 309",
         "310 CANrAnA MIEDICAI ANI\u003e SUIGICAL J1OURNAL. nust indicate that these changes are not specially.essential as factors of neuralgia. Professor Erb lias given us iii this. the eleventh vohne of this valuable series, a dissertation on diseases of the I eril leral cerebro-spinal nerves. The coiteritsf\u003et* this volume are divided into two parts. In the fist, which comprises the greater part of the work, will he thund considered functional diseases of the periplieral nerves, or neuroses,-he takes up and discusses nen- roses of the sensory nerves-and then lie passes on to neuralgia of individual nerves. Ie then takes Up neuralgia of the fifth pair, cervico-occipital neuralgia, ncuralgia of the brachial plexus, neuralgia of the dorsal nerves, intercostal neuralgia, and neural- gia of the lumbar, sciatic and coccygeal plexuses, and a chapter on anæsthesia-general cutaneous and particular forms of anoestiesia. The author tien passes on to discuss the neuroses affecting the nerves of special sense-neuroses of the nerves of taste and of the olfactory nerves. The motor nerves next demand his attention, and he commences wvith a general description of spasm and convulsions, taking up the mode of appearance, pathogenesis, etiology, symptomatology, sequel, electrical relations, prognosis aid treatnent. Special formus of sj)asfi next come in order. Clonie and tonic spasm of various muscles or groups of muscles, supplied by nerves. Under this head are treated spasm of the diaphragm, writers' cramp, tetany, con- tractures. Ii the next division are considered paralysis. After a general consideration of the subject, the special forus-of paralysis are given. This forms the iirst part of the work. and, as we before observed, takes up the larger part of the book. In the second part, the author takes up and discusses the anatonical diseases of the peripheral nerves, such as hyperemlia of the nerves, inflammation of the nerves, or neuritis; atrophy of the nerves and hypertrophy, with neoplastic formations il the nerves. We have endeavored in very limited space to give to our readers a general view of the contents of this volume. The ground gone over is very extensive, and much which is treated of here will not be found elsewhere. The subjects are all ably",
         "REVIEWS AND NOTICES OF BOOKS. 'handled, accurate in description, and highly practical in bearing. The translation is very clear and readable. and we cannot but express a belief that the CyclopSdia, as a whole, wil become an unfailing source of reference to those seeking for information on the subjects treated of in these volumes. Messrs. William Wood \u0026 Co. have done their part etcellently, and each volume, as it appears, is not only a store-liouse of information, but an -elegantly got up book. On Coughs, Consumption, and .Diet in Disease. By HORACE DoBELL, M.D., F.R.C.S., \u0026c., \u0026c. Edited by D. G. Brinton, M.D. ; 8vo., pp. 222. Philadelphia: D. G. Brinton, 115 South Seventh street, 1877. This little work is a compilation or collection of extracts from publislied lectures delivered by Dr. Horace Dobell, of London, England, and are so arranged as to form a continnous treatise on the physical (liagnosis and treatment of diseases of the chest. Dr. Dobell is well-known to the profession as an enthusiastic workler, and has devoted much tiie and attention to pulmonary diseases. This can be fully attested when it is borne in mind that he is at the present time engaged in the publication of arnual reports on diseases of the chest. The first report, published in 1875, was fully appreciated; the report for 1876, quite recently published in England, we have not, so far, received. . Dr. Dobell has enjoyed unusual advantages, as he was for'some sixteen years attending physician to the Royal Hospital for diseases of the chest; after which lengthened ser- vice he was elected on the consulting staff to that institution. This gives him a claim to be heard with attention, as his expe- rience has been large. The editor and compiler of this little work divides the subject into three parts. In Part L he gives the diagnosis of bronchial and pulmonary diseases. There is fully described the systematic examinations of the chest, as £ollowed by Dr. Herbert Davies, Dr. Sibson, and Dr. C. J. B. Williams. We then have a chapter on the diagnosis of early 311",
         "CANADA MEDICAL AND SURGICAL JOURNAL. plhthisis, on the value of cavernous sounds, and of the importance- of hSmoptysis as a symptom ; on winter cough, on the diagnosis of narrowed air passages; post nasal catarrh, car cough, and of the natural course of a neglected cough. Part II, consists of the treatment of colds, coughs, and con- sumption. In this will be found a description of the pathological conditions existing ini winter cough, hints as to the avoidance of cold, the early treatment of colds, and the therapeutic resources in Catarrh ; the management of consumption, and on the use of pancreatic emulsion in phthisis. In the third part will be found directions as to suitable diet in sickness, the diet of consumptives, the use of nutritive enemata, and special-receipts for medical food. This little work seems very practical in its bearing, and will be of use to the busy practitioner. Extracts from British and Freign iciurnals. Unless otherwise stated the translations are meade specially for this journaL Subcutaneous Injections. - Subeutaneous in- jection of pure or distilled water as a means of relieving pain. Dr. Lafitte read a paper in the Medical Section of the Nantes Scientific Congress for 1875, on the subeutaneous injection of water. He says he has found it most useful in many cases; lie relates a number of cases, and states he has several times relieved the severe pain of acute rhenmatism by these injec- tions. le used water subcutaneously as early as 1872, and succeeded in immediately relieving pain in a wornan who was suffering most acutely from lumbago. Eight grmm. Of dis- tilled water vas injected, and the pain did iot return. In cases of sciatica, supra-orbital and facial neuralgia, as well as in intercostal neuralgia and rheumatic affections of the joints, ho bas found water injected subcutaneously quite as useful as morphia. le says that the result is not always favorable, and that the pain frequently returns, but so it does after morphia injections. Dr. Lafitte never fbund that the hypodermic use of",
         "BR1USTI AND FOREIGN JOURNALS. water caused local abscesses as is the case with the subcutaneous injection of other substances. Water causes at first a burning pain which soon disappears. About 4 grmm. is the usual quan- tity to inject, The injection, which is done in the usual way, must be done at the painful spot, otherwise it is useless ; several ordinary-sizedl (ss) syringes-ful miay be injected; after you. have enïptied one syringe, wait two minutes, if by that time the pain is not relieved inject another syringe-ful, and so on up to six, till the pain stops, waiting two minutes between each injec- tion. Lafitte says ho has never found need for more than six syringes-ful, and tat two or three generally suffice. 2 grmm. of water was the smallest amount which proved beneficial, and to use more than 10 to 12 grmm. is useless. Bad results fron these rcpeated injections never occur. Dr. Pillet speaks highly of hypodermic injections of water in lumbago and intercostal neuralgia. Dr. Lelut says that for the last three months he has used the pure water injections, witb the best results. -le relates how he came to use it. His servant one day upset the bottle containing his morphia solution for sub- cutaneous injections, and to conceal ber clumsiness filled the bottle with ordinary water, Dr. Lelut, not knowing this, injected the water into the thigh of a patient who was suffering severely from sciatica, and wlion lie was treating by the suboutancous injection of niorphia. The patient was astonished at the instant relief of the pain, and said :\" Wlat kind of a liquid is this you are using which causes me no uneasiness or no sickness at the stomach like the former ?' Since then Dr. Lelut bas ured nothing subcutaneously but water. Dr. Dresch praises the usefulness of this injection especially iii muscular rheumnatism. He also tells of a case of osteo-sarcoma of the thigh in which he used daily 60 ctgm. of morplia subcu- taneously, chloral, cicuta and other remedies, and where hypo- dermic injections of water succeeded in relieving the pain quite as well as morphia without producing the disagreeable Coltitutional effects of that drug. Dr. Dresch does not use Simple water, but prefers peppermint water. Dr. Burney Yeo, of London, says he found subeutaneous",
         "314 CANADA MEDICAL AND SURGICAL JOURNAL injections of water useful in relieving the pain of a patient suffering from thoracic aneurism. Dr. Gorrequer Griffith lias used these injections since 1868. He prefers warm water. Dr. Richards of Birmingham, also recommends it, he injects six drops of warm water at a time.-(Schmidt's Jahirbücher, No. 5, Bd. 170, 1876). Chronie Enlargement of the Spleen. (Local treatment by Professor MOSLER).-The operation of Splenotomy which has succeeded well in animals, and also has been repeatedly performed in men, proves that the partial extir- pation of the spleen, (of which nine successful cases are known) as well as total extirpation of a normal spleen, may succeed if the operation is undertaken in conseoluence of wound of the spleen from accident; but that the operation for internal disease has been most unfortunate in its results, six cases ont of nine being followed by death. The two cases operated on by Koberle and Bryant for leukæmia, died during or immediately after the operation from severe hæmorrhage. Furthermore, the admissi- bility of the operation is questionable, owing to the difficulty of diagnosis, as the case of Péan proves, this case was diagnosed as cystic disease of the left ovary, and afterwards it was found that a unilocular spleen cyst had been extirpated. In chronic spleen enlargement, Mosler recommends inýjectiOn into the substance of, the spleen, and so treats his cases. He found that lie could inject tincture of iodine through the abdon- inal wall s in the splenic region without an after intense peritonitis. In man he injects a weak solution of carbolic acid, or Fowler's solution of arsenic. In this way he treated a patient 33 years of age who had suffered from intermitting fever for 1- years, which had run an irregular course and was subsequent to an attack of typhoid fever; lie also suffered from odema of various parts of the body. The spleen was much enlarged. For sixteen days, twice daily, he was given a subcutaneous injection of .amorphous hydrochloride of quinine (one part to five of water),",
         "BRiTISn AND FORE)t÷N JoURN.\\LS. and immediately after the injection a bag of ice was applied over the part for several hours to protect from local inflammation when this precaution is not taken there .are apt to be abscesses and gangrene. Althouigh a diminution in the size of the spleen took place, Prof. Mosler thought a more rapid diminution would take place by injecting into the substance of the spleen itself. This lie did and afterwards applied~an ice bag over the part for several Iours, in order that by contracting the muscles the amount of blood iniglit be reduced. He injected a solution of carbolic acid (2 to 1 00 of' water) and one month later injected the saine amount of Fowler's solution of arsenic, of the strength of one to ten of water. After the injection of the carbolic acid the pain was so great that 0.2 grmm. of' morphia had to be injectedi hypodermnically, and during the following twelve hours an ice bag applied. After a couple of days there was no pain and no elevation of temperature nor was there a reaction of any kind. A distinct lessening of the size of the tumour was made out immcdiately after the injections into the substance of the spleen and the gencral appearance of the patient w-as muchi lin- proved. Professor Mosler finds quinine the best remedy for injecting into the spleeni as it is nost useful in lessening the blood contents. Czerny used injections of arsenic solution withi good effect in enlarged glands. In onè patient lie inijected 740 drops ii 74 'injections of 10 drops each, and within seven inonths the patient \"as completely well.-(Arciv. f. Elin. fed., 1875. Quoted Supra-orbital Neuralgia. - (Dr. C: RoESE, Leipsig, 1876.--Inaug-iDissrt).-The most frequent causes of supra-orbital neuralgia are malaria, syphilis, hysteria, cold and injury. Furthermore, it accompanies different forms of eye affections, and in some rare cases is due to tumorous thickening of the bones of the skull, \u0026c. Typical malarial neuralgia Occurs in the young and middle-aged, and men are oftener affected than women. Shoemakers on account of their work",
         "316 CANADA 31RDICAL ANI SURGIC.\\L JOURNAL. are peculiarly susceptible to neuralgia, but not the typical form. Typical supraorbital neuralgia is observed in the course of cold or hysteria. The pain of supraorbital neuralgia generally begins in the morning and lasts for from half an hour to six Iours. The quotidian type is exceptonal. The right supraorbital uerve is more often affected than the left, and both are verv seldoni affected together. The proportion of these kinds in sixty-one cases was 35: 18 : 8. In occasional cases a glaucomatous condition and anæsthesia of the refinoe bave been observed: the connection between them has not been made clear. The best remedies in typical cases of neuralgia are quinine andt arsenic. fron is also very useful. Among the preparations large doses of ferrum oxydatum s. hydlricurn, have been well thought of. Hot foot baths are also beneficial, especially when the neuralgia is double. Blistering the forehead or painting it with iodine may also be tried.--Schmidt's Jahrbacher, No. 8, 187G. Is Syphilis Transmissible by Milk ?- R. Voss inoculated tlirec prostitutes with milk of a syphilitic woman, suffering -from a papular- syphilide, and condylonata about the genitals and anus the breasts were quite frec. Thie nilk was obtained by pressure, and ijiected hypodcrnically. The first case was syphilitic. the inoculation was naturally with- out effect. The second had gonorrhoa, and was inoculated with the milk on the 27tl of September. There formed a large inflammatory swelli'n-as in the other patients-whicl suppura- ted, and was healed by the 24th of October. On the -3rd of November, 40 days after the inoculation injection, a papular eruption came out about the place of injection, and on the 8th showed itself on the renaiuder of the body as a mnaculo-papular syphilide, combined with swelling -of the lymphatic glands. Under inunctions of Hg., the symptoms disappîeared. The author, in consequence, regards it as proven that the inilk of a syphilitic person is just as capable of producing syphilis as the blood.-Petersb. Mfed. Vochensclhr. in C(e'?ntralblatt. No. 44.",
         "RISH .AND FREIGN JOIRNALS. Miliary Tuberculosis of the Pharynx. -In a paper read before the Berlin Medical Society, Dr. B. Fränkel described six cases of tuberculosis of the pharynx, which had comé under his observation. In everv instance there was also miliary tuberculosis of several or all the other important organs of the body. In answer to the question: Does the tubercular process ever originate in the pharynx ? it cannot be denied that tubercle often exists in the ings or elsewhere before it makes its appearance in the pharynx, though Isambert (Annales des Maladies de l'oreille et dupharynx, ii. page 16.5), mentions cases in which the latter was first afrected. In all of Dr. Fränkel's cases the apices of the hugs were already diseased when the patients flrst came under notice, but the disease- of the pharynx was the first to attract their attention and continued to be the chief objectof solicitude up to the very last. The ulceration of the pharynx was of an umistakably tuberculous char:cter, with a tendency to spread superficially, of a chcesy or lardaceous appearance, and seldom presented any evidence of granulations. The edges of the ulcers were irregular and excavated, and only in some instances surrounded by an inflammatory arcola. In the vicinity of the ulcers there were a greater or less num- ber of small grey nodules; when numnerous or confluent these gave rise to the so-called lardaceous infiltration, and it seems probable that the ulceration extends by means of their disintegra- tion. Swelling of the lymphatic glands, especially those of the neck, was aiso .1 constant symptom. , The most important subjective spiptom was always pain in the throat, which was increased by the act of swallowing. The severity of the pain varied greatly in different cases, as did also its character. Some patients also.complained of a sharp lancin- ating pain in the car caused by the act of swallow-ing. This, however, is commonly met with in other forms of sore throat, andl does not depend, as some suppose, upon ulceration in the neighborliood of the Eustachian tubes. All the patients expe- rlenced greater or 'less difficulty in swallowing, and avoided doing so as much as possible, on account of the pain or uneasiness which it occasioned. 3î 7",
         "CANADA MEDICAL AND SURGICAL JOURNAL Solid food could not be taken when there was extensive ulcer- tion and fluids often regurgitated through the mouth or nose, and to this difficulty in taking food is to be ascribed, in part at least, the rapid emaciation which characterized the later stages of the disease. The ulceration would appear to begin as a rule at the sides of the pharynx and could be observed in all stages in the same case, from the deposition of isolated or confluent grey nodules, to the formation of large ulcers 'which appeared to have under- gone caseous degeneration. The uvula. when also involved. was thickened and infiltrated with tuberculous deposits. Sometimes there was a tendency to hypertrophy with polypoid excrescences about the tonsils. The ulceration never attacked the oesophagus, but sometimes extended to the tongue and lips. The larynx was generally not affected until the disease had made considerable progress in the pharynx, but eventually it would seem always to have become involved, the first indication of which will be seen in an ædematous condition of the epigiottis, and afterwards .ilceration of the same, and also of other parts of the larynx. TIherc was always an increase of the temperature, subject, howcver to great variations. and giving a curve similar to that of acute miliary tuberculosis. The diagnosis of this form of disease of the throat reqitires some care, for although it does not in any way resemble the ordinary throat affections, such as diphtheria, angina follicularis, \u0026c., it might readily be mistaken for the so-called scrofulous ulcers of the pharynx, but in the latter disease it is to be noticed that the ulcers are deeper, more sharply defined, and tend to have a longitudinal rather than a transverse direction; more- over, the yellow spots around them are seen to be genuine abscesses, and not merely grey or checsy nodules. It is, however, only in some cases of syphilitic ulceration that any real difficulty in the differential diagnosis can occur, for in either disease there may be swelling of lymphatic glands in vari- ous parts of the body, the ulceration may attack the tongue, lips and cheek, and in one of Dr. Fränkel's case, there was also",
         "BRITISH AND FOREION JOURNALS. swelling of one testicle which might have created doubt as to the nature of the constitutional affection. If the history of the case is not sufficient to establish the syphilitie.or non-syphilitic character of the affection, a careful examination of the ulcers will almost certainly suffice to decide the point, for the mucous plaques of-the early stages of syphilis cai hardly be confounded with the tubercular infiltration and ulceration above described. The ulcers of the pharynx, which occur in the later stages of syphilis besides being deep and sharply defined, tend to cicatrize and contract, and thus assume altogether a different appearance from ihat of the tubercular ulcers. Tubercular .ulceration of the pharynx almost always ends fatally within a few weeks or inonths. Treatment would seem to be unavailing, though of course supporting measures are indicated. Some relief to the pain is afforded by painting the throat with a solution of morphia and glycerine. Death takes place from exhaustion and not from any impediment to respiration in consequence of extension -of the disease to the larynx.-Berlin. E lii. Wochenscrift, Nos. 46 and 47. 18T16. Dislocation of the neck from a blow- Charles Orton in the Lancet, considers this case to be of some interest, not only on account of the rarity of the accident itself, but also of the cause of the accident, which was by a blow by a man's fist. The case was sent for trial at the Stafford Assizes, and the man who struck the blow, pleading guilty, was sentenced to twelve months' hard labor. I did not secthe deceased until five hours after death, when I made the post-mortem examination. The eye-witnesses describe him as stooping forwards, with the chin slightly turned to the left. The blow was delivered undèr the riglit angle of the jaw by the right-hand fist, partially from behind and partially sideways, to the deceased, who fel towards the left, but backwards, and \" seemed dead at once.\" He never -moved after faDling. Poist-mortem, exatination.-A man apparently beyond fifty years of age, fairly built but not muscular, and one who had no 319",
         "CANADA MEDICAL AND SURGICAL JOURNAL. doubt suffered from inflammation of iung and pleura, adhesions being thick and strong on the right side of the thorax. The piece of lung on the table shows to all appearance the cicatrix of an old cavity. Heart and other organs healthy. The head had lost what the French call its \" solidity,\" rolling about in any direction. It vas a pure and total dislocation between the atlas and axis ; the head, to which was attached firmly the atlas, was thrown forwards; the odontoid process thus pressing on the front of the cord, and causing instant death. The posterior and other ligaments connecting the atlas and axis and axis and occi- pital bone were ruptured; but there vas no fracture, not even of the odontoid process, and, what I opine .to be still more raí·e, no rupture of the transverse ligament. I think this case will go far to prove the truth of Dupuy- tren's declaration \" that such accidents are wholly beyond the resources of our art.\" I am aware that Malgaigne quotes two cases of recovery after total dislocation of the neck between at- las and axis. In one case which occurred in the practice of his father, the head was bent forwards, the chin touching the top of the sternum, and remaining it that position immovably flxed, all other portions of the body preserving their natural functions. In the second case, under Ehrlich, there was dislocation of the atlas backwards. The head was found resting on the right scapula, having completely lost its solidity, rolling from one side to the other. The patient was unconscious, and the whole body in a state of complete paralysis. The reduction was ac- complished with an audible sound, and the head resumed its position firmly ; but there is a further statement made that the head was afterwards maintained in place by a bandage. In the latter case I cannot understand the head, after rolling about, being placed \" firmly \" in position, with an audible sound. In the former I cannot understand the immovability of the head, the chin on the top of the sternum, and the functions of the body preserved. At least it differs greatly from my case, where the chin -reached to the middle of the sternum, and where there was perfect mobility of the head, which could easilybe placed in position, but would not remain there.",
         "insnITISi ANI) FOREIGN JOURNALS. Three cases of Injury to Nerves.-By Edmund Owen, M.B., F.R.C.S., Eng.. Assistant-surgeon to St. Mary's Ilospital, and to the Hospital for Sick Children. Some time since, a boy was brought to me who had, a day or two previously, received a severe blow from a stone over the right eye. The skin was.contused in a small spot over the sup- raorbItal foramen, and a large crop of vesicles had broken out on the forehead and scalp, all over the extensive area of distri- bution of the supraorbital nerve. This case is particularly inter- esting, vhen taken in connection with Dr. Broadbent's remark-s on Herpes, in the Journal of Dec. 9th, and with the following case. The second case is that of a labourer from one of Her Maj- esty's dock-yards, who was under my care, at St. Mary's Hos- pital, two years ago. * Three months previously he had met with a severe wound of the front of the wrist from a piece of broken glass. A recent cicatrix existed over the inner side of the ten- don of the flexor carpi radialis ; and on pressing the finger firmly over it-that is, against the median nerve-the patient com- plained of severe pain. There was impaired sensation over the anterior and outer aspect of the hand ; and on the backs of the last phalanges of the outer fingers, including the radial side of the ring finger, sensation was almost completely obliterated. (Hilton on Rest and Pain, second edition, page 174). As the man said that lie vas 'improving, we advised no interference, although, in all probability, some small fragments of glass still lay against, or imbedded in, the nerve-trunk. While he was under observation, a copious eruption of small bullS spread it- self over the area of distribution of the median nerve in the hand. If injury to the nerves gave rise to these two conditions, herpes in the child, pemphigus in the adult, may not many of the pathological conditions of the skin -which follow fracture of bones of the,extremities he due to nerve-lesions ? 'The third case is that of a barman, who is now an out-patient of mine, suffering from abscesses on the inner side of the elbow. A year ago lie was treated for a similar affection at another hospital, ihen it was found necessary, he says, to make at diff- erent times, no fewer than thirty incisions for the evacuation of abscesses. Many of the scars are even now clearly perceptible. One of them (rather a large one) lies over the inner side of the forearn, just below the elbow. Possibly, the gentleman who-made the wound had satisfied himself that no large artery lay close by, and with the position of nerves he did not occupy himself. But, somehow or other, the unfortunate barman has 110W a wasting of the inner side of the forearm and of the muscles of the little finger. lis metacarpal bones, now unsupported by 32Q1",
         "CANADA MEDICAL AND SURGICAL JOURNAL. ilterosseous muscles, stand up in sad relief, whilst noth'ng is to be found between the metacarpal bones of the thumb and index finger but a flabby web of tissue-a poor representative of the abductor indicis and the abductor pollicis. Sensation in the parts supplied by branches of the uliar nerve is but slightly affected. Possibly these fibres escaped complete division. The man says that ho suffers from \" pins and needles \" in the hand occasionally, and the skin is extensively chapped and fissured; but this latter condition obtains also in the unaffected hand, being due to the peculiarities of his trade.-British Med. Journal. Dislocation of both Hips.-Dr. J. B. Crawford, (American Journal of the 3iedical Sciences, October, 1876), was called on July 13th, to see Thomas Jones, a large and pow- orful man, aged about thirty, who had been injured four or five hours previously while working in a coal-mine by a massof rock from the roof falling upon him. ,Upon examination, a dislocation of both hips was found; the head of the right femur rested upon the dorsum of the ilium, the leg was flexed upon the thigh, the knee lay upon the lower portion of the opposite femur, and the toes were turned strongly inwards. The head of the left femuir was displaced into the ischiatic notch. The limb was nearly straight, the thiglh being but slightly flexed, the knee nearly unbent, and the toes inverted. The lower portion of the spine was strongly arched. The amount of shortening could no be ascertained. The amount of deformity of the hips was less conspicuous than is usual in single dislocations of the same kind. The patient was thoroughly anæsthetised, and the reduction effected by manipulation. First flexing the left leg upon the thigh and the thigh upon the pelvis, Dr. Crawford pressed tihe thigh obliquely across the abdomen, at the same time rotating the femur, using the leg as a lever, and then carrying the kaee across to the left side, lifted the thigh to a right angle with the body, and made moderate vertical traction; when after dislodging. the head of the bone from the sciatic notch, it glided readily and roiselessly into its proper place. Considerable force with rotation of the femur, was required to carry the flexed thigh across from the riglit to the left side of the abdomen ; all the other movements vere effected with comparative ease. Not more than two minutes were occupied in the process. The re- duction of the remaining luxation was attended with more difli- culty. Dr. Crawford first moved the limb in the line of its easiest motion ; flexing the leg upon the thigh, and the thigh upon the pelvis, as before, carrying the knee well upward and obliquely a cross the median lino of the body. Then attempting to abduct $2 2",
         "BIUTISII ANI) FOREIGN JOURNALS. ,while rotating the limb, he found the movement in that direction suddenly arrested. Again, pressing the thigh firmly upon and obliquely across the abdomen, and abducting and rotating as before, he succeeded in disengaging the head of the bone and bringing it apparently to the posterior border of the acetabulum; but upon bringing the limb down to a horizontal position, the 'head of the femur had returned to its former situation upon the dorsum ilii. The manipulations, varied somewhat, were repeat- cd several times iwith the same result. Finally, having brought the head of the femur to the posterior border of the acetabulum, and finding it again arrested at the edge of the socket, Dr. Crawford directed the pelvis to be held firmly down by two assistants while he made strong upward traction upon the thigli bent at a right anglet with the body. In about a quarter of a minute the dislocated bone returned to its socket with a sound tiat was heard distinctly. The patient left his bed ten days after the reception of his injury, and walked about the 'ward with but slight difficulty. The records of surgery furnish but a very few examples of .simultaneous dislocation of both hips. Dr, Gross in his \" Sys- tem of Surgery \" says that the accident is exceedingly uncom- mon, and mentions but three instances of its occurrence-one recorded by Professor Gibson, one by Cooper, of London, and -one which occurred in the practice of Dr. Boisnot, of Philadel- phia. Hamilton; in his work on \"Fractures and, Dislocations,\" mentions only a single example of this iujury, that of Professor Gibson. Each of these cases, where the particulars are given, differed from the others, as well as from the one here recorded, in regard to the character of the dislocation ; in one the dis- pladement being illiac and thyroid, in the other illiac and pubie,. while the one here recorded was illiac and sciatic. The subjct of the present report told Dr. Crawford that ue was·at work, standing on a surface which inclined at an angle of about forty degrees, with the feet widely separated, the right one being much lower than the left, and the body bent forward. While he was in this position, a large mass of rock, weighing many hundred- pounds, fell from the roof several feet above him, striking him in the lower dorsal region, bending the thighsupon the body and pressing him forcibly down upon the rock on which he was standing. le was certain that both joints were dislo- cated at the same instant, as the falling rock immediately rolled or sid from and released him. Severe bruises upon his back and a deep cut on the right arm, were the only other injuries .received .-Lon don Medical Record. 323",
         "CANAI)A MON TREAL, JANUARY, 1877. THE ACT OF AMENDMENT RELATING TO THE PRACTICE OF MEDICINE IN THE PROVINCE OF QUEBEC. We have delayed publishing our Journal vith a view of laying before our readers the act just passed by the Local Legislature to amend and consolidate the acts relating to the- practice of medicine and surgery in the Province of Quebec. We are only able to give a translation of the act, for, strange to say, we have been furnished with a copy of the bill in the French language, and although we sought to obtain an English copy, so far it has been withheld. There may be some few technical errors in -what ve publish,. but we will keep the type standing, and should there be any errors or omissions of importance, we shall have them corrected so soon as the act appears or is published by the Legislature, and shall furnish our readers with it. Some disappointment may be felt by the profession generally that a central board of' examiners, or a single door of entrance into the profession, does not form the prominent feature of this art. Such was, indeed, the character of the bill submitted to the Legislature by the College of Physicians and Surgeons of Lower Canada, and such was the very generally expressed wish of the profession. We- should gladly have seen that method of entrance into the pro- fession adopted in this act. The University of Laval, how- ever, submitted before the Committee of the House, to whom the bill had been referred, its Royal Charter, and held that its rights- could not be ,disturbed by Local Legislative enactment. This, of course, would have involved questions of law, which, had they been gone into, and argued upon by counsel, would have delayed or perhaps completely burked legislation, as the session was. drawing to a close. It was thought better, therefore, to accept a compromise, and a sub-committee was struck, composed of",
         "THE QIUEBEC MED[cAL ACT. -members of the House, delegates from the Universities, repre- sentatives of the College of Physicians and Surgeons, and representatives of the French-Canadian Medical Society of Montreal, who drew up and submited the bill which wc publish, -and which, with some few alterations, received the sanction of the Lieutenant-Goverinor, after having passed both flouses of the Legislature. The changes in the law are very important; and we mav hope that, in the course of a few years, if efficiently worked, the profession will be in a far better condition than it is at pres- ent. It will be observed that the schools retain the right of granting diplomas, which vill entitle the holder to registration on payment of fees ; but the graduate must give evidence of having studied his profession during a period of four years, during three of which lie will be required to attend the lectures of some university or college or incorporated school of medicine recognized by the Board of Governors. The preliminary qualifications of the student must be testified to by his having passed a satisfactory examination before examiners appointed by the college, and this examination must precede his entering on his professional studies. To ensure efficient teaching and examinations by the schools, the Provincial Medical Board shall appoint assessors, two or more of whom shall visit the universities and colleges and incorporated schools during their examinations, and shall report to the Board of Governors the scharacter of those examinations ; and in case those duties are not efficiently performed, the Board- of Governors shall 'have power to refuse registration to candidates from that sehool against Whom an adverse report bas been made. These are the principal features of the act as regards preliminary and professional education. The act, moreover, provides for a fgeneràl registration of ail members of th profession practising iaedicine, surgery and midwifery in the Province of Quebec This bas to be complied with within twelve months of the pass - ing of the act ; neglect on the part of any practitioner of medicine to comply with the law in this particular, renders him liable to a ine.and to be deprived of ail civil rights as a medical practi-",
         "CANADA MEDICAL AND SURGICAL JOURNAL. tioner so long as he remains unregistered. Article XXI. is very specific on this point. There are some other points about this act, of importance to the profession. But we lay the whole matter before our subscribers, with a view of eliciting discussion and that the members of the profession may be prepared to meet its requirements and carry out its provisions. An act to amend and consolidate the acts relating to the pro- fession of medicine and surgery in the Province of Quebec. I. *Whereas the laws now in force in the province of Quebec, for regulating the qualifications and examination of candidates for the study of medicine, surgery and midwifery ; for the registration of medical practitioners, aud for the infliction of penalties upon persons nfringing the provisions of the Medical Act respecting the practice of medicine, surgery and midwifery, require amendment ; Be it therefore enacted by the Queen's Most excellent majesty, by and with the advice and consent of the legislative council and of the legislative assembly of the Province of Quebec, and it is hereby enacted by the authority of the same, that fromand after the passing of this act, the act or ordinunce of the legislative council of the late Province of Quebec, passed in the twenty-eighth year of the reign of bis late majesty King George the third, and entituled, An act or ordinance to prevent persons practising physie and surgery within the Province of Quebec, or midwifery within the towns of Quebec and Montrea 1, without license, and ail other acts or part of acts in any manner relating to the practice of medicine, surgery and midwifery in the Province of Quebec, or in any manner relating to the mode of obtaining licenses to practice- medicine, surgery or iidwifery therein, shall be and are hereby repealed, except in so far as relates to any offence committed against the saine or any of them before the passing of this act or any penalty or forfeiture ineurred by reason of such offence. II. And whereas it is expedient that the medical profession of the Province of Quebec, be empowered under certain restric- tions to frame its own statutes for the regulation of the study of medicine in all its departments, and by-laws for its own govern- ment ; be it therefore enacted. That all persons resident in Lower Canada and licensed to practice medicine, surgery or màidwifery therein at the time of the passing of the present act, and all persons who may hereafter obtain a license to pratce- 326",
         "TilE QUEBEC MEDICAL ACT. medicine, snrgery and midwifery in this Province, shal!, and are hereby constituted a body politic and corporate by the name of The Collee f Physicians and Surgeons cf the Province of Quebec,.and shall by that naine have perpetual succession and a common seal, with power to change, alter,break or make new the sane ; and they and their successors by the name aforesaid may sue aid be sucd, implead and bc impleaded, answer and bc answered unto in all courts and places wVhatsoever, and by the name aforesaid shall-be able and capable in law to have, hold, receive, enjoy, possess and retain for the ends and purposes cf this act and for the benefit of the said college, ail uch sums of money as have been or shall at any time hereafter bc paid, given or bequeathed to and for the use of the said college and by the name aforesaid shall and may at any time hereafter, without any letters of mortmain, purchase, take, receive, hold, possess and enjoy any lands, tenements or hereditaments or any estate or interest derived or arising out of any lands, tenements or hereditaments for the purposes of the said college and for no other purposes whatever ; and may sell, grant, lease, demise. alien or dispose of the saine, and do and execute all and singu- lar the matters and things that to thein shall or may appertain to do; provided always that the real estate so held by the said corporation shall at no time exceed in value the sui of $20,000. III. And be it enacted, That from and after the passing of this act, the persons who compose the college of physicians and surgeons shall be styled Members of the College of Physicians and Surgeons of the Province of Quebec.\" IV. And be it enacted, That the affairs of the said college shall be conducted by a board of governors, forty in number, and elected for three years-fifteen of whom shall bc electedl from among the members of the college, resident in the district pf Quebec'; nineteen from among its members resident in' the district of Montreal ; three from among its inembers resident in the district of Three Rivers ; and three from among its members resident in the District of St. Francis: and of the said Board cfiGovernors neither more nor less than eight shall bc resident in the city of Quebec, and neither more nor less than eight in the city of Montreal; Provided always that not less than two members out of the city members shall be delegates froi each of.the universities, colleges and incorporated medicai schools now existing in the Province of Quebec, to wit: The University of Laval, the University of McGill, the University of Bishop's Coliege, and the Jncoiporated School of Medicine and Surgery,",
         "CANADA ME1)ICAL AND SURGICAL JOUltNAL. Montreal, affiliated with the University of Victoria College, or with any other British University'; and that at eaci election of the board of governors, every member of the said corporation shall have the right of voting by proxy. 2. Of the aforesaid districts, the district of Quebee shall comprise the present judicial districts of Quebec, Gaspé, Saguenay, Chicoutimi, Rimouski, Montmagny, Beauce, and Kamouraska; the district of Montreal, shall comprise the present judicial districts of Montreal, Terrebonne, Joliette, Richelieu, Bedford, St. Hyacinthe, Iberville, Beauharnois and Ottawa ; the district of Three Rivers shall comprise the present judicial districts of Three Rivers and Arthabaska, and the dis- trict of St. Francis shall consist of the present judicial district of St. Francis. 3. The members of the board of governors shall be elected for a period of three years, but any member inay resign bis appointment at any time by letter addressed to the Secretary of said board, and upon the death or resignation of any member of the said board, it shall be the duty of the Secretary forth- with to notify the university or body wherein such vacancy may occur, of such. death resignation or removal, and such university or body shall have the power to nominate another duly qualified person to fill such vacancy, or if the vacancy be caused by the death, resignation or removal from the electoral city or district of any member elected from the electoral districts or cities, the board of governors shall fill up such vacancies from amongst the eligible members of the college in the city or district where such vacancy shall have occurred by an election by ballot at the next ensuing meeting subsequent toc the occurrence of such'vacancy, and it shall be lawful for the board of governors to exercise during such vacancy the powers of the board hereinafter men- tioned. V. The said board of governors shall be, and are hereby constituted, \" The Provincial Medical Board,\" in which capa- city they shall meet to perform the several duties devolving upon them under tiis act as the board of Governors of the College, not less than twice in each year, at such time and place as by them shall be deemed most fit, and on which occasions, seven shall be a quorum for the transaction of business. VI. And be it enacted that from and after the passing of this act, no person shall practice medicine or surgery, or midwifery, in the Province of Quebec, nless ho shall have obtained 'a 328",
         "-rE QUEBEC 31EDICAL ACT. license from the Provincial Medical Board: who are hereby :authorised to issue such license. VIL Be it enacted that every person wlio lias obtained or may hereafter obtaii a medical degree or diploma, in any university or college mentioned in section 1V of this act shah be entitled to such license without exanination as to his quali- fications. Provided always that tie Provincial Medical Board shall have the power.and option of extending the sane privilege to the holders of Medical degrees and Diplomas of other British and Colonial Universities and Colleges. VIII. And be it enacted, that from and after the passing of this act, no person shall be admitted as a student of imedicine, surgery or midwifery, unless he shall have obtained a certificate of qualification from the Provincial Medical Board, and no one shall be entitled to the license of the college on the presentation of Diploma unless he shallh ave been previously admitted to the study of medicine in accordance with the provisions of this act, or unless lie lias passed an equivalent preliminary examination before an authorized College or Licensing Board in Her Majesty's Dominions, acceptable to the Board created by this Act. IX. At the first regular meeting of said Board after the pass- ing of this act, there shall be appointed by the Provincial Medi- cal Board for three years [subject to the continual approval of the Board,] four persons actually engaged in the work of gen- -eral education in the Province of Quebe, to examine all persons ·about to begin the study of medicine, surgery and midwifery, on the subjects of general education hereinafter nientioned as belonging to the preliminary qualification of medical students, viz ; one examiner skilled in the French language and one skilled in the English language for the City of Montreal, and one skilled' in the French language and one skillel in the English language for the City of Quebec. The subjects of the preliminary qualification to bc English and French, Latin, geo- graphy, history, arithmetic, algebra, geomctry and any one of thefollowing subjects, Greek, natural or moral philosophy ; and ,the candidate to present a certificate of good moral character. Provided that all iedical students who before the passing of this act shall have passed their preliminary examination before the examiner or examiners of any university, or incorporated schòol, or provincial medical board, shall not be required to pass before the examiners mentioned in this section. X. Every person wishing to obtain a licence to practice me- dieme, surgerv and midwifery in this province, and to bc 329",
         "CANADA MEDICAL AND SURGIcAL JOURNAL. registered under this act, and wlo shall not have ob:.inied a degree or diplonma in medicine surgery and midwilfery from any Of the institutions mentioned in clause four of this act, shll befoe being entitled to sueh license and to registration in this pro- vince,pass an examination as to his knowledge and skill for the efficient practice of medicine, surgery and midwifcry, before the examiners appointed by this board; and upon passing the examination required, and proving to the satisfaction of the examiners that ho lias complied witli the rules and regulations made by the provincial board, and on payment of such fees as the board may by a general by-law establish: such person shall be entitled to a licence to practice medicine surgery and mid wifery in the Province of Quebec. XI. And b it enacted, That the said board of governors of the coliege of physicians and surgeons shall have power - 1. To regulate the study of medicine, surgery and midwifery, by making rules with regard to the preliminary qualification, duration of study, curriculum to be followed, and the age of the candidate, applying for a license to practice : Provided always that such rules shall not be coitrary to the provisions of this Act. 2. To examine all credentials purporting to entitle the bearer to a license to practice, and all degrees or qualifications souglit to be registered in this province, and to oblige the bearer of such credentials, degrees or qualifications to attest on oath, to be administered by the chairman for the time being, that he is the person whose nane is mentioned therein, and that lie be- came possessed thereof legally. 3. To cause every member of the profession now practising, or who may hercafter practise in the Province of Quebec, to enregister his name, age, place of residence, iativity, the date of bis license and the place whiere he obtained it, in the books of the College. 4. To fix the period of probation whichi persons must undergol before being eligible for election as governors of the college, which period shall not be less than four years, and to make ail such rules and regulations for the government and proper working of the said corporation and the election of a president. and officers thereof, as to the board of governors nay seem meet and expedient, which said rules and regulations shal, before they shall come into effect, be sanctioned by the lieute- 330,",
         "TUE QUEBEC MEDICAL ACT. nant-governor in Council of this Province after the saine shall have been submitted to hini for approval and by him allowed. XII. The \" provincial medical board \" ; 1. Shall from time to time, as occasion may require, make rales and rcgulations for the guidance of the \" examiners,\" and may prescribe the subjects and mode of the examinations, the time and place of holding the same, and generally may make all such rules and regulations in respect to such examinations not contrary to the provisions of this act, as they may deem expedient and necessary. 2. It shall regulate the study of medicine, surgery and mid- wifery by making rules with regard to the preliminary qualifi- cations, duration of study, curriculum of studies to be followed by the students. Provided always that such rules shall not be contrary to the provisions of this act, and that any change in the curriculum of studies fixed by the board shall not come into effect until one year after such change is made. 3. It shall have power to make tariffs of rates to be charged in towns and country for medical, obstetrical or surgical advice, or for attendance-or for the performance of any operation or for any medicines which shall have been prescribed or supplied. 4. It shall appoint assessors not of its own body but from among the registered members of the college, to visit and attend the Medical Examinations of the various Universities, Colleges, and Incorporated Schools, of the province and to report to the Provincial Board upon the character of such examinations, such assessors must net be chosen from the pro- fessors of any of the said universities, colleges or incorporated schools ; and should such report be at any time unfavorable· t9 any university, college, or incorporated school, the Pro- Vincial Board shall in such case and under such circumstances have the power t' refuse the registration of the degree or diploma of the institution so reported upon, until suci examina- tion-shall have been amended. That for such purpose the Provincial Board shall appoint or elect assessors, two or more of whom shall a t tend the examina- tions at each University, College or Incorporated Medical Behool. 5. It shall be the duty of the above institutions to notify the Provincial Board of the time or times at which their examina-",
         "33'2 CANADA MEDICAL AND SURGICAL JOURNAL. tions shall be held, at least one month previous to such examina- tions. XIII. The Provincial Medical Board shall have the power to fix by by-law the salary or fees to be paid to the \" officers,\" .and to the I examiners \" and assessors appointed by the said board ; as well, also, the fees to be paid by all candidates entering on the study of medicine, as also by all candidates for the license to practice medicine, surgery, and midwifery, as well as the foc to be paid for registration.;- and the said board may dispose of all fees received in whatever, manner they may think most conducive to the interests of the college. XIV. And be it enacted, That the qualifications to be re- quired from a candidate for examination to obtain a licence to practise shall consist in his not being less than twenty-one years of age ; that he has followed his studios uninterruptedly dnring a period of not less than four years, commencing from the date of his admission to the study of medicine by this board, and that during the said four years he shall have attended at some university, college or incorporated school of medicine, within Her Majesty's dominions, not less than two six months' courses of general or descriptive anatomy,-of practical ana- tomy-of surgery-of practice of medicine-of midwifery-of chemistry-of materia medica and general therapeutics, of the institutes of medicine or physiology and general pathology, of clinical medicine and of ciinical surgery,-one six months' course or two three months' courses of botany,-one thrce month's course of hygiène and a course of not less than twenty- five demonstrations upon microscopic anatomy, physiology and pathology also, that lie shall have attended the general practice of an hospital in which are contained not less than fifty beds, under the charge of not less than two physicians or surgeons for a period of not less than one year and a half, or three periods of not less than six months each ; and that he shall also have attended six cases of labour, and compounded medicine for six months. And to remove all doubts with regard to the number of lectures which the incorpo rated schools of medicine of the Province of Quebec are bound to give, be it enacted and declared that each six months' course shall consist of one hundred and twenty lectures, exceptin the case of clinical medicine, clinical surgery, and medicaljurisprudence. Of the four years study required by this act, three six-months sessions, at least, shall be passed in attendance upon lectures at a university. college, or incorporated school of medicine recog-",
         "THE QUEBEC MEICAL ACT. nised by this Board, the first whereof shall be so passed the year immediately succeeding the preliminary examination. XV. And be it enacted, That all persons obtaining the license- to practice froin the College of Physicians and Surgeons of the Province of Quebec, shall be styled members of the said college,. but shall not be eligible as governors within a period of four- years from the date of their admission.as members ; and the said election as governor shall be made under such rules and regulations therefor, and in such manner as the said Board of Governors shall ordain. Members of the college shall pay the sum of two dollars a year for the use of the college. XVI. The Provincial Medical Board shall have the power to make rules and regulations respecting the admission of females to the practice of mid wifery in this province. XVII. The Provincial Medical Board shall cause to be kept by the registrar a book, or register, to be called the Register, in which shall be entered, from time to time, the names of all persons who have complied with the enactments hereinafter contained, and with the rules or regulations made or to be made by the Provincial Medical Board respecting the qualifications to be required from practitioners of medicine, surgery and mid- wifery in the Province of Quebec ; and those persons only whose names have been or shail hereafter be inscribed in the register above-mentioned, shall be deemed to be qualified and licensed to practice medicine, surgery and midwifery in the Province of Quebec ; and such register shall at all times be open and subject to inspection by any duly registered practitioner in the province, or by any other person. XVIII. If shall be the duty of the Registrar to keep the. register correct in accordance with the provisions of this act and the orders and regulations of the Provincial Medical Board, and he shall from time to time make the necessary alterations in the addresses or qualifications of the persons registered under this act; and the said Registrar shall perform such other duties as shall be imposed upon iDm by the Provincial Medical Board. XIX. If the Registrar shall wilfully make, or cause to be made, any falsification in any matters relating to the register, he shall incur a penalty of one hundred dollars, and shall be disqualified from again holding any office in the college. XX. Every member of the medical profession wvho, at the time of the passing of this act, may be possessed of a license 388",
         "CANADA MEDICAL AND SURGICAL JOURNAL from the College of Physicians and Surgeons of Lower Canada to practice medicine, surgery and midwifery in the Province of Quebec, shall, on the payment of the fee of one dollar, be enti- tled to be registered on producing to the Registrar the document conferring or evidencing the qualification, or each of the qualifications in respect whereof he seeks to be so registered, or upon transmitting by post to such Registrar information of his name and address, and evidence of the qualifications in respect whereof lie seeks to be registered, and of the time or times at which the same vas or were respectively obtained,. provided ie register within one year after the final passing of this act. XXI. Any person entitled to be registered under this act, but who shall neglect or omit to be so registered, shall not be entitled to any of the rights or privileges conferred by this act so long as such neglect or omission continues ; and he shall b lable to all the penalties imposed by this act, or by any other act which now may be in force against unqualified or unregis. tered practitioners, and he shall pay a fine of five dollars every year until he is registered. XXII. No person shall be entitled to recover any charge in any court of law for any medical or surgical advice, or for attendance, or for the performance of any operation, or for any niedicine which he shall have- prescribed or supplied, nor.be entitled to any of the rights or privileges conferred by fh' próvisions of this act, unless he shall prove upon trial that he s registered under this act and bas paid his annual contribtidn to the college. XXIII. No certificate required by any act now in force or that may hereafter be passed in this province from any plysi- cian or surgeon or inedical pra/titioner, shall be valid unless the person signing the same be registered under this act. XXIV. Any registered member of the .medical professiqa w'ho shall have been convicted of any felony in any court shall thereby forfeit his right to registration, and, by the direction cf the Provincial Medical Board, his name shall be erased from the register ; or in case a person known to have been convicted of felony, shall present himself for registration, the Registrar shall have power to refuse such registration. XXV; 1. Any person not entitled to be registered in this province, wyho shall be convicted upon the oath of one or mnore .itnesses in accordance with the provisions of 38 Vict., Chap .334",
         "THE PROVINCIAL MEDICAL ACT. 25 of this province, of having practised medicine, surgery or midwifery in the Province of Quebec, for hire, gain, or hope of reward shall, upon summary conviction before a sheriff, or district magistrate or recorder, or judge- of the sessions of the peace be condemned to pay a fine of not less than $25, nor 'exceeding $100. 2. A like penalty shall bc incurred by every person assuming the title of doctor, physician, or surgeon, or any other nane implying that he is legally authorized to practice medicine, surgery, or midwifery, in this province, if unable to establish the fact by legal proof ; and every person who by advertise- ment in any newspaper or by printed or written circulars, or by card, or by sign boards assumes any addition, name or description implying tr calculated to lead persons to infer that he or she is a duly registered or qualified practitioner of medi- cine, surgery, and midwifery, or any one of them, or any person ffering or giving his or ber services as physician, surgeon, or midwife, if not duly licensed and registered in this province, shall in each such case be liable to be condemned to a like penalty. 8. In every prosecution under this act, the proof of registra- lon shall be incumbent upon the prosecuted. 4. All prosecutions under this act, shall take place before any sheriff, or district magistrate, or recorder, or judge of special sessions of the peace having jurisdiction in the locality where the offence was committed, and, such sheriff, or district magistrate, or recorder or judge of special sessions of the peâce, besides the penalty above mentioned, shall have power to condemn in costs ; and in the event of the costs or .the penalty not being paid, to order an imprisonment for a term not exCeeding thirty days, unless the penalty or costs be sooner puid. XXVTL 1. And be it enacted that the penalties imposed by this Act, shall be recoverable with costs a-nd that the same may be sued for and recovered by the said College of Physicians and Surgeons of the Province of Quebec, by its incorporate name, and being recovered shall belong to the said corporation for the use thereof. And noither in any such suit or in any other civil action to or in which the said corporation may be a party or interested, shall any meinber of the corporation b deemed incompetent as a Witness by reason of his being-such member.",
         "3\u003e6 CANADA 31EDICAL AND StRGTCAL JOURNAL. 2. All penalties recoverable under this Act, shall be paid over to the court convicting, and by the latter, to the treasurer of the Provincial Medical Board. The Provincial Board mav authorize any person to prosecute in his own name, any person for any infringement of. this Act, and the Provincial Medical Board shall have power to allow the prosecutor the whole or a. portion of the penalties recovered. XXVII. In all cases where proof of riegistration under this Act is required, the production of a printed or other copy of the register, certified under the hand of the Registrar of the College of Physicians and Surgeons of the Province of Quebec, for the time being, shall be sufficient evidence that all persons therein named are registered practitioners, in lieu of the. production of the original register ; and 'any certificate upon: such printed or other copy of the register, purporting- to- be signed by any person in his capacity of Registrar of the College under this Act, shall be primafacie evidence that such person is such Registrar, without any proof of his signature, or· of his being in fact such Registrar. XXVIII. The present Board of Governors elected under the provisions of the acts herein before repealed shall be conti- nued and shall act until after the next triennial election, but subject in all other respects to the provisions of this Act ; and all by-laws, rules and regulations heretofore made by the said. College of Physicians and Surgeons of Lower Canada shall remain in force until repealed or modified unider the provisions of this Act. XXIX. The officers appointed under the provisions of the, acts repealed, shal retain their respective offices, and perforn their respective duties under the provisions of this Act, and all books and registers heretofore kept by them in conformity with the acts hereby repealed, shall be continued in use for their· respective purposes under this Act. XXX. The College of Physicians and Surgeons of the Pro-· vince of Quebec, is hereby vested with all the rights, powers, privileges property and assets heretofore belonging to the. College of Physicians and Surgeons of Lower Canada. XXXI. Nothing in this Act contained shall be construedý to affect the rights of any persons under the provisions of Act- 28 Vict., Chap. 59, and amendments thereto 29 Vict.,.ChaP. 59."
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      "label" : "[Vol. 4, no. 2 (Feb. 1895)]",
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         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine"
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         "Toronto : Medical Pub. Co., [1895]"
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      "title" : [
         "Dominion medical monthly [Vol. 4, no. 2 (Feb. 1895)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "Dominion Medical Monthly Vot. IV.] TORONTO, ONT., FEBRUARY, 1895. [No. 2. ORIGINAL ARTICLES. (No paper published or to be published elsewhere as original, will be accepted in this department.) A BRIEF NOTE ON ANTI-DIPHTHERITIO SERUM OR DIPHTHERIA ANTITOXINE. By CHARLEs FORBES, M.D., etc., London, England, Late Surgeon Warsa Gold Mine, West uArica, London Correspondent to Indian Medical Record etc., etc. The history of all therapeutic discoveries invoiving complex physiologicul problems, has a charn for most medical men, many of whom are highly gifted disciples of science in its broadest sense. Cicero says, \" E nihilo nil fit,\" but it is curious to note what slight and fortuitous circumstances may lead towards or elicit a discovery which may thereafter confer great benenfits on the human race by leading up to the successful treatment of one of our most fatal maladies. Baginsky rightly remarked that 'it was difficult to fix the exact therapeutic value of anything in diphtheria. About ten years ago, in conjunction with others, I gave small doses of precipitated sulphur, supple- mented by insufflations of powdered· sulphur. This plan certainly proved efflcacious in many cases. Still later it seems to have suggested to Dr. R. Brownlow Martin the idea of treating this disease by means of \"tabloids \" of magnesium sulphite grs. 5 in each, at frequent intervals, employing in addition insufflations of the same into the pharynx and larynx, by means of a (special insufflator with movable glass barrels and an apparatus which at the same time depresses the tongue (manufactured by Burroughs, Wellcome, \u0026 Co., London). .This and the \"tabloids\" are a great improvement in method, and according to Dr. Martin's little book on the subject, highly efficacious. These facts have been amply proved by clinical reports in the current journals. Despite these facts, diphtheria cases treated in hospitals show the hideous mortality in inixed cases of 5o per cent. and upwards. On the other hand, the injection of anti-diphtheritic serum obtained from immunized horses by Roux's method, has reduced the previous rate of 3",
         "DOMINION MEDICAL MONTHLY. mortality from diphtheria by at teast one-half. This is a great advance in therapeutics. Moreover, no ill effects follow the hypodermic injection, save only in some cases a transient urticaria and slight edema at the site of puncture, disappearing in less than half an hour. Now, just a vord as to the events which led to the adoption of thts plan of treating diphtheria. The first attempt to protect patients against diphtheria was set on foot in Italy in 1868 ; fifteen children werc inoculated with the diphtheritic virus, but one died. Bogola (Sienna) shortiy afterwards inoculated twenty-nine children with this same \"materies morbi,\" but did not lose any of his patients. So much for remote history. The discovery of the truc bacillus diphtheriS by Klebs and Lœffler, 1883-84, placed the matter on a scientific basis. The next stage of the proceedings vas that Roux, and Yersin, and others, by cultivating the virulent bacilli in broth for some time, found that they gave rise to one or more toxines or ptomaines. Behring and Kitasato proved e\u003e:perimentally by injecting cultivations of the bacillus into guinea-pigs. Behring succeeded in immunising animals, as also have Kitasato and Frænkel, but what is more noteworthy as the crowning touch of the discovery, Behring found that he could cure animals of diphtheria, however produced, by injecting a blood serum obtained from the jugular veins of animals rende-ed immune by repeated previous injections of the diphtheritic toxine. Behring's researches in every particular are corroborated by Roux, who found, moreover, that by mixing a certain proportion of anti-diphtheritic serum with the solution con- taining the toxine and hypodermically injecting the mixture into animals, no effect was produced (iMfedical Press and Circular, September 26th, 1894). Aronson began to immunise horses in 1893, when he demonstrated that the \"iserum \" obtained from these protected animals was a valuable prophylactic against diphtheria. Behring, Aronson, Ehrlich, and Roux agrec that the horse should be selected as the source of the curative serum, as it can safely be inoculated with larger quantities of toxine, and is more speedily rendered immune. Dr. Roux states the results of the injection of anti-diphtheritic serum which he obtained in conjunction with Drs. Martin and Chaillon at Hospital for Sick Children, Paris, between the dates of February 1st to July 24th, 1894: 448 cases, 109 deaths, mortality 24.33 per cent.; under old treatment, 1890-94, 3,971 cases, mortality 51.7 per cent. Behring comes to some remarkable conclusions\u003e published in extenso (Berlin. Kini. Wochenscrift, October, 1894): (1) That many poisons (snake venom, etc.,) can be antagonised by blood serum treatment ; (2) that the only blood antitoxine that can antagonise disease is anti:diphtheritic serum ; (3) that 0oo cases of diphtheria treated within the first forty-eight hours of attack by the injection of a 10 cc. dose of the serum, not five will perish from diphtheria; (4) that this serum is a specific in an eminent degrec ; (5) that each blood antitoxine has a curative effect on one rnorbid product only; (6) that it is formed when the diphtheria toxine meets the reactionable albumen of the body, i.e., the .blood ; (7) that the antitoxine or antidote after",
         "DOMINION MEDICAI MONTHLY. 33 injection preponderates in the blood and tissue juices over the toxic material of the diphtheria bacillus. The following table vill serve to illustrate the clinical succcss of the remedy in Europe (Britishi Medicatfournal, October 2oth, 1894): AUTIrORITY. NO. OF CASES. MORTALITY. Behring and Kossel.. ................ 30 20.0 per cent. Ehrlich ............................. 96 15.05 \" Ehrlich, Kossel, Wasserman .......... 153 23.60 \" W cibgcn ..... .... ........ ....... 66 28.0 K atz................................ 128 13.20 \" Wetiger .. ......... 63 28.0 \" Roux ........ . ... ................. 448 24.33 \" Aronson ............................ 192 14.0 \" A total of 1,226, giving a mlortality Pf about 20 per cent. A series of over forty cases of diphtheria treated successfully by various practitioners throughout England by injecting anti-diphtheritic serum. Rumor also states that Dr. Klein has prepared a supply of serum, and that Messrs. Burroughs, Wellcome \u0026 Co. are now in possession of a large quantity produced from their own horses with exceptional care. The hypodermic syringe I employ and advise others to niake use of, too, is manufactured by Burroughs, Wellcome \u0026 Co. It possesses the following good points : being thoroughly aseptic, can be sterilized by boiling, and the platino-iridium needles likewise can be heated to redness in a spirit flame without tarnishing or softening the metal, as platinum, though unaffected by heat, in this com- bination is a great heat conductor. I must add that all hypodermic punctures should be made under strict antisepti*c precautions into the muscles of the back or buttocks, after washing the skin with a lotion (one \"soloid\" of cor- rosive sublimate to a pint of water). NOTE.-It is important that the syringe employed should be completely sterilized, both before and after use, while manipulating anti-diphtheritic serum. As to the dose of serum to be injected, that should be from 5 cc. to 30 cc.; the earlier the treatment is begun, so in proportion the dose can be reduced. Ten cc. is a fair dose, but in bad cases 2o cc. can be injected at once with above mentioned precautions, and repeated in twenty-four hours if temperature remains high and pulse rate undiminished; these generally, how- ever, fall within a few hours after first injection. As to local treatment of the throat nothing need be done beyond the occasional use of soJution similar to the undermentioned : R Boraciu................................. gr.xxx. Glycerini (vel paroleini).................... 3iv. Aq. ad................................31. passed into the larynx, etc., by means of a paroleine atomiser. I trust these few hints will be found of service to your readers, as I hear that diphthèria is prevalent in Toronto. 87 St. Augustine's Road, London; N.W., England, December 5, 1894.",
         "DOMINION MEDICAL MONTHLY. Reports of Societies. FIRST QUARTERLY MEETING OF PROVINCIAL BOARD OF HEALTH. Dr. Macdonald presided at the first quarterly meeting of the Provincial Board of Health, at the Health De- partment, January 17th. The other members prescrit were: D.s. Rac, Oshawa; Kitchen, St George; Vaux, Brockville; Covernton and Cassidy, Toronto, a:id Dr. Bryce, Secretary. A communication was received from Hamilton ýtating that the ice crup, aftee being cut on Burlington Bay, is floated through channels in the ice towards the ice-houses. In its tran- sit, this ice is necessarily exposed to pollution from the sewage-laden waters of the bay, and there is danger of its being used for domestic pur- poses. The Secretary will remind the local health authorities of the law on the subject. A letter from Barrie informed the Board that diphtheria had broken out in Vespra township. Advice will be given that a health officer be at once appointed. A com- munica'Ler from Strathroy stated that all the small-pox patients there had recovered and had been dis- charged. The cost of the outbreak to the municipality was given. as $i,6oo. The action of the Secretary in advising that properly disinfected bed-clothing, which had been used by small-pox patients, might be given the McCallum family whose house had been burned to prevent the spread of the disease, was approved. A communication was received from Pickering respecting the alleged feed- ing to hogs of diseased horse-fßesh and knackers' refuse. A committee con- sisting of Drs. Kitchen, Rae and Cassidy was appointed to investigate this matter and to confer with the Minister of Agriculture. A com- plaint was received from Sandwich West township respecting the inactiv- ity of the local board of health in reference to the small-pox outbreak. A specific complaint was that per- sons had been allowed to go about too freely. The Secretary will refer the local health authorities to the stringent provisions of the Act. Word was received from the village of Wyoming that the hotel where scarlet fever had occurred had been improperly placarded. The placard was not put up on the front door as it should have beci, but upon the in- side of the back door. The Secretary will direct the local health authorities as to their duty. At the afternoon session the Board adopted a report of the Secretary containing suggestions for the sani- tary improvement of Coal Oil Inlet in Hamilton Bay. The five chief causes of possible pollution were given as these :-the sewage from the eastern main sewer of the city ; the drains from Laurie's pork-pack- ing establishment; Rawlin's knackry; the Stroud cattle barns; Freeman's superphosphate works. Dr. Bryce re- cormmended the construction of tanks of masonry for the reception and sub- sequent precipitation of the sewage. According to this plan the sewage is to be discharged by syphonage every twelve hours into a series of delivery pipes running to a point two feet above high level of the bay water, and is to be made to filter through sand prior to entering the bay.",
         "DOMINION MEDICAL MONTHLY. The quarterly report of the Com- mittee on Epidenics showed that during 1894 there werc thirty-six cases of sinall-pox in the Province, five deaths and fifteen introductions or an average of two and one-third. At the present time thcre are five cases, one in Toronto, one in Wind- sor, one in Sandwich West township, one in Sandwich town and one in Elma township, ail of which are of a mild type. Several of the cases reported werc traced to Detroit and Chicago. The report continued : \" While the Committee rnay con- gratulate the Province on its hcalth organization, which has produced for 1894 so satisfactory a statistic as the above, it cannot but express the opinion that the patient endurance of the lack of efficiency i dealing with outbreaks of small-pox in a neigh. boring. State which, in 1885, and again in 1892 and 1893, encouraged and insisted upon the maintenance of a border quarantine by the Mari'ne Hospital Service of the Federal Gov- ernment has ceased to be a virtue. For months chaos has reigned in the City Health Department of Detroit; small-pox has been treated in private houses in the centre of the city private physicians have gone in some instances from patients with small-pox, to attend patients sick from other dis- cases ; patients suffering from mild forins of the disease have, it is stated, been allowed abroad within a fortnight of the onset of the disease, and again and again have new cases occurred from people going from houses sup- posed to be disinfected, while such gross carelessness seems to have pre- vailed that persons unprotected by vaccination were allowed to work around the small-pox buildings. Of the latter it is statcd the fatal case of small-pox whichi occurred in Deceii- ber last in St. Thomas is an examplc. The Committee is not aware how far State supervision in the matter of the public health in Michigan exists, but certainly the state of affairs which lias existed during the past ciglt months demands an early and radical cure on thè part of someone.\" The Conmittee stated that the several outbreaks which have occurred during the year have again brought into prominence the need of some regular provision being made for supplying trained nurses and physi- cians at a moment's notice. MEDICAL INSPECTOR NEEDED. The need of a medical inspector to give personal attention and direction to outbreaks of sma.ll.pox is fur- ther amply illustrated by the pres- ence of diphtheria in many localities. The total municipalities reporting outbreaks during the last three montls is at ieast seventy-five offi- cially reported, while private informa- tion states that the disease exists in many other localities, froin which no reports have been received, but wlence physicians have sent for antitoxine. Diphtheria is as con- tagious under the conditions of close contact in the close and fetid atmos- phere of a church or schoolroom as small-pox or any other of the erup- tive diseases, Even with ,imperfect methods of collecting information the disease was reported during 1894 from rio municipalities, or more than one-seventh of ail organized in Ontario, and during the last quarter at least seventy-five municipalities",
         "DOMINION MEDICAL MONTHLY. have reported its presence. Ii a town with a population under to,ooo, twenty-five cases in thirteen days of the present nonth vere reportcd. Here is present a disease causing a percentage of deaths fron twenty-five to thirty-five of cases, mounting up during the year at the present rate to several thousands. Were small-pox present to even a hundrcdth part that diphtheria lias been during the past five months the business of the Province would be paralyzed. Re- ferring to the distribution of anti- toxine by the Health Department the Committee said that the demand had been quite active, showing at any rate that many physicians were interested in the therapeutic value of the nev remedy. A large amount of antitoxine had been sent out, but the Secretary had reccived a very limited number of reports. The physician using the renedy had too frequently failed to realize the object of the Board in distributing it, and had looked upon the department as a convenient depot at which to obtain a supply of a new drug. \" It is lardly necessary,\" the Com- mittee said, \"to remark that with such reasoning, let antitoxine as a remedy be ever so wonderful, it is doomed to more or less failure owing to its imp oper use. How far it is the duty of the Board to continue to maintain a supply on hand if such a view of it is to continue is not for your Committee to decide. While on the one hand, by enabling the Board to keep itself informed of outbreaks which under old conditions itwas not awareof antitoxine has proved-of great value, it may, it is feared, serv-e to divert the energies of physicians and hcalth officers fromn the exercise of those preventive measures which the Board has Uccn endeavoring to incul- catc in the past, and whiclh, whether with antitoxine or without it, are the only sure means by which ve can hope to finally eradicate diph- theria' The report vas received and the discussion on the sane laid over tilt next day. The Board resumed its sitting at i a.m., January i 8th. Owing to the temporary absence of Dr. Macdonald, the chair vas filled by Dr. Covern- ton. Dr. Cassidy then presented his report on Anti-Diphtheritic Serum.* This report was adopted. Aft:er a general discussion on the use of antitoxine in diphtheria, it was mnoved by Dr. Cassidy, and seconded by Dr. Bryce. \"That, having heard the re- ports of the services afforded by the use of antitoxine in Europe, Ameri- ca, and in the Province of Ontario, the Board expresses approval of this course of treatment, and wishes the secretary to continue to supply the antitoxine to physicians desirous of using it.\" The motion was carried. J. J. McKenzie, B.A., presented the laboratory report.t A report was then presented by Dr. Cassidy showiig correspondence with the New York Pasteur Institute about the antitoxine of tetanus, and contain- ing a request made by the Toronto Clinical Society that the antitoxine of tetanus should be procured by the Board, so as to be made available, *This report lias appeared in our January number. †This report appears on page 45 of this nun- ber.",
         "r I I when necessary, to the physicians of the Province. The report vas adopted, and the secretary vas instructcd to correspond with the New York Pasteur Institute, or with Dr. Tizzoni, of Bologna, Italy, so that the most reliable preparation of this antitoxine may be obtained. On resuning in the afternoon a letter was read from Mr. Doran, the Stipen- diary Magistrate at North Bay, about an outbreak of diphtheria at Warren, with six deaths from the disease. A complaint was received fron Clifton louse, near Niagara Falls, about the horse manure accumulated near the cab-stand. Dr. Johnson, Sarnia, wrote asking the opinion of the Board as to the propriety of vaccinating prisoners in gaol at that place. A communication was received from S. Nordheimer, Esq., the Consul- General of Germany, inquiring ff a microscopic examination is made of the tissues of hogs killed in Canada for trichnia, etc The importance attached by the German Government to this question vas due to the fact that large quantities of hog products were exported from Canada to Ger- many. A reply vas sent by the secretary informing Mr. Nordheimer that no such examination was made. The Chairman's annual address was then read by Dr. Macdonald.* The report was adopted. Dr. Bryce submitted a report on behalf of the Committee on Epidemics upon the question of a Home for Con- sumptives.† The report was adopted, and the Board adjourned until next morning. *The Annual Address appears on page 38. tThis report appears on page 43. On Saturday morning (January 19thi). oi resuming, the Board passcd accounts for vaccination, and for attending to an outbrcak of diph- theria in the unorganized territories. Plans of the proposed vaterworks at Port Hope vere submitted and referred to the Committce on Water Supplies. A report vas read on a conten- plated water supply for Bracebridge. Action was deferrcd until plans are prepared. Instruction was given to the Con- mittee on Legislation to take such action as vould secure the amend- ment of Section 30 of the Public I-Iealth Act, so as to make clear the control which the Board should have over the establishment of sewerage, and, also, to sp.cure the amendment of sub-Section 4 of Section 616 of the Municipal Act, with regard to the powers of Local Boards of Health to initiate works. A letter was received from Dr. A. C. Robertson, of Maynooth, asking the terms on which he could obtain a supply of antitoxine, as di phtheria had broken out there. The outbreak, he said, had started in the midst of a score of lumber camps, and. if it got a foothold there would be a bad outlook for thelumbermen. A supplyofanti- toxine will, it is understood, be for- varded to Maynooth. The special committees on the burial of the dead and tuberculosis were continued. The report of the special committee appointed to inquire into the sanitary condition of the shoddy manufactories of the Province, was read by Dr. Kitchen.* *This report appears on page 49. M DOMINION MEDICAL MONTHLY. 37",
         "DOMINION MEDICAL MONTHLY. The report was adopted, and the Bcard then adjourned. Ti-E ANNUAL ADDRESS OF THE CHAIRMAN. By J. D. MACDONALn, M.D. To the fembers of the Provincial Board of Heafth : GENTLEMEN,-The year past has not been an idle time for the Board, and still less so for its Secretary. The list of business done is tolerably large, too large to be noticed here in detail. It has included investigations into the drainage of towns ; enquiries respecting nuisances complained of in many localities, and respecting tue origin of outbreaks of diseases ; into the condition of Ontario with reference to its protection from the inroads of infectious diseases, particu- larly of small-pox, by revaccination of the healthy and the isolation of the sick. There have been length- ened discussions on the subject of tuberculosis. Scarlatina also demand- ed our attention, as did typhoid fever, in its outbreak not far froin this city, and in a locality much frequented in summer by families of its inhabit- ants. Respecting this invasion it may be remembered that its origin vas exposed and the mode of its sup- pression pointed out by Mr. McKen- zie, the analyst of the Board. The Board also lias had its repre- sentatives at meetings of scientific societies. Dr. Kitchen, at the Con- gress at Rome, merits our thanks, as do also those who represented us at that held in Montreal at a later period. The matters which required our most anxious attention had rela- tion not alone to our own Province, but also to the health conditions of the regions bordering upon us, to wit, those across the lakes. In these latter, in their large and populona cities and towns, the dangers wlich it is our duty to obviate often exist in a greater degree than among us ; so that we and our neighbors, having a common interest as regards our health conditions, it is the consta~nt endeavor of our Board to provide, that within our own bounds there lurk no sources of evil to those who dwell near us, as well as to prevent, as far as we may be able, the transmis- sion of evil from our neighbors to our own people. It seems not out of place here to say, perhaps it may be only to repeat, that institutions, such as this, which we form, have not only their own peculiar usefulness, but have, more- over, an influence in promoting a sentiment of common interest and interdependence on the part of neigh- boring peoples, and thus, in removing the jealous rivalry so often existing between these, to the discredit of their good judgment and civilization. We were constrained to have a special meeting in July, convened be- cause of the appearance of small-pox in the northern part of the Province, bordering on the lakes, the disease having been brought thither in vessels sent for the conveyance of lumber to the American cities. Since that time a perpetual vigilance lias been neces- sary ta prevent, if possible, the trans- mission of the disease from those cities. The effort, it has to be çon- fessed, has not been altogether suc- cessful, and up till the end of Decem- ber we have to record a gradually increasing number of localities where sickness in this form has appeared",
         "DOMINION MEDICAL MONTHLY. and where deaths have occurred. It is needless here to advert to the rea- sons why this loathsome and destruc- tive but prevertable malady prevails so much in the American cities near us. No doubt sanitarians there are strenuous in their efforts to check or to stop its progrcss. They, how'ever, have to encountcr unfavorable condi- tions, and these arc likely to create many centres for the diffusion of the trouble. A short time ago a serious note of warning was sent to a lifc as3urance company in Canada, from one of its medical advisers in Detroit, with reference to the incrcased risks which were to be encountered by the company in its business in that city, and lie recommended that it should seriously consider the propriety, or the prudence, of including revaccina- tion amongst its requirements. It vill be seen that such-an insti- tution must have an insuperable diffi- culty -in adopting such a course. The necessity of this additional safeguard seems plain, in the general interest, but some stronger influence than that of a business association working in its own interest vill be required to bring revaccination into general favor. The additional safeguard might again be in some way brought under public attention, by the efforts of this Board and its provincial auxiliaries. Hap- pily, as yet, the people of Ontario have not lad a very general necessity f.r testing the benefit of revaccina- tion, but it is well that the measure should be kept before them as a probable necessity. In the meantimne, the prevalence of small-pox lias be- come such that it has been thought prudent, in the public interest, to issue weekly bulletins of its increase or diminution. So far, increase alone lias had to be noted. Within the last year the Board has had to deal with a discase of uncer- tain nature. Its place in nosology we would have liked to have seen distinctly stated. The case was at one time said to bear a strong resem- blance to leprosy. So far that suspi- cion has not been verified by the evidence of men who have had more opportunities of seeing leprosy than lias been the lot of physicians in Ontario. The characteristic bacillus could not be found and the disease was concluded to be syphilis. The subject of it vas a tramp of more than ordinary filthiness, who appeared to look upon his condition as of advantage in his vocation. He was remittec to an hospital for treatment. Perhaps it need not be noted, as a matter-of surprise, that great-difmculty vas experienced in getting an hospital to consent to admit him. The Board's Committee appointed to deal vith the subject of tubercu- losis lias been dontinuing its work. More especially lias it been aiming at causing the public to appreciate the infectiousness of the malady. The efforts of the cornmittee have not been so successful in that direction as some of its most zealous advocates of infection thought might be reason- ably expected. It is hardly a mater. of surprise that men are difficult to be persuaded regarding this matter. Differently from other diseases of a recognized infectious nature, as, for example, the eruptive fevers, plthisis and its cognate affections of bone or gland, seem to have no period of marked prevalence. It holds posses- sion of the community continually,",
         "DOMINION MEDICAL MONTHLY. and destruction of life from it has no intermission. So its cominng or going are not to be observed, as can be donc in the class of diseases which have given a character, in the general opinion, to diseases which are admit- ted to be infectious. In its course, too, it is so gradual and insidious that, before its presence is suspected, it has had time to give a rnarked character to the bodily frame and appearance of its victins, so that it has come to be thought to be not the cause of a certain bodily configuration and gencral appearance, but the result of these; and as, in the meantirne, it has had a long opportunity of infecting a whole family, or a whole social circle of relatives and friends, it lias come to be popularly regarded as an inherited disease, with the existence of which external conditions have merely a secondary relation. Further, being everywhere present and always, it seems as if it were of the character of a natural force, and too great to be successfully contested by puny human opposition. So nurnerous are its sub- jects that the separation of the sick from the healthy, so as to prevent in- fection of the latter, would seem to leave too great and sad a gap in the family and social life of very many. It is such a consideration as this which makes the proposal of \"homes\" for consumptives so much the object of dislike to both the friends and the physicians of those who are consump- tive. Both friends and physician know that the final parting will come soon, but neither like to anticipate it. In the eye of both, the departure of the consumptive for the \"home\" is, so far as the family is concerned, the first step to the funeral of one who is the especial object of the sympathy and affection of the houschold. The family physician likes not to be called on to reconmmend the step, and the whole family shrinks from the avowal which it implies. These considera- tions may be taken as . sample of many which are offered by the oppoi- ents of the establishment of \" homes\" for consumptives, and it may probably be some tirne before these parties will look kindly on the proposal that the Government of Ontario should legis- late or vote inoncy for such institu- tions. In the meantime the duty of those who believe in the possibility of stamping out consumption is to continue urgir on the notice of the country and the Governmaent the reasons for their belief, and to point out a practical mode of giving effect to it. No doubt facts wivll force conviction sooner or later, and the ip- fectiousness of consumption, as of tuberculosis in other forms, will come to be. known and provided against; but the evidence will be of a kind which will' be the more slovly ad- mitted to be conclusive the longer it is drawn solely frorm observations on the human subject. From the insidi- ous, protracted nature of the disease, and by reason of the social habits of. men, it is very difficult to prove infec- tion. Indeed, it is due to the neces- sarily imperfect nature of observations on man that the idea of the infectious- ness of consumption has been lost for a while. Sixty years ago the belief in it was very general, at least among the laity. About that time a school of physicians arose, one of whose efforts it was to discourage the idea of infectiousness, and old men have heard courses of lectures delivered, of",
         "DOMINION MEDICAL MONTHLY. which.the aim was to ridicule it. Its absurdity, as we were told, was espe- cially manifest in the spread of yellow fever and of Asiatic cholera. Some of us have books on our shelves, the works of men who have bcen our own contemporaries, whose denial of in- fectiousness extend even to such a disease as scarlatina. Wc now can apply more correct tests than were attainable in past times. Microscopic research lias given ocular proof of the reality of infection, and of the mode of its action, while observation of disease, natural or artificially induced, in the lower animals, has afforded opportunity for tracing more distinctly the passing of infection from one subject to an- other. With respect to the infectiousness of tuberculosis many veterinarians have arrived at very conclusive results. The subjects by means of which these gentlemen have their more perfect opportunities for observation can be more easily kept in control and gnder observation. They arc not permitted to wander at will, or go in the direc- tion of evil influe.nces. The result of the observation of many veterinarians seems to be all in favor of the cer- tainty of infection as the source of tuberculosis in the animals which they treat, and so exclusively the source that they assert, that no matter how a herd of cattle may be cared for and housed, whether its condition be one of dirtand general unwholesomeness, or one of cleanliness, comfort and healthfulness, tuberculosis will appear among them if it is brought, and not otherwise. Unhealthy surroundings will not cause its appearance, and opposite conditions are no safeguard against it. These views have been distinctly put forth at a conference of veterinarians with a Medical Association in the United States, and reported in the Boston MlYfedtcal and Surgical Journal, for the perusal of which I am indebted to Dr. Cassidy. I have thought it well to advert to this matter in this way, in order that attention may be called to the views of the Board on the subject of the infectiousness of tuberculosis in all its forms. The subject is not now one for discussion by the medical profes- sion alone, but must take its place among those which are topics of con- sideration among all men. In the meantime the public seems hardly prepared to accept the views of the nature of phthisis or tuberculosis which have been just stated ; and we may expect on the part of many as much opposition,and withal as heated, as that which in some quarters is being offered to vaccination. Nay, perhaps a better organized opposition for maintaining it. We may expect to find opposed a large portion of the medical men of the country, who naturally will not look favorably on plan or system which may remove their patients from their own care. Until that opposition is weakened or overcome, much cannot be expected from governing bodies. These neces- sarily leaning on public opinion, as they must do, under our constitutional systems, cannot go in advance of that opinion. It is beyond their function to do so. Therefore, the general acceptance by people and by govern- ments will depend upon the light which they get from this and other such institutions, as thesc persistently hold forth what are weil-grounded",
         "DOMINION MEDICAL MON.THLY. scientific views on the infectiousness of this very prevalent malady. The last natter to which we shall advert is one of surpassing interest, a new light which, if found to be a truc light, will be next in importance to the discovery of Jenner, second to that discovery only, because it does not promise, like vaccination, per- manence in its effects. It is not prophylactic, as cow-pox inoculation is, in a majority of instances. We refer, of course, to the new mode of dealing with diphtheria, by the sub- cutaneous injection of what in the meantime, for want of a better name, goes by that of \"antitoxine.\" If we are to rely on reports from scientific centres, this substance, while appar- ently in the hands of some a means of saving many lives, is not to be allowed by others to pass unchal- lenged as a curative agent in diph- theria. Many men of mark still strenuously deny its usefulness, and aver that they who suppose that they have tested its usefulness successfully have been following a phantasm; that they have often been in error in diag- nosing diphtheria, and, of course, as often wrong in their conclusion regard- ing the curative effects of the agents, which they have been employing to stop the course of that malady. Not- withstanding this opposition to the claims to usefulness of antitoxine, its employment is increasing and si, also, its good reputation seems to grow. So hopeful is the medical pro- fession of its good results, that there is no doubt but that the treatment by means of it will have a fair trial, and that its value will be determined be- fore long, and if, as is claimed for it, it is curative in nany instances, so as to make it manifest that the percentage of deaths is greatly lessened, its value will have been confirmed. Meantime, however, it is not to be forgotten that diphtheria epidemics have not been always of equal fatality, or attended by equal distress. Time may show that we are at present, the world over, experiencing an epidemic in which numbers of cases run their course favorably, owing perhaps to the pre- valence of better hygenic conditions. Hence it is not impossble that a con- siderable proportion of the success attending the use of antitoxine may be delusive; but there appears no room for doubt, even in the supposed conditions, that much relief lias been gained, muéh suffering prevented, and many lives saved by the injection of the serun charged with antitoxine. If the success of the material thus used becomes assured, other vehicles less offensive than infected serum of the animais may be found, and our friend, the analyst of the Board, has in- formed us that the whey of goat's milk lias been found as useful as blood serum. The new substance is cer- tainly less repulsive to the imagina- tion than the old. Within our own working limits, we have occasion to estimate the value of this, or of any mode of procedure from which relief might be hopefully anticipated from the sufferings resulting from diph- theria. On the list of contagious diseases which have prevailed in On- tario within the past year, and which lias been prepared in the Secretary's office, it will be seen how great has been the comparative prevalence of this malady. It is nearly equal to that of all other diseases of the group. Nay, it may be said truly that, on the",
         "DOMINION MEDICAL MONTHLY. authority of that list, it is more than equal. In many of the reports trans- nitted to the office its \"prevalence\" is merely mentioned, or there are \"some cases\" or \"gsomUe families\" affected, but the cases are not enum- erated. There is, however, enough reported to justify the belief that in. its prevalence and mortality diph- theria exceeds all other contagious dis- eases put together. In this character we would, however, remind all that, destructive as diphtheria is, it is infin- itely less so than the history of small- pox shows the latter always to have been, and still to bc, in communities unprotected by vaccination. On view of the growing aversion to the coin- paratively trifling annoyance caused by vaccination as compared with the dreadful destruction of life of small- pox unchecked by this little opera- tion, it will be well that our own and other populations, were recon- ciled to the practice of compulsory vaccination under heavy penalties. No one, in the gratification of a fancy or even in the carrying out of a con- viction, has a right to make himself and his family a centre of mortal in- jury to the community in which lie and his family or friends live, and which affords him protection. Among the duties of the Board in the direction of improved water supply and of drainage, may be mentioned its successful endeavor in behalf of the former in the case of the town of Ingersoll, and its, as yet, unsuccessful dealings with the city of Hamilton with regard to the latter. Ingersoll had certainly good cause to apply for our intervention, but a visit of in- spection by a committee and its representation of the necessity of im- provement to those whose duty it was to afford the pure supply of which the town stood in need, werc followed by immediate and successful operations on their part. As to Ham- ilton, no such success lias attended our efforts to bring about the improve- ment desired. The nuisance is ex- cessive and affects the interest and. the comfort of a large neighborhood. There are, however, interests opposed. The worlk, too, will be expensive, and the city hesitates to enbark in it. The public burdens are already heavy, and there is much to do which is even more important than the matter of its \"Iinlet pollution.\" But in a little time, no doubt, steps shall be taken to move in the direction required by both the Local Board and by this Board. The sense of what is right and creditable to itself will cause the city to make pure and pleasant the. shores and inlets of its beautiful bay. REPORT ON A HOME FOR CON- SUMPTIVES. By P. H. URYCE, M.A., M.D. To the Chairnian and Members of t/e Pro- vincial Bocrd of Healtl: GENTLEMEN,--'our commnittee on epidemic lias for several years reported on the problem of how to lessen the great dcath rate from tuber- culosis in Ontario, and presented at the last quarterly meeting proposed regulatiotns for placing tuberculosis on the list of notifiable diseases. The more, however, that the prob- lem is studied the greater the urgency seems to be for the establishment, as. a corollary to such compulsory notifi- cation, of a Home for Consumptives on some inland and elevated tract of warm and dry soil, protected by an",
         "DOMINION MEDICAL MONTHLY. evergreen forest growth, and con- ducted under conditions which have been found most successful wherever such sanitaria have been established. It would further secm to your committee that such provision can only be realized in the near future by its establishment being undertaken -by the Government ; and that there- after, when it has gained public recognition, the counties might be encouragcd to establish in favorable localities similar homes, modelled on that crected by the Governiment. Such a home would necessarily be something between an hospital and a sanitarium, the maintenance of which night bc, in considerable part, pro- vided for by the products of agricul- tural, horticultural and other indus- tries, and by the nioneys reccived from pay patients of the better class. The arguments for the establish- ment of such an institution may be briefly summed up as follows: i. That, according to the Hospital Report for 1892, one patient of every twenty amongst the i ,oo8 inmates of the General Hospitals of the Pro- vince was tuberculous; while almost as many more, or 4-5 percent., suffered from acute bronchitis or pneumonia, a considerable proportion of whom, according to rnedical experience, are likely to have subsequently developed consumption. 2. That, the amount of Govern- ment aid to the hospitals in 1892 for the maintenance of these 1,197 patients, was at the rate of, say thirty cents per diem -$35910- which, if the number were maintained for the whole year, would have amounted to $131,07 1.50. 3. That the General Hospitals in the different cities of the Province have not in any single instance, as far as your corxfmittee is aware, any methocd, as by separate vards, for preventing the consumptives (one in every twepty) from mingling with patients suffering from acute and exhausting diseases, vhich render them especially liable to inoculation with tuberculosis. 4. That vith 750 deaths in the twelve cities of the Province during 1892 from tuberculosis, and probably as many more persons suffering from the disease, there was as a result a notable danger of such persons spreading the disease not only within their own families, but also amongst thcir fellov-workmen and workwomen so long as they were able to perform labor, forced upon them by their limited meicans. Other arguments, put in a more general way, have been presented in the Report on Tuberculosis prepared by your Secretary, ant' published by the Board last y as'well as in articles read before the Association of Executive Heaith Officers in August last, and published in that report. Proposals to establish an hospital for consumptives in Tdronto have, as you are aware, been made, but so far the idea has taken no definite shape. However valuable such an institu- tion, if established, will become, it cannot as an hospital fulfil the con- ditions which most recommend them- selves to your committee. As is well known the lakeside cities, and even rural municipalities bo'rdering on our great lakes, have an incidence",
         "DOMINION . MEDICAL MONTHLY. of deaths from consumption notably greater than the inland and more elevated counties. The following table, published before in previons papers, may be repeated, and year after year, may be illustrated. Deaths from tuberculosis in cities in 189î, 1,89s and 1893 in Ontario. 1891O, 1892, 1893, c\u003c3ie.\u003e. IRatio per ltio por iatio per 1000 of P'op. 1000 of Pop. ý000 of l'op. Toronto .......... 2.4 2.5 2.0 Windsor .......... 2.7 1.2 1.6 Kingston.......... 2.2 2.1 1.8 Ifaimiltoi ......... 1.8 1.6 1.7 Brantford ........ 1.7 2.0 2.4 London .......... 1.6 1.3 1.3 IIellevil:e.......... 1.4 2.9 1.7 St. Thomas ....... 1.4 1.2 .9 St Catharines ... 1.3 2.9 1.9 Ottawa .......... . 2 1.8 2.4 Ouelph............ i 1.6 2.1 Stratford.......... .9 .9 1.1 It scems, therefore, apparent that the location of sucli a home of a provincial character must be chosen vith a view to the very best location from the climatic and geological standpoint. It has been stated elsewhere that from the calculation based on the annual death rate, probabiy five thousand consumptives are at any one time living within the Pro- vince. If it were assumed that even a number equal to those treated at present in hospitals for tuberculosis ani- other pulmonary complaints were provided for gradually, it would mean an institution not larger than one of the provincial institutions for the in- sane at the present tilpe. Without going further, however, into the question, your committee believes the time has arrived when the demand for such an institution is general. It commends itself to the Inspectors of the Department of Public Institu- tions, both from the public health and economic standpoints ; and your com- mittee would tlierefore recommend the adoption of the report, vith in- structions to have it forwarded to the proper authorities for consideration. This is all the more urgent in view of the fact that the point was raised in the discussion with the Govern- ment of the proposed regulations for the compulsory notification of tuber- culosis-if cons'unptives were pre- ventcd from engaging in employment in workrooms and factories, where iningling vith others was necessary, that other disposition of them was at present impossible. All of which is respectfully sub- mitted. PROVINCIAL BOARD OF HEALTH LABORATORY REPORT. By J. J. MCKENZIP, B.A., Bacteriologist and Analyst to the Board. To le Chairman and Members of the Pro- vin.-ial Board of Heal// : GENTLEMEN,-The work of the Laboratory during the past year has been, as heretofore, partly c' emical and partly bacteriological. The fol- lowing is a summary of the work donc: Chemical analyses were made of water samples as follovs : Weils from Alton, Ont., four samples ; well at Lorne Park, one sample ; Lindsay public water supply, two samples; St. Thomas public water supply, two samples; Windsor water supply, four samples; Belleville, three samples ; Oshawa, one sample; Belleville Deaf and Dumb Institute, two samples ; Goldsmith,one sample; RiverThames at Chatham, twosam ples; Lake Erie water near Chatham, two samples ;",
         "DOMINION MEDICAL MONTHLY. Chenal water, Chatham, one sample ; l'ort Hopeone sample-.tvcnty-seven samples in all. These analyses, which owing to tlcir length ar here omitted, will appear in full in the annual report of the Provincial Board of Health. Bacteriological and chenical an- alyses were made of two samples of cheese and one of bread supposed to have caused ptomainic poisoning. The results were negative. Bacteriological examinations vere made of the following water sup- plies : Irigersoll, three samples ; well at Lorne Park Station, one sampie; Windsor public vater supply and Detroit river, four samples ; sewvage effluent, onc sample; Battleford In- dian Industrial Home, five samples (wells suspected to have caused typhoid); Belleville Deaf and Dumb Institute, two samples; well at Gold- smith, one sample; wells at Lynn, two samples; Chatham City supply, three samples; Port Hope, two sam- ples ; Peterboro', fourteen samples (river water, public supply and wells). A considerable increase in the vork of the Laboratory has been occasioned by the action of the Board in offering to make for the rural municipalities and towns examinations, free of charge, of suspected diphtheria exu- date and sputum from suspected cases of tuberculosis. It is surpris- ing, however, that notwithstanding the exceeding importance of such examinations for the early diagnosis of these diseases, health officers and others should not have availed them- selves more extensively of the Board's offer. It is practically only since November ist that the number of samples sent in have begun to in- crease, and this is apparcntly not so much due to the first circular issued by the Board as to the distribution of diphtheria antitoxine, the instruc- tions in regard to the use of vhich included again a reference to the ne- cessity of a bacteriological diagnosis and advice as to methods of taking samples and shipping to the Labora- tory for examination. In soie cases, even where advantage was taken of this offer of the Board, the results have not been satisfactory, owing to the culpable carelessness of the send- er. Although the instructions were made as explicit as possible, still some physicians have sent the sam- ples packed in an excecdingly loose and carcless manner,cither from sim- ple inattention to details or on ac- count of the expense involved in packing carefully. I am inclined to believe the second lias been more frequently the reason, espceially since reccntly one medical health officer objected to paying the cost of the telegraphic report upon a diphtheria membrane ! The necessity of care in these mat- ters is of so much importance to my- self and others who may handle the packages, that I have adopted the fol- lowing procedure in regard to them : If the material were not enclosed in a bottle it was destroyed without being examined, and the sender noti- flied of the reason. If it were enclosed in a bottle, butùthe bottle not enclosed in a wooden or metal box, it was ex- amined, but the sender was warned, and if he transgressed again the sam- ple was not examined, but destroyed. This method lias been successful in most instances, but it will be neces- sary when new circulars are printed",
         "DOMINION MEDICAL MONTHLY. to be cven more explicit thart in the last. In all, from June ist, 1894, to Janu- ary 15th, 1895, cighty-one samples have been examined (excluding, of course, samples destroyed). Of these cighty-one, thirty-six were suspected exudates, forty-onc suspected sputum, two fæcces fron suspected intestinal tuberculosis, one urine from suspected tubercular cystitis, and one a tuber- cular liver abscess. Of the thirty- six suspected exudates twenty-cight proved to be diphtheritic, and eight non-diphtheritic; of the forty-five samples suspected to be tuberculous thirty vere found to contain the bacil- lus of tuberculosis, and in the remain- ing fiteen it was not found. Thesc eighty - one samples were clivided according to the months, as follovs Months. Diphtbria. Tuberculous. Jumo ................. 1 C July ................. 0 6 August .............. 0 8 Septenber .............0 2 October.............. 5 3 Novemciber............ 3 7 December............ 12 7 January (ialf mor'h).. 9 3 Total. 10 6 8 8 8 10 19 12 An arrangement of the samples ac- cording to this source makes more apparent the lack of interest which medical health officers have taken in this work : One physician sent six samples, two physicians sent five samples, one physician sent four samples, six physicians sent three samples, nine physicians sent two samples, and twenty-flve physicians sent one sample. Latterly, as far as possible, a record has been kept of the micro-organisms associated with the diphtheria bacillus in exudates, but in the absence of 4 clinical data for the cases, and with carclessness in taking the samples, no conclusions of importance can be drawn from thesc results. As a rie the commonest associated form has been a short streptococcus or diplo- coccus (it occurs in both forms), which in many respects resembles an aber- rant type of diplococcus pneumonie. The streptococcus longus, the most important associated form for the prognosis, lias been noticed but seldom. The method of packing described in the circular of the Board lias proved fairly satisfactory where carefully carried out, but the suggestion to scal the cork in the bottle with scaling- wax I have found objectionable. .1 would suggest that in a new circular the sealing-wax be omitted. In a recent paper by Dr. Hesse, of Dresden, in the Zeitscrft far Hlygiene, upon the bacteriological diagnosis of diphtheria, a suggestion is made which I think might,in some instances, be used here. Dr. Hesse docs for the district in which Dresden is situated the same work in regard to diphtheria which I am doing here, and he has found the following method most satisfactory. Medical practi- tioners are provided with sterilized test-tubes, through the cotton plug of which passes a sterilized glass rod. When a case occurs, the rod and plug are removed from the tube, the rod is rubbed over the suspected membrane, then returned to the tube, which is enclosed in a box and sent to the Laboratory. When it arrives, the in- fected rod is again removed and rub- bed over the culture medium. The advantages of this are twofold : first, the greater cleanliness ; and, second,",
         "DOMINION MEDICAL MONTHLY. the fact that if it 's dtsired to take into account associated forms, the drying of the film on the rod prevents the developnent of saprophvtic bac- teria, which alvays occurs in a picce of moist membrane enclosed iii a bottle. Siice seeing this paper I have had one opportunity of using the method. This was in a case of diph- theria in which tlc exudate had dis- appeared fron the throat ten days before. The rod vas rubbed over a spot where membrane had existed, and was brought to me twenty-four hours later. I succceded in getting a good culture of the bacillus of diph- theria. It would not be possible to use this method in all cases, but in larger municipalities withhealth officers fully alive to the neccssity of an carly bac- teriological diagnosis, I think it would be ivell to attempt it; and in case of special outbreaks, it would certainly be the best method to pursue. Among the eighty-one samples ex- amined there are only tvo of sufmcient interest to [nerit a more extended re- port. These were in connection with a number of cases of quinsy which par- tookofanepidemiccliaracter. Thefirst case was fatal, and was not considered diphtheritic at all, except that there appeared on the fauces a glazed white patch, as if membrane was about to form. The funeral was public, and two of those who were at it about a week later developed throat trouble. In one case, a child, it was diagnosed follicular tonsillitis, and ran the usual course; in the other case, a young man who had had several attacks of quinsy, the disease was diagnosed quinsy. Pus formed in the tonsils and there were glazed white patches in the fauces, one as large as a twenty-five cent picce. Wipings werc sont me of these patches, and of the tonsilz, but the diphthcria bacillus vas iot found. The bacteriological examination slowcd only diplococci like diplococ. cus pneumonio, and a streptococcus. Four more cases occurred in the saime house. Pus formed in every case but one, and the pseudo mem- brane was present in all. A specimen was again sent mc from the fifth case, and the bacteriological examination failed to reveal the bacillus of dliph- theria. On account of the interest attached to the case a more thorough examination was made. A portion of the cotton with the exudate was droppcd into sterile bouillon, allowed to grow for forty-eight hours, and then injected ([cc.) into a rabbit. The rabbit survived, having a sliglt lump at the point of inoculation for two weeks.' Another portion of cotton with the exudate was enclosed in a pocket iii the skin of a guinea pig. It developecd a lump at this point, which fimally broke, and the pus was found to contain staphylococcus pyogenes albus and streptococcus longus. The animal rinally died. The bacteriological cultures from the exudate showed the following forms : i. Staphylococcus pyogenes albus. 2. A form which occurred in diplo- cocci and short streptococci. 3. Streptococcus longus. A rabbit was infected subcutane- ously with i cc. of a tventy-four hour bouillon culture of the streptococcus longus. It developed a lump at the point of inoculation, but this disap- peared in about ten days. rit the end of two weeks the animal died,",
         "DOMINION MEDICAL MONTIILY and the streptococcus could not be found in the organs or blood, but was still present at the point of inocula- ti on. The results of thcse inoculations seem to show that the streptococcus longus had in these cases a low clcgree of virulence, and it is possible that its presence accounted for the diseased condition, and for the apparently in- fectious character of the outbrcak. In this connection it must be remenm- bered that streptococcus longus is the forn vhich is almost constantly prc- sent in scarlatinal anginas, and there secms to be little cloubt that wherever found it is simply a varicty of the form vhich has been called strepto- coccus pyogenes or streptococcus crysipelatis. In virulence it varies exceedingly according to the source from which it is derived, and in cul- tures in the Laboratory any virulence which it nay have is specclily lost. A series of original investigations have been begun this year on the sub- ject of synthesised culture media, but the work is not sufficiently advanced to merit a report. All of which is rcspectfully sub- mitted. REPORT ON SHODDV MILLS IN THE PROVINCE. By E. E. KrrcIn, M.D. To the Chairman and Members of the Pro- vincial Board of Health: GENTLEMEN,-Your Committee appointed to enquire into the con- dition of the shoddy manufactories of this Province, from a sanitary standpoint, beg leave to report that they have had considerable corres- pondente and interviews with the Inspector of Factories, as well as having visited and macle a personal inspection of a number of factories in operation. The terrn shoddy\" is more especially applicable to the raw ma- terial, as manufactured at soie four or five different mills, and is generally known by the tern \"cxtract.\" The best of the \" extract \" is sent to the woollen manufacturers, to be macle up into cloth and blankets, etc., wvhile the refuse is used in the manufacture of mpattresses, upholstery and cover- lets. Some of the iills manufacture their shoddy from old, ilthy rags, collecteci by pedlars or importcd fron foreign countries, and use no new material, while others use only cleaned rags and new ones collected as clippings from tailor shops, etc. We cannot do better than give you the process as ive found it followed in a few of the mills visited. First Mill.-This factory obtains rags of all sorts from peclars, fron Toronto, Detroit, etc. The rags, as received, are in a filthy state, and are sprinkled with a little sal-socla solu- tion, and without any washing go directly to the \"picker.\" The room is extremely filthy where the process goes on, and then they are sent to an upper room, where dust accumulates upon them, and then go directly, vith or without admixture with new wool, cotton or clippings, to the rollers, where they are macle into flocks or batts. These batts, averaging about two pounds each, fall on the dirty floor, and are then packed and sold direct to the manufacturers of mat- tresses, bed-comforters and cheap upholstery. These rags are bought for seventy-five cents per one hundred. pounds. The fulling machine re-",
         "DOMINION MEDICAL MONTHLY. duces their weight by about 33 per cent. These mattressc: are made up mostly of swamp grass, faced with these batts. The mian in charge did not know of any disease from these rags in recent years, except skin diseases ; but tells that in 1864, when he worked in a similiar mill in Galt, there was a spread of small-pox from the rags in that mill. We might add that this shoddy is also sold to the manufacturers of felt. The flocks are taken and mixed with rags and an adhesive com- pound ; and steam at high pres- sure is forced through them, which would seem to remove any danger from such material. In this mill eight men are employed, and more than seven hundred pounds of rags daily are used. Second Mill.-This mill is under good and intelligent management. It gets rags from all quarters local, and largely frorm London, England They likewise get a large quantity of union rags from other mills, more particularly woollen mills.\" It em- ploys about eight hands steadily, and has good buildings, and everything well arranged. This mill occasion- ally supplies batts, from union rags, for mattresses and comforters, for customers ; and also supplies a large quantity of the shoddy used in various wvoollen mills. The principal work of this mill is to treat union rags by the patent process of \"carbonizing.\" This process is carried out by driving fumes of hydro-chloric acid, made fron salt and sulphuric acid, into a revolv- ing cylinder, double jacketed, and heated with steam in the jacket. This method first requires some two hours heating to dry the rags, aided by a fan, after which the acid fumes are forced in froin a retort. The fumes destroy the cotton fibre coin- pletely ; the carbonized fibre falls from the rags leaving the u oollen portion behind uninjured. These are sent to woollen mills and made into cloth, This process wilil completely disinfect the rags, and is known by the name of \" Cole's Patent Process.\" There are three other mills in the province using the same process. The reason given for its not being more generally used, is its expensive- ness. The owner says he knows of no disease originating from rags since its use amongst the employés. Third Mill.-.Thisisa woollenshoddy factory, and employs 150 hands, and has ninety-six looms in operation. They secure rags from all points, and buy, especially,so-called soft woollens, as knitted goods, etc., and also new clippings. Do not buy old rags at all. in this factory the first opera- tion is to separate light colored goods from dark, and then put them in large color vats and boil them from two to five hours, and add dye stuffs, chiefly madder and logwood. These are afterwards taken out and dried with steam heat, and dusted to get rid of the excess of coloring mat- ter. The union or mixed goods are then assorted from the all-wool goods, and the all-wool rags go to the cc picker,\" while the union are sent to Cole's mill at Doon, to be carbonized and get rid of the cotton. The picked rags go to the weaving-room, after leaving the \" picker,\" where the dif- ferent qualities of wool are made up with new wool, cotton, etc., and come out as cloth with all the fr.eshness. and beauty of new wool goo.ds.",
         "DOMINION MEDICAL MONTHLY. These mills give a fair example of the treatnent of rags in all the shordy and shoddy woollen mills of the Province. The process in the last two mills is eminently satisfac- tory, while that in the first mill is a fair representation of ,others of its class, and is equally unsatisfactory. In closing our report, we would recommend : (i) That immediate steps bc taken to prevent the intro- duction of rags into this Province from a foreign country, without their being accompanied by a certificate vouch- ing for their thorough disinfection. (2) That all rags, except new ones, be required to undergo a thorough process of disinfection before being passed through the \"picker.\" Attached to this report are the names and addresses of all shoddy and shoddy woollen manufacturers, who are now doing business in the Province of Ontario. A. K. McKay \u0026 Co., Woollen Mills, Orillia ; Mrs. Sarah Harrison, Wool- len Mills, Owen Sound; Auburn Woollen Mills Co., Woollen Mills, Peterboro' ; Woolien Mill, Streets- ville ; Canada Mattress Co., To- ronto Junction ; T.. Andrews \u0026 Co., Woollen Mill, Thornbury; Wes- ton Woollen Co., Weston; W. C. Pollock, Almonte; David Sheppard, Almonte; J. M. Schiedel, Breslau ; J. T. Huber \u0026 Co., Doon; Mrs. Mar- garet Cooper, Galt; J. O. Hutton, Huttonsville ; James Porritt, Port Elmsiey'; John -Kirkham, Rouge Hill; Harding \u0026 Co., Simcoe; Wm. S. Duncan, Stratford; Sinith Wool Stock Co, 219 Front Strcet East, 'Toronto; New Toronto Wool Stock Co., New Toronto; A. Bauer \u0026 Co., Waterloo; Cole \u0026 Co., Doon; Sykes, Ainsley \u0026 Co., Glenwilliams; Sam- uel Beaumont, Glenwilliams ; Shuh, Waterloo; Rumbel Felt Factory, Berlin. WOOLLEN, KNITI'ING AND SHODDY MILLS. Standard Woollen Co., Front St. East, Toronto; Joseph Simpson, cor. Esplanade and Berkeley Streets, Toronto; M. J. Smith \u0026 Co., 169 Front Street East, Toronto; Toronto Mill Stock Co., 123 River Street, Toronto ; John Fisher \u0026 Co., Woollen Mill, Alli'ston; Wm. Algie, Knitting Mill, Alton ; Benj. Ward, Knitting Mill, Alton; Peterboro' Mattress Co. Ashburnham; G. Hogg,Woollen Mill, Barrie; C. Young, Woollien Mill, Beaverton; W. Lott, Woollen Mill, Belleville; H. J. Bird, Woollen Mill, Bracebridge; Trent Valley Woollen Co., Woollen Mill, Campbellford ; G. Routh \u0026 Son, Woollen Mill, Camp- bellford ; Telfer Bros., Woollen Mill, Clarksburg; Joseph Atkinson, Wool- len Mill, Cataract; Cobourg Woollen Mill Co., Woollen Mill, Cobourg; E. Cook, Woollen Mill, Gananoque; Wm. Morrison, Woollen Mill, Lamb- ton; David Graham, Woollen Mill, Inglewood; John Beemer, Woollen Mill, Inglis Falls; Jacob Messinger, Woollen Mill, Hanover; John Mc- Murchy, Woollen Mill, Huttons- ville ; Kingston Hosiery Co., Woollen Mill, Kingston; Markham Woollen Mills Co., Woollen M ill, Markham; W. H. Perry, Woollen Mill, Napanee; James Randle, Woollen Mill, Mea- ford; A. Jackel, Woollen Mill, Mid- land; G. Upton, Woollen Mill, Nicol- ston ; James Cumming, Woollen Mill Norwood.",
         "52 DOMINION MEDICAL MONTHLY. Special Selections. HÆMOGALLOL AS A SUBSTI- TUTE FOR THE INORGANIC PREPARATION OF IRON. -I Wm. Henry Porter, M.D., in Post- Graduate, says: While in many instances the older and inorganic preparations of iron are amply satis- factory, there are still many cases met with in which these iron preparations prove absolutely worthliess in every respect. And even at best the iron in any of these forms is still an artificial and absolutely unnatural preparation. Therefore it was de.sirable to secure some preparation that would more closely follow the indications of the natural chemico-physiological laws- which govern the animal economy. A little more than two years ago Professor Kobert, oi Dorpart Univer- sity, succeeded very largely in satisfy- ing these requirements.i This was accomplished by taking the hæmoglobin of the bullock's blood and acting upon it by means of a re- ducing agent, such as pyro-gallol. This deoxidizing agent displaced the oxygen almost or completely from the hærmoglobin, and left as the final product a smooth powder of red- dish-brown colour containing all the constituents of the normal homo- globin except the oxygen. To this substance he gave the naine hæmo- gallol. It is an almost tasteless pow- der, which can be administered in solution, in pill or capsule form. Hæmogallol is absolutely non-irri- tating to the most delicate and sensi- tive stomach, and can be administered in every possible form of anærmia dur- ing the height of the acute infectious diseases, even during the fibrile period, with advantage. Professor Kobert found that hæmo- gallol vas absorbed very rapidly from the alimentary tract, and taken into the entero-hepatic circulation, and that when the hS-moglobin was defi- cient in quantity in the blood it was rapidly increased unde.r the steady introduction of this compound. The hæmogallo when it reaches the circulating blood appears to seize readily the oxygen in the blood and take up again its previous comple- ment of oxygen which was displaced by the deoxidizing agent, and thus it reverts back to hæmoglobin. This much accomplished, the repro- duced hæemoglobin incorporates itself rapidly with the globulin elements of the red corpuscles, and thus the total. percentage of the hemoglobin in the bfood and in the red cells rapidly rises. When more hæmogallol is intro- duced into the circulation than the system can possibly utilize in the restoration of the hæmoglobin to its normal standard, the excess of homo- gallol or unoxidized hæmoglobin, passes rapidly out of the body with the urine, without producing any un- toward effects upon the kidneys, and without any unpleasant symptoms further than an increased colouration of the renal excretion. A good drug is simply wasted if more is adminis- tered than ca.n be utilized. If now at the same time that the hæmogallol is being exhibited the proper kind and quality and amount of food is sup- plied, rapid improvement in the phy- siological state must follow. At the same time the circulation,",
         "DOMINION MEDICAL MONTHLY. respiration, digestive and glandular actions must receive whatever atten- tion is necessary to bring them as nearly as possible to the normal standard. Ail these conditions satisfied, the hænogallol will rapidly augment the oxygen-carrying power of the blood corpuscles, general assimilation will be rapidly improved, the anæmic state will disappear and a normal standard will be quite rapidly established. All pathological processes will tend to give place to those of a normal type, Since the introduction of hæmo- gallol, the author lias used more than twenty pounds of this compound,with uniformly good results. Anoemic conditions of years' dura- tion, in vhich all other forms of iron had failed, responded quickly and completely to hærmogallol until per- fect cures were effected. In the anærmia of the chronic dis- eases such as lithæmia, oxaluria, neur- asthcnia, rheumatism, nephritis, and diabetes, hæmogallol has produced much better and more decided results for good than any other form of iron tried or commonly used in these cases. The most elegant method for ad- ministering hoemogallol is in combin- ation with sugar or chocolate, faintly flavoured with vanilla, and then com- pressed into tablets or pastilles. The chocolate pastilles which are commonly found in the market are known.as haæmogallol chokolade-pas- tilles. Each of these pastilles con- tains o.5 grammes (7.5 grains) of the hæmogallol. One of these pastilles at a time is an average dose for an adult, although three or four times that number can be taken three times a day. One- half to one pastille is the average dose for a child. This fori of iron, on account of its great palatability, is particularly adapted to children and those who are specially fastidious. The hoemogallol tablets, made up extemporancously from the hoamo- gallol powder, so far as my experience goes, are equal to any in the market. Homogallol appears to yield the best results when taken about one- half hour before eating. This forn of iron is especially valu- able on account of its great palata- bility and the case and rapidity with which it is assimilated. Thus far only' good results have been obtained fron its use, and as yet no contraindication lias bcen met to oppose its free and universal adminis- tration. THE PREPARATION oF DIPHTHE- RIA ANTITOXINE 13Y ELECTROLYSIS. -Smirnow gives i n the Beriner Kin- ische Woclienscir;ft, No. 30, 1894, an account of experiments which he has made on the preparation of antitoxine- by electrolysis, in the hope that this method might supplant the tedious and expensive method of animal im- munisation. After injecting a dose of pure bouillon culture of diphtheria, which proved fatal in a control experi- ment, into guinea-pigs, he employed bouillon cultures through which a cur- rent of electricity had been passed, as a heilserzm, vith successful results. He is hopeful that the serum prepared by clectrolysis may be effective in the human subject.",
         "DOMINION MEDICAL MONTHLY. THE PRACTICE OF PRIMARY AMPUTATION IN TRAUMA- TISMS OF EXTREMITIES IN CIVIL LIFE SHOULD BE DIS- CONTINUED.* First.-Conceding that an amputa- tion is an opprobrium of the healing art, that its performance always entails an irretrievable sacrifice, the dictates of conscience, sentiments of humanity, our patients' well-being, our own reputation, and, many times, corporate interests, ail enjoin on us the importance of resorting to this procedure after injuries only as an extreme and last resort, when the resources of science are exhausted and we are positively assured that resuscitation of the damaged parts is out of the question. Second.-As a general rule, unless the shattered, mangled limb has been quite totally destroyed or has been traumatically amputated, immediately after injury, no one can pronounce whether the limb is in a state of temporary asphyxia, suspended ani- mation or is permanently devitalized. Tlird.-As serious or mortal shock from internal, organic injury, not infrequently is associated with the mechanical disorganization of an extremity, the question of severing the limb should not be entertained until reaction ; for, to amputate in the moribund state, or in the presence of collapse, is not in consonance with sound tenets of surgery. Fourtli.-In all such cases of mang- ling of a limb as may entail the severance of it, enough has been accomplished at the primary dressing *Abstract of paper by TiîoMAs MANLEY, M.D., visiting surgeon to HIarlem iHospital, New York. if all shattered and entirely detached fragments of bone have been removed, efficient hemostasis secured, the parts thoroughly cleansed, the limb placed in comfortable position, dressed and splinted. Fif/.-Resection, ebonation and modern osteoplastic operations, when judiciously and skilfully employed, in a large number of cases, will now enable us to preserve many limbs, which her-tofore have been ruth- lessly sacrificed. - Six/tå.-The allegations that the dangers of septic infection, gan- grene or tetanus are augmented by discarding primary amputations are not supported by facts. Seventh.-By delay, until vital processes are established, advantage obtains through (a) our patient being now better able to sustain the shock of an additional mutilation ; (b) a de- marcating line, clearly isolating the decomposing from the living tissues; (c) through improved nutrition, aiding recuperative processes, and (d) lastly, but not of trifling importance, it per- mits of a truce by which one is enabled to carefully analyze his case, consult with his confreres and authors, and decide with deliberation and discern- ment on the most judicious course to pursue. Eîgi/h.-As the upper extremity is the prehensile organ of the body, by the use of which our existence is maintained, and, besides, preserves a vitality and regenerative properties far in advance of the lower extremity, an immediate severance of it, or anyof its digital appendages, after an acci- dent, when these are not wholly and irrevocably destroyed, trenches on the border line of positive malpractice an-d cannot be too severely condemned.",
         "DOMINION MEDICAL MONTHLY. Nintiå.-Nearly every description of a distorted lower extremity, free from pain, is vastly more valuable than the most expensive or elaborate prosthetical appliance for its substi- tute for either support or locomotion. Regardless of hov or where a stump is formed, but very few ever bear an artificial limb with any degree of comfort. Tenth.--To prematurely or injudi- ciously amputate a limb is a most grievous calamity, for the loss is irretrievable, and its restoration i- quite beyond human possibility ; while to procrastinate at its very vorst can work no greater da.mage to the member ; the only debatable feature in the subject remains: Are our patient's prospects of recovering with his life diminished by waiting until vital processes determine with precision the living margin. Eleveni.-Traumatically amputat- ed parts or limbs are those in which, though there nay not be a complete physical detachment of material structures, the living bond is severed, vessels and nerves are destroyed, the parts are reduced to a pulp and hang together by the integuments, tendons or fasciæ ; or may have been quite completelyground or torn off These cases do not, strictly speaking, belong to the category embraced within the above resume, for the reason that, as vital detachment has been effected, the question of a forma amputation of any description is quite out of the question. GUNSHOT WOUNDS OF THÈ IN- TESTINE.-In an article on this sub- ject Dr. Hefeelfinger, in the Texas Courier-Record, draws the following conclusions () Laparotomy is the only rational procedure in aHl cases of gunshot wvounds of the abdomen where there is reasonable evidence that the ball has entered the abdom- inal cavity, and each moment's delay will materially lessen the chances of recovery. (2) If there is a reason- able doubt as to whether or not the ball lias entered the abdominal cav- ity, give the patient the benefit of that doubt by doing an carly explor- atory operation for diagnostic pur- poses. (3) 1In vounds of the pan- creas complicating gunshot injuries of the in estine a resection of this gland may be done, care, being taken not to include the head or common duct, as death invariably follows such procedure. (4) The segmented cat- gut rubber ring being unaffected by the imbibition of intestinal secretion is one of the very best aids in circular enterorrhaphy or lateral anastomosis. (5) A ring composed wholly of cat- gut is entirely worthless as an intra- intestinal support on account of its highly absorbable qualities. (6) When the Lembert stitch includes only the serous or a part of the mus- cular coat they do not, as a rule, ulcerate their way into the bowel, as is claimed by some, but usually be- come encysted and remain near their place of introduction. (7) An intes- tinal wound when properly treated usually becomes securely sealed in from six to twel\"- hours by the for- mation of plastic peritoneal exuda- tion ; but this must not be too con- fidently relied upon, as it may be very materially retarded. (8) If there arise evidences of suppurative peri- tonitis, do a second abdominal resec- tion, disinfect the cavity and apply drainage.",
         "DOMINION MEDICAL MONTHLY. IMPROVED METHOD OF LAVAGE.- (Brit. Med. jou-). A very simple im- provement in the apparatus for wash- ing out the stomach, a procedure often of great value in the treatment of gas- tric disorders in childhood, lias been described by Dr. W. Beattie Nesbitt, in the A rchives of Pediatrics, Septem- ber, 1890. The fluid is obtained as usual from a siphon bottle placed above the level of the child, but the india-rubber tube from this bottle is connected vith the stomach catheter, not by a piece of straight glass tubing, but by a glass tube shaped like a widely-open tuning-fork ; the handle of the tuning fork is con- nected with the stomach catheter, one limb with the tube from the bottle, and the other with a waste tube conducted into a suitable recep- tacle. It is convenient to have the tube from the bottle and the catheter of red rubber, and the waste tube of black rubber. The tubes from the two limbs are placed over the fore- finger of the right hand, and are held loosely in the palm; either can then be easily compressed by the thumb. Wlien it is desired to fill the stomach, the catheter having been introduced, the waste tube is com- pressed, and the fluid readily flows into the stomach from the bottle ; when the stomach is to be emptied the red or siphon tube is compressed, and the black released. If the eye of the catheter becomes blocked, as often occurs, the current is easily reversed by compressing the black and releasing the red tube. Dr. Nesbitt recommends the use of a mouth gag, and, after inserting the tube, places the child on its side, with the face slightly downward. Before removing the catheter the stomach is filled quite full. An act of vomiting generally follows the withdrawal of the tube, or, if not, it may be excited by titillating the fauces. \" In this way,\" writes Dr. Nesbitt, \"I have often seen removed large pieces of coagulated putrid cascin, half an inch to an inch in length, of such a. tough leathery consistence that no anount of wash- ing would have broken them up.\"- Journal of hie American ledical Association. VIRCHOw ON THE SERUM TREAT- MENT OF DIPIHTIIERIA.-The Berlin correspondent of the Britisl Medical' Journal writes that Virchow gave his opinion with characteristic caution. He said that lie lad been inclined to be sceptical as to the good results obtained in diohthieria last summer in tlie Kaiser and Kaiserin Friedrich Hospital, as lie thoughît none of the cases was of the severest type. In August, however, the supply of anti- toxine fell short, and since then the mortality from diphtheria in the hos- pital had risen remarkably, showing that the epidernic was severe in char- acter. I-le summed up his opinion as follows : The serum exercises a strong pr'otective influence for weeks, perhaps months, say three or four months. Whether this influence be lasting can be shown only by further experience. Moreover, this alone- can furnislh the answer to the cardinal question, Is it a specific for diph- theria? But much has already been gained when, for instance, it is pos- sible in a family where three or four children are down with diphtheria to immunize even one child, and this, in all probability, can be donc by the serum.",
         "DOMINION MEDICAL MONTHLY. Dominion Medical Monthly. EDITOR W. BEATTIE NESBITT, B.A., M.D., F.C.S. LoN. ASSOCIATE COITORS. J. J. CASSIDY, M.D. * W. A. YOUNG, M.D. AlI lierary cont;/Zunicationls, e.chanfgcs, and - books for review, shoId be addressed to /11e DoMINION MEDICAL MONriHLY Etditor, 97 Confederation Life Bildi, Toronto. Address all business communica/ians Io /the Pub/ishiers, THe MEDICA L P U IILISH ING Co., OF ToRoNro, Rooms 97, 98, 99 Con-Lfederation L(fe Building, Toronto, CaIaidz. TORONTO, FEBRUARY, 1895. MEDICAL EXPERTS. There have been columns written on the subject of medical expert testimony, and the importance of it is again brought to our notice by a case which was tricd recently in the criminal court. There physicians of good standing gave evidence directly opposed to one another, and, as would be expected, the defendant was able to secure excellent testimony in his case, we understand, for the fee of $4o.oo. The Crown in this case pays but $4.oo, which, of course, is a ridiculous amount when you consider the time and annoyance it is to a physician to have to wait around all day at the beck and call of the Court. It is perfectly apparent to a medical man how conscientious, yet absolutely diverse views may be taken in the same case by two men, each equally qualified. It becomes usually a matter of interpretation of symptoms as stated to them, of a case which they never saw, by people entirely unskillcd and ignorant of the value or impor- tance to be attached to the different symptoms which they profess to remember or the conditions which they think existed. This being the case, it is no wonder that the con- scientiously opposing opinions of physicians in giving evidence should not be received in the manner they deserve ; in fact, they become the subject of ridicule with the laity, and professional experts have become a by-word anong the people. It may be said it is a very easy matter to criticise, but it is a more difficult matter to suggest a remedy. We think that the remedy is so simple that we cannot conceive vly it lias not been applied before. Medical expert testimony of a scien- tiflc character should not be at the beck and cal of every prosecuting attorney or of the defence ; it should take the position it deserves to take. The man of science should not be the servant of cither side ; he should be the judge of scientific facts, and of evidence put in in support of such facts. It is only by occupying this- the judicial,the only correct position for the man of science to occupy- that his talents and training are of most service to the public and the law. We would, therefore, suggest as an immediate and easily applied remedy for this class of testimony. that experts should be adjuncts of the Bench ; that the man to select the knowledge required should be the judge without influence or direc- tion from any source. If this be",
         "DOMINION MEDICAL MONTHLY. donc, and physicians cease to be the servants of contencling parties in the Courts, it will be but a brief period until %we are entirely rid of the odium which professional expert testimony has brought upon us. ANTITOXINE. Antitoxin or Antitoxine.-The British Mledical Journal, in speaking lately of this word, points out that the niame vas originally copyrighted by the proprietor of one of the new coal- tar compounds,which is used, it is said, with much success as an antipyretic, having no depressing action on the heart. As the British MedicalJour- nal says, it is a question whether the copyright will be able to hold its own against usage, as the term antitoxine is generally applied to the serum for diphtheria, tetanus, etc. It is a ques- tion how far cither of the names are pathologically correct. However, judges are not pathologists, so it maay easily be decided which will win. HEALTH NUMBER. We are sure that the profession will appreciate the space we have given this month to the reports of the Board of Health, as it places the many physicians in town and country, who are frequently consulted in regard to this question, en rappori with the pres- ent work of the Board. Our thanks for the reports in the present issue are due to one of the members of our staff, Dr. J. J. Cassidy, member and ex- chairman of the Provincial Board of Health. Book Notices. White's Materia iMeZdica. Edited by WILCOX SECORZD. Amc-rican edi- tion, $3, Philadelphia * P. Blakis- ton, Son \u0026 Co. This work is one of those which naturally become a sort of con panion to the physicia-n, being of such a size, compact, condensed yet authoritative, that it becomes invaluable for ready reference. Those who have had the first edition are aware of its merits, those vho have not should lose no time in becoming acquainted with them. Ortiopedic Surgery for Students and Practitioners. Illustrated with two hundred a.nd eighty-five woodcuts. Philadelphia: Lea, Bros., \u0026 Co. This is, indeed, all that it claims to be, and vhile the art of illustrating has advanced greatly in recent years, we cannot say that the illustrations excel the clearness and lucidity of the text. As the most recent and thorough exposition of surgical sci- ence in the treatment of deformities, this book should be in the hands of every practitioner. Directions for Laboratory Work in Bacteriology. By FRED. NovEY. Ann Arbor, Mich.: Geo. Water. The science of Bacteriology has been so simplified as regards the almost mechanical manipulation, that it should be almost a hobby for every physician to -iest him by ·change of occupation. Some of Koch's greatest work was done as a country doctor, and certainly in all such mat- ters as examination of sputurn, etc., etc., we should hardly expect to see",
         "DOMINION MEDICAL MONTHLY. to-day the physician who should re- quire assistance. To all who are do- ing any kind of vork Dr. Novev's book will be of great assistance. Text-Book of Nornmal Histology. By GiEo. A. PIERSOL, M.D., Professor of Anatony in the University of Pennsylvania. Philadelphia: J. 13. Lippincott Company. The second edition of this valuable work excels the first in wcalth of illustration, which, of course, is to be expected in such an exhaustive work on histology. This work, cither in the hands of the student or practi- tioner, vili be found invaluable in giv- ing that thorough grounding,in normal conditions of tissue, without which all pathological teaching is wasted. Obstetric Surgery. By EGBERT H. GRANDIN, M.D., Obstetic Surgeon to the New York Maternity Hospi- tal, Gynoccologist to the French Hospital, etc.; and GEORGE W. JARMAN, M.D., Obstetric Surgeon to the New York Maternity Hospi- tal, Gynæcologist to the Cancer Hospital, etc.; with eighty-five illus- trations in the text, and fifteen full- page photographic plates. Royal Octavo, 220 pages. Extra cloth, $2 50 net. Philadelphia: The F. A. Davis Co., publishers, 1914 and 19.16 Cherry Street. This work is one which should be in the handsofeverypractitioner. Allthe operations are well illustrated, and the descriptions clear, terse and accurate. Much has been done also to simplify and perfect the technique. Fortu- nately the occasion for serious opera. tions in obstetric practice seldom arises, but when it does the want of a \" friend in need \" such as this volume would be, is seriously, perhaps irre- mediably felt. S.u'gical Patholog' and Therapeutics. 3yJOiN COLLINS WARREiN, M.D., Professor of Surgery in Harvard University. Illustrated. Philadel- phia: W. B. Saunders. It is more than a plcasure to re- view such a splendid work as this latest production from the press of a publisher, who lias alr-ady donc so much for medicine, as V. B. Saunders. This work typographically could not be excelled, and as for the subject matter, the name of the author is suf- ficient to guarantee us the thorough and masterly exposition of the sub- ject which we find within its pages. Nothing could be lner than the care- ful and accurate manner in which the various processes of disintegration and repair are explained and illus- trated. From thoroughly scientific premises the deductions as to thera- peutics scem to follow as naturally as day docs night. We cannot too strongly urge every physician wishing to thoroughly acquaint himself vith the modern basis and practice of sur- gery to possess himself of this volume. Other vorks from this publisher vill be reviewed in the next issue. NEW ANTITOXINE TREATMENT OF DI1HTHERIA.-(Editorial in Brt- isiz iVedical foirnal, 1894, ii., 77L-) We continue to receive reports from correspondents in various parts of this country of the employment of the antitoxine serum in the treatment of diphtheria. In a very large pro- portion of cases complete success has happily attended the method. Dr. Watkin Hughes, for instance, reports that during the present severe cpi- demic of diphtheria at Barnham Broom, Norfolk, he has attended forty cases ; of the first thirty treated by",
         "DOMINION MEDICAL MONTHLY. ordinary nethods, ten died ; in the ncxt folloving ten cases, vhich were very severe, the scrum treatnent vas used, and every patient recovered after a single injection. To obtain the bcst resuits, experience already accumulated proves that the treat- ment must be adoptcd at an early stage of the disease ; but at the pres- cnt tiie, unfortunately, there is con- .siderablc difficulty in obtaining a sufficient supply of scrurn. In France its preparation on a large scale lias been un'dertaken by the Pasteur Insti- tute, and it is hoped that in a couple of months' time the supply will be sufficient for the needs of France. The British Institute of Preventive Medicine expects shortly to be in a position to supply a considerable quantity. The treatment, hovever, is rapidly passing out of the experi- mental stage, and in the case of a disease so murderous as dipltheria, which produces annually so fearful a mortality, especially among children, the public may well look to the State to take steps to secure a constant and adecquate supply of the remedy at a reasonable cost. Prof. Behring, in an address before the German Natural- ists' Society at Vienna, stated that in Germany and Austria alone the mor- tality fromn diphtheria might be esti- mated to be about 2,ooo,ooo in every ten years. The serum treatment would reduce this high mortality, amounting to over fifty per cent. of the persons attacked, to ten per cent., and, if enployed in the early stage, to five per cent. \"In other words,\" he added, \" about i,5oo,oo lives may be saved every ten years, but, of course the serum must be obtainable in large quantities. This is not now the case, and will not be the case until the State takes the matter in hand and prcpares it at the public cost.\" The mode in vhich the seruni is obtaincd at the Pasteur Ins'titute is as follows : The animals wh, h arc to furnish the antitoxic scrum are ren- dcred immune by the injection, under ccrtain precautions, of the toxine of diphtheria. This toxine is formed vhen the virulent bacillus is grown in broth, and in practice the rate at which it is produced is increased by drawing a current of air through the culture liquid. After three or four weeks the culture is sufficiently rich in toxine to be used. The animais employed arte horses in good health and previously tested by the injection of mallcin, to prove that they are frce fron glanders. The culture, filtercd through a porcelain filter, yields a clear liquid, with which the horse is inoculated by injection under the skin. Gradually, by repeated injec- tions over a period of two or three months, the horse is brought into a condition in which its serum possesses very high antitoxic properties. The animal does not suffer in health at all, or only to a very slight degree. The efficacy of its scrum having been ascertained by a test experiment on a guinea-pig, the animal is bled. It suffers little from this operation, and it is possible, if necessary, to bleed it again in two or three weeks, but it is advisable in the interval to strengthen its immunity by some further injec- tions of the toxine. The animais used are cab horses, sound in constitution, but broken down in limb, who, after inoculation, live a life of case and luxury, varied by a periodical phle- otomy such as our grandfathers sub- mitted to voluntarily two or three times a year."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA LANCET. Wrr..JaXr EDWARD 30WXAN, E.D., EDITR, 0. 10. MONTREAI, DECEMBER 15, 1863. VoL. 1. FEW REMARIm ON VACCINATION .%,;D ja cow upon the skin of a Christian.\" in this city, RE-VACCINATION. Inotwithstanding the polineman's alam bell, no- tices in the newspapers, occuaional promptings Br Wa i. W II-4n. 31. . . .s E. fron the pulpit, and large posters in certain locali, ra.erof tA\u003c L,.ht .l'emy. £c. he. ,. ., tie. indicating oflices for vaccination purpose, Ird ir frm,/ only about 400 have availed thenselves cf the ser. Oa the 1Ith May, 186I, an actwasnasented to by vices of the public vaccinatora during the pat two a Estellency the Governur General To provid years; and of these, the greater number were vac- the tore general adoption of the piractice if cinated when the act, through the ageuef of the ceination.- That act provides that no publie City Council, first obtained partial publicity. ne should be paid tu any Hospital, unless it liad Wer ail the rest attended to by private practi- small-por % ardl; that the City Cotncils ofQiebtec, tioners there would ie no occasion te fine! faulti; Rivera, St. Hyacinthe, Montreal, Ottawa, but it is not so: there are many families whose ton, Toronto, Hamilton, Londun, and Sher- children never bave been, and without sone atrin- e should cuntract with legally qualified gent compuls'ry law, never will be noculated cal pracîtiners for tht vaccination of ail with the vaccine virus. Yet small-pox is, par who might comle to them : and that cot- ercelcae, a -anadian disease. It i ratrely ab unt ient places be appointed in cch ward for fron thiis city, and neyer absent fron the cout.ry. purpuse. IHy thiat law, parents are bounti to in every town and village throughout the province their children to he vacci.uated within three numerous traces of ia former presence are visible. udar months after their b.irth; to exhibit then if we visit the French Canadian districts re fnd the medical practitioner on the eighth day after familv after family \"tspotted\" with it; and manty ination; . id to obtain front him a certificate a mother will tell us she bas to deplore the oss of saccessful vaccination. lut if tih. child la a loved one, by a disease which added to the usual unfit for vaccination, a certificate te that borrors of death, the swollen distorted features Ct is tu be given, and every succeeding two that forbid the last embrace-nay even the last said it tie child is to lie takten to the medical look of recognition. In those districts wheresmali- titioner, until vaccinated, or found insuscep- pox ia most irevalent, vaccination la unknown; le of vaccine diseae. Parents who do not com- and I at assured by professional gentlemen of with the requirements of this art, are liable, the higLest respectability in country districts, conviction, to a penalty not exceeding tive il is useless to attempt to convince many of ; and n' 4uch plea of con.iction shotild be the hunbler classes that 'here is any conserva- ticient def, nee against any complamîît which tire intiuenc- in the practice. Many regard sma i afterwarl be bruuglt against the parent or pox ai one cf the necessary ills associated with ian for non-compliance with the provisiotns ut our existence. The child must get ils teeth, have act, respecting the same child. measles, scarlatina, hooping.cough, and amall-por. Stch is the substance of a law which is gootl so And sone go so far as te expose the child to the a I, gou; but whicl la defective in being too contagion of the latter when its bealth is good, ted, and too partial in ils scopte. It was the hoping therchby il Might run the gauntlet with four Provincial Parlianent tob has e followed greater comparative safet;. The untutored savages legislatures of other countries, and to have in this country fiy from It in terrer; and whe, a law tu rentier the practi.e of vaccinatiun nne i;a stricken with the disease (and it la suppobed Pulsory, not ouly in the larger cities, but to have iad more victims than the \"Idre-water,\" gbout the province. Such a laiw wotuld not introduced by the beneficent white man) ha drowns 'e been considvred inquisitorial, and 'rould have iimself-preferirng a resting place among the fisbe 4d persons of ail conditions, and of every ¡tu lying a bloated, putrid mass, with no one to it. As it la, the reidents of the larger citte , venture near him to moisten bis lips. lone henifited ; and sucb of tiem, only, as 'Tis strange a subject so deeply aftbeting the con- , of their own good pleasure, to sthî iii to the munity, shoulti not bave recelved attention earlier; uted invitations of the Irublic vaccinal .r. The and 'tis passing strange thiat when attention was at let towns, ai Braickville, Prescott, Pt rt Hope, length directed, a bill of the nature described-€o tvIle, Cobourg, \u0026c., and ail the nuric.,ins villa, partial in its score and action-ehould have been aornpovided with public vaccinators; whie in foistei to lead persons to repose in fancied secu- at. districts, physicians in private hpractice, to rity, believing something haid been done to ward off left the duty of vaccinating, are rarely- this loatisone malady. I cannot say what the suc- .1sosie places in Eastern Canada, ai least-are cess bas been in the other cities and towns men- applied te for that purpose. The mass of the tioned in the act, but in this city we have not an la intened to be benefited by ibis law are not entirely vaccinated population. Within the pais with the necessity for, or the usefulness few weeks, smalt-po bas carried off large numbers intiuon--na, many bave a deep rooted pre- in the west end and in the east end of the suburbe; against the practice of \" ptatting a scab fronm and here and there throughout the city it bas marked",
         "74 CANADA LANCET. or appropriated its victims. It is not my desirt- to shows \"the degree of success which attended tih censure our City Couacil with the imperfect manner eperation in 1000 cases lu each of four diffetet in which the duty conefded toit bas been di\u0026charged ; categories, together with the general result upen but I may observe, that, as the Conncil bas taken all the men vaccinated.\" upon itself the duty-not commanded but permit. ted--of enforcing the law, that duty should he I'-.la .î erar.,t o porn.'N er the Jrnris .n performed fully and entirely, or not at ait. The partia\" success obtained by the public vaccinators, à (Doctors Leprobon, Canpbell, and Ricard,) is due entirely to their own teal. These gentlemen ave, in most instances, sougt out those Who were not - vaccinated, and carried the lym¡sh to them. Il can- - not be expected, however, that for the toiserably 3à small fee of 2S cents, medical gentlemen slould leave their other occupatio.,q to uavel far in qiuest - afdthose who should be forced to go le then. Greater publicity is wanted; and etepl-e should be ' made to understand that there is a law to compel ~ vacciuation ; and that lbw should make examples 1..I..r- A per1.t ut those who endanger the lires of their own chil- vacine pu. dren and those of others by a non-compliance not 4 a 1..t1tt*d. with iL. apu Throeghoet the whole of Europe the p:actice of' tnt. a i 17 q.e9 8.44167.193. vaccination bas long been genertl. le France, Aeuit.. . dj. in*as $ sa sta Prussia, Bavara, Wirtemberg, Dennark, tc., whcer . a longer or shorter residence permitted me tu be- Total.' 1 0loit l0m 1't. Ne conte familiar with the sanitary laws of these * * -1t-\"\" countries, the practice is general among civilians, j 1 n- and compulsory among the military ; and nut eu. ot; 3R. t 427.61 M.64 ir only one, but repeated vaccinations. Nor bas !tecit.1686 A moditl. the British Government, though distel 'hing any- Afaluram in thing seemingly inquisitorial, been tees rigid tnthe t accine do. the.85ap.t320.425 BoasU enfbrcement of se good * law : and in a number of, the Times for October, Fe read of an inquest on the Total., lt¶ 1000 luofl le0en U bod of a child dead of snall-piox, whers the Jury - - - rendered a verdict atotnting to manslaughter i I.'e.t .r Reremuant r in the Artifi Miléis. against the parents, for neglecting tu have the chii - àci vaccinated. *db in the neighboring States the practice la general,. and every precaution le takien that prudence can 1 g suggest to prevent the occurrence. or tu limit the e S - ravages of the disease. Sotit uf these, however, . 2 seem to be rather the hurried promptings uf fear, Renite. c than of vlsdm. I . But wei1 founded doubta are entertained by phy- sicans and others, concerning \"e coattinaae of the - 2 protecting influence of vaccinu.,on. The scar upon 2 the arm produced by the vaccine virus is not now -- -- -- - regarded as a guarantee pour toujours against the i r r occurrence of the more unsightly emall-pox scars laccne pus. upon the cbeek. .How much oever we may le dis- 1 tule. 0327. M.. t;12.12 4r.F6 s to land the discovery of Jenner (and certain- nut LM A modled t other of the present, or the past centures can luïi,. \" 10.32844g 1.94g gas s be compared with it ie importance,) cases or small- I I A failure In por occnrig after zur.cessful vaccination are tou ; ecrut .accine do. 4O1f 4ya%.99 1.94 9 35 4W frequent, to P.. us to doubt there is a linit ti . | Total. lil'It the duration of that proteeting influence. On the' '-.-------- - - . ontinent of Burope, tIis limitation was recognized' A PermIet ad acted 'apoe upwards of twenty years ago., l \" p liu.29.004 6\u0026.08 FifPeen years aftervards, the subject was forced Itecruit, 43A nodifed upon the attention of the British Army Medical ractine da.21228969174.11105. department, when in 1858, a number of cases of j aftdi .t8 . n emall-pox baving occrred le the armey, particularly a - linidia, among person:3 who had been previously Tota . 00 Iwo 10 1 vaccinated, a departmental order was IssuedI \"ttat ; . .. . ln future, every recruit sbould, on jolning bis regi- h ment be vaccinated, even if he shot id be fuend to . W hat is remarkable in the lforegoing t bave marks of -mall-pox or of previeous vaccina-, the fact that previous haccination -r ete tion.0 A number of soldiers \" in whom the marks: atmal-po, seems to have h h-t little in a of vaccination were not deemed satisfactory e dete ining th general results ; and ! beg vaccinated and lte resutse vert kttsepaorate fo direct attention specially to that fact 4 those of U;. recraits\"; and the following table rect a very general but a very erronous b shared la by many pbysicians-that te",
         "CANADA LANCET. 75 (sAfter one or two trials) to suceessfully inoculate, ; a single instance of varioloid. In the Prussian witb the vaccine virus. adults who bail prel iolty I army previous t the adoption of re-vaccination been vaccinated, is a certain index that the sstem there ere (taking te average of ten yers,) 104 is stili saturated h, and uinder the protecting ii- a'il deaths hy small-pox ; now the annual deaths agence of the lympih introduced, it may bave been, for the re-vaccinated ar ny is 2! As.1 analysing usany years before. This is a g-ave 'error which the 4U fatal cases of small-pox which, during the manyv persons have had cause to reg-et thev hail ever last 20 years have occurreil in the Prusqian army, etiertained. Tit returns furnished by the Wirtem. *Says Mr. Simon un the authority of Professor Heim, herg army are -A r\"ng'y confirmatory oIf what 1 uow e fiitd that only four of the number were persons whi (it is said) bad been successfully re-veccin- st lt t rR.-r. ..,.-town a, rt. Vrrfm-.tr a ted.\" During thelpast 20 years, the period dur- mng which re-vacciration has been compulsory in z -a.- the Ilavarian army, not one death nor even a case ltotcZ w _àg of unmodified small-pox bas occurred in that body à 9 of nearly ttty thousand men1 Denmark ba, dur- imneretn e in the sarne period, presented a like immunity; - taough like her sister kingiom she bas been ex. S- posed to simall-pox contagion during several epi- natin --- h- âdemies. * -9 ,i : -.m i cannot permit myself to encroach at greater length on the coluins of the Journal; and more- ierft a.în.06 2M *-.3 I1p j over, sufficient bas been written to render it at 1 least desirable, that some law shotitld be enacted, M.:-A it. ti 2.' . and when enacted, enforced, for the universal prac- Nue \u002b 2 46tn.l 4ut.6 4e 't tire uf vaccination, and the more general practice of re-vaccination. in the mean time i should suggest .......that the Cou.ncils in the different citieq mentioned Mr. Smon, speaking of the above fignres, say in the Act, give greater publicity Io, and enforce Ilt is evidently impossible to argue that all whbo the observance of the law as il is, until we on revaccination \u003eieIded perfect vaccine vesicles I possess a law as il should be; and that the public veild, un ordinary expnsure to small-pox infctiou, I vaccinators be inviteni to re-vaccinate the aduit have becone infected with small-pox . for \"ino- p..puiation, and be compensated therefor, as for culation of lymph, whether racciue or variolois, I priniary vaccination. And might we not secure the is, so ta itek, a foner and more delicate test of co-operation of the many thousand vo,3\u0026uateers and sesceptibility to the snall-pox poison than is the militiamen throughout the Province by inviting breatbingof an infected atmosphere. On the other them to imitate the practice now followed by tbeir haud, there could be little reason to dotbt that i brethren in voluntary service in Great Britain, and they would live Sbeen distinctively the endangered; in conpulsory service on the continent of Europe, ran. Not that ail or nearly all of them voulid and sibmit to be re-vaccinated. The example, ai- have suffered, but sitat, fron among them, more, tentied with but little inconvenience, and, where tihan froin among other vaccinatedt persons, the oc- public var cinators are ta 1w ijund, no expense, easional sufferers by small-pox vould have come.': would have many imitators in those who woul-1not The statistics of other continental States are not, fail tu perceive the comparative immunity from les confirmatory-. i regret I an not posresed of semall-pox which the practice would bave afTorded. ligres relating to the army of that country--ever Thi, nu loubt, will already have suggested itself forenost in all thait science can elucidate or huma- to, nany tif those who peruse the .statisties fur- aityprompt,-Frantce; butvw ithhefollowing, taken nishei in this bastily writteu paper. To my own frels the statistical report tif the. British army, suf- 1 mind the sibject bas been suggested, most pain- Scient will be obtained. fully, by observing, in the bed room of an able bodied young nan dying of smail-pox, a sus- pended bayonet and cartucihe box, whose owner, ks.Ts m1 1000 it vaccixAraoNe. by a little timely and trifling ate, mnight bave bteen ,. -sp.red ta bis country. To my professional bret- ren thiroughout the Province, I should urgently o -j r t Mun ods. uqi ar recomnend the duty tas i clearly conceive it s a o suefn. isuce. i duty), of apprising the non-vaccinated among their patients, of the danger of the neglect; and the -'vaccinatei, that the scar upon the ar is a gua- twutan. «3u-Os 2S1 42 4.A.3 s13.0 a rautee of immunity from small-pox, which bas itsa 1 1limit in duration. Not tiat we may ever hope to u......... 43 . witness the entire disappearance of this loathsome Bitih Rferuit. .M gs sa.1 Mo.9 « tialady-but reasonably to expect to limit, at least, 0.2 M . 3 4 and to deprive of its virulence, a disease which is r 3 | . . 411.5 frightfully common amongst us. - -'- ----. .- Montreal, 9th Dec., 1863. Professor Helm states that lin Wirtemblrg, dur- - - - - . lit the fire years, 1833-7, though small-pox lnfec. tion bad betn sieteen times imported into different Dr. Strsk in the .dreaiv der Heilknatde, states tbat regiients of the army, there bacd ensued among, bhe has noticed th . the heart becomes enlarged l the 14,384 revacciuated soldiers, only - in tbe some csses of chlorosîs, diminishing again on Te- plo1t of one whose Te-vaccination, two year' covery, and cls the atention of the professiun to dre, bad been followed by \"tmodified success,\"- the subject.",
         "'l6 CANADA LANCET. Two deaths bave occurred from chlorofram * onte from the wrant of a stimulant before its admin. - -- - - .- - istration, and although we do not know the cai MONTREAL, DECEMBER 15, 1803. of the other, for we were not prestent, we have ai. - -- - - -~-.~. - . certained that, s with the first, electrid ; has nsl Of all the public charities of the civilized wrld be-en ava'lat,le for resitsctatiton until ton late to b, h of any service. Thr spine case which bade so fair Sbore are probably none in whitici, icu 1î.tIKrtstssi 0far an excellent a.aification was allowed to bremne the number of operations performed, more cases of disl.aced, and the pour man thereby robbed af bis bad surgery are se constantly occurring as is only chance of re.cavery. what la termed the General Hospital in titis city; It will Ie nuticed that vae hiave bren eye sit. and we may safely add, no place on the gilobe ta here ns oan many a .o thise mi..forstune, al thosgh ls thee blunders would be se long and sto patiently n a, sa r fqiw t for ndow on thit osphit tolerated without murmuring, au they are in non- orurred in our abitence, and we are afraid that treal. And whilst we perfectly agree with every these surgeonq will nit enlighten usi in this matuer good citizen that tiis institution, on ti. wihole, Is it k; but a week or two sinct. we were informed ofa a grat blessing to the commuity, and that , case ..f leath front ovariotnny ; we dc not know 1 but thait tih operation was weil performed, but ve a\u0026ire are admirably conducted by its governors bave bren refus.eî the not.s .,f the case un the pi-\u0026 and lis committees of management, we- must reiner- that the suargein diai nul desire t., have It notired. tantly add--in ail but one thing-the u' iî t wis am fipe men ahpuüntsm enlt apptuiu. and control of its attending physicians ansi sur- for lîis théy are %b incompeteut? Wiû 1 l haue ve viiiife.aa4i that ttry art- prof.*asioro anti ch. i nccl trachî'rs in Mflill Cifltege, or apirants t. We will net give our opinion cuncerni- the ile honotr,.. 'e tierefure ral upen the leaders et practice of medicine within its walls, net that we ibis institution for soute new mie 1-y whicb tc \u003e bave net noticed many erreras, but tbat it would mone these blighit ispon ils faues or st Ivaat toadeç be useless te stalt cases where our diagnosis couldtame enetic course Io privent sncb men froc diagneais ever again ili'agrcing itliklu.ooperatieus. Jstuin possibly b called into question : in surgery, how- demands tie alpeal, altlsough past erlarience lus ever It la different, for carelessness li I ia tou palpa- sbown that it wiii be useless. ble to be denied; we will therefore enumerate some But we have ater mes ofcltcking itis sacriki of these. o human lif,-thrs' uutragpa un eut posr. M First then la the lois of lifte from bluriiering iu!lltital lis a public Institution, reiviug essai eases of lithotony: in one, the artery of the bulb grania frent government, ant liberal contriit wa divided, and the patient allowed te die from front eut cititros, nay more, ta sîf a trie ad hbmorrhage; in another, the bladder was entered noble girl te us fren men witse nanes cm nase tbrough the trigone, the prostate renaining un- Ie furgotten. We bave therefare a nigit te ib toued, and death took place from ir filtration of u eue sick poor vien w. senti te it frr pre urine ; in a third, after a long and unstuccessful lionacce shouit have the beat of nedical at\" attempt te reach the staff, the unskilfui surgeon 'nce. .tie g to of tîete andioe!th moSt wisely repented, and handed the knife into publi weUkre', it behooves us fu etquire luto lb abler hands te complete the section. We wer pre -ause» cf attela accidenta, and tit beat mode cf p\u003e smnt at the second mentioned, and at the autopsy. enting ttc. for tit future. We bave also witnesaed lately sote very bati oper- Let tit gevercers rimedy, tien, the fiat ad ations for cataract. lu one, the iris was cut ino grextet error-ofplacing ibis ispitai se comp» with the knife, and the eye hopelessly ruined ; in îy, crin te te very secreoaryaiip, mb the ba s another, the vitreous humour was allowed te escape midical men su cloaely bond together by with the lens, and the patient rendered blind fur com un interest aud se incapable cf manaa life. We bave been present too when the whole even hem eau affaira-by itening ne longer b eye bas been abstracted unneceasarily, as w their recemmendation for tit nomination of Ysa thought, and without benetit te the patient. wu physicians la preference t eider and mort \u0026 have witnessed a caae of fracture of the femur perienced cnes, viilat se many cf the latter 0 which was alloved to ossify with much sbortening, bath ready and wiliing te accept tiese appcl* and which was refractured by an elder practitioner menu, and te give tieir truly valuable servies to save the credit of the hospital, but unfortunately gratuitousiy te te pour. And let theselect this excellent man has net always been at band to be indeîendent men, vit by heu presence SD sh\"ud its doings, for two of its cases bave lately art as a kind cf cbeck on tit-e eles profes. been rectifed at the Hotal-Dieu: one, a fractured Let tie secritarysblp aise b. confidet te MMI tibia was straightened that hai been permitted te good ionest citizen, who wiii net b. intereated ls grow together in an angular position; the other, biding errera cf titis kind, but wl. wiii atW the case reportid on page 29 of this periodical, was every faciliîy fer fiee investigation inte if BU5 a factnred arm which had been allowed te go out We bave ourselves expurienced muci difficuli! I with a piece of deat boue pressing upon the blood- acquiring information on accont of the oecnml vusuls and nervis Of the part, to the great dis- being a metical man$ and connected vith Me comfort of the patient and discredit of this charity. University. Sot long asince, in au operation fbr the removai of a Let as employ ne ialf-vay meures in itis Wk amour from Scarpa's triangle, the femoral vein and ter, for, fron long indulgence, tiese profess CO\u0026 ether important vessels were divided, and the pa- aider titt they bave a rigit te control oui it4I sli d te deatit front the. careleaunes. tmrgetfa ict t hey are but as invieten ts ii",
         "CANADA LANCET. ,entitled to remain only so long as they perform gave the sensation of being scalding hot, la a their duty faithfully. Let a stract rude then be few days three angry looking ulcers formed where btablisheid that every surgeon wha destroys life the iodine hal been appplied; the lburning how- tbrough ignorance of anat'omy, or by culpabiale ne- ever still continued, and every thing, even ice gligence, be sumnarily dismied. For no excuse itself, frt t hlim like niolten lead. Ail that inge- #hould he at-ceptrd fur operaiions thus badly per- nuity coiuld suiggest proved unavailing In relieve rnmed., for the rule.. of the hospital give theam un- this aymptom for upwards of three. weeks, when ai limited 1.rivih-ges in maikinag Ist-înrtem examina- mixture of chalk with lard was prer.cribed.! as an ton*, le whichi thvy aw a lissecting roaom in experiment ; thia acted in a most extraarlinaar,- thair c4illege ; Il-y houl therefure prepare them- tuanier 1.y conaspletely removing the pain in Ieit. airîs hy ,ttudy. if eiarrwisî. incuanipetenat or inex- thaan a houri it however returned sonewhat after a ,erieuc.-l, h..fore riskinig the lives of thteir felluw time. Tiis ointneat was continiued tl cicatriza- caestures. This rule aluute a ould bLe fnund tu pre- tion, which was unusually tedions. At each tine of duce an immediate and miarktai inapruvemevnt in the dressing, the feeling produced by the cool salivi. surgery o'f tIhe hospital. was deescribel by the patient as delightfual. And fanaliv let there be a, rule e-stabli-lhed here - I have been inormed by a brotber prartitioner m in Europe, that all ,atinsust be performel that in anotier similar ca.e, when the excessive oa certatin dayq of ti wvek. vxcept in ca.,e tif pain was in lthe intlegument of tlhe serotumi. every agent necessity, and tiait plhysieian4 gent-rally application proved usteless until the Part was le advised of dtai, andl invited tu attend and se. bathed with creain.-Editor. that these ioen do their duty. Tu Lavma Or TIS titTR-OrL PLas? As a GaLacTanunrg. Ai'uewt. LTEAmTI.aloiaTInt .ETtoLanY, PTuLotoy | lly 4'. Il. F Rarrs, M D.. M.RrI'.Et .t.r., Phys. ASt TastaruT or TIus t.O*osr.Ivat. MALtRMa- clan to, the anaanta Fv*a Ha.qaatal for Women anal voxs or Tai RncTra àau, Astim. By William1 Childrean. lodenhiamer, M.I With plate- Published by j The galactagogne properties of castor-oil leava 6. S. \u0026 W. Wool, New York, 1860. i were known tl the Spaniuards of Peru and Chili. The style of thit authlor is ennei.e and agreeable, tM. Frezier, engineer in ordinary ta the crenchl aud bis subject interesating ; lais wurk will well re- king, in lais narrative of a voyage te, those larts. pay perusal, although its iuamediate study may not , perfurmed during the yeaurs 172-i:-14, rupped be requirel. 1'ufurtuaately it belonags to hat clas | for some days at San Vincente, one of the Cape de ofbooks which a physician, having no cases of lthe Vende islands. In his description of that island. he kind to treai. feels indiiffernt in possessing. and qtates, thait ana«ng other Plants he saw there ti. ntarely willing te admit aï necessary. It shows Palma Christi or Rieins Ame'ricanu,., by the Spa- itelf forth however in bold relief as one of the l niards in Peru called Poterilla; and they affirm must important and useful, when he is called toi Ilat the leaf of it applied to the breasts of the operate on some unfortanate child thrown suddenly O nurses brings milk intu them, and applied tu the inhis charge. Glad of the oîpr**anity of examin- loins draws it away. ing its valuable pagee, ha will then agree wti us I The employient of Ca5tor-oil leavies as a guise- en Its extreme utility, and in conasidering that no' tagogue in this country, dates since 1850. lu a medical library cant ho called complete without il. Papier read before the lritish Associat:an, at Edin- Ih isa large octavo tof upwards of 400 pages, filled] burgh, in 185u, and afterwards publisbed in the vith beautiful lithograpaha and besides separate Lancet, D)r. alcilliana brouglht the elfects Of this Al distinct treatises on lte ditferent species of remedy before the pnfessiona. \" The leaves of this alformation and their treatment, c 'ttaining in plant in llunavista in the Cape de Verde Islanda, elucidation of the subject, tpwards of th:ee hain- are known as the isofareira, which is in reality the died cases, gathaered fron evecy reliable source, Iticin s Communi: of botanists, and occasionally dasified, and tabulated. lly these we find that of the letves of the Jatropha CuarcanQ, both belonging 156 on which operations have been performed, 87 te the natural order of Euphorbiacea. Two kinds 119e recovered : thid is encouraging, fer of 42 for are known in theso islands, the red and the while. iichl nothing hadl been doue, ail but twelve suc- They are both varieties of lthe Same plant, but the aanbed. Finally, fifty Pages are devoted to the re\u003cl is avoideal by the natives, the former being dIlrent modes of performing the operation for ab- saatt to be galactagogue in its properties, the latter dominal artificial anus, which are plainly illus- eminently emmenagogue. btted by the lithographs. Nor can we close with- In cases Of clildbirth, where the appearance of ut remarking that in. admring thtis handsome the milk ls delayed, a circumstance of not unfre- vinte we compliment its publishers; they too, quent occurrence in those islands, a decoction is dely deserve our praise. made by boiling well a handfiul of the white Bofa. reira in six or eight pints of spring water. The fn (..breasts are bathed with this decoction for fifteen or twenty minutes. Part uf the boiled leaves are Oajous Eymar or Trsomru or lonis.-A pa- then thin-.r nread over the breast, and allowed toi tient, an elderly man, having painted himself with remain unaL. ail moisture bas been removed front 0rng tincture of iodine, on the aide a little above them by evaporation, and probably in some anea- te hilp, for the relief of pain, soon afterwards ex- sure, by absorptioa. This operation of fomenting .Il9eced a severe burning in the part. A poul- with the decoction, and applying the leaves, is wIa s directed, which althongh it removed the repeated at short intervals until the milk flows retaar portion of the metalloid, rather aggravated upon Inaction by the child, which it usually does in Uin relievedl the distress. Cold. water, saturuine the course of a few hours. lactions, infusions with opium, and the varions On occasions where milk is required to be pro- 1of lnttents, net onlygile\u0026to alleviate. but duced in the breasts of women who have not given",
         "lis CANADA LANCET. birth to or .sickled a child for years, the mode of* Some patients complain while taking it ef treatment adopted la as foillows:-Two or three sensation in the eyes, not exactly amounting handibla of ihe leaves of the Ricinus are taken and pain, but accompanied with dimnesq of sight. treated as before. The decoction is ptured, while ,iu not think ibis ls due tu any peculiar efletv yet hullInî, into a large vessel, over which the the caîstter-t.il plant. i have onlv noticed it a wonsan riit, -n as to receive the vapour over ber uesak women ; and rather attribute it ii the fbrme thighs ani gesertivt. organs, clthls be.ing carefusllv flnw of the secre'inn, an effect eixactly analoge tucke.d ars,'l lier, os- as tio prevent the eêenpe ofI* to that which :s observed in nuîrse*s who tas the at.an. In this 1sstitioin sie rnasins.. f-r ten or suck led toob lon. when the child take.9 the laa twelvse minsutes, or until the deenction cutling a A secund is thai the dose afier a time reuirma little. she is enabled to hathe the parts with it, lie msich incrrase.1, as the renedy apprars te 1 whieb1i she dtes for fifteen or ses.ts.y isîuut-, mor. its effect. A temporary ssitpension, and the e The breasts are then similarly bathed, and gentIv stitution of another galactagogue, remedies t; rulbbed with the hand, s; and the leaves are after- - inconvenienrce. wards applied tu them in the manner already A third objection is the diffictalty in procaii describld. These several operations are repe.ated the leaves or -italks in lsiflicient qluantity. ltq three times during the first day : on the sec'ond day, iears that tliev are ssit iruportedci into the coaiý the woman has lier breasut bsurnsesl, the leaves ap- and all those that can be x tlainel are prodne, plied, and the rubibing repeated thret or four time-s. fromu botanical gardens. The larger number . 4in the third day, the sitting over the steami, sthe. plyed by nie came from that of lr. utile, t risbinag, and the application cof the leaves ton, with . Covent-Garden. Tihe importance of this remediies the tomentation of the brest.,, . ar .sgan had galactagugte, will dotibtless ore long cause itsi recourse to. A chilis la now puit tn the nipple portntion, tir grnwth in larger u¡uantities. und iu the majrity .f intances, it finals aalia- Tie last objection applies ta an occasiunal d dant supply of milk. la the event of milk not oh herved ter its administration. The rots being secreteud on the third day, the saime treatment' decuctioen were before said tu he diuretic. b is continued for another day; and If then there leaves in decoction are occasionally so alse. still be ...i if success, the cie is abandoned, as i have heard uf two examples. lu the one so birs the persun is suippossed nost to be susceptible tu the , i cuild hear, a large qluantity of water was dai influence of the Hofareirat. passed under ils intinence, and it ilid not appeas Wnnen with weli developed breast4 are musit *proIduce any increase of the secretion of milk. k easily affected by the litifareira; whi.n srnall and, tihis case, lowever, I am not aware if the breus ahrirelled, the plant is saisi to art more un the uter- were kept warm. if not, it is conceivabl.- thst. ine system, bringing on the menses, if their period I effect similar to that observei with diap be distant, or causing their immsoierate tiow, ifs should occuir. Thiese remedies, it ia known, their advent be near. 'not tact as sudorifics if the surface of the Dr. McWilliam gives the cases of three wumen in j kept cool, but as diuretics. If an analogou whoce breasts milk was inducei by the employnsent planation applies to galactagogues, it points of the Hofareira ; in ail nf which pregnancy al the importance of keeping the breasts very occurrel same years previosusly. when the decoction of castor-oil leaves is gives Dr. Tyler Snmith bas mail enmue experiments I ternally. Moreover, we are led to this mode siluon thie use of tiis plant. lie tried the effects of management by noting the mianner in hich the leaves in five cases, in ihree uf whicl it proved remedy is employed in Bonavista. Hot fo successful. In sue it produscesi a copious flow of' tions of the leaves are there always applied 1 the catamenia, in another leucorrhoea. From his to the mammary region. Where this diuretic experiments lie believes that the castor-oil leaves, is produced, it is well therefore to smearthe applied externally, bave distinct galactagogue 1 of the leaves over the breuat in the same effects. lie followed out in his experiments the as a belladonna extract la sometimes used, wi descriptions given and quoted above fram Dr. Wil- wars» ordinary poultice outside it, and this.coit liams' paper, but did not apply the siteam of the nation will probably fulfil all tise indications ld decoctiou to the generative organs ; nor does be treatment. in the second case, both the s appear to have given it internally. of the urine and the milk were much in I believe I am the ' ·t who bas used castor-oil and to snch an extent as to make it obligaterq leaves and stalks internally as a decoction in tiis the sake of the palient's strength to discontinsio country. I was led to do so from having frequently I am not aware, as both of these cases occurrmi observed that suckling women, after taking a dose the practice of others, whether bot fomenta of castor-csil, noticed that they secreted a larger were also applied ta the breasta. The breatsfl quantity of milk, a result which I certainly c-nnot rule should always be kept warm, when this entirely attribute to the removal of accumulated fie- dy is given; and when the diuretic efect il cal matters ; because I bave not seen the same fuli duced, not only kept warm with poultices, but effect from the use of other purgatives. Dr. Tyler smeared over with extract. Smith alludes to tiis effect having been noticed by When the castor-oil leaves are given as au others, although, he adds, it may do tiis by moder- sion to women who are not snckling, I bave ating febrile excitement. It occurred to me, there- servei two effects, both of which seem to fore, that in defective lactation, the exhibition of lis specific action. Firt, it produces internal castor-cil leaves and stalks in a decoction might in the breasts, which lasts for three or four produce, or more directly cause, a flow of milk. I Then a copious leucorrhoal discharge takes have now given the remedy iu several cases, and after which the effect on the breasta entirely I must say I bave not been disappointed. The pears. During the duration of the pain at flow bas been remarkably increased. A few objec- breast I make no doubt that, if a child had tions against its tise, however, shontld be men- applied, the saction would bave determid tioned. lactest secretion. This, however, is au",
         "CANADA LANCET. 79 t which I have never found a patient wil ling to t plied to the geat of injury, quietude and ice being sutait herself, and so have not beeni able to prove. the mnoat reliable agents for cure in such cases. If, 1 have \"ner yet observe.1 any very decided ac- lanwever, tle loqs of substar ce be extensive, as in usa of the leates as an emmenagogue. lI some*e aise of certain wounals inflirted I.V the explosion of .,tasen it sectms l pois4es scarcely any infdlence. Ishells, primry amp.utation shouiald be performed. The pieiaratito\u0026ns , thi-i drug which I have sead Agxiai, if the uillet pass com.letely tlhr.outgh the have been a strong dertaction or liqnor, ani an joint, cutting simply a groot.ve ona the articular sur- ertract, the- duoe of the former being fron one to ftres, withoutt cnmzminution or splintering, i be- Iwo drachms daily, in watter; of the latt.r ti'e lieve it te le nutr iuty tu try tu save thé limb; but .--Wurk on Infant Ferdini. if severe arthritis should sispservene, it will iltea be- conto nur diuty lti amputate without i la.y. la ail i.UX-$IIUT WOtUî»i OF TITE K.%EE-JtI\\T. case' of woundis in the neiglhburbood if lite kuce- . joint, assuciate*d vith conmainutiou and splintering Dr. Litiil, of Stantan iiluspital, Washington, in a of tse articular etdi of either dite femur or aite tibia, siemmunication to the Atrrician Aedical Times, amputation shnuld tie pierformed as sootn as the diag- gys:-it smetines ba.pa.ns abat a musket-Ahot ' nousi s maide ont. * ts the knee in such a way as tu open the' joitt to pter ur lent extenit, withuut breaking hine, antdv UENNET WINE te patiett gels Well wiit a god limls. I have Ien three cases of this kind, al of whicit terminated 'Y ly \".Iason..aE.. Dit...t. lvorably. But if the articulating end of cither A bout Iwo years sintc, failing ta obiain any te femur or the tiblia happens at thr sanae time te benefit fron the pesàine then asualily soli. 1 badt b. splintered by the huilet, tie natutre of the case. recourie tu the direct preparation of a solution of sentirely changed. The patient will net make a gastric juice from the cal's statuuah ; ant st grati- pod recovery. Soener or later the joint will swell fying has been th' restuit, so satisfactory andi re- q, and becume higlly inflamed ; great constitu- markable :*s etects a. a retsaedy in ga-stric derange- donal disturbance will alt be develnined, and the *:nents, that i wisi te communticate to the profession atient will iltimately lose his lire if thge limb be the mode of preparation which I have funtnd the ariemoved by timely amptation. most convenlent, and the best for every lurpose. Th mut dangerou cases, howevrr, are those Take the stomaich of a calf fresh from the butcher; berein the bullet entera the limi at a distance cut iff about three or four inches of the upper or (geater or less) from the joint, and without open- cardiac extremity, which, containing few glandular iaathecavityof thesynovial membrane, or p*rhaps* follicles, may he thrown away. Slit up the sto- uithouI even coming into relation villa ii, ;hatrtar atch lngiîtuaily : i¡-' it g..avly with a dry thebone in such a way that the fissures exatai ta nai k:tn, t.akiug caria lit r-'t,.e a4 lifti- of the clean the cartilage covering the articulating end uf the mucus as poaitile. Tien cut it itou stuali pieces, bNIe, or even ilato the synovial cavity itself if the the smaller the better, and ptit all lito a common \u003eiltering happenas ta be very great. Tite danger; wine bottle. FIl ui the bottle with good sherry, Cilse cases is much increased by their insidious and let it remain corked for tare weeks ; at the chaater. The patient may do well for eight days end o this tige il is lit fur use. or even two weeks after bu is woundei, and then Dose.-One teaspbo\u003cmtiful in a nineglassful of df a sudden be seized with great pain in the joint, water immediately ater meals. followed speedily by heat, lenderness, and natch '.est of Qulity.-One teaspoonful will solidify, sealling; ait the éarne lime le has constitutionai tn the consistency uf blanc-mange, in from on. àierbance in the shape of surgical fever andt great to tw:, minutes, a cup of nilk (say eight to ten niiensness. If the traumatic origin of this acute oinces), as, the temperaîture of 1000 Fahr. In tIis atritis happe.is to be overloaked, and if lite case actio on lie caseine of the milk, it may be said haput under treatment as if it had begun spun- that tie wine atone vould have some effect, but touly, the infiammation will exiend rapidly vine willot salidify milik, nur will it curdle it at fai the joint to the thigh, and in a short tinte ita- ail except at a nuch higher temperature, and in lvs il se extensively, that, if the surgeon shaill match larger proportion than the above. 'OW wish to remove the limb by amputation, he This preparation, wbich I propose to call \"llen- Mnot find healthy tissnes through whica to ope- i et Wine,\" has many advantages over the watery ateI; and before long the thigh will be converted ;infusion of rennet which is obtainei from the salted ton vaut absces communicating with the joint. and dried calf's stoanach (used largely in cheese are the se called cass of secondary inflam- mtaking). The latter la also a good preparatian, a of the Irnee-joint, and are certain te turn solidifying silk in the saie way white it remains badly if the limb be net amputated in season. 'fresh i but it is auch more troublesome in the mak- soon, therefore, as this forim of traumatic arthri- ing, and in warm weather it soon begins to react developes itself, its exeeeu' ngly dangeraus char- on the animal matters contained in it, and becomes should be recognized, and the limb caat off spoiled. For these reasons, it cannot convenaiently the inflammation bas had tiae te spread be used in medical practice. Renaet vine, on the tgl the thigh lu the Trin of diffuse cellulitis. contrary, la se easily amade, requiring no saltang or nll snc cases amputation must b performed drying of the stomacb, is sa inexpensive, and can yif it be expected lo save the patient, so readily be prescribed in private and in hospital With regard to the treatment of gun-shot injuries practice, that I have little doubt, when known, it gFerai e the knee-joint, I believe that in ail will become one of the mst vaineda remedial arti- of wounds of the soft parts alane, whether cles in the bands of the profssion. synovial sac be opened or not, au effort should I recommend the employment of goo sherry, ade te save the limb, provided the loss of sub- because this wine bas sufficient body ta keep the Il not great. For this pirpose the patient infusion perfectly sounad for any length of time, and lie Mtll in bed, and haveJet consanitly ap.- is not so strong in alcohol au.to suffer any.apparent",
         "80 CANADA LANCET. tasa of solvent power in taking up the active prin. Bid (8. Douamn)-On Austraisalan Climate. and tib ciple of the rennet Induence in the Preventh.n and Arrestof PulmonarCe cipleton #vu thvene.is l. 174. »,à. tid. (4gma#t., To the physiologist, it is unnecessary to say, that t.ardtiter ÇW. T.)-u-\u003cutlue is iourm fur Ra'ning In PhlbM this remnedy should be given after or during, not Dia nosns for th ise of Stimdeutu and icdkal Praa before, meals. A single doie, given daily after uUat*m. bvu. i. L (Teitpken.t dinner, I have found quite sufficient in the general or Women. -u.agtl\u003ei aisisof reiniany ; fDusa run of cases requiring il. How this small quantity on a courr of L.et.m \" delvemi t st. Mary*a MIo.M can act so speedily and eflectively it is, perhips, Medical Schoci vo.. Pp,. o, i, îLnarin.l not easy to explain, when we consider the .a srgo u n itiislAi- T.,sa aft D. 3ed Soril. aldcietil . 'a' (u.,i. 411.lis ;'burcb\u0026l dupply of the gastric secretion necessary for the liilt.l, (uhnantheth s lil.îrneeuf utNerlmanicai and lopsi thorough digestion of an ordinary meal. The Iloicalifrest in th. Trateiaent of Acridentsa iad Sursa alla the ilu.is: V7lu.. Ur l'ai,: a Vowiel action is, propably due to thuse indirect chemical; Letur deli\"rai th- ltas of raetors changes, called catalytic transformations, which j Enlant in àln. ladi alld lotl. avo.. lp. sNXI. lt. idI, some organic substances, by their mere presence Ilo: i Ilarnard, an t initate Tr-am e-nt of Stnetou oft Ilul lVrrthra by thit, ofas.yumî . the \" Stites and contact, induce in each other and in other InIatur.u aa t.Si.. :qa let. ,%K. h sltriritill.) proximate principlei; und thuis, perhaps, the con- Layroek (Thouas)--The- *riripI, snd M,-thuda ,fm version of a stall portion of food into healthy 1rat (hservatiu and li.a.arnh. far the u t ot Ad albuminose by this small quantity of sound gastric t s and Jardua rlactit. naa a pdit. with . ,tace, may induce the same healthy action through- simpkin.) out the somach contents during the entire piroces.s Save W. t;.) ou Lieand fleath: Feur Lcturedel of stomach digestion. It la at least equally difli- A t aith Af nir.1 hy i al Ial caP' cuit to explain the action and rapid exteusion of Winslow (FUrhiass-0iberare I*sImaeas of the Brala ferments generally, in their appropriate sulutions. Mind. srsi edit.. r-viad. Pst ivo.. pp. M. losl. I have often been forcibly struck by the magical gHardwicke.î effect of this small dose in removi. _ offensive odor fron the breath of young persons,- distressing Peina eceived since l Novenber. symptom, sometimes aggravated rather than re- to *at. 2. Arn. M Tiaia . istoa hieved by purgative niedicine; and I may also men- aad Surg. Journal to ac. in. Philadelphia MIed. and tion, that in one of these cases cod-liver oil was porter tNv. . l'hiladelphia nta Ca easily tolerated afterwards, thougi never before. Joural Nov. ala Su7F. Jns n ai Lbv .D It would be a mistake, however, to suppose that don Chemist and Druggiat. Nov. Am. Dn 'ts, the oi is at aIl acted on by the gastric fluid. The Dec. Londun ublshera*Circular to Nov. 15. oit globules of coagulated milk are seen, under the Books and Pampdets reived durirg the Mouh, microscope, unchanged, tbough imbedded in the l e suliditied caseine; and the digestion of il, taking he W. Atca ai M. n :iral aliaa du li.h place only after passing the orifices of the pancrea- il\u0026 sons .8a6. From the piubliulierx. tic and biliary ducts, is entirely intestinal; but The Dioseasels. Injuries, and Nlalrirmations nf the ' intestinal digestion itselfmust surely be influenced a hd An, kswitremarka on abiti a \"si.tiimation. J. Aho.FIXVý 4h a.ditaoaa. 8vo., lep,. 411. Ch essentially by the healthy preparatory action of the a sons. 5da. -o¾m the publisherh. stomach secretion on the albuminous compounds Astlima, it tathology and Tratment. , ByH. H. presented to il, and thus the digestion of cils and 3\"a)- r P.sllato Uharlai:har fat te. nd «týerenPksloo andl [àatlioloy t fatty matters, though not even commenced in the cal school. avo.. pp. a72. Clurill A su5-., Sa). stomach, may be facilitated by their being mingled the author. with the products of healthy gastric action, when A Treatise on the Patholoy of the Uri... incu submitted tn the succeeding operations of the pan- c. l. gao t .shail. . L.om. Thud cres and liver. Medicdl Times. Prom, Braithoaite. Manual of Opht\"Imoscoto Sur5ry. Hy Jabs Il senior Asst. Surgeon to the Royal Westminat. r p Hompital. $rd editio, vo., pp. 296. Churchili A ILO dofsg0ttam. k1863. From the pub ra. doventh Annual Report oftheb United Lunatlo Diets.'ed Waters.-Peppermint and other waters, ai- of Nottingna Re. though retaining this niame, a rarely ditilled. They arm Some valuable pamphlets from »r. T. Skinner of made up eatemporaneoouly by rubbing one drop of the Pool, on Choloroform in Midwifery; on Fistula and iti sential 0il with a few grains of carbonate of magnesia, lotir. therapouio Treatment; and on the Granulation of rires in gratiualmy an ounceof water, and filtering. lnpres- _ _ _ _ criptk as containing any other powder, the oit ia trituratied w ath h. a the mixture made up without the necessity of Subsoriptions paid sine lth November. previo n itration. To purl/g Lard.-To every eight pounds of lard, add an Dr. W. IL Brouse, Dr. Eaaton, and Dr. W. J. Joues, ounce of powdered alum, and a tabf-spoonfil of common Preseott; Dr. I. A. Uordon. and Mesrs. A. . - alt,. Melt itin a water bath, stirring it frequently, until et of Bckville: Dr. J. A. Macdonald and Lr. Tho.:l the beat of the boiling water, when lt must beskimmed and Kingstn Dr. (à. J. Pottis, Omemee; Tho$. Carre, X allowed t cool. Neu turn it out of the vessel, crape off Stratroy; Dr. A. . Walter PIttsburgh, Penn.; Dr. It the sedimeut, and waa, and work throughty in a runnuing P. Spencer. Watertwn, N. '.; Dr. A McDonald, D. atream of water. Gauthier, Dr. Dagenais, and A. G. avidon. Esq.a .-The Montreal Couerai Hospital containsat present Montreal: Dr. C. IL Boynton, Wells iver, VI.; Dr eight-y-two occupied bds. Beeker, Belnmre. ud Aragnessa-.Addthree unnds of carbonate oft * - - - - -- no si to en gallonsof water, ore putti it into a soaDEAT. eJlier. and pump in the mai quantity ogas employed lu tâda eit. on the 4th inat., Alexander William Arg I maktue snda water. and you wili have tan gallons of he ie, M.D., aged M years and aix montha. ns salturatd Iufid magneis:, the directions for which Dr. elii was oue of he few anadians who did wi be the ame as hose for Murraiy's. in the Crimean war, s Assistant Surgeon li Her ra o publie in Great a' from the - -- -th 10111 tuetu, 1863. nrir their The Canada Lanceot la publishei monthly ae thee biOfpage, pn ' aai, u and pnes one dollar, (or four shilling sterling) per annum. e ha *uoel*a. tances may be made to . E. Bowman, M.D., Editr Beale (Licnel S.)-Urine, rl,7 tandCalel, Proprietor, or to Mr. John LoveiL anaao the Tresnaent of Urina P= , 2nd ed.it. P\"s g\u0026o.pp. 44Is. Od. *Cnca PRISD IT JON LOVELI, ST. NIOMoAs gT., E\""
      ],
      "title" : [
         "Canada lancet [Vol. 1, no. 10 (Dec. 15, 1863)]"
      ],
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         "8_05197_10"
      ],
      "published" : [
         "Montreal : [s.n., 1863]"
      ],
      "label" : "[Vol. 1, no. 10 (Dec. 15, 1863)]",
      "key" : "oocihm.8_05197_10",
      "source" : [
         "Hannah Institute for the History of Medicine"
      ],
      "pkey" : "oocihm.8_05197",
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05197_10",
      "lang" : [
         "eng"
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      "note" : [
         "Monthly."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w LII Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored andlor laminated I Pages restaurées et/ou pelliculées E' E Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. D Additional comments / Commentaires supplémentaires:",
         "CANADA EDITED BY GEORGE F. FENWICK, M.D. Professor of Clinical Surgery, McGil Universit ; Surgeon to Montreal General Hlospital, -\u00260-, c. CORRESPONDING EDITORS: HoN. D. McNEIL PARKER, M.D., A .. WILLIAM BAYARD,' M.D., MEMBER LEGISLATIVR COUNCIL. N. S.( ST. JOHN, NEW BRUNSWIOK. MONTREAL: GEORGE . DESBARATS, No. i PLACE D'ARMES HILL mA 319 ST. ANTOINE STREET. 1873.",
         "INDEX TO VOL. I. PAGE. Abstract of Lecture on Excision of the Knee-ioint.................. 360 Action of Digitalis.................. 42 Acupressure,with a Description of a Modification .................... 507 Address by the President Canadian Medical Associetion......... 166 Allison, L. C., M.B., on the Small- pox Epidemic in St. John, New Brunswick............... ....... 6 A Means of Preventing the Forma- tion of Stone in the Bladder. Dr. Day................... 512 Amputation of Leg in a case of Ele- phantiasis Arabum, complicat- edwithSloughing. Dr.Anderson 291 Anderson, William, M.D., C.M., of Glasgow. Surgical and other cases occurring an Newîound- and........ ........... 289 Aneurism of the Thoracic, Aorta, case of. By Dr. Ross.......252 An Improved IMeans of Plugging the Posterior Nares........ 506 Antiseptic Injection and Drainage Tubes in Empyema...... .511 A Trip to London. - Dr. Roddick... 214 A Visit to the London Hospitals. Dr. Mondelet............ 341 Baynes, George-A., M.D. Case of Wound of theKnee-doint treat- ed Antiseptically.............. 301 BellJohn, A. M., M.D. Case of Cerebro-Spinal Meningitis..... 543 Bessey, W. E., M.D. Casesfrom my Note-book .................. 159 Bessey, W. E., M.D. -Case of Ocre- -bro-Spinal Meningitis. 113 Bigelow, H. R. Some conclusions about General Paresis. 540 Bronchoòele, Fibro-Cystic, Removal of by Operation............ 208 Burland, William B., M.D. Case of Cerebral-Apoplezy .........484 Canadian Mediel * Association; Second -Day's Proceedings..... 178 Case of Cerebral Apoplexy, by Dr. Burland......................... 484 Case of Cerebro-Spinal Meningitis, by Dr. Ross..s .............. 111 Case .of.Cerebro-Spinal Meningitis --Death in thirty-eight hours. Dr. Bessey.. ............113 Case of Cerebro-Spinal Meningitis; Reported by Dr. Wood, Coati- 00...................... 152 Case of Cerebro-Spinal Meningitis. Reported by Dr. John Beil...... 543 Case of Dissecting. Rupture of the Heart.......................... 515 Case of ContractedKnee-joint cured by Operation................... 159 Case of Empyema. Relief by na- tural openina... .......... 565 Case cf Encephalid of the Skin of the Forehead. Dr. Anderson.. 291 - PAGE. Case 'of General Cystic Degenera- tion of the Kidneys. Dr. eddy 385 Case of Impalement on a Brush- handle, with Perforation of the : Diaphragm ................6 Case of Lithotomy. A rapid re- covery .. ....................... 564 Case of Litiotomy, Fatal from Em- bolism of the-Pulmonary Artery 509 Case of Louis St. Aubin............ 560 Case of Mismanaged Shoiulder Pre- sentation in which Decapitation was Practiseci. Dr. Simpson... 44.5 Case of Nasal Polypus. Dr. Ander- , son......................... 295 Case of Paralysis with Aphasia. Dr. Reddy............... ...... 1 Case ofParaplegia of Five Years' Duration. Electrical Anoes- thesia......... ............... 82 Case of Pelvie Abscess.. Dr. Sher- riff ...,1 ... .................. 115 Case'of Pleurisy with Effusion, Tu- bercular Meningitis, Coma and Death. Dr. Ross.........../... 439 Cases of Scarlatinal Empyema. Dr. Sherriff ................ 337 Case of-Wound of the Knee-joint. Dr. Baynes...............301 Cases of Wound of the Knee-joint. * Dr. Simpson....... ;;........... 403 Cholera: Its Spread in Russia and India ..... ............ 142 Clarke, Octavius H.E. M.D. Ob- servations on Dr.Pratt's Essay on the Origin-of Fever. .....,. 257 Clinical lecture on Bed-Sores...... 561 Clinical lecture on the treatment of large Abscesses............ 554 Compound Dislocation of the Ankie- aoint. with Comminution of the Fibula. Dr. Anderson.......290 Compression of the Aorta in Post- partnm:HSmorrhage. Dr. An- derson .......................... 289 Correspondence from E. -H. Tren- 1 holme, .D.............. 499 Criticisi on the Discussion at the - Pathological Society on PySmia 369 Death of a child from chyme enter- . ing the Lungs ..... ;....... 568 Dietetics of Phthisis.............. 140 Discussion on the Medical Bill. Ca- nadian Medical Association.-.. 170 Dislocation Forwards of the Sternal end 9f the Clavicle..........368 Dislocation of Femur into Thyroid Foramen Reduced at the end of Eight Weeks....... ........ 481 Distribution of Prizes at St. Thomas' Hospital....................... 94 EDIroInAL: The Canada Medical and Surgical Journal.......................... 43",
         "INDEX. PAGE. The \" Canada Lancet \" and Cana- dian Graduates........,........ 45 Medioal and Surgical Report of the Montreal General Hospital. 46 The Canadian Medical Associa- tion ............... n ........... 89 A Conjoint Examining Board.. . 91 The late Professor Frascr, M.D.. 92 The late J. B. Blanchet, M.D., M.R.C.S.,Eng................... 94 Sewer Ventilation................ 138 Medical Qualifications in Jamaica 139 Montreal General lospital, Ap- pointment, of, Dr. Ross ..... 140 Sewer Cleansinke and Ventiation. 191 Death of Louis. F. C. Skey and Alfred Poland.................. 192 Confession no Proof of Guiit...... 192 Sewer Cleansing and Ventilation. 234 Epidemics and Meteorology ..... 235 A New Test te Prove the Presence of Actual Death............ 237 Death of Dr. John Dickson....238 Sanitary Reform.................. 282 The Silicated Carbon Filters..... 284 Messrs. T. Morson \u0026 Son on Crea- sote ........................ ...285 Royal College of Physicians and Surgeons of England............ 285 To Correspondents............. . 2s5 Advance Westward of Choiera... 286 The Ontario College of Physicians and Surgeons and the Students of Medicine.................... 326 The BeauportLunatic Asylum... 332 The Fossil Man at Montone...... 333 The Emperor Napoleon 111...... 377 A Medical Act for Nova Scotia... 380 An Explanation................... 382 The Treatment f Lunaties in the Province of Quebec............. 382 Death of Mr. Carden and Mr. Holmes Coote................... 384 A New Antiperiodic...........384 The Choiera and Quarantine..-. 425 Bill-An Act to Amond the Onta- rio Medical Act................. 426 Death of Dr. William Sutherland, Jr ...... ...................... 430 Hamilton Medical and Surgical Society.......................... 430 Structure of the Scalp of the Negro 431 Religious Mania.............. 431 -The Ontario Medical Amendment Bill ............................. 476 Annual Convocation McGill Uni- versity.......................... 477 The Registration Bill............ 517 The- Ontario College and its Diploma ........................ 516 Examination Papers, College of Physicians andSurgeons,Ontario 521 Pancreatine , and Pancreatie Emulsion ....27 Dr. Colin C. Sewell.... ...... 528 Diarrhoea in Teething............ 528 College of Physicians and Sur- geons of.Ontario and its Diploma 572 The Registration Bill. . ........ 573 The Late Sir George E. Cartier, .Bart M.P...............:. 573 English Recollections of a German Surgeon, by Dr. Stromoyer ..... 27 Epilepsy Provoked by Contusion of the Sciatic Nerve............... 86 Epitholioma of Lower Lip, Opera- ton, Recovery. Dr. Anderson. 292 PAGE. Erythema Nodosum............... 96 Excision of the Knee-joint, Recov- ery.............-................ 393 Extraction of Cataract.............. 558 Fenwick, G. E., M.D. Case of Cal- culus Vesicoo, Lithotomy by Lateral Operation............. 391 Fenwick, G.E., M.D. Case of Fibro- Cystic Bronchocele.... ........ 208 Fenwick, G. E., M.D. Surgical cases occurring in the Moneal General Hospital.............. 3ul Fenivick, G. E., M.D. Cases of Sta- phylorraphy..................... 348 Fenwick, G. E., M.D. Case of Ex- cision of the Kioce-joint, Re- covery .......................... 393 Fenwick, G. E., M.D. Cases of Ex- cision of the Hin-joint, Recovery 397 Fenwiok, G. E., hi.D. Report of Sixteen cases of Stone in the Bladder Removed by Operation 115 Fracture of the Skull from the Kick of a lorse. Dr. Anderson..... 292 Fracture of theVertebral Column. 557 General Paresis. Conclusions in regard to it..................... 540 Girdwood, Gilbert P., M.D., M.R. C.S., Eng. Valedictory Address te the Graduates in Medicine and Surgery, McGill University 433 Health of Factory-workers......... 96 JIeat of the Present Summer and its Effect on Mortality.......... 143 Herbert, Z.. M.D., C.M. Case of Spontaneous Expulsion in Shoul- der Presentation................ 156 Herbert Zotique, M.D., C.M. Re- marks on a Curions Inquest.... 262 Hingston, W. l., M.'D L.R.C.S.E. Observations on Lithotomy and Lithotrity....................... 247 Hingston, V. Il., M.D., L.R.C.S.E. temoval of 'ongue and Lower Jaw ............................ 406 HosPrTL Re'oats: Case-of Depressed Fracture of the Frontal Bone,.with Fracture of the Fourth and Fifth Cervical Vertebr.- -Under the .care of Dr. G. E. Fenwick; reported by Mr. W. A. Molson............ 16 Case of Injury to the Spino, Para- plegia, Head Symptoms Death on the Sixth Day. Uner the care of Dr. John Reddy; re- ported by Mr. P. S. Shepherd... 18 Case of Acute . Rheumatism. Underithe care of Dr. R. P. Howard; reported by Mr. J. C. Cameron...................57 Case of, Acute Rheumatism - with Delirium.., Under the care of Dr. Drake -reported by T. ,G. Roddick, M.D...............59 Case of IdiopathicTotanus. Under the care of Dr. Drake reported by Mr. H. W. Hockrie.......-119 Sypilitic Ecthyma. U nder the care of Dr. D. C. MacCallum; reported by Mr. Carmichael.... 127 Punctured: Wound, severing the Coccyx from the Sacrum. Under the care of Dr. MacCallum; re- ported by Mr. J. C. Cameron... 129",
         "INDEX. PAGE. Amyloid Degeneration of the Kid- neys, \u0026c. Under Dr. MacCal- lum; reported by Mr. H. Brown 131 Albu'inuria case of. Under the caro of Dr. MiacCal1um ; report- ed by Mi. H. R. Bigelow....... 133 Chronic Eezema treated by Local - Applications of Caustie Potash. Under the care of Dr. D. C. MacCallum; reported by Mr. D. A. Carmichael. .... 220 Phlegmasia Dolens. Under the care of Dr. D. C. MacCallum : reported by H. R. Bigelow...... 221 Case of Tuberculization of Lungs. Under Dr. D. C. MacCallum; reported by Mr. W. Ewing...... 222 Case of Scirrhus of the Pylorus, Absence of Pain. Under the care of Dr. Rosa; reported by Mr. E. A. Gaviller............. 269 Cancer of the Mammary Gland in a Man. Under the care of Dr. Ross ; reported by Mr. E. A. Gaviller ................. -...... 271 Case of Extra-Capsular Fracture of the Neck of the Femur. Un- der Dr. Ross; reported by Mr. E. A. Gaviller................. 272 Compound Fracture of Tibia, Gangrene, aputation, Re- covery. Under the chre of Dr. Fenwick; reported by Mr. W. Ewing.................. 307 Compound Fracture of the Elbow- joint, Amputation. Recovery. Under the care of Dr. Fenwick; reported by Mr. D. O. Alguire. 309 Case of Charbon, Recovery under the care of Dr. Fenwick ; re- ported by T. G. Roddick, M.D.. 310 Case of Purpura (Simplex). Un- der the care of Dr. Wright: * reported' by C. H. Chipmaon, M.D Assistant-House-Surgeon 312 Case of Tertian Ague, originating in Montreal.. Under the care of Dr. Wright; reported by C. R. Chipman, B.A. M. D........... 313 Case of Brght's bisease. Under the care of Dr. Ross; reported by Mr. J. C. Cameron* ......... 315 Cases of Staphylorraphy.- Under the charge of Dr. Fenwick : re- ported by T, G. Roddick. M.D. 348 Case of Gun-shot Injury. Under Dr. Fenwick; reported by T. G. Roddick, M.D................ 351 Case of Periodic, Supra-Orbital Neuralgia. Under the care of Dr. Ross; reported by Mr. R. W . Bell. .................... . 47 Obstinate Intercostal Neuralgia cured by Hypoéermic Injection. Under Dr. Ross; reported by Mr. Cameron............... 448 Cervico-Brachial Neuralgia of . Long Standing cured by Hypo- dermic Injections. Under Dr. Ross. reported by Mr. D. O'Brien ........................ 449 Sovere Brachial and Sciatic Neu- ralgia treated Hypodermically. Under the care of Dr. Ross; reported by -Mr. James McLeod. 451 Recent Sciatica cured by Hypo- PAGE, dermie 'Injections. Under 'the èare of Dr. Ross; reported by Mr. R. S. Elhson.............. 452 Headache,with NocturnalExacer- bations; no Syphilis; treated with IoL. Pot. and Hwpodermic Injections. Under r. Boss: reported by Mr. J. B. MoConneil 453- Chronic Phthisis; Sudden Death fron Homoptysis. Under Dr. Ross; reported by Mr.- P. E. Richmond........................ 454 Enteritis, from- Constipation, Speedy Relief from Morphia. Under -Dr. Ross; -repiorted' by Mr. F. J. Shepherd...:......... 456 Febrile Urticaria ; High Range of Temperature. inder the care of Dr. Ross; reported by Mr. J. C. Cameron..... .........456 Howard,, lenry, M.D., M.R.C.S., . Eng. Extract of Annual Report to Inspectors of Prisons and Asylums for 1872............... 412 Howard, Henry, M.D., M.R.C.S., Eng., on the \" Total - Abstin- ence Question..... .......... 411 Howard, R. P., M.D., L.R.C.S.E. Observations upon Scarlatinai Pleurisy .......... ............ 241 loward, R. P., M.D., L.R.C.S.E. On the First Epidemic of Cere- bro-Spinal Fever in Montreal.. 97 Howard, R. P., M.D., L.R.C.S.E. Remarks on Dr. Sherriff's cases -of Scarlatinal Empyema........ 339 Hydropneumothorax............ 325 Influence of Belladonna on Sweat- ing .....,...\".................. 501 Introductory Lecture delivered at the Opening of the Fortieth Session MoGill Medical Faculty. Dr. Wright.................... 193 King, Mr. Thos. D. Notes on Me- . teorology and Health........... 495 King, Mr. Thos. D. Meteorological Observations for October and November, 1872.............. 336 King, Mr. Thos. D. Meteorological Tables for August and Septem- ber, 1872.. ............ ..... 240 King, Mr. Thos. D. On the Science of Meteorology and its Utility.- 49 King Mr. Thomas D. What is In- sanity...................... 529 Last Words about the Epizooty. 432 London Correspondence............ 303 London Correspondence.......... 415- London.Correspondence........... 460 - London Correspondence............ 548 Lithotrity and Lithotomy, Observa- . tions on, by Dr. Hingston...... 247 Lithotomy by the Lateral method, Recovcry. Dr. Fenwick....... 391 Lithotomy, Sixteen Successful cases by the Lateral method of oper- ating. Dr. Fenwick.......... 145 Malpresentation of the Fotus during labour ...... ...... .............. 5 71 Maniacal Attacks in the Beginning of Typhoid Fever............. 87 McCurdy, John M.D, C.M., on Removal'of large Calculus im- pacted-in the Urethra...... - 340 Medical and Surgical History of tue W ar.................... ...... 511",
         "INDEX. PAGE. MaIcA, NErws Ventilation of Law Courts. ...... 238 Bequests, \u0026c., to idedical Chari- ties... ... .......................239 Report of the Oxford Delegates.. 239 Sir William Hamltont............ 239 Monthly Summary of Meteorolo- gical Observations........... 240 Cholerp, in Poland, Russia and Austria ... .....................286 Carbozotate of Ammonia in place of Sulphate of Quinine......... 287 Three-g. ain Doses of Morphia... 288 Bleached Tincture of Jodine..... 288 Cases of Cholera in Hungary. 288 Dr. Ditterich on Gout............. 333 Difficult in Diagnosis of Tuber- cular deaingitis. ... .... .. 334 Simulated Chlorosis.............. 335 Meteorological Observations. Oc- tober and November......... 336 The Kilmacolm murder.......... 574 Cicatricial Keloid of Uterus...... 576 The Drainage of Berlin........... 576 Mental Effects of Rheumatism..... 95 Meteorology and its Professors. Statement oi Facts by the Au- thorities of the University...... 409 Meteorological Instruments and how to Use them, byMr. Thos. D. Ring ....................... 52 Meteorological Tables for June and July, 1872 .................... 144 Mondelet, W. H.. M.D. Visit to the London Hospitals.......... 341 Notes of a Fatal case of Hysteria... 85 Notes of Three cases of Cerebro- Spinal Fever, by Dr. Reddy.... 106 Notes on Dislocations............... 366 Notes on Meteorology and Health, by Mr. T. D. King.............. 495 Notice to Correspondents........... 446 Novel Treatment of Ilernia........ 77 Obesity a Cause of Disease of the Female Sexual O ans. 516 Observations on Dr. Tratt's Essay on the Origin of Fever, by Dr. Clarke ...................... 257 On AniesthetiCs, by Dr. W. Ander- son, F.R.C.P.................. 372 Ophthalnoscopic : appearances in Epilepsy ........................538 Poisoing by.Aconite treated Suc- cessfUy by Digitalis ........... 374 Poisoning by Fumes of Carbolie Acid ........ ...........375 Preocaution ,against Cholera by the Shipping Inspection Committee and Privy Council............. 233 Pregnancywith Imperforate Hymen 424 Pro Bono Publicola... ........432 Prolonged Dyspnoea after labour... 568 PRoCREDINGS OF SoCIETIES: Medico-Chirurgical' - Society of Montreal; Meeting held May 4th, 1872. Dr. Drake on Erratic Erysipelas................... 61 Medico-Chirurgical Society of Montreal; Meeting held July 6th, 1872. Dr. Fenwick on a case Qf Recurrent Fibroid Tu- mour in the Axilla.............. .67 The - Canadian Medical Associa- tion Annual Meetilig.......... 165 Medice-Ohirurgical Society- of Mo.ntreal. Annual Meeting October 5th, 1872. Election oi Officers........................- 2 Medico-Chirurgical Society of Montreal. The President's Ad- dress........................ Dr. Fenwick's case of Goitre... 228 Medico-Chirurgical Society ' of Montreal; Meeting held. Dr. F. W. Campbell on' Tertian .Ague............ 317 Dr. B aynes on a case of Wound of the Kuce-joint ............... 318 Medico- Chirurgical Society of Nontreal: Meeting held March 7tb, 1873.' Dr. Ross on a case of Tubercular Meningitis. 457 ReddyJohn, M. D., L.R.C.S.I. Case of Cystic Degeneration of Kid- neys (with plate)..... ........ 385 Reddy. John, M.D.. L.R.C.S.L Case of Paralysis with Aphasia....., 1 Reddy, John, M.D.,L.R.C.. Notes on Three cases of Cerebro-Spinal Fever ................... ..... 106 Reduction of Dislocation of Iip- joint Nine Months out.... ...... 162 Remarks on a Ourious Inquost by Dr. Hfebert..................... 262 Remarks on Dr. Sherrif's cases of Empyema. by Dr. Howard..., 339 Removal of Calculus impacted in the Uretbra of a Paraplegic Woman. Dr. McCurdy ........ 340 Removal of Fibro-Cystie Broncho- cele ............................. 208 Removal of Tongue and Lower Jaw by Dr. fingston............... 406 REvnEws AND NoTicas oF BooKss: History of Medicine, from the Ear- liest Ages to the Commencement of the Nineteenth Century. By Robly Dunglison, M.D., LL.D.; arranged and edited by his son. 20 Earth as a Topical Application in Surgery. By Adinell Rewson, M.D..:..................... 2 The Phyician's-' Prescription Book. By Jonathan Pereira, M.D;, F.R.S................... 26 Dr. Rigby's Obstetrie Memoranda. By Alfred Meadows, M.D...... 27 Lectures on - tho. Principles and Practice of Physie. fBy Sir Thomasa Watson, Bart; - M.D.; F.R.S........ ...,.......70 A Treatise on Diseases of-the Bones. fBy Thomas M. Msrkoe, M.D.\u0026c.-...-..........75 Spermatorrhea :\"Its Results and Complications. By J. L.Milton 134 Sciatica, Lumbago and Brachial- gia: Their Nature and Treat- ment. By Henry Lawson, M :.137: Syphilis: Its Nature and Treat- ment. By Charles R. Drysdale, .137 Sciatica, Lumbago and.Brachial- gia: Their Nature and Treat- m\\ent. By Henry Lawson, M.D. 187 Bordks Received for Review....... 190 The Urine and its Derangements. By George Harley, M.D., F.R.S., \u0026c ................23(",
         "INDEX. PAGE. A System of Surgery ; Pathologi- cal, Diagnostic. Therapoutic and Operative. By Samuel D. Gross, M.D., LL.D., D.C.L., Oxon................ ......... 232 Books, \u0026c. Received for Review. 233 Epidemic Cerebro-Spinal Menin- gitis. By Dr. Meredith Clymer 274 On Some Disorders of the Ner- vous System in Clriidhood. By Dr. Charles West............. 275 / The Science and Practice of Medi- cine; Third American from the Sixth London edition. By Dr. William Aitkin; edited by Dr. M. Clymer........ ...... 277 The Physician's Visiting List for 1873....... ..................... 281 Received forReview: Meteorology and its Professora.............. 281 Galvano-Therapeutics. By W. B. Neftel, M-................... 319 Handy-book of the Treatment of Women's and Clildren's Dis- eases. By Emil Dilluberger... 320 Meteorology and its Professors. By T. D. King.................. 321 Books Receivedfor Review.:..... 324 A Practical Treatise Ôn Urinary and Renal Diseases. By Wm. Roberts, M.D.,* F.R.C.P.L.....353 The PathologyL Diagnosis and Treatment of Diseases of Wo- nen. By Graily Hewitt, M.D., P.R.C.P.L... ... ......... 356 Surgical Disèases òf Children. By. * Dr.-M-.P. Guersant. ....... 358 Books eceived for 'eviewi. 359 Treatment of Syphilis wit2 Sub- outaneous Sublimate Injections. By Dr.' George Lewin.. .....417 On the Functional Diseases of the, Urinary, Renal and Reproduc-, tive Or ans. By D. Campbeil Black, M D . .........419 Clinical Lectures on Diseases Pe- culiar to Women. By .Lombe. Atthill M.D...... ....... 421 A Manua l of Qualitative Analysis.\" B3y Rober Galloway, F.C.SE.. 42S Books Received for Review. 424 The Practice of Surgery.' By Thomas Bryant'F.R.C.S.'. -464 Neuralgia and Diseases:that Re-, semble -it By Francis E. Anstie; M..:............. 467 Obstetric Aphorisins for th'oeUse of Students. By;Joseph G. Swayne. M.D.........470 Fistula, Hmorihoidà 'arid Dis-' eases of the 'Rectum.~ By W. Allingham, F.R.C.S., Eng. 472 Bopks Received- for -Review...... 475. The Science and Art of Su'rgery. .J. E.-ErichsenF .R.C.S., Eng.. 5*021 Conributionis toiental Pathology 504 Books Received for Review...... 505- The Influence of Mind on the Body. By Dr. K. Tuke, M.D. M .R. ,.P........................ 551 Roddick. T. G., M.D. Case of Right - Hemiplegia with Aphasia...... 488 Roddick, T. G., M.D. Report of cases of Strangulated Femoral Hernia...................... ..493 Roddick, T. G.. M.D. Report of cases o? Staphylorraphy........ 348 PAbE. Roddick, T G., M.D. Trip to Lon- don...... .............. 214 Ross. George, A.M., M.D. Case of Aneurismn in the Thoracia Aorta 252 Ross, George A M. , M D Case of - Cerebro-Spinal Meningitis...... 111 Ross George, A.M., M.D. Case of dhronic Pleurisy with Effusion- Tubercular Meningitis - Coma and Death .............. 439 Scarlatinal Pleurisy and Thoracen- tesis in that Affection, by Dr. R. P. Howard...................... 241 Sequel to a case of Ligature of the External Iliac Artery for Ele- phantiasis Arabum, by Dr. An- derson.......................... 291 Sherriff, F. W., M.D., L.16C.S.E. Case of Pelvic Absce. ...... 115 Sherriff, F. W., M.D., L.R.C.S.E. Cases of Scarlatinal. Empyema. 337 Shoulder Presentation Spontaneous Expulsion of the 'jhild.......... 156 Simple Dislocatior of the Knee- joint...... ............... 367 Simpson, Thor, M.D. Case of Mismanage'.i Shoulder Presen- tation, in ,which. Decapitation was Prarcised................... 445 Simpson, Thomas, M.D., on cases of Wour.i of the Knee-joint...... 40\u00263 Slayter, WY. B., M D. Case of Stran- gu'.ated lmbilical Hernia. 154 Stonrin the Bladder; report of Six- teen cases by Dr. Fenwick..... 145 tone in the Female Bladder.......557' Strarigulated Femoral Rernia..... 491 StrangulatedUmbilical HErnia,oasea of...................,...... 154 Tewksbury, S. H., M.D., of, Port- land, Maine, on Vesico-Vaginal Lithotomy .................. 296 The Oanadian Medical Association, Annual Meeting of.............. 165 The cure of Cancer by Electrolysis. 142 The First Epidemic of Cerebro- SvinalFeyerin.Montreal. Dr., Howard........................ 97 The Lymphatics of-the Skin....... 515 The Post-mortem Examination of the King of Sweden -..:.,..,.. 233 The Small-pox Epidemic in. St. John, New Brunswick. Dr. 'Allison..................... .. 6 The Total Abstinence Question.... 411 Treatment of Chronie Disease of the Bladder. ................. 559 Treatment of Hoemorrhoids.. .... 143 Treatment of Inertia of.the Uterus 80 Treatment of Small-pox by Vaccin- ation and. the Injection of Lymph .................. 40 and: 78 Tuberculosis and Pymmia:.......- 88 Two cases of Morbus Coxas, Excis -. sion of the Hip-joint, Recoveny. 397 Valedictory Addies4 to the Gradu- ates in Medicine and Surgery, McGill University. Dr. Gird- wood........................... 433 Vance, R. A., M.D., the Ophthal- moscopie appearances in Epi- lepsy.......................... 538 Vesico-vaginal Lithotomy. Dr. Tewksbury...................... 296 Wagner, A. Dixon, M.D., C.M on Reduction of Dislocation of the Femur at the end of Eight",
         "INDEX. S PAGE. PAGE. weeks .......................... 48i Wright, William, M.D., L.R.C.S.E. What is Insanity ................... 529 introductory Lecture on the Wood, George, M:D.. Coaticook, on Opening of the Fortieth Session Cerebro-Spinal Meningitis . 152 ofthe McGill Medical Faculty. 193 LIST OF CONTRIBUTORS. ALGUIRE, D. o., Mr. ALLISON, L. C., M.B. ANDERSON, WM., M.D. 0.M. GLAS. AUTHORITIES MOGILL UNIVERSITY. BAYNES, GEORGE A., M.D. BEL, JOHN, A.M., M.D. BELL, B. W., Mr. BEssEY, W. E., M.D. BIGELOw, H. R., Mr. BROWNE, ARTHUR A., B.A., M.D. BROWN, H.' Mr.- BURLAND, W. B., M.D. CBIPmAN, 0. H., A.M.,' M.D. CIAM, O. H. E ., M.D. CAIUERON, J. C., Mr. CAMRIHAZL, D. A., Mr. DRAxE,' JOsEPH M., M.D. ELLISON, S. B., Mr. EWING, W., Mr. FENWICr, G. E., M.D. GAVILLER, E. A., Mr. GmIDwoOp. G.P., M.D., M R 0 8 ENz. HEBERT, ZOTIQUE, M.D. KINGsTON, W. H., M.D., L B 08 E. HOcERIDGE. H. W., Mr. HOWARD, HENEY, M.D., M.R.O.S.E. lOWARD, B. P., M.D.,e.CSE ,eNG, Taos, D., Mr. MOCALLUM, D. C., M.D., M.E.C.8.E. MOCONNELL, J. B., Mr. McCURDY, JOHN, M.D., C.M. MOLEOD, JAMES, Mr. MONDELET, W., M.D. MOLSON, W. A., Mr. O'BRIEN, D., Mr. REDDY, JOHN, M.D., L.R.O.S.1. RICHMOND, P. E., Mr. RODDIoR, T. G., M.D. Ross, GEORGE, A.M., M.D. SHRPHERD; F. J., Mr. 'SMMHI, F. W., m.D. SIMPSON, T., M.D. SLAYTER, N. B., M.D. TEWKàüURY, S. H., M.D. VANC, . A., M.D. WAGNER, A. D., M.D., C.M. WOOD, GEORGE, M.D. WRIaHT, WILLIAM, M.D.,L.R.O.8.E.",
         "CANADA NEDICAL AND SURGICAL JOURNAL ORIGINAL COMMUNICATIONS. À Case of Paralysis with )hahia ecrring on hie Fiftt Day after Parti-Hion--Deatharà Post .Mortem. By'Jons REDDY, M... L.R.C.S.I.1 \u0026c. Phys;ician to the Montreal General Hospi- tal, \u0026c. f wish to supplement a paper read by me before the Medido ::ç.hirurgica1' Society of Iontreal, on the 9th March last, on Pasalybis with Aphasia, (when I gave the history of four cases,) by reenrding another case which has since corne under my charge, and whièc*h. deem of sufficient interest to lay before your readers, particularly since, as it teriminated fatally, I lad an opportunity of veiifyirig the diaghosis 'by a post mortem. It bCars a striking resemblance in some of its pathological features to Case No. 1 in my formier paper. Mrs. M., aged 45, of middle-stature and spare habit, I confined on the 17th April, 1872, of a large male child. The labor was of short duration, 'terminating favorably--(this was her, seventh labor).- On the second day she remarked that before her.gonfine- ment she had been much troubled with a cough which had now nearly altogether subsided. On the third day the breasts weie well filled and: the child nursed freely ; she appeared in good spirite, ·nor did anything unusual arise - to affect her perfece recovery tili the morning of the 22nd (or fifth day), when, on my arrival, the nurse infoi med me that some short tine- previously $he awoke, as if in a fit« or. dreamy fright her face was quite dis. toi-ted,; the abilityto'speak or sit'up being:absent; that when the fright had subsided she was seizecl w thgeoughing, and forced up qlUite-a quantity ot thick saliva which flowed from.her mouth up to this mpment 1he appeared to, be doing well, and 1iad spoken to her a short timepreviously. I found her lying on the. ighit side, partiallyproppedup in bed; thiek, glairy mucus, in a long string, flowing ficm the right side of hei mouth. The face and right",
         "Q CANADA MEDICAL AND SURGICAL JOURNAL. side of body hemiplegie ; her pulse 7S, and temperature 98 2-5; she was also aphasic, with the exception of answering \"no \" or Iyes,\" intelligently. to leading questions :,could swallow, but not freely; her breathing was peculiar and apparently sonewhat oppressed; the face had, a peculiar-, bluish tinge, and the right jugular was very full and tense; bowels had been freed the day previously with castor oil; the lochia were correct, but the milk had considerably diminished; had frequent coughing fdts, and ejected quite a quan- tity of glairy, transparent mucus, free of air; percussory sounds were nuch clearer than natural all over the chesti heart's action: first sound slightly below par, second regular, no murmur existing; subcrepitating rales heard all over'the chest, anteriorly and pos- teriorly, occupying about the first two-thirds of inspiration, whioh had a prolonged character; expiration was short, sudden and quickly accomplished. I may mention here that partial emphy- sema of both lungs had existed for some years back, and 1 have had frequently to attend her for severe attacks of bronchitis. when she had, that characteristic breathing and cough that peculiarizes asthma; the urine vas normal in coloi' and quantity, and did not contain albumen; tickling the sole of the foot on paralyzed side produced active reflex movements; no muscular rigidity was pre- sent. From the above symptoms and sigus i at once came to the con- clusion that obstruction of the right side of the heart existed, (probably pulmonary a.4ery); also, that embolus, no doubt, occupied the middle and, possibly, anterior, cerebral arteries of left side. Treatment consisted. in : Turpentine epithems to be applied every fourth hour to the chest; during the iutervals,. hot linseed poultices, to which a smal quantity of mustard -was added ; the patient's body to be raised against pillows to relieve the dyspnoea, and to give a tablespoonful of the .following mixture every fourth hour:. I, Bromidi Potass, Sjj; lndide, Potass, gr xxxvi; Chlo- roform, gjj; Ext. Polygai Senegw Fluid, 3jj; Aquie ad ävj.; diet, milk. chicken broth, \u0026c. This treatment was steadily persevered in all the day with par- tial relief. The, face has lost the bluish tinge, and; the venous congestion has also subsided. 23rd.-Pulse; 80 z temperature, 98 2-5 was very restiess during the nigb; constantly âesiring to be raised forwards inio a sittiig posture':' has expectoratèd quite a quantity- of viscid' mucus lochia present; but paler; milk entirely gone: continue treatU ment.",
         "PARALYSIS WI APH A IA. Evening.-Syinptoms appear much more grave face cougested to a bluish purple coler; pulse, 104 , orthopnæa,· with higlly exaggerated respiration; rapid suffocation imminent. Ordei'ed a zinc sulphate emetic,' which was followed by immediate relief and marked benefit, as the patient could lie flatter iii bed, and the breathing was relieved. Continue treatment. 24th.-Pulse 8L; temperature, 99 passed a restless night, with considerable dyspnoea; diarrhœea also set in about 4 a.m., and the expectoration has nearly ceased; she appears now tranquif. Ordered a few powders of conipound powder of chalk whiile neces- sary. Evening.-D)iarrha much better: no marked difference in the generalsymptoms. 25th.-Pulse, 88, temperature, 99 2-5; condition about the same as yesterday; diarrhSa better, but the cougli more trouble. some. 26th.-Temperature, 99; pulse, 94; full, but occasionally irregu lar; face puffy and red: very great restlessness, and a seeming inability to assume any posture of ease; respiratory movements hurried ; heart's action strong, laboring and irregular; intelligence perfect, but aphasic state more decided; no power of auswering no or yes, which to this existed throughout- suborepitant rales are again heard all over the chest. Ordered a mixture of aconite and digitalis occasionally, to supplement present treatment. Evening.-Pulse, 86 heart's action more regular, but the lungs seem gorged with mucus; face lias again assumed the cyanotic color; veins of neck turgid; the zinc emetic again resorted to, with partial relief 2ith.--Pulse,.108-irregular: heart's impulse net se full, but the irregularity exists ; the diarrhoea has again returned, and the clear saliva isflowhig freely from the mouth; sliglit difliculty in swal- lowing. These latter symptoms, I consider, are due to the para, lytie affection. She is evidently growing worse, and at mid-day this became most striking. At 5 p.i. she was seen in consulta. tion with me by Professer G. W. CampbelI, who was at once struek with the nature of the case. She vas then perfectly conscious and lier perceptive faculties active; yet all the symptoms had se increased in gravity that wie could only regard the case as utterly hopeless. Increase in hie strength of the doses of bromide and iodide of potassium was agreed upon, but of which she had only one or two doses, as tow'ards niidnight she became very restless: synmptoms of suffocation setting rapidly in, and she died a quaiter te seven in the morning.",
         "4 CANADA M1EDICAL AND 'SUEGICAL JOURNAL. AU TOPS\u0026Y eight and- a half hours after death: body much. emaciated; .rigor moitis marked. Brain.-On removing the calvarium, which was. not, more than ordinarily tbick, the dura mater was found f mly adherent, to it through the enlarged paccbionian bodies; veins of dura mater full; general appearance of membrane noimal. On exposing the- brain there was nothing marked in its condition excepting that it was soft in consistence and pale. The arachnoid was not thickened in any part, and contained little, if any, fluid in its spaces. On making ibe usual section of the right hemispheie, the punctao vasculosao did not appear more than usually marlked or engorged with blood. The riglht laterail ventricle contained bout a drachm of clear serum. Nothing atnormal was noticed in connection with its contents, excepting the rltered consistence whichseemed to pervade the entile brain substance. Careful and minute sections of the corpus striatum and thalamus opticus were made without any positive result. Lefl Bemishere.-Punete vasculose nomiaV: brain substance softer, in fact than opposite side; gives way ratier than cuts under the knife.- On extending\"the section to a level with the corpus callosum a localized- spot of softe'ning in area about an inch and a quarter squaxe, 'was f'ound exténding from the laterial and anterior aspect of the corpus sriatum foiwards and outwards to near the circumuference of' the brain, ifivolving the fissure of Sylvius and those 'convolutions known as the Island of Reil. The general aspect of the softened portion was white, but in places- say, in three or four spots, varying , in size from a ý.ea to a small. marble-there was bloody infiltration and staining -of the brain matter of a diffuse pinkish character. The ventricle contained about half a drachm of straw-coloi ed serum, with minute flocculi of lymph floating therein. There were two, small depositsof lymph.,of the size of a split pea. on.the floor of the ventricle; one over the semicircularis the other in the extreme angle of the anterior cornu. f They were fù mly adherent in their places. Base Brain.-General appearance identical with that of",
         "PARALYSIS AIND APHASIA. hermispheres. Arachnoid not thickened or ædemitons in any place. A - ~ D A.-nteio (omnctnC-Blr H.-Right Carotid. D.-Left .Middle Cerebral with Embolus. rteries-Lefit iddle Cerèbral.-At .the point of divison into its branches, three quarters of an inch from thé càrotid, the vessel appeared to bulge and felt decidedly resisting to the feel, thought to be atheromatous. Immediately beyond this, and plugging the .two m-tin branches, from the very bifurcation, were tirni, dark clots, well detined and readily distinguishable from the vessels, both in their front and rear. Each clot w s about half or three- quarters of an inch in length, and occupied the entire calibre of the vessels.. All the branches beyond the obstruction :were ernpty, collapsed and smællir, apparently, than normal. ýThere were also noticed two or three smill but soft clots in the left a.nterior communicat-ing; .aíd left posterior qommunicating arteries. These occupied only about half the calibre of the vessels. -Nothing requiriig special notice was found elsewhere in tie brain. Ieart.-Norrr size. Considerable fàtty -accumulation, oespe- -cially overleft ventricle. Left Ventricle. Normal in thickness. Mitral valves healthy. ig fit Veitr.le .-ricuspid valve 'entangled in an imnmense waned òlot or antemotntem polypus, which likewide extiended up the pulmonary ai-tery~fot \u0026 considerable'distance. ortas.-Vallvs no mal and patent. Three or four snall spots of atheroms, sdarcely raised from the surface of the vessèl, and nonelarger th, theead of a pin were noticed Otherwise heart perfectly healthy. Lungs.-Margin emphoýemitous. General condition healthy.",
         "6 CANADA MED1CAL AND SUIN\u002bICAL JOURNA L. After the post-mortem 1 examined, under the microscope (250 diameters), a portion of the brain taken from the corpus striatum, and from the ?inkish, softened substance in the Tsland of Reil, r found quite a quantity of oil globules and a large number of cor- puscles of a somewhat roundish shape, varying in size from half a split pea down to the eighth of an inch; some having a small papilla at one end, others having .a granulated appearence. On comparing drawings I made of these with what Gluge calls his compound inflamation:globiles\" many .re identical. The accompanying wood-cut is an exact representation of the embolus which occupied; the left ce-ebral artery, and does ample justice to the very beautiful and carefully made wet preparation put up for me by Dr. Roddick, House Surgeon, Montreal General Iospital, who ailso kindly assisfedim~at. the post mortem. 8717 ST. CAT11Eusia STRýEET, MONTREAI., J3th June, 1872. The S-mall-pox Lpidemic in St. John, V. B., in 1871. By L. C. ALLISON, M.B. Read before the New Brunswick Medical Society, 3rd April, 1872. (Continued from iage I!J VirL. V11I C«nada rc\u003cîical .Journal.) TREATMENT OF HIMORRHAGIC 4MALL-POX, As long às the head continues hot and aching I would applycold to it, either by a bladder filled with ice, or by iced fomentations constantly repeated. An ice-bag may also be applied over the loins. Anti-emetics are useless if not hurtful. -While the vomit- ing lasts I would give the patient small pieces of ice, or let him suck iced milk through a quill tube; and in all cases of small-pox I may say that-it is woith some trouble-to.obtain a regular supply of milk, as well as to see that the patient takeshis drink, what- ever it may be, by small mouthfuls at a time. Dry heat. may: be applied to the epigastrium, with. a small sand 'or. sait bag, or a small flat stone, ora tinoup, heatedand laid'on a piece of flannel. I would not apply turpentine or mustard, far less ,a blister to the skin, fbr if you set up derivation from tie, cutaneous vessels, or let the cuticleget rutlled, you will make a new point for hiémorr- hage to come from. the second day, or as soon as the hoemorri hages have commenced,. the pulse, becorne soft. and feeble, and vibices begun to appear, a mixture should bemade of wine, brandy, or whiskey, with milk and eggs, if these last can be- obtained, flavored with sugarand a littie nutmeg or cinmunon, and the patient should be dosed' with this ad libitum. Internal astringents will not control the ha.morrhage, but if a.ny are aiven",
         ". SMALL-POX ,EPIDEMIC. I would use gallie or tannic acid,.or tie acetate of lead witit or- without opium, and eschew turpentine as there is invariably more or less hamaturia and generally more. Such is the only treatment that'I c'nsuggest for théséeà'didable c'S nd although' it'is mierely phlititvè, I tbiiñ that in so'me degreoit mitigates the patient's siffei-inge, which is pretty nearly al that we can do.i n thec-se to wheli I:atelyadluded amn satisfed that the frè use of, alchoici stimulknts along with, mîlk -and egg, prolonged the patient's existence ilso: lfe às a blacksmith, a large finely'made man, in the prime of life, but débilitated by having but recân-t!y recovered fromanx attack of typhoid fever. le had ÏIitésfinal arid renal hUmorrh'ad, with abuidtnt:petehim upon1the legs did arms and some large claret-coloured vibice I was agreeaby s\u003euîised by bis surviving through the first week, but on the finth'day my attempts at ,timulation and iutrition were put a stop to by hie superntion of paralysis of the îisophagus and soft patlate, ren- dering him unablèo swallow.Next day he died. D-r. Aikmnan (Ghlagow MJedicaldJoùrnal, Nov ekbera 8'71.) regards this foin of small-pox asidue to prostrated innervation-and recon- nIends wet ;packing and the. internal use of, trychnia... As I have not seen bis -original article I do not know: how far or with wha t results the planhiasbeen tried. , lad. I known of it at the time I would certainly bave tried ity though not, with any high.hopes of si;ccess, for Lthink that.if the nervous centres. are affected it enn only be secondarily,. and through a perverted crasis of tie blood which neurotics. cannot rectify. One thing I have ,forgotten in speaking oi the, hemorrhages.: They are chiefly from mucoùs membranes and beyond the reach of interference. Butifthey occur on tie surface as they will fr.om old scars,. newly healed cuts, frost- bites, ulcers,,\u0026c.,they must be.ohecked by thelocal application of astringents such: as the perchloride or:pernitrate' of iron,- or if on the extremiities, .by a pad or a bandage. In one of my cases there was upon each leg a large iilcer, whose surface, on the second day, presented a villousappearance, ard bulged above the skin like .a stuffed crinison ;velvet pin-cushion. The same evening ,free hfflmorrhage took place frim these surfaces ; I never saw capillary circulation so active. Although I attended within a few mintes, he.had lost a large quantity Of blood in the interval; cold spong- .ing lhad..no effect upon the hæémorrhageybut I . arrested it by applying aicompress and bandage to each limb. ,No-further blecd. ing took, place during, the night, but next morning the patient: was passing passing.pure blood from both bladder and rectum, and il the afternoon lie died.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. IN TrE TREATMENT OF PETECHIAL SMALL-POX% . Quoted'in Lancet, 10th February, 18\"2. milk should be given while the vomiting lasts, and.when it has ceased, the brandy and. egg mixture should; b.e added. If the eruption developes itself it wijl be a confluent. of the most untvourable, and the fever will be typhoid in character. Hence my :practice was .te give nutrients and stimulants freely, and, I think that Dr. Holden's case was the same., !I sometimes gave the sesqui-carbonate, of ammonia in doses .of gr. iv. to gr. vi., but when there was much tendency %o hFemorrhage .I preferred to use the alcholie stimulants, on the, theory of Richardson that alkalies lessen the coagulability of the blood.. In treating the CONFLUENT CASES that were uncomplicated with hemorrhage or petechiFe I followed the rules that are generally laiddown by'our authorities and which I need hardly detain you by recapitulating. During the prelimin- aàry fever all that isineededis t'relax the bowels by a mild saline aperient, e.g', the sulphate of mrgnesia combined with dilute sulphuric acid, to give cooling drinks, of which ffrated lemonade is the best-if it can be.had, and feed with arrow.root or thin oat- meal gruel. When the secondiry fer has set in, milk and beef tea should be given, but it must be kept in mind thit besides the prostration due ,to the disease, we have to contend with the exhausting effects of a very extensive suppuration, which is not always contined to the superficial and visible regions of the body. We must always' be on the look-out for.deepuseated~abscesses and for diffuse cellulitis in the limba.. Should this last event hppen; an incision 'ought to be mide à soon as flictuation hts become 4listinct;-'and beforethe wound:hea, oxtensivè sloughs will come away from the deep-seated fasciau where thé trouble originated. 1n ene of my cases, whièh was' not otherwise a very severe one, large portions of: the iatermu4cular planes of thé fore irm ware thrown off in this waoy. Cellulitis ismet with:in mild casasweL1 as in severe ones, especially, where the p dientu i4 deficiena in phy'sicaf and mental stamina. Vhy- it.-shouldhappen aftei\u003c a; muoderate eruptiori I-caríinot te-L, unleås .r a portion e nateries morbi .having beeni diverted,-in sorne way, to tie deep fascia, instead ofPseeking its usual outlèt by the cutis. Secon'dary complications\u003ewere not nurnerous in my observation. I met iith three or fóur cases of absce:s it th4se vh, recovered, and two cases of bronchitis and' another ofipyemia among those which proved fatal. The only mischief to the eye which I saw was in a",
         "SMALL-]POX - EPIDEMIC. ' 9 -confluent case that proved fatal'on 'the twelfth day,'and in which both eyebalis -became abscesses and discharged their contents on the day before death. I should'also'mention the natural compli- cation of pregnaney. I fioind, piegnat \"women in 'ihfected -families ten or.twelve-tines, and was twice unforttinate enough te find them the' iirst attacked. One or these mothers had been previously vaccinated, and she got off with -varioloid; but ber child was born jaundiced, and died of confluent small.pox, which showed itself: on the 7th *day after birth.* An attempt to vaccinate it failed. The other mother had confluent small-pox, of which sie died. :Vaccination succeeded in producing- vesicles upon the child, and, I think, mitigated the small-pox which followed, but it still proved. severe enough te exhaust the diminutive patient after a -struggle of nineteen days' iduration. I had time to vac- cinate the other pregnant women,: .nd but one of them took the ·disease. She had it in a milddistinctformand recovered speedily, but her child was born dead two or three weeks afterwards. with twelve large 'flattened papules, something like those of urticaria, scattered over its face. The abdomen was tumid, divested of cuticle, and ofa reddish-brown color. I have ne doubt that this child received the disease from its mother in utero, and died of it while she was recovering, some time before its birth. I need hardly detain ~you with any remarks upon the milder forms of small-pox and their treatinent. In speaking of points of treatinent that applyto all cases alike, I will be as brief as possible. First, as. regards specific tr eatment there aio none deseving of any confidence. The plan of indue- ing artificial þustulation, at an early stage, by ointments of tartar einetic and 'croton oil, f ne-ver' tried, and I do not. think that it sounds plausiblè even in theory. After what has been already 'stated I need not -point out the mischief that would be likely te attend upon itin 'a case of hiumorrhàgic smäll-poi, where every superficial ' b'each of the tissues tends toI become the seat ôf obstinate capillary hmmorrhage In cases tending to confluence it would seriousl 'add to the patient's discomfoíti which is sure te be quite sërioidus'enu without any addition'from the treatment, wr case.' the 'plan will be quite officious and uncessary., In shot h great faith in the old maxim thät -h yes* bot ave,,ra l-i i'là the', les-aruptiontliat- appears the better. -If'suppuration could drW the niiasmaway befo're it hid tim to' initureitseif in the blodd. the patie'tîiticeetha±:Ehave:mentioned, and anothr -who' had gonorrosought o have had at least seme ferm 'of sinall-pox less' severe than the hm-morrhagic. The la seems founded upon a, mistake. The niateries inorbi does, indeed,",
         "10 CANADA MEDICAL -AND SURGICAL JOURNAL. determine in greater quantity to parts where there is increased vascularity, such as ýrecent scratches, \u0026c., but only after itihas been fully matured, or, as the older physicians used to say, \"con- cocted\" in the blood, and has - begun to :show itself in other parts of the skin as well. These scratches have a preference but not a-priority of eruption. Neither.did I experiment with the sarracenia, which some have- extolled so highly as a specific, for I believe that during the last ten or twelve years the merits of this ill-looking and ill-tasting decoction have been pretty effectually exploded by an extensive series of trials- Apropos of this subject I may add that whenever you find;the adjectives \"ludian \"l or \" Great, Iridian \" prefixed to the name-of a remedy, and a remarkably wonderful list of cures attached to it,-you may at once tiîke it upon yourself to. affirm, decidedly, that the thing is 'not so, especially if it should happen to be a remedy for a disease from which Indians notoriously suffer more than any other race of mankind. Tin short, wve have as yet, no specific lor small-pox. But there are a number of drugs which have been recommendèd from tine to time as useful adjuvants in the treatment. I shall mention only three of thei, which were' uscd to some extent by Dr. Ilolden and myself, and these are sesqui-carbonate of amminonia, carbolie acid, and the hyposulphite of soda. - We found that Carbonate of Animonia exerted no influence in modifying the eruption or shortening any of the, stages of the diséase. In doses of'from four to eight grains it is a good and useful stimulant-in cases where there is no marked tendency to hienorrhage. But when this tendency, exists I would withhold, it for. the reason aiready iven. Until Iately, he se of m¡¡os ik ofSoda was alnost confined to. cases of Sarcina Mentriculi,, in which it proves useful as is generally supposed through destroying the microscopic germis of the disease, by the sulphurous acid which. it, disengages. Two or three years -ago Professor Polli,. of Milan, proposed to administer.lt in infectious diseases, with the idea of arresting fermentative changes in the blood in the same manner. ,In some of the miasrhatic fevers goodi results are strted tohave been.obtained from the practice but I cannotconfirm,them with regard to small-pox. . L administered the hyppsulphite in dpses of gr.. x, to 3ss repeated. 'eyi-yfour hoursi, in severat instances,.but, coul nieyer satisfy mnyself that; it had any nect, either in modifying the eruption or.in sensibly ameliorating the symptoms.ý I think that it is an open question whether this drugreally. does evolve free suliphurous, acid afte.r",
         "SMALL-POX -EPIDEMIC. absorption into the blood in. the same manner as it evolves it in the stomach. Carbolic -dcid hias.also been highly:recommended as an internal remedy in zymotie diseases I know not upon awhat theory, but probably upon ,the .similar one of arresting germ multiplication and so hindering fermentation in the blood. I administered it in a number of cases,from an early period in the disease., sometimes alone and sometirnes combined with Aqua Mindereri, in the.form of carbolate of ammonia. I never observed that it checked or aborted the eruption, but I have so often seen the concdmitant symptoms, especially the headache, improve during its adminis- tration, that I am rather inclined, to think favorably of- it as a palliative. I would not speak.dogmaticailly upon this point, as in estimating the effects of remedies upon symptoms there are many sources of error capable of misleading much more caroi!l and elaborate observations than any which I had an opportuinity of making. Nor should it be forgotten that in making such enquiries we must attach a much greater value than usual: to negative results, as conpared with positive or what appear to be positive ones. In quite a number of cases the symptoms referred to resisted- the effects of carbolic acid as well as those of other remedies. Yet, in some forty or fiftv instances. where I adminis- tered it'seerned to relieve themmore or less. in at least,three out of four. In one case.where the eruption was not copious, but theý headache very severe and persistent, I increased the dose to the very large one of gr. x, and the headache, at once ceased. In fine carbolic acid will not shorten thestages or lessen the mortality of the disease, but as a pallia tor of synptonis I certainly think that it deserves a more extended trial. In the LOCAI, TRrATMENT IE T : ERPfITII \u003eN I used carron oil to relieve the itching and found it answer very well. It is not a very pretty or savory preparation, but in tlis disease such points are of lessconseque ce than tsual. In youpg children, when the eruption is copious, the hands should be muflled with cotton wool or the softest ragsthat yeu can get, ad inspite of ýwhat you can do th eywill often succeed in tear'ing the vesicles extensively, for tho cuticle is very thin. and tender. When, the cutis lias been laid bare the raw surface should be olud witl carron or olive oil and dressed with cotton woçl. This acci- dent. is very liable to happen in those severe .cases wliere a wrinkled ,ulke appear, oosel filled with bloody or t bid serum. Thesehöuld be evacuated and the wrinkled cti le smoothed don andoiled. I dd not nind tine to make ny",
         "12 CANADA MEDICÀL AND SURGICAL JOURNAL. observations upon the value of unguents in -preventing pitting, but am to believe it trifling, if anything. The pitting, I think, depends mainly, if not entirely, upon the nature and amount of the eruption, and is not controllable by local remedies. In dis- crete eruptions it does not take place to any extent, but I never saw a confluent case that recovered without showing more or less of-it. It does not occur until after the remains of the original pustule have disappéared. Sydenham, in noticlng this fact, attri- butes it to a corrosive humor contained in the small furfuraceous scales that succeed the crust after it hts fallen off. Light seems to have but. littile effect upon it, for T just now remember three of my patients of the same sex and -nearly the same age, two of whom lay ir darkened rooms, and the third in one that was well lighted. These cases were closely alike in symptoms and pro- gress, and the degree of pitting vas about the same in all three. While speaking of the local treatment of the eruption I may allude to the sore throat which is always a distressing symptom in confluent cases. A variety of drinks have been recommended, the most elegant of which isan infusion marie by pouring hot water upon black currant jelly-(Marson). If this cannot be had, molasses and water in the proportion of one part of the former to four or five of the latter make a very good substitute. 1 think that I have now touched upon all the points of treat- ment upon which I have any special remarks to otïier. I have not -deemed it necessary to occupy your time by repeating all tie practical details that are iniversally agreed upon, but have Coa- tented myself with noticing some points upon which there are differenees of opinion, and upon' such points stating my own and the reasons which I have for holding it. To go into full details of the complications ¯that may arise, and the treitment which they require, would have led me beyond my limits, and was, moreover, unneeessary as ail these have been thoioughly set forth by such excelläät authors as Gregory and Marson. whose desc'ip- tioùs and directions leave nothing for any one to add to them. They are' by far the- best moderri ' authorities that I have met with. The objective phenomena of the disease have beeiwell delscribëd byTrousqeau and almost , well by. Sydenhaii, whose observatins-mnade two hundred years ago acl undei dis- advantages of which we can hardlye onceive the magnitude-a're wonrde fully ti-uthful and accurate, and form, as everybody knows, the foundation upon which the whole moder system of treating the eruptive fevers has been constructed. The epidemic of 1870-72 will add largely to the information supplied by these -authors and by otliers, as ithas brought unde common observa-",
         "SMALL-POX EPIDEMIC. ¯ e tion, foims of the disease which hitherto have been but rarely met with. I have still a word or two to add upon DIRINFECTA T. When the patient has got well, 'the last part-of our. duty is always to disinfect-the preinises. Even while the disease ,is in progress it. is well to surround it with agents that evolve an acrid gas, which aestroys the organic effluvia, and in doing so, probably decomposes part of the miasm by means of which the infection is- propagated. For this purpose various substances have been used, of, which I know none that is handier, cheaper, or more effective than chloride of lime, which, when moistened with sulphuric acid, gives off its chlorine freely.. Sulphurous acid gas,, generated by the combustion of sulphur, bas been used occasionally. Its fumes ought certainly to effect À thorçough destruction of the organic effluvia, but even when largely-diluted with atmospheric air they are so :intolerably acrid in respiration that they are hardly to be employed, unless it be possible to get .all the people off the premises. The crusts that .fall from the patient's skin, and the dressings that have been applied to it, should all be carefully collected and burnt. , Such of the clothes and linen as are wash- able should be washed with Con-dy's fluid (a saturated solution of permanganate of potash) in the proportion oÈa tablespoonfvl to the gallon of water, and if they Bre boiled it will be all the better. Heavier clothes and nattresses should be fumigated for at least twenty-four hours with chlorine or some other disinfecting gas. But'bedding that has got very dirty, old straw ticks and clothes of little value, had better be burned at once. i have now, gentlemen, laid before you a hasty sketch 'of the epidemic of 1871, in which I bave tried, as far as possible, to collect the important facts apart from repetition and minute details. I bve lalbouied to be as brief as possible. I hope that I have not been obscure. The disease of which I have been speak- ing is a strangely interesting one. It has, indeed; many repulsive aspects both for the physician and his patient. There is no ail- ment which puts the7patient s much in need of assistance from others, and at the same time throws so many difficulties in the way of his obtaining it; wbich in so large a measure combines protracted suffering and peril, with the risk of future deformity and disablement, which renders him so hateful to bis fellow beings at a time when lie so much needs their kindness and sympahy. There is none which demands fromi the physician more skill, readi- ness, and patient, inselfish labor, at the saie timethat it involves",
         "14 CANAD. MEDlCAL AND SURGICAL JOURNAL. him in so many quarrels, exposes his reputation to such serious risks, and earns him so little in the way either of pecuniary recompense or public gratitude. It brings us into contact upon the one hand with filth, stench, and physical loathsomeness; on the other with fright. seltislmiess, and many other despicable traits of human character. Yet with all this, there is no disease whiòh offers us so intereiting an exhibition of the abnôrmal but rega. lated workings-of nature in the human body. There is none from which a conscientious phýsician can derive, in. greater measure, the satisfaction that rewards useful labor bestowed from no unworthy motive. And there is none which tends more to call out and exercise those qualities of kindness and philanthropy which every physician should endeavour constantly to display towards his patients as far as poor human n ture will let him. TA BLES. vi.)-STA1iTIUS 1) \u003c\u003eRDINARY EP JEMICS U\u003eeaths froin Distinct Natural Srnal-poN ................................. 1 in 10 Contluient \"l \" di............................... 1 in 3 SmaUi-pox after Vaccination................................. 1 in 33 Aitken, Praetice of Physic,\" vul. i., J). 256. B.)--STATLST[CS TAKEN AT ST. J.11N, IN 1871. (1.)--NATURE OF THE CASES. Attacked. Died. Mortality, per cent. imorrhage Small-px........-.-.....-............1..1.. . Al Petechial ,. 4. ..........................14 14 AU -Cotent and Copious maull-pox.................... .5 18 40 Discrete Small-pox................-.......... .54 .8 14.8 Varioloids........ .--.....-.................l Nil 0571 .!.)-EFFECT OF VACCINATION. Attacked. Died. Per Cent. Non-Vaccinated ........ ..................18 69 50- in 2 accinateCd...............-----.-.....--.67, 2 :î-1in34 ARREST OF THIE EPUJEMIC BY VACCINATION. Attacked, Died. Cases in February .. . -.-........... ... ................... 85 28 \" March............................................. 74 25 April-'....---;---------..................... 19 - 9 M ay....... ......................................... .. 86 \" June... ......:.....-- .................. ........ 5 4 Julyt..-.......... ..............................4 The Di.trict Vaccinations vere donc in Marcb. -",
         "SMAILL-POX EPIDEMIC. (3.)-EFFECT OF AGE ON THE .MORTALITY. iioder1~aro*dAttacked. V det;r 1 yt:ar old ...........-... -.-...... ...- .,. . 9 , \" 5 years old.................. 35 From 5 to 20 years old ..... ........................... 103 \" 20 to 40 \" .............................. 55 Above 40 Years old......-... .....-.... .......... 12 205 (4.*--DUIRTION 0F THE FATAL CASES. No. i Nature. No Nature. No. 1 3 Homorrhagie. 80 11 ........ 154 2s 3i8l1 ...........- .155 7 83 7 Petechial. 156 8 7 ....... 87 6159 8 .............. 91 4 160 i1 12 92 10 .............. 162j 20 15 .............. 9515 ...-..... 164 21 6 Petechi. 97 15 Discrete.† 166 ..........- 104 5 .............. 1681 27 . ......----..-- 106 6 .............. 170 9 -...--..... 107 9 Petechial. 175 43 2 Petechial. li 5 ............... 176 45 6 ......... .. 113 4 .............. 177 46 .6 ............ 114 19 Copious. ‡ 178 47 13 Petechial. 123 3 lauorrhagie. 181 49 6 \" 126 9 ............... 182 52 14 ............ 132 I1 Petechial. 184: 1 îeeli~ 8 57 10 ........... 133 5 .............. 185 60 2 Hoinorrhagic. 135 2 omnorrhagic. 186 62 M Petechial. 144 5 .............. 191 68 2 Rlwmorrhagic. 147 9 Howmorrhagic. 199 74 11 ............. 150 7 ........... 202 78 5 .............. 15 5 . 203 79 6 Peteehial. 7 ', * .ours. The average duation of fraction. † Pyæmia.ia. Nature. 7 .............. 9 .............. 9 .............. 3 lomorrhagic. 6 ............ 18........... 10 .......... 5 ........ 8 ............. 3 H1\u0026morrhagic. . lRmmorrhagie. 5.··......... 8 Petechial. 2 -11mmorrh agie. 1~ 11 'j Infant. these fatal cases was severi days and a Died. 6 19 29 19 4 71 Per Cent. 66 54.3 28.1 34.5 33.3",
         "MEDIAL AND SURGI0AL CAsS OcCURRING IN Tax PACTICH 0F TIN MioNTRE A L GENERA L-UoSPITA L,. Case of Depressed -Pacture of* the Frontal Bone, with Fracture of Fourth and Fifth Cervical Vertebr\u003ce, under the care of G. E. FENwICK, M.D. Reported by Mr. W. A. MOLSON. Oscar Stromme, aged 27, Norwegian sailor, 'was admitted to Montreal General Hospital, under care of Dr. Fenwick, IlthJune, 1872. at 7:30 a.m. He had beenassisting in the storing of ice on board the steam2hip \"France,\" and, while standing at the edge of the hatchway, the books holding the block of ice gave way, and he.was'precipitated to the very bottom of the ship, striking, with bis feet, the.blade of a spare fan. The violence of the fali threw him-irst forwards upon the edge of the blade, causing fracture of the skull, then backwards, breaking bis neck. le was brought to the hospital almost immediately, when his condition was found to be as follows: Tulse 72, regular but weak ; temperature in axilla 97 3-5; lividity of .entire surface; wasquite rational, but knew. nothing of the particulârs of the accident. On examiDation, a wound, three inches in lengthand three-fourths of an inch in breadth, was found to extend across the foreheadrat the roots of the hair, communi- cating with a depresion in the skull, three inches in length, in the line of the' external woîund, nearly an inch in breadth, and from one-half to three-fourths of an inch in depth, the deepest portion being above. 'In moving him, he complained bitterly of pain in the back of the nDek, and, on examination, it was thought that a depression of one or more cervical vertebroe existed. Sensation was entirely absent in the lower extremities and for some distance 4p, the trunk. . There Fas loss of power in the upper extremities; but, on being disturbed, he complained of pain in the arms espe- cially the right. The breathing was most peculiar, being entirely diaphragmatic, the chest-walls not moving in any part; reflex sensibility entirely absent; -paralysis of the bladder and rectum. Before admission to-hospita-several ounces of brandy had been administered to him, which produced considerable irritability of stomach, causing violent emesit.",
         "HOSPITAL REPORTS. A bladder of ice was applied to the h'ead, hot applications to'the feet, with beef-tea and pieces of ice internally. 9 p.m., same day.-At times he bas been 'slightly 'delirious, but when spoken to was immediatélyi aroused and answered intel- ligibly. The'paralytic symptoms bave not altered,with thisecep. tion, that the pain *on moving the upper extremities is inereased. ie has taken nourishnent freely-without vomiting.- -Pulse 80; pupils slightly dilated; passed a small quantity of water inxthe forenoon; bowels quiet; the, breathing continues quick'and purely- diaphragmatic, showing that the lesion to the cord ex:sts below the portion giving'off the phrenic nerve. June 12th, 9 a.m.-Patient pretty quiet -during the night; mental condition somewhat the same as yesterday; pulse 100; temperatüre in axilla 101; no vomiting; sensibility absent as high as the nipples, above them intense hyperSesthesia, especially of the right arn; face slightly cyanotic; has not urinated for nearly twenty.four hours. 8:30 p.m.-Pulse 92; temperature in axills 101 4-5; temperature between the toes 102 4.5; temperature of cheeks 108; has been delirious all day, and for the past three or four hours breathing has beer. more labored: eau be aroused only with great difficulty. It was found necessary to catheterize hii, when about half a pint of dark-colouied ammoniacal urine was drawn off. HTe continued to grow worse from' this time, and died early on the morning of J une 13th. Autopsy Sixteen Hours after -.Death.-Rigor mortis well marked. Head: besides some of the, echaracters mentioned above in the history of this case, there was noticed, on removing the calvarium, a depression of the inner table, corresponding to:the internail frac- ture.' This depressed portion of bone extended for about two inches in breadth. Through the fracture, the brain could be reached by an aperture in its upper part; considerable effusion of blood, with formation of clot between the bone and dui-a mater. It niay be mentioned that the external wound was situated higher on the forehead than the fracture, showing that the violence' -iuàt have been from above. Dura Mater wounded over the left hen2i- sphere, opposite the opening in.the innei table,. for about ore inch'in length. On remwving the membranes atthin-clot-f blood was found ý*ccupying the entire space between'the dtfla;'iater and the·rachnmoid on that side ; veins engorged with'bloodl - gerieral congestioni and\" staining of surface of entire ;hemisphre; occa- sional fiocculi oflynph benéath the- ràchnoid; correspoiding to the opening in the duia imeter, was a voùnd lu the brain substance of -the same dimensions, with.considerable 'hoemorrhagic efl'sion",
         "18 CANADA MEDICAL AND SURGICAL JOURNAL. in the neighborhood; brain matter softened and readily washed away under a stream of water., On making section of the right hemisphere, the brain was found softened for about half an inch below the bottom of the wound.: Puncto Vasculose normal; ventricle healthy; other portions of the brain normal, with the exception ofslight bloody, extravasation beneath the dura mater, over. portions of the left hemisphere; weight. of brain. fifty (50) ounces. Back.-Upon cutting down on theback of the neck, an extravasation of blood into the tissues was noticed, extending for a distance of five inches alongthe left vertebral groove, with frac- ture of the spinous processes of the fourth and, fifth cervical vertebrea. The spinal dura mater, being exposed, it was found covered with a thin layer of extravasated blood for about three inches.of its extent, or over that portion corresponding to the above-named vertebr. Examined, in situ, the cord was found deeply indented in two places, but more opposite the fifth than the fourth cervical vertebre; and, on removing it, fracture of the entire body of the fifth was found. In that situation, therefore, the cord was impressed from two aspects, thus accounting for its .ihnost entire division. lCase oflInjury to Spine-Paraplegia-HIlead Synptons, Deatih on sixth da. Under the care of Dr. JoHN REDDY. Reported by Mr. F. J. Shepherd. J. M,,aged 59, was brought to the MontrealGeneral Hospital, on ,the evening of the 10th of May, suffering from paraplegia, the result f injury to the back. H.siory. When in the,act of stepping on a scaffolding it gave -way, precipitating him a distance of some ,wenty-five feet to the pathway.below. When taken up, he, was found insensible' and immediàtely brough4t to hospital. on admission heliad sufficiently recovered to be able to give a lucidaccount of the accident, pulse shabby, lips pale, and genoral liyidity. On examination,there was.disovered a depression oppo- site the eleventh dorsalvertebra,,with intense:pain in.tharegion. o useNhis own words \"he wase mangwhotook a little but.was never out.,ofthe waywith liquor. He says he perfectly sober when the aocidentcurred. Ie had also aslight scalp wound. .M zt,1h...: eems quite sensible this -morning, veyé, talkatiye, hasaalàllrapid,ha b ypulse,,coatedtongueurinighlyalaline, éfgund necessay. to :catheterize him, drinks freeyand vomits coristantly, complains ofgreat.pain about th middle olQ, ,he back and sidesa,.morning.temperature inaxila 1002-5, pfge ll8,.evgning",
         "HOSPITAL REPORTS. temperature in axilla 100, pulse 100, and still shabby and small, abdomen distended and tympanitic. Treatment.-Water-bed, ice to spine, cold to head, stimulants, four ounces of brandy, beef-tea and mik ad libitum. Ordered Po- tass, Bromid grs x Potass, Jod. grs. v every four hours. May 12th:9 à. m.. Pulse somewhàt stronger and less rapid, tongue dry, brown and cracked, skin moist and cool, urine dribbles cons- tantly, vomiting and thirst have ceased, still complains of great pain in the side. Temperature in axiila 98 1.5, pulse 96. 8.30 p. m. Pulse not so strong, skin hot and dry, temperature 96 2-5, pulse 80. May, 13th 9 a. m. Bowels open this morning, quite delirious, had strange illusions sùch as fancying that some one was trying to remove the bed-clothes, eyes very restless, Naks and laughs cons- tantly, skin moist and cool, respiration performed imperfectly, has a troublesome, short cough, indicative of weakness of the respira. tory muscles, heart's action feeble, temperature 99, respirations 25, pulse 95. 8p. m. Puls'e less frequent and weak, skin hot and dry, delirium more violent, general tremor, similar to that in delirium tremens, extremities cold, temperature 101 3-5, respirations 26, pulse 75, was ordered two ounces more of brandy. It becomes a question whe. ther this delirium is not that produéed by alcohol. May 14th 9 a. m. Pulse somewhat, stronger, delirium still conti. nues, grasps at imaginary objects, treinor continues, great restless- ness, can answer a direct question intelligibly and recognizes persons and objects, conjunctiva stiffused, paralysisof bladder and rectum continues, last night had a turpentine ,epithem applied to chest, and chloral, hydr grs x administered .very two hours.: May 15th 9 a. n. Very: weak, condition semi-comatose, can be aroused with difliculty, no delirium, eyes dull, heart weak, respi- rations very irregular, temperature 101 4.5, pulse 88. 8.30p. m. Pulse hardly perceptible, respirations very weak, quite conscious, says that he does not expect to last long. -May 16th. Died at 2 a. m. Auropst.-Brain. Arteries atheromatous, especially right carotid at its division-dura mater firmly adherent to calvarium, Pacchionian bodies large and very adherent, _Brain substance firm in consistence, puncioe vascdoso normal, slight effusion of lerous fluid into yentricles. Spinal column.'-Great extravasation over the spine from the 5th to the 12th dorsal vestebra, comminuted fracture of the entire 7th dorsal vertebra; the cord in that region being pressed upon-from ,both:aspectsy a spicula.penetrating its substance. The entire cali.",
         "20 CANADA MEDICAL AND SURGICAL JOURNAL. bre of the cord was softened and disintegrated in this spot. Frac- ture also of spinous process and arches of the eleventh, dorsal vertbra, cord quite healthy beneath. History of Medicine, from the Earliest Ages to the commencement of the nineteenth century. By Roinny DUNGLISoN M. D: LL.D; Late, Professgr of the Institutes, of Medicine and Medical J urisprudence in the Jefferson Medical College of Philadelphia, \u0026c., \u0026c, Arranged and edited by liCoAnD J. DUNGLIsON M. D. Philadelphia; Lindsay \u0026 Blakiston. Thi;,ork, as we are informned by the editor in his preface, is:an embodiment of the course of lectures delivered by the Elder Dun- glison, many years since at the University of Virginia.. At-this Stùie, it appears, the \" history of the progress and theories. of Medicine\" formed one of the subjects which he:regularly taught to his stc[ents-ànd it is with truth remarked that \" it was a wise provision that thus incorporated with the other features of a didac- tic course- a knowledge -6f Medical ýLiterature awhich, however valuable, is -geierally considered as an accomplishment rather than as an indispensable necessity.\" The present work is stated to have been issued tO supply a want very generally felt for some congenial cenvenient work for ,lack of:which this- study has been ahnostentirelyýneglected. The first chapters are devotedto a des- cription of the -very eai'liest- known: proceedings which can be supposed to bear the semblance of medical procedure, and at some lenáth-i: treats ,of the various mythological and superstitious rites practised amoýigst -the ancients, -under the pretence of curing the sick and -tells'how in- old times-. the word \" Abracadabra\" hung around the:neék as ar amuletiould2 be used to chase- away-'the ague, an hexameter fron the liad to-alay-theagony ,of gout:and a verse of thel lamentationsto cure the- Rheumatism. The, glim- nerings of attemp ts t'-arrive at:rules fo'the treatment of disease ai-e- then traced sucëessively as witnessed ,amongst the Jews, -the ancient Ronans theýJHindoos; the . Chinese,'Scythians, Celts and the ancient/ Greeks. This occupies the first, ten-chapters after which'vea-rive:at the time of HJippocrates B. 'C 470, Who was the rät/to introducesome ehtirely,rew teaching into the,:science of medinethein its very infancy.: He taughti whàt, was ý quite opposed:to-il then preconceivedtideas ·that ' nature rwas thefirst",
         "REVIEWS ýAND -NOTICES 0F BOOKS. physician,'\" and impressed the necessity of observation ofAier workings. He also was perhaps. the, very- firt to endeavor by hygienic or rather disinfectant means 4o check the spreàd- of an epidemie which was rapidly extending. Hie caused fires to be burnt as wellas aromatics over the whole city in ,order to, purifyr the atmosphere, whiéh measures are related to hae been .entirely successful. ,His immediate successors and the so.called dogmatic school are next reviewed, when we corne te the great philosopher Aristotle who made many discoveriès in Natural Histoe-y and some in Anatomy and was: the first to locate the origin of all the vessels in the heart. - The next marked advance was the separation by Praxagoras, who lived shortly after Aristotle, of the arteries from the veins, although-he was: in gross error as regards their real pur-. pose, in the economy, for he supposed that the arteries were always filled with air. We are then introduced te the Alexandrian School foremost amongst whom was Herophilus, whose name is still retained in modera anàtomy in the torcular Herophili, and whose nomenclature of the fissure on the floor of the fourth ventrile is still extant as the Calanius Scriptorius. Another name closely asso- ciated with his is that of Erasistratus who, attempted some physio- logical theories such as: that digestion was performed by attrition. \u0026c., and who desýcribed the tricuspid valve. Next coine the.Em-; pirics who' despised anatomy and professed to ýact solely upon. the result of experience. IThe- Empirical School terminates the most ancientperiod of the history' of medîcine, and - that which gives a type te thehealing art of the subsequent ages.\" We have then a description of the state of medicine\u0026during the early.Chris- tian eras4including the works of two great men, Celsus and Galen, a delineation of the different sects into whih , physicians were . at this time divided and a description of, the various abuses to which they subjected their art. -At the time of the appearance of Galen, it is said that Il the schoolsof medicine were :a. prey- to the most pernicious dissensions, thepartizans of the schools of Erasistratus,; of Hippocrates, Herophilus . and of the Empirical, meéhodical, eclectic and pneumatic' sects, divided in their opinions, agreed-in; onep bint, that of converting medicine into a ·tissue of frivolous, subtletiesnd useless discussions. ' In the, midst, of this disorder, Galen appead-;a-dled back te the safer road of patient thinking, and âceurate observation which so iuch distinguished the Hippo- cratic:schoolh\" it.is poiinted·out,:howat and after this period the, progress of nedicir .was still retarded by the admixture of a strong religlous' and, partly superstitious feeling in ail medical education -nd procedure.- Following further, we find -explained howv tlie annihilation of medical education was begun by the super-",
         "22 CANADA MEDICAL AND SURGICAL JOURNAL. .stitious and intolerant orthodoxy of the Christian Emperors of the East and completed by the dismemberment of the Roman Empire and the destructive invasion of the barbarians of the North. We then learn how the Arabians retained what little was still known of the nedical art which they had obtained frorm the Newtorians, who had it .in safe keeping, and from the Aimian philosophers expelled from their country by Justinian. We then pass by the 7th century, which contained Paulus JEgineta, called the first man- midwife, and during which we find the first attempts at Chemistry and Pharmacy amongst the Arabians and the very firat description of the small-pox given by one Aaron Ahran. We are thus brought, after the 6th century, to the period of the Monks of the West, .who'almost exclusively exercised medicine as a work of piety and charity, and as a duty attached to their divine calling. They however neglected the study et science, having recourse, to a great extent, to prayers, relics of martyrs, holy water and other ceremo- nials of the Romish Church, \"l n the 14th century medical ins- truction experienced in European countries, a revolution of the highest importance and one to which Medical Science is indebted for its subsequont progress.\" By this reference is made to the public practising of dissection of the human frame and consequent insight into anaomy and physiology: but notwithstanding this important step, the progress of medicine vas retarded by tho ex- tensive study of astrology, and theimplicit faith placed in its tea- ching by the ignorant public. In the 16th century all the different branches of medicine were studied and many books written which are still extant. From this time dates the gradual awakening of the world to the importance of the science of medicne and many familiar names begin tio appear, names which in some cases have not even now lost all the authority which they once possessed. Arriving at the l7th century, we have the great 'discovery of the real nature of the cireulation of the blood, the days of the Humoral theory and amongst many well-known -names, those of Willis, Mal- pighi, Sjdenham, Wharton and Borhaave., After this period the medical sciences begin fairly to'assume the important place in literature and 'the extensive practical iniluence which they occupy and exert at the present day. It is indeed hard' to properly esti- mate how closely'the welfare of this entire universe is interwoven with subjects intimately connected with the art of- preserving and maintaining health. Every day we find fresh sigis of the interest taken by the public in purely medicàl concerns so fully are they being convinced that it is only by the diffusion'of general knoiv- ledge upon these subjects that an enlightened public opinion will be enabled to combat the causes of disease and death. We refer",
         "REVIEWS AND YOTICES'OF *BOOKS. more especially to what is now known as the Science of Iygiene, and it is strange to think how- long it has taken to arouse ànything like a proper feeling in the civilized. world as regards these all ireortant matters-and it is extrenely interesting to note the gradual progress of medical enlightenment, as depicted in the volun:e before us. leading up by insensible degrees from the first dawning discoveries of the nature of disease, to the periodof the present day, when we have succeeded in' discovering the causes, or rather modes of origin, of many contagious and other affections, and now endeavour to preent, if possible, the occurrence of disease rather than have to cure it when it has occurred. We have perused this volume with much pleasure and recom- mend it to all as a very useful and really instructive book; and one which we hope may have a large circulation, for we are sure that its study by all thinking men-both students and practitioners of medicine-cannot hut be productive of great good and much pleasure of an instructive nature.- It is well printed on tinted paper and is got up ir a manner v\u0026iy creditable te the publishers. The present edition is issued only to subscribers, but it is a vork, we think, of such merit, and so generally useful that we' trust its pages may in future be thrown open to the general medical public.' Earth as a Topical Application in Surgery; being a full expositiot.v of its use ii-all cases requiring topical applications admitted. in the Men's and Women's Surgical Wards of the Pennsyl. vania Hospital, during a period of six months in 1869. By ADINELL HEWsoN, M.D., One of the Attending Surgeons t(o the Pennsylvania Hospital. Philadelphia: Lindsay, \u0026 Blakiston, 1872. The greater part of this work is taken up with fthe histories, in detail, of a number of surgical cases, ninety-three in all, which were treated by Dr. Hewson in the Pennsylvania General Hospital three years ago, It is satisfactory to find that ail the cases hive been reported without exception or selection, wad consequently; as the author justly observes, since there weie nimerous and con stant witnesses of the cases, and the-details of ail of thern being given, he has avoided the suspicion of suppressing anything ivhich could have then led him to other conclusions, The ideà'of using dry earth as a dressing for foul wounds in surgical practice, is ee which has naturally arisen from thé considei'tion of the undeni. ably useful purpose whicli the satmè substance has been found tei subserve in the deodorizing of feecaland other disagreeable mitfors,",
         "24 CANADA MEDICAL.AND SURGICAL JOURNAL as established by the extensive use of Moule's patent earth closets. It is from this source that the author acknbwledges to have first drawn his idea of this novel surgical dressing.. fe quotes, hlwever, a letter from an eccentric individual named Minshall Painter, of Delavare County, .written in 1857, which, he says, contains the germs of the very idea he is attempting -to, develop; but it seems to us Minshall Painter is a long distance ahead.of his successor in his admiration of the rnud system, for he actually contends that a free supply of honest dirt .kept. pretty constantly applied to the outer covering of the human frane is rather conducive to health and longevity than otherwise, which, we musL say,is somewhat opposed to the old adage still, we are happy to think, universally.regarded. that 'Cleanliness is next to Godliness.\" \"For instance,\" he says, \"children that crawl on earth and play in the dust, and occa- sionally filltheir mouths with it, provided their nurses occasion- ally clean them, are generally healthy. And .again, we have heard of savages who eat largely.ofsomq varieties of clay, and somé ftinilies. not ,over-tidy, enjoy good hentlh., whilethose more scrupulous do not enjoy the best.\" The earth or clay used in all the experinients %,ns the same, viz., \"fi-om deep diggings, well dried (but not.roasted) and sifted through a fine flour-sieve ; the yellow' subsoil, rich in ,ferruginous clay, ard entirely free of all sand, grit, or foreign matter.\" It is applied, according to circumstances, either dry or moistened.with water in the form of paste. Besides'this, he frequently makes use of '«gauze and: c;ollodion,\" supports to the wouids, in place of ordinary.lplaster. \"The gauze is a-strong silken tissue, with meshes large enough to allow the. collodion to penitrate anddiy on the skin beneath. I have been.in-the:habit o sing, as a less expensive but equally efficient artifle, the tarletan mucli employed by old ladies for caps in our lain city. Its mode of application is this : Strips-are .to be cut fromn,such tissues along. itswoof orlengthwiseand of con venient nyidth,as we cut the ordinary,or adhesive plaster.. The. énd;of one of thesestrips is to beplaced at some distance,on one sidefrom the. edges.of .the.wound, and there.esecured by paird f cpllodion on its:meshes. When;thecollodior becomes dry. ve have'the.strip.so firmly fixed thatit, will bear any degree of trac- tion necessary, and fa more thai the. adhesive:properties ofz any fori of plaster-lill perlmit. B3y traction- on its free end. it is then to be .drawn across the wound, and being satisfied that it gives all the support required. it is: to be: secured by the: collodion at this free end, and ata point similarly remote from the edges of the wound.\" , Over this is applied the.earth.",
         ". REVIEWS -AND NOTICES -OF BOOKS: The cases treated include, amongst, them, the nmost formidable accidents and injuries, ivhich it- is possible to mejet ,with in- the. whole range of surgery; suchi, for instance, as seyere compound fractures, extensive and sloughing cellulitislarge and deep burns and scalds, amputations, bad forms.of chronic ulcor, abscesses and diseases of bones, \u0026c. ; and a considerable measure of: success, on the whole, is claimed for this -special treatment. Dr. Hewson is not, however, unwilling to admit his nön-success in those cases vhich did not progress in a satisfactory manner. In some instances he refers his failures,.howvever, to the great difficllties experienced in enforcing a fair. and honest application of the dressing, and in ensuring the due rest of the ptient' in his ,bed owing both to rebellion on the part of the nurses to iomit was troublesonie, and to objections on the part of tue p itients vho thought they were being experimentedi upon.* The principal result claimed' to have bean obtainec by these carth-dressings is fodorizing. The power. of dry earth in this respect is undisputed, andi we think that the author has fully sustained the proof of its eflicacy in this respect, after a most rigid trial, especially iii sone cases oi extensive cellulitis, accom- panied by very profuse discha :ge, of ftid, pus.. Tihe beneficial effect here obtaine by theeoval of all offensie dor, was, doubtless, very great; but, though agreeing to this, we cannot admit that we do not possess other, chemical substances, such as carbolic acid and the permanganate of potash, which are found just as effectual in renoving odor, and, at the same time, furnish more cleanly and less troublesome dressings than the earth., Application:of earth, sucli as has been described, is shown nùt to be accompanied by any feeling of pain or irritation; but, on the contrary, the dressing has, generally, been pronounced by the patients thenselves as cool and agreeable. Whenpainis present it is claimed that the earth generally servesto allay this; but,;we can, hardly agree that that. point has been: satisfactorily demon- stratedi.. Instances; such as those. quoted,, ,here, under its -use pain wasnot felt where ,we might.have expected it to be present, are, perhaps, just as often met with ,underthe application of plain cold water.. .-- This mode of dressing' woundsis further believed to prevent, to somne. extent, -the occurrence of inflammati6n and to· favor the healing -process.»To what extent: it can really accomplish these desirable. ends we thini,. must remain to be decided! by further and more- extended series of experiments; A- theory óf 'the modus operandi is attempted to be constructect on purely chemi-",
         "26 CANADA MEDICAL AND SURGICAL JOURNAL. cal data; but, as-it' is wholly hypothetical and of no praotical utility we decline to enter into the discussion of this.point. To conclude, this book is, fron its very novelty, worthy of perusal, and 'may, perhaps, lead to something more; but we do not think that the system recommended is one at all likely to come into general use. The Physician's Prescription Book, Containing Lists of the Terns, Phrases, Contractions, and Abbreviations used in' Prescrip- tions, with Explanatory Notes; to which is added a Key, containing the Prescriptions in an Unabbreviated Form, with a Literai Translation. By JoN;euN PEREIRA, M.D., F.R.S. Fifteenth Edition.~ Philadelphia: Lindsay \u0026 Blakis- ton. Montreal: Dawson Bros. This little hand-book of the art of prescribing has made its appearance in a fifteenth edition, which fact shows that it must be used and appreciated by some class of the drug-handling frater- nity. It goes fully into an explanation of all the Latin medical ternis which have ever been in general use amongst the profession, explaining the different shades of meaning between different Latin words, and teaching how to express in Latin the sane thing in different ways It contains, also, a complete Latin syntax for the proper arrangement of sentences in prescriptiona in good medical Latin, upon the model of Celsus, who is here truly styled \"oir greatest and almost only authority in everything relating to medical Latinity.\" We fear that the book is not one which is likely to be practically useful either.to the medical student or the practitioner of the present day owing to its having reference entirely to the writing of prescriptions in the Latin tongue, which has been wholly given up, both by the late British and American Pharmacopæias., Ie'is admitted in the introduction to the work- that it is on -many grounds preferable. to write the directions for the compounder in thehvernacular, and - yet nearly the whole book is devoted to teaching (what it requires considerable study to master) how to elegantly express the sane in Latin. The author _onfesses that the latter languag' is not nowa-days fully understood by many who prescribe medicines, and in a foot-note relates how he once, with great surprise, heard an eminent hospital surgeon con- fess his inability to write in Latin the directions to the patient. We know many eminent hospital : surgeons in the. sane predicament, but we hardly think that at the present day- that ignorance of .the old-fashioned .curt and :sometimes :pedantic Latin woulde in any way detract from their ability to understand.disease and prescribe",
         "STROMEYER'S ADDRESS. for it in their own imother tongue. Tothe pharmaceutical student, however, this little manual, may. be useful, as serving as: a guide and help to him-in pursuing his studies amongst old authors, or in understanding the directions of those who still make use of the dead language in:their:prescriptions. Dr. Rigby's Obstetric emoranda: Fourth Edition, Revised and Enlarged.' By ALFRED MEADOWS, f.D., Physician to the General Lying-in _Hospital. and to the Iospital for Women; Author of a \"Muiual of Midwifery,\" \u0026c. Philadelphia: lindsay \u0026 Blakiston. M1ontreal: Dawson Bros. This small manual is one wvhich most especially commende itself to the junior practitioner and to.student-pupils who take charge of midwifery cases for their preceptors. It contains a succinct resumr of what it is absolutely necessary to know con.cerning the- female pelvis anc. generative organs i concerning pregnancy andl the accomplishment. of natuial labour ; together with the duties of the medical attendant at every stage. It reminds, also, of the- various complications. and dangers which may arise during the pregnant condition or during the act of parturition i at the samle time .mentioning the modes of procedure found most useful in combating or subduing these. It concludes with a few words upon. puerperal fever. The whole is well and conveniently arranged for refèrence, and, is expressed:in language at once concise and intel- ligible. It carries out fully the object expressed ;y its title, for it contains all those \"things to be remembered \" whilst practising. the obstetric act. PERISCOPIC DEPARTMENT. AN ADDRESS ON ENGLISH{ RECOLLECT IONS OF A GERMAN SURGEON. BEING .A SPEECH DELI ERED, AT ST. THOMAS' HOSPITAL, 4AY 23, 1872. By Dr. STRoMEYER, ,f Hanover. GENTLEMEN--I suppose may leave it- to the 'hind care of my youngest Englishfri.end, M William MeCormac, to account for the liberty take Jn addressing you. Let me~ask your indulgence",
         "-28 CANADA MEDICAL AND SURGICAL JOURNAL. for spoiling the. Qeen'sEnglish, which is not my native language. This is the.first- time that ipeak to.an English audience. As a surgeon, I dare: say, I -am not quite a foreigner, having got a :sprinkling -of English surgery even by inheritance. My, father, who was a member of the Royal Medico-Chirurgical Society in London, and well known in his ti ie, by hàving introduced vaccin- ation in Germany, was a regular pupil of St. Thomas' Hospital, 'from 1792 to 1793, under Mr. Cline, at a time when Sir Astley Cooper 'was a demonstrator of anatony there. He had a very high opinion of English surgery, and wsed to say that the best surgeons in the universe were to be found in London; that during a twelve-months' presence there he witnessed only a very few cases in which-his opinion was diflerent about the propriety of the operations which he daily saw performed. He was ableto judge for himself, being already thirty years old when in London, and having been a pupil and assistant of ProfessorRichter in Gottin- :gen. I followed my father's example, and have been a pupil myself at St. Thomas' Hospital in 1827 and 1828. Mr. Henry 'Green introduced me there, and made me icquainted with the splendid circle of 'surgeons then living in London-Benjamin Travers and John Tyrrell, of St. Thomas' Hospital; Bransby Cooper, Astôn Key, and Mr'. Morgain, of Guy's Hospital; William Lawrence id' Henry Erlé, of St. Bartholomew's Hlospital; Sir Benjamin Brodié and Mr. Rose, of St. George's- Hospital; Sir Charles Bell, of Middlesex Hospital; Mr.'Guthrie, of Westininster Hospital Mr. Wardrop, of Westminster Eye Infirmary. 'Sir Astley Coopèr had alroady retired to the country. 'I have only seen him' on an occasional visit to St. Thomas' Hospital, where he used to come from time to time when he was tired, as he said, of looking after the ewes. ÏIt *i àhghly gratifying.to see how his presence used to be hailel. Thé same\" scene toolk place when old John Abernethy appeared in St. Bartholernew's Hospital. The students flocked around him, and hle generally gave them a speech, in parting,- in the open court of the Hospital, ending by quoting Shakespeare. Being very partial myself to the great poet, I liked these quotations, whih reminded me of.Sydenham recommending to réad \"Don Quixote,\" For a surgeon inothing is so injuriousas dulness; he must always be in good spirits when his services are required. Sir Astley Cooper äsed'to say that a'surgeon ought not to read too much ; but this, I supposé, meant dull authors, not Shakespeare or Cervantes, who are both of them very accurate observers of humannature, like Dickens, Sterne, and Fielding, whose \" Tom Jones,\" I daresay, you may happento know. I could speak for hours if I were to say what influence the",
         "STROMEYER'S ADDRESS. surgeons in London whom I have named had on my mental devel- opment. First of all, I admire the truly noble character of the- profession, the good feeling of its masters to each other, their candour, their bumanity in the treatmènt of severe:cases. I caw only repeat what my father said fifty years ago-the operations whieh I saw were, all -of them, necessary, well planned, and, in most cases, executed with great dexterity. Manual dexterity was considered as a quality which scarcely deserved to be men- tioned; it was only spoken of where it shone by its absence in a bungling operator. Every operato\u003en was executed with .the. sole view to save the patient's life or to diminish his sufferings, no6 to show the dexterity of a virtuoso, Circular amputation was pre- ferred to the more showy flap amputation. This I lad not forgotten when I had some influence in recommending the circular amputa. tion in times of war, where it is of greater importance still than in chronic cases of civil practice. In 1827 I examined the invalids, in Greenwich Hospital, on whom amputation had been performed by the flap method, and found-that the fleshy cushion had disap- :eared entirely. Besides this, I admired English surgery for the simplicity of its application. The great conformity of principles resulting from simplicity struck me as highly valuable, because-it makes a deep impression on the mind of a younger member. This conformity gives English surgery a national character. It is not the same in other countries, where only your- very particular friends admit that you are right in saying that two and two make four, or that a severe gunshot fracture requires amputation. I was well satisfied with the great caution of English surgeons in adopting innovations. I saw no resections then, and there wwno trace of lithotripsy yet. It is better to begin slowly, ena; thef te go _ on steadily. This is otherwise in -Germany.d in France, where surgeons are fond of novelties. At p.,zent you may wit- ness the effect of greater caution. Sir fenry Thompson has eclipsed the inventor, of lithotripsy, Civiale himself, whose instru- ments, indeedwere not worth tryig till Heurteloup had found the right ones'for, him. SirWilliam -Fergusson, by his articular resections, has surp assed most Continental surgeons. Mr. Spencer Wells' in ovariotomy, all'living surgeons. From what I had observed.in.Londôn, I came to the conclusion that the beneficial influence of surgery and the high standing of the profession depend chiefly-(I)- on, the good feeling :of its members towards their patients and towards each other, not ex- cluding those of:a former time; (2) on simplicity; (3) on a totàl abnegation.of selfishness in planning and executing surgical oper. ations.",
         "30 CANADA MED'ICAL AND SURGICAL JOURNAL. Yeu may ask nie, gentlernan why I could not have learned that just as well in Germany. There is no place there which can boast of such a number of great surgeons at the same time. Our greatest capitals have but a few surgeons of eminence in comparison. Whatever may be their merit, their example is not se striking as that of a whole body acting the same principles. In Paris the number of surgeons is greater than in our-German universities of Berlin or Vienna, but net te be compared to London, which I consider is a central point of surgery for the whole globe. This, gentlemen. you nay o s p of a man w- o has watched the progress of surgery during half a century. I wish it may remain so for centuries. After having been in London, I happened to be in Paris at a time when Lisfranc was thundering against Dupuytren, whom he used to call \"le barbare de la Seine,\" as a sample of the good feeling amongst the profession there. It is one of the great advantages of travelling, and of seeing eminent men of other coun- tries, that, by observing them in their activity, one may acquire a better notion of their character. Their writings excite greater interest, because we are inclined to give them greater credit. I always admired the simplicity of style in English authors in general, and of surgical writers in particular. Sterneridicules the pompous style by mentioning the expression of his French barber about' the solidity of a new wig, \"You may immerse it into the ocean.\" An Englishman, jays Sterne, would have preferred a pail of water. To avoid tha harber's style, I took prýecioue; good care never to say ocean whta I meant a pail of water. After sketching these general impressions, permit me.~gentle- men, to give a few particulars of the manner in which some of my English teachers have iniluenced me. Having so lately seen one of the greatest battle-fields of modern history-that of Sedan, where I met Mr. William MacCormac, who, from over-exertiou, did not look so well as to-day-and the siege of Paris afterwards, lot me speak of Mr. Guthrie first. I cannot say that I:liked him personally quite so well as many of the others ; but I admired his energy in maintaining the great prineiples -acquired in the Penin- sular War-the necessity of early pr7miry. operations, of tying a wounded artery, if possible, on the wounded spot itself. I have done all in my power to keep his -doctrines,-those. of the admir- able Henien, and 'of old' Baron Larrey, in fresh memory since 1848, when-the' time seemed te approach that Germany must go var fer its own development. For a man: of sense, there cau - be no doubt about the necessity of early primary operations-; but in military practice there are difficulties in which it is the duty of",
         "STROMEYER'S ADDRESS. every medical man to maintain the sacred cause of humanity. The sentiment was appreciated even by a conqueror like Napoleon I., who said of Larrey that he was the most virtuous man lie had ever known. It was. one of Mr. Guthrie-s best qualities that he always gave very positive reasons for what lie did; so another per- son could easily find out. whether his own views must be in accord- ance with Mr. Guthrie's opinions. There was no fickleness about him. I differed from him in one srssential point-that of his pre- ferring amputation for gunshot-fractured thigh to conservative treatment. Guthrie places .t4o much stress upon the imperfec- tions of conservative treatment, the result of which is often a very disablied limb, whose possession does not make the patient very comfortable. But these imperfections admit of improve. ment, while a. high amputation gives no prospect cf.-better chances: it will always remain a very dangerous operation. Our first object is to save a man's life, and the second to m4ke him comfortable, but not in his grave. My results of con. servative treatment in gunshot-fractured thigh, during the first three campaigns of 1849, IS50, and 1866, did not go beyond 50 per cent. healed. I saw the reasons of our failures, tried to avoid them, and went on with conservative treatment. In the two cam- paigns of Schleswig-Holstein (1849 and 1850) the patients had to be carried to considerable distances. After the battle of Langen- salza, in -166, I was unable to prevent many cases from being spoiled by an injudicious use of plaster bandages. It was in Floing, near Sedan, where we succeeded in saving 77 per cent., twenty-seven amongst thirty-tive patients, who have been carried to no great distance, and were treated without putting much restraint on their shattered limbs. From my own father I had learned the advantages of Percival Pott's position, which may be omployed during the first period in Most cases; in others or lIater the double inclined plane, or a straight.wire basket, will suffice. According to my opinion, the great principles to be followed in compound fractures in general are-(l) dressing the, wounds without lifting the limb; (2) avoid- ing oenstriction .and (3) not irritating the muscles in straining them by mecharjical contrivances. A gunshot-fractured thigh permits a weight to be suspended to itrkeeping the limb a little at rest,. like the hand of an assistant, but not an extension by weight or other contrivances, that gives the limb its proper length, except in very few cases, as mentoned by. Mr. MacCormac in his \" Notes and Recollections,\" which jhealed without difficulties and without- any perceptible shortening. The most, ccmmon case is, that for some time after the accident the muscles retain a.ten-",
         "32 CANADA MEDICAL AND SURGICAT JOURNAL. dency to retract, which is increased by opposision, and ceases by- and-by in a favourable position of the broken limb. The idea of subduing muscular action by constant extension, even in compound fracture, is not new; but it had no been tried before by contriv- ances so dangerous as a plaster of Paris bandage. This is.applied under chloiofornm, which relaxes the muscles; the limb-is made straight, and as long as its fellow. When.the action of chloroform has ceased, the muscles recover their activity, and are kept in extension in spite of their violent efforts to contract, which often break the plaster bandage. The tension, which is kept up by mechanical means, makes the sensibility rise to a highpitch, and severe, inflammation-follows. If the plaster bandage be loosely applied; by- putting wadding and a flannel roller between, it is often well ,borne, but the limb is as short afterwards as if no, bandage had been employed. While I was writing this in Hanover, on May 1 a young captain came to me, from whose gait ne one- 4ould have thought, that he had had a gunshot fractured thigh in 0 plaster bandage had been applied on the third day ; he couid nàt bear it. The surgeori who took it ofnext day told hin thathe fragments had taken a bad position under the bandag\u0026. From this time he was treated without restraint, and cured in six wseks, his .limb lying in a wire basket. The ahortening· was one. inch-of his left lower extreniity.z lis brother met with the same- accident'at the- same time, but was healed with a shortening of five inches. Large splinters came away by suppuration, some of them being three inches long. The 'captain came to consult me about -his brother. lHe is in service again long ago. The :danger of, early plaster bandages orr other parts of the skeleton is less than in the thigh; but it exists and is -very great in the humerus, where pressure is very liable ,to stop the venous current, or to drive a splinter of-bone into the brachial artery. l' tréat these fractures by letting the àrm lean on a soft cushion, which is tied.to, the ·thorax, the forearmn being suspended .in. a sling. In Schléswig.Rolstein -I had-twenty-four successful cases amongst twenty-niie. 'Ore of the German surgeons who took part ir - the late war-Dr. Rapprecht, of 1%nichi.e-ýprefers the plaster bandage; but amongst the three cases·whichýhe had to treat there was of e whichproved fatal on the seventeenth day by hienorrhage a splinter of bone having opeined the brachial aterly; . differ frein Mr Guthrieb'tesidés, in bis appreciation ôf tre, phining-thesküll, whichiiave ed t ekelude entirely-froni niilitary .practice,-asuseless in, some and unnecessary ini other cases. 4 consider a -state of 'coma, -froni depressed skUlL'ni or-e'e",
         "STROMEYER'S ADDRESS as an indication for applying the tropan than a-comatose stateýin typhus as an indication -to rouse the patient«from it ,by any other means but those which are in accordance with his generalistate- cold, for instance, but not stimulants. As soon as the fragments of skull become detached by suppuration, the comatose state ceases by itself. The greater difficulty in settling:this skull question consista in this-that some patients survive the use of the trepan, or of an early. extraction -of splinters, and that some recover their senses very soon after the operation. This seems to be. a conclusive - proof of the legitimacy of active interference. But there is no depending upon it; the patient may die just-as weil afterhaving recovered his senses completely, and, as experience has shown, more easily than if you let himn continue comatose by not distur- bing the splinters. This might have been expected. from very solid physiological reasons.. By taking away the splinters aan early period, in cases where the dura mater is wounded, youi open the arachnoid cavity; air and. acrid matter -can enter it Brain substance, when bruised, thus becomes putrid, while it might have been eliminated by reabsorption without access ,of-air. Subcuta. neous operation practised in modern times have done a great deal to put more stress on excluding air; but even before their tiie, Dease and Sir Benjamin Brodie came to a conclusion that access- of air was- to be. avoided in cases of fractured skull, and that no, interference ought to.take place for depression· unless it was war- ranted by cerebral symptoms. John Hanter was not- yet arrived at this degree of caution when he said in his Lectures (Palmer's edition, vol. i,, p. 493)-\" All fractures of the skull may- be called compound; for. if not so naturally, they are made- so by t;he removal of the scalp. TI the retrograde t~endency of surgical interference with a broken skull it was an important step not to remove tlie secalp - but other steps were to be argued. An open scalp wound over a broken ,ekull does not produce a great change in the danger of the case. . Spreading inflammation of the membranes of the brain or deep-seated suppuration does not necessarily follow from it; but ;these arevery likely to take place if you openlie ara- chnoid cavity, byremoving the splinters which have kept it'eloàed. When the splinters come away by a- very limited suppuration-at a later period, the arachnoid cavity is closed by adhesions of dura mater to the brain. . It is is often impossible to say, before- hand, whether the dura mater has been Open or .not. If it is open, the danger is rendered much greater by rem'ov- ing the splinters. The\u003e Medical Tjimes and gazette of 1860 0J",
         "3 CINADA MEDICAL AND SUÉGICAL JOURNAL. contain a list of eighty-three cases n which th's trepan -had been used, fifty.one -of whemn died and thirty-two recovered. Amongst those who did well the dura nater had been woundedi; but in three cases the- others as well were such, that, àccdrding to my experience, they might have redovered without using thé tre- pan or early extraction of splinters. Gunshot fractures of thé skul are always conipound; their successful treatment:wlthout active interference deprives this of one of its strongholds--the presence of an' open'wound, which forniu3ly seemed topermit further.violence. During the two SchleswiglBolstein camnpaigns of 1849 and 1850, I'had- to -treat forty casè of ;gunshot-fractured skull, thirty-three ofwhom recovered, niid sevén died.- We had one.case of trephining with happy-result; lít it was of that d!s- cription that it might have done well witho it 'interference? 'Thé others were subjected to -n antiphlogistic treatment by ice, bleed- ing, purgative znedicines, and. low' diet. The splinters were not removed, before being qluite loose. I have een blamed by 3r. Pirogoff ,and others for' totally excluding active local interference in :gunshot sküll' fractures; many other\"have followed may example. You will admit; gentlemen, that- thlre is no khowing of-what use a thing nmybebefore having tried t. My object was to know-how far'we might\"get without active interference. The result was notunsátisfactòry. It ws the sané thing with the treating typhul ;patieuts -without stimulants. ':tBy -trying it on -_physiologicai principles, derived frommorbid ar atomy, I found it very successful. 'What :häs pleased' me most, frei a medical peint ocf view, dujring the late war, was te find two höspitals in Rheims and n in Versailles whr -he number of deaths from typhus was not, above 8-'per cent. Weak broth dsome ounces cf- very sour wine were all the stimulants employ d till 'the\"feièP- was over.he.wine whichs I tasted. was so Sour thft'it must have ,contained more acid than cemnion vinegar does, aîs I 'kiow froni ,cdomparative e'xperiments îwith 'potash. Se it pr bably'did the samne service:s phosphoric acid, which I prefer,;it a well-beiled raterruel'for diet duriïig the febrile stage.S The two ,hospitals la Rheiis were close to each' other ; iinn 'the 4atierts were coofed by immersiorin-in the other, by aetive ventil tioen ltents, 'whilei the results wi'e qüiite the sane inàb th Inôther hospitals the xmortality frein yphus -amounted to-25, even td'50'p'er-cent Nothing shòws the greatlQalueo f the medical ai-t and-science botter than such striking 'iifferences in the résults -Î treatineit under :the saie circumstàtces in regard to oî1stituiori,caùses} and symptomns. se\u0026 During the great part\" of5hy présènce -in London' I ;sed te se",
         "STROMEYER'S ADDRESS. sri the surgical patients at St. Bartholemew's Hospital underthe r of that clever and highly accomplished surgeon, Mr. W. Lawrence, whose kindness aid very instructive conversation I shall never for- get. I saw a great number of patients under him with phlegmo- nous inflammation, who were treated by incisions at an early stage, before suppuration had set' in. This bold practice was at that time little known in Germany, where it was spread afterwards; and is generally empoyed up to this day. Cases of this description do not permit hesitation, and show the use of the treatment very evidently. The effect of an antiphlogistic treatment is iot so strik- ing in many other cases. It is only by a longer experience that a surgeon is enabled to say whether a case of fractured skull, or a compound fracture of the 1imb, has been greatly benefitted by a venesection, which has been made, not in a late period when'sup- puration is forming, but early, when reaction is taking place, when the face becomes flushed, and the pulse full and hard. Amongst the many wise' things which Sir Astley Cooper has said, was the advice to visit a patient with a broken skull three times a day, in order to find the proper time for bleeding him. ' This does not produce a similar effect like An incision in phlegmonous inflam- mation* it does not restore the patient's cònsciousness, but 1it keeps him alive. : That this really takes place can only be judged from other cases in -which bleeding at a proper time has been omitted. -,But bleeding is out of fashion n . in Germany as weU as elsewhere. The discovery that pneumonia can be cured with- out bleeding has been the first cause of this antipathy. I have treated pneumonia myselffvithout bleedingi and had very goôd results. Ilost but 5 patiènts out of 558 during ten -years in the general militaiy hospitaf of -lanover, from 1858 to 1864. Odir patients were cupped at once, and took phosphoric acid. I never allowed this to be proof that venesection was equally unnecessary in surgical cases, which have no typical course like pneumon'ia. It was a mistake of former times that pneumonia might be subdued by repeated bleeding-it ruris its course in spite of that. I have tried in ain to maintain its use in surgical practicI there is n\u003cz swimming right across a mighty streaníi; one must wait for thi proper time of lowWater t- cross it. 1t must be some years a}So that Mr;Synice said ableeding-landets weie to be found in'Gat Britainlo more This;1 suspectfhas been the acm ô?f antipithy to bleeding-: Fron thai moment it was no ifmore a distincjion not to bieed. ý Bleeding ventures ot sbihõ its head àgain li- the Medical Times and Gäzet tiowv rather timidly-i'ecording asés which would have been fatal without venesection 'Lancetsan be 'asily supplied again,: and a few cabbage-leaves, as Dicle -s",
         "36 CANADA MEDICAL AND SURGICAL JOURNAL. says, will be sufficient to give a little practice before opening a vein in man. Perhaps I am- mistaken in My expectation that bleeding will soon have its turn again. Perhaps I shall be damned in a future time, for having been the last of the -Mohicans recom- mending venesection. At all events I would in that case meet very good company-all my old friends in London. On July 6, 1827, I witnessed the first case of hoemorrhage from thrombosed vein, in St. Thomas's Hospital, under Mr. Tyrrell's care. A shoemaker had been stabbed by his own wife, with an awl, in the right upper-arim. The wound appeared trifling to him -he did not notice it for somne days: then an immense swelling of the upper-arrn took place; the forearm became gangrenous. Mr. Tyrrell amputated close to the axilla. In exanilugs.the separated limb, it was found that the brachialvein-had been freeiy opened bythe instrument; that alarge hole; filled witb coagulated blood;hd frmed near the vessels. The brachial vein was throm- bosed to a considerable extent above the puncture. It struck me that the internal bleeding must have taken place after the obstruction of the brachial vein, and that gangrene had been pro- duced by stagnation. remembered this-case many years later, when I found, in military practice, that secondaryhmorrhages i , open w'ounds take place from similar causes. I described them under the name of phlebostatic homorrhages. Other prefer to cal. them pyçcmic, putting little stress upon the venous obstruc- tion, But pyomia does not always exist in these cases,:and the Influence of venous, obstruction is evident. , You will see -this if you should happen to bleed again, which must. be done by stop ping the venous current above the place where yoü _open .the vein. Every open wound would bleed 'under a similar, contriv- Let me observe :hre, what I have forgotten to mention elsewie that capillary:thrombosis, of some extent, below an injured ve issmust have the siame effect, as thrombosis of the main veiu, because \"i$icreases the degree of pressure which the column of blood exerts in Ekntering the,limb. . The quality of the blood in it must become altered'1y inpediments of either kind/ and healthy.nutritio cannot be kept These observations: are of great interest ilita surgery- they teach us to be' very cautious in treating we hch may have affected vessels of considerable size, whose bleeding nnb-eeu arrested by bruising or by. coagula., The injured vessels may heai without hSmorrhage, if the reflux of venous.blood remain free; but if there- be any, obstruction, either by. capillary or venous thrembosis, secondary hSemorrhage can:occur. Before.this takes place the wound often changes its aspect from altered nutrition.",
         "STROMEYER'S 'ADDRESS. Mr. Guthrie's plan of tying a wounded artery on the spot oftén does very well in minor vessels, but it often fails in the femoral artery. The large vein accompanying it has often been torn or bruised by the same ball. After tying the artery on the spot, the vein often .becomes totally impermeable, and then hoemorrhage recurs; or the limb becomes gangrenous. It may be proper i some cases to gain time by putting a ligature above the wounded spot;, before new hliemorrhage occurs, the vein may have under- gone a favourable change. In other cases,.it is better to amputate at once. I cannot dismiss Mr. Tyrrell's nane here without mentioning how I used to admire his cataract operations. lie did thei gener- ally by a superior corneal incision of the greatest regularity.- - I adopted-his method of sitting behind the patient's head in oper. ating on the right eye. I had seen Graefe, the elder, in Berlin; Jaeger, the elder, in Vienna, and Roux in Paris, perforni extrac- tion as well with the left as with the right hand, but'I preferred the more cautious English way. I often thought of Tyrrell's beau- tiful operations and their results when the time came that iridec- tomy seemed necessary for the great majority of cataracts before extracting then. I have hailed -Dr. Liebreich's innovation 'as a candid acknowledgmen bthat modern oculists, had -gone too far iu this.respect, and that the iris ought'to be spared if possible or reasonable. To Sir:Benjamin Brodie I feel very thankful to this day for what I have seen of him- in treating diseases of the urinary, organs, 'but chief1y for his skilli n diseased joints, le was the fiistsurgeon who enjoined the doctrine of'keeping diseased joints at rest by put- ting themon a splint.' The leather splints which he recommend- ed had been partially, superseded by starch or.plaster bandages, but luse the leather splinits constantly-in my chronie cases, when the patient is to- go. out to bathe, or' to use other local applica tLons. -Sir Benjamin Brodiets influende on the treatment of articular diseases hais been great'in Germany. His work on the subject lias been tran'slated in 1821; by Dr. Eolecher, of Hanover It had to fight its way in Germnany agaiùst Rost's authority, who -,had intro- duced the red-hot iron as a general remedy for miost chronic\"'cases - t is usedno more now. - The grcat :principle which Mr.'Hillon has so ablyacvocated, of keeping diseased parts at rest,' eithereby' :mechanical or byphysiological means, has done away with the red- 'hot iron. It wasSirBenjamin Brodie's farther merit topoint out cases where articular disease is spurieus, and where rest proves hurtful. I considerBrodie's work:on local nervous affectioiïs,pub lished in 1837, as one of the greatest value on account of the",
         "38 CANADA MEDICAL AND STJGICAL JOURNAL. number of persons who may be benefited by his doctrines.,--I had given a short extract of it in my \" Manuai of Surgery,\" but this had no eflect in rousing the public attention. My German countrynien- imagined that local nervous affections were a parti- calar gift of nature to English young ladies. Not a month passes but I, see a striking case in Hfanover. My son-in-law, Professor Esmarch, who travels a great deal during his vacations, bas been able to pick out a number of cases in different parts of Germany, and to extricate them from the spider's web of injudicious treat- ment. Perhaps I ought to have written myself about tbis subject more at large, but I despaired of doing it,better than Sir Benjamin Brodie. Professor Esmarch published a small volume last year on \" Articulari Neurosis,\" which, I hope, will go far in spreading Sir Benjamin Brodie's doctrines, whose German translation has failed to produce the desired effect. This subject is intimately con- nected with the exertions of that great genius, whose discovery of the different, roots of motor and sensitive nerves lias spread a lustre on our century. Perhaps no man bas given se much to think of to his contempo- raries as Sir Charles Bell. - He did net live long enough to witness the wide expanse of studies derived from so simple a source as that of the different roots. Bell's researches on paralysis of the facial nerve alone were sufficient to create a number of similar ones. The connection of this illness with rhcumatisa; the liability which persons have for it who are subject te abdominal affections; to impediments in the circulation of the abdominal viscera, pointed to other diseases with diminished nervous energy -in the organs of sight.and of hearing, for instance. In following the hints given by Sir Cbarles Bell, I found that every local affection originating from violence, or spontaneous inflam- mation, wasinfluenced in its course by an enlarged liver or spleen, and that- for, a cure it is necessary. to reduce- their size. This accounts for the very general, but more empirical, use of blue pill and. bark, and advises us to examine the size of the liverand spleen by percussion, especially in chronic -cases which show very little tenclency to heal-in secondary- or tertiary syphilis, for instance. Marshall H1all's discnerCy of the reflex funetion gave a. new àtimulus to think on the great importance of Bell's discovery, from wbich it had taken its origim This, doctrine of the reflex action of the nervous system eau only be compared to the dis- covery of the blood circulation. It gave an idea of thermanner in which the nervous action is kept on day and night, and reflex getion following the other. Trying to understand, this action, I",
         "STROMEYER'S ADDRESS. was led to assume a second pWnciple, which is ultimately blended. with reflex action. I found .that immoderate reflex action in muscles, or muscular crgans, was generally combined with painful feelings, sometimes in the neighborhood, sometimes remote from the seat of spasm. As a similar train' of combined sensations must take place during:healthy action of the muscles or muscular organs, I guessed that the action of the muscular system was necessary to maintain the nervous energy. Sir Benjamin- Brodie, in his work on local nervous affections, opposes the popular use of the naine of spasm for painful feelings. This is the case in Germany. People make no difference between Krampfe, spasm, croup, and Schmerz, pain. There is some reason for it; where there is spasm there used to be pain, but often in remote parts. Instead of pain, spasm is often combined with altered sensibility, partial or general. The, German naine for hyateria is \"mutterkrampfe,\" mother cramps. The uterus being a muscular organ, it may well be that hysteria partially consists of habitual spasm of the uterus, as a reflex action from the ovaries, or from other parts of the systeu. This idea was well known in former tines. Yeu can find it in Shakespeare's \"King Lear,\" who is made to say, \"IHow this mother swells up towards my heart.\" One of the most striking examples of pain originating in spasm, is that of the glans penis, from contractions of the bladder around a stone in it. Another well-known example is pain in the knee, arising from reflex spasm of the flexor muscles of the hip-joint from inflanmation of its bones, sonetimes from other causes. In a particular case, where there was no inflamed hip-joint, I succeeded-in doing away with the knee-pain by dividing the rectus and.pectineus muscles. I have pointed out sénsations, combined with muscular action, in all the organs of sense and in many cases of1disease. I have written on my theory of combined motor and sensitive nervous energy; first, in Hanover, 1837, in the; Go11engar Gelehrten Anzeigen, an article which I reproduced in Ltàtin ,after having become Professor of Surgery in Erlangen. I have followed up this subject no farther, because it would have cost me -the exertion of a ivhole life to carry it to a degree of perfection equi. valent to a clear demonstratian by physical- evidence. -But the fact that every pain, which evidently does not depend upon local alteration -of texture, depends on spasmodic action of seme:mus- Colar organ. has been of great use -to, me in practice; and I can advyise you to put this question to yourself in every case. ofthat description-,.where is.the seat of spasm ? Remember that it is as well in the voluit4rysas in the involuntary ones that spasins can",
         "40 CANADA MEDICAL AND SURGICAL JOURNAL. take place. Perhaps you little suspect that the liver is an organ whose muscular energy is of great importance. 'But if yoe zhad felt the pain in passing.a biliary calculus, youwould think otheir- wise.. I have felt it myseif, and took six grains of opium in one night for it. Pains' in remote parts of the body are very frequent in liver complaints, in the shoulder, in the head, or in other prts. 1 could tell a great number of cases in which -local nervorus affec- tion of an extremity proceeded from the liver, others from the accumulation of hard foces in the large intestines, keeping up spastic action for their expulsion. It is. very easy to cuie 'themn, after having found -the real cause, without any topïcal application whatever to the affected limb. After having spoken of such a variety of things and for such a length of time already, let me bid you farewell now, gentlemen, and thank you heartily for the kind attention with which you have been listening to me. I wish you inay remember your studies in London with the-same- feelings of gratitude and satisfaction as I do after forty-four years of practical life.-Medical limes and ,Gazette. THE TREATMENT OF SMALL-POX BY VACCINATION AND THE INJECTION OF LYM-PL. 13yR. C. FCnLEY, L.R.C.S. The doctrine universàlly held, that vaccination will be of \"no use \" if delayed till five days after the inhalation of the germ of variola, I think, is erroneous. For some time past I have been in the habit: of vaccinating every case of smail-pox that has come under, my, care and the result, as : show, is very encouraging, and seems to indicate that vaccination is -not only prophylactic but curative. I have found, however, that, althougli-the ordinary pro. cess ofvaccination by scratchingthe arm is suificient to modify the disease in infants, it is aliost inoperative in adults; Af ter having discovered that the ordinary process was almost useless in grown- up persons, I adopted- the method of injecting lymph by means of Dr. Wood's hypodermic syringe. This. instrument -I also found occasionally to ýfail, because, on passing the wire through the needle after the operation to keep it clear, I have: found-it eject the:lymph which I had hoped had been in the blood.- This, I an afraid,:has been the cause of two otherwise unaccountabl) failures",
         "TREATMENT OF SMALL-POX. - l out of sixty cases. How to obviate this source of fallacy occupied my thoughts for a considerable time. At last, however, I suc- ceeded in inventing an instrument that promises to transfer lymph directly from the tube in which if is contained into the cir- culation. It consists of a -hollow needle with a bore sufficiently large to admit of the introduction of a vaccinetube. The process consists in passing the point of the needle, charged with a tube of lymph, under. the skin, and blowing the lymph directly into the blood. I have purposely described this minutely, in order that, if any of my brethren do me the honor of verifying the iesults of may treatment, they may not commit the errors which experience has pointed out. It would occupy too much space to describe many cases; I shall therefore only give three to illustrate the effect of the treatment at the different periods of life-infancy,- childhood, and manhood. Case L-Baby 0., aged one month, and unvaccinated. When first seeni, the papular eruption was over the face, hands, and legs. There had been three cases of small-pox in the house. One had been sent to the Small-pox Hospital, where the mother had visited him. I ascertained that this was really the case from the resident physician, Dr. Saxby. I vaccinated the child at once. Next-day, when I called, the eruption had entirely disappeared, with the exception of two papules on the face, which were now more prominent. On the third day these two papuiles disappeared, and a fresh crop of four-and-twenty, chiefly over the head, made its appearance ; and these became hard, and did not fill like ordinary vesicles. In three days these had also disappeared. The vaccination itself did not show any signs of taking till the tenth day, and was matured on the'thirteenth. Case II.-M. R., aged thirteen years, vaccinated in infaicy, and whose siâter had died of small-pox a week before. I was called in on a Satur*Iayi and found her face considerably swollen, and the papular eruption on the hands and forearms. I at once injected two tubes of lymph into the arm. On Sunday the erup- tion had disappeared fromthe hands and arms, and appeared on the feet. On Monday it hid spread up the legs and trunk. 'On Tuesday it had entirely gone 'away, anxd there was nothing to be seen but the inflamed areola at the~point where I had injected. Case IIL-J. W, aged thirty-four, a stableman of dissipated habits,·and never vaccinated. I saw him\"on-the second day of the eruption, and injected two tubès of lymph; The case, instead of beig confluent, as mîght have been expected, was discrete, except at the ali of the nose.- e went on very favorably, and the erup- tion began to desiccate on the ninth day instead of on the fif-",
         "42 CANADA MEDICAL AND SURGICAL JOURNAL. teenth, eighteenth, or twentieth. There was no areola at the point of injection. I think these cases, selected froin a number of such, show that there is, at least, a germ of truth in my statement that vaccination is curative of small-pox. I find that the treatment is much more successful in the youthful than in the adult period of life; and I am beginning to think that this arises from adults requiring, as it were, more of the remedy. 'It is alse more effectual the carier the operation is performed. I have usually found that the vesicles did not attain the size they do when the disease is allowed to run its course; they do not often become pustular, and desiccated earlier. No doubt I have had failures and deaths; the latter five in sixty cases, in three of which I did not look for recovery from the first on account of other complications, and two were unlooked for : all were females-a fact of itself of some significance. I reserve for a future communication a detailed summary. of all my cases; meantime I trust I have said sufficient to encourage my brethren calmly to investigate the subject. I should have mentioned that the instrument I employ for transferring the lymph directly into the blood was made for me by 3fr. Young, cutler, North-bridge. LAUaRIsToN PLACE, EDINBURGIH, May, 1.872. -The Lancet. ACTION OF DIGITALIS. M. Gourvat (Gazette Médicale, 1871, Nos. 29, etc., and 1872, 1, 2, 4, 5,) finds that moderate doses of digitaline given to the frogs paralyze the motor nerves of voluntary muscles; and larger doses destroy the irritability of the muscles themselves. Involuntary muscular fibres appear to be stimulated by it. Moderato doses cause a transient contraction of the arterioles; large doses cause al1onger contraction. in both cases the contraction of the arte- rioles is succeeded by paralysis and dilatation. The contraction is caused-by the action of the digitaline on the vaso-motor nerves, and not on the walls of the arterioles themselves. The beats of the heart are rendered stronger, slower, and more regularyby moderate doses. . The arterial tension is incrcased.. The retarda- tion of the pulse is duer tôthe increase in the arterial tension, and L proportioned to it. The contraction, of the arterioles lessens'the se.cretion from the skin, mucous membranes, and - glands, except the kidneys, the urine being increased.-Med. and Surg. Reporter.",
         "CANAD.A MONTREAL, JULY, 1872. THE CANADA ME)ICAL AND SURGICAL JOURNAL. For the past eight years we have conducted the Canada Medical Journal, and it is not for us to state how far that periodical has given satisfaction, nor what amount of influence for good it has clone anongst the profession generally. We did endeavor to make it a scientific periodical, and we feel proud at the thought that manyimportant papers have appeared for the first time in its pages. A change has taken place in its management,:inasmu h as the editors determined to separate, because of reasons personal to themselves, - the details of which would be uninteresting to our subscribers. The present periodical under the editorial charge of the senior editor of the -old journal, is a separate and distinct work. -We shall endeavor to conduct it on the same broad principles which. guided us in the management of the old journal. It is not the special organ of any school, and although we are connected with McGill University, yet we will endeavor to give' equal justice to al the teaching bodies of our country. The present number will be sent to all the subseribers to the old journal, and we solicita continuance of their patronage. We issue this periodical on the first of the month, and no exer- tion will be wanting on our part; to make it a regular and welcome visitor. We will endeavor to extend the circulation, and should the: support given us by the profession warrant it, we will either reduce the- price of subscription or else add to the amount of reading..matter. Il' commencing this work, we do so feeling the responsibility: assumed, -as we have added to our editorial charge the risk of publication at our own- expense. We truiat. therefore, that those Of our friends who desire to seeAn independent periodical prosper, wil not only continue their subscriptons, but will aid us in giving it a truly Canadian character, by sending to our pages, for publica- tion, a record of their observations, which will be serviceable in",
         "44 CANADA MEDICAL AND SURGICAL JOURNAL. the best interests of our profession. It becomes every man's duty; a duty he owes to himself and to his profession, to carefully note the record of all cases of general interest. All observations, however trivial they may appear at the time, have a direct bearing on the advancement of the healing art; perfection is alone to be attained by practical observations, and each case is of importance to record, as forming a part of the general history of disease. We trust, therefore, that these few observations will be looked upon favor- ably, and that each professional brother will consider himself bound, by a sacred tie, to the general brotherhood of earnest workers and independent thinkers, and will regard it as a duty to observe carefully, and record accurately an'd truthfully, the cases which may come before him. There are those who, through diffi- dence, neglect to publish a report of their observations. There are others who regard the cases of every-day observation as unworthy of record; but, we must remark that the phenomena of diseased action cannot fail to be of interest. We remember some years ago, in accompanying a friend of high scientific attainments round the wards of our. hospital, remarking that we regretted that the cases of interest were so few. \" Ah,', he replied, \"every case however trifling, should possess deep inte- rest to the scientific observer.\" We felt justly rebuked by the force of the observation, and -have endeavored, since that time, to feel and take an- interest in watching the oper- ations of nature in the course of disease. It ise, indeed, the entire business of our professional career; it becomes our duty, as- it should be our earnest wish, to do ail things well, and do them with our migbt. This journal ivill be devoted to the record of cases from purely Canadian writers on several occasions. We have received letters from medical men, requesting to know on what terms their papers would be published; to such we would observe that this is to us a labor of love.. The present .position of the journal does not war- rant the expenditure of money to secure communications which might be of very questionable value.; We think that the publica- tion of papers. should beregarded as sufficiently remunerative, to the writers, as, if they possess merit, the extended: circulation which these papers receive, through tie medium of- the. journal, is sufficient in itself, or shoùld be regarded as such by the authors, Y -they will without fail, reach the eye of the profession'generaUy,ý as well in our own countryas abroad. Literary pursuits are well known tw beunrenunerative, and it requires a genius -with the imagination of a Dickens.tg secure by his pen a competency for his retiirng years. The worst paid of ail literary men are physicians and surgeons' when they do enter the lists.",
         "EDITORIALS, TIE \"CANADA LANCET\" AND CANADIAN GRADUATES. At the risk of exciting the ire of our cotemporary, the Canada Lancet, and of again being called \"vulgar and intemperate,\" we refer to an article in the June number of that periodical, although we did intend to pass it by in silence. We certainly did oppose the Ontario Medical Act, and we do still, as we think our friends in the West have considerably lowered their dignity by amalga- mating with persons whom they cannot regard as legitimate mem- bers of the profession. In Lower Canada all practitioners have to hold the license of the, College of Physicians and -Surgeons, and a similar law could have been procured in the Western province had the profession been true to itself. We remember well the time when a similar Act to our own was sought for, and also the political juggling which was practiced by some Upper Canada members of the Legislature on that occasion to upset the Bill, which opposition was, unfortu- nately, successful. This, in a great measure, was the result of a want of concerted action on the part of the profession. There was no harmony, no apparent desire to secure a general Act, which would have been beneficial, and when the irregulars sought for Legislative powers they were unopposed, because the profession thouglit that by permitting then to become incorporated they would strengthen their own position in securing a Bill.which had received the six month's hoist. The profession of to-day, are suffer- ing the consequences of the want of watchfulness on the part of their former representatives, but we think that their present posi- tion is worse than before the passing of the Ontario Medical Act. They have legalized and given professional statua to men who held no such position before the passing of the Ontario Medical Act; nay, more, these persons possess greater powers and larger representation . at the Council Board than do members of the regular profession. The Canada Lancet may rely upon it that there still remains a large mass of the old leaven, and that this fresh outburst, as it is termed, is merely a repetition of views we have always held, and which, we fear, will continue to be maintain. ed by us. Welhave watched the course of medico-political changes, and we sec, in the action of our Western brethren, many moves which are, to say the least, questionable. We fear there is trouble ahead ; still, b united action. the profession, undoubtedly, will over- come their difculties. We do not, however, think it wise to hold out inducements to any set of men to enter. the profession, save through one portal. Since the profession in Ontario hold that position at present, let them guard the portals and admit none but those fully prepared with the watchword and passes. We have seen the attempts of the, irregular men to wriggle themnselves out of the position; they seek emancipatiori. It would be our idea to break the bond of union, and erase every name from the register, and allow them freely to flood. the country, if they wish, with fellows of their kind. We * have faith and confidence in the truthfulness of our art. There are scientific facts which come home to the people of a country, and although they may be led astray by the glitter of tinsel, they will sooner or later discover for themselves that it is base metal.",
         "46 CANADA MEDICAL AND SURGICAL JOURNAL. MEDICAL AND SURGICAL REPORT OF THE MONTREAL GENERAL HOSPITAL FOR THE YEAR ENDING APRIL, 1872: DISEASES, ACCIDENTS, \u0026c. Diseases, \u0026e. Diseases, Abseessus Var...... 35,.. Expy ensa. Adenitis ............ 1 .. Endometritis Ambustio ....9,1 Enteritis Amenorrhos., .... 1.. ntropion . Anoemia. .......... . 14.. Anchylosis.......... . 5 .. Aneurism Aortie .... 2 2 Epithelioma \" . . Abdom.. .. 1 ErYsipeas Anthrax ...... ...... 1 Erythea Arthritis Ch...... . 1 Favus......... Ascites............. 1 1Febria. Ataxia Locomn....... 1 .. rsa ou.... Atroph. Testis....... 1 n it. ' . Optic . Post partum. Balanitis ..........1 Typhoides Bronchitis Ac... 9 Fissura Ani Ch\u003e. . - 9 Fistala Bubo ................. 1r. I. Butis...........4 .. VosiVagin Calculas Vesico. 3.. Fractura alvi. Carcinoma Axillar. 1 .. Costar. \" Facies. . 1 Crani. cc, Mammo; 4 Cruris. de, I-Recti,... I.. Cruris Co... . Uteri., .. 1 Femoris. c Ventric.. 3 2 Femoris Co.. \" Var...1 1 ible Caries Femoris. 4 .. lneri. \" Humieri ...... 2 .. \" le mr . . \" Maxil Infer.. SMaxil. Sup.. 1 . oaap,'' \" Os Nasi...;.. 1 .. \" Os Tarsi..... 1 ..t tatarsi \" Phalangis ... 2 .. patell Cataracta ......... 8 ;.* CPelvi Cellulitis ..........;41 -Phalang C.. Cephalagia .......... 1 . adil Cerebritis .;......2.. Chiorosis ........i.. Cholera. Canadens,. 1.. Chórea.... .. 1 .. . Cicatrixt .....;. 4 . agea Cirrhosis;Hepat. 1 Condylomata 3.. ......... Conurctivitis . 3 . c CGustipatio:. .. .. 1.onrbe Contusio;. . 42 . o C.iti; ....... 9. orrh Dbilitäsn...U.E 28 2 Iencai \" :Senilis. .... 3 .1Ieâiî Delirium~ Trreuns . 2 2ldoc Diabetes......2 . Diarhaa; -..s.q. 17. .lstrs - a 'Chron ;'... . ;1Ite' Dsenteria....:14;. g . Dysmerrha. 3 .Infiltrati rin osa......... 1 .isolat Ecthya d.é..... 1 EczemisrAc... .-. ~2 2Laygt A EmphEmpyem....L...,.. 2.. 5 8 2. 12 14 1 .. 44.. 15.. 9 :. 5 2 41 :8 1.. 2.. 114 121 .5 10 2.. 2.. 2.. 1 1 7.. 5 .. 1.. 1 . 5.. 8.s 12 - 1.. 14. i. 1 i 5 1 15 Diseases, \u0026c. Loucoma............. Loucorrhoea .... .... 2.. 1Lichen Ruber,,,.... 1.. Lupus............ 4. Luxatio Clavie. .. \"é Humeri.. 2.. \"L3 ad et UlnS, 1 \"Porperal.... 1 Mastitis. .... ..... Meningitis...........i Menorrhagia ... .. - 2.. Metritis ....... . Morbilli ...... .... 10 Morb Erightii....... .78 \" Cordis. i. 3 Coxe. . 3.. Myelitis........1... ecross Femoris. 5 :ncri'.:. 2 £5 Phalang .. . \" TibiS ..... 1 Nephritis Ac. . 2 Neuralgia.;;.. .....18.. Onychia.=.........i.. OphthalmiiaGonor.- 3.. Scrof. 1. \" Tarsi... 5 Orchts. ...........10 . Otitis Ae.........2., ' Ch..........1.. Oxaluria ........... 1 Palati Fissura. 1. Paralysis Var. 2 1 Partialv. 1:. yesicw . 1. Paraphymosis . Paronychia . 7 Parotitis . Periostitis Ao.....- 4 \" Ch.. 2 . Peritonits 2 2 \"Pelvi.. 1. Phthisis Ac.,;.. .2 Ch 36 18 Phymosis........., Pleuritis .Ac 4 Pleurqdynsia ;. .. Pleurdpneumonia 12 1 PneuMonia 20 5 PolypusNasi 1. Prostatitis Ch 1 lPrui.igo 2 ~Pyoeia Ranuila... ........ 1 Retiitis . 2. 1Rheumnatism Ac;..;. 40 i1",
         "MEDICAL AND SURGICAL REPORT. 4/ DISEASES, ACCIDENTS, \u0026.-Continited. Diseases, \u0026c. c Diseases, \u0026c. a Rheumatism Muse.. 171.. Synditi Ch... . 2.. Tumor Max Sup. 1.. Rupia.............. 1 . Syphilis Ac........... \" Palati ....... 1 Seabies ........... 11.. \" . C.......... 13 .. \" Testis... 1 Scarlatina........... Tetanus Traumatie.. .. 1 \" Uteri.;... 2.. Sciatica ........... 5 .. Tonsillitis...... ..15 .. Ulcus Corneo ....... 10 Scrofulosis ......... 3 . Torticollis . 1 Recti ...... 4 . Sinus............. 1.. Toxicatio ............ 1 Uteri......... 9.. Staphyloma ......... 1 .. Trachoma.i....... 19.. \" Var......... 58 1 Strabismus ..... .... 3 - Triciasis ...... ...2 .. Uteri Antiflex.. 1.. Strictura-Recti...... 1 . Tamor Abdoin -.... 1 .. Varicella..........3.. 4 - UrethrS .. 8 \" Adipose ..... 4f.. Variola ............ 3433 Subluxatio ........4 .. \" Axil. . 1. Varoloid............ 47 Sycosis Menti. . 1.. . \" Coli. .. Vulnus.......... 30 Symblepharon., 21.. \" Cystic........ 2.. \" Oeuli........ 1 Synovitis Ac. . 10 \" Fibrous. 2 Discharged . 1,35G Died.............. 123 Total.......... 1,479 .MAJOR OPERÂTIONS. Amputation of Arm................ \"l - Breast............. Leg.............. Thigh............ .. Excision of Tumor Axil.:....... Epith. of Lip... Gland. of Neek. Fibrous. Malignant ..... Carried Forward. \"Brought forward .......... 25 Elbow-joint ............ 3 Knee............... 1 Extraction of Cataract .............. 6 Extirpation of Eyeball........... 1 Iigation of Interosseous Artery. \" Radial \".. Paracentesis Abdominis............ 4 I Thoracis................ 3 Perincal Section .......... ........ 5 Staphylorrhaphy............ ..2 Total. ................ 52 MINOR OPERATIONS. Abscision of Uvula.............4 Amputation of Fingers.,...... 23. OteesrsToesi.'...;.....;....8 athterisms................... 162 \" of Nasal Duct. -8 Cauterization of CystieTumor. 7 Epilations.......................... 15 Evulsion of-Aural Polypus........4 \" Nasal :.... 1 \" Nail :.............. 6 Excision of,.Epitheliona....... ...2 \" Cystic Tumors .12 \" .Fatty Tumors. 2. Fibroid Tuiors 3 Extraction of fBullet 1 Incisions, Various.........:.289 .fridèctomb.;... . . . 9 Carried forward........ 546 Brought forward. .;.. 546 Operation for Fistula in Ano . 3 ntropion ..... 2 Lachrymal Fistula., 1 Strabisus..:.. 2 Blowmnan's ..:.. . . 1 ParaicentesssOculi. .. ..'.-::..:12 Reduetion of Para.phymosis 6 ReMoval of 'reign Bodies S from nose 4 Sequestrum... ...8 Skein (1aftins.. ... .12 Tapping in ilydrocele ..12 Teeth-E±tracted... .207 Tentony... .. ......4 Vacc ations .................. 116 Mounds.Drmssed....... .,. 515 Total...; ..... .1866 Total Major Operations....... 52 Gnd - a.......-......1866 Grand Total1................. 1418",
         "48 CANADA MEDICAL AND SURGICAL JOURNAL. FRACTURES. IŽS.DooR. Simple ............... ........... 76 Compound ................................. 18 Total... .......................... 94 OUT-nOoR. Fracture of Claviole................ 5 Brought forward ......... 37 \" Humeras.............. 6 Fracture of Radius \u0026 Ulna ....... 6 \" Lower Jaw............ 2 \" Ribs.................... 2 \" Phalanges ........... 2 \" Scapula .............. 1 \"L \". 0......... 2 ,\" Uina............... 2 \" Radius............... 20 Carried forward.......... 37 Total.................... 48 Grand Total........................... 142 DISLOCATIONS. 1m-nooR. OUT-nooR. Dislocations of Shoulder ........... 3 Dislocations of Elbow .............. 1 \" Elbow .......... 1 \" Shoulder........... 8 Total ..................... 4 Total ..................... 9 Grand- Total............................. 13 We publish above the Annual Medical and Surgical Report of the Montreal General Hospital, this being the Fiftieth Anniversary of that excellent charity. In looking over the financial statement we find that there was a surplus after all liabilities were paid. This is very encouraging, and is a further, pr6of of the interest taken by our citizens in the success of this noble institution. When we compare the medical reports of to-day with those of a few years back, we notice the great increase of the surgical cases which are submitted for treatment. . This can.be accounted for from the faót that Montreal is fast developing her-factory facilities We doubt not that in a few years the city will so extend in every direction that it will be found necessary either to add to our Rospital acommodation or, possibly provide other institutions of a kindred character. We. trust that the Governing Board will, this year see the urgent necessity of removing the present small-pox hospital to a mnore suitable locality, as it is unjust to the occupants ofthe General Hospital to submit theIM to the danger of contact witi s fearful a malady."
      ],
      "published" : [
         "Montreal : G.E. Desbarats, [1872]"
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      "title" : [
         "Canada medical and surgical journal [Vol. 1, [no. 1] (July 1872)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w LII Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored andlor laminated I Pages restaurées et/ou pelliculées E' E Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. D Additional comments / Commentaires supplémentaires:",
         "QxC HE-4L MAGAZINE AND LJTERARY REVIEW. Edited by GEO. A. BAYNES, M.D., \u0026c., \u0026c. VOL. I. ânoitreal: JOHN DOUGALL \u0026 SON, PRINTERS, ST. JAMES STREET. 1876.",
         "PREFACE. In closing the izth number of the PUBLIC HEALTHi MAGAZINE, and thereby completing the first annual volume of this seres, it is our first duty to return our warmest thanks to the subscribers who have so generously sustained us. There arc disadvantages to whicl every new undertaking is liable, but on the whole we have reason to congratulate ourselves thdt our effort have been appreciated and our success in every way been equal to our most sanguine expectations. Space prevents our particulirizing the course of some continued articles on many useful and mportant points, but our index is sufliciently full to afford facility for reference. The arrangements that we have been able to make during theyear for promoting the important objects of the Magazine, will secure afuli share of natter on all the iital subjects of Santary Science; and in addition to this a fair portion of our editorial matter will embrace reviews on the leading publications of the day, so that the next volume will contain not only Sanitary but scientific and literary natter, giving to our work the double character of essentially useful and practical information, as well as seeking to cultivate that taste for literary culture and studies, which just and well digested reviews are so eminently adapted to fuster. Our negotiations to fnrther this end are nearly matured, and we can confidently assure our subscribers that if the volume now completed has not dis- appointed them, the next will anplyrepay their continued patronage. Reiterating our thanks and soliciting our present su\u003escrbers and others who may be induced to add their names to Our hist, to signfy their kind intention early, we shall enter upon the next volume with that confidence which a good cause always inspires, and which a generous support is so calculated to establish. GEO. A. BAYNES, EDITOR.",
         "PUMh6 Êieàjtj mâtàikie AN\u003cD LITEISARY REVIEW. ANNL'AL SUI4sÇRIPTI0N $2.0o, or.; SING;LE COVIFS 20 CMMT. A Iimited n.:rnber of attverticinuntî, taken at reasýOnaI)Ie rmtes. Cir.uItsitù,i euarankecd ocr r,000 te'r ,itPtM. By, Lzi iv Maeor In, Firé-11eldch 1 l3eing the labt Lecture~ of the course on Hygiene and P\u003eublie Ilealth delivtrttl to the Theological clasýec in lhe se,,,Àon Of 1874-75. By GEo. A. I3AYNE:, M.D., \u0026c,\u0026c. PRIC- 15 CENTSi. Can be obtained frorn ail Boolsellcrs. '%ITI[ In.tOactitcar-y Olatr BY GEO. A. BAYNES, M.D. Rernittances are only to be made 10 DR. GR-o A. BAYN:S Editor \"PUBLIC 1IEALT11 MAGAZINE,\" 1,3Sý3 St. Catherine street, Mon- treal; or, JOHN DOUGALL \u0026 SON, P. 0., Mýon- mral.",
         "INDEX TO No. I. Abattom. Iry J J. Dugdale, M. D. C. 1., Ilcalli Officer . Acadcny of Physical Educatimn, (reliew) ........... ........ 110 Adams, C. F., Pat's Criticisn, (poc- tr....... ....... ...... 114 Adulteratin of Soap, by Sapo..... 77 Adlvice -ra- (pety ....... vl85 \"Advice to a W:e,\" by llenry Pye Chevase, F. R. C. S.,(review)..49.80 Atrated leveage... . ..«.... 30 Alcohoi, A few facts about, (edito. rial).......................... 155 Alcoholie Thirst ....... .... 349 Alexander Chas., M. P. P., on Civic ISmall Pobx Hijtal......... 143 Anlin. bya Ilat......... 117 Annual Calendarof McGill College, (review%)...................... S3 Antiquity of Ilygiene and its Scope aa a tudy, (editorial).......... 21 April, Synopsi, of Mortality for.... 358 Arctic, Ietotalism at the......... 92 Auotin, F. J., M.\u003eD., C.M., L.R.C. P S., on Clairvoyance and Spirit- ualisn ...................... 98 Continued ...................... 129 Australia, Board of llealth.... .... 109 Bacon vs. Shakspere, (rcxiew)..... 371 Baker lomer on Chemical Fire Extinguisher ................ 170 arnjumi, Mr. Fred. S., on Physi- cal E ducation................. 68 taths, Public, (editorial)......... 19 Baynes, Donald, A. M., M. D., L. R.C.P., Edinburgh, on 1lay Fever or Summer Catarrh ........-.. 353 Bayncs, Geo. A., M. D., \u0026c., Sug- gestions. given to the Local Legis- lature on lygienic Vital and Mor- tuary Statistics ................. 212 Baynes, Geo. A., M. D., \u0026c., cx- tracts from Joint Report submit- ted to the Dominion Government April roth, 1876...-.......... 321 Baynes, Geo. A., M.D., \u0026c., on the Moral and Intellectual Training of Children................... 378 Bell, J.ohn, M. D., Convalcscent Iom1c at Murray Blay.......... 78 \". Besemcr,\" The.............. 57 Bllack, J. IL. M.I., \"Taking Cold\" 221 Illind Ucse of Drug .......,...... 128 karld of Ilcalth, (Australia)....... log Board of lealth, Letter from Dr. A. B. Ltrocque, lcalth Officer.. 15 Bnynoni, Capt ................. 63 Burial Alive..................... 62 Buried Alive. (editorial).......... 120 Cab 1orse',A plea for............ 251 Canadian Illustrated News, (review) 2tr Canadian Mechanics' Magazine, (re. view)........................... 238 Catalogue of Authors in the McGill Collcge Library, (rcview)....... 308 Caution to Ladies................ 159 Citizens' Public Icalth Association, (editorial)........ ............ 25 Citizens' Public Iealth Association meceting....... 11-41-44.206-303.330 City of Montreal, Mortality of the City and Suburbs of the, for 1875. 232 Channel Feat, by Capt. Webb.... 126 Chemical Fire Extinguishcr, by Ho. mer Bakcr.................... 170 Chevassc, lcnry Pyc, F. R. C. S., Advice to a \\Yife, (revicw)...... 49 China Mania.................. 349 Chlorail Hydrate, Mischievous useo f 28 Chloroform, Deatls from ......... 318 Cholera, (editorial)............... 30 Cholera, Epidemic of, 1873, (rc. ViCw).......................211-237 Clairvoyance and Spiritualism, by F. J. Austin, M.D............98-129 Clergy, the, (editorial).......... 24 Convalescent Home at Murray Bay, by John Bell, M. D............ 78 Cookcry for the Sick........... g191 Cookery for the Poor..........253.282 CORRESPONDENCE. Board of -Iealth................ i Sewer Gas...................... 4 Adulteration of Soap............ 77",
         "VDEX. Drainage of Private louses .... 79 Manufactur of Liquor Expose.... 110 IUAssurance sur la Vie.......... 112 Small Pox Hospital ............... 143 Loss of Life by Accident .......... 145 The Chcmical Fire Extinguiishcr.. 170 isatin on Insurance.......... 210 A .cw Words about the Montrcal Drains........................ 235 Trapping .f Closets, Scwcrs, \u0026c.- the D Trap.................. 273 Gas from Crude Petroleum........ 275 Drainage ....................... 305 D Trap for Vater Closcs of Dwell. ings........... .............. 307 Ventilated louse Drainage....... 331 PTysical Education, by N. E. B... 364 Ventilated House Drainage....... 367 Cremation, (cditorial)............ 30 Crcspic, Dr. Alfred, J. II., on Vcge- tarinism ....... ...........104.134 Crespie, Dr. Alfred, J. Il., Short Sanitary Papers...........161-228 Crespie, Dr. Alfred, J. i., Sanitary Leg 1islation.................... 199 Croydon, Sewage Utilization at.... 93 Cupboard Ventilation............ i57 Dana, A. I., on Uses and Abuses of Lifelnsurmnce..........*3.3.344 Dead, the Disposal f the........348 Death (rom Chloroforn......... 318 Devil's Chain, (review).......... 308 Diarrhœa in Leicester, England, (editorial)..................... 132 Digestion, process of (editorial).... i8î Disinfection, Practical (editorial).. 5 Doctor Edw. Jenncr.............. 1oS Domestic Medicine............... 28 Drainage, by Joseph Smith, C.E... 305 Drainage of Private Ilouses, b M. D 79 Dress and Health, or How to be Strong. (review)................ 172 Drugs, Blind Use of.............. 128 Drummond, Geo. A., Proposed Plan of Public Scavenging.......... 33 D Trap, by London Correspondcnt. 273 D Trap for W.C.'s of Dwcllings, by J.H.Sringle C.E... .. 307 DudaleJ J., M.D., C.M., 3ealth Officer, (Abattoirs).......... 65 Dust upon the Eyes, Effect of, by A. Proudfoot, M.D.; late Surgeon to the City Hospital, Boston .... 3 Dusty Streets, (editonal).......... 120 Dwellings for the Pioorer Classes, (editoriel)................. ... x50 Earthwormsas a ThcraMputic Agent, (cditorial).................. 122 Economical Wife.............. 349 EwnToit:A.. Editorial Notices and Answcrs to Corrcspondcnts .32-64.99.128-16\u003c.256 -351 Fcw Words of Prcfacc........... 20 On the Antiquityof Ilygienc and its Scope as a Study .............. 2Y To the Clcrgy.................. 24 Citizens' Public lcalth Associa. tion.......................25 Filtration............. 26 Small POx..................... 26 Ladies' Sanitary Association....... 27 Small Pox Hospital.............. 50 St. George's InCbriatc Home...... 52 Practical Disinfection............. 53 Scavenging .............. ...... 55 Our Sidewvalks.................. 5 The Kindergarten ............... 5 Vaccino.phobia.................. 89 Physical Education.......... .... 91 Small Pox...................... 91 Montreal Veterinary College....1.. i8 Public Baths.................... 119 Dusty Streets.................... 120 Burial Alive...... ............ 2o Diarrhoa in Leicester............ 122 Earthworms as a Therapeutic Agent........................ 123 School Punishment............. 124 Schools and School Houses....... 148 Dwellings for the Poorer Classes.. 15o Ventilation and Warming......... 152 Fo l........................... 154 A Fev Facts About Alcohol...... 155 Infant Life and the Protection Due to it ..... ........ ............. 175 Suburban Residences............. 7 Infection from Old Rags.......... i8o Process of Digestion.............. i8î To our Subscribers............... 184 Ilygienic, Vital and Mortuary Sta. tiStis.......................... 212 Sanitary Ilints, or H1ow to Keep Your Home Ilealthy........... 215 A Few Hints on the Management of the Individual................. 239 Mortality of the City and Suburbs of Montreal..................... 245 Mortuary Statistics of Toronto..... 247",
         "LIDEX. Scw~er Vcntdlatîr.n ....... 279 $mall Pox Ilo1ital...... ....... 28a IHcalth of Oti a................ 281 soreThroat ..................... 3 Sanitary$tatistict................ 311 French l'rotestant Ladics 'Co llegcat St. \u003eyacinthe ...... 339 PhyNical Iducation of Girls ...... 342 Our Starving Poor ....... 376 The Canada Medical Record on Editorial Ethics.. ........... 377 Edwarl,, J. Baker, lh.). on Filtra. tion of the Public Water Supply. t Edward', J. Baker, Ph.D\u003e., on Mont. real Water Supply............. 36 Extract, from the joint Report sub. mittcd to the Dominion Govern- ment by Dr,. Marsden, Playter, and Baynes, April roth, 1876............--.......... 321 Eyes, Rule, f.-r the Care of....... 95 Father of Sanitary Ieforn.......252 Few Facts abvut Alcohol, (editorial) 155 Few Words about the Montreal Drains, by T. Smith, C. E...... 235 Filtration, (editorial)............. 26 Filtration of the Public Water Sup. ply, by J. Baker Edward,, Phd.. 1 Food, (edhorial)................. 154 Foot and Mouth Disease.......... 268 Foreign IIealth Statistic...168-209.234- 271-302.363 French Protestant Ladies' College, St. Hyacinthe, (editorial)...... 339 Gas from Crude Petroleum, by Duncan MlcMartin............. 275 Girls, Physical Education of, (edito. rial)...................... 343 Gleanng, for the Curious, from the larvest Field of Literature...... r3 Godfrcy, R. T., M.D., \u0026c., on Ilouse and Sewer Ventilation.... 225 Greta, L. A., on Manufacture of Lrquor Expoed............... 110 Hay Fever or Summer Catarrh, by Donald Baynes, A. M., M. D., L.R.C.P, Edinburgh........... Hygiene, A land.book of, by Geo. Wilson, A. M., M. D., C. M., Edinburgh, \u003creview) ... ......... 3 Health ofJerusalem ............. 76 Health of Ottawa, (editorial)...... 281 Health, Tobaccn in Relation to.... r58 Hints on the Management of the Individual, (editorial).......... 239 House and Sewer Ventilation, by R. T. GoClfrcy, M.P ........ 225 Ilow to Keep Vour IInme Ilcalthy, or Sanitary linte, (eitorial).... 215 Hygene, A Iland.book of, hy GCo. iln,A.M., M.., C.M., (re. v.)................. ... 31 Ilygiene, IL Antiquityand it%$Scope as a Study, (editorial).... ...... 21 Ilygienc of the United States Army, (review)...........-......... 146 Hlygienic, Vital and Mortuary Sta. tistic, Suggestlons gitvcn to the Local Legslature, 1y Geo. A. Bayncs, M.D., \u0026c., \u0026C......... 212 Infant.s' Home, Protestant, (revicw) 82 Infant Life and the Protection Due to it, (editorial)............ . 175 Infection from Old Rag%, (cditorial) 180 Jenner, Dr. F4xward.............. roS Jerusalcm, Health of............ 76 unish Race, Longevity of thr.. 2b3 -indergarten, The, (editorial)... 85 1-adies, A caution t0............. 159 tadies' Co!lege, Freruh Protetrnt, (editorial).................... 33» Ladies' Sanitary Association, (edito. rial)...... ........ 27 L'Assurance sur la Vie, by P. LV' Ferrière...................... 112 Lâ'Ferrière, P., on L'A'urance sur la Vie........................ 112 Larocque, A. B., M. D., Hlcalth Officer, on the Board of Hlealth.. r5 Legislation on Insurance, by Ed. ward Stark.................... 210 Liernur's Pneunatic Drainage Sys- tem, by Adam Scott, C.E...... 193 Life Insurance, Its Uses and Abu- ses, by A. H. Dana, Esq.....313-344 Life Insurance? What is, (editorial) 29 Longevityof the Jewish Race...... 283 Loss of Life by Accident, by a sub. scriber..................... 145 Manufacture of Liquor Exposed, by Louis A. Greta................ i1 Marsden, Wm., A.M., M.D., Ex. tract of joint Report submitted to the Dominion Government April roth, 1876-.................. 321 McGill College, Annual Calendar, (review).................. .. 83 McGill College, Catalogue of Au- thors in Library of............ 308 McLaren's, Alderman J. C., Venti. lated louse Drainage.......... 331",
         "INVDEX. McMartin, Duncan, Gas froi Crude Petroleum .................... 275 M.D., Drainage of Private Houses. 79 Medical Record on Editorial Ethics 377 Meetings of Citizens' Public Health Association.....11.41-44-206-303-330 Meeting, Mayor's................ 6 Mental Effects of Cold........... 186 Meteorological Observations from McGill college Observatory. .329.361 -168.299 Mischievous Use of Chloral Hydrate 28 Metropolitan Main Drainage ..... 125 Montiea, Mortality of City and Sub- urbs, (e .iorial) .............. 245 Montreal Veterinary College, (edito- rial).......................... 118 Montreal Water Supply, by J. Bak- er Edwards, Ph.,0 ............ 30 Moral and Intellectual training of Children, by Geo. A. Baynes, M.D.,\u0026c-.................... 378 Mortality of the City\u003cnd Suburbs of Montrlal, (editorial)............ 245 Mortalit; of the City and Suburbs of Montreal for 1875......... ...232 for January 269 \" \" for February 300 \"\" for March 327 for April 359 Mortality for April, Synopsis of... . 358 MortuaryStatisti, for August, 1875, in five Southern Cities.......... 142 Mortuary Statistics of Toronto, (edi- torial)...... ................. 247 New Sewer Trap ................ 58 New Standard Atlas of the Domin- ion, (review)................ 146 Notes on Hlousehold Sanitary Mat- ters, being continuons articles by J. H. Springle, C. E... .48-71-101-139 --165-204 Obituary of Dr. Ednund Alexander Parkes........ ............* 333 Old Rags, Infection from, (edito- rial)..... ................ 180 Opinions of the Press..........160-192 ORIGINAL COMMUNICATIoNs. On the Filtration of the Public Wa- ter Supply................ I Effects of Dust upon the Eyes- ... 3 Proposed Plan of Public Scavenging 33 Montreal Vater Supply.......... 36 Abattoirs....................... 65 Physical Education.............. 68 Notes on Household Santary Mat- ters........................ 71 Clairvoyance and Spiritualism. ... 98 Notes on H1ousehold Sanitary Mat- ters.......................... lot Vegetarianism................... 104 Clairvoyance and Spiritualisn con- tinued........................ 129 Vegetarianism................... 134 Notes on -Iousehold Sanitary Mat- ters ............ ............ 139 Short Sanitary Papers............ 161 Notes on Household Sanitary Mat- ters.......................... 165 Capt. Liernur's Pneumatic Drainage System ....................... 193 Sanitary Legislation.............. 199 Notes on Household Santary Mat- ters.......................... 204 House and Sewer Ventilation...... 225 Short Sanitary Papers............ 228 SewerVentilation.............. 257 Ventilated House Drainage . 2ý9 Sanitary Legislation............ 321 Hay Asthma.................. 353 Moral and Intellectual Training of the Young............ ..... 378 Ottawa, Health of, (editorial).... .. 281 Our Sidewalks, (editorial)........ 55 Our Subscribers (editorial)........ 184 Preface, A FewWords of, (editonal) 20 REVIEWs. A Hand-book of Hygiene ........ 31 Advice to a Vife.............80-49 The Christian Worker........... 49 Protestant Infants' Home......... 82 Annual Calendar of McGill College 83 The \"Sanitarian \" of New York... 115 Academyof Physical Education .... i 6 A Report of tle Hygiene ofthe U. S. Army............... ........ 146 New Standard Atlas of the Domin- ion of Canada .......... ...... 146 Dress and Health, or How to be Strong ...................... 172 Gleanings for the Curions, from the HarvestField of Literature...... 173 Canadian Illustrated News........ 211 The Cholera Epidemid of Z837.... 211 Canadian Meclianies' Magazine .... 238 Physicians'Combined Cali Book and Tablets....................... 277 Devil's Chain.................... 308",
         "JNDJx. Catalogue of Authors............. 308 Bacon vs. Shakspere........... 371 Rourk, F., M.D., C.M., on Sewer Ventilation.................... 257 Royalty and Tempe.ance......... 1571 Rule, for the Care of the Eyes .... 95 Parkes, Dr. E. A., Obituaiy of.... 333 Pat's Criticism, by C. F. Adams, (poetry).... ........... .....r4 Ph»ical Education, by Fred. S. iarnjum, Esq........... ......68 (editorial)........ 91 of Girls, (editorial) 342 Physicians' Combined Call Book and Tablet (review)................ 277 Playter, E., M.D., Extract from Joint Report submitted to the Dominion Government Apr. r8th, 1876......................... 3211 Plea for Cab Horses.............. 257 Pneumatic Drainage Syste.n. (Lier- nur's) by Adam Scott, C.E...... 193 Poisoning by a Hat, (Anilin)...... 17 Practical Disinfection, (editorial). 53 Preface, A Few Words of, (cdito- rial)......................... 20 Private Houses, Drainage of, by M.D..................... ..79 Process of Digestion, (editorial).... r8î Protestant Infants'Home,(review).. 80 Proudfoot, A., M.D., C. M., \u0026c., Effects of Dust upon the Eyes.... 3 Public Baths, (editorial).......... i19 Public Meeting, Report of Mayor's. 6 Public Scavenging, Proposed Plan by Geo. A. Drummond........ 33 Punishments, School, (editorial).... 124 Sanitary Association, Ladies', (edi- torial)........................ 27 Sanitary Hints; or, How to Keep Your Home Healthy, (editorial). 215 Sanitary Household Matters, Notes on, being continuous articles by J. H. Springle, C.E. .48-71.10(.139 -165-204 Sanitary Legislation, by Dr. Alfred r H. Crespi.................. 199 Sainrary Reforms, Furtherof....., 252 Sanitary Reports from the Following Cities........................ 169 SANiTARY REPORTS AND MEETINGS. Mayor's Public Meeting........... 6 Citizens' Public Health Association Il -41-44-206303-330 The Vestry of St. Mary Abbott's, Kensington.................... 74 Health of Jerusalem............. 76 Board of lealth, Australia........ 109 Mortuary Statistics for August, 1875, in five Southern Cities......... 142 MeteorologicalObservations.299.329-168 Foreign llcalth Statistics..168-209.234 -271.302 Sanitary Reports.... ........... 169 Mortality of the City and Suburbs of Montreal for the Year 1875... 232 Mortality of the City and Suburbs of Montreal for January, 1876... 269 -300-327 Synopsis Rain and Snow Fail for 1875......................... 272 Sanitary Statistics (editorial)...... 311 Sapo, on Adulteration of Soap.... 77 Scavenging, Proposed Plan by Geo. A. Drumnond............... 33 Scavnging, (editorial)......... 55 School Punishment, (editorial).... 124 Schoolsand School-houses(editorial) 148 Scott, Adam, C.E., on Capt. Lier. nur's Pneumatie Drainage ...... 193 Sevage Utilization at Croydon.... 93 Sewer Tap, New.............. 58 Sewer Ventilation, by Dr. F. Rourk 257 Sewer Ventilation, (editorial)..... 279 Short Sanitary Papers, by Dr. Alfred J. H. Crespi...............161-228 Sidewalks, Our (editorial)........ 55 Small-po:c (editorial).......26, 50, 96 Small-pox Hospital, by Chas. Alex- ander, M.P.P................ 143 Small-pox Hospital, (editorial) .... 280 Smith, Joseph, C.E., on Drainage. 305 ,Smith, Joseph, C. E., Few Words about the Montreal Drains...... 235 Smokers, Beware............... 6o Soap, Adulteration of, by Sapo.... 77 Sore Throat (editorial).......... 31c Spiritualism and Clairvoyance, by F. J. Austin, M. D..........98, 129 Springle, J. H., C.E., D Trap for W. C's. of Dwellings........... 307 Springle, J. H., C.E., on Ventilated House Drainage............... 289 Springle, J. I., C.E., Notes on Household Sanitary Matters.48-71-1or -139.155-204 Statistics, Foreign Health ........ 168 Stark, Edward, Legislation on In- surance... .................. 210 Stimulants, Use of by Women- - ·. 59 St. George's Inebriate Home (edi- torial)...... ................ 52",
         "INVJ)RX. St. Mary Abbott's, Vestry of...... 74 Vegetarianiâm, by Dr. Alfred J. H. Streets, Dusty, (editorial)........ 120 Crespi...................104, 134 Suburban Resientes, todaurial).. 178 VeLntlated Ilus. Jranaage, Ly AI- Synopsis of Rain and Snow Fall for dennan J. (. McLaren.......331 1875......................272 Ventilated House Drainage,by 1.11. Taking Cold, by J. D. Black, M.D. 221 Springle, C. E................ 289 Tectotalism at the Arcti,.......... 92 Ventilation and Warnnng, (edtu- Temperance and Royalty......... 157 rial)...... .................. 152 Therapeutic Agent, làhnrms Vestry of St. Mary Abbt KUtL' ens- as a, (editorial)................ 123 ington, Eng.).. .. ............ 74 \" Tipphlng,\"T'reatmnent of ........ 127 Veterinary College, Muntreal, (eth- Tobaccdin Relation to Ilealth.... 158 torial)....... .......... ..... ir8 Turunto, Mortuary St.aLLu, uf, d- \\\\ arming an.d V.ntdauun,edaunaI 152 itorial)........................ 247 Water Supply, Montreal, by Dr. J. Trappingof Closets-The D Trap, Baker Edwards............... 36 by D. B.. .................. 273 Webb, Capt., after his Channel Feat 126 Uses and Abuses of Life Insurane, Wife, An Economial........... 349 by A.H. Dana............313, 3441Winter....................... 249 Va.ino-phobia, (editurial)........ 89 Women, Use ufStimulant\u003e, by.... 59 J. GARDNER, CHEMIST, 288 ST? JAMES ST., Fully assured of the Superiority of 0%eavu's Esp Waïter FH4Ue»1 irgeà apu tlvst, desirous f purhasing Water Filters, tu dufer untd thuy havu rud the Prospectus, whiLih nov. ,an bu had un appliatun at hi stoJru. GARDNER'S MEDICAL HALL, 233 ST. JAMES STREET.",
         "PUBLIC HEALTI MAGAZINE. VOL I.] JULY, 1875. [No r. ON THE FILTRATION OF THE PUBLIC WATER SUPPLY. DY DR. BAKER EDWARDS, F.C.S. The waters of the Ottawa, and of the north district generally, which flow past Montreal Island, are remarkable for the sandy or flinty character of their minute animal and vegetable organisms, and for the presence of alkaline silicates, which, when comming- led with the waters of the St. Lawrence, become precipitated into gelatinous hydrate of silica. As the result of frequent micro- scopic examinations of the deposits formed by subsidence of the water supplied to my laboratory, and also the deposits separated by the process of fliration in my house filter, I find that the de- posits consist of r. Angular fragments of sand and ßiit. z. Gelatinous silicious magma. 3. Organic silicious filament of DIAToMS, also spiculee and gemmules of fresh water SPONGES and skeletons of alge. This deposit resembles in general character the well known \"TRIPOLI PowDER,\" used for the burnishing of mnetals, the keenness and polishing power of which is due to the presence of similar vege- table sandy fragments, which are scarcely less hard than \"EMrERy PowDER,\" and will cut fine scores in the brass work of taps and valves, followed by hard particles of sand, giving rise to contin- ual leakage. Therefore, I subnit that the filtration of the water l\u003eefore it is pumped into the mains of t/e city, would, by removal of this gritty flinty rntter, accomplish a saving of waste alike in",
         "PUBLIC IIEALTII MAGAZINE. wATER, TAPS, VALVES AND VORKING MACHINERY, which would more t/ian repay the cost of filtration, and prove at the saime time a GREAT SANITARY BENEFIT. With regard to the cost of filtration, I ascertained, when in Liv- erpool last year, that the cost of filtering i1 millions of gallons per diem, includingcleansing and change of filters and interest of capital, involved a coniparatively small ouday, and was main- tained at a rate of £1,25o sterling perannum, say $575 per annumin for each million gallon, per diem. The balance ol the Liver- pool supply is drawn fron vell-water naturally filtered through the red sandstone rock. The recent engineering experience of Liverpool adds much to the interest, and establishes the practicability of this question, and indicates the solution of a difficulty now existing in Montreal. A thorougli investigation as to the cause and locality of wATER WASTE has lately been made in Liverpool, already fanous for its advance in sanitary matters, and the result obtained by the use of district nieters and a proper systen of INSPECTION has shown that a very large amount of waste is preventable, that a great deal occurs during the night from carelessness, and during the day from im- perfect fittings. Under the intermittent system the consumption in Liverpool was on the whole average 33ý gallons per head per day; ini cer- tain districts 58 to 6o gallons per head per day. Under the con- stant service system this fell to i9i gallons per head per day. Under the system of district meters and inspection, this is now reduced to 12 gallons per head per day, with a constant, more uniform and ample supply. Now a consuimîption of 33½ gallons per head per day indicates a wASTE of 21 gallons per head per day, and this saving is effected at a cost of one farthing per r,ooo gallons, whilst an additional supply must be reckoned to cost from 5d to 6d per i,ooo gallons. I venture to think that the adoption of tle Liverpool district plan in Montreal, of which filtration is the first element, would rstly. Double the available supply.",
         "INJURIOUS EFFECTS OF DUST UPON TtE EE. :ndly. Atyord also a spare head of wavter for jus!ing se.ers an] dan sing streets. 3rdly. I Mprere the sanita.ry condition of the city by the supply of filtrated water and thus guard against prevailing en- demnic and threatened epidermie discase, reduce the rate of infant mortality, and pronote the general health and sobriety of the citizens at large. The state of the vater supply for the past three or four weeks has been unusually foul, and the water delhvercd to the city is in a state quite unfit for hunian consuniption. I have satisfied myself that niere settling tanks would bc of little avail, as I find the water still turbid after standing for ten days. Nothing but coin- plete sand filtration can render the water fit for drinking purposes, and the position of the newlv excavattd reservoir appears to bc vell adapted for a filter bed, at a moderate cost. Like other Montreal improvements,\" the cost will be enormously enharced by postponenient, and fron every point of view it appeais desir- able. nav, imperative, that a well considered plan of filtration should be adopted without further delay. Lbit.ory of Bishop's College, Montreal, May i5th, 1S75. THE INJURIOUS EFFECTS OF DUST UPON TIE EYE. BY A. PROUDFOOT, M.D., LATE HOUSE SURGEON TO THE CITY HOSPITAL, BOSTON. Much lias been said of late about the filthy' condition of our streets, in which we are at one tine obliged to wade ankle deep in nud, and again through clouds of dust, consisting largely of organie matter, which, being drawn into the lungs during in- spiration, becomes a great source of irritation to the strongest aniong us; but to those who are unfortunately predisposed to tubercular diseases, it kindles the latent spark which only too often proves fatal. It may be interesting to sone of our citizens to know that dust, or a minute foreign body, lodging in the eye, is perhaps one of the most common causes of disease in that organ. It is easy for anyone who lias had the misfortune to get a",
         "PÙBLIC IÈALTIt MAGAZIld few grains of sand, coal-dust, or any such substance, into the eye, by the amount of pain and inconvenience lie experiences, to forn some idea of the injury that delicate organ nay sustain from their being allowed to renain in it for a short time. These cases are so sudderly followed by pain, that the person is forced either himself to renove the offending substance, or to apply to some skilful person to do so for him. There are but few persons who have not suffered fron this cause more or less frequently. And here allow me to remark that I have often seen an eye more seriously injured by the bungling attempts of unskilful friends to remove a foreign body, than it would have been if left to itself. I therefore recommend my readers to go at once to some doctor in whom they have confidence ; by so doing they will save theni- selves much pain and inconvenience. It is not to these exceptional cases that I wish to call the at- tention of the public, but to the effect of the clouds of dust which rise fron our streets, and vhich enter the eyes in such minute particles as not immediately to give rise to urgent symptoms, but which are none the less certain in their action. A person walk- ing in the streets gets a littie fine dust blown into bis eyes, and takes little notice of it. The eyes are at first slightly reddened, and little inconvenience is felt. Unfortunately, however, the irritation is kept up from day to day; the eyes become pernan- ently bloodshot; they are heavy, and a burning or itching sen- sation ik feit; the tears are more abundantly secreted, and mucus collects in the angles of the eyes or on the margin of the lids. We nun has e the imildest furm of ophthalnia, \" Simple Conjunc- tivitis.\" The e es bectoming thus affected, a shght exposure to dust, change' of temperature, cold winds, \u0026c., is required to pro- dure more severe forns of disease, viz., Catarrhal and Purulent Ophthilmiia, the latter being not only very destruLtive to the eye, but extrimel\u003e ontagiou, sometimes atfetmig whole families. It not unfrequently becomes epidemic in favorable localities, and it is by no means uncominon in Montreal at the presentmoment, especially among the poorer classes, although I have lately had some cases anong persons who were by no means poor. They attributcd the trouble entirely ta their having got dust into their eyes in rather more allopathie doses than usual. While I was living in Boston, an epidemic of ophthalmia broke out among the",
         "INJURIOUS EFFECTS (OF DUT UION THE EyE. children of one of the charitable institutions of the city, and .lthough the cases were immediately isolated, and the most vig- orous measures to prevent contagion adopted by Dr. H. W. Wil- liams, who was in attendance, the diseasc continued to increase until the Dr. discovered that the floor of the room in which the children were allowed to play was sprinkled from time to time with sand, which became powdered berteath their feet and filled the air while they were at play. It was not until the floor of this room was swept and scrubbcd that the disease was checked. This form of disease is usually known as \" Egyptian Ophthalmia,\" from its prevalence in that country. It is extremely common on the western prairies of America, among the Indians and settlers. I have even seen the dogs and cattle affected with it, and it is no doubt due to the dryness of that climate, and the prevalence of wind and sand -storm:, which resemble the sand-storms of the desert. It is so easily propagated, that in the army, or on board ship, the greatest precautions are necessary to stamp it out on its first appearance. Dr. Frank, in his Army Medical Reports for 186o, p. 406, says, \" It has originated spontaneously from overcrowd- ing and foul barrack atmosphere, and from defective arrange- ments for ablution.\" Dr. Parkes says that 4 it is quite enough for us to know, first, that it is contagious-that is, transmissible; and, secondly, that if not produced, its transmissibility is singu- larly aided by bad accommodgion.\" It is transmitted by tht dried particles of pus and epithelium. The evolution of am- monia from decomposing sewage has also been assigned as a cause, so that it is absolutely necessary to have good ventilation and purity of air. Mr. Welch's facts show that impure atmos- phere is the great cause, and contagion a secondary one. Care- ful and constant use of water should never be forgotten. The same linen and tuweling should never be used by those who are not affected, and as careful arrangements in regard to isolation should be practised if the disease lias broken out as we use in any epidemic disease. Another important matter to be remem- bered is that relapses are very frequent. A man once affected has no security against a recurrence of the cisorder. If our citizens would avoid an epidemic of ophthalmia, we would recommend that water-carts be more generally used on all our streets, and that the mud be scraped ap and immediately removed, instead of being left in heaps to be dried by the su and redistributed,",
         "PUBLIC IIEALTI! MAGAZINE. PUBLIC MEETING. A Public Meeting was convened by MaoR IINGSTON at the request of a numerously signed petition, at the Mechanics' Hall, last month. On the meeting being called to order, Dr. BAYNFS was requested to act as Secretary, and Mr. MERCER tlen moved the first resolution, viz.: \" That, notwithstanding all the exertions of the City Council to iniprove the public hcalth, the present condition of the city calls for spelcial and immediate action to remove the causes of discase, and to diminish the death rate.\" And went on to say: \" The question wvhich we are met to consider is a most im- portant one to every citizen, and yet it is one to which we al- na)s g!r L but little attention, unless some terrible fatality brings the mtter to our own door. So long as our own famihes and our immediate neighbor3 enjoy good health, nu are content \"Montreil is the most unhealthy city in the Iominion, and \u003eet n1e lhe un ncxcr thirking that ne are responsille fvr its con- ditiun.\" le thcn mentioned a case in point that occurred to him that very afternoon: \"I was returning from a visit to the bouse of a friend in whuse family not many months ago five members were stricken down with t\u003e pioid fever, on account of bad sewage. As I was p sing that lane which runs west of Beaver Hall Terrace, bctween DorLhester street and Belmont Av.enue, I was arrested by a most offensive odor, and looking round tu discover the cause, I found that lane hcaped with manture, in a word, all filth lying gastous and poisonous.\" He said he did not bring this case forw ard as an extreme one, on the contrary he feared that it was but one out of many; but it was brou git under his notice accidentally. What can we ex- pect when there is so much filth lying about the houses of some of the most clever medical men in the city ? \" The question of the sanitary health of the city is a very diffi-",
         "PIb 11 LiN cuit one, but not so dificult as it was soie year, ago, when sanitary science was in its infancy and was not so well under- tool. We have here now some of the most able medic, al iien this side of the Atlantie. The time was when London and Paris, the two Iargcst, were also the two unhealthicst cities in Europe; but although they have in the nidst of them that which would give rise to mnany contagious diseases, yet we know that such means have len taken to thoroughly cleanse and purify them, that they are now the twn most healthy cities in Europe. Liverpool, some years ago, was another nost IInhalthy city; but its dcath rate has been reduced greatly by closng and doing away with ail cesspools, by removing all offensive matter at once, by increasing the water supply, and by filtration, and by prevent- ing garbage from being allowed to lie in the back lanes, and by seeing that the tax which was specially levied to improve the health of the city was de, oted to that purpose, and to no other. These systematic arrangements have had their effect. What has been donc for Liverpool we may do for Montreal, if we but try. He believed there was no other city in the Dominion so well adapted for hygienic improvement, but the strcams of pure water which trickle down from the hills arc changed into filthy water. The endless number of streets, the lufty buildings, and the numerous population, these all turn the ways of nature npside down, unless due precautions arc taken. In this city, in the winter months, typhoid and other preva- lent distascs cxit to an alarming extent at a season which should he most destructive to all those kinds of infections; but ne know that all these diseases are w orse in i inter than in summer, and why ? Because the garbage is left lying upon the streets, and with every rain that comes is washed into the earth, until the earth is perfectly saturated with it, then it rises again and fills our houses with foul air, and then up go the double-windows and doors are kept closed to keep out the piercing cold and kcep in malarious gases.\" Mr. MERLER then concluded with the remark that he hopcd this meeting would not be like many he had attended, where every motion was carricd unanimously, but nothing mor; thougl't of them after leaving the room.",
         "PUBLIC 11EALTIL MAGAZINE. The Rev. Mr. STEVENSON then rose and beconded the motion, saying: \" It secms to me we are situatcd very favorably indeed for sanitary ineasures. Wc have a beautiful mountain on one side and a fist-flnwing river on the other, and I cannot help believing if it be truc that our death rate is so high, it is our own fault. If we only tuok uhat nature has given us and made use of it as we ought, we should render our sense of safety much greater than it is. Our health is perfectly within our own control. I say that our s\u003epstem of drainage should bc improved; that our water sup- ply should receive proper attention. I do believe the time lias come when the water supply ought to be filtered. I do not in- tend to reflect on any body. I would, therefore, without blam- ing any one for the past or present, call attention to the state of things as they exist. The water supply is not filtered, and at sromc seasons unfiltered water from a river is very unhcalthy ; wC should have a very -arefully .onducted method of filtration. In Iierpool the results of such a course wlly paid in many ways for the outlay.\" Ad. McCORD then rose and rernarked that \" we want all the assistance we can get.\" He touched upon the difficulties of getting a bill passed in Parliament, and continued, saying: \" Last year néarly one thousand deaths from small-pox occurred in fontreal; the death-rate is thirty-four and a fraction per thous- and, and this death»rate requires an explanation. It is amongst the French people that these deaths from small-pox occur. It is to our Freni fellowd-itizens that attention should be directed. Liverpool has a death-rate of only twenty-nine per thousand, Glasgow twenty-five per hundred, Edinburgh the same. These facts have been represented to the Council, and the French members of the Council are willing to assist in passing a by-lav to reduce this high rate. He mentioned the designs that were on the table for the improvement of the Craig Street tunnel, and statcd that they intended to make the outlet at Colborr. Avenue or the Ruisseau Monjeon. He spoke of the exertions that were being made to obtain public baths-recommending the wo- men to use them also. He then spoke of the precautions necessary to prevent the spread of small-pox, typhoid, and other fevers, by isolation; scavenging should be very well performed, and the filth should not be allowed to lie as it does at present,\"",
         "The Rev. Mr. CA RMIciiAEi, then proposed the scrond reso- lut ion, Ni/. : \" That this meeting urges on the City Councl to s4pare no e\\- pense necessary for dealing with the present emergery, and re- grets that the Coun il bas heen unable to pro de all hie fonds rctiuirctl by the lcalth Coimmittee. It a.lo re' ommiends that if foundl ncess.arv a spIecial health tax be le. îed on the rate-payers, and placed at the dsposail of the Board of Hcalth.\" He then said this was one of the most unhcalthy î ities in the world. le then recited the case of his own drain. He had applicd in vain to the Corporation, and at last his landlord (flixhop l:ourget) removed the cvil at his own expense. He offcred to assist in the So iety with a will. M. P. Rva stated that that bugbcar the Craig Street drain was the same as swenty-fis e years ago-all talk and no action for its change. He then ad% ocated the expenditure of money to remo% e the disease from out of the city, and then we might talk about lay- ing out a Mour.tain Park-but what good would a Park be to us after discase had carried us off? He did not know what good a Park would be to dead men. His Lordship the METROPOLITAN then noved: \"That a ' Ctizens' Public Health Associaition' be formed to aid the constituted authorities, and to educ.itej, pubbit opinion in matters connected %Nith sanitary reforrn.\" Mr. WîiîiTE, in seconding the mution, said, he belic cd in doing everything in a practical mannr-not bringing thcory before the public and neer acting upon it. He said the Quebec Gate Barracks wcre uscd for our immigrants, but the building ias not fit for habitation; that there had been a case of black, small- pox there, and that no measures had been taken for its proper removal or disinfection; but, on the cuntrary, the neighbors had been called in to sec how much the \"dear child's face was swollen.\" He then proposed the following gentlemen as a Pro- visional Committee, with power to add to their number, to forni a Citizens' Health Association: PRINCIPAL. DAWSON, LL.D., J. BAKER EDWARDS, PH.D., REv. CANON BALWIvN, P. P. CARPENTER, PH.D., REv. JAMES CARMICHAEL, DRs. G. P. GIRDWOOD, REv. MR, STEVENSON, \"' THOMPSON, I'Utll\u003eI METING%..",
         "PUBLIC IEALTH MAGAZINE. MESSs. NATHAN MERCER, DRS. PROUDFOOT, \" M. 1\u003e. RYAN, \" RIcA, Tiios. WHITE, \" GRENiER, \" C. o. PERRAULT, c LussiER, \" EDVARD MURPHY, c MAJOR, \" SPRINGLE, MEssRs. HENRY LYMAN, DOUTRE, s SAUNDERS, PETER REDPATH, d RADFORD. Mr C. 0. ]'ERRAL LI then spkuk d FienMh En suport of the motion, and said that Muntreal was behnd all European cities of any pretensions, and that lie was willing to co-operate with this proposed Society or Association. Principal DAWSON, LL.D., then moved: \" That the best thanks of this meeting be hereby presented to His Worship the Mayor for his courtesy in presiding, and for the interest he is taking in improving the health of the city.\" He said we wanted clean streets, clean bouses, clean yards, clean garments, clean pure air to breathe-in fact clean everything. We did not have sufficient space round our houses. Rev. Canon BALDINw, in seconding the resolution, spoke in flattering ternis of His W.rship. Mr. DOUTRE said he wanted Craig Street tunnel large enough for a pony and carriage to drive in. His WORSHIP said, \" I have to thank you for the compli- mentary remarks from you all, and I think after the abuse the Corporation came in for, you could not do less; but I do not take it to myself, as I have only been in office six weeks. I must say when I took office I entered chaos; but now we have got things into some sort of shape, and I hope we will be able to carry out some of our proposed reforms. We can compel the removal of offal from a man's house, but lie can barbor double- distilled death within doors, and we have not the power to cross his threshold. The Local Legislature is far in advance of the Dominion in sanitary knowledge. It has not only the power but it shows the disposition to favor sanitary measures. The Que- bec authorities are willing to grant us all the powers we require for the asking. We have not the authority to make a man put in the best drain for the purpose-he 'can use vood if lie is so disposed. The difficulties are really more legal than medical or",
         "CITIZENS' PUBLIC HEALTIH ASSOCIATION. chemical. He then said that the education of the people as to vaccination would have to.be constant, and that to talk of com- pulsory vaccination *as nonsense, for if the Police Force of Montreal were one hundred times greater it could not enforce it. The public mind must be constantly educated in this matter and must be coaxed into it. He expressed joy at the formation of a ncw Sanitary Society, and said that the Board of Health would bc only too glad to receive any practical suggestions that would be laid before then. The meeting then adjoturned to Saturday eening, the i5th inst., at eight o'clock, at the Natural History Society Rooms. CITIZENS' PUBLIC HEALTH ASSOCIATION. A full meeting of members was held at the Natural History Rooms on Saturday evening, to organize this society. Letters were read from the Bishop and Principal Dawson, explaining their necessary absence. During the temporary absence of Mr. H. Lyman, Mr. Thomas White was voted to the chair. Among those present we noticed Prof. Johnson, LL.D)., Rev. James Car- michael, Mr. Chas. Alexander, M.P.P., Messrs. P. Redpath, Mer- cer, Springle, Ackland, Radford, Jones, Drs. Edwards, Thomp- son, Proudfoot, Baynes, Lussier, LaRocque, Austin, Osler, and other gentlemen. The Treasurer received various subscriptions from those who were also giving very valuable time to the pub- lic service. The minutes of the previous meeting having been confizmed, and the report of the Constitution Committee read, its articles were taken up seriatim, and after some little friendly discussion, the following rules were agreed upon with remarkable unanimity : i. This So:iety shall be called the \" Citizens' Public Health Association.\" Its objects shall be to increase and diffuse know- ledge on all subjects relating to the public health, by the discus- sion of sanitary subjects, by the exposure of sanitary evils, and by promoting sanitary legislation. 2. All members shall pay an annual subscription of two dol- lars, due on May ist, for the year ensuing.",
         "PUBLIC HEALTII MAGAZINE. 3. The affairs of the Asso.iation shall be conduc.ted by a President, two Vi-e-Presidents, a Recording and Corresponding Sccietary, a Treasurer, and a Count.il of twehe members, who shall be eleLted by ballot at the Annual Meeting, and shall hold office for one y car, or until their su\u003c.essors are appointed. 4. The CounLil shall have power to make by-laws, providing they are not inconsistent with the Constitution of the Society, including the number to form a quorum, and also to appoint, fioln among the members of the Assouiation, suth Committees as may be found desirable. 5. An Annual metin¿ shall be held during the ýnonth of May in each year, whlen the report of the Coun-il and tie Treaburer's accounts shall be submitted, and a Council and officers elected for the ensuing year. 6. The Council shall call meetings of the Assocation, for the rcadirig and disicussion of papers on sanitary subjets, to which the public shall be i ited; a Lopy of all such papers to be. pre- served with the minutes of the Association. 7. The President, or either of the Vice-Presidents, shall, on the requisition of at least ten members, call a spec.al meeting of the Association. 8. All motions submitted to the meeting shall be in w riting, and decided by a show of hands; but the Chairman, or any mem- ber of the CounLil, shall hase pon\u0026er to adjourn to tae next meet- ing any motion of whikh notiue has not been given to the mem- bers, b\u003ey the SeLretary, in ariting, at least a week previously. 9. All interim dot uments issued in the naine of the AssoLia- tion must be signed b) une of the presiding officers and the Sec- retary. The meeting then iroceeded to the election of officers-a dif- ficult thing when su many exc;llnt nanes presented themselves for choice. Mr. Henry Lyman Nvas first proposed, but declined from press of other engagtments. Mr. Alexandet ledlined for the same reason. After a ballot, Mr. N. Mercer was elected by acdlamation, and, being caULd upon for his opening address, spoke substantially as follows: \" GEN LLMEN,-I confess I had hoped to escape this nomi- nation by the election cither of Mr. Lyman or Mr. Alexander. But 4s the work must be done, and you hae honored me with",
         "CITIZENS' PUBLIC HEALTIt ASSOCIATION. your desire that I should direct its operations, I do not think my self at liberty to decline. Unfortunately I shall be living out of tovn du ring the summer months, but I will attend to the du- tics of my office in the ï. ity. There is a .ast anount of work to be donc, and I don't know what portion of it this Association is going to undertake, or to what cxtent they vill be able to inilu- ent e the authorities in impro% ing the hcalth of the city. At iresent I am sonewhat diýhecartened at the little publi interest show n. The cundition of the back streett is perfectly appalling. Many of the front streets are bad enough. This very day I have been inspecting sonme of the streets at the East End. They are such as to increase all our sic(kness, and pirepare for terrible in- fantile mortality in the sumer. He was glad to say that Alderman McCord spoke in a sanguine mianner, and promised a wholesale sumnuning at the beginning of june. I ha e been threatened with a summons for the w retched state of our back lane; but I show ed that it was my neighbors, and not 1, who kept the horses and were -?t fault; and they have been compelled to clear. I spoke of a similar nuisance at the Mayor's meeting. I an glad Messrs. White and Lyman are here present to explain. The meeting was duly con- % ened un an influential requisition. In England such a meeting wuuld ha% e been attended by hundreds instead uf tens, the Press would have fully repoited it, and the Editors wvould hase com- nented on it one way or the other. Unfortanately, Mr. Lyman was holding another meeting at the sane time and place; it only related to an assessment in one particular ward ; yet that was well attended and fully reported in all the papers. How was it with the Mayor's meeting, which affected the whole community in their lives-not nerely in their poLkets ? The report in Mr. White's paper was the worst of all; mwhile in the Star, on the contrary, there was a very good report. At the beginning of that meeting I made a statement whiclh, were some grcat dis- ease attacking the city, would, I don't hesitate to say, haie created a great deal of excitement. I fixed upon one particular street. We must bring the responsibility of these things home to particular streets and particular men. I chose the lane to the west of Beaver Hall Terrace. Why ? Because there werc some of the chief M.D.'s of the city, including professors at McGill",
         "College; men we should go to for idvice on sanitary matters. How these gentlemen could live for one single day without mak- ing attempts to improve it is a perfect marvel. A few days after a friend of mine in that terrace had diphtheria, and the two doc- tors in attendance discussed the propriety of making a present- ment on the condition of the place. Such a fact should not have been overlooked by the Press. If Dr. A., Dr. B. and Dr. C. are allowed to create such nuisance, what can we expect from the general public? Gentlemen, we must be practical, not content- ing ourselves with reading and discussing papers and holding meetings. We must divide the city into districts, and appoint two or three to report on each. It may take many months to do this work, and you have, perhaps, no idea how much labor lies before us all. Mr. White explained that the reporters were often obliged to accommodate one another. On this occasion they appear to have considered that the taxation meeting would be most intere.ting to the outside public, and only one of them had remained in the lower room. Mr. Lyman was in a position to state decidedly that at the time the St. Antoine meeting was fixed for 3 p.m., the Mayor's meeting had been announced for 4 o'clock. It was the latter which had been altered, and caused the unfortunate collision. Messrs. M. P. Ryan and Ovide Perrault were then unani- mously elected Vice-Presidents, thus representing the Irish and French portions of the citizens. Mr. Peter Redpath, being unanimously elected Treasurer, pro- mised to discharge its duties as well as possible, and hoped to enroll a large nunoer of members to support the operations of the society. Dr. G. A. Baynes was then elected Recording, and Dr. P. P. Carpenter Corresponding Secretary. Dr. Carpenter stated in the name of both gentlemen that he felt sure they would work harmoniously together, and they would each spare no labor to advance the interests of the Association. The following gentlemen were then named as the Council for the current year: Rev. J. Carmichael, Judge Coursol, ex-Alder- man Alexander, M.P.P., and J. Kennedy; Drs. Edwards, Thompson and Proudfoot; Messrs. Lyman, Weaver, Springle, T. White an1d C. Jones. l'UBLîC HËAt.THI MArAfg.",
         "-msynt-tt. LETTER FROM DR. LAROCQUE, HtEALTH OFFICER OF MONTREAL. MY DEAR DocToR,-At your request I give you with great pleasure a synopsis of what lias been done in Montreal towards tue organization of a Board of Health since I had the lo)nor of being appointed one of the health officers in 1869. I' shall also say a word on what has been done by the Federal and Provincial Legislatures in relation to public health natters, especially to sanitary legislation. The first year of office was em- ployed in visiting, and in making to the Board of Health reports containing suggestions to aineliorate the sanitary state of the city; vital statistics were also compiled and published. During that year the health officers were not present at the meetings, either of the Health Committee or Board of Health. When Judge Coursol came into office, being apprised of that fact, lie gave instructLons to the City Clerk to have the health officers present at the meetings of the Board of Health. To that time there was no special health department; all sanitary business was transacted in the Central Police Station. An application was made to the Local Government, and acquiesced in, for the use of part of the building now occupied by the Health Department. The duty of the Sanitary Police consists in visiting yards, privies, cellars, lanes, \u0026c., \u0026c. They daily record their work in books. Complaints received at the departinent arc eatered in a book, and attended to by the Sanitary Police. Public vaccina- tion lias been perforned at the office three times a week. The object was to institute arn to arni vaccination, had the children been brought in greater number. Statistical tables are compiled from the veekly death-lists received from the Catholic and Pro- testant Cemeteries. We must say that from want of pover the idny suggestions included in the different reports of the health officers were not LUTTER, PRoMN DR. LARkOcQUE.",
         "PUDL1C IEALTII MAGAXIMË. carried throtgh. Last autumn a series of sanitary clauses to be inserted as amendnents to the City Charter were handed to the City Attorney, and put in legal form and presented to the Coun- cil, which decided, however, to ask for general power in health matters. The Quebec Legislature has given the Council power to pass mostly any by-law to enable the Heaith Department to en- force vaccination, carry out necessary sanitary measures, and to regulate contagious diseases. The following section is that which was adopted: \"Besides the purposes for which the said city may, by sec- tion 123 of the said Act, 37 Vict., Chap 51, pass by-laws, the Council of the said city is hereby authorized to pass by-laws for the following purposes, that is to say, to enforce a cormplete and efficient system of vaccination, to establhsh offices for that pur- pose, to appoint officers, to authorize them to make domicihary visits to destroy the linen, clothing, and any other article infected with small-pox or any other contagious disease, to isolate patients laboring under such diseases whensoever the said offi- cers shall deem it necessary for the welfare of such patients, or of the public at large, to cause any person who shall have died of any of the said diseases to be buried within a short delay, and generally to take such measures as the Council of the said city may deem necessary to regulate, control, prevent, or arrest the progress of small-pox, or other contagious, endemic, or infec- tious disease in the said city, any law now in force to the con- trary notwithstanding.\" A code of sanitary by-laws has passed the Board of Health and is to be presented next M%'onday to the Council. , A sub-committee of the Board of Health meets every Wed- nesday, in order to organize and put in working order the different departments of the Board of Health. A statistical table of deaths is about to be printed weekly and distributed. Records of the death-rate, especially by zymotic and diarrhœal diseases, and by consumption, according to street, ward, age, nationality, are to be kept. The inspection of yards, privies, cellars, lanes, drains, location of houses, reports of small-pox and typhoid cases are to be registered according to headings, in order to be able to know at any time the exact sanitary state of the different wards, even street, in relation to zymotic, diarrhœal diseases, and consumption. This manner of sanitary book-keep-",
         "LETIIER FRONI DR. LARoCQUE. ing will enable the Health Departnent to ameliorate the mnost unhealthy portions of the city. The sub-committee is determined to pay Most particular at- tention to public and private drainage. Before 1865 no record of the drainage of the city was kept. The system of drainage i so obscure that in too iany cases it is an impossibility to have right information concerning the condition of certain sewers. Many of the main sewers seeni to be in the worst state, or else not al at the proper level. For instance, on St. Catherine street, froni St. Lawrence to St. Denis street, proprietors cannot drain their ground on acount of the main sewer not being at a sufficient depth. Mr. Deom, confectioner, occupies a house corner of St. Catherine and Elizabeth streets. The basement used as a work-. siop is damp, in some places muddy. His men, after a few days' employnent, generally complain of sickness and leave. He ha\u003e lost, within the year, four children. One died last Monday, 24th inst. Two died of lung affections, and two of scarlet fever, with bronchial symptois. His medical attendant bas certified that the state of the cellar contributed to their deaths. Opposite, sickness has prevailed for some months in M. Letondais' family, w'ho gives me authority to publish this statement. A proprietor owning a tenement bouse at the corner of St. Elizabeth and Dorchester streets, wanted to pass a drain through a passage leading to Dorchester street sewer. He went to enquire at the Inspector's Departnent about the sewer, when lie was told that there was no sewer there. He was obliged to pass the drain un- der the bouse, contrary to sanitary raies. Vaccination is goin1g to be actively pursued. Three vaccinating bureaus have been established-East, Centre, and West. The Sanitary Police are to visit from bouse to house, and require fron parents certificates of vaccination. If a sufficient nuniber of children are brought to the bureaus we shall be able to furnish lynph to the medical men of the city and of the country. The questions of milk, liquor, meat inspection, abattoirs, public baths, sanitary construction of houses, utilization of the contents of privies, measures to stamp out small-pox, hospital for contagious diseases, are ail to be grasped by the sub-conmittee.",
         "PUBLIC IIEALTH hMAdAZINE. In order to be able to compare the sanitary condition of ouf city with that of others and direct usefully the operations of the Board of Health, a systen of vital statistics is absolutely neces- sary, which can only be got by a correct registration of births, deaths, and marriages. Several attempts have been i nade in Nain to induce the Federal Government to legislate on vital statistics. Knowing the great advantage that vital statistics would have been to our Board of H-ealth, two years ago I went to Ottawa to confer with mem- bers desirous of bringing in a bill of registration. The mieasure was not brought forward. However, a committee of hygiene, composed of all the medical men of the Legislature, was formed; a report (copy of which I address ) ou) was adopted. The princi- pal object, as you can sec, is to form Boards of -Iealth in the prini;vi cities of the Donlinion and to establish a Bureau of Sanitary Science at Ottawa Several members of the Federal Legislature regretted that the question of public health was ex- cluded wlien the Dominion Constitution was drafted in 1867. Federal sanitary legislation encounters obstacles from local and provincial interests I know, however, fron a good source, that the ocil Legislature would aid the Federal Go% erniment in pass- ing any sanitary measure which would conduce to the sanitary welfare of the Dominion. A permanent committee of hygiene now exists in Quebec. A law to regulate burials in the Province of Quebec lias been passed, and a report recommending compulsory vaccination, has been adopted. This is certainly a proof that the Quebec Legislature is determined to adopt sanitary measures. A fourth attempt to organize a health association lias been made. The nanes of the citizens who are at the head of this movement are a guarantee of success, if they are determined to work. We all know pretty well what is required for the healthy state of Montreal, and even of the whole country. The greatest difficulty is in sanitary legislation. I would, therefore, kindly request the Health Association to take up the very important question of sani- tary legislation, and especially of vital statistics, If, by a cor- rect system of vital statistics, we could show that the high death- rate of the country is due to diseases the most part of which are",
         "LETTER FROI DR. LAROCQUE. preventable, statesnien could probably be persuaded to attend to sanitary legislation. Our present legislation has a tendency to ameliorate the material state of our country without reference to the health of the people. You have undertaken the publication of a \" Public Health Magazine\" in order to diffuseamongbt the peopleuseful information on public and prh ate hygiene-a science considered the greatest conquest of medicine, but, unfortunately, too much ignored. It is to be hoped that the intelligent portion of our population will appreciate the value of a sanitary leaf by enregisterng their naines as subscriber\u003e. In our present state of civilization a sanitary journal, based on \u003eound principles of physiology, psychology and pathology, cannot but tend to amehorate the con- dition of our society, ,vhicl seems to ignore the elementary principles and laws of hygiene, the object of which is not only tu ward off disease, but aho to give developmnent to man, physi- cally, intcllectually and morally. Whatever social position mai occ upîie, lie ought to *know how to put hiiself im connection with the different stimuulantb of hfe, air, water, light, food, \u0026c. Everything which militates against mind or body ought to be brought before the bar of health. Gentlemen in every profession and calling should hae an intimate knowledge of practical hygiene. Every houscliolder should know how to regulate his house in sanitary mneasures. E ery architect should be careful m his constrution, \u0026c. Ali of whicli I an sure we will find in your excellent publication. I remain, dear Doctor, Your devoted -onfrere, A. B. LA RocQUE, M.D. Heatlt Oficer. MONTREAL, June 3rd, 1875.",
         "PUBLIC HMELTIH MAGAZINE JULY, 1875. A FEW WORDS OF PREFACE. THE spirit of enquiry as to the sanitary condition of Montreal and its neighborhood bas gien rise to the formation of a new sanitary society, the object of which has been briefly set forth in the resolutions noved and ably supported at the publit meeting on the Sth of May at Mechanies' Hall. It has been felt by many that the time is also cone when sufficient interest in the subject has been manifested to lead to the publishing of a monthly maga- zine, in which all the most iniportant local information on the sub- ject will be gathered, and interesting matter upon the saine subject collected from abroad. To this end the publication of a nonthlv magazine of sanitary science, de% oted to general informa- tion upon subjects affecting the health of the comnunity, entitled Publie Health,\" is commended to your notice and patronage. The Editor is in communication with Editors of other similar pub- lications, and is, therefore, in a position to afford reliable intelli- gence on the subject of health in other parts of the world. Original matter ipon the most interesting questions of the day will be published, and articles on useful and practical subjects wvill have their due place. Reports of societies forned for sanitary objects will be condensed and become niatters of record. Every beneficial hint that can aid the family in securing the easiest modes of pre- serving healthy dwellings and households will have its due atten- tion. Articles upon the preparatic,i of food, its qualhties and nutritive properties, will be part of the useful information it is proposed to furnish The maga.ine wvill be both instructive and interesting, and every pains will be taken to secure its use- fulness",
         "ANTIQUIir OF HVGIENE. REMARKS ON TI-IE ANTIQUITY OF HYGIENE AND ITS SCOPE AS A STUDY. It is not to lie wondervd at that the ancients, ignorant of the Li% ing and True( God, \"in whom we live and move and have our being,\" shniild conjecture that there existed supernatural beings that controlled the laws of nature, cither in their bencficent or injurions effects; and as the one Supreme Being was unknown, the concliion arose of \"Gods many and Lords many,\" appro- priating to a presiding deity the cause and effect of every known plhenomenon that came under their observation cither in the heavens above or on the carth beneath. Every element, there- fore, of nature had its gods; fire and water, winds and waveý, summer and winter, day and night, the fruits of the earth, and the blessings and misfortunes of mankind-each had its superin- tending genius, who became the personification of the good to bc desired, or of the evil to be deprecated. Among these tutel- ary deities none had greater honors paid to her than Hygeia, the daughter of ,Esculapius, the Goddess of Health-indeed the veneration held for this divinity vas surpassed by none. Nor is this; to be attributed to any other cause than self-preservation as the first law of nature, and the consequent mqxim that \"health is the greatest of blessings,\" It is no modern notion, therefore, the intimate relationship of hygiene to medicine, as being that part whose subject is the pre- servation of health, while medicine, from its root, \" merfeor,\" to cure, is applicable to all substances that possess any property capable of mitigating or curing disease. There is a trite adage handed down from oar fathers, \"Pre. vention is better than cure,\" from which we may fairly deduce that the study of Hygiene precedes, as an initiative, the study of medicine, and can at any rate clairn never to be separate from it. What is Hygiene then ? Briefly it is the art of preserving health, that is of obtain'ng the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote. To this end Herodicus, who flourished before Hippocrates, and who went by the surname of \" Gyninastic\" was the first to introduce medical",
         "PUDLIC IIEALTII MAGAZINE, gynnastXs for thc inprocmcnt of hcalth and the cuare of dis- Case. HtippIèotrate devte himself tu the .tudy of hygeic. while follow ing physi ander thc guidante of lits grandiathct, Nebrua, an eminent physician. IL was the custom of Hippocrates to study the tablcts in the temples of the gods where mndi% aduls Iid, written down the diseascs under whauh they labored, and the means b) whii.h they recoicred. It ivas his profireny n sat- tary prceaut;ns that enabed hin to deiver Athens (rom a dread- fuii pestilen c in the beginning of the Peloponnesian nar, for which he n'.as publiil rewarded nith a golden cruwn. Galen, or, mure properly, Claudaus Galnu c, ic ntiatc friend of ti\u0026. Emperor Marcus Atarelius, and vhu is said to have written thrce hundred voIumcs, a large part of whii nere lost in the dcstruction of the Temple of a at Rome, whcre they had been deposited for safety, acknoiledges his indebitedncss to Ilippocrates, and it may bc truly confessed that to the writings of these tn'o eminent men, the moderns arc debtors for many useful discocrics. lis celebrated tripartite. epiochs of a huaman being, on which lie descants with grcat perspi..uity and le.arness, are noted expressly as First, of Growth, (including infancy ad yuuth). Second, of Matarity, when, for manay yarà, the body remîans apparently stationary. Third, of Decay, wlhenl, without actuail diseasc, though doubtless in conscuence of some tihemial changes, muletular feebleness and death commence in some part or uther, forewarn- ing us of general decay. These epodhs of life must be before us whdle we are studyng the ýarious -Irtamstantces that intidentally arise to disturb the natural course of the health and vigor of the human organzation under the viclssitudes of these several changes. Now Hygiene is that part of medicine whose subject is the preservation of health and necessitates an acquaintance with those laws which are conducive to the maintenance of the nor- mal condition of health. It embraces not only a knowledge of healthy man, regarded individually or in society, but an acquamnt- ance also with the objects used and employed by him, with their respective influence on his constitution and organs. Thus, by",
         "the knowledge of the tno, tie ,tulcnt ma) lay down certain flixcd laws of Hygienc, a departure fromn which rannot fail to pro- dure Il c onsequnt es, whle adhernem e theretu muîst eN er le attendeildi ;ith benefi al results and secure the mner rational expertation for the continuance of health. Systemuatiçally, therefore, We may i lassify ounr sul.jct under three distinrt heads, according to Dr. Parkes . i.t. In relation to the natural conditions w hic.h surround man, and whhih arc essential for life, such as air, water, food, sunlight, \u0026c., \u0026r.,-in short, relatively to nature at large. 2nd. Man in his social and corporate relations as a member of the community, with the effect upon him ariing fron i ertain rustons, trades, conditions of dwellings, clothing, \u0026c. 3rd. In his t apacity as an independent being. havmng withn himself sources of action in thoughts, feelings, desires, personal habits, all of which affect health, and which require self-reguia- tion and control. You ivill sec, therefore, that if so large a field piroferly romes under the study of hygiene, it may be said to embrace all iaws that have for their aim the most perfect culture both of mmd and body, for the two are inseparable, as is manifest from the fact that the body is affected by every mental and moral action, while the mind is cqually sensible to the influences arising from bodily conditions. A perfect system, therefore, of hygiene must com- bine the knowledge of A/isü4a, mental and moral culture, and mnust train the body, the intellect and the moral soul, with a just regard to the necessities of each in a well-balanced order. If we may credit Rabbinical theories, sanitary rules were blended intinately and niuven into the divinely appointed order of their ceremonial obserances, and a due regard to hygiene, or the pre- servation of the health of the people, was secured under the law of Moses. The elaborate detail of things clean and unclean, compassing, as it did, that which might be eaten or not caten, carefully excluding every animal and bird as a subject of food whose habits and propensities led it to indulge in filthy and gross substances. established the rule that nothing could be consid- ered wholesome for man that had not avoided all putrescent matter and the grosser form of aliment. Hence every carnii or- ous beast or bird was rejected from the iist of the proper food A'NTIIQUITY #IF HGF",
         "24 PUBLIC HEALTH 'MAGAZINE of man. Every animal that had not certain marks or habits that constituted it of the species of rumnatmg and cloven-hoofed combined, was excluded from the class of clean and wholesome. The rigid rules enforced on the subject of cleanhness, embracing the removal of all f/llh from their camps; the coverinig wit/h carth of all fetid malter.; the great attention to ablutions; the stringent regulations as to contact with diseased or unclean per- sons, or widli dead bodies-while they excluded persons for times long or short from the congregation m its religious aspect, se- cured likcwise the wise precaution of separating such persons from the comniuni*y while in absolute contact with what was unhealthy and unclean ; and, added to all this, the wisestlegisla- tion on the all important matter of the alliance of the sexes, pro- hibited unions of too close consanguinity, and established the highest order of moral obligations. WNe may fairly assert, there- fore, that the subject of hygiene stands foremost in moral obliga- tions to man, individually and in community, and boasts of the most ancient and divinely ordered rules to secure its observance and establish its blessings. If we consider the reality of the fact that the divine lav stooped down and took hold of man by the ordinary infirmities of flesh, and dealt with special regard to thé lowest element of which he was moulded, we shall not easily over- rate the sacredness attached by the Creator to the human body, which 1e constituted the dwelling of the Spirit, nor shall we wonder at the superintending care that could say \" the very hairs of your head are all numbered,\" \"and in his book were all your members written wvhen as -yet there were none of them.\" WHEN it was proposed to publish this Magazine of Hygiene and Public Health, these two thoughts naturally suggested themselves: First, was the subject one which could fairly demand that atten- tion and study which it claimed; and, secondly, was there not a special class of gentlemen invited to subscribe who shouli devote lheir serious consideration to acquiring some-knowledge of it (I mean the Ministry)? To the first there was this plain answer, that what the necessity cf the day was peremptorily calling for information upon, and for measures to secure, had even on this",
         "CITIZENS' PUBLIC HEALTH ASSOCIATIiN. ground a title to every honest effort to proinote, and a right to the quota that every man could add to the general stock, and that as the study was at the root of existence itself, it would bc difficult to over-estimate its value. To the second thereply was equally clear. That what demanded the joint co-operation of all men to secure, undoubtedly claimed the special assistance of a class of men, whose everyday life would bring thern in contact with those forms of evil which the study of our subject could alone qualify them to alleviate or prevent. I trust, therefore, that the effort to lay before you what the great principles of Hy- giene have established will be accepted in the spirit in which it is offered: an earnest desire to promote your individual useful- ness in the great cause of our duty towards man. PARTICULARS concerning the formation of \" The Citizens' Public Health Association\" will be found elsewhere in this num- ber. We heartily congratulate the energetic gentlemen who have brought their scheme to a successful issue. A society of thekind was inuch needed, and by the names that we sec enrolled upon its list we are happy to say that it will be an influential associa- tion. Its constitution is short, but very liberal and desirable. The Council of the Association consists of twelve gentlemen; but the President, two Vice-Presidents, Treasurer, Recording and Corresponding Secretaries are ex-offcio members of the Coun- cil, making a strong company of eighteen men, who are deter- mined to work for their fellow-citizens, gratiiitously, in obtaining reformation in matters affecting the public health. We wish theni every success in their undertaking. There will be much to contend with, and many times there may be a feeling of despondency as apparently insurmountable obstacles present themselves. But we promise all the help in our power, and feel happy in enrolling ourselves under such a banner and in such a cause. In a future number we shall be happy to give some practical suggestions, which we hope will be received in the liberal spirit in which they are offered.",
         "PUBLIC HEALTH MAGAZINE. IN an article on the filtration of the public water, by Dr. J. Baker Edwards, which will bc found in another place, lie puts the importance of the subject before us in a most lucid manner. He says that by adopting the Liverpool district plan in Montrcal, of which filtration is the first elcment, it would \"istly. Double the available suply, 2ndly. Afo d, also, a spare head of water for flushing sewers and ceansing strects ; 3rdly. Improve the sanitary condition of the city by the supply of filtered water, and thus guard against prevailing endemic and thrcatened epidemic dis- case, reduce the rate of infant mortality, and promote the gen- eral health and sobriety of the citizens at large.\" As we can not hope to have this great improvement for some little time yet, it belhoves us to protect ourselves to the best of our ability, and we advise all our rcaders most earnestly to procure a house filter without delay. There is no means of purification equal to a good filter. The silicated carbon filters entirely deprive water of organic impurity, and are so constructed as to prevent the passage of the most minute bodies. Water passed through them is for all practical purposes as pure as can be. DISGRACEFUL.-WC were called to sec a patient last week in St. Andre street, suffering from all the symptoms of an impend- ing fever, and we enquired if she had been exposed to the con- tagion of small-pox. She related the following outrageous par- ticulars : On the 1st of May, she, with lier husband and four children, moved to the new tenement house they were at prescnt occupying. After they had been located for forty-eight hours, and got all the furniture and carpets in, a neighbor called to see them, who lived on the sane flat, having a common stairway between them. Having entered into conversation, he coolly remarked he was glad they were come, for it was very lonely for him to sit ir a sick room all day, mentioning that he was nursing his wife and two children with small-pox. When they found this out, the husband ordered him out of his apartment and locked the door, immediately procurcd disinfecting powder, and used everything in his power to prevent infection to is own family, using for himself the back yard stair for ingress and egress. When he taxed the landlord with his shameful conduct in allow- 26 ,",
         "LADIFS' SANITARY A-SOCIATION. ing him to come into his house when he knew it was infected with small-pox, he merely laughed, and told him it was not \" ketching.\" Is there no punishment for suchftagrant crimmn- alit ? Are we at the mercy of sordid landlords, who, rather than lose a couple of months' rent, will sacrifice the lives of their fellon bcings ? The poor mother was sent to the Montreal Gencral Iospital suffering with a severe attack of small-pox, from whiïlh she has sinte died. Symptoms have shown thenselh es in one of the hildren sine. What have our city fathers been about to allow a uit) like Montreal to be decimated year after year, without et en stirring a finger to help us ? We hail with delhght Alderman MtCord's new by-laws. We have had the pleasure of looking then user, and we mustsay rhat they are a step in the right direLtion. Let the Board of Health join with the experi- enced members of the Citizens' Public Health Association, many of whom have for years studied sanitary measures. o0 WE sec by a late number of London Public Health that \"the Ladies' Sanitary Association\" is still as vigorous as it was io years ago. In their last report, read by the Secretary, Miss Rose Adams, the average yearly receipts of the Association reached £350. The Association has devoted much of its time and money in the issu- ing of tracts on sanitary reform. These little books are written in simple language, and revised by some eminent medical gentle- men, anong whom we noticed Drs. Sutherland, John Brown Sieveking, Arthur Farre, Edward Smith, Richardson and others, which guarantee their sound principles. Their titIes explain sufficiently the important work they are intended to perform: \" The Health of Mothers,\" \"How to Manage a Baby,\" \"How to Feed a Baby,\" \"Word about Fresh Air,\" \"The Use of Pure Water,\" \"The Worth of Fresh Air,\" \"The Advantage of Warm Clothing,\" \"The Value of Good Food,\" \"How to Nurse the Sick,\" \"Why don't Women Swim ?\" \"The Evils of Wet Nursing,\" and many others too numerous to mention. There are brànch associations in France, Germany, Holland, Italy, Hungary, and other countries. Why cannot some of our earnest women be impressed with a sense of the needless suffering and wide-spread ignorance conLerning the laws of health, and determine to make an effort to mitigate these evils? If such an association were formed here, we promise all the assistance in our power to further their good purpose.",
         "PUBLIC HEALTH MAGAZINE. -o- THEi MisCduEvous USE OF CHLORAL JIYDRATE.-There is much reason to fcar that the use of chloral hydrate is becoming indiscriminate and mischievous. Medical mien everywhere would do well to strongly discountenance its consumption except under professional advice. Even in the nost experienced hands it has proved fatal, and it may be remenibered that twenty grains once given by a well known physician-now dead-as a hypnotic pro- duced sleep from which there was no awakening. An inquest was held at Bedhill last week on the body of a lady, when the verdict of \" Died from an overdose of chloral\" vas given. She appears to have taken the drug regularly for a long time, receiv- ing supplies from a local chemiîst. Mr. F. B. Hallowes, who made the post-mortem examination of the body, concluded that she must have died from an overdose, although the:e was unmis- takable evidence of diseased heart and lungs.-Lanet. o DoMESTIC MEDICINE.-The Sanitar Record, of London gives another instance of that pernicious habit of domestic drugging which need only be mentioned to be condemned. It says: \" Another death in consequence of the culpable manner in which narcotics are administered to children occurred recently at Hol- loway. The child having been restless, the mother bought some syrupof poppies, and gave it a spoonful. On the following morn- ing the child was found to be unconscious, and died shortly after. Dr. Shehy, vho made the !ost-mortem, pronounced the cause of death to be opium poisoning; and, in ansver to a question, stated that laudanum was sometinfies nixed with treacle as a substitute for syrup of poppies. A verdict of death from narcotic poison- ing was returned. The coroner, in his summing up, renarked that he believed the fault mainly lay with the public, who were utterly ignorant, or not very particular, as to what they bought for their children.\"",
         "WHAT IS LIFE INSURANCE? WHAT IS LIFE INSURANCE? i. It is the exercise of Prudence and Benevolence. 2. It secures independence, donestic happiness to the widow and orphan. 3. It is more efficacious in its operation, as regards the moral and domestic comfort of the people, and in its tendency to re- duce taxation, by its reduction of pauperisn, and possibly of crime, than the legislation of our wisest statesmen, and, if uni- versally adGpted, would be a national blessing. 4. It affords to persons of every class, and in every station of life, the nieans to avoid much future misery to their families, and to render then independent of public or pri.ate charity. 5. It is a scheme by which any sum of noney may be secured at death (whenever that event inay take place), or be received at any age of the life assured. It is truly impossible to overestimate the value of lfe in- surance. When we look upon those scenes of misery and suffer- ing, which promise a long continuance, and know that by one simple act of self-denial ail these might have been prevented, we cannot fail to recogrize the power for good which lies in a life insurance policy. The reasons which were valid when a man first secures this policy are always valid. Why, then, debate about continuing the insurance as long as life lasts ? If it be a question of economy, we should begin with sacrificing our luxuries, not our necessities. The life insurance policy is one of r the necessary thin-gs of life. It may be compared to bread, fuel, clothing; for, hereafter, it becones ail these things. The an- nual insurance premiums purchase these necessaries of life to be used in distant years,-supplying our home then with what our hands are supplying now. The charity of life insurance is the worthiest of aUl. It is mainly devoted to widows and orphans, often left, otherwise, entirely destitute and penniless, and it not only provides afflu- ently for them, but, at the saine time, preserves inviolate their independence and respectability of character. It relieves and sustains, but never humiliates or degrades. The wisdom of life insurance is emphatically indorsed by",
         "30 PUBLIC HEALT'H MAGAMIfld. authors, divines, and statesmen; its security is approved by financiers and business men ; and its benefits are daily realized by all classes. CREMATION.-At Dresden the technical solution only of the cremation question bas been arrived at. Its legality has yet to receive authoritative sanction. The cases in which corpses were subjected to the process were purely experiniental ; but, now that science has vindicated cremation, the society for promulgating it, which includes many of the leading citizens of Dresden, has nemoriahzed the authorities for permission to put the process in practice in a \" Creination Hall,\" specially built, and specially provided with a furnace. The request, it is thought, will be granted. CIULERA.-Cbolera bas broken out in various parts of Cey- lon. In Colombo and Galle especially the disease bas %iolently attacked the population. In the former town 405 cases were reported in a short time, of which 288 proved fatal. The Cingal- ese are not distinguished for cleanliness, and it will require all the efforts of the European medical practitioners and authorities to subdue the outbreak.-Lancet. MEssRS. BLACKWOOD \u0026 BIRKs, successors to Chas. Wilson, who for many years studied the comfort of the general public in preparing aerated beverages for summer use especially. We have tested them all-have seen the manner of iheir preparation im their factory, 99 St. Urbain street, and can recommend them to our readers as free froni any injurious ingredients. Messrs. B. \u0026 B. are also sole agents for the celebrated \"Yamachiche\" Mineral Springs.",
         "A HANDIOOK r HYO ENE: By George Wilson, A.M., M.D., and C. M., (Edin.), Medical Officer of Health for the War- wick Union of Sanitary Authorities; formerly Medical Officer H. M. Convict Prison, Portsmouth. London: J. \u0026 A. Churchill, 1873. We are indebted to Dawson Bros. for the above book. This ik the second edition of the work, and it seems to have met with general favor from the publie of lingland. We have reviewed it very carefully, and we must say that Dr. Wilson has certainly paid great attention to the study of Hygiene. He has written % book which gives a sunmary of the whole subject. It is well adapted to health officers, and likely to be of considerable use to the general public. It contains a short in- troductory chapter on \"Public lygiene and Preventable Dis- ea\u003ete,\" and then takes up seriatim the functions and constituents of food, air, ventilation and warming, water, dwellings, sewage, disinfection, and the duties of health officers; and in an appendix an epitome is given of the various health acts and the powers and obligations contained in *hen. All gentlemen who are in- terested in sanitary matters will find a fund of information en- tirely free fron medical technicalities. The author makes one remark aniong many that we must not omit to bring before the public notice. He says, in speaking of the causes of deteriora- tion and disease in genis homo, that \"These may be divided into two classes, namely, Social and ilaierial.\" By the material he means impure air, impure water, insufficient or'unwholesome food, dampness of soil, d-ficiency of warmth, \u0026c., \u0026c., which he says properly belong to \" Legislative enactments. The social causes of deterioration and disease, on the other hand, are little, if at all controlled by State interference.\" But the greater part nust be remedied by constant animadversion through the Press, the Pulpit and the Platform, as well as by general instruction to family circles and schools by the physician, the minister, and journalist, or any other philanthropic persons who will carry due weight with them. Sanitary works can never, by theniselves, make a comnunity healthy; they must be aided by social virtue. The whole nation must earnestly strive by continuous efforts at self-improvement to cultivate good personal habits, for, as Dr. Wilson truly says, \" public virtue is essential to public health, and both tonational prosperity.\" Such books as this will, we trust, aid in that general education in sanitary matters'which must be the first step towards a satisfactory public health. We should advise all those who are interested in such matters to buy it-if for no other reason but their own household regulation,",
         "ediloial i lli t 0tif a #1td 115w£ïe5 le(7£5}1$215 The editor be6s to state that PuBLic HEALTH magazine is not a publication of part\u003e or of prejudi,e, but of prugress, and as su,.h its pades are thruwn ulien to all who wish to .ontribute to the commnon stock of sanitary knuiwedge. We must not be eln- sidered as holding the saine e as ie% r article not froni our owN n pen. We vuuld esteem it a fa% or if all whu n ish to further sanitar science would forward us, as early as possible, reports, panphlts and nenýsjapers containîng infornation on sanitary subjects. Contributions are in, ited upon any subject allied to iygiene ur iuliiL health. Centlemen sending nç..nspapers are requested to mark any matter that they wish our attention drawn to. ShloKERs, BEWARE.-W ha e receined ) our coim uation, and ivill notice it in our next number. KINDERG RIEN.-'We will answer your commum.ation upon the opening of the September term of schooling. A 1 B.We lia% e re eined your letter on a small-pox hospital, and ivill bring the matter before the public next issue. SicK NURsE.-The nicest preparation for the extract of beef is that recommended by Dr. Tanner. \" Take une pound of rump steak, mince it like sausage meat, and mix it with one pint of cold water. Place it in a pot by the side of the fire, to heat very slowly. It may stand for two or three huurs before it is allowed to simnier, and then tet it boil gently for fifteen minutes. Skim and serve The addition of a small tablespoonful of cream to a teacupful of this beef tea renders it richer and more nourishing. Sometimes it is preferred when thickened by a little flour or arrowroot.\" THE amount of the subscription to this Magazine will be $2 oo per annum, post-paid. Remittances are only to be made to the EDITOR PUBLIC HEALTH MAGAZINE, P. O. Drawer 25, Montreal Clubs, Reading Roons, \u0026c., supplied at a liberal discount, if more than one copy is required."
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         "Technical and Bibliographic Notes /(Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur Ù Covers damaged/ Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations I Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available I Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. tý Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Il E:1 Coloured pages I Pages de couleur Pages damaged / Pages endommagées D Pages restored and/or iaminated / Pages restaurées et/ou pelliculées LEI' W W» Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached f Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1I se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination. W",
         "Che Canadian murnal of Mediine and $urgerv A JOURNAL PUBLISIED MONTHLY IN THE INTEREST OF MEDICINE AND SURGERY VOL. VIII. TORONTO, SEPTEMBER, 1900. No. 3. Original Contributions. CLUB-FOOT IN THE ADULT.* MY 13. i. McKENZIE, B.A., M.D., Snrgcon to the Toronto Orthope\u003cic ilospita); Orge o cdi surgeon to Grace General ilospital; Associnte 1'rofffsor of Cli ica! Surger ) f Ie tarie 3Iedieal College for Woitnei; Vice-Presidenit of the - nr in Orthopedic Association. TzouGm club-foot is seen not very infrequently in persons who have attained to aduilt years, yet so general is the impression among the laity and in the profession that the condition is incurable that the surgeon's advice is seldom sought. Taving had experience, especially in the last two years, with several cases, in persons vary- ing in age between the sixteenth and forty-third years, and be- Jieving that the treatment of these cases is eminently feasible, and that the results obtainable are sucli as to improve in a marked degree the patients' appearance, confort and general well-being, i have felt justified in bringing this subject to the notice of the Association. In al, I have treated seventeen, cases bctween the ages named; seven of these cases were thirty years or older. The average age was twenty-six years. Eleven of the cases had both feet de:formed. I shall give particulars of only a few cases: CAsE 1. T. S. D., aged 29, tinsniith, had strongly marked de- formity of both feet at birth. He is a healthy, stout man of about 150 pounds. To systematic attempt.had been made to correct the deformity, which is now typical (Figs. 1 and 2). First operation with anesthesia, -December Sth, 1898, the plan- tar fascia, tibialis posticus tendon, and the anterior portion of the *Read by title ath meetingof-tho.American Orthopedic Association,inWashington, 3lay, 1900.",
         "THE CANADIAN JOURNAL OF interlial lateral ligament eut subeutaneously, the anterior portion -of the foot strongly abducted and retained in position by plaser'- -of-Paris casing. January 10th, 1899. Further cutting of restricting bands of fascia subcutancously, further abduction of the feet and retentioin by plaster-of-Paris. February lst. The varus having been overcoine, the tendo- Fig. 1, Case 1. Fig. 2, Case 1. Achillis was eut subcutaneously and tlke feet brought to an aigile of 100 degrees and retained as before. February 17th. Furtlier correction made by subeutaneous cut- ting and nanual force. Mi'arch 10th. Dismissed from hospital wearing boots and using crutches. Dorsiflexion to 80 degrees. April, 1900. Patient walks renmarkably well, remains upon his feet at business in the store all day, lias, in pursuance of his occu- 42",
         "MEIDIOINE AND SURGERY. pation, the putting -up of cave-trougis, limbed ladders, and moved about upon the roofs of buildings, The range of motion at the astragalo-crural joint is about 25 degrees. Os 2. F. B., aged 10, double club-foot, congenital and strongly marked, fasciotomy and tenotomy imucl as in the former case. August Oth. Further correction made. Fig. 3, Case 2. Fig. 4, Case 2. September 1st. Further correction made. October 6th. Teindo-Achillis eut, and both feet brought to an :angle of 90 degrees dorsiflexion. One dressing subsequently, with- -out anesthcsia, brought the feet to 80 degrees of dorsiflexion. November 19th. Began walking, using boots and a cane. This latter thrown aside in two weeks. April, 1900. At the present time, walks well and sufiers no 143",
         "4 'THE CANADIAN JOURNAL OF inconvenience. through remaining on his feet, as n.uch as denianded by his ordinary work as an offitec hand (Figs. 3 and 4). CAsE 3. O. S., agcd 18, a large, healthy Inan of 180 pounds, right 2lub-foot, eongeni tal. Subeutaneous replacemen t and reten- tion as in other cases. December 21st. Further cutting and replacement. January 25th, 1900. Tendo-Achillis cut and equinus corrected, February 13th. Further correction of equinus by inanual re- placement. March 4th. Disnissed from hospital, walling with a cane. December, 1899. This patient -walks remrarkably well, withî scarcely a perceptible liip. Fig. 5, Case 3. CASE 4. F. S., aged 16, right club-foot, congenital. June 6th, 1899. By suboutaneous fasciotomy and tenotomy and manual replacement, the varuswas fully overcome. June 20th. Tendo-Achillis was eut, and dorsiflexion to an angle of 80 degrees secured. July 13th. Dismissed cured. April, 1900. The foot is unduly pronated, and I have found it necessary to have his boot built as in a moderate case of flat-foot. CAsE ,5. J. Ô., aged 27, riglht club-foot, congenital. August 23rd, 1899. Subcutaneous fasciotomy and tenotomy: Partial replacement of the varus and retention by plaster-of-Paris.",
         "MEDICINE AND SURGER1'%Y. September 19th. Repeated. October 10th. Repeated. October 31st. Tendo-Achillis eut and equinus so far corrected as to bring the foot to an angle of 90 degrees with the log. November 28th. Dorsiflexion to 80 degrees secured. Decembc-r 2nd. Disinissed from the hospital. April, 1900. This patient walks with a very slightly noticeable lipij. There is good moveient in tho foot through an angle of 30 degrees. Extreme flexion is shown in Fig. 6. CXSE 6. E. R. F., aged 30, double club-foot, congenital. Cou- siderable difticulty was met with in eorrecting the varus. Anes- thesia given four times at intervals of about four weeks, and feet strongly abducted by manual force. The skin at the inner border of the foot having torn through, the opportunity was taken to eut obstructing bands of fascia. In this manner threc months were Fig. 0, Case 5. occupied in fully correcting the varus, a much longer time than in any other case. A few days ago the tendo-Achillis was cut, and the feet brouglit to an angle of 100 degrces with the leg. Still under treatment. There are a few points in connection with the history of these cases, to which I wish to cal your attention. lst. They are cases from the sixteenth to the forty-third year of age. 2nd. In none was there any operative intervention other than subentaneous cutting. It is truc that in thrce feet, one in Case 1, and in both feet in Case 6, the skin gave way, making an open wound. 3rd. The average time from the first operation until the patient was able to walk with a cane, was about three moiths. 4th. In. Case 1, T. S. D., in whose foot an open wound resulted through the employment of manual force, the result is less satis- factory than in the otherfoot. There is.a more marked disposition 145",
         "146 THE CANADIAN JOURNAL OF to contraction and less mobility. The same difference is shown in Figure 7, another patient upon whon I operated in 1890, making the regular open incision recomnended. by Phelps, in one foot (the right), andci employing subcutaneous tenotomy and man- ual force with more frequent dressings in the other (the left). The foot in which the open incision was made is not as good as its fellow. 5th. Based upon my experience of about 400 cases of club-foot, of 'which 28 feet were in persons over 15 years of ago, I would say that neitlier operation on bone, nor the open incision is called for, except in a very small proportion of cases; in less, say, thani' 5 per cent. 6th. The result, other things bei ng equal, is better where there bas been no cutting, other than that donc subeutaneously. 7th. The time occupied in treatment is no lolger than when the open incision is made. Fig. 7. Sth. Whatever mnethod of treatment be adopted, the defornity of the foot per se should be fully corrected before the relationship of the foot to the leg be interfered with. Otl. In all of the 28 feet here referred to, the result is nost gratifying, ývith two exceptions. One of these is a young womanu, twenty years of age, who weighs about 200 pounds. The defor- mity in her case was doubtless due to anterior poliomyelitis which came on at a very early age. In this case the foot bpcame displaced too far outward, and ber present condition is littie better than lier former one. A similar result in a slight degrec followed in a young man of seventeen years, althougl the case was doubtless con- genital. 10th. The age of some of these patients, several of them rang- ing between 30 and 43 years, and the eninently satisfactory resuts obtained at this age render it conparatively certain that age is not .a serious barrier in the way of correcting this deformity.",
         "MEDICINE AND SURGERY. CASE OF t1ALIGNANT (?) DISEASE OF GALL BLADDER, SIMULATING HYDRO-NEPHlROSIS.-FEEDING TIROUGH THE GALL BLADDER FOR THREE DAYS.* BY F. N. G. STARR, M.R.(TOR.) Associatt- Professor of Clinical Siirgery, University of Toronto; Surgeon to Western lospital and Oit Door Departient of Toronto General Iopitail and Hospital for Sick Children. Urox several occasions I have reported cases to. this Society that have terminated fatally; for a change I thought I would report one. that still lives. To me it is one of peculiar interest, and I trust it will seem to you to be vorthy of your notice. The patient, a feinale aged 51 years, consulted me at my house on March 22nd, 1899, complaining of a pain which began in the right renal region, shooting down the right side of the abdomen to about the middle of Poupart's ligament, and then across to the lef t. Upon examination of the abdomen I found a mass about. the size of a duck's egg three finger-breadths below the costal magin, ap- parently not continuous vith the liver. It moved with deep respi- ration, was freely movable on palpation, but would, not retract entirely into the renal region. There was resonance on percussion between the mass and the liver margin, as well as over the pronin- ence of the mass. It was tender to pressure, and had to be mani- pulated very gently. She told me that at times when she would sit up she would have a sensation as if something would slip up under the ribs. There vas no history of gall-stvnes or of dis- colored stools, but there was a history, extending over months, of pain in the side, associated with a diminution in the quantity of urine which would last for a day or two, then a large quantity would be evacuated and the pain relieved. There was also a history of gas on the stomach, acconipanied by distress and nausea coming on suddenly. The urine, upon examination, was amber-colored, with a sp. gr. of 102, acid, but contained neither albumen nor sugar. Undèr the microscope there were a few dumb-bell crystals. An offensive discharge fromn the vagina had been in existence for sone time, but an examination of the uterus and appendages revealed no growth or malposition of the organs. There had been no menstruation since October, 1898. I made a provisional diagnosis of floating kidney. On April the Oth, nearly three weeks later, I was called to sec her, and learned that three days before, after suffering great pain, she passed a large quantity of urine-more than half a chamber- pot-after which she was comnfortable for a time. The pain re- *RCad beforc the Toronto Medical Society, May, 1900. 1 47",
         "8THE CANADIAN JOURNAL OF curred, and she was suffering greatly 'when I saw her. Very little urine had passed each day. I passed a catheter and drew obft eiglit ounces. From 9 p.m. on the 9th tilli noon on the 10th she passed just four ounces. The mass had increased greatly in size, and now extended to the left as far as the umbilicus. It was less freely movable. The patient vas vouilting a great deal. I ad- ministered the usual remedies for the relief of vomiting, and resorted to lavage without success. I now came to the conclusion that the floating kidney had in some way produced a kinking of the ureter, and that I had to deal witli a hydro-nephrosis. I tem- porized for two days, but finding there was no improvement in her condition, I advised operation for the relief of symptoms. Accordingly, on April 12th, I eut down in the loin over the right kidney, and to my surprise found the kidney normal in size and appearance. The ureter was, however, greatly distended be- cause of pressure upon it by some intra-peritoneal tumor. T closed this wound and opened the abdomen over the prominence of the mass, which now extended more than an inch to the left of the umbilicus; this I discovered to be a greatly-distended gall bladder. Pù.tting an aspirating needle into this a considerable quantity of dark brown grumous material was drawn off, which under ihe microscope proved to be made up of cholesterine crystals and dlis- integrated blood. After carefully protecting the generai peri toneal cavity by means of gauze-pads and sponges, I freely opened the gal bladder, finding that it had a very thick wall varying from a quarter to half an inch. Passing my flnger in, and afterwards a long probe I was able to determine the patency of the common bile duct. Believing the case to be one of malignant disease, T sutured the nargins of the opening into the gaIl bladder to the nargins of the abdominal incision, put in a drainage-tube, and then closed the remainder of the wound. For several days the tube drained away a considerable ainount of this dark brown fluid, but the discharge gradually became more and more like bile until finally clear bile was discharged. The stools throughout had been of a natural colon. A few hours after operation a large quantity of urine was drawn off. As soon. as the. patient began to come out of the anestheti-the vomiting recurred, and the stomach would retain nothing. T re- sorted to nutrient enemata for about thirty-six hours, keeping ber in fairly good condition by-this means, but at the end of that time the bowel refused to retain these. On the evening.of the third day after the operation I saw the patient and.found her sinking rapidly, stoinach contents wei'e regurgitating from the mouth, she was very restless, the face was drawn and pinched and the eyes sunken, the temperature was subnormal, the pulse irregular, running at 140 to the minute and barely perceptible at the wvrist-the end seemed near at hand. Mr. Irving H. Cameron came in at this time, and 148",
         "MEDICINE AND SURGERY. 149 we were discussing the advisability of giving a subcutaneous injec- tion of normal saline solution, when it occurred to us that through the gall bladder we had a direct opening into the duodenum, and we might possibly succeed in introducing normal saline into the small intestine in this way. I put about Oiii into the irrigator, in- sorted nozzle into drainage tube, packed around tube to prevent as much as possible any leakage, and then conmenced the injection with the irrigator at an elevationof about eighteen inches and af ter- wards raised it to about three feet. Of course there, was some leakage, but I am sure the patient got about a quart of the solution. Inside of half an hour the effect was narvellous-the patient be- came restful, the pulse full, the temperature slightly elevated; the voniting ceased and she had her first undisturbed sleep. These normal saline injections were repeated twice during the night, and the improvement continued, though at times there was nausea and some vomiting. In the morning the success of our experiment was so apparent that I ordered three oimces of peptonized milk to be injected through the drainage-tub, every two hours. This nethod of feeding was continued for three days, when, as there had been no more vomiting, I ventured to nourish the patient in the usual way. She was moved home at the end of six weeks, and though she was very weak for sorne time, yet at the end of four months she had improved sufficiently to be able to do a little house- work, and at the end of six months she was able to- do all lier own housework. At this time she weighed more than she had ever weighed in lier life. She continues in good health, thougli she still wears lier drainage-tube, and for this reason: On one or two occasions the tub- lias become blocked with mucus, when she would complain of the old pain under the ribs, hence fearing lest the closing up of the opening would Iead to a recurrence of lier old symptonis, I have advised lier to put up with the incouvenience of the tube. My object in reporting this much mis-diagnosed case is to call attention to this unusual method of feeding a patient when the condition has become hopeless. I have so far been unable to dis- cover that this method of feeding has been tried before, and until some responsible and reliable surgeon proves beyond a doubt that I an nistaken, I shall claim that my patient was the first to clearly demonstrate the usefulness of this novel but rationalmethod of feeding. T am unable to account for the mistake I made as regards reson- ance unless it vas transmitted resonance f rom a greatly distended Color. As to the diagnosis of the case I am still in doubt, and hope that her health will. continue so good that I shall renain in doubt for a long time to corne. 471 College Street,. Toronto.",
         "THE CANADIAN JOURNAL oF THE RELATION OF THE PROFESSION TO SANATORIA FOR CONSUIPTIVES.* BY P. H. BRYCE, M.D., TORONTO. As miglit be expected of an Association having the status of the Ontario Medical Association, I find that amongst its objects, as set forth in the constitution, Clause 4, has \" The Pron.otion of the Public Hlealth,\" and that one of its standing conunittees deals with \"Public Health, Vital Statistics and Climatology.\" I further recall to the recollection of the Association the fact that in 1899, the treatment of consumption in sanatoria was quite fully discussed, and that the Association lias cordially adopted the method as having great value as a therapeutic measure in dealing with this prevalent disease. Owing to the interest exerted by this representative Association to the ever-increasing knowledge of the ýxciting causes of this disease, and to a more accurate study of its immediate cause, and of the protean phases under whicli the disease presents itself, scien- tific medicine lias arrived at the conclusion that any effective var- fare against it must depend -upon the promotion of the nutrition of the body, and its graduail restoration to a condition of physio- logical health. To--day we find the saine principles accepted for the treatment of other diseases, as typhoid, acute mania, the inan- ageient of surgical cases, etc.-indeed, of all disease. In view, however, of the insidious and usually chronic char- acier of tuberculosis, physicians are confronted with the most serious obstacles in supplying such \" home \" conditions, espe- cially in the houses of the wage-earning classes, as will promote a return to that physiological condition w'hich we denominate heahh. Iu view of the confessed failure of the profession to establish cures by the routine therapeutic menasures, it has been forced to turn for help to the study of that chapter of Hippocrates, neg- lected for centuries, entitled \"De aeribus, aquis et 7ocis,\" '.On Airs, Waters and Localities.\" Recog'nizing, hîowever, that its application in a practical mian- ner must be largely dependent upon house conditions largely be- yond their control, the profession as represented in this and other associations, has endeavored .to educate the public and our legis- lators regarding the need for organized effort to supply conditions under which this trinity of forces cau operate so contiuously and systematically that the vis medicatri: naturace eau operate under' the most favorable circunstances. *Read at the Ontario Medical Association, Toronto, June, 1900. 150.",
         "MEDIOINE AND SURGERY. 151 So general bas been the education on this point, and so un- answerable its logic, that at the last session of the Ontario legis- lature a Bill was introduccd, and after full consideration was unanimously passed, providing for the systematic establishment of sanatoria for consuiptives in every county in the Province. The compreheusive and practical character of the Bill is such that I believe it can be said that it is the most con.pirehensive and ad- vanced legislation on the subject which has be\u0026n adopted in any country, and reficots credit equally upon the people, their legis- lators and the profession. Briefly it provides: 1. That counties or cities, or a union of numicipalities can establish a sanatorium after a by-law lias been passed pro.viding. money for the purchase of land ind the erection of a buildin. 2. That its management and maintenance must be vested by the C(ouncils in a Board of Trustees. 3. That its location, and the fitness of the building for the purpose, -ust be satisfactory to the Government. 4. That the Governinent may then grant a sum not exceeding $4,000 toward its construction. 5. That a weckly payment of $1.50 must bc made by any municipality from bwhich a resident is sent with the consent of its. Health Board, and a siimilar sum will bc given by the Legislature. G. That the further expense of m:aintenance must be supplied by the patients, public charity, and the county nunicipality estab- Lishing it. The Bill has sone of the provisions which apply to county In.- dustrial Bomes, but in view of the scientific and inedical character of the work, has provided for the appoiitment to the management of physicians and citizens most likely to fully realize the. aims of such an institution. In view of the fact that some twenty counties have instituted Industrial Bomes for the aged poor, who can only be looked upon as an inavoidable burden, it does not seein unreasonable to expect that we may sec the institution in niany counties of sanatoria for- consuinptives, when we remeniber that it has been found here, as in Gernany, that sone 50 per cent. of all sick work-people between 20 and 30 years of age, are suffering from. tuberculosis, and that sone 37 per cent. of all deaths between 15 and 60 are due to this disease. As the menbers of this Association arc aware, it has been ny duty to study the statistics of the Province for many years, and hence it is natural that I mnay have becone especially impressed with the xelatively enormous mortality from this disease, not in. oue but in every part of the Province; but every physician is -n- fortunately too well aware of its ravages. The problem of how we shall be able to bring this new addition to our armamentarimiti into operation inust seriously engage our attention.",
         "THE CANADIAN JOURNAL 07- In England, Broadbent, Playfair, McCormack, and indeed all the leading n.embers of the profession, have taken the matter up, and under the patronage of the Prince- of Wales and Lord Salis- bury, have banded theiselves into an associatiojn or league for the Prevention of- Tuberculosis. Such a snilar association the situa- tion demands in Ontario. There the Association has taken up the work of popular eclucation on the subject. Here a similar work is demanded to set in motion the splendid nachinery provided under the Act. What is especially demanded of suchi an association is, that the work shall be controlled in the highest irterests of science; and to this end it becomes the duty of the prof ession to become the leaders in the work in everýy coùnty. To theu we look for guidance in the selection.of sites, the plan- ning and construction of buildings, and the chief voice in the man- agement. It will not do for the profeision to take a mercly passive or advisory part in the worik. We are aware of not a few instances where an undue promin- ence of'the lay element has worked disastrously in the interests of science in the construction and anaigeinent of our ilospitals. In this work in -which the supervision of the consumptive denands, as WaIther and others have shown in Germany, the nost thorougi scientific knowledge of medicine, of hygiene and climatology, asso- eiated with the highest executive capacity for obtaining the best results, this point of medical supervision must be especially recog- nized. - Already the physicians of Toronto have taken steps tb organize a Toronto JBranch of the proposed Provincial Association, and have carefully considered the details of such an association. It is expected that steps -will be taken while this Association is in session to organize a Provincial Association, under which may be formed many local associations., and which in its tuurn will becoine one of eight in a yet larger Dominion Association. Such asso- ciation has been pronised the distinguished patronage of the repre- sentative of Her Majesty in the Province, Sir Oliver Mowat, whose name is so intimately associated with that wonderful aggregatiin of charities tvhici has made Ontario the admiration of countres across the sea. The work is national,. touching as it does the life of the iili- vidual, the happiness of the family, the vigor of the people, ani the welfare of the state. Its scope is the investigation of the social influences which tend to deterioration, whether physically, intellectually or morally;. and which it is the proud privilege of medical science especially to prosecute. To the profession,. vho are the \"eyes and ears \" of the people in all whiei affeets themu nost personally, society looks for guidance as inplicitly as 152",
         "MEDIOINE AND SUItGERY. in ancient times the people looked to the auspex who scarched in the entrails of his victim for the fate of the army or the recovery of a potentate. The century has seen pass its little systems froin Thoinsonianism and Joanna Southcott's visions, only to be followed by others of their kind in rapid succession. Only what. is true remains, and to the true men of science alone is it given to say, as Sir Humphrey Day said a hundred years ago, \" That -we reason by analogy fron simple facts; we cofisult only a state of human progression arising out of its present condition; we look for a tim.e that we may reasonably expect-for a briqht day, of which we already behold the dawn.\" EXPLORATORY INCISION IN OBSCURE BRAIN LESIONS.- SOME POINTS IN THE SUROICAL TREATMENT OF 1ENINGOCELE.* BY L. W. COCKBURN, M.D,, M.R.C.S. ENG., HAMILTON.- WauN requested to read a paper at this meeting I selected these subjects, not because I feel specially qualified to speak upon them, but rather with the object of drawing forth expressions of opinion upon two subjects wheih, in comparison with the advances made in other departments of sargery, appear to me to be in a sormewhit backward state. The brain is still one of the \" darkest continents \" of the body, and it is perhaps too much to, hope that ex-ploratory incision, w'hich in abdominal surgery is so useful, will ever find its counterpart in the surgery of the brain. I have, however, sometimes thought it niight be more frequently resorted to than it is, and in support of this view I will briefly cite and make a few comments upon two cases that have come under my care. I wil give the histories in the briefest skeleton for in order to economize time. April 5th, 1894, H. I consulted me about his son, O. L., aged 13. Famiy history, nothing special. Past history of patient nothing special. Sickness commenced about two years previously. Complained of pain on the left side of the head, which became severe and incessant. Localized in a spot over the ascending fron- tal convolution close to the, longitudinal fissure. Had lost all power of speech for some time prior to date of my first visit. Cross examination could elicit nothing that threw any light on the cause of the boy's condition. Was told that he had been seen by seven or eight doctors before he came under ny care, and that many different opinions had been expressed as to the nature of the case. The boy was pale and anemic looking; hu lay huddled up 'Rcad at the Ontario Mcdical Association, Toronto, June, 1900 153",
         "154 THE CANADIAN JOURNAL OP iii bed in a darkened.room, perfectly silent, with an expression of pain iii his face, some photophobia, and his hand constantly applied to the left side of his head. I went carefully over tbe boy, but could find iothing 'in his nervous system or elsewhere to account for bis condition. I exam- ied him several timies during a period of two weeks, but always with a negative result. . told the parents I did not feel certain as to what the trouble was, but tiat the evidence pointed towards nerasthenia. Hle was taken to Toronto, and I lost sight of him. Early iii August the parents again brouglit the boy to me. I was informed that the doctor in Toronto had found a verýy tight and irritable prepuce and had advised circuncision, w'hich was donc. No im- provement followed, and tlie parents were in despair. I advised an exploratory incision, explaining, of course, the experimental nature of the operation. The parents uonsented. He entered St. Joseph's Hospital on August L3th. Operation August 16th. Horse- sloe skin incision and hole in skull to correspond, dura mater aho laid back by a horseshoe flap. Hole in skull rather larger than a 50c. piece. Brain pulsated and appeared normal. Brain gently pressed back and little finger inserted under edge of bone, exploring cortex for about 3-4 incli beyond edge of bone. Nothing found. Dura bone and scalp all replaced. Stitches removed eigith day. Discliarged August 25th, and I again lost sight of hin. A few weeks ago a prosperous4ooking youug man valked into ny office and asked for bis bill. I told himn I thought lie had made a mis- take. \"Oh no, doctor,\" lie said, \" do you renember ny head l?\" -He toldi me that after the operation the pain began to get easice, that it gradually died away, his power f speech returned, that lie *got quite well and had remained so ever since. F. H., aged 22, consulted me in the early part of January, 1899. Family history: Father healthy; inother neurotic. Seven brothers and sisters, all healtby. Past history nothing special: Present illness: When about seven years of age received a wound on the left temple. Wound healed; no ill effects for a year or more. Then began to have pain on left side of head, localized in a spot about three inches above the external angular process,. behind the site of tIe old wound. Pain acconpanied by vomiting. At- tacks of pain and vomiting -would recur about once a week This lias beengoing on for years, and the attacks of pain and voniting -are sufficiently severe to incapacitate him for work. I went over the whole case, but could find nothing except somne exaggeration of the si.perftcial reflexes. General health intact. The constant pain and vomiting being practically the only symnp- .toms present. On January 2Sth, I admitted him to the City iHospital for I. *1",
         "MEDICINE AND SURGERY. observation. On the supposition of the case beiig one of neuras- thenia lie was placed upon large doses of bronide, but without mucli benefit. He was discharged February 19. Since then his .condition las remuained nuch the saine. ln this case I have ad- vised exploratory incision, but so f ar the patient has declined. Comments. I believe the first case vas cerebral neurasthenia. That he began to improve after the operation is undoubted. What share the operation may have had in the improvement, or whether any powerful impression produced on the nervous systemn would have caused a like satisfactory result are debatable points. I think the second case is also neurasthenie, thougli the history of traumatism miglit form an additional argument in favor of opera- .tion. It is in cases of suspected tumors that exploratory incision would find its principal use. Now, brain tumnors, with the possible exception of syphilitic and tubercular cases, are mortal lesions,· and tierefore anything which liolds out a hope of savinig the patient is justifiable. For clinical p-urposes tumnors of the brain miay be roughl*y divided into those producing no symptoms; those yro- ducing slight symptois; those producing narked symptôms, but of such a cliaracter that localization canuot be inferred therefrora; t hose producing definite localizing symptonis. Operation has usually been confined to the last class of cases. I think in all cases of suspected tuinor exploratory incision should be undertaken. I should like to propound this question: Given a case pointing tc brain trouble of soie kind, if after careful watching, if afuer ·excluding all constitutional conditions, if after all inilder remedies have been fLaithfully tried, and, finally, if the patient clearly under- stand the experimiiental nature of the procedure, is au exploratory incision justifiable? I think it is. My remarks on meningocele will be very short. On April 5tI, I operated on a fair-sized meningecele. The skin and subeutaneous tissues were peeled down to the neck of the ·tumor. All bleeding stopped. Tmnor then opened and interior of sac exainined. No nerves were found in the sac; the neck of the tuimor was therefore tied tightly with fine sillk, and cut away about one-half inch bevond ligature. The deeper parts were under- mined, drawn together over the stimp with buried kangaroo ten- dons, and the skin united with silk. Usual aseptic dressing ap- plied. The case did w'ell until April 10th, when cerebro-spinal. fluid was found escaping. The wound was opened and the mneck of the sac was re-tied. The next day the leaking continued, a11d. -another attempt was inade to render the sac water-tight, but.with- out success. Leakage of cerebro-spinal fluid continued, and the child died, April 18th, thirteen days after the operation, with symptoms of mneningitis.",
         "156 THE CANADIAN JOURNAL OF No formal autopsy was made, but the wound was examined, when it was found that the ligature had eut through the pedicle. Connents. According to most of the standard text-books, the surgical treatment of spina bifida has settled down into a state of quiet immobility, in which the treatment by the injection of Mvforton's fluid is copied from book to book through successive editions with monotonous regularity. In spite of the weight of authority against me, and in spite of the fatal issue of the case just mentioned, I believe excision is the treatment of the future. Injection is unsound in priaciple. The condition is one of con- genital hernia, and I think should be treated in accordance with the principles governing the radical treatment of hernia in other parts of the body. What man in these days would dreani of in- jecting an irritant fluid into an ordinary hernial sac, which corm- municated freely with the abdominal cavity, in order to produce its obliteration ? The fatal issue in this case was due, in ny opinion, not to faulty principles, but to faulty technique. Such occurrences are, unavoidable in pioncer operations, but if the lessons they teach are taken to heart they will not bo thrown away. In any future case I would peel the skin off the neck of the sac, leaving as inuch as possible of the soft parts ai!ound the neelk in situ, then place a temporary ligature round the neck and open the sac. If no nerves were present, I would then cut away the tunor about two inches away from the temporary ligature and then peel the dura mater away from the interior of the sac down to the bite of the temporary ligature. I would then clamp the moiith of the dura mater, remove the temporary ligature, and then tic the dura mater with tendon, eut away the redundant dura, and turn -the remaining soft parts constituting the neck of the sac in over the stump of the dura mater. I would then deeply undermine the sides of the incision and draw them together over the hernial opening -with the buried tendon Ligatures, unite the skin with fine silk and apply a thick collodion dressing. A meningocele becones. ver*y tense when a child cries, and this tension is the measure of the pressure the ligature of the sac will have to stand; under these circumstances the importance of getting the wound quickly uiited over the hernial opening is obvious. Anothier important point noticed was the effect on the patient of ope? ing the sac. Imme- (iately on opening it evidences of collapse appeared, and the anesthetist becomes anxious. Such a state of affairs is not con- ducive to deliberate operating. Temporary ligature would, I think, obviate this difficulty, as I have no doubt that the symptoms of collapse were due to the sudden change in the intra-cranial pressure consequent on opening the sac.",
         "MEDICINE AND SURGERY. 157 5011E PROOFS THAT SI'IALL-POX IS PREVENTED BY VACCINATION.* BY w. F. ELGIN, M.D., GLENOLDEN, PCA. IN order to study this question in a systematic manner, I will divide the subject into three parts, though begging you to remember that they are so intimately associated that in the following facts and figures it vill be impossible to discuss them separately. My first proposition is one that may be considered as the most important and the other two simply corollary, and must follow as a matter of course. 1. Vaccination always protects against small-pox i recently vaccinated cases where positive proof exists that the vaccination was genuine and not spurious. 2. Where immunity is partially lost by lapse of time, an attack of small-pox is usually milder and followed by a lower deat rate by reason of partial inmnunity still existing. 3. Statistics show a smaller death-rate from small-pox whero vaccination is general than vhere it is not. Now we know that small-pox is not a respecter-of persons, and that there are very few, if any, naturally immune to small-pox; so that when a person, after having been vaccinated, refuses to have small-pox, even though inoeulated with virus from a varioloua vesicle, we are justified in assuming that the vaccine had protected him; and when such an instance is multiplied innumerably, the assumption becomes a scientific certainty. Jenner records nine- teen cases in persons who had naturally contracted cow-pox and appeared incapable of taking the disease either through abundant exposure on one hand, such as nursing and sleeping with patients, or by actual inoculation of small-pox, known as the \"variolous test.\" Again, he vaccinated a healthy boy, of eight years of age, with matter from the hand of an accidently acquired cow-pox vesicle, and six weeks later inoculated small-pox, and again some months later, with nô results., Crookshank speaks of this experiment, and does not deny it. Jenner reports still further f.ve other cases of like importance. This' same experiment was performed by Mr. McPherson, at Moorshedabad, India, and he reported it in Duncan Stewart's report on \" Small-pox in Calcutta, 1884.\". Inoculation of small-pox on the human subject being prohibited by law, we cannot use the variolous test. But Copeman (Gilroy lectures) shows that the monkey (Rhoesus) reacts to vaccine and Written specially for TuE OANADIAN JOURNAL OF MEDICINE AND SUIRGERY. 6",
         "158 TiE CANADIAN JOURNAL OF smaill-pox just in the sanie way; he also found that after the animal lad gone through a course of vaccinia, it was impossible to success- fully inoculate it with small-pox. So nmch for experimental work proving iny first statement, nud where is any anti-vaccination hLcrature proving to the contrary? Wre will now consider proposition No. 2. Should smaill-pox be contracted after successful vaccination,, the disease is nilder and with a consequent lower death-ratc, by being nodified by the partial imniunity still existing. As to this let us examine statistics of the Shefield epidernic of 1887-88, as reported by Barry to the Local Governnent Board. The attzack.rate of vaccinated children under 10 years %vas 5.0 per 1,000. The denth-rate of vaccinated children under 10 years was 0.09 per 1,000. The attack-rate of untaccinatcd childron under 10 years was 101.0 per 1,000. The death-rate of unvaccinated children under 10 years vas 44.0 per 1,000. Aniong persons over ton years of age, living under commnon conditions of infection, The attack-rate in persons twice vaccinated was -. per 1,000. The attack-rate in personà once vaccinated was 19.0 per 1,000. The attack-rate in porsons not vaccinated was 94.0 per 1,000. Death-rato among twice vaccinated people was 0.08 per 1,000. Death-rate aiong persons once vaccinated was 3.0 per 1,000. Deati-raté among unvaccinated persons was 51.0 per 1,000. 1iroin Leicester, in the epidenic of 1892 and 1893, and offici- ally reported by the Health Officer, we'quote the following: UNDER TEN YEARS OF AOE. Death.rate Cases. Deaths. per cent. Vaccinatd........................ 2 .... 0 .... 0.00 Unvaccinated ................ .. 105 .... 15 .... 14.30 OvER. TEN YEARs oF AoE. Death-rate Cases. Deaths. per cent. Once vaccinated ................... 176 .... 1 .... 0.57 Unvaccinated........,.............. 48 .... 4 .... 8.30- Revaccinated...................14 .... 0 .... 0.00 Doubtful as te vaccination (no marks visible)!....................... 2 .... 1 .... 50.00 Whittington in Derbyshire, in 1893 and 1894, had 135 cases, with 13 deaths. The following is from the local Medical HTealth Officer: Of 459 persons vaccinated in infancy, and living in houses invaded -with small-pox, 25 per cent. were attacked, and 1.5 per cent. died; while of 23 unvaccnated persons so exposed, 82.7 per' .s,.",
         "I 159 cent. were attacked, with a death-rate of 26 per cent. No vacci- nated person under twenty years of age died. Gayton, before the Vaccination Conunission (2nd report, p. 245), foulnd that 40 per cent of vaccinated children. could be revac- einated at the ages of from 6 to 10 years. Of children under simiilar conditions, exposed to small-pox, less than 10 per cent. were attacked, thouîgh under the saine exposure no leas tlan 92 per cent. of urnvaccinated children of the saie age contracted the disease. These points are well brought out in the following table by Gayton. in his analysis of 10,403 cases in the Metropolitan Smnall-pox Hospitals: Vaccnted, Vaccinated, Said to bc caccin. Good Marks. lnperfect Maks. ated, no Marks. Unvaccinated. A ges. .:eb 0 to5........... 51 0 0 182 21 11.5 128 47 36.7 677 383 56.0 510 10.......... 267 2 0.7 714 48 6.7 325 87 26.8 1187 563 47.4 10 to 20...... 1015 17 1.6 1970 9s 5.0 419 81 19.3 521 160 30.7 2440......... 7-5 37 5.1 1898 258 13.6 420 140 33.5 382 181 47. Over 40 ........ .18 6 12.5 266 51 19.2 131 44 33.8 79 34 43.0 All liges....... 20\u0026 62 3.0 4851 455 9.0 1295 352 27.0 2169 938 43.0 MEDICINE AND SURGERY. Along the same Une, quoting from Barry's report on the Shef- field epidenie, we gather the following figures: Of 8,198 persons re-vaccinated prior to the epidemie, thius re- newing a partially lost immunity, only 25 were attacked, being an .attack-rate of less than 3 per one thousand and a death-rate of 0.1 -per cent.; while of 56,233 persons who were not re-vaccinated .during the epidemie, two were doubtfuliy attacked and none died. Again, I wish to introduce a table prepared by Dr. Cory, which will illustrate the ages at whieh deaths occurred from small-pox in prevaccination timnes as compared with the present: Ages 0.to 5 stolo 10to 20 20to40 40to 60 60to 80 80 upwards. Provaccination tines .. 83.15 15.79 15.79 1.16 0 0 0 .Since vaccination ...... 3.07 10.34 16.34 58.41 18.16 3.24 0.32 Thus it -will bc seen that small-pox was formerly a children's .disease, occurring under the age of five years. Now, however, where vaccination has become generally practised, the highest -death-rate is between the ages of twenty and forty years. What but vaccination could have caused this change ? Sone of our",
         "1 4. 160 THE CANADIAN JOURNAL OF opponents, while -admitting this fact. say all this is due to sanitary reform and modern methods of dealing with contagious diseases.. Let us look at the measles, then. From I760 to 1770, the death- rate from measlks was 12 per 1,000 from all causes. This gradi'- ally rose until 1830, when it reached 46 per 1,000; in the decade 1880-90 it was 36 per 1,000. This does not=look encouraging from the standpoint of sanitation alone. Now let us take uqp the third proposition, which we have par- tially proven. I will first call your attention to Dr. Bizzozoziro's now celebrated lecture, delivered in Rome. He says, \" Germany stands alone in fulfilling, in a great measure, the demands of hy- giene. .Hayhig, in consequence of the calamities of the small-pox .epidemic of 1870 and 1871, enacted the law of 1874, which makes vaccination compùlsory in the first yeai' of life, and revaccination obligatory at the tenth year, what was the result i With a population of 50,000,000, having lost 143,000 lives by small-pox, she found by her law of 1874 the mortality diminished so rapidly that to-day the diseaseaseumbers only 116 victims yearly; and these cases occur almost exclusively in towns on her frontier. If it vere true that a good vaccination does not protect against small-pox, we ought to find in small-pox epidemics that the disease diffuses itsel f in the well-vaccinated as vell as the non-vaccinated countries. But it is not so. In 1870-71, during the Franco-German war, the people inter-penetrated each other. The -German having its civil population vaccinated optionally, but its army completely vaccinated, while the French (population and arny alike) were vaccinated perfunctionally. Both were attacked by small- pox. The French army lost 23,000 soldiers by it, while the Ger- man, 278; and 'in the tent, breathing the same air, the French wounded were heavily attacked by it, while the German wounded having been vaccinated, had not -a single case.\" Note the following :-These died annually from small-pox pe r' every million of inhabitants: *Lcality. Before Vaccination. After Vaccination. Sweden........... 2,050 ........ 158 Austria................... 3,095 ......... 841 Torest .................. 14,046 ........ 182 Moravia............... 5,402 .......... 55 Silesia (Austria) ............. 5,812 ... 198 Prussia (Eastern)............3,321 ......... 56 Berlin ...................... 3,422 .... 176 Copenhagen................ 3,128 ......... 286 In other words, The mortality of C(openihagen, after the intro- duction-of vaccination, was only one-eleventh.of what it was before - n Bérlin ohe-twentieth, and in Sweden one-thirteenth. The remarkable,diminution in the sinalli-pox death-rate, especi- a b l p e c ---i .... . I 3 - -4:",
         "MEDICINE AND SURGERY.. 161 ally within tlie last fifty years, is shown in the following table with regard to the london death-rate: Average aninual deatils Average suinutil déaths Tears. Per 1,0e 0 from al causeà. Iroin asniall-po):. 160-79........... 80, ........... 4,170 1728-57.............52,000........à 4,260 1771-80......... 50,00..............o020 1801-10.29,200.............2,040 1831-35. .... 32,000 830 1'838-53.............24,900 513 1854-71.......... 24,200 ..... 388 1872-82. ............ 22,100 ........... 262 1883-.9.. ........... 19,800 ........... 73 During 1855-.64, when vaccination was optional in Scotland, the annual death-rate from small-pox was 340 per million inhabi- tants; but when vaccination was made compulsory the death-rate dropped to 80 per million for the years 1865-90. Upon the same point Edwardes gives some interesting figures from Sweden, where the small-pox statistics go back to 17.74. From that dateio the be- ginning of this century the average annual death-rate was 2,008 per million people. From 1801 to 1815 vaccination vas optional, and the death-rate fell to 631. In 1816 vaccination becane com- pulsory in Sweden, and duxing the period 1816 to 1885 the death- rate has been 173 per million; while the last eight yea's of that period it has been but 41 per million. In Boston, in 1721, with a population of 11,000, there were 5,989 cases of small-pox, with 850 deaths. In 1730, with a popu- lation of 15,000, there were 4,000 cases of small-pox -with 500 deaths. While after the introduction of vaccination there were in Boston, from 1811 to- 1830, withgreatly increased population, only 14 deaths from this disease, and from 1881 to 1887 only 18. deaths. From the 29th annual report of the State Board of Health of Massachusetts, we take the following: \" From 1888 to 1897, 330 cases -of small-pox occurred. in the State; of these cases 143 had been vaccinated, while 149 had not, and 38 wère returned as doubt- îul. Among the vaccinated, the death-rate was 6.3 per cent.; among the unvaccinated it was 25.5 per cent. No child under one year was attacked, while 18 infants (1nvaccinated) wère attacked. Among the vaccinated childreii under 15 years of age were 20 àttack£s, no deaths; among unvaccinated children under 15 years of age, .77 were attacked and 15 died, or 19.5 per cent.; among faccinated adults or persons over 15. years of age were 120 cases, -With 9 deaths, 7.5 per cent.; while among unvaccinated adults there were 71 cases, 'with. 23 deaths, oi. 32.4 per cent. Here are sone of the Baltimore, Md.3 statistics. ]Ruhrah, of the ·Quarantine Hospital, reports 1,106 cases; 441 of these had",
         "'LTE CANADIAN JOURNAL OF been vaccinated at some tiie previous; 645 had not; twenty had,. but unsuccessfully. Of the 441 cases previously vaccinated', there were G3 deaths, mortality 14.3 per cent.; of the 045 not prcviously vaccinated, there, were 315 deaths, or 48.8 per cent. mortality. Most of the previùusly vaccinated cases had a discrete or mild forin of the disease, while most of the previously unvaccinated had the confluent or dangerous form. Again let me quote from Dr. W. 'M. Welch, in charge of the Municipal Hospital of Philadelphia: \"From a study of 5,000 cases, it is apparent that there were good cicatrices (as evidence of previous vaccination), only 8 per cent. died; with fair cicatrices, 14 per cent. died; with poor cica- trices, 27 per cent. died, while the death-rate of the unvaccinated was 58 per cent. In New York City, prior to 1876, the death-rate per 100,000 was 59.57. After that time vaccination was-encouraged and done free, though not compulsory, and the death-rate fell to 8.38 per 100,000. I quote from a letter written to the Philadelphia Medical Jour- nal., by Dr. Geo. Groff, Sec. Superior of Blealth Board, Porto Rico, under date of October 23rd, 1890. \" Sirs: I have the honor to inform you that the existence of a single case of small-pox is at this moment unknown on this island. Nine months ago a serious epidemic threatened, and the disease pervaded the island; since then 800,000 vaccinations have been performed.\" It is possible to stamp out small-pox in Spanish- American countries; and yet one of our anti-vaccinationists claimed that the credit of this work belonged to improved sanita- tion and isolation, when any one at all conversant with the situa- tion will tell you that the lov-class native is one of the most un- sanitary objects in existence, and that the whole U. S. arm:y would scarcely be effectual as a quarantine agent. Again, it seems so peculiar, to say the least, that they should grant the I-Iealth Board sufficient intelligence to stanp out small-pox and yet be vanting in ability to determine the relative usefulness of the means which they employ. In other words, they would grant that Dr. Grotf can stamp out small-pox,, but have not sense enougli to tell how-le does it; but must be informed by men who stay at home. In closing I will call your attention to leicester exp.eriment, or system, of \" quarantining \" for small-pox. In the health officer's report, 1892, he explains that by \"·Quarantines \" are ineant prac- tically persons who are in small-pox infected houses, for it is clear inmates must, more or less, have been exposed to contagion. He goes on further to say: \" Such persons may be quarantined separ- .ately in hospital wards and reception houses especially provided (a method,\u003eby the way, I do not recoinmend), or at their own homes.\" 1;.62",
         "Further on lie says: \" I have been able with comparative ease, by means of my inspectors, to quarantine hundreds of persons at their own homes, with success that has been gratifying botli financially and otherwise; 1,261 persons were quarantined, of whomn 123 eickened, 9 per. cent. Each infected bouse was visited daily by one o«r the other of the inspectors for 14 to 16 days.\" IEet us ex- amine this for a moment. Who is to act as inspector ? We know that fully 95 per cent. of persons not artificially protected are sub- ject to snall-pox. Suppose that none of your force of inspectors are protected, and in from 12 to 14 days 90 per cent. of them are attacked with the disease, and are themselves walking pest-houses. Again, -wh at an inhuman thing to quarantine a well man in con- tagious surroundings, with only one chance in ten of escaping the dread disease, and withhold froi hin wbat has been proven to change this proposition for better to nine chances in ten, because a few fanatics so decree! Even here, where many were protected by previous vaccination, 9.7 per cent. sickened in the quarantine. Now turn to another picture as reported by Dr. E. P. Oden'hal, Physician, in charge of the Oraney Island Hospital, Norfolk, April i, 1900: \" I have lad under iy care 82 cases of simall-pox and 34 suspects, who were vaccinated -when açhmitted, and in not a single instance has small-pox suspect developed the disease, thougli 26 of the suspects have lived in the sane wrards with the patients. The cases being of such a nature that separation was impossible. \"In imany instances mothers have nursed their own children during the course of the disease, and where T vaccinated them withî glycerinated lymph during the first three or four days after ex- posure, I felt perfectly safe in. allowing mother and child together, and have not as yet seen snall-pox develop in these cases.\" In conclusion, T would say it is possible to produce proof on proof in support of the three propositions which I present for your consideration, but wyhere is the necessity ? Wien people close their eyes no amount of liglit can illumine their understanding, and where a person is looking for truth surely enough facts have been presented, and only one of three conclusions is tenable: (1) That all those who testify are wilful and malicious liars and unvorthy of credit, and yet they are some of the best citizens. (2) They are not of sufficient intelligence to interpret facts as they find then; yet they are in charge of tie public healtl and are so selected on account of especial skill. (3) That tbey do tell the truth, and that facts overwhelming establisli claims that they make in favor of vaccination as a pro- tection against small-pox. Glenolden, July 31st, 1900. MEDICINE AND SURGERY.",
         "'T HE CANADIAN JOURNAL 0F CORPORAL PUNISHMENT AND CRIME.* lY w. S. . MONCX, ESQ., OF THE DUBLIN BAn. THE corporal punishment of criminals is a very wide subject, and I shall not attempt a full discussion of it or examine in detail what other members of the Medico-Legal Society have said or written on it. Indeed, a full discussion of the question of whipping alone would occupy too inuch time and space. I shall, therefore, con- fine myself to some remarks on the subject which, I hope, may not prove entirely unconnected. Commencing with the Mosaie Law, to which reference is often made, it contains no provision for imprisonment, whicli is at present our most ordinary punishment for criminals. Moses, in fact, had no prisons, and prisons, throughout the Bible, seem to hàve been used as places of detention or safe custody, not of pun- ishnent-the inmates being untried prisoners, not convicts. Other early legal systems. present the same feature. With the exception of restitution and fines, all punishments were thus cor- poral, and they were chiefly reducible to three: death, whipping, and mutilation, in accordance with the lex talionis. Very few persons would, I think-, now desire to revive the Mosaic Criminal Code and to abandon our imprisonment system, while the lex talionis has been expressly condemned in the New Testament. This being so, I think no argument in favor of capital punish- ment, whipping, or of any other kind of corporal punishment, ean be drawn from the fact that it was included in the Mosaic Code. The disgrace involved in whipping is supposed by some to have a deterrent effect on criminals and intending crirninals, though perhaps the persons who use this argument tell us that they would apply the punishment only to. hardened brutes who do not mind the disgrace and do not feel degraded by the infliction. lere let me remark that the disgrace attached to any punishment dependsi to a large extent on its infrequency. No punishment which is in * Read at the December meeting, Medico-Legal Society of New York, 199. 164",
         "-use every day on persons of all ranks, will be regardel as very disgraceful, and this actually occurs with whipping in some Oriental countries, where statesmen are not exempt from that punishment. And there are also public schools in which, owing to its frequency, whipping is not regarded as any disgrace. It is one thing to be the only boy (or girl) out of one hundred who is considered bad enough tô be whipped, and whose whipping will, therefore, be long recollected by the others as a remarkable inci- dent in their school life, and it is quite a diferent thing to be one of a large number of whipped persons whose individual chastise- ment will soon be forgotten, owing to the constant recurrence of similar incidents. In 'eligious liouses, too, whipping was not regarded as disgraceful and was often self-inflicted, and I am not sure that this practice (as wiiell- as its use in penitential discipline) has quite died out. If whipping is made an ordinary punishment, the element of disgrace will soon sink to very narrow proportions. The chief reason why it is considered more disgraceful in the case of girls, than of boys, is that it is more unusual. But then it is painful, and pain has a strong deterrent effect. Pain has a deterrent- effect, but its efficiency in this respect may be easily overrated. The foot-baller or cricketer often suEers a great deal of pain but lie does not give up the game on that account. The pugilist expects to suñer pain every time that ie fights. The elemeiit of danger is indeed often rather an incitement to sports than the reverse, yet the danger almost always includes the risk of tedious and painful injuries, as well as of death. What would become of our armies if the soldiers feared pain, or of persons suifering from infectious diseases if the nurses feared it ? I have aiready referred to persons voluntarily undergoing pain from re- ligious motives, and I could give many other examples. It is a fact, I believe, that school-boys have sometimes asked to be :whipped instead of being kept in-doors and forbidden to engage in their usual amusements, and if some letters on the subject can be trusted, girls have sometimes made a similar choice. Again, pain derives much of its terrors from being unusual .and unkuown to the offnder. The anticipation is worse than the \" corporal sufferance.\" A person who has never undergone or witnessed a whipping, or been intimate with one who underwent it, may look forward to it as something very dreadful, -but if it becomes a coin- mon punishment it will soon assume a different aspect. The prisoner reflects that what others have borne, lie can bear; that shortly afterwards they did not seem much the worse for it, and that when asked about it they made light of it. And there can be nPo doubt that a mau's power of bearing pain increases as ie be- comes used to it. As a rule, long and painful illnesses are b-rne patiently. 165 MEDICINE AND SUR-ERY. 15",
         "THE CANADIAN JOURNAL OF But we a'u told that the man vho is convicted of a, crime for which he is liable to be whipped, first begs the judge to let him off that penalty and then petitions the executivo for remission of it, and linally roars loudly when he is being whipped. Be it so. What does -it prove ihe very saine thing often occurs in the case of a naughty child, but is it not a fact that it is usually the very sane boys whko arc whipped again and again ? I amn not now referring to \"juvenile offenders,\" but to vlhipping in schools and famailies. A reforination effected by a single whipping is here the exception, not the rule. The most ordinary cases are those of no whipping and repeated whipping. Yet the child who, has been repeatedly whipped probably exhibited all these symp- toms of terror and pain on the first occasion. I read, not long- ago, of the case of a girl whipped for pilfering (at school) who, screaned loudly at the time and vas detected conmitting the same offence the next day. Some persons feel very strongly at the moment, but their feelings are very transient. A great exhi- bition of terror and loud cries of pain afford no guarantee of per- manent amendment. If we take any seliool in which the rod is in use, the chances are that the child vho has got most of it iin the past, will get most of it in the future. It is a grcat mistake to estimate the deterrent effect of any punishment by the feelings of the culprit at the time of infliction or shortly before it. Cap- ital punishment vould have an enormous deterrent effect if we were to -measure that effect by the feelings of the doomed man when the day of execution is close'at hand. But when he coi- nitted the crime (supposing that it is not conunitted under the influence of some passion which prevented him froi reflecting at all) lie probably expected to escape even suspicion and arrest. Then he had his chance of acquittal or disagreement of the jury, or of nercy after conviction. The chances that he will be hanged are, in bis own opinion, very small, and hie is as ready to risk a good deal on the throw of a dice as a gambler is. In cases w'here no crime is concerned, a man may risk his life recklessly, yet feel terrified when brought face to face with death, while on the other hand he may behave with calmness and presence of mind when in danger, and yet resolve not to act so recklessly again. But I am told that criminals who are whipped very seldon. incur the penalty a second time. Be it so. That is a natural consequence of the unusualness of the punishient as long as it continues to be unusual. A man may be an habitual offender and, yet not incur an unusual sentence a second time. Speaking of the English practice, whipping is never compulsory. In cases- where the law permits it, the infliction is left optional with tb\u003c' judge or presiding magistrate. Many judges and magistratâ decline to pass sentence of whipping at all. Others confine it to.",
         "MEDICINE AND SURGERY. cases of uinusual aggravation, and the nuiber of crimes for whicb it can be inflicted is small. In the case of juvenile offenders,. there is also au ageimit, and a boy cannot be whipped if lie is over that age. It is not then surprising that criminals who have- undergone two or more wvhippiigs are not very nunerous. But can we. suppose that juvenile offenders are unlike other juveniles. and become reformed characters after one whipping when other boys rarely escape witli a single infliction ? I believe nothing of the kind. I have no belief in the alleged results of exnerienc-e wlien merely stated in general terms. Au ounce of statisties is ofteri worth more than a ton of opinion. When a mian lias imbibed, ii early life, a predilection for any punishment or any criminal' systein, he will usually sec everything in experience that tends to- confirm his previous opinions and nothing that conflicts with then. The opinion of a man -who has changed his mind im consequence of experience is indeed usually entitled to some wveight, because the change affords somne evidence of close observation, indeperid- ence and impartiality. But the man whose opinions have never been changed or modified by his experience, but wlio, nevertheless, confidently appeals to experience in support of them, is seldom worth attending to. We have i controversy going on, as I writi, with respect to the creation of a Court of Criminal Appeal in England. Barristers and 'icitors of long standing write to say that their experience has .atisfied them. that the Home Office is a better appellate tribunal tailan a. Court of Criminal Appeal would be. Now, as to what a Oc art of Criminal Appeal would do in any given case, they can have -- experience whatever, and as to what Prcentage of the decisioîs of the Home Office are riglit, they have really no real experience eifther; for, as a nle, they eau have n.o kmowledge of the inocence or guilt of the appellants, except that a secret tribunal, which assigns no reasons for its decisions, has allowed or rejected the appeal. But the very question at issue is, whatpercentage of these allowances oi rejections are right ? There is, I think, no satisfactory evidence that whipping is a peculiarly efficacious punishmnent, vhile there is a good deal of evidence to the contrary. In almost all civilized countries it is failing into disuse in every department-not merely in the punish- nent of criminals, but in the army andi navy, in the côrrection of children, in the maintenance of d'iscipline in public institutions and asylums, and in fact in all cases wliere it was formerly re- sorted to. I do not think the young people of the present age, (lne worse than their predecessors, thongh they get mnuch less whipping. I do not think that girls are worse than boys, though they get much less whipping. I do not think that children who. have been whipped are, as a rule, any better conducted than th-ose 16T*",
         "- THE CANADIAN JOURNAL OF who have not; and if I were going to employ a discharged conviet I would give the preference to one who had not been whipped. I have no belief in punishing any man because he deserv, it. The object of state punishment is, 1 apprehend, to protect the citizens and to prevent crime. Anything more than is required for these purposes, is unjustifiable cruelty. A man may deserve to be torn in pieces by wild horses, yet if nobody vould gain any- thing by punishing him, no punishment ouglit to be inflicted by the state. -But further, there is no reliable measure of vhat any man deserves. Describe a crime to a dozen different persons and you will perhaps have a dozen different opinions as to what the perpetrator deserves; and, moreover, nobody can estimate the criminal's real demerits without knowing his previous history, his motives and his surroundings. If we have to punish a thief according to his deserts, we have to compare personal property vith physical suffering, and there is no standard by which we can decide how much of the latter is equivalent to a given amount of the former. The only mode of measuring ill-desert, that I know of, is lex talionis; and this is inapplicable to the thief vhenever he lias not the means of making restitution. We cannot take val- uable property from him, if he has no valuable pxoperty to be taken. If we whip him, low :many strokes does le deserve ? I know of no means of arriving at a satisfactory answer. There can be no equivàlent in quantity between two things that are dissimilar in kind. Even the lex lalionis i3 really unequal in its application. \"An eye for an eye and a tooth for a tooth \" is a very rough rule for adjusting crime and punishment. One man may have a bad eye or a loose tooth -which -were not of. muich value, while wvith another both are perfect, and perliaps his whole means of livelihood depends on his sight. Then there is a difference between a hasty blow which, aided perhaps by negligence, or un- s.kilful treatment, results in the loss and the deliberate destruction of the organ-to say nothing of the element of provocation. But our criminal systent introduces a further element of difference between the crime and the punishment. Tie offender is seized and carried off to prison, to the injury 4 his trade or occupation. THe has to bear all the costs of his own defence. His critre and his punishient are published to the world, and finally he lias probably to.remain for some time in prison in order to enable the punishment to be carried out. There are thus a number of elements which nake the punishment -worse than the injury for vhich it is inflicted, even when the lex talionis is adhered tos . closely as the circumstances will permit. In England, in the case of adults, the sentence is always one of combined -whipping and, imprisonment. Assuming that the prisoner is whipped in accord- ance with the lex talionis, why is a term of imprisonment, quite 168",
         "MEDICINE AND SURGERY. outside of that old-fashioned rule, superadded ? Or why is one act of violence punished by two or three whippings ? The Mosaic law does not provide cither for the coinbination of whipping with imprisonment or for repeated whippings, inflicted for the same offence. And if whipping is so effectual a punishment, why should more than one whipping be required in any case ? Then there is a general objection to almost every kind of corporal pun- ishment, viz.: that it tends to brutalize the people, especially when the sentence is carried out in public. That a public whipping is a brutal exhibition and calculated to do harm to the spectators (especially to the young) will, I think, be conceded in case the victimn is innocent; but how is the case really altered on the as- sumption of his guilt ? The spectacle is the same in both in- stances, and it has a demoralizing effect similar to that of a bull- fight or a dog-fight. Public hangings and public floggings have been abolished long ago in England. But has this abolition got rid of the evil? Graphic descriptions, with illustrations, appear in low-class newspapers, which figure largely in the windows of print-shops and can be purchased for a penny or two-pencê; and J may add that while such public exhibitions are demoralizing, privaey oft3n deprives the punishment of much of its deterrent effect. Those who constantly inflict the punishment are most likely to be injuriously affected by it; but they are often police- men or warders who ought to discharge (and are expected to dis- charge) their other duties with as mucli humanity as is consistent with firmness. A brutal policeman or a brutal warder is even more undesirable than a brutal judge. Whatever the prisoner's demerits may be, the constant dealing out of brutal punishnents will harden and coarsen the minds of al who are engaged in it. There is, moreover, a practical objection of another kind. Some judges, if allowed discretion, would use the lash on every possible occasion, while others would never employ it unless com- pelled to do so. A punishment which is unequal in its nature is thus rendered more unequal in its administration by the divergent views of different judges, in relation to'it. If made compulsory, a similar question would arise as to the number of strokes, some adopting the maximum and others the minimum number for the saie offence. It is true that in every case in which the sentence is left largely in the discretion of the judge, a diversity of practice will spring up, unless corrected by an appellaté tribunal, because sone judges will always be severe and others lenient. But there is a difference between a lenfent judge and a judge who objects on principle to the employment of a particular punishment. 'fhe men who escape w-hipping under one judge may be much wr'se than those who naadergo it under another judge. Hanging may be made a compulsory sentence, because it admits of no degrees,",
         "' THE CANADIAN JOURNAL OF but in whipping the number of strokes and the instrmnent makes a very material diference, and these particulars can hardly be fixed by, law in such a manner as to exclude the discretion which .difEerent judges -will exorcise in a differeut manner, Anytling like a uaiforim practice and a fitting of the punishment to the .crime seems, in the case of this punishment, to be unattainable. S may add that any punishment froi vhich offenders of one sex .are exempt, arc liable to become unequal in application. Of two .joint offenders the female may be the worse, but the male has incurred a penalty from which she is exempted. Now there is nothing more calculated to render the publie dissatisfied vith our penal systein. than gross inequalities in its application, and in the case of whipping I do not sec how such inequalities can be avoided. This evi. attains its maximum in Egiland, where there is no court of criminal appeal, and both -whipping and non-whipping judges carry out their respective views without any interference on the part of the Home Secretary. That the prison system lias its drawbacks must of course he -admnitted, but I think those of the corporal punishment systemu are greater. At all events the latter system does not admit of much improvement. Electrocution docs not seem to possess many ad- vantages over hanging, and I do not know that mnany improve- ments in the mode of inificting whippings have been made during this progressive century. On the other hand, the prison system has been improved and is sisceptible of much further improve- ment. It eau be rendered at once more reformative and more -productive than at present. Every able-bodied prisoner should -earn his own bread while in prison, and should, in the great ma- jority of cases, be a better man when lie left than -when lie entered. The improvement of our prison systems is one which has attracted much attention, of late, at both sides of the Atlantic, and there is every reason to hope that it will be carried on until really good -results are attained. The substitution of corporal punishmnents for imprisonnient, at such a juncture as this, would, I thinki, be -a very unfortunate step. It vould be the substitution of an un- improvable system of punishment for one which is at present in -a state of rapid progress. A perfect system of punishinent is indeed impossible. All systems have so many defects that hu- manity is not the only reason why we should desire to sec punish- ments constantly standing at the ifrreducible, minimum. The *smallest amount of punishment which will adequately protect the lives, liberties and properties of the people, is the amount which -should be aimed at by the statesman no less than by the philanthro- pist. The statesman, like the general, should aim at attaining his ends with the least possible loss to those who are under lius 4orders. Hte may have to sacrifice a large nunber of lives in order 170",
         "MEDICINE ANb SURGERY. to gain lis object, But hè should never sacrifice them. unnecessarily.' He should keep his object steadily before 1im and sacrifice nothing that does not contribute to its attainment. Malice and revenge are as much ont of place in the court house as in the battle field.- ledico-Legat Journal. w. A. Y. DYING DECLARATIONS. A FEW SUGGESTIoNS nY ANDREW J. MRSOIL, ESQ., OF CHICAGo. IT is passing strange that, upon a topic of this importance, so little bas been done in our system of jurisprudence. Before considering what improvement could be attempted, it may bc well to recall the present status of dying declarations. They are limited not only to criminal cases, but narrowly to one branch, and that is homicide. In this case, and only in this case, are they admissible, and even there are to be rejected unless the declaration was made at the time when the declarant must have been actually in extremis, and further under a sense of im- pending death, and without hope (or as some say, the slightest hiope) of recovery. What under these conditions is said may, in case death actually ensue, be by the bystanders repeated upon tfie trial. The thury .upon. hi hey are admitted is first, that the declarant, under the solemn circurmstances requisite, must have felt fully impressed with the responsibilities of the future life, .and hence prompted to speak the truth, just as if an oath had actually been administered, and secondly, through the necessity of the case, it being homicide, and the victim being often the only witness, the assertions made by the victim would be the sole testi- mony connecting the accused with the offence, and if it were not admitted murder vould inevitably go unpunished. The purpose of this paper is not to criticise the very salutary principles above referred to, but on the contrary, to suggest making then more efficient, more practical, and of greater extent. As stated, the rule is applied only in criminal cases, but no adequate reason (except that the custom has thus been established) exists why it should not also be used in civil cases. The general principle is that a party accused in a criminal litigation is more leniently dealt with, in every respect, than, is a party accused in a civil litigation. In this ve see the dying decla- Read before fhe Medico-Logal Society-of New York, NLovenber Session, 1899.",
         "'T.HE CANADIAN JOURNAL OF ration to bc a marked exception, as it is Admissible against a de- fendant in a criminal complaint, and not against a party in a civil litigation. A person injured in a railroad..accident or other disaster, and conscious of immediate dissolution, is surely under as great a solemnity of ltimato responsibility as any one, and his expres- sions thus made should bo allowed as evidenco in subsequent litiga- tion, though of a civil nature. Truc, it may be said that even there he might wilfully lie, with a purpose of fixing tho blame upon some one else, and vith the expectation of enabling his dependants thus to obtain compensation through the courts, but the sanie reasoning should exclude, from a criminal trial, the declaration made by the victim of the assassin, because, while indeed it may not have been made with a purpose of aiding the dependants to recover pecuniary compensation, it still may have been made under motives even more powerful, namely, hatred or revenge. \"Revenge is sweet\" may be in the mind of the declarant. \"Heavon hath no hate liko love to anger turned, And Hell no fury lilke a woman scorned.\" Under these circumstances, the oath in the court room has frequently been violated, and no doubt the awful moment, at the brink of eternity, has frequently failed to force absolute truth upon the lips. But in whatever way, and for whatever purpose, dying decla- rations be used, there should properly be a modification of the conditions under which they are accepted. As noted above, the declarant must be essentially without hope, or, as some say, without the slightest hope, of recovery when uttering the declaration. In the majority of instances, quite naturally, and even necessarily, the physician is a witness and probably the sole witness to the dying declaration. The first duty of the physician is to encourage the patient. Even laymen know that words of cheer (though the speaker him self lack confidence in them) are better than words of discourage- ment. Patients often rally from the most critical condition when brightened up and aided by strengthening words of the physician or friends, and again, patients often in a fair way of recovery have been thrown into despair and death by tlie doleful utterances of those surrounding them. It is, therefore, quite difficult and strangely inconsistent for the medical man, upon the one hand, to exert himself by way of stimulating, encouraging and strengthening the patient with cheer,. ful words provocative of hope of recovery, and at the same time, for the purposes of the law, to treasure up the assertions of one 172",
         "V1o miust, of his own comprehension and that of the physician's, be at the time without any hope of recovery. Pretermitting all reference to the various constitutional or atatutory provisions and safeguards, such as trial by jury, and the confronting of witnesses, and the precence of witnesses in court (because, if necessary, all these could be changed or modi- lied), and not undertaking, for the present, to point out in detail the execution of any reform, lot it suffice to suggest that physi- cians, by virtue of their office, should have power to administer oaths, and hence could place the patient under the responsibility of an oath while arousing in hin the hope of recovery. Provision might be -made tiat the physician thus takc the statement of the patient, and if timie aud circumstance permit, that the party to be affected be notified of the same, and have afforded him an opportunity, either before the same physician, or before some one else authorized to administer oaths, to cross- examine the declarant. If the party to be alfected be not known or not accessible, some public officiai, as for instance the State's Attorney, or perhaps some justice of the peace, or judge of a Court of Record, or perhaps some commissioner to be appointed by such judge, should be charged withi the duty of such cross-examination, and the same should be put at the disposal of all parties who may be found in interest. Or yet again, the physician himself might, by force of law, if no other plans be practicable, be authorized to conduct some- what of a cross-examination, at least to the extent of testing the mental capacity, the motive, the memory, the perceptive powers, and in general the truthfulness and accuracy of the declarant.- Medico-Legal Jozrnal. W. A. Y. ME DICINE AND SURGERY. 173",
         "'THE CANADIAN JOURNAL OF rPharmaco[ogy and IN CIHARGE. OF # A J. HARRINGTON,. M.R.G.S.(Exo.) 'herapeuics ANUSOL AS A THERAPEUTIC AGENT.-CLINICAL NOTES. LIns. R. L. consulted me some months ago in reference to a condi- tion of severe constipation, so severe as to cause lier a great deal of physical suffering, not to speak of annoyance. On going into the history of lier case, I found that iy patientwas a multipara,having given birth to five living children. Her last baby was then seven months of age, and was a big strapping girl, the heaviest baby, the mother said, she ever carried. At the time of labor she lived away quite a distance from any assistance, and vas attended by a neigh- bor, but had no physician at all. She was in labor for about 20 hours, the pains being very severe, but seemingly for a time quite ineffective. She complained of having liad very profuse lochia, lasting for nine or ten weeks after confinement, and added that she had ever .ince been ver;y tender around \" the back passage,\" so mucli so that even lier underclothing would scald lier. Mrs. E. said that it was only since lier last confinement that the constipa- tion had been so severe, thougli for years she had been \"in the habit of taking saits and senna a couple of times a week.\" She said that she had asked lier old doctor, some years before, as to -what iedicine she sþould take \" for opening purposes,\" and lie told -ber that al she was advised to do was to eat plenty of vegetables, take- an occasional cathartie, and once in a while a rectal injection. As lier symptoms called my attention probably to a perineal tear, I nade an examination and found, first of all, lier abdominal muiscles were abnormally relaxed. There was an extensive tear in the peri- neum extending back to the margin of the sphincter ani, but did not involve that muscle except to the extent of a few fibres. As it was quite patent that, owing to this injury, received no doubt when lier last baby was born, lier levator ani muscle had- no longer its proper power, and that, apart from the condition of local tender- ness present, such a condition would at least aggravate lier consti- pation, I recommnended lier to allow an operýation to be done to restore the parts. She consented, and the following day I dià a. \\174",
         "simple perineorrhaphy, using salmon-gut sutures. I had a certain amount of difficulty in repairing the edges of the wound ere draw- ing them together, the parts being in a state of unhealthy granu- lation. After denuding the two surfaces to be apposed, they cane together nicely, and in seven days had healed without any difliculty whatever, restoring the perineum to its original condition, and with every prospect of giving as good support as before the laceration occurred. As to-continuing the treatnent already recomnnended, I iustructed my patient to stop carrying out the directions given her until after the operation anyway. The advice as to eating of vegetables was certainly all right, but possiblyin lier case a little stereotyped. I felt (1) that the plen- tiful residue of vegetables migbt fall down and to some extent þer- manently displace the intestines, unsupported as they were by the abdominal muscles; (2) that the constant taking of catharties would irritate the bowels, set up a state of hyperemia, and lead to chronie catarrhal conditions, and (3) that the injections would still further distend the rectal ampulla and make matters worse than they were by distending the spàce for the further collection of fecal matter. I felt that what was needed, possibly more than any- thing else at that particular stage, was not treatment of the con- stipation in itself, but the repair of the muscles of the pelvie floor and the toning of the muscles of the abdominal wall by massage and electricity. After my patient vas able to be up, I applied the faradic current to the abdominal muscles every day for about fifteen minutes, and also instructed her to massage with her own warm hands, oiled, her abdomen each nmorning before rising. I have no reason to think that she did not carry out my instructions. On making my last visit, I told Mrs. L. to eat whole wheat bread, a certain amount of fruit and vegetables, but not to resort to the use of catharties till she reported herself to me a month or so after. T hoped that she would be able to give a favorable report of her case, but such was not so. She had meanwhile been on a visit to fhe country, where for six weeks she had had plenty of exercise and been as judicious about her diet as she could be. She said slie thought that she was now, if anything, a little better, but. could not say that the improvement amounted to mnuch. She complained of a good deal of pain on the right side, and vhen I examined her there, I found a condition of perityphlitis present, with consider- able tenderness on palpation. On further palpatioi all along the cours of the colon, I found irregular masses of feces here and there, one of considerable size at the junction of the ascending and trans-erse colon. The tenderness over the cecum I put down to the same cause. .Fearing any inflammaiitory action in the appendix, I determined to give no drastic purgatives whatever, but temporize sonmewhat. I kept up the electrie current, and had a nurse admin- MEDIOINE AND SURGERY. 175",
         "' THE CANADIAN JOURNAL OF ister gentle but persistent massage along the coursé of the trans- verse and descending colon, with a rectal injection, administered by means of a long hard-rubber tube. I gave internally S minim doses of nepenthe, wliich in twenty-four hours had reinovec all the tenderness, withiout the accomnpanying danger, as witl other pre- parations of opium, of increasing the constipating effect. After the condition of perityphlitis had subsided, I put lier on some of the ordinary laxative preparations, cascara, rhubarb, snall doses of elaterium, an occasional tablet of hydrarg. submur, and latterly Waugh's prescription, composed as follows: W Aloes purificat ................................. grs. xx. Ext. belladonna................................ grs. iv. Ext. nucis von ................................ grs. v. Olei resinoe caps. ............................... grs. iv. Misce. Fiat piluke, No. xx. One pili daily at bedtime. This caused a good deal of relief, and my patient kept up this prescription, without my knowledge, for two months. She came back to me however, complaining that it had lost its effect, and wanted some \" new medicine.\" I prescribed some anusol supposi- tories, and instructed lier to insert one in the rectum each night before retiring, stooping well over in order to do so. I also .advised lier to sip Hunyadi water every morning. I told lier in passing to avoid strong coffee and. alcoliolic drinks, if she took any. Ste reported herself to me in ton days time, and was evidently satisfied with lier cliange of treatment. She said that for the first time in years she liad received relief, and that sle had had a healthy motioi three and four days a week. I found iher tongue had lost the fur, present any other time I had seen lier, and fhat she had had fewer headaches and been able to eat lier food with a certain amount of relish, also a new thing for lier. I instructed lier to replenish lier stock of suppositories, and to tise one every shird niglt instead of as frequently as before. When I last saw lier she was improving steadily, and declared that she was taking a great deal more enjoy- ment out of life than ever before, so much so that she expected to be again confined in five months' time. Robert G., bank messenger, aged 41 years, consulted me not long ago for what lie termed \" bleeding piles.\" He said that not less frequently than once a month lie had severe attacks of hemorr- hage from the rectum, being sometimes attackel down town, ren- dering his condition exceedingly awkward and diFagreeable. -fis duties, he said, necessitated a great deal of walking, and this ho blamed for al] his trouble. I asked him how long lie had been« a. suifferer from this complaint, and lie said that he first noticed that lie passed blood with a very constipated motion nearly a year ago. 176",
         "I found that lie, in, spite of the constant exercise lie had to take, was constipated nore or less all the time. To relieve this, lie had simply made a habit of eating brown bread and taking porridge every morning. He had never taken any medicine, niot caring to see any physician about a matter of the kind, lie said. I made an exanination of the rectum, and found a condition of subacute proc- titis present, a small-sized rectal speculum. causing him a good deal of pain when opened. I found several sessile internal hemorr- hoids, sone alnost as high up as the sigmoid flexure. They were quite small and spongy,with sof t, dark red, easily-bleeding surfaces, so much so that -when I touclied them wiith a probe they oozed blood. The mucous lining of the rectum was in a condition of chronic catarrh. The tissues surrounding were very vascular, and the surface covered with a thick coating of mucus. Mr. G. coin- plained of severe stabbing pains arond the anus all the time, mak- ing him ahnost ashained of himnself when on the public streets. There was a continued feeling of licat or burning in the part, with the sensation as if there were a foreign body present inside the anus all the time. These syinptoms would be worse after any hygienic or dietetic error, and lie had to use great care in sucli matters. As a result of these continued sensations of irritation, nervous pheno- mena coinmenced to appear. He complained of anorexia, slug gishness of the bowels, dulness of the intellect, ringing in the ears, vertigo, etc. The act of defecation was latterly quite painful, so imuch so that lie had even resorted to using a warm douche after- wards to relieve the stinging present. The aniount of blood lie passed varied fron tine to timl, sometimes slight, sometimes quite profuse. He toldi me .,that the only reason lie welcomed a bleeding attack was because afterwards for a day or so lie would experience quite a relief of the nervous symptoms above alluded to. Owing, however, to the repeated attacks of hemorrhage the last month or two, lie noticed that he w'as less able for his work, and was inuch more easily tired. I told him that there was no use of his taking any niedicines for tie relief of his trouble, but that lie had better lay off work for a week and have the internal piles cauterized, when lie would at once- get well and strong again. He was one of the nervous individuals, and would not consent to any operation, and in fact abnost insisted upon ny adopting some less severe measure, lie ail the 'while assuring me that lie was quite certain le would get well under my treatment, at the same time being honest enough to vouehsafe the fact that one other doctor, whom lie had called in, had advised him to \"have an operation pe-forned, and be done witl it \"-as \" a bird in the hand is worth,\" etc. I decided to do the best I could and trust to luck. I recommended exercisq in the opOn air, regulation of the diet, the avoidance of all kinds of ex- Cesses. careful attention to a daily stool, and the performing of MEDIOINE AND SURGERY.",
         "178 THE CANADIAN JOURNAL OF light gynuastic éxercises, which might be adopted to antagonize hyperem.ia and congestion of the abdominal vessels. I tried to so regulate the diet that it would leave behind the least possible solid residue, and would not contain irritating substances, such as strong spices, very acid articles, strong alcoholic drinks, or very strong tea and coffee. I advised the use of meat once a day, and lettuce, cabbage, fruit, and preserves in small quantities. I impressed upon. him the necessity and importance of having regular passages of a. soft, nmshy consistence, and that lie should be careful to sponge off the anus after each movenent with a weak solution of lysol, which I prescribed. I told him to take cool sitz-baths from tinie to time, with tlle. object of hardening tie piles and preventing inflammatory pro- cesses. I touched the small 3p)ngy bodies with a solution of iodine and potassium iodide (potassium iodide 2.0; iodine 0.2; glycerine 40.0) so as to render them more tough and xesisting, and if possible cause their absorption. I kcpt up that treatment for some little time, but still heinorrhages occurred, one so profuse as to saturate every piece of clothing he was wearing. I decided then that can- terization imust be done, and advised my patient accordingly. But I received \"no \" for a reply a second time. As lie, evidently dis- appointed with his second nedical adviser, said he would go to the country for a while, and sec wiether that would assist in his re- covery, I gave him a prescription for 25 suppositories of anusol, one to be used each night, and sent him awey, asking iin. to write me in two or three weeks as to his condition. I had almost for- gotten the case, when in a fortnight's time I had a letter from M-r. G., saying that le was better, iad had but three \" bleedings '\" since leaving the city, and, that the tenderness on defecation was con- siderably improved. I wrote him, advising that le keep up the suppositories every night, paying the same attention to the regnle- tion of his diet, his exercise, etc., as before. At the expiry of a six weeks'vacation lie returned to resume lis work, and incidentally called upon nie. He 5aid thant lie had had no further hemorrhage since writing ne, four weeks before, and that his bowels moved regularly and without any discomfort. He looked very much improved in. ap- pearance, having lost the haggard countenance he had when lie left the city. On examination of the rectal lining, tie chronic infan- matory appearance had largely gone, and tie small vascular sr-sile bodies had became considerably hardened, showing no tendency whatever to bleed when touched. I attribute the change for the better to action of the bismuth compound in the anusol supposr tories, acting as a disinfectant, and deodorant, but more especially as an astringent and a granulation-promoting agent.",
         "e ICHTHYOL IN TUBERCULOSIS. TDrE internai use of iclitliyol iñ tuberculosis of the urinary organs is recomnended by Dr. Richter, of Glatz, who gives the clinical liistory of a girl of nineteen, which serves to illustrate the benîo- ficial results obtainable by the administration of ichthyol. The patient took sick with cystitis in the middle of March, 1898. For more than a year she was treated in the usual way with diet, medi- caments, mineral waters, and irrigations, without attaining any improvenent. The diagnosis was made of tuberculous disease of the bladder, and at the date of the report the doctor was satisfied that the case was one of tuberculosis of the kidney, because all the diagnostic symptoms which Dr. Honig states to be characteristic of the affection were present. Tie urine vas turbid, contained albunin, epithelium iii various amounts, pus corpuscles, at times also blood and blood corpuscles; never any casts. The painful vesical tenesmnus, which steadily got worse as the disease progressed, made life a torture. The patient Lad to abandon lier position early in the disease, lost appetite, became bed-ridden, had fever, and progressively got paler and thimier. Then even cough and nmuco-purulent expectoration set in. The injections of iodoformized oil, which bad been prcscribed by a specialist, were d'scontinued on the solicitation of the patient and lier relatives, who decided henceforti -ot to have anything more done in the case, inasmuch as the disease steadily grew worse in spite of the most painstaking treatment. The condition was regarded by all as a hopeless' one. Dr. Richter, at this juncture, pleaded for at least one further trial, and that with iclithyol. This drug was then employed. It was at first given in doses of 25 drops and gradually increased to 'iO·drops, three times daily, well diluted. This enormous quantity vas talen every day uninterruptedly for months, without repugnance and without any by-effects. At the date of the report, the patient had consumed more than S kilos (11 lbs.' ; she had resuned lier occupation, looked healthy, and had no feeling at all of illness. The urine was still sliglitly cloudy, and *contained traces of£ albuuin. The author, at the end of his report, states that the good effects ôb;ained induce him to continue the use of the ichthyol, aud ex- presses the belief that there is a possibility of complete recovery. *Dcttscdic M«?iznal.Zeitung, 1900, No..22. MEDICINE AND SURGERY. i 179",
         "THE CANADIAN .JOURNAL OF Public Health and Hygiene. ...IN CIIARGIC or. . . J. J. CASSIDY, 31.D., ANI E. Hl. %DAMS, 31.D. ANNUAL MEETING OF THE ASSOCIATION OF EXECUTIVE HEALTH OFFICERS OF ONTARIO. TiiE fifteenth annual meeting of the Association of Execitive H-ealth Officers of Ontario was opened in the University Hall, IKingstonî. at 10.30 a.n., August 14th. The following gcntlemen were present: Dr. W. Oldwright, Toronto; Mr. A. McGill, B.A., Assistant Anolyst of the Department of Inland Revenue, Ottawa; Dr. Walkem, Q.C., Dr. A. P. Knight, Dr. Herald, Dr. W. Connell, Dr. Chas. Sheard, Toronto; Dr. Cassidy, Toronto; Dr. Bryce, Toronto; Dr. Vaux, Hamuilton; Dr. Kitchen, St. George; Dr. Hall, Chathaim; Mr. Dunlop, Obatham; Dr. Fee, Kingston; Rev. Jas. Cumberland, Stella; Dr. Kilborn, Oso, Ont.; Dr. Acland. Oronhya- tckha, Deseronto; Mr. Taylor an d Mr. Stecvly, London; D r. Third, Dr. W. T. Connell, Mr. 0. Y. Ford, Dr. Anglin, W B. Crow, 'Ireuton; Dr. MeCrimmon, Palerno, and Dr. McCuP.ugh, Owen Sound. In the absence of the President, Dr. T. V. flutchinson, Dr. Oldwright, Toronto, took the chair. 1ayor Minnes delivered the address-of welcoinc and extended a cordial invitation to the visitors to a coiplimentary trip anong the Thousand Islands that eveniing. Dr. Oldwright thanked the Mayor on beliif of the Asso- ciation. It gave the inembers great pleasure to ineet in Kingston, which was well known as an historie city, a city of education and of nilitary faine. On account of the liiited tine of Mr. Gill, Ottawa, his paper came first. It wvas a brief paper on the effects of food preservatives bn public health. The speaker took the stand that the use of chemicals to destroy the germs in milk was dangerous to hunan life. Dr. Sheard, Toronto, said that he-had had several cases come under his notice where persons, especially young children, were poisoned by the re-freezing of ice-cream. The second freezing of ice-cream, when it stood in the freezer, formed, an acid which was dangerous to health. Dr. Bryce, To- ronto, siid that according to Hon. Mr. Ballantyne, the importance of cleauliness in the dairy had not made the advances it should have in the last 25 years. Dr. Connell said that milk in w1hich extracts had been put to preserve it, was refuse 1i in the dairy school. The paper vas also discussed by Drs. Hutchison, of London, and 180",
         "MEDICINE AND SURGERY. 181 Cassidy, of Toronto. Dr. Shcard read a paper on his expevience in recent vaccination work. He said in Toronto there was ,ittle oppusition to. vaccination. Reports fron uauy physicians came under his notice, aud the result was high)y successful. It was the duty of the health oflicers to sec that people were thoroughly vac- einated. Dr. Brycc, Dr. Cassidy, Dr. Oldwright, Dr. Hall and Dr. Hutchinson took part in the discussion. At the second session, 2 p.m., Dr. Cassidy, Toronto, read an interesting paper on tuberculosis and meaus for its cure. After going thoroughly into the statistics of the fatal resuhs froin the disease in this country, as well as in Europe, the doctor gave the resuilts of post mortern investigations, showing that many persons at some period of their lives infected with tuberculosis, had recov- ered, liltinately dying of other discases. Dr. Cassidy quoted Professor Richet, of Paris, who had recently reported experinents made in connection with this discase, by feeding raw ineat to dogs. Professor Richet stated that dogs ivuulatecl with tuberculosis and fed on raw- meat did not die; but dogs, similarly infected, and fed on their ordinary food, died of tuberculosis. Dr. Osler, Baltimore, believed that the cure for tuberculosis was nutritions food and fresh air. The patient shoild sleep in a roomn witl a window open. Raw eggs was a good diet and woild cure severe cases of tubercu- losis. Dr. Bryce, in discussing the paper, told of the treatment of tuberculosis among the working people in Gernany. These people had a systen. of insurance which provided that persons who became disabled -were put into a sanitariumn, and tie 'percentage of those cured was so higli that the iovem.ent resulted in the erection of sanitaria in the country. In these sanitaria nutrition was care- fully attended to. The cities in the Province of Ontario have mostly doubled during the last ten years. Industries were spring- ing up, competition was keen, and people had to wvork overtime. The scarcity of food and long hours caused the spread of tubercu- losis. It was time for the members of the Association to look care- filly into the matter. The President, Dr. Hutchinson, London, delivered the annual address. He thought that the nembers of the Health Association were fortunate in choosing the beautiful City of Kingston, whose listory from the tine of New France and Jacques Cartier was replete with startling events. In the latter end of the eighteenth century the death-rate of Great Britain and Europe was 88 deaths out of every 1,000 of population. Just one iundred years later it was only a fraction of that. Ie then said that up to the last century Jenner, Howard and Captain Cook were the only tnree sanitary reformers of note. Up to Captain Cook's time, 1773, scurvy decinated the .British army and nihvy. Capt. Cook inaugn- i r",
         "THE CANADIAN JOURNAL OF rated such sanitary aud hygienie systems that in a thrce years'- voyage around the world he lost but four nen. These deaths were not due to scurvy; while Anson, in his famous voyage thirty years before, lost by scurvy alone in three years 600 out of 000 men. The inost dif)ìcult task for a health officer vas to convince the pub- lie that they cannot escape disease without absolute cleanliness and pure water. The subject of greatest'importance was that the miik supply for the use of the public should be pure. In order to get this, pure water would have to be supplied the animals. The milk should be boiled before using. There were a large number of streams in Ontario which were polluted on account of people living near them. The authorities should pay more attention to the prevention of the polluti'on of the streams, the furnishing of good water to herds, and force the use of proper sanitary arrangements in connection with dairies. There would then be less need for a continual beg- ging of funds to build sanitaria for consumptives and for the acconunodation of other sufferers from kindred disease. He referred to the low death-rate in London, Ont., wlich was due to the vigilance of the Board of Health. He strongly cou- demed the use of bread tickets and old paper money. Last year there were 3,000 more dea'ths in Ontario from consumption than from ail other infectious diseases. In Ontario, one person in every 1,000 of the population died annually froin consumption. Last year the Province lost 2,500 wage-earners from this disease, which ineant a direct loss of $2,500,000, and an indirect loss of an almost incalcuhtble sum. Besides, consumption -was conta- gious, and therefore many deaths from this disease night be pre- vented if proper precautions were taken. The hygienic remedies for consumption were pure air and pure food. The managers of the free libraies and public and Sunday-school libraries should not issue books to those affected by consumption or infectious diseases. Spitting in conveyances, streets or public buildings should not be allowed. There -yere too many studies in the public schooh. Military drills and exercises were beneficial for children in publie schools. Dr. Bryce read a well-prepared paper on the education problem viewed from a public health standpoint. .1-e said, among other things, that the pupils were kept in rooms which had not sufficient air-space, and the children were sent to school too you«ng. He be- lieved that children should have larger play-grounds, and should have anilitary exercises. Dr. E. E. Kitchen, St. George, Ont., delivered an address on \"The Sanitary \\eeds of Cheese Factories and Creameries.\" Te referred to the shipment of butter and cheese to Great Britain, and' alluded to the losses in curing the cheese. A great deal of Cana- 182",
         "dian butter oily -sold as second quality butter in the old country. In the City of London lie saw in stores Danish butter and butter from other countries, and lie was sorry to sa.y Canadian butter broudt the lowest price. Cleanliness in naking butter wvas the greatest necessity. First-class cattle were needed. Several f ar- mers kept cattie -which were not fit to milk. In Denmnark pure nater runs through the cow-sheds. The milker should be clean. In F olland the milkman, while doing his work, wears clothes fresli from the laundry. A good tin pail should be used, and the nilk should run through a filter. Good, solid brick cheese factories should be built, with concrete floors. The wvalls should be finished liard, so that hot water could be turned on. The curing-rooin is more important than the factory. Itwas not necessary to build this of brick. Two thicknesses of boards would do. The floor need not he concrete, but a hard floor was necessary. The temperature of the factory should be riglit. It should be kept down to about 65 degrees. Air ducts of 150 feet do well enougli. Two layers of earth tiles were needed. At the entrance a well should be built. Above sbould be galvaniized iron pipe, and a wheel to generate currents of .fresh air. In the curing-room, there should be ducts to remove heated air. Last week, -when the temperature w'as 94-, he visited a factory and found it only 68 by means of the air ducts. The butter should be packed in nice tasty packages. Tn answer to a question, Dr. Kitchen said the practice of put- ting whey froni the factory in the same can in whicli the milk is brought to; the factory was dam aging, and could not be too strongly condenned. In the evening the members of the Association were entertained at a search--liglt excursion anong the islands of the St. Lawrence. The outing was of a very pleasant character, and was thoroughly eiijoyed by all. At 9 a.nm., August lth, prior to the beginning of the third ses- sion, the gentlemen of the Association visited the Penitentiar. They were courteously received and showed through the institution by the warden, Dr. Platt, and the surgeon, Dr. Phelan. After their return, Dr. Cassidy toôk the chair. . Dr. Herald gave a brief outline of the sewer systeni of the City of Ringston. Dr. Br.ypc -read a paper by Mi-. Willis Chipman, C.E., Toronto, on \" Septic Tank Method of Sewage Precipitation.\" Dr. W. T. Connell read a paper on \"Yitality of Typhoid and Diplitheria Bacilli in Milk.\" A paper on the \"Use of Anti-Toxin in Toronto Contagiou. Disease Hospitals,\" by E. B. Shuttleworth, Ph.D., Toronto, wvas read by Dr. Bryce. Dr. Herald moved, seconded by Dr. McCriimmon: \"That while MEDICINE AND SURGERY.",
         "184 JOURNAL OF MEDICINE AND SURGERY. increasing the staff of the inechanical laboratories in connectiou- with Boards of H3ealth, branch laboratories be established at Kings- ton and London, as there are competent men to do the work at these places.\" Carried. A motion by the Rev. Mr. Oumberland, seconded by Dr. Knight: \" That this Association approves of the Act respecting municipal sanitaria for consuinptives; that thanks are due to the legislature-of Ontario for the saine, and we strongly urge upoun niembers of this Association the necessity of forming local associa- tions to co-operate with local boards of health in carrying ont the teris of this Act,\" was carried. The election of offlicers resulted as follows: President, Dr. W. T. Connell, Kingston; Vice-President, M. Davis, Berlin; Seore- tary, Dr. Bryce, Toronto; Cominittee, Dr. Ri\u003cchen, St. George; Dr. H. M. Cowan, Galt; Dr. Vaux, Hamihon; Dr. Oldwright, Toronto; Dr. McCriinuon, Palermîo; Dr. MeCullough, Owen Sound; Dr. Herald, Kingston. Brantford was chosen as the next place of meeting. APPOINT1ENT OF DENTISTS TO STATE INSTITUTIONS.* THE teeth play so important a part in the animal economy their salvation is a matter of great importance for the welfare and health of every individual, and attention should be given the teeth, especially those diseased, as well as to other physical infir- mities. Physicians are appointed by the State for State institutions. Why should not dentists also be appointed to then? I understand that steps in this direction have already been taken in Georgia, and that a dentist has been appointed to the Georgia Insane Asylumn at Macon. Dental and oral hygiene should be taught in our public schools, especially in the primary grades. A year ago the Superintendent of the Oleveland city schook became interested in this matter, and a course of instruction in oral hygiene vas instituted. From reports, it seeins to have been a successful effort. The schools of Toledo are about to adopt something of this sort, and smaller places are becoming interested. It might be well for this society to appoint a standing coin- mittee on hygiene, and let themn prepare a scheme for instruction, and recommend its adoption by teachers in the public schools of the State. *Extraef crom President's Address by Dr. L. P. B3ethel, at thirty-third amnual meeting of OhioState Dental Society, December 5th, 1899.",
         "J. J. CASSIDY, M.D., DIor Pi, 89 BLOOR STREET EAST. TORONTO. Surilpr-.,1RtUcR 1.. lilot*-IAN.afDC3. . Sic il nver- lty: M[ D Uiniversity of Toronto: Strgeon TIronto t..n..rai ilospital; Surgcort (iad Trunk itR.; Vons- ,trine Sinrcon Toronto Ifooi for incurables: l'est in xanTner Un.tt.l States Goventtet,i.: anid F. N. T. StAit, M.lJ., Toronto,. Associato l'rsres)sor of ci't-t-al Sttrgery, Lectursr nti Denonstrator li Arsny, sToront Uitversity : Sttrgeot ltlie Out- lu..? th.lmý,rtinient Torontio Cenitral liospital and Ilos. pitai for SIck Clildre;. Clinmad Surocry-AI.TX. Pna1tonst, M . c'.3. PAinurgi UtvIs. tity : P1rofessor of Ainatotny and Director of ite Attattrtal Departinelnt. Toronto Univeralty: Asso. clatt, Professor of Clinîcal Snrgery, Toronto Uttmver. sity: Secretary Meiical Facutty, Toronto University. Orh\"eyitc Strgery-l. Y.3cKEI\"ct1 8,A., -M.)., Toronto. Surgeont to the Toronto h olosptitai Surgeon t.- tie Out-Patient Deptartitnenit Toronto G-eterftl lic- pitail - Assilstait L'refessor of Clitticat Surtery. Ontarto .ttnical Collego for Wornen : 3Metnber of tin Atnerican Ortopei ,saociation; tand il. tP. Il. GAt.LOWAY, M1.U, Toronto, Strgeon to the Toronto Orthopedic Ils itait Orthopediic Surgeon. Torontto Western lIos. l-a%Î: %Icntber cf the Ancerican Orthopetiic Associa. ti.n. Oral Surgery-. Il. ADA Ms, M.D.. D.D.S.. Toronto. Surgi«tt Pathology-T. Il. NM\u0026Xt. t.D., New York. Villtig Surgeon to Ilarlen ioplital. Professor of Sury. New York School of Cliiali Medicine. News York, etc., etc. Gyneney aid Obstetrics-r.cE. T. MciKEUnit. M Dt., M it C S Eng.. Citattant, Ont.; and J. Il. LoWE, M.D., Newttnarket;Ont. Ried'cal Jurisprulence and Torieology-N. A. l'OWF.L. M. D., Toronto, andI W. A. IPU\\s, M.D., Lit.C.P. Lonid., Toronto. W. A. YOUNG, M.D., L.R.C.P.LOND.. SUUINCSS MANAOtA. 145 COL.EGE STREET, TORONTO. dreduicine--J: J. CAssIDY. M.f.D , Toronto, Minmer Ontario 'rovicial UIoari of 1irlith; tnsuting Stretn, Torontto eneral li*spiltti ta ani W'. J iLoN, M.. Toronto, Phltysiclans Toronto Westi n 1iositalî. Clinica Med\u003ccine-ALE:xAtiElt MC'iEDRA,. MD., 'ro. femor of sedicitio nt ('liteal 3edlinelt Torontto Uttiversity : Iiyslelnn Toront Genetrit lospitil. St. Milael's lilospital, and Victoria llsital for Sick Childreti. Mental DIases-EzRA Il. STArrottD. .D.. Toronto, Ilesidiett Physician Toronto Asyitn for the Inaoiitî. tbîieliltlth ant lip fi ene-J. J. CAsIsDY. M.D.. Toronto, Mernber Ontario lrovincial 1oard off Ilealth ; Cton'sutlt, ing Strgeon Toronto General Ilospital; and E. Il, AIAM$ 31.1., Torotnto. Phrnnolg/ :d Thterapeuitici-A%. J. IIAPri\\NOTON, M.D., M.t.C.S.Eng., Toronto. Physioloy-At. l. EADi. M.D., Toronto, Professor Of Piystology Wonta's Ilditcal College, Toronto. Pediatrics-AUGUSTA STt)We GuEleS. M.D., Toronto Professor of tDheaie of Clitidret Vomansît's Mteditc College, Toronto. lathologys-W. Il. PEiP'i.E. 31.D., C.M..Trinity University . lathologist lospital for SIek Chilldren. Toronto; Doinonstrator of Pathology Ttitity Mesical College . lhîysiciani t Outdoor Det1artnt Toronto Generai Hospital: Surgeon Caiîtati alcine I.IL. Toroî,to: and J. J. .MAcgEszîr. t.A. M B.. Ilrofessor of Ptologv at tUacteriology. Ttonto Uitverity Ophthalmiology and Otol.-J. M%. MACCAi.LuMx. M.D.. Toronto. Assiustat Pnti cia n Toronto CeneraI Hos. pitatI : Oculist asd ttArist Victoria lospital fur Sick, Children, Toronto. Addr. all Conantunfeations, Corresp.ondentce. Books, .latter Regarding Advertis- it, and ninke all Cieques, Dbraftl and Posit-olice Orders payable to \"Tihe Ctnaindltîii .Jouri..sl of Medicie sand Surgery,\" 145 Colege St., Toronto, Canada. Doctors will conter ta favor by sending nows, repnrts ani papers of interest frstn tny section of the country. Individual expérience and tiheories nre also solicited. Conttribitorg mnt kindiy reisnentber iit.all leipers, reports. correspon. dence, etc., nttet be in ont iandsi by ito 'fteenth of the inonth previous to publication. Advertîetnents. to insuro insertion li thre issoao of any inotti. should be sent not later thian the tenta of the pro- cedfing iontith. VOL. VIII. TORONTO, SEPTEMBER, 19oo. NO. 3. Editorials. ALCOHOL AND EPILEPSY. Tim occurrence of epilepsy in individuals vho consume consider- able quantities of alcoholie liluors, especially of the stronger kinjs, is occasionally noted; but, according to Dr. Bratz, whose observa- tions were made at the Welshgarten Asylum, the epileptic seizurc shows itself in alcoholists in two quite different forns. Cbt canadian jornal of medicine and Surgery",
         "186 *THE CANADIAN JOURNAL OF Alcoholic epilepsy is not an autonomous diseawe. like essential £epilepsy, w'hicl, whatever its etiology nay be, continues during the lifetiie of the individual attacked. It is only a nervious symptomn of thronic alcoholism, which frenuently appears at the saine timo as delirium tremens, and like that disease disappears as the result of abstinence froin alcohol. Such attacks show a strong tendency to reappear whcn the alcoholist indulges in fresh cesses, so much so that the discase may last during the lifetime of the individual attacked, thus meriting the appellation of alcoliolic epilepsy. Alcoholic convulsions occasionally appear in persons of a per- fectly sound constitution, and nay thus be considered as exehi- sively the outcome of the chr'onic use of alcoholie intoxicants. In the inajority of sucli cases, however, alcoholism exorcises its con. vulsifying action on nervous %issues, which are predisposed by hcredity or by other precoclous alterations in the brain. Tlhis predisposition to alcoholic cpilepsy often shows itseIf by nervous -disorders in childhood, and also by dhe short period of time inter- vening between the beginning of alcoholic excesses and the appear- mce of convulsions. All the cases observed by Dr. Bratz, in addition to the epileptie seizures, showed other symptoms of alcoholic poisoning, viz.: almost constant trembling, contractions of fhe muscles, disorders .of the sensory nerves, changes in the optic Èerves, headache and insomnia. There was a change in the mental state of the patients, -an exaggerated irritability being the condition most frequently ob- served. Two weeks after their entry into the asylum epileptie seizures ceased entirely to appear in these patients. All the different forms of idiopathic epilepsy were observed, petit mal rarely, haut mal frequently, the hystericai form fre- quently, the latter appearing in patients who did not ezhibit the stigmata of hysteria. Alcoholie epilepsy does not affect the two sexes to the same extent, as Dr. Bratz inade observations on / alcoholic men out of 400 male epileptics, but on only five alcohlolic -women out of 250 female epilepties. This remarkable differe-ce he explains by the fact that German women do not often drirác \" schnaps.\" These patients had connitted different crimes, which had beea provoked by alcohol, and were not due to epilepsy. Abstinence from alcohol sufficed to cause the rapid disappearance of the",
         "i seizures, but as the patients began drinking again, after leaving- the hospital, they were again attacked by the epileptic seizures. )r. Bratz explains the pathogenesis of alcoholie epilepsy as due to an excitement of the nervous elenents of the brain by intoci- cants, an exciteient which mnay disappear rapidly. This theory also takes note of the effects of other factors (heredity, rickets, ctc.), the predominance of haut mal, the appearance of co-ordinato imoiwments (hysterical), in sone of the attacks, the simultancous appearance of epilepsy and delirium tremens, and inany other par- ticulars. The second and'more unconmon form of this disease is the habitual epilepsy of alcoholists, and is only observed in persons who have for nany years been accustomed to consume large quai,- tities of strong liquors. This disease rarely appears before the fortieth year, unless other causes hasten its developnent. Its anatomo-pathologie basis consists of organie changes in the brain and particularly arterio-selerosis, the first epileptie seizures only disclosing these irreparable changes of structure. It is not, there- fore, surprising that the suppression of alcohol does not prevent the re-appearance of fresh epileptie attacks., In sucli cases, the seiz- ures are accompanied with variable symptoms, according to the extent and intensity of the lesions-vertigo and convulsive attack3, coma and mental confusion, progressive mental breakdown, and chronie psychoses. Thesc attacks are quite siiilar to petit mail and haut mal, and do not assume the hysterical character. Deli- rium. tremens is never observed after the appearance of the symp- toms. The first form of alcololic epilepsy hardy ever changes to flie second form. In the latter disease, the habituail epilepsy of alcoholists, heredity exercises very little influence. J. J. c. D. PLAYTER'S SANITARIUM. ATTER a full trial, P. Ellis, Police Magistrate for the Town of To- ronto Junction, York, Ontario, sentenced Dr. Playter to pay a fne of $200, and the costs, $:M.50, for unlawfully establishing an offensive trade or business (free Sanitariim for Consumptives at Moore Park) without the consent of the Municipal Council of the Township of York. Moore Park, which is situated close to the reservoir of the city MEDICINE AND SURGERY.",
         ",IE GANADIAN JOURNAL OF water-works, contains several villas, one of which- was occupied by Dr. Pl .. ter and used as a sanitarium for the treatment of consump. tive patients. The neiglibors were displeased and alarnied at the proximity of the dreaded bacillus to their dwellings, and Dr. Playter was notified by the York Township local Board of Health to cease carrying on the business of a sanitarium in the dwelling he occupied. 1e refused to comply, hence the action of iaw. It appeared from the medical evidence that, inter alia, the sputa of the patients were caugit on rags, which were afterwards buried in a pit; that the rooms were kept neat and clean, and that the patients were skilfully treated. The neighbors thouglit that their property would depreciate in value, and that they would be infected with tuIberculosis owing to their proximity to Dr. Playter's dwelling, the nearest house being about one hundred feet from the Sani- tarium. No medical évidence was ofered to show that infection of a neighbor had taken place, and the assumption of the prosecu- tion, that the bacilli tuberculosis contained in the sputa of the patients, who right expectorate on the grass-plot surrounding the house, would mingle with the dust and subsequently attack the respiratory passages of the neighbors or *wayfarers, must be re- garded as problematical, when one considers that the house is sur- rounded by a clean lawn, exposed to sunlight and open to every wind that blows. Even if one were willing to grant that Dr. Play- ter's neighbors.might be exposed to some risk of infection, it would be small, in comparison with that of the people of Toronto, if the consumptive patients were allowed to reside at their own homes in the city, or roam at will, expectorating through the public parks. Then again, when one remembers that there is no lospital for consumptives in Toronto, that in fact the management of the only sanitarium in the Province for the treatment of that disease (the Gravenhurst Sanitarium) requires a weekly payment .of $6.00 per capita; that there is a tuberculosis mortality of 1.0 per 1,000 living persons in Ontario, one would suppose that a serious efort to start a sanitarium for the benefit of the tuberculous poor would have been received with more favor. As an indication of popular feeling, the friglit evinced by the Moore Park residents shows the alarm experienced by the people of the Province at the proxinity of cases of cons.umption. The doctrine that tuberculosis is con- tagious, which even in 1890 was received with almost general in- credulity by the assembled medical health o1icers of Ontario, -at 188",
         "p 189- Ile Lindsay Convention, has, since then, taken firi root eveni among the laity, and the action at law, Regina vs. Playter, nay b: taken as proof of that belief, and also of a determination that sani- taria shall be so built and located as not to be a menace to the public health. The results obtained from sanitarium treatment abroad so far appear to be hig4l]y satisfactory, and it is earnestly to be hoped that no means will be taken to make the establishment of such institutions in Ontario unnecessarily difficult or expensive. Sanitaria, if wel conducted, are not a source of danger to the occupants of the surrounding houses any more than are hos- ])itals for consumption under the same conditions as to general management-a statement that has been officially made by the British National Association recently, in answer to a wide-spread apprehension entertained to the contrary by the public at large. Certainly, if real progress is to. be made in the successful treat- ment of consumption in Canada, correct ideas on the dan'gers aris- ing from this disease, the exact nature of the contagion, and the truc methods of its spread, should be clearly put before the public. i the meantime the latter cannot be blamed for accepting the dictum of medical science in its ordinary sense, and treating ctonsumptive persons as the carriers of a very dangerous contagion, with all the exclusion which that term implies. Unfortunately, however, for the consumptive poor, whatever interpretation may be put on the doctrine of the contagiousness of consumption, until sufficient sanitaria can be constructed, their lot will not be a happy one. One bright spot in the picture is that the treatment of consump- tion is gaining ground. Strangely enough, also, the destruction of the bacilli and the neutralization of their products, so far unsuc- eessfully attempted from the outside by germicides and antitoxins, may be accomplished from within by the living tissues. Hygienic treatment consists in strengthening the organism to effect its own cure. The conisideration of this vie.w aud all that it implies will doubtless be most instructive to uninfected persons, as well as for the strieken victims of consumption, showing to the latter that the road to victory over their disease lies in submitting with implicit obedience to the regulations of sanitarium treatment; an.d to the former, that the prime features of that treatment, viz.: Continuous living in the fresh air, -vhether sleeping, lying on verandahs, or MEDICINE AND SURGERY.",
         "THE CANADIAN JOURNAL OF walking, -great attention paid to nourishment, regnular exorcise and the use of the bath, will so strengthen the human organismn that tho oniuipresent bacillus, even though it attack the body, will, in maniy instances, not inflict a lethal injury. -. a. c. POISONING BY ANILIN. OccAsIOUmLY une sees in the miiedical press allusions to the pi,1n- ous effects of anilin. Thus workmuen, exposed to the vapors evolved in the imanufacture of anilin, acquire a cyanotic hue cf the face, lips, and mouth, suffer fron giddiness, headache amd chilli- ness, and weakness of the lower limnbs. They are subject, alN, to bronchial irritation, nausea, contipation, diarrhea, and cutaw-om eruptions. Ini most of the cases reported the poison would appear te have been absurbed through the respiratory tract, although when taken by the nouth the cyanotic syniptonis mentioned have bren present in a high degree. In a reported case (the National Dis- pensatory, p. 180), the pulse was thready and frequent, the inspira- tions shallow, 30 in a minute; muscular tremor and twitching pervaded the body, the head ached and there was some drowsiness, but the mind was otherwise clear; the patient was restless and lis breathing oppressed as if by a weight. Vomiting was provoked by an emetie, and on the third day he had entirely recovered. The skin -continued bluish for more than forty-eight hours. Stocking, cravats, gloves, etc., dyed with anilin have oecasioned eezeminathus eruptions on the skin in contact with them. In La Presse Medicale, July 8lth, 1900, Professor Lai.1uzy and Dr. Brouardel report a series of cases ii which poisoni, by' anilin was observed, and the patients treated by them. They stated that ten children were attacked, at diferent times, _vith symptoms of poisoninig, the cause being at first obscure. In every instance, however, the affected child had worn shoes of yellow leatier, which had been subsequently blackened -with a shoe dress-: ing of a penetrating and rather disagrecable odor. No cramph, trembling or vomiting were observed in these cases. The symlp- toms noted were: Loss of consciousness, passing, in some instances, into deep torpor, sensations of cold and a bad color of the skin of the face: in sone of the children being simply a pale color, i' 190",
         ".others a greyish hue, passing into a slate color, or even a cyanotic blue color. The younger children, who were attacked suddenly with symp- ions of great depression, passed into a state of torpor and reinained in that condition for several days. The older children, froin niiie P~!IIIIhIF¶ I ~ - .-~ -'v.- - g..- .\u0026i S9f~ ~ ~ 22 THOMAS H. MANLEY, M.D., New York City. to fourteen years of age, exhibited similar syiptoms, but of a less 'severe type. They had headache, sneezed frequently, and com- plained of severe sensations of cold in the body, which persisted in rspite of the use~of.bottles of hot water. Their faces were extremely pale, the hands and lips being bluish in color. On analysis, the MEDICINE AND SURGERY.",
         "192 *THE CANADIAN JOURNAL OF shoe-dressing 'was found to contain fixed anilin dyes, a volatile product being also present in large quantity (90 per cent.), and acting as a vehicle for the dye. In the opinions of the observers, the anilin poison penetrated into the systems of the patients by the cutaneous routé, the anilin vapors being disengaged from the dye in the leather by means of the moist heat of the feet of the children, and afterwards absorbed into the circulation b'y the blood-vessels of the skin. J. J. c. TURN OUT IN FORCE! Tui Canadian Medical Association, which convenes in Ottawa on the l2th of this month, will last from that day to the 14th. Every- thing points to the meeting being a huge success. It will be noticed from the list of papers herewith appended that a perfect feast of scientific food can be loolced forward to, so that no visitor ought to bel disappointed., Suchi men as Mr. Edinund Owen, of London, Eng., Dr. F. Shattuck, of Boston; Dr. Orford Gerster, of New York; Dr. Nicholas Senu, of Chicago; Dr. Allen McLane Hamilton, of New York; Dr. J. Clarence Webster, of Chicago; Dr. L. H. Warner, of Brooklyn; as well as a largenumber of our best men from the principal cities of Canada, will be present, and take au active part i-n the meeting. Let us make this the very best meeting to date. This eau only be accomplished by every man registering, and not necessarily waiting· upon others to lead the way. The papers so. far promised include: 1. Address in Surgery--Edmund Owen, London, Eng. 2. Address in Medicine--E. Shattuck, Harvard Univ. 3. Address in Gynecology--Wm. Gardner, Montreal. 4. Gall Stone Cases-Orford Gerster, New York. 5. Title to be announced--N. Senu, Chicago. 6. Recognition and Management of Tabes ,Dorsalis-Allen MeLane Hamilton, New York. 'T. Case of -Endothelioma of the Omentum, Operation, etc.;. Meningocele, Operation, etc.-W. H. Klock, Ottawa. S. 'The Proposed Ontario Bill for the Treatment of Inebriates -A. M. Rosebrugh, Toronto. 9. The Modern Treatment ue Retroversion and Prolapse of the Uterus-A. Lapthorn Smith, 1\\-ontreal.",
         "10. Treatment in Typhoid Fever-W. B. Thistle, Toronto. 11. Gastric Heemorrhage-G. E. Armstrong, Montreal. 12. Some Cases in Stomach Surgery: Gastrostomies, two cases; Gastro-enterostomies, two cases; Pylorectomy-A. E. Garrow, Montreal. 13. Gangrene of the Leg, following Typhoid Fever-. H. Chown, Winnipeg. 14. Title to be announced-N. A. Powell, Toronto. 15. Notes on the Therapeutic Value of Hot Air-0. F. Martin and B. D. Gillies, Montreal. 16. Title to be announced-J. Clarence Webster, Chicago. 17. Title to be announced-ll. .L Beemer, Mimico. 1S. Notes on Atropine-R. D. Rudolf, Toronto. 19. Gasoline as a Surgical Detergent-Bruce L. Riordan, Toronto. 20. The Successful Treatment of Two. Important Cases of Disease of the Eyes by the Combined Methods of Mercury and Iodide of Potash Internally, aid Pilocarpine Hypodermically- Geo. H. Burnham, Toronto. 21. Our Race and Consumption-Sir James Grant, Ottawa. 22. The Physicians' \"Vaster Empire\"-John EHunter, Toronto. 23. Some Experiences in the Treatment of Hernias-F. J. Sheppard, Montreal. 24. Notes of a Case of Tubercular Disease of the Tubes, with Acute Peritoneal Infection-H. A. Bruce, Toronto. 25. The Summer Bealth. Resorts of the River and Gulf of St. Larence-E. H. Adams, Toronto. 26. Empyema, with a Study of Thirby Cases from the Olinical and Bacteriological Standpoints-W. F. Hamilton, Montreal. 27. Physicat Trainiug.: it.j Range and Usefulness in Thera- peutis-B. E. McKenzie, Toronto. 28. A Case of Traumatic Neurasthenia-D. Campbell Meyers, Toronto. 29. Adenoids in Private Practice: a Report of One Hundred Cases-P. G. Goldsmith, Belleville. 30. Recent Pathological Studies of the Blood, with Lantern Demonstration-L. H Warner, Brooklyn, N.Y. 31. A Case of Syphilitic. Gum.mata of the Spinal Cord, suc- cessfully treated by enormous doses of Iodide of Potassium- Erancis W. Campbell, Montreal. MEDICINE AND SURGERY. 193",
         "THE CANADIAN JOURNAL OF 32. Dilatation and Prolapse of the Stomach-A. McPledrn,. Toronto. - 33. Tendon-Transplanting in Paralytic Deformities-Clar- ence L. Starr, Toronto. 34. A Case of Congenital Ptosis, with Associated Movenient of Affected .Eyclid dnring; the Action of Certain )Iuscles--J. M. Maccallum, Toronto. Programmes will bc sent to each member. The General Sec- retary, F. N. G. Starr, Biological Department, Toronto, vill bo glad to hear from non-meibers intending to be at meeting, so that he can send programmes, etc. Dr. Powell, the President, wili DR. WM. BRITTON, President of the Ontario College of Physicians and Surgeons. accept it as a favor if all intending to be in Ottawa at the Lii~ne-of the meeting will kindly notify him-.i. at once, so that lie will know what accommodation will have to be provided. w. A. Y. EDITORIAL NOTES. The Responsibility for a Late Operation in Appendicitis.- During the present era of surgical asepsis, the claim of the surgeon to be allowed to do a surgical operation at an early stage of an 194",
         "acute disease, suci as appendicitis, would seei to be incontestible. This claim is founded upon observations which show that an carly operation prevents serious subsequent disease, aind w'hen it is donc aseptically on a patient of a sound constitution is, of itself, quite' innocuous. Unless a physician is prepared to assume the respon- sibility of treating a case of appendiciti8 by imedicinal neans, hc should consult with a surgeon as soon as pos 4ble after lie las made the diagnosis of appendicitis. It is manifestly unfair to the sur- geon to call him in at a late stage and to expect him to achieve favorable resuits under unfiaorable conditions. Althougli fromu a professional consideration for the reputation of the attending physician, a consultiug surgeon niay not speak of the injinical in- fluences of delay in operating, it does not follow that he should place himself and his art in a false position by counselling an opera- tion in a case wlere failure is almost certain to result. Yet when the proper time for doing an operation for acute a:pendicitis has passed by, a surgeon who advises an intervention assumnes a respon- sibility which rightfully belongs to the physician, who had the first opportunity of making a diagnosis of appendicitis in the given case. Besides, without reference to the loss of reputation sustained by a particular surgeon, if an operation for appendicitis, though donc at an advancecd stage of tie disease, fails to cure thô patient, dis- credit is thrown by the public on surgical art, instead of on ithe delay, which made the tardy exercise of that art unavailing. International Congress of Medicine.-The committee on papers of the Thirteenth International Congress of Medicine,held at Paris, -August 2nd to August Oth, have issued advance copies of reports in several of the departnents, viz.: Laryngology and Rhinology, Surgery of the Young, General Surgery, Internal Pathology, Sur- gery of the Urinary Organs and Diseases of Children. The lan- guages used in these papers are French, English and German. We wish to express our cordial thanks for the favor conferred, and we shall have great pleasure in publishing some of the reports in future numbers of this monthly. liot Weather Increases the Mortality.--The hot weather during the month of August caused a large mortality among tie aged and the very young at Toronto. On August Sth, 27 deaths were reported at the Toronto City Hall, naking a total of 75 since n0oon on August Ath.. Of tic 27 deaths on August Sthî, 14 were MEDICINE AND SURGERY. 195",
         "TIE CANADIAN JOURNAL OF children under twelve months old. There were also six very aged women, froin 72 to 76 years of age. The higliest temperatures registered at Toronto were 97 degrees F. August 7th, and 96 degrees F. August Sth. An Improved Registration Shows a Fair Birth-Rate.-The recent regulation of the Provincial Secretary's Department, order- ing doctors to report the births whicli they attend, lias had its effect in the increased number of births reported to the City Olerk, To.- ronto. No less than 502 births were registered in July, a figure greatly in excess of any single month in many years. There were 06 deaths and 143 marriages registered. Alum in Baking Powders.-Alun baking powders are con- demned in Bulletin No. 68, issued from the laboratory of the Inland Re:-enue Departnent, Ottawa, Canada. Physicians and others who feel interested in the study of this subject should read Professor McGill's able presentacion of the effects of alum baking powders on digestion. PERSONALS. DR. G. S. RYERSON returned froin South Africa two weeks ago. DR. FRED. FENTON commenced to assume the awful responsi- bilities of married life a week ago. DRs. N. A. Powell, J. D. Thorburn, Murray Macfarlane, F. N. G. Starr and A. J. Johnson have returned from their vacations. WE heartily congratulate Mr. Irving Cameron, of this city, on the honor bestowed upon him recently by the Royal College of Surgeons, England. DR. LESLIE M. SWEETNAM, of Toronto, one evening last month entertained some of his nedical friends by exhibiting lantern slides made from photographs which the doctor took while in California and New Mexico. The slides are the finest ever shown in Toronto. Dr. J. N. E. Brown's Proniotion.-\" The mills of the gods grind slowly, but they grind fine.\" Our fi'iend Dr. J. N. E. Brown, -Secretary to the Commissioner -and the Yukon Council, lias re- ceived the announcement that he has been made Secretary of the Yikon Territory. Never did promotion fall on rnore deserving and more capable shoulders, and we heartily congratulate Dr. Brown and the people of the Yukon. 196",
         "MEDICINE AND SURG'RY. THE PHYSICIAN.* BY S. WEIR 'MITCHELL, M.D., LL.D., PILADELPHIA. THiE hunt is o'er ;-the stone-armîed spears have won ; Dead on the hillside lies the mastodon. Unmoved the warriors their wounded leave; The world is young and bas not learned to grieve. But one, a gentler sharer of the fray, Waits in the twilight of the westering day, Where 'neath his gaze a cave-man, hairy, grim, Groans out the anguish of his mnangled limb. Cauglit in the net of thouglit the watcher kneels, With tender doubt the tortured imember feels, And, first of men a healing thought to knov, He finds his hand can check the life-blood's flow. What.sense of pleasure won that helping hand You best can tell, you best cau understand, Who, looking back across your busy years, Know what your hands have spared of pain and tears. First of your guild ! Before ne sit to-day His latest offspring, while the Century gray, Proud of your past, and of your futmre sure, Knows that what else may perish you endure. What nced to tell your story ? Brief the task. You are the wondrous history you ask ! A living record ! They who first in vain Thrcbed with desire to sec a brother's pain More largely livo in you; and yours the joy, The priceless happiness without alloy Of him, the first, who saw his infant art Bring back the life-blood to the failing heart. Heirs of the ages! Heritors of thought By Galen gathered, or by Celsus taught, Greek, Arab, Roman breathe in you to-day, And the great captains of that long array, Who through dark centuries led your slow advance To the proud sunburst of the Renaissance. A splendid lineage! Who may hope to trace The dateless legend of your ancient race ? lo ! through:the mist of years Isee them rise, The great, the good, the witty and the wise The poet's laurel crowns your blazoned shield. Sage, scholar, statesman reap your ample field. Your niames are many on the fearless.roll Of those who signed a nation's birthday scroll. *lead before the Congress of Americtn Physicians and Surgeons, held at Washington, D.C. lfay 3rd, 1900.",
         "198 THE CANADIAN JOURNAL OF Too oft our changeful story seeis to show Thab what men knew they only seemed to know. They lived, they toiled, they joined the silent dead. On dusty shelves their books repose, unrcad. The scholar wandering o'cr this vast domain Once iich with living thought, nay think how vain Oùr work ivill seem to those who hither come To sun our gains when we, in turn, are dumb. Yet thab which wins to-norrow's grateful praise Is the sure child of faltering yesterdays, And cotntless hands must till the stubborn soil That one nay reap the harvest of their toil. To know, alas I but feeds the crave to know; Upon our hands life's endless riddles grow, Until we learn that every hard-won hill But sets the far horizon farther still : Yet ah, low keon the ninîd-tlhrill of delight Whîen somle new sun illumes our lessening night, And probleins, dark for many a wveary year, Shine, sinply answered,-Ittuminous and clear. With conscience caln you see the centu-y go, And know how much to you its glories owe. It saw grow safe beneath the surgeon's knife- Aliost too safe-the sacred hunian life. It saw forever stilled the cry of pain. Which shall we dare to count the higlier gain ? Two older victories'we gladly place In the proud annals of our English race; hen some glad seraph gave to Jenner's car The whispered spell that slew a giant fear, And, strangely killed despite his guard of lies, Touched with a needle's point the imonster dies. When, too, as ee amid somle deepest night, Sees the quick lightning fill the world vith light, Our patient, indest Harvey saw revealed The wonder-secret life se long concealed. Who would net envy those Who share alone With God the secrets only He lad known Who win the joy of soaring unconfined Hifgh e'er the levels of the common mind, Or, humbly searching soie well-trodden ground, Find the rare jewel no one else had found. Such were the sires with whon your art began, For you, whio, thoughtful, that proud record scan, Know the truc children of the mighty dead Are they alone who in their footsteps tread, And that a man's true ancestors are they Who, dying, left hin all that genius may. You wield new armis, are 'neath nev flags arrayed, Yet you are still what these our fathers made. What they have given it needs not me te find, Nor what high masters schooled the growing mind; Great was the sire who gave to you and these The stately oath of stern Hippocrates. The creed was old before the Christ was born To give it Ieavenly light and larger norn Of ampler meaning, when a white-robed nan Taught-as those wonder.years in sadness ran--",
         "MEDICINE ANIS SURGERY. Teuglt as lie practised our divinest art. M'ho lioals the body best cain heal the heart. Your guild is old and no historic page Records its birth or dares to set its age. A score of codes the lawyer's lcarning needs The pricest is servant of an hundred creeds That sow dissension and that stir debate, And in their turn have fed the fires of hate But ye, o'er all the earth, in every land, Find the warn greoting of a brother hand. One creed is yours, and till all time las ceased Still you are doctor, and are somiewhat priest. The colder mani mnmay vainly try to live Freo fron confession such as sorrows give: The priesb hcars part of life--you hear the whole, When fear or anguish racks the tortured soul. 'Tis we who know, and haply we alune, Vhat grandsire's sin a life lias overthrown, Whlat mborn taint lias been the fatal source That gave temptation such resistless force. How can we lack the charity that wins From God-like knowledge largo excuse for sins ? Not yours to pass upon the other side, Or giving part, to leave the rest denied. Our best have owned the rare draniatic power Which gives to synpathy its lifting hour Go learn of then, the masters of our art, To trust that wise consultant called the ieart. There are amîong us those wvho haply please To think our business is to treat diseaso, And ail unknowing lack this lesson still, 'Tis not the body but the man is ill. God's ways are dark, and in their gloom we walk Not ours to know why life's grin spectres stalk. We tread mysterious paths in touch with pain, Birth, death, disease, strange pliantoins of the brain. Perploxed we recognize the doubtful hour When indecision paralyzes power. No intuition leads with certain liand- Tuition rather-and the sure comniand Of reason cempetent to read with case Tho dimi and lialf-scen signais of disease: So doth the poet question Nature's soul, And knowing part, infer the larger whole. Would I imiglit cail these grave consultants here To trace the coning century year by year, To learn what crippled theories she flings On the dust-heap of forgotten things, What blazing head-lights slrink to tallow-dips, What well-known naies must suffer tine's eclipse. Yet hope shines over in lier inaiden eyes. Her silent lips are treasuries of surprise. What ghastly shapes lier stately presence fly What ancient plagues beneath lier footfall die Fair leritress of every human hope, Richi with the inarvels of tine's widening scope, 199,",
         "THE CANADIAN JOURNAL OF However higli iay riso thy soaring wing, Whatever change thy fuller days nay bring, Our ancient lessoni will be ever now ; That priceless lessoni will be ever true Tinie did not teach it; tiie ivill change it not. This, this shall last tirougli all our lore's forgot, To give what none can menasure, nono can weigh, Simply to go wliere duty points the way To face unquestioning the fever's breath, The hundred shadows of the vale of death To bear Christ's message through the battle's rage, The yellow plague, the leper's island cage, And with our noblest \" well to uinderstand The poor man's call as only God's coniniand.\" Ay, under every century's clanging sky Shall the Greek iaster's triple signal fly,- Faith, Honor, Duty,-Duty cahnly done, That shouts no self-praise o'er a victory won; One bugle note our battle call, One single watchword, Duty.-That is all. Where are your honors 7 Ribbons, tites, place, In othier lands reward the winner's race. But here, to-day, beneath our equal sun, The simple guerdon of sonie victory won Is but to liear your Ave! lHail 1 Well donc 1 Alas ! not always even this is sure For 1im who lessens that which men endure. We are but nortal, and, with blinded eyes, May fail te sec who surely won- the prize, Or sec too late, as once we saw in vain The fate of him Who wrought the death of pain. Guard vell that menory, lest again ive flout Some hero-victini with our tortnring doubt. How thanked ve Morton ? Ah! \"No joy-bells rang, No poeans greeted, and no poet sang. No cannon thundered froi a peaceful strand That bloodless victory to a grateful land. We took the gift, se humxbly, simnply given, And, coldly doubting, left the rest to Heaven.\" Swift pass the days. Our century slowly dies,- Quick beats lier pulse aiid filmy are lier eyes. Her flowing robes are red iviti countless wars, Her tender breasts are sad with nany scirs; Yet in her dying oyes prophetic glows Some sweet prediction of a world's repose. Lo, at her side the cijming sister sbinds, .And bends to hear, and folds those wasted hands. \"What shal I bring which thou hast failed to find? What nobler hope have I to give niankind ?\" Hark ! Froin the lips vhere life had seemned te cease Comes the low murmur \"Thou shalt give them Peace.\" --Phila.. Med. Journal. 200",
         "RELATIVE EARNINGS OF THE PROFESSIONS THROUG?- OUT THE WO\\RLD. Tus law is probably the mnost profitable, of the so-called learned professions. There are more and larger prizes to be gained by an acuto and cloquent disciple of the legal art than are open to the riedical man or the minister. Li this country and in Great Britain the incomes of the foremost advocates and of attorneys in lucrative practico for the most part overshadow the yea'rly earn- ings of the best-known physicians and surgeons, and to a still greater extent those of our spiritual advisers. Occasionally one hears of very large fortunes being left by prominent doctors-Sir William Guil, Sir Andrew Clarke, Dr. Pepper, and Sir Williani Jenner are cases in point; but those are exceptions, and sums accumulated by medical men cannot bc compared either in number or magnitude to the colossal amounts amassed by members of the legal fraternity. When, however, the average incomes of these threc classes of the comimunity are considered, their relative posi- ton in the United States and in Great Britain will be found to difer. Viewed thus in the 'United Kingdom, the clergyman is at the top of the list, the lawyer second, and the doctor last; while here the lawyer or doctor gets a larger share of the \"loaves and fishes,\" and the minister has to be content with the crumbs. An article in Medicine for April refers to a recent editorial in, the Chicago Times-Herald, discussing the relative incomes of Chi- cago doctors and lawyers, whicli says: \" It is doubtful if the aver- age income of lawyers in Chicago is $1,500, but that is because the average is reduced by the large number of failures and of lawyers who scarcely make their board during the early days at the bar. There are a few law firms in Ohicago which make from $50,000 to $100,000 a year; perhaps twice as many from $25,000- to $50,000; many more from $5,000 to $25,000; perhaps five hundred from $2,000 to $5,000, and the multitude from $2,000 down to nothing. Of physicians the same is t.aue on a reduced seale. We doubt very much if the average income of doctors in Ohicago is $2,000. The city is full of young M.D 's without enough practice to -give them a personal atmosphere of disinfect- ants. One or two successful specialists may make as high as $50,000; but the fingers of one hand would probably keep track of the regular practitioners who can count on $25,000 a year.\" The average income of a physician in large cities on this con- tlent may be placed at $2,000, in the smaller towns at $1,500, and in the rural districts at $1,200. Two or tbree New York physicians are said to make over $100,000 a year, five or six about MEDICINE AND SURGERY.",
         ", THE CANADIAN JOURNAL OF $50,000, but the average incoie, although rather higher than in Chicago and in other American large cities, does not greatly ex- ,eeed $2,000 yearly. The minister averages in the city perhaps .$1,200, and in the country certainly not more than $800 yearly. As regards living expenses, both tb'- lawyer and minister have au advantage over their professional brother. In New York, for example, office accommodation suitable to a physician is very dear, in a good neighborhood. costing not less than $70 or $80 a month, \\which with board and lodging and other necessary disbursements, -w'ill represent a sum of $120 monthly, a sufficiently weighty bur- -den for'a struggling youthful practitioner to bear. The young ininister bas no rent to pay, while the legal neophyte can regulate bis outlay in this respect according to the length of his purse. L evertheless, the lot of the medical beginner compared with that of a pastor in a like situation bas its compensations. He is at least more or less independent. The minister, on the contrary, is as a rule permitted to exercise his own will but to a limited degree, and often is doomed to go throngh a lifetime of toil, sub- servient to the caprices of censorious elders and deacons. An -excellent description of the trials of an Ainerican country minister and the various upileasantnesses witli which he lias to coitend at the hands of his congregation, is given in the \" Damnation of Theron Ware,\" the best novel written by the late Harold Frederic. When all is said that can be said, the first few years of medi- cal practice are years of arduous effort, full of disillusionment ,and disappointment. The late Sir Andrew Clarke told Dr. Osler - \" From the vantage ground of more than forty years of bard work he could say that he had striven ten years for bread, ten years for bread and butter, and twenty years for cake and aile.\" The truth undoubtedly is, and especially in large centres of population in Anerica, that the opportunities for a physician to obtain adequate compensation for his services are yearly becoming less. This is niot due to any deterioration in the quality of the present-day prac- ·titioner or an evidence of falling off in medical or surgical skill. The fact is irrefutable that the medical profession in this and in all civilized countries stands on a higher plane in the matter of training and knowledge than ever before. The reason for the de, crease in medical incomes is indubitablyalmost wholly o\\ving to the more eager competition among regular practitioners, to hospital and dispensary abuse, and to the lainentable increase in quackery. The supply of medical men is greater than the demnand\u0026; the mar- 'ket is flooded, and the imost potent remedy we can suggest for this evil is that, as lias been many tiies advised in the ilfedical Record.. a uniform higb standard of medical education should be establised. du every state.-ifedical Record. ,202",
         "'The Physician 's Library. BOOK REVIEWS. Osteopathie Treatment in the H1ypnotic State ; or, Suggestion Massage the Cure for incirables. The most wonderfui treatment of the age. By Pno. TrOMAs BaS- SETT KEYES, M.D., Of Chicago, formerly Professor in the Harvey Medical Col- lege, etc.; Formerly President American Psycliological, Medical and Surgical Suciety; Felldw of the Atmerican Association of Physicians and Surgeons. and Chairnan of its Section of Psychological Medical Science ; Member of the Medico-Legal Society of New York, and one of the Vice-Chairmon of its Legal and Scientific Section ; Member of the American Association for the Study and Caro of Inebriates, etc., etc. Chicago : Surgery, Medicine and Psychology, Publishers. According ta the learned author of this book, \" Osteopathy \" seeñns ta have little or nothing ta do with the banes, but is \" the science of treating disease by mnanipulating diffcrent parts of the body, particularly the nerves.\" He designates a good osteopath as a \" bone-puller and kneader,\" and in order to .give hiim a good knowledge of anatomy, presents him with a nuinber of \"special cuts,\" which may be a success as \"cuts,\" but assuredly precious little knowledge of anatony will he acquired froni theni. However, as the science of osteopathy was successfully practised by the \" desciples \" (sic) of Chong Fow, in China, over 3,000 years 3.C., we may presume that a good knowledge, or any knowledge whatever, is nat an essential quelification in an accomplished \" bone-puller and kneader.\" One chapter describes \" my easy method. of hypnotization, a very impor- tant part of which is ta persuade the patient to 'tune his body ta the air, tune his body ta the operator's voice,' \" etc. Another chapter treats of massage, and describes the various \"grips,\" such as \"massage up, down, and spiral ; kneading, rolling, stroking, slapping, per- -cussion, heating, pressing, shaking, vibration, chapping. pointing, clapping, knocking, percussion,\" etc., all of which may bo·compressed into one word- quacking. These, along with \" suggestive hypnotism,\" and \" appropriate iusic,\" will cure all the ills of body and mind, even \" cure the incurable.\" Special instruction is given for curing \"dysentery or bloody flux,\" by deep pressure on the nerves as they emerge fron their openings, and so on up the spinal coluni,\" which no doubt would be an easy procedure ta an acomplisihed \" bone-puller and kneader.\" Diflicult parturition is relieved by \"pressing on the pubes just on each side of the clitoris,\" or \" on the second -sacrai faramnina.\" *Various methods have been employed ta expedite delivery. Haritman says \"he has often witnessed difiicult labor accelerated by a draught 8-f tie husband's urine,\" and \"horse dung infused in wine is eficacious im expelling the placenta\" (\"Paris' Pharmacologia, p. 20\"). No doubt cau be entertained that the author's method is mure agreeable, while it is probably -equally successful. The author's teaching as ta psychology is admirably simple, and- pofoundly .scientific. He settles conclusively thie question, \" What is Life ?\" which has .so long perplexed the scientific world. \"The body is made up of the sur- MEDICINE AND SURGERY. 203",
         "204 * THE CANADIAN JOURNAL OF rounding elements. Its vital principle depends upon the life (electricity) gen- erated fromn the food we ceat, the liquids which we drink, and principally froin the atmospheric.ir, which contains more electricity than any other substance known, save iron, cobalt and nickel. When the system becomes exhausted, germns of disease find an easy access to the body ; when this systeni is active the'body remnains healithy.\" Thei-e is only one theory which will compare with this, viz.: that of Thompnl- son, the founder of the Eclectic School. Be maintained that \"the body is composed of four elemente : earth, air, fire and water; that lient is life, and cold is death. Our life depende on heat--food is the fuel that kindles and con- tinues that heat.\" In the iast chapter the author gives us his views as to the cause and treat. nient of cancer. His first statement is that \" carcinoma is simply a return to the 'foetal state,\" but afterwards lie adopts the theory of \"Aesclebiades of Prussia\" (Asclepiades of Prusa, in Bithynia, Asia Minor), \" who in the first century, B. C., taught that the body was composed of atonis and corpus. cles, and that disease was the result of a lack of harmony, or discord between the atoms and corpuscles.\" As to the treatment, after first asserting that \"everyone knows that cancer cannot be cured either by medical treatment or surgical operation,\" lie declares that it can be cured by means of Suggestive Hypnotism, aided by suitable music, by which parts of the body of the hypnotized patient are harmonized, and the patient made to tune huimself to the music. The success attending this wonderful treatmnent depends, however, upon the fact that there has been, previously, a total extirpation of the part with the surrounding glands. Scattered through the book are nunerous errors in spelling, such as \" desciples,\" \" diabetis\" \" hnceerrloids,\" \"plethcera,\" \" spincter,\" \"cales- thenics,\" and while some allowance should be inade in such little miatters to profound thinkers, such errors should have been corrected by a competent proofreader. J. I. I. Fractures. By CAIM BEcK, M.D., Visiting Surgeon to St. Mark's Hospital, and to the New York German Policlinic ; formerly Professor of Surgery New York School of Clinical Medicine ; Consulting Surgeon Sheltering Guardian Society, Orphan Asylum, etc. With an appendix on the prac- tical use of the Röntgen Rays. 178 illustrations. Philadelphia : W. B. Saunders \u0026 Co. 1900. Canadian Agents : J. A. Carveth \u0026 Co. Price, $3.50 net. Tiere are none who will doubt the fact that, since the X-ray canie to be as generally adapted to surgical usages as it is nowadays, the treatnent of frac- tured bone lias come to be a very much simpler matter indeed than before it was -possible, as it is to-day, to actually sec in life the exact amnount of displace- nient between the fractured ends, as also the extent of the break itself. Books on the subject of fractures written within the past few years, la. had to depend for illustrative purposes upon wlat was afterwards fcind' nem the cadaver, whereas the work by Dr. Beck, now under review, is rrecly illustrated with what he found before, as well as during treatnent, a record. whiclh èould not be gainsaid or in the least doubted. The book is splenididly illustrated, the lialf-tones of what was found by means of the Rböntgen Rays being par- ticularly clear, and adding immnensely to the value of the book as a work of reference for the surgeon. What a common matter it lias been in the past for the surgeon to be in considerable doubt as to whether lie had to deal with a case of dislocation or one of fracture or both. Since the empl'oyment of the X- ray, however, it lias been cleaily shown that fractures occur at least ten tinies more frequently than luxations, a discovery which alone lends considerable aid in a correct diagnosis. How important it is to bc able to.say which it is, the after-treatment of -one being so different froni the other ! The author lias divided the book into two parts, one dealin« with fractures il general, the other with fractures of special regions. Under l\u003eart I., Dr. Beck",
         "«oes into signs, diagnosis, process of iepairs, disturbances in the process of reipa and treatient. Part II. takes up the various fornis of fracture, sh1ouldr and upper extreiity, the pelvis and-lower extremity, fractures of the; bon.s of the trunk, and lastly, fractures of the skull. He adds a most inter- esting appendix on the practical use of the Röntgen _Ray, a chapter which alone is worth the price of the book. The publishers are to be congratulated. upon the splendid typographical finish of the book as a whole. w. £ Y, l systemactic Treaise on Materia Medica and Therapeutics, with Reference to the Ms. t Direct of Drugs. By FYLEY ELLINGwOOD, M.D., Professor of Materia Medica ii Bennett Medical College, Chicago ; late Professor of Clem- istry in Bennett Medical College. Author of \" A Synopsis of Medi- cal Chinistry,\" \" Manual of Urinalysis,\" Editor CMcago Mecical Times. With a condensed consideration of Pharmacy and Plharnacognosy, by PaoF. JoN UiI LLOYD, Pli. D., late President American Pharmaceutical Asso- ciation ; 'Professor of Chenistry and Pharmacy in the Eclectic Medical lzinitute of Cincinatti ; author of \" Etidorlipa.\" Chicago : Chicago Medi- cal Press Co., 103 State Street. 1900. The large majority of books reviewed in the columns of a iedical journal are the works of menibers of, what is ordinarily termed, the regular sohool. Why, however, should it be that works written by eclectic physicians nust necessarily be, or usually are, excluded fron the pages of many imedical jour- nals i We answer: \" No reason in the world,\" provided, of course, the books have mnerit, and are lot written in the usual one-sided nianner, which is too frequently the case in such instances. Dr. Ellingwood has in his Treatise on Materia Medica and Therapeutics, given the general profession a book which has considerable nerit, and we feel that lie ouglit to receive generous support fronm all sides. What the Doctor clainis in his preface, \" to present the more recent observations of the actions of drugs,\" has been fully carried out in sub- sequent pages, his work as a whole being well written and a great improve- ment upon many of the books on niateria medica and therapeutics already pub- lished. .it is not often that one finds in books so confident and exact an opiî.ion hold by the author, as in this case, in reference-to the-action of various drugs, and at first the reader might feel that sucli a degree of confidence was nisplacud, buton reading the text noreclosely.will find that such idea is erroneous, and that the iriter but proves his facts as he goes along. The book is divided into ton sections: Agents Acting lUpon (1) The Nervous Systei ; (2) leart; (3) Respiratory Tract ; (4) Stonach ; (5) the Intestinal Canal; (6) Agents influeueing the character of the blood ; (7) Agents acting upon the Genito- Urinary (irgans ; (8) Upon the Foemale Reproductive Organs ; (9) Agents Used in the Control of Hemorrhage, and (10) Agents acting upon Micro- Organmsms and Parasites. The book will prove an addition of no inean value to those on the subject already procurable, and we trust that the author will not be disappointed in the result of his·efforts. A Manual of Surgical Treatment. By W. WrTSo CUEYNE, M.B., F.R.C.S., 1F.R. S., Prof. of Surgery in King's Collge, London.; Surgeon to King's Colegue Hospital and theChildren's Hospital,PaddingtonGreen, etc , andF. F. BUHAsan, M.D., M.S., London, F.R. C.S., Teachuer of Practical Surgery in Kinmgs College, London ; Surgeon to King's College Hospital and the Child- ren's JIospital, Paddington Green, etc. In six parts. Part I. The treat- ment of General Surgical Diseases, including inflammation, suppuration, ulceration, gangrene, wounds and their complications, infective diseases Ind tumors. :The administration of anesthetics, by Dit. Pnx. Longmans, Green \u0026 Co.. 29 Paternoster Row, London and Bombay, 1899. Toronto: The Copp, Cldrk Co., Limîited, 9 Front Street, W. Price, $3.70 net. The authors of hiis book have very wisely, we think, realised how lacking -miny of even the most extensive w, lzs on surgery are in the space devoted to Treatment. Too niany are muel oo verbose upon the subject of patho- INEDICINE AND SURGERY. 205",
         "TIHE CANADIAN JOURNAL OF logy, symaptomns, diagnosis and prognosis, ending up with a few cursory anîd al- together mucli too brief paragraphs upon how to treat the case. Hoiw often doos it occur that a surgeon will turn up, perhaps, one of the latest works to sce what treatiment he had better adopt in a particular case, and come away dis- :gusted with the short account given of thue very subject lie was inost anxinus to read in detail. Cheyne and Burghard, oh the other hand, have realised this defect, and have devoted the first part of their \" Manual of Surgical Treatient \" to the best methods of treating genieral surgical diseases, and have done it in a most readable and satisfactory manner. The best criticisn one could give of the book vould be to say that they have described in full those metlods which experience taught then were the best, and whicli they themîselves would adopt under similar circumstances. We commirend the book as one worth buying. Atlas and Epitome of Special Pathologic Hùtology. By DocsN DR. îEmxN DuRocK, Assistant in the Pathologie liastitute ; Prosector to tie Municipal Hospitl, L.I., in Munich. Authorized translation froni the German. Edited by Lunvie HEKTOBN, I.D., Professor of Pathology in Rush Medi- cal College, Chicago. Circulatory organs, respiratory organs, gastro-intes- tinal tract, with 62 colored plates. Philadelphia: W. B. Saunders, 925 Wainut St. 1000. -3.00 net. Canadian Agents, J. A. Carveth \u0026 Co., Toronto. That direct microscopie study iust necessarily form the basis of an accur- ate knowledge of disease, and is the only true Ieans of muastering pathologic histology is unquestioned. Such a work as this, with its many beautifully execúted plates, showing staining in every stage, will prove nothing less than a perfect boon te any student of the subject, be lie in his third year in medicine, or a practitioner of many years standing. The work takes up the circulatory, respiratory and gastro-intestinal organs. One of the most interesting and in- structive chapters is that under the liead of the respiratory organs, entitled, \"Infaretioi.\" One plate, No. 35, shows very clearly (1) lung tissue in which the alveoli are normal ; (2) compressed and airless lung tissue ; (3) in- farcted lung tissue infiltrated throughout with red blood corpuscles, slowing where necrosis las occurred in several places. Anotier plate whieh calls for notice is No. 49, showing diphtheria of the pharynx, and diphtleria of the tonsil, exlibiting the exudation of fibrin in the pharynx between the necrotie opithe- lial cells, with dilated blood vessels, sone of which are filled viti fibrinous thrombi, and in the tonsil the large number of disintegrated epithelial cells and, lymphocytes of tonsillar origin. This atlas will sbe followed by two more; one completing special pathologie histology, and the other general pathologie histology. Coplin-iManuial of Pathology, including Bacteriology. The Technique of Post- Mortems, and Methods of Pathologic Rcsairch- By W. M. LA CorrL, M.D., Professor of Pathology anil Bacteriology Jefferson Medical College, Philadelphia ; Pathologist to Jefferson Medical College Hospital, and to the Philadelphia (Blockley) Hospiali ; Bacteriologist to the Perin'ylvania State Board of Heualth. Third edition revised and enlarged. 330 illus- trations and seven colored plates. Octavo, 846 pages. S3.50 net. Plil- delphia, l'a.: P. Blakiston's, Son \u0026 Co. It is, to say the least of it, sonewhat unusual, even in these davs of d- vanced literary taste, for an author to find not only that his first editin is rapidly exhausted, but tliat lie is called upon to write a second ere any tuile lias elapsed. Still more unusual is it for a iriter to have to agail conpletcly rewritehis work in about twelvo mointls after edition number two is placed upon the market. Such, however, fell te the lot of Dr. W. M. Late Coplin; the third edition of whose Manual of Pathology ve have pleasure in looking over once more. Ris idea as to freely illustrating lis work coincides exactly Ivitl ours in this respect, .and la in this e.dition increased largely bis illustratiolis 206",
         "MEDICINE AND SU RGE1Y. rondering the book of still greater value. Soie of them are colored, but, best of all, the majority are original. \\V have read over carefully and with won- derful pleasure the chaptor upon Post-Mortems, and can but say that anyone desirous of knowinig exactly how to open properly the cadaver, so as to learnî the various pathological conditions present, slould read the section devoted to that subject in Dr. Coplin's work just published. Part of the increase of the size of the book is due to new chapters added, dealing with the nervous system, and also vith the muscles and joints. The author has all through his book evidently desired to make it useful to those desirous of securing clini- cal results, having paid special attention all through to correct technique in bacteriological work. Medical Eectricity. A practical hand-book for students and practitioners. By H. LEwis JONEs, M.A., M.D., Fellow of the Royal College of Physicians, Medical Oflicer in- charge of the Electrical Departiment in St. Bartholo- miew's Hospital, being the third edition of \" Medical Elect:ricity,'\" by W. E. SrEvESsoN, M.D., and H. LEWS JONEs, M.D., with illustrations. London: HI. K. Lewis, 136 Gower St., W.C. 1900. Price 10/6. This work lias been re.vritten alnost in its entirety. It has hadadded to it ;sevcrail new points, cnhancing its value very considerably. We refer princi- pally to the section devoted to discussing the utilization of the current froi eloctrical light mains for miiedical purposes, 'and most interestiing reading it forms. The author discusses the precautions which have to be taken with both the alternate as well as the direct current. The converting of -thie elec- trio liglt current for use in physicians' offices in Canada is becoming so coin- -mon that this chapter alone makes the book very saleable in this country, and we only regret that the section devoted to this particular subject is so short. A short chapter on X-ray work lias becn also added to the book, and is very interestinîg indeed. What is referred to, however, in the appendix, does not interest Canadian physicians, giving a list of the different towns in the United Kiigdomn where the publie electrie light supply lias been installed, with details .as to the character of the current furnislhed. The book will be found fully up to date, and is writteni, not in the dry style characteristic of medical ,vorks, but is quite racy and attractive to any student of imedicine. -Opcratire and Practical Saugery. For the use of students and practitioners. By Tuos. CA DINE, M.S. (London), F.R.O S., Assistant Surgeon Blr:stol Royal Infirnary. With 550 illustrations, nost of which are origi- nal drawiugs by the author. Bristol : John Wright \u0026 Co. London : Simp- kini, Marshall, Hamilton, Kent \u0026 Co., Limited. 1900. Tlhere are a great niany works on surgery at present orî the market ; sone .are systems dealing with the subject in its entirety, and many even of which are largely a reliash, of those preceding them, but cf course more up-to-date. Others are only nanuals, suited botter for the use of students wlio wish te get a digested account of those points on which most stress is laid at examinations. There are not a great many, however, whose authors depart sufficiently froni the beaten pathi and give, as a result of their labors, something sufficiently nlew and practical as to mierit their publication. Mr. Carwa,ýrdine's book is ciPIIntly practic'd, and, as he says, \" deals witlh the art of surgery in its every- da) 'ications. Froin looking over his voluiei, we should say that lie has ceriahuiy carried out his original ideas in that regard, as in every chapter he lias aiied to make the work one which will be nost appreciated by the sur- gon who desires to get, perhaps in a hurry, mnost practical information in the shortest space of tine. We bespeak the very heartiest support of the medical profession for this new addition to the surgeon's ariamentarium. w.A.y. The Care Of the Child in HCalth. By NaTUAN OPPENHEIM. Yew York: Thîe jacmnillan Ce. Though this book evidently is not written forthe instruction of physicians, 2-07",
         "THE CANADIAN JOURNAL OF but for that of parents, yet it contains mnuch that would be new, useful and practicable for the busy practitioner. It is truly refreshing to find a book written so fearlessly. In his attacks upon the Cherisled but hurtful dogmas of the past, tho author proves himself a veritable iconoclast. 'lie Iareit who reads carefully this little book, will have intelligent scient.ific views instmil of superstition ü.ith which to regard sucli subjects as maternai impression, anid heredity. Alniost without exception the various topics discussed are lhandled in a mannier which munsb disarm hostile criticisn. It would be inter;tiig, iowever, to ask the author to advance a good reason for advising that a child 'b trained to turn its tocs out when walking (p. 153). A slur which is uncalled for in its severity, and undignified, is cast upon the somewhat narrow and perhaps ucharitable views of some of the religious teachers of tlie timne (1. 224). The book evinces a virility, a candor, and a truly scientific knowledge of the subject in band, whichi make it a really valuable contribution to the literature of childhood. n. E. M. London to Ladysmith via Pretoria. By WINSToN SvENCER CHURcHIJ,, author of \" The Story of the Malakand Field Force, 1897 ; 'The River War,\" antl historical account of the Re-conquest of the Soudan ; \" Savrola, a Romance.\" Toronto: The Copp, Clark Company, Linited. Paper,. price 75 cents ; cloth, $1.25. To anyone who is a Britisher at heart, and has, in consequence, taken akeen, interest in following the British-Boer var in its different phases, a book such as \" London to Ladysmith,\" written, as it is, in so rattling a style, will prcre a great attraction. To followWinston Churchill in his wanderings from Lon- don to Southampton, thence op board the \" Dunottar Castle\" for Cape Town, his arrival at Table Bay, his muovements till captured by the Boers with the- armored train, his involuntary removal to Pretoria, and, most of all, bis won- derfully planned escape froni his military confinement and arrival back at Lorenzo Marquez, and thence on to Ladysmith, altogether formus a narrative of unusual interest, and we Can prognosticate that anyone starting it, as the writer was: wicked enougi to do, even on a Sunday, will run big chances of conipleting it ere he sleeps that night. .Diseases of the Chest, Throat and Nasal c\u003cvities. By E. FLETCHER INoALS5,. A.M., M.D., Professor of Diseases of the Chest, Throat and Nose, Rush Medical College, Chicago. 4th edition, with 256 illustrations. New% York: William Wood \u0026 Company, 1900. The author lias succeded admuirably in his avowed endeavor to make bis. vork as clear and concise as possible. It impresses one as the production of a busy practical physician whose views are crystallized by personal experieuce, in which failure lias but led to success. The reader is invariably drawn to an- author 'who, without too much show of egotism, speaks in the first person. It begets a feeling of confid\u0026nce iiimiîn. Sucliis the feeling vitl which enerises- from a perusal of this book, that he feels that the author is candid and straight- forward. While the most important changes and additions are foundin the articles on pleurisy, pneunonia, pulnonary pthisis, diphtheria and empîyeia of the antrum, yet the whole work lias been made to include the results of expert- ence and research up to June of .this year. Such are the advances in nedical science, that authors are ever busy in keeping their books up to date, aud practitioners ever poor in keeping their book-slelves in the sanie desiraleu state. J. M1. 31. The Reign of Law. By JAmEs LANE ALLEN. Toronto : The Copp, Clark Co.. Cloth, $1.25; paper, 75 cents. A tiade of the South, not before the war, but after the land had been bap- tized in blood and tears. This story is a picture, and to those wliolook closelY the color-blending is exquisite ; here and there the strong phases of character as thoughthe cclors were daslhed in with a palate-knife, then the few glazes of 208",
         "hlumor and the high lights of childish and darky drollery, and thon the pains- taking bit of work in the foreground, the declaration of love, so lhlItly sketch\" t in, just to keep the perspective, proves the delicacy of the touch of the arti ît story-muaker. To have once been in \"' ole Kentucky \" and inhaled the halsaimic odor of the heimp\u003e fields is a pleasure ; but one deep, Iung-iilling breath .f the fragrance of the woodlands and hemip fields inlaled through the media -f the pages of James Lane Alleni's book, is a joy forever. As a fit- ting seting for the language used, surely it nay be termed good Englisb, the typography is clear and large, a balm for weary eyes, and the book a sonie- thing worth possessing. w. A. Y. Origind Contributions Concerninf the (\"landular Strictires appertaining to lie fnmaa Eye 'and its .Appenday. With 7.1original illustrations. By ADOLiF AiT, I.D , Professor of Ophtliaimology in Beaumont Hospital Medical College, St. Louis, Mo. .Americ«n Journal of Oplhctlmology, Publishers. 10.Price, $1.50. This s--Ihject, to which the ordinary text-books devote but a few lines, is carefully and fully dealt with in this beautifully illustrated little hook. The illustrations are all froin the author's,own specimens-the opinions advanced are bs oiwn also, and frequently differ from those generally received. A more accomplishied histologist than the reviewer iight have criticisuis to offer-he lias noie. J. M. M. ililda W;d;e. By GRANT ALN. Toronto : The Copp, Clark Co., Liiited. Papber, 75 cents ; cloth, $1.25. Illustrated. By those who read and. enjoyed, a while ago, \" The Tents of Shemi,\" this ist novel, \" Hilda Wade,\" of Grant Allen's, will no doubt be welcomied, especially should it interest physicians, as it dips and dimples the surface of the streai of things inedical in a way to amuse, or at least give the doctors what they enjoy-a chance to l differ.\" The story has too inuch action to ever piive wearisomne, and the numerous exciting incidents perhaps înight be best siinmed up in Newsboy Jorry's language as hi- endeavors to sell his even- ing papers : \" A shipwreck, a inurder, a fire alarm--whichever you like-have a paper, sir ? \" 'ie PreparationL of Riyersont Entbmbury. By ALnEnR MÜ. CaR)rAN. Toronto: The Publishers' Syndicate, Limited. Paper, 75 cents. A \" purpose \" novel, by a young Canadian, of especial interest perhaps to the nieibmvi of the Methodist Church, as froma among their nuiber the author lias selecteil his characters, drawn his parable, but evidently not his satisfactory conclusins. A note of wvider interest is sounded toward the end of the story iii the discussion and views expressed on the capital and labor problei, and an ahinost lh\u003eotograiphie representation of a \" strike,\" shows the fine descriptive power poessessed by the young writer. REPORTS, PAI1PHLETS, ETC., RECEIVED. TirE Twenty-thîird Annual Report of the State Board of Health of New -Jersey, 1899, is a well-bound and carefully compiled report. It is well illustrated with half -tone photogravures, some of which speak volumes in them- selves. ''lose subnitted with the milk inspector's report from actual photo- raphs of places inspected, are worthy of wide circulation, and our own milk .tpeetors could, well in thie public interest, follow the New Jersey intspector's hale by taking a camera along. Some of the subjects chosen wereî as fol- lowrs : Showing wlhere the milk bottles are washed,\" \" Manure pile, privy, bottle-wvashing outfit and milk-house.\" In the former, an old pair of trousers MIEDICINE AND SURGERY. 209",
         "9 THE CANADIAN JOURNAL OF are hanging out to dry over the milk bottles, which are in old boxeq ('n t dila- pidated bench near an outhouse looking suspiciously like a privy. Tn the latter case a very suggestive board marked \" private,\" on a little bou' telis that it is certainly a privy, and on one side of this is a nianure pile and table, and on the other the bottle-washing outfit and milk-louse, and all in c] n ju' ,tion. What would the camera reveal among our ovn milk dealer ' A patient in my otice told mu tie other day that he became suspicious tIt his mnilk bottles were not properly cleaned by the milk dealer. Being soim'what of an amateur detective, he followed up his milkuman on his route, and fnund whule ho lad one or two hundred custoiers taking milk in bottles, tht'i ie milkmnan only had five or six bottles in his mlîgon. Milk is one of the great carriers of disease, and inspection as to cleanliness of method camnot he too rigid. E. il. A. Tar State Board of T furi Michigan has for distribution a dozen Teachers' Sanitary Bulleti.. Reports.\" Some of the subjects chosen are: \"The restriction and prevention of tuberculosis,\" \" -istology and bn.eterio. logy as a basis for sanitary instruction in high-grade sciools,\" \"Fresi air iii schools,\" \" Restriction of small-1,ox,\" \" Discussion of dangerous comununic- abl2 discases,\" etc. HOMEOPATHIC OPPOSITION TO SCIENCE. h is with gcnuine ie gret tiat we notice homeopathie journa'hm, oe by one, and with increopsing violence, ally themselves against the great scientific truths upon which inductive medicine is based, We do not speak of the details of trE atment or methods of medica- tion, but of the very ground-work of common-sense and induction upon which rationdity in imedication and prophylaxi : is based. The reason we say we sincerely regret tiis is that in going over absolutely to this standpoini seientifie medicine is deprived of a desirable buiffer or initermediate betweenî the ravings of popular hatred of science and the experimental sehool of imedicine it'elf. As a result we have the portentous, literally terrifying, recrudes- cence of the blind diabolismîs of quackery which we are iow wit- nessing. Just as the bitterness of the honeopathists inerraser' against vivisection, experimentalism, vaccination, meneured siologic tests of drugs, etc., just so fast we behold the appalling growth of the lunacies of demagogic quackery. We wih our homeopatiie friends (who try so bard to be enemies) could r'ec'og- nize that it is no longer \"allopathy \" alone which supporte the germ-theory of disuase, the prophylactic nature of serotheraIw, the validity of experimentation, etc., but that such things, in all \u003c4en- tials, are accepted and have been forever passed upon by the 'cien- tific minds of the world who care as little for \" allopathy \" a- fthey do for \"homeopathy.\" The saddest proof of this reactionisimi of homeopathy against sane conmon-sense consists in a virulent d- nunciation in one of their journals of the medical inspection of schools. The plan is cursed with all the malignity of hatred, as interfering with cducation, insulting to the medical profecion, and as spreading discase. To sucli results does the underseored logic ]ead !--Philadelpia iedical Journal. 210"
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         "IMAGE EVALUATION TEST TARGET (MT-3) % Y // {•/ \u003c? 1.0 !Si- IIM I.I 1.25 •;^ I 32 2.2 t 1^ IIIIIM 111= U III 1.6 ^ V) % 7 ^r /^",
         "V CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions Institut Canadian de microreproductions historiques",
         "1980 Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. y Coloured covers/ Couverture de couleur I I Covers damaged/ D D 0 D Couverture endommag^e □ Covers restored and/or laminated/ Couverture restaurde et/ou pelliculde Cover title missing/ Le titre de couverture manque □ Coloured maps/ Cartes g6ographiques en couleur G Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ I I Planches et/ou illustrations en couleur Bound with other material/ Relid avec d'autres documents r~y| Tight binding may cause shadows or distortion along interior margin/ La reliure serrde peut causer de I'ombre ou de la distortion le long de la marge int6rieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ II se peut que certaines pages blanches ajoutdes lors d'une restauration apparaissent dans le texte, mais, lorsque cela dtait possible, ces pages n'ont pas dt6 film6es. Additional comments:/ Commentaires suppldmentaires; L'Institut a microf Jlm6 le meilleur exemplaire qu'il lui a 6t6 possible de se procurer. Les details de cet exemplaire qui sont peut-dtre uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la m6thode normale de filmage sont indiquds ci-dessous. □ Coloured pages/ Pages de couleur □ Pages damaged/ Pages endommagdtas I I Pages restored and/or laminated/ D Pages restaurdes et/ou pellicul^es Pagef discoloured, stained or foxed/ Pages d6color6es, tachetdes ou piqu6es Pages detached/ Pages ddtachdes □ Showthrough/ Transparence I I Quality of print varies/ Quality in6gale de I'impression Includes supplementary material/ Comprend du materiel supplementaire Only edition available/ Seule Edition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont dtd filmdes d nouveau de fapon d obtenir la mei'leure image possible. 0 This item is filmed at the reduction ratio checked below/ Ce document est filmi au taux de reduction indiqud ci-dessous. lOy 14X 18X 22X [ 26X 30X y 12X 16X 20X 24X 28X",
         "32X ils lu iifier ne age The copy filmed here has been reproduced thanks to the generosity of: Saint John Regional Library The images appearing here are the best quality possible considering the condition and legibility of the original copy and in keeping with the filming contract specifications. L'exemplaire filmd fut reproduit grSce d la g6ndrosit6 de: Saint John Regional Library Les images suivantes ont 6t6 reproduites avec le plus ^rand soin, compte tenu de la condition et de la nettetd de l'exemplaire film6, et en conformit\u003c§ \u003c)vec les conditions du contrat de filmage. Original copies in printed paper covers are filmed beginning with the front cover and ending on the last page with a printed or illustrated impres-sion, or the back cover when appropriate. All other original copies are filmed beginning on the first page with a printed or illustrated impres-sion, and ending on the last page with a printed or illustrated impression. The last recorded frame on each microfiche shall contain the symbol —^(meaning \"CON-TINUED \"), or the symbol V (meaning \"END\"), whichever applies. Les exemplaires originaux dont la couverture en papier est imprimde sont filmds en commenpant par le premier plat et en terminant soit par la dernidre page qui comporte une empreinte d'impression ou d'illustration, soit par le second plat, selon le cas. Tous les autres exemplaires originaux sont filmds en commenqant par la premidre page qui comporte une empreinte d'impression ou d'illustration et en tnrminant par la dernidre page qui comporte une telle empreinte. Un des symboles suivants apparaiiia sur la dernidre image de cheque microfiche, selon le cas: le symbole — ^ signifie \"A SUIVRE\", le symbole V signifie \"FIN\". Maps, plates, charts, etc., ^nay be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tableaux, etc., peuvent dtre film^s d des taux de reduction diffdrents. Lorsque le document est trop grand pour dtre reproduit en un seul cliche, il est filmd d partir de Tangle supdrieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images ndcessaire. Les diagrammes suivants illustrent la mdthode. rata \u003e elure. 3 32X 1 2 3 1 2 3 4 5",
         "6 PI President i ing M",
         "Health \"Wli^^ U^U^ U»W U^ KJ\"^ L/V ^\"^ ^^ ADDRESS ■7^ V\u003e . / ^—t .UPOK THB PKOGEESS OF MEDICAL SCIENCE, BEAD JJEFORE THE NEW BRUNSWICK MEDICAL SOCIETY, BY WILLIAM BAYARD, M.D., EDIN. President of the Societi/, Vice-President of the Canadian Medical Aasociatioti, Correspond ing Member of the Oynceoological Society of Boston, Chairman of the Board of Health, and President qf ths Hospital Board of St. John, N. B. ES LIBRIS CASE, ^ No. // jlt.|(0h«,i.S.: PUBLISHED BY REQUEST.",
         "1871. P] President , ing",
         "Health David l^ussell JccL l2cqu\\ f^vid Pussell Jock Bee|ucst. ^ ADDRESS UPON THB PEOGEESS OF MEDICAL SCIENCE, \" BEAD I3EF0BE THE NEW BRUNSWICK MEDICAL SOCIETY, BT WILLIAM BAYARD, M.D., EDIN. President qf the Society, Vice-President of the Canadian Medical Association, Corresnond ing Member of the Oyncecological Society qf Boston, Chairman of the Board of Ueam,andPresid€ntqf the Hospital Board of St. John, N.B. ^ PUBLISHED BY REQUEST. 1871.",
         "ii. MtI Medical I ninanimc '' The p iSth of Dr. V",
         "52GX St. John, N.B., February §th, 1871. Mr Dear Sir.— I have to inform you that, at a meeting of the Medical Society in this city held on the 1st of February, a resolution was unanimously passed to secure the publication of the address upon ** The progress of medical science\" read by you before the Society on the iSth of January ; and that 500 copies be obtained. lam Sir, yours \u0026C;, Chas. Holden, Secretary, Dr. W. Bayard, President N. B. Medical",
         "Society. k\u003e.'\" ,/\u003e",
         "«'■/ PROGRESS OF MEDICAL SCIENCE. Gentlemen. — The By-Laws of our Society direct that the president shall be elected annually ; the rule is a good one, placing, as it does, the \"honourable situation \" into the hands of those who gave it, perhaps to be bestowed upon a more worthy member ; and my term of office having expired, I must this evening call upon you to select another in my stead. In retiring from the chair in which you have so kindly placed me, I would do injustice to my feelings, did I not avail myself of this oppor-tunity to thank you for the courtesy that has been universally exhibited towards me, and let me add, that our meetings and debates have been conducted in a spirit of fraternity and kindness highly pleasing to reflect upon ; illustrating the fact that associations like this tend to cultivate the heart, as well as the head, and * to promote professional good-will, and genuine brotherhood among their constituent members. That the study of medicine is vastly promoted by such associations must be acknowledged. For the stimulus of mind upon mind, invigorates and sharpens the intellectual faculties, and produces a kind of intellec-tual contagion stimulating members to exertion. Our mutual intercourse criticisms, and discussions, form \" at once a school and an ordeal,\" teaching us to become more rigid observers of the medical phenomena occurring in our practice, more careful in our classification of these phenomena, and more perfect in our deductions from them. Few of us leave this room without having heard some new professional fact, or idea, calculated to arrest our attention, and perhaps destined to give us a new and increased interest in some particular disease. And we are justified in assuming that the progress made in the healing art during the present century, may be attributed, in a great measure, to the stimulating and regulating influence of medical association. ;",
         "is 6 Most of us have heard it broadly asserted that the healing art has\u003e remained comparatively stationary during the present century, while other departments of science and art have, during the same period; advanced with great rapidity. It is true the marvellous applications of steam are creations of the present century. Watt and others hove taught mankind to subdue and harness that \" docile monster \" to. different kinds of machinery. By the steamboat wo are safely wafted from shore to shore independent of wind or tide, and with the swift rush of th ) \" iron horse \" we are conveyed from placp to place with the speed of the bird. It is also within the memory of most of us, that a greater feat has been achieved ; the Electric Telegraph, that \" railway of the mind,\" has annihilated space, and enabled us, instantly, to whisper our very thoughts from one extremity of the world to the other. And the \" science of chemistry has taught the artist to convert that sun himself into a matchless painter,\" who, with wonderful rapidity, can elaborate the most difl\u0026cult portraits and complex landscapes, with a degree of perfection unattain-able by the human hand. Yet it may be confidently maintained, that during the period in which, these brilliant discoveries have been taking place, medicine has advanced in various directions and forms, by strides as marked and as great as those belonging to any other department of art. To prove this statement let me endeavour to recall to your recollections some of the principal advances and changes that have been produced during the present century. Time will not permit, even were I able to discuss in detail, however briefly, the alterations that have occi ^red in Bome of the branches of medical study. As for example, in chemistry, a science, the very language of which has become revolutionized under the guidance of the atomic theory. Physiology has greatly improved, and is daily gaining additions to its domain. And anatomy itself ha» advanced in modern days, as is evidenced by the discovery that almost all, if not all the component elements and tissues of the human body^. and of the bodies of other organized beings, do either consist, or have originally consisted, of nucleated",
         "cells. I need not tell you that Pathological Anatomy was known and in some degree appreciated in olden times. But it is within the present century, that, by its light, the nature of diseases previously all but unknown have been explained, such as Bright's disease, morbus Addisonii endocarditip, ramoUisement of the brain, phlebitis, oedema glottidis, emphysema of the lungs \u0026c., \u0026c. It has enabled us to separate into specific diseases, affections formerly confounded together ; as, for instance, the different diseases of the heart, various kinds of tumours, inflam-matory affections of the lungs, pleurisy, pneumoni-i and bronchitis, \u0026c., \u0026c., and it has corrected our ideas respecting the nature of some maladies, by teaching us, for example, that delirium tremens is not to be confounded with inflammation of the brain and treated as such; that hydrocephalus, which was formerly recognised as pure dropsy, is the result of inflammatory or acute tubercular disease; that gangrena senilis is caused by obstruction and arterial inflam-mation, and not the result of weakness ; and that cirrhosis should not be confounded with pleurisy. It has also taught us that in hysterical subjects, affections strangely resembling destructive disease of tha synovial membrane of the joints, paay occur, without the existence of such disease, and it has enlarged our knowledge of the causes and consequences of pyaemia. By it we have recently learned that the parasites infesting some of the brute creation used as the food of man, when taken into the human stomach alive, will produce a parasite of a different character, namely the tape-worm. For example, the bladder- worms growing between the fibres of the lean flesh of a measly pig constitute a preparatory stage of the common human tape-worm, the \" toenia solium,\" and in systematic zoology are described under the name of cysticerci cellulosoe, when eaten by man, are transformed into tape-worms. It is stated by Kiichenmeister that on the 24th of November, 1859, he gave a prisoner 20 measles, and 20 more on the 18th of January 1860, in sandwiches made with sausage. The prisoner was executed on March 31st, 18G0, that is, four months after the first, and two months and a half after the second eating of the measles. A, the post-mortem examination 19 tape- worms, 11 of them 5 feet",
         "long 8 ^ere found in the small intestines. If the meat containing the pa asite is thoroughly well salted or cooked, no injurious consequences will resul from eating it. The microscope has changed and corrected our ideas respecting certain maladies, by proving the vegetabl'j or cryptogamio structure of various eruptions upon the cutaneous and mucous surfaces of the body. It has revealed to us affections, the existence of which was previously unknown, as leucocythgemia, sarcinae ventriculi, \u0026c. It enables us to ascertain the malignant character of certain tumours and discharges. By it we learn that most of the entozoa found in the interior of the human system, enter it in the form of ova, along with our food and drink, thereby enabling us to modify our sanitary system, and it has greatly enlarged and will doubtless continue to enlarge our knowledge respecting the different morbid states of the urinary secetions. Indeed the microscope in the hands of the modern practitioner, answers in a moment questions unanswerable without it. The department of Pathological Chemistry has advanced much within the present century. It is advancing daily, and a herculean amount of work and information may be expected from it. We have reason to believe that if we knew the pathological chemistry of the blood and fluids as well as we know the pathological anatomy of the solids of the body, then medicine as a science and an art would make advances of the greatest moment. Pathological chemistry and pathological anatomy together, enabled Dr. Bright to establish the great importance of albumen in the urine, as connected often, though not always, with organic changes in the kidney but always indicating change in the pathological chemistry of the blood itself. And the recent researches of Dr. Richardson and others, have established that in very many inflammatory diseases, the fibrine of the blood is increased in quantity, and that the change of the fibrine from a fluid to a solid state is caused by increment of heat. Pathological chemistry has also proved to us that the fibrine in the blood is increased in cholera, while it is decreased in malarial and typhus fevers. And recent experiments have demonstrated the fact that the white corpuscles escape from the blood-vessels in",
         "inflammation. A higher and more lefined organic chemistry may yet enable us to detect the presence of special toxicological or morbid states of the blood as producing the characteristic inflammations of the skin in eruptive diseases, puerperal and other fevers. May it not be a blood poison which gives rise to the numerous local, serous and other inflammations so often observed in patients suffering under albuminuria, and by it that vexed question may be settled, as to whether rheumatic fever is due to a materics morhi, and whether such materles morhi is lactic or acetic acid; and a higher chemistry may perhaps enable us to neutralize theso patho-logical poisons in the system, or eject them from it. The recent beautiful theory of Liebreich suggesting the adoption of the hydrate of chloral as a therapeutic agent, when he says that \" the hydrate treated with an alkali is resolved into chloroform and a formate, The blood being an alkaline fluid, therefore when the hydrate is introduced into the organism, every particle ol it will consume the sur-rounding quantity of alkali, and the decomposition will be completed only j after the required amount of alkali has been furnished by the blood- Immediately a minimum quantity of chloroform is formed, and passes I to the first place of action, viz., the ganglionic cells of the cerebrum. I The action with the increase of chloroform in the blood extends to the ga iglia of the spinal cord, lastly, it extends to the ganglia cells of the heart. The researches of Dr. Richardson, based upon the sugges- Ition of Liibrcich, and the practical experience of the medical profession Ircspecting its use, illustrate what may be expected from a higher p;:tho- logical chemistry. When we contrast medical practice at the present day with what it /as sixty years ago, it must be acknowledged that the modern practi-tioner is greatly assisted by the late improvements in the means of thynical dingnosis. By it he endeavours to discover during life, that phich was formerly revealed only by the scalpel after death. A perfect diagnosis cannot be arrived at, till we have an exhaustive pathology — for without a knowledge of what is possihk in disease, diag- losis must be defective. Moreover, that which might' be considered a pathological fact to-day, by changing ciicumitanccs may be",
         "proved 10 erroDeous to-morrow. Therefore, in the present state of our knowledge, we must be guided by the probable in disease. That experience which is able to anticipate causes, and from causes their effects, often enables the practitioner, as by prophetic insight, to diagnosti^ite conditions which neither direct physical examination nor the most systematic arrangement of symptoms would explain. But, as already stated, modern invention and research have greatly contributed towards determining the true nature, and consequently in fixing more accurately the true treatment in different diseases ; as, for example, Laennec and a host of subsequent observers have taught us how to map out the condition of internal parts, the action of which we hear, but cannot see. Czermak and others, by the application of optical instruments, have exposed to view organs of the body before inscrutable ; the pharynx, the vocal cords, the trachea, the vagina, the uterus, the bladder, \u0026c. ; so that many of the hidden causes of disease are no longer a matter of conjecture, but of sight and demonstration. The ingenuity of Helmholtz has disclosed the secrets of the eye ; and it is not asserting too much to say that the ophthalmoscope has done more to increase our knowledge of diseases of that organ than has been accom-plished during a century by all other means ; and that the oculist can point to brilliant triumphs over diseases hitherto deemed incurable ; and he is not now obliged to class a number of deep-seated diseases of the eye under the head of amaurosis— to which the remark of Walther is so applicable — \" a condition where the patient sees nothing, and the doctor also — nothing.\" The opthalmoscope also teaches us that some states of j he eye are pathognomonic of suspected conditions of other parts of the body. The Sphygmograph of \" Marey \" has so supplemented the sense of | touch that the wave phenomena of the pulse and heart are ref^istered by which we can fathom the secrets of the circulatory apparatus. The thermometer has been brought to our aid with good practical I results illustrating the temperature in different diseases. And the test tube ably assists us in diagnosticating morbid conditions! of the urine, \u0026c. gery the",
         "o\\ 11 Materia medica has greatly improved during the present century. Many new medicines have been added to the Pharmacopaeia, and feome have properly been expunged from it. The modern discovery of the active principles in our vegetable medicines under the form of the alka-loids, as quinine, morphia, mimm; atropine, \u0026c., \u0026c., has given the jaJ^H practitioner of the present day the means of exhibiting some of the most powerful and useful medicines in a concentrated form ; not in the shape of large ^lowders and nauseous tinctures, infusions and decoctions. And we have reason to hope that the work has only commenced, and that tho chemist may further assist us by disarming most of our drugs of their revolting and disagreeable taste — a boon to both practitioner and patient. Possibly most of the indications in therapeutics may yet be attained by the administration of medicines in other and less repulsive modes than through the stomach. While inhalation has been practised since the time ; of Galen, still modern chemistry and ingenuity have done much towards establishing it as one of the methods of exhibiting medicine. The method \\ of subcutaneous injection is of modern creation, — daily experience proves I its value, — by it we obtain a more rapid and certain eflfect from the remedy employed. The practitioner of the present day can point with pride and satisfac-tion to the late improvements in Practical Surgery, without comparincr jts present state with the period at which the chafing-dish and the searing\u003e- iron were as indispensiblc to arrest haemorrhage as is now the ligature ; and when the cries of the suflfcrer were smothered only \" by the hissing of the heated cauteries against the surface of the bleeding wound.\" Appreciating the wonderful powers of nature in the cure of disease, his treatment of wounds and injuries is more simple and rational. He now allows the bleeding to cease, washes away all coagula, closes the wound and applies light water-dressings instead of the complex ointments, compresses, pledgets of carded tow, rollers, straps, \u0026c., in use forty or fifty years ago. Nor has he the same dread of the appliance of stitches as his forefathers had. In fact, some of the greatest triumphs of modern sur- gery are associated with this simple mechanical process, as for example, the operations for cleft-palate, vcsico-vaginal fistula, ovariotomy,",
         "\u0026c. 12 The antiseptic system of treating wounds, recently suggested and put in practise by Lister, commends itself to the consideration of every sur-geon ; though a difference of opinion exists as to it= merits, still expe-rience may establish it as superior to all other modes of treatment. There has been a great improvement in the treatment of sores \" tending to heal,\" by the substitution of moist applications, instead of the oint-ments formerly employed, and in the \" callous or indolent\" ulcer by the application of blisters to the surface of the swollen part. I must also mention a very recent practice of M. Riverden, of Paris, that of trans-planting portions of the skin for the closure of large granulating surfaces of ulcers, following burns, \u0026c. The substitution of effectual draina\u003c\u003e;e in sinuses that remain after the evacuation of abscesses, for stimulating injections, sponge tents and pres sure, is an improvement. And the drill, in decp-scatcd abscesses of bone, has, of late years, saved many a limb. In few matters has surgery more improved than in the treatment of diseased joints; formerly recovery was considei*ed almost hopeless, under the use of caustic-issues, \u0026c. ; whereas we now confidently look for recovery under perfect rest and extension. And should bony anchylosig take place, an artificial hip-joint may now be produced, by an ingenious operation suggested and recently performed successfully by Professor Sayre, of New York. Since the commencement of the present century, many new operations have come into practice, as ovariotomy, the operation for vesico-vaginal fistula, cleft palate, removal of the tongue, the radical cure of hernia excision of the upper and lower jaw, perineal incision in aggravated urethral stricture, delegation of the carotid, subclavian and other large arteries ; in ophthalmic surgery, iridectomy, \u0026c., and lithotrity, an opera-tion characterised as one of the greatest additions to modern surgery, and one that must largely supersede the cutting operation of lithotomy, for while the mortality from lithotomy ranges from one in six to one in ten, that from lithotrity, according to Sir H. Thompson, is about one in thir-teen, and from present experience, it may be assumed that all stones weighing less than one ounce, in grown persons, should be removed with the lithotrite.",
         "powcn 18 Increased knowledge of anatomy, physiology, and'pavliology,has enabled surf'eons, within the same period, to rcmed^ distortions and deformities [arising from cutaneous and joint contractions, by subcutaneous incision I and plastic operations. Prior to 1809, when MacDowell, of Kentucky, first performed the [operation of ovariotomy, every woman labouring under ovarian dropsy was looked upon as doomed. And when Lizars, of Edinburgh, first I operated in Groat Britain, he was assailed by a certain amount of ridicule I need not say to you that it is now one of the established operations land for one of such magnitude marvellously successful, with a mortality I of less than thirty-five per cent. The experience of the practical surgeon teaches him to rely upon the [powers of nature, and that it is his duty to assist and oftentimes to guide her, in other words, he is the pilot who can steer the ship, but who Icannot make the wind blow. Knowing the wonderful assistance that nature will afibrd him, it is his boast that, in the present day, he can [treat diseases without operative interference, where formerly the knife [was considered indispensible; that he can substitute minor operations for |more severe ones ; that he can often save limbs by the removal of diseased joints, where years ago amputation was deemed inevitable ; for example I leed only mention excision of the hip, knee, ankle, shoulder, elbow and Iwrist joints, to prove the wonderful benefits of conservative surgery of Jate years. Removal of the ends of the bones in compound dislocations ind fractures, instead of the limb, are examples of modern conservative surgery. I may also mention the treatment of aneurism by compression, icupressure, flexion, manipulation, galvanico-puncture, \u0026c. Improvements in individual operations have taken place, as in ampu. [ations, in the operation for hernia, that cf removing cartilaginous jodies from the knee-joint, that of opening the tanal from the inferior punctum, so as to obtain room for the passage of probes large enough [emove the obstruction in fistula lachrymalis, instead of styles permanently htained. Acupressure, a new mode of restraining hsemorrhage, as recommended Professor Simpson, is well worthy of practical application by the",
         "sur^ 14 geon, for by experience alone, its value can be tested ; it has its advocates and its opponents, so had the discovery of John Hunter; and who can suy that it may not, at some future day, superrode the use of the ligature. The most brilliant discovery in modern medicine, and one of the greatest boons ever conferred upon mankind, is the power the surgeon possesses of wrapping the patient in a painless sleep, while he is subjected to the horrors of the operating table. Yet, while accepting immunity from suflForing, the patient incurs a certain amount of risk — statistics having proved that death has resulted from anesthscsia, regardless of the agent used, once in between 2,000 and 2,500 cases. Th3 mortality is small, but let us hope that a substance may yet be discovered that will produce the effect required with impunity. Local ancsthacsia, by freezing the part, is of modern origin, and is suitable for minor operations. Practical Medicine advances by the discovery of new facts, and by the application of such facts to the treatment of disease. During the present century its advance has been quite as great as that of surgery. The means of diagnosis at the command of the modern practitioners - — his increased knowledge of the nature of disease, — and the improve ments in chemistry and materia medica, enable him to apply his remedies with greater judgment, and to combat disease with more con-fidence of success than did his forefathers. It would be hard to find a medical man in the present day recom-mending '' Lizards^^ for the cure of cancer and venereal disease, as did Dr. Lettsom — a practitioner of standing in London — -^ho read a paper to the medical society of that city in 1783 recommending them. Well may the following lines be attributed to him. He is made to say : When patients come to I, 1 physics, bleeds and sweats 'em, And if they choose to die, What's that to I, I lets 'em. 1. Lettsom. Let us glance at the treatment of disease by hleeding. It is not man^l years since the lancet was in the hands of every practitioner, in daily, and I might say almost hourly use, whereas now it is one of tho rarest operations J and instead of the loss of blood, we have the exhibition I of stii use oi of thii -by error, father titiom \" char favoui such I strong Mai to a p( accuse patien being 1 In I I ments I a disea \" grad and all cod-liv longer Ifailing Icalcula |the av( two yet |he adc arrcs jof oxa jthe ur ■potass i Imany i",
         "Isuccess 15 advocates and who ise of the ne of the 3 surgeon subjected immunity -statistics less of the ortality is . that will ly freezing )ns. Is, and by \u003euring the I )f surgery. actitioners e improve- apply his] more con- day rccom- 1 ase^ as did ad a paper em. Weill \u003e say: I 3 not many I r, in daily,! one of ths I exhibition of stimulants ; — and in place of almost starvation, we have the abundant use of nutriment. Now the question may be asked, what is the cause of this great change ? It has certainly brought upon our predecessors, by some, — the charge that they were ignorant and blind followers of error. But the reflecting man cannot bring his mind to believe that the fathers of British medicine were alwa;/s bad observers and mistaken prac-titioners, consequently he is forced to look for the cause, in the '^change of type of disease'' There are many strong arguments in favour of this doctrine, — arguments difficult to controvert, and when such men as Allison, Christison, Stokes, Graves, and \"Watson, give their strong adhesion to such belief, we may readily pause before denying it. Many of us can call to mind the time when cold water was forbidden to a person with fever, and as for milk, he who gave it would have been accused of \" feeding the fever\" and thereby endangering the life of his patient. I need not say to you that such notions exist no longer, both being freely used. In proof of the progress in practical medicine I may refer to improve-ments in relation to particular diseases. Consumption, — for example — a disease in which the physician's duty consisted in watching the slow \" gradations of decay,\" — making a prognosis of two years duration, — and alleviating suffering as best he could. But now, under the use of cod-liver-oil, mineral acids, bitters and supporting nourishment, he no longer regards the disease as hopeless, and treats it looking for a cure; Ifailing that, he confidently expects to prolong life. The experience and calculations of Dr. Williams justify the expectation, for he informs us that |the average duration of life of phthisical patients has been extended from ;wo years, the limit assigned by Laennec and Louis, to eight years. And Ihe adds, that \" in not very few cases, the disease is so permanently r arrested, that it may be called cured.'' I may mention the treatment of oxaluria, phosphatic, and other diatheses indicated by the state of the urine, the use of iodine in goitre and other affections, iodide of [potass in syphilis, gout, \u0026c., bromide of potass in epilepsy, \u0026c., arsenic in lany affections of the skin, the alkaline treatment of rheumatism, the [successful use of nitrite of amyl in tetanus, and in angina pectoris,",
         "of 16 hydrate of chloral as a narcotic, of quinine in acute lumbago, of drachm doses of tincture of henbane, with a little sulphate of magnesia three times a day in orchitis, of large doses of quinine in military surgery as a remedy for pysemia ; the banishment of scorbutus from our ships, \u0026c, \u0026c., also the vast improvement that has taken place oi late years in the treatment of diseases of the womb and its appendages, and in diseases of the eye, I may refer to the use of atropia as a substitute for belladonna, and the calabar bean as a local application to contract the pupil. Formerly all infantile diseases were considered by some as the results of febrile action, and treated as such, by others, as the results of weak-ness i\\nd treated with tonics and stimulants, and by a third class as the result ) of the irritation of worms and treated with anthelmintics. 3todern investij^ators have proved that the different organs of the child are liable to nearly the same diseases as the adult, and should be treated accor-dingly. The inortality of infants is still very large, but of late years it has greatly decreased. Towards the middle of the last century, 60 out of every 100 children born in London, died before they had reached their fivrt year of age ; but the mortality has steadily diminished, so that now, about 35 in every 100 die at that period. About 600,000 are born annually in Great Britain ; of these 300,000 would have perished. Now about 200,000 die, thus showing a saving of at least 100,000 human beings a year. In New York the mortality is still very large; one-tliird of the children born, die in the first year, and one half before they have attained their fifth year of age. In Geneva, records have been kept since 1590, and it has been ascertained that a child has now five times greater chance of living to the age of twenty-one years than it had three centuries ago. About the middle of the seventeenth century, one in every forty or fifty women delivered in London, died of child-birth and its consequne- ccB ; but as medical science has advanced, that mortality has decreased, till now about 1 in 150 or 200 die. There are about 600,000 accouch- ments yearly in Great Britain, still about 3000 mothers perish. If the old mortality held good, not less than 11,000 or 12,000 maternal",
         "lives 17 rould now be lost. Consequently we may proudly point to .this modern Advancement in medical science, effecting, as it does, in this item alone, saving of the lives of 7000 or 8000 mothers a year. The moitality in the army, years ago, was immense. It was a dis- [raoo to those in authority who positively refused to listen to the repeat- Id appeals of the medical staff. And it was not till after the Crimean War, rhen Miss Nightingale brought the fact before the nation, that the laws jh\\oh preventive medicine had established and applied in civil lifo were |ut in force. The result was that since the period named, the mortality the Guards has fallen from 20 to 9, and in the infantry from 18 to 8* Lud the improvement in war is still more striking. In the Crimeau war le sick in hospital were nearly seven times the number of the killed, [hile in the Chinese war they were nearly equal. The relative propor- |ons of zymotic sickness in the two campaigns were as 6 to 60. The present death-rate of fever in En gland amounts to 385 per 10,000 population, while a century ago, its death-rate was nearly 539, id at the middle of the last century the annual death-rate from all juses in London, was 355 per 10,000 of population, but in the middle the present century, it was only 249. In Sweden, in the period from [55 to 1775, the death-rate was 289 per 10,000 of population, while )m 1841 to 1850 it was reduced to 205. In pursuing this subject let us contrast the state of the unfortunate latic of the present day \"wi a what it was sixty years ago, when deemed sapable of human feelings he was incarcerated in a dungeon, bound jth chains, surrounded by filth, cut off from the friendship and charity his fellow mortals, and treated with contumely, scorn, and stripes, a [man being buried, yet liviiLg. Need I say to you how changed all [s is now, and with what happy results ? With the knowledge that the )r sufferer possesses the feelings, impulses, and affections of man, he is |\"rounded by comfort, all restraint is, or should be removed ; and he is under proper medical and moral management, ^he preservation of human health, and the prolongation of human k are two of the great and noble objects of practical medicine. These lects are to be attained more by the prevention of disease than",
         "by 18 to enable us to prevent diseases, we should be yrclj their causes. These causes and the best means ig^ them, have in a special manner engaged the attention of tbj physician of modern days. By it he has learned the vast importance ol sanitary measures. His investigations have taught him that the attack of almost all diseases are increased in intensity and frequency, in ouj households and communities, by the want ot sufficient air, light, watcj and drainage, as well as by the deleterious eflFects of decomposing anii and vegetable matters allowed to remain within and around our dwellings! and by the human effluvia concentrated in small and stifling bed-roomi They have taught him also that when the preceding causes of disea have been abated, in special localities, by proper sanitary arrangement human life as a consequence has been saved, misery avoided, an pauperism prevented. We find the mortality in country districts always less than in townJ In the country districts of England, it is about 1 in 58, while in tlj towns it seldom falls below 1 in 45. In all large towns where prof sanitary measures have been adopted the mortality has decreased. M example in London, in 1840, the death rate was 1 in 40, it is now 1 45; BO in Boston, in 1855, it was 1 in 39, it is now 1 in 41. As a further proof of the influence of sanitary measures upon certaj 'ocalities in towns, I may mention that St. Giles, in London, formerhl filthy parish, now since every stieet and court has been brought und| control, the mortality has been reduced from 50 in the 1000 to 15 the 1000. Class and occupation exercise their influence upon mortality, for i are told by Dr. Lyon Playfair that in Liverpool the average age at dea of the gentry was 43 years, tradesmen 19, and laborers 16, the avei age of all classes being 22 years. In pursuing this subject I may mention that it is estimated that thtl are 8000 preventable deaths in New York, yearly. It is further mated that for every death there are 27 cases of sickness, which wod give a total of 216,000 cases of preventable sickness to be tread When we reflect upon the misery, wretchedness and pauperism",
         "produd 19 be mlHby these 216,000 cases of sickness capable of being prevented, it affords means oH ample occupation for the physician, the philanthropist and the statesman, in of tkl Let us look at one other advancement of practical medicine, one to jrtance oBwhich the physician may proudly point as the greatest discovery of the le attackHage, a victory of medicine over disease and death. I allude to the sy, in cuMliscovery of vaccination by Jenncr, to whom Providence, as it were\u003e ^ht, wate^ntrusted the office of teaching the surgeon, with an almost invisible peck of matter upon the point of his lancet, to defy, in a measure, one f the most fatal diseases that ever afflicted the human race. The vast importance of this discovery can only be appreciated whenr e take into consideration the ravages produced by small pox prior to the ntroduction of vaccination. We are told that this disease was a terror 0 mankind, \" sweeping over the land like fire over the prairies, smiting own prince and peasant;\" that about the year 1519 in Mexico, it ddenly carried oif 3J millions of population ; that in Brazil in the year 563 it extirpated whole races of human beings ; that about the same eriod in the single province of Quito, it destroyed 100,000 Indians \u003e at in Iceland in 1707 it carried off 18,000 out of a population of ,000; that in Greenland in 1737, nearly two thirds of the population ere swept away by it ; that in France it caused one-tenth of all the ipon certa^aths, and in England one-fourteenth; that the annual mortality from it , formerljB Europe alone amounted to half a million ; that one-third of those aght undBtacked died, and that it destroyed, maimed or disfigured one-fourth of OO to 15 lankind. Let U3 now look at the pleasing side of the picture, and see what the rtality from this loathsome disease is at present. The following illus, tions selected from various sources, give an approximative idea of mortality from small-pox in each million of the population before since the introduction of vaccination. d that thlB Fweden 2050 185 Copenhagen 3128 286 ■ Westphalia.. 2643 114 Berlin 3422 176 further e« Moravia 5402 255 England 3000 200 rhich woiODoctor Farr tells us that the combined mortality of small-pox, measle*^ be treatn scarlatina at present, is only half as great as the mortality occasioned am produMsmall-pox alone, before the introduction of vaccination. ng am; dwelling, 3ed-room of disc ingemen 3ided, a a in towni bile in tl dere pro ;ased. Ti LS now 1 xlity, for je at dei the",
         "ave 20 ft Experience and statistics teach us that small-pox occasionally occun among those who have been vaccinated ; that if 1,000 persons who ha^ been well vaccinated should be exposed to the contagion of the discas about twenty-six will take it ; that among vaccinated persons infectej with small-pox, the danger of the disease is chiefly determined by tlj badness and insufficiency of their vaccination ; that the fatality of sma pox when it attacks the unvaccinated is 350 per 1,000 ; that its fatalitj to such vaccinated persons as it infects is, taking them indiscriminatelj 70 per 1,000, but, distinguishing vaccinated persons into two classej first, those who have been vaccinated in the best known manner, ai second, those who have been badly vaccinated, the fatality of sraall-poj if it infects the former, will be 5 per 1,000, if it infects the latter, 15 per 1,000 ; and that the risk of the one is 30 times that of the otlicj Or, in other words, let an unvaccinated person contract small-pox, an the chances are more than one in three that he dies. Let a very badlj vaccinated person — a person with one imperfect cicatrix — contract sma pox and the chances are not quite one in eight that he die?, Letl person with two good vaccine cicatrices have small-pox, and his chano of dying are less than one in forty. But persons who have been vacJ nated in the best and most complete way, will, if they ever get smaj pox afterwards, not die of it at the rate of much more than one in tij hundred. \" It may be safely asserted that the lancet of Jenner, armed with cow-pox matter, has saved in the world more human lives than gij powder and the sword were ever successful in slaying, during any centu in the history of mankind. And let us say, honour to the man wl found the way to arrest this dreadful scourge, and who taught us ta the seeds of the disease transferred to another soil might be madej germinate with a healthy and saving influence — a glory to our art, to the nation (claiming him as a son. Yet that nation neglected I bestow any mark of distinction upon the doer of all this good. Sa favours being reserved for the inventor of instruments for the destruoti of human life — the user of them — the courtier, and the politician ; man whose life is spent in ministering to the suffering of his fellow-: liowever successfully, being generally the last to receive such honours!",
         "MHWWjilfliyi^ It is to be regretted that notwithstanding the facts before us, men are be found ignorant and weak-minded enough to deny the benefits of lis wonderful agent. And we hear of \" anti-vaccination societies,'^ [mposcd, I am happy to say, with very few exceptions, of men not Honging to the profession ; men whose prejudices must have destroyed \u003ey r easoning power they might have possessed. According to Short's mortality bills of London, plague, dysentry, lall-pox, ague, and child-birth were the most destructive diseases in the le of Sydenham. It is needless for me to say that they sustain their rmidable and fatal character no longer. And does not the history of J ♦ le past encourage us in the belief that perhaps in 60 or 70 years hence Ider the guidance of hygienic and medical means, the same may be Id of those diseases that are at present the most destructive and deadly their efiFects upon our population ; namely, consumption, convulsions, bhus-fever, scarlet-fever, pneumonia, and bronchitis. We have the [est of small-pox by vaccination as a stimulus to induce us to follow footsteps of Jenner. And who can say that means may not shoitlj be ^ised to arrest the ravages of scarlet-fever, measles or whooping-cough ? the conquest of small-pox appeared to our fore-fathers — judging from writings of Dr. Mead — as impossible as the conquest of these maladies appear to any one now. ''hile we contend that medicine has advanced we must also acknow- ;e the uncertainty of the art. The source of this uncertainty may be partly in its imperfections, but more in the intractability of intense IS of disease, the ferments of which poison the system to such an 3nt that death must inevitably be the result. Take as an example, ;nant scarlet-fever; observe the utter prostration, rigors, stupor, [Hen throat, offensive breath, and thready, failing pulse, which indi- intense blood-poisoning. Here death is as certain as if the patient taken a poisonous dose of prussic acid. Medicine is foiled by the rwhelming power of its antagonist. In conclusion let us hope that enough has been shown in this paper, srfect as I freely acknov^ledge it to be, to prove that the science of ticine has kept pace with other sciences in the march of improvement,",
         "•J 22 YiCt, in the face of such facts, the workers in our noble profession arl too often told that they are not advancing because they cannot conqueil death, or triumph over all forms of disease. I do not allude to believersj in \" t«m«\" or \" pathy's,\" it is their interest to say so, and we can aflForJ to treat them with silence. But, I grieve to say it is the fashion now-a] days to hold up the stumblings and uncertainties of medicine to thel public gaze; to invoke ridicule and censure, and should a practitioner getl into the hands of a jury, here again he has to contend against ignorance! of medical power and responsibility, and expects to be told that if hej does not save life or limb he must pay the penalty. St. John, N. B., January 18th, 1871.",
         "..\u003ei'!' )fession arl ot coaqueil ;o believers i can afforl lion now-ai ine to tb«| titioaer getl b ignorancel , that if hel / V"
      ]
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         "Cover title.",
         "\"Issued by the Board of Health of Halifax, N.S., for the use and information of the Citizens.\"",
         "Title from title screen.",
         "10 p. ; 23 cm."
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         "Sanitation, Household.",
         "Hygiene.",
         "Communicable diseases -- Nova Scotia -- Halifax -- Prevention.",
         "Hygiène de l'habitat.",
         "Hygiène.",
         "Maladies infectieuses -- Nouvelle-Ecosse -- Halifax -- Prévention."
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      "label" : "Sanitary and preventive measures, disinfectants and how to use them : what may be done by the public to guard against contagious and infectious diseases.",
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         "[Halifax, N.S.? : s.n.], 1885 (Halifax, N.S. : Blackader)"
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      "identifier" : [
         "08201"
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      "title" : [
         "Sanitary and preventive measures, disinfectants and how to use them : what may be done by the public to guard against contagious and infectious diseases."
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      "text" : [
         "Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtan the best original copy available for filmîng Features of this copy which may be biblhographically µnique, which may alter any of the images in the reproduction, or which may ,significantly change the usual method of filming, are checked beldw Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée E Cover title missing/ Le titre de couverture manque Coibured maps/ CIrtes géographiques en couleur Coloured nk (i e other than blue or black)/ Encre de couleur (i e autre que bleue ou noire) D -Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight bmndng-may cause shadows or distortion along interior margn/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la marge intérieure Blank leaves added durng restoration may appear within the text Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées Additional comments I Commentaires supplémentaires L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer Les détails de cet exemplaire qui solt peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous ~- Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or lamnated/ Pages restaurées et/ou pellculées Pages discoloured, staned or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Fn Showthrough/ 'J Transparence Qualhty of print varies/ Qualité inégale de l'impression Includes supplementary material/ Comprend du matériel supplementaire D Olly edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc , have been refilmed to pnsure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc , ont été filmées à nouveau de façon à cbtenir la meilleure image possible t, t', This item is filmed et the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous 14X - 18X 22X 26X ci1 1 161111 1111 48 32i Xl 12X 16X 20X 24X 28X 32-X",
         "Keep v et in a oe place for referencè i'SANiT AY AND DISINFECTANTS, AND HOW TO USE THEM. WHAT !AY Bl BONR BY THE PUBLIC CONTAGIOUS OR INFECTIOUS DIEASES, Issue.d by tbe Board of Ilealth of falifax, N. S., for the use and information of Me Cit1iens. HALIFAX, N S: PRINTED BY BLACKADAR BROS. 1885. L t",
         "IL Y JOHN JAMES STEWART COLLECTION £ ~ tt J s1't t ''t t tt. ~ t t t I. i ~ ~ tt~ 't \\ t tt t t t .4 t , ttt",
         "SÂNITARY AND 1P ENTIVE EASURES, \u0026c The following samtary and preventive measures, especially împortant at this season of the year, are published for the guidance of citizens in the management of their dwellings and for 'personal application,- Thorough ventilation of dwellings is ebsential to the health of the occupants. Fresli ah is a most important means of promoting and sustainng the healthy action of the body. Personal cleanliness and cleanliness about dwelîngs and premises should be most scrupulously observed. A source 'of danger to health is the decompo- sition of organic matter in and abont our houses. Ceiars, drains, cesspools, outhouses, should be exaîiined to sec that they contain ïothing to poison the air. Damp cellars are injurious to healthr. The foul and humid air fron them will permeate the house, in spite of every effort to prevent it. A remedy should at once-Ae instituted. For the prevention of disease, a good nutritious diet and regular habits of life are. indispensable ; temperance in all things is to be observed ; and avoidance of all excesses\" is strictly insisted upon. Constant vigilance is necessary to ,uard- agains the many causes which, during the spring and s onths, have a tendency to disturb the stomach un :wels, thereby depressing the nervous çystem and diminishing the power to resistilise2se. To secure, as far as possible, a good sanitary condition of the city,, information of all nuisances, of whatever character, whether public or private, should be reported without delay to the City Medical OffEcer, or to the Ilealth Insp'ectors, at the Board of Works' office.",
         "CLEANLINESS The essential preventive of disea-se ib cleanliness. Keep your houses, cellars, y-ards, vaults and snks clean, whenever it can be done. Whitewash the walls of your houses, cellars, fences, outhouses, shops, factories, storeà houses and every other place, about your premises where dampness exists, and where mould oci. miidew forms. It keeps the walls dry, swivet urld clean, and prevents the accumulation of ,moistur , which plonotes putrefaction, givmng rise to fungi, vhi h are thought, by many to be a specific caise of disease.\\, Avoid ail collection of coal ashes mIxed with kitchen ýgarbage, slops,,stag aut watei, and other semi-solid 0i liqþid filth, anywhere about your preinises. Sewers, house- ramns, waste-pipes, and water- closets should be frequently tlushed with watei-let on the largest practical volume. Water closets and house drains should be plushed ni this muainer every day Your premises, particulrly bleèpmg apai;tnents and cellars, should be thor'oughly ventilated. Ventilation is ,no less a purifier than water. It cleanses by oxidizing and 4ryig. Keep your houses open, and your' windows hoisted during the day in good weather, that they inay have the full benefit of sun-light and a free circulation of air. Avoid the possibility of exposure to sudden changes of weather at night. When the weather, is cool or rainy, be,surpe to keep a fIie in the bouse m order to prevent dampness. DISINFECTANTS. These are' equally important. Thedy absorb imptire exhalations, prevent decomposition, and destroy noxious gases'; but in no instance should they be considered Of ethployed'as substitutes foi a pure, atniosphere, obtained by free ventilation. These are simply aids in restoring aid presei-ving healthful purity, and not substitutes ,for cleanliness and pure air. They may, be employèd In ridootùhs yards,, ý'rivies, *aults, sinks, wtter-elosetssick bbds,',bed-pans,, âtlbles, and in other places about jntuÉ premises,'or whereVer practicable, when there are offensive odors emitted.",
         "DISINFECTANTS, AND 1-HoV TO USE THEM, tick-lîne -This may be employed aâ a purifier, to act a a dryei in'damp apartments, to absorb carbonie acid, a, d to assiht in the oxidation of organic matters, It nay be strewn as dry lime on the earth, or placed upoin plates, r, better still, in the shape of whitewash upon, the walls. n the latter forni, the addition of a small quanttty of carbol c acid adds to its eficiency. Charcal is a poWerful oxidizmg agent. It miay be used as a oodorant and disinfectant. It s)iould be freely 4rewn on l e floors of cellars, and al places which may be damp ai d Mouldy It shoulald always be used ia a crushed and resh state. Uarbolic id serves an excellent purpose as a disin.- fectant. Bein very strong it shôuld be considerably diluted with wa er A wineglassful (two ounces) of the pure liquid, weli mixed with a qtart of wârni water, for' use in night vess s, smks, water closets, lo for wetting*a bheet to hang in thg door way of the sick chamber. Half a wiîieglassful to odne quart of' iter for washing furni- ture, walls, \u0026 One pint of strong carbohc acid to five gallons of warm water, should be occasionally poured into binks and drains leading into sewers. One ounce of the crystals mxed with four pounds of slaked lime forms a good powder for covering over offensive heaps of fith oc refuse that it is impossible or inexpedient to remové, (Jarlbolc Acid Soa) For the hands. Sulphate of Iron, Sulpli'te of Zino, Su4lphate of Copper, Commoia Alum and ..Nerate of Lead are useful disinfectants to destroy living organisms, and to neutrahze. offensive, miasms. To use theni, dissolve one or two pounds of the substance in a gallon of water, and throw .the solution into the offdusive nass. Bulphate of Iron is the cheapest of thebe substances. Eight or ten pounds of it dissolved in five oe six gallons of warm water, with or witlíout one pint of, crude carbolie acid added, miakes the teapest and best disinfe ting fluid for common' us n privies, water-closetg, drains and sewers. Cl/eorde of,Ltne.-This spbstanue niy be'employed as the, most convenient and available eou4e of, chlorine. Exposed in an open dish, or strewn u\"on the loor, it Mwill",
         "4 slowly emit chlorinD! and may be made more copiously to yield it by the )iddition of a little vinegar. Foi the purpose of correcting offensive inatters, and for utensils, sinks, water closets, drains, \u0026c., it may be mixed with water in proportion of one pound to one gallon. , It is estimated that one pound of good chloride of lime will, on the average, disinfect, for tne time,- about a thousand gallons of liquid sewaoe. Pernanganate of Potas8ium.- luTJus substance does not exert much influence upon living substances, but is very powertul in disinfecting dead organic matter. It is, therefore, not so useful in the sick room as some other ,articles. The property of attacking dead and decaying organic matter makes it a val'uable purifier of drinking water. Make a solution of the salt as strong as water will dissolve, then add to this stiong solution from ten to five hundred parts of water, according to the requirements of the occasion. Lmen should be thoroughly immersed in it, and then speedily rinsed ont in cold water to avoid staining. It is among the neatest and most effectual of the disinfecting liquids, and can be used m smaller quan- tities than most others. Fumigation with Sulphui is an excellent method of purification. Place the sulphur ii an iron dish supported upon bricks, placed iu a wàsh-tub containing a little water; set it on fire by hot coals, or with the aid of a spoonful of alcohol.2 All doors, windows, and'other openings should be closed, and allowed to remain so about twenty-four hours. After this the room should he well aired for several dayb. About two pounds of sulphur will be required for a room ten feet square. °The amount should be -inereased for large1 iooms in the same proportion. Heat.--3oiling water or steam may be employed as the most certain rmeans of disinfecting contaminated clothing, \u0026c. Hot-.air is a ,good disintectant, but the teniperature must be fron 210 © to 250 o Fahr., i and applied at least one hour to be effective, to disinfect wearing apparel, bedding, \u0026c. Before t1e' emptyrng of pries or, ces\u0026pools, the con- tents, should be disinfected. For, effective, disinfection, a solution of two pounds 'of sulphate of iron (copperas), in a gallon.'of wter, or of one pint of a liquid obloride",
         "of zinc in a gallon of water (to each of which two ounces of strong Calbolic Acid has been added), bhould be used, in the proportion of one pint to each eubic foot of con- tents. After thorough disinfection, a quantity of-eithei of these solutions should be poured down daily, to keep the cess-pits in good condition. Chloride of Lime may also be used. PERSONAL DUTIES. Observe strict cleanliness in your person and clothing. Bathe daily, during the summer, if you have the convenience; if not, wash freely with cold water every day . Change your undergarments as frequently as youi circumstances -will admit. , Be moral, regular mn your habits of life, mieals, exercise and sleep. Be careful to dress comfortably for the season, avoid the night air as inuch as possible, and when thus exposed, put on an extra garment an'd do not go into the night air when in a state of perspiration. Be careful to avoid the use of alcoholic drinks Po not buppose that their use will prevent the occurrence of disease. On the other hand, those who ndulge in the cust'om are always fair subjects of disease, and when attacked, the intemperate are particularly in a condition to offer feeble resistance. Live temperately, ive-regularly, avoid alexcesses in eatng crude, raw and indigestible food. Take -your meals at regular seasons, neither abstaining too long at a time, , nor indulging too frequently. An overloaded stômach is as much to be dreaded as an'empty one. During the prevalence of cholera, dysentery, \u0026c,, do not neglect even the slightest diarrha, no matter how paiínless at first. While the health of the community depends in great degree, upon a rigid observance by oflicials of all the 4aws of public hygiene, it is no less dependent upon the faithful application of fthe prindiples of hygiene upon, the part of individuals, and it will be # satiefection to 'citizens to t 0 1o h I",
         "know, that whatevei labour and expenbe may be ncurred in uproving the condition'of their dwellngs will.- not be lost should no epidenic reach us, for the vei-y means that aie most efficient rn affording protection against the pre- ventable causes of epidemie disease are Most applicable and reliable against the propagation of disease in gener'al. The followimng buggestions are offered for the purpose of more widely extending the knowledge of a few well attested facts concerning the treatment of contagious sickness and to remnind all persons that greater care should be exercised to-prevent the Ipread of these much dreaded diseases. CARE 0F THE 810K. When a 'case of contýigious oi nfectious sickness occurs in any family, the sihk person should be placed in a ioom, apart fron the other inmates of the house, and bhould be nursed as far as possible by one person only. The sick chamber should be well warmed, exposed to t.unliglt and well aired. Its furnitmie should be such as vill permit of cleansing withouf injury, and all extra articles, such as window and table drapery, woolen carpets, upholstered fminiture, and all hanggs should be ienoved ftLom the roomi, durng the sickness. The physician and nurse, as a rule, should be the only persons admitted to the roon. Visitors to the mnfected house should be warned of the piesence of disease therein and children especially should not be admitted. Childien in the fau»ly should not attend school noi imingle with other children until the patient has wholly 1ocovered, and all infected articles have been disinfected. To dzsinfect the clotldng or beddmg tdefiled in any inanner by the excrenent of the sick, throw then into a solution made by dissolvimng together one pound of the Sulphate of Zinc, and- òne-h'alf pound, of salt in foui gallons of water, to which add two ounces of pure Carbohc Acid. Suffer them to remfain therein at least half an hour,; theii immediately place them irÉ boifng water and continvu -. 49",
         "I bòiling. The above solution 1s useful for bed pans cha ber vessels, and foi soiled floorb and defiled places The evacuations should be 1eceived at their very îssue from the body in a vessel containing about half a pmut of either the above or one of the followîng solutipns. A solution of four ounces of strong Carbolic Acid In a gallon of warn water. A solution of one quart of Chloride of' Zine in three quarts of water. A solution of two pounds of sulphate of iron (green copperas) in a gallon of watei. When death occurs, the body should be inmediately placed in the coffin, with disinfe4ýnts and the coffin tigh7fy andfnally closed. ý The funeral should be as pri ate as possible, and the corpse should not be exposed to view. CONCERNING SPECIAL DISEASES CHOLÉRA, Diarrhnea and other disturbances of the stonaci and bowels,itrequently precede an attâck of cholera, and place the person in the most dangerous condition foi the recep- tion of the cholera poison The excitiug causes of this condition are overloading the stomacly, taking large draughts of cold water, eating tainted and unwholesome meats, over-ripe or under-ripe fruits and vegetables, the intemperate use of spirituous liqpors, excessive exertion in the heat of the day, much exposure in the night air, sitting in currents of air and sleeping without sufficient coverîng, éspecially between midnight and morning. The early symptoins of the disease are sudden loose- nessof the bowels, the'iiseharges becomingcopious, watery and whitish, oppression, dizziness, nausea, vomiting and cramps in stomach and, legs. Ordinary diarrheeaLin timies of Choiera epidenic, should not be nèglected, and whei",
         "the above symptoms appear, miedicai 'aid rslîould be sum- nloned immediato1y, as -it 1% in this eariy stage that inedicai trcatment is of greatest use;' While 'waiting for the physician, put flie Lpttient-in bed and make hiot a ipli- cations fo feet, legs and bowd1m, There, are strong reoisons -for believing that the choiera poieon ,resides in the boivel discharges of the sufferer, and that the disease is commnimtiited to others, not tiuôpgh the atmosphcre, as is the case with small-pox, scarIQt-fevcér and mneasies, but by this ýpoison reacbing the stoinach and homwels throui the drinkhig-water or food. 4It is not, \"thertforè, necessary or wise to fieç froui ehoiera 'SutI'erers, who, if properly \u003cüared foi',, need flot con\u002bimurncate the disease to others. S$%ALL-POX. 'Vaccination is mine of the best means of preventing the attack of sinall-pox. El very chil 'shduld be vaccinated wsithini thrcc months aftcr it birthi, and any parents or Per\u0026oinà havingr chaige of, iafguits, and not having thern -vaecirnated are gruil ty of an offerice -which, in some countîie%,ý inaikes thent 1iabke to prosecation. and fines.. 1Ail pèrsons shoukd bé re-,Nticcinated, after twelve yetirs' of age. I Nurses should ûlways be selected froni\u003e those whe, are theniselves pi'otcpted frorn smia11-pox, either by hayîipg had: the disease, or hy havfipg bepn thorougfily vaccinateci. X'Vierc snù'ýll-pox prevails lu 'ar family or ,-cighboiebioi, every, person shoulid be imuiediately rcýiragninated ýunç1er the, dire1ction 6f alJegally 4ualificd mQedical practitioner, SinallIpox is suppQosed to b0m tdagro din\u003e Aeoù4vaeceiice, therýfbre,\u003c cvcry sniia-pôx piÏtient, shoùld lié strictly seclua1ed during the wvIoi9e prog-rcss of the eage , as wellr asdttniig èoùvaléscence. freom it 'arid mntil power of infecting others is pastè 'r TYPH1OL F1ÊVPRo -TyphQid feverb accordin to the rnMst reliatb ýAùthority r 1n4y be,ý eQ1t,,atetd by, nfection or ~o~aion. 'It *s 1s suppo8é,p ýùed tonatbeI *ouy dAcayd x L fi \u003ef r Jfi r\u003ef i \u003cf \u003e",
         "anim*band vegetable substance, foul drains and other souró of filth. The discharges froûri the bowels. of the typhoid patient are supposed to be the source of the great- est danger, and *may infect the atmosphere of the sick chamber, the drain, cesspool, vault, or by filtration may infect the well, ci'stei- or other soutee of drinking wafer, and-produce the disease in other persons. SoARLET-FEVER. Scarlet-fever is like small-pox in its power to spread rapidly from person to person ; it is highly contagious. The* disease shows its fii'st symptonis in about one week after exposure, as a- general rule ; and persons who escape the illness during a fortnight after exposure may feel thm- selves safe from an attack. Scarlet-fever, Scarlatina, Canker-rash and Rash-fever are names of one and the saine dangerous disease. On recovery, the sick person should not mingle with others, until all roughness of the skin, due to the, disease shall have disappeared; a month is considered an average period, during which isolation is needed. Beeause children are especially liable to take and to spread scarlet-fever, and because schools afford a free op- portunity for this, every child from a family in which a case of the disease occurs, should be kept froun school for a period of four weeks, coanting from the beginning of, an attack. DIPHTHFRIA. Diphtheria is contagious, and infectious, and may be easily communieated, either directly or indirectly, from person to person. It may be conveyed directly in the, act, of kissing, coughirig, spitting, sneezing ; or indirectly by infected articles used, as owels, napkins, handkerchiefs,\u0026c. The poison clings witl.great tenacity to rooms, houies articles of furniture and clothing, and may occasion the disease even after the lapse of months. Diphtheria attic1s al classes, at all ages and all sea- sons -of the year. By preference 'it attacks children and",
         "those who are debilitated from exposure to filth, dampness or, foul air frorn whatever source. It is better not to use handkerchiefs for cleansing the nostrils and mouth' of the patient, but rather soft rags which should be immediately burned. . Childret in the family should not attend school nor mingle with other children until the patient has wholly re- covered and all infected articles have been disinfeioted. C MEAsLEs. Measles, like scarlet-fever and small-pox, is liable to spread from person to person by contagion or by in- feetion. It may be contracted directly from the person- who is ill with t e disease, orit may be taken from the house in the e'othi g or anythigg that has been used by or about the sick persqn, and which has not been thoroughly disinfected. It attacks personsof all ages and at all 'seasons of the yeir. It manifests itself in About a week after exposure to the disease, and as a'rule, occurs but once in thesame person. The preçautiopary rmeasures mer tioned above have been compiled from the best information obtainable, and are most earnestly recomnendôd to the people, with the knowledge that their application. will avert a vast amQuit ofpreventible disease, and aid materially in mainiàining a sound condition of the publichealth. , 3y order of the Board ofHealth, J, C. M4OKINTOSH, Mayor, u Chairman Board of lIealth Joun MCIX*rs,, Ohairmay Snitary Coromm e. C ty Medical cet,",
         "I - i s à 4 f e, f e. f f f.\"JC - f - If J fIf.f \u003c '-f f ~1 'f f9.; 'f f f f f O f I~' -f.' 4 ff.41 ~ ~ e. ,1 ~ f Y fi f f 4 ~ 4V f \"'' r f - f' J f. f J t f f f. f ~ff f~f 4fv;~ 4~ '1% f f. f f ff.,1', f 4 C~f ~ i f f f ff, j\u003esJ1fX.c ff fi f f f 'f .? 4-, ,~ c f ff - f f ~ f f ff~4 ~'f \u003cif f ff.j .if 'f f f f/t f J ffff 44 4 \u003cC r ~' f ff ~ ~~~1f.fi\u003cf ~1 f . - 4 f. V f4\" \"~ - 6-f If C fi f f f f~ f. If '- if ~ - 1 c f"
      ]
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "Dominion Medical Monthly EDITORS: W. H. b. AIKINS. M.D. I W. b. NsSDITT, a.A., M.D., WI14 'r-e ACTwty coU.AoO$tAttON or A. Il. ATV(ERTON, M.1. J. J. t'.\\rfDY, M.D. A. A. MArlinNA1.0, M.n. l. 11 RURNs, \\A. J. 1.*R%*nON., M.n1. t;. s. XYERM.N, M.D1. VoL. 1.] TORONTO, ONT., NOVEMBER, d-93. [No. 5. ORIGINAL ARTICLES. (No papeir publi,ldc or to be pubtlishcd elowiere as origind wili be accepld in this el ut.) A BRIEF HISTORY OF THE RECENT OUTBREAK OF SMALL-1OX IN TORONfO.* nV J. E. GRA.\\.\\M, M.D., M.R.C.P. LOND., PROFEýor., 0F MEDICINE, TORONTO 11NIVERRITY. In response to the request of your honoured President, I have vrittcn -n the fol- lowing brief notes the history of the outbreak of variola, which took place in Toronto, invSeptemiber and October, 1S92, about a year ago. The points which are of special interest in the histories of these few cases are (1) the great difthult.y, ns well as the great importance of making an early diagnosis; (2) the difficulty of distinguishing in some cases the symptoms and signs of varioloid fron those of neeinia; and (3) the great value of general vaccination as a prevention to the spread of small-pox. On Sept. 12th, a patient was admitted into No. 5 Ward of the Toronto General Hospital, suffering from interstitial hepatitis and ilephritis, with cardiac complication. His temperature was elevated when he entered the hospital, and a rash shortly after- wards appeared which proved to% be that of c9fluent small-pox. The patient died during the pustular stage, thirteen days after his'admission into the hospital. The ward.tender H., who attended the patient above mentioned, ivas taken iil Sept. 25th ind the eruption appeared on the 28th. This case ran the typical course of a moderately severe form of variola. The rash was slightly confluent over the face and discrete over the remainder of the body. The temperature chart, as you will see, vas also quite typical, high during the stage of invasion, nearly normal during the first five days of the erupLion and rising again when suppuration took place. Unfortunately the conjurictivie were severely attacked and the sight of one eye was permanently injured. Otherwise he made an excellent recovery. He had never been vaccinated. 3 *Rea at Toroito Clinical Society, Octoccr i ith, 1893.",
         "D24 )OMINION MED1)ICAL ÏMONTHLY. The nurse, Miss C., who had also been in attendance upon the first case in Ward No. 5, was the next victim. She exhibited febrile symptoms, together with severe pain in the back and head on Sept. 26th, and the rash appeared on the 29th. This proved to be a case of varioloid. The pustules were more abundant on the face than on the body, but were nowhere confluent. In fact the rash was largely confinied to the face. The temperature chart in this case vas also quite typical of varioloid, and there is nothing specially to note in the history. The patient made a good recovery. A few superficial cicatrices remained on the face. She had been vaccinated during childhood. Both of these patients were at first isolated in the atic of the Toronto General Hospital, and afterwards, on Oct. 7th, sent to the temporary small-pox hospitai. On Oct. r2th, Dr. W., the resident assistant physician, who had charge of Ward No. 5, in which the first patient was treatåd, and who had been more or less in attendance on the wvard tender and nurse, vas suddenly seized with chills, followed by high fever, with severe pains in the back and stomach. On the third day a scarlatina- form rash appeared, which spread )ver nearly the whole of the lower part of the trunk and lower extremities. On the fifth day the rash disappeared, and a few papules were noticed, about a dozen in number, which rapidly becane pustular and soon underwent des;iccation. As the papules appeared the constitutional symptoms entirely subsided. The tenperature during the period of invasion ranged about 102' to 103', and fell when the papular eruption appeared. Dr. W. had been vaccinated in childhood, and was again vaccinated on Sept. 26th without result. This case presented great diffi- culties in diagnosis. The fever and severe pain in the bowels at first suggested peritonitis, then the scarlatinaforn eruption suggested the possibility of the p.odronial rash of variola, or perhaps the erythena accompanying some other septicæemic condition. The pustules were so few in number and disappeared so quickly that the case might almost be considered to have been one of variola sine eruption. Owing to the doubtful char- acter of the attack the patient was isolated in the attic of the hospital, and was not sent to the temporary building erected for the sniall-pox cases. During the course of the disease I was in great doubt as to its true character, but after its fuil development, and upon taking a'l the facts into consideration, the only conclusion I could arrive at was that Dr. W. suffered from a very mild forn of varioloid. If the vaccination done in Sept. 27th had been successful the difficulty of making a diagnosis would have been .much greater, as is shown by the history of the next case. Nurse M., who had spent a good deal of time with Nurse C. in the early part of lier illness and n ho was vaccinated on or about Sept. 26th, was on Oct. îoth taken ill with chills and fever, together with pains in the back and limbs. Her arm was at the sanie tine nuch swollen, and the skmn as far as the elbow presented a reddened inflamed appearance. On the third day after the commencement of the fever a scarlatinaform rash appeared over the lower. part of the abdomen and lower extremities, which ran its course in about three days. Upon] the disappearance of the rash, the fever and other constitutional symptons subsided and the patient, although a little weak, felt otherwise quite well. No papules or pustules appeared on any part of the body. The patient was isolated in the attic of the hospital until her recovery. The opinion generally expressed by those w'ho saw her, an opinion in which I concurred, was that the fever and rash was due to the vaccination. It would, however, .be extremely difficult to prove that the case was not one of variola sine eruptione. 124",
         "DOMINION MEDICAL MONTHLY. Dr. M., who had charge of the ward-tender and nurse while they were in the attic of the hospitai, was vaccinated on Sept. 29th. The vaccination was not successful, and on Oct. 2nd he removed the dried blood with his finger-nail, inflicting a slight wound. Tie. part shortly afterwards became inflamed, and in eighit days froin this date, on Oct. xoth, he was seized with chills and fever. At the sane time the seat of the vaccination was occupied by a large characteristie pustule and a general sub- cutaneous cellulitis existed throughout the arm. The glands in the axilla were swollen and movement of the limb produced pain. For the first two or three day ive vere of opinion that the corstitutional symptonms might be altogether the result of the inflammation of the arm. On the third day, however, the temperature fell nearly to normal and a nunber of papules, about ioo, appeared on the face and upper part of the trunk, which presented a hard, shot-like feel. These changed r':'dly to vesicles and pustules passing Lhrough the typical stages in a very short time. After the coim- mencement of the eruption and upon the subsidence of the temperature the case vas diagnosed as one of varioloid, and the patient was sent to the snall-pox hospital. The question might here arise, might this not have been a case of vaccinia, in which the pustule was delayed in development, and ii vhich the eruption became general? The decision was given in the negative. It is a little dorbtfui if such a condition exists as a general vaccination. It is at any rate very rare. Many of the cases reported under this head have been the result of secondary inoculation or a simple pustular eruption. In this case the papules presented the usual marked shot-like feel, and ran the ordinary course of variola. The patient nade a good recovery, and a few indistinct scars were ail that re- mained after the disease disappeared. Another interesting question arises in connec- tion with this case. Might it not be possible that the patient inoculated himself when lie removed the dried blood from the seat of vaccina'ion. On Oct. 2nd lie vas then in close attendance upon the two small-pox patients, and might possibly have conveyed the virus on his finger-nails. The eruption appeared on the 1oth, just eight days after inoculation, the time usually occupied by the stage of incubation in such cases. It is, of course, impossible to decide this point, as the Doctor was constantly exposed at the same time. Dr. B.. who practises in a suburb of Toronto, called to see the patients, the ward- tender and nurse, on Thursday, Sept. 22nd, and remained about fifteen minutes in the wards. The Doctor is a careful observer, and, no doubt, closely inspected the eruption. On Thursday, Oct. 6th, exactly two weeks after exposure, prodronal symp- toms commenced, viz., an occipital headache, which gradually increased in severity on the following Saturday, the constitutional symptois became intensified. He then experienced a feeling of pain and stiffness in the muscles of the back, constriction of the chest and sore throat. His appetite, however, remained good and he did not notice any loss of strength. On Saturday, he experienced a slight anorexia, a peculiar irritable feeling over the whole body, difflcult to describe, pain in the joints and in the lumbar region. He suffers .om marked insomnia. Temperature at night, 102°. On Monday, the pain in the back increased in severity, and. was also felt in the region over the lower ribs, in the joints, especially the right knee and ankle. Head- ache continued, appetite gone. Pharynx very red and painful. On Tuesday afernoon I saw the patient. We discussed the possibility of variola, but as the temperature had not been high and on account of the congestion of the 12S",
         "DOMINION MEDICAL MONTHLY. mucous membrane of the pharynx, swelling of the joints, and especially on account of the long time which had elapsed since exposure, we thought the case vas probably one of subacute rheuniatisn and prescribed soda salicylate and phenacetine. The temperature that night rose to 1022°. On Wednesday a few shot-like papules appeared on the face and at the roots of the hair. On Thursday the pains became much less severe and the papular rash extended over the scalp and right side of the face. A few spots only were scattered over the chest and arms, and one or two on the paln of the right hand. Tenperature fell to 99. The attack may be said to have ended with the exception of great bodily weakness and deprcssiorn (pulse 40 -50), a condition possibly due to the anodyne and anti- pyretics lie liad taken. No secondary fever followed. The rash seemed to abort largely in the vesicular stage, as only a few pustules were forned. The skin presented a smooth surface in about ten days after the commenceient of the eruption. Con- valescence was rapid and uninterrupted. I have given the history of this case more in detail, as it presented many very interesting points. (\u003c) The long stage of incubation, sixteen or seventeen days froni the time of exposure until the first rise of tenperature. Fourteen days are given as the maximum length of the stage of incubation. The cases reported in which this stage was apparently prolonged to twenty-two or twenty-four days were probably instances in which the poison may have been carried about the person some days before actual contagion took place. (2) The mildness of the constitutional symptoms in the stage of invasion. The pulse remained about 1oo-1 1o, and the temperature did not rise higher than io2-. The pain in the back was not more severe than in other parts of the body. As a general rule the constitutional symptoins of varioloid are very severe, even in the milder cases. Altogether the diagnosis was extremely difficult, and was not made until the appearance of the eruption. The misleading features were the length of the stage of incubation, the comparatively speaking rnild constitutional symptoms, and the prominence of the joint pains. Dr. B. had been vaccinated when a child, and no doubt the mildness of the attack was due to that fact. As soon as the eruption appeared he was remov. d to the small- pox hospital, where he remained some weeks. It will thus be seen that the number of individuals attacked was six, and that of these five recovered. Of the latter all had been vaccinated except the wvard-tender, and he only had the confluent forni on the face. It is surprising that the disease did not make further ravages. The limited character of the outbreak can be explained in two ways: (1) The general adoption of vaccination, and (2) the complete isolation of the patients, when the diagnosis was made certain. One would have supposed that patients in Ward No.- 5, in which the first case occurred, might have contracted the disease. So far as I recollect the patients in adjacent beds suffered from typhoid fever, and according to som-ie authorities the presence of this disease renders the individual impervious for the time to- the small-pox virus. It might be interesting here to relate, although not bearing directly upon the subject, that in the typhoid cases vaccinated, the vaccinia ran a typical course ; in one, however, the development of the vesicles was immediately fol- lowed by a relapse of the fever much more severe than the original.attack. The question of most importance suggested by the histories of these cases is: How early can a diagnosis be made; not a positive diagnosis, but one which would 126",
         "DOMINION MEDICAL MONTHLY. lead to the taking of proper precautions to prevent its spread ? The two synptoms which should lead one to suspect small-pox arc: (i) The sudden rise of temperature; (2) The severe pains in the back, aching of linibs and nausea with or without voniiting. The sudden rise of temperature may occur in pneulmonia, scarlet fever an1 erysipelas. Pneumonia can usually be distinguished by the frequency of the respirations, as well as by other auscultatory signs. And in erysipelas the local signs present them.27 selves early. Much attention should be paid to the presence of severe pain in the back A case which I had to do with in my first year in Toronto often occurs to me in this connection. A few months after conimencing practice I became connected with the volunteer force, as assistant surgeon to the 1oth Royals. Iii the month of June I accompanied the regiment to camp at Niagara, and on the iorning of our arrival, while the tents were being put up. I was called to see one of the mien who had been taken suddenly ill. I found the patient in a high fever, and suffering from a severe pain in the back; no eruption. Knowing that snall-pox existed at that time in the city, the presence of that disease at once occurred to me, and I concluded to send the patient back as soon as possible. Fortunately the boat had not left, so that the man returned to Toronto that forenoon. He suffered from a severe attack of variola. The presence of variola in the neighbourhood is no doubt a great aid in forming an opinion. In the first cases our suspicion may be sufficiently aroused to put us on our guard, but a definite conclusion cannot be arrived at until the eruption appears. The presence of the initial rashes is an important element, and one which is some- times very confusing. Dr. Savill, in a recent paper on the diagnosis of small-pox in its early stages, expresses the belief that these initial rashes are comparatively rare. In the six cases I have related, they were present in two, one of variola and one of vaccinia. These ;ashes are either scarlatinaform or morbilliform in character, and occur en the seco:d or third day of the stage of invasion. The principal characteristics which de.cinguish thern from measles or scarlet fever are: (r) Their appearance over tbc lower part of the trunk and the thighs, but in sone cases they are more general ; (2) They disappear in one, two or three days; (3) They are not acconipanied by the symptoms either of measles or scarlatina. Even when the papular eruption peculiar to variola appears there nay stil! exie sonie doubt as to its character. The most striking feature is the peculiar, liard, shot-like feel of the papules, which are first found on the forehead or at the roots of the hair. Dr Savill recommends careful examination of the forehead by passing the fingers over the surface even before the appearance of papules. They can be felt before they are seen. The accompanying fall of temperature and subsidence of constitutional conditions is, of course, a great aid to diagnosis, as 'uch a change does not take place with any other eruptive fever. One of the greatest difficulties we experienced in the recent outbreak ivas the diagnosis between varioloid and vaccinia. Such difficulties must frequently arise, because so many vaccinations are done when a case of variola appears. It will be noticed thàt a great similarity existed between the cases of Dr. W. and the Nurse M. Both suffered from high temperature, both had prodromal rashes, which bore a striking resemblarnce to one another, and in both cases the temperature fell on the disappearance of the rash. In Dr. W.'s case, however, the vaccination was",
         "DOMINION MEDICAL MONTHLY. not successful, his temperature was higher, and on its fall a number of shot-like papules presented themselves, which underwent development into vesicles and pustules. If the vaccination in Di.. W.'s case had been at all successful, the diagnosis would have been much more diflicult, if not impossible. The diagnosis between varioloid and varicella, although generally not difficult, may occasionally give rise to a good deal of doubt. In New York State, some years ago, an epidemic of varioloid was mistaken for varicella until two or three undoubted cases of small-pox made their appearance. The severe constitutional symptoms and the prolonged character of the stage of invasion are the principal means of diagnosis until the eruption appears, which, in varioloid, presents the peculiar shot-like feel. The soft character of the papules, the very superficial vesicles, and their appearance in successive crops, are very characteristic of varicella. Measles are suinetimes nistaken for small-pox, and instances have not infrequently occurred in which actions for damages have been taken for sending patients suffering from that disease to the small-pox hospital. The greater severity of the constiLutional symptoms in the stage of invasion, the absence of marked catarrhal conditions, and the presence of the hard, shot-like feel to the papules, will be sufficient in most cases. Then, as Dr. Savill remarks, the element of time is an important one in diagnosis, so that the age of the eruption should be carefully noted. At the end of twelve hours the papules of measles begin to fade, those of small-pox get harder and larger, and after an interval of twa days, become vesicular, whereas varicella is vesicu-ir almost from the very commencement. In these days, when vaccination is so generally practised, the majority of cases of small-pox are mild-some so mild as to be mistaken for acne. In the mildest cases of varioloid, however, there are some constitutional symptoms, and in acne the age of the spots and the presence of comnedone are sufficient to make a distinction. Some years ago, when an interne in the Brooklyn City Hospital, a patient was admitted in a partially comatose condition, and before a history of his case couid be obtained he died. His body was in many parts covered with a rash, which strongly resembled confluent small-pox. In such a case the want of knowledge of the previous history of the patient may make the diagnosis somewhit uncertnn. I have not spoken of the peculiar odour as an aid in diagnosis, . - developed until afl doubt is past as to the nature of the disease. My experience in the recent, as well as in former, outbreaks teaches me that cases of varioloid occur in which a diagnosis is almost impossible, even when the disease is fully developed, and that the proper management of such cases require complete isolation, and at the same time their not being exposed to the virus of the disease while any doubt exists. A special ward for such doubtful cases should exist in connection with the Isolation Hospital. The expectant plan was followed in the treatment of conjunctivitis the following solution was used: Atropia sulph., grs. ii.; resorcin, grs. v.; acid boracic, grs. x.; aq. distillat, 3 i. At the same time the eyes were b-ithed with a warm boracic solution. No local treatment was used to prevent pitting. Mild disinfectant sponge baths were used for the purpose -f cleanliness and sterilization. As to the pathology of small-pox, little has been ïidded to our knowledge in recent years. It is probable that it, as well as the other -xanthems, are examples of germ diseases; but the micro-organism peculiar to it has not yet been discovered. 128",
         "DOMINION MEDICAL MONTHLY. Vaccinia, the virus of which is in all probability a modification of that of variola, has been thoroughly investigated by Dr. Martin, of Boston; but I an not aware that he lias yet arrived at any dernite conclusion. The importance of the presence of pus organisms lias been fully substantiated. It is doubtful if we can add niuch to the following conclusions arrived at by DF. Sydenham over two centuries ago : \" As to what may be the essence of small-pox, I am, for ny own ,art, free to confess that I an wholly ignorant, the intellectual deficiency being the mislortune of human nature, and common to myself and the world at large. Nevertheless, when I carefully weigh the evidence derived fron the above-naied symptoms, it suggests to nie the idea of inflammation-of an inflammation specifically different froni all others-of an inlamma ion, both of the blood and humour. In clcaring herself of this, nature is at work during the flrst two or three days at the digestion and concoction of the infiamed particles, with the intention of afterwards discharging then upon the surface of the body for the sake of maturation, and finally of expelling then froni her boundaries under the form of little abscesses.\" ULCERS OF THE LEG AND VARICOSE VEINS. BY W. W. BREMNER, M.D., TORONTO. Late Assistant Surgeon to the Hospital for the Ruptured nnd Crippltl, New York. Ulcers of the legý are very frequently found to be difficult of cure. Many methods have been advocated for their treatinent. The object of this paper is to bring to the notice of the Canadian profession a very simple and successful method of treatment which has proved, after an extensive trial, both in private and hospital practice, very satisfactory in the relief and cure of that rather difficult class of cases. It consists in the application of a perfectly flexible and absorbent dressing in such a way as to restore the venous circulation and remove all cedema from the leg, at the saine time absorbing all the discharges and pernitting of free and painless exercise. The materials chiefly used are circular cotton bandages (knitted), three inches wide in six yard rolls, absorbent lint and suitable ointnents and lotions. There is no special ointment suitabl- to every case, but each case must be considered separately. Whatever kind of ulcer, or wherever situated on the leg, the bandrfe must be applied in the sanie way. To apply the bandage and dressing, cut a piece of absorbent lint the size of the wound, and apply to it the ointment thought suitable; place this on the ulcer, and over it place several thicknesses of lint larger than the ulcer. The patient should be seated in a.chair and place his foot on a stand of the sanme height. Wherever the ulcer is situated, the bandage must be applied so as to evenly compress the whole leg from the toes to the knee, making the pressure rather greater at the lower portiori of the leg. No reverses should be employed, and 'it requires many more turns on the ascending portion of the leg, where only the top edge of the bandage holds, than are required on and above the calf. This is important, as too much pressure above congests the lower portion of the leg. It makes a much nicer finish to put on the last roll from above downwards, thus keeping in the loose lower edges. Four rolls (twenty-four yards) are required at least, for each case; two rolls on the leg and two for washing. In heavy patients it is better to use more bandage. The idea is to have the pressure so regu- lated that the venous circulation is restored to its natural condition, while the arterial is unaffected. The change thus produced in an -ulcerated and cedematous leg is like 129",
         "DOMINION MEDICAL MONTHLY. that produced by proper drainage in an unwholesome swanip. The dressing should be changed on an average every second day. In the great majority of cases in private practice and in those coming to the Rospital for the Ruptured and Crippled, New York, this was found sulficient. When the ulcer is cured, it s better to continue the bandage for several months. Patients can be taught to apply it themselves. 'Free exercise is most beneficial, and patients cai continue their work as usual ; in fact, the very first application usually relieves nost of the pain. In varicose veins the bandage should be applied in the same way, and on the whole is much superior to elastic stockings. In recent wounds of the leg this inethod of bandaging shows to greatest advantage. In acute synovitis of the knee, or indeed of any joint, it is most valuable ; giving an even, constant pressure unobtainable by any other means. It is most useful after adhesions in a stiff joint have been forcibly broken up. A synopsis of the first ioo cases of ulcer treated by this bandage is appended, but is omitted for lack of space. The average period of treatmîent was five w'eeks. Eiglity per cent. of the patients were permanently cured (nany of these cases being very chronic) ; in inost of the remaining twenty per cent. the pain was relieved and the swelling renioved. 39 Bloor Street East. CLINICAL NOTES. ANTE-PARTUM )ECOM POSITION OF THE PLACENTA, WITH MATERNAL INFECTION.* BY G. S. CLELAND, M.D., TORONTO. During the evening of Deceiber the 17th, 1891, I was asked to sec Mrs. R., aged 34. She infornied me that she had had several severe chills, followed by fever, and was then suffering with headache and an aching over the body generally. She did not direct my attention to severe pain i any particular location; temperature, 104 F.; pulse rapid. I ascribed lier condition to an attack of la grippe, which was then preva- lent. About 5 o'clock the following morning I was a i,î sunmoned and found lier recovering fron a chill more severe than any previous. Her condition was altogether much worse, the temperature being 107.2 F. ; pulse, 16o. I then endeavoured to ascertain some other cause for lier condition. She had been married àbout six nionths, menstruation taking place regularly, and living no other symptonis of pregnancy, she did not think herself pregnant. On examining the abdomen, I found the uterus enlarged and apparently gravid ; there was no vaginal discharge. The temperature did not remain high, but gradually lowered so that in half an hour after, when Dr. A. F. McKenzie saw lier witli me, it was 105 F., and fell sonewhat lower before we left lier. Larger doses of sulphate of quinine than she had been having during the night were ordered. I saw lier several times throulgh the day, when she.appeared to be improving. In the evening-that is, twenty-four hours after my first visit-I was again summoned, but being engaged, requested Dr. McKenzie to see her. On his arrival lie learned that the fotus had been expelled and destroyed, so that he did not see it. He however, renoved the piacenta, which was decomposed and very offensive; after irrigating the uterus, he left the patient confortable. She ultimately made a good recovery. Read at Toronto Medical Society. 130",
         "DOMINION MEDICAL MONTHLY. Reports of Societies. THE CANADIAN MEDICAL ASSO- CIATION. ( Coiitiiuellfrt-it las ntnit r. ) Reported by Di. J. N. E. Bwows Omchi steogapher of the Ascain ADDRESS ON SUIFRV. Dr. -ingston,,of Montreal, gave the address on Surgery. It consisted of an historical review of the subject. He held that in Egypt, before the time of Moses, many so-called modern operations were practised. The Greeks considered surgery a divine art. Pythagoras, about 6oo B.C., elevated surgery to a science. The Egyptians and Greeks practised neph- rotomy, used tents, issues and noxas, and trephined the skull; they also practised percussion as. an aid to diagnosis, and drew fluid fron the chest. Hippocrates made use of immediate auscultation as a meais of recognizing disease. But the fall of the Macedonian Empire seriously interfered with the progress of surgery. The Alexandrian school were skilful in abdominal surgery. They first used the catheter 22oo years ago Ammonius crushed stone in the bladder. There was another retrogression in the science at the time of the Ciesars. Celsus found that there might be rupture of brain sub- stances without fracture of skull. He was first to describe the contre coup. Hele- donius opened the bronchial tubes. The Arabians were credited with greater po- ficiency in surgery than history willjustify; but to them we owe the preservation of Egyptian surgery. ie suturing of wounds was practised by Albicasis, also the incis- ing of the kidney for abscess. The Council of Tours forbade the clergy to spill blood. By this prohibition surgery was divorced from medicine and got a serious set-back. When Columbus dis- covered America the physicians of Europe were not superior to the medicine men of the aborigines of America. Vesalius laid the foundation of modern surgery. Par advocated cupping for displacements of the uterus. Wiseman, in Britain, was original but crude. His reports of sue- cessful treatment of cancer are so reniark. able as to arouse suspicion as to the accuracy of his diagnosis. Wiseian believed iii the magic royal touch for the king's evil. Surgery, the speaker went on to say, preceded iedicine in this country. The Governor of Nouvelle, France, was always asking for surgeons to be sent out. The people did not need physicians. Dr. Hingston then described the marvellous advances of surgery during the past forty years in the treatment of many surgical cases; but was sorry that in sonie cases this divine art had so degenerated to a commercial question, owing to the greed for gold spirit which had extended to some of the niembers of the prokssion. le especially cauterized the practice of those one-idea gynocologists who referred all fernale disorders to the uterus and iratituted a daily tinkering process as a means of obtaining money. THURSDAY MORNING. Dr. Holmes, of Chatham, read a paper which consisted of a report of two cases of laparotomy for unusual conditions. The first gave a history of nisca rriage preceded by læmorrhage, and this was followed by pain in the left iliac region, where a-swelling was discovered like an orange in size and shape, two inches to the left of the uterus, and fluctuating. Laparotomy was per- formed, and an ovary containing three ounces of pus removed. The abdominal cavity was flushed and usual dressings ap- plied: no drainage tube. The important point in the case was that there vas no disease of the tube. This was unique as far as he was able to make out from the records. The second case Dr. Holmes had seen after the patient .had been iil ten days. Pain was present in right iliac region where",
         "DOMINION MEDICAL MONTHLY. the attending physicians detected sone hardness. Chills and fever, constipation, voniiting and great prostration were suc- ceeding symptons: also great tympanites. No tumour could be made out at this time. Exploratory incision was deemed neces- sarv. Appendix was sound. There was 1n obstruction, but peristalsis was absent. The gut was stitched to the wound, with the idea of incising if bowels did not niove soon. This .had to be donc, the patient being then almost in extremis. A copious evacuation of foecal niatter fron the fistula took place. Stinulants could then be retained, and the patient improv- ed. But the fistula was a great annoyance. DM. Holnies mode several unsuccessful attempts to close it, but failed. Patient was then transferred to -Iarper's Hospital, Detroit. Resection of the aifected por- tion of bowel was made and the ends join- ed by Murphy's buttons. Patient made a good recovery. 'The doctor showed the kind of button used, and gave a report of operations in which it had been success- fully employed. 'Dr. Atherton agreed with Dr. Holmes that abscess of the ovary without affection of the tube was rare. In regard to peri- tonitis with paralysis, he found puncturing, to allow the gas to escape, a good measure, two or three times if necessary. He had seen no trouble arise from such proceed- ing. This might be tried and laparotomy avoided. Dr. Holmes replied to this by saying that he had employed this measure, but it was in cases where the abdominal walls were thin. Where the walls were thick, as in the case reported, he considered it un- wise. In fact, when the abdominal wall was opened, one of the assistants intro- duced a small trochar, but without relief of the syrmptoms. Dr. Bell, of Montreal, then presented a paper on- \" SoME UNUSUAL CONDITIONS MET \\VITH IN HERNIA OPERATIONS.\" The doctor reported five cases, all of marked interest. The first vas a case of hernia in a woman aged fifty-five. There were not the syniptomns of strangulation, but she suffered great pain. Teniperature, 102; pulse, oo; bowCls open. The tumour was situated in Scarpa's space in right groin, looked livid red, was indurated at the base and fluctuating-a pointing abscess, in fact. It was opened : a pint of fætid, sanious pus escapcd. A mass of onientum protruding was cut off. Then the interesting point in the case was noticed-in the centre of the mass was a tubular cavity resembling the large intes- tine. It was stitched into the skin wound. To the outer side of the mass the appen- dix was found strangulated and sloughy. This was rernoved and bowel returned. Patient made a good recovery. The second case was one of congenital inguinal hernia attached to the bottom of the tunica vaginalis. The hernia was easily reducible, but would not stay so. It was so troublesome operation was decided upon. Was omental and the peculiarity was, which accounts for the inability to retain it, a hyditiform cyst growing from the omentum and adhereat to the bottom of the sac of the tunica vaginalis testis, just long enough to allow the hernial con- tents to escape within the internal ring, and yet short enough to naintain constant traction upon chis portion of omentum and bring it down in spite of any truss. The protruding omentum was tied and the cyst was removed. Patient made a good re- covery. This was a unique case, Dr. Bell thought. The third was a case of congenital cœcal hernia in a child three years of age. Hernia had existed fron birth and was irreducible. Radical operation done. Through the peritoneum, the cScum and ileum could be made out, and were founid adherent to the cord. Even after splitting canal it was impossible to reduce. When peritoneuni was opened and trar tion made on ileum, it readily slipped.",
         "DOMINION MEDICAL MONTHLY. back. The supierfluous neck of the sac was dissected aiway and the remainder sutured down around the cord, the con- joined tendon brought over and sutured to Ponparts' ligament and canal closed by a suture. The next vas a most interesting case where there was hernia of a tubercular ovary and tube, through the inguinal canal of a female infane. It was diagnosed omental hernia,-was solid to feel, freely moveable, pediculated, and gave an im- pulse when child cried. Was exposed but scen iot to be omentum. Resenbled undescended testicle, but patient was fernale. Was removed-diagnosis still uncertaii. Operation finished success- fully. Subsequent microscopical examina- tion revealed tubercular cystic ovary. The final case cited was a most inter- esting one-suppurative inflammation of hernial sac simulating strangulation. On- set sudden (from a fall), and constitutional symptoms rapid, calling for immediate action. Cutting down sac was found very thick and -edemations from which, upon incision, half an ounce of sero-pus escaped. It was occluded above. Another incision was made into the sac above the occlusion and a loop of small intestine scarcely con- stricted, slipped back into abdomen. Patient got entirely well. Thie doctor in- clined to think patient had suffered from hernia before, that sac had become shut off, and that the reputed recent cause merely pressed it further down, and the manipulation for reduction had set up an inflammation, possibly through the agency of the anoeba coli, which went on to sup- puration. Dr. Canniff asked how Dr. Bell diag- nosed the omental tube which was cut off from intestine. Dr. Bethune detailed at length a case of strangulated hernia which ivas not operated on, on account of stubbornness of patient. Suppuration occurred, and a focal fistula established, which finally closed and patient made a good recovery. Dr. McFarlane, Presidetnt of the On- tario Association, and Dr. Temple, dele- gate froni that body, were ivited to seats on the platform. Dr. Bryce vas not present to read his paper on \"PorH1vALxis IN 'Tu'rRcU- LOSIS,\" but his paper vas handcd in as read. TIURS1AY, P.M. The Association assembled in Victoria Hall at 3.30. Dr. McPhedran addressed the Associa- tion on the subject, \"THE MORE RECENT METHODS or DIANcosis AND TRE1AT- MENT oF DISEASES OF THE S'TOM\\CH.\" He said that fornerly it was taught that the stomiach w's the principal and only organ of digestion, but now it vas known that the whole aliientary tract takes part in the digesting p-rocess. He said the function of the stonach vas three-fold, viz.: 1, To receive food and to partly change starchy and albuminous food into absorbable bodies. 2, To pe- vent the fermentation of the food. 3, To discharge its contents partly into the blood, but chiefly into the dueodenum. For the first three-quarters of an hour no free hydrochloric acid was, he said present in the stornach, as it combined vith the albuminates, if present; there was hypersecretion of it, which arrested the digestion of the starches. It reached its maximum in onount in four or five hours. The gastric juice retarded the ac- tion of, or destroyed more gerns, speciflc and non-specific, than any of the other digestive ferments. The duration of nor- mal digestion, he said, depended on the character and amount of the food, also on the age of the patient. The symptons of stonach disorders were multiple and various until the last aecade ; our knowl- edge of gastric disorders depended on experiments and symptoms, accidents, etc. Noyv we owe nuch of our knowledge to the stomach tube. Thi-, ) said, should be soft. The patient not only readilybecame accustomed to it, but even often would 133",
         "DOMINION MEDICAL MONTHIX. request its use. An approximate knowl- edge of the stonach's con'.ents would, in most cases. be all that was requisite for the physician in active practice. A test breakfast should be given consisting of a round of toast or a riy roll, with a cup of water -r of veak tea or coffee, without sugar or milfl. This should be withdrawn from the stomnach after one hour's diges- tion. The acidity of a normal stomach, lie said, should be due to lactic acid for the first thirty or forty minutes, after this tine to frec hydrochloric acids. These acids were discovered by Uffimann's and Clinherg's tests respectively. It had been taught that absence of hydrochloric acid indicated carcinoma. This was not so. It miglit be absent in other conditions and present even excessively, in this. Hovever, it could be said that its ner- sistent absence foried strong evidence in favor of cancer. The tube was useful in discriminating between gastric catarrh and carcinoma. The washing out would be followed by improvemwent in cases of the first, but not much in the second. Its principal use, however, was in dys- pepsia, in determining the solidity of the contents. On this our treatment could be based. The lavage sti.mulated the gastric gland secretion, and s:imnulated the mus- cular walls to renewed activity. Proper dit and genera! treatment would suffice to cure many cases. This treatment was particularly usefut in alcoholics, also in infantile disturbanices. Constipation was relieved by its use, also the gastric neu- rosis ; reflex voniting of pregnancy, the the patient being fed through the tube. This subject was one of immense import- ance on account of the immense frequency of the disease of the stomach, four-fifths of all the ailments medical men were called on to treat being caused by derangement of this organ. Drs. Ferguson, \\Vesley, Milils, Gardner and Praeger discussed the paper. The meeting then divided into sections, Dr. . H. Canieron presiding over the! Surgical side, while Dr. Moorhouse pre- sided over the Medical. SURGICAL SECTION. Dr. Primrose preserited a paper, subject, \"A L.ARGE SARCOMATOUS GROWTH IN THE NEcK, wITH SECONDARY !E)Pos1T IN THIE Luso;.\" It was found in a boy four years of age, a patient in Victoria Hospital, To- ronto, under Dr. Cameron. It extended on the riglit side of the neck from the niedian line in front to a point tcar the vertebral spine, and fron the lobule of the ear to the clavicle. Was noticed two years and three nonths before, corresponding to the region of the right lobe of the thyroid gland. Caused little pain, was sornewhat lobulated, with promineit vuins coursing over its surface. Fluctuation distinct. Measurement on tumour side of neck, hori- zontally, 15»% inches ; left sicle, 6 ilches from lobule of car on riglit side (over tumor), to outer extremity of the clavicle 7 ilches, on left side, 25, inches. Left pupil twice the size of riglit. Some dys- phagia. Child died in July. The tuior was found in the P. M. to possess several processes, but it had not infiltrated or eroded the surrounding tissues, a point to be considered in the diagnosis. There were secondary deposits in the lungs. The anatonical relations of the various structures adjacent were much altered. The large vessels on the tumour side were entirely obliterated; those on the left side were enlarged. The processes spoken of were in the direction of least resistance. The muscular structures in the neighbor- hood were atrophied. In the upper part of the tumour there was a predominance of fibrous tissue, and septa of this tissue divided it off into lobules of spongy tissue. A peculiar con- dition was found in the spinal cord, the cord bein£ surrounded below the dura mater, by a mass of tissue, resemibling in gross appearance the tumour growth, out it was not the same It contained con- 134",
         "DOMINION MEDICAL MONTHLY. nective tissue corpuscles and nerve cells and fibres. Its nature Dr. Prinrose had not made out. The tumour itself was ex- arined imicroscopirally, and proved !o be sarcomatous. The beauty of Dr. Prim. rose's paper was that lie had froren trans- vers- sections througlh the child, whirh exenplificd iii n anost splendid way his palper. The sections were nmuch admired by the Association. Photographs of the saine were also presented for inspection. Dr. Praeger spoke in high ternis of the paper and the sections. Dr. R. Fergusotn, of London, then gave a report and presented \"A !EcENT SUccEssruL CAE Of CIoutcY'TroMv.\" The symptoms of gall-stones in this case were for a long time obscure, the pain being referred*to 1he epigastrium ; no pruritus, fieces lacking the characteristic colour, and the absence of jaundice. Pulse and ten- perature reniained normal. She had many attacks of pain which were relieved by hot appliances and morphia. These paroxysms did not appear or disappear suddenly. Gastric ulcer, gastritis and intestinal colic were excluded. Gastralgia as probable. Stomachic treatment gave no relief; the ordinary treatnent for gall-stones afforded no relief. But finally snoie of the typical symiptons of gall-stones began to show themselves. Patient was transferred to the hospital with a view to operation. But after lying quietly for two or three weeks, she improved so nuch that she went home, operation being postponed. But she soon became worse. On one occasion she had felt, :after a severe par- oxysm of pain, a dropping of something iii the region-where the pain existed. Opera- tion was gone on with. Eighty gall-stones removed. The edges of incision of the gall-bladder were sutured to the edges of the wound. A-cough retarded the process of healing. Repair did not take place w'ell. Suppuration set in. Parotitis in left gland set in; also a localized peritonitis. The attacks of.pain returned. Dr.F-erguson then-tried to insert a catheter through into the bile duct, which lie thought lie acroi- plisheol. ''he side of the catheter appeared to grate on soie hard substance, but improvement took place, and patient re- turned home in ten and one-haif weeks after the operation. But in four wtks he symptons re.appieared, pain 'very severe, chlioroforni had to be administered con.- stantly, as norphia seened insut\u003ciicnt. She inhaled thirty-six ounces. Another operation was decided on ''he incision vas extended downwards i iniches lower, allowing exploration with the finger in the region of the bladder. A body 2. ilUches long, pá inch thick, was scooped out Uf the gall-bladder. Its structure had not been deteriîned. h'lie opening in gall- bladcler was secured by a pur.e string suture, and a drainage tube inserted into bladder. Patient made a good recovery, although véery nearly collapsed at the close of this operation. The pain in the second instance, the Doctor thought, might have been due to the presence of the mucous cast (if such it was), which might have been forced out of the bile ducts into .. bladder. The Doctor's paper was valued highly. The patient vas present, and the seat of operation exposed for inspection. A sirmall biliary fistula was still to be seen, but in other ways the patient seened perfectly well. Dr. Canieron, chairnian of the section, asked why cholecystectomy might niot be donc in such cases rather than chole- cystotony. Dr. Prieger had had a case where the pain was referred to the epigastric region. The Doctor then outlined the case. It proved to be much like Dr. Ferguson's, only that the stones were in the duct, instead of in the bladder, and adherent to each other. In closing, the edges of the bladder were stitched to the sides of the wound. He was of the opinion that chol,:cystectony should be preferred to cholecystotomy. Dr. Meek had seen and helped with Dr. Ferguson's case, and agreed with him as 135",
         "DOMINON MEDICAL MONTHLY, to the causation of the rccurrenrce of pain after the first operation. Dr. Meek cited another case in which the peculiarity was the immense dilatation, of the bladder, one they had recently operated success- fuily upon. He was surprised to hear that Tait had adopted cholerystectony instead of -1holecystotom\u003ey. Dr. P.ger tr.ld of a similar case he liad to that or Dr. Mack; the bladder con- tained one and a half pints of bile aid some forty stones. Dr. Smlh, of Fingal, then reported on Dr. Mack's last case, Vhich was under his care. Patient vas doing well. A point lie dwelt on was that the temperature, at the tinie of operating, was 105. In three hours it was normal an(d liad rernained so. Dr. Caieron then spoke of the pro- priety of renioving the gall-bladder. In \"ases, especially where there was great distension and the presence of a number of stones, that operation was preferable. There would thus be less danger to the peritoneun after the operation ; the per- -nce of a biliary fistula is done away with. l'lie bile, instead of excaping ex- ternally, should take its natural course and thus carry out its digestive function in the intestines. Dr. Cameron spoke of the administration of very large doses of gly- cerine, two or three ounces eacli hour of the paroxysi, for the relief of cases of gall stones. He supposed it acted by its hydragogue effects--dehydrating, and thus relieving, the swollen mucous membrane. He had seen satisfactoryresults from its use. Dr. Ferguson said he liad tried equal parts of glycerine and succinate of iron (about half an ounce of glycerine), four tinies a day. MEDICAL SECTION. \"SoýiE OF THE USES OF SULPHUROUS AcID,\" * was the subject of a paper read by Dr. Arnott, of London. Dr. Hodge presented \"THREE CASES OF FRIEDRICd'S ATAXIA IN ONE FAMILY: two sisters and a brother. Father had *Will le published in this journal. eczeria of the legs so badly that lie was obliged to use crutches, also lad leuco- derma of hands. A paternal uncle suf. fered from hen abpia. These vere the only neurotic points in the fanily history. 'T'he Cirst, M. W., tt. 41, had a history of falling downstairs, having silice then a weakness in the legs. Got worse silice she was ten ycars of age. Now patient could not walk. ithout support. Staggers vhile standing, even with eyes open. Left alone, fills forward. Gait like one drunk. I.eg nuscles suiffer only atrophy of disuse. Legs sensible to pain, touch, and temperaturc variation. fHas pain now and then in right hip. Piantar rel.exes normal; patellar increased. Feet in con- dition of talipes varus. Marked curvature of spine. Upper extremity normal. Pupils act nornially. When she fixes to either side, there is marked horizontal t'ystag- mus. Face not synimetr'cal-mlouth drawnî to left side. Tongue, on protrusion, turned to right and exhibits fibrillar twitch- ing. All senses normal. The second, Sarah, t. 37, lias suffered since she vas 13, but nothing wrong .with the gait till six yeais ago, at which time she received a hurt in the knee. Now she cannot walk without a cane. She would fall forwards if unsupported. In most respects she resembles ber sister. . Her speech is slow and not very plain. The brother, ret. 36. Feet began to deform at 15. When eyes were closed lie would fall backwards. Gait wide- legged and zig-zag, and sonetimes stamp- ing. Lying down, he can do all the ordinary movements of the legs. In prominent symptoms, much like sisters, Right land is claw-sliaped. Atrophy of muscles of hands. Left hand somewhat affected, too. Curvature of spine. Suffers with excessive sweating. Drs. Meyers, Macallum, Mills, Arnott and Moorehouse took part in the discus. sion; Dr. Hodge replying. Dr. McKeough then fOllowed by read- ing a paper on' PUaRPEF AL EcLAI.PSIAt.\" 136",
         "DOMINION MEDICAL AIONTHLY, In all cases the urine should be examined, more especially in primipara, vho nake up 7i of the cases. Albuminuria, how. ever, was not aiways followed by eclampsia. 'The10 prophylactic treatmnent should be directed to dict, and the use of eliiina- tivc.. Fluid diet-milk being best - should be reconrnended. Salines should he given to.keep the howels free ; while, for the skin, nothing was so good as the daily hot bath for \u0026-cyminutc,, the temperatture or immersion 99° and gradu- ally raised to i 1. Ice might be applied to the head, and large quantities of water should be freely given the patient. If after this treatmnent the albuminuria is still present, labor should be induced. The success, the reader of the paper then described. If any, nrvous symptoms showed theiselves cldoro form should be admiinistered. One should always keep in mind in treating such cases threc points in the etiology, heightenel vascular and nervous tension ; the presence of sonie poison, probably from the kidneys, in the system, and the presence of the fotus in utero. If eclaipsia cones on in spite of all previous treatnent the steps should be, first, sedative; second, eliminative, and, third, induction of labor. The doctor referred to venesection. In certain ple- thoric cases it might prove useful. But in trying it as a last resort, in two cases, it c d not save theni; in fifty cases in Guy's in which it was performed, 30/, died. Immediately after, in twenty-four cases vhere it was used, 2o3'°/, died. Dr. Wesley Mills, of Montreal, then took up the subject, \"PECULIAR FoRnms OF SLEEP OR ALLIED CONDIToNS.\" He gave a report of his observations of the arelomys nonas (woodehuck) during a period of five years, and more particularly during its season of hibernation. With the phenomena presented, he compared strikingly similar phenomena in two or three cases in human individuals. Some of the points were the periodicity of the attacks of stupor, abstinence of food and consiquent enaciation, great slowing of respiration and circulation, the partial cessiion of stupor to o.ctend to urination and defecation, the tendency to increacd reflx action. The Professor*s accouit of the let.argic conditions in mani was lisiened to with exeeding interest, the cases, sotmue of themn being authentir, hav- ir,g cone uder his own observation. Tel, 1 rofessor, as an evolutionist, contended t these tendencies were analogous tu those in the low er animals, and inherited, so to speak, fromi thei. Although Dr. Mills takes this advanced view, lie says lie is inclined less than ever to pooh-piooh what is said re'garding trances and other similar popular notions. Dr. A. B. Macallui, of Toronto, while admiring Dr. Mills'able palier very greatly, took soie exception to his views. He contended that pathological conditions in the subjects whose cases were cited caused the lethargy; no such change in the brain of the lower amlmual, so far as lie knew, took place. The subject, however, was one cf extreme interest in connection with medical psychology-question of the re- lationship of periods of lengthened sleep to mental disease. Dr. Mills would be pre- pared,. be said, to believed, in the Rip Van Winkle legend. Dr. Cameron regretted that Dr. Mills had been obliged to omit the latter part of his paper, which dwelt with the real nature of the hibernating and allied con- ditions. It would have been interesting to have heard a comparison betveen such various conditions as sleep, ordinary coma, the somnolent form of status epilepticus, etc. Regarding the pigmentary and fatty changes Dr. Miill spoke of, ail were familiar. Pr. Cameron inclirmed to think it was a question rather of pathological chemistry than a gross pathological change. Dr. H. A. Macallum, gave Dr. Bucke's tide-theory, that sleep was influenced by, or in the sane manner as, the tides. The child's sleep corresponded to the two periods of rest between tides. 137",
         "DOMINION MEDICAL \u0026[ONTH-LY. In reply, Dr. Mills said that changes had been seen in tfie brain cells of hiber- nating animals. He believed the object of the condition was for preservatioa of life. In winter, when it was difflicult to get food, the woodchuck did with little or none. On account of his peculiar condition, inherited, no doubt, froni his sluggish ancestors of ages ago, \"Sleepy Jo\" (one of the cases reported) found it agreeable to his constitution, and econ- omical, to spend that portion of time when sustenance was difficult to obtain, and weather inclenent, in the lethargic state. Regarding the Rip Van Winkle story, he (Dr. Mills) thought it was like Shakespeare's, a case in which the genius anticipated the science. Dr. D. C. Meyerq, of Toronto, then read a paper on \" MULTIPLE NEUIUTIs.\" * 4 GPHTHALMIC MeMORANDA\" was the subject of Dr R. A. Reeve's paper. He re- ferred to the progress that had been made in opthalmology since the introduction of such instruments as the ophthalmoscope: also in' the treatment of such affections as trachoma, lymphomate, astigmatis- stricture of the lachrymal duct, etc, The speaker outlined the present treatment for siich affections and nethods of em- plhying surgical therapeutics wvhere neces- sary. He discussed at some length the subject of sympathetic ophthalmia. ..Dr. Osborne, in discussing the paper, spoke of the necessity of treating the nasal catarrh which was found in many cases of lachrymal duct affections. He also spoke of the great value of the oph- thaimiorneter in astigmatism. Dr. Reeve replied. Dr. Harrison, the President elect, was then voted into the chair. Votes of thanks were heartily given to the retiring presi- dent, the rmedical profession of London, and the railroads. Dr. Anglin moved that the usual hon- orarium be given to the Secretary. Carried. *Will be published in this journal. Dominion Medical Monthly. AlU literary communications, exchanges, and books for revicw, should bc addrcssed to the D0iJNION MEDICAL MONTHLY, 50 College Street, Toronto. Address all business comnmunications Io hie Publishers, THE MEDICAL PUBLISHING Co., OF TORONTO, Box gr3, Toronto, Canada. TORONTO, NOVEMBER, 1893. THE LABORDE METFHOD IN ASPHYXIA. In the August nuinber of this journal wve drew attention to the ments of the Laborde method of restoring life in cases of apparent death from drowning, asphyxia of new-born chiidren, etc. In France, Spain and Italy, this method is already well known to the profession, and prac- tised _with signal success. Dr. Aubin, of Marans, France, after describing an ob- stetrical case (prinipara) in which he had adiministered chlorcform and delivered by the forceps, proceeds to say that (17a Tri- bune Médicale) the child when born -did not cry, and was completely cyanosed and notionless. There was no pulsation in the umbilical cord, and when the latter was cut the blood which issued fron it was quite black. Confiding the delivery of the placenta to the nurses, \" I immediately practised on the infantrhythmical tractions of the tongue, and after a quarter of an hour observed slight respiratory efforts. I observed that the cyanosis diminished before the movements of respiration be- came visible, which proxes that under the influence of the tractions, hoematosis goes on (so to speak) in a latent fashion. The treatment was kept up for about twenty minutes, until the baby cried. The infant is at present in perfect health.\" A similar",
         "DOMINION MEDICAL MONTHLY. case ;s reported by Dr. Gougeux, of Calvados. A good deal of time was spent in endeavours to restore the infant to life by the use of flagellation, the hot bath, friction with alcohol, inbufflation sub- sequent to cleaning out the throat, and artificial respiration. These having failed, resort was had to the Laborde nethod. To the surprise of the doctor and his assistants, zfter two or three minutes' work, respiration was re-established and the child recovered. Dr. Springer, of Alencon, reports a rase where a man who had been withdrawn insensible from a pit, which contained manure and the waste of a seltzer water factory, was treated unsuccessfully for twenty-flve minutes by artificial respira- tion, friction, cold affusion, etc. \" Having secured a dressing forceps I seized his tongue with it, and at the second traction an inspiration occurred followed by a series of others. \" For an hour and a-half the respiratory movements became slow and ceased as soon as the tractions were suspended, after that tine the traction could be dis- continued. The coma did not disappear until after thirty-six hours, during which time all sorts of means were used to rouse the patient.\" Certain points in this case are decidedly worthy of attention. The long duration of the coma, showing the intensity of the poisoning, enables one in a certain way to measure the intense excitirig power exer- cised by the tractions on the respiratory centres, more particularly when we reflect that twenty-five minutes of' artificial respiration had produced an entirely negative result. Then again, in similar cases, it shows the necessity of perseverance, however precarious the final result may appear on beginning the treatment. From the report of these cases, and those we have already quoted, it will be evident to our readers that the Laborde 4 method has a very wide range of utility, and that it may be employed with advantage in cases of suspended animation, produced by various causes. We shall be pleased to receive reports froni physicians who have had occasion to apply it in practice. DOMINION REGISTRATION. This journal has already spoken out with no uncertain sound on the desirability of modifying the present systen of medi- cal registration, so that a physician who-is qualified in one province would be re- garded as qualified in another. It is to be hoped that the many in- fluential medical societies this wInter shall take the matter up, and approach the proper authorities so as to have the existing regulations modified in such a way that there will be a common standard of quali- fication and a common registration for the entire Doininion. Dr. Sheard, in his address before the Canadian Medical Association. at London, spoke freely in favour of somethirig being done in this important matter. We are glad to learn that our contemporaries, the Mariimne Medical News and the Montreal .Afedical Journal both speak up- on this topic in the October numbers in an approving manner, and direct attention to the fact that there is:now a wide-spread demand for some change. It will not do any longer to pooh-pooh this feeling. It has come to stay. Canada is our country, and we should have the privilege of following our regular occupa- tion in all parts of it without restriction. A physician, .qualified to practise in one province, should be entitled to practise in another province without the humiliation of another examination at the hands of examiners, often his juniors; and, in miny cases, as practitioners, his inferiors in ex- perience if not also in·learning. We quote from Dr. Sheard's address: \"I may express the hope that the time is 1-39",
         "DOMINION MEDICAL MONTHLY. niot far distant when there will be some central examining board or boards for the whole Dominion, when a license from such a board will be a qualification to practise from one end of the country to the other.' VETERANS OF THE WAR OF 1812. It will be a surprise to nany of our readers to learn th.t pensions are still being paid by the Dominion Government to survivors of the War of 1812. Accord- ing to the Auditor-General's Report for 1893, there are fifty-two recipients. The youngest is ninety years of age, the oldest 1o5. The-great preponderance of French niames is remarkable as showing the tough- ness and enduring qualities of the French \"habitant.\" With half-a-dozen exceptions, all reside in Eastern Ontario or in the Province of Quebec. The amount dis- bursed is $3,26o. THE LODGE PRACTICE. No medical practitioner who has had any experience with lodge practice will uphold it for a moment. The reasons against it are many and weighty. In the first place, the plysi-:ian ag:ees for a certain sum to perform an unknown amouit of work. In the next place, he is destroying his independence, to a great extent, by engag- ing beforehand to attend any person or persons. He places himself in the position of being abused in a most merciless man- ner, as has often happened within our knowledge. He is also lowering his dig- nity very rnuch by allowing himself to stand for election against another member of his profession. Let societies exist if they will, and let the doctor join as many societies. as his time, money, or inclination.may permit of; but lie should not attend at a tendered price. It would not be so bad if he took a society as lie attends a family, and ren- dered hia bill in the usual way and at the usual rates. I eft to the'nedical men themselves, we do not sec much hope of this evil being abolished. If sorme refuse to take lodges, others will not, and so the evil is perpetu- ated. It would relieve ëvery physician in this matter at once if there were some legislation amending the Ontario Medical Act, so as to render it an unconLtitutional act to do contract practice as it non , xists in lodges. By such an Act physicians would be greatly benefited. Al this competition for the lordge and electioneering would at once cease. One physician, who is a member of a lodge, would have no grounds to suspect antther physician, who is also a member of the same lodge. Some of the worst examples of bad feeling that we have ever met with between members of the profession have arisen out of this elec- tioneering in lodge practice. It is to be hoped, in the interests of the public and the profession, that the Medi- cal Council, the Medical Défence Asso- ciation and the medical societies will appoint committees to look into this whole question. These committees should have power to confer with each other, and for- mulate some honourable method of dealing with this great evil. We trust that no one will run off with the idea that we are advocating a union or combination for the purpose of controlling prices. Nothing of the sort is in our mind. But, while this is true, we strongly urge that some action be taken to prevent all sorts of unions and combinations getting the mastery over us, and controlling us through the lodge-room. The same amount of work will have to be donc then as now, but with this differ- ence, that we will do what we are paid for, and be paid for what we do. We are in- formed by one physician in this city who received about $ioo froni oin lodge that, during the period this remuneration cov- 14o0",
         "DOMINION MEDICAL MONTHLY. ered, he rendered servic2s amounting to about $300. We all see the evil effects of lodge practice, let us now do something to remedy the abuse. THE REST TREATMENT OF PHTHISIS. Several times already we have refirred in our columns to the value of rest in the treatment of phthisis. The text-books, usually found in the hands of students, do not contain any explicit information upon this important question. Many years ago Bartholow called atten- tion to the bad effects of allowing con- sumptive patients to take exercise vhile they had fever; and in more recent years Volland, Dettweiler, Keating and others .have directea attention to this matter. In a recent number of the Anerican Lancet, Dr. T. J. Mays again discusses the subject. His arguments are sound. The ground which he takes admits of no contention. We refer with much pleasure to the resolution passed in the Section of Clima- tology at the Pan-American Medicai Con- gress, recotnmending the erection of na- tional hospitals and homes for the infected poor. THE TREATMENT OF SYPHILIS.-Dr. L. Duncan Bulkley (in Septemwber Post- ,Graduate) remarks that in the treatment of syphilis, mercury still holds the front place. He condemns strongly the habit of trying different preparations of mercity. The attending physician should becone familiar with the action of some one form .of mercury and adhere to this. In the early stages of the disease, the author reêommends mercury with chalk, .after the method.of Jonathan Hutchinson. He used the drug in the form of grain tablets. The- patierit is to take one .every two or three hours. When the treatment should-be more energetic, give two tablets each alternate dose. Should salivation threaten, the dosage can readily be reduced. The treatment by inunctions and in- jections the author does not recommend. In the later stage of the disease, the mixed treatment is preferred. This con- sists in combining \" the mercury in the same mixture with small doses of potas- sium iodidc, together with iron and nux vomica and gentian. This should be con- tinued throughout the secondary stage. In the tertiary stage, and for the later lesions, when serious symptoms threaten, the nainstay is the iodides. These should be given in large doses, well diluted, and on an empty stomach. Vichy is a good vehicle to give the iodides in. Mercury should also be used in these conditions ; but it should be pushed freely and by inunctions as it gives rise to less irritation in this way. The duration of treatment must vary ivith the case and the patient. It may be laid down as a rule, however, that two years' faithful treatment is a minimum period. Some cases will require a much longer period. The treatment must be kept up until the patient is free from the danger of later manifestations. ANTIRABIC VAcCINATIONS AT PASTEUR'S INSTITUTE IN 1891. -Mr. H. Pottevin, in the Annales de l'institut Pasteur June, :89z), gives a detailed statistic of the vaccinations practised at this establish- ment during the year 1891. During the year in question, .1,564 persons have undergone treatment. Nine patients died of hydrophobia, giving a mortality of 0.57 Per cent. As five of the patients unsuccessfully treated died. fifteen days after the end çf the treatment, they should not be counted in forming an estimate of the efficacy of the v.accinations. As a matter of fact animals inoculated, after trephining, under the dura mater with the virus of common",
         "DOMINION MEDICAL MONTHLY. hydrophobia, take generally from fourteen to eighteen days to develop the disease. It follows, then, that wlien the first symp- toms appear in a patient in less than fifteen days after the last inoculation, it must be admitted that the nervous centres have been attacked by the poison during the treatment, and the treatment, not being finished, cannot show all its power. The real mortality in 1891 was there- fore 0.25 per cent., the lowest obtained up to the present day, as will appear from the following table :- Patients. z886 ..... ....2,671 1887 .........1,770 1889 ......... 1,830 1890............1,540 x891.........,559 TOtal... 10,992 Deaths. 25 13 9 7 5 4 63 Mortality Per Cent. 0.94 0.73 0.55 0.38 0.32 0.25 0.57 This result is very likely due to a more thorough appreciation of the danger arising from bites of rabid animals, and a better application of the treatment. Of the five patients who were attacked with hydrophobia before the treatment was ended, four had been bitten in the head. The speciai danger of bites in this region of the body is due to the fact that the virus has but a short distance to travel in going from the head or face to the brain or the upper part of the medalla spinalis.-La Tribune fédicale. TREATMENT OF SCABIES AT ST. Louis F'OsPITAL, PARIs, 3Y PROF. FOURNIER (Journal des Connaissances 4Médicales.)- The patient strips naked and rubs himself from neck to heel with soft soap for half an hour. During a second half hour he remains in a bath and continues his fric- tions. After leaving the bath Helmerich's Ointment is rubbed all over his body. The patient dresses and remains in this condition for twenty four hours, after which he takes a éleansing bath. His garments are exposed to a temperature of 230° F. in a disinfecting stove to kill any parasites which might be present in them. The theory of the treatment is easIly explained : the frictions and the bath open the burrows in which the sarcoptes reside, and the ointment kills them. Out of 12,294 patients treated in 1890, only three or four.per cent. have r2quired the treatment repeated. Unfortunately, it is rather painful, and the eminent special- ists of the St. Louis Hospital, Messrs. 'Bazin, Hardy, Lailler, Vidal, Besnier, have endeavoured to render it less painful and more rapid, while at the same time keeping it cheap, prompt and sure. Professor Fournier uses the following lotion in civil practice : IW Glycerine ............ 200 grams. Gum tragacanth ....·. 5 \"l Flowers of sulphur . ... roo Subcarbonate of potash. 35 Essence of mint .... il lavender aa i gr. 5o. i cloves ... . I canella . . In the hospitals of Vienna prefterence is given to a slower treatment. Men are interned in an hospital for five days, and women for from five to seven. The following local treatment is used: R Beta naphtol....... 15 grams. Soft soap .......... 50 i Chalk ............ 1o Axunge ........... oo ULCER OF THE SToMAcH.-Dr. Germain Sée, in a communication to the Paris Acadeniy of Medicine (Gazette des ZHopi- tau\u003cx), 21St September, makes the follow- ing statements :- i. There are two varieties of ulceration of the stomach, both the result of over acidity, aided by anatomical conditions and circulatory troubles, entirely diffe-ent from acute or chronic gastritis. 2. The gravest forni of ulcer is that where there is bleeding, caused by the rupture of a diseased vessel. Here the hyper acidity can and ought only to be sought for in the intervals. between the hærmorrhages by the aid of the stomach",
         "DOMINION MEDICAL MONTHLY. tube, which is a real danger at any othei time. Once tue over acidtty is recognized it leads the treatment whicli should be first, the use of the anti-acids; and second, of milk, neat, albumin, which neutralize the acidity. The excessive acidity causes spasm of the pylcrusand leads to dilatation. Abundance of vater should be drank to lessen the strength of the gastric juice. 3. The second form of gastric ulcer is the simple peptic ilcer. This form is recognized mainly by dyspepsla, gastralgia, vomiting and heartburn. This has been called by the Germans \"nervous dyspep- sia.\" It was formerly called catarrh of the stomach, This. howc -. is quite vrong. True catarrh of the stomach is not an over acidity, as in the ulcer. The true diagno- sis rests on the examination of the gastric juice. 4. The over acidity may last day and night for a long time, as in chlorosis, be- fore any ulcer forms. Strong suspicions may be entertained that there is an ulcer if the pains are severe and paroxysmal, and when the vomitings are severe and frequent. The other characteristics are identical in the two conditions of excessive acidity with and without an ulcer. NON-OPERATIVE TREATMENT OF SAL- PINGO-OVARITIs.--Dr. Geo. E. Shoemaker, of Philadelphia, in New England iedical Monthly for October, 1893, makes the following remarks on the above subject:- i. There are many cases of salpingitis, ovaritis, or a combination of both, that improve very much, or even recovei alto- gether, by suitable non-operative treat- ment. These cases, however, are liable to relapse on subsequent exposure or injury. 2. In treating these cases a full course of the rest cure may be necessary. Every effort should be made to restore the lost balance of general health by good feeding, electricity, massage and tonics. 3. The best application is the elastic r wool tampon, The wool should be well powdered with boric acid, and covered by a thin layer of cotton. These tampons should be very carefully applied by the aid of a Sim's speculum, or with the patient, in the knee-chest position. The tampon is good for two to four days. It exerts a mild pressure and supporting influence on the congested tissue. 4. When endometritis exists, the patient should be thoroughly prepared, and the endometriui carefully curetted. This is not followed by any increase in the tubal trouble, and lias dhe effect of relieving the endonietritis. 5. Pessaries catinot be used until all adhesions have been relieved, and the organs replaced. In this way their use comes in rather late in the management of these cases, if indeed they are used at all. To use them while there are adhesions or displacements is only to do harm. 6. Cases that cannot be relieved or cured by the non-operative treatment, de- mand the removal of the diseased tubes or ovaries. The true conservation of the patient's health demands this. CALOMEL CONJUNCTIVITIS. - Dr. H. Friedenwald, of Baltimore (in August issue of Am. Jour. Ophthahno!ogy), gives an account of several cases of severe con- junctivitis,.caused by dusting calomel into the eye while the patients were taking potassium iodide internally. The potas- sium iodide soon appears in the tears, and comes into contact with the calomel. A reaction takes place, one of the results being the formation of mercuric iodide. The author has proven experimentally on rabbits that the internal administration of the iodides and the local application of calomel to the eye give rise to severe in- flammation. Hirschberg's, Fricke's and Schlaefke's observations, and chemical analyses in such cases, are cited by the author. The paper is a valuable contri- bution. 143",
         "DOMINION MEDICAL MONTHLY. THE APOPLECTIC PULsE.-Dr. Chas. L. Dana (in the Pos/-Gradua/c for August) has an article on the abo'.-e subject, froni which these statements are taken: i. There is a class of cases in which the arteries are extremely dilated, and their walls thin and soft. 2. Persons of this class, if they have apoplexy, have hwmorrhage and not throm- bosis. 3. The treatrment is different from that indicated for persons who have rigid arter- ies and actual high tension. 4 The treatment is essentially directed to strengthening the vascular system, and lessening peripheral resistance. This is donc by giving the tincture of iron and salicylate of soda, and putting theni on a fruit and vegetable diet, with a little meat and some milk. 5. Careful watching of these patients enables one to protect them against other attacks. REMOVAL OF ELEPHANTIASIS TUMOUR OF SCROTUM.-Dr. R. Martin Gil (in Gaceta Med. Catalana, Sept., 1893) gives an account of a case of elephantiasis arabum of the scrotum. The patient noticed the swelling first in 188o. When the turnour was removed it weighed thirty pounds. The patient weighed 158 pounds and was in his sixtieth year. A clamp was applied to the scrotum to control the homoirhage. The wound was dressed, for the first three days, 'with bichlioride solution, one in two thousand. Afterwards the wound was dressed with iodoform. He was discharged from the hospital on the twentieth dcy. At no time was there any fever. THE CURABILITY OF SYPHILIS.-Dr. W. R. Gowers (Inter. Med. Mfag.) expresses the opinion, in his lecture on syphilitic hemiplegia, thatsyphiliscannot be regarded as a curable disease. He contends that it is impossible to say that any case is cured, as, after the most thorough treat- ment there are often recurrences. Mercury and the iodides have a powerful influence over the organisms of the disease and the new tissue formations they have given rise to. But the germs of the bacterial organ- isms of the disease are niuch harder to de- stroy than the organisms themselves. Thus there iay be left in the system, untouched by treatment, the germs of the disease. The removal of all the symptoms does not free the patient froni the liability to a re- turn of the disease. He holds that for a period of at least eight years the patient should take iodides for three weeks twice a year. TREATMENT OF ERYSIPELAS BY .ICH- THYOL.- %. Hallopeau (Gaze/e des Hoff- taux, 5th Oct.) remarks on the value of ichthyol in the treatment of erysipelas, that the treatment lasts for about two days, and the disease for about three. The use of ichthyol is due to M. Juhel-Renoy. It consists in circumscribing the erysipe latous patch by the application of the following : Gutta-Percha ........ gram. 25 Chloroform.......... \" 5 Ichthyol............ \" 25 The patch is smpared over with the- following ointment: Vaseline Ichthyol............. ....aa These applications do not give rise ta much pain. The only inconvenience is the discolouration of the skin. Tincture of iodine, in ten-drop doses, night and morning, does good. ANALGESTA BY COCAINE.-In a recent article in the Revue Generale de Clinique et .Tlerapeuuique, M. Gauthier describes how hypodermatic injections of cocaine can be given without danger. He recom- mends that trinitrine be added to the solution of cocaine. He says that trini-",
         "DOMINION MEDICAL MONTHLY trine is entirely opposite in its action to cocaine, being in an eminent degree the vaso dilator medicament, controlling in a wonderful degree the symptois of cardiac and cerebral ischSmia, and like cocaine producing its effects a few minutes after injection but in a totally inverse fashion. Fron one to three minutes after an in- jection of two or three drops of the alcoholic solution of trinitrine 1 to ioo, the skin of the patient becomeE warm, the face reddens, the eyes become in- jected, the cars buzz, etc. The following is M. Gauthier's formula: W ater .................1o grams. Hydrochlorate of cocaine .30 cent. Alcoholic sol, of trinitrine, I-1oo, x drops. M. Gauthier adds that this form of injection has ahways been satisfactory. FORMULA OF A COI1PoUND ANTISEP- TI.-The following formula designed by Mr. De Christmas, is published in the Annales de l' Institut Pasteur. It is a combination of different antiseptic sub- stances, and is almost equal in power to bichloride of mercury without aniy of the inconveniences of the latter. Carbolic acid ....... 9 grams. Lactic acid......... 2 \" Salicylic acid ........ . \" Menthol ........... 1o centigr. This compound, calle.d by the inventor, phenosalyl, is very slightly toxic, since, although possessing half the activity of the mercurial salt, it can be used in weak solutions, viz.: 5 and 7.5 to 1o,ooo of water. A strength of 20 to rooo completely sterilizes tubercular sputa (one part of sputum to five of the solution) after an exposure of fifteen minutes. The conpound is prepared by heating the three acids together until they are liquified, and then adding the menthol. Tt is quite soluble in glycerine, and may be easily dissolved in water up to a pro- portion of four per cent.-Rev. Scient. Items, Etc. An International Chemical Congress will be held at Brussels, 1894. Manitoba Medical College has upwards of a hundred students this session. The college lias been refitted. The total number of matricuLated medi- cal students in the universities of the German Empire in the sumnier semester of 1893 was 8,838. A new supply of \" Hydatid cases » have been recently added to the hospital clinics at Winnipeg, by the. arrival of a fresh batch of Icelandic immigrants. The officiat prospectus oi the University of Vienna shows that during the summer session of this year the total number of students in the medical faculty ivas 2,610. By the will of the late C. B. Beck, of New York, the New York and Presby- terian Hospitals of that city each receive a legacy of about half a million dollars. Could our Canadian millionaires do better than remember the hospitals when making their last will and testament? IN Great Britain, the regular university professors in the medical departments usually receive from $3,ooo to $5,ooo a year for their lectures. In many of the American universities, as Johns Hopkins, Pennsylvania, etc., the salaries are quite, as good. In the University of Toronto, we learn, the salaries paid to the profes- sors for last session were ab-out $440. St. Boniface hospital, Manitoba, is build- ing an addition to accommiodate a hundred patients. The new operating theatre on the top story will be one of the most com- 145",
         "DOMINION MEDICAL MONTHLY. plete and convenient in Canada. The staff consists of suigeons, physicians and specialists. Dr. A H. Ferguson, surgeon- in chief; Drs. McArthur and J. o. Todd, surgeons; Drs. Lambert, Poplham and Deschambault, physicians; Drs. Dame and Mc)iarmid, gyioecol.gists ; Dr. Hut- ton, anæsthetizer. The building will be ready for patients on the 1st of November. The Editors have to cordially thank the physicians of Canada for their appreciation of the columns of the DoMINION MEDICAL MONTHILY, as a medium for placing their cases and views before the whole profes- sion. To such an extent, in fact, is this the case that in future they cannot promise to insert in any given issue letters of more than one page in length. They are very desirous to receive more. especi.illy short reports of cases in nractice from their country brethren of the scalpel, as they feel that the active country practitioner neets many rare and interesting cases, the chronicling of which would be of much value to the profession. We learn that a deep interest is being taken by the profession of Ontario in the niatter of Medical Council elections, and that already there are several candidates in the field. There are many questions of importance to be considered, and the nonths to elapse before the elections can be used to advantage. It lias been sug- gested that the voters should ascertain the views of the various candidates upon such subjects as inter-Provincial or Dominion registration, lodge practice, and the pay- ment of members of the Council, before casting their ballots. Many members of the College express themselves as being in favour of doing away with the fee of ten dollars per day for attending Council and èommittee meetings, thinking that the honour attached to the position should be sufficient remuneration. Per son als. Dr. J. H. O'Donnell represented Mani- toba at the World's Sanitary Congress, Chicago. Dr. M. B. Ferguson, brother of Dr. A. H. Ferguson of Winnipeg, has returned froim Europe, after spending thrce years there. Dr. W. J. McGuigan, of Vancouver, has left for an extended trip He will visit the medical centres of this continent in addition to those of Europe. Sir Andrew Clark vas stricken with paralysis, Oct. I9th, when talking with a patient at his residence in London. The day before the attack he presided at the Royal College of Physicians during the Harveian oration. He died Nov. 6th. We are pleased to state that Dr. A. H. Ferguson, Professor of Surgery in the Manitoba Medical College, bas joined our editorial staff. He will keep the readers of the MONTH vLY advised concerning matters medical in the prairie province. Book Notices. Public School .Pysiology and Tenperance. By WILLUAM NATTRESS, M.A., M.R.C.S. Eng. William Briggs, Toronto. This little volume of about 200 pages has been authorized by the Education Department as a text-book for the public schools. The book, though small, deals with a wide range of subjects. Under each section the author very judiciously works in what lie has to say on smoking and drinking. The physiological part is well up to date, and the explanations clear and well arranged for the readers into whose hands the book is to be placed. The chapters on \"Aids to the Injured,\" \"The Prevention of Disease,\" and \"Physical Exercise \" are particularly good. This is one of the few small books that can be recommended. 146",
         "DOMINION MEDICAL MONTHLY. Hfanual of Practical Anaomy. By D. J. CUNNINGHAM, Professor of Anatomy and Chirurgery, University of Dublin. Vol. r., Upper Limb: Lower Limb: Abdomen. Young J. Pentland, Edin- burgh and London. Many will remember the former fasci- culi of this work. It has now been very much nodified in form. It appears in two volumes, of neat size. The matter has also undergone very thorough revision. We are glad to note that the author pays so mucli attention to sections, made through the part lie is describing. The aid to be derived from frozen sections cannot be overestimated. The cuts are, as a rule, clear and well chosen to assist the student. Taken all in all, \"Cunning- hani \" is the best practical anatomy with which we are acquainted. Correspondence. The Editors are not responsible for any vicws expressed by correspondents. Corr-spondents are requested to be as brief as posible. IS ALCOHOL A SEDATIVE AND DEPRESSANT? EDITOR DOMINION MEDICAL MONTHLY : SIR,- In your issue of October you pub- lsh suchareportof my remarks on Dr. Harri- son's paper on alcohol, that I fear anyone reading it will think I have taken leave of my senses. I therefore request that you will do me the favour to allow me to correct any such impression. As your readers will see, Dr. Harrison had introduced the subject in an excellent article, entitled \" Is Alcohol in all Cases and in all Doses a Sedative and Depres- sant ? \" I took exception to this statement of the question, as no drug ever did or ever could be expected to act exactly alike in all cases and under every circumstance. I said that even water or milk, under certain circumstances, proved very harmful. I said that the profession is divided over a question which is not an absurdity, but the plain, simple question, Is the general action ofalcohol that of a stimulant or a sedative ? In other words, does alcohol stimulate and strengthen a patient, or does ki merely produce a false appearance of improvement by rendering the patient less sensitive to morbid impressions ? I said that not only was the general pro- fession divided, butthatemîinent authors are divided, and that even hospitals are divid- ed, as instance, the 'emperance Hospital, in London, England, and another in Chi- cago. In proof that those holding the stimulant theory do not have it ail their own way, I pointed to the paper by Prof. Wilkes, of Guy's Hospital, read before the British Medical Association in ú891, in which he savs * \" Those medical men who according to preconceived or ancient no- tions have styled alcohol a stimulant, ·have really been wiatching its sedative action.\" I remarked that during the spirited dis- cussion which followed, no one questioned this statement. -Iundreds of medical nien, especially in the Old Country, hold the sedative theory, as well as very many of the profession in this country. To shew that the authors are divided, I pointed to \" Whitla's Materia Medica and Therapeutics,\" now held to be one of the best, if not the best, book on the subject for students. It says : ' We will never under- stand the action of alcohol as long as we regard it as a stimulant.\" I mighr also have cited among the authors, Dr. B. W. Richardson, who has expended more time and labour over this question than any other man living or dead; also Dr. Norman Kerr, of London ; Dr. Davis, of Chicago, author of \"Principles and Practice of Medicine,\" and many others, of less note. I also tried to point out that whilst many would agree that alcohol is a seda- tive, as evidenced by their prescribing it to procure sleep or to soothe an excited nervous system, yet these very ien would prescribe it as a stimulant in the next case to which they we e called. The same Babel of ideas was exhibited during the",
         "DOMINION MEDICAL MONTHLY. discussion of Dr. Harrison's paper. One distinguished professor said that alcohol aczd as a stimulant, a narcotic, and an anodynei all in the saine case and at the sane time. There may be reason in this, but it lies too deep for me. It reminds me of the Irishman who inveived a gun to shoot out of both ends, but whtn lie lad it completed he never could be sure which end it ivould go off at. I pointed out this confusion of ideas, and urged for free, full, and kindly discussion. The truth seens to be that those who hold such views, when they want a narcotic effect, prescribe alcohol; wvhen they want a stimulant effect, they prescribe alcohol; and when theywould soothe pain they pre- scribe alcohol-like the juggler who vill give you any kind of drinkyou call for out of one bottle. Of course, there is no authority for such loose views, as most of the old authors manfully take the stand that alco- hol is a fo-\u003ed and a stimulant. It requires little reflection to see that this will not hold water, for surely if it be a food and a stimulant it should be valuable in all severe tests of endurance. Yet Ringer says, \"Varied, repeated and prolonged ex- perience and the testimony of army medi- cal men prove that troops endure fatigue and the extrenies of climate better if alco- hol is altogether abstained from.\" Many other quotations night be given to shew the inconsistency of those who advocate the stimulant theory. I would here also take exception to Dr. Harrison's statement that lie \"finds a con- siderable number of conscientious and able inedical men who claini that alcohol is not of the slightest use in the cases in which we have been in the habit of pre- scribing it : that it is not only not a stimu- lant, but a powerful sedative and depres- sant.» The statement is self-contradictory. I presume that all medical men agree that sedatives are frequently useful. How, then, could anyone, after admitting that alcohol is a powerful sedative, claim it is of no use ? I think the Doctor lias misunderstood what was meant. I know there are inany able Men who claim that even as a seda- tive or narcotic, alcoliol is inferior to others which we have at our conmand. Those who have embraced the sedative theory have generally donc so after years of painful groping for the truth, and vill not be found to be entirely devoid of in- telligence. The main argument on which the stimulant theory rests is that of indi- vidual experience, than which I claim tLere is nothing more delusive. It hus nothing more than a suggestive or con- firmatory value. While individual experi- ence is one of the tests to which every question niust be submitted, yet it is only one, and that one of the least importance. Al sorts of absurdities have found refuge under its wings, such as chaulmoogra oil, chian turpentine, elixir of life, etc., etc. Why did profuse bleeding hold its own so long? Because the experience of the patient and the physician showed that it gave relief to present suffering. And it would h:ie held its own yet if a clever mind had not demonstrated that a much larger nunber died of those vho were bled -han of those who were not. Let a similar test be applied to alcohol; have a hundred cases of a certain disease treated with the ordinary doses of alcohol and a similar number without. I for one will bow to a test like that if fairly conducted. I would also bow to clinical experience if it were backed by reason ; but individual experience alone which for ages refused a mouthful of cold water to a fever-parched patient and shelteredsomany abominations as cures, I must decline to follow blindly. Dr. Harrison has rather an original argument to which I wish to direct atten- tion. He says: \" When your patient is nearly moribund-when it is evident that the weight of a feather thrown into the wrong scale must be fatal, and you give a decided dose of brandy; if brandy be a sedative, its effects must necessarily be 148",
         "DOMINION MEDICAL MONTHLY, fatal. The mere fact that the patient rallies under its effects in this frightfully low rondition, shows that it cannot be a depressant.\" I must admit that the Doctor lias prognosis down to a liner point than any other man 1 ever saw when lie can tell to a feather-veight how near a patient is to death. I have secen a numlber of able and experienccd practitioners at-a patient's bedside decide there was not the slightest chance of recovery, and yet they were wrong, and vice versa. The assured way in which lie speaks of patients so nearly dead being snatched from the grave by alcohol would lead young practitioners to believe that many patients at death's door will recover if they administer brandy enough. Allow me to tell theni that I tried that dodge for rany years, and it fooled me every time. Up till a few years ago few of my patients went to heaven sober, yet [ failed to observe in any single case such a mar- vellous result. And now I think I see more patients rescued simply by conserv- ing the powers of nature. But that is only my \"individual experience.» Moreover, the Doctor has not told us of what his patients wvere dying. If it were of nervous shock, I might be inclined to agree with him that alcohol might seem to do good, and in some cases have real value. But a patient dying of exhaustion of the forces of nature can hardly be helped by tUe administration of a drug which vill cause a well man to stagger or even put lim asleep. Sir William Gull, in 1877, said: \"The advantage of alcoliol is its effect on the nervous system, ior the time being rende,- ing the patient more indifferent to the process going on. And the Encyclopedia Britannica says : \" Alcohol relieves weari- ness by paralyzing the power to feel it.\" So in a similar manner does alcohol cause a patient to feel better by taking away or diminishing, for the time, his power to feel the unpleasant effects of the disease. I grant that in this way it may occasionally be u3eful when given for a short tinie only, but when given for a length of tinie I: be- lieve it does' a great deal of harni; and when we require a sedative we have others which in most cases are far superior to alcohol. I trust I have said nothing which could give offence to the gentleman who vas so good as to introduce the subject and to devote so nuch care to it, My only desire is to set nyself right and to have this subject thoroughly ventilated. London. H. ANO'rT, IS ALCOHOL A SEDATIVE AND DEPRZSSANT? ErTron Do\u003emziroN4 îIsEnDCAL MoTiiLy: Sin,-.The paper by Dr. Harrison, re- ported in yours of Oct. ist, is interesting, inasmuch as it opens up a debatable subject in vhich the profession of medi- cine is much interested. Excusing me for the interpolation, but I think the title of the paper should have been, from the arguments adduced, \" Is alcoiol a sedative or a stimulant?\" This is not only a medical question, but has takern its place, and is here to stay, in the realm of politics and social economics. Is alcoliol a seda- tive and depressant î In arguing this7out on parallel lines, we must take into con- sideration the circunstances under which it is administered, and is it possible for a drug to have a double action ? Vou give alcohol to a man whose venous circulation is congested, and full of carbon ; whose system is filled with effete and excremen- titious matter, with an oppressed brain, and it becomes a dangerous depressant. Give it to the nervous invalid, whose system hàs been drained by debilitating discharges, or worried by mental trouble and physical disease, and then it is a valu- able sedative. Give it to the victim of neurasthenia, with his bankrupt brain and bloodless spine, for it is better than strychnine, or phosphorus, or all the 149",
         "DOMINION MEDICAL MONTHtA. vauntcd drugs used in that terrible disease -to him it is a sedative nost acceptable to lis poor, worn-out system. (f «e it to the pale, emaciated victim of consunlption, whose consuming fires are burning up the vital spark ton quickly, and it stands be- tween himîu and death, and offers a substi- tute for his own fle'di and blood-to hini it isaglorious sedative. And oh l you rich and young and healthy, you do not require th's elixir ; your lines are fallen in pleas- ant places; look out sonie poor victim, sinking under this terrible disease, who cannot afford to procure it. And lastly, give it ta the old man, shaken with palsy in his second chilldhood, tottering towards the grave, and it will sooth his passage, and give hlim blessed sleep, and carry him back again to the days of his youth, when lie was young and strong and foremost amongst the reapers in the fild ; to him it vill bu a sedative-the milk of old age. There are few doctors who could not give so nany instances of the beneficial effects of alcohol as a stinulUit, as recorded in the paper, if not blinded by prejudice and fanaticism. In the year 1848, there was a young doctor (ego) taken sick with one of the dreadful remitt'.ng fevers peculiar to the lowlands in the Island of Jamaica. I-le is not responsible for what occurred during this illness. In consequence of the delirium that attended it, le only received it from a kind friend who stood by him during this trial. After a lapse of twenty- seven days the fight was alnost over. The attending physician, who lived tventy miles away, came on that day and an- nounced that there was no hope, and advised that the carpenter on the estate should prepare a box for the moribund patient, as the obsequie3 are not orna- mental or very prolonged in that country. This friend, in conjunction with another, sat up for the last time. The latter, who had had some experience in the fevers of that country, suggested that as it was a hopeless case, they should administer a good dose of braiidy. The patient made no resistance, and the liquor went down by gravity. The pulse returned, and a gradual warmth diffuscd itself over the body; the dose was repeated, and the patient returned to consciousness. In 1857, the writer vas surgeon '-n board a troop-ship cro4sing the Atlantic, laden with seven hundred souls, miei, wonen and children. For some reason, the tug appointed to pull the ship through the Cliannel, vas lot up to time, and she stood on lier way without it. Conitrary vinds prevailed and stormy veather set in, so that it was more than six weeks before the port of Quebec was made. John Bull,careful of the health and comfortof his soldiers, lad provided for the men each one pint of porter, and for the wonen with babies two pints. Fron the unexpected length of the voyage all the medical con- forts vere exhausted. The first effect of the loss of the beer was that the women who had children at the breast became dry-\" the paps gave no suck.\" One after another of the little ones was con- signed to the deep, for want of their proper nourishnent. In this emergency, I asked to see the bill of lading of the ship Zon. I found that there was a consign- ment of bottled porter to a firm at Quebec. I made a requisition to the captain for it, and it was forthcoming. The women lad their porter again, and the lacteal fluid made its appearance also, much to the benefit of the little creatures. Car a drug have a double action ? Alcohol is allowed to be an antipyretic, by lowering an ab- normal temperature it becomes a sedative, and fron the effect produced it then acts as a tonic. Dr. Paris classes narcotics, antispasmodics, tonics and astringents un- der the head of stimulants. He says: \"Substances which, in a moderate dose, occasion a temporary increase of the actions of the nervous and vascular sys- tems, but which are followed. by a greater depression of the vital powers than is 150",
         "DOMINION MEDICAL MONTHLY. commensurnte with the degree of previous excitement, and which is generally fol. lowed by sleep.\" He thus defines nar- cotics ani sedatives. and proves ilcohol ta have a double action. Many practiti-m. ers anticipate this, and combine a tarcotic with a stimulant. A favourite prescription of mxy old naster's used to be : Liq. opii sed, 25 drops; Hoffman's anodlyne, 30 drops; tinc. Iavand, 3m drops, and j oz. of camphor, mixture, and it seidon failed to give relief. The two nost active prin- ciples of opium are morphia and narcotine, which would appear, fron the researches of M. Majendie, to exert very different effects upon the animal systeni, die former imparting to opium its soporific, the lat- ter its exciting property ; vhence it is pro- posed to remove this latter principle in order to render its effects milder, and at the same time to divest it of those ob- jectionable properties, which so greatiy limit its medicinal utility. The great question of the prohibition of alcohol is now before the public, and if the Medical Faculty is the conservator of the public heaith, it behoves it to speak out in no unmeasured ternis of the dangers attending such a poli:y. Whilst the press is silent, afraid to open its mouth, it is the duty cf the medical organs to stand be- tween reason and- fanaticism, and to pre- vent so objectionable a measure froni being placed upon our statute books. Yours, etc., I-IENRY B. EVANS. Picton, Ont. Progress of Medical Science. AN OPERATION FOR INGROWING TOE-NAIL. BV SAMUEL E. MILLIKEN, M.D., Lecturer on Surgery at the New York Polyclinic. Although some diversity of opinion exists as to the treatment of ingrowing nail, it is my opinion that the principal conditions to be overcomie are the follow- ing: 1st, reinval of the irtitating paît of the nail; 2nd, excision ai the infected soft parts, and 3rd, the prevention of suppura- tion during the aling process. It is not only necdless but harmiful to remove the entire liail, particularly fron the great tae, as the subsequent irritation of the shoe will be a great source of incon-* venience to the patient. Any nttempt to reiove the nail in part without excising the infected soft parts will often be fol- lowed by suppuration, and hence consid- erable delay in the recovery. The operation which I have performed for four years (the originator of which I do not know), is Cirst to inject froni fivG to ten minins of a four per cent. solution of cocainc into the end of the toe, with thc smallest h podermic necdle, taking care that the amesthetic be deposited a far back as the matrix, and imniediately apply sonie forn o constriction at the base of the toc that the circulation be thoroughly controlled. In fron three to fve·ninutes the area to be operated upon will be am- sthetized, when the scalpel is thrust along- side the ingrown part and the soft parts are transfixed. The first cut (Fig.' i) should be made parallel with the nail un- til the end of the toc is reached. The flap left should be cut oT with a separate stroke of the knife, and on a slant until the matrix ic exposed. With a pair of sharp-pointed scissors, about one-fifth of the nai is separa'itc-d (Fig. 2) and the seg- ment pulled out with a pair of dressing for- ceps. The whole denuded surface should be thoroughly curetted so as to remove any infected tissues and to insure the complete destruction of that part of thie nail. .Dressing.-Before removing the con- striction, the surface should be dusted with iodoform and covered with a small piece of rubber tissue. By taking that precaution, the granulations will be pre. vented from shooting up into the meshes of the gauze overlying.",
         "DOMINION MEDICAL MONTHLY. The absorbent gauze cati best be applied in the form of a roller bandage, and thus accomplish the part of an hoemostatic. For the prevention of infection from with- out, the whole toe is covered with rubber tissue and additional pressure made by a simple roller bandage. FIG 1. When the constrictor is removed, if there be hrmorrhage, by elevating the foot for half an hour it may he controiled. The only indication for re-dressing the wound during the first forty-eight hours, will be the pain fron too much pressure, and this may be relieved by changing the outside bandage without exposing the parts to the external air. By applying the same protective dressing twice a week, complete cicatrization will usually occur in 15 days. The inside of the nail is .here illustrated, because the operation is best shown. Advaztages.-rst. With all infected and irritating tissues removed, the patient cati go about with comparative comfort. 2nd. The matrix being removed in part, the nail will grow symmetrically. 3rd. Both sides may be operated upon simultaneously and yet have the toe pro- tected by more than half the nail. 4th. The cicatrix resulting, prevents the soft parts bulging out and becoming irritated by the nail afterward.-New York Polyclinic. YELLOW FEVER iN BRAZIL.- The British Consul at Santos, in a re nt report, states that yellow fever has been present in Santos, Brazil, for the last fVe years. It has varied in intensity from time to time but has never disappeared. The mortality among seamen during ihe height of the pestilence last year was enormous, and as all who died were buried within two hours, it was practically impossible to trace individuals. In mañ-y cases no register was kept even of their naines. It is known, however, that men were dying for weeks at the rate of thirty to forty a day. At the time of the Consul's report there were be- tween two and three hundred cases of yellow fever in the hospi- tals. The danger was con- siderably aggravated by the fact that seamen dur- ing their enforced-stay in Santos have every facility to obtain a very cheap and injurious form of rum call- ed cascaca, and are thus encouraged to live a dis- orderly life. Recent re- gulations, however,- have considerablyalleviatedtheir condition, since they are now permitted to be discharged from the ships on which",
         "DOMINION MEDICAL MONTHLY. they arrive, and to take ship on outgoing vessels at the Eirst opportunity. The Con- sul also states that snall-pox is extrenely prevalent in Santos.-British Mfedical Jurnal. S TAT E 'M E NT OF THE SUMS PAID TO EACH MEhLBER OF THE MEDICAI COUNCIL FOR TRAVELLING EXPENSES AND HOTEL ACCOMMODATION WHILE ATTENDING COUNCIL AND COM- MITTEE MEETINGS. The following is taken from Sessienal Return No. 86, which was brought down by order of the Legislative Assembly on 5th of May, 1893. It is from the Trea- surer of the Medical.Council, and gives a detailed statement of paynents to members of the Medical Council for travellng and hotel ex5enses during the years 1890-91-92. UTY31NTS TO MEMtRS OP TUI CouNcIL ron HOTmI, AND TRAV'\u003cLL1N EXPEs., JUNE 14, 1890. To whom, tiI Dr. D. Bergin .............8 $ 0 $20 50 C48 50 .lohn L. Bray ..........7 2450 1380 3830 Wm. Britton ........... 17 50 Nil. 17 50 C. J. Canipbell .........5 17 50 930 U$0 \" l. W.Day ........ 5 1750 01i 200W \" A. G. Fenwik . ....... 6 21 (10 1000 3100 Fife Fower........... 21 il 32 \" W, B. Geikie..... 1750 il. 17 50 W. T. Harris .........5 17501 450 2200 G. ienderson ........ 61 22 75 8 2. 31 00 James Henry.........5 17 5 3 7 2125 A. J. Johnson......... 5 17 50 Nil. 17 50 George Logan... .. .. 22 j5 1800 40 î5 L. L'uton ..............O 2100 930 3030 J. McArthur .........5 17 50 9 25 26 75 l. H. Moore...........7 24 50 14 OU 3850 W. H. Oliphant . 17 50 Nil. ... 50 \"IR. B.-Orr...........5 17 50 Nil. 175, D. L. Philip ..... .....5 1750 450 2200 A. F. Rogers,... .....7 2450 1900 43 r) J W. Rosebrugh.... 5 17 50 22 50 J. lussell ............ 5 1750 500 2260 \" H. Ruttan........... 5 1750 10 00 27-50 James Thorburn. 5 17 50 Nil. 17 50 . IL. Williams .........5 17 50 5 30 23 40 ................. 9 00 $100 15 $080 15 PAv.tis -ro amtnenz or Tue counci, roa aOTEL AN TIt..vtaLstya E.orssn\u003c, Juane 13, 1S01. To v.honi. Dr. D. Borgin 7 $24 60. $.21 5. $40 John l. Bray . ........ 111 130 340 Wmt. 1ritto.......... 17 1 il 17 0 C. J. Capbell 30. 30.0 \" A. . enwick.........O 21 0..0 3 7 0 1 0 G. Uen'rson .0 1 2. 3125 James lienry..........5 17 60 3 50 21 0 A. J. Johnson......... S 17 60 Nil. 17 60 J. W, Rosebrug h ...... G 21 ou 4 25 0 Fife Fowler. .......O 21 00 il on 32 00 James Fulton......... O 21 0O O80 3(3 z0 George Logan. .......7 24 50 .. GO 41 60 L. Luton ..............( 2100 980 3038 A. Itnttan .......... O 210) ici00 siCo V. Il. Moore...........6 21 001 14 5u 35 50 D. D 1hilip .......... 0 21 00 4 15 25 75 \"l. B. Orr. ... ...... 17 50; Nil. 17 50 Jamtes Thorbtirn .. 17 50 Nil. 17 0 W. B. Geikie .... 1 5 Nil. 17 50 Ilenry W. Day........ 7 24 01) S 75 32 75 George M. Shaw . ... 2100 40 2560 A. F. Rzogers.......... 7 24 501 17 On 41 50 W. H. Oliphant... b 17 50 Nil 17 50 J. A. Willians ....... 5 1750 22 50 Total7................. $51 50 $180 OU $000 50 PÀ\u003etvsTO %1931URRS OP' TIIt? CO\",CIL FOl 1MOTES, AM\u003c»I TRAvaLLi\u003eExî Ju 18, 1802. To whon. Dr. D. Bergin ....... .. John L. Bray ......... Wm. Britton ........ C. J. Camlipbell . . A. G. Fenwick........ W.T. Harris.......... G. Henderson..... ... James Ifenry ... .... A. .1. Johnson ......... J. W. losebrugh Fie Fowr....... James Fulton ........ George Logan......... L. L.uton ... .. . A. Rutta,....... .... V. IHMoore .......... \"D. L. Philip. .... .. l\" I i ,Orr. ..... ..... James Thorburn .... W..B. Geikie ......... Henry W. Day........ i. Art hur Williams.... \"A. . Rogers Thos. Miller ......,.. E. Vernon ...... . .. Total................. 5 5 6O 5 5 5 5 5 65 5 6 5 5 56 5 56 \"8 $17 50 S24 00 21 00 13 50 17 50 Nil. 17 50 8 20 21 00 1000 17 50 4 00 17 50 0 00 17 50 3 00 17 50 Nil. 17 50 3 50 ,7 50 13 00 21 00 9 80 17 50 23 00 21 00 9 80 17 50 10 00 2100 15 00 17 50 4 00 17 50 Nil. 17 50 Nil. 17 -0 Nil. 17 50 7 60 17 50 .5 00 17 50 23 00 17 50 3 50 17 50 3 50 E ~G57 1,0 3 53",
         "154 DOMINION MEDICAL MONTHLY. ALL PAYMENTS MADE TO MEMBERS OF THE COUNCIL FOR HOTEL AND TRAVELLING EXPENSES IN CONNECTION WITH COMMITT.EES. 0 Apr. 24,1891. 22ï51May 9, . . 2204 e 27, . 2302 Junel3, 2331 il 16, g. 2 et 17, f . 31 n 17, f. 2423 Mar. 17,1892 4 e 17, e .. 5 1. 17, l . 6 fi 17, e. 7 et 17, e . 8 n 17, e. fe e 17, t . 2430 e1 17, . 1 il 17, e . 2 , 17, e. 4 n 17, f. 9 Apr. 7, f. Ienry W. Day.. A. F. Rogers .Jas. Thorburn. D. Bergin ...... D. Bergin. John L. Bray.. A. J. Johuson Jas. Thorburn W. Il. Oliphant,. V. Hf. Moore ... Il. W. )ay .... J. A. Williams.. A. J. Johnson .. 1). Bèurgin ...... Fife Fowler .... Wn. Britton.... Jas. Thorburn .. R B. Orr ...... C. J. Campbell.. W. 13. Geikie.. .. J.Arthur Williami Service. Comnmitteere Legisation.... re Education .... Select Coin. re curriculum Committee re curriculuni reLegislation.... fi f . .. . ft . . e Ap. .. Details. 8. Odays'hotel,$2l.00; trav'l'gexp. S17.50 $38 50 10 e 35.00; , 36.00 71 00 0 , 31.50; , Nil . 31 50 2 7.00 ; 25.50 32 50 13 4 4.50, , 75.50 121 00 2j et 6.75; 11.00 10 76 5 le 17.50; le Nil. 17 50 5 il 17.50; .. Nil. 17 50 4 fi 14.00 ; e Nil. 14 00 2 et 7.00; a 13.75 20 75 2 7.00; , 895 15 25 1 n 3.50; u 5.00 8 50 1 , 3.50; , Nil 3 50 1 8 3.50; e 25.50 29 00 2 . 7.00; le 1300 20 00 1 I 3.50; il Nil. 3 50 1 l 3.50; e Nil. 3 50 1 t 2.50; fi Nil. 3 50 1 e 3.50; I 0.50 10 00 1 350 ; il Nil . 8 50 1 et 3.50; If 5.00 8 50 $,92 75 COMMITTEE re LEGISLATION. C* S Date. To whon Paid. 2203 April 18, 1891 Dr. A. F. Rogers . .... 4 et 23, ., , V. II. Moore ................. 5 et 23, et . Ilenry W. Day ................ a t . 24, i r. A. F Rogers .... .......... .. 8 fi 24, .. fi R. A. Pyne ........................ 2276 Way 9, .. , James Thorburn.................... 6 il 10, il ... D. Bergin .......................... Mar. 17, 1892 i 17, 1% l 17, fi i, 17, et e 17, si -, 17, 91 f 17, il f 17, il q 17, t * e 17, et i 17, et April 7, May 6, V. HI. Moore........................ H. W . Day .. .... ................ J. A. W illiams ..................... A. J. 3ohnson ...................... D. Bergin .......................... File Fowler ........................ Vm. Britton ...................... James Thorburn................... R. B. Orr ......................... C. J. Campbèll ..................... W. B. Geikie .... ......... J. A. Williams (on 6th April)........ R. A. Pyne ..................... .. 4 4 7 10 to oov. andj 2 2 1 2 2 1 1 1 1 e625; 40 $14 00 $18 00 $72-00 40 10 50 1550 66 00 70 21 00 17 50 108 5C 100 35 00 3600 171 00 -- $417 50 er disbu!rsem'nts for cabs $1.50 250 $1.0 ...... ........... ....'.f 2 5 9 .. 121 50 121 50 40 7 00 2500 72 50 7250 014 0 20 7 00 13 75 40 75 20 7 00 8 25 35 25 10 3 50 5 00 18 50 10 3 50 .... 13 50 20 3 50 25 50 49 00 20 7 00 1300 40 00 10 3 50 .... 13 50 10 3 50 .... 13 50 10 3 50 .... 1350 10 3 50 0 50 20 00 10 3 50 .... 13 50 271 00 10 3 50 5 00 .... 18 50 er disb rsem'nts stenogra pher, 127 80 telegr mis,S2.80 ...... ..... 7 Total .......................... $317 30 W. T. AIKINS, Treasurer."
      ],
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         "Toronto : Medical Pub. Co., [1893]"
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      "title" : [
         "Dominion medical monthly [Vol. 1, no. 5 (Nov. 1893)]"
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      "label" : "[Vol. 4, no. 1 (June 1856)]",
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         "Montreal : Printed for the Proprietors by Owler \u0026 Stevenson, [1856]"
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         "The medical chronicle, or, Montreal monthly journal of medicine \u0026 surgery [Vol. 4, no. 1 (June 1856)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w LII Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored andlor laminated I Pages restaurées et/ou pelliculées E' E Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. D Additional comments / Commentaires supplémentaires:",
         "THE IIEDICAL CH1{ONJCLE OR UONTRÂL MONTIJLI JOURNL OF MEDICINE \u0026SURG-ERY. LICIT OMI]BU@, IXCT N0118R DI\u0026MITATEU AMTI MIDIOJ TUEE!. UbTDBY 'WiMlam' Wrght, M.!). \u0026 1). C. XacCallum, MRD. MONTREAL: Prinlt0d for the PrOprietOrg by OWL\" \u0026 STI\u0026VZNWOr, at thoir Steam- Proe Printing EutbIithniený, Transoript Building.",
         "Contributors to the Fourth Volume of the Medical Chrealle. BARNSTON, J., M.D. BROWN, V. A., M.D. CHRISTIE, THOS., M.D. CUNYNGHAME, T., MR. DE COUAGNE, A., M.D. FRASER, DR. N. S. FRASER, W., M.D. GIBB, G. D., M.D. GIBSON, J. B., M.D. GRANT, J. A., M.D. HINGSTON, W. H., M.D. LANE, ALEX., M.D. LEE, J. C., M.D. McCALLUM, D. C., M.D. RAE, JOHN, M.D. i ROWAND, ALEX., M.D. SEWELL, J. C., M.D. STRATFORD, J. S., M.R.C.S. STEVENSON, J. M., M.D. STEIN, A. B., DR. SHAVER, P. R., M.D. VON IFFLAND, A., M.D. WIGHT, R., DR. WRIGHT, WM., M.D.",
         "INDEX. PAGE POs Tumomr over the left ilium above the Hip, by G. D. Gibb 450 Arm Presentation with Prolapua of Cord 14 Another Exchange 38 Apenent Solution 70 Ametrican Medical Association 78 Acetate of Lead in large doses 100 Anestheuia by Carbonc Acid 114 Are we to have a Medical Coroner 1 118 Arthritis of Bipjoint, Dr. Fraser 125 Ascaride, I50 Amphyx*a, its rationale and its remedy 151 Alexs t. Martin 157 Albuminuria 184 Adim Tumour, Removal of 244 Antwyyphities, b Dr. Wright 281, 321, 361 Assimlative q ties of Fatty Bodies 311 Agus, Iod of tassium in 312 Apolhecaries and Druggists, Education of 332 Anesthesia, Local, by cold 353 Amputation of Leg, eligible spot to perform 356 Arsenie in Intermittent Mania 385 Acne Rosacea 420 Books Received for Review 38,78, 160, 200, 274, 319, 360, 398, 471 Barnsten on Nutrition 91 Belladonna, Effect on Secretion of Milk 346 Bladder, Foreign Body in 355 Bliters to Cervix Uteri 384 Barnston on Laryngismus Stridulus 401 Brown on Internat Strangulated Hernia 405 Bill to Regulate Sale of Posions 432 Case of Poisoning by Laudanum, by J. M. Stevenson 454 Colchicum Antumnale, as a source of Aleohol 24 Chloroform in Intermittent Fever 96 Chloroform in Delirium Tremens 469 College Of Physicians and Surgeons, Meetings 35,159,185, 271 Co !tal Bydmcephalus 81 Es 71, 184 Caution to Mothers 72 Chronie Brouchitis 113 COlUge Of Physicians, Usefulnes. of 119 Clinial Notes 121 Corrsiv. Sbhlimate, Case of Poisoning by 192 PAGES Compound Comminuted Fracture 170 Convulsions 185 Congenital Hernia 185 Chorea 185 Coroner's Inquests in California 19 Catarrb, Chronic 230 Croton Oil, Late Case of Poisoning by 23t, 274 Correspondence, London 236, 25, 95 Cramps, Remedy for M Caustic in Navns 25 Compressor, A New Instrument 291 Cunvaghame on the Compremor 291 Christmas Jingle M Canstic toi Cancer 34 Caustic in Nevuus3 Cicatrices, Colour of, in Negro 345 Chlorate of Potau, Employment of 357 Carbuncle, Treatment of 355 Collodion in Umbiheal Hernia 384 Carbonic Acid Gais, Local application of 385 College of Dentiste, Engln 391 Circular to Physicians 394 Convulsions 4M0 Collodion, Covering pills with 4 Creosote in Dysentery 12M Craem , Remedy for 421 Collo nim -421 Character of Examinations 439 CLINicAL Lcruaxs. Trousseau-Modified Small Pex 22 Stanlev-,\u0026one in the Bladder 68 Aran-Amenorroea and Dysme- norrhea 144 Lloîd-Puncture of Bladder 180 Skey-Varicose Vein 226 Lloyd-Hernia 261 Wa tonCataract 300 Skey-Lithotrity 340 Soly-Paralysis 378 Champouilien-EPm ent of Jodine 416 Lawrence-Infantile m 4gg Diseases peculiar to Sandwich Island 3,147 DianhSa 70, 114,150, 151 Dysmenorrbes 71,150 Dîphthentis 71 Dummriaand Seriity 131, 165 Disoction of Shmulder 185 DeCouagne, 12amrk on a Cs",
         "PAGE Paez DeathoiDr. Paris 393 MontreAl General Hospital, Appoint- Doctor, a Criminal 435 w.ents nt 38 Eau sedative de Raspail 25 Medi eal News 40,80,120,160, 200, Enresis 150 360,'400, 440 Ergot of Wheat 185, 347 Mir.scopy of the Kidneys 114 Extra.uterine Fetation, Case of 371 M.imma, Excision of, by Dr. Fraser [126 Ergotine in Epidemic Diarrbe 385 ýtMcGill College, Circulars of 1856-7 156 Fracture of both thighs, case of, by 'Aredical Colleges, United States 192 Dr. Fraser 121 MacCallum on Disease of Supra-renal Fraser's Clinical Notes 121 Capsules 201 Fraser on Poisoning by Corrosive Sub- Medical Coroners 211 limate 163 Milk, Dispersion of 2 F-eocyid Potassium and Urea 230 Medical Schoels of Canada West 268 Fatal atake Lin Dispensing 351J McGill College, Appointments in 273 Gibb on Adipose Tumnour over the left Medical Practitioner, Good opening for 318 ihum above the Hip 4,'aO Notables froa my Case Book 1 Grant, Case of Compound commainuted Nux Vomica, New test for 24 Fracture 170 New Drugs in Paris Exhibition, 1855 31 Grant on Punctared Wonnd of Plura Narrative of Cases 41,214,292 Costalis 446 Nutrition 91 Gibon on Spina bifida 245 Necremia 116 Glycerine in Chronic Eczema 313 New Invention 158 Government Patronage of IMed. Scho ols 314 New Appointment 160 femnoptysis, Treatment of 27, 230 Nipples Sore 265 HoPITat REPoaTs. Neuralgia, Valerianate of Ammonia in 267 Marine Hospital 199.240, 319,. 400, New Review 359 439, 471 Ophtbalmia 71 Nontreal Dispenisary 39 Obituary 160, 437 General Hospital 79, :280, Pericardium, Tappîng of 26 399 471 Percussion and Auscultation, New mode Hingaton on Coijgental Hydrocepbcalus 81 of exploration by 28 Hemorrhoids 151, 23C Palmer Poisolang Case 72 Hemorrhage as a Sign of Cancer in the Protessor of Aitioty, McIll Cllee 77 Uterus 468 Pneumoria Discussed in 33 Apboriss 115 Ierni, Remarks un a Case ot 218 Prevention of Poisoning 188 Hospital Reports 238 Philadelphia Coll. of Physicians. Tran- Herniaria Glabra as a Diuretic 265 sactions of 194 Hygroma, lodine in 265 Prescott Minerai Wawr 194 Hermia, Internal Strangulated 405 Parapiegia 230 Hygiene and Nursing of Infants, aphor- PhotophobîL 231 laras 01- 25 Phosp aieolLine ià. \u003epitiai Ciirvatire 468 Indecent Advertisemeits 33 Poweress labour 248 Iteh 70 Popliteal Absces frum Aiigeioteucitis 345 Iodo-tannic fluid in ulcerb 114 Proto-iodine for Iran Plastei 345 lnquest on a Physician 317 PrOjectoftheCoIlegeofPysiciamîaC.E. 357 IrrIgation in Phagedena 355 Perchloride cf Ironas a lionîostic 3M Internittent Fever, Salt mn 384 Punctured Woiind of 1'ura Co.tdis. hy In-growing Nail, Cure of 386 J. A. Grant 446 lodofor 423Pseudnembrinous litlanation 420 Journal de L'Instruction Publique 439 Quinine in Hooping Cougb 29 Louisville Review .38 Qackery, Pbibition of, in Rusaja 356 Lane on Acetate of Lead 100 Rae on Discasea peculiât tû Sandwich Lee on Dysmenorrhoea and St!rility 131, 1651 lands 3,-17 Lavai University 193 Radial Arterye Wuund of 127 Letter to Editors 319 Reginen 154 Landolfi's Treatnent of Cancer 349 Rbeumatism 231 Laceration of PerinSun, Treatment of 387 Rowand on Smaii Pox 241 Latest Anesthetic 393 Recreant MrGiOlte 392 Laryngismus Stridulus 401 ReportofMedicat Superîiteadentofthe Loa\"evity 438 Provincial Lunatic Asylum 436 Xcfli diffll, Medical hiners inP 1856 37 Retaied Plcenta, On 467",
         "ImmDE. PAOR PAGa RavyzwS An BILIOGMAPUICAL NoTIcas. SU\u0026ar, Action of, on the Teeth 25 Lehmann-Chemical Physiology 14 Stn, Narreuve « Cam 41,214,292 Jones-Ophthamic Medicmne and Sur- Scariatina 71 ,ery 17 Strychnine, Antidote ta 7 Nelgai-CutiiOO dicaea 19 Syrupas Ferr lodidi lit Ne ia-Cotaneous disease 711 Wright-Headaches 21 Sore Nip e1 Brown-Diseases of Women 21 Syphilis erLjat Caoeof, byDr.Fraser 1n Thompson-Stricture of the Urethra 56 Stratfe i on Wound oi Radiaf Artary 127. Milton-Spermatorrhea 63 StenoLs Funhculi Umbilicalua, 0n 467 Bozernan-Vesico-vaginal Fiatula 6 StevenIon on Poiacning by Laudanum 454 Milier-Principles of Surgery 66 Sumner Complainte in Chidre loi Neil-Analytical Compend 67 Small Pox, Ectrotie Treaiment of 161, M Bowman-Medical .'hemistry 68 Slipra-Renal capaulei, Digeu cf gui Report on Choiera of 1854 102 Small Par, Prevention of Pitting in 241 Flin--Physical Exploration 100 Small Pox, Nitrate 01 Silrer in 243 Gardner-Causes and Treatment of Spina Binda, cae of 245 Stenlity 111 Stretford on Powerleu Labour 248 Hlow to Nrse Sick Children 112 Stone in the Bladder 266 Wilson-Disector'a Manuel 112 Subsriber8, To 274, 470 113 Sactna Tum -urs 345 Wrigbt-Headachex 113 SPermatorrhoea, Mechanical Prm. Carpenter-MicroScope 136 Aure 384 Dungliion-Hunian Fiysioogy 138 Syphilis, Secondary, Prep. of lodine i 424 ieyleide-Ueber Resectionem 1391 Something for Collge oePhysician 434 Curling- Diseas of me Testis 140 Therapeuetia Record 25, D., 133,150, Charber-Digestion and its Deran.ge- 1 184,230, M6, 304, 344, 384, 420, 446 mente 141 Therapeuti Action of Vapor of Bi-o Dunglison-NewS Retoedies 143 pcuret o b Carbon 24 Churchill-Dseaffl Sf Children 173 TapeC Worm 70 Bennett-Uterine Pathology 176 Trtnity Colege, no Medcal Facty i 18 Taylor--ýMecal Jurisprudence 177- Thepentical Contribution 281, 321, 361 Foote-PactitiOuer's Pharaacopema 179 Therapeutic Rets f the Ci4drens Draper-Human physology 219 Hoap'1. Munich 304 Bcwrnan-Pracicai Chenýqtry 226 Tannic and G aUje Acide 354 Haakefi-Essy on physiology 226 Titree Came of Tracecîoomy in Croup 469 Wocd.-MatSna Medica 253 Univenrity Meicase Sf nAcun 272 Meigs-Obstetrics 258 tflcers of Leg, Spender s Cha k oint- Lym-QSvariotomy ment n 424 gregory-Inor 'Ir Chemistry 261 Variole. Mercuriel Collodion in 70\u003e Smi-OSperbsirve Surgery 294 VomitiTg 114 Bck-Materia Medica Verinous Diathesis 155 Barlett-Fevers 299 Vesico-var-in-M ic oa 155 AUen-Pracical Anatomi.t 300 Vive la Bagatelle 159 90lland-Mgjjcal Notes 335 Voix XCLuind on Eetrotic TIatsmeit cf Pueiso - Physician', Precri pton lSogay Pox 161 Bok 339 Von iffand on Medica Coroners 211 Trnacting- o A erica Medica the Te AC ociatio 372 -ox - t ad it D e243 Rigby-Femase Disu 376 I I Sanitary Msures 421 - tre 377 o in Retroversi Uteri 265 TodlMedi Lectures 409 Von Iffld, honora ta Dr. 275 Fo t--C bfot 413 VomitinPcfor forty yeer duration 12 GibbD -HCongenia Malformation 415 Ventral oegi, operation \u003cor 347 MontgormerY--..Sjgns and Sjanptotns of Varie.. Ulcer and Varicosa Veins 427 Bwgnancy 4 45 Wsht, ReMOval ry Apose Turncur 244 Rth-Fea Fermentation as a Wrght, TheraPeutical Contributions euw of Diseuo 460 281, 321, 361 SeW.1l, Notables troin My Case Book 1 XiPhiseain Chisel Sound 29 Shaver on Arm Presntation With pro- Zinc, Oleo-meaýte of, as a Substitut. laP1e SfpCerd 114 toread Mer 25 Sa13a8Y SplsScdr by A. Von dfi n4nd 441",
         "Tr H E MEDICAL CHRONICE. VOL 17.] JUNE, 1856. [No. 1. ORIGINAL COMMUNICATIONS. ART, I.-A few Notables from my Cas. Book. By S. C. SEwaL., .A., M.D., ke., Ottawa. 1. H.EMORIHAGIC DIATHESIS. In the township of Cumberland are two families of firat cousins, chil- dren of a brother and sister, who shew no more disposition to hemort- hag than is usual. Two or tbree out of each family have died of trau- inatie hmorrbage from very triding cuts, andtue others have been at de\u0026th'a door froma this cause. A boy, aged six was brought to me. Ha had been bleeding for five days from a scratcheon the hand, I bound iinely powdered ergot on the wound, and gave hIm ol. terebinth inter- mally; ho did 'well, but I earned that he died six months afterwards from a trifiing wound. These cases are interesting from the circumstance of thi atnnge idiosyncrasy appearing, throughout the whole of the mem- bers of the two families of first cousins, while the parents showed no suck teadency. 2. cAsU or UNonCEDsD PACTURE AND DISLOCATION, VIZ.: FRACTURE 0% TS Aar\u0026IaoaP HALF or TRIS GLENOID RaAD 0 TNE aCAVULA, AND AN- TIRIo 01SLOCATION CF TES HEAD OF THE HUMERUS. On the 24th February, 1855, Mr. Burns, of Kemptville, St 65, wa thrown oUt of a cutter in such a manner that he fell on the back of bis right ahoulder. On his arrival in Ottawa, I was sent for. On stripping him, the right arm hung perpendicularly down by the aide, voluantary motion gone, Passive mobility great, crepitus occasionally detected at the ahoulder, when I raised the arm. The head of the humerus was under the Qlavicle. It was evident that there was fracture. I aser- tained that there was no fracture of the head of the humerus, or any part of the boae. The acromion and coracoid processes were intact. Tii neck of the acapula evidently was not transversely fractured, and I",
         "2 OarmiAr COMMtrCATIONS. was pretty certain I could feel the head in situ. I should have men- tioned that the patient was very thin, and the muscles much atrophied. I only suspected what was the matter, and endeavored to get the head of the humerus into its place. I employed first one and then two pow- erful men to make the extension without succeeding. I then put bim under the influence of chloroform, and applied the same force with no result. The direction of extension was varied, but still I was baffied. The bead of the humeras could be drawn even beyond the point where it ought to have slipped into its place, but it refused so to do, and seem.* ed to be kept at a distance anteriorly from the head of the scapula. I now employed three powerful men to make extension, and three coun- ter-extension, giving them directions to pull ery slowly, and to keep it up, so as to tire the muscles. When the head af the humerus came on a line with the glenoid cavity, I pushed it forward, when a loud grind- ing crepitus was heard by all present, and the bone slipped into its place. The power of moving the arm immediately returned to the patient, but on my moving the arm, crepitus could be plainly distinguished in the shoulder. I asked Dr. Grant to look at the case, who was quite satisfied that there was fracture in the shoulder. If this was not a case of fiac- ture of the head of the scapula, what was it 1 The points to be noted are:- 1. That the arm hung perpendicularly down by the side, not the po- sition of simple dislocation of the head of the humerus forwards. 2. Active or voluntary motion (except slight movement of three fin- gers) lost. 3. Great passive mobility, not found in simple dislocation of humerus forwards. 4. When replaced, the humerus remained in situ, but crepitus was still distinct on motion whether active or passive. 3. XOniE 0F ZNC AS A TOPICAL APPLICATION N VENEREAL SOREs. Having noticed that iodide of zinc was very strongly recommended as possessing the power of resolving enlarged tonsils, I instituted some experinents with a view of establishing its virtues, with but indifferent results. During this investigation three cases of syphilitic ulceration of the throat happened in mypractice. It occurred te me to try it in these cases, and I had reason to be surprised at the rapidity with which the cure was effected. Since that I have used it in syphilitic ulceration of the nose and tongue, some very bad, with equally satisfactory results. lu fact noue seem to resist it. It is now three years since I have used it, and every fresh case only confirms its great powers. My opinion is entitled to soe weight, as, since 1836, j have used Ricord'' Acid Ni-",
         "RAE--DIsRAan PICUIAR 'TO TE ANDWSH rLANDs. 3 trate of toercury in similar cases, and am able to contrast the relative merits. Of its value in primitive chancre I am unable from experience to decide, but am certain that within the period of incubation it has equel powers to, if not greater than the nitrate of silver to deetroy the specific character of the sore, and I am inclined to think that on trial, its powers % ill be found to extend beyond the ten days allotted by Bi- cord to the period of incubation. I could cite the approving testimgny of medical men who have tried it at my suggestion, but I would recom- mend the inembers of the profession to try it for themselves. As the way of preparing may not be generally known, it may be well to describe it. Take a piece of bright zinc plate, place it over the month of a jar .nd sprinkle it with iodine, the brown liquid that rom into the jar is iodide of zinc. ART. II.--Dieases peculiar to the Sandwic \" slands. By JouZ a, M.D., Kaoli Hana, Mani, S. I. Cutaneous diseases are very rife among the nativeà. These have been generally all classed by travellers under the head of scrofula; yet I do not think I have seen a case of the scrofula which is so frequent in Great Britain, and sometimes is seen in Canada. There are several diseases, however, having some analogy to it, and to which the natives give various names. One of these is the puspm, which, with some la- titude of translation might be Englished, as a constant springing forth of fIleshy knobs. The first cases of this disease that presented thenselves to me had this appearance. Over the whold body, or over the lower limbe, there were sores, geneally circular in form, and varying frbm a quarter of an inch to an inch and a half in diameter. The general skia was little affected. There was a slight ichorous discharge from the sores, and fiabby granu.Jous shot ont from them all, so as to project a line, or a quarter of an inch from the surface. An intolerable itching beset some, partially covered with a scaly cuticle, and evidence of new ones coming out, was afforded by red looking boils appearing at varions points. I conjectured that the malady wa connected with ome vene- real taint, a'Id applied an iodine wash externally, and gave mercury in- ternally (blue pills.) Under the stimulus, the superfuons granulations subsided, the dioharge became less and les thicker, and in a fortnight or. three weeks the sores were covered with a pretty firm coating of new skin and cuticle.",
         "ORIGINAL COMMUNICATIONS. I was here first led to remark the extraordinary vigor with which the renovation ofskin and cuticle goes on among this race. Although, in these cases, the original skin had been completely destroyed, yet, in a month or two, the scars were scarcely perceptible, being only noticeable, on a cursory view, by a more polislied surface, and requiring a close in- spection to trace the line of demarcation between the old and ne wly or- ganised substance. I subsequently found many varieties of this, or a similar affection. On the scalp it assumes the appearance of scaly blotches. Frequently it shows itself in a swelling, aceompauied at points with acute pain over a large extent of the areolar tissue. For instance, the whole extent of one upper extremity, including the fingers and shoulder, or all the space occupied by one or both scapula, and part of the back, or one cheek may seem greatly swelled. There being no discoloration, one would fancy this to be produced by simple oedema; but on grasping the part, though it yields to the impress of the finger, it- does not pit, bµt possesses an elasticity, which enables it, on the pressure being withdrawn, imme- diately, to resume its preceding form. If not checked, this swelling points at one or more places, and a copious thia discharge, with a gaping sore or sores, gradually assuming the appearance of those I have des- cribed, is the result. Sometimes the muscular fibre seems to be in- volved, and then, though the external sore skins smoothly over, there in a considerable depression under it, marking the loss that bas taken place. On more extended inquiry, I was led to doubt the connection of the affection with venereal, and am not yet satisfied as to this point. I tried varions other methods of cure. I found several more or less effectua). Thus applying cautiously, and to portion by portion, a solu- tiod of cor. sublimate, or, soinetimes, simply touching the part or parts affected with lunar caustie, would check, or remove it. But I think on the whole my original treatment, by some combination of iodine and mercury, succeeds best with me. I have indeed never found a case that has withstood the united action of the two. I ought, however, to add that I have seen cases, in elderly people, where the malady affecting one or both of the lower extremities, bas assumed a form, very closely resembling elephantiasis, as it appears among the Spanish, or rather negro population of New Grenada-the limb permanently swelled and stiffl with deep scars, apparent los of muscle, and a toe or two dropped off. I have wished to essay the effect of a similar treatment on some of these, but have not found any willing to try it, and very much doubt if it would have any considerable success.",
         "aÀz-DElZI PXCULIA To THE SANDWICK IaLANos. 5 Akin to the puupuu,is an affection of which the native nameis alaala, that attacYs the neck. When at its acme it stretches from ear to ear in front, in a sort of very large, and very rongh neeklace. Were one to make a string of smallish unopened oysters, by piercing a hole right through each, and arranging them by putting them back aind belly, and with their edges, therefore, outward, and were he to place this on the bare neck, in the position I have indicated, it would cloeely resemble the appearance presented by very many cases of alaela. Add to this, that the neck is stiffened, the face swollen,and a feve:ish state induced, and you have the characteristics of the complaint. After continuing for months, or years, 'he necklace slowly drops off, leaving a wide scax, which is gradually almost completely obliterated. I have not treated this complaint, as the natives seem to think that its irature is to come and go of itself. It seems generally to attack boys, when at the age of puberty, and to prevail must in rainy districts. At Helo it is said to be very rife. These are the more prominent varieties of cutaneous disease, but I may add, that itch is rather common, and often seems to be the exciting cause of puupuu, making a troublesome combination. You will observe that all this differs from scrofula. The glands are not peculiarly affected, and the discharge, in so far as I have seen, ia not charged with curdy flocks. It may be, however, that in some of my cases, this characteristic feature might have appeared, had it not been that the treatment seemed rapidly to affect the discharge, convert- ing it into proper, or as it used quaintly to be termed, laudabls pus. Thougli the two cutaneous affections of which I have spoken may b. made to comprehend the mass of such complainte, yet, were one to at- tempt a minute description of all in which the skin is more or less in- volved he might perhaps find something analogous to whatever nosolo- gists have noted froni ring-worm to leprosy and scrofula. In fact most of the natives have, or have had, some skin disease or other. A scaling off of the cuticle, leaving but a thin remnant that easily bleeds, is common among the aged. Their predisposition to these diseases is indicated by their uncomfortable feelings when deprived of the fresh water bath, and by the quantity of old euticle which rolls off their skia when for a few days they have been unable to obtain this luxury of a tropical climate. One would suppose that in a climate of so equable temperature asthis, ç1iseases of the lungs would be rare, but the fact is that they are by no means so and that many of the racc, especially young women, are car- ried off by consumptions. Affections of the bronchial tnbes-colds and coughs-are frequent, from exposure to wet and consequent cold. If these are attended to, and",
         "ORIGINAL cOMMUNIcATIoNs. squills and laudanum are almost specifie for them, they pass away ; but, recurring frequently and being neglected the bronchial affection be- comes deeper seated, pus is brought up, and things go on much as they do elsewlere, until death closes the scene. My stethescopic perspicacity is not sufficient to speak with certainty as to the existence of tubercles, and the strong prejudices of the natives rua altogether counter to any sectio cadaveris, but I believe they would be fuund, and that their presence is, in many cases, the predisposing cause of this disease. The malady in question, in the opinion of old residenters, and I know some who have dwelt on this island for forty or fifty years, ias become muci more frequent than formerly. They assign several causes for this. First, since the breaking up of the old order of things the condition of the female sex bas undergone a change. In some respects they are more restrained, but in others less so, and ou the wbole an intercourse of the §exes more promiscuous and premature than before, is very common, and a cause of a waning in the vigour of the fermale frame. The con- stitutions of many of these has also suffered from the inroads of vene- real maladies. But to this I shall'afterwards recur. The diet also, from circumstances the detail of which would lead me too far out of my road bas become less abundant. The people eat less fish and pork than formerly, and sometimes are pinched even for toro. Again, the general adoption of something hke the dress of civilised men, seems to have produced a change in their habit of body, which, physiologically and perhaps ethnogically, is worthy of notice. Their hue bas less of red and more of black in it. It would seem, that, when the surface of the body is exposed to the skyey influences, there is a greater rush of blood to the minute external vessels, reddening the hue. Tihe whole person becomes, in a measure, face. May not this be one cause of the change of complexion which to a great extent bas taken place in the Celtic and Germanie races? We know from Cesar and Tacitus, that even in the severe winters of the Germany and France of those days, the hardy nafives scorned much encumberance of clothing as a mark of effeminacy, and that fair hair and blue eyes were univer- sal, corulei oculitatiloque come. The present Gaul is generally swart, and so are very many Germans. And civilization a thousand years since gave these a general and warm covering to the whole person. Howeverthat may be, the alteration in hue, which I _have noted, i- a fact of which I have no doubt. It has been accompanied by a greater susceptibility to cold, and to the inroads of those diseases, which that susceptibility produces. Venerealdisease in some modification or another, are very widely",
         "EÂ-DISEAISS PECULIAR TO TEE SAMDWICN IULANDs. 7 spread. For this the voluptuous propensities of the women, and the concourse ofsailors to these parts sufficiently accounts. Were I to at- tempt a description 4 all the modifications these assume, uy epistie would swel to a treatise. I shall confine myself to one or two re- marks:- When such diseases are promptly met by proper treatment, they very readily yield to the simplest meaus of cure ; but, if neglected, or inefec- tually tampered with, they become both severe and obstinate. Stric- tures, connected mostly with the growth of large warts, and tumors in the urinary passges, are very common among females; and, for want of proper aid, have been very fatal. One man, when speaking on the subject, told me, and as a thing by no means remarkable, that he had thus lost two of bis sisters. In the male sex, such strictures ubstinately recurring, and complicated with affection of the bladder, are also fre- qent and difficult to treat. Deep seated, and very malignant u]cerm in the throat, and other parts, with total derangement of tha system, have carried off, and atill carry off, many. But I believe there are few of these latter cases that would not yield to the persevering use of the ap- propriate remedies. Of imported diseases, the mesles was, some years since, one of the most fatal, sweeping off whole families. The large developement of the areolar and kindred tissues, for which the natives are rernarkable, may porhaps explain this fatality. To the same constitution of body I am in- clined to attribute the peculiar phases assumed by the small pox in its re- cent visitaticn, and by the cow pox, its preventative. Ihad sufiloient op- portunity to remark these, having been sent by the board of health of this island round the larger part of it, for the purpose of attending trs 0 sick and vaccinating the well, You have probably heard that this scourge niade a fiearce inroad oi. Oahu in 1853, beginning at Honolulu, the capital of t'hese isiani. By the returns, the number attacked was .about five thousand; the deaths about two. In the other islands the deaths reprted amounted to two or three hundred. It is suspected, however,,t.hat these reports fll con- siderably short of the reality, and from the.retunms of the census for the year 1854, not yet completely made upy it is caloulated that the whole amount of the population will appe 4o have fallen from 80,000 in 1849 to 70,000 in 1854. The deficit m * y attributable to the smnall x. The mortality at Honolulu , I believe, augmented, as ed9lini such circumstances is the , by a sort of panic terror t natives, andseems to had its influence even on d in other authorities. W gave greater force to to think 0fact, that vaccinat* was no protection. ve rendersit not",
         "ORGINAL COMMUNICATIONs. cinated, it was said, fell equally with those who had not. It was not for some time that this assertion was proved erroneons, and that it was shown that vaccination, properly performed, and the vaccine disease running its due course, is a real preventative here as elsewhere. It in, howevjer, in so far as my own experience enables me to judge, and as I have learned from others, a thing well ascertained, that, to carry vac- cination properly through, is a matter. of much greater difficulty with this thnn with other races. The main difficulty, as it appears to me, arises from the peculiar con- stitution of the natives rendering them so propense te skin disease. In consequence of this, if the vaccination be succesaful it is very apt to awaken some other affection of the skin which may be a sequel to it or a concomitant of it. For instance you may see the vaccine disease running its due course. The scales even may fall off leaving only a slight swelling of the part, but, instead of this disappearing it may be the prelude to a troublesome sore of an inch or perhaps twoin diameter, which finally healing up, the diseased surface contracte, the skin smooths over, and but very slight trace of a scar remains. More fre- quently the supervening diseases come on when the ,ceine vesicle in in progress, and a compound and disagreeable sore Trom which large quantities ofirmph like fluid may be discharged, is the consequence. It is apparent that if lymph be taken from such an arm it may produce either a true vaccine vesicle, or a compound, but yet truly prophylacte- ric disease, or may give rise to a sore, which, though troublesome is ne preventative. Now a good deal of vaccination has been performed by the natives, and their idea is, the larger and more severe the sore, the more trustworthy. This I believe to have been one considerable cause of mistake and failure. The safest plan, if practicable, is to vaccinate fron infants. In them the lymph is generally pure. It is less to be depended on in children, and, in perhaps the majority of adulte, is more or less contaminated. Another, and I believe a frequent cause of par- tial failure, is the vesicles not being allowed to reach complete maturity. Children, and grown boys and girls can searce restrain themselves for a week or two from plunging into the frequent streams, in which it in their'daily delight to gambol. And if one go ail follow. At night, too, between sleeping and waking, their habit of scratching every diseased surface recurs on natives of all ages, and, unwittingly, they destroy the forming vesici or scab, which they may have been rèally desirous of -gmserving intact. I conceive that, wben the progress of matters has suscept4ls broken in on, the prevention is not perfect, and was unable to susceptibity'p of an attack, proceeding from the concentrated vuu- Venereal diseaeis aging almost uncontrolled, in the crowded suburba",
         "ass-msiNAUns PCUrU.k TO TUB U\u0026NWIeN reLAJss. of aucha city ns Honolulu. I may add that I have probably examined mane thousands of arms and that the general appearance is this: The .waces of a sore much larger than among whites, but amooth anclevel with the adjacent surface, towards the edges of it the ulight traces of the diagnostic pits, often only perceptible by turning the arm so that the light strike obliquely on it. To the central space, void of pits, they give the name of the aunburnt spot, from a notion of the missionaries, that it was produced by exposure of the arm to his rays. This is the most usual appearance, but it varies considerably in numerous instances. If having examined such an atm yon learn on inquiry that the constitu- tional symptoms had run their due course, you will generally find the syatem of the individual resist fresh vaccination. The amal! pox itself, as I have seen it attack the native race, has these peculiarities: The eruption considerably less than in whites, and seldom confluent; but, the pustules not so prominent, often flattened, and then blackish, in which cases the fever assunes the typhoid type, the patient ainks, and generally dies. I believe the practice with the profession in these islands has not varied much from what is usual, with the exception of a more free use of wine and other stimulants. The mortality seems to have been about 40 per cent. At Lahaina ewing to the judicions measures of the authorities, ably seconded by the exirtions of the medical men there, not only was the disease alto-. gether confûned to the strangers who brought it, but among thema the mortality was leu, say about 25 per cent. * The idiosyncrasy of the Kanaka, the vigorous life in him, and the great resources of the areolar tissue, are marked by the singular fact, that, however much or deeply pitted when he firat leaves his conch, yet, in nine cases out cf ten, these pits fill up, the akin amooths over, and in a few weeks there are no vestiges of the disease, or only alight discolourations, which probably the course of time,will, in a few months or years, completely obliterate. Before concluding I ought to add that a new mode of treitment, or rather, as concerns Europe, the revival of an old one, was adopted by Ra Makau a native friend of mine of considerable intelligence, and whose influence is extensive over a large portion of this island. It is this: The patient is sweated by being laid on mats over a heated bed of stimulant native herba. This, he tells me, has the effect of bringing ont a large and promsinet eruption, in which case no typhoid symptoms supervene, and recovery under bis bande was universal. I have bad no ieans of investigating the matter sufficiently, but am inclined to think there in ome truth in it. The idiosyncrasy of the native renders it not",
         "OfterwAL COMCUrCATroars. improbable, and the inquiries I have made are confirmatory of the suc- ces. But, I should feel more confidence in the statement, had some unsuccessful cases been confessed. Rheumatism is not uncommon among the natives, and very frequent with the whites. I have not found it hard to treat with the former. I do not recollect prescribing f'or a white man. The former generally, in their own practice, resort to bathing in a torrent of cold water, and what they call loomy loomy a sort of vigorous shampooing of the parts affect- ed. One or two friends of mine, who were long laid up with it in Ho- nolulu, and under the best inedical treatment there, have assured me that they have found no relief till they adopted this plan. Among the white race also, there is a proneness te genuiie scrofula, if there be any taint in the system, and cases of consumption also occur. Disorders et the bowels, diarrhoa and dysentery, are sometimes fatal, but there is perhaps nothing in these, or two or three other maladies, worthy of being noted. The case is different with regard te a malady which spread over this Island and Oahu in 1852, and the history of which seems to me to pre. sent some remarkable and instructive features. I have next te notice the existence of considerable tracts of low lands devoted to ite cultivatiou of taro, and the existence, in such situations of extensive fish ponds. When I first cast my eyes over these Islands, I could not but think that these muddy pools, full of deaying vegetable matter, were likely te be productive of disease, of ague perhaps, or of more malignant fevers. I was assured that the salutary influence of the trades, sweepiag rapidly all miasma into the wide ocean, secured from all such attacks, and had reason te thiuk that this notion was, to a certain extent, correct. Still two circumstances induced a shade of scepticism in my mind, as to the absolute immunity of the Islands from any such attack,one of these was that the native language recognizes the existence of chills and fever, and the other characteristics of ague, and that, in fact, I had cured a native woman, who had been muach reduced by febrile attacks, chiefly I think by the administration of quina. Another thing was the admitted prevalence, during the sensou of the Konas or south- winds, of a malady, which the Missionaries termed influenza, and which was said to be almost universal in its attacks. I had, however, seen nothing positive, until the summer of 1852, when a gentleman from California, when sitting in the sane room with me one morning at Wailuku, called my attention to his baùds, the fiqgera and nails of which I found assuming the appearance characteristic of immediate ague. They were cold, se was his face, the features of which were annk and pallid. I told hini that he was probably in fora fit of ague,.and psyd",
         "niE-ntasiss WtCrerU To YU TaWeWIR ULÀes. bim if he had hadit in California. On his answering in the affrmative, and informingme also that ho had corne over the mountain from Lahaina the morning before, I imagined that the ftigue and cold of the ride, had brought on a return of a complaint which keeps so tenacions a hold of the system.. I told him he had botter get to bed, ho said ho would, but must go out first, and moving for this purpose, I made way for him to pass, and waited his return. This lasting longer than I thought ne- cessary, I went after him, and found him lying on the grass insensible with blood flowing from his nostrils. We had kim carried in and placed in bed, where he soon somewhat recovered. He said ho knew nothing of the fall, but recollected having been seized with a strange dizsiness as he was going out at the door. He had a slight shako and consider- able fever with much pain of head. The fever oontinuing long, towards afternoon I gave him a few grains of James' powder, of which I happened to have some that was very good. This bringing out slight moisture and producing abatement of fover, I gave him a full dose of quina. As bis tongue was very fou], I had sometime before given him a few grains of blue pill. In the evening ho felt better, bnt complained of pain in the forehead and strange restlessness. He suggested opium. I asked him if he had often used that drug, Sud; on hig replying in the affirmative, and finding his pulse nearly natural, I gave him two toaspoonfils of paregorie. This was about 11 at night. He slept pretty well, felt tolerably com- fortable in the morning, and after a slight dose of salts, which brought off one or two dark and foetid stools, his tongue-cleaned, and his appetite returned. I gave him another full dose of quia, and afterwards repeat- ed it in smaller quantities being under the impression, all the time, that it was scorium of ague, somewhat modified. Soon after this, I heard from a missionary friend, that the influenza, had been for some weeks prevailing in T.Ahaina. From the description, I judged the disease, so named, was sorne sort of fever. Soon alter- wards it got the name of the Lahaina, and, finally, in this island, of the Boho fever. There is much intercourse between Lahaina and Hono- lulu. It reached the latter port in about two months. Gradually it spread over this island of Mani. Its progress was very slow, it being Christmas before it reached Hana, the north eastern division of the is- land, though the distance of that region from Lahaina, in a direct line, is considerably under sixty miles. But it made at last the whole round. it was two months before it crossed the mountain intervening between Tahaina and Wailuku, where I then resided, the distance in a direct lino being under eighteen miles. The ,attack was sometimes very slight, sometimes severe, and attended with much suffering, but seldom protacted, most individuals gettingover it in a week or two, and there",
         "ORIrINAL comxulUcTos. being almost no fatal cases. The whites were always first seized, and very few of them altogether escaped. Next it spread among the natives but very sparsely, here and there only a case occurring. The first patienta I had, after the case I have described, were whites, who had come out of Lahaina, or had been there. After about half a dozen such cases, it spread amaong those who had not been there. They had pain, sometimes excruciating, in the forehead, just over the orbita, reaching from temple tu temple. The eye bad a great deal of the pecu- liar aspect I told you of, in my former letter, as diagnostic of the Panama fever. This orbital pain was universal, and in some cases was the only symptom of disease. One friend of mine had even this only in a slight degree, with some intolerance of light, difficulty of reading, a flow of tears occasionally, and a little los of appetite. He took no remedies, and these symptoms went offin a few days. Bleeding at the nose was very comnion, and, in some cases even alarming. There was a dead heavy pain in the back, in severe cases becoming acute, described as in- tolerable, and shooting through to the extremities of the ribe. There were aiso pains in the legs. The pulse was quickened, the tongue slightly furred, and the alvine evacuations were for a few times dark, coloured, and offensive. Oppression of the chest and cough sometimes supervened, especially among the natives. The first attack was very commonly attended with chilis. It was altogether sudden and without premonitory symptoms. Two or three friends of mine were seized when riding on horseback, and got hume with great difficulty. One of these recalled only that he had felt a sensation of giddiness, and then there was a blank, and he found himself lying on the middle of the road, and his horse strayed away. I believe wherever it prevailed the phenomena présented were very similar to what I have described. I followed a similar treatmeut to what I had chanced to adopt at first, giving James' powder, slight doses of mercurial and saline purgatives,and finally quina. Sometimaes wben there was great redness, 1 added opium in the form of Dover's powder. The last I found of great service among the natives. Under this treat- ment the attack did not last over thirty-six hours. The quina prevented relapses which were apt to occur if onitted. I believe the disease ha'l the same character, and the mode of treatment was very sidfilar, all over this island, and in Oahu. It seemed rather more severe in Hono- lulu, where almost every white man was simultaneously seized, so that the stores were almost all closed for a week or two. The population of that port was theni something over twelve thousand, about a âfth being foreigners. I very soon came to the conclusion that the malady was identical",
         "PZ-DrsseU PsCUIAR TO TBs SANDWIC ISLANDs. 13 with the Panama fever, only ruch alighter, and told my patients so. I soon afterwards saw the same remark made in the Polynesians, the only English newspaper at that time published in Honolulu. This similarity is one among other reasons, why I have wished to give you a sketch of the progress of a malady, so little serious in its effects. It seern to me that the beginning of diseases, and the aspect they assume when putting on their most deadly formas, are particularly deserving attention. The former correspond to the insantia incipienia of Bacon. Now here it was evident that the first impression wus on a certain part of the brain, and then extended to the nervous ystem in general. Such I appr-hend is the case in the tar more severe Panama and Chagres fever. Again it seema to me that the progress of the malady serves to show how those forms of disease which we attelnpt to classify under the terms contagious, epidemic,endenic, \u0026c., blend and mingle together. I have said it first broke out in Lahaina. That port is on the south-west of the Island. The amall town stretches along the margin of the sea. Immediately behind, aruund, and on it, are tara patches, and large fish ponds. About a mile inland the mountains rise up and surround it like a wall of some thousand feet in height. The heat is generally great, and, this season, no trade-winds or land breezes had been felt for many weeks. I should add, that the de-composing lava mountains form beds of ferruginous clay. Thus, it was a fit nucleus for febrile disease. There was sufficient pabulum to feed it on ahould it be once generated. The predisposition of a single individual gave it birth, and, possibly, form; for, a few days after that first case, the mialady with which he had been seized spread around. Having thus,shortly, uit were, grown into strength, it was able to progress beyond its birth place, and make way in regions that never would have first produced it. Undoubtedly individuals carried it from point to point, for it never progressed where there was not free intercourse. It was thus carried from Labaina to Honolulu, yet it was not strictly contagions. Amongst the natives, for instance, it attacked only individuals, here and there, a quarter or half a mile distant, and havng had no recent communication, and when it once reached HQnolulu it was a real epidemie. It never reached the other islands because the intercourse is much less free between them. ( To be contisudI.)",
         "UV13WO aM aSLMOsPHIrL MorCes* ART. III.-Case of Arn Presentation with prolapsus of the Cord. By P. R. SnAvEa, M. D., Stratford, C. W. On the 4th instant I was summoned to attend Mrs. F- , in labour with ber primipara. When I arrived (a distance of 10 miles) I found the patient had been in labour sone 15 hours, and that the waters had been evacuated 10 bours prior to my arrival. Upon a vaginal examin. ation I found the left arm protruding from the vagina, with prolapsus of the umbilical cord to the length of about six inches and perfectly pulse- less. I immediately informed the friends of the patient that the child was dead, and the mother in a very critical situation. Her pulse was 120, face flushed and hurried breathing, the vagina dry, hot and swol. len, and the uterine action very powerful, but of cburse ineffectual. I immediately ordered hot fomentations to the region of the uterus to produce relaxation of that viscus if possible, so as to enable me to per. form version if practicable. The uterine contraction had been so ener. getic that the child was crammed into the pelvis like a wedge. I then administered tinct. opii 13 cum tart. ant. gr. ss. After waiting until I had induced quiescence of the organ, I then administered chlo. roform until I had produced the full effects of the anesthetic. I then introduced my hand to turn, but upon the introduction I found the ute. rus so firmly grasping the body that I could with great difficultyinsinlu ate mny fingers between the uterus and child; but after some dela (keeping my hand in utero ) I succeeded ir. obtaining the feet, and by gentle waving motion I brought themn into the vagina, the contraction then were re-established, and before the patient became conscious thi body with the head were expelled. In five minutes after the expulsic of the child the placenta was detached, and the uterus firmly contracte The recovery was rapid, and the patient now is quite well. Stratford, C. W., April 20, 1856. REVIEWS \u0026 BIBLIOGRAPHICAL NOTICES. I.-Manual of Chemical Physiology. From the German of Profes't C. G. LESMÂr, M.D. Translated with notes and additions. J. CHaSToN Morï.R, M.D. With an introductory essay on Vit4 Force. By SAMUErL JAcxsoN, M.D., Professor of Institutes 4 Medicine in the University of Pennsylvania, \u0026c. Illustrath",
         "uzvÈiMs .gn SiELnoaprcit A rtOri!. 15 with forty wood-cuts. Pp. 331. Philadelphia: Blanchard \u0026 Lee. Montreal: B. Dawson. Quebec: Middleton and Dawson. In the January number we reviewed Dr. Lehmann's large work on physiological chemistry. The one now before us, is an epitome of that work, and contains \" the positive facts which can now be voki .n as the certain possessions of physiological chemistry, in rs compressed a form as possible.\" The American edition contains t wo chapters frm the pen of Professor Jackson of Philadelphia. 1st. Introductory essay on the human organization and its forces. '2nd. Remnarks on Dr. Leh- mann's doctrine of vital forces. The philosophie mind in all ages bas been earnestly directed towards the elucidation of the mystery vhich involves the subject of the mate- rial and the spiritual. What is mind, and whut is matter 1 What their nature, and what their relations? Are they distinct entities, or are they not? Is mentality a mere property of matter? What is life? These, and many questions of similar import, have stirred the souls of men, and the midnight oil bas burned-the patient investigation has been accom- plished-the musty records of the past, and the ever fresh tablet of nature bave been deeply rend-'the body of the student has become bent, his brow furrowed and bis hair sprinkled with groy-and what availeth it ? Much of great and glorious knowledge has certainly accrued to us; but still we only begin to perceive the heighth, depth, and extent of our ignorance of nature-her workings and her mysteries. True, enthusi- asts now and then startle us with the cry of Eureka, Ereka \"- d we sieze their volumes with avidity, eager to know if the starding enigma of compound man has at last been solved-if the interior artana of nature have finally been penetrated and forced to yield their secrets ; but, alas, we read few chapters ere we discover that, although apparently satisfactôry to the writer, there is naught for us save wild conjecture, or, at the best, a plausible and decent hypothesis. That man is made ip of a perishable material body, and an imperishable immaterial spirit, we fully believe. Our convictions, however, have not been forme'd from, or strengthened by the perusal of the writings of philosophera, or the re- searches of science. They are solely based on the authority of that Book whose teachings we are ever ready to receive withunquestioning confidence. The Scriptures teach it, therefore, we believe it. Our author, like many others who have made one branch of science their constant study, thinks that vital rhenomena are quite explicable by the principles of his favorite science. Whilst, however, he labors to prove that physical forces are sufficient for the production of ail the vital proceses, he clearly cannot divest his mind altogether of the idea that there is sotte fbrce operating in the human organism, which",
         "RZVIEWi AND 33LIOoaAPHICAL NOTICEs. differs in its manifestations from any known physical force. \" The oor- rectndsu of the view,\" he says, \" which ascribes vital phenomena to me- chanical conditions cannot be purely tested tilt the existence of this new force has been proved ; but how can such proof be ad4uced in reference to a force the simplest effects of which are unknown to us; and which dif- fers from other forces merely by its disregard to all restrictions, and of the limits prescribed by physicists to laws ? It may be briefly aserted that the exclusion of physical agency aflords no proof of a purely vi'al force, and yet there is no other means by which its existence can be established. The physicist who rigidly follows the leading maxima of his own science, must admit the possibility of a vital force, although, he may regard any proof of its existence as at present impossible.' In dis- eussions of this nature too much] importance is placed upon terms. Men will contend for precisely the same thing but in bitter hostility to each other, merely from the fact of their having called the same thing by a different name. Now Dr. Lehmann, and his critic Dr. Jackson both agree that the physical forces, as far as they are known, do not suffice to explain life-processes ; that although they enter very largely into their production, there is beyond them,and apparently distinct from them,an- other dynamical ageucy. This, which Dr Jackson, with other physiolo- gists, calls vital force, Dr. Lehmann supposes may yet be found to be a physical force, whose manifestations are different from any that we are now acquainted with. Here they differ merely as regards terms ; for what matters it, whether this force be called vital or physical so long as it is recognized as the power which operates through matter, and by its relations to other forces, or modes of force, produces that arrangement of matter to which the term organie has been applied for the purpoee of distinguishing it from the inorganie, in the formation of which we per- ceive the operation of the physical forces only. Dr. L. asserts that the idea of vital force is illogical ; for a force is merely the abbreviated expression of a law from which the causal con- nection of certain phenomena inay be deduced; and that a vital force is no law. We agree with Dr. Jackson that this statement proves Dr. L. \"las not investigated the physiological facts of embryology or organo development, or he could not have so broadly aserted that the vital or organic force corresponds to no law, and is not anecessary cause i mul- titudinous consequent phenomena. So far is this statement from being correct it may confidently be aserted that the evidences of law, of causal connection and dependence are as strong,as palpable, in the phe- nomena, the direct results of organic or vital force-those of organisa- tion-as are to be lonnd i any of the physical forces. A few facts wiHl provo this position. Prevent the spermatomoon from saching the a,",
         "REVIEWS AND BIBLIOoRAPHICAL NOTICES. no monadiform germ cell, the primary form of ail animais, is produced. Le this germ cellbeartificially broken or injured,and no blastoderni will be formed; injure the blastoderm,and either no embryon and chick will be developed, or this last will be imperfect.\" P. 44. - Force, according to our conception, is the cnergy of the Almighty Will operating through the maerial substrata of the univers.. As the substrata differ widely from each other, so the manifestatitns ot force differ, constituting what Physicistsdescribe as the phenomena of so nany diffirent forces. The source or origin of force being one and indivisible, unchangeable ; force, in simple terms, being God in nature, it follows that it an never be lost, but, sa soon as it ceuses to exist iii one ori it must, of necessity, manifest itself in one or more different forms. Every change in the relations of the materialsubstrata through which it operates will give rise to a change in the phenomena. Hence we find that ail the so-called separate forces are readily convertible one into the other. -that they are strictly co-related, and \" possess equivalents of power in their action.\" We would not have it for a moment supposed that in giving expression to this view, we are inculcating any thing savouring of Pantheism. Nothing is further from our purpoe. God,unduubtedly, is in all things, or rather, all things are in Him. lie pervades ail nature. He is the great life-organ, whose pulsations send streaims of vivifying energy to the ultimate ramifications of every extromity of Ilis muighty universe. But, Ie is more than that-He is the incompreheusible Soul ; the Eternal first cause, the Creator, Upholder and Director of ail things. Ul.--T :princples and practice of Ophthalnic Medicine and Sargery. By T. W. JoNEs, F.R.S., Professor of Ophthahaic Medicine and Surgery in the University College, London; Ophtlhalhnic :ur- geon te the Hospital, \u0026c. With 110 illustrations. Second A mc- rican, with additions from the second and revised London edi- tion. Philadelphia: Blanchard \u0026 Lea. Montreat: B. Dawson. Quebec: Middleton \u0026 Dawson. 1856. We have always regarded Mr. Jones' Ophthalmic Medicine and Sur- gery as incomparably the very best manual ever published, in the Eug- lish language, upon the subjects of which :*t treats. The second editiui appearu under many advantages over the first ; and we may safely assert ofit,*that we know of no other work on the eye we can so confidently recommend to the atudent for study, or to the practitioner for practice. Witoiit extending Our approbation further, we propose relating a brief",
         "REVIEWS AND BIBLlOGRAPHICAL NOTICES. account of the opbthalnascope, one of the latest marvels in ophthalmic practice, for the edificatior, of our readers:- The ophthalmascope is employed for a two-fuld purpose : 1. To iUlu- minage the fandus of the globe of the eye, and 2. To oblaiu from the foregoing result a clearly defined view of the ocular surfaces presented. It is variously constructed, the more commonly used on the European continent are those of Anagnostakis and of Jaeger. The former, whieh is probably the more superior of the two, consists of a round concave mirror, having a diameter of 2 inches, and a focal distance of 44 inches, the silvered surface being protected by a blackened copper plate. The centre of this mirror is perforated in a round hole of the dianieter of i inch. The instrument is, lastly, set in a handle, and is then complete with an ordinary spirit lamp. l order to use it, the pupil first having been dilated by atropine, the patient is seated, the lamp ignited and placed upon the side of the eye to be examined, and in front of the latter the ophthalmascope is held, the Surgeon looks througih the central aper- ture, and notes the appearances presented. The principle tl on which the practice is founded is equally simple: the rays of light from the lamp are conceatrated by the mirror, and are deflected thenco upon the cornea, where, in consequence of their inteisified illuminating powers, the deeper parts within and behind the posterior chamber become visible. An extemporaneous instrument may be made at any time by scratching off fromn near the centre of a fragment of common iooking-glass a little cf the silvering; this, with a lamp, suffices for myopie eyes, but presby opic eyes will require, in addition, a convex lens placed between the lamp and glass. In using either of the foregoing soma little difficulty will, at first, be felt-thus the exact distance may not be readily got, when this is too great, a mere reflection will be perceived upon the cornea ; when less, a kind of red glare is brought out fron the fundus of the eye ; and when still less, the diferent teztures of the retina will beom. conspicuous. Of course these variations reqiire to be performed carefully and gradually. Instead of a spirit lamp, a wax caudie or an argand burner, or a solar burner, mnay be used. The candle suffices for the ex- amination of the crystalline lens. The flame of the lamp should g ene- rally be a little in advance of, and quite 'ncar to the car of the patient, and always in the same plane with the eye of the patient and of the observer. in order that different parts of the interior may be sueces- sively seen, the patient is to roll his eye about in various ways, nccordimg as directed, or if he is incapable of doing so, the Surgeon may obviate this difficulty by a little change in the position of bis own eye, and oph. thalmascope. Again, as the nearer the lamp approaches to the mirror, the more the focal dince is elongated ; so the further is the lamp to be",
         "navtzws 1nn mIoGAParCL NOTICas. placed from himself, the nearer the observer deuires to look. And, lastly, in making the variations, the mirror and patient may be kept fixed, after the focal distance of the former is determined, while the shiftings are confined to the illuminator. Several cantions are to be observed in ophthalmoscoping, and .these refer principally to cases of amaurosis, which is the disease, for the dis- covery of which it is chiefly intended. Thus, according to Dr. Dix, who has an article in the Virgiinia Medical Journal upon the sub- ject, the instrument is not to be employed in \"Fist. AU cases of incomplete amatrosis which are of recent date, in which vision is but little affected, and wh ici were preceded or at their commencement ac- companied by severe pain in or near the eye, by intolerance of light, or by tenderness of the globe to pressure. Seond. Recent cases attribut- able tu exposure to excess of light. Lastly. It should never be used in cases of acute inflammation of any of the textures of the eye.\" The use of the ophthalmascope is not without its dangers to the operator himself; in no case is it advisable for him to prolong an examination much beyond one minute. Its too aseiduous employment might not unlikely induce amaurosis in the sanie wayas intense artifieial light, when other- wise reflected or refracted, proves baneful to microscopists, watchmakers, sea captains and others. By this valuable speculum all the parts behind the iris are as clearly perceived through the expanded pupil as are the anterior textures to the unassisted eye, allowance, necessarily, being made for the refracting influence of the trausparent humors of the eye that is under surveillance. III.-Atlas of Cutaneous Diseases. By J. MOoRE Nr.LIA, M.D., Edin., M.R.I.A., Honorary Doctor of Medicine, Trinity Coliege, Dub- lin; Fellow of the King and Queen's College of Physicians in Ire- laud; Ilonorary Fellow of the College of Physicians of Sweden ; lonorary Member of the Cork Medical Association ; Physician to Jervis Street Hospital; Lecturer on the Practioe of Medicine in the Dublin Sehool of Medicine, \u0026c., \u0026c. Philadelphia: Blanchard and Lee. Montreal: B. Dawson. Quebec: Middlefon \u0026 Daw- son. 1856. Neligan's atlas ofeutaneous diseases supplies a long existent desideratum much felt by the largest class of our profession. It presents, in quarto size, 16 plates, each containing from 3 to 6 figures, and forming in all a total of 90 distinct representations of the different species ofskin affections, grouped togetber in genera or families, in accordance with the classifi-",
         "REVIEWS AND BIBLInGRAPHICAL NOTICEU. cation constructed by the author in his \"Practical Treatise on Diseases of the skin,\" as published in the American edition of the latter. The illiistrations have been taken from nature, and have been copied with sich fidelity that they present a striking picture of life; in whicl tl.e re- thnced scale aptly serves to give, at a oup d'ail, the remarkable pecï'.r- ities of nech individual variety. And while thus the disease is render- ed ruore defmiable, there is yet no loss of proportion incurred by the ne- cessary concentration. Each figura is highly coloured, and so truthful has the artist been that the most fastidious observer conld not justly take exception to the correctness of the execution of the pictures under bis scrutiny. This production reflects the highest credit on the esta- blishrment of the enterprising publishers, who have brought it out, ap- -arently, without sparing themselves either personal expense or great lm(lertak:ngs. It is worthy of remark that the illnstrations were express- ly taken in Dublin, from patients either under the care or inspection of lr. 1Neligan, so that the work is eminently original. No pains were \u003epared to obtain accuracy of finish with truthfulness of representation; and as an instance the following circumstance may be mentioned - \" The Duguerreotype bas been employed in several of the illustrations, in order to aid the artist in accurately reducing the figures,and retaining the exact proportions between the size of the eruption and the part of the body affected.\" Accompanying each portrait is a short account of the chief facts of the case to which it refers, such as the age of the pa- tient, the duration of the disease, the phases passed through by the erop- it il, the effect of remedial agents, \u0026c. The above publication is sold at the comparatively low rate of $4.50, and this is placed within the reach of every professional brother. Both the student and practitioner whose pecunivy resources may be limited, and 'who do iiot enjoy the privilege of having the command of a well- stocked public library, will hail with great satisfaction the appearance of this work. And they May congratulate themselves at being favoured vith what must soon be generally recognized, as not only one of the Lest books in its way, but aiso as one recommending itself to preference over longer known productions professing a similar object-viz., that of facilitating the comprehension of a most important class of affections, vhich w ithout the proffered aid would often be either unintelligible or greatly misapprehended, since, then, their descriptions would only be conveyed by oral tradition or printed directions.",
         "REViMWO AND IrILIOoRAPmCAL NOTICES. IV.-Ha-ade\u0026r. Their causas and.their cure. By Hmv G. WRirGT, M.D., M.E.C.S.L., L.S.A., Fellow Roy. Med. -Chir. Soc. Physi- cian to St. Pancras Royal Dispensary. J. Churchill, 1856. prom the anthor. The reader is here presented with a work eminently practical in cha- racter. Its style is exactly that required by a subject so popular. And its matter is remarkably well arranged. We should be glad this treatise received a widely spread diffusion through the ranks of the laity as well as the professional circles of society, for to both it is capable of proving generally useful. We quite agree with the Doctor that people are too often disposed to put up in the best way they can with the aches of life they call minor, and which they, erroneonsly, suppose are either not within the province of medical treatment or else not fitting cases to engross the attentions of the Physician. A vast amount of human suffering might most unquestionably be prevented by a timely adoption of means adapt- ed to nip it in the bud. And however indisposed the publie are to accept this truth it is one upon which practitioners always endeavor to act when they are afforded an opportunity. The study of prophylatics is alsq, we are glad to know, rising of recent years in importance and in- terest, by the many valuable acquisitions brought within its folde by in- creasing experience and observation. Of the minor aches, headache is believed to be by far the most prevalent and the one met with under the greatest number of varieties. It sometimes constitutes the whole disease but more often i but a single symptom, and according to the other marks of disorder coupled with it, declares the particular lesion upon which it depends. Often, again, it is but a warning of many dis- tant dangers, which, unless it be overcome, will surely follow. While at other times it is a sympton of present derangement. Were the laity aware of these essential differenes in the import of headaches, we feel sure they would refrain from injuring thermselves by their pemnicious practices of-treating each and every one upon some simple plan of their own. And, therefore, as we said, we wish this book were distributed among them to be learned and acted on. Practionets also will find much valuable information particularly in the symptomological and thera- peutical portions, and the whole is enriched by a copions formula of use- ful prescriptions. V.-On smm diam of ssmen admitting surgical treatment. By IsAAc BAKEa BERowN, F.R.C.S., Surgeon Accoucheur to St. Mary's 1os- pital, Vice President of the Medical Society of London, \u0026c., \u0026c.",
         "22 .CLTNIC.L LCT . Illustrated by twenty-four wood engravings. Philadelphia i Blanchard \u0026 Lea. Montreal: B. Dawson. Quebea: Middleton \u0026 Dawson. 1856, pp. 275. Some few months ago the London edition of this work was reviewed in the last volume of our journal, so that on the present occasion but little remains for us to do. It may, indeed, suffice for us to say we have much pleasure in renewing the favorable opinion of its merits that were forrnerly expressed. For the benefit of our readers we must, however, aiso add that the present edition is not a reprint of the English copy but appears to have been published on this continent, independently, of the latter and almost cotemporaneously with it. Purchasers in Canada will find it advantageous ia an economical point of view to secure the American edition which compares very favorably with its associate- the text is clearly printed and well illustrated with explanatory wood euts-while the selling price is much lower. CLINICAL LECTURE. (Medical Circular.) On Modified Small-poz and Varicella. By M. Tnousss\u0026u, Physician to the Hotel Dieu, Paris. Many physicians in our days still confound modified small-pox and varicella, and yet these two diseases are as unlike one another as vacci- niais unlike variola. When ah individual who has been vaccinated comes into contact with a person labouring under small-pox he becomes affected with small- pox of a particular kind. If the latter person come, in return, into con- tact with persons who have not been vaccinated, to these he commu- nicates small-pox, usually distinct, but sometimes also extremely con- fluent. Small-pox and modified small-pox are one and the same disease, only the latter bas been mcdified by previous vaccination. Varicella occurs in individuals who have been vaccinated, as well as - in those who have not,-in such as have had small-pox, and in such as have not. At the Hôpital Necker, where all the children had been vaccinated when a case of varicella bas been admitted into my wards, I have seen the disease spread to every one of my little patients. Vari- cella never gives rise to smalil-pox or to modified small-pox. It becomes, then, highly important to know with certainty how to distinguish it from modified small-pox, which, you- know, does not possess the same immu- nity. Let us pursue a little further the development of this subject. MODIFMD SMALL-POX (vAI.oLM DISEASE). When I began my medical studies, thirty-four years ago, it was gene- rally admitted that an individual who had been vaccinated, could never afterwards have the small-pox. la 1825 a terrible epidemic small-pox broke out in Paris, when some individuals who had been vaccinated be-",
         "CLuI.L LCTUIa. came affectedwith a disease resembling small-pox. Mr. Huuom,oneot the physicians of the Hôtel Dieu, who had devoted much attention to the study of small-pox, denied the occurrence of small-pox after vaccina- tion. The thing seemed so extraordinary, that when a veccinated person labouring under small-pox was brought into an hospital,a volley was rung to collect the greatest possible number of physicians to consuit on this anomaly. But after the epidemic of Edinburgh and that of Marseilles, this was no longer contested. The di\u0026irent Governments of thé Ger- manie Confederation took, on that occasion, the following measure: They caused not only ail the Military to be vaccinated, but every one who entered the Service, although he might previously have undergone that operation, had t6 submit te vaccinated aiew. - Small-pox may appear soon afler vaccination. At the Hôpital Necker I saw a child seized with amail-pox, whom I had vuccinaated two years before. A woman and her ehil ren were attacked with ail- pox after vaccination. The mother died; the children had only a be- nign varioloid affection. The precursory forms of the varioloid disease are nearly the same as those of amall-pox. Baides the initial féver, there is frequently seen a scarlatinous or petechial eruption, which, in a prognoeti view, is but of slight importance. On the fourth day the eruption appears. In the va- riola discreta, the pustules are accompanied by a well-marked inflamma- tory areola; in the varioloid disease the pustules become slightily umbili- cate, are not unequal, continue acuminated, are more or leas projecting, and finally becopie encruated. . The ninth or tenth day of the disease- that is, the fifth or sixth of the eruption-shows the dessication complete, which is never the case in small-pox. When the tumefaction, in small- pox, ceases ail at once on the ninth day, i have told you it is a sign ai- most always mortal. Jn modified amall-pox, by the ninth day the whole is finished. vAArcar.. There are physicians occupying an eminent scientific position, who declare that varicella is only a modification of small-pox,--a particular form or variety of variola; a great and very dangerous error. When a case of varicella is received into my wards at the Necker-if, for exam- ple, it is the lst of June-I direct this to be written : \" Froa the 15th to the 17th of June there will be other cases of varicella in my wards.\" And this prediction bas never failed. When the case was one of modi- fied small-pox, eleven or twelve days afterwards I was muré to see the varioloid eruption appear. So yon »e how essentially différent i ,the period of incubation i the two diseases. A vaccinated child that bas bad variola will take varicella, shovld varicella be in the family; but the same thing does mot occur in variola and in the varioloid diseaze. Childrensufferin from varicella havet the outset, fever, with agmal red spots; then b W are perc.eived-phlycteam of perfect transparenOy, without any surrounding infiammatory areola. What takes place in va- roella, thirty -ix hous from the outset of the disease, you do not see in amall-pox atillbout the eighthor the ninth day. In small-pox the emp- tion is siuutaneous: in varicella it is succeSsive. You observe fever",
         "CLINiCAL LECTUaE. and spots; and about the fourth or fifth day you see the fever entirely disappear. The first day of the eruption in varicella, the balla, is transparent ; the se- cond it isa purulent phlyctena;and the third it contains alactescent fluid. In variola discreta the pustule, in form, is round, like a drop of wax adhe- ring to the skin. In varicella the bulla is unegual and jagged : in small- pox the pustule is umbilicate ; the bulla in vancella is not, and leave be- hind a speck of a deep bistre colour, easily distinguishable from the yellow mark left on the skin by smali-pox. Twelve or fifteen days are requir- ed for the completo evolution of the variolie pustule; four or five suffice fur that of varicella. Varicella is always a disease of little severity. I have never seen it terminate fatally, and I do not know that any one has ever sunk under the attack of a weroleue, as it is still calleJ.. As sequelS of varicella in children, synrptoms may be seen that may become fatal; as, for example, when there is a tendency to suppurate, a pemphigoid disease may arise, sometimes with very large bullS, leaving extensive ecchymoses. The disease has then nothing in common with snall-pox, from which it difelrs essentially. Thus, then, sinali-pox and the varioloid disease (modified small-pox) are identical, whist varicella is distinguished fromn them by dissimila- rities in the period of its incubation and febrile attacks, in its furi, the duration of its cruption, the nature of its pustules, and degrea of seve- rity. THERAPEUTICAL RECORD. (American Fharmaceutical Journal.) On the Therapeutic Action of the Vapor of Bi-Sulphuret of Carbon.- Dr. Calvin G. Page recommends the vapor of bi- sulphuret of carbon tu be applied externally, for neuralgic and rheumatic pain, by holding a wide-mouthed vial, containing half a drachm of that liquid, se that the vapor will be brought in contact with the part affected. The vapor pro- duces at firt a sensation of coldness, then a feeling of warath with prickling, which rapidly increases until it can nu longer be borne. Dr. 'ag believes it to be a valuable agent for the temporary relief of pain, and in certain cases with permanent benefit. Fecula of Cokhicum Autumnale as a source of Alcohol.-M. F. Comar says that the fresh bulb of Colchicum, yielded te himn 21 per cent, of starch granules and that he waa unsuccessful in detecting inulin, which bas been announced as an ingredient of the cormus of tiis plant. M. Comar thinks this large percentage of starch i worthy of attention as a source of alcohol, and by*an experiment, extracted 64 centilitres (11 pint) of that fluid from 141b, of the fresh bulbe. New Test foi Nuz Vomica.-Vielgruth bas proposed the following simple test for nux vomica. A few grains of the suabtance suppotied te",
         "TU*Iru U inL a.ofl. 2W contain nux vomica is treated with prof spirit. The tinoture is eva- porated to dryness, at a temperatuhe mot *OO\u0026dint 968 F. A dropr two of dilute sulphuric acid is added to the residue.The whole is again exposed to the above mentioned temperature; when, if aux vmia is present,abeautiful carmine-red color ennes. If the heat be stopped ml ten or fifteen minutes, the color disappears, but will reappear with leu brightness on reheating. Oleo-Margarate of Zinc as a sulbsitute for Lsd Plasr.-M. de Mus- sey, during a residence at the Pyrenees, was struck with the fact thatin those patients who make use of diachylon planter, a black stain was caused by contact with the sulphurous water of the baths, in all places to wbich the disehylon bad been applied. It was found that if the skin had been in contact with this preparation for a few minutuouly; a sufficient quantity of lead would adhere to iorm a thick layer of sul- phuret lead, after being plunged into the water which was with difficul- ty removed. Simply handling the plaster was enough ta produoo th same reaction with the mineral water. on the fingers. This fact sug- geste that lead poisoning may occur by the esternal appHcation of lead in this form. At the request of M. de Mussey, M. Boileau, Sr., of Lu- chon, in the Pyreuee, made some nice \" zinc plater\" by prees tating white soap in solution with sulphate of zinc, and afterwards adding, to the dried orecipitatie resin, etc., as in diaohylon. Its eflBcacy as a, sub- stitute for lead plaster han been tested affirmatively. Action of Sugar on the Teeth.-M. Larez, in a course of investigatioa, arrived at the following conclusions, viz.- 1. Refined sugar, from either cane or beets, is injurious to healthy teeth, cither by immediate contact with these organs or by the gas developed, owing to its stoppage in the stomach. 2., If a tooth is macerated in a saturated solution of sugar, it is go nuch altered in its chemical composition that it becomes gelatimous, and its enanel opaque, spongy, and easily broken. 3. This modification is due, not to free acid, but to a tendency of sugar to combine with the calcareous basis of the tooth. Eau Sedative de Raspaid is prepared of three strengths.:- Take of Solution of ammonia (22O) 60 partis 80 parts 100 parts Tincture of camphor, 10 \" 10 \" 10 f Common sait, 60 \" 60 \" 60 \" Water 1000 \" 1000 \u003c 1000 \" Dissolve the common sait in the water, then mix the camphor and ammonia together, and add ther to the saline solution. M. Baspail intends No. 1 for persons whose skin iseaily:affected by rubefacients. No. 2 for allaYing the pain fromthe sting of insecte, and No. 3 for these patients who have, a hidi callous skin. It is emplQyed in. hemicrania, cerebrîls congestions, and rheumatic affections. It la applied by, cour- presses to the part afftcted, and when near the eyes care should be ex- tendçd to protect them.",
         "PURMscoPs. PERISCOPE. Tapping of the Pericardium.-M. A ran, physician of the Hospital St. Antoine, at Paris, brought before the Acadeny of Medicine the case of a young man,%23 years of age, who was admitted under his care in July, 1855, with all the symptons of severe pericarditis. The tient had been treated for pleurisy in the sane hospital a few months before, and there was reason to believe that tubercles had formed in the lungs. As the young man was, on his second admission, very weak, and aflected with diarrhea, the antiphliogistic treatment could not be used with saf- ficient energy ; and the inflammation of the pericardium, far from be- coming subdued, was speedily followed by effusion. The liquid was so abundant, that very severe fits of dyspnea came on, and M. Aran there- fore resolved to tap the pericardium. Though physician to an hospital, he performed the operation himself, with a small-sized trocar and canula, the direction being from below upwards, in the fifth intercostal [space, a little below the spot where the dulness on percussion was well marked. The actual extent of the distended pericardium was figured by concentric lines drawn on the chest, and the actual situation of the heart oarefully ascertained by auscultation. About twenty-eight ounces of a reddish transparent serosity esoaped, with great relief to the urgent symptoms which had called for the operetion. An injection was then thrown into the cavity of the pericardium, composed of an ounce and a half of water, half an ounce of tincture of iodine, and fifteen grains of iodide of potassium. The injection was well borne, and a few drachms of the hquid having been allo.ved to flow out, the wound was closed by com esses. The symptoms, however, returned, and twelve days er the operation tapping was again had recourse to, when forty-nine ounces of a greenish albuminous liquid escaped. A stronger iodine injection was now used. The operation gave the patient neither pain nor uneasiness, and in the space of ten days the dulness had considerably diminished. But as the heart and pericardium improved the lungs grew worse ; symptoms of tubercles became more plain, and dropsical effusions in varions parts.of the body appeared. The latter symptoms were removed by blisters and vapour baths, and the patient finally recovered so far as the affection of the pulmonary organs would allow; but the whole treatment used for the pericarditis with effusion was completely successful.-Lancet. Chloroform in Intermittent Fever, by Dr. N. Dalton, of Logan, Ohio. Some time in September last, I visited a young athletic man, laboring under an intermittent, with gencral visceral congestion, which seemed to menace his life. I was convinced he must die, unless he was speed- ily relieved. For promptitude, I was induced to try the internai use of chloroform, and gave him about two drachms, with half gr. sulph. mor- phine. In a few seconds, he fell asleep, and slept soundly. His plse which could not be felt at the wrist, came up to about nmety, fuli and soft, and, when he awoke, to my astonishment, expressed himrself per- tectly well. Ali the unpleasant symptoms had given way, nor was the cold stage followed by any feverish reaction. This ail occurred in les than an hour. I was so much pleased with ils effects that I concluded to test its anti-periodic properties by risking the probability of its retur.",
         "Puas coPI. 3'r From fbur to five weeks did elapse before it did return, during wbich time, and since, I have given it in the cold stage of quite a number of cases of simple intermittent, in doses varying from one to two drachms, in a little camphor water, both alone and combined with the morphine, and in every case have had the pleaiure of witneuing the same prompt arrest of the disease ; and in but two cases bas there been any return of the ague, and in one only has there been any feverish reaction ; but ail are instantly arrested. I mentioned the matter to my partner, Dr. Hoffinar., who has used the chloroform in a number of cases with the saine happy results; also, to Dr. Pullen, who tried it on himaself, with the effect of immediately arresting the chill, leaving him te feel as well as usual after an intermittent attack; but, being fearful ef its anti-peri- odic properties, took from two to three grains of quinine the next day, and las not had a return of the ague since. I will report more fully as soon as I can get time, possibly during the coming month. In the meantime, I hope you will lay this before your readers in some shape, that it may be more generally tried. If found to be as serviceable in the hande of others as in ours, it will be of incalculable benefit, both in relieving human suffering, and in a mone- tary point of view. Shoild it, on the other hand, serve no other pur- pose than promptly to arrest those alarning and so frequently fhtal con- gestive chills, it will do mucl good.-Ohio Med. and Sug. Journal. Te Treatmenat of Hemwpysù, by M. Aran. M. Aran agrees with those who entirely condena the employment of blood-letting in the treatient of homenoptysis, as it only temporarily arrests the bleeding, while it is dangerous, owing to the debility and increased susceptibility to the intercurrent aflections it gives rise to. He bas, for nome time past, been engaged in testing the efficacy of the varions hiemoatatic agents employed in hoemoptysis; and in this paper he gives the results of his observations. He considers the essence cf turpentine a most va- luable remedy, gives it in doses of from 10 to 30 drops every hour, either in a spoonful of water, or mixed up with magnesia as a bolus. Marked amendment usually occurs in a few hours, and in from twenty- four to thirty-six hours the bleeding ceaies. is ialessnuitable for yonng or plethoric subjects, with febrile action, than in weak, cachectie indi- viduals, exhibitmg atonie characteristics. Ergot of rye and ergotine are fat les eflicacious; but chloride of sodium, given in doses of 1 to 2j drachms, proves very efficacious in some cases, and bas the advantage of being always at hand. Among the astringents, tannin, and especially gallio acid, are to be recommended; the latter, while quite as effiaci- ous, does not exert the same desiccating effect upon the tissues, or in- duce the obstinate constipation produced by tannin. As a mean dose, M. Aran gives 15 centigrammes (a centigramme is 1-7 grain) every hour or alternate hour. He bas had litile experience in the use of eme- tic and nauseating remedies; but, in tbxee cases in which oermtrine ws employed, the bleeding ceased as if by enchantment. Thi clas cof re- medies, inleed, would 4eserve to stand in the first clans of haemostatiQ agents, were there not others possessing like efficacy, and yet not giving rise to the painful nausea these produce. M. Aran bas derived great",
         "2A ,scoPm. advantage from the combined use of digitalia and nitre. In ordinary cases, ho gives, in the twent y-four hours, 30 centigrammes of digitalis, and 11 granirme (a gramme is 15 grains) of nitre, divided into four doses; but, in very severe cases, these doses may be very rnuch in- creased, so that the digitalis has been given to the extent of 1 \u0026 gramme, and the nitre to 4 grammes, without injuriously affecting the action of the heurt, while the effect produced on the hemorrhage has been re- markable. Its arrest, never, lowever, takes place so suddenly under the use of these medicines, as when turpentine or gallic acid is em- p!oyed. In abundant but not imediately dangerous hemorrhage, we can choose among any of the nbove-mentioned means. In extremely abundant lRmorrhage, we must arrest the flow as speedily as possible, by agents which do not depress the powers of the economy too much, and which are not too slow in their operation. Neither ergot, acetate of lead, nor alum is sufficient to meet the danger. Turpentine, gallie acid, chloride of sodium, or nitre with digitalis, can alone be trusted; but the necessity of iucreasing the dose with the intensity of the hemorr- hage may perhaps render the chloride of sodium, and especially the nitre and digitahs, dangerous, through the possibility of a production of a too great depression of the heart's action. It is, therefore, to gallie acid or turpentine that we must chiefly trust in these severe cases; and we must not linit ourselves to their employment, but also endeavor to procure a temporary arrest of the hemorrhage by ligatures to the limbs, and the application of ice tu the chest, allowing the means employed in- ternally to consolidate this tempomry cure.-Md. 7Vmes and Cazete, Jan., from Gaz. Iop. 1855. A new m\"de of ezploration by the simultansw emplopment of Percus- smrn and Auscultation.-Although but little practice is required to recog- nize, by the different degrees of sonoriety, intensity, and tone, the si- tuation of the internal organs, and the marked changes which may occur in them, yet, to distinguish changes of function or structure, which oc- casion but very alight modifications of the normal sounds, the highest cultivation of the ear is essential. The means hitherto employed have not always enabled the most expert and experienced to detect the exist- ence of internal changes. A very simple procedure, which, su risng- ly, has not suggested itself before, bas been recently prope by an American physician, at present at Honolulu, on one of the Sandwich Islands. Two persons are required to practice this mode of observation. One percusses whilst the other applies the stethoscope to the vicinity of the spot percussed. While he who percusses distinguishes only the coarse sounds, and the broad differences of sonoriety ; to the ear of the aus- cultator is conveyed the ftintest sounds and vibrations, with their mi- nutest shades of variation. Dr. O'Rorke, who reports this method, in La lancette Francaise, thinks that it will become exceedingly easy to trace, by its means, the exact limits ofthe heart, the liver, the different portions of the intestines, the course of the great vessela, and to ascer- tain the presence of liquids and gases in the internal cavities. The",
         "PamiscoPE. fingers were used to percus in these trials, but any substance may serve equally wellas a pleximeter. The stethoscopo is directed to be placed, according to the case, more or les near the spot percussed. The only objection which can bc urgeil agninst the method of explo- ration seems to be the necessity of having an assistant; but, as it will only be occasiónally requisite to resort to this rigorous mode of investi- tion, it may be found generally inconvenient.-Charlston Medicai and Revwiee. Quinine in hoping-ough.-In some parts of Europe, after treating the preliminary stage of hooping cough with enotics of ipecacuanha, emol- lients, and revulsives, quinine is generally relied on to complete the cure. It is given immcdiately after the fit, in order to give time for the remedy to act before the succeeding paroxysm. Other remedies commonly employed, such as belladonna, assafetida, sulphuret of po- tassium, coffee, cochineal, \u0026c., d,) net seem to aid the curative action of quinine. All this may be received as evidence of the existence of pe- riodicity in connection with the disease thus treated, which is often the case, doubtless in this country, also.-Mempahù Medical Recorder. On the Xiphiternal or PeriSrdial Chisel-Sound. By Dr. E. Smith. The author commenced by laying down the following propositions, distinguishing between facts and hypotheses:-1. (fact.) A single chisel- sound is heard in the lower sternal region, in persons apparently healthy. 2. (hypothesis.) The sound is due te white pericardial patches, plus toxéemia. 3. (fact.) It is usually accompanied by a certain form of dyspepsia, which diaappears with it under treatment addressed to the assumed pericardial leston. 4. (hypothesis.) The attendant dyspepsia is only sympathetic. 5. (fact.) The disease, of which the chisel-sound is the manifestation, is almost confounded with ordinary dyspepsia, or some other disorder, although a diagnosis can readily be effected by ob- serving the concurrence of thé physical signa with the symptoins. 6. (fact.) The natural course of the disease is to persist; and, 7. (fact.) It is not dangereus to life. 8.(fact.) Itrequires no treatment when unaccom- panied by disorderof digestion, or cf any cf the other natural functions. 9.(hot.) When it is present with any other disease, benefit te that diseae usually results from cardiac treatment. 10. (fact.) It readily yields to mild antiphlogistic reatment addre sed to the assumed lesion. Il. (fact.) It can only be diminished, but not removed, when the heart is diseaaed in its valves or muscular tissue. 12. (hypothesis.) The di- ease consista in general dyscrasia, witl local perverted nutrition; the dyscrasia being allied te that of dyspepsia, gout, or rheumatism i anid the local leion consisting in milky patches on the pericardium. 13. (hgpo- thesis.) Toxvmia invariably coexista with white patches on the . '- cardium, when the chisel-sound is heard. 14. (hypothesis.) le patdbes arise eitber by an inflamrnatory or a non-infammatorypre. 15. (hpotheais.) 'Thechisel-soqnd doea not follow upon he e \"faroniid subèòue peifiditis, exce\u003et when dyscrana -",
         "PsalsCoPE. pervene up the pericarditis. 16. \u003cfact.) Pericarditia9, mild and limited, will occur, and will disappear without giving rise to the chisel- sound. 17. (hypothesis.) The white patches on the pericardium are analogous to those observed on the liver and spleen. 18. (hypotheais.) The white patches that arise froi a perverted nutritive procesa are at- tended during their formation, by hypermina and pain. Dr. Brown said that he did not attempt te explain the physical cause of the chisel- sound : it was a single sound, synchronous with systole, and resenbled the ioise made by a chisel cr short plane used forcibly acros the end of a piece of timber. It is heard at the lower part of tlie %ternum, and over the xiphoid cartilage, and is most intense thcre evu vhen it ex- tends over the whole sternum. The extent of curdial dniness is sorne- times incrensed tuwards the proecordia, but not always. Tlhe dyspepuia accompanying the chisel-soutnd is net aienable to stuichies and tonies, but is removed, together with the sound, by leeches, bWlers, tartarized antimony, and iodide of potassium. The author related a numnber of illustrative cases ; and concluded by desiring the assistance of the liro- fession te investigate the subject.-From Dublin Mdical Prss. IntermiUtent Opaciy of the Cornea, Supervening ajier Sleep. By V. Rosas. The following case is probably unique in the records of scieuce, and we thereforo reproduce it in detail:- The patient is a man of 25 years of age ; L. dates bis disease Iroi about eighteen months anterior to the preseut tine. Ile first perceived it on awakening from a sleep, which had been preceded by great fatigue of vision, almost uninterrupted for two days and two nights. Since that period, lie experiences every day on rising from bed, obsctrity of sight, attended with a corresponding want of transparenîcy of the cornea of the right oye. This obscurity usually lasts four hours; it is only when the patient engages in violent exercises, or under the influence of other exciting causes, such as electricity, stimulating ointmonts, \u0026c., that the opacity continues a little longer. Cold douches to the head, on the contrary, remove it in the course uf half an heur. Imniediately after awaking, the patient experiences nothing particular, so long as bu remains in the recumbent position in bed; but as soon as he makes the least inovemont to ramise himself, he perceives his sight becomes gradu- ally obscure. The affection attains its maximum in five minutes; it remains in this state for an hour, and then decrrases steadily until it wholly disappears, in the time already mentioned. The right eye, when examined during the period of transparency of' the cornea, presents a slightly injected state of the ocular and palpebral conjunctiva, the cornea, the lustre and degree of curvature of which have undergpone no modification, being perfectly clear ; the aqueous humour and .e anterior chamber exhi bit no abnormity. The iris is detached in many points, fiom the ciliary ligament, the chief solution of continuity being above ; it, as well as the other, presents this pecu- liarity, that it engages only the anterior layer cf the membrane; the pgmentary layer às not at all separated from its adhesions te the ciliary",
         "pstRscops. i ligament. The pupil is carried downwards and inwards; it has an oval form, but retains its normal magnitude, and contracte vigorously under the influence of light. The ophthalmoscope diseloses a considerable in- jection of the retina and decided hyperæemia of the choroid; the latter is also easily seen without the nid of au instrument. The treatment consisted at first in cold douches to the hend ; it bas already been stated that they had the efiect of reducing the daration of the attack to half an hour, but they did not prevent the supervention of the su bequen paroxysm. After haviug borne them for a fortuight, the patient reftuaed to submit to them longer. Sulp hate of quina, opium, morphia, iodide of potassium both internally and externally, were aflter- terwards tried. None of these means were successful. Mercurial inunctions around the eye and the application of electricity liad the eiflect of prolonging the duration of the opacity by half an hour. Six weeks' treatment having failed to nodify the symptoms, the patient was advised to try what rest alone would do. What cause can be assigned for this singular affection? lVhat explaia- nation can be given of this periodical opacity of the cornea? hi the present state of science it is imposible to say. The author for a time was of opinion that it proceeded from an accumulation of epithelium on the anterior surface of the eye; but he was forced te renounce this explan- ation after having ascertained that the vision bccame obscured, not dur- ing sleep, but at the moment when the patient was about te leave his bed. Dr. Jacob pertinently observes:-In \" Ophthalmology\" just now some people are seeing too much and sone too little, so let readers beware, for there is much nonsense current in priut about things \"unique\" in this line. The eye in question has evidently undergoue considerable change in structure from inflamloation, fron which it is not yet recov- ered, and wil probably undergo more.-Dublin Med. Press. LICET OMNIBUS, LICET NOBIS DIGNITATEM ARTIS MEDICM TULRI. NEW DRUGS IN THE PARIS EXHIBITION, 1855. One of the most important appears te have been a new variety of opium cultivated in Algiers. Judging of its merits by the process of morphiometry, it is net inferior to some of the best varieties of smyrna, opium; on the average 9.4 per cent. of morphia have been extracted from it, and the variations were from7 to 11.3 percent. Algeria opium as this species may be Called, can be produced at comparatively a cheap",
         "»snmIi\"a DSOAMUIZUT. rate, vis., 18s. . pet 4.: as may be inferrd, the crops must neoemrily be luxurant; in one year (1851) the poppies were no thickly set te. gother, and no remarkably prolific that 17 Ilb. 13 oz. of yield were çb- tained from a 'single acre of gronad. Cauadian isinglas also attraoted considerable attentisn ; until very recently it was unknown or uneared ihr. Now, however, it in likely to fall into extensive and general de. mand. For ita quality in very superior, and were the same skill and\u003c attention given to its dressing or preparation, as there is to the Siberian and East Indian varieties, there can be no doubt but it would most sue- cessfully compete with these in the market. IL is procured fhom the swimng bladder of the sturgeons, (Acipuuswr) [Huso. ?] which abound in the great rivers and lakes of this Continent. A farinaceous article, ri\"hly nutritious in character, deserves notice. The root of the plant yielding it, is enormous in sine, and from a single one, from 20 to 50 lbs. of starch have been extracted. The vegetablo grows in somae parts of Jamaica, but ita identity bas not been satiafactorily settled. It in report. ed te be a species of the genus lpomma, but this opinion has been doubt- ed, and the botanical source has been referred to a canna-the c. aduira. The tubers of the latter agreeing mot cloaely with the above; in the natural state being found as large au the human head, and Icaving it probable that under cultivation they would attain the weight above in- dicated. An aromatie volatile oil, resembling the far famed otto of roses, was exhibited. It is the essence of geranium, and is got by distillation from the leaves of the Pdargonium roseum and P. odoratissimum. About 800 g.ains are afforded by 220 lbs of the materials, to whicli the petioles and herbaceous stems are allowed to remain attached. British Gniana among a host of curiosities, sent a specimen of caba calli bark; a decoction of which has the reputation of beiug an excellent lotion for uilcers of an indolent nature. The bark is separated from a tree which runs up to the height of 50 feet, and furnishes a very hard closly grainied tiniber, that is Wqll adapted for ahipbuilding, The wogd cuts into squares varying from 12 to 18 inches; i is not likely to fall a prey to insects, as it contains a bitter principle ; and it is said it must be fasteaed with copper nails. Another bark froma the same place was called cowechi bark. IL in a valuable remedy in dysentery. The lIbor is to be scraped and mixed with cold water until the water becomes mucilaginous. One suali tumblerful of this ia to be drank every eight hours. Curarhuri bgk from the same country is stated to used at home in the state of de- cociog, igLernally as an emetic, and locally as a wash for fou @ores. It no dnbt çontainaa peculiar acid principle that has not yet been isolated. Several other barks enjoying nearly similar therapeutical properties were gemisted writ the oregoing, vis., hya-hya or Milk tree, kirabelli, mora,",
         "EUV~BIAL 'D8WAft1~EUT. pacuri, soapwood, and wild caenw. Thussohiegyaboand is a atrie- gent matter,they are largely used in the cure of woundsabrwaionsuloeu, \u0026e., mmd surprising effeots are amoribed to their empoym . The natires of British Guiana are very subject to a malignant uloeratib of the rectum, and for relief of the distresu, thus entailed, they esst to these drup. Of the arlicles contributed by Jamuica two may be friefy notioed. One was a very fine sample of nutmeg. It appearing tt the myrisica moukata thrives admirably in Jamaica, more espeialUy lu a humid locality. A single tree 15 feet in height, puts out branches ta the ground, and matured from 900 to 1000 fruits yearly. The othir was a meal distinguished as 1 the Plaintiin.\" It is prepared by alioing the immature frait of the maa paradiiacas into thin peces, drying dem in the su, and pounding or grating them. The starch constitutes ahighly nutritious food for infants, and is excellent for puddings. A vast aum- ber of other drugs, equally novel, wore also on sight, but we bave not been fable to leara enough of thoir propertios or value, to permit our venturing any statement concerning them. The show of ohemicals was described as very magnificient and complete. INDECENT ADVERTISEMENTS. A great deal of virtuous indignation bas been expended by platforn speakers and pulpit orators upon the immoality of the cheap literature of the day. Whilst some have unjustly condemned all \"light read- ing,\" including under this head the best works nf our most oelebrated writers of fiction, others, with more discrimination, have separated the wheat from the chaf, and denounced only that kind of reading whioh is noted for its wild extravagances, false views of life, and immorality; and which is so woll known as the \" yellow-coverod literature.\" No good man, no lover of his country or bis kind, but must fel deeply pained to witness the number of filthy and obsceno pamphlets whieh are yearly imported inta Canada from the neighbouring Republic. The licentious creations of the polluted mind of a George Sand, a Paul de Kock, a Sue, a Reynolds, and a host of minor writers of the sanie stamp, are begin- ning to find numerous readers among the youth of our population ; and thus, seed is being sewn broadcast, which is certain to yield, as it bas already done in the United States, a luxuriant crop of infleiity and libertinim. Ieplorable as are the efleots on the morals of a communi- ty resuhing fron a wide-spread circulation of suoh novels and novel- lettes, it is not these that society has must to dread ; it i rather the ten- fold more abominable and insidaeus produuLbOs of the I manly vigour\"",
         "EIDITOIAL DEPARTMENT. achool of writers-those despicable panders to the lowest and baseat passions of our nature. Had we anything to do with legislation we would certainly impose penalties of the severest nature upon those who, under the name of science and with the pretence of benefitting their fellow-men, send abroad woiks calculated to subvert everything that is lovely, virtuous, and of good repute in the human character. Nor would we apare their aidors and abettors-those publishers of papers, who, for the ake of filthy lucre, give place to their advertisements, and thus assist in scattering the germa of a moral plague throughout the land. The Montreal Press has, up te the present, kept itself remurkably fiee fron the pollution of indaoet advertùements; and it was, therefore, with feelings of sorrow that, in taking up a number of one of our hitherto respectable papers-a paper which we know is received into many respectable families, we observed no les than four filthy announ- cements in its advertising colum ns. Were we the head of a young fa- mily, we would infinitely rather place in the hands of our children the lightest of light reading, so long as it contained nothiig offensive to morality, than a copy of the paper we alude to. One thing we would be certain of by so doing-we would not ho placing in their hands a mateh to fire their dormant passions, by giving them directions where to obtain pictorial representations of the male and female organs of generation, \u0026c., \u0026c. The only one of these advertisements which we intend noticing, for they are all equaàly foul and mischievous, is said to be embellished by \" 100 electrotypedpicture repruestations,\" and among other things to contain-- \" The anatony of the generative organs of the male and female- Kidneys, Bladder, Seminiferous tubes, their number and length, impo- tence and sterility of Birds, Boar, Rat,,Camel, Horse, Bull, Ram, Goat, Guinea Pig, Lion, Elephant, Panther, Cat, Doe and Fish-Prostate Gland, Puberty, the changes it produces in the system-Instinct, differ- ences between Man and Aninals, Womb, Pregnancy and Parturi- tion, Ovum, Ovaries, Process of Impregnation, Fotal Circulation, Puber- ty, Duration of Virile Power, Impotency and Emissions, Sterility, Causes and Cure, Barrenness,'Causes of Unfruitful Marriages, Libertinism, Self- abuse, how to tell the sex of children before birth, Prevention of Off- spring, Deaths in Parturition, Causes of Seminal Diseases and Debility, but mode of retaining Sexual Viger to old age, Children diseased by nurses, Child-bearing, Fruitful mnonths, Color of Hair, Epilepay, Temper, Total Abstemiousneus, Choice of a Partuer, Causes of difference of the Sexes, Royal Families. Persians and Mongulaus, Marry:ig Age, Bache- lors and Old Maids, Formation of Foetus, Resemblance in the Offspring of the Parents, Quackerv and Quacks, Specific, History of Venereai diseases, Virulent and non-Virulent, Weakness peculiar to Females, Me- dicines in resturing Menstruation, Syphilis, Primary and Constitution B3uboès, GonnorrhoSa, Gleet, Retention pf Urine, Excoriations, Innocent,",
         "EDrORIUL DEPARTMEIT. and Unforseen Affections, Strictures, their symptoms. Inflammation of the Neck of Bladder, Varioocele, Hydrocele, \u0026c.\" What a learful array of all that is essentially gros. and lewd, in the above. And think, only think for a moment, that the sheet containing lt lies every day within the reach of numbers of pure and unsuspecting 'youth of both sexes. Oh! if parents only knew, what is known te every medical man in the country, the desolating elfects, physically, r\"aly, and mentally, which these execrable works have produced in those who have perused and believed them, they would nover allow a paper containing such an advertisement over the threshold into the sacred precincta of their home. Better.never read a paper, if it were necessary, than to risk the introduction of a serpent into the bosom of their ihmily, whose venom, when onco inftised, poisons the very springs of moral action, and serves to render the affected one an object of dis- treu to bis friends, a disgust te others, and a loathing te himself. There is one matter in the above advertiseuent which, we think, ought te sub- ject all parties concerned in giving it publicity, to a tate prosecution. For the protection of society, and suppression of crime, the authorities should take cognizance of, and vigorously put down, every attempt te give currency te plans for the purpose of effecting the \" prevention of offipring.\" From what we know of the publisier of the paper we have alhided te, we believe nothing is further from his intention than to aid in the increase uf licentiousness in the Province. We believe he has allowed those advertisements to get into his respectable paper, either through ignorance of their contents or their bearing. We hope, therefore, that he will now see the necessity of immediately removing them from his columns, which are disgraced by their presence. MEETING OF COLLEGE OF PHYSICIANS \u0026 SURGEONS, C.E. MONTREAL, 13th May, 1855. The semi-annual meeting of the Board of Governors of the College of Physicians and Surgeons of Lower Canada, was held this day ut the Mechanics' Institute, when there were present:-Drs. Hol mes, Fremont, Robitaille, Marmette, Boudreau, Landry, Marmden, Von Iffland, Russell, Chamberlin, Poster, Fowler, Badeau, Brigham, Boutillier, Glines, Weil- brenner, Johnstone, Campbell, Munro, Bibaud, Sutherland, Boyer, Joues, Peltier, Sabourin. Dr. Holmea, the President, took the Chair.",
         "3b EDIToRIAL DEPARTMENT. Th.- miiinuten, rr the last semi-annual meeting, lidd in Qiebec, ut tuber, 1855, were read and approved. Messrs. Lelievre and Anger's account for lawsuit expenses ii cIse Of Dr. Lachance vs. Widow Crépeau was rejected, and it was è cided by the meeting that the said accuunt should be paid by Dr. Li chance. Dr. Steine, a gentleman practising ii Lachine for some time, appI, to the Board for the License of the College, on the plea that lie k already many years past obtained a certificate fron the Board of D aininers, then in istence, and that iavmng been obhged to return . Europe soun after his exanninatiun, lie did not apply for lis License 1 that time, but kept the certificate of his examnation as a voucher. Dr. Steine's demand vas granted, and lie accorcingly received il Licerse of the College of Physicians and Surgeons of Lower Canada. Dr. Peltier, the Secretary, presented a petition from Mr. Moses Itha bal! begging that a License be granted to him without examination. Dr. Chamberlin moved, seconded by Dr. Bouthillier, \" That a Cor mittee of three members be appointed, to whom shall be referred a parers, petitions, commuunications, upon which they will report to t Board.\" Drs. Bouthillier, Chamberlin, and Freiont were called upon to at on the said Committee. The Commnittec, atler laving examined the petition and certificatt of Mr. Moses Mayball, reported that in their opinion the College has a the power to grant the prayer of the petitioner. The following gentlemen, with University Degrecs, vere sworn,art granted their Licenses:-Drs. Stevenson, J. C. Lee, W. J. Jones, A. l Kollinyer, IIamel, Labarge, Dupuis, Alex. Kirkpatrick; all graduatesc Mrl'Gill College. Dr. Stein received also his License. The Board thon proceeded to the examinations. The following gentlemen, after satisfactory exanination, receive, their Licenses :-Messrs. Ch. Augé, Th. Sauriol, Dufresne, J. Leblanc M. Palardy, 0t. Germain, DeMontigny, Lafleur, Tramblay, L. Cyr, J Stansfield, L. A. Weilbrenner. The following young gentlemen, having passed their preliminary ex. ainination, were admitted to enter upon the study ofMedicine:-Messrs. Lavalle, Leocault, G(ludu, Gaviépy, Rousseau, Brousseau, Mathieu, Le- claire, Coursol, Deniers, Desroche, Lenoir, Lénery, Viger, Delvechis,",
         "EDrTOU.L DmT'rý'T.4 Tanguay, Brassard, Chevalier, Barcels, Desjardins, Fraser, U Millan, Douglas, Duchesnay, Lachance. Tiere being no ot'wr businebs, the Board adjourned. IECTOR rELTIER, M.D., Edii., Secretary for the District of Montreal. MGILL COLLEGE-MEDICAL HONORS-1856. At tbe usual convocation of the University, at the end of the past Session, the following gentlemen, having fulfilled the requirenients of candidates, received the degree of Doctor of Medicine and Surgery. To their names and residences are added the subjects of their inaugural dissertations:- William Justus Jones, Brockville, C. W., Uterine Homorrhage. Joseph Alexander Hamel, Quebec, C. E., Tibercle of the Lungs. Edvard Laberge, Chateauguay, Apoplexy. Joseph G. B. Dupuis, Montreal, C. E., Puerperal Convulsions. Alexander H. Kollmyer, Montreal, C. E., Syphilitic Virus. Walter James Henry, Montreal, C. E., Iritis. Alexander Kirkpatrick, Chippawa, C. W., Hydrocele. James C. Lee, M. D., London, C.W., Diseases of Females. James McGregor Stevenson, London, C. W., Asiatic Choiera. The gentleman last named passed his examination last year, but vas too young to be graduated earlier. He lias been spending the interval in Great Britain, and while away becamne a Licentiate of the Royal School of Surgeons, Edinburgh. To three of the above, Prizes vere awarded- 1st. Prize for Thesis, Mr. W. J. Henry. gnd. Do do Mr. W. J. Jones. Prize for Final Examination, Mr. C. Laberge. It was also annouriced that the students undermentioned had passed their primary examination. Mr. Duncan Thomas Robertson, Quebec, C. E. Mr. Andrew A. Boylan, Montreal, C. E. MI . Etienne R. Riel, Ottawa City, C. E. Mr. Charles Glen, Chambly, C. E. Mr. John McMillan, London, C. W. Mr, R. Whiteford, Three Rivers, C. E. Mr. Levi R. Church, Aylner, C. E. Mr. L. R. Church having exhibited nost proficiency in his answer- ings, to him was given the Prize for the best prelminary exanination.",
         "XImkLL flEPARKUNT. APPOINTMENTS AT MONTREAL GENERAL HOSPITAL. Dr. J. Reddy, of this city, has been elected by the Governors of this Institution as attending Physician in the lieu of Dr. Arnoldi, whose office ws vacated by bis removal to Toronto. We congratulate the deserving Dr. on having received this honorable appointment, and hope he will not let his opportunities slip by unimproved. Mr. A. H. Koll- myer having retired from the apothecaryship, left a vacancy which has ben judiciously given to Mr. L. R. Church. THE LOUISVILLE REVIEW. We have received the first number of this new periodical. It is a bi-monthly journal of practical Medicine and Surgery, and contains 144 pages. It is edited by Drs. Gross and Richardson; the former of whom is favorably known to the profession by being the author of several excel- lent works. We have been much pleased with our perusal of the pre- sent work; the original articles generally-both communicated and edi. torial-are of a high order of merit, and in particular the retrospective re- view of Richter, whieh we think full of elaborate detail and critical acu- men. The Louimille Revicw supplies the void left in medical literature by the suspension of the Westein Journal of Medicine and Surgery, which was one of the most respectable journals issued in the South Western States. We have great pleasure in adding it, to our already extensive exchange Eist. - ANOTHER EXCHANGE. The New Orleans Medical andl Surgical Journal, edited by BENNET DowLxR, M.D., \u0026c. Bi-monthly. Pp. 145. $5 per annum. This journal is one of the very best in the Union. Rich in first rate wiginal articles and edited with an ability and vigor far above the ordi- nary range. We shal always anxiously look for its arriva). BOOKS RECEIVED FOU REVIEW. Curling on the Testis. Second Arnerican from the second and en. larged English edition, 1856. From Meusrs.Blanchard \u0026 Leas, Philadelphia.",
         "HOPITAL lEPORT. 3U HOSPITAL REPORT. MONTREAL . TSPENSARY-ANNUAL REPORT. FROM lst .bAT, 1855, TO 1st MAY, 1856. Patienta ad, 1, 364; disehrged cured 223; relieved, 196; ment to Hospital, 3; det., *; 25 were attended at their own residences. Aous.-Under 2, 19; from 2 to 8, 42; from 8 to 20, 87; from 20 to 40, 98; from 40 to 60, 96; over 60, 22. Febis Con. cent....... 3 \" Intermitt......... i \" Remnitt..........I1 \" Typhoid......... 1 Scarlatina Simp........ 1 \" Malig.... ... 1 Variola Discret......... 4 Rbea tbaim............ 13 \" Chr......... 6 Lumbago............... 5 Pleurodyni. ........... 4 Cache: a .............. 1 Chlorois .............. Hlemorrhag............. Epistaxis............... 1 Debilita.............. Morbus Cordis,......... 3 Palpitatio.............. 1 Asthma ............... 1 Bronchitis.............. 9 \" Chron......... 6 \" Sent .......... 3 Catarrhus ............. 22 \" Chr........... i \" Tracheal....... 1 Indeunza.............. 2 Phthisis................ 23 Plearitis, subac......... 1 Pneumonia............. 3 Apbtbe ..... . ........ 2 Cardi\u0026lgia............. 2 Cholera, Infant......... 2 \" Sporad......... 2 Coliea Crapul.......... 1 \" Pictou ........... 1 Constipatio ........... 17 Dentitio .............. 3 Diarhoa.............. 24 \" Chron........ b ISEABES AND ACCIDENTB Dysenteria............ 3 ysapepsia......... 12 meie ............... 2 Gastralgia............ 2 Gengivitis......... 3 Helminthiasis ........ 10 Hypochondriasis...... 2 Tonsillitis .......... 1 Tympanitis .......... 1 Hemorrhois Int....... 1 Prolapsus Ani........ 1 Uresis............... 1 Hydrops Renal........ 1 Epilepsia............ 2 Hemirlegia.......... 3 Hydroceph. Acut..... I Vertigo.............. 1 Melancholia ......... 1 Hemicrania.......... 1 Odontagia ........... 2 Scatica ............. 1 Hysteria............i1 Arpoecia........... Eczema..... ....... 3 Ectbyma............1 Erysipelus........... 1 Erythema........... Favus .............. 1 Herpes Lab.......... 1 Intertrigo............ 1 Impetigo............. 1 Lepra. Vulg.......... 2 Porngo larv.......... 2 \" decav........ 1 Psora ............... 3 Tinea Capit.......... * Vaccinatio............ 1 Cataraet............. 1 Conjunctivitis ......... Hoideolum............. Ophthalmia........... Cophosis.............. Otitis ................ Otorrhea ............. Adenitis .............. Abscemss ............ Ambustio............. Contusio.............. Fractura Clavic ........ \" Manus........ Gelatio................ Hernia Inf.......... Hydrarthue............ Inflam. C-lc .......... Cruris......... Injur Humeri.......... orbus Coxa......... Morsus Hominis....... Labii Scrofulos........ Paronycbia ........... Periostitis ............ Phlegmon ............ Torsio.... .......... Tumorr (Sper. Cord.). ... Ulcus................. Vninus ............... Balanitis.............. Bienorrhagia........... Gonorrhoea............ Preputii Ine..... ..... SyphilisPrim .......... \" Consec......... Amenorrbea......... Leucorrhœa.......... Mastoitis ......... ... Uteri Relaxut........ DiSgAsIs P.oviNG FATAL. Cholera Sporad, 1; Hydroceph Acut, 1; Phthisis Pulm, 1 ; Sarlatina Malig., 1. ArEmNa PgrsrcANs. Jannary, April, July and October, Dru. BoYzR and WRIGHT. February, May, August and November, Dru. JoNus and PELToEa. March, June, September and Decembr, Dra. FEN- wict and R. P. HowaRD.",
         "MfllAL NSWS. It buee proposed to add tartar emetie ta the phosphorons parte employed in making friction matches, Inl orer, by inducing vomiting. ta revent the accidents which sometimes occur ta children from eating them.-The probable ifetime in ShefB;ld and such towns is only 6 years, while in Surrey it la 52.-A drachm of aqua ammonia added to a lon of syrup wilI lregaently prevent iti fermentation.-A Committeéof the Academny of S'eness, New York , have reported that it is a matter of impousibillty tu pas a sponge probang through the rimaglottidia beaow the chorde vocales ; it failed ta pais in 18 attempts-\" I can't bear children,\" said Mr@. Prim, disdainfully. Ms. Partington, lookag overher specs, mildly replied. \" Perhaps if you could you would like triem better.\"-M. Dagot saw a colt 11 days old which could hé milked like a cow, but the flow wastronger when the little animal drew milk from the mother; fluid of the saine kind then flowed in abondance from the colt's own breast each timie thé sucking aupration wa made.-The insect which is so well known as being the cause of scabies bas been proved to have been derived from the lion, ta which noble animal it is a natural paruit.-Jas. Roberts, Minister of Quarn- ford, attesta this certificate of one Brian Heathcote, a Quack. \" This ai ta certifoy That i bave attendea Joah. Asbmnor Sine the time of his misfortun And hé in verrey promising according ta The time the Bone is knt end growne verrey nisely and the arm Straight the Elbo * i ribt in its propre place.\"-lorfalify of medical swn.-Three-fourthe die before the age a 50, and 10-11ths before 60.-Dr. Thos. J. Boyd, the oldest prnctitioner in New York, died lately et the aga of 84, having ben 63 years in practice, He died in harnais., as within a week ai bis death hé wa seen tottering on bis way ta vis:t a patient, suppart- ed by a dutiful daugter.-Wm. Fred. Chambers, M.D., R.C.H.F.R.S., formerly physi- cian ta St. George's Hospital ta William IV, Adelaide, Victoria, \u0026c., who led Lonws Imm 1836 ta 1848, dhed on the 16th December last, at the agp of 70 years.-Dr. H. Clntter- back died lately in London at the advanced age of 89, the oldest and mont respected of ber physicians.-Paul Dubois received 30,000 francs [rom the Emperor for his services dunng the late aceouchment; his father Antoine received 100,000 [rom Louis' uncle when hé attended Marie Louise when ahe gave birtb ta the King of Rome.-It ia now proposed'l cure -by \" medical inhalation,\" not only consumption, but even diseaes of the bart, livua disese, and chronle disaes generally. The great curer is a New Yorker.-John C. Warren, the eminent Surgeon at Boston, died a few weeks ago. He was bom in 1777 and had been practising over fiPly years. An American editor cocclodes his notice by oab serving, \" when John C. Warren died a great man fell in Iuael\"-A Mrs. Phin, of Bir- mingham, England, showered into the fond lap of ber happy lord, on a late occasion,5 child- ren, 3 boys, born alive and doing well, and 2 girls, born dead.-The various Colleges, \u0026c.. in the States, have sent forth, et the end of thî last sessiu, 1239 Doctors, with fuil power, if not skill, ta drug and carve humanity.-Alexis St. Martain still lives, h ia 52 yeais of age, and hé is to hé in Boston on show. No one bai peeped into bis stomach since Beau- mont until latterly a Dr. Bunting got hold of him. En passand, Dr. B. is said to hé of Montreal; this must be wrong, we know of no such party.-What je mind 1 Dr. Hunthas. çivén this answer,-for the benetit of those who can understand it. Mindis the traditioala impres of force progression throu;h brain ma'ter.-A mal@ giraffe bas recently been bora at the Zoological Garden, Paris, this is the firat birth of one of these animale in Europe; hé la 76 feet high.-3 young lions were born in the Managerie in Howard St. in Boston, 2 have died since.-Fish, having four diLtinct and useful legs,according to the Rochester Union, abound in a rivulet near Fort Defiance, New Mexico.-Dr. Vierardt, the inventor of a pulse indicating instrument, show* that in man the frequency ofthe pulse in diminished by increase of temperatur.-Dr. Molescbott, of HeidelbLrg, inveatigating the influence of light on the phenomena of respiration, flmds that animals breathe 1-5th lesa frequently in the dark than in the light.-A new tberrometric agent has been inventad ty a Russian philosopher, an adaptation of thermo-electric currents, by which the temperature of the deepsat parts of the ocear may hé measured.-M. Gerdy, Professor of Surgery at the Faculty of Paris, \u0026c., has just died, at Pais, of pulmonary consumption. The deceased would neyer believe himself laboring under ihis fatal affection.- Tho Philadelphia UMrcal dnd Sa\u003e- gical Journal says, that 300,000 ounces of quinine ara annually consutned in thé United stales. It sell at (rpm $3 ta $4 on ounce.- The Empreai of the.Frewh was delivered with long force.. Chloroform was administered in amail quantitv, but it ceused such great excitement and dclirium that it was discntiued.-Mons. fobard thinks the pyra- mids were boUilt as signal heights and points of observatàa ta ships, bots, travellers and armies."
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      "text" : [
         "THE LEGÂTL NEWS.39 *h 9zl 3es VOL' VIII. OUÇBER 17, 1885. No. 42. (n 1883 it was enacted that \"levery appeal from interlocutory judgments (8kc) shall be in- scribed, by the clerk of the Court, and heard by privilege\u003e in a summary manner, without any reasons of appeal or factums.\" 46 Vic. c. 26, sec. 6. An application was made by the successful party in a case at Quebec ( Oct. 8) to tax a factum which he had filed. After consultation a majority of the judges, (Dorion, C. J., Monk, Ramsay, Cross, Baby, JJ.) were of opinion that tije proper interpre- tation of the section referred to was that the factum was not obligatory, not that it was prohibited, and that any party could stili file a factum, for which he, would be entitled to charge in bis taxed bill if sucoessful, but that there should be no delay to file it. The object of the enactment was to shorten the delays in these appeals, not to render their decision more difficuit. In the opinion of Mr. D. Macmaster, QC., on the Riel case, referenoe is made to the ad- 'verse authority of Mr. Justice Stephen, in bie Digest of Criminal Law. We may add that in Mr. Justice Stephen's \"lDigest of the Law~ of Criminal Procedure,\" (A. D. 1883) p. 2, il is stated that Ilthe criminal law of England extends to high treason, miaprision of trea. Bon, and concealment, of treason committed out of the realm of England by any subjeci of lier Majeéty,\" and reference is made t( the statute 35 Heu. 8, c. 2.-The case is to bE heard before the Judicial Committee of tht Privy Council on the 26th inst. The books contain a few cases which maý be cited with reference to smnall-pox. On\u003c bears upon the responsibility of physician in1 performing vaccination. In Landon N Jiumphrey, 9 Conn. 209, it was held tha the physician, whi.le he does not guarante the specific value of the vaccine virus, ye guarantees its freshness; so that if - ho inocu late a patient with virus in an altered statÀ COfstit.uting as it thon would more putri anIimal matter, and erysipelas or injuryt any 11mb necessits.ting amputation should Iensue, he will be held, responsible for the suf- fering, bass of time, and permanent injury to the patient. It in also the duty of a physician to take ail possible care toprevent the spread of small-pox or other contagions disease. So, where the paper upon the walls of a room i which there had been small-pox patients had become so soiled and smeared with the amall- pox virus as to make its removal necessary, a physician or other attendant may order the paper to be tomn down, and it was held ini \u0026avey v. Tr-eble, 64 Me. 120, that the landlord cannot maintain an action against the phy- sician for doing this. In England it is ani indictable offence for a physician, or any one else, unlawfully and iujuriously to carry along or to expose in a public highway, on which persons are pass- ing, and near to the habitations of others, any person mnfected with the small-pox, or any contagions disorder; and it is for the accused to \u0026how that the object of the carrying or ex- posure was lawfnl; Rex v. Bu?,iett, 4 M. \u0026 \u0026. 272; Rex v. Stton, 4 Burr. 2,116; Rex v. Van- tandillo, 4 M. \u0026 S. 73. These cases are referred *to in Rogers, IlLaw and Medical Men.\" Inoculation for the small-pox lias been re- férred to as a thing actually performed in some recent cases. In England, isince 1840, it has been an indictable offence te iiioculat6 for the small-pox; 3 \u0026 4 Vic. cap. 29, sec.- 8. *30 \u0026 31 Vict. cap. 84, sec. 32. And by 16 Vict. i(Can.) cap. 170, s. 1, it was made an indict- t able offence in Canada: Consol Stat Can., cap. 39, sec. 1; and the license of any phy- sician contravening the A\u0026ct thereby becomes Snuil. The following paragrapli from an Enghiali paper shows how even subordinate, judges are ~remnnerated in England- \" 'At a recent meeting of the corporation of the oity of 5London, it wau decided to raise the salary of the amst- antjudge of the Mayor's court from £1,600 to £2,0O0 per annum. Mr. Woodthorpe Brandon, who now occupies the pest, hms been in office ince 1873, having formerlY ebeen registrar of the court, in which position ho on- t joyed an income greater than ho hitherte received ini h- ie judiciai capacitr.\" The salary as now arranged is just double dthat of the judges of our Court Of Queen's ,o Bencli and Superior Court. 329,",
         "THE LEGAL NEWS. COUR SUPÉRIEURE-MONTRÉAL.* Certiorari-Règlement de la Cité de Montréal- Billards et Pools. JUGÉ :-Qu'une table de pool n'est rien autre chose qu'un billard, et qu'un règlement de la cité de Montréal imposant une taxe de $100 sur les billards comprend également les tables de pool.- Vincelette v. De Montigny, et La Oité de Montréal, Loranger, J., 2 février 1885. Saiuie-consertoire-Bail-Cession de biens- Insolvabilité-Intervention-Droits du syndic. JuGÉ:-lo. Que les cessions de biens faites à un syndic pour le bénéfice des créanciers, ne donnent pas le droit au syndic cession- naire d'intervenir dans une saisie des biens du débiteur insolvable par un créancier, pour réclamer, en sa dite qualité, la possession des effets saisis; cette cession n'a aucun effet vis- à-vis les tiers, et ne peut lui permettre d'ester en justice ni pour le cédant, ni pour les créan- ciers du cédant. 2o. Qu'un bail de meubles pour une cer- taine somme représentant leur valeur, avec la condition que lorsque la somme stipulée sera payée les meubles seront la propriété du locataire, est parfaitement régulier et consti- tue bien un louage et non pas une vente.- May v. Fburnier, Mousseau, J., 23 avril 1885. Meubles- Vente judiciaire-Adjudicataire- Tiers-Saiie-Revendication. JUGÉ :-Qu'en l'absence de fraude ou de collusion, un tiers, propriétaire de meubles qui ont été saisis et vendus judiciairement, n'a aucun droit en revendication contre l'ad- judicataire qui en a payé le prix, son recours est sur le produit, s'il n'est pas encore distri- bué, ou s'il l'est, contre le saisissant pour la valeur du meuble.-Mackie v. Figeant, Ma- thieu, J., 25 juin 1885. Mise en demeure-Demande de paiement-Lieu de paiement-Vente de marchandises-Lettre - Usage du commerce. JUG*:-lo. Qu'un marchand qui poursuit sur compte pour marchandises vendues et livrées est tenu, comme dans les cas ordinai- res, de faire personnellement ou par procu- *To appear in ful in Montreal Law Reports, 18.0. reur, avant l'action, une demande de paiement au domicile du débiteur; que la demande faite par lettre du marchand, par envoi de compte ou par lettre d'avocat est insuffisante. 20. Que la coutume ou l'usage du com- merce ne peut prévaloir contre une disposi- tion formelle de la loi.-Smardon v. Lefebvre, Jetté, J., 31 mars 1884. Société commérciale-Dissolution-Paiement des dettes-Garantie. JUGÉ :-Que lorsqu'à la dissolution d'une société commerciale, l'un des associés assume le paiement de toutes les dettes, l'autre asso- cié, contre lequel les créanciers de la société auraient obtenu des jugements conjointement et solidairement, ne peut obtenir une con- damnation personnelle contre celui qui s'est chargé des dites dettes, et faire déclarer que les biens de la société sont son gage et doi- vent le garantir contre les jugements des créanciers, mais qu'il a seulement contre lui une action en garantie.-BrouiUet v. Bogue et al., Mathieu, J., 25 juin 1885. Exception d la forme-Timbres judiciaires- Alias bref de sommation-Informalités. JUGÉ :-lo. Que lorsque le demandeur ne rapporte pas son action le jour du retour, et qu'il est, en conséquence, forcé de prendre un nouveau bref, ce dernier ne peut être consi- déré comme un alias, et le montant des tim- bres judiciaires qui doit y être mis lors de son émanation et de son retour est le même que sur le premier. 2o. Que le bref de sommation n'a de forme légale et met le défendeur en demeure de comparaître en cour, qu'en autant que le montant des timbres judiciaires fixé par la loi y a été apposé lors de sonémanation et de son retour; que l'informalité résultant du défaut des dits timbres rend l'action nulle et elle peut être déboutée sauf recours sur ex- ception à la forme.-Riendeau v. Casey, Chag- non, J., 15 avril 1885. Action qui tam-Indivisibilité de l'action-Com- pensation-Garantie. JuGf*:-1o. Qu'une action pénale n'est ni divisible, ni compensable ; qu'en conséquen- 330",
         "1--1E LEGAL NEIVWS., ce, un plaidoyer de compensation fait à une action de cette nature sera renvoyée sur ré- ponse en droit. 2o. Qu'en matière pénale, il n'y a pas lieu à la garantie; qu'il s'ensuit que, dans une action qui tam, le défendeur ne peut, par de- mande incidente, appeler le demandeur en garantie.-Normandin v. Berthiaume, Mous- seau, J., 20 octobre 1884. Police d'assurance-Precription-Cunditions- Propriété-Femme commune-Autorisation maitale-Rticence. Juo* :-lo. Que la condition mis au dos d'une police d'assurance contre le feu, que tout recours légal contre la compagnie d'as- surance qui a émis la police est prescrit après le laps des douze mois qui suivent la date de l'incendie, n'a rien d'illégal, et que cette pre- scription doit être mise en force. 2o. Qu'une femme commune en biens et sous puissance de mari ne peut valablement faire assurer les meubles de son ménage sans l'autorisation de son mari ; et que le fait de n'avoir pas ainsi déclaré son état à la com- pagnie d'assurance rend nulle la police d'as- surance.-Rouseau v. La Compagnie d'Assu- rance Royale, Taschereau, J., 6 juin 1885. Achat et vente-Billet promissoire-Terme- Compensation. JUGÉ:-lo. Qu'en matière commerciale, lorsque l'acheteur néglige de donner au ven- deur un billet promissoire, tel qu'il aurait été convenu, ce dernier peut, alors et avant l'expiration du terme, poursuivre l'acheteur pour le montant de la vente. 2o. Qu'il peut aussi, dans le cas précédent, offrir le montant de la vente en compensa- tion à l'encontre d'un billet promissoire dont l'acheteur réclame le paiement contre lui.- Quintal v. Aubin, en Révision, Torrance, Rainville, Jette, JJ., 20 juin 1883. Douaire coutumier - Enregistrement- Oréance antérieure ou préférable - Adjudicataire - Nullité de décret. JUGe :-lo. Que lorsqu'un douaire coutu- tnier a été enregistré sur un immeuble, une créance ayant la priorité de date et d'origine, mais enregistrée sur le même immeuble sub- séquemment au dit douaire, ne constitue pas \" une créance antérieure oupréférable,\" purgeant le douaire coutumier dans le sens de l'article 710 C.P.C. qui n'a trait qu'à l'antériorité de rang, et à la préférence à raison d'un privilè- ge en vertu des lois réglant les privilèges, les hypothèques et l'enregistrement des droits sur les immeubles. 2o. Qu'un adjudicataire qui connait per- sonnellement qu'au moment de l'adjudica- tion l'immeuble par lui acheté est affecté d'un douaire, ne peut subséquemment demander la nullité du décret et de son contrat d'ac- quisition, à raison de cette cause d'éviction éventuelle qu'il connaissait.-izotte v. Des- chesnaux, En Révision, Torrance, Papineau, Jetté, JJ., 30 décembre 1884. Mandat-Procuration générale-Achat-Tiers. JUGÉ:-Qu'une procuration générale dans les termes suivants : \"Je vous autorise à \" conclure tous contrats que vous jugerez à \" propos avec les cultivateurs pour la culture, C ette année, de la betterave à sucre et aussi \" les travaux pour sa culture,\" n'autorisait pas le mandataire d'acheter des cultivateurs des betteraves à sucre, et ne pouvait lier le mandat vis-à-vis des tiers pour le prix d'achat de ces betteraves.-Jarry v. Senécal, Mous- seau, J., 13 juin 1885. Action qui tam-Acte des élections fédéralee- Affidavit-in de non-recevoir. Juot:-lo. Que l'action pour recouvrer la pénalité imposée par l'acte des élections fédé- rales est une action qui tam qui doit être pré- cédée d'un affidavit sous le statut 27-28 Vict., ch. 43. 2o. Que le dit acte des élections fédérales (37 Vict., ch. 9) n'a pas soustrait ces actions à la nécessité d'être précédé d'un affidavit. 3o. Que cette absence d'affidavit est une fin de non-recevoir qui peut être invoquée au mérite.-Rouleau v. Lalonde, Cimon, J., 14 mars 1885. Pari-Enjeu déposé entre les mains d'un tiers- Droit d'action-Paiement. JUGÉ :-Que lorsque dans un pari la somme d'argent pariée a été placée entre les mains",
         "1 IIE IJEGAtI NEWS. d'un tiers, celui qui a gagné a un droit d'ac- tion contre le tiers pour s'en faire remettre le montant, ce dépôt étant assimilé à un paie- ment; C. C. 1927.-Riendeau v. Blondin, Rain- ville, J., 12 novembre 1880. SuccesSiom awante- Insolvabilité - Légataires universels et particuliers-Réduction de legs- Renonciation-Droits des curateurs. Juot :-lo. Que tous les biens d'une suc- cession insolvable ne sont pas le gage des créanciers de préférence aux légataires par- ticuliers, de manière à ce qu'ils puissent em- pécher ces derniers de prendre possession de leurs legs; s'il doit y avoir réduction des legs particuliers pour payer les dettes du testateur, les créanciers ont une action contre les léga- taires à ce titre pour obtenir cette réduction, mais il ne peuvent faire mettre au nom d'un curateur nommé à la succession insolvable tous les biens du testateur. 2o. Que la renonciation d'un légataire uni- versel unique ne rend pas la succession va- cante s'il reste d'autres héritiers au testateur. 3o. Qu'un curateur nommé à une succession vacante par la renonciation des légataires ou héritiers n'a que les droits qu'auraient eu ces légataires ou héritiers.-La Banque Ville-Marie v. Rocher, En Révision, Johnson, Torrance, Loranger, JJ., 30 avril 1885. Inocription en Révision-Contestation d'élection municipale-Appel. JUGÉ :-Qu'un jugement final rendu par la Cour Supérieure sur une requête en contes- tation d'élection municipale ne peut être inscrit en Révision, ce jugement n'étant pas susceptible d'appel; et une inscription ainsi faite en Révision sera rejetée sur motion.- Beauchemin v. Hua, en Révision, Doherty, Loranger, Cimon, JJ., 30 mai 1885. Bail-Réparations-Dommages-Réilation. JUGÉ :-Qu'un propriétaire qui, en faisant des réparations à sa maison, emploie des matériaux émanant des odeurs infectes, les- quelles causent des dommages à son loca- taire, sera condamné à payer le montant de ces dommages en sus de la résiliation du bail.-Leesque v. Daign4eault, En révision, Sicotte, Gill, Loranger, JJ., 30 mai 1885. QUEEN'S BENCH DIVISION. ToRoNTo, Feb. 9, 1885. Before WiIBON, C.J., ARmouR, J., O'CoNNo, J. CONwAY v. CANADIAN PAcIFIc RAILWAY CO. Railways and Railway Companies, 42 Vict., ch. 9, 46 Vict., ch. 24 (D)-Liability tofence. [Continued from page 328.] On the other hand, it was no more trouble or expense to the company to fence in the one case than in the other: but their doing so as regards occupants under such circumstances would be an encouragement to actual settle- ment. Under these circumstances the Amending Act of 1883 was passed, I think, in all proba- bility, for the protection of people situated, in respect to occupancy, as the plaintiffs were. It is immaterial whether different parts of the lot were occupied by several persons or not. If a village had been formed at the place in question of such occupants, it could make no difference, except to increase the necessity for fencing, if there was an increase of cattle. That the plaintiffs entered the house which they occupied as the tenants of and paid rent to Worthington, could make no difference. Whether his tenants or not they were in occu- pation. However, Worthington, as appears by the evidence, abandoned the house when his contract was completed, and after Novem- ber, 1883, the plaintiffs continued in posses- sion independently, cultivated a small portion of the land, used another part for pasture, made an effort to obtain title, as recognized settlers, from the Crown Lands Department, and were awaiting an answer, expected to be favorable to their application, when the horses were killed. The term \" occupied,\" as used in this clause, must be construed in its ordinary grammati- cal meaning; in that meaning which natur- ally and obviously belongs to it, and has been given to it in common language. It is not a technical term, but one of the common understanding of mankind, and as such in common use; Wilberforce on Statute Law, p. 122; Hardcastle, pp. 26, 27, 74. As to what occupancy is,-\" Occupancy is the thing by which title was in fact originally gained ; every man seizing to his own contin-",
         "lied use such spots of ground as he found most agreeable to, hi8 own convenience, provided he found them. unoccupied hy any one elso :\" Blaeketone (by Kerr, 4th ed.) vol. ii, p. 74. \" Occupancy ie the taking possession of other thinge, which bofore belonged te, no- body :\" 2 Broom \u0026 Hadley's Commentaries,' p. 411. The plaintiif'e case, in this instance, greatly resembles and le strongly eupportod bY the Englieh case of Dawson v. The Midland R.W. Co., L R 8 Ex. p. 8. If theoforogoing je not the correct interpreta- tion of the amonding act in question, I know flot what it ineane, or that it moans, or can, Ineoan, anything. Failing short of that, it means, as I appre. bond, nothing difforent from, or more than, the Act which it purported te amend. The Amending Act, thon, le meaningloss and idie. Blut I arn not dispoeed to tako thie view of What I conceive to be an important Act of Parliament, having a useful and juet object ini view, and which le expresed with suffi- Cdont cloarnoss and precision by the Act itef. It is unnocessary, therefore, to look for indicia Outuide of the Act, for they can only aiford help te give it a forced, instead of a natural 'iterpretation. 1Ithink judgnont should be entored for the Plaintiffs for $300 and coes. .\u0026Iwouia, J. The word «\"owner,\" as used in the Consolidatod Railway Act of 1879, ie therein te ho understood te mean any cor- Poration or pereon who, under the provi- siene of that Act, would ho enabled te soul and 00o1vey lands te the company; eec. 5, se. 14: and the word \"lande\" is to include ail reai estate, messuages, lande, tenements and bore- ditamnents of any tenure ; sec. 5, euh-soc. 6. Terilway c pay shall set forth in its too of reference agoneral dosignation of the lande intended te be pased ovor and taken therefor, and the names of the owners and occupiere thereef, so0 far as they can hO acortained; sec. 8, euh-sec. 1, a. and b. IlAny omfission, mis-statement, or erroneous desig- naftion of euch lande, or of the owners or DOdCupierd thereo.... may.. . be corrected:\"1 sec. 8, euh-sec. 5. \" The lande which niay ho t-kOfIL without the consent of the proprietor thlereof ehall net exceed,\" \u0026c., sec. 9. .AUl cerporations and porsons whatever, tenante in tail or for life, grvE de aubeitution, guardiane, curaters, oxecutors, administra. tors, and ail other trustees whatseever net only for and on hehalf ef themselves, their heure and succeesors, but also for ani on be- haîf of those whom they represent, whether infants, issue unhorn, lunatics, idiots, feMes covert, or othor persona eeized, peeesed of, or interested in any lands, may contract, eelî and convey unte the company ail or any part thereof: soc. 9, euh-sec. 3. IlAlter one month, \u0026c., application may ho made te the owners of lands, or te parties empowerod te con- voy lande, or interested in lande, which may suifer damago from. the taking of materiale, or the exorcise of any of the powers granted for tho railway, and, thereupon, agreements and contracta may ho made with euch parties touching the eaid lande, or the compensation te ho paid for the same, or for the damages, or as te, the mode in which euch compensation shall ho ascertainod as may eeem. expedient te both parties, and in case of disagreement\" \u0026c., sec. 9, euh-sec. 10. \"lWithin throo menthe from the paseing of thie Act, in the case of a railway already con- etructod on any section or lot of land, any part of which ie occupied, or within throe menthel altor euch construction hereaftor, or hofore euch construction, within six menthe after any part of such section or lot of land has boon taken possession of hy tho cornpany for the purpose of conetructing a railway there- on Çand in the lest case alter the company hbs heen se requirod in writing by the ocu- pant thercof), fonces shall ho erectod and maintained ovor euch section or lot ef land on each aide of the railway, \u0026c., but thie clause shail not ho interpreted te the profit of any proprieter or tenant in any case whorein the proprieter of any such section or lot ehaîl have accopted compensation from. the com- pany for diepeneing with the erection of sucli gates or bars :\" 46 Vic. ch. 24, sec. 9. euh-sec. 16. \"lIf, after the expiry of such delay, such fonces, gates and cattle-guarde, are net duly made, and until they are se, made, and after- ward if they ame net duly maintained, the company ehail ho hiable for ail damages which shailhoe done on the railway by their trains or engines te the cattle, herses or other anima,1s ilitE LÈGAL ÈýÈ1#S-",
         "of the occupant of the land in respect ol which such fences, gates, or guards have not been made or maintained, as the case may be, in conformity herewith.\" These last two clauses were by 46 Vic. ch. 24, sec. 9, substituted for the following clauses m the Consolidated Railway Act of 1879: \"Within six months after any lands have been taken for the use of the railway, the company shall, if thereunto required by the proprietors of the adjoining lands, at their own costs and charges, erect and maintain on each side of the railway fences,\" \u0026c.: sec. 16, sub-sec. 1. \" Until such fences and cattle guards are duly made, the company shall be liable for all damages which may be done by their trains or engines to cattle, horses, or other animals on the railway,\" sub-sec. 2. \" The term \" proprietor,\" as used in the Act, is included within the term \" owner,\" and the word \" owner,\" as defined in the Act, would seem to include only those corpora- tions and persons mentioned in sec. 9, sub- sec. 3, and would thus include proprietors and tenants; and by the Consolidated Railway Act of 1879, sec. 16, it was only as against such owners of adjoining lands that the rail- way company were bound to fence. What difference, then, do the clauses sub- stituted for section 16 in the Consolidated Railway Act by the Act 46 Vic. ch. 24, sec. 9, make in the law as it stood before the passing of the latter Act? Are the railway company bound to fence as against any one but an \" owner \" as defined by the Act? He is no longer required to be the owner of adjoining lands ; it is sufficient if he be the owner of any part of a section or lot upon which the railway has been constructed, or a part of which has been taken possession of by the company for the purpose of constructing a railway thereon ; but I think he must be an fowner \" within the meaning of the Act, which term, as I have above said, includes proprietors and tenants; and I think the word occupied in the substituted clause means oc- cupied by the owner, that is, the proprietor or tenant thereof; for where there is a tenant, both he and his landlord are owners within the meaning of the Act; and I think the term \" occupant\" in the substituted clause means owner, that is, proprietor or tenant, and I think the use of the terms proprietor and tenant so occupying in the substituted clause, in the connection and manner in which they are used, shows this to be the true construction of the clause. The clause will then read as follows :\" With- in three montbs from the passing of this Act, in the case of a railway already constructed on any section or lot of land, any part of which is occupied by the proprietor or tenant thereof, or within three months after such construction hereafter, or, before such con- struction, within six months after any part of such section or lot of land has been taken pos- session of by the company, for the purpose of constructing a railway thereon, and in the last case, after the company has been so re- quired in writing by such proprietor or ten- ant thereof, fences shall be erected and maintained over such section or lot of land, on each side of the railway, \u0026c.; but this clause shall not be interpreted to the profit of any proprietor or tenant in any case wherein the proprietor of any such section or lot shall have accepted compensation from the com- pany for dispensing with the erection of such gates or bars.\" \" If after the expiry of such delay, such fences, gates, and cattle guards are not duly made, and until they are so made, and after- wards if they are not duly maintained, the company shall be liable for all damages which shall be done on the railway by their trains or engines, to the cattle, horses or other animals of such proprietor or tenant of the land in respect of which such fences, gates or guards have not been made or maintained, as the case may be, in conformity herewith.\" This construction brings all parts of the clause into harmony, and is, I am satisfied, having regard to the various provisions of the Act which I have above quoted, the true con- struction to be put upon the clause. The provisions of the Act respecting line fences, R. 8. O. c. 198, entirely support this construction, and the question under discus- sion has to be considered to some extent with reference to these provisions. It is not reasonable to suppose that the Legislature intended that the railway cçom- pany should be bound to fence against any tRE --------------",
         "THEE LEGÂL NEWS. person who, should without any titie what- ever, and as a mere trespasser, occupy any Part of a section or lot upon which the rail- way has been constructed, or a part of which bas been taken possession of by the company for the purpose of constructing a railway thereon, and that, too, when such person would flot ho compellable by, nor could he compel, hie adjoining owner to make, keep up and repair a just proportion of the fonce which marks the boundary between them. The plaintiff was a person precisely in this position, and so, was Worthington, to, whom, she at one time paid rent. 1 think, therefore, that the company were flot bound to fonce as against her, and that the order niai must ho discharged with costs. See Dougla8 v. London and Northweatern, R. W. Co., 3 Y. \u0026J. 173; Re Evans, 42 L. J. Chy. 357. Order ni8.i discharged, with costs. THE RIEL CASE. An opinion by Mr. D. Macmaster, QC., on the cas of Louis Riel, now under sentence of death, bas been made public, in which a new Point of general interest bas been raised. The learned counsel says: The prisoner was indicted at Regina, in the bXorthwest Territories of Canada: 1. For levying war against Uer Majesty \"iu the said Northwest territories of Canada, and witbin this realm,\" while a subjeet of ]ler Majesty, and 2. For levying war while living in Canada and enjoying Uer Majesty's protection. Re was tried by a stipendiary magistrats, a justice of the peace, and a jury of six, under the provision of \"The Northwest Territories A\u0026ct, 1880,\" convictsd, and sentenced te ho hanged. Xy legal opinion is now asked: 1. tTpon the competency of the court that tried him, and 2. TJpon the legality of the conviction and sentence. L. The court which tried the prisoners was, in raY view, legally-though exoeptionally- cOUStitUted, in virtue of special dèlegations of 18eslative power from the Imperial te the Cnadian Parliament. 'I The indictment is franied under the sta- tute 25 Edward IIL, cap. 2, which. bas nover been formally re-enacted as a law of the Dominion of Canada. How far it may ho in force in the Northwest Territeries as part of the common law is open te 90me question, owing to the restricted language of the sta- tute of Edward. The indictment is for levying war against Her Majesty \"«uit the Northwest Territeries of Canada and within this realin.\" The sta. tute 25 Edward III., is, as it expresses, \"iA declaration which offences shaîl ho adjudged treason,\"1 and among these is, \" If a man do levy war against our Lord the King in bie realm.\"l Are the Northwest territories a part of the realm within the meaning of the statute of Edward ? Referring to this statute Sir Mat- thew Hale says that \" Ireland, though part of the dominion of the crown of England, yet is no part of the realm of England.\"1. \"The like is to ho said for Scotland, even while it was under the power of the crown of England, as it waa in some times of Edward L. and some part of the time of Edward III.» The Court of Queen's Bench of Ireland hms docided that the same statuts of 25 Edward III. oniy became applicable te Ireland by the provisions of 10 Henry VIL, cap. 10, passed by the lrish Parliament, introducing it inte Ireland. The House of Lords subsequently confirmed the decision of the Irish court. Sir M. Hale thus discusses the clause in 25 Edward III. :-\" Now as te this clause of high treason: 0w ai hoe levy guerre contre notre Seigneur Me Royj en 8on realme.\" \"lTo make a treason within this clause of this statuts there must ho tbree things con- curring «\"1. It muet beaerying of war. \"g2. It muet ho a levying of war against the king- \"l3. It muet ho a levying of war against the king in his realm.\" The italies are used hy the learned jurist. After stating that Ireland and Scotland are not within \" the realm,\"' as before stated, hie continues: \"And the same that is said of Ireland may ho said in ail particulars of the Isle of Man, Jersey, Guernsey, Sark and",
         "THE LEGAL NEWS. Alderney, which are parcels of the dominion of the Crown of England, but not within the realm of England as to this purpose concern- ing treason.\" In a celebrated case of treason, it was held that the words: \" This realm,\" \" meant the United Kingdom of Great Britain (excluding Ireland) and nothing else.\" A prisoner who had stolen goods in Guern- sey and brought them into England was arrested and committed for trial in England. Mr. Justice Byles, at the Devon Summer Assizes, 1861, after consultation with Baron Channell, held that Guernsey not being a part of the United Kingdom, the prisoner could not be convicted of larceny for having the goods in hie possession here, nor of receiving them in England. The following joint opinion was given by the attorney and solicitor-general, Sir Robert Henley, and the Hon. Charles' Yorke, in 1757:- \"My LORns,-In obedience to your lord- ships' commande, signified to us by Mr. Pow- nall by letter dated April let, 1757, accom- panied with an enclosed letter and papers, which he had received from Jonathan Bel- cher, Esq., chief justice of His Majesty's colony of Nova Scotia, relating to the case of two persons convicted in the courts there of counterfeiting and uttering Spanish dollars and pistareens, and requiring our opinion, in point of law, thereon; we have taken the said letters and papers into our consideration, and find that the question upon which the case of those two persons convicted of high treason depends is this: Whether the Act of Parliament, 1 Mary, c. 6, entitled, \" An Act that the counterfeiting of strange coins (being current within this realm), the Queen's sign-manual or privy seal, to be adjudged treason,\" extends to Nova Scotia, and is in force there, with respect to the counterfeiting Spanish dollars and pistareens in the said province? And we are of opinion, first, that it doth not ; for that the Act is expressly restrained to the counterfeiting of foreign coin current within this realm, of which Nova Scotia is no part. Secondly, we are of opinion that the pro- position adopted by the judges there, that the inhabitants of the colonies carry with them the statute laws of the realm, is not true, as a general proposition, but depends upon cir- cumstances; the effect of their charter- usage, and acte of their legislature; and it would be both inconvenient and dangerous tg take it in so large an extent. The statute 25 Edward III., is simply a definition of the crime of high treason. By that definition it is high treason to levy war against the King in his realm. From the authorities cited it would seem that it is of the essence of the offence that the levying of war should be within the realm. Mr. James Fitzjames Stephen, in his Digest of the Criminal Law, says that it is treason to levy war against the Queen in her Domin- ions, and refers in a foot-note to the statute under consideration and the works of Sir Matthew Hale. He does not explain his reasons for using the term \" dominions\" for \" realm,\" though his definition is no doubt better adapted to the present conditions of the Queen's world-wide sovereignty. Hie digest, however, does not always express the law as it is and was objected to on this ground by the Chief Justice of England when it was proposed by legislative action to con- vert the digest into a criminal code. Mr. Justice Stephen did not pretend that hie digest in all cases expressed the law as it is. He aimed not merely to consolidate but to improve the criminal laws. I could not, how- ever, in fairness overlook the definition of so great an authority as Mr. Justice Stephen, though I do not think it impairs the force of Sir Matthew Hale's interpretation of the sta- tute. The value of Sir Matthew Hale's con- structions, Mr. Justice Stephen himself con- cedes in his History of the Criminal Law in these words:-\" The Act 25 Edw. III., is still the standard Act on which the whole law of treason is based, and the constructions put upon its different members by Coke, Hale, Foster and others, have been in many instances adopted by the court, and muet still be taken to be part of the law of the land.\" Upon the whole, there is fair ground for argument that the North-west Territories of Canada are not within \"the realm\" as in- tended by the statute of Edward, and if not, it is doubtful if that statute can be made to apply to offences committed there, without more express enactment. The difficulty here presented is obviated in the United States by a clause in the constitu- tion which declares that: \" Treason against the United States shall consist in levying war against them, or adhering to their enemies, giving them aid or comfort.\" The object of the statute of Edward was to define and limit the matters which should be adjudged treasons, and to prevent the Sovereign from making arbitrary encroach- ments upon the life, liberty, and property of his subjects by resort to prosecutions for ill defined and constructive treasons. The validity of the conviction and sentence might be tested by an application to a judge of the Supreme Court of Canada for a writ of habeas corpus. There is an appeal from the decision of a judge in such case to the full court. 336"
      ],
      "title" : [
         "The legal news [Vol. 8, no. 42 (Oct. 17, 1885)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_04844_406"
      ],
      "published" : [
         "[Montréal : Gazette Print. Co., 1885]"
      ]
   }
}
{
   "doc" : {
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PUBLIC ilEALTHl MAGAZINE VOL. I.] SEPTEMBER, 1875. [No. 3. (1Or inal qfoilliimnictio. --o ABATTOIRS. BY J. J. DUGDALE, M. D., C. M., HEALTH OFFICER. Amongst those matters relating to public health which frorn time to time have engaged the attention of the Board of Health of this city, that of the erection of abattoirs has been, for several years past, soiewhat prominent and pretty freely discussed. It is cause for regret, however, that, notwithstanding the frequent discussion of the question, and the almost general admission by the butchers of the need which exists for the erection and main- tenance of such public slaughter-houses, yet, up to the present time, no definite steps have been taken towards the accomplish- ment of such purpose either by the butchers or on the part of the Board of Health. Certainly, last year, the Coi.ncil took an important prelimin- ary step in that direction by authorising a deputation to proceed to the United States, visit several of the principal cities, and make inquiries regarding the character of their abattoirs, their mode of slaughtering, \u0026c. The report of Alderman McCord, the present Chairman of the Health Committee, one of the deputation, lies before me, wherein the Alderman clearly and concisely details his opinions regarding the question as it relates to this city, having ex- amined. the abattoirs at Jersey City, those on the Hackensack and at Brighton, in the suburbs of Boston, as well as many be- longing to firms or private parties. It is impossible to do justice to the report by a simple reference such as I can make to it in",
         "66 PUBLIC HEALTH MAGAZINE. this way , but I may be permnitted tu note two reLommendations \"First,.that the tÀty of Montreal build an abattoir after the most approved priniples, furnished with e.ery applian(.e for facilitat- ing the work tu be dune and neting sanitary retquirements, and in this abattoir alune should the killing of animais intended for food for the cIty be permitted. Se\"ondly, that the butchers should assocate thcmsehes in a Joint StoLk Company for the purpose of eretting and maintaining an abattoir.\" The latter recommendation Alderman McCord prefers, and states that \" None of the abattoirs xisited are the property of the City Cor- porations.\" I have no desire to be conisidered impracticable, bat I sub- mit that, with more than eighty slaughter-houses in % arious parts of the tity, some of them loLated in the most densely populated districts, and imany of them without any system of drainage to carry off the animJ refuse and blood, it becomes the duty.of the Corporation to ureLt thet abattoir-if the butchers will not under- take that duty-and it does not appear at all likely that they nwill do so, or that they recogni/e it as a duty-and thus remove from our tity one cause of the many preventable ones which arc pro- ducing disease and death in our midst. It is «-arcely neLessary tu say that as a result of slaughtering animals in so many plaLes the earth ini the locality of each is bturatcd with the bloud of the animals killed, mixed with the water used in the proLess of dleaning, and this liquid-in some cases repîorte.d to m -findb its way underncath thl foundations of dwelling-huuses, producing most disagreable effets upon the iminates-o that the inhabitants living in the neighborlood of those slaughter-houses, not only suiffer fron breathing the pol- lutcd atrnosphî_re surruunding their dwellings, but, on closing their windows in the vain hope of exluding the poison from without, thiy find that they only succeed in condensing it within. rhere is no intention on my part to blame or cast any reflec- tion upon the butchers of the city as a class; on the contrary, I t-vuld naen; sectral of then who possess slaughter-huuses whiih are models of cleanliness and completeness in almost every re- spect. Yet frum those establishments-the washing and other re- fuse mast necessarily find their way into the sewers, speedily un- dergo de\"umposition, and emit their poisonous e\u003ehalationis by the",
         "ABATTOIRS. shafts and gratings at the corners of the streets, and, as pre- viously intimated, the greater number of those are alnost en- tirely destitute of all sanitary regulations. There are many other evils to which allusion might be made as necessarily connected with such a condition of affairs. The meat, if kept even for a short time after being killed, in the atmosphere of the slaugliter- house, is impregnated with the foul odors, and soon becomes tainted and unfit for food. Again, it is utterly impossible for our two Meat Inspectors to see and examine a tenth part of the meat killed in the city, or the large quantities introduced to the markets by the farmers fron the surrounding districts of country. The Inspectors have shown theniselves very efficient in the discharge of their difficult duties since their appointment to 'that office about a year ago, having seized and confiscated about 14,000 pounds of meat during the twelve months ending the first of August-a great part of which was fron animals slaughtered in various stages and conditions of disease. Several small abscesses, filled with fetid purulent matter, were shown to nie in the carcase of one animal seized by Mr. Montmarquet. Some of this meat wvas from beasts that had died-to use the expressive language of Mr. Moore-\" before they were killed.\" Yet, notwithstanding the activity and faithfulness of the Inspectors, I an assured by them that there are large quantities of meat sold which is utterly unfitfor human food. Hence one of the strong arguments in favor of public abat- toirs is that, before slaughtering, all animals should pass the in- spection of the properly qualified officer, and that no meats should -under a penalty-be offered for sale in the city without the stamp of the Inspector. It was very correctly stated by one of the butchers at the meeting called by the Mayor, and held a few veeks ago in the Council Chamber, for the purpose of discussing the whole ques- tion intelligently with the butchers, that the buildings should occupy a largg space, and that for all the purposes of an abattir at least one hundred acres of ground would be needed. Of course the manufacture of sausages, mnelting of fat, cleansing of skins, utilizing of blood, and other kindred interests, would be all carried on at the abattoir.",
         "PUBLIC IIEALTII MAGAZINE. It would be necessary to have an abundant supply of water and a good systein of drainage. The flooring should be impervious to water, say of asphalt, or material somewhat similar in character. The removal of the fat-mnelting establishments, especially, from the neighborhood of the various soap factories would be a great boon to the inhabitants living in the vicinity of those fac- tories, as frequent complaints have been made from time to time of the disagreeable effluvium arising fron theni during the melt- ing operation. It is scarcely necessary to add that the concentration of those interests in one or two places outside of the eitý would not only enable the proprietors or authorities to carry them on at much less expense than at present, but would also set free large quan- tities of valuable land in various parts of the city which might b used for other purposes, so that not only would the land in ques- tion become more valuable, but also the properties in the imme- diate vicinity would greatly increase in value. There are many other matters in relation to this subject to which I have not referred, bit I shall possibly tike up the sub- ject in a future number of the PUBLIC -IEALTII MAGAZINE. -o PHYSICAL EDUCATION. BY MR. FREDERICK S. BARNJUM. The approach of the period for resuming school duties, and the consequent return of hundreds of children to our city, for the purpose of pursuing their studies, induces me to offer a, few words of advice to parents on the subject of physical education, not as opposed to, but as I would have it, proceeding side by side with mental education. My experience warrants me in speaking with confidence, as I have for some years past been carefully studying the matter, and watching closely the effect of properly graduated exercise on children of both sexes, and the result has convinced me that physical training is not a mere pas- time, but a neuessity. To thisI am aware many will reply, \" Well, but we have got on very well in the past without all this sort of thing.\" Very",
         "PitYSiCAL EDUCATION. truc; and there was a tine wvhen the same argument might have ien advanced against mental education-when the arts of read- ing and writing were considered unnecessary, for an otherwise accomîplis.hed gentleman. Walter Scott makes Douglas say: At first in heart it liked nie MIl, When tie king piraisid his clerkly skill, Thanks to saint l3otlhi, son of llie, Truc Gavin, ne'cr could pen a line.\" I fincy few nobles of the present day could be found to agree with these sentiments of the gallant soldier ; far from that, the cry is ever onward, and still onward, and in response to the de- nand, brains are worked as they have never been worked before, and numbers are ycarly sinking exliausted in the race. As afore- tine, the body vas cultivated to the exclusion of the mind, now this is completcly reversed, and let me tel[ the advocates of past supineness that during even the period when they suppose all went snoothly, nunbers of children werc visited with de- formaities and maladies, which might, by proper treatment, have been prevented ; and adults have carried about with them, through weary years of suffering, the fruits of early neglect. This has been the case more especially with girls; the only training they used to reccive, as far as I am aware, was a certain amouint of military drill, or some very elencntary extension motions. There nay have been some exceptions to these, but the fact has never reacled me; of one thing, however, I think there can be no doubt, and that is that the physical training of very young chil- dren has never received the attention it deserved. If it be ad- mitted, as the above-named efforts to afford exercise go to prove, that physical education was necessary fornerly-vhat shall we say of the present day, when mental education is driven at such higli pressure. Is it not most important that there should be some diversion from the tendency to neutralize nerve action, some means of equalizing the circulation-diverting the too great pressures on the brain-calling into play every part of the body, producing a vigorous action of the heretofore tied-up limbs, and thereby insuring a perfect circulation of the blood. Are not parents justly proud of the elastic and graceful carriage",
         "PUBLIC IKEALTI[ MAGAZINE. of their childrcn. For hoîr, i ask, can this be su casily attaincd as by elgaging in the beautiful cxcrcises wiihi hiunîdreds of utr titi- zens ha% itnessed ith deliglit and admiration at iy rUharsah, and which a parent cxprcssed tu me as being the \" puetry of mu- tion.\" And truly it was su, the verses being coniposed on those ut casions of f om nifty to sixty bright and hap\u003ey eiildren from four to ec'n years of agc; and it has alorded me nu small gratifi- cato.î to r,:ceivc, as I ha c frequently donc from parents, thc as- smuance that their children had rc..ci% cd the grcatcst benenft froi attendance at niy caIsss, and this bas been tspecially the case with children whose growth has been excessixe, and who haxe t.onsequcntly \" contracted z, habit,\" as it is called, of stouping, this \"habit\" bein; nothing more than the natural desire tu case the wcak and aching loins . the idea that the shoulders bas c anything to du with it being founded on a misapp\u003eiuhcnsion of the facts. With these cases the only plan is to attack the seat of the w cakness, i. c., tic loins, for as soon as these are strengthlened the stooping position disappears, and the child walks ere.t in its renewed strength. The best evidence I can offer of the truth of all this, is the fact that two-thirds of the children attending my special junior class were âcnt to me by the medical adxiscrs of their families. Hov often do parents bring to us girls and boys, espe- cially the former, more or less deformed, the vitims of cither ig-.orance or carelessness. It is \" the old tale\"-they saw noth- ing until eight, nine or twelve months ago, as the case may be, and yet, on close questioning, we invariably found that tic de- formity has been creeping insidiously on for years, and was in some cases advanced too far for permanent benefit. It is these sad cases that make us feel so earnest in the cause of physical education. The welfare of the rising gencration interests me warmly. I have felt my way most cautiously in dealing with children, and the result is that I would have the little one. begin at an age as early as possible; it is not a matter of years, but ability to comprchend-somne children of four years of age pro- gress faster than those of sexen or eight. By giving them sucli moi ements as do not unduly strain their tender frames, they are gradually worked up to a point of development and elasticity that keeps far off the dread and subtle enemy-deformity, and",
         "NOTErS ON HIOUSEHOLI SANITARY ?iATTER. not only so, but by particular attention bcing paid to secur;ig a (ll iniation of the hngs in breathing, which cain only be secured by a correct position of the body, another dread-that of con- sumption-is cffectually held at bay. It nay appear unnecessary to enlarge so iuch on this sub- ject, but I have feit it a duty to endcavour to arouse parents fronm the apathy which tiey display upon a matter of suci vital importance to their childrcn. Soie, I ai sorry to say, are pre- vented froi sending thcir children hy the small fee required, and yet thee saine pteoile would, if their child's life was visibly in peril, spend a fortune to save it; but froi nost unaccountable blindnesthey plead the nunierous deînands upon their purse for varions educational items, as a reason why their children \"cannot take gymnastics, as they phrase it. To such I would say thait in no0 possible way couild they better invest a few dollars yearly, than in securing the present and future physical welfare of their children. To those parents who have never witnessed these exercises, I extend an invitation to visit my classes, which commence mi October. And in conclusion I would say that it is iao mere mat- ter of business which urges nie to impress upon the public the clains of phvsical education; but a deep conviction which de- termined me to devote my life to developing it into as complete a systeni as possible, and to seck for my reward in witnessing a re- storation of that standard of physical excellence, which the exi- gencies of modern civilization have tended so much to deterio- rate. NOTES ON HOUSEHOLD SANITARY MATTERS. Biv JAs. il. SPRINGLE, ARCHITECT AND CIVIL ENGINEER. (Cednca'frniPge 49.) NOTE 2. In the August number of the HEALTH JOURNAL I explained the nature of the risks incurred by the introduction of water- closets into dwellings, and the dangers arising from the disgrace- ful and unworkmanlike nianner in which such works are most",
         "'UBJLIC 11EALTII MAGAZINE. frcqucntly done in dwelling houses, and, in vicw of the fact that there is not,snor cvcr lias becn, any munitipal regulation what- ccr rcspecting the drainage of houses, nor any supervision at. tcnptcd in a matter affecting so scriously the hcalth of the citi- uns, it is not surprising that nany anongst us advoLate the en- tircibanisliment of vatcr-dlusets from all dwelling huuses. Far butter, thycisay, to return to the old plan of outside privies, with allheir nt.onveniences, than to bring the commluon scner abom- inations into thet iery muidst of our sleeping ap.rtments. To all this wc haie to answer, that, ilthe plumbers and other artificers, to whum the drainage of dwclling houses is entrusted, arc to be allowcd to go on without cuntrolewith these important works in the banic rcckless inanne* as hithrto, it wou/d bc much butter to abandon water-closets and return to the old order of things, for the hcalth of the citizens could not ielp bcing improved by the change. On the other hand, in cities that have a plentiful supply of watcr (and we havc aplentiful supply), a properly constructed wa- ter-clust, placed in a dwcIling under the personal superis ion uf a competent inspector, and not allowed to bc used until said in- sp\u003eector hassatisfied himself that ecery part of the work is con- plete and perfect, frum the ventilating shaft on the roof to the junction with-the street sewer, is unquestiaably far superior to all other contrihances for the removal of excreta. Earth closets, ash closets, and the whole tribe of similar inventions, arc not to be compared with it for cleanliness, comfort and -fficiency. No other system is so admirably adapted to the exigencies of our Canadian climate. Secured from our intense frosts, it removes excreta by water carriage to the common-sewer by the mere pul- ling a liandle or -turning a tap; whereas, the dry earth system, the tub system, or the ash closet, are none of-them selfracting, but require manual labor to replace the receptacles and remove their çontents. Nor is there any advantage clained for thiese portable contriîances which càniiot be better obtained by the best form of water-tight privy vault, built of brick in cement, and arrangedto be einptied every winter. I have alluded incidentally to privy vaul\" Lecause they will always be largely used in Montical as well as water closets, and because outside water-closets, in a clirnate like ours, are out of",
         "NOTEs ON sUsElioLD 5ANITMRY atATTERK tie question. As for the sacrifice of valtable nianure which is supposed to be made by running the contents of our scwers int the river, it is quite certain that the sewage of Montreal is far too much diluted with water to admit of its ever being utilizcd for agricultural purposes ; while, from a sanitary point of view, no inconvenience or danger need be apprehended from the diffu- sion of the city sewage in the passing voluime of such a nighty river as the St. Lawrence, for if we take the daily discharge of the sewers into the river to be ten millions of gallons, the river itsclf, in the saine period of time, passes no less than two hîtndred and seventy thousand millions of gallons. However destitute of value, tierefore, the setige of Montreal may be, it is highly prob- able that if the soit pits of all privies throughout the city werc constructcd as they arc in the city of Paris, the contents thereof mnight, as in that city, be niade a source of revenue, instead of being, as it is lere, a scandalous and costly nuisance. P. S.-In the August nimber I recommended water for the absorption of efiluvia in bath-roons, \u0026c. This was only intended to apply to houses wlhich iad no ventilators to the soit pipes, and in the second paragraph the printer lias converted joints into points. (7To k svntinud.) o- The Editor begs to state that lie will be happy to receive any communications on the following subjects, and others allied to Hygiene : Water supply, drainage, ventilation, building, adulter- ation of food, \u0026c., warming, clothing, education, manufactories and their influences on health, scavenging; also, Public Health Reports fron Canada, United States, or any, part of the world. PUBLIC HEALTH MAGAZINE being a monthly periodical of pro- gress, advocating neither party interests nor influences by pre- judice, its columans are thrown open to all who desire the advance- ment of sanitary knowledge. Contributors, in sending papers, will please mark the places they especially wish our attention dravn.",
         ",S1111t -ilŠ j!T$ THE VESTRY OF ST. MARY AUIWTT', KbNSING lON. Wc have just recivcd a report issucd by the \" Vstry of the Parish of St Mary Abbott', Kensington, W. Londn,\" oun the sprcad of Scarlet Feer, with instructionîs for preventing, the spread of infectious or contagiouis diseases, such as scarlet fever, smnall-pox, \u0026c. Wc reprint them, although we gave our readers a synopsis of the like in our August mutmber. Our Board of lealthx should distribute colies gratuituusly to our fellow-citi- zens of some such suggestions, not forgetting a strong one on re- vaccination. i.-Separate the sick person fron the rest of the family di- rectly illness appears, placing himu, if possible, in a roomi at the top of the house, and taking care to renove carpets, curtains, and all unnecessary articles of furniture and clothing therefromn. 2.-Admit fresh nir by opening the ipper sash of the window. Tie fire place should be kept open, and a fire lighted if the wea- ther periits. Freslh air should be frecly adnitted through the whole ho.usç-bv mcans of open windows and doors. The more air th through the bouse, the less likciy is the disease to sprea(.. 3-Hang up a shect outside the doòw of the sick roon, and keep it wet with a mixture made cither with a quarter of a pint of carbolic acid (No. 4), or a pound of chloride of I me, and a gallon of water. The floor should bc well sprinkled frcquently with ether of the saine disinfectants, and cloths, wetted with cither, huîng up in the room. 4.-Everything that passes from the sick person should be recivcd into-vessels containing half a pint of a solution of green copperas, made by dissolving one pound of copperas in a gallon of water. A like quantity of the solution of copperas should bc added to the discharges before emptying them into the closet. 5.-Every sink, closet or privy should have a quantity of one of he above-named disinfectants poured into it daily, and the gretiest care should be taken to prevent the contamination of drinking water by any discharges from the sick person. j.-All cups, glasses, spoons, \u0026c., used by the sick person should be first washed in the above-naned solution of carbolic",
         "'11 VES'TIRV MU 'S.T. 31AIY AlîflnTT'tS »0«;~ 711 ami, n:îd Alcriwards i hot vi war, lieforc bcing uvd liyv itlîer pvrst1il. 7.-Nu article tif COIio 'o,1%tlll lie alliiWed (0 rilla«i, llî th ronni , mid un fond oir drink ihai the pek ~rm lias tirie. tir tit has lieusi in th ic- rk muni, should bc giveil t.' atiy\"ne else. \u0026.111 bcd] aind body Iiinen, as %ooun a. rîndfroiti the 4Ak jtevýon, and hefort: lcing taken friill the room, bolile lr%î puit jin 1 Solution of rurbolie acid of the aIbow-e.nlied ,.treiigîh, rcliniing tiberein for at i. a'il » otr. and ifzcrv.rd,. boiled iii %vicr. t).-Itistcad of lînkrîcs iîall j\u003eiL:ec,; of r.ag suld ie uNed, aIn tiv-se, wlhcn sailcd, -,bIild be iiiieîicly) bîmrnt. io.-PerNons -ittending ain the %it-k slîinld, ni wvar woitillen girnients, as tlîcy ire likerly bo retain ilifectils pkn; drc-.scý; 0( cotton, or of Soille %Vashiabl ilnacril, sbauld lie %vorln. Nilr.ses ~Jiould alwiys washi thecir hauds îmîuiicdiatcly aller atlcuidiing lu the sieck persan, usiîug curboli acid soap) îu.sted of ordinary up 1 î.-It iq of the utimosi iînprt.incc îb.t the sit] k oclu hc not frluetitcç li), otir than those in ininiediate ittundlznue on the sî-k, as the cloihing of visiiors is very liable la carry away infc lion. 't'lihe selies Ind duisty pawcer which piei froin the skin in scarlet fever, and the cmusts in, smaillinx, bieiug hîghly inter- tious, thecir c,.rape should bc prevented by silncaring 0 ovo the sick p:erson ail over cvery day ih canlph-rIted ail. This and the afîcr use of wirml baîlis and crroiic acid soap are niost essentiai. The sick person imuistii bu c allowed lu niîx with ihe Test of the faîiiy unltil the p)eling )-L en firt-1y i-case, and the skin is perfcctly sînoaib -, clathes tused ditring the timte of illness, or in any way exposed to0 infection, ,nust not lie iiotyr; gatin mili I/hy have bc.en properli, disiJcted. i3.-Whciin the sickness lias, terinaiitcd, the sielk rooni and ils contents should be disinfecîcd and clcansed. This shotuld be donc in the foilowing inanner: 'Spruad ont and bang %ilon lines ail articles of clothing and beddîng; iw'di closc the fire place, win- dowvs and ail openings ; fihen takze a quarter to haif a paund of brinistone, l)raken int sinall picces ; plu tiieni into an iran dish, supl)orted over a pail of water, and set fire t0 the briinistone, i)y putting soine live coals upon it. Close the door, and stop ail1 crevices, and allow the rooni ta renmain shutt uip for twcenty-fouir hours. The rooni sbould then bc frecly vcntilatcd, by opening the doar andi windows, the ceiling should. be whitewashed, the paper stripped froin thc walls and burne, and the furniture, and aul wvood and painted work, bc well ivaslicd with saap and wvaier containing a little chioride of lime. Beds, mattresses, and articles which cannai well be %vaslhed, should, if possible, bc submuitted to the action oil heat iii a disinfcîing chamber. Unfil is,1 pr-o-",
         "PUBLIC IEALTII MAGAZINE cess of disinfection is efectually carricd out, the room cannot b. safey occupiced. 14.-Children should not bu allowcd to attend school froni a house in which there is infectious disease, as, although not ill thenselves, they are very likely to carry the infection, and so sprcad the discase. No child should bu allued to re-cnter a school without a certifiLate frui the medical attendant, stating that l'e can do su without any danger of infecting other children. 5 -Ini casu of death, the bc.dy should not be renoved froin the rooni, except for burial, unless taken to a mortuary, nor should any article be taken from it until disinfected as before directed in Rule No. 13. The body should be put into a coffin as soon as possible with a pound or tw o of carbolic powder. The coffin should be fastened don i, and the body buried without any delay. T. ORME DUDFIELD, M: D., Medical Oficer of Ieallh. HEALTH- OF JERUSALEM. For more than a year small-pox has been exceedingly pre- valent in Jerusalem, Bethlehem, Jafia, and other towns in lales- tine. There are, unfortunately, many native customs and pre- judices which militate against a cessation of the epidemic. In the first place xaccination is alimost entirely neglected. There is no attempt to isolate small-poN patients, while the sufferers are carefully guarded against the access of fresh air, by which means the atmosphere in the apartmcnts and the clothes of the persons therein -become saturated with the poison-thus greatly facilitat- ing the communication of the disease to others. Again, the pre- judice against adopting medial treatment for small-pox is al- most universal, while the general in.anitary condition of the towns and villages is notorious. On the whole the mortality does not seem as great as might ha% e been expected, the disease not having been of a virulent type. But numerous deaths have occurred, and a great many eyes haie 15een destroyed for want of efficient treatment. With the season of early fruits, which are frequently eaten in an unripe state, diarrhœa and cholera have become common in Jerusalem. Some of the cases have been of great severity, accomîpanied by cold :kin and tongue, husky voice, a bluish tinge of countenance, feeble pulse, and cramps of the legs. Desultor attempts at improi ing the sanitary condition of Jerusalern continue to be made, and the stLady influx of Eu- ropeans cannot but ha% e a beneficial influence on the health and prosperity of the Holy City.-T2e Lancet.",
         "To te Edior PuzN'ic Ieath MFýeazgaine: DEan Smt,-Allow me a few lnes in your journal to call at- tention to) the gross adulteration of soap, as a matter atTecting the public health and comfort. Some ycars ago, when living in a boarding-housc, my w asherw oman occasionally brought home my hcavy flannels in a condition I could not for mie time under- stand. They seemed to bc damp from theh stithcss and hcavy odour; but no process of drying improvcd thum. Since then I have heard housekcepers complain of the stiff, sticky state, in which their blankets wvere returned from the wash. Almost every one has had occasion to observe the stic.ky condition of his hands after using some kinds of soap in wabhing. The unfortu- nate wight who, in bathing, attempts tu cleause himself with any ordinary bar of brown soap w ill find himself at the end of the process so far resembling a fisher's smack in that he is well pitchcd, at least without, and instcad of accomplishing the ortho- dox result of opening the pores lie has taost effectually closed them. Ali this is due to the inciedible quantities of rosin, light or dark colored, according to the color of the manufactured article, which is added to ncarly all the cheaper vareties of yel- low and brown soaps, while to the white soaps some kind of dense white powder is added to give them volume and weight. By these adulterations the poor ignorant hardworking washer- woman is cheated out of more or less than half of the genuine compound she thinks to buy in good faith, besides, perhaps, hav- ing to do lier work over again and losing lier reputation as an artiste into the bargain. It is bad enough to be filled up and dirtied with city dust, and have to attempt to wash it oiT with the compound distributed froni the cit vater works, and alrcady graphically described in youi columus, without having to be rosined like a fiddlestring or powdered with suspicious mixtures. To obtain pure soap at a reasonable price, each family will be compelled to retrograde to the primitive fashion of making it themselves. Trusting you will pardon me for taking up so much of your valuable space with this matter, I am, \u0026c., SAPo.",
         "PUlLIC IEALTIH MAGAZINE. To tlie Edilor of Pu\u003eic Ilealth farazine : Duan Sin, -Institutions of great importance tu jlasses and coni- imlunities oftcn beugin piictly a.id unperceived, but when the con- (itionlis and l.itLlia.ls foi thezn growth are continuously present, they increase in strength and usefuniiess like the acorn into the toppling and giant oak. SuLh lhas been the nanner of growth of many of our institutions foi the aid of the sick and pour and friendless. More particulaily would we advert to the growth in Scotland of a Seiius of seaside homes foi these ciasses, that, hav- ing found its origin in the love of one or two knd hearts in that land, increascd and prospered in the geial light and warmth of charity, until these homes havc become an honored and power- fuli agent of beneficence. A young shoot from that parent sten seems to have floatea across the Atlantic and last sunner quietly taken root at Murray Bay, on the shores of the St. Lawrence. The acknowledged eIficacy of a residence at the seaside as a means for the restora- tion of health and strength and the more general application of the golden ride have been the soil and atmosphere in which this new plant has thriven and, let us hope, shall continue to thrive so long as any may require the shade or shelter of its hospitable branches. While the whole mountain and province have been in fruitless Tabor to produce a Convalescent Home of magnificent propor- tions at Montreal, a single kind heart with single faith rented a cottage at Murray Bay, and, gathering in some poor weak and sickly women and children from this city and elsewhere, com- menced the first Convalescent Home in Canada. The means for its support werc more than supplied by admiring witnesses of the effort. Returning spring showed that-il young institution at Murray Bay had not been killed by the frosts of apparently inactive win- ter months, for on visiting the seaside in the full height of sum- mer we find that the Home has grown to more than twice its for- mer size, and has succeeded twice in putting forth a branch, while its vigor and beauty show how deeply it has struck its own roots into the hearts and pockets of the benevolent and intelligent public. While it is hoped that those who approve of this effort will",
         "CORRESPONDENCE. voluntarily send in liberal contributions for its support it is but just to say that those more immediately connected with it have nade untiring effort to do the most good viti offerings sent. An advantageous lease of .uitable houses has beei secured and ar- rangements have been niade for reduced fare to Murray Bay and return, while Miss Hervey undertakes the personal supervision of the internat and general management of the institution. Many of limited means vill liait vith, joy this new chance of regaining health nuver before dreant of, the wealthy will have the opportunity of conferring an unwonted boon on sone invalid prolégc, and medical men nay reasonably recommend to many of the working classes a remedy often formerly desired, but never before possible to use. I amn, sir, JOHN BELL, M. D., I Belmont Street. o- To the Eiftor of Public Ilealith M3fagazine. DEAR Sir--I was called to see a patient at the corner of Dor- chester and Aqueduct streets the other day, suffering fron Glos- sitis, general malaise, sore throat, and other symptoms indicating a very unsanitary state of the atmosphere, and, intimating ny sus- picions, I was shown into the cellar, when, to my astonishment, I belield the whole place in a state of inundation, bite mouild sat- urating the fioor above, and on examination I saw that it had actually caused fungus growth to ascend through the flooring inte the bedrooi. Would you please bring this niatter before the public, as I an certain this is not an isolated case, but I have no doubt nany of our older (and some nev, if the truth were known) houses are equally as unhealthy, and should be looked after by our health officers. The unfortunate tenant lias repeat- edly reported the fact to the landlord, but he will do nothing. I have written to the Health Office well as to you, sir, in hopes that the city authorities will insist , -on something being done by the landlord, or that thcy will do vnîat is necessary and send in the bill to him. I an, Sir, yours, M. D.",
         "-o- \"AnvicE io A W1FE,\" on the Management of her own Hcalth, \u0026c., \u0026c. By Pye 1-enry Chavasse, Fellow of the Royal College of Surgeons. We are indebted to Mr. H. F. Jackson, of 931 St. Catherine street, for the above work. It s a book of 246 pages, every one of which is filled with very necessary and important advice to a wife. It is divided into four subjects, aci of the utnost con- sequence in the economy of feinale health, with an introductory chapter on gencralities, the whole essential to a young married wonan. Mr. Chavasse, in his own peculiarly interesting manner, treats the subject very exhaustively. He says: \" I know I am treading on tender ground, but my duty as a medical man, and as a faithful chronicler of these matters, obliges me to speak out plainly, without fear or without favor.\" The object he seens to have constantly in view, is \" the hcalth of wives.\" He most deter- minedly opposes the present mode of conimening married life. le says: \"The present fashionable system of spending the first few months of married life in a round of visiting, of late hours, and in close and heated .ooms, calls loudly for a change. How many valuable liv es ha, e been sacrificed to such a custom ! I.ow many mishaps, \u0026c., \u0026c., have resulced therefrom? Night after niglit, gas, crowded rooms, and excitement, are lier portion. Fashion is often-times but another name for the suicidal under- mining of l'ealth and happiness.\" His advice to a young mar- ried lady to take regular and systematic out-door exercise is admirable. We thoroughly endorse his views. There ib too much close confinement either at home or at parties, \u0026c. He advocates free ventilation to keep her house hcalthy and sweet and to keep off disease. Thorough bathing is another point lie insists strongly upon, and in five lengthy paragraplhs lie enters most minutely into the subject of cold or tepid water ablutions, according tu the seasons. If she attends to this every morning it will most assuredly strengthen lier.",
         "\" ADVICE TO A W1FE.\" With regard to Diet, he advises, above all otier meals, tu cat a hcarty breakfast; it is the first meal after a long fast, the systei requires it. \" Suppers,\" he says. \"are an abomination,\" and he is not far wrong. He gives minute and valuable instruc- tion as to diet, which should be read by men as well as young wives. \"But,\" lie adds, \"be temperate in all things.\" Wine lie only advises if wcakness is great, and then only to be taken if a medical man orders it. le says, \" Gin-drinking nurs- ing mothers, it is well known, have usually puny children; in- deed the mother drinking the gin is only another way of giving gin to a babe- -an indirect, instead of a direct route, both lead- ing to the sane terminus-the gra'e.\" He continues by quot- ing fr ni Dr. Parkes, \"If alcohol were unknown, half the sin and a large part of the poverty and unhappiness in the world would disappear;\" also he agrees with Shakespeare when he said, \" O thou invisible spirit of wine, if thou hast no name to be known bv, let us call thee Devil.\" In speaking of sleep lie advises early retirement and con- sequent early rising. Young vives should endeavor to keep thenselves always in bloon, which lie says carinot be done unless they have the full benefit of their \" beauty sleep,\" for \"one hour's sleep before midnight is worth two after.\" He asserts, and with truth, that \" sleep is of more consequence to the human economy than food.\" All these important points are touched upon and handled with care. They will all conduce to make a happy home. The wife will be good-tempered and happy, and always endeavoring to cernent her husband's affection more closely toher as did Peggy in Allan Ramsay's \" Gentle Shepherd:\" \"Then I'll e, oy wi' pleasure a' my art To keep him cheerfu', an' secure his heart. At e'en, when he comes weary frae the hill, l'Il hae a' things made ready to his will. In winter, when he toils thro' wind and ramin, A bleezing ingle an' a clean hearthstane ; An' soon as he flings by his plaid an' staff, The seething pots be ready to take aff; Clean hag-a-bag l'Il spread upon his board, An' serve him vi' the best we can afford; Good humor and white bigonets shall be Guards to my face to keep his love for me.\"",
         "PBILIC JIEALTII MAGAZINE. It not only treats of ail the private and necessary manage- ment of a yuung wife, but ecen gives good sound adkice in the culinary department. To sum up lie ad- iscs as the bcst physic- \" early rising, thorough morning ablu.iun , good substantial plain food , great moderation in the use of stimulants; a cool and wcll ýentilated house, espetially bedroum ; an abundance of fresh air, exercise, and occupation, a chcerful, contented, happy spirit, and carly going to bed. All these are nature's remedies, and are far superior and are far mure agrecable than any others to be found in the materia medisa.\" Attention to these will, in the words of Wordsworth, make a perfect woman . \"A being breathing thoughtful breath- A traveller betwixt life and death ; The reason firm, the temperate will, Endurance, foresight, strength, and skill; A perfect woman, nobly plann'd, To warn, to comfort, and command; And yet, a spirit still, and bright, With sorncthing of an angel light !\" PROTESTANT INFANTS' HOME. We have just received the fifth annual report of the Protest- ant Infants' Home. The Home seems to be doing a very credit- able work, thanks to the energetic ladies who have in hand the guidance of its affairs. Their finances are in an excellent condition ; they have on hand $3,ooo for the expenses of the coming year. Besides, there is a fund, already subscribed, of $6,oou towards a new building. We cummend this charity tu the liberality of our citizens, a new building being very much needed. We were struck with a remark in Dr, Bell's report, which we will copy, showing the unsanitary state of the present old Iouse : \" The old'house in which the Home is yet unfortunately placed, is quite unSt for the purpose. No means are provided for venti- lation, and the decaying urganic matter, necessarily accumulated in cra\u003cks and crannies throughout the old fashioned building, soon pollutes the atnosp\u003ehere-of the rooms when the chilly and cold weather of the greater part of the year compels the closure of the only apertures for ventilation. The air, thus rendered",
         "ANNJUAL CALNDAR OF 0 M'GILL COL.GE. inpure, injures the children not only through the lungs, but also by the infection of the fond constantly exiosed to myriads of gerns which at once cause ferment.tioni and decay, thus largely adding to the cause of the gastrîc and intesutinal disorders that are the banc of the institution, as they are the chief factors in the marasmus or dcbility, and the death of nearly trece-fourths of the whole number of infants dying in the present house. \" Medical advice cannot be better given than ii urging the placing ot the Hom. in a more suitable building, surrounded by healthful grounds for summer use; -nd I have been sadly con- vinced that medical treatment of any kind can prove of but little avail when opposed to such overwelming forces as at present operate against us. After what experience has tauglit us, it needs no prophet to interpret the meaning of 42 deaths from infantile debility out of a total of 72; 30 of whom died under the age of one month. A properly ventilated building vill remedy this to a very great extent.\" We also notice the addition of three medical gentlemen to the staff, Drs. Ross, Wm. Osler and Gardner. This will give Dr. Bell much help in his duties, and we must congratulate the insti- tution upon securing the services of such an able staff. ANNUAL CALENDAR OF McGILL COLLEGE AND UNIVERSITY. The Calendar of the forty-third session of this University, comnencing from September, 1875, is before us. There have been several changes in the staff of the Medical Faculty, owing to the retirement of Dr. Campbell from the chair of Surgery, so eminently filled by this veteran for forty years ; as also of Dr. Drake, ivhose health prevented him from continu- ing the duties of the chair of the Institutes of Medicine. Both these gentlemen were honored, on their retirement, with Emeritus Professorships; Dr. Fenwick taking the Chair of Theory and Practice of Surgery ; Dr. Roddick, Clinical Surgery; Dr. Gardner, Medical jurisprudence. The only really new and important change as to the chairs themselves bas been the erecting of the Lectureship of Hygiene into a Chair, which Dr. Robt. T. Godfrey, late Professor of Surgery in Bishop's College, Lennoxville, has",
         "84 PUBLIC IIEALTIH MAGAZINE. reccived. We can most hcartily congratulate the student of medicine on this eNent, because it is most sincerely to bc hupcd, and reasonably cxpcted, that the objcct cf thc Faculty in the crcation of the Chair is to nake the subject no more an optional summer course, attcndcd by few, if any, but one to bc delivered at a scason when a full attendance during one of the matri.ulation ) cars may be put in by cadi student, and the course made so full and instruàt e as to become thorcughly popular and appre-iated. Thc fact that the calendar is silent, both as to the tnie when. the lectures shall be delivered, or cvcn the fées to be paid for attendanLe, luuks icry like the old hum-drum systcm that preNailed in our own undergraduate days. It is certain that the community expecrt a well-qualified medical man to be some authority on âe subject and practice of Hygienc, and as it is a daily tupi. of inquiry, and an all-impU;tant matter in town and country, let our deservedly pupular University sustain its character in this brandi as in all others. We shall be well pleased to draw attention ta any instructiic and popular course that nay be in preparation, and we are sorry that the newly-appointed Professor had not seen ta saine proninence being given as to the rouise, swith itâ details of illustration, inodels and applianecs for experiments, su as to enlist the interest of the pupil. Wc must s also congratulate the University upon obtaining the services of Dr. Osler (who has made a specialty of Physiology and Patho- logy) for the ChaAr made .acant by the resignation of Dr. Drake, on account of ill health. Dr. Shepherd, son of Capt. Shepherd, was named as Demonstrator of Anatomy, rendered vacant by the appointment of Dr. Rfddick ta the Professorship of Clinical Surgery. We must not fail to notice the lLudable regulations adopted for thesecuring of buitable boarding houses in healthy localities, under the supervision af the authorities.of the University, and if we might suggest a ineans of securing suh residences, and procur- mr'g the aLU.mmadation J well % entilated rooms and the modern appliances of baths, \u0026c.; let the Governors of the University add to the ardinary boarding price, payable by the student to the landlord, a monthly aditional gratuity to secure the sanitary comforts that will add to the health of the student and invigo- rate him for his severe mental exertions. We truly mourn the omission from the list of Goernors of the vell-known bene olent co-fuunder, the late William Molson, Esq., whose tablet on the hall that bears his name records his nemoiy as the tomb of the late ionorable. James McGill, recently removed to the front of the centre building declares also the re- cord of a grateful Tniversity.",
         "PUBLIC BEALTHI MAGAZINE SEPTrEMBIER, 1875. THE KINDERGARTEN, OR CIIILDREN'S GARDEN. \"lMutter ist der Genius der erstcn Kinithùt.\" FrSbel, born in 1782, was a pupil of Pestalozzi, and left us the legacy of the Kindergarten. As its name implies, it is a chil- dren's garden. Tuition is given not by book-lcarning, but by pleasant awsociations and agrecable instruction, in the open air, or indoors, made fresh and pleasant by the cultivation of flowers, \u0026c. Wordsworthi says, \"The child is father to the man.\" Man* receives the heritage of vigor or debility, of health or illness: which his childhood has bequeathed to him; and, therefore, ve cannot be toc careful to watch over this decisive period of life. In this respect, a day of childhood is worth a month of ado- lescence in its intluence upon his future health. Montague says, that \" those who separate the education of the mind from that of the body do a great wrong.\" M. Dupanloup, in his celebrated work, published thirteen years ago, compared \" education to a skilful gardener, who places the plant confided to him in a good soil, sprinkles it with water, surrounds it with favorable conditions, nourishes it and shelters it with care, that it may produce its fruit or flowers in due sea- son,\" and, as Education is the handmaid who tundertakes tl e grave w rk of transforming the child into the mai, it must b.' considered under its physical as well as its mental conditions. Montague again says that \" Health is the factor wbich gives. value to all the zeroes of education.\" Thus we see the great value these truly philosophic men attached to the physical edu- cation at the same time that the mental endowments were being developed in the tender plant. Hufeland has laid down the fol-",
         "lowing rules, whih ought .to bi known by heart by evcry parent and by every teiacher:- r. The first object ta bc kcpt in view is \"to promote the dc- vclopmcnt of the organs, especially those upon which the dura- tion of the physical and moral life depend, ta cxercise thcm properly, and to make them as perfect as possible.\" And what are they? Thcy are the stomach, the hcart, the vascular and nervous system. Hlcalthy lungs depcnd on the use of pIurc air, aided by spcak- ing, singing and running. A good stomach is aaquired by put- ting nothing into it but wholesone food, nourishing, and easy of digestion, neither highly spiced nor stimulating. The hcalth of the skin is rnaintained by dcanliness, frequent washing, baths, and the enjoyment of fresh air in a moderate temperature, and lastly by exercise. 2. Before we try to develop the physical and moral faculties wc must bc assured of the gencral hcalthy condition of the body. This is the basis of all education, and indeed of life itself. 3. Baths, pure air and exercise, are three objects never ta be lost sight of, and they are the best we can cmploy. 4. The clothing should be loose, clean, an firee fron pressure of any kind, and bc suited to the climate. 5. Nourish the vital powers. Habitual exzrcise in the open air is the best way te do so. Fortify the ris mzediatrit niaht and you will avoid the neces- sity of applyng to the doctor, for if you go ta him for every trifle you will lose the habit of self-reliance. 6. From the beginning, moderation must bc stri tly observed as to diet, both in quality and the way in which it is caten; this habit will become a \"law for the future\" and make ife longer and more pleasant. Frebel was well aware of all these invaluable axioms when he proposed to educate the young mind tohabits of observation by health and necessary exercise in a \"Kindergarten.\" The New York Tribune, in a late number, in speaking of a Kinder- garten in Boston, says :- \"I wish I could make a picture for you of this roomn and the little people in it. There are pictures on the walls, such as Cheney's crayon of the Sistine Madonna; on brackets are grace- runLic litAi.1ril NIACPAZIt.",
         "TitE tI1RGARTrN, Ç*R CIILrtItN'S rAuEN. 7 tal bt; baouqauets arc in pitty vases; btt, above al), therc is i we fh f green thing4 growing, pntted plants in large variety and l a % ery thrifty rondition. This idea of growing plants, vo must i nîlrstand, is one «if Froee's essentials. It is gond for the body. le thinks, to tend them; it is gond for the soul to blie and watch then Earh rhild has one or more. Hin plant is s nuch his own as his rap or his mittens. lie waters it-he pi. ks off the dead leaves-he turns it toward the ,suin-he is praud of it beyond ii -asure. The children who arc present eac-h day are allowcd. as a fasoar. to tend the plants of .le absent; and they do this fanlft'ully and witlh great deliglit. ' Imagine, in thbis picture-adorned, blossoning room, a dozen little tots, more or less-girls and boys being about cqually re- presented. Fancy thei seated in littile cairs, so as not to tire their tiny legs, before bng, loiw tables, just about as high as the seat of a grown-iup perýon's chair, made of light, polished wood, divided by blad lines into square inches, by which the cyes of the children prvsentlv lecone arcustomed to mea.sure objects. Ibe:re they sit f\u0026r half an1 hour, buby, perhlaps at building with block,, perhaps at mdeiillig in clay, perhalis at folding paper, or drawing, or embroidering on cards; for no John or Richard who has bec-i trained in a kandergarten will be necessarily dependent on his wife's caprices as regards his tuttons. This work goes on for half an hour, and then there is half an hour of play, But, first, I must tell you about the ' occupation.' as they cali it. «Building with blocks sotnds like mere fun, doesn't it? but, really, it exercises these little minds very actively. They were given, when I wvas t\u0026 ere, a cube, which in Frobel's list of ' Gifts' is numbered the fourth. It is composed of eight wooden oblongs. two inches in length,an inch wide, and lialf an inch thick. These little oblongs are shaped like bricks, you perceive, and with thern the children are instructed to build. Each one must have his own idea, and plenty of room is thus given for invention. One built a bridge, with steps leading up to it, suggested by the one in the Public Garden. Another made a summer-house and ex- plained his notion of its construction. Another made what he called an engine, with the gate shut when the bell rings, and the sign-board over it. He had a spare oblong, and he set it up on end and said it was the man to tend the gate. Another little fel",
         "PUBLIC IEALTI{ MAGAZINE. low, full of fun and brightness, made a school-house and set a solitary oblong in front of the door. 'Who is that?' asked Miss Garland. 'That is Elise, coming all alone, as she did this morn- ing,' he said, lai.ghing. Elise was a small maiden, with bright eycs and many ru ffles, who was usually escorted by a nurse, but who had surprised them that morning, by coming, with the ut- most dignity, quite alone. \"After this half-hour's 'occupation' was over, there came half an hour of play. The plays are set to music, and are the most admirable systemof gymnastits imaginable. Let no one aspire to teach a kindergarten who cannot sing, at least tolerably, for amusement is all accompanied by singing. They play mostly ring plays, so contrived as thoroughly to exercise the muscles, to teach grace of motion, and to prepare the little folks for future dancing. After half an hour's play comes another 'occupation.' Perhaps it is drawing. For this purpose they have peculiar slates,., grooved inte little squares a quarter of 'an irch each way. This aids them to be accurate in their lines. As they go on the slates are changed, the grooves becoming less and less deep, until at last they can draw as accurately on plain slates as they-could at first on the grooved ones. Or perhaps they weave paper, choos- ing their own combinations of color. Or they model; and one little boy had shaped out of clay a surprisingly good turtle. Their leaf impressions in clay were extremely delicate and pretty. All the time their attention is alert; their habits of close and accu- rate observation are forming, and they are so interested in what is going on as te know no weariness. They wait on themselves, and put away all their implements as soon as they have finished tusing them, with a careful orderliness which is in itself an excel- lent training for the future man or woman. They .arn to be in- dependent and self-helpful. \"Dr. Budgett says he paid a visit to a kindergarten, at Paris, containing sixty children, in two classes, from three years to seven or eight, all girls. It was astonishing to see how happy the little ones appeared in their work. I there saw them solve many of the elements of geometry and prove they knew thein by describ- ing the curve, the angle, the plane, and the sphere, as they ap- peared in a line of stenography; and all this they had learn without a book and by amusement only.",
         "VACCINO-PHOBIA. \"A child of seven years of age read a stenographical phrase in natural history, though she could not write a dozen words.\" We might add much imore on this interesting and ail import- ant question of Hygiene of Schools and Kindergartens, but space will not permit. Suffice it to say that it is a system much to be encouraged, giving, as it does, such opportunities for mental de- velopment, not at the expense of physical energies, hke the ordn- ary systems for the young. VACCINO-PHOBIA. The clamorous assertions of the anti-vaccinationist remmînd us of the opposition which was raised when Dr. Jenner tirst mode lis discovery, and sketches were published by his opponents, showing, amongst other dire effects of the introduction of the vaccine virus into the human system, people with cows' horns springing out of their foreheads; a style of illustration which might be aptly imitated by drawing pictures of the opponents of vaccination with asses' ears naturally growing from the sides of ilicir heads. On investigating this frothy, noisy opposition of what do we find it to consist ? Of a number of men and women, for the most part illiterate, led by some few individuals, ivhose educa- tion has only sufficed to develop their weak mental points. The most active promoters of the agitation against vaccination are the proprietors of certain quack medicines. As to the class of speech of the vaccinophobists one knows not which to wonder at most, the folly of the speakers, or the fanatit.ism of the hearers of such rubbish. In every sentence uttered, \" suppressio veri\" and \" dictio falsi\" struggle- for supremacy, and it is hard to say which has the upper hand. It is gratifying to turn from the incoherent ravings of the anti-vaccination party to the mass of evidence which has been produced in proof of the value conferred upon mankind by Jenner's discovery. It is almost impossible to realize any com- mensurate idea of the ravages of small-pox prev ious to the intro- duction of vaccination; but some notion may be conveyed by the fact that during the eighteenth century 400,oo persons died",
         "PUBLIC HEALTH MAGAZINE. annually in Europe of this loathsone discase. In Germany, be- fore the protective practice of vaccination was resorted to, out of every 1,ooo deaths, sixty-six werc from small-pox, now only seven per 1,ooo are due to this affection. The Blue Book upon this subject, compiled by Mr. John Simon, F.R.S., shows that the mortality from small-pox in Copenhagan is now only an eleventh part of what it was before the introduction of vaccina- tion; in Sweden, it is but a little over a thirteenth; in Berlin, as well as in Austria, only a twentieth; while in Westphalia, the fatality from small-pox is mercly a twenty-fifth paît of what it was when vaccination was not practiced. In England, where vaccination has been less stringently enforced than in many European countries, it has been shown that out of every 1,o0o deaths in the half-century, from the year 1750 to 18oo, there were nincty-six deaths from small-pox; and ouL of every 1,ooo deaths in the half-century, from 18oo to 1850, there were only thirty-five deaths froni the sanie cause. B But we nust not weary our readers by the repetition of facts with which many of them are acquainted. We cannot,however, refrain frorm reference tu one of a, decidedly marked character. In Malta. froni 18S8 to 1838, inclusive, the aggregate numnber cf the British troops stationed un that island being 40,820, the total mortality 665, only T wo deaths uccurred from small-pox amongst the soldiers. Yet, during that period, Malta, was visited by two very severe cpidemics of .,mall-pox, in 1830 and again in 1838, which destroyed no less than 1,169 of the native population, who, unlike the British soldiers, did not enjoy the protection of vaccination. In English epidemics, the percentage of fatal cases ont of those who are attacked of small-pox is from 5 to ioper cent. amongst those who have been previously vdccinated, while it ranges as high as 5o to 6o per cent. in those who have not been similarly protected. In other words, the chances of recovery are ten to one in favor of the patient with small-pox who bas been vaccinated, and the probability is, in the case of one who has not been vaccinated, that he will die. Will either fools or fanatics benefit by the salutary lessons conveyed by such facts as these ? We fear not. But, at any rate, they ought to show intelligent people the blessings deriva-",
         "PHYSICAL EDUCATION, \u0026C. 91 ble from vaccination and strengthen the hands of the authorities in dealing with the obstinate, and men who openly incite to a breach of the laws (as well as endanger the health of the coin- nunity) by delivering to ignorant audiences addresses full of un- truthful statements aniid the rapturous shouts of the poor de- luded hearers. Most of these evidences are from Public Health (London), but they are so applicable to our East End fellow-citizens and anti-vaccinationists generally, that we thought it well to publish them. PHYSICAL EDUCATION. We bcg to draw the attention of our readers to Mr. Barnjun's very excellent paper on the Physical Education of the Young in the public schools of this country, and we quite agree with him. We have frequently urged that more might be donc in this direc- tion, and with very great advantage to the health and physique of the youth of this country. Too much attention 's iven to the mental, and too little to the physical education of al classes, and the consequence is that many of them are stunted in growth, jaded in aspect, and very vulnerable to the exciting causes of constitutional disease. Sweden, Prussia, Russia, Italy and Sax- ony have all acknowledged the necessity of such a training, and we should be glad to add Canada. SMA LL-Pox.--From research we find that the loathsome dis- ease, \"small-pox,\" lias been in existence for more than a thon- sand years B. C., it having been epidemic in India, China, and thereabout, from time immemorial. But it was quite unknown in Europe before the beginning of the eighth or end of the seventh century. The Greekand Roman physicians do not seem to have been aware of its existence even. Would to Heaven we were as ignorant of it here in Montreal !",
         "TEETOTALISM AT THE ARCTIC. Among the points of interest connected with the Arctic Ex- pedition there is one of minor importance to whi'S some little attention and observation will nevertheless be directed by medi- cal officers. We allude to the dictetic value and physiological effects of alcohol in preserving the health and strength of the sailors under the exceptional circumstances in which they will find themselves. Th.- crews of the vessels taking part in the expedition are exceedingly fine men in every way, capable, one would think, of encountering any hardships, and of performing any work that it is within human pover to accomplish ; and, sup- posing their constituticnal vigor to remain unimpaired, and their supplies of food and clothing to be adequate to their require- ments, we are quite ready to believe that the consumption of alcoholic spirits might be found unnecessary or even injurious in the case of those who happened to be teetotalers. And Sir Wil- frid Lawson and the friends of temperance will doubtless be glad to learn tht there are several teetotalers among the sailors. One of the ice quarter-masters is stated to have made several voyages to the Polar regions without ever having broken his pledge of total abstinence. The medical otlicers of the expedi- tion intend noting any difference in health or stamina between those who are total abstainers and those who consume their regulated allowance of grog. It will be remembered that the military forces in the Red River expedition under Sir Garnet Wolseley substituted cold tea for spirits, as was generally be- lieved, wivth much advantage, while some difference of opinion existed anong tho.e vho joined the late expedition to Coornassie in regard to the utility of a spirit ration. As an officer remarked, \"in the one case they seemed to live on the climate, and in the other the climate lived on them.\" Many, perhaps the majority, held that a regulated and small allowance of rum at the end of the day, or at the conclusion of a long and fatiguing inarch, had",
         "SEWACE UTILIZATION AT CROYDON. a beneficial effect on the system, and considered that it tended, when consumed with a meal, to stimulate the appetite and re- inove the sense of depression and fatigue more quickly and effec- tively than did the saine amount of food without the rum. Apart froin variableness of climate, the nature of the duties and the amount and character of the food obtainable, we suspect that differences of habit, constitution, and temperanient will be found to account for the differences that exist in this respect. A young and vigorous fellow, gifted with an appetite for anything, provided lie can only get enough to satisfy his wants, who has never been accustomed to alcoholic stimulants, would be injured by their use unless under very exceptional circumstances. But there are others outwardly as strong and healthy-looking, and endowed with considerable powers of endurance, but with a more impres- sionable nervous system, who both feel and apparently are the .better for a moderate amount of alcohol. The practice of one can hardly be a law to the other. After all, however, very much must necessarily turn upon the amount and nature of the duty done, and the readiness with which good and suitable food can be had.--The Lancet. SEWAGE UTILIZATION AT CROYDON. On Saturday, the r2th inst., Dr. Alfred Carpenter entertained most hospitably, at Beddington, near Waddon, where the Croy- don sewage farm is situated, a very large party of guests, con-. prising nost of the distinguished members of our own and other professions specially interested in and qualified to judge as to the disposal and utilization of sewage. Dr. Carpenter records in an explanatory notice given to each visitor or. the occasion that the objects for which inspection was invited were to show (r) that a sewage farm is not a swamp or marsh ; (a) that it does not injure the health of a neighborhood; (3) that it does not damage residential property, except from the ideal point of view; (4) that it turns poor land into land capable of yielding luxuri- ant crops ; (5) that its produce is beneficial to cattle ; (6) that cattle fed upQn sewage produce are themselves healthy.; (7) that the food produced is fit for human consumption; (8) that a large farm cannot be carried on successfully except a large capital be",
         "U4 PUB3LIC IJEALTI! MAGAZINE. invested in it; (9) that the experience of sewage irrigation on the saime land for fifteen years will justify the capitalist in put- ting capital into sewage agri.ulture. The farm under considera- tion belongs to the Croydon Lotal Board of Health, and is, wve believe, the first of its kind established in England. It has now been in working order for about fifteen years. The plan of irrigation adopted appears to be excecdingly simple. The crude sewage, as it cornes fromn the town scwers, passes first through one of Latham's strainers, the extrancous matters (as rags, paper, hardened faces, \u0026c.) being mixed with dry straw and garden-refuse collected from the dustbins in the town, made into a compost, and partly sold to inarket gardeners at 2S. Gd. per yard. The sewage is at once applied to the land -i e., in a perfectly fresh state; and the testimony was un- doubted as to the absence of smell on the land. The total quantity applied varies from three to cight or ten millions of gal- Ions. The farm consists. of 5oo acres, 150 to 200 being under rye-grass cultivation; 5o are meado'v, and are mainly used for the purpose of cleansing storn-waters; 82 are under cultivation for·market-garden purposes, and the rest are sown with mangolds or other roots or cereals. A most excellent luncheon was pro- vided by the host, ail the materials for which had been grown or bred on the farm, as well as trout eni mayonnaise, taken from the river Wandle, into which the effluent water floys. Samples of the efiluent water were also shown, and were tasted by some of the company. The weather on Saturday was most unpropitious, and was enough to damp the energy of al but such men as Dr. Carpenter, who chose a most pleasantly practical way of assisting to seule a much-vexed but very important question. We may remnd our readers that, as the farin has now been in workng order for fifteen years, the advocates of the system have had ample op- portunities of drawing the above deductions, and the opponents of irrigation an equally good chance of disproving them. It must be remembered, too, that Beddington is a ratepayers' and not a model farm, so that money has not been spent, as Dr. Car- penter puts it, \"for æsthetical purposes. \"-Ibid.",
         "RULES FOR TIH CARE OF TitE EVES. RULES FOR THE CARE OF THE EYES. UR. D. F. LINcOLN, the SCcrctar) Of the Health Departient of the American Social Science Assoitation, has given the foi- lowing \"rules for the care of the eyes\": \"When writing, reading, drawing, sewing, etc., always take caire that- \"(a.) The room is comfortably cool, and the feet warm; (b. There is nothing tiglit about the neck; (c. There is plenty of light without dazzling the eycs; \"(d.) The sun does not shine directly on the object we are at work upon; \"(e.) The light does not cone frorn in front; it is best when it comes from the left shoulder; \"(f.) The head is not very much bent over the work; \"(g.) The page is nearly perpendicular to the line of sight: that is, that the eye is nearly opposite the middle of the page, for an object held slanting is not seen so clearly. \" (h ) That the page, or other object, is not less than fifteen inches from the eye. \" Near-sightedness is apt to increase rapidly when a person wvears, in reading, the glasses intended to enable him to sec dis- tant objects. \"In any case, when the eyes have any defect, avoid fine needle-work, drawing of fine maps, and all such work, except for very short tasks, not exceeding half an hour each, and in the morning. \"Nev . study or write before breakfast by candle light. \"Do not lie down when reading. \"If: cur eyes are aching from fire light, from looking at the snow, from over-work, or other causes, a pair of colored glasses may be advised, to be used for a while. Light blue or grayish blue is the best shade, but these glasses are likely to be abused, and, usually, are not to be worn except under medical advice. Almost all those persons who continue to wear colored glasses, having perhaps first received ad-,ice to wear then fron medical men, would be better without theni. Travelling vendors of spec- tacles are not to be trusted; their wares are apt to be recom- mended as ignorantly and indiscriminately as in the times of the 'Vicar of Wakefield.' \" If you have to hold the pages of Harper's Magazine nearer than fifteen inches in order to read t easily, it is probable that you are quite near-sighted. If you have to hold it two or thrce feet away before you s'-e easily, you are probably far-sighted. In either case, it is very desirable to consult a physiLan before get- ting a pair of glasses, for a nfsft may permanently injure your eyes.",
         "90 IsærOAIAL NOTIMES AND ANSWER TO oRESPONDENTS. \" Ne, er play trikLs with the cycs, as-squinting or rolngthem. \"Th c\u003ecs arc often troublesome when the stomach is out of order \" %ioid reading or scwing by tnilight or when debilitated by recent illness, especially fever. \"El cr\u003e beamstress ought to hae a -utting-uut table, toplace her work on such a plane with refcrene to the line of vision as i make it possible tu exerise a dlose s-rutiny without bending the head or the figure much forward. \" Usually, except for aged persons or \u003c.hronic invalids the w inter tcrnpcrature in work-rooms ought not tu exceed 6o or 65°. To qit with impunity in a room at a lower temperature, some added clothing n ill be neressary. The feet of a student or s.ean- stress should be kept cumfortably warn while tasks are being done Slippers are bad. In winter the temperature of the lower part of the room:is apt to be ro° or 15° lower than that of. the upper. \" It is indispensable in all forms of labor requiring the exer- cise of vision of minute abjects, that the worker should. rise from his task now and then, take a few deep inspirations with- closed mouth, stretc-h the frame out into the most erect posture, throw the arms backward and forward, and if possible, stcpto a window or into the open air, if only for a moment. Two désks or tables in a room aie valuable for a student; one to ztand at, the other to sit at.\"-2TIie Sanitarian, X 2 o- (diiorill e0tict n1d 15lrplerltilf5. A FATHER.-YOU had better apply to your usual physician for advice. THE amount of the subscriptiun to this Magazine will be $2.oo per annum, pust-paid. Remittances are only to be madè to the EDITOR PUnLic HEALTH MAGAZINE, P. O. Drawer 25, Montreal. Clubs, Reading Rooms, \u0026c., supplied at a liberal discount, if more than one copy is-required. MR, RODERT BLACkWOOD, who has succeeded to the business of Mr. Charles Wilson, is now extensively engaged in manufac- turing æerated beerages for sumner use especially, from -the recipes of his predtor. We ha.ve tested,them all-have seen the manner of their preparation i'n his factoiy, 99 St. Urbain street, Montreal, and can recommead them to our readers as free from any injuriuus ingredients. Mr. Blackxvoud is also sole agent for the celebrated \"Yamachiche\" Mineral Springs."
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      "title" : [
         "The Montreal medical gazette [Vol. 1, no. 11 (Feb. 1, 1845)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best copy. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur Coversdamaged / i Couverture endommagée Covers restored and/or laminated I Fi Couverture restaurée et/ou pelliculée D Cover title missing I Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates andlor illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Di Only edition available / Seule édition disponible i Tightbinding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. z Additional comments / Commentaires supplémentaires: L'Institut a essayé d'obtenir la meilleure copie. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci- dessous. Fi Coloured pages / Pages de couleur Fi1 Pages damaged / Pages endommagées Fi Pages restored and/or laminated / Pages restaurées et/ou pelliculées L~X Fi Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression ElIncludes supplementary materials I Comprend du matériel supplémentaire Fi Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Includes some text in French. Continuous pagination.",
         "TUF. MONTREAL MEDICAL GAZETTE, ENG A MONTHLY JOURNAL OF MEDICINE, AND THE COLLATERAL SCIENCES. VOL. . MONTREAL, FEBRUARY 1, 1845. No. 11. MEDICO.LEGAL REPORT. Having examined on Tuesday, l'7th inst., at the request of the Coroner and a sworn Jury, the reinains of a humian body discovered by some labourers in the process of excavation in the rear of a new building lately erected in St. Paul Street, I have to make the fol- lowiug report The body was interred in a bank, and according to the report of the Jabourers, about four feet below the surface of the earth, close to or upon the foundation of an old privy, and when observed was covered y a couple of boards. The carth having been frozen, the boues of the keleton were removed by the aid of a pickaxe in detached fragments, o that nothing is known of the position in which the skeleton lay. An ýld leatlcrn initten and three half-pennies of a comparativcly recent koinage were at the sanie tinie disclosed. No buttons nor other vesti- es of wearing apparel were found though strict search was made. When Èrst seen by me, the bones were promiscuously mixed together in a ox, in the possession of the Beadle of the French Cathedral; several ýf the vertebrm were wanting, but in other respects the skeleton was tire. The bones of the leg werc disarticulated from the feet, wlhich cre concealed by boots. These were of the TeIington shape, of a mmon description, an-1 of British manufacturc, and in contact with e feet were socks of coarse grey u:orstd, considerabiy decayed. On examining tie different parts of the skeleton more miinntely, the lowing appearances werc noted complete absence of all tle soft solids, whether muscular or vis- ai. Lumps of a wlitish substance adlered to the boues in various x",
         "MEDICO-LEGAL REORT. places ; they were soft and greasy, inflamed readily on approachi to a candle, and otherwise gave every appearance characteristic of .Adipo- cere. The ligamntous connection of the bones, and their cartiluges had all disappearcd ; and with the exception of the bones of the feet, and two of the Cervical Vertebroe none were in apposition. Two masses of decomposed animal matter of a blackislh tint occupied the Orbits. At the Occiput was some natted hair of a \"fair\" colour mixedvwith earth, on raising which a reddish tint was clearly perceived, as if produced by the coloring matter of blood. Sone of this was dif- fused through water, but the colour imparted to the water was brown. A portion of brain was perceptible througlh the Foramen Magnum, and therefore the skull was renoved to a warm room for the purpose of thawing it, and permuitting of closer exarnination. The Atlas and second Cervical Vertebra were frozen tpgether in such a position that the posterior edge of the lower articulating surfaces of the Atlas rested on the anterior edge of the superior articulating surfaces of the second Vertebra, throwing the Odontoid process backwards into the Spinal Canal, whicli was filled with medullary natter in a stato of de- compositon mixed with earth. On cutting open the boots, the soft parts of the feet were found converted into Adipocere, from which aIl the bones of the Tarsns and Metatarsus imnmediately separated or fell asunder. Slull.-In the centre of the Parietal bone on the riglt side, and to- wards the posterior inferior angle of the Parietal of the left side, vere two large irregular openings, evidently of recent origin, from the whiteness of the fractured edges, produced undoubtedly by the blows of the pickaxe eniployed during the work of excavation. On the Oc- cipital bone close to the Additanentum Sutur e Lambdoidalis was à depressed fracture of about au inch and a half long, in a transverse di- rection from the suture, and about two inches deep, forcing the boue inwards in a pointed manner upon the Right Lateral Sinus ; the ante- rior point of the fracture being formed by the suture at its juncture with the Squamous, from which live fissures proceceded in a radiated inanner througlh its extent, the lowest of whicli extended to the Fora- men Magnum, and traversing that opening, continued itself on the Occipital bone on the opposite side, extending froni near the Condy- loid Forainen to tlic Lanbdoidal suture. The depressed Occipital frac- ture was not of recent origin, as proved by the darkened appearance of the fractured edges, and the quantity of carthy matter found in it. The occipital protuberance, and left side of the sanie bone to which the matted hair vas attached, was of a deep purplish black colour, as if stained by a long maccration as it were in blood. A blotch of a si-",
         "MEDICO-LEGAL 'REPoRT. milar color was noticed also on the Riglit Superior Maxillary bone, ex- ending from the inner angle of the Orbit downwards. On renoving the Calvariuin, the Brain w-as found shrunk to about two-thirds its natural size, and emitted the most offensive odour. Not the slightest trace of organization vas observed, but the Cerebral Sub- stance, with its membranes, formued a pultaceous mass, and with the exception of that part corresponding to the middle lobe of the left heý mishere, which was blood red, and that in immediate contiguity with, and adjoining to, the fracture, which vas blackish bordered by red, it was generally of a pale leaden hue. The centre of the Brain, in the line of the Corpus Callosum, had degencrated into a purulent looking fluid, which was evidently Cerebral inatter far advanced in decomposi- tion, or in its last stage. The inference whicli appears clearly deduceable from the above pre- mises, is that the deceased met his death by violence, and that lie was soon after interred, denuded oj all upper clothing, but with his booots on. The blackish tint on the brain, in the neighbourhood of the Occipi- pital fracture, is owing to decomposition of extravasated blood mixed with brain, a more rapid decomposition taking place there in conse quence of more direct exposure to the causes inductive of decomposition, The blood here extravasated must have proceeded froin the Riglit La teral Sinus, whici musi have been most extensively lacerated. The blood red tint of the brain, corresponding with the left middle lobe, may be referred totextravasation from rupture of, probably, the Middle Meningeal artery, from contre coup : and its retention of the red colour, the result of non-exposure to direct decomposing agencies. The remarkable relative position of the two Cervical Vertebrm, might have been the result of accidental causes, after decomposition had se- vtred the ligaments which united them together ; but, though this ;s possible, yet it is far more probable that it was the resuilt of the se- vere blow on the Occiput, w-hii threw the head and Atlas forvards, producing a complete dislocation of the neck, with pressure on the spi- nal cord, and instantaneous paralysis of the whole body. The presenco of medullary matter in the spinal canal, although. not absolutely confir- matory of this view, yet considerably strengthens this supposition. The blow on the Occiput must have been inflicted with some heavy instrument of metal, probably by an axe ; the Occiput being the strong- est and thickest part of the Cranium, would have resisted such a frac- ture by instruments of a muchi lighter description. The blow must have been given transversely, and from its position, Jnust have been received unawarcs by the individual. The question of the time of inhumation is involved in difficulty. It is",
         "MEI3CO-LEGAL REPORT. not possible to deteruine this with any accuracy. '1Thecomupléte disappear- ance of the soft solids, would appear to extend the period of inhumation to eight or ten years, while tie-existence of brain, decomposed althougn it was, tends to limit it to a much shorter period. Probably five or six years may be regarded as approximating to the truth. Judging from the appearance of the Sutures, and the hair, the age of the individual ray be estimated at about thirty-five years. A. HALL, M.D. Joseph Jones, Esq., Coroner. .Montreal Gazette. TO TIE EDITORS OF TIE MONTREAL MEDICAL GAZETTE. GENTLEMEN,-On the 7thl inst. the Montrcal Gazette contained a \"Medico Legal Report\" whieh vas cu.îsnunieated to ftant Journal by A. Hall, Esq. M. D. and which I arm certain vill be found well worthy of a perusal by all your subscribers. I an, therefore, induced to ré- quest you will favour them, as vell as me, by transfèrring it to your pa- ges-as I an perfectly certain that the majority of them have not met with it. My object for soliciting this favour is principally to direct the attention of every member of the profession to the necessity of pay- ing more att..J on to subjects having reference to Medico-Legal inves- tigations, and also that remarks on such subjects should be made known to the profession generally through the proper mediwn. The manner in which Dr. Hall bas drawn -up bis report redounds much to his credit ; he has shown ingenious reasoning and drawn very scientific inferences. No part of the report can be actually found fault with ; nevertheless, in a Medico-Legal point of view, it would have been additionally satisfactory to have been informed of the natui-e of the soil wherein the remains had been feund ; whether gravelly, sandy, or of a clayey character. Also, whether it indicated a current moisture or a stagnant one ; as al these circumstances are known to afTect materially the slow or the rapid process of decomposition. To me it seerms from the tenor of the Report that the decomposition must have been rapid and that the inhumation of the body vas not at a'per iod so far removed as the Doctor infers it to have been. True, he says there were no vestiges of clothes, yet a mitten, money, and boots were found. The money distinct and the quality of both the mitten and the boots still preserved-the latter sufliciently soas to- enable him to state they were of British manufacture. Had the deceased been strippcd of bis clothing, it is difficult to conceive how the mitten could have been in the grave, and still more so, the money. Therefore, I would be inclined to infer that the soil was favorable to rapid decomspositiOll and it is well knowns thats the more rapid decomposition gocs on, th1o 332",
         "more siniultaneously do all the parts, whether inuscular, integumental, inembraneous, ligamentous or cartilageneous disappear. T.hat th- mit- ten and the boots remained, may be owing to the tannin in the leather; hence also the reason why the soft parts of the féet were converted into adipocere. As to the fact, that the deccased met bis death by violence, and pro- bably received the blow unawares, no one can doubt ; but we get no idea ofthe probable position in whicl the deceased may have been at the time the inj ury was inflicted. For my part, after having, through the kindness of Dr. H., carefully examined the skull, and listened at- tentively to his oral description of the relative position of the atlas and dentata, and connecting this vith the fact of the discovery of a mitten and coin, I an disposed to infer that the deceased must have been asleep with his face on a table, or perhaps sitting on a chair with the back of it to his front so as to make a resting place for his arms, that lie might sleep upon them; or, what is perhaps more likely, he was sleeping with nothing to rest bis head upon at al], a circumstance which would naturally enougi drop lis chin tovards his chest and bring his head in that position, which the e% ideiaees of the fatal blow clearly in- dicate it had been in at the time. Some may deny the possibility of a dislocation of the dentata with- out fracture, but I think, with Dr. Hall, that the direction and violence of the blow, connected with my supposed position of the deceased at the time he received it, will clearly establislh \"fnot only the possibility but also the probability\" of a dislocation. With these few remarks I beg to hand you a copy of Dr. Hall's Re- port, and request you will favor me by publishing both in your next number, Respectfully, I remain, yours truly, FRS. C. T. ARNOLDI, M. D. 20th January, 1845. ON A NEW MODE OF DRESSING WOUNDS AND ULCERS. By Dn. LANGiRn, M. A. Î., Surgeon to Beaujon Hopital.-This mfethod consists in applying, on the surface of ·the wound or ulcer, a solution of gum arabic, and on it a bit of goldbeater's skin ; thus dressed, a vound, an inch in diameter, was reduced in the space of eight days to one-third or one sixth of an inch in extent. Cicatriza- tion took place so rapidly, that the granulations, covered with a thin epidermis, were as numerous and visible as before, but could.be touch- ed withiout causing pain. A wound, produced by amputation of the breast, highly inaamed, about four and a half inches in, breadth, under this treatnent, healed rapidly, and purulent secretion did not take place.-.London Medical Times. 333 EXTRA»,CTS.",
         "1R. LISTON'S BURGICAL LECTUIES. ON SOME OF TIE DISEASES OF THE EAR. From 31r. Liston's recent Lectures on ihe Operations of Surgery. With regard to the car, i have already spoken of foreign bodies in the meatus, and I stated that they were to be removed in much the same way that you would extract foreign bodies from the ncstrils. You must not attempt their remnoval by forceps, but put a fine bent probe, or a scoop, behind them, and, with a slight motion of the wrist, you turn them out of their place. Before you make the attempt, you must be very sure that there is a foreign body in the car. This you can ascertain by using a speculun, which enables you to see perfectly into the bottom of the external meatus. The patient must be placed in a proper light, or the part may be illuminated by a good lamp. ie rays of light may be brouglit to a point, aud thrown into the bottom of the tube, as ingeniousi; deý ised by my friend Dr. Warden, through the medium of a small prism, adapted to thie speculum. You mect with cases of inflammatiin of the meatus from variouis causes-coid, \u0026c. These inflammatory affections often end in abscess; you endeavour to prevent it by the application of Iceches to the part; but when matter is formed, its escape is to be favored, and for that purpose fomentation should be applied. You may meet with ease.s where the abscess is apparent, and then you cn puncture it. These abscesses are alvnys attendd with i ery great suffering : lie parts are highly sens vhen in a state of health, but still more so when diseased ; tle s0ôcesses, howevcr, gcnera]]y burst nontaneously a ie course of a ,vy short time, and then the patient is relieved. Deafness, ,course, will arise fron te presence of foreign bodies, or from thevelling of the meatus or parts around it. It frequently takes place in consequence of the accumuladon of cerumen, and, in- deed, thib is the mùost commun cause of deafness, and nearly the only one that you can witli any ccrtainty count upon reumoving. Old peo- ple are often reileu cd from deafuess of long standing, by having for- cign matters w a:h,.d out from the external meatus. There bas been a discusbion as to what is the Lest ýoIution to cmploy for dissolving,the accumulated secretion. You v.ill, in one of the volumes of the \"Ed- inburgh Medical Essays,\" find a very goùd paper on the subject, in vhieh are detailed trials wit7t udrious alkaline and other olutions, ani the conclusion arri% cd at is, that tepid water will answer as velI as anything elbe. You use for the purpose a tolerably large and well- valved syringe, with a properly-fashionîed nozzle ; now and then yoU use a scoop, and pull out portions that %v ould not otherwise come awfay. You. often find large plugs of cerumen mixed with cotton and wool, -which patients have put into their cars, to prevent cold air getting in,",
         "MR. LISTON'S SURGICAL LCTURES. as they say. It is also said, that deafness arises from there being too little wax, from the ear being dry, and in these cases all sorts of stim- ulating oils have been dipped into the car, with, I believe, but little advantage. Then you find deafness aribing frum obtuseness or para- lysis of the nerve, and that is thouglit som.etines to be remediable. You may endeavoui to rouse the sensibility of' the parts by blistering over the mastoid process, and sprinling the raw surface with strych- nine in minute quantities. Deafness also occurs to a greater or less extent (and this is irreme- diable) where suppuration has taken place in the internal car, and where the bones of the tymapanula have been destroyed. You cannot restore these parts, and you cannot expect the functions to be restor- ed, fo liere is a great change of tlhe structure of the orgau. Patients nften continue tu have a discharge froi the car for a long period; there bas been an attack of inflamination and suppuration during some in- flammatory affectinn or fe er of childhood, as scarlatina ; it goes on for a long timn. and parc..ts desire to have it dried up ; but beyond having the part kept clean, I advise you not to interfere. If you em- ploy a strong injection, you nay give rie to diseuze in deeper seated parts, and endanger life. There are disebargcs from tie external car now and then connected with abscess situated deep in the temporal bone. I have seen two or three cases where the matter which had formed within the cranium was discharged by the car. There may be abscess of the brain, or ab- scess between the dura mater and the anterior aspect of the tempo- ral bone; and this certainly cannot be remedied by any external application. I have seen the discharge checked by long ciposure to cold and wet ; fever has ensued, and the patient has speedily per- ished. The functions of the car are sonetimes interrupted im consequence of affections of the throat. Common people know that when the \"almonds of the ear,\" as they say, come down, they are deaf. If the tonsils remain enlarged and swollen, the hearing is obtuse. The same thing occurs from polypi and other tumors of the throat. In cases in which I have removed them, the patient had beei deaf for years. I have mentioned in one of my books the case of an old gentleman who had been deaf for very many years ; he went regularly to church, for form and example's sake, it would appear; for after a great many poly- Pous tumours had been extracted, he declared that he never, till then, heard one word of the service. The tonsils have been removed now and then with great advantage in cases of deafness, but though relief has been thus afforded, I would nut by any means advise you to resort",
         "MR. LISTON'S SURGICAL LECTURE9. to it li all cases. You are not warranted in cutting aw ay the( tonsils or uvula under the assumption that they are the cause of the deafness, more especially when there is but little, if any, abnormal change in them. After all, there is not a great deal to be done for the cure of deaf- ness. There are many cases easily remedied, but a great many others are quite irremediable. The deafness which ensues in consequence of the deficiency or destruction of parts cannot be remedied ; in many cases where the nerve is affectcd, no relief can be afforded; but where it arises in consequence of obstruction of the Eustachian tube, or the presence of tunors, the surgeon may sometines afford considerable re- lief. It bas been said that deafness arises from the Eustachian tibe being closed up by mucus, and in order to remove it, all sorts -of quacks have been in the habit of injecting air and fluidb into this passage; but the only effect of this process, so far as I dan sec, woaldbe to drive the vitiated secretions further into the passages, and impact thein there. In some cases of permanent obstruction of the Eustachian tube, in cases of thickening and induration of the membrane of the tympanum, and in collections of blood in the cavity, the druin of the ear has been perforated. This is an operation not attended vith difficulty. The only trouble is in keeping the opening fromu closing again. The ope- ration may require repetition unless it is performed in sucih a way that a portion of the membrane is wholly removed. This may be accom- plished by means of a sort of punch dexterously applied. The instru- ment must be so guided as to avoid the attachment of the handle of the malleus. I have, in a few instances, seen patients thus slightly bpne- fited, but great :ucces ca:ment be anticipated from the proceeding.- London Lancet. SMALLPOX AND VACCINATION. J. Curtis, Esq., one of the Parish surgeons of St. Pancras, London, gives the following among other results of his observations: \"With respect to the power of vaccination, I am of opinion that it modifies smallpox, if performed at any period previous to the appear- àùce of the eruption, and probably even a day or two afterwards. Therêfore, whenever an opportunity occurs, I always vaccinate per- sons infected with smallpox, even though the eruption shall have bc- gun to make its appearance. \"In the spring of the present year I had fifteen cases of smallpox among my parish patients. One was sent to the Smallpox Hospital, and therefore must be left out ofthe caleulation. Of the 14 remaining patients, 1 *was 30 years of age, the others under 8 years; not one bad",
         "D. Dr.u'ER ON THLE INFLUENCU OF LIGHT. been vaccinnated previous to infection by smallpox ; 5 were vaccina- ted .tr infection, and lad the two cruptions going on together; and 1 out of the 14 died. \"Upon looking back to the account kept of my parish patients for the last 12 years, I find the mortality in cases of smallpox among the unvaccinated to be about 1 in 6. \"Supposing my calculation of the proportion of the population vac- cinated to apply generally, and also Dr. Gregory's account of the rela- tive mortality of the vaccinated and unvaccinated, the relative chances of death from snallpox of the two classe.s may be stated thus :- \"Of 300 of the population, 200 are vaccinated ; 100 take smallpox naturally, and 20 die. \" Of the vaccinated, an equal number, or 100, take smallpox, and there die 10, being '5 per cent. of the vaccinated. Therefore, the vac- cinated have six times the imnunity from sinallpox that the unvacci- nated enjoy, \"I have scen many cases of snallpox after vaccination, but very rarely a death froi that cause ; in fact, many of these cases required no medical treatnent at all.\" INFLUENGE OF LIGHT ON VEGETATIOK. PrIL0.OPHEnjaý have long ago determined that light consists of vibra- tory, undulatory, or wave-like movements, which take placein an ethe- real medium existing everywvhere. It is a more recent discovery that these vibrations are the first origin of the vegetable world. In the work to which 1 have alluded, I have given the detai, of this most interesting connection. Out of a liinited number of ponderable sub- stances, such as carbon, nitrogen, hydrogen, oxygen, and a few others, allkinds of organized structures are formed, and there is an extensive machinery to collate and group together these different bodies. Light in itself can produce as many different effects as there are possible combinations of color, for each one of its rays has peculiar powers of its own, and it is also attended by other invisible aud imponderable principles which have their modes of action. An organized structure of a given kind is therefore the result of the operation of inany of these forces, and is an expression of the aggregate action. In the full development of a perfect tree there has been expended a measured quantity of forces of ligit or of heat, and the organized mass, as it standsbefore us, in the product of those forces, is the resultant of mil- lions of vibrations of the luminiferous ether, which have acted upon ponderable atoms ; vibrations, which have stood hi a certain relatiòn to each other, as the symmetry of the vegetable parts indicates. In 33 \u003e7",
         "8Ln. DRAPER ON THE INFLUENCE OF LIGHT. the operation of human agency something of the same, thouglh of a grosser kind, may be seen. We have not, it is true, the power of call- ing into existence, or of determining in an eiduring shape, or of giv- ing an embodied form to material atoms ; but in the same manner that nature, operating'through ethereal undulations, creates the various :rms of vegetable life, there lias been committed to us a control o, er those yosser undulations which move in atmosphcric air, and constitute sound. Thei imagination, the genius of the grett masters of music, have al- ready grouped together combinations of these waves, which are des- tined to an eartily immortality ; combinatious, which, when once heard, leave their indelible impression on the memnory, and are to us an embodi- ment of symmetry and harmony. These ideal creations which exist only for the mind, are analogous, in vety many points of iew, to those more tangible ceations which are formed by ethereal waves, and which nature bas reserved in lier own hands. The symmetrical or beautiful forms which are transmitted to the brain bj the eye, appeal at last to that same, that common princil which receives melodious or harmo- nious sounds transmitted by the cdr; and the creations of human genius, -whether tley be exp:essed in the ]higJage of iusi\"' or paintin;, wie- ther th\"y are heard in tie 'athedral or seen on the canvass of Claude Lorraine, givi is pleasure, bc3ause their final impression is made on a mathematical orgaP, wh'ch is so constructed as to appreciate whatever is symmetrical in position, 'v.iatever is graceful in figure, whatever is harmonious in movement. From this point of view, therefore, I lcok upon the vegetable world as an embodiment of the action of ethereal agents. A tree, when covered with blossoms in the spring, or laden with fruit in the autumn, is a resultant of the play of those active fores which have been emit- ted by the sun ; an expression of what has been done by vibratory movements operating on ponderable molecules. As soon as the young plant has exposed itself to the solar beam, growth rapidly begins to tak' place, and organized matter to be condensed from the air, and now a green color is developed, and the stem elongates, and leaves are put forth. In carrying forward all those multiplied oper.tions whieh have ended in thiese events, its leaves and its stem have gone upward in searcli of liglt-liglt wlich has symmetrically arranged their parts and furnished their substance. ]But these general views are far from giving us an accurate idea of the forces that have been expended or the motions which have been executed in producing tle result we con- templrte. A forest trec, from its magnitude, rising perhaps a hundred feet from the ground, and spreading its branches over hundreds of sqautre yards, may impress us with a sense of sublimity ; a section of '3Š8",
         "DL DBAPER ON 'rHB INFLUENCE OF LIGHT. its stem might assure us that it liad lived for a thousand ycars, and itg total weight could only be expressed by tons. An objectlike thismay indeed call forth our admiration ; but that admiration is expanded into astonibhment, whben we come to consider minutely the circumstances wlich have been involved in producing the result. If we conceive a single ,econd of time, the beat of a pendulum, divided into a million of equil pari , and cach one of those 'ncoiceiî ably brief periods divid- .d- agnain into a million of other equal parts-a wave of yellow liglit during une of these last small intervals bas Vibrated five hundred and thirty-ilve times. And now that yellow light is the agent which has Leen mainly involved in building up the parts of the tree, in fabricat- ing its various structures, and during every one of a thousand sum- mers, from sunrise to sunset, the busy rays have been carrying on their operation. Who, then, can conceive, w'hen in the billionth of a second such enormous numbers of moi enients are accomplibhed, how many have been spent in erecting an aged furebt oak ? Who also can con- ceive the total amount of force employed, from century to century, in arranging the ve-getation of the surface of the globe ? I therefore regard a planetary body like the Earth, in its orb.tual revolutions round tihe sur, as a predetermined focal centre, on whicli the emanations of tiat. star shall be expended, first in producing vege- tabie organizatioa, and finally in lending their aid to the evoludons of animal intellect. The forces which New ton revealed, as urging such a body forward, or causing it to glide in its elliptic path, appear only as an incidentail though essettial part of the raechanisn of the universe, the interest of which disappears in that higher interest which must at- .ta\"h to whatever stands in intimate connection with organization and vitality. Those many-colored luminous wavelets, which are ceaseless- ly crossing the interplanctary spaces, go forw'ard oun an appointed er- rand, and sooner or later discharge their final task ; nor are the planets in the solar system a colony of opaque globes, rotating without purpose or end around the central attractive mass. The solar system is an orb of movement and light, full of vibrations of every tint, visibk and in- visible, which here and there envelopes and enshrouds revolving points of organization and life.-Dr. Draper's Jntroductory Lecture. USE OF THE FORCEPS. In general it is a very good practical rule, and well calculated to prevent the rabh and unwarrantable use of the forceps, 'that the head of a child shall have rested six hours as low as the perincum, that is, In a situation which would allow of their application, b-fore the forceps are applied, though the pains should ha% e ceased during that time'- Ibt. JROBERT LEE.",
         "1Ut. ·ISTONs SUnaGIQA rICTUoes. SURGICAL OPERATIONYS lIN THE MOUTH, \u0026c. I have alrcady bpoktn of the bad ef''s of decayed teeth and stumps, and havet told yuu that aa xbscess occasiunally forms at the fangs ofthe teeth. You will find now and then, on taking out the stunp of a tootli, that there is a swelling, ard on examination you discover that it is a cyst, containing purifurm matter. Sometimes thes2 cysts are of a very large size. I have seen - cyst-a complete abscess-as large as the tip ofthe finger, come away on renoving a tooth. ThesL abscesses even break. externally, and if any of the cyst is left, matter w-ill continue to be discharged for some time. Theze abseL ses sometimes so increase in size as to lead to a swelling of the jaws. An abscess formed at the socket of a tooth, now and then makes its way along the tooth. If the sockets have been a great deal absorbed, the matter at last cornes up' and presents itself ander the gum. It is described under the nane parulis-gum boil. There is a superficial swelling of the gum, fol- lowed by suppuration; but the troublesome cases are those in whieh abscesses form in the very sockets of the teeth ; they are attended vith great pain, swelling of the face, and so on. The abscess gradually ad- vances, and may be discovered fiuctuating very distinctly. You open th mouth, and see a large swelling on the upper or lower jaw, which you find to be eladtic, and on putting a kaneet into it, there is a great escape of puti id matter, which is attended with much relief to the pa- tient. If a patient lias suffer -' from th3 once, the cause ought to bo taken away to prevent the recurrence of it. Mie is unwiilling o have the teeth taken out wlhen the parts are qaiet and doing - Al, but some of these collections form deep in tLe jaws ; they go on in'-reasing, the pari- etes of the abscess expand, and cavities in the bone are at last forined, of considerable size. When formed in the upper jaw, thz abscess 'may burst into the antrum, and somctimes there is a cavity, indepen- dently of that in the upper jaw, a large chronic abs:ess. The same thing occurs in the lower jaws. Sometimes the plates of the bone sep- arate to a great , xtent, and if neglecte-1 for some time, you find tumors formed, of a very large size, vhich are gradual and slow in their pro- gress. Thes. cases are known under the name of spina ventosa. It is only in patients who have been neglected, and in whom the discase bas been alluwed to increase from month to month, that any thing of this kind is observed. Then, again, in removing decayed teeth, or portions of them, vhich have been allowed to remnain long, you will now and then perceive a fungous growth on the extreaity-\u003c. soft, pulpy swelling, adlhrent i. the apex of the fang. Again : if you notice a carious tooth wlhen e7- tracted, you wiill sonetimes find a soft fungus i flic lollow of it, ad",
         ")IR. LISTON'S SURGICAL ILECTUREs. if you take .the trouble of splitting it up with a pair of cutting -pliers, you will find that the wlhole canal id filled up by a bwelling,which ex- pands like a mnushroum. These swellings often increase in size ; they fill up the renainder of the cro of the tooth, and soinetines form a connection with the spongy gums. Incother cases the swelling coi- mences at the gum, by the side of the decayed tuth, it gradually in- cresses in size, and perhaps iinvolveb the guins of the adjoiuniug teetih. Sorne of these swellings are as liard as the guin ; sume are soft and pulpy, and bleed on a slight touch ; and sone again, though very sel- dom, assame a ialignant character. Thlese tumurs are generally of a oenign nature, thdy are firim in their consistence, and, if thoroughly extirpated, are not reproduced, but if any portion is left, they return. If the sucket of the touth, in which the disease comnenced, is not taken away, and indeed the whole gum, the disease L\u003e sure to come back in a few months, following the analogy of tumors in other pa: ts. I huve told you that, however bengn in its nature a fibrous or fatty tumor may bc, if any portion of it be left, it vill be reproduced ; but take away the whole, and there is.little chance of the patient being again troubled with it. These tumors sometinies are of a bad character ; but even in those of a contrary nature, where the operation is imperfectly performed, there is a return of the dibease. The patient, nuch annoyed of course, again recurs to his surgeon ; caustic ib perhaps applied from day to day; becoming alarmed, he at last places himself under a person of more experience ;ý the whole is then taken away, and there is no fur- ther trouble. IIere are sone drawings from preparations belonging to Mr. KXsmyth, of Edinburgh, showing tuniors of the gums. One represents a turnr occupying the posterior part of the upperjaw, witlh all the stumps stuck in the niddle of it. The teeth are all in a bad state. Those persoxis who are foulish enougli to allow useless portions cf the teeth tu renain, mnay lay their account to suffer from this dis- ense. The pain has gune off, the nerve iL destroyed, and they think there is no occasion for interfering with the teeth or having them taken out. They do not care abut the fotor of their breath ; they have perhaps arrived at a time of life when they thinik nothing of it ; but there is always a deal or imischief if these sturnps in the jaws or guns are not taken out. They keep up the swelling and the tumors in the gunis. Here is another drawing, showing a tunor ,î the gum, wheo.m the swelling lias gone up from the interior of the tooth, and has sl.read over in a nushroom-like form, and becoming adherent te the spongy gus, lias formed a large swelling. In order to get rid of iIese tumuors effectually, you must take away",
         "MR. LISTON.'S SURGICAL LECTUREiS. the whole of the growth. Most frequently you find them connected -with the decayed fangs of the small grinders upon one side or other of the jaw, and most frequently the lower jaw. Sometimes you find them far back in the lower jaw, growing fron the decayed roots of the last large grinder, and spreading their influerce to the guis of the, wisdon tooth and the grinder anterior to it. It is then a diflicult matter to get .quit of the swelling. If it be of larger size, the patient can only open his mouth with difliculty, and you get but an imperfect view of it. In the fore part of the mouth there is no difficulty at all. Al you have to do, then, is to extract a tooth, sound or unsound, on each side of the tumor ; the gums are more or less involved in the disease, and you can take them out with the forceps. If the discase were connected with a canine tooth, you would tIen take out the first small molar tooth, and the lateral incisor ; or suppose it were confined. to the gums of the canine and first molar,-then you would take away the lateral incisor of that side, and the second small molar. You then ,apply a small saw (such as this) to the socket, and cut down the jaw, with a view of getting rid of the part from which tlie discase has commenced, of removing the alveoli and the diseased sockets of the teeth. Before you apply the saw you carry your knife round the base of the tumor, and having applied it, and eut down the bone on eacl side, then, by the means of cross-cutting pliers, you remove the teeth and the sockets, together with the tumor. When the gums of severaL.teeth ara affected, you must take away a tooth on each side, and eut away the sockets of al the teeth. If you do this, there is no necessity for any further proceeding. Some surgeons recommend that you should employ an escharotic, as the potassa fusa, to remove the disease more effectually, but this is unnecessary. It is better to go far enougl with the saw and the forceps. In order to get rid of tu- mors far baic, and to avoid the necessity of cutting open the check, it is mecessary to have forceps of various sizes and forns. Altlhough these instruments look very large and coarse, and sucli as one might say farriers would employ, yet they enable you to remove the affection with less trouble and pain to the patient than if you use small and in- efficient forceps. If you 'were to apply forceps half ti size, you would find that you could not eut the sockets througli cleverly; that they would bend, and you would have to repeat the operation ; whereas, if you go properly to work, you will have no difficulty in accomplishing your object.-London Lancet. ROBERT LIsTox. 342",
         "343 SINGULAM EF 01ECT OF LIGHTNING. \"'Charlotte, an adult woman, aged twenty-nine years, was standing -about five feet from the root of the tree. After remaining in a state of insensibility for some time, she gradually recovered lier conscious- ness. A dose of castor oil was then administered. The skin on lier right shoulder vas abraded for a space as large as a dollar. ler clothes were rent into shreds ; on the riglit side of lier body, the skin was blistered and marked with discolored streaks, vhlich extended an- teriorly on the lower portion of the abdomen towards the pubes. A ,small streak )ikewise extended along the interier aspect of the right arm, She complained of pain in the stomach and bowels for three weeks. No voniting or burning in the hands and feet, as was experi- enced in the next case. She lias been married several years, but has never been pregnant. Her menstruation was perfectly regular prior to the reception of the shock ; but lias since that lime been very irre- gular ; sometirnes having two periods per month, and then escaping Iwo months. The flow bas also been much diminished in quantig. IIer health has not been very good since she was struck ; manifestly resulting fron ber menstrual irregularity. A recent copions bleeding bas afforded lier evident and imnediate relief. Her reproductive functions appear to continue dormant.\" \"Sarah, a womian aged, at least, seventy years, was standing imme- diately beside the last. She likewise gradually recovered lier con- sciousness. No medicine was administered. Her clothes were rent; and after a few days, marks of discoloration were manifested along the right arn and right side of the trunk. A violent paroxysin of vomit- ing followed the restoration to a state of sensibility ; which continued, with occasional interruptions, for ten or twelve hours. As in the pre- ceding case, she complained very mucl of pain in the region of the stomacli and bowels, for at lest two weeks after the accident. A troublesome sensation of burning was experienced in the palms of ber bands and the soles of ber feet ; and in the course of two or three weeks a swelling made its appearance under the right foot, whichî ulti- mately resulted in the exfoliation of a portion of the thick indurated epideruiis of that part, about one and a halif inches in diameter.\" \" The catanzcnial discharge, which had, in accordance with the ordi- Mary arrangement of nature, ceased for more than twenty years, -was completely, and thtus far, pernianently re-established!! At least, a discharge froi the genital organs, having ail the obvions and sensible physical characters of the catemenia, and observing, with vigorous ex- actitude, its peculiar law of periodicity, lias been established, and con- tinues to recur, vith the utmost regularity, up to the present time (A.ugust, 1844.) after the lapse of more than a year! She has not",
         "SINGULAR EFFECTS OF LIGIITN]NG. missed a si:gle menstrual period since she was struck by liglitning. To use a liberal paraphrase of her own language, ber \" Moons retura as regularly as when she was a young woman.\" The flow comes on with the usual permomitory symptoms, Her manma bave undergone on obvious preternatural enlargement, apparently originating in a sym- ,pathetic àrritation, emanating from the establishment of the reproduc- tive functions. This woman lias had but one child, to which she gave birth, soon after reaching womanhood. The catamenial flux is repre- sented to have been regular up to the period of its natural cessation, between forty-five and fifty years of age ; subsequent t\u0026 which epoch, she bas presented all the appearances ordinarily attending the gradual approach of the state of senility in a vigorous constitution. The elec- trical s7 )ck, likewise, completely relieved ber of a troublesorne stran- gury which had harassed ber for four or five years. Very recently she bas, occasionally, had a slight recurrënee of the same complaint; althougli under a much milder form. Otherwise, ber health continues perfectly good; there being, so far as symptoms show, not the slightest indication of the supervention of organie disease of the uterus.\" \"I regret that no opportunity bas been afforded for examining, ina critical manner, the condition of the genital organs, and the character of the fluid which is periodically discharged ; as it would bave effec- tually removed any degree of scepticisi which might possibly arise in the minds of some persons, on the score of the vagueness of negro tes- timony. I trust, however, that the systei of minute interrogation and rigid cross-examination, wlicbh was adopted in eliciting the facts, has precluded the possibility of the occurrence of any material error ; es- pecially when it is considered that there could be no possible motive for -practishig deception, in a matter of this kind, on the part of a faithful old slave. Under any view of the question there can be no reasonable doubt concerning the strict menstrual periodicity of the phenomenon ; and it would be difficult to assign any other than à functional origin to a discharge observiug such a lawr.\" \" A comparison of the details of the two cases which survived the electrie shock, manifests a remarkable analogy in the appearances pre- sented, and in the symptoms which supervened. In both instances tbe clothes were similarly turn-marks of discoloration indicatcd the pas- sage of the lightning over the surface of the skin ; and the saie per- sistence of pain in the region of the stomach and bowels, existed duiring the progross of convalescence. This latter symptoin, common to both -together with the continued vomiting in the last case-doubtless arose froin the violent shock which the solar ple:us of the ganglionic systein of nerves sustaned, by the powerful operation of the electrical e.nergy.\" 344",
         "EDITORIAL NOTICES. A remarkably striking impression was made upon the uterine func- tions in both instances in the one case, eausing marifest derangement of the functions of menstruation, as indiented by the irregularity of its recurrence, and the paucity of the flux :-in the othei, we observe the abnornial phenonienon of the apparent re-establishment of the cata- menia, after more than 20 years cessaion under the natural progress of superannuation. Ilere we find a remarkable example of the pro- duction of diametrically opposite effects fror the operation of the sanie agent-under, apparently, identical circunmtances-and acting, seem- ingly, with equal degrees of intcnsity on the animal economy. Per- liaps this nmy bc considered a natural illustration of the truth of the lomoeopathic aphorisn, \"similia similibus ciian'ur ;\" but admitting the validity of the axiom, it is quite clear thiat Nature did not, in these instances, acconplish the end by adninistcring inifinitesnal shocks of electricity !! Nor does this fact present anything cither novel or para- doxical in its aspect, except when observed through the mieroscopic opties of hoineopathy. TIIE MOXTREAL MEDICAL GAZETTE. Onines artes, qun ad htnianitatem pertinent, liabent quoddan commune vinculumu, et quasi cognatione quadam inter se continmentur-Ciccro. iONTREAL, FEBRUARY 1, 1845. The course adopted by the Medical Faculty of McGill College, in reference to the petition of the College of Medicine and Surgery, lias been, to say the least of it, unwarrantable ; an interference with the undoubted riglits of the subject, an attempt to convert a measure of iueral and catholic application into a contest of a purely personal character, and striving to sway the opinions of the Legislature as well by unjust means as by umtenable conclusions. That that Faculty had a riglit to petition Parliament we admit, but whether that prerogati-ve should have been excrcised is we think questionable : having however gone thus far, action here should have ceased ; because it would bave been nanifest that the intended pur- pose of the petition was effected, namely that inducing meinbers to deliberate before sanctioning an net w'hich might place undue power in the hands of men capable of unwisely exercising them: the Faculty 345",
         "by such a mode would have taught those who took an intercst in the case, that it placed perfect reliance in the j udgment of our representa- tives, satisfied that having put them on their guard it had exonerated itself from any responsibility, should, in the event of the Act being passed, immoral results ensue. Now what has been done by the Faculty of McGill College ? It addressed a circular letter, (dated in December,) to the members individually, setting .orth their claiis and at the sanie time attempting a defence of unfounded accusations ; tlis is not delivered till the very day on which the Report of the Committee, to whom had been referred the petition of the College of Medicine, -was to be made, thus by a ruse introducing and forciiig upon the House circumstances with whicl it had nouglit to do, and upon which it was, as such, profoundly ignoranit; for the Faculty were not at the bar pleading their case : in this trick of fence there was a complete failure ; by the accidental absence of Mr. Scott, to whom the petition liad been entrusted, the report vas postponed. *We niust go back a little. The petition of the McGill Faculty had been entrusted to Mr. Mofflatt; by him it vas presented, and by an order of the House this, together with that of the College of Medicine, was printed Mr. Moffatt at the same time naming two medical men, members on his own side the benches, to sit on the Committee named by Mr. Scott; on reading the counter petition, the lecturers had but one course to adopt, namely to meet the allegations of the counter petition, and respectfully, in writing, submit them to the Committee, composed, it will be remembered, of nominees from each side, thus exhibiting to the members comprising it, their reasons, and to one of these, too, who from his seat in the House, had expressed his disapproval of their petition ; what was the Report adopted unanimously by the Committee ? It vas favorable to the prayer of the petitioners of the new school. On the very day then on which the Report was anticipated, the cir- cular, of which mention has just been made, was issued: on perceiving the course in which the McGill Faculty persevered, and by means which we pronounce unwarrantable, we dcternined that in the extra promised to our readers the month previuus, (in which we had not the slightest idea of introducing these subjccts,) the whole matter would 346 EDITOnIAL NOTICES.",
         "EDITORTAL NOTICES. 347 be placed before the Medical public, and also before the Members; we did so and we cheerfully abide the verdict of the former and the de- cision of the latter. We have been induced to dwell thus long because of another coun- terblaste having been issued, the aim and patent purpose of whieh is to bias the prejudice, not to direct the judgment of those unacquainted with the merits of the case ; this too was published and issued six days after our extra, to which it purports to reply, and was distributed to members on the evening on which it was known that the second read- ing of tie Bill was to take place, and of course on which the discussion would be held; here again c the ruse failed; owing to the Bill not being printed, it was postponed for a week; the reply is however of a charac- ter so puerile so lachrynose withal, thiat we reserved all notice of it till this moment : and we shall touch on but two heads of our offend- ing, the alpha and omega of their charges against the lecturers of the new school in general in the former, and against ourselves in especial in the latter. We are accused of ingraLtitude and laving acted with bad grace, in having undertaken to deliver lectures in Montreal, and why ? Because all of us last year had benefited by tlc sacrifices, the Faculty of Mc- Gill College has yearly made since tie establishment of the Medical In- stitution in 1822. Than this opening parental larmoiement, scarce any- thing could be more touching; the suggestiun of sudh a grave accusa- tion must have been taken from Plato, who cumplained, philosopher as he was, of his pupil Aristotle, because lie taught in the same city; but surely thei Faculty do not intend us to understand that we individually eaused them a sacrifice, or that we did not do justice to their teaching ? Now, conversant as we are with the affairs of that School, we hesitate not to assert that we owe them not a debt of gratitude in their public capacity of lecturers. We are wrong in using the plural, for we knew but one of them as a teacher-the present professor of Medicine ; the fees were paid, and thus far we, at all events, contributed our mite in rendering less the sacrifice ; but independently of this, that very school is indebted to two of the present Lecturers of the College of Medicine, for ýserviccs rendered at an early period by the one, and at a More recent period by the second; certificates of which are in the pos-",
         "EDITORIAL NOTICES, session of the parties; no mention, therefore, should have been made of benefits granted without their having beei returned; should we ever live to count twenty years of existence-aye, or ten-there will not be anything more flattering to us than the knowedge, that any of ourpupils were capable of teaching a science, the rudiments of which we had reason to think we ourselves had inculcated. We must, while on the sub- ject, be allowed to say a feiv words in regard to the sacrifiees; positive outlay of money we mean. We know that up to thetime of the leasing of the present house, the expenses for each Professor seldom exceed- ed £25, and this sun perhaps only by the Professor of Chemistry, and we ask allunprejudiced men-is not to a young practitioner the circum- stance of lecturing in connection with an institution of any kind-is not the almost certain appointment as a consequence to the Montreal General IIospital-are tiese not considerations ? And we ask of those who know what was the position, twenty-two years ag;, of the gentle- men triumphantly mentioned in the last rejoinder-Was lecturing anud preparing lectures, (the chief labour of whicb is in the first two years,) such an immolation by them of time ? It was iot. This unfortunate journal, ourselves, arc said to be the organ of the New Sehool-grave charge ; we are criminal in raising our voices in directing the science of Medicine, doubly so in directing our efforts towards the making of the new sciool known-and what has forced us to be in appearance exclusive ? for it is but in appearance ? What encou- ragement did this journal receive from the Faculty of McGill Col- lege ? We are almost tempted to exhibit how deeply indebted we are to theni individually and collectively, and yet the immaculate Faculty call us the organ. We are the organ and we grind it to some tune. The Faculty is appalled, and well it may-for we are almost morally confident that a just appreciation of the petition will grant, with but few modifications, the clauses in the Bill incorporating the New School of Medicine, which consummation, if it bring not with it grace to us, will savour much of disgrace to those who have unjustifiably opposeid themselves to the passing of an Act wicli they have not yet shewn las injured-c-cept in anticipation. Further we recommend to the Faculty to give time for another opposition-what will they think when we inform them that some otier ungrateful gentlemen are about forming a school, and intend petitioning for an Act such as ours-not,",
         "EDITORIAL NOTICES. of course this Session, but next-do they now look upon the ball as fairly in motion ? Gladly and joyfully have we been informed of this -and cheerfully offer what assistance we may to the pioneers. By the way we hear that the Faculty arc about establishing an organ ; we trust that it will be double barrelled-and we hereby offer our services as a hand at the bellows-if accepted we'1l wager our old editorial chapeau against any of the collegiate tiles, that we will blow a blast that shall make the organ skiri. We have reason to congratulate ourselves upon our prospect of suc- cess in obtaining our Aet-but independently of purely personal con- siderations, we are deiighted to perceive that the Medical Faculty of McGill Cohlege are abs9lutely advertising that there are four Chairs to be filled iii connection with the Medical Department-we are the more self gratulatory, when we reflect that we-aye ï --have produced this -.ot only the proposed extension of the courbe, but the offering of the Chairs to a quasi competition, that is to those who are possessed of the highest testimonials. But we regret tliat this is but a half measure ; in the first place, th Clinical Lecturer mustbe an attendant at the Iospital, and there are but two at present in that institution unconnected with the Faculty-the choice we conceive, irrelevantly of other considera- tions, must fall on Dr. Crawford. With this we are truly pleased, for tardy justice wili tihus be given to that gentleman ; the Chair ofBotany and of Medical Jurisprudence will, we predict, be filled by two of the Faculty, or by those in clobe connection with it. The entering eel partially into our own views of a concours, is satisfactory, and P:esagcs further backsliding from the ancient regime. It is a curious coincidenec that the advertisenent should appear nearly at the same tine, that stress is laid on the sacrifices sustained by the Medical Faculty ; is it wishled to unvittingly involve others in pecuniary loss, by beoming participators in the spoil, or is it thu, honestly granted and afortiori that there are advantges independently of the auri sacra. fames, to be derived fron these situations.",
         "350 OBITUARY. Died, on Friday the 24th January, ALEXANDER ScOTT, M. D., a native of Banffshire, Scotland. Dr. SCOTT had been for a long time suffering from a serious complaint, which, steadily advancing, completely exhausted his strength, and he cxpired without any of the acute suffering which characterizes more acute and rapid discases; indeed, from the astupsy, the afflection must have been gradually producing its results fior years, and so imperceptibly that its nature was not suspected by himself, yet amidst this ruin of constitution in the meridian of life, he was but 36. years uf age,) the power and vigour of his intellect remained unimpaired to thie last moment; during the whole period of a long illness, his calmness and se- rthity of mind marked lis whole demxeanour and rendered a bed of death, the throne on which sat patience and resignation, manifesting an abiding faith in the will of the Creator. Dr. SCOTT was a man of liberal acquirements, not only in bis profession, but in those departnents of a gentleman's educa- tion, which shed a lustre on the individual; he was a good Greek and Latin scholar, and well versed in the classies of our tongue- in fact in a few moments conversation a stranger could at once recognize the man of attainments. He was one of die favorite pupils of the famous Dr. Knox, and had a train of uinforseen cir- cumstances not intervened, he would have become his assistant, and would unquestionably bave risen to an eminence far greater than that which fell to his lot in the land of his adoption ; a posi- tion lie was well qualified to occupy. MEDICO-CIIIRURGICAL SOCIETY. We have been prevented by press of other matter from noticing the proceedings of this Society as regularly as we could have desired, nor can we do more in this number, than present our readers with a short abstract of the various subjects submitted to the members for consideration.-Ens. M. M. G. November 2, 1844.-Dr. FismR in the Chair. Death from extensive fracture at te base of the skull.-Dr. F. ad been called to the individual in question, who was in a state of coma, friom a f'll which she had had from the top to the bottom of a long gallery staircase. She remained comatose until death, sir, hours after",
         "3MICDICO-CIIIRURGICAL SoCIETY. the fall; nu fracture could be detected during life, but on post mortem examination, a large extravasation ofblood was found on the external surface of the cranium, with a comminated fracture of the basilar pro- cess of the occipital bone, including the posterior clinoid processes, a fissui, extending nearly to the foramen magnum from the occipito temporal suture. The poor wonan (St. 60) had long been subject to attacks of vertigo, and lad probably fallen while in one of these. Noveiber 16.-Dr. IoLMEs in the Chair. The subject of aortic aneuris was submitted, and three cases re- lated. One at present existing in the person of a female of upwards of forty years of age, in whoin the abdominal aorta is sensibly and pal- pablyaffected. Another whiel occurred in the person of a man, seen by Dr. H. in consultation with another memaber of the Society, and which was only detected after dcath ; the patient labouring to all appearances under asthina, and the third in .he person of a young lady St. 17, now under Dr. I.'s treatment, in whum althougli the stethescope announces the sound of aneurisin, yet there are no constitutional symptoms pre- sent to confirn the diagnosis. November 30, 1844.--Dr. TRESTLER in the Chair. After relating the particulars of a case of placenta provia, in which the child was safely delivered and alive, the Doctor drew the attention of the Society to the child itself, who had an imperforate anus, and in whom after death a conmunication was found to exist between the rectum and urethra opening into the vagina. The child lived for six weeks and was then carried off by Smallpox. December 14, 1844.-Dr. CRAWFORD in the Chair, in the absence of Dr. HALL. Dr. Crawford related the results of his further experience of the use of Tr. of Iodine in Smallpox, since his first announcement in this journal. Ie mentioned several cases which induced him to feel in- creased confidence in the remedy. Dr. Bowie, who had been led by Dr. C.'s favorable notice of the re- medy to employ it among several of the emigrants who Lad arrived during the past season, confirmned the good opinion entertained by Dr. C.-Dr. Arnoldi, Jr. contended, that the whole mass of blood being charged with the poisonous virus, this application could rot be made to any particular portion of the body, without incurring the risk Of very mnuch increasing its influence on some other part, or from its astringent quality producing a revulsion to some deep organ. I-e cited a case in support of his arguments, which had occurred at the Self-Sup- porting Dispensary. 351",
         "MEDICO-CUIIIRRGICXL sOCIETY. Dec. 28, 1844.-Dr. MACNIDER in the Chair. The modus operandi of ergot was the subject sclected by D.. M. for the Society's consideration, and in addition to lis own opinion, he stated that of Dr. Craig of Paisley, w'hich had appeared in one of the late numbers oftlie London Lancet. After a fll discussion ofthe ncrits of this agent in obstetrical practice, Dr. Badgley subinitted to fle Society the results obtained by chemical analys-s by Wiggin, Bonjean and Abbéne ; and also the opinions entertained of its therapeutie ef- fects, by Messrs. Perdu and Sachero, first published in the Annali Uni- verali di Medecina, for 1844. January 24, 1845.-Dr. BuîAUD in the Chair. Facial Paralysis, in a young lady fruu the country ; all the mus- cles of the left side of the face haid lost the poVer of liotioi, the cause vas obscure, but it was the opiniuni of Dr. B. that the exposure of that side of the lcad to a current of air hiadrbeen the exLitinîg cause in an individual of a nervous tempuraient, ahltugh Ahe lad never suffered from hysteria or other nervous cuiplaint; after the enploynent of counter-irritation conbined w ith nercury, the Dr. lad put lier upon a course nf Strychnine, and she was recovering gradually. The proceedirgs of the Mledico-Chirurgical Society of this city, ai its last meeting, will long bc remïenibered by us with sincere satisfaction, as proving, that lowever little sucl institutions imay b- as yet appre. ciated by members of the prufession i Mintreal, they arc looked upon by our brethrei ini Canada W as they are admitted by the profes, sion at home, to be real objects of value and interest; and 2d. tiat tle Montreal Medico-Chirurgical Society will prove, as we expcted, il proposing its estalblislnent, the parent of a general Medical Association for Canada. A letter from the SecreLty of the Toronto Medico. Chirurgical Sociuty Laving been rcad, expres:i% e of fic th illingnîess of the ,members of tiat Sucitety tu co-uperate nith our uwn \"i any na- sures whici may bc rgarde as tending tu pruniote citlier the iutual interests of these institutions, or the interests gcnerally of the Medial profession in this country ;\" it was resolved, on motion made by Dr. B3adgley: \" That the Medico-Chirurgical Society of Montreal accept with great pleasure the pruffered co-operation of the Toronto Medico. chirurgical Society in their enîdeuutiro tu cary out tluose general neasures for the.advancement of Medical Science, the elevat£on of pro.",
         "EXTRACTS. fessional character, and the establishment of union and cordial feeling among the members of the profession ; the tendency of which cannot but prove of paraniount advantage alike to the profession and the pub- lie.\" It was also resolved ; that the Secretary be instructed to put him- self in communication vith the Secretary of the Quebec Medical So- ciety on the saine subject. Verily, most of the prophecies Inade by us sixteen months ago are about being realized, as will be seen by the contents of this number. Dr. Macnider has j ust published his 3rd report of the Montreal Lying in-liospital, establiihd by hinself three years ago ; during the past year 62 patienits la% C been rcCCiv ed into tLe inustitution ; several others were rcftied, froim not being fit objectb. We are very happy to add, that the suo.cription li.t was quite suflicient to ncet the disbursements ut the ycar, and we hope that thiî, ycar's collection will be considerably larger. Many of the btudeunts of the College ofMedicine availed them- selh es of this valtable channe for practical instruction ; indeed, inore applicatiounb were made to Dr. M. for cases, than lie was able to meet. SOME REMARKS ON BRONCHOCELE OR GOITRE BY BEVERLY R. MORRIS, A.B., M.D. Or TRINITY COLLEGE, DrBLIN-rIIYSICIAN T\" TnE TORK: DISPENSARY. This unsightly disease has at all times excited a considerable sliare of attention, and its origin has been attributed to the action of nume- rous causes. It is not my inte-ition to enter upon a detail of these causes, (us they may be gatliered from any book on the practice of physic,) but shortly to notice w'hat I believe may be considered as a not unfrequent exciting cause of the disease. I believe that we shall gcnerally find bronchoccle to be developed in persons of a strumous diathesis, and many of the circunstances under whîich it bas arisen, tend to favour this conclusion ; among these I nay mention its great prevalence in certain parts of North America before it was cleared of its woods, and its entire dibappearance after their removal. This change, so favorable to a frec circulation of air, could not but nct strong- ly in improving the tone of the system generally, which must be greatly relaxed and weakened by a constant residence in a damp and close at- mosphere of the dense primeval forests of tliat country. Certainly in this country, a large number of the cases of this discase occur in those witli fair skin, and other indicationis of a strumous habit. The disease to which I would call attention as an occasional cause of goitre, is rheumatism ; and thougli the rheunatic and strumous diathe-",
         "sis cannot be considered as. identical, yet there are points of similitude between them, and tley are both occasionally found in the same indi- vidual. Indeed, in the three cases which I now bring forward, there were evident marks of the existence of a strumous diathesis. The first case is interesting also, in another point of view, viz., as exhibiting the constitutional effect of iodine when it was only applied externally. The possibility of this has been denied by some writers, but I have observed its occurrence in numerous cases where the appli- cation was continued to any protracted time. CASE 1. ilugust 10, 184.-Mr. R- aged 45, consulted me for a swelling in his neck, whiclh he attributed to an over-exertion of the organs of voice. The tumour bas been coming on for several months, and now gives him, at times, a good deal of pain, both fixed, and ]an- cinating, when swallowing. There is no discoloration. The tumour extends from a little above the thyroid cartilage on the left bide to the clavicle ; it is oblong, being about an inch and a half wide, and of the length described. It is rather firm, smooth, and elastic. I found that he had been subject to rheumatism, chiefly of the bands, but albo of the back part of the scalp and neck. On questiuning huim closely, I fuund that the rheumatisn had left his bands suddenly when the tumur in the neck first appeared. May not this be rheumuatic thyroiditis ? The general health and appetite are generally good ; the tongue is cean; the bowels are regular. He bas a greatly enlarged prostrate gland, whielh sometimes interferes with the passage of the urine, but is not troublesome at present ; lie has been under treatment for it, but only with temporary benefit. 1 only ordered half a drachm of hydriodate of potass in an ounce of soap liniment, to be rubbed into the tuuour every night. Vov. 2. He bas continued very steadily using the liniment, 'but lias occasionally been obliged to omit it for a day or two (particularly at first,) caused a good deal of nervous irritibility, and swimming of the head. The tumour in the neck lias nearly disappeared; and the en- largement of the prostrate gland is greatly lessened, so much so, that lie now feels no inconvenience at all from it. He continued to use the liniment up to the end of the nonth, wlhen being entirely cured, it was discontinued. CASE2. Sept. 18, 1842.-Mrs. W , aged 31, ill ten years, bas.a bronchocele involving the whbole of the thyriod gland. It ex- tends on each side to the angle of the jaw, and is very prominent over the thyroid cartilage, but docs not descend below it. It is firm and of even texture ; she traces its first appearance to a rheumatie ietasta- sis. She is of a decidedly scrofulous habit. About the time of its 354 EXTRACTS.",
         "appearance she was worked very liard as a dairy-iaid. It lias always beeu inuch larger during attacks of rheuinatism, to which she bas been very subject. The other glandular structures appear lealthy; the general health is good. -R. potass hydriodatis zss, linimenti saponis zj. M. Fiat linimentum, tunori senel in die appiicandum. .ov. 17. She lias derived ery considerable benefit. The turnor is snaller and softer ; the skin over it is much wrinkled.-Pergat. CAsE 3. Janiuary 30, 1843.-Mrs. S-- , aged 44, ill four nonths. There is a general swelling of the thyroid gland to some ex- tent. She .3ays it cularges most at the catamenial periods, and when an attack of azthna comes on, to whicli she is very subject; she bas had repeatedly attacks uf rlheunatibn, but cainnut trace the dibease to that cause.-Ordered iodine internally as well as externally. Tlhugtrh in this case the connection between the rlheumatism and the enlargeient of the tiyroid gland was not traced, yet I introduce it because of tleir co-existence. Cases bearing upon tlhîs question might be easily multiplied, but I trust those I have brought forward mnay be thouglt sufficient to prove fie position I have laid down ; and tu possess enough ofinterest to in- duce others to turn tleir attention towards the subject of rleumaatism, as an occasional exciting cause of goitre.-London and Edinburgh lledical Journal. YORK, June, 1844. ANTIDOTE TO lPRUSSIC ACID. Messrs. Smith have experimented on prussic acid, and have found that a sulplate of iron, consisting of four proportions of the per-sulphate, and threc of the proto-sulphate, combined vith a proper proportion of an alkaline carbonate, will neutralize hydrocyanie acid, the resulting comnpound being the insoluble Prussian blue. 210 grains of the sait oj iron, and 144 grains of the carbonate of potash are required to neutra- lize 56.8 grains of real prussie acid, but they recomniend that hvlen used as an antidote, not less than three timues the theoretical quantity slould be given, as from the presence of food, mucus, \u0026c., in the sto- mach, it is improbable that the antidote would mix immediately with the poison at every point ; so that to render the action more certain, a large excess is advisable, more especially as thiis would be attended with no evil consequences, as the only effect that could follow an excess, would be the formation of sulphate of potash, and an insoluble mixture of proto-carbonate .nd peroxide of iron. Should there be renson to believe that tlie stomacli contains mucli frc acid, whielh night interfere with the deconiposition of the salt, a dose of magnesia slould precede Ihe exhibition of the antidote, but not otherwise.-M1fed. Times, Oct. 1-2,from Lancct. 355 EXTRACTs.",
         "TREATMENT OF PLETIIORA BY SALINE MEDICINES. \"The treatment of plethora is often not nearly so easy as that of anæmia. In many cases it will not suffice merely to abstain froni animal food, and to drink large quantities of simple cooling beverages, in the hope of attenuating and impoverishing the condition of. the blood. Then, again, the effects of bloodletting are generally only transitory ; and, moreover, the very loss of blood seems not unfre- quently to induce a more active proportionate formation of it. On the whole, the use of saline laxatives, and of the hydrochlorate of ammonia (sal ammoniac,) seem to be the most useful means that can be employ- ad for the relief of plethora, when it gives rise to inconvenient symp- toms. \"Dr. Lheritier, in his recent treatise on pathological chemistry, in- forms us that he has found that the proportion of the red globules in the blood of rabbits was decidedly modified by the internal use of this salt, in the course of two or three weeks. \" IThe nitrate of potash has similar effects ; so also have the alkaline subearbonates, and the liquor potasso itself. Perhaps the latter is, on the whole, the most efficient impoverisher of the blood, provided, also, the diet is spare, and not too nutritious, and all malt liquors are avoid- ed.\"-Medico- Chirurgical Review. ASTRINGENT REMEDIES. The following are the results of Dr. Gottschalk's experiments, as regards the astringent power of the sulphates of copper, zinc, and iron; acetate of lead ; alum ; sulphuric, muriatic, and nitric acids ; creosote, \u0026c. 1. The strongest astringents, as alum, acetate of lead ; sulphate of iron, lose mucl of their constrictive powers, if employed in a liquid form. 2. The liquid form, counteracting astringency on the one hand, causes, on the other, a relaxation of the animal tissues, and thus affords an easier ingress to foreign matters. 3. The acids (muriatic and sulphurie) possess no constrictive power, beyond making the tissues a little denser. The vegetable astringents, according to the author's experiments, do not merit this designation. lis experi- ments, performed with decoct. querc., ratanh., gall. turcic., \u0026c., prove 1. That the above remedies display no constrictive effects, if used in a form, in which they are prevented withdrawing the water from the tissues with which they come in contact. 2. They are the less con- strictive, as they are received with greater facility into the organs (as in a liquid form,) thereby increasing the density and bulk, but without constricting the parts. 3. If we except substances, which cause con- traction by their action on the nervous system (as strychnine,) we possess no vegetable constrictive agents, but merely exsiccatives and refrigerants.-Dr. Gottschafd in Schmidt's Jahrbucher. 356 ExTRACTS.",
         "EXTRACTS. BATIIS AND WASIIIIOUSES FOR TITE POOR. A public meeting bas been held in the city of London, under the presidency of the Lord Mayor for the purpose of forming an Associa- tion to furnish the labouring poor with Baths and Washhouses. The intention, as stated by the Bishop of London, is, that the workingman shall have a bath to himself, where, at a price within his means, he may perform bis ablutions in private ; and that bis wife nay ha :e a public washhouse to resort to, where for the washing of her family's clothes, she vill be supplied with hot and cold water, tubs and other conve- niencies, at the rate of id. for every six hours-besides the use of a drying-room, furnished with all necessaries. A similar establishment, on a liinited scale, lias been for some time in operation in the town of Lierpool, and with such manifest benefit, that the corporation have determinîed to extend the system. We are friends to all proposails of the kind in favour of lite working inan ; and we think that charity bas got upon the riglit track, wlien she gives ii forms that rais,_ the moral mat, while they comnfort the physical.-AtheInum. VICARIOUS MENSTRUATION. Dr. A. Forget communicated to the Socielé .iledicale d'Emulation, the following curions fact :-Miss - , ætat 16, dark hair and eyes, general health good, menstruated for the first tine at 15, since which period, tlie catamenia came on regularly every month, without pain, and lasted four days. On the 27th of March, 1844, two hours after their apparition, a friglit caused them to cease suddenly. The next day, intense cephalalgia declared itself ; face red and heated ; contin- ual drowsiness ; throbbing of the heart to an unwonted degree ; ano- rexia, \u0026c. Ist April: Miss - experienced considerable difliculty in opening the right cye, accompanied wich the sensation of a foreigi body under the lids, and spots of blood were soon after observed on the enrresponding cheek. During the day, at differenttimes, hSmorrhage took place from the inner canthus, the blood being of bright red, flow- ing, tear-like, drop by drop, On the succecding days, it transuded, not-only from the conjunctiva, but likewise from the skin covering the riglht cheek, the nose, chin, and back of the hand ; once only fromn the meatus auditorious externus, the scalp, and the tongue. No precur- sory symptoms were manifested, except those already mentioned. The parts fromn which the blood escaped, may be classed as follows :-chin and nose ; inner canthus ; back of thehand ; meatus auditorius ; scalp, and tongue. The hmorrhage ceased as soon as the patient went out, anad the whole time it lasted, its consistence, color and temnperature of the skin, were in their normal condition. On the l5th April, violent",
         "Jac EXTRACTS. coliEs declared themselves: which ceased as soon as the patient iad evacuated a tumblerful of liquid, llorid blood. Finally, in the begin- ning of May, the catamAnia appeared as usual. The treatnent em- ployed consisted in mustard foot baths, fumigations of an infusion of artemisia vulgaris ; fourteen enemas of varm water, and, an infusion of arteinisia vulgaris.-London 1[edical imes. MEANS OF ARRESTING HEMORRIAGE FROM LEECII BITES. M. Morand lias lately proposed the following plan for arresting hie- morrhage from leech bites :-He forns a small ball, of a mixture of olive oil and yellow wax, six parts of the first to one of the last, and after wiping the blood from the wound, lie rapidly applies it to the bleeding orifice. rressing on it with his finger, lie then sprends il around. If adhesion does not immediately take place, and the blood continues to flow, lie adds a sußficient qu'antity of the oily mixture to form a cake, two-thirds of an inch in thickness, covering all the leech bites. The first time M. Morand tried this plan. vas on a child four years of age, attacked with pleurisy, who had had ten leeches applied to the chest. Several of the leeli bites continued to bleed in spite of the various remedies that had been tried. The oil and wax mixture at once arrested the liremorrliage.--J-onrnul de iléd. MANUFACTURE OF CASTOR OIL IN THE WEST. Dr. Drake, in his Travelling Letters, gives the following acconnt of the growth and manufacture of this important article in some of the western and other States. \"To pass froni geography to pharmacy, I must teli you something about the manufacture of castor oil in this city, (St. Louis) and some of the neighboring parts of Illinois. It seems to bave been commenced by Mr. Adams, of Edwardsvillc (Peek's Gazetteer,) about twenty years ago. The produce of the first year was 500 gallons, which he was then enabled to sell at $2,00 a gallon. In 1831, he made 10,000 gal- lons, whicli lie sold at 75 cents. From a gentlemah of this city, who owns a steam oil press, I have some additional statisties of this impor- tant manufacture. \"According to his statement, tlie quantity now manufactured in Ili- nois and Missouri, is above 100,000 gallons a year ; which is the Dro- duce of from 8 to 10,000 acres of land. The crop varies from 10 te 15 bushels, an acre, each. bushel yielding about 2 gallons of oil. Its price ranges fron 72 cents to $1 a gallon. In these latitudes the crop is somewhat uncertain, being liable to injury from long-continued droughts and early frosts. Indiana, Virginia and New Jersey furnis,",
         "EXTRACTS. together, from 25 to 30,000 .gallons a year : Tennessee as muih, per- laps, as she consumes. The castor oil bean flourishes well in Mexico and the West Indies, but the importation of oil is greatly diminished from what it once was ; at the sanie time the price is much reduced, and the quality greatly improved.-Boston Iedical and Surgical Journal. ACTION OF LIIGHT ON VEGETABLES. From a paper by Dr. D. P. Gardner, of New York, on this in- teresting subject, to which Dr. Draper has given much attention late- !y, we copy the following conclusions to whieh lie has arrived. The paper referred to was first publisied in the American Journal of Science and Arts, and bas also been printed or discussed in the Lon- don Philosophical Magazine, the new Edinburgh Philosophical Maga- zine, and the \u003eibliothèque Universel de Genève, and was reported favorably upon in the French Academy of Sciences. \"In conclusion, it appears tlat the following facts have been es- tablished. \" lst. That chlorophyl (the green matter of leaves) is produced by the more luminous rays, the maximum being in the yellow. \"2d. This formation is due to pure LIGInT, an imponderable distinct froim all others. \"3d. That the ray towards which plants bend occupies the indigo space of Fraunhofer. \"4th. This movement is due to pure LIGUT as distinguished from ieat and tithonicity. \" 5th. That pitre 1GHT is capable of producing changes which re- sult in the development of palpable motion. \u003c6th. The bleaching of chlorophyl is most active in those parts of the spectrum which possess no influence in its production, and are Complimentary to the yellow rays. \"7th. This action is also due to pure LIGUT. \" We have, therefore, an analysis of the action of every ray in the luminous spectrum upon vegetation. The several effects produced are not abruptly terminated within the limits of any of the spaces, but overlap to a certain extent, a fact which coincihLs with our experience of the properties of the rays. Whilst heat and tithonicity are capable of causing the union of mineral particles, light appears to be the only radiant body which rules pre-eminent in the organie world. To the animating beams of the sun we owe whatever products are necessary to our very existence.'-1bid.",
         "NEW FILLING FR TEETIL By imitating, as nearly as possible, Ihi. constituent principles of flic enamel of tee.th, M. Osternaier.lias obtaiined a compou'nd, which at ilrst soft, becomes liard afte* its introduction into the cavity of a de-cayei tooth, so that lollow teeth thus filled serve as well as sound teeth for mastication. This compound is prepared as follows : mix quickly thirteen parts of pure and finely powdered caustic lime, vi.th tveIve parts of anhy- drous phosphoric acid. This powder becomes moist during flic mix- ture, and iii this condition it is to be introduced into the cavity of the tooth, previously dried ; and the surface moulded of the proper formi. The mixture gradually changes into phosphate of lime, and becomes dry and very solid. It must be used within one or two minutes nfter being niixed. It remains to be seen whether ;ts duration will corres- pond with its other advantages.-Gazelte de Iôpîieaux. CAMPIIOR A PRESERVATIVE OF ERGOT OF RYE. By JOJIN N. S WsoN, M. R. C. S., \u0026c.-I was not a little surpris- ed to read some remarks by M1r. Rawle, stating camphor to be a pre- servative of ergot of rye. I can only say that I have been in the habit of usingit for the last nine or ten years, but not exactly in the man- ner described by hi. 1 order the camphor to be iixed with the powdered ergot, in the proportion of a grain in every scruple. By this means I think the camphor is more intimately diffused throughout the whole than can possibly take place by the plan proposed by Mr. Rawle. I do not give this either as a new, or, indeed, my own dise covery ; for I adopted the method by having seen it iii the practice of Mr. Spurgin, an old practitioner also, at Saffron Walden, and from *whom I have every reason to believe that your correspondent also ob- tained the saine information, le having been engaged in the same gen- tleman's practice.-London Lancet. TII MONTREAL MEDICAL GAZETTE, Is PUBLTSIIED MONTU1LY. SUBSCRIPTION, FIFTEEN SILLI1NGS PER ANUM. Correspondents are requested to address the Editors, and in every instanC prepay their communications. RNTED AND PUBLISIHED BY LOVELL \u0026 GIBSON AT TEILR BOOK AND JOL PRINTLNG OFFICE, 360 EXTRAcTs."
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         "[Montréal : \"Gazette\" Print. House, 1875]"
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      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 4, no. 2] (Aug. 1875)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SUJRGICAL JOURNAL. ORIGINAL COMMUNICATIONS. Case of Scarlatina mniliaris. By WM. OSLER, M.D., Prof. Institutes of Medicine, McGill College. C. S., æct. 9, had been convalescent for over two weeks from a moderately severe attack of small-pox, and was only remaining in hospital on account of two ulcers in the leg. During the night of the ·3oth of June she sat up with the nurse till 4 A.M. watching a dying child, and as on getting up at 7 A.M. she complained of a few pains in her back, and looked very pale and unwell the nurse sent her back to bed. She was not sick at the stomach, nor had she any shiverings. Up to this time she had been doing very well, and no change had been noticed in her health. About 9 A.M., the nurse observed that she had become of a bright'scarlet color. At the visit, at 4.45 F.M., there was intense hyperæmia of the skin, the whole surface being of a brilliant red colour, and on touching gave the impression of pungent heat. The redness was diffuse and uniform, only here -and there,-on close examination, a punctiform character was observed. Throat not sore; tongue thickly coated ; pulse 140; temp. 101. Ylly 2nd. 8.45 A.M. Had a tolerable night. Pulse 136; temp. 104. Tongue coated. Eruption remains, being even more intense, and some additional features. of interest added. - Thickly scattered over the.whole trunk, upper ex- tremities.and thighs, are small miliary vesicles about the size of No. 4 shot, tolerably firm to the touch, and filled with a yellowish creamy fluid. Over the nape of the neck and back they are so closely set that hardly any 4'",
         "50 CANADA MEDICAL AND SURGICAL JOURNAL. intervening skin can be seen. On the dark brown cicatrices left by the varioles they exist in groups. On the arms they are not so numerous, but on the extensor surfaces, especially about the elbowjoint some of them have coalesced to form large bullæ, which are filled with the same yellowish-white matter. Only a few of the vesicles are evident on the legs, but on close inspection small, clear, subcuticular papules are seen, like the vesicles in an early stage of development. Legs and feet are somewhat swollen. 5.30. P.M.-Pulse 148; temp. 102.4. Tongue very much coated. Bowels opened once . freely. Feels heavy and is not disposed to take much nourishment. Face suffused, but general redness not quite so marked. Vesicles on back and chest appear firmer to the touch, and on squeezing a portion of skin their contents do not flow out so readily. They also exist in numbers over the scalp, and are very thick on the forehead along a narrow strip just at the roots of the hair. Only a few are present on the face,; and these are larger and more of the nature of bulle. On the trunk and thighs they are most numcrous, and on pass- ing the finger over the skin in these regions the sensation of closely set fine papules is experienced. The legs are œdematous, bright red in colour, and- especially about the small ulcers, which have now -cabbed over-have a glistening aspect. Fauces and pharynx look quite natural, and are not at all congested. Urine normal in quantity, not very deep in colour. Sp. gr. 1015. Examination of the contents of the vesicles show ther. to be made up entirely of pus corpuscles, mixed with a con- siderable quantity of granular matter. 3rd.-8.3o A.M. Pulse 128; temp. 99.4. Tongue has: lost its white coating and is now of a dark red colour, some- what swollen and with papille prominent. She had a very good night and made a fair breakfast this morning. General redness still evident. Vesicles drying and disappearing on the chest. None have appeared on the legs, which are much less swollen to-day. Back and thighs very rough to the",
         "SCARLATINA MILIARI.-BY DR. OsLER. 01 touch from the partly desicated vessels, feeling like pig-skin or exaggerated cutis ansepina. General symptoms good. Urine abundant, pale, and contains no albumen. 5.30 P.M.-Pulse 120 ; temp. 99. Tongue a little dry, dark in colour and studded with swollen papillæ. Rash fading On chest and extremities, still very intense upon the back. Some of the miliary vesicles have burst and disappeared from the trunk, leaving the skin roughened in parts. Several large ones exist now on the backs of the hands, which are filled with a purulent fluid, and similar ones, though larger, Still remain upon the extensor surfaces of the arms. Feet and ankles have lost their glistening appearance and are not -%o much swollen. A few vesicles have come out upon the legs. Over the whole scalp the vesicles have uniformly coalesced, and the contents form a thin layer of purulent maatter,-a miniature of what is sometimes seen in bad cases of confluent small-pox. Pain complained of in the back of the neck, a region where the vesicles were most abundant, and in drying have left it hard, rough and painful. General symptoms continue good; bowels opened twice; urine contains no albumen. Sp. gr. 1012. 4th. 1o, A.M.-Had a good night ; pulse ioo ; temp. 98.2; tongue moist, brighter in colour, and papillæ not so promi- nent. Throat natural. Skin still hyperemic, especially about the back. Desquamation of fine, small crusts and thin scales beginning on the chest. On the back of the neck and about the axilla, the crusts are semi-detached and can be readily picked off. Back and abdomen still rough and granular, and on close inspection the dried remnant of each little vesicle can be seen. A few purulent bullæ still per- sist about the hands and legs. Urine pale in colour; normal in quantity. Sp. gr. ior i. No albumen. 6.30 P.M.-Pulse 96; temp. 98.2. Tongue clean. Rash disappearing and desquamation progressing. Says she feels quite. well. 5th, 9.30. A..-Pulse 88 ; temp. 98.2. Back covered'with acales and fine crusts, which are rapidly becoming detatched",
         "52 CANADA 31EDICAL AND SURGICAL JOURNAL. and falling off. On the limb the scales are smnaller, thin- ner and more furfuraceous. 6, P.M. Pulse 84; temp. 98.3. 6th,-Pulse 92; temp. 98. Desquamation proceeding rapidly, crusts almost all off -the back and neck. Appetite good. 7th.-Pulse and temperature normal. Thin flakes of epidermis are peeling off the arms and legs. On the trunk the scales are smaller but exceedingly abundant. The back is still very rough and covered with small, fine scales. Urine natural. 8th.-Desquamation, beginning on the face, and crusts can easily be picked away from the roots of the hair. Appetite good ; asked for meat. 9th.-Feet and legs covered with membranous flakes. Body quite clean. 12th-Desquamation nearly completed. Urine abundant, pale. Sp. gr. ioo. No albumen. * Microscopical examina- tion negative. 16th-Had a bath which has removed the rest of the scales. Several small pustules - Acne - have appeared about the face. 2th.-Quite well ; ordered to be discharged. Remarks.-A local eruption of miliary vesicles occurring in Scarlet fever is not uncommon enough to demand notice, but such a plentiful crop as was present in this case is rarely met with, even in epidemics characterized by this peculiarity. The pustular nature of the contents of the vesicles, from the first, their curious confluence on the scalp, and the existence of pemphigus-like blebs on the limbs, brings the case into the category of those dcscr .bed as Scarlatina pustulosa. Not a little confusion would appear to- exist as to the forms of Miliaria, and their relations'to Sudamia,· Hebra. Neuman and other German authors describe three forms : rubra, alba, crysalina, of which the two former constitute Sudamia, while the latter is regarded as Miliaria proper. Again miliary vesicles, as described by the above authors,",
         "SCARLATINA MILIARIÉ.-BY DR. OSLER. 53 contain a watery, transparent fluid, of a feebly alkaline or neutral reaction, the contents of which never became pus- tular. In English works they are spoken of as cloudy, turbid and purulent from the comencement. Sudamia, according to the latter, are clear, transparent vesicles pro- duced by sweating ; Miliaria are turbid and purulent, not necessarily produced by sweating, but occurring often at the height of a febrile affection. These miliary vesicles correspond to Hebra's M. alba, which he reckons as Sudamia. Fox strikes at the root of the matter when he calls Miliaria inflamed Sudamina. There can be no doubt that, given suitable conditions-active hyperæmia of the skin vith consequent augmented temperature and increased supply of pabulum-the minute particles of proto- plasm, which exist in the fluid of almost all vesicles, would develop into pus corpuscles, just as they can be made to do outside the body in the serum from a blister. In this case the vesicles appear to have developed inde- pendently of any sweating, and to have been pustular from the outset. The first rorning they were noticed, I looked carefully for any trace of clear vesicles, but about the trunk none could be detected. On the legs, however, certain clear, sub-cuticular papules did exist, which from some cause or other did not develop, but it may have been-probably was-in this way that the Miliaria originated. Quite an exceptional feature in this case, and one very rarely observed, was the entire absence of any affection of the throat. I examined her carefully, twice every day in a good light, and not even a trace of congestion was seen from first to last. An interesting question arises :. where are we to look for the source of infection ? The small-pox department is separated by a considerable interval from the general wards as well as from the houses about, in both of which places scarlatina is rife. If we are to suppose the Scarlatina poison to, withstand dilution to such a degree that it remains active after passing through the wide space which",
         "54 CANADA 3fEDICAL AND SURGICAL -ouBNAL. separates the Small-pox* hospital from the neighboring buildings, can we attribute a minor degree of vitality to the small-pox germs which must be wafted out of the ventilat- ing shafts in countless numbers to be distributed in the neighborhood ? Experience has taught us that we cannot. Another, and perhaps more likely, source of infection must not be overlooked. On the i1th and 12th ult., I attended for a confrer¢ a case of Scarlet fever in the immediate vicinity of the hospital, and on the evening of the 12th I went direct from the house to the hospital. At this period she was almost convalescent. The stage of incubation is so variously placed by different authors, ranging from three days to a month or more, that'this may have been an instance of pro- longation of the period of latency. With an impoverished condition of blood the Scarlet fever poison may not have met with sufficient quantity of that 'mysterious some- thing,\" different for each exanthem, upon which the germs are supposed to live, grow, and at last, happily, exhaust; and hence a lengthened period of incubation, with retardation of the eruption. Case of Multiloculat Ovarian Tumour.-Removal.-New Method of Ligaturing the Pedicle. By JoH11 BELL, A.M., M.D. On the 14th of june, I was requested by Madame M. to see ber daughter who was suffering from a tumour in the abdomen. I saw her the néxt day, and diagnosed the tumour to be ovarian and cystic in its nature and recom- mended its removal. The patient, a French Canadian, recently came up with ber family from Rivière du Loup, en bas. She is 21 years of age, single, of médium height, of well-developed figure and frame, with pale or rather sallow skin. Until' the last few days she had been able to.walk about with comparative comfort, but now she spends most of the time lying down. Her appetite has been habitually poor, and there were but",
         "MULTILOCULAR OVARIAN TUMo0U.-BY DR. BELL. few articles that she relished. Has suffered occasionally from vomiting. Her urine is not albuminous. At the request of the patient and family, Dr. G. W. Campbell kindly saw her in consultation with me on the 16th. After examination of the tumour he pronounced it to be of the above character arid probably unilocular from its globular form. Considering the extreme distension of the walls of the cyst, and the near approach of the hot summer weather, together with the otherwise favorable mature of the case, he advised its removal without un- necessary delay. The dangers of the operation and probabilities of suc- -cess were fairly stated to the patient, and after a week's consideration she consented to have the tumour removed on Saturday the 26th June as Dr. Campbell was going out of town for his summer vacation in the beginning of the following week, and she was anxious to have him present at the operation. On the 23rd Dr. Ross saw the patient with me and a careful examination of the tumour was made. The circum- ference of the abdomen at the umbilicus measured 39 inches. A line from the ensiform cartilage to the umbilicus mea- :sured 71 inches ; umbilicus to pubic crest 7 inches ; from umbilicus to right sup. spine ilii, 8- inches; umbilicus to left sup. spine ilii 9 inches. The outer side of the hips were marked by numerous linea albicantes, but there were none on the abdomen. The tumour is firm and globular, .being slightly more protuberant on the right side, and'rests across the brim of the pelvic canal, not descending into it. The cervix uteri is normal in size and position or perhaps a little higher in the pelvis than normal, and the sound shows the uterus to be of normal size, but with the fundus thrown somewhat to the left. The uterus is more fixed than ueual and can be moved farther. to the right than the left .side, from which it is surmised that the tumour is one of the right ovary. Fluctuation was indistinct in every part of ,he tumour but most -prceptible on the right side, which",
         "56 CANADA MEDICAL AND SURGICAL JOURNAL. Dr. Ross thought was due to the density of the cyst fluid and the presence of a large cyst on the right, with a mass of smaller cysts on the left or fiatter side of the abdomen. Percussion showed the intestines to be dis- placed chiefly to the left side, and the liver considerably upwards, the colon being resonant throughout. The anterior abdominal wall was freely movable over the sur- face of the tumour conveying a leathery creaking sensa- tion to the hand. The diagnosis was therefore that the the tumour was unattached by adhesions, multilocular and of the right ovary ; the cysts containing dense fluid and one on the right side being much larger than the others. The tumour was first noticed in December last (1874) as a small lump in the right inguinal region. It never caused any pain or discomfort except what arose'latterly from its size and weight. The patient has never enjoyed very robust health, but there is nothing peculiar in the history of the case that might point to the origin of the degeneration. Menstruation was at first regular; it then became sup- pressed for three months and has lately taken place every two weeks. /une 26tM. Operation at I A.M., in an airy room on the third flat of the patient's home, whicth is situated in a healthful locality, with numerous trees in the gardens and yards around. Present, Drs. G. W. Campbell, Hingston, Fenwick, Carlyle of Toronto, Craig, Ross, Roddick, Patton., Cameron and Mr. Stafford. Dr. Cameron of the General Hospital kindly gave chloroform, and continued the anæs- thesia with'ether, of which about a pound vas used. She took the anesthetic well, although at times she became rather weak. The bladder having been emptied with a catheter, an incision of four inches in length was made, in the median line through the skin, a thick layer of fat and the subjacent tissues down to the tumour whose walls were thick, tense and marked with very large veins. On introduc- ing the hand vhich was done with difficulty, no adhesions were found, and the fundus uteri could be felt to the front",
         "MULTILocCLAR OVARIAN TUMOUR.-BY DR. BELL. 57 and left side of the tumour whose pedicle was tightly drawrr across its front surface and attached to its right side, thus causing the pedicle to be long and thin. The tumour had evidently been rotated by the filling of the larger cysts changing its shape. The patient was turned on her right side, with the pelvis facing downwards,- and one of the Spencer Wells'. large Canula Trocars, with rubber tube attached, was introduced into the tumour. Only a small quantity of thick, viscid, greyish, flocculent fluid appeared. By repeatedly pushing the cutting part of the instrument, further in different directions some pints of this fluid flowed out. A small luantity of blood appeared in the fluid as the wall of each new cyst was entered.- The walls of the abdo- men being now closely held against the tumour, a tenacu- lum forceps was fixed in the cyst at each end of the abdom- inal- wound, and an incision made between them into the tumour. The incision was carried through a considerable thickness of small cells before the larger cyst at the right was reached. The hand «was now introduced to break up the remaining cysts, some of -which protruded into the cavity vacated, and seemed to be arranged concentrically inside one another. All the cysts contained the same kind of fluid, and as it gradually poured out the sac was gently drawn down until the mass passed out through the wound. The pedicle vas long, thin, and about three inches broad, the lower border containing a number of enlarged vessels, A ligature of Prof. Lister's No. 3, carbolized catgut doubled, was applied about midway between the tumour and the úterus, in the following manner, which is like the ordi- nary lock-stitch of a sewing machine. The double catgut was drawn through the eye of an aneurism needle to near· the middle of the ligature. The blunt point of the needle was passed through the pedicle, about three quarters of an inch from its lower border, and then withdrawn along the longer end of the ligature, leaving a loop of the catgut on the opposite side. The shorter end of the ligature was brought round and passed through this, and the loops sub-",
         "58 CANADA MEDICAL AND SURGICAL JOURNAL. sequently made. The aneurism needle, still armed with the longer end of the ligature, was again passed through the pedicle about j of an inch from the first loop and again withdrawn along the longer end ôf the ligature, leaving a second loop, through which the shorter end of the ligature -was continued. In the same. manner a third loop was made and the needle slipped off the ligature, whose ends were now tightly drawn and tied over the upper border of the pedicle. By this method the four divisions of the pedicle were not only tightly ligatured individually, but were also so forcibly pressed together collectively, that, had any of the vessels been wounded in passing the needle through, all risk of bleeding, from the punctures was removed. The ends of the ligature were-again tied round the whole cir- -cumference of the pedicle,. folding it up in its grasp. The pedicle was sévered:close to the ligature, as there was no danger of the latter silipping.. The gaping ends of the enlarged vessels showed no sign of bleeding. One of2 the largest arteries was, however, secured with fine .catgut in the end of the stump as a matter of precaution, and, the ends of the- ligature cut ofl short. The circumfer- ence of the .pedicle compressed by the ligature was not greater than, one's thumb. The now retracted uterine end of the pedicle, was dropped into the abdomen, and a very small quantity of coloured fluid, brought to the wound- by pressing, the abdominal walls, was removed. with a carbol- ized sponge.- The left o#ary was healthy. The wound was closed by four deep. carbolized catgut. sutures, each includ- ing- about half an inch of péritoneum on either side of the incision. Superficial sutures of smaller catgut, between the ,deeper ones,- coipleted the perfect co-aptation of the edges",
         "MULTILOCULAR OVARIAN TUMOUR.-BY DR. BELL. 59 of the incision. The wound was dressed with dry cotton wool, previously prepared by pressing it out of an alcoholic solution of carbolic acid, with a. broad flannel bandage encircling the body. On being rèmoved to bed she was restless for a while, eructating occasionally froni the effect of the ether, and when awake she expressed herself as \"mal, mais pas de douleur.\" A teaspoonful of brandy and water was given her, but it caused pain to swallow. In half an hour 30 drops each of laudanum, and solution of morphia, were given as an enema,and almost immediately she fell asleep for an hour. After being aw'ake for a short time she again fell asleep, and had been sleeping soundly, on her\\jght side, for some time before I left at 3. 15, P.M. 26th, P..-Pulse 124; Temperature, 102.3. Patient slept for some time after I left. Had taken some beef-tea, but had vomited, or eructated it several times. Gave five drops of chlorodyne (Browne's) in a little brandy and lime water. To be repeated if required.; 12 P.M., (Midnight). Pulse, 132 ; Resp. 31 ; Temperature, 1ò2. Had vomited a mouthful of beef-tea twice. Slept several times. Some eructation. Perspiring freely. Talks and laughs. Has no pain; feels \" bien, mais faible.\" Takes ice, milk limewater and brandy in small quantities. 8 oz. dark urine -of slightly ammoniacal odour removed by catheter. 27th. 10.30 A.m.-Pulse, 12ò ; Resp. 40; Temperature, 101.7. Slept nearly all night in short intervals. -Perspired freely.' Vomited three times, the last bilious. Tongue clean. No tympanites.. No headache. Pupils slightly côntracted, as she hàd taken-:5 drops of chlorodyne since the ôperation. Has had altogether about à ttmblerful of milk, beef-tea and limewatêr, with three teaspoonsful of brandy since last visit. 6 oz. dark urine, of a normal odour, removed. To hâve champagne ii small quantities. r P.M. Pulse, 132 ; Resp. 4o-; Temp. 103.3. Has tiot vomited since. Perspired. Feels occasirial \"coups de",
         "OU CANADA MEDICAL AND SURGICAL JOURNAL. douleur \" in the wound. Has slight sore throat. To have m j Fleming's Tr. Aconite every hour, until further orders, with spirits and water to moisten tlie head, as the weather bas been very warm and \" close,\"-the temperature in the shade being 84, Fahr. Her urine was removed regularly three times a day, and measured from 4 to 6 ounces each time. 12, P.M.-Pulse, 120; Resp. 35; Temperature 102. The head to be sponged with spirits and water, as she finds the warm still air very oppressive. 28th, 8.30 A.i.-Pulse, 118; Resp. 35; Temp. 102.7. Slept nearly all night-awaking only at intervals. No pain. Ppils slightly contracted. Vomited twice. Abdomen commencing to be tympanitic. 6 oz. dark urine, of normal odour. Examined the wound and found the dressing dry and only stained along the -line of the incision, which is apparently perfectly heýaled throughout. To continue acon- ite and be sponged occasionally. 6, P.M. Pulse, 114; Resp. 30; Temp. 102.7. Has passed a small quantity.of flatus per anum three times. Vomited (five times, rather freely-ejected matter coloured with bile.) Has occasional shooting pain in belly. Face flushed Pupils normal. I. P.M.-Pulse 124; Temp. 102.8. Dr. Gardner saw her with me at this visit. Vomited a little. Considerably more tympanites. 4 oz. dark urine. On introducing the finger per anum, the rectum was felt above distended with wind, which seemed to be retained by a flexion of the bowel. Given enema Tr. Opii 3j. Essent. menth. pip. 3 ss; aq. 3ij. To be sponged every three hours. 29th, (Tuesday) 9 a.m.-Pulse, 114; Resp. 25; Temp. 102.3. Slept from 12.30, and from that to 5 without inter- ruption, Feels refreshed and \" bien\" without qualification. 6 oz. urine. 11, P.M.-Pulse, 128; Resp. 26; Temperature. 103. Dr. Fenwick saw the patient with ine at this visit. Face flushed. Sore throat gone. Slight sanious discharge from",
         "MULTILOCULAR OVARIAN TUMOUR.-BY DR. BELL. the lower end of thc wo\u003eUnd. Two broad strips of plaster a yard in length, were applied across the wound, and'around the body for support, in addition to the cotton and flannel. 5 oz.- of urine. 6 ,M.-Pulse, 140;\u003e Respirations, 29; Temip. 102.7. Vomited twice. -Pupils someivhat contracted. 11, r.,iý.-Word was sent that patient was worse, as her hands were coli. Dr. Fenwick kindly accompanied me, as I feared lest hæmorrhage might be taking place. The patient was found to be warm, of good colour and per- spiring freely, so that the breeze through the rooms had cooled her hands, which were however of good color. Pulse, '140; Respirations, 28 : Temperature, 104.4. Has no pain Tympanites moderate. Urine nearly 4 oz. To continue, chicken broth with brandy and water as she finds these agree best with her. Gave as an enema a small teaspoonful of laudanum with ess. peppermint and water. 3oth, [Wednesday].- During the night she slept and 'waked at intervals, with mild delirium, imagining she was -driving in a carriage, or that it snowed, \u0026c. She died at 5.30 A.M., quietly, as her friends expressed it, \"like the going out of a candle.\" Post mortem examination 12 hours after death. Rigor mortis well marked, Surface pale. Abdomen -moderately distended with flatus. A sanious discharge could be pressed from the wound in places. Sutures still holding firmly.. The whole anterior abdominal walI was reflected by two incisions ; one across the lower part of the abdomen, and another at right angles to its right extremity, thus exposing the wound in the peritoneum without disturb- ing -the sutures. The edges of the peritoneum were well and evenly brougbt together, although one of the sutures -should have been drawn a little tighter. The edges of the wound were united throughout their entire extent, with the -exception of a channel at its lower end, and small areas here ,and there which were moistened with a sanious fluid. The intestines were-distended with gas, and the sulci and angles",
         "62 CANADA MEDICAL AND SURGICAL JOURÑAL. between them , everywhere contained firm, pale-yellow lymph. The peritoneum was not congested. There was a small quantity [4 oz. ] of reddish-grey, semi-transparent serumin the bell7. On pushing aside the intestines lymph was found deposited over the peritoneum, especially in the neighbourhood of the ligated pedicle, which was resting on the brim of the pelvis, The stump in retracting had drawn the firmly tied ligature into a hollow which was so com- pletely filled in with firm lymph, that only a part of one of the knots could be seen. Dr. Fenwick has had a wood-cut of this part prepared from a drawing by my friend Dr. Arthur A. Browne, which shows the masses of lymph raised to give a view of the ligatures. The ligature had not moved in the least degree, nor had a drop of blood passed it. Notes of examination of tumour, by Dr. Cameron. Tumour symmetrical in form, an elliptical space denuded of peritoneum (which has retracted) marks the line of attachment of the pedicle. No signs of adhesions. The veins running across the tumour are very large. The walls of the tumour are composed of multiple cysts, from the size of . pea to that of an orange. These small cysts in the walls are most numerous in the right half of the tumour. The walls are in some places very thin. The body of the tumour consisted of four large cysts ; the two largest were on the right and were evacuated during the operation. The longest circumferezce of the tumour is 24k inches; the shortest 18. inches. The longest diameter is 9î inches. The shortest, 6k inches. 1. Beaver Hall Terrace, July 23rd, 1875.",
         "HOSPITAL REPORTS. MEDICAL AND SURGICAL CASES OCCURRING IN THE PRACTICE OF THE: MONTREAL GENERAL HOSPITAL. CASES UNDER THE CARE OF 'DR. D. C. MACCALLU.- Reported by JAs. C. CAMERON, M.D., House Surgeon, Montreal General Hospital. From the numerous carefully reported cases of Dr. MacCallum's Ward Clerks, I have arranged the following brief notes: Case i-Colica Pictonum.-Reported by Mr. C. S. Stroud. J. B., æt. 41 years, was admitted into Dr. MacCallum's wards June 4, 1875, complaining of constipation and severe- abdominal pains. Patient bas always been a strong healthy man of sober industrious habits; has never worked among paints or lead. He states that for three weeks previous to admission, he bas been in the habit of indulging very freely in some excellent-tasting cider, sold by a certain saloon- keeper in the Eastern part of the city. He used to take sometines as many as fifteen glasses a day. One week after he had begun to drink the cider so freely, he complained of griping pains in the abdomen, followed shortly by nausea and loss of appetite, and by irregular alternations of fever and cold clammy perspirations. His bowelsý became con- stipated, the fœces being scanty, dry, hard and of a dark color. His gums became swollen and tender, he complained of a, peculiar taste in bis mouth, and was troubled with frequent epistaxis. Upon admisssion the blue line around the edges of the gums was very well marked, the expression of countenance anxious, the skin dull, dirty and, cadaverous, the abdomen considerably contracted. He suffered from pain in the back, retraction of the abdomen, and twisting or grinding pains of great severity around the navel. After the administra- tion of several purgatives, bis bowels were freely opened,",
         ",6 CANADA MEDICAL AND CURGICAL JOURNAL. and on the 7th, he was pût upon five grain doses of the Iodide of Potassium, three times daily. The symptoms gradually disappearcd, so that on the 14th he was discharged from Hospital. His urine was examined by Dr. Girdwood, but no trace of lead could be discovered., Upon enquiring into the cause of the lead poisoning, it was ascertained that the cider was pumped up through a leaden pipe. Several of his companions who partook of the same cider complained of similar symptoms ; one of them who came to visit the patient had also a well-marked blue line around the gums, but the other symtoms were not so urgent, for he had drunk much less of the cider. Case 2-Aortic Vulvular Disease..-The notes of this case were taken by Mr. R. McDONNELL. J. L.. Ot. 40., was admitted into Dr. McCallum's wards May 30, 1875, suffering frompalpitation and great dyspnoea. The patient was treated in the Autumn of 1873 by Drs. Wright and Ross for Double Aneurism, Popliteal.in the left leg, and femnora-poplileal in. the rig-lt. After the failure of Digital Compression and Flexion, instrume-ntal compress- ion was tried, as a dernier resort; Carte's and Skey's tou r niquets were applied and the man-instructed how to manage them himself. Eventually the instrumental compression was successful and both aneurisms were completely cured. The full report of the case. can be seen in the number of the CANADA MEDICAL.AND SURGICAL JOURNAL for January, 1874. Since he was discharged from the hospital in 1874 he has been employed in a warehouse. Soon after commenc- ing work he began to feel severe, paroxysmal pains in the lumbar region, accompanied by unusual pulsation of the ·arteries, especially the Abdominal Aorta. Severe cramp and'spasmodic contraction of- the lower extremities were occasionally feit. During the winter ie was unable to do any hard work, or to remain out of doors on a very cold day. His appetite has been decreasing, and he has -lost weight rapidly. On admission his expression vasanxious,",
         "I OSPITAL REPORTS. extremities livid, tongue dry and coated with a white fur. pulsé, 80 ; hard, strong and inelastic. He complains of great dyspnoea; his most comfortable position is on the right side with the knees drawn up. The pulsations of the superficial arteries on each side of the body are quite synchronous. The heart's actidn is violent; the apex beat is displaced somewhat downwards and outwards. The area of cardiac dullness is -increased one inch to the left side. Auscultation reveals the physical signs of obstructive and regurgitant aortic disease. At the base of the heart a loud louble bellows murmur is heard ; the systolic bruit being propagated up tre aôrta to the carotids, while the diastolic is transmitted downwards to the ensiform cartilage. This latter phenomenon is due, as was first pointed out by Dr. MacCallum, to the propagation of the sound, produced by the regurgitating blood at the patent aortic orifice down along the septum ventriculorum to the right apex. Both murmurs can be heard somewhat indistinctly behind, at the lower angle of the left scapula. No signs of abdom- inal aneurism could be made out. Femoral artery at the seat of the old aneurism, feels like a hard thick cord, while the popliteal enlargement is barely perceptible. He was put on a mixture of digitalis and iron, and improved so much that he was allowed to leave the hospital on the 6th of June. About a week afterwards while working for the Cor- poration on Mountain street, he suddenly dropped dead. A Coroner's inquest was held, and a verdict of \"Died from Disease of the Heart\" was returned. The heart and the old aneurisms which would have been of such interest as pathological specimens were thus unavoidably lost to the profession. Case 3.-Peculiar Case of Rheumatismi.-The notes of this case were taken by Mr. W. CROTHERS. A. G., æt. 21, laborer, was admitted on the 4th of May, complaining of slight pain in his side, and of general debility. 5",
         "66 CANADA MEDICAL AND SURGICAL JOURNAL. Upon examination no abnormal sounds were heard in the lungs. A coarse blowing systolic murmur was made out, most distinct at the left apex, and transmitted around the left side to the lower angle of the scapula and the left intervertebral groove. By 'palpation a very distinct thrill could be felt over the apex, synchronous with the first sound, heart's action was intensified. The pulse was 8o, small and somewhat feeble. No redness, pain, swelling or tender- ness on pressure, could be discovered in any of the joints.. Tongue was coated with a white fur. The saliva was acid. The urine was acid and contained no albumen. Upon enquiring into his history, it was ascertained that he suffered' from a mild attack of inflammatory rheumatism two years. previously. Could not tell whether his heart had been affected, as he had not been attended by a medical man. The present illness had begun with a chili two days before admission, followed by slight fever and a feeling of lassitude and prostration. From the peculiar symptoms, Dr. Mac- Callum considered the case to be one of acute rheumatism in which the very unusual phenomenon had occurred, of the heart being affected before the joints had become swollen and painful. Upon this supposition he was ordered half dram doses of Potas. Bicarb., every four hours, and a blister was applied over the procordial region. After a day or two his knees became tender and swollen,. and shortly afterwards'his wrists. Under treatment, how- however, the pains disappeared, the secretions became alkaline, and the heart murmur softer. So that on the i5th of May he was discharged quite well. No murnur being perceptible. During Dr. MacCalum's quarter there have been a great many cases of: rheumatism, many of them being very se- vere and conplicated with heart affections. The treatment that seemed to secure the most favorable results, was a 0'mbinafi6n 'of alkàies and blisters. At' thé outset pot. bicarb. w'as -iescribed in thirty to forty grain doses every three hours, till the secretion ceased to be acid, when;",
         "HOSPITAL REPORTS. iron and quinine werc generally substituted for the alkalies, Digitalis being added to the iron if any heart complication existed. Locally, blisters from one to two inches in width were applied, encircling the limb a little above the painfnl joints. The relief from the blisters was most marked, the patients very frequently asking for a blister when a fresh joint was . becoming painful. Fuller's alkaline wash vas tried in two cases, but the results were quite unsatisfactory and blisters had finally to be resorted to. The average duration of treatment was twenty-one days, the longest being five weeks. The early exhibition of alkalies failed in many cases to ward off the complications; in two instances, although alkalies had been pushed from the outset, a severe attack of pericarditis supervened; and in. several other cases,, an endocardial murmur was produced. All the cases made a good recovery. Excision of Einlarged Glands in Azilla, By GEo. E. FENwICIK, M.D. Reported by J. D. CLINE, B.A., M.D., Assistant House Surgeon, Montreal General Hospital. E. W., æt. 20, was admitted into hospital on the 26th of June, under the care of Dr. Fenwick. She was a well made healthy-looking country girl. Says she was never considered delicate. Family history good. About two years ago the lymphatic glands in the left axilla began to to enlarge without, however, any deterioration to her general health. There is no history nor suspicion of syphilitic taint. Lately these glandular tumors were becoming so large as to interfere with the usefulness of the left arm.- There was no pain in them. On her admission into Hospital, Dr. Fenwick observed that he did not believe that consti- tutional treatment would have any marked effect in reduc- ing the size of these glands or occasioning their absorption. That:these tumours were usually met within young women, and th.at if left alone they sometimes grew to a large size. In this.case several of the glands were enlarged and could",
         "CANADA 3IEDICAL AND SURG1CAL JOURNAL. with ease be removed by enucleation ; they were perfectly free having no firm attachments, and that he considered it advisable to remove them without dela v. The glands in the right axilla were larger than usual in that region, but there was no evidence of general glandular enlargement. On the 28th of June, the patient Wvas put upon the operating table and chloroform administered. An incision about four inches long was made down the centre of the axillary space. The operator as he came to each enlarged gland seized it, and cutting through the cellular tissue as far as the investment of the gland, readily enucleated it. Fourteen in all were removed, varying in size froin that of a large bean to that of a turkey's egg. There was no hænorrhage. The wound was closed by a continuous suture of carbolized catgut and through the opening at the lower part of the wound a piece of drainage tube was left protruding, being retained in its place by a strip of adhesive plaster. The night after the operation there was a little fever, the temperature rising to about 1oo°, this disappeared next day, after which there was no further constitutional disturbance. The whole incision healed by primary union except the lower part through which the drainage-tube pro- truded. This was gradually pushed out by granulation of the deep part of the wound, and in six days the girl was sent home having only a superficial granulating spot at the lower end of the wound. The dressing throughout was a very dilute solution of carbolic acid. The catgut suture was not removed at all. It produced no irritation whatever. Wound opening thie Knee-joint. Successful Result. Under cire of Dr. FENWICK. Reported by J. D. CLINE,.B.A., M.D., Assistant House-Surgeon, Montreal General Hospital. Wounds opening into the joints are generally of sufficient gravity to give the practical surgeon much urieasiness as to the ultimate result. When a larger and important joint is opened there is great danger of loss of the limb if not of the life of the patient through the constitutional disturbance",
         "HOSPITAL REPORTS. which frequently follows. Accidents of this nature occuring to an adult are almost invariably destructive in their ten- dency. Occasionally in children and young adults injuries to large joints, in which their cavity has been laid open have been recovered Irom. This favourable result may however be regarded as exceptional. Accidents of this nature are fortunately not often met with and the import- ance of the subject is such as to warrant the publication of the following case. G. C. act. 14 was admitted into hospital on the 24th of June. Three weeks before this while standing near a man who was using an axe, the handle of the axe broke and the axe hitting him on the outside of the right knee made a cut about three inches long under the patella laying open the joint. The edges of the wound were stitched together and dressed with plaister. The wound healed in a week when he went about, the leg being stiff but not painful. After he had been going about for a week, on Saturday night he had a very severe chill and next morning the joint was very pain- fui and much swollen. A poultice was applied and on Monday morning the wound opened again. On the follow- ing Thurs2ay, the 24th of June, he came into the city to the hospital. The condition of the joint at this time was as follows :-It was swollen, hot and painful : on the outside of the joint was a wound two inches long, part of it being united, through which drained away a copious discharge of purulent synovia which became coagulated around the edges of the wound. Through the centre of this a probe could be passed into the joint. The limb was immediately put on a MacIntyre splint, and linseed poultice applied. The discharge was very profuse for some days, but in a week it became much less, and the pain disappeared. Now the poultice was changed for a simple dressing of carbolic lotion. The discharge changed in character and became more like natural synovia and in two days it ceased entirely. July 15th. The patient has been now three weeks in hospital and the condition of the joint is as follows :-",
         "70 CANADA MEDICAL AND SURGICAL JOURNAL. The external wound is almost healed; there is no pain; patient can move the joint without pain; there is no rough- ness on movement of the leg,; the patella is moveable yet when moved it communicates the sensation of thickening of the synovial membrane; there is visible and palpaple enlargement of the whole joint. The joint is still fixed on the splint. July 24th. The splint was to-day removed and a glue ban- dage substituted. The boy could flex the leg almost per- fectly. He is now going about with the bandage. He can bear the weight of his body on the right heel and has no pain whatever in the joint. Primna\u003e)y Hunterian Sore on lower eyelid, wder care of GEO. E. FRNWICK, M.D. Reported by J. D. CLINE, B.A., M.D., Assistant House Surgeon, M. G. H. N. M., a Dane, Ot. 44, was admitted into Hosipital on the 7th of July. His right eye and cheek were very much inflamed, and on the palpebral margen of the lower lid was a sore about the size of a spilit bean, vith prominznt edges, and well marked cartilaginous induration of the edges and base. There was a sinilar sore at the inner canthus. His eye had been sore ie said for three weeks. He attributed it to exposure to sun and wind. The patient had been a farm labourer. There was a large indurated gland at the angle of the face, and a éhain of simaller ones down the right side of the neck, below the mastoid process. On his admission there was applied to the side of his face lead lotion, which removed the erysipelatous readness of .the cheek ; but the sores 'vere spreading. July 9th. Touched the sores with strong nitric acid. July i2th. As the sores did not tend to heal, Dr. Fenwick put him on constitutional treatment, odering: \u0026 Hyd. Bichlor.gr. i.; Potass Iod. 3 i.; Ext. Sarzaæ fld. i.; Aquæ ad. 3 vi.",
         "REVIEwS AND NOTICES OF BOOKS. Of which a tablespoonful was taken three times a day. ,On the same day the sores were again cauterized with nitric acid. From this day the sores began to improve, and by the 24th the large sore was reduced to the size of half a split pea; the induration was disappearing, and also the enlargement of the glands. As the man was anxious to return to work lie was discharged but ordered to continue the medicine. It was impossible to ascertain what had been the direct source of contagion. I omitted to remark that he had no sore any- where else on his body. He had been sleeping with a fellow labourer, a young man, and using the same towels, but he did not know whether this young man was diseased or not, He had never suffered from anything of the kind before the present sore made its appearance. From the peculiar nature of the sore, its firm hard car- tilaginous base, the scanty secretion, absenee of pain and the induraticn of the lymphatics at the back of the neck; and furthermore its rapid improvement, under constitution- al treatment, their can be no doubt that the case, however -singular its situation, is one of primary syphilitie origin. ComIpenzditm of CiIdrens' I)iseases; A Handbook for Practitioners and Students ; by Dr. JOHANN, STEJNER. Translated from the second German edition by LAWSON TAIT, F.R.C.S.-Svo. pp. 403: New York, D. APPLETON \u0026 Co. The rapidity with which the first edition of this admirable work was exhausted testifies to the estimation in wbich it was, held by the profession generally. In Germany a second edition was called for, and Mr. Lawson Tait has embodied in his translation the. additions and corrections which appeared in the revised edition. The first division of the book,'treats of the investigation",
         "72 CANADA MEDICAL AND SURGICAL JOURNAL. of disease in infants and young children, and is systematic, and practical. The second division is concerned with disrâses of the- nervous system, and this extensive subject is treated of* concisely and clearly. In the-subsequent divisions are taken up the diseases of- the organs of respiration, circulation, and digestion ; of the- urinary and sexual organs ; general diseases of nutrition, zymotic diseases, and diseases of the skin. The chapter upon diseases of the nervous system: and digestion, are very good, and·before treating of the diseases of the digestive organs, the author makes some prelimiuary observations upon the nourishment of children. In Epilepsy, in those cases in which the cause cannot be discovered and removed, a favourable result from the ad- ministration of any drug can scarcely be expected.-He has. tried atropine in these cases but without anv good effect, and he considers it, even in minute doses, an unsafe remedy for. children.-Potassium Bromide has given negative re- sults in his hands, except weakening and diminishing the- paroxysms in some cases, after large doses had been givén and a degree of saturation of-the 'system attained. It has- never effected a permanent cur'e in bis experience.. In exudative -croup, tracheotomy is advocated, and, ac- cording to the statistics of the operation at the Children's. Hospital at Prague, 34-6 per cent. of these cases have been saved by this means. - Mr. Lawson Tait, gives some valuable directions for the after treatment of cases of trache- otomy, drawn from his own large and varied experience. Tife chapter upon diseases* of the urinary and sexual organs is very complete, and carefully written, as are also. the remaining chapters on general diseases of nutrition zymotic diseases, and diseases of the skin. At the end of the book is an Appendix containing rules for the management of infants, which have been issued by the staff of the Èirmingham sick children's Hospital, and",
         "LITIIOTRITY-RESULTS OF-BY SIR H. THOMPSON, which we could wish that every mother in our land not only knew by heart but faithfully carried out. We are sure that this book will be found a very useful one by .many practitioners ;. it is written in a concise and clear style, its only defect to our mind being a profusion of sesquipedalia verba.-The translator has done his work faithfully and efficiently, and Messrs Appleton have pre-- sented it to the profession on this side of the water in a cre- ditable form, although unfortunately there are some typo- graphical errors, and at the foot of page 402 we are sudden- ly lost, the paragraph as it stands, being unfinished. Have we received by error an incorniplete copy of the book ? SURGERY. An Inqueiry into the Condition of Fifty-one cases of Litho- trity in Elderly Adulis, Made at Periods of One» r Two- Years After Operation. By Sir HENRY THoMrPsoN, Surgeon Extraordinary to H. M. the King of the Bel- gians ; Emeritu' Professor of Clinical Surgery in Uni- versity College; Late Surgeon to the Hospital. In the Lancet of April -rd I reported the results of My last ioo stone operations (lithotomy and lithotrity) on adult patients averaging 63-- years of age, amongst whorn there- were 6 deaths, and consequently 94 recoveries. Mr. Thomas Smith made an enquiry in the following number of the journal relative to the condition of the patients on whom lithtrity'had been performed, at any period not less than twelve months after the procedure, with the\"view of ascer- taining whether the results of that operation were per- manent. Such an investigation I thought desirable, and. promised to make it ; for although the general results must be well known to myself, I had never applied an exact or numerical.test in order to determine them. I have therefore sought, by writing and personal inter-",
         "74 CANADA MEDICAL AND SURGICAL JOURNAL. -views, to obtain information of the present state in all those -cases of this series in vhich the operation of lithotrity was performed more than twelve months ago-that is between December, 1872, when it commenced, and May, 1874. Con- sequently the time after operation is. much longer than that which Mr. Smith suggested, for while the last case was treated fully twelve months ago, more than two years and .a quarter have passed since the first of the series was ope- rated on. I find that between the dates named-a period of about -seventeen months-I performed lithotrity on 53 patients, of whom two died, leaving 51 cases of recovery.' The mean interval betwen the date of operation and the present re- port of condition, for these 5 I cases which are the subject of inquiry, is, therefore, about twenty months instead of \" one year.\" An examination of these cases, given in a tabular form below, shows that respecting six patients I have been unable to obtain the information required; but the weight ,of such evidence as exists relative to these is greatly in favour of their being better and not worse than the average, since their mean age is only fifty-four years, nearly ten less than the mean of the whole series. As I am compelled to omit these from my reckoning, I believe that my report is less favourable to lithotrity than it ought to be. The number of individuals, then, of whom I have precise information is 45, averaging about sixty-four years of age Of these, ii have since died. The causes, certified by their medical attendants were-2 of organic heart disease; i of malignant disease ; i, at eighty, of natural decay ; the other 6 of urinary disorders and advanced age together (the mean age being sixty-six years). All but one of these latter were individuals who for several years had passed no urine except by catheter, who owed their lives solely to surgical art, and -who without it must have died miserably some years before. The prolongation of life had been entirely due to the im- proved modern means of mechanically removing retained airine and accumulated phosphatic deposits. Of the 45, 34",
         "LITHOTRITY-RESULTs OF-BY SIR H. THOMPSON. are living still ; 28 of them enjoying good health and active existence, at a mean of sixty-three and a half years of age. The other 6 have some signs of recurring calculus, 2 having had a newly formed calculus removed; all are well but one of these, who is in bad health and suffers much. I think I may leave these figîires to speak for themselves. I shall make one.observation, however, which, although a very natural one, does appear not to receive the considera- tion which I think it deserves. Supposing' that these 53 cases of lithotrity (including 2 deaths with 5 1 recoveries) had been cut instead of crushed, how many fatal cases would have followed the operation ? Their average age being sixty-three, 14 deaths would not have been a bad result, somewhat better than published tables offer us.* But after these operations, mainly done in 1873, only ii deaths have since occurred up to the present date. And even if we were to reckon all these as deaths resulting from the operation, althugh as may be seen below, they were quite uncon- nected with it, we still should have a total of recoveries larger than after lithotomy. There is, however, much reason to believe that the few examples of chronic cystitis with re- curring phosphatic deposits, subsequent to lithotrity, occur generally in those.feeble and diseased persons to whom litho- tomy.is most commonly fatal. The fact is, that almost all those patients vhose subsequent troubles remain, and who to superficial observers, appear to discreditilithotrity, do in reality owe theirexistence to the operation, and are trophies of life absolutely saved by it. Thus it is that lithotrity, as I have observed, has created a new set of cases-men who, until the process was brought pretty nearly to its present perfection, never lived. Re- specting them I should like to .write the results of, my ex- perience, and hope ere long to do so. They are men whom lithotrity keeps alive-who, thanks to the ease and safety I may refer to my own table of 1827 cases, collected with great care, among othersf as suppor-ng this view. c Lithotomy and Lithotrity,\" 2nd ,edit., p. 142.",
         "7G CANADA MEDICAL AND SURGICAL JOURNAL. with which a small and newly formed phosphatic calculus can be crushed, go on for years to live and even to be active. These cases have to be kept apartfron other caseýs of stone, because it would invalidate any inference from numerical statements were à surgeon to reckon as a \" case of lithotrity- each time, perhaps twice a year or more, he removed a cal- culus from such a patient, although it might not' always necessarily be very small. But it is not to be forgotten that before the time of lithotrity there was no adequate help for such a patient except by the cutting operation, and many such died miserably with bladders filled with phos- phatic material. I am very glad to have made this inquiry, although it has entailed no little pains and labour ; since I venture to hope that it may proveto be, not merely a ne«r,-but also-a useful contribution to our knowledge respecting lithotrity. i. A gentleman aged thirty-six; operation, Nov. 1872; uric-acid calculus. I have no knowledge of the address. He made an excellent recovery ; and I should, at his age have probably heard more of him if his health had not con- tinued good. 2. A gentleman aged seventy-five ; operation, Dec. 1872; phosphatic-calculus. In May, 1875, Mr. Gardner, of Glou- cester-terrace, reports to me this patient in his usual health. 3. A gentleman aged sixty-nine ; operation, Jan. 1873 uric-acid caléuli. This patient who was under the care of Mr. Newton of Upper Wimpole-street, writes me (June, 1875): \"I am in perfectly good health, and have no uneasi- ness or feelings that lead me to suppose I have any stone in my bladder now.\" 4.. A gentleman aged sixty-five ; operation, Jan. 1873; phosphatic clculus. Mr.J. H. Bartlett, of Notting-hill, writes me that this patient had no further symptoms of cal- culus, and that he died of heart disease three months after. 5. A gentleman aged sixty-eight : operation, Jan. 1873. This gentleman had for many years passed all his water by catheter. His life had been prolonged, with very advanced",
         "LITIIOTRITY-RESULTS OE-BY SIR Il. THoGM1PSON. 77 prostatic disease, by great care and frequent removals of phosphates as they formed. He died, his urinary organs being. quite worn out, with extensive sacculation of kidneys and ureters, 'in December-of the same year. '6. A: gentleman aged fifty-one ; operation, .Feb. 1873i uric-acid calculus. . Mr. Allen, of Milner-squaxe, Islington, writes me (May, .1875) that-this patient is'perfectly well. 7. A gentleman aged thirty-six ; operation, Feb. 1873; uric-acid calculus. * No. return, and is perfectly free from symptoms at present. 8. A gentleman- aged sixty-four-; operation, Feb. 1873; phosphatic calculrs. This patient had always passed all his urine by catheter. He had no return.of his stone. -He became insane, and used the instrument very carelessly. In January, 1875, I was called to see him with severe extra- vasation of urine, resulting from injury, of which he shortly after died. I saw him with my friend. Dr. Murchison. 9. A gentleman aged sixty; operation, Feb.-March, 1873 ; phosphatic calculus. I heard from this gentleman a few days ago (May 1875). He is in excellent health, and is leading a very active life. 1o. A gentleman aged sixty; operation, March, 1873; uric-acid calculus. Dr. Manson, of Chesterfield, writes me (June, 1875) that this patient \"remained quite free from .any symptoms of recurrent calculus to the day of his death, which resulted from typhoid feverin December, 1873. He was perfectly satisfied with the result of the operation.\" 11. W. C--, aged sixty-seven; operation, March, 1873,; uric acid; treated at University College Hospital For many years lie has passed small uric-acid calculi ; and, having recently had one in his bladder which he was unable to expel, it has been successfully crushed for him in the country. 12. A gentleman aged seventy-one ; operation, April, 1873. Writes me (May, 1875) that he continues quite well. 13. A gentleman aged sixty-seven ; operation, April, 1873; uric acid. Recently seen by myself, he is perform-",
         "78 CANADA MEDICAL AND SURGICAL JOURNAL. ing his duty as a member of Parliament, and enjoys excel- lent health and strength. 14. A gentleman aged sixty-one; operation, April, 1873. I have just seen him. He is in perfect condition as regards his bladder. His stone was a large uric-acid formation. His medical attendant, Mr. Leppington, of Great Grimsby, writes me that \" he has had no symptoms of any return of vesical mischief.\" 15. A gentleman aged fifty-nine ; operation, April, 1873 ; oxalate-of-lime calculus. He was quite well six months ago, but I have not got his address, and have failed to find him. 16. A gentleman aged seventy-nine; operation, April, 1873 ; uric acid. Had no return of his calculus, and died about a year afterwards of some other malady, apparently from natural decay. 17. W. B. H.- Aged sixty-three; operation, May, 1873 ; uric acid. Treated in UniversityCollege Hospital successfully, and his present address and condition are un-. known. 18. A gentleman aged sixty-seven.; operation, May-June, 1873 ; large phosphatic stone. Writes me, (May, 1875,) that he is perfectly well, and better in health than for many years. 19, A gentleman aged sixty; operation, May-June, 1873. large uric-acid calculus.. Dr. Evan Jones, of Aberdare, writes to informîme that the patient had rigors in -Septem- ber, and signs of blood-poisoning ; no abscesses ; and died. comatose Oct. 23rd. He had left me in fair condition at the end of June,:with some suspicion that the kidneys were- not sound. 20. J. W. -(University College Hospital,) .aged fifty- four; operation, June,11873 ; phosphatic calculus. Has long passed all his urine by catheter. Having just written to ask how he goes on, he replies-that he was quite well for a long time after operation, but he begins to, have signs of some phosphatic formation and wishes soon to be examined. 21. J. W.- ,aged thirty-six; operation, June,, 1873 ;",
         "LITHOTRITY-RESULTS OF-BY SIR H. TJOMPSON. 79 uric-acid calculus. Treated successfully in Universit 1- lege Hospital, and his- present address and condition e unknown. 22. A gentleman from the Brazils, aged fifty-six; opéra- tion, June and July, 1873 , very large phosphatic calculus. One of the most formidable cases I ever had. He made a most excellent r.ecovery, always, as before the operation, passing all his urine by catheter. He came to me last sum- mer (two -years after operation), and I removed a small phosphatic formation which had been developed, and he left me as well as ever. 23. A gentlernan aged forty-one; operation, July, 1873. I have just seen this patient ; he has enjoyed fair health, and has had no return of his malady. The stone was ori- ginally oxalate of lime, and he is subject to irritation in the urinary passages and occasionally to orchitis. He leads an active life. 24. A gentleman aged seventy-seven; operation, July, 1873 ; uric-acid calculus. In excellent health for his age. No return of his malady. Uses a catheter twice a day, and is under the care of Dr. Jackson of Southsea. 25 A gentleman aged sixty-two ; operation, Oct. 1873 phosphatic calculus. Had long passed all his urine by catl.eter and at short intervals. I removed a phosphatic calculus of considerable size, the result of constant cystitis ; but he died exhausted from incessant catheterism about a year after. 26. A gentleman aged sixty-five; operation, Aug. 1873; uric-acid calculus. Seen again in the latter part of the year. Recovery perfect, but have not the address, and cannot learn any later particulars. 27. An American gentleman, aged sixty seven; opera- tion, Aug. 1873 ; phosphatic calculus. He wrote to:me in the following year that there was no return whatever :of his complaint. 28. A -gentleman aged sixty; operation, Aug. 1ß73; large uric-acid calculus. I cannot learn anything of this. patient.",
         "80 CANADA MEDICAL AND SURGICAL JOURNAL. A gentleman aged seventy-seven; operation, Aug. r ýj ; uric-acid calculus.: I have just seen this patient, (June, 1875). He has had no return whatever of calculus symptoms, and is passing his catheter three times in the twenty-four hours on account of inability to empty, his bladder from enlarged prostate. He is enjoying excellent health. 30. A gentleman aged sixty-seven ; operation, Aug. 1873 ; uric-acid calculus. This patient has notbeen rnuch relieved. He passes his urine chiefly, if.not altogether, by catheter, and, in spite of all treatment, phosphatic matter forms and must be removed. 31. A gentleman aged fifty-six; operation, Nov. 1873; a phosphatic calculus. He had no return of it. Mr. Pearson, of Manchester, writes me that he died of malignant disease in January last. 32. A gentleman aged seventy-eight ; operation, Nov. 1873 ; uric-acid calculus. His medical attendant, Mr. Hicks, of Easingwold, writes me (June, 1875); \" The patient has been perfectly free from vesical troubles ever since.\" 33. A gentleman aged seventy-six; operation, Nov. 1873 ; uric-acid calculus. Have just seen him, (May 1875) ; he has liad no return whatever of his complaint. 34. A gentleman aged seventy-two; operation, Nov. 1873 ; oxalate of lime. I saw this patient a month ago (May, 1875). He is in perfect health, and has had no return whatever of his complaint. .35. A gentleman aged sixty-three; operation, Nov. 1873; uric-acid calculus. His medical attendant, Mr. Robert Parker, of Malpas, Cheshire, has just written me (June, 1875), that this patient is \"feeling as well-as ever'he did in his life.\" 36. A gentleman aged seventy;; operation, Dec, 1873; He made a most excellent recovery ; left me a hale and hearty man, and I have no doubt is quite well, but I have no clue to his address' I believe he is living in Dundee or its neighbourhood.",
         "-LITHOTRITY-RESULTS OF-BY SIR H. THOMPSON. 81 37. A gamekeeper at Balmoral, aged sixty-one ; opera- tion, Dec. 1873 ; a phosphatic calculus. He has just written me (May) that he \"is keeping well and able for his duty.\" 38. A gentleman aged sixty-four; operation, Jan. 1874; a large phosphatic stone. Seen with Dr. Holman, of Reigate. Had not emptied his bladder some time before operation. Still uses his catheter. In good health, and has no return of his malady. 39. A gentleman aged sixty: operation, Feb. 1874. This was a uric-acid stone of unusual size, and the difficul- ties were remarkable. I saw the case constantly with Mr. Blaker of Brighton. He had long-continued troubles after- wards from inability to pass urine by his own efforts and frequent catheterism. He has slowly improved, and is now in a comfortable condition, with no return of stone forma- tion. 40. A gentleman aged sixty-one'; operation, Feb. 1874; a uric-acid stone. I have lost sight of him, and cannot learn bis address. 41. A gentleman aged seventy; operation, Feb. 1874. A uric-acid stone, complicated with advanced disease of the bladder. The former was easily removed, but no improve- ment took place, and he died of the latter about six months after. 42. A gentleman agéd sixty-two ; operation, Feb. 1874; a uric-acid stone. Called on me May, 1875. In excellent health ; no reappearance of stone symptoms. Occasion- ally under the care of Dr. Macdonald, physician to the Duke of Argyll. 43. A gentleman aged sixty-seven; operation, Feb. 1874. Died suddenly of mitral disease about ten days àfter the stone, mixed oxalates and urates, was successfully removed. 44. A gentleman agedseventy-eight ; operation, March, 1874: -paosphatic calculus. Has many years passed all his urine by catheter, and had had a stone removed in 1870; 6",
         "82 CANADA MEDICAL AND SURGICAL JOURNAL. the second in 1874, after which he lived about five months,. 45. A gentleman aged sixty-six ; operation, march, 1874; very large uric-acid calculus. This gentleman has just written me (June 1875): \" I an well pleased to infor.n you that I have been very well indeed until -the latter end of March.\" He adds that he has lately had a little irritability of the bladder, which has passed off. 46. A gentleman aged seventy-two ; operation, March, 1874 ; uric-acid calculus. Seen with Mr. Sibley, of New Burlington-street. Is now (June, 1875) in perfect health no sign of his malady renaining. 47. A gentleman aged fifty; operation, March, 1874; a uric-acid stone. Has been in excellent health since. In January last he passed a small uric-acid calculus per ure- thram. He is now living at Antwerp, and is quite well. 48. A gentleman aged sixty-five; operation, April, 1874; a phosphatic calculus. This patient had for many years passed all his water by catheter, frequently doing so as often as twelve to fifteen times in the twenty-four hours. He has been quite well until lately, and has just called (June, 1875) to inform me that symptoms have reappeared. I find a re-formation of phosphatic matter, which I shall have to break up and wash out. Otherwise his health is excellent. 49. A gentleman aged sixty ; operation, April-May, 1874; uric-acid calculus. Hc called on me in February last, in excellent health, and without any symptoms of his old complaint, and walking several miles daily. 5o. A gentleman aged sixty-eight; operation, May, 18- 74; large uric-acid stone. Dr. Lambert. of Sunderland, writes [June, 1875) his \"condition at the present time is perfectly satisfactory.\" 51. A gentleman aged sixty-one; operation, May, 1874; uric-acid calculus. Dr. Helsham, of Brixton-road, writes, in May, 1875, that this patient is travelling on the Conti- nent in perfect health.- The Lancet.",
         "ANNANDALE OE KNOCK-KNEE. A nnandale on Knock-kzee. In the Edinbirgz Vedical y7ournal, July, Mr. Annandale describes a new operation for the cure of knock-knee as follows. On the 3rd of March last, a little girl aged six, was brought to me from Glasgow, on account of a serious deformity of her right leg. Mechanical means had been employed for two years with the object of relieving the con- dition, but without success, and the deformity was steadily increasing in severitv. A careful exanination determined an aggravated form of knock-knee, and it was found impossible, in any position of the limb, to bring the leg into a straight line with the thigh, the head of the tibia forming a considerable angle with the condyles of the femur. The femur had a distinct bend in- wards and forwards about the junction of its lower and mid- dile thirds, and the condyles of this bone were much more oblique in their direction than in the natural condition. The adductor muscles were somewhat contracted, and the distortion was such that the patient walked with difficulty. The left limb, was well developed and natural in position. A study of the case convinced me that the oblique position of the condyles, the result apparently of the bending of the shaft of the femur, was the principal obstacle which was preventing the tibia and leg being brought into a line with the thigh, and it therefore seemed to me, that if this obli- quity could be removed, the deformity might be cured or very much relieved. Two ways of removing this obliquity suggested them- selves. The first was to divide the shaft of the femur at the point where bent ; the second to remove an oblique slice of the-condyles. The latter operation would be attended with more risk than the former, because it necessitated the incision of the knee-joint. But some little observation de- cided me to adopt the latter proceeding, for I felt sure that it would be more effectual than the former, and I trusted that the risks of opening into the joint wôuld be counter- acted by the careful use of the antiseptic treatment.",
         "84 CANADA 31EDICAL AND SURGICAL JOURNAL. The consent of the child's parents having been obtained, I operated on March I6 in the following way. An incision, about five inches in length, was made along the inner aspect of the knee-joint, the articulation opened into, the internal lateral ligament cut across, and the patella and its ligament being drawn outwards, the crucial and ex- ternal lateral ligaments were also divided. An oblique slice was then sawn off from the condyles of the femur, the tibia not being interfered with. After the removal of this slice of bone the leg was readily brought into a straight line with the thigh ; and a drainage tube being inserted into the cavity of the joint, a few sutures were applied, and the limb placed on a wire splint, in the straight position. The whole operation was performed under the antiseptic spray, and the usual antiseptic dressing was applied to the wound. Some suppuration of the wound followed the operation, but this gradually ceased, and on March 24 the discharge was so slight that the dressing was changed only once in two days. On April 25 the wound was quite superficial, and on the 29th of this month, the wound was soundly healed. On May 6 the patient'was allowed to get out of bed, the joint being supported by lateral splints, which were removed daily to permit of passive movements of the joint being made. On May 30 the splints were entirely removed and the pitient allowed to bear weight on the limb. At this date the limb was perfectly straight, and of equal length with the opposite one. The lateral mobility of the. joint was very slight, and very much as in the natural condition. Flexion and extension were very limited. On June.5 I placed the patient under chloroform, and forcibly bent the knee to rather-more than a right angle, and I also moved the joint freely, so as to break down the ad- hesions which had resulted from the operation. No bad consequence.followed this forcible bending of the knee ; and two days after the patient .was again going about the ward with the help of crutches, and able to bear weight upon the limb, the mobility of the joint being decidedly irnproved.",
         "CASE OF STERILITY.-BY DR. sMITrT. Remnarks.-I am not aware that this or any similar ope- ration has been before practised in case of knock-knee, but the successful result obtained in the case reported encou- rages me to recommend this method of operating in òertain aggravated cases of the deformi-ty which have resisted the division of the biceps, tendons, or other tense structures, and carefully applied mechanical treatment. The employment of thé antiseptic treatment in this and similar operations I consider most valuable, and I must con- fess that it was my confidence in this treatment which led me to freely incise so important a joint, and to carry out the proceeding described.-The London Medical Record. M I D W I F E R Y. Case of Sterility from Anteßexion of the uterus, and con- striction of the Internat Os Uteri, Cured-By HE YWOOD SMITH, M. A., M. D., Physician to the Hospital for Women and British Lying-in Hospital. Of all the causes of sterility depending on malposition of the uterus, that of aniteflexion is the most frcquent. Other malpositions of the uterus, except marked retrover- sion, leaves the cervix uteri depending into the posterior original cul-de-sac in the dorsal decubitus ; but in acute (I here use the word acute with regard to the angle, not time) anteflexion, the os uteri is lifted out of the posterior cul-de- sac, and placed in a position unfavourable for the imbibition of the semen. Anteflexion, dysmenorrhœa, and sterility, are three conditions so frequently associated, that, vhen a patient comes complaining of dysmenorrhœa, and is also barren, a vaginal examination more of ten reveals anteflexion than .ny other condition. And :here it may be noticed that it is the dysmenorrnœa that causes the patient to seek for advice. Among the applications for relief at hospitals, pain is that for which medical advice is generally sought, seldom barrenness. The latter is either considered a blessing, or women give themselves up to their fate, never",
         "86 CANADA MEDICAL AND SURGICAL JOURNAL. for a moment supposing that such a condition is remediable; whereas aiong the upper classes, when property or name are at stake, medical men are more frequently consulted for relief from barrenness ; and in such cases, pain not necessarily being an eleiment of complaint, the sterility may be found to depend on many causes other than flexion. It is therefore, perhaps, more among the poorer classes that favourable results, as far as sterility is éoncerned, may be looked for from operation and treatment for the cure of anteflexion, and for the relief of obstructive dysmenorrhoea. E. S., aged 29, married six years, became pn out-patient at the Hospital for Women, February 2oth, 1871. The catamenia commenced at the age of 18 ; they were regular, with some pain generally before the flow. The passage of the thick sound before the period lessened the pain. She was admitted into the hospital on July 3rd, 1871. The uterus was normal in size ; a thick sound could be passed after some gradual pressure, and the constriction held the sound rather firmly. On July. 3th, Dr. Protheroe Smith's uterine dilator was used to half an inch. On the 17th, the dilator was used to three-fourths of an inch, and the con- striction at the internal os divided bilaterally with a straight knife, as. well as the external os slightly, and a spring metallic (Greenhalgh's) stem introduced. On the i9th, the stem was extended half its length, with some forcing pains, and was replaced. On the 23rd, the patient was free from pain. A slight blood-stained discharge con- tinued. On the 26th the stem was removed; and on July 31st, the patient was discharged. In April of the followingyear (1872), she was seen again. The external os was divided a little more freely, and the spring stem again introduced. It remained in altogether nearly three weeks. The patient continued under observa- tion from that time, the thick sound being occasionally passed until conception took place, after the catamenia of November 13th, 1873 ; and she was delivered of a living female child on August 31st, 1874.",
         "CASE OF STERILITY.-BY DR. SMITT. The above case is given in order to encourage practi- tioners not to lose sight of a case after operation for dila- tation of stricture of the internal -os, because pregnancy does not immediately follow, but -to persevere, by the occasional passage of the thiclk sound, to maintain the cervical canal in a state of sufficient patency. Moreover, it often happens that, for some time after forcible dilatation, there may exist some chronic irritation of the cervical mucous membrane with or without gran- ular inflammation of the labia uteri, which, giving rise to leucorrhœa, of some form or other, May hinder impregna- tion. And here it nay be well to insist on the necessity of not trusting to dilatation alone, whether by tents or by the introduction of graduated sounds, to enlarge the cervical canal. For if dilatation alone be had recourse to, its action is only temporary, for the uterine fibres are there- by merely stretched, as India-rubber might be, and, on the stretching force being intermitted, the cervix returns to its usual condition. The dilatation must be associated with, and, made sub- sequent to, incision of the canal. After incision of the -cervical..canal from within, which need not be extensive, dilatation then continues the incision with a slight rupture, and, this being skept from closing, the dilatation remains permanent., Many failures of this treatment are due to the external os being too freely divided, and being thereby rendered too patent; the act of imbibition is greatly inter- fered with, if not altogether prevented. The object to be gained is slightly to enlarge the cervical canal, and, at the sane time, not to destroy the orifice of the.uterus.--British1 JPedical %ounal. The profession throughout the country vill begad to hear that Dr. Bovell, for many years one of the leading con- sulting physicians in Toronto has returned from the West Indies, where he has been, for the last four years,.",
         "CANADA MONTREAL, AUGUST, 1S75. DRUGGISTS PRESCRIBING AND THE-SALE OF POISONS. In the act of amendment, to the act of incorporation of the Pharmaceutical Association of the Province of Quebec, there exists a most stringent clause against the sale of poisons except on the prescription of a physician. The provisions of that clause are comprehensive, it is suf- ficiently indicated that \"poison is not to be sold\" to a person unknown to the seller; unless introduced by a person known to the seller; and -on every such sale of every such article, the seller shall before delivery, make or cause to be made an entry in a book to be kept for that purpose, stating in the form- set forth in schedule B., of this act, the date of the sale, the name and address of the purchaser, the name and quantity of the article sold, and the purpose for which it is stated by the purchaser to be required, and to which the signature of the putchaser, and of the person if any who irtroduced him shall be affixed.\" Then follows a list of poisons which are prohibited to be sold. We -notice that Chloral Hydrate is not down in the list referred to and we think the omission should engage the at- tention of the Legislature at its next session with -a view of ameriding this clause ; making it more définite and in- cluding some dangerous drugs which are not 'to be found in the list of poisons. This isl a subject which should en- gage the atiëntion of the Pharmaceutical Association itself",
         "DRtJGGISTS PRESCRIBING. as it is in the interest of public safety that members of that association should not take upon themselves to prescribe- and dispense drugs of this character without a physician's prescription. Recently a medical mari was called to see a patient of his who was profoundly under the irifluence of a large dose of chloral, upon inqu-ry he ascertained that a druggist in this city, had taken upon himself to prescribe and dispense a large bottle of solution of chloral hydrate, the patient took a dose and feeling himself dizzy, took a second and this was followed shortly after by a third, fortunately the man had a profound sleep ofseveral hours duration, and then recovered. We say fortunately, because' no disaster followed, had the man died, a coroner's jury could hardly have brought in a. verdict other, than one of manslaughter against the druggist for his reckless neglect of the spirit of the Pharmaceutical act. This is no isolated case of breach of the spirit of that act. Quite recently we were called upon to assist a confrere in removing from the stomach of a man by aid. of the stomach pump the contents of an ounce bottle of Chloro- dyne. It is difficult to determine the precise quantity of morphia contained in an ounce of Chlorodyne, but fron its effects, and by general consent, it is believed to be at least- of the same potency as laudanum, and therefore it is as dangerous a drug to use indiscriminately as is the tincture of opium. We are cognizant of several cases of opium eaters who have abandoned the use of the article itself and taken kindly to Chlorodyne. It seem to supply for a time at least that distressing craving for the accustomed stimulus which is experienced by those addicted to this. wretched indulgence. Here is a strong argument against the sale of patent drugs which are known to contain poison, except in quantities which can not possîbly take life. We- believe that in the case above referred to, had the patient been left to himself, life would shortly have ceased, the first washings of the stomach not only filled the air of the roor with the odour of Chlorodyne, but the water itself",
         "90 CANADA 3EDICAL AND SURGICAL JOURNAL. was quite-discoloured, and after allowing it to stand, the heavier particles of the Chlorodyne settled to the bottom of the basin in which it was collected. While on this subject weý cannot refrain from mentioning another case of somewhat different character. A young robust man, a laborer, called on a druggist, who is regarded by the common people to be a doctor and is so styled, and complained of having a severe cold with cough. The drug- gist without knowing what lesion in verity existed, prescrib- ed and dispensed a cough mixture which was to put hini all to rights in a few days. The man faithfully took the remedy, became worse and ultimately was brought to the Montreal General Hospital where he died six hours after his admis- sion. A Coroner's inquest was held, and after some diffi- culty the House Surgeon obtained the consent of the jury to open the body, and ascertain the cause of death. On examination he found that the man had suffered from pneu- monia,and that his.lungs were in the first stage of consolida- tion. The investigation ended in a verdict of death by the visitation of God, and.not as it should have been, of-gross neglect on the part of the poor fellow to obtain efficient aid in bis extremity, and of censure or a verdict of manslaughter acainst the druggist for daring to trifle with human life in prescribing for and misleading a fellow mortal to bis, own destruction. Many other similar cases we could mention, where temerity on the part of druggists has been followed by death to the victim. This is not pleasant to record, nor is it pleasant to contemplate. The practice of medicine is a most serious and responsible undertaking for a man whose duty it becomes, he is dealing with human life, and if through neglect or ignorance a life is sacrificed he will be held accountable by his Maker. Coroner's inquests in this district have become a by-word of niockery of judicial inquiry. A case occurred quite recently, of a man who died suddenly ; it was known that he was suffering from thoracic aneurism, because shortly before death he had: been an inmate in the Montreal General 1-ospital, and his condition",
         "TUHE CANADIAN ,MER»IGAL ASSOCIATION. had been made out by the attending Physician. An inquest was held and the verdict of the jury, suggested we suppose ,by the Coroner, was death from Apoplexy. THE CANADIAN MEDfCAL ASSOCIATION. Before this nuni.ber of the journal reaches our subscribers the Canadian Medical Association will have met at Halifax Nova Scotia to hold its eighth annual meeting. Hitherto little has been donc by this association with aview of placing the Canadian profession in a proper light as a scientific body before the world.* We expect much good will ultimately result fron these neetings although from lack of a proper system of organization very little has so far been donc By a proper system of organization we do .not desire to throw any slur on the association, \"ut think that if the British system were adopted, of establishing branch Asso- ciations throughout the country that real and valuable work would be donc at these annual gatherings.. There are nany subjects which will we doubt not receive due consi- deration. Vital statistics will ve believe form a part of the ;programme but without a uniform systeri of governmental registration it will be difficult to arrive at anything like truthful results. Registration to be effective must be ýenforced and carried out by officials appointed bythe Crown. Such has been the experience of every country in the world, and we in Canada need not expect to receive reliable information on this subject so long as the present system is permitted to continue. The Roman Catholic Church is averse to a secular system of registration, because it holds that if permitted to be carried out by civil enactment the church would ]ose that hold over the consciences of the faithful which acts as a barrier to civil marriages, and neglectof baptism. Such are the arguments which we have heard advanced. We can only say. that. if the votaries of, the church are alone held to- their duty by",
         "92 CANADA MEDICAL AND SUROICAL JOURNAL. compulsion the sooner they are out of it the better. -No true son of the church will neglect the teachings of that church in matters of faith. Nevertheless as a society of men we cannot ignore the fact that marriage is a civil institution, however desirable it may be that it should be sanctioned and consecrated by a religious ceremony. Infant Baptism is quite another thing. The church teaches that infant baptism is essential, there are however those outside the church, whose teachings they ignore, who do not believe in the necessity of infant baptism This class throughout Canada is by no means small, and without the existence of a law compelling registation many of the children of this class do not appear at all on the register. The fact of having a registration law does not in any way interfere with the doctrines or obligations imposed by the church on the people. These are pure matters of faith and not of custom, and we cannot sec that secular registration would in any way interfere with them. The Canadian Medical Association is c6mposed of representa- tive men of a liberal profession, most deeply interested in this subject, and we think that an earnest appeal from that body would have due weight in the councils of the Com- môns at Ottawa. Registration should be uniform through- out the Dominion. Furthermore from the variety of re- lioious sects which äre to be found amongst our people, no particular sect should be permitted to have anything whatever to do in carrying out a registration act. To be efficient it must be under government control. MONTREAL PUBLIC HEALTH ASSOCIATION. In th~e last number of our Journal we took occasion to. notice, what we considered at the time, some ill-digested. remarks of the Chairman of the Montreal Sanitary Associa- tion regarding the dirty backlanes. At a subsequent meet- ing the chairman is reported to have commented rather earnestly on the editorial in the Journal, saying that he.",
         "MONTREAL PUBLIC HEALTH ASSOCIATroy. -considered that these remarks were very much out of place in a medical journal. At this stage a vencrable-looking old gentleman, whom we presume is anxious to bring home the responsibility of these things to particular men, asked the very pertinent question \"Who is the editor of the Medical Journal ?\" Having had his curiosity satisfied he resumed his seat. The chairman then continued and wished to know what right the residents in Beaver Hall Terrace had to store their manure in the lane in rear of that terrace. To this we can only reply that these back lanes form a part of the property on which the house stands. As far as the stable manure is'concerned, perhaps the President of the Montreal Sanitary Asssociation thinks that by a strong protest on the part of that Association the order of nature will be arrested, and that animals will accommodate the -association by depositing no more manure. The trial is certainly worth the trouble, and may be attended with suc- -cess. \"Wonders will never cease. But we suppose as long as the present order of creation e' ts, and that animat deposits are made, they will have to be stored, for a time at least, in some convenient corner. An outsider to read the -comments of the Chairman of the Montreal Sanitary Association would be led to suppose that these manure heaps were regarded by the residents as a species of luxurious 'smelling-bottle, and that they retain these manure heaps in -spite of the pleadings of the press, the thunderings of the Sanitary Association and its chairman, and the occasional summons of Mr..Recorder, with the petty annoyance of loss of time and having to pay $x.5o, the costs of an action, which is grievous, and which in any other court could not for a moment stand. We are happy to announce that Dr. James A. Grant of Ottawa,,who has been absent in Europe during the past two .months, arrived by the Allans' steamship Pollynesian, on Sunday, ist instant, very much improved in health.",
         "94 CANADA MEDICAL AND SURGICAL JOURNAL. THE SMALL POX HOSPITAL. We do not wish to be con'sidered unnecessary alarmists, but we would remind our readers that during the past-four or five years small-pox has been very prevalent, lulling in the summer, to break out with greater virulence towards winter. We have heard that the city contemplate closing the small-pox hospital at the Hall house.. This is all very well if another suitable place be provided. The small pox wards of the Montreal General Hospital must be removed or else the hospital will be ruined as a general hospit.al. It has been stated that the governing body of the Montreal General Hospital feel that in closing the small-pox wards they render themselves liable to action for damages. The- reading of the 24 Vic. Cap. 24, clause i is that \" no warrant shall hercafter issue for the payment of any sum of money granted by the Legislature to any hospital, unless nor until a certificate, signed by a meclical officer of such hospital to the effect that there is in such hospital a distinct and sepa- rate ward set apat for the exclusive accommodation of patients afflicted with small-pox has been filed with the clerk of the Executive-Council.\" Now this we take it docs not oblige any hospital to keep up a distinct and separate ward for the accommodation of small-pox. An hospital may be intended exclusively for some special disease or condition. Take for instance Lying-in hospitals, of which in this city there are some three or four, this clause in the Act applies equally to them, and yet no man in his senses would coun- sel connecting a small-pox ward with any of these institu- tions. We have carefully looked into this subject and find- nothing in the charter of the Montreal General Hospital which can be construed into an obligation to keep open a small-pox ward. But take the other side of the question. How would an action lie supposing the friends of a deceased person went to claim damage in consequence of their re- latives having contracted small-pox which led to their death, they having in good faith entered the hospital to be· treated for a slight surgical injury or trivial attack of",
         "LICENTIATES OF LOWER CANADA. 90 disease ? These are matters for the governing body of the Montreal General Hospital to carefully consider, and if instances are required wherein valuable lives have been sacrificed, and important surgical operations destroyed, in consequence 'of the small-pox disease spreading into the general wards, we fancy a goodly number might be prodtuced. LICENTIATES OF THE- COLLEGE OF PHYSICIANS AND SURGEONS OF LOWER CANADA. We notice by our English exchanges that a person named William Robert Smith of 309 Holloway road London claims to be registered in Canada as a Licentiate of the College of Physicians and Surgeons of Canada. For the information of our contemporaries we may observe that no such college exists in Canada. In Lower Canada or the present province of Quebec the profession are incorporated under the name and style of the College of Physicians and Surgeons of Lower Canada. This act of incorporation was passed in the tenth year of the reign of Her Majesty Queen Victoria. We have the honour to be the Registrar of the College and have looked over the names in the register and have failed to meet with the name of Mr. William Robert Smith. Six years ago, or in 1869, the profession in Western Canada were incorporated by the Local Legisla- ture of Ontario under the name and style of the College of Physicians and Surgeons of Ontario. These are the only legally recognised bodies in this part of the Dominion forming Canada proper, that possess the right to grant a license ad practicandum. We cannot say whether Mr. Smith's name appears on the published list of the Ontario College as we are without a copy of that document.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. CINCHO-OUININE. The foll]owing card vas received from Messrs. Billings, Clapp \u0026 Co. some time in March last, and was mislaid, we now give it insertion because having published, two years since, in the ëolumns of this journal an article headed \" What is Cincho-Quinine ?\" this card is as it were a reply to that question. We cannot speak practically of the effects of cincho quinine, never having employed it; but should suppose from its alleged composition that it would be use- ful and beneficial in cases where the alkaloid itself will not agree: A CARD. 'We desire to call the attention of the faculty to the following analyses of Cincho-Quinine, from some of the most eminent chemists. BILLINGS, CLAPP \u0026 Co., Boston. Chemical Laborator, of the Universiy of PennPsylvania, WEST PIIILADELPHIA, January 29, 1875. 31ESSRs. BILLINGS, CLAPP \u0026 Co. GENTLEMEN,-I have received by express a package marked, 4 Sealed by S. P. Sharples, January. 22, 1875,\" and containing a bottle of Cincho- Quinine, with the label of James R. Nichole \u0026 Co.. Chemists, Boston, which have tested, and found it to contain Quinine, Quinidine, Cindonine, and C nchonidine. Tours respectfully, F. A. GENTH, Professor of Chemistry and Mineralogy. Laboratory of ehe University of Chicago. CHICAGo, February 1, 1875. I hereby certify that i have made a chemical examination of the contents a bottle of Cincho-Quinine, and by direction I made a qualitative examina- :tion for Quinine, Quinidine, and Cinchonine, and hereby certify that I found hese alkaloids in Cincho-Quinine. C. GILBERT VHiEEL-R, Professor of Chemstry."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. Ab Address upon the I Progress ,of Mfedical Scicncc,\" read before the -New Brunswick Medical Society. BY WILLIAM BAYARD, M.D., Edinburgh, President of the Society, \u0026-., \u0026c. GENTLEMEN.-The By-Laws of our Society direct that the president shall be elected annually; the rule is a good one, placing, as it does, the \"honourable situation \" into the hands of those who gave it, perhaps te be bestowed upon a more worthy member: and my terni of office having expired, I must this evening call upon you to select another in my stead. In retiring from the chair in whicb you have so kindly placed me, I would do injustice to my feelings, did I not avail niyself of this oppor- tunity to thank you for the courtesy that has been universally exhibited towards me, and let me add, that our meetings and debates have been conducted in a spirit of fraternity and kindness highly pleasing te reflect upon; illustrating the fact that associations like this tend te cultivate the heart, as well as the head, and to promote professional good will, and genuine brotherhood among their constituent members. That the study of medicine is vastly pronoted by such associations must be acknowledgcd. For the stimulus of mnird upon mind, invigorates and sharpens the intellectual faculties, and produces a kind of intellee- tual contagion stimulating miembers te exertion. Our mutual intercourse criticisms, and discussions, formn \"at once a school and an ordeal,\" teaching Us to become more rigid observers of the medical phenomena occurring in our practice, more careful in our classification of these phenomena, and more perfect in our deductions frein thein, 1e'w of us leave this roon without having heard some ncw professional fact, or idea, calculated te arrest our attention, and perhaps destined to give us a new and increased interest in some particular disease. And we are justified in assuming that the progress made in the healing art dnring the present century, may be attributed, in a great measure, te the stlaulating and regulating influence of medical association.",
         "CANADA MEDICAL JOURNAL. Most of us have heard it broadly asserted that the healing art has remaincd conparatively stationary during the present century, while other departments of science and art have, during the saine period, advaneed with great rapidity. It is truc the marvellous applications of steam are creations of the present century. Watt and others have tauglit mankind to subdue and harness that \" docile monster \" to different kinds of machinery. By the steamboat we are safely wafted from shore to shore independant of wind or tide, and with the swift rush of the \"iron horse \" we are conveyed from place to place with the speed of the bird. It is also within the memory of most of us, that a greater feCt has been achieved the Electrie Telegraph, that \" railway of the mind,\" has annihilated space, and enabled us, instantly, to whisper our very thoughts from one extremity of the world to the other. And the \" science of chemistry has taught the artist to couvert that sun himself into a matehless painter,\" who, with wonderful rapidity, cau elaborate the most difficult portraits and complex landscapes, with a degree of perfection unattain- .able by the human hand. Yet it may be confidently maintained, that during the period in whieh these brilliant discoveries have been taking place, medicine has advanced in various directions and forms, by strides as marked and as great as those belonging to any other department of art. To prove this statement let me endeavour to recall to your recollections some of the principal advances and changes that have been produced during the present century. Time will not permit, even were I able to discuss in detail, however briefly, the alterations that have occurred in some of the branches of medical study. As for example, in chemistry, a science, the very language of which has bcone revolutionized under the guidance of the atomie theory. Physiology has greatly improved, and is daily gaining additions to its domain. And anatom'y itself has advanced in modern days, as is evidenced by the discovery that almost all, if not ail the component elements and tissues of the human body, and of the bodies of other organized beings, do either consist, or have originally consisted, of nueleated cels. I need not tell yon that Pathological Anatomy was known and in sone degree appreciated in olden times. But it is within the preseart century; that, by its light, the nature of diseases previously ail but unknown have been explained, such as Bright's disease, mnorbus Addisoflu endocarditis, ramollisement of the brain, phlebitis, odema glottidis enphyséma of the lungs \u0026c., \u0026c. It has enabled us to separate into speCific diseases, affections formerly ceonfounded together; as, for instance, thî 442",
         "PROGRESS OF MEDICAL SCIENCE. different diseases of the heart, various kinds of tumours, infiam. matory affections of the lungs, pleurisy, pneumonia and bronchitis, \u0026c., \u0026c., and it has corrected our ideas respecting the nature of some maladies, by teaching us, for example, that delirium tremens is not to be confounded with inflammation of the brain and treated as such; that hydrocephalus, which was formerly reeognised as pure dropsy, is the result of inflammatory or acute tubercular disease; that gangreua senilis is caused by obstruction and arterial inflam- mation, and not the result of weakness; and that cirrhosis should not be confounded with pleurisy. It has also taught us that in hysterical subjects, affections strangely resembling destructive disease of the synovial membrane of the joints, may occur, without the existence of such disease; and it bas enlarged our knowledge of the causes and consequences of pyomia. By it we have recently learned that the parasites infesting some of the brute creation used as the food of man, when taken into the human stomach alive, will produce a parasite of a different character, namely the tape-worm. For example, the bladder-worms growing between the fibres of the lean flesh of a measly pig constitute a preparatory stage of the common human tape-worm, the \" tænia solium,\" and in systematic zoology are described under the name of cysticerci celluloso, when eaten by man, are transformed into tape-worms. It is stated by Küchenmeister that on the 24th of November, 1859, lie gave a prisoner 20 measles, and 20 more on the 18th of January 1860, in sandwiches made with sausage. The prisoner was executed on March 31st, 1860, that is, four months after the first, and two montbs and a half after the second cating of the measles. At the post-mortem examination 19 tape-worms, 11 of them 5 feet long, were found in the small intestines. If the meat containing the parasite is thoroughly well salted or cooked, no injurious consequences will result from eating it. The microscope has changed and corrected our ideas, respecting certain maladies, by proving the vegetable or cryptogamic structure of varions eruptions upon the cutaneous and mucous surfaces of the body. It has revealed to us affections, the existence of which was previously unknown, as leucocythomia, sarcinie ventriculi, \u0026c. It enables us to ascertain the malignant character of certain tumours and discharges. By it we learn that most of the entozoa found in the interior of the human system, enter it in the form iof ova, along with our food and drink, thereby enabling us to modify our sanitary' system, and it has greatly enlarged and will doubtless. continue to enlarge our knowledge -especting the different morbid states of the urinary secretions. Indeed 443",
         "CANADA MEDICAL JOURNAL. the microscope in the hands of the modern practitioner, answers in a moment questions unanswerable without it. The department of Patholoqical Ch.emistry bas advanced much within the present century. It is advancing daily, and a berculean amount of work and information may be expected from it. We have reason to believe that if we knew the Pathological Chemistry of the blood and fluids as wel as we know the pathological anatomy of the solids of the body, then medicine as a science and an art would make advanees of the greatest moment. Pathological chemistry and pathological anatomy together, enabled Dr. Bright to establisli the great importance of albumen in the urine, as conneeted often, though not always, with organie changes in the kidney, but always indicating change in the pathological chemistry of the blood itself. And the recent researches of Dr. tichardson and others, have established that in very many inflammatory diseases, the fibrine of the blood is incrcased in quantity, and that the change of the fibrine from a fl£id to a solid state is caused by increnient of heat, Pathological chemistry bas also proved to us that the fibrine in the blood is increaised in cholera, while it is decreased in malarial and typhus fevers. And recent experiments have demonstrated the fact that the white corpuscles escape from the blood-vessels in inflammation. A higher and more refined organie chemistry may yet enable us to deteet the presence of special toxicological or morbid states of the blood, as producing the characteristie inflammations of the skin in eruptive diseases, puerperal and other fevers. May it not be a blood poison which gives rise to the numerous local, serous and other inflammations so often observed in patients suffering under albuminuria, and by it that vexed question may be settled, as to whether rheumatic fever is due to a materies morbi, and whether such materies morbi is lactie or acetie acid; and a higher chemistry may perhaps enable us to neutralize these patho- logical poisons in the system, or eject them froi it. The recent beautiful theory of Liebreich suggesting the adoption of the hydrate of chloral as a therapeutie agent, vben he says that I the hydrate treated with an alkali is resolved into chloroform and a formate. The blood being an alkaline fluid, therefore when the hydrate ià introduced into the organism, every particle of it will consume the sur- rounding quantity of alkali, aud the decomposition will be completed only after the required amount of alkali bas been furnished by the blood. Immediately a minimum quantity of chloroform is formed, and passes to the first place of action, viz., the ganglionic cells of the cerebrum7 The action with the increase of chloroform in the blood extends te 444",
         "PROGRESS oF MEDIOAL SCIENCE. the ganglia of the spinal cord, lastly, it extends to the ganglia cells of the heart. The researehes of Dr. Richardson, based upon the sugges- tion of Liibreich, and the practical experience of the medical profession respecting its use, illustrate what may be expected from a higher patho- logical chemistry. When we contrast medical praetice at the present day with what it was sixty years ago, it must be acknowiedged that the modern practi- tioner is greatly assisted by the late improvements in the ineans of plysical diagnosis. By it he endeavours to discover during life, that which was formerly revealed only by the scalpel after death. A perfert diagnosis cannot be arrived at, till we have an exhaustive pathology-for without a knowledge of what is possible in disease, diag- nosis must be defective. Moreover, that which might be considered a pathological fact to-day, by changing circumstances may be proved erroneous to-morrow. Therefore, in the present state of our knowledge, we must be guided by the probable in disease. That experience which is able to anticipate causes, and froma causes their effects, oftei enables the practitioner, as by prophetic insight, to diagnosticate conditions which neither direct physical examination nor the most systematic arrangement of symptoms would explain. But, as already stated, modern invention and research have greatly contributed towards determining the true nature, and consequently in fixing more accurately the truc treatment in different diseases; as, for exaniple, Laennec and a host of subsequent observers have taught us how to map out the condition of internal parts, the action of which we hear, but cannot see. Czermniak and others, by the application of optical instruments, have exposed to view organs of the body before inscrutable ; the pharynx, the vocal cords, the trachea, the vagina, the uterus, the bladder, \u0026c.; so that many of the hidden causes of disease are no longer a matter of conjecture, but of sight and demonstration. The ingenuity of Helmholtz has disclosed the secrets of the eye; and it is not asserting too much to say that the ophthalmoscope has donc more to inerease our knowledge of diseases of that organ than Las been accom- plished during a century by all other means; and that the oeulist can point to brilliant triumphs over diseases hitherto deemed incurable ; and he is not now obliged to class a number of deep-seated diseases of the eye under the head of amaurosis-to which the remark of Walther is so applicable-'-, a condition where the patient secs nothing, and the doctor abo--nothing.\" The opthalmoscope also teaches us that some states of the eye are pathognomonic of suspected conditions of other parts of the body.",
         "CANADA MEDIOAL JOURNAL. The Sphygnograph -of Il Marey\" has so supplemented the sense of -touch that the wave phenomena of the pulse and heart are registered, by which wve ean fathom the secrets of the circulatory apparatus. The thermometer las been brought to our aid with good practical results illustrating the temperature inýdifferent diseases. And the test tube ably assists us in diagnosticating morbid conditions of the urine, \u0026c. Materia medica has greatly improved during the present century. Many new medicines have been added to the Pharmacopeia, and some have properly been expunged from it. The modern discovery of the active principles in our vegetable medicines under the form of the alka- loids, as quinine, morphia, salicine; atropine, \u0026c., \u0026c., bas given the practitioner of the present day the means of exhibiting some of the most powerful and useful medicines in a concentrated form ; not in the shape of large powders and nauseous tinctures, infusions and decoctions. And we have reason to hope that the work has only commenced, and that the clieist may further assist us by disaming most of our drugs of their revlting and disagreeable taste-a boon to bòth practitioner and patient. -Possibly most of the indications in therapeutics may yet be attained by the administration of medicines in other and less repulsive modes than ohugh the stomach. While inhalation has been practised since the time of Galen, still modern chemistry and ingenuity have done much towards establishing it as one of the methods of exhibiting medicine. The method of sbcutaneous injection is of modern creation,-daily experience proves its value,.-by it we obtain a more rapid and certain effeet from the remedy employed. The practitioner of the present day can point with pride and satiisfae: tion to the late improvements in Practical Surgery,. without comparing its present'state with the peñiod at which the chafing-dish and the searing-I irou were as indispensible to arrest bomoihage as is now the ligature Saud whe \"he' cries of the suffererl ere smothered only \"by the hissing .of l e ated cauteries against the surface of the bleeding wound.\" Y Appreciating the wonderful powers of nature in the cure of diseaseï, s treatuent of Wounds and injuries is more simple and rational. le uow allows the bleeding to cease, washes away all coagula, closes theý oí and applies light watei dressings insteadof the complex ointientS compresses, pledigets'of carded tow;rollers, straps,\u0026c., in use forty or fiftY rs agohNr his e tih sane dread of tle\" 'appliance of stitclieâ a hi, ,fiòefathers had. 'In, fact some of the g-eatest triumphs of:móde s are associatecdwith this simple mechanical process,ás for óa l the operations for cleft-palàtevesico vaginal fistula, ovariotomy, \u0026e",
         "PROGRESS OF MEDICAL SCIENCE. The antiseptie systein of treating -wounds, recently suggested and put in practise by Lister, commends itself to the consideration.of every sur- geon; though a difference of opinion exists as to its merits, still expe- rience may establish it as superior to all other modes of treatment. There bas been a great improvement in the treatment of sores \" tending to heal,\" by the substitution of moist applications, instead of the oint- ments formerly employed, and in the \" callous or indolent\" ulcer by the application of blisters to the surface of the swollen part. I must'also mention a very recent practice of M. Riverden, of Paris, that of trans- planting portions of the skin for the closure of large granulating surfaces of ;ulcers, following burns, \u0026c. The substitution of effectual drainage in sinuses that remain after the evacuation of abscesses, for stimulating injections, sponge tents and pres- sure, is an improvement. And the drill, in deep-seated abscesses ,of bone, bas, of late years, saved many a limb. In few iatters has surgery more -improved than in the treatment of diseased joints; formerly recovery was considered almost hopeless, under the use of caustic-issues, \u0026c.; whereas we now ,confidently look -for recovery under perfect rest and extension. And should bony anchylosis take place, an artificial hip-joint may now be produced, by an ingenious operation suggested and recently performed successfully by Professor ,Sayre, of New York. Since the commencement of the present century, many new.operations have come .into practice, as ovariotomy, the operation for vesico-vaginal fistula, cleft palate, removal of the tongue, the radical cure of hernia, excision of the upper and lower jaw, perineal incision, in aggravated urethral stricture,.delegation of the. carotid,, subelavian and other large arteries ; in ophthalmie surgery, iridectomy, \u0026c., and lithotrity, an opera- tion characterised as one of the greatest additions to modern surgery, and one that must largely supersede the cutting operation of lithotomy, for, *While the mortality from lithotomy ranges from one in six to one in ten, that from lithotrity, according.to Sir H. Thompson, is about one in thir- teen, and ,from present experience, it may be assumed that ,all stônes eighing less than one ounce, in grown persons, should be removed with the lithotrite. :ncreased knowledge of anatomy, physiology, and!pathology bas enabled urgeons, within the same period, to remedy distortions and deformities ,rising from cutaneous and joint contractions. by subeutaneous incision ad plasti operations rior to1809, when, MacDowell, of Kentucky, first performed the operation of ovariotomy, every woman labouring under ovarian dropsy",
         "4.~CANADA MEDICAL 'JOURNAL. was looked upon as doomed. And when Lizars, of Edinburgh, first operated in Great Britain, he was assailed by a certain amount of ridicule. I need not say to you that it is now one of the established operations, and for one of such magnitude marvellously successful, with a mortality of less than thirty-five per.cent. The experience of the practical surgeon teaches him to rely upon the powers of nature, and that it is his duty to assist and oftentimes to guide her; in other words, he is the pilot who can steer the ship, but who cannot mako the wind blow. Knowing the wonderful assistance that nature will fford him, it is his boast that, in the present day, lie can treat diseases without operative interference, where formerly the knife was consideredindispensible; that he can substitute minor operations for more severe ones; that he eau often save limbs by the renioval of diseased joints, where years ago amputation was deemed inevitable ; for exrmple I need only mention excision of the hip, knee, ankle, shoulder, elbow and wrist joints, to prove the wonderful benefits of conservative surgery of late years. Removal of the ends of the bones in conipound dislocations and fractures, instead of the limb, are examples of modern conservative surgery. I may also mention the treatment of aneurism by compression, acupressure, flexion, manipulation, galvanico-puncture, \u0026c. Improvements in individual operations have taken place, as in anpu- tations, in the operation for hernia, that of removing, cartilaginous bodies from the knee-joint, that of opening the canal from the inferior punctum; so as to obtain room for the passage of probes large enough to remove the obstruction in fistula lachrymalis, instead of styles permanently retained. Acupressure, a new mode of restrainng homorrhage, as recommended by Professor Si'mpson, is weil worthy of' practical application by the sur geonfor;by experience alonejits value eau be tested; it has its advocates and'ts oponents, so had the'discovery of John- H1unter; and whb canSay that it may not, at some future day, supersede the use of thi ligatüí-e. The -most' brilliant discovery in modern medicine, and one of the. greatesVboons ever »conferred upon mankind, is thé power the surgei possessés of wrapping the patient in a painless sleep, while he is subjectd. to hti horrors of the operting table.Yet, while accepting innunity frion suffering, the patient eincurs a certain: amount of :risk_.-statisti haing pro'ved that death has resulted from anesthæsia, regardless of the agent vsed, once in between2,000 and 2,500 cases.I Th3 mortalit n\"alI, but lecushope that a substance may ,yet be\"discovered thatbtil produce tie effeca required-withiinpunity. Local anesthesia by fi the part, is of modern origin, and is suitable for minor operations. 448",
         "PROGRESS OP MEDICAL SCIENCE. Practical Jledicine advances by the discovery of new facts, and by the application of such facts to the treatment of disease. During the present century its advance has been quite as great as that of surgery. The meanus of diagnosis at the command of the modern practitioners -his increased knowledge of the nature of disease,-and the improve- ments in chemistry and materia inedica, enable him to apply his remuedies with greater judgment, and to combat disease with more con- fidence of success than did his forefathers. It would be hard to find a medical man in -the present day recom- mending \"l Lizards\" for the cure of cancer and venereal disease, as did Dr. Lettsom-a practitioner of standing in London-who read a paper to the medical society of tbat city in 1783 recommending them. Well may the following lines be attributed to himu. He is made to say: When patients come to 1, 1 physics, bleods and sweats 'em, .And if they choose to die, What's that tò 1, I lets 'em. . LETTsom. Let us glance at the treatment of disease by bleeding. It is not many years since the laneet was in the bands of every practitioner, in daily, and i might say ahnost hourly use, whercas now it is one of the rarest operations; and instead of the loss of blood, we have the exhibition of stimulants ;-and in place of almost starvation, we have the abundant use of nutriment. Now the question may be asked, what is the cause of this-great change? It has certainly brought upon our predecessorsi --by some,-the charge that they were ignorant and blind followers of error. But the reflecting man cannot bring bis mind to believe that the fathers of British medicine were always bad observers and mistaken prac- titioners, consequently ho is forced to look for\" the cause, in the \"change of type of disease.\" There are many strong argumentsin favour of this doctrine,-arguments difficult to controvert,:and when such men as Allison, Christison, Stokes, Graves, and Watson; give their trong adhesion to such belief, we may readily pause before denying it. Many of us can call to. mind the time when cold water was forbidden a person with fever, and as for milk, ho who gave it would have been ecused of II feeding the fever\" and thereby endangering the life of his patient I need not say to you that suci notions exist no longer, 1both b ing freely used. :n proof of the progress in practical medicine' Imay refer to improve\u0026 nients in- relationAto partinular diseases. Consumption,-for examplce a disease ln which the physician's' duty consistédt in watching the slow 'eradations of decay;'-:-making a prognosis of two yers duration/- dd9",
         "450 CANADA MEDICAL JOURNAL. and alleviating suffering as best he could. But now, under the use of cod-liver-oil, mineral acids, bitters and supporting nourishment, he no longer regards the disease as hopeless,, and treats it looking for a cure; failing that, he confidently expects to prolong life. The experience and caleulations of Dr. Williams justify the expectation, for lie informs us that the average-duration oflife of phthisical patients has been extended from two years, the limit assigned by Laennec and Louis, to eight years. And lie adds, that \"in not very few cases, the disease is so permanently \" arrested, that it may be called cured.\" I may mention the treatiment of oxaluria, phosphatic, and other diatheses indicated by the state of the urine, the use of iodine in goitre and other affections, iodide of potas in syphilis, gout, \u0026c., bromide of potas, in epilepsy, \u0026c., arsenic in many affections of the skin, the alkaline treatment of rheumatism, the successful use of nitrite of amyl in tetanus, and in angina pectoris, of- hydrate of chloral as a narcotic, of quinine in acute lumbago, of drachm' doses of tincture of henbane, with a little sulphate of magnesia three times a day in orchitis, of large doses of quinine in military surgery as a remedy for pyoemia; the banishment of scorbutus froma our slips, \u0026c, \u0026c., also the vast improvement that has taken place of late years in the treatment of diseases of the womb and its appendages, and in diseases of the eye, I may refer to the use of atropia as a substitute for belladonna, and the calabar bean as a local application to contract the pupil. Formerly all infantile diseases were considered by some as the results Of febrile action, and treated as such,,by others, as the results of veak- ness and treated with tonics and stimulants, and by a third class as the results of the irritation of worms and treated with anthelmintics., Modern investigators have proved that the different organs of the child are liable to nearly the same diseases as the adult, and should be treated accor- ~dingly. The mortality of infants is still very large, but of late years it has greatly decreased. Towards the middle of the last century, 60 ,out f every 100 children born in ]London, died before they had reached their first year of age; but the mortality hassteadily diminished, so that noW, about 35 in every 100, die at that period. About 600,000 arc born annuallyin, Great Britain ; of these 300,000 would have perisbed. Now about 200,000 die, thus showing a saving of at least 100,000 human beings a year. In New York the mortality is still very large; one-third of the children born, die in the firstýyear, and one half before they have2, attained their fifth- year of age., In Geneva, records have been kePt since 1590, and it has been ascertained that a child has now five timies .greater chance of living to the age of twenty-one years than it had thre centuries ago.",
         "PROGRESS OF MEDICAL SCIENCE. About the middle of the seventeenth century, one in every forty or fifty women delivered in London, died of child-birth and its consequen- ces; but as medical science lias advanced, that mortality lias decreased, till now about 1 in 150 or 200 die. There are about 600,000 accouchi- ments yearly in Great Britain, still about 3000 mothers perish. If the old mortality held good, not less than 11,000 or 12,000 maternal lives would now be lost. Consequently we may proudly point to this modern advancement in medical science, effecting, as it does, in this item alone, a saving of the lives of 7000 or 8000 mothers a year. The mortality in the army, years ago, was immense. It was a dis- grace to those in authority who positively refused to listen to the repeat- ed appeals of the medical staff. And itwas not till after the Crimean War, when Miss Nightingale brouglit the fact before the nation, that the laws which preventive medicine had established and applied in civil life were put in force. The result was that since the period named, the mortality in the Guards has fallen frem 20 to 9, and in the infantry from 18 to 8. And the improvement in war ls still more striking. In the Crimean war the sick in hospital were nearly seven times the number of the killed, while in the Chinese war tbey were nearly equal. The relative propor. tions of zymotic sickness in the two campaigns were as 6 to 60. The present death-rate of fever in En gland amounts to 385 per 10,000 of, population, while a century ago, its death-rate was nearly 539, and at the middle of the last century the annual death-rate from aR causes in London, was 355 per 10,000 of population, but in the middle of the present century, it was only 249. Ia Sweden, in the period from 1755 to 17755 the death-rate was 289 per 10,000 of population, while * from 1841 to 1850 it was reduced to 205. In pursuing this subject let us contrast the state of the unfortunate lunatic of the present day with what it was sixty years ago, when deemed incapable of human feelings. he was incarcerated in a dungeon, bound with chains, surrounded by filth, cut off froin the friendship and charity of bis fellow mortals, and treated with contuinely, scorn, and stripes, a huan being buried, yet livirg. Need I say to you how changed all this is -nowand with what happy results? With the knowledge that the porsufferer possesses the feelings, impulses, and affections of man, hie is' surrounded by comfort, all restraint is, or should be removed.; and he is u'thuder proper medical and moral management. preservation of human health, and the prolongation of human ]ife, are two of the great and noble objects of practical Medicine. ý These objects are.to be attained more by the prevention of disease. than by its cure. But, to enable us to prevent diseases, we should be well",
         "CANADA MEDICAL JOURNAL. acquainted with their causes. These causes and the best means of -avoiding them, have in a special manner engaged the attention of the physician of modern days. By it he lias learned the vast importance of ,sanitary measures. His investigations have taught him that the attacks -of almost all diseases are increased in intensity and frequency, in our households and communities, by the want of sufficient air, light, water and drainage, as well as by the deleterious effects of decomposing animal and vegetable matters allowed to remain within and around our dwellings, :and by the human effluvia concentrated in small and stifling bed-rooms. They have taught him also that when the preceding causes of disease have been abated, in special localities, by proper sanitary arrangemeuts, human life as a consequence bas been saved, hlisery avoided, and pauperism prevented. We find the mortality in country districts always less than in towns. In the country districts of England, it is about 1 in 58, while in the towns it seldom falls below 1 in 45. In all large towns where proper -sanitary measures have been adopted the niortality bas decreased. For ýexample in London, in 1840, the death rate was 1 in 40, it is now 1 in ,45; so in Boston, in 1855, it was 1 in 39, it is now 1 in 41. As a further proof of the influence of sanitary measures upon certain localities in towns, I may mention that St. Giles, in London, formerly a filthy parish, now since every street and court lias been brought under ,control, the mortality has been reduced from 50 in the 1000 to 15 in the 1000. (ilass and occupation exercise tbeir influence upon mortality, for we are told by Dr. Lyon Playfair that in Liverpool the average age at death ,f the gentry was 43 years, tradesmen 19, and laborers 16, the average age of all classes being 22 years. In pursuing this subject I may mention that it is estimated that there are 8000 preventable deaths in New York, yearly. It is further esti .mated that for every death there are 27 cases of sickness, which woald -ive a total of 216,000 cases of preventable sickness to be treated When we reflect upon the 'iisery, wretchedness and pauperism produced by thcse 216,000 cases of siekness capable of being prevented, it afford4 ample occupation for the physician, the philanthropist and the statesmaO-' Lot us look at one other advancement of practical medicine, one to which the physician may proudly point as the greatest discovery of the age, a victory of medicine over disease and deatb. I allude ý to the 4liscovery of vaccination by Jenner, to whom Providence, as it were, entrusted the office of teaching the; surgeon, with au almost invisibe speck of -matter upon the point of bis lancet, to defy, in a measure, OU \u003c\u003ef the most fatal diseases that ever afflicted the human race.",
         "PROGRESS OP MEDICAL SCIENCE. The vast importance of this discovery can only be appreciated whena we take into consideration the ravages produced by small pox prior to the introduction of vaccination. We are told that this disease was a terror- to mankind, \"sweeping over the land like fire over the prairies, smiting down prince and peasant ;\" that about the year 1519 in Mexico, it suddenly carried off 3½ millions of population; that in Brazil in the year 1563 it extirpated whole races of human beings; that about the same period in the single province of Quito, iG destroyed 100,000 Indians; that in Iceland in 1707 it carried off 18,000 out of a population of' 50,000; that in Greenland in 1737, nearly two-thirds of the population were swept away by it; that in France it caused one-tenth of all the deaths, and in England onc-fourteenth; that the annual mortality from it in Europe alone amounted to half a million; that one-third of those attacked died, and that it destroyed, mainied or disfigured one-fourth of ankind. Let us now look at the pleasing side of the picture, and see what the ,mortality from this loathsome disease is at present. The following illus- trations selected fron various sources, give an approximative idea of the mortality from small-pox in each million of the population before- and since the introduction of vaccination. Fweden....... 2050 185 Copenhagen..... 3128 286 Westphalia.. 2643 114 Berlin......... 3422 17G Moravia...,. 5402 255 England....... 3000 200 Doctor Farr tells us that the combined nortality of smnall-pox, measles and scarlatina at present, is only half as great as the mortality occasioned by small-pox alone, before the introduction of vaccination. Experience and statistics teach us that small-pox occasionally occurs among those who have been vaccinated; that if 1,000 persons who have been well vaccinated should b exposed to the contagion of the disease, about tweuty-six will take it; that among vaccinated persons infected with small-pox, the danger of the disease is chiefly determined by the badness and insufficiency of their vaccination ; that the fatality of small- pox when it attacks the unvacciniated is 350 per 1,000; that its fatality to such vaccinated persons as it infects is, taking them indiscriminately, 70 per 1,000, but, distinguishing vaccinated persons ;nto two classes, first, those who have baen vaccinated in the best known manner, and eCond, those who have been badly vaccinated, the fatality of small-pox, if it infects the former, 'will be 5 per 1,000, if it infects the latter, 150 per 1,000; and that the risk of the one is 30 times that of the other. Or, in other words, let an unvaccinated person contract small-pox, and the chances are more than one in three that he dies. Let a very badly 451",
         "CANADA 3MEDICAL JOURNAL. -vaccinated person-a person with one imperfect cicatrix-contract small- pox and the chances are not quite one in eiglht that lie dies. Let a person with two good vaccine cicatrices have small-pox, and his chances of dying are less than one inforty. But persons who have been vacci- nated in the best and most complete way, will, if they ever get small- pox afterwards, not die of it at the rate of much more than one in tro hundred. It may be safely asserted that the lancet of Jenner, armed with the cow-pox matter, lias saved in the world more human lives than gun- powder and the sword were ever successfulin slaying, during any century in the history of mankind. And let us say, honour to the man who found the way to arrest this dreadful scourge. and -who taught us that the seeds of the disease transferred to another soil might be made to germinate with a healthy and saving influence-a glory to our art, and to the nation claiming him as a son. Yet that nation neglected to bestow any mark of distinction upon the doer of all this good. Such favours being reserved for the inventor of instruments for the destruction ofhuman life-the user of them-the courtier, and the politician; the man whose life is spent in ministering to the sufferiniz of his fellow-man, however suecessfully, being generally the last to receive such honours. It is to be regretted that notwithstanding the facts before us, men are to be found ignorant and weak-minded enough to deny the benefits of this wonderful agent. And we hear of \" anti-vaccination societies,\" composed, I am happy to say, with very few exceptions, of men not bel onging to the profession; men whose prej udices must have destroyed any reasoning power they might have possessed. According to Short's mortality bills of London, plague, dysentry, small-pox, ague, and child-birth were the most destructive diseases in the time of Sydenham. It is needless for me to say that they sustain their formidable and fatal character no longer. And does not the history of the past encourage us in the belief that perhaps in 60 or 70 years hence, under the guidance of hygienie and medical means, the same may be said of those diseases that are at present the most destructive and deadly in their effects upon our population; namely, consumption, convulsions, typhus-fever, scarlet-fever, pueumonia, and bronchitis. We have the arrest of small-pox by vaccination as a stimulus to induce us to follOw the footsteps of Jenner. And who can say that means may not shortly[ bc devised to arrest the ravages ofscarlet-fever, measles or whooping-cough? For the conquest of small-pox appeared to our fore-fathers-judging froma; the writings of Dr. Mead-as impossible as the conquest of these maladies can appear to any one now.",
         "VALEDICTORY ADDRESS. While we contend that medicine has advanced we must also acknow- ledge the uncertainty of the art. The source of this uncertainty may be found partly in its imperfections, but more in the intractability of intense forms of disease, the ferments of -whieh poison the system to such an extent that death must inevitably be the result. Take as an example, malignant scarlet-fever; observe the utter prostration, rigors, stupor, swollen throat, offensive breath, and thready, failing pulse, whichi indi- cate intense blood-poisoning. Here death is as certain as if the patient had taken a poisonous dose of prussie acid. Medicine is foiled by the overwhelming power of its antagonist. In conclusion let us hope tiiat enough has been shown in this paper, imperfect as I frcely acknowledge it to be, to prove that the science of medicine bas kept pace -with other sciences in the mareb of improvement. Yet, in the face of such facts, the workers in our noble profession are too often told that they are not advancing because they cannot conquer death, or triumpli over all forms of disease. I do not allude to believers in \" isms \" or \" paty's,\" it is their interest to say so, and we can afford to treat them with silence. But, I grieve to say it is the fashion now-a- days to hold up the stumblings and uncertainties of medicine to the publie gaze ; to invoke ridicule and censure, and should a practitioner get into the bands of a jury, here againi he has to contend against ignorance of medical power and responsibility, and expects to be told that if he does not save life or liib he must pay the penalty. St. John, N. B., January 18th, 1871. Vkledictory Address to the Graduates in Mfedicine ancd Sutrgery, McGill University. Delivered on behalf of the Medical Faculty at the Annual Convocation, held in the William Molson Hall of the Univer. sity, on Friday, the 31st March, 1871. By GEoRGE E. FENwicK, 1M.D., Professor of Clinical Surgery and Medical Jurisprudence. GENTLEMEN GRA]DUATEs.-It is a time honoured custom to address to the Graduating class a few parting words of counsel, and in doing so allow me to call your attention to the very important era in your career which bas this day commenced. Yeu go forth from these walls fully recognized by the outer world as regularly educated physicians and sur- geons, and in every respect save one we can endorse that opinion; from the very creditable manner in which you have severally acquitted .jourselves at the examinations, we feel confident that you will one and all refleet credit on McGill University. The one point alone in which jou will for a time feel your own incompetence is that of experience; resembling the period of early childhood you are about to trust to your",
         "CANADA MEDICAL JOURNAL. own powers; your gait may at first be trembling, and for a time you will painfully experience all that hesitancy shown by the infant when first it parts from its mother's arms on its onward walk. The conscientious physician at the outset of his career is fully aware of his want of experience -experience which lends to him courage to persevere in what lie feels is riglit. Brimfull of theory lie assays to treat diseases according to doctrines that he has scen successfully put Li practice at the bed-side, and if disaster attends his efforts lie is too apt to attribute his want of success to his own short-sightedness, or else to look upon his theory as a delusion. Surgery, on the other hand, being a more exact science, will generally yield more apparent favourable results. But to be a surgeon a man requires all that firnmness of resolve and decision of character, with , mechanical aptitude, whieh is occasionally seen, but which is by no means a conmon gift. To be a surgeon a man requires a special training. Many men can perform operations; tbey may possess a sufficient amount of animal courage to risk the severance of vital parts, and even jest at a spouting artery or quivering muscle-but gentlemen, this is not surgery, Let me counsel you, therefore, at the outset of your career, not to be too full of confidence on the one hand, nor yet too diffident on the other. Be care. ful to study well cach case intrusted to your charge, and if you have any doubt, remember that the life, perchanco, of a fellow-mortal is in your hands, and seek aid and counsel, if attainable, from those of larger experience than yourselves. Be not hasty at arriving at a conclusion as te the nature of any given case: it may look clever, and perhaps if a lucky hit be made, may tend to elevate you in the opinion of those who employ you. If, on the other hand, by arriving at too hasty a conclusion the interest of your patient suffers through your error, it will be: a source of life-loug annoyance, although the circumstances may bc known to you alone. Throughout your pupilage you have had ample opportunities of seeing the principles taught in the class roomn put in practice in the wards of the BHospital. And although medicine and surgery must bo looked upon as progressive sciences, and change is almost of daily occurrence, yet many aphorisms received in early life couie back to the physician and surgeon with such force as to convince him that the exporience and intuitiVý knowledge of those who preceded him, were based on sound prineiples. Gentlemen, you have entered on a life of drudgery, where the strain of mental work is only equalled by the bodily fatigue which eah day wil allort. While other men take their ease and comfort, the physicia and surgeon is foreed to labour. No rest can he expect; his days a4 456",
         "VALEDICTORY ADDRESS. uights are given in the service of others, and in the end he receives thanks, given grudgingly, for what no money value can compensate. What Man is there, that is mortal, who can endure the constant strain on the energies, physical and intellectual, which the practising physician or surgeon has to go through ? Throughout your career you will fully recognise the necessity of keeping pace with the advance ýof knowledge; this will necessarily entail devotion of a great portion of your time to study. Returning home after a day of fatigue and mental anxiety, you will feel that your work is incomplete and you will be forced to labour still, while your more fortunate neighibour is enjoy- ing the solace of domestie repose, without a care, and without the chance of disturbed rest in sleep, which is to our exhausted energies a physi- 'ological'necessity. Remember that to give satisfaction you are expected to be successful, and the successful man is not usually a book-worm; he should, with his mental acquirements, possess an amount of common sense, to know when and how to apply his knowledge. Bear in mind that the world is sensorious, hypercritical; every action of your life will be carefully serutinized and criticised-criticised in no spirit of benevulenee or honest kindliness-~your very success will be subject of remark and, perchance, disparagement; s that wearied of well doing you may at times feel 'disposed to relinquish the practice of your profession in disgust. Do not expect to receive anything but hard knocks; and as the world bas seemingly conspircd against us as a class, let the knowledge of what you are to expect draw you in closer bonds of union towards your brother practitioner. Ever remember, in your walk through life, if brought in antagonism with a brother, that you are fellow labourers, and if you 'observe error or misconception, give honest counsel and advice. If on the other band, you are convinced that the counsel and advice of a brother is correct, although adverse to your own preconceived opinion, yield with gracefulness, and do not enter into a controversy, which may end in your own discomfiture. It may not be considered out of place to refer casually to the present position of the profession in the neighbouring province of Ontario. Those of you who hail from' the west are fully aware that the standing of the Profession has been lowered by ill-advised but, perhaps, honest men. As professio nal men, you will find yourselves allied and on an equality with nany whom you cannot meet or recognize as physicians or surgeons. -y of these persons constantly advertise in the daily papers that they ýre Licentiates of the College of Physicians and Surgeons of Ontario. inie never attended a course of lectures on medical or surgical science, FF 457",
         "CANADA MEDICAL JOURNAL. and some never passed any examination as a test of proficiency; nor have they further qualification than that above referred to. These persons possess greater powers in the Medical Council of Ontario than do mem- bers of legitimate medicine. This insult, for I can call it by no other name, has been put upon our profession by the Local Legislature of Ontario; but it admits of remedy. Individually you are powerless; but, as a body, yeu can wield a power that will, in time, completely change the present aspect. If, as one man, the regular profession of Ontario act foi the common weal, they can do much towards obtaining a repeal of the present objectionable law under whieh they are governed. During the last few jears there has been formed in this Dominion of Canada a Medical Association on the same basis, and with the saine object as the British Medical Association, which has been for many years past in the parent state the rallying point of the profession, and has exerted so great an influence in advancing the present high character of medical education in Great Britain. It is greatly to be desired that members of the Medical Profession throughout the Dominion should join our association, and further our objects, which are not alone those of social and professional intercourse. I would suggest the establishment of Branch Associations throughout the country, and that each Branch so formed should send one or more delegates to our annual gathering. Let the work be entered into in an earnest spirit of reform, and, above all, by the profession in Ontario with a full determination of relieving itself from its present anomalous posi- tion. Coming back to a subject more pertinent, allow me to announce that the-governing body of this University has decided on the erection of a new building for the use of the Medical Faculty, and arrangements have been made whereby we hope that before the coiinmencement of another session, a handsome and commodious building will be far advanced toward completion. This, with all modern appliances, will give increased facili- tics for illustrating the practical portion of the course. This is a want 'which bas been severely felt in view of the increasing number of students attending the classes of this faculty. In conclusion let me allude to the high trust you have this day assumed. Your conduct in every day life will be narrowly scrutinised, and what in other men would be passed over as a foible, or error in judgment, iil lin you be censured as a crime. A physician is expected to be grave, serious, thoughtful, as thoughli he were ever dealing with the grim messenger- tils, I need hardly tell you, is toc much to expect, but there is a wide difference between cheerfulness and levity. Endeavour, therefore, so, t 458",
         "MEDICO-CHIEURGICAL SOCIETY OF MONTREAL. conduet your walk tbrough life, that at its close you will be remembered with affection and esteem. Let your life be pure, simple, spotless-ever ready to promote a good work of benevolence in connexion with your pro- fession, so that at the end you may reasonably expect the approbation of your fellow men, and look forward with hope for a reward beyond the grave. The physician is a very intimate friend in a family, and is often the custodian of family secrets; how necessary, then, for him to be silent and reserved. The world is full of littleness, but, in this respect, the medical man should take a high and bonourable stand. Bacon held \" every man a debtor to bis profession, from the which, as men of course do seek to receive countenance and profit, so ought they of duty to endeavour, themselves, by way of amends, to be a help and ornament thereunto.\" At the outset of your career you will have many temptations, which, if yielded to, lead into the vortex of unsatisfying pleasures. Life is al too short to be frittered away in vanity; time lost can never be recalled, and yon will bitterly regret, if, after years spent in frivolity, you arrive at that period when the mental energies are failing, without having availed yourselves of the world's advance. Be therefore no laggards-- persevere fromn the very outset-acquire habits of regularity and industry-so will you experience a measure of satisfaction at the end Of each day's toil, and at life's close feel that your career lias not been object- less. MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. xEErING BELD 18TH MAaRCH, 1871. Dr. ROBERT GODFREY, Vice-President, in the chair. Dr. GEORGE D. FENwIcic related the following interesting case 1 am induced to bring before you this evening a case simple in character, but ai interest from its rarity:-E. S., aged 51 years, a strong, healthy woman, the mother of eight children and a widow, con- sulted me professionally on the 28th January, for au attack of mumps; the parotid and sub-maxillary glands of right side were swollen, tender, ana somewhat glazed; there was considerable pain of an aching charac. ter, great distortion of the face, and inability to open the mouth or i swallow anything but liquids. She had been ill for two days, the attack having come on gradually. As her bowels had not moved for two days, I prescribed a saline aperient, and advised the face to be swathed im flannel. The following day she appeared better, had passed a good night, 459",
         "460 CANADA 3EDICAL . JOURNAT. the swelling was quite as great, but there was,-less aheat of surface-and' less tenderness IL ordered a' saline- mixture of chlorate'of'potashfo be repeated* every' two-or threehours. Oni thedfhirda-day- of mxuy attendance, the fiftr of the disease; the-swelling and teidernessi was almosti gone and- she, expressed herself as feeling very much better,; towards evening she was attacked with violent headache, retching, and a a sense of fulness in the lower part- of the abdomen onthe right side, which was tender on deep pressure: The following morning she noticeda distinct catamenial flow' which,,lasted four' days and. then gradually'\"subsided. Duringthis attack the tenderness 'of the abdomen continued; and she was unable to stand, in the erect posture -without increasing the' pain; she noticed also that while in bed stretching out the right leg occasioned increased pain so that she retained the thighs flexed on the abdomen. This discomfort gradually subsided and she-recovered without further' trouble,:after a week's conEnement tobed. It will be'remarked slie was 51 years, of age, and the catamenial flow had-ceased' during the past six years. Metastasis in mumps' isnoticed as occurring to the testis in:ther male aud the nmamma in the female ; the' brain or its membranes have, in'some cases, been affected'secondarily.. When the testis becomes affected-it has' been-noticed to occur on the sane side as that on which the disease has attacked the parotid gland,' and in some cases when both parotids, have been affected metastasis has\"taken place to:both testes; the. same.fact.has been noticed as occurring in metastasis to the mammæ; but I have' failed to observe the record of metastasis taking place to the ovary; though why it'should not-as likely, occur to this- organ, as being the ana- logue in the female of the testiclein ,the. niale,.will appear at first sight somewhat singular. In the case at present recorded, certainly the ovary was affected, as evidenced by the sense of fulness in that region which was accompanied by deep-seaed tenderness. In the mumps in \"Reynold's Practise of Medicine\" -'th' w riter 'states that the labia and' uterus are in some cases s(condarily affected' but no ther author mentions'the fact' tláat uetastasis takes place to the ovary. This is the only case of'tle kinde have had an opportunity of oticing during a practise extending over twentyfour years, altiough I have o'bserved on, several' occasions in, adults tié testis becoming affected aftér subsidence of the disease in thei parotid glnd.. ' Dr. I nDY enquired'if teli fever subsided when th'e. menstrual fAlow commenced. Dr FENWIdK said tha t id.",
         "XEDICO-CHIRURGICAL SOCIETY -0F -MONTREAL. d61 Dr. DAVID said that- some years 4go -a-somewhat-similar case- occurred in hispractice. - Mùmps broke-out - ina family,and -five or -ix -were attackedaith.it; two of them,ýwere youngladies,;:17 and -20 -yèars of age; both,were'very irregular ina their menstraation,-pale, and -hlorotic. -before theattack. :During the course ôf, the 'disease they-hoth-sùfered fromímenorrhagia, when the: mumps eat once- subsidèd. Fromi that day till thepresent -time they have both-been-quite regular. One is married, andlhasd-alarge:family. T Old authors -state J that -a-condition-of -things similardtoýthat.mentionedby Dr.\"FENwIcK ý-was -common ; --such was, howevernot the scase-now, -butwhether due toIbetter treatment, he could notsay. Dr.LREDDYfsSaid the interesting part inDr.2FENWICK's case-was-the suddentappearance ôf the discharge so: long after - the time of natural .arrestiwas -past. 'Dr.IDavID mentioned a case that occurred many-years ago in Wales, where a lady, over 70 iyears . of age, had a menstruâl flow fronr metastasis. ,Dr.IHINSTON:thought there -were'two remarkablethings-in -the case related by iDr. FENwIcK : -first, that mumps shoulds have occurred at all,inialady ofso igreat an-age; -and:secoridly,- that it should bring on a flow. -Iàatély, :therewas an epidemic of mumps among elic - students of -St. Mary's, College,, where, 1in boys, there was -metastasis-to, the breast. Fle:recentlyalsoehad another case ina little girl who had fnot attained -pubertypýwheret.there twas metastasis to-the-breast. Dr. GODJFREY stated that mumps had been very prevalent -in'his- prac- tice. Inone family, where all or nearly-all-were-attaked, one of the members had\u003ethempass on to suppuration. -Dr. FENwIcK îin reply stated that -he .had examined all theolder authors that were-accesssable to- him, and could not find any reference to the subject ; his friend, Dr. David, made a broad statement, but did not ,mention anyauthor who drew- special attention to this point. Dr. PELTIER then read'the'following paper on IETROVERISION OP.THE UTERUS: ,On the 20th January, 1870,-I was, called to attend a Mrs. C., aged 2S, from Rochester, who had arrived in this city the month previous- she is the mother of three childrenliving-from that dateupto the 75th oef February (16 days), she was'labouring under bilious fever, for which she received. all the, treatment- which is ordinarily followed i n such cases b allpractitioners of-experience. I had been.told at my first visit that she was pregnant, and ;regretted nuch that she was so; mentioning also, that it was about two months since she had had ber last changes. Ail that she cornplained'of then was",
         "CANADA MEDICAL JOURNAL. f a bilious disorder. I saw lier every day, and found lier improving, so much so, that I allowed her to get up on the morning of the 4th. On the evening of the 5th I was called suddenly to see her, when, to my surprise, she had a very high pulse, a swollen abdomen, with tympanitis; a slight discharge of blood gave me to believe that miscarriage was about to take place. I calmed her fears as to any serious consequence, and, after having ordered some antispasmodic, I retired. Next morning, the 6th, I was in attendance early, fearing that some storm vas ahead. I was not mistaken, for I found my patient in what I might justly call a typhoid state-facies hypocratic; sweating profusely; pulse small, thread- like, 120; abdomen still distended; urine had not been discharged since evening previous; bowels had been moved; still slight discharge of blood; great nervous excitement from great pain all over abdomen; rest- lessness, and anxiety about her position; pains simulating that eflabour. I did not hesitate to enquire at once as to the cause of these sudden changes, which the symptoms proved to be alarming. - I made a vaginal examination and found-what ? a globular tumour low down, which startled me; after a more minute examrination, I could not reach the os tinc, and concluded that I might have to deal with retroversion of the uterus, which, necessarily being gravid, made the case. very much worse. Examination per rectum convinced me that itwas really complete retroversion. I tried to replace the uterus, but to Do' avail; passed the catheter into the bladder, expecting through this agency to obtain replacement. If.w were to.believe authors-M4oreau, Hunter, Velpeau, Dewecs, Meigs, and others-replacing the womb would be always successful. I am sorry that I cannot agree with them, at least, when having to replace a gravid uteras. It is trua that this is the first case of the sort which it has been my lot to meet. I therefore concluded that, as the case would prove fatal, it was my duty to inform the husband, and also lier sister. A consultation was advised, and at noon, Drs. »'ORSONNENS and TRUDEL were in attendance; their examination corroborated what I:had thought to be completed retroversion Thecase being urgent, we decided on trying to reàclh the os tincS with finger, if possible, and with a ema erotchetsafterwards, so as to allow us to puncture membranes and to give escape to the embryo. We did succeed in puncturing the membranes with a straiglit catheter, it which there vas a small stylet, the point of which is in a lancet forin. The embryo did riot escape; the mother breatlied her last two hior after tue operation.",
         "MEDICo-CHIRURGICAL SOCIETY OF MONTREAL. 45 A post-mortem examination was made at 8 a.m. next morning, the 7th, when the uterus, retroverted, was found pressing on rectum, with elongated round ligaments, and occupying the bottom of the pelvis; great inflammation of peritoneum, but no exudation ; womb was opened, and there we found an embryo a little more than two months old. I sec that a case exactly similar to this one, so far as the retroverson by itself is concerned, is related by Dr. WEEt, of Glasgow, where the the patient, after undergoing a similar process as the one I resorted to, jperfectly recovered after a four months' fotus had been extracted. Now, gentlemen, this is a most appalling case, which I submit to your reflection. There is one remark to be made concerning this case, that ,n the evening previous-that is on the 5th--I was told by lier sister that she had taken Clarke's pills, some days before she was taken ill, to lbring ou miscarriage. ' This led me to believe that, probably what I had taken to be bilious fever, might have been symptoms of the retroversion of the gravid uterus from the use of these pills, which had acted forcibly S the muscles of the uterus, and reacted therefore by irritation of the sacral plexus on the spinal marrow, and thence on the different organs, particularly the stomach and liver, giving rise to irritation such as to simulate bilious fever. Dr. REDDY. Did you suspect that the patient had previously used mechanical means to procure abortion ? (No.) Did you adopt but the 'one method ? (Yes.) Did you find retention ? (Yes.) Had had a very similar case following a fall-patiént was greatly collapsed for twelve hors after the accident; the symptoms were much the same as those detailed, save that they were not of a typhoid character. After reduc- tien and the use of leecies and warm fomentation she quite recovered. Dr., HINGSTON enquired how Dr. PELTIER recognized through the rectum so readily, the retroversion of the uterus; he believed it very dificult to diagnose retroversion without something in the uterus itself; and further that it was almost impossible to reduce a uterus thus dis- plaëed without the sound or some other instrument introduced into the cavity. In a great majority of cases, if a pregnant female complain of severe (and perhaps sudden) pain in the back and epigastrium and there be no prolapse, you will probably find retroversion or retroflexion. Dr. FENWIcK could not agree with the last speaker as te the difficulty Of 'diagnosing retroversion or the necessity of the sound., He had sen ,several cases and in these the nature of the malposition was readily made _out by the general sympton s, as frequent micturition and difficulty in defecation, and by the vaginal touch, discovering the os high-up behind ithe pubis and the existence of a globular tumor encroaching upon the rectum.",
         "CANADA MEDICAL JOURNAL. Dr. HINGsTON bad met with cases in which the os was against the bladder and a tumor in the rectum and still the sound went forwar.d. le thought we should al use the speculum less and thesound more, and we would get better information. Dr. REDDY spoke of the difficulties occasionally encountered in the use of the sound, as for instance, an obstruction at the,inner os, .and recommended the. Sims' probe as free from this objection. Dr. FENwIcK did not wish to be understood as condemning the use of the sound, but simply that he did not considerit a difficult matter to fully reorganize retroversion without it. In Dr. PELTIER'S case there were- reasons why the sound should not bave been used, as he -was led to believe that the uterus was gravid. Dr. CRAIx thought the uterus was a much abused organ. There- was. fartoo ,great a tendency to attribute every disorder arising among females, to irritation of the uterus. A vote of tbanks having been tendered to Dr. PELTIER by the Society, the meeting adjourned. PERISCOPIC DEPARTMENT. CEMICAL CLIMATOLOGY. By R. ANGUS SMIT Esq., PH. D., F.R.S. We.live in air, and the air flows continually through us; no wonder, then,,that we are influenced by climate, which means the condition.of the air. When we speak of climate we ithink of the .atmosphere in' constant motion,.bringing withrit different ,degrees of temperature and moisture from distant regions. ,t is everywhere constantly changing, but-the ghangesare of more.frequent and of greater amplitude in some places than ,in others. The average condition ;s the climate of a.plgce. -The changes ,made by the movements .of the air, are numerous. The operationsof pan also are productiveof changeso.striking.and so vital; that weimaybe said to -make .a climate for -urselves _according;to our ,mode.of living. , We rush over the world, scarcejy considering that the air we inhale,must change, at almost every step.; sand we build:ourbouses not thinking thatevery :feld has a climate of its, own, unless circuDò stances are more ,nearly, the same than we can:hope for in our nountry In extensiye tracts, where,§oil,tlevel, ,and inclination are;similar, suchas great prairies or steeps, therewilbe ;few changes, until:the borders are npproached, in wbich case contiguity ýof other influences will produce;a variation. In England, yhich is comparatively -a small cquntrywith much variety of soi, it is difficult to find a place where a short distance '464",
         "CHEMICAL CLIMATOLOGY. does not produce some change, and in Scotland, a still smaller and more aried e ountry, the differences of climate are more striking. Indeed every farmer studies his land in this respect; and the fields are devoted to- varions purposes, according to climate as well as soil. We are exposed to great changes of climatesarisîng from the condition of our civilization; and although we cannot effect complete alterations, it is possible to do something. To leara the method, we must by carefuI observation ascertain how -we are effected. Who would have thonght that persons living, in a swampy district could be cured of ague, and regain their 'steadiness of muscle by simply putting drain-pipes under the soil around them ? ' Who would have thought that cold, bracing weather, which is popularly supposed to be healthy, would be so deadly to many, as is shown by the Registrar's reports ? But so it is, and we despise less than before the instinct that shrinks from cold. Who would not be surprised at the meteorologist watching the fluctuations of bis barometer, remarking, \" This is a dreadful night somewbere, and wrecks must even now be taking place ?\" But the admitted correctness of such inferences and their practical utility show the value of observa. tions of the·barometer, and hygrometer, and of the wind and rain fall. Circumstances led me to examine the subject rather from the point of view which may be called chemical, as distinguished from the physical and medical views. CONSTITUTION OF -THE ATMOSPIIERE. Cases. Regnault.was -the first to show clearly that there are consistent differ- ,ences in the amounts of oxygen and nitrogen in the atmosphere of' unwholesome :placesnot closely confined «within walls. Having been appointed ,to examine the air of mines by the Royal Commission of -Which Lord Kianaird 7was .chairman, I was led to examine several hundred specimens of air differing from the standard usually found on -the surface of the earth. It -was needful toexamine ;tbe purer air also- s amIeans of comparison. This was done by obtaining.specimensfromn the principalhilltops of Scotland, and fromn heath-lard and shores, as wellas from the surfaceof the ocean. A few were also obtained from German degp workingsand a very smalluumber frommarshy places in rance and Switzerland. A considerable variety.of artificial climates in elQse places wqrealso examined, andound to approach,the condition of he lesscrowded or ,btter class ofmetal mines. In addition to these the air of.town and country was compared, and that foundin different States of the weather. The result as regards oxygen is shown in the-",
         "CANADA MEDICAL JOURNAL. following table. The details of the analyses may be seen in the report on the \" Air of mines and Close Places\" in the appendix to the report of the Royal Commission in 1864; and in the late volume of the Nemoirs of the Literary and Philosophical Society of Manchester. OXYGEN IN THE AFa.-UMMARY 0F ATERAGEs. Volume per cent. N. E. sea-shore and open heath (Scotland)................ 20-999 Atlantic, lat. 43° 5. long., W., 170 12',................. 20.99 Tops of bills (Scotland)...... 29-08 In a suburb of Manchester in wet weather............... 20-98 In a snburb in Manchester in wet weather............. 20-96 In the outer circle of Man- chester, not raining....... 20 947 Low parts of Perth........... 20-935 'Swampy places, favorable weather. ..........20-922 to 20-95 In fog and frost in Manchester. 20-00 In a sitting room, which felt close, but not excessirly so.. 20-89 Best ventilated wards in three London hospitals- Day.................. 20-92 Midnight.............. 20.886 Morning.............. 20-884 lu a small room with petroleum lamp....-................ 20 84 Ditto, after six hours......... 20-83 Pit of theatre, 11.30 p.m ...... 20-74 Gallery, 10-30 p.m........... 20-86 About backs of houses and closets.................... 20-70 In large cayities in metalli. ferous mines (average of many).................. 20-77 lu currencs in metalliferous - mines (average of many).... 20-65 Court of Queena's Bench, 2nd February, 1866............ 20-65 Ditto at Lantera.... . ...... ..20-49 Under shafts in metalliferous mines (average of many).... 20-424 In samps or depressions in metalliferous mines, (average of many)................. 20-14 Wben candles go out.. ......18-5 The worst specimen yet ex- amined in the mine......... 18-27 Very difficult to remain for many minutes................... 17-2 CARBo.NIC ACI IN THE AIR. Hills above 3,100 feet..........0336 Do. between 2,000 and 3,000 ft. .0332 Do. between 1,000 and 2,000 ft. .0334 Do. below 1,000 feet..........0337 At the bottom of the same hills .0341 On bills in Scotland from 1,000 feet high to 4,406..........0332 In the sts. of London, summer. .0380 ln the London parks and open places.'................... .0301 On the Thames at London.... -0343 Where fields begin........... .0369 Manchester streets, ordinary weather...................0403 During fogs in Manchester.... .0679 About middens .............. .0774 In workshops, to.............3000 In theatres, worst parts, as much as ................. .3200' In mines, largest amount found in Cornwall............... 2-5000 Average of 339.............. *7805 After finding carbonie acid and oxgen, we have been accustomed to tahe the remainder as nitrogen. It wvould, however, be well to knowif there is really any tendency in nature to keep up a definite amount of nitrogen. We know nothing that can diminish or increase its amount .directly to any appreciable extent; and 'when the amount of oxygen is diminished by breathing, the space is filled up by carbonie acid, leaving -the same 'proportion of nitrogen as before. If, however, this carbonic acid is washed out or absorbed, we' have at once air with increased nitrogen, but diminished oxygen. This may be supposed to happen whea Tain- washes carbonie acid out of the air of towns, as in a perfectlYJ 466",
         "CHEMICAL CLIMATOLOGY. tight chamber, the carbonie acid formed by breathing is absorbed by lime. Then the nitrogen increases proportionately, the exygen diminishes Teally, but the air is kept for a long time in a state pleasant to breathe. It is found, however, that in towns when the rain washes out the carbonie acid the oxygen is greater than before. In such cases the rain probably makes an exchange ; it absorbs the one and gives out the other. This however, has not been proved, and inquiry is wanted. It is interesting to examine how far this action may be carried. Some of the analyses gave more than 21 per cent of oxygen. This number is not given among the averages, which alone are used here. It is usual to think this a mistake, but it may not be so: as nature has evidently a mode of adjusting differences, certain portions of the air may have at times a greater stock of oxygen for the purpose. The purity of air may be considered as favorably affecting the sanitary state of the more moist counties; but the actual increase of oxygen there is not proved. We may suppose that as pure water, dissolves air with a greater amount of exygen in it than common air, the pure air may give out soine in falling. In that case we require to suppose that the amount abstracted from the upper regions of the air renders the proportion smaller. This would explain the fact that a smaller amount is found on the tops of moun- tains. We have in vegetation a source of oxygen at certain seasons, and also in animalcular life; bnt this would not be available to produce the result on a sudden in a town during rain f-al. The formation of ozone in the upper atmosphere does not give us more oxygen; we obtain only a more active condition of that element. The formation of ozone at the surface and of nitrous gas also, by evaporation, affect, in conjunction with the elimination of oxygen by organisms, the supply of that which May le removed. It would be interesting to know what is the constitution of the air in various seasons of the year, and over various lands and crops, as well as amongst the crops, and in forests. It will be observed from the table that the amount of carbonie acid ioes not fall below 0'03. Smaller values have, however, been observed inpiains. When the oxygen rises high, the amount may be considered torrect, even when the percentage is volumetrically wrong. For example let some of it be as ozone; the condensation of the ozone would produce a result greater than 100. The amount of nitrogen is generally calcu- ated from the renainder, and not directly estimated. It may turn out that by following this clew, we may obtain a mode of analysis of the air rO Ozone if it is condensed oxygen. ome people will probably inquire why we should give so much atten- 467",
         "eqvb CANADA 3IEDICAL JOURNAL. tion to such:minute quantities-between 20·980 and 20-999-thinking- these :small differences can in no way affect us. A little more or less oxygen might not affect us; but supposing its place oecupied by hurtful -matter, we must not look on the amount as too small. Subtracting 0·980 from 0-999, we have a difference of 190 in a million. In a gàllon of water-there are 70,000 grains let us put intoit an impurity at the rate of 190 in 1,000,000: .it amounts to 13-3 grains in a gallon, or 0-19 :grammes:in a litre. This amount would be considered enormous if it consisted of putrifying matter, or any organie matter usually found in water. But we drink only a comparatively small quantity of water, and ,the whole 13 grains -would not be swallowed in a day, whereas we take ,into .ur.lungs from 1,000 to 2,000 gallons of air daily. The detection of:impurities in:the air is therefore, of the utmost importance,and it is only:by the:finest methods that they can be ascertained in small quan- tities pf air, even when present in such quantity as, to prove deleterious to health. We must remember also that the blood receives the air and such impurities as are not-filtered out in its passage, while it is the stomach which receives the water we drink, and that organ has for many sub- -stances a power of disinfection and destruction which blood does not possess. If by inhalationwe took up at the rate of 13 grains of unwho.- :some matter per day-half a grain per hour-we need not be surprised if ithurt us. Such an amount is an enormous dose of -some poisoni, and ýyet this is not -above one -two thousandth part of a grain at every inhalation. It is marvellous 'what small amounts may affect uS even when by repeated action, they do not cumulate as certain poisoDS do. The carbonic acid numbars might have been used instead of the oxygen numbers, with the same resitn. On the actual affect of carboaie acid there are separate experiments: but its amount is an important index to the state of the air. The organie matter is the dangerous agent, but of all organic matter, some of it -may be wholesome, soule neutral, and some putrid, but -the most dangerous seems to be the organized, existing in minute germs or spores. ,We began by assuming very small shades of difference, namely, 190 in a million; but if iwe examine the table we find much greater amounts Take, for example, the pit of a theatre: we have, by subtracting 2044 -from'20-999, a difference of 2,590 in a million, or 14 times more. -A so on we may go to the lowest, where we have 17-2, which taken froa 20-999, leaves 3-799 or 37-990 in a million, or 200 times more than tle first example. The conclusion to be drawn from al] this siiply is5tIha we cannot make the analysis too minutely.",
         "CREMIAL CLIMATOLOGY SOLID BODIES IN THE AIR. Boussingault, Vogel, Southwood, Smith, Pasteur, and others, have found organic matter in the air. Spores and germs were long ago known 4o be disseminated by it, although unseen, but there was no systematic method of examining the air of mines, it was found that the tubes in which air specimens were collected contained a good deal of dust, some of which was erystalline. These crystals were chiefly sulphate of pot- ash, but some were nitrate of potash, and perhaps carbonates from the eploded saltpetre. It was possible, therefore to obtain in a very distinct form the solid matters in such cases. This and some previous experiments led naturally to a very simple mode of washing out the impurities of the air. The air of a large bottle was shaken in contact with water: the air was renewed as often as was desired, and the water then examined. The results obtained by this means were very distinct, and no air was found so free from impurities as to leave the water clean. By this mode forms and organ- isms were obtained which clearly have vitality, since in some the power of locomotion was developed. In one atmosphere a certain milkiness is observed by washing a single bottle of air; in another it requires a hundred bottles to produce an equal amount. If the amount of visible impurity were all that was required to be known this method wouid be sufficient for all purposes; but it is desirable also to know the quality of the substances. In a nowhousc where there were diseased cattle, a large amount of matter was found in the air, which was easily seen by washing a half-gallon bottle of air, or even less, M ay not some of these substances carry, r be themselves the disease ? The only difficulty lies in discriminating between those which conveyed the disease and those which did not. lhere are forms floating even where healthy animals live; some found, for instance, in a stable where were healthy horses, and some in the wet on walls and windows of places exposed to perspiration. Hospitals might le examined in this way, and many other places, such as swamps, which Might be expected to give marked results. If, however, the undevcloped spore shows no distinctive mark, it may dcveloped by keeping it in the medium in which it was caught. istances occurred when no locomotion was at first visible, but became 'O after a time. This was observed several years ago in perspiration, a ast year in the washings of air. Now, if we could develope thei Rs to distinguish, an important point would be gained. :he air. washings promise to be very interesting. Those obtained 469,",
         "CANADA 31EDICAL JOURNAL. om Buxton, at Blackpool, and at Manchester may be known at once. Those obtained near Buxton contained lime and were white, althougih on a wet day and at least a mile from the blasting of the rock. Those at Blackpool on the seashore, were remarkably clean; they were taken after rain. Organisms were not sougaht in frce country air. PRODUCTS OP DECOMPOSITION. It is known that when organized bodies decomposed, more or less, ammonia is given out. it ought, therefore to be found in the air. I have not yet determined the smallest amount of washings in which ammonia can be found. This will, however, be a mode of ascertaining the condition of air so far as decomposing matter is concerned, from which there will be no appeal. The amount of soluble salts of chlorine and sulphuric acid has oftea been examined, and differences have been found to a very great extent. Of the chlorine of the chlorides the smallest amount, in a certain measure, was 31-78 grains inland, that is at Buxton, Derbyshire, and the highest 312-5 in a manufacturing town where ehlorides were decomposed. The inquiry has also shown that chlorides increase in the air when coal is burnt, even when there are no. manufactures for specially decomposing chlorides. The amount of sulphuric acid, free and combined, was found to vary ftom 75 to 4,000 in equal bulks. Some of the washings were rather laborious, as from 100 to 1,000 bottles were gencrally used for outdoor specimens. By the use of this method we may be able to estimate the amount of sea air which comes to any region when it cau be freed oif the presence of coal, and by means of the sulphates we shall be able to tell the amount of decomposition. At least it seems to me the sulphates must come from decomposed matter, giving out sulphuretted hydrogen or its ammonia compound. I do not doubt that an equivalent of ammonia will often be found with the acid : but not always, since, by the experi7 ments of M. Robierre of Nantes, the upper air contains nitrates and the lower air ammonia in predominance. Gernez has found sulphates in thé' atmosphere of Germany. They have been found in the rain at Darms- tadt and vicinity, at Zwingenberg, and at Giessen, and at all places where sought. The remarkable point is their inercase on land; tbere seems no reason for this except decomposition and coal burning. seems too much to refer the whole to the fuel. RAIN. In the rain from the Hebrides. (and the Atlantic, as collected by Carpenter as far north as the Shetlands), the sulphates diminished far 470",
         "CHEMICAL CLINATOLOGY. below the chlorides there ; the rain partakes of the quality of sea-water. Still we require to account for the great ease with which the salts are diffused in the atmosphere; we de not yet know whether there is a power of separation. At the present experiments are against this, and lead ratber to the belief that the rain contains actual sea-water with an addition of sulphates. Now, what is the origin of these sulphates ? We should expect the great ocean to keep all the gases formed within it ; but diffusion is rapid, and the spray is often high, so that opportunities of minxture must occur. Specimens of sea rain examined are too few to answer all questions that arise. The mode of washing the air mxay be resorted to in examining ventila- tion and the air found in very dry places. When the examination is to be made out-of-doors, and in a country with a large rain fall, we have provided by nature a mode of air washing. Country rain and town rain are easily distinguished-at least the rain of places where much coal is burned; the one is clear and colorless, the other black and muddy; the one is tastless, the other tastes of soot; the one is neutral, the other is acid and corrodes metals and even stones and bricks, destroying mortar- rapidly, and spoiling many colors readily. These common observations require only to be supplemented by the- refinements of chemical experiment. This can readily be done, for the rain washes the air, and we find it purer. The impurity which goes into the water is easily taken out. The results are similar to those obtained by washing the air; the first and most striking is the sulphurie acid arising from fie burning coal. SPECMEN 0F RESULTS BY EXAMIILNG BAIN. Bydrochloric Acid. Combined and Un- combined Chlorine. Relation to the average of that from Row, Dunbar- tonshire, taken as 100: Compara- tive quantities only. Row, Dumbartonshire..... 100*00 1 Birkenhead.............. 461-87 41 Near an alkali work...... 495 83 5 Whiston [from covered tank................ 512-24 5 Newcastle on Tyne... 115877 Ii I\u0026anchester,.............1438-00 14J Liverpool............. 1684-00 17 Waterloo (shore near do].5214.30 52 nIe,.-Sulphuric Acid. Relation to that from Row, Dunbartonshire, taken as 100. Row, Dunhartonshire .... 100'00 l Waterloo................ 329-34 2i Whiston................ 398-28 4 Birkenhead.............. 464,47 4, Liverpool............... 706-02 7 Newcastle-on-Tyne . 891-43 9 Manchester............973-00 9î Near an alkali work....1470-no 14 Rain.-Total Acid. Relation to that in Rain from Row, Dunbarton- sbire, which is taken as 100. Row, Dunbartonshire..... 100'00 1 Whiston................ 470-69 41 Birkenhead.............. 528-29 51 Liverpool............. 938-21 9î Waterloo ............. 961-98 9i Newcastle-on-Tyne......1054-73 1OJ Manchester,..........1272-54 11 Near an alkali work......1539.27 15t AMoNIA. hi quite proved that there is more ammnonia in inhabited than unin- 1",
         "CANADA MEDICAL JOURNAL. habited places. There will be less difference when there is mauch rain or inuch wind, or very great dryness. These conditions are in reality favorable to health, each with its peculiar exception and modifications. Liebig examined the Giessen rain ; others have made similar examina- tions, but much yet remains to be done. Rain waters collected during 1869. Ammonia Free, and with Acid. Parta pev Million. Darmstadt, February........... 5-30 Do. during a thunderstorm, May 26th .................. 1-00 Zwingenberg, near Darmstadt, on the top of a bil, July........ 0-85 Heidelberg, Schlossberg, June 15. 0-40 Tyree, May.... ............. 0.40 HKelly, Wemyss Bay, Clyde, south west wind, June 12th-15th.... 0-15 -St. Helens, west- wind, February 13th-March lith............. 6-00 Do., much east wind, April 22nd May 26th.-................ 3-67 Manchester, 30 feet from the ground, August.............. 1-50 Do., same place Seplember...... 2-70 Do., 12 feet from the ground, back of Laboratory, April.... 18-00 Do., same place. August........ 4-20 Do., during a thunderstorm; rain had fallen heavily, just before, September 10th.............. 0-84 Do., 2 feet from the ground, be- hind the Literary and Philoso- pical Society, 9th 31st Aug.... 9·09 Do. same place during Sept..... 2-80 The amount in Darmstdat seeis higih for a smal place. The washing of the air by the rain is strikingly shown. The advantage of a slight elevation and distance froin a town is shown at Zwingenberg; and at Schlossberg, on a slight elevation behind the town. The greater purity of sea air is sbown on the coast at Wemyss Bay. No specimens were collected vith greater care than those from Wemyss Bay. The above mnay be accepted as at least valuable comparative amounts. The differ- ences in height are shown in Manchester. These experimentsagree witlh those made at Vantes, by Rlobierre. The ammonia dininishes, whilst nitric acid increases, up to a habitable height. The Manchester spee6 mens were behind horses, or in confined situations. By these means we may be ablo to to ull plainly and authoratively if a place is close or otherwise: and to say fhat the rain or the air when washed, must not show more than a given amount so as to bc fit for respiration- In this way it may be possibly authorative to fix a limit to the density of the population and the extent to which manufactures may be carried on within a given. .area. ALBUMINOUS MATTER. Wc cannot; however, except that all the nitrogen of organic substances should pass into ammonia at once, especially as it has been shown-tht there are substances visible in the washed air. These may be in part nitrogenous bodies carried up: and if we decompose these, we shal obtain the ammonia. After obtaining the ammonia, by the Wanklye method, by boiling with carbonate of potash, we can apply his mode of",
         "CHEMICA L CLIMATOLOGT. decomposing albuminous bodies mainly by the use of caustie potash, and permanganate, so as to obtain the ammonia resulting. We can thus to some extent analyse the organie matter of the air. If ve treat the rain of varions places in this manner, we have results corresponding to the density of population to some extent; but there will also be diferecec caused by currents, rates of decomposition, and washing. We have for example :- Rain waters coUected during 1869. Do April 23rd............ 020 Alburnioid Ammoml. i ja. rart pe mm Manchiester, 30 feet from the Darmstadt, February........ 0·30 græ'.Ud, August ........... 0·15 Do., during a tbunderstorm, ý Do., n-nme place, September..... 0-30 May 2etb ................ 0075, Do., 12 feetfrom the ground, Feb. 0-3A Zwingenberg, near Heidleberge, Do., same place, June.........o July...................... 0-15 Do., During a tbunderstorm. Beidelberg, June 15th......... 0-087 Rain had fallen heavily just Tyree, May.................. 0-30 bfore. Collected about 2 ft. Kelly, Wemyss Bay, southwest fromtihe ground, Sept. 10th.. 0.079 wind, June 2nd-15th.... . 0.075 Do,, 2 feet from the ground, be- St. Helens, west wind, February bind the Literary and Philoso. ]8th-March 11th............ 0-15 phical Society, September.... 0-25 We have here the amount of ammonia from substances decomposed by caustie soda and permanganate. Darmstdhansat and Tyree are both rather high, Darmstdhansat being a town, might be supposed to have cause suffi- cient. The Tyree specimen was, I believe well collected, as the inorganic salts were such as precluded the idea of ail impurity cf that kind; but some local cause may have affected it, such as the decom- poSing of weeds, as there is a large kelp work on the island. NITRIC ACID. .1 curious result is found in the case of nitrie acid; the Continental rain contains much more than our rain, so far as the observations yet go. This is what migbt bave been expected, because in a drier atomosphere there would be less nitric acid carried down, and in a warmer there would be more formed, if nitrification in the atmosphere requires the same temperature as in the soil. It is uncertain whether this is an acei- Qent or a comm n characteristie. In another point there seems a eifference between the Continental atmosphere and ours. Pettenkofer inds 0-05 per cent. of carbonic acid in the free air at Municb, which is A town of wide and open streets, especially at the University. In the streets of Manchester a smaller amount is generally found. About 0-04 is the amount in tolerably open situations. GG 47g",
         "CANADA MEDICAL JOURNAL. Bain waters collected during 1s68. Manchester, 30 feet froni the Nitric Acid per Milion. ground, August..........1.482 Darmstadt, February......... 8-894 Manchester, 12 feet from the Do., during a thunderstorm, ground, February..........0.370 May 26th....,............. 1-112 Mancbester, 12 feet frani the Zwingenberg, July............ 0-370 ground, July..............1668 Heidelberg, June 15th......... 0-370 Manchester, 20 feet from, the N. Ulst, March............... 0-556 ground, Sept..............0-741 Kelly, June 12th, 15th......... 0.185 Manchester, during a thunder- St. Helens, March 1lth-April 22. 0-926 storm. Raia had fallen beavily Do., April 23rdMay 3th.. 0 a556 njust before. Septfmber 10 The 1arare amouut of solid matter in specimens f rin sent from Glas- gyow led nme to, conneet it withi the great mortality of that town. Steps are being taken ta obtain specimens of raja in several towns for the prgsecutirn of this branF. of inquiry. For a satisfactory investigation of the subjet we must look ta the multiplication of these experiments, and perhaps ta the establishent of a department at saie observattries for chernical elimnatology and meteoro- l emy.-.Jornal to cottish thoet-ological Socity. NOTES ON DIOGEINESIS AND ABIOGENESIS. Br, E. MÇCURi;. M.A. The spntaneous genration question bas been nvested fvith an increased, interest since the delivery of Professor lluxley's nddress, at the, late meetin of the British Association. The advocates of thc oppasi theories an the subjeet have started ta workwith renewed zeal to bring the niatter ta a definite issue. iProfessor Hluxley and Dr. Bastian stand for- -ward as the aoknowledged leaders on bath sides. The labours of thýe latter gentleman, wha contends for t pe spantaneous generation, or abie- genesis theary, are certainly very zealous. fo s recen t papers in l g ature\" have wou for fm any partisans bath here rnd oa America. The York Méfdical Gazette of the,5th of Naveinber devotes an article ta the\"\" subjeot, in which there is exlîibited'a considerable leaning \u003eta the Abie-; genesis theo us.The experiments of Dr. astian upon sealed tins preserved ment, and flasks cntainingorganie riatter, expose fore a lngthe. ened period tao atemperature as higli as 300' Fahrenheit, sceln 'gea weight tatig owriteri' tiht article. The abjections of Professor TyndalI however ar e impjrtallyv nticed, and t Editor car for falt er an crucial experiménts, l Pordeor tft ts importyan Dquestion may be s fottrle de thinkse haowlever, that there arc a pbor cside.The l ragu e ot the supporters of the Abioenesis elory. There paeustrhave benre",
         "NOTE OF BIOGENESIS AND ABIOGENESIS. maintains, a period-prior to the \"origin of species,\" or the era of natural selection\" - when the first organie compound came into existence ; and he is inclined to believe that this must have taken place by the \"re-arrangement of the molecules\" of inorganie matter, by the operation of physical forces under certain fixed conditions of which we are yet quite ignorant; and that this process is very probably going on around us still. Dr. Cameron, in his\" IReport o'n Publie Health,\" in the November number of the Dublin Quarterly Journal of Medical Science, after reviewing Professor Huxley's late address, states that Dr. Burdon San- derson believes that the recent researches in this subjeet have established at least one fundamental doctrine-namely, that every kind of contagion consists of particles. The smallest organisms as yet discovered are of a spheroidal corpuscular form, called micrococcus by Hallier, and micro- zym by Béchamp. It may be interesting to give the former gentleman's opinions regarding their structure, a review of whose work appeared some time ago in the Medical Times and Gazette:- \"If for instance, micrococcus gathers on the surface of the fermenting fluid, the newly-formed subdivisions of the parent cells remain in con. nection, forming links of a chain. In the sanie way, these chains may form in masses upon the mucous membrane of the mouth and pharynx, and pass, more or less broken up, through the alimentary canal, and may be found in large masses in the foces. Remak gave these forms the name of Leptothrix buccalis; but since leptothrix is a kind of alga, I haie pre- ferred to call them mycothrix. In the sanie way, beautiful arborescent growths may be produced under certain atmospherie influences which have been called hornyscium, but which sbould rather be called the hor- *myscium form of micrococcus. In like manner, anthrococcus may pre. sent several varieties, which have been classified as oïdium, torlhansua, \u0026c Mierococcus, cryptococcus, and anthrococcus are, therefore, iot sepa- rate species, but merely morpho,or forms representing stages in the growth of different fungi,. which, however similar they may be to each other, neyer oe their specifie characters. A fa-t of the utmost value in the study of vegetable parasites is that we ar3 enabled to make each yea t. cell bud and develop, if w'C place it, on an appropriate solid soil and pro- *Videý it witi filtered air. \"In the blood and tissues of the human body, rich in nitrogen, of course, tie microccocus of fungi alone is to be found. Anthrococcus is, however, fiequently found on the surface of the mlucous membrane of the mouth nd stomacli, whilst cryptococcus is sometimes met with in the contents of the stomazh after certain kinds of food have been taken. When the 475",
         "CANADA MEDICAL JOURNAL. micrococcus of any fungus occurs in large masses in the blood of man. it may generally be looked upon as a pathological indication. I have, how- ever, occasionally found the microccoeus of Penicillium crustaceum in the blood of perfectly healthy people. At all events, the occurrence of micro- coccus in blood can only be considerea as of any real pathological moment -when it is known from what fungus it proceeds. \"The micrococcus cells are generally so small that they require to be magnified 2,000 diameters to be examined, as they do not present dis- tinctive characters. The fungus fron which they have been derived can only be determined by cultivating them. I have succeeded in finding the micrococcus of certain fungi in a considerable number of diseases, and have always found one form peculiar to one and the same disease. To develop the fungus, in each case a supply of filtered air and a solid sub- stratum are necessary, as mentioned above. Under these circumstances, the micrococcus gradually enlarges, until the cells reach about the dia- meter of the respective fungus. These large translucent cells, which have been named \" sporoids,\" are capable of budding. \"-Journal of Cataneous Medicine. THE LIvER THE SEAT OF FORMATION OF UREA.-The latest researches upon the place of origin of urea, and especially tbe beautiful experiments of M. Gréhant, have demonstrated that the kidneys are by no means secretory, but purely exeretory, organs for urea. Dr. Cyon, in the last number of the Central blatz, published a few facts in the form of a provisional communication, to show that it is probably produced at the liver. The plan of experimentation adopted (in common with M. Istomin) was as follows: The whole of the blood was abstracted from the carotid of a dog, and a portion, after being defibrinated, was trans- nitted by means of mercurial pressure through the liver. Coincidently three.canulæ were introduced-one into the inferior vena cava, the second into the hepatic artery, and the third into the vena porta. The results\u0026 of careful analysis showed that the blood which had passed through the liver contained a much larger proportion of urea than ordinary arterial blood. In one experiment 100,c. c. of the arterial blood 'when defibri,' nated contained 0.08 grammes of urea; but after having been passed four times throngh the liver, the same qu9ntity contained 0.176 grammes.-7 Lancet. 476",
         "MONTREAL, APRIL, 1871. SMALL-POX-ITS PROBABLE ADVENT. For some months past the City of Montreal has been free from that scourge Small-pox. How long we are to remain so is questionable. A -case, the first of the kind, was admitted into the Montreal General Hospital recently. The patient was a passenger by the steanship \"Scandinavian\" on her last trip to Portland, and, so far as we could ascertain, he must have contracted the disease before leaving Liverpool. We are aware that Small-pox of a very severe type exists in some quarters of the city of Liverpool, and we may fully expect any number of cases with the tide of emiigration.. In conversation with a confrere the other day, he suggested the idea of shipping agents insisting on vaccination being performed on ail passen- gers, prior to embarkation for this country; this we do believe a good suggestion if it could be carried out, and would be very beneficial, both to the owners of vessels as well as to the individuals emigrating. Sir James Simpson, in a paper which he published shortly before his last fatal illness, suggested universal vaccination, adult and infant, with a view of \" stamping out,\" as he termed it, the disease, Small-pox. With regard to the protective influence of vaccine, we think that no man of sound and disposing mind would entertain a doubt on this head. From the observations of Ganster and others it has been proved that the protective influence of vaccine diminishes every year after the fourteenth, dating from its performance, so that it becomes a settled axiom that Te-vaccination of adults is a wise precautionary measure, in view of a threatened epidemic of Small-pox. It is a fact that Small-pox is more or less epidemie throughout Europe; all the large seaport towns suffering from the diseuse in variable intensity, it becomes the duty of the Government to issue special regu- lations with regard to careful quarantine. No vessel coming from an nifected port should be permitted to pass the quarantine station; if a single case of Small-pox bas broken out on board during the passage, ithout careful ventilation, fumigation and cleansing. All vessels shlould be obliged to stop at the quarantine station, or all the",
         "CANADA 3!EDICAL JOURNAL. passengers should be carefully inspected by a medical officer prior to permitting them to pass up to Quebec. No exemption should be made in the case of steamships. The delay may occasion some- inconvenience to importers; but that delay should not be for a moment thought of vhen compared ith the fearful consequences of introducing into our country, by direct contact, so fearful a scourge as Small-pox. It is a settled fact that Small-por has a distinct period of incuba- tion. The diseuse consists in a specifie poison, which, on entering the circulation, gives rise to a train of symptoms more or less severe, according to i. dividual peculiarities. The period of incubation is stated to be twelre days, that is, dating from exposure to the commencement of the attack. This period of latency is unattended with symptoms o indisposition. About the twelfth day after exposure the individual shows the first indication of the disease, and three days thereafter the eruption commences to appear. It is our owa experience, and we beieve the experience of most physicians, that vaccination, if properly performed, will, even though the poison of Small-pox is already in the system, have a modifying influence. This fact is, perhaps, the strongest argument in favor of re-vaccination; and, -with regard to the suggestion that all pas- sengers should be vaccinated, or re-vaccinated, prior to embarcation, we believe that, if shipping agents would rigidly carry out this rule, much good would result, and there would be less chance of their vessels being detained in quarantine for variable periods, extending in some instances over several weeks. With regard to universal re-vaccination, we have always recommended it, and practised it when requested to do so. The trouble and incon- venience is trifling; no possible harm can accrue ; much good may, how- ever follow, more especially in a large community, among whom them must be many who are not protected, and who, by submitting to a trifling operation, not more painful than the scratch of a pin, and a few days uneasiness, place themselves in the very best possible condition of rest ing the poisonous influence of a most loathsome disease, which, n all lik- lihood, will become epidemic in spite of the utmost care to prevent sue a catastrophe. ANNUAL CONVOCATION McGILL UNIVERSITY. The Annual Convocation of this University was held in the Wil Molson Rall, on Friday, the 31st March, 1871, for conferring degrees 1 Medicine and Surgery, and Law. The proccedings were opened with prayer by the Venerablerte deacon Leach, D.0,L., TL.D., the Vice-Principal. 478",
         "ANNUAL CONVOCATION 31CGILL UNIVERSITY. - The Dean of the Medical Faculty, Georige W. Campbell, A.M., M.D., made the following announcement:- The total number of students in the past session was 150 (an increase of 10 over the preceding session) of these there were from the Province of Ontario, 78; from the Province of Quebec, 61; Nova Scotia, 4; New Brunswick, 1; Newfoundland, 2; Prince Edward Island, 2; United States, 2. The number of students who passed their Primary Examination, which includes Anatomy, Chemistry, Materia Medica, Tnstitutes of M1edicine, and Botany or Zoology, was 26; as follows:- Hamilton Allen, Alex. D. Blackader, B.A., Arthur A. Browne, George M. Christie, William Copeland, Daniel C. Cram, George M. G. Farewell, George W. Gernon, John R. Hamilton, Zotique Hébert, Harry Hether- ington, Robert Howard, Samuel N. Jackson, Thomas Kelly, Albert E. Mallory, Louis T. Marceau, Peter McLaren, James T. Monroe, John Morrison, B.A., William R. Nicol, William J. Sharpe, Leonard St. John, George A. Stark, Alexander Stewart, A. Dixon Wagner, William E, Waugh. The number of students who passed their final examination for the degree of M.D.C.M. was 29. Of tnese, 16 are fron Ontario, 9 froin Quebec, 2 from Nova Scotia, 1 from New Brunswick, and 1 from New- foundland. Their naines, and subjects of their theses, are as follows:- R. A. Alexander, Urinary Calculi. L. Il. Beaudry, Pathology of the Secre- tions, Alexander D. Blackader, B.A., Com- mon Sensation. Il. R. Brisseit, Diseases of the Heart. A. J. Cattenach, Mlorbus Coxr. W. Clarke, B.A., Acupressure. F. F. D'Avignon, Strabismus. G. M. Duncan, Chloral. John Duncan, Calculus VesicS. G. W. Fatulkner, Dysentery. C. X. Freeman, Diabetes Mellitus. M. Gardner, Typhoid Fever. J. R. Ramilton, Talipes Varus. L. G. Hunt, Tubercular NIeningitis. T. G. Johnston, Diabetes Mellitus. H. McConkey, Erysipelas. C. F. A. Locke, Dyspepsia. G. W. Major, B.A., Enterorrhea In- fantum. Alonzo W. Marston, Circulation of the Blood. J. H. Mathieson, Surgical Cases. F. I. Mitchell, Scarlatina. C. J. Rattray, Venereal Diseases. T. D. Reed, Pneumonia. J. A. Reid, Vivisection. W. G. Rose, Typhoid Fever. R. Stevenson, Post Partum HoSmorr- hage. F. Warren, Debility. J. F. S. Webb, Neuralgia. H. P. Wrigbt, Intermittent Fever. Of the above-named gentlemen, four have not conmpleted their twenty- first year, and cannot therefore receive tieir diplomas at the present con- iocation. Their names are Messrs. Locke, McConkey, Warren, and Wright. They have, however, passed all the examinations, and fulfilled all the other requirements, and only await their majority to receive the degree. 479",
         "CANADA MEDICAL JOURNAL. The Medical Faculty prizes are the Holmes Gold Medal, awarded to the student who takes the highest marks in th3 aggregate of primary and final graduation examinations, and Thesis; and two prizes, one for the best final, and one for the best primary examinations. The Holmes Medal was gained by John H. Mathieson, Embro, O. The prize for the best examination in the final branches was awarded to H. P. Wright, Ottawa, O., and in the primary branches to T. Kelly, Durham, O. The gentlemen who, after the prizemen, passed the best examination in the final branches, were Messrs. R. A. Stevenson, T. G. Johnson, W. Clarke, B.A., A. W. Cattanach, 0. F. A. Locke, W. G. Ross; and in the primary branche, H. Allen, L. T. Marceau, G. A. Starke, A. A. Browne and W. Copeland, in order of merit. 7PROFESSORS\u003e PRIZES. Zoology-Prize, M. D. Stark. Practical Anatomy-Senior class prize, J. Hils; junior class prize, Messrs. J. B. Comeau and Ellison, equal. Senior class deserving honor- able mention, Messre. Alguire, Kitson, Carmichael, Ward; junior class deserving honorable mention, Messrs. Chevalier, Young, Rattery and 3olson. Practical Chemistry-Prize, C. Sheppard. The graduates were then called up, and after the oaths had been administered by Dr. Craik, the ceremony of capping was performed by Dr. Dawson, Principal, who presented each with his diploma. Dr. Stevenson then delivered the valedictory address on behalf of the graduating class. Professor Fenwick addressed the graduates in Medicine and Surgery on behalf of the Faculty. This address will be found among our original communications. After the proceedings of the Law Faculty, the benediction was pro- nounced by the Rev. Professor Cornish and the convocation adjourned. COLLEGE OF PHYSICIANS \u0026 SURGEONS OF ONTARIO, Written Examinations for the year 1871, beginning Tuesday, April 4th, at 9 a.m. CarmisTur. Dr. Sangster. State clearly the course of the Electric current in a galvanic battery, and which is the positive and which the negative Electrode. Describe the Thermometric scales, and state how readings in one may be reduced to equivatent readings in the others. Describe the nature, sources, properties and uses of ozone, also mode ofdetect7 ing its presence and amount.",
         "COLLEGE OP PHYSICIANS \u0026 SURGEONS OF ONTARIO. 481 Distinguish between colloids and crystalloids, giving examples. AGive general rule for calculating the Sp. gr. of gases of known composition. IGive brief synopsis of the chemistry of Fe. and its compounds. Distinguish between Monads, Dyads, Triads, \u0026c., with examples. State 'the differences between Rectified Spirits, Proof Spirits, and absolute Alcohol, stating how the last may be obtained. Give the name and compo- sition of a few of the Conatomic Alcohols of the series, ANÀToxy. Dr. Sullivan. How would you expose the fornia? and describe it. Trace the 3rd division of the 5th nerve from its origin, its branches, and sum up the parts supplied. Name in order the parts exposed in removing the Trapezius Muscle, low are the portal and internal Jugular veins formed ? course and relations. Describe the iris, membrana tympani and Velum interpositum. Describe the duodenum, its relations ; with vessels and nerves supplying it. Dissect the plantar arch. ParstoLoGy. Dr. Covernton. What are the conditions necessary for the perception of taste ? What nerves exer- cise the special sense? Describe their origin and distribution, and give a brief account of supposed mechanism. Describe the auditory apparatus, origin and distribution of terminal filaments of auditory nerve, also functions of external and middle ear and Labyrinth. Origin, distribution, function and inter-relation of great sympathetic with cerebro-spinal nerves. What are the functions of medulla oblongata and mesocephalon as nervous centres ? Arrange the cerebral nerves according to their several functions, viz.: nerves of special sense, common sensation, motion, and mixed nerves. Relate the peculiarities of the fotal circulation. Where are the Wolffian bodies situated and what are their functions ? MATMIA MEmcA. Dr. Tuck. Name the chief medicinal agents classified as diureties, state the purposes for which they are employed, and write a prescription in full that will have a direct diuretic action. ýGive the medicinal properties, uses, doses, and modes of administration of lIodine, Belladonnaand Aconite. Name the pharmaceutical compounds of Lead, their uses and doses, poisonous effects and antidotal treatment, Distinguish between narcotics and hypnotics ; anæsthetics and anodynes, with examples of each and their peculiar physiological effect. ToxicoLoGY. Dr. Sweetland. What is a poison ? What are the symptoms of arsenical poisoning? Give the antidotes and reason why they are antidotes. Give tests for corrosive sublimate.",
         "CANADA 31EDICAL JOURNAL. Contrast the symptoms of poisoning by opium with tbose of apoplezy a\u0026 intoxication. What treatment would you adopt in narcotic poisoning. In a case of suspected poisoning, wbat precautions would be necessary to observe in making post-mortem examination ? BoTiiy. Dr. Cornell. What is Botany? Of what does the vegetable kingdom consist? What does the term plant\" imply? Are there any examples of plants growing without being attached to any Axed body ? if so, give examples. Are there any plants endowed with sensibility ? if so, give examples. What analogy is there betweei plants and animals? What important position does the vegetable kingdom occupy ? 1s there constantly any reciprocity of favors going on between the vegetable and animal kingdoms ? if so, give examples. SuRGarY, other than operative. Dr. Lizars. Describe the causes, symptoms and diagnosis of lumbarabscess. Describe causes, differential, diagnosis and treatment of orchitis. Describe the diseases which may demand castration. What are the diseases which may affect the antrorm of higmore ? Describe the symptoms of memabranous croup and cases in which trachotomy is justified. SUEGIcAL PATHOLOGY. Dr. Field. What are the four principal conditions necessary to tbe normal nutrition of parts? What are the two chief forms of atropby ? Describe an atrophied muscle in each form. Describe the pathological changes that take place in the formation of an absces also the process of repair or filling up the cavity produced by the discharge of pus. Enumerate the products of inflammation that exude from the blood-vessels of inflamed parts. In subcutaneous injuries does extravasated blood take any part in the repara tire process ? if it does, in wbat manner ? is the nominal mode in the repairing of fractures by ensbreaking or intermediat lattus ? Describe the reparative process in fractures. What experience in pathological conditions between dry and moist gangr Give causes in both forms. OPERATiVE SuiGEaY. Dr. Lizars. Describe two or more methods of vaccinating a child, and the changes that a be expected to occur if the vaccination is successtul.",
         "COLLEGE OF PHYSICIANS \u0026 SURGEONS OF ONTARIO. Describe the operation for deligation of the subelavian artery in its external third, the structures to be divided and the parts to be avoided. Denote the diffierent degrees of rupture of the perineum (female} causes and modes of operating for the relief thereof. Describe the usual cause of vesico-vaginal fistula and describe the operation for its relief. Describe Perrigoff's modification of Syme's operation at the ankle joint. Describe the operations of Iridectomy. Describe the operation of resection of the knee joint, and mention the cases in, which it would be most likely to be successful. A child is brought to you with double barelip and cleft soft palate, when should you attempt to relieve it? and the reason for selecting the period, and describe the operation that would be necessary. OPSATIVa MIDWIFSRY. Dr. Ilope. If the fotus and pelvis are duly proportioned, but the position of the child unpro_ pitions, what instruments should be used to restore the lost relation Of position? Gxive tbree cases where the use of the forceps is indicated, and describe the proper position of the patient for the operation, the manner of applying the instruments and of making extractive force. Describe a case where craniotomy is indicated and the manner of performing. the operation. Give diagnosis and treatment of a case of epileptic puerperal convulsions. State diagnosis and treatment of prolapsus of the cord. MIDWIFERY, other than operative. Dr. lope. State son e of the signs which show that labor bas commenced. Ilow would you distinguish true and false pains ? Into how many stages is labor divided ? Describe the several stages. Describe the first and second positions of the head. What is the best position for delivery? GassatL PrTHoLoGY. Dr, Wrigbt. 31istory of Tubercle- What conditions form passive congestion ? What are the structures involved an\u0026 what are the general rules for treatment? SUROOCAL ANAToxy. Dr. Sullivan. What is the relation of the parts passing beneath the anterior annular ligament of the wrist joint? What parts are divided in excision of the elbow joint ? Give course and coverings of femoral hernia, where the stricture generally occursr and the dangers likely to be encountered in dividing it. 1ow would you perform Symes\u003e operation ? and mention in some order all the structures divided. GiYe course and relations of interna] maxilary and obturator arteries. 483",
         "CANADA M1EDICAL JOURNAL. MDicà.L JURIsPRUDENcE. Dr. Campbell. Give sigas of de.ath ani give the order of the phenomena by which death is recog- nized. Distinguish between wounds inflicted before and after death. Iow are stains of human blood recognized ? Ilow far may concussion of the brain be distinguished from intoxication? Give the sigus of pregnancy. Give signs of recent delivery. Describe the hydrostatic test in infanticide. Give definition of insanity. Different forms if insanity. How can fevered insanity be recognized? PACincE or MEDICINF. Dr.Wright. What are the symptoms of pneumonia in the adult, its several stages and their pathological conditions, the prognosis and treatment? Wbat circumstances are necessary to the production of malaria? What diseases does it give rise to ? How would you prove the existence of such a cause cf disease? What characters have tbey in common ? and what effects follow their long continued influence ? The symptoms of acute and chronic Bright's disease, the rules for the detection of albumen and their fallacies, prognosis, and treatment. What diseases of the chest have increased resonance on percussion ? In what ià percussion unaffected (or only slightly); and in what is it dull and what is it flat ? and what value is percussion as a means of diagnosis, and how is percus- sion performed ? SaNXTÂRT SciscE. Dr. Carson, What is Sanitary Science? What sanitary measures should be enforced by the public authorities at all times ? What measures should be adopted in anticipation of au epidemic of cholera? In small pox ? How far may the endemic diseases of Canada be prevented, and in wbat way? What are the ordinary impurities of drinking water, and how may they bc detected and removed ? In making out a dietary scale for a jail or asylum what proportion of nitrogenou food should be daily allowed for each inmate? Give an example of a daily ration for an adult prisoner on the cheapest scale compatible with health. What is the minimum cubic span that shonld be allowed to each bed in an hOS- pital or barrack? Name some of the ordinary disinfectants and how they are supposed to act.",
         "SUCCESS OF A MCGILL COLLEGE STUDENT. SUCCESS OF A McGILL COLLEGE STUDENT. We have mueh pleasure in announcing the suecess of another Graduate of McGill College, in Great Britain. G. W. BL10, M.D., C.M., L.B.C.S.E., and late Assistant-Surgeon in the United States Army, bas reeeived the appointment of House Surgeon t\u003e the Kidderminster Infirmary, one of the best appointments of the kind, i England. His election and appointmient, which took place on the Sth of December last, and resulted in an unanimous choice, was contested by a large number of candidates, among whom were many able men who Lad held good surgical appointments in different parts of England, including two ex-house surgeons of Charing Cross Hospital, and one of University Col- lege, London. This institution, although styled an Infirmary, is in reality an hospital, althoughi out-patients are attended at their homes, when too ill to be removed, or unable to be admitted into the Institution. A very fine. new building is in course of erection, the memorial stone of which was laid last spring by the Countess of Dudley, and will be completed. and ready for occupation by the end of May next. It is fitted up in the best style of art, with all the latest hygienie improvements and detached fever wards, \u0026c., \u0026c. Dr. BLIGH'S professional opportunities have been of the very best, kind. The late fratricidal war in the United States of America opened a splendid field to young surgeons, of which lie was not slow to avail himself. The influence and initerest which he commanded secured him the greatest respect and consideration of many of the leading surgeons ofthe U.S. Army; and his taste, inclination, and mature judgment-then a very young man not twenty-one years of age-soon placed him in the coveted position usually assigned to older and more experienced hands- operating surgeon. He was sent to the front, where lie laid the founda- tion of his future successful career. His field and hospital operations zount by hundreds, and that of excision of the shoulder joint he has per- formed eighteen times in that service. His testimonials from the U.S. MArmy form an honorable and bright record, and aie the surest vouchers i ils future distinction. We wish him the success we are confident awaits hL, superior attainients and abilities, notwithstanding bis utremely retiring disposition. Dr. BLiG is a nepbew of Dr. MARSDEN, of Quebec, by whom, Le Waâ educated, and under whom he studied. The latter gentleman was, 485",
         "CANADA MmEICAL JOURNAL. in addition to his other professional honours, adnitted as a Corresponding Fellow of the \" Edinburgh Obstetrical Society\" on the 13th of July last, ,on motion of Dr. C. BELL, the President, seconded by Dr. KEILLER.- Communicated. THE PROFESSION IN TORONTO. The profession in Toronto met in considerable numbers on the Sth of Mareh, and passed a series of resolutions on the existing state of medica amatters in the Province of Ontario; the two following vere the Most important:- 3rd. \" That we will not support any candidate who will not agree to modiy the law under which the profession of Ontario is at present .iacorporated, at least so far as to bring its Council and Examining -Board in conformity with the provisions of the contemplated Medical Act for the Dominion of Canada.\" 4th. \" That we further urge upon medical mcn the desirability of requesting candidates to advocate a repeal of the Ontario Medical Act, which unites us with persons knowa as Ilomoeopaths and Eclecties.\" We need hardly add that wc cordially endorse the action of our bre- thren in Toronto, and sincercly trust that the stand thus taken may influence at least some of the recently returned memnbers. If the profes- sion of Ontario, however, really wish to place themselves right before the medical wcrld, they nust act unitedly. PRACTICE FOR SALE. Any young medical man, desirous of at once entering upon a good country practice, where there is no cpposition, is referred to our adver- tising columns. We know the medical man who offers his practice for sale, and are aware that ill hcalth is alone the cause of his relinquishing it., We trust that our Canadian Medical Associa.tion is not going to bc. unrepresented at the forthcoming meeting of the American Medical Association, which takes place in Mray, at San Francisco, California. 486",
         "DiL N. G. ORDWAY, of Portland, Maine, who was sued for malprae- lice in the matter of an operation performed upon a patient's hand, has Teceived a verdict ir bis favor on the singular defence, as reported by a local paper, \" that the ether used in the operation affected the physician se tiat he was unconscious of wrhat he did.\" DEATH FROM CILORAL HYDRATE. DR. GEORGE G. NEED1iAM reports in the Journal of PsychologicI Ie\u0026cine a case of fatal cerebral congestion following the administration of IHydrate of Chloral toa mar ied woman, aged 50 of hysterical diathesis, who had suffered for some tvj years with symptoms of mental derange- ment, consisting of distressing \"nerousness,\" fcar of impending death, lesitation, suspiciousness, etc. Ophthalmoscopio examination showed an eularged and tortuous condition of the retinal vessels. In October, 1870, ihe loss of a relative threw her into a state of much excitement, for which she took, on October 19tb, 115 grains of bromide of potassium. On the 21st, chloral hydrate was prescribed in thirty-grain doses, of which she took six, as follows:-On the 21st, at 5.30 p.m. and 11 p.m.; on the 22d at 10 a.m. and 3 p.m.; on the 23d, at 1 a.m., 8 a.m., 8.10 a.m., and 1.30 p.m. On the afternoon of the 22d she was sleeping quietly, with a somewhat rapid pulse, ançi was found in the samte condition at two visits (morning and evening) on the 23d. On the morning of the 24th ber continued sleep ereated alarm, and ineffectual attempts were made to rouse her, which were maintained during the day and night. Suiphate of strychnia was thrice injectedl in doses of one tbirtieth of a grain at intervals of four hours during the night. Coma progressed to a fatal termination on the afternoon of the 25tb. The autopsy revealed extreme hypermmia of the pia mater and brain substance. A year before the patient had taken nearly the same quantity of chloral within the samne period of time without ill effects. The writer suggests that the previous administration of a long course of bronide of potassium maY increase the danger of full doses of chloral."
      ],
      "published" : [
         "[Montréal : Dawson Bros., 1871]"
      ],
      "identifier" : [
         "8_05176_82"
      ],
      "type" : "document",
      "title" : [
         "Canada medical journal [Vol. 7, no. 10 (Apr. 1871)]"
      ]
   }
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         "r,^^\\r.%. ^-^\u003e\\ S^^.. \"\"\u003c.\u003c\u003e ^..K% IMAGE EVALUATION TEST TARGET (MT-3) 1.0 I.I 1.25 |50 '™^ ^ 1^ 2A 1.8 1-4 IIIIII.6 V] \u003c^ /2 /a c? / ^3 « \u003c^\\ \u003c^A",
         "^'h'- CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions Institut Canadian de microreproductions historiques",
         "1980 Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. L'Institut a rnicrofilm6 le meilleur exemplaire qu'il lui a 6td possible de se procurer. Les details de cet exemplaire qui sont peut-§tre uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modificatioiT) dans la mdthode normale de filmage sont indiquds ci-dessous. D Coloured covers/ Couverture de couleur □ Coloured pages/ Pages de couleur D Covers damaged/ Couverture endommag^e □ Pages damaged/ Pages endommagdes D D Covers restored and/or laminated/ Couverture restaurde et/ou pellicul6e Cover title missing/ Le titre de couverture manque □ Pages restored and/or laminated/ Pages restaurdes et/ou pellicul6es r~7] Pages discoloured, stained or foxed/ 1\"^ I Pages d6color6es, tachetdes ou piqu6es □ Coloured maps/ Cartes g6ographiques en couleur □ Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) □ Pages detached/ Pages ddtachdes □ Showthrough/ Transparence □ Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur D Bound with other material/ Reli6 avec d'autres documents 0 r~yl Tight binding may cause shadows or distortion along interior margin/ La reliure serr^e peut causer de I'ombre ou de la distortion le long de la marge intdrieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ II se peut que certaines pages blanches ajout6es lors d'une restauration apparaissent dans le texte, mais, lorsque cela 6tait possible, ces pages n'ont pas 6t6 film6es. □ Quality of print varies/ Quality indgale de I'impression I I Includes supplementary material/ Comprend du matdriel supplementaire Only edition available/ Seule Edition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont 6X6 film6es 6 nouveau de fapon d obtenir la meilleure image possible. D Additional comments:/ Commentaires suppl6mentaires; SThis item is filmed at the reduction ratio checked below/ Ce documf*nt est film6 au taux de reduction indiqu6 ci-dessous. 10X 14X 18X 22X 26X 30X y 12X 16X 20X 24X 28X",
         "32X The copy filmod here has been reproduced thanks to the generosity of: Saint John Regional Library L'exemplaire filmd fut reproduit grdce d la g6n6rosit6 de: Saint John Regional Library The images appearing here are the best quality possible considering the condition and legibility of the original copy and in keeping with the filming contract specifications. Les images suivantes ont 6t6 reproduites avec le plus grand soin, compte tenu de la condition et de la nettetd de l'exemplaire filmd, et en conformity avec les conditions du contrat de filmage. Original copies in printed paper covers are filmed beginning with the front cover and ending on the last page with a printed or illustrated impres-sion, or the back cover when appropriate. All other original copies are filmed beginning on the first page with a printed or illustrated impres-sion, and ending on the last page with a printed or illustrated impression. Les exemplaires originaux dont la couverture en papier est imprim^e sont film6s en commenqant par le premier plat et en terminant soit par la dernidre page qui comporte une empreinte d'impression ou d'illustration, soit par le second plat, selon le cas. Tous les autres exemplaires originaux sont filmds en commenqant par la premidre page qui comporte une empreinte d'impression ou d'illustration et en terminant par la dernidre page qui comporte une telle empreinte. The last recorded frame on each microfiche shall contain the symbol — ♦•(meaning \"CON-TINUED \"), or the symbol V (meaning \"END\"), whichever applies. Un des symboles suivants apparaitra sur la dernldre image de cheque microfiche, selon le cas: le symbols — ^ signifie \"A SUIVRE\", le symbols V signifie \"FIN\". Maps, plates, charts, etc., may be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tableaux, etc., peuvent dtre filmds d des taux de reduction diffdrents. Lorsque le document est trop grand pour §tre reproduit en un seul clich6, il est film6 d partir de Tangle sup^rieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images ndcessaire. Les diagrammes suivants illustrent la mdthode. 1 2 3 1 2 3 4 5",
         "6",
         ":e] PROPERTY OF CASE. A No. ^. AN ADDRESS VPON THE I'KOGUKSS OK klEDiciNE, Surgery % HvdiKNE, DL'RINC^ THK L.\\ST 100 YKARS. Uelivered by retjiiest at the St. John Mrchanic^^ fiiKtltide, on Feb -ith, 1SS4. BY WILLIAM BAYARD, .M. D.,",
         "Err. li Prog jADIES The that th« iddress \\ind Hii to perfc |]esitati( subjects Dopular Wei )e com )hraseo lible he ipon tl Ihem Q Siuently lUSt 11 kethrei It n Irt, and lisease, |nd pro kig is a Is to ot' )miiiei lie",
         "pos AN ADDRESS UPON THE [Progress of Medicine, Surgery and Hygiene. By WILLIAM BAYARD, M.D. iADiES AND Gentlemen : — The Governing Board of this Institute has deemed it right that the Centennial of* oiir city shall he commemorated by an iddress, among others, upon \" The Progress of Medieine^ Surgery ind Hygiene during the last 1 00 years.\" I have been requested |:o perform that work, and I assure you I undertake it with much lesitation, doubting my ability to command your interest upon kibjects seldom or never, to my knowledge, introduced before a popular audience. Were I addressing a body of my \" confreres\" ray task would )e comparatively easy; I could then make use of technical )hraseology and enter into details such as would not be permis-sible here. Nor can I attempt to give you an exhaustive report ipon the subjects named ; time will not permit, and many of Ihem are better fitted for the class room than this hall ; conse- luently, a very superficial outline is all I can offer you, and I lust necessarily repeat much that I said to my professional j\u003erethreu upon a former occasion. It must be acknowledged that the real nature of the medical |rt, and its actual power m ministering to the relief and cure of psease, is little understood, and can only be learned by continued ind profound study. And while the truism that \" a little learn- kig is a dangerous thing\" applies with equal force to medicine Is to other subjects, still, a general knowledge of the healing art )mmends itself to the consideration of all. It would enable le possessor of it to form a more correct judgment as to",
         "the Address Upon the Progress of ^ledicine. capabilities of his me;lical adviser, teach liim to avoid the causes of many diseases, and to recognize the approadi of others. It would also teach iiiin the fallacy of lending a credulous ear to the statements of \"nostrum mongers\" found in the daily papers, | many of them as disgusting in expression as they arc plainly | devoid of honesty and truth. It has often been asserted that the healing art has remained com}\u003earatively stationary, while all other departments of science and art have, during the same period, advanced with great rapidity. It is true that in 1760 every species of thread was spun on the single wheel, that wind and water were the chief inanimate motors, and the messenjxers the horse and the dromedary. Then came industrial inventions fabulous in their results, justifying statisticians in the assertion that within little more than a century the increased power obtained through labor-saving machinery equals the adult manual labor out of two worlds as populous as our own. It is also true the marvellous applications of steam are creations of the present century. Watt and others have | taught mankind to subdue and harness that \" docile monster\" to different kinds of machinery. By the steamboat we are wafted with comparative safety from shore to shore, independent of I wind or tide, and with the swift rush of the \" iron horse\" we are | conveyed from place to place with the speed of the bird. It is within the memory of most of us that a greater feat has | been achieved. The \" \"\"lectric Telegraph,\" that \" railway of the mind,\" has annihilated .space and enabled us instantly to whisper; our very thoughts from one extremity of the world to the other, i And more recently we have been taught that by the accumula-tion and .storage of that wonderful and invisible agent, electricity, light, heat and motion can be produced to such an extent as will probably inaugurate a new era in our domestic economy. By the Telephone we have learned that the intonations of thel voice can be conveyed, enabling us at pleasure to conver.se,| though separated by miles of distance. And the science of Chemistry has taught the arti.st to convert that sun him.self into a matchless painter, who, with",
         "wonderful Address Upon the Progress of Medicine. 5 rapidity, can elaborate the most difficult portraits and com[)lex landscapes with a degree of perfection unattainable by the human hand. Therefore, when Tennyson says, \"Science moves but slowly, Slowly creeping on from point to point,\" he forgets the extraordinary progress it has made during the ])resent century. Yet it may be confidently maintained that, during the period in which these brilliant discoveries have been accomplished, medicine has advanced, though silently and unobserved, in [Various directions and forms, by strides as marked and as great [as those belonging to any other department of art. It may be asked. What is Medicine? It has been called the jart of diagnosinji: variations from health, of which it is estimated that there are 1146, and prescribing remedies. It is this and more. It is essentially the science of health, and, I may add, the prevention of those calamities which afflict mankind, and which have received the title of diseases, and the recognition of this fact has taken it out of the region of mere empiricism. Iln order to arrive at a correct conclusion as to its progress Iduring the period named, we should possess some knowledge of [its state prior to that period. Anatomy, Physiology, Chemistry, Surgery and Physics had [made some progress. Harvey had discovered the circulation of the blood. Haller had demonstrated that muscular irritability was connected with nervous action. Astruc had announced the reflex phenomena of the nervous system. Morgagni had founded the science of pathological anatomy. Sydenham, Mead, Hoif- lan and Boerhaave had contributed to the advance of practical Tiedicine. Boerhaave was one of the most accomplished physi-cians of the eighteenth century, and, if we may judge from the [egacy left by him to suffering humanity, he could not have had high opinion of the efficacy of the drugs then in use. When le died he left a handsome volume, the title page of which lleclared that it contained all the secrets of medicine. When",
         ".'I. 6 Addreiis Upon the Progress of Medicine. the volume was oi)enc(], cvory j)ago but one was blank ; on it was written : \" Keep the head cool, the feet warm, and the bowels ope7i,'^ advice reminding us of that given by an old Scotch doctor, who said : \"There were but two things for here and for hereafter — for here, to keep the bowels open ; for hereafter, to keep the fear of God before our eyes.\" Boerhaave's legacy not i.iaptly typified the acquirements of the medical art at that period. To (piiet the nervous system, to equalize the circulation, to provide for the normal action of the intestinal canal, and to leave the rest to nature, was the goal that had been reached 100 years ago by such cautious and wise men as Sydenham, Morgagni and | Boerhaave. The medical world was at this time governed by Theory, Empiricism, Authority, and Speculation. The majority of practitioners blindly followed the authority of the past, and bled and dosed by the book, or adopted some strange theory. For | example : Doctor Letsom, a practitioner of standing in London, read a paper to the Medical Society of that city in 1783, recom-mending lizards for the cure of cancer and other diseases. Well f may the following; lines be attributed to him. He is made to | say: — \" When patients comes to I, I pliysics, bleeds and sweats 'era, And if they choose to die What's that to I, I lets 'em.\" A good illustration of the speculative tendency may be found in the theory formed by Hahnemann, at the close of the last century. He ignored all previous medical knowledge; denied the existence of any curative power in the human system ; that | any knowledge of anatomy, physiology, pathological anatomy, i diagnosis, or the investigation of the nature of disease, wasi necessary to the physician, and claimed that symptoms alone i should be treated, and that the more the medicine was diluted] the greater its power over disease. Doubtless very many recovered while swallowing his \" in-finitesimal nothings.\" But on account of its manifest absurdities,",
         "and Address Upon the Progress of Medicine. reco ra-it was 9 his theory was rejected by all Hciciitific men. And while it dis-plays a curious instance of the aberration of the lunnan intel-lect, it has reminded the physician of the limits of his art, and of the great power which nature [)lays in the cure of disease. Cullen, one of the most leai'ned physicians of that period, fonnd'd his pathology and nosolot^y uj)on pure theory, and declared it to be the duty of the philosophical in(piircr in medi-cine to control his observations by ids theories, not his tiicorics by his observations. His views were generally accepted in Eng-land. The theory ])ropounded by Brown, which aj)peared shortly after that of Cullen, is another illustration of the sj)eculative tendency in medicine at that time. It rested upon assumptions, not facts. He substituted a stimulating for a lowering mode of treatment, which met with a{)proval in Germany, France, and Italy. Such was the condition of the medical art and science at the close of the 18th century. It was reserved for John Hunter, one of those remarkable men who appear at rare intervals, to recognize and teach that medicine is one of the natural sciences, and should be studied by rigid and careful observation ; that theory was useless, cxcej^t so far as it rested upon facts. Regarding a knowledge of the whole organic and inorganic world as necessary to a proper com-prehension of the structure and functions of man, he contem-plated nature as a united whole. The Hunterian Museum, in London, testifies to his industry and researches, and stands as a model for those who follow hira. While Hunter was at work in London, his great contem-porary, Bichat, was following the same line in France, who, it is said, made upwards of 600 post mortem examinations in one wasH winter. Such work killed him, for he died of typhoid fever at the age of 31 years. He and Hunter represent the turning point in medicine from theory, idealism, and speculation to accurate and close observation. m-H By observation, Cuvier, Owen, and others, ascertained the intimate relation of the teeth of an animal to its whole organiza-",
         "ii 8 Address Upon the Progress of Medicine. tioM ; and Agassiz made the discovery that the organization of fishes was connected with their tegumentary membrane. I will now proceed to bring to your minds some of the advances and changes that have been produced during the present century. By Chemistry, for example — the very language of which has been revolutionized — we have been taught the various antidotes to be used when poisons have been swallowed ; also by it we are enabled to detect the presence of such poisons in the human system. To such perfection has chemical analysis arrived, that many poisons can be detected in numerous parts of the body years after death — a warning and terror to evil-doers. Chemis-try has also assisted and perfected our diagnosis in various diseases of the kidney. By it we have learned that nitrogen gas, one of the elements in the air we breathe, when forced into com-bination with other substances, produces most destructive com-pounds. When combined with oxygen gas, it gives us acids with teeth sharp enough to gnaw a file. When combined with potash, sulphur and charcoal, it gives us gunpowder. When associated with the sweet and bland substance, glycerine, it forms nitro-glyceriiie, dynamite, etc., agents so powerful as to appall mankind by their destructiveness. It comes out of its chemical unions with a crash, but at once floats in the air with all the harmlessness of the summer breeze. It also teaches that the chemical constitution of the oil, or attar of roses, is precisely similar to that of the ordinary illuminating gas of our cities. In the one case we have a volatile oil with a gratifying odor, while in the other an invisible gaseous body with an exceedingly oflTensive odor. The chemist also knows that upon the sun, a body 93 millions of miles distant, the metal Iron exists in vast quantities in a volatilized condition, and that this earth of ours contains inflam-mable and explosive material enough to blow it into atoms at a moment. It has been shown that, of our 45 miles of atmos-phere, one-fifth, or a stratum of nine miles in thickness, is oxygen gas. In pure oxygen, steel burns like a candle-wick.",
         "Ani Address Upon the Pro(/nss of Medicine, 9 elc'ctrioal or otiior convulsion whioli would (lisniTan\u003cro or decom-pose this conihinatiou and send an increased quantity of oxygen — the heavier gas — to the earth, would wrap everything in flames. Or like etl'ects might follow from any great change in the constitution of the water of the world. Vater is composed of eight parts of oxygen and one of hydrogen, and the intensest heat ever produced is by a combination in which the two gases were in the exactt proportions found in water. The department of Pathological Chemistry has advanced much within the j)resent century ; it is advancing daily, and a vast amount of information may be expected from it. Tlie beautiful theory of Liebreich, suggesting the adoption of the hydrate of chloral as a therapeutic agent, is due to it. He found that \" the hydrate, treated with an alkali, is resolved into chloro-form and a fomeate. The blood being an alkaline fluid, there-fore when the hydrate is introduced into the organism every particle of it will consume the surrounding quantity of alkali, and the decomposition will be completed oidy after the required amount of alkali had been furnished by the blood. Immeiliately a minimum quantity of chloroform is formed.\" The researches of Dr. Richartlson, based upon the suggestion of Liebreich and the practical experience of the medical profession respecting its use, illustrates what may be expected from a higher pathological chemistry. By it the fact has been established that, in many inflamma-tory diseases, the fibrin of the blood is increased in quantity, thereby assisting our treatment of such diseases. Through it Pasteur made the great discovery that fermentation is due to the action of living organisms, a discovery which is rapidly revolu-tionizing our ideas of the causes of disease. Pathological Anatomy may be said to have been founded by John Hunter, who bequeathed to England the best pathological museum in the world ; and by the labors of Sir James Paget and others this museum has been supplemented, and kept pace with the advancement of pathological",
         "science. /. 10 Address Upon the Progress of Medicine. By the light of pathological anatomy the nature of diseases l)reviously all but unknown have been explained. Bright's disease, and very many others, can only be studied and elucidated bv clinical and anatomical investigation. It has enabled us to separate into sj)ecific diseases affections formerly confounded together. With the aid of the microscope, it has taught that the })arasites infesting some of the brute creation used as food of man, when taken into the human stomach alive, will produce a parasite of a different character, namely, the \" tape-worm.\" For example, the \" bladder worms,\" growing between the fibres of the lean flesh of a \" measly pig,\" constitute a preparatory stage of the i common human tape-worm, and wiien eaten by man are trans-formed into those animals. Physiology, with the aid of clinical medicine, has made great progress, and is daily gaining additions to its domain. Materia Medica has greatly improved during the present century. Many new medicines have been added to the pharma-copoeia, and some have properly been expunged from it. The discovery of the active principles of our vegetable medicines, under the form of alkaloids, as quinine, morphia, salicine, atropine, etc., etc., has given the practitioner of the present day the means of exhibiting some of the most powerful and useful medicines in a concentrated form — not in the shape of large powders, nauseous tinctures, infusions and decoctions — but in the various elixirs, capsules, etc. And doubtless the work has only commenced. We may expect that the chemist will assist us in disarming most of our drugs of their revolting and disagreeable taste — a boon to both practitioner and patienf. While Inhalation has been occasionally practiced since the time of Galen, still, modern chemistry and ingenuity have done much towards establishing it as one of the methods of exhibiting medicine. The method of Subcutaneous Injection is of modern creation. Daily experience proves its value. By it we obtain a more rapid and certain effect from the remedy employed. The practitioner of the present day can point with pride and satisfaction to the late improvements in Practical Surgery,",
         "with- Address Upon the Progress of Medicine. 11 out comparing its present state with the period at which the cliafing-dish and the searing-iron were as indispensable to arrest bleeding as is now tlie ligatnre, and when tlieciies of the sufferer were smothered only by the liissing of the heated iron against the surface of the bleeding wound. The most brilliant discovery in modern medicine, and one of tiic greatest boons ever conferred upon mankind, is the power tlie surgeon ])ossesses of wrapi)ing the })atient in a painless sleep while he is subjected to the horrors of the operating table. From time immemorial efforts have been made — some witli partial success — to produce insensibility to pain. But it was reserved for Morton, a dentist in Boston, wiio, in 1846, practi-cally established the fact that sulphuric cdher possess(3d the power required. Shortly after that Sir J. Y. Simpson produced similar effects with chloroform. But, while accepting immunity from suffering, the patient incurs a certain amount of risk, statistics having proved that the deaths from tether are 1 in 23,204, and from chloroform 1 in 2,873; consequently, sether, being eight times less dangerous, siiould always be used. The effects from chloroform are more rapid than those from a3ther, but this should, not justify its use in the face of the statistics named. Many other anesthetics have been discovered. Local Anccsthesia, by freezing the part, or by the application of \"Cocaine/' is suitable alone for minor operations. Pasteur, Tyndall, and others have established the fact that living organisms are constantly floating in the atmosphere, and when planted in a genial soil they multiply and induce decom-position. Some of these micro-organisms, as the micrococci, bacteria, and bacilli, are capable of producing disease in the human body. Long experience has taught the surgeon that the obstacles to the speedy union of wounds are suppuration and fever. Pro-fessor Lister, a classmate of mine when in Edinburgh, realizing the trutli of the germ theory of Pasteur, and believing that putrefaction in wounds is not a mere chemical change, but a vital one, devised a complete system to annihilate putrefaction at",
         "its 12 Address Upon the Progress of Medicine. , I. I source, and thus do away with the obstacles to union. His system consists in treating the wound in such a way as to prevent decomposition, in providing for the entire disinfection of every-thing that can come in contact with it — fingers, sponges, instru-ments, etc., and taking care, by means of drainage, that no putrifying matter can be retained in the wound. This lie accom-plished by antiseptic dressing ; in other words, by disinfecting every part of the wound with a solution of carbolic acid, or some other antiseptic — for there are many — by preventing the access of air to it, and by providing for the drainage. So successful has the system proved that it has properly been called after him, and his name will be handed down to posterity, beside that of Jenner, as a benefactor to mankind; and I am | glad to add that the Government of England, recognizing the good he has done, has recently created him a Baronet. Prior to the antiseptic treatment of wounds, pyaemia, erysip-elas, and hospital gangrene were the surgeon's terrors. He no longer dreads them, and, in the words of Professor Volkman, \" he is responsible if either disease should appear.\" While the insensibility produced by anaesthetics is a boon to the patient, it greatly aids the surgeon. His mind is no longer distracted by the cries and movements of the sufferer ; he is not | compelled to hurry his work, and his operative procedure becomes I more or less mechanical, dependant upon his steadiness of hand and knowledge of anatomy. With the aid of auEesthetics, and | the antisejitic treatment of wounds, he does not hesitate to per-form operations which, fifteen years ago, would have been consid-ered madness or crimes. Under Listei'ism, the mortality from compound fractures i and amputations of the thigh is between 4 and 5 per cent., while prior to its introduction the mortality was 40 per cent., and nearly the same result applies to other operations and injuries. As an illustration of the progress of operative surgery, I may mention that a })ortion of the chest wall and ribs have been removed, leaving the heart and lungs exposed by an opening as large as a child's head, yet the patient recovered in four weeks. Tl.",
         "i:'\\ Address Upon the Progress of Medicine. 13 . His )revGnt every- instru- :hat no accom- ifecting or some e access ly been jsterity, ul I am jing the ery sip- He no oik man, boon to 0 longer he is not becomes of hand (tics, and B to per- 1 consid- fraotiires | )er cent., icnt., and i injuries, urgery, I lave been I pening as | iir weeks. The stomach and intestines have been frequently opened, — the womb, kidney, and a portion of the wind-pipe removed. The surgeon no longer hesitates to open joints, or to remove fluid accumulated in the membrane covering the heart and lungs. Recently a man was taken to one of the hospitals in London, laboring under symptoms justifying the conclusion that a tumour existed in a particular part of the brain. A portion of the skull bone was removed, the brain substance cut into, the tumour found and removed. While the man did not survive the opera-tion more than four months, the improvement in his symptoms was such as to justify the expectation of his ultimate recovery. The operation proved tiie correctness of the diagnosis, and what can be done to a vital organ like the brain, and doubtless this operation will be repeated with success. The o[)eration of Ovariotomy, first performed by Dr. Mc-Dowell in 1809, alarmed the medical world in consequence of the supposed risks attending it, and fell into disuse, biit was re-vived and established as one of the common operations of the day by Sir Spencer Wells, who performed his first operation in 1858, since which time he has performed it 1000 times, with a mortality of 231. And it has been estimated that in Great Britain and the United States alone the operation has, within the last thirty years, directly contributed more than 30,000 years of active life to woman, all of which would have been lost had Ovariotomy never been performed. Practical Iledicine advances by the discovery of new facts, and by the application of such facts to the treatment of disease. The Microscope has changed and corrected our ideas respecting certain maladies. It has revealed to us affections, the existence of which was previously unknown, and without it could never have been known. The Ophthalmoscope has done more to increase our knowledge of the secrets of the eye than has been accomplished during a century by all other means, and the oculist can point to brilliant [•triumphs over diseases hitherto deemed incurable, and he is not I now obliged to class a number of deep-seated diseases of",
         "th^ I 14 Address Upon the Progress of Medicine. eve under the head of \"amaurosis,\" — a condition where the patient saw nothing, and the doctor also — nothing. The Oph-thalmoscope also teaches us that some states of the eye are pathog- noinatic of suspected conditions of other parts of the body. The StetJioscope has tauglit us how to map out the condition of parts, tlic action of which we can hear but cannot see. The Laryngoscope lias exposed to view organs of the body before inscrutable, — the pharynx, the vocal cords, the wind-pipe, etc., etc. The Sphygmograph has so supplemented tiie sense of touch that the wave phenomena of the pulse are registered, by which we can fathom the secrets of the circulatory apparatus. The Thermometer has recently been brought to our aid, greatly facilitating our diagnosis and prognosis of disease. Other instruments have been devised for the purpose of as-sisting the medical man of the present day in his diagnosis. In proof of the progress of practical medicine, I may refer to consumption, — a disease destroying at present one-fifth of the adult population, and a disease in which the physician's duty consisted in watching the slow \"gradations of disease,\" making a prognosis of tico years duration, and alleviating suffering as best he could. But now, under the use of cod-liver oil, mineral acids, bitters, and supporting nourishment, he no longer regards the disease as hopeless, and treats it, looking for a cure ; failing that, he confidently expects to prolong life. Experience and cal-culations justify the belief that the average duration of life of phthisical patients has been extended from two years — the limit assigned by Laennec and Louis — to eight 3'ears ; and in not very few cases the disease is so permanently arrested that it may be called cured. Recent investigations, establishing the belief that the disease is caused by parasites infesting the lungs, induce us to hope that means may yet be devised to arrest its ravages. Indeed the \" germ theory \" has so changed our views respecting the causes of disease, tliat great results are expected from it. Pasteur's recent treatment of persons bitten by rabid animals is an illustration of what may be expected from",
         "it. Address Upon the Progress of Medicine. 16 Let us glance at the treatment of diseases by bleeding. It is not many years since the lancet was in the hands of every prac-titioner, in daily, and I might almost say hourly use, whereas now it is one of the rarest operations; and instead of the loss of hlood, we have the exhibition of stimulants; and in place of almost starvation, we have the abundant use of nutriment. Many of us can call to mind the time when cold water was for-bidden to a person with fever; and, as for milk, he who gave it would have been accused of \" feeding the fever,\" and thereby endangering the life of the patient. Now the question may be asked. What is the cause of this great change? The best authorities of the day — being unwilling to believe that all of our forefathers were bad observers — attribute it to the change of ti/pe of disease. In pursuing this subject, let us contrast the state of the unfor-tunate lunatic of the present day with what it was 60 years ago, when, deemed incapable of human feelings, he was incarcerated in a dungeon, bound with chains, surrounded by filth, cut off from the friendship and charity of his fellow mortals, and treated with contumely, scorn, and stripes, — a human being buried, yet living. Need I say to you how changed all this is now, and with what happy results. With the knowledge that the poor sufferer possesses the feelings, impulses and affections of man, he is surrounded by comfort ; all restraint is — or should be — re-moved, and he is put under proper medical and moral manage-ment. Let me direct your attention lo another advancement of practical medicine, one to which the physician can proudly point as the greatest discovery of the age : a victory of medicine over disease and death. I allude to the discovery of Vaccination by Jenne}', to whom Providence, as it were, entrusted the office of teaching the surgeon, with an almost invisible speck of matter upon the point of his lancet, to defy, in a measure, one of the most fatal diseases that ever afflicted the human race. The vast importance of this discovery can only be apprecia-ted when we take into consideration the ravages produced",
         "by h j f i I* V V 16 Address Upon the Progress of Medicine. small-pox prior to the introduction of vaccination. We arc told that this disease was a terror to mankind : \" sweeping over the land like fire over the prairies, smiting down prince and peasant;\" that about the year 1519, in Mexico, it suddenly car-ried off three and a half millions of the population ; that in Brazil, in the year 1563, it extirpated whole races of human beings; that about the same period, in the single province of Quito, it destroyed 100,000 Indians; that in France it caused one-tenth of all the deaths, and in England one -fourteenth ; that the annual mortality from it in Europe alone amounted to half a million, and one-third of those attacked died, and that it de-stroyed, maimed or disfigured one-fourth of mankind. Let us now look at the pleasing side of the picture. Ex-perience and statistics teach us that small-pox occasionally oc-curs among those who have been vaccinated, — that if 1000 persons who have been well vaccinated should be exjmsed to the contagion of the disease, about 26 will take it ; that among vac-cinated persons infected with small-pox, the danger of the dis-ease is chiefly determined by the badnes.^ and insufficiency of their vaccination ; that the fatality of small-pox, when it attacks the unvacdnated, is 350 per 1000; that its fatality to such vac-cinated persons as it infects, is, taking then indiscriminately, 70 per 1000. But distinguishing vaccinated persons into two classes : first, those who have been vaccinated in the best known manner, and, second, those who have been badly vaccinated, the fatality of small-pox, if it infects the former, will be 5 per 1000 ; if it infects the latter, 150 per 1000, and that the risk of the one is 30 times that of the other. Or in other words, let an unvacci- nated person contract small-pox and the chances are more than one in three that he dies. Let a very badly vaccinated person — a per-son with one imperfect cicatrix — contract small-pox, and the chances are not quite one in eight that he dies. Let a person witli two good cicatrices have small-pox and his chance of dying are less than one in forty. But persons who have been vaccinated in the best and the most complete way will, if they get",
         "small- Address Upon the Progress of Medicine. 17 pox afterwards, not die of it at the rate of much more than one in two hundred. It may be safely asserted that the lancet of Jenner, armed with the cow-pox matter, has saved in the world more human lives than gunpowder and the sword were ever successful in slaying during any century in the history of mankind. And let us say honor to the man who found the way to arrest this dread-ful scourge, and who taught us that the seeds of the disease, transplanted to another soil, might be made to germinate with a healthy and saving influence — a glory to our art and to the nation claiming him as her son. Yet that nation neglected to bestow any mark of distinction upon the doer of all this good, such favors being reserved for the inventor of instruments for the destruction of human life, the user of them, the courtier and the politician ; the man whose life is spent in ministering to the suffering of ins fellow man, however successfully, being generally the last to receive such honors. It is true, a monument was erected a few years ago to the memory of \" this saver of milh'ons of lives.\" It was placed in Trafalgar Square, but has since been relegated to an obscure corner at the far end of the Serpentine, to be admired by nursemaids engaged in keeping erratic children from falling into its stagnant water — a disgrace to the nation claiming the honor of his work. It is well, therefore, that the charm of the medical profession does not lie in the shadowy prospect of honors. Now, Ladies and Gentlemen, let me say a few words to you upon the siibject of Hygiene, which signifies the art of preserving the health of body and mind during a period consistent with the laws of life. It aims at the prevention of disease by the removal of its avoidable causes. Disease is a departure from a certain assumed standard of health, and has been divided into general and local. General diseases are such as affect the whole frame rather than a special part of it. Local diseases, such as occupy special parts of the body. There are 58 forms of general diseases, and 843",
         "local Address Upon the Progress of Medicine. To these arc added 91 of other conditions of disease 5 forms of injuries. Of the whole diseases, 33 are said fectious or contagious. So we may start with the fact in our minds that there are in detail before the scholar of the preventive art 1,147 diseases and injuries to which the human family are liable, and which he has to study with a view to their abatement or removal. Of the c iseases, between 90 and 100 demand the attention of the sani-tarian, as representing the more common maladies, and those wli'ch yield the ordinary mortalities, and which, successfully combattcd, would leave little to be done in the way of prevention. The preservation of human health, and the prolongation of human life, are two of the great and noble objects of practical medicine. These objects are to be obtained more by the preven-tion of disease than by its cure. But to enable us to prevent diseases we should be acquainted with their causes. These causes, and the best means of avoiding them, have, in a special manner, engaged the attention of the physician of modern days. By this study he has learned the vast benefits derived from \" preventive medicine\" — the triumph of vaccination over small-pox, the almost obliteration of that dread disease, scurvy, a disease known to have yielded 10,000 helpless sick from the Channel fleet after one voyage. His investigations have taught him that the attacks of almost all diseases are increased in intensity and frequency in our house-holds and communities by the want of sufficient air, light, water and drainage, as well as by the deleterious eflPects of decomposing animal and vegetable matters allowed to remain within and around our dwellings, and by the human effluvia: concentrated in small and stifling bedrooms. They have taught him also that when the preceding causes of disease have been removed or abated in special localities by proper sanitary arrangements, human life, as a consequence, lias been saved, misery avoided, and pauperism prevented. To recognize an evil and the cause of it is half way to curing it. But the mast sanguine mind could not have anticipated the a , year",
         "41.( Addreds Upon the Progress of Medicine. 19 wonderful improvement tliat has taken place during the last twenty -five years. As an illustration, I may tell you that the death-rate of the army in England is only two-fifths of what it was before the Crlmeun war, the death-rate in India is only one- third, and the death rate in the West Indies one-tenth. Indeed life in the West Indies is actually healthier, especially for young soldiers, than service in England, whereas sixty years ago a tour of service there was looked upon as almost a sentence of death. In civil life, statistics teach us that the improvements of later days have resulted in \"a diminution of 2 per 1000 in the gen- \" eral death rate ; and witii the knowledge we now have of the \" causes of disease, we may be sure that a general death-rate of \"not more than 15 per 1000 may be confidently looked for.\" Class and Occupation exercise their influence upon mortality. For example : In Liverpool it appears that the average age at death of the gentry was 43 years; for tradesmen, 19 years; and for labourers, 16 years — the average of all classes being 22 years. Locality also exercises its influence, it having been found that the mortality in country districts is always less than in towns. In the country districts of England it is about one in 58, while in the owns it is seldom below ^ in 45. Temperature exercises its influence. The mortality is in-creased in extreme cold w^eather and in extreme warm weather. Eegistration reports in England show a steady decline in the death-rate. It is estimated that from 1870 to 1880 about a quarter of a million persons were saved from death and three millions saved from a sick-bed, as a result of a better general knowledge and enforcement of sanitary laws in that country. In London, for example, the death-rate in the seventeenth cen-tury was 80 per 1000, while in the present day it varies from 22 to 24 per 1000. The span of individual life is progressively lengthening. Reliable statistics prove that in England, from 1838 to 1854, the average length of woman's I'fe was 41.9, and of males, 39.9 years, while now the averages are for women 45.3, and for men 41.9",
         "years. i 20 Address Upon the Proyress of Medicine. The (lead are not the only victims. Lyon Phiyfair states that for every death tliat takes phice in the community of Glas-gow, 34 people are ill, each on an average 18J days; or, in other words, that for every death we must count G30 days of illness. In New York, taking working people alone, and tenement-house populations, where sound health is an exception, the constant ratio of the sick to the well is often as iiigh as one-third. In pursuing this subject, I may mention that it is estimated that there are 8000 preventable deaths in Now York yearly. It is further estimated that for everv death there are 27 cases of sickness, which would give a total of 216,000 cases of prevent-able sickness to be treated. It is also estimated that everv case of sickness in a community is equivalent, on an average, to a loss of fifty dollars. When we reflect upon the misery, wretchedness and pauperism produced by these 216,000 cases of sickness ca|)able of being prevented, it alTords ample occupation for the mind of the physician, the philanthropist, and tlie statesman. The mortality of infants is still very large, but of late it has greatly decreased, 'i^owards the middle of the last century 60 out of every 100 children born in London died before they had reached their fifth year of age ; but the mortality has steadily diminished so that now about 35 in every 100 die at that period. About 600,000 are born annually in Great Britain ; of these, 300,000 would have perished. In New York the mortality is still very large — one-third oi the children born die in the first year, and o)ie- Aa^f before they have attaine\u003cl their fiftli year of age. About the middle of the seventeenth century one in every 40 or 50 women delivered in London died of child-birth and its consequences; but as medical science has advanced that mortality has decreased, till now about 1 in 150 or 200 die. The present death-rate of fever in England amounts to nearly 385 per 10,000 of population, while a century ago its death-rate was nearly 539. At the middle of the last century the annual death-rate from all causes in London was 355 per 10,000 of population, but in the middle of the present century it was only",
         "249. Address Upon the Progress of Medicine. 21 It has been estlmatoil by Mr. Simon \"that the deatlis which ''occur in England are fnWy a thii'd more numerous than they \"would be if our existing knowledge of the chief causes of '•'disease were reasonably well aj)i)lied tiiroughout the country.\" Pure air is composed of oxygen, nitrogen, and carbonic acid gases in various proportions, with watery vapor and traces of ammonia. But the air we breathe is seldom pure, often contain-ing certain impurities. It is so vitiated by respiration and transpiration that the changes j\u003eroduced in an occupied air space are as follows: The aniount of oxygen is greatly lessened, the carbonic acid and watery vapor are largely increased, ammonia and organic matter are evolved, and suspended matter, in the shape of low forms of cell life and epithelium scales, thrown off. A decrease in the proportion of oxygen, with an increase of carbonic acid, together with the organic impurities, so vitiate the air as to render it one of the most potent of all the predisposing causes of disease. Aniong many other diseases developed bv respired air, consumption holds a prominent place on the list. About 30 cubic inches of air are carried into the lungs at each inspiration, to be brought in contact with that wonderful surface, said to occupy a space of from 10 to 20 square feet, covered with delicate tufts of blood-vessels, which stand upon the surface of between five or six millions of air-cells, and through which the blood flows with great velocity. The solid particles entering with the air may lodge in the mouth or nose, to pass into the stomach, or decompose or dissolve in the lungs, or remain there to become a source of irritation and perhaps disease. Many of them are inhaled without any knowledge on the part of those who breathe them. We can, therefore, readily understand the rapidity with which gaseous substaices will enter the blood. As an example of the effect of vitiate 1 air, I need only mention the sad mortality in the Black Hole of Calcutta, where 123 prisoners died in one night out of a total of 146. The air in an inhabited room cannot be maintained in as pure a condition as the external air. To keep it at a healthy standard it should be renewed without perceptible draughts, at the rate",
         "of 22 Aihh'CHH Upon the Prorfresa of 3Icdmne. 3,000 cubic feet per liour for each juliilt. If the cubic space per head is small, the renewal of air must necessarily be more fre- (pient. Thus, with a s|)ace of 100 cubic feet, it should be re-newed 30 times per hour, whereas with one of 1000 feet, three renewals would be sullicient. You will therefore readily recog-nize the necessity for proper ventilation in our houses, in our bed-rooms, and in our public 'iwHtitutum^, particular/i/ our .school.^, where — very improperly — hundreds are congregated under one roof. Recent iu'-estigations have taught us that the gases generated by the (lecomi)osition constantly taking i)lacc in sewers and cess-pools are carl)onic acid, nitrogen, sulphurated hydrogen and ammonium sulj)hide. Tiie particularly f(ctid smell of sewer- air is owing to the ])resencc of organic matter. It contains bactarisD and other forms of cell life, and, like other organic eifluvia, promotes the growth of fungi, infects water and milk, and taints meat, and is recognized as one of the most, if not the most, })rolific causes of disease. Tiiere can be no question that the polluted air from cesspits, drains and sewers becomes the medium through which enteric fever and other diseases are frc- \u003ciuently propagated, if not engendered. The sewer-air, laden with morbific ferments or contagia, rapidly finds its way into liouses, especially in cold weather, in consequence of badly con-structed drains and soil pij^es. It may be imperceptible to the senses, but its baneful effects make themselves felt none the less. Therefore with our present knowledge of these facts it becomes the imperative duty of house-owners, architects and plumbers to so construct the drains and plumbing that the atmosphere of the house shall not be poisoned by this sewer air, and they assume a heavy responsibility when they neglect to do so. The soil pipe should always be made of iron, well tarred inside and out; it should be perfectly air-tight, open at the upper end, and extend from the sewer to several feet above the roof of | the house, but below the chimney and four or five feet from it, and ten feet from any window or opening in the roof. Special care should be taken that the part of it entering the house from conti bran pute brail",
         "the Address Upon the Pror/rcss of Medicine. 2:i the drain ho iJiorourfhhj closed, and every openin*^ into it should he properly tra[)ped. For any huilding without traps and vent pl[)es, itself becomes a vent for any common sewer it may con-nect with. No vent i)ipe should ever enter a chimney, for wiien tiiere is no heat in it there will he a downward drau^Iit. 1 may further remark that street drains should he ventilated by shafts, so as to i)revent the eilluvia from them entering the windows, as they do, of many houses in this city. While dwelling upon sanitary sul)je(;ts, I may claim the ri^ht to say a word upon the treatment of the young in our sciiools. The secret of a thorough education lies in tlic uniform development of all the powers. One should not be develoi)ed at the expense of others. Anatomy and physiology teacii us that the brains of children under seven or eight years of age are im- ])erfectly d(!veloped ; their reflective faculties and powers of con-centration are feeble. As a rule they learn from observation and mcmorv, not from understanding;. Tiieir bodies and minds alike re(iuirc frequent change, consequently they cannot perform long continued tasks without injury. It has been justly said that a task or lesson of 15 minutes duration is long enougli for a child between the ages of five and seven years, and 20 minutes for one between seven and ten vears. V In children at this earlv age the memorv and attention should be stimulated, not taxed. The muscles should not be en-feebled by sitting or standing for hours, but should be invigora-ted by exercise. This cannot be accomplished by school restraints for three or four hours. Better let them be entertained iu the \"Kindergarten.\" Daily observation teaches us the injurious effects of long continued and excessive mental strain upon fully developed brains. If such \"tijury is produced — and I think few will dis-pute it — then how much more injurious must be the effect upon brains, the anatomical structure of which is in no way fitted for the",
         "work. 24 Address Upon the Progress of Medicine. The rule in scliools requiring or exacting all to accomplish a certain amount of work, regardless of the mental or physical ability to perform it, in many cases produces an injurious strain upon the mental faculties. And while a system of rank and rewards, based upon the possession of an arbitrary standard of acquirements, may be desirable as having a stitDulating influence upon boys, I think it highly injurious for girls. The eagerness for success, the apprehension of failure, and the dread of disgrace in them, are so much more acute than in boys, that they are easily injured by apjieals to these emotions. In my own experi-ence I hiive repeatedly known the illness of young girls to be exaggerated and prolonged in consequence of the anxiety respect-ing the loss of place or marks at school. Again, I think the health of teachers — who arc largely composed of young females — is an element for consideration. It is well known that a large proportion of them fall from a con-dition of perfect health and energy into invalidism, too often followed by consumption. Many causes aid in producing this condition ; some eat too little, or take tea and bread instead of meat, or go to bed hungry and cold, or neglect their noon meal, or hurry their breakfast, and some are weighted down with home cares. But the chief causes are excessive and long-continued mental strain in a vitiated atmosphere, and often at times when they should be on the sofa. From a health standpoint, the \"half-time\" system, such as is largely adopted in England, should commend itself to all who are responsil)le in this matter. It consists in sending the children to school for three hours each day, and employing them in other | pursuits, such as learning different trades, etc., for the rest of the working hours — six in all. \" It has been found generally that \" children thus employed make as good progress in study as \" those who attend school for six hours each day.\" If this system were generally adopted, I believe it would prove of incaluable benefit to the rising generation. It would i largely prevent the serious consequences of that mental strain \\ whicli medical men are too often called upon to",
         "treat. Address Upon the Progress of Medicine. 25 It cannot be doubted that a large number of lives would be saved yearly if our existing knowledge of the causes of disease were reasonably well applied. This knowledge is not applied, because people cannot be dragooned into cleanliness or made virtuous by [)olice regulations. They must be educated upon the subject, and taught the benefits resulting from its application and the misery consequent upon the neglect of it. As an illustration of the apathy displayed regarding sanitary measures, I may mention that vaccination is very generally acknowledged to be a protection against small-pox. Yet in 1871 when that disease appeared, in a malignant form, in this city, it was known that there were upwards of 5000 persons — chiefly children — who had not been vaccinated, while for years they had the privilege of having it done, free of charge, at the Board of Health office. So sluggish were they in this matter that the authorities were compelled to a])point physicians to visit every house and vaccinate all before the disease could be \"stamped out.\" While I contend that medicine has advanced much, I must acknowledge the uncertainty of the art. The source of this uncertainty may be found partly in its imperfections, but more in the intractability of intense forms of disease, the ferments of which poison the system to such an extent that death must in-evitably be the result. Take as an example malignant scarlet fever, or diphtheria ; observe the utter prostration, rigors, swollen throat, oifensive breath, and thready, failing pulse, which indi-cate intense blood poisoning. Here death is as certain as if the patient had taken a poisonous dose of prussic acid ; medicine is foiled by the overwhelmning power of its antagonist. In conclusion, ladies and gentlemen, let me thank you for tiie patient hearing you have given this address. I freely acknowledge its many imperfections. The subject covers such a wide range that I have found it difficult to condense it : but I hope that enough has been shown to prove that the science of medicine has kept pace with other sciences in the marcli of im-provement. And, it may be asked, who has achieved",
         "this 26 Address Upon the Progress of Medicine. progress? I answer, The workers in the medical profession — men who, wliile earning a living, perform more gratuitous labor tiian all the other professions combined. It has been truly said by and eloquent writer ; \" Go into the abodes of the sick, and \"the poor and deserted, wherever there is disease or distress, there \"you will find some medical practitioner exercising his glorious \" art, patiently, freely and fearlessly, for those whom poverty or \" vice or the breath of pestilence has deprived of every other \"friend. Or, again follow him among the higher classes of \" patients, and you will find him there the friend and honest ad- \" viser of those who can seldom hear truth from any other lips.\" And when their daily round has ended may be found committing their observations and experience to paper for the benefit of mankind. \" Such are the toils — the perils that he knows — Days without rest and nights without repose. Yet all unheeded for the love he bears His art, his kind, whose very grief he shares.\" An estimate may be formed of the literary work of the medical profession when I tell you that it comprises one-thirtieth of that of the world. Again, follow them on the field of battle, where — without the excitement of contest, but in equal danger with the combatant — they are found ministering to the suffering wounded, or perhaps winning \" Victoria crosses \" by some act of heroism for the benefit of their disabled patients, and I am proud to say such examples are not few. May I not therefore, in the words of Oliver Wendell Holmes, say: \" How blest is he who knows no meaner strife Than art's long battle with the foes of life. No doubt assails him, doing still his best, And trusting kindly nature for the rest.\" them and grav -grt. \"see the^ u",
         "no REPLY TO DR. PRESTON'S LETTER. To the Editor of the Sun : giii; — In mv lecture at tlic Mcclianics' Institute I said that tlie medical world, at the close of the 18th century, was governed by theory, empiricism, authority, and speculation. In support of my assertion, I spoke of a strange theory propounded by Dr. Letsora, a so-called allopathic physician, and as an illus-tration of the speculative tendency of that age, I mentioned the theory formed by Dr. Hahnemann, the founder of homoeopathy. I said that he ignored all previous medical knowledge, denied the existence of any curative power in the human system, claimed that symptoms alone should be treated, and that the more the medicine was diluted the greater its power over disease. I also said that, on account of its manifest absurdities, his theory was rejected by all scientific men, and, while it displays a curious instance of the aberration of the human intellect, it has reminded the physician of the limits of his art, and of the great power which nature plays in the cure of disease. These remarks do not appear to have pleased the friends of Dr. Preston, or himself, for he felt bound to animadvert upon them in your paper of the 22nd instant. He gave us an elaborate and well written history of Hahnemann from his cradle to his grave, an account of the books he wrote, and classed him \" as the \" greatest benefactor of the human race that the past century has \"seen,\" but he forgot to inform us that at one time he deceived the world by selling at a high price, under the name of \" Piwmm\" a nostrum which contained nothing but borax. (27)",
         "I 1 28 Reply to Dr. Prcston^s Letter. However, tlie character of the man is not the question ; his \"speculative theory\" is that with which we have to deal. All that Dr. Preston says of hira may be true — though he must pardon me if I do not agree with hira — but his theory may be absurd, nevertheless. I have classed it as such ; if I am wrong, I must take the consequences ; if right, no wrong is done. It is not my intention to discuss the merits of Homoeopathy; I have neither the time nor the inclination to do so. But I was under the impressic^n that Homceoj)athy had progressed, like rational medicine, with time ; and I give Dr. Preston credit for too much good sense to believe that he accepts all the theories propounded by his \" benefactor.\" Let us see what a few of them are. His system is expressed by the I^atin aphorism, similia similibus curantur, or like cures like; that is, diseases are cured by substances capable of pro-ducing symptoms resembling those found in the disease under treatment. The second great fact which Hahnemann professes to have established is the '* efficacy of medicinal substances reduced to a wonderful degree of minuteness or dilution.'^ In his work on chronic diseases he gives us his mode of preparing his little doses. He tells us that one grain of the medicine is to be added to 100 grains of sugar of milk, and after just so many minutes devoted to rubbing and scraping it together, it constitutes the first dilu-tion. Each grain of this powder contains the hundredth of a grain of the medicinal substance mingled with the sugar of milk. Continue the process, and the second dilution will be one ten- thousandth, the third dilution one-millionth, the sixth dilution one-billionth, and so on to the thirtieth, and even up to the two- hundredth dilution. It has been computed by Sir James Symp- son that one grain of arsenic, at the fifteenth dilution, would require material equal in bulk to sixty-one globes the size of this earth to absorb it. When liquids are to be used, the same process of dilution is to be observed. Again, he informs us, at page 316, of his Organon, that \"The \" homoeopathic medicine becomes poteutized at every",
         "division, Reply in Dr. Prcdon^s Letter. 2J) ; his All must ay be rroiig, )athy ; I was I, like :lit for leories )ressed e Gureft )f pro- under 0 have d to a ark on 3 doses. to 100 levoted st dilu- th of a )f milk, ne ten- dilution he two- i Symp- would size of le same at \"The division, \"and diminution by trituration or succnssion (shako), a dcvolop- \" ment of the inherent powers of medicinal substances which \" was never dreamed of before my time, and which is of so \" powcrfid a character that of late years I have been compelled, \" hy convincing experience, to reduce the ten succussions (shakes), \" formerly directed to be given after each attenuation, to tiro. \"Tliere are, however, hom(eo])athists who carry about with them, ''on their visits to i)atie!its, the homoeopathic medicine in a fluid \"state, and vet who assert that thev do not become more hi\";hlv \" potentized in the course of time; but tiiey thereby show their \" want of ability to observe correctly.\" Is this reasonable or absurd? Give it a ten-mile ride in the pocket of a doctor, on the back of a hard trotting horse, and dynamite would be iiothino; to it. At page 822 of his Lesser Writin(/s he says : \" If we wisii \"to attenuate a drop of the juice of sun-dew to the decillionth, \" shake each of tiie bottles with 20 or more succussions from a \" powerful arm, in the hand of wiiich the bottle is held ; in that \"case this medicine, whicii I have discovered to be the specific \"medicine for whooping cough. Mill have become so powerful in \"the fifteenth attenuation liiat a drop of it given in a teaspoon- \"ful of water would endanger the life of the child ; whereas, if \"each dilution bottle were shaken but twice (with two strokes of \"the arm) and prepared in this manner up to the decillionth \"attenuation, a sugar globule the size of a poppy seed, moistened \" idtli the last cdtemmtinn, cures this terrible disease with this \"single dose, without endangering the health of the child in the \" slightest degree.'' M'lrahile dictu ! ! At page 879 of his Lesser Writings h ■ advocates another mode — discovered by Korsakoff — of pre|)aring his little glo-bules. He says : \" Thus much is deducible from his (Korsa- \" koff's) experiments, that since a single dry globule, imbibed \"with a high medicinal dynamization, communicates to 13,500 \" unmedicated globules, with which it is shaken for five minutes, \" medicinal power fidly equal to what jioioer it 2)ossesses itself, with- \"out suffering any diminution of power itself, it seems that",
         "this / '.1 30 Reply to Dr. Prcston^a Letter. \"marvelous communication taivcs place by means of proximity \" and contact, and is a sort of infection, bearing a strong resom- \" blance to the infection of healthy persons, by a contagion \"brought near or in contact with them.\" Wonderful indeed !!! The third great doctrine of Hahnemann is that seven-eicjhtlis at least of all chronic diseases are produced by the existence in the system of that infectious disorder known in the language of science by the appelation of Psora, but in the less refined por-tion of the community by the unmentionable name of Itch. In his Organon, page 183, he tells us \"that Common Itch \" (Psora), is the only real fundamental canse arid producer of all \" the other numerous innumerable forms of disease which, under \" the names of nervous debility, hysteria, hypochondriasis, epi- \" lepsy, mania, melancholia, imbecility, caries, convulsions of all \"sorts, cancer, fungus hoematodes, malignant organic growths, \" gout, jaundice, dropsy, hcemorrhage from the lungs, nose, stom- \" ach, bladder,etc., asthma, barrenness, deafness, impotence, cater- \" act, paralysis, defect of the senses, and pains of a thousand kinds, \" etc., which figure in the systematic works on pathology, as pe- \" culiar independent diseases.\" In his \"Lesser' Writings\" page 831, we are informed that ^^No one free from psora {itch) ever gets inflammation of the lungs.\" He also informs us, at page 292 of his \"Organon,\" \"that \" even a primary itch eruption of recent origin, though it may \" have spread all over the body, may be perfectly cured in per- \"sons that are not too weakly, by a dose of sulphur, thirtieth \" dilution (or potency) given every seven days, in the coiu'se of \" from ten to twelve loeeks, so that it will be seldom necessary to \" aid the cure with a few doses of carbo vegetabilis, thirtieth \" dilution, also given at the rate of one in the week, without the \" slightest external treatment, besides frequent changes of linen \" and good regimen.\" He recommends another mode of giving his medicine, which he calls \"Olfaction\" — in other words, smelling. It is needless to describe",
         "it. I Reply to Dr. Preston's Letter. 31 I have given the above extracts from the writings of Hahne-mann, in vindication of the remarlis I made in my lecture, not ill a si)irit of opposition to believers in liomcopathy — they have a perfect right to their opinion, and I doubt not they will grant me the same privilege. W. BAYARD, M. D., Etc. St. John, Feb. 23, 1884."
      ],
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         "05977",
         "FC 02 0203 no. 05977"
      ],
      "published" : [
         "[St. John, N.B.? : s.n., 1884?]"
      ],
      "title" : [
         "An address upon the progress of medicine, surgery and hygiene, during the last 100 years : delivered by request of the St. John Mechanics' Institute, on Feb. 4th, 1884",
         "CIHM/ICMH microfiche series ; no. 05977"
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      "label" : "An address upon the progress of medicine, surgery and hygiene, during the last 100 years",
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         "Bayard, William"
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         "1 microfiche (19 fr.).",
         "Followed by, a \"Reply to Dr. Preston's letter\" by the author, which is directly related to his address.",
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         "Medicine -- Addresses, essays, lectures.",
         "Surgery -- Addresses, essays, lectures.",
         "Hygiene -- Addresses, essays, lectures.",
         "Médecine -- Discours, essais, conférences.",
         "Chirurgie -- Discours, essais, conférences.",
         "Hygiène -- Discours, essais, conférences."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "MAGAZINE L 1T FRA RY ýE VI1E W. Edited by GEO. A. B4S, M.D., \u0026c.. \u0026c. ORIC.NAI COîMMUNICATIO\u003eNS. Il-iPg. l'âge. Report .,'f lte Bord of I Ielth ùf 'l'lie Pneuniaic Systeni of Se%%era e the C(ý of Brooklyn......7 ;alid iit, \u0026f4lcair to, thxe (*jt% I -Feve4,, rw Sinnie Catarrh, it'i * 0f Molet:a. ByR I Carr Î\\1 and 'rregïjneiit....8 ITarrkAý lt C E.......... iffi\u003enjo«ellict t)f the morîn.Iity of the City antd Siburbsý of Faculty o\" edicine ini the Montreal, for J41;Y, 1876' S Uistversi t ci Àholp's College, Foreign Hlefflh statisîic.......S2 gonXil........9 T'otal Nlortality- b\u003e' Pge-s, Nation - - pýality, and WVai.ds..........83 E\u003eTRA. . tiblic Heahth in the United ýtat«e- 84 uNlliciypa iismanagelient 'l'lie Uoatd, oi Ifealî .... 9p j T~:'îEs.'l he -Workingmetn's Dwelling. Ii- Provea!nent. Conpany b-v ith iA Manuial of Diet ini I-lealth and...................96 Disase...............VacciRati0iv'.............98 1Lacrosqè---he National (;arne of M\u0026itrýa1 S.m bnaing Club....99 Caad -87 1dtraNoie 00 Agi Cotè\u0026\u003eicU\u003ef.oi. \u003esertUoit\u003e an4d \"k (ý fr .Neew, beo#re the iOtA of 040h lààntk, frice, $2 jper Annum, pay(able in Advance. JOH-N DOUOALL SON, PRUNTE\u003cS,-ST. JAMES STREZr. r- àýWcp4=o wit.tc Aç± pt Lae* y . BAiim VP,., in tle, Offce of-",
         "PUBLIC HEALTH MAGAZINE AND LITERARY REVIEW. VOL. IL.] SEPT EMBER, 1876. [No 3. :O: THE PNEUMATIO.SYSTEM OF SEWERAGE AND ITS APPLICATION TO TUB CITY oF MONTREAL. By R. Onac HARis, C.E., Associate Member Inst. C.E. In the July number of Public Health Magazine soine facts were given regarding the great system of sewerage which goes under the naine of the Pneunatic System, but the information there given was only in outline, and it is proposd 0now to enter into publie details regarding both of the great systeins of sewerage-the water carriage or common system-and the pneumatic or air carriage system. The subject is wide, and tinte and labor are required to go into all the relations of the questions involved so as to lay bare the causes which have forced on in a manner the invention of the Pneumatic System. These causes are the defects which have been found in the water carriage system, and have led to its failure. As they become better understood this system will be abandoned. It is proposed in the course of the following articles to give : a. Full details and explanations of the Pneumatic System. b. Cost of do., embracing analysis and sale of manure. c. Sanitary results as far as ascertained, contrasted with sanitary results of water carriage. d. Application to Montreal. c. If space permits, a history of the water carriage system, and an account of its present £ondition.",
         "PUBLIC IIEALTH MAGAZINE. After long years of trial and incalculable cost, our present systein is an adinitted failure in almost overy sanitary sense. The costly and magnificent sewerage works of the great cities Ilave been executed by \u003engineers w«ho thought less about medical facts than they did of the engineering problenis which they had to solve. Colonel Il ', the Engineer of the Sewers of the City of London, masterly report to the Common Council, last January, on the Liernur Pneumatic System of Sewerage, recommending its trial in some of the new districts of the city. But he says at the end of his report that there will arise difficulties in obtaining for it a trial, because \"the existing \"system of sewerage bas been so lauded, its sanitary value bas been so dwelt upon, its defects so inuch passed over, it bas so \"imany advocates, so nany reputations almost in fact depend upon its being reckoned a successful system.\" And again \" If the governmeat believes in its motto of \"salus populi suprema vox, it will do well to inaugurate a com- \"prehensive, and open enquiry into the results of the present sewerage system, and it will be well for the metropolis or some large town to give the Pneumatie System a fair trial.\" The writer of the present article, after a personal pro- fessional examination, was completely convinced of its success, and believes that it will be universally adopted before many years. As an illustration of the Iliigh esteem in which it is beld by good authorities, the following quotations are given: LasEna.-It is in operation. The resident government engineer of the Rhine lands, writing in answer to the Win- chester Corporation, says : \"In conclusion, I wish to state that Capt. Liernur bas completely solved the sewerage question.\" The Mayor and Corporation of Leyden in their Report recommending extension, say: \"t Since it has been put in \"operation (1871) the good and regular working has been \" daily witnessed, and there were no failures to report. And further on they speak \"of the immense beneficial \"'influence it bas on the public health, resulting from the fact \"that excrements are daily removed without polluting the \"soil, stream or atmosphere in any way, or being a nuisance to \"anyone.\" Speaking of the system financially, in asking for the funds",
         "PNEUMATIC SYSTEM OF SEwERAGE. to extend it, they say : \"It is hence a matter of certainty (from \" experience of the sale of the manuro) that all expenses will \" be repaid and our outlay returned.\" AMIsTERDAMl.-The common Council at Amsterdtm, after testifying that the technical results agree in every respect with the assurances of the inventor, say: \" The results in a sanitary \"point of view obtained are in general, but particularly for \"Amsterdam, of the utmost importance, while it has been '\u003cdemonstrated that the system is capable of removing human \"excreta from the houses without offending sight or smell \"before any noxious gases can be developed and escaped.\" They then \" decree the compulsory application of the system in seven different parts of the city, rcmarking that in \" three of these the inhabitants had thoemselves demanded it.\" DORDREcT.-The Director of Public Works says, and repeats it to the Wincbester Corporation : \"I consider the \"system technically and sanitarily perfect, and financially, I \"have the best expectations of it, from the sale of manure. SAxoNY.-The Commission from this Kingdom, in their Report to the Minister of the Interior, conclude by saying : \" We consider the System. a great stage in advance in the \" sewage question, and cannot b-t recommend that to many an \" engineer and physician who now oppose it, may be given an \" opportunity of satisfying themselves of its good working by \" ocular demonstration.\" PRAGUE.-The Report of the Imperial Engineer Department in the first trials at Prague cóncludes by recommending the extension of the system to all the barracks and military buildings in Prague, and this wats at once carried out. VIENNA.-The verdict of the International Mledical Congress is summed up in two sentences from this Report. \" The trials made in the presence of many members of \" the Congress convinced themu that the entire systeu is \" capable of doing its task completely. All the various motives \"occupy such a small space of time, operate so smoothly and \"without attracting notice, that the invention called forth the \"utmost admiration unanimously. The certificate from the Director General of the Vienna Exposition, which vas fitted with the Pneumatic System, says among other things: \" That the closets and urinals were \" entirely inodorous, both during use and during the emptying \" process,\" and \" that so long as the Exhibition lasted, no",
         "PUBLIC HEALTIH MAGAZINE. \" interruption whatever took place; that no trouble or nuisance \" was experienced, and that the whole gave satisfaction in every respect.\" The Board of Health, in their Report nade at the request of the'Rotterdan city authorities, reconimend its adoption by the city. They say : ,\" Liernuris Pneumatic Systom, botter \" than any other, satisfies the demands that, for the sake of \" cleanliness and Public Health, can be put upon a System for \"collectiig focal niatter. Its practicul feasibility, as well froa \" a technical as from a financial point of view, has been \" sufficiently proved to us.\" MANcHEsTER, Charlton Sanitary Authority.-The Chairnau writing to us the result of the visit to Holland of their deputation, says: \"The best proof I can give of the strong \" impression made upon our minds by our visit to Rolland, is \" the fact that we have invited Capt. Liernur to report on our \" District and ielp us, if ho can, out of the difficulty in which \" we find ourselves.\" The Lancet in its account of the System, says: CTheoretically \" it is perfect.\" The \" Engineering\" says \"Every old system has in a \"ense failed, and consequently we find that in the United \" Kingdomn generally the whole question bas to be treated \" de novo. Capt. Liernur bas attempted, and so far as we \"can judge, with a large amount of success, to grapple with \"the difficulties of the sewage question, more especially because \"I e disposes of all the dangerous parts of sewage literally \"without sewerage.\" It is evident that a systom of sewerage to be successful must fulfil the following conditions : lst. It must be able to collect the excrement and filth of a large city, and transport it with speed, certainty and regularity from the city. 2nd. It must do this by mechanical contrivances actuated either by steam or water powers. 3. It must be donc without injury to the health of the population. 4. Tfie sowage must be returned to the soil in the form 9f a portable manure. To secura these objects, if the system were applied to the City of Montreali, the following means would bo taken: The sewers and drains whicli are 'already built along the",
         "PNEUMATIC SYSTEM OF SEwERAGE. 73 streets vould only be allowed te recoivo rain water and the vaste household water, and refuse water from trades and factories would only be admitted after being purified. A systema of porous pipes might also be laid te drain the subsoil water into these sewers, so that the subsoil water above a certain level should. be always dry. A system of 5 inch pipes, cast iron, would be laid to carry off all the =xcreta, chamber slops and the coarse putrescible matter, such as kitchen waste, by meansof air suction to a central reservoir, there to bn dried into powder, for sale to farmers. It is claimed by Capt. Liernur that the sale of this would have a large profit after paying all expenses. A main object is te reduce as much as possible the quantity of water mixed with the subsoils. Therofore, the existing water closet arrangements would be changed as follows: The privy for the Pneumatie System consists of a funnel sbaped tube-in appearance much the same as that in a water closet- but much deeper, painted a dark color, of sucl' a chape as to avoid being soiled as wuch as possible. There is no pan and of course no handle. The funnel shaped tube is in a manner double because.at its lower part it is surrounded, but not touched by, in fact overlapped by the upper part of another funnel shaped tube, whieh last is the real receptacle of the matter. The backs, both of the water tube and of the hopper or inner tube, are vertical, but they taper on their fronts and sides. This shape is to prevent the excreta from soiling them. The outer tube is of glazed earthenware of a dark color, the inner one, or hopper, of iron, with an enanelled surface. At its lower end the hopper terminates in a bent tube or syphon connecting with a vertical soil pipe. The Pneumatic privy is used in the ordinary way. The excreta lie in the syphon tube, any fresli addition to them causes an overflow into the soil pipe. Once in every twenty-four heurs the vacuum is let on, and the soi pipes are emptied, but a certain portion always remains in the syphon, acting like a trap. The emptying process requires about one minute of time ordinarily. The vertical soil pipe is continued upwards te the closets on the upper floors, and finally it passes above the level of the highet closet. It is continued, by a smaller pipe te the roof, and may there be furnished with a charcoal Ilter, if thought desirable te avoid the escape of any gases or germs.",
         "PUBLIC IIEALTI MAGAZINE. If thought necessary for ventilation, a tube of 2 inches diane- ter eau pass fron between the funnels of the pneunatic privy to the out.side of the roof, and in the top of this tube can bo fixed a Wolpert Ltift-Z.ger or air sucker. This is a very inexpensive apparatus of tin, composed of two cones of tin about 6 inches high, one outside the other, and the space of about half an inch between them. Tho tube passes up through the cones, and the slightest motion.of the air produces a draft upwards through it. This apparatus is a nicety whieh is not required, as owing to the depth of the funnel and the small quantity of matter exposed, there can no odor arise. It is to be remembered that the top of the soil pipe passes out through the roof, which ventilates the syphon at the bottoi of the privy funnel. The pipe which thus ventilates the privy funnel serves also to ad- mit the atmospherie air vhich nets as a cushion te drive the fecale before it when the vacuum is let on the pipes once every twenty-four heurs. The air required for this purpose does not enter through the seat. Ilence may bo seen the folly of the absurd remarks which were at one time much regarding this part of the Pneumatic arrangements by some who had net un- derstood it. The period of twenty-four heurs for emptying is fixed upon because it is assumed as a well ascertained fact that no injurious change arises in foecal matter until it is at least thirty heurs old-but the pràcess of emptying might just as conveniently be performed every twelve hours. The process only requires a minute )r two. Col. Haywood says: \" Gencrally such of the seats and the \" interiors of the Pneumatie privies as I inspected were very \" clean; the funnel shaped beppers bencath the seats were in \" most cases contact with foecal matter; in most cases there was \" no sinell in the closets. * \" When the cocks were opened, and the excreta lying in the \" syphons were acted on by the vacuum, there was some com- \" motion in the exereta in the syphons under the closet tubes, \" and for a few seconds a noise like the bubbling of water when \" escaping froin the neck of a bettle. But there was no smellin \" the closets eaused by it. None of the syphons in the closets \" were cleared out entirely by the operation-sufficient romain- \" ing in themr to forin a trap. I was informed by the Burgo- \" master that personally he considers the system a complote \" success.\"",
         "P.NSIU:%IATIC ,YbTEM OF SEWERAGE. The writer of this present articlo can fully confirin vhat is bore stated by Col. Haywood. Examination of the closets in Aimsterdamn and Lisbon was entcly sat-isfactory. In Lisbon a closet examined vas ni a very small bouse lived in by a family of the poorer classes. It was in the roam serving b\u0026th for lving rooni and kitchen, in a small compartmnent, distant about ton feet from the fire. It vas hot iveather, but overy- thing was clean and odorless. This is a practical illustration of the actual working of the system- brought into hLtraction with human bouse-life. Its success iwas clearly complote and apparent. It is to bo bore remarked that the fact of the suc- cess of this system extending throughout five or six years ought ta bo suflicient ta ronder arguinents unnecessary. The bottom of the soil pipe, after it entors the ground, is joined by another syphon ta the branch pipe, and on this pipe there are other syphons, through all of vhich the férule passes to reach the main pipes-there is thus no possibility for bad influences entering imto the house from the main pipes. The apparatus by which the kitchen fat-sediment and putrescible waste is separated from. the waste water would b more eaaily explained by aid of a diagram. The wastoi water from the sinks passes through a pipe into a small underground well outside the building. At the bottom of this well is a pocker forming a trap by a syphun connecting with the branch pipe from the house; across the top of this pocket is a strainer formed of fine galvanized wire gauze, which allows the water ta pass upward thraugh it, and overflow into a waste pipe, through which it passes away into the rainwater sowers. The fat-sediment and kitchen waste is left on the underside of the gauze, and when the Pneumatic blast is lot on, it is all sucked away into the pipes with the fecale. By this form of trap the bouse is isolated even from the rainwater seivers, so that in the event that the waste and rein- water ucewers should give off bad gases, such gases could not entbr the houue. The amount of this kitchen waste is more considerable than is generally supposed. As an. average per day per inhabitant for the whole town, it bas been reckoned by sewerago authorities as equal ta about four ounces, in the form iof a slush, made up of small fragments coated with fat and pulpy material. The passage of the focale and the sink refuse bas now been traced in detail into the branch jppcs. On each branch pipe a",
         "PtYnLIC IIEALTH MAGAZINr. cock is placed so that the pipe can be closed, if ropairs should require to be made, vithout interfering with the action of the other paris of the system. By the time the fecale has rcached the branch pipe, it has assunmed the lquidity of water; even the paper has becomo dissolved, owing to the character of the fluids in which it is immersed. This liquid mass has to be propelled by a cushion of air acting behintd it, te the central reservoir. ihis would not be possible in a level pipe, because the air would over pass the liquid and leave it behind. The pipes are therefore laid in alternate inclined lines and short upriglit elbows or risers. By gravitation the fecale runs down each inclined length of pipe, until it reaches the next vertical riser, up whieh it is lifted or pressed by the air. It then runs down the next inclination, and is lifted up the next riser. If other pipes for gas or water occur in the path, they are avoided by putting in risers. The fecale is thus urged fromn the branch pipes froma every house in the street into a main pipe along the whole length of the street. The main pipé runs into a street reservoir, which is a small cast iron tank, capable of containing 6 or 8 cubie feet--cylinders with spirical ends, so as to be strongr enough to resist atmospherie pressure caused by the vacuum inside them. From the street reservoirs, pipes called central pipes convey the fecale te the central reservoir. Ml the pipes arc connected with the reservoirs by cocks, so that the vacuum can be caused to act upon one street at a time if necessary. A vacuum gauge is attached to the street reservoirs, se that the men who officiate can watch the process of emptying, and always be aware when they have sufficient vacuum pressure at work. The process is very speedy, occupying, when donc under the observation of the writer, about three minutes-but it is claimed that one minute is generally sufficient. This partly depends upon the quantity to be removed. It was anticipated at the outset of the systein that a difficulty would bc encountered, by reason of sonii3 houses or streets supplying more foecal matter than others less numerously populated. It was feared this would allow the pipes of oee street or house to be emptied sooner than the pipes of another house or street-thus admitting air in one set of pipes, which would destroy the vacuum, and thereby prevent the completion of the emptying of the other pipes. This was avoided by making",
         "PNEUMATIC SYOTEM OF SEWERAGE. 77 the suin of all the vertical risers equal on every branch pipo of one lino of main pipes. This causes each branch pipe to represent a barometric tube. If two branch pipes thus con- structed communicato respectively, the ono with a single lieuse and the other, say, with a barrack, occupied, say, by a thousand soldiers, the one cannot be emptied before tho other, because tlie pipe containing less material will not begin to discbarge until se much of the material in the other pipe has been disclarged as will suffico te equalize the pressure in the two pipes arising from the columns of fecale. All the parts of the system being laid six or seven feet under ground, could net be affected by frost. Every pipe in the svstem is of cast iron, five inches inside diameter. They are laid with socket joint and lead. They require the sanie care in laying as ordinary gas or water pipes. After use for years they have been taken up, and showed no trace of corrosion or of clogging. The fecale having reached the Central Station in the condi- tion of a dark liquid, is ready for conversion into poudrette. It remains in vacuum in the central réservoir, and is drawn off as required into an evaporating chamber, also in vacuum. At this stage the matter which we are calling .fecale consists of about 90 per cent. of water and 10 per cent of solids. The yield per head per day is 60 ounces-54 ounces being water, 6 ounces being solids. Adam Scott, the distinguished writer and lecturer upon the sewage question, gives se clear an account of the process nf producing poudrette that it may be copied here with great advantage:- \" The method followed te couvert the fecale into a dry 'powder consists in separating this 90 per cent. of watcr from \"the solids by evaporation or distillation. The heat employed \"is the waste steam of the air pump engine which collects the \"fecale. To understand the possibility of this, it must be rernenbered that in few steam engines is there more than 7 \"per cent. of heat, which the steam takes up in the boiler, \"converted into motive power, and 93 per cent. escapes in the \"exhausted stean. \" The heat in question is called latent heat, which is \"ineasured in physies by caloric imuits, one such unit being the \"amount of heat employed te raise the temperature of one \"pouud of steam by \" Fahr. Se long as steam remains steam,",
         "\" the amount of .tlories necessary for its existenco is coitiained \" in it, otherwiso it would not bo steain at all, and this is the \" case with the wasto steam of a high pressure engine. li \" amount of calorie depends, of course, upon the degree of \" sensible heat of the steaim, and upon the number of pounds of \"steam there is at one's disposal. It is, in fact, this sensiblo \"lieat which has been-diminished in giving off work. Thus, \"one pound of steam of 90 pounds pur aiuare inch pressure \"contains 1,179-7 calories, with a sensible heat of 320-5' Falir. \" After escaping froin the cylinder, however, it will be cooled off \"to about 212e, but will still contain 1,100 calories, wlich can \"be given off to any substance the steain cones in contact with.\" \". sensiblo heat of 2120 Fahr. is, however, too low for \"evaporating purposes, unless uider a much dimiinished \"pressure. Captain Liernur, therefure, follous the example of \"sugar manufacturers in applying that heait to the fluid to be evaporated in combination % ith a patia l iacutiii, and as the \"vapor arising from such a boiling coLtains still a considerable \"amount of heat, meiasurable in calories, he uses it for a second \"evaporation process. The practicability of this nay bu under- \"stood at once when it is considered that a fluid înay be set \"boiling with the steam of another fluid, and this inay be \"repeated. Sugar manufactories call this process à double qeget, \" or à triple effet, the last being where iapor of a second boiling \" is used for a third. \" To economise still further the exbaust steam of the air \" punp engine, it ie conducted through coils of pipes, placed in \"the flue through which the hot gases and smke fron the \" boiler pass to the chimney. Its sensible heut, as experienîce \" shows, is increased by this process to about 2300 Fahr., and \" the supernatant moisture transformed again into dry steam. \" The whole becomes thus practically dry steain, contaming \"about 1,152 calories to the pound. \" This dry steam of 230 is now conducted through coils of copper pipes placed in an upright hermetically Jlosed boiler. Into this, about nidway in height, the faveal matter is intro- \" duced after having been mixed with one per cent. of sul- \" phuric acid in weight to prevent the formation of ammonia \" during the ev.aporating proeess. The admission takes place \"continuously, and the matter is continuously ivithdrawn froin \" the bottoin, it then having lost about half 'the water it cou- \" tained. This loss is uccasioned by the evaporation due to the \"Iheat of the steam of 2804 cireulating in the coil of pipes, and PUB.IC H1EAL1.T MAGAZINr..",
         "'NEUYMATIC SVSTEM OFEwERAE. due to the fuct that the vapors are carried off to a condenser, thus producing a vacuum of 25 inches mercury, under whieh reduced pressure the boiling point is rcached at as low a \"teinperature as 2030. \" This condenser is formed by the second apparatus. It principally consists of a horizontal copper cylinder, revolving on its own axes, during the time that it receives the vapors of the first apparatus, and is suspended in a shallow trough, intu which the already thickeued reduced matter from the \"first apparatus flows. - In rotating it becomes on the outside covered witi a thin layer of that substance. This thin layer is hence heated nearly to the degreo which the vapors of the first apparatus impart to the inside of the second. But this cylinder itself is housed in a hermetically closed vessel, which stands in connection with the air pump engine, By means of an ordinary cold - water spray condenser, the pressure within the vessel is kept down tu about 13.6 inches nercury, under which the boiling \"point is reached as low as 375 0 Fahr. Under the combinea. effect of this degree of vacuum, and the heat imparted at 203 0, the final evaporation of the thin layer in question takes place extremely rapidly, aad it becomes a crust baked on the uutside of the revolving cylinder. A stationary slanting knife (or docteur) placed underneath, meets the cylinder in \"its turning round and scrapes this crust off in the form of \"small flakes or shavings, which becone the poudrette. It faces in a box placed on rollers under the knife. The \"apparatus can be opened in the ovening. The poudrette can \"then be taken out and put in bags for transport to manure \"xmarkets like guano. \" Analysis of the water distilled from the fecale in this way \"shows it to be far purer than the standard of drinking water \" prescribed by the Local Government Board. The process, above deacribed by Mr. Adam Scott, is at the present time being carried out by the city of Dordrecht in Holland. At Amsterdam, Leyden, Prague, Brünn, Olnutz, \u0026c., the fecale is as yet merely decanted in barrels and sold to the farmers as liquid manure, as the apparatus for conversion into poudrette is not yet erected in those cities. This brings us to the question of the value and analysis of the fecale-the cost of works, and what return has been already, and may be in future. obtaircd from the sale. Upon this will be based the next article.",
         "Ro TtILîC 1IALTII MAGAZINE. MORTALITY OF THE CITY AND SU3URBS OF MONTREAL, FOR JULY, 1876. -71 DistAsrs. 19 K. Smal1 I'ox ........................ 2. %Fca,%......................... «. 3. Scadlaina ....................... D. iphthcria... .................... 5Qurnsy.... ..................... 6. Croup............................ 7. - pn Cough .................. S. TyphoitliFever, (Infanile Remittcnt cvcrl 9. Typhug, and Infantile Fever ......... zo. i-dçapsing Fcvcr................... li. Fevcrs ................. 12. ErySipClaS............... ......... 13. «Metria, (Puerperal Fevar)............ 1.4- Carbunclc...- . ......... 15. Influenii ........................ 16. Dyâcntcry......................... 17. Diarrhoea........................ 18. Pyoemia .................. .... .... i9. Choiera Infantum.,................. 20. Cholem...........................I 22. RCMittCnt FCVCr ....................j 23. Cerebro-Spinal MeIningitis ........... 1 . syphilis .......................... * 2. 3.Glanclrs........................ i. Privation ......................... 2Purpura and Scurvy ................ L D *Ielirum Tremens Alcoholism. .... M 4. Intcm cranc.... KV-. i.fhrul h ......................... ruit1c. 2. 'Worms, \u0026c....................... i. Gout ............................ e2. RheUMatiSM .................. 3 1)ropsy andi !snaria ............ i .4. Cancer...........................f Q 5. Norna (or Canker) ................. . 6. Mortification .................... 1. Scrofula.... .................... .;:2. Tabes iet\u003ecnterica ...................I -C3 Pihthisi, (Cons. oftLungs)............ 4- Hydrocephalus ..... ................ 5.~ Tubercu lar NMcningitis...............J Carri\u003cxijorward................. Total by Sec. \u0026e. Female. 17 17 I 2 2 2 2 6 5 3 Total lx.th Sexes. 34 3 4 1 7 9 I 2 2 I I 2 3 1 4 Z 2 3 I I I 1 2 K I 16 24 40 3 2 5 203 192 395",
         "MORTALITY RETURN.. si MORTALLITY OF TII1E CITY AND. sUI)IIRIIS OF MONTREAL-(Cnr.) BIrmgåpt fonmrd .... ......... . 1. Cephalitis........................... 2. Apc lexy ........................... 3. P.Ara yi j............................ 4. Inanity........ ............ .... 5. h rc .............................. j 6. Epilep.y .......................... 7. Tctanu ............................. S S. Convulsions......................... - 9. Other Brain diseasec, \u0026c............... r. Carditi, Pericarditis and Endocarditis.... 2. Aneurism . ................. :i 3. Other Ilcart disaces, \u0026c... 1. Epi--taxis ............................. 2. Laryngitis ad' Tahitis ............... 3. Ilronc hts....................... s 4. Pleurisy.............................. éco 5. Pncumona.......................... : 6. Amhma.............................. 7 y. Other Lung disease, \u0026c.............. z. Gastritis ...................... ..... 2. Enteritis............................ 3. Feritonitis........................... 4. Ascites............................. c. Ulceration of Intestines ....... ...... bIIernia...................... ....... . 7. Ilcus and Intussusception.......... ° 8. Stricture of Intestinc. ............. 9. Fistula............................. o ro. Discases of Stomach 4nd Intestincs, \u0026c. ., Pancrcas Discases, \u0026c................. 12. liepatitis ........................... 13. Jaundice............................ 14. Liver Disease, \u0026c.................... 15. bpleen Disease, \u0026c................... r. Nephritis............................ 2. Ischuria............................. o 3. Nephria (Bright's Disease)............. 4. Diabetes............................. -2 5. Calculus, (Gravel, \u0026c)................. » 6. Cystitis and Cystorrhoa ............... P 7. Stricture............................ 8. Kidney Discase, \u0026c.............. VLOen* i. Ovarian Discase... ........ eratIve OrUan 2. Disease of Uterus, \u0026c,.......... V1or1 1. Arthritis..................... Loo. 2. Joint Disease, \u0026c................ motion T btaly Scx. Male. vemial. sxc't. 6 17 8 17 10 r5 4 8 4 I 2 9 :9 2 2 2 2 1 1 1 Carricdver......... ............263 245 513 Distats.",
         "8z PUnLIC IIEALTII MAGAZINE. MORTALITY OF TIIE CITY AND SUBURBS OF MONTREAL.-(Con). Total Total by Sex. both DISEASES. Sexcs. u O àfMale. Femalo. Broughd over........................ 268 245 513 i Absccss.......................... (V ntcgnà 2. Ulccr............. menta'y 3. Skin I. . Stillbo....................... Child. 2. Iremature Iirth.................. ren. Infantile Debiliy................. 41 Cof nosis........................ 5. Spina I3iÇîda and other Malformation .... 6. During Dentition .................. i.. O! PIaramenia........................ Wom'n iI 2. Childbirh...................... PeP .- Oh! Age......................... IV. of tion. i. Fractures, Contusions, Wounds .... SBrsand Scalds................... 3. Poison....... ..................... 4. Droivning......es ................. x 5. Otheri ise........................... i. Murdcr, Manslaughter.............. 2. Execution ......................... 3. W unds D lt........ ................ 2. Poison ... ......................... 6. Drovning n....................... 4. O her eis ........................... i. Chirurgici .......................... No known .......................... Infection purulente................... Emesis ............................. Lo. D Jwnn .......................... 13 14 27 1 4 5 3 2 5 5 5 5 2 7 I 2 I I I I I I Total..................... 362 322 684 c- FOREIGN HEALTH STATISTICS. United Kingdom of Great Britain, during three weeks, ending May 27th, 17,383 births and 10,736 deaths vere registered in London and twenty other large towns, and the natural increase of the population was 6,667. The mortality from all causes was, per i,ooo : In London, 21.33 ; Edinburgh, 22.33 ; Glas- gow, 26.66 ; Dublin, 24.66; Portsmouth, 20.33; Norwich, 22.66; Volver- hampton, 66.33 ; Sunderland, 16.66; Sheffield, 25.66; Birmingham, 22.33; Bristol, 25 ; Liverpool, 26.33 ; Salford, 30.66; Oldham, 26.66 ; Bradford, 26; Leeds, 34.66 ; Ilull, 22 ; Newcastle-upon.Tyne, 23.66 ; Leicester, 20; Manchester, 29.33 ; Nottingham, 22.33. Other foreign cities at most recent dates, per i,ooo: Paris, 26 ; Rome, 34; Vienna, 32; Brussels, 25 ; Berlin, 24; Hamburg, 27; Calcutta, 33; Bombay, 35; Madras, 34; Amsterdan, 38; Rotterdam, 26; The Hague, 27 ; Christiania, 32; Breslau, 43; Buda-Pe:,th, 45 ; Turin, 22; Alexandria, 47; Copenhagen, 26 ; Munich, 39 ; Naples, 35.- The Sanita;ian.",
         "MORTAI.tTY RETURNS. 83 TOTAL MORTALITY BY AGES. Under i year .........* ................. .................. ... 457 From i to 5 years................................................... 35 5 to o \" ................................................... il \" loto 15 ....... ................... ............. . .......... 7 15 to 20 \" ................................................... 16 20 tO40 « .................. 42 4 40 to 60 .................................................. 29 \"60 to 70 \" ................................................ 8 70 to So \" ................................................... 10 \"0 to90 \" ................... \"'90 to 100\" ................................................... 1 roo years and over................................................. .. Not known ........................................................ ... Total...................... 684 TOTAL MORTALITY BY NATIONALITY. French Canadians .................................................. 487 British Canadians ...... ...................................... 167 Irish .............................................................. 9 English............................................................ 1o Scotch....................................... ..................... 3 Other Countries .................................................... 6 Not known ........................................................ 2 Total...................... 684 TOTAL BY WAEDS. St. Ann's Ward............................................ 86 St. Antoine 4 ............,............................ 125 St. Lawrence \" ......................................... 69 St. Louis \" ................................................ . 42 St. James \".............. .......... 146 St. Mary \"............. ........... 164 WV est.......................................................... ... ... Centre................... ......................................... 10 East .............................................................. 10 Not known..................r...................................... I City IIospital ...................................................... 3 H otel Dieu ........................................................ 12 Montreal General Ilospital........................................... i Other Institutions.................... .............................. los Foundlings................................................. .. 5 Outside City Limits ........................................... 167 Total................... 959 N. B.-The foundlings and deaths outside city limits arc not included in classification of diseases, ages or nationalities.",
         "PU'BLIC IIEALMl 1» TIIE U'NIIED b1AIE;. I dnso Uiq %QItfa~ lsi ~ - -P .0 2OUU7ICJo-. ~e - -- urnt dniuq c ,to-,e.t . - - ci 4poq*.0-t 0- , tzt. . 6 0 ivmzuvl 1 O - - --;- c~noj n;doo~j j~ - 'e. dito., - é , Ci lD CI \u003e-CI e t- t- Oc t-' ~t- *~zfl~p1z~ ct-o o--. - VMUL QUtu ~ v - cc-t..c c-c -~ xo~-ît~mg C.~ O 00 1 ePd0- - , .. CII:-e t c C mmb, i 7 CI\"- --- - CD 3X -, rc tt CX .-- 'oeoJ~t~wp ZO.\u003e lOL .EZOeMtQ - --t- (p~ '0 -r *0 O, *Onaý 9 »Pau gqlv*(l",
         "- I _______________ I -~ I Co UR7 FOR ExLAPI.NArîoN SE PAGE 96. I.- k j-- - COURT . . ...........",
         "gtbict»i A MANUAL OF .DIET IN frEALTH AND DzsEASE. By Thomas Ring Chambers, M.D., Oxon F.R.C.P., Lond. Hon. Physician to H.R.H., the Prince of Wales, \u0026c., \u0026c., \u0026c., (Ilenry O. Lea, Philadelphia). The public have long been in want of a practical work on this subject, freu from chemical and botanical technicalities. He divides the subject into threc parts-first, the theories of dietetics ; man's natural food ; the choice of food, describing minutely butcher's meat, fish, poultry and garac, gardon produce, fruit, grueui ies and chandlery, dairy produce, alcoholie drinks, water, ail uf whicli every householder shoald endeavor to instruct himseolf in. A chapter on the preparation of food is most instructive, and especially useful to those who wish to be good housekeepers, for there is nothing so unwholesome as ill-prepared food. \" A good.cook is, to a certain extent, born, not made ;\" but much may be done to improve a young cook, if you seo she has a knack for such employment. Dr. Chambers maintains that no kitchen is complete without an open range, and continues by affirming that there is more economy in it than in closed stoves; be this as it may, certainly the roast is more tender and toothsome whea roasted as in the days of yore, than now. He concludes the first part by a chapter on digestion, a subject that 1 La peculiarly competent te handle, having before written a treatise upon it, or rather upon indigestion. There is a table of articles of animal food, which are given in order of their digestibility, beginning with sweet-breads and lamb's trotters, boiled chicken, venison, 'and so on. This alone is invaluable to the dyspeptic. The second part begins with the regimen of infancy and motherhood, gradually proceeding te that for childhood and",
         "PtInLC HEALTHi MAGAZINE. ynuth, then to manhon-1. Ie says the principal meals for a commercial life Abuuld be breakfast and dinner-breakfast bcfore, and dlinner after the work, with a light lunch at mid- day. Animal food should be used by a iard worker at both breakfast und dinner, but it is not required at lunch ; farin- accous food, vogetables, fruit, should bo the staplo of the mid- day meal. \" The most porfect rogimen for the healthy exerciso of thought is such as vould bo advised for a growing boy- frequent small supplies of easily soluble mixed foed, so as to supply tho groatest quantity of nutriment without overloading the stomach or running the risk of generating morbid half- assimilated products.\" Thero is no mor fatal habit to a literary man than. that of using alcohol as a stimulant between meals. The vital powers go on getting worn out more and morc without their cry for help being porceived, and in the end break down suddenly and often irrevocably. When any extraordinary toil is temporarily imposed, extreme temperance' or ovcn total abstinence, should be the rule. Much to the point is the experience of Byron's Sardanapalus: \"The goblet I reseryo for hours of ease, I war on water.\" In a separate chapter he enters into the injuries to digestion from certain trades, and gives good advice as te the avoidance of such affections. Athletie training has its place, with most minute tabulated rules for those entering for field games, races, \u0026c. Those about ta travel have also much te learn from Dr. Chambers' work. lie ends the second part by very valuable deductions drawn from numerous experiments on the effects of alcohol. The third part is devoted to the dietetics of sick- ness. Much information on this particular branch that can be obtained nowhere else, may be obtained from this work by the medical profession. We have derived much pleasure and profit 'rom the study of its pages, and we advise all who value health to purchase and read for themselves, as it would bo im- possible to give any idea of the scope of the work in a review",
         "REvi1:ws. Auli as this. Ta the sick wo aiso reconîmnd it. IL Ms a thnroughly practical work, and written in a comprehensive manner. LAinosn--r. NATInNÂT. GAits op CANAIA-by W. G. Beers, Secretary of the National Lacrosso Association of Canada. (Dawson 3rothcrs). This little manual of tho gane of Lacrosso has been receive'd; and, being an old player, ive read itf witi muclh interest. Ruleo for the guidance of the game wero very necesary, overything being counted fair play in our school days, were it over so palpably foul. It is amusingly vritten, giving a history of tho gamie, and full instructions how to use the cross in facing, throwing the bail, catching and carrying, dodging and checking, picking up, tipping, frisking, \u0026c. Thera is an appendix containing the laws of tho game. Wo know of no game that is more calculated to increaso the health and pluck of the young Dominion. The book is illustrated with photographs of the first Montreal team, some of whom are still active. members of the Montreal Club. No boy should be without this manual, a cross and ball. REPORT OF THE BoARD OF IIEALTI OF THE CITY oP BROOKLYN-- Froma May 8th, 1873, to January 1, 1875. It contains a mass of information of great value ta the City of Brooklyn, and much that will be of use ta other cities. First, we bave a report from the Sanitary Committec itself, and adopted by the Board of Health, signed by the President, J. T. Conkling, M.D. Then follow the annual -report of the Attorney and the staternent of the Finance Committee. The Com- mittee's Report on the principal causes of tho excessive mor- tality of 1873 is very interesting as shewing the many remov- able causes there are for the preventiun of diseases. Then foi- lows a report of the Comuittee on the manufacture and adulter-",
         "PUBLIC HEALTH MAGAZINP. ation of candies and liquors-exposing the many deleterious adulterations used. There are three principal adulterations:- (1.) Articles used to supplant sugar, or to givo \" bulk ;\" (2.) Coloring natters; (3.) Flavoring extracts. The Report proper ends here. An appendix to the work thon follows, containing the report of the \" Register of Vital Statistics\" for 1873, and another report for 1874. The Sanitary Superintendent's Report comes next, followed by the Reports of Drs. Colton, Raymond, Fisk, Reed, Hall, and Corbally-Sanitary Inspectors. There are-numerous tables and charts which vill bo and are of great value. The arrangement is difficult to follow, and much value might be added to the work by issuing an index. There is much in it that we recommend our own Health Authorities to copy. :o:-- HAY-FEvERI, OR SU'MMER C..TAIRRH, ITS NATURE AND TREAT- MENT. By George M. Beard, A.M., M.D., \u0026c., \u0026c. Harper \u0026 Brothers: Franklin. Square, New York. Many are the authors who have endeavored to instruct us upon this subject, and many are the theories that have been propounded. But this treatiso describes besides Iay-Fever, its carlier forin, \" Rose Cold,\" its later form \" Autumnal Catarrh,\" and a mniddle forrm, or July cold, hitherto undescribed. It is dedicated to thfe officers and members of the United States Hay Fever Association,-an association that was formed by the sufferers from this most distressing affection, for the collection of symptoms, \u0026c., and phenomena that accompanied the attacks. The author gives the history of hay-fever, and numerous ex- tracts from the writings of such investigators as Wyman, Blackley, Abhotts Smith, Watson, Salter, Phoebus, Helmboltz, and Moore, and thon proceeds to the way in which he procured his evidence by issuing circulars to rll the members of the aasocia- tien, and also by sending them to the hotels and places of resort of those suffering from the disease. He thon takes up and tabulates the answers to fifty-five searching questions on the",
         "REvLEwS. 89 ago, occupation, inheritance, temperanent, \u0026c., \u0026c., of tho sufferers, the symptoms and course of the fover, tho diagnosis and prognosis-its provention and treatmnent. His deductions from this mass of information arc very con- clusivo, and we must confess, ainco reading his work, to have become a convert to his theory, and discarded thoso of others. Tho conclueions which will be most likely to excita surprise aro those which show the relation of this diseaso to the nervous system. To thoso who have given the subject no more thought than is suggcsted by gencral observation of cases, and who have beeu witness of the unquestionable fact that the malady numbers among its subjects somo who are otharwiso unusually strong, it sce0rs beyond belief \" that hay-fover is moro markedly hereditary than any diseaso of which statistics have been gathered; and that the majority of its victims ara of the ner- vous diathesis, and suffer otherwise from au indefinito number of nervous symptoms.\" Ho has demonstrated without a doubt that all the irritants that are supposed to cause the disease, such as heat, dust, pcllen, \u0026c., or all combined, cannot produco the disease, except when acting on a prcdisposcd organization. Hs continues thus: \" The theory taught in this book, that this disease is a complex resultant of a nervous system especially sensitive in this direction, acted upon by thc enervating in- fluence of heat, and by any one or saveral of a large number of vegetable and otber irritants, has the advantage over other theories that it accounts for all the phenonena exhibited by the disease in this or in any other country.\" In this we quite agree. The transmissibility of the disease from parents to children; the temperaments of the subjects ; the capricious interchang- ing of the early, the middle, and the later forms; the periodi- city, the persistence of the attacks and their paroxysmal character, the points of resemblance between its symnptoms and those of ordinary asthma ; the strange idiosyncrasies of differýnt individuals in relation to the different irritants; the faet that it is a modern diseuse, peculiar to civilization; the fact that its",
         "rtI1LIC 1HEALTH MfAiA7.Nr. most abounde whero functional nervous disorders aro mnst fr,-- quent, and if apparently on tho ineroao )an passu with other nervous diseases, and finally, tho faet tnt it is beat relievoa by thoso remedies that act on the nervous systcm-al1 theso otherviso opposing and inconsistent phenorncna ara by this hypothesis fully harmonizcd. Any one, but more especially thoso suffering from this affection, will find amplo food for thouglt in this work, and wo ndviso our readers who arc desirous for such valuable information to seek it in Dr. Dcard's work. SIXTH ANNuAL ANNOUNCEMENT OF Ti FAcU.TY 0F MED . CINE IN THE UNIVERSITY OF BisioP's COLLEGE, LaN- '4oXV1LLE. WVe have received the announcemcnt of this Faculty for the session of 1876-77. As regards the subjects taught, and the time necessarily devoted to their acquirement, the curriculum of one university is pretty much the same as another; and there will be fbund, therefore, but slight differences in the programme for the students' attendance either in Bishop's Collcge or McGill. The only material difference observable is the deter- mination of McGill University to thrust hygiene into the back- ground, and fairly shelve it by making it an optional subjcct, whercas her young and enterprising sister comes boldly to the front, and makes hygiene a compulsory subject for ber degree of M.D.C.M. It is strange how difficult it is ta persuade this old estab- lished Institution to keep up to the requirements of the times, the \"pari pasu \" is constantly wanting in her, and hence it is, that lier competitor, alive to the exigencies o. the times, and the popular movements of the day, wisely lays herself out to secure provision to meet the demand, and by this means gains a step in advance of the more ancient and imposing Unversity. We live in essen- tially practical times, and we cannot afford to slight public opinion. The art of healing must ever go on while accident and disease stalk the earth, but the prevention of disease and the art of preserving health is as noble a science, and as essential to the well-being ofmankind, as the remedial art. After the step McGill",
         "REVIEWS. linversity took in raising the lcctareship of hygiene to a profcs- sorship, wc may wcll ask was it only to dignify the laie incumbrnt of the chair of surgery in Bishrp's College by an cmpty title ? Or, did the univcrsity honcstly determine to give to hygicnc its truc place of usefulness and importance? Which ? If the former, it was an unworthy act, and the prcsent p'rofcssor may wcll Icel the honcor a disgrace, and bitterly rcgret that lie yieldcd such an important position as Professor of Surgcry for an optional subject that any old woman could consequently fill. The Profcssor iof Hygicnc in McGill University cntercd nis duties with a fuli and ardent determination to make this increasingly important subjcct a popular and useful course, but the damper \u003cdan optional, i. e., a disrcgardcd, subject, has cooled him down, and the friends of McGill, who cxpected bcttcr things of her, and hopcd that the iresh blood that had been frecly put into the old lady's vcins during the past ycar would have brought out this subject into deservcd prominencc, arc alike disappointed, and frecly confess that Bishop's Collcgc Faculty of Medicine have dccidcdly stolen a march on her. The attractive manncr in which the subjects of the various professors' chairs are elaborated in the calendar of Bishop's College arc enough to make an carncst student's mouth water. Compare the pages x to 22 in Bishops College calen- dar and pages 54, 55, and half of 56 in McGill College calendar, and say is this doing justice to the able men who fil the chairs of McGill, and is this all that can be donc to attract a student ? And while we compare pages, observe paragraph xi , page 55, and page 16 of Bishop's College on hygiene.. If we are to have a calendar, embracing full announcements of al courses in our McGill University, then let us go in for an 8 oz. shot instead of a 4 Oz.. it's only a cent more to send per post, and we :;hould get the information we want, and in an attractive form. Ccrtainly its present shape is very fashionable, being cut quite tight to the stomach, but for ourselves, we prefer a little more skirt.",
         "PUBLIC HEALTH MAGAZINE LITERARY REVIEW SEPTEMBER, 1876. MUNICIPAL MISMANAGEMENT. THE BOARD OF HEALTH. Our readers, no doubt, are all aware of the public meeting lately held in Mechanics' Hall, called by the Mayor, at the request of a large body of citizens, to, take into consideration the present state of the city finances. We attended, as every citizen, who has the interest of the city at heart, should. We were pleased and gratified te hear those who were competent to express their views in regard to the wanton extravagance that bas been displayed, and were much struck with a fact that fell from the lips of Sir Francis Hincks. He said that in looking over a pamphlet lie wrote 27 years ago, when ho was for the èecond time finance minister, he had found that the present debt of the city of Montreal was greater now than the whole debt of the Province at that time. Is it any wonder, thon, that the citizens are indignant. Surely there is something rotten in our municipal affairs, that we are sunk into such a load of debt,.without value received. \"Where has the money gone te ? We cannot see, nor are we able te inform our readers. Perhaps the vigilance committee appointed by tbi meeting, on the 15th, will find out and let us know. We shall wait anxiously fer it. But we now must say a word upon a subject that we regret was net even mentioned at the publie meeting, although of more vital importance te us than our taxes-we refer to \" Public Iealth.\" What do we receive fromu our aldermen te assist us in this ? Comparatively a paltry sum when compared with the millions granted te the other committees. What, as we have",
         "THE BOARD OF HEALTH. said before, is the use of our parks and fine streets, if we and our children are threatened day by day with loathsome diseases whichl visit us in epidemie forms ? What have we to record P Thirty-four deaths from small-pox in July, and in the second week in August no less than twenty-five deaths. Our Board of Health is warned by the health officers that this fearful disease is gaining ground daily, and we may look for one of the Most awful visitations of this scourge, before another winter passes over our heads, that we have ever been visited with. We do net blame the Board of Health itself for all this, for we know that they doing the best they can, without money. What we claim is, that some of the funds from our taxation be given them te protect us and our families from disease and death. Thanks te our Mayor and his untiring zeal, he has surmounted many of the difficulties that presented themselves, and has made the Board of Health what it is. When Dr. Hingston was elected Mayor,.the health of the city was totally neglected (except what was done by ex-aldermen Kennedy.and Alexander) The Board of Health existed only on paper, and its by-.aws had been only enforced, a few times since its formation. After Dr. Hingston's election (which, by the way, was principally on sanitary grounds), he at once reorganized the Board, and has succeeded in placing it in good working order. 'The health officers now know their duty, and are made te do it. The meat inspectors are made te make returno of the amount of meat confiscated, from whom taken, and what was the reason for such action; also all diseased animals are seized. The Sanitary Police are also compelled te make daily reports of the places visited. The Sanitary Inspecter subinits his report also, with the fore- going, to the Board of Health, at its weekly meetings. These meetings are held at 4.30 p.m. on every Wednesday, and are presided over by the Mayor. The business is gone through in an orderly and satisfactory manner which other commtittees of the coporation should endeavour te imitate. There is a. weekly mortality table also submitted. It is",
         "PUBLIC HIEALTH MAGAZINE. very complete. The disease are al properly classified accord- ing to age, nationality and district. In fact, it is in such a fori that scientific statists can, at a glance, compare it with documents of a similar character in other parts of tho world. The citizens well know and appreciate Dr. Hingston's exertions as Chief Magistrate, but as President of the Board of Health, he as rendered services infinitely more valuable, though not of so publie a nature. Whilo all our press in Ontario, and theMedical Association on this continent are talking of the necessity of establishing Boards of Health for each state and province, Dr. Hingston has succecdced in establishing the Board of Health of this city upon a permanent basis. * The work that is dono wcekly is of incalculable benefit, and the manner in which it is done is a model for others elsewhere. Besides the examining of reports, the Board has acted with a strong and vigorous will in a manner net before attempted. We refer te the ordering of drains througli private property, when the interest of health demands it, and without any reference te expropriation. In this way, work has in some instances been commenced within twenty-four hours of the time from the issuing of the order. Some may think that the Mayor has stretched his authority a little too far, but the citizens, knowing it is for the public good, are quite prepared te support him in his-actions. There is now a notice of motion before our Council, that the Board shall be elected and represented by a member of the Council from eich ward, and we would suggest to Ald. Grenier te add to his niotion part of Sec. 3 of the by-law already in existence, viz., \" te appoint \" ............ an additional number of persons, not less than nine \"nor exceeding eigliteen citizens, inhabitants of the City of \"Montreal, te be assistant members of the said Board of \"Health............. \" This proceeding is suggested \"whenever it shall appear that the city of Montreal is treatened with any formidable epidemie, endemic, or contagious disease.\" Now, as we have",
         "THE BOARD OF HEALTH. before said, the health efficers have informed the Board that an epidemic of small-pox is at present raging, and will, beforo the autumn, reach alarming proportions. Now is the Lime therefore to add greater strength and more scientific support to the present body. Vaccination and isolation are now acknowledged by the scientific world as the only preventatives of small-pox, and we call upon our Mayor and Board of Realth to exercise its powers in this direction as strictly as they have in the matter of drainage. The by-law on vaccination reads thus :-Sect 10, 24 Vie., Cap. 24- \" If any father or mother, or person, so having, as aforesaid, \"the care, nurture or custody of any such child, as aforesaid, \"shall net cause such child to be vaccinated within the periods \"prescribed by the net, or shall not, on the eighth day after vaccination has been performed, take, or cause to be taken \"such child for inspection, according to the provisions of this \"act respectively contained, then such father or mother, or \"person having the care, nurture or custody of sucli child, as \"aforesaid, se offending, shall be liable te a penalty net exceed- \"ing five dollars, recoverable on summary conviction before the Inspector and Superintendent, or Police Magistrate or \"Stipendiary Magistrate, \u0026c. liow here is machinery that only requires te be set in motion te stamp out the plague spot fiom amongst us. The by-law with respect te isolation is equally strict, and has been ordered by the Board te be put in force.",
         "PUBLIC IIEALTI MAGAZINE. THE WORKINGMEN'S DWELLING IMPROVEMENT COMPANY-(LnITED). (Vids Wood Cut bettceen pages 84.5.) This month we give a view of the tenement block of working men's dwellings which have been erected by the directors of thiz, company on a site which they have secured in Falcon Court and Disney streef, Borough, London, England. Ve have often ex- pressed the opinion that something in this way should be done here for our workingman. It is through them that we have our comforts, and we in turn should see that they have homes that are a comfort to them when they feave their workshops, and not unhealthy dens as many of them. are, Of course there are many who can avail themselves of the advaritages street cars give them, and have healthy suburban residences, but we refer to the majority who, by reason of their poverty and nature of their occupations, are compelled to reside on the spot, and must of necessity have houses provided for them. It would give us ex- treme satisfaction to see such a scheme entertained. As to the safety of the investment there seems no reasonable doubt, and if properly managed it should yield a handsome dividend. The public always seem to rush with avidity to secure stock in the many public schemes that are proposed every day, which too many live to regret. Leave these speculators who only offer delusive securities to themselves. We maintain that public enter- prise in the direction of the improvement of the social condi- tion of the people ought to be more supported by individual pecuniary help, and we know of no more satisfactory way of in- vesting money than in companies such as this, where -not only a safe investment is secured, but the person so investing has the satisfaction of receiving a fair and reasonable interest for his capital, in addition to the gratification also of knowing that his money is doing good to his poorer brethren. On refereace to the plan, between pages 84-5, it will be seen that each floor (ofwhich there are4) contains twelve distinct dwell- ings, provided with separate sculleries and other domestic con- veniences, and with an entrance of its own from the courts which",
         "WORKINGMEN'S DWELLING. surround the site. There will, therefore, bc sixty tenements, consisting of 125 rooms, exclusive of sculleries, \u0026c. There are three staircases; one in the centre of the building, which leads to the balconies off which the tenements in the upper floors of the main building are approached or entered, and one at either end in the north and south wings. The area of the site is about 7,000 square feet, the area of the building itself being 5,250 feet, thus leaving two yards, or recreation grounds, of respectively goo and 750 square feet. The height of the building is fifty feet. It is proposed to adopt two- systems of ventilation, viz., those of Dr. Ancell Ball and Mr. E. G. Banner, both in separate wings, and Dr. Ball's improved stove is to have a trial. Messrs. Brown and Green, of Luton and Bishopsgate Street, have, we are informed, offered to supply, gratis, one of their portable cooking stoves. Shafts for dust and refuse are provided for each floor, with properly contrived double doors to prevent annoyance to intervening tenements when dust is sent down. The roof is to be flat, composed of asphalt or concrete. The exterior of the building will be faced with stock bricks, and will be of a plain but neat character. The iron balconies in the centre portion of the building will also be very plain, but will add materially to the appearance of the building, as they will relieve the eye from the enormous mass of brickwork which is behind t hem A calculation as to the cost of these dwellings and the rents that can be obtained in this neighbourhood has been made, and we are informed that a fair dividend on the outlay will be ob- tained, which will leave ample margin for a reasonable interest to be paid to the shareholders. We might add that every means is to be taken to improve the physical condition of the occupiers of the dwellings, and every inducement offered to them in the shape of economy. The principle of co-operation is to be adopted, and we understand that arrangements are being carried on whereby coals and other commodities will be obtained at wholesale prices. A company that wiill thus consider the re- quirements of its tenants and the velfare of the people for whose",
         "PUBLIC IIEALTHI MAGAZINE. bencfit, as weil as their own, they seck to provide with iniproved hcalthy homes, ought to reccive the support, moral and pecuniary, of all right-thinking Christian men, and ve hope Io licar of the great success which they will doubtless meet, and which they so richly deserve. In addition to the foregoing, the Company are in negotiation for a site upon which they propose to crect a large and commodious block of buildings, in addition to the ordinary dwellings, containing ·a Workmen's Club, with accommodation for lodgings for bachelors, smoking, reading, and class-rooms, and also a large hall for lectures, which will be provided and paid for by the Company. This will be a work of greater magnitude than the present; but it should, and will doubtless, meet with equal success. VACCINATION. The following facts have been culled from other periodicals for the information of our readers and bencfit of the anti- vaccinationists generally:- \"A good deal of opposition continues to be shown towards the vaccination process by the native population of Jamaica. Several epidemics of small-pox prevailed in different parts of the island last year in spite of the great efforts made by the doctors to stamp out the disease. * * * * The public have resisted all advice in the matter of sanitary and pre- cautionary me2sures, have courted sniall-pox by willful and un- necessary exposure to its influences, by refusing * * the safeguard of vaccination * * * * The large public institutions where vaccination could be enforced, escaped almost entirely the ravages of the disease, although situated in districts which suffered severely from small-pox.\" Elsewhere we find a letter from an army surgeon, from which there is only one conclusion to be drawn :- \" Corporal W. R., 13th Regt., came back from London, after furlough, on the 14th March. On the 24th of the same month he became sick, with the usual signs of fever. He was taken into hospital, and gave the following history :-' That he had been staying in London and been to see a favorite niece, who was",
         "VACCINATION. down with the small-pox,' and the 'child had it very bad.' On this the \"an was placed under canvass, and subscquently small- pox developed itself. After a most minute inquiry I found that by an oversight in the regimental orderly-room this man's name had been omitted from the list of men to be re-vaccinated ; and going over the book with the Àdjutant it waz, fotfnd that this man was the only one in the regiment who had not been re- vaccinated. Here, then, was the only man ivho -had small-pox, and the only one who had not been vaccinated. Small-pox was prevalent enough in Dublin, Belfast, Glasgow, and yet no case occurred amongst the men-he concludes by saying:- \" Of course I include women and children in this statement, and also include the large number ef women living in town who were married without leave, but all of whom vere re-vaccinated and escaped small-pox.\" We would bespeak the attention of the anti-vaccination school headed by Dr. Coderre, Messrs. St. Pierre, Thibeault, \u0026c. to the following statement of facts also. At a meeting of the Salford Board of Guardians, the Work-house Hospital Surgeon, reported that out of 400 cases of small-pox he could not find any one in which the patient had been attacked after revaccination had been successfully performed. Other medical officers present also bore testimony to the protection afforded by revaccination. The mischievous doctrines promulgated by the anti-vaccinationists vill be estimated at their truc value by a public who will take the trouble to consider the significance of such facts as these we have now recorded. :o: MONTREAL SWIMMING CLUB. At last Montreal can boast that there is a swimming club. That well-known volunteer, Lieut.-Col. Lebranche, has accon- plished what many have talked of. With him, as in his soldier- ing, action was his vatchword, and the result is a club of 400 members, and only six days has his office been open. His jovial face might be seen fron his office door, as it were inviting all perspiring souls to enter and put down their names, enrolling themselves as members. Afew have stood by him, and there is to be a public meeting in a few days for the election of officers and the formation of a programme of future work of which we will duly inform our readers.",
         "PUlLIC ILTIU MAGAZINE. g elifIxii moti;ce . SYNOPSIS OF METEOROLOGICAL OBSERVATIONS IN JULY, FROM McGILL COLLEGE OBSERVATORY. * Barometer readings reduced to sca.levcl and temperaturc of 329 Fahr. † Pressure of vapor in inches mcrcury. e Ilumidity, relative Saturation, loo 9 Ten inches of snow is taken as equal to one inch of watcr. Mean temperature of month, 70.7. Mcan of maxima and minima tempe- rature, 70.87. Grcatest heat was 87.6 on the roth; greatest cold wras 49.9 on the 25th, -giving a range of temperature for the month of 37.7 degrces. Greatest range of the thermometer in one day was 20.4, on the 25th ; Icast range was 4.9 degrees on the 2nd. Mean range for the month was :4.82 degrees. Mean height of the barometcr was 29.9005. Highest rcading was 30.188 on the 27th; lowest reading was 29.490, on the 6th, giving a range of o.698 nches. Mean elastic force of vapor in the atmosphere was equal to .55rg inches of mercury. Mcan relative humidity was 72.6. Maximum relative hun idity was 97 on the 3rd. Minimum relative humidity was 42 o the 25th. Mean velocity of the wind was 9.15 miles per hour; greatest mileage in one hour was 27 on the 3rd. Mean direction of the wind, W. S. W. Mean of sky clouded was 58 per cent. Rain fell on 17 days. Total rainfall, 4.33 inches. REPORTS of the Medical Health Officers for the City of Mont- real for 1875. These long-looked for reports have come at last, but we regret to say that they do not corne up to our expectations. They have been so thoroughly discussed in the public press that wc forbear saying anything further about such confliting ducuments. We regret that the Board of Health allowed their publication before having received and adopted then in committee, as their inconsistencies reflect upon them. EnrAT.-The following errata appeared in the August number: On page 36, last lino but one from bottom, for \"facilities\" read \"velocities.\" On page 38, first lino, for \"frce\" read \"freed.\" On page 50, line 12, for \"wards\" read \"modes.\" 10o0"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PUBLIC HEALTH MAGAZINE. Vox: 1.] AUGUST, No75. [No 2. PROPOSED PLAN OF PUBLIC SCAVENGING;. l'y S GEO. A.DiUliN. (Reart l4efoe the Citizen\" 'ubli Hcahh APw\u003eciation.) The substance of the following plaper and the proposal it cov- ers, were to have been submitted to the publir meeting at which this Association was forned ;-but no opportunity for doing so having then occurred, I readily embraced the invitation to submit the matter at the present meeting: It is a remarkable fact that, in this great and growing 'City, no system of public scavenging has ever existed. It is (I an in- foried on enquiry) truc that the Health Conmiittee or Board of Health, have some appliances for the relief of extreme cases, and that on application to them this machinery can or may be set in motion ; but it i.1 not asserted by any one that this pro- vision is other than palliative, and its very existence is unknown to the majority of the citizens. In effect, each householder has the disagrecable, troublesome and costly duty forced upon him of rernoving froin his premises all refuse matter whatever which cannot be passed into the severs. As a necessity it is impossible for him to deal with as it should be; he must permit its accumulation in or about his premises tilt a cartload is made up, or tilt its presence cannot longer be tolerated, and then he must seek out a carter and bar- gain for its removal. Again, as a matter of fact, and in consequence of no pro- vision being made for its disposa], the carter is compelled to get rid of it, by depositing it in vacant lots and land in the suburbs",
         "and outskirts if the city-ne cssarily in the neighborhood of dwellings-and there it still tndangers the public health in. deed I have frequently scen on sttcets and roads in the lower parts of the city, d.epo.sits of garbage of the miost abominable description, which had been got rid of in this .,ay. Further, and apparently as a direct and natural consequence of the above state of things, it %ppears to bc a traditional inatter of necessity that all houses in the city should be furnished with outbuildings and have acces to a back lane; ard, in passing through our most fashionabl. quarters, a glimpse can bc had into a dirty and unpaved lane, presenting a vista of dirt-heaips, where, under precisely similar circumst1nces, in New York or Boston, the space would bc occupied by neatly turfed yards, separated froni ach other by low painted fentes, and permitting the free access of sunlight and air. In short the present condition of things is a direct defiance of all sanitary laws, without a single counterrailing advantage. 1-ow is it to bc bettered? Let us lay down this principle- that it is absolutely essentiail that aIll house refuse, not tributary to the sewers, shall bc removed day b\u003e day, or at frequent inter. vals, fron cach and every house i. the city, and these resuilts flow froni it. Vou at once rernove the dut froni the individual; it can only bc acconplished by co-operation, and it is idle to speak of any other system of co-operation but that already ex- isting-our civic government being in effect nothing but a systen of co-operation for this and kindred purposes. It is the bounden duty of the city authorities to undurtake the work, and there is neither originality nor novelty in the statc mient, nor in the following scheie, for it has been recognized and acted on for an indefinite period by most cities of the least in-. portance. I apptehend that the finction of this Association must always be to deal witi general principles and watch re.ults, and that it should not go beyond influencing the authorities to perform the duty in an efficient manner; consequently I do not ask it to deal with the details of the plan which I noný propose-nor indeed shall I pretend to do more than sketch it in general ternis . First-Let the city undertake the duty, organizing for PU1BL.IC IMEALT11 IArAZINE.",
         "PIIJtIAC 04UAVENVII.4. 35 Ille pbtirlin a nriw rivic Ocip.irtnicnt, tu 1w called.the \" Cianing i )î~at1t'n,~t ont rolled liy a \u003colnitte as ii-mal, and direttly miîgcd Iiy a permnanent tîlicer, who %1îoild pusses% thce excil. tial -iltalîttc% tif as-tivity, ittnlttion, and 3one admninistrative, ailîlit%, .uîd, if lirtilialle, experience in -,iui1ar%,crvircelcse. wlwerc. lie ehiouhi control the whole of tIme %itbordinatesi and lie~ rcs1îrulnsilil fir ail charges int\u003currvd, and for the efficient wîirking nf the whole. l'le exp)cne of the dcliarîniciit should, in the iumantitue, lie miet frimn the ordinary revenue of the cîty; litia ntimnatel) lîil lie îîrovided for by a 'tpeci.tl assessinent for Seitei,-Tlih -,if and pilant sloî)ild Ibe as follows: Tu'o ClerksN. Fiur lP~iknStîinititvsiduiit, or Forcinien, ivliose dutics should lie wliolly out, of doorb. Qwe /umAr\u003cd strect Ncaivengers. Fifty.îhirec large carts or %vaggon, on two wlicets, flot nallkr than two cmtbi yards caliacîy) without hecaping, and better largur. Fifty-five large heaivy drauighî horses, not lcss than x5,3 highi. and ail nccce.sary tools and apparatus. 2\"hrd-ro~ide thrce or four depots outside the city, con- vuenicntIy acesbefroni tie main country roads, to whiclh ail refuse, nmatter tan bic cirried by tlme %vaggons, and from which ht cain bc supplîcd to fariners andi markut-garden ers as IllantIrc. At firs t n must jîrobably bc givun away, but ultînmately it will be .salalîle, andi sorne considerable surn obtained froin tixis source to the credit of the departiment. lt will lie founti to bc necessary that th e service bc cc'nducted wvitm absohite regularity, so that the tinme of the visit to each struct may lie countcd on wvhh certainty, and ail refuse inay be put in an accessible place, and after the service is once properly started, the retention of ail such imatter on any premiseb sirbuld subject the offender tu a smart fine. The whole business of the department as above sketched, can bc nmanagcd by a corporation with officier-cy, economy and success, and should be taken ini hand as a wvhole, and the details %vorked out by the officers wvho are to be continuedl ini poiver, and 1 trust that no attemipt ivili bc made to work it l)y conract, which îs certain to end in failure.",
         "PUBLIC HEALTH MAGAZINÉ. Vhatever nay be thought of the details, let this Association lay down in unniscakable terms, that nothing short of an effi- cient plan for securing the removal of all offal at short intervals, from every d'or in the city vill be accepted, and let its influence be used tQ convince the public that however costly suci a sthemîe nay be, it can be denonstrated that it may be carried out at a snaller outlay by the city than is now entailed on individuals, and further that the decency and improved sanitary conditions to be secured by this and in no other way, are not to be measured by money. MONTREAL WATER SUPPLY. BY, DR. J. BAKER EDWARDS. (Read before the Citizci's Public Ilealth Association.) It lias been frequently and very truly said that Montreal, from is natural situation shovid be the most healthy city on this Con- tinent. It is certainly placed under remarkable physical advant- ages, and as regards two great desiderata for large cities, viz.: draik ge and water supply, nature lias donc all in lier power, and it only remains for intelligent man to apply known princi- ples of mechanicail skill to render these advantages available to every citizen. The water supply of towns and cities, especially those situated on the banks of rivers, lias become in England one of serious magnitude, and its importance to the liealth \u003ef communities has demanded and obtained laws of the most stringent and protective character. If any country in the world can afford an unlimited and boundless supply of water to its inhabitants, it is to be ob- tain.ed in the Br'tisli Isle, Favored by the wïarm exhalations of the Gulf Strean, and the condensing towers of its mountain tops in Scotland, Ireland, Wales, and the Isle of Man, to say nothing of the hills of Mendip and Cotswold, Derbyshire, and the Grampians of England proper, its wonderful population is abundantly supplied by an excessive rain and dew fall. Yet all this exuberance of nature is more than counter-b2 ,nced by the",
         "MONTREAL WATER SUPPLY. 37 abonnding energy and manufacturing industry of the country vhich expands itself on water powers and ivater privileges, throwing upon the rivers and streams the irresponsile onus of getting rid as best they nay of the injurious and worthless products of their chemical and cleansing operations. Now, aftee many years of stream and river pollution, after actions for damages which have turned into the pockets of landowners and lawyers the accumulation of profits of years of nanufacturing industry, a Royal Commission is proposed to take the whole subject into consideration, and to place limits on the rights of individuals and communities to use or abuse the streams and flowing waters vhich flow past their land, and to enable the State to hold these in trust for the benefit of the coniniunity at large. If, as a Dominion, we are wise, we shall, as good and intelli- gent children, avail ourselves of those great moral and social les- sons which our parents in the Old Country have learned at a large cost, both of expense, annoyance, and personal ruin. The law is as simple as Divine revelation cati make it. Thou shalt love thy neighbor as thyself.\" If in\u003ctividuals, or comipanies, or corporations, seize upon conmon property and undert-ike public distribution of the benefits derivable therefrom, they are bound by every moral principle to' see to it that in serv- ing themselves and their communities they are doing no injury to any one-and if the moral instinct is blind, deaf or halt, the State is bound to step in to the rescue of the citizen. e I buy meat or vegetables the municipal law protects nie, and I have a remedy against the seller if the meat be bad. If I buy milk, I am supposed by some occult by-law of the City Council to be protected from buying milk anid water, (how this works I am not prepared to say) but as Dogberry says \"it is the law.\" But if I buy water, the Corporation is the seller and the law-naker too, and I must hold my peace and pay my taxes. I get water, more or less, generally more. More by sand anti sediment, more by consequent plunber's repairs. More by fish, alive and dead, \" en gros et en detail.\" More on \" de tail\" when they stop by thîeir fragments the water-taps. More on \" de gros\" when they breed and multiply in the fish-pools of Heshbon, near Raven's Crag, where nets would break if we vainly attempted to capture them therein.",
         "PUBLIC HEALTH MAGAZINE. I do not trust myself on this occasion to speak of the quality of the Montreal water-it would be froin mne a \" thric told tale.\" I have again and again p\u003eonouinced t \" unfit for human con- stm.iPtion,\" and my medical confreres generally agrec w ith me in this verdict. Still the f untains play and the w ate s ripple- from granite vases, and the cup.is offered to thc thiist3 wVayfarer in the naine of beneficence, say ing, \" come and diink.\" I now present to you some samples of water collected on the 1oth of May last for our public meeting, and whIh I should hav c then shown and spoken about had opportuinity offered, and whijh I regr tted vas the best refreshment whiclh could at the moment be offered to the thirsty lips of our cloquent Piesident. 1nis vatet remained muddy for a inonth, then undeinent a kind of fer mentation, and finally settled down to its prescnt stagnant and undrinkable condition. For some years ni\u003e Lieiical confrerc, Dr. G. P. Giidwood, lias publicly denounîced the unliolesome condition of the city wateî supply, and the mut.h ,espected and experienced Editor of the Canada Medical Journal in this month's issue, \u003epeaks out bravely to the saie eiect and fully endorses all that I have said upon the subject: \" The waters ut the Ottawa, which flow past oui city, coine down in a continuous stream several hundied miles foui what is termed the height of land, receiving in its course the waters fron tributary streams and rivers, so that it drains the entire valley of the Ottaw i. In its course downwards it nay be said to remove the refuse drainage and sewage of over half a million of people. This is a subject which can be discussed by the - Citizens' Public Hecalth Association.' The water from oui house-taps is a kind of animal and vegetable corpound, almost as thick as pea- soup, though not quite as savory; and the only means at the dis- posal of the tenant, with a view to improve its condition, is the use of a private filter. This is a luxury enjoyed by the man of means; the poor man is forced to drink the water as it is sup- plied, and thinks his water tax heavy enough without an addi- tional tax for a f lter. Hence as philanthropists and political economists, we should not only advocate but insist on the use of a public filter. It is a matter of fact based on observation, that the drinking waterof Montreal is particularly noxious tostrangers.",
         "MONTREAL WATER SUPPLY. 3U Persons visiting our city, cithet un business or for pleasure, soi- dom get awaay wvithout buiTering fiun severe diarrhoea or cholera. It is by no ncans uncomnion foi these attacks to prove fatal, We need only to turn to our mortuai y statistics to ascertain the fact that cholcia, diarrhoa and dysentuty are very often fatal during the heat of sunmmer, and this pi incipally amongst the floating population. The citizens tlemselves occasionally suifer though not in the samne degrec, as they becuomc as it w'ere accustomed to the impurities. But there are other diseaîses, equally dangerous to life, which nay be produced by the inpurity of our water sipply-such as typhoid feve, and the generation of the numier- ou family of entozoat, so commonly met witlh in chddren, and which arc occasionally fatal. On luoking ovet the work of Dr. T. Spencei Cobbold, on Helmiiithiology, vith reference more particularly to the internal parasites of inan, tie reader becomes hnrrified at tie nuinerous foi ns, and mujuriuus results of taking into our stomachs the osa or the yuung of v.u ious entozoa, which live and generate within tus.\" Tlhese aflections are known tu be pîevenitable, and with regard to cholera, diarrhœa and dysentery, they arise frequently fron some irritating material taken intu the stomach, sone substance which the body cannot utilize, and which is therefore Cast out. Cati we wonder at such a result, wien we present as a beverage to our visitors a vile compound of hu-nan and animal excrement, fish spawn, vegetable refuse and ger ms of all sorts. Naturally the stomach rejects it, and what passes into the lower tracts of the intestinal canal acts as an irritant and is thrown off. Why kill off our children by the host of bowel and other derangements incduced by drinking these impurities? Our city parents do not like to assume the expense of a public filter, although we believe the expense would be trifling compared to the ultiîmatt' benefit to the fair name of the city. To this might aptly be applied' the couplet: \"KIl a man's family, and he may brook it, But keep your hands out of his breeches pocket.\" Sone four or five years since I suggested the propriety of an zannual clearance and cleansing of the Mountain Reservoir, and uipon its subsequent drainage an amount of filth and live stock was",
         "40 PUBLIC HEALTUI MAGAZINE found in it fully to justify my disgust at its then condition. Since that time. however, it has, I am informed, been but once emptied, and it is now in a not very inviting condition. I have advocated, and still advocate a gencral filtration of the public water supply, and as the materials arc at hand and not costly, I again urge this upon the attention of the citizens. The mode of filtration is simple, and only implies intelligence and labor. The most available filter is composed of .- Fine sand, a ft. 6 in. z. Coarse sand, i ft. 3. Shells, 6 in. 4. Fine gravel, 3 in. 5. Coarse gravel, 3 ft. 3 in. These are best disposed in waves, and below the convex curve of each undulation is placed a porous earthenware pipe convey- ing the water into a reservoir, whence it is distributed. This filter will remove the whole of the suspended matter, three- fourths of the organic matter, and one-half of the mineral salts in solution, yielding a very pure and soft water. It would be necessary to have two or more sets of filters, and about once a week or once a fortnight throw one set ont for cleansing, which may be done by simple washing, drying, and re-sifting of ma- terials. The quantity filtered is about eight gallons per square foot of surface per hour. Filters of 270 square feet would yield about 1,700 gallons per hour per day. The cost of such filtration is about $575 per annum per million gallons per diem. The distribution in Montreal is excessive, amounting to sixty or seventy gallons per head per day, while Glasgow and Edin- butgh supply thirty-five gallons; London, twenty-one to thirty- four, by various companies; and Liverpool has reduced its con- sumption from 334 to 191 per head. Now, as it is much cheaper to filter the water than to increase the supply, by preventing the large amount of waste now going on we might practically double the available supply and have an abundance of water at thirty gallons per hcad and the costof filtration would be saved. As a house filter I can cordially recommend that recently con- structed by Messrs. Prowse Bros., of this city, which combines the advantages of the best known materials, simplicity of struc- turc, readiness of cleansiing, and consequently durability. . In conclusion I would urge upon the public to demand from the City Fathers water that is water, and nothing but water, on the above sanitary and economic grounds.",
         "CITIZENS' PUBLIC HEALTH ASSOCIATION. This Association held its first public meeting in the rooms of the Natural History Society, on the iith uit. The meeting hav- ing been called to order, the President gave a short outline of the work proposed to be donc by the Association. He recommend- ed that the Association should feel their way cautiously, and not put their hands to anything they could not carry out in a practi- cal way. He said they should inform themselves of all the in- fluences affecting,or threatening to affect, the public health; en- quire into the causes, origin and distribution of the different dis- eases prevalent in the city; bring before the Board of Hecalth all matters appertaining to health, and obtain from as many sour- ces as possible reports of yards, drains, \u0026c. He laid great stress upon educating the public mind in i ýatters of hygieae. He con- tinued by saying that it vas only by the influence they could bring to bear upon public opinion that they could acquire power and make themselves be felt as an influential body. He then stated that radical improvement was wanted in the mode of im- posing taxes, and their distribution. Mr. G. A. DRuMMóND was then called upon to read his pa- per, which will be found in the original communications at page 33. Alderman McCon» then spoke to the paper in a very able manner, but his remarks scem to imply that we are in a very bad condition as to our treasury. He concluded by stating that if we wanted a healthy city the Board of Health must have more money to work with, and if the Corporation could not give it we must be content to have a special tax levied for that purpose. He said that the committee of which lie was chairman was quite willing to undertake the scavenging systen as proposed by Mr. G. A. Drunmond with a few amendments.",
         "MIr. ALEXANDE, M. P. P., did not put a happier face on our present condition, but ratier the reverse. Prof. A. JoIîusON, LL.D., then stated that the Corporation represented the citizens. The) arc nlothmng by thcmselves. If we can manage to brng public opinion to bear upon them, as has elen done,.by the Teipelur.nce Association, we can brng them to a siise of their duty ; but su long as we are content to remain quiet and put upi with dicîr apathy we may expect no- thing. Tlhey have money, and we nust compel tiei to apply it in the best way, and not squander it in show outside, but .make tht inside clean first. The nanner of macadaiizng our streets is simply, a nuisance , they use a soft stone that is ground intto dust iîmediately. After addresses from Messrs. Rm n.ii, Ly n, zu nows, TURroN, Drs. CoR\u0026DNERi, GiRwvooD and others, lis Vorship Mayor IIINGsioN, haI ing beun invited to Address th meeting, spoke sonewhat as follows: GEN rLEiMEN-I hoped to be permitted to reman suent this evening ; but being asked to express my views, I may say thev have been already expresscd on several occasions, and the views on the substance of th:s evening's paper have been expressed in the short report of the Board of Health subnitted to the Coun- cil the other evening, and referred to the Finance Comminttee for ,their consideration. It is to me, as it must be to you all, a sub- ject of regret that the citizens generally do not take more inter- est in matters relating to public hcalth. The report submitted by the Board of He ilth was une which cost its members much thought, yet, so far, it has not been commented upon by the press.* We hear fron time to time of the uncleanly state of the city, and since this Society is organized we hear somewhat more than for- merly. But as this Society is organized to instruct the public in matters sanitary, I should suggest that it begmn by informing the people that, if the city i. not efficiently cleaned, it is partly because the aniount paid by the citizens is totally inadequate for the pur- pose. Baltimore pays at the rate of $i.8o per head; New York pays somewhat less ; while Montreal, with its difficulties of a *This bas been remedied, tne press having since discusecd the report in ques. tion, and endorsed the views of the Board generally.-ED. P. Il M. PUBLaC IlEALTH MAGAZINE.",
         "CITIZENS' PUBLIC 11EALTN ASSOCIATION. linatical character to contend with, never paid more than 18 cents per head, and this year only xo cents ! That so niuch is donc with this limited, this niscrably bmall pittance, is the best testi- niony that can be offered of the energy of the Road Conmittec, and of that efficient but overworked officer, the City Surveyor. The strects are to he eaned this year for four thousand dollars ! Now, can ary one in bis senses believe that work of such mag- nitude can be donc for such a sui- -work that would require 150 horses and mien for a considerable portion of the year ? Why, it would not suffire to purchase hay and oats for the horses. It is proposed hy the report to which I alluded, to incréase this amount, and to place the cleaning and sprinkling under the Health Departnent. It is also proposed to clean not only the streets, but the lanes and yards also, and I must do ny friend, Mr. Drummond, the justice to state that the practical suggestions ie miade to me sone days agô nere, to a certain extent, the cause of the introduction of that portion of the report. Should the Finance Committee sec its way to furrish the necet ,ary assist- ance-and I an satisfied that the intelligent and conscientious Chairman of that Committee will do al in his power in the mat- ter-the streets, yards and lanes will be cleaned by the authori- ties, and individual citizens will bc relieved. It is estimated that this work can be donc efficiently for $5o,ooo annually, or about 30 cents per head-a much less amount, it is believed, than is paid by individual citizens for cleaning at long intervals. When I proposed to take upon our shoulders the ceaning of the city, the members of the Road Conmittee seened not disinclined to be relieved of the work, and the City Surveyor, who lias to look after the making, grading and repairing of our streets, and the construction and alteration of our sewers-work almost disproportionate to the strength of any nan-shared in those views But a question of noney arises, and a question of author- ' ity also. The Board of Health bas the \"power and authority in relation to,\" \u0026c., \"as are possessed by the said Council,\" \u0026c. It is empowered to \" adopt and enforce all sanitary nieasures, and all measures relating to the cleanliness of the city.\" But vhether it bas the power to draw checks upon the city treasury, or whetler it has the power to have those checks respected, are X",
         "PUDLIC IIEALTII MAGAZINE. matters now under the consideration of the City Attorney. Of tl:is, however, i can assure this meetmng,-tha. the vell abused nembers of the Corporation are anxious to do aill they possibly can towards the aielioration of the condition complained of; and this Association must do its duty in preparing the iminds of the citizcis to adopt this anchoration. The following resolution was then proposed by Mr. P1'wrR RrPATuit, and seconded by Prof. JOHNSON, LL.D., and the Cor- responding Secretary instructed to forward it to the Corporation in the name of the Association: \" That this Association hopes that the Finance Committee of the Corporation will not be obliged to refuse the application of the Board of Health for mneans to clean the streets and lanes of the city, and to water the streets; and prays the Corporation to take steps to procure the funds necessary to carry into effect the offer of the Board of -{ealth, feeling assured that public opinion will fully sustain theni in so dong.\" 'rof. JouxsoN, LL.D., then proposed, seconded by Dr. PROUDFoor, That it is expedient that every member ot this Asso- ciation should seek to strengthcn and extend its influence by endeaxoring personally to induce others o join it, and that, for this purpose, subscription books bc formedand distributed among the nembers of the As:,ociation, or that one or more paid can- vassers be employed if thought necessary.-Carried. A vote of thanks was next passed to Mr. G. A. DRUMMOND for his very interesting and intruLtive p«.per on scavenging. . The meeting then adjourned. CITIZENS' PUBLIC HEALTH ASSOCIATION. A meeting of the above Association was held in the Natural History Roons on 9th inst., at 8 p. m., Mr. Mercer in the chair. In introducing the subject lie said: \"Gentlemen, we are met here to-night to consider the question of our water, and a paper will be read by Dr. Edwards relating to that question. The editor of the Canada Medical and Surgi- cal Yournal, says 'It is a subject which can be discussed witi far",
         "CITIZENS' PUIBLIC I[EALTII ASSOCIATION. grcater advantage to the citizens than by silly renarks conceriiing our dirty back lanes.' This was said by a doctor who is supposed to feel a very great interest in the hcalth of our city. If there is any one thing more injurious to the city than another it is the dis- graceful state of our back lancs. At a previous meeting I made sone allusion to this filth that was allowed to remain under the very noses of nany of the nost cininent physicians of our city, and to-night I repeat the allusion, and I should like those niedical men to reply to the charge I now make against them i-1 using their back lanes for storing their manure and garbage fron their stables and houses. I say enphatically that they have no more right to throw filth in those back lanes than I have to go and deposit such in their dining-rooms. This is stronglanguage, but it is necessary to use strong language in a case such as this. I will not make any further renarks. I have çondensed what I intended to say, and made up in strength what I have lost in length. But I reiterate that it is unworthy a medical journal.\" Dr. Edwards then procceded to read his highly interesting paper upon our water upply, which will be found in our original matter, after which héèôalled upon Mr. Louis Lesage, Superin- tendent of Montreal Water Works, to explain the proposed new systen of water supply. Mr. Lesage, although lie had come unprepared to address the - meeting, yet feeling that he should be able to say something upon such matters, spoke as follovs:- 4\"Ourvater supply has been incrcasing fron a snall pumping engine and a wooden pipe at the mountain to that we now get from the Lachine rapids. It was proposed to go sone thirty or forty miles distance, where a pure lake could be found, and con- duct the water to the city by gravitation, and the question was considered whether this should be adopted in preference to the present works, but as this would entail a very large expenditure if was thouglit the city could not yet undertake such a large work ; but the idea of making a new canal of large dimensions did at last prevail. The first part is now in the course of construction, and is expected to be donc carly next year, the remainder vill be donc in a few years. The water power is sufficient to raise one hundred millions of gallons in suminer and thirty-one millions in",
         "d4 - PUlBLIC IEALTI1 MAGAZINE. winter. We are awarc that thesc calculations arc not exactly cor- rect, but at any rate they are on the safe side. The quantitv is nbwin@lnt, the qualhty is not very good, and the question of tilter- ing the watcr has cone up. A large filtering basm is a nccesssity. It is easy to. filtei at either by side filtration or through filtra- tion. I intend to tale great pains in studying the question, and will li-ing it under a pr.iîtical estimate. All the filtration should be done below for the reason tiat it is clcaper, and therc is less weighit to raise, friction also being iess. ihe water committee have not taken the water filtration into scious consideration vet, but.several allusionshave been made to it, and I do not think .t will bc very long before we may have it in actual working. Our winters are so severe that it nay have to be donc under zover, and I am afraid that the cost may somewhat exceed that quoted by Dr. Edwards. Now the water supply will not purmp more than S,oooooo and we usà 9,ooo,ooo; the rest over and above S,ooo.ooo is supplied by steam. The service pipes in the city are now coated with a sediment, which, by a sudden flow of water, becomes disturbed, and of 3:ourse enters the houses, It would cost so very nuch to clean it off'that I am afraid te propose it.\" , Alderman McCord then rose and made a few appropriate re- marks, and sâid that we must limit ourselves in quantity of land aixd have the best system of filtration that is possible to be had, and- stated that the Water Committee had instructed the Superin- ten.dent to consider the best mode of filtration, and to place before them estimates of its cost. Alderman Stevens then rose, saying: \" The great difliculty that has been experienced ever since I have been in the Corpora- tion has been expense, zs we always have been in arrears. Ever% gentleman here knovws that at one time we had to get a regiment of soldiers to clear away the ice at the Aqucduct. It is to otir interest to wait until the new cut is finished and sec how it will work before spending a million and a half down below, for if the cut is usêless the rest of the money would be saved. Our difli- culty has been that the aqueduct become pretty much solid ice during winter, but our theory is that it will not form nor gather under acovered surface, but vlether it will be driven there we egnnot say.\"",
         ",ýANITrARY NOITER, 47 \"Ve have enojugh of a water suIpply now for drinking proes, but ve have not en'mgh for hydrailic purposC. Wu are under, great cxpense now, and I have nuo, doubt every gentleman perfectly' iidertand1s vhMien his4 water bill comnes due that bis water tax is a vers beavy one, hence we have never gone ser- inuslv into the matter of filtration. I îf our supply ever becones polluted from the formation of a village above our present cut, it would be necessary to--et water from a place forty miles back talled the Lac Ouara. This back water bas a lake capable of supplying ten cities. The only.reason we do not go there directly is that we can supply tie city mich sooner the way we are doing. Our city is not large enough to go into this cxpense. When it becomes large enough it will be quite easy to go into this systemn of supply by gravitationx. I am in hopes to be able to put. on a tilter in front of our ie- ceiving pipes at the reservoir. I do not favor a setiling bin.\" Dr. Carpenter expressed great fear of any such thing as .a settling basin, stating that water, wlen left to stand, absorbs many foul and poisonous gases. Dr. Baynes then rose and suggested that considering the flith that hiad accumiulated in the pipes a filtering metre be furnished to every house. A vote of thanks to Dr. Edwards was then proposed by Dr. Cordner, secondetby Ald. Stevens, and carried. To the Editors of Public Ilealth Mag in': Sîn,-I propose to send you a few notes on sanitàry niatters, in reference to dwelling-hu.es, with suggestions for removing or mitigating the e. ils whidi arise from ehe imperfect drainage and ventilation of the sane. These notes are drawn f\u0026om an extensive practice of many years in designing and constructing",
         "48 PUBtL.Ic IIEALTil MAGAZINit. dwellings, and will be given pretty nuch as thcy were taken down and (in some cases) correctcd by subsequent experience. I an, Sir, yours, \u0026c., JAMES Il. SPRINGLE, MONTREAL, JUly, 1875. Architect and Civil Engincer. Note r.-On Seu'er Gsi.--E. cry houscholder in a sewered city like Montreal should clearly uinderstand when lie provides that modern convenience-a water closet-for his dwelling-house, that lie introduces directly into said dwelling, and niost frequeritly into the immediate vicinity of the sleeping apartments of the sane, a tubular branci of the common sewer of his strect, and that what- ever of effluvia or foul gases, or vermin. are generated or find place in the sewer, can also-unless hindered by some clever expedients of the plumber, whiclh will be noticed lereafter-pass directly up froi the sewer to the water-closet, the bath-room, and such bedroons as have fixed wash-stands, and in a greater or less degrec, to all the apartnents of the house. Moreover, this brandi sewer is exposed to a number of risks and casualties froni which the common street-sewer is exempt. It is frequently made of lead very little thicker than stout brown paper. By the ingenuity of the plumber it is passed underneath kitchen floorrs, behind stud partitions and between floors and ceilings; at every turn it is liable to bave its goints broken and displaced by the carpenter who lias to cover it up out of sight ; so that, irrespective of trapping and ventilating, it requires the greatest care and the closest watching, to keep this branch sewer and the works attacied to it, intact, after it lias been fixed in place by the plumber. Whîen it is considered in addition to the above-that cheap and, consequently, defective plunber's work is very prevalent, it is not surprising that ninety out of every hundred dwellings, having water-closets, are troubled more or less with sewýer. effluvia; andwenu4 if it should be found that this efiluvia shifts to different parts ofU.t4 house with changes of the wind, sonetimes appearing in the liv-f'jMfS ing rooms at- the lower parts of the house, at other times in the sleeping rooms and oLcasionally at opposite sides of the house, iis pretty'ýcertain that the branch sewer or soil pipe is",
         "prtirK.. lIZUFlVEla j ou P LVII%W. lirokcn or dkîaIllcc.d tinder the~ basemenflforsr, and ni- tiiîc ,Iiçitild lie~ last in ha.ingq *î rejoaire.d. If efi1îîvia k ris v in thc*n \u002b àev(4\u003cs~ vîiaiiitvtlC thu rcatt th.. baji1-ronnm, or the ri\\es wasth. ,.111aîîa~t ta g.w1 #aiîylc Li'ttctially rucmovt.l lay c\u003e1tinuing the iiraîirh %UCr or --mil pilot Ill Ibroligli the roof, of thet %aine a', it il lbucw, inaIde of soldercd tin and co%«rc.d wvîth a Tredgal ventilator tif the saine inatcrial. .A Very plch~\u0026jan kA-r getting rid of e.fI1uvia frtim liath- ,, rcaoiin. and watr.do'tt iý, the iuillowifg : Every day. s -ýoonil 114df( u ,\u003c j the laadi ,,crt;te i% over, hal fll dii t bath with frecsh Cald water Ut tUIW4hd froîn the tal , and lut ht remaîn undi.ýturbed till ii shtly before the bath ,k reaîîi!rud the foliint; day. The wvatur wMiabsorb aiyvitluvi.a whish niy bc prcesent in te air, and if once or twice 1%cl.ahandfîîl of any disinfectant is dîssotvozd in thc wvatur luefore it is mun off, sewer efiluvia will scon disaîapear if te trais of dte îlîîînber'. iork arc ini good order. Ini dwcllin,,4. %ithiout bathsý, the kitehen sinl, shoîîld bc nmade tiIm tif b la\u003ehttig it %tarxd nearH\u003e full of frceh %vater ail night; an~d. by occa-sîonilly dksn,\u003elving a disinfectant iti the watcr b)efore rmnnintz ih off, the sincil froin the sinkl will soion eaç,if dtlw IioflKs R'cîivi'îa FOLj RFvirw 'Mr. 11I F T %tî.csoN has .~r.us foi rc% iciW Advice Io a Wifé,- on the NIan-igeînent of lier own I-IeaIth, \u0026c., -\u0026C. PBv Pyt: Hunry Chevvasse, Fellow of thec Royal Colluge of Surgeons. Tt Ciinîsl'i-Aq WVoizviEî This is a new contribution to OmnonthIy journ.ilikm. Puiihe ndcr the auspices of the Yotong M,\\en's Chiri!stian Association. l'le îaLn 9bject of the pubflication is to diffuse information concerning, and'to afford increased and systematic ptublicity ta, the work in ivIich the Asqnrai.tion is engaoed, also ta fîtrnish, fir thie guidance and encouragement of Christian lahorers, con- a-v.c. of'.rt tli 'tn i.tdç tay LEvingelical organizations ibrmiigheeut tht ý%o.r1d 1\u003erire - ivte rents jpcr , jy, ur fifty. cen4,ýper annum., Hall- price ta inbers of the Association.",
         "PUBLIC HEALTH MAGAZINE, AUGUST, 1875. SMALL-POX HOSPITAL. A gentleman writes to know if the authorities arc really in earnest about the division of $5o,ooo between the two hospitals at present existing, and asks us to give some suggestion for the help\u003e of the Corporation, and also to let our readers know both something of the disease itself and how it is managed in other parts of the world. Fever and small-pox hospitals have been long established in many large English towns; but of late years it has beconie usual for the civil authorities to erect temporary hospitals dur- ing outbreaks of infectious diseases; so that when the disease is, discovered, those affected are at once removed from their, homes. Thus the probability is that the disease is checked and in a measure prevented from spreading,-an admirable plan where the climate at all seasons permits it. In speaking of small-pox, Sir Thomas Watson says: \" Theye is no contagion so strong and sure as that of small-pox; none that operates at so great a distance.\" The contagion is so strong that it may be carried long distantes from streetIo-tstreet. The poisonous matenal is thrown off from the cutantous an'd. nucous suifaces-the exhalations, excretions, and-secretions also tecm with it. The air soon becomes contaminated-4t attaches itself to the clothes, and it is so tenacious that, though èxcluded from the-air, it may remain aL. . e for an indefinite period. Seëing, then, the vitality of which it is possessed, if a per- manent hospital is to be built, the greatest care should be taken to segnaterials gf the least porous nature both within and with- out. Thevwals.andceilings should be capable of being purified",
         "SMALL-POX HOSPITAL. and thoroughly cleansed by ordinary ablution, and, for this pur- pose, surfaces such as slate for walls and floors, and soldered tin for ceilings, would answer. The expense of this would not very largely increase an ordinary estimate of other material. If the hospital is to be constructed like an ordinary dwelling, we think most people would rightly deem it as insanitary. On the other hand to ask a body of gentlemen with $25,ooo to build and re- build a new small-pox hospital whenever the old ones have become too impregnated for the safety of the general public, is absurd. No other body but a city corporation is fit in this country to undertake such a task. We have no Sanitary Board of Guardians, as they have in England and elsewhere, to under- take such an onerous duty. The cry that is always in the mouths of the people of the Province of Quebec, is the two religions and two nationalities. Whatever is done fir the English and Protestants must be donc for the French and Roman Catholics, as if disease was a discriminator of religion or nationality. That the hrge-hearted men who direct the Montreal Gencral Hospital do not think so, is evidenced by the fact that there are more Roman Catholic patients within its walls than Protestants. If we learn anything from the parable of the Gooa Samaritan, it cer- tainly is, that religion has nothing to do with doing good to our neighbor, as the wounded nan's necessity was the only passport to the stranger's benevolence. To fritter away the grant by a division, is such pure pander- ing to the unworthy cry of bigotry at a complete sacrifice of the general good that it will only be another monument of our shame; for it must be well known that to attempt to build, fur- nish, and equip a small-pox hospital with $25,ooo, is only a pre- mium to call on the city for $5o,ooo more, for it cannot be donc. If the Corporation do not wish to undertake the responsi- bility, then let the whole $5o,ooo be given to trustees, composed of English and French, and with it the old Hall house and site: then build or renovate what is necessary, appoint a staff of medical officers, nurses, \u0026c, and have only one hospital-give it the name \" Civic Hospital\"-that will satisfy all parties, both national and religious. The city will be thus doing its own work and the public helping the poor who cannot isolate themselves.",
         "PUBLIC IlUALTll MAGAZINIE There arc nany persons who would willingly pay to be attended there, rather than infect their own houses and families. But, above all, let vaccination be compulsory, and subject the refractory to a fine if they neglect it. ST. GEORGES INEBRIATE HOME. We have seldom been more gratified than in visiting ne establishment opened as an Inebriate Asyluin by the benevolent exertions and substantial support of the congregation of St. George's Episcopal Church, and which is under the able direc- tion and attentive oversight of Mr. Frederick Birnjum, aided by the truly maternal care of Mr. Barnjum's mother. For situation and scenery the residence couild scarcely be surpassed. The house, while it lias the cottage character, is really a large double- house, with verandahs, and the, internal arrangements most com- plete. On the ground floor is a spacious dining-room, communi- cating with offices for the cuinary d-2partnent. 1-rom the hall you enter a pleasant room used as a library for the inimates here there is a small se1ection of books with shelves that invite the kind lîberality of the many who would take a delhght i add- ing their quota. to what is to afford one of the rational means of employing the time and attention of those who have voluntarily subjected themiselves to the restraints of \" The Hoine.\" On the left you enter the suite of apartments belong- îng to the Superintendent and his famîily, and here is a com- modious and well-appointed surgery, fitted up with plaini medi- cines, \u0026c. The upstairs has no less than ten excellent bed- rooms, with a inagnificent large bath-room. The whole residence is neatly and comfortably furnisied, and the board and attend- ance,,as far as expense goes, so moderate, that it in every way facilitates this last effort of reclaiming the inebriate. We have seldom seen in any house such general content, and all is made so cheerful and happy that the restraint self-imposed by those seeking to be reclaimed is not felt. A thorough air of comfort stamps everything within and without. There is a pretty garden",
         "PRACTICAL DISINFECTION. full of roses, and looking out on the woody side of Nuns'island, with the beautiful broad river flowng at the bottom of the field, where the boat-house affords constant employment for exercise and health. There is ample room for lawn games, and beautiful large outbuildings for healthy gyninasti. exercise in wet weather. It is comipletely \" rus in urbe,\" for while surrounded with noth- ing but fields, a quarter of an hour's drive takes you into town, or to join the omnibuses that runî to the Point St. Charles ter- minus. The kind hospitality with which we were received and shown over this home for the recovery of the inebriate, gave us the fiullest assurance that there bas seldom been opened under auspices more favorable and with a better hope of success an establishment so painfully needed and so often asked for. We do sincerely trust that those who have so often in vain sighed for such a home and so continually asked, why have we not such, will at once avail themselves of this great desideratun in our midst. Visits of encouragement and fellowship in the work are felt by those who are giving their life and strength to sustain it as it should be, and we do hope that the noble-hearted persons who have hegun this good work will give every aid to the efficient and active labors of the gentleman who lias charge, for much de- pends ilpon a full and generous trust iii his discretion and man- agement for a successful conduct of the establishment. . PRACTICAL DISINFECTION. 1. HYGIENE OF THE SICK-Roon.-The first duties to be at- tended to in infectious diseases are to enforce isolation of the patient-make certain that the room is well lighted and well ven- tilated-remove all superfluous furniture, such as carpets, cur- tains, \u0026c. The nurse should have minute instruction as to the management of the patient, and insist upon the utmost cleanli- ness being maintained; the disinfection of excreta, slops, soiled linen, \u0026c., and their removal afterwards. To complete the isolation of the patient, aerial disinfectants must be used. The best manner for doing so is by means of a sheet moistened with a strong solition of chloraluni, carbolic",
         "PUBLIC IEALTII MAGAZINE. acid, or Condy's fluid, and suspended outside the door of the room. The clothing should be received in a tub containing chloralum or carbolic acid. The ejecta, \u0026t., should be instantly covered by Burnett's solution, copperas, chloralum, ot (arbohle acid. Care must be taken in using gcneral disinfeLtants that they do not counteract each other-for example, (.,arbolic aLid de- composes Condy's fluid. The inunction of the patient with Lamphurated oil or a neak solution of glycerine and carbolic acid, followed by bathb durng convalescence in the exanthematous diseases, acts with guod re- suIts. 2 After a case of illness from an infectious disease, the rom should be cleansed thoroughly and disinfected, the furniture and every particle of wood-work should be washed vith carboùc awid, soap, or a strong solution of chloralun. If the ruom has been papered, the paper should be remoýcd. Then fumigate the roon with chliorine, suilphurous acid, or nitrous acid gas for beveral hours. After this whitewash with quick lime and whiting, and re-paper, if desirable. All clothig, hedding, \u0026c,, should also be diâinfeLted by steeping in a solution of chloralum or carbulic a6id and boiled. The best mode is by baking iù an oven for an lour at least at a dry heat of about 2.oo or 250°\u003e ahr. But uýcry artile which can be spared should be burned. 4. DI'FNFECTTON OF WATER-CLOShFrS, SIKs, N.-All traps and scwer-pipes should be constantly under supervision, and fre- quently have disinfecting fluids poured down them--especially during epidemic diseases-and all the time in Montreal, for we seem to luxturiate in constant epidemies of small-poA, typhoid fever, \u0026c. - 5. DISINFECTION oF THE DEAD BoDY.-Why do it at all? Because we wish to remove the chances of infection to as remote a degree as possible from the living. The first, the best, and only truly innocuous plan is by eremation. By that means the putrid corpse cannot ever slay his brother. But more of this in detail at a future time. Until such timle as custom and fashion influence us to the contrary we mnust be contnt with washîng the body over with a strong solution of carbolic acid or chlo- ralim, placed in the coffin with more disinfectants, the lid screwed down, and buried without delay.",
         "SCAVENGIN.-OUR SIDE-wALKS. SCAVENGING. \\Ir. (eo. A. Drummond's paper on \"Scavenging\", will be found elnhere. It is a most ex.celleint plan and should bc put im operation at once. But the refuse should be removed every day '.nd not allowed to collect, for fermentation froni the garb- age will surely begin at once, and of course the evil con- sequen.es are inevitable. In crowded parts where families are in tenements, a common bin should bc used and roofed in to keep it dry. No slops or excrement should at any time be al- lowed to bc thrown into it-because the fermentation will be acIelerated and be offensive. Regular and frequent %isits should be paid to it. The cleaning of the streets, and back courts or lanes, is a most important branch of scavenging. Gutters and pavings are so badly constructed that it is next to impossible to prevent filth accumulating. After rain there are numerous small stagnant pools to be seen through the whole city. The macadamized streets are being constantly pulverized and give off clouds of dust containing large quantities of decompos- ing animal and veget ible matter-while in paved streets this filth is collected in the interstices. There can be no doubt that for sanitary purposes the smooth and impermeable surface supplied by the \" Val de Travers As- pha/t\" is durable, elastiL, and inodorous, and e., ily cleansed by water. In the poorer localities, where there is little traffic and much filth, a washable surface such as Gencral Scott's \"Selenite\" would add greatly to the health and appearance of the city. OUR SIDE-WALKS. It is only just, when we are not slow to complain of griev- ances, that we should be prompt to acknowledge benefits. The measures taken of late by the city authorities to pave our streets and remove the wooden side-wialks cannot be too thankfu.lly re-",
         "PUBLIC IHEALTII MAGaZINE. ceived. In a sanitary point of view it will bc fruitfuil of mnuch bencfit to the city, for it is difficuilt to estimate how Car this nuisance of rotten planks has added to the general causes of ill health. Any casual passer-by can sec for himsclf as the plank lias been removed how invariably the bed on which these decay. ing boards were lying, presents a deep black nuck of vegetable matter, which, after every shower of rain, threw up an unhealthy gas under the very windows and doors of our dwellings. Every sort of creeping insect that feeds on decaying inould found un- der our walks an undisputed home and gencrations of rats have lived and died there. It was fuil time to rp up this nuisance and do away with this oft condenned system of pathways that was sheltering and accunmulating the decayed vegetable matter of years. The shade trucs certainly flourish under the systeni, and to them is due in part the relief of their absorbmng the rising 'nhealthy miasma from the matter below-and it will be found that where shade treus lad not beun plantYd the sniell and n tiqous vapour fron the side- ialks have aided to produce the unhealthiness of the localit3. We do not pretend to pass any judgment on the character of the present path-way, whether the (lag-stone in the centre would not hae been ail the better for six inrhes more width, nor of the combination of the crushed stone on each side ; it may answcr, perhaps will, but in comîpari- son, sanitarily, let us rejoice in the change. o0",
         "TH'E \" THE \"BESSEMER.\" The daily journals have already acquainted the public with the fact that the saloon steamer, designed conjointly by Mr. Bessemier and Mr. Reed, crossed from Dover to Calais on Satur- da) on an official trip, with a large party of scientific and other distinguished men on board Ail professions connected directly or indirectly with marine matters were represented on the occa- ,ion, so that the peculiar properties of hull outline, machinery, ventilation, and chiefest, of the swinging saloon, might be fully and fairly tested by competent critics. As to the first two items above named, it is not our province to say anything. Great care appears to have been taken to secure the comfort of passengers by special ventilating arrangements for the saloon, as wiell as for the other parts of the ship. They are somewhat similar to those on board H.M.S. \"Assistance.\" An unusually large number of small syphoned upcasts are provided to carry off foul air from the nethermost parts of the ship. The swinging'saloon is specially ventilated by ground glass louvred wirdows, that extend along cach side close to the roof. Although at the time of the passage across, the thermometer in this gorgeous apartment stood only at 65 degrees Fahr., we believe that, for the exigencies of the sum- mer months, further provision for up-casts will have to be made. It is necessary, too, to draw attention to the fact that the stoke- holes were excessively and most unnecessarily hot. The ther- mometer at the forward door of the aft stokehole (which should serve as down-cast) stood at 96 deg. Fahr., and it is evident that both forward and aft the \" plenum\" supplies are not sufficient. But ail these defects are remediable, and can sodn be remedied by the well-known ingenuity of the contractor and his staff. Of Mr. Blessemer's \"spcialité,\" the swinging saloon, nothing can be",
         "PUBLIC HIEALTIf MAGAZINE. said, because the apparatus was not in working order, and, in- deed, under any circumstances, the -ea vas so smooth that no crucial trial could have been made. Looking for a fair and com- plete trial at no distant date, we do not care to canvass the prin- ciple of the invention or the probabilities of success, but may record that in point of luxurious accommodation and all sorts of comfortable appliances, the \"Bessemer\" rivals any passenger ship afloat.-Lancet. 0 A NEW SEWER TRAIP. Dr. Dukes, the medical officer to Rugby School, lias directed our attention to a new sewer trap, patented by Messrs. Potts \u0026 Co., of Handsvorth, Birmingham, under the naine of the \"Edinburgh Air-chambered Sewer T:·ap.\" This trap, on the house side, communicates freely with the open air, and on the sewer side is placed also in communication with the air by a special shaft. As in Molesworth's trap and somre other traps, the principal object of the new trap is to disconnect the house drain from the sewer, so that no sewer air shall pass along the house drain into the house, but under al circumstances which would determine such passage, shall be diverted into the open air. This is effected in the new trap by the house drain opening into achaniber which communicates freely with the open air by a grat- ing. The outlet of the bouse drain is closed by a flap which opens on the slightest pressure; and the grating is made double in order that charcoal nay be placed in the interspace if thought desirable. A diaphragn in the chamber, depending from the grating, is believed to be effectual in determining an in-and-out current of air. The chamber opens into the sewer through an ordinary syphon, or midfeather trap, and on the sewer side of this trap provision is made for attaching a pipe to be carried to the roof of the house. The apparatus isanotlerand very ingenious attempt to apply in comon -drainage practice the principle of breaking the direct communication of house drains with sewers, so long insisted upon by Mr. Robert Rawlinson. It promises to be a",
         "UsE OF ,sTIMUILJVNTs IY VOM EN. very effectial and easily applied mneans for this purpose; and it v, to )e welcoiiiel as helping to make wholly inlefensille the too conmnon practice of builders and architects in overlooking the essentia! priuciple of safe drainage which this trap is designed to secu re.-Tite Lancel. -O USE OF STIMULANTS lY WOMEN, Dr. Edniunds, in writing to the ffca//k Reformer on the use of stimulants by wonien, says:- A very large najority of the ladies of my own acquaintance on the other side, who are a fair sample perhaps of the ladies living in London society, have acquired the habit of using wine, table-beer, stout and frequently whiskey and brandy, to a large extent, I think, owing to the mistakes on the part of my own pro- fession in the advice which they have given. The result is that the babies of the present generation are never sober from the earliest period of tlieir existence until they have been weaned. This is a shocking statement for me to iak-e, but I should not be doing my duty here, unless I were to make it as broadly and strongly as that. It is a simple fact. The mother's blood, practically, is entirely in common with that of the child. You know perfectly that, if a mother takes even an ordinary dose of such medicine as castor-oil, it will very often affect the baby more than it affects the mother ; that one has to be exceedingly careful in prescribing for mothers simply on that ground. Now, what does that simple fact with which all you mothers are familiar show ? Why, it shows this that the soothed condition of the body after the mother has taken half a pint of beer is really the first stage of drunkenness in that child. When I hear a mother telling me that whenever she takes a little whiskey and water or brandy and water because the child is fractious, she finds that her milk agrees with it better, I am obliged to ask her if she knows what she is doing; if she knows that she is simply making herself the medium for distilling into lier babe's systen almost the whole of that spirit which she takes into her own; and whether she is aware that that soothed condition of the child is really the",
         "PIBLIC IIEALTIH MAGAZINE. first stage ci drunkenness. The fact 1., tihe balby i. only the in- finitely more scnsitivc extension of the mnother'b syton, and it is norchkely than any other part of the nOth r' systcm tu rtawe.L the things which arc injuriuus that arc t.ik.n thruh hei L .adiun of the nother's diet. Wcll, now, ladies, bear that 4n miad when you arc told to take wint, or bcer, or braLndy , uinda..tanjd that you arc nercly distilling that winc, spirit, and ler, into ) our a.hild's franc , that the very nould whih th4t a.Éid as t' pr..s.rf e for the rest ut Ats life is being cUnstruttetd Vut of laoud that is Alcohul zed-ut. of a condition of the aptem in whiclà intuxi- cation is the real, substantial uelni.nt fur thta ;Ïrbt tn,-lh a. 1munthls of its grow th. I ask those of yuu n ho muay iaa. thutiga t yur duty to retomimnnd yuung numun nIho do not kun bpatter to take. thsu:, things, whether that ib not agraý-. and imapor tant faut for you to think of. SMOKERS ! BEWARE! You dont know whtat you arc doing, ! You arc \"onlyjust enjoying a pipe \" on your way to work, or while you are working, or after work is donc? \" Only Just \" ? What does onlyjust mean ? You are onlyjust spoiling your digestion and your teeth, in- juring your liver; making your complexion sallow, your eyes dull, your life sluggish; and sowing the seeds of various chronic and acute diseases, which may be long in showing them- selves, but will surely come at last-in short, you are onlyjust rom- mitting suicide by a slow but surepoison! Poison! sav yon. Wlho says it's poison ? All medical writers class tobacco with alcohol, opium, and other POISONS. Dr. Hossack says that \" numerous instances of dyspepsia, apoplexy, palsy, epilepsy, and other diseases of the nervous system, are attributable to the use of tobacco.\" Dr. Waterhouse says that \"thé- oil of this plant is one of the strong- est vegetable poisons, insomuch that we know of no animal that can resist its mortal effects.\"",
         "SIOKERS i HEWARE 1 'Well, Lut we haie knwun many people cured of di.cases by it.\" Thiat may L. . n lai e kntn n many tured by alcohol, opium, mercury, auàd e.n by prusi aç,id itsclf, which is the dcadliest, of poisons, but tiese poisnus nceer ture, without injuring the system at the sanie time. You ray chew tobac to kill the worms, but yuu ivill' kill your stunmaçh as well. You may smoke to cure ith touth-ache or the head-athe ; but the poison will take up its quiet dwJlling in your system, and shorten your days.- Besides, don't Le wa\u003es taking medicine; and be so kind as to take it in yuur own roums, along with your castor oil and salts; and then w. shall not Le pulsuned by your sm-ky air. A celebrated pliy sulogist said that tobacco ivas bad, een in small quantities, for al1 perons in health; and that it was bad as a medicine, -eept in asthia, and that then it should be used only when the fit was coming on. Now, lads ! you that arc just wavering whether to begiv or not, don'/ begin / Keep your nose and mouth clean, and never touch the filthy weed. Never fear being laughed at. If you want to be manly, show that you can stand a scòff or a jeer; improve your minds at school and by reading; breathe the fresh country air; lead useful lives; kcep yourselvessober and chaste; and then you will be noble men, and happy ones too. And you, teetotalers ! Are any of you inconsistent enough to smoke ? There is scarcely a reason you give for smoking but the drinkers urge the very sane, sometimes with greater force, for drinking. A great authority in these matters has said that 4Moderate smoking is more physically injurious than moderate drinking.\" The only difference between tobacco and alcohol is, that the one deadens, while the other inflames the passions. Your pipes are a terrible stumbling-block in the way of teetotal- isi, and injure your health and character more than you are aware. Respectable smokers ! you that enjoy your fine-flavoured cigar in your own gardens! Think of these lads and truly vulgar people whose practices you are encouraging. Give it up for their sakes. Christian professors ! you know that you cannot justify smok- ing by a single principle of the Gospel. It is one of the lusts of",
         "PULIC IIEALTII MAGA2fNE. the flesh which you must crucify, if you would do your Master's will. Snokers .' .Sfers 1 Clhewers I Opium-atr I Throw your weeds away. Break the pipes. Ilurn the boxes. Kilt the inserts on vour plants, and not yourselves, with the toliacco. Give it up altoether and at once. It is the only safe cure. It may be hard uork, but others have done it, so why shîould not you ? And when you ha% e given it up, g/yaur neah- ar.; 4, do he sam,,e.-P. P. C., Oberlin Press, Varrinton. -0o BURIAL ALIVE. In a long letter addressed to the Times, Mr. Se inour Iladn deals with the various objections wiiich haie been urg.d against his proposals for a reform in the mode of burial. The horrur of hurial alive, by mistake, is one of these, and tlierefore, in order to demonstrate its groundlessness, lie addrc.ed a question upon this point to Sir James Paget and five other leading hospital surgeons and physicians, asking whether it has em or- curred to them, in their extensive experience, to sec a case of so-calied suspended animation or trance, which, in their opinion, could be mistaken for death ; and wliether thcy thouglit, taking the present state of medical knowledge into consideration, that the occurrence of such a case, or of such a mistake, could be regarded as possible. Their reply is unanimously and cmphati- cally to the efrect that no case of the kind lias ever happened within the experience of any one of them; and they further ex- press a strong belief that the dread of such a contingency is wilhout ground, in this country, while they state that the signs of death are as certain after a few hours' suspension of the %ital functions as they can be after many days.-Publü Health, Lon- don.",
         "CAPTAIN 1oVTo14. CAPTAIN BOYTON. Captain Boytonimay bc fairly congratuilatd on the successful accomplishment of a feat which demonstrates the efficiency of bis swinming apparatus, and the courage, self-reliance, and powers of endurance of its inventor. We arc indebted ta the courtesy of Dr. Diver, of Southsca, for the following interesting particulatrs. Dr. Diver saw Captain Boyton on the inorning of the day lie left Boulogne for Cape Grisnez, at the 1-lotel Christol. le was in perfect icalth and spirits, and stated that he had been taking grent carc of himself, and living principally upon under- donc beef-steaks and eggs. There was a contrast between the state of his health on this occasion and that on which lie pre- viously attempted to cross the Channel. Ile was received on board the \" Prince Ernest\" at about 2.30 on Saturday morning, wihen lie had b=en about 23.1 hours in the water. He was per. spiring very freely, conplained of a general stiffness, with pains in his wrists, from paddling. 1e stated that for the first few hours lie suffered terribly, and that he even wished his dress might burst and lie go down. Hle was very sleepy at this time, and actually slept in the water and dreamt, waking with a start, and finding himinself paddling. Sane very strong green tea was given ta him, n hich dispelled all his unpleasant symptoms. The last two or three miles, h'e said, secned never-ending ta him, and lie would not again go through what he had experienced for any moncy. He was undressed, sponged and rubbed down, and. placed in hot blankets. His face was very red, and in same places the skin had cracked from exposure ta the sun and sait water. He ivas fatigued, but not very much, considerin,; what lie lad gone through. His face was greased,.and cold wez rags afterwards applied ta it, which relieved him ncii. His pul::e was 71, and his temperature 99°. The action of his heart was feeble, but this is natural in him, and was observed on the former occasion. He was full of spirits at his success. In about an hour he walked ta the Pavilion Hotel, looking, with the excep- tion of his face, very little the wrse for his interesting trip.- The Lancet.",
         "PUBLIC HEALTII MAGA?'NE. H1otsS. OnAL.-A \u0026urrespondent says that, according to the instruLtiuns of the City Clcrk, of whic..h due notice nias givein in the Lity paperb, lie placd a barrel uf house uffal in a cunenient puition for the sea% tnging (arts to take away, but to his aston- ishmt.nt it nas not toucied, but had ei identl\u003e been disturbed and turned up with a shov el. H1. Nient to enquire about it, and was tuld that lie n st hai e had matter in the barrel other than lan ful offal. He says lie had coal ashes mixed with the garbage. The triumphant sanitary poliLeman said, \" There, I told 3 ou ) ou must haie had tuff in your barrel that should not haie been there.\" So he writes us to define to hin what eonstitutes house offal. On looking at the appendix uf the munieipal by-laws for 1870, page 187, sec. 12, we find that \" House offal shall include any dead animal, dirt, sawdust, manure, soot, ashes, cinders, shaxings, hair shreds, oyster, clam or lobster shellb, and all gar- bage, i hether consisting of animal or % egetable matter, and other offen5i e substances.\" Would tht. IIçalth Committee pklase in- forn us by what rule thie seavengers are guided in their Lhoice of what shall be takenor not taken ? o--- To the Editor Public Health Magazine: Dfa. SIR,-Is there no influence which the new lealth Assoeiation tan bring to bear on the Catholie pulpits thiroughiout the country to induce them to draw th,- earnest attention of the habitans tu the neeessity of isolation in small-pox cases ? Would not a committee calling upon our energetic Co-adjutor-Bishop Fabre, have some good effct ? Rcsiding as I do during the summer in, a French-CanadXi parish, I am painfully aware of the utter ignoiance prevailing with regard to small-pox. In fact I sometimes think the old women of tl-e parish rathzr enjoy a good small-pox epidemic. Yo\"rs truly, \"ROMAN CATIHOLIC.\""
      ],
      "published" : [
         "[Montréal? : s.n., 1875]"
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      "identifier" : [
         "8_05170_2"
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      "type" : "document",
      "title" : [
         "Public health magazine [Vol. 1, no. 2 (Aug 1875)]"
      ]
   },
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   "doc" : {
      "lang" : [
         "eng"
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      "note" : [
         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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         "text"
      ],
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      "key" : "oocihm.8_05173_34",
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         "Library and Archives Canada."
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      "label" : "[Vol. 3, no. 10 (Dec. 1878)]",
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      "pkey" : "oocihm.8_05173",
      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 3, no. 10 (Dec. 1878)]"
      ],
      "published" : [
         "[Toronto? : s.n., 1878]"
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      "identifier" : [
         "8_05173_34"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur [J Covers damaged I Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments I Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w W Coloured pages / Pages de couleur Pages damaged I Pages endommagées D Pages restored and/or laminated I Pages restaurées et/ou pelliculées wv Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough I Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination. w",
         "THE SANITARY JOURNAL. DEVOTED TO PUBLIC TTEALTH, VOL. III.] DECEMBER, 1878. [No. io. SUGGESTIONS FOR PREVENTING THE SPREADING OF INFECTIOUS AND CONTAGIOUS DISEASES. BY ALFRED CARPENdTER, M.D., C.S.S:, ETC. (From the Sanitary Record, concluded.) If isolatiotn can be accomplished without removal it sbould be in a room situated at the top of the house, the staircase to which should only be used by those tending the sick person. There should be access to a water-closet, if such things are in use, which should only be resorted to by the nurses and for the disposal of the patient's excreta. The windows in the room should be open top and bottom ; there should be an unclosed fire-place in it, so that currents of air may circulate freely, and a proper degree of warmth be obtainable at all times. A free ventilation provides a certain means for diminishing dangers ; dilution of air brings bxidisation of the floating particles or infectious matter, and dwarfs their growth, for they cannot increase and multiply without material to assimilgte to themselves. Albuminoid ammona is their pabulum. If water containing albuminoid ammonia and other ammoniacal compounds is passed through a few feet of earth, the noisome elements which would, under some circumstances, spread disease are changed into nitrates and nitrites, and become perfectly harm- less. They are oxidised by contact with the oxygen contained in the earth, and their noisomeness is destroyed. A similar resuit arises with germs of mischief when circulating in the air; the ammonia is removed, ozone acts upon the albumen, and dilution, if carried out to a sufficient extent, is destruction. Ail curtains, carpets, and unnecessary articles of furniture should be removed fromi the room which is occupied by the patient, and no direct intercourse be kept up between the inmates and the test of the bouse. A sheet should be hung up outside the door of the room, and, if possible, a second sheet a few feet frçm the first, so that when one is moved'aside the other should be closed. These'sheets should be kept quite damp by having them frequently",
         "THE SANITARY JOURNAL. sprinkled with water containing carbolic acid or chloride of lime in solution. A gallon of water, in which a pound .of lime is diffused, or a quarter of a pint of carbolic acid, will, by evaporation from the sheet, produce a condition of atmosphere which will help to dwarf any particles of diseased matter. Such things may accidenfally escâpe from the room by the door into the passages leáding to the rest of the house. The floor of the room which is occupied by the patient should be carefully examined, and be freely beeswaxed, so that all crevices between the boards may be closed; it should then be frequently sprlnkled with some of the solution, and cloths dipped in the same hung about the room. The bed and body linen which have been used by the patients should not be taken from the room until they have been dipped into a solution ot carbolic acid of similar strength to that just recommended. They should remain in the water at least an hour, and afterwards should be boiled in abundance of water. At the same time, it is better not to preserve any article (especially in bad cases) which is of slight consequence ; pieces of rags should be used instead of pocket-handkcrchiefs j old rags and woollen cloths retain the infection very readily, and it is better to burn up such things after use than to preserve them. In support of this view I may mention the following circumstances, the facts of which were com- municated to me by the medical man in attendance. The island of Mull is on the west coast of Scotland, very bleak, and with an ex- ceedingly scattered population. Small-pox made .its appearance at some shanties or mud huts at a long distance from any other place, but when it was also present upon- the mainland. The huts were deserted by the inhabitants, they became dilapidated, the roofs fell in, and the ruined walls were exposed to the elements for some time. The property changed hands, and three years afterwards the new owner sent a gang of men to clear away the ruins for the purpose of building some decent cottages at that place. The men employed on the work fell ill with small-pox. The same medical man being called from Oban to attend them, recollected the former cases at the same spot, and he came to the conclusion that some old rags which had been turned out from the ruins had contained the foci of disease, and had infected the new comers. Dr. McGillivray, the medical attendant on the cases, informed me that he was not aware of any other cases of small-pox at that time in that part of Scotland. These facts teach us several important lessons. Persons in attendance on the sick should riot wear woollen garments or any material which cannot be washed or easily exposed to a degree of heat sufficient for the destruction of adhering particlls of mischief. Cotton dresses should always be worn in the sick room by the attendants. They should also wash their hands iItimediately after attending upon a sick ,person. It is also better for them to use carbolic soap instead of ordinary soap. For similar reasons it is of thè greatest importance that the sick room, should nôt be frequehted by any persons who are not iamediate attendance upon the 346",
         "PREVENTION OF SPREAD OF INFECTIOUS DISEASES. patient. The clothing of visitors is liable to carry away infection, and all should be rigorously excluded except for very special reasons. If obliged to enter they should prevent their clothes coming in con- tact with the patient or the bed upon which he is resting, and before entering another house it is always prudent to walk some distance in the open air. In a majority of cases of infectious disease the greatest danger is derived from the excreta. Everything which passes from the sick person should be put into vessels containing a solution of sulphate of iron-green copperas it is commonly called. It acts most de- cidedly and most certainly in deodorising and disinfecting organic ratter. A pound of coperas, which costs a few pence, should be dissolved in a gallon of water, and all discharges which come from the patient and ail washings should be at once mixed with some of the solution. Some of it should be put into vessels into which they are received, and some more cast over them before they are thrown down the water-cçloset, and every closet, or sink, or privy, into which discharges of any kind are thrown, should have a quantity of the copperas solution poured down it daily so long as it is used by the patient or the nurses. It is highly important that this rule be speciaUy adhered to. It is sometim.es the custom for the excreta to be buried in the garden; this is not always sufficient unless much care is used, for fowls and other birds may disturb it, or rats or other vermin carry it away before its danger is destroyed. It is far safer to act upon it at once with a solution of sulphate of iron, and then no danger can arise. These are all matters which are fairly within your province to enquire about, and to give instruction to those whose duty it is totake care of the sick. There is also another point of some importance to nurses and the friends of a sick person. Al cups, glaises, spoons, and otbeç articles used by the patient should be washed in a solution of caf- bolic acid'; no food or drink which has been tasted by the sick person or that has been kept in the sick room should ever be taken by any one else. It is unwise to keep food there at all, except such as is required for immediate use. This applies especially to milk. There is no kind of food more useful than milk. There is no kind which absorbs infectious matters more certainly. If vessels containing milk are kept in a room in which there is a scarlet or typhoid fever patient, or if the gases from a sewer into which the excreta o( such patients have been discharged without having been disinfected find their way into a dairy, the disease in question wiU be distributed by the milk, and a severe epidenic may be produced, I have known several instances of outbreak of disease which could only be fairly explained on this theory. It is al but impossible to prove it by absolute experiment, because the cause is genera4y re- moved during thq stage of incubation, and when the diseae appears has ceased to be in operation. Nurses and all attendants upon persons who are sick, sbould bc careful to wash their hands before taking food themseves.. Thq 347",
         "THE SANITARY JOURNAL. Mosaic custom on this point should be rigidly enforced. This is especially the case in typhoid fever, cholera, and scarlatina. The patient having been removed to the infectious wards, or if the case has been treated at home and he has recovered from his illness, you will have sometimes to advise what is to be done to the patient himself as well as to the room he has occupied. His own disinfectionàis not exactly within your province, but I will tell you the advice I generally give when I speak upon the individual cases. After the patient has been removed, ail the articles of bedding, and such clothing as will not bear washing should be hung about the room; you should then close up the fireplace, windows, and doors, so that ail external air may be excluded; then take an ordinary spirit lamp with a cotton wick, or still better, one of the lamps which Mr. Keats has specially designed for the purpose, put into it about four ounces of sulphide of carbon, place it on a stone slab in the centre of the room, light the wick, shut the door carefully as you leave the room. The air of the room becomes pervaded with suphurous acid, and ail organic matter in the room is completely disinfected by it. Failing the lamp and the sulphide of carbon, you may obtain the same result by breaking up a quarter of a pound of sulphur into small pieces, put them into an iron dish, sling it over a pail of water in the middle of the room, and set the sulphur on fire by putting some live coals upon it. The room must then be completely closed up, and allowed to remain so for twenty- four hours. If you -use the sulphide of carbon you must be careful, as it is highly inflammable; but it is very cleanly, and quite easily applied. The room may be opened the day after, and the doors and windows thrown open, and a good fire made. The ceiling should be lime-whited, the paper scraped off the walls and burnt, and ahl the woodwork well washed with soap and water. The floor must be scraped, the crevices between the boards cleaned out, and then well washed with solution of chloride of lime, and until these processes are completed to the satisfaction of a medical practitioner the room must not be again occupied. It is highly important that this rule should be adhered to, and ail houses which have become vacant immediately after a case of infectious disease has occurred in them must be watched by the inspector, and it is his duty to see that they are not again let by the landlord until the law has been com- plied with; and also all rooms which are let out to lodgers, and hotels or places of public resort, must be disinfected when cases of infectious disease have occurred there before they are again occupied. It is clearly your duty to put the law in force against the offender wherever you have reason to believe that it has been infringed, and you ought in every case to take care that the penalties are pressed for; much mischief has resulted from persons innocently going into danger without any warning from those whose interest it was to keep the fact of infectious disease having occurred in the place a secret from the new comers. The full penalty of 20/., to which the landlord has subjected himself, or even at times committal to prison, 348",
         "PREVENTION OF SPREAD OF INFECTIOUS DISEASES. which is at the discretion of the magistrate who hears the case, is none too severe a punishment to inflict upon those who wilfully break this law. The next point to which I may now direct your attention is the attendance of children at school. I have suggested that you should be in frequent communication with the masters and mistresses of elementary schools, so that you may know what children are absent on account of illness. You may also warn them that infectious disease exists in such-and such a house, and that children from that particular house or court should be excused attendance at school until they are certified to be safe. Many serious epidemics have had their secondary impetus from the attendance of an infected child, and disease has been by its means spread over a very considera- ble area. If the case has had a fatal termination you should visit the place as quickly as possible, and see that the body be uot removed from the room, except for burial. The body should be put into a coffin as soon as possible, with plenty of powdered charcoal on the bottom of it, and some carbolic acid powder sprinkled ,over the body. The coffin should then be at once fastened down, and buried as soon as possible. If the bed and the mattrasses upon which the death took place have been soaked by discharges from the patient, it is best to burn them without delay, with all coverlets and cloth articles of clothing which will not wash easily. Local authorities have the power of doing this and recouping the poor the value of the article destroyed. It is better that an excess of caution should be used in this direction than that any risk should be run. Many cases of puerperal or child-bed fever have been caused by a neglect of this rule. A poor person often reserves the bed or mattrass which has been out of use for her confinement ; she is more prone at that time to take an infectious disease. The virus capable of producing it remains in the bed, and soon after her confinement she succumbs to its influence. It is not necessary, however, to burn up all things which have been infected or exposed to the chance of infection. I mentioned that heat destroys all germs of disease, and every sanitary authority should have a disinfecting apparatus at command, in which articles of clothing, sheets, articles of furniture, books, carpets, and other things capable of bearing a heat of 3oo degrees, could be baked. There is one which has been arranged by Fraser Brothers, which is very useful for the purpose. I suppose the Northampton authorities possess such an one; if they do not, I should strongly urge them to have one put up for public use. Much good results from the use of such an apparatus, and much valuable property may be preserved from destruction. It is necessary that the articles should remain in it long enough to have the whole of their structure raised to a tem- perature of 3oo degees, otherwise some particles of mischief may escape destruction. Feather beds and such like especially require to be kept in the apparatus for a long time. It is best to place a 349",
         "THE SANITARY JOURNAL. thermometer in the middle of such articles, and not have them removed until it is shown that the proper temperature has been reached. I will now say a few words regarding the disinfection of individuals. Those patients who give off scales of excreta from the skin, such as small-pox and scarlet fever, should have the body smeared over with some fresh pure oil or lard, so that the particles may be arrested from floating away in the air. Warm baths should be used every day during the progress of recovery, and every means taken to retain the desquamating skin within the sheets, and when the latter are romoved they should be at once plunged into the solution of carbolic acid or chloride of lime formerly mentioned. When the patient is sufficiently recovered to bear it, he should be bathed in water con- taining a quantity of Condy't Fiuid, an ounce to a gallon. The hair should be cut short, the head freely washed with the saine solution, the nails of both hands and feet cut, and Condy's solution or carbolic soap rubbed in beneath them. If the whole of the skin has exfoliated, as in scarlet fever, or if the scales have all been removed if the case is one of small-pox, there will be no danger whatever after this treatment in the patient mixing with his fellows. It is the custom to speak of a quarintine of a month after recovery from infectious disease before a patient may mix with other people. Tnis quarantine is highly injurious to some people, and it is not necessary if the rules I have laid down are carefully followed in the diseases I have mentioned, and if care is taken in regard to the excreta, so that they are disinfected, is any danger likely to arise in other cases. I need scarcely urge upon you ihe necessity of re-vaccination in outbreaks of small-pox; a house to house inspection is absolutely required whenever a fresh case of small-pox appears in a new dis- trict, and all those adults who have not been efficiently re-vaccinated should be urged to protect themselves in that way. There is one fact with which you ought to be acquainted, which is that no person who has been engaged as a nurse at the Small-pox Hospital is allowed to enter upon her duties until she has been re-vacinated, and no nurse has fallen ill of small-pox in that establishment during the last forty years. Time warns me that I must conclude. I thank you for the patient hearing you have given me, and if my observations are of service in preventing the spread of disease, I shall be amply rewarded. PoIsoNoUs WALL-PAPER.-In a lecture on 'Poisonous Wall- Paper,' delivered a short time since before the Manchester Chemists and Druggists' Association, by Mr. Siebold, the lecturer stated that out of sixty or seventy papers of various colors-blue, red, brown, pink, etc.-analyzed by him, ten only were harmless, the rest con- taining arsenic. The result, therefore, of Mr. Siebold's investigatioxs should have the effect of rendering the heads of families suspicious of some of the most innocent looking colors. 350",
         "ON SUGAR ADULTERATION. ON SUGAR ADULTERATION. As this subject is being discussed somewhat at the present time, we give the following article upon it, from the pen of Prof. Henry Morton, Ph.D., in the Plumber and Sanitary Engineer. My attention has recently been directed to a series of annonymous articles appearing fron time to time in various daily papers, which, while differing in many respects, have certain marked characteristics in common. . . . While no one could feel more interest than I do in the suppression of fraud and adulteration in the refining of sugars or in any other business, I am for that very reason extremely disgusted at seeing the cause of true reform disgraced and hindered by such proceedings as these, which can by no possibility lead to any good end when so con- ducted, but simply throw discredit on the honest and judicious efforts which are being made by men of position and character in the same direction. With this view of the subject I consider it my duty to expose the false statements and suggestions in reference to scientific facts which I find in these articles, and thus do what I can towards the prev'en- tion of an unfounded public opinion, which if once established may be very mischieviously utilized by designing men in various ways. In the first place, then, I find repeated statements or suggestions that glucose is a very unwholesome substance, and has no business to be found in sugar unless it has been artificially prepared from starch, corn or the like, and added to the sugar by the refiner. To make clear what are the facts in this connection, I will explain briefly what glucose is and what are its sources: At the outset 1 should say that glucose can exist in two states, differing fron each other in sweetness and in the power of rotating the plane of a ray of polarized light. That rotating the plane in the direction in which the clock hands move is called dextro-glucose or dextrose, that rotating the other way loevo-glucose or lævulose. Now it is believed that all sugar in the sugar-cane is first formed as glucose, (probably as a mixture of both kinds) and changes into sugar as the cane ripens. All cane juice at all events contains some of it, and if the juice is allowed to stand untreated, the sugar rapidly reverts to the condition of glucose, and with all the care and all the appliances which modern science and art place at our disposal a con- siderable conversion of sugar into glucose is sure to occur during manufacture. When this conversion of sugar into glucose, or as it is technically called \" inversion of sugar \" occurs naturally, as above, the products consists of dextrose and lævulose in such proportions that its influ- ence on polarized light is nothing, or the two opposite rotations neutralize each other, but if this inversion is effected, as it may easily be in a very short time by boiling a sugar solution with a minute quantity of hydrochloric or other strong acid, then the lovulose so far predoninates in its optical effect as to give a resulting left-lia id 351",
         "352 THE SANITARY JOURNAL. rotation equal to about one-third of the right-hand rotation due to the pure sugar originally. Of the two kinds of glucose the lœvulose is sweeter and does not crystalize ; the dextrose is less sweet but may be orystalized with difficulty. Hence as this inverted sugar would render the sugar moist, if left in it must be removed from hard sugars, and it will moreover dissolve the coloring matters and thus acquire a dark color. In older processes of sugar making or refining, a light color was chiefly obtained by crystallizing, and draining or washing away the coloring matters and glucose together; hence a light colored sugar was of necessity free from glucose. Recently however what is known as the \"Scotch \" method has been largely adopted. In this meth\u003cd by a free use of bone black the coloring matter has been largely re- moved from the glucose, and then the crystallization and drying so conducted as to leave this in the sugar. By this means a product is obtained of a light color and yet con- taining all the glucose that in former times would have been found in a darker sugar. As this sugar is sold at a much lower price than it would cost to make the old sort, it seems to me that the thanks of the consumer are due to the manufacturer for what he has done in this direction, unless it can be shown in some way this glucose is in- jurious. Let us see, then, what are the facts on which an opinion can be based in this respect. ist. Glucose, i. e., a mixture of dextrose and lævulose constitutes the sugar of all sorts of fruits. 2nd. The first step in the digestion of sugar, is its conversion into glucose in the stomach. If, there- fore, glucose will hurt us, we must never eat any sugar. 3rd. Starch is converted into glucose with great rapidity by the action of the saliva. If we chew a little bread for a minute, spit it out and test it for glucose, we will find this body present in appreciable quantity, even in this short time. In fact, the first step in the digestion of starch, as well as of sugar, is its conversion into· glucose. Starch being our principal vegetable food, it is therefore evident that we must give up all vegetable diet to escape from this glucose if it is in- jurious. These facts above stated will be found in every work on Phy- siology, but for ready reference we would refer here to Johnston 's Encyclopedia, 1878, article Digestion, by Dr. C. W. Greene, and to Foster's Physiology, Macmillan and Co., 1878, page 188. Having thus disposed of the nonsense which has been written about the injurious or non-nutritious properties of Glucose, I will next turn to the question of Muriatic Acid. Muriatic Acid, if present in sugar, will rapidly modify it, turning it into glucose and impairing its color, so that any manufacturtr who put it in would very soon find out his mistake by having his sugar returned to him, and he would either reform his methods or be driven out of business in short order. But in the meantime, would the cominunity be poisoned or have \"holes eaten in their stomach like copper boilers ? \"",
         "ON SUGAR ADULTERATION. If there was acid enough in the sugar to set one's \" teeth on edge,\" anyone who was foolish enough to eat such stuff, would, of course, injure his teeth and might not find the sugar agree with him any more than too much vinegar or too many pickles. But he would not be poisoned. Muriatie acid is in no proper sense a poison, any more than is vinegar or acetic acid. Strong acetic acid if swallowed in quantity, would be fatal; but if diluted, as it is in vinegar, it is harmless. Just the sane is true of muri- atic acid. The best proof of this is that muriatic acid constitute an essential part of the gastric juice. Now, be it understood, that I would not for a moment defend the use of muriatic acid in sugars. It would be bad policy on the part of the manufacturers, and would be making an article liable to deteriorate. But while this is so. I would also deprecate the ignorant and malicious attempt to frighten the public at large with the false assertion that they may be poisoned before they know it by muriatic acid in their sugar. This is at best a foolish bugbear, and if asserted by anyone who has any pretensions to scientific knowledge, is very disgraceful. By all means expose the names of those manufacturers who put muriatic acid in their sugars, if there are any who so do ; but leave out the nonsense about eating holes in the stomach like copper boilers. In this respect it can only be dangerous to those whose brassy ex- terior argues a copper substructure. As regards chloride or muriate of tin :-This also should not be tolerated in sugars in any appreciable amount, and as it might by accident, if used at al], be somctimes left in dangerous quantities, it would be best to forbid its use, as the use of lead for a like reason has been forbidden in France. But here also no needless fright should be stimulated. If a sample of sugar contains so little tin that a chemist can only find a trace, and cannot get a weighable quantity from ten pounds of sugar, no one need fear lest he should acquire \" a tin lining in his stomach \" by eating such sugar. If sugars are found containing dangerous amounts of tin, let their manufacturers be expo:ed byall means; but letthis bedonein asensible way, and not by setting a lot of ignorant newspaper reporters scribbling about what they do not understand, and making dark and mysterious suggestions which have all the characteristics of black-mail. Many years ago an enterprising firm went into the manufacture f water pipe lined with tin, and secured the services of a chemist, not unknown to a certain sort of fame, to persuade the public that they were being poisoned by the lead pipe then in use. From what was then said and written, a ýredulous person would have been con- vinced that the entire population of New York had been poiFoned long ago,.and ought to have taken up its abode in Greenwood years before. Lead pipes, h0wever, are still used, and New York still seems fairly populous. The poisonous properties of tin were not then ventilated, but its 353",
         "THE SANITARY JOURNAL. turn has come now, and we should not be surprised to see the tin- pan and tin-pail and tin-dipper and tin-man held up by the horrified reporters to the indignatiop of a deluded public, as soon as this sugar business has been exhausted of its popular interest. DR. WM. FARR ON TRUE TEMPERANCE. We (Medical Times and Gazette) lately noticed the Thirty-ninth Annual Report of the Registrar-General, and intimated that there was in it a letter by Dr. Wm. Farr on the causes of death. This treats effectively of the use and abuse of alcoholic liquors. This letter has its full share of Dr. Farr's characteristics as a writer: the lavour of classical erudition, and the apt and ready quotations which remind us of the days when physicians could truly be called learned ; the subtlety and acuteness in exposing errors, only equalled by the gracefulness and neatness which leave no rankling wound, and the sterling vein of good sense fortified by long experience in the art of medicine, and in dealing with the theories which from tine to time enlighten or obscure it. To begin with : Dr. Farr demolishes a fallacy which bas obtained extensive circulation of late; it is that the working classes are be- coming more and more intemperate, and that high wages are squandered in drink. 'In the three years (1871-73) of high wages in the manufacturing districts, the proportion of deaths by alcoholism is low. The deaths by drink rose, on the other hand, in the three years (1874-76) of depression, probably because some sought con- solation in drink, because the hours formerly spent in the workshop were spent in the public-house, or because the previous habits then began to bear fatal fruit. The fact remains, independently of any theory, that in three years of hard work and high wages-three years of prosperity-2230 people died of drink ; while in the three years or idleness and reduced wages-three years of adversity-33 16 died of the same causes, delirum tremens and other results of intemper- ance. This is contrary to a current opinion; and it may be worth while to point out that in the three years of prosperity the annual consumption of spirits in the United Kingdom was less than in the three years of adversity. It was 36,ooo,ooo gallons a year in pros- perity, 42,000,000 gallons a year in adversity. Dr. Farr easily demolishes that sensational pessimism that seems \u003eto delight in exaggerating the total quantity of drunkenness amongst us. Drunkenness, he says, unlike gluttony is a 'public scandal,' and therefore is a very unfair test of the general morality of a popu- lation. Worse things are done in secret, and never talked about. L 1876, in the metropolitan police district, 32,328 charges of drunk- enness were made. Taking it that 32,328 persons were disorderly drunk during the year, then 4,179,379 were sober. In the month of June, 1877, the number apprehended as drunk and disorderly daily was 97, ofwhom 8o were convicted. 'Thus such drunkards in a given",
         "ON TRUE TEMPERANCE. day were to the rest of the people of the metropolis as about one to\u0026 43,419. In studying the question on both sides, it is plain that an immense majority of people are sober.\" Evidence derived from prisons, police courts, and lunatic asylums is often taken as proof of general intemperance ; but from such sources we learn the condition of but a morbid fraction of the population. Dr. Farr does not hesitate to express his belief that the present customary mixed diet, including wine and beer, in due proportion with vegetable and animal food, 'while it yields the maximum energy of life, is conducive to its duration.' But as there are men of weak heads, incapable of self-control, the various temperance societies offer them judiciously the pledge of total abstinence. But whilst denouncing excess of any sort, he denies the ill effects of its moèlerate use, and challenges the teetotalers to show the mortality of large bodies of total abstainers. Repudiating the insane dictum that alcohol is always and everywhere a poison, he claims for it a medicinal effect in many maladies. It is a capital remedy in fevers- reduces burning heat and calms delirium. May it not, he says, arrest the action and prevent the invasion of soie zymotic diseases ? But, above all, it is the moral effects that deserve eulogy. The true effects of wine are not learned fron chemistry, but from the senses, of which the poets of all ages, and philosophers, are natural expositors. ' Material stimulants play their part in the emotions of the loftiest as well as of the lowest orders of mind. Whilst, therefore, conceding the prudence of total abstinence in some cases, the temperate use is- the more excellent way-with this further recommendation : that its pr;nciples may be extended to dishes as well as to glasses, and to luxuries of every sort. Excess in fo)d is not so noisy but quite as injurious, and is a much more degrading vice than excess in drink.' The self-control furnished by religious training, and the mental stimulation engendered by education, are the real remedies for in- temperance, while teetotalism is a mere patch. We should like to see Dr. Farr's little gem of a paper printed separately and widely circulated among the well-meaning clergymen and women who are now spending their strengh in propagating teetotalism. DIET AND LONGEITV.-A thoughtful person in Medina, O., has practised with increasingly beneficial results the following interesting. and economical experiment in dieting: For breakfast, fine graham gems with butter; no inconvenience followed-cost, three cents. Dinner, one-fourth pound rice, one ounce each of sugar and butter ; a gdod meal-cost, five cents. Supper, one-fourth pound of corn meal, one-half pint milk-cost, three cents. Water q. s. Total day's cost, eleven cents. For a change, he suggests one gill of beans, which, by the quart, cost less than half a cent. He clairms to work hard, eats nothing between meals, is renewing his youthfulness, and only dreads the lonesomeness to be experienced by living to 'a very great age.",
         "THE SANITARY JOURNAL. HYGIENE AND CONSUMPTION. Dr. Holland writes the following on this subject in Scribner's Magazine :- At the tables of how many farmers and mechanics, we wonder, is the buckwheat breakfast gone into disgrace ? We readily recall the time when uncounted multitudes of families broke their fast of twelve hours and faced the work of a blustering winter day with nothing but greasy buckwheat cakes and molasses! They might almost as well have eaten sawdust; and what had they for dinner ? Boiled salt-pork and potatoes, and for supper boiled salt- pork and potatoes again-cold, and made palatable with vinegar ! Ah, we forgot the pie-the everlasting pie, with its sugary centre and its leathery crust-the one titillation of the palate that made life tolerable. Good bread and butter or milk, abundant fruit, beef and mutton, nutritious puddings-all these things have been within the reach of the people of New England, for they have always been the thriftiest people in the world ; but they have cost some- thing, and they have not really been deemed necessary. The people have not realized that what they regarded as luxuries were necessaries, and that the food upon which they have depended for protection from the climate and for the repair of the wastes of labor- has been altogether inadequate, and has left them with impoverished blood and tuberculous lungs. After taking into account all the influence of heredity, which is made much of in treating of the causes of phthisis, insufficient nourishment is responsible alike, in most instances, for the deposit of tubercle and the inflammation to which it naturally gives rise. There are many men who by a change of living render the tubercles already deposited in their lungs harmless. Vitality becomes so high in its power that it dominates these evil influences, and they live out a fairly long life with enemies in their lungs that are rendered power- less by the strength of the fluid that fights them. We have seen consumption cured again and again by the simple process of building up the forces of vitality through passive exercise in the open air, and the supply of an abundance of nutritious food; and we have no doubt that it can be prevented in most instances by the same means. No human body can long endure the drqught made upon it by a cold climate and by constant labour, unless it is well fed, well clothed, and well housed. Somewhere deterioratiori will show itself, and in New England-nay, all over the kingdom of Great Britain it is the same, where the people are worse fed than here-the poverty of blood shows itself in the deposit of tuberculous matter in .the lungs. There should be by this time some improvement in New England, in consequence of the increased intelligence of the people; but so long as so many of them are running westward, and their places are taken by an ignorant foreign population, it is not likely that the statistics will show much improvement for a great many",
         "CAUSES OF DIPHTHERIA. years to come. If our physicians could only be paid for preventing disease, and could be permitted to prescribe for each family its way of living, there would be but little difficulty in routing from its strong- hold that most fatal and persistent enemy of human life, which we call consumption. CAUSES OF DIPHTHERIA. Dr. Van Wagener of New-ark, N.J., has analyzed 112 cases of diphtheria, and writes as follows in the New York Mdical Yournal: There can be little doubt that diphtheria may faily be classed among the ' filth diseases.' Whether its poison is produced de novo, in de- composing.masses of vegetable and animal tissue, or whether our sewers and cesspools are simply the hot-beds in which the disease- bearing spores are rapidly propagated, is a very nice question, and one which cases occurring in a large city cannot help us to solve. For, though many of these cases must have been exposed to cess- pool gas, it is fair to suppose that the specific poisons of all zymotic diseases are constantly present in our air. However, that ' filth ' in its various forms is an important element in the development of this disease is proved in at least four particular instances by these cases. The first occurred at the house of an architect living in a healthy and cleanly portion of the city, and who prided himself on having ventila- tion, sewerage, and water supply as perfect as possible. Several loads of manure were dumped in the garden, about thirty-five feet from the well, with the intention of spreading them over the grounds before snow fell; but, as the mass became frozen, it was allowed to remain. As the snow melted in the spring, it carried a rich infusion of this filth into his well. So gradually had the water became tainted that the family still used it, though they noticed a peculiar taste, and considerable deposit on standing. March 1 7th, the first child had a mild diphtheria. March 26th, nine days later, the second sickened. The cesspools, well, and privy were pronounced all right at this time. April 7th, twelve days later, a third was attacked. April ioth, three days later, the fourth. April 12th, two days later, a fifth-the wife-had malignant diphtheria. I exam- ined the garden myself then, and found lines which the ooze from this manure-pile had taken in its course to the well. The water was found to. be so foul that it appealed to the sense of smell, as well as that of taste. It deposited a considerable light-brown sediment ou standing, which, under the microscope, proved to be manure d\u0026ns, and great rpases of confervoid vegetation. Here, undoubtedly, was the cause of all the trouble. Aqueduct water was substituted, and fortunately all recovered. One of the children also had scarlatina about this time, Laving been exposed to that disease. Such water undoubtedly prepares the system for a ready reception of any zymotic poison, and vastly increases the tendency to any morbid action. In the other three or the four instances referred to, filth was still more evidently the cause of the disease. 357",
         "THE SANITARY JOURNAL. THE PRESERVATION OF THE TEETH. Good, well preserved natural teeth are indispensible to both health and good looks, though they are liable to be sadly neglected by many. Dr. J. W. Clowes, of New York, one of the oldest practitioners of dentistry, is accustomed, on dismissing a patient, after putting the teeth in good order, to present him with a copy of a neatly printed little tract, full of valuable hints, as follows : When the teeth of a patient have been under professional treat- ment, to the extent of a thorough overhauling or placing in 'order, he is advised as follows, for his personal observance and benefit. Saving a set of teeth is one of the most positive and undoubted processes in the world, providing the dentist does his work well and the patient does likewise. This statement is made in all candor, that the patient may comprehend his position ; for, if he would retain his teeth, he must \" make an effort \"-he must indeed be a co-worker. When both the dentist and patient are faithful, there can be no result but success. Therefore, O reader! peruse, ponder, and practise these DIRECTIONs.-In the morning, before breakfast, always brush your teeth-- first with water only, then with powder. Powder should be used at least once a day. Without powder teeth cannot be kept c*an. Using a brush with tooth soap, just before retiring at night, is a commendable practice. To brush effectually, place the upper and lower rows of teeth parallel to each other, the points of the fronts touching; then use your brush upand down the teeth between thegums being not unmindful or fearful to brush as well the gums as the teeth -thereby toughening the one and cleansing the other. Your back ':eeth need more brushing than your front ones. Wisdom in this respect will be displayed, should you show a partial care for the back and outsides of the rearmost teeth, above and below. After each and every meal use a dull toothpick, waxed silk floss, and rince the mouth with moderately cold water. The intention of these is simply to remove food from among the teeth. Decomposed acidified food, animal or vegetable, is the worst enemy your teeth have now to en. counter. The enemy, the combat, and the prize are before you ! Will you win or lose ? If I have learned how to place your teeth in their present condi- tion of health, I have learned also, how you may keep them so-as I, in my operations, have employed appropriate implements, so must you n yours. These implements are always on hand for those who want them. I do not obtrude them upon any one ; I merely state the fact that they are attainable. Employ other means-trust to other implements if you will-but in that case absolve me from all responsibility.",
         "GERMS IN THE BODY. GERMS IN THE BODY. One of the greatest advances of medical science in modern times, says the Health Reformer, has been the establishment of the germ theory of disease, which suppqses that many diseases, like typhoid fever, diphtheria, malarial fevers, yellow fever, etc., are produced by the reception into the system of living germs, which multiply in the blood and interfere with the life processes of the body, occasioning a vigorous effort on the part of the body to expel them,-a remedial effort, which is termed the disease. It is the belief in this theory which gives so great importance to ventilation, disinfection, and all sanitary precautions, as by these means the poisonous germs and their sources are removed. A thorough carrying out of the principles developed by this theory will accomplish more for the relief ef human suffering than all other agencies combined. Obvious as the theory seems, there are still many able physicians who oppose it very strenuously, and its advocates are called upon for evidences of its truth which cannet be refuted. To afford such evidence has required an immense amount of careful and laborious observation on the part of numerous scientific workers. One of the active of these has been Prof. J. G. Richardson, M.D., professor of hygiene and demonstrator of histology in the medical department of the University of Pennsylvania. Dr. Richardson actually de- monstrated the possibility of the presence of germs in the blood by drinking four ounces of a liquid which was calculated to contain 27, 000,000,000 germs. A short time after, he drew from his finger a drop of blood, and upon examination found it to contain multitudes of the same germs which he had taken into his stomach. A few hours later he again examined a drop of blood, and found that the germs had undergone the sanie process of development which they showed in the liquid, a portion of which he had swallowed. This seems to be as complete demonstration of the theory as could be desired. POPULAR ERRORS.-An exchange gives the following popular errors : It is a popular error to think that the more a man eats the fatter and stronger he will become. To believe that the more hours children study the faster .they learn. To conclude that, if exercise is good, the more violent the more good is done. To imagine that every hour taken from sleep is an hour gained. To act on the pre- sumption that the smallest room in the house is large enough to sleep in. To imagine that whatever remedy causes one to feel immediately better is good for ihe system, without regard to the ulterior effects.- To eat without an appetite ; or to continue after it has been satisfied, nierely to gratify the taste. To eat a hearty supper for the pleasure experienced during the brief time it is passing down the throat, at the expense of a whole night of disturbed sleep, and weary waking. in the morning.",
         "THE SANITARY JOURNAL. NEW, CHEAP, AND SELF-GENERATING DISINFECTANT. We have been applied to in reference to the following formular for disinfecting purpose. A similar one from Dr. Day has been publish- ed in some of the papers without the exact proportion of the ingre- dients. It is unquestionably a good one ; Dr. Day has made the subject a special study for many years. Dr. John Day, of Geelong, Australia, recommends for use in civil and military hospitals, and also for the purpose of destroying the poison germs of small-pox, scarlet fever, and infectious diseases, a disinfectant ingeniously composed of one part of rectified oil of turpentine, and seven parts of benzine, with the addition of five drops of ou of verbena to each ounce. Its parifying and disinfecting properties are due to the power which is possessed by each of its in- gredients of absorbing atmospheric oxygen and converting it into peroxide of hydrogen-a highly Ictive oxidizing agent, and very similar in its nature to ozone. Articles of clothing, furniture, wall- paper, carpeting, books, newspapers, letters, \u0026c., may be perfectly saturated with it without receiving the slightest injury; and when it has been once freely applied to any rough or porous surface, its ac- tion will be persistent for an almost indefinite period. This may, at any time, be readily shown by pouring a few drops of a solution of iodine of potassium over the material which has been disinfected, when the peroxide of hydrogen, which is being continually gener- ated within it, will quickly liberate the iodine from its combination with the potassium and give rise to dark brown stains. It may be applied with a brush or a sponge, or, if more convenient,as is the case with certain articles, such as books, newspapers, and letters, it may be simply poured over them until they are well soaked; they may then be allowed to dry, either in a warm room or in the open air. LIFE HISTORY OF A SEPTIC ORGANISM. -A paper was read upon this subject before the Royal Society by the Rev. W. H. Dal- linger, F.R.M.S., (Pacfic Med. \u0026 Surg. 7ournal) in which were decribed the experiments made to determine its thermal death-point The conclusion as to the latter agrees with former observations in showing that germs resist heat more than adult forms. The adults of the organism observed (an infusorian found in the early stage of a bole), were destroyed at a temperature of 142° F., while the spores or germs resisted a heat of 22o' F. The experiments of Messrs. Dallinger \u0026 Drysdale have shown that boiling an infusion does not destroy vital germs, so that the theory of Abiogenesis is deprived of aid from any of the elaborate experiments heretofore made with boiled infusions. The flagellate infusorian described undergoes frequent self- division or fission. But in some instances it assumes an amaboid state, conjugates with another individual, and the sarcode of each blends into one which becomes sluggish in movements, elongates and discharges minute germs, which, when carefully followed were seen to develop into the adult form and size.",
         "BRIDAL TOURS. BRIDAL TOURS. The SANITARY JOURNAL has long ago protested against the absurd but fashionable bridal tour. The Hospital Gazette gives the follow- ing on the mattter: It would be an interesting thing to study the number of ills from which the present generation is suffering, imposed upon them by custom, or descended to them from their ancestors. If it is the fashion, which means the custom, to lace tightly, women will lace, even though they know that they are doing themselves temporary or even permanent injury. They repent when various uterine troubles make every day duties a task, and themselves poor, exsanguinated invalids, with 'shattered nerves.' And, by the by, 'shattered nerves' covers as great a multitude of sins as charity, only in a different way. One would think that the average female manacled by corsets, distorted by ill-dressing, with overheated head from false hair, and cramped feet and powdered face, had imposed upon her- self enough misery without adding more to it; but it seems not. A young woman, brought up in the lap of luxury, or otherwise, suffering from both her own sins and the sins of her ancestors (physical sins), gains the admiration of some man who loves her devotedly, and would risk even his life to save her miserv or pain, and marries him. At this time of life, when the sexual function has just burst fully into life, at this period, when a good constitution is needed to stand the' excitement of love as well as fashion, when the uterus and its appendages are congested, what does she do ? She starts of with the young man of her choice, and jauns about the country in jolt- ing railway cars, or starts for a voyage across the ocean. She throws aside the very thing that she needs, at the very time she needs it most-rest-and leaves friends and home to meet strangers and strange things, and put up with the fatigue and excitement of travelling. This is essentially wrong, and is only done because it is the custom for the happy couple to do it. We do not,'doubt that the foundation' for many-of these shattered nerves are thus laid, and in these few words put forth our demurrer to the pernicious practice. the only argument in favour of which is that it is the fashion to do it. A lady brought a child to old Dr. F. to consult him about its health. Among other things, she enquired if he did not think the springs would be useful. \" Certainly, madam,\" replied the doctor, as he eyed the child, and then took a large pinch of snuff. \"I haven't the least hesitation in recommending the springs-and the sooner you apply the remedy the better!\" \" You really think it would be good for the dear little thing, don't you?\" \" Upon my word, it's the best remedy I know of.\" \" What springs would you recommend, doctor?\" \"Any will do madam, where you can get plenty of ' soap and water.\"' 361",
         "THE SANITARY JOURNAL. THE COFFEE TAVERN MOVEMENT. In view of the large amount of disease caused by intemperance in the use of spirituous liquors, the Sanitary Journal cannot but rejoice at the movement which has been made by certain well-known philan- thropic gentlemen in Toronto to establish coffee taverns in the city. Had but one-tenth part of the, for the most part, well-meaning but comparatively not very fruitful efforts of total abstinence workers been directed toward the providing of counter attractions for the masses who congregate in bar rooms, and too often drink to the great injury of both mind and body, we have no doubt that a larger amount of good would have been accormplished. And it is to be hoped that all temperance people will render all possible encouragement and assistance to this excellent movement. The results of the coffee movement in England have been what may be regarded as of the most encouraging character. Besides the many houses which have been established in London, some have been opened in Liverpool, Birmingham, Bristol, Gloucester, and Southampton. It is said, that, there where most drink houses are to be found, there are the best neighborhoods for these coffee taverns. The results have shown that these taverns, attracting large numbers of all classes, can be made to pay. They are established by com- panies which issue shares, which may be taken up by working men. Besides the bar in the centre of the room, there are noticeable small marble tables accompanied by plain but comfortable seats, while, unlike the lower class of coffee-houses, the place is light and cheerful, and gives evidence of a certain desire to please the eye; the exterior is also made distinctive, if not attractive, by the coat of red paint, which is the characteristic of the houses. They contain good whole- some food, and they know that can be got at a price which certainly is not dear. Besides the entertainment which was provided at the bar, customers find at all hours of the day newspapers at the tables, so that anybody who likes to look in and see what they have got in the way of refreshment may stay there and read the papers as long as they like ; they do not wish to turn them out, but they can have the shelter, the light, the warmth, and the literature, and then enjoy themselves in a rational way. Further than this, working men are at liberty to bring their own meals and eat them within the house. Then they have one other thing of importance to offer, viz., that those who wish to obtain refreshment to be drunk off the premises can do so. In the bouses already opened they do as good a jug business as they do a bar business, and this is not the least useful part of the work which the Coffee Tavern Company undertake. They are not a merely benevolent association, but their operations are conducted on a purely commercial basis, and they appeal to the public for support on the ground ofthe goodness of the refreshment which is offered to them, and on no other ground whatever. They ask them to pay a price which, low as it is, will pay the Company,",
         "HYGIENE OF CELLARS. and they trust that the fact that the price is low and the things good will commend itself to the public. We heartily wish the coffee tavern movement in Toronto much success, and believe it will be the means of accomplishing much good. And we hope and expect to see such resorts soon established in many other cities and towns in Canada. . HYGIENE OF CELLARS.-Dr. R. C. Kedzie, President of the Michi- gan State Board of Health, Prof. of Chemistry in the State Agricul- tural College, has contributed to the last Annual Report of the State Board of Health on \" Healthy Homes for farmers,\" from which the following is an extract :-' Go down into the cellar and examine the foundations of life : see whether the cellar is dry and well ventilated, and the air sweet and wholesome ; that no vegetables and .useless rubbish of any kind are left to rot in your cellar. Or do you find al kinds of things going to decay, the cellar wet, the walls slimy, mold spreading over everything, and a close and stifling odor pervading the air of your cellar? If these inanimate things could give voice to their warning, what a sound would startle our ears in hundreds of .cellars in our State. Here lie in ambush diphtheria and membranous croup, the destroyers of childhood, and typhoid fever that strikes at all ages.: here lurk the seeds of consumption to bring forth the slow but sure harvest of lamentation and woe !' ' For the stone shall cry out of the wall, and the beam out of the timber shall answer it.' But though these voiceless things speak no word of warning, they bang out the flag of danger; the spotted mold and fungus attacking the timbers of your cellar show that destructive agencies are at work. Why, man ! death is gnawing the very sills of your house, and shall he spare those tender morsels, your children ? These damp, musty, rioldy cellars are seed-beds of disease. Do not hope to preserve health over such a charnal bouse. Do not leave vegetables to rot in your cellar to spread rottenness through all your house. The wet cellar foretells wet eyes up-stairs ! Drain it, and under drain the surrounding soil so that your cellar shall always be dry. Drive out all mustiness and mold by ventilation and by abundant use of white-wash. Make the air of your cellars at all times sweet and wholesome, because much of this air will find its way into the rooms above. But if you neglect all these things, and the angel of death spreads his dark wings over your household, do not charge the effects of your nastiness and laziness to a very mysterious Providence ! ' A prudent man foreseeth the evil znd hideth himself ; but the simple pass on and are punished.' IT is argued by a French physician that persons suffering pain should freely indulge in årying and moaning, as these expressions are intended by nature as a means of lessening physicil anguish. The attempt to suppress crying in children is deprecated, as the conse- quence may be St. Vitus' dance, epileptic fits, \u0026c. 363",
         "THE SANITARY JOURNAL. AMUSEMENTS OF GREAT MEN.-An exchange gives the following amusements of eminent men : nearly all learned men and hard st.idents have resorted to some amusement, however trifling, to un- bend the mind after the strain put upon it by severe study. It was a standing rule among the Jesuits that not more than two hours should be spent in study without relaxing the mind by some simple recreation. Spinosa is said to have amused himself by setting spiders to fight each other, and sometimes he became so interested in their queer performances that he would burst into immoderate fits of laughter. Descartes would lay aside his profound speculations to work in the flower-garden. Samuel Clarke, the great logician, was fond of violent exercise, and was several times found leaping over tables and the backs of chairs, by visitors to his study. DeGrammont, entering suddenly the private room of the Cardinal de Richelieu, founti the minister jumping up against the wall. To catch the prime minister in so undignified an occupatlon was oftentimes dangerous; but De Grammont, with true courtier's tact, in- stantly cried out, \" Two to one I can jump the highest,\" and joined in the sport with great zeal, taking care however to let the Cardinal jump the highest. To this stroke of policy he is said to have owed his advancement. Contemplative and quiet men seem to have been fond of amusements which accorded better with their habits. To such the game of chess, and angling, \" the con- templative man's recreation,\" have afforded delight and amusement. Others have turned from works requiring the most profound study, to writing on the most odd, andoften ridiculous subjects which would occur to them, and in this way have rested their wearied brains. To KEEP THE SKIN OF THE HANDS Sorr.-B. P. Marsh, A.M., M.D., in the Herald of Health, recommends the following, which we have no doubt will prove satisfactory to those who try it. 'The simplest and perhaps most satisfactory is to always keep side by side with one's toilet soap, a boule of mixture of, one part tinct. benzoin and four parts chemically pure glycerine. Thoroughly wash the hands with warm soapsuds and rinse with water free from soap ; do not wipe, but let them drain a moment, and then while stili wet, apply a few drops of the above preparation, and dry with gentle pressure of a soft towel. Another is to always thoroughly rub the hands with linseed oil before washing with soap. Either of the above measures will keep even a naturally harsh-skin soft and pliable. While at work, exposed to wind, damp or dust, or engaged at any kind of housework, such as scrubbing, ironing, or dish-washing, there is no better protection for the hands than smearing them often with mutton tallow. SCIENCE MADE EASv.-Friend to Scientific Authority: \" Doctor, how is a man to tell a mushroon from a toadstool ?\" Scientific Authority : \" By eating it : if you live, it is a mushroom; if you die it is a toadstool.\" 364",
         "VENTILATING EXHAUST COWL. VENTILATING ExHAUST COWL.-The following is the report of the sub-committee (consisting of Captain Douglas Galton, C.B., F.R. S.; Rogers Field, B.A., M. Inst. C.E. ; William Eassie, C.E.) ap- pointed by the Sanitary Institute of Great Britain to practically test the ventilating exhaust cowls exhibited at Leamington in October, 1877. The sub-committee appointed at Leamington to test the ventilating exhaust cowls beg to report that they have given the- matter their most careful attention, and carried out at the Royal Ob- servatory, Kew, an elaborate series of about xoo experiments on, seven different days, at different times of the day, and under different conditions of wind and temperature. After lcomparing the cowls very carefully with each other, and all of them with a plain open pipe as the simplest, and in fact only available standard, the sub-committee find that none of the exhaust cowls cause a more rapid current of air than prevails in an open pipe under similar conditions, but without any cowls fitted on it. The only use of the cowls, therefore, appears to be to exclude rain from the ventilating pipes ; and as this can be done equally, if not more efficiently, in other and simpler ways,. without diminishing the rapidity of the current in the open pipe, the sub-committee are unable to recommend the grant of the Medal of the Sanitary Institute of Great Britain to any of the exhaust cowls. submitted to them for trial. W. EASSIE, ROGERS FIELD, May 30, 1878. DOUGLAS GALTON. THE REQUISITES OF GooD SEWERAGE.-In a lecture recently given before the American Social Science Association, Colonel George E. Waring, jun., of Newport, R.I., laid down the principles of effective sewerage. The sewer should be so tight as to prevent all leakage. Its fall or inclination need not be great, buý must be regular, giving an equal cleansing velocity of 120 feet per minute in every part, with no dead water. Ample ventilation should be secured by man-holes and open gratings 1oo yards apart, and by tubes in each house con- nected with the soil-pipes, and opening above the roofs. Free dis- charge at the outlet of the sewer, and the means for flushing it periodically, must also be provided. With these precautions there need be no sewer-gas. The size of the sewer should be carefully adjusted to the volume it will have to carry, so that heavy rains will flush and cleanse it, carrying out any substances or other things that would cause accumulation and obstruction if the sewer were dispro- portioned to its work. ACTTJALLY BuRST.--Exchanges are noticing the case of a man who literally burst, split his diaphragm in two and diedfrom four plates, of. potato soup, \" numerous \" cups of tea and milk, followed by a large dose of bicarbonate of soda to aid digestion I His stomach swelled enormously, and tore the diaphragm on the right side causing immediate death. 365.",
         "THE SANITARY JOURNAL. INFLUENCE OF EXERCISE ON THE LUNGs.-One of the condi- tions of perfect health is physical exercise. In its absence the whole system suffers deterioration and falls short of that developement which is necessary to the vigorous action of the different organs. More than any organ, however, do the lungs suffer ; and it is not dif- ficult to explain why. In order that an organ be well nourished, it is necessary that it should be abundantly supplied with blood, and one of the many agencies which plays an important part in propell- ing the blood thirough arteries and veins is muscular contraction. The alternate contraction and dilation of the muscles forces the blood along the vessels. When a person is exercising vigorously, the respiratory movemdhts become greatly increased, the air vessels be- come dilated, the blood is propelled through the minute capillaries which constitute a large portion of their structure, and the lung tis- sue receives the nourishment which it requires, and which is neces- sary to its integrity and efficient actiun. From insufficient bodily exercise, then, the lungs suffer in two ways-viz., for want of suffi- cient blood to nourish them and for want of necessary expansion. The result is that the lungs. more frequently than any other organ, become affected in those who lcad inactive lives. This fact makes it incumbent on all, and especially on those who have weak lungs, to spend a portion of each day in vigorous phyisical exercise. We mean by this exercise which calls into vigorous action all the muscles of the body , exercise which causes the skin to glow, prespir- ation to start. Two hours of this kind of exercise each day is not too much ; and it should be performed, when possible, in the open air. A celebrated French physician says that a person, to be healthy and strong, should exercise to the point of prespiring every day. CARE OF CHILDREN.-An exchange gives the following sensible remarks on this subject .-The foundation must be well laid to in- sure healthy and happy children. The child must be well slept, well aired, well fed, and well bathed. By a thorough understanding and practice of these four simple rules, much of the physical, mental, and moral suffering in life would be avoided by parent as well as child. If a healthy child (and a delicate one proportionately) is regularly put to bed about dark in a quiet, well-ventilated, or even cold room, after a supper of plain food, it will naturally awake at daybreak, good-natured, with a keen appetite for a wholesome breakfast. Nutritious, plain food at regular hours, with no candy or stimulants, and free bathing, help the system to ward off many prevalent children's ailments, and to bear with much less danger the few that nust necessarily come to the majority of little ones. The child that is just given a little confectionary or any unsuitable food, and then rocked to sleep, should cause no surprise at waking peevish and feverish. It is simply the result of imaginary affection and want of knowledge on the part of the one in charge. It will certainly pay in the end to search diligently the cause when a little child is pro- verbially cross.",
         "THE PRIME OF LIFE. THE PRIME OF LIFE.-Between the ages of forty-five and sixty, says the Sanitarian, a man who has properly regulated himself may be considereçI in the prime of life. His matured strength of con- stitution renders him almost impervious to an attack of disease, and experience has given soundness to his judgment. Hijs mind is resolute, firm, and equal; all his functions are in the highest order; he assumes mastery over his business; builds up a competence on the foundation he bas laid in early manhood, and passes through a period of life attended by many gratifications. Having gone over a year or two over sixty he arrives at a stand-still. But athwart this is the viaduct called the turn inlife, which, if crossed in safety, leads to the valley of 'old age,' round which the river winds, and then beyond, without boat or causeway, to effect his passage. The bridge is, however, constructed of fragile material, and it depends how it is trodden whether it bend or break. Gout and apoplexy are also in the vicinity to waylay the traveller, and thrust him from the pass ; but let him grid up his loins and provide himself with a fitter staff, and he may trudge on in safety and with perfect composure. To quit metaphor, ' the turn of life' is to turn either into a prolonged walk or into the grave. The system and powers having reached the utmost expansion, now begin either to close like a flower at sunset or break down at once. One injudicious stimulant, a single fatal excitement, may force it beyond its strength, whilst a careful supply of props and the withdrawal of all that tends to force a plant will sustain in it beauty and vigor until night bas entirely set in. CONVALESCENCE. -The appetite of the convalescent (Saturday Review) is fitful and capricious ; yet his friends insist upon stuffing him at all sorts of odd hours, as if he were destined to fill a tureen de foie gras. Between breakfast and luncheon he must swallow some raw meat-juice and a glass of wine ; at three p.m., he must take some strong jelly ; between dinner and bed-time he bas to face beef tea, and during the night-watches he is dosed with Leibig's Extractum Carnis. An attack of biliousness soon follows, which bas to be re- lieved by cooling but unpleasant medicines. The doctor tells him that he never intended him to be overfed in such a manner, and reads him a long lecture on the incapability of the stomach to re- spond to too frequent calls upon its energies. In place of being over-gorged he is now over-tonicked, until a buzzing in the head and sudden deafness demand rest for the system from medical pick-me- ups. THE SANITARY authorities of the Tyrol compel midwives, under a penalty, to provide themselves with a five per cent. solution of car- bolic acid. Before attending a case of labor, they are obliged to wash their hands with a mixture of one part of this with four of water. All instruments, sponges, etc., which may have been used, must be similarly disinfected. It is hoped in this way to prevent puerperal fever. 367",
         "THE SANITARY JOURNAL. THE STATISTICAL BUREAU. We hope the movement toward the establishment of a Central Bureau of vital statistics in connection with the Dominion Govern- ment will not be permitted to cease. Our esteemed friend doctor (now Senator) Browne, who has manifested a deeper interest in the public health and statistical matters than any other Legislator in the Dominon, will in his new and higher position be still able to press the matter, and we trust he will not fail to do so. Indeed we feel assured he will not let the subject drop through. The fact that a medical man (the Hon. Dr. Tupper) is so to speak, so near the head of the present Government may perhaps be favorable to the success of the movement. The necessity for a Central Bureau of this kind at Washington is being strongly urged by Sanitarians in the United States. With provincial departments of health in each of the provinces, a Central Federal Bureau will be essential to a complete system of health and statistics for this Dominion. IMPORTANCE OF DIET.-How much the success or failure of our lives depends upon the food we eat, we little comprehend. No science is so neglected and so little understood. Man would not dare to treat a valuable horse with the same recklessness with which he treats himself. For with care he selects food for his horse, few if any changes being allowed, and he procures a competent groom to look after and care for the animal, that he may be capable of fleetness and endurance; while with himself he sits down to his table groaning under its burden of variety and richness, and without regard to the requirements of his system or the affinity the food may possess, fills himself to the utmost capacity of his stomach, regardless of conse- quences. But had he first passed this partaken dinner over to his chem- ist and allowed him to analyze it and hand it back to him labeled, he would have turned pale and wondered if such was truth. Again, were he to step into a drug store and attempt to promiscuously mix chemicals as he does his food, without regard to chemical laws, he would soon have his head blown from his body. Why not then study and invçstigate the laws of our own natures, and be as wise as is the ox or the ass that knoweth his master and his master's crib, and accuse not a kind and loving Providence of cursing us with ill health when the curse lies at our own door ? WHAT is really wanted is one recognized and sufficiently powerful Minister, not to centralise administration, but on the contrary to set local life in motion-a real motive power, as well as an authority to be referred to for guidance and assistance by all the sanitary authorities for local government throughout the country. The department should keep all local authorities and their officers in the active exercise of their own legally imposed and responsible functions, and should make itself acquainted with any default and remedy it. 368",
         "EFFECT OF GAS ON FABRICS. EFFECT OFGAS ON FABRICS.-Dr. William Wallace, of Glasgow, by a series of experiments has determined that the sulphuric acid left in the air by the combustion of coal gas is a great cause of the destruction of the color of cotton goods. Even the fabric itself is often rendered so tender by the destructive action of the acid as to be utterly useless. It is on this account that it is deemed by our best authorities very injurious to people with very sensitive lu9gs to inhale air which has been poisoned and rendered irritating by the combustion of coal gas. If the use of the gas is unavoidable, the most thorough ventilation should be secured. VACCINATION will not prove successful in a patient who, at the time, is under the influence of arsenic, says an English health-officer, Dr. E. J. Syson, quoted by Dr. E. M. Hunt, Medical Record, March 9th. (The Proceedinzs.) \" The Antecedent Treatment of those Ex- posed to Zymotic Diseases.\" He suggests that other remedial agents, especially those classified as azymotics, will also cause the failure of a properly formed vaccination. This hint opens the door to a wide field of investigation. The human lungs reverberate sometimes with great velocity. When windy individuals indulge in much verbosity. They have to twirl the glottis sixty thousand times a minute, And push and punch the diaphragm as though the deuce were in it. Chorus :-The pharynx now goes up, the larynx with a slam Ejects a note from out the throat, pushed by the diaphragm. CAUSE OF DIPHTHERIA.-It was found (Zealth Reformer,) upon examination of two hundred houses in Boston where there had been cases of diphtberia, that the disease was in every case preceded by derangement of the waste pipes, so that there was an escape of sewer gas, laden with disease germs. AMBIGUOUS-The recently-published report of an Irish benevolent society contains the following anbiguous paragraph : Notwithstand- ing the large amount paid for medicine and medical attendance, very few deaths occurred during the year. BILLS WILL BE sent with this number to those in arrears, and we hope friends of the JOURNAL will not forget that it is near Christmas times, when all accounts should be \"squared up \" and that they will kindly, by promply remitting the amount, save the necessity and trouble of sending the accounts agaiu ; for it involves considerable trouble and expense. 369",
         "BOUND VOLUMES OF SANITARY JOURNAL. Vols. I. \u0026 II.--Cldth, (Nearly 4oo pages, each were published at $2.00 per annum) . $2.25 each. Vols. I. \u0026 II.-Bound, and current vol., . $6.50 (POSTAGE PRE-PAID.) J. G. TROTTER, . DENTIST, 53 King Street East, Opp. Toronto Street, TORONTO, ONT. Residence, 164 Jarvis Street. WEXELBERG \u0026 00., Manufacturers of the PATENT IMPROVED FLAT CRIMPED SHEET METAL ELBOWS FOR CONDUCTORS and STOVE PIPES. No. 29 William Street, TORONTO, ONT. IMPORTANT TO PHYSICIANS. A great saving of valuable time may be made by using the PIJYSICIANS DAY BOOK \u0026 LEDGER Which will exhibit at a glance, under date f occurrence, every visit made, the lengt of time consumed, whether day or night, and to whlch member oi a fax4ly. It aiea includes The Daiy Cash Aonount and Obstetrie Escord, OF GREAT VALUE On application with stamp the ublishers wil send ta any physiclan a full descriptive circular wlth stbecimen pages. Physiciana who are using the baoks are delighted with them. The sales have been very large, ad the eighth edition la now in the press. Agente Wanted. HENRY BILL PUBLISEING 00., Norwich, Conn."
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         "Dominion Medical Monthly Voi. IV.] TORONTO, ONT.,· APRIL, 1895. [No. 4. Reports of Societies. THE PROVINCIAL BOARD. HEALTH. OF The second quarterly meeting of this Board began at Dr. Bryce's office Ap-ril 3rd, i i a.m. Present:-Dr. Mac- donald, chair-man ; Dr. Bryce, secre- tary, and Drs. Cassidy, Rae, Kitchen, Covernton and Vaux. The minutes of the first quarterly meeting and of a special meeting held on March i ith having been read and ad.opted, the Secretary read a number of letters. One was from the owner of a building at Strathroy, which had been used as a small-pox hospital and subsequently burned down by some unknow*n pe- sons. The owner wvanted comnensa- tion from the Government. Ne was advised to refer the matter to arbitra- tion. Mr. Doran, S.M., who resicles at North Bay,sent an account for services. rendered in connection vith an epi- demic at Warren. A lengthy corre- spondence from Chapleau, a village on the C.P.R., in one of the unorganized. townships, was read. Chapleau has a population of about 6oo but it is not yct a municipality. Diphtheria is' prevalent. Dr. McKenzie, a physician - employed by the C.P.R. Co., had been asked to take charge of the village, nominally as Sanitary Inspector,oving to the fact that the police magistrate of Sauit Ste. Marie waz, by the -Iealth. Act, ex officio the Medical lealth Officer. Dr. Bryce had advised hirn to placard houses and to employ sani- tary police. Dr. McKenzie ývill send his account to the Provincial Boardt of Health. A lengthy petition- wasz also presented, asking that Mr. H. A.. West,'óf Chapleau, be made a provin.- cial constable to assist Dr. McKenzie.. Dr. Baker, Secretary, State Board. of Health, Michigan, wrote asking if the Provincial Board of Health was, aware that there was scarlatina at Sault Ste. Marie. He was informed! that this Board was not ignorant of the fact. Mr. Spencer, police magistrate of Glamorgan, wrote suggesting that in the unorganized townships the - school trustees of a section in which. diphtheria or other infectious disease prevailed should be empowered to- ernploy physicians and appoint sani- tary police. The expenses incurred. .in putting down an outbreak of diph- theria in Glamorgan amounted to - $300. Glamorgan is poor,,and.wants.",
         "DOMINION MEDICAL MONTHLY the Ontario Government to pay the bill. A letter froin Trenton was read, stating that a case of diphtheria was not properly isolated, and another letter from the same town complained of a want of public urinals. Accounts were presented for vac- cinating eighty-seven persons in Mus- koka at the rate of twenty-five cents per head. A complaint was received from a party at Toronto Junction, asking for damages for an unoccupied building which had been occupied as an isola- tion hospital. The complainant was advised to refer the matter to the county judge. A letter from Walkerton was read stating that a cow near that town had actinomycosis. After an adjournnient for lunch, the Board resumed at 2.30 p.m. An interesting report of an attack of hydrophobia, which had o.curred in a dog in the township of Ekfrid, Middlesex, was read. A lad bitten by the rabid animal had gone for treatment to the Pasteur Institute, New York, and his friends wanted the expenses of treatment to be partly borne by the Provincial Board of Health. (See page 94.) The Local Board of* Health, St. Catharines, was warned by the Sec- retary to prevent the feeding of offal, etc., to hogs in the vicinity of the water-supply of the city. A special report was presented by Dr.Bryce recommending the appoint- men.t of County Medical Health of- ficers. The report was adopted. (Sec page 98.) The Board then went ipto Com- mittee of the Whole, in order to con- sider a plan for providing legislation to inalke school trustee boards in the unorganized townships ex offic.io local boards of health. A scheme of the proposed legisia- tion was drawn up and discussed, but not adopted, the final settlement of the question being allowed to stand over until the following day. The Board the à adjourned till 10.30 a.m. Thursday. TI-IURSDAY, 10.30 A.M. On resuming, the Board heard some correspondence respecting rumored outbreaks of ergot disease in cattle in Haliburton. No reports were made. Mr.. Willis Chipman, C.E., Galt, appeared before the Board to promote a proposed system of sewerage in Galt. The report, was received and re- ferred to the Committee on Sewage, with instructions to report to the Board later. The Board resumed at 2.30 p.m., and considered the proposed forma- tion of local boards in unorganized districts. It was concluded that as school trustees in the unorganized districts have puwers as trustees it would be well to make them e. offlcio local boards of health, and to give them the powers of local boards of health. A local board so formed could procure medical aid 'and appoint a sanitary inspector, or employ a physician and give hin powers as a medical health officer, with the approval of the Minister of the Department to which it is attached. The Provincial Board of Health could grant to such a local board a· surn, bearing the same proportion to the",
         "DOMINION MEDICAL MONTHLY amount raised for health purposes as the school grant does to the school moncys raised in the school section, this payment to be made out of such moneys as may be set apart by the Legisiature. (See Act for regulating health matters in the unorganized districts.) The account of Mr. Doran, S.M., for $8, was passed. An account for vaccination in the unorganized districts vas left open for consideration. An account of $300 fromGlamorgan was referred for particulars, and the sccretary wasinstructed to submit the matter to the Board at a subsequent meeting. A letter was received from Dr. Tizzoni, of Bologna, informing the Board that the antitoxine of tetanus vas prepared and kept by Messrs. Merck, of Darmstadt. A second letter from Messrs. Merck infoimëd the Board that the price of one bottle, sufficient for the treatment of a single case of tetanus, was 90 shillings. The Board considered that this was a large sum to pay for a treatment which might not be required for many months, more particularly as the anti- toxine depreciates by keeping. The secretary was instructed to write to Dr. Gibier toascertain if this antitoxine could be got in New York. A letter was read from the town engineer of Woodstock, asking if there was any legislation providing for the expropriation of land for a sewage farm. He was informed that there was no such legislation. FRIDAY, 11 A.M. The Board 'having .esumed, it was moved by Dr. Kitchen, sêcônded: by Dr. Covernton, that one hundred copies of tie March number of the DoutrNoN MEDICAL MONTIILV be ordered and paid for by the Board. Carried. Dr. Oille and Alderman Carlyle, of St. Catharines, appeared before the Board to discuss a nuisance which threatened the St. Catharines water- supply. They requested that an amend- ment be made to Section 6.1, Ontario Health Act, by which a local, board of health would have pover to inspect or order an investigation to be made of a nuisance in an outside munici- pality, which prejudicially affect.ed the sanitary interests of the said .Board). They were informed tlýat the legisia- tion would be asked for. Dr. McKenzie was recommended as sanitary inspector, and Mr. West as sanitary policeman for Chapleau. Dr. Bryce presented the report of the Committee on Epidemics. (See page 96.) The Board went into Committee of the Whole to consider the appoint- ment of the Standing Committees. The following wcre recompinded: (1) Epidemics, Drs. Coverxiton, Cassidy and Bryce; (2) Public Water Supplies, Drs. Vaux, Rae and Bryce; (3) Sewers, Drs. Bryce, Kitchen and Vaux; (4) School Hygiene and Ventilation, Drs. Cassidy, Rae and Covernton ; (f) Finance, Legislation and Publication, Drs. Rae, Cassidy and Bryce ; (6) Foods, Drinks and Poisons, Drs. Kitchen, Rae and Bryce. The Chairman, Dr. Macdon- ald, to be ex oficio a member of all committees. The report was ad@pted. It was then moved by Dr. Cassidy, seconded by Dr. Vaux, that the matter of distribu.ting reports of the",
         "DOMINION MEDICAL MONTHLY proccedings of the quartcrly mcetings of the Board to the local boards be referred to the Comnittee on Publica- tion, to bc dealt with. The proceed- ings of the second quarterly meeting then tcrminated. Correspondence respecting an out- break of rabics in the Township of Ekfrid, and bacteriological :eport of the examination of the rabid animal by J. J. Mackenzie, B.A.: Dr. P. H. Bryce, SecreIary of the Provincial Board of Health, Toi onto, Ont.; DEAR SiR,- -Dr. McEwen, of Mel- bourne will express you, in a sterilized vessel and securely packed, the pos- terior portion of the head and neck of a dog supposed to be rabid. I am not certainly aware that your laboratory has facilities for examining such a case bacteriologically, but send in the hope that you have. If so, please demonstrate nature of bacteria present in this case (head has been frozen since i2th .inst. until packed), and if hydrophobia gerns can be found, let us know as soon as possible. If in- oculation experiments are necessary, please send word as to microscopic appearance of a scètion. Perhaps this should properly have been sent to Mr. Mackenzie, but the closing part of this letter will showv why I send to you. Dr. McEwen may also address the head to you, in vhich case please hand to Mr. Mackenzie. The dog bit a young lad (say 17 years) on the backs of both hands, through a rather thmn pair of woollen mits, on Wednesday, the 6th inst. The dog at that time was not sup- posed to be rabid, ar.d had previously been a fairly even-tempered dog ; but on the same night it left home, after making some attempt to bite its ovner, and \" took in \" a circle of country of ten or more miles, biting nearly every dog in its course, and also farin and clomestic animals and fowls. It attacked two or three people (as far as heard froin), biting only one, and that did not penetrate the skin on account of a heavy glove ; and it did not return home until Sunday, ioth inst., about 2 p.m. On return it did not attemlpt to bite its owner or any of the family. It v .- eevidently sick and stupid ; vould not answer when called ; eyes sunken and glassy; much enaciated ; owner offered it bread and milk, but would not touch them ; a piece of meat placed in the nouth was immediately rejected, with evident pain ; did not bark or growl prostrated som ewhat,which increased, and on Monday night or Tuesday could only rise on front legs, the hind parts being evidently paralyzed ; some convulsive attacks noticed, but not severe. -Dog then killed. In its course through the ,ountry it passed through a village, and bit every dog in sight. It would run from one group of dogs to another, biting and snapping, and not stopping to fight. Other dogs. on its approach, would run away from it, although some of therm had the reputation of being good and cager fighters. I did not mention that the saliva was scanty and thick and ropy when seen at home on Sunday'and Mon- day. In my opinion all clinical symp- toms denote rabies, but would not affirm such without a laboratory ex- amination. The Township Council has been asked; to defray expense of sending bitten lad to the New York Pasteur",
         "DOMINION MEDICAL MONTHLY Institute for treatment. Dr. Gibier telegraphs nie that the cost for mini- mum period of treatment of fifteen clays will be $200, and board $50. Have requested of him if any reduc- tion cannot be made. Boy's parents are unable to pay anything towards the cost, as I am informed thcy are very poor, barely making a living for themselves. Our Council wishes to knov froni you if the Provincial Board vill bear any of the cost in case they decide to send him. They do not wish to incur expense unless they are reasonably ';ure of the dog having hydrophobia, and not some simulating discase. In case you cannot examine parts zent, please vire on receipt wvhat proportion of cost the Board will pay, if any, and oblige, . Yours sincerely, L. HYTTENRAUCH, M.D. P.S.-Also, has Local Board of Health pover in this matter.-L. H. Appin, Ont., iVarch 17th, 1895. L. Hyttenrazuch, Esq., M.D:, Medical Health Oficer, Townshiip of Efrid, Ajþþin - DEAR DOCTOR.-I am in receipt of your communication of the 17th instant, and am obliged for your full 'statement of the movements of the dog supposed to be rabid. From all 'ou have stated I have no hesitation in concluding that the dog is rabid, and the person bitten should be sent as soon as possible to the Pasteur Institute, Nev Yorc. While it would be satisfactory to know the result of inoculation ex- periments in rabbi's, it has been.found that -unless the removal of 'e med- ulla has been done very promptly after death in the most thorough manner, the inoculation experiments vill.kill by soine saprophytic germs before the hydrophobia, even though present, can develop. Mr. Mackenzie vill inoculate rab- bits to-day if the specimen arrives, but it will be probably twelve or fourteen days before symptoms of rabies can develop. In the mean- time every day lost increases danger, and the absence of resuits, if any pu- trefaction has gone on in the cord, will not relieve us froin our responsi1- bility with such clinical symptoms. I would urge the township to send the patient at once to the Pasteur Institute; and I shall lay the matter before the Board at the next meeting, although there is no good reason why we should treat this difficulty other tian the cases of small-pox in other townships. The action taken in reference to the Dorchester case several years aga vas largely an experiment for the benefit of the Province. I shall be glad to learn of the ac- tion taken and the results of the treatment. I have the honor to be, your obe- dient servant. PETER H. BRYCE, Secretary. Toronto, Mai-cll 19th, 1895. To thje Chairman and Memlibers of the Pre- vincial Board of Healti : .GENTLEMEN,-l received from Dr. McEwen, of Melbourne, on Tuesday, March 19th; a box containing a por- tion of the skull and brain of a dog supposed to have been rabid, a full account of which is given in the cor- respondence. ' Immediately on the receipt of it, I took a small. quantity of the interior",
         "DOMINION MEDICAL MONTHLY of tl-e medullaoblongata, triturated it in a sterile mortar with sterile beef broth and injected it underneath the dura mater of tvo rabbits. Rabbit No. i received about one-half c.c. of the mixture, injected far back over the cerebellum ; rabbit No. 2 re- C.e:ved about one-tenth c.c. on the sur- face of the cercbrun. The folloving day I treated a third ralbit in the same manner. The morning folluw- ing the operation the rabbits vere quite vell and the wounds healed rapidly by firs.t intention. The following is a table of the tem- peratures and veights of the animais from day to day: Jabbir. No. 1. tatbit No. 2. Rabbit lo. 3. Dato -- - - - - Weigit Teim. ight, Tti. Weight Tomt. Mar. 19 1170 grs. . ms i 20 . .. n 21 .... 91.4 1322 . 102.8 06 . 23 1130 gris. 100.8 774 grill. 07.8 731 grins. 100.5 s 24 .. . 103.2 .. - 102.4 101.8 25. .... 103.8 ... 100.3 1014 20 1005 grmns. 102.0 823 gris. 100,4 760grms. 99.6 27 ... 102.0 102.0 .... - 102J, *28 094 grîns. 100.5 788 grls. 90.3 781 grils. 101 2 29 930 grils. 91.2 750grms. 110.1 810gris. 102.2 630 .... .07 1 gris 99.5t 752 grill. 102.3 .1 852 grms. 91.0 7 2grms. 07 Sý 7:ï0 gris.o2.6 500 grns. 07.4 0OgniS.103 2 .... 624 grms. 1)4.81 S23grls. Rabbit No. i died April st; rabbit NO. 2 April 2nd. In the case of No. i the anîimal dici flot at first showv paralysis, but rather great eakness. 7In the case of No. . the animal showed paralysis (complete) of the right hind leg, and partial paralysis ivith hyperocsthesia of the left hind leg. .The post-mnortemn resuits wvere prac- tically the same in both animais, in- tense congestion of the .wbole central nlervous system, but especially so of the spinal cord. The incubation period in the case of Rabbit No. i is rather short for the first passage of street rabies ; but that may be accounted for by the exceedingly large dose which he re- ccivcd. In rabbit No. 2 theperiod of incubation (fourteen days) is about the average length of time for the first passage. Rabbit No. 3 is still living, and lias shown as yet no symptoms ; to-day is the fourtecnth day for it.* To be absolutely certatin,-of course, it is necessary to pass the virus on through otier rabbits. I purpose doing this. .1 think, however, that there is little doubt that the rabbits died of para- lytic rabies. I have the honor to be, your obe- dient servant. J. J. M AC KE N7Z IBE Bacteriologist. Toronto, April 4h, 1895. REPORT OF TXrE COMMITTEE ON EPIDEMICS. Presented by Dr. iRnycE. To Ie Chairman and fembers of the Pro. viacaal board of Hea/lt : GENTLEMEN,-Your Committee takes pleasure in reporting, for the information of the Board and public, the satisfactory position of the public health during the past quarter. As will be remembered, at the time of the last meeting there were six cases of small-pox in the Province at five places. The following report of Dr. C. A. Hodgetts, in detail, gives the origin and progress of the Aylmer outbrealk, and that of. the Guelph outbreak caused thereby : \" The action taken by the Local Boards of I-Iealth of·Guelph City and Township, and by the authorities of Rabbit Nô. 3 died April 11, wit.h an incubation period of twenty dayE.",
         "DOMINION MEDICAL MONTHLY the Agricultuîral College,,and-by your secretary, fortunately prevented the extension of vhat seemed at one time a very serious danger. Through the action taken, the College term was continued without any serious inter- ruption, and the business of the com- munity was onlv teiporarily dis- turbed. The outbreak illustrates, however, the necessity for this Board notifying all public institutions of the Province toadopt systematic neasures for the regular vaccination of in- nates. The danger in such institu- tions here is accentuated by similar outbreaks in Yale University and at Storrs Agricultural College, Connec- ticut. The Province is now free fron a single case of small-pox, and a very considerable number of persons in every district wlcre the disease lias been have been vaccinated.\" )zh1/eria.-Wlhile the disease has prevailed to a notable degrec-through- out the winter, there have been evi- dences of a general lessening of its prevalence throughiout the Province, both from report of local outbreaks and in the demand for diphtheria 'antitoxine. Thus, in December there- were 40 orders sent out ; in Januaryi there were '57 orders sent out; in February there were 46 orders sent. out, and in March there were 38 orders sent out. While the results of the use of anti- toxine have, according to such reports as have been received, continued to be very satisfactory, it must again be stated that the Board has not been favored, except to a very partial ex- tent, with a return of the blank form for reports, sent out with every bottle, filled in with details of results. This is even more regrtable than the· statement of rqceipts of payments for antitoxine.forvarded. As stated be- fore, it lias been supplied at the Nev York cost price to practitioners throughout the Province, and always perfectly fresh. Under such circun- stances, it would have been thought that renittances for the favor of the Board vould have been prompt. A statement regarding the anoint of antitoxine was presented. Scar/atina.-The corresponclence from many parts of the Province which is presented shovs, however, a gencral dissernination of outbreaks of scarlatina. They do nct seem to be of a high degree of virulence, but, as the reports show, there is everywherc a percentage of deaths. The in- munity of the Province froni the disease during the past .en years lias before been remarked upon ; but there can be no doubt of the increased inci- dence of the disease during the past two years. Thus the nortality in the 12 cities from scarlatina in 1892 was 99, and in 1893, 146. The returns for 1894 are not yet complete, but it is probable that the rate throughout the Province will have exceeded that of 1893. Thus the cities had 116 for 1894. Diphtheria and scarlet fever in cities in 1894: Cities. Diphtheria. ay er. Toronto............ ........... 103 Go Hlamiltoi........... .......... os 2 Ottava... ...............79 23 London ...................., 48 Kingston...................... 5 Brantford ..... ........... .... 5 23 Guelph........................ 2 3 St. Thomas..................... 1 St. Catharines............ .... 4 2 Stratford... ................... Belleville...................... . WVindsor ... .................. .. : Total ...............307 116",
         "DOMINION MEDICAL MONTH1LY Your Conmittee would call the at- tention of the Board to the fact of the proposed regulations re scarlatina, submitted for approval, being still under consideration, and would urge that the neccl of these regulations be again brought before the attention of the Minister. The several communications pre- sented with regard to outbreaks of contagious disease in the unorganized municipalities accentuate what has been said before with regard to the necessity for some more systematic organization, wNhcreby the Board will be enabled to deal more satisfactorily vith outbreaks when they occur. Under the Act of 1889, much valu- able work lias been donc by the sti- pendiary and police magistrates ; but inasmuch as there are a number of growing committees without munici- pal organizations, and therefore with- out any means for giving financial support, it has been impossible with the grant at the disposal of the Board to organize any permanent health organization in. these places. Your Committee would suggest that some recommendations be made with a view to so amending the Municipal or Education Act as to make provi- sion for some kind of incorporation into either villages or police villages, such as will meet the needs of the case. There are, moreover, growing up in many centres villages around mining companies and lumber camps, where much capital is invested, and which are amply able, from the finan- cial standpoint, to maintain a good health supervision of their districts. A thorough inspection of these should be made with a view to making sug- gestions as to water-supply, an isola- ted building for the sick, and, where absent, arrangenents for the regular attendance of a medical man. Your Cominittec would, therefore. present the report for your considera- tion, trusting that sorne means vill be discovered for adequately dealing with the important. health interests of a district extending fron Mattava to Rat Portage. All of which is respectfully sub- mitted. Toronto, April 3rd', i895. SPECIAL REPORT RiCOmINiENDING TILE APPOINTMENT OF COUNTY MEDICAL HEALTI OFFICERS. Read by Dr. IiRvcip. To the Chairman and M'enbers of thte Pro- vincial Board of Health: GENTLEMEN,-Therc has naturally grown up with the development of public health w'ork throughout the Province, a certain feeling in. mqny municipalities for some more exact methods for dealing with the ques- tions which arise within the borders of our several counties than can be de- veloped under our present municipal health boards. The essential reason for this wvill be admitted by those who have been observers in this work, viz., that the amounts of money which. are comnonly spent by local boards of health at present are not sufficient to produce any definite attention being paid to health work, unless under the pressure of an out- break of sinall-pox, or occasionally of diphtheria, if it becomes epidemic. To illustrate this, I take the aiounts of money..expended under the leading local boards of health in",
         "DOMINION MEDICAL MONTHLY 'the municipal returns, made to the Department of Agriculture for the ycar 1893, frorn two of our oldest and most prosperous counties: Oxford, 1893, townships 1i,. total $481.oo, varying froni $0 to $97.00; towls and villages, fron $5.oo to $481.oo ; Grey, 1893, townships 16, total $286.oo, varying from $o in four townships to $75.00; towns and vil- lages, $6.oo to $344.oo. Now, these figures mean cither that almost no attention is given to public health in these districts, or that the-amounts of money thus expended have not been returned under the proper hcading. As a matter of fact, both causes exist. With' regard to the returns 1 find in those for one of our largest villages, which I visited in 1884 on account of a serious out- break of diphtheria, that the returns under local board was as $24.oo, while under poor relief werc charged: sums for diphtheria nurses, etc., amounting to $121-95. This wili doubtless explain how, in nany places, the amounts returned for public health work are so small. When, however, I find $5.oo for the Sanitary Inspector and $5.oo for the Medical Health Officer, in examining details of e;xpenditure, it nust bc concluded that the public health of such munlicipalities has been most satisfactory, or that local boards of health in nany instances exist only in name. When I find such amounts set down, however, for town- ships where correspondence shows public funerals in cases of diphtheria took place, and where schools finally were closed on account of the disease, lit would seem a fair -inference that, ffrom the public. health standpoint, imiiprovcnents are not on1ly possibk but seen to' be greatly needcd. At the instance of this Board the Lcgislature introduced a provision iii the Act of 1890, whereby municipal authorities were empowered to forego their powers in health matters to a medical officer appointcd by the County Council. Up to the present timc I am not aware of acvantage of this provision having been taken in any case; but the advantages of such a step) in the interests of the public hcalth of any county cannot, in ny opinion, be ovcr-estimated. In order to appreciate fully the advantages of such a step, it is necessary to recapi- tulate the principal work which boards of health are supposed to perform. i. The first and nost immediate cluty is that of sutppressing outbreaks of contagious diseases. During the past year some twenty outbreaks of small-pox occurred. These have had to be deait with by the local hcalth officers. From the figures alr-ady given it is made plain that a Medical Health Officer has not been expected to give medical attendance, and, as a conse- quence, special medical aid has had to be given at the rate of from $îo to $20 per diem, and this, in some in- stances, frorn two to three months. It is hardly necessary to say that such an expenditure for one or two cases of small-pox falls heavily on a single rnunicipality. In an instance wlhere the amount' has been obtainetI, the tdtal cost of the outbreak was $1,6oo, and in another some-$6oo for medical services alone. This is, however, but one disease. With the numerous outbreaks of diphtheria which 'have occurred in cvery part of the Province ive have",
         "DOMINfON MEICAL viONTILY abundant evidence to prove th;At th( practical absence of any activr health authority lias allowed outbcaks to obtain a headway, with an ultinate loss of life and expenditure or a nost serious amount. As an illustretion, I mnay refer to one of the apcations bcfore you foi relief, from a towniship stated to have 140 ratepayers, with an asscssncnt of $23,77 j0, a rate of 57%,4 mills, and a bill of $32(, for con- tagious cieases, and a total inidebted- ness of $1,4.09.80. Had a county officer existed in this instancc, spe- cially devoted to this work, and paid for his services by the county, the epidemic could hardly have got under such headway, or, had it donc so, the expenditure vould have been spread over many municipalities. instead of one. 2. The vork of supervising chicese factories and dairies, the pig-pcns in connection with thci, and the sani- tary oversight of Public Schools, both in the matter of good water. outbuild- ings, heating and ventilation, are all nost necessary duties laid upon Local Boards at present. Remembering the growing importance of this vork, it vill be seen that the work necessary to be donc is of a most extencded and important character. 3. The investigation of outbreaks of hog-cholera, of actinomycosis and tuberculosis in herds, and in milch cows both for dairy and public milk suppies, is another growing and most important part of Local Board work. The complaints constantly received from medical officers and sanitary inspectors vith regard- to these sub- jects show how greatly is needed the constant supervision of a trained medical officer. '4.. The ycarly introduction of pub- lic wate- supplies in our growing tovns and villages, and the need of accurate investigation of sources of disease-from badly-constructed sewers and drains, is similarly denanding the prescuce of an officer who shall make local conditions a special study and take steps to prevent the pollution of publie vater supplies. 5. Another and very -pressing need is the presence of sone medical expert in every county to whom can con- ver icntly and quickly bc sent by local mcdical practitioners samples of mem- brane from cases of suspected diph- theria, and sputa from cases of sup- posed tuberculosis. The work underta2n iin thie labora- tory of the Board during the past year arnply illustrates the good vhich may be donc in this direction by supplying accurate information at the earliest moment, and thereby enabling medi- cal men to take prompt steps to- vard arresting the outbreak at the outset. 6. The development of the science of bacteriology has not only enabled us to diagnose these diseases vith an accuracy hitherto impossible, but it lias also given to us at lcast threc well-known antitoxines as diagnostic or preventive agents in discase, viz., vaccine against small-pox, antitoxine in diphtheria, and tuberculin in tu- berculosis. The presence of a trained bacteriologist as a county mcdical officer woulçl enable him to system- atically vaccinate the children of the county schools, to keep on hand diphtheria antitoxine, which could be had at the shortest notice from any point in the county, and to diagnose any suspected tuberculous animals",
         "DOMINION MEDICAL MONTH-LY before the herds became videly inoc- ulated with the disease. Summing up, then, briefly the ad- vantages to be gained by such an oflicer, they arc: i. The efficient and progressive ad- ministration of public health work in the counties. The difference betwcen the present methid and such a niethod vill be as marked as the presciit nethod of county inspection of schools as compared with tlat in the clays when the township council appointed some local clergyman who once a ycar put his lead within the door to sec that school was \" being kept,\" and then passed on. 2. A direct saving of lives through a limitation of the number of out- breaks of disease, and a notable sav- ing of time and money to ratepayers, and therefore to the country. 3. No increase.in the direct outlays, if compared so far as possible withi existing expenditures. 4. The possibility of a medical officer by assisting local practitioners in several essential branches of their work, developing that active support and sympathy for public health work so necessary for its success in the place of what lias hitherto existecd in many instances, an active hostility to health measurcs, because it has been' possible for one medical practitioner, by·getting the appointment of a med- ical health officer at a mere nominal authority, to exercise what has not alvays been acceptable, an official oversight of the cases of a rival prac- t:tioner. In many instances this has resulted in the abolition of the office of medical health officer, even in sone of the larger towns. '5. The existence of local ccunty officers so easily in touch w'ith the Provincial B3oard of -Icalth, that an accurate estimate cf the health con- ditions of the Province at any time notice vill be possible, while cletailcd scientific investigations would be car- ried on by this Board with the assist- ance of such officers in a manner at present largcly impossible. We should gradually be able to collate informa- tion vith regard to local geology, underground vater, raiifalls, relative incidence of suelî cliscases as malaria, etc., until the Board vill, by and by, be able to vork the cletails into a Public Health Map of the Province, vhich will form the basis of a scien- tiflc and historical w'ork of inestimable value for the future. 6. The encouragement of a high standard of scientific work in our universities by offering encourage- ment to scientiflc students to folow out in medicine special lines of inves- tigations, such as watcr analysis, food analysis,:investigation of animal dis- cases, and other lines of biological study. The public press and the practising physician are to-day fully convinced, that the country lias an abundance, even a surplus, of doctors, of the average class, but no one has yet stated that tiere is a surplus of men of such accurate scientific attain- ments as to be able to follow out chemical and scientific investigations with any great success. Like specialists in education, agri- culture, mining, etc., we have in public lealth a large amount of work like beside, yet outside the work of the practising physician, which can only be done by such trained men as I have referred to, and in conclusion I would suggest that some permissive",
         "U' ':11NION MEDICAL MONTHLY legislation be obtained which will not only give the power to appoint such county officers, but which will estab- lish a fixed remuneration on such cer- tificates of efficiency being obtained as may be approved of by this Board. I trust that this Board will give this matter further consideration, and appoint a committee to pursue the subject vith medical socities and county councils. AN ACT FOR REGULATING HEALTH MATTERS IN UNOR- GANIZED DISTRICTS. i. In any case where a school section exists in the unorganized districts, outside of any municipal jurisdiction, organized as provided under Cap. 55, entitled, \"An Act Consolidating and Revising the Public Schools Act,' the trustees of said school section shall be ex ofcio a Local Board of 1-lealth for such school section. 2. The Local Board of He-alth thus organized in any such school section shall possess and exercise, so far as applicable, all the powers and duties laid upon any Local Board of Health under the various Public Health Acts of Ontario. 3. The Local Board of Health in any such section is hereby empowered to annually appoint a sanitary inspec- tor for the area over which its juris- diction extends, and to supply such medical services as at any time may be required, by employing a compe- tent physician, who shall possess any powers of a medical health officer under the Public Health Act which may be laid upon hin by the Local Board of Health. This Act is recomnended, but has not yct been made law. 4. The Local Board of Health of any such school section is hereby empowered to provide by an annual assessnent, to be ievicd and collected in the sane manner and at the same tine as the Public School moncys, such moneys as may be deemed necessary for the public health work for the year. 5. The Provincial Board of Health may, with the approval of the Minister of the Department, pay out of such moneys as niay be set apart by the Legislature for the purpose, a grant to the Local Board of -lealth of any such school section, to supplement any expenditure made by it for public health purposes in the preceding year under the Public Health Act; such grant to bear the same ratio to the amount of money raised by said Local Board of Health and expended for health 'purposes during the pre- ceding year as existed between the amount of school moneys raisëd by local assessment during the preceding year, and the amount by which such school fund was supplemented through the annuali grant made to the Board of School Trustees of said school section by the Department of Education of Ontario. AN ACT TO MAKE FURTHER PROVISION FOR THE PUBLIC HEALTH. 1-1er Majesty, by and with the ad- vice and consent of the Legislative Assembly of the Province of Ontario, enacts as follows: 1. This Act .may 'be cited as \" The Public Health Act, 1895.\" , 10o2",
         "DOMINION MEDICAI MONTHLY 2. Section 9 of ' The Public Hcalth Act \" is hereby repealed, and the following section and sub-sections arc substituted therefor: (i) There shall be a local board of health in cach township and incorpor- ated village, to be composed of the reeve, clerk and three ratepayers, to be appointed by the municipal coun- cil in the following manner: One member to be appointed for three years, one member for two years and one member for one year, each mem- ber retiring to be replaced by a mem- ber appointed for three ycars from the date of his appointment. (2) There shal be a local board of health in each town containing less than four thousand inhabitants, ac- cording to the municipal enumeration of the previous year, to consist of the mayor, clerk and three ratepayers, to be appointed by the municipal coun- cil as follows : One member to bc appointed for three years, one mem- ber for two years and one member for one year, each member retir- ing to be replaced by a member ap- pointed for three years from date of appointment. (3) There shall be a local board of health for each city and for each town containing more than four thousand inhabitants, according to the munici- pal enu'meration of the previous year, to consist of the mayor and six rate- payers, to be appointed by the muni- cipal council as follows : Two mem- bers to be appointed for thrce years, two members for two years and' two members for one year, the retiring members to be replaced by two mern- bers appointed for three years from date of appointment., 3. Section 30 of the said Act is hereby rep-ealed and the following section and sub-sections substituteci therefor: (1) Wherever the establishment of a public water-supply is contemplated by the council of any city, town or village, it shall be the duty of thesaid municipal council to submit to the Provincial Board of Health, together with the plans, an analysis of the water from the proposed source or sources of supply, and an affidavit stating that the water analyzed .is taken from the proposed source, and that the analysis submitted to the Board exactly represents the condi- tions of the sample examined. In case the source of any proposed public water-supply cloes not, in the opinion of the Provincial Board of Health, meet the sanitary requirements of the municipality, either by reason of the quality of the water, or because the vater is likely, owing to the situation of the proposed source=of supply, to become contaminated, it shall not be lawful to establish such waterworks without first obtaining from the Pro- vincial Board of Health a certificate signed by the chairman and secretary stating that the proposed source is the. best practicable, having regard to ail the circumstances of the case, and that ail proper measures have been taken to maintain the supply in the highest possible and practicable state of purity. (2) Whenever the- construction of a main sewer or of a system of public sewerage shall be contemplated by the council of any city, town or vil- lage, it shall be the duty of the said council to place itself in communica- 1.03",
         "t)OMINION« MEDICAL MONtHVI\" tion- with the Provincial Board of Iealth, and to submit to the Board before their adoptIon all plans in-con- nection with said sever or scwerage system. It shall be the duty o'f the Provincial Board of Health to inquire and report upon said sewer or system of sewcerage, as to whether such is calculated to meet the sanitary re- quirements of the inhabitants of the said municipality ; and as to whether such sewer or system of sewerage is likely to prove prejudicial to the hcalth of the inhabitants of the said municipality or of any other munici- pality liable to be·affected thereby. (3)·The Provincial Board of Hcalth may make any suggestions or amend- ments concerning the plans submitted, or may impose any conditions with regard to the construction of such sewer or system of sewerage, or the disposal of sevage therefrom, as it may deen necessary or advisable in the public interest ; and the construc- tion of any main sewer or system of sewerage shall not be proceeded with without being reported upon and ap- proved of by said Provincial Board of Health, and no change in the con- struction thereof or in the disposal of sewage therefrom liable to injuriously affeut the public health shall be made without previous submission to and approval of said Board. (4) The decision or report of the Provincial Board of Health with re- gard to any systen of water-supply, or any public sewer or public system of sewage, or the disposal of sevage therefron, shall be subject to appeal to.the Licutenant-Governor in Coun- cil, such appeal to be made within one month after the filing of the report or decision in the office of the Ministcr of the Department to which the Pro- vincial Board of Health is attached ; and such decision or teport, when not so appealed against, or when con- firmed or amended, and confirmed upon appeal by the Lieutenant Gov- ernor in Council, shall be binding and conclusive upon all the municipalities and persons affectcd by the same ; provided always that % henever it shall appear that' any change of circum- stances or conditions has arisen the Provincial Board of Health mnay, if it deem it advisable, make further in- quiry and repo-t as to any system of vater-supply, or main sewer or sys- ten of sewerage or the disposal of sewage, which report shall be subject as aforesaid, and have the same force' and effect as aforesaid. 4. Section 99 of the said Act is amended by adding thereto the fol- lowing sub-section : (8) Whenever any medical health offi- cer, sanitary inspector or other health officer of the Board of Heaith knows- or has reason to believe that blood, offal, or the meat of any dead animal which has not been -previously boiled or steamed when fresh or before be- coming putrid or deconposeci, or which, although boiled or steamed, is putrid or decomposed, has beGn or is being fed to hogs, he may summon the owner, the person in charge, or any person found feeding the same, before a justice of·the peace for vicia- tion of the provisions of this section ; and wherever such blood, offal or decomposed flesh is found on any premises, the burden of proof that such was not intended to be so fed shall rest with the person charged.",
         "DOMJNION MEDICAL MONTILY Should the charge be proven, the health officer making the charge may seize and carry àway, or caùse to be seized and carried away, the animals, whether dead or alive, to vhich the aforesaid blood, offal or unboiled or putrid meat has 'been fed, -in order that said animals may be destroyed or so disposed of as to prevent them from being exposed for sale or used for food for man. AN EARLY GRAvE COMPLICATION OF PHARYNGEAL DIPHTHEJIA.- Aufrecht ( Therapeutische Monaishefte) calls attention to a particular form of diphtheria of the pharynx, which, despite its limited local extension, rapidly killsthe patient in two or three days. It lias been held that these almost fondroyant cases were to be attrib.uted to a grave infectious myo- carditis. Recently, however, the author has observed three cases of this kind where the autopsy .showed no trace of myocarditis, but a sub- acute nephritis. The author, there- fore, insists upon the importance of systematic examination of the urine from the beginning of diphtheria, even when no symptom points to a renal lesion. The symptoms observed in these cases have bcen very great fre- quency of pulse, a semi-comatose condition, delirium, high fever, and inarked albuminuria. Guided by these cases the author lias been able, in a fourth case, to combat this nephritis in the beginning by the administration of large quantities of alkaline and saline water (Wildungen) for the pur- pose of incrcasing diuresis and reliev- ing the choked-up kid'nevs.-Medical and Sur'gicaI Reporte. Special Selections. MEDICAL TREATMENT OF D!S- EASES OF THE STOMACH.* BY A. JACOBI, M.D. Abnorrnal gastric conditions may depend on incipient pulmonary tuber- culosis (ied. Rec.), peribronchitis, chronic pleurisy (particularly the dia- phragnatic forrn), asthma, and dis- cases of the heart and blood-vessels. These disordiers, then, require treat- ment. Where there are nausea, infla- tion, and sour or bitter taste, irri- gation is iindicatcL To repeat this for -its psychic effect is inadvisable. But to clear the cavity of all the food rennants, one or two washin'gs are not sufficient. The tube should be soft and have a double opening at its lower end. It should be moistened vith warm water. Its use is contra- indicated in acute gastritis, except that caused by poisonous or ferment- ing food, in painful pharyngitis, gas- tric ulcer, a dilated hcart, or ancurism or strictured œsophagus. About 5oo gms. of warm water or warm alkaline water are run in, once or several times. When mucosis separates the ingesta from the absorbing and secreting epithelium, irrigation is indicated. Then chloride of sodium and car- bonates act as solvents. In bad cases of chronic gastritis, solutions of i to 2000 of nitrate of silver are of benefit when preceded by warm water with carbonate of sodium. In an atonic and non-secreting stomach, papayotin is an excellent aid to-digestion. Pan- Ainericu Aedimo-Surgical.Bulletfi.",
         "DOMINION MEDICAL MONTHLY creatin changes starch into dextrin, splits tii) fats, etc.; bu.t in acids it has no) effect, and, therefore, it is useless to put it into an acid stomach. Pep- 'in in water with I-ICi dissolves albu- minates. \\When the stomach docs not secrete it, as in anæemia, scrofuilosis, etc., its use is beneficial. The preparations of bismuth are a gentle and anti-fermentat ive protec- tive to the gastric mucous membrane. The gastric neuralgia of the anamic, hysteric and pregnant are favorably acted on by it. When nitrate of sil- vci- is to be taken, no salt should bc allowed in the food, and -the stonach should be fairly empty. Solutions are better than pills. To an adult one-half to one grain in four ounces rnay be given in table- spoon doses every two hours. For irrigation a few grains of the sil- vcr salt to a pint of water may be employed. Charcoal is of no use when wet. It should be given in wvafers or capsules, and only the carbo-animalis should be used. For atonic stomachs bitters are appropri- ate. The roots of gentian, calumba, quasiia-wood, dandelion, Irish moss and condurango are beneficial. The best of all bitters is nux vomica. Rhubarb in small doses has no ca- thartic effect. It inproves the appe- tite, particularly in rickety children. Motory incompetence may be treated with orexin, spices, massage, internal douches (hot and cold), electricity, etc. Lack of I-ICI results from anoe- mia. defective enervation, atrophy' of glands, cicatrices or tumor. Pepsin is deficient at the qame time. They can be supplied in medicine. Ex- ceqs of acid is more frequent. It may be due to chronic gastritis, ulceration or neurosis. The abuse ot tobacco or alcohol also causes it. Whatever ex- cites gastric secretion -must be avoided. Instead. of aromatics, acid, bicarbon- ate of sodium, etc., give nitrate of sil- ver in solution-i to 3000 or 6ooo in tablespoon doses. In all cases an- tacids are indicated, such as prepared chaik, magnesia, bismuth, etc. Buty- ric acid ought to be neutralized be- fore food is taken.- Magnesia must be given ten minut s before a meal. Round ulcer requires, theoretically, absolute rest. The only food per- missible is sterilized milk, not to be -drunk, but -taken by the teaspoon. The stomach should be kept alkaline. It must not be inflated. The meals should be small but frequent. Opi- ates are good to enforce rest. Irriga- tion ought to be avoided. In the vomiting and neuralgia of neurotic persons these remedies have served best the author: i. Half to one d-op doses of tincture of iodine every one to three hours; 2, arsenious acid in doses of one-fifth to one-third of a mil- ligramme every one to three hours ; and 3, the valeriante of zinc in doses of from 75 to 125 centimeters daily in divided doses. The oxide of zinc is also useful, in six daily doses of from two to five centigrammes each. In vomiting of pregnancy, one drop every hour of wine of ipecac has proved useful. The application of the interrupted current, one pole to the neck and the other to the epigas- trium, is also effective. Constipation may give rise to vomiting, and should be relieved by purgation and rectal irrigation. In piotracted fermenta- tion the character of the food -must be inquired into. The nose and pharynx should be examined. Among the",
         "DOMINION MEDICAL MONTHLY anti-fermentatives used by the author is -ICI. Thirty to forty drops in a quart of water make a good drink. Creosote,, hypermanganate of soda, resorcin, calomel, etc., act very well. In gastric hæmorrhage, neither sound nor irrigate the stomach. Chlo- ride of iron and acetateof lead can do little good. Avoid using alcohol, and even water. Ice internally maydo good by contracting the stomach. Ergot, hypodermically, may be used. Keep the stomach contracted by a heavy ice-bag; the body recumbent ; food, as iced milk, in small quantities. Subnitrate of bismuth is ušeful, and probably will be the only thing toler- ated. Rest for the mind and circula- tion can be obtained by the hypoder- mic use of morphine. The loss of appetite in gastric carcinoma rnay be benefited by nux vomica, calumba,. and particularly condurango. Anomia needs mild iron preparations; consti- pation should be treated with vege- table, and not saline, purgatives ; for pain we may give morphia, but not chloral hydrate ; charcoal or creosote is used for eructations; vomiting is checked by morphine, creosote hydro- chloric acid. To a certain extent the secondary symptoms can be- more than simply treated. Mèthylene blue is efflcacious in many cases; in doses of one-to two drains daily it will. re- li'eve and improve. Tumors are often reduced in size by its use. Prof. Wilson says in cases of typhus ·that a decided difference between the morning and evening temperature can be considered as a favorable sign, even when the evening temperature shows a considerable increase over the morning temperature. THE COOL-BATH TREATMENT OF 'ENTERIO FEVER.* C. STEFNNETrîr REDMOND, L.R.C.P.L Although the cold-bath treatment of typhoid is identiried with Brandt, of Stettin (Britisi Medical journal), it really originated with Dr. Currie, of Liverpool, in 1787. After his dcath, it lapsed until it was revived by Brandt, in 1861. The indications for the bath are a continued tempera- ture of 102° F. to 104 F. for several days, with marked evening rise, and no local lesion, like pneumonia, to account for it. The temperature should be taken half an hour before the bath and regularly every three hours. Whenevër the rectal tempera- turc rises to 102.2° F., the bath should be repeated. In some cases a tepid bath at 87° F. or 90° F. for thirty minutes is better borne ; in others, a bath 66° F. or 78° F. for fifteen minutes. When the temperature no longer rises to 102.2° F., but still remains above normal, a warm or tepid bath for fifteen to thirty minutes night and morning is beneficial and grateful to the patient. The author has compiled from various sources the following code of rules: i. A temperature of 102.2° in the rectum calls for a bath, and it must not, as a r'ule, be permitted to rise higher without giving the bath unless the patient is in a sound sleep, 2. The bath, long enough for the patient to be at full length in, is bro.ught close to the bedside, and the - Amercan Medico-Surgicar Bulletin.",
         "DOMINION MEDICAL MONTHLY patient carefùlly lifted' in, and out in the horizontal posture. 3. Half an ounce or i ounce of old pale brandy in. 2 or 3, ounces of soda or aerated limewater to be given first (in case of adult). 4. The patient always must pass water before being put in the bath. 5. The patient to be immersed up to the neclc ; the head- to be con- sta.ntly sponged ; and the chest and extremities, not abdomen, to be gently rubbed by an attendant. 6. The first bath to be given- at 90 F. or 85°, and cooled down by adding cold water to 75° or 70°. If the patient bears it well, subsequent baths may be given at 8o°, and cooled down to 700. The cold water is poured over the patient's head and chest. 7. Average duration of bath, ten minutes; some say until patient begins to shiver; but if he begins to feel cold, or gets uneasy, the bath must be cut short. Where a patient is nervous or bears the cool baths* badly he must be kept in tepid ones at 87° for fifteen, twenty, or thirty minutes, the more prolonged'immer- sion producing the desired effect. 8. Lift the patient.carefully on to a couple of large, soft bath towels laid over a mackintosh sheet, and rub him dry briskly, except the abdomen, which dry gently, envelop him in a warm blanket, and- put -him in bed, covering lightly, and give him a cup of warm coffee and milk or pepto- nized cocoa and milk. 9. Half an hour after take the temperature, in therectum preferably, when it should be 2° or 3 'lower. 1o. Take the temperature every three hours, and as soon as it again rises to 102.2.° F. repeat the bath, unless he is sleeping, when, as a rule, lie must not be disturbed, even if the temperature rise to 104°, but the bath deferred till lie awakes. i. iUsually a bath is indicateci every six hours. Sometimes, how- ever, during the fastigium the pyrexia is so obstinate and uncontrollable as to call for a bath every three or two hours. 12. During the- night, baths are seldom called for except by an ex- tremely high temperature. 13. In case the bath lowêrs the temperature only 1° or less, or only for a very short interval, it becomes necessary to lower its temperature to 660 (cool bath) or even 45° (cold), and lumps of ice may be put in the bath to cool it down with perfect safety, as was donc in one of my cases. In Strümpell's experience, baths below 730 F. are seldom needed. He regards 80° to 85° F. as the average. 14. If intestinal hæmorrhage occur, baths must be disçontinued. The advantages of the bath treat- nient are : (t) Diminution of fever and calming of the nervous system; (2) Disappearance of headache, stupor and delirium ; (3) Irritability of the gastro-intestinal mucous membrane, more or less relieved with less thirst, vomiting and diarrhœa ; -(4) Irnprove- ment of the pulse; (5) Diminished dehydration of tissue and lessened danger of bed-sores ; (6) Diuretic action on the kidneys; (7) Reduction by 50 per cent. of mortality. The objections to the treatment are: Expense, public prejudice, nervous dread of patients, and increased fre- quency of relapse. The contra-indi- cations are : Peritonitis, perforation, 108",
         "DOMINIO14 MÈÙÏÔdAi MÔNTILY 1 hæmorrhage, and advarnced cardiac weakness. Broadbent does.not think albuminuria or pulmonary complica- tions prohibitive. TREATMENT OF GOUTY HEART.* ). J. MITcHELL BRUCE. The author contributes an exhaus- tive paper on the subject of gouty heart ( The Practiioner), from which we .extract the following pertaining to treatment: Some' of the best results in the treatment of gouty heart have been obtained from the use of recognized mineral waters; but baths.and waters call for the greatest care in the selec- tion of them, and for even greater caution, if possible, in the use: of them. Without judgment on the part of the'doctor at home and :the doctor abroad, such a patient, especi- ally if over 5Q, may be very easily pulled to pieces. The diet -should. be spare .in ' amount, and of an ordinary mixed kind. We have to remembe-, when dealing with the gouty heart, that this great nervo-muscular organ is often nourished insufficiently, as well as poisoned. It is good to order a fair amount of water to be drunk at each meal'; and Vichy water is per- haps the best beverage of all. In many instances, a small, definite quantity of stimulants-such as whiskey, orf a pure red wine-has to be allowed at meal times.; but al white wines and beer must be strictly forbidden. The question of smoking must never be forgotten. To insure * Materia3fedica and Therapeutic8. the best ard speediest resuits, tobacco in every form is best avoided entirely, Some patients plead for one pipe a dy ; but I have known even the last pipe to have to be given up by the gouty old man with a wealk heart before cardiac distress disappeared. Drugs are valuable, if properly selected; uscless or worse than use- less, if prescribed in a routine fashion from the list of cardiac tonics. If ve wish to know what class of medicines does most good in gouty hêèrt, we have but ta ask the sufferel after an experience of a yêar or two. It is remarkable how many of these pa- tients suggest blue pill, or tell us spontaneously that they have found it better than all the other remedies prescribed for them ; other patients praise saline purgatives. Plummer's pill, taken every second night for a fortnight, is highly successful. Next to purgatives, the drugs that give most satisfaction are potassium iodide, arsenic, strychnine, and digi- talis, with its allies. If pain be a prominent feature, iodide should be ordered, in combination with alcalies; ,if faintness, strychnine, varioùsly corn- bined. Arsenic and strychnine make a valuable combination in some in- stances. The use of digitalis demands judgment. Prevalent views about vasomotor angina might at first siglit suggest the opposite class of femedies -those which lower blood-pressure very readily and very rapidly,..parti- cularly the nitrites and nit-ogly- cerine. But we must not forget that the sufferer from gouty heart has no such pulse habitually, no such evidence of cardiac vigor as we associate Wvith high 'tension and as we typically find in sorne tog",
         "DOMINION MEDICAL MONTHLY cases of chronic Bright's disease 1 and that if the tension do sud- denly rise to a dangerous height during the angina, such a paroxysm may be safely regarded as a pheno- menon of weakness, not of genuine strength, of the vasomotor system. The poor puise and the signs of large, feeble heart rather suggest cardio- vascular tonics. It will be well, therefore, as a rule, to order, say, five minims of tincture of digitalis, to be taken with each dose of any of the preceding drugs or combinations that are given. In some of these patients, strophanthus occasionally prove. pe- ,culiarly suitable as a substitute for the older drug. During the anginal seizures we naturally trust to the nitrites and nitroglycerine, which are so powerful and so swift in their action. In more prolonged instances, good results are had with a hypodermic injection, con- sisting of two minims of the B. P. injection of morphine and two minims of the solution of strychnine hydrochlorate-that is, 1-5 and 1-5o of a grain, respectively' of the two drugs. The effect of this combi- eation on a disabled heart is often extremely satisfactory. Whilst a single dose of morpfline given by the physician himself is re- commended in the acute phase of the gouty heart, it is urged to discount- enance the use of sedatives-particu- larly hypnotics-for which the sufferer often craves or has actually acquired a habit. Sulphonal lias lately replaced chloral hydrate in considerable mea- sure as the popular remedy for sleep- lessness. Such drugs do endless mis- chief in the-insomnia of irregular gout if indiscriminately used. IMMUNITY AS ILLUSTRATED BY EXPERMENTS WITH CHOLERA.' Metschnikoff (Ann de l'I'st. Pas- teur, 1894, 'pP. 529-89) discusses the subject of cholera and vibrios in relation 'o immunity and intestinal cholera. * The conclusions reached are of considerable interest and are appended without further reference to the details of his investigations : 1. \" Local imrrlunity cannot be ex- plained by particular conditions which prevent the microbe from liying, for it nay be found beyond the cholera area and in places quite free from it. 2. \"Local immunity cannot be re- garded as an unconscious and per- manent vaccination of the inhabit- ants. 3. \" The blood of persons residing in exempt places does, not protect against Koch's vibrio. 4. \"The injection of cholera cul- tures does not protect. 5. \" The development of the cholera., vibrio is considerably affected when growing in association with other microbes. 6. \"The immunity of animals to intestinal cholera is, in a great measure due to the inhibitory influ- ence of the fora of the gastro-intes- tinal canal on the choleravibrio. 7. \"As long as young rabbits are being suckled they are very sensitive to the cholera vibrio, and this cholera is aided by the action· of certain. microbes. 8. \"Young *guinea-pigs are less. sensitive than young rabbits tò intes- .'inal choiera. *Medical and Suigical Reporter. 110 o",
         "DOMINION MEDICAL MONTHLY 9. \" Young rabbits cannot be vacci- -nated successfully against intestinal cholera, Cither with sterilized or living cultures. 10. \"Young rabbits iaybgoccasion- ally vaccinated successfully by means of the serum of animals vaccinated against choiera peritonitis. Normal horse serum is useless. I i. \" The attempts to prevent cholera by means of microbes have shown that bacteria exist in the alimentary canal inhibitory of the cholera vibrio, but at present the re- sults are inconclusive. 12. uIn the immunity and recep- tivity of man and animals to intestinal cholera, the microbic flora of the ali- mentary canal plays an important part. Reiying on this fact we may readily reconcile the fundamental truth that the vibrio of Koch is the specific cause of cholera with the data -of epidemiology, especially with the influence of places and time on the progress of cholera epidemics.\" THE WARM MILK WET-PACK.-- (Dr. E. Wigglesworth, Boston Medical .and Surgical journal.) Dr. W. B. Sampson writes from Transvaal, South Africa, to call attention to the advan- tages in zymotic diseases, of a wet- pack ; not, however, of water, but of warm milk. An epideinic of typhoid fever, due to the use of milk which had stood in buckets previously washed in water subsequently ascer- tained to be- infected, suggested the idea that, if milk wvould so easily absorb germs from wood, it rnight do the saine from the human body. Experiments in' cases of erysipelas seemed to confirm the truth of this theory, and, accordingly, in an cpi- demic of small-p'ox, galactopathy wvas substituted for hydropathy to reduce fever, prevent pitting and sootle the nervous systern ; perhaps, also, in some degree, to nourish the patient. Thrce blankets were laid upon a mat- tress, and covered by a single sheet saturated with one and a half pints of fresh, warm milk (not boiled). The patient was laid upon the sheet. This was then wound tightly around him, the ends brought over his shoul- ders, and his arms left bare. The blankets were then,one by one, packed over him, and lie restec thus for an hour. This was done once in four hours. After the pack, a warm bath or sponging. Dr. Sampson. mrports that in eighteen cases so treated by him, in the small-pox lazaretto at Kimberley, before the eruption appearei, the disease was aborted, and the patient convalescent in five days. In one case, where the erup- tion had just marifested itself, the milk-pack was used twice as often. The eruption disappeared entirely within twenty-four hours, and in four days the patient was ableto leave his bed. Subsequent experiments in cases of the various infedtive fevers gave good results. The milk-pack was found to lower temperature, stop delirium, procure comfort for the patient, and promote sleep. It is, in its action, gentle, soothing and won- derfully recuperative. It causes no weakening, but increases the patient's flesh and.strength. Tried side by side with -hydropathic wet-sheet packing, the superiority of the milk-pack was manifest. In scarlet fever, measles, typhus, typhoid and even malarial and puerperal fevers, renarkable re-",
         "DOMINION MEDICAL MONTHLY sults were obtained. One case of scarlet fever yielded in thire days. Milk compresses to the throat in diphtheria gave the best results. If this remedy should really prove as efficacious as it is simple, therapeutics has made an advance.-College and Clinical Record. PROFUSE MENSTRUATION.-The Canada Lancet contains an able article on this subject by Dr. Chas. P. Noble, vho, after a thorough discussion, offers the following conclusions: i. Men- orrhagia in young virgins is usually functional, due to disturbances in the vaso-motor nervous system or to re- laxation of the tissues, in general caused by the rapid growth which at times takes place about the time of puberty. Because of its pathology, menorrhagia in young virgins is usually curable by general treatment. 2. Menorrhagia occurring in young child-bearing women is usually due to some mishap in connection with pregnancy or parturition, such as the retention of products of conception, laceration of the cervix or perineum, retro-displacement of the uterus, sub- involution, inflammation of the uterine appendages, and pelvic congestion. Menorrhagia in this class of women is curable. It usually requires local treatment of an operative nature. When due to sub-involution and mal- positions of the womb, operation is unnecessary. 3. Menorrhagia in women ápproaching the forties, and in those vho are older, is usually due to gross diseases, of the uterus, such as fibroid tumors, polypi, adenoma, or malignant -tumors. Menorrhagia oc- curring in this class of women, except when due to advanced malignant dis- ease, is curable, but almost invariably requires operatic trcatment applicable to the disease present in the particu- lar case. '4. As nenorrhagia is a symptoin and not a disease, an exact diagnosis is requisite in every case. With the exception of young virgins, it is desirable that a physical exam- ination of the pelvic organs be promptly made. The importance of this exanination is the greater with the increasing age of the patient. Special considerations should influence the practitioner to postpone the local examination in the unmarried, unless it be reasonably certain from the symptoins that gross local disease is present. 5. There is no treatment for menorrhagia per se. By general meas- ures, such as rest in bed and the use of digitalis, strychnine and ergotine, pelvic congestion can be lessened, and in that way menorrhagia can be, at least in part, controlled ; but it can- not be too strongly insisted upon that in every case of menorrhagia an exact diagnosis must be made, and the appropriate treatment addressed to the disease which is present.-Mfedi- cal and Surgical Reporter. CoUni-I MIXTURE.-Cough inix- turcs should be regarded as a relict-of andient and unscientific methods of practice, and as most·of them do more harm :than good, their emplôypnent should be relegated to well-merited oblivion. Some physicians favor a Turkish bath as a remedy for a bad cold, and in ,exceptional cases this plan works well ; but it is not suited to many, for the reason ,that a bad cold is but the warning sigial that the",
         "DOMINION MEDICAL MONTHLY vitality of the organism has been re- duced, wlhile the susceptibility to dis- case is increased. An able-bodied man accustomed to Turkish baths can stand one of these in case of a cold ; but it is of more importance that the condition of the alimentary canal should receive the sane or like attention. The danger is not all from without ; it is probably greater from the alimentary tract than from the skin, and those vho advocate the use of the bath, to be consistent, should at the same time insist upon the free use of a suitable saline. In the second place, all successful (?) cough mixtures contain nauseants which tend to dis- order the digestion ; but were this effect only temporary, 'no material harm would ensue. These nauseants, however, are now promptly eliminated, and- when the patient would be in a fair way to recover, their insidious influences begin tc manifest them- seives, so that neither the physician nor patient can understand why con- valescence is prolonged. Cough mix- tures are doomed ; eventually they will be damned. In the third, place, cough mixtures contain more or less saccharine substance-usually sugar in the form of syrup, originally incor- porated probably to make a nauseat- ing draught palatable; but it is now well known that the introduction of sugar, into the stomach, when in an unhealthy condition, is most objec- tionable, inasmuch as it starts up fermentation, produces body heat, and even by the wildest stretch of the iniagiriation has no distinctly benefi- cial effect upon the cough. Let us have a new régime for the winter campaign.-Editorial in American Therapist. ADMINISTRATION OV QUININE. -Dr.Patein (Mied. Wcek). At a recent meeting of the Therapeutical Society at Paris, a committee was appointed to investigate as to the best preparation of quinine obtainable, and the form best suited for the preservation and use of this drug. As a result of this inquiry, committee reported the following conclusions,: Solutions of quinine salts should be reserved for the cura- tive treatment of attacks of intermit- tent fever. As a prophylactic remedy., basic hydrochlorate of quinine is less .irritating than the sulphate and more pleasant to take-on account of the ab- sence of the extremely bitter taste characteristic of the latter. The dose can be carefully regulated, and it contains a proportionately larger quantity of quinine than the sulphate. It is easily transported, and keeps perfectly. Hydrobromate of quinine, it seems, ought to be employed parti- cularly for the treatment of obstinate fevers, in which -the hydrochlorate has failed to produce the desired effect. Quinine salts should not be put up in the form of tablets, as repeated ex- amination of saniples from various sources has proved that they are either too brittle or completely in- soluble. After having administered such tablets to rabbits,the investiga- tors found them two hours later tc, be entirely unaffected by the gastric juice. Better results were obtained with gelatin capsules and medicinal pearls, which readily dissolve in slightly acid solutions or in the stomach of a rabbit. The advantage of these preparations is the ease of controlling their composition and their small size. Pills, contrarily to the prevailing opinion, gave",
         "DOMINION MEDICAL MONTIHLY the most prompt and invariable results, even wlcn silver-coated pills, which had been kept for upward of a year, were used. Pills or pearls, containing ifteen centigrani- mes of quinine hydrochlorate, may be administered for prophylactic pur- poses-two daily, in a little water. VICTOR HoRzsLEv's OPINION 0F ELECT1U3IC ELT.-In a lecture de- livered before the London Institution, on \" Truth and Falsehood as to Elec- tric Currents in the Body,\" Professor Horsley said, among other things : l The actual currents in the body are only secondary phenomena accom- panying some other manifestation, and they are indeed so feeble as to require the use of extremely sensitive instruments for their detection. The statement that 'electricity is life' is only one of the numcrous impostures pronulgated for rnaking, money in this connection, for, with, the excep- tion of certain animals, such as the clectric eel and the torpcdo fish,\\vliere the electric currents are necessary to enable the animal to obtain food, currents of clectricity have no primary importance in the life of the animal. There is an immense amount of false- hood in relation to popular ideas as to what is and what is not the legiti- mate use of electricity in medicine. The application of suitable currents, which must possess considerable in- tensity, is legitimate enough for pro- d.ucing contractions and stimula*ting the parts to which they are applied; the-use of galvanic or faradic currents as aids to diagnosis is also sound sciençe. But when it is remembered that the resistance of the skin is ex- tremely xigh, and that a considerable current must be employed to over- come this resistance cre any stimulus cati be established in the body, the whole fabric of the popular delusion upon the subject becomes apparent, and the extraordinary nature of the play upon the popular ignorance by such means as the videly.-advertiscd electric belts is equally evident; and it is this want of lnowledgce which led the public to believe in the horrible impostures that were sold for promo- ting the physiological processes of the body.\"-3nllltin°of Pharmacy. UNCONTROLLABLE VOMITING OF PREGNANc.-Bonnet (British MAed. lour.) relates a case where the patient was twcnty-two, and single. Her first pregnancy went on to term; but, in her second, labor was induced at the fourth month in consequence of hyperemesis. During the early part of the third pregnancy vomiting be- came very severe, lasting a month, and reducing lier to an alarming ex- tent. Wlen just over six weeks preg- nant a laminaria tent vas introduced; on January 14, 1890, the vagina was plugged with iodoform gauze. For twenty-four hours thevom iting ceased. Next day the tent was removed, and the sickness returned. On January 17, two tents were introduced as high as possible. The vomiting again stopped, réturning when the tents were taken out. Then five tents were progressively introduced, and left in place for three days. The sickness stopped and did not return. The uterus showed no signs of contracting throughout the course of the above treatment. The patient took food Wcll and grew stout. Seven and a half months later she was delivered of a healthy child at term.",
         "DOMINION MEDICAL MONTlLY Dominion Medical Monthly. W. BEATvrE NEsurr-r, B.A,, M D., F.C.S.. LON. ASSOCIAT ÈDITORS. J. J. CASSIoW, M.D. * W. A. YoUNG, M.D. A /literary co;nntinica/ions, e.rchanges, and books for review, s/ou/dd be addressed /o /ie DorNN ION M EDICAL MONTIJLî' Edibor, 97 Cofederation Life Buiiding, Toronto. Address al busizess comnntuniations Io lte Piiblis/ters, 'rE MEDICAL PUnLISHING Co., oF TORONTO, Roonts 97, 98, 99 Confederation Lie Building, Toronto, Canada. TORONTO, APRIL, 1895. CORONERS. We are glad to see that other medical journals are following our lead in this' matter, and we should like to have the hearty co-operation of all the journals in remedying what is at present a very bad condition of affairs. Tihere has been 'rmuch feeling aroused lately in the apportionment of the various inquests. There are two vievs to be taken of this matter. The first view is that, as the present. law stands for the appointment of coroners and the regulation of, their duties under the law, one doroner is as good as another, so that the medi- cal man acting as coroner in a certain district, whoconsiders that he should have the conduct of given inquests, bas a perfect right, both morally and legally, to feel aggrieved when he is over-ridden by officers of the Crowvn (rom which he hinself holds his appointmet. The other phase of the question is, as we pointed out before, the public interest, and there is no doubt, as tic coroner holds not only an investigating, but a judicial position in relation to inquests, that tic more experience a man has in this peculiar class of work, the more thoroughly he is acquainted vith crininalogy, the more thoroughly he is posted in all forms of' procedure, the better vill public interest be served. This matter comes up at the present time in connection with the statements we have heard regard- ing the number of inquests conducted: by Arthur Jukes Johnston; notably, the Hyams and Dicks inquests, and also the fire inquest. Now it is un- doubtedly apparent that in these cases the interest of the public will be better served by a gentleman of Dr. Johnston's skill and experience than by anyone else that could be mentioned in the city, and we say this with perfect knowledge that the staternent cannot for a moment reflect upon the personal qualifica- tions or attainments of any of the other- medical men in this city. From. ail this it is apparent that something rnust be done in the matter, and we would suggest that the citV could be divided up into districts, each under the charge of one man, with some gentleman as a presiding coroner over the whole city, the duties and remulieration of all being fixed. This plan might like- wise be extended to other cities and counties in the Province.",
         "DOMINION MEDICAL MONTHLY PROVINCIAL BOARD OF HEALTH. A special meeting of this Board was held at Dr. Bryce's office on March 11th. The following members were present: Dr. Cassidy in the chair, Dr. Rae, Dr. Kitchen, and Dr. Bryce, secretary. The object of the meeting was to receive reports from the Legislativé Committee and from a special cômmittee appointed to investigate à charge respecting the feeding of putrid animal refuse to hogs and fowls. The Board considered these reports in committee and adopted them. The recommendations of these committees are inco\"porated in an amendment to the Ontario Health Act. (Vide p. 102.) It was moved by Dr. Rae, seconded by Dr. Kitchen, and carried, that the Government be asked to increase the salary of Mr. Mackenzie, anaiyst of the Board, owing to the perilous nature of the work he has to do in examining diphtheritic membrane and tubercular sputa. The report of Dr. Hodgetts, re- specting small-pox in the township of Malahide, was read. There were seven cases and two deaths. His bill fôr services in Malahide and other places, $302.75, was ordered to be paid on motion of Dr. Kitchen, seconded by Dr. Bryce. The B rd then adjourned. March 27th.-Mr. Haycock's bill to destroy the Ontario Medical Act was given the six months' hoist by a vote of 15 to 71, the Patrons as body voting for it. The old parties voted together against it. Mr. Hay- cock nay know something about- farming, but it is difficult to conceive- what he can have learned about the- rules regulating the conduct and behavior of medical men towards the public and their fellows, as well as the best means of keeping up the- standard of medical education, unless \"he knows it all.\" As a vitty con- temporary said recently, \"-the man who knows it all would not be such a bad fellow if he only kept it to- himself.\" The leader of the Patrons,. however, having begun to attack legislation in which he had no busi- ness to interfere, it was only right that the recognized political parties. in the Province should unite to crush him. The Haycock bill, however, bears prima facie evidence that it was not entirely the production of the bucolic legislator. Thë introducer of the bill was, if we may be pardoned the- simile, the haycock behind which certain free-traders in medicine, and nedial sore heads, et -hoc genus omne, concealed their personalities tyhile launching their envenomed darts at the Ontario Medical Council. A cunning attempt was made to. make the bill- inure to the advantage of the Go nment, and certain fea- tures of the bill appear to have com- mended-thenselvcs to the favorable- o.pinion of the Premier; but that gentleman,,.in speaking to the ques- tion, st.ated that the whole case for the bill had broken down. \"Theie- ivas no ground at al] for a revolution- ary proposal, -no pretence that the powers-given to-the medical profession had been abused, or that anyone had been unfairly dealt w * There was nothing to justify the louse in sup-",
         "DOMINION MEDICAL MONTHLY porting the bill, and he would, there- fore, vote for the amendment.\" Mr. Whitney, representing the Co'nservative party, ably supported the position taken by the Attorney- General. \"'In his opinion the bill should be thrown out of the House without ceremony, and there had been times when bills like that had been destroyed by the common hang- man.\" Section 16 of this precious bill was rather niediæval in its tendency. It provided that midwives who had attended ten cases of confinement should be allowed to legally practise midwifery upon payment of a fee of SI to the treasurer of the municipality, that such midwives would not be liable to a fine for giving professional services, and would be entitled to recover fees for services rendered. The leader of the Patrons should have introduced another clause to the e'ffect that, in case an action for damages should be brought against a registered inidwife for any injury caused through her :ignorance, negli- gence or want of skill, the Board of Patrons would be held responsible for and would pay the order for damages granted by the Court. Book Notices; Twentieth Century Practice. An In- :ternational Encyçlopædia of Mod- ern Medical Science. 1-y leading authorities of Europe-anAd 'n-erica. Edited by THoMAS L. STÈDMAN, M.D., New York City. In twenty volumes. Vol. Il. Nutritive Dis- orders. New York: William Wood \u0026Co. 1895.. The second volume of this unique work Qpens with an article on \"Ad- dison's Disease and Other Diseases of the Adrenal Bodies,\" by Sir Dyce Duckworth, of London. The second article, on \" Diabetes Mellitus,\" is from the pen of Professor von Noor- den, of Frankfort, whose studies in i.netabolism have justly attracted so much attention both in this country and in Europe. Contrary to what we might expect in a t-eatise written by a German physiologist and path- ologist, this article is intensely prac- tical, sixty pages of the 150 being: devoted to the subject of treatment.. Following this is an exceedingIy' interesting article on \" Rheumatism,\" by Dr. T. J. Maclagan, of London,. the originator of the salicyl treatment of this disease. The next article is. one on \" Gout,\" by Dr. Henry M..' Lyman, of Chicago, the only Amerf- can writer in this volume-and he has made a worthy contribution to American medical literature. It %is not too much to say that the article is one of the mcst thorough and com- prehensive treatises on gout that has ever been written. \" Arthritis De- formans \" is the title of the- next article, which is from the pen of Dr. A. E. Garrod, a son and worthy pupil of Sir Alfred Garrod. The sixth article- of the volume is-one on \" Diseases of the Muscles,\" by Dr. Dujardin-Beau- metz, of Paris. The closing treatise of the volume is one on \" Obesity,\u003e\" by Professor Oertel, of Munich; \"Oertel's\" is knowvn as one of tfie most successful methods of treating obesity, and the profession is to be congratulatèd on having a descrip- tion of this method and an explana- tion of.its rationale from the hand of the inventôr himself. Finally, all this mass of material -is made available to",
         "DOMINION MEDICAL MONTHLŸ the reader by an excellent index in addition to the ordinary table of con- tents. T/te Ceentuîy Cyc/opcvdia of Naies. A, Pronouncing and Etymological Dictionary of Names, in Geography, Biography, Mythology, History, Art, Ethnology, Archæology, Fic- tion, etc., etc. Edited by BENJAMIN E. SMITH, M.A., Managing Editor ,of the Century Dictionary, assisted by a number of eminent specialists. Published by the Century Co., New York. This is certainly the-most complete book of reference ever published, and is a perfect mine of information on all subjects which are not to be found in urdinary encyclopædias or diction- -aries. It combines in itself complete 'Classical, Mythological, Art, Histori- .cal and Bibliographical Dictionaries-; ·Gazetteers of Geography, Biography, and a Dictionary of dates-in fact, all' the varicus information that a literary man requires, or a general teadei wants, to verify or correct the -numberless references to little-known ,or obscure allusions and phrases they meet with in their reading. It is so arranged that every name can be easily found, and the information it contains is exact, condensed and com- prehensive. No-work has ever been published that is as valuable as this -Cyclopædia is in its special line,.and it will certainly occupy the first rank .as -a book of reference. Its conveni- .ence in bringing into one volume all the information contained, in.number- less handbooks, Biographical, Geo- graphical and Classic Dictionaries, -renders it indispensable to all who wish their reading to be ofeducational. value. It is a work that should be in every library in the land-in fact, no library can be considered complete without a copy of this valuable workc Messrs. McAinsh \u0026 Kilgour, Ço- federation Lifc Building, are the Can- adian agents for this work. A Manual of Bazdaging. Adapted for self-instruction. By C. H ENRI LEONARD, A.M., M.D., Professor of the Medical and Surgical Diseases of Women and Clinical-Gynæcology in the Detroit College of Medicine. Sixth editicin, with 139 engravings. Cloth, octavo, 1 89 pages. Price, $1.o. The Illustrated Medical Journal Co., Publishers, Detroit, Mich. The main feature for commenda- tion of this book over othcr similar works is that each illustration shows the direction of the various turns of the bandage with arrow-heads, and each turn is properly.numbered,; this renders fhe book a self-instructor to the reader of it, who has but to put the. various bandages about the limbs of an office-companion.a few times, when the \" trick \" of its application upon a patient has been learned. It takes the place, in this way, of hospi- tal drill. Besides the \" Roller Band- ages,\" the various Ts \"Cravats,\" Slings,\" \" Tailed,\" \" Adhcsive\" and \"Plaster\" bandagesand \" Immovable Dressings\" are given. The book is divided into sections treating of \" The Bandages of the Head,\"of\"The Body,\" of \" The Upper Extremity,\" of \" The Lower Extremity,\" ' Knt.ts,\" \" Strap- pings,\" \" Compresses\" and,\".P.oultices\" with full description of making and applying the same. There is an illus- tration for nearly every bandage de- scribed. It has.been recommended-as a text-book in various medical. colleges",
         "DOMINION MEDICAL MONTFILY and hospitals in this country, and has had two editions sold abroad. A medical student could profitablyspend his vacation evenings in mastering the application of bandages by using this book as a guide;· and to a prac- titioner it would not come amniss. Funny Bone, a bodk of ïi-irth, foi doctors, druggists, dentists, medi- cal students and others, çontaining funny sayings, jokes, good stories, dialogues, conundrums, ludicrous things, ditties, etc, etc., from a great many sources, with over 150 new and original. comiç ilhistra- tions. By Dr. L. Ciuslus, Ph.G. All of which pertain to the medi- cal and pharmaceutical ptofessions. The Funny Bone Publishing Co., publishers, 1421 Market Street, St. Louis, Mo. Mailed upon receipt of price, 50 cents. We heartily recommend this most amusing book to our confreres in the profession. It is brirnful of what is of most interest to physicians. The * Year-Book of Treatment for 1895. A comprehensive and critical review for practitioners of medicine .and surgery. In one izmo volume of 501 pages. Cloth, $T.5o. Philadelphia: Lea Brothers \u0026 Co. 1895. The eleventh consecutive issue of this.annual summary of medical pro- gress vill interest the wide .circle of readers -who have learned its substan- tial value. To have the real advances in treatment in all departments of medical practice culled by recognized specialists from the immense mass of medical literature, and presented with critical remarks in a classified form for immediate use, is assuredly a help towards success which busy practitioners will not neglect, and which other practitioners will consult for the soundest of business reasons. The reader interested in a special subject can quickly post himself on whatever is new and good in treat- ment by a perusal of the chapter devoted to it, and the general prac- titioner can with facility turn to any topic by a glance at the index. Those desiring to read up the literature of any subject can find no more con- venient guide than the selected list of new books, new editions and trans- lations. .The volume is exceedingly cheap in proportion to intrinsic value and serviceableness. The Treatment of Wounds, Ulcers and A bscesses. By W. WATSON CHEYNE, M.B., F.R.S., F.R.C.S., Professor of Surgery in King's Col- lege, London. In one 12mo vol- urne. of 207 pages. Cloth, $1.2 Philadelphia: Lea Brothers \u0026 Co. 1895. This little work owes its brevity and its widespread usefulness to the fact thàt it is devoted wholly to the treatment of affections which, though nominally surgical, are yet s com- mon as to form part of the daily woik of every practitioner. Antiseptic methods have revolutionized surgical procedures and have added vastly to their successes. Moreover by throw- ing light upon formerly unexplained failures they have increased not only the knowledge, but also the confi-- dence of the surgeon, an element which.must be recognized as having an important influence upon results. Professor Cheyne .has long been known as one of the foremost of London surgeons, and as a critical student of antiseptic procedures in their practical bearings. In this vol- ng19",
         "DOMINION - MEDICAL MONTHLY urne he has'described the methods of treatment which he employs and which lie knows \"to be efficient and to be the simplest consistent with certainty in iesults.\" Index ofiMediciie. By SEYMOURTAY- LOR, M.D., Member Royal College of Physicians, Senior Assistant Physician to· the West London Hospital. In one large 12mo vol- urne of Soi pages, with 35 engrav- ings. Cloth, $3.75. Philadelphia: Lea Brdthers \u0026 Co. The author has prepared a work of great value alike to physicians and students. In a certain sense the name \"Index \" is a misnomer, for the vol- ume is in fact a concise \" Practice of Medicine,\" the diseases being grouped systematically in order to secure for the reader the many advantages re- sulting from rational arrangement. After valuable chapters on \" Disease,.\" \"General Pathology,\" \"General Dis- eases,\" \" Speciflc Infectious Diseases\" and \"Specific Fevers,\" the various organs and systems of the body are considered, and the cause, symptcms, pathology, treatment and piognosis of each affection are succinctly stated. Numerous illstrations, together with tabuhtions of differential diagnosis, tests, etc., elucidate the text and con- dense a great amount of necessary knoxledge in the clearest manner. The work is one which merits and will doubtless obtain a wide popu- larity. Personal. $3,000 practice and village property in western Ontario for disposai. No opposition. Address; A. A McDuff, St. Thomas, Ont., THE PROLONGED BATH.-Modern Medicine says that a patient in the St. Louis Hospital was recently kept im- mersed in a bath tub for six weeks, for the cure of a large sloughing ab- scess, a current of water being con- * stantly passed through the tub. The writer has, within the last twenty years,,treated many cases of gangrene, crushed limbs, sloughing sores, etc., by this method, and has found better results than by any other. Its suc- cess is due to the asepsis secured by the constant immersion. The pres- ence of a large quantity of water is not favorable to the development of pus-forming germs, so that suppura- tion is lessened, and at the same time the poisons resulting from the action of the disease germs are washed away. These poisons, when left in contact witli the tissues, paralyze the living cells and destroy them, thus hinder- ing the -reparative efforts ; but by the constant cleansing effected by contact of water kept pure by frequent re- newal, the tissues are protected from the toxic influence of these poisons, and healthful repair is thus promoted. While in Vienna some twelve years ago, the writer found patients living in tubs of water, who had been im- mersed. for periods varying from six months to a year or more. The cells of the body are accustomed to con- tact with moisture; in this respect they may even be compared to aquatic animais,. The blood celils are carried by a current of watery fluid, and the tissue cells are all con- stantly bathed in this fluid, so that the contact of water with the living tissues is a condition closely analo- gous to that which is Paturally main- tained within the body.--Food. 1o0"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICA L \u0026 SURGICA LJOURNAL GIrigjina1 \u0026ommtmuications. MEDICAL FACULTY OF McGILL COLLEGE. LECTURE BY, DR. GEORGE Ross, BIEFORE THE FACULTY ON TIIE OPENING OF THE SEssioN. GEN'TLE\u003eIED,-The introductory Iecturer of Westminster lNpita lst-year-very trutifuiiy remarked that he was sure both speaker and students would much prefer a day's shoot- ing to either giving or hearing an introductory lecture. This year the lot lias unfortunately fallen upon me to perform that duty, and I cannot say that I have accepted the honor with feelings of unmixed gratitude, but must endeavour to acconplish the task as best I may. To those of you who are here for the first time as students of this University it is my pleasant privi- lege to offer, on, the part of this Faculty, a hearty welcome. To liose who'having been, are returning here once more, wi beg to say that we are glad to sec you all, and trust you come filled with the determination to continue the prosecution of your studies with renewed zeal and interest. We do not for a moment suppose that the long vacation since last session has been to you simply a continued rest or interlude from study. On the con- trary, we would believe that much of it has been spent in fur- thering yoùr enquiries, and extending your knowledge of the subjects entered upon during the earlier portion of your curri- Cuuni. Some oF you, indeed, we know have devoted much of 13",
         "194 CANADA NEDICAL AND SURGICAL JOURNAL. this time to following the practical courses originated this year for the first time in our University in the forn of a summer session. And here I will remark that the institution of this summer session for practical courses and special series of dem- onstrations, was felt by the Faculty as imperatively called for and I feel that the appreciation accorded it, as shown by the unexpectedly large attendance, proves that its introduction bas filled a want which was beginning to be felt. The number of subjects included in the study of medicine, bas been for some years back steadily increasing. The standard of proficiency demanded in any of them bas also been continuously raised. Now, the effect of ail this lias naturally been- to magnify to a large extent the amount of technical knowledge it is absolutely necessary to obtain in order to pass the required examinations To accomplish this necessitates the employment of much time in purely didactic teaching, with lectures and weekly examina- tions ; and thus against his will, the student finds himself to some extent obliged to give ail his energies to the attendance on theseïd the mastering-of-their subjectniatter to the exclusion of other more practical and therefore more interesting and ulti- mately instructive and truly educational subjects-those I mean in which lie himself is the actual observer, receiving his know- ledge directly from the application of his own senses, such as practical physiology, practical chemistry, practical clinical work, ophthalmology, \u0026c. The time of the student now during the winter session, is every moment so occupied by the acquirement of -what lie soon will need for the satisfaction of the examiners that bwhat does not immediately bear on this is only too apt to be relegated to a later season, and then perbaps come ultimately never at all. And it is well to remember that science begins with the careful observation of facts, and ends with the system- atic statement of what is observed, and this is the order and the way in which the student is most likely to be allured into studious habits and into a scientific frame of mind. Gentlemen it does not require that I should. expand into any panegyric upon the profession of medicine. Your presence here to-day of itself, is proof sufficient that you deem that noble profession one worthy",
         "INrROoUCTORY ADDRES-BY DR. ROSS. to reccive the devotion of your life. You are not indeed mis- taken ; the profession of medicine affords to its votaries-those at any rate who are true and faithful to.her teachings-a sure reward for all the toil and trouble they may take to enquire into her mysteries. It is in its essence a combination of science and of art. The science, like all science, is illimitable, and lays under contribution all truc kriowledge in whatever department it may have come to iight. The art is continuously progressive, always improving and endeavouring to furnish the means of keeping pace with the scientific requirements. Here then, surely is a field large enough to satisfy the most ambitious for the employment of bis talents and thé occupation of bis time. And then consider the subject matter. Wbat is it that thus engages the attention of so many master-minds of every community who are always found enrolled within our ranks ? Nothing less than the study of man himself-man in all bis relations, social, moral and intellectual-as well as purely physical. It is the study of the development of that noblest work of God-who iwas actually made in the image of bis Creator--of bis development traced from the microscopie maternal ovum td the perfect creature in all his pride of physical perfection and towering mental superiority. It is the study of the beauty, uniformity, ingenuity, and marvel- lous applicability to intelligent purpose of every separate portion of bis wonderful frame. It is the minute examination by eunning meehanical contrivances into the very minutest recesses of every atom of every structure of which these parts are composed. The study of the, chomical composition of all these varied tissues and fldids, the study of the changes taking place in this complex body as long as what we call life endures-the laws which govern changes and control function, and ultimate in causing death; and-after death the study of the appearances caused by prema- turely pervered vital laws or found as a result of the great and universal law of finality. This constitutes the study of medicine proper, based upon a due understanding of anatomy, physiology and chemistry. Did the world so exist that simply Men and women were born, lived and died with constitutions perfect and minds and bodies obeying always the healthy laws 195",
         "CANADA MEDICAL AND SURGICAL JOURNAL of Nature, the end being simply brought about by a gradual change in the structures and organs of the body,-such as what we call old age-I say if this were the case, then would there iever have arisen the necessity for medicine or. physicians. But this is not so, and never will be. If it were, the studies of physiology and anatomy would then be followed simply for the obtention of knowledge and truth, and not with the view, as now, of making suci knowledge subserve an ulterior purpose towards our race. In the earliest records of the human race we find evidences that disease, with all the pain and suffering it entails, was not unknown. Besides, therefore, studying as mere ýdilettanti the mysterions workings of the human body through simple thirst for knowing, it is a matter of the most vital impor- tance to all mankind to have these mysteries understood and explained. The existence, then, of disease has led to the development of a system of therapeuties, or means of cure, niedicinal or otherwise,-and to accomplish this we further require our armamentum, or Materia Medica, which furnishes .1s wi th the necessary means for the c-omplishment of that end. You should never forget that the chief end and aim of medicine is to cure and to relieve. Lamartine bas well said: La médicine guérit quelquefois, soulage souvent, console tou- jours.\" Depend upon it, the public will never tolerate us or pay us fees merely to stand by the bedside of those they love as mere scientific observers, or a sort of Greek chorus, for although there be times -when the highest wisdom is to hold our Siand lest we rudely quench the struggling spark of life, it far anore often happens that we can do much either to cure or relieve pain. But to do so we must learn alil we eau, and must ever be learning. Again, \" Prevention is better than cure.\" That trite and vell-worn adage is undoubtedly to be the coming watchword of the medical profession. You will at once per- ceive that I refer to sanitary science. It is not new. The «ode given by Moses contains admirable sanitary directions. But sanitation, i.e. the endeavor to preserve health so that we shall not have disease to cure, long fell into disregard. Of late years, however, we ail know what energy has been applied 196",
         "INTROLUCTORY ADDREES.-Y DR. ROSS. towards this most useful of all the useful branches of medicine. It is necessarily to medicine that the people must look to be taught the means for carrying out this desirable olject. Medi- cal men know more of diseases than other people do ; they not only know much about the remedies that have to be employed, but they of necessity know nuch about the ways in which they may be prevented. A re they not tien bound to use their knowledge for the good of imankind ? Aro they nut bound to make that knowledge as perfect as thev can ? Sir William Jenner, in a recent utterance, said: \"No one acquainted with the present state of the science and art of medicine will for a moment question that to prevent disease is its first and most important ain.\" And likewise Sir William Gull \" It is enough fbr us that diseases prevail to stimulate our best efforts for their prevention, without our asking a question beyond.\" Besides, think for a moment what has already been accomplished in this way. Look at the discovery of vaccination, the preventive of small-pox, the most terrible and fatal plague that ever appeared on the face of the earth. Ignorance and prejuJice still exist against the reception of this inestimable boon-notably in this unhappy city of our own. But liglit must surely con- somle day to the darkened minds of the dupes of the Coderre school. A year ago the GDrman Parliament passed a law making vace:- nation and re-vaccination compulsory throughout the empire. Let us hope that ibis will give us soon the unexampled spectacle of an entire country freed from this horrid pestilence by the wisdom and, foresight of their rulers guided by the teachigs of sanitary scicnce. The day will sbortly come wben every one of you whom I now address will be in a position to belp in procuring the passage of a similar law in this country, and it will-be your duty to do so-a duty you owe to the memory of Jenner. Again, think what the science of preventive medicir.e has donc for scurvy, that decimator of the armies and navies of the world. It is virtually gene. Typhus fever bas also alnost disappeared, and wc have a right to hope the day is not far dis- tant when enteric fever will share the sarne fate. This faculty do not include this branch amongst those compulsory to the",
         "198 CANADA MEDICAL AN) SURGICAL ýOURNAL. student, and in doing this we have the support of the practice followed by nearly all the British universities. It is well that this fact should be stated, because a recent attempt has been made to discredit our curriculum on that account. The ulti- mate end of your study is to obtain a well grounded knowledge of the three great divisions of medicail science and art- Medicine, Surgery and Midwifery. They constitute the triple structure upon which you are to build, and it is.to be erected en a triple foundation. Anatomy, Physiology and Chemistry are the three corner-stones on which the erection is to be bascd. Materia Medica, Medical Jurisprudence and Hlygiene are, in effect, based on and compouiided of other sciences. Could you but have presented to you at once all the details of the work upon which you are about to engage it would indeed appear huge, colossal, impossible of attainment. Fortunately, you cannot thus grasp at once the entire range -of subjects which you will have to traverse. But separate portions being successively laid before you, you will be able to seize them one by one, and finally end by possessing more than at first your most sanguine hopes would have induced you to antici- pate. Timber to timber, stone to stone, and brick to brick, must be gradually, with toil and patience, put together-the entire structure of your knowledge. Do not, then, allow your selves to become faint-bearted at the load of labor that presents itself to view, but only let its contemplation make you more earnest and determined to make good use of every moment at your dispoal. I do believe that you need but little urging to work. But there are different ways of doing this work as every other. Donc in one way the energies will be found to have been frittered and wasted and the result to be comparatively small, whilst carried on after a different method a much greater result will surely be achieved by a similar expenditure of force. Work applied to scientific pursuits differs much from that in letters pure. It has been well said that Il learning and know- ledge in science, as in life, are distinct: whereas in the world of letters learning and knowledge are one.\" Ln medicine you will quickly find that your books and your teachers are guides",
         "INTRODUCToRY ADDRESS.-BY DR. ROSS. 199 only ; you cannot depend on them exclusively. New problems in discase, caused by a never-ceasing change in the circum- stances acting on the organism will speedily necessitate your judging for yourselves. The best teaching you can have is that which lcads you to educate your reasoning powers instead of stultifying them by artificial tricksiof memory, or other simi- lar devices, which leave in the mind a verbal existence only instead of establishing therein some definite image. A recent periodical thus clcarly puts this point: \"A good or bac memory is a good or bad understanding. The faculty of recol, lection, or the power of recalling a piece of knowledge when it happens to be wanted; is chiefly a matter of metlocl.\" It is use- less throwing detached facts into the mind like loose pebbles into the sea. That is the way to lose them. Each point must be studied in detail, and when this is donc a host of subsidiary facts and conditions will be discovered connecting it to other facts of memory with which it should be habitually associated. These secondary qualities and properties forn the strings of thouglit by which Nature has ordained that the lessons she teaches shall be recollected. Artificial memories are miserable -substitutes for the natural connecting links of knowledge thus provided. If, instead of wasting precious time and equally precious brain-power driving things into his memory, the stu- dent will devote an equal amount of energy to the full and exact comprehension of his work-for example, the facts and circumstances that determine the number, shape, and direction of the ridges on a bone, or the foramina by which it is per- f'rated, the course and relations of an artery, the number and distribution of the branches it gives off-lie will not only have the subject fixed more permanently, but lie will acquire so much collateral information in this natural process of study, that presently he will find himself naking unexpected progress. In short, it is good policy to leave the contingency of remem- hering al.one, and to concentrate the whole attention on the preàent duty of learning with the warning consciousness that nothing is \"really learnt which is not thoroughly understood.\" Medicine is advancing daily, and in such advance \"the ultimate",
         "200 CANADA MEDICAL AID SURGICAL JOURNAL. court of appeal is observation and experiment, and not authority,\" and the sooner you educate yourselves to observe, clearly and carefully, and to draw correct inferences from your obser- vations, the more self-reliant you-will become, the less liable to be turned hither and thitherby every new-fangled idea in medical doctrines, and tlie less servile a follower of some dominant thcory or captivating teacher. \" L'homme,\" says Paschal, \" est visible- ment fait pour penser ; c'est toute sa diguité, et tout son merite, et tout son devoir est de penser comme il fa ut.\" Thus the more the didactic lecture system is supplanted by the constant con- current employment of practical demonstrations and investiga- tions in which the student himself is the active worker, the more truc to its real purpose will the teachings be. To enlarge this sphere of education is the tendency of ail progressive establish- ments for the instruction of students of medicine. In thlis College a large field is opened out to you by the ample oppor- tunities afforded in a carefully-conductcd dissecting-room-a laboratory for practical chemistry-courses of practical micros copy, and a large hospital,.where clinical work is much insisted upon. And here I would like to express a hope that before long our student may also be found in possession of an efficient physiological laboratory, an object which the present require- ments of a complote medical education absolutely demand. Indeed it is not too much to expect that the Introductory of next session shall contain an allusion to this addition as a then accomplished fact. Your aim then should not be to learn ser- vilely for the mere purpose of knowing so much, but to learn so that you nay be by so mucih the better educated. Even so, the absolute handiwork of your profession must never bmpeglected. The habit must be acquired of being able to use your hands and to use them well. Without this, when brought face to face with actual disease or accident, all your knowledge is in vain. A surgeon once pithily said of one of his dressers, \"Ie has learnt everything ; lie can do nothing.\" He alone is learned who reduces his learning to practice, and practical skill without learning degrades our profession to the level of the days of barber- surgery and meival medicine. I need hardly say that it is only",
         "INTRODUCTORY ADDRES.--BY DR. ROSS 201 in hospitals that a student can acquire this manual dexterity. Frequence and regularity in attendance at the hospitals cannot be too nuch insisted upon. Care, attention, and application to the work going on there cannot be too mucli commended. It is often quite possible to forecast the probable future success as practitioners of medicine of the indi-vidual members of any class by an observation of.their daily conduct in these respects. Trousseau calls the clinique the cope-stone of medical study. I do not consider that I detract in any way fron the r.elative im- portance of any of the other branches, if I permit myself to add a few more words to you on the subject of clinical study, in which I am myself moi-e immediately engaged. Freguent practice in hospital wards, we have said is absolutely essential for abtaining familiarity with surgical manipulations. So, also similar. though different, practice is equally essential for acquir- ing the ability to istitute a practical diagnosis. The first requirement for an accurate diagnosis is to learn to recognize- morbid signs. This is what vou have to learn to be able to do, and it is practice alone, the constant exorcise of one's own individual faculties, his sense of sight and hearing and touch and smell, which will ever make him proficient in the art. To be able to recognize morbid signs von must accustom yourself to be about and amongst sick people, constantly examining, en- quiring and observing. Book learning alone can never suffice to enable you practically to interrogate patients, to know and appreciate healthy and morbid physical signs and sounds- to handle and inteiligently use our aids in physical examinations, the s'tthoscope, ophthalmoscope, thermometer and laryngoscope, to estimate peculiarities, mental and physical, of various indivi-- duals; to ascertain the truc action and therapeutical value of various drugs, to be familiar with the pathological appearances presented by the human fraine diseased. All these and a thou- sand other things can be acquired by experience alone, and te enabie a student to obtain this experience he must frequent his hopital and must study medicine clinically. \" When you are Young,\" said the great Trousseau, \"let your fields be the hos- pitals and the clinics, and when your knowledge lias increased",
         ",:j CANADA MEDICAL AND SURGICAL JOURNAL. let the hospitals and clinica still be your fields of industry. By pursuing this plan you will attain expertness in your art, know- ing what science teaches and baving the power within yoursel. res of originating.\" In former days didactic teaching had not been systematized, experimental investigations, morbid anatomy and reasoning therefron were hardly dreamt of, but observation alone was trusted to obtain a stock of medical lore. To illustrate -which, and to contrast with the education of the present day, I may quote for you the following passage from a book more than 200 years old, entitled \" The Accomplisht Physician, the honest Apothecary and the Skilful Chirurgeon.\" It says: \"First, it's most necessarily requisite our young student should be perfectly instructed in the Latin and Greek tongues, being the universat keys to unlock all those arts and sciences, and no less a grace tio the future physician. Secondly, being thus qualified for a student, he ought to apply himself close to the study of philoso- phy, for wbich Oxford and Cambridge may justly challenge a pre-eminence over other Universities. But because, according to the first master, Hippocrates, art is long and life is short, lie *ought to ingage bis diligence, to absolve bis philosophical course in two years at least, and in the interim, for his recreations and 'divertisements, enter himself scholar to the gardner of the physie garden, to be acquainted with the fietures of plants, but parti- cularly with those that are familiarly prescribed by practitioners to prevent being outwitted by the herb-w'omen in the markets, and to enable him to give a better answer than it is'storied once a physician did who having prescribed maiden hair in his bill, the apothccary asked bim which kind lie meant. T'other replied, \" some of the locks of a virgin.\" Thirdly, Supposing our student to bave made a sufficient progress in philosophy, he may now pass to Leyden, and enter himself into a Collegium Anatomicum. A proficiency in that part fits him for a Collegium Medigium Institutionum, and afterwards a Collegium Practicumi, and then it's requisite he should embrace the opportunity of ,visiting the sick in the hospital twice a week with the Physiec Professor, where he shall hear him examine those patients with ,all the exactness imaginable, and point at every disease and its",
         "INTRODUCTORY ADDREs5.-B3Y DR. RoSS. . 203 ,symptons as it were with his finger, and afterwards propose several cases upon those distempers,dcemanding from every young student his opinion and bis grounds and reasons for it, withai requiring of hia' what course of physie ought to be prescribed.\" He then advises the student to live a year with an apothecary to karn compounding, to sojourn another year with a chirurgeon, so as to see hin dress his patient's wounds, and thus to acquire that art aiso. He must thon visit Paris, Boulogne, Montpelier and Roma, and sec the practice of the great physicians there; by which, he remarks, one will be raisec far above those vulgar ones who have never felt the cold beyond the chinneys of their homes. Of this travellerd and accomplished physician it is finally observed: \" The vulgar will then be able to discern the difference between hia and the ordinary churchyard physicians, who by their sordid deports and dangerous practices make it their business to case the blind people of the weight in their pockets, and plunge them into worse diseases.\" Now, gentle- Ien, I think, I have spoken enougi about work, let me say a word about its lawful opposite--rest. You, above all others, should remeaber that brain-work as well as all kinds of physical work or minual labor requires for its accomplishment destruction of niatter. The one therefore no more than the'other, can bo continousi-the attempt to make it so, or nearly so, must surely and inevitably lead to failure. Do not then fail into this error. Regulate your hours of study, so that thcy shall not interfere with a rational amount of suitable exorcise and needed repose. Regularity and steadiness at your work will always enable you to do this. The arrangements of the curriculum may appear to you in anny respects unreasonable. They are not perfect. But blar in mid that th1e parts which seea to you to be faulty h1a.ve objects which you nay not nov pereoive. Patiently endeavour to make the most of what appear to you its useless 'provisions. Your patience wil! often be tried by having to listen to what seems .out-of-place accounts of departments of knowledge as yet Ilite unfamiliar. Da not \" cut \" lectures because you de net see their value. Endeavor to attend them regularly and to carry away as mch as you can, and you will find your sub-",
         "204 CANADA MEDICAL AND SUROICAL JOURNAL. sequent work in other subjects as well as in that department rendered easier. There are two kinds of students who are apt to suffer from overwork-one is. the extra-diligent student, working hard and striving, it may be, for a prize. To him we would say: Be careful; the last straw breaks the camel's back. There is a limit beyond.which you cannot safely go. 'The other is lie who, having let slip precious hours as the session has glided swiftly b wakes Up at lact to the alarming consciousness that lie must prepare to nmeet his exanminers. To any wbo feel conscioùs of an innate tendency to slothfulness or procrastina- tion we would say : Be diligent from the outset, and then at the end there will exist no necessity for that excess of work against vhich we now would warn you. Work therefore, but also rest, and be sure your efforts will be crowned with success. Man- ner is probably more looked to in the practising physician than in one of any other profession, and naturally so, because, being frequently from the nature of lis calling intimately and confi- dentially associated with persons themselves of refined and cultivated manners, anything less on the part of a medical attendant is necessarily criticised, and is obstructive to bis suc- cess. Aim, therefore, to cultivate during your pupilage kind, genial and. considerate conduct towards each other, and towards all, which will surely mould such an habitual demeanour as it. should be your desire to possess. Believe me, the age of Abernethian asperities is not the present-nor suppose that it is an indication of a virtuous and independent mind to speak curtly, gruffly or unsympathizingly to the sick. On the con- trary, a kind word is always in place, and is sure to carry its own reward. I would conclude, gentlemen, by once more -bidding you all a cordial welcome, expressing a hope that this session will witness a continuance of the same mutual cordiality andi confidence which has always hitherto characterized the relations of the teachers and classes of McGill University.",
         "TREAT3ENT OF DIPIITHERIA.-BY DR. COOK. THE TREATMENT OF DIPHITHERIA. BY G. R. Coox, B.A., M.D., GANANOQUE, OST. As the treatment of diphtheria is receiving a great deal of attention at the present time, the experience of even a junior member of the medical profession may not prove unacceptable. During the past thrce months twenty-four cases of diphtheria -have cone under my notice, most of them occurring in children. The first was a gi-rl aged twelve years, previously strorig and healthy, vho was suddenly seized. with pain in the head and throat, accompanied by great depression of the bodily powers. As she had previously ha-d tonsillitis, not much alari was felt in the family, and the usual household remaedies were employed. After forty-eight hours, as she became much worse, I was sum- Moned, and I found the tonsils, uvula and pillars of the fauces covered with dirty grey or ash-coloured patches, while there was so much swelling that she could scarcely swallow, and the attempt caused her much pain. Rccognising the severity of the case, I at once proceeded to treat according to the rules laid down by our Professor of the Practice of Medicine, and also after the manner of that cele- brated German, Oertel. But, alas ! each dose of medicine (iron in full doses, quinine to control the temperature, and sulpho-carbolate of soda as a parasiticide) seemed to give the disease a fresh impetus; each hot application to the neck appa- rently called up a fresh feast for the nirococci; each inhalation of steam only causcd these microscopie organisms to seek refuge in the deeper tissues; and the constantiy repeated gargling with solutions of chlorate of potash, chlioride of sodium, chlori- nated soda and solutions of carbolic acid and iodine, utterly failed tô lessen the fetor which enanated from the mouth and nostrils. Nourishing diet and stimulants were given at regular imltervals, but, notwithstanding the good nursing and treatment, both dietetic- and medicinal, which. she received, each succeed- img effort to rescue the sufferer from the grasp of such myriads Of living organisms was attended with more discouraging results 205",
         "CANADA 3MDICAL AND SURGICAL JOURNAL. than the former one, until after an illness of six days septicoemia struck the fatal blow. Since this, I have adopted a diferent mode of treatment, which has been attended with much success. Upon recognising a case to be one of diphtheria, I at once order a purgative, and, I prefer a saline. The circulation is much disturbed, the head and neck being very hot and dusky, while the feet are cold and clammy; I therefore next endeavour to restore the equilibrium by bathing the f1t in water as hot as it can be borne, nutil, they glow-in some cases repeating this hourly, and continuing to do so at intervals, as it may be iecessary, for two or three days, at the same time towels wrung out of ice-water are applied. to the forehead and throat, and changed as often as they become warm, which at first appears to be almost every minute. These I continue night and day until evidences of local excitement are subdued. The patient is to use ice constantly during this treatment. The medicinal treatment I look upon as of equal importance, and is a valaable adjunct to the cold. To eight ounces of a saturated solution of chlorate of potash, one drachm of hydrochlorie acid is added, and a ·tea- spoonful every threc hours is given to a child of three or four years of age-the dose for children of six years and upwards being a-dessertspoonful. In some cases this mixture is given alternately with salicine every two hours, as I believe that the latter, besides possessing autiseptic powers, promotes digestion. Sometinies the mouth is washed out or gargled with a solution of chlorinated. soda, but with this exception no gargle is used. Stimulants and nourishing diet in a liquid form are given from the outset, and of course special symptoms inust be treated as they arise. I do not kinow whether the cold destroys the microscopie organisms directly, or whether they cease miul- tiplying and die because the action of the cold on the affected textures deprives them of support, but the latter, I think, is the probable cause, as after a few hours' perseverance in the treat- .ment the inucous membrane becomes pale and bloodless, the patches cease to spread, the ashen hue turns to white, the breath soon becomes sweet, and a bright line of demarcatin- 200",
         "separating the affected from the non-affected portions may be distinctly seen to retreat and carry with it the crumbling edges of the patches until all are obliterated. I have treated upon my plan nineteen cases, some being well advanced and severe, and in no instance has the disease lasted beyond seven days. Not one proved fata, and only one showed symptoms of diphtheritic paralysis, from which, however, a per- fect recovery was made.' To strengthen what I have said, I may add that diphtheria proved very disastrous to some fami- lies in this locality, suddenly sweeping away all the younger members, notwithstanding all the efforts of the attending physicians. S omspondenico. LoNDON, Sept., 1876. MY DEAR MR. EDITOR ;-In keeping with -a promise, made' to you last spring, I propose tu give you a shcrt and imperfect account of the medical sights one may see .n a short stay in Paris. As you well know, there are so many Canadians who have- visited the London Hospitals, so many wyho are at present here, and so many who are likely to come over at one time or another, that it is unnecessary for one to enter into any description of them or to tell you of the various modes of practice to be seen in England. Not many of us make their way to France, and of these few the majority hurry to Germany, now so thronged with forein students. In writing a letter of this kind, two extremes are to be avoided. If you confine yourself to personal experiences your writings will. savour of egotism, whilst on the other hand, if you deal merely with geineral facts you put yourself under the suspicion of having filched your information from the Paris Guide-book. The Parisian Hospitals are all governed by one board, that board being imder the direct control of the Government. This. System possesses many advantages, as we can readily imagine,. but on the other hand there is a, lack of that rivalry betwee, 207 CORRESPONDENcE.",
         "20S CANADA MEDICArL AND SURGICAL JOURNAL. 'hospitals which acts so beneficially in keeping up the efficiency -of the staff, and in creating a desire to afford the students the best instruction possible. Another feature -which seens peculiar to French hospitals, is the large amount of work donc by the \"internes\" or house staff. These appointments are held for a space of four years, and during that period the men are changed from hospital to hospital, so that wlien their time expires they have had extensive exper- ience both in the general and special departments of the profes- sion. The Htel Dieu is always the first place visited by strangers, on account of its being the oldest and the bestknown of the Parisian Hospitals, as well as by reason of its proxiimity to the Cathedral of Notre Dame, on, of the finest sihàts in the place. The interior of the building wih its small narrow staircases and passages, reminds one not a little of the tower of London. The wards though low and rather too crowded, are kept beautifully clean and neat. Like nost foreign wards they are very large, some accommodating over a hundred patients. The surgical practice of the 1-lotel Dieu seenis very extensive, pro- bably due to its position amongst the dwellings of the poorer population. The surgeon there whose reputation stands the highcest is M. Richet. He was, unfortunately for me, taking his sumnier holidays, and so I can tell you nothing of his practice. In the treatment of burns and scalds they have recourse here to a method somewhat novel. The injured limb is enveloped in cotton wadding, almost six inches in thickness, over this rollers are applied, and the limb allowed te remain undressed for sev- eral weeks. low this plan answers I cannot say, as my stay in Paris -was not of sufficient lenLrth to allow me to see the results. A thing which strikes one as a great defect in the Parisian system, is that too many patients are allotted to one medical mau. You know how few patients a- London surgeon secs,and how much care and attention is devoted to each one. The reverse holds good there. The visiting surgeons in some hospi- tals sec almost a hundred patients a day. It is really hard to",
         "CORRESPONDENCE. understand hôw they can sufficiently study the clinical phenom- ena daily presented to their notice either for their own or for their students' instruction. The Hûpital Boujeau is a very large one, in fact one of the largest here. At this institution the surgical patients, those with suppurating wounds, are treated out of doors, in tents. This plan seems an excellent one, and-one which, I should think could easily be carried- out at the Montreal General Hospital, during the sumr moriths, when the bouse is full and the sur- gical practice at its height. Among the many cases in the wards of this hospital was one of double hip disease in a girl twenty years of age. Through the kindness of M. Péan, of the HIpital St. Louis, to whom I brought letters of introduction, I was enabled to witness one of his operations of ovariotomy. It was a private case, and the operation took place in one of the convents in the suburbs. The tumour was exceedingly large and consisted of one entire cyst. M. Péan operated with -reiarkable rapidity and coolness. As at all French operations, the \" pinces hémostatiques \" were used in large numbers to control the bleed- ing from the abdominal incision. These instruments are merely modified torsion forceps, and arc applied to all the bleeding points in the exposed tissues. One frequently secs as many as twentv or thirty hanging on the edges of a wound at the same time. ,ut to return to our tumouir. The incision extended rather high up, about an inch above the unbilicus. The fluid was removed with a large aspirator capable of holding several gallons. There were no adhesions. The pedicle, which was long and narrow, was fixed in the abdominal incision by long pins, while b-are-lip pins united the edges of the incision. After having nearly died from the heat of a Parisian summer -I refer to myself, not the patient-I returned to London to find everybody out of town. Physicians, surgeons and accou- cheurs had with one accord departed, leaving the assistants to do-the w'ork. There was then, and there is now, great talk about the Turco-Servian war. Mr. MacCormac, .of St. Thomas', whose reputation as a military surgeon was 14",
         "210 CANADA 3IEDICAL AND SURGICAL JOURNAL. established in the Franco-German war, had already gone. IIe was soon followed by Mr. McKellar, one of the assistant sur- geons, who brought with him some six or eight dressers selected from the students of the hospital. Since that time many have gone to the seat of war. There are three ways of going: wyith the Servians, where you run the chance of being hanged by the Turks ; with the Turks, where you are likely to have the pleasure of seeing your English friends being put through that process; and with the National Society for Aid to the Sick and Wounded in War, where you may get shot by both parties. Altogether, the best thing to do is to stay at home. The medical world bas been in a state of excitement for some tine about the celebrated Bravo poisoning case. I believe the dispute between Sir William Gull and Dr. Johnson is still sub judice, the profession being divided in opinion as to who was in the right. The outcry about vivisection scems to have entirely sub- sided. The silly sentimentalists who were 'wont to revel in the horrors of imagined cruelty to the lower , animals, have now, fortunately for science, a congenial employment in raising an equally absurd but more hurtful agitation about the greater atrocities perpetrated in Bulgaria. R. L. McD. SeViews and notices Of 1ookhs. Chemistry, General, Medical and Pharmaceutical, including the Chemistry of the U. . Pharmacopæia ; a MJianual on the General Principles of the Science and their Applica- tions in Mlfedicine and Pharmacy. By JoHN ArTFIELD, Ph. D., F.C.S., \u0026c. Seventh edition. Revised from the sixth (English) edition by the author. Philadelphia: Henry C. Lea, 1876. That the Manual before us has met with such support from the publie as to require in so short a period the issuing of a seventh edition, is a subject on which the author may well be congratu-",
         "REVIEWS AND NOTICES OF BOOKS. 211 lated, and it is but a just tribute to the care and attention-with which he has carried out the task he has set himself, and an evidence of the success he has attained in the fulfilment of his intention of writing a handbook for students of chemistry as applied.to medicine and pharmacy. The present volume is the seventh edition published in Philadelphia, and like the third and ifth editions contains the phemistry of the United States Phar- macopScia. It brings up our knowledge of the subject to the present date, and has been enriched with numerous -wood -engravings illustrative of apparatus and modes of work. In the beginning of the book are some hints to students, which we commend tO their earnest perusal. There is also a very complete list of apparatus and re-agents required by the student with this handbook in hand. There is ,a ist of contents in the beginning and a most copious index at the end of the book, making the work very complete as a book of reference not only to the student but also to the practitioner of medicine. There is an excellent chapter on Chemical Philosophy. The arrangement of the work is admirable, and to each element its more important compounds used in medicine or pharracy is given, together with both synthetical and analytical reactions. The systematic analysis of eompounds, substances or fluids is also treated of, and copious tables are given showing the modes of systematically _eparating the different elements from one another. To the student who has carefully studied the book and gone through the various operations therein given, and who has tested his work by answering the questions which are so liberally dis- tributed throughout its pages, an ordinary examination in the professions tQ which this work is particularly addressed should present no difficulty. There are, towards the end of the book, chapters on analysis both qualitative and quantitative, and also on toxicology and analysis of morbid urine, and urinary calculi ; it also contains",
         "212 CANADA MEDICAL AND SURGICAL JOURNAL. copious tables of weights and measures, and of the solubility of salts, and a large and full table of officinal tests for impurities i preparations of the British Pharmacopoeia, with a reference to the page where the test is more fully considered. It is only necessary to see the naie of the publisher to know that the paper, printing and general appearance of the book are all that can be desired. We cordially recommend the Manual to all students or practitioners- of medicine or phar- macy-from it the former will obtain, by careful study, a thorough knowledge of the subject, and the latter will have at hand a never-failing book of reference.. A Systen of iMidwifery, including the diseases of Pregnany, and the Puerperal State. By WILLIAM LEISIIMAN, M. D., Regius Professor of Midwifery in the University of Glas- gow, \u0026c., \u0026c. Second American from the second and revised English Edition, with additions by John S. Parry, M. D., Obstetrician to the Philadelphia Hospital, \u0026c., \u0026c. 8vo. pp. xxiv. 766. Philadelphia: Henry C. Lea, 1875. On a former occasion we noticed at some length the first edition of this excellent manual, so that it will be unnecessary to go fully into the consideration of this the Second American from the second revised English edition. Eince the publication of Tyler Smith's lectures on Midwifery, no text-book which was in reality the exponent of British practice had appeared in the English language until Dr. Leishman supplied the want by his system of widwifery which was published about three years ago. The value of this work is fully attested by the exhaustin almost complete of both the English and American editions of the first issue. In this edition the American editor has added such notes as are deemed essential to the American Practi tioner. He has also added a chapter on Diphtheria, and one 01a Puerperal wounds. There will be found also in addition s010 'illustrations representing some modifications in obstetrical instr ments employed by practitioners on this continent. The chief feature in this work is the: exactness. in description of tho",
         "BRITISH AND FOREIGN JOURNALS. mechanism of labour; it exhibits most accurate observation and is a perfect analysis of the subject ; it is clear precise and masterly. The work is in every way a valuable addition to the works already beVfore the profession on the science and practice of obstetrics, and will, we doubt not, be the favorable text-book used in our schools. It fairly represents the present state of knowledge on the subject of obstetrics, arid may be fully trusted by the practitioner, as it .contains all the information requisite, set forth in pleasing and judicious language. The style is par- ticularly clear, and very readable, and the teaching sound. A Treatise on the Scieûce and Practice of MIidwifery. By W. S. PLAYFAIR, M.D., F.R.C.P., Professor of Obstetric Medicine in King's College, Physician to King's College, Hospital, \u0026c., \u0026c., with two plates and one hundred and sixty-six illustrations on wood. 8vo. pp. 576. Philadelphia: Henry C. Lea, 1876. This work is also a valuable text-book, and we should say will becomea favorite with the medical student. It wili be found to embody all recent advances in the science, as well as the prac- tice of obstetries. The author in his preface states, that \" On certain points he has recommended practice, which not long ago would have been considered hetorodox.\" This may be regarded :as highly beneficial in a practical sense, as it shows that the author is not servilely bound by the opinions of those who have preceded him. - Hé expresses his conviction that such changes, 1n opinion on those points of difference will stand the test of experience. The author calls attention to the short term of three months in which the lecturer on Midwifery is expected to teach his art to bis class. This is without doubt a mistake which MiIl have to be remedied, and we fully concur in the opinion that the great impörtance attached to this branch of medical science 'n the ,present day will call for amendments in this respect in the regulations of the schools of Great Britain. In our own eountry the regulations are such that two full courses, each of 213",
         "214 CANADA MEDICAL AND SURGICAL JOURNAL. six months duration, are exacted to qualify a student to present himself for examination. The work is in every respect a valuable addition to those already in the hands of the student of obstetrics, and we fully recommend it to our readers. Extracets from Eritish and Foreign eurnals. Unless otherwise stated the translations are made specially for this Journal. The Inheritance of Syphilis.-The author recognises two ways in which syphilis may 'be inherited; in the first or congenital syphilis, properly so-called, the disease originates in a morbid state of the semen or ovuin at the time of procreation. In the second, the syphilitic poison is communi- cated to the foetus from the blood of the mother, this he calls \" lnfectio intra uterurn.\" In regard to the latter, his views are at variance with those usually accepted, for he contends that syphilis contracted by the mother during pregnancy cannot be transmitted to the foetus in utero. Although nearly all authors agree in stating that syphilis contracted during pregnancy is only likely to be transmitted to the- foetus during the earlier months of that condition, a careful analysis of the literature of the subject shows that there is not a single well established case in which a child whose parents were both healthy at the time of conception, showed signs. of hereditary syphilis at birth, nO matter what the period of pregnancy may have been when the mother contracted primary syphilis. According to Kassowitz, of 37 children whose mothers became infected during pregnancy, 16 died in the first month; 6 in the second and 3 in the third, but without showing any signs Of syphilis'; 7 lived and remained perfectly healthy. This immu-- nity of the child notwithstanding the infection of the mother during pregnancy, is most strikingly illustrated by a case related in which a woman caught the disease from her husband in the second month of her second pregnancy, but gave birth to a",
         "BRITISIH AND FOREIGN JOURNALs. healthy child at full term. After subsequent conceptions, how- ever, she was delivered of several still-born children, and lastly of one affected with hereditary syphilis. On the other hand it cannot be denied that the outbreak of c:nstitutional fever in the mother may occasion such constitutional disturbanco as to cause the death of the fotus, and abortion or miscarriage, without any infection of the latter. The foregoing facts show that the syphilitie poison never extends through the vascular membranes which separate the circulation of the mother from that of the foetus, in the direction of the latter. The same law holds good in the opposite direction, that is to say, the syphilitie poisoi never passes through the walls of the uterine and placental blood vessels from the fœtus to the mother. This is proved by the well known fact that syphilitic children are very frequently borne by women who themselves renain free from the disease. The author has observed 76 cases in which the existence of hereditary syphilis existed beyond all doubt, but in 43 of these the mother was free from taint ; and he says moreover, that a syphilitic father after having begotten several aborted or still-born children will beget healtby children after he alone has been through course of mercury. This could not occur if the mother, who has not undergone treatment, were also the subject of constitutional syphilis A further proof is seen in the case of women who have borne syphilitic children to a first husband, but after his deatli, having married a healthy man produce hencefortli a healthy offipring. If the woman becomes syphilitic in the course of her pregs, nancy the infection is always of external origin, that is from the man. Sometimes the supposed tertiary syphilis which is said to occur in women without primary or secondary symptoms is not syphilis at all but merely .a cachexia brought on by repeated abortions. If we acknowledge the possibility of an \"Infectio intra uteruvn,\" there only remains the one way in which syphilis can become inherited, and that is by contamination of the pro- duct of conception by some specifie property in the reproduc- 215",
         "CANADA MEDICAL AND SURGICAL JOURNAL. tive elements derived from one or both parents when conception takes place, and at no other time. The liability to transmit syphilis to the offspring is not confined to the period during which syphilitic eruptions occur, for it exists as long as there is any syphilitie virus in the body, and according to the author, 10 years may be taken as the average number which elapse before a syphilized person who bas not been treated will cease to transmit the disease to bis or her offspring.. This conclusion is not influenced by the fact recognized by the author that parents suffering from well-marked tertiary syphilis do not beget syphilitic children, because these tertiary symptoms are merely a peculiarity engendered by the syphilitic poison now nearly entirely extinguished, in consequence of which peculiarity ordinary sources of irritation call forth an excessive production of cellular elements in the parts affected. The mercurial treatment of syphilis has the effect of diminish- ing or even entirely extinguishing the liability mentioned, so that syphilis inherited from persons who have undergone a proper course of mercurial treatment will occur in a.comparatively mild form if at all. The law already laid down by other authors, that \" the inten- sity of inheritance diminishes step by step with the spontaneous wearing out of syphilis in the parents,\" is entirely in accordance with the observations of Kassowitz. According to this law, syphilis inherited from recently syphilized parents is more yiru- lent than when the latter have been infected for a long time, and manifests its severity in causing abortions and miscarriages. When syphilis was first contracted during married life, in almost every instance the healthy child immediately succeeding the infection (but conceived before the latter took place) was followed by several miscarriages. The author considers that the effect of the syphilitic poison upon the fotus is the chief cause of interruption in the normal course of pregnancy; the fotus dies and causes premature contractions of the uterus. This series of events occurs early in proportion to the more or less recent infection of one or both parents. Although a post-mortem examination of the still-born child",
         "BRITISII AND FoREIGN JOURNALS. often reveals *no palpable signs of syphilis, the author thinks that this may be explained by assuming that its death occurs at an early stage of its life, before secondary phenomena have had time to make their appearance, probably in consequence of altered nutrition, increased temperature, \u0026c. Abortion caused by syphilization of the mother is less frequent, and may be due to the fever which ushers in the secondary symptoms, or, still more rarely, to disease -of the maternal placenta.* A considerable time alWays elapses before syphilized parents are capable of producing children that can live. In nearly all the cases observed by Kassowitz at least three years elapsed, and in more than half of them five years. Of 330 children born to syphilitie parents, seventy-three were still-born; twenty-four per cent. of, those born alive succumbed to the inherited dyscrasia within the first six months, and only two- ifths of them survived the first half-year. When a living child is born whose parents are syphilitie, Lbe visible signs of syphilis are present at or appear within a certain time after birth, and the more intense the infection, or, in other words, the nearer the period of conception is to the time when the parents con- tracted the disease, the earlier these signs make their appear- ance. A child born with syphilitic eruption is much less likely to live than when the eruptiorL occurs some time after birth. The specifie exanthein is almost always seen before the end of the third month, very rarely as late as four or four and a-half months after birth. When the eruption occurs as late as three months after birth itis a sign that the syphilis has almost died out in the parents, and there is reason to hope that the next child may be free from taint. It thus appears that there is a gradual diminution in the intensity of the syphilitie poison and in the severity with which it affects the product of conception, thougu no rule can be laid down in this respect when the parents have undergone a course of mercury. * Kassowitz has examined a large number of placentoe where miscarriage has undoubtedly\" occurred in consequence of syphilis, and finds the foetal portion cither quite healthy or only diseased to a very slight extent. 217",
         "218 CANADA MEDIoAL AND SURGICAL JOURNAL An analysis of 330 syphilitic births, the offspring of 119 marriages, shows that the transmission of syphilis is constant, inasmuch as a healthy child was never produced in the interval between the births of any two that were highly syphilized. That the father most commonly is the source of the syphilis is to be explained on social grounds. Other things being equal, there is no difference between the two sexes in the period of time after infection during which they prodice syphilitic offspring. Scrofula, phthisis, and rickets are sometimes met with in the children of parents who have been syphilitic, though the former may not have presented any signs of hereditary syphilis ; but rickets is altogether the most frequent, and the author thinks that it is caused in all probability by some specific process pre- viously affecting the bones. Nevertheless, rickets cannot be regarded as a distinct form of hereditary syphilis. Electrolytic Treatment of Tumours.- Dr. Julius Althaus, of London, thinks that the limits of the use- fulness of electrolysis in the treatment of tumours are now SO thoroughly ascertained, that they will be neither notably enlarged nor diminished by future observations. The following is a short resum6 of his latest conclusions as to the vatrieties of tumours in which electrolysis is useful. 1. Noevus.-Electrolysis possesses undoubted advantages over al the other methods of treating this variety of tumour. The ordinary round, flat naevus, which is elevated but little above the level of the skin, is often cured by a single electrolytic applica- tion; but the large port-wine spots often require half a dozen sittings. Dr. Althaus uses for the operation from 10 to 15 cells of Daniell's battery, both poles being introduced into the tumour. As soon as the circuit is closed the destruction of the nvevus begins, the blood-vessels and skin seeming to wither up rapidly. The destruction takes place most actively in the neighbourhood of the positive pole. The current should not be too strong nor continued too long in any one spot, or it will Icave a cicatrix.",
         "BRiTISH AND FOREIGN JOURNALS. After the -operation, the surface should be covered with a gold- beater's skin, but no dressing is necessary, for there is no dis, charge and no pain. The scab falls off in ten to fourteen days\u003e. leaving a healthy surface that gradually assumes the appearance of the neighboring skin. 2. Bronchocele.-Electrolysis is less painful and less danger- ous than the usual surgical treatment of the cystic form of goitre. Dr. Althaus introduces two or three needles connected with the negative pole of the battery into the cyst, the positive electrode being applied to the skin in the form of a moistened sponge. The current decomposes the fluid in the cyst, and converts the solution of chloride of sodium into a solution of caustic soda, which cauterizes the *secreting membrane of the cyst, and pre- vents the production of more fluid. Two to six applications- generally bring about a cure. The hypertrophic bronchocele is much less amenable to treat- ment, and is generally let alone by surgeons. When, however it becomes dangerous by pressure on the important structures, electrolysis is indicated, and may be advantageously combined with injections of tincture of iodine. The latter breaks down the internal structure of the tumour, especially when it is old and firm, and so secures a freer passage for the electric current through the mas3. In recent cases the injections may be omitted. 3. Atheroma.-Electrolysis removes this variety of tumour quickly, and without risk, and leaves no cicatrix. The action is more rapid when both poles are introduced into the tumour, than. when the negative alone is used. ' 4. Recurring Fibroid.-As the knife fails to cure this variety. of tumour, Dr. Althaus. thinls that electrolysis should receive a fair trial. The results he has obtained with it so far have not been particularly encouraging, probably because in all bis cases the tumdurs had obtained enormous size, and had existed a long time. Inone desperate case, on which Sir James Paget, Sir William Fergusson, and Mr. Coesar Hawkins had refused to operate, electrolysis relieved the intense pain, and caused a diminution of the size and hardness of the tumour; but the- 2 i9.",
         "'220 CANADA MEDICAL AND SURIGICAL JOURNAL. treatment could not be followed out for a sufficient length of time to give positive results, as the patient was unable to remain in London. 5. Cancer.-Although electrolysis cannot replace the knife in the treatment of primary carcinoma, it often produces excel- lent results in epithelioma and recurrent cancer. It cannot 'remove the cancerous diathesis, but it relieves the pain, enables -the patient to sleep, improves the appetite, and strengthens and quiets the entire system, and so renders the last' months of life :more bearable.-Berliner klin. Wochenscrift.-N. Y. iJiedical Record. Cure of Tetanus by mechanical mea- sures.-CALASTRIE. (Gazaetta Medic, Lombardia, No. 27.) A patient, who was convalescent after various attacks of hoemorrhage from the skin and mucous membranes, was wounded in the sole of the rigit foot and had partial tetanus result. There was considerable rigidity of the muscles of the cervical region and those presiding over the movements of the jaw. Sulphate ,of quinia and chloral were followed by temporary relief only. Then C. thinking that the difficulty of injecting sufficient nutri- iment was due to the localization of the tetanic affections in the 'muscles named above, concluded to overcome the rigidity by forced movements of flexion, extension and rotation. This was ,continued till voluntary movement became possible. The jaws were then separated little by little from day to day, until they could be more widely opened, and the patient could himself take solid food. This treatment was continued during the morith of August, and by autumn the cure was completed.-Chticdago Medical Journal and Examiner. Treatment of Acute Albuminuria.- (By F. DE HAVILLAND HALL, M.D.)-Directly any albumen *was detected in the urine, the patient was ordered the perchlo- ride of iron, and was allowed no solid food except a little bread and milk, and as much water as he liked to drink; this treat. ment, ,ogether with le aping the skin gently acting, sufficed in",
         "BRITISII AND FOREIGN JOURNALS. the majority of cases, but in a certain number the urine -was almost suppressed, and in some there were uromic symptoms. Whenever either of these contingencies occurred I forbade all food for twelve hours, the child to have nothing but water and a drink made of acid tartrate of potash (sj. ad Oj.) in sweetened water with a little lemon-juice. If at the end of this time the kidneys were beginning to act I allowed, a little milk, but not more than a pint in the twenty-four hours ; if, however, the uromia continued with little or no urinary secretion, I persevered with the water and bitartrate of potash, and in severe cases nothing else has been given for thirty-six hours. Dry cupping, mustard poultices over the loins, and a purgative were the only additional remedies employed. The explanation of the gooCI effects of abstention from solid food, and especially meat, during the course cf acute desquamative nephritis, is that if a patient is entirely deprived of nitrogenous food the work of the kidneys is lessened and the urine is rendered less irritating, and the mild diuretic action of the bitartrate of potash seems to be useful. If any one will take the trouble to compare the treatment of acute Bright's disease as laid down in the various text-books on the subject, ho will be much puzzled-as to what course he had better pursue, for \" when doctors disagree who shall decide ?\" and it cannot be said in this instance \"that in the multitude of counsellors there is safety.\" The great point of dispute is as to the employment of diuretics. Dr. Jolhnson, who is the great opponent of this plan of treatment, gives as his reasons that there is \" first a morbid condition of the blood, which bas excited disease in the kidneys, and that as a secondary consequence of the renal disease the blood has become contamin2ted by the retention in it of urea and other excrementitious matter,\" and he-therefore advises that the kidneys should have as little work to do as possible, and that the other excretory organs-should be called upon to asssist in carrying off the waste products to theý utmost of their power. lis treatment consists of-1. Warmth in bed. 2. Diet. \" The food should bo scanty, consisting of gruel, arrowroot, milk, or weak broth.\" 3. The use of the warm water or hot air bath, and. 221:",
         "222 CANADA MEDICAL AND SURGICAL JOURNAL. antimonials to cause diaphoresis. 4. The bowels to be kept freely open. \" The circumstances which indicate the necessity of addi- tional remedies are a very scanty secretion of higbly albuminous and bloody urine, witb, occasionally, severe pain in the back, more or less pain in the head, some degree of drowsiness or delirium, a.t length, perhaps convulsions or coma, or an alter- nation of these o formidable symptoms.\" For these lie recommends cupping on the loins. As regards didretics, lie says: \"I mention the subject only for the purpose of deprecating their employment.\" Dr. W. Roberts, on the contrary, writes :-\" Objections have been made, on theoretical grounds, to tlie saline diureties (acetate and. citrate of potash) in -acute Bright's disease. Experience has proved, however, that they may be employed with great advantage. They become changcd in the primie viS into alkaline carbonates, and these diminish the acidity of the urine and render it more bland, as it percolates the renal substance.-In a considerable number of cases of acute Bright's disease, coming under treetment early, I have obtained almost invariably the best results by the free administration of :the citrate of potash.\" His treatment is as follows:-\" An endeavour should also be made to allay the fever and restore the action of the skin, by a citrate of potash draught, given -every two hours, in effervescence, or a mixture of the liq. ammon. acet. in two or three drachm doses, with fifteen drops of the tincture of henbane in an ounce of inf. lini. The diet should be composed of light farinaceous substances, with milk, beef-tea, and broths. Flesh meat in any form is objectionable in the early stages.\" Dr. Dickinson bases his method on the necessity there is for an abundant flow of fluid through the kidneys to wash out the extravagant growth of epithelial cells and prevent them block- ing up the tubes. \" Hydragogue purgatives and vapor-baths, while tending comparatively little to remove the elements espe- cially belonging to the urine, divert the water which is wanted for thi, purpose. Of all diuretics water is the most valuable. 'The patient may be restricted to a fluid, but nutritiouS diet,",
         "BRITISH AND FOREIGN JOURNALS. while pure water is taken freely. In children, when the kidney responds readily to this simple stimulant, the disease will gener- ally recover without further treatment. In grown persons, or in children when the disease is severe, digitalis is a most valuable adjunct.\" He strongly condemns the employment of hard purging and sweating, and he would reserve the repeated use -of hydragogue purgativ.e for obstinate and hopeless cases only. Dr. West thus criticises Dr. Dickinson's treatment by the administration of a large quantity of water :-\" Nothing what- ever that was observed during its use among my patients at the Children's Hospital seems to justify one's regarding the drinking of two or three pints 6f cold water ii the twenty-four hours as more than a useful adjunct to the treatment.\" From what I have seen of this disease I am inclined to agree with Dr. Dickinson rather, than Dr. West, but I cannot too strongly enforce the opinion of the latter as to the inutility of catharties in the treatment of acute albuminuria, there is the risk of checking perspiration and thus throwing additional work on the kidneys, and sometimes obstinate diarrhea is set up. The authorities to whom reference bas been made are suffi- cient, I think, to show the difference of opinion in reference to the use.of diuretics in the treatment of acute Bright's disease, for while all are agreed that the more powerful and irritating drugs of this class should not be employed, some advise the use of the milder diuretics, whereas othors say most emphatically \" Diuretics are not to be given.\" The diuretics which are usually recommended as the least irritating are the sweet spirits of'nitre, cream of tartar, and infusion of digitalis ; if the stomach rejects the digitalis, an infusion four times the strength of the pbarmacopœial one may be applied to the abdomen as a fon:entation. Dr. Southey attributes the success of the employment of the tartrate of potash in Bright's disease to the \" abundant diuresis of alkaline urine ;\" and goes on to say, \"I am speculative enough myself to imagine that an alkaline fluid, passing through the urine tubes, has some similar action to that of weak soda or potash solutions upon sections of dead kidney-tissue under the",
         "224 CANADA MEDICAL AND SURGrLAL. JOURNAL microscope. I mean, that fat granules are saponified, cells rendered more translucent, the interstitial tissues become more loose, and the circulation is thus facilitated.\" It was some such idea as this which first induced me to try the plan of treatment I advocate, and the success attending it bas induced me to call the attention of the profession to it, in the hope that a more rational plan of procedure may be adopted than the bard purg- ing and sweating which is still too much in vogue. As a general rule, far too little attention is paid by the medical attendant to the diet of the patient, tiat is to say, the directions given are vague in the extreme, but in acute albuminuria, as in typhoid fever, any indiscretion in the food may be visited with the most severe punishment,-an attack of convulsions may be caused by excess in the first, just as I have scen perforation result from taking solid food too early in typhoid fever. I would sum up the treatment in acute Briglit's disease in the following words 1. Milk and water with arrowroot, no solid food. 2. Milc diuretics, such as the citrate or bitartrate of potash with a free supply of water. 3. The skin kept just moist. 4. A. daily evacuation of the bowels.-The Practitioner. Death from Hemorrhage into the Bladder.-A curious case recently occurred in the practice of Mr. Il. O. Thomas, of Liverpool. An octogenarian consulted him concerning some urinary obstruction, arïd was advised to go to bed where he would be scen by an assistant. The assistant was despatcbed, armed with catheters, and passed a No. 12 without difficulty, but was astounded at finding that instead of urine a free flow of blood occurred. The blood was mixed with urine, and a quart was withdrawn, which immediately coagulated. All bis veins were very much enlarged, and gorged with blood. He was conscious, but very irritable and unmanageable, and complained of great pain. In the evening, an india-rubber catheter was passed, and a pint of blood was drawn-no urine. The next day feverish symptoms set in, pulse 120. Tempera- turc 103.4.0 A catheter was again passed with a like result.",
         "BRITISII AND FOREIGN JOURNALS. Patient was becoming unconseious and swollen, and after passing the catheter again with the customary result, he died the next day. The only probable theory as to the cause of death is that a rupture of a small vesical vessel occurred which filled the bladder with blood, preventing the entrance of urine, and finally caused uremia and death.-Students' Journal. Injecting the Male Bladder without the aid of a Catheter.-For the last year Prof. McGuire, of Virginia, has made use of the following simple prc- cedure in injecting the. male bladder. le takes the ordinary rubber-bag syringe used to inject the bladder through a catheter, the nozzle of which is provided with a stop-cock, and tapers to a point. The bag is filled with warm water, all the air bein-g care- fully excluded,and the nozzle oiled and introduced into the urethra for an inch and a half. The urethra is then gently compre:sed around the nozzle of the syringe, the stop-cock turned, and by a gentle and continuous pressure on the bag, the water forced along the urethra into the cavity of the bladder. It is important to avoid all rough manipulations, and to inject the fluid slowly. Witli a little practice the patient can perform the operation quite readily himself. This method of injecting the bladder is especially applicable to those not rare cases in which the introduction of a catheter causes pain or urethral fever. The warm water may be medicated, but it is important to remember that the mucous membrane of the bladder is more sensitive than that of the urethra, and consequently these injections must be milder thair simple urethral injections would need to be. Prof. McGuire has employed this method with advantage in a case of malignant vascular tumour of the bladder, and prepara- tory to the operations of lithotrity and lithotomy. In a case of severe cystitis following the first of a course of lithotrity sittings, distending the bladder with water by means of a bag syringe was followed by'such immediate and great relief that he was able in a few days safely to employ the lithotrite again. In a case of severe strangury, the same proceeding gave almost complete 15 22 5",
         "226 CANADA MEDICAL AND SURGICAL JOURNAL. and immediate relief. It is, however, in cases of cystitis andi enlarged prostate that Prof. McGuire anticipates most benefit from this method of injecting the bladder. In these cases, the- introduction of the catheter, and its necessary retention in the bladder for some minutes, often cause urethral fever and in creased irritability of the bladder that more than counterbalance the good the iijection may have done. The frequent introdue- tion of the catheter, moreover, in the case of chronic hypertrc- phy of the prostate, undoubtedly has a tendency to increase the already existing trouble. In these cases the bag syringe eau, with few exceptions, be substituted for the catheter. Four or five ounces of warm water, simple or medicated, are to be injected and retained for a few moments and then expelled. What w'ill remain in the bladder will be, not the phosphatic, irritating urine that was there before the operation, but a smnall portion of this diluted with water. By repeating the injection the residual fluid can be made entirely unirritating.- Virginia Med. Monthly.- N Y. Medical Record. On the coincidence of Pulmonary Phthisis with Valvular affections of the Heart.-By EayST FaOMuoILT.-Rokitansky was the first to maintain that certain affections, and notably chronic endocar- dial diseases were antagonistic to pulmonary phthisis. Already som-, authors, such as Frelerich, Von Dusch and others, have pointed out, bt without giving the facts in support, that this assertion is subject to exceptions. The author has examined 277 cases of heartdisease and found most unmistakable pulmonary phthisis in 22 instances. Contrary to the assertion of Lebert, according to whom, affections of the pulmonary valves furnish the majority of the cases of phthisis, the valves the right heart were affected in but one single case: all the others were affections of the left heart. The conclusions of the author are embodied in the following propositions : lst. The coincidence of pulmonary phthisis with valvndar",
         "nRITISII AND FOREIGN JOURNAI S. affections of the heart is far from being as infrequent as is gen- erally supposed. 2nd. Pulmonary 1 hthisis is rather more frequently associated with affections of the aortic orifice than with those of the auriculo- ventricular opening of the same side. The diffirence, however, is but slight. 3rd. Simultaneous affections of îeveral of the cardiac orifices is very seldom found together with pulmonary phthisis. Still, stenosisof the punonary orifice existing with other valvular lesions seem to form an exception to this rule.-(Revue des Sciences Médicales, 15 January, 1876.) Poisonous condition of the blood of some slaughtered animals.-It has been estab- lished by Signol, after prolonged investigation, that the blood of healthy horses which have been either slaughtered or smothered by means of charcoal fumes, left in the cadaver for at least 16 hours, acquires fatal properties if it is injected to the extent of eighty drops into goats or sheep. This blood contains only bacteria, which do not multiply in the animals injected. The blood of the deep· veins, situated in the neighborhood ýof the intestines, 'becomes more rapidly poisonous than that of the more superficial veins. The blood of animals which have been strangled and not submitted to the carbon fumes, contains bac- teria, and the corpuscles are agglutinated together, the circum- stances wvhich are looked upon as characteristic of charbon. At the end of from 6 to 9 hours the blood is not fatal, but already produces abscesses. The blood of an asphyxiated horse becomes toxic more rapidly than that of one which bas been slaughtered. Blood taken from an animal inoculated and then sick from the effects, does not seem capable of producing the disease ; on the confrary, blood taken after its death seemed in most cases to transmit it perfectly.-(Revue des Sciences Médicales, 15th April, 1876.). 227",
         "228 CANADA MEDIcAL AND) SURGIcAL JOt1RNALI Glycom ia.-Glycemia is the result of a physiological function, it has its source in the organism and not in the food. A communication by M. Cl. Bernard to the Academy cf Sciences comprises the following points: 1st. Glycomia does not differ in carnivorous and herbivorous animals ; it is independent of the kind of food. This law is established by numerous experiments which lead the author to the following conclusions: \"Whatever be the nature of the food, in herbivorous as well as in carnivorous animals, durin'g digestion, during abstinence and even during fever, the blood always exhibits almnost the same proportions of sugar. These facts seem to me sufficiently distinct to refute the theories which have placed the source of the sugar of the blood in the food, and suflficiently clear to demonstrate that there exists on the contrary, in the living organism, a glycogenic function which maintains and regulates the quantity of the sugar in the blood and renders it indepen- dent of the variable conditions of digestion.\" M. Bernard then explains the objections kvhich can be made to the different processes, and he passes in review the physiological conditions which can cause the quantity of sugar contained in the blood to vary. Apart from these changes, the proportion of sugar is always sensibly the same. The comparative conditions in this respect of the blood taken at different parts are the following: lst. Throughout the arterial system, the blood exhibits a proportion of sugar sensibly identical. 2nd. In the general venous system, the proportion of sugar is variable, but always less than that in arterial blood. Finally, one can conclude that, normally, the venous blood of the limbs, trunk, head and neck, contain less sugar than corresponding arterial blood ; so that the saccharine matter is destroyed in al hese organs in prop-ortions undoubtedly variable, but sufficiently difficult to determine.- gazette Hebdomadaire, 18th August, 1876.",
         "BRITISH AND FOREIGN JOURNALS. Malformation of the Small Intestine.- M. Polaillon communicates to the Chirurgical Society of Paris an observation on malformation of the small intestine, with operation for artificial anus by the method of Littré. Five hours after birth the infant vomits meconium, although the anus was permeable and normal. The day aftýr birth the belly was distended ; vomiting. An enema produced a discharge of only a small quantity of muc.s. The third day the infant bas sunken eyes; there are established all the signs of intestinal obstruc- tion. A flexible bougie, introduced by the anus, penetrates 10 centimetres. Fæcal vomiting. M. Polaillon seeing that he had to de with obstruction of the gut, performed the operation for artificial anus by the method of Littré. The knuckle of the intestine is fixed to the wound and eut. Escape of intestinal matter; the infant seems to be relieved; he dies during the day. The small intestine was interrupted about its middle by a complete membrane. between the stomacli and this meinbrane the intestine measures 86 centimetres ; betwe~n the obstruction and the cæcum, 64 centimetres. Malformations of the small intestine are rare at this point ; ordinarily they are found in the region of the duodenum. This observation demonstrates that meconium exists in the upper part of the small intestine, and probably comes from the liver.-Gaazette ffedomadaire, 18th Aug., 1876. Treatment of Certain forms of Acne.- Dr. Chantry claims that he bas obtained gratifying success in the treatment of rebellious cases of acne of the tuberculous and hypertrophie variety, by the use of iodide of sulphur internally in combination with Hardy's lotion externally. He gives at first one, then two or three of the following pills: e. Sulphur. iodid., gr. s.; Extr. solani dulcamaræ, gr. ij. M. He employs also the following lotion: W. Aquæ, 3 iijss.; Tr. benzoin, 3 i. Potass. eulphuret. M. A teaspoonful in lukewarm water, to be used mornilig and evening. (Hardy). If this lotion causes too much irritation, it must be replaced by lotions of filtered bran- 'Water. In some cases the iodide of sulphur causes gastralgia, 229",
         "230 CANADA MEDICAL AND SURGICAL JOURNAL. and its use must be discontinued; but if this does not occur, a noticeable amelioration of the affection is found in about twelve or twenty days. The hard, purple elevations which surround the tubercles slowly soften and become less swollen, the usual desquamation of the epidermis takes place, and soon nothing remains but a diffuse, pale congestion, which disappears slowly, and is often succeeded by triangular cicatrices. In a case of acne rosacea of the face, of nine months dura- tion, which had resisted several methods of treatment, the iodide of sulphur could not be boine, and iodide of potassium was given instead, in doses rapidly increasing to a drachm a day. At the same time the diseased parts were rubbed briskly every evening with sulphur pomade (15 sulphur to 30 lard). In fifteen days the cure was almost complete, and two months later there had been no return of the disease.-Lyon Médical.-X Y Medical Record. The Etiology of Herpes Zoster.-Baren- sprung, as is well known, was the first to express clearly the connection between the course of the nerves and their affection, and to place it on a proper anatomical basis. He had, in 1861,, from an analysis of 50 cases, established theoretically a corres- ponding affection of the intervertebral ganglia in herpes on the course of the spinal nerves, and of the Gasserian ganglion in zoster on the territory of the trigeminus. Two years later this view was confirmed by finding inflammation of the spinal ganglia and commencement of the dorsal nerves in an individual who had died of phthisis and with zoster dorso-pictor. Since this time three cases have been published with post-mortem reports, in all of vhich there was found an inflammatory condition of the spinal ganglia and roots of the affected nerves. Kaposi publishes (Wien. lMed. Jahrbb.) the clinical history and post-mortem appearances in a case of zoster lunbo-inguinalis wifn disease of the spinal ganglia, which is all the more remaark- able, as there was not, as in the other cases, any local compli- cation.",
         ". BRITISH AND FOREIGN JOURNAIS. The patientia man 54 years of age, suffering fromn stricture, and false passage, died on the 9th day after the appearance of ihe zoster, which affected the right lumbo-inguinal region, of pyemia, in consequence of purulent infiltration of the scrotum -and penis. There was found moderate hyperemia of the spinal 'cord and its membranes in the lumbar region ; vertebre, dorsal and lumbar, unaffected, so also the soft parts in the region of the pelvis, the vessels, and the intervertebral ganglia of the left side. The ganglia of the right side were notably enlarged, denser, and with difflculty removed from the closely adherent adipose tissue. The microscopie examination showed the pathological changes to be most intense in the second and third lumbar ganglia, evident also in the last dorsal and first lumbar, and only just perceptible in the fourth and fifth lumbar ganglia. These changes consisted in an evident hyperæmia and extrava- sation in the peri and intra-gangliar fat tissue, less in the connec- tive tissue, also exudation and hæmorrhage in the ganglion cap- sules and cells, causing a retraction of the latter from the former and finally in a paleness and degeneration of the protoplasmic ,bodies of the ganglion cells.-Schmidt's Jahrbcher, 27 July. Inflammation of the Breast in Young 1Xen.--This affection, though not very rare and easily treated in the majority of cases, sometimes is most difficult to treat successfully; in books on surgery it is but slightly noticed. Mastitis is most frequently the result of a blow, but still many cases come under observation in which it arises from no known cause. ' It often occurs in healthy youths about the- ýtime of puberty, and is accompanied by most severe rain, slight fever, and swelling of the glands of the axilla; the breast is very tender to the touch, and feels hard and knobby. Mastitis generally ends in resolution, hardening or suppuration, and frequently recurs in the s'ame individual. The treatment is simple. If the patient cannot bear cold applications, warm fomeütations may be frequently applied. After the pain and inflammation ha somewhat subsided, apply a mercurial plaster over h3 breast an:1 g've iron and qu'nine interrally.- Wentsche Zeitscher (Chir.), qu)ted in Schmidt's Jahrbûcher. 231",
         "232 CANADA IMEDICAL AND SUROICAL JOURNAL. Treatment of Umbilical Hernia in In.. fants.-Dr. Giuseppe Rapa says lie bas, for the last twenty- years, been in the habit of treating umbilical hernia of children in the following way:-After the child bas been washed, the mother holds it in her lap with the shoulders to the left side and pelvis on her right knee ; -with her left hand she fixes the upper extremities of the child, and with the right the lower. The surgeon should then paint the hernia and its neighborhood with collodion. The hernia is then reduced, and a compress dipped in collodion applied over it and held in its place for about three minutes by an assistant. The compress should be held in its place by long stiips of adhesive plaster, which should meet at the spinal column, and over this a broad roller is applied and the whole surface of the roller painted with collodion.-Revue Clinicale, 2nd Series, quoted in Schmidt's ahrlûeher, 1876. The inutility of Cutting the Frenum in new-born infants, by Dr. Bailly :-The author thinks that division of the frenurn lingue is perfectly useless in new-born children, and can even become dangerous in cases in which the deep parts are divided, which contain important vessels. Accord- ing to M. Bailly the frænum has no effect on suction and on articulation of words. Relative to suction it is to be remarked that very often a very decided frSnum is only recognized at the end of several days during iwhich the child bas not failed to suck quite regularly. Sometimes, even, it is only at the end of several months that chance discovers this condition in children otherwise thriving,-proof, that as far as sucking -was concerned there was no inconvenience. It is scarcely supposable other- wise, considering its extensive frequency, that the fræcnum does- escape notice in plenty of children in country districts where the doctrine which concerns it bas not penetrated, and where, were it recognized, no one would probably be found capable Of performing the operation; a condition which does not prevent infants from nourishing themselves and thriving like others. M. Bailly inclines to believe the reproach is no better founded",
         "BRITISII AND FOREIGN JOURNALS. as to its effect on the articulation of words. Although having less complete evidence in regard to this, he cites the case of a woman of twenty-six years who has no defect of pronunciation, and whose \"tongue cannot pass beyond the line of the teeth.- Bulletin de Therapeutique, 16th July, 1876. Hyoscyamine.-Dr. Petois relates two cases of uncontrollable vomiting in pregnancy, which were cured com- pletely by hyoseyamia after all the usual remedies failed. He gave a teaspoonful hourly of a mixture containing five milli- grammes of hyoseyamia in 125 grammes of water.-L' Union Medicale, Sept., 1875. (Edinburgh Medical Journal.) Bicarbonate of Soda in Toothache.- Dr. Dyce Duckworth records a case of severe toothache, which was almost immediately cured by the application of a solution containing about half a drachm of bicarbonate of soda in an ounce of water, after other remedies as chloroform, etc., had failed.--Practitioner, April, 1875. Hyposulphite of Soda in the Treatment of Boils.-Dr. S. Duncan Bulkeley states that hyposul. phite of soda, in doses of thirty grains three or four times a day, largely diluted, and on an empty stomach, is the treat ment mainly adopted by him for preventing the formation of bous. Should this fail, he gives large doses of quinine.-' American Practitioner, May, 1876. Nitrate of Soda in Dysentery-Dr. Caspari gives large doses of nitrate of soda in acute dysentery, and finds that it is as efectual in rectal as in the intestinal forms of the disease. Re gives from three to six drachms in divided doses in twenty-four hours. The solution should be warm.- Bull. Gén. de Thér. (Edinburgh Medical Journal.) 233\u003e",
         "CANADA MONTREAL, NovEMBER, 1876. THE HEREDITY OF SYPHILIS. Every one who has carefully studied the discussion on syphilis in the Pathological Society of London last spi-ing wili .\u003ee struck by the divergence of opinions expressed by men ivho have justly earned the right to speak with authority on the subject. Indeed the only safe conclusion that can be drawn after weighing the dicta of so many profound thinkers is that the whole subject still remains to be worked over both by the clinicist and pathologist before any syphilogical doctrine hitherto advanced can be accepted as complete and satisfactory. The investigation of clinical facts concerning syphilis is, perhaps, attended with greater and more numerous obstacles than are met with in the case of any other disease. The frequent tendency of syphilitic patients to distort or con- ceal the truth from feelings of shame, distrust or otherwise, the inexpediency of pushing inquiries to such an extent as will excite awkward suspicions on the minds of the patient's friends or relations, the long duration of the affection, and lastly its liability to become modified by individual peculiarities of con- stitution or in consequence of treatment, presents an array of difficulties which might well appal the stoutest-hearted searcher after truth. For the pathologist the whole story of acquired secondary syphilis, at least, is almost a closed book. This fact, though, perhaps a fortunate one, is a serious impediment in tho way of ascertaining the exact connection between secondary and tertiary syphilis. With so wide a field for research, and so important a subject",
         ". THE HEREDITY OF SYPHILIS. let us hope that the laborers will not be few, nor their harvest of fresh facts a scanty one. The question of heredity is one of the most important in connection with syphilis, and yet it is one of the least settled, probably because syphilographers are as a rule not favourably situated with regard to their patients, for the purpose of making sufficiently protracted observations. In this respect the general practitioner eould avail himself of his better opportunities of watching the results of syphilitic marriages, and by keeping an accurate record of the same materially aid in the settlement of such problems as the following, and many ethers of equal practical importance: Can a woman bear a syphilitic infant without becoming infec- ted herself ? What length of time must elapse before a syphilized man can marry without danger of transmitting syphilis to his offspring ? Is congenital syphilis capable of being transmitted to the third generation ? Does syphilis ever cause scrofula or tuberculosis ? In the selected matter of this month wll be-noticed an article translated from the \" Centralblatt,\" on the inheritance of syphilis, by a German writer of some note, Dr. Kassowitz, and although many of bis statements are open to criticism, the article in question wil repay perusal. According to this writer a woman may contract syphilis during pregnancy, and suffer from the usual constitutional symptoms, and still give birth at term to a perfectly healthy child. This, if true, is a most remarkable fact, but we are inclined to think the element of time lias probably been neglected in the investigation of this point,-that the iinmunity of the infant, under such circumstances, is apparent though not real, for if the law of Colles, enunciated in the year 1837, be accepted, that syphilitic infants nursed at the breast often infect the breast of the wèt nurse, but never that of their own mother, the conclusion is irresistible that the mother bas also been syl.hilized, although she may not bave shown any secondary symptoms, or as Mr. Jonathan Hutchinson expresses it: \" Syphilis thus acquired by blood contagion from the foetus would appear to be for the mother, parallel with vaccination with regard to small-pox, she gains inmnunity without suffering from any severe form of the disease.\" 235",
         "CANADA MEDICAL AND SURGICAL JoURNAL. But let us suppose the order to be reversed, and the mother's blood becomes contaminated with syphilis whilst she is carrying a healthy foetus in the womb, there is surely no reason why the fetus should not pass through a similar process and gain pro- tection in the same way ; if so one of two things would be neces- sary before a child born under these circumstances could be pronounced free from syphilis. It would be necessary to test the fact by inoculation, or to await the advent of some of the later sigas of inherited syphilis, such as interstitial keratitis, which it is now well-known may sometimes be delayed until middle life. It is not, however, our intention to discuss all the questions raised in the paper alluded to, inasmuch as it is fresh clinical facts that are wanting for their solution, and without these we cannot hope to advance our knowledge of this important subject beyond its present uncertain boundaries. OUR CIVIC SMALL-POX HOSPITAL. We should like to ask the Chairman of the Health Committee one or two pertinent questions. For what purpose has the Civic Small-pox Hospital been constructed. Is it intended simply as a place to which to remove all the unfortunates afflicted with the dread disease, leaving them to the strength of their consti- tution to determine whether they shall live or die ? Or is it really meant to be what its name implies-a Hospital-that is to say, a properly governed institution for the medical care, and if possible the cure of those admitted to its wards ? If the former, we have nothing more to say. If the latter, we must be per- mitted to observe that we fear, that, as at present conducted, it fails to fulfil its object. It is but recently that we have made ourselves acquainted with the actual mode of furnishing medical attendance to the patients at the Small-pox Hospital. It will be remembered by many of our readers that some months ago one of our two health- officers was permitted by the Board to omit all attendance at these Hospitals, on the ground that it interfered with his private practice. Since that time we have always been under the im-",
         "OUR CIVIC HMALL-PO HOSPITAL. pression that the other official Dr. Larocque, was in regular attendance there. We now, however, learn to our surprise that no regular visits of a medical officer are made at all. He goes only when sent for by the matron, in the meantime the patients take care of themselves. A medical friend of ours recently sent a patient there, and nearly a fortnight afterwards was puzzled at getting a message requesting him to come to the hospital and say if he were well enough to go out. On going he was told by the patient that lie had seen the medical officer but once since his admission. Now we contend that this is essentially wrong, and is a great injustice to those who go and to those 'whc send patients there for treatment (?). Can it be wondered at, that people refuse to go if this is the way they are to be treated ? The excuse given for this is that the matron can always judge when any one is sick enough to require medical aid ! Can we believe that, if the public knew the facts they would consent to allow the bestowal or not of medical attendance upon their friends to depend upon the discretion of the female superinten- dent ? We cannot for one moment admit that the duties of a medi- cal attendant of such an establishment are fulfilled by his simply making a hurried visit when particularly asked to do so by the matron. We desire rather to see it a portion of his regular duties regularly performed, to exercise a constant and intelli- gent supervision over the entire hygienic, dietetic and medicinal regime of the Institution. He should most unquestionably be obliged to acquaint himself daily with the condition of all the patients, and to sec that all their requirements are punctually attended to in accordance with his directions. 'his is what is expected from the attending physicians of the General Hospital (who attend gratuitously) ànd why should not the same be demanded here ? Whon the Montreal General Hos- pital had.charge of the small-pox patients, the Governors paid a physician a fair sum for attending upon them, but insisted upon hisvisiting twice daily through the entire wards. How thoroughly this duty was then performed, all connected with the Hospital Very well know. 237",
         "238 CANADA MEDICAL AND SUIGTCAL JOURNAL Whilst on this subject we would further remark that this public Institution in which it is of the most vital importance to retain the public confidence, is entirely without any of those salutary checks (periodical inspections and reports) which ob- tain in the case of most other public establishments. It might not be amiss to take into consideration what would be the best means for carrying out some such inspection and periodical report to the public on the subject. We do not desire to criticize more than we can help, but there is one other point which we would like to mention. The matron is permitted to compound and dispense all the drugs and medicines required in the house. This .lady, whatever her qualifications may be (and we are ready to admit them), in regard to energy and capability for governing and managing the general afifirs of the house, has certainly bad no medical edu- cation whatever, and knows nothing of the nature and properties of medicines. It is not right that responsible work of this kind should be performed by one possessing no qualifications for it. Either the medical officer in charge should do the work himself or have some other competent person to do it for him. We hope that Alderman McCord will sec his way to make some changes in the directions we have indicated, for we are sure that upon proper consideration, they will be found to be most just and reasonable. THE NEW CORPORATION BY-LAW. We observe that a by-law is proposed by the City Corporation, whereby a fine of forty dollars or two months' imprisoriment is to be imposed on all practitioners of Medicine of the City of Montreal for the neglect to report to the Health Committee, within twelve hours of its occurrence, every case of infectious disease. We cannot think that the by-law will be permitted to pass in its present shape, as it will, in our opinion, lead to endless litigation. What is meant by infectious disease ? If it is limited to small-pox and typhus fever, let us understand it to be so, but even so, we hold that it is no part of a physician's duty to report to the lealth Committee any of the private concerns of his patients. We fear if this by-law is passed that it will not",
         "· PHYSIcIAN'S VISITING LIST FoR 1871. work, as -v e should suppose that the majority of physicians would resist its enforcement. What are we coming to, with two health officers, and a health committee, yet are we without a head that can give counsel to the citizens on health matters; Quite recently a young man was laken with small-pox in aboard- ing-house in Bleury street. lis physician at once procured a private room in the Civic Small-Fox Hospital, and had him re- moved thither in that vilc and hideous vehicle provided for the- purpose and called the city small-pox van. Five days after the removal of this gentleman a couple of sanitary officers went to the housè, put up posters with the words small-pox in Frencli and English and threatened the mistress of the establishment with fine and other penalties if she dared to remove the notices. Now this appears to be wrong. ýThe city officials should not be instructed to resort to such measures. There was no small-pox in the house, nor was itlikely that there would be, every precaution had been taken. The room had been cleansed and disinfected, the becd- clothes and furniture removed, and it was à gross injury to the proprietor of the house as well as the whole neighborhood, as it was calculated to create unnecessary aiarm. We certainxly think that if persons determine not to remove their friends to a proper place provided for them by the city, then would the authorities be perfectly justified in notifying the neighborhood that small-pox was certainly in that house; but to placard a house with posters intimating that small-pox was in that house, when it was not so, is, to say the least, calculated to do damage to individuals, a damage which could, we should suppose, be -emedied by an action at law. If this rule is to be carried out in all instances, we should say that there would be a goodly lot of houses disfigured with posters bearing the words picotte, small-po:r. THE PHYSICIAN'S VISITING LIST FOR 1877; LINDSAY \u0026 BLAKISTON, PIIILADELPIITA. We have received a copy of this most useful little book, and as we deem it indispensable to the Physician in active practice, we hasten to notice it. It is in the same style as its predeces- sors, this being the twenty-sixth year of its publication. The contents are an almanac, table of signs, Marshall Hall's ready 29",
         "240 CANADA MEDICAL AND SURGICAL JOURNAL. method of treating asphyxia. A list of poisons and their antidotes, and a most useful table for calculating the period of gestation. Then follow blank leaves for visiting list, for every day in the year. Monthly memoranda, addresses of patients and others, nurse's addresses, accounts asked for, memoranda of wants, obstetric engagements, vaccination engagements, a few sheets for record of births, also for record of deaths, and general mem- oranda. Messrs. Lindsay \u0026 Blakiston, in their announcement state the list can be had to contain a record of from 25 to 100 patients weekly. They publish also an interleaved edition which will be found of great service to the busy practitioner, as in it he can keep short notes of cases, to be transferred or written out at greater length in his proper note-book. It is an exceed- ingly handy little book, can be carried in thc pocket. It has attached a pocket and pencil. The price is very moderate, ranging from one dollar, the price charged for a book intended for 25 patients weekly, up to three dollars for two volumes for 50 or 100 patients per week. It is to be procured by ordering direct or through Dawson Bros., St. James St. WILLIAM R. WARNER \u0026 00. We are pleased to observe that William R. Warner \u0026 Co., manufacturing chemists of Philadelphia, have received the Centennial Medal for the superiority of their Soluble Sugar- coated Pills. We can testify to the elegance of these prepara- tions, as well as to their reliability. ,We believe that this is the third occasion on which the excellence of these preparations has been testified to by awards of medals at the World's fairs. Messrs. Kerry, Watson \u0026 Co., are the agents at Montreal. Dr. Stark writes to correct a mistake which occurred in the October Number of this Journal in the formula which he gives for the treatment of Gonorrhoca. The formula should be as follows: 63. 01. Erigeron. Canad. 3iij ; 01. Lig. Santal. 3iss; Spt. Vini Rect. Diss; Syr. Simpl. ad Dij. M. Flavour with essence of wintergreen. Shake before using. A teaspoonful every three or four hours. It will be seen that the amount of 01. Santal. Lig. is much diminished in the formula, being 3iss instead of 'iss, and the quantity of spirit is increased, being 'iss instead of 3i. He also sends the particulars of two other cases, being Nos. 6 and 7 of the series. In No. 6 the discharge ceased in five days, and in No 7, in seven days and a half."
      ],
      "published" : [
         "[Montréal : \"Gazette\" Print. House, 1876]"
      ],
      "identifier" : [
         "8_05177_53"
      ],
      "type" : "document",
      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 5, no. 5] (Nov. 1876)]"
      ]
   },
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   "doc" : {
      "title" : [
         "The Canada health journal [Vol. 9, no. 5 (May 1887)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_04586_9"
      ],
      "published" : [
         "Ottawa : Health Journal, [1887]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempteu to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque L Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than Nue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure D Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Pages restored and/or laminated/ Pages restaurées et/ou pelliculées r Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Titie page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison D Masthead/ Générique (périodiques) de la livraison D Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "PIAI. CANADA H EALTH-. JOURNAL, A MONTHLY MAGAZINE 0F PREV.ENTIVE MEDICINE, -EDITED BY- on thie 111gli Deaili Rate in Canada and its Pro-- volition ....(o.......................... 109 What Rags niay o-The INccessity for Great caution on thoir importation, etc.......... 113 Prohibition a Delusion-Neither Practical or Nccessary ................ ............ 116 Overwork and W'orry....................... 118 Cousulxuption, is it Conitagionis9............... 119 Consumption and its Prevenition ........... 2 31iscellanleouls Extracts and selectionls-A 13ad Hal\u003eit-Delcrium Tremuens froni Tea-.Micro- Organlisulis in thxe «M\\ot1-Nàostrin \\'endors The Appetite a Guide-Best Foods thxe Cleapest-Poisonous Wall Papers- Diet and Diingto--Dispiostl of Sewage-flownvar(l Fil- tration-Disinfectants and tlheir Uses-3ac- illus of Tylxoi-Clhoosi)g a Pîxysician .... .125.129 Subscription Price, $2.oo per The Public Hcalth for April................. 13o Table of Dcatlhs for the Month ..............1j31 Special Miscellancous Rteins................. 132 E\u003clitor's Special Corner-The Golden Rille- Jlolidays-Whither shal ive go ?-Cauxitinig Oxit-Txe Caledonia Spriings-Ic....133-184 Observationis mud Aunoùtions-Txe Woodstock Ilealth Convention-The Toronto ]loar4's Repoyt-Contagiousiiess of Conisuliptioi- The Cetiry on Diet-Sir Henry Thoinpson, Physician, on Diet-Rest aud Sleep)-Dr. Carpenter on Disinfcctants-,A -Valuiable Serial ............................. 13-136 year; Single COPY, 20 Cents. ADDRESS ALL COMMUNICATIONS, \"IIHE4LTH JOURN4Le Ottawa.\"l VOL. IX. IEI~ No. 5.",
         "HENRY WATTERS, R) OBINSON \u0026 KENT, BARRISTERSt IlE.TC. Office: Victoria Chambers, Chemist~ and Druggist, 1 9 Victoria Street, Toronto. 214-216 Sparks St., Ottawa. Special attention given to the Cornpound-. ing of Physicians' Prescriptions. N PEARSON, DENTIST, fornerly . of Newmarket, corner of Kinig and Yonge Streets, Toronto. N. G. ROBERTSON. NEY o h mod. Ct this out and r tu e t us, and wve will send M ONEYtyou'freec.\"s soniethIn of great value and limportance to you, thar 1 tav o in business wnich Nvill brIniz you iun motoxnoney right. nt way than nthinz c l n this worlil. A n one can do the -výkad]euthome. Either sex; ail ities. Soemethingnw that just coins iioney feinill vorkers. We wll start you; capi- tai net needed. This is one of the genuine, arn- Dertant chances of a Iie!n.Those m ho are ambitieus and euterprising willnotdelay. Grand outflt free AddressÉthue.\u0026CO., Augusta, Maine. ,,- - k-7 TUE GICAND UNION HfOTEL, Opposite the Grand Central Depot,. New York City, Offers travellers and familles srriving or leaving the city te visit Saratoga, Long Branch, White Mountains. or other Suininer Resorts, superior accommodations. Ail inprovonients, E'irop)ein plan, over 600 elegantly fornished roomus, fltted up at an expense o! a Million Dollars. $1.00 and up)vards per day. Riclily furnisbed suites for families, and elegautly furnislied rooms for dinner parties for ten and npwards. Cuisine and wvines et superior menit. Tie Restaurant, Cate and Wine Roonis supplied with the best at moderato price. Toilet and Baggage Reons, for ladies snd gents, where coats, valises and parcels eau ha left free. W. D. GARRISON9 Manager. td'GusW Baggage taken te and frein the deoaifrec, and $3. 00 cab hire saea tej stopping ai this Ilo! i. Be sure and try the Grctnd Union.Hotel. TORONTO SHOE OOMPANY, 146 and 148 King St. East, Cor. Jaryq St. We Invite your Confidence and Patronage. 1-48 Old Heéadquarters. a 146 New Ladies' ParlQr, strThe -Gj,êat* and only One Price Casli Boot and Shîoe House in Toicuto. -'a H. A. E. KCENT. v r t: t; f. o",
         "THE CANADA HBALTH JOURNAL., IMAY, t887. No. 5. ON TEIE HIIGIL DEATII RATE IN CANADA AND ITS PREEŽTION. AS ADDRESS TO THE 31EMBERS OP TUIE PARLIAMENT 0F CANADA. L AST year I toc\u003ek the liberty of ad- .4dressing you ini relation to the de- sirability of some speciat means being taken for the prevention o? the exces- sive 1loss of humari life in Canada from year to year from preventable diseases, ascomparod with the niortality in Eng.- land. As it appears to me to be a sub- ject of very grave importance, and one which most naturally concerns the mnbers of the highest parliament of Canada, 1 feel constrained to, venture to again address you upon it. During the year that bas since past, the rate of mortality in the twenty odd Canadian cities and towvns wbich have mnade now for the Iast three or fbur years regular monthly reports of their deatbs Wo the Departinent of Ag- riculture in Ottawva, has continued to exceed by 20 per cent. or more the mor- tality in the chiot cities in the mother country. If, as seems roasonable to, suppose fromn roasons given below, the saine rate of mortùlity that is r. .orded ini these Canadian cities and towns pro- vails tbroughout the Dominion, this iniplies a loss in Canada every year of at Ioast twenty tbousand human lives, over and above what it would bc were the mortality in Canada not propor- tionably greater than it is in England. Twenty of the chie? Canadian cities and towns which made these monthly reporte during lat year (1886) cern- prised an average population for the year, I assumne, of flot more than 640 - 000. In order not to understate the~ population of these cities and towns, 1 have estimated on the basis that the rate of' increase during the five preced- ing years, 1882 to, 1886, inclusive, was the sanie proportionately as i t was d ur- ing the decennial perîod betwcen 1871 and 1881, according to the ceosas ini each of the last named years, and then added'50,000 more to allow for any possible inecease over and above this estimation. These twenty cities, with their 640,000 people, reported to the Department of Agriculture here a total for the year of 16,018 deaths, or a mor- tality nt the rate of 21S per 1,000 of population. If there were any errors or defects in the mortality roturns fronri these cities and towns, they would be, those of omission; and indeod, it is not. unikely that, at this carly period of the registration of mortuàiry 6taitisties. in this country, a number of deaths re- înained unrecorded: if so, the rate of' mortality, I need hardly write, was stili groater than this. In the twenty-eight largest cities or \"«towns\" in England, with an estimated population of over 9,000,00, there wvere recorded, during the same year (1886), 189,610 deat*hs, as shown by the Itegistrar-General't3 weekly, re- ports; equal to an annual, death rate of",
         "110 TUE CANADA HEALTH JOURNXAL. 20.9 per 1,000 of populà'tion. There cîties and towns, with the exception the system of registration je most per- that, in the cîties during the warmest fect, and few, if any deaths am~ unre- season, the infantile rnortality le pro-, corded. bably greater than it it3 in the country. In the Canadian cities therefore the On the other band, the mortality from mortaiity was 20 per cent. greater diphtheria ruid. typhoid fever, two than in the cities in England ; and over commonly prevailing diseases, is found 25 per cent. greater thati in great .and to be usually greater proportionately' crowded London, where it was less in rural than in urban districts; white than 20 per' 1,000 of population. on the whole in cities, more attention ln the previous year, 1885, with the is commonly given to bealtb matters, smnall-poz epidemic, tho mortality in than in the country. and many causes the Canadian cities was about 30 per of disease are more prevailing in the 1,000 of population, or nearly 50 per latter than ini the former. cent. greater than in the English cities. The total number of deaths then, This high mortality. in Canadian annually, in the Dominion, with its cities was lai'gely due, to be sure, to the 5,000,000 of pcopl *e, can bardly be higlier death rate (probably largely, much less than 125,000; estimating at too, of infants) in Montreal, Quebec, the rate of 25 per 1,000 of population, Ottawa, St. Hyacinthe and Sorel; ai- zthe rate, certainly, of the cities and though in the \",Queen City,\" Toronto, towns. the mortality was 20 per cent. higher Now with proper sardtary adminis- than in London, England. tration and reasonable attention to the In deaths from zymotic diseases, ordinary rules of healtb, 'there je no wbicb are tbe best indicators of sanit- reason why the inortality should be ary conditions or requirements, the bigber in Canada than it je in England. Canadian cities show to a stili greater W'e have bei-e a healthy, invigorating disadvantage. They returned a total climate, with bardly any overcrowding record for the ycar of 3,852 deaths from or destitution. But white in Canada, this class of diseases; equal to an an- with the exception of Ontario and a few nual death rate from these causes alone of the principal cities, where sorne of over 6 per 1,000 of Population. slight, effort bas been made, rio general In the English cities the total mor-* attention whatever bas been givets to tality from zymotics alone was 2-9 public bealtb meat§ureS. in England, on per 1,000 of' population for the the contrary, for the last quarter of a year, or lees than one-baif that in the century or more, a grent deal bas been Canadian cities. done, both by the Government and the The rate of mortality from, diphtheria municipalities, for the prevention of -in the Canadian cities was nearly ten diseuse and premature deathe. Conse- :tines as higb as in the English cities; quently, as most people know, the mor- and tbat from diarrhoeal diseuses more tality in England bas been gradually than, twice as high, and from. fevers talling lower andi lower during many nearly iwice as bigb , 'in the former as year8 last past, and hundrede of thous- in the latter. % ands of lives bave been saved. Now ve bave no reason to believe With the sme practical health mea- that the mortality in the rural districts sures earried out in Canada that are in Canada is èny lower than à~ is in the exercised in England, what reason",
         "TUE CANADA HEALTHI JOURNAL. 1 could there bo wby the mortality ini this country should flot be reduced to as low a rate as it is in that? Noue whatever. Ronce it follows that, by failing to p)ut inti practice in Canada suitable measures for promoting and preserving the health of the people, froin 20,000 to 25,000 buman lives are every yenr, destroyed lu Canada by preventable di.- soess; or in other words, that number of lives might be saved, and s0 tbe aver- agre of Jife ho prolonged, twenty per cent. beyond its present length. When an epidémie breaks out and destroys two or three thousands of lives in one locality in a few weeks, it is regarded as a dreadfal calamity, croates great excitement,. and prompt action is taken to suppress the epi- demie. If it were shown that 20 per cent. of the horses, or cows, or sheep, or hogs in the Dominion died every year fromn some cause or causes which might be prevented, would flot action sc'on be taken with the vîew of preventing sucb destruction of animal life? Yet it bas been clearly sbown on more than one occasion that at least 201000 human beîngs die every year in Canada frein preventable causes-that ut least 20,000 more die than sbonld die, and yet hardly an effort bas been mnade to prevent this destruction of life; although much bas been done in the way of importing lives frotn other countries. Last year 1 pointed out the money value of these 20,000 lives, and the di- rect loss sustained by the country through this number of premature deaths, in accordance with estimates put upon the value ofhuman. life, the costs of sickness, etc., by political econ- oinista in England and the United States, aud gave, in detail, the couts of mnaintaining a portion of the lives up to the different ages of five, ton and twenty years, at which aixed portion of them. die, before roaching the useful or productive period of life, which is ail lost Ly their deatb. and the direct loss of' the labour and usefuluess of those of the 20,000 Who live on to more than twenty years, into the period. of labour and usefulness-to 30, 40 and 60 years of age, and also the money*value of the lost time in the sickness preceed- ing these deaths, the coRts of sicknes inall-m doctors' bil, medicine, nurs- ing, etc.,-and the expenses of funer- ais, and showed clearly that on a 10w estiriate, the premature death of these 20,000 individuals is a direct boss to, the Dominion 0f over fifty ilitions of dollars every year; or in other words, by preventing these 20,000 premature deaths, and thus probonging, by 20 per cent., the average length of life in Can- ada, there Nvoubd be thereby a direct annual gain to the Dominion of over fifty millions of dollars. Furthermore, if we could so improve. the public health by practical .sanitary administration and the education, of the public in bealth raies and proceed- iLgs as to reduce the mortaiity to 17. per 1,000 of population per annuin, as in England tbey expeet to be able to do in a littie tinie, the most emninent scientists believing that the average of lufe should be such as to give, at most, only this ratio of mortality, this would be equal to a saving of over one hun- dred millions o? dollars a yeatr. Enormous sains tiiese may appear, but nevertheless I have based my cal- culations on the estiniates o? the beat authoities snd the lowest es1timates have been taken. Again, we all know bow etostiy sickness aund death are, and how large au amount of sieku would precede the de-ith of 20,000 or 40,000 Ili",
         "THE CANADA HEALTIL JOURNAL individuals, bosides the loss of the tirne of the older ecs. In the calculations, I omnit britireIy the pain and anguish and bereavement caused by the sickness and deaths. I take no notice of the widows and or- phans. These are beyond calculatiop. These add incalculably to the loss. I bave not takeon into account the ands fr any special epidemie, over adabove the ordinary average animal miortality. This i8 sonietimes enor- mous, when including the suspension of business an(l tradoe. And ail or mucb of it would bc prevénted by propftr attention to public health pro- ceedi ngs. Another enormous loss to the coun- try arises from want of econoiny in selecting and cooking foods. A little' knowledge distributed amongst the masses of the people in reference to tbo selection, preparation and cooking of food, besides proventin1g mucb sick- ness, and intemperance in the use of spirits, wvou1d save each family many dollars every year, and many millions of dollars would thereby be savcd to the country. Some systematie health organization, besides attending to the usual, ordinary and well-kiiown sani- tai-y wants of the people, could do a great deal ina the way of assisting the Conimissioner ofLInland Revenue in the prevention of fo2od adulteration, which with meats and mulk often bad from want of careful, systeniatic inspection, are slowly but surely sapping at the life of the people, and more especially of infants. Consumption among cattie is believed to be more coxumon than is generally supposed. luI the ninth an- nual report of the Agricultural College and Experimental Fanm at Guelph, Ont., it is stated that, ,The extont to which this disease exists among the botter breed of cattle in this country is alarming, for many roasons ; not the least one of which is the danger to which the public are exposed froni the consumption of ment fro n such ani- mais.\" Much could be done, even by meanR of simply educating the people, in the way of preventing the t3pread of this disease, as weIl as other diseases of animais; and as well arnongst ani- mnals thomselves as froni the diseased animales to man. It is weil known that many diseuses of animais may be, and doubtless often are communicated to nian. But 1 have tilready exceeded the space to which 1 thought I would limit myself in this address, and to on- umerate ail the wvays in which the health of the people could be promoted, would be to too greatly oxceed my liuit. What can be donc ? WVho are to take action toward the prevention of this enormous annuailobas? Whether wisely or otberwise, the power to enfonce sanîtary nicasures, it appears, bas been placed ýn the hands of the provinces. But what is to be donc when the provinces fail to set upon the powers conferred upon thcm. Lest year I endeavonred to bring to- gether the views of the late Senator Brouse and others, in reference te what might be profitably donc by the Fedoral authorities. Lt is univor- sally believed that much more can be donc in the way of preventing disease, by investigating the causes of diseases and the collection of' vital statisties, and by tbis and other means educating the masses of tbe people in the waPys and ruies of health, than eau be donc by ceercion. There are many people, it is true, who require to ho forced to attend to ordinary essentiel sani- tary requirements, but a langer propor- tien neglect these requirementstbnough ignorance of the evil effects of inatten-",
         "THE CANADA ]KEALTH JOURNAL. tion, and of the good effects of proper attention, to them, and througb ignor. ance of the causeis of disease, and of the mens by which disease may be avoid- ed or prevented. The great and chief tbing i8 the0 SystematiO EDUCATION Of the masses of tbe people in the raies and ways of health. To do this, effectually, a system of vital statisties is mest es- sential, thougb much educational pro- gcrless May be made in advance of the statistics. I wonld most respectfully urge upon the Fcdeî'al parliarnent and the gov- ernment in particular the desirability of some early action on behalf of these tbousands of human livýes who every year fait victims to PRLEVENTABLEc di- sease and for preventing the great lose to the Dominion thereby entailed. At Ieast a commission or a committee xnight be appointed to consîder the question. It ie a qucstion of much greater importance to the. peopile of' this iDominion than that of \"Temper. ancett or \"Prohibiti\u003c,n,\" whîch indeed form but a part of the greater one o Publie Health. WHAT IRAGS MIAY DO-THE NE(JESSLTY F01R GRIEAT CAUTION IN THEIII IMPORTATION, \u0026C. 1 H1E report, issued in pamphlet form of the speciat committee of the American public heaith association on the disinfection of rage, at the meeting in Tor-onto in October last, gives some very suggestive and instructive histo- ries of rags and clothing and the serions part such often play in the spi-end of i nfectious, matig~nn d iseases. Fol low- ing are some extracts from tbe report: In 1870 the first cases of smait-pox that appeared at Breda were among persone who had been wvasIhing infect- ed ciotbing trom a small-pox patient, coming from an infected district. In 1870, 1881, and 1882 the same tbing happened at Utrecht. In 1873 a pillo'v infected by a smali- pox patient caused several cases of smail-pox to appear at Goreem, wbile in that same year a rag-picker's daugh- ter was attacked after having bought sorne rage from. a person who had had smali-pox, and caueed aiso a ne-\" epi- demie te break out. The appearance of the -disease at Ohe and Laak, and ait Olkmaar, was also due te the importa- tion of infeeted clothes from, infeted tocalities in I3elgium and at the Hague. The origin of the emalil)pox epidemie in 1871 at Heerde and Epe the mcdi- cal inspecter attributed to rage. In that saine year Schyndell and Rozen- burg were iuvaded witb small-pox by the importation of infectcd clothe8 from Schiedam. The cases of smalt. pox that broke out in 1873 in the hos- pital nt Utrecht were traced to insuffi- ciently disinfected bed-quiite, which had been infected by 8mail-pox patients treated thera in 1872. The same enigin is given te the Tilburg epidomie in 1873. In 1870 and 1880 consecutiveiy were attacked with small-pox persons who, 'white working in *a paper factory at Maestricht, had buen bandling rage, or had visited the iocality where rage are selected, whereas during ail tbat time ne other caue of the disease was known in Maastricht, but ouly in Belgium, wheuce the suspected rage were partly comin«. In 1880 a dealer in rage con- veyed small-pox trom Rozindal te Vouw. In 1881 the infected rage from. Gouda caused an epidemie ait Baron,. 113",
         "THE L'AN4DA HEALTII JOURNAL. drecht, etc., etc. It would b. a waste of time to cite ail the cases wjhere rags and infected linen have brought on epi- demics. And when we look nt the, report on choiera, we are amazed to see that its origin and propogation are alwvays, traced to the influence of clothing, dresses, and the traffic in old garments and rags.7 Thus, a rag-picker from Amsterdam, wbere choiera was raging, introduced it into the city of' Tiiburg in 1885 in a truck-Ioad of infeeted clothes. At Druten a rag-picker wvas the firet victim in that commune. At Mearssen the flrst one attracked with choiera was a ragman. Again,at lieus. den, Ouden bosch, Hindelopen, Ni ensis- burg, Leeuwarden, and Bois. ie-Duq choiera was propogated by the hand- Iing and washing of old ciothes, cloth- ing, bed-clothing, etc. In Engiand, France, Gertnany, Oe., the same facts go to provo tbe propa- gation of diseases, and principally of small.pox. One of the most intercst- ing Nvorks on this subjeet is certainiy floctor Giibert's report on the epidemie at Marseii les, that had oxactiy the same characteristics as the smali.pox epi- demie of 1874 and 1875, and proved beyond doubt the great influence of rage on eI)idemics. S.-, to, cite only two facts, in 1874 there wver-3 117 x'ag stores in Marseilies, of wvlich 46 wvcre in one district. In that district the number of deaths from smali.pox ivas three times larger than in any other district, wbiie of 167 cases of death 64 c-urred in rag-pickers' bouses, or -n bouses ini close proxi mity torag-pickers8 or rag-satores. ln that district (4ilbert, found a ceilar, a secret store-room, for rags, which infected six persons, of which four died. Ki'iegstetten is a smali village, in the Canton of Solothurn, at Oighty to one bundred kilometres' distances from, Zurich, and flot connected with this town either by water (lake, river or marsh\u003e, or ty trade and industriai commerce. There is a paper miii at Kriegstetten, and a wvorkwoman, who had to tear the rags, was suddenly talc- en with choiera, and died the foiiowing day. The foilowing days sixteen mor'e workiwomen (ail occupied in tearing the rags) were talion sick; of these, eleven died. A carefuil examinat*on showed that ail1 of these ragts wen t fr-om Zurich, and from choiera houses:- there- fore, the wvhoie mass of rags was disin- fected by boiling. After this no case of choiera occurred. The large estab- lishment of the paper miii, as weil as the village, remained free. I mentioned the thct in a littie address to the Swiss people, which I have the honor to, send you; and nobody doubted the fact or made any opposition. The fact was known everywhere in Switzeriand. The Britîsh JiicdicaI Journal cf Mtiy 1 ith, 1878, speaks of \"1rags as dissem- inators of disease,\" and refers to \"tho measures taken by the Austrian Gov- crninent to prevent the spi-end of di- sease by obtaining the adoption of uniform precautions in ail the neîghl boring states, in the shape of' strict enforcement of sanitary regniations aud the prohibition of the importation of rngs.\" \"The authorities of Austria,\" the article remarks, \"have for some time forbidden the importation of rags.\" Vol. I., page 863, of the same journal says: \"An epidemic of~ sinail- pox, which spread somewvhat widely. broke out at Abenbeim, in the canton of Worms, Rhenish Hiesse. Ahnost ail the patients at the outset were five Nvomen, whô worked in a rag-factory cutting up and assorting rags. The cases were investigated, and it wvas found that a portion of these rags came",
         "TRE CANADAHREALTE JOURNAL.15 froai Mai'seilles, where sînall.pox pre- vailod to a serious extent.\"' Tho British Mediccd Journal of J uiy 3d, 1880, says: Girls who wvorked at storing rags at Canterbury contracted the diseuse and commun icatod it to twvelve others. The thon hoalth offi. cer said that during the period of three years thore had not been a case of sinail pox in the tity the origin of which. had flot beon traced to the fac- tory. In 1878 cases originatcd in the Saînc lactory. In 18'19 ainother case occuirred there. Dr. Butterfield, in lis iast annual report on the health of Bradford, wroto: No case of small-pox had occarred in the borough for many montbs, when a girl who had not ieft the neigbborhood. was takçn sick. In a few days another young woman eru- ployed in the saine work exhibited symptoins of the disease. Marcb, 1878, several persons, residing apart, but working in the saine room, at a mag- warehouse, were simultaneousiy affect- cd witb sinaîl-pox, and f'rom, theni extcnded to about thirty others. At Whittlesford, in 1873 and 1875, there were two outbreakrs of small-pox from the saine cause. At Thetford an epi- demie of -six montlhs' duration, and froin wbich sixteen or sevonteen deaths resultcd, wvas traced by Dr. HL. J. Hun- ter to two %vomen engaged tolgether in (eutting up some foreign rngs, and wvho fell i11 the samne day. Under date of Jan uary 2Oth, 1883, the British .lfedi\u0026d Joiural said: Ail outbreak of small-pox bas just takren place at New Cathcart un,àer pecuiliar circumstances. A locai firm of papor- makera recoived in Decemnber last a quantity of rage froin Koniguborg viai Leith. The workpeople in their om- ploymont have been ongaged in cutting them. up recently, and within the last few days four of them, have sick.,bed with what is foarod will tnirn out to be the saine disense. John Barnes, a .laborer, had been suffering for two days from. diarrhoea, and cramp, when, on December 2Stb, ho was taken iii with the symptoms of choiora and died. The next day flarnes's wifo and two other persons who visited the sick man were scizod with choiera, but recovored. The son of the deceased man thon arrivod. Lt appoars ho bad been appronticed to bis uncie, a shoomnaker in Leeds, and that his aunt died of choiera flfteen days before, ber effeets having been sont to Barnos without baving been washed. If ho trunk cnntaining the things bad been oponed by Bamnes in the ovoning, and the next day ho was taken iii and died. In 1854 choiera was flot known in tbo county of Bedford, wben it broko out in the village of JLidgmont, and oloven cases oceurred, ail of which wero fatal. Lt was ascertained that tho first case occurred in a man whose son bad died of choiera in London a week or two befnre, and whose ciothes, were sont down to the country. The poor man unwrapped the bundie of clotiies biniseif; ho ivas seized witb the disease and died. Thia case ivas the nucleus of the others. An instance of' similar nature was reported from, Lustheim, noar Municb, where the first case of choiera was generatod in the house of a laborer, oneo0f wboso daughters was in service at M1unicb. Tho latter sont ber parents clothes belonging to a family some members, oîwhich had just died fromn choiera. These old clothes were at once appropriated and worn. Three days afterward (Septernber 2lst, 1854) t~he father and mother were seized with choiera and died. On the 22nd and 25th other mombors of the famiiy took the disease. Dr. iaebert reports 115",
         "TEE CAN»A HEALTH JOURNAL. the case of a man wçho was attacked with choiera, having worn the clothes of a person who hid died of thedisease two months previcasly. On the 24t1 of December,1848, a womnan and two children died of choi- era in Suon Fields, Southwark. The clothes of the. child were se.uý, to Boston for the use of a third child living with its gi'andmother. The old lady and child unpacked the parcel and both were attacked with choiera. There -were no other cases in Boston until eight montbs afterward. Lt is iveli autbenticated that during the opidemic in the UJnited States in 1873 choiera 'vas introduced in effeets of emigrants. The vessels whîcb brougbt them, were in perfect sanitary condition. Passengers were heftlthy, and remained so after landing and until tbey reached Carthage, O., Crow River, Minn., and Yankton, Dak., where their goods were unpacked. At each place, within twenty hours after poison par- ticles were liberated, the first case ap- peared. Many years ago, in one of the early outbreaks of choiera in the then North- west, a mattress soiled by a choiera patient ivas tbrown overboard firom a vessel on or below Lake Huron. The mattress eloated down the St. Clair River, anid being seen frora the shore, a man svent ont in a boat and brought it to the shore, where his wife wvashed and çarcd for it. This man and his wife both contracted the choiera. I had this information from Capt. E. B. WVard, fromn wbose vessel the choiera- soiled rnattress was thrown over- board. PROHIBiTION A DELUSLON-NElTIER PRACTICAL NORI EFFECTUAL-SOMNETHING BROADE R DESIRABLE. T IIE foiiowving remnarks from. the Journal of Jnebriety, a work of high standing, is opportune and in full ac- cord witb our own views. We hope the time wili corne when prohibitionists will take broader views and ernbrace in their well intentioned efforts means for the physical. development of the people and the prevention of disease amaongst theni. If the efforts which bave been put forth by the temperance people bad been directed toward the promotion of the public healtb gener- alIy, very much more good would have been done, as -well in -the prevention of intemperance and sickness as ini prolonging life. Like an army unexpectedly attacked and thrown into c'nfusion, or a ship strnck by a squall, in disorder unil the aathority of the captaiu ris assei'ted, the temperance moralist and reformer are astounded at the sudden aiarming prevalence of inebriety. In the confu- sien of this discovery tbey seize on the wiidcst means for relief, and follow the noisiest enthiusists and the most im- practicable scbe-zies. Leaving to one side ail the varjous means of cure by prayer and plcdge, tbey tamn to poli- tics, and are trying to unite thleir con- fuiQed efforts juto political party, which will enforce l'y iaw their theories of the causes and cure of inebriety. This prohibition movement, from. a scientific point of view, bas neyer at- tracted much attention. Bat to-day it assumes such arrogant dlaims of power to remedy the evils of *drink, condemning ail who differ, that it most naturally invitvu the scientiat te ex- amine its pretentions and theories. In this inqairy the Journal ofluebrL. ety has ne politicPal interest or theory",
         "THE CANADA HEALTU JOURNAL to sustain. A8 the organ of mon who are making inebriety a scientific study, it demanda the facto, and the evidence upon which they are based must be presented and compared before the truth ot any phase of this subjeet is accopted. Any views supported by facts are welcome, and the kinelest sympathy i,% extended to ail measures and movements for the relief of inebri- ety, no matter how crude or' impracti- cable. Ail euch efforts are regarded as agitations and iavolutionary strug- gles incident to every advance of science. The probibitory movement is based on the tboory that inebriety je only caused by aleohol, and that this drug is a Iuxury which can bc withdrawn at will, thus removing the evil. Also, that inebriety depende upon the matnu- flitture and sale of alcohol compounds, and wvîlI disappear wben the supply ceases. The rcrnedy le to drive out the maker and seller of spirite, and banieli alcohol. It is a curious fact that prohibitory legisiation has been tried for ovet' a thousand years, from time to time, againet alcohol, tobacco, tea, coffee, cocoa, and opium. Moral, social, theological, and governmental forces bave most fiercely and violently tried to supprese the use of these drugs. Despote wvho held, the lives and thoughts of their subjects, and con- trolled ail their acte, bave falled to break up tbe use of stimulants and îîarcotics. Even the Chinese despotic rule faiied to stop the use of opium. Kinge and Popes have combined againet the use of tobacco, only to be defeated, and over and over again leg- isiation aguinet the use of alcohol bas been unsucceseful. Now and then temporary, local, and limited succes follows, but after a time this disap- pears, and the evil continues in even greater proportions than bof'ore. Thus hfstory repentb itself in tbe movement of prohibition to stop the ovils of ineb- riety. The tbeory of prohibition is not sus- tained from a study of the 1nebriate and inebriety. Alcohol je not a luxury, to be used or flot at the will of anyone. It je a narcotic epirit which lias been uised in ail tiges, cli mes, and by ail peo- ple, to soothe and rolieve the wearied brain and unstable organization. AI- cobol and its conipounds, have ever l)een used to supply some demand of brain and nerves, seme defet-t or debîl- ity. This demand je not created by the form or the prevalence of alcobol, it je an inherited or acqnircd defeet. The aiîmy of inebriates are recruite frorn states and conditions of life far back of the distillery or saloon. In this country tbey are often victime of our higli-presenre civilization; of con- tinuous nerve strair.s and drains, wbich not only exhaust but cripple the race and its descendants. The demand for relief which je found in spirite bringft ont the manufacturer anci retailor to supply it. They may increase this de- niand, but they do noV create it. When once the victim finde relief from this drug, law and moral suasion are powerless. kEanish the maker and dealer of spirits, and the current le turned into other channels equally dangerous. Opium, ether, and otber druge corne to supply the demand. The chemists of to-day are constant- ly discovoring new and endlese varie- tics of alcobols, which wili aiways have a place in the arts and sciences and wherever tbey are i'ound Wo bring reet and quiet to this abnormal eraving of the race tbey wiil be used under al circumetances. No probibitory meas- tires can discriminate in this field,.. and no present knowledge will indicate the",
         "THE CAINADA IIEALTHI JOURNAL. alcoholie compounds that are dangr- ous or s-afe wvhich sliould or should flot be sold. Prohibition is a delusion when it assumes that to, stol) the m.inufacture and sale of alcohol is to, break up inch- riety anàl cure the inebriate. Lt is a delusion to expect that party, potities, and law can break up the disease of in- ebriety, or that a knowledge of the evils of inebricty wiil point ont the causes and romedies. It is a delusion to suppose that the evils of inebriety eau be reniedied and controlled wvben its causes and nature are practically unknown. Opinions, theories and be- liefs by earnest entbusiasts ean mot bring the authority of knowledge based on -%eIl-ob\u003eerved fficts. Until inebriety is made the subject of exact study, and the laws which govern its rise and progrcss are ascer- tained, and the complex causes and conditions. of life from wbith il. springs are pointed ont,ý prohibition wili fait to probibit, and every mens of trentment net founded on exact study wiIl die ont. Probibitory legisiation may net as a dam te the drink current ibr a titte, and the streamn appear to be stop- ped, but the certain breaking down of the (lain and overflowing muin that foi- lows point to the errer of flot bcginn- ing baek te, the source. The drink problcmn can flot be solved by moral suasion or prohibition; it is aqucstion for science and scientifie study. In the march of progress, beyond the noise and enthusiasmn of temperance reforin- ers, Lbe great forces of civilization are seen recruiting inebriates along fines of causes and effiéet as fised as the mno- tion of the stars. Ini the saine range the scientists catch glimpses of the laws of prevention and cure, fironi wh ich in slow, measured steps inebriety and its evils can bc reacbed, curca und prevented. OVER-WORK AN~D WORRY. T 11E following, valuable cxtracts are froi an excellent periodîcal. the Alieudst and ANeurolo9ist: Thecre is doubtlcss noe lass of* discases more largely preventable than diseases of the ervus ystein, and though the causes of these disasters are somnetimes, remote, yet they are usually traceable to violations 'of the laws cither of men- tal or bodily hygiene. Over-study in early life. witlîout causing an immed- jate break-down, may dwarf the devel- opinent and lay the foundation for f u- ture invalidisin, and we believe that a etonsiderablo proporton of nervous disorder is attributable to, such inflit- ences that in carly life wvhen the ner- vous systein is sensitive and impres- sible, check its normal growth and leave it ever after irritable nl unsta- bic. The saine considerations aÈ'»Iy te over-work in adults. There is tnt brain failure niow-a-daysâ from w~hat is calied over-work, and yet mnch of it is probably due more te the m\u003cwaer of work than te, the amount of work. Bard and prelonged mental labor is net injurious if carried on under proper conditions; the brain is streng- thened by exercise, and the work of a man of un intellectual pursuit, if prop- erly diversified, 1$ recreation. The barmn of mental laber is in working at wrong heurs, or withont systein, or, with both, and tension that wear upon the brain more than work. In this age men rush, and rush mneans high ten- sion, and tension means rapid wear and",
         "TRE CANADlA HEBALTH JOURNAL. waste of vitality. Emerson says \"1al baste is vulgar,\" and he might have said it is injurious to heulth, and those who work with that high pressure whicb baste invites, are certain to, suf- fer for it. It should be considered one of the beatitudes of mental physiology, that systematie, deliborate montai labor is normal; it develops the brain and prolongs the peried of its activity in old age, and the converse cf this is also true, that mental labor porformed with anxiety, haste and high pressure is ex- hausting and is certain, sooner or Iater, te produce injurieus resuits. Those who deal mucb with nervous disorders know how large a share cf these trou- bles is due te the habit of wvorryîng. People fail into the habit of %vorrying about those lîttie mishaps that of ne- ccssity come up in the lufe of every one, and the habit once fornied is a difficuit one te overcome; ivorry, above al] things, consumes vitality, and disar- ranges the harmonious working of the funetions; it ]ends to loss of' alppetite, to sleepless nights, te irritable nerves, to impaired nutrition ; it robs the dis- position of attractive qualities, it les- sens the mental -vigor-and it not infrp quently is a father in the productie. of nervous disorder. Sensitive people, those who are easily wounded and dis- couraged, are most apt to, worry when affairs go wrong, and yet tbey are just those whom sverry will barm the mest and who will lose the meat in lite by indulging in it. Triais and reverses may destroy the over-sonsitive or the weak, unleas such persons prepare for themn by the cultivation of patience and courage. Those, bowever, who are not fretted and depressed by the small mis- Laps and adversitics of life are the bet- ter for encountering, them, for tbey are a part of the necessary and kindly discipline cf experience that helps us te, build up character, and strengtbens it, as the stormn that bonds the vigorous treo strengtbcns and consolidates its health, fibre. CONSUMPTION, 18 IT COXTAGIO US ? S 0'1%lyearitS ago wec gave from time totime in thisJeuRaYALa greatdcal of evidenco whicb seemcd te show voiy conclusively that censumptiol' is a con- tagions disease. IVe beliove that the discase in its usual form is contagicus and that it nover arises in any other way except by means of infection, mcst probably the bacillus tuberculosis, bcing communicated from the sick te the welI, or the susceptible. The following on the subject are a few extracts from a pamphlet on I'Consumption and its Prevention in Mau and Animalti,\" by the editor cf this jeurnal, only a few copies cf whic bhave yet been issued : From the period of the carliet rec- ords in the historyof medicine, the centagicus nature cf tubercutlar con- sumption has been believed in by pby- sicians cf the highbest repute. Uver two thousand years z'go, (400 B. C)., Hippocrates, the \"1father cf medicine,\" believed in it. Aristottle (320 B1. C.) wrote that the Grecks in bis day bo- lieved in it; and he sks why ronsump- tien,à 1sore eyes\"' and itch are common te persons wbo asseciate with others suffering from these affections. Later (A. D. 180\u003e, Galon %vrote that it is dan- gerous to pas the whole day with a consumptive person.\" Coming down to mucb more recent periode, Morton, over two hundred years ago, wrote of Consumption thst 'cotgospri\u003eci- pie often propagates this di.se, for,",
         "THE CANADA H1EALTH JOURINAL. as I have often found by experience, an affeeted person niay poison a bed- W~low by a kind of nijasin like that of a malignant fever.\" Iliverius, about the sanie period of time, believed con- tagion to be the \"chiefe\u0026t\" cause of consumption. \"lWe may observe wvomen te bo affected by thoir bus- bands,\" ho wrote, \"and moen by their wives, and ail the ejildren te die of the sanie, flot only from infection of their parents seed, but froru the conipany of hlm that wvas first infected.\" The eminent Italian physician, Val- salva, a professer of Bologna, in the early part of last century, wvas hiniseif predisposed to, consumption, and avoid- cd being presont at dissections of the iungs of persons whli had. died of tbe disease. Valsalva's illustrious pupil,' Morgagni, professor in the University of Padau, declared that ho had neyer dared te make more than a few post. mortemt examinations of persons irbo bad died of this diseuse for feaar of con- tracting it. A law once existed in Italy by whicb the proprietor cf a bouse in whicb a consumptive bad died could dlaim payrnent for bis furniture, which was burnt. It wvas ofton difficuit there for a person suppced to be consump- tive te, obtain lodgings. Over a Century ago a reaction re- garding belief in the contagnousness of consumption cornmenced te show it- self. Eventually, ini .orthern Europe and Americaespecially, doubt develop- ed jute general disbelief. In the warm- er latitudes however the opinion favor- able te, contagion nover lest its hold; and the reaction bas prebably paved the way te more rational and accarate views, based on modemn scientifie in- vestigations, whicb will b. generally accepted. Within a comparatively fcw years the belief that the diseas is contagious bas agnin become very gen- eral. The recent investigations of Kock have resulted in making belief in its contagiousness almost irresistible. If the bacilli are the cause cf the dis. ease, it can hardly bo otberwise than contagious. D. Wm. Buld, in an article on the nature and propagation of pbtbisis (London Laacet, Oct, 12, 1867,) takes strong ground in favor cf\u003e contagion. lie concludes that \"-tuberculosis is a truc zymotie disease of speeifie nature, in tho saine seuse as typhoid, scarlet fever, typhus, syphilis, etc., are; and that, like these diseases, tuberculosis nover criginates spontaneously, but is perpetuated solely- by the law cf con- tinuous succession. The evidences cf\u003e thîs hc finds in,-\u003ca) Consîderations based on the pathology of phthisis, consistiinr in the evolution and multi- plication in the orgauism of a specîfic, niorbid matter, %vith a tendency to elimnation, and casting off of the sanie, like zymotie diseases generally. (b\u003e Actual instant-es in which there is evi- denco to, show communication f rom one te, another. (c) The geogrraphical dis- tribution cf phthisis in past and pres- cnt tumes, and especially its f'atality now ln countries whicb were entirely fiee fromn i wheu first discovered by Europeans. (d) Its greater prevaieoce in low ievel3 and crowded communi- tics, and entire absence, except by im- portatiou,at high levels -the same con- ditions which govern zymotie diseases. (e) Its high rate of prevalence ini con- vents, harems, barracks, penitentiaries, etc-, i. e., lu the samne social conditions known te propagate zymotic, disease.\" \"AÀs facte provisig hie statementabout geographicat distribution (c), he adds that when the South týea Islande were first discovered, there was ne pbisis there; but that since the aboriginos have cerne into contact with Europeans",
         "THE CANADA HEBALTII JOURNIAL. 2 the disease bas becomne so wide.spread as to, threaten their extermination. This is a striking con trast, only to be explained, ho tbinks, by the importa- tion of a new and specifle rnorbid germ. The lato Dr. Rush, of Phîladeiphia, wbo made accurate inquiries, satisfied himseif that there was no phthisis ainong the American Indians when Amer-ica wvas dtscovereLd, whercas now it is very tom mon and vory fatal arnong them. l\"Fur-ther-mot-, in Afri ca, everywvhcre along tho seaboard, whcere the biacks have corne into conetant and intîrnate relations ivith the whites, there hbis been a largo mortality ftom the di- scase; but in the interior, wvhere there lias been only occasional contact ith a few great travellers; the diseuse bas not been found. 0f this fatt Dr. Liv- ingston and other African travellers have griven Dr. Budd positive assur- ance.\" (\"lIs Consumption Contagious,\" by Il. C. Clapp, A. M., M. D., Boston.) 'Dr. Bowditch, late chairman of the state board of health of' Massachusetts, a number of years ago made some in- vestigations relatingr te the cause of eonsumption, by sending a list of ques- tions to prorninent, physicians in active practice ini several of the States and in London and Germany (Fourth annual report of the state board of he-alth, Mass., 1872). 0f 210 physicians who, rcplied, 28 did not answer the question ont contagion. 0f the remainder, 110 answered in the affirmative; 45 in the negative; and 27 were doubtfül. Many besides answering -'yeW\" or \"no\"' wrote -somothing like the following: IL amn a firm believer that consumption 18 a contagious, diseuse, mucb more so than is generally believed. 1 have in My minci several cases where there was almost positive evidence of contagion.\" \"In very many cases, I have the opin- ion, from my own observation, that censumption is communicable by con- tagion or infection.\" \"tIam more in. clineci than 1 'vas at one time to attach importance te the influence of contag. ion.\" 111 arn thoroughly convinced thüt phthisis is frequ6ntly caused by contagion and deserves to be cifissed with typhoid foyer in8 ibis, respect. 1 have seen un mistakiable evidence whero a healthy wifb contracted this diseaso, and vice versa.\" In 1878, Dr. ll\u003clden, of Newv Jersey, made sorno similar investigations. Out of 250 answers te, a list of questions, 126 physicians answored 'Ivos\" in re- ply te the question on contagion, 7U ef %whom were emphatic, and gave cases in confir.mation ; 74 answered \"no\" and 50 were doubtfül or could net form an opinion. Dr. bildon hirnself commenced pe-actice, it is statcd, with the idea that consumption was communicable only from parent to offs3pring, but at length ivrote as follows: \"I1 can enumerate nt least a score of cases which have been watched with this very object in vieiv, andi in which the resuit has been the saine. Wives after husbands, husbands after wives, intimante companions and faiithful nurses, who slept in the saine bed, or wore the samo clothing, have fallen victims. 0f course, it is not te be intimatcd that ail, or even a major- ity, tan be affecteci by contagion any more than in those diseuses now indis. putably contagilous. Malignant scarlet Lover, diphitheria, and cerebro-spinal, monigitis are braved by fiithful nurses and friends, who, escape in more than a majority of instances. To prove con- tagion now, is, no ensier than when the non-contagiousness of erysipelas had its defenders, andi the records of the surgical wards of the bospitals et Paris, and Berlin, and London, had accumu- 121",
         "122 TE CANADA* HEALTIL JOURNAL. lated a fearful rnortality ere the obdur- ate prejudices of the profession were awakened to a new belief.\". Dr. C.lapp, of Boston, in a recent iverk (\"1Is consumption contagious\" 1881), records the history of 25 cases, itistraUtiVe Of the contagions3 nature Of this disease, which ho selected \"1froih among those which cati be found on record scattered through tbe annais of medicai literature.\"' In the bistory of the 25 cases, mention is made of 66 persons who became consumptive seerningly tbrough contagion. 54 of these were distinctly stated to be freo from bereditary taint, and of the others, \"1probably some wouid have been found to ho lîkewise frce if their family his- tories could bave been obtained.\" THE LAPEST RECORDED EVIDENCE. A paper on the question of the con- tagiousness of' consumption, by Dr. Brochin, trauslated from Le Journal de ilMecicine de Paris, by F. R. Camp- bel], A.M., M.D., is puhlished in the May' issue ef the Bqffalo .Médical and Surgicul Journal, of which the foilowing are extracts: .No question kj ofgreater importance te, the prattitioner and sanitariari than that oftbe contagiousness of puimonary consumption. I arn surprised that tbe 8ubject is not more frequentiy discussed, in our scieutific societies, and that the report of our eminent confrere, M. Val- lin, is not taken as the basis of further researches. While the profession is stili divided on this que-stion of the contagiousness of tuberculosie, the number of l\"con- tagiouuists\" is daiiy increasing. If oach physician would search through the records of bis practice there would be discovered. such a number of cases pointing to the propagation of cou- sumption by contagion that the moat t;keptical would be convinced. We do not mean to sa\u003e' that con- sumption is as contagions as smail.pox, scarlatina, typhoid fever, or even ery- sipelas. If it weire, wve would ail die of tuberculosis. But wve cannot conscien- tiousiy dcny that consumption is often propagated from person to person ivheire the surriounding and physicai conditions of those exposed are suitable. Lt is, therefore, the dut\u003e' of physicians to take certain precautions to arrest the ravages of this di-end disease. I 'viii nowv submnit rome fhcts tending to demonstrate that pulmonary tuber- cuiosis is contagious. In October, 1885, I was calied te attend Madame G., a sebool teacher, wvho fer some timo bad tomplained of a cough and a feel- ing of fatigue. She was a adyv25 years of age, married tbree years, hav- ing, had two chidren. Since ber last confinement she bad had a cougb, and lost weîghit and strength. A physical examination of the cbest revealed un- doubted signs of tuberculosis in its first stages. lier grandmotber and a sister had botb been affected witb lung di- sease. lier dutics as teacher in a large school exhausted ber strength ver\u003e' much. She lived witb ber husband in the bs:ement of the sehool building, in roomns badly Iigbted and ventilated. The discase increasecd s0 rapidly tbat in January, 1886, ber husband inferm- ed me that she passed whole nights in cougbing and spitting, and her perspi- ration was so excessive that it waa ne- cessary to change bier ci otbing several limes every night. She died in Marcb, and ber husband, wbe was absoluteiy without any tend- eney te consumption as far as famiiy bistory and physical conformation was concerncd, became tubereulous and, at bis writing, Marcb, 1887, bas an enor- mous cavity in bis left lung and tuber- cular granulations in the larynx. This fact appears to me to ho demon- strated, that a healthy man, without 122",
         "'CHE CAIbADA HEALTU JOURNAL.12 :iny constitutional. predisposition to, phthisis, if exposed for a long perîod to, the exhalations of a tubercular pa- tient will acquire the diseae himself if the bygienie surroundings are unfav- orable. Madame Y., aged 31 years; fither -ind mother died of consumption. be- cime tuberculosis itself, and died after an illness lasting four years. Herbhus- band, aged 33,wias a strong, bealtby man, without any bistory of tubercu- losis in bis famaily, occupieý the same rooma with bis wife up to tbree nionths before ber deatb. Even before she died hoe was affected with a cough, lost his appetite, becam'e emaciated, and hiad night sweats. On auscultation I (liseovered a consolidation at the apex of the left luug. llow could the di- sease have been acquired except by contagion ? Madame P.; aged 25 years, married thrce years, tivo chidren, exbibited signs of tubeiculosis in Novembter, 1884. After careful and prolonged treatment, ber condition improvcd and she renewed lier housebold duties, but continued to cougb. Rer husband, aged 30 years, bitherta in the best of liealth and witbout any bereditary tendency to lung disease, 'vas attacked with wvhat was apparently acute brou- chtitis. But alarming symptoins of consumption soon developed, and in spite of energetie tre'atment ho died of phthisis ini July, 1886. Ris wife is still living, but bas a cavi$y in ber ieft lung. Ber cbildren are in gond bealth. This case relates to the bimtory of ne entire family. The father, aged *35, prirtLer by trade, iras obliged to work mauy hours a day to, support bis xwife and six eilidren. 0f these chil- dren, two died of tubercular ini eniogitis wben two years of age. The third year the father became il], and died of consumption in six montbs. The eld- est son, wbo assisted his mnother ie the bouse, dîed of acute tubereulosis. This Nvas the fourth death frorn tubercuiosis iu three years in this famiily. You wiIl say that heredity mighit explain ai, but how wili you ticcoinut for the fbllowing: The niother, an cxtrcrnely robust and energetic; womnn, îvilli no heredit. ary tendericy to ûonsumiption, contin- ued to do lier utnîost for ber hnisband and eildren. She soon became plithis- ical, and in a short tinie died. Oue of the remaiujing thrce children, a girl 16 years of age, is aiready pale, emaciat- ed, and seenis te be tuberculous. Ie this bistory, ire can explain the disease of the fether, who was the son of a consumptive, and of the children, by heredity. But wbat other cause than contagion eau bc inçoked to ex. plain the affection of the mother ? Will yoi say that overîvork: and grief iras the cause? Tbese rnay be con- tributing causes, but are flot suffloient to, explain the appearance of tubercu- losia le a robust woman, bitlierto in the best of health, and irithout a family history of the diseuse... .. .. 1 could give many more exanîples of the contagiousness of cousumption îi'bîch I have obserred ini my practice during the last fifteeu years. But it is a subjeet so extensive that prolonged' study and deep researcb are necessary to ecr up ail the factors lu these cases. 1 bave only desired to cail attention te some facts jointing to the contaglous. ness of I)hthisis, and I would be very bappy if other members of the profes- sion %vould publisb their observations on this subject. If it eau ho demon- strated beyond quesion that tutbercu- losis is contagious, it becomes our duty to provide separate wards for consump- tives in hospitals; to insîst on the iso- lation of our patients in private prac- tice, and te employ disinfection and antisepties in the treatmcnt of thee case matters; wbieh bave been bither- to entirely neglected in this country, althougb carried eut le Germany end Eegland. 123",
         "TUlE CANADA ILEALTH JOURNAL. CONSUMVTION. AND LTS PREVENTION. C ONSUMPTION we aiwnys have with us. Not Iess than ten thousand, dcaths arce nused every year in the Do- minion by th is diSease, Smaî-p)ox COrnes now and agaili, in limited localities, and causes much aiarm. Choiera threateris and alarms too. Hygienie precautions, sornetimes very active, are takien to 1)l'event the spread and niortality of these diseases. But ivhcre one death is caused by either small.pox or choiera, ton, twenty or More are caused by Consumption. It is such a terribLly prevalent and flaia disease in almost cvery country, in both man anid animais, that fe* questions arc of greater importance tha«n that which relates to its prevention. Lt is a ques., tion which concerns every individual, of every age. high, low, rich and poor alike, for no one is exempt from the disease and its influences. ýNoreovcr, Constimption seems to be almost every wliere on the increase; 'vhieh fluet makies the question a stili more serious one. The disease is now almost uni- versally regarded by the medical profession as a preventabie disease, and the subjeet of its prevention becomes oneO of great practical importance. Lt is very strange, indeed, consider- iîlg the great Iataiity of this maiady and the large proportion of sickness and of deaths it i.s eontinually causiîig in almost evcry country, that more general attention has flot heretofore been given by sanitarians to its pro- vention. Thoso taking interest in public hoalth proceedings-in the pre- vention of sickncss and promature death-bestoiv their Vhoughts and timie chiefiy on those diseases wbich prevail epktemically and in a short period of time destroy mnany lives in a few days or a iew weeks, while this dreadt*ul disease, Consumption, whieh is daily cutting off, after nuonths and years of aimo.st hopeoless sufféring, vast nura- bers of' lives-often thc brightest, Most usefùi unost valuable lives, bas not received from practicai sanitari- ans the attention it demands. Lt is very sud to contempiate the ,carelessness aid. indifference mani- fested with reference to, the prevalency of this malady and that no special means have heretofore been adopted to stay its progresa or prevent it. If the same amount of nuortality caused. by -Consumption in one year were brought about in a month or two by some opidemie, or more clearly con- tagious diseuse, with a brief period of sickness, panic-stricken citizens would fiee befbro it and from their homes, and active measures would be enforced to, check its spraad. \"But it is flot so wvith this insidious flatterer; as 4. stealth it fastens itself upon the victim, while ail arounid appear to Lie uncons- cious of its presence, and look upon it with as much eareless compiacency as thon\u003c -gh it as much belonged to, humanity as tho ravages of time itself.\" And s0 it stalks on, coutiting its ten thousand victims at toast yearly ini Canada aione. Healtb Boards and othor organiza- tions for the prévention of disease, issue by thousands and distribute amongst the people pamphlets con- taining brief iristuretions, by ivhich different opidemnic disoases mnay be prevented. Pamphlets for the preven- tion of smali-pox, of scarlet foyer, of diphtheria and of choiera have been x.ssu 'd from, time to time by the State boazd of health of Michigan, and of many of the other States; and our own Federal Goverament, niany years",
         "THE CANADA IIEALTR JOURNAL. 2 ago issued a pamphlet on tbe preven. tion of choiera. Why should flot mensures of t.his kind, and other Mensures, be put jnto practice for the prevention of' Consumption? Proba. bly no disease is more preventable by propor hygienic moeans titan is this one. The very fact of' its slow development rendors it especially controllable. It is to, be boped that health boards will, in the noar future, turn their attention more espccially to the prevention of Consumption. M ISCELLANEOIJS EXTRACTS AND SELECTIONS. DR. MARY WÂLKER earnestly recom- mends that mensures ho taken to in- duce people o ouve monoy when they die to go into a fund for the suppres- sion of the use of tobacco. A GREA T n umber of rnicro..organ isms inhabit the month in the normal state; a stili greater number may be found thora accidentally introdiiced eitlier by tho food or by the inhaled air, and front ivatit of cleanliness. M. Vignal (4rch. de Pluys) round in the buccal coatingt and in the dental tartar eighteen differ- ont species of micro-organisms, and from these ho succeded in isolating seventeen. Honce the importance of cleaning tho mouth ib obvious. A viERY bad and serious habit, which appears to be sproading, is arsenic eat- ing by young wonten. The attention of tho New Y-jrk Board of Health has repeatedly been called to the promiscu- ous uso by young women of arsenic wafers. Dr. J. T. Nagle recently re. ccived a letter from a lady in Harlem, who writes, My daughters for some time pust have been eating arsenic wafers. I underatand that thousands of women are eating those wafers, and that as mariy more are resorting to other leas expensive, although more powerfal poisons. This practice is not unknown in Canada, and a loud note of warning should be sonnded by the press. DELIRIUM Tazsoe\u0026s FiRoX TEcA.- «oaci Healthgi vos the folbowingon thtis.: Thoine, the taxie principle of the coin- mon beverage, toit, is not boss than two hundrod times more powerful as a poi- son than is alcohol; that la, a few grains of thoine wiIl produce as deadly effeots as two hundrod times as much alcohol. A strong cup of tea has more intoxieating properties in it, than an equal quantity of beer. Notwithstand- ing the poet's eulogy, \"The cup t.hat cheers and not inobi-iates.\" An Eng- lisb writer teilla of a part:y of London newspaper correspondonts, who meet regularly on Saturday nigbts, and have a regubar sproe on ton. Somo of thoin are genorally found under the table iii the morning. The London Lancet toells of* a young lady who reoently auffored with delirium tremens front chewîng tea beaves. How mucb more evidenco, ia needed to, convince our akeptical, tea-boving friends. NOSTRUM VENDORS WbI bave a bard time in Russia. A list of patent, medicines, drawn Up it appears by a committee of physicians, the import- ation of which the Russian Government bas decided to prohibit, bas recentty been published. It consise, of about eigbt hundred preparations of English, *Americant, French and German origin. Pilla, plasters, hair restorers, cough drops, medicated foods, ointments, and many miscellaneous preparations for a great variety of aliments, are ail clas- sed together in one \"clong medical index expurgatorlus.\" 12b",
         "THE CAIXADA HFJALTI JOURNAL. TEE APPETITE A NEGATIVE GUIDE. -(Amn. Practitieneî) The appetite is a goed guide ne (leubt, but bâter per- haps as a nogativo tixtn a positive guide; better te, be heeded by the sick in its vetoos than yielded te iii iti sup- plications. Ne doubt since the studoît, *days et' lîppecrates, stories have been going thle rounds eof the profession, and the laity tee fer that iatter, et' asten- ishing cures preduced hy semne tabeeed article of diot. One bas a story te tell ofsore perishing child that snatcbed a plate of bacon and greens and ato themn witb such greedy relish that the *deting niether ceuld net contrel lier symnpathy eneugh te restrain it, more espeeially as the doctor -had told ber 'lit could nover get weli any way,\" and 'wbieh yet tboreaftor wvent rîght on tô' reeevory. .Another patient, aftor mak- ing bis wvill and taking leave et' friends, had been seized with a craving fer buttermilk, and after drinking a liberal ameutit %vai promptly restored te health. And se on, Li a volume might be written et' such stories. But on our duil understanding the fu~rce eof the whele argument is lest. Wben our patient begins te crave bacon and cab- pge or becf and turnips we are always much pleased with the request that inakes the craving known. We take it as an omen of goed, showing that the crisis bas passcd and the bealthy functiens, of the system are re-cstablish- ,ed. Notwithstanding, it deesn't lbllow by any mcans thaut ho gets tbem. PoisoNeus arsenical wall papers doubtle8 of'ten give rise te trouble, and sornetimes serions symptoins, thé,. cause et' which is unsuspected by citb- or patient or physician. Prof. J. R. Chadwick reperted recently te the .Sffolk District Mfedical Seciety the resu lt.of an expérience in bis own fam- ily, by whichà ho was convinced that protracted ill-hoalh of' twve of bis chil dren-dyspepsia, collicky pains, hocad- aches, palpitation of' the hecart, palier and debîlity, wero due te the presence cf arsenic in the wall paper of the nur- sery in which much of theji' time had been spent. PILADELPHIA, the Sanitary Ero, in- formns us, with its comparatively low death rate on the wholo, is exception- ally higb in typhoid foyer. According to comparisens published by Dr. (,has. Smnart, U. S. A. The typhoid death rate bas increasod fer the last two de- cades, having averaged 5.58 in the former and 6.61 in the latter; keeping pace with the progiressive contamina- tion of the water. At the same tîine, New Orleans, with its extremoe disad- vantages, but witb rain water only te drink, bas dimainished its typhoid rate frein 4.15 to, 2.46. Taz best geeds are the cbeupest and goeds which appear te be the cbeapest are generally the dearest in the end. This is perhaps more especially the case in regard to, food stuifs, in which teo the bealtb is cencernied. The Arnerican Analysat lh'.s, steadily main- tained this position and is gratified te find that its efforts have produced a decided change for the botter. These manufacturore who are ever on the alort for an improvrment in tho quai- ity et' their goods, bat, who, while sut'- fering -in censequonce of the cempeti- tien of inferior goods At lower prices ha- e resisted the teurptatien te Iower tht juality of their own preduets now begin te realize the good fruits ef their integrity.\" IT is claimed that thie popular drink et the future, says tho J Y. Medical Tirne, wiII hé milk charged with car- bonie acid. It is eaid tbat inilk thus carbonated *ill keep ad inïdéfinite leuith ef turne.",
         "i ANY readors af 1t11s JOURNAL Who are iatonding ta visit Naples this year wvill be pleased ta leara that medical statisties quoted by the Piiigola repre- sent tho public health of the city as r being greatly improved. The number of deathe, which ia February of laet year was 155 1, thîs year did not exceed 1407. The diminution of infections disease, toa, is floteoWathy. Much at- tention bas ai lato beon given ta the sanitary improvemoat ai the city. FEw realize bow largety the diet in- fluences the cutire buman organisai. One ai the \"fundamental truths\" laid down by Brillat Savarin, in bis fumous -Pheysiologie Du Gout, publhied in 1825, .-%vas that \",animais feed, man eats; the inan of sonso and culture alone under- stands eating.\" Savarin was biniecli the most abstemiaus ia the niatter of table gratification, but none ever under- stood botter tban ho tho principles which underlie the cultivated. taste for enting, and whieh render that obliga- tion an intelleotual pleasure far remov- cd fromn the grossnese af more seasual iudulgence. \"Notwithstaading the mass of literature, practîcal and specu- lative,\" say8 the Americau Aital,st, 11to which the preparation af food for liuman use bas given birtb, and de- spite the universat attractiveaess of the subject itself, it is a lamentable fact that excepting amang a vory ro- stricted clase ai the world'a population tbe art of âining is nat sustained on the elevated plano it je entitlod ta occupy. WVhen weobserve, as we do 80 frequent- Iy, how many porsoas even among those recognized as bolonging to \"igood society\" are destitutu of the asthetie instinc't which should gavera thern when taking part in that most import- ant of ail social. observances, we cau readily conjecture how comparativoly few tbey must be, who underatand the MIE CANAD)A ILEALT11 JOURNAL. art of providing the meal iteelf, and regulatîng it so that every require- ment af healtb, comfort and onjoymnent -mental as wvolI as physical-sball be attended to an bohalf af those who aveÔ ta be its pairticipants. The first pria. ciple whieb ehould gavern dinner giv- ing and dinner eating are tbereforo a subject in wbich ail mankind-and es- pecially ail womankind-are deeply concerned.\" THE ])ISPOSAL OP SEWAGE.-Dr. 0I. W. Chancellor, of' Baltimiore, lias been in Euirope inspecting sewerage. Ho finds that of' about four huadred differ- ont systems the best, and One which ii; used in part in Paris, is the pneurnatie systoni. The principleofa tbia system is that there are a nutubor of stations, into which flaws the sewage. At the central station is a powerlul suetion whieh draws the sewago into a large reservair, ta be, disposod of by crema- tion or any other way desired. in sanie places, where the eiewage ie usod for irrigation, ho states that th- land is kept green, but it is flot a succose, as it je kopt too moist, and the water ifi flot purifiod ta, the extoat supposod by sanie of' the irrigation eatbusiaf3ts. Chief Engiacer Allen of Warcester, Mass., preeentod his repart upou the sewage problemn af that City. Ho spent soveral monthe ia Europe in examùin- ing different systems in use there, siid siace hie rotura ho has examiaed the broad -irrigation systera of Pallmila, Illinois. Ia his repart ho favors the sanie plan that bas becan recommondèdé for Providence, namely, chemical pro- cipitation. INTERiCNTrENqT DOWNw,\u0026aRD FiLT- TioN.-The Sanieari, Record deacribes this procoes, which 18 very*eoniïnori ln England, ln the fallowing way: latêr- mittent downward filtration niay b. termoed a natural systera of purificatiôn",
         "THE CANAI)A HEALTH JOUR\u0026rAL. of sewage by mneans of the filtering and aerating action of the soil; it is carried on by discbarging (with or without previous precipitation\u003e upon a proper- ly prepared area, the sewage of the town undor drainage. This sewage is conducted upon tho prepared area, by a series of carriers, and thon allowed to fiter through the land into drains laid about 6 foot under ground, from whence it (as an effluent) is conducted to, its outfall, niostly a river. -The ac- tion upon the scwago is thrcof'old-viz., evaporation, neration, and filtration, and if properly conducted should gîve an effluent of a very higli standard. As to the amount of land requisite for the purification of the sewango of a tcwn of 20,000 population, authorities dift'er, but taking tho daily amount of sewago per bond at 50 gallons, and the average of Byve persons to, oach house equal to 250 gallons per bouse per day, thon tho fact that this quantity miust be got rid of in about eight hours, it would flot bo safe to reekon leas than 1,000 gai. ions per bouse. Thon taking 4,000 houses, there would be 4e000,000 gal- ions of sewage to deal witb, ivhich could be successfully treated on 5 acres of sucli land; but it would, of course, require that a very far larger amount should be provided, as no land could be expected to ho constantly under treat- ment, and the least amount should be Byve times this quantity, so, as to have only one-fiftb under trea' mont. Great *diversity of opinion exista upon this subjeot, and no very bard and fast lino eau be drawn. Each case must rest upon individual monits and local cir- -cumstall3es. DISINFECTANTS AND THEIft USES.-- Dr. Alfred Carpenter delivered an ad- -dress at the st montbly meeting of the Association of Public Sanitary In- * 8peetors on \"lTheory and Practice as to Disinfection.\" Ho urged (Brit. Med. Jour.) that sanitary inspectors, who had very great power if they used it carefuilly, sbould reason out the grounds of the application of any par- tîcular mode of disinfoction,rather than give a blind obodionce to a written or-' der. With regard to small-pox, -ho pointod out that germs of living prot- oplasm in the breatb of a patient would take root if immediately transplanted to the membrane of' a suac£epti ble por- son, but if fioated about in the air for 100 yards thoy would lose their vital- ity? Isolation, with ventilatien, as rapidly as possible, was necessary in sucb cases., For disinfecting the fur- niture of a house after infeetious di- sease, stoarni was preforable, and hoe ad- vised aIl local authorities te provide thenxselvos with the means of applying stoam heat. Dr. Carpenter did flot recommend carbolic acid as a disinfect- ant in cases of disense, for it wvas found that the acid preserved the dormant germ from decay. This also held good of alcohol ; the use of spiritueus liquors as a protection against tlie evils of imn- pure water was no protection at aIl. The same argument applied, though in a minor degree, to suîphurous acid. The best disinfoctant was a solution of biobboride ofmercury. Lt requîred to be used with care, but it wvas rapid in its action, and so powerfal that a solu- tion of i part in 5,000 of water would in fifteen minutes destroy every living germ. dormant or otherwise, with which. it came in contact. The best disinfectant for sewers was siphate of mron. ECENT STUDIES ON THEC BAOILLtIs 0F TYPHOID.-Ât a recent meeting of the Société Médicale des Hôpitaux, the Phi1adkýphMa Medical Times informs us, M. Chantemiesse preaented some inter- esting statements of the result of bis",
         "THE CANADA HEÂLTH JOURNAL. studios, in company witb M. Widal, upon the bacillus typhosus. It is on- largod nt the extromitios, extremely mobile, and offers strong res3istance to the usual modes of staining. Lt can ho developed in ment broths, botter in gelatin, but best of ail upon tbe potato, upon whicb it shows itself as a moist- ened tbread, aftcr throe days, sometimes flot until after fifteen days. Slowness of development is spocialUy character- istie of this bacillus. Reproduction takes place rcndily in pur~e water, os- pecially if the water be storilized. Lt rosists cold, and will endure a tonipor- aturo of 450 C. without porishing. It is destroyed by a temporature of 80a C., as well as by boiling for sevoral minutes. It incroases more rapidly in a moist than in a dry soil. As to tbe alction of antiseptics upon its vitality, -a 1/2000 solution of corrosive sublimate wili provent its culture; a 1/800 of suiphate of quinine wviIl produco the same offeet; wbile the 1/400 of carbolic acid wiIl have no effeet at ail upon its multiplicatiorn iu a culturo-fluid. By adding a two-per cert. solution of by- drochiorlo acid to the culture the growth of the bacillus is retarded. but it does not die, for, ou dropping a littie -of tho fluid containing it into an allia- lino broth, it will bogin again to multi- ply witb ail its original vitality. CHOO0sINO A PIIYsicIÂN.-Estelle Mon. deil writes in an exchange as fol- lows on this subjeet - A physician is a necessary adjunct .te, most familles, and ho should bo solectod. with care or the bass of life and treasure inay bo great Too froquently, ln -cases, of omergoncy, the ono \"chandies 't by'l is called, and if ho is of leasing addres and -serves us welIlu this partic(.ular case, ho is installed the -fanmily physi-. cian witbout, further kîitoWedge of bhis. fituess. True, the majority of people are too ignorant to sit in judgmont upon an MD., fluent witb phystoiogical terme and latinized romedios. StilI, it would sooni that common-sense might aid us bore. But that it doos flot always, or that it la totally lacking in somo, the following incident goos to show. \"Iseo0 yen have cbanged doctors,\" remarked a lady to ber neigbbor. \"Yos, I got. so tired of Dr. Brown. Hie was always asking wbat 1 gave Freddie t eoat, the first tbing, and wbat ho drank, and vll snch things. Now, I want a doctor to doctor and not inter- fore witb my eating,\" she said rather pompotisly. This expresses the feeling of too many. We want a physician who willpatch v8 vp, and most anybow will do, only ho muet flot interfero with tbe habits that are wrockcing us and making bis services nocosary. A New York physician turned from bis coffors hun- dreds of dollars, by telling a butterfly o? fashion that ho could net cure ber of a nervousncss that throatened te bocome dangerous, as long as she wore the un-, natural, high.heoled. shoos. She left his office in angei., declaring hlm a \"1fanatie and an ignoramus.\" And we are sorry te, say that sncb any phyài- clan wilI be dubbed, who bas the cour-' age of his convictions and dares tell oe o? these wasp-waisted, padded and. painted bundles of weaknesses, that al she requires for ber tbousand-and-one ailînents, la iight, loose clotbing, whole- sOo food, sunebine and exor*cise. Fortumately for the tempera et this class, tbeugh uufortunately for their feeble bodies, they can always find those Who will ýcater té their caprices. But beware of sncb a doctor. Ife who flat-. tors you and humera you i'a moat un-ý worthy your confidence, sud nlot to ho trusted with the beaitb and lives o?. yýour family.",
         "THE PUBLIC HEALTE FOR APRIL. MORTUARY RETURNS FRO31 TWENTY-8IX CAMADIAN CITIES AND TOWNS. T RF, total number of deaths in April in the twenty.six chief Canadian cities and towns-wbich inake monthly retnrns to, the Departnient of Agricul- ture in Ottawa was 1377; a number greater by 40 titan that recorded in March. This shows à mortality for the month ait the rate of 25 per 1,000 of population per annum. While in Montreal and Quebee the mortality ini April temained almost identically the saie as in Maroh, in Toronto thore was an incase in the month of over one per 1,000, and in Ottawa,w here the morta i ty wa8 low in March, there was an 'inerease of nearly 7 per 1,000, or 40 per cent., in April,ý above the previons month. In St. John, in London and in Kingst-On there was a marked increase ini the mortality, while in Hamilton and Halifax there was a decreaise. In Montreal, Hamilton Three Rivers, Sorel and St. Hyacinthe tbe mortality in April was above the average, 25 per 1,000; in Toronto it wasjust equal to the average, and in the other cities and towns iý was below it. . From zymotic diseases there was an increase, in the totals, of 34 per cent., or fromn 153 deaths in March to 206 in 4êpril. This inerease was meade up alraost entirely in Montreal and Toron- to, from measies and diphtheria in the formier eity, and diphtheria in the latter. *Stili, no deaths. are reported from small-pox, it is Most satisfactory »0 nýçte. ILt is pearly a year now since a dpath has been recorded i - any of the cieies or tow ns in Canada from. t.hi8 loathsomne disoease.' This is compli- meýntary to the management of the, qaraçntines (confirmnatory ot the. high: èompinMcnt paid to tbem a îew years \u0026go at an Amsterdam confé,rence of quarantine officers, by Dr'. Van Leent and also to the efficient manner in which the disease and its infiaction was stamp- ed out in the cities and towns in whicb it was prevailing early lust year. Measies caused 34 deatbs in April in the places under notice ; an increase of 35 per cent, as oompared with the pro- vious month. There was a large in- crease in the mortality f rom. this cause iD Montreal; while there was a decline in Hamilton, and an entire cessation in Sorel, in both of which the disease wai very prevalent in the previous month. There was no inereaso in the mortality froin scarlet foyer. From diphtberia there was an in- crease of 65 per cent in the mortality: -there having been 46 deaths from. this cause in March and 75 in April. 0f the 75 deaths in Apt-il, 20 were in Montreal and 24 in Toronto. If meapIes and diphtheria caused the same fear in the public mind as, and the same precautions were taken to, pre- vent their outbreak and spread as are taken for the prevention of, small-pox, they would be as rare as small-pox, for tkey are eqnally preventable, as by means of strict isolation and, especially in the case of diphtheria, absolute cleanliness-with pure air and pure water. There was flot anything more of spe- cial note in relation te the publie health in April in the principal citles and towns. Tùz AÂssembly of Wisconsin -have passed a bill appropriating 815,000 am a contingent f und to, be used, if uleces- sary in the neit two years by the.State- Bloard of Health in preventing the in- troda'etion'of choiera into, that State.",
         "TIB CANADA HEALTH JOUR~NAL. 131 Vic 2.puà 4 i ce CL 0o z w -uw. od jno ?o t: .O't.1 W~ = t ( -11 aIo A t: t 1I: stýmesai qOi 1 ~ leu [e m .toW . . . . . .' .: . . . . . . . . P4tIcLS 'Jenoj 4 El7 i : -~Cq~\u003c ~q... .... .. I \"4 . .4. . . . . . . . . - 1",
         "TRE CANADA HIEALTHI JOURNýAL. WUEAT GERM MEAL, a new cereal food nianufactured by Messrs. Irelaîid \u0026 Son of Lachute, Que., is by far the-mnost de- licieus preparation for porridge we have *-yet eaten. We b-d been using a \"1gemi wlieat\" nianufaictured i Cincinnatti, U.Sp but consider tlîat no\u003ct' prepared in the Lachute Mlilis decidedly superior, as itis freer f rom dark specs and of a richer, mnore \"1foody - flavour. It is niost deli- cious and delicate, and %ve have heard it called \"a.-ngels food.\" if Messrs. Ireland *\u0026 Son can lceep) Up the quality equal to that wve have used, it should conituand a large \u0026ale. WVe have pleasure in recoin- ruending ail wlio desire a pure, nutritions, ýdigestible breakfast dishito ask tlîeir grocer ..(wbo eau always obtain it) for this food .and try it. IN recomnending foods or any thing else in thus JOURNAL, we need luurdly write, :thlat we cannot be bouglit, that no suni of .nxoney liowever large, would induce us te' :reconunend anything, for anyýbodly, wluîch, 'ive do flot, froun personal knowledge, believe te be MI we reconîmend it te be. *When wve do not of ourseif knowv, we may 'give the opinion of other. Knowing wel the importance te health of the diet, we .are particularly interested in good and pure food stuifs. ý iq MiLx, we bave taken muéh interest, ithinking of the innocent littie lives so often diepending upon it-se, oft-en, aMas! we ~Fear, destroyed by its bad quality. Long ;before - bottled \" inilk was sold any where in Canada, we urged iii Toronto the advan- 4agff of the practice, to which we have ýmore recently repeatedly drawNv attention. PNot long ago we submitted a bottie of Mr. 3lcTiernan's unilk (an ordinary bettie, as psually left at our bouse) te the examina- iion and anialysis of a most competent ýracticaI analyst and were pleased te find, âswe lhad expected, but wishied to malce pure, that it was a good, pure milk, of high standard, and we think it due to Mr. MlcTlernan in bis efforts to supply good ýnilk, te make this knoewn to the public. * UEOttawaRiver boats-thie \" Empress\" and \"4Prince of Wales,\" are now again on their route. Frein experience we van state tbat the condition and management of these beats are unexceptionable in every respect. A trip on thein between Ottawa and Montreal, or between Montreal and Car- rillon, or Ottawva and Grenville, and return, affords a niost pleasing and refreshing lioliday. ANOTHER very pleasant trip, we under- stand, froin a nuinher of reliable persons whio hiave taken it, is thiat between Ottawa and Kingston, onuthe - Ella Ross,\" and aise, the round trip frein Montreal te, Kingston by ivay of Ottawa, and tlien froni Kingston te Montreal. ORDINANCES 0F THE CANADA 11EALTH JOURNAL Pare Air: The conplete destruction* of aI svaste organic niatter, by fire or othier- wvise-; ne collections any whiere of bodily exerenent-perfeet sewerage or daily dis- infection or deodorization withi frequent remnoval ; thirough ventilation of aI build- ings, public and private; complete isola- tion and disinfection in all cases of in- fectious disease., Pue W'ater: Strict prohibition of thie pollution of aI inland waters-rivers, lakes, streams-by sewage or other waste sub- stances ; tliorough filtration of ail public water supplies; closing of suspected wells Pure Wholesome Food: Prompt and severe punishunent of aIl adulterators of food, with frequent and repeated analyses; thorough inspection cf foods-meat, milk, fleur, bread, fruits, \u0026c., with punishinent cf all offeringiunpureor bid food; improved methods of preparation and cooking food. Education of the Public in ail Matters Pertainiag to Healtb. HEALTH AM FORt D.uLy PRACTICE. Do net shiut eut toe closely with shut- ters or blinds, the sunsliine freont your reouns. NEITHER rooms nor the human body can be long in good condition without abund- ance cf sun light. Go not into cold -watcr wlhen you are mucli heated, non when coolieig fast. but wait te get somewhiat cooled, yet'still wari. DIUNK net freely cf iced or very cold water, especially wjien much heated or after a meal, butsip it alowly. PUT ice areund, instead of in, the water jug, as ice is often impure",
         "Canada Hlealthi Journal. A MONTHL V.4MA4GAZINE 0F PRE FENTIVE MEDICINE. ?IRMTEENTEf YE\u0026R of Pub*loaton. * \" Spcclally dealgncd for meadlcal and other healthl oMil cers, liendsl of fillailies acta all ilaterestea ls loi- 08n:aotilag Ille pubalicw liealths. Tite only lit*alta Jottrixtl tn tige Englaah l:tngtit jubhlaed in Caimtduo Ir\" Aix.. -To l'r.eent salkeku and proinote public aud Coillinuaîîicatlonq sgolcteai on al aanlt..ry m1bjects. Locail lacaltia omeiers would cntear a fiavor by aacndlig to tige~ \u0026litore.tapics of tieirr.îaort. ljrief nantices ot tltar sanltary condition, liglprovemns. or evcnts in any way connected with laealth. See Club Rates t eUti Boards andi othiera on adver. tislng Page. AU conmnnatinns, with remittances or otberwlse, abould b. addressed, \"Health dournal,\" Ottawa. Cati. * ' . . . . NINTE VOLUIM A bile crosçt olal osite thislnlictes titiat the utha.srlber ta wlaaaaat it la adlreaa.ll isittdalatd fnr titis vaecar's sub- scrilbtiaan (frotta Ja. ta lec. ', :aiaii Ml sttla will eaaîalr à fcav\u003car ley klacdly rtiiiittltag, for wltiela we alcalI feul oligeL We cotatc tatadlerttka ta taaakt* tsit gtrttt itai %end tiatsti by ail car otlatgwiaat und oigîy chaarge Q1.50f. 'Ail moat rataitting datrist\u003e ige est y Iart at titi %,\u0026tr- tige tîra-tt antt or twaab-tttisst exisct ta itny $2.60; tacttitSia tlttti iaestaaasa faiîs.s lIoa iati Iay $3.00 fai tlacr %laallaul Jtsatiai:tl, coaat.aîîaiag no maares raialing inatter titan titis ne. 81.50 anw la worta muore ta ias titan *2.00 îanay inontîta beiaae. with cost of Uie. MaINl atda1 îo-aa. WIII aIl frieltita îca tlail.k of titis. tuai4 lt-Ils w; ilst tliai work lay an enriy rentittunea, AoVEacàaaa%Ts Or uinexepiat4on.alle ela:ar.ta11- is' tIn to, a lasniteai extmrt andl at reiaaaa:lea ratas. inciats of~ \"patent anedicinea.' not, accetes EDITORS' SPECIAL CORNER. With duns the space of this journal lias not often been occupied. But it would secin as if sortie people like to be dunned. To a large number of the subscribers no aceounts were sent last year at aIl, and many are two and three years in arrears Duriug the Last two or three months ac- counts have been sent to inost of these and to many of tlîem (necessity coinpelling) twvo and even three tinies, in closed envel- opes, tlîe postage alone amnounting to quitte a large sum. To mnost of these we know a fewv dollars, ait ay time, is a small matter, and they could pay just as well at one turne as another. A kindly, most respectful ap- peal was ruade to them, for an early remit- tance, as paper and printing jobs cannot be obtained for nothing, and have to be paid for. Rundreds of tliese have (juite disap- pointed, and really, i tlie circunîstances, mucli surprised us, by flot paying or giving, apparently, the slightest attention to the appeal made. To tîsese we would simply suggest the good, and in ail Ijunan inter- course the IIEsT, old \"4golden rule\" and aslIc iiîem to endeavor to imagine the position of theniselves and thiat of the publisher re- versed, and to try and thîink hiow they would feel if they had been treated as th\", are now treating the publisber. Would they think the treatment approaching tlîat of conunon farnesse If any had forgotten or overlooked the littie matter, they can now mend it very mucli by irenutting at once. We hope other resalera to whom the 5above does flot apply will pardon this ne- \u003c'say '\u003cdigresson.\" THE holiday tiiue is at haud;- at hand, alas ! ever only for the few%. In this rush- ing age, when almost everybody is burming the candle of life at. both ends, ahnost everybody should at least once a year sus- pend tlîeir labours and take a complete holiday-a vacation; inake a void in their life and be for a time free froi service. Such is a most wonderful restorer and reno- vator. It only wvants the will and almost amy one could comniand tlîe time, and yet do as much if not more %vork in the year and with much more case and pleasure. If there could be proclaimed from. some sufficiently authoritative source a month'a holiday for everybody every year, and the month could be spent by ail reasonably weil, and at least free f rom dissipation, by this means alone life wvould be mnade happier and sweeter and longer, and insan- ity would no longer increase froin year to yea!r. Most înen are over taxed, either by work or anxiety or worry. WomeLn are less se. More wouten than men live to advanced age, their average of 111e is longer, fewver of thieni beconie insane, few- er commit suicide. Men especially should endeavor to rest more, and to shake off their anxiety and cesse to worry. What is life for? Not alone to acquire wealth aud position. Seek happiness for To-DA\u0026Y, not for to-morrow. Every muan, should niake it arule to go away from hie work for a '\"holiday\" every year at least and tahe his family, who lias one Excepting the farinera, who can best take a holiday at angother Seasn, July and Auguet are oit",
         "134 ~THE CA.NADI IIEALTII JOURNAL. the w~liole the best niontbs for a rest. as then the systemi is inost relaxed froin the lîeat and the least fitted for labour, mental or physical. WVITIER then shall the weary fiee? It is not at ail necessary to, go far for change and rest. The great înajority eau not. To breathe the pure air froin tlie sea is doubtless a great advantage for those who, can do so. provided, always, tiiere is no crowding, that tliere are w~ell ventilated roins, pure water ani goo)d, well-cooked food; fc-% of wlichl essentials can Le ob- t-ainedi at the ordinary *-watering-places,'* where. indeed the opposite conditions are very liable to l)revail, withi too muclh dis- sipation. Siali towns on the shiores of lakes are often resortcd to, but the water and the druinage in tliese is frequently bad. and tiiere are often more inconveniences than coinforts. Whierever one decides to go, the sanitary conditions of the locality and the lodgings shiould be weli looked after, and often mnedical advice on these points, frorn (isinterested physicians, miglit be profitably obtained. There is in Canada a great want of well located and weil constructed buildings where suinnier lodgings could Le obtained at reasonable rates. CAMXP»'%0UT is becoming common. And perhaps after ail tiiere is no better, while àifter the outflt is once obtained, there is certainly no more economical, way of spending alholiday. Alniost anynianwlio can obtain a tent or two, or rough boards for the construction of a slielter froni min, van go from bis home during the warm. season, -with a faniily too, and live for a few weeks at less expense, as a rule, if he desires to do so, than lie can live at home. High ground should Le selected, thehbigher the better, a safe distance froin amy swam- py locality, where abundance of good wvater niay Le readilv obtained. In many such localities good miilk and eggs can Le procured, and in sonie of them, ffish. With a sujîply of good bread, or flour with which to unake it, and carefully selected canned ineats and fruits, with lemons and otber itie luxuries, according to, circumstances, no one could suifer for want of \"4good living\" and ought flot to desire anything more. In thîis way, many thousands of professional mon, artisans and even bard- worked laboring men, and their fainilies, mighit secure the biessling of a change and a vacation. THE Caledonia Springs is the favorite Canadian watering place with many on this continent, a large nuinhor visiting tlien annually froni the United States. They are highly spoken of by many leading physicians, both in Canada and the \",States.\" Dr. Grant, of this cîty, who is, wve need hardly write, one of the foremost of the Dominion, writes as follows: \"At this season of the yoar most people who cau take a holiday are looking forward. to the selection of somie place where change and rest wilI, if possible. renew the vigor of life. Two points are usually most at- tractive to, the lover of cliange-our sea side resorts and our minerai springs. One naîurally asks, %vlcre amn I to derive the greatest benefit? Sea bathing and sea air are certainly invigorating in a sense, but after caroful observation it lias been ascer- tained that the greatest degree of benefit is brought about by first enjoying, for two or three weeks, the influence of somne of our minerai springs, in order to, place the in- ternai. systein in a healthy and vigorous state, by washing out the groat organs and thus giving increased power and activity. Most people are quite content with bath- ing, as usually adoptod, without giving due attention to the washing out process, which is just as necessry, in the great in- ternai. orgaxas of th 'e system. The springs of ail others, now attracting attention, and well mnerited too, are the Caledonia, owing to the excellence of the suiphur and saline waters, and the extensive modern appli- suces for thoir use in cevory form.\"* ImpuR EC is doubtless often a source of disease. People for the most part are quite indifferent.as to, the source and condition of the ice thoy use for cooling drinks. It is well known that the frost does not de- stroy ail bactoria that may be in wator Le- fore freezing. Ice may appear absolutely clear and yet contain dangerous substances. People swallow ice when they would tura in disgust from the water of whiel- the ice is formed. It ie a good practice to, cool pure water ln bottles or othor receptacles surrounded by ice instead of putting the ice into the water to, Le swallowed, ajud this practice should Le universal until.ic is rade artificially fromi purifled water. 134",
         "THE CANADA HliBALTH JOURNAL. 8 OBSERVATIONS A'ND ANNOTATIONS. THE Sanitary Convention, in connection with the first Annual Meeting of the Ontario Association of Health Otficers, lield in Woodstock on the l7th and l8th of this nionth. was attended by a fair nuinher of able niedical officers wlu ouglit to have drawn a better attendance of those for, whose benefit chietly the convention ivas lield, nainely thlwple of Woodstock. Among the bealth officors present were, Drs. Elliot. of Orillia. Coventry, Windsor, Grifliu, Brantford, Daniel Clark, Toronto, Yeounans, Mount Forest, Burrows, Lind- say and McL,,ellan, Trenton. In theabsence of the President of the Association, Dr. Sweetland of Ottawa, owving to, sickness in bis family. we understand, the first Vice- President, Dr. Coventry of Windsor, read tbe annual address. A nuinber of valuable papers were read and discussed, a synopsis of some of whil we hope Wo give in tbe next issue of the JôltRNAL\u0026. Dr. Coventry was elected President for the ensuing year. THE attendance of the putblic at the Woodstock Convention, we are sorry Wo learn, was on the whole net; large, indeed a local organ states that; it was sniall, and Ilanytbing but a success,\" altliough at the evening session it was fair, With \"4quite a nuniber of ladies.\" Tlue apatluy of the people in inatters of this kind is niarvellous. The only way is to 14keep at theni.\" The general interest however in subjects relat- ing te health is certainly on the increase, especially in soine of the cities and towns wbere they have active health, officers. Élealtu conventions in Michigan have been numerous and largely a±tended. There they have an active and popular State Board of Health whicli is continually, in various practical ways, awralening an in- terest amongst tbe people. Tue Toronto Local Board o! Health's Report forljast year is by far the most respectable volume that has been issued by thue City Health Department for many years. The Boad 'Ilforbade the public in future placing privy vaults on their pre- mues,\" but should have gone further and prevented the use of sncb entirely. There is no reason why some of the inhabitants sluould be permnitted to use theni and flot others. The Medicai Healtb Officer's Re- port contains niuchi useful information, on the outbreak of sina1-poxç during the early part of the year. on vaccination and on the work of inspection. The health of the city oughit Wo iprove, but very niuch yet reniains to be done. A better water ,ul)ply and a purified bay are indispensible Wo the city .s bealth. THE contagiousness of consunl)tioflj which %ve strongly favour, and the fact that physicians and others are so frequent- ly exposed Wo the infection and yet do not contract the disease, niay be explained in the following way, as shown by recent ex- perjinients. The bacillus of consuinption is a slow.ly developed organisni. requiring about ten days whien cultivated artificially before it begins Wo grow. If applied Wo an open wound it will be ahnost certain Wo be reinoved by washing or otlierwise before it bas tinie to establish itself ; but if inject- ed under the sicin, local tuberculosis de- velops itself, and this is followed. Inter, by a general infection. Ini like manner it niay l\u003ee in the case of the lungs. 4\"Whlen a healthy individual inspires the natêries niorbi, it is removed by expectoration, be- fore it bas tinie to establishi itself and growr. But wlhen a portion of the lung remains consolidated for a lengtbi of time, as after a catarrhal pneumonia, then the tubercle bacillus finds a suitable nidus, and tille to grow, and foci of infection are thus estab- lished.\" So likewise, persons who respire but imperfectly and do not; expand and use the apex of the Iungs, the organisnî may chance to remain alnost undisturbed in that Iocality until it develops and multiplies. Thus, as we have Iongcontended, ' it would appeai,, t as the Caimda Loaicet says, ,\"that the disease isnfot per- se biereditary, but the pre-disposition Wo such conditions of the lungs as favor the reception and growth of the cause of the disease, is ber- editary.\" TEM CzNTURy bas added an other to the list of services it bas done it readers. In its weme for May it publihes the flrst of a series of papers by Prof. W. 0. Atwater, of the Wesleyain University, Middleton, Cotn., on the Chemistry of Foods sud Nutrition. Prof. Atwater malces an ex- haustive study of the chemistr of foode, 135",
         "136 TE CANADA HEALTH JOURNýAL. u1t t ince of the uVnited States National 3fuseunî j»i bi.lialf of its food collection, and it is said that lie lias studie(t food and nutirition as no otlier student in tlîis country lias stüdiodl it. His chief aimi is to show tuie econoînir value of foods, a subject little understood even b)y the intelligent. Hie savs. i1 have lie» led ta thie conclusions that, in this voiuntry. niiany people, not only tuie w\"ell to dIo, but tliose in nioderate cir- cuinstances also. use a needless quantity of food; thant part of thiis excess, hîowever, j5 siînply thrown away, so thiat the injiury ta, htealthi, grat: as it ina lie, is doubtless iiiiicli less than if ail %vere eaten ; tixat one great fault witli (ur dietaries is an cxcess of ineats and of sweet meats; that even anmong those who desire ta econoinize tliere is great pecuniary loss froi» tie selection (if inaterials iniii the actual nutrients are really. thougli îlot apparently, dearer tin need ie, ti at înany wliose means are limiitel inie stili more- serious mistakes iii tlieir clioice of food, so thiat tbey are often inadequately nourislied wlien thiey iniglit lie well fed at less cost ; and wliat seerns tiie niost îîaiîmful tihing of ail, thiat it is generîhly the very î.oor that practice the worst econoiny iii tlie purcliase as well as in the use of their food. REsT and sleeî, as wehave long con- tendcd, is tie great retitorer. Dr. J. Leo- nard Corning, of Nev York, in tlhe pro- ceedings of tdie «Medical Society of Newv York, says :-, Proloiiged sleep, may lie set down as tîme cardinal i\u003eriiiciile of plhysia- logical brain rest. It mxust lie combined withi systeinatic and scicntific feeding, in order thmat repair of the exliausted brain nhay îroceedl in a pliysiological manner during the interval of unconscious repose. lic sechades thme suhject in a darkenedl rom»n, eventually for fromin ten to fifteen hxours at a tinte. The anhaunt of slccp is progressively incereased by habit, moderate mnedication and lxydrotlierapy but lie never rcsorts ta forced sleep by the reck-- less use of sedatives. '%Vien tme patient awakes, nourishinient is adnîinistered, but alysin an easily dijested forn». Thie few hours of wakefulness are devoted ta soute forin of amusement, but all formis of nien- taI exertion are strictly prohibited. SIR HEYRy TnioxisoN says, -I have coine- te the conclusion that nxoretiian liaf the disease W hiceh emhbitters the middle anid latter part of life iii due ta avoidable errera i» (liet.... .and tîmat more mischief in the forrn of actual disease, of iunpaired vigor and of shi(rtened life, accrues ta civilized. man ..... in Englamd and thirouglhuut central Europe front erroneouis habits of eating tman front the liabittal use of alcohoio drink considerable as I know tlmat evii te lie.\"* Againble says: It is a.failure to un- derstand, first, thme importance of preserving a near equality between tlie supply of nutrimnent ta the body biody and the exî\u003eenditure produced by the activity of thme latter; and secondly, ignor- ance of tiue mmethd of attaiining thmîs object in practice, whlmih gives rise to the various forms of disease calculated tu imbîtter and sîmorten life. Dit. ALFRED CARPENTER of Croydon, Eng., write as follows iii a late number of thme Britisht Méd ical Jouritil :-In your an- natation of mny address to the \"Public: Sanitary Inspectors,- in tîme Journal of April 9tm, publislmed on anothier page of tîmis issue of, tlie JOiuRàNAL, tliere are two references whichi mnay mislead if flot ex- plained. The microbes wlmich sprrad sniali- pox will in ordinary instunces lose their vitality ini the air in nîuch shorter distance thon \"1100 yards \" wlien they liave been detachced fron» feverisa patients. It is only wlien tliev are dornant, or in a condition in whichi the active agenry of life is sus- pended, that tliey înay lie wafted somie distance auid retain tîmeir vitality. As ta ,carlbolic acid, 1 (lid, aud do, recoitimend it as destroying thie living growving germs ; but I stated tliat i» dilute solutions it hiad no destructive effect upon tîme dormant spores, thmat, somuetlîing more than carbolic acid is necessrry to effect this abject, and tîmat tîme over-advertised nostrtuus which are being puslhcd by manufacturers are flot ale ta put an entire stop te infective, agencies ; nay. thcy are -miîsting to pre- serve the dormant seeds fron, cLecay, sa thiat in sucx cases, wlmcn trusting to snch, w'-ý are trusting to broken reeds. A VALUABLE SERIAL, wlmich ought ta, be in te hands of every Mayor, Alderman, Town Councillor and Ilealth Officer in the Dominion.\" Sa it is stated of the CANADAk HEALTE JOURNAL in a Report on Epidemic Diseases, \u0026c. By J. T. Bell, Eaq., late Chairman Board of Health, Belleville. 136"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEIcAL \u0026SURGICAL JOURNAL JANUARY, 1886. Irigçina fommunnications. INNERVATION OF THE' HEART OF THE SLIDER TERRAPIN (PSEUDEMYS RUGOSA). (Continued.) By T. WESLEY MLLLS, M.A., M.D., L.R.C.P,, EG. Lecturer on Physiology, McGill University. One of the greatest results of the new heart physiology bas been the fresh light thrown on the functions of the vagus nerve. Formerly the vagrus was regarded :as the motor nerve of tCe heart, and as acting chiefly as- a controller or inhibitor. This view must, in the light of the most recent investigations, now be modified. Before discussing the mode of action of the pneumo- gastrie, a few well-established facts may be stated. Both Gaskell and Heidenhain have shown that primary accele- ration of the rhythm of the heart is a frequent result of stimu- lation of the vagus in the frog. The former observer states that lie has in no case seen this effect in the land tortoise. Though I hav'e myself often looked for it in the slider terrapin, and tried by varying the strength of the stimulating current to produce it, I have seen it in but one case; in that case, however, the acceleration was very marked. Here, then, is at once new light ; the vagus may not as a first effeet slow but accelerate the heart-beat. One of the best marked results of vagus stimulation noted among a large number of cold- blooded animals now examined by myself and others is after- acceleration of the cardiac rhythm. So far as niy own prolonged 21",
         ":822 CANADA MEDICAL AND SURGICAL JOURNAL. investigations of this subject in the terrapin go, the following statements may be made ; and as this subject seems to me of the utmost importance to medicine, I shall give the results very much in the words of my original paper 1. \" The action of the heart being slow, the acceleration is very marked; if rapid, it may be slight or wholly wanting. It follows the sanie laws in this respect, in fact, as the accelerating sympa- thetic-i.e., the degree of acceleration is inversely as the rhythm at the moment of stimulation.\" 2. \" The after acceleration always lasts a considerable time, and in some cases a very long period.\" 3. \" The heart being feeble, and its nutrition suffering, vagus stimulation then produces its most marked effects on both rate and force of beat, but especially on the latter.\" 4. \" Stimulation of the vagus removes peculiarities of rhythmic sequence.\" 5. \" Stimulation of the vagus gives rise to increased diastolic relaxation.\" This refers to the effect during actual stimulation; it is never a genuine after-effect, though it may for a few seconds outlast the stimulation. As a primary effect of stimulation, must be noted also: (a) Weakening of the cardiac pulsatioIs without alteration of the rate of beat ; (b) A similar weakening or slowing, or both,prior to actual stand-still. Eichorst and Zander had noted degenerative changes in the heart after section of both vagi. Traube had also pointed to isolated facts of similar import, and with a fine insight read their meaning in the dim light of his day. . Gaskell and Heidenhain, whose work was published about the same time, had, though with different explanations, pronounced the vagus the trophic nerve of heart. Ransom has furnished unmistakeable evidence for the truth of such a view as applied to the cephalopod mòllusk, Octopus. In my own experiments on the chelonians, the heart has been studied in all conditions of nutrition-most of the cases being kept under observation for two and often for three days ; these observations have also been extended to the fish and the alli-",
         "HEART OF THE SLIDER TERRAPIN-DR. MILLS. gator. Such study has enabled me to formulate the laws of vagus action with a completeness not previously possible, and especially that important law of inverse proportion, as I have called it, viz., that the after-effect qf vagus stimulation is ini versely proportionate to the rate and force of the beat at the tine of stimulation. It follows that the worse the condition of the heart, and the more it needs assistance, the greater the capacity of the nervous system to render that help. This fact, which was never clearly brought out prior to my own investiga- tions, has led me to aissert, in the previous part of this paper, that I believed that our present explanations of the causes of heart diseases are too mechanical ; and that the above facts- for facts they are and not theories-will, in the future, modify both our cardiac pathology and therapeutics. The question as to how the vagus acts -is very difficult, and one that cannot be fully answered until still more numerous observations have been accumulated. Gaskell's views as to the mode of action of the ganglia in the heart-substance of the frog and land tortoise have been quoted in the first instalment of this paper ; but since Gaskell wrote, certain facts have come to light which must render a modifica- tion of his views necessary. Most .remarkable was Ransom's discovery after very careful microscopic examination, that in the heart-substance of the highest class of 'mollusks there were no ganglion cells, while at the. same time the vagus (\" visceral \") nerves had in the most remarkable manner a beneficial influence on heart work and heart nutrition. It seems to me it is difficult to over-estimate the value at the present time of such work as is now being done in this realm of comparative physiology. It is now clearly shown that ganglia are not, in all animals, essential to heart action or heart nutrition. We are led to enquire: Are they essential in the higher animals-are they so in mammals ? The work for the mammalian heart is still to be done in great part; but in Ludwig's laboratory, Tigerstedt has, by one investigation, rendered it very doubtful that the movements of the heart are, even in mammals, absolutely dependent for their origin on ner- Vous structures at all. 323",
         "324 CANADA MEDICAL AN] SURGICAL JOURNAL. Does the vagus nerve act directly on the heart muscle, or mediately through its nervous ganglia? Certainly Ransom has answered this question in favor of the former view, so far as the mollusks are concerned. How is it as to the frog, the chelonians, the fish, etc. Although I hold the view subject to correction by further observations, it seems to me that the evidence that the vagus in the animals specially examined by me (the chelonians, the alligator, and the fish) acts, or at least may'act, directly on the heart muscle itself to produce those effects characteristic of the nerve. The evidence on which this opinion is based will be clearer after the consideration of my publication on the heart of the fish especially, some account of which will probably appear in this JOURNAL. Another question much debated for the past fifteen years is Does the vagus contain two sets of fibres vith antagonistic in- fluence-the one depressors of cardiac action and the other augmentors ; or do the same fibres act at one time as aug- mentors and under different circumstances as depressors ? This question, so far as the frog is concerned, has been settled in favor of the former view by Gaskell, though I have shown that this investigator is in error in supposing that the vagus nerve is a pure depressor in the crocodilia. Whether the vagus may not be such in certain animals requires further investigation ; but it seems to be tolerably safe to assert that in all animals above fishes the vagus contains both depressor and augmentor fibres. At the same time, this has not - been positively demon- strated for all; and among the other lessons taught us by these recent cardiac investigations is the danger of too wide generali- zation, and the desirability of subjecting as many animals as possible, even of closely allied structure, to examination. It has been shown that similarity of anatomical structure is, in a general way, associated with similarity of function ; but this is not invariably the case, and we have learned'of not a few in- stances of \" physiological isolation.\" To some of these I shall have to refer in later papers. Prior to my own investigations on the chelonians, and those of McWilliam and myself on the fish, carried on at the same time, thouglh independently, very little was known of reflez",
         ".HEzutT OF THE .SL[DEiR TERRAPIN-DR. M[LLS. cardiac inhilbition among cold-blooded animals, except what was brought out by the researches of Goltz on the frog. The case for the Slider Terrapin ,was tested in twelve speci- mens. The following forms of stimulation were employed:- 1. Injury due to removal of plastron, etc. 2. Electric stimula- tion of the brachial p!exus and sciatic nerve with the rapidly interrupted current. 3. The same sort of stimulation applied to the main sympathetic stem in the upper thoracic region. 4. The same applied to the viscera. 5. Sponging over the peritoneum and muscles. ï 6. A stream of cold water over the peritoneum. ý 7. G6ltz's \" Klopf-Versuch \" (tap) over peri- toneum, especially in the region of the bladder. 8. A pushing- down force with the end of the wooden handle of a seeker, in the same region as that noted in 7. Without giving details in each case, the results may be thus stated: A stream of cold water allowed .to flow over the lower part of the peritoneum, and injury from operative procedure have almost always been followed by more or less cardiac inhi- bition, frequently lasting for many minutes (often complete stand-still of the heart for a shorter period). The relatively greater effect of such forms of stimulation, as sponging over the peritoneum, as compared with. electrie stimulation, even with such stimulation of the great nerves, is very striking. Stimulation of the main sympathetie, in the thoracic region, has produced more decided effects than corresponding stimula- tion of the brachial plexus, etc. In some cases the latter liad not the slightest effect. Electric stimulation of the viscera has generally produced little effect. When trying the \" Klopf-Versuch \" (abdominal tap), I was forcibly reminded of what Prof. Goltz had told me when explain- ing his own method of performing this experiment on the frog, that there 'is the greatest difference in individual frogs of the same species as to susceptibility to reflex inhibition. That this applies to all the chelonians, my experiments abundantly show. To get the above results, the cardio-inhibitory centre in the medulla and the vagi must, of course, be intact, The afferent nerves are numerous, doubtless. There are a number of other points connected with the pneu- 325",
         "326 CANADA MEDICAL AND SURGICAL JOURNAL. mogastric nerves, the depressor nerve of the heart, the sympa- thetic nerves, and especially with the great question of inde- pendent rhythmic capacity of the different parts of the heart, which inust be deferred for comparison, in a later communication, with results obtained by the i vestigation of the heart of the sea-turtie and other chelonians. ON CEREBRAL SYPHILIS. By GEORGE ROSS, A.M., M.D., Prof. Clinical Medicine, McGill University; Physican to the Montreal General Hospital, \u0026c. (Read beforç the Medico-ohirurgical Society ofMointreal.) Some cases having recently come under mycare t g different phases of this disorder, I venture to bring them before this Society, with a few remarks which they have suggestcd. The older writers used to ascribe a great variety of disorders of the nervous system to constitutional syphilis: vertigo, epilepsy, apoplexy, amaurosis, etc. They had, of course, no scientific foundation for so doing, but really made a kind of scapegoat of this protean malady in order to explain what was otherwise obscure. Later on, came those who declared that syphilis never attacks the brain or other nervous centres. The investigations of our modern pathologists have, of course, settled this matter, showing that these important organs nmay, and often do, become the seat of syphilitic disorders. They have alsoshown in what various ways the different structures entering into the composi- tion of these organs may be subjected to pathological changes, the direct result of syphilitic contamination. They have shown that symptoms of present disorder may be induced by local in- flammation of a specific nature, by the invasion of a neoplasm or special new growth, by softening due to the obstruction of dis- eased vessels, by the interference of a tertiary swelling of the periosteum, or as a result of constitutiônal disease of the bones themselves. It has been thought, too, that symptoms of cerebral syphilis may be observed whilst the autopsy shows no special changes in the brain. In some such cases, however, careful and experienced observers have shown that histological changes of a sufficiently-important character have been slowly developed as a",
         "ON CEREBRAL SYPIIILIS-DR. GEO. ROSS. result of the general poison. As these various facts have been substantiated, more and more of the cases of disease of the nervous centres became traceable to a previonrs infection of the system with syphilis. On most of these points there is a universal consensus of opinion, and in the writings of many eminent neu- rologists in England, Germany and elsewlhere we find abundant teaching upon thc main features of s\"philis of the cerebro-spinal axis. The great variety in the grouping of symptoms-the strikingly different disease-pictures vhich may be presented- the diagnostic difficulties often met with-the great practical importance of the cases-have all combined to render the field of brain-syphilis a peculiarly attractive one to clinicians and pathcîlogists. Indeed, the doubt which still overiays the etiology of many of the commoner chronic nervous diseases leaves ample scope fol further investigation. In the case of tabes dorsalis, e.g., in spite of all the attention bestowed upon the subjcct, it is still a moot point whether or not it should be looked upon as usually of syphilitic origin. The importance of determining, as far as possible, the relationship of any of these nervous disorders to syphilis cannot be overrated. Take the case, for instance, of the disease I have just alluded to. Last winter, a hospital patient came before me with an exaggerated ataxia which I have seldom seen surpassed, together with the usual accompanying changes in sensorv conditions, reflexes, etc. A suspicion of syphilis was entertained, especially from the existence of certain local sýmptoms in the spine pointing to an affection of the bony canal. Under anti-syphilitic treatment this very unpromising case, to the surprise of many, made a rapid recovery. Some years ago a gentleman consulted me for a severe eruption upon the face, for which he had sought relief for twelve months with- out, success. It annoyed him extremely, being very unsightly, and was accompanied by almost continuous insomnia, so that he walked the streets at niglit, became despondent, and came very near committing suicide. I failed entirely to get any history or any corroboration of syphilis, but was convinced that the cutaneous affection was of this nature, prescribed accordingly, and had the satisfaction of seeing him free from his tormentor. 3--7",
         "328 CANADA MEDICAL AND SURGICAL JOURNAL. A year or more after, he had an occasional epileptic fit (he had not, I may say, followed bis treatment ivith regularity). I strengthened the dose. But, after a time, he became irritable, irascible, and fractious, showed weakness in the legs, lost bis capacity for business, and suffered from pain in the head. Finally he lay in bed and became ,from stupid, comatose-deeply s- and bis death was hourly expected. Now, besides observation of the symptoms I have mentioned, and which, taken together, were highly significant, I had the important clue of the previous cure of the eruption by mercury. Without this, evidence of past syphilis would have been, by any one a stranger to the case, set down as absolutely wanting. I maintained that this comatose man would get well: and was laughed to scorn. But I insisted on pouring in all the iodide of potash I could-and he did get well. His friends who sat up several nights to close bis eyes call him to this day \" the resurrection man;\" Now, actual cases of this kind cannot fail to make a great impression upon a thinking man when coming under lis own observation. The recognition of the underlying cause of the phenomena observed is absolutely essential for the institution of a successful treatment. There are, perhaps, no cases you can think of in which the issue [of life or death hangs more directly upon the action or inaction of the physician in charge. The severer forms of cerebral disturbance often 'immediately threaten life, and, except promptly treated, will inevitably prove fatal. They are with great certainty met by the recognized remedies for the syphilitic disorders : and all other therapeutic efforts, without these, will prove totally ineWfective. Every one knows the diffi- culty of determining, in many cases, whether the individual have suffered from constitutional disorder or not. On the other hand, the history may be clear, or careful scrutiny for remaining traces may give unmistakeable. evidence; in which case-our path is rendered easy. The fact seems universally admitted, and it quite coincides with my own limited experience, that persons who suffer from late-developed syphilis of the hervous centres are extremely likely to give no account of the well-defined secondary symptoms which are so common ; at times, even, are",
         "ON CEREBRAL SYPHILIS-LR. GEo. tOSS, not aware that they have ever had any secondary symptoms. So important, in nervous cases, is the treatment, that the prac- tice of giving a full course of potash as a test is highly recom- mended, and should be adopted in every case presenting the slightest element of doubt. Many such cases will arise, for the reason that although the concurrence of various symptoms and circumstances renders easy now and then a correct diagnosis of the syphilitic origin of a nerve-disorder, even without the ielp of the patient's history, yet there are no pathognomonic signs as yet definitely ascertained which will point conclusively, with- out the aid of the history, to the specific nature of the case. More dependence is to be placed upon the grouping together of various symptoms than upon any individual symptom. Take, for instance, Epilepsy. Many cases of general convulsions re- semble, in almost every respect, what is called \" Essential Epi- lepsy,\" and yet are due to constitutional taint. They cannot always be diagnosed as such. Then, the therapeutic test alone will often determine the question. If specific, bromides fail and iodide succeeds. But in other cases of epileptie character, cer- tain other symptoms may be so associated .with the convulsive attacks as to point the observer in the right direction. Dr. Buzzard says \" there is frequently a history of antecedent pain in the head for months before the first fit.\" This is no part of the simple form. It was characteristically present, together with .paresis of the limbs of one side, in the following case CASE OF CEREB14AL SYPIIILIS-PERSISTENT H1EADCHE-REPEATED EPILEPTIC ATTACKS-RAPID CURE UNDER MERCURrAL INUNCTIONS. J. C., oet. 30, single, admitted to hospital Oct. 8, '85, suffering from severe headache, and having recently had some epileptie fits. The first attack of this kind occurred on the 13th Sept. On that day he was seized with a sudden feeling 'of numbness, shooting rapidly up the right leg as far as the knee: the leg became cold and almost powerless. He stayed in bed.the re- maihder of the day, trying to rub some life into the affected limb. Next day returned to work, but the leg felt heavy and inclined to drag. On the 20th, the right arm felt heavy and tired. By the 25th, thiý arm was useless, cold, and somewhat anæsthetic. 329",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Had medical advice, and under treatment improved so much that the affected arm seemed as good as the sound one. On the 30th, whilst bathing his leg, he experienced in the calf a severe cramp which bent the leg upon the thigh ; stooping to take hold of it, suddenly his whole body was seized with clonic convulsive movements. Thinks he did not lose consciousness at all. Had two more fits on the 6th October. He had remained at his work up to this time, and came to the hospital on the 8th Oct. On making further inquiries, it was learned that three years ago he contracted syphilis; fifteen months ago had alopecia and severe iritis of both eyes. He has during all this time suffered from pain in the head, sometimes very severe, and always wvith noc- turnal exacerbations. The iritis was actively treated at the ophthalmic clinic. He says that he bas been taking medicine of some kind more or less continuously since the trouble began. On admission, there is partial loss of power of right arm and leg,. dizziness, a \" numb shooting \" pain on the left side of the head, deafness and tinnitus in the left ear. He is a strong, well-built man. Face symmetrical, conjunctivie congested, especially the left. Pupils act well. In walking, the right foot shows a slight want of firmness, but there is no dragging. Grasp of right hand feeble as compared 'with the left. No optic neuritis or other change in the fundus oculi. Other organs normal. On the 12th he had three fits, two in the morning and one whilst I was examining him before the clinical class. He sud- denly exclaimed \" I'm off,\" and had a very severe epileptic fit. The diagnosis was \" cerebral syphilis,\" probably in the super- ficial portion of the left hemisphere, and in a stage of active progress. He was therefore ordered to be brought rapidly under the influence of mercury by means of inunction.' The pain in bis head soon began to show signs of diminishing in severity. On the 15th, had the aura or premonitory cramp in the right leg, but by having this firmly grasped, the impend- ing fit was averted. On the 17th, at midnight, another severe fit, and this was followed by a succession of four more, at inter- vals of a few hours until the afternoon of the 18th. There had been very severe pain in the head for a short time before this attack. The same day (17th) the \" mouth and gutns were sore,\" and the next day the mercurial ointment was omitted. Sharp salivation continued for the following week. He' was (18th) 330",
         "ON CEREBRAL SYPHILIS-DR. GBO. ROSS. 331 ordered iodide of potash, beginning with eight grains and in- creasing one grain every day till he should take thirty. Im- provement was steady and continuous ; headache was rapidly removed ; had no more fits, thoughli he occasionally had an odd sensation in the leg, which made him afraid lie was going to have one; power returned in the right 'hand and his gait was firm. He was about the ward on the 2nd November, feeling very well, and was discharged on the 28th, still taking 3iss of iodide daily, and with directionsto continue the treatment and report himself at intervals for the next three months. Here, the history was unmistakeable, the attacks were recent, full treatment had not yet been tried, and the prognosis was most favorable. The result showed that this was fully justified. It is doubtful if, in this case, it is possible to locate the seat of the disorder. I have thought it is probably situated upon the convex surface of the left hemisphere: But, according to Hughlings Jackson, \",the convulsion points simply tQ disease of some kind, not to any particular pathological change of, or in the side of, the brain opposite to that in which the spasm sets in.\" Two remaining cases, of which, if you will allow me, I will present a few notes, illustrate, in the one, a sudden liemiplegia, and in the other certain very obscure peripheral and mental symptoms, which it was thouglit could hardly be explained, except from specific disease. CASE OF CEREBRAL SYPIIILIS-PROLONGED PAIN IN THE HEAD- SUDDEN LEFT-SIDED HIEMIPLEGIA-IMPROVEMENT. J. O., et. 40, was admitted 25th October, '85, suffering from complete paralysis of the left side and a severe pain in the right side of the head. Patient is an old soldier, who has had ague and fevers in the East. Ten years ago he was knocked down by a blow from the butt-end of a gun ; was stunned for a few minutes, and was confined to bed for four dayé. Suffered no ill effects subsequently. There is a scar, but no evidence of fracture, at the seat of injury. Seven months ago lie was inocu- lated with syphilis, for which lie had some treatment, still pre- senting numerous brown stains upon the limbs and decided enlargement of glands in groins and neck, and at elbows. About three weeks ago began to suffer from pain in the right side of",
         "CANADA MEDICAL AND SURGlCAL JOURNAL. the head, especially the temple, which was severe, and frequently kept him awake ail night. On the 20th Oct., got out of bed and on his way to the closet dropped suddenly to the floor. Says he did not lose consciousness. Was carried back to bed, quite unable to move bis left arm or leg. Speech was affected, and the tongue felt thick. On examination--Paresis of left facial muscles ; tongue protruded slightly to the right. Complete motor paralysis, with flaccidity of the left limbs. Sensation impaired. Superficial reflexes on that side diminished. No change in optic dises and fundus. No enlargement of spleen. Heart normal. Urine contains neither albumen nor sugar. Was ordered Hydrarg. Protiodid. gr. î and Potass. Iodid. gr. x ter die. Pain in head continued, with insomnia, for some days, but then gradually gave way, and by the 19th Nov. is reported quite absent, since which there has been no return. Incontinence of fèces was a troublesome symptom during the first two weeks. His mental condition at first was very uncertain, wandering a little at times, and inclined to ask silly questions. He is now quite rational. The motor power has been slowly, but steadily, returning. He can move the leg about, and flex it in bed quite freely, but cannot yet stand upon it.l He also begins to move the arm. He remains under treatment. A recognized peculiarity of sudden hemiplegia from syphilis is that there is no loss of consciousness: the patient feels giddy, perhaps, and on attempting to rise finds that he is paralyzed. It is not, however, confined to syphilis, and cannot be relied upon as diagnostic. The antecedent èontinuous head pain, the degree of mental disturbance and the incontinence of feces (which seemed rather mental than from organic lesion), and the improvement under specific treatment, have seemed to justify the diagnosis. If correct, it will be remarked that the case is an example of involvement of the brain at a very early stage, seven months after infection, for it is admittedly rare to meet with this until at least one year has elapsed, and, indeed, gene- rally several years. SENSORY DISTURBANCES-LETHARGY-MENTAL~IMPAIRMENT- DEFECT OF SPEECH. R. C., oet. 36, admitted 7th November, '85, coinplaining of numbness of the right side and difficulty of speech. On the 3rd January, 1883, patient had a sudden attack of smothering 332",
         "ON CEREBRAL SYPnILIS-DR. GEO. ROSS. or choking, lasting half an hour, during which time he could not speak distinctly, but only mutter. Nothing further hap- pened until last January, when one day, at work, suddenly felt numbness in the right hard, which crept up the arm and side of the face, and in the right leg to the knee'; had to drop his tools; the fingers of the right hand becanie flexed, but he could force them to opën. Numbness and spasm continued for a quarter of an hour, and then completely disappeared. Was able to walk home immediately after, when it was noticed that his speech was very indistinct. There was no headache, vomiting or fever- ishness. He continued to work even up to a short time before his admission, but his friends soon noticed that his mental and general physical condition were much changed. He became dull, slow of speech, and somewhat stupid. Having been a good tradesman, he could not perform the work given him in a proper way, and was discharged from one shop after another, protest- ing all the time that he was quite well and capable. His memory failed a good deal. During the summer he had repeated attacks of the kind already described. His wife says that he would come home after one of these quite dazed'and dull, could hardly speak at all, and would go to bed. Would sleep a great deal for the next twenty-four hours, rising only to take food, and saying a few words in a heavy, thick fashion. This would pass off and he would return to work. On examination, good phy- sique, medium height, good intelligence, a slow, hesitating and deliberate mode of speaking, which he says began* with the first attack. Says he does not suf'er in any way ; has nothing the matter, except that he is afraid of the attacks coming on. There is good motor power in all the limbs, and sensation is intact. Thoracie and abdominal viscera appear normal. Examination of eyes negative. On searching for evidences of syphilis, nothing could be determined beyond the occurrence of gonorrha twenty years ago. No traces of the constitutional disorder could be detected. He was given gr. 1-12 Bichloride of Mercury three times daily. Remained in hospital two weeks, and was, at his hi's own request, discharged, without any material change in his condition, and no definite numb-attack having occurred in the meantime. In this case, the slow, deliberate speech is like that from multiple sclerosis, but there is no tremor, and the attacks have never been of the apoplectiform character which belongs to the latter. There is no optic neuritis or other sign of brain tumor. 33",
         "CANADA MEDICAL AND SURoICAL JOURNAL. TWO CASES OF GUNSHOT WOUND OF THE TESTICLE. Br JAMES BELL,, M.D., Assist. Surgeon, Montreal General Hospital; Surgeon with the Field Hospital Corps in the North-West. (Read before the Mledico-Chirurgical Socicty of Montreal) CASE I.-W. B., æt. 28, a tall, muscular fellow belonging to the Midland Regiment, was struck by a rifle bullet in the skir- mish which immediately preceded the final charge and rout of the rebels at Batoche on the 12th of May last. He was on the very bank of the river when the bullet struck him on the outer side of the left thigh, just below and behind the great trochanter and opposite the end of the natal fold. He was tumbled over the precipitous bank, and was with some difficulty secured and brought into the zareba, where the hospital staff were by this time pretty actively engaged. When undressed, it was discov- ered that the bullet had passed through the thigh, re-entered the perineum through the base of the scrotum, behind the left testicle, and th'ice made its exit through the body of the right testicle, making a large rent in the scrotum and tunica vaginalis. The testicle waq carried completely out of the scrotum, and at the point of e. , of the bullet a fringe' of frayed and lacerated glandular structure protruded beyond the visceral layer of the tunic. This fringe of lacerated tissue I removed with sharp scissors, and after removing several pieces of cloth from the track- of the bullet, and cleansing the sac with weak carbolic lotion, I returned the organ to the scrotum, and closed the ecrotal wound with catgut sutures, leaving a capillary drain beneath. There was no hemorrhage or other troublesome symptom, and the wounds were dressed with carbolized gauze and iodoForm. The patient felt .comfortable after being dressed, and next day was put on board the steamer \" Northcote \" with the other wounded men, and sent up .the- river to Saskatoon in chargè of Assistant- Surgeon Wright and a dresser. On arriving at Saskatoon he was found to be suffeiing from urinary infiltration. Extensive sloughing occurred, and his life hung in the balance for days, 334",
         "-GUINSHOT WOUND OF THE TESTICLES-DR. BELL. -but the serotal wound never reopened, although most of the left side of the scrotum sloughed away. (The bullet had evidently wounded the urethra in passing through the perineum.) As the wound through the thigih began to heal, he suffered severely from pain, of a burning and tingli-ng character, in the sole of the foot and shooting pains along the course of the great sciatic nerve and its branclies. This and the large granulating surfaces left after the sloughing of the skin and cellular tissue made his convalescence slow, and he was brought down the river on the hospital barge with the last of the wounded, and arrived in Winnipeg on the 15th of July. By this time his wounds were all perfectly healed, although he was still suffering from the sciatic neuralgia. The right testicle was now about half its original size,- firm, free from pain or tenderness, and freely mov- able in the scrotum. This case presents points of interest, apart from the wound of the testicle ; but what I wish particularly to call attention to is the recovery of the testicle from a very severe wound and great loss of its substance. CAsE II.-J. D., æt. 32, a French half-breed, a powerful, muscular and ruffianly-looking fellow, was one of several rebels -half-breeds and Indians---who were picked up on the battle- field at Batoche on the night of the 12th of May, severely wounded, and brought to our camp for treatment. He had a large' contused and lacerated wound, about two inches in diame- ter, entering on the posterior and outer aspect of the left thigh, just below the great trochanter, and passing forwards, upwards and inwards, partially separating the adductor longus muscle at its origin. There were also several irregular superficial wounds about the buttock and left side. The left testicle was completely .carried away, as well as the whole lower two-thirds of the scro- tum. The right testicle hung down uncovered, and in its lower half was filIed with fragments of metal. (The wounds were thought o have been produced by the bursting of a shell, the large wound being caused by a rough irregular fragment of metal passing through the thigh.) In the morning the shreds of the left testicle were removed, and his wounds cleansed and 335",
         "336 CANADA MEDICAL AND SURGICAL JOURNAL. carefully dressed, and he, with another rebel (Jobin, who subse- quently died), was sent up to Saskatoon on the steamer, along with our own wounded. He had severe constitutional symptoms for a few days-fever, delirium, etc.-but these soon passed away. The right testicle was not subjected to any operative treatment, but was treated expectantly, and in a few days the lower half of the testicle sloughed off, leaving an irregular granulating surface. The other wounds progressed favorably, and as there was no possibility of this portion of the testicle being covered by the natural processes unaided, I had the patient anesthetized, loosened up the skin of the scrotum remaining, pared its edges, and covered in the testicle. The result was extremely satisfactory, and in a few weeks before the wounds in the leg had healed, the scrotum had completely united, and the remaining portion of testicle could be felt firm and painless within it, and apparently attached to the cicatrix at the base. In the latter part of June, all his wounds having healed, he was sent off to Regina to stand his trial, as lie vas animportant State prisoner. The success attending the expectant treatment of these two cases bas led me to think that hardly any laceration of the tes- ticle can be, in itself, so severe as to necessitate castration, although, from what I have been able -to gather on the subject from the literature within my reach, immediate removal cf the organ is recommended in severe injuries by most authors. Ail authors agree that the injured testicle usually atrophies, and .is. sometimes the seat of neuralgic pain, so that in point of useful- ness it might as well be removed at once. Patients, as a rule, however, prefer not to have the organ removed if it can possibly be saved, and from the statistics given in the surgical history of the American war, the expectant treatment seems to have been safer than active operative treatment ; 586 cases are reported, nearly all of which were complicated. The testicle was extir- pated in 61 cases (and from the reports of the cases some of the testicles removed were not very severely injured), .18 per cent. of these cases died, while of the remainder only 11.9 per cent. died. Matthew, in the surgical history of the British army in",
         "CLINICAL NOTES ON \"CHOREA LARYNGIS \"-DR. MAJOR. 337 the Crimea, reports four cases treated expectantly; all healed, but atrophied later on. Heman (Principles of Military Surgery) says that even when fungous protrusion cî the substance of the testicle occurs, clipping off of the fungous portion is all that is necessary to secure healing. CLINICAL NOTES ON \"CHOREA LARYNGIS.' WITH CASE RECORD. By GEO. W. MAJOR, B.A., M.D., Late Clinical Assistant, Hospital for Diseases of the Throat and Chest, London, Eng.; specialist to the department for Diseases of the Nose and Throat, Montreal General Hospital ; Fellow of the American Laryngological Ass'ociation ; and Instructor in Laryngology and Diseases of the Nose and Throat, McGill University Montreal. Laryngeal chorea, recognized as such, is of comparatively rare occurrence. It is within the limits of possibility, however, that a small percentage of all cases of spasmodic cough occurring in persons of neurotic habit is of a choreic nature, and that if the act of coughing were investigated laryngoscopically, more numerous instances of this affection would be recorded. An uncontrollable desire to couglh, especially if of a barking, character, when de- veloped in a person the subject of chorea, should at once suggest its probable nature. In forming an opinion, it is e'ssential that the hysterical element should be carefully excluded, a task not very easily accomplished, as one condition frequently coexists with the other. A typical case of laryngeal chorea may be defined to be one in which there is an involuntary and uncontrollable cough during waking hours, absent during sleep, spaàmodic in character and accompanied by various sounds resembling the noise produced when straining, the barking- of a dog, and so forth. There is associated with it spasm of the expiratory muscles of the chest and abdomen. The speaking voice is normal, articulation is perfect, and the general health usually good. On laryngoscopie examination, which is generally well borne, the act of coughing is found. to be preceded by spasm of the laryngeal adductor muscles bringing the vocal cords into close relation, often with an audible click, when the action of the ex- 22",
         "338 CANADA MEDICAL AND SURGICAL JOURNAL. piratory muscles suddenly forces tbem apart, producing the somewhat characteristic cough. Between the acts of coughing the glottis assumes a variety of shapes, constantly changing its outline, indicating choreic movements of the intrinsic laryngeal muscles. The larynx itself presents but slight departure from a state of health, if we except trifling congestion of its mucous membrane, and occasionally, perhaps, a moderate degtee of swelling. Under the designation of chorea laryngis a number of cases have been improperly described, as, for example, those in vhich the expiratory muscles of the abdomen, or of the chest and abdomen, have alone been affected, producing a spasmodic cough, it is truc, but in which no laryngeal evidence of chorea was ob- tainable. Strictly speaking, the term should be confined to those in which we find by direct inspection motor implication of the intrinsic muscles of the larynx,- whether accompanied by spasm of the muscles of expiration or not. In other words, the diag- nosis of chorea of the larynx should depend upon recognized choreie movements of the laryngeal muscles, and the existence of a general chorea preceding, accompanying or following the laryngeal motor neurosis should strengthen and fortify rather than detract from the accuracy of our diagnosis. In the absence of spasm of the expiratory muscles, one'must be prepared to make a diagnosis without the assistance of cough as a symptom. Such cases are, however, exceedingly rare, as the whole range of medical literature furnishes but one (Knight's) solitary instance. For the better illustration of this uncommon neurosis there is appended a short clinical report of a case which recently came under observation, a perusal of which may be found interesting: Mlle. R., a healthy-looking young lady of sixteen, was seen in consultation with her medical attendant, Dr. Proulx, on Oct. 27, '85. She was suffering from a cough of a barking character, which was not only a source of discomfort to herself, but of great annoyance to her family.ý The cough, which had'already lasted two months, occurred at regular intervals of three or four minutes and was entirely absent during sleep. All the ordinary reme- dies, local and constitutional, had already-been resorted to with-",
         "CLINICAL NOTES ON \"CHOREA LARYNGIS \"--DR. MAJOR. 339 out perceptible improvement. On critical observation the cough was found to be explosive as well as barking, and was followed by a decidedly laryngeal sound resembling that of odematous laryngitis. The young lady complained of some slight distress of breathing when recumbent. All attempts on the part oif the patient to control the ceugh were unavailing. Articulationwas perfect, and at the time of the consultation there was an absence of symptoms of hysteria, general chorea, or other nervous affection. On making an examination of the larynx-a matter, by the way, of easy accomplishment-moderate congestion of the lining mucous membrane, especially in the neighborhood of the aryte- noid cartilages,. was found. The vocal cords; though not of normal pearly lustre, were not hyperæmic. The act of coughing was observed with the nmirror, and pre- sented the following features : The vocal cords were first thrown into violent contact, and after so remaining for a few seconds were as abruptly forced apart, when the cough took place. During the act, the spasm of the adductors never thoroughly relaxed, but varied in degree. The laryngeal sound which fol- lowed closely in thewake of the first respiratory effort may thus be aecounted for. Spasmodic action of the abdominal expira- tory muscles coexisted. In the intervals between the acts of coughing. the glottic space presented a varied configuration, without, however, in any way interfering with the function of healthy respiration. Throughout this kaleidoscopic. period. of glottic images there predominated in a marked degreýe the' well- known. outline of double thyro-arytenoid paralysis, with paresis of the arytenoideus. This latter condition may have had no direct connection with the neurosis, and probably had not, but was more likely a secondary result of continued strain and fatigue extending over a long period of unnatural activity. Laryngeal chorea was diagnosed. On'expressing this opinion, Dr. Proulx cordially endorsed it, and in. support of it stated that preceding the stage of cough there had existed a well defined more or less general chorea, which necessitated the vm.hdrawal",
         "340 CANADA MEDICAL AND SURGICAL JOURNAL. of the young lady from the convent school at which she.was a pupil. On December 4h, in reply to a letter of inquiry concerning the progress of the case, the doctor reported decided improve- ment under the use of liquor arsenicalis, supplemented occasion- ally by valerianate of zinc. There had been a gain in weight and an improvement in appetite. The cough also showed decided amelioration. Altogether, he considered the patient as speedily convalescing. Laryngeal sprays of cocaïne did not afford any relief-as good an argument in favor of the neurosis of motion theory of chorea laryngis as it is against the theory of reflex action from laryn- geal hyperæsthesia. The foregoing clinical history is most instructive, as it groups in a very complete manner the characteristic, though not always constant, features of chorea of the larynx-a condition the re- cognition of which is extremely important, as it may exist inde- pendently of any other choreic symptom. The -treatment of this disease must be carried out on the general principles found useful in controlling chorea in other organs. Works on General Medicine do not treat of this local manifestation of chorea, nor, indeed, do the authors of standard publications on Diseases of the Nose and Throat. For information on this obscure phe- nomenon we are dependent upon rather less than a score of articles (the majority of vhich are case reports) that have appeared from time to time in the medical journals. Five investigators only have recorded their observations in our language.",
         "PHARMACOLOGY AND THERAPEUTICS-DR. STEWART. 341 REPORT ON PHARMACOLOGY AND THERAPEUTICS. By JAMES STEWART, .M.D., Professor of Materia Medica and Therapeutics, McGII University; Phy- sician to the Montreal Dispensary, and Director of the University Dispensary for Diseases of the Nervous Systein. STROPHANTHUS AS A SUBSTITUTE FOR DIGITALIS. It is now one hund-ed years since digitalis was introduced as amedicinal agent. First used as a cathartic and emetic, after- wards its diuretic properties.were discovered, and, still later, it was principally used for its so-called sedative action on the heart. It is only a few decades since its true cardiac tonic action was even thought of, and it was not until modern pharmacology stepped in and demonstrated this action that it came to be uni- versally recognized as such. After many ups and downs, it has finallv secured a lasting foothold as a therapeutic agent. During the past few years many drugs have been introduced as substitutes for digitalis. There is a genéral impression among physicians that digitalis not unfrequently acts in an explosive sort of way. That it is a so-called cumulative agent. By this is meant that it is retained in the system for a certain time with- out acting in its usual way, and that suddenly the action of what has been absorbed for some time is all at once made manifest, and that in this way dangerous effects will be produced. When the evidence upon which this supposed action is closely examirned, it will be found to have little or no weight. It is absurd to suppose that a drug like digitalis can be retained in the blood for an indefinite length of time without being elimi- nated. The same law applies to it as to every other agent that circulates as a foreign body in the blood. Within two or three days at most, all drugs circulating in the blood, unless they enter into chemical combination with the blood constituents, must be either eliminated or deposiced in the tissues. There is no evidence whatever that digitalis is deposited in the tissues after circulating. The only other possible way it could be re- tained in the system would be its deposition in the liver on its way from the intestinal mucous membrane to the general circu- lation. We know that the liver possesses a peculiar function in",
         "342 - -CANADA MEDICAL AND SUROIcAL JOURNAL. retaining, destroying or excreting certain alkaloids. But that digitalis is ever retained by the liver is highly improbable. When its action is closely awatched, itwiill always be found that each and every dose produces its effect on the circulation. There is nothing of the mysterious in its action. It follows the general law of absorption and elimination. It is undoubted that digitalis is slow in bringing about its physiological action, that it bas to be administèred in full doses for two or three days before the more pronounced actions on the heart and vessels is seen, and, further, that its action continues some days (three or four) after it is discontinuéd. It is this slowness in acting. that is the principal drawback in its use. Time is an important element to patients suffering from cardiac failvre, and for this reason alone it is important that we should endeavor to fnd an agent that is capable of doing all that digi- talis can do, and particularly one that can do it at all quickly. During the past few years many drugs have been introduiced as substitutes for it, prominent among which are caffeine, scillain, adonidin, convallamarin,. antiarin, helleborein, oleandrin, and erythrophloein. With the exception, perhaps, of caffein, none of these agents have come up to expectations, and even it cannot take the place of digitalis. It certainly acts more quickly, but less effectively. The latest aspirant for this honor is a substance called strophantin, a glucoside obtained from strophanthus, a plant widely distributed throughout Central Africa, and used by the natives as an arrow poison. · It pi-oduces a follicle from 9 to 12 inches in length, within which are containedfrom ohe to two hundred oval seeds. These seeds, when ground and formed into a paste, constitute the poison with which the arrows are smeared. Prof. Fraser, of the University of Edinburgh, has made this plant the subject of an extended series of experimental investi- gations both in man and the lower animals. The results were presented to Ütle members of the British Medical Association, in the section of Pharmacology and Theêrpeuties, at the CaIi. meeting, and will be found in the British Medical Journal of November 14th, 1885. Prof. Fraser found that strophantin, no",
         "PHARMAcOLOGY AND THERA PE UTICS-DR. STEWART. . 343 matter how it is introduced into the blood, powerfully affects the contractile power of all striped muscles. The muscular contrac- tions are more complote and prolonged. The heart muscle is the first to be affected. The contractions are increased in force and rendered slower, while in over-doses the heart's movcments comes to a stand-still in rigid contraction. These effects take place even after the influence of the cerebro-spinal centres is removed. They closely resemble those of digitalis, and are accompanied, as in the case of the latter, by a rise in the blood-pressure, and, in certain conditions, by an increased secre- tion of urine and a reduction of temperature. One part of strophantin in 100,000 vill quickly stop the heart of the frog in systole, while digitalin in the same proportion, although it produces slowing and increased vigor, will not arrest the heart. Dr. Fraser even found strophantin, in the proportion of 1 to 6,000,000, arrests the heart's contractions of the frog in extreme systole il twenty minutes. This shows-a very marked difference in the power of these two agents in their direct action on the heart. Digitalin, on the other hand, was found to exert a much more powerful influence on the blood-pressure than strophantin. In a frog whose central nervous system was destroyed, a solu- tion of digitalin of the strength of 1 to 20,000 passed through the blood-vessels, prodúced, in six or seven minutes, such extreme contraction of the vessels as practically to prevent the solution from passing any longer. A solution of the same strength of strophantin had no appreciable, nor could any marked effect be obtained from solutions more than six times the above strength, a very temporary effect only becoming obtainable from a solution- of 1 in 2000. \"Strophantin, therefore, exerts a much [more powerful action upon the heart and less powerful action on the blood-vessels than digitalis.\" This difference in action, it is conjectured. may be of considerable therapeutic importance. In purely cardiac lesions, it may be found that strophantin, which acts principally on the heart and but little on the blood-vessels, may be a more efficient cardiac tonic than digitalis, as the latter, at times, greatly increases the peripheral resistance, while at the same time it increases the systolic vigo'. These deductions are matters, however, of mere conjecture.",
         "344 CANADA MEDICAL AND SURGICAL JOURNAL. Dur. Fraser gives an account of several cases of cardiac disease where he employed strophantin. The first is that of a man, aged 43, who was admitted into hospital suffering from great breathlessness, cough, and swelling of the feet. . The liver and spleen were enlarged and the lungs oedematous;.= The heart was enlarged, and its mitral valve incompetent. The pulse at the wrist was scarcely to be felt, small and irregular, and 40, pul- sations could only be felt in the minute, while 160 could be de- tected at the heart. After a two days rest in bed, the patient was given a tincture of strophanthus, which apparently rapidly and greatly improved lis condition. The pulse became stronger, more regular, and less rapid. The odema of the legs and lungs rapidly disappeared, and the patient expressed himself as feeling very comfortable. Twenty-four hours after the administration there was a rapid and great increase in the quantity of urine excreted, and which eontinued. The patient ultimately left the hospital in comparatively good health. The second case was that of a boy, aged 14, who had been ill for three years, and who, on bis admission into the hospital, complained of breathlessness, etc. He had œdema of the legs and lungs. There was ascites, occasionally vomiting and diar- rhoa. All the above symptoms were due to a constricted and leaking mitral valve. On the ninth day after bis admission he began taking strophanthus. The frequency of the pulse almost immediately began to fall and the quantity of urine to increase. The quickness and irregularity of the pulse soon gave place to slowness and regularity. He made a satisfactory recovery from the urgent symptoms, and was convalescent six weeks after bis admission. The third case is one of mitral and tricuspid incompetence in a lad aged 16. He began to suffer from breathlessness three months before he came under treatment. His feet, legs, belly and face were swollen, and the urine was greatly lessened in amount. Very shortly after commencing the use of strophanthus there was a marked change for the better, which continued and increased until his discharge. In the fourth case, the strophanthus was administered hypo- dermically in doses of 1-50th of a grain. The patient was a",
         "PITARMACOLOGY AND THERAPEUTICS-DR. STEWART. 345 woman, aged 33, suffering from mitral regurgitation, following acute rheumatism. There was great obstruction of the circula- tion, with anasarca; the pulse was so rapid and feeble as to be almost uncountable, and the urine was scanty and contained albumen. The action of the drug was apparently distinctly Manifest twenty minutes after the irst injection, and continued for a period of twenty-four hours. The pulse, which was 136 before the injection, fell in one hour and a-half to 124, in two hours to 98, and in three hours to 88. The urine .amounted, on an average, to 29 ounces daily during the six days immedi- ately preceding the injection; on the following day it amounted to 36, and on the second day, and before any more strophantin had been given, to 50 ounces. The fifth and last case related is that of a female, aged 22, who was under observation for a long time, while suffering from miLral regurgitation. In five minutes after the injection of 1-50 of a grain of the strophantin the pulse, which at the wrist was not previously countable, was 108 ; in one hour it was 92 ; in one hour and forty minutes it was 86, and could be easily and correctly ,counted. The character of the pulse tracing was distinctly improved in twenty minutes; and in forty minutes the patient volunteered the remark that she had not felt so little distress from palpitation and breathlessness for six weeks. The beneficial influence of the single injection in this case lasted eight days. The increase in the flow of urine was maintained for the same length of time, The average quantity of urine voided in the two days preceding the injection of strophantin was 27 ounces ; it was increased on the following day to 55 ounces ; on the second day to 58, on the third day to 70, on -the fourth day to 74, on the fifth day to 82, on the sixth day to 78, on the seventh day to 64, and on the eighth day to 78. THE TREATMENT OF LUPUS. It will be remembered that at the International Congress held in Copenhagen last year, with the exception of Kaposi, al] the speakers who took part in the debate on lupus looked upon this disease as a tuberculosis of the skin. Although tubercle bacilli",
         "CANADA MEDICAL AND SURGICAL JOURNAL. are very frequently found in lupoid infiltrations, and carefully- conducted experiments have shown that the injection of lupus tissue into the blood and tissues of the lower animals causes tuberculosis in many cases, we are still far from certain what is the exact pathological relation there between lupus and tuber- culosis of the skin-whether they are the same or different affections. Since the tuberculous nature of tl)e lupus tissue has become so generally accepted, miany experini.-ats have been conducted with the view of testing what, if, any, influence is exerted over it by antiseptics. Doutrelepont of Bonn has used corrosive sublimate for this purpose. He employs a solution of the strength of 1 in 1000. Compresses soaked in this solution are fixed over the affocted parts and covered with gum paper. He gives a report of some twelve cases in al], where a complete cure:has resulted. The length of time before this end was attained varied from three to six months. The ages of the patients varied from 1.4 to 54 years. The cases included the several varieties of lupus-ulcerative, serpiginous, hypertrophic. Not only was there healing of ulcerative surfaces, but a complete absorption of the lupoid infiltrations-\" a complete involution. of the new formation.\" In no case was there observed any of the untoward effects of the mercurial preparation, either local or general. In situations like the eyelids, where it was not convenient to apply the compresses, the sublimate was used in the form of an ointment made by dissolving one part of this salt in a sufficient quantity of sulphuric ether, and then mixing it with 300 parts of vaseline. In order to prevent relapses, it is recommened to continue the application of this ointment after an apparent cure has been obtained. If Doutrelepont's observation are correct, we have in corrosive sublimate the most -1cient means yet discovered of treating lupus. It should be mentioned, however, that in a number of his cases arsenic was given internally while the sublimate was being applied externally. It is a well known fact that the in- ternal use of arsenic, like cod liver oil, has an influence in induc- ing the involution of lupoid formations. 340",
         "PHARMACOLOGY AND THERAPEUTICS-DR. STEWART. 347 LACTIC ACID AS AN ESCHAROTIC. At a meeting of the Society of Physicians of Vienna, held on November 20th, Prof. Mosetig-Moorhof exhibited two patients illustrating the value of lactic acid as a destroyer of new for- mations. One case was that ôf a man, aged 55, who came under observation about six months previously with an epithelio- matous ulceration of the left temporal region, involving the left angle of the eye. It was six cubic centimetrès in extent, and extended transversely from the lobe of the ear to the angle of the eye, and vertically from the edge of the hair to the angle of the lower jaw. The disease first made its appearance three years previously. A microscopic examination confirmed the clinical diagnosis of epithelioma. On twenty-six different occa- sions lactie acid was applied to the ulcerated surface, and four times a 50 per cent. solution of it was injiected into the infiltrated borders. As a result of this treatment, the .whole of the large granulating surface described had completely healed, with the exception of a very small healthy granulating surface. The borders, from being rough and hard, had become smooth and soft. The second case was that of a woman aged 60, whose trouble began four years ago in the form of a rodent ulcer, which slowly and steadily progressed until it destroyed almost the whole of one cheek and infiltrated the orbit, necessitating the removal of the* globe. The carcinomatous nature of the infiltration was confirmed by an histological examination. Twenty applications of lactic acid caused a marked change. The disease soon ceased to progress, and the borders commenced to show signs of healthy action. After the removal of a small piece of dead bone in the ,upper jaw, this tissue also showed healthy action, and when the woman was exhibited there was nothing to indicate or to lead one to believe that she had a malignant ulceration. The granula- tions were healthy, and healing was proceeding satisfactorily. On account of the very extensive destruction of tissue there could, of course, be no return to the normal condition. Mosetig-Moorbof, in answering the question, Were his patients healed ? said lie knew not, but lie was certain that the acid had",
         "CANADA MEDICAL AND SURGICAL JOURNAL. removed ail the diseased tissue, and that was ail the surgeon could do. These cases were certainly a very severe test for any agent. They were practically incurable cases-cases such as no surgeon would attempt to remove. The treatment extended over several months, and on both the patient and surgeon's part required great patience and perseverance. The acid is applied in its pure state to the raw surface. Pieces .of cotton wool saturated with it are fixed to the diseased parts, and kept there from six to twelve hours. The application causes considerable pain, and while this lasts it may be taken as an index of the active action of the acid. After its removal, the parts should be washed and covered with cotton wool. The local application of fatty substances should be avoided, as they will subsequentiy interfere with the activity of the lactic acid. A second application should be made in two or three days. It is claimed for lactic acid that it is a powerful destroyer of diseased tissue, especially new formations, and that it spares healthy tissue. The only effect of its application to the latter, even for a period of twenty-four hours, is to cause redness. 4,uicWs and otices of ohs. Handbook of Pathological Anatomy anid Histology. By FRANCIS DsLAF11ELD, 1.., and T. M. PRUDDEN, M.D. New York: Wm. Wood \u0026 Co. In this second edition of his handbook, Dr. Delafield, besides associating himself with Dr. Prudden, has greatly extended the scope of the work which was at first merely interded as a guide in post-mortem examinations. The authors modestly state in the preface that the present edition \" is intended' to supply ail the needs of students and practitioners who wish to add a knowledge of the lesions of disease to that of its symptoms.\" This would seem a very odd reason for limiting the text of the book to a mere statement of anatomical conditions found'after death with- out attempting in any way to explain their significance or even show the connection between the various lesions of the same disease, still less to deal with their causes. The arrangement 348",
         "REVIEWS AND NOTICES OF BOOKS. of the book is strictly according to locality, a plan which, while making it convenient for reference, also makes its style appear abrupt and jerky, so that the reader, feeling after a few minutes as if he had stumbled across a. dictionary, can scarcely help wishing that it would not change the subject quite so often. - With regard to the facts contained in it, since the authors systematically abstain from stating any special tendencies or complications, there is very little to which exception can be taken, though the paragraph dealing with acute interstitial nephritis, \"a rare form of nephritis, one of the noticeable features of which is marked dropsy without the presence of albumen in the urine,\" excites curiosity without satisfying it, and the fact that, after passages like this, no reference to the literature of the subjecd is given, makes it doubly provoking. The classification and nomenclature is often puzzling, and in many places, particularly with reference to the forms of peritonitis, there is a good deal of hair-splitting, having no obvious pathological basis. The chapters on Tumors would be more complete if papillo- matous growths had not been ignored. The absence of any chapters on diseases of the eye and ear is a serious defeet. As might be expected from any work of Dr. Delafield's, the illustrations form a promínent feature, and show a high degree of artistic finish, but in this, as iu most American works of this sort, we notice the employment of needlessly high magnifi- cations. Why Dr. Delafield should require lenses magnifying 700 or 800 diameters to demonstrate merely what less gifted individuals can see perfectly well with 200 or 300 must remain a matter between himself and his optician. The illustrations of lung diseases, which are the best in the book, are the same as those issued separately some years back under the title of \"Studies in Pathological Anatomy.\" A valuable addition consists in the collection at the end of the book of short practial notes concerning the lesions met with in poisons and in deaths by violence. This is well worthy of study by any one having to deal with medico-legal cases. The authors, in attempting to adapt the book to all the re- quirements of students and practitioners, have aimed at what ,349",
         "350 CANADA MEDICAL AND SURGICAL JOURNAL. would be quite impossible in a work of this size. Students need a book in which the doctrine is forcibly set forth and the signifi- cance of the facts fully and clearly explained. References to authorities are for the most part unnecessary and confusing, while on the other hand, in writing for practitioners Who are capable of weighing evidence on doubtful points, the references should be full and copious. The book under consideration, there- fore, though quite unsuited to the requirements of medical stu- dents, should be found very valuable to practitioners, and its value would be greatly enhanced if, in a future edition, the references were systematically filled in. The publishers have done their work admirably, both as to the style of the book and the execution of the engravings Fowne's Elementary Chemistry.-Lea Brothers \u0026 Co., Philadelphia. This is an American edition of Powne's Organie Chemistry; by Watts, from the twelfth English edition (1877), togther with Watts' late book, \" Physical and Inorganic Chemistry.\" These two books are bound together, making a very ponderous volume of over one thousand pages of rather trying print. When we consider the outrages we have suffered at the hands of Fowne's Chemistry, we have some difficulty in approaching this new edition with an unprejudiced mind. We remember in our undergraduate days becoming more or less intimate with most of the inhabitants of our book-shelf, even chumming at times with Gray's Anatomy, but never at any time succeeded in obtaining more than a bowing acquamtance with Fowne's Chemistry. It seemed right and proper to read Fowne's, and to see io noted among the college text-books. It always inspired a profound respect, but it never occurred to us to make our- selves master of it as we did of our Holmes or Dalton. A master of Fowne's ! What presumption. We submitted to nightly defeat in our futile endeavors to become familiar with it. Our coy advances everywhere met with a cold, perplexing re- ception, till at length compelled to fall back on the companion- ship of lecture-notes or quiz-compends, we passed our examina- tions with unalloyed pleasure.",
         "REVIEWS AND NOTICES OF BOOKS; Fowne's Chemistry, however, still retains its position as the orthodox college text-book. This is undoubtedly \"partly due to force of habit and partly to its former worth as a class-book, when the facts were fewer and the laws of chemistry still re- mained disconnected. With the strides chemistry has of late years made, Fowne's Chemistry, under the editorship of Mr. Watts, has made frantie efforts to keep pace, but with cach edition such a mass of new facts had to be added that its use- fulness as a text-book has gradually decreased, until of late years not only has that usefulness departed, but it has been positively detrimental to the teaching of sound chemical science in our colleges. The book is oppressive in size, too detailed in matters of fact, and wanting in logical scientific enunciation of the theory. Every student buys one ; few read it ; all dislike it. The present edition attempts to deck out the rickety old skeleton in modern style, but the result is the production of a volume not complete enough to be called an encyclopSdia, and too much padded with unnecessary detail to be used as a text- book for students. For those who like Fowne's Chemistry, however, this new edition is probably just the sort of book to meet their views. Clinical Studies on Diseases of the Eye: Including those of the Conjunctiva, Cornea, Sclerotic, Iris, and Ciliary body.-By DR. FERDINAND RITTER VON ARLT, Professor of Ophthalmology in Vienna. Translated by LYMAN WARE, M.D., Surgeon to the Illinois Charitable Eye and ihar Infirmary, Chicago. Philadelphia: P..Blak- iston, Son \u0026 Co. The author of this work has been so long known as a master mind in the science of ophthalmology that his writings are always sure to be received with more than ordinary appreciation by those who wish to keep abreast of the times in ophthalmic lore. It will be seen that the subjects treated of in this volume are of primary importance to the general practitioner, including, as they do, all the diseases peculiar to the conjunctiva and anterior portion of the eyeball, which, indéed,'comprise the majority of 351",
         "352 CANADA MEDICAL AND SURGICÂL JOURNAL. all the morbid conditions to which the eye- is liable. It is a grave fault to be noticed in most handbooks on the eye that the necessarily limited space allotted to each division of the work involves too much brevity in the consideration of just those sub- jects which this work treats of in a complete and exhaustive manner ; but what lends to it a special charm for the reader is the knowledge that the author is giving to the world the benefit of bis own extraordinarily rich and fruitful experience as a clinical observer and a practical therapeutist. It is to be hoped that the author will carry out the half promise contained in his preface, and publish other volumes embracing the entire range of ophthalmology. Judging from that which we have now before us, such a complete work would probably become the most popular ophthalmic treatise of the time. The translator is to be congratulated on the faithful and thorough manner in which he has performed his task ; the few notes and additions he has made are of real value, and at the same time do not give the impression of altering in the least degree the original character of the work, in the conscientious presentation of which, by a semewhat scrupulously close translation, there are here and there observable some of the faults in phraseology that are, perhaps, more or less inseparable from all translations. The American edition of this work is certain of a circulation suffi- ciently extensive to meet the most sanguine expectations of both author and transiator. A Treatise on Nervous Diseases: their Symptoms and Treatment. A Text-book for Students and Prac- titioners.-By S. G. WEBBER, M.D., Clinical Instructor in Nervous Diseases, Harvard Medical School; Visiting Phy- sician for Diseases of the Nervous System at the Boston City Hospital, etc. New York : D. Appleton \u0026 Co. Dr. Webber's work is intended for students and practitioners, the aim of the author being to give a fairly full and accurate account of the more prominent diseases of the cent.ral and peri- pheral nervous system. We have now a large number of works on the nervous system in the English language, but we know of",
         "REVIEWS AND NOTICES OF BOOKS. 353 no work that-is better adapted.for the needs of the student and young practitioner than Dr. Webber's. ln the first chapter the author deals witli the methods to be adopted in testing 'motion, sensation, and the reflexes. A description is also given of some of the more prominent symptoms common to many nervous affections, and the treatment to be adopted. In the next chapter, a short and, as far as it goes, accurate account of the anatomy and physiology of the brain is given. The following six chapters deal with the diseases of the brain. A particularly full and in- terestin g account is given of cerebral hæmorrhage. Chapters IX to XXI are devoted to, the diseases of the spinal cord. The author believes that exposure to cold, especially cold combined with wet, is one of the most frequent exciting causes of tabes dorsalis. It has always appeared to us that cold plays a much more prominent part in the causation of this disease than it gets credit for. The marked frequency of a history of syphilis in tabetic cases is beyond all doubt, but it is far from being proved that the sclerosis is induced by syphilis. In no other tissues have we such changes from syphilis as we find in tabes, and when we consider the comparative worthlessness of antisyphilitic treatment in this disease, even in patients with marked syphilitic histories, it is clear that syphilis is not a direct cause of the disease, except in rare cases. The evidence that exposure to cold and wet is sufficient to cause tabes is beyond all doubt. The diseases of the sympathetic and peripheral nerves are dealt with in a very practical manner. The concluding chapters are taken up with a description of neurasthenia, tetanus, tetany, myxodema, the foxic neuroses, syphilis, together with an account of the so-called functional affections of the nervous system. A Practical Treatise on Diseases of the Kidneys ànd Urinary Derangements.-By CHAS H. RALFE, M.A., M.D., F.R.C.P., Lond., Assistant Physician to the London lospital. With illustrations. London: H. K. Lewis. This work, which is one of \" Lewis's practical series,\" is in- tended to meet the requirements of the general practitioner and the student of medicine. It gives a more detailed account of 23",
         "354 CANADA MEDICAL AND SURGICAL JOURNAL urinary derangements than is to be found in any of the ordinary handbooks on the practice of medicine. It begins with a des- cription of the symptoms common to many of the kidney diseases, such as dropsy, uræmia, acetonæmia, neuralgia, asthma, derange- ments of digestion, etc. One hundred pages are devoted to the means employed for making a clinical examination of the urine. The author strongly urges the necessity, when testing for albu- men, to employ heat, in addition to some of the other tests now so comnonly employed. The latter, he says, should never be entirely relied on, partly because they sornetimes precipitate other bodies, suel as uratos, alkaloids, peptones, mucin, etc., and partly because in themselves they do not discrimuinate be- tween the modifications and other forms of albumin. It matters little, however, which reagent is selected, so long as heat is one of the tests employed. The causes of albuminuria are given in detail, and special stress is laid on the frequency and import- ance of the now so-called functional albuminuria, The theories advanced to explain why albumin exudes into the urine in some diseases, or, rather, why it does not transude in health, are fully described. The view that the epithelium of the glomeruli and tubules possesses the power of retaining .the albumin in health is strongly borne out by the fact demonstrated by Dr. Robertson of Glasgow. le injected atropine into a cat whose urine was free from albumin. On the first and second days after- wards the urine became albuminous, but was fi-e on the thiîrd, when the animal seerned quite recovered from the effects of the drug. The atropine paralyzes the renal epithelial cells, as it does the cells of the submaxillary and mammary glands, and - thus the re-absorption of the albumin is prevented ; it therefore appears in the urine. No doubt many of those cases of transient so-called functional albuminuria are due to the paralyzing influ- ences of ptomaine-like agents during their elimination by the kidneys. These agents arise during the progress of pancreatic digestion. There are other factors, such as increase in the ten- sion of the renal arterioles and changes in the specific gravity of the blood, which take a part in the transudatièn of albumin. The author explains the small amount of albumin in the urine",
         "REVIEWS AND NOTICES OF BOOKS. throughout- the entire course of chronic interstitial nephritis as due, during the first stage, to there being little or no interference with the functional activity of the renal epithelium, that it is able to reabsorb the albumin forced through by the increased pressure ; while in the late stages, when the epithelium is des- troyed, there is so little blood circulating in the organ from the obliteration of its vessels by the contracted tissue that there is little albumin in cousequcence to transude. For the same reason the indurated kidney of chronic cardiac disease -and the waxy kidney are not attended by any great transudation of albumen. The different forms of Bright's disease are fully and clearly described, as well as the suppurative inflammations of the kidney and its outlets N3w growths, parasites, and abnormalities of the kidney each form the subject of chapters. In the treatment of diabetes, particular stress is laid on the great value of an old, but much neglected, remedy, viz., opium. Cases are given showing what large quantities 'of this drug can be taken in this disease without causing its usualuntoward effects. When a patient is returning from a diabetic diet to his old way of, living, it is necessary to give the opium in increased quanti- tics. There appears to be little or no danger of the opium habit being contracted. Under its influence the urine diminishes greatly in quantity, the appetite and thirst are restrained, and the patient gains in strength and weight. There is no danger of bringing about diabetic coma from the use of opium, even in large doses. The opium is called for, when, after a fair trial of restricted diet, sugar still continues to be excreted in the urine. Chapters on lithuria, oxaluria, phosphaturia, peptonuria, and hemoglobinuria conclude a work which will be found to be a pro- fitable addition to the physician's library. The American Journal. of the Medical Sciences for January, 1886, appears in a new and enlarged form, being called the International Journal of the illeclical Sciences, and under the joint editorship of Dr. J. Minis Hays of Phîladelphia and Dr. Malcolm Morris of London. The prescrit number contains several papers of much merit, contributed by leading English",
         "356 CANADA MEDICAL AND SURGICAL JOURNAL. writers as well as the usual original articles from promineut cis- Atlantic authors. The special departments of the quarterily summary of medical progress have each been placed under the direction of a responsible and experienced director. This vell known quarterly is maintaining its high position, and the recent changes will undoubtedly add nuch to its value and interest. Baooks and 3?amphlets .eceived. CLIMATOLOGY AND MINERAL WATERS OF THE UNITED STATES.' By A. N. Bell, A.M., M.D. New York, Wm. Wood \u0026 Co. DIAGNosIs OF DISEASES OF THE BRAIN AND OF THE SPINAL CoRD. By W; R. Gowers, M.D., F.R.C.P. New York, Wn. Wood \u0026 Co. DISEASES OF THE LUNGS OF A SPECIFIC, NOT TCBERCULOUS, NATURE. By Prof. Germain Seô. Translated by E. P. Hurd, M.D., with Appendices by Geo M. Sternberg, M.D., and Prof. Dujardin-Beaumetz. New York, Wm. Wood \u0026 Co. CLINICAL NOTES ON UTERINE SURGERY. By J. Marion Sims, A.B., M.D. New York, Wm. Wood \u0026 Co. VENEREAL MEMORANDA FOR THE STUDENT AND PRACTITIONE'. By P. A. Morrow, A.M., M.D. New York, Wm. Wood \u0026 Co. CUTANEOUS MEMORANDA. By Henry G. Piffard, A.M., M.D. Third edition. New York, Wm. Wood \u0026 Co. THE EXTRA PHARMACOrIEIA, with the additions introduced into the British Pharmacopia, 1885. By Wm. Martindale, F.C.S., \u0026c. Medical References and a TherapeutiC Index of Diseases and Symptqms. By W. Wynn West- cott, M.B., Lond. Fourth edition. London, H. K. Lewis. PRACTICAL SUGGESTIONS RESPECTING THE VARIETIES OF ELECTRIC CURRENTS AND THE USES OF ELEBTRICITY IN MEDICINE. By Ambrose L. Ranney, M.D. New York, D. Appleton \u0026 Co. THE INFLUENCE OF SEN ON DISEASES. By W. Roger Wiliiams, F.R.C.S., \u0026c. London, J. \u0026 A. Churchili. A MANUAL OF ANIMAL VACCINATION PRECEDED BY CONSIDERATIONS ON VAC- CINATION IN GENERAL. By Dr. E. Warlemont, Translated by Arthur J. Harries, M.D. London, J. \u0026 A Churchill. TUE PRINCIPLES AND PRACTICE Or MEDICINE. By the late Charles Hilton Fagge, M.D., F.R.S. Including a section on Cutaneous Diseases, by P. H. Pye Snitb, M.D., M.C.S.; chapters on Cardiac Diseases, by Samuel Wilks, M.D., F.R.S.; and complete Indexes by Robert Edmond Cannington, M.D. Vol. I. Philadelphia, P. Blakiston, Son \u0026 Co.",
         "MONTRÈAL MEDICO-CIIIRUItUICAL SOCIETY. Societyj stroceedingçs. MEDICO-CIIIRURGICAL SOCIETY OF MONTREAL. Stated Oleeting, November Cth, 1885. T. G. RODDICr, M.D., PRESID.ENT, IN.THE CHAIR. Jouble Ovariotomy.-DR. WM. GARDNER exhibited the tumors removed at one operation from a case of double ovarian disease. The patient had been under observation for a year, the tumors slowly increasing, evidently cystic-that on the left side causing a great deal of pain, and being situated low in the pelvis. The tumors were multilocular cystomata, of the size of a large in- fant's head. The left.sided tumor was intraligamentous, requir- ing enucleation from the broad ligament, and giving rise to very troublesome pelvic bleeding. The right tumor had a good pedicle and was secured by ligature without much difficulty. Over each tumor the Fallopian tube coursed, being much elongated and distended, sausage-like, all except a small part at the uterine end. The tubes, in parts, measured 1- inches in diameter. They were filled with fluid resembling that in the cysts. No trace of ovarian stroma could be found ; still the woman had always menstruated regularly and profusely. Although the operation was a long one, the patient being over three hours under ether, she made a perfectly easy recovery, the tempera- ture once only reaching 100\". Ovarian Tuînor. -DR. TRENIOLME exhibited this specimen, which- ho had removed that morning from a woman, aged 42, who had suffered for about twelve years, and had been tapped eight times. There were a great many adhesions over the front, none behind. The cyst weighed 32 Ibs., and was made up partly of hard nodular masses, feeling like scirrhus. Dr. Johnston was asked to examine these masses and report at next meeting. Typical Case qf Psoriasis.-DR. RoDDIcK brought this speci- men, a boy aged 15, before the Society as being an unusually good example of this disease. All varieties werc to be scen over his bddy and limbs. Three years ago this lad had been treated, with good effect, with chrysophanic ointment and arsenic, but of late had given up al treatment. The disease dates from about a month after he was revaccinated-that is, when about 7 or 8 years of age. Dr. Roddick knew of another similar case dating from vaccination, but said it wae most probably a coincidence, not the cause. 357",
         "358 CANADA MEDICAL AND SURGICAL JOURNAL. DR. BLACKADER had observed several odd symptoms persist- ing after dermatitis, caused by vaccination. Fatal Pulmonary Embolism, arising from simple femoral throbosis.-Da. GEORGE Ross exhibited the specimen. The heart and lungs had been removed together, and the right side of the heart and pulmonary artery laid open. The left branch of the latter was seen to be plugged by a thick fibrinous clot beginning an inch above the valves, the lower end lying loose in the main artery and for some distance curled back upon itself. Still nearer the heart, in fact'almost touching the valves, lay a second loose clot of the same appearance, about thrce-quarters of an inch long. The clotting extended far into the lung, even to the small branches. The right branch and its divisions were quite similarly occupied by an extensive fibrinous deposit. The femoral vein was also shown, containing a clot several inches in length and extending a long way down the internal saphena. The patient was a young woman who.had presented the usual symptoms of a simple anæemia for some months, when she de- veloped pain and swelling of the right leg. . She was then admitted to the Montreal General ilospital under Dr. Ross, when the existence of femoral thrombosis was readily detected by the presence of a firm cord in the situation of the vessels. Her general condition was good; with the exception of a mode- rate degree of anæmia. One week after admission, after having passed a good night, she complained at 5 a.m. of suddenly feel- ing faint. This soon passed off, and nothing more vas thought of it. The day nurse afterwards saw lier during the forenoon lying in bed knitting as usual. At 12.45 p.m. she became sud- denly breathless, panting and distressed. The house physician saw her at once, and gave stimulants, but at 1 p m she was dead. The occurrence of pulmonary embolism was immediately suspected. Dr. Ross remarked that, although very frequently meeting with femoral thrombosis, it was the first time be had ever observed this fatal accident following from it. It had been bis misfortune, a short time since, to meet with a sudden death ten days after a natural confinement and an apparently perfectly natural puerperium. An autopsy in this case likewise showed the fatal result to have occurred from pulmonary embolism, as had been suggested-the source of the clot, the uterine sinuses. The present case was of interest, from the syncopal attack in the early morning, which, no doubt, was produced by the sur- prise of the heart at the arrival of the foreign body. He bad been very much struck in both these cases by the great extent",
         "MONTREAL MEDICO-CIIIRURGICAL SOCIETY. of the clotting through the branches of the pulmonary artery, which must have taken time to form, although no pulrmonary symptoms prevailed during that period. DR. KENNEDY lad aÌso seen a case of sudden death take place on the thirteenth day after a natural delivery, and while appa- rently convalescing most satisfactorily. No autopsy was held, but death, no doubt, was caused by -embolism. Lacera tion of the Spleen; Splenectomy; Death.-Tfhe PRE s- DENT showed some frâgrmenits of spleen which lie had removed by operation from a man, the subject of a terrible accident. DR. EBERTS, who accompanied the ambulance waggon, gave the particulars of the accident., He found the man lying on the deck of one of the ocean steamships, suffering from shoek, almost pulseless, and cold. He learned that the man had been working in the hold, and that a bucket holding about ten hurn- dred weight of coal fell on him. The bucket struck an obstacle in its descent, and had partly burst. A small wound was made in the left side, between thé last rib and crest of ilium, probably from a sphnter or loosened bolt. DR. RoDD»ic said that on arriving at tlie hospital lie found a portion of the omentum protruding through the wound in the side. He enlarged the opening and found internal bleeding ; a piece of spleen was withdrawn, and it was fbund that the hemor- rhage came from its torn surface. Ail the spleen was then removed and the pedicle tied. The kidney was fbund displaced and thouglit to be lacerated. The man died in five or six hours. Three or four ribs were broken and bent inwards, probably caus- ing the laceratiorns. DiR. JOIINSTON, who performed the post-mortem, found about five ounces of blood in the abdomen and about as much in the pleura. Thie diaphragm, thougli scratched on its under surfIce, was not torn through. Different views were taken by members as to the cause of the lacerations. DR. WILKINS said lie had seen in the hospital, three or four years ago, a case where a young man, from being thrown off the cars, had a kidney very much lacerated and his liver less so. Ail this without any external wound. DR. GARDNER reminded Dr. Roddick that lie (Dr. R.) lad exhibited suc a specimen some years ago to this Society. La- ceration of the kidney was produced in an old lady who feul down stairs. No external wound was made.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. The PRESIDENT then delivered an address on the past year's work. Dr. Roddick began by thanking the Society for the honor they had done him in electing him president for the second term. He referred to the deep interest he had always taken in the wel- fare of the Society, and spoke of its formation in 1870. Some of the carlier papers and discussions were very interesting, the older members of the profession being al] at that time in the habit of attending the meetings and contributing papers. Refer- ence was made to the fact that three of the former presidents and two secretaries had died during the brief period of existence of the Society. The present membership of the Society is 69, one only having joined during the year. The work donc com- pares favorably with preceding years, although the average attendance bas been small. The following papers were read during the year :-\" Missed Abortion,\".Dr. Alloway ; Sycosis, Dr. Wood ; Six cases of Removal of Uterine Appendages, with resuits, Dr. Trenholme ; Notes of two cases of Lead Poisoning, Dr. Mignault; Out-door Practice, Dr. R. MacDonnell ; Hydrate of Chloral and Camphor as a Local Anæsthetic, Dr. Smith; Notes on the Diseases prevalent among the Indians, by Perey Matthews, M.R.C.S., Edin., read by Dr. Robt. Bell ; Remarks by Dr. O. C. Edwards ; Pulsating Empyema, Dr. Geo. Ross ; Musculus Sternalis in Anencephalic Monsters, Dr. Shepherd ; Antiseptic Midwifery, Dr. Armstrong ; Partial Epilepsy, Dr. Mignault; Atmospherie Materies Morbi, Dr. Henry Howard Comma Bacillus, Dr. McConnell; \"Tetany,\" Dr. Stewart: Case of Extra-uterine Gestation treated by Faradization, Dr. Gardner ; Notes on Gynoecology, Dr. Smith. Besides these, there were two very important special meetings leld-one \" to consider Dr. Tuke's Report on the Insane Asylums of the Pro- vince of Quebec\".; the other \" to discuss the proposed Public Health Bill for this Province, and also to make known a scheme for the management and prevention of contagious diseases, espe-. cially cholera.\" Many living specinens were exhibited, and some of the papers were illustrated in that way. The thanks of the Society are due to Dr. Sutherland and Dr. R. J. B. Howard for the admirable pathological demonstrations given during the year. The announcement was made that for the future Dr. W. G. Johnston would conduct this department of the proceedings, that gentleman's devotion to the subject of pathology being weil known. In conclusion, the President congratulated the members on the progress which, as a Society, they had made, and pointed out the many advantages likely to accrue to both young and old in the profession by frequent attendance and constant participation in the debates of the Society.",
         "MONTREAL MEDICO-CflTRtIRcCAL SOCIETY. Gunshot Wounds of the Testicles.-DR. BELL read a paper on two cases. (See page 334.) The PREsIDENT said he had seen both these cases. In the first he believed the bullet burnt its track close to the urethra, which sloughed, and caused the leak five or six days after. DR. GODFREY said lie well remembered the case of a man under Dr. Stephenson's care in the hospital (1840), who had an injury to the scrotum, followed by erysipelas and sloughing away of all the integument. A consultation of the staff was held to see if castration ought to be performaed. It was decided to try dressings of the old Edinburgh red wash. The testicles under this treatment became well covered with a good-looking scrotum. DR. KENNEDY ha.d seen a man who had been gored through the scrotum by a bull ; a portion 4 by 3 inches was torn away. After bringing the rest together and sewing, it appeared almost as perfect as ever. DR. CAMPBELL mentioned having seen a man with but one testicle and hair on his face only on that side. He had also seen.a man with three testicles. Dit. ALLOWAY had a friend who, while fox-hunting, was thrown and had the whole scrotum bared from the testicles. - He got a needle and thread from a farmaer and stitched him up. The PRESIDENT spoke of a case lie bad seen in hospital; the man had fallen from a height and been caught by a nail, tearing all the scrotum and skin of the penis away. By the aid of skin- grafting be made a good recovery. Injuries to the Sternurn.-DR. BLACKADER related two such cases. One, a boy aged 18, who, while exercising on the parallel bars, felt something in his chest give, and causing him to sud- denly drop. After a fortnight's rest lie went back to the gym- nasium, and whilst doing a sirnilar exercise again had suddenly to let go, with symptons as before. This time he (Dr. B.) was consulted, and on examination found separation of the first and second pieces of the sternum. Dr. Roddick was also consulted in this case. The second case was that of a young married lady, aged 26, who had been hit by a tennis ball. Here the lower portion of the gladiolus was riding over the manubrium. The parts were painful and swollen. Plaster was applied and rest ordered. Fracture of Clavicle with Em pliysema.-DR. C AMPBELL said that three weeks ago he was sent to attend a coachman who had 361",
         "362 CANADA MEDICAL AND SUROICAL JOURNAL. gone to sleep on the seat of his brougham and had fallen off, striking his clavicle against one of the wheels. The parts about were greatly swollen and emphysematous. Fracture of the clavicle was easily made out, and it was thought at first it must have been broken. le was sent to hospital, where it was found that only the clavicle had been fractu-ed. The PRESIDENT said this was a rare complication, and could only be produced by direct violence, not by the usual fall on the head or shoulder. Stated ieetiag, 2Vovenber 20th, 1885. T. G. RoDDICK, M.D., PRESIDENT, IN THE CHAIR. Parovarian Cyst.-DR. TRENUOLME shewed a cyst, weigh- ing 55 pounds, removed by him from a woman aged 42 years. There were no adhesions, but the cyst was very vascular on its anterior surface ; here also its walls were much thinner tha7h posteriorly. Patient dcing well. DR. CAMPBELL read a paper on Vaccination aud Revaccina- tion. Ie attributed the cause of so many deaths occurring in French Canadians under ten years, during the present epidemic of smallpox in Montreal, to the fact that it is just ten years since the opposition to vaccination began. There was conse- quently a very large accamulation of unprotected inaterial in a certain quarter of the city, and in that quarter smallpox raged fiercely. He then took up the question of affinity between human smallpox and cow smallpox, and proceeded to argue that they were one and the same disease. He showed that variolous matter had been in numerous cases inoculated on the cow, and the resulting matter retransmitted to the human subject in many thousands of cases, giving vesicles in all respects similar to what is known as \" Jennerian,\" and with full protective influence against smallpox. The comparative value of humanized and bovine vaccine was fully gone into. Dr. Campbell stated that till the present epidemic le had always used the dry, human- ized crust or liquid humanized lymph, and was satisfied with the result, not having had in over twenty years a case of small- pox in any child thus vaccinated with humanized lymph. For the last three months ne had employed bovine matter, and his experience was that it was very unreliable-the failures being numerous. He, however, repeated the operation many times,",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. and this perseverance resulted eventually in excellent success. He assured the Society that after as many a.5 ten failures, the eleventh time had succeeded and good revaccination, taken place. laving medical charge of the Infantry School Corps station in the barracks at St. Johns, he had used bovine lymph on the men, and in a force of one hundred and twenty-three he had, after numerous repetitions,. succeeded , in having good results in one hundred and twenty. In private practice such results could not have been obtained, for the patients would not have submitted. lumanized lymph does not require such per- severance, and is therefore, he believed, preferable. , The paper was a lengthy one, and discussed the question fully. Discussion.-DR. REED thought the weight of evidence went to show that vaccine was a germ sui generis, cultivable on the human and bovine species, and referred to the report of the Lyonnese Commission, and to the fact that Martin of Boston, after prolonged. trial, had given up the attempt to make vaccine by variolous. inoculation of animals. The Board of Health of Montreal had already furnished 20,000 points of ,Boston virus to its officers for the present epidemic. Would prefer arm-to- arm vaccination, but the public prejudice. is strongly in favor of bovine vaccine. The experiences of this year indicate that, in presence of contagion, revaccination should be practised without regard to lapse of time or a previous attack of smallpdx, as several cases of varioloid had been observed in the city, which had occurred Within a few months of successful vaccination with two marks, and also several cases of second attacks of smallpox. Dn. McCoMNEii remarked that he could not agree with Dr. Campbell's conclusions that vaccinia was variola modified by passing through the heifer. The weight of evidence was mostly in favor of the view that they are distinct affections. Dr. McConnell sp'oke of the unreliabitity, in his experience, of much of the bovine lymph supplied during the present epi- demic ; it failed more often than it succeeded, and in many cases where the virus seemed to gain a foothold a \" raspberry- excrescence\" was the result, which was doubtless only a local irritation of the skin, appearing sonetimes ten days or a fort- night after vaccination, and affording no protection whatever against smallpox. From the facts that the points became use- less in a week or two, while vaccine crusts will retaii their infective properties for months, or even years, there would seem to be a difference in power not easy to explain. If the action of the virus depends on a germ, perhaps we have it in 363",
         "364 CANADA MEDICAL AND StJRGICAL JOURNAL. the spore condition in the crust, while it may be in a growing condition, if taken from the vesicles about the eighth day ; and being, in the case of bwine lymph, propagated continually from vesicles, circumstances not well understood may have led to the attenuation so evident in much of the bovine lymph supplied him. Dr. McConnell had, during the greater part of the epi- demie. used humanized lymph, and had very few failures and a much more typical vaccinia, and lad seen no eviI results occur- ring in those vaccinated (25,000). From one to two hundred persons might be vaccinated from a single good crust.. Da. J. J. GARDNER, house surgeon to the Protestant Civie Hospital,ý said le had had several patients in the hospital with smallpox who had been recently successfully vaccinated. One, a young girl about ten years of age, came in with two or.three primary marks and two revaccination marks from a vaccination performed two months previously. She had a light attack of smalipox. A young man aged twenty-five came in with hemor- rhagic smallpox, and died in a few days ; he also had primary marks and marks from a successful vaccination performed two months previously. Dr. Gardner intends writing out a com- plete report of such cases. DR. KENNEDY said lie bad used humanzed vaccine for the past ten years from the same strain, and it always gave satis- faction. During this epidemie his supply gave out, and ho was forced to use the bovine lymph, often producing a spurious take,\" looking like a strawberry; stil oftener, it would not take at all. He found it almost impossible to vaccinate infants with the animal lymph. He had performed successful vaccina- tions with a crust a year old. He mentioned having seen two young girls, sisters, both pitted from attacks of smallpox ten years ago. Took smallpox again this fail. He was sent to attend one of them, and finding she had smallpox immediately vaccinated ber sister, who, however, must have had the disease already, as the eruption came on seven days later. Dr. Ken- nedy believes the vaccination lowered her attack, as her illness was much lighter than her sister's. DR. MILLS said that the history of bacteriology went to prove that the quantity of germs thrown into the system the greater the constitutional effects, therefore he would vaccinate in several places. Many other of the members gave it as their experience that the animal lymph was very unsatisfactory in its re'sults, and spoke of the almost impossibility to vaccinate young infants with it.",
         "MoNTREAL MEDICO-CHIRURGICAL SOCIETY. DR. RonDIcO said that the vaccinator, with his unclean lan- cet, might be the cause of some of the very bighly inflamed arms spoken of. Di. STEWART exhibited a man, aged thirty, who has been suffering for about six months with the prominent symptoms of lateral sclerosîs. The case was looked upon as of protopathic origin. Stated Meeting, Dec. 4, 1885. T. G. RoDi»ciç, M.D., PRESIDENT,' IN TuE CHAIR. Blac/c Gallstones.-Da. MAcDoNNELL exhibited a number of gallstones which had been removed from a dissecting-room sub- ject. The stoiies were of a jet-black color, and resembled pepper- corns in shape and size. When dry they were very friable, breaking with a resinous fracture and being easily ieduced to a powder resembling India ink. This kind of gallstones, though rarely met with, has been described by Bucld, who gives an excellent colored illustration of them. They do not contain cholesterine, but are made up of bile pigment -and lime. Appendiv Vermiformis communicating with the ileum.- DR. MAcDONNELL also exhibited a specimen of appendix vermi- formis which had formed a communication with the ileum about an inch from the valve. A probe could be passed through the appendix into the ileum. It was thought that the attachment to, and communication with, the ileuin was due to a concretibn which had previously existed in the appendix and had caused adhesive inflammation ; as the specimen was taken from a dis- secting-room subject, there was no history. Thrormlbosis in the left ventricle of the Heart.-Da. G EoiE Ross showed a heart which had been removed by Dr. Johnston from a patient who lately died in the General Hospital. Both sides of the heart vere greatly distended, and there was marked bulging of the wall of the left ventricle just above the apex. The cavities contained soft blood-clots. There was no clot in the pulmonary artery or its branches. On opening the left ventricle a firm, decolorized and apparently organized thrombus was found filling the spaces between the columnæ carneæ in the vicinity of the eptm an prjecting slightly into the cavity at a point corresponding to the bulging previously mentioned. The thick- ness of the thrombus exceeded that of the ventricular wall, which in places was reduced to one-fifth of an inch. A space between the thrombus and the heart wall was filled with a choco- 365",
         "366 CANADA MEDICAL AND SURGICAL JOURNAL. late-brown fluid and the endocardium seemed to have disappeared. At some points the heart-muscle was pale and in part fibroid. A small, firin, decolorized clot was also seen lying loosely behind the left coronary segment of the aortic valve: from this was prolonged a clot which conpletely plugged the left coronary artery. A small, firm clot filled the left auricle. Valves normal. Dr. Ross remarked that the patient was a strong, healthy girl, about 25 years of age, who came into the hospital to be treated for an ulcer of the leg, which was supposed to be of syphilitic origin. Suddenly she was seized with a violent pain in the left side of chest and great difficulty of breathing ; her pulse was almost imperceptible at the wrist, and she was in great distress.. The dyspnoa and pain grew worse, and the patient gradually sank and died five days after ture first seizure. Dr. Ross at first thought it was a case of pulmonary embolism, but was now at some loss to account for the symptoms. DR. ARMSTRoNG suggested that the clotting of the blood in the left coronary artery and the consequent loss of nutrition might, perhaps, account for the symptoms observed before death. DR. MILLS said that possibly the plugging of the coronary artery might explairn the other clots and the peculiar symptoms, the lower clots being formed by the weakening of the heart's action due to loss of nutrition from plugging of the left coronary artery. In such an enfeebled heart a mrmur could scarcely be expected to be heard, the obstruction to circulation and inter- ference with nutrition giving rise to pain and disturbance of action of the pneumogastrics. Dr. Mills, in conclusion, remarked that there were other cases reported with the same symptoms, due to plugging of the coronary artery alone. EncystedOGalculus of the Bladder.-DR. SUTHERLAND showed for Dr. A. E. Malloch, of Hamilton, Ont., a bladder with an encysted calculus. Dr. Malloch's report was as follows: J. C., aged 76, had cystitis of one year's standing, due to catheteriza- tion, necessitated by retention of urine, the result of hypertrophy of the prostate gland. The bladder had been sounded for stone on two occasions, and explored with the finger by an incision made in the perineum, but no stone was discovered ; the bladder was drained through the perineal incision, but no appreciable relief followed, and the man died four days af ter. On examining the bladder post-mortem, its coats were found to be much hyper- trophied, and the prostate of large size. The summitgresented a diverticulum a third the size of the whole bladder, \"and con- tained a calculus the size of a small marble, and composed of",
         "MONTREAL MEDICO-CII[RURoICAL SOCIETY. triple phosphates. The communication between the bladder and diverticulum was of small size, and would only admit a lead- pencil. Elepliantiasis of the Le.-DR. SUTHERLAND exhibited a re- markable specimen of elephantiasis of the left leg, which had been sent to the muscum of McGill University by Drs Gooding and Greaves of Barbadoes. The leg had been removed from a negro, aged 23, who had suffered since the age of 11 from attacks of fever. After each attack the leg increased in size, until, frôm the great ificonvenience it caused him, he decided to have it amputated. The enlargenent commencing about three inches below the knee-joint, it was decided by Drs. Gooding and Greaves to preserve the joint. Whilst amputating, but little blood was lost, but some four pints of lymph escaped. The man survived the operation only nine days, dying of pyærmia. The leg, after being preserved some time in alcohol, measures around the calf 25± inches, instep 21 inches. Fracture of the 8Sine.-DR. B EnRD presented a specimen of fracture of the spine, which had been removed several days before by Dr. W. Johnston from a patient who had been under his care some three years before. The man, three winters ago, whilst cleaning the snow from the roof of a house, missed his footing, and fell to the pavement below, a distance of some fifty feet. He ivas immediately brought to- hospital, and, on exami- nation, it was found there was a fracture ot the back in the lumbar region. There were great swelling and deformity of the parts and complete paralysis of sensation and motion of legs. fHe hlad also incontinence of urine., The patient remained in hospital some months, regaining, after a few weeks, partial sen- sation and motion. The deformity very much lessened after the effusion was absorbed. He even took a situation as coachman for some time after leaving hospital. Last spring he hired him- self out as assistant gardener, and said, whilst digging one day, felt something give way. Then he had severe pain and some swelling at site of the old injury, and lost the power to use his leg. ,He was brought to hospital, and it was found there were some swelling and great tenderness at site of old injury in lum- bar region, complete loss of sensation, and but little power of motion in lower extremities. After being in hospital a week or two, he developed phthisical symptoms, and was transferred to the medical wards. He died of phthisis a few days ago, and at the post-mortem the vertebroe of the lumbar and lower dorsal regions were rémoved. The specimen showed slight left lateral curvature, with moderate angular curvature opposite the second 3G1ý",
         "368 CANADA. MEDICAL AND SURGICAL JOURNAL. lumbar vertebra. On making a vertical section, the body of the second lumbar vertebra was seen to be partially absorbed, and a ring of bone encroached upon the cord at this spot. There was a fracture of the spines of the second and third lumbar, and the invertebral substance between these two vertebre had completely disappeared. There appeared to have been a frac- ture, also, of the lamina of the second lumbar. The cord and membranes disclosed nothing to the naked eye, and were removed for further examination. Cerebral Sypltilis.-DR. GEo. Rdss then read a paper on this subject. (See page 326.) DR. HENRY IL0WARD, after complimenting the reader of the paper on the excellent manner the cases had been reported, stated that he had seen many obscure affections of the biain due to syphilis, and had seen many apparently hopeless cases recover after anti-syphilitic treatment. In many fatal cases no cause is discovered after deatli-that is, there is no gross lesion. He believed that, in the future, changes will be discovered by the aid of the microscope which will fully explain everything. What is necessary is a more exact knowledge of the histological anatomy of the brain, and then the pathological condition ivill be more readily recognized. Even now, brains foimerly con- sidered normal are found, on accurate microscopical examina- tion, to have undergone distinct pathological changes, especially in and about the bloodvessels. DR. STEWART considered that cerebral syphilitic lesions are much better treated by mercury than by potassium iodide ; mercury is an antidote to syphilis, potassium iodide is not. Mercury should first be tried, and inunction is the best method; in this way the remedy is introduced more effectively, even than by hypodermie injection. DR. A. LAPTHORN SILTii related a case of epilepsy where the post-mortem revealed a syphilitic gumma in the brain. There was no history of syphilis. DR. F. W. CAMPBELL said he had some experience with' inunction in the treatment of syphilis, and he had found that at times it is as difficult to get the patient under the influence \"of mercury by this method, as when mercury is given by the mouth ; he had seen some patients salivated by five grains of blue pili. DR. SHEPHERD, in speaking of the difficulty of getting a his- tory in many cases of suspected syphilis, mentioned several cases in which there were well-marked tertiary symptoms, but",
         "MONTREAL EEDICO-CIRJURGICAL SOCIETY. 3 no history of primary or secondary Iaanifestations. In one case, that of a medical man, secondary syphilis developed, and absolutely no history of primary sore could be obtained. In tertiary syphilis, he advised first the use of potassium iodide ; if that failed, then mercury ; and if mercury failed, then a combi- nation of the two. He mentioned also that he himself is easily Balivated by five grains of blue pill, and lie knew of severaL like cases, and asked whether such a small amount of mercury is efficient to act as an. antidote to the syphilitic poison. He thought not. DR. WILKINS regretted sufficient notice of meeting had not been given to afford him time to look up bis cases of cerebral syphilis, of which he had several. Although pain in the head is usually present in cases of this kind, he could call to mind two well marked cases of this disease in which the absence of pain was a prominent feature. One of these cases had been under observation for several years, and was attended with repeated attacks of paralysis without loss of consciousness, yielding to treatment with iodide of potassium. As soon as symptoms improved lie discontinued treatment, and in the course of a few months was again attacked with similar symp- toms, again yielding to treatment; but lie did not keep it up. This was repeated thrce or four times, some paresis remaining permanent. Another case was one in which the symptoms set in with stupor, but without loss of consciousness. This state was quickly followed by epiliptiform convulsions coming on with but slight intervals, and lasting in ail several hours. He improved rapidly under large doses of iodide of potassium. Both patients stated that they were not troubled with headache. From the speedy action of the iodide, Dr. Wilkins thought these might be}ong to that class of cases in which, post-mortem, no gross lesion was perceptible, but that the microscope revealed neoplasms affecting bloodvessels, narrowing their calibre, limit- ing or cutting off the supply to certain portions of the brain, and thus accounting for the motor symptoms that were present. Dit. ALLOWAY reported a case of epilepsy, \"due to syphilis, cured by large doses of potassium iodide. Di. RoDDIcK said he had treated the second case spoken of by Dr. Wilkins, six years ago, for the primary sore. He had always treated him since; here iodide of potassium always did good. Dr. Roddick mentioned that urethral chancres were not always recognized as such, but most frequently were treated as cases of gonorrhoa. Secondary symptoms coming on, the 24 369",
         "370 CANADA MEDICAL AND SURGICAL JOURNAL. physician was often puizzled. Some of the syphilitic lesions seen in adults were due undoubtedly to hereditary syphilis. DR. Ross, in reply, said that pain in the head, although a prominent symptom in his cases, he should by no means always expect to find. No one symptom is pathognomonic of cerebral syphilis; but pain comes near to being so, especially if it be nocturnal. Many cases are most obscure, and no history of syphilis can be obtained. (From our own Correspondent) CHATHAM MEDICAL AND SURGICAL SOCIETY. Stated jleetiny, Dec. 4th, 1885. G. H. TYE, M.D., IN THE CHAIR. ffHnorrhage from a Wound qf the Uervix Uteri, simulating an impending abortion.-DR. McKEouGH related a case of a voman -who had had two previous miscarriages, and who, he supposed, was threatened with another. The patient was between three and four months pregnant, complained of some pain in the pelvis, which, however, was not intermittent, and, judging froi the condition of ber clothes and bed, there had been consider- able loss of blood. Pulse was quick and feeble. Her counte- nance was pale and anxious. Numerous clots were removed from the vagina, which was afterwards tamponed with pledgets of cotton-wool soaked in boro-glyceride. Tihe following day the patient admitted that she had attempted to produce an abortion by violence, a large knitting-needle and a catheter being the implements used. After the tampon was removed, an examina- tion of the cervix was made, and revealed an old bilateral laceration. In the posterior everted lip was a recent deep, ragged wound, to which a clot was attached. Its removal caused a fresh spurt of blood, which was controlled by pressure. Tiis occurred six weeks ago, and there have been no symptoms since of a premature expulsion of the fotus. Henorrlage fron the sac of a Spina Biida, resenbling symptons of Placenta Prævia.--DR. TYE reported a case of a woman to whom he was called recently, and found in labor ; pains were coming regularly, and with each contraction of the uterus there was quite a profuse gush of blood. The accouche- ment had commenced with the escape of a very large quantity of water, which was immediately followed by the loss of a con- siderable amount of blood. The os was not sufficiently dilated to make a diagnosis positive, but the doctor thought it miglt be",
         ". ChATHAM 3mEDICAL AND SURGICAL SOCImTY. a case of placenta prævia, As labor progressed and the os dilated, an acephalous monster was diagnosed. The fotus, on being expelled, was found, besides being acephalous and having rudimentary genital organs, to have a large spina bifida, extend- ing from the neck to the sacrum, the sac being ruptured. ,To the spinal openings large clots of blood were attached, and over the interior of the sac small clots also adhered. The placenta came away in half an hour with a very moderate amount of hemorrhage. The child was exsanguine, but the mother showed no symptoms of loss of blood. Multiple Sarcoma.--DR. HOL.Ms read the history of a case of multiple sarcoma, prefacing it with a few remarks upon this form of neoplasm. le first pointed out the distinguishing fea- tures of these tumors, both from a histological and clinical stand- point. .Referring to their microscopical characteristics, he des- cribed the usually accépted divisions of round-celled, spindle- celled and giant-celled or myeloid sarcomata. Of all tumors that affect the bones, these were by far the most common, and they showed a decided preference for the epiphysal ends. In diagnosing them, they -were to be distinguished from carcinomata, benign growths (especiallythe enchondromata), syphilitic enlarge- ments, osteo-myelitis,and white swelling. From syphilitie growths they could be distinguished by the history of the action of spe- cific treatment; carcinomata were generally more rapid in their growth, the lymphatics are more frequently affected, and the cachexia more marked ; white swelling usually occurs in scrofu- lous subjects, interferes with the function of the joint, is liable to suppurate, skin is glossy and tense, and the superficial veins often enlarged, temperature elevated, more painful, and is more or less amenable to treatment. While a sarcoma may pulsate, and has a Iiability to'spontaneous fracture, it does not interfere with movement of joint, etc. So long as the investing capsule of a sarcoma remains intact. the enlargement simply encroaches upon adjacent parts, but as soon as the capsule ruptures, contiguous structures become involved, and systemic infection takes place more or less rapidly through the blood-vessels. Traumatism is the most fruitful cause of primary sarcoma, about half the cases. being traceable to blows, bruises, etc. Complete early extirpa- tion offers the best chance of cure. If the tumor be so situated as to admit of amputation, it is wise to remove the limb as high as is compatible with safety to the patient. The case was that of a boy, aged 17, with a good family history. A tumor, neither painful nor tender, appeared upon the radial side of the palm of the hand, and grew pretty rapidly ; it was removed four",
         "372 CANADA MEDICAL AND SURGICAL JOURNAL. months after it was first noted. The wound seems to have done well for a week after its removal, when the tumor reappeared and grew rapidly. The following week several tumors appeared upon different parts of the body, and when the case vas first seen by Dr. Holmes these tumors numbered twelve or fourteen, and were situated chiefly upon the arms, neck and back ; those on the back were arranged in pairs along the spine. The tumor and suppurating wound on bis hand eventually became very painful ; to relieve him of the pain, and to rid him of the offensiveness of the discharge, which gave rise to a septie fever, the hand was amputated. The operation gave him great relief, and for a time bis downward progress scemed arrested, but he subsequently lost ground, and died eight months after the first appearance of the primary tumor. Quite an interesting discussion followed the reading of this paper, in which Drs. Hall, McKeough, Murphy, Rutherford, and the Chairman took part. The subject was considered cmi- nently practical, notwithstanding that cases of this kind were not frequently seen by country practitioners, still, when they did occur, the necessity of recognizing them at once was of the utmost importance. If a thorough knowledge of these neoplasms were more general, their recognition in an early period of their growth would be more frequent, and lives might be saved which are now sacrificed. Pharmaceutical Notes.--DR. HALL showed a preparation of iron that he had manufactured himself and found serviceable in cases where the tincture was inadmissable. A solution of 544 grs. of citric acid in 1 oz. of water is heated over a water bath and brought to boiling point; then 1 oz. of a solution of liq. ferri perchlor. (1 to 3) is added, afterwards 1000 grains of carb. sodoe. It is then allowed to cool, and proof spirits added to make 4 oz. He claimed that it was almost tasteless, perma- nent, alkaline, miscible with water, and of the same strength as the tincture. It is cheaper than dialyzed iron, and mixes better with water, while it agrees with the most delicate stomachs. Dr. Hall also gave some practical information regarding the pre- paration of suppositories. He gave the following mode of pre- paring them, which, after much experience, he considered the best and simplest for physicians who had to manufacture their own : Mix the necessary ingredients together with a little water, then grate over the mass the desired quantity of l. theobroma, rubbing up the mass at the same time with a pestle until all the ingredients are well incorporated. Shape with hand and spatula, which is preferable to moulds. Use Canada Balsam if they require any adhesive material.",
         "CANADA MONTREAL, JANUAR, 1ss0. THE LONGUE POINTE ASYLUM. The visit of Dr. Tuke to this asylum, the startling report he, furnished of the dreadful abuses existing there, the excitement produced throughout the country by these revelations, the urgent cail to the Government for an abatement of such crying evils- these things surely cannot yet be forgotten. The public, indeed, very soon lose sight of any philanthropie object when the press cease writing upon it; but we do believe that the attention of the entire commaunity was so forcibly directed to the disgrace- ful state of affairs in Longue Pointe Asylum that a strong interest is still felt in knowing what progress (?) is being made towards ameliorating the condition of its unfortunate inmates. After the exposure by Dr. Tuke, the Provincial Government took the matter up and passed an Act in June 1884, the most important provision of which consisted in placing the entire medical management of the institution in the hands of a medi- cal board, to be appointed by the Government. This board was to govern the admission and discharge of al] patients, to be responsible for the classification of patients, to make all rules and regulations for their moral and physical management, and to assume the medical treatment of al! cases. Under this act, Drs. Perrault and Duquet were nominated to act with Dr. Henry Howard. As soon, however, as this was done, the \"fair Pharaoh whose heart vas hardened\" appointed Drs. Durocher and Prieur to perform the duties above detailed. When the Government oficers presented themselves in order to carry out the instructions of the Executive, they were politely informed that ·Sister Teresa had no use for them ; she had",
         "374 CANADA MEDICAL AND SURGICAL JOURNAL. medical men of her own. Hard as it may be to credit, it is neve'rtheless true that, in the face of the Act quoted, for months past, the entire management of this great Gov- ernment institution, containing nearly one thousand luna- tics, has been looked after by two nominees of the nuns themselves, and the Government has looked helplessly on, quietly submitting to be openly defied by this bold Mother Superior. The nuns claim that they have the right to appoint their own medical attendants under their contract. We cannot but believe that the law officers of the Crown are satisfied that the Provincial Parliament had power to pass the Act of June 1884. If so, it is clearly the duty of the Government to see that its. provisions are carried into effect, and, in the interests of humanity, we call upon it to do so. - The law was passed in response to a great outcry on the part of the whole people, and because the necessity for such legislation had become imperative. How is it that any individual or number of indi- viduals can thus set theinselves above all law, and above the deliberate wishes of the people as expressed by their parlia- mentary representatives ? Hiow is it that no reform whatever o:an be carried out in the asylums of this province ? Dr. Tuke t.imnd us in this respect a hundred years' behind European and American countries, and perhaps equally so' behind our very neighbor of Ontario. Are we forever to remain so? Are we forever to be a byword and a disgrace amongst peoples ? If not, let the Government exert its strong arm, and let us for once see vigorous action taken to enforce the right. THE INTERNATIONAL CoNGRESS.-It is well known in this country that Dr. R. P. Howard, Dean of the Medical Faculty of McGill University, was appointed by the original committee of the Congress one of its Vice-Presidents. It was a graceful act on the part of our neighbors to place a leading member of the Canadian profession in this post of honor. When the trouble arose following upon the meetings of the American Medical Association at New Orleans and of the newly-appointed committee at Chicago, no action was immediately taken by Dr. Howard or by any of those Canadians appointed upon the sec-",
         "tions. It was well understood, however, that .they did not approve of the ousting of the old committee or the action taken by the new. Dr. Howard, when directly appealed to to state whether he accepted the position, felt obliged to send in his resignation, which he did some weeks ago. -It is now some time since a committee of the Board of Health was named to enquire into the origin and early spread of. the smallpox in this city. This is a matter of great general impor- tance, and one on which we have already expressed an opinion. We hope that this committee is at work and will shortly give uS a full report. Al the facts of the early stages of the out- break should be clearly stated, and the lesson might ý then be learnt how, under similar circumstances, to avoid such a dire calamity as this year befel our city. SMALLPOX AT LoNGUE PoINTE.-Smallpox broke out some weeks ago at Longue Pointe Insane Asylum-how many weeks ago we do not know, information on points of that kind being unattainable. There are cigIteen cases and there have been four deaths. We have been informed that all the latter were unvaccinated. Three months ago, the nuns were ordered by the Central Board of lealth to have the inmates vaccinated. It seems, however, that nothing effectual was donc until the outbreak, months afterwards. The work was then performed by the phy- sicians in the employ of the nuns-the Lady Superioress, the now-becoming-well-known Sister Teresa, having snapped ber fingers at the Jaw, the Government, the Central Board, and every other body, organization or individual claiming to exercise any authority over her. It remains to be seen how quietly our good Government will sit under this new affront-an affront offered both directly to itself and also to the Provincial Board, whose mandates it is bound to have enforced. THE INSANE IN THE UNITE» STATES AND CANADA.-We have received Dr. Tuke's latest book bearing this title, and have de- rived much profit from its perusai. When the author came to this country with the British Association, his chief object was to familiarize himself with the system under which the insane were managed in these Provinces and in the various States of the Enrron.IAL 375",
         "376 CANADA MEDtCAL ANI) SURGICAL JOURNAL. Union. A lifelong alienist, whose name is a household word amongst the profession, and whose opinions command all the respect such a record deserves, every facility was afforded him for the accomplishment of his purpose. Canada was visited, and, fnding in this Province a state of things calling loudly for immediate reform, he published in this JOURNAL (subsequently copied by the daily press) an account of what he saw and what he would suggest to remedy the evils only too evident. This narrative is included in the present work, together with similar details concerning the asylums of Ontario. These are of .the deepest interest to the Canadian profession, and should be widely read. The bulk of the volume, however, is composed of Dr. Tuke's observations on 'the American asylums, with some com- parisons between the treatment there and in model European institutions. It will be found that the scrutiny shows nothing of which the people of the United States need be ashamed. In- deed, in this respect, their civilization reaches a high order. We hope that, as asylum matters here seem likely to again attract considerable public attention, Dr. Tuke's book will be studied by every physician, for it contains the thoughtful statements of one who is, with reason, looked upon as the most experienced and the most reliable authority in England on all subjects con- nected with asylum management. THE SOUNDS OF THE HEART. It has been urged that the heart contraction, being a sort of single muscular twitch, could not, in consequence, produce a., sound, for it was known that the voluntary contraction of a skeletal muscle caused a sound corresponding to 36-40 vibra- tions per second ; and this latter, indeed, was considered as evidence that a \" tetanus \" or summation of single contractions was always produced when a voluntary muscle contracted. Prof. G. Yeo and Mr. Ilerroun, working in concert, have greatly shaken this doctrine. They found, on submitting a voluntary muscle to stimuli, interrupted 10, 15, 20 or 25 times a second, the \" susurrus \" arising was in each instance the same, and that this corresponds to the so-called muscle tone. It would appear from this, then, that the tone heard over a contracting",
         "teITOnIAt. 377 muscle dos not correspond necessarily to any definite number of vibrations of the muscle, but to certain regular or irregular motions of the same, giving rise to vibrations of the membrana tympani. If this be true, one objection to the first sound of the heart being of muscular origin is removed. Prof. Yeo and Dr. Barrett have instituted some experiments at King's College, physiological laboratory in order to ascertain whether Halford's statement that the first sound of the heart ceases when the great veins of the heart arc clamped is true. These observers, using a binaural stethoscope, after opëning the chest of an animal (dog), exposing the heart, compressing the great veins, and allowing the heart to empty itself, still heard the first sound, though less forcibiy than before. The heart was then removed from the body and held in the hollow of the hand, surrouided by warm weak sait solution. It beat vigorously and the first sound could be heard fairly well. , Again, ail but the apex was eut away ; the tip, of the forefinger was placed in its cavity (left ventricle), and a stethoicope applied. Still a sound corresponding to the first could be heard. Prof. Yeo attempted to demonstrate the above before the Physiological Society of England, and while several observers agreed as to the identity of the sounds, some, including one able investigator, objected to the method as fallacious. It is plain that before long we may expect an improved heart physiology. ANNUAL DINNER OF McGILL MEDICAL UNDER- GRADUATES. The medical undergraduates, with the professors and bene- factors of the University as their guests, assembled in the Ladies' Ordinary of the Windsor, Dec. 3rd, to exchange mutual felicita- tions on the occasion of their annual dinner. The room was tastefully decorated and the tables ornamented with flowers and plants. The àttendance of students was large, and the dinner altogether an enjoyable event. Mr. R. A. Kennedy, B.A. '86, occupied the chair. On his right were seated Dr. R. P. Howard (Dean), Prof. Johnson, Prof. Bovey, Mr. John Dougali, Prof. Girdwood, Dr. Munro, Prof. Stewart, Prof. Wilkins, and Dr. T. Wesley Mills. On the left were the Hon. Justice Torrance, Mr. Andrew Robertson, Mr. G. W. Stephens, M.P.P., Dr. Anderson (U.S. Consu",
         "CANADA MEDICAL AND SURGICAL JOURNAL. General), Dr. McEachran, Dr. Roddick, Dr. Shepherd, Prof. McLeod, Dr. R. L. MacDonnell, Mr. Therrien, Victoria Uni- versity, Dr. Rodger, Dr. Ruttan, Mr. McVety, Kingston, Mr. Dickson, Toronto, Mr. Lemming, Toronto, and Mr. Longevay, Bishop's College. The vice-chairmen were Messrs. W. J. McCuaig, T. J. Nor- man, and J. G. McCarthy. Letters of regret were read from the Governor.General, Lieut. Governor Masson, the Dean of Trinity College, Toronto, and several others. When the cloth had been removed, THE CHAIRMAN extended to the Dean and guests the welcome of the medicalundergraduates. It was the fourth annual dinner at wbich the stu(ents an(d professors had met together around the same festive board, and his only regret was that nany of those. who had been invited were unabie to avail of the invitation. He proposed the toasts of \"the Queen,\" \"the Governor-Genieral,\" and \"the Lieutenant- Governor,\" which were loyally and enthusiastically received. Ma. T. G. McGANNON, i »posinl the toast of\" the 1President of the United States,\" said that the people of Canada sympathize with the people of the United States in the loss they had sustained throngh the death of Vice-President Hendricks. He rtferre(l to the ainicable rela- tions which existed between Canada and the United States, and le trusted that the good feeliug would long continue. uR. ANnEISON, Consul-General of the United States, responled. He said that these manifestations of such great good will on the part of Canadians for the President of the tnited States was most gratifying, and if he were not in an oflicial position he might think that the friendly feelings to whiclh the proposer of the toast relerred mniglt becomne so strong that Canadians ight sone day put it at the head of the list without any fbar of disloyalty. Referrinig to the snallpox epi- demie, lie said that soon after its appearance in Montreal the cliet went forth froin Washington that travellers fron Montreal should be quarantined. Hle thonght that after this extreme ineasure the toast of \" the President \" would be cohlly received, but lie found that. the toast was so well received at the dinner to the gallant CoII. Straubenzee, that it looked as if a portion of a fourth of July audience hiad broken looso in the banquet ball of the Windsor. (Laughter.) -le had con- tinned to find the enthusiasm manifested at several dinners since then, and he was deeply thankful on bohalf of the Chief Magistrate of the republic for the evidence of good feeling. (Applanse.) Mn. OnrTo proposed the toast of \" Our University.\" le referred to the higli status of McGill aiongst-the educational institutions of the world. Pnoe. JoHNsoN, int the absence of Principal Dawson, replied. Witli the exception, said the Professor, of the Nova Scotia Unîversity, McGill was the oldest university in Canada, and it therefore merited in somre decgrec the affectionate term of \"Oid lcGill.\" But although McGill was somewhat old in years it was young in vigot r and young enough to mnake strides in progress, and McGill vas making progress thanks to one generous benefactor, and, with the assistance of others, a splendid addition had been made this year to the imedical school. He was glad to find that, in spite of the fear of the smallpox epidemic,",
         "the attendiance of students was larger this year than any other-num- bering, he believed, over 500. But the progress noticeable in the interior of the College was even more gratifying. Formerly the stu- dents of one faculty hardly knew the students of another, but now all had extensive opportunities of social intercourse-a matter which was of great importance to the University and to the students themselves. There wero now more students who went from arts to medicine than formerly. But there was yet a great field of progress before the Uni- versity, and this was 1l the more appáîrent when they saw the munifi- cent donations for uni.versity purposes from private individuals in the adjoining states. Only very recently it was announced that one rich iai had given about $20,000,000 for a university in California. This mighit seem an enormous sun, but it was nothing compared to the endownents of Oxford, and yet Oxford needed more noney. The people of Montreal were, indeed, not behindhand in princely munifi- cenco to McGill, but ho nontioned these facts to show that every penny that could be obtainesd for the University could be well expended in prom(sting tho interests of education in Montreal and in Canada.- (Applause.) 'Hox. JUsTicE TORIRACxn one of the govornors of the University, also responded. -He wis an old stuident himself, having begun his Univer- sity careor over fifty years ago. He knew somethmg of medical st- dents, for he was in Edinburgh University himsolf, and ho had hearty synpathy with the muedical undergradnates. To tho voung men he would say, \" Do not bo in too groat a hurry for success, but stick to the ship, and some day you will h wanted.\" He would also remind them of the words of Astley Cooper, \"Do justice to your profession, and one day, rely upon it, your profession wiII do justice to you.\" In conclusion, the Judge helieved that lie could not do botter than remind the students of the words of a ceolebrated Fronchman, \"You must never feol discouraged; success will cone suddenly.\" (Applause.) MR. W. D. SVMr proposed the toast of \"Our Benefactors.\" No toast, he aid, should be more cordially received by the students of McGill, for the gasthering around the festive board that evening was indirectly (ule to the liborality of \" our benefactors.\" To thei was also due th prestige of McGill whici attracted students froin British Columbia to Newfounidland, and oven from England. The princoly genorosity of Donald A. Snith to NcGill would be remenbered as long as thiere vas an educational establislhment in Canada, and in the days to comse those whose naines were associated with his would bo no less honored and respected. (Applause.) MR. G. W. Snes, M.P.P., in repflying to the toast, referred to the time in tho history of McGill College medical dinners when the annual banquet was ield in tie second story of a grocery store on St. Urbain street, and wlen the menu was grilled bones wîth plenty of popper and a glass of beer. (Laughtor.) McGill was represented in all parts of theglobe by active, able and intelligent men, and from the past records of the College lie was sure that the studonts of the presont day would distinguiish tiemsolves as those of the past had donc. On bohalf of the benefactors, ie assured tihe students of their intorest and anxiety for thoir welfaro. They felt, however, that in giving dona- tions they performed the leist part of the work, for werc it not for the Dean and men like imn who preceded him, McGilI would not occupy the high position it did to-day. (Applause.) Du. MCEACHRAN embracOd the opportusnity to repiy to thse toast, not as a benefactor, but with a senso of obligation. for the bonefits which the profession and tie Veterina-ry College derived fron McGill Uni- versity. He was proud of the gradually growing mutual friendship 379 EDITORTAL.",
         "380 CANADA MEDICAL AND SURGtCAL JOURNAL. and esteem between the medical and veterinary professions. H11e believed there was no profession which received less remuneration for its services than the medical, considering the time, the care and the study it required, but he trusted that the abonni of McGill would always look to the high motive of benefiting their fellow man rather than of making money. (Applause.) If this principle were carried ont, and the work honestly and conscientiously performed, then; in the words quoted by Judge Torrance, success would come some day, and, perhaps, suddenly. (Applause.) MR. J. A. PORTER proposed the toast of ' the Dean and Professors,\" which was cordially received. le referred to the kindly interest taken by the professors and the students, and the esteem of the students for their worthy Dean and professors. DR. HOwAR, Dean of the Faculty, who was- heartily greeted, responded. He said le had always been a medical student, and le hoped always to be a medical student, and nowhere did he feel more at home than at those annual dinners. . The professors felt that they had the regard as well as the confidence of-their students, and unless they felt this many would disregard the arduous ,work of teaching and apply themselves to the more lucrative one of practising their profession. The sacrifices mado by the professors implied a love of work, and to love the work they must love the young men amongst whom they worked. It was a feeling of pride to the professors to know that they were educating young mon into one of the nost noble professions, and he believed it was admitted on all sides that the stu- dents loved tho professors and that the professors loved the students. (Applause.) He spoke the sentiments of every professor present when le said that the professors accepted the toast in the spirit of affection with which it lad been tendered. Referring to the changes which had taken place in the medical staff of the University, he said i that out of what seemed to be a great evil lad arisen a great good, for the one departnent Lad been enlarged into three departments, and in the enlarged building the new teachers, lie was glad to say, were doing excellent work. (Applause.) DR. Ginnwoon, replying, said le was deeply grateful for the enthu- siasm with which the.toast had been received, andi he took it as an evidence of the respect and esteei which the McGill students always entertained for theirprofessors. Whatever might Le said of the pro- fessors and the benefactors of McGill, yet it was the students who made the University and who carried its good naine and prestige al] over the world. Prof. Roddick, Prof. Stewart, Prof. :Sheplerd, Prof. Wilkins, Dr Mills and Dr. Ruttan also responded. They referred to the good feel- ing between the professors and the students, and expressed much pleasure at meeting their pupils around the same table. MR, J. F. Wni.iMurs proposed \" the General Hospital,\" coupled with the name of Mr. Andrew Robertson, President of the Board of Gov- ernors. Mr. Williams referred to the excellent management of the hospital, and the facilities it afforded to the MeGill students to obtain a practical knowledge of the details of thieir profession. He trusted that the building would soon be îniproved. Mit. ANDnRv RoBERTsoN, in reply, said that if the proposer of the toast was not satisfied with the buildings of the General Hospital, neither did he like them. (lear, hear.) For twelve years Le had in his mind the enlargement of the building, and his predecessor, Mr. Peter Redpath, had the saie idea before him. They had now the ground for the buildings and a little money, but they wanted more",
         "CORRESPONDENCE. mnoney, and lie hoped they would soon get the plans. He was reminded of the story of the clergyman wlo preached the foliowing charity sermon: \" He who giveth to the poor lendeth to the Lord, and if you liko the sucurity you had better put down the cash.\" So it was with the citizons of Mointrel-if they liked the security in building up a hospital wortly of the city cf Montreal, let then put down the cash. In conclusion, lie would ienind the students of the words of the Anierican poet tri the worh1's broad fi1h of battle, ll the bivouac of life, Be not like dumnb, driven cattle; Bea hero in the strife. Let us then be up and doing With a heart for an.y fate, Stilil achievig, still pursuing- Larn to l abor and to wait.\" -(Applause.) The toast of the \"Sistor Universities \" was proposed by Mr. J. A. Dickson, and replied to by Messrs. Lemming, McVety, Longeway and Therrier. \"'The Graduates\" was proposed by Mr. DeCow, and responded to by Dr. Rodgers. \" Class '86 \" Was proposed by Mr. Lafleur, and responded te by Mr. Bradley. Tie toasts of \" the Ladies \" and \"the Press \" were suitably honored. The health of the Chairman was then proposed and enthusiastically received. To the Edior of Tas CANADA MEDICAL \u0026 SURGICAL JOURNAL. DEAR SIt,-I am very sorry to see the spirit of your editorial copied into the Miedical Record of the 19th December, more especially so as there has been an era of good feeling between the medical profession of the United States with those of the Dominion, and aiso between the two great representative medical societies of both countries. You seem to take it for granted that because the \" tone of the great medical weeklies of the easterh cities show very plainly that there is- still war' between the adherents of the old and new committees,\" that such a condition exists. The additional committee made by the American Medical Association at its late annual meeting in New Orleans held their first meeting in Chicago. The original committee were invited to be present to take part in the delibe- rations. Three were present, but because the action of the majority did not suit them they resigned. The additional committee have gone on and perfected the arrangements for the Congress, and placed the whole matter in the hands of an executive committee to complete details. \" The great medical weeklies of the eastern cities \" have doue nothing in aid of the Congress, and thus far have done every,thing in their power to kill it (I may except an editorial",
         "382 CANADA MEDICAL AND SUROICAL JOURNAL. in the Medical News of Philadelphia of the 12th instant). Could you travel through this country you would be surprised to find what little influence these \" great weeklies \" have had over the medical profession in reference to the International Medical Congress. The \"quarreling \" you refer to lies with the editors of the \"great weeklies \" and a few of their special friends, who had assumed to themselves that they were the American medical profession when they only formed the six hundredth part. You say: \" To attract the workers of other countries the sections must be controlled by the mèn most emi- nent in their respective departments (eight, so far), but the present officers of sections, with few exceptions, do not reach beyond a respectable mediocrity.\" I venture to assert that the names of the gentlemen placed by the Committee at the head of the sections are the peers of any member of the profes- sion in the United States, and there is no one even in the great Eastern cities that will dare to throw down the gauntlet to the contrary. I deeply regret such a comparison should come from the profession of a neighboring country'; but perhaps the \" great weeklies\" of our neighbors do not any more repre- sent the profession there than ours do here-especially in. the matter of the International Mcdical Congress. You say if cer- tain things cannot be donc, \" give it up.\" I can assure you this advice will not be heeded-the American people never give any- thing up ; neither will the medical profession give up the Con- gress. The American Medical Association, speaking for the medi- cal profession, invited the Congress to meet in Washington. The invitation was accepted. The American Medical Association will see that all arrangements are made for its reception in its own way, and I can assure you and the medical profession abroad that the most perfect and elaborate arrangements will be made for their reception, and it will rest solely upon themselves whether they will be present to attend and aid in making the Congress more instructive and more useful than any before. Yours respectfully, W!. BRODIE, M.D. \u00264 Lafayette Ave., Detroit, Mich. -The sudden death of Dr. Marsden of Quebec,.immediately after his return from attending a meeting of the Qâebec Cen- tral Board of Health at Montreal, lias caused a deep and vide- spread sorrow throughout this province. Dr. Marsden was born in Lancashire, England, in 1807, and came to Quebec in",
         "MEDICAL ITEMS. 1812. Hie began bis medical studies in this country, and completedý them in London and Paris. For the past thirty years he lias occupied a prominent and honorable position among the physicians of Quebec.- Before the incorporation of the, Quebec Medical School and Laval, University, he delivered courses of lectures on Anatomy, Physiology and Surgery. He bas been an extensive contributor fo the medical press of the country, bis work on \" Cholera \". being the most important of these., He occupied the position of President of the Canadian Medical Association in 1874. For many years lie was Presi- dent of the College of Physicians and Surgeons of Quebec, of which he was senior Goverior. He was also an honoirary Fellow of the Botanical Society of London, a corresponding Fellow of the Mediéal Society of London and of various other learned and scientific bodies. At the time of his death ho ivas an active member of the Quebec Central Board of Ilealth. He was indefatigable in his efforts to prevent the smallpox from spreading to Quebec, and for the enforcement of means of pro- venting its ravages in this city. Dr. Marsden's death is a great public loss. DR. A. H. SMITH, one of America's distinguished obstetri- cians, died at bis home in Philadelphia, on the 14th December, after a long and painful illness. Dr. Smith was borni in 1835, and ivas consequently fifty years of age,-and, althougli a com- paratively young man, he lias done a great deal for the advance- ment of his own paaticular specialty. He is best known abroad as baving made a very important modification of Hodge's pes- sary. He was one of the founders of the American Gynocolo- gical Society, and was its president at the ninth annual meeting held last year. lis death is sorely felt by those who knew him. Honest and modest in all his work and ways, he as passed away regretted ; but bis influence will long live to stimulate to good work those who knew bis worth. ,J. B. Lawford, M.D., McGill, 1879, having passed the final examination in November last, was admitted to the Fellowship of the Royal College of Surgeons of England on Dec. 10, 1885. -Dr. Wm. Stephen lias gone to practice his profession in South America. lie sailed from Liverpool a month ago, and will fix bis residence at Rosana, Argentine Republic. -The Johns-.ffopkins University Circular for October, 1885, contains in abstract three papers by Dr. T. W. Mills, 383",
         "384 CANADA MEDICAL- AND SURGICAL JOURNAL. Lecturer on Physiology, McGill University. The first of these is on \" the Rhythm and Innervation of the Heart of the Sea Turtle.\" This is a continuation of Dr. Mills' work on the physiology of the chelonian heart. The second is on \" the Physiology of the Heart of the Alligator.\" This is, with the exception of a short paper by Gaskell on ' the Crocodile,\" the firet published observations on the heart of this group of ani- mals. Dr. Mills bas, as the result of his investigations into the Crocodilia, come to the conclusion that the vagus is a powerful cardiac augmentor, at least in the alligator. The augmentation in the force of the beat is more marked than acceleration in the rate. In the third paper an account is given of the action of certain drugs on the cardiac rhythm of, fishes. Dr. Mills' experiments promise to be fruitful in results. AN INDISCREET DOCTR.-Dr. Haywood Smith, the well- known and highly esteemed London physician, was unwise and imprudent enough to allow himself to be inveigled into the Arm- strong case by Mr. Stead. le chloroformed the girl, examined ber, and certified to Mr. Stead that she was \" pure.\" The English medical press naturally condemn bis action, and the British Gynæcological Society bave accepted bis resignation as secretary, expressing their thanks at the same time for the dis- tinguished services he bas rendered to this Society, and affirm- ing \" their belief that in what he did in reference to the Arm- strong case be was actuated by what he believed to be the highest motives, while committing a grave professional error.\" SALICYLATE oF QUININE. -In certain cases of subacute or even chronic rheumatism, and in some cases of acute rheuma- tism where salicylate of soda bas proved ineffectual, M. Vulpian bas substituted the salicylate of quinine in the same doses. The deafness, headache, etc., are less marked and the effect is much more satisfactory. TuE SUPPoRT oF QUACKERY.-\" Charlatanism,' says Dr. Holmes, \" always hobbles'on two crutches-the tattle of women and the certificates of clergymen.\" -A question in Medical Jurisprudence : How are the sinews of war connected with the bone of contention ? and how do these affect the musselmans ? -\" Luminous doctors' signs are prominently advertised in the pages of a contemporary. That is just th'è-kind of doctors who run the least to such things. As a rule, it is where the \"inward and spiritual grace\" least abounds that there is the greatest ostentation of the \" outward and visible sign.\""
      ],
      "published" : [
         "[Montréal : Gazette Print. Co., 1886?]"
      ],
      "identifier" : [
         "8_05177_162"
      ],
      "type" : "document",
      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 14, no. 6] (Jan. 1886)]"
      ]
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         "IMAGE EVALUATION TEST TARGET (MT-3) 1.0 I.I 1.25 - IM IIIII22 ,w4 ** 2.0 1.4 llllil.6 VQ \u003c^ /2 m. o /,. ■m ■\u003e: / -(^ Photographic Sciences Corporation 23 WEST MAIN STRELi WEBSTER, NY. 14580 (716)",
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         "32X The copy filmed here has been reproduced thanks to the generosity off: Library of the Public Archives of Canada L\u003e\u003e:emplaire filmA fut reproduit grAce h la gAn4^rcritl de: La bibliothAque des Archives publiques du Canada The images appearing here are the best quality possible considering the condition and legibility of the original copy and in keeping with the filming contract specifications. Original copies in printed paper covers are filmed beginning with the front cover and ending on the last page with a printed or illustrated impres-sion, or the back cover when appropriate. All other original copies are filmed beginning on the first page with a printed or illustrated impres-sion, and ending on the last page with a printed or illustrated impression. The last recorded frame on each microfiche shall contain the symbol — ^ (meaning \"CON-TINUED\"), or the symbol V (meaning \"END\"), whichever applies. Les images suivantes ont tti reproduites avec le plus grand soin, compte tenu de la condition at de la nettetA de I'exemplaire film*, et en conformity avec les conditions du contrat de filmage. Les exemplaires originaux dont la couverture en papier est imprimie sont filmAs en commen^ant par le premier plat et en terminant soit par la dernidre page qui comporte une empreinte d'impression ou d'illustration, soit par le second plat, salon le cas. Tous les autres exemplaires originaux sont filmis en commen9ant par la premiere page qui comporte une empreinte d'impression ou d'illustration et en terminant par la darniAre page qui comporte une telle empreinte. Un des symboles suivants apparaitra sur la derniire image de cheque microfiche, selon le cas: le symbole — ► signifie \"A SUIVRE \". le symbole V signifie \"FIN\". Maps, plates, charts, etc.. may be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tableaux, etc.. peuvant dtre fiim^s d des taux de reduction diffArents. Lorsque le document est trop grand pour Atre reproduit en un seul cliche. 11 est fiimi A partir de I'angle supArieur gauche, de gauche A droite, et de haut en bas. en prenant le nombre d'images ndcessaire. Les diagrammes suivants illustrent la m^thode. 1 2 3 1 2 3 4 6",
         "6 1 } ©",
         "m Crarts iax tl^t times in Canabai, NUMBER ONE. A f THE ■' /k NEW PARTI NATIONAL BEING A LETTER TO THE EDITOR OF THE \"TRICOLOR FLAG,' HIS REMARKS THEREON, AND A PROGRAMME. S.A.TIE.E. PACIFIC. » T- 1IMWHT \u003cs J U THOmZE^ TliANSLA",
         "TION. N, in-:!",
         "p\u003e crriuts for the times in (ilanaba, NUMBER ONE. THE NEW PARTI NATIONA HKIM. A LKTTKi; TO nil; HDlToi; oF Tlfi: \"TRICOLOIl FLAO,\" Hrs RKMAUKS THKKKON, V ,1) A I'IMX .KA.MMK. Jk. S-A-TIRE. . pACipr.. ...z ATLANTIC. J U'THQfRir.EO ' TC^ANSLA",
         "'.'lOJI. NOTE BY THE r1\u003c.\\NSLAr()K. A few words and phrases ol\" this interesting production hnve been left untranslated. These are generally well known by Rnglish speaking people But for the information of some who may not undcrstind. it may be well to say that : \" l.es perf.des Anglais \" means The treacherous English. \" Nous verrons \" : Time will sliow. \" Kn bon accord \" : In a friendly spirit. \" Insouciance \" : Profound",
         "indiUereu'C. TO THE EDITOR nF II IK CC MONTREAL. Sir, At a time when the great uprising of our people calls fnr wise and f,rm direction, 1 venture to submit a programme for consideration by the Parti National : God has committed to us the glorious mission of extending the French name, fame, and race, uniil it again lias the domination ol this Continent. It is for us to organize tf) attain this end. The lime lias come for a Programme. We have hitherto been timid and vacillating. We have had regard to the feelings, the sentiments, and the rights of others than ourselves. Hencf. ovn Wkaknks.-;! The time has come to throw such consideration to the win Is. A bold and outs[)oken manifestation of our ultimate purpose is the duty of the hour. Whv shoui.l* wf. ff.ar to okclauk rr ? I.et us leave the prudent, the half-lu-arted, and the timid to their own devices. Ir is for u-, to initiate a bold and uncom- ])roinising policj — a policy, in fact, a hi Napoleon. Let craven spirits amongst us be content with jusiice and equality. We of the advanced party will steadily contend for domination and supremacy. These sentinients will doubtless be considered loo advanced by some, and their publication premature. But they coincide with tlie principles and ideas which iiave long been so brilliantly advocated in the Tricolor. And they will, when [proclaimed, find an echo and answer in the breasts ul lliousands ot our",
         "countrymen. Tlvn- are fliornu^h. They ;iii. outsitokeii. 'I'liL-y arc for the tlllK'. 'I'wo manifestations are now calling; Tor onr allegiance as rrenclunen ; There is the party of ' thoroii};li * and supremacy, and there is the party of moderation and equality. I need not say that I helong to the lirst. ' Thorough' or Ultra: tliis is my motto. And it shoidd be the motto of all Frenchmen who aim to fulfd thr ^^eat mission of onr ra^e in this country. 'i'liis great principle liar, hccn the guiding star of those l)enevolctU instructors who have educated our Canadian y\u003c(Uth for the last generation. 'I'his lias led to ail the marvellous triumplis of thcii history. And if the same i)rinciple has led also to their humiliation and do.vnfall in every country where they have been established, it was not the principle that was to blame. b\u003eit the perversity of a misguided and unbelieving peojjie. ' Lei us imitate our great instructors. Let. us put aside henceforth the miserable counsels of peace, of modirati(3n, of a cowardly goodwill to our natural enemies. [f, like our instructors, we carry out our principles wiih an unflinching firmness, we shall duubtlcss, liki.' them, have a brilliant triumph. And if our triumph be succeeded, as theirs invariably has been, by the downfall and ruin of our cause, we shall it any rate have the proud satisfaction of having for once, at least, lifted up the French Hag, the French cause, the French name, above every other tl.iu, name, and cause on this (.Jcmtinent ! I;ut we will take the risk of the downfall. It may not come in our time. liiose .vho come after may V)e involved in it. Meantime, the glory, the exultation, the victory will be ours ! Cherishing, as I do, these sentiments from the bottom ot my heart, I beg to submit the accompanying Manifesto for the con-sideration of the party. .\\ VdL'NG En -nib SI A",
         "ST REMARKS BY THE EDITOR. The pro^iMinmc, subiniltcil licrcafter, by our enthusiastic young friend is a brilliant suggestion. It is so strong, so rose- coioreil, so thorougli ! Its ring is unmistakable. It is delightful to find such entluisiasin amongst the younger race of Frenchmen. It inspires us with ardent hope for the future, and ensures the acconiplishment of our dearest hopes and aspirations. It is, however, a (piestion whether the time has come to speak so plainly. A little reserve may be jjrudent at [)resent. The policy of the great and good instructors he names should be re-membered. While thorough, they were discreet. They have never been eipialled in the art of concealing their intentions. If our enemies, /rs /\u003efr/iJrs .7//j,'-/\u003c//V, were to become acquaint- cd with this jjrogramme, they would be put upon their guard. Therefore let us be discreet as well as bold. Dul we can incidcate the prin(;i|)les of the programme, with never-ceasing attention and perseverance. Let us make them known by private circulation until the times are ripe for a i)ul)lic aiinouncement. The press can do mu( h. S ) can schools and colleges. Hut juilicitrasly. The Church may possibly be relied on for co-oper-ation. iUit h.-re we p.uise. The ground is (An/'^c'jvus / jV(\u003ei/s I'crrons. At any rate this ])rogramme is worthy of study. It will make a distinct line of cleavage am)ngst us. Tliere are I'Venchnun and Frenchmen, Tiiere are tiie peaceable, the moderate, and those who think themselves far- seeing and wise. These doubtless form the large majority of our countrymen. They are content with being on an equal footing with their neighb:)urs, and desire to live en Ikui accorJ with them. Ikit what of that ? Agiinst these we put such fury, restless, and ambitious spirits as the author of this programme. These have always been the glory of our race. These, though constantly persecuted, con-stantly })ush on to victory or",
         "death. 0 „ i, ,„ ...is class ,ha. we are ,-\"\u003c! \"• ^or.,. The TRU:nKOR is no tame and craven sheet. A.nidsl s.crn.s of ,,ersecufon U '■\" 'f'dThfflaTsh.n ny so.e day over .he Citadel of ...ud.ec „„r e rarlia,nent l.uildin^s in Ottawa, over the (;over„n,en. , „e , Toronto, over the Citadel in Halifax, over the I.e^tsla- lirHalls of the L North-west, over the l\u003eaeif,c Ocean, and .n time, over the Capitol .at Washmnton ! GLORIOUS rROSl'ECT ! Whde ,az,n« on it we forge, our -\"\"\"\"; y^^'^;,;;;' 1 l,;,„l „s Ir MUST ANi\u003e !-iia:.i. \"^■ kkai,i/mi, kvkn prudence hehu d ; \" J ,^^ „,„„. ,k m^ ^'^\"'\"''''''^'^' ' 1, ,11 !„\u003e fin'n/iu/ Yes it shall, and we And the i.rogr.iminc shall be fri/iim. will endorse every word of it. The Editor. '^^^ «;.^«3",
         "p^Pr, 1885. Ivdl^^I^IF'EISTO ! PARTI NATIONAL! WMKRKAS rr IS INDISI'U'I'AP.M:: That the French r: c^ n the first in the world, First in Arts, First in Arms, F\"irst in Civilization, First in defence of the true religion, IT THEREFORE FOLLOWS : That wherever they exist, they have the ri^^ht to rule, and to impose their ideas on less cultivated peoples. Peaceably if they can, forcibly if tliey musl ! IT IS FURTHER INDISPUTABLE: That 'w carrying out this just and beneficent intention, the French nation and race have been for many centuries subjected to incessant and shameful persecutions on both sides of the Atlantic : — FOR EXAMPLE : Not to speak of persecutions in former reigns, when the blood of innocent French soldiers was being shed on various battlefields in Continental Europe by ruthless and barbarous",
         "foes, WE WIT,L MENTION : The persecution suffered in the reign of Louis XV. by Voltaire, and the Encyclopaedists, at the hands of bigoted and blood-thirsty believers in Christianity, in England, and other foreign countries ; ALSO : The persecutions showered, by murderous fanatics, on Robespierre, Danton, and their noble associates, when contend-ing, amidst blood and slaughter, for the fraternity and liberty of the human race ; AND, SPECIALLY: The long series of persecutions suffered by Napoleon I. at the hands of various European nations, when he took the lead of France, and benevolently sought, by force of arms, to sub-jugate these nations to her advanced ideas. IN P.ARTICUl.AR : The persecution of England, in driving French fleets from the seas, and French arms from Spain. The persecution of Russia in fanatically driving back the benevolent French army that came to fraternize with her at Moscow, exposing it, thereby, to the horrors of a retreat in winter. The persecution of the combined Powers, in marching on the beloved capital of our race, and occupying Pans with hordes of barbarians ! ! Not to mention other instances, FIN.M.LY, The wicked, shameful, base, nefarious, and never-to-be- forgotten persecution which broke out against the great Emperor, on his return from Elba, and culminated in the unprovoked and wicked massacre of Waterloo ! !",
         "! Hero let us pause awhile, to reflect upon the wicked plotting which succeeded the downfall of our hero, and which continued under several reigns, disguised under insidious friendships, and ])erfidious alliances. But Persecution, at length, broke out openly, and we pro-ceed with the shameful recital, mentioning, amongst other instances : The Persecution of the whole French nation, when England gave an asylum to an expelled French King, Louis Phillippe. The many Persecutions suffered during a long and benefi-cent reign by the successor to the name and fame of the great Napoleon : FOR, AS IS WELL KNOWN : Napoleon III., following the example of his great predecessor, sought to impose the will of France on the nations of Europe, viz., on Prussia, on Austria, on Ru.ssia, for the highest purposes of civilization and the Christian religion. But his good intentions were constantly thwarted by the ignorant and brutal fanaticism of the inferior races of Central Europe — beer-swilling Prussians, lUvarians and the like, who never ceased to worry and persecute l'\"rance, by refusing to accept her ideas, and obstinately clinging to their own. FINALLY: On his taking up arms to coerce these savages, by occup\\ ing their territory, they turned upon him with incredible and barbar-ous ferocity, and compelled him to retrace his steps. NAY : Their [)crsecuting bloudthirstiness was not satisfied with this ! They pursued the armies of France over her sacred and holy soil, shed oceans of blood, captured fortres^^^s and armies, and, finally, wrung from our fallen chieftain, the dreadful capitulation of Sedan ! ! !",
         "! 10 Then, Frenchmen all over the world, held up their hands in holy horror, and prayed that the eyes of the blind and bloody persecutors of our race might be opened ! But, their thirst for slaughter was not yet appeased. Their persecuting instinct was not satisfied even with this. THEY LAID SIEGE TO PARIS ! THEY CAPTURED IT! Then was extinguished, for a time, by ruthless hordes of Goths and Vandals, the light of civilization, of Art, of Literature, of Fashion, of Science, and of Religion ! FINALLY : They tore from our beloved Mother two of her precious provinces, and cruelly despoiled her of thousands of millions of money. Thus has France sent forth her armies of martyrs to religion and civilization, and their blood has moistened the battle-fields of every country of Continental Europe. BUT, As the blood of the martyrs is the seed of the Church, so doubtless will the light of French art (especially certain develop-ments of it), French literature (novels in particular), French Socialism, and French Equality and Fraternity, ultimately through these sacrifices penetrate the darkness that shrouds the half- civilized portions of Europe (particularly England and Germany) and introduce a higher, purer, and better day. Then France will be Avenged. AVENGED ! ! CONSIDERING FURTHER, That the same incessant spirit of persecution has followed our race on this Continent ; — namely",
         ": 11 The persecution by which, after the fortunes of war had given Quebec to England, she persisted in retaining it, and bar-barously conquering the whole country. The persecution suffered by our fathers when such western centres of French enlightenment as Fort Frontenac, Fort Niagara and Fort Detroit, were torn from the dominion of a civilized power like France, and delivered over to the brutal bar-barians of the race of Vandals that drove us from the heights of Quebec. The persecutions by which Englishmen have covered Canada with commercial enterprises of their own, — canals, rail-ways, factories, lines of steamers, banks, ships, mercantile houses, thus compelling large numbers of French citizens to learn a foreign language in order to obtain a livelihood. The persecution by which the Government of the country is carried on according to English ideas and precedents, thus intro-ducing a base style of constitutional liberty, instead of the paternal and irresponsible regime of Intendants and Governors sent from our dear mother France, to which our ancestors were accustomed. The recent and still burning persecution by which the poorer portion of the population of Montreal were compelled to adopt a preventive for small-pox against their most cherished convictions, habits, and traditions, the said preventive being of foreign origin, and naturalized amongst our deadliest enemies, England and Germany. FINALLY: With what language can we clothe our horror, our detes-tation, our indignation, our burning sense of wrong, of foul oppression, of deliberate and wicked malice prepense^ involved in the cowardly, the base, the bloody, the barbarous, the diabolical MURDER of that great S^t, incorruptible Patriot, and Hero Martyr, LOUIS DAVID",
         "RIEL, mm 12 the pattern of French vak)r, tlic model of true disinterestedness, the bright example of every Patriotic virtue ! Joan of Arc! Guy Fawkes ! the Chevalier Bayard I and George Washington in one t I FRENCHMEN! VENGEANCE! Having tliese persecutions indelil)ly engraved on our mem-ories, being determined to avenge the wrongs suffered by our-selves and our ancestors, and also to fulfil the great mission of our race on this Continent, we hereby declare it to be our purpose amongst other things. FIRST : To propagate over the whole Dominion first, and then over the whole Continent, that ultramontane type of the Catholic religion, which allows no compromise or quarter to heretics, and will burn them as soon as it has the ]io\\ver, after the pattern of the glorious day of St. Bartholomew. SECOND : To propagate over the whole Dominion, and especially through Ontario and the Maritime Provinces, the true French IKiltern of Government, viz.. Liberty, Ecjuality, and Fraternity, alternating every few years with the paternal despotism of a strong man or Military Leader of our race. He will coerce rebellious spirits, muzzle the press, shoot down his foes in the streets of Toronto and Montreal, and introduce a regime oi order, harmony, and tranquility, after the fashion of our lamented hero NAPOLEON HI. THIRD To propagate French ideas of health and hygiene, by which the purifying influence of small-pox shall have full sway over this Continent, unhindered by the mischievous meddling of fanatics, whether of our own race or any other (for even all Frenchmen are not wise in this matter).",
         "Fll 13 NOW THEREFORE For the attainment of these and other great objects, we Frenchmen of the French, do hereby bind ourselves together as a League and PARTI NATIONAL ! for the defence of our race agains. foreign persecution, and to secure its advancement to a position of SUFREVIACV. AND AS TO METHODS ! \\VF. Ar^F, AC.RF.ED UPON THE FOLLOWING FIRS r : That the French language, equally with the English, shall be spoken, and be the official language in all Legislatures, Courts and public offices, whether Govermental or municipal, in every Province of the Dominion, with a view ultimately of its being the sole language authorized. SECOND : That the proceedings of the Parliaments of every Province, shall be reported and carried on in both languages. THIRD : That the Roman Catholic Church shall have the same rights as to tithe and taxing in all the other Provinces of the",
         "Dominion It that she has in the Province of Quebec ; also that the educational system cf the whole Dominion be assimilated to that of the same Province. FOURTH : We will demand as a right that the Tricolor Flag be displayed on all public buildings in all parts of the Dominion, and particu-larly over the I'arliament buildings and (iovernor-General's residence at Ottawa, and the Parliament buildings and Lieutenant- Governor's residence in Toronto. FIFTH : We will insist on the Prime Minister of the Dominion being a Frenchman, as well as the First Minister of the other Pro-vinces. — though willing, out of consideration to the inferior race, to allow some of the subordinate offices to be filled by an Englisliman, Irishman, or Scotchman. J3UT, Seeing that all English speaking people are members of Orange lodges, and so are deadly enemies of our race, we will res^crve the right to withdraw the last permission at our discretion. SIXTH: We will require a Crucifix to be set up in every Court House in every Province of the Dominion, and that all witnesses testify ui)on it, no matter what may be their creed. SE VENT II: For the purpose of promoting Commerce between Canada and our Mother Country, we will endeavor to bring about differ-ential duties in favor of all articles exported to or imported from France, together with exclusive bounties to Ste unships carrying Mails to a French",
         "port. 15 EIGHTH : We will pledge ourselves never to speak English in transact-ing business with one of the inferior race, but to compel them to speak French to us. This pledge shall extend to our brethren who have emigrated to the United States, and are employed in factories there, in order that our great mission may be accomplished in New Eng-land also. NINTH: For the purpose of developing and increasing our race in Canada, we will demand large grants of land for colonization, together with liberal subsidies of money to encourage our brave settlers to face tlie terrors of the wilderness. (Such grants and subsidies to be exclusively for Frenchmen.) FINALLY: We bind ourselves to put aside all thoughts of the welfare of Canada, as such, and to forget, ignore, and cease to think of any interest but that of our race in it. We will live solely for our mission : — We will speak and vote in Parliament and elsewhere solely as Frenchmen : — We will vigilantly watch all financial bills, so as to have clauses introduced to the special advantage of our race. We will kee]i this end solely before us in Municipal matters and matters of Commerce and business. In short, Whether we eat or drink, buy or sell, walk or ride, travel or abide at home, we will never cease to think, speak, work, and pray, for the great cause of French supremacy and domination. And if it should become necessary to devise such measures as will make Canada (and in time the New England States also), intolerable to all but Frenchmen, — such as fostering small-pox, taxing English properties and English trade corporations,",
         "iiic. 10 we will not hesitate to do this, even if it have the effect of de-stroying our trade, diminishing the value of property, closing factories, and driving away numbers of our own people along with the whole of our enemies. For what is wealth, what is trade, what are manufactures, what is property, what is temporal prosperity, when weighed in the balance against such a glorious object as the enthronement of our race in Canada ? Let trade and commerce from the country fly, Hut give us only French supremacy. Let the Englisl^ abandon their mansions, their warehouses, their banks, their churches, their colleges, their ships; we will then teach these barbarians a sublime lesson of insouciance. What care we ? We shall be poverty-stricken, we shall be overwhelmed with debt, but we shall have the country to ourselves ! Then we shall be devout, we shall be independent, we shall be proud, we shall be happy ! ! ! ! V/VE /.A FRANCE! VICTORY OR DEATH ! '\"•x^^",
         "■nr* of de- losing along tures, led in ent of ouses, e will i with ;"
      ],
      "title" : [
         "The New Parti national : being a letter to the editor of the \"Tricolor flag\", his remarks thereon, and a programme : a satire.",
         "CIHM/ICMH microfiche series ; no. 11258",
         "Tracts for the times in Canada ; no. 1."
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         "11258",
         "FC 02 0203 no. 11258"
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      "published" : [
         "[Montreal? : s.n., 1885?]"
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      "label" : "The New Parti national",
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         "1 microfiche (13 fr.).",
         "\"Authorized translation\".",
         "Original issued in series: Tracts for the times in Canada ; no. 1.",
         "16 p. : 22 cm."
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      "subject" : [
         "Canada -- English-French relations -- Anecdotes, facetiae, satire, etc.",
         "Canada -- Relations entre Canadiens anglais et français -- Anecdotes, facé ties, satires, etc."
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      "pkey" : "oocihm.8_05185",
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05185_108",
      "label" : "[Vol. 9, no. 12 (Sept. 1881)]",
      "source" : [
         "Scanned from a microfiche held by Hannah Institute for the History of Medicine."
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      "key" : "oocihm.8_05185_108",
      "identifier" : [
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      "published" : [
         "[Montréal? : s.n., 1881]"
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      "title" : [
         "The Canada medical record [Vol. 9, no. 12 (Sept. 1881)]"
      ],
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE CANADA MEDICAL RECORD. VOL. IX. MONTREAL, SEPTEMBER, 1881. No. I2 00ONTENT'S. ORIGINAL COMMUNICATIONS, eltS,2,7 ORIGINAL~~~~~~ COMNCTOSIelts 9.Sphilis ini Mar- -Improvement of Sayre's Treat- Vacinaio wih CîfLyxphby ried Life, 9.-tgmat o ment for Spinal Curvature, 3o6. 'Vaccination with Calf Lymph, by. t aao W. E. Bessey, M.D .......... 289 Maize, 3oo.-Rest after Deli- -Sulphr for Pimples on the very, 31. - Management of Face, 306.-Maternai Impres- PROGRESS 0FMEDICAL SCIENCE Abortions, 3o3-Amenorrha, sions, 3o7.-Epistaxis cured by An Opinion as to Quinine in Pneu- 303.-Treatnt of Pneumonic a Blister, 307.-Cod Liver Oit monia, 296.-Benzoate of Soda Fever by the employment of the in Epilepsy, 307.-Beef Sup in Whooping Cough, 296. - Wet Sheet, 303.-Treatment of positories, 307.-Treatment of Treatment of Leucorrhœa in Chronic Prostatîc nlargement, Amenorrhoa...............307 Children, 296--For Fresh Cold 304. - Therapeutical Employ in the Head, 296.-Management ment of Iodoform, 306.-Mor- of the third Stage of Labor, phine in Puerperal Eclampsia, To our Sulscribers, 305.-Saccha- 296. -3Treatment of Diabetes 3o6.-Ergot in Neuralgia, 36. rated Pepsin...............308 VACCINATION WITH CALF LYMPH. By W. E. BESSEY, M.D., Public Vaccinator to Board of Health, Montreal. Read before the Canada Medical Association at Halifax, N.S., August 4th, I881. 1R. PRESIDENT, GENTLEMEN,-The subject of vaccination with lymJ/z diredfrom the animal is one which at present is occupying so much of the -attention of the Profession every where that no apology is necessary for its introduction on an occasion like the present. A discussion of the topic of animal vaccination, if fully entered into, would involve a rehearsal of the entire history of vaccination with a consider- ation of the many unfortunate results which have occasionally been observed to follow ordinary arm to arn vaccination-this, time will not permit. The troublesome consequences which have fron tine to time been observed to follow the use of fire lymjh are the disagreeable facts which the iProfession have always had to contend against, and this, coupled with the frequency with whicli attacks of genuine (variola) small-pox, sometimes fatal, have followed spurious vaccination, has led in some quarters to a most determined opposition to the practice of vaccination. The unfortunate resinits which have followed vaccination m ty, in all fairness, be said to be in- excusable, inismuch as with due attention, and a proper knowle Ige of the subject, such casualties might always be prevented. Such accidents are usually traceable to long humanized virus taken from scrofulous or other- wise tainted or unhealthy subjectb, or it may be from sources quite unknown to the practitioner using it, and directly responsible for the results. That vaccine is very sensibly, but gradually, de- teriorated by long human transmission has been well established by Bosquet and others. In the illustrations accompanying this paper I have en- deavored to give an illustration of a perfect vac- cination. The resulting cicatrix fr6m vaccination with bovine lymph, early removes of the human- ized and long humanized almost inert. We have learned from the mistakes of the past that two t/zings are absolutely necessary to guarantee per- fect safety in the daily practice of vaccination; and to ensure that degree of prophylaxis -or immunity from a future attack of small-pox vhich the patient has a right to expect.",
         "290 THE CANADA MEDICAL RE.CORD. First, absolute purity. In this, as in other cases, we flnd that the in- exorable law of propagation holds sway, and \" we reap that we have sown.\" If our lymph has contained pus mingled with ïvaccine germs, we will have a crop of septic poison- ng, taking the form, it may be, in a favorable sub- ject of edematous inflammation or erysipelas, fol- lowed by abcesses. If it has contained the taint of syphilis, then following the decline of the vaccine vesicle will appear a hardened base with elevated edges; or in its stead perhaps a phagedenic ulcer, which it will require all the skill of the surgeon to treat. If an ichorous liquid has been included in the discharge of lymph flowing from a.vaccine vesicle, which may be the case in an unhealthy subject in an advanced stage of the disease, then such lymph will prove most virulent in its action, when used upon another subject, and following the vaccine vesicle (which will go through its stage of develop- ment and appear all right) there will be an acrimonious discharge and a slow healing ulcer, with possibly several new sores occurring where it bas touched. Again, sone forms of imperfect vaccine p us tules are described by old writers on Vaccination under the head of Spurious Vaccination. Willan describes three, and Burns (of Glasgow, 1820),one; and as security against small-pox is not conferred by spurious vaccine vesicle, it becomes necessary to study carefully not only the characteristics of the genuine disease as produced with pure bovine virus or its early removes, but also those appear- ances which characterize spurious vesicles. To meet these dangers we have been obliged to go back to as perfect an imitation as possible of the original conditions noted by Jenner in his observations and experiments. These were based upon the observation eve ry where corroborated-that milkers upon whose hands the disease vaccinia had been casually pro- duced by con'tact with the disease as it appears spontaneously upon the cow's udders were thoroughly protected, or enjoyed a perfect immu- nity from subject attacks of small-pox when exposed thereto. Neither could they be made to contract the disease by inoculation. It will be self-evident that the above conditions are more nearly fulfilled in any given child's case when vaccinated with lymph direct from the heifer, than when lymph of long human transmis- sion bas been used. The question arises, does the virus obtained by this inoculation of heifers with the virus of origin- al cow-pox induce a development of vaccinia in greater perfection and of more protective efficacy, in consequence, than that derived from the use of virus which has passed through a long series of human transmissions? I maintain that it does, and this is one of its principal advantages. For, whatever may be our opinion of the degree and permanence of protec- tion afforded by long-humanized vaccination, it can hardly be doubted that the nearer the inten- tionally induced disease approaches in its phen- omena to that accidentally contracted by grooms and milkers, which bas been proved beyond cavil to be perfectly and permanently protective, then the safer must we be in the assumption for artifi- cially induced attacks of the vaccinia disease direct from the animal, of a like thorough and permanent protection. It may also be asserted that the lymph from the heifer when applied to the child exhibits perfect. ly all the phenomena of the disease described as having resulted from the use of the earliest removes. in Jenner's time, and though admitting that the virus of carefully selected human subjects one or even ten removes from the animal may be equally protective, and less liable to failure in the use, yet the risks fron possible evils, such as syphilitic, erysipelatous or septicomic contagion, are such as to make the choice of animal lymph almost an imperative dufy of the practitioner of to-day. It may safely be asserted that the use of virus direct from the animal ensures safety from scrofular syphilis, cutaneous diseases, pus inoculation and more especially imperfect vaccination from the use of deteriorated lymph. Vaccine virus, being indigenous Io the heifer, does not~ degenerate by frequent transmission through the animal, but, when removed to a foreign soil-the human subject-it undergoes modifica- tion, and if the greatest care is not observed, is liable to undergo very serious degeneration, for it cannot be doubted that a very gradual but imper- ceptible change does take place from one trans- mission to another, sometimes more perceptible in one case than another. This change bas always been observed to be, in the direction of a shortening of the period- of incubation and developement, a decrease in the",
         "THE CANADA MEDICAL RECORD. intensity of the vaccinal phenomena, and a diminu- tion of its effect upon the system. The vaccinal phenomena seen in different cases may differ materially, because of the different sources from whence the lymph lias been obtained, for the reason that no two stocks of vaccine, have manifested precisely the same characteristics : each is distinct in appearance, development and dura tion, and all equally protective. : Some of the early lymph used in Jenner's time showed a tendency to undue violent irritation and alceration, which evinced a tendency to spread and be troublesome, and in some cases was attended with erysipelas ; later stocks have not manifested these characters. The Beaugency stock of France vas mild in character, and, wherever propagated, its use lias given every satisfaction. The Esnean (Belgian) in the hands of Dr. Worl. mont, has attained great popularity because of its ,characteristic results. Nothing could have given greater satisfaction than the virus obtained by propagation direct from heifer to heifer of our own Canadian Longue Pointe stock, observed near Montreal on Nov. 6th, 1877. Its use has been very extensive by the Board of Health of Mon- treal, and has been entirely free from any unplea- -sant complication, as the following statement of the Vaccination Conimittee will attest, and which subsequent experience lias confirmed. The undersigned memnbers of the Vaccination Conmittee of the Board of Health, City of Montreal, having for a ength of time had under their personal observation the results of the vaccine lymph supplieil to this Board by W. E. Bessey, M.D., have pleasure in bearing testimony to its purity and reliability. Anong many thousand 'children where it has been and is now being used, neither undue irritation nor trouble of any kind has occurred, and as a fact that the lymph was direct from the heifer became known, 'he prejudice unhappily existing against the practice of vaccination in certain portions of the community has been overcomne. (Signed), W. H. HINCSTON, M.D., Chairman. J. W. hMOUNT, M.D. F. X. Z. TASSE, hI.D. A. B. LAROcQUE, M.D., liedical Haealth Ofjlcer. A new source of lymph has been recently dis. covered in the United States, called the Co/asset, which is being propagated by Dr. Martin of Boston. Of its characteristics I am unable to speak. I am desirous of placing on record a protest against a statement made in the Boston Transcri/t, to, the effec tthat Dr. Martin clainied no well- authenticated case of spontaneous cow-pox has occurred in America ? Dr. Martin must have been aware of the well-established existence of an epidemic of cow-pox among the herds in the neigh- borhood of Montreal in 1877, immediately pre- ceded by an outbreak of horse-pock .attested by Dr. McEacherm, V.S., Principal Montreal Veter- inary College, and the high character and standing of Dr. Hingston, through whose patient the Lennie Longue Pointe stock was discovered, must be a sufficient answer to any objections that night be raised against it. It occurred in this wise: A patient of Dr. Hingston's, whose husband was a farmer at Longue Poin!e, called upon him to have lier child vaccinated, Nov. 5th, 1877, because she believed their cows had small-pox, and she feared the child might take it, and enquired whether cow3, ever had small-pox? (An epidemic of small-pox had previously been raging in the city). On beings apprised of the circumstance by Dr. Hingston, I visited the farm next morning, in company with Dr. Reed, then another public vaccinator, and found a number of animals in different stages of the disease. I procured crusts and lymph, and on Nov. 7th made my first attempts with it on a number (1o) of children. One only of these was successful, namely the child O'Mara. I paid a second visit to this farm, and obtained some lymph from a heifer in the best possible con- dition, and with this I succeeded in vaccinating other children and some heifers at Logan's farm. Since then the succession lias been kept up con- stantly fron animal to animal, and the happy influence, the supply of vaccine from this source has had in eradicating prejudice, and establishing confidence in the minds of the people and profes- sion of the city of Montreal,has more than satisfied me for the very great trouble and expense con- nected witlh its propagation, ivhich the necessity of my position as public vaccinator, in the face of the determined opposition of a misguided public, forced upon me. Let this suffice as to the source of our Canadian lymph. The objects sought to be attained by the practice of vaccination, are, as I understand it: 1st. To secure protection against future attacks of small-pox, and, 2nd. In doing so to avoid wiha may be termed \"accidents,\" in the form of unpleasant or unfortunate results, which. it must be admitted, have been altogether of too frequent occurrence. The first of these objects has not been secured by vaccination, as it has been too 291",
         "'292 THE CANADA MEDICAL RECORD. frequently performed in the past without care or discrimination as to the lymph used, and with perfect indifference as to the result. This lack of prophylactic power is without doubt traceable to the use of degenerated lymph, although some practitioners of my acquaintance point to their own experience and that of the Royal Vaccine Establishment of England as arguments against this view. But the frequent recurrence of post-vaccinal small-pox can be accounted for in no other way than by the assumption of a previous imperfect vaccination, which observation in small-pox hospi- tals has fully established as true. One of the reasons why old practitioners pre- ferred a crust for vaccination from was because crusts of a typical character never forri where the vesicles have been imperfect either in type or developrnent, and hence by a continual. survival and reproduction of the fittest they were able to go on for years without- much apparent degeneration in the lymph in use. Perfect vaccinia is ahways attended with pro- found constitutional fever, and this is much more marked where heifer lymph is used than where exhausted virus of long human transmission has been employed, and is usually coincident with the rise, development and decline of the areola which begins middle of 8th and lasts until 12th day. Stress Irequires to be laid upon this constitutional fever, which was considered of the greatest import by the earlier vaccinators, who deemed a vaccina- tion unattended with it not to be depended upon as protective against small-pox. This was Jenner's explanation when ost-vaccinal variola excited so much comment soie years after the introduction of vaccination, laying down as a dictum that in all such cases the alleged vaccination had been surious, and that the unfallible test of a perfect vaccination-such as alone was proplyhactic against small-pox, consisted in the occurrence of this acconpanying febrile action ; that without it the patient nust not be considered protected, but should be revaccinated. In my own judgment a better test of a perfect vaccination is the production of characteristic vesicies, passng through ahl their several stages of development, decline and fall of crust, le aving behind them indelible cicatrices or depressed scars of the peculiar and well.defned type. The resulting vaccine sca- is a matter of great importance, and offers to the observing practitioner ai excellent guide with respect to the perfection of a vaccination owing to the direct relation between the two. A great variety of vaccine scars are to, be met with, while there is but one typical of a perfect vaccination. Decanteleau, a French writer, in a monograph upon \" the cicatrices of vaccine,\" gives illustrations. of sixty, fifteen of which are typical of varieties always to be seen.* I have endeavored to obtain a good chrorno-lithographic illustration of some of these, with perfect resulting vaccine vesicles, after use of bovine lymph takèn from cases in practice. These variations from the normal type may be, accounted for in the following manner : They may result: ist. From the use of lympli enfeebled by a long series of hunian transmissions. 2nd. Some imperfect condition of the vaccine- however pure-preventing its proper development, or an insusceptibility on the part of the patient; or ,,3rd. Violence applied to the vesicle by which it is lacerated, as from s(atches, adherent clothing,. etc. 90 per cent. of the variations are due to the first cause, a small number to the second, and fewer still to the third. Since in all but the very feeble good vaccine will produce a perfect vesicle followed. by a typical scar, even rupture of the vesicle, while modifying, fails to prevent the formation of a characteristic cicatrix. The phenomena resulting fron vaccination with virus direct from the animal differ materially from those presented by long-humanized lymph, and frorm, what may be termed slurious vaccinations. Jenner described the fully developed disease and areola as having the appearance of \" apearl ufmo a rose leaf,\" and the crust resulting as of a shape exactly the same as that of the vesicle, circular in form, with a very decided umbilication in the centre. The color of the crust a rich dark brown, sonietimes a dark mahogany or amber color. The Longue Pointe virus gives usually a grouP of smali vesicles, circular, umbilicated and con- tiguous, but not confluent. After several human removes it becomes confluent, and as many o these vesicles may be produced as the operator de sires by extending his crucial scratches. It de velops slowly-sometimes very tardily-until the 6th day, when a small vesicle begins to form, which by 7th day is quite distinct, and by the 8th is fully developed and contains a quantity of clear water lymph, which if extracted wili reproduce it self with a slight quickening or shortening of tini in the several stages of the phenomena.",
         "THE CANADA. MEDICAL RECORD. On the afternoon of the Sth day the areola bas begun to form, which is very decided on the ninth. The vesicle now bas the look of a bead of pearl imbedded in a ground work of a rose color, ex- tending from half an inch to one or two inches .and tumid. But we. should never have redness deepening to purple, or extensive swelling-that is indicative of edematous inflammation, the result of pus poisoning or local septicæmia from pus crusts or impure lymph. The fever should be very marked from the 9th to the i2th day, by which tirne the lymph bas be- come dry and opaque. From that date to the i8th the scab or crust is in process of formation, and about the 21st day may be removed or falls off soon after, leaving an excavated depression or pit, baving a smooth central point and radiating hands extending to the circumference. If the lymph bas been hurnanized a number of foreolations or pin pointed depressions will appear' among the radi- ating bands. The whole should be terminated by the 3oth day, but, if violence has been used, and an irritated sore or vaccinal ulcer bas been created, time will be required for the healing. And here I would like to enter my protest against al kinds of interference with vaccinal sores, beyond cleansing with warm water and the appli- cation of a little salad oil, by means of a feather, to the surrounding cuticle, if irritable. Bandages, adherent garments, ointinents, powder, and ail other tamperings of the ignorant and the pretentious are to be deprecated and condemned. In these phenomena there is seldom seen a single vesicle, generally a group of them. They progress in de- velopment very regularly and gradually, seldom or never create any undue irritation or ulceration, and are attended with a well-iarked and decided constitutional fever, I have frequently applied Boyce's test or re- vaccination as a test of the constitutional effects resulting from the .use of the lymph in cases where a good result had been obtained, and always with a negative result. I also inoculated six differ- ent children with virus obtained from small- pox cases, but without producing anything more than local disturbance and a slight fever. The action of this stock of lymph bas always been of a benign and satisfactory character, and it bas proved to us in Montreal a providential blessing by removing prejudice and opposition to vaccination., A very frequent species of spurious vaccine is eidenced by a Pustuar rather than a vesicudar eruption. - It increases rapidly, instead of gradu ally, thus a raised centre is situated on a hard in- flamed base, surrounded with diffused redness. It contains a fluid at no time clear, but turbid and opaque. It soon bursts and discharges an abun- dant irritating matter, forming, when it does, flakcS of a dirty white crust. If a scab be formed or the vesiclé bas had the general aspect of a vaccine vesicle, and has progressed regularly, it will be found on the ninth day to contain purulent matter, and will probably dry up and fall off by the 12th day, leaving a soft sloughy sore to granulate. This affords no protection to the subject. Another type of spurious vaccination shows itself in the form of a perfect vaccine vesicle in its course of develop- ment; it matures early, is white or pearl colored, with a slight tinge of yellow, perhaps I ought to say at once that it is straw-colored-the vesicles seem too full, and the point of umbilication is elevated, as if ready to burst, which it frequently does, discharging an acrid purulent fluid, which is very infectious, and new pustules are created where it touches, a disagreeable sort of secondary vaccina- tion or Boyce's test. It leaves a ragged-looking spreading ulcer, hard to heal. This is sometimes covered with a friable scab, which falls every two or three days, to be renewed again, and so on for weeks or months together. A piece of clothing becoming adhered to one of. 'these sluggish, soft, or, as I call them, scrofidous, vaccine sores is certain to cause trouble, as with its removal the surface of the sore is opened anew, aggravating its condition, and bringing upon the head of the unlucky practitioner the anathemas of the patient or friend. This condition of things may occur with the best virus in a scrofulous subject, no matter how pure, carefully preserved or skilfully used. But it more especially and more frequently follows where long humanized virus bas been used, :and the greliter the number of removes from the original source, the greater the tendency to this unpleasant complication. Dr. Willan described three typical spurious vaccinal results: 1st. A single pearl-colored vesicle, less than the genuine. The top flattened, but the margins not rounded nor prominent. It is set on a hard base, slightly elevated, with an areola of a dark rose color. 2nd. This is cellular, like the genuine vesicle, but smaller, and with a sharp angulated edge, areola pale red and very extensive. 4j",
         "TIIE CANADA MBDICAL RECORD. 3rd. A vesicle without an areola. None of these afford any security against snall- pox. Three causes were suggested to account for the failures : ist. From matter having been taken from a spurious vesicle, or from a genuine vesicle at too late a period. 2nd. From a patient being seized soon after vaccination with some contagious fever, as measles, scarlatina, \u0026c. 3rd. From the patient having been affected at the time of inocula- tion with some chronic skin disease, as tinea, lepra, \u0026c. These eruptions ahvays disappear after vaccin- ation. And. 4th. It has been supposed that in arm-to arm vaccination puncturing the vesicle in order to take lymph from it, by disturbing the process of development, may destroy its prophylactic influ- ence. It must, therefore, be manifest that some test should be adopted whereby we can ascertain whether the systen be protected. Tvo have been proposed : First Boyce's test or a re-vaccination on the tenth or twelfth day after first. If the system be protected no regular vesicle can be produced, only a vaccinal sore will result. Second, variolation, or inoculation with small- pox virus. If the system is protected this may produce a small pustule, wholly unattended with constitutional fever; sometimes a slight febrile action may be excited, attended with an efflores- cence of the skin, which rapidly disappears, but without any pustule. If performed nine days after vaccination it will not be a fair test, its action then being nil. Another objection to the use of humanized lymph of any remove is its liability to convey syphilis. This is no myth, but a reality against whch we must guard. In large cities and more densely populated rural towns, it is impossible to be certain that any given child is free from the taint of syphilis, in view of the frequency with which young men become syphilized, and at a later period·become fathers o families. No treatment can eradicate the tain from the system, and therefore no such person can propagate a perfectly healthy offspring. In large cities and more densely populated rural towns it is impossible to be certain that any given child is free from any taint of syphilis, seeirig the frequency with which young men (who later become fathers of families) become syphilized, and, after undergoing a course of treatment, more or less effective, marry, reproduce themselves, and' inevitably impart to the offspring whatever bloodi taints were lurking in the parent constitution. This, by means of vaccine lymph, may be spread to large numbers, if proper precaution be not taken to avoid it, and no amount of care can guard: against such a danger where humanized lymph is made use of for public or extensive vaccination. My friend, Dr. Robillard of Montreal, relates ar experience of his with some tubes of lymphs obtained from a druggist in Liverpool purporting to be from the Royal Vaccine Institution, England, by which two or more children were syphilized and required subsequent constitutional treatment to restore them to health again. Mr. Hutchison publishes illustrated plates of Vaccinal Syphilis occurring in eleven out of four- teen Vaccinees, vaccinated from a child carefully selected at one of the stations of the English Naitional Vaccine Institute. Ten had chancre on both arms, one on a single arm, and three escaped. I was once called upon to treat a case of syphi- litic lepra on a child which a senior practitioner had vaccinated a year previous, since which time the child had never been well. I treated it con- stitutionally and the symptoms entirely disappeared. The Lombardy Gazette, Feb. 2, '78, narrates 26. cases. The Rivala calamity will also be fresh in the minds of professional readers. We are all liable to convey soine blood contami. nation or septic poison of more or less import by the use of humanized lymph, no matter how care- fully it may have been selected, and an action of damages for malpractice would be liable to follow, much to our detriment at the sane time, by using a sample of vaccine from which perfect protection cannot be secured and froin which many serious accidents are liable to follow. It seems to one alive to the advantages of vaccination with bovine lymph, ahnost criminal culpability to use humanized lymph for the purpose of vaccination when animal lymph-from which no bad result can follow and perfect protection may be guaranteed-can be obtained. The advantages to be derived from the use of heifer-transmitted lynpk may De briefly enumer- ated as follows ist. Amumai vaccine guarantees against the-. possibility of transmitting any diseased contai r nation. Cutaneous disease, syphilitic or septic con-', tamination are quite unknown as a sequence. 2nd. It enables a constant supply of pure lymph S294",
         "THE CANADA à to be kept up, on which to draw in an emergency To this end it is desirable that the Dominion or Local Government should subsidize or otherwise maintain an Animal Vaccine establishment, so that every facility may be afforded for its propagation. 3rd. It gives the greatest possible guarantee of protection by enabling the practitioner to carry out true Jennerian vaccination, which bas been amply proven by the recorded experiments of Woodville and others to be permanently protective. 4th. It enables vaccination to be carried on wvithout reference to those already vaccinated- or tbe necessity of our tapping a vesicle to obtain humanised lymple, thereby rendering it less pro. tective, and it prevents a vaccinefamine. It bas been objected to vaccination with animal îymph that ist. It is too violent. This I have found to be reversed in the case of Longue Pointe virus, the action of which bas ahvays been imild and pleasant. I have found always that the less pure the lymph bas been that was used in any given case, the greater the local disturbance, and not long since I was asked to see two cases in which abscesses had followed the use of humanized Iymph giving a great deal of trouble. 2nd. It bas been asserted that animal vaccine might communicate diseases from the animal. This objection cannot hold where only healthy animals of the choicest quality are used, and in a condition fit for the butcher. 3rd. That it is difficult to take unless used when quite fresh. This is the only objection worth considering, Which may be met and overcome by trying to understand and appreciate the fact that bovine ýalbunzen is much less soluble than the human, and therefore special care is necessary to liquify the lymph on the ivory point by dipping in cold mater previous to using, and rubbing finnly over the scratches to remove the lymph effectually. This -quite overcomes the difficulty. 4th. That it does not keep long active. If collected on ivory points or slips, and properly Put up for preservation, it keeps active as well and ;is long as any other lymph. 4th. That it is difficuit to propagate. This objection disappears in the hands of a omipetent and painstaking physician. There is njO- special difficulty in vaccinating animals that cannot bereadily overcome with proper appliances 2ndsuitable premises EDICAL RECORD. 295 In the propagation of animal virus in the most efficient state for human vaccination, it should be: collected at a certain and brief period during the early stage of the vesicle, while that taken at a much later stage is found quite efficient for the vaccination of other animals. Animals should be selected of the best possible quality, and should be vaccinated directly from each other. It cannot be denied either that for the success-' ful vaccination of animals and collection of virus in the best condition for use, a high degree of intelligence', patience, experience and skill are required. It will not do to assign the task to an. ordinary stable man. 6th. It bas been objected that animal virus is expensive. This objection will always continue owing to the trouble and expense which are inseparable with its propagation, but if the Government could be induced to give a money grant sufficient to establish and maintain a National Vaccine Institute, the expensiveness of it niight be no longer an objection The common practice of vaccination bas been very carelessly conducted as a rule, and the public have had no guarantee of safety from impure virus, for the following among other reasons. ist. Because of the absence of any Government provision for the maintenance of a proper Vaccine - Institute where a constant supply of Pure virus could be produced, for gratuitous or partly gr tuitous distribution. 2nd. From ignorance and carelessness of prac-' titioners in collecting and preserving lymph or crusts for future uses. 3rd. Too low fees for vaccination, considering its vast importance and the trouble and responsibility which it entails, thereby encouraging indifference..' 4th. Neglect of public vaccination by municipal bodies, and low salaries given public vaccinators where it is carried on, vesting the character of service rendered entirely upon the physician's o*n conscientious sense of duty. As this is, a question of State Medicine, some- thing should be done by the State to establish a Vaccine Institute. It would be very gratifying to find the example of the Government in the mother country followed by the Government of the Dominion in providing animal vaccine at the public expense for gratuitous distribution. I trust the Committee on Sanitary Legislation appointed by this Association may use its influence",
         "TEE CANADA MEDICAL RECORD. with the Dominion Government to secure an annual grant for the maintenance of a National Vaccine Establishment, where a good supply of animals can always be kept under conditions favorable to the propagation and perpetuation of 'the stock of lymph. Such an establishment is an imperative necessity in this country, in the interests of the profession and the public. biogje4 0f Âcedwcd/ \u0026cence AN OPINION AS TO QUININE IN PNEU- MONIA. A writer in the St. Louis Clinical Record says: \"I think a good many pneumonic patients are killed with quinine. If there is any indication or reason for giving it, I don't know what it is. It disorders the nervous system, impairs digestion. It has no influence in preventing hepatisation or hastening resolution. I know a man in my coun- try who has complete amaurosis from taking qui- nine for pneumonia last winter. His doctor gave him half a bottle in twenty-four hours on the 'vaso- motor,' 'inhibitory,' 'accelerating,' 'depressing,' 'constiicting,' dilating,' hypothetical theory of the day. But the fashion now is quinine, from a stone- bruise to a broken neck. If no more quinine should be used than is really beneficial in disease it wouldn't be worth a dollar a bottle.\"-Pacic Med. and Surg. Journal. BENZOATE, OF SODA IN WHOOPINC- COUGH. D. Tordeus, of Brussels, writes that lie bas prescribed the benzoate of soda in a number of cases of whooping-cough, and that in all the cases the parents reported that the coughing fits began to diminish in force and frequency after one or two days of treatment. He gives four grains of the salt every hour to a child of two or three years. The drug seems not alone to diminish the force and frequency of the paroyxsms, but also to exert a favorable influence on the mucous membrane of the respiratory tract, and to prevent the develop- ment of serious pulmonary complications.-four- nal de néd., etc., de Bruxelles. TREATMENT OF LEUCORRHEA IN CHILDREN. Leucorrhœa in children, says M. Bouchut (Practitioner; fron Le Praticien), is caused by vulvitis, not vaginitis or metritis. He therefore treats this condition by extreme cleanliness, re- peated bathing with bran-water and lead-water, lotions of corrosive sublimate (two grains to ten ounces of water), carbolic acid (two grains to the ounce), and occasionally solution of nitrate of silver (three grains to the ounce). In the inter- vals of applying the lotions a pledget of lint satu- rated with coal-tar or an ointment of red precipi- tate may be placed between the labia. Such a pledget kept in place by a pad protects the sur- rounding parts as well as the labia themselves from the irritating secretion, which is often present in considerable quantities. For the general treat- ment M. Bouchut recommends the administration of cod-liver oil and quinine to strumous patients, and of arsenic to those with eczemnatous eruptions. FOR FRESH COLD IN THE HEAD. Dr. T. F. Houston writes: For fresh cold in the head, accompanied with obstruction in the nasal passages, 1. Carbolic acid................ 3 i Absol.e alcohol........ ..3 ij Causti- -;'\u003eiution of ammonia 3 i Distilled water................ 3 iii M. Make a cone of writing paper; put a small piece of cotton in it; drop on the cotton ten drops of the mixture, and inhale until all is eva- porated. Repeat this every two hours unti relieved.-So. Med. Record. MANAGEMENT OF THE THIRD STAGE OF LABOR. Dr. Max Runge, in a communication to the Obstetrical Society of Berlin, criticizes the current teaching regarding the management of the third stage of labor. He takes as the special text of his animadversions the directions given by Fritsch, which are to the effect that imediatcly after the birth ofthe child the uterus is to be seized by the hand on the abdomen, and the placenta pressed out. Dr. Runge states that for a long time he faithfully carried out this method ; and so did others in Prof. Gusserow's clinique. The objec- tion to it is, that the squeezing out of the placenta is begun before that organ bas become completely.' separated ; consequentl-, when the placenta 'bas been expelled, often a Lit of the membranes may yet be attached to the ttrus and, be left behind after the placenta has been taken away. While this teaching was carried out it was quite a coim- mon thing for a pair of forceps to be needed to remove these retained pieces of membrane, and secondary post-partum hemorrhage became ex traordinarily frequent. He refers to a former. 296",
         "THE CANADA MEDICAL ÉCORD. communication of his own, in which, treating of post-partum hemorrhage, he expressed his surprise that within a short time'he had many cases of this complication. Then he supposed this frequency was - fortuitous. Now he knew the reason, which was his undue haste in pressing out the placenta. Midwives are now instructed, after the birth of the child (and having, of course, seen that the utérus is sufficiently contracted upon the placenta to pre- vent hemorrhage), to wash and dress the infant before proceeding to press out the placenta. The separation of the placenta and membranes, Dr. Runge holds, is not complete until, upon an average, about a quarter of an hour after the birth of the child; and therefore about this length of time should be allowed to elapse before the pla- centa is pressed out. Since instructions based upon this principle have been given to the students and midwives of the Strasburg Obstetric Clinique post-partum hemorrhage has become of very infre- quent occurrence.--Journal of sychological Mc- TREATMENT OF DIABETES MELLITUS. Prof. Flint, in a recent clinical lecture on this subject, said : The treatment is emphatically dietetic. There have been a great many remedies proposed from time to time, recommended as having control over this disease. Now I am not prepared to say that there are no remedies which do exercise more or less control over it. But we should commit a grave error, and act very much at the expense of the prospects of our patients, if we gave any remedy which rendered them less careful in attending to the dietetic treatment. In other words, the diet- etic treatment is to hold the first place. This treatment consists in withholding from the food almost entirely (for entirely we cannot) sugar in any form, and all the starchy constituents of diet capable of being transformed into sugar. That is the principle. Well, if we merely state that to patients, and tell thein they must not eat sugar, they must not eat starch, they will not be likely to carry it out. In the first place, it is not likely they will know enough of the subject to be able to carry it out, even if they were so disposed; and unless we go further, and are very careful as re- gards details, we shall find that the elimination of these constituents of the food will not be done ; they will flot tolerate it. If we are to succeed we should give appropriate attention to the prepara- tion of the food, the number of articles which the patient should be allowed to take, and the varia- tion of the food from day to day, to make this anti- diabetic diet satisfactory to the patients ; that is, satisfy their appetites and the purposes of nutri- tion. This can be done, and if it is done the patient carres out the treatrment, because it is no hardship to carry it out ; and the treatment is to - be carried out not for a few days, or a few veeks, or a few months, but for an indefinite period-foi years, and perhaps during the whole of -life. How is this second object to be effected ? We must place before the patient a list of all articles of food which are to be avoided, specifying them; not contenting ourselves with the statement :n general terms, but specifying on the one hand all the articles of food which he must not take, and on the other hand all the articles of food, animal and vegetable, and so on, which he may be allowed to take. He' should have such a list before him, and such articles should be selected from the allowable ones as to make a variety from day to day, and so prepared by the artifices of cookery as to render thern satisfactory. It can be done, but it requires patience, and it requires care on the part of the patient or somebody else, and it re- quires some means. A very poor man, who has no one to look after these matters for him, and who has not sufficient means to obtain all the articles of food which are desirable, will find it very difficult to conquer this disease ; and in cer- tain public institutions-this hospital, for* in- stance-it is very difficult to carry out the proper dietetic treatment. It requires so many things and so much attention to details that the dietetic treat- ment is very unsatisfactory in public hospitals. The article of food which will cause most trouble is bread, and diabetics realize the force of the statement that bread is the staff of life. Fre- quently they say at first that they care little for bread, and can get along without it with 'no trouble ; but they do not find it so after a while; Thev find that there is a craving for bread, and they feel that they cannot do without it. So there have been various substitutes for it. There is what is called the diabetic flour, which is bran very finely ground so as to divest it of all rough par- ticles ; but it has no nutritive quality whatever. It is really no better than sawdust, so far as nutri- tive value is concerned, and the patient adheres to it only a short time. For the past two years the patients that I have seen have been in the habit of using a bread which so far seems to be very satisfactory, but it is not entirely divested of starch. It is what is called gluten bread, pre- pared by the Health Food Company, corner of Tenth Street, and Fourth Avenue,' of this city. Analysis shows that it is not entirely divested of starch, but it is so prepared that it is not deprived of the agreeable qualities of ordinary bread. Last winter I brought a loaf of that bread before the class and distributed it. I like it to eat myself, finding it by no means disagreeable ; and patients take this bread and it meets their wants, thus re- moving a great obstacle to the successful dietetic treatment of this disease. I do not deem it necessary to go over the entire list of these dietetic articles. You will find them by reference to different works. But the thing to do is to go into minute details with the patients. Explain to them fully just what is to be done. Well now, after they enter upon this course of - - 29~",
         "THrE CANADA MEDICAL RECORD. treatment in a very considerable proportion of cases the sugar diminishes at once, and sometimes it speedily disappears. Of course we should ex- amine the urine from time to time to determine its condition as regards the presence of sugar and the anount of sugar. This treatnent does not cause a disappearance of the sugar in all cases. I have a patient under observation now whon I saw for the first time about three weeks ago-a young, thin, intelligent man, -who, I have reason to be- lieve, adopted the anti-diabetic treatment and lias carried it out fully. I prescribed no medicine at first, and that has been my custon, in order to see vlat the dietetic treatment will do of itself. In this case it has accomplished very little so far; and this case I am led to fear therefore will be one in which we cannot expect much success fron treatment of any kind. If the dietetic treatment does not succeed we have no other resources ; that is, no medicinal remedy yet known will suc- ceed. It may have a certain influence over the disease, but it will not effect a cure. Then I could mention other cases. A gentleman whom I have seen now for two years, who until lately lias taken scarcely any remedies, but lias carried out the dietetic treatment very faithfully, presents urine which gives no evidence of sugar whatever. He retains his strength mentally and physically; he is a man of great activity, being engaged in business involving large responsibility, able to go on with it, and finding the dietetic treatment perfectly satis- factory-finding it no hardship. Now, as to medicines, as I have said, a -great number have been proposed from time to time, have been tried a short time, and then have passed out of use, others taking their place. This patient is not under my own care here. He is under treat- ment with the sulphide of calcium, a fifth of a grain three times a day, together with the dietetic treatinent, so far as it can be carried out. With regard to this sulphide of calcium, one patient-a medical man in this vicinity who suffered from this disease-consulted me about three years ago, at which time lie found that he had diabetes, adopted the dietetic treatment, relinquished his duties in town, whicli were exceedingly laborious, and went into the country, and his urine after a time showed no evidence of sugar. When I saw him last, whicli was a few months ago, I had never seen him look better, and he said to me that lie had never felt better in his life. And, by the way, as an evidence that this disease may have existed some time be- fore the patient's attention lias been directed to any disease, this has been said to me over and over again by patients, even when the urine still contained sugar. They were not aware that they had any disease, as they felt much better than 1h,2y had for months, perhaps -for years before. They would not be aware that they had any dis- ease were it not for a chemical examination of the urine. If they could put that out of view they ivould not have the consciousness of having any, disease at all. This gentleman, who was a very 298 able practitioner, was led to use the renedy that I have just mentioned from finding it recommended, as he told me, in sone medical journal. He has the impression that the sulphide of calcium had con- siderable to do with his apparent cure. Well, I am free to say that when I talked with hini about it my own belief was that he was apparently cured by the dietetic treatment, and by a change of habits of life, the avoidance perhaps of some ex- cesses. To one patient who came to see me I stated these facts with regard to that remedy, and I said, \" If you feel no objection I will prescribe it for you.\" This was a case in which the dietetic treat- ment had been extreiely successful, and most of the time there was very little if any sugar in the urine. I told the patient that the remedy in ques.- tion would do no harm ; that I thought I could say that. He said, \" Well, let us try it.\" I put him upon the remedy, beginning with small doses, and increasing thern. I began in his case with an eighth of a grain, but I think we might begin with a quarter of a grain; in other cases I have begun with a quarter of a grain three times a day, after a fortnight doubling it, going up to two grains, and continuing it indefinitely. Well, this patient went on in that way, and he is very much impressed with the idea that it has been of use to him. Now we must make some degree of allowance with re- gard to the opinion of the patient as to the effect òf the remedy. I do not mean to say that the re- medy has not been of value, but I do not feel as certain as the patient does with respect to its value. I am also prescribing the same remedy in three or four other cases, but the period during which it lias been used is too short, I think, to enable one to form a correct judgnent with re- gard to it. I shall certainly continue the use of the remedy, for it can do no harm; and, moreover, it is a gratifying thing to the patient to be taking a remedy which lie supposes may be of use. The moral effect of remedies, as people's views are now, is by no means inconsiderable; it is a factor which we cannot altogether ignore in the treatment of disease. This disease I believe may be kept in abeyance indefinitely by appropriate dietetic treatment, and yet I am extremely doubtful whether apatient can ever properly consider that there is a permanent recovery.-Amnerican Practitioner. SYPHILIS IN MARRIED LIFE. By M. FouRNIER. Lecture delivered at the St. Louis Hospital (Paris). GENTLEMEN,-I-ow often, in your practice, are you consulted by individuals who, having been unfortunate enougli to contract syphilis, desire to know if they are completely cured, and if theY may marry with safety!",
         "TRE CANAD The importance of the reply you will make to suéh a question cannot be over-rated. - If you in- terdict marriage to a man in a fit condition to marry, your medical sentence may destroy his happiness and his subsequent career. If you ,authorize the marriage ofa man still suffering'from syphilis, you expose not only the individual him- self, but alsci his young wife, to whom he brings the disease a- a wedding present, and again the entire famuly which may result from the union. I have witnessed too often these sad dramas of family life, and I can affirm to you that nothing can be more execrable than the situation of such a man before a wife who v eeps, but forgives; before her family, who do not forgive; and before a nurse infected by the child, who recriminates, gives rise to scandal, and divulges the secret. We will, then, seek to resolve.this terrible problem regarding syphilis in the marriage relations. And, primarily, an important question presents itself for consideration. Does syphilis constitute an absolute obstacle to marriage ? ' A man who has the syphilis should renain a bachelor; \" this is what you will very often hear. I could cite two very honorable prac- titioners of my~ acquaintance who have renounced marriage on this account. One of the two, who enjoys a high reputation, has never allowed him- self to be pursuaded by me, and always replies : \"When a person has syphilis, he should keep it for himself alone.\" To this I reply: whei one lias the syphilis it should be cured, and then marriage and a family may be thought of. syphilis is not an insurmountable obstacle to, nor an absolute interdiction of, marriage; daily observation shows cases where such marriages have been contracted with safety: we meet every day with married men whon we have seen suffer- ing from syphilitic lesions, and who have trans- mitted absolutely nothing to their wives, and have children as healthy and flourishing as they can desire. I have been able to find fifty-one published cases besides those I have observed in my own practice. These fifty-one syphilitic fathers had ninety-two children, all free froni the disease. I recall one such case where there were four children and another where five children were born. I have been physician of both families for many years, and have never observed a trace of syphilis in the children. I conclude, then, by asserting, with a conviction fortified b'y observation, a man may enter the married state after having contracted Syphilis; but he should marry only under certain conditions. A young girl espouses a man presenting syphi- htic lesions ; after being married a few months a physician is called to the young wife, who presents Strange and uncommon symptoms ; syphilitic erup- tions are found, mucous patches about the mouth, grandular enlargements, falling of the hair (alope- -cia), etc. If the physician seeks for the origin A MIEDICAL RECORD. 299 of these lesions, he is unable to find any trace of initial chancre, or of a bubo, faitlhful companion of the chancre ; secondary lesions alone are found without any trace of primary lesion ; on the other hand, if the husband is questioned in secret, he will affirm and protest energetically, that lie has never had any venereal disease, that lie has alvaÿs carefully examined himself after intercourse, etc. He is riglt; in effect his wife may become syphilitic through contact with this man who exteriorly appears not to suffer fron the disease; this apparently paradoxical fact has been too fre, quently observed to place its occurrence for one- instant in doubt. This mysterious contagion is explained by the fact that the woman is with clild. Always, in such cases, you will find that the woman has borne a child or had a miscarriage a short time previously. The mother has, in fact, been in- fected by the child and not by the father. Conta- gion has taken place through the placental exchange going on between mother and child ; a fact abso- lutely proven to-¿ay. I hold it as a constant fact that a syphilitic father is dangerous for his children. But I admit that the possibility of transmission is nuch less certain than has been generally sup- posed when the father alone is affected, the iother remaining free from the disease. Paternal influence may be rare and restricted, but it is sonetimes exercised. Syphilitic fathers have procreated syphilitic children, the mother remaining free from infection. Ricord, Trousseau, Diday, Liégeois, have all given incontestable cases. But this is but a part of the question, whicb assumes gravity from the following considerations : The death of the fœtus in utero is very frequent under the conditions of which we speak. The child of a syphilitic father dies in the womb of its mother and is expelled by miscarriage or by premature labor. A young wife becoming enceinte lias one, 'two, three miscarriages, without it being possible to find any other cause except the syphilis of the father. And what proves this to be the real cause? If the father places himself under a course of treat- ment, the following pregnancies proceed to full term and the children are born alive, without the disease. I have observed such cases very many times. I will cite one case among many others : One day I met a former companion. His wife, though of fine constitution and very strong, had miscar- ried four times in succession. I-then recalled to mindthat my friend had suffered, long before, from syphilis, and häd not followed any regular course of treatment. I, therefore, advised him to place hinself under a course of treatment for his syphilitic affection, which I did not consider cured. My counsel was rigorously followed, and fifteen months later I learned of the birth of a fine child, who is ten years of age to-day, and enjoys excel",
         "THE CANADA MEDICAL RECORD. Jent health. Two ulterior pregnancies in the same case also terminated happily. Whenever the physician finds himself in the presence of a series of miscarriages, occurring in a healthy woman of good constitution, lie should commence to suspect that these accidents are due solely to the syphilis of the father, who has de- stroyed his child in the womb of its mother. Another important point is : a syphilitic father may transmit the disease to his wife, and then, the father and mother being syphilitic, what vill be the condition of the children ? Three alternatives present themselves :- i. The child will perish in utero, and that is assuredly the best for the child. 2. He will be born at term, but infected with the disease. 3. He will survive with his health compromised and exposed to all the alternatives of disease. a. For the first case-death in utero-expe- rience has demonstrated its frequency; thousands of cases sufficiently prove its occurrence : all the observations are so exactly in concord that they appear stereotyped. The pernicious influence continues to be felt even in ulterior pregnancies; there has been observed series of four, six, and seven successive pregnancies terminating always the same way, in miscarriage. 1 have seen, at the Lourcine Hospital, a young woman, strong and of splendid constitution, who married in her nine- teenth year, and had three successful pregnancies. Her husband, in an extra conjugal adventure, con- tracted syphilis, communicated it to his wife, who became enceinte and miscarried in the fifth month ; a second pregnancy terminated in premature labor, the child being dead ; a third, a fourth, a fifth pregnancy had the sane ending ; the sixth terminated in miscarriage, in the third month ; the seventh at the sixth week, in the same way. This case is extremely interesting-seven miscarriages succeeding three successful pregnancies and super- vening after transmission of the disease. b. In another series of cases the child is born lii ing, but infected with the disease, and is conse- quently exposed to all the dangers of infantile syphilis, from which, by careful nursing and atten- tion, a few infants may be saved, but the great majority perish. c. It is possible that the child escape death and the disease also, but the influence of the heredi- tary taint wvill show itself in another way ; by the natural debility which characterizes the most of these children, who are weakly, wrinkled, like old men, and of very poor constitution; nothing attests the existence of syphilis, but they are so puny that they cannot survive and usually succunb, wasting away gradually, without any apparent disease, no particular lesions being found at the autopsy. Or, again, they have certain morbid predisposi- tions: ist. They are born hydrocephalic, or fre- quently become so. 2nd. They are very frequently subject to nervous troubles, to epilepsy, while they are very young, and later to convulsions ; they very often die in simple convulsions. Finally, they are generally lymphatic, and have feeble vital resistance to scrofula. But scrofula is not, on this account, a metamorphosis of syphilis, as has been erro- neously pretended; it is a fixed morbid entity, just as is syphilis ; it is, however, incontestable, that venereal disease constitutes a predisposition to -scrofula, inasmuch as it is a debilitating, asthenic malady, acting on the organism in the same dele- terious manner as insufficient nourishment, conflu- ed, impure air, and crowding in small, humid tenements. Do not depart thinking I have exaggerated in drawing so sombre a picture; I have but presented to you what I have but too often seen, these hidden fanily dramas which are a veritable social misery. I will cite but a few cases taken at randoni; here it is one of the most popular actors in one of the great theatres, who, having contract- ed syphilis, treated it with supreme indifference. Happily lie did not infect his wife and lad a heal- thy child, but he was attacked himself later on by a syphilitic ulceration, which took on a phagedenic form. I was unable to arrest its ravages, and it invaded successfully the face, nose, upper lip, soft plate, and pharynx, and in the end caused the unhappy being to beconie an object of Lorror and disgust to all about him. In another case an artist, a painter, contracted syphilis; the disease was incompletely treated, and he was attacked with an affection of the eyes which finally caused complete loss of vision, and the unfortunate was obliged to apply to the public Board of Charities to save himself from starvation. i could not finish if I undertook to recount all the sad social calamities I have witnessed. What should be said of the author responsible for all these evils ? He is more ignorant than guilty, and it is a duty we owe to society to instruct the pub- lic concerning these dangers they ignore.--fed and Surg. Reporter, Phila., Jan. 22. STIGMATA OF MAIZE. Last winter and again this spring the JVews called the attention of its readers to corn-silk, technically stigmata of maize, as a remedy in nephritic and cystic troubles, etc. The medicinal properties of corn-silk were brouglt to the notice of the profession by Dr. Dufau, a French Physi- cian, in Le Courrier Médical. He commends the remedy in uric and phosphatic gravel, chronic, cystitis, mucous and muco-purulent cystic catarrh, and in cardiac and nephritic dropsy. Dufau has given it without injury for three months at a time. He has known it to triple and even quintuple the quantity of urine passed in twenty-four hours. He, says that in dccoction it is unreliable and uncer-\u003c tain. He gives it in a syrup largely diluted, upon an empty stomach. Stigmata of maize is said to have, been used time immemorial by the Mexicans. 300",
         "THE CANADA MEDICAL RECORD. 301 Dr. Landrieux, of France, has published two cases showing its diuretic properties. The first was an individual with ascites from cirrhosis. Under the influence of the drug, given in a syrup, the urine -arose rapidly from five hundred grams to twelve and fifteen hundred grams. In three weeks all ascites disappeared. The other case was the subject of heart-disease, with great edema of the legs, enormous ascites, pulmonary and renal congestion, and a considerable diminution of urin- ary excretion. The stigmata of maize increased the quantity of urine from two huidred to eight hundred grams in twenty-four hours. The edema and the ascites disappeared in a short time. Dr. Landrieux terminates his article thus : i. Not only the different preparations of the stigmata of maize are useful as a modifying agent of the urine, but these same preparations can be equally considered as an incontestible diuretic agent; 2. Diuresis is rapidly produced; 3. The pulse becomes regular under its influence, the arterial tension increases, while that of the yeins diminishes ; 4. Complete tolerance of the drug, and in ch«ronic cases the treatment might be continued during a month or six weeks without the slightest inconvenience. We trust that some of our friends have tried this remedy, and will write us the results. We have used. t in a single instance, but with a decided effect. Two double handfuls of corn-silk were boiled in two gallons of water until but a gallon remained. A tumblerful of this was given thrice daily to a patient of eighty, the subject of dropsy of the legs. His urine was scant, but a thorough examination failed to discover in the heart or kid- ney or liver any cause for the dropsy. While tak- ing the corn-silk decoction, which relieved his dropsy, he declared that he had never made so much water in all his life. Professor Scheffer, of this city, is now prepar- ing an extract of the stigmata of maize. Experi- ments must yet deternmine the time for gathering the silk, and the proper dose and best form of the remedy. It may be that the silk should be gather- ed before it is impregnated by the pollen from tassel.-Lotisvize Mfed. Tines. REST AFTER DELIVERY. Dr. H. J. Garrigues read a paper which was a revised edition of his former paper on the subject, read Sept. 8, 1877, and pubiisned in the \"' Pro- ceedings of the Kings County Medical Society.\" The question was, \"I How long should a woman remain in bed after confinement?\" It was desir- able that practice, in this particular, should be as uniform as possible, and the author believes that the views entertained should not be so divergent ,,as at the present time. The chief representative of those who recom- mend that the time should be shortened as much as Possible, was Dr. Wm. Goodell of Philadelphia. At this point Dr. Garrigues referred to a case in which the woman was urged by ber medical attendant to rise early, and she rose on the fourth day after delivery ; and on the fourteenth day she was induced to ride in a carriage, but it was nearly at the cost of ber life. From that single illustra- tion, however, he did not wish to draw any definite conclusions. At the time Dr. Goodell's paper was read, 756 cases were reported, with a total mortality of only six; and the chief reasons why its author recom- mended early rising after delivery were the follow- ing: i. Labor, if it was a physiological process,. should not be made to wear the livery of disease. 2. The upright position excites the uterus to con- tract, and thereby lessens the amount and duration of the lochia. 3. Uterine diseases are not known among the nations whose women rise early after delivery; and 4. Experience has shown that con valescence is far more prompt and sure than when the woman is kept in bed for a prolonged period. To these points Dr. Garrigues directed the attention of the Section. He maintained that although partu- rition was a physiological process, it was one in which the transition from the normal to the patho- logical condition was extremely common ; and, that was especially truc of women of modern times. Again, if the upright position favored theý discharge of lochia and diminished its amount, and lessened its duration, it must also be borne in mind that serious displacements were liable to be produced by placing the roman in that position before the changes incident to the post-partum state had gone on suffilciently io enable the tissues of the pelvis to resist propciy superincumbent weight and pressure; and there- fore by other means should the influence of the, lochia be nodified. While it might be truc that uterine disease did not apparently exist among the- women of nations where early rising after delivery was commonly practised, there were two factors by which such a conclusion must be modified when applied to modern civilized women; first, not much was known of uterine disease in ancient nations, and, second, modern women with all the enervating influence of what is termed civilization cannot resist disease as did the ancient or the modern uncivilized matrons. With reference to the good results obtained by Dr. Goodell, he thought they were due to the general excellent care given to his patients, rather than to early rising ; and besides he thought it impossible to judge of final results by those- obtained in the average length of time which the woman remained in the retreat after delivery. Dr. Garrigues then quoted from leading author- ities in three chief countries in Europe, all of whom recommended absolute rest in the horizontal position for one, two, and even three or four weeks after parturition. In New York, also, most obstetri- cians favored the long period of retention in bed after delivery. In the language of the author of the paper, \"anatomy and physiology teach us that the puer-",
         "THE CANADA MEDICALý RECORD. peral uterus is large, heavy, flabby, anteverted and anteflected ; that all the surrounding parts destined to support it are distended, soft, and yielding, that its interior presents one large wound bathed in a fluid rich in disintegrated tissue-elements ; that the placental site is pervaded by large venous sinuses, filled with recently-forned blood-clots ; that at least the vaginal orifice and often other parts of the obstetric canal present open wounds ; that the process of transformation, absorption, and regeneration required at least fwo months ; and that the retrogression is most active during the second week.\" It is not necessary that the woman should lie upon her back after the first twenty-four hours, but her position might be changed to that upon either side. The liability to hemorrhage, displace- ment of thrombi, causing sudden death, and the occurrence of septicemia, was regarded as suffi- cient reason for insisting upon rest in the horizon- tal position for several days at least after delivery. The vagina should be kept clean with disinfectant injections. It was with reference to rest after deli- very in normal childbirth that it was desirable to reach a unanimity of opinion. Upon that point Dr. Garrigues had reached the conclusion, from the combined teachings of experience and physio- logy, that the woman should be kept lying quietly in bed, alternately upon the back and side, until the uterus has contracted sufficiently to be behind the symphysis, and for two months she should avoid any great exertion. Dr. Isaac E. Taylor remarked that the views held by Dr. Goodell were substantially those entertained by Hamilton and White, and pub- lished several years ago. The important point, however, was with reference to the management of the woman after normal natural labor, and lie did not agree with Dr. Goodell, because lie believed that we must be guided by the nature of the case under observation: what was the woman's physiological condition? what was the condition of the uterus as regards its length, weight and posi- tion ? etc. Dr. Taylor then referred to a case in which the uterus returned to the pelvic cavity within five days after delivery, and the woman made a rapid and good recovery; but not every case progressed so favorably as that one. He kept the woman in bed until the uterus had returned to the pelvic cavity, whether it required one or four weeks. So far as rest after delivery was concerned, we must judge by the constitution of the woman. Rising within two or three days and sitting on a vessel would, doubtless, facilitate removal of clots and -also the lochia; but if the woman suffered formerly a good deal from the discharge, etc., lie kept her ir bed three or four weeks. There could be no line drawn or rule laid down which could be made applicable to every case. Dr. S. T. Hubbard remarked that lie had found .a great difference anong women with reference to the time after delivery at wvhich they could get up without injury. His rule had been to keep them in the recumbent posture, if possible, nine or ten days, and prevent them from walking for two weeks. le thought the time must be regulated by the attending physician without reference to any rule. Dr. Tusky fully agreed with Dr. Garrigues, and also believed that an important factor in prevent- ing the development of puerperal fever was main- taining the recumbent posture after delivery for a week or more. He referred to a case in which the woman, feeling perfectly well on the fifth day after a normal labor, arose, and puerperal fever immedi- ately followed. Some women might get up on the first day after delivery and no harm follow ; and so it occasionally occurred that a person fell from a third-story window and received no serious injury, but he regarded such as exceptional cases, and thought that no woman should rise before the eighth or ninth day after a normal labor. He also approved of injections of the cavity of the body of the uterus as recommended by Hegar, whenever the external os was patulous. Dr. Caro remarked that we need not go to R ome to study Roman women, for they were here, and he then referred to his experience among Italian women in the city of New York, which had been that early getting 'up after delivery frequently destroyed the life of the woman, and was a most prolific source of all kinds of pelvic disease. He never allowed a woman to rise, if it could be pre- vented, before the ninth or tenth day. He regarded cleanliness as godliness, but it was a virtue which most of the Italian women discarded ; and doubt- less their habits in that respect contributed largely to the development of diseases among them. Dr. Garrigues, in closing the discussion, remark- ed that he took it for granted that there were injuries more or less severe to the obstetric canal in every case of labor. The injury might be very slight, but it was sufficient to permit the absorp- tion of septic material; hence the care that should be taken to keep the passages properly cleansed and the discharges properly disinfected. The minimum time which he would keep the woman in bed was eight days, a period long enough to allow granulations to form for the repair of in- Jury done to the tissues of the obstetric canal.- N. Y. Medical Record. MANAGEMENT OF ABORTIONS. Dr. Parvin (Tle Obstetric Gazette, July) pre-: sents his manner of meeting the difficulties of these cases. He says : suppose a case of incomplete abortion having hemorrhage which by its peis tence of profuseness brings danger to the patient, or commencing offensive discharge that heralds a possible septicæmia, and then interference is ml perative and must be immediate. Let the patient lie on her back, upon a bard bed, her hips brought - 302",
         "TUE CANADA MEDICAL RECORD. to its edge, lower limbs strongly flexed ; then intro- duce Neugebauer's speculum, and bring the os fairly in view; now catch the anterior lip with a simple tenaculuin or, better, with Nott's tenacular forceps, and then if there be any flexion-and it is not uncommon in cases of spontaneous abortion to observe this-use gentle traction to strengthen the bent canal; at any rate fix the uterus by the instrument.* Now take a pair of curved polypus forceps of suitable size, or, better stili, Enmet's curette forceps, and gently intro- duce the closed blades into the uterine cavity, open them slightly, then close them and withdraw when the fragments of membranes can be removed, and the instrument be re-introduced. Repeat this three or four tines, if necessary, until all membranes or placental fragments are extracted. Then, by eansm of an applicator wrapped with cotton wool, swab out twice, or oftenr, the uterus with Churchill's tincture of iodine-one of the best of local uterine hæmostatics, if not one of the best of antiseptics. Finally, let the patient have ten or fifteen grains of quinia, and it will be very rarely, indeed, that her convalesence is not prompt and perfect. AMENORRHŒA. in cases of this nature, due to torpid action of the ovaries, Dr. Goodell orders the following pre- scrption : ». Ex. aloes, 3 j.; ferri sulph. exsic, 3 ij., assa- fœt. 3 iv. M. et in pil. No. c, divide. Sig.-One pill to be taken after each meal. This number to be gradually increased, first to two, and then to three pills after each meal. If the bowels are at any time over-affected, the patient is to stop and begin again with one pill. Where the amenorrhoa is due to arrested devel- opment, Dr. Goodell has derived the very best results from the constant use of Blot's pilI, as re- commended by Niemeyer: 1e. Pulv. ferri sulph., potas. carb. puræ, aa 3 ij., mucil. tragacanth, q. s. M. et in pil. No. xlviii, div. Sig.-To be given daily, in increasing doses, until three pills are taken after each meal. This gives the large quantity of twenty-two and a half grains of the dried sulphate of iron per diern. If these pills give rise to constipation, Dr. Goodell uses this formula : R. Pulv. glycyrrh. rad., pulv. senne, aa ss., sulphur sublim., pulv. feniculi, aa 3 ij., sacchar. purif. 5 jss. M. t Sig.-One teaspoonful in half a cupful of water at bedtime. Where the suppression is due to change of habits and loss of health, tonics are employed. When the *It is well to use a uterine probe in order to ascertain the ourse of the [cervico-uterine canal and the depth and size of the uterine cavity. 30% suppression comes on suddenly, from cold or ex- posure while in the midst of the menses, and is- accompanied by severe lumbar pains, the patient is placed in a mustard hip-bath, a Dover's powder is administered, she is put to bed and hot drinks are given to provoke copious diuresis and dia- phoresis.-N Y. Record. THE TREATMENT OF PNEUMONIC FEVER (ACUTE LOBAR PNEUMONIA) BY THE EMPLOYMENT OF THE WET- SHEET. Dr. Austin Flint, in a recent clinic (Gai/lard's Medical fournal, March, 1881), presented three cases of pneunonic fever, treated antipyretically by means of the wet-sheet, no other active measures of treatment having been employed. The favor- able course of the disease under this treatient, in these cases, was highly gratifying. Dr. Flint said, 4Inasmuch as these cases are but a small propor- tion of those which have been treated in my wards during the session, you may ask why the treatment has been thus limited. The treatment is, as yet, novel in this country. In relating the first tvo cases at a meeting of a medical society of which I amn member, doubt was expressed by other members as regards a favorable influence produced by the treatment, together with distrust of its pro- priety and safety. I was not without apprehensions, in the first place, in respect of the treatment i'self, and, in the second place, as taking the place of other therapeutical measures, notwithstanding the strong testimony of some German writers in behalf of the efficacy of cold baths in this disease. These considerations led to a careful selection of cases. The cases selected were those in which the disease was in an early stage, the patients apparently robust, the pyrexia considerable or high, and no, complications existing. I am by no means sure that the treatment might not have been employed in other cases with advantage, but it was thought best to select cases in which there was the least likelihood of harin were the effect not satisfactory.\" The plan of treatment ivas as follows : The directions were to employ the wet-sheet whenever the axillary temperature exceeded 1034 Fahr. The patient was wrapped in a sheet saturated with water at a temperature of about 8o' Fahr., the bed being protected by an India-rubber covering. Sprinkling with water of about the same temperature was repeated every fifteen or twenty minutes. If the patient complained of chilliness, he was covered with a light woolen blanket, whieh. was removed when the chilly sensation had disappeared. Irn none of the cases was the blanket used much of the time when the patient was wrapped in the wet- sheet. The patient remained in the sheet until the temperature in the mouth fell to 1020 or lower, care being taken to watch the pulse and other symptoms. When the temperature was reduced, the wet-sheet 1",
         "THE CANADA MEDICAL RECORD. was removed, and resumed if the temperature again exceeded 103° Fahr. The first case entered the hospital on the third day after the attack. On the second day after bis ,entrance the wet-sheet was employed thrice. He remained in the sheet the first time, two hours and forty-five minutes ; the second time, an hour-and a half, and the third time, an hour and ten minutes. On the second day the wet-sheet was employed once, and continued for one hour. On the third ýday the wet sheet was not employed, the tempera- ture not rising above 1030. On the fourth day the wet-sheet was employed once, and continued for an hour. There was complete defervescence -on the fifth day, and no return of the fever after- ward. Dating from the attack to the cessation of fever, the duration of the disease was seven days. The patient bad no treatment prior to his admission into the hospital. The treatment in the hospital, in addition to the employment of the wet-sheet, consisted of carbonate of .ammonia in moderate doses, whiskey given very moderately, and a little morphia. The patient was up and dressed five days after the date of the defervescence. There were no sequels, and the patient was discharged well. The second case entered hospital seven days after the date of the attack. She had no medical treatment prior to her entrance. The wet-sheet was employed on the second day after ber admis- sion, and continued for six hours. Complete defer- vescence took place on the third day. Recovery followed without any drawbacks. Both lobes of the left lung were involved in this case. The inva- sion of the second lobe, probably, was about the time of her admission into hospital. The third case entered hospital three days after he was obliged to give up work. On the day of bis entrance the wet-sheet was employed, and con- tinued for ten hours. The wet-sheet was employed on the second day after his admission, and contin- ued for five hours. Defervescence took place on this day. The duration of the fever was five days, dating from the time he was obliged to give up work and seven days from the occurrence of chills and pain in the chest. Dr. Flint said the histories ofthe cases as bear- ing upon the treatment employedwere of consider- -able interest. They certainly show that in cases like those which were selected, the treatment is not hurtful. More than this, they render probable the inference that the disease was controlled and brought speedily to a favorable termination by the treatment. They also go to show that the disease is essentially a fever, and that treatment is to be directed to it as such, and not as a purely local pulmonary affection. It remains to be determined by further observations how often and to what ex- tent this method of treatment bas a curative efficacy. It is also an important object of clinical study to -ascertain the circumstances which render the treatment applicable to cases of pneumonic fever, and, on the other hand, the circumstances which may contra-indicate its employment in this dis-, ease. To this series Dr. Flint adds a supplementary case of decided interest in which the pneumonia began in a well-pronounced chill, fever, headache, pain under the left nipple, cough, and a feeling of general prostration. Being without a home, the patient spent the time from Feb. 18th to the morn- ing of the 21st in a lumber yard without food, and with no shelter but a pile of boards. During this time there was a snow-storm of considerable severity, and the temperature fell as low as 10° Fahr. On admission there was a dusky redness of the face, and the expression was anxious ; pulse 122, respiration 52, temperature 102.25°. He complained of dyspnea, pain in left side and cough. The expectoration was semi-transparent, adhesive, and had a reddish tint. Increased vocal fremitus, dullness, bronchial breathing, and bronchophony over the left lung. Treatmcnt.-Whiskey, S ss, Ammoniæ carb., gr. v, every two hours, and a milk diet. Tempera- ture in the afternoon, 104.250 F. 22d. Temperature, a. m., 99 ; p. m., 99.250. Puls:! 115 and feeble. Ordered tr. digitalis, gtt. x, every tbree hours. 23d. Patient improved. All the signs of solidi- fication are yet present, and the crepitant râle is heard behind. Pulse 70 and full. Digitalis dis- continued. Respiration 32. Flush had disappeared from the face. 24th. Temperature, a. m., 98.25°; p. m., 98.251. The physical signs now show beginning resolution. Dullness is less marked, bronchial respiration bas given place to broncho-vesicular, bronchophony to increased vocal resonance, and the subcrepitant râle is frequently beard. 25th. Much better. Temperature, a. m., 97.50'. Has a good appetite, takes beef-tea and milk. 281h. Patient is up and dressed. Two inquiries suggest themselves in connection with the history of this case. One is, did the disease end from an intrinsic tendency to recover in spite of the circumstances under which the patient was placed for the first two days of his ill- ness ? It is, of course, absurd to suppose that the disease was arrested by the whiskey and ammonia which were given after bis admission into the hos- pital. The second inquiry is, did the exposure in the open air for three days shorten the duration of the disease by means of an antipyretic effect? These inquiries are submitted by Dr. Flint without discussion for the reflection of the reader. TREATMENT OF CHRONIC PROSTATIC ENLARGIEMENT. Mr. Thos. Smith, surgeon to St. BartholomeidS Hospital, in a recent lecture published in the Lon- don .MJedical Times and Gazette, gives the following advice on the above subject U04",
         "THE CANADA MEDICAL RECORD. Ttirmet.-Your assistance will rarely be sought in the early stages of this disease; but should you be consulted by an elderly patient suffering from undue frequency or difficulty in mic- turition, it will always be prudent to make a digital fxamination through the rectum, to ascertain the condition of the prostate. The examination is best made with the patient lying down on his back. Your finger-nail being filled with soap, and the finger well oiled or greased, it should be intro- duced very slowly, so as not to excite spasrn of the sphincter. Should you judge that the urinary difficulty is caused by prostatic enlargement, the occasional passage of a full-sized instrument will often relieve the inconvenience, and, if steadily persevered in at regular intervals, will generally secure the patient against all the more serious consequences of the disease. In cases where the difficulty in micturition has gone on iteproduce an inability to empty the bladder completely. it is of primary importance that at least once in the twenty-four hours the urine should be all drawn off; but in barrying out this plan it is necessary to exercise caution, lest by suddenly emptying a greatly distended bladder you should produce a complete paralysis of the organ, with a loss of the power of voluntary micturition, and cystitis. As a general rule, if there be not more than one pint of retained urine in the bladder-that is, urine the patient is unable to pass for himself, it may be safely drawn off at once. But if there be more than this of residual urine (and there may be several pints), you should draw it off by install- ments, taking away a little more each day, until the bladder is completly emptied. This complete evacuation of the bladder, when once accomplished, should be repeated each day, by means of an instrument, and for the purpose an india-rubber catheter, a bulbous-ended or a Coudé catheter, should, if possible, be used. fBy these means, in an early stage of the disease, the patient will generally regain the power of nor- mal micturition, or at all events, if this result be not attained, he will be secure from the worst consequences of the disease. The treatinent may be carried out by the patient himself if you will be at the pains to teach him how to pass an instrument-nowadays a compara- tively simple process, owing to the great improve- ments in catheters ; for you should know that since the introduction of the various forms of soft catheters now in use, the instrumental treatment Of prostatic enlargement has lost more than half its terrors and much of its danger. This large silver prostatic catheter which I now show you-at one time almost the only instrument used in these cases-is truly a formidable weapon with its long shaft and wide-sweeping curve. It was constructed to ride over the prostate, but in the hands even of experienced surgeons it frequent- ly failed in the performance of its normal functions and rode under the gland, or through its substance. Used with a strong and steady hand it rarely failed. to draw off water. As an instance of its powers in this respect, I may mention a case within my knowledge where a prostatic catheter in the hands of an energetic surgeon drew off some gallons of' water, which, however, a post-mortem examination. disclosed to have come from the peritoneal cavity I will suppose now that you are called upon to treat a patient with retention of urine dependent upon enlarged prostate. The difficulty will usually have come on at night time; the patient will, as a rule, be advanced in years ; and the prostate can be felt in the rectum unduly prominent. In such a case let me advise you first to try a flexible red rubber catheter, of full size; it will often find its. way round a corner, and through a urethra which would be impervious to a more rigid instrument. This failing, you should try and pass the sanie catheter with a stout wire stylet reaching two- thirds of the way down the instrument; this gives. you more power to push the catheter onwards, and l'eaves the end flexible, to accommodafe itself to the distorted urethra. Next in order you may try the Coudé catheters which I show you: then, if necessary, the bulbous French instrument, a gum elastic, without and with the stylet ; and lastly, others failing, a silver instru- ment. Whatever instrument you use, let it be a full size; it will go in as easily as a smaller one, and is less likely to damage your patient. Keep the point of the instrument on the upper. wall of the urethra; and, above all things, use no force. After drawing off the water in a case of retention, the patient will, for a time at least, require the regular use of the catheter until lie recover his power of voluntary micturition ; and should there. have been great difficulty in introducing the cathe- ter, I should advise you to tie it in for the first twenty-four hours. In the subsequent treatment of these cases of prostatic retention, in addition to other troubles. you will often have to contend against an increas. ing frequency in micturition. The frequent desire to pass water must be resisted as much as possible by the patient, or it will grow upon him. The blad- der must be conxpletely emptied, and, if need be, washed out, at regular intervals, and the patient exhorted not only to resist by a strong e '-rt of the will the solicitations of his bladder, but to avoid all sights and association that are likely to suggest to him the necessity of micturition. With this object in view, you should counsel your patient to keep his catheter and chamber-utensil out of sight; as soon as possible to leave his bed-room during the day; and to occupy his mind by any pursuit which may draw his thoughts away from his urinary necessities. f3O5",
         "3o6 -THE CANADA MEDICAL- RECORD. THERAPEUTICAL EMPLOYMENT OF IODOFORM. The.journal de Medicine Belge gives, according to the Journal de pharmacie et de chimie, a formula which permits the employment of iodo- form without inconvenience. According to Dr. Lindeman the balsam of Peru completely masks the odor of iodoform ; two parts of this balsam neutralizes perfectly one part of iodoform. The best vehicles are lard, glycerine and above all vaseline. Here is a formula that the author xecommends: I Iodoform..................i part. Balsam Peru........3 parts. Vaseline........ ..... 8 parts. He also often prescribes the following : I» Iodoform................................i part. Balsam ..........3 parts. Alcohol, glycerine or collodion..12 parts. First mix exactly the iodoform and the balsam Peru, then add the other ingredients.-Journal de fedicine et de Chzirurgie. MORPHINE IN PUERPERAL ECLAMP- SIA. C. C. P. Clark says he has never seen opium, properly used, fail to ward off eclampsia when it seemed to be threatened; that he bas many times seen it obviously and at once put a stop to the par'oxysms after they had been commenced; and that he bas never known a patient to die of this disease when that medicine had been administered in season, in srufficient quantities, and in the pro- per manner. When prenionitory symptoms of eclampsia appear, continuous or paroxysmal pain in the head, alterations and figments of the senses, especially of sight, mental dullness, ataxy, a countenance ex- pressive of suffering and apprehension, an irreso- lute and incapable manner, and complaint of inde- .finable distress, he orders two or three grains of opium per diem with full confidence that convul- sions will be warded off. He does not ignore eliminants, but does not trust to them alone or .chiefly. When the convulsions have appeared, he says, the patient \"should have forthwith injected into her ann a grain and a halfof morphine by weight.\" \"Should the paroxysm return any time after two hours, this dose should be repeated. And if she be in labor, she should have another dose after eight hours any way.\" He asserts that a comatose or half-comatose condition is no contraindication to such use of morphine; and he urges that this course be pur- sued unhesitatingly unless the patient be obvious- ly moribund ; and has the greatest confidence that morphine so used ivill succeed in all cases where the brain bas not already sustained irreparable injury by a long succession of paroxyms, qr by a few of great violence.-Amer. Jour. of Obstetrics. ERGOT IN NEURALGIA. Dr. Marino, of Palermo, says that local injec- tions of ergot give better results than any other treatment in tic douloureux, not even excepting quinine. Some cases, not all, of sciatica were relieved in the same way. Other forms of neuralgia' should receive the same treatment. The inje¯ctiois usually cause pain, but abscesses seldom follow if cold water compresses are applied to the point of puncture. One or two injections suffice, as a rule, but they may have to be continued some tume. About two grains of ergot, in water or glycerin, is the proper dose.-Londo* Medical Record.. St. Louis Clinical Record. IMPROVEMENT OF SAYRE'S TREATMENT FOR SPINAL CURVATURE. Mr. Richard Davy, of London, believes he has an improvement on Dr. Sayre's method of tripod suspension in applying the plaster of Paris jacket in spinal caries. He places the patient in a hain- mock, face downward, arms hanging through slits in the canvas. Extension may then be used or not, according to the views of the surgeon, and the plaster of Paris or other dressing leisurely applied; including the cauvass. A free circulation of air is allowed access to the body and the dressing dries rapidly, the patient often sleeping during thé time employed. After the drying is complete the spare canvass is trimmed, and the patient literally. takes up his bed and walks. After reviewing some of the other methods of treating spinal caries. according to SARE's plan, that is of providing an outside support of the body, relieving the weak' spinal column, Mr. DAVY concludes in favor of his own plan. Aside from the small expense and inconvenience involved, he thinks suspension not always safe in spinal, and especially cervical, caries.-American Practitioner. SULPHUR FOR PIMPLES ON THE FACE. Dr. Gage Parsons believes that Mr. Erasmus, Wilson was the first to propose sulphur lotion i acne punctata, according to the Practitioizer., The usual lotion of the flowers of sulphur witlr glycerine and water is undoubtedly a valuable remedy, but from the readiness with which the sul- phur separates it is inelegant and inconvenient,, while it is not quite satisfactory in its results. A far more efficacious mode of using sulphur is to dust the face with pure precipitated sulphur, every night with an ordinary puff used for toilet: purposes. Recently two severe cases of acne of two years' standing, which had resisted the ordiv- nary methods of treatment, yielded at once to sub phur thus applied. If the sulphur be scented with oil of lemon or roses it willform an elegalt, cosmetic.",
         "THE CANADA MEDICAL RECORD. MATERNAL IMPRESSIONS. The following occurred in the practice of a Maryland physician, according to the Dublin Y9edical Journal: \"A lady, during pregnancy, carried with her a pocket edition of MoORE's poe- tical words, which she read almost constantly. Her child, at three years of age, exhibited a most wonderful gift of putting sentences into rhyme; in fact, naturally expressed his little ideas and thoughts in flowing measure !\" Blame not the bard-but a case like this shows how important is a well-assorted library to a gravid uterus.-Brtish Med. Journal. EPISTAXIS CURED BY A BLISTER. Dr. Verneuil relates the case of a man whose epistaxis occurred every third day. Sulphate of quinia was given without avail; ergot was adminis- tered with no better result; so was digitalis. The patient had been a habitual drinker. The liver vas thought perhaps to be '' cirrhosed, although no enlargement or tenderness was found in this region. A large fly-blister was applied over the liver, since which time the epistaxis has not returned. COD LIVER OIL IN EPILEPSY. Dr. Fairbairn, of Brooklyn, N. Y., writes The digestive disorder and annoying and disfiguring eruption which result from taking the bromides in large doses for a length of time, are serious dis- advantages connected with'the administration of these salts. A remedy which will prevent the bad effects of a medicine, and at the same time will rather aid than detract fron its good effects, is cer- tainly a valuable one. I think in this case we have such a remedy in cod liver oil. A young lady suffering from epilepsy has been under my care for the past five months, who bas taken bromide of potassium in large doses for 'nearly a year, and by this remedy cod-liver oil has warded off the above troublesome results. The.mode -of taking it was this : Brom. potas., 3 ss., was taken thrice daily after eating; this was followed one hour after each dose by ol. morrhuæc, ss. When first attacked by the malady she had eight convulsions in twenty-four hours. She began the bromide in 3 ss. doses, but was compelled to stop it on account of the gastric derangement. A fnend recommended the cod liver oil. She resumed the bromide, adding the oil, and bas taken it with- Out further trouble since. The eruption, before profuse, ' disappeared under 'this management. The disease bas been well controlled, only four convulsions having occurred in the past seven lmonths. I doubt not that the cod liver oil bas had its share in the direct benefit done to the ner- us system, besides affording a protection from 'y the irritating salt to the coats of the stomach. In summing up the good effects of the oil I find: t. Absence of the digestive disorders; 2d. Ab- 3WrY sence of the acne eruption; 3d. That the anæemi usually found in persons taking this medicine con tinually, is far from ,being marked; 4th. The, body is better nourished,,and appetite unimpaired. I have made trial of this treatment in others cases, with similar good results. ' As the articles that have appeared in your Journal in the past month on the bromides, have made. no mention of this device, I have been led to write the above.- N Y. Medical Record. BEEF SUPPOSITORIES. Though the rectum is, strictly speaking, an ex- cretory organ, it may nevertheless, by virtue of its absorbing power, take the place of the stomach and small intestine in the ingestion of medicinal and alimentary agents,. Dupuytren used to say that owing to the absence of digestion the agent passes more directly, more purely and more surely to its destination froni the rectum than it does when taken by the stomach. Hence the speedy efficacy of chloral in mania and the vomiting of pregnancy; of opium and ipecac in dysentery, etc. With this. fact in view I have lately used Johnston's or Lie- big's beef extract incorporated with cocoa butter in the form of suppository to support life in chronic gastric disorders, adynamic diseases and all cases where the administration of food by the ordinary channel was impossible. The beef is easily combined with the butter, or to save time, or for other reasons, the hollow suppositories may be used. The advantage of the suppositories over the beef injection will inmediately com- mend itself.-Dr. James I. Tucker, in Cicago Med. and Surg. Journ. TREATMENT OF AMENORRHEA. William R. D. Blackwood, M.D., Physician to. St. Mary's Hospital, writes, in the Medical Bulle- tin : A large number of remedies have been credited with emmenagogue properties, many of therm being inert, and some of them simply irritant poi- sons whose employment has frequently resulted fatally, especially when used with criminal intent, as abortifacients. Strychnia affords excellent re- sults in many instances. A favorite with me is the following : Strychnia sulph ....... ...... gr. j; Cinchonidia sulph.................. 3 j; Ferrum per hydrogen..... .. Assafetida pulv................... Ext. qussia........................ q.s. M. In pil. No. 6o div. Sig. One four times daily. I usually add at bedtime ten drops of Squibb's fluid ext. ergot in water ; and a forcible jet of cold water along the spine every morning on rising for a few 1minutes, with brisk friction of the abdomen, succeeds admirably in many cases. Exercise in the open air, equestrianism particularly, with at- tentioi to a normal action of the skin, kidneys, and bowels is essentia!.",
         "308 - THE CANADA MEDICAL RECORD, Z UothÇl _%ournta of «ebitilne ani V-jarnate JDITOR : FRANCIS W. CAMPBELL, M.A., M.D.,L.R.C.P., LOND ASSISTANT EDITORS: R. A. KENNEDY, M.A., M.D. JAMES PERRIGO, M.D., M.R.C.S. Eng. EDITOR OP PHARMACEUTICAL DEPARTMENT: ALEX. R. XOLLMYEB, M.A., M.D. BUBSCRIPTION TWO DOLLARS PER ANNUM. All communications and Exchanqe must be addresuedto the Editor, Drawer 356, Post Office, Montreal. MONTREAL, SEPTEMBER, 1881. TO OUR SUBSCRIBERS. The CANADA MEDICAL RECORD, with this number, closes the ninth year of its existence. We have much to be thankful for, and we look *back with feelings of great satisfaction to the progress which the RECORD has made during that .period. For the past two or three years we have, however, felt that the growing* claims of practice, as well as duties devolving upon us in other spheres of Medical work, has prevented our giving that constant attention to the RECORD which its interests demanded. The result has been that every now and then our appearance has been delayed, and this in ïspite of every effort to prevent it. We have, we believe, succeeded in making arrangements by which this great drawback will in future be avoided. Dr. Perrigo has withdrawn from the Editorial chair, much to our regret, and is replaced by Dr. Cameron, who is already known as a ready, vigorous and logical writer., In future the Assistant Editors will take the active work of the RECORD in their own hands, and will relieve the Senior Editor of the major part of it. In this way, with a division of labor, we anticipate being able to appear regularly within a day or two of a given date. Arrangements have been made for the publication of a number of communications, lectures, \u0026c., from some of the leading Physicians and Surgeons of Montreal. We are also pro- mised, from one well qualified, a series of papers on the Early Medical History and Medical Men of Montreal, while the Editors propose monthly to give the history of the Medical Charities of Montreal. A monthly \" Hospital Chat \" will also form a feature of - the RECORD for the future The RECORD has a Dominion reputation for the practical character of its selections. This depart, ment will still continue under the control of the Senior Editor. The RECORD is not the organ of any Medical school, clique, or party. We haye conducted it for nine years with this intention, and we challenge any one to prove that we have been unfaithful to the programme laid down by us when the RECORD was first issued. We ask the co-operation of all-we will treat every one alike -the profession, as a whole, will be our care. And now we are addressing some for the last time,-we allude to quite a number, who have received the RECORD for periods varying from nine to six years without ever paying a cent of, subscription: We have, through \u003cthe RECORD,'by letter, and by post card, politely asked you to pay up; you have not heeded our request, and as we can but think that such conduct is intentional, and therefore dishonest, we have decided t'O terminate our monthly visits to you. If any who read this desire to know if it is they who ar meant, we refer them to the date on their address label, which will give the desired information. If we wrong any, the matter can be easily set righif by the amount due being paid. We ask the kind aid of our friends to extend our circulation. Our Nova Scotia and New Brunswick subscribers have done much for us 'i that way, so that a very large percentage of the Medical men in both these Provinces are on oui list. What they have done, other~s can. Will you? SACCHARATED PEPSIN. The experience of physicians has been sO favorable to the use of Pepsin as an aid to impairéd digestion and kindred affections, that it is onl necessary to say the Saccharated Pepsin Jno Wyeth \u0026 Bro. of Philadelphia manufacture exhibits the principle most fully, and will give therapeutic results to the entire satisfaction of the physicians wishing to prescribê this remedy. Each tea-spoon ful of the Liquor Pepsinæ prepared by the same firm represents the full dose of Saccharated Pepsifl five grains, combined' with Lactic and Muriatc Acids, Glycerine and water. THE CANADA MEDICAL RECORD."
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      "title" : [
         "Canada medical journal [Vol. 2, no. 9 (Mar. 1866)]"
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         "[Montréal : Dawson Bros., 1866]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. Oi the Exanthemata which haveprevailed in Quebec during the past twelve months. By W.x. JAnEs ANDERSON, L.R.C.S.E. Wheu we consider the important functions dependent on the skin; tht through it there transpires in an adult, every twenty-four hours, from thirty to forty-five ounces of matter, and that the diseases which affect it cause one ninth of human mortality, the importance of the st\u003eidy of the Protean forms which the exanthemata present will at once be admitted, especia11y at the present time, when there is much reason to suppose that they, as well as other forms of disease, have been, and still are under- going change of type. Having already made the exanthemata my special study, I have availed myself of the opportunities lately presented by the Prevailing epidemics, of prosecuting my enquiries, and in so doing, I have had the advantage of consultations with several friends, who have \"eorded me opportunities of observing many cases of interest both in prvate and Hospital practice, and I now propose to give the results. Of the primary sources of the exanthemata, we know nothing certain, At it is instructive to mark the gradual expansion in their diagnosis. Aof them have sprung up since the sixth century; and the Arabian Physicians were impressed with the belief, that small-pox and measles, the only two of the now numerous family, thon known, were pathologically ssociated; and as late as 1687, Diemerbroeck asserted that these two iseases were only different degrees of the same malady ; but Sydenham, SContemporary, who had devoted much of his attention to measles, Penanently separated small-pox from them (which. he designated '5)ibih), aind pointed out also the probability of scarlet fever being ther distinct disease though the belief of the identity of measles searlet fever still generally prevailed, and it was only a century later z vo.n.-",
         "CANADA MEDICAL JOURNAL. that observers recognized them, as two distinct diseases, arising from two distinct miasms. About the middle of the present century, no less than twelve distinct forms of exanthematous fever, were recognised, and divided into three classes ;-first, the greater exanthemata seriously affecting life, viz, small- pox, measles, scarlet fever and erysipelas';-second the lesser, vaccinia, varicella, herpes and miliaria ; and third, the simple efflorescence, lichen, urticaria, roseola and erythema. It could not be denied that these bore a certain pathological relation to each other ; but it was said that this principle was not more applicable to small-pox and cow-pox, than it wa\u0026 to small-pox and measles, to small-pox and chicken pox, to measles and scarlet fever. \" The relationship,\" says Dr. George Gregory, \"may possibly consist in somie modification of the clements which compose the muorbid miasm, and may be analagous to that whieli exists between nitrous oxyde and nitrous acid and nitric acid, but is very different from absolute identity.\" That these poisons were very different, was supposed to be proved by the alleged fact of the body being capable of receiving at the same time, the germis of two exanthemata, 'whieh went onpari pxassu or the lesser might be suspended by the greater. It was also noted that when one epidemie diminished, another increased, and that each year was distinguished by some master epidemic, and hence the recogpi- tion of vicarious ?norta1ity, by which the blessings of vaccination were to a certain extent counterbalanced. Thus when small-pox eeased, measles prevailed; when measles disappeared, scarlet fever held its fatal sway, ao much so, that Mclntosh, writing in 1831, says, I The plagueis scarcely more dreaded in Constantinople than 1arlet fever is in Edin burgh.\" In 1840 scarlet fever was so general and so fatal, that th, mortality exceeded by one fifth the ravages of small-pox. During the epi- demie of 1838 we find that under the law of vicarious mortality, the sum totail of epidemie mortality, on an average -of years sine th introduction of vaccination has rexnained nearly the saine. In treating of the exanthemata, most of the eminent writers have cognised certain laws as bearing on-them, viz:- lst. Law. of contagious origin ; 2nd. Law of universal susceptibility; 3rd..Law of epidemie diffusion; 4th., Law of presence and course of constitutional.proneness, 5th. Law of the course of the local or cutaneous affection; Gth. Law of non-recurrence. And in 1851,Dr. George Gregory thus wrote;-\" The peculiar\u0026 course of exanthernatous fever enables us to predict the result, or",
         "ON EXANTHEMATA IN QUEBEC. 387 commonly say, to prognosticate in eruptive fevers, with a certainty which it is not permitted us to do, in any other tribe of diseases.\" Since then, however, circumstances have occurred, which have compelled mnany greatly to modify the views which they had entertained; and perhaps few will now be found, who would be willing to subscribe the six laws above given. Many now believe with Drake (who gave it as the result of thirty-years' observation) that scarlet fever and measles may be merely varieties of the same species, and think tbat it is quite possible that the same miasm may produce different exanthemata. Many more will be found who re- pudiate altogether the law of nonî-recurrence, believing, for instance, that searlatina m:ay be taken not ouly twice, but miany times. It will be my object to sbew the bearing which the cases which have recently come under my notice have on the question. The past season has been characterised by a more than ordinary pre- valence of exanthemata, and there are at present epidemie, variola and varioloids, varicella and its several forms. Scarlatina and morbilli of various types, and lastly roseola, many cases of which, I have reason to believe, have been classed under the heads which I have previously men. tioned. I shall first select for remark scaratina. It has been very pre- valent and very fatal, and so far as I can judge from pretty extensive en- quiry, has generally shown a typhoid tendency. On the 25th of last November, I was asked to sec a little boy about seven years of age, at his parents' residence in St. Louis suburbs. There were 'leven children from twenty-two to three years of age. The house was not drained, and was badly ventilated, and scarlatina had been some time prevalent in the vicinity. The little patient had hot skin, quick pulse and sore throat; I could discover no eruption, though I suspected acarlatina fever. The mother had given a dose of laxative medicine, which had operated very powerfully. There not being any mustard in the bouse, I recommended coal oil to be applied round the throat, a gargle of chlorate of potass, a soap bath at bedtime and acidulated barley water- for drink. Next day I found the throat relieved, no eruption visible, but it eould be distinctly felt alo;g the back. Continued the treatment with the addition of chlorinated waters, after Watson's formula. lu the evening the eruption showed itself imperfectly, and was of a raspberry hue, more ike measles than scarlet fever. On next morning's visit, found hc had passed a tolerable night, and that the eruption was pretty freely develop- ed, but the cervical glands were also very much eilarged. There was îet no unfarourable symptom, but having been informed by the mother that she had lest ber three first children by scarlatina in one day, and as an- er of the fana.ily a girl of fourteen years of age showed premonitory;",
         "CANADA MEDICAL JOURNAL. symptoms, I asked permission to bring Dr. Moffat of the staff, who had been for some time in attendance on the father of the family, and I had the advantage of his aid and counsel during the whole of my subsequent attendance. Dr. Moffat advised perseverance in the treatment already adopted ; and the case, though severe, with typhoid tendency, progressed favourably till the 30th, when there was some retrocession of the eruption, attended with aggravation of throat symptoms and oppression of chest. Solutionof nitrate of silver was applied to the throat; a mustard bath and a sinapism to the chest, afforded great relief, and carbonate ammonia and camphor waters were also administered. On the 31st diphtheritic symp- toms were presented; the disease had extended from the throat to the larynx; and early on the morning of Dec. 1st, the little sufferer expired suddenly. In the meantime on the 28th Nov., there appeared on various parts of the body of the girl already mentioned, a dullish raspberry eruption, and the tonsils were swollen and ulcerated, yet she could not be prevailed on to go %o bed, being desirous of helping her mother with the other child- ren, several more of whom had now suecunibed to the disease. At length an attack of epilepsy, te which she had been for some years subject, com- pelled her to keep her bed. The eruption continued to extend, and continued of the same dull colour, deepening to a purple when the fits came on, which they did several times a day. It was considered requisite to give ammonia and wine freely, but the disease of the tonsils extended to the larynx, the fits became more frequent, great oppression of breathing which was only temporarily relieved by the sinapsims, and it was utter]y impossible to keep the extremities warm. On visiting her on the afternool of 5th Dec., I was overpowered with a most offensive smell, which oU enquiry, I found proceeded from a profuse discharge of a thick dark tarry matter from the uterus. The whole surface of the body was MO ' tled and livid and deathly cold, and she expired while I was there. M this time all the children were down with the fever, except the secOd\" son, a lad of twenty, and though none of thqm showed the bright ý- eruption, and there was a tendency to a sort of erysipelatous action a the tonsils, yet by great attention to the throat, by the frequent u gargles of -chlorate of potass, of hydrochlorie acid, of tinct. of py cum, and by painting with solution of ·nitrate of silver, and by internal administration of carb. and citrate of ammonia, indiy frequent application of sinapsims, all fortunately overcame the dis8S- On the 9th December, a dull miliaryeruption·began to show itsalfaon face and forehead of the second son already mentioned; there W slight sore throat, but great tendency to laryngeal symptomèv",
         "ON EXANTHEMATA IN QUEBEC. nia. The eruption extended over parts of the body, maintaining its miliary character and dull purplish hue. He also suffered from severe rheumatic pains, especially of the shoulders, for which it was found ne- cessary to prescribe iodide and citrate of potass. This case also term- inated favourably, though the aphonia continued for many days. Three of the cases were complicated with epilepsy, and from the unfavourable circumstances under which we had to conduct the treatment, (eleven patients being confined to two small rooms, communicating with cach other) several of the jounger children had dropsy, and the elest daughter, nineteen years of age, had sharp secondary fever, accompanied with blebs, There were no proper means of ventilating the chambers, and though chloride of lime and Condy's fluid were freely used, the air was so vitiated, that both Dr. loffat and myself remarked that we could not remain anytime in the chambers, without finding soreness of our throats. la al the cases with the exception of the second one, the anginose symp- toms were sufficiently marked to characterise the disease as scarlatina, but in none of them was the eruption such as would answer, either in appearance or course, the description usually given of that exanthem. The case of the second son might be with propriety viewed as a se-vere case of roseola miliaris. I may mention that Dr. Rowand was called in to consult, and on one occasion saw eight of the cases, but did not think it necessary to suggest any alteration in treatment. Dr. Marsden, Who rws calied in, on the same occasion as Dr. Rowand, as a friend of the family, also concurred. I shall advert to one other instance of scarlatina in a family in the anMe suburb, but residing in a well-ventilated house and possessing every coaMfort and convenience fo-r health or sickness. I was called on the 8th Jan, last to consult with Dr. Rowand on the case of a fine girl of about twelve 'Urb ul agz, whose case of decided scarlatina had been compli- 'd with chorea, with which she was then alarmingly affected, and sader which I regret to say she subsequently died. The symptoms of SCarlatina in this case had been well marked, as to the angina eruption subsequent desquamation; but in the cases of two of her brothers, ichI had an opportunity of seeing, one much more resembled measles à the other roseola. ow come to a very interesting case. On Sunday, 28th January last, Xo0fat invited me to visit with him, a boy in the same suburb St. Ris e informed me that some timne previous he had been summoned, 7ait this boy's brother who was about eleven years of age. He found Presenting all ,the symptoms of some impending exanthem; on in- yhe found that he had been vaccinated, the cicatrices being present. 389",
         "CAN\u003cADA MEDICAL JOURNAL. To his surprise however in a few days the case presented itself as a most severe attack of confluent small-pox, from the crown of his bead to the sole of his feet. Undei- Saracenia, administered internally, and solu- tion of nit. silver applied to the face, he made a most favourable reco- very, and no pits were left. This boy had scarcely recovered when the baby, a child over one year of age, fell sick ; a sort of purple eruption made its appearance, attended with sore throat, which became diphthe- ritie, and the child suddenly died. Next day the little boy we were about to visit was attacked with high fever and sore throat, but as yet no eruption had appeared. On entering the bouse we found the child lying in bed, the countenance fiushed, but no eruption ; however on removing the bed clothes, the whole body was seen red as a lobster. This turned out an unmistakable case of scarlet fever ; he had no bad symptoms, and bas made a most favourable recovery. The mother bas since had a very sharp attack of angina unaccompanied by eruption. Here we have within one month, in the saine family, and- in the same room, a marked case of confluent small-pox; a case of diphtheritic zoseola ; a most undoubted case of scarlatina, and a case of angina- Were four specifie miasms present, or was one specific poison sufficient to produce these different forms of disease ? I may here mention, that in the London Lancet for May, 1845, Dr. Robert Barnes bas reported an instance of the infection of the system at the same time, by the poisons of small-pox and scarlatina, in a girl of nine years of age, from whom varioloid was oommunicated to lier three sisters, and scarlatina, to another girl in the house. From which Dr. Barnes assumes, that a patient affected with coexisting small-pox and scarlatina, may serve as a common focus of contagion, from which either of these diseases may be 'separately transmitted. Dr. Bickley the American editor of Dr. Gregory, in commenting on these cases, s5YD ' he bas not unfrequently seen variola preceded by scarlatina, and alsO, coexisting with it. Mr. Marson, of the London Small-pox Ilospital, hs seen seven cases and numerous instances of the coexistence of differe eruptive fevers-The Md. Chir. ,ev., Oct., 1847, contains cases- Barthez, Relliet and Levey, of scarlatina coexisting with variola tWlve times, and with morbilli seven times ; and since then we have , d epidemies of rubeoloid, scarlatina or hybrid. forbilli or Ieasles.-MeasIes have been very prevalent, but, as generai ruie, have not been by any means so fatal as scarlatina. Mea and scarlatina have been, in many instances, present in the same Be bourhood and sanme family, and hybrid lias not been of unfreqiient currence.",
         "ON EXANTHEMI'A IN QUEBEC. 3fl On the 24th January, I was called to visit a boy, fourteen years of age, the son of the gardener at Merton 1odge, two miles from the city. He had been complaining for several days, with what, under ordinary circumstances, I shôuld have been disposed to consider premonitory symptoms of measles, but as lie had been in contact with a family with smal-pox, I hesitated to say whether it would turn out to be ineasles or small-pox. On the evening, rubeoloid eruption appeared partially on the face, and epistaxis occurred; there was coryza and very troublesome cough, and pain in the larynx. Coal oil was applied to the throat and chest, steam inhaled, and chlorinated water administered. On the fol- lowing day, the eruption h'ad extended to the back and thiglis, and laryngitic irritation still very promiinent. On 26th eruption well out, ad undoubtedly morbillious-the laryngitic irritation shown by a very troublesome short cough, being still the most promninent symptom. On 27th eruption disappeared froni face; all symptoms ameliorated. On 2Sth eruption totally disappeared from body. On 30th quite well, only toguard against urgency of appetite. On this day the eruption appeared ou three more of the children, and other two and the mother were com- plaining. On the 31st eruption appeared on the mother and one of the reraining children. In the five children, the measles were fully devel- oped, and ran their course regularly. The mother believed that she had metsles before; and recollected that the little boy nine years of age, still unattacked, had lad them very severely. This latter continued to lounge about, complaining of headache, soreness of his bones, and sore ihloat, and his face was flushed, and pulse accelerated. Had measles not been in the bouse, I should have suspected scarlatina ; but on the 2nd February, slight miliary purplish eruptions appeared, chiefly on the back thighs, which prevented him from sleeping at night, from a stinging itchiness, which kept him constantly scratching. He had no cough. After the second day the eruption gave no further trouble, and disappeared on the fourth. The body of the mother was completely covered with true 116rbilious eruption. Coryza was very severe; the eruption on the fore- lead was the same as that on the body; but on the cheeks, instêad of a h, there had appeared triangular purple blotches, about an inch in ertent, attended with intolerable itching which was readily relieved by aging with tepid waters. On the evening of the fourth day all the 'yptoms were alleviated, and the cruption was fading gradually away. the following morning I was surprised to find my patient with her esollen with a confluent conoid eruption, and a new and distinct old eruption over the whole body. On the following day theeruption illlmore developed, and vesicated on the apex. I was alarmed by",
         "CANADA MEDICAL JOURNAL. a most offensive smell which proceeded from her person, and, on enquiry, I ascertained that it proceeded from the menses, which had ceased on the 17th January, but had unexpectedly returned. The eruption on the body had also assumed a coppery colour. In addition to the chlo- rinated water, I now prescribed effervescirg draughts of carbonate of ammonia and citric acid, and a solution of citrate of ammonia, to be fre- quently taken. On examination of the vesicle by the magnifying glass, there appeared a tendency to become pustular, and I was inclined to consider it a case of mild vesicular variola; but on the following day the eruption on the face began to dry, and the skin to crack, and on the sixth day from the appearance of this second eruption it began to desquamate, and the conoid eruption on the body showed under the glass on its apex, a small shrivelled dry seale or rather scab. On the eighth day the face was clean, the conoid eruption could not be felt on the body, but a brownish spot, nzot pit, showed where each cone had been. * Ail fever and uncomi fortable feelings had passed away, and nothing further was required but attention to diet. The six children were all treated alike, and required nothing but a simple dose of senna and tartars, and the chlorinated waters. The diet during the eruption was confined to barley waters and sago or porridge. On mentianing this case to Dr. Moffat, he directed my attention to a case then under the care of Dr. Duif, of the artillery, in the garrison hos- pital, which, with the permission of Dr. Duif, I have had the opportuniti of watching. The man, an artilleryman, had been attacked with al the - premonitory symptoms of a severe exanthem, but no eruption for a tine appeared; at length a purplish papular eruption appeared round the l oin like a belt. On Friday, 9th February, I visited him with Dr. Duff; the eruption on the loins was beginning to fade, but the face was nOt covered with a papulo-vesicular eruption, and he was complaining of very sore throat. On Saturday, 10th, I again visited him with Adset, and on examining the eruption with the aid of the glass, thi vesicle was found to contain fluid, which appeared to be thickening, d unless it should terminate as the case I have mentioned, I had ne dou it would become pustular. Sunday, 11th, vesicls becoming pustUlh Monday, 12th. On visiting him with Dr. Duff, this morning, the face swollen with confluent small-pox. A ring of pustules surrounded faC wrist and ankle, and looking through the glass several of thenshow depressed eertres. This man had been vaccinated. This case re:Misâ me foriibly of that which occurred to Dr. G. Gregory and W. iiammonI nt Windsor, and which was at first pronounced to be fever; two d",
         "ON EXANTHEMATA IN QUEBEC. afterwards roseola, and still two days later, small-pox. Such cases have been styled, erythema rubeolasum and variolosum, but I think it better described by the terni used by Dr. Erasmus Wilson, viz: roseola punctata. Variola, \u0026c.-Variola, varioloid and varicella bave been remarkably prevaleut during the past twelve months, and as yet there is no diminu- tion in the number of cases-variola bas been both severe and fatal, and varioloid in persons who had been undoubtedly vaccinated bas been of frequent occurrence, but I have not heard of any fatal cases. During the past week, I have seen two cases in the Military Asylum, under Dr. Moffat, two little brothers of the respective ages of five and seven years. They are the sons of a soldier, and their mother says they were both vaccinated in early infancy, by the regimental surgeon, and the cicatrices are now quite distinct. Both cases are progressing most favourably, under saracenia and painting with solution of nitrate of silver. Mild and vesi- cular and vesica pustular variola, bave presented themselves in such a form as not to'entitle them to the designation mild, given to them by Dr. Thomson ; and varicella presenting its threefold lenticular, conoidal and globose eruption, has been ushered in with symptoms so remarkably severe, as to warrant the belief, that the disease might be variola ; and i Some cases, the vesicles so closely resenibled, at a certain stage, those of variula, that no one would venture to affirm that they would not become Pustalar. Many such cases, I have no doubt, have been classed as small pOr. From a review of the present epidemics, I have cone to the conclusion, tLt a very great change bas taken place in the character of the exanthe- mata. Can any one who knows the high powers which Sydenham rongbt to bear on his investigations and descriptions of disease, suppose for a moment, that if the marked distinction, which at a later period shoWed itself between scarlatina and morF\"i, had been present in his , that he would have hesitated to separa therm from each other, as hedid, morbilli from variola. I can have no doubt that the type of con- tiaued fever is not what it was thirty years ago ; and I believe that the tIacter of the exanthems has changed as greatly within the same period. ea small-pox began to disappear, measles and scarlet fever assumed Stinctive types, and produced a mortality which had not previously attended them ; afterwards they presented themselves in the coexisting or id form, and within the last ten years, roseola-which, on its first ePPMaDce, was viewed as a very slight affection, neither deserving notice n ' 5treatment-has assumed an importance and severity which rank it yariola, scarlatina and measles, \u0026c. \u0026c.; the most experienced,at times, ng it difficult to pronounce to which of these it belonged. 393",
         "CANADA MEDICAL JOURNAL. During thirty years of my medical life I have seen epidemics wbich I had no difficulty in pronouneing scarlatina or measles; but after 1838, I have met with numerous cases which I could not conscientiously pro. nounce the one or the other. And latterly, I think, to find a case which would answer, in every respect, the description either of measles or scarlet fever, as given to us by the authorities thirty years ago, is the exception and not the rule. I am one of those who, without denying the contagions- ness of scarlet fever, decline to admit its contagions origin. No doubt can possibly exist, that in a very large proportion of cases, scarlatina is produced by contagion; but I believe that many epidemies, and nany sporadie cases, are produced without personal contact, or contact with fomites, and that a certain combination of circumstances can develop an eruption possessing all the chiaracters of scarlatina. I not only believe this, in connexion with scarlet fever, but also with variola, morbilli, varicella and roseola. All my observations mnade during ten years, as health officer of the Port of Pictou, N. S., went to convince me, that all these diseases had arisen from causes icreated on board ship at sea, and had not been produced by contagion from the country of emigration. My later observations incline me to believe, that scarlatina L:as not its own specifie miasms and morbilli another and roseola a third; but that the system being in certain dis- tinct conditions, the same poison may produce the disease to which the condition is prone. If this be not admitted, then we must believe that, as one of the instances I have cited, a small rooi in St. Louis suburb contained, at the sane time, four distinct poisons, viz, of variola, roseols, scarlatina and angina. I believe that the types of morbilli and scar.- tina have changed and are changing still more; and that under the temn roseola, we are presented with varieties of exanthems, daily increasing iii importance, which were not dreamed of in the philosophy of the standard authorities of thirty years ago. We can, however, congratulate ourselves that, while the type of disease has changed, the resources of our art ar increased; and that though we may be at a loss to classify an epideM1ne, our sound principles of pathology will lead to no uncertain practice-f an that we have at the present timQ attained a more complete maste'y overl disease, than was at one time thought possible. Quebec, 25 St. Genevieve Street, 12th February, 1866. A Few Thoughts on Puerperal Fever. By GEO. D. SPOoNES, M-- Considering the anxiety the above-named disense excites a minds of all who encounter it, its frequent fatality, and the obscurityl",
         "DRt. SPOONER ON PUERPERAL FEVER. which it is yet involved, I presume any remarks calculated to inspire greater confidence in the minds of physicians when contending with it, or which are intended to give a clearer if not a more rational insight of its character, wili be quite in order, and not foreign to the object of your publication. By som'e, puerperal fever is treated in an unvarying routine, believing the disease to be always essentially the same, and these may be divided into two classes. One class believes the fons et origo mali is in phlo- gosis of one or more of the abdominal viscera, and as might be expeeted, their treatment is strongly antiphlogistie and depletive ; the other believe it to be typhus or adynamie in its nature, and their treatment is stimu- lant and supporting. Both are right, and both wrong; and he who attaches himself unwaveringly to either, although perhaps apparently successful for a season, will in the end meet with great disappointment. Dr. Mitchell is an unflinching advocate of the former, (sec his paper in the fourth vol. Obstetrical Transactions, p. 96.) and lis ti eatment, fol- lowing Dr. Armstrong, is to bleed to syncope, followed by the adminis- tration of large doses of opium and extensively irritating the whole abdominal surface. Having adopted and practised his views. I will give the details of the management of thrce cases, with their result. Mrs. F., mother of a large family, aged 35. I was called to see her two days after confinement; she complained of severe pain in her hypo- gastric region, with high fever, pulse 133, and middling as to fulness and force, slight perspiration, dark circle under eyes, sallow complexion ; she âcribed ber trouble to having taken cold through injudicious exposure. I bled her to incipient syncope, administered hyd. submur gr. j et puIv. opii. grs. ji every five hours, applied a blister over seat of pain, darkened the room, and enjoined absolute quietude. This was continued 10r six days, when the pain and fever being ccmpletely gone, castor oil 'ru administered-the bowels having remained inactive dànring this time 'which operated well and the patient steadily recovered. Mrs. c., nowther of several childrcr., had an abortion at thrce months; ittended to by an old woman. I found her thrce days after complaining oter.Y severepain in hypogastrie region, with fever and delirium; on enkeination, found a large putrefying lot in the \u0026s uteri, which ocourse was removed. I - bled her, although very weak, to inci- int fainting, and proceeded as in the other case. In eight days she 'â8 able to be up for a few minutes at a time, although at first her life g 'uite despaired of by ber friends. Several other cases might be mer.tioned, treated on the same principle, ofWhich recovered ; the prominent symptom and complaint of which, 395",
         "CANAZA MEDICAL JOURNAL. as in the foregoing, was the pain in the hypogastric or lower abdominal region. But, last summer, I was called to attend a Mrs. P. in ber frst accouchement, which was quite satisfaetory, except that the pains were weak with long intermissions, necessitating an occasional drachm of the tinet. ergot, and terminated in about ttn hours, the patient feeling pretty well exhausted. On the fourth following miorniug was called to see her, and requested from herself to bring something to quiet the nerves. On arrival I found ber nerves quite unsettled-had not slept daring the nig'ht, nipples very painful-looked depressed and complained of great weakness, dark circle under the eyes-articulation not so distinct as ?Àaual, which she aseribed to a feelir.g as of thickness of the tongue; bad asked the nurse strange questions during the night during which time the bowels had operated twice; some tymipanitis, pulse weak, quick and regular, skin cool and moistened with sweat, no pain in abdomen or pelvis, even by pressure. Supposing the trouble to be merely of the nerves, I prescribed morpb. acet. and spirit ammon, arom. with rest and quietude, and solution of gutta percha tissue in chloroform for nip- ples. The second evening after, I was called to visit her again, and on arrival about 8 o'clock, to mxy great surprise, I found her quite incoherent and much prostrated-high fever, skin bot and dry, tympanitis much in- creased, tenderness of hypogastric region, patient very weak, she thougbt she was improving, \u0026c. Treatment as in other cases venesection to S 1 sinapism to hypogastrium, pulv. opii. gr. j, et hydr. submur. gr. j every four hours, quietude, \u0026c. Next morning at 5 o'clock, was called again in haste, but on MY arrival at 6 o'clock, she had expired. The nurse said she complainedof nothing, but gradually sank. I will leave your readers to draw their own inferences as to the treat- ment and the result; but for my part, if I ever have another case of this kind, the treatment will be of an exactly opposite character. From the foregoing it must be evident to all unabiassed ininds, that the types of two diseases were met with, which are very different in their symptoms, andrequire altogether different treatment; and consequenly, that there is a radical error in the nomenclature of these puerperd complaints. According to the classification at present in vogue, eVerY inflammation of almost any organ of the body, contracted from delivery to seven or ten days after is called puerperal fever-pleurisy for instance; and' this fever was formerly described as being almost uniforMlIY fatal. Now, however, the vast majority of this so-ealled fever recoer* This improvement cannot be owing to a difference of treatment, as which is now the most successful was practised to even a greater etaDý 396",
         "DR. SPOONER ON PUERPERAL FEVER. formerly; but is explicable on the assumption, that the puerperal fever of the ancients, which was almost uniformly fatal, is now made to include their disease, and which yet retains its pristine malignity, and a great many other diseases of a simple inflammatory origin, and quite amenable to antiphlogistic treatment. It seems to me, therefore, that there are included under this specifie term two fundamentally different diseases, viz: One having its origin in inflammation of one or more of the organs, usually those of the abdomen or pelvis, apparently in consequence of the edinary exciting causes of inflammation-neither contagious nor infec- tious,- may prevail epidemically, as other inflammations sometimes do, pueumonia for example, and is quite under the power of well directed antiphlogistic medication; and a specific fever, which bas not its origin in inflammation of any of the organs but which may secondarily set up disease therein, is contagious and extremely fatal, requires a stimulant and supporting treatment, but which usually defies all medication. Dr. Churchill is one of those who favour the infiammatory theory, and he divides it into five varieties, depending upon the part inflamed, and recommends autiplilogistie treatment; but also states, with Dr. Tyler Smith, that cases occur without any inflammation manifested before or discoverable after death, and confesses that the latter are very fatal. It is evidently wrong to include under and apply one specific name to a great many different diseases, particularly if the name be the name of one of the symptoms, because its tendency is to lead to routine, and to distract the attention from the truc pathology. There is a strong tend- eney to treat the same diseuse in the same way under all circumstances, bearing a difference of degree; so, if one specifie term, bo applied to the exanthematous affections, one can readily imagine what the treatment would be; the body would be kept warn as it should be in rubeola, or cool as it should be in variola, and the resuit would necessarily be disastrous. This generalization is injurious to the student, because haing hit mind impressed with the great mnortality from puerperal fever, ho is, in its treatment at first, anxious and meddlesome ; but having had several cases as it ordinarily occurs, and conducted them te a !ctisfactory 1ssue, he falls into the error of thinking be has hit upon the Litherto nadiscovered means of successfully combating it, and his anxiety ginis Iay to ill-grounded confidence and routine; but after awhile a truc representative case of the malady occurs, and the patient becomes a a80rifice before he knows what fe is about. Clarke, C. W., Feb. 1f%. 397",
         "CANADA 31EDICAL JOURNAL. The Optical Defects of the Eye, and their Treatment, by the Scientific use of Spectacles. BY A. M. RIOSEBRUGH, M.D. (Read before the Canadian Institute, February 3rd, 1860.) The following pages were written as an introduction to a course of lectures recently delivered by me on the diseases of the eye. I havenot thought it Ticeessary to alter the form, as I propose publishing them as a pamphlet, hoping that they may be useful, not only to the members cf my ophthlae class, but to Canadian medical students generally. In their preparation, I must here acknowledge my indebtedness to the elaborate works of MIr. J. Z. Laurence and Mr. J. Soelberg Wells, of *London, and especially to the very comprehensive treatise of Professor Donders, of Utrecht, published in 1864, by the New Sydenham Society. CHAPTER I.-OPTICAL CONSIDERATIONS. The eye is pre-eminently an optical instrument, and the phenomena of vision all depend upon the laws of optics. Hence, a knowledge of some, at lcast, of the elementary principles of light is essential to a cor- rect appreciation of the physiology of the eye. The diagnosing of optical defects of the eye,-long and short sight, \u0026c., \u0026c., an'd their treatment with the scientific use of spectacles, require some knowledge of the laws of refraction, and the properties cf convex and concave lenses. The philosophy of the ophthalmoscope can hardly be understood unless the principles of both refraction and reflection are thorougbly mastered. You will, therefore, I hope, not consider the time ill-spent if, before proceeding with the investigation of diseases of the eye-you reviewwidt me some of the elementary principles of opties which lie at the foadn ation of all ophth\u0026lnmic science. The nature of light is not known. I can no more tell you what ligbt is, than your professor of physiology can tell you what life is. We knol that the sun shines, but how it shines we cannot tell. \"Two different theories have been advanced of the more intimlt nature of light.\" \" One, the Newtonian (corpuscular) conceives I1ý , each luminous point is constantly giving off a succession of lumiDO02 corpuscles which follow each other in uninterrupted succession 0n imaginary line or axis like a string of beads on a rigid thread.\" The undulatory theory (Christian Huyghens') on the other Ise considers space as pervaded by a subtle gaseous fluid or ether; thit luminous bodies have the power of communicating to this ether a 398",
         "DRt. ROSEBRUGU ON OPTICAL DEFECTS OF THE EYE. motion which affects the retina the same as vibrations of the air affect the auditory nerve. Sir John Herschel, speaking of the great ingenuity of the undulatory theory says, \"if it is not true it deserves to be.\" The sun is the great natural source of light; as it shines by its own light it is cailed self-luminous. The fixed stars are also self-luminous; so is a lighted lamp and bodies in a state of ignition. But most bodies by which we are surrounded, are seen only by reflected light. The light from an object seen by moonlight is reflected twice before it reaches the eye. The moon reflects the light from the sun, and the object the light which it receives from the moon. Every luminous object gives off, or radiates, in every direction, an infinite number of straight lines of ligIt. Each of these Unes taken alone is called a ray of liglit. A bundle of rays iscalled a beam of light when the rays are paralle/ to each other. When the rays diverge from a luminous point or are made to converge to a focus they are calied a pencil of rays thus: Fig. 1 represents a pencl of rays diverging from a flame F, after pass- ing through a convex lens they are rendered parallel and these parallel rays passing through the second convex lens B, the rays are converged to the point (focus) P. The parallel rays may be ealled a parallcl pencil ; the diverging rays 'ergent pencil, and the convergent rays a convergent penci. The point where rays of light meet is called the focal point or simply a focus. Strictly speaking, there is no such thing in nature as parallel rays; the nearest approach we have to it are the rays of light we receive from the Sua and the fixed stars. Practically, we may consider rays of light parallel that are received by the pupil of the eye from objects that are tweaty feet distant or any greater distance. Pencils of light from objects than twenty feet distant are more decidedly divergent. À good illustration of a divergent pencil -can be obtained from a ghtedlamp or candle in a dark roomi. If a piece of card board, with a 399",
         "CANADA MEDICAL JOURNAL. small circular opening in it, be held near the lamp, you will have, upon the opposite wall, an illuminated spot of the same shape as the opening in the card, but very much larger. This will prove not only that the rays diverge, but also that the rays proceed in straight lines. * Convex Lenses :-We shall now proceed to the consideration of convex lenses, which, for our purpose, is the most important part of the subject. Lenses are made of various transparent substances as amber, alum, quartz, glass, diamond, and even of ice. Those in ordinary use are made of glass. When the two surfaces of a convex lens hâve the saine degree of curva- ture, the lens is said to be equi-convex. When one of the surfaces is flat or plane, the lens is called a plano-convex lens. Glass spectacles used by old persons for reading, \u0026c., are commonly made double convex. In order to simplify the subject as much as possible, let us confine our attention to lenses that are equi-convez. In fig. 2 let A bc the centre of the circle B O D of which A B is the radius, and let E be the centre of the circle F G I of which the radius E F is equal to the radius A B. The circle P G H will be equal to the circle B O D. The part D H, common to both circles, represents a se- tion of an equi-convex lens. The lino A E is called the axis of the lens and the lino D H is called the diameter. The centre of the diameter (where it is intersected by the axis) is the optical centre of the lens. Reading glasses and burning glasses are examples of a double co nve lens. Many of you have doubtless seen the experiment of setting fire tO wood, paper, \u0026c., by means of a burning or sun glass. The explanatioaï (' Convergent pencils of light do not exist in nature. Parallel PeçnCles.o divergent pencils of rays can be rendered convergent by means ofa ceonVeÏ\" Thus in fig. 1, the rays diverging from F. are made to converge to? bytl' convex lenses, A. and B.)",
         "DR..'PROSEBRUGH ON OPTICAL DEFECTS OF THE EYE, 4u1 of tiis is simply that the convex lens possesses the property of con- verging a portion of the sun's rays to a point called the focus. In Fig. 3, P P represent a pencil of parallel rays converged to a focus at F, by means of the double convex lens L. The focus for parallel rays is called the principal focus. it is always the same distance from the optical contre in the same lens. The length of the focus for parallel rays is, ii equi-convex lenses, equal to thelength of the radius of curvature. The shorter the focus the greater is the \"power \" or \"strength \" of the lens. A lens that cnu bring parallel rays to a focus at a distance of one inch from the optical centre of the lens, would be called a one-inich Ikus. Another lens whose focusis two inches fron the optical contre, is called a two-inch lens, and se on. Convex lenses therefore receive their names according to the number of inches, or fraction of an incl, the principal focus is distant from the centre of the lens. The strongest lenses used for spectacles are those called cataract glasses; they are worn by patients who have had their crystalline lenses remnoved. Their strength ranges fron 2 to 4 inches focal length. The weakest spectacles that are ordinarily used have a focus of 36 inches. Convex lenses having a focus of 36 inches do not enlarge the letters of a book at the ordinary reading distance. Let us now sec what practical application we can make of this priniciple of convex lenses. Supposing that a person accustomed to using convex spectacles gets en of the glasses broken, and applies to you to learn the power of fthe glass that would be necessary to replace the broken one, or in other 1rords-to learn the strength of the glass that is still whole. How would 9aproceed ? One method is to use the lens as a sun glass, and ascertain bYhneasurement how far from the glass, sun's rays are brought to a focus, lfyou find, for instance, that the focus is 10 inches from the lens, you i have ascertained that the person lias been wcaring glasses of 10 inch or as they are sometimes called No. 10 convex, or simply\u002b 10 (pus 10). 'he method, however, that is usually adopted, depends upon a property a'401vex leases that will be more fully explained as wo proceed. AA VOL. IL",
         "CANADA MEDICAL JOURNAL. If, for example, you hold up a 10 inch convex lens at a distance of 10 inches from a white all-the wall being about 20 feet from au open win- dow, opposite-there will appear, behind the lens, upon the wall, an inverted miniature image of the window, and trees or buildings, \u0026c., in front of the window. If the lens be held at a greater or less distance from the wall than the focal length of the lens, the inverted image will be indistinct. Measuring the distance therefore that the lens must be held from the walF, to produce the best defined image, will give the focal length image of the lens. Suppose, now, that we bring the lens within, say 5 feet of the window, and hold a sheet of white paper at the principal focal distance behind the lens, viz., at ton inches, we will find a change in the inveted picture; there will still appear distant buildings, trees, \u0026c., but the sash of the window will be very indistinct. If, however, we move the sheet of paper 12 inches from the lens-that is, two inches further from the lens, we will again sec the image of the sash, but scarcely uny trace of the buildings, trees, \u0026e. This experiment is an illustration of the fact that the nearer an object approaches the front of a convex lens, the more dis- tant its image will be behind the lens; thus, when an object is 5 feet or rather 60 inches from the front of a 10 inch convex lens, the inverted image is found to be 12 inches bchind the lens; when 30 inches, it Will be 15 in.; when 20, that is, double the length of the focus, the image will be double the length of the focus behind thelens; viz., 20 inches; when 15 inches, the image behind the lens will be removed to 30 inches. As the object approaches the principal focal distance of the lens the image recedes much more rapidly ; thus, when at 12 inches, the image will be 60 inches; when at 11, the image will be 110 inches behind the lens. When however we bring the object to within 10 inches of the lens-that is, at its principal focus, there will be no image formed behind the lensi as the rays after passing the lens will be parallel. (I would recommend you, gentlemen, to perform all these experiment for yourselves, as in that way only can you become familiar with these in1 portant principles. These latter experiments can be performed best'l' dark room-taking for an object the flame of a lamp or candle.) From the above we can easily understand the principle, lst, that the less divergent the rays of a pencil (that is, the more nearly they approf parallèl rays,) incident or falling upon a convex lens, the nearer willthé focus of th convergent pencil be to the principal focus of the leUt 2nd, and the more divergent the incident pencil, the less converpefl (the more nearly parallel) wili be the refracted pencil, and the e distant will its focus be from the principal focus of the leins.",
         "DR. ROSEBRUGH ON OPTICAL DEFECTS OP THE EYE. Questions of the following nature very often arise in optics, viz., the length of the principal foeus-of a convex lens and the distance a certain obeet is in front of it being given;-to find how far behind the lens will the-inverted image of the object be. Or to express it more tech- nically, the length of the principal focus of a convex lens and the length of the divergent incident pencil being given, to find the length of the focas of convergent refracted pencil. Thus: suppose you have the following question: A 10 inch lens is 60 inches from an object; how far behind the lens will the inverted image be ? This could be solved immediately, by actual trial, and measurement, but this is not always practical. , The rule given in some text books on opties is as follows: multiply the length of the divergent incident pencil, that is, the distance the object is froin the iens, by the focal length of the lens, and divide by the difference ; thus: 60 x 10=600, 60-10 = 50, 600 divided by 50=12; or 6X010 00 --=--12= the distance behind the lens. ÇÛ-10 5o 'There is another property of convex lenses which I must not omit to mention; namely, what is called its magnifying power. When a convex lens is placed between the eye and an object,-the objeet being at a less distance from the lens than its principal focus, the object will appear enlarged or magnified. The shorter the focus of the lens, the greater is its magnifying power. Thus, a 4 inch lens lias a greater niagnifying power than an 8 inch Icns; a 2 inch lens greater than a 4, and a 1 inch greater than a 2 inch lens. The 1 inch lens has, in fact, double the magnifying power of a 2 inch lens; a 2 inch, double that of 4 inch; a 4 inch, double that of an 8 inch, \u0026c. The \" power \" of a lens is therefore inversely proportional to its focal length. For this reason a different form is used in expressing the !Power\" or strength of a lens. A 1 inch lens is taken as unity, and as a 2 iuch lens is just half the strength, it is simply expressed 3-, and as a 3inch lens lias just one-third the power of a 1 inch, it is written *; a 4 ulai is ¼,'\u0026c. We will find that this nomenclature is not only very Cnveient, but scientifically correct. \",For example, suppose we have two lenses of 4 inch focus each, and we -,sh to know their conbined I power\" whea used as one Ions ; we sirply -d their reciprocals thus ý \u002b ½= =. The two lenses have, therefore, e magnifying power of -, which is the reciprocal of 2, and are conse- quently, together, equal to a 2 inch lens, which oan be proved by actual easurement. Again, having a 6'inch lens, and a 12 inch lens and we to know, their combined strength, \u002b =%=½ ions which 403",
         "CANADA MEDICAL JOURNAL. represents the power of a 4 inch lens; the 6 and the 12 inch lenses taken together being equal to one lens having a focal distance of 4 inches. To save repetition, I may here state that when a concave ]eus enters into combination with a convex lens, it has a neutralizing effect upon the convex lens. If we have a convex 6 and a concave 6 the one would neutralize the other,-thus --1 = 0. But if the convex lens has the higher power, the concave lens simply weakens it-that is, lengthens its focus-thus, if we have a convez 6 and a concave 9 the result will be .- =g , z which represents the strength of one lens having a focus of 18 iuches. If, however, the concave lens has the higher ilpower \" it will siiply be weakened by the concave lens,-the combina- tion -will bc equal to a concave lens having a lower \" power\" or a longer focus than the concave lens taken,-thus reversing the last example. Suppose we have a concave 6 and a convex 9, we will then have-- \u002b - or simply ½--¾= - å=- , which represents the strength of a con- cave lens having a focal distane of 18 inches. This fractional nomenclature (taking 1 for numerator and the focal length of the lens for denominator) will assist us also in understanding the principle of the formation of images at different distances behind a convex Icns, according to the distance of objects in front of it. Let me remind you that when an object, for instance the flame of a candle, is placed ja the focus of a convex lens, the diverging rays of liglt from the object are rendered parallel by the lens. Thus, a lens having a focus of 20 inches will render parallel peneils of light diverging from an object 20 inches froi the lens. Bearing this in mind let us ugain try the solution of the following question, propounded not loIT since, viz. :-When an object is 60 inches in front of a 10 inch couve' lens, how far behind the lens will be the inverted image of the object? Or, te express it differently, when a divergent pencil of light enauata from a point 60 inches froi a 10 inch convex lens, at what distance be- hind the lens will the pencil be converged te a focus? Now we know that a lens of 60 inches focus, placed in the positica of the 10 inch lens, would render the rays parallel that fall upon it froin the object 60 inches distant. Were it possible, therefore, to divide the 10 inch lens into two lenses, one having a focus of 60 inches te render the rays parallel, the remaining portion would bring these parallel rays to a focus at its principd feocuis. Deducting then - from iv wi 1 the strength of the remaining portion of the lens - =h =-fi t two parts then and - are equal te the one lens A. And aS u will render the rays parallel fromu the object 60 inches distant, aM, these parallel rays falling upon the otlieï part -,1 they will be brou 404",
         "DR. RIOSEBRUGH ON OPTICAL DEFECTS OF TUE EYE. to a focus at the principal focus of this part, viz : at 12 inches from the lens. Let us illustrate this with another example. Suppose that an object is 30 inches in front of a convex lens of 10 inch focus, and we wish to know how far behind the lens will be the focus of a pencil of rays diverging from a point in the object. We will bave 1 -= = - ; this J represents the power of a 15 inch lens, which we know will bring the parallel rays to a focus at 15 inches behind the lens. Fig. 4 illustrates this; O represents an object 30 inches from a ten ineh convex lens; the lens supposed to be divided into two parts, one liaving a focus of 30 inches, and the other a focus of 15 inches. The 30 inch lens refracts the rays of the divergent pencil d, d, d, d, so as to render theni paralle], as shown at P, P, P, P, P. These parallel rays, Meeting the 15 inch lens, arc again refracted and arc converged to a focus at F, which is the principal focus of the lens, viz., at 15 inches. Fig. 1, page 3, represcets a 10 inch lens, at a distance of 20 inches from an object, F. The ]ces is supposed to be dividcd into two equal parts, of 20 inch focus cach: the first half renders the diverging pencil parallel, and the second half converges the parallel pencil to a focus, at 20 inches froi the leis; - = (Gr. Giraud-Teulon, of Paris, has ascribed the origination of the above theory te Mr. J. Z. Laurence, of London, to whom we arc very iuch indebted, for his prieworthy efforts te popularize this, hitherto neglected, ield Of Physiological and Pathological Opties.) Let me next direct your attention te certain optical considerations, 'Whieh have a most important application, in the treatment of optical de- fects of the eye. YOu may remember that in a fermer experiment, a 10 inch lens was held ten inches from a white wall, so as te show the miniature in- 'lerted picture of the window, \u0026c., 20 ft. distant; and that when the Iens was brought to a distance of sixty inches froi the window, it was fouend 6thet image of the window was formed 12 inches behind the lens, atead of 10 inches, and that at 10 inches the image was se indistinct as O be Scarcely recognizable. NOw suppose that a 12 inch lens be immovably fixed 12 inches from",
         "CANADA MEDICAL JOUCRSAL. the saime wall, it wilil then be in a proper position to bring parallel raye to a focus on the wall, where it will form an inverted picture of the win- dow, and objects at a distance beyond the window. If we now bring the fiarne of a lanip, for instance, to a distance of GO inches from the lens, no distinctly defined image of the fiaie will appear upon the wall; but if, by any ineans, we can render the pencil parallel tbat diverges froi the ûame, the 1 2 inch lens will then converge t accurately to a focus upon the wall, whcre we wiii have an inverted image of the fiaiie. Froin the knowledge that we have now obtained, we know that a 60 inch lens placed in front of the 12 inch lens will render these rays par. allel. All that we have to do then is to combine a 60 inch lens with the 12 inch lens : the 60 inch lens to render tie rays parallel that diverge from the flame, 60 incles distant, and the 12 inch lens to converge these rays to a focus, at the principal focal length of the lens. This is exactly what we do in supplying old people with convex spectacles. Their eyes are constructed to biring parallel rays to a focus, on the retina; but the rays froin near objects are to divergent to be brouglt to a focus upon the retina without artificial aid; this deficiency is 'what we supply with suit able glasses. Before leaving the consideration of oltieal lenses, there is one subjed to which I wish to direct your attention; namlcly, the formation of au inverted image behind a ceavex lens. Many of you are probably familiar with the fact, that when light i admitted into a darkened roomr, through a sinall orifice, there appea upon the opposite wall of the room, an inverted, diin, shadowy picture of buildings, trees, \u0026c., in front of the aperture. This can also be sccP, Ou a smaller scale, by holding a sheet of white paper a few inches froin te key-hole of a darkened hall. The cause of this is exphained by Fig. 5. Let A B represent the position of a fûame of a lamp that.is distance in front of an aperture of a darkened box. Pendils ofdiverd rays of light radiate from the apex of the flame in every directiU ý of these pencils is represented in the figure to iluminate the end 4M6",
         "DIL ROSEBRUGH ON OPTICAL DEFECTS OF THE EYE. box. and one of the rays escaping through the snall orifice c; this ray passes in a straigtt Une to the back of the box, and strikes the point a, which it illuniintes. Rays of light diverge from the lower part of the flame, also; ore of these rays is shown to enter the aperture c, and to pass to the baek of the box at . lu a sinilar way it might be illustrated that pencils of light radiate from every point in the flame A B. and that one ray fromn each point passes into the box and illuminates a portion of the back. Il this way we have an illumina ted spot at the back of the box, vhieh is an exact counterpart of the flame in front of the box, but inr)tCd, the apex of the fame poînting dowuwards. Tte reason that the picture is reversed is that, as rays of light (in the sanie mediunm) pass in straight lines, a ray from the top of the flame, after passing tIe aperture, must ncessarily pass to the lower part of the back of the box ; and a ray froi the lower part of the flae must necessarily (in moring in a straight linei pass to the upper part of the back of the box. You will observe, also, that the size of the image depends upon its distance beliind the aperture ; if the imtaze is as far behind the aperture, as tc object is in) front, the ima:ge will te of th same size as the object, if half tte distance, half hIe size, as seen at f Ifin the above experiment, the aperture te enlarged, it will be fbund that the image at the back of the box vill become much less distinct the More the aperture is enlarged, the more indistinct will be te i ge. The reason of this indistinctness in tte image is that, when the aperture Isenlarged, a nuinber of diverging rays frou one point in tthe ilnc pass through the aperture, and eadh one repeats the image, so thut tIe parts of tbe image overlti) each other. This is shown in Fig. 6. A B represents the fane of the lamp, and 0E D F the image behind an aperture. The aperture is supposed to be jst large enou41 to admit two divergent rays, each of these rays pro- aIces a separate image ; thus, the point A is repeated twice at 1) and F, and the point B is repeated at C and E. The larer the aperture, the 'ore light is admitted, but the more indistinct is the image. now, a convex leus be inserted in the enlirged aperture, these \"\u0026yerent rays that enter the aperture (from every point of the object) 0 COverged to a focus ; thus, in 407",
         "CANADA MEDICAL JOURNAL. Fig. 7 Fig. 7. A C represents an object in front of a convex lens, and a c the inverted image behind the lens. Rays diverging from the point A and falling upon the lens L are brought to a focus at a ; rays from B are similarly focussed at b, and so on. In a siinilar manner, diverging rays from every point in the object A C that enter the lens, are brought to a focus in the image between a and c. We will then have in tbe position of a e a distinct inverted image of the objcet A C. If this image is rceeived upon a sheet of white paper, we cati sec it only upon its front surface; but if it is received upon thin oiled paper, or upon ground glass, we can see it from behind; and if, while viewing the image from behind, the ground glass be removed, we can still sec the in- verted image (or at least a portion) occupying the same position as the ground glass just occupied-being suspended, as it were, in the air, and forming what is called an -,rial image. In order to see this ærial iniage under favourable circumstances, one eye only should be used, and should be in a line -with the lens and the object, and should be at least teninches behind the position of the inverted lens. CHAPTER II.-OrTICs or NORMAL EYE. The human eye, fron before backwards, is about one inch in diameter. Its transparent media are the cornea, aqueous humour, crystalline leas, and vitreous humour. This combination, witli the convexity of the cornea, igequal to a couvex lens having a focus of about on? inch (mor accurately !- of an inch. When a normal eye is directed to a distant object (i. e. in a state of rest), parallel rays of light are brought to a focus upon the retina, end 0, very minute inverted picture of the object is sharply defined upon that membrane. If the sclerotic coat be removed froni the back of the eye 0f an ox, and theeye be placed in an aperture of a darkened room, witht0e cornea looking, for instance, towards the opposite side of the street, a,",
         "DR. ROSEBRUGH ON OPTICAL DEFECTS OP THE EYFa. in'verted imiage of the buildings \u0026 * ate ma of the bu gs, c., in front of the aperture will be seen at the back of the eye. The impression that objects make upon the retina, is conveyed through the optic nerve to the brain, but in what manner this commu- nicates to the mind a knowledge of the appearance of objcets, is more than wc ea tell. We can simply say with Potterfield, that ,\" God has willed it so.\", We are aware, however, that although the eye nay bc free from dis- ease, and the connection between the retina and brain in every way perfect, if the optical nmechanismi of the eye be in any way defective so as to produce ill-detined images upon the retina,--vision will bc indis- tinct, and that the distinctness or indistinctness of vision will be in exact proportion to the ldistinctness or indistinetness of the inverted pieture. lence the necessity of undcrstanding the optics of the eye in order to comiprihe ti e pathology and treatment of the numerous opti- cal defeets to wliiîa it is liable. CisE 1.-Let me here take an example. A few weeks ago a physician if this city sent a patient for my advice, fcaring that hc was losing the Siglit of lis left eye. Upon examination, I found that lie lad what we eau Iparalysis of accommodation \" of that eye. Rle could sec distant objects with perfect distinetness, but near objects e was unable to defre; lie could not read large type unless the letters Werc very large, and several feet fron the eye. The eye was, in fact, sirply passive, like a convex lens, or a camera-obscura with the screen to recve tlie image inmovably fixed at the principal focus of the lens, and Could only bring parallel rays to a focus on the retina. I found that by rendering the diverging rays parallel, by means of a Convex lens, lie could sec near objects distinctly; by placing a six inch eOnvex lens before that eye, lie could read fine type at six inches, with a tel' inclilens at ton inches, with an eighteen inch lens at eigliteen inches the \u0026et The six inch lens rendered the rays paral:cl that diverged fron the letters six ineies distant, and these parallel rays falling upon the eye Were brouglht to a focus upon the retina. [A six inch lens does not in- erase thc apparent size of letters one-half, whereas this patient couldnot \"I ltters ten times the ordinary size at six inches, or any distance less tha about two fet from the eye.] The ten inch lens rendered the rays Paralel froin objects ten inches distant, and the cigliteen inch lens from ebject5 eighteen inches distant. The oye was unab'e to bring diverging rays to a focus upou the retina; In otherwords, it lad Iost the power of \" accommodation.\" (We can tem- 409",
         "410 CANADA MEDICAL JOURNAL. porarily paralyse the accommodation of the eye by applying a strong solution of Atropine.) A normal eye differs from the glass lenses we have been describing in the fact that it can, not only focus parallel rays upon the retina, but also rays that diverge from objects as near as fron four to six or eight inlches from the eye. When parallel rays fali upon a one inch convex lens, they are brouglit to a focus one inch beiind the lens, but if au object, for instance the flame of a lamp, be brought to within f\u003cur inches of the lens, we know that the focus will fall furtier than one inch behind the lens. If we wish to receive the inverted image of the lanp upon a screen, the sereen inust be held one inch and a third behind the lens. Now when an object is brouglit to within, say four inches of the eye, it has no power to move the retina backwards to receive the image that would be formed behind that membrane, but, what answers the same purpose, it has the property of so far increasing its refractive power, as to bc able not ouly to render parallel these diverging rays, buL also to focus them upon the retina. This incrcase in the power of the eye is equal to the addition of a four inch lcns in front of an eye that has itq \" accommodation\" paralysed, as a four inch lens rendors rays parallel that diverge fron objects'four inches distant. Fig. 8 represents the section of the normal eye. Whcn it is accom. mnodated for distant. objects parallel rays P P are focussed upol the retina at F, while diverging rays froin , would form a focus at fd. When, however, the eye is acconmodated for the near object 0Othle6 diverging rays are focussed upon the retina at F. The manner in which this increase in the refractive power of the eye is effected is still a disputed point. Most physiologists, howCvereî are now inclined to the theory that it is caused by an increase 1 curvature,-a thickening fron before backwards, of the crystalline lS The accommodation of the eye was at one tirne believed to be pro n e the external muscles, but it is now ascertained that the accomm0dto remain perfect with all the external muscles paralysed.",
         "DR. ROSERRUGH ON OPTICAL DEFECTS OF THE EYE. The Inear \" and \"far \" point.-The nearest point to which objects can be brought to an oye and be seen with perfect distinctness, is called the \"near point, and the farthest point of distinct vision is called the \"fur\" point. In a normal eye the near \" point is about seven inches from the front of the cornea, and the \"far \" point is at an unlimited distance. In childhood, however, the \"near \" point is about 31 inches frovn the eye, nd recedes as age advances. At the age of forty the \"near \" point of a normal eye is nearly eight inches from the eye. When the \"near \" point recedes to a greater distance than eight inches from the eye it becomes inconvenient; sneh an eye is called pres- kyopic or long-sighted. When the \"far \" point is not unlimited, but is at a definite distance from the eye, as, for instance, from six inches to four or five feet from the eye-such an eye is called myopic or short-sighted. Range ofAcconmodation.-The distance between the \"l near\" and \"far\" point in any eye is called the \"range of accommodation.\" If a person eau read distinctly very fine type at four inches from the eye, and can also see clearly at an infinite distance, the range of accommoda- tion would be said to equal ¼, because when such an eye is directed to objects at an inflaite distance, (accommodated for parallel rays) in order to see clcarly objects only four inches distant, it is necessary to increase the curvature of the crystalline lens, or, in other words, the \" power \" of the oye to an extent equal to the addition of a four inch convex lens; the power of which is expressed by î. If a person's Il near \" point is at eight inches from the eye, and his \" far ' point at an infinite distance, his range of accommodation would be said to be equal 1. If the \" near \" point of a myopic eye be threc inches, and the \"far\" point be twelve inches, we get the range of accommodation by the equa- tion g- L . (To be continued.) The iris was thought, by others, to have the power of increasing the refrac- tive power of the eye, but it was proved by a case that occurred in Dr. Von Graefe's practice that accommodation can stili be effected with entire absence of the iris. Iehnèholtz and Cramer have proved, by meaus of the ophthalmnomctre, that When the eye is accommodated for a near object it undergoes the following hanges :-Ist. The pupil contracts ; 2nd. The pupillary edge of the iris moves frard; i3rd. The peripheral portion of the iris moves backwards ; 4th. The 4terior surface of the lens becomnes more convex (arched); 5th. The Jena DOt change its position ; 6th. The cornea retains the same degree of cur- atore.",
         "CANADA 31EDICAL JOURNAL. The Removal of a Foreign Body after Twenty-Five years presence bencath the Skin of the Upper Arm. By G. P. G1anwoon, M.b., M.R.C.S.E., late assistant-surgeon lst Battalion, Grenadier Guards. Mr. W - , vhose wife I was attending at the time, casually asked me one day -whether it was a painful operation to remove a splinter from under the skin of the arm. I replied not. He then said that twenty-five years ago, as a child, hc fell whilst playing on an old waggon in bis native place, and ran a splinter of wood into bis right arim, on the inner side, inmediately overthe centre of the course of thebrachial artery, when it was broken off in the arm. A snall portion was removed at the time, but the other and mucli larger portion remained behind, and the wound healed over it. He said he would consider about having it removed, and nothing was done at that time. A few days afterwards, a friend caught hiih by the arin and gave him a squeeze, and appa- rently forced the one cnd of the splinter through the skin. When Isaw him again it was to ask nie to renove the splinter. On examination, I, found a small tumour just beneath the skin in the position already nen- tioned, about one inch and a quarter lorg, and half ai Inch wide, the long axis being across the artery. Over the centre of this tumour was a small abrasion of the skin nearly healed up. The splinter was readily removed bv a small incision aeross the one end, and drawing it out with a pair of forceps. There is nothing in the operation that makes this case worthy of record. Is is, however, an interesting fact, that a fragment of wood, a little more than an inch in length and half an inch wide and thre' cighths of an inch thick should remain embedded in the tissues for a period of twenty-five years. Bullets, metallic ligatures, and sutures we know, will remain for years without giving any trouble unless they are pressing on some nerve or artery, but it is *not often we have the oppor- tunity of secing fragments of organic matters being so enbedded. l this case mo discomfort was expcrienced until an accidental pressur caused a protrusion of one end through the skin. To avoid a recurrenDc ofsuch an accident, my patient determined to- have the splinter remaoved",
         "SYPHILITIO CACHEXIA. HOSPITAL REPORTS. Case of Tertiary Syphius-ÀWuminuria-probable Waxy Degene. ration of Kidney, Spleen, \u0026c. Direct Pulnonary .Mfurmur. Under the care of D. C. MACCALLUM, M.D. Reported by Mr. J. MC- CURDY. John Brown, aged 29, an immigrant, unmarried, was admitted into Montreal General Hospital on the 27ti December, 1865, under the care of Dr. MacCallum. listory.-W bile a soldier in the Crimea. twelve years ago, he con- tracted a chancre, which was followed in a few weeks by a cutaneous eruption on the trunk and forehead, of twenty-four days' duration,. Since that time, he has, till lately, been free from any cutaneous affec- tion. For the last few months he has been getting thinner and pale, be- coming casily fatigued on exertion. In his passage from Ireland to this country, he was sea-sick during the whole period; and, when lie landed, he was extremely weak, had occasional bleeding at the nose, and frequent vomiting, He notices that for sone time back he has been making More water than usual, and that ho is obliged to rise frequently during the night to void it. Symptnoms on admission.-He is of light complexion, freckled, with a hrsh dry skin. His appearance is aantmic, and the exposed portions of the body have a peculiar dusky-yellow hue. There is no oedema of the face or ancles. Tongue is coated and moist. Pulse 84, regular. Cica- trir of chancre on glans penis, and of buboes in the right groin. Syphi- litie lepra (L. gyrata) in circular and crescentie spots, on the right arm surrounding the elbow-joint, on the inside of the left elbow, and on the ront of bis forearm, on the trunk below the right nipple, and in the ght and left iliac regions. Large irregular spots on inside of right iýgh, and outside of left. Nodes on shins, with marks of old ulcers. large erescentie spots on outside of both fore-legs. On the arms and body are white circular, slightly eroded spots-remains of a tubercular 8eptiginous irruption. A blowing systolie murmur is heard at base of heart. Most distinct, ofld harsi quality, at the pulmonary cartilage. Very indistinct at eartilage, and not propagated along aorta. Rapid loss of intensity Og lefà side of heart, and scarely heard at left apex, but propagated a1Vfg1y down the right side, and heard very distinctly at the rigit apex. aPer beat is in the normal situation, and transverse dulness not in-",
         "CANADA MEDICAL JOURNAL. creased. A loud, very musical bruit de diable is heard in the veins of the neck. Spleen is enlarged, and painful on pressure. Its line of vertical dul- ness is seven inches and a half in extent, and it reaches forward to'within four inches of the middle line of the abdomen. Its lower edge reaches to within three inches of the upper border of the ilium, and is found, by palpation, to be firm and easily defined. Liver is very slightly enlarged in the downward direction. lis bowels have always been regular. Urine is pale, sp. gr. 1015, of acid reaction, containing a large amount of albumen. Result of examination of the deposit is not decisive. The blood has relatively a large number of colourless corpuscles. Diagnosis.-l. Tertiary Syphilis. 2. laxy Degeneration of Kid- 'neys, Splcen, and possibly, of.other Organs.-All that is wanting to. complete the diagnosis being the presence of hyaline casts in -the urine A Direct Pulmonary tturmur.-On the following grounds. It has its greatest intensity at the pulmonary cartilage, it is propagated with litle loss of intensity along right side of heart to right sXpex-towards the left apex, with intensity greatly diminished, and up the aorta to scarcely any distance. Still the contrast between its characters as heard at the aortie cartilage, and that which it is found to possess at the pulmonary valves is greater than would obtain, if the sound were communicated to the pulmonary artery, from a bruit originating at the aortie orifice. The absence of swelling or pulsation in the veins of the neck, of signs and: consequences of pulmonary congestion, preclude the existence of regur- gitation through the tricuspid orifice. - Progress of the Case.-30th,, Vomiting biliary matters. Tongue furred. and urine seanty, ordered haustus albus (magnesia carb. et sulph. nocte. 31st. Bowels not yet moved, but experiences less nausea. Fu On milk diet, mutton chop extra, and ordered to take, tr. ferr e mxx. aeid. nitrom. in x. ter in die. . . Jan. 1st. Bowels frecly moved, urin7e more ceopious, sp. gr. 1 Urinary deposit contains no hyaline. casts, but an abundance o?.lag crystals of oxalate of lime ;;urozanthine in slight excess. 2nd. Passed in 24 lis. 34 oz. urine, sp. gr. 101,6;surea, (caleulate means ofRev. Dr. Houghton's table, from amount of urine in 24 hs ad gr.) 256 grs. Albumen (anount in 2 oz. ascertained ,by drying weighing the precipitate obtained.by boiling with nitrie acd) 13 1 oz. or 442grs. in, 24 hs. - Tenderness on pressurehas disappeare the spleen which retained its former dimensions. 3rd. Albumen of same amount in urine. Bowels continue ope 414",
         "SYPHILITIC CACBEX1A. 415 4th. Passed urine 79.5 oz. sp. gr. 1012. Urea 470 grs. Albumen 3 grs. to 5j. or 239. One hayline cast was discovered after a vigorous search. Still oxalate of lime; urine of last 120 hours still acid. 5th. Passed urine 101 oz. sp. gr. 1012, urea 561 grs. Albumen 3 grs. to j. or 354 grs., acid when passed but that of 24 hours has an ammoniacal odour and a deposit of phosphates. 6th. Passed urine 112 oz. sp. gr. 1013, urea 740 grs., albumen 5 grs. to j. or 560, still much urozanthine in urine, few or no oxalates. Cardiae murmur is becoming more intense over the 3rd costal interspace. Pa- tient sleeps but little, and continually complains of cold. 7th. Passed urine 112 oz. sp. gr. 1013, urea 662 grs., albumen 2' grs. to 5 j. or 255. The albumen of the last few days differs in character from that previously obtained. Formerly it used to dry into a semi- transparent, vitreous substance resembling gum-arabic, but now it is gelatinous whcn fluid, and dries into a dark pulverulent mass. 8th. Passed urine 110 oz. sp. gr. 1012, urea 650 grs., albumen 4 grs. to ::j. or 440 grs. After coagulation and separation of albumen, the urine remained eloudy. Upon adding tests for. urozanthine no narked change in colour ensued, but a colourless jelly was obtained by agitating it with ether. The cardiac inurmuri is to-day harsh, almost rasping, and the peculiar methods of its propagation are still more stril, ng. Patient drinks a great deal of water, sometimes as much as conggs at night. Lepra fading from the trunk. White blood corpuscles not quite as numerous as before. The blood ivas examined both before and * ýter his dinner, and shewed a considerable increase of colourless cells at the latter period. 9th. Passed urine 106 oz. sp.gr. 1012, urea 638 grS. albumen 7?. grs. to or 759. Albumen of to-day easilyBeparable, and dries into a trans- Parent mass. Complains of pains in the epigastrium. Stop mixture, zPulv. IRhei. Co. 3 j. and sinapsims to pit of stomach. 10th. Passed 95 oz. sp. gr. 1011, urea 508 grs., albumen 3, grs. to 5*j. or 333. Bowels freely moved and pain much diminished. Ordered HIey water. 1j1th. 1assed urine 104 oz. at sp. gr. 1011, urea 552 grs, albumen 4 to, 5j. or 416. . The deposit contains hyaline casts in abundance, 'îthInany squamous trigonal cells. Tenderness on pressure over the er edge of the spleen,, and excessive pain occasioned by palpation er region of left kidney. th. Passed urine 122 oz. sp. gr. 1010, urea628 grs. Albumen 2½ grs. or 305. Albumen tenacious, and separable with difficulty. Mix- to be resumed. -415",
         "41b CANADA MEDICAL JOURNAL. 13th. Passed urine 134 oZ. sp. gr. 1009, urea 670 grs. Albumen 3 grs. to jor 402. 14th. Passed urine 92 oz. sp. gr. 1010.5, urea 502 grs. Albumen 3 grs. to j or 294. 15th. Passed urine 118 oz. sp. gr. 1010.5, urea 607 grs. Albumen 41 grs. to jor 521. 16th. Passed urine 135 oz. at sp. gr. 1011, urea 722 grs. Albumen 7 grs. to j or 945. The cardiac miurmur remains the same in intensity and modes of transmission. Tenderness, still, in kidney and spleen. The latter retains its former dimensions. There is feit a slight venous thrill on pressing lightly over the veins of the neck, and a remarkably musical homie murmur is still to be heard. Patient looks nuch better. Lips are redder. Lepra fading slowly. Ordered beer one pint. 17th. Passed urine 155 oz. at sp. gr. 1011, urea 820 grs. Albumen 6½ grs. to j. or 1008. Blood examined to-day. White corpuseles in same ratio as before. Red corpuscles do not colleet in rouleaux, but aggregate in masses, and when a current is created by pressing on the thin glans that covers them, they adhere to each other in passing, streteli out for some distance, and separate in a tailed form. 18th. Passed urine 124 oz, at sp. gr. 1011, urea 658 grs. Albumes 4 grs. to j. or 496. Tenderness in spleen increased. Stop beer, and apply sinapisms to the spot. 19th. Passed urine 114 at·sp. gr. 1011, urea 606 grs. Albumen1i grs. to j. or 342. 'Pain and tenderness in spleen excessive. Mixture stopped. 1 ant. tart. gr. ½, liq. amm. acet. 3 ij. oan., 4 horis. Torub forming a scum in 24 hs. urine. 20th. Passed urine - at sp. gr. 1011. Alb. 3r grs. to j.or,- Cannot lie ou left side. Stomach very irritable. Mixture to be taken in one-balfilose. 21st. Passed urine 41oz. sp. gr.1013,urea 266 grs. Albunien 2(gr to ' j. or 103. Mauy granular casts, noue were perfectly hyalined Uri smoky appearance. 22nd. Passed urine 102 oz. at 1012, urea 602 grs. Alb. 2 gr j. or 204. Slight swelling of the face, and pallor. Spleen measu ins.in a vertical direction, Pain less complained of. Mixture stoppW, To have two ounces of Gin. 23rd. Passed urine 115 oz. sp. gr. 1011, urea 550 grs. AlbuIiM gr. to j or 173. 25th. Passe\u0026 urine 131 oz. at 1010.5, urea 593 grs. Albimen 2gb to 5 j. or 262., At 4 p. -n. suddenly seized with a violent pain loins, especially severe on the left side.",
         "TERTIARY SYPHILIS. 26th. Passed urine 122 oz. sp. gr. 1011, urea 648 grs. Albumen 2 grs. to j. or 244. Pain in forehead very severe. Has lost sleep during last 48 hours. Left eye congested, its sight is confused. Face odema- tous, especially the left side. Pulse full and frequent. Tongue coated. I Plv. Jalap Co. »ij. Gin to be stopped. 27th. Passed urine 65 oz. at sp, gr. 1010, urea 335 grs. Albumen grs. to j or 423. Powder has not operated. Edema of face still greater, and pain almost unbearable. Patient is almost delirious, and experiences twitchings of the limbs, 13 croton oil mj, castor oil 3 ij. 28tb. Passed urine 31 oz. at 1012, urea 182 grs. Albumen 2± grs. in 5 j or 70. Copious watery evacuations. Pain much relieved, and edema of face visibly subsided. Appetite returns. 29th. Passed urine 79 oz. at 1011, urea 420 grs. Albumen 5 grs. to \"j. or 395. Still remains easy. Slight pain still remains over loins, and sensitiveness on pressure. Murmur, as beard at right apex of heart, is more intense than pver before. 30th. Passed urine 77 oz. at sp. gr. 1011, urea 409 grs. Albumen 54 grs. to j. or 504. 31st. Passed urine 101 oz. at sp. gr. 1010, urea 516 grs. Albumen 3 grs. to j. or 303. Patient is much improved in appearance, Appetite- greater. Sleeps more soundly. Cardiac and venous murmurs remain as, before. There is slight odema of the face. The specific eruption bas, almost entirely disappeared. There are slight traces of it only on the- lower limbs. Urozanthine is not in great excess present in the urine,. and oxalate of lime has lately been never found, Blood still exhibits a tendency to fibrinate, and the colourless corpuscles are still in excess. 4pleen's vertical dulness nine inches, its anterior border beiag felt three inches from the middle fine of the abdomen. The following table bas been compiled for the parpose of showing at glance the varying amounts of urine and albumen voided daily, and the totals for one month. Its consideration may also tend to throw some %ht on the circumstances that attend the occasional appearance of hya- niiasts in the urine, and the changes that congestion of the kidney Iay effect in the material of the casts. y the rough modes of computation employed, it will be seen that the test amount of urine passed in one day was 155 oz, and the least 31 The largest quantity of albumen for the sa me period, 1008 grs., he smallest 70 grs. The waxy ceasts appear to have been desquamated time, wheu, for some cause, the urine was suddenly diminished in aat The albumen was not materially affected on these occasions. BB fVOL. Il. 417",
         "CANADA MEDICAL JOURNAL VPEA. ALB. TO TOTAL AL. DAT. UR1MIN oz,0 SP. Gr. GRS. GRS. GBS. Jan. 1, 1866 - oxalite 1011 - - - \" 2, \" 34 casts (?) 1016 256 13 442 \"c 4, \" 79.5 oxal. no. 1012 470 3 239 \"i 5, \" 101 casts or 1012 561 3.5 354 4 6, \" 112 oxalates 1013 740 5 560 't 7, 102 none 1013 662 2.5 255 \" 8, \" 110 \" 1012 650 4 440 9, \" 106 c 1012 638 7.5 759 10, \" 95 c 1011 1 508 3.5 333 11, \" 104 casts 1011 552 4 416 4 12, \" 122 none 1010 628 2.5 305 \" 13, \" 134 4 1009 670 3 402 \" 14, \" 98 \" 1010.5 502 3 294 \" 15, \" 118 4 1010.5 607 4.5 521 \" 16, \" 135 \" 1011 722 7 945 \" 17, \" 155 4 1011 820 6.5 1008 s 18, \" 124 \" 1011 658 4 496 I 19, \" 114 \" 1011 606 3 342 \" 20, \" -- 1011 - 3.5 - \" 21, \" 41 casts 1013 266 2.5 103 \" 22, c 102 none 1012 602 2 204 \" 23, \" 115 \" 1011 550 1.5 173 \" 24, \" 131 \" 1010.5 693 2 262 \" 26, \" 122 4 1011 648 2 244 \" 27, \" 65 t 1010 335 6.5 423 \" 28, \" 31 4 1012 182 2.25 70 4 29, \" 79 \" 1011 420 5 395 \" 30, \" 77 \" 1011 409 5.25 404 4 31, \" 101 \" 1010 516 3 303 Total.. ..2717.5 29329.5 14871 124 10687 Average.. 100.65 1011.4 543 4 395.7 REVIEWS AND NOTICES OF BOOKS. On the Diseases, Injuries, and Maformations of the Rectum and A40i with Remarks on Habitual Constipation. By T. J. AEHTA formerly Surgeon to the Blonheim Dispensary, Fellow of the ll Medico-Chirurgical Society, Corresponding Fellow of the Pt1 logical Society of Montreal, \u0026., \u0026c. With illustrations. 000 American, from the fourth English edition. Philadelphia: 1e3q C. Lea. 1866. Montreal: Dawson Brothers. Of the numerous diseases which come under the observation 0 surgeon, none, perhaps, are met with more frequently, or cause trouble than those which are embraced under the various heads of,ïo- work; and a somewhat singular fact is, that authorities on the",
         "DISEASES OF THE RECTUM AND ANUS. are not at all numerous. Standard writers upon surgical topies glance but briefly at this class of diseases; and often, indeed, will the enquiring student search such works for the desired information, but in vain. This is to be regretted, for there are many practitioners unable to afford fre- quent additions tol their library, and depend upon text books for all necessary information in time of need. When, however, such an addi- tion can be afforded, we can recommend this volume of Mr. Ashton's in the strongest terms, as containing all the latest details of the pathology and treatment of diseases connected with the rectum. We have read the greatest portion of the work with a good deal of care, and although wc cordially recommend it as an authority of great merit upon the subjects of which it treats, yet there are one or two faults, to us so conspicuous, that we feel that we cannot omit to mention them. First of all then, to our idea, Mr. Ashton commits a fault-one which is common to many authors-and that is, instead of simply writing a work for the benefit of ris professsional brethren, there is an attempt, every here and there, to show what wonderful cures were performed by him upon Mr. So-and-so, who came from some great distance for the purpose of obtaining the benefit of his experience. We do not for a moment doubt the correct- ness of the statements made, and no one who reads the book will doubt that its author has both talent and experience on the subject on which le writes; but we do object that, in a work of such practical utility as the one in question, there should be anything which would give rise even to a possible suspicion that the author's object in publishing the work 'Was to push his own professional reputation and extend his practice, rather than to benefit the science and art of medicine. One more slight fault that we have noticed is that here and there we have come upon repetitions, following close one upon the other. Perhaps this latter is irdly avoidable, and, therefore, we do not lay much stress upon it; but the former is so often noticed in works that, however unwilling, we feel that it was not right to pass it over without comment. The first chapter of the volume is on itching and irritation of the anus, a very prevalent disease, whieh Mr. Ashton states is often regarded as a local complaint, hule, in truth, it is but a symptom of a constitutional disease. Local reraedies are, however, at times useful, and he speaks favourably of ltions of acetate of lead, with vinum opii, black wash, and ointments ofzinc and lead. Chapter V. is on Fissure of the Anus, and Lower art of the Rectum. This disease is of very frequent occurrence, and ties rise to more suffering, in proportion to the pathological condition f .the structures involved, than, perhaps, any other ills to which the an frame is liable. 419",
         "CA-NADA MEDMAL JOUR!NAL. \" If the fissure exists at the verge of the anus, and is of recent origin, the patient must be directed to have recourse to ablution with soap and water, night and morning: after evacuating the contents of the bowels, half a pint of cold or tepid water should be thrown up - and when this has been ejected, a small piece of lint, saturated with a lotion of a solu- tion cf leed with opium, or one of similar properties, must be kept applied to the part. When there is much spasm. of the sphincter, the extract of belladonna, in the proportion of a drachm of the extract to an ounce of spermtaceti ointment, or ointment of acetate of lead, is commonly suc- eessfýil in relieving this distressing symptom. Belladonna has been em- ployed in combating pain and spasm in diseuses of the rectum by many eminent surgeons for a number of years. \" If, after a fair trial of the simple ineans that have been recommended, the fissure does not heal, but on the contrary, the edges become indu- rated, and the surface pulpy and indolent, the free application of the nitrate of silver, at intervals of a few days, for two or three times, wll generally induce a healtby reparative action in the part, though often at the cost of much pain to the patient. The use of belladonna ointmeut and enemata after stool must be continued. \" But cases will occur in which both these plans fail, and it willbe necessary to have recourse to a modification of the operation recom- mended by M. Boyer, namely, incision, through the ulcer; but it needs not be carried through the sphincter, as lie advised, though since his time, and even at present, the greater number of surgeons divide the parts to the extent he recommended. \" The operation may be performed in two ways, either by cutting from within outwards, or without inwards. In either mode the patient must rest on his side. with bis knees drawn up and the buttocks projecting over the edges of a sofa or bMd, or he may lean over a table or back of a chair. For the purpose of cutting from within outwards-the plan hitherto generally adopted-a straiglit probe-pointed knife will be 111st useful; it is made thieker at the back than an ordinary bistoury, by which a ridge or button on the end is rendered unnecessary. The fâe finger, previously oiled, being introduced into the rectum, the knife must be pressed fiat upon it till the point reaches the upper margia f fssure or ulcer, when its edge must be turned, and an incision s through the mucous membrane, without extending it through the Ochb structures. The other mode of mnaking the incision is that advoedt by M'r. Syme, and is performed by transfixing the ulcer beneat' base with a small, sharp-pointed curved bistoury, and cutting inD$W through its centre; the opposite side of the bowel must be proteele the introduction of the finger, as previously directed.\" 420",
         "DISEASES OF THE RECTUM AND ANUS. 4Z1 The most important chapter, however, is that upon Hoemorrhoidal Affections, and it is impossible for any one who reads it attentively not to be struck with the very practical value of Mr. Ashton's remarks. He gives Montègne's classification, dividing hoemorrhoids into eight varieties, but at the same time says, \" No better classification can be adopted in respect to the pathological structure of the several tumours, as well as to the treatment to be pursued, than the division into internal and external hIzmorrhoids.\" Internal hemorrhoids, he says, consist of three varie- ties. \" The first consists of loose folds of mucous membrane, with the Submucous cellular tissue hypertrophied, the arterial capillaries abnor- MIally dçveloped and actively congested, the venout radicles being in a like condition. When these tumours are prolapsed, they are seen to be of a bright-red colour, spongy in texture, the surface villous like the conjunc- tiva in chronic ophthalmia ; they readily bleed, the blood being spirted out ln fine jets, as if from dilated pores, or oozing from the general surface. Its character is arterial. These tumours are usually attached by a broad base near the upper margin of the internal sphincter; sometimes the anal integument is implicated cither from the great size the hæmorr- hoidal tumours have attained, or their originating near the external Orifice. In the second variety the tumours are more solid, somewhat round or pyriform, with a smooth dull-colour surface. They are attached by a peduncle, and, when iot prolapsed, lie in the pouch of the rectum above the internal sphincter. They are composed of mucous raembrane, hypertrophied cellular tissue, and veins having their tissues tauch thickened. The third variety differs essentially from the two pre- teding, and its character would be more clearly indicated by the term Vascular exerescence, it being a fiorid, excessively vascular, granular Condition of a portion of the mucous membrane, seldom exceeding a Shilling in size, and generally much smaller.\" As ointments to be applied by means of bougies to internal hæmorr- hoids, Mr. Ashton speaks most favourably of combinations of conium, Opium, or hyoscyamus, with spermacetic ointment (ten grains of either to the ounce) ; and, for the relief of excessive hæmorrhage, injections of iced water or solutions of copper, logwood, \u0026o., are recommended; but he says he places much dependence on an injection of tannic acid, about a drachm to twenty-four ounces. At the same time, sulphurie acid or meetate of lead andopium must be given internally. The radical treat- tuent of this form of disease is, of course, removal by means of the liga- tire, although, somewhat strange to say, Mr. Ashton does not seem to think that there are many cases which will not be sufficiently relieved by local applications. He says,",
         "CANADA MEDICAL JOUENAL. \"In the majority of cases it will not be necessary to interfere surgi- cally with internal piles, if the patient strictly attends to the instrue- tions of his medical adviser with respect to diet and exercise. Even when the tumours are large, and have existed for some time, the use of soap and water externally, night and morning, the injection of coli water or lime water after cach dejection, and keeping the bowels easy, will enable the subjects of them to pass their lives in tolerable comfort.\" This fact we are not prepared to deny, but must be allowed to express our doubts of its correctness. External piles must be removed, this being the only satisfactory treatment-although other plans cf treatment may be adopted-but it will only relieve for the time; ulItimately recourse must be had to the knife. This chapter contains the record of a number of cases, all going to prove the views put forth by our author. The other chapters of the work are all interesting and practical. Tbe work is very neatly produced by Henry C. Lea, of Philadelphia; he is successor to the well-known medical publishing house of Blanchard \u0026 Lea. A Text Book on Anatomy, Physiology and Hygieme for the use of Schoos and FoRadies. By JoUN C. DRAPER, M.D., Professor of Natura History and Physiology in the New York Free Academy, \u0026c., Ae with one hundred and seventy illustrations, Svo. pp. 300. New York : Harper \u0026 Brothers, publishers, Franklin Square, 18G6. Montreal: Dawson Bros. Is there a necessity for a work of this nature, and with the object pro* fessedly to teach the youthjust so much of the anatomy and physiology d the human frame as would in many instances lcad to the very worst results Dr. Draper, in his preface, says: \" Although the chief object has bees tO \" propose a text-book for academic students, the work is also desiped for the use of schools and families.\" Again we would seek to find the utility of laying bare (except to a strong mi-nded woman) the many fuo tions of the living organism. Works of this nature are not generlY sought by the young for the purpose of instruction, but with a view O satisfying a norbid curiosity, and especially will you find well thuramb and read and re-read those parts which relate to the reproductive or'a-c'n Althorgh the space devoted to this subject in this volname is exel' ingly short and concise, yet as a whole, we think it Ubjectionabla\u0026 fashion of the age appears to be to break down that fine barrier of modee- , the very pride of the human female, and we do think that the greatst should be exercised in the introduction of objectionableliteratureespe ly for childrmen.",
         "TRER\u0026PXUTIVAL ?RAGX1.ZNTS. 2 PERISCOPIC DEPARTMENT. Ltitit. POISONING BY PHIALAOJFS SERFENTS. By Wn.x S. Rowzs, Act. Assist. Surgeon U.S.N. Observing your excellent article in the laSt number of the JOrP\u003eRŽAL, on the injurious effects which may result from the inhalation of poison- ous gases set free by combustion of \" sulpho-cyanide of mercury,\" in the form of the new toy, the \" eggs of Pharoah's serpents,\" I beg leave to give the particulars of a case that came under my observation a short time since in Washington, D. C. The\" eggs\" being, as you say, one of tfge fashionable sensations of the day, are introduced into the drawing rooms amd nurseries of many of our citizens, who are in a measure ignorant of their true character, and who may realize the fact only when serious mis- chief bas been donc. A gentleman of =y acquaintance, who has been troubled with a slight bronchial affection for several months, ignited one of the \" eggs \" in a close room ; and while watching the singular appearance of the mellone slowly exuding fromi the apex of the cone, was seized with vertigo and asphyxia, and, losing consciousness, feU to the floor, the flame from the burning \"egg \" igniting a portion of his clothing. He recovered in a moment, but suffered with an aggravation of bis bronchitis for several days, accompanied with severe hemicrania. I have heard of another case similar to the above, in which a child 'as partially suffocated by the obnoxious gases.-Boston Afedical and \u0026rgical Journal. THERAPEUTICAL FRAG-MENTS. By THEODonS C. MLLEa, M.D., Athens, East Tennessee. VALERIANATE OF ZINC IN SLEEPLESSNESS.-In some form of fevers, the typhoid pneumonia, etc., where opium or morphine increased the dificulty, I succeeded admirably, by giving 2 gra. of val, zinc 4 times slaily, -)YSENÇTER.--In' one epidemic where t'e disease showed more of a tatric nature, the following removed the whole disease in a few days: 1 Epsom salts, § j. Camphor water, fl 7 viij. Muriatic acid, fi 3 j. F nid ext. ipecae, S j. 81 S.-A tablespoonful every 2 bours. 423",
         "CANADA MEDICAL JOURNAL. CHRoNIC DYSENTERY.-In a very severe case, after the use of a variety of treatment, I restored the patient complete in eight days, by giving the following: 1 Flnid ext. cascarilla, fl , ij. Camphor water, fi D iij. Vinum opi, fl M. S.-Every two hours a large tablespoonful. HYPOPHOSPHATE OF QUINIA IN DYSENTERY.-In the year 1861, August, I observed a form of dysentery, confined only to a small space of country, and which was obstinate to treat, but gave, by the -adminis- tration of hypophosphate of quinia (2 grs. every 2 hours), the most satisfactory results. LACTUCARIUM IN DYSENTERY.-In September, 1862, I observed by the combination of lactucarium with small doses of ipecac, a quick and sure remedy. It is nothing new as the same has been praised many years ago by Dr. Rothammel.-(Heidelb. Klin. Annal. v. v.) CIMICIFUGA IN ILHEUMATIC OPHTHALMIA.-In several cases, Ifound the fluid extract an excellent remedy. In one case it improved the patient, but did not completely cure him, till I combined it with iron. CIMICIFUGA IN CHRONIC YOMITING.-In a case of a lady 28 years ,of age, who had been treated by physicians in all her reach for over a year, and who laboured for one day under a cardialgia, the next day under a severe vomiting, I gave the ale. ext. of black cohosh 2 grs. at a dose, with pulv. altheæ. in pill form. In twelve days it arrested the disease, but let her take afterwards for two months, 1 gr. pill four times dailyî This was in 1861; the disease has never returned.-Journal of Materia Medica, New Lebanon, N.Y. AGGRAVATED DYSMENORRfEA; EXPLORATIONS OF THE UTERUS WITH THE ENDOSCOPE; CURE. Aune Crolly, aged thirty-five, unmarried, settled in England maflY, years, and has worked in a cotton factory ; of full habit, rather pale an flàaby, and apparently in good health, admitted June 23, 1865. Nistory.-Two years ago.had bleeding, followed by copious h ,O lhage from the womb, which was accompanied by discharge of \" clats this occurred suddenly, and continued cight months without interiSiO but was not attended with pain. Ras been repeatedly under ràe0d!t treatment in England, and took mercury to salivation. : Bleeding ceased for five weeks ; it then returned, and Las cbntin U",
         "AGGRAVATED DYSMENORRHEA. to the present time ; it is now, however attended with pain, «which she describesas being of a \" squeezing\" kind, and accompanied by \" forcing.\" Os uteri is patulous, and plugged with glairy mucus ; itslips are con- gested, and on the slightest irritation florid blood flows freely from them. Examined with Dr. Cruise's endoscope ; the lining membrane of the uterus presented streaks of vascular engorgement, like the conjunctiva in a state of chronie inflammation : in several situations, also, the mucous membrane was seen to be rough and granular. It was toucbed, through the endoscope, with a twenty-grain solution of nitrate of silver, and the blanched surface so treated was subsequently distinctly visible through that instrument. Treatment consisted, in addition to the above, in repeated leeching of anus, warm hip baths, injections of sulphate of alum and oak bark, mild aperients, and vaginal suppositories, composed of acetat. plumbi, gr. x, extract opii aquæ, gr. i, unguent hydrarg. 3 j. M. July 5.-Greatly improved ; no bleeding for several days, and pain in breasts, which, when hæmorrhage was troublesome, had becen urgent, no longer exists. Diagnosis-Dyswenorrhea froin uterine congestion. 'July 19.-Examined to-day; os uteri much less patulous ; it is now pale, and a transparent glairy mucus oozes from it ; no hæmorrhage or pain for last thrce weeks ; breasts still tender to pressure, but pain removed, partly by means of aconite and chloroform liniment, and gr. i of valerianate of zinc, ter in die ; but mainly, no doubt, by the treatmýent directed~to the uterus. Discharged this day. With the assistance of my colleague, Dr. Cruise, the interior of the iterus was examined by means of his endoscope, by Dr. Churchill and William Stokes, jun., at a time when vascular congestion existed in high degree. There can be no doubt that the practical value of the endoscope was illustrated in this case, as without the use of it-although one might infer from the symptoms the condition of the interior of the womb-it 'ould have been impossible to have the advantage of ocular demonstra- lion of this, and to have directed local treatment with the eye. September 13, '65.-I received a letter from Crolly's mother to-day, 4M Bolton, England, thanking me \"for saving her daug'hter's life,\" te;, \" after she had been treated to no effect in England.\" I mention this letter, which was not in any way solicited, for the pur- 8Ose of showing that up to tbat time the girl had continued well.-ibid. Cical eords ofilfater .Jisericordæ Hospital.",
         "CANADA MEDICAL JOURNAL. SUCCESSFUL CASE OF CSMAREAN SECTION. By Professor JACOLUCCI of Naples. On the 4th of August, 1862, -Philomene Morvillo, nine months preg- nant, was brought to the Hospital of Incurables. This woman wasonly forty-one inches in stature. On examination, the following were ascer- tained to be the dimensions of the pelvis:-From right to left anterior superior spinous process of the ilium, eight inches; from middle of one iliae crest to the corresponding point on tbe other side, a little less than two inches; right sacro-coty-löidion space rather more than one inch, left ditto one inch. On the 27th August labour pains set in, and on the arrival of Professor Jacolucci he found that the waters had escaped, and tbat the umbilical cord was protruding. The pulsation in the cord becoming gradally more feeble, the Cæsarean section by the method of Mauriceau was decided on. The abdominal cavity and anterior wall of the uterus having been laid open, the operator introduced his hand in the direction of the right iliac fossa in which was found 'the head of the still living foetus. The loss of blood was considerable. By the retraction of the uterus the wound in that organ diminished to half its extent. The twisted suture was then employed, and the application of a bladder filled with ice to the abdomen and cold enemas constituted 'the entire treatment during the next three days. The wound in the abdomen united by the first intention. The thirteenth day after the operation the points of suture were remov- cd, the cicatrisation being complete. The lochial discharge and lacteal secretion were established normally; and at the expiration of fifty days the patient left the hospital. Professor Wurtz has been appointed Dean of the Faculty of Medicine of Paris.-Dublin Medical Press and Circular. OBSTETRICAL CLINIC OF PROF. CHAS. A BUDD. Reported by S. HENDRICKSON. Sub-acute Inflammation of Cervil Utetit Endocervicitis. Mrs. S., æt. 24 years; has been married fifteen months. No childreD Patient enjoyed good health previous to lier marriage. lHer general health is also at present good; appetite fair; bowels-regular; monthly pen4O4% constant, lasting four days. She comes here complaining -that she exPe; riences pain during the act of sexual congress. Now, apriori, upon what may this inconvenience depend ? This during copulation may be dependent upon-first, vaginitis, which i tion always causes violent paroxysms of pain on introducing any, 426",
         "THE NEW ANBSTHETIC. into the vagina. even the finger in making a digital examination. Another cause is ulcerations, in the vagina, around the carunculoe myrtiformes, from a failure of the hymen, lacerated in the natural way, to heal. Another cause is vulvitis. Other causes may be a general hyperosthesia of the uterus from hypermia, or inflammation, or ulceration of the cervix. We very frequently find this hyperoethesia at the time of sexual intercourse, associated with sterility. On making a digital examination, there seems to be no soreness about the vulva or vagina, but the patient shrinks on touching the neck of the uterus. There is a slight disposition to retroversion of the uterus. On making an examination per speculum, the neck of the uterus is seen to be the seat of a subacute inflammation, giving rise to endocervi- citis, or catarrh of the neck. The pain, therefore, which the patient com- plains of, is due to this sub-acute inaflmmation of the cervix, and the sterility upon the endocervicitis. (The case was now exbibited to the class. There was seen a thick, tenacious, alluminous fluid issuing from the cervix.) Probably this inflammation may bave existed for many months, and is Dot the result of her new relations. What is the cause of the cervical catarrh? All we can say is that it is a remnant of the detritus resulting from inflammation which has existed at an antecedent period. One great obstacle to the success of our treatment in these cases is the continuance of sexual intercourse. Ilence you -zan see the benefit to e derived in such cases by causing a temporary separation of the wife from her husband. We will treat this patient by scarifying the cervix, taking about half an ounce of blood, and then pass the saturated tr. iodine by means of a probe tipped with cotton, to the os internum. THE NEW ANmSTHETIC. Professor Simpson, the well known discoverer of Chloroform, has recently een experimenting further in the same direction. In a late number of he dedical Times and Gazette he gives his observations concerning its eets--the essential portions of which are embraced in the following:- \"The last of these compounds-the bichloride of carbon is the new xaaesthetic which fbrms the special subject of the present observations.. Ivas first, I believe,,discovered by M. Regnault, in 1839. Ithas already d various appellations from various chemists, as perchloroformene, Prelorinated chloride of methyl, dichloride of carbonî carbonie 427",
         "CANADA MEDICAL JOURNAL. chloride, tetrachloride of carbon, supeicloride of carbon, perchloru- retted hydrochlorie ether, and perchloruretted formene (see Gmelia's 1 Handbook of Chemistry,' vol., vii., p. 355, and Watt's ' Dictionary of Chemistry,' vol. i, p. 765). \"If it becomes, as I believe it will, for some medicinal purposes, an article of the materia medica, it will réquire to have a pharmaceutical nam-e appended to it, and perhaps the designation of perchloroformene, or the shorter teri chlorocarbon, may prove sufficiently distinctive. In its chemical constitution, bichloride of carbon, or chlorocarbon, is an- alogous to chloroform; with this difference, that the single atom of hydrogen existing in chloroform is replaced in chlorocarbon by an atoi of chlorine, for the relative chemical consitution of these two bodies mray be stated as follows :- Chloroform = 0211013 Chlorocarbon == 02010 3. \"The chlorocarbon can be made from chloroform by the action of chlorine upon that liquid ; and Genther bas shown that the process mnay be also reversed, and chloroform produced from chlorocarbon, by treating it in an appropriate vessel with zinc and dilute sulphuric acid, and thus exposing it to the action of naseent hydrogen. The most conimon way hitherto adopted of forming bichloride of carbon consists in passing the vapour of bisulphide or' bisulphuret of carbon together with chlorine through a red-hot tube either made of procelain or containing 'within it fragments of porcelain. There result from this process cliloride of sulphtýr' and bichloride of carbon, the latter being easily separated from the for- mer by the action of potash. The bichloride of carbon, or chlorocarbon, is a transparent, colourle$ fuid having an ethereal and sweetish odour, not unlike chloroform. I specific gravity is great, being as high as, 1-56, chloroform is 1-49*- boils 1700 Fahrenheit, the boiling point of chloroform being 141°. The density of its vapour is 533, that of chloroform being 4-2. Beside trying the anæsthetic effects of bichloride of carbon upon m self and others, I have used it in one or two cases of midwifery ani surgery. Its primary effects are very analogous to those of chlorofo, but it takes a longer time to produce the saine degree of anaisthesia, ana' generally a' longer time to recover from it. Some experiments Wi uponnmice and rabbits have shown this-two corresponding animI these experiments being simultaneously exposed, under exactly siui circuinstances, to the same doses of chloroform and chlorocarbon.' '9 the\"depressing influences of chlorocarbon upon the beart is gieater that of chloroform; and, consequently, I believe it to be far more d ous to employ as a general anesthetic. agent. In a case of midwife",
         "THE NEW TEST FOR ARSENIC. which it was exhibited by my friend and assistant, Dr. Black, and myself, for above an hour, with the usual anosthetic effeets, the pulse latterly became extremely feeble and weak. In another case in which it was ex- hibited by Dr. Black, the patient who had taken chloroformn several times before, was unaware that the new anæsthetic was diferentfrom the old; her pulse continued steady and firm, although she is the subject of val- vular disease of the heart. The surgical operations in which I have used chlorocarbon have been, the closure of a vesicovaginal fistula, the division of the cervix uteri, the enlargement of the orifice of the vagina, and the application of potassa fusa to a large flat navus upon the chest of a young infant. In all of these cases it answered quite well as an anoesthetic. The child did not waken up for more than an hour and a half after the employment of the caustic, which was used so as to produce a large slough. Its pulse was rapid and weak during the greatest degree of anoesthetic sleep. One of the mice exposed to its influence, and which was removed from the tumbler where the experiment upon it was made, as soon as the animal fell over, breathed imperfectly for some time after being laid iipon the table, and then died. a IChlorocarbon, when applied externally to the skin, acts much less as a stimulant and irritant than chloroform, and will hence, I believe, in all likelihoodbe found of use as a local anesthetic in the composition of seda- tive liniments. \"In two cases of severe hysteralgia I have injected air loaded with the vapours of chlorocarbon into the vagina. The simplest apparatus for this purpose consists of a common enema syringe, with the nozzle introduced into the vagina, and the other extremity of the apparatus placed an inch or-more down into the interior of a four-ounce phial, containing a small juanity-as an ounce or so-of the fluid whose vapour it is wished to 1aject through the syringe. Both patients were at once temporarily relieved from pain.\" NEWTEST FOR ARSENIC. The wonderful delicacy of the previous tests for arsenic which have een thought to be almost perfect, are surpassed by the electrical test. y neans of a simple apparatus all the arsenic in a substance may be 'tpidly extracted. Place a solution of arsenic matter in a platinumvessel, Piunge a zinc wire into the liquid, and the arsenic will appear on the SPatinam; by prolonging the action the whole of the arsenic may be ex- eted from the conpound. This process is superior in sensibility, and .Srequires far less' manipulation of the suspected substance, is inuch r trustworthy for toxicological examinations thanthe methods now 429",
         "MONTREAL, MARCH, 1866. A HEALTH OFFICER. Although we have written strongly in previous numbers of the journal ,of the apathy of the Hcalth Committee-we feel that as they have at at last moved in the matter of sanitary reform, we eau extend to theni car congratulations upon having taken a step for which the entire city wvill commend them. The Finance Committee, baving agreed to recom-n mnend an appropriation of $1600 for the employment of a medical maa es Health Officer for the City of Montreal for eight months, the Health Committee advertised for applicants. On the 2nd of this muonth the Committee met, and opened a number of applications. . After mature deliberation, it was decided to recommend the appointment of Gilbert Prout Girdwood, M.D., M.R.C.S.E., late assistant-surgeon lst Battalion Grenadier Guards; and without detracting from the merits of other applicants, we think, that from the high testimonials presented on behaif of Dr. Girdwood, (a requisition in his favour signed by all the leading English practitioners being presented) the Committee could not vell conie to any other decision. At the time we write, the Council have not met, and the appointment has not therefore been made, but, la the reantime we congratulate Dr. Girdwood on the probability of b appointment. When made, we trust he will at once enter heart anl soul into his work, and practically show the value of his labours-bse we believe, the city will see they cannot dispense 'with his services. we said in our last number, the appointment of a Health Officer shod be permanent, and we trust that he may so become. DR. MARSDEN'S PLAN OF QUARANTINE. In our February number, we inserted an article from our friend :T Narsden, of Quebee, giving the details (along with a plan) of a CÉ quarantine which he has suggested, and which, we understand,",
         "MEETING OF MEDICAL PROFESSION. urging upon the Government for adoption. Dr. Marsden's experienoe during the varions epidemies which have visited this country has been very extensive, and his opinions are, therefore, entitled to weight, which wil, doubtless, be accorded to them. The plan is evidently based upon the theory of the contagiousness of the disease-a question which is still unsettled-and the arrangements to prevent non-intercourse of persons suffering from the affection in its various forms, mild and severe, are very complete. Whether the disease be contagious or not, it cannot possibly be a fault to err in the belief that it is, and take all precautions. Those, therefore, who may disagree with Dr. Marsden in his belief on the con- tagiousness of the disease, can but admit he errs-if at all-on the safe side. More particularly, however, we believe Dr. Marsden's plan would be an immense service in an epidemic of typhus fever, and other well- known contagious maladies. While our authorities are reflecting upon this plan, or, perhaps, resolved to make no change in the quarantine at Grosse Isle, the New York Board of Health have adopted the plan of Dr. Marsden, and state that a Bill will shortly be presented to Congress, vith the intention of making the system complete and universal along the entire American Atlantic coast. To our friend this must be satisfactory; ind, should our own Government pass his suggestions by unheeded, it 'Would be but another illustration of the old but true proverb, \" A man has no honour in his own country.\" A meeting of the medical profession of Montreal, called to consider the expediency of adopting such measures as might be deemed advisable in view of the pospible appearance of cholera, was held in the Mechanies' -all on the evening of the 2nd instant. Dr. George W. Campbell was called to the chair, and Dr. J. L. Leprohon was appointed Secretary. Considerable discussion ensued, and it seemed to be the unanimous opinion of all present that the Council was the proper body to take action a the matter, and as they had already exhibited considerable zeal in lloposing various measures-it was not advisable for the profession to interfere. The appointment of a Health Officer, as suggested by the Health 'nmmittee, was highly approved, and after passing the following resolu- tion, the meeting adjourned. Mloved by Dr. Hingston, seconded by Dr. D. C. MacCallum, that the 5PPointnment of an efficient Hiealth Officer, with all the powers properly _ %onging to such office relieves the members of the professiou from necessity of present action in the matter.",
         "CANADA- MEDICAL JOURNAL. We have to thank our readers for the response they have made tO 00 appeal for literary aid, and trust they will continue to forward to us su communications as they may deem of interest. But we must insis aP0 communications being prepared solely for our journal. In future We positively decline papers forwarded simultaneously to several journalos OLEUM ERIGERONTIS CANADENSIS AS A REMEDY IN HEMORRIU DIARRHRA, AND DYSENTRY. Dr. J. W. Moorman, of Hardinsburg, Ky., recommends in the 4 acn Journal of Med. Sciences the use of oleurm erigerontis canade1S ' the treatment of hoemorrhage, diarrhoea, and dysentery. Several favo'f ble cases are related. The usual dose according to the U. S. DiSP'e tory is from five to ten drops, but Dr. Moorman has given it with b1)8 in much larger doses-from 3 ss. to 3 j. \" It may,\" he says, be gI \" in a little water, to which a small quantity of sugar may be added. cases of hoemoptysis, 10 or 15 drops may be placed on a handerc-il inhaled at the same time it is taken internally. The same method' answer in epistaxis. In diarrhoea 15 drops every 4 hours until it D lieved, will in most cases be sufficient.\" Although in dysentery Moorman has not obtained the gratifying results claimed by so0, or less advantage has in every case been derived from its use. ge cludes: \" In heemorrhage and diarrhoa of debility I know of nO be remedy, and I trust the profession will give it a trial, and jet know the results.\" ANMSTHESIA BY NITROUS OXIDE GAS. Dr. Carnochan performed two severe surgical operations on Sa e last, at Ward's Island Emigrant Hospital,while the patients were under t influence of nitrous oxide gas, administered by Dr. Colton. The O tions in both consisted in the amputation of the leg above the a The patients said that they knew nothing of what had taken place, one declared, on waking, that he had not been asleep, and the OPera had not been performed! Dr. Carnochan and several surgeOn5 f tbo were present, expressed themselves well pleased with the effects O gas. It required less than one minute to put the patient asleeP' after the operation was completed, and the gas removed, the patien0t0 covered entire consciousness in about twenty seconds. There weOt vomiting or sickness attending or following the operation, and the Pa, awoke as fresh as from a natural sleep.-Philadelphia Medic\" Surgical Reporter. 432"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL JOUIRNAL. ORIGINAL COMMUNICATIONS. 7'le Uses of Pus in the Animal Eonomy. By A. P.- Rmi», M.D. L.R.C.S. Ed., \u0026c., \u0026c., Professor of Medicine and Clinical Medicine in Dalhousie College and University. Rcad before the Halifax Medical Society, Feb. 6th, 1872. IL is not my object in this paper to discuss the ordinary qualities of this animal fluid, nor how or why it may present itself, but, rather to seek for evidence of its beneficial influence, qualities which are not much insisted on by Pathologists. Received opinion makes it a speci.dly noxious fluid, and the aim of the profession has been, and will be, to prevent its appearance if possible; and so fair we are right. if our endeavours are to pre- vent the circumstances which give rise to it, and happily i no other way can we succeed in our attemnpts. Its cheicudal composition is very near]y the same as that of the blood, and hence very cloely allied to that of the tissues. The Pus globules we have every reason to believe, are the white blood corpuscles which, having passed through the capillaries, form part of the effusiou into inflamed ti-sues, and at the focus of the in- tihmmation being deprived of their nutrition, have lost their 'itality, and must separated from the living parts. The exuded fluids in the immediate vicinity of these globules, o lose their vitality from the saime cause, and the two together form what we call pus. RIs formation explainsý to us one of the services it renders. Use 1st-It is the methIod by which Dead Exudation Corpuscles and fluids assume a condition allowing of their subsequent re- nioval by a channel which is not necessarily injurious to the sys- tem at large, whereas they would bc if permitted to enter the biood, to be expelled by the emunetories. Few proofs will need to be adduced to sustain this, position, for we are too well aware of the pernicious influence exerted by the entrance of decomposing mnatters into the circulation,",
         "CANADA MEDICAL JOURNAL. The collection is ordinarily expelled by what is termed an abscess, evacuated after its approach to the surface, either by nature or the bistoury. But in some instances the abscess is not evacuated, being what is termed, absorbed or encapsulated. Use 2nd-It is the method by which the before mentioned mat- ters (so collected together when from favouring circumstances they cease to produce irritation in their vicinity) are absorbed or removed by the emunctories. The solid parts first having uniergone a fatty transformation, owing to the influence ex- erted on tbem by the free circulation of blood in the walls of the abscess. Use 3rd-It is the method by which dead exudation material finally becomes encapsulated. The abscess ceasing to produce inflammation in its vicinity, the free circulation of blood in the abscess wall exerts such changes in the composition of the fluid parts of the pus, as permit of their absorption without injury to the health of the solid part, which cannot be so dealt with becomes inspissated in the form of the innocuous substances. Fat, Phos- phate of lime, Carbonate of lime and other salts, united by an in- determinate animal matter. Or in other words, through the agency of pus, dead portions of the economy may become interred within the living system in some out of the way place, (where it would have been impossible to remove it to a greater distance) and then to give no more trouble than the little burying ground in the ploughed field, that was there established by the Pioneer Settler from necessity, many years ago. So far our attention has been devoted to pus as a means of getting rid of a too profuse inflammatory exudation, but it has a far wider area of usfulness. John lunter long since demonstrated that pus is s solvent of dead animal substances-raw meat being easily dissolved in an abscess, or in pus kept warm out of the body-llence, Use 4th-It is the method by which tissues of all kinds, when deprived of their vitality, are reduced to a fluid capable of easy removal, as the contents of an abscess. Use 51-It is the method adopted by nature to assist vital absorption in amputating dead tissues, either externally or in- ternally. Use 6t/-It is the method which assists Ulcerative Absorption, so teried in bringing an abscess to the surface. One portion or side of the abscess wall becoming gradually thinner as the abscess points.",
         "THE USES OF PUS IlN THE ANLAL ECONOMY. 339 1 will give my explanations in the few'est possible words. Take a case of simple phlegmon or carbuncle, at first a very small amount of pus escapes, and the core or dead cellular tissue has tensile strength by reason of the white and yellow fibrous tissue of which it is composed, and it adheres strongly to the yet living parts, requiring either the kiife or caustic potassa for its immediate removal. Yet we know that in time, it will be all liquified and pass away as pus, be dissolved as perfectly as if by caustie potassa. Again, in the case of a slough, ulcerative absorption so termed, divides the living from the dead, and at this point pus is formed, which exerting its solvent power dissolves the dead tissue up to the surface of the living-over which it has no influence. I will not deny that this is a vital action, (the real process we do not yet understand,) but knowing the chemical pioperties of pus, it is fair to assume that when circulation and vitality ceae at the ine of demarcation, ordinary chemical changes may and do supervene; the pus bathing the living surface is in the best posi- tion to separate the dead from the living, because at this point the heat is greatest, and the higher the temperature, up to 100 z F., the more active the solution. lence, why it may be that the dead tissue is most dissolved in proportion to its nearness to the living surface. Suppose a case of inflammation of the liver eventuating in an abscess two inches in diameter. As a result of the disease, the proper tissue of the liver, that occupied at least a portion of this space, dies surrounded by the dead exudation products or pus- which pus dissolves the tissue, (it being most favourably situated for solution,) and increases in amount as if by growth, rendering everything fluid up to the induratedi wall in which circulation and vitality still go on. It is not difficult to understand also in what way pus favours the gradual pointing of the abscess. The wall nearest the surface gradually becomes thinner; and the pus as well increases in quantity, that is \"ulcerative absorp- tion \" goes on, which means waste of tissue-and as well implies an increased amount of pus-or in other words, it is fair to assume that \"ulcerative absorption \" is due-to diminished circu- lation in the part-the equivalent of diminished vitality, which is tantamount to increased death of the surface of the abscess wall at the part whici is getting thinner, and the rapid removal by solution in the pus of the dead wall tissue, thus increasng the amount of pus, the abscess rapidly approaching the surface. It may be saîd that dead animal tissue' breaks down into pus,",
         "3411 CANADA MEDICAL .JOI~NAL. but this is disproved by every day experience, for there is no resemblance between putrelaction (a graduail conversion into inorgnic compounds, gaseous and saline) and conversion into pus, whicl is in every way distinct. The pus may undergo a similar putrefaction. but this is a sub- sequenît change. In the inflammations of cold blooded animals and birds, no pu- is foried, and the changes which occur are rather undecided. If the Science of Medicine so lar progresses, as to enable us to prevent inflammations of a type sufliciently severe to cause pro- fuse exudations and deatli of tissue, w-e might have a condition approaching that of cold blooded animals, but until then, we must recognise the great service conferred on us by an agent that col- lects the dead products of inflammation, and favours their expul- sion or harmless burial, that amputates and hquifies our spha- celated tissues in situations.where tbey could not be touched by the surgeon, and that at the saime time paves the way for their complete remroval. 98, Argyle Street. L~îiFA., pebruary 7il1, 1872. London Practice. By JAnEs Pnao, A.M., M.D., M.R.C.S. Eng., Denonstrator of Anatomy, University of Bishop's College. No. Il Charing Cross Hospital I visited very frequently, following the late Dr. Salter in the Medical side, or Mr. Iancock im the Surgical. The operating day is Saturday. Under Dr. Salter's care, I saw a case of Hydatids of the Liver in a female of about thirty. Dr. Murchison, of the Middlesex Hospital, was called in consultation. He strongly advised tapping. Mir. lancock tapped the tumour with a small trochar, drawing off about two quarts of fluid. The next day, the patient complained of considerable tenderness, but that graduflly subsided, and a good recovery was made. Dr. Salter wras an excellent clinical teacher, being most precisè in everything. It wîll be very difticult to replace him. I was in- forined that he was on the evo of publishing a work on the heart and lungs. He had a most retentive memory, and would re- iember patients and the beds they occupied in the hospital, even if some considerable time had elapsed. His wards were always full of asthmatic cases, and the amount of pains he bestowed 340",
         "LONDON PRACTICE. upon them was astonishing. H1e gave the lodide of Potassium largely, and had great faith in its efficacy. Ie thought highly of Belladonna when the dyspnœea ivas urgent. lIe was a great ad- mirer of Niemeyer, and sonetines followed his treatment as regards the cold application at the outset of inflammation. Ihave seen several cases of infammation of the mamm;io under his care, where he applied only cold iced dressings with benelit. Dr. Salter held the opinion that pre-systolic muimmar was of far more frequent occurrence thas is generally allowed. le, like the rest of the London physicians. gave chloral hydrate in all cases demanding relief from pain. In painful dyspnoa from heart dis- ease, he was accustomed to give it in pretty large doses. I hlave seen hii treat several cases of homoptysis and homatemesis, w'here he very uniformly administered turpenine. Ie seemed to consider it a specific. In rheumatic fever, quinine in five grain doses. three times a day, was the remedy ernployed, and the nijority of cases did not run a longer course than twelve days. and a great nany not more than seven. Judging frons the rheumatic cases that came under my observation, heart complications seem to be more frequent in England than here. I also noticed that those patients who lived close to the Thames, suffered more than those who came from some distance, and that they invariably required a more supporting treatiment. Un Mr. Hancock's side, there vas ailways a large number of cases of joint diseases to be seen. There hardly passed an operating day, without an excision. Tte surgery in London is very conservative, and I have seen con- siderable risk run sometimes in endeavouring to push conserva- tisi to an extreme. Il this hospital there are two wards devoted to childrein, and among the little patients, a good many cases of hip-joint disease are always to be seen. The treatment is muci the sane as here. Mr. Hiancock excises tise hip-joint early, but dtoes not hesitate to operate even when the whole acetalulun is diseased. and some of the pelvic'. bones in addition. Mr. Hancock was the first surgeon to perfori tihe operation when there was muci disease of the pelvic bones, but ie shews thiat the muscles and fascia, become so infiltrated with plastic Imatter and consequently thickened, thsat a pretty good barrier is forned to protect the pelvie cavity. I have scen lim perforni Pirogoff's operation on the foot, Ciopart's and Syme's, butas a rule, inl disease of the bones of the foot, lie follows ne rule, but saves all lie can. M1r. liancock's naime is associated with that of Kôlliker, in 341",
         "CANADA MEDICAL JOURNAL. shewing that the urethra is surrounded through its entire length with an organie muscular coat. Charing Cross Hospital is famous for the number of accidents it admits. I noticed that those of the lower classes (such is their habit of drinking,) who were brought in with broken legs, almost invariably had delirium tremens, two or three days afterwards. Bromide of Patassium and chloral hydrate formed the treatment then. One London physician, Dr. Wiltshire, strongly recommends half ounce doses of Tr. Digitalis, in traumatic cases. Under Mr. lird's care, I saw several bad cases of prolapsus uteri, where the operation for constricting the vaginal aperture was performed. Ie followed Baker Brown's niethod of renoving a large portion of the inucous menbrane, of the shape of a horse- shoe, froin the lower portion of the vagina, and then bringing the opposite sides together by deep quilled sutures. These sutures were taken out the fourth day. The cases all did wiell. Mr. Hancock had a peculiar treatment for old indolent ulcers that had no tendency to head. Ir con-ited ii filling the ulcer with melted beesw-ax and handabging, leaving it that way for four or five days and then renewing. By the kindness of Drs. Ilingston and Coderre. I was allowed to try the method in two cases at the Hôtel-Dieu. It succeeded very well, although the cases were not very Lavourahle ones. I may mention that I have seen Mr. Han- cock operate thre tirnes for hernia, and in each case he opened the sac, and strongly advises it in all caes. Chaiing Cross Iospitad is situated in Agar Strcet, West Strand, and was established in 1818. The present building was erected in 1831, and last year an addition was built, giving thirty more beds. It has a sehool in connection with it, and the first year of its existence, ihere was only one student. and now there are sixty. Since the foundation cf the hospital 350,000 patients have been relieved. lIs aniual expnses are not more than four thousand pounds. When visiting the Middlesex Hospital, 1 went around with Dr. Murchison, and never have I seen teachers examine students as thoroughly at the bed-side. Ie was sure to pounce in any mian who had not been followinîg him regularly. Under his care, I saw a case of Locomotor Ataxia, where atrophy of the optic nerve ensued as'early as six nonîths after the commencement of the disease. The patient was taking pieperations of silver. I saw also several cases of diabetes treated by opium. I did not see any of the surgical practice of this institution. Middlesex Hospital was founded in 1745, when it could only give accommadation for eighteen in-patients. It now receives an-",
         "LONDON PRACTICE. nually 21,000 cases, and its income is seven thousand pounds. It has one ward devoted altogether to cancer. At Kings College Hospital, 1 was fortunate in seeing Sir William Ferguson tie the subclavian artery twice. The first case died a few iays afterwards, but the second recovered. The second was a case of traumatic aneurisn of the axillary. The nian had been wounded by a hay fork. During that sane ionith (February, 171,) the subclavian artery was tied four times in London. I saw excisions of the knee performed by Ferguon Wood and Smith. la all of tier, the incision was oval. Enîg-afting was attempt( in the healin- of indolent ulcers. Some of the Ca es did very well, but a good many off thema failed. The expens-es of this ho-pital are over £7,000 a year, and the niew building whiJchl is iow eing elaiged cost upwards of ilOO,Otou. At St. George's IIo-pita!, I vi\u003eited the oitliopnioi departmentr altogether, and fellowed -Mr. riodhust. In tienting hip-joint lases, ie does not use Liston': pliat ]il, but emnploys instead a large gutta-perha splint well rpadded. which secures the whole pelvis. Ire extends the lmb by the weight rni pulleys, and c-ounter-e-xtension by me.ms of handages pas-ed unler the arm- pits, and attached to the oefd of the bed. lie conriders sub cutaneous cetion of th1e adductor lonigus, grailis and rensor- vagina, as advised by i:mer, of no0 use whatever, and scouts the idiea of its being antiphlogi-tic. Barwell, on tie other hand, ens- ploys it, but only in the third stage. I saw two cases where tIse ch-in was bound down to the sternum. caused by the contraction of cicatrices, the iesult of burns. Hle made severA parallel ici-isin which relieved the defornity coa- siderably. Thsese ineirins lft b large gaps into which lie engrafte i se poitions of ,kin tiakn froim the side of' the neck. 1h covered then with lint and let, thei for sevenl days. Iealing went oi rpidiy fi-m tiose centres, and in four or live wieeks, they were quite well. Thse first of' thseae cases is muentioned lis his bok ou k eformities,\" published last Februauy. The second one I saw in March. Mr. Brodhurst is a g eat advocate of brise- ment forcée, and advises tenetomy befo-ehansd, so that the iii- flnence of' the muscles may be perfectly remoived. lie says that this operation of brisemsent is very frequenîtly risunsderstood, as some surgeons consider that it mesus forcible extension, and con- sequently the force is mis-applied, that instead of flexing the limb, it is extended lie says wien this is done, it is apt to lead to imisclhief, but when the force is applied in flexing the limb, no danger can happen. Ie very kindly took ne to see this opera- 343",
         "CANADA MEDICAL JOURNAL. tion in a private patient, a Poli:h gentleman, who had an anchy- losed hip. the result of gonorrhcel rheumatism. In six weeks the patient was ;alking about with a cane. Pai\u003e.ve motion, in this case, was commenced the third day after the opei-ation. The income cf St. George's TIospital is about £10,000. Its mu- seum contains a very valuable collection of spceiimens. Before conchding this lettee'. I my state there is a Hlomoeo- pathie lospital, in Great Oimond Street, which was established in 1850, t, rough thc exertions of some English disciples of Ifahne- miann. Its annual incone is about 3,000. SURGICAL CJsES OCUEU,1Ne 1N TRE PRaCTICE o!' TE 31ONTREAL GENERAL IIoSPITrAL, UNDE THI .RE 01F G. E. FENÇwîc1K, M.D. Case 11.-Penetratiig Wound \u003cf /he Chest. Reported by Mr. A. STEWART. W. McL., at 35, a stout Irishman, was adnitted into the Mont- real General Iospital, on Satuiday, the 16th Decenber, 18' 1, under the care of Dr. Fenwick, snifering oin a penetrating wound of the chest. H1e gives the following account of the nanner in which he re- ceived the wouid. On the Saturday evening above mentioned, while sitting in his own house he heard a rap at the door : on opouing the door he was met by three persons, urknown to hini, one of wohn dealt him a blow on the chest with a knife. After receiving the wvound ho imade prisoners of two of them, and kept them in his house until the police had arrived. IIe did not suffer any from shock, and thero was very little hamorrhage fron the wound, and no hamoptysis. On examirniation after his admission, the wound was found ituated about an inch and a half below the middle of the left clavicle, about an inch1 nd a quarter in length. and directed downwards and towarls the right side. On exainn- ing the wound iit the inger, the intercortal muscles were found to be wounded. There was extensive empihysera. on the left side, extending fron the clavicle to the lower margin of the ribs, and from the sternum back into the axillary space. There was great tenderness all over t-he eni\u003ehysematous part, and severe pain and tenderness along the lower border of the pectoralis major muscle. On percussing the che.t, both sides were found",
         "HOSPITAL REPORTS. equally resonant, and on auscultating, the vesicular murmur was also alike on both sides. The wounrd was closed by metallie sutures and adhesive plaster. Patient was put to bed, and ordered hlif diet and a pint of beef tea. Pulse 80 per minute, and slightly irregular; respiration 22; temperature 99 4-5ths. December 18th.-Feels quite comufortable. no tenderness over the emphysematous portion, considerable pain and tenderness along the lower border of the pectoralis major muscte. On taking a deep inspiration he complains of pain in the region of the woundà; vesicular murmur heard over both lungs: has e slight tickling sensation at the base of the left lung. Pulse 57; resp. 20; temp. 98 4-5ths. 19th--Slept very little last night, does not feel quite so well to - day, complains of pain in the region of the wound during inspira- tion; emphysena has nearly disappeared, except in the axilla. Pulse 96; resp. 20; tenp. 99. 2th-Feels considerably better to-day, not so much pain in the !egion of the wound, and no pain along the lower border of the l\u003eetoralismajor muscle; emphysema graduallydisappearing. Pulse rG6; resp. 20; temp. 9-. 21st-Still improving, slight pain in the region of the wound ; sutures taken out, wound almost healed. Pulse 68; resp. 20. 22nd-Feels quite well, emphysena all gone, was allowed to sit up to-day. Pulse 70: resp. 20. 26th-Discharged from the hospital quite well. se O 12-Skin Graftiny in a Cuse of Ulcer of the Leg, of fificen years draftion. RlepoIted by Mr. sIENRY 11rusaIxo. J. S., at 53, was admitted into the Montreal General Hez;i on September 14th, 1s7I, under Dr. Wright, suffering with a large indolent ulAýer which had existed for 16 years. It was of an ovat form, and about 22 inches in o'ne direction by 2 in the other, and situated on the inner anukle. Different methods of treatment wero followed, without any success, until the l5th October, the patient having now cone under the care of Dr. Fenwick, he decided on trying skin grafting. October 15th-Two grafts were taken fromn the arm of the pa- tient, and placed at about an inch apart in the uleer, and! covered 'with isinglass plaster, dressed with warm water and lint, the whole being lightly covered with a bandage. 345",
         "CA.AD- 'MEDICAL JOU3RNAL. IQth-Examned and found bothi grafts adherent, pre.Qenting a blish appearance ronnd their margins. 2Oth-th-One of the grats \"-s disappeared, andi the other, hardly as distinct as before. '23rd-Grafts agaTn making their appearan\u003cce in the forma of new tissue, not, ha-vingy disappeared, »-nevely having aSý-1umed1 the s'aine appearance as the surrotinding grnuaios 3oti-'rhe grCfs have por~eivery fâvourably, new tissue bein- fornied a'udtIieir etiges, ani al-o the edces of the ulcer. Novenibe- lQAlegl the. two foritier gralts dicl remark- ablyý velI, calisiug a, 1ange part of tbe ulcer to centi ze. :sti il quille an openi.ng being leit, Dr. 1 (IiidC\u003ccie-nie DIIo C apýply two molle gpraftsý which was actcording1y donc, -andhe~e in the ~~a Manner. I lth-Gr.iits loking wçell to-diy, having asundthat bluish white appeamance, Wliicel they gencnd1ly do at flrt. l2t-Btidetlytbey are about to take;z doric up carefully with warnm -water dressAigs, and allowed to remnaii until iGth-*Wlien thev were exiiiiinetl, andi both founti to be in siglit anîd dloing splendiidly, hvtving conanenlet tlhr-owýiug Out their littie bands of newly formnet ti-ý,suc. which aire extending in ail dirfictionis over the suilae. àOh-o looin so wi4l to-day. Legils Io \u003e411,W utihealthy- sa, agi-cit deal of, pus becing thrownl ont to be dese1 wîth 41 reà ivash' \" da-ily. 23'd-Are nowv exlÜbiting more sîpus of iiè tliau when lat ex- amnineti. C!cýt1-ization1 going on slowly both froin Ille gitsandi aifies of the x1lCer. 26tÀ-DOiu c w-cil, proce.s.s of reparation going onkprettyraPZiily. 'Che ravs cf tiS',ue front the grafts, meCeting those front tllns sides forntids (as it were,) leaving tsuali interspares, iwhieh!- howv- ever are al.so closdng ut\u003e Èst. 9,lth-\u003c)niy three littie openimgýs novv remaiîi. IlRed wash\" dressing continueti. '29tlh-Openizigs continue to, close graduailly. Dec. 5th-..TIo-daýy oi-tly one littde opnirrenitinz. 0rdereti pat- tienes clothes, allowedl te iinove about the ward. 7th-Ulcee eoyiipletely cicatrized, Leing covered with a layer of bluish w'hite ski;\u003e thich bidc, fair to he a strong and per- maanent cure.",
         "HOSPITAL REPORTS. Case 13.- J. O'D., et 55, was admnitted into the Montreal General Hospital on September 16th, 1871, suffering with two large ulcers on the anterior surface of the leg, one about four inches below the knee, the other on the anterior surface of the ankle. The borders were considerably infaimed, and the granulations large and in- dolen t. Dr. Fenwick ordered linseed meal poultices to be continued for three days, at the end of that time the inflammation had subsided greatly. On the 26th October ordered the leg to be strapped according to Baynton's method. This had the effect of cutting down the tall granulations, and placing the ulcers in a fit state for receiving the grafts. Uctober 30th-Two grafts were taken friom the arin and placed on the upper ulcer, the lower oe being heated by the strapping. On this occasion ne plaster being at liand, the grafts were covered with oil silk and done up with warm dressings. November 2nd-When the oil siik was remnoved, one graft came away, the other remained adherent and presented a bluish white appearance, showing that à had become vital; the granulations surrounding it very health v warm water dressing applied. th-Grafts progrcssin g vo ura bly, new tissue forming pretty rapidly fr0m the grafts, and alo at the edges. But wshat of the lower ole ? 10th-Examniied to-day, grafts doing well, but the lower ulcer conipletely healed under strapping treatment. 12th-The graft is doing a large amoiunt of good to the upper one, the cicatrix is forming fast. The patient says it never was so nearly cured before. l3th-Ulcer just about closed, one smîall openiing reniains. 16th-The small space is gradually and steadily being closed, by the little shoots of tissue whîich are spreading out in all directions. 19th-Completely closed up. Patient leaves hospital to-day, lMAuns-In this case skini graftig can hardly be said to have proved so eminiently successful, it rather indicates that Baynton's strapping wlen properly and carefully applied, is just as eflicacious and in this instance it proved a little more so; as to the per-man- ency of the cure, I cannot speak, not having seen the patient since lie left the hospital. 34'7",
         "348 CANADA MEDICAL JOURNAL. J. K., admitted to the Montreal General lIospital, for treatment of kn ucerated siure situated on the front. of thewvrist about two inches in length. 1 yoe in breadtl of oblong shape the long diarmeter beiÎne directed aciozs the .wist. the resuit of a scald. December 5th-A piece of Akin was taken from the patient's arin, and divideid intotwo grafts, each teing about the size of an oat, they we e placed on the ulcer, at about an inel apart and dressed in the usual manner with the isinglass plaster. 6th-Exnined to-day. and in attempting' to remove the lint, grafts and all came away together, however. they were again re- placed. It being remarked at the time that it was very unlikely thry would take again, having once been disturbed. Sth--The prediction proved true, they did no good whatever, but assuned a puffy white appearance; they cane off and were not replaced by any moare, but the ulcer was dressedlwithi \"red wash, and bandaged, under which treatment it heated rapidly Now ailthougi the grafts failed signally in this case, the cure being efflcted just as rapidly perhaps as without thei, still they cant be said to have had a fair chance. case 15.- M. L., adimitted into the Montreal General IIospital, to be treated for an ulcer situated on the outer side of the leg, the result of an application of some nostrun for the relief of a pain she suffered at its present site, that ended in producing this un- healthy ulcer, which at the tinie of admission was of sonie four or live weeks standing. It w-as circular in foi ni, and about an inch and a half in dianeter, its edges were thin and bue, and its sur- face studded with tall filabby pale granulations. November 19th--Bynton's strapping was first ordered, but w-hether froni any negligence or mistake on the part of the dresser, in its application, or fron not being continued a sufficient length of tine it failed in doing any good, other than that of cutting down the granulations, and giving to the sore a more healthy aspect. 2f9th-To-day the ulcer is presenting good soil in which to trythe efficacy of skin grafting. A graft of about half the size of a five cent piece w-as taken from the thigh, and placed on the centre of the sore, and dressed in the same way as the others.",
         "HOSPITAL REPORTS. December 2nd-Grafts still.ii the centre of the sore presentin a dull white appearance. 5th-Still 'visible, but does not appear so heahyv as went la t examined. 8th-It remains i sight. but is îot of the slightest beneit. Laving neilter forned an i-dand ie no imparted to, th uler any healthy action whatever. 12th-Graft bas disappeared. in what uauner I cannot sa'. Black wasli orlered as a lotion ad dre ied witl lint and n daged, under whlich it became rapidly cure Cae J6. J. A.,at 40 adintted into fle Montîreal Gener-al Hospital. November 14thi, I 1, for treatient of two very large ulcers sitn- ated one on eaci leg, at tlie anteri'r surface, near the ankles, that on the left heing fully five ineites wide, :nd' extending greater part of the way around the leg. the riglt not so large and situated more internally. November 22nd-Bli\u003ctering and poultieing continuied until to- day, when, deeming the urfaes in a fit state to Ireceii-e the grafts, four small piece wresplaced i each about an incl apart, being well\" pressed, ini witl Ilhe poii of a bistoury; strapped down withî pLaster (isinglass dî'es-ed witl hot water and ban- daged: 23rd-To-dty four or live siunil grafts were placed On the rigit leg, and dressed sane as above, to reiain undisturbed for three days, the dresser merely changing lie lint daily, but on no account to renove te grafts. 26th-Exaininîed to-day, onlv three of the live on the right le- are visible, and thiree of' those on the left. The remaining Ones having disappear'cd as they occasionally do, preparatory to conm- mencing their r'eparative proces. Al-eady there is some slight action begun on ite edges. 29th-Not mjuch toue seen as yet, otnly one or two of those little islands are formuing. Decenber 2nd-Things are prog'essing more favourably now, Puite a number of the grafts aie forming islands of new tissue, anid te healing process is going on. Fron the sides this is especially the case with the left leg, w-hich is doinig rernarkably well. 6th-Tle riglt not having donc so wellas its fellow of the oppo- site side, is to be grafted again.",
         "CANADA MEDICAL yOJRNAL. 10th-Left improving rapidly. l2th-Four new grâfts were to-day placed ,upon the right, and dressed as usual. 35th-The left continues improving rays of tissue are shooting \u003eut from the grafts in all directions. The last four are in sight, but look rather oedernatous and puffv to augur any good results from them; the difficulty I fancy, lies in the fact that a large amount of pus is being exuded from the sore. 17th--The left is now improving rather slower than heretofore. ordered to be strapped (both legs were strapped.) 20th-Straps removed, and found the grafts on the right leg in site and looking well. Al1 other modes of treatment stopped, both legs are now to be dressed with red w-ash daily, 24th-Still improving, right leg doing very well. January Ist-Continues to improve but slowly of late. 2nd--There is no doubt but that the grafts have proved very beneficial in this case, for during the past month the ulcers have continued to improve slowly but steadily, and to-day are much better and nearer cicatrization than at any other time, since they first appeared. 'Case 17.- At its commencement this bid fair to be the most interesting of all, not only on account of the grafting, had it succeeded, but also for the many other peculiar circunstances connected with it. It is that of Robert St. 11, a negro, who was admitted into the Montreal General Hospital, suffering with sloughing of the cellular tissue of the penis, from infiltration of urine. It appears that for a long tine previous to his admission, he had been troubled with gonorrhea, which in spite of treatment went into ulceration of the urethra, producing a fistula, and the urine instead of infiltrating as it generally does into the scrotum, or up into the cellular tissue of the abdomen, found its way as I said before, into the cellular stricture of the penis, giving rise to diffuse cellulitis of the organ, and sloughing 'of the tissue. At first five incisions were made to allow the escape of pus, and poultices were applied for some time until the organ began to assume more natural proportions. When these were stopped, the integument was found to have sloughed from the whole under",
         "MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. 351 surface of the penis, and also left a large granulating surface on top of the dorsumn. Upon these ulcerated surfaces skin grafting was attempted. The grafts being taken from the arm of one of his fellow patients, belonging to the l\"white persuasion.\" Mr. Pollock has tried the reverse of this and had splendid results, thus proving by the dark .spot on the cicatrix, that the grafts had really suc- ceeded. But even thouglh the grafts in this case had taken, it could not have been proven by the white cicatrix which would remain, as the effect, some might think of the white crafts, because it is well known that an abrasion or uleeration of the surface in the negro, in which the I rete mucosum \" is destroyed, always when heaied leaves a white cicatrix. I do not propose in this, as in other cases, giving a daily report of the grafts which were tried: they did not succeed, and it would hardly be interesting to give a long list of the changes and ap- pe4rances they passed through. It is not to be wondered at that they did not take, because as the patient bimself, expressed it, \"it was a werry critical position for the grafts to take hold of,\" and ne doubt he was very near right, if iot altogether so. For owing to the fact that the paticnt was coitinually troubled with erections. the change inthe state of the organ would tend to disturb the grafts. Or this failure might have been owing to the 'irritation produced by the urine and gonorrheal matter which was continually being discharged, and must sometimes, especially at night during sleep, have trickled down about the grafts, irritating themr and preventing them from taking on a healthy action. MEDIC.CIlIRURGICAL SOCIETY OF MONTREAL. NEETING IELD JANUARY, 27th, 1872. The Society met in their rooms, the President HEcToRe PELTIER, Esq., M.D., in the chair. After preliminary business, Dr. A. I. DAvr, read the following case:- I have hurriedly put together the notes of a case that occurred a-few nonths ago in ny practice, and which soon ended fatally, and which I think is worth being given to you, from the fact, that",
         "CAYNA1)ý 'MEDlCAL 3O1IEINAL. l believe nany practitioners have never seen a case, or at least, if they have, have not recognized it, but mistaken it for some other form of disease. Although periaps, its niost essential feature, were r-ecognized long ago-as lmog ago as the time of Sir Charle-1 Bell, it is only within the last few years, since it was describe I and nanied by Duchesne, of Boulogne, as Locomotor Alazy that the attention of physicians lias been drawn to it as a special diseae. Before his observations were published, it was looked upon and inistaken for some forn of cerebral or spinal paralysi\u002b-from whicl it is quite a distinct alection, althougi closely reseibling it in many points. Mr. R., 59 yeais of age, of spare form, of exceedinly active habits, and particularly temperate, a telier in one of our princilil banks, suffered some years ago fromn Sciatica in the right side. which resisted all treatment, and he was persuaded by some of h-i \"good natured friends,\" to visit a water cure establishiment in the United States. He reniained there about ten days or a fort - night, and returned home but little relieved. The very sevei e pain however gradually abated, and comparatively speaking, ie was free fromi suffering for a couple of yeurs, when the disease returned in all its severity, and he was again persuaded by his over judicious friends to return to the sane water cure establii- ment. But he suffered so intensely froni the treatment there adopted, whicb was pumping cold water on the thigh fron a di- tance of 10 or 12 feet, that lie only renained two days, and on returning home placed himself under mîy care, and the disea.se gradually subsided, and lie remained well, i.e., without any return of the Sciatica for some 7 or 8 years. I mention these facts-ierely as facts, to give his history as fa r as I am able, and not because I either believe or think, they had anything to do with the subsequent disease, although he hins-elf could never divert his mind of the idea but that it was a return of his old attack, that notwithstanding the length of time wlhich lhad elapsed; and that the cold water pumped on his thigh was the cause of his future disease, be that as it may, I think il but right to mention it. About three years ago, Mr. R. began to suffer fron severe paxins in his thighs and legs. The pains in the right, the one in which lie had had Sciatica sonie years before, as you will recollect 1 liave nentioned-being much more severe than those of the left. 1-Je fancied at first, it was a return of his old complaint-extend. ing further than before, and called them \"rheunatic pains \" and did not apply to me for advice, but tried all sorts of liniments that are advertised as cures, for this and similar, and perhaps di÷",
         "MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. 353 similar complaints-from Perry Davis' liniment to a saturated tincture of capsicums, but with, as you can well imagine, onlymo- mentary relief. He soon discovered that with the pains le had difficulty in walking, which of late las been termed Asynergia, or loss of Co-ordination of the muscular movements of the lower limbs, and is a pathognomonic sign, I may mention en passant of this disease. The pains and difficulty of walking, nc t amounting to paralysis of the lower extremities, but a staggering as it were continued more or less for near a twelve month, but never entirely left him altogether, when on the evening of the 12th March, 1870, while holding a step-ladder, for uie of his sons to get up on to do some thing to the cornice in the drawing-room. le suddenly exclaimed that he saw everything double, and was afraid, (the pain in his legs being so severe, iaking him quite weak,) he would fall down, that le was assisted to the sonf, and his wife gave him a glass of strong brandy and water. After a short time, she finding hilm a little stronger, persuaded him to go to bed, Le passed a pretty good night, but as the diplopia still continued, next morn- ing I was sent for. On my arrival I found him up and dretsed, lyîng on a sofa, he stilI saw everything double, his pulse was inal and weak, but hib mind was clear. bis meiory good, and the p\u003eainb in the legs he described as 'evere, but iot as intense as they hAd been the evening previoub. This state of affairs eontinued for five or six days, whei one of the visions, if I may so teri it, began to be less distinct than the other. and the next day, that is about 24 hou s after the one sight or vision appeared less distinct, whatever he looked at as well as being doubled, seemed to be going r«pidly up and down, that is from the floor to the ceiling of the rooni, and froni the ceiling to the floor. This peculiarity only lasted about 4S hours, and before the end of the week his iqht hiad returined to its iatural condition, and he saw as well as ever he had done, but the pains in the legs cominued as severe as ever, and he tottered a good deaI in wilking, andi was qute unable to go up or down stairs. On closely questioning his vife, I discovered she had once or twice during thefirst days of his attack, noticed he had had 8quinting, but only for a moment or so, just suflicient for ber to have observe it, but she tiouglt nothing of it till I lad closely askedl her about it. The treatment that I adopted was a combination of lodide and Bromiide of Potassium. But looking upon the case as one of Locomotor Ataxy, and of a serious claracter, I suggested the pro. Priety of a consultation, and ou the 3lst March, Dr. G. W. Camp- bell. saw him with me. Dr. C. took the sanie view of the case as- W",
         "CANADA MEDICAL JOURNAL. I had, and as the pulse still continued exceedingly weak, suggested adding 10 grs. of the Citrate of Tron to each dose of the Potassium. which I did, he continued takiug the medicies for a long time and gradually improved. During the summer he went into the country for a fortnight, and returned home very mich improved; the pains had almost left his legs, he could walk well, all tottering had left him, and he retnrned to hi; work at the bank. I should mention that during his illness it came to my know- ledge, from conversations with the cashier, that the authorities of. and his fellow clerks in the bank, had for many months noticed a deliciency in bis mind and meiory, a want of recollection in counting bills and in such ntters; and opportunity was taken of his serions illness, to remove him from the responsible position he occupied, to one where he would scarcely have any responsibility at all, but of course at a reduced salary. This seemed to affect him a good deal, and from what I have since learned, he fretted very much about it--thinking he had not been well treated, but nevertheless he continue 1 attending daily at the bank. During the month of Janmary, 1871, bis wife and family considered him better than he had been for years. On the evening of the 2nd February, on returning from the bank in as apparently good health as he had Latterly enjoyed and partaken of his dinner, he went up stairs, and as he landed on the top step, suddenly called out he could not muove. Asking one of his daughters who happened to be near to hold him, or he would fall. which she did till her mother came, and they assisted him to bis room and got him to bed. I was immediately sent for, but being out of town, Dr. Srallwood kindly sav him for me, he found him partially insensible, aud paralysed on the right side, he prescribed the usual treatment, and sav him again near midnight with Dr. Hlingston, he was more insensible, and had had five or six of what bis wife described as slight convulsions, and he continued mnch in the same state till death, which took place 36 hours from the time the attack had set in. I regret to say I was not allowed to make a post-mortem examuination. In the commencement of the paper T stated that this curious affection-Locomotor Ataxy is different and distinct from cerebral or spinal paralyss, and is not yet well understood. in most cases the pain in the legs, and which the patient usually cails rheumatic, are the first symptoms, and may continue for a longer or shorter period, sometimes for years, when double vision, with slight squinting follow these, as in the case just related, may disappear for a time and then return, and as in this case, end in epilepric convulsions, which carry off the patient. Again, the pains may",
         "MEDICO-CHIlr URlGICAL SOCIETY OF MONTREAL. 355 continue for iontlis or even years, causing such weakiness, that the patient cannot properly maintain his balance. he totters like a drunken man, indeed can scarcely. walk, he has to a 'certain extent. lost the power of controlling the action of some of his elemuentary muscles. The morbid anatomy has been well described by Dr. Lockhars Clarke. In two cases he examined, he found grey degeneration anfd disintegrationf the posterior columns of the spinal cord; of the posterior roots of the spinal nerves: of the cornua and some- times of the cerebral nerves. In the latter stages of the disease nearly all the nerve fibres of the posterior columns, and the pos- tArior roots fall into a state of granular disintegration and ulti- mately disappear. Usually the, posterior columns retain their normal size and shape, in consequence of hypertrophy of connective tissus which replaces the lost fibres. Corpora Amylacea are usually abundant, and oil globules of different sizes are frequently interspersed among them and col- lected into groups of variable :hipe and size, around blood vessels of the part; and Dr. Clarke is inclined to believe from his in- vestigations, that the posterior cornua are always more or less affected, and he thinks they are the first parts that are mortally ch nged, and Le thinks the peculiar symptoms of this disease de- pends solely on the lesion of the posterior colums, of the pos- terior nerve roots; but Le adds, probably also of the posterior cornua. Since I met with this case, I have been shown by a friend the \"Bulletin General de Therapeutique,\" for January, February, and March, 1-6, in which are several articles by Dr. G. Dugardin Beaumetz, of the Hospital de la Pitié of Paris, in which he recom- mends phosphorus in the treatment of Locomotor Ataxy, and he says it appears to have a favourable influence in the progressive forim of the disease, as it acts as an excitant and tonie to the ner- vous tissue, an indispensible element. IIe recommends it to be given in very small doses at the commencement, say about 1.60 of a grain, gradually increasing the dose till 1-6 cf a grain is reached. But it must be discontinued as soon as the digestive organs be- come deranged. As I said before, I was not aware of this recom- mendation of Mons. Beaunietz, or I should most certainly have tried it. Although I must say in this case, the combination of Iron with the lodide and Bromide certainly did a great deal of good.",
         "PERISCOPIC DEPARTMENT., NOTES ON A CASE OF RHIINo1JTHi, OR NASAL CALCULUS. B lures F. WEFrT. F.R.C.S, Senio-, Surgeon to the Queen's los- pital. and Consuhing Surgeon to the Birminghirnî Dental H1oepital. The accompanying case is worthy of note fron its extreme rarity, and Iron the fact of its pro'lucing looening of the teeth on thle opposite side to tit on whicl the calculu, was found. Nasal celculi generally, as in this cas. fori around some foreign body whieh has been accidentaly iUtro(luced. This patient cannot reniember anytinxg haîving been inerted into his nostlN, so that probably it had been thire lor ten or moie years, and its exist- ence onliy became apparent when it led to a disagreeable dis- charge frcn the nostril, to bulging of the nasal process of the superior maxillary boue, and to loo\u003eeninîg of the central and lateral incisors. G. B., aged 17, a boy of strumnou nal.it, and a parish apprentice to a tailor, came to the Dental lospital in this town, on the 'nd of Augu-t, 18î1. Mr. C. Si n, oe of the dental surgeons of that institution, found the nose, e:pecially on the right side, much swollen ; and also mueli inflammation and tumefaction of the upper lip and gumi. The central and lateraîl incisors were very ioo.e. He had an of1'ensive discliarge fron the nîose, and was in iuch pain. He :tated that the swelling came ou suddenly two days previously, without any assignable caure. lie had suffered six uonths before in a similar way, and was for a few days an out- patient at the Hloînemopathic Hospital, and tilein obtained relief by using fomenjtations to the nose. le had never had syphilis or any injury to the parts. Mr. Charles Sims, tlinking it a case for consultation, brouglit the patient to me. It was decided as a tentative proceediug to extract the left upper central and lateral incisors, they being very loose. Mr. Sims rernoved thiem on the 5th of August ; a copious disclarge of very ofTen-ive pus followed the extraction. lie was directed to ,yringe the mouth and nose with ozoised water.",
         "('1 AS ES OI? STlRANGULATED)lE~L. *x The gun ui cklvedy â,surneda liealthv ajpieax'ance, and'the Iýo wa. m ich, Heiv(.le at~h~ as an out.pittient at the Queen't 1uptlbut liot ei-ttilitz xlîicl Ietter at. to the n tSal SyIItw'-1 ,\u003c)I Novenxher I 3thi lii mde intnî uiuao of' the 1îatielit whený. auu~l Iaclu.vcin lwenlty 0ran1 ,U11ore1 b -Lj~oe. nd'eivdithd-..ngùîp iii tw'o î\u003eiece, fi-'11 the riglit nost1ii. IL wa.s Lill anl ixieh in lei-h, aia quarter of ain iuich in breadt±, andl WAS eoxpoýed' of ho1ht of* lime, and ucîgesî. cuxcîtdavtui a pebble ties -ize of* a Lirge peit. The };U3ictufl iitchrytnsile on1 ILi t ~i(l w,îs \u003ec, clo-.ed tiat, no tears could pas, inro the no,tril. 1 thejex'e\u0026ae 'leeued it îee-sary to blit it up. ýaid to Pas an Aiiel'.s 1ètobe lowni the nslduct. On Novewber t h s e was nsuchi lebs ,wollen; the dlis- eharce iunheaixd the u-ais werýu pa.\u003esîug zsaturally iinto tihe xso-e. Tbe lachryna.l probe W~agai uýûd. -No *Iriez' of bolie hIa' tckeii place. Tfie riose i oflycd its vp'rer propoi-tions. aid' the boy isý quite weli,-Laiece., J3r.M S;1A21,.1an uary, 2 CASE~S C0F 1TZ A-N U LA TE IIIiJINIA. l7nder tise care'of J. ,Faira, M. D.,'C. S. J. UJsc -Modun Mobun, a lxndloo sircar, aged 45, wws adnsitt-ed oi, iue 15th MLy, J 471, with symptomis of' \u003etrangulu.ted oblique.' itiguirco ciotal hernia on thse iigit, side. Tise hernia was of Ibur, yeis* duration, but lad hitherto been iedueible, ai-d the present syucipt6ils, paiîn in the tunsour, which was veîry large, and ûi tise unibilical region, constipation and constant vonsiitiig. had set in about two Lours before adnisin.Js pul.e was weak and de- pre,ed. Thse usual nsauechioroforni ýIns taxis,, \u0026c. hving failede thse operation fori strngulated Lerniki misperfo)rmed wvithout fui-tier debay. Thse strîctuire wVas ltUBJi to Ije at tise vzternal irig it was ilivided, witlioutulieiiing the sac. and1 thse heriaî; îeducedl. Tins woundj was tiitiselticjlly dvessed, isealed î-apidly. and he was disciuarged, cure'd, on 290h June, 1S71. C .ýn L-oei Cisunder Bosýe, a Beu'guli, âged 55, 0, bi-oker. Wms %(dniitted on, the 13th September, 1 d7, with ,yiiiltoui., of stra n3gulated oblique, inginio scrotal be-ni.a o31 tise rigist side. The ierni 'vas of fsfteen years duration, bad once been strangulateid belore, 'but was reduced by, taxis. Thse symiptoms, vorniting and constipation, had been present for soure timre. All thse ordinarv Meussus-es for reduction liaving fîtiled, tise operation was prci- 3 1-) -à",
         "CANADA MEDICAL JOURNAL. formed. The stricture was found to be at the external ring. and was divided without opening the sac. The wound healed, and he is now well, and waiting to have the operation for the radical cure performed. CAsE IIL.-Fekeer Chand, a Hindoo trader, aged 70, a very infirm old man, ivas admitted on the llth November, 1871, with symptoms of strangulated, oblique inguino-scrotal hernia on the left side. It was only of three months duration lie said, and was not very large. It had never before been obstructed; the symptoms of strangulation, vomiting and constipation. with pain in the tumour and abdomen, har set in twenty hours before admission. The or- diniry measures-taxis under chloroforma, enemata, ice applied to the tumour-having failed, the operation was performed. The stricture was found at the external ring. and was divided without opening the sac. He was immediately relieved of symptomîs of strangulation, but sank on the 1Th Nov ember, witb symptons of gangrene of the scrotum, and chronic dysentery. On examination it was found that the lungs were congested. There was a fibrinous clot in the right auricle, extending into the ramifications of the pulmonary artery. The lower portion of the ileum was partially gangrenous, but not perforated. The scrotum was gangrenous. The kidneys were extensively diseased. He was a very infirn old man, and had no power of recovery. The gangrene of the scrotum was probably caused, in his debilitated condition, by the attempts at reduction by taxis before operation. CASE IV.-Nilmoney Paul, aged 45, a stout aged looking man, by occupation a clerk, had suffered from inguino-scrotal hernia of the right side for five months the tumour was very large, and the'hernia had previously been reducible. When the symptoms of strangulation set in, the hernia had been incarcerated for two days ; it had come down when travelling on the railway, and he could not reduce it. When I saw him on 5th November, 1871, the symptoms of strangulation were urgent, and general peritonitis was setting in. I operated without delay, and had to divide thick layers of adipose tissue, before the stricture which vas at the external ring, and in the canal at the margin of internal oblique and trans- versalis, was reached ; it was divided without opening the sac. The symptoms of strangulation were immediately relieved, and the",
         "BILLROTH ON ACUPRESSURE, \u0026C. bowels acted freely, but he never rallied, and sank five hours after the operation. He was evidently of an unhealthy constitution, and had probably bad kidneys. No post-mortem was permitted.-Indian 3Medical Gazette. BILLROTH7li ON ACUPRESSURE. ACIUTORSION, AND TORSION. In fifty cases of amputation Irofessor Billroth performed acua- pressure or acutorsion, using on an average four needles in each case lie lias perforned it on two hundred arteries, includinig tifteen cases of amputation of the thigh; lie has had no oppor- tunity in cases of amputation of hip-joint, laving had no caes lately; in exarticulation of shoulder lie never succeeded in fixing the needles firmaly enough to rely on methods above named. Acu- tcrsion was perforimed more, acupressure les frequently, acuiil.a- pressure in no case. -Iamorrihage following removal of needles occurred in one case only; he accounts for it by his having per- formed acupressure according to the first English method, comu- pressing against the integument, the brachial artery, the medin nerve, and belly of the biceps muscle; this caused fluxion Lo the compressed parts; removing the needle, they receded, tearing tLe adhesions which had compressed the artery. fe therefore ab stains from acupressure en masse, and reconmends careful acutor- sion. In acutorsion, he considers one lialf turn sufficient, and preferable to a whole turn or more, since the needle is removed more readily. Gold needles occasionally become bent if very long; but they can be removed without causing irritation, and are there- fore preferable to all others. Prof. Billroth attempted torsion in several cases of amputation of the breast, with such negative results that he abstained,from it until agaii led to it by English surgeons, and Porta, who perforned it four lundred times without secondary hwinorrhage (out of 23 attempts of torsion of the lemoral artery he failed flour times, and applied ligatures.) During last summer Billroth performed torsion in five aniputs. tions of the leg, two of the foot, two of the fore, and one of the upper arm; also upon the greater number of arteries in several amputations of the thigh. Secondary hamorrhage occurred in one case, from the posterior tibial; he believes this was due to his having forced the torsion. To perforni torsion successfully, lie considers it necessary-1. To isolate theà vessel thoroughly; 2. To grasp the end of the same with a strong, well-litting pinzette: 3. There must be a certain length",
         "CANADA MEDICAL JOURNAL. of vessel from the end to the nearest branch. Thes;e condition; are not given in the mammip, hence his previous failure. Although Porta recommends maaking but slight traction, foui to five turns in snl, and six to eight in large vessel, Billroth has in every case drawn out the vessel from one tc oie and à ha fr inch, and turned the pincers until the vessel was t'irn isunder, one por- tion remainig in tlie instrument, tlie other receding; this was done to alter the walls as mnucli and as far a posiile, iii order to gain ai extensive thrombus. Posi-mortem examnination hias pioved these views to be correct the advantage of an exton-iv t], u i., .wever, counter- l¼alanced by the fact that vessels i-olated for a greater distance. and denuded of their sheath, become necrotic. In cases below the knee and elbow, Billroth considers torsion advisable, if not to near a larger branch.-ew Y k Medical Journsal. BILLROTH ON OVARIOTOMY. This eminent surgeon, in his \"Reminiscences,'' published in the Weiner Jed. Wochenschrift, says of Ovariotomy: First of all, surgeons must dismiss from their minds that ovario- tomy is a dangerous operation; and, through the med ium of well- informed practitioners, this conviction must maike its way with the public. After ovariotomy, skilfully performed according to the i ies of art, recovery is the general rule, and a fhtal issue the con - stantly-diminishing exception. Comiparing it with some other operation;, ovnriotomy, taking the mass of cases, is shown by statistics to be less dangerous than amputation of the thigh, dis- articulation of the shoulder and hip-joints, or excision of the hip or knee. Its danger is about the same as that of amputation of the arm, excision of the shoulder, partial excision of the jaw, lith itomy in the young, and similar operations. We must, how- ever, perforrm ovariotomy strictly according to the rules laid down by the English operators in their classical works; and only after having attained the same results should we venture to practically put into force our own ideas, in order to improve upon these. 1 h-id the good fortune to see Spencer Wells operate upon two con- plicated case, and froin thema, as well as fror oral communication with this remarkable min, I learned mnuch. I constantly follow his precepts, knowing that lie has long since thoroughly thought ont -and tested all that can happen to myself. I shall willingly regard myself during my lifetime as lis scholar; and contented shall I be if it falls to my lot, by means of this operation, to snatch",
         "BLACK SMALL-POX, AND ITS TREATMENT .361 from certain death one-half of the number of lives he has been enabled to save. Up to the present time I an tolerably contented with my re- suits. I give here a short account of them, in order fo encourage tlie performance of these operations, and especiall to inform the colleagues into whoe .hands these lines may fall that I have per- sonally, no reason for supposing that the results attendant upon Ov triotomy will be less cheering in Vienna than they are in Lon- dn. liflerto, I have performed \"it nine times; and of these patients only two have died, giving, therefore, only a mortality of 22.2 per cent. - The first four cases recovered one after another; then two fatal cases occurred, to be followed again by three re- coveries. ' The fir.\u003et case is related in my Zurich \"'Chirurgische Klinik,\" and the second, third, and fourth cases in the \"Chirur- gische Klinik,\" publislied at Vienna, in ]68. BLACK SMALL-POX, AND ITS TREATMENT. Mr. John Aiken, of Glasgow, ihas the flollowing valuable article in the Glasgow 3fedical Journal:- The onset of this fearful form, in nost of its symptoms, re- sembles that of ordinary small-pox. It is attended by the usual sickness, fever, furred tongue, etc., but in addition there is very great oppression of the breathing, and great prostration of strength. The pain in the back, so often looked upon as patiognomonie, is quite a variable symptom, its place being occupied by the hurried and oppressed respiration. The patient is usually brought to the hospital about the fonrth or fifth day of the disease, but in a few cases we have had the privilege of observing its progress from an earlier date. The ordinary state of patients on admission, and progress of the disease, may be described as follows: The patient lies on his back, apparently exhausted, the legs stretched out, and the arrms and hands lying as if powerless, by the sides. The face is flushed, and a deep red colour, with more or less of a cyanotic hue. The respirations are hurried, imper- feet, and not filling the chest-often exceeding 30 per minute. The pulse runs from 100 to 140, and, at this tine, is full, but soft, and often intermitting. The skin is hot, and gives to the hand a feeling of acridity, whlelc the thernometer records from 104 O Far.",
         "CANAýDA MEDICAL JOURNAL. to 106 Z Fahr., and in one 108-2 0. In many cases, and especially in the early stage, the skin is excessively tender, the, patient suffering acute pain, even from an attempt to examine the state of the pulse if not very gently conducted. The cornew are pre- ternaturally bright, and sometimes the conjunctivoe are injected while the eyelids are swollen and of the samue dusky red as the face. The skin on the surface of the body has a similar appear ance. This congestion.. for the tirst few days, disappears on pres- sure, but is freely intermingled with a punctated ecchymosis. In the most rapidly fatal of those cases, there is always no trace of a vesicular rash, while in others a few scattered vesicles of ordinary size may be distinguished, and in most favourable cases a very flat rash of a vesicular nature may be found shining through the cuticle like so m.1ny white spots, yet never developing suffliciently to be perceptibly raised above the surface of the rkin. It eau be felt beneath the cuticle like grains of sand freely sprinkled over the skin. As the case proceeds, the points of ecchymosis, sometimes slowly, but sometimes with fearful rapidity, increase in size and number, and, coalescing, form large collections of extravasated blood. A similar effusion soon takes place frora the conjunctival vessels, se as to form mere sacs of dar k-coloured blood, more or less hurying the cornete. Should the patient be a female, from a comparatively early period in the case we find uterine hwiorrhage. This may commence at any period between the second and fifth day, but more fiequently toward the fifth. At first the blood is fluid and dark in colour, but, as the quantity increases, it is discharged in the form of large, dark-coloured clots, which are easily broken down. In some cases the quantity lost may be so great as actually to cause death. Such was the case in E. R., a young woman 23 years of age, who died with all the symptons of post partum hæmorrhage, on the beventh day of the diease. A careful in- quiry could elicit no possibility of early pregnancy; in fact, the girl stated that she had menstruated almost immediately before her present illness. It occasionally happens that hæemorrhage occurs at or near a menstrual period; but although this is a note- worthy circumstance, it is not a fact of great clinical importance. The ordinary menstruation occurs, as usual,. during small-pox, often slightly increased in quantity; but this has no prejudiciaI effect, but rather the reverse, as it fiequently is followed by a relief of the mental disturbance, and occasionally an abortion Of the rash. If, however, the case be oe of hwimorrhagic smal-pOSP the quantity discharged soon becomes excessive, and all the char; acters of normal menstruation are lost. Towards the close of the 362",
         "BLACK SMALL-POX, AND ITS TREAMENT. 36 fifth or on the sixth day (sometimes a little later if the patient be a female,) the sputa become rust-coloured, and the oppression of the breathing rapidly increases. The quantity of blood becomes greater hour by hour, until the expectoration has the appearance of tar mixed with viscid mucus. In one case,. to which we shall afterward have to refer, bright arterial blood welled from the mouth in the form of a fine froth for several hours. It was care- fully ascertained that in this case there was no epistaxis. The urine about the same time becomes Iirst tinged ,or smoky, and then loaded with dark coloured blood-never in the form of clots, but occasionally containing fine shreds. The stools toward the close contain blood in large amount, either in a tarry state ini- mately intermingled with feces or in a fluid state evidently shed from the lower bowel-~the fecal matter, when distinguishable, being very pale in colour and clay-like. The subcutaneous ecchymoses increase until large masses col- lect in a cellular tissue, distending it, and raising lumps as if of recent bruises. Sometimes this takes place in the forehead and eyebrows. causing them to overhang the eyes, and giving to the whole face a most repulsive expression. Such a state never lasts long. The temperature, which has hitherto been six or seven degrees above, the normal, suddenly falls beneath it: the pulse runs up until it is almost uncountable, frequently intermittinîg and very feeble , the respirations increase in frequency and decrease in efficiency, the air being but little car- ried into the lungs, thougli the struggles of the patient for breath are agonizing. Blood pours from all the mucous su-faces, and, oozing through the distended conjunctiva trickles over the cheeks with the tears-giving to the face, already sunken and death-like, an aspect more disgusting than it is possible to describe, and causing one to wish for the terimination which so soon relieves the sufferer. During the greater part of the time the patient re- tains his consciousness, and it is only at the very conclusion that the sufferings are veiled by the advent of semi-coma. In children I have seen obstinate bleeding from scrofulous ulcers on the neck. The blood shed was fluid and very dark in colour, and the bleeding was not controlled by touching the surface of the ulcers with nitrate of silver. Until the end of May last not a single case was known to have recovered. Before long I became satisfied that we had to deal, not with ex- traordinary virulence of the small-pox poison, but with its develop- ment in a peculitrly fitting soil; in fact, that it was not the epidemie nature of the disease, but the condition of the patient, 363",
         "CANADA MEDICAL JOURNAL which was the main determining cause of the type. A fortunate sequence of cases suggested the seat of the mischief. It was a well known fact that a change of residence from the eountry , a small town, where a person has been constantly employed in the open air, to a large city and an in-door employment. is followed by very marked symptoms of impaired nervous energy. This history and these symptoms preceding the commencement of .the attack I found in a number of consecutive cases, and I was thus led to extend my inquiry into other causes of enervation in the previous history of the patient. Epilepsy, paralysis, chorea, and other causes of impairinent of the nervous system, appeared in the previous history of some, while in others, where the cause of nervous lesion was not so evident, nothing more than previous symptoms could be elicited, attributed to confinement in close or ill-ventilated work-shops, heat, or some other depiessing agency. The great prostration and the tendency to hypostatic congestions which I observed invariably in such cases strengthened my opinion. Having thus been satisfied that the lesion lay in the nervous system, the next step vas to try what could be done in the way of treatment. I chose strychnia as the most powerful nervine tonic with which I was acquainted, and determined to push its use to the greatest extent possible. The following was the mixture used:- R-Liquoris Strychniae. Tinct. ferri hydrochlor., aa Sj. Inf. quassite, ad ,viij. M. Sig.-One to be given every three hours. Considerable fear was entertained at first lest mischievous effects should be produced by the large doses of the strychnia in the ex- hausted state of the patient, but experience showed that gjss of the Liquor might be given in the twenty-four hours, if tihe case was very severe, and yet no physiological effect be produced; while in an ordinary case, in which mcrely -j, per diem had been given, slight trismus and pain and twitching in the muscles of the neok resulted. In those instances in which the case came under treatment early, our results were very satisfactory. If the hamorrhage had not yet commenced, it was often prevented, or merely occurred to such an extent as to show the tendency; while if it had com- menced, packing in wet sheets for a few hours was found a most valuable adjunct to the treatment. Mr. Greaves had previously aatisfied himself that this practice had a beneficial, though tran- sient, effect upon the hiemorrhage ; but it had becn discontinued",
         "C\\SE OF SNAKE-BITE. on account of the great exhaustion it produced, which we now found could be avoided by the combination and the administration of a'small dose of stimulant on the removal of the pack.\" The nexti beneficial effect noted was the relief to the respiration. The crepitus, which before could be heard all over the back of the chest, diminished, and the respirations became much more efficient and decreased in frequency. The colour of the face improved, the pulse became steadier, and the ecchymosis disappeared. The rapidity with which this latter efiect took place w-as a matter of great astonishment to us all. I have seen a young nakn brouglit in with the whole skin like the colour of the.bloom upon a plum, the breathing rapid and oppressed, the urine con taining a lai ge quantity of blood, while not a trace of rash could be found on the body; and in three days the ecehymosis disappeared, the breathing became tranquil, the urine clear, and a copious small vesicular rash was developed upon the skin. ' This now introduces the next feature-viz., the development of the rash. This usually takes place to a greater or less extent within the ftirst twenty-four hours of treatnent; but it is not the ordinary rash of snall-pox. it consists of a greater number of minute vesciles, which continue fHat, and as the case progres.-es, coutle.ce, detaching large pieces of the cuticle, vlich is raised into enormous blebs .onetimes stand- ing three-fourths of an inch above the surface, and filled with a sero-purulent fluid. These bur-t and formi crusts which eventually fall of; leaving no pits, but a tender pink skin beneath, which was often the seat for some time afterward of furfuraceous desqua- mation. This development of rash after the use of strychnia I have seen in cases not of a h;'morrhagic type, and was, thus led to adopt the rile never to give it until the rash had fully declared itself. My colleagues and myself have now treated in this way over forty cases which cane under treatment at a time when there was a possibility of doing them good-viz., eitheir before the com- mencement of hoemorrhage, or before it had become alarming ; and we have had the satisfaction of guiding fully two-thirds of such cases to a successful termination ; while under any other method we believe they would have died. CASE OF SNAKE-BITE. Communicated by J. FAYR, M.D., C.S.I. I am indebted to Major C. A. McMahon, Officiating Commissioner of fIissar, for the following very interesting account of a case of death from the bite of bungarus ceruleus, in which homaturia was 365",
         "CANADA MEDICAL JOURNAL. a promment symptom, and where life seems to have been prolonged by the internal administration of stimulants. From Major A. C. MVcMahon to Dr. Fayrer. I enclose an interesting account of a death from snake-bite. Mr. Davis, a customs' patrol, was bitten on the 31st of August, (evening,) and did not die until II a.m. on the 3rd of September, having been kept up by ammonia and brandy all that timne. They case is interesting, because Mr. Davis had skilful treatment from the first, and the most approved remedies appear to have been applied. Mr. Davis became perfectly insensible almost imne- diately after he was bitten (showing that the poison was powerful and active) and yet he wis restored, not only to consciousness, by the internal administration of ammonia and brandy, but he became sufficiently well to do some work, anc sign sone official papers, (the latter part is not mentioned in the accounts I send you,) the influence of the poison having been checked for so long, one would hardly have anticipated a fatal termination about 63 hours after the poison was received into the system. It almost seenis as if when a man is being bitten by a full-grown cobra, or krait, stimu- lants only postpone the fatal hour. The case is an interesting one, and I shall be glad to hear your opinion on it. The snake was evidently a krait. low ignorant men are of what snakes are deadly and what are not! 3Mr. Davis surely did not know. The two accounts I enclose are by Mr. Edwardes, District Super- intendent of Police, Rohtuck, and the Sub-Assistant Surgeon of Honsi. I think they give, taken together, a very full, complete, and accurate account of the case. - Statemnent of Mr. F. N. Edwardes. On the 3lst August, 1871, I was on ny tour of inspection at police station Mahnim in this district. and on the customs like. A,, Mr. Davis, an assistant patrol, went out patroliing on foot in slip- pers in the evening, and returned at 8.30 p.m.; as he entered the gate of the compound, he was bitten on the instep by a small snake, a karite or krait, or kerite. lie had time to kill the snake, which was about two feet long, of a yellowish colour, with blackish stripes across its back withhis slipper. On iMir. Davis being bitten,, he called out to the guard at the \"thuk \" (or weighing house,) to bring a lattüe, and by the time the men reached a distance of not 100 yards, Mr. Davis was insensible; they brought him to me at 8-.30 p.m., or a few minutes after he was bitten, with the part biýten bleeding and a string tied under his knee, which I fancy he",
         "CASE OF SNAKE-BITE. 3l57 himself tied. I gave him ammonia and brandy in a wine-glass, cut the part where he was bitten with a penknife and rubbed am- monia into it; on my giving him the second or third dose and rubbing his foot with ammonia and having him walked about, he came round, and at 9 p.m., was all right and perfectly sensible. I still kept walking him about and giving him small doses of am- monia at short intervals,.-first with brandy and afterwards with- out, as lie did not like the brandy. About 10 p.m., I allowed him to sit down in a chair, he then became a little sick, but came round again. I left him at Il p.m. perfectly sensible, and the only thing lie complained of was a pain in his leg. I was obliged to come into Rohtuck and was myself unwell. Shortly after Mr. Davis was brought in and after he came round, I thought it as well to send for the customs' native doctor at Hansi, and wrote him a putwanah, ordering him to come to Mahim at once, and on my reaching Rohtuck, I wrote to Mr. Davis' brother, telling him of the case and advising him to go out; lie went out on the Ist Sep- tember, and tells me found his brother very well, but complaining of the leg being tied up and wishing to open it; lie remained per- fectly sensible and well that day, that night, the next day, the 2nd September, and that about 1 a.m. of 3rd September, began vomit- ing; at first lie thought it vas nothing, but on his vomiting a second time he got up and attended to him. On his asking his brother how he felt, lie said that he found his chest paining him a great deal, and complained of suffocation; after this lie tried to vomit again, by putting his finger down his throat, but failed. The native doctor was present, and continued giving ammonia with brandy. He after this once fainted and began to get weaker and weaker, and after about 3 a.m., lie did not speak, and died about 11.30 a.m. On the 3rd September, Mr. Davis states, that after he fainted, lie got convulsive, three times, that on the 2nd Septem- ber, about 3 or 4 p.m., he remarked that his brother was passing blood in the urine, stools, also from the part bitten, and vomiting. MIr. Davis states that lie remarked the blood getting blacker and blacker as death approached. RoirrCa, 6th October, 1871. Statement of case by Sub-Assistant Surgeon B. R. Paul. With reference to your docket No. 773, dated 9th instant, Ihave tbe honour to submit the following particulars of Mr. E. F. Davis's lamentable deatl, which occurred on the 3rd ultimo, at 1l a.m. On the 31st August, 1871, Mr. Davis after taking his dinner at 8 P.m. with Mr. Ed%ýardes, Assistant Superintendentof Police, Roh-",
         "CANADA MEDICAL 1OURNAL. tuck, (who had come to Mahin on his; tour of inspection) wet out patrolling on foot towaid, the Hani line, and Un his retuis, not very far from lis bungalow, just near the nika,* he saw a small, thin, black and -white sna.ke lying on the road, which he at- tempted to kill with his foot. but the slippers le had or beiig loose, unfortunately cane off, and tie snake bit hima on the riglt foot, just above the great toe. lie, lwever, killed the snake 'iii walked a few steps, when he fell and became quite insensibie and was carried by sone of the peons to the bungalow. Mr. Edwardes immediately administered soine strong doses of brandy and liquor ammonia (which I had lefi with Mr. W. Forster for snake-bite,) which niade him vomit and brougit him to lais senses; he was kept awake all night, and brandy and aminonia were administered frequently. On the morning if the 1st ultimo, at 9 a.n., 1 received the notice and immediately started whh a proper supply of medicines to Mahim, and found Mr. Davis, thougli quite sensible, yet very uneasy; hlis right foot and leg up to the thigh were very much swollen, and in several places had become blue, especially at the bitten part, fron which blood was oozing in drops owîing to its having been previouly incised by the knife, and a kind of stone, called zahr-wohre, was applied for the purpose of absorbing the snake poison. The pulse was slow, respiration not diffHcult, pupils slightly contracted, urine frequent aud consisted of pure bloud; sputa also frequent and consiýted of pure blood; couplained of great thirst and feeling of uneasin 5s throughout the whole body i stabbing pains now and then at the bitten parts; stomach very irritable and would not retain anything. Treatent.-Stimnulating mixture with liquor amnionia was exhi- bited every half an hour, which was retained; the swollen parts were fomented wi h decoction of meen, vhichs gteatly relieved the pain, and reduced the swelling, and the patient was not ailowed to sleep. On the morning of the 2nd, le said he felt better, sat down for half an hour on in easy chair, and took a little sago, whiclh was re- tained; pulse a little inproved, but the urine and sputa still bloody, though iess frequent. Stimulating mixture continued every second hour, instead of half an hour; fomentation continued. A4t 2 p.m., he conplained of severe pain in tie abdomen, wlhich wmas relieved by hot fomentation, but le made several unsuccess- ful attempts to evacuate his bowels. At 5 p.m., he asked to have soie chicken brotl, and wanted to * The high thick thorn heldn carriel acrosý tlie eomitry by the Customs Dep:st ment to prevent smnuggling. Neither mau nur beat can get over or through it.",
         "AFDRESS BY SIR W-M. W. GULL. have an unditnubed sleep. wlhich were allowed, as nowit has been more than 48 hours since he had been bit. At 10 p.m., a relapse took place; he voinited the broth, mixed with a large quantity of blood, and felt very uneasy and prostrated; stimulating mixture withliquor ammonia was given, too, frequent]y every quarter of an hour. At 12 p.m., he again felt worse, suffocation and headache en- sued; his bed was taken out into the verandah, and the medicine was continued. At 2 a.m., the patient got very weak and insensible: pulse very low, breathing very difficult. ennl ions cormenced. and he could only be rousec by lond calling, and with difficulty could swallow the medicine which was given. At 4 a.m., he became comatose; could not be roused at aIl, neither could lie swallow medicine or water; cold perspiration broke out over the face, eyes depressed, extremities becane cold, pulse scarcely perceptible, breathing prolonged and stertorous; convulsions more frequent; twitching of the right hand and beat. ing of the right foot, the lef t side of the body became paralysed, eyes insensible to liglit and congerted, involuntary discharge of bloody urine and stools, au nt Il a.m. lie breathed his la.st; his corpse was carried into Rohtuck for inteinment by his brother, Mr. Davis (Head Clerk, Deputy Co'nmissioner's Office, Rohtuck,) who arrived at Mahim at the saine time as 1 did. In conclusion, I would beg to state that Mr. Davis solely died of snake-bite, and ladt no other dîseqse. He was addicted to opium.- luriun Medical Gazette. HXAI, lth October, 187, ABSTRACT OF AN ADDRESS ON TIIE ADVANCEMENT OF MEDICINE. Delivered at the Annual Meeting of the Clinical Society of Lon- don. By Sir' WX. W. GULL, Bart., M.D., D.C.L., FR.S., Presi. dent of the Society. In addressing you this evening, gentlemen, I have in sone sort to throw myself on the forhenrance of the Society, for, though I have been able to bring certain ideas together on the subject on whieh 1 desire to speak, I have not, for want of time, been able to adopt a form of words such as I would have liked. In some sense 1 arn the spokesman of the Society as its President, in especial when laying before the public the objects of the Society as I would now do. X",
         "CANADA MEDICAL JOURNAL. We, in our calling, differ from some theologians in one important respect; they look on this world as a decaying world, as mnuch worse than it once was; we, as students of nature, are opposed to this view, for if we look to the history of nature we see we are ever advancing towards perfection, even if we are not likely to reach it. This is an improving world, and we are met to advance that idea. We believe that this world has something better in ,tore for all than anything which has yet been seen, and are like to the cnvalescent, whose last day should be always the very best he hbs ever speut, Some men are apt to think that science has certain limits set to it, beyond which no man may go; but we Le- lieve that knowledge extends far beyond the strictly scientific limit. Doubtless, were the early lower animals assembled together in conclave, they would conceive it quite impossible to transcend their status; that when the world came to megatheriums, let us say, then it must stop. They could not conceive tb possibility of such a being as man. But at this point we join the theologians again in accepting a metaphysical element, in forming conceptions of thmngs of which ie have no positive knowiedge. In this way we may be said to worship nature, but only in a very limited sense. We look upon our being, not as perfect, but as becoming perfect, and, we are here to-night-and at all times have it as our object-to improve these defects of nature, and in endeavouring to perfect the human frame. Respecting the object we work for-this living organism of ours -one great advance has of late been made. We are acquiring a physiological notion of disease. Disease is no entity; it is but a modification of health--.a perverted physiological process; and this must at all times be insisted upon Were it not that we fear death, and dislike pain, we should not look upon disease as any. thing abnormal in the life-process, but to bc as part and parcel of it. Few would now venture on a definition of disease; for in reality it is but the course of nature in a living thing which is not health. In health the balance of function is even; incline it to either side, and there is disease. That being so, just as the hfe- process constitutes an individual and puts him apart from his fellows, so must any alteration in it be individual, and not general. But to the ignorant disease is an entity-an evil spirit whicb attacks us and seizes us. lence aries the word \"seizure,\" which, though in a somewhat different way, we still use, but with a pro- test. To the charlatan, di-ease is a set of symptoms to be attacked by a variety of drug,-a drug for each symptom. To us, disease is a life-process of a perverted kind. Many states are not now called diseases which used to be, and 370",
         "ADDIz£ BY . IS WML W. ('LL. there are still some tu be expunged. Somie people are always ailing. Some have feeble st ibility, and to them it ise natural to be ill as it is to others to be well; but this i, not disease. Se, to- aged persons get il.- but this is not dikease-in reality it is natural change simulating disease, and when we try to cure such we use all the farrago of the chemist's shop to prevent the sun setting. So syphilis at last ceases in the system to be yphils, and becomes an early decay. It is curious to consider the various morbifie agents at work within our bodies, the lines in which they work, and their seats of action. These as yet have been but little studied, and deserve attention. Thus, it is very doubtful if scarlatina begins in the blood, as we should ail be apt to say, rather than in any other tissue or fluid. Let it be our object to ftid out where all these begin within the body, and how they enter the body. In future, I hope, comparative pathology, which is just beginning to be studied, will teach us muchl for in our bodies we men have many o gans which are of little or no use to us, and are only relics of a former state of being. What, for instance, is the comparative anatomy of tonsils ? Were I to make a man, I do not thînk 1 would put tonsils on him. Yet these, and such like organs, in accordance with the general law, are more prone to disease than aý e the others which are of real use in the system. I remember the case of a man who had a permanent vitelline duct, He had been out on a cold day, and the motion of the intestines twisted thei i a mass round this persistent duct, and he died. I made a prepaiation of the duct, andwrote under it-- Cui vitam atque mortem (ledit diverticulum.\" Every part of the body is alive, and has its own individual life and pathology, whether it be imme- diately required or not; only, if not required, it is more prone to disease than if it were. I could, for instance, suppose a fotus of four montlis going to the doctor and saying--\" I am going all Wrong; my Wolffian bodies are disappearing, and kidneys are coming in their stead.\" Yet that is as much a condition of dis ease as some of those conditions of which I speak. It is of the utmost possible importance, then, to be able to tell what we have and what we have not to cure. Hoew often do we fLad people trying to do what s impossible. Some women have ne more vital capacity than a canary bird; they are constantly ill, and it is useless to attempt to make them well. A man came to me, and said: \" I don't know what to do with So and so. I have given lier everything 1 could.thinkolf, and she will not get strong.\" \"Why,\" i said, \"you have been trying tO put a quart into a pint Pot. You cannot make lier strong, and never will.\"",
         "CANADA1 MEDICAL JOUJNAL. So, when a new instrument or mechanical means of diagnosis is introduced, we must try to make ourselves masters of it, so as to be able to use it arigir, even though this is troublesome to our- eelves; only we must beware of applying the knowledga thus acquired too early to practice. Thus, as regards the ther- mometer, doubtless it yields us most valuable information, but we must beware of using it as a guide to Our treatment until we have a more comaplete knowledge of the condition of bodily tem- perature. But after the phy.ical comes the vital ditgno'is. It i\u003c well to know exactly what i- the condition of eawh part of the ,ysteU; but to what is the wrong due 2 That 'io weighmng or neasuring can give you-only expenence. A man his pneumoni-that is a too vague fact: what are the dyoamics of the die o One manî with a pneumonia will get rapidly vell aUid Le right a gain in a few diys. wheieas another mai will not get well at all. iio i different individuals, a forn f die apparently the saime may be diflfr- ent from the beginning, and thi, we caniot aiwty\u003e make out in Our diagnosis. especi dly il internal diseae. hi lkl dheaes we can do better. During the Last week J Lave been called wn, ats msct Of you know, to formi a diagnosis of the workings of die mind. lere the break-down nay be the first 4ign of the diseased condition, just as itmay be in heart diease, pentomtis, and a score ef otherdiseases. A man, after racing up a hill, finds himself breathles and spitting blood. He comes to you, and you find heart diease. It does not mean that the heart disease was produced1 by ruxîming up ithe hill; it ouly means that au organ, equal to its ordinary duties, failed when unusual stress came to e laid upon it, So is peritouiti, often the result of disease previously latent, but brought on by exposure to cold, or somle such agency. SomDe men say that such cases as those of doubtful sanity should not be tke up by *uý-that or- dinary men are quite as w'ell fitted for linding out the truti as we are, with all our training, Il eo, all I say is, that it is no honotr to us that it is so. Now therapeutics is the end, thougi the study of dieased con- ditions might be pleasant enough by itself. We are sometinoS twitted with letting Nature alone to do hier woik. We do nOt. And here, again, we join issue with the tleologian.. They i!Y@ If it is God's will that a man die, so be it.\" But say we, 'God's will is to be found oti it is not a mere ftMe.' We are not ignorant woi shippers of natu e. and whetber a man is dooned to die or 'lo we know only by the lesult, We are eonnective agents. We have to adjust and correct. We know the tendency to recurrence tO",
         "PUS AND PUS COR-PUSCLES. the equilibrium-that is, health-and we endeavour to assist in adjusting this balance in each individual. In fever, for instance, two things are promptly at work-de- structive changes, and changes tending to recovery. In such dis- eases there are certain superficial accidents which we are apt to notice. In fever there are olten complications; but these are really part of the fever-process, and are not to be interfered with by themselves. Our study must be, how best to bring the condi- tion to a safe ending: for a patient in fever may get. well of the fever, and yet die of a bedsore. In conclusion, if I have spoken more as regards medicine than as regards surgery, I think the surgeons ought to be indebted to me for hints towards the extirpation of superfluous organs-a grnnd prospect for the surgeons of the future.-British Medical Journal. PUS AND PUS CORPUSOLES. The Times and Gazelle remarks that two highlyintesting memoirs on the chemical composition of pus corpuscles, and on the chemIcal composition of pus, by Drs. MIEscrER and HoPiE-SEYLER respectively, have recently been published (Hoppe-Seyler's Xed. Clem. Untersuch., 1871, pp. 441-486); indeed, Prof. Iloppe-Seyler -no mean authority-regards Miescher's researches as the most important contribution that has been made of late years to the chemistry of pus. We propose to briefly summarize the results arrived at for the benefit of our readers. Miescher, in order to obtain pus corpuscles free from serum, treated pus and fabrics impregnated by it vith saline solutions of appropriate density. In these liquids the pus corpuscles sink to the bottom of the fluid, and may be obtained tolerably pure by repeated washings. Attention was first directed to the albumi- noids of the protoplasm. Pus corpuscies are mainly composed of albuminoids, and, when treated with solution of common salt, they are converted into a viscid gelatinous mass-a change dependent, as Rovida has shown, on the formation of a ring of hyaline substance around each Corpuscle ; but this is not due to inyosin, for Miescher could obtain no reaction for this body. Pive albuminoids were obtained. agreeing (in numnber, at least) with the live different albuminoids found by Kühne in muscle. These were-alkaline albuminate, undetermined whether kept in solution by alkaline phosphate or no0t; an albuminoid coagulable at 1180 to 1200 Fahr., which was not merely albumen dissolved in alkaline phosphate; an albumi- 37j3",
         "CANADA MEDICAL JOTJRNAl. noid coagulable at the temperature at which ordinary serum albu- men coagulates; Rovida's hyaline substance ; and a fifth albumi- noid, the reactions of which need not be described here. Mies- cher was unable to detect paralbumen, though he does not deny its presence. The alcoholic extract of the globules was only investigated for lecithin and cerebrin, both of which were found to be present, the former in abundance. No glutin or chondrin was found in the watery extract, nor in the serum of pus. It must be understood that a mixture of lecithin and cerebrin forms the substance to which Liebreich assigned the name 4' pro- tagon,\" a highly phosphorized material, for lecithin leaves, on incineration, produce an ash very rich in phosphoric acîd. But Miescher bas also demonstrated the presence of another phos- phorized substance in the nuclei of pus corpuscles, to which he has assigned the name uclein; and he surmises that this body, on account of its phosphorous, plays an important part in cell-growth and in the genesis of the cell albuminoids and their derivatives. Nuclein closely resembles mucin. but is richer in phosphorous, and it appears to exist performed in the corpuscles, With reference to the questions of the origin of pus corpuscles, their identity with the white blood globules and lymph corpus- cles, and their ultimate fate, Hoppe-Seyler's results are remarkably interesting. Since living white blood corpuscles cannot be obtained from the blood in quantity sufficient for chemical analysis, and the spleen, although furnishing them abundantly, contains cere- birn and glycogen (both of which it is necessary to exclude), a novel expedient was adopted. Fresh crystalline lenses froni the ox were introduced into the abdominal cavity of dogs, and, as was expected, the lenses became infiltrated with lymph corpuscles. The presence of glycogen was proved most clearly in the lenses at the period corresponding to the greatest number of active lymph cells; hence the conclusion that the glycogen comes from these. If, however, the lenses were allowed to stand still the corpuscles became rigid, sugar was found, but no glycogen. Since no glycogen was detected in the pus from inflammatory abscesses and wounds, its occurrence is a means of distinguishing lympï cells from pus corpuscles, although these have their origin in the former.",
         "MONTREAL, FEBRUARY, 172. SANITARY REFORM. In the last number of this journal, we spoke of the contagious character of certain diseases, ,uch as Small-pox, Scarlet Fever, Measles, Whoopng-cough and Cholera. We alluded, moreover, to their being eminently preventible, by the adoption of certain precautionary measures, to which we propose to allude in this pre- sent issue of our periodical. It bas been computed that Jenner's great discovery. saves fron death by Smal-pox each year, in the British Isles, 80,000 lives, but there is not a country in Europe in which the beneficial resuit of vaccination has not been fully tested and proved. In Marseilles, in 1828, Snall-pox was epidemic. The Acadeny of Medicine, Paris, took special care to collect the statistics -f that epidemic. It was found that 8,000 persons in the city were unprotected by vaccination or a previous attack of Small-pox. Of these 4,000 or one-half, took the disease and many of them died i on the other hand, 30,000 persons in the city had been vaccinated, or were otherwise protected, and of these, 2,000 took Small-pox, and some of these cases were of a severe type. We merely mention this case, more to place it on record, than to add any material weight to the already overwhelming evidence which is obtainable on this point. The assumption that vaccina- tion is actually and in reality a preventive to the disease Smaall- pox is incorrect. In -a great number of cases it proves a protee- tive power which is at once striking and unmistakable, but that it is absolutely in every case a protection against the disease Small- pox, experience has proved to be untrue. This, however, is no reason against the erployment of vaccination. Vaccination has been shown to be one of the most efficient means at our disposai, for the prevention of the spread bf Smail-pox. But there are other means which experience bas proved to be equally efficient, perhaps of greater efficiency. These in the main consist in isolation, strict seclusion, surround- ing the sick with nurses and attendants who are themselves in-",
         "CANADA MEDICAL JOURZNAL. capable of being affected, inasmuch as they are known to be pro- tected against the disease i and the early purification hy disinfect- ants, and frequent ablution of the patient, his clothing, bedding, and the apartments he has occupied. When the cattle disease spread from Europe to England, in 1867- 6, it was found to be a highly contagiouis malady, so much so that an infected animal would communicate the disease to a whole herd. The most efficient meatns for the arrest of the disease consisted in the destruction of the diseased animal, and sonetimes of all those that had been exposed to the contagion. This of course was an expensive but most efficient method of treatment, and in due course of time tiue Iliuderpest, as it was termed, dis- appeared. But inasmuch as the Lycurgan Laws do not at present exist, this mothod of stamping out contagious diseases is not ap- plicable to the genus homo. There are however measures quite as effectual as the pole-axe, which if faithfully carried out, would ivithout doubt arrest the spread of contagious disease. We observe that the Editor of the Canadian I/lustrated News in alluding to the articles which have already appeared in our journal on the subject of \"Sanitary Reform,\" propounds the novel doc- trine that vice and ignorance give rise to contagious maladies. If this be the case, it is greatly to be vondered at that these diseases are so prevalent among the virtuous and educated. Experience certainly bears out the proposition of Si . Y. Simpson, that con- tagious diseases never spring up de novo, but that they are always due to contagion or infection in some form. The Editor asks: \" Whence then the small-pox ? Does Sir James mean to teaclh us that it was crented, like the dog or the hawthorn, and must of necescity be propagated by its secdl?\" Mvtost certainly. Small- pox is (lue to a specific poison, but requires an appropriate soil for its development. We have it in the sacred volume' that the Alnighty permitted Satan to try the patience of Job, and he did so by afflicting him with boils and other sores. We nay the-efore infer that snal-pox was an invention of the devil, with as mucli logical precision, as that it was created like the' dog or the haivthorn. The Lditor of the Illustraked Nevs mistakes our meaningwhen he says : \"Suich hospitals under the ch'urge cf a Boardi etf Health withl powers that would be very likely claimed fo- it, nigbt be made the agency for nuch domestic agony by separating those who from family ties and personal feeling would rather.be together in sick nes as in health, and even unto Aeath.\" We never would re commend extreme measuresof this character, but if persons assume the respoisibility of the care of friends' under such con- - 376",
         "SANITARY REFOiM. ditions, they should be obliged to comply with the most strict measures of isolationj and segregation. We know of families in this city, and during this present epidemic of small-pox, who systematically sent their children to public schools, even while the disease smail-pox was in their houses. And we could trace if necessary the propagation of measles Pnd scarlet fever from the saine want of forethought and common sense. Such is the experience we doubt not of every medical rmn- It would appear that these measures cannot be forced on the people except by Act of Parliament. Man is so stupidly doltish, that reconnendations for the preservation of his health, comfort, or his very life will be by him neglected, or altogether ignored, unless they come with the authority of law, with certain pains and penalties attached for their neglect. 'Sanitary laws are based on actual observation and experience. It is well for any people if they profit by the experience of others. But the enforcing of sanitary regulations on the ignorant, becomes the duty of the Governraent of a country. In the case of Canada, the Government being without advice on this all important sub- ject, cannot be expected to follow the suggestions of Local Boards of Realth, or of every w-iter (however earnest), who takes up this subject in the interest of the whole community. What we would again urge, is the calling together of a, General Board of Health for the Dominion, not alone to counsel the Government, but to prepare an efficient and comprehensive bill to be submitted to the c'ommons of Canada during the coming Session. If this is not done, or if measures are not entered into with a view of arousing the people from the state of lethargy which exists, we cannot tell what amount of sickness and death are before us, and it will then be too late to set to work to remedy the evil while a state of panic exists. We observe that other countries are, as it were, setting their house in order, with a view Of averting the threatened approach of pestilence, or at least of being fully prepared for its invasion. But in Canada we have not taken the first step. We are crying out , Peace, peace, where there is no peace.\" It is a subject unpalatable, and therefore ignored or wholly neglected-but it is not the wisest course to pursue, and we earnestly pray that our fears may prove without foundation.",
         "378 CANADA MEDICAL JOURNAL. THE MEDICAL OFFICERS OF HEALTH OF MONTREAL AND TIIEIR CIRCULAR. on............ 187 To Das. DUGDALE AND LARtoCQUE, Medical Officers of Iealth, City Hall. 1 report the following cases of Small-pox: No. Street. Ward. (Signatire,) M.D. We received the above printed document, purporting to emanate fron the M1edical Officers of Health for the City of Montreal, and we were inclined to.regard it at first with favour, until we read an effusion Which appeared in the Montreal Gazette of the 5th February instant, headed \" The Medical Society's Opinion.* We copy the article in extenso, as it is too rich to bear any cutting down: \"Drs Larocque and Ricard having been named by the Medical Society of this city to examine an article in the 1ledical Record of New York, which treats of certain measures adopted by the New York Board of Health, for the prevention of the spread of con- tagious diseases, such as -scarlatina, small-pox, etc., and to report, and also having received instructions to confer with the Board of Health, and reconmend the adoption of similar precautions by this city, prepared their Report, submitted it to the Medical Society on Wednesday last, and- on Thursday to the Board of Health.ï The following recommendations were made : First, that every Doctor in the city shall be bound to report to the Board of Health every case of contagious disease under his tare second, that every.person keeping a lodging house'oihotel, or the, relations and parents of persons thus affected shall be bound in like manner. On receipt of such information tle Health Officers shall go to the place, and dècide whether the sick persons (of their owu free wiil)-shall be taken to the hospital. If the patient goes to the hospital, a sanitary policeman shall be ch~arged - with seeing that the house, and the effects that were used about the sick room, are disinfected. If he stay at the ,house the sani- tary policeman shall ascertain two or three tines a week whether the sanitary measures ordered at his visits are carried out., So soon, too, as the patient leaves his room, they must proceed to disinfect it. If the infectious disease be smal-lpox the vaccinatorý; of thiat district should be notified in order that he may proceed to re-vaccinate the whole family, as well as the residents in each ofQ the neighbouring houses,. and if necessary those who live acrosa ,the way.'",
         "'1HE HEALTH OFFICER 'S CIRCULAR The following rules to be observed in cases of small-pox, measles and scarlet fever, should be in the hands of all those who have sick people in their hands. That the Doctor, the nurse and the mother of the patient should be the only persons permitted to enter the sick room, or to touch the clothes used by the patient, unless they should have been disinfected. Second, that all those who do not wait upon the patient should be kept away from his room; and no use should be made of his clothes until they have been soaked for at least one hour in a pre- paration composed of three ounces of sulphate of zinc, one ounce. of carbolic acid, and three gallons of water, and afterwards washed' in boiling water. The feather bed, and all other bedding should be submitted to a complete fumigation before being used. The chamber vessel should constantly retain a disinfecting fluid, and be washed with. boiling water whenever used. The closet, or latrines, should be daily disinfected, by throwing in chloride of lime, in the proportion of one pound to a gallon of water, besides a couple of ounces of carbolie acid. In lieu of handkerchiefs it is recommended that piece of cotton be used, to be burned as soon as done with. So soon as the patient leaves his chamber, the ceilings, the walls, and wood-work, should bc thoroughly-washed with hot water and soap. They also recommeend that energetic measures shall be taken to vaccinate all those who have not yet been vaccinated. and those in whoni first vaccination bas heen dloubtful, and following the practice of the New York Board of Ilealth, to use only the lymph taken from the arms of absolutely healthy children-putting aside that which has been gathered Eeventy-two hours. They also re- commend that a circular should be issued through the churches, informing parents of children that they are bound by, law to have their children vaccinated within three months after birth- also that if any contagious disease, such as small-pox, measles, scarlet fover, or typhoid fever, breaks out in a family, they themselves are bound to give notice of the fact to the Board of lealth, within twenty-four hours after the diseae appears. In fatal cases the family should obtain a certificate of death from the family physi- cian . and if he be absent or if they have not employed a doctor, fron some doctor of the city. We can assure our readers that the Medico Chirurgical Society of Montreal, which is composed of ail the leading practitioàers of oui, city, is not the Society here alluded to, nor have tgiese sapient suggestions so far as we can ascertain, been submittè~d to that body. We may be in error, or perhaps we look on this subject in a different light to the promoters of the suggestions above, but certainly they savour of an aniount of ignorance and impertinence which is seldom met with. Are the Health Officers in earnest when they request their fellow Practitioners to report to thein any cases of smal-pox; or other' contagious disease, in order that they the Health 'Officers, may .379",
         "CANADA MEDTCAL JOURNAL. be il a-position to repair to the house of the patient, and decide the very knotty question of the fitness of the patient for removal to hospital. Is not every practitioner quite as capable of deciding this question as either of the Health Officers, or both of them together. But if the patient complies, his friends are then to be pestered by a sanitary policeman, who will isue his orders with the same amount of sang froid, as he orders householders to cut the ice from before their door steps, with the threatened alternative of being summoned before Mr. Recorder, and fined in case of non- compliance. We need hardly allude to the other suggestions concerning dis- infectants; no two minds agree as a general rule, and we see no good reason why a formula need be prescribed by the lealth Officers. Certainly if we required a disinfectant. we could select from the numerous remedies of that class some few which would be equally good and perhaps better, than a mixture of sulphate of zinc and carbolic acid in water. The recommendation to substitute a piece of cotton for pocket handkerchiefs is particulary good, but we would pity our patient's nasal appendage. The concluding suggestion is a matter of very great importance. In fatal cases a certificate from a medical man, setting forth the cause of death should be always obtained ; perhaps the Health Oflicers are unaware that a bye-law exists in the city code, com- pelling the keepers of all cemeteries to refuse burial without a niedical certificate of death, or a Coroner's order. We fear the suggestions of our city Health Officers will fall through; certainly in their present form they will not be complied with by the pro- fession generally, nor lias the Corporation the power of enlorcing theni. DRUGGISTS PRACTISING AS PHYSICIANS AND SURGEONS. We beg leave to call the attention of the authorities of the College of P'hysiciains and Surgeons to the following advertise- ment:- A: C CIŽ N A T IO N. Those who have not been vaccinated, and wish to be, for 5 cents. with the purest and best Vaccine, had better call round at, JOHN BIRKS', CHEMIST \u0026D DRUGGIST, 588 ST. CATHERINE; STREET, where upwards of 400 have been done during the last two weeks with perfect satisfaction. Don't fail to call at once. If the law under which the profession is governed has become obsolete, vhose is the fault ? The College has a purse in which",
         "THE CANADA MEDICAL JOURNAL. several hundred pounds are to be fouDd. We should imagine that a legitimate way of spending at least the interest of that money, would be in prosecuting all offenders. We are cognizant of the fact that several Druggists in this city, are constantly in the habit of prescribing over the counter, some go so far as to perform minor surgical operations: and others visit patients, and charge for their visits. These men, all of them, have set the College at detiance, in refusing to take out their license as drug- gists. Seeing they can act as they please without being interfered with in this particular, they next proceed to style themselves doc- tor, and assume the rights and privileges of that class, feeling con- vinced that the Iold fogies- of the College cannot hi any way molest them. If the penal clause of the act incorporating the profession is inoperative, why allow it to reniain so? Have it amended, and let us be in a position to change the present unsatisfactory state of things. TEIE CANADA MEDICAL JOURNAL. We have received a letter fron a contributor, on the subject of the objects of oui Journal, and who compares our Joarnal, unjustly we think, with the London Lancel and other medical periodicals, published every week in England. In publishing the CAAD Me.A JOURNAL we were induced to do so to give to the profes\u003eion in Canada, a means of making known their observations in the treatment of disease. No person can conceive the amount of labour conuected with a publication of this character. Single handed we have laboured unremunerated, except in feeling that we have done some little good; and we will continue to labour-although the profession lias not sustained our work, yet we hope that in time our confreres will be induced to earnestly aid us, by recording cases which nay come under their observation. This would benelit themuselves as well as the profession they have selected. It is no wise nan's policy to hide his light beneath a bushel. Lt is the char- acter of a churl, or of an indolent man, to allow important obser- vations to go unrecorded. What would be the present position of Medicine and Surgery, if earnest and painstaking observations had never been placed on record. We cannot but feel that Canada has not taken that stand in scientific observation which she ought to hold. The Medical and Surgical profession is as well administered here as in other coun- 381",
         "CANADA MEDICAL JOURNAL. tries, and yet, with very few exceptions, there has been very little done, that can be pointed to with honest pride as being the work of a Canadian. We have felt on more that one occasion than our labour was one of supererrogation, and ve have more than once been on the eve of relinquishing the task of publication, for we have feltthat our journal was not appreciated, nor was it a welcome guest. If, however, our subscribers would become our contribu- tors then indeed would much good result. and the CANADA MEDICAL JOURYAL would have fulfilled its mission. T1HE USE OF SECONDARY LYMPIL The British Medical Journal says: Our Manchester correspondent writes that the extent to which re-vaccination lias been practised in Manchhster during the last few months, has afforded rare op- portunities for deciding some questions which were before held by some to be still sub judice; for example, the custom which has prevailed among the mill owners of having all their ivork people vaccinated, has settled the question of the value of secondary lymph as compared with virgin lymph. Out of many similar ex- periences, the following may be quoted by way of illustration. A fortnight ago a surgeon vaccinated 300 operatives ; in 150 of these cases he employed virgin lymph; in the remaining 150, secondary lymph was used. The first series gave the following results; 19 cases were unsuccessful; in 16 cases, small papules and spurious vesicles resulted, while the remaining 115 showed well-marked primary vesicles. The second series gave very different results; for out of them 50 were entirely unsuccessful, -6 terminated in papules and small spurious vesicles, and only 14 yielded true pri- mary vesicles. A WEST OF ENGLAND CIRCULAR. Roger Giles. Sur John Parish Clark, \u0026 skulemaster reforms ladys and gentlemen that he drass teeth withowe waitin a moment, blisters on the lowest tarms and viziks vor a penny a pease. Hfe Zells Godfathers Cordel, kutz korns and hundertakes to keep hevery bodys nayles by the year or so on, Young ladies and gen- tlemen larned there grammer language in the purtiest manner, alzo gurt kare takèn off there morals and spellin, alzo Zarm Zinging teechin the bais vial and all sorts of phancy Work, Queerdrills, pokers, Weazils and all other contrary dances tort at\"",
         "MEDICAL NEWS. hoam and abroad at perfekshun. Perfumery and snuff in all its branches, As times be cruel bad He begs to tell that he has just began to sell all sorts of Stashuary wares, Kox, liens, foles, cheese, Poltry, blackin bauls, herrins \u0026 coles skrubbin brushes,. trakel, Godiey bokes \u0026 Bibles, Gimblets, micetraps, brick dust, \u0026 whisker seed, and hall sorts of sweatmeats, inkludin taters, sassages, and other gardin stuff also phirute, hats, Zongs, hoyle, lattin bukets, and other eatables. Korn \u0026 bun yard zarve, and all hardwares, le also performs fleabotomy on the shortest notice and further more in partikular he has laid in a large assortment of trype, dog's meet, lollipops and other pikels,-such as Hepsom Zalts, hoysters, windzer Zoap \u0026c, old rags bort \u0026 sold heare \u0026 nowhereshelse new laid heggs hevery day by me Roger Giles. Half Holiday. AMERICAN MEDICAL ASSOCIATION. The Twenty third Annual Session will be held in Philadelphia, Pa., May 7, 1872, at 11 A.M. The following Committees are exproted to report:-On Cultiva- tion of the Cinchona Tree. Dr. Lemuel J. Deal, Pennsylvania, chairnian; On the Anatomy and Diseases of the Retina. Dr. R. F. Michel, Alabama, chairman; On the Comparative Pathology and the Effects which Diseases of Inferior Animals have upon the Human System. Dr. George Sutton, Indiana, chairman; On the Structure of the White Blood Corpuscles. Dr. J. G. Richardson, Pa., chairman; On Vaccination. Dr. T. N. Wise, Kentucky, chairman; On Skin Transplantation. Dr. J. Ford Thompson, D.C., chairman; On the Nature and Process of the Restoration of Bone. Dr. A. L. .,:cArthur, Illinois, chairman; On some Diseases peculiar to Colorado. Dr. John Elsner, Colorado, chairman; On Corres. pondence with State Medical Societies. Dr. N. S. Davis, Illinois, chairman ; On National Health Council. Dr. Thomas If. Logan, California, chairman; On Nomenclature of Diseases. Dr. Francis Gurney Smith, Pa., chairman ; On What, if any, Legislative means are expedient and advisable, to prevent the spread of Contagious Diseases. Dr. M. H-. Henry, New York, chairman; On American Medical Necrology. Dr. J. D. Jackson, Kentucky, chairman ; On Medical Education. Dr. J. S: Weatherly, Alabama, chairman; On Medical Literature. Dr. Theoph. Parvin, Indiana, chairman; On Prize Essays. Dr. Alfred Stillé, Pa., chairman ; On the Climatology and Epidemics of-New Hampshire, Dr. G. R. Crosby; Vermont, Dr. G. B. Bullard; Massachusetts, Dr. E. Cutter; Rhode Island, Dr. Edward T. Caswell; Connecticut, Dr. J. C. Jackson; New York, Dr. W. F. Thoms ; New Jersey, Dr. E. M. Hunt; Pennsyl",
         "CANADA MEDICAL JOURNAL. vania, Dr. W. L. Wells; Marylaid, Dr. C. Il. Ohr; Georgia, Dr. A. J. Semmes; Missouri, Dr. W. S. Edgar ; Alabana, Dr. R. F. Michel; Texas, Dr. S. M. Welsh; Illinois, Dr. David Prince; Indiana, Dr. Dugan Clark; Disti ict of Columbia, Dr. J. W. Il. Lovejoy; Iowa, Dr. J. Williamson; Michigan, Dr. S. Hl. Douglas; Ohio, Dr. J. A. Murphy; California, Dr. F. W. Hatch; Tennessee, Dr. W. K. Bow- ling ; West Virginia, Dr. E. A. H{ildreth; Mnnesota Dr. Charles N. Hiewitt Virginia, Dr. A. G. Wortham; Delaware, Dr. L. B. Bush; Kansas, Dr. Tiffin Sinks, Mississippi, Dr. J. P. Moore- Louisiana, Dr. S. M. Bemiss; Wisconsin, Dr. J. K. Bartlett; Ken- tucky, Dr. L. P. Yandell, senr.; Colorado, Dr. R. G. Buckingham; Oregon, Dr. E. R. Fiske North Carolina, Dr. J. F. 1Haywood; South Carolina, Dr. M. Simmons. Physicians desiring to present papers before the Association should observe the following rule \"Papers appropriate to the several sections, in order to secure consideration and action, must be sent to the secretary of the appropriate section at least one month before the meeting whicl is to act upon them. It shall be the duty of the secretary to whom such papers are sent, to examine theni with care, and, with the advice of the chairman of his section, to deternine the time and order of their presentation, and give due notice of the same. OFFICERS OF SEc los.-Chemistry and Materia Medica-Drs. R. E. Rogers, Philadelphia, Pa., chairman, Ephroim Cutter, Boston, Mass., secretary; Practice of Medicine and Obstetrics-Drs. D. A. O'Donnell, Baltimore, Md., chairnan, Benjamin F. Dawson, New York, N.Y., secretary ; Surgery and Anatomy.-Dr. John T. Hod- gen, St. Louis, Mo., chairman, W. F. Peck, Davenport, Iowa, sec- retary; Medical Jurisprudence, Hygiene, and Physiology--Drs. S. U. Busey, Washington, D.C., chairman, E. L. Howatd, Baltimore, Md., secretary ; Psychology-Dr. Isaac Ray, Philadelphia, Pa., chairman, John Curwen, Harrisburg, Pa., secretary. Secretaries of all medical organizations are requested to for- ward lists of their Delegates, as soon as elected, to the Permanent Secretary. Railroad and Ilotel arrangements will be announced at an earlY date. W. B. ATKINSON, M.D., Permanent Secretary. 1,400 Pine Street, S.W.. corner of Broad, Philadelphia. 384"
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   "doc" : {
      "published" : [
         "Ottawa : Canada Health Journal, [1890]"
      ],
      "identifier" : [
         "8_04588_9"
      ],
      "type" : "document",
      "title" : [
         "Canada health journal [Vol. 12, no. 9 (Sept. 1890)]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur D Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée [ Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) O Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. D Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured. stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression - Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-téte provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. 1OX 14X lX 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "~5 CANADA HEALTH JOURNAL A Monthly Review and Record of SANITARY PROGRESS - EDITED BY Public Health and National Strength and Wealth. For Contents see next page. Subscription Price, $i a year; Single Copy, io Cents. Address: \"Canada Health Journal,\" Ottawa, Can VOL. XII. SEPTEMBER, 1893. No. 9. HORSFORD'S ACID PHOSPHATE Unlike all other forms of phosphorus in combination, such as dilute phosphoric acid, glacial pl-- phoric acid, neutral phosphate of lime, hypophosphites, etc., the pho:.phates in this product are in solu- tion, :,adily assimilative by the system, an-d it not only causes no trouble with the digestive organs, but pronotes in a marked degree their heathful action. In certain foris of dyspepsia it acts as a specific. Dr. H. R. Merville, Milwaukee, Wis., says: \"I regard it as valu- able in the treatient of gastric derangements affecting digestion.\" Send for descriptive circular. Physicians who wish to test it will be furnished a boule on application, without expense, except express charges. Prepared under the direction of Prof E. N. HORsFORD, by the Rumford Chemical Works, Providence, R.I. BEWARE oF SUBSTrVUTES AND IMITATIONS. CUTION:--Be sa re the word \"IORtSFORD'S \" is orlnt he u vie label. All others are spurious. Never sold ln bulk.",
         "0O1T]ENTS The Enormous Economy, and the Suffliciency, of Abstinence fron Flesh Food- - - - - - - : - - - - - --................... ............................. 151 How about your Neighbor?....... ....... ................ ............ 152 The Cholera again.-What the leading Medical Journal says ........... 154 Notification of Infectious Disease and Mistakes in Diagnosis.............. 154 Crime and the Publie Health again....... ............................ 154 Cycling, its Dangers and how to avoid them..... ....................... 155 Non-compulsory Vaccination in Michigan ... ......................... 156 Miscellaneous Notes .......................................158-10 On the Causes and Prevention of Tubercular Consumption in Mankind and the Doniestie Animais .............................. ....... 161-166 Editorial Notes .......................................................167-170 GD NEWS FOR THE DEBILITATED When Solid Meat Cannot be Digested A Perfect Substitute is IT CONTAINS AEL THE NU''TRITIOUS ELEMENTS OF PRIME BEEF IN A FORMI THAT OAN BE EASILY DIGESTED BY TUE VEAKEST STOMAOIH. BY DIETETICS. Is the trade mark for a class of hygienic preparations that w'ill cure Indigestion, Dyspepsia and Diabetes, when medicines fail. Hypocrates some 2,300 years algo traced baclk the origin of medicine to dietelics, Our Desiccated Wheat, Gluten Flour, Patent Bar- ley and Baravena Milk Foo:l will isiree with any infant or invalid, and nourish themn into health and strength. Every mouthful wili prove effective. A physician who passed S oz. of:uigar every day vas cured of dialietes by our Gluten Flour. An infant a few inonths old vas cured in three days. The cereals from which thcse foods are male are treated in the light of ail the scientific progress of the times by converting the starch into dextrene, etc. Ask for them, use them and be convinced, The trade supplied by THE IRELAND NATIONAL FOOD C0., (Ltd'- 109 Cottingham, St., and 134-148 Mariboro' Ave., TORONTO.",
         "CANADA HEALTH JOURNAL A Mlonthly Record of -Saisitary Progress. SEPTEMB1EiR, 1890. No. 9. THE ENORMOUS ECONOMY, AND THE SUFFICIENCY, OF ABSTINENCE FROIM FLESHT FOOD. IF the millions of lard working people who labor ten or more lours a day, year after year for decades, and can only earn enorgh to keep their family from month to month and are never able to save enough to get a home of their own would give up the use of animal food, life for them would be vastly easier, pleasanter and more \"worth living.\" In point of economy in living, abstinence fron ani- mal food is enormous. It lias been esti- mated that a given acreage of wheat wil feed at least ten times as many men as the qame acreage devoted to the growth of beef and mutton. There are two points in relation to fleh meat diet upon vhich there are erroneots views, and to which we desire to draw - tentio: . one, that abstinence fron it is too mucli of a deprivation to the palate or taste-that it is a luxury that one cann be expected to deny one's self ; the other, that a diet excluding flesh meat is not sufficiently nourishing and sustaining, especially for laborious occupations. As to the first, we may as wv Il quote the words of a clever writer in the last num- ber of the New York Medical Times, in an article relating to an animal diet and in- sanity : He says, \"Tliere is an aversion against the very idea of quitting eating weat. because of the deprivation imagined to be involved in the tieasure. But such deprivation is a very unecessary fear. Nature is more accommudating than man believes lier to be. ieat-diet, and still more the frequent concomitnt condi- îments, dull the gustatory nerve. A palate which is all day excited not only by meat- juice,but pepper, piniento, thieïn, nicotin and alcohol, must call rieu insipid, and will consider a dislh of spinachi with pota- tocs a poor dinner. But a palate vhich is never stinulated, but restored to its natural susceptibility, enjoys a piece of brown bread and a cup of milk as hugely as any gourmet iispaté de foie gras and siliery. And tien there is the comfort of an easy digestion. The vegetarian, not ex- cited by over-stimulation of the palate to over-repletion, manages easily to always have appetite to spare, and to enjoy his very digestion after meals.\" Very savory and delicious dishes are now made from the cereal foods-wheat, corn, oats, \u0026c., and vith the improvements which of late years have been made in the preparation and cooking of these foods, they may be now so served as to be not only as easily digested, in most stomachis, as even a simple steak, but to many people as pala- table as flesh food. It is, in fact, nearly all in use-habit. As to the second point, the nutriment and sustaining value of a vegetable diet: everybody knows that the cereals contain mucli morenourishment, pound for pound, than does flesh meat, that whole nations, and vigorous, subsist almost entirely upon then, without flesh food, and that the strongest men in the vorld eat no flesh neat. Furtlierm\u003ere, somie very eminent nien have been long abstaiiers from flesh and found their brain the clearer and more vigorous by sucli abstinence. It seems not to belquestioned tlhat flesl meat tends to creare a desire for alcoholie stimulants and that a vegetable diet will lessen or even cure sucli desire, while ten- dency to¡tie universal practice of over-eat- ing is mucl increased by the use of flesh. Finally, sone of the most eminent phy- sicians of the day -Sir Henry Thompson, Prof. Dujardin-Beametz and, others- recommended abstinence fron flesh in ad- VOL. XII.",
         "-152 - vanced life for lessening the effects of age, in certain cases of insanity, and in many derangements of the nutrient 'ind excre- tory organs. Animals at death-after being slaughtered, retain in the fluids and tissues of the carcase a large amount of excretory matters which, it is probable, give rise to the poisonous ptomines so soon formed after death ; and which would soon have been eliminated by the excretory organs of the animal-the kidneys, skin, liver, etc.-had it not been slaughtered. Dujardin-Beaumetz, in a recent lecture in Paris, said : \" As soon as death smites the living being, and at the very instant whven death appears, the ptonines manifest their presence. At first non-toxie (non-poison- ous), they become toxic from the fourth or fifth day which follows deatli......As man consumes a great quantity of animal substances whose time of killing often goes back to eiglht or ten days, it is easy to un,- derstand whvat a fruitful source of poison- ing may be here found; this danger is avoided by those who adopt the vegetarian reginen.\" By toxines the Dr. does not mean active poisons, but such as produce a gradual deleterious effect upon the hu- man organisms. He continues : \"IHence, a vegetable diet becomes obligatory when- ever, by the bad functioning of the kid- neys or digestive tube, the toxines may accumulate in the economy.\" This diet \"reduces to a minimum the toxines which enter the economyby the food. The affections of the digestive tube or of the stonach, to which it is applicable, are numerous.\" \" To sum up, and as the conclusion of this lecture, I would say, if fromn an an- thropological and physiological point of view, man is onnivorous, and may, ac- cording to climates and according to his necessities, live on a flesh diet, or on a mi'xed diet, or a vegetable diet, fron a therapeutic point of view the latter regi- men, as applied to our climates, consti- tutes a very important method of treat- nient, which is denanded in a great many gastric and kidney, as well as general diseases. HOW ABOUT YOUR NEIGHBOUR? IND your own business\" are words conveying most excellent advice in nearly all circumstan- ces, but what one's own business always really is, bas never been, it appears, very clearly defined, and there is one condition or relation in which one is not only justi- fied in prying a little into one's neighbour's affairs but in which this becomes an in- dispensible duty. No matter ho,ý Lmy and vigorous you may habituahly be, \"dear reader,\" or how judicious, sensible and careful you may be in relation to your own individual health, and that too of your family, a careless, selfish or ignorant neighbour, if not closely looked after, nmay inflict you ný itl a most malignant oc fatal disease. You, may even suspect such a neighbour, and avoid him and strive to keep your children away from him and from his,'but unknowingly you may seat yourself on the cushioned car or cab seat which he bas just infected by sitting on it for a time or you may stand beside him in a shop or market-place ,long enough for him to infect you; he may, all unintention- ally, infect your well, or you may buy from some such one infected food. Your children, in spite of your utmost care, may chance to play or be long enougli in con- tact with his to become infected with a fatal type of scarlet fever or diphtheria. You must, therefore, to a certain extent or in certain circuistances, mind your neighbour's business, or you may suffer terribly for neglecting to do so. In other words, what should be your neighbour's business becomes in these circumstances your own business, In well organized communities special health officers, called inspectors, are em- ployed to look after the neighbours. The position or function of an inspector is an exceedingly important one, therefore, and a man of special fitness, special ability with tact and good common sense, must",
         "- 153 - be selected for it. Without a first-class, suitable inan, niany causes and sources of disease, and its spread, may be overlooked. For safety, every home in the community in which you live, at least, however hum- ble it may be, must be in as good a sani- tary condition as your own :1 hygienically all must be as perfect as possible. To get the best men for such positions the pay must be liberal. Often municipal authori- ties do not pay such officials well, because the people-their supporters, will not sus- tain them in so doing. Wise supporters, or electors, will take care that the health of- ficials, the most important officials of the municipality, vhether city or town or only village or township, are so paid that they may have the \"heart\" to do their work well-to be \"up betimes\" and \"vigi- lant in their calling.\" And indeed, at best, every man should, himself , take heed, a little, judiciously, to his neigh- bour's sanitary condition, even before the sense of smîell is affected, and so aid the health officers, remembering that \"eternal vigilance\" is, too, the price of cleanliness and health. THE CHOLERA AGAIN. WHAT THE LEADING IIEDICAL JOURNAL SAYS. HE British Medical Journal of August 16th, says : \"Now that the cholera, which has been slowly advancing- as in all epidemics prior to 1865-by the North Persian and Euphrates Valley routes, has suddenly appeared on the Red Sea lit- toral, there is no longer any good ground for entertaining the hope, even should the present epidemic in Spain not spread be- yond the Peninsula, that Europe generally will escape, though from the lateness of the season the brunt of the attack may, as in 1865-6, be postponed until next year.\" In referring to America, it continues: \"It is notorious that that continent lias been involved in all epidemics, even those in which, as in 1871 and 1875, Great Britain lias escaped.\" And again: \"It is true that for five-and- twenty years we have in our own country (Great Britain), with the simplest system of detention and inspection of infected or suspected ships and persons, enjoyed entire immunity, thanks to our good sani- tary arvrangeients, especially as regards water supplies, which the remarkable ex- emption of Seville and one or two other Spanish towns, and of Rome, have proved to be the most powerful factors in the pro- pagation of cholera.\" Now what of the future? What is the plain duty of every health organization in Canada? Our reply is, to prepare for a possible, indeed probable, visit from this dreaded disease next summer ; and that it is not too soon to commence preparations now--to commence preparations for a pure water supply and for thorough drainage and cleanliness. In many cases, next spring will be too late to make thorough and complete Dreparations. There are a great many of the smaller tovns through- out Canada which, depending now on more or less contaminated, dangerous wells for a water supply, are in much need of a better system; many in which the more prudent and thoughtful. those with due regard to their health interest, would like a better system, but in which the \"major- ity\", that often too mighty, because mis- lead, irresistable force, is opposed to such improvement, as being unnecessary. Now is the time to move in such towns. The near approacli of well defined danger will change many votes in this respect. The systems in some of the larger towns and cities are not so safe as they should be, and in their present state might be the means of the distruction of thousands of human lives. The Queen City, Toronto, seems to have but a very unsafe, treacher- ous supply, which should be put in much better shape before next summer. It is, depend upon it, high time now to begin this sort of work and, too, to make pro- vision for improved sewerage, \"all along the lines.\"",
         "NOTIFICATION OF INFECTIOUS DISEASE AND MISTAKES IN DIAGNOSIS. HE practice of notification 'to the health authorities of all cases of in- fectious disease with their imedi- ate isolation is obviously of such great value as a prophylactic that it is becoining alinost universal. In England, the optional act, which only caine into force less than a year ago, lias been voluntarily adopted by authorities which have jurisdiction over about 12,000,000 of people. This, with the compulsory act applied to London, and with those fifty-six towns or localities which had previously obtained powers of compulsory notification by special local acts, makes compulsory notification now practiced with respect to about 20,000,000 of people. In Canada, we learn that the practice is generally very fairly carried out. A few fines for neglect, in certain places, have been imposed. With the tre- mendous gain to the public conferred by this practice, great responsibility is thrown upon medical practitioners, especially fromi possible inistakes in diagnosis. Some practitioners in the United States have encouùtered actions for heavy dam- ages from mistakes in this way, and there lias been some serious trouble of a like kind in this country. Such mistakes are liable to occur to almost any physician, especially without the utnost skill and care. According to Dr. Russell, medical officer of Glasgow, of 1,499 consecutive cases admitted to Belvidere Hospital as suffering from infectious disease, 114, or 7·6 per cent., did not suffer from the dis- ease which they were supposed to have when they were sent in ; and of that 114 no fewer than 85, or 5·7 per cent. of the total cases, had no infectious disease at all and ought not therefore to have been removed. There are two principal remedies for the troubles to practitionersliable to arise froni errors of this kind in the practice of notifi- cation. First, physicians wherever the practice is enforced or carried out, should insist on having provided, in connection with the isolation hospitals, observation wards for the reception of cases of doubt- ful diagnosis. Physicians have generally \" taken kindly\" to this practice of notifi- cation for the public good, and the least the public can do is to afford this protec- tion, where possible; and it could usually be made possible. Such provision obvious- ly provides also for the public safety, and it is little short of criminal neglect when such wards are not prcvided. The other renedy we will but nerely nane : it is better facilities for the study, and closer study by students at the schools, and even by physicians at past-graduate schools, of clinical cases of infectious dis- ease, in order that the greatest skill may be brouglt to bear on diagnosis. This is strongly ur¿,ed by Dr. Russell. CRIME AND THE PUBLIC HEALTH AGAIN. UR esteemed cotemporary, the British Whig(of Kingston, Ont.), which lias long been one of the foremost Jour- nals on the continent in the discussion of health subjects, althougli \" in accord with uany suggestions\" of this Journal, thinks the suggestions relative to physical esercises in the public schools in the August issue\" not practicable.\" It must be observed that we .did not mean or suggest that just such physical training as employed by Dr. Wey in the Elmira (N.Y.) Reformatory should be practiced inthe schools, but \"some such\" \" according to circumstances.\" The British Whig says, \"Crime cones to soie as a heritage, the legacy whicli dishonored and disreputable parents leave to the young, to whom their example lias been all along degrading ; to others it cornes as a sort of disease, which is contracted froni evil associations froin which parents and guardians take no special pains to protect them.\" Exactly; or almost : we would omit the words, \" to others.\" Crime cornes Jargely, chiefly as a \" heritage \" of \" disease.\" It is to",
         "-155- remedy, to prevent the individual increase of, such disease that we suggest special physical training or culture in the schools. Of about half a million pupils in the selcools of Ontario, clean and une ean, not nearly half it appears receive any physical edu- cation. As the Whig says, the \"schools have been established for purely educa- tional purposes.\" Every body now admits that both mental and physical education should,-nust, to be successful-go hand in hand together. And what sort of physical culture do the nearly forty-five per cent. of the Ontario pupils receive, now, amid the mental gorging vith in- assmilable food ? Such as it is.-good enough probably so far as it goes, good enough of its kind-it is given to all alike ; alike to those with a heritage of dis- ease inclined to criminality and to those with a heritage of a well organized physi- cal structure inclined only to honest pur- pose. Is this the right sort of physical culture? We contend that it is not ; and that if the state undertake to educate the young, it should, in common fairness to the people, educate properly. The dull or stupid boy, the slow, stooping, shuffling boy vith soft fiabby muscles, the boy with a face indicative of criminal tende-ncies, should receive special physical culture not at all required by the other boys ; and why should not tie dirty boys be washed and made clean? as they are in some of the public schools in London and on the continent of Europe. Is there a public school in Ontario in which the atmosphere soon after the pupils are assembled does not indicate that soine of the pupils need a good washing-a hot and a Turkish bath ? If the twelve men criminals upon vhom Dr. Wey performed his reformation experinients, as mentioned in our August issue, lad been so fortunate in early life as to have had similar, physical culture to that to which they were subjected in after life at Elmira, and which made as it were nev men of them, it is not at all likely they ever would have become criminals, And in such subjects in early life, the culture could be simpler and would, in this susceptible period, be productive of still better and more marked effects. Furthermore, we contend that such physical culture in the sclools would be a great preventive of the insanity which seenis to be everyvhere on the increase, a subject to which ve purpose alluding in the next number of the Journal. The time is probably not far distant wlen the pre- vention of both crime and insanity will be regarded as directly associated with public health regulations. CYCLING, ITS DANGERS AND HOW TO AVOID THEM. NYTHING which induces persons of sedentary occupations to excercise out of doors should receive every possible encouragement. Cycling is coin- paratively a new form of excercise and is not without its dangers. But little lias been written on this continent to guide cyclists in the hygienie bearings of the excercise. We fail·to find anything of this sort even in the \"Talk on physical culture\" recently given at the Health Officers Con- vention at Owen Sound Dr. B. W. Rich- ardson. of London, Eng., lias written a good deal on tie subject. In the last issue. of the zEsclepiad lie admits that since lie first warned the public years ago of the dangers of immoderate cycling changes have taken place in the construc- tion both of bicycles and tricycles which materially modify the old drawbacks. Heis still of the opinion that cycling should never be practice-d by boys and girls, since it differs from other exercises in the fact that it molds the bodily frame work, as it were, to its own mode of motion; and riders in course of time almost invariably acquire what lie calls \"the cyclist's figure,\" vhich is not graceful and indicative of the possession of perfectly balanced powers. Of two things, at least, he is satisfied. They are that the temptation of competi- tion is to an earnest and practiced cyclist",
         "-156 - a \" demon of danger; \" and that the sys- tematic pursuit of cycling should never be fully comnenced before the age of 'wenty- one years. As stated in the Iowa Board of Health Bulletin, alnost all children who use the bicycle nuch-especially taking long rides-become deformed, and iii walking assume what is known as the. \"cycler's posture.\" If any one will observe a large number of bicyclers in a parade it will be seen that nearly all if not all as- sume a position of stooping, a drooping of the shoulders, iii a degree more or less marked which, if in children is practised much, becomes a fixed posture, compress- ing and narrowing the chest and develop- ing the'liibs of the body abnormally. \"It has been demonstrated repeatedly that girls and women who run sewing machin- es are always more or less injured thereby -the injury being largely proportionate to the amount of such exercise. If it is true that the light exercise of the limbs conbined with the sitting posture requir- ed in the use of the sewing machine is injurious, how much more injurious is the severer excercise of propelling oneself on a bicycle, or even on a tricycle, es- pecially up hill.\" Eminent physicians, and careful observers like Dr. Richardson, have already met some forms of disease that are peculiar to this unnatural mode of exercise. It is said to be specially try- ing upon persons with heart trouble, and even those who have never been regarded as suffering in this way find palpitation and other functional heart difficulty in riding up.hill, or even rapidly on the level. While it should not be indulged in nuch by children, adults are recommended to combine with it valking up hill, and in long trips that at least one mile should be taken on foot for every seven on the cycle. The British Medical Journal (Aug. 16'90) in an article on Cycling and Hernia says : A somewhat unnecessary amount of alartu may possibly be created on the subject of cycling by some recent correspondence, especially as a statement purports to have been made by more than one medical man that cycling predisposes to hernia. It lias not been our experience that any increase in this affection is attributable to cycling. One correspondent appears to attribute ail harm to sitting too high on the machine. If danger exist it is due rather to the fact that scarcely 5 per cent. of the riders make any attempt to fit themselves to their machine. As a rule the handles are 'far too low and the seat rather too far back or forwards. Of the comfort of sitting up with the handles in such a posi- tion as not to necessitate bending the back nearly double, we can speak from personal experience. No one who lias once got the handles high enough, the feet in the right position, and the seat at a proper angle, will ever ride the machine so as to strain the legs, bend the back, or bruise the per- ienum. We would earnestly urge cyclists then to give due attention to the points above indicated for ensuring safety in this'pleasant exercise. NON-COMPULSORY VACCINATION IN MICHIGAN. A T the last year's meeting of the Mi- chigan State Medical Society Dr. Hemenway offered a resolution : \"That, in the opinion of this Section, the public good demands compulsory vaccina- tion by State law.\" On motion, of Dr. Baker, Secretary of the State Board of Health, the resolution was laid upon the table for one year, in drder that prepara- tion could be made to discuss the subject. At the recent meeting, for the current year, Dr. Baker read an exhaustive paper in opposition to compulsory vaccination. He said: \"I suppose it is true that many physicians favor compulsory vaccination. How is it, then, that one, who for the last seventeen years lias been constantly em- ployed in studying out the best methods of restricting and preventing small-pox and other diseases, has come to question the utility of compulsory vaccination ? I believe this is one of the many instances in",
         "-157- which a pet theory does not' 'work \" as it should wlen an attempt is made to put it in practice. We all know, that is, the medical profession knows, that vaccina- tion and revaccination are preventives of snall-pox, and that, as a rule, those who have snall-pox are those who have not been recently vaccinated or re- vaccinated. In Michigan the intelligent classes are more generally vaccinated than are the ignorant and improvident. If all persons could be vaccinated and revacci- nated about once in five years, snall-pox would be prevented, seeins to me to be ex- tremely probable. Where, then, is the objection to compulsory vaccination? I will try to explain. In ny opinion, there is a fallacy in the assumption that a State law theoretically compelling vaccination will actually result in securing vaccina- tion more general than can be secured by educational methods. My objection, then, to a State lav for compulsory vaccination is, that vaccination would:not be so gener- ally perforned where it was most needed under a compulsory law as it may be under the present law. Mr. Simon, many years a leader in public health work in England. once feared that the people miglit mistrust a gift which the law would compel theni to accept. Dr. Baker said : \" To present to a man facts and reasons, relative to vaccination, as abstract proportions is one thing ; lie may thus be convinced, lie may be convinced also as applied to his own child; but tell the sanie man that the law says that lie hiniself must submit to having inserted in him a virus that will work a change in his blood, probably make him slightly sick for a few days; thjen his feeling of repug- nance may be sufficient to prevent hiin from accépting any evidence of prospec- tive good which can be put before him. \" Compulsory vaccination of an intelli- gent adult person is suchi an interference with the liberty of the individual relative to his own person, as in my judgnent is not for the public good. I think the final result will be better if the natural risk of the death penalty by small-pox be per- mitted to eaci responsible person. There can be no dou ,t that intense feeling or eiotion powerfully influences the ac- ceptance or non-accceptance of evidence, by even the most intelligent persons. The anti-vaccinationists have had. the aid of such men as Herbert Spencer-perhîaps the greatest philosopher of our age,-anl of Alfred R. Wallace who shared witlh Dar- win'the honor of first publishing the prin- ciple of natural selection. Mr. Wallace does not stop with opposing compulsory vaccination, but attacks the principle of vaccination itself, as do most of those who oppose compulsory vaccination. l One of the strongest reasons why I (1o not favor compulsory vaccination is tlat such a law at once leads the people to dis- cuss the subject of the interference with their own persons, and to decline to listen to facts and reasons supporting the belief in the beneficence of vaccination. Of 'course Dr. Baker favours vaccina- tion, and after quoting statistics froin the New York health department, lie contin- ues: \" Witlhout doubt, prompt notification- and isolation, and thorougli disinfection are important measures for the restriction of .small-pox, but in sucli instances as the one just quoted, it is vaccination that prevents outbreaks from becoming epi- demies. . . . Michigan is greatly more than England endangered from small-pox througli its spread by immigrants and travelers, yet during the ten years, 1878- 1887, while the State Board of Health has been trying to secure vaccination througlh the educational and advisory methods of the present law, the reported mîortality from small-pox in Michigan bas averaged only about 13 annually per million in- habitants, while in England in the sanie years it lias been about 54, or a little over four times as great. We must admit, how- ever, that much of the recent immunity froi small-pox in Michigan lias been due to prompt notification, isolation and disin- fection, and that the vaccinal protection of the inhabitants of Michigan is not wlat we could wish; for the public good vacci- nation and revaccination should be much more general; and I appeal to the iedical profession to give its support to the pre- sent law, aid to do what it can to dissemi- nate among the people knowledge of the importance, and beneficence, of vaccina- tion and revaccination, withiout which knowledge no law on the subject will be useful to the people of this free country.",
         "MISCELLANEOUS NOTES AND EXTRACTS. MEAT INSPECTION. injuries or sudden illness, the internai At the forty-nintli annual meeting of organs should be sent to a licened abattoir the Britis Medical Association, wicwit e carcase for the ritsli edial Asocatio, wich inspection and as a guide to the inspector was recently lield at Birmingham, Mr. in bis wor; further. ail private slaughter- Thomas Walley (Principal, Royal Veter- houses should be abolished, or %vhere, as inary College, Edinburgh) said that the in sina l villages or tovns, a public slaugh- subject of meat inspection might be con- shoube cud and c unde the sidered under three heads ; (1) The necess- direct control of the sanitary authorities. ity for the adoption of a systeni of meat He held that in ail abattoirs there should inspection in this country; (2 the best be one or more lay inspectors, but they inspctin i ths cuntr ; 2) he estshould not be emipowvered to condlein fleshi; method of carrying out meat inspection ; for this purpose a sanitary board (consist- (3) the principle that should guide using ing of a medical officer, a veterinnry of- and condemnation of meat. The follow- ficer and a lay inspector) should be estab- lished in connetion wvith every abattoir ing are his remarks under the two first but inspectors (lay or professional) slould heads: (1) Meat inspection was necessary only be appointed after submitting tleiu- for the reasons (a) that the British were selves to examination hy a competent ex- the greatest of flesh eaters in the world aming body, and the decision of the sani- (b) that the vast majority of the flesh-eat- should b flai. e iroscop ing portion of the public were utterly ing with the flesh of animais that had ignorant as to the characters whiclh distin- sufrered froni nicro-parasitie or parasitie guished good from bad ueat; (c) that disease. through the medium of animal flesh many SINOULARITES 0F DiPlITHERIA. lives had been lost, and many people had At the Manchester Meeting of the British suffered injury to their health; and (d) Medical Association, Aug lst, the Medical that the flesh eaters had a right to protec- tion from suclh dangers, and froi the evil designs of those who profit by the trade medicine, said: The fact that diphtheria in bad meat, and also by the fact that there i unlike typhoid fever, increasing instead was no law to compel them to declare ns is very from wlat source the tiesh they sold lad renuarkabie, and at present inexplicable been obtained, nor to declare the nature of for altiough tiere is good reason to believe the disease fron which an animal had suf- it is dependent on enanations of an im- fered. (2) In order that meat inspection pure cuaracter, to some extent fron sewer should be properly carried out three and drains, but more especially from sou things were necessary, (a) that all animals charged vith organic matter in a state of intended for human food shonld be exam- putrefactive change; and although it is i ied, prior to slaughter, by competent persons ; (b) that not only the carcases variably soc vith dalpes f tie but the viscera of all animals intended for veln ansou, eite dvith o th food should also be examined ; (c) that concomitant oid growts, itcu those pensons whose duty it was to carry ceno t ade out sucli inspection should possess the nec- a out vith any certainty or cessary knowledge of their work to enable definiteness. Its conveyance throuigh the theni to discharge the duties devolvng medium of mîlk is a feature interesting in upon them in an efficient manner. In- ieseif, tlough not peculiar to this disease, spection of all animals prior to slaughter could not be carried out in all cases, for and its suggested connection with the dis- example, in those instances in which as eases of certain domestic and domesticated the result of accidents it was found nec- animais is a question of equal interest and cessary to slauglhter 'animals in places i offering a wide field of in- other than abattoirs, and also in the case of dead nieat from foreign countries ; but vestigatioi. The former principal incid- vhere animais wveré killed on accounit of ence of the disease upon country districts",
         "- 159 - and its recent increase in towns is a point of much interest. Witlh regard to this in- cidence upon town populations during recent years, I may point out a very re- markable exception which this city affords where, since 1873, the diphtheria mortality has gradually fallen froin 0.31 to 0.11 per. 1,000, or to about one-third, while in twenty large towns during the sanie period it lias as gradually risen froi 0.09 to 0.27, or three times as many. This exceptional position of Birmingham nay possibly be owing to geological andi geodesic conditions, thougli it is difficult to believe that this is the only explanation. IMPORTANT CoMMUNICATIONS ON SULPIIUR DISINFECTION. The following froi the Anerican Jour- nal of Medical Sciences. will be valuable to all concerned witl disinfection Lansing, Mich., August 23, 1890.--E. B. Fraser, M. D., Secretary of the State Board of Health, Wilimington, Del.- DEAR DocTOR: Your letter of August 18, acknowleding the receipt of a copy of my letter to Dr. Duffield (giving results of ex- perience of lealth ofticers in Michigan, and an account of the experiments by Pasteur, Roux, Dujardin-Beaumetz and others relative to sulpurous disinfection), is before me. You ask me for further opinion, and refer to the report of the Maine State Board of Health for 1889, page 251, and Dr. T. Mitchell Prudden's esti- mate of the want of value of sulphurous disinfection. There are at least two valid objections to the acceptance of Dr. Prud- den's conclusions to which you refer : (1 His experiments dealt witli a micro-organ- isn which seens to be different froin the one most generaily accepted as the prob- able cause of diphtlieria. Therefore, lie may not have been dealing with a micro- organimn causing diphtheria. (2) The quantity of sulphur burned-the strength of the sulphurous acid fumes which le employed-is not stated. It laving been proved by actual experience with disease, and by other laboratory experimenters (Pasteur, Roux, Dujardin-Beauietz, Val- lin, Legouest, Polli, Pettenkofer, Dougall, Fatio, Pietra Santa,) that sulphurous acid gas is not ahvays a disinfectant whien em- ployed in small proportions, and that it is a disinfectant hen employed .n large pro- portions, such as result froin burning of three pounds of sulphur to each thousand cubic feet of air-space, no different conclus. ion should be reachied froi Dr. Pruden's e xperiments as publislied. You mention that Dr. W. H. Welclh, of Baltimore, \"enters his protest\" against disinfection by sulphurous acid gas. I respectfully submit that entering a protest shiould count for very little in science as against results of actual, practical experience in the res- triction of diphtheria; it should not even take rank withi definite statements of re- sults of laboratory experiments. Laborr- tory experiments are very valuable, but they need to be repeated by the saine ob- server and by other observers, in order to eliminate errors due to accidental or inci- dental conditions. Micro-organisis which, after subjection to a disinféctant, may yet have sufficient vitality to reproduce in a laboratory where the most favorable con- ditions are supplied, couldnot possibly do so in the hiuman throat, or elsewhere in the hunan body, because of the ,well- know power of the fluids of the body to destroy iicro-organisms, as proved by Dr. Prudden's and other laboratory experi- ments following, but not confirming, Metschnikoff's doctrine of the phagocytes. Practical health officers need to employ a gaseous disinfectant that shall at once reach all surfaces. ledges, cracks, drawers and receptacles of dust, wherever it may be, in a room, that shall perneate ali articles sufficiently permeable to admit dis- ease-causing micro-organismis; that will not necessitate too much labor in the re- moval of furniture or other articles, and that shall have power to destroy or suffici- ently weaken the vitality of the \"geris\" of such diseases as diphtheria and scariet fever, and occasionally small-pox, as they are usually distributed in the sick-room, and that shall not destroy family portraits and similar articles. Only two such dis- infectants are prominently before us for choice-chlorine and sulphurous acid gas. 0f these two, sulphurous acid gas is made in proper quantity, with more certainty and less trouble than is chlorine gas; and, at present, I regard the veight of evidence in its favor as equal to that relative to chlorine gas, concering which not so much evidence has been published. Prac- tical experience in Michigan proves that by isolation of first cases of diplhtheria, and disinfection of premises after death or recovery by burning sulphur, etc., four- fifthîs of the cases and deaths whicli would otherwise occur from that disease are pre- vented.",
         "- 160 - SUNLIGHT AND SICK ROOIS. In an exhaustive address by Dr. Robert Koch, at the Berlin International Sfedical Congress last nonth, in referring to the destructive effects upon bacteria of heat, cold, \u0026c.. he said : Aiong these factors, liglit appears to nie to be one of the nost important. As to direct sunlight, it lias been well known for sone years that it kills bacteria vitli tolerable quickness. I can aflirn this as regards tubercule hacilli, which were killed in from a fewi minutes to sonie liours, according to the thickness of the layer in which they were exposed to the sunlight. What seens to ne. hîow- ever, to be particularly noteworthy is that even ordinary davlighit, if it last long enough, produces the saine effect: cultures Of tubercle bacilli die in five to seven days if exposed at the windov in comnpact masses. Dr. B. W. Richardson, in a recent lecture on \" Disease. and lIow to Combat it,\" remarked : Still a custoni prevails, despite ail our sanitary teachings that the occupant of the sick room in the private house should be kept at al liours in a darkened roomn Not one time in ten do we enter a sick roon in the daytime to ind it blessed with the lighît of the sun. Alhnost invariably, before we can get a look at the face of the patient we are obliged to request that the blinds nay be diawn up, in order that the rays of a inuch greater healer than the iost. able physician can ever hope toe may be admitted. Too often the conp\u003eliance with this riequest reveals a condition of rooni whichi. in a state of darkness, isinvariably one of dis- order evervwliere; foods, niedicines. furniture, bedding misplaced; dust and stray leavings in all directions. Ii brief, there is nothing so bad as a dark sick roou ; it is as if the attendants were an- ticipating the death of the patient; and, if the reason for it be asked, the answer is as inconsistent as thieact.' The reason usually offered is thiat the patient cannot bear the lighit; asthough the liglt could nlot be cutoff fron the patdient by a curtain or screen, and as thougli todarken one part of the roon it vere necessary to darken the whole of it. A more injurious practice really could not be imaintained than that of darkness in tlie sick rooi. It is not only that dirt and disorder are results of darkness ; a great renedy is lost. Sunlight is the remliedy lost. and the loss is momentous. Sunlight diffused through a room wars and clariflew the air. It has a direct iniflu- ance on the minute organic poisons, a dis- tinctive influence whiclh is imiost precious, and it has a clieerful effect upon the mind. The sick should never be gloomy, and in the presence of the light the shadows of gloomt fly away. H1appily thie hiospital ward, niotwithstandinîg its nany defects (and it la. m.hy), is so favored that it is blessed with the light of the sun whien- erer the sua shines. Il paivate practice the sane remedy ought to lie extended to the patient of the louseliold, and the first wordIs of the physician or surgeon on en- tering the dark sick rooi should be the dying words of Goethe, \" More light more lighît.\" DIsuNFECTING POWDER OF CHLORIDE oF LIME. Tlhe Abstract of Saiitary Reports pub- lishies a translation froi the Central blatt fur Bakteriologie und Parasitenkunde, as follows (in Sanitary News):- Contrary to the previous statenient of Kock. Sternberg, and, lter, Jager, found that chloride of lime possesses decidedl g.rmaicide power. In consequence of tliese contradictory re- sults, Nissen undertook, at the suggestion of Koch, a new experimental researcli to decide the quection. The result of this shows tlat. as a niatter of fact, clloride of lime lias very great disinfecting power. At first micro-organisms withiout spores, and havinîg comparatively little resisting power, were tested, in bouillon culture, by Es. aarcli's nethod. A chloride of lime solution gives au abundant precipitate vith bouillon, the cultures were first diluted. The chloride of lime solution was added eithier filtered or not filtered. Tle result was the sane in either case. The bacillus of typhoid fever was destroyed in bouillon cultures, at the end of five min- utes. by 0.12 per ocnt. )f chloride of lime; the cholera bacillus aad anthrax bacilli without spores by the saine proportion usuallv ini one minute. Anthrax spores of umoderate resi.sting power (killed in tlree minutes by flowing steam). dried on silk tlireads, were destroyed in fifteen to tliirty minutes by a 5 per cent. solution of chloride of lime. . . . Putrid fluids and feces ,were very quickly \u003ch.infected by the addi- tion of chiloride of lime. Bouillon which lad become putrid was, as arule, thoroughi- lv sterilized in five minutes by the addi- tion of 0.1 per cent. of chloride of lime, either in solution or aa pow er. destroyed the tv hoid bacillus inside of ten minutes. Nissen thinks. therefore, thiat chloride of lime is especially suitable for the disinfec- tion of bed-pans.",
         "ON THE CAUSES AND PREVENTION OF TUBERCULAR CONSUMPTION IN MANKIND AND THE DOMESTIC ANIMALS. GENERAL AND INTRODUCTORY. Tubercular consumption is such a terribly prevalent and fatal disease in almost every country in the world, in both inan and animals, that hardly any question can be of greater importance than that which relates to its prevention. It is a question which concerns every individual, of every age, high, low, ricli and poor, alinost alikd, for ni one is exempt from the disease and its influences. Moreover, the disease seems to be every w'here on the increase; which fact makes the question a still more serious one. That the disease as found in man and in the lower animals is identically one and the sanie and that it is infections and intercomnnnicable between man and the lower animals-from man to animals and from animals to man-is now universally conceded by all authorities. Moreover, the disease is now universally regarded by the niedical profeý.iion as a preventable disease, just as inuch so as typhoid fever, and the subject of its preventioi becones one of very great practical importance. A great many people, even amnongst the more intelligent classes, look upon con- sumption as something to which human beings are so naturally subject that they are powerless to prevent it ; yet, vhen once synptons of its presence become mani- fested in the body of any one, there is not the sliglitest hesitation in at once resorting to means for its cure. Any one of ordinary intelligence who will examine into the now well known causes of consunption cannot fail to readily see that it is not only a preventable diseaseý, but that it may be more easily and surely prevented than the more actively infectious diseases which prevail epidemically; because its prevention is more largely in the hands of the individual. It is most strange, considering the great fatality of this malady and the large proportion of sickness and of deaths it is con- tinually causing in almost every civilized country, that more generail attention lias not heretofore been given by sanitarians to its prevention. Those interested in publie health proccedings have perhaps naturally enougli bestowed their thoughts and time chiefly on those diseases whuch prevail epidemically and in a short period of time destroy many lives, or which, prevailing only endemically or to a much less extent, destroy life much more rapidly. GENERAL PREVALENCE OF THE DISEASE IN MANKIND. The record of deaths in the province of Ontario shows that many more deaths are caused by consuinption than by any other disease. It causes on an average more than one-tenth of all the deatls registered in the province. We have no record as to its mortality in the other provinces. Fron the data obtainable, however, in Canada, in the United States and Great Brit-iin, on the continent of Europe, and else- where it cause,; froni one-fifth to one-tenth of all the deaths which take place through- out the civilized world. At least twelve thousand, doubtless. and possibly fifteen thousand, human beings of all ages die every year in Canada froin tubercular diseases, chiefly pulmonary tuberculosiq, or consumption. Besides, as it has been estimated that for every one who dies of the dizcase, three others are the subjects of it, there are probably not less than forty thousand people in this Dominion c:mbsta\u003cntly suffering froi tubercu- losis. Furthermore, fron the long period of debility, sickness and inability to work which invariably precede death from this disease, the actual money outlay which it causes in the country, aside fron the deatis, ,is vastly greater tian the cost of any other disease ; the proportionate loss to comniunities from it, in comparison with other diseases, being much greater in relation to the sickness than to the deaths.",
         "- 162 - PREVALENCE OF THE DISEASE IN ANIMALS. ESPECIALLY COWS. George Fleming, F. R. G. S., \u0026c., \u0026c., wlho is I believe recognized as the best English authority. in his Manual of Veterinary Science, vol. ii, says: \" Tubercular Pbthisis probably prevails among the domesticated animals over the entire globo, thougl its frequency will depend upon various external influences, as well as upon the constitutional tendencies of different species and breeds. In some conutries it is enzootic and very destructive. Such is the case in densely populated districts and in unlealtliy cliniates, or in regions where animails are improperly fed and housed.. In Mexico, for instance, it is very counon; and causes mucli loss, about thirty-two per cent. of the animas slauglitered for food being found affected. In Europe. particularly in the cow-slieds of the large towns and cities, it is extensively prevalent ; and in this country [Eng.] it bas long been recognized as a coimon disorder among animxals, but more especially as effecting the bovine species.\" The British Medical Journal, in a recent editoral on this subject says * WVhen we find that in one town 17.5 per cent. of the cattle are suffering from the disease, that in another 4.5, and that in otiers where the inspection is extremiely inadequate, and wlere thousandis of cases never come under the inspector's eye, the precentage is almost as great, it can be readily iniagined how widespread is the disease. In Germany, wlere tlie inspection lias gradually become more thorough, the number of cases of tuberculosis reported lias rapidly increased froum a very small percentage to 20 per cent. in some districts. The saine lias been the experience of other Continental cointries, and so we are convinced it will be in this country (Eng.) if the Board of Agriculture will but take adequate measures to bring about a proper and complete inspection. At the meeting of the British Medical Association in 1888, Dr. Alfred Carpen. ter said it bad been his duty to hear evidence when application was nade for the condemnation of tuberculous carcasses, and that if alil sucli meat were prolhibited it would be impossible to feed sucb a population as that of London. One of the princi- pal inspectors of the largest meat markets in London, lie said, stated in the evidence that sonietimes as much 80 per cent. of the meat on sale was so affected. In the United Statesl the disease appears to be becoming very comimon. Mr. Salmon, Chief of tlie Washington Bureau of Animal Industry, at the meeting of the American Public Health Association last year, ('89) declared that from \"an inspection of about half a million \"cattle, the \"widespread prevalence of the disease is certain.\" In the second report of the Maine State Board of Health (for 1887) is given in detail the history of the destruction by this disease of two very valuable ierds within the past two years; one, the Orono ierd in Maine; the otlier, tliat of the Willard Asylum Farm, .New York. At a meeting a year or two ago of the Butchers' Association in California, the agent there of the Bureau of Animal Industry spoke strongly of the increased prevalence of the disease-of the \" rottenness\" of the cattle-there. The New York Times, during this year (189), publislhed an extract froni a paper by a Mr. Francis Blake, of Boston, who described an outbreak of the disease in his dairy of ten cows. A veterinarianx, calling to prescribe for one of the animais, found it tuberculous, and upon examnination found six of the ten animals to be suffering fron tubercular coisumption. Mr. Blake said, I iad supposed that I liad as fine and healthy a lot of animals as could be found in the State. None of them, to the layman's eye, had any outward symptonis of the disease; in fact, a skilled veter- nary surgeon who.had been familiar with the stable for years lad not suspected trouble until a few lays before. The autopsies disclosed a state of physical rotten- ness, most alarming to me, as the milk fron two of the worst cows has been con- stantly used in ny housebold up to the day of inspection. This experience led one of bis neigliborr. to inquire as to the condition of his own cows, with the result that",
         "- 163 - the disease was found in three out of seven of them. Froi what I hear, said 'Mr. Blake. it is lrd to find a lierd of cattle kept for the sale of milk, in whicl there are not cases of ttherculosis. A nunber of cases of a like cliairacter bave beenî reported. AS RELATES TO CANADA. In the report published last year of the Cominittee of the House of Commonis on tuberculosis in cattle it is stated that, \"lWe in Canada have reason to congratulate ourselres that our cattle are mnuch more lealthv\" than those in Europe and the United States. \"Even on the assunption that our farniers and niedical practitioners have not liad their attertion specially drawn to this trouble,\" the report continues, \"IWTe can undoubtedly believe that this insidious and fatal disease is not so prevalent w'itl us.\" Still, plainly. tie disease does exist iii Canada iiiniany localities and, it can hardly bc doubted, vill spread if means be not adopted to check it. At the opening of the Montreal Veterinary College, in October, 1887, Mr. McEaclren, Chief Veterinary Surgeon of the Dominion, said, lie was aware that the disease was \"on increase aniong cattle in Canada as elsewiere.\" In the ninth annual report of the Agricultural College and Experimental Farm, Guelph, Ontario, it is stated that \"the extent to w-hii this disease exists amiont the better breeds of cattle in this country is alarming, for imany reasons iot the least one of which is the danger to vhich the public are exposed fron the consunption of neat fron such animals. Fron an econonic standpoint the outlook is serious, is the ainnual oss mîust be very great.\" The Presigient of the New Brunswick Medicasl Society, Dr. P. R. Inches, at the annual meeting in 188S of the Society, after alluding to a numîber of outbreaks of the disease, and 1 to the danger to the public health therefreni, said : \"Since writing the foregoing, I have learned fron a reliable source of the existence of the disease i n this neiglborhood. Cases are muet with not unfrequently, and it is only a few days ago that the termination of one of those cases took place. The animal, a Jersey cow, lad been ailing for quite a time, and was examîîined by a leading veterinary surgeon, who diagnosed the case as one of tubercule.\" ie animal was isolated, quarantined, and kept under observation. After death an examination took place, wliici verified the diagnosis in every particular. The case was reported to thie De- partmuent of Agriculture. The veterinary surgeon tells me, said Dr. Inches, that \"sucli cases are not rare.\" About two years agoI sent out questions tO a large nunber of veterinary surgeons throughout Ontario, with thespecial object of finding out the facts as to the frequeney or otherwise of cases of the disease in this province. I receive d a goed nmany replies, althougli not so many asI had hoped for. Collectively tliese w-ent to shov tlat, in the opinion of the writers. the disease was not very cominon, but that on the w'hole there vere a good many cases of it. Some of the respondents ientioned recent cases observed, w-hile others wrote that althougli few cases had comle under thîeir own observation, othier veterinary surgeons, they were inforned, hîad observed many cases. One wrote, in affect. that lie hiad reason to believe the diseuse connon, but that stock ow'ners wisled to keep it quiet: and lie expressed the visl that his miame should not be publicly mentionied in connection w-ithî this information. RELATING TO TUE AGES \u0026C., Of cattle in wIhich the disease is most noticeable, the following official statistics froni flie public slaughterhouse of Augsburg w ill be of interest :-During 18-9, of 23,502 calves slaughîtered, only one (an animal 3 weeks old) was found to be tuberculous. Of 13,67M hîead of older caIttle, 012, or 4.4 per cent. were tuberculous. Of 8,537 oxen, 167. or 1.04 per cent. were tuberculous; wlile of 5,008 cows, 445, or S.88 per cent., were affected with that disease. In -4 cases, or aluiost 1 per cent. of the cows, the udder was the seat of tubercuhlt.is. In 67 of the",
         "- 164-- 612 cases in which disease was discovered, the flesh was declared unfit for food on account of generalised tuberculosis and destroyed.-(Brit. Med., Jour., June 1890.) OF THE O'rHER DOMESTIC ANIMALS, The feathered race appear to be miost prone to this disease ; especially the com- mon fowl, pigeon, partridge and other grain-eating birds. Dr. T. W. Mills, Professor of Physiology, McGill, University, at the last:Decemaber meeting of the Montreal Medico-Chirurgical:Society, exhibited specimnens fron a tuberculous pigeon, a white Jacobin, bred by himîself, which had died two days previously. The bird had been ill onlly three weeks, and was fairly well-nourished at death. The tubercles were very widly distributed, the organs inflaned, and bound together by recent adhesions. Owing to enlargement of the organs and pressure, the apex of the heart was squeezed to snch an extent that it nust have becone functionless. Tuberculosis is not connion it appears in horses, sheep and swine. NATURE AND CHARACTERISTICS OF THE DISEASE. This disease is characterised by the deposition in the lungs and other organs of what is called tubercular natter,vith wasting of the tissues, Usually its progress is slow and its commencement insidious. It appears that in animals it invariably terminates fatally. The tubercle when recently formned is a litible nodule, usually spherical when isolated. varying in size froi a very minute point to that of a millet seed. It is usually dense, tenacious, and diflicult to crushi or tear ; at first grayish white, and semi-transparent, but when fully developed it is of a sonewhat yellow color, and opaque. Large masses are fornied by' the aggregation of these miliary masses. In the progress of the disease the bodily tissues and organs seem to gradually waste away and be replaced by this mnorbid product. The tubercular masses sometimes become so numerous and developed in the bovine species as to increase the lungs to thrice, and even five times, their natural weigt-the diseased organs sometimes weighing fromu forty to sixty pounds. The liver, spleen, kidneys, and various other glands, and the intestines, frequently contain large deposits of tubercular niatter. The musales, or flesl, are rarely affected in this way. There is also a general wasting of all the bodily tissues, familiar to all, as the parasitie product increases, or the disease progresses. The disease lias been known by different names. In the human body it lias long been commonly called consumption-pining and wasting-or plithisis, the Greek for wasting away ; in the lower animals, as the grapes or pearl disease, and sometimes the animal lias been called a\" vaster.\" These are now all known to be one and the same disease, although long thlought to be distinct. That the imumnediate cause of the disease was a specific poison or infection capable of producing the mmalady when inoculated into a healthy body was first made known in 1843, by Kleucke, andstill further corroborated by Villenin in 1865. In 1881 Dr. Robert Koch isolated and cultivated this poison or infection and clearly demonstrat- cd that it is a living vegetable organism or parasite of the lowest forn of organic life, called abacillus (little stick); aci bacillus bemng about one seven-hundredth of an inch in length, or about as long as the diamneter of a blood corpuscle, mostly straiglit, vith somewhat rounded ends. Under a powerful microscope, when stained witlh certain dyes, it often presents a dotted or beaded appearane, indicative of the production of 3pores, like the. noulds and niosses; the spores being analogous to tie seeds of the higlier vegetable organismns, and by which the bacilli nmultiply vith marvelous rapidity. The nunmber of beads averages about si.i to caich rod or bacillus. The spores. it mnust be noted, have greater vitality and are muchi more difficul t to destroy than the parent rod; just as the seeds of most plants will withstand a teniperature and other conditions tiat would destroy the life of the plant itself.",
         "- 1(55- These organisis, fron the sputa of men suffering from the disease, and froni other sources. have been cultivated in certain fluids, as ox-blood semai, and the bacilli thus cultivated or grown introduced into the bodies of varions anlimals, as rabbits and guinea-pigs, and the disease thereby set up1) in the animals ; the disease being characterised by the usual progressive forai ation of tubercular nodules. Tuber- culous matter probably corsists chiefly of disintegrated tissue cells * and it always contains the characteristic bacilli. In later stages of the disease it may become softened and easily broken down by the fingers, like a piece of chesse-caseous tuber- cle. Still later, il may become quite soft a :1 creamy in consistence. But very few if any authorities now question the correctness of Koclh's theory,- thiat without .the tubercle bacillus there is no ttberculosis. Whether the bacillus be the inmediate and direct causu of all the peculiar symptomsof the disease through exhausting the vital powers and tissues of the body by meanus of the enormous multiplication in it of the parasite, or whether it be that it gives rise to a toxic substance which gradually poisons and destroys the tissues, this bacillus is now ahnioàt universally believed to be the specific, immiiediate cause of tuberculosis, and tia a case of the disease vill not develop without the bacillus germni any more thai a stalk of wheat or corn will spring up without the parent grain in the soil. The greater vitality of the spores and the viability of the rods are points of the utnost importance, wv'hieh must ever be borne in mind ; since, if the mucus saliva or expectoration of an animal or human being suffering froi tli disease be dropped or cast upon the ground, or floor of a room or stable. it is obvious that sucli secretions after hecoming dry may be a source of danger to other animals or humanl beings who mnay accidentally take up the poison. The disease commences in a very insidious manner, both ini man and the low'er animals, naking the early conditions and symptois very obscure and inappreciable: and it may have been in existence for montls before the earliest outvard niani- festations can be fixed upon. Reynal says, those who are in the habit of visiting slauglhter-houtes wilI often have occasion to note the presence of tubercles in the lungs of cattle which, during life, would not have been suspected of suffering from an incurable muîalady. When living they must have appeared: perfectly healthy, and have fattened as if nothing lad been amiss with them. A FEW WORDS ON TIIE CONTAGIOUSNESS OF THE DISEASE. Fron the period of the earliest records in the history of med icine, the contagious nature of tubercular consumption has been believed in by physicians of the highest repute. Over two thousand years ago (400 B. C.)., Hippocrates, the \"father of nedi- cine,\" believed in it. Aristottle (330 B. C.) wrote that the Greeks in his day believed in it; and he asks why consumption, \"sore eyes\" nd itch are common to persons who associate with others suffering fron thiese affections. Later (A. D. 180), Galen wrote that it is dangerous to pass the whole day with a consumptive person. Com- ing doiv to ntch more recent periods, Morton, over two hundred years ago, wrote of consunption that \"a contagious principle often propagates this disease, for, as I have often found by experience, an affected person mîay ;oison a bed- fellow by a kind of miasmi like that of a malignant fever.\" Riverius, about the sane period of time, believed contagion to lie the \"chiefest\" cause of consumption. * n*e ay observe women to be affected by their husbiands,\" le wrote, \"and men by their wives, and all the children to \u003clie of the sanie, not only fron infection of their par- ents seed, but fromn the company of hini that was first infected.\" The enunent Italian physician, Valsalva, a professor of Bologna, in the early part of last century, was hiniself predisposed to consumption, and avoided being present at dessections of the lungs of persons w-lio hal died of the disamS'. Valsalva's illustrious pupil, MIorgagni, professor in the University of Padau, declared that he",
         "- 166 - had never dared to make more than a few post-mortem examinations of persons vho had died of this disease for fear of contracting it. A lav once existed in Itlay by vhich the proprietor of a house in which a consumptive had died could clain paynment for his furniture, which vas burnt. It was often difficuit there for a person sup- posed to be consuniptive to obtain lodgings. Over a century ago a reaction regarding belief in the contagiousness of consuip- tion comnienced to show itself. Eventually, in Nortliern Europe and America especially, doubt developed into general disbelief. In the warmer latitudes however the opinion favorable to contagion never lost its hold; and the reaction and more recent general beleief in its contagiousness have paved the way to more rational and accurate views, baset on modern scientific investigations, which will be generally accepted . The recent investigations of Kock have resulted in naking belief in its contagiouness quite irresistable. Dr. Wm. Budd in an article on the nature and propagation of phthisis (La ncet, Loti. Oct. 12, 1867), took strong ground in favor of contagion. Ie concluded that \"tub- erculosis is a true zymotic disease of specilic nature, in the sane sense as typhoid, scarlet fever, typhus, syphilis, etc., are: and that, like these diseases, tuberculosis never originates spontaneously, but is perpetuated solely by the law of continuous succession. The evidences of this lie finds in,-(a) Considerations based on the patho- logy consisting in the evolution and multiplication in the organismn of a specilie, morbidi matter. (b) Actual instances in which there is evidence to show connuni- cation fron one to another. (c) The geographical distribution of phthisis, past and present, and especially its fatality nov in countries whicli were entirely free froni it when first dicovered by Europeans. (d) Its greater prevalence inI low levels and crowded connmunities, and entire absence, except by importation, at high levels. (e) Its high rate of prevalence in convents, harems, barracks, penitentiaries, etc., the sane conditions known to propagate zyniotic disease. When the Soutlh Sea Islands were first discovered, Dr. Budd says, there was n1o plithisis there ; but since the aborigines have come into contact with Europeans, the disease has become so wide-spread as to threaten their extermination. The late Dr. Rush, of Philadelphia, who made accurate inquiries, satisfied hinself that there was no phthisis among the Anerican Indians wlen America was discovered, whereas nov it is very commnon and very fatal anong themn. In Africa, everywhere along the sea-board, says Dr. Clapp, where the blacks have come into constant and inti- mate relations with the whites, there has been a large nortality from the disease ; but in the interior, where there has been only occasional contact with a few great travellers, the disease lias not been found. Of this fact Dr. Livingston and other African travellers have given Dr. Budd positive assurance. Both in Canada and the United States nany cases have been recorded most stronzly and clearly corroborating the correctness of the theory of the contagious- ness of the disease ; while scores of scientists in Europe have proved it by recent experinents of inoculating various animals vith tuberculous matter, both froni other animals and froni man. The tubercle bacillus is doubtless sonewhat peculiar, requiring a more special soil for its developmnent than the infections of many other diseases, sucli as small-pox, scarlet fever, \u0026c., thus niaking consumîption contaglous in a much less narked degree than these epidemic diseases. The infection of tuberculosis will only take root, or develop and grow, lin a specially susceptible subject, while it does not, it appears, as does the infection of typhoid fever, and of somne ocher epidemnic diseases, develop at all outside a living body. The soil must be fertile or the bacillus will not take root and grow. (To be continued.)",
         "EDITORIAL NOTES. ELSEWHUERE is given in this number of the JOURNAL a portion of a new edition of a pamph- let \"On the Cause and Prevention of Tubercular Consunption in Mankind and the Domestic Animals,\" compiled and written by the editor of this JOURNAL. Although ve have already given much on this subject,the pamphlet alluded to contains all that is practically useful in rela- tion to it, up to date, including soine quite recent knowledge, and we think it will prove acceptable and useful to our readers. It will be completed in the two or three next issues of the JOURNAL. DR. Kocii at the Berlin Congress, relative to the prevention of culosis, said that after a long search for growth-hindering remedies lie bas at last bit upon a substance which bas the power of preventing the growth of tubercle bacilli, not only in a test tub-, but in the body of an animal. I can only say this much about then, he continues, that guinea-pigs, which, as is well known, are extraordinarily suscep'tible to tuberculosis, if exposed to the influence of this substance, cease to react to the inoculation of tuberculous virus, and that in guinea-pigs suf- fering fronî general tuberculosis even to a high degree, the norbid process can be brought coni- pletely to a standstill, withuut the body being in any vay injuriously affected. DR. Koci regards his discovery as only a therapeutic agent, and not it appears as a sub- stance to be inoculated with the view or hope of ''conferring perfect ininunity against the dis- ease,\" as the New York Medical Record reports it. le only claims \" the possibility of render- ing pathogenic bacteria in the living body harni- less without injury to the latter.\" This is a very great deal, to be sure, and is of vast im- portance. We are inclined to think this is all that scientific investigation need or should aim at. We believe in the principle of conplete prophylaxis-prevention--the destruction of the bacillus-the infection, outside the body when possible. Dr. Koch's discovery will probably aid greatly in making this possible. HOWEVER IIARMLESS a foreign enemy may be, we prefer that be remîain in bis own country and not invade ours. So with the infections of disease. We would prefer to keep thei out- side our body and for this we must destroy theni. The time will couie when even vac- cination for snall-pox will not be necessary- the infection will be virtually destroyed-the disease stamped out. RELATIVE to other diseases whích run a. more rapid course Dr. Koch is not so hopeful. He says \" It is true, I look for relatively smi1.:r therapeutical results in the case of dis- e ises with a short incubation period and a rapid course. In these diseases, as for example in cholera, the chief reliance will always have t\u003e be placed on prophylaxis. I an thinking more of diseases of less rapid course (like tuberculosis), a.s these offer more points of attack to therapeu- tic enterprise. ON INFECTIONS of many other diseases Dr. Koch's rernarks are interesting. Lamenting that in many infectiotus diseases \" bacteriology bas left us completely in the lurch,\" he says : We knov nothing as to the generating factors of in- flucnza, whooping cough, yellow fever, cattle plague, pleuro-pneumonia, and, it appears, scar- let fever, niensles and small-pox and nany other undoubtedly infectious diseases... I an inclined to think that in the case of these diseases we have to deal, not with bacteria, but with organized generators of disease, which belong to quite different groups of ni icro-organisms. This opinion is all the more warranted by the fact that peculiar parasites, which belong to the lowest order of the animal kingdom-the prolo- zoa hav, recently, as is known. been found in the blood of many animals, as well as in the blood of human beings suffering from malaria. M. OL.IVIER bas recently reported cases of contagious tuberculosis at Neuilly. A family of seven occupied a bouse on Rue du Pont. In two years, five.out of the seven were attacked with tuberculosis ; two are dead and three seriously ill. Inquiry showed that the bouse had fornerly been occupied by a fainly suffering fron tuber- culosis. In 1887 a child died in it from that disease ; the first case, supposed to be the origin of contamination. Dr. Ollivier concludes fron this. and other cases, that it is dangerous to inhabit a bouse which bas bieen previously in- habited by tuberculous patients, unless it be thoroughly disinfected. THE British\"Medical Journal reportsthe fol- lowing : On February 19, while Dr. Gutzman was holding an anutopsy in the case of a patient who died of acute miliary tuberculosis, the nail of his right middle finger was slightly raised fron the matrix. A pricking sensation was experienced at the tip of the finger, but no- wound could be seen. The band was thoroughly disenfected in a subliniate solution and alcohol, and the incident forgotten. On March 2oth the-",
         "- 168 - end of the finger hecamte painful. a smnall abscess ieing fomui under the n.iil. hl'is was opened, and the pus remouvel. whici on being examiied by Ehriich's ieihod, vas found to contain three tulrcle: btcilli. Tie cavity was cleanedl lit anad di infeted with alcuihal Su far there have been no general gymptoms. IN a paper by Dr. Thomas More Madden, of Dublin, for the recent meeting of the British Medical Association, lie said : As I fornerly pointed out, and the observation is now more applicable than \"ws the case ten years ago, the acute forms of ttubearculosis conimon during childhood resonuble. the infective diseases in their origin fron a specific germ, whether gene- rated in the body or introduced from without. The latter is probably the case in the tuhercular diseases prevalent amîong the children of the poor, in whose dietary various forms of preserv- cd foods now enter largely, as it stetis difficult to conccive any certain gunarantee that the cows iurnishing the supply may not, in somte cases, suiffer from tuberculosis, this disease being very prevalent and not naterially aflecting the quantity\u003cof milk. TH N. Y. Medical Times says : The fact that the bacillus of putrefaction is destructive to other forns of nicrobes, is said to do away with the generally accepted theory that infection from the air and water of ceneteries is to be creaded. According to the National Druggist, Esnarch conc-ludes after thorough examination, tiat no form of pathogenie microbe now known, survives for any length of time in itie dead body, and the more active the putrefactiona, the shorter the survival of the microbe. As FtjRTiER LIGHT on sulphur disinfection, referred to elsewhere, Dr. Baker, secretary Michigan Board of Health. has written to the health officer of Detroit a letter. called forth by a rumor that the latter was about to dispense with the use of burning sulphur in the disenfect- ion of the rooms and appurtenances of persons affec ed with diphtheria. It will be remember- cd that the efficacy of such fumigation lias lately been denied in case the sulphur fumes are not mingled with the vapor of water. Dr. Baker maintains that the few laboratory experiments on which this contention is fotnded should not be held to outweigh the experience of heailti officers in the restriction of diphtheria. He states, nioreover, that it is not necessary to use water with the sulphur, bt that the essential thing is to use enough sulphur-three potimds ftar each thousand cutc feet of space, at least. IN Boston the process of disinfection is to close up the apartments to be disinfected, tightly, and to burn four tounds of sulphur to each I,ooo cub/c fed of space, evaporating water witht the ieat of the burning sulphur, and keep- ing the room closed for ten hours. In case of smiall-pox this is all they ordinarii do ; but in case of diphtheria, scarlet fever and typhoid fever, where the sputa or some other of the secretions may have becone fixed and dried upun articles or surfaces in the room, and, nioreover, vhere a stronger germicide is required for the sporebearing germ vhich is likely to become so fixed, they rub the walls, floors, and other liard surfaces with a solution of bichloride of meicury-I to 5oo -and Loil one hour articles of clothing and bedding. ON TH1E ETIOLOGY oF DIPHiTiERlA, Dr. Thursfield read a paper at the recent Congress of the Sanitary Institute of Great Britain, in which lie showed that there had been a steady increase 'in the mortality from this disease, due apparently to its greatly increased prevalence in large towv'ns. The deaith per million from diph- theria had risen in London to 346, and in the twenty-seven other largest towns to 162, while in rural England, which fornierly suffered more than the towns, it was 159. DR. THuRSFIELD while admitting that the majority of cases of dipltheria are to be traced to direct infection, considers that in a cer- tain proportion of the otbreaks the disease is evolved under favourable circumstances from sore throats of a catarrhal nature, and apart from any influence of what were known as the filth nuisances. Structural daampness of habi- tation is the condition of all others most favour- able to the incipience, the severity, and the spread of diphtheria, and to the persistent vitality of the germ of the disease. As to the last point, he had repeatedly found, when there was no evidence of importation, that there was a history of a previons outbreak in the same house, often with a long interval of years, and he therefore hesitated tu put a limit to the time beyon,1 which revivification of old germs should be considered iniprobable. ON TYPHOID fever, and its so called spontane- ous origin, Dr. Thursfield, at the meeting last month of the British Medical Association said Although it is only on inferential evidence that cases can be said to owe their origin to the revivification of old germs, in mtany such cases the evidence is overwhelming, whilst in others such a source can only be suspected. I an confident that this is a much more frequent source of outbreaks of typhoid fever than is",
         "- 169 - generally suspected, and that it is the true ex- planation of niany of the so-called spontaneous cases. FOR EXAMPLE, a boy aged ii years, got thoroughly wet through goir.g to school, and was allowed to ruimain all day at school until his clothes had dried on him. Eighteen days after he sickened with typhoid fever. The bouse was in every wvay unobjectionable from a sanitary point of view, and here was a case in which the popular explanation, so commonly volunteered, that the fever came from catching cold, would seem to be the only one admissible. This family, hovever, had only lived in the house four months. and three years previously a case of typhoid fever had been imported into the house. The cottage had been disinfected by sulphur fumigation and lime-washing \"as for as applicable,\" but the vall paper in the bedroons had not been stripped, and there or elsewhere about the premises the infection had remained, and had revived under favourable conditions of season and subject. THE Sanitary Inspector, the official organ of the Maine State Board .of Health, says : Accord- ing to the Canada lealth Journal the death- rate iiong the members of the House of Coni- nions of the Dominion has been for severa years, at the rate of over twenty per I,ooo, [three times higher than the mortality in adults in public institutions,] \"which fact should be an influential lobbyist whenever the Canadian Parliament is calied upon to consider practi- cable and reasonable methods of leading their people generally, themselves included, to live natural healthy lives. Jusr so. Dr. S.S. Burt (Med. Rec.) says that phthisis pulmonalis is an infectious disease, only the soil must be fertile or the bacteria will not take root and grow ; that the inheritance of the affiection is siniply the descent of the degraded cells presenting the vulnerable points for a pos- sible encounter with the vagrant germs. That all specific treatment is futile, in view of our pre- sent knowledge ; and though persistent de- struction of the infectious matter is our best means of prophylaxis, 'et to restore the vitality of the lung tissue is a hmportant as to destroy the tubercular bacilli. THERE is a popular belief, says the British Medical journal, that cut flowers and plants in living or sleeping rooms are apt to be injurious, owning to the continuous exhalation of carbonic acid gas from them. A writer in Amateur Garclening has recently shown that the air of a closed greenhouse, where more than 6,ooo plants were growing, exhibited only 4.03 parts of carbonic acid per Io,ooo (very little more than the normal amount) this being the average of three experiments made early on three different mornings after the greenhouse had been closed for more than twelve hours. There was usually a slightly larger quantity of C02 gas present in the air by night than by day. WHETHlFR cut flowers have a greater effect in producing carbonic acid than living or pot plants, the writer does not tell us, continues the Journal, but it is reasonable to suppose that some of the injurious influence attributed to flowers exhaling heavy or sweet perfumes in sleeping or sick rooms is really due to the con- ceaiment hy these perfumes of the accumulated offensive products of respiration or transpiration, which leads those w ho are exposed to their in- fluence, or the attendents on the sick, to belkve that the atmosphere of such rooms is fresh and wholesome, and ierefore, to neglect the usual methods of ventilation. CHICAGO leads in the appointnent of v'omen as health inspectors,having appointed five intelli- gent women, at a salary of $i,oooeach, the same amount paid to men for the sanie work. The duties of the women \"are to inspect place:s where women and children are at work, and if unsanitary conditions are discovered, they are empowered to order necessary changes. In many places the conditions they found were ''sickening.\" Much good has already come from their work. DR. TucKER, analyst of the N. Y. State Board of Health, finds the cream of tartar sold in drug stores uniformly pure, while that sold by the retail grocers was pure in only twenty- six per cent. of the cases. Some of the samples were entitely fictitious; acid phosphate of lime being most common. GuN-LANcINa we have always been averse to. Dr. Forchheimer (Archiv. Ped.) says of it : I. It is useless (a) as far as giving relief to symptons ; (b) as far as facilitating or hasteninr teething. 2. It is useful only as a blood-letting, and ought not to be used as such. 3 It is harmful, (a) in producing local trouble ; (b) in producing general disturbance on accounlt of homorrhage ; (c) in having established a nethod which is too general to do specific good and too specific for universal use. 4. It is to be used only as a surgical procedure to give relief to surgical accidents. Tis is the way they try to make the people respect health regulations in France (Brit. Med. Jr ) : Madame Romagne (a Spanish lady), her",
         "-170 - son and maid, who recently neglected to notify their arrial in France frui Spain, accopding to the decree of June 28th, 1890, wcre condcmned to three days' imprisonnient, with a fine Of 5 francs. Senor Yorrono, for the saie offence, was sentenced to three days' inprisonment, with a fine of £C2. IN a recent communication to the Acadenie de Medecene, Paris, M. Laboulbene stated that trichinU are easily detected in meat; the smallbst section made in the direction of the fibres reveals the presece of the cysticerci. The muscles of the head and neak, and the inter- costal muscl.s arc the nmost easily c.ained. FJioM Munich Dr. Osier writes to the New York medical Journ.l that withisi the past ten 3 ears Munich has gradually acquired a thorough drainage system, and lie was shown a set of charts in couarse of preparation for the Berlin Congress, illustrating the remarkable reduciion in the number of cases of typhoid fever In crtain sections of the city, formierly much affect- ed, the disease is now alnost unienown. The cht*t showing the hospital experience during this period follows the sanie falling curve. Munich is now one of the healtiest of the conti- nental cities, whercas it formerly had an except- ionally high death-rate. particularly from zymo- tic diseases. Dr. A. L Loomis, one of the leading phy- sicians of New York, says that, wlhen lie first visited the Adirondack forests twenty-eight years ago he was suffering fron what was re- garded as a hopeless case of pulmonary disease. After an eight nonths residence there lie re- turned home perfectly restored. Since then he bas constantly sent patients to this region, and from this experience lie is prepared to niaintain liat no other such health resort exists. For this reason he is especially active in preserving the forests for this purpose. He wants the German forestry system practically applied to to the Adirond:ick region. Let us have many such preservations in Canada. To riHE importance of light on health we bave referred on another page. Most persons would say that the outside light is two or three time. as strong as that within our bouses. It is now scientifically stated that persons strolling on the seashore in sunny weather are in a light not two or thrce tinies, but 1S,oo times stronger than that in the ordinary shaded and curtained roomus of a city bouse, and. that those walking ailong the sunny side of a street are receiving more than 5,ooo times as much liglht as they vould ireceive indoors in the usually heavily curtained rooni. Ir is belie'ed (N. Y. Med. Times) that if a scarlet fever patient be sponged with some trong antiseptic solution from the beginning to the end of the desquamation, spread of the con- tagion will be prevented. An epideiic of lead poisoning caused by flour is reported. Analysis revealed the pre- sence of threc milligrammes of lead to everv kilogramme of flour. The miller confessed that one of his workmen had stopped some holes in his mîill w iîb niolten lcad. The writer of this has seen lead in holes on the surface of turned up miill-stonea-on the surface which grinds the flour. TiE 3ritih Medical Journal, with the enter- prise worthy of the leading Medical Tournal of the world, the organ of the British Medical A.sci.tion, piubishes in its last issue portrits of cight of the \"leaders of German Medicine,\" at the Berlin Congress. TiE Prince of Wales bas accepted the post of president of the International Congress of Hygiene, which will be held in London in 1891 to bc opened probably in August. TiE National Women's Health Association of America was organized in Philadelphia July 23, with Caroline Dodson, M D., as president; Its object being to bring the laity and the medical profession into closer relations. The Russian govermnent bas enacted some very stringent laws against the adulteration of food and drink. Any person guilty of the act will be liable to a fine Of $200, oi imprisonnient for thrce months, for the first offence, double this penalty for the second, deprivation of all rights as a citizen for the third. THE Massachusetts Board of Health bas examined 76 samples of water 336 saniples of ice from 58 localities. Clear ice from polluted sources may contain but a very small proportion of impurities, yet it is dangerous. At the recent annual meeting of the British Medical Associatton a resolution was passed that the Bi:ls Conmmittee approach the Govern- ment, with a view to obtain the abolition of private, and the establishment of public, slaughter-hous-s, with skilled inspection of meat.\" AT a meeting recently held under the presid- ency of the Bisbhop of Marlborough, recently it was resolved that a Clurch league should be formed to move the nation to take up the ques- tion of the dwellings of the poor."
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         "Trmn MONTREAL MEDICAL JOURNAL. VOL. XXV. AUGUST, 1896. No. 2. ig3tuia (oimimncatiolns. THE CENTENARY OF VACCINATION.' MA.14TH, l'69. . Y J. G. A1A.i, M.U., M.R.C.S. Professor of Pathology, MicGill University; Pothologist to the Royal Victoria Hospital. On May the 14th, 1796, Dr. Edward Jenner, of Berkeley, in the County of Gloucester, first inoculated a huiîan being with matter taken from a vesicle of cow-pox. The inoculation so made developed into a well-inarked pustule, the pustule witlh which now-a-days we are so well acquainted, and the inoculated individual was later found to be absolutely refractory to the inoculation of matter taken froin a case of well-developed snall-pox. This successful experiment it was which inaugurated the practice now spread throughout the world, of vaccination against small-pox and led to the arrest of a foul disease so coîmnon during the last cen- tury that almnost every other individual in Europe showed signs of its ravages, so rare now-a-days as to be extinct wherever vaccination and re-vaccination is rigorously enforced. To-day, therefore, we celebrate the centenary of vaccination, and it is fitting that we, whose life-work is devoted to the combat with disease, should consecrate, even if it be but a few minutes, to calling into remembrance the great deeds 'which were of old, and should emt- ploy this occasion to look before and after, considèring what lias already been accomplished and what the future holds in store. For 'Lecture delivered before the post-graduate students, McGill University, fay 14th, 1896.",
         "ADAMI--CENTENARY OF VACCINATION. only now, one hundred years after Jenner's lirst vaccination, are we beginning to apply successfully the principles underlying Jenner's nethod of arresting infectious diseases, principles which Jenner hiin- self appreciated, but could not satisfactorily establish-and now with a fuller knowledge of those principles, a future dawns upon us, rich in hope. Mindful of the day, and as a pious duty, let me first briefly recite the main facts that led up to the discovery of vaccination, recaliing imatters that are historical and, I doubt not, well-known to you. Our knowledge of snall-pox goes back to remote tines. The earliest sure reference to it is of its appearing iiin the Abyssinian army at the siege of Mecca, in what was known as the Elepliant War, of about the year 570. The earliest references to siall-pox in England, if we leave out a possibly correct reference by Gaddesden early in the fourteenth century, occurs in letters of the years 1514 and 1518. The disease gradually rose to prominence about the end of Elizabetlh's reign. In the autumn of 1641. we hear of 118 people dying witlh smnall-pox in London in one week, at a time wlhen the population was between 300,000 and 400,000, or roughly about the saine . as that of Montreal. The experiences in England were simuilar to those on the European continent gencrally. Towards the close of the seventeenth century the disease becane more and more general and more and more feared. lu Iceland, in 1707 to 1709, after an absence of nearly 40 years, it killed 18,000 in a total population of 50,000. In England, in 1723, Dr. Jurin calculated tlat upwards of 7 per cent., or some- what more than 1-14th part of mankind, died of small-pox. In 1775 it would seem that in Chester, only 1,060, or 1. out of every 14, had not contracted small-pox. I have seen it stated as an explanation of the lack of beauty revealed by the pictures by Sir Peter Lely, Si Godfrey Kneller and others, of the Court beauties of the 17th and 18th centuries, that so common wias the disfigurenient by pock-marks that complexion was taken as the test of beauty, that the woman whose face was not dis- figured by small-pox became of necessity the beauty of lier neigh- bourhood, if only lier features were not absolutely commonplace. To arrest the ravages of small-pox it would seem that from a very eaýIy period, in various parts of th world, it had been the custoin to inoculate young and healthy individuals with matter fron those suffering from mild attacks of the disease, founded upon the common knowledge that one attack of small-pox protects against a second. It would appear to have been a most ancient custom in India, and at the",
         "A I)AMJ - L~ENTE V ~\u003c A(CiNA'Vi\u003c)N~. Ibegjiirlg of the .~ iglltdel)tI C(!IfliJr3 tIj\u003cý 011.4toli wi.s \u003eqrend tllrough' the Nlltlloll-.Ijtuî uIv-(, \"I'r-ipoiz, Algeriii, 'I'ill'key in Asili, Arsllin. iiul (hrcassia *Thc, Dv -k oz r. B ichritrd ý1 eadf fýx lainetIi(± bjest L.jv of the- Cirem.ssiiii \u003eii, lore tiîr tilry tic Iirieevitiol rî \u003cA' e tia~SlJieU Mi' being dueli to thé' fact tillit Iy il)oeuhj\u003cînitj 1 llid iiisei±5i., ii Litir yoiitîtu ff1etS ulpoln te iliiii wüc 1JecjL y ii, anail 0111is tl\u003c.-y WC' \u003eït? fox i f JJÙliIurs uaa\u003cS'f tic.dses, It m~'is iniC\u003eitLttJ\u003cjI thlt tliiat mist :ILdvitruci,] filew MvC)Iaus Çof lier pftroil, thse IL;vly %Ifry Wortley .lniuWl f(, of' the ai ,u5' to the 'Suljl)jlle Porte., was so îsusc, îxswese withl tise vaiî of tise ilssetlioal tiisat Slue otnsdan old Gre oîsla a'îsîul inc.)Cuiatxîr, w'ho wvitIs %r. Mataatise stirg4,-i)tj \u003cA' tb'r e Iassv, iIocuIlate\u003ci bel. Solis, aniIl Ssueeesu w4ss tis 01:alua~tja,\u003c11, n lit!l rettiri toiLxgas1s' ujee lier. ild1al5J aJalsî'lter Vo vlitt ss±'ne ol)U3'#tio\u003eJ. L.ady _NIar3' was wveii knaîwl ; tlme dau\"igtiiro tlis\" flfti Earl (if K gsuS.se I»id uit tise agi: of i' 'li IotQil liiafJ\u003cail a t4it 'A ;t fic Kitcat Club ustye (iect4dd a In-sîe ' veasaicr.Ss sareJle liusbausd against tise, Cozssexst of' lber txier ii vjcJiti aexs- alistirnetiv ad»nelpoelriitliose-e elJays, hoth as regardis tise Special.lcus alsd tise pa«ttlai tonsiflst. St. waýti 0u I*riîesif' f Mary .A.StAA. the 1jetendler of vfjlosssanjs riglits lin lIer iday. 1 - iiiexstiont tbaesc faets licauze p)ejrxîe 1 atil Sorteri(s S tisa f poi irolsdt\u003cid* the 'leb-Iatces at thi 'ssx' Caîrîgrî.s', and J weonjal not sieejîs te) f.-rgelt tie Claills qof tisat (2ou(ïes 9pJZ u) osaiatoi h:,.r-Llt pocit, Poipe, Wws onrsuel\u003cf be axia tl'ii l 4A sier !Tvl ditbo us vnoosu~fosf. \"liv JIý clid] 'i) lieas: Iîee_ýcile 'îîsý \u003cf t\u003e\u003cý îîuzxla:s tir i iteatue.Tio rival tic-toricsý lave gaiwa:d stoîzsp ort os th.t slue haLl borroivi.ed a pair (if slhe.ets fr\u003cssî, Ji*-tus (lie hux\u003c irîduicid b X~'rtey~Jusrtrufariiily tsi becoirri(c li;s ;îihLor~At lit:îîî axi-l Lady Mary' C.:turried the .Shievt unw.u4îea cnd thsat~ islle haai byýrher witty axsid (q\u003cfajfzIianner ledIiii hiru A', i int rt ienul av-oiing his love( Voi lier, whsecrceat :'h auJrise'i at b»J eud v xi scornf ully. Wluichec%«er lxc corret, tljierij is fo 'Jioult tJat hie m1otie bitter, not te say brutal. tinrgs aberit hsier, ýcAd su îr dte, 4;irec- late ahroarl stoei aile) laynpcoiîs c-l aliisost equaJ ýStrtus;,h. #ShJe wag a gDreat ivcsran in lier duy, aid bier ati!voeacy ()f rî1-o:ieclt'x sud miieh te ensure the popularitv cf th. proess The successfu] re-sults exc.ited wide,-spr;,ail iîe't.ansd rtbie 1oiýthre gradulh eamne eteiLs\"-ivdiy V xptrd It iý\u003ec.lua~ejt~x i England alone up to, the ve\"ar i 7.58 theCre la i ut leaswt 2(fX iUeno e~ jvrulations whtile in. thic 1atit-r hialf f' thecI4 trvtf'",
         "ADAMI-CENTENARY OF VACCINATION. - Suttons, Dimsdale, and others would seem to have variolated thou.. sands of individuals. Dimsdale indeed was invited over to Russia to inoculate the Enpress, the great Catherine, and he did this with such success that he was made a baron of the Russian Empire, appointed 'Councillor of State, physician to lier Imperial Majesty, and, in addi- tion to an annuity of £500, was presented with the not inconsiderable douceur of £10,000-truly an imperial gift. But while this process of variolation spread, small-pox at the saine time becane increasingly frequent. The process, indeed, was essentially dangerous; while it is true that those who were variolated very rarely died, not unfre- quently the same could not be said concerning their friends and neighbours, for those who were variolated sutffered from the truc disease, and were as much liable to be carriers of infection as were the victimus of pox by natural means-indeed more so, because the mildness of the induced disease led to a lack of care. \"\" is it was that towards the end of the eighteenth century small-pos, instead of being stamped out, -vas more prevalent than ever. It -would not seem to be an exaggeration to say that almost every second man was pock-marked. While this was the case, it gald also been recognised ainong the farming classes, not in Great Britain alone, but elsewhere--sporadi- cally-that milkmaids were specially exempt from the disease; and it was further noted that there was a relationship between this exemp- tion and the fact that these milkmaids had at one tine or another been affected with cow-pox, a disease of a vesiculo-pustular nature, appearing in an .epizootic form, and showing itself more especially upon the teats of milcli cattle. And it is cvident that even before Jenner's great experinent there had been occasional inoculations with cow-pox, so as to protect against small-pox. The best authenticated of these cases was that of Benjamin Jesty, a Dorsetshire fariner, who in 1774 inoculated his wife and two sons with virus taken on the spot from the cows of Fariner Elford, of Chittenhall, whither Mr. Jesty carried his family for that purpose; and in 1791 a schoolmaster in Holstein, Peter Plett by name, did similarly. Holstein then as now was a great dairy district, and there, as in the south and - west of Eng- land, the tradition existed that milkmaids who had been infected with cow-pox were unaffected by small-pox. Thus, having seen a physician practise variolation, Schoolmaster Plett came to the conclusion that he would employ cow-pox lymph, and in tie year above mentioned, there being an epizootie of cow-pox in the neighbourhood, lie inoculated three children with the virus from a cow. His method vas rather crude, lie used a pocket-knife and made cuts upon the back of the",
         "ADAMI-CENTENARY OF VACCINATION. hand between the -thumb and first finger. The operation had the desired effect. Three years later when aIl the other children of the school sickened with sinall-pox the three remained quite healthy: but unfortunately the choice of region for inoculation had led to so severe an inflammation that Plett never again ventured to repeat the pro- cess. These and yet other observers, it nay be, had vaccinated prior to Jenner, but with this difference, that they made no attempt to repeat the process, to establish the correctness of the process by later inoculation with variolous matter, or to spread abroad the beneficial resuits accruing therefrom. Only after the publication of Jenner's famous \"Inquiry \" was any attempt made to publish the results obtained. Jenner, on the other hand, having once succeeded, was not satisfied until after repeated attempts he felt assured that he had determined that an attack of induced cow-pox protected froin the snall-pox. Then, two years after this first experiment, he published the inquiry into the causes and effects of ,the variolS vaccinS, and thereby inaugurated or led to the inauguration of the process of vac- cination. That motion can be brought about by the boiling of water may have been known for centuries, but it is not to Hero, of Alexan- dria, or even to the Marquis of Worcester that we are to ascribe the honour in connection with the discovery of the steam engine, it is to James Watt, to him who applied a knowledge of the properties of steam to the production of the steam engine the honour is due. Hundreds of patriotic Germans may have dreamý of and sighed for the unification of Germany, but the honour and the glory of having brouglit about that unification is now and must always be Bismarck's. And so in connection with vaccination, while we are ready freely to acknowledge that there were others who inocu- lated before Jenner, yet it is to his labours and his researches, and to hiim alone, that the honour. and glory must be ascribed, if now- a-days small-pox has almost vanished from our midst, not to mention the further honour of having inaugurated the method of protective inoculation. So now for a brief sketch of Jenner. He was born in the year 1749, a younger son of the Rev. Stephen Jenner, vicar of Berkeley. He was apparently not very strong as a boy, and his education was conducted partly at home, partly at Cirencester, which is not very far distant; and being intended for the medical profession was, after the good old fashion, bound apprentice to a surgeon at Sudbury. Completing his apprenticeship lie u ent to London, and there became a pupil to him whom we may truly call the father of British path- ology, the great John Hunter. And he would seem to have been a",
         "ADAMI-CENTENARY OF VACCINATION. favourite pupil, for Hunter recommended him to Sir Joseph Banks to aid him in arranging the collections which he hiad made during Cap- tain Cook's first celebrated voyage of discovery. One biographer, indeed, states that Hunter solicited Jenner to becone his partner; but the old life in Gloucestershire was more to his liking, and he returned to Berkeley, where lie soon became the leading practitioner. But at the saine time, lie did not lose his love for observation, and his publications, more especially-a paper upon the habits of the young cuckoo, gained him his F.R.S. It was here at home in Gloucestershire that lie learnt the tradition concerning the effects of cow-pox, and set himself to work to collect together what cases he could find of cow- pox having rendered those affected thereby refractory to small-pox. He collected together a considerable number of very clear cases, some of which lie tested by variolation, and lie found that inoculation of matter taken from small-pox patients constantly was without effect in those antecedently affected with the getuine cow-pox. And the conclusion was forced upon him that it miglit be possible to propagate the cow-pox by inoculation, not only from the cow to the human sub- ject, but also from man to man. And as the complaint when trans- ferred fron the cow to the milker possessed the quality of preventing the small-pox, it seened probable that this quality miglit be retained even by propagation of the virus in succession froin one human being to another. At lengtli, in the spring of the year 1796, the cow-pox having broken out in a dairy near Berkeley, Sarah Nelmes, a milk- maid, became infected in one hand which liad accidentally been scratched by a thorn. Here was an example of the genuine disease, and Jenner selected a healthy boy nained Edmund Phipps, a boy who had not suffered from sinall-pox, and on him on the historie May the 14th lie inade his first trial. On the seventh day the boy complained of uneasiness in the armpit and had a slight headache. On the following day he was perfectly well, and by now the incision of the arm had assumed nearly the appearance of a part inoculated with variolous lympli. The inflammation subsided, the crust formed and dropped off, leaving a permanent eschar, and six weeks later, on the lst of July, Jenner inoculated the boy with variolous matter, making numerous punctures and slight incisions on both arms. No effect was produced other than such a slight and transient inflammation as usually ensues after the inoculation of persons who* had already suffered from small-pox. Several months later the inoculation was repeated, but without effect. At this period Jenner did not essay to carry on the vaccination from arm to arm, and the epizootie of cow- pox having died out, ho had to wait two years for an opportunity to",
         "ADAM.i-CENTENARY OF VACCINATION. continue his observations. On the 16th of Mareb, 1798, he vaccinated his second case, a boy named Summers, with virus from the teat of an infected cow, and the vaccine lymph was transferred from Sumniers to William Pead, while from William Pead several children and adults were likewise vaccinated, and from one of this third of the series the lympli was transferred to several others. Several of these persons were next inoculated with variolous pus without effect, and Jenner ascertained that the vaccine lymph in passing through a series of five individuals retained the property of rendering the vaccinated insus- ceptible to the contagion of small-pox. These were the cases which were published in the Inquiry, which appearing in the latter part of 1798 created immediately a most pro- found impression. It is unnecessary for me here to state in detail how Cline, Pearson, Woodville and'others immediately took up the process, or how, long before Jenner's death, the process of vaccination had spread all over the world, and lie had been the recipient of grants of £30,000 from Parliament, and hiad been given honorary degrees at Oxford and elsewhere. Already, before his death, the diminution in the small-pox mortality in the leading countries of Europe was very remarkable. Dr. Parr, the greatest of English vital statisticians, bas made the following calculations as to the London death rate in periods previous to the introduction of the Registration Act, and Dr. McVail has continued the series up to 1882. No words of mine can be more eloquent than these figures. With the process of tiime we have become better acquainted with what constitutes satisfactory and successful vaccination. Jenner held, and his own observations upon those who had accidentally taken cow- pox strongly supported the opinion that a single attack of cow-pox, and consequently a single. vaccination, conferred immunity for the rest of life. Before his death this had already become seriously doubted, but it was long before re-vaccination was generally adopted; it was long, indeed, before· the first serious attempt was made to enforce vaccination of the whole population in Great Britain; up to 1853 vaccination was optional, and only in 1872 was it made obliga- tory. Even now at the present day re-vaccination is not enforced for the whole population, save in Prussia. But how effective this is is shown by the following table, or better still by the diagram here copied from the report of the German Vaccination Commission of 1884 in the British Medical Journal (for diagram see page 89), show- ing the good effects in a class of population which is efficiently looked after, namely, tlhe army. For comparison the accompanying diagram shows the ismall-pox cases and deaths per 100,000 in an",
         "88 ADAMý1--CENTENARY F VACCINATION. arniy and among a people in which vaccination and re-vaceination are not so rigorously enforced. APPROXI.ATE AVERAGE ANNUAL DEATiR RATE 'Teiis or~ VARims pORt FROM SMALL-POX PER MIL wiCII DATA ARI R ON. . LION oF LIVING. GivE.N. Before Intro- After Intro- duction of duction of Vaccination. V'accination. 1777-1806 and 1807-1850. rower Austria................... 2,484 340 \" Upper Austria and Salzburg .... 1,421 501 \" Stvria ................ ..... ..... 1,052 446 \" Illyria ... . ..................... 518 244 \" Trieste ..........................14,046 182 \" Tyrol............................ 911 170 \" Bohemia'......................... 2,174 215 1776-17'0 and 1810-1850. Prussia (East)................... 321 56 \" \" Prussia (W est) .................. \" Westphalia...................... 2,\"J 114 \" Rhine Provinces................ 908 90 1774-1801 and 1810-1850. Sweden.......................... .2050 158 1751-1800 and 1801-1850. Copenhiagen .....................3,'128 286 DEATII-RATE PER MILLION IN LONDON AT SUCCESSIVE PE'RIODS. AViERAQE AN- AvmER.%GE AN- Y BAR.UÂ DEATUiS NUAL I)EATIIS FR05! ALL PR05! CAlusES. Ss!ÂýILIP.-r 16W1-71). 80,000 4,170 17 28-57.-r 52,000 4,260 Optional Variolation., 1771-80. 50,000 5,00 S 1801-10. 29,200 2,040 Optioiial Vaccination.' 1831-31. 32,000 83044 188-53. 24,18 513 24,200 3 Obligatory; badly e 182-822 22,100 262 Obligatory Vaccination; more efficient. I have not, gentlemen, griven yon this evening many statisties, but those diagranis, if they were thse solitary records we possess conceru- ing thse resuits accruing froni proper vaccination, would be, sufficient Vo prove absolutely thse enormous benefit to thse nation of vaccination and re-vaccination. Mhile upon statistics, I mnay hero, thanks to thse great kindness of Dr. Wyatt Johnston in permitting nie to use obser- vations and statistics coinpilecl by him and not yet published, say a few words showing, tise other side of tise picture, namely, showing thse fatality froin sinal1-pok in an imperfectly -vaccinated comimunity, to- it, in this city of Xontreal. I i2ht perchance have slected. more",
         "a o At\u003e ut\u003e -'an lA lu 0W \u003ctua m \u003e",
         "ADAMI-CENTENARY OF VACCINATION. convincing, or rather more satisfactory tables, for it is a matter of notoriety that, thaiks to the condition under which we live in this Province of Quebec, it is a mnatter of peculiar difficulty to arrive at even approximately correct vital statistics. The fact that the records of births and deaths are compiled from returris sent in by religious denominations, and that the duty of recording is in the hands of priests and ministers, who, I believe, receive no adequate renunera- tion for the work,-this fact alone makes the compilation of 'Vital statisties a matter of peculiar difficulty.. I might have chosen fuller statistics fron such reports as those of Dr. Barry on the Sheffield epidenic, but the facts here given comie close home. I refer to what iappened in the epidemnic of 1885, which was started by cases which caie froin Chicago in the beginning of that year; whereas in 1881 there had been five deaths from small-pox, none in 1882, one-in 1883, and none again in 1884, in 1885 there were no less -than 3,164, the average number of srall-pox deaths per 1,000, being .18.9, the per- centage of small-pox deaths to deaths .from all causes being 40.6. Taking now the analysis by religion and- race, we arrive at the follow- ing very suggestive table: MONTREAL. CATI oics. CTII S. PROTEsTANTS. TOTAL. Population .............. 93,641 29,627 44,223 167,491 1885.. Deaths fromn all causes.. 6,061 877 887 7,825 Deaths per 1,000..... 64 .7 29.6 20.05 46.71 Deaths from sinal-pox 2,887 181 96 3,164 Deaths per 1,000..... 31.0 6.2 2.1 18.9 We may therefore state that even- if now, a- century after Jenner's iirst vaccination, small-pox is not eradicated, the fault doés .not lie in the incapacity of the process to prevent the disease, but in the incapacity of legislators and peoples to recognize its beneficent effects. It may to enthusiasts appear to be a serious assault upon the liberties of the subject to compel him and his offspring to undergo inoculation with vaccine lymph. But when his neglect to be vaccinated leads surely to the continuance of the disease and'to the possibility of discase 'nd death or disfigurenent being propagated sooner or later in his neighbourhood,.then assuredly the governmnent as representing the-nation has a full right to legislate for the safety of the nation as against the pei'sonal predilections of the individual. We, here in.",
         "ADAMI-CENTENARIY OF VACCINATION. Canada, and more especially in this Province of Quebec, cannot but be warned by the grim history that cornes to us recently froin the county which gave birth to Jenner. Wu have leariit other things also during this last century which Jenner at first did not recognise, and first and foremost that there is a possibility, rernote it is true, but nevertheless existent, that in inoculating from man to man the diseases to whichi man is liable nay bie conveyed and inoculated along with the lynph. We now know that as a precaution against such an untoward event thure should be constant return of the virus to the cow, and that calf lyrnph, and calf lyimph only, should be employed. And only within this last year or two the researches of Copenan and Straus have shown that the adhix- ture of such lymph with glycerine leads to the graduai destruction of the microbes in general harmless which constantly containinate fresh lynph, while at the same tine the glycerinated lyniph appears not to have decreased but to have increased in. activity, thus eipIoying glycerinated lymph that is two months old we can be absolutely sure that we are using a pure and aseptie naterida. Despite all efforts a century of vaccination and of study of vaccine lyinph has not as yet discloscd to us the specific organism of vaccinia, or, as I have recently shown elsewhere, of the more virulent modifica- tion of the disease, namely, variola. We cannot, therefore, state that we have fully nastered, or even that we have begun to master the bacteriology of vaccinia; we cannot cultivate its gerrn or supply to the public pure attenuatl 4 cultures for purposes of inoculation. But this -we can say with certa'nty, first, that a single vaccination protects against small-pox for at least four years and for a longer period in the majority of individuc.s; secondly, that re-vaccination reduces the likelihood of infection with small-pox almost to nil; thirdly, that the vaccinated and à fortioi the re-vaccinated individual, if attacked by small-pox, suffers froin a rnild and modified form of the disease; fourthly, tii the Amployment of matured glycerinated cal£ lymph is a ineans whereby the uncontaninated virus is introduced into the system, so that erysipelatoid and ether disturbances can be reduced to a minimum, and when present arc due to want of cleanliness on the part of the individual and not to the lymph inoculated. But, now, what is the essential nature of the process of vaccination and of the immunity conferred thereby? To answer this question adequately in the few minues remaining is practically impossible; to deal with the subject as it deserves would require a series of lectures. It would imply showing how nearly a century after Jenner made his first vaccination the principles which",
         "ADAMI-CENTENARY OF VACCINATION. he laid down were applied to other diseases. It would involve, too, a description of much of the life-work of that French chemist, Pasteur, who with his earliest experiments was to enligliten the world by creating a new science, the science of bacteriology, and through whose influence a new era was to begin in the treatment of disease; for it was Pasteur who first showed in this century that from a study of bacteriology we could learn to combat infectious disease in the most rational inanner. His earliest experiments were made on a disease of fowls called chicken cholera, whose gern he discovered and isolated in pure culture. Rapidly following upon this discovery it was found t.hat such cultures when kept for a long time in the laboratory lost their pathogenic power and that fowl inoculated therewith, not only survived the injections, but were apparently thereby rendered immune to the action of his most virulent cultures of the same kind of germ. Here, thon, was the beginning for experiments of all kinds in the various infectious diseases. Just so soon as the germ of any disease was discéovered the saine efforts were made as in chicken cholera to produce immunity along the sane lines. It was thus that Pasteur saved millions upon -millions of francs to his country by producing nimunity in cattle and sheep against that dread and fatal disease of anthrax which had up to that time proved a veritable scourge to farmers in the richest and most fertile territories of the land. The story, however, is doubtless familiar to you all, as are probably also the general features of similar experiments performed on -other diseases. It need nerely be said here that subsequent' to the dis- covery by Pasteur that cultures of germs might be attenuated with age, other means were soon found of producing the saine results and more rapidly. And thus by artificial heat, by compressed air, by exposure to light, by chemical re-agents, etc., the necessary attenua- tion of germs was easily produced and the subsequent iminunity. It was but a step from this to the discovery of the toxines, that is to say, of the fact that bacteria in their growth develop chemical poisons which by a process of careful filtration may be separated in solution froi the bacteria whence they have been derived. When later it was found that not only could in-nunity be induced by inoculation of attenuated gerns or of their toxines similarly treated, but that the blood serun of animals so innunised could likewise act both as a preventative and a curative agent, the climax of rational therapeuties was reached. These facts which concern the subject of serumtherapy are too much of the nature of current events to require details of description here to-night. What is, however, of some interest con- cerns the mode of action of these vital therapeutie agents, .and I will conclude with but the briefest reference to this most interesting topic.",
         "ADAMI-CENTENARY OF VACCINATIO. Formerly it was thought that an attack of most infectious diseases created an immunity against subsequent invasion of the saine gernis, by reason of the fact that all the pabulum necessary for these gerns had been consurmed already ; or that perhaps the germs when once they gained a foothold in the body, produced self-destructive cheni- cal pdisons, thus preventing a further developmnent at a subsequent exposure. The experiments which have proved these theories in all respects untenable, and which have shown that other factors come into play, represent some of the most spirited and prolonged discussions which the medical world has ever been called upon to witness. With charac- teristic animositv the Gernan and French sclools upholding diverse opinions, have found it difficult to aglree, though their combined theories have given to nost observers all the essential explanations of thuis acquired innunity. Tlrough the researches of Metchnikoff, of Massart and BordeL, of Nuttali, Pfeiffer and a host of others, we now know that the invasion of the body by miicro-organismns is followed by a chemical attraction of certain cells of the host, inducing thus a battle royal between the invaders and the invaded. That not only cari the cells destroy bacteria by intracellular digestion, but that where the leucocytes themselves break down or are destroyed, they mygive off to the bodily humors in which they lie, certain secretions or excretions which render these huniors bactericidal. It is impossible here in these few moments to niake more than a passing reference to this interesting topie ; though as a valuable signm of the times and as an indication of the valuable work whîichl lias been done withii recent years it cannot be ornitted ; and it is but a fitting tribute to the great originator of this valuable means of curing disease, nanely Edward Jenner, that this day, the 14th day.of May, 1896, 100 years froin his celebrated inoculation, should be duly noted in the mnedical world.",
         "CHRONIC POLY-ARTHRITIS IN A CHILD. F. G. FmEY, M.D., Associate Professo, of Clinical Medicine in McGill University; Physician to the Montreal Gencral Hospital. Whilst acute or sub-acute articular rheumatism is extremely com- mon in children, it is universally admitted that both chronie rheumna- tisin and osteo-arthritis are extrenely rare conditions. Cases of rheunatoid arthritis are recorded or referred to by several of the systenatie writers on children s diseases. Henoch (Lectures on diseases of Children), and WMTest (Diseases of Children), each refer to two cases. Garrod (Gout and Rheunatic Gout) figures thé hand and foot of a child of three in which the proximal phalangeal joints are affected. Osler speaks of having seen three or four cases in children, whilst Howard (Pepper's Systein of Medicine) and Fagge both refer to its occasional occurrence in early life. Lloyd Davies (Lancet, 1893, 11., 928) records a, case in a child of six following an attack of acute rheumnatism a yeâr previously. The joints affected were some of the smnaller articulations of the hands and feet, and also the wrists, elbows and knees. The following case is still under treatment by Dr. Kirkpatrick at the Montreal General Hospital. I an indebted to Dr. P. C. Leslie for the clinical history. The patient, a girl of 11 years, was adnmitted to the hospital March lst, 1896, for pain and stiffhess ofi the joints. The mother attributes the onset of the illness to a kick on the ight ankle in May, 1892. There was no ill effect at the time, but two inonths later she began to limp and the ankle became swollen. The disease was then regarded as of a tubercular nature and a plaster of paris bandage was applied for several weeks in August and again in March, 1893, but -without very nuch benefit. In the aiutumn of 1893 the right knee became swollen, followed by the metacarpo phalangeal articulations and a little later by the wrist, left ankle and left knee. After Christnas the child was unable to walk. She has since then been confined to bed and the legs have graduilly become drawn up and contracted. The neck became pain- ful and the head twisted to the left in Decenber. The swelling passed away froin the joints in 1894, leaving them stitf and useless.",
         "FINLEY-CHRONIC POLY-ARTHRIT[S. Early in 1894 she had an attack in which there vas loss of power and sensation in the right arm for three months, but not accompanied by pain. There is a history of frequent exposure to cold and starvation. There is no rheumatic or tubercular history in the family. Present Condition-The child is well nourished and of good colour; pulse 108; temperature 990; respiration 24. The hcad is turned dowvnwards and to the left side ; there is marked diminution in the rotatory movemnents of the head with rigidity of the left sterno- mastoid and trapezius muscles; flexion and extension are free. The joints affected are the wrists, elbows, ankles and a few of the smnail phalangeal joints of the flingers and toes. Many of the joints are painful and tender. The wrists are slightly flexed and swollen There is much rigidity and stiffhess and the moveients are greatly limited, flexion and extension being performed through a few degrees only. The right elbow is stiff, it cannot be extended beyond a right angle and there is a slight crepitating sensation on inoveient. In the left elb\u003eow there is also diininished movemnent, but to a inuch less extent. In the lower extremities the hips and knees are contracted. Both ankles are thickened and rigid and the right foot inuch everted and flat. The proximal phalangeal joints of the first, second and third fingers on the right slie and the corresponding joints of the first and second fingers of the left hand are swollen, thickened and give the impression that the bones are enlarged. The Roentgen photograpi, however, shows that the bones are normal and that the thickening is therefore confined to the soft parts. J'he left thumb as shown by the photo- graph presents a forward dislocation of the two terminal phalanges. To the touch the dislocations give the impression that there is a bony outgrowth in the neighbourhood of the joints. Somle of the fingers have a slight deflection to the radial side. and the terminal phalanx \u0026f the right middle finger is freely movable from side to side. There are no Heberden's nodes. The skin over the backs of the wrists and hands and on the front of the ankles is glossy and tense. The heart, lungs and other organs are normal. The urine contains neither albumen nor sugar. The patient lias now been in the hospital for thirce ionths, bein« treated with iron, cod-liver oil and gentle extension of the lower ex- treiniuties. There lias been marked improvenent in the movenients of the hand and hcad and she eau now use the fingers for sewing or rolling bandages.",
         "FINLEY-CHRONIC POLY-ARTHRITIS. rhe pain and tenderness have almost entirely disappeared. The course of the disease has been a febrile throughout. The presence of nodular bony elevations about some of the sinall oints of the hands at first led to this case being regarded as one of osteo-arthritis, but by the help of the Roentgen photograph it would appear that the bones are not altered, and that an osseous enlarge- ment is simulated by dislocation of certain bones and thickening of the tissues. Owing to the absence of any changes in the bones it is perhaps more correct to regard this case as one of chronie rheumatism rather than rheumatoid arthritis. In the absence of any definite known etiological factor it is not easy to draw a sharp line between chronic rheumatism and rheuina- toid arthritis. It is indeed an open question whether thèse diseases are distinct or merely different manifestations of the same cause. Osier defines osteo-arthritis as a \" chronic disease of the joints cliaracterized by changes in the cartilages and synovial membranes with peri-articular formation of bone and great deformity.\" On the other hand, Hutchison states that bony outgrowths are rare in young people and if present usually of small size. In its clinical features this case corresponds closely to the descrip- tion of chronie ulcerative rheumatic arthritis or crippling rheumatism given by Jonathan Hutchison (Illustrations of Clin. Surgery). In this condition a large number of joints are affected at the same time. the onset is sub-acute at its.outset, attended by a good deal of swell- ing, and it affects more especially the small joints of the hands and feet, Whilst true arthritis deformans shows a marked preference for the senile period, this fori may bc found at any age, and often before iniddle life. Very often partial dislocation of the joints involved is produced and the consequent defornity mnistaken for bony enlargemnents. Anatomically th(, changes consist of fringes and velvety thickening ani blood staining of the synovial membrane, thinning and absorption with patches of erosion oun the cartilages. In conclusion I inust express my indebtedness to Dr. Kirkpatrick for this case and to Professor Cox for the Roentgen photograph.",
         "r - ~fl'~ CHRONIC POLY-ARTHRITIS IN A CIIILD.",
         "TWO CASES OF CHRONIC ARTHRITJS DEFORMANS IN YOUNG CHIE{LDREN. flY ALBERT G. Niciot.s, M.A., M.D. Resident Physician to the Royal Victoria Hospital. Cases of arthritis deformans in children uncler ten years of age appear to be very rare. Strümpell in his Text-book of Medicine men- tions that hie has only met with a few cases hetiween the ages of 10 and 15. Osler mentions having seen only four cases in childen under 12 in five years experience. Recently, in the March nurmber of the A'rctrees of Pedi«trics, Koplik has reported a typical case in a child of seven. The cases here reported were both in the Royal Victoria Hospital in Dr. Stewart's wards. Th'lie second case, a child aged 6, is very striking as the joint involvenent began at the early age of t.wo vears. C.AsF I. Mary C., tet. 9 years. Always healthy with the exception of an attack of w'hooping-cough three years previously, No history of any similar affection or chronic disease in the family. The child enteredt the Royal Victoria Hospital on May 30th, 1894. The, history obtained ras that the child first began to suffer about one year previuusly. The first thing noticed wvas a sealy eruption upon the chest, limbs and back (psoriasis). Alnost at the saine timec the child complained of cold extremities, with stiffness of the lingers. On attempting to walk she complained that her ankle was painful. Later on she felt severe pain and stiffness in both shoulders. The pain was not constant, but was exacerbated during change of weather. The stiffness of the joints, however, persisted and gradually got, worse. The child also lost flesh. On admission the physical examination was as follows Patient slightly enaciated, not specially anomie. Temperature, 97.2~; pulse, 90; respiration, 24. Complained of slight fleeting pains in the limbs when she walked. Cardiac dullness reached on the left to a point one-half an inch outside the nipple line in the 5th space. First sound at apex was accompanied by a soft bloowing systolic murmur, which was transnitted towards the sternum. Pulmonary second somewhat accentuated. The hands were claw-like owing to the inability of the patient to extend the terminal phalanges of the 7",
         "NICHOLLS-CHRONIC ARTHRITIS DEFORMANS. fingers. All the joints of the fingers were prominent and enlarged, being of a pearly white colour. The second metacarpal bones of each hand were enlarged and proninent. There was wasting of the interossei. On the tendons of the flexor carpo radialis and palmaris longus of the left arm were about a dozen nodes about the size of a bemp-seed. On the lower extremities both internal malleoli were considerably enlarged and the tarsi thickened. Sligit enlargement of the proximal end of the first phalanx of the left third toe. There was slight stiffness about the shoulders, but no obvious deformity. There was no redness or heat about the affected joints, but they were painful on, movement. There was an eruption of psoriasis about the extensor surfaces of the knees and elbows, also about the ears and nose. During the time she was under observation the tenperature, was, on the whole, slightly above the normal, and the pulse averaged about 90. The case was unaffected by treatment. CASE II. Christina H, t. 6 ; admitted on March 3rd, 1896. In this case there was a strong tubercular family history. One aunt died of phthisis. The mother was in the hospital at the saine time as the child with a tubercular knee (?) One brother had psoas abscess. The history was that when the child was two years old she began to suffer with pain in the left knee, which gradually became enlarged. A little later the joints of the fingers became painful and swollen. One year later the rigit knee became enlarged, the other joints remaining as before. The pain and swelling varied in intensity from time to time. When five and a half years old, swelling and pain in both ankles were noticed, and a little later still the child began to complain of pain in the wrist and in the left shoulder. On admission the patient was found to be a small, poorly-nourished child. Moderately anoemic. Lungs normal, heart normal. Very marked rheuinatoid lesions were present. All the articulations in the niddle and ring fingers of both hands were considerably enlarged. In the terminal phalanges especially there was distinct bony. overgrowth, giving an appearance as of nodes. The metacarpo-phalangeal joints of the first and second fingers of both hands vere similarly enlarged. There was marked interosseal wasting. Distinct impairment of the power of extension of the left elbow-joint was noted, but there was no obvious deformity The left knee was imuch enlarged in every direction, there being evidence of effusion into the ·joint. The joint could be flexed and extended completely without crepitus or causing pain.: The right knee was simailarly affected, but to a much less extent. The muscles about the knee-joints were sonewhat atrophied. There vas also",
         "NICH'OLLS--CHRONIC ARTHRITIS DEFORMANS. 99 distinct prominence of the lower end of the left fibula, giving the ankle a full appearance. No pigmentation was anywhere noticed. While under observation she complained of no pain. Temperature was usually between 980 and 99°. Pulse averaged 100. There was coisidered to be a possibility of this being a case of tubercular arthritis when first seen, but the onset of the trouble, with the slow involvenent of one joint after another, the synmetrical distribution of the lesions, the multiplicity of the joints affected, and the muscular atrophy, ail rendered it certain that the case was to be placed in the category of chronic arthritis deformans. The character of the lesions theiselves was perfectly typical of this disease.",
         "NOTES UPON A CASE OF MULTIPLE ABSCESSES OF THE LIVER, ASSOCIATED WITH PURULENT BRONCHITIS AND INTERSTITIAL PNEUMONIA; ABSCESSES IN THE SPLEEN AND PANCREAS. B'Y J. G. ADAm, M.A., M.D., Professor of Pathology, McGill University; Pathologist to the Royail Victoria Hospital, Montreal. The case about to be recorded is in the main of interest because of the relationship betveen the morbid conditions noted in the title of this article. For the clinical report I am indebted to Dr. W. G Reilly, Resident Physician to Dr. Stewart at the Royal Victoria Hos- pital. The patient, a man aged 38, had been a labourer and exposed to all sorts of weather. He gave an alcoholic history. Six years ago he suffered from a left'sided pneumonia and pleurisy. From this attack he never completely recovered ; he nanaged to perfori his daily duties, although unable to do heavy work, and he was troubled with a cough. Two years ago he practically gave up work altogether, but kept up and about, although his condition was steadily becoming worse. In Noveniber last he took to bed, the cough lad been very troublesoine and the expectoration profuse, while there was.progres- sive weakness and loss of flesh. In the last few nonths the patient lad repeuted chills, followed by sweats, especially at night. O pon admission to the hospital (March 10th, 1896,) the patient was emaciated and haggard, sleeping poorly on account of the cough, w'ith difficult respiration and a horrible fetor of the breath. There was well niarked clubbing of the fingers. le eoinplained of no pain. The left side of the chest was found uiuci flattened, with very little niove- ment, ani there was a dull note unon percussion. On tI right side the breath sounds were harsh, but otherwise normal ; on the left side the breathing was feebler than normal at the apex, blowing in the axilla, while all kinds of moist râles accompanied respiration. The sputuni was profuse, purulent and fetid, containing no recognisable tubercle .bacilli. The odor of the breàth was so fou] that prolongued exami- nation of the patient was a severe task ; even wVhen he vas placed in an isolation ward the odour from him spread over a wide neighbour- hood. Nothing very definite was discovered in. connection with the digestive system ; examination of the abdomen gave negative results;- the bowels were regular.",
         "ADAMI-MULIPLE ABSCESS. There was progressive failure until death ensued upon the ninth day after admission ; the temperature had continued febrile with slight remissions, the respirations remained about 34, the pulse varied bet-ween 112 and 130. At the autopsy performed 28 hours after death, the body was found to be that of a very gaunt, enaciated male adult. The fingers were clubbed ; the left side of the chest was flattened above the 4th rib. The right inng was firmly adherent along the lino of the 3rd and 4th ribs, but the apex was free. The upper lobe presented multiple lobular abscesses, with gangrene. The middle lobe was less involved, the lower lobe was crepitant, congested, but free from foci of pus so far as could be seen by the naked eye ; there was some bronchiectasis, and fôul grey fluid poured out of the eut bronchi. W7eight of lung 880 grammes. The left lunq was much heavier (weighing 1345 grmns,) with exten- sive and firm adhesions from the fifth rib upwards all along the pos- terior aspect, up to and including the apex. The upper lobe was greatly disorganized, with numerous cavities and areas of breakin« down. Close to the apex, in fact right above it, was a fairly large sm ooth-walled cavity which was evidently extra-pulonary, its walls being formed by the pleura, both visceral and parietal, with the adhesions bietween the two ; this communicated with the underlying intrapulnonary cavities. The heart presented little wvortly of note, beyond brown atrophy. The right bronchus, near its origin, presented a vell, marked linear ulceration eroding to the cartilage, the peri- bronchial and periosoaphageal glands were greatly enlarged, dark and noderately firmn; there was no sign of caseation or other evidence of tuberculosis in thein. Upon opening the abdomen there was evidence of old general adhesive peritonitis, with a displaceiment of the colon, stomîach and liver. Between the spleen and the stomach there was necrotic tissue with abscess formation and adhesions. On separating these adhesions while removing the spleen, pus exuded from this area, and there was further seen a small perforation of the size of a quill, in the stomach, around which were some moclerately firi adhiesions preventing the escape of the gastric contents. Another area of per foration, about 3 cim. in diameter, was present whfere the spleen ipinged u\"pon the diaphragm. This extended into the substance of the spleen, and superficially into the diaphragm, but not through it. The spleen was sof t and flabby, its upper extremity presented a large subeapsular abscess, the size of a walnut, and from this there were a few branching tracts of suppuration, leading a few centimetres into the spleen tissue. Thus smaller foci of pus were ranged about the main 101",
         "1DAMI--MULTIPLE ABISCESS. abscess. Thig subcapsular abscess coii nîrni cated with the suppurating are. betweoen the spleen and diaphragm, aid the arrangement of the various parts was such liat evidently the abscess liad started within the spleen substance, and secondarily had burst through or extended throughl the capsule, the allection of the diaphragmn being relatively recont. The spleen gave tie amyloid reaction (sago spleen). The pancreas was large, soemewhat reddened and contai neid within its sub- stance a large abscess, 1.5 cm. in diamneter, situated near to the tail of the organ ind close to the splenic vessels; a soft clot existed in thc. splenie veli aIlongside of which was situa ted the abscess. The 1iver was large, weighîingv 2340 grm., the upper aspect of the right lobe presented two slight Iluctuating nodules situatecd towards the left side of the lobe. A similar but larger bulging mass was present at the lower extremity of the enlarged right lobe. Froin the lower aspect of te lobus spigelii was a similar discoloured patch with fluctuation Ol section the organ in the main was moderately pale, and presented very numerous lirge and smnall abscesses filled with glairy pus, ii solme the colour vwas grayish, in others bright yellowish-green. Tho largest mass of these abscesses was an aggregation beneath the upper surface of the riglt lobe, fornming in soie parts cavities the size Of a walnt ; in e etirs, characteristic aggregations of smaller cavitie, surrounded by very deeplIy congested liver tissue, and having ani ovl oulilne. On further dissection, many of these larger cavities could be seen toe o irrangred along definite tracts and in close proxiiity to the bile ducts. Fresh preparations of the pus showed only a moderate nunber of pus cells present, witli fat globules and crystals. A large number of various kinds of cocci and bacilli were present. The other orgals of the body presented little calling for remark ; the portal vein was free the kidneys showed a condition of parechic1yfnattous nephritis, vith but slight anmyloid reaction in the cor'tex. A microscopical exournatin of the v'arious organs showed tlat the lungs were the seat of well marked interstitial pneumnonia, witi numeros foci of necrosis. There was no sign of tuberculosis in auy of the nmerous portions examiTined ; the spleen presented a veriy - advanced condi tion of auyloid change. Sections through the pancreus in the neighbourhood of the abscess showed a very interesting condi- tion. There was a lateral thrombus in the splenie vein of a suppur'a-. tive nature'; while the wall of the vessel imnediately beneath this showed extensive infiltration, with small round cells. Whether this' thromnbosis is suflicient to explain the productioi of ain abscess in the pancreas immnediately outside the vessel, or not, I feel n little hesita - 102 )",
         "A DAMI-MULTIPE IAUSCESS. tion in stating positively. Sueh is possible, but I should havte expected to have found the thrombus presenting a more extreme pyiplnic condition than was noticeable in this case. The pancreatie tissue itself, beyond showing a richly nucleatcd condition of the alveoli, presented two or three foci of adenomaltouschange-smalIl and limitel areas preseiting the appearance of a medullary carcinonma, with singularly smnall amount of interstitial stroain. I speak of these as being adenomnatous, inasmnuch as I have met with somewhatsmilar little foei in other cases in which, as in this, there bas been no evi- dence of nalignaunt disease in other organs. The liver showed in parts great congestion of- the capillaries with atrophy of the cells and further evidences of retention of hile pigment. Scattered through the subsLance were moderately small abscesses, whose centres showed complete necrosis of the cell elements ; while at the periphery of each was a thick zone of! smnall cells with frag- menting nuclei. The paucity of c lis in the pus froin these abscesses, to wlich reference bas already been macde, wèas evidently due, not Lo Lhe fact that there lad been littie migration of leucocytes, lnt Lo the ensuing necrosis. Rommad,-I would appear that ail the conditions here described are closely connected, and LIat we have in this case a chain of condi- tions following one after the othér frori a condition of dehlyed resolu- tion with aite lobar pneunmonia. The condition of the Ilungs, instead of being as suspected, one of Luberculosis (although it mnust be acknow- ledged thaL the failure to discover the tuberee bacilli had rendered this a doubtful diagnosis) was one of interstitial pneumnonia aid bronchictasis, passing on to fretid bronchiis, gangrene and gan greous cavitation. Sections of the lung tissue showed no evidences of tubercles. Following upon the destruction of the lung tissue there had linally been developed not only the a:muyloid degeneration of spleen and kidney, due to the chronic purulent bronchial discliarge, but also a condition of general sepsis, with, it would appear, septic euimblolisin lu the spleen and .evelopment of the splenic abscess which eventually extended so as to become subdiaphragmatie also ; from this aIiscess the suppurative micro-organisms found their way along the splemie vessels, setting up, it may lic by the lymph channels, abscess formation in the tail of the pancreas, and by Lie vein leading to septic emnbolisminl n umeros branches of Lie portal vein. It is dufficult to sLate, indeed impossible to state positively, wlhat wjas .he organism associatecI with these abscesses, the autopsy having beei performed Loo long af ter death. .Not inprobably the pyogenic cocci were the cause ~ - 10d",
         "SEPTIC INFECTION IN TYPHOID FEVER WITH REPORT OF A CASE. ALBERT G. NICHOLLS, I.A., M.D. Resident Physician Royal Victoria Hospital, Montreal. The subject of septic infection, not only in typhoid fever, but in other specific infectious diseases, is one which has attracted iucli attention in the last five years, and a great deal of work, experi- mental and otherwise, lias been donc upon it, chiefly at the Pasteur Institute in Paris. Ca'ses of septic infection in typhoid are sufficiently rare in ordinary experience to warrant record, the more so as many cases already recorded have been very inadequately described and are coinparatively valueless. The rarity of such cases may be inferred fron the fact that in Osler's statistics of 229 cases (Johns Hopkns Hospilat Reports, Vol. IV., No. 1) there is no case of general sepsis reported. and in the records of the Royal Victoria Hospital for the last twenty-seven months, comprising 185 cases, the case here reported is the only one that was definitely proved to come under this class. Under the head Typhoid Fever three main types of cases nust be recognised. The first class consists of the ordinary typhoid fever as it is known to the text-book. Under certain circunstances the bacillus of Eberth gets into' the circulation in sucli quantities as to give rise to a general septicomia or septico-pyemia, and sometimes to certain local effects. In persons recently dead fron typhoid it is usually possible to cultivate the specific germ fron the ulcers, mesenteric glands, spleen, liver, kidneys'and bo'ne marrow. It is a well-known fact that the B. typhosus remains in the borly for a long time after the symptoms have subsided. As late as the seventh week Quincke founid it in the bone inarrow, and Welch found it the bile of a rabbit that had been inoculated four nonths before. It has also been found in pus in a case of periostitis as late as a year after the original infec- tion. It seenis probable, then, that the bacillus must attain its wide distribution in the organisn through the blood-stream. Yet it is not invariable to find the bacillus iii the.blood ; on the contrarv the dis- covery is peculiarly rare. Flexner explains this fact by the gernicidal action of the blood. While io doult the serum of -blood removed from the body pos-\" sesses such powers, it by no neans follows that the plasma during",
         "NICIIo*LL.SE\u003e'rIc INFECTION IN ~riio \u003eFEVERt i i life possossos thoe saine proportics. I t seoîns là-lre pûiht Li, Lu bacilli in tlue biood arc killed by tho iII1g. idc in dic iî.ûby its remnoval, or else Lbue large maujority ort blî are, as. itwr,8riiIi out of the blood by tlio, vatrions \u003crgaîs imil tir not nmuilLiply iR whierc, actively circuilating. lit froini nLTy cuet\u003elimo Iiicilli .4iot!içi vinetr tho circulatirn in ]rninl)ers w %e , Qu'. cOElili I)O.Io flgZIr septicemria, grent prostration, deiils, s ç, rigors Jui it irQgtil i, pyrexia, jtist as in at case of goerieral infection witli LiS4e )rdfIiIry -. py(\u003egeniu rgLïsfls Besides titis crIilocid ms:jefn itir\u003e met witb. lIn typhidç foerý thie brunt of tiu \u003cisuefils tîpoi tiî's, l*y1mpicîu' tissue, w'vtlh the gi-eat£1r1 intersity bite ImsuoI bu lm foclis oJifee,' thiat is to say, blie initestinal r'Annds '1hr is exo a eiîdfen-Y Lo t0he proliferationr (À lyîîtiphoidj tissue(.vrwee aul stutui llctr of' round colis atre f'ounld, notably il) tJt ver of typimufidesrcormla l inicroscopiealv etrid (2veii I\u003ey t1,}u rake'J seye. Rec-d, in a recettpollE r»rir ini tm e /n'ifIûjk'i IIIN/J'dtip, -points out that thiese cieio f coclis mr: fe. it' wits i-il n]eCrosis, and in sonfîO cases lie lias iouni d~ îc (d bte formastionî of i)rolis ti.5sue-. 'JIlesc.5 OîSrVLi iJS v have , I\u003eeni bûuitieJi3 exporimentai inoculationts. Tbhes-e ixrea it n:risfil', d ot :\u003c,I iri variabi v to bo assrociatse( wl i t1he priesen rc(e ( 'if iii 4'eîîitî long .Lfg noited thje bne inî byp)lîo-idforr Lfic. prod liwtifire fr pare-ncliyniatousj, degeieratiorî, and. trioýritioYjs t1hat ý-thi 1v oioiow' hi- ruipture of thie mîusclc's, rucirases, rttslvrlje'.î aLnd te ianortai iahss ht Seor,?o\u003c net urfkltheî, 01tit in a pr-oiung-rd case, %vlîen ihe oiginai nl tc\u003ebsie~uiî\u003c~' iulb: re-Sîsti ria power fif the, patie-nt u ardlyu i-siis ae,' and su on. that. ihei, eenr1tei rwiv gmentnr \", ir.at txo culJSO exti-îsive, intiazurnatio endirig irn ýsn[pp11ratij(Jn$ Ilit t}:~vyjh,,ie bacillus can cause suppur-ation îsrul po~d In 1 8S7 ph~-nir bandyure clturies (if b';tyriliW ax:iiu in tWO, CP3S. ÇA slIppuratiNO peiVistitis ;~ in 18esr )rIciff foulr'3 à t periosteai b') - Achaline alsto rCïrcrts la '-.Fixtra v/ others found it in a splenieabscss, hai m Yr,îd';'eb~ Seen it Cauirz puirulent co tt: 'hnVîe~ i have: found i- eausinz ertv eî'rits i~eb f'îod k, inipr uue ispuaieaeii~ 'w ~ r;r're where the: -B.tpou asd uprai' rbt. r:façi 'Robert-soin have r-ýeCnt1iv d \u003e--,,riho A a~ f puale rh the: wrist ~ ia\u003c3\u0026az xhme Roci Vic rii F4ti\u003ei Fle-xnue-r has :.r~tyr'tcri a s fes v-hsI~vd 1 or,",
         "106 NICIIOLLS-SEPTIC INFECTION IN TYPHOID FEVER. etemiia associated with suppurative parotitis. Hie obtained the typhoid bacillus from the blood, lungs, mesenteric glands, spleen, bone marrow and kidneys. Streptococci were found in the parotid gland and in the lungs. Multiple abscesses were found in the kidneys. A third and very interesting class of cases cone under the lead of \" secondary \" or mixed infections. The co-existing developient of several pathogenic germs in the sane patient is a well knowi plienoieion in other diseases besides typhoid, as for example, in tiuberculosis (Koch), scarlatina (Raskina), tetanus (Vincent and Vail- lard), cholera (Meteh nikotf1), and variola. The, wiole subject of these ixed infections is a very iiteresting and important oie, inasnuch as these secondalîry germns play ail important rôle in the development and course of the( original malady. Such secondary infections ofte inîsk the symptoms of typhoid and always render the prognosis very grave. These cases naturally fall into two groups, the first, where the organism is simultaneously attacked by the bacillus of Eberth and some other gern, and the second, when the secondary infection is an incident in the course of n attack of typhoid fever. Th'lie latter is more often tie case. Such cases run an atypical course and elinically are marked by the following signs : Intense prostration, stupor, at times low delirium, subsultus, lividity, higli temperature, chills and local manifestations of the septie process. Most of these signs naîy of course be found in a severe attack of ordinary typhoid, but are cer- tainlly very exceptional il those cases treated early by the bath imiethod. As a rule secondary infëction is more apt to take place in the ambulatory forn and in those cases which are conplicated with diarrnilo and great prostration, and protracted convalescence. Thec geris most usually found are the streptococcus and staphylococcus albus and aureus, pneuiococcus, bacillus coli coiiiiuni s, and bacillus tuberculosis. It would seem, and this is confirmed experimentally, that the blood of a typhoid patient is a spcially good culture medium for the growth of the germs just inetioncd. Tie most usual point of entrance is the intestinal lcers, but absorption may take place fron the mouth and pharynx, skin abrasions and possibly fronm the bladder and urethra. This is quite possible wlhen we reimeimîber the number of bacteria .that ean be found in the gastro-intestinal tract even il heailth. Von Besser found the streptococcus seven times in the saliva of eighty-one persons, and in cases of nixed infection. Vincent 'found it in the fecs three times out of seven. When these germns gain an entrance the manifestations of their action may remain purely local or again may cause a generalised septico-pymemia.",
         "NICIIOLLS-SEPTIC INFECTION IN TYPIIOID FEVERI. Vincent, in a communication to the Bulletin de la Société M1édicale des Iôpiaux, Nov. 13th, 1891, referred to the relative frequency in nan of mixed infection with B. typhosus and streptococci, and pointed out that the prognosis in such cases was more grave thani those in which the staphylococcus Vas present. In pus of abscesses in 41 cases of typhoid, Vincent found the staphylococcus pyogeis aureis alone or vith staphlycoccus nbus in 32. Ail recovered. In eight cases he found the streptococcus eitier alone or with the typhoid bacillus. Five cases died. According to Vincent iii 31 autopsies on typhoid cases. the strepto- coccus and B. typhosus were found six times. . The following is an abstract of the cases : Cass 1. D*eatii on 3rd day. Otitis nediaL purulent. Streptococci andi B. typhi in large quantities in blood and viscera. CAsE Il. Deati on 25lth day. Angina on 2th1. 1. typhi and streptococci ins pleen, liver and mnesenteric glands. Streptococei in pharnyx. cervical glands on left side and in blood. CAsE III. Death on 23rd day. Erysipelas of face on 17th day. Foci of suppura- tion in kidniey. Streptococci in erysipelatous patch, glands'of neclc and ail viscera. B. typhi in spleen. CAms V. Deat h ons 22nd day. Anigina ont 201h day, with siuperlicial slough on nvula. Aluinitiant streptococci inI piarynx'glainds of the neck. spleen, liver and blood. CAse V. Two areas of suppnrationa in the spleen. 13. typhi and streptocci in ail viscera and in mnwaingenl exndate. C.Asx VI. General purpura, lasted 12 days t 1l0 death. l'eyer's pat ches normal. Streptococci in blood. Ail viscera gave B. typhi and streptococci. This last case is speciaily important as it shows that, like B. Luber- ciulosis, which cau produce septic:emia without t characteristic tuberelos (experimntal tubercuilosis of Yersiln's type), the bacillus of typhoid canl produce general septicammia, and death without the eharneteristic intestinal lesiolis. Vincent describes an interesting sories of experimients wilich he imade on the subject of iixed infections. Five rablbits which lie inoculated with pure cultures of B. typhosus ail recovered. tif five inoculated with streptococcus alone one died. 0f live inocuilated with both B. typhosus and the streptococcus one recovered and four died in fron 56 hours.to 39 datys. Threie presented han morrhagie swelling of the Peyer's patches vith swelling of the mesentericglands.and spleen In ail cultures of both germs were obtaLined fron the organs. Jin the rabbit which lived 39 days none of the above signs were present and no cultures were obtained. Vincent has also shown experinentally that in the rabbit after inoculation vith the B. typhosus alone we get in seven hours a great increase in the polynuclear leucocytes, reaching a maximum at the end of 20 hours. In case of inoculation with the 13. typiosus9 and 107",
         "NICIIOLLS-SEPTIC INFECTION IN TYPIHOID FEVER. streptococci the opposite occurs, and at the end of 24 hours the leucoevtes are almost absent and there is not1iug but cellular debris to be seen. This seens to prove that the ordinary means of defence which the borly possesses are ahnost powerless to protect against these mixed infections. Besides this systematic infection nany local lesions have been described cither due to the B. typhosus alone or to a mixture o\u003ef organismns. The following haVe been reported : Skin abscesses, al.iscess of the liver, pancreas, spleen, kidneys. parotid gland, thyroid, ituscl e, and mesenteric glands, suppurative orchitis anid epididymitis, sulpplurative meningitis, suppurative proctitis, purulent pericarditis, pyothorax, imalignant endocarditis, purulent cholecystitis, perinephritic 111bscess, suppurative otitis media, facial orysipelas, suppurative arthritis, ostoitis and periostitis, memnbranous pharyngitis, pyuria. The followin case of typhoid with general miiixed infection is of interest on account of its rarity: CASE.--Williamn B., ait. 30, entered the Royal Victoria Hospital on Decemher 5th, 1895. I an indebted to Dr. A. A. Robertson for the cliniical history of the case. 'l'h patient first began to feel il] about six weeks before admission. Once or tvice a week he felt feverish and out of sorts, with headache aMid por appetite. On one occasion his nose bled. This condition lasted for about tlree weeks, until Novemnber 18th, when he was compelled to go to bed. The symptomns at that time were headache, feelinig of heat, anorexia and constipation. These syniptons persisted after admission, except that diarr-h oea replaced constipation. On a'bhîission lie was found to be a fairly well-nourished man, apparently very ill and drowsy. Temup. 104·8, pulse 120, resp. 24. The skin was slightly livid. Digest.ive Systen-Tongue swollen, rough and heavily coated in the centre, with red edges. Bowels loose and the stools were yellowish and liquid. Abdomen considerably distended generally. Sligit tender- ness in right iliac fossa. A few doubtful rose-spots wore present. Liver palpable; spleen easily palpable. Ci eidatory Systen i--Pulso rapid, dierotie, and capillary pilsation in fingers. Heart-Apex beat in fifth space just insido nipple lino. First sound at apex rather muffled. Both second sounds accentuated. Uriine-Clcar, acid, high-coloured, sp. gr. 1020. Considerable albu- men. No sugar. The clinical course was as follows.: Dec. 12.-Patient up till this day has been in the sane condition as on admission. Forty-three baths have been given. Cyanosis has 108",
         "NICHOLLS-SEPTIC INFECTION IN TYPBOID FEVER. deepened. Tongue very dry and saliva very tenacious. The right half of tongue is distinctly swollen. On the left side of the soft palate is a greyish menbranous patch which peels off readily and does. not leave a raw surface. A culture was made. Uvula and pharynx red and swollen and show some whitish spots. Dec.. 13.-Growths froin the patch yielded imicrococcus tetragonus, and a few short, straiglit bacilli, not resembling B. Loffleri. The patch on the left side is as before. On the riglit side of the uvula is a grey patch about one-quarter of an inch in diameter. A portion was removed and proved to 1;e membranous, about 5 mm. thick. On the under surface was the appearance of hiemorrhage; cultures were made from this. The right half of the tongue was much more swollen than before, red and glazed. Friction sounds were heard iin both axilla, also tiere were sigiis of broncho-pneuinonia. idight.-Respirations 60, pulse 152, temnperature 104-2\". Grey patel in the throat lias disappeared. Culture made from bloòd. Dec. 14-The patient died suddenly at 7.10 a.mi. When seen a iew imoimients after, the dependent parts of the body were aliready deeply' blood-tinged and bluish. Cultures from the throat gave the samne germns as before. The blood yielded an atbundant mixed growth of streptococci, staphylo- cocci an-d two bacilli, one about the size of, and conforming~ to, the tests of B. typhosus ; the othier wvas a very large, thick~ -bacillus, of which the character was not absolutely determuined. AturoPSY-(Performied by Prof. Adamîi seven hours after death)--Post-mortemî ri.zidity complete. Langs--Acute dry piem'isy. witl areas of broncho-pneumonia. These areas were more freqnent towards the apices than at the bases. Bronchi injected. Peri'ron- chial glands normal. Iieart-Slight degree of brown atrophy. Liver--Of mnoderatcly pale carmine colour, with darker mottlings. Lobules 'ot recognisable. No necrotic areas. Slightlyfriable. Considerably enlarged. Spncc--Enlarged. Capsule tense. Spleen substance soft. P\u003eancreas-Noth ing nlot iceable. Kidn eys-Cortex svollen an d calic\"s reddened. Mescntcric and Retro-peri/oneal GlandsEnmlarged and moderately soft. T'onsils--Su ppurative foilienlar tonsillitis. Tongue--Riglt, ialf swollen, red and glazed. On section, showed hnimorrhages and small abscesses. The disease was more nmarked anteriorly, but there was dis- turbance even to the extreme po,terior part. Larynx-Mucosa reddened. Ilcum-Walls peculiarly thin, pale and atrophied. Peyer's patches in the upper part showed no change. Lower doivn, while not injected, they presented occasional pale (healing) ulcers with snooth bases and thin edges. Lower dowvn still there was slight injection ; 75 cim. above the ileo-cecal valve was a much injected patch 5 cr. long, stili, however, thin and flat. Below this the injection conti-nued and the flat ulcers were fairly frequent. In every case the ulcers were healing. 109",
         "NIcHOLLS-SEPTIC INFEC'ZON IN TYPHOID FEVER. Colon-As far as the sigmoid flexure rarb ulcerated solitary follicles occurred with overhanging edges and sloughy bases. MICROSCOPICAL ExxurNÂTo-Tongue-Papillo show hSmorrhage in -their substance; considerable superticial necrosis with early abscess formation at their bases. At the apex of sone Of the papillm hordes of bacteria are seen; in deeper structures of the tongue are multiple embolic abscesses. Muscular tissue infiltrated with sniall round cells and showing foecal necrosis. Streptococci and staphylococci noted. Spleen-Marked congestion. A few isolated bacilli. Sone læmorrhages with old blood pigment. Considerable increase in splenie corpuscles. Lirr-Atrophy of the liver cells and infiltration of small round cells in parts. A few scattered bacilli which stain rather better at the ends than in the niddle. Pancreas-Areas of necrosis. Kirlacis-Parencynatous degeneration affecting chiefly the convoluted tubules. Congestion. Ilere and there areas of snall round celled infiltration. Lungs-Septic embolie broncho-pneiumonia. Streptococci and staphylococci present: Testiclc-Parcnchynhatous orchitis. Great congestion. Some blood pigment in interstitial tissue. Tonsil-Crypts lined with cellular exudate, somte of which is breaking down; great congestion. Crowds of bacteria superficially situated. Recli-Striw hazy. Muscle cells irregularly swolleni. Multiplication of nuclei. Cultures were taken fron all the viscera, fron the tongue abscesses, and from the blood. Al the cultures gave mixed growths of streptococci and staphylocôcci. The cultures fromn the spleen, in addition, showed a short thick bacillus with rounded ends, actively motile, which corresponded to the B. typhi in every respect, except that it turned litmus agar red, although it did this but very slowly. The colonies were characteristic. From the tongue, in addition to streptococci and staphylococci, was obtained the colon bacillus. 110",
         "A CASE 0F INFECTIVE ENDOCARDITIS IN TYPHOID FEVER. W. T. CONNELL, M.D., M.R.C.S., Eng.. Professor of Pathology, Queen's University; Patholog'st, General Hospital, Kingston. A case of typhoid fever, with the fatal complication of ulcerative endocarditis is, I think, sufficiently uncommon to merit being placed on record. OsIer, in his Text-book on Medicino, quotes the Munich records of two thousand post-mortens on typhoid fever, in which eleven presented this complication, while in his own experience he had met with it but twice. The history of this case, as nearly as can now be obtained (most of the records were in the hands of the late Dr. Saunders and are not now attainable), is as follows: I. DeW., male, aged 21, was admitted to Sampson ward, Kingston General Hospital, under the care of Dr. H. J. Saunders, on September 26th, 1895. He had been ill for about ten days previously, and on admission was quite weak, and had a temperature of 104f F., and pulse [08. There was marked abdominal tenderness, and a few scattered rose coloured spots were detected-over the abdomen and on the back. There was slight diarrhea with watery stools. . The case ran the usual course for the following two weeks, presenting no pecu- liar features. The temperature always ranged bélow 102'l° F., and pulse 96. The diarrhoea ceased under treatment. On October Sth the evening temperature reached 99° F. Next day there was a slight chill with rise of temperature to 103° F. and pulse to 112., From this to the termination of the disease the temperature was markedly remittent (between 99°. and 103-° F.) On the 16th of October the patient became delirious and remained so till death on the 25th. During this period he passed fauces involuntarily and had retention of' urine, reguiring catheterization. Hie died comatose on the evening of 25th of October. No murmurs were detected over the heart area till foùr days-before death, when a soft systolie murmur was detected and was best heard at bottom of sternum. The urine contained a small amount of albumen and a few pus corpuscles. -The necropsy, ield'twelve hours after death, presented the follow- ing general features; Typical typhoid ulcers of the sinall intestine",
         "CONNELL-ENDOCARDITIS IN TYPHOID FEVER. in various stages; the mucous membrane of the ileum over a space of two by one and a half inches, just above the ileo-coecal valve, -was dark and commencing to slough; there were infective vegetations on the tricuspid and mitral valves; a few scattered pyoemic infarcts in the luiig ; nunierous pyonic infarets in spleen, and. many miliary abscesses in both kidnevs. In Detail.-Tlhe body was much emaciated and of a distinctly sallow hue. Rigor mortis had begun in the upper extremities. No other points of interest were found on external examination. Perimis-- sion was obtained to examine the heart and abdomen only. Abdomen flat; no fluid in peritoneal cavity. Stomach and intes- tines inoderately distended. Blood vessels of the great oinentum and of mesentery injected ; those of the inesentery of lower eigh teen inches of the ileum were markedly congested. On exanination of these vessels no signs of thrombosis were present in arteries or veins. Nothing abnormal in large bowel. Appendix normal. In the small intestine there were found numerous ulcerated patches in the lower part of the bowel. These patches corresponded to the situation of Peyer's glands. The ulcers were generally circular or oval in out- line, and as a rule reached through to the muscularis. Most of the ulcers in this situation were freely suppurating. The last two or three inches of the mucous membrane of the ileum vas very dark' and in places could readily be pulled away from the sub-imucosa. Higher Up the bowel were scattered ulcers, usually single, and ranging from - to L inch in ditneter. The remnaining solitary follicles were enlarged nearly to the duodenum. Many of the ulcers higher up in the bowel had coinnenced to cicatrize. Tie tontch and d odem presented nothing abnormal., The liver weighed 62 ounces, %vas pale and rather soft, and. was in\" a condition of cloudy swelling. The portal vein was filled with dark fluid blood., Cultures vere made on agar-agar jelly from the liver pulp, and colonies of stapiylococcus pyogenes aureus developed freely, along with a few colonies of a bacillus which from its morphological and cultural characters I considered a variety of the B. coli cominunis. - Gall.bladder empty. Bile ducts patent. The spleen weighied 7¾ ounces, %vas closely adherent to the sur- runding peritoneum, was dark in colour, pulp soft, alrmost diffluent. On the surface of the organ were fromn twelve to fifteen infarets ranging in size from a wainut to a pea. Some were broken down into a purulent debris, and were surrounded by a narkéd inflani- natory zone; others were more recent. Cultures on agar-agar made",
         "CONNELL-ENDOCARDITIS IN TYP1IOID FEVER. froni the spleen pulp grew numerous colonies of staphylococcus pyogenes aureus and three colonies of undoubted bacillus typhosus. Cultures from the infarets gave pure growths of the staphylococcus. The mesenteric glands were enlarged and quite soft, but showed no pus formation. The suprarenals and pancreas were natural. The kidneys weighed each 41'ounces. Their capsules were slightly ad- herent over numerous scattered, pin-head sized, whitish spots-niliiary abscesses-exuding a minute bead of pus on section. No cultures were made from these. The cortex of both kidneys was rather pale and slightly swollen (cloudy swelling), the inedulla dark red. The renal pelves, ureters and bladder wcre normal. The thorax was examined through the diaphragm. The pleural cavities contained no fluid. Here and there on the surface were flakes of recent lympli covering infarcted lung. The lungs presented about six or eight walnut-sized pyoenic infarets. Two or three of these infarets were completely broken down into a purulent debris, other- wise the lungs were normal. The riglit lung weighed 19 ounces, the left;17ý ounces. The pericardium contained only a trace of serous fluid. The heart weiled 8L ounces. Right heart fiaccid, the left con- tracted. Muscle, pale, soft and flabby. Right .auricle contained sof t post-inortem clot. Triicuspidl valve was markedly diseased. One cusp was destroyed by an ulcerative process, leaving only the ragged attached edge, pro- senting at one spot a rougli pea-sized vegetation which crum bled under the finger; a second cusp presented a bean-sized vegetation, and the edge of the valve was slightly eroded. The other cusp was normal. The right ventricle and pubnonary artery were normal. Left auricle normal. Mitr«l valve.-The aortic cusp presented several siall pea-sized vegetations and was slightly eroded at one point. The left ventricle, aortic valve and aorta were normal. A culture froin the clot in the right auricle remained sterile. A microscopical preparation of one of the vegetations shôved numerous ierococci masses. Although this post-morten examination was not a complete one, yet I think one could have no hesitation in stating that the source of infection was from the ulceration iii the bowels. Further, the infec- tive vegetations and the arterial pySmia were due undoubtedly to infection by the coiimon staphylococcus pyogenes aureus, in all prob- ability via the portal system. The bacillus typhosus is capable itself of exciting infective vegeta- 113",
         "114 .CONNELL-ENDOCARDITIS 'IN TYPHOID FEVER. tions on the valves, but this case follows in causation the type of the vast majority of cases of infective endocarditis in being due to the staphylococcus aureus. The question might readily arise in such cases: Would not early treatment by intestinal antiseptics have greatly lessened the tendency to infection and perhaps have been the means of preventing the fatal infection ? I would say, in all probability such tréatment- would have such a tendency, but.pyemia as a cause of death in typhoid fever is too uncommon to make a routine treatment by intestinal antiseptics a necessity on this account.",
         "UPON A CASE OF FOAMING LIVER (SCHAUMLEBER) WITH THE DEVELOPMENT OF GASEOUS BULLA IN VARIOUS ORGANS, DUE TO THE PRESENCE OF THE BACILLUS AEROGENES CAPSULATUS.' BY J. G. ADAMI, M.A., M.D., Professor of Pathology, McGill University; Pathologist to the Royal Victoria Hospital. While I have to confess that I have nothing new to add with regard to this interesting fori, the bacillus aerogenes capsulatus, about which Professor Welch and Dr. Flesner are issuing a full study in the new Jouirn.al of Experimnental Milfeciiine, and while I have to confess further that I have been so much 'occupied vith other work that I have not been able to make a full study of the case, neverthe- less, inasmuch as I believe I am recording the first in which this form of anerobic microbe has been recognised in Canada, I may possibly obtain forgiveness if I publish a brief note upon the case. A. C., aged 45, a strongly built luinberman, had for the past five or six years suffered from dull aching pains in the loins. He was a teim- perate ian and had no other complaint. While drawing wood four weeks previous to admission he felt a soreness over the whole body, but continued. at work. Upon the following day, the soreness gave place to actual pain, localised in the abdomen and loins. The pain was so severe tbat atf noon he ceased work and took to his bed. The pain becane at times agonizing, but never became localised to any spot in the abdomen. Ie suffered from recurrent chills, his urine became very red (? bilirubin) and a week before entering he became jaundiced. Upon April 9th he was admitted to the Royal Victoria Hospital, under Dr. Bell, to vhose house surgeon, Dr. Anderson, I am indebted for these notes. Upon admission the patient complained of no pain, but only of extreme weakness. Despite the fact that he had been ill for four weeks, he still preserved a well nourished and muscular appearance. There was the anxious abdominal facies, with moist perspiring icteric skin. The temperature was 1020, the pulse 120, the respiration 28. The abdomen was pendulous, and there was tenderness over the whole, particularly over a small area, 3 inches to the left and 5 inches above the umbilicus, where percussion was dull and an indistinct mass -IRead before the Montreal Medico-Chirurgical Society, April 17, 1896.",
         "ADAMI--FOAMING LIVER. could be felt. There was some tenderness also in the left groin. The urine contained albumen and bilirubin, the fæces were liquid and dark, containing blood and pus cells. Shortly after admission the patient vonited coffee ground vomit, and continued to vomit thus until his death, 5 days later. The patient continued so weak that it appeared hopeless to attempt any operative interference. Upon. the 14th he was coughing constantly, and was in great pain. The pulse was weak and rapid. The abdomen was distinctly enlarged and tympanitie, and the enlargement appeared to be progressive. The tyinpany extended for about 1 inches above the edge of the liver, which could at this time be distinctly palpated. The blood upon the 14th exhibited great leucocytosis, the red corpuscles did not form into rouleaux and there was marked poikilo- cytosis. On the 15th the patient died. The body was placed in the cold chamber, and the necropsy per- furmed 28 hours after death. The necropsy revealed that there had been a perforative appendicitis. Below the cocum in the pelvis, between it and the rectum, was an abscess of the size of a large tangerine orange. Into this abscess passed the appendix, which had ruptured at the junction of the lst and 2nd fourths. The gangrenous distal portion of the appendix lay in the abscess cavity. The abscess was sharply defined. The mesentery of the siall intestine vas very thick and fat, and upon cutting tlirough it in removing the intestines occasional simall foci of pus were cut across. Upon further exami- nation these foci were found to be linear, and the pus to be in and around the branches of the superior mesenteric vein. Deeper down in the nesentery was an extensive sloughing abscess cavity, its branching corresponding to the nesenteric vein. The superior mesen- terie appeared to open into this abscess cavity, its terminal and upper portion alone being clearly recognisable. The abscess cavity extended up to the head of the pancreas and the duodenum, and in the third part of the latter w-as a fine perforation leacling into the abscess cavity. Evidently, therefore, we had here to deal in the first case with a case of appendicitis, which possibly taking into account the history of long continued soreness and pains in the lower abdomen, may have been of the recurrent type. Eventually there had been perforation and localised suppurative peritonitis and abscess formation, with suppurative thrombosis of the branches of the superior mesenterie vein; and this .thronbosis had grown along other branches of the vein; and had led, eventually to a condition of retroperitoneal abscess. But there had been further ehanges. ' Bubbles of air or gas were 116",
         "ADAMI-FOAMING LIVER. noticed in the vir.s of sundry of the abdominal viscera. Unfortu- nately there exists no note as to whether also the presence of air was noticed in the coronary veins. My impression is that I distinctly noticed this condition, but in the absence of any deßnité note I can affirm nothing surely. When, however, the liver was reimoved it was found to float high out of the water, and the saine was noticed with regard to the kidneys and to a somewhat less extent, in connection with the spleen. It should also be added that the abdomen was found greatly swbllen, even more so that it had been at the tinie of death, and upon opening it there was an abundant exit of gas. The liver was not much above the normal size, and presented rounded edges. Its surface was smooth with a dark slaty background, mottled over thickly with pale yellowish circular patclies, 2 to 5 mm, across. On\"section it was extremely emphysomatous, and crackled on pressure, and when a lighted match was brought close to the cut surface and pressure was exerted upon the organ, the expelled gas caused a series of minute explosions. The eut surface had a reddish-brown colour on the whole, but varied from bright red to even a greenish tinge. It exhibited numerous small whitish areas of necrosis, with softened centres, and also numerous sharply defined bulle (where thégas had been); these averaged 3 to 5 mm. across. It wvas noted that althougl the mesenteric exhibited so extreine' a condition of suppurative thrombosis, no thrombi were to be seen in the large vessels of the liver. The spleen was large, soft and almost difliuent. It had a slightly emphysomatous feel, but presented no clearly marked bullS. The kidney also showed no large bullS although it floated so easily ; there were, however, numerous whitish areas of necrosis or abscess formation 2evel with the surface, and resembling those seen on the surface of and in the liver. On section, the cortex was plainly swollen, with siihilar areas both in the cortex and in thè medulla. Bacteriologically the surface growths gave in the main, colonies of a minute diplococcus. A deep agar lactose tube showed in 24 hours a slight growth along the needle track away from the siurftice. In 48 hours; the deep growth was more distinct and one babble of gas was well developed. In 72 hours there was abundant development of gas bubbles, but now in the upper part of the needle track there was a developmnent of the saine minute diplococci whieh had been seen in the previous cultures. Preparations made by breaking the tube and taking material only from the lower portion of the growth gave large bacilli corresponding in every respect with those described by Welch. as the B. aerogenes capsulatus. 117",
         "ADAMI--FOAMING LIVER. Sections of the liver and other organs showed large colonies.of this same large bacillus corresponding to the areas of necrosis recognised by the naked eye ; but there was very faint evidence of the presence of the capsule, even when preparations were made by Welch's nethod of demonstrating the capsules. At most where the bacilli were crowded together, a faint delicate halo could be seen surrounding each individual. Welch and Flexner have, however, called attention to the fact that the capsule is not constantly recognisable. Tlt the bacillus in this case had commenced to grow in the tissues ante-morten is shown in the tirst place by the development of tympanites on the day preceding death. In the second, I take it, by the localised growths in the liver and kidney, these growths cor- responding to the localised necroses in these organs. Ai the saime time it is clear that in this as, if I mistake not, in all cases, the presence of this gas-producing germ was of the nature of a secondary infection, and indeed i am inclined to doubt whether under ordinary conditions the bacillus can grow in the human organism without the simultaneous presence of acrobie microbes. This, perhaps, would seem to be contrary to the experience gained by inoculating pure cultures of the germ into the lower animals ; yet it must be renem- berec that the conditions of such inoculations, the number of microbes aud also the amnount of products. of growth injected form, taken together, a very different process to that which must occur in natural infection. 118",
         "A CASE 0F INFECTION BY TJHE BACILLUS AÉROGEN ES CAPSULAI'US.1 By W. IL. JA'MIz.so, MD., Dernonstrator in Pathology, McGill University ; Assistant Pathologist to tihe M1oit- real oneral Hospital. It is just a few weeks ago since Professor Adarni presentexd before this Society the liver rernoved from the body of a man who died at the Royal Victoria Hospital from a general infection, following on an attack of appendicitis, the bacillus arogenes capsulatus having biee found post-inortern in the various organs. This, I believe, is the first case of the kind recorded in Canada. Scarcely a. fortniglt later, at an autopsy on a case of pycloneplroses at the Montreal General Hospital, an almost identical condition of the orgaus to that described by Dr. Adami was found. I was enabled at the time to make anaërobic cultures fron the various organs, but succeeded in obtaining a growth from the liver blood only.' Inasnuch as the bacilli have never yet been exhibited beforo the Society, I thought it would be-of interest to show them here to-night and to describe briefly the conditions under which the organism was found. The history of the case (for whieh I arm indelted to Drs. Finley and Cowie) is brießiy as follows: A. L., a French Canadian, aged 23 years, was admitted to the wards of the Montreal General Hospital April 22nd, 1896, having ten days previously injured his side by falling over a wash-tub and irnediately losing consciousness ; later vomit- ing.supervened and persisted intermittently for some days. Two days before admission swelling was observed in the left side and on the same date he had a severe chill. The condition on entering showed the patient to be a well-nourisled muscular man with a moderate degree of anemia ; he complained of no pain. Pulse 84, respiration 24, and temperature 98-°. Physical ination showed the lower thoracie and upper abdom- inal regions on left side to Ie large and sormewhat bulging, this bulging extending across to the nipple line on the right side and downward on the left to the level of the urmbilicus. Palpation revealed a firm, snooth mass extending beneath the ribs Read before the Montreal Medico.Chirurgical Society, Jurse 12, 1896.",
         "120 JAMIESON-THE BACILLUS AEROGENES CAPSULATUS. on the left side, backwards to the left loin and downwards to about 3 inches below the umbilicus, passing beneath the ribs on the right side about 1 inch inside the nipple. This mass had an indistinct rounded edge directed downward and to the right. There was no pulsation but distinct fluctuation. Auscultation revealed no bruit. The percussion note was dull over the area described, this dulness ex- tending up into the left middle axilla. The mass was aspirated April 23rd, and a few ninims of a chocolate coloured fluid withdrawn, which on microscopic examination was found to consist chiefly of blood cells. The diagnosis of hematoma with probably some pre- existing kidney disease, was made. The urine contained blood till May .3rd, when it became clear with a trace of albumen. On this date the patient had a chill and his tem- perature rose to 1012°, pulse 130, and respiration 36. On the following day he complained of pain in the back on the left side, extending round to the front and across the abdomen to the right side. Vomiting set in and the tumour, which had diminished considerably in size, now became again enlarged and tympanitic. On May 6th the patient's condition was very grave, and it was decided that an operation held out the only chance. He was, there- fore, sent to the operating theatre, placed under ether, and an incision made in the left lumbar region, evacuating san immense cavity of gas and fluid of a dark red colour, and of very putrid odour. Manual examination revealed a large cavity with rough, shaggy walls. Un- fortunately the patient succumbed before the completion of the operation. The autopsy was performed by Dr. Johnston and myself 24 h9urs after death, and' the following notes have been abstracted from the report : Body fairly well nourished ; sub-icteroid tiit of skin ; above right Poupart's ligament is an oblique scar ; abdomen slightly distended and tympanitie ; whitish froth about nostrils. On the left flank a recent sutured incision ; on opening this a brownish-bloody pulp exudes, which microscopically is found to consist of red and white blood cells and some granule cells. Abdomen.-Old amputation of appendix ; chronic adhesive peri- tonitis with slaty pigmentation. The left kidney converted into a large sac, the size of a head, filled vith gas and grumous, fetid and bloody contents. Colon stretches in front of this. but is not in any way involved. Sac extends somewhat to right of the middle line. Spleen in about normal position. Subsequent examination of the sac' shows it to be over one foot in vertical diameter, the inner surface",
         "JAMIESON-THE BACILLUS AEROGENES CAPSULATUS. ' 121 rough, greyish and shreddv, and in places greenish, with areas of necrosis. The wall presents at intervals rounded orifices communi- cating with diverticula from the main sac, evidently altered and dilated calyces. Thickness of wall averages 1 inch, and at lower extremity kidney structure is recognized. Kidney in a condition of putrid pyelonephrosis and perinephritis. At upper extremity, em- bedded in connective tissue, is the left supra-renal, which is firi, but showing no new growth and is easily detaclhed from the sac. The left renal artery is adherent to the wall of the sac. Left ureter obliterated and shows fibroid infiltration, and below the sac is an irregular space with greyish necrotie and very fætid walls. Right Kidney much enlarged, pelvis dilated, roughened and red- .dened; ureter dilated as far as the bladder ; evidences of acute parenchyniatous nephritis. Spleen enlarged, foaming and with acute cloudy swelling. Liver.-On surface numerous greyisli brown circular areas the size of pin points ;- these are sharply defined and the centres in nany appear to contain a minute gas bubble; these rapidly increase in number and size when exposed to the air. On squeezing, a brownish frothy blood abundantly exudes. (Liver floated in preserving fluid, and after a few hours was mucli distended, with abundant froth about it.) Gall Bladder-Contains about 3i frothy bile. Frothing in splenie, portal and other veins exaniined. Heart-Contains a little froth mixed with blood clots, healthy except for slight thickening of valves. Both lungs filled up pleural cavity and seemed more voluminous than normal. Anatomical Diagnosis-Old amputation of appendix ; chronie adhesive peritonitis with slaty pigmentation ; left pyeloneplirosis and perinephritis with obliteration of left ureter ; right hydronephrosis and acute parenchymatous nephritis ; submucous emphysema of the stomach ; foaming and acute cloudy swelling of spleen; foaming liver (\"Schaumleber\"); frothing bile ; calcification of mesenterie glands. IIMicroscopical Examination of liver blood showed on cover slips in each field froin 1 to 5 large bacilli 3 to 5nt in length, mosty with square ends, a few with rounded; occurring for the most part in pairs and surrounded by a clear space. These were the only bacilli present. A guinea pig inoeulated iutraperitoneally -with 1 ce. of liver blood. died in about 36 hours, with rapid formation of gas after deati, the body at the end of 24 hours being blown uÿ to nearly twice its origi- nal size. Examination revealed an emphysematous condition of the tissues and organs, and gas was demonstrated in the blood vessels. On microscopie examination bacilli resembling those found in the",
         "122 JAMIESON-THE liACILLUS AEROGENES CAPSULATUS liver blood were seen, though not in pure culture, due probably to the entrance of other bacteria after death. Froi anaërobic cultures taken from the human body on 2 per cent. glucose agar I succeeded in obtaining a growth fron the liver blood after 36 hours with formation of gas. The colonies were more numer- ous towards the bottom of the niedium, aind appeared as rounded and oval whitish, tlattened masses, varying f rom a pin head, to a little more than 2 mm. in dianieter ; opaque in the centre with irregiular outline, while -in their inuediate vicinity were bubbles of gas. No growth on the surface nor for 2 to 3 nn. benath it. On microscopic exaini- nation, bacilli in pure culture, answering to the description of the bacillus aërogenes capsulatus, were seen. I was unable to obtain sub- sequent cultures, but there can be little (oubt as to the identity of the bacillus. A slide showing the bacillus is placed under the micro- scope, and attention Imust be drawn to the fact that Welch and Nuttali, who diseovercd and isolated the bacillus in 1892, have pointed out that the name bacillus aërogenes capsulatus appears at times to be a misnomer, inasnuch as the capsule docs not secem to be always constant. 1-owever iii this specimen -tained by Welch's nethod, the capsules can be made out in a consicerable number. [n view of the very full account of this bacillus given in the Johns Hopcins lospital Bulletin, July-Aý.ugust, No. 24, 1892, it is needless for me to more than mention soimle of the chief points about its micro- scopic appearance. It is non-motile, výaries soinewhat in size, but its average length is fromn 3 to 6 mki., thickness a litle greater tha:n the anthrax bacillus. Unsual forms are straight, but slightly curved or bent fornis are seen; end rounded or square, or nearly so where the ends are adjacent.« They occur singly in clumps or short chains, but have no tendency to forn long chains, this being a distinguishing point between them and the anthrax bacilli. Tlhey stain with the ordinary aniline dyes and also by Gram's method. Capsules may often be demonstrated around the bacilli, varying froin one-half to twice the width of the bacillus. They grow on ordinary media in the absence of oxygen. An interesting clinical feature in this case is the strong probability of their presence in the body during life, as was evidenced by the previously dull tuinour becoming tympanitic, and the escape of gas on making the incision into it on the operating table. Since presenting the above report to the Medico-Chirurgical Society our attention has been called to a case admitted under Dr. Hutchison, where a man sustained a compound fracture of both bones of the forearmn.",
         "JAMIESON--THE BACILLUS AEROGENES CAPSULATUS. I28 The arm was dressed as usual in splints, and on t.he following day so great was the swelling that the bandages had. to be rerhioved. During the next twenty-four hours the swelling still increased and marked emphysema ensued, the teiperature rapidly rose to 106°, and the emphysenia extended up as far ai, the scapula. Operation was refused and the patient lcft the hospital and died on the following day, all the customary syniptoms of septicoinia having developed, It is more than likely that this case was but another example of a septieovnia following infection by the bacillus inörogenes capsulatus, and this short note is added without further comment thian;'to suggest the possibility of a general septicnia arising in this way fromn an external wound.",
         "RE T.R O S'PE C-T OF CUR RENT LITERATTJR E. Relapse in Scarlatina. GRIFFTI. \" On relapse in scarlatina.\"-Quwzrterly Medical Journa1,t October, 189.5. Cou «. \"De la scarlatine à rechute.\"--emaine Méd., 1896, No. 30. The question of relapse in infectious fevers, although umiiversally admitted in typhoid, has not been the subject of mucl attention in scarlatina. Griffith found, in 2,000 cases admitted for scarlatina to the Bagthorpe Fover Hospital, that 14 suffered from second attacks whilst actually under observation. In these cases, the secoùd attack was marked by a rash, lasting from one to four days, sore throat and fever. Comby relates briefly tvo cases of relapse in children of four and six years. In the first case a scarlatinal rash ap'peared during the period of desquamation; in the second, on the fourteenth day of a' normal case, fever and rash appeared. In estimating the frequency of relapse several sources of error are present. An crytheinatous rash is common in such complications as nephritis or tousilitis. Rendu interprets the rash as a streptococcus manifesta- tion, and states that a pultaceous angina is always present, proving a source of secondary infection. Such erythemas, however, pass off rapidly, and may be excluded in the cases observed by Griffith. The question as -to whether the second attack is an auto-infection or due to a second infection from neighbouring cases is referred to by Griffith. If the latter supposition is correct, it would be an argument against placing large numbers of cases in a ward. Griffith's supposi- tion that a mild case of scarlatina nay contract a second attack from contact with a virulent type of the disease hardly seems to be war-",
         "ranted, and it would -seem an unnecessarv refinemnent tu classify different types of the disease in different wards as suggested by this writer. Arsenical Paralysis. COMBY. \"Arsenical Paralysis,\"-La Sem. Méd., 1896, 33. So many cases of arsenical paralysis have been reported in the last few years that its symptonatology is well established. Paralysis resulting from peripheral neuritis lias now been repeatudly observed fron the medicinal use of the drug, and occasionaill following the ingestion of a single large. dose, provided the patient recover from the iminediate gastro-intestinal syniptoms. Accidental poisoning by con- taminated wall papers has also produced paralysis. In-addition to neuritis the lar«e cells of the anterior cornua have been found atrophied in both nian and lower animals. The interest of Comby's case lies in the fact that there was incon- tinence of urine and fheces in addition to paraplegia and abolition of the reflexes. Incontinence is certainly very unusual in cases of this kind, and points Atrongly, as pointed out by M. Rendu in the discus- sion of the case, to a co-existing affection of the cord. In its.symptois arsenical paralysis bears a nuch closer resemblance to alcoholie than to lead neuritis. Affecting chiefly the lower extremnities, invol)ing the sensorv as well as the motor fibres and frequently causing ataxia or so-called pseudo-tabes, these affections can only be distinguished bv the historv of the case and by a cheinical examination of the urine for arsenic. Considering the great frequency wih wich arsenic is given to choreie children in large doses, arsenical neuritis is fortu- nately a rare disease, and the administration of the drug is seldom accompanied by any further discoinfort than temporary gastrie de- rangemnent. Tabes and Syphilis. STORBECK. \" Tabes and syphilis.\"-Zeits. î. Kli. Ifd., XXIX., J2. Storbeck bas re-opened the question of the etiology of tabes and its relationship to syphilis. Statisties on this point still present great variations. Gowers considers that syphilis precedes the disease in 70 or 80 per cent. of cases in the lower classes. Be further states that syphilis may be excluded with confidence in perhaps 10 per cent. Fournier regards 93 per cent. of tabeties as subjects of syphilis whilst Westphal places the number. at 33 per cent. Storbeck has studied Eihe question carefully in 108 tabetics. Of 125 MEDICINE.",
         "126 MEDICINE. these 22 had certainly had syphilis ; in 63 syphilis could be excluded and in 23 the question was doubtful. Admitting that half of the last named were syphilitic, a ratio of 30.5 per cent. would represent the proportion of tabetics who had suffered from syphilis. Storbeck thinks this number is not higher than might be expected from the frequency of syphilis and therefore regards the relationship between these diseases as unproved. It is obvious that it is often impossible to prove an old attack of. syphilis, owing to defective memory or wilful deception on the part of the patient. It is only in cases where a clear history or undoubted stigmata of the disease persists that a positive opinion can be expressed. In all statisties of this nature considerable latitude, must be allowed in the personal equation of the observer. F. G. Filey.",
         "The Treatment of Loss of Nerve Substance in Peripheral Nerves. G. CARL IUBER. A study of the operative treatment for loss of nerve substance in peripheral nerves.\"-Jour.nal of Miforlphology' Vol. XI.,,No. 3.. The importance of restoring the physidlogical functions of peri- pheral .nerves, which have been subjected to loss of continuity, and the frequency of injuries which cause this condition, have led the author of the above paper to carry out an extensive series of investi- gations as to the best methods available to this end. The various operations eniployed in the treatment of nerve injuries of this nature are briefly as follows: (a) Nerve stretching. This method, advocated by Schller, does not mean that the nerve itself should be actually stretchid, but that it imay be drawn out from the loose counective tissue surrounding it, and the limb being placed in proper position, 'the separated ends can then be united. This has been done even when a distance of 4 or 5 cm. separated the divided ends. (b) Implantation of a nerve segment reinoved from a recently anputated limb or from one of the lower animals. (c) Tubular sutures; these consist in inserting the two ends of the divided nerve into a decalcified bone tube. (d) Union of ends with catgut threads, or a bundle of catgut threads (sittwcre à dislance, Assaky). By the use of catgut threads it is be- lieved that it is easier for the down-growing central fibres to reach the peripheral end. (e) Nerve flap from the central stump, or a flap from both peri- pheral and central stumps. (f) Grafting of the central end of the peripheral stunip of a divided nerve to an accompanying nerve trunk. (g) Cross suturing the long central and peripheral stumps, in cases where two accompanying nerves are eut obliquely, and grafting the central short stumnp to the central long one, and the peripheral short stunp to the peripheral long one. (A) Resecting the bone or bones in the extremity and suturing the nerve. The author, in his experiments, einployed the method of implanta- tion, tubular suture, the use of a bundle of catgut threads, the flap operation, graftiig injured nerve into accompanying sound nerve, and",
         "finally cross suturing and grafting. The animals used were dogs. As a rule the ulnar nerve was selected for opeiation; in a few cases the median or sciatie was used. When a nerve was implanted it was usually taken from the sciatie of a cat. The author, in his investiga- tions, experimented upon fifty of these animals, and the operations were conducted as aseptically as possible. The wound was closed, as a rule, with a double set of sutures, the deeper ones embracing the connec- tive tissue overlying the nerve, the other the skin and muscles. By this method any exposure of the nerve operated upon was prevented, not even did the skin wound subsequently open from any cause. From the experimental work of other workers, as well as of the author, the following conclusions nay be drawn 1. That it is possible to restore the functional activity to the peri- plieral part of a divided nerve with loss of nerve substance if the resected ends are united with a segment taken fromn some other nerve trunk, with catgut threads or with a boue drain. 2. Implantation of a nerve segment, the two ends of which have been sutured with one \u003er several catgut sutures to the resected ends~ of the injured nerve, gives the most favourable result. 3. The regeneration of the peripheral end is the result of an out- growth of new axis cylinders from the central stump, which eventu- ally reaches the peripheral part of the resected nerve wherein their growth continues. 4. Imnplanted substances, whether they be catgut threads, bone drain or an implanted nerve seginent (which soon degenerates, the collapsed sheaths remaining), are to be regarded merely as guides to the down-growi ng axis cylinders. 5. The fact that the new nerve fibres have a much straighter course and more regular arrangement following upon the implantation of a nerve segment than after the use of catgut threads or a bone drain, shows that the degencratèd tibres of an implanted nerve segment offer much more favourable mechanical conditions for the down-growing axis cylinders. 6. The above methods may be used innnediately after the injury to the nerve, or at a later period. In the latter case the return of fune- tion takes place more slowly. 7. The operation of making a nerve flap is not to be recommended, as the flap from the central end usually degenerates, nor docs it sup- ply so favourable a union as when a segment is carefully inserted. 8. In cross suturing the long ends of two divided nerves and engafting the short-ends to. the accompanying long stumps, regenera- tion of but one of the peripheral segments (the long one) of the two injured nerves can be hoped for ; the other peripheral segment remains degenerated; hence implantation of a nerve serment would be preferable in dealing wvith the latter. E. J. semple. 128 SURGERY.",
         "The Etiology and Treatment 'of Exophthalmie Goitre. PUTNiAM, JAMES' J. \"Modern views of the nature and treatment of exophthalmic goitre.\"-Boston iM'Tedical and Surgical Journal, Vol. CXXXIII., No. 6. KINNICUTT, F. \" The theory of the thyroid origin of Graves' disease, with its bearing on the surgical treatment of the disease.\"-.N\"w York l Medical Record, April 18, 1896. STAnR, M. ALLEN. \"On the nature and treatment of exophthalmic goitrc; with special reference to the thyroid theory of the disease and to the treatient by thyroidectomny.\"-Te Medical News April 18, 1896. BALDWIN, W. W.. \"Some cases of Graves' disease, succeeded by thyroid atrophy.\"-The Lancet, January 19, 1895. OwEN, DAVID. '\"Further notes on the treatment of a case of, exoph- thalinie goitre.\"-T4e Britisl Medical Journal, Feb. 16, 1895. MAUDE, ARTHUR. \"Notes on the treatment of Graves' disease by thymus gland.\"-The Lancet, July 18, 1896. One of the most interesting stories in connection with recent pro- gress in medical kiowledge is the gradual clearing up of the misty views previously held in connection with the etiology of exophthahlnie goitre and with it the steadying of the therapeutic indications for its treatment. The frequency with which this affection was met with, its peculiar grouping of syimptoins, its obscure relationship to many other diseases of the nervous system, and its resistance to ordinary methods of treatment, have made it a fascinating object of speculation and research to both physician and pathologist. Many theories have been offered and temporarily accepted as its explanation, but one by one have they been discarded as each in turn has been found to fail in explaining all the symptoms. The theory of cardiac disease, organic or functional, was the first to be rejected and was supplanted by one, ascribing the symptoms to changes in the cervical lymphatie glands. Patholocrists, however, failed to find sufficient evidence to",
         "PHARMACOLOGY AND THERAPEUTICS. support either this supposition, or that referring the symptoms to a lesion of the vasomotor centre in the medulla. Mobius, of Leipsie in 1886, first suggested that the symptoms were due to a toxomia, the result of hyperactivity of the thyroid gland. This opinion lias gradually gained ground, especially sin e Greenfield, in the Bradshaw lectures of 1893, showed that well defined structural lesions, evidently a true hypertrophy of the glandular elements, and indicating an exaggerated, and probably perverted function are met with in this gland in severe cases of exophthalmic goitre. These observations have been confirmed by many pathologists both in Eng- land and on the Continent. Evidencing the truth of this theory is the striking contrast exhibited between the symptoms in Graves' disease and in myxedeina, vhich latter is now generally regarded, as due to a defective f unctional activity in the thyroid. Tbis antithesis of clinical phenomena is atated by Kinnicutt as follows: \", In Graves' disease enlargement of the thyroid gland is present, in inyxœdema an atrophy of the gland. In the one case the skin is fine, soft, moist, and warm ; in the other coarse, liard, dry wvith a tendency to desquamate, and cold ; in the one perspirations, often profuse in character and easily excited, aïe conspienously present; in the other their absence even in the warmest weather is equally noticeable. In Graves' disease the temperature is never subnormal and pyrexia of greater or less degree occurs on slight causes ; inii myxedema the reverse holds .good. In the former -an excitable, mobile pulse, tachycardia, and palpitatioi prevail ; in the latter a sluggish heart action and slow pulse. In Graves' disease irritability and excitability, in myxoedema apathy and aulness of apprehension and perception attract the attention. In. th former tremor is one of the cardinal symptoms, in the lattr it is absent, except in its rare occurrence in the form of tetany. In Graves' disease the nutkition of the hair, nails, and skin is, aS a rule, well maintained ; in myxoedema the reverse obtains.\" lu exophthalmic goitre the eyes are abnormally widely open, anid generally von Graefe's and Stellwag's symptoms are present, while in myxedema there is a marked tendency to hcaviness of the eyélids, so 'that the upper lid falis, and there is distinct narrowing of the palpebral tissure. Further- more the large number of cases of Graves' disease occur between the ares of twenty and thirty, during the period of the greatest activity of the generative functions. The interval between forty and forty- five, the period of decline of these functions, furnishes the most numerous instances of myxœdema. Again, the development of myxodema in sone instances, subsequent",
         "PHARMACOLOGY AND THERAPEUTICS. 131 to recovery froù typical Graves' disease is another argument in favour of this theory. With alterations'in the parenchyma, an over-growth of interstitial tissue, Dr. Greenfield states, is developed which gradu- ally invades the glandular structure, and more or less interferes with its function. Cases of this kind have been reported by several observers, among others by Gowers and Ord. Dr. Baldwin in his paper reports four such cases. And lastly, both Stari- and Kinnicutt draw attention to the similarity between the symptoms of exophthalmic goitre, and those produced by an excessive dose of thyroid extract. These nay be stated to he: (1) a rise of teinperatuie above normal ; (2) iucreased rapidity of tb', pulse, and palpitation ; (3) a burning sensation with some flushing of the skin, which may become moist ; (4) rapid emaciation ; (5) a con- dition of mental excitement ; (6) exophthalmus. If the dose be still further pushed insomnia, polyuria, diarrhoa, and flue tremor nay develop. These arguments appear almost unanswerable. Kinnicutt points ·out, howrever, that although in inany cases the pathological conditions found represent a truc hyperplasia of the gland, mu some cases, changes attended by a considerable loss of secretory tissue have been associated with the symptons of exophthalnîic goitre. Such cases undoubtedly imilitate against the thyroidal theory of Graves' disease in so far as hypersecretion alone is regarded as the causative agent, but not if a perverted function, with qualitative changes in the secretion is accepted in explanation. In addition to these actual pathological conditions, it would appear necessary for the full devel- opment of the symptom complex of this affection that we shall have in addition an inherited or acquired neuropathic tendency. The spontaneous and rapid -disappearance of the symptoins in occasional cases, and complete recovery' under treatinent in others, indicate that extensive structural changes are not always present, and it would appear that sometimes peripheral irritations elsewhere in the body are suflicient to maintain functional activity of the gland which ceases on the removal of the irritation. If the'conclusion above reached is valid, that exophthalmic goitre is due to au excessive or perverted secretion of the thyroid gland, asso- ciated with an irritable or neurasthenic condition of the nerve centre, that treatmerit will prove most successful which in one way or another effects a diminution in the activity of the thyroid. Starr thinks it not improbable that the good results following treatment with belladonna, pushed to its physiological limuit, are due to a spcific action of the drug, arrestiing the secretion of the oland.",
         "PHARMACOLOGY AND THERAPEUTICS. The rest cure is probably one of the nost successful methods em- ployed in the treatment of Graves' disease, and associated with the use of iron and tonics acts probably by quieting general nervous irr- tability. The mental condition has a very marked influence upon the symptoms of this disease. From every-day experience we recognize the distinct action which the mind has upon the var'ous glands of the body. The secretion of tears is almost-entirely prodiced by mental impressions ; the secretion of saliva is markedly stimulated by sensory impressions; the secretion of gastric juice and the whole process of digestion are decidedly affected by mental conditions. It is probable, therefore, that the secretion of the thyroid gland is affected by mental conditions: and there is an overwhelining amount of testimony to the effect that the onset of exophthalmic goitre can be traced to mental conditions, especially of the nature of fright, dread, and inxiety. It is impossible, therefore, tu ignore the mental relation between a restful state of the mind without anxiety and a diminu- tion or more natural secretion in the glands of the body, and it seems probable that the success of the rest cure in these cases is due to the little understood but powerful effects of the mental state upon bodily functions. Electricity is an agent which has had a high repute in the treat- ment of this affection. Allen Starr says of it, \" Inasmuch as various methods of its application have met with success in certain hands, and the saine methods have utterly failed with others, it is difficult to determine its real value as a therapeutic agent. It is possible .that it nay act through the mind by suggestion. It is also possible that it may have a distineù influence upon the secretions of the gland.\" Rockwell has obtained the greatest success by the use of very strong galvanie currents (60 mille-ampères), applied througrh a clay electrode directly to the gland, and such a current would undoubtedly result in chemical changes within the gland, modifying its secretion. Dr. Putnam, of Boston, favours strong faradic curients, causing con- traction of the muscles of the neck and compression of the gland. The testimony in favour of the action of aconite and veratrum viride in the treatment of exophthalmic goitre is too definite to be ignored. It may be attributed possibly to their depressant influence upon the heart, in this way reducing materially the flow of blood througli the gland. Ergot also by contracting the medium-sized arteries inay exert its beneficial action in the same way. A remedy which Dr. Starr thinks has been of much service is glycero-phosphate of sodium in'20-grain doses three or four times a day. This drug was first employed by Trachewsky in Kocher's 132",
         "PHARMACOLOGY AND THERAPEUTICS. clinie, and was found to have the effect of diminishing the size of en- larged thyroid glands. Very recently attempts have been made in a purely experimental way to treat patients suffering froin exophthalmie goitre by mncans of the administration of thyroid -.xtract. The consensus of opinion, however, seens to be that not only is this treatment of no service, but that it is actually harmful. In one unfortunate case a fatal result appears to have shortly followed the use of the thyroid. If the above theory of the disease is correct there is every reason why the administration of thyroid in this affection should be avoided, and Dr. Starr is of the opinion that in the fev cases where an improve- ment bas been noted the patients were not suffèring fromn teue exoph- thalmic goitre. There are, however, several. cases recorded which wrould apparently indicate-a favourable influence upon this disease fromn the administra- of thymus extract. The origin of this treatment is as follows: David Owen, of Manchester, reported a case of exophthalmic goitre as cured by the use of thyroid glands given in bulk. Some months after lie published a correction of this statement, having ascertained that owing to ignorance on the part. of the butcher his patient had been supplied with thymus glands exclusively. He ascribed the improve- ment therefore to the thymus. And Dr. Maude very recently reports four cases under which all the symptoms were improved by its use. On the other hand, a case is reported by Dr. Willians in which this treatment, like that with thyroid extract, was of positive harm to the patient. With our imperfect knowledge in regard to the functions of this gland and to its clinical action in this affection, we are not in a position to say anything definite as to its use. The question of the surgical removal of the gland while appearing at first sight to be the most rational form of treatment, is one which denands careful consideration owing to its high rate of mortality. It is to be reinembered that there is in mnany cases a very decided tendency to recovery either spontaneously or under the influence of treatment. There are numerous cases, however, in which after a longer or shorter period serious symptons develop, or in which other treatment lias proved of so little avail that the question of operation lias to be faced. Dr. Starr lias collected 190 cases from medical litera- ture in which operative treatmnent lias been undertaken. Of this number 23 cases died imiediately after the operation ; 74 are re- ported as improved; 3 are reported as unimproved. In regard to the remainder, no final results are reported. The occurrence of sudden death immediately after the operation, or within two or three days of 133",
         "134 PHARMACOLOGY AND THERAPEUTICS. it, is a fact of very serious import. Death after these operations is not owing to hoemorrhage, nor to any want of .septic precautions. In all the cases reported tlere have been a sudden rise of te mperature to 105°, 106° or 107° , a very rapid pulse (180 to 200) ; extremne nervous excitability and restlessness, with great anxiety and distress; profuse sweating and finally collapse and death from heart failure. Dr Starr thinks that the most reasonable explanation for this séries of symptoms, would appear to be an intense poisoning of the entire system by an excessive absorption of thyroid juice taking place sud- denly during the operation. In the 74 cases reported as cured, there was as a rule no marked iminediate result, but a steady progressive improvement extendling over several months, until finally the cure was reached.- The first symptom to improve, according to Dr. Starr, is the tachycardia. In the majority of cases, the pulse has been notably slowed within twenty-four hours of the operation. -Afterwards there -is a gradual subsidence of the nervous excitability and restlessness and tremor. The exophthalmus persists longer than any other symptom. Dr. Starr says, in conclusion, that in severe and intractable cases of. exophthalmie goitre in which the rest cure and niedicinal treatment have failed to relieve, the operation of extirpation of the thyroid must be considered as justifiable. and should be advocated by physicians. ' It should, however, not be undertaken hastily, nor by surgeor.s with- out previous experience in the extirpation of goitres, and it is always to be remembered that a sinall portion of the gland inust be allowed to reinain, else the patient will develop symptoms of myxoœdema. A. D Blackader:",
         "Transient Myopia in Diabetes Mellitus. APPENZELLER. \"Vorübergehende Myopie bei Diabetes Mellitus.\"-- Centraiblatt für Augenheilkunde, May, 1896. This is the record of a very interesting and typical case. It was a recent case and under careful observation. The refractive variation was seen to run a parallel course with the exacerbations and ioprove- iments of the constitutional trouble. Evidently this was caused by an increase in the refractive index of the aqueous tumour and disappeared with the return of the same to the normal. Few cases of this nature have been mentioned, but yet if looked for they cannot be uncommon. Hirschberg, of Berlin, is the authority inost- frequently mentioned in this connection, and he even goes so far as to -say that late myopia coming on without cataract between the fortieth and fiftieth year is a certain sign of diabetes. Ocular Hereditary Syphilis in the Second Generation. GALEZowSKI. \" De l'hérédité syphilitique oculaire a la deuxieme generation.\"-Recueil d'Ophthalmologie, Janvier, 1896. After observing several cases of keratitis diffusa and choriodo-retinitis in adults and children, in which neither they nor their parents had suffered from acquired syphilis, Dr. Galezowski was Icd £u inake further investigations as to the cause. From these he-discovered that the grandparents had had acquired syphilis. .ln such cases, which Fournier has termed para-sypiilitic, the. con- tinued mercurial treatment was invariably followed by.,-ither marked improvenent or cure. Sub-conjunctival Injections of Corrosive Sublimate. BoURGON. Annal d'ocalistique, CXIV., 1895. STUELP. Archiv.für Augenheikunde, XXXI., 1895. SEGEL. Ktin. Monatsblatter f ür Augenh., XXXIII., 1895. Bourgon's cases are a strong plea against the use of thése injections. injected it in si: cases. Three had opacities of the vitreous, and the result was by no means encouraging, as only one of the three said",
         "OPHTHALMOLÔGY. that he thought lie did not see so mistily. The other three did not even show a subjective improvement. Stuelp, in a series of preparations and studies on eyes, in which sub-conjunctival injections had been made, says that it is impossible to discover a trace of mercury in the interior of the eye. Hence any effict must be simply due to the irritation set up by the injection, and accordingly injections of sodium chloride would exert quite as good an effect as the sublimate. Seggel has four cases with favourable resul'ts to report. One case was a suppurating wound after cataract extraction; one, an infected wound of the cornea and iris ; one an orbital cellulitis froni infection from periostitis of the metatarsal bones, characterized by sudden ex- ophthalmus and chemosis and lastly, a case of plastic irido choroiditis. Seggel makes the injection as far from the limbus as possible and uses no fixation forceps. Daily injections only are indicated when suppuration is threatening. Fron vhat we may gather from these reports favourable resuits, it would seem, may only be expected when suppuration is threatening or already exists, it appears not to be of much use in lesions of the deeper parts of the globe. The Relation of Tuberculosis of the Eye to Tubercular Disease in Other Organs. DENG. Archiv. f. Atugenheilkitn, le, Bd. XXXI., 1895. T;iis interesting article is really a valuable collation of material which Dr. Denig made in order to ascertain the proportion of cases of eye tuberculosis in which evidences of general tuberculosis existed. He was led to do this as the existence of a true local tuberculosis of the eye is denied by nany ophthalirologists. From the examination of four hundred patients he draws the result that true ocular tuberculosis is just as possibly a local disease as tuber- culosis of a joint or lung is local, in the sen'se of a primary affection. This type he distinguishes from the inetastatic variety, which latter seldon occurs. The variety of the disease decides the prognosis. If in the eye it be not of the form known as a granulation growth it is favourable as regards li e, for the granuloma tends to metastasis and soon threatens life. Etiology of Strumous Ophthalmia. Go oN NORRIE. Centralbatt f Praktische Augeneilk., Oct., 1895. Norrie, in 1889, mentions \"pediculi capitis\" as a frequent cause 136",
         "OPHTHALMOLOGY. of strumous ophthalmia, and now again advances it nïore decidedly as the result of further experience. The form of the ophthalmia may vary, being a blepharitis or a phlyctenular conjunctivitis or keratitis. Norrie's observations in his hospital elinie in Copenhagen showed that many children having these diseases of the eye were also infested with lice, most frequently the \"pediculus capitis.\" He also found that so soon as these parasites were got rid of the eye trouble rapidly improved. Herz considered the \"eye trouble as reflex from the irritation of the scalp; this Norrie denies, as does also Goldzieheî, who says the children scratch their heads and get some of the secretion of the louse into their eyes by rubbing them afterwards. Norrie holds that scratching the head sets up ulceration of the scalp, which becomes infected by streptococci, etc. Through repeated scratching the fingers become covered with bacteria, and these by rubbing the eyes afterwards are introduced into the eye-inoculated into the cornea or lids. What part the irritating secretion of the louse plays is uncertain. J. . Stirlinq",
         "[The editors will be glad to receive any reprints, monographs, etc., by Canadian writers, on medi- cal or allied subjects (including Canadian work published in other countries) for notice in this department of the JoupÀAL. Such reprints should preferably be addressed to Dr. KennethCameron 903 Dorchester street, Montreal.] PERIODICALS. APRIL, 1890. BRIrisn MEDICAL JOURNAL (APRIL I1TH.) Successful cases of trephining for meningeal h-umorrhage ; ligature of the carotid-Francis J. Shepherd, Montreal, p. 005. T Hn MEDICAL RECORD (NEW Yonx) (MARci 14TH AND 21sT, APRIL 4TH AUND 11TH). On the relationship between inflammation and sundry forms of fibrosis. (The Middletoin-Goldsmith lecture for the year 1896)-J. George Adami, Montreal. THE CANAmAN PRACTITIONER. Roentgen skingraphy-E. E. King, Toronto, p. 241. Epilepsies of the insane-E. I. Staflord, Toronto, p. 247. A case o! cholecystduodenostomy for lithiasis, with the aid of a Murphy button-F. Winnett, Toronto, p. 258. Tus CANAnA LANCET. Two cases of movable bodies in the knee-joint-George A. Binghani, To- ronto, p. 259. Five years' experience with the cold bath treatment of typhoid 'fever- William Osler, Baltimore, p. 261. TuE CANAmAN MEmiCAL REVIEW. Notes on an eplenic of herpetic tonsillitis-John R. Hamilton, Port Dover, p. 119. Foreign bodies in the intestines simulating gall-stones-D. McKenna, To- ronto, p. 122. Tua DoINeON MEDICAL MONTHILY AND ONTAIO MEDICAL JoURNAL. The non-instrumental treatment of the diseases of women-J. D. Albright, Akron, Pa., p. 309. Hygiene of Canadian railways (concluded)-p. 371. THE MARITIME MEDICAL NEWs. Report of cases of diplitheria treated by antitoxin-E. J. Elderkin, Wey- mouth Bridge, N.S. Complications of scarlet fever-A. J. Mader. LA CLINIQui. De l'examen des urines, comme aide du pronostic et au diagnostic-Eug. St- De l'examen baicteriologique dans la phthisie pulmonaire, la diphterie, et la blennorhagie-Pierre Bedard, p.- 39.. Du mal de têtc d'habitude, cephaléeou cephalagie--Philippe Ste. Marie, p. 407. De l'abus du tabac-J. Lamberet, p.417. De la syphilis'a\u003cjuise-J. Eug. Provost, p. 424. L'UxioN Mx mCALE DU CANA. Etude Médico-Légale. Les aliénés devant la loi (suitel-Georges Villeneuve, Montréal, p. 193.",
         "CANADIAN MEDICAL LITERATURE. Note sur la curabilité en aliénation mentale-E. P. Chagnon, Longue Pointe, p. 212. Six années d'expérience en chirurgie abdominale avec résultats ultimes et immédiats (suite et fin)-A. Lapthorn Sinith, Montréal, p. 213. MAY, 1896. THE CANADIAN PRAèTITIONER. The drainage tube in abdominal surgery-J. F. W. Ross, Toronto, p. 313. Gyna:cology among the insane-Dr. Hobbs, London, Ont., p. 321. Optico-ciliary neurectomy-G. 11. Bnrnham, Toronto, p. 327. Cycling for women -R. E. Doolittle, Toronto, p. 329. THE CANADA LANCE'r. What shall we do with our alcoholic inebriates ?-J. W. Grosvenor, Buffalo, N.Y., p. 299. Acute broncho-pneuionia-P. D. Goldsmith, Peterboro', p. 304. -CANADA MEDICAL RECORD. Comparative pathology-J. A. Macphail, Montreal, p. 357. The pathology and complications of hydrocele-Thos. H. Manley, New York, p. SOL Pure milk,T. Bradford MeConiiell, Montreal, p. 371. TnE CAXADIAN MEDI[CAL Bl EV IEWV. Hlereditary syphilis-Allan Baynes, Toronto, p. 149. DOMINION MEDICAL MON·TIY AND ONTARIO MEDICAL JOURNAL. The criminal insane-A change in the law required-W. J. MeGuigan, Van- couver, B.C., p. -81. Case of laryngeal diphtheria treated by intubation and antitoxin alone-Dr. Horsey, Ottava, p. 485. What is a fatal dose of carbolie acid ?-J. J. Cassidy, Toronto, p. 458. THE MARIT1IE MEDICAL NEWS. Treatment of insoninia-W. H. lattie, Halifax, p. 141. Prophylaxis of taberculosis-J. F. Macdonald, Halifax, p. 149. IL'UNIox MBDICALE DU CANADA. Eclamipsie puerpérale-Albert Laurcndeau, St. Gabriel de Brandon,,Que. p). -57. Note sur un epithélioma hétéradénique de la région rétro-anale--M. Legueu et .A. Marien, Montréal, p. 269. Causerie Médicale-E. Merrill Desaulniers, p. 273. LA CLINIQUE. Une observation-Paul Prévost, Montrèal, p. 441. Le système métrique (poid et mesures)-J. E. W. Lecours, Montréal, p. 452. De la cocaine et de ses accidents-E. Delbose, Paris, p. 454. JUNE, 180. THE CANADIAN PRACTITIO.rNER. Address of the President of the Ontario Medical Association-F. LeM Grasett., Toronto, p. 39-I. Tongue-like accessory lobes of the liver-A. McPhedran, Toronto, p. 401. THE CANADA LANCET. Sub-acute and chronic cystitis treated by vesical balloon-J..G. Clarke Baltimore, p. 339. The exploratory incision in abdominalsurgery; its indications and technique -J. H. Carstens, Detroit, p. 345. CANADA MEDICAL RECORD. Massage in skin diseases-J. Leslie Foley, Montreal, p. 413. 189",
         "CANADIAN MEDICAL LITERATURE. Foods, their uses in disease-George Fisk, Montreal, p. 418. Two cases of tubal pregnancy successfully treated.by operation-F. R England, p. 426. t CANADIAN MEDICAL REVIEW. Diseases of the oral mucous membrane-E. Herbert Adams, Toronto, p. 179. Extra-nterine pregnancy operation-J. Spence, Toronto, p. 186. TiHE DoMINION MEDICAL MONTHLY AND ONTARIO MEDICAL JOURNAL. Dislocation of the acromial end of the clavicle, with reports'of four cases- T. H. Manley, New York, p. 594. Tracheotomy; a few practical hints on the operation-Walter Hamilton Toronto, p. 596. MARITIME MEDICAL NEWS. Treatment of heart disease-Lewis Hunt, Sheffield, N.S., p. 177. Expulsion of a fibroid from the uterus four days after confinement-G. D. Turnbull, Hebron, N.S., p. 187. L'UNION MiDICALE DU CANADA. Vagissements intra-utérin-J. B. A. Lamarche, Montréal, p. 321. De l'hémorrhagie dans le cas de placenta proevia, lorsque le foetus est mort et macéré-J. A. Ouimet, Valleyfield, Q., p. 322. Le nutrition et ses maladies (simples notes)-E. P. Benoit, Montreal, p. 328. LA CLINIQUE. De la conduite a ternie pendant la période de délivrance dans un accouche- ment a terme-G. E. Larin, Montréal, p. 519. De l'hémorrhagie dans les cas de planceta prouvia, lorsque le fœtus est mort et macéré-J. A. Ouimet, Valleyfield, Q., p. 635. De la septicémie puerpérale-Elz. Montpetit, Montréal, p. 543. Traitement de l'éclampsie puerpèrale-Elphège Réné de Cotret, Montréal, p. 567. De la septicémie puerpérale-G. A. Lacombe, Montréal, p. 617. De l'eclampsie puerpérale-C. S. Gauthier, Montréal, p. 646. Two Cases of Movable Body in the Knee-Joint---G. A. Bingham. From the first case, a body measuring three-quarters of an inch long, half an inch broad, and half an inch thick, and held by a nar- row pedicle, was removed under cocaine anesthesia, with a good result. Both the patient's father and mother had suffered from rheumatism as long as he could remember. His only sister had alse been a sufferer and ho had himself had occasional slight attacks during the last ton years. The second case, a wonan, wrho denied any tubercular or syphilitie history, had removed frorn ber knee-joint a body the size of a large bean. Suppuration followed, and continued in spite of every effort to cheek it. .It was thought that some syphilitie cachexia existed and under large doses 'of iodide of potash she improved con- siderably -in health, though' tle local condition had nit appreciably improved. The w'riter, afteè- quotingý Barwell's description' of the origin of these bodies, expresses' his opinion. that they occur nost frequently in persons with soie 'cachexia, and that he would hesitate'",
         "CANADIAN MEDICAL LITEÏlATURE. to operate in cases where a gouty, rheumatic, tubercular or syphilitie tendency vas discovered, at all· events before submitting the patient to a thorough course of constitutional treatinent. Hygiene of Canadian Railways. The Ontario Board of Healtli, with a view of ascertaining the actual status of hygiene on the Canadian railways traversing that Province, sent a series of j questions to the two large trunk lines, as well as to the Wagner and Pullman Companies running cars over those lines. The answers received were, in many respects, satisfaè- tory and should convince the publie that the interests of health are not only not neglected, but safe-guarded. The first question dealt with the ventilation of the carriages, and the replies showed that al the Companies used natural ventilation, fresh air entering the open door or windows of the carriage and escaping principally through the clear-story windows in the roof. The lavatories and closets were provided with specially designed ventilators. The replies regarding the cleansing of the cars were inost satisfactory. The cars, as a rule, were washed out dailv, or on long runs, swept out and dusted daily, and washed at the. end of the run. Special attention was paid to the closets and urinals. After readiug the replies given to this question one is obliged to draw inferences laudatory of the cleanliness of the carriages as compared with the of schools, court house and other public buildings. The cars were, about once a year, thoroughly renovated and painted and upholstered, if necessary. Tie stuffy sinell noticeable in first- class day cars and sleeping cars is partly due to the woollen and stuffed seats and backs, which in spite of frequent removal and beat- ing still retain the animal odours emanating fron the clothing and perso»s of their occupants. This will continue so long as the public will prefer green or red plush, to leather mpholstered seats and backs, even with a wire spring seat beneath. The question, \" What action do you take if an invalid occupies a berth ?\" was intended to ellicit the method adopted in cleaning a sleeping car berth .which had been occupied by a tuberculous patient, and it was found that such patients could occupy berths without hindrance. Patients with the other infectious diseases were not allowed to travel by day coach or sleeping car, but if such should occur, the cleansing. aúd · disinfection of the ear followed as a matter of routine. The question relatie e to leating showed that stearm from' the loco- Imotive was now used, though the systen of hot water heating still prevailed. The methods of lighting were unsatisfactory, for with a very ,1141",
         "14.2 CAiDIÂ~MEDICAT. LITELATTUE. l'ew ecr s wihswc±L tise I\u003eift4ell gas Was.s 11Sd, Ont wvas tihe liîsninaît eIiIil)itJyC51. 'o tiILe Iait, tlsongh 1:31 110 îssc-ans the Ieist, important qltiiel aisied, thé replies sis\u003cwed tliit ail préecautions wVere taî.ken, to s5f-mlfil aS. sppiy tuf pure ice an.îd pure driaskzing wnaster, Sur'.stiaols aire \u003c\u003efeis5s ill tiis repuo rt ais odetn iass.svmsse th iaï, shosuli hù inistie, asd il' tiesse il'l s.ricz ont las' inr ( '555ls iiiW will euj \u003e'i ttel5 i llgt~5 -i a.ilkvay CS-rli5IIgs or v1m)isilil issa' Tongue-likie Accossory Lobes of the Liver---A. McPhodran. Acesssory 1\u003c,lises o\u003ef tAie li ivr sure. fususa i n ;à grtinst vIaîriety of mhaîpeM iiii )s5is\u003epllg. i.it iiy 1-lIau tsi) t:rssîr iii Le liaisssssf usomîa Lu ssuirS Iroii tui ates- Lii series oi casses nli si vesil by Iiii ii. tile wries eUCIl lStisait diciîr 15sia-itioii Se Lo ts fý \u003e11 ieesspii .1141ass Tisit; li5~tipesi u u s *5tiglit-1sitng, licir Lo trsiitss ûîr .11 en- la. .g\u003clgal- ssîidr.11)1:fi rst (:55s Vi a. %vsjlsai, agl'A 42, wi fuasîst.iîsuLioni. lse %ussausî vals fulIl sun i tender ini uLII p)arts, lijtt toehîl L the rigldit, hIxtw tlie eca)Stal laiis, win' utlusssollr-ik( 55555MS I dO)'1liALeu, alids wiie f4±xtdlssfls tti iln l hi la tihe lisse! of* liisiii is:IS 'semilsa.ku-V5. lssiç .SSti .pi-i itil theS %îssolie, is urj\u003c5 i IVer 1xsitia l ,f) L. tise 1biii s~, Ismdi 1),]iid il, suas! ;as i iiisle5lL LJ i t, Iay Liiie ris lt Icsi iey. lors msli)s i e ism ro1iQsdel mass1.5 fi t; P55J:'tIs gfrsl 01a . lieise itarcgiIi. \"'wc., q)tiIelCI5. We' very Sîssilar Li)a t1i i fil-St, s:xespt 0111IC.ttiesoese wereis long kinsi i litr1row.\u003c)sr A.wousssas xvi\u003e Iliant il. iitsry of*sseusaîe ùiûe 55\u003e51e tims* atos walsI iiSi g of* il. lian 5.iy liirgs sl ins: o isit\u003ehe 1urisssry tr1Liet1 A\\ wVei i-s hfiil m 5i55s iii th-'. rigpi 5t i155 ..s ei5-I xes si dsswi y as.i3's he.s dit' s the( il iumss, leid ù) L'ie,0 \u003cinfoiss55)1 \u003e o 5. luiseM i esai as*tîss vi ti Llise riglit kîsIlicy. 1,1143iunr:vais tiSe 5:1\u003e1.55 to ise Losgse-ike oi\u003e; 41 tse iver, iî(Aisînd %vlitIc iay tise rigist klsseiy, t.o auli ape u l:iseiliLisy. 'JVise SiLtîiis (if thîe ase w!us isot sLru ii sg o sisa.Ii imis sssof, gfréenl 5111'.11. MxiainatLîon révai:. ïsasimsi tu lit! ai4Acra'ii e ls:\u003cf' theO liver. J'i ehCils di'ed itext ilauLy 142",
         "CANA DIAN ME[A1IT~IAUL.I43 ie*tll was lounrl at autopsy ti- Iiive been dlue Lo hoernorrh-lagie psuil A latin who, ifi la 3IIptoJil uf fiatillent fyppi,'oii in i n] Ij$of weigrht, ha1L(I a 111118Jtns~ in die r'Cgioil of Mie pylortis. E.vci)ythlilg poiflt43d te the exisLiuc o e carcilioi-ia Iii IL ra-fvte posisiI\u003eilfty. mIlreïonths latOP, however, hli jid iînproved' ini healti, WliJaeu the iIIinsl Tcotild lbe mure reatily exiuinined. find wvýs. fouII( Lu ie l\u003eroiti imil 81mifotli, iiL a sharply defined liver-likie eldgo( aint which wie lýla? oiulaed ly fui accessory lobe. The mnan mIllJeqIen tly cerni)let.Iy V(rji\u003clhis Iicaltli.",
         "A Manual of Anatomy. By IRViNG S. HAYNEs, Ph.B., M.D., Adjunet Professor and Demonstrator of Anatomy in the Medical Department of the New York University, etc., with 134 half-tone illustrations and 42 diagrams. Philadelphia: W. B. Saunders. 1896. The number of dissecting manuals already on the market makes it im- perative that any new work on the subjeet should furnish good evidence for its raison d'étre. Dr. Hraynes prefaces bis volume with the statement that \"nothing new is presented in the text except a slight contribution touching the visceral (thoracic and .abdominal) relations obtained by means of \u003c composite\" photographs.\" A distinguishing feature of the work are the illustrations, which are reproductions of photographs of original dissections. With the exception of those of the cerebral convolutions (which are excellent) these illustrations are unfortunately so indistinct as to be utterly useless to the student, and one wonders if they, too, are the result of \" composite\" photography. The same remarks will not apply to the diagrams which are niainly clever adaptations of well.known anatomical drawings. The directions to the dissector are nost meagre, and the information is arranged in that semi-tabular florm which reminds one of the \"Quiz Compend,\" while the great number of \" cross references\" will not facili- tate the work of the student. The index is particularly full, and the letter press, of course, excellent; but taking the book as a whole, we cannot sec that it will b of any service as a student's manual, and it does not profess to be more. J. M. B. Researches into the Anatomy land Pathology of the Eye. By E. TREACHER COLLINS, F.R.C.S., Assistant Surgeon to e.Le Royal London Ophthalmic Hospital, Moorfield ; Hunterian Professor, .Royal College of Surgeons, England. 1893-1894. With 10 plates and 28 tigures in the text. London: H. K. Lewis, 136 Gower Street. 1896. It is difficult in a work 'like this of Mr. Treacher Collins' to particn- larize on any special point distinct from others. It is pre-eminently the thorough work of a good student. In bis position as pathologist to the Moorfields Ophthalmie Hospital, he has access to a great quantity of material, of which he has made good use. The great point he' lays stresss on allthrough his book is the impor- tant factor that a knowledge of embryology is in helping to interpret the changes met with. In bis own words: \" Not only does embryology. help to elucidate morbid processes, but I think I shall be able to show that",
         "REVIEWS AND NOTICES OF BOOK. very valuable suggestions as to doubtful points in the development of tissues may be obtained from the changes which occur in disease. The way in which these two subjeets, Embryology and Pathology, mutually help to explain one another is the keynote of much that is to follow.\" It would be superfluxous to mention examples as the whole work abounds in them. itsufflces to give the above paragraph as an indication of the lines followed in this study. Some points require further investi- gation, but enough is conveyed to demonstrate the truth of the author's premises. The book is very clearly written in a plain straightforward way devoid of any haziness. MUr. Treacher Collins lias to be thanked for making a valuable addition to our knowledge of the puthology and anatomy of the eye. J. W. S. In Sickness and in Health. A Manual of Donestie Medicine and Surgery, H{ygiene, Dietetrics and Nursing. J. W EST lOb'LEVELT, Editor. Pp. 991. New York : D. Appleton \u0026 Co. It is a difficult thing to write a book on medicine for the laity, but in this work the editor seems to have included ail necessary information without, on the one hand, beéoming too technical nor, on theother, encour- aging people to become \" every one his own doctor.\" The advice given will indeed have the opposite effect, that of preventing unskilled persons meddling with serious conditions. As an example we may quote the following sentences: \" There is no application whieh will take the place of a free opening for the escape of wound discharge.\" Again, in speak- ing of poultices, \"The action of a poultice is to spread the poison and to render the tissues less liable to resist the bacteria.\" These two extracts from the chapter on the treatment of inflarned wounds indicate the manner in which the book is compiled. There are plenty of plates to illustrate the text, and as ail conditions likely to arise in the family are dealt with, the work may prove a most useful one. RC. K. 10 145",
         "Ct2t~3 ~VOC2~CIX1i~3$. ML1ONTREAL MEDICO-CHIRURGICAL SOCIETY. Staied Mifeetinzg, May 1611t, 1896. A. D. BLACKADER, M.D., PRES1DENT, IN THE CHAIR. Discussion on Albuminuria. Dr. R. F. RUTTAN and Dr. H. A. LAFLEUR introduced the subject. Dr. F. W. CAMPBELL said lie would confine the few reinarks which he would make to a forim of albuminuria, of which lie had had a great many cases, in fact was meeting with very frequently--he meant what is termed normal albuminuria. Most medical writers use the term albumen, but the most modern authorities call it albumin. The word albumen is simply the Latin word, meaning \" white of the egg,\" though as a inatter of fact it is applied to every formn of albumin, the latter representing the proximate principle. In Watt's Dictionary of chemistry, one of the most important works of its kind in the English language, the termination in. is exclusively used. That the mere presence of albumnin in the urine or its absence does not indicate that nephritis exists or docs not exist, is not generally recognized. The former is, however, often a phenomenon of such grave import that its recogition and meaningr is a inmatter which demands serious con- sideration. It is now fully admitted that albumin imay be met with in the urine as a physiological event, sometimes siall, sometimes in fairly large quantity; sometimes transient, sometinies remaining for weeks, and be perfectly compatible vith perfect health. In this category he did not include the albuminuria following deranged digestion, great mental or physical exertion, excesses in eating or drinking, or exposure to low temperature, because although it is sometimes found in the urine during all these conditions, its discovery under such circuinstances is extrenely difdicult, even with the most delicante tests. The cases to which lie referred were those where with the ordinary tests albumin is readily found in the urine of persons enjoying perfect health, and we cannot find any assignable cause. [t was during his work as a life insurance examiner that he met with the great majority of these cases. He referred only to renal albumin aid not to cases which accompany blenorrhoea, vaginitis or cystitis. The tirst suggestion of its existence was made by Gabler in 1865.- In",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. 1870 Ultzmann recognized albuinin in the urine of eight perfectly healthy persons. From that time onward the numnber of cases largely increased, this discovery in the majority of instances being due to life insurance examinations. He said how this came about would be readily understood when lie stated that a few years ago the urine of a life insurance candidate was only examined under special conditions and therefore rarely, whereas now it is examined in every case Such an important fact has attracted a great deal of attention, and some writers have attempted to explain that its presence was due to some pathological cause, which in inany instances is of so slight a nature as to be overlooked. Chateauburg found that the urine of 46 out of 50 pupils at one of the government schools, who were busy pre- paring for exaninations, contained albumin. The saine authority after numerous experiments came to the following conclusions: 1. Albumin is found in the urine of the majority of persons, more or less abundantly, and transient in its character. 2. Rest in bed lias a clearly mnarked influence in dliminishing the amount of albumin excreted. 3. Bodily fatigue greatly influences the production of physiological and transient albuminuria. 4. Intellectual labour augments with nost people the quantity of albumin existing in the urine. 5. Cold bathing exerts considerable influence in increasing' physio- logical albuminuria. 6. Sexual excitement and menstruation manifestly affects albumin- uria in the healthy. 7. Albuminuria. is as frequent in children as in adults, but the quantity of albumin excreted is less. 8. Digestion if accompanied by rest does not exert much influence upon physiological albumin. Dr. Campbell, in conclusion, said that these investigations were of practical importance, as the discovery of albumin is calculated, unless its significance be understood, to croate undue anxiety. Witl its real meaning understood, and with a microscopic examination, the physi- cian is in a position to reassure his patient and to avoid the.errors of unnecessarily energetic measures of relief from dangers whicl do niot exist. . The microscope is'the only:reliàble test as to w\"héther or' -iot renal disease does or does.not exist. Dr. J. B. McCONELL thought that the subject had been very fully covered by both the papers, and. that it' was- one of the greatest im- portance froii a life insurance point of view. He drew attention to the point that in testing with nitrie acid. and heat, acid albumen, 147",
         "MONTREAL 31EDICO-CHIRURGICAL SOCIETY. which is soluble in water, may be formed and lead to an error. He noted that both speakers had rejected the pressure theory, but thought that the fact that albuminuria occurred after violent exercise in ath- letes and soldiers rendered the theory probable. Dr. J. G. ADAMn was glad to sec, from what had been said by the readers of the papers, how fully it was accepted now-a-days that Heidenhain was right, and that the presence of albumen in the urine iust bc iegarded as due to a disturbance of the secretory mechanism of the glonierular epithelium. At the saine time lie had to confess that since he wrote his first paper on this sulect in 1886, his views had undergone sonie slight modification. Then he had held that all the albumen appearing in the urine must have passed through the glomeruli. He would not say that lie felt convinced even now that this is not the case, and he certainlv believed that the main bulk of the escaping albumen passed through the glomeruli ; but there were certain cases of extensive and acute congestion of the kidneys, as in acute parenchyinatous nephritis, in whieh there is a most pronounced breaking down of the protoplasmn of the convoluted tubules; and with such breaking down lie con- sidered that there must bc a certain amount of albumen passing into the urine, originating thus from the disintegration of the cells. In the imiaînnary gland the secretion is largely the result of active cellular destruction, and milk is rich in proteids. This breaking up of the cells in the kidney tubules is, as is well known, associated with the developmnent of curious vacuoles, which eventually are to be recog- inzed free in the lumen of the tubules. As to the exact composition of these delicate vacuoles, nothing is known, but certainly they can be and are associated vith cell destruction and approaching disso- Iation. )r. N. 1). GuNN referred to several classes of albuminuria of inter- est to the general practitioner. The albuminuria of pregnancy was of initerest because of the liability of serious trouble later on. If the case is seen early enough, the condition can be controlled, but if the patient is allowed to follow her daily avocations, it goes on to uroemia too ofteni. This is really a physiological albuminuria passing off with the birth of the child. The amount of albumen present is no index of the conditions present ; it ýwas not theaniouit of.albumen. secreted, but the amîount of toxie -produets in the blod, not excreted, which did harm. Another class of cases was thatin which there were nervous symp- toms, the commonest being occipital headache, -aud where this. w as associated with a high tension pulse, a diastolie valvular action; 148",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. coupled with hereditary taint, even though no albuminuria was present, a pre-albuninic stage night be pronounced. Spasms of the calf muscles of the legs during sleep ; electric shocks experienced by persons falling to sleep, auditory symptoms and itchiness of the skin which singly inay mnean nothing, combined would lead one to suspect toxie products circulating in the blood. Dr. C. F. MARTIN drew attention to the absence of albuminuria occasionally where most extensive lesions of the kidneys might be found. This occurred not only in conditions of chronic interstitial nephritis of the ordinary type, and in senile renal changes, but in other conditions as well. le had for some time made examination of the urine of moribund patients at the Royal Victoria Hospital, and subsequently observed the renal changes detected at the autopsies. In a number of instances there had been apparently normal urine as examiined carefully in the usual inanner, and yeL, the kidneys had often presented distinct evidence of parenchymatous change, with degeneration of the tubular epitheliunm and the presence of detritus in the lumina of the tubules. In a large number of cases, too, there was apparently a recent productive change as well, and yet the urine was free from albumen. Examination of fresh sections under these conditions had showed, too, considerable fatty degeneration of the epithelium, and yet the urine had been normal. . A few cases are on record where extensive fatty change and necrosis in the parenchyma had been present with unalteredt urine. Rosenstein lias recoided one such instance. These facts would seem to render it all the more probable that the glomerulus is, after all, mainly responsible for the incidence of albuminuria That the epithelium is, however, to some extent capable of influenc- ing the Viresence of albumen may be argued from the theory generally recognized that hyaline casts Le., an altered forn of albumen, seem at times to originate fromn the epithelial cells 6f the tubules ; yet in 'these instances the circulatory system must Le undoubtedly altered, too, in order to induce an albuininuria which responds to the usual tests. To say tlat the so.called physiological albuminuria is really a misnomer, and that, the presence of discernible albumen in the urine implies some lesion of .the renal structures would seem'quite rational on an analogy wvith ·the conditions usually found in ordinary parenchynatous nephritis. Under those circumstances it is only local areas of the kidney that are affcted, w hile adjacent parts appear quite normal. In the saine way vhen only a trace of albumen is present, it is more 149",
         "L50 MONTREAL MEDICO-CHIRURGICAL SOCIETY. than probable that some minute local lesion of the parenchyma is present as a cause of the abnormal urine. An interesting condition, too, in which sometimes the kidneys are extensively diseased without albumen being found in the urine, is muanifested sonictines in the case of neoplasms. Two such samples, which were passed around, showed in the one case sarcomatous nodules involving nearly all of both kidneys, while in the other a metastatie cancer had affected more than two-thirds of both organs, and yet the urine in cach case had been normal within a few days of the respective patient's death. Dr. W. F. [AM:rOX referred to two cases of albuminuria in con- nection with lngina. li one seen in Vienna there was no evidence of infectious disease and it w-as looked upon as a case of general intection from strepto- coccus. In the other, under Dr. Buller's care, there was mild angina, a little later severe nervous symptoms, and later again albumen casts were demonstrated in the urine. He emphasized the importance of determining the presence of peptone as already referred to by the leader in the discussidn. ln the occurrence of casts without albuinen, lie thought it was possible that the albumen ývas so minute in quantity as to escape detection by the tests ordinarily emnployed. Staed Meeting, May 291, 1896. F. G. FINLEY, M.D., FinsT VICE-PRESIDENT, IN THE ORAIR. Myxo-Sarcoma of the Femur. Dr. JAs. BELL 'reported this case, a report of which will be pub- lislied later. Excision of the-Rectum by Heinecke's Method.. Dr. G. E. ARMSTaOaG reported the following case and showed the patient M. M., it. 58, was admitted into the Montreal General Hospital suffering from carcinoma of the rectum. The growth involved the upper part of the external sphincter and the whole circumference of the rectum as high as the finger could reach. It was quite evident that the whole growth could notbe removed fron the périñitær1nd that the sphincter was so nuch involved -that it could not. be säved. The lumen of the rectum was so niuch encroached upon that -onT liquid f£eces could be passed. On the 5th of March I performed a left inguinal colotomy after the 150",
         "MONTREAL MEDICO-CIIIRURGICAL SOCIETY. method of Maydl. and on the l27th of March proceeded to remove the growth according to Heinecke's method. First, I placed the nian in the lithotomy position, and after intro- ducing a sound through the urethra into the bladder to act as a guide, I ruade a curved incision in front of the anus and carefully separated the rectum and all infiltrated tissue from the urethra, prostate, and pos- terior surface of the bladder. This being accomplished, and all bleed- ing points controlled, I turnei hiim on to his side and made a median incision down over the centre of the sacrum and coccyx. I then with a saw divided the sacrum and coccyx in the Une of the super- ficial incision, and the sacrum transversely below the level of the third sacral foramen. I could then out-fold my two flaps. This gave nie perfect access to the pelvis. I then deliberately opened the peritoneal cavity and separated the rectum andi meso-rectm fromn the anterior surface of the sacium until I was well above the limtits of disease. I coulid catch the large vessels in the meso-rectuni before dividing them, thus reducing the hæSmorrhage to a minimum. After all bleeding points were secured, and when I was ready to close the opening in the sacruiîi and soft parts, the rectum was divided at a point well outside the body, thus insuring against infection. The upper end of the rectum was attached externally. The patient has Made a perfect recovery, has gainecd in weight and is now, as you see, in comparatively good health. He walks well, can sit down with comfort, and does not seem in any 'way to suffer from the division of the sacrum or coccyx. This method gives good access, enables the operator to reduce the loss of blood to a minimum, and if the lower end of the rectum and sphincter are free from disease, permits of the union of the upper to the lower end, with subsequent closure of the colotomy wound and the removal of enlarged lymphatic glands. Dr. JmEs BELL considered the great drawback to excision of the rectum was the almost constant involvement of the pelvic glands. He recommended inguinal colotomny as a preliminary operation in order that a more perfect diagnosis could be reached, and where the glands were not involved a further operation could then be performed. Volitional Tremor Simulating Disseminated Solerosis. Dr. G. GORDOs CA.PIBELL. exliibited the patient antd gave the following accouuttof thé case: L. F, a French-Canadian aged 71, came to the Out-patient 1epart-, nient of the Montreal.General Hospital two years ago complaining of shortness of breath and swellic, of ihe legs. Physical examination 151",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. revealed the presence of valvular disease of the heart. At the saine time a tremor of the upper extremities was noted, and enquiry elicited the fact that the patient had suffered from it all his life and it had not interfered with his occupation of carpenter and cabinet-maker. The tremor was distinctly \"intentional\" in character, being absent while the liibs were at rest and becoming inarked on the perform- ance of voluntary movements. It was best brought out in the act of writing or lifting a cup of water to the mouth; was more marked on the left side and was increased by emotion. Fine movements, such as threading a needle, were perforimned without difficulty. No other syiptoms indicative of sclerosis were present, and the personal and family history had no bearing upon the case. After being two years, under observation the condition described was unchauged. Dr. J. B. McCONNELL referred to an almost identical case in which the legs also were affected. He looked on it as insular selerosis with- out other symptoms. Dr. F. G. FixV.EY had examined the case and thought it was difficult to classifY tremors of this sort. He had noticed a report of two cases in Berlin recently. In one which had 6een diagnosed as hysteria the post-inortem revealed disseminated sclerosis. In the other, thought to be sclerosis, no lesions were found. Tubercular Ulceration of the Cocum. Dr. .J. G. ADAmI exhibited this case, which showed peculiarly exten- sive tub\u003eercular ulceration and loss of tissue. Tubercular ulceration of the ccui and of the colon is relatively conmon, but in general the ulcers arc not very extensive. Hgre the ulceration had been so extrine that over the greater part of the cœcum there was one large area of ulceration. A few stray islands of mucosa persisted sharply cut off from the floor of the nicer, which was granular, but relatively smooth. The ulceration extended into the colon, where the largest ulcer (in tie ascending portion) was 10 cm. long and conpletely sur- rounded with the narrowed viscus. There was a well marked patch of uleuration in the appendix, and again another ulcer within l' cm. of the anus. This had perforated and communicated with the skin minediately outside the anus, forming a fistula. The specinien was obtained fromi a girl of 24, presenting chronie ulcerative tuberculosis of the epiglottis, lariynx and trachea, aùd o'f the small intestines and peritoneum. Dr. WYATT JORNSTON asked Dr. Adami if he had noticed 'nd couild explain the differenc'e in the distribution of tubercular ulceration of the ileun. In one set of cases the lesions were liimited mainly to the 152",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. typhoid position, nanely, the lower part of the ileum; in the other they were more numuerous in the duodenum and upper part of the jejunuin and scanty or absent in the lower part. Dr. ADAmI had noted a great nuiber of cases in which thero vas simulation of the typhoid distribution, but had not noticed so many where the upper end of the intestine was affected. Wounds from Firearms. Dr. WYATT JOINSTON exhibited a series of specinens illustrating the various wounds produced by firearms. Pure Milk. Dr. J. B. MCCONNELL read a paper on this subject, in which, after dealing with the composition and impurities often found, he gave in detail the precautions that should be taken to ensure a supply of pure and wholesone mnilk to the consu er. Concurrent Diabetes and Exophthalmic Goitre. Dr. C. F. MARriT read the following case report: The coincidence of two such maladies as diabetes and exophthalnic goitre in the saine patient has already been recorded in not a few cases, and yet eacht% newly added instance is of more than ordinary interest in view of thé apparently associated features in their etiology. The subjoinedl report is therefore very briefly submitted, thougli without any effort to comment on the nature of such an association. A French-Canadian aged 28, who was a piano inaker by trade, came to the out-patient department of the Royal Victoria Hospital complaining of frequent imcturition, excessive appetite, general weak- ness and persistent sweating. He had been ill about one year, the weakness being an early symptom and progressive, while the micturi- tion, sweating and increased appetite supervened some nonths later. To these signs were added a gradualy developing tremor, great nervousness, palpitation, and dyspnoea on exertion ; also gastric dis- turbances with occasional obstinate vomiting. During the year lie had lost about twenty pounds. There vas no. history of diarrhea. He was a man of temperate habits, and except for the usual diseases of childhood lie had always enjoyed good health. The faniily history prebented no evidence of hereditary taint. An examination of the. patient showed himu to be a rémarkably thin young an with. sniall, soft musclés, and moist skin. His eyeballs were rnarkedly prominent, giving him an expression of 'terror and anxiety. Von- Gi' aefe's and Stellwag's signs were distinct; that of Möbius could not be definitely made out. 1.53",
         "1MONTREAL MEDICO-CHIRURGlCAL SO.CIETY. The thyroid gland was enlarged bilaterally and rather soft. His pulse was of low tension, soft and rapid, beating 150 to the minute. The heart sounds were normal. The respirations were increased in number, but the lungs themselves appeared free front disease. The urine was pale and clear, acid in reaction, sp. gr. 1035; a small quantity of albumen was present and a large amount of sugar. The nervous system was not abnormal further than is implied in the synptoins just mentioned. He was adnitted to the wards for a few days and further notes of the case were made bv Dr. Fry, the house physican. During his sojourn lie had slight pyrexia, a constantly rapid pulse, persistent nervousness and excitability. The glycosuria remained unaltered in amount, though there was never inarked polyuria. He was discharged after twèelve days and for a short time only attended the dispensary. ,Just one year later he returned to the out-patient departnent of the hospital, where I again examined him. le had maintained fair lealtlh in the interval the goitre had somewhat increased in size, and there was still a large quantity of sugar in the urine. Tlie above notes, which though brief, state the main features of the case, are sufficient to render it certain that we were dealing with a case of true diabetes associated with Grave's disease, and not mnerely a transitory glycosuria. And their concurrence is especially interest- ing in view of the numerous analogies which mav be formulated in their respective etiologies and morbid anatomy. In both diseases, for example, hereditv is thought to play'a part; both occur in neurotie individiuals, and not infrequently are preceded by great mental excite- ment, worry, fright, etc., sometimes, too, after trauma, and in both we find individuals affected at the saine period of life. . Regarding the morbid anatomy, it is recognized that in both of these affections lesions of the sympathetie systein are often manifest, or ag'ain, injuries of th Fourth ventricle, tunours, lemnorrhages, parasites, etc., while experimentailly cvidence nay be adduced to some extent along these same lines. That some definite anal ogy exists would further appear evident in view of the experimnents recently inade by Falkenbei-g upon dogs. He records thaýt in several instances the extirpation of the thyroid gland has been superseded by diabetes. Perhaps the most sugestive work upon this'subject is that of Laucereaux, who in a clinical lecture published in the Semaie Médi- cale of March, 1895, discusses -the subject of trophoneurosis. He 154",
         "MONTREAL iIEDICO-CHIRURGICAL SOCIETY. relates several instances in which patients have ianifested three different conditions, all of which he regards as very closely related in their etiology, viz., acromregaly, diabetes and êxopitialmic goitre. Ie tends, therefore to group the threce conditions together, their pathological significance implying some vaso-trophie neurosis. Similar suggestions have emanated from other authors, inainly in France, aiong others froin Henrot, of Rheims, and from Valat. In conclusion it may be said that while the occurrence of transitory glycosuria is a fairly common occurrence perhaps in marked forms of Graves' disease, and that in two cases recently in the hospital we havé met with that condition, nevertheless the permanent presence of glycosuria with other definite symptois of diabetes seems 'to be very much more infrequent. Sated Meeting, Jwne 12th, 1896. F. G. FINLEY, M.D., FIRST VICE-PRESTDENT, IN THE C1ATR. Lymphangioma of the Tongue. Dr. G. E. AR31STRONG exhibited a photograph of the tongue and read the following report: This photograph represents a lyimphangioima of the tongue which I reiioved froi a young woman 22 years of age. She first noticed it fifteen years ago. It occnpied tlie right anterior third and a portion of the left side of the tongue. During the past few years it lias been growing rather rapidly, and when she was adiitted into the hospital it vas so large that she could not bring the upper and lower teeth together for purposes of mastication and it seriously interfered. with speech. I removed it by a V-shaped incision and fortunately obtained perfect union by tirst intention. Dr. Johnston reports it to be a lymphangioma. It is doubtless of the saie nature as the enlarge- ment in inacro-glossia, but the lymph spaces are very distinct--more so, I think, than is generally the case in the latter condition. Dr. F. G. FFNLEV asked if the glands were affected and if there were lyinphatic growths in the other parts of the body as well. Dr. Arms trong replied that they ivere not affected. Dr. J. G. ADa asked if the vesicles were thin walled.and showed any tendency. to rupture, and was answered in the .negative. A Case of Bacillus Aerogenes Capsulatus. Dr. W..H. JAIESON pad a.paper on this case. .See page 119.) Dr. J. G. ADAMI congratulàted Dr ,JamiesoIi. on, getting pur' cul- tures. He also had found that he rarely got the capsule except where 15.5",
         "\"156 MONTITEAI. MEDICC0-01IIIURM1ICAL SOCIETY. thtt ür'ganisirns were present in great masses, ats in the kidney whien a dtlet halos was notice(] between the varions hacilli. Ife found thern t'\u003e SîLè-iII wehl and Soine of the I:etresudts oltaiued wcre, froin hSmra- D r. G.L E. Ai~sI' referred to tise clinlical history as griven by Dri. Cdauwnson, and sail aftwr thc patient wvas l:roughlt into, bis warcl th'*ei- li d b een a suddlen change for the -morse, audL thie condition seiftt1(( b be thid of - ente~ iamnia due ta a freshi hoemorrhage. The patiwnt luni taken ether liadly, and l.efo'e the incision a litre of nurbil. salt solution was inJected into a vein and the condition iuiprved.On cmptying the citvity another litre of sai\u003e solution was gri enl, but tlhu Patient flied while lie was exploringe the cavity. Branchiogenio Oyst. i '. J. G. AINi Mivpre titis case, whlichi will lie plublishied later. D r. ,f. s iý~î Sid the pattÉiet Imd ben Sen-t to Iiimi with the hiagnusis ol* IL Stll))Ilatili(P lyînlîa-tic gland, whicIh he cnfb'minedi. On illakiuîg Isis incision l1(e openci) the cyst, the coitent-Is of wvhich were like. em(Ili ai\u003ct, w'ilt vc.ry littie, if î1ny, rm-nous Inaterial. Hlle wvas Atck wviLli the casc wvit1î whicil the, 11Lss Wils dissecte.l ont, quite iîhikt lympldii tie glîials in gelleral. Reseolion of Bowel. i W. J. 1 x. Il~îrîî edt;he folltowilrngaerpr .M. SL. J., aivuid 48 yours, was aditteil b ward K, Monltruial Genleral Ila4,ia o April i 1tlî, I N,9, sulrrinîg froîîî obst\u003eruction of thd l\u003eow(ls of six' dêlas \\(hrat-imi. Tilt-. patient il îînintilligenit 11n11 coulli givle no110 fcoy ntr of dIlir iihlîîeis. 01u i-xaiiîu\u003ciitionl no Sigils of aloinimial obstruction could h-e maude tm; it. m' ~ails w'eI'tJ Ilaccid. li thef, vighbt inguinal regiun Il simnaîl 11011a1il 1.11a14aanr ývèt fatL, fîill ovallef- with1 tiat j\"t3eussion nloto ; m.) iîaajîîîlsit t'il eotlghling.r Fr-iitnd(S ;titt(df thii si balle01l lPIr\u0026s(mt foi. iine rIîîî.c~.a~u.î '8\u003c, janis3e i 00, respirat ion 24 opain car VDInIitiIaf.n Lageeîeîît aafbt atraild (lie oliv '.ail wee tr\\-ýi thffouti relier. Onî Lts.e i Sth i opienat tHe itlaIùomeîa il iii h iîlidîai unem aîîd flaling tise 81ieLhl Iia.aveI îssuil thîrolli tlî1itera ahii nî.eii i , sutures. MerC pplied te tîq wamif 1 and. mn incisimiî iriiadec awa tu tuincau, iand LIeIa vldritwn aiwil aftel. clictiîg t111 stri cti i. A gmgeuansîatchî Nitil il efrai.î wis fliund. ltisectionl ol' il-56",
         "MONTTREAL MEIOCIUGOLSOCIETY. 157 about 21 lces %vgs cloue, the endis beincg brourght tocether hy Czernny -Lei kier tue aud the parts rý,tnrne-d. On the 1 Oth and l7th the pattienL clid fairhy, but sigîlts of colihise %vt-re preseait. On the i8th the~ condition wras desperate,; somei ster- toraceoUs vibilutinrç- bt t, cond(itionl i1U1)oveO ; retiuined nourish- ment ; bowels inovid with no pain ; tecndorness on ýymnpaniitis. .[ This condlition eoritinud for' soine days, wherî colIaps-t- rtuturnecl, the patient digof exlîanstion on the 27th, or htwAolv \u003clays ilftelr operiLti on. Temilbura ture was -,iu b)-ititt îl front date, o f admission, f'or several htys rernamng ni; at . Pi'nse beLweun 100) andl 120 per rai nute, [Notes troiti c'asù report of Dr. MNcI)Oulalcl, hiolse surgeIon]",
         "A Montfhy Record of the Progress of Medical and Surgical Science. VOL. XXV. AUGUST, 1896. No. 2. THE CANADIAN MEDICAL ASSOCIATION. Judging by the preliminary programme just received, the coming ieeting of the Canadian Medical Association in this city, under the. presi dentsh ip of Dr. Thorburn, of Toronto, promises extremely well. Many papers of interest and importance are to be read, and at the several city hospitals, the Notre Dame, the Hôtel Dieu, the Montreal General, and the Royal Victoria, clinical cases of much interest, cither medical or surgical, will be shown. On behalf of the profession in Montreal we desire to extend a hearty welcome to all our professional friends in the Dominion who purpose being present, and to assure them that Montreal will endeavour to mak-c the three days pass pleasantly as well as profit- ably. The following is a list of the papers already promised for the coming meeting of the Canadian Medical Association: Presicnt's address,. Jas. Thorburn, Toronto; Address in surgery, John Stewart, Halifax ; Address in medicine, Geo. Wilikins, Montreal; Address in bacteriology, J. G. Adani, iMIontrea ; Address ini midwifery, J. F. W. Ross, Toronto; Ha:morrhagic pancreatitis, A. McPIhedran, Toronto; One hundred cases of retroversion of the uterus, treated by ventro-fixation and Alexander's operation, with results, A. Lapthorn Smith, Montreal ; The influence of mitral lesions on pulmonary tuber- culosis, J. E. Graham, Toronto; A note on amputation at the hip joint in tubercular diseasc, A. Prinrose, Toronto; Tetany following scarlatina, J. B. McConnell, Montreal ; Tlh foot, its architecturé 'und clothing, 13. E. McKenzie, Toronto ; Oplithahlnia neonatoruin, R. Fer- guson, London ;. Observations on the relation between leuchSemia a'nd pseudo-leuchSemia, C. F. Martin and G. H. Matthewson, Môntreal Etiological treatment of acne vulgaris, A. R. Robinson, New York",
         "Thyroidectomy, 1D. Marcil, St. Eustace, Que.; Some observations on the heredity of carcinoma, T. T. S. Harrison, Selkirk; Some applica- tions of entoinology in legal medicine, Wyatt Johnston and George Villeneuve, Montreal; Electrie baths and dyspepsia, A. L. de Mar- tigny, Montreal; Plysiological demonstrations of interest to medical men, Wesley Mills, Montreal; The theory of the eliminative treatnent of typhoid fever, W. B. Thistle, Toronto; Oral surgery, S. Lenox Curtis, New York; Clergyian's sore-throat (?), J. Price Brown, Toronto; Vaginal fixation of the round ligaments for backward dis- placeients of the uterus, Flirama N. Vineberg, New York; Non- malignant tumours of the tonsil, with report of a case, H. D. BRamil- ton, Montreal; Sinus thrombosis, associated with acute suppurative otitis media, occurring during scarlet fever, J. W. Stirling, Montreal; (a) Exhibition of an artificial nose-bridge, (b) Some cases of foreign bodies in the eye, in which the electro-magnet was used successfully, F. Buller, Montreal; Remarks on cold air in the treatment of puhuon- ary tuberculosis, Edward Playter, Ottawa; Hereditary cerebellar ataxia (with patient), D. Campbell Myers. Toronto; A report on three cases of abdominal section for conditions comnparatively rare, H. IMeek, London; Early atrophy- of muscles in cerebiral disease, Frederick G. Finley, Montreal; Militia medical reorganization, W. Tobin, Halifax. Papers have also been proiriised by Drs. J. D. Thor- burn, of Toronto ; Wm. Osler, of Baltimore, and F. J. Shepherd and H. S Birkett, of Moiitreal. THE BRITISH MEDICAL ASSOCIATION. The meeting of the British Medical Association just brought to a close has, froi all accounts, proved one of the imost successful in its history. Carlisle, though a comparatively smxall city, has outvied mnany larger cities, not only in the extent of its welcome, but in the perfection with which aIl the detailed arrangements for the meeting were carried out. What interests Canadians inost, however. in connection with this meeting is that the invitation extended by the Montreal branci of the Association to hold the next annual meeting in this country was enthusiastically received and very courteously accepted. This action must be considered as a particularly gracefuIl coxipli, ment to the whPle pi-ofession in Canada, as ýit will uiiquestionably involve a considerable loss of tiie and expense to the inenbers of the profession in the imother country. We trust, therefore, that ail mein- bers of the profession in Canada, and particularly in-Moutreal, the city chosen for the meeting, will vie with one .another in endeavour- 109 EDITORIAL.",
         "ing not only to make our individual guests heartily welcome, but also to make the meeting of 1897 a complete success. Mucli credit is due to our confrères, Dr. Armstrong and Dr. Adami, who were present in Carlisle, for their successful urging of the claims of our branch, and also to our Toronto friends, Dr. Cameron, Dr. MacCallum, Dr. Peters and Dr. Doolittle, who, we understand, gave every assistance in their power to our representatives, nor would we forget the naies of Sir William Hingston and Professor Osler, who at previous meetings have strongly urged the claims of the colonial branches. We rejoice at the result and feel that with the meeting of the British Association for the Advancement of Science in Toronto next August, followed shortly by the meeting of the British Medical Association in this city, next year will indeed be a red letter vear for Canadian science. It behooves not only the respective Provincial Legislatures and the Parliament at Ottawa, but also liberal-handed citizens throughout the Donnion, to cone forward generously with assistance and enable those in charge to make both meetings an unqualified success. We must acknowledge also the honour which our English confrères in this Association, probably the most influential medical body in the world, have conferred upon the profession in Canada. Followinv close upon the appointmient of Sir William Hingston a few years ago to read the surgical. address at the meeting in Nottingham, coues the selection of Dir. Roddick, Professor of Surgery in McGill University and President of the Montreal Branch, to till the high office of Prcsi- dent of the General Association. We are confident that no effort will be wanting on his part to elicit the best efforts of the Canadian pro- fession in assuring a successful and enthusiastic meeting. NEW BOOKS, ETC., RECEIVED AND NOTED. Systetm of Snrgery, Vol. IV. Edited by Fred. S. Dennis and John S. Billings. Lea Brothers, New York and Pliladelphia. Archives of Clinical Skiagraphy. Edited by Sidney Rowland, B.A.. London The Rebman Publishing Co. lydro-galvanismî of the Urethra. By Robert Newman, M.D. Reprint from the transactions of the Electro-Therapeutic Association, 1S96. Post-nasal Adenoid 1-ypertrophy. By J. E. Schadle, M.D. Reprint from the Laryngoscope, July, I896. The Sanatorium or Closed Treatment of Phthisis. Beprint from the New York Medical Journal, June 15, 1896. The Value of Respiratory Gymnastics. , Reprint from the Boston Medial and Surgical Journal, May 8, 1896. By Edward O. Otis, MàD. Affeetions of the Lingual Tonsils. B. W. Scott R'ener, M.D. 160 EDITORLIAL."
      ]
   }
}
{
   "doc" : {
      "published" : [
         "Toronto : [s.n., 1875]"
      ],
      "identifier" : [
         "8_05199_71"
      ],
      "type" : "document",
      "title" : [
         "The Canada lancet [Vol. 8, no. 11 (July 1, 1876)]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE CANAD)A LANCE \u0026 gotMyjournal of eakata and sutgttal $t1tue, (titism and §¢W0 Vol VIII TORON{ Price 30 Cents. 190. 11.jTORONTO, 'UL *$36 per Annum CONTENTS.--4Index next pa«e.) CINCHO-QUININE. C INCHO-QUININE, which was placed in the hands of physicians in 1869, has been tested in all parts of the country, and the testimony in its favor ls decided and unequivocal. It contains the important constituent@ of Perueian Bark, Quinia, Quinidia, Cinchonia and Cinchonidia, in their alkaloidal condition, and no external agents. UNIVERSITY OF PENNsYLVANIA, Jan. 22, 1875. I have tested CINCHo-QUININE, and have found it to contain quinine, quinidine. cinchonine, and cinchonidine.\" F. A. GENTH, Prof. of Chemistry and Mineralogy. LAoBRAToRY op THE UNIVERSITY oF CHicGo, February 1, 1875. \"I hereby certify that I have made a chemicaI examination of the contents of a bottle of CINCHO-QUININE, and by direc- tion I made a qualitative examination for quinine, quinidine, and cinchonine, and hereby certify that I found these alka- loids in CINcao-QUININE.\" C. GILBERT WHEELER, Professor of Chemistry. \" I have made a careful analysis of the contents of a bottle of your CINCHo-QUININE, and find it to contain quinine, quinidine, cinchonine, and cinchonidine.\" S. P. SHARPLES, State Assayer of Mass. In no other form are contained the important alka- loidal principles of Bark, so as to be accessible to medical gentlemen. In it is found Quinidia, which is believed to be a better anti-periodic than Quinine ; and the alkaloids actingin association, unquestionably produce favor- able remedial influences which can be obtained from no one alone. In addition to its superior efllcacy as a tonic and anti-periodic, it has the following advantages which greatly increase its value to physicians :- xst. Itexerts the full therapeutic influence of Sul- phate of Quinine, in the same doses, without oppress- ing the stomach, creating nausea, or producing cerebral distress, as the Sulphate of Quinine fre- quently does, and it produces much less constitutional disturbance. 2d. It h;ls the great advantage of being nearly tasteless. The bitter is very slight, and not un- pleasant to the most sensitive or delicate woman or child. 3d. It is less costly; the price will fluctuate with the rise and fall of barks; but will always be much less than the Sulphate of Quinine. 4th. It meets indications not met by that Salt. Middleburg, Pa., April 13, 1875. Gentlemen. I cannot refrain from giving you my testimony regarding CINCHO-QUININE. In a practice of twenty years, eight of which were in connection with a drug store. I have used Quinint in such cases as are generally recommended by tht Profession. In the last four or five years I have used very frequently your CINCHO-QUININIE in place of Quinine, and I have never been disappointed in my expectations. JNO. Y. SHINDEL, M.D. Gents: It may be of some satisfaction to you to know that I have used the alkaloid for two years or nearly, in my practice, and I have found it reliable, and all I think that you claim for it. For children and those of irritable stomachs, as well as those too easily quininized by the Sulphate, the Cincho acts like a charm, and we can hard ly sec how we did with- out it sa long. I hope the supply will continue. Yours, with due regard, J. R. TAYLOR, Kosse, Texas. I have used your CINCHo-QUININE exclusively for four years in this malarial region. It is as active an anti-periodic as the Sulphate, and mlore agreeable to administer. It gives great satisfac- tion. D. H. CH AsE, M.D., Louisville, Ky. I have used the CINCHo-QUININEt ever since its introduction, and am so well satisfied with its results that I use it in all cases in which I formerly used the Sulphate, and in intermittents it can be given during the paroxysm of fever with perfect safety, and thus lose no time. W. E. SCHENCK, M.D., Pekin, Ill. I am using CINCHO-QUIN, and fmid it to actias eliably and efficiently as the Sulphate. In the case of children, I empioy it, almost exclu- ively, and deem its action upon them more beneficial .han that of the time-honored Sulphate. g W. C. ScHULTZE, M.D., Marengo, Iowa. lote CINCHo-QUININI in my practice bas given the best ,u o f results, being in my estimation far superior to Sul- abate of Quinine, and bas maiy advantages over the sulphate. G. INGALL, M.D., Northampton, MaS. Your CINcHO-QUININE I have used with marked success. I prefer it in every way to the Sulphate. D. MAcicAY, M.D , Dallas, Texas. We will send a sample package, for trial, containing fifty grains of CINcHo-QUININE, on recelpt of twenty-five cents., or one ounce on receipt o one dollar and sixty cents, post paid. Special prices given forj orders amouating to one hundred ounces and upwarda. WE MANUFACTURE CHEMICALLY PURE SALTS OF Arsenic, Ammonium, Antimony, Barium, Bromine, Bismuth. Cerium, ·Calcium, Copper, Gold, Iodine, Iron, La.d, Manganese, Mercury, Nickel, Phosphorus, Potassium, Silver, Bodium, Tin, Zinc, etc. »W Price List and Descr5tive Cataloguefurnished upon application. BILLINGS, CLAPP \u0026 CO., Manufacturing Chemists, (SUCCESSORS TO JAMES R. NICHOLS \u0026 CO.) BOSTON, MASS.",
         "I. 2 THE CANADA LANCET. INDEX TO CONTENTS. Oriainal Communications. Consultation with Homoopaths ........................3SU Address at the June Meeting of the Bathurst and Rideau Medi- Soupart's Amputation,...............................330 cal Association. --By J. A. Grant, M.D., etc., Ottawa ........ 317 Treatment of Severe Sprains ..........................331 Ammoniated Tincture of Guiacum in Inflammation of the Acute Rheumatism, Therapeutics of.................... 332 Throat. -By J. H. Garner, M. D., Lucknow................ 320 Excision of Hip-Joint.--Sayre .........................332 Correspondence, Reports of Sooieties. Justice........ ....................·.............322 Minutes and Proceedings of the Ontario Medical Council . 334 Selected Articles. Bathurst and Rideau Medical Association................. 340 Therapeuties of Carbolic Acid ....-..................... 323 Editorial. Treatment of Chronic Constipation... ................... 326 Vaccination as a Preventive of Small-Pox841 Drèinent et Ith .e..x..t.e..i....).''......... '. .. 326 The Council and Examining Board3... .......43 Dilatation of the Cervix Ute i s smenor a........... 327 The Western Medical Colleges ..8........ . 344 Lithotomy and Lithotrity Compared ..................... 327 Phosphorated Oil in Psoriasis ..........344 So-caled Ulceration of t tr............... .. .... 327 American Medical Association ......................... 345 Empyalemad eaino h 8Uei............. 28 Notes and Comments ............................... 344 346 8 a Thoracentesis.-Bowditch................. 328 Books and Pmphlets..... 346 Saxual Hypochondriasis ..................... ........... 330, Births, Marriages and Deaths .....34..... MOLLER'S PUfEST NORWEQ:iAN 00D4UVER 0n. DE BEscHE, Physician in ordinary to H. M. the King of Sweden and Norway, says . It the very best ever prepared for medicinal purposes.\" AnnoTTs SMITH, M.D., M.R.C.P., North London Consumption Hospital, says: \" It is more easily assimilated and is productive of more immediate benefit than the other kinds of ~ ohl are.\" DR. RUDDocKs, M.D., L.R.C.P., M.R.C.S., says: \"We are glad to be able to give our em- phatic recommendation to so pure a preparation.\" J. MÂRioN Si, M. D., New York, saya: ' I have prescribed it almost daily, and have every reason to be perfectly satisfied with it.'\" Da. L. A. SAYRE, New York, says: \"Moller, of Christiania prepares an 011 which is per. fectly pure, and In every respect all that can be wished.\" N. B. SAnDs, M.D., New York, says: \"It is remarkably free from impurities. W. H. Schieffelin \u0026 Co., NEW YORK. Sole Agents for United States and Canada. MICROSCOPES. JAMES W. QUEEN \u0026 CO., 924 Chestnut-St, - - - PRILADELPHIA. K EEP constantly in stock, the most complete assortment of MICROSCOPES and ACCESSORIES to be found in any house In the WORLD. In addition to their own Manufactures, they have always on hand Stands and Objectives by Powell \u0026 Lealand, Ross, Crouch, Hartnach, Nachett, etc., etc.; and being the exclusive Agents, for the United States, ei MsasRs. R. \u0026 J. BECK of London, keep in stock all the productions of these most eminent manufacturers. Also, over 10,000 PREPAigE OBE- IN EVERY DEPARTMENT OF THE SCIENCES. An illustrated and priced catalogue, of 118 pages, will be malled to any address on receipt of Ten Cents. Address as above. Anatomical Models and Osteological Preparations, SKELETON8, SKULLS, MIGROSCOPIO PREPARATION8. Special attention is hereby called to the fact, that we can supply a number of MEDICAL WORKS and CHARTS, either American, English or French Publications, at second-hand, at greatly reduced prices. W ORDERS FOR THE IMPORTATION OF BOOKS TAKEN. -@ Letters will be promptly answered and catalogues sent. Address BERENDSOHN BROS., 202 William Street, New York.",
         "THE CANADA LANCET. 3 WILLING \u0026 WILLIAMSON'S NEW MEDICAL WORKS. PAGET.-Clinical Lectures and Essays, by Sir James Paget, Bart. Edited by Howard Marsh,, F.R.C.S., $5.00. WAGNER.-Manual of General Pathology. For the use of students and practitioners of Medicine. By Ernest Wagner, M.D., $5.50. BILLROTH.-General Surgical Pathology and Therapeutics, in fifty lectures. A text book for students and physicians. Translated and revised from the sixth German edition ; by Chas. E. Hackley, M.D., $5.00. HOSPITAL PLANS.-Five essays relating to the construction, organization, and management of Hos- pitals. Cqntributed for the use of the Johns Hopkin's Hospital of Baltimore, $6.00. VAN BUREN \u0026 KEYES.-Diseases of the genito-urinary organs, with Syphilis. With engravings and cases, $5.00. SEGUIN-Medical Thermometry and Human Temperature. By E. Seguin, M.D., $3.50. SALTER-Dental Pathology and Surgery. By J. A. Salter, M.B., F.R.S., $4.50. TAYLOR.-Syphilitic lesions of the osseous system in infants and young children. By R. W. Taylor, M.D., $2.50. LORING.-Determination of the refraction of the eye, by means of the ophthalmoscope, 50C. net. LOOMIS.-Lectures on the respiratory organs, heart and kidneys. By A. L Loomis, M.D., $5.00. RINGER.-A handbook nf Therapeuties. By Sydney Ringer, M.D., 4th ed., $4.25. WILLING \u0026 WILLIAMSON 12 King. Street East, Toronto.",
         "4 THE CANADA LANCET. CODMAN \u0026 SHURTLEFF'S Atomization of Liquids for Inhalation, Local Anaesthesia, \u0026c. BY the Atomizer, any medicated liquid may be converted into the finest spray. In this state It may be inhaled into the smallest air-cells, thus opening a new era ln the treatment of all diseases of the throat and lungs. (Fig. 15). It consists of the sphere-shaped brass boiler A, steami outlet tube B, with packing box C, wK_ formed to receive rubber packing through which the atomizing tube D passes, stean tight, g and hy means of which tubes, of various sizes, may be tightly held agaitNt any force of steam, by screwing down the cover while the packing is warm ; the safety-valve E, capable of gradua- tion to high or Iow pressure by the spring or screw in its top, the non-conducting handle, by which the boiler may be lifted while hot, the medicament cup and cup-holder G, the support H, iron base I 1, the glass face-shield J, with oval mouth-piece connected by the elastic band Kwith the cradie L, whose slotted staff passes into a slot ln the shield-atand M M, where it may be fixed at any height or angle required by the milled screw N. H Thewasteu medicamentcup andlampareheld in their places insuch a manner that they cannot fiout when the apparatua ia carried or used over a bed or otherwise. Fig 15 Th cople tea Atomizer.p Ail its joints a;re bard soldered. It cannot be injured b:, exhbaustion of water, or any attainable pressure of steam. It does not throw splrts of bot water, to frighten or acald the patient. Is compact and portable, occupies -pace of one-sixth cubi foot only, can be carried from place to place without removing the atomising tube or the G water, can be unpacked and repacked without loss of time. Will render the best of service for many years, and is ebeap in to best sense of the word. Price ; brasa Fig. 15. Thie complote Steani Atonzer. parts, nickel plated, addi\u002b!pnal, $2.50. Neatly made, strong black walnut box, with convenient handle, addif al $2.50. 8 The most desirable band apparatus. Rubber warranted of very best A -, p quality. Valves imperishable, every one carefully fitted to its seat and work perfectly in all positions. The bulbs are adapted to al the tubes made by us for Local Anaosthesia in Surgical Operations, Teeth Extraction and Iu- halation. Price $4.00. Each of the above Apparatus i supplied with two C carefully made annealed glass atomising tubes, and accompanied with di- rections for use. E ss..I \u0026 8URTLEUF. D Every steam Apparatus is tested with steam, at very high pressure. Each E m ON. apparatus ia carefully packed for transportation, and warranted perfect. Also, HAND BALL APPARATUS, (Fig. 5, without ahield) with two glass tubes. ................................. ............................$3 50 THE BOSTON ATOMIZER with two glass Atomising tubes ...... 2 50 Fig. 5. Shurtleff's Atoiizing Apparatus. \" TREMONT 4 \" ........ 2 00 Pat. March 24, 1868. GLASS ATOMIZING TUBES, to fit any of our Apparatus, warranted ct......................................................... ................................... 25 PERFUME ATOMIZER, nickel plated, for toilet use ........ ................ .. ..........................150 SILVER SPRAY \"...................1 50 NICKEL PLATED TUBES, for Local Animathesia and for Inhalation..... .. ...................... ....75e. to 2 00 RHIGOLENE. for Local Anoesthesia, best quality, packed .................................... ........................... I00 NASAL DOUCHE, for deating diseases of the Nasal Cavity, eight different varieties, each with two nozzles packed $1.20, $1.50, 2.00, 2.50 and 3 50 N.B.-To save collection expenses, funds should be sent with the order, either iu fori of draft, post-office order, or registered etter. WM For complete iilustrated price-list of Apparatus, Tubes, \u0026c., see pamphlet. Will send by mail (post-paid), on application, a pamphlet containing two articles, by distinguished foreign autbority, on * Inhalation of Atomized Liquids,\" with formulS of those successfully employed. Also, an article by Dr. L. W. Thudichum, M.R. C.P., on \"A New Mode of Treating Diseases of the Nasal Cavity,\" with hie formulie. Also an illustrated description of the bost Apparatuse for the above purposes, and for producing Local Anathesia by Atomisation of Rhigolene. Instruments made to order, Sharpenedl, Polished, and Repaired. An Illustrated Catalogue of Surgical and Atomizing Instruments sent by mail, postpaid, on application. CODMAN \u0026 SHURTLEFF, Makers and Importers of Surgical and Dental Instruments, 13 and 15 TREMONT STRIERT, BOSTON. H. J. ROSE, corner Queen and Yonge Streets, Toronto, Agent for the Instruments, also the Pamphlet mentioned. . H. gGBGTHE CENTRAL PHARMACY. MANUFACTURER OF AND Chemists and Druggists ORTHOPCEDICAL INSTRUMENTS, rog SOUTH E-IGHTH STREET, PHILADELPHIA. Corner of Queen and Elizabeth Streets, Toronto, SAVE on band the following new remedies which will Aspirators, Axilla Thermometers, Hypodermic Syringes, . be sent to any address in all quantities, Nelaton's Catheters, Plaited Satin Sewing Silk for Surgical purposes, Hawksley's Metallie Cincho-Quinine, Mono-Bromide Camphor, Stethoscopes, Elastie Stockings, Guarana, Jaborandi. Apparatus for Club Foot, Croton-Chloral Hydrate, Sallcyllc Acid, BouLegs, Spine \u0026c., \u0026c., \u0026c. Diseases, \u0026c. Special attention given to Physicians' prescriptions for Office use, such as Elixirs, Fluid Extracts, Illustrated Catalogue and Price List sent on application. ' Pilla, t3yrups, etc.",
         "THE CANADA LANCET. University of Pennsylvania--Medical Departmentu Thirty-sixth and Locust Streets, Philadelphia. 111TH ANNUAL SESSION. MEDICAL FACULTV. GEORGE B. WOOD, M.D., LL.i)., Emeritus Professorof Theory and Practice of Medicine ; HENRY H. SMITH, M.D., Emeritus Professor of Surgery ; JOSEPH CARSON, M.D., Emeritus Professor of Materia Medica and Pharmacy. ROBERT E. ROGERS, M. D., Prof. of Chemistry ; JOSEPH LEIDY, M. D., LL. D., Professor of Anatomy ; FRANCIS G. SMITH, M.D., Pr(f. of Institutes of Medicine ; R. A. F. PENROSE, M.D., LL.D., Prof. of Obstetrics and Diseases of Women and Children; ALFRED STILLE, M.D., Prof. of Theory and Practice of Medicine and Clinical Medicine; D. HAYES AGNEW, M.D., LL. D., Prof. of Surgery and of Clinical Surgery ; HORATIO C. WOOD, M. D., Jr. Prof. of Materia Medica and Pharmacy; WILLIAM PEPPER, M.D., Prof. of Clinical Medicine; JOHN NEILL, M.D., Prof. of Clinical Surgery; WILLIAM GOODELL, M.D., Clinical Professor of Diseases of Women and Children ; JAMES TYSON, M.D., Prof. of General Pathology and Morbid Anatomy. Demonstrator of Anatomy, H. LENOX HODGE, M.D. ; of Surgery, CHARLES T. HUNTER, M.D. ; of Practical Chemistry, GEORGE M. WARD, M.D. ; of Experimental Physiology, ISAAC OTT, M.D. Clinical Instruction is given at the University Hospital by the above named Clinical Professors, and also on Diseases of the Eye, PROF. NORRIS ; Diseases of the Ear, PROF. STRAWBRIDGE ; Nervous Diseases, PROF. H. C. WOOD, JR.; Skin Diseases, PROF. L. H. DUHRING. Morbid Anatomy and Histology, PROF. J. TYSON. The Philadelphia Hospital also is contiguous to t' .. University, and its Clinical Lectures are free to al medical students. Students may be examined on the elementary branches at the end of the second course, and, if approved, may devote themselves during their third course to the applied branches only. THE RECENT ADDITION BY THE BOARD OF TRUSTEES OF SEVERAL NEW PROFESSORS TO THE FACULTY, WILL IM- POSE ON THE STUDENT NO INCREASE OF EXPENSE OR DURATION OF STUDY, OR OTHER EXAMINATIONS FOR THE DEGREE THAN HAVE HITHERTO BEEN REQUIRED. During the Spring and Summer, Lectures on Zoology and Comparative Anatomy, Botany, Hygiene, Medical Juris- prudence and Toxicology, and Geology, are delivered by Professors ALLEN WoOD, HARTSHORNE, REESE and HOWELL, of the Auxiliary Faculty, and are free to matriculants of the Medical Department. The Lectules of 1876-77 will commence on Monday, October 2d, and end on the last day of February ensuing. FEES.-For one full course, $140 ; or for each professor's ticket separately, $20. Matriculation fee (paid once only), $5. These fees are payable in advance. Graduation fee, $30. Letters of inquiry should be addressed to ROBERT E. ROGERS, M.D., DEAN, P. O. Box 2838, Philadelphia. E trn-Medini Instrumpnts DR. MARTIN'S COW-POX VIRUS ec and Batteries. Absolutely Pure Non-Humanized Vaccine Virus, Obtained by the method of TRUE ANIMAL VACCINATION, FL E M M IN C \u0026 TA LBOT, Instituted by Prof. Depaul of Paris, in April, 1866, from the No. 814 F/LBERT STREET, PH/LA DELPHIA. famous case of Spontaneous Cow-Pox at Beaugency, in France, and inaugurated in America in September, 1870, by Dr. Henry A. Martin, with virus and autograph instructions .from the hand of Prof. Depaul. Our establishment is by far AVING largely increased our manufacturing facilities, the largestand most perfet in the world. la we are now prepared to furnish the finest work, with the latest improvements, on reasonable terms. LARGE IVORY \" LANCET\" POINTS, PACKAGES OF Portable Galvanic, Faradic, and Caustic Batteries, with 10..................................$2.00. complete applying apparatus, and Electrodes and Conduc- tors, in all their varieties, constantly on hand. PRIMARY CRUSTS (SCABS), MOST CAREFULLY Contracts made for the erection of permanent batteries in SELECTED.....................$5.00. 'hospitals, colleges, and private offices. All Virus is fully warranted efficient. It will be packed A full supply of Electro-Medical Books always in store. to go with perfect safety by mail. Pull directions for use Communications by mail promptly attended to. Send for accompany each package. Remittances must accompany Catalogue. order. Safe delivery of Virus insured. DR. HENRY A. MARTIN \u0026 SON, E8TABLI8HED 1886. NEW YORK. Boston Highlands, Mass. H. PLANTEN \u0026 SON, Surgeon's Pocket Case for Sale-cheap. M EDICIN A L OA PSTJLES Surgeon's Pocket Case, entirey new, containing the no°lowin Anstruments-Slver Cateter, maie and femrale combined, an OF ALL KINqDS. ALSo, 1caustic HiolderCre ., ý-\u003e eoo (5 f h aKnife, Gum Lancet, Hamilton's Artery Forceps, Exploring Needle, Empty Capsules sizes), for the easy administration of Grooved Director, Pair of Scissors, 2 Silver Probes, 6 Needles, Skein nauseouS medicinal preparations. Silk \u0026c. Price $18. Ligt and S.m7ptes $ont on application. AV Sold by aIl Drugg1sts. ÂdÏdress Id.D., \" LnCET \" Office, Toronto. 1",
         "THE CANADA LANCET. e* * * * Sugar Coated Pis are more soluble than Gelatine or Compressed Pills.-Prof Remington's fper read belon- rneran P/iarrnaceutical Association, Bostopi, 1875. WARNÉR \u0026 COS PIL8. PHOSPHORUS Is an important constituent of the animal economy, particularly of the brain and nervous system, and is regarded as a valuable remedy for the following diseases: Lapse of Memory, mpotency, Softening of the Brain, Loss of Nerve Power, Phthisis, Paralysis and Neuralgia. Th Pilularform has been deemed the most desirable for the administration qf Phosphorus. It Io in a peifect state of subdivision, as it is incorporated with the material while in solution, and is not extinguished by oxidation. This method of preparing Phosphorus has been discovered and brought to PRFECTION by us, and is thus presented in Its elementary state, free from repulsive qualities, which have se long militated against the use of this potent and valuable remedy. This is a matter requiring the notice of the physician, and under all circumstances the adminig- tration of Phosphorus should be guarded with the greatest care, and a perfect preparation only used. Its use in the above named complaints, is su'pported by no less authority than Prof. Delpech, Prof. Fisher, to Berlin, Dr. Eames, (in the Dublin Journal,) Dr. Burgess, and Dr. Hammond, of New York. The speclal treatment indicated in these cases is: jet. Complete rest of mind, especially abstention from all occupations resembling that upon which the mind has been overworked; 2nd. The encouragement of any new hobby or study not lu itself pain- f, which the patient might select; 3rd. Tranquility to the senses, which expressly give in these cases incorrect Impressions, putting only those objecte before them calculated to soothe the mind ; 4th. A very nourishing diet, especially of shell-fieh; 5th. The internai administration qf Phosrphorus in Pilular form, prepared by WILLIAM R. WARNER J- T. m-PILLS SENT BY MAIL ON RECEIPT 0F LIST 0F PRIOES.-M Pli Phosphori, 1-100 gr. in eacb, Pil Phosphori, 1-50 \" \"' Pli Phosphori, 1-25 « « Pil Phosphori Comp. . Phosphorus, 1-100 gr. Ext. Nuc. Vomica, * gr. Pil Phosphori et Nucis Vomico, Phosphorus, 1.50 gr. Ext. Nuc. Vomicie, i kr. Pil Phosphori, et Ferri et Nuc. Vom. Phosphorus, 1-100 gr. Ferri Charb. (Vallet) 1 gr. Pil Phosphori, et Ferri et Quinia,. Phosphorus, 1-100 gr. Ferri Carb. (Vallet) 1 gr. Pil Phosphori et Ferri et Nuc. Vom. et Quinie, Phosphorus, 1-100 gr. Ferri Carb. (Vallet) 1 gr. Ext. Nue. Vom., J gr. Quinia Sulph., I gr. Price per 100. $1 00 1 00 .1 00 2 00 2 00 2 00 2 90 .2 90 Ext. Nuc. Vom., * gr. Quinla Sulph., 1 gr, Treatise on \" PHOSPHORUS; Its claims as a therapeutic agent.\" Furnished on application. Address, WMILAIM R. WARNER \u0026 aO., Manufacturing Chemists, No. 1228 Market St., Philadelphia. Warner \u0026 Co's. Standard Preparations for sale by ELLIOT \u0026 CO., Wholesale Druggists, ToRONTO, CANADA.",
         "THE CANADA LANCET. 7 HARVARD UNIVERSITY. MEDICAL DEPARTMENT-BSTON, MASS. Finety-Third Annual Announcernent,1876-77. FACULTY OF MEDICINE: CHARLES W. ELIOT, LL.D., President. HENRY P. BOWDITCH, M.D., Assi't. Prof. of Physiology, CALVIN ELLIS, M.D., Prof. of Clinical Medicine, Dean. CHARLES B. PORTER, M.D., Demoustrator of Auitomy, JOHN B. S. JACKSON, M.D., Prof. of Pathol. Anatomy. and Instruotor ln Snrgery. OLIVER W. HOLMES, M.D., Professor of Anatomy. PREDERIC I. KNIGHT, M.D., Instructor iu Percussion, HENRY J. BIGELOW, M.D., Professor of Surgery. Auscultation aud L'ryngoscopy. JOHN E. TYLER, M.D., Professor of Mental Diseases. J. COLLINS WARREN, M.D., Instructor in 8urgery. CHARLES E. BUCKINGHAM, M.D., Professor of Obstetrics REGINALD H. FITZ, M.D., Assistant Professor of Pathlo- and Medical Jurisprudence. gical Austomy. FRANCIS MINOT, M.D., Hersey Professor of the Theory WILLIAM L. RICHARDSON, M.D., Instructer in Clinioai and Practice of Medicine. Obstetrics. JOHN P. REYNOLDS, M.D., Instructor in Obstetrios. THOMAS DWIGHT, Jz., M.D., Ipgtruotor iu Histology. HENRY W. WILLIAMS, M.D., Prof. of Ophthalmology. EDWARD B. WOOD, M.D., Assistant Professor of Chemistry. DAVID W. CHEEVER, M.D., Prof. of Clinical Surgery. HENRY H. A. BEACH, M.D., Assistant Demoustrator of JAMES C. WHITE, M.D., Professor of Dermatology. Anstomy. ROBE.RT T. EDES, M.D., Prof. of Matona MediE. WILLIAM B. HILLS, M.D., Instructor lu Chemistry. nOther InstructorsI GEORGE H. F. MARKOE, NHstructor M MatItos Medica. FRANK W. DRAPER, M.D., Lecturer on Hygiene. TaE FOLLOWING GENTLEMEN GIVYU SPECCIIL CLINICAL 1NISTBUOTXoN: RFRANCIS B. GREENOUGH, M.D., ad EDWARD WIGGLESWORTH, J., M.D., Au Syphilis. JOHN O. GREE.L M.D., R Dd CLARENCE J. BLAKE, M.D., in Otology. JAMES R. CHADWICK, M.D., sud WILLIAM H. BAKER, M.D., u Disesses of Women. CHARLES P. PUTNAM, M.D., sud JOSEpH p. OLIVER, M.D., iu Disesses of Childreo SAMUEL G. WEBBER, M.D. ad JAMES J. PUTNAM, M.D., In Diseasof the Nervous Systemi. Eplan of Study as radically chaged iu 1871.* Instruction is no given by lectures, recitatiens, clinical teaohing -uEd practical exercises, distributed throughout the academie s. ar. This yearbegina September 28,1876, sud ends ou the lAst W.edesdsy Du June, 1877; it is divided into two equs terms, either of hich is more than equivalet to the former S RWinter Session,\" as regards the amount sd character of the instruction. The course of instruction has bse. greétly enlsrged, so as to exteud over three years, aud hss been so srranged as to carry the studeut progressively sud system- aticJlly from one Mubjet te snother lu s .it sud natur., order. In the subject of aatemy, histology, Jhem.stry, M nd pathologisi anatmy, laboratory work i lrgely .ubstituted for, or added to, the noua methods of instruction. Instead cf the custom.ry hastY oral examintion for the degree of Doctor of Mediciue, held at the end of the three year' peniod of study, a series of examinations ou aIl the main subject of medical instruction las been distibuted through the whole three years; sud every candidate for the degree muet Tass a sstisfsctory examintiu in every ne of the principal departmets of medical instruction durig hi e instu dys DIVISION 0FSTUDIES. F r ta Fir t Year-A tooy, Physiology uand General Chemistry. For t Second Year-Medical Chemistry, Matsit Medica, Ptthologicsl Anatomy, Clonical Medicine, Surgery sud Clinical Surgery. Fr tea Tird t esr-Therapeutis, Obstetria, Theory sud Practice of Mediciue, Clina Medic e, Surgery sud Clinical Surgery. Students ire dlvided into three classes, according to their time cf study aud proficiency. Students vho began their professional studies elsewbere, may be admitted to advtced standing; but ail persons ho pply for admission tc the second or third year's clyas must pa an examintion in the branches slready pursued by the class to vhich tey seek admission. Examinations ar held inu the following ordero At the end cf the first year-Aatomy, Physiology and general Chemistry. Por fhe secodyear-Medical Chemstry, Materia Medica, sud Pathological Anatomy. third yeTr-Therapeutis, Obstetriis, Theory and Practice cf Medicine, Clinic al Medicin e, and Surgery. Exainatins are ie hld before te opening of the S thool, begiuning September 27th. Students wh do net intend to effer themselves for a degree ii aise be received at any part cf the course, for eone term or more. Ady student may eobtain, ithout as examinastion, a certificate cf hi period cf connectinc aith the sedhol. REQUiiE S FOit A DEG in .-Every candidate mut be tety-oue years cf age; must have studied medicin thr fuAl years, have poet t leart -Ae continuons yesr at this School, have passed the required examienmtiins, sd have presented a thesis. h COU\"S1 \"R GRÂDUÂTyE.-Fr the purpose cf affording to those lready Graduates of Medicine, additioal facilitie for pusig clilical, lsboratory aud other atudiel, lu such subjects as may secialiy iuterest tbem, the Faouity bas est=~ise a course vhicb comprises the folloviug branches :--Physioloy, Medlical Cbemistry, Pathological Austemy, Surgery, Auscultation, Percussion ud Laryugoscopy, Opbthalmology, Otology, Hygiene, Dermatolegy, Syphilis, Pyscho- logical Medicine, alsctrotheraputc s Gyoecology eSd Obbteticn. Single branches may be pursued, sud ou payme t cf the ful o fe ause the tivilege of mtte.ding any cf the ther exercises cf the Medical SchOl, the usof its laboratories sd ibrary, ad ass ether rightr eccrded by the iuniveraiy piie be granted. Graduates cf other Medicat Shhools ho may desire t obtain he degree cf M.D. at this Uiversity, viii be admitted te examinatioli fer this degree ai'ter a year's study lu the Graduates' Course. FcURs.-For Matriculation, $p; for the Y ar, $200; for eoe Term en, $120; for Graduation, $30; for Gradutes, Course, the fee for euh year e $200, for eue Ter, $120 sud for single courses sncb fees al are specified i the C ta- logue. Payment lo ada btce. Members cf any ee departmeut cf Harvard Uiversity have a right te attend lectures sud raitatnlos lu thy other departeut o itheut paying additioui fees. For further information, or Catalogue, address DR. R. H. FITZ, Secretary,,108 Boyluton, Street, Boston, Mass. *In and after September, 1877, an examination on outrance will be required. For particulars see Catalogue.",
         "THE CANADA LANCET. SAVORY \u0026 MOORE, 143, New Bond Street, London, beg to call the attention of the Profession generally, to some of the later preparations brought out in England, the purity, and uniforrn strength of which can be guaranteed. GENUINE PANCREATIO EMULSION and PANCREATINE. The reputation of these preparations is now so thoroughly established, that they may be said to be the only remedies of the description recognized and prescribed by the leading members of the Medi:al Profession. No small ortion of their popularity is to be ascribed to the fact, that they are palatable to the most fastidious, keep good in ail c imates, and are readily miscible in water, milk, \u0026c. In ail cases where Cod Liver Oil fails to afford relief, or cannot be retained by the stomach, Pancreatic Emulsion and Pancreatine are the only remediea to supply its place, increasing weight, and ensuring strength and appetite ; whilst in many cases they prove a most valuable adjunct to the Oil, which they asuist in digesting. PANCREATINE W INE. A most pleasant vehicle for administering Cod Liver Oil, with which prescribed by itself will be found to be a powerful assistant to digestion, and as a remedy for this purpose in largely used in England. PAN RE.ATISED COD LIVER OIL * A reliabl. combination of Pancreatine with the * Oil, rendering its digestion easy and rapid. PEPTODYN, the New Digestive Digests all kinds of Food-the FARINACEoUS, FIBRINOUS, 1,adOLEÂQGINOUS, (being a combination of thé several active principles of the difestive secretions, Peptic, Pancreatie, \u0026c.) Five grains of the Powder digests-100 grains of Coagulated Albumen, 100 grains of Fat, 100 grains of Starch. BEST FOOD FOR INFANTS As Supplied to the Royal Families of England and Russia. B Feeding Infants on the best, i. e. the most nouriahing and easily digested Food, has recently occupied much of the attention of the Profession, and the fallacy and danger of employing Starck, in the form of Corn Flour and other high-sounding titles, has been repeatedly pointed out. This Food resembles Mother's Milk more closely than any other kind, containing the highest amount of nourishment in the most digestible and convenient form. DATURA TATULA, for Asthma and Chronic Bronchitis. Recommended by the Profession as a remedy of great power and usefuiness in cases of short and difficult breathing, spasmodic coughing, \u0026c. Grown only by Savory and Moore, and prepared in all forms for smoking and inhalation. Wholesale of Messrs LYMAN, CLARE \u0026 Co., and Retail of the Principal Druggists in the Dominion and America. DETROIT Me0dioad Gollogo SESSIONS OF 1876-77. PRELIMINARY SESSION opens September oth, and continues one month. REGULAR SESSION opens October 4th, and continues live months. RECITATION SESSION opens second Wednesday in March, 1877, and continues four months. Three Hospitals and two large free dispensaries furnish an abundance of clinical material for illuetrative and practical teaching. One or more clinics held daily. a Al lecture# are delivered on Hospital grounda. Senior etudents have daily practice in the art of examining patienut. The peculiar feature of this school is the intimate union between its clinical and didactic instruction. FEES for Preliminary and Regular Sessions : Matricula- tion, $5; Hospital fees (good for one year), $10; Lecture fees,'$40; Graduation, $25; Lecture fees to third course students, $25. For the recitation term, the lecture fees are $10 to those who attend the other courses. Al others are required to matriculate and take out Hospital tickets. Announcement or further information can be promptly obtained by addressing \u0026 LEARTUS CONNOR, M.D., Secretary, 94 Casa Street, Detroit, Mich. JOHN REYNDERS \u0026 CO., (Late of Otto \u0026 Reynders,) No. 309 Fourth Avenue, New York, U NDER THE COLLEGE OF PHYSICIANS AND SURGEONS,) Manufacturers and Importers of SURGICAL AND Orthopoedical Instruments, SKELETONS, AND ANATOMICAL PREPARATIONS. 'iae Manufacture and Importation of every article used by Physicians and Surgeons our Specialties. . Our Illustrated Catalogue and Price LiSt mailed on application, eclosing twelve cents for Postage.",
         "THE CANADA LANCET. 317 THE CANADA LANCET. A MONTHLY JOURNAL OF MEDICAL AND SURGICAL SCIENCE. VIII. TORONTO, JULY IST, 1876. No. ii. Original mmuaio . 41DRESS AT THE JUNE MEETING OF TIIE BATHURST AND RIDEAU MEDI- CAL ASSOCIATION, PERTH. J. A. GRANT, M.D., F.R.C.S. EDIN., PRESIDENT. GENTLEMEN,-Five months have now elapsed ýeCe our meeting at Ottawa City. During that Se the active intellectual capacity of the \" work- ITen \" of our noble profession has been oc.. LPied and the results of honorable labor scattered btadcast throughout our British, American and nadian publications. Doubtless the new mate- Of thought has already been before you and has eived timely consideration. To-day I shall eyfly occupy your time by adverting to sorne facts edical and surgical, more as a refresher in the dat of our professional duties, and at the same e to elicit the observation and experience of e members of this Division equally interested the promotion of scientific professional work. leeding,\" within the last twenty years in the mtIMent of acute inflammatory diseases, has un- ergne marked modifications, some of which are tdoulbtfu character. The day was when the lan- tWas used too indiscriminately, and in many %tanuces the injurious resuits, no doubt, led to the alOst entire suspension of one great means of ar- tg the progress of inflammatory action. It is wknown fact, at present, on both sides of the rtic, that the mortality from pleuro-pneumonia, nitis and other inflammatory attacks of vital is very considerable in previously robust Vg\u003corous subjects. In England so much has been the case that bleeding even in the first t of acute diseases condemned in hospital %d d Private practice, is ïow being justly and ably hys idered, by master minds in pathology and 0logy. The address of Sir James Paget, before the meeting of the British Medical Associa- tion in 1874, at Norwich, is pregnant with valuable practical observation, in which he places consider- able stress on the importance of bleeding, when adopted under the guidance of sound medical in- telligence. Again we have the published papers of Dr. Richardson, F.R.S., on the saine subject in which he adduces cogent facts to substantiate the benefit and advantage of bleeding in many acute diseases. In 1856, Professor Alinson wrote in the Edinburgh Medical Journal, that our advanced knowledge of diagnosis and pathology had little to do with the great revolution in treatment, but that the \" human constitution \" was fundamentally altered, and that medical men were as right in bleeding twenty.years before his day as they are correct now in not having recourse to the \" lancet.\" Stokes of Dublin has since expressed the same idea in modified terms. Cullen and Gregory have been ridiculed by their successors from their supposed want of a knowledge of the true physiology and pathology of the great inflammatory process. Their ideas, however crude and rudimentary as they were, had at their base some strong principles of common sense. In 1840, Sir Henry Holland stated that \" current opinions and prejudices were wholly on the side of bleeding,\" and that a physi- cian needs all his firmness to decline the practice. To-day we are aware of the fact that bleeding is considered not fashionable. Dr. Bennet, of Edin- burgh, who, prior to his demise, deprecated the practice of large bleedings, admitted that moderate bleeding may be useful in palliating certain sym- ptoms particularly in the treatment of uterine afec- tions. Tilt, in his \" Uterine Therapeutics \" re- fers, particularly to the benefit of moderate bleed- ing in plethoric patients when the uterine f unction is associated with pelvic pains and well-defined dysmenorrha. His experience points to bleed- ing in such cases a few days prior to the \"Cata- menia.\" Dr. G. Bedford also favors bleeding in certain diseases of menstruation. With the ad- vanced medical education of the present,,and the various means at our disposal for the diagnosis of disease, would we not likely fall into the error of bleeding the chlorotic and nervous, and how neces- sary is caution in this small operation, when we recognize the fact thatplethora may exist with apparent weakness and be greatly 'relieved by bleeding. We have all seen and treated acute THE CANAD3A LANCET. 317",
         "318 THE CANADA LANCET. cases of pneumonic disease, during our Canadian winters. For many years I adhered to the oh- servations of the late Dr. Bennet and others, but circumstances have caused me to change my ideas somewhat and have recourse to the lancet. My notes of several cases of acute pulmonary conges- tion point to marked benefit from early bleeding, and I am satisfied that there are few cases of acute local congestion, in robust subjects, in which bleed- ing if adopted sufficiently early, will not be pro- ductive of beneficial results, tending towards the suspension of excessive vascular action and the prevention of tissue disorganization. Sir Thomas Watson, (May 1875, Med. Times) writes: \"The complete disuse (of bleeding) was in his judgment a more serious mistake than over use had been.\" Under these circumstances it would be well in our medical district, to observe as closely as possible and report upon the present influence of bleeding in acute diseases. Of the various diseases which come under our notice in this part of Canada, \" Rheumatism \" is not by any means the least uncommon. The sud- den transition from summer to winter, and the want of proper care in keeping up the normal tem- perature of the body, by warm flannel clothing, add greatly to the frequency of such attacks. In addition to these causes I have frequently observed both in hospital and private practice, that the ex- cessive use of spirituous liquors, was a prolific source of this disease, in its various forms. Ac- cording to the recognized pathology of rheumatism there is a certain constitutional state dependent on deranged digestion, during which, exciting causes, occasion local effects, and thus a disturbed balance is brought about, between the excess of lithic acid and the po*er of excretion by the skin. Although the generally accepted idea of the pathology of rheumatism points towards a blood disease, there does appear to be difficulty in defining the precise manifestations of a well defined acute attack, where in addition to the usual constitutional symptoms, there is local pain, keat, redness and swelling. Professor Bennet of Edinburgh after most careful observation came to the conclusion (vide Clinical Med.) that the real pathology of acute rheumatism has yet to be determined, and as a preliminary step, a careful hist,[ogical examination of the affected tissues, was absolutely necessary Rheumatic poison has a most singular predilection for three textures of the body ; two of which are chiefly WD- volved in locomotion, and the other the important covering to the most vital part of the entire sys- tem. Again, fibrous, serous and even muscular tissues are, under a normal state of the systeri, nourished, supported and repaired, in proportiO0 to their structural peculiarities. Thus have I eI' deavoured to account for the difficulty experienced in this disease, around the joints. In the laboratOry of the human system, the chemical changes are varied and remarkable and during abnormal ie' flammatory action, how greatly in such structure$ must the process of vital activity be retarded, de' layed, and complicated. During the last half century, no disease has called forth for its relief a greater variety of remedies. Of the new, one O the most popular at present in rheumatism '0 salicylic acid, just introduced to the profession by Staff Surgeon Stricker, of Berlin, January 3rd, 187 The results in the wards of the late Professor Traube, of Berlin, were exceedingly satisfactrl and from the reports published is the followin% statement : \"Al the patients treated were not o1iy relieved of their fever, but also of the local syll' toms, that is, the swelling, redness, and espec\" ally the Painfuljoints, within forty-eight hours, rOst of them within a much shorter period. ed largest quantity of pure salicylic acid which '00 found necessary to produce the effect, was fifte grammes, and the smallest 5 grammes ; but tløt even larger quantities can be taken internally. ' Stricker does not pretend to express any opinida' present on the effect exerted by the acid on t cardiac complications of rheumatic fever. Dr. Reiss, of Berlin, points out that the action of sali lic acid must be more than purely symptomatic, siIo in some cases a single dose, not only permanendly reduced the temperature, but also was followed be general improvement in the patients condit id' Professor Kohler, of Halle, has investigated t action of salicylic acid carefully, and the result O his observations, point to the important facts, both salicylic acid, and salicylate of soda, wIh injected into the blood of rabbits, cause a lf e blood pressure ; a diminution in the frequencY the pulse, and respirations. The soda salt lem equally well whether injecgd into the jugular O or taken into the stomach, whereas the solUtio' the pure acid in water has no effect when given bl the stomach either as to lessening the pu1le\u003eof 318 THE CANADA LANCET.",
         "TUE CANADA LANCET. 319 reducing blood pressure. According to Kohler, it s considered almost certain that salicylic acid be- 'oes converted into its soda salt by combination *ith the alkalies present in the intestinal secretions, ed that it is thus absorbed into the blood, and Produces its physiological action. The data of liess,Goldhammer and Nathan donot exactly agree; hOwever, the impression now formed is, thqt sali- clate of soda, is most likely to become a valuable '%ti-febrile remedy, and Professor Kohler predicts for it, a great future, as a means of reducing the teraperature of the body. Time and experience will alone settle the place \"4d power of this new and interesting compound '-and if in the perverted laws of nature, and the diturbed chemical affinities of the system, so re- rkable in \" rheumatic fever,\" this acid and soda bse can rapidly and certainly regulate the sys- teIIic disturbance, science has achieved a lever- ý9e over disease of which our age should feel g'hly gratified. erAT EMBOLIsM.-Since the valuable observations lf Virchow, issued in his \" Cellular Pathology,\" the Ibject of embolism has been brought prominently %der the notice of the profession, and thus we have plained the local obstructions to circulation, so equently taking place after acute rheumatism, ty- Oid fever, and the not uncommon attacks of 1eler, shortly after parturition. Thus we have either to deal with the fragment of a thrombùs, 'dged in most likely at the bifurcation of a large tery or the fragments of a coagulum in more or ess altered condition (by a species of crumbling r'ocess) finding their way into smaller branches of the arteries and giving rise to consequences pro- Portionate to the extent and peculiarity of the ob- Stniction. Recently the interesting subject of em- soliSm has taken a new phase and come under the tice of the surgeon as well as the physician. The investigation of the cause of sudden death rter fractures of the long bones has brought to St quite a new pathological feature of intense Interest. In 1862, Genker and Wagner, two an pathologists, discovered that embolism '%ld be produced in the lungs by fat, introduced tO the venous circulation. In 185;6, F. Busch Ually published a case in the Berlin Medical °ournal, in which death resulted from fat embolism, d pròved that in fractures of the long bones the contained in the crushed marrow can be absorbed by the veins, carried thus to the lungs, and there induce embolic changes, sufficient to cause death. For some time the idea of death from fat embolism attracted little attention, how- ever, the recent paper of Professor Czerrny, of. Freiburg, has given fresh interest to this subject, as one worthy of close clinical examination. \" We must, therefore,\" says Czerrny, \"remember the possibility of fat embolism, when a patient with an injury of the bones becomes suddenly worse, without assignable cause, a day or two after the accident and when the symptoms point to circula- tory disturbances, first in the lungs and secondly in the capillaries of certain parts of the general system. However, we can only be certain of such cause of death, by the post mortem appearance. Sufficient has already been written on this subject to call forth vigorous investigation, in which line of thought some of our young surgeons may earn con- siderable distinction. The optical department of atmosphere in rela- tion to the \" Phen: mena of Putrefaction and Infec- tion,\" is the heading of the recent interesting and attractive lecture of Professor Tyndall, at the Royal Society. The experiments of 1868 and 1869 into the decompositions of vapors by light brought about the necessity of procuring some optical pure air. The careful study of Tyndall's experiments opens up many new and interesting lines of thought, pregnant with material intim'ately associated with both practical medicine and sur- gery. Many years ago Pasteur pointed out that the air of cellars, long undisturbed, was in a great measure destitute of germs, and recently Tyndall has demonstrated that if the chamber containing air was smeared with glycerine and kept quiet for a few days, it would become optically pure; he also pointed out the important fact that expired air is optically pure. The practical result of his careful observations, is that \"the power of scatteringlight and the power of producing lite. go hand in hand.\" His experi- ments consisted of boiling fully more than one hundred different infusions in optically pure air and then exposing them in the same air. He then boiled the same infusions in ordinary air and exposed them freely after boiling. Those from the optically pure air remained fresh and free from organic life, whereas a few days sufficed to develop in the other infusions, not only putrefaction, but 319 THIE CANADA LANCET.",
         "320 THE CANADA LANCET. swarms of bacteria as well. Professor Tyndall now directs attention to the fact that there are particles floating in the air, too fine to be recog- nized by the microscope and yet capable of acting on light, and he favors the opinion that these small ultra-microscopic particles are probably the germs of low organisms. The success of Listers antiseptic treatment is based on the destruction of these low organisms, which introduced into a wound, promote suppuration and materially retard the healing process. Professor Vussbaun, of Munich, has just issued an able pamphlet des- cribing the successful results obtained in surgery since the introduction of Lister's system. Although the treatment is expensive from the high price of materials employed, yet it is the cheapest for hos- pital use, owing to the shorter period required in the treatment of surgical cases. The observations of Dr. Maclagan, at the Pathological Society, May, 1875, Med. Times,) correspond exactly with the recent ideas of Tyndall, inasmuch as he ex- pressed the idea, \" that the organisms which pro- duce the phenomena of disease are not those which we see and describe as bacteria, but other and more minute organisms, and.\" he says, \" in- deed, it is still an open question whether diseased germs have ever been seen, of their existence wejudge by the phenomena to which they give rise.\" The influence of unseen atmospheric particles or forms is no longer a matter of doubt. Such have a place and power, still the precise modus operandi re- quires much extended observation, in order to sift truth from error, and with the rapid scientific strides of our age we must ackriowledge that \" there are more things in heaven and earth than are dreamt of in ourphilosophy.\" AMMONIATED TINCTURE OF GUIACUM IN INFLAMMATION OF THE THROAT. BY J. H. GARNER, M.D., LUCKNOW. I observed in your issue of June ist, a few lines on a \" remedy for chronic hoarseness.\" Ammoni- ated tincture of guiacum, in inflamed throats, whether acute or chronic, seems a remedy that is totally unknown to some practitioners, and wholly ignored by othèrs. In fact, the profession seems to have forgotten, to a great degree, that tr, guaiaci ammoniata exists at al. Through youi columns, I beg to submit my experience of this remedy for the last quarter of a century, and would ask my brethren in the profession to give it a fair trial, and see if their experience does not fully correspond with mine. \" In cases of chronic hoarseness,\" I use it with almost invariable success in the form of a gargle. A clergyman in this sec- ticn was always, after preaching, much troubled with hoarseness. He applied to a practitioner Of high standing, who excised the uvula. This gave no relief, and he was often, he said, in agony after service. On examining the fauces, the tonsils were enlarged and flabby, the arch, and as far as visi- ble of the fauces was of a deep rusty red, with small white spots. Hé was very hoarse, and had at intervals spasmodic twitching in the tongue and throat. I gave the following gargle : Z-Tr. Guaiaci Ammon., 3iij. Liq. Potas., 3iij. Tr. Opii, gij. Aq. Cinnam., ad. 3 viij.-M. Fiat garg. Utend om. hora. The liq. potassa helps greatly to keep the gulO dissolved, otherwise it would separate, in small black lumps of gum. He was relieved the first time he used it, and in forty-eight hours, was per- fectly well. In his case the hoarseness was prO- duced by public speaking, and had annoyed hi0 for some years ; in fact, so much so, that he told me he would be compelled, from the irritation Of the vocal cords, to forego the ministry, if he did not obtain relief; but the use of the gargle perfect' ly cured him. Others of his profession were also relieved by this prescription. I use this remedy in inflamed throats, and find it most powerful as a remedy in all sorts of inflae mation of the fauces. In the first stages of quifl its action is astonishing. It seems to scatter the disease at once. Of course if pus has been forned it cannot be expected to cause absorption, but t will allay the inflammation, and give speedY re lief. I do not mean to say that tr. guaiaci. ae' will entirely stop inflammatory action in quinsl' but I do say that the irritation and choking sense' tion are very much relieved. In cases of inflamed tonsils, and sore throat, when produced by, or accompanying measle scarlatina, cynanche parotidis, and croup, 1 ts the pure tincture, as follows : Tie a bit of spO0%g or rag on the end of a stick, and saturate THE CANADA LANCET. 320",
         "THE CANADA LANCET. 321 thoroughly, then holding down the root of the tongue with the handle of a tablespoon, I apply the tincture freely to the fauces. This produces a momentary asphyxiation, but when the patient gives a cough, it is gone. In general this is repea- ted every hour or two, according to circumstances. It is common for practitioners, to have young ladies apply to them for hoarseness and sore throat, arising from, or in connexion, with suppres- sed menstruation. In many cases, this will be found a very annoying trouble and difficult to re- lieve. In such cases, in addition to the above treatment, I use the following: Z-Ferri, Sulph. 3j. Spt. Ather Nitros, 3ss. Morph. Sulph., gr.iij. Infus. Gent. ad., 3xij. M. Sig.-Coch. mag. ter, quaterve, in die. The bowels are relieved if necessary, by a few grains of hydr. chlor. and pulv. scam. In common colds with distressing cough, in Whooping-cough, and hectic irritation from phth- isis, a gargle of tr. guaiaci. am., although it rnay not exactly cure, will wonderfully relieve, and is well worthy of trial. If a portion of the gargle Passes down the œsophagus, all the better. But the longer it is in actual contact with the irritated fauces, the better will be the result. I have read with much pleasure in the June issue Of your journal, a synopsis of a paper by Dr. C. E. lillington, on Diphtheria, read by that gentle- Inan at the New York Academy of Medicine. As far as my own experience of diphtheria is concern- ed, it is a rare disease ; yet it is astonishing the Ieumber of cases of this virulent disease that come lnder the care of some practitioners. In fact, When unable to tell what is the matter with the Patient, the disease is immediately dubbed \" diph- theria,\" and the Gordian knot is at once severed. San sorry to say that my faith in reported and P'blished cases of \" diphtheria\" is by no means \"l¼bounded. I have seen cases of common sore throat, croup, laryngitis, measles, inflammation ol the lungs, pericarditis, mumps, scarlatina and bronchitis, as well as typhoid fever, all distinctl treated as this ubiquitous diphtheria. I recolleci that when a severe cold first received the name o: influenza,\" some thirty years ago or more, il eas unfashionable to have any other disease, es Pecially among the gentler sex, and nervous olc bachelors. At present, diphtheria is \" extremdy \"' fashionable, which being the case, we shall take for granted that all those cases reported by Dr. Billington are correct. In the last thirty years of steady practice, I have only met six cases, that I could fairly say were true diphtheria. In various sections around me, I hear occasionally of medical men who have dozens of patients with this disease ; but when they or their friends come to me, I can only find a moder- ate cold, or mild sore throat, and not unfrequently a throat irritated by caustic, which in a day or two, yields to a gargle of tr. guiac. am., with a gentle laxative. I agree with Dr. Billington, that diphtheria is a truly local disease ; that the local affection commences first, and that the gravity of the symptoms is in proportion to the severity of the disease, as seen in the fauces. The first symptoms are uneasiness and a choking sen- sation, a reddish spot follows, on which a white and sinall speck forms ; under this the part be- comes black, the breath is very fœtid; swelling in- creases ; severe typhoid symptoms succeed ; then rapid prostration, syncope, and death. In my humble opinion, it is rapid mortification, to a great extent, of the fauces. There is evidently a poison- ous and virulent ichor produced, and this being absorbed by the system, as well as by the lungs, soon ends in death. I am not aware at the present moment of the nature of the ichor or pus in diphtheria, whether it be acid or alkaline. It is a well-known fact that the ichor in erysipelas is powerfully alkaline. Al that any one has to do, to prove it, is to scratch the first case he sees with a lancet, and after the blood ceases to come, a clear bead of ichor dis- tils, which, by testing with a bit of litmus paper, the deep blue is struck in a moment. Erysipelas then,is nothing more or less than an alkaline and vir- ulent ichor, produced in the true cutis, which rapid- ly increases in quantity, and spreads. The treat. ment advocated by Dr. Billington in diphtheria seems to be systemic, by the tr. ferri. mur., and local, by the carbolic acid and liq calcis, the for- mer acting as in erysipelas, by counteracting the alkali in the blood, and the latter as a local irri- 1 tant. As I have no experience in the tincture of t iron treatment, nor in the carbolic acid, I shall - say nothing, except that reason seems to go with it. In my own cases two died, and four recovered. 321 THE CANADA LANCET.",
         "322 TE CAADA LNCEà I was called to see a young woman, (Miss B.), some years ago, the messenger stating that her throat was closing, and inflamed. I took some am. tinc- ture of guaiacum with me, and on arriving found her dying. I used the sponge and gave relief, but she was gone beyond the aid of treatment, and died within an hour. It was true diphtheria. Her sister and another young lady were now com- plaining, and the throats of both on examination had the small white spots on a red and tumid base. I used the sponge till the fauces were consider- ably denuded of epithelium, and bled, and they both recovered after using the sponge a few times, at an hour's interval. I followed up the treatment by a mild cough mixture, adding a few grains of quinine, and three drachms of acid sulph. aromat. They were all under 15 years of age. The next patient was also a girl about 8 years old (Miss L.), who by exactly similar treatment re- covered. The other two were boys, aged 6 and 8 years respectively. I treated them alike, but one was sinking and died very soon after I arrived ; the other recovered quickly. Am. tinct. guaiac., on being rubbed on the fauces, seems to act by chang- ing the character of the inflammation from a mortifying type, and restoring it to a healthy one. The fœtor soon ceases, the swelling subsides, the pulse becomes easy and reduced, the anxiety and langour of expression vanish, the breathing ceases to be laborious, and strength returns. A good nurse does more for recovery than the doc- tor, in such circumstances. I cannot understand the use of caustics here. In fact, I consider them, in inflammation of the fauces, only in the light of a virulent and irritant poison, when applied crude, and have little faith in their use, except in syphilis. I am sure the generality of experienced practition- ers, will agree with rie on this point. Diphtheria, as far as I have seen, gives no time for parley. It demands vigorous treatment. The typhoid pu- tridity of the fauces must be banished at once, and a healthy state produced, and I am not aware of any agent that acts with the almost magical rapidity of this much neglected remedy. In conclusion, I may remark, that many medi- cal practitioners are seeking new things as reine- dies, regardless of the virtue they possess. To the Editor of the CANADA LAINCET. SIR,-I observe from the report of the proceed- ings of the Medical Council in the daily paperS, that the Examining Board has again been appointed in great measure from among the members of the Council, and that the principle of appointing out- siders has been entirely ignored. The medical profession throughout the entire Province is urgent in demanding an entire change in the mode of appointing examiners, and that principle .must be conceded sooner or later, and would come with better grace if the Council were to adopt it of their own action, rather than be forced into it by the pressure of professional opinion. Those members of the Council who fought manfully against this vicious principle, and stood up for the rights of the profession as against the monopoly of the Council, deserve our warmest thanks. The elee' tions will soon come about, and then the professioP will be in a position to assert its rights in suct matters.- No one in favor of continuing the prÇ- sent mode of appointment of examiners need as the suffrages of any territorial constituency in the Province. Many medical men in this locality havc expressed their surprise at the remarks made bl some members of the Council, regarding the stric- tures of the LANCET. They would muzzle the press, and restrict its usefulness ; they would e0' deavor to coerce you to conceal, what every medi' cal man in the Province desires to be inforfled about, if in their power. We have no doubt, how' ever, you will do your duty regardless of the threats and bitter invective of these self-constituted individuals. You may rest assured that you wil be upheld by the profession. It appears to those of us outside, that the action of the Council is governed in almost everything by two or thr noisy orators, who imagine that the business of the Council must be transacted throughout in the ma\"- ner that their vanity may dictate, and that no olle else has any right even to express an opinion or make a suggestion. The members of the Council rnust remember that the eye of the profession iS upon them, and will hold them to a strict accouOt for their wrong-doings. Yours, \u0026c., JUSTICE THE CANADA LANCET. 322",
         "THE CANADA LANCET. 323 ý#t1«ttd IMICI* THERAPEUTICS OF CARBOLIC ACID. In i 86o Lemaire drew attention to carbolic acid as a remedy, and Mr. Calvert also early investi- gated the applications of tis substance. It has Iately been brought prommently forward as an antiseptic by Lister (a), Pasteur, Sansom, and Others. These writers contend that putrefactive Changes are due to septic infusoria in the atmos- Phere, and that carbolie acid acts by destroying the life of these organisms. The recent experi- Ments of Dr. J. Dougall with carbolised lymph Would tend to prove that carbolic acid is not antizymotic. The local and topical effects of car- bohc acid are more energetic than those of crea- 8Ote. The former acts as a powerful stimulant and Caustic to the skin, and when incautiously applied has not unfrequently caused gangrene. It may be laid down as a rule that the strength of topical ap- Plications of carbolic acid to wounds should not exceed one part of the acid to eight of water or to Six of oil. Carbolic acid is a potent antiseptic, and is ex- tensively used to correct the fkter of gangrenous and offensive sores. In the treatment of wounds it acts beneficially by averting the tendency to the formation of pus, preventing inflammation, moder- ng pain, and arresting hemorrhage. Mr. J. Wood 'advocates the employment of sulpho-carbolate of linc as an application to wounds, suppurating ab- scesses, after-operations, and in gonorrhea and ,enereal sores (b). Carbolic acid represses exuberant granulations, and acts as a stimulant to weak, indolent, and un- healthy ulcers. As a topical application it has been recommended in the treatment of necrosis, Caries, carbuncles, diphtheritic surfaces, lupus, and Cancerous sores. It certainly relieves the pain of ancer, and cases are recorded in which it appeared tO have modified the disease. As a gargle in dlPhtheria, carbolic acid has been extolled, and in Other affections of the throat and pharynx, as in lilcerations and enlargement of the follicles, pul- verised solutions of it have ordimarily proved bene- .cial. As to the anesthetic effects of carbolic acid lhen locally applied, Dr. A. H. Smith (c) con- s the statements of Drs. Bill and Squibb ; it tenders the integument entirely insensible, but does not interfere with the capillary circulation. (4) For details as to the antiseptic method adopted by rofessor Lister the reader is referred to his monographs 'hd papers on the subject, or to an able sunrary in Pro- sor Sydney Ringer's \" Handbook of Therapeutics,\" 4th 'tion, 1874. ) \" Medico-Chirurgical Transactions,\" voL lii. (c\u003e Medical Times and Gazette, vol. ii., 1872. Prof. Erasmus Wilson uses it as an anaesthetic to diminish the pain produced by caustics in lupus, \u0026c. Carbolic acid is sometimes used for the cure of soft hæmorrhoids, which it effects by corrugat- mg the integument. Carbolic acid aborts the pustules of cow-pox and small-pox, and a solution of it in oil (i to 8) is greatly recommended by Dr. Scott, of Dumfries, as an application to prevent the pitting after the latter disease, and also in cases of gunpowder burning (a.) In malignant pustule Dr. Estradère successfully uses carbolic acid, both externally and internally. In arthritis of the knee, subacute adenitis, \u0026c., Huter advocates parenchymatous injections of it. The internal administration of carbolic acid should be regulated by its effect on digestion; it should always be given freely diluted. Irritability of the stomach and a red tongue contra-indicate its employment. Dr. Fuller and others have found carbolic acid to be of great service in cases of fermentative dys- pepsia, even when charcoal has failed to afford relief (b). It will be found that ten or fifteen grains of sulpho-carbolate of soda taken before food will prevent flatulence occurring after meals. In torpQr of the bowels with offensive breath and in sarcina ventriculi, Kempster advocates its em- ployment (c.) Anal injections of carbolic acid are of value in mucous diarrhœa of the large bowel, and Rothe recommends the internal administration of it in the treatment of diarrhœa and cholera (d.) Salkowski employs carbolic acid in the treat- ment of some causes of vomiting (e.) A case of tænia is recorded in which the administration of two grains bf the acid every hour caused the ex- pulsion of the head and body of the worm on the second day. Lemaire gives clysters of carbolic acid for the cure of ascarides. In homorrhagic ulcer of the stomach the ad- ministration of grain-doses freely diluted has proved efficacious in checking the bleeding. When given internally, carbolic acid can be de- tected in the blood ; it is stated, however, that it undergoes partial oxidation into oxalic acid. Carbolic acid powerfully depresses the circula- tion. Carbolic acid has been employed in the treat- ment of various affections of the respiratory organs. Dr, Carlos, of Bahia, acting on the supposition that the epidemics of whooping-cough in the West Indies were due to the sporules of some fungus was led to give carbolic acid in such cases with marvellously successful results. In a recent com- (a) Edinburgh Medical Yournal, August, 1871. (b) Britsh Medicalournal, February 20, 1869. (c) American pournalof Medical Science, July, 1868. (d) Schmidt's7fahrucher, April, 1872. (e) British Medicaliurnal, May 25, 1872. THE CANADA LANCET. 323",
         "324 TRE CANADA LÂNCET. munication (a) Dr. Robert Lee reverts to the value of inhalations of carbolic acid in whooping- cough, and in the journal containing this publica- tion Dr. George P. Rugg writes claiming priority over both Dr. Lee and Dr. Burchardt, of Berlin, in suggesting the use of vapour of carbolic acid in whooping-cough. The latter writer prescribes the steam from a solution of one and a-half or two parts of the acid in ico parts of water for inhala- tion thrice daily. Dr. C. G. Rothe, of Attenburg, recommends in- halations of carbolic acid in phthisis, and he gives the following formula :-Crystals of carbolic acid and spirit of wine, two parts each ; tincture of iodine, one part; distilled water, ten parts. Of this mixture from 25 to 30 drops are to be added to a tablespoonful of water for an inhalation. Dr. Angelo Cianciosi (b) relates a case of sup- purative pneumonia following a stab in which he injected into the pleura a solution ot 50 centi- grammes of the acid in 200 of infusion of cinchona with marked benefit. In catarrh with offensive discharge, ozæna, nasal polypi, \u0026c., Kempster gives inhalations of a solution of one grain of the acid in an ounce of water (c.) In gangrene of the lung the administration of carbolic acid has been found useful by Sal- kouski (d), Gartner, Leyden, and others (e). Car- bolic acid has the power of reducing animal heat, and it has hence been suggested that its employ- ment would be beneficial in febrile conditions attended with excessive calorification. M. Déclat recommends carbolic acid for the treatment of intermittent fever ; he injects subcu- taneously '75 drops of a one per cent. watery solu- tion four times the first day, three times the second day, and twice on the third day (f). M. Treulich states that in cases of intermittent fever in which quinine has failed, carbolic acid will often effect a cure. He gives as an average dose four grains in infusion of gentian, and he records eight cases in which there were large tumours of the spleen which were cured under this treatment (g). After the administration of carbolic acid the urine becomes dark and smoky-looking, present- ing an appearance very similar to that in bad scarlatinal nephritis ; sometimes a deposit is formed not unlike altered blood, but it certainly is not disintegrated corpuscles. The dark matter is entirely derived from the drug, and is a form of indigo blue. The depth of colouration is no in- dication of the amount of acid present. It is said that the urine is coloured dark more frequently (a) British Medicalournal, October 1, 1875. (b) Indipendente, No. 4, 1875. (c) Amerian ournal of Medical Science, July, 1868. (d) British MeraIournal, May 25, 1872. (e) Schmidt's phrbucher, April 1872. (f) Comptes Rendus, lxxv., p. 1489. (g) Wiener Med. Presse, November 12, 1871. from the external than from the internal use Of carbolic acid, a fact Ferrier attempts to explain by suggesting that the acid becomes oxidised in the former case before its absorption. On the addi' tion of sulphuric acid to the urine the odour of tar is developed, and chloride of iron yields a beaut- ful blue colour. The urine in health contains e trace of carbolic acid. Carbolic acid sometinies causes the transitory presence of albumen in the urine (Waldenstrom). Neumann has shown that hyperæmia of the kidneys with separation of reali epithelium constantly occurs in dogs poisoned bl carbolic acid (a.) According to Fuller, although carbolic acid causes the disappearance of lithic deposits, it does not act beneficially in gout or rheumatism (b.) A case of diabetes successfully treated with carbolic acid is quoted in the Philadelphia Medical Tma- for Jan. 3oth, 1875. Fifteen and a-half grains Of the crystals were dissolved in an ounce each Of peppermint water and distilled water, and of thio' a sixth part was administered night and morning* Drs. Ebstein and Muller also recommend carbolic acid in glycosuria ; they suggest that abnormal fer- mentation may in many cases cause or permit the occurrence of glycosuria (c.) It may be here mentioned that although carbolic acid will prevelt the fermentation of sugar, it is said not to have the property of preventing the conversion of starc' into sugar or the decomposition of amygdaline. Injections of carbolic acid have been suggested for the treatment of catarrh of the bladder. Bere dgen uses in chronic eczema a solution of fire parts of the acid in ten of diluted spirit and 120 o water; this solution he applies every morning with a camel's hair brush. In acute eczema carbolic acid is injurious (d.) Thé foregoing solution has been found very use ful as an application in psoriasis. Neumann gave carbolic acid internally in psoriasis, and found that it reduced the hyperæmia, but did not affect the thickening of the cutaneous tissue, consequentîi it proved more successful in the treatment of the acute than of the chronic cases. Zimmerhaus givd in psoriasis pills each containing three-fourths Of grain of carbolic acid ; he beginithe treatment with the administration of six of these pills daily, al'd gradually increases the dose to twenty of the Pi in the twenty-four hours; by this treatment he usually effects a cure in from four to seVeo weeks (e.) Dr. M'Nab recommends for the treat' ment of psoriasis an ointment consisting of OOC part of the acid in four of lard; he applies th every night, and covers the part with gutta percha (f). (a) Medical Press and Circular, October 5, 1870. (b) British Medical 7ournal, February 20, 1869. (c) Berl. Klin. Wochenschrift, December, 1873. (d) Centralzeitung, No. 20, 1875. * (e) Wiener Med. Presse, 42. (f) Lancet, March 19, 1870. .324 THE CANADA LANCET.",
         "THE CA.NADA LANCET. 325 By Hertel, of Copenhagen, Guntz, of Dresden (a), and by Salkouski, it has been found very beneficial in the treatment of prurigo. Hertel finds that carbolic acid acts specially on two symptoms accompanying cutaneous affections, namely, itching and hyperemia. The action of the acid in tinea and some other skin diseases is attributed by some dermatologists to its power of coagulating albumen, stimulating the skin and ex- cluding the atmosphere. Dr. Edgar Browne recommends carbolic acid as an application for sweating feet (b.) In skin affec. tions of cryptogamic origin the acid has undoubt- edly proved serviceable. In alopecia areata Dr. Watson uses carbolic acid successfully; he employs a lotion night and morning consisting of one drachm of the acid to three ounces of glycerine; in a case so treated the scalp was covered with abun- dance of hair in seven months. Dr. Prior, of Bedford, states that carbolic acid will cure porrigo favosa, and that for achorion Schonleinii it is the safest and surest parasiticide (c.) According to Kempster, it effectually destroys acarus scabiei and pedicularis capitis (d.) Dr. J. C. Nott, of New York, records a case of carbuncle aborted by carbolic acid; an incision was made into the carbuncle, and cotton-wool soaked in the acid was inserted into the wound every day for a week. Other successful cases are also recorded. In erysipelas, Dr. Murell advocates the topical use of carbolic acid, and he has obtained success- ful results in the phlegmonous form of erysipelas by hypodermic injections of the acid as proposed by Aufrecht (e.) Dr. Hirschberg relates a case of traumatic erysipelas successfully treated by hypo- dermic injections of a two per cent. solution of carbolic acid (f) A lotion of one part of the acid to roo of water is recommended in pruritus ani. It is also useful in pruritus pudendi. Sponging the body with a weak solution of car- bolic acid is said to drive away mosquitoes. With reference to its action on the nervous system, car- bolic acid in excessive doses produces spasms, the severity of which is only equalled by those produced by picrotoxine or codeine, and which terminate in paralysis and death. According to Labbec, the convulsions produced by carbolic acid are rather epileptiform than tetanic, its special influence being apparently exerted upon the cerebellum and me- dulla oblongata. In gonorrhœa an injection of twenty grains of sulpho-carbolate of zinc in eight ounces of water, to (a) Sclidi's ahrbucher, (b) Practfion or, Decembe (c) British Medical 9ourna (d) Amnerican 7urnalof.4 (J) Philadielphia Medicalan 26, 1874, and Centralblatt, F (f)Berl. xii. »\u002bochensch April, 1872. r, 1869. 1, October 26, 1867. fedical Scienre, July, 1868. d Surgical Reporter, December ebruary 21, 1874. be used two or three times daily, has proved satisfactory. Dr. Lloyd lýoberts, of Manchester, early drew attention to the efficacy of carbolic acid in the treatment of ulcers of the os and the cervix uteri, and in chronic uterine catarrh. An outline of his mode of procedure is given in Prof. Ringer's \"Handbook on Therapeutics.\" It may be here mentioned that the fluidity of the acid may be main- tained by the addition of a few grains of camphor, as suggested by Mr. Weir, of Dublin. Dr. Green- halgh recommends as a vaginal pessary ten grains of carbolate of lime made up with stearine to correct the fætor of ulcerating cancer in the womb. For internal use, Dr. Sansom recommends the substi- tution of the sulphocarbolates for carbolic acid. These salts are devoid of caustic and irritant action, and are soluble in water; they may be given in doses of from 20 to 40 grains. The soda salt is the most efficient, then that of magnesia, then that of potash, and lastly that of ammonia. These salts are decomposed in the system into carbdlic acid, which is given off in the breath, and sulphate of soda which appears in the urine. Dr. Sansom col- lected and preserved the urine of animals to which sulphocarbolate had been given. He found that after six months the urine had not decomposed ; it is not unlikely, therefore, that the administration of these salts may be useful to keep the urine sweet in cystitis, enlarged prostate, paralysed bladder, \u0026c. Dr. Brackenridge (a) speaks highly of the value of sulphocarbolate of soda in the treatment of scarlet fever. He agrees with Dr. Sansom that this salt acts internally in infectious diseases by disinfecting the disease germs within the body. Acting on this theory, lie recommends the administration of sul- phocarbolate of soda to persons exposed to the poison of scarlet fever, diphtheria, measles, \u0026c., and he relates several striking cases illustrative of this suggestion. He gives the salt in doses of from 5 to 30 grains three or four times daily, and even more frequently when it is well borne. Carbolate of quinine has been recommended as a medicinal agent by Prof. Bernatzik, and Brawn gives it in puerperal cases; by Duchek it has been adminis- tered in typhus and pyærmia. (b) Bufalini suggests camphorated phenol as a sub- stitute for carbohic acid, whether internally or ex- ternally, on the ground that it is less dangerous, and that its employment is not attended with the disad- vantages of the acid. Many cases have been re- corded of poicaning by carbolic acid, arising both from its internal use and from the external applica- tion of it to a raw surface. It gives rise to giddi- ness, nausea, a feeble pulse, delirium, coma, or collapse, and sometimes in severe spasms ending in paralysis and death. The post-mortem examina- tion reveals a liquid state of the blood, and a pale (a) Màledical Times and Gazelte, July 24, 187 5. (b) %7hrbuch der Gesaz;zmten, Med,, Au -t, 20, 1867. J. 325 TEÈ CANADA LANCET.",
         "326 THE CANADA LANCET. and shrunken condition of the lungs. There is in- tense venous congestion of the brain and its mem- branes; and in Neumann's experiments on the lower animals he found that carbolic-acid caused conges- tion of the brain-substance, and fatty or granular degeneration of the liver in the lower animals. Olive oil is stated to be the best antidote, but the combination formed by oils with carbolic acid tends rather to facilitate the absorption of the latter. The administration of albumen, which forms with the acid an inert coagulum, is unquestionably a better measure. Husemann considers that saccha- rate of lime acts more efficaciously, an opinion with which I an inclined to coincide. Most authorities s:ate that the treatment of a case of poisoning by carbolic acid should consist- first, of the immediate administration of emetics; but as the alimentary tract is rencdered insensible by the local action of the poison, emetics are entirely inoperative and useless. Without doubt, however, the stomach-purnp should be used without delay, and plenty of milk and the reputed antidotes should be administered. Carbolic acid is largely used to prevent stenches. When offensive gases are once formed they are not destroyed by carbolic acid as they are by chlorine or by permanganate of potash, carbolic acid can only prevent their generation. The fact of venous congestion of the brain having been observed as a consequence of carbolic acid poisoning bas led to the adoption by Dr. Moslen, of Griefswald, of venesection of the external jugu- lar with a successful result.-Dr. Grftlt, Med. Press and Cir¢ular. TREATIENT OF CHRONIC CONSTIPATION. LThe Yedical Times and gazette contains an in- teresting article on the \" Therapeutics of Chronic Constipation,\" by Dr. J. K. Spender, of London, and though not of very recent date, we subjoin an extract as presented in the Ha7f-Yearly A bstract of the Medical Sciences, relating to the treatment of this annoying maiady.] The treatment promises not 3mere relief, but final cure, and \"compromises four therapeutie factors : (a) minute and frequent doses of watery extract of alees, very rarely of extract of colocynth; (b) a dose of suilphate of iron (gr. jss or ij), always combined with each dose of the direct aperient; (c) regulation of the diet; (d) constitu- tional exercise. The author writes chiefly of factors (a) and (b). The quantity of extract of aloes, in all but extraordinary cases, lie says, should not exceed one grain. It is conveniently given in the forn of a pill. With this pill there should al- -ways be mixed a dose of sulphate of iron varying fronm one to three grains ; this is the essential point ofthe treatment. A-ny other toiic of the neurotie kind cannot supply the place of the iron; iron is not onlyfacile princeps, but is not interchangeable by anything else. Extract of nux vomica may be added, if the prescriber pleases, as an ornamental appendage or as a means of blending the other con- stituents together; and ,belladonna is a remedy of definite auxiliary power; but both these drugs, quoad constipation of the bowels, are uncertain or unsatisfactory, and raiely do permanent good. Dr. Spender begins, then, by desiring an adult patient to take a pill composed as above three times a day, immediately after the principal neals. He is cau- tioned that at first there will be probably no ap- parent effect, and that two or even three days may pass before any medical evacuation of the bowels takes place, perhaps even thon difficult and discom- forting. But within the next forty-eight hours there will 'be most likely an evacuation of the bowels once or possibly twice in the day ; but notlh- ing approaching to purgation ougit ever to be per- mitted, and, therefore, the patient must be instruct- cd, on the occurrence of the first loose motion, to withlhold a pill, and to take only one in the morn- ing and one in the evening. ie then continues for a time his morning and evening pill, and is pleased to discover that so slender a medicament has such a decided effect. Not improbably, at the end cf another week or fortnight, he is compelled, by the sanie reason as before, to drop another pill, and the same result is now brought about by one pill daily, as was originally produced by three pills. Within another month, he may reduce his allowance of medicine to a single pill once or twice a week ; and finally his whole scheme of medical treatment be- comes merely preventive in its design and scope, and he takes a pill occasionally for the sake of main- taining health and warding off old troubles. \" When there i8 real or fanciful difficulty in the administration of pills, the best way of carrying out the plan above described is by combining the mis- tura ferri composita 'with the decoctum aloes com- positum, the doses being dotermined by the applica- tion of the sane principles.\" The treatment seems altogether rational, and we hesitate not to recommend it. The object sought is not mere evacuation of the bowels, but restora- tion of lost tone.-Med. News, cin. TREATMENT OF THE ITCH.-L' Unlion f¢édicaie gives, under the name of Wilhem Petters (without further indications), the advice of using Peruvian balsam or styrax mixed with two parts of oil, in lieu of sulphur ointment. Very gentle frictions with the balsam or the styrax, without previous soaping, will destroy the acarus, as the balsam very easily penetrates into the furrows of tlie skin with- out the latter being torn. In this way the eczeri- atous eruptions following the use of sulphur are avoided. 3 26 THEÎ CANADA LANCET.",
         "DILATATION OF THE CERVIX UITERL IN LITROTOMY AND LITHROTRITY COM- DYSMENORRHEA. PARED. Dr. John 3al recommends the following method At a meeting of the Medical Society of London, of procedure in cases of constricted cervix ute.'. held on the 13th March, Mr. W. Coulson read an Having procured the thorough evacuation of the interesting paper, in which lie gave a statistical bowels of the patient, place her upon lier back, review of the comparative results of Lithotomy and with the hips near the edge of the bed, and when Lithotrity obtained during the past five years in she is profoundly anSsthetized introduce a three- those metropolitan general hospitals that publish a bladed, self-restraining speculum ; seize the os uteri yearly report. The tables drawn up by Mr. Coul- with a double-hooked tenaculuni, draw it down to- son showed that the number of cases of stone in ward the vulva, and then introduce a metal bougie the bladder treated by operation at four of the as large as the canal will admit, following it in largest hospitals, during five consecutive years, was rapid succession by others of larger size, until one 148, with 24 deaths, or an average mortality of i is 'reached whieh represents the size of the in 6.16. At St. Peter's Hospital, on thé other dilator. Then insert the dilator and stretch hand, the average mortality for ail cases of opera- the cervix in every direction until it is en- tion for stone in the bladder, during the same larged sufficiently to admit a No. 16 bougie, period, was i in i i.16, or six deaths out of a total which is all that is generally necessary. Then in- of 67 cases. This remarkable difference in results troduce a hollow gum-elastic uterine pessary of was, in Mr. Coulson's opinion, to be accounted for about that size, and retain it in position, by a stem by the selection of the operations. In large hos- secured outside the vulva, for about a week, in pitals lithotomy is the common operation, but at which timue it has done its vork and is ready St. Peter's lithotrity is the more frequent. These to be removed. During this time the patient facts were proved by a table which showed that, should be kept perfectly quiet, and usually upon lier while the total number of operations of lithotrity in back. Dr. Ball claims that the operation saves a four large London hospitals during five years was great deal of tirne, causes much less constitutional 29, at St. Peter's, during the sane period, the num- disturbance than the use of tents, and is not only ber was 44. With respect to lithotomy, some im- safer than the metrotome, but is free from some portant differences were pointed out. In the large serions objections to the use of the latter, there general hospita'. the deaths after lithotomy and being no resulting cicatrix to interfere with the lithotrity are nearly equal, while in St. Peter's litho- dilatation of the parts, and the condition df the trity was twice.as successful as lithotomy. At five patient after an unsuccessful operation being no large hospitals there were 28 cases of lithotrity, worse than before. He says that it relieves the con- with five deaths; at St. Peters, 43 cases, w'th three striction entirely, by breaking up al the adhesions, deaths. Not the least interesting fact brought out which are often firm and unyielding ; that, acting was the similarity of the results obtained at Uni- as a derivative, it cures the hyperomia of the cer- versity College Hospital, Hôpital Necker (of Paris), vix; and that, further, it establishes a radical and St. Peter's Hospital. In the special depart- change in the nutrition of the whole organ. ment at University College Hospital the mortality He details nine cases of stricture of the os and of lithotrity was r in 16; at the Necker Hospital, cervix complicated -with. vaginismus, ehronic endo- i in 15.6; and at St. Peter's, I in 14.3.--Te cervicitis, version, sterility, dysmenorrhea, etc., in Lancet. all of which very great relief or permanent restora- tion to health was effected by rapid and forcible dilatation. In a foot-note the editor of the New York Medical Journal quotes Dr. Ellinger, of Stutt- TRE MOST USEFUL DRUGS.-According to the gart, as recommending the operation-1, in stricture .Afedical Times and Gazette, a party of ten medical of the cervical canal; 2, stenosis due to flexions; men were dining together not long since. and one 3, metrorrhagia in a flabby, swollen uterus, but of them, during dessert, started the proposition without new growths; 4, retained catarrhal score- that, supposing all present were lirnited in their tions; 5, for exploration of the uterine cavity ; 6, practice to a selection of six pharmacopoeial reme- replacement of a flexed uterus; 7, sterility. Dr. dies, which would be chosen as being most useful; Ellinger declares that lie has never had leason to compound drugs to be excepted. Each of the regret rapid dilatation, and urges it, where dilata- party wrote the names of the six drugs he should tion is justifiable at all, to the exclusion of al select, and handed to the doctor who started the other methods.-Medical News., proposition. On examining the lists it was found a majority of votes were given in favour of opium, quinine, and iron ; between nmercury and iodide The London Lancet reports a death from chlo- of potassium the votes were equally divided, as, roform at Leicester, England. they were also between ammonia and chloroform. THE CANADA. LANCET. 327",
         "328 TRE CANADA LANCET. ON SO-CALLED \"ULCERATIONS\" OF THE OS UTERI. What is commonly considered and treated as ulceration of the womb is not ulceration at all, but one of two conditions, both of which, once clearly understood, are simple enough. In the first condi- tion, frequently found in its typical form in women who have not borne children, and where the cervix and os retain the normal shape, there is seen a red abrasion often entirely encircling the os; it is occa- ,sioned by the irritating discharge poured out by a uterus affected with catarrh, or, as is commonly said, endometritis. We all know how often comes a so-called cold in the head, with its accompanying discharge from the nose ; the uterine mucous mem- brane is liable to a similar catarrhal discharge. The woman affected with a discharge from the nose re- moves it by the use of the handkerchief, and so prevents it from excoriating the upper lip and the edge of the nostril; if the discharge is sufficiently irritating or excessive to cause some excoriation, perhaps the use of the handkerchief is supplemented by the application of cold cream or other unguent to the part. Now let the same woman, from, it may be, the same cause, have a uterine catarrh. She cannot keep the irritating discharge constantly removed fron the surface of the cervix uteri, nor can she practically apply any unguent; and the end of the cervix in that woman is soon in the same condition as the upper lip and nostril of the little ragged boy who runs about the street on a wintry day, having no handkerchief to use and no cold cream to apply: namely, the epithelium is removed, and a raw, excoriated surface comes to view. Catarrh of the uterus has generally become chro- nic before the patient applies to the physician, and the papillæ at the abraded spot, as a result of long- continued irritation, frequently have become much hypertrophied, and deceive the inexperienced eye into diagnosticating granulations. Too often, addi- tional irritation is caused by the physician, who, totally misunderstanding the case, happens to cure the \"ulcer\" by lunar caustic or his other \"favorite application.\" What educated physician would think of attacking the excoriated nostril and upper lip referred to by \"burnig ou the 'ulcel/\" giving no attention to the catarrh, its cause ? Why should we do the same thing in exactly the sane condi- tion in ànother part of the body? If the discharge be stopped by proper applications to the inner surface of the uterine cavity, the so-called \"ulcera- tion\" will take care of itself; for you may depend upon it that if you are not more skillful than most physicians in making your application, enough will be spilled upon the excoriation outside to stimulate that part sufficiently.-Dr. Wing, Boston Ma. \u0026' Surg. your. The plague has réached Bagdad. to cases dailyi EMPYEMA AND THORACENTESIS. [Answers by Dr. Bowditch, of Boston, to a series of questions propounded by Dr. Holliday, of Cleveland, 0.] It always gives me pleasure to aid a professional associate, and one especially like yourself, prepared to advocate thoracentesis by any and all legitimate means. I will endeavor to keep as closely as I can to your questions. First-What per cent of recoveries? I am sorry that I cannot answer exactly on this point, because many of my patients I saw only in consultation, and many of them I lost sight of after- wards. But let me approximate, if possible, to a general answer to the question. I have up to this time operated (328) three hundred and twenty- eight times on (207) two hundred and seven per- sons. No one has died immediately or in conse- quence of the operation. I see, however, that some of the European jour- nals report deaths, after the operation. I have never met witi any/zing of the kind, although one woman, under the care of another physician, and when ether was used (I never give it in such cases), died very suddenly, as I believed, owing to éther being administered, while one lung was wholly compressed. Ether may be and has been some- times administered safely. There is however aways a danger in its use in such cases. These cases of death after thoracentesis are be- coming in Europe so conimon, that one English journal asks, whether we may not be compelled to go back to old ideas again, and consider thoracen- tesis a very dangerous oj5eration, and only to bej5er- formed as a last rcsource / Nothing could be more disastrous for our patients or really more foolish than for us to adopt this assertion as true. The writer of the remarks shows an entire want of appreciation of the real simplicity of the opera- tion, and of its innocuousness whe.1 performed with an exploring trochar and canula and suction punp; by \" asqiration,\" infact, though not in naie. I can only explain this unhappy result in Eu- rope, by the desire of the operator to do too nuch, and thus prolong the operation beyond the proper time for the patient. They desire to get out all the fluid that can be drawn. Now my rule, which I believe is the only safe one, is to stop suction the moment the patient begins to suffer from any uncomfortable symptoms -stricture of the chest, severe harassing cough, etc. A mild cough I always like to hear, as it indicates expansion of the lung. With this rule before me, I have often drawn less fluid than I hoped to get-nevertheless, as the safety of my patient, not my own wishes, was the end I had in view, I have always rehed upon it- and as I have stated without any untoward result such as has happened abroad. 328 THRE CANADA LANCET.",
         "*IIItiijIM*JiII-uJ~jLL IILIL ~ ~--~--~ THE CANADA LANCET. This rule applies to all cases which I have hither to seen, whether I found serum, pus, bloody oi fætid fluid in the pleural cavity. In regard to the percentage of death from empyema, as I hinted above, I cannot give it, and instead I present you with the following statement of my general recol- lections. ist. Children with empyema are much more likely to recover than adults; nearly all of them recover. ind. Adults, with recent trouble, are in a more favorable condition than those in whom the dis- ease bas lasted for months. When the disease is recent the lung expands rapidly, and the patient begins to get well from the moment thoracentesis is performed. But when chronic, it expands. a slowly, but surely. b perhaps only partly. c or finally, not at all. In the first conti:gency, if the rleurisy be in a previcusly healthy person, and if the other lung be wholly pervious to air, the patient generally gets well. At times, however, after repeated operations, phthisis is liable to set in. In suci a case tþe repeating of the aspiration I deen a bad mode of proceeding. The better mode is this : If, after once or certainly twice operating with the explor- ing trochar, I find this constant tendency to the re-accumulation of pus, I advise that a free and permanent aperture should be made. This may be done in two ways. rst. By a trochar and canula just large enough to admit the passage of a drainage tube. The apparatus may be described as follows: The canula is made with a broad lange, upon which I sew a piece of sticking plaster with a piece of oiled siik over the back of it to prevent it being soaked and soiled by the pus, which will flow over it. i plunge in the trochar and let the pus flow, re- gardless of the entrance of the air, the canula being held firmly to the thorax by the sticking plaster, to which the canula has been sewed before operating. In a few moments, however, I order either a plate of cotton wadding or a bunch of oakum, or a -poul- tice, and allow the pus to flow as freely as it may, urging the patient to lie, if possible, so that the opening will be in the most dependinig part. This operation was done recently on a child with the best results. She has recovered so far as the pleurisy is concerned, but the case being chronic, before the operation was done, I fear tuberculosis may eventually set in. 2id. The other operation for a permanent operation, which I have advocated, is a free in- cision of one or two inches between the ribs. This of course is a much more painful operation, but I am inclined to think the better of the two. The essential object, however, that we wish to attain, is a pernanent and free discharge of pus. But let me here enter a \"caveat.\" I have seei a permanent opening made by another which I disapproved of. The patient had had pleurisy for which repeated thoracentesis, with an exploring trochar, had been made with great relief, at times lasting for months. But the patient had also, evi- dently phthisis, marked by disease of both lungs, crackling under both clavicles, \u0026c. Certainly it would seem a fiori that in such a case a perma- nent opening could do no good, and must be a real annoyance by its unpleasant discharge. I do not now, therefore, advise a permanent opening in such cases for evil has always been the result in my ex- perience. In regard to subsequent treatment by injection I would say that when \"laudable pt\" is thrown out, and the lung is gradually expanding ; if the patient be improving, I do nothing. Why should we ? I can see no valid reason for interfering. I think îome patients have been made much worse (in Berlin for example) by over-doing in this way of \" washing out the cavity.\" But suppose the patient fails and has hectic fever, \u0026c., I then try injections of warm water and at times they are all that is needed and produce the most happy results. I find they have done better in my practice than any more stimulating treatment. I think, now-a-days, carbolic acid might be used with advantage, but i have not used any. 3rd. Constant drainage is my rule. 4th. Is the open method preferable to repeated thoracentesis ? Whilst serum is drawn I always hope for the best, and repeat thoracentesis by aspiration. If pus-I have answered above. If bloody serum-I never make a permanent opening because a bloody serum even once drawn, at a first operation indicates in my experience al- ways an incurable and usually malignant disease of the pleura or lung. Of course, in this last contingency a permanent opening would seem to be contraindicated. 5th. \"l Causes;\" Undoubtedly empyema may oc- cur in a person previously healthy, and especially is this true of young children. But I often find a bad constitution at the bottom of the matter and of course this makes the progress less favorable. Of the three sequelæ naned by you, Tuber- culosis is the only one I have seen. Never have Brights disease, or enlarged liver been noticed, al- though they may have existed. Enlargement of the heart and sudden death with cardiac signs, after months of trouble, I have seen in a few cases in which though the fluid apparently did not reac- cumulate, the lung never regained its free expan- sion. 6th. 1 send by this mail a copy of my paper be- 329",
         "330 TKE OANADA LANCET fore the Academy. Hoping that this will arrive in most careful and thorough consideration, viz. : the season for your paper, and wishing that your propriety of consulation with so-called homoeo. society were within a reasonable distance so that paths. While he disclaimed utterly any belief in I might hear your views and perhaps express my their therapeutical theories, it is not to be disputed own.-Lancet and Observer, Cin. that there are among them a large number of men who, by education and social qualities, are com- petent practitioners. An important element of the question is, the fact that our predecessors, from SEXUAL HYPOCHONDRIASIS. whom we receive our ethical code, have so inter- Every physician has had greater or les. experi- preted its rules that its enforcement has enabled enwit phsciantins uerigether really erin the homœopaths to appear before the community ence ivith patients suffering, either really or in at large as martyrs in a just cause, and one result imagination, from sexual irregularity, hich gives bas been that they count among their sympathizers rise, in some cases, to a great deal of anxiety and many of the most intelligent and influential mem- trouble, generally needless. Under these circun- bers of society. The speaker then proceeded to stances the physician is sometimes called upon to suppose cases which might arise in the practice of dectde questions that involve thics as weli as any physician, in which the duties imposed upon therapeutics. We are glad to have the igh autho all of us by a common humanity would require rity of Sir J. Roget, as a precedent in such cases, that he should co-operate with a homœopathist in and it affords ts pleasure to quote the following spite of ethical rules. Another speaker followed fcom a late lecture, published in the Briisl fedi- hini in the same vein, and it was evident from the cal yornrl In referring to the case of sexual attention which the company gave, and the en- hypocondriacs, Roget says : thusiasm of their applause, that the sentiment met clTo al alike you nay try to teach a judcious with a ready endorsement. carelessness about these thigs ; a state of mnd The company was not a mere handful of un- which would be an inestimable blessing to any heard-of and uninfluential men, but, although besides these sexual hypochondriacs. Many of mostly composed of the younger members of the your patients will ask you about sexual intercourse, profession, some are professors in medical schools, and sonle jill expect you to prescribe fornication. many are connected with prominent hospitals and I vouid just as soon prescribe theft or lying, or dispensaries, and are officers in our medical socie- anything else that God has forbidden. If men ties; and a few of them, including the speaker, will practise fornication or uncleanness, it must be vere the chamnd ions of the recent demonstration of their own choice, and on their sole responsi- in the c Presoyterian Hospital Affair.-New bility. We are not to advise that which is morally Remedies, Ney York. wrong, even if we have sone reason to think that a patient's health would be better for the wrong- doing. But in the case before us, and I can ima- gine none in which I should think differently SOUART'S AMPUTATION. there is not good enough for so much as raising a question about wrong-doing. Chastity does no Mary Q., thirteen years old, entered the hospi- harm to mind or body, its discipline is excellent. tai May 20, 1875. Two years and a half before iarriage can be safely waited for; and, among the this she fell from a sled while coasting, and one of many nervous and hypochcndriacal patients who the runners passed over her left foot. She walked have talked to me about fornication, I have never home, and continued to use the foot for several heard any one say that lie was better or happier days, when it became painful and swollen. After after it.\"-Med. .Vews, Cin. a time sinuses formed, and a portion of the cuboid bone was removed. At the time of entrance sinuses communicated with the tarsus below both malleoli and on the sole CONSULTATION WITE1 HOMOiOPATHS. and dorsum, of the foot. The ankle joint was movable without pain. The patient was cachectic, On the twenty-fifth of Jast month, at a dinner and a generous diet was ordered and use of the given by nearly eighty physicians of this city to one foot prohibited. In December the patient's health of their number who was about to accept a posi- was very good, but this foot was smaller than the tion in a neighboring town and a professorship in other, the toes were somewhat drawn up, and five itsniedicalschool,theguestoftheeveningmodesome sinuses communicated with the centre of the remarks which, at the time, produced profound im- tarsus. pression on the companyand elicited loud applause. Under these circumstances.operative interference .He said, in effect, that the time is rapidly approach was deemed advisable, and January r, 1876, ing when a question would force itself upon the Soupart's amputation was performed, This method attention of the profession, and would demand consists in taking a long internal flap and saving",
         "TuE CŽ~ADA LANCET. 331 the intemal plantar artery. An incision is begun on a level with the scaphoid bone, carried down the inner side to the median line of the sole, from this point along the median line and through the heel as far as the tendo-Achillis, The extremities of this incision are joined by one slightly curved, which passes directly wider the external malleolus. The ankle is disarticulated, and the long flap care- fully dissected fron the bones. The malleoli and articulating surfaces are then sawed. By this method a flnely-shaped stump is formed, covered with the thick skin and sole of the foot, and the internal pjantar vessels nourish the flap abundantly. Examination of the foot after removal showed the entire tarsus to be extensively diseased. The patient did very well after the operatior., the wound being nearly clused January 3 rst. There have been several cases of Soupart's am- putation in the hospital during the last year, and a very serviceable stump is formed, to which an artificial foot can be fitted with but little deformity, and upon which the patient walks quito naturally. -Bston Med. \u0026 Surg. 7ournal, May 25, 1876. ON THE TREATMENT OF SEVERE SPRAINS. BY SAMPSON GAMGEE, F.R.S. EDIN. \"Severe sprains are often serious fracturesthough no boue be broken, or only a bit may be chipped off; the ligaments and fasciæ are ruptured, blood being extravasated into the joints, into the sheaths of -tendons, and for some distance not infrequently between the layers of muscles. The swelling is great, the pain intense. The orthodox treatment by leeches and fomentations is valueless, coin- pared with circular compression and perfect imrr.-- bilization.\" Personal experience only adds strength to this opinion, and yet the orthodox antiphlogistic treat- ment continues to find favour with authorities. To quote one of the most recent and distinguished : \"As to severe sprains, at first, while the active state of effusion is present, antiphlogistic measures are necessary. Where it is grateful to the patient. the sedulous application of ice-bags is, I think, the best; but if this is not tolerated, leeches, followed by warm fomentations or evaporating lotions, or irrigation with spirit and water, will best check'the tendency to effusion. As soon as the patient can bear it, equable pressure by strapping and ban- dage or by splints, with perfect rest, should be adopted.\"t Not only can the patient bear well- * On theTreatment of Fractures of the Limbs, by Sanp- son Gamgee (London, Churchill, 1871), p. 152-3. † A Treatise on Surg. xy, by T. Holmes. London, x875, p. 257- applied pressure from the first, ho-wever great the swelling and acute the pain, but it may bc laid down as a general proposition, tu wnhich I have never seen an exception, that in severe sprains, effusion is most surely checked, and, once' it has occurred, its absorption is most rapidly promoted, while pain is most effectually relieved, by pressure and immobilisation. It is as true now as when Velpeau taught it, that \" compression is t? - sover- eign resolvent in contusions with infiltration and swelling.\"* By way of illustration, I may briefly relate the progress of a case in which I was consulted by my friend and colleague Mr. John Clay. His patient, an elderly gentleman, had recently sprained his right ankle in going over a ploughed field. As he had a policy in one of the accidental insurance companies, its medical officer saw the case, and he advised an incision to give vent to matter, which he thought had formed in the centre of the swel- ling. In this advice he was sustained by a hospi- tal surgeon, who was additionally called in on be- half of the company. Mr. Clay, dissenting, in- vited my attendance. I found the right ankle hot and exquisitely painful. It was so much swollen that its circumference over the heel exceeded that of the corresponding sound joint by nearly an inch and a half. The skia on the outer side of the ankle was especially hot, red, tense, and shining; palpation in this situation communicated a feeling of elasticity closely simulating, but not amounting to, fluctuation. With Mr. Clay's concurrence and assistance I enveloped the limb from the toes to the knee in fine cotton-wool, applied well-moulded pasteboard 'splints on each side, bandaged with methodically uniform compression, and starched the outside. A second consultation was held in the course of three days, when I found the patient very much easier. He had had a good night's rest and had been able to turn over in bed, and could bear the limb lifted and put down again without pain. On opening the apparatus in front I found the swelling had considerably decreased ; the pre- viously red skin was yellowish and shrivelled like the skin of a late ri'ssett apple, not looking, as at my first visit, like the red shining skin of a prime Blenheim. That shrivelled look is always a good sign. I pared the edges of the case, and re-ad- justed with firm pressure. Three days later more shrinking was met by fresh paring, and still firmer bandaging. At a consultation held a fortnight after the first, the patient was perfectly easy-. No one thought any more about puncturing in search of matter. The insurance company compromised the affair by paying doirn a substantial sum of money, and I replaced the pasteboard apparatus by \"Le resolutif par excellen.z dnq's les contusions avec infiltration et gonflement, c'est la -.pression.\"-Velpeau, Lecons Orales de Clinique Chirurgicale, Bruxelles, 1841, p'. 428. z 1112 THE- CANEDA LANCET. 331",
         "-'i - ---- THE OANADA LANCET. strapping the joint with emplastrum elemi sprez on leather, and a Churton's bandage applied vii smooth lirmness. When I last saw the patie with Mr. Clay, he was walking about his garde with a stick; the plastei had been very proper removed, and the swelling had subsided, the on] difliculty to locomotion being stiffness of th joint. I cracked the adhesions by using the r quisite amount of well-applied force, and we coi curred in advising free use of the joint. In a not w:hich I received from my colleague seven weelk after our first consultation, he wrote : \" Our pý tient is progressing very satisfactorily ; he comes t business every day, walks about a great deal, an does not require surgical supervision.\" The case is a typical illustratior of the propos' tion that severe sprains require immediate comi pression and absolute immobilisation.-23e Lancei THER APEUTICS OF ACUTE RHEUMA TISM. Few more humiliating conclusions have been ar rived at in therapeutics than that which a leadi.g1 physician in London came to about ten years ago as the result of his hospital experience-viz., thai Medicine had nothing more efficacious to oppose to the course of rheumatic fever than mint-water Not that it did any good, but that nothing else materially affected the course of the disease. We never believed in this conclusion, and we do not now. If it was justifiable then, we venture to hope that it is no longer so. We have latefy published accounts of the action of salicin and salicylic acid in acute rheumatism in a certain number of cases, which seem scarcely to allow us to dIoubt that these substances cut short the process of acute rheumatism as certainly as quinine cuts short the process of intermittent fever. Dr. Maclagan, of Dundee, explained, in .Te Lancet cf March i ith, how he came, quite independently of, and prior to, any other physician, to treat rheumatic fever with salicin. He regarded the disease as miasmatic in its orign, like ague, and likely, therefore, to yield to a medicine of virtue in intermittents. This theory is of little consequence. We think it al- most certainily a wrong one. But it led him hap- pily to the use of salicin, and the salicin stopped the xheumatic fever in six or seven cases. That is to say, that a patient with anxious face, a tem- perature of ro2 anC )ver, acid sweats, joint-pains, \u0026c., would, in twenty-four or forty-eight hours after, experience a great diminution of pain and a fall of two of three degrees of temperature, and in fôur or five days be free from pain and convalescent In other words, the course of the malady was changed from that of a disease requiring six weeks to that of a febricula, extending over less than six days be- 332 Ld fore the return to a normal temperature and entire th freedom from pain This is a promising result, and, nt if it should be confirmed by a larger experience, -n will be a matter of congratulation to mankind. [y e 8th of April our \" Mirror \" contained par- ly ticulars of four cases treated in St. Mary's Hospi. ie tal by Dr. Broadbent with, not salicin, but salicy- e- lic acid, in accordance vith the practice of Stricker i- of Berlin. The results were as striking as in Dr. .e Maclagan's cases. Temperature came down .s rapidly, and pain was relieved quickly. a- We cannot forbear noticing in an editorial way o such important therapeutical statements as these, d if it were only for the purpose of askirig practi- tioners withont delay to test them by a use of the i- remedy in similar cases. Dr. Maclagan gives salicin in preference to salicylic acid. Doubtless the action of both in rheumatic fever is identical, but lie gives good reasons for preferring salicin. We must guard our readers from supposing that we consider the power of salicin or salicylic acid settled by these experiments. It will take a very much larger number of cases to decide this ques- tion or any similar one. We have too often been - lifted up in regard to the power of medicines only to be cast down again. But en'ough bas been done of late years to make us more hopeful and t less sceptical. Dr. M ilson Fox's results in cases of rheumatic hyperpyrexia, the effects of veratrum vinde in the hands of Dr. Silver in relieving pain and reducing temperature in the disease under consideration, the similar effects in other hands cf quinine in conjunction with alkalies and opiates, warrant us in hoping that rheurnatic fever will soon be recognised as one of the diseases in which phy%- sicians can be sonething more than students of natural history. We shall be glad to publish well- reported cases bearing on the efficacy of the salicin or salicylic acid.--TZe Lancet. - CASES OF EXSECTION OF RIP-JOINT Dr. L. A. Sayre, (New York Pathological Society) presented specimens and read the histories of cight cases of morbus coxoe, in which he had exsected the hip-joint. The first case was a child four years old e fainily history good ; parents did not remember that the% patient had received any injury. The child was greatly debilitated, owing to a profuse discharge of pus proceeding from the affected joint. On March 28ti, 1875, exsection iwas performed. On opening the joint, it was found that the head and neck of the fernur had been absorbed, and that the upper portion of the shaft was covered with a thick involu- crum. The femur having been sawn off below the lesser trochanter, it became a necessity to remove au additional fourth of an inch of the bone, whicli was diseased. The patient was then placed in a wire",
         "THl? (1AYA TA June 13th, 1875.-Sinuses nearly closed. Patient placed in long axtcnsion splint. January lst, 1876.-Can wvalk with splint ap- plied; sonie motion at hip-joimt; sinus on posterior of ih1um not entirely healed. The second case was that of a boy, aged five years; family healthy. Two years and a half beforo, the patient fell and struck his knee, from which time the disease dated. Blisters ad been applied at in- tervals, at the seat of the disease. Wheon Dr Sa re saw the patient, he was greatly emaciated, and the disease of the hip-joint vas in its third stage. On April 31st, 1875, the joint was exsected. The head of the femur had been partly absorbed, and a portion of it was lying loose in the cavity of the joint. Per- foration of the acetabulum was detected, and the neck and part of the shaft of the femur were ab- sorbed. February 2nd, 1876.-Sinus closed. There is motion at joint. Can stand upon leg on removal of eplint. The third case was that of a girl, six years of age family history good ; no recollection of having age- ceived any injury. Ras been lame since February, 1872. When Dr. Sayre saw the case, the followirig condition was observed * The leg was shortened, fixed and adducted, and two sinuses were found on the anterior aspect of the thigh. Exsection was performed on March 31st, 1875. The head and great part of the neck of the femurhad been absorb- ed, and the acetabulum perforated to the extent of half an inch in diameter. The femur was sawn off half an inch below the lesser trochanter. Fragments of dead bone were removed from the acetahulum. In August, 1875, the child had aliost thoroughly recovered. j The fourth case was that of a girl, aged five years. r The patient, when seen by Dr. Sayre, was in the third stage of the disease. No history could be ob- e tained. There was partial anchylosis of the limb, 1 and in the position usually characteristie of hip-joint t disease. Several sinuses were found, opening on the posterior parts of the thigli. The usual opera- u tion was performed on September 22nd, 1875. The c head had been absorbed in great part ; its remaining t portion was unattached in the joint. The acetabu- t lum was perforated; in the opening were found re- h mains of the head of the femur. The femur was b sawn off above the lesser trochanter. a November 18th, 1875.-Patient removed from p the cuirasse and placed i a long splint. O February 2nd, 1876.-Since the application of li the long splint, the patient has been walking about. The long splint -was removed, and instead a short a ep one was applied. The sinuses were almost tr closed. ID The fifth case was that of a girl, aged three years, 1 of healthy parents. No history of injury. The first ai indication of the disease appeared in the summer of ai 1874. During the summer of 1875 an ab- in Ah JLN uET- 333 scess made its appearance on the posterior as- pect of the thigh; this continued discharging at the time the operation was performed. There vas anchylosis, shortening, and adduction of the limb. On September 29th, 1875, exsection was performed. Absorption of the head, neck, and part of the greater trochanter had occurred. The acetabulum was per- forated. The dead bono having been removed, the patient was placed in a cuirasse. December 13th, 1875.-Patient can walk about. The sixth case was a girl, sevon years old ; she had jumped from a high stoop two and a half years before the operation, from -which time she complain- ed of lier hip. A diagnosis of morbus coxoe, in the second stage, vas made by a physician who saw lier three months after the occurrence of the accident. The application of a short splint was resorted to, and worn by the patient for three months with. benefit, but was discarded during au attack of scariet fever and was never reapplied. The limb was flexed, adducted and anchylosed at the time of the opera- tion, and a number of sinuses were seen near the hip, througi which, when a probe was introducéd, could be detected the presence of dead bone. The exsec- tion of the hip was performed on December l5th,. 1875. Partial absorption of the head of the hone bad taken place. The femur was sawn off below t'ho lesser trochanter. February 2nd, 1876.-Patient placed in long 3plînts. The seventh case wa,. a boy, aged nine years, whose mother died of phthisis. The disease existed For three and a half years before the patient's ad- mission to Bellevue Hospital. On entering the- hospital, flexion of the right Ieg at the hip and knea oints existed, and an abscess was detected over the ight anterior spinous process. Symptoms of amyloid degeneration of the liver and kidneys were manifest- d. Exsectioji was performed on February 2nd, 876. The head was partly absorbed and the ace- abulum perforated, through which the head of the emur had passad, mnaking luxation impracticable ntil the bone had been sawn off below the tro- hanter minor. There -was some hemorrhage from he involucruin, -which was controlled by a compress. ae child was placed in the wire cuirasse, which ad subsequently to be removed, on account of a ed-sore. It had then to be placed on a water bcd' nd a splint applied to the unaffected side. The atient died on April 19th, 1876, from exhaustion. n post-mortem examination, it was found that the ver, spleen and kidneys were waxy. The eigith case was that of a boy eight years of ge, whose family history was good. Five fistulous acts, leading to diseased bone, were detected by r. Sayre. Exsection was performed on April 5th, 876. The head and neck of the femnur were- sorbed, and the acetabulum was perforated. An. bs, ess was found to exist between the ilium and nex periosteum.-Med. and Surg. Reporter.",
         "causes of the scandal which lad unfortunately ¢ t JI $ Í¢Ít artached itself to the conduct of the recent spring examiners. In fact the Council lad been called MINUTES AND PROCEEDINGS OF THE together a month or six weeks sooner than it othcrwise would have been on account of the dis- ONTARIO MEDICAL COUNCIL. creditable charges which had been brought both by the public and by the medical press against First Days Procedings. their Board of Examiners. Being a member of The annual meeting of the Medical Council of the Board and responsible to the Council, it would not become him further to enter upon the -Ontario was held in Toronto, commnencing Thurs- subject than to call their attention to it, and to ask day the Gth inst., and continued in session four days. for the fullest, the most searching, investigation, The following menbers were present :-Drs. and that they would take such a course in the Aikins, Bethune, Campbell, Clark, Ross, Allison, matter as in their wisdom they might think proper. McLaughlin, Berryman, Bogart, Carson, Brouse, ELECTION 0F OFFICERS. W. Clark, Cornell, Edwards, Henderson, Dewar, On motion, Dr. Daniel Clarke was appointed -Grant, Logan, Lynn, Henwood, Hyde, Irwin, President for the ensuing year, and Dr. Campbell Lavell, Macdonald, Morden, Morrison, Muir. Vice-President The President, Dr. Edwards, took the chair Dr. Brouse roved, scconded by Dr. Aikins, that the Standing Çommitfees of last year be re-elected, shortly after three o'clock. The minutes of last which motion was carried, the only changes being meeting were read. the appointment of Dr. Edwards and Dr. Hodder The President, in retiring from that position, to take the places of thencwly elected President said that his opinion in regard to the Medical and Vice-President on those Comittees. Council was that if rightly managed it should oc- PETITIONS. ,cupy the a!ne position and enjoy the same con- Petitions were presentcd from Dr. Hope and fidence in Ontario which the Medical Council of others, of Belleville, praying that the CounCil Great Britain did in the Old Country. He referred mîglit grant registration te certain graduates of to the fact that the Executive Committee had waited upon the Ontario Government and asked MeGl olege, Mntreal; a from Dr. Hun them for a grant whereby the Council night have e of Bualo nquiing by whtasho d a local habitation, a pathological museum, and a library; but for sone reason the Government had THE EXECUTIVE cOMMITTEE. not granted the request. He thought the time had Dr. Dewar presented the report of tho Executive now come wlen stay of proceedings should not be Committee. It stated that the Committec Met on granted in prosecution of unlicensed practitioners, the i9th July, wih Dr. Dewar as Chairman, and except in very exceptional cases. Ample time had that thcy proceeded with the nomination of prose- been given medical men to pass the examinations cutors, and rcsolved that they should receive no .and be registered according to law. He thought fees for expenses in prosecuting except such pro- the Council should now take action in this matter, portion of the fees collected as may be allowed by and not leave it any longer to the Executive Com- resolution of the Council. A deputation waited mittee and the. medical p.ifession. He felt that upon the Government to ask for aid towards de- the Council had failed in the appointment of pro- fraying the cost of the exaninations, but theh' cf- -secutors in the different counties. Thes\" gentle- forts were not sufficiently satisfactory te the pro- men took but very little interest in the duties of fession. The Committee presssed upon the Gev- their position, and would not undertake prosecu- crament thc neccssity of remuneration to medical tions unless a medical man would enter the com- witnes:es, and the payrent by the Govemment of plaint and take the whole odiun of the case. He the expeüses of examr ers. The Committcc rc- thought the Council should take some steps to rid cornmended that a new metbqd should be insti- the country or unlicensed practitioners who were tutcd for prosecuting unlicensed practitioners, and swarming in the western part of the Province. that a new code of rules and regulations should be With reference to the eramainers, of whom so much frameJ. had been said, and of whom so nrich had appeared, Dr. McLaughlin stated that he understood thc his feeling was that it was wise in the Council to Committce first asked the Goverameat for $xooo have appointed the examiners among themselves. and subsequeatly increased their derand te $5,ooo. but that the time had now come when they should If this wcre truc it might account foi thc non-suc- be appointed from outside the Council altogether. cess of the applioetion. (Hear, hear.) It would be the painful duty of the Dr, Campbell raid that the first surn merely re- Council to iPstitute an investigation into t re ferde to the expense of examinations. The i THE CANA-DA LANCET. 334",
         "1~ vi i second application embraced a much wider view, and looked forward to a system of medical ex- aminations, with illustrative specimens, and the establishment of a library and museum. What they had asked was not unreasonable, considering that the Veterinary College had received $2,ooo from the Government. There ivas a probability, too, that the College of Technology raight be given over to the Council, and in that case they would requi:.e an increase of fuids to provide for extra work. .What the Government had objected to was the principle of granting the aid sought for by sucli an extensive association as the Medical Council. I I 335 THE BOARD OF EXAMINERS. Dr. Dr. Campbell presented the report of the Board a thor of Examiners for the Autunn and Spring examina- aminer tions. of the There were 137 candidates who entered their only b names fru the spring examination. Of these 42 being received the licence of the College; 6o passed the Dr. primary examination; 15 were rejected in whole; Comm 3 were not present at the 1ral examinations ; 15 he ivas did not appcar ; one passed the first year's exam- Dr. ination, and one was put back for breach of rules. would The Chairman alluded to the comments that ted wit had been made ir the public uress in regard to the before result of the late examination. trusted Dr. Clarke suggested that it would be better ta gatory postpone discussion or the matter for the pre- broadcý sent. .ward a Dr. Campbell said he wished the press, who had The circulated the 3candal about the examiners, to know that it had not the slightest foundation. Dr. Berryman said he wished to clear himself The of any reflection that might be cast upon him ow- e ing to a clause in the report, stating that the exam- ment, w inations were delayed owing to the lateness of the as follo return of papers from the representatives of Vic- toria College and Trinity College. He was the re- Balance presentative of Victoria College, and felt sone ex- Fines up Dr. Pyne planation was required. He was examiner in Matricula three different subjects, botany, toxicology, and Septembc sanitary science, and had about 300 papers of April E\u003e about 12 pages each to go over between Friday Interest.. and Tuesday. He had two branches ready by Sundries. Tuesday, and the schedule of the third by the fol- Tota lowing morning. He found it impossible without, desecrating the Sabbath, to finish all three branches by Tuesday. Expense Dr. Grant srid that in his opinion the matter Otheracc was one of grave importance. The reports that Returning had been circulated in the newspapers were de- Prosecutio cidedly njuious to the profession if not disproved Registrar' and it was their duty to institute a rigid and tho E xpense o rough investigation. If they wished,to elevate the Reb:tes tc standard of the profession, they must first set a Execative good example to the young men who came up to Postage.. them for examination. He belie-red that a good Balance in deal had been done in this direction, and the stu- Total $3,368 40 124 70 1,233 13 698 74 930 o 2,820 o 67 51 11 50 $9,253 98 $1,071 04 884 22 52 55 600o 85oo 6oo oo 657 40 730 25 27Z 00 64] 40 2 14 4,197 9 .................... - .... $9,253 98 r2 THE- CANADA LANCET. n hand....................,. . .-. on illegal practitioners ... ........... Council znoneyr ................. tion Fees . .................. er Examinations.. ........ ........ xaminations ........................ .... .... .. ...... ........... .... .... .............................. ... 1 .............-..--..............-. EXPENDITURE. of last meeting of Council ............ pased by Finance Committee....... )u t; . .. . . .. . .... ... . . -officers' Fe .......... n of illegal practitioners ............ s Salary........................... f October Exarinations............. .April ,, ....... o Rejected Students. ........... Comnittee...................... ... .............. ................ hand ...........................-.- t. dents knowl upon. sion th that ti shaker consis une, M matter the Co Dr. that th trusted would now found it necessary to have a thorough edge of the subjects they were examitied Before they closed their labours that ses- ey should endeavor to regain the confidence he reports circulated in the press must have î. He moved that a Special Committee, ting of Drs. Brouse, Logan, Morrison, Beth- uir, and Ross, be appointed to enquire into of the recent examnations, and report to uncil. Macdonald seconded the motion, and hoped e matter vould be thoroughly sifted. He that on enquiry the newspaper reports Le found to be exaggerated. Clarke (Guelph) trusted that there would be ugh investigation, for the sake of those ex- s who had honestly worked in the interest profession. The Board of Examiners had een too anxious to do their duty, and too anxious, perhaps did too much. Dewar said he would be glad to make the ittee aware of everv circumstance with ivhich acquainted. Brouse said he hoped that an invitation be extended to all those who were a:quain- h any facts bearing on the matter to appear the Committee and give evidence. He that those who had made statemients dero- to the profession, and had scattered them ast throughout the country, would come for- id make good their statements. motion was carried. TREASURER'S REPORT. Treasurer, Dr. Aikens, submitted his state- hich was referred to the \"inance Committee, ws :- RECEIPT-S. 4\u003c",
         "336 THE CANADA LANCET. MULES AND REGULATIONS. The Conmittee recomnmended that advertise- Dr. Campbell's Bill to amend the by-law in re- ments be inserted in two papers, and the Pre- reg'ard to rules and regulations was read a first and sident only be authorized to give orders for the second time and referred to a Special Committee, same.--Carried. to be nanied by the President. Tird Day's Proceedings Second Day's Proceedi \"gs. The Council met at io o'clock a.m. The Council assembled at zo a.m., but after the FINANCE COMMITTEE. transaction of routine business, adjourned, to ad- The Finance Committee reported that they had mit of the varous commttees proceeding with found the Treasurer's accounts to be correct, and their atork. that there was a balance of over $4,ooo in hand. Dr. Alison moved n'That the Committee of It was recommended that $5o additional be paid Education be instructed fot to recommend any to the Treasurer, as remuneration for his services. member of the Council for examiner, but that They further stated that the expenses for the me bers of the profession otside the Council Executive Committee had amounted to $7oo, and o ohae bhom ethedb mediae associations, recommended that the number of its members be or others whom the Comiîttee have reason to be- 1reduced. lieve capable of performing the duties, be recom- Dr. ï. Clark introduced to the Concil a depu- mended to the Council for appointment.- tation from the Medical Association of the county ine said that lie had consulted his constituents of Waterloo, consisting of Dr. Walmsley, President in regard to this matter, and in making the motion of that Association, and Dr. Bowlby, who, it was which hie had just read to the Council hie was istated, would present a case for the consideration giving expression to their wishes. They ail knew of the Council. the feeling of the profession throughout the coun- The President welcomed the deputation in the try about these examiners. The feeling vas that name of the Council, and stated that as soon as the Council should noet act in defiance of, but in the nature of the case was made known the accord with the profession. The various medical Council would do all in their power to settle the associations ivere, e beieved ithout an excep- dificulty. After referrmng to the fact that their tion, in favor f having the examiners chosen from body constituted the Medical Parliament of the profession generalsy. je twas convinced that Ontario, and that all matters of dispute would be a rural medical ni was just as capable of per- willingly adjudicated, upon by theni, hie said hie forming the duties of examiner as those who had thought that before proceeding te discuss the heretofore acted as such, for he noticed that same matter it would be necessary that the true nature of the questions given by them î?ere very ridicu- 0f the case be made known. bus, having been taken almost verbatim et /iteratum Dr. Dewar then moved, seconded by Dr. Hyde, from the text books. \" That the deputation be allowed to bay their case Dr. Iyde seconded the motion. While he sup- before the deptting.\"-Carried t ported its principle most cordially, ie thought it Dr. Walmsley stated that they appeared before would be better to let the matter remain in abey- the Council to oppose the licensing of a woman ance until the Speciai Committee appointed in re- named Eby, of Berlin, (who claims to have for- gard te the late examinations should have repor- merly practised under the Eclectic system.) The ted. ground of their complaint was that Mrs. Eby was After sodne discussion it was agreed that the not a properly qualified person. Another reason motion should be laid over. was that if this woman was licensed, it would be Dr. W. Allison neoved, seconded by Dr. Mc- held as a precedent. He thought that the papers Laughlin, \"That leave be given to introduce a in connection 'vith the application had better be by-law to fix and determine the salaries of certain read. officiais and others, with a view of more effectu- Dr. Bowlby said, he had no objection to Mrs. ally rrying out the provisions f the Medicai Act Bbys practisîng midwifery; on the contrary, he The by-law was read a first time considered she had been decidedly useful, and he Dr. Conll prented at Reort ofthwas entirely opposed to prosecuting people of her Dr. Corne i presented the Report of the Print- Aass ; but he understood that stepF had been taken ing Committee. wn-. a view to procuring a license for ber, and ho The Council went into committee on the re- was at\" dedly opposed to this. She vas not a port. Some discussion ensued on the clause refer- properly qualified person, and were a license to be ring te the oose anner in hich severai accounts granted to her it would be doing an injustice to had been incurred, by menbers f Council having those who had spent the best part of their lives in authorized advertisements and printing without studying previous to passing the prescribed exami- the knowvledge of the proper officials. nation. So long as Mrs. Eby continued to prac-",
         "TuE OAINADA LkNOET. 337 tise midwifery only he would be content to let her alone. It would be a very different matter, how- ever, if the applicant were to be placed on an equal footing with themselves ; and it was the prospect of this that had brought him there to-day to oppose the application. Dr. Dewar then moved, seconded by Dr. Hyde, \" That all the papers in connection with the case be received by the Council, and that the whole case with these papers be remitted to the Registra- tion Committee for consideration, and that said Committee be asked to take immediate action.\" Carried. REPORT ON EXAMINATION IRREGULARITIES. Dr. Grant, chairman, read the following : The Committee called various witnesses and made a full enquiry into the subject of the recent medical examinations, and beg to submit the following:- i. The written examination was regular and satisfactory in every respect, except in the case of a German student, whose papers were passed in an irregular manner and contrary to the directions of the Council, although his standing was sufficiently high to enable him to qualify. 2. The chief irregularity was brought about in the oral examinations, owing to the unexpected absence (at the appointed time) of Drs. Bethune and Berryman, thus occasioning the delay com- plained of by the students. To obviate such in the future, we would recommend to the Council that a change be made in the examiners, being fully of opinion that on so important an occasion the carrying out of the examination should be attended with promptress and regularity. 3. In future the students presenting for examin- ation should be provided with an ante-room, so as not to obstruct the proceedings of the examiners by outside irregularities, such as experienced dur- ing the present exaininations. 4. For the future your Committee would re- commend that every possible care be taken to maintain the honor and dignity of the position, that every degree of justice be accorded to those coming forward for examination, and that no inter- course between examiners and students, such as would indicate the points of examination, should take place. 5. The examinations as a whole were satisfac- tory. Still, while regretting exceedingly that any irregularities should have taken place, we are of opinion that the published accounts of such were considerably overdrawn. 6. In the performance of the duty assigned your Committee, every opportunity was afforded all concerned to give such evidence as would in any way clear up the point at issue, and we feel satis- fied that for the future your honourable Council will have no occasion to consider such irregulari- ties. Several gentlemen who had been members of t Board of Examiners asked permission at this stage of proceedings to withdraw, that the Council might have an opportunity of discussing the report fully and fairly. Dr. Brouse moved the adoption of the report. Dr. Allison opposed its adoption, on the ground that there was nothing in it. A very grave charge had been made through the public press against the examiners, and he had hoped that the report vould contain either express repudiation of the charges, or else censure those against whoin the charges had been made. Dr. Brouse thought that if the report was care- fully considered, it would be found that the language was sufficiently pointed. Some discussion followed, during which Dr. Berrymian spoke at some length in his own defence, and concluded by saying that if he had a friend in the Councli, he hoped that he would move that the clause referring to him be expunged. Dr. Brouse replied that he hoped Dr. Berryman would not press the matter any farther. He (the speaker) held evidence in his hand which, if read by the members of the Council, would not induce them to make the report any milder, to say the least of it. The report vas adopted. Dr. Allison then noved, seconded by Dr. Hyde, \"That the Committee on Education be instructed not to recommend any member of the Council for examiner ; but that members of the profession outside of the Council who have been selected by the Medical Associations or others whom the Com- mittee have reason to believe capable of perform- ing the duties, be recommended to the Council for appointment.\" In explaining his reasons for making this motion, Dr. Allison hoped the members would not oppose it without due consideration. Many members in the country were quite as competent to act as ex. amiaers as members of the Council. He wished to have the confidence of the profession in the country. The whole of the examiners should be outside the Council. Dr. Hyde also spoke in favor of the motion, and thought that the present monopoly system should be done away with. He found no fault with the examiners who preceded, buthe did not like a moio- poly. The honor should be divided and bestowed upon members outside, at least there should be a fair* share. The Toronto University changes its examiners every two or threeyears, and the Council should take a leaf from it. The Council should endeavor to regain the confidence of the profes- sion. Dr. W. Clarke spoke at length on the subject, after which Dr. McLaughlan moved, seconded by Dr. Lavell, \"That the Council will always endeavour to avail themselves of the services of the most competent examiners selected from the registered practitioners of Ontario.» THE CANADA LANCET. 337",
         "338 THE CANADA LANCET. Drs. Dewvar, Ilethune, Macdonald, Campbell irregular practitioners in Ontario, and to colleet and Berryman spoke gagainst Dr. Allison's mot e annual fees froi rgular practitioners. Dr. Ross was in favour of the motion of Dr. AI. Dr. Logan, ia seconding the resolutionexpained lison. The question was one of much importance. that niany parties wereo ot prosecuted ow ino It was apparent from the matters which lad cone local prosecutors refusing to act aganst illegal up that day for their consideration that there ivas practitioners in their immediate neiglebour somethimg wrong vith the examiners. He thought hood, and conscquently many physicians re- also that it was unfair that none of the examiners fused to pay the annua fee. y hat they required were selected from outside of the Council. i vas to satisfy the profession that they were doing Dr. Brouse moved, seconded by Dr. I wasi, something for those who ere registered practi- That the motion of Dr. Allison be laid on the tioners. tabDe. \"ACarried s Dr. Ross moved in amendment, \" That this Dr. Allison xpressed is determination to bring Council recomiend the Electoral Division As- the motion to a vote at a future sitting. sociation to institute thec necessary prosecutions THE FINANCE COMMITTEE. against illegal practitioners.\" le considered that if it were generally known that any one could prose- The Finance Co mittee submitted a supple- cute and pocket the fine there would not be any mentary report. The report stated that an exami- difficulty ini getting individuals to prosecute. Last nation of the R\\'egistrar's book showed that lie hiadycrheevsapulcroetrapotdfr recive onassssmntsmad bytheCouci the year there was a public prosecutor anpointed for received on assessients made by the Coinci e this section, but that individual turned his back on suin of $t.hao, whicdu tas counparatively a smal thei and went over to the qaacks, and so nothing portion of the a eiount due to the Council fro the vas gained by it, and this Council was depreciated egistered practitioners, and recommended tlat the in the estimation of the public. It would be far uinual fée for the current year be $r.-Carried. better to establish electoral associations through- REGISTRATION COMMITTEE. out the Province, and let the recomendation go Dr. Bethune brought up the report of the forth froni the Council advising them to institute Registration Com ugtee in the case of Mrs. Eb the necessary prosecutions. hihreicomme \"iThat the case be rerre' Dr. Dewar spoke of the success which lad at- uhicl recommeuded That the case be referred, tended the prosecution of illegal practitioners in ut of courtesy to the representatives at large bis division, Port Hope, but lu other districts the Eclectics) in this Council, as the matter had here- lus diviion, Pot H en otes trict e fore been under their consideration.\"--.Carried. prosecutions had flot been so successful. H-e knew SELECTIO OFn uEAioNSof instances where any amount of evidence was SELECTION OF' EXAMINERS. forthcoming, but Dr. So-and, So would ask that bis Dr. Allison's motion to alter the mode of nane should fot be mentioned iu connection with pointing the Examiners was again brought up the case, and so the whole thing fel througi. He d was voted upon without discussion. was not in favor of the electoral associations, for Yeas.-=Drs. Allison, Edwards, Hyde, Irwin and they would not act with the Council sn this matter, oD.-5. as medical men did not care about being looked Nays.-Drs. AIKENS, BETHUNE, CAM1,PBELL, upon as detectives.. ARSON, WM. CLARKE, DEwAR, HENDERSON, After some further discussion on the subject, Dr. VELL, LOGAN, LYNN, MCDONA'LD,MCLAUJGHLIN' Ross's amendment was put to the vote and declared ORDEN and MUIR.-I4. ' lost. Dr. Morden's motion was carried. SALAan URIES- BLDr. Wm. Clarke moved, \" That Mr. Thos. Rol- SALARIES BoLL. leston, of Walkerton, and Mr. Hogg, of Paisley, be Dr. Allison's B3ill to fix the salaries of tlîe offi- public prosecutors for the county of Bruce.\u003e\"-Car. Is was read a third time and passed. ried. The salary of the Registrar was fixed at $750 per MEMBERSj FEES. umi; of the Treasurer, $250 ; the allowance to Dr. Carson noved, \"That the members of this mbers of Council while attending its meetings, CoDl Creived \" That the mtem e of the per day, and travelling expenses, and the mem- nci receiv no fees for their attendance at t of co ittees, $ per day.eetgs of the Council of Ontario Collee of r. Pyne was elected Registrar, and Dr. Aikens Physicians and Surgeons.\" er. a DDr. Allison moved, in amendment, \" That the asurer. motion be laid or, the table.\"--Carried. Fourth Day's Proceedings. VOTE OF THANKS. he Council met at o o'clock. Dr. Ross moved, seconded by Dr. Allison, \"That this Council desires to convey to the Senate of the APPOINTMENT 0F A PUBLIC PROSECUTOR. Ulniversity of Toronto its sîncere thauks for the use r. Morden moved, \" That a public prosecutor of the University buildings, and also to express its ppointed to institute proceedings against all regret for the occurrences during the recent examin- r ai w (J to ap R C L cia ann me $8 ber D Tre T D be a",
         "THE OANADA LANCET. ations, and that this Council will use its utmost exertions to prevent the recurrence of the same in the future.\"-Carried. Dr. Henwood moved, \" That this Council make application to the Legislature of Ontario for the purpose of the Medical Act being so amended that the territorial divisions may return two mem- bers instead of one to this Council.\" Dr. Henwood thought that by doubling the re- presentation at the Council the interests of the profession would be served in a variety of ways. \" In the multitude of council there was wisdom,\" and lie had no doubt some valuable suggestions could hardly fail to be obtained from the additional representation. He also pointed out that they would have a larger number froin which to draw their examiners. Dr. W. Clarke did not want to have any agita- tion in the House about this matter, for they rnight get things they did not want. He advised them not to go before Parliament; they had bothered them enough already about various amendments to the Medical Act, which at the present time was working very well. If they doubled their number it would also double their expenses. Dr. McLaughlin explained that the present term of the Council would be concluded before any alterations could take place. If the matter Was postponed until next session it would be best. He hoped, therefore, that Dr. Henwood would with- draw his resolution. Dr. Bethune, vas opposed to the principle em- bodied in the motion. The Act was cumbersome enough already ; lie agreed that the matter was one of importance, but lie thought it would be best to lay it over. Dr. Ross was in favour of the number of the Council being increased, which lue believed would be satisfactory to the profession, especially.in view of the fact that the present council is evidently in- clined to create a nonopoly by appointing from their number the greater portion of the examiners. The motion was allowed to lie on the table. RULES AND REGULATIONS REPORT. Dr. Dewar, from the Committee on Rules and Regulations, reported that in the case of Dr. John L. Burkhart, the gentleman now named if practis- ing in Ontario, was doing so illegally, as Dr. Ed- wards' temporary permit would not be valid after the spring examinations. Your Committee further report that they have received a tariff of fees from the Territorial Asso- ciation of Saugeen and Brock, and recommend the acceptance of same by the Council and that it receive the signature of the President. Your Com- mittee also recommend that the claim of Dr. Camp- bell, for expenses incurred in carrymng out the in- structions of the Executive Committee in making applications to the Legislature of Ontario and the Dominion Parlianent for Government aid to this Council and in endeavouring to obtain a proper tariff of fees, to the amount \u003c,4\" je paid.-Car- ried. PROCEEDINGS OF COUNCIL. Dr. Clarke presented the report of the Special Committee appointed to regulate the proceedings of Council. The Committee had only time to ex- amine the by-law to end of section 8, sub section 2, and certain corrections in said by-law, and re- commend that saine corrections be embodied in said by-law, and that oo copies of the said by-law, be printed for distribution by the Registrar to mem- bers of Council.-Carried. REGISTRATION COMMITTEE. Dr. Bethune presented the report of the Regis- tration Committee. The Coininittee recommends that Dr. F. L. M. Grassett be allowed to register on passing the final examinations before the examiners, of the College of Physicians and Surgeons of Ontario, and that such examination be passed with- in one year from the present date. That the per- sons referred to in the petition of Dr. Hope and others, and also the case of Dr. Chaffey be allowed to register on compliance with the terrns contained in the foregoing clause as applied to Dr. Grassett. Dr. R. H. Hubenstreet, of Buffalo, be referred to the clause respecting the -nnual examinations which applies to his case, and that the Registrar be in- structed to forward him copies of sane. 93 persons have registered sinco last report; 124 names have been added to the student's list, and the Registrar lias received notice of 12 deaths. In reply to Dr. Dewar, it was stated by Dr. Bethune that Dr. F. L. M. Grassett had not passed his primary examination. There were many cases of the saine kind coning up, and the Committee thought they would allow this matter of registration to stand for another year, with a view of eventually getting rid of it. He believed it was thoroughly understood that this would be the last year of such registrations being allowed. Dr. Clarke considered it would be impossible for the Council to agree to such a resolution. They vould have to repeal the by-laws and almost the whole statute if they allowed this to pass, as the examinations weie fixed by by-law. Dr. Lavell stated that he had known young men snapping their fingers at the Council, and stating that tliey would go to England and get themselves registered in spite of the Couneil. Dr. Dewar said this same subject had been dis- eussed before the Council a year or so ago. He would move, \" That the clause referring to the registration of the medical nien be expunged from the report.\" Dr. Aikins considered that if they gave way in this matter they might as well throw away the .Act. It was unfair that persons studying at other places t 339",
         "THE OANADA LANCET. and thon coming back liero should be recognized and thoir own University not recognized at ail. Dr. Blthune proposed to amend the clause by striking out ail words after \" register,\" and inser the words \" on complying with the rules of th Council.\" -Oarried. EDUCATION cOMMITTEE REPORT. Dr. Clarke prosented the Education Committee's report :-Tho Cominittee r2commend the following changes in the curriculum: Elementary Botany (text-book Gray's first lesson) to be added to coin pulsory subjects in matriculation, and expunged from the medical curriculum; also that 6, 7 and 8th books of Charles XII be substituted for 1, 2 and 3rd books, and that \" StewartVs Physics,\" be added as a text book in natural philosophy. The medical examinations for 1877 to bo held in Toronto and Kingston, at such time as may be fixed by the President; that ail students commencing their attendance on modical lectures after July, 1876, must submit to the annual examinations. The un- successful candidates in matriculation to have the usual rebate. The following were recommended as examinerson the subjects assigned then : Medicine, Medical Diagnosis, Pathology, and Medical Botany, Dr, F. Fowler; Surgery and Surgical Pathology, Dr. Robertson ; Materia Medica and Sanitary Science, Dr. .1. H. Wright; Midwifery, \u0026e., \u0026c., Dr. Worknan; Chemistry, theorotical and practical, Dr. Morrison ; Anatomy, descriptive and surgical, Dr. McLaughlin ; Physiology and Microscopic Anatony, Dr. Grant; Medical Jurisprudence and Toxicology, Dr. Logan; Homoeopathic Exafniner, Dr. Morden; Matrieulation Examiners, Messrs. A. McMurchy and S. Woods.-Carried. The examiners' allowances were set down at $100 ea.h. The matriculation examiners to receive $2 for each candidate as before. Detectivo Smith, of Toronto, was appointed public prosecutor for Ontario. The usual votes of thanks were passed, and a present of $100 -was unanimously voted to Dr. Campbell, the Vice-President, for his arduous labours in the interests of the Council. The Couneil thon adjourned sine die. BATHURST AND RIDEAU MEDICAL ASSOCIATION. The annual meeting of the above Association was held on the 14th ult., at Perth. The follow- ing medical gentlemen were present:-Dr. Grant, Ottawa, President ; Drs. Hill, Sweetland, Bentley, Lynn, Wilson, Malloch, Horsey, Wright, Hender- son, Cranston, Patterson, Bell, McEwen, Ander- son, Preston, Munro, Campbell, Lanark, ;Pickup, Howden, Kellock and Grant. The minutes of last meeting were read, and ap- proved. The President then delivered an able and in- teresting address, which will be in another column. The following officers were elected:- President (ex-offco)--Dr. Grant. 1st Vice- President-Dr. Patterson. 2nd Vice-President-- Dr. Preston, M.P.P. Treasurer-Dr. Hill. Secre- tary-Dr. Lynn. Executive Committee-Drs. Cranston, Ander- son, Bell, Kellock, Dickson, Giles, Sweetland, Wright and Malloch. The President appointed Drs. Henderson, of Ottawa, and Howden, of Perth, to read papers at the January meeting in Ottawa. Dr. Pickup, of Pakenham, formerly Assistant Medical Superintendent at Beaufort Asylum, read an interesting paper on \"The Nature of Insanity.\" Dr. R. W. Bell, of Carleton Place, read a care- fully prepared paper on the \"Sanitary Influence of Light.\" A short discussion, participated in by members present, followed, upon the leading points of the foregoing papers. The authors were thanked, and requested to send them for publication to the CANADA LANCET. Dr. Cranston moved, seconded by Dr. Hill,- That this Association desires to record its approval of the action of the Medical Council in removing from the Examining Board those gentlemen against whom charges of irregularity at the last Medical Examinations had been brought and proven. This motion, which was an amendment to one proposed by Dr. Sweetland couched in stronger language of disapproval, was, after a lengthened discussion, carried by a small majority. The gen- eral feeling appeared to be that the medical pro- lession had suffered by the grave \" irregularities \" of certain medical examiners, which it was desirable to condemn very strongly. Dr. Preston moved, seconded by Dr. Patterson, That for the future it is the wish of this Associa- tion that the Examiners should be chosen froin the general Profession as well as the Medical Council and teaching bodies.-Carried. Dr. Sweetland brought up questions relating to the tariff, and the difficulties in connection with the collection of medical accounts. Moved by Dr. Bell, seconded by Kellock,-That the question of a code of medical ethics for regu- lating professional intercourse amongst medical men of this Association, be referred to the Execu- tive Committee for consideration, and report there- on at the next meeting.-Carried. A vote of thanks was tendered to the Chairman and Secretary, after which the meeting adjourned. In the evening a supper was given in the Allan House to the members of the Association by the resident physicians in town, the Mayor, Judge Senkler, members of the Press, etc. 340",
         "THE OÂNADA LANOET. 341 THE CANADA LANCET. 11onthly Journal of Medical and Surgical Science Issued Promptly on the First of each Month. Communications socited on aU Medical and Sci- \"-t ubjects, and aleo Reports of Cases ocrtg\u003c 4rM8,. AU Letterg anad Communications to b. addrcssed the di. EdUtor Canada Lýaneet,\"f- Toronto. -IVTs.-DAsON BRos., Montreal; J. \u0026 A. MCMILLAN St John J. M. BALDWIN, 806 Broadway, New York, and BALLIDas tNDALL \u0026 Cox, 20 King William atreet, Strand, London, England. TORONTO, JULY î, 1876. 'ýACCINATION AS A PREVENTIVE SMALL-POX. OF We are in receipt of a very able essay on this bject by Dr. W. C. Chapman, Vice-President of e Toledo Medical Association. Dr. C. commences *th a natural expression of surprise and indigna- 41a,thatinthis year of grace 1876,unreasonable and \u003c4tal prejudice against it should exist in the minds n any educated or intellectual individual, and by Y of showing in the most unmistakable manner, e losses sustained by a community from the pre- '%lence of a small-pox epidemic, he quotes the 1lowing passage from a paper presented by Dr. nfljamin Lee, of Philadelphia, at a meeting of the Nblic Health Association in Baltimore. \" An Þ1lroximate determination of the loss sustained by i4 city of Philadelphia, in dollars and cents, in '0?sequence of the presence of a spiall-pox epi- 4MIic in the winter of 1871-2, and placing side by ede with this the degree in which the loss might Ve been prevented by judicious sanitary legisla- t legally enforced. The total loss sustained ng the epidemic of those years is placed at e enormous figure of nearly twenty-three millions .tdollars, and Dr. Lee believes that go per cent. '*the cases, and 97 y/ per c8nt of the deaths could .4Ye been avoided, and that less than three-quarters million dollars would have represented the loss by sickness, death and disability. Aver- the value of a human life, he finds that the l loss sustained by reason of sickness, death disability, was nearly sixteen and a half millions \"dollars. He then reviews the history ofthe origin Spread of small-pox, in former centuries, with 1ightful attending mortality, in an exhaustive 'Ier, inclining to the belief that the disease described by Procipius, which made its appearance in Egypt in the year 544 was true small-pox. Europe was not long free from its invasion. Gregory, of Tours, speaks of a disease which appeared in south- em Europe in the year 581. From the description given by him, the character of true small-pox is apparent. In the Harleian manuscripts, published some time before the year 900, the word Variola is used, and Moore in his history of small-pox, states that the word occurs in the Bertinian Chronicles, published in the year 961. The dread in which the disease was held by the people, is shown by the following prayer, found in the first named manuscript: \" In the .name of the Father, of the Son, and of the Holy Ghost, Amen. May our Saviour keep us ; Lord of Heaven, hear the prayers of thy men-servants and of thy maid-servants; O Lord Jesus Christ, we beseech thousands of angels, that they may save and defend us from the fire and power of the small-pox.\" Dr. C. then traces down successive epidemics to the end of the eighteenth century, discusses the question whether it was coeval with creation or had a subsequent be- ginning, and whether the same causes which originally produced, may reproduce it without contagion. He rather inclines to the belief, that although the doctrine of spontaneous origin admits of being supported by ingenious and plausible argu- ments, the weight of evidence is decidedly in favor of the invariable origin of small-pox by contagion. He then gives the history of the introduction of inoculation as a palliation, by Lady Mary Wortley Montague, its subsequent abandonment from its proven ability to spread the disease as readily through the community from an inoculated case of 9mall-pox, as from a natural one. From this he passes on to a glowing eulogium on Jenner, the generally believed discoverer of vaccination as a prophylaxis. We say generally believed, because we apprehend the evidence extant to prove that to Jenner is due only the merit of elaborating, with great care and labor the discovery of another, is known to comparatively few members of the pro- fession. In evidence of this we translate from Trosseau's Medical Clinique Tome Premier, page 43 the following passage : \"The idea is far from me, of contesting the honor due to Jenner for the discovery of vaccination ; it is necessary however for historic truth to make known the various documents which have been collected re- 341 THE OANADA LANCET.",
         "342 TfIE CANADA LANCET. cently in the Gazette Medicale de Lyon, documents borrowed from the London Lancet of the 13th of September, 1862, and which would appear to es- tablish incontestably that a Gloucestershire farmer, Benjamin Jesty, was the first to try in 1774, inocu- lation of cow-pox, which he practised on his wife and his two sons, with the view of rendering them exempt from epidemics of small-pox. The same journal contains a letter from Mr. John Webb, from which it would appear that small-pox may be communicated to the cow, and that those who take from the cow this small-pox, so modified, be- come after some days of restlessness, exempt from variolous contagion. Trousseau then quotes from the London Lancet of the 25th of October, 1862, a recitalof the circumstances that led to this discovery by Benjamin Jesty, also a letter from Mr. Alfred Hairland, on this discovery of Jesty's, an extract from the annals of the Vaccine Institution, and lastly the epitaph on Jesty's tombstone, which reads thus: \"Sacred to the memory of Benjamin Jesty, who departed this life the 16th of April, 1816, aged 79 years. He was born at Yetminster in this county, Dorsetshire. An upright, honest man, par- ticularly noted for having been the first known person to practise the inoculation of cow-pox, and from his great strength of mind to undertake the experiment of vaccinating his wife and two sons in the year 1774.\" If Jenner was not, as it would thus appear, the discoverer of Vaccination, un- questionably to him belongs the honor of familiar- izing the public mind with its preventive powers. Jenner published his first essay upon the subject in the spring of 1798, entitled : \" An enquiry into the causes and effects of the Variola Vaccine, a disease discovered in some of the western counties of England, particularly Gloucestershire, and known by the name of cow-pox.\" Dr. Chapman arranges the subject of vaccination under the four following queries. 1st. Does vaccination protect the system from the contagion of small-pox ? 2nd. Why does the protective power of vaccination become so im- paired as to render re-vaccination advisable ? 3rd. What causes have prejudiced the public mind against the operation of vaccination ? 4th. What measures should be instituted to en- force a due appreciation of the benefits Qf vaccina- tion ? We prgpose epitomizing his views on these four queries. Dr. Seaton, in reporting the results of vaccination in Scotland and Ireland, says, that in the twelve years, from 1853 to 1864, there waS an annual death-rate in the former country of 1,054, there being no vaccination act prior to 1863. 40 the years 1865, '66, '67, '68 it was respectivell 175-200, 124 and 25. In Ireland, from 1830 to 1840, the annùal average mortality was 5,800; from 1840 to 1850 it was 3,827, and from 1850 to 186o it was I,;272. Vaccination became compulsofl in 1863, and in the years 1864, '65, '66, '67, '6 they were respectively, 854, 347, 187, 20, and 19. In the first three months of 1869 there were onl1 three deaths, and in the next quarter of the ye9X none. Pr-fessor Aitken in his report to the Epidemiological Society of London, proves the beneficial influence of even an imperfect enforce- ment of vaccination enactments by the followid statistics :-ist. To prove the influence of vaccinW tion in England, it is shown that out of evef 1,000 deaths in the half century from 1750 tf 18oo, there were 96 deaths from small-pox; ail out of every 1,ooo deaths in the half century froO 18oo to 185o, there were only thirty-five deatl# from small-pox. 2nd. To prove the influence of vaÇ' cinatdbn on the Continent, it shows that in vario# German states sufficient evidence can be obtaine to show that out of every 1,ooo deaths before vOt cination was used, 66.5 were deaths from small-pO* but that out of every 1,ooo deaths in the h# century from 18oo to 185o, after vaccination cavO into use, the deaths from small-pox were only 7-3e 3rd. To prove that in countries where vaccination 0 most successfully carried out, small-pox is lea mortal, it is shown that in this country (England) where vaccination has been voluntary, and fr quently neglected, the deaths from all causes beißd 1,ooo, the deaths from small-pox were as folloW' London 16, Birmingham 16.6, Leeds 17.5, Engla and Wales 21.9, Perth 25, Paisley 18, Edinburge 19.4, Glasgow 36, Galway 35, Limerick 41, Dubl 25.6, Connaught 6o, tIl Ireland 49. In other coe' tries, where vaccination has been more or less ce pulsory, the deaths from all causes being 1,ooo,t deaths from small-pox were as follows :-WCO phalia 6, Saxony 8.33, Rhenish Prov. 3.7, PoDe rania 5.25, Low Austria 6, Bohemia 2, Lombard 2, Venice 2.2, Sweden 2.7, Bavaria 4. Dr. four has collected statistics from the records of tM British army and navy. It is shown that in 0 branch of the service, with an aggregate strengtO 44,61,1 during the tweSty years from 1817 to i -li2 TEHE CANADA LANCET.",
         "THE CANADA LANCET. inclusive, there were only three deaths from small- P9, in a total mortality of 627. During the same Period, among the troops of Gibraltar, the aggregate strength being 44,61i, and a total mortality of I,9i, there occurred only one death from small- POX- At Bermuda, Nova Scotia, New Brunswick, Cape of Good Hope, and the Mauritius, there Were no deaths from small-pox for twenty years, 4d in Western Africa, where the unprotected POPulation was dying by hundreds, there were no deaths from the disease among the troops sta- tioied in that region of country. It is thus shown COnclusively, that since the introduction of vaccina- tion, the rate of mortality has been reduced in thOse portions of the world where the operation been enforced. E COUNCIL AND EXAMINING BOARD. ln another place will be found the report of the i4Çceedings of the meeting of the Medical Council O Ontario, which was held in Toronto, early last 4'ýkth. The meeting was much more orderly and 41ness-like than any which has taken place for 4'j4y years past. Almost the first business, after the election of the President and Vice-President, a the appointment of a committee to investigate irregularities, which took place last spring, in VOnection with the examining board. This com- r4ittee sat with closed doors, and examined such %ience as was voluntarily adduced, the majority 9f the witnesses being members of the examining d. The report which was submitted to the 4-uncil and adopted, showed,even on the strength such evidence as was to be obtained from volun- Witnesses, that certain irregularities did .take ; their exact nature however was not stated. names of two gentlemen were mentioned in 4CQnnection, one of whom is outside the Councib %te other formerly a prominent member, but seems suddenly to have lost cast entirely. 1141Y a few months ago he was so strong in the dýlence of the members of the Council, that he appointed examiner in no less than three dif- t subjects. It was hardly to be expected that rdinary person could examine so many papers Priday afternoon until the following Tues- tQuch less a man of Dr. Berryman's well known \"uPn1ctuality. We are therefore constrained to ask, why was he appointed to sq many branches ? He himself såys it was because he was the only competent person. The evidence Qf miscoduct or irregularity on the part of these two gentlemen has not been made public, therefore we are unable to form any opinion, on the merits of the case, but the belief has been publicly expressed that they have.been made the scapegoats on this occasion, not by the committee (far be it from us to say one word derogatory to the committee), but by those who gave evidence before the committee. With reference to the examining board, the pro- fession will observe that its constitution is slightly changed, but not to the extent required. The ap- pointment of Dr. Workman as examiner in mid- wifery is highly to be commended, and there is not one word can be said personally against those members of the Council who have been appointed, or rather who assisted in appointing themselves, on the examining board. They are quite compe- tent to act as examiners, although not better quali- fied than many outsiders that could be named. It is the principle involved in these appointments that is objected to. It certainly does not look well, to say the least, for these gentlemen to vote for their own appointment in one motion, and thçn turn round in a few minutes afterwards and vote them- selves each one hundred dollars for performing the duty. There are three principal grounds of ob- jections against this system of appointrnent. 1st. It creates a monopoly in the Council, and destroys its character as an appellate body. 2nd. The gentlemen appointed from the Council have a voice in their own appointment. 3rd. They have the power to vote themselves whatever sum they please, as remuneration for their services. The schoolmen, with a disinterestedness which is highly creditable to them, have given way to pro- fessional opinion so far as to appoint, those ex- aminers who represent the schools, from without the Council. We have, therefore, the territorial men chiefly to blame for the continuance of a system which is utterly repugnant to the profession. Dr. Allison and those who voted with him (see list), deserve the thanks of the profession for the noble stand they took on behalf of the profession. Some of those who expressed themselves privately, as opposed to the principle, gave way in the end to the wirepullers and allowed this iniquitous principle to be continued yet another year.",
         "344 THE CANADA LANCET. It has been remarked by some who were careful observers of what transpired at the meeting of the Council, that the wirepullers have simply appointed the present board of examiners, in order to keep the seats warm for themselves until a future time. THE WESTERN MEDICAL COLLEGES. It would appear from an agitation carried on in the American medical journals, that no restrictions are put upon thé practice of medicine in the State of Missouri. There is no State organization exact- ing any test of qualification, as in some other American States ; but a sort of unimpeded\" free trade \" in medicine exists, the effects of which, it is interesting to note are bitterly deplored. The want of an adequate test and standard has led to the multiplication of medical colleges, and these numerous institutions have been permitted to enter on a career of reckless competition in the manufac- ture of graduates. In order to fill the graduating classes of the western institutions, the professors are charged with offering inducements in the shape of low fees, low standard of preliminary attainments, low standard of professional examinations ; and these not sufficing, they fill up their classes with beneficiaries. As a consequence of this system, it is stated that there are men dubbed with the doc- torate in medicine, who are unable to write decent English, or spell correctly, and of whom it cannot always be safely asserted that they are acquainted with even the elementary principles of medical science. Of course, the inevitable result of such a state of things has been to cast discredit on the medical profession, and to degrade the value of a medical degree. This state of things also inakes it plain, that it is a great and dangerous mistake in medical educa- tion, to under-estimate the necessity of preliminary education of a high order, and an equally great and dangerous mistake to skip over in the medical curriculum, the fundamental and collateral studies, such as physics, chemistry, zoology, botany, etc. These studies being somewhat severe, and not im- mediately practical like the purely professional branches, are not popular with a certain lazy and incompetent description of students ; and by cur- tailing them and making other more attractive branches take their place, as would appear to be the practice in the colleges of the Western Statcd just so many facilities are presented for the entrl into the medical profession of men of limited int' lectual capacity and defective training. The perception of these causes and their opert tion ought surely to be a warning for us in OntariO; and in this spirit simply we have referred to thel* Let us maintain a high professional standing, DI attending to the things which are so obviousll pointed out. PHOSPHORATED OIL IN PSoRIASIS.-At t1 Demilt Dispensary, New York, Dr. Bulkley h been using phosphorus in many cases of psoriasiý giving it it doses of one-hundred and sixtieth 1 one-eightieth of a grain, in cod liver oil. Ve4 good effects have been observed in a number cases, a part of which must of course be attribut to the oil. Dr. Bulkley supplies the followM caution with respect to the internal administrati# of phosphorus :-\" I have once observed a In severe bilious attack, with jaundice, come during the taking of the phosphorated oil, whb passed away soon, on ceasing the use of the saCD and the administration of a cathartic and so mineral acid. But it was a warning by which have profited, and now I generally omit the reIn every week or so, administering acetate of potoa in the intervals, and with excellent results.\" THE LIERNER SYSTEM oF DRAINAGE.-It is clao ed that the Lierner system of removing sewage atmospheric suction) is best adapted to the wantO0 Canadian cities, and of the inclement parts of lot# America, where the winter's frosts interrupt t action of water carriage. An important test w will serve as a test of this claim, is about b afforded, by the introduction of the plan into RU If it succeed there during the Russian winter, way will be paved for its introduction into Bos Montreal, Toronto and other cities. To PREVENT FURUNCLES.-For checking the new formation of boils, Dr. Bulkley, of New Y relies mainly upon the hyposulphite of soda, g internally, thirty grains three or four times largely diluted, and on an empty stomach. S0 times this fails, when large and repeated doses quinia will pretty certainly do the work. THE CANADA LANCET. 344",
         "THE CANADA LANCET. THE AMERICAN MEDICAL ASSOCIA- TION. a The 27th annual meeting of the American Med. 4O'n. was opened in Philadelphia on the 6th of fî hie and remained in session four days, Dr. J. t 'arion Sims, President, in the chair. In his ad- d dress, the President touched upon medical educa- ti and the code of medical ethics. The points in the code to which he alluded were the restrictions 48 to advertising, patenting of instruments, and the eCrecy of the consulting room, all of which he 'COndemned. In fact, Dr. Sims does not wish to 4 hampered by cast-iron rules, but would rather trust to the higher code of honor and honesty t %ich should ever prevail in a liberal profession. e then took up the subject of syphilis, and urged *ith great force the desirability of legislation, with SView to meet and cgmbat this terrible scourge. e remarked, the sea was the great highway for 8YPhilis, and sailors were the great carriers of the kOson, and suggested that they should be put 1'4der strict quarantine. A very interesting paper *4 read by Dr. R. C. Kedzie of Michigan, on \u003cXatural Purifiers,\" in which he contended that *ter and air held the first place. In conclusion, e noved a resolution that \" no municipality should introduce a water system without at the 4tue time providing an extensive sewer system.', br. Garcelon of Maine, read a paper on surgery lr. Seguin introduced the subject of Medical Re- Cords. A most interesting and instructive paper 8 read by Dr. Woodward, on the Differential gnosis of blood corpuscles, in which he took Casion to say that he would not swear that cor- sukles from dried blood-stains were or were not human, if it involved the life of a human being. e draft of a Bill, by Dr. Baker of Lansing, 'Mich., to be sent to Congress, was read before the section U State Medicine. Dr. Busey read a very able ré8ume of Gynecology during the past year. Dr. in of Boston, moved a resolution on the sub- oet Of bovine or animal vaccination, and secured th appointment of a committee to report at next eeting of the Association. In the section on lhgery Dr. Sayre exhibited his plan of treatment or the cure of Potts' disease of the spine, which % highly commended. A communication was from the Medical Society of Victoria, asking a list of medical colleges recognized by the American Medical Association. This occasioned warm and exciting discu'ssion, and was finally abled. Dr. Bowditch, of Boston, was elected President r the ensuing year, and Chicagb was selected as lie place of the next annual meeting, on first Tues- ay in June, 1877. CANADA MEDIcAL ASsoCIATIoN.-The ninth annualmeeting of the Canada Medical Association vill be held in Toronto, on Wednesday, 2nd August, 1876. The chair will be taken at 1o A.U. Members intending to be present, can obtain cer- ificates entitling them to return tickets at reduced fare, from the local secretaries, Dr. Zimmerman, Toronto; Dr. F. E. Roy, Quebec; Dr. Gordon, Halifax, N. S.; Dr. McLaren, St. John, N. B., or rom A. H. David, M.D., Ed., General Secretary. Montreal. SPECIAL HoSPITALS.-The London Lancet, in a late issue, has an article on the desirability, from an educational point of view, of establishing spe- cial departments in the large general hospitals, rather than the multiplication of small hospitals for special diseases. Specialists and special hospitals have been growing into disfavor of late, the reason of which is in great part due to their being over- done. The evil, if evil it be, will work its own cure. An Englishman who insulated his bedstead by placing underneath each post a broken-off bottom of a glass bottle, says that he had not been free from rheumatic gout for fifteen years, and that he began to improve immediately after the applica- tion of the insulators. A local paper quoting this item wisely adds : \" There's many a fellow who could cure his gout, if he would break off the bot- toms of his glass bottles\u0026in time.'' The medical profession of Lyons, France, are not in favor of the etablishment of small-pox hos- pitals ; which leads a facetious journalist to re- mark that they deserve to be \" pitted.\"' HONORs.-M. D. Stark, M.B., Trin. ronto, passed the examination before College of Surgeons, Eng., on 17th received the diploma of that body. Coll., To- the Royal May, and 345",
         "34 TH CNDALNCT ÇSAUGEEN AND BROCK MEDICAL TARIFF.- This tariff having been legalized by the Medical Council, the profession in the division are in- formed that they may obtain copies by wfIting to the Secretary, Dr. Brock, Guelph. All those members who have paid their subscription will re- ceive a copy free, others will be charged twenty- five cents to defray expenses. Bill-heads, with tariff printed on the back, can be supplied for two dollars per thousand. Dr. Fordyce Barker, of New York, has been appointed to the position formerly occupied by Dr. Marion Sims, in the State Hospital for Women. The appointment is a very popular one in New York, and has been followed by a large addition to the funds of the Hospital. THE MURDER oF Dn. GEORGE CooK.-Dr. George Cook, Medical Superintendent of the Insane Asylum, Canandaigua, N.Y., was fatally stabbed in the neck by an insane patient, on the morning of June 1 2th, and died the same even- ing. PRIZE MEDAL.-We have pleasure in announc- ing that Messrs. Wm. R. Warner \u0026 Co., of Phil- adelphia, have been awarded the Prize Medal at the Chilian World's Fair, for the superiority and perfection of their soluble sugar-coated pills. BANQUET.-A banquet was given on the 6th ult., to Dr. A. H. Beaton, of Stayner, who is about to remove to Orillia. It was largely attended. Sir Wm. Fergusson is almost hopelessly ili. He is said to have organic disease of the heart, dropsy, and renal albuminuria. ÂPPoINTMENT.--Robert Parker, M.D. of Stirling, to be an Associate Coroner, for the County of Hastings. The following gentlemen have been appointed members of the acting staff of the Toronto General Hospital, for the ensuin year : Drs. Aikins, Buchan, Cassidy, De la 1{aye, Fulton, Geikie, Graham, A. J. Johnston (Pathologist), Reeve (Ocu- list), Spragge, Temple and H. H. Wright. CYCLOPŒDIA OF THE PRACTICE OF MEDICINE. By Prof. Von Ziemssen. New York: Wm. Wood \u0026 Co. We have before us the 4th volume of Ziemssen on the diseases of the respiratory organs, including general diagnosis and therapeutics of diseases of the nose, naso-pharyngeal space, pharynx and larynx, by Professor Fraenkel ; diseases of the larynx by Professor Von Ziemssen ; croup, by Professor Steiner; diseases of the trachea and bronchi, by Professor Riegel; diseases of the pleura, by Professor Fraentzel. They are all carc fully written and tend to enforce on the practi- tioner the great importance of never attaching too much stress on any single symptom, however valu- able that may be of a disease, for none is infallible. The symptoms of disease may be compared to the threads composing a cord, which may represent the diagnosis; each of the threads by itself IS unable to support a weight which is readily borne by the entire cord-each thread is one degree of evidence, and their union alone can constitute the certainty. The more experience we have, the more distrustful we become of any one symptom ot even one set of symptoms taken apart, and the less reliance we havé in any one remedy or one mode of treatment. Auscultation is one thread, a stout and good one we admit in the cord, but it is not the cord itself, and if trusted to alone, will often prove fallacious-percussion, mensuratiol, the use of the laryngoscope and thermometer are all important threads, but they must be viewed collectively to arrive at a right diagriosis. This 13 forcibly pointed out by the above writers. THE PATHOLOGY AND TREATMENT OF CHILDBED, Dr. F. Winckel, of Rostock. Translated frorf the second German edition by James R. Chad' wick, M.D., Harvard University. Philadelphia: H. C. Lea. Toronto ; R. Carswell. This work treats in a very practical way of the accidents and diseases of parturition, such as lacer- tions of the perineum, and os, displacement of the vagina, uterus, hemorrhages, thrombosis, pyernia, puerperal fever, milk fever, sore nipples, mammarf abscess, puerperal eclampsia, mental affections and skin diseases. Like most of the Gerrman works, the subject matter is discussed in a most able and scientific manner, while at the same time suifficie prominence is given to the treatment. The volu0 contains about 475 pages, is wAll printed su will be a useful addition to the medical man'w library. On the 8th June, the wife of G. A. McCallu»i M.D., Dunville, Ont., of a son. On Tuesday, 13th June, at his residence in Coi' borne, W. Carter Deans, M.D., late of Oshawa, aged 39. On Thursday, June 8th, at Drummondilles Esther, the beloved wife of James McGarry, . 346 THE CANADA LANCET.",
         "THE CANADA LANCET. COLLEGE OF PHYSICIANS n SURGEON MEDICAL DEPARTMENT OF COLUMBIA COLLEGE, COR1ER 934 MT. and 4th AVE., 1EW YORK CITY. SEVENTIETH SESSION, 1876-'77. rAC-tLTr Or MEflICImm. ALONZO CLÀRK, I.D., President and Professor of Pathology and Practical Medicine. WILLARD PARKER, M.D., Professor of Clinical Surgery. JOHN C. DALTON, MD., Professor of Physiology and Hygiene. SAMUEL ST. JOHN, M.D., Professor of Chemistry and Medical Jurisprudence. THOMAS M. MARKOE, M.D., Professer of Surgery. T. GAILLARD THOMAS, M.D., Professor of Obstetrics and the Diseases of Women and Children. JOHN T. METCALFE, M.D. Emeritua Professer of Clinical Medicine. HENRY B. SANDS, M.D., Professor of Anatomy. JAMES W. McLANE, KD., Adjunct Profesmor of Obstetrias and the Diseases of Women and Children. THOMAS T. SABINE, MD., Adjunct Professor of Anatomy. CHARLES F. CHANDLIR, Ph.D., Àdjunct Professer of Cheistry and Medical Jurisprudence. EDWÂRD CURTIS, M.D., Professor of Materia Medicà and Therapeutice; Secretary of the Faculty. FRANCIS DELAFIELD, K.D., Adjunct Professor of Pathology and Practical Medicine. JOHN G. CURTIS, M.D., Adjunct Professer of Physiology and Hygiene. WILLTAM DETMOLD, M.D., Emeritus Professor of Clinical and Military Surgery. WILLIAM H. DRAPER, M.D., Clinical Professoer of Diseases of the Skin. CORNELIUS I. AGNEW, KD., Clinical Professor of Diseases of the Eye and Ear. ABRAHAM JACOBI, M.D., Clinical Professer of Diseases of Children. FEÉSENDEN N. OTIS, KLD., Clinical Professor of Venereal Diseases. EDWARD C. SEGUIN, M.D., Clinical Professer of Diseases of the Mind and Nervous System. GEORGE M. LEFFERTS, M.D., Clinical Professor of La copy and Diseases of the CHARLES McBURNEY, M.D., Dtmonstrator of Anatomy. CHARLES KELSEY, M.D.. Assistant Demonstrator of Anatomy. FACULTY OF THE SPRING SESSION. JAMES L. LITTLE, MD., ROBERT F. WÈIR, M.D., Leoturer on Operative Surgery and Surgical Dresung. Lecturer on Disesses of the Genito-Urinary Organ. GEORGE G. WHEELOCK, M.D., MATTHEW D. MANN, M.D., Lecturer on Physical Diagnosis. Lecturer on the Microsbope as an Aid to Diagnosia. A. BRAYTON BALL .D H. KNAPP, M.D Lecturer on Diseases of t'e KAideys. Lecturer on Diseases of the Eye and Ear. T I-IE COL L.IC3-IA T'rE AR?.. The Conegiate Ysar etnbraces a special Sprlng and a regular .inter Session, attendance at the latter only bei required for the grduatlng course. The Spring Session for 1876 begins March 11, and continues till June 1. Thd Rgular Winter slon for 1876- begins oaday, October Z and continues till March. The College Commencement for the oonferring of degrees is held annually at thé close of the Winter Session. Tuition I by the following methods :-L DIDAOTIC LECTURES WITH DEEM0W8tTION8. During the Winter lsouo, trom Ave to six such lectures are given daily by the Faculty of the College, on the seven general branches of medical Sciense. Attendance obliit- tory. Feu $20. for the course on esch branch, or $140. for the entire curriculum. During the Sprlng Bession, two lectures on speci toics ae given daily by the faculty of the Spring Session. Fes $5. for the course on branch, or $30. for the entire curriculum. IL. CLIN- TA CHING. This important element cf tuition receives the fullest attention. Ten Clinies, covering al the general and special departments of Medicine and S mrgery, are held weekly thro ut the entire year in the College Building itself. The attendance il about b000 patient * yearly. In addition, the Faculty, being stro represented on the Staffs of all the larger Hospitals and Dispensaries of New York, give daily System\u0026tic clinical lectnres 'n one or more these institutions as a regular feature of the College Curriculum. The great clinical resources et Bellevue, Charity snd Roosevelt Hospitals, the Demiet Dispeusary, the New York Eye and Ear Infirmary and the Manhat- tan Bye and ar Ho ital, are thus made of avail for the instruction of the Student. Attendance a\u0026 Cliniesa optionanl sd without extra charge. Id REE ATION u n the topils cf te r ar lectures are held dafly througbout both Sessions y a Gor\u003e of Examiners. Attendance optional. F.es:W tor Session. 40n. 8ession, %SO. dolglate Year $60. IV. PERSNAL INSTRUCUION. Pracllal Anatomny la taught in the dissecting-room om October to May, and every Student la expected to dissect. Fee $10. good for a Collegiate Year. PraciCal Chmenistr7 is taught in the Laboratory in the Spring. ee $18. Cases of Obstetrics are furnished te advanced Students without charge Personal instruction in OprativO Surgery Minor Surgery. Physical Diagnosi Ophthzalmoogy, otoogy, and Ljaryngoscopy la aise given by Intructors, eminent in iLese several departments, for very moderai. tee\u0026 Attedanos ptioLEXPENSE. The nwcessary collegiate expenses are the yearly matrieulation tee ($5., good fora Collegiate Yea\u0026r and the tees for the diadactic lectures of the Winter Session ($0. for the Course on each branch, or $140. fer the entire curriculum). In adltion, a Grad eting 1F6 0f $80. i choAred. T radating course requires three years study, and attendance upon two courses of lectures, on each of the seven branches of th* Winter Curricum. Lecture fees are remmitted graduatet of the College, te graduates of other Collegea ot three years standiN to Thheologi- cal Students, and te Students who have already attended te full courses of lectu.es, the latter of which, at least, has been at this Colle\u0026 To matriculants, who have attended two full courses elsewhere, a full course ticket is granted for $70, Al tees are payable in advane. OARD can be had for from $6. te $9. a week, and the Clerk of the College will aid students in obtaining th sane. For turther information, and for the Annual Catalogue and Announcement, addrea, Secretary of the Facuty, COLLEGE OF PHYSICIANS AND SURGEONS, Comuna 238 BraanT \u0026 Fouain Avimos, Nmw Yoa. 9 S,",
         "10 THE CANADA LANCET. BELLEVUE HOSPITAL 0 EEDI cA Éà 1. CD O L FI. ci ]E, CITY OF NEW YORK. SESSIONS 0F 187O-77. T HE COLLEGIATE YEAR in this Institution embraces a Preliminary Autumnal Term, the Regular Winter Session, and a Summer Session. THE PRELIMINARY AUTUMNAL TERM for 1876-77 will commence on Wednesday, September 13, 1876, and continue until the opening of the Regular Session. During this term, instruction, consisting of didactic lectures on special subjects, hnd daily clinical lectures, will be given, as heretofore, by the entire Faculty. Students designing to attend the Regular Session are strongly recommended to attend the Preliminary Term, but attendance during the latter is not required. During the Preliminary Term, clinical and didactic lectures will be gien inprecisely the same number and order as in the Regular Session. THE REGULAR SESSION will commence on Wednesday, September 27, 1876, and end about the ist of Marck, 1877. ISAAC E. TAYLOR, M D. Emeritus Prof. of Obstetrics and Diseases of Women and Children, and President of the College. JAMES R. WOOD, M.D., LL.D., Emeritus Prof. of Surgery. FORDYCE BARKER, M.D., Prof. of Clinical Midwifery and Diseases of Women. AUSTIN FLINT, M.D., Prof. of the Principles and Practice of Medicine, and Clinical Medicine. W. H. VAN BUREN, M. D., Prof. of Principles and Practice of Surgery with Diseases of the Genito-Urinary System and Clinical SurgeF. LEWIS A. SAYRE, M.D., Prof. of Orthopedic Surgery, Fractures and Dislocations, and Clinical Surgery. ALEXANDER B. MOTT, M.D., Prof. of Clinical and Operative Surgery. WILLIAM T. LUSK, M D Prof. of Obstetrics and Diseases of Women and Children, and Clinical Midwifery. EDMUND R. PEASLEE M.D., LL.D., Prof. of Gynascology. WILLIAM M. POLK, M.b., Lecturer on Materia Medica and Therapeutics, and Clinical Medicine. AUSTIN FLINT, Ja., M.D., Prof. of Physiology and Physiological Anatomy, and Secretary of the Faculty. ALPHEUS B. CROSBY, M.D., Prof. of Descriptive and Surgical Anatomy. R. OGDEN DOREMUS, M.D., LL D., Professor of Chemistry and Toxicology. ,EDWARD G. JANEWAY, M. D., Prof. of Pathological Anatomy and Histology, Diseases of the Nervous System and Clinial Medicine PROFESSORS OF SPECIAL DEPARTMENTS, ETC. HENRY D. NOYES, M D. Professor of Ophthalmology and Otology. JOHN P. GRAY, MlD. LLD Professor of Psychological Medicine and Medical Jurisprudence. EDWARD L. KEYES 1.D., Professor of Dermatology, and Adjunct to the Chair of Principles of Surgery, etc. EDWARD G. JANEWAY, M.D., Professor of Practical Anatomy. (Demonstrator of Anatomy.) LEROY MILTON YALE, M. D., Lecturer Adjunct upon Orthopedic Surgery. A. A. SMITH, M.D., Lecturer Adjunct upon Clinical Medicine. A distinctive feature of the method of instruction in this Coflege is the union of clinical and didactic teaching. Ai the lectures are given within the Hospital grounds. During the Regular Winter Session, in addition to four didactie lectures on every week-diy, except Saturday, two or three hours are daily allotted to clinical instruction. The Spring Session will consist chiefly of Recitations from Text-books. This term continues from the first of March to the first of June. During this Session there will be daily recitations in all the Departments, held by a corps of eaminers appointed by the regular Faculty. Regular clinics are also given in the Hospital and College Building. Fees for the Regular Session. Fees for Tickets to aIl the Lectures during the Preliminary and Regular Terni, including Clinical Lectures........8140 00 Matriculation Fee..................... .............. ........................5 00 Demonstrator's Ticket (including material for dissection)............................................................. 10 00 Graduation F...............................................................................30 00 Fees for the Spring Session. Matriculation \u003cTicket good for the following Winter)............. .... .. .......... ............... 00 Recitations, Cinics, and Lectures..................................................................................... 85 00 Dissecting (Ticket good for the following Winter) ................... ....................................10 00 Stndents who have attended two full Winter courses of lectures may be examined at the end of their second course ua.o# Materia Medica, Physiology, Anatomy, and Chemistry, and, if successful, they wili be e.camined at the end of thir thir ourse upon Practice of Medicine, Surgery, and Obstetrics only. For the Annual Circular4nd Catalogue, giving regulations for graduation and other information, address PROF. AUSTIN FLINT, JR., Secretary Bellevue Hospital Medioal Celoge.",
         "THE CANADA LANCE T. il PURE COD-LIVER OIL, Manufactured on the Sea-Shore, by HAZARD \u0026 CASWELL, from Fresh and Selected Livers. The universal demand for Cod-Liver void of color odor, and fiavor-having a Oil that can be depended upon as strictly bland, fish-like, and moRt persons, not pure and scientifically prepared, having unpleasant taste. is sosweet and pure been long felt by the Medical Profession that it ea be retained by the stomach we were induced to undertake its manu- when other kinds fai, and patients soon facture at the Fishing Stations, where the become fond of i. fish are brought to land every few hours. The secret of making god Cod-Liver and the Livers consequently are in great II lies in the proper application of the perfection. proper degree o heet; too much or t00 This Oil is manufactured by us on the little will seriously injure the quelity. sea-shore, with the greatest care, from Greet attention to cleanliness is abso- fresh, healthy Livers, of the Cod only, lutely necessary to produce sweet Cod- without the aid of any chemicals, by tbe Liver Ou. The rancid Oi found in the simplest process and lowest temperature market is the meke of manufecturera who by which the Oil can be separated from are careless about these matter. the celor of the Livers. It is nearl-i de- Prof. Parker. of New York, says: 'II have tried almost every other manufacturers O, and give yours the deided preference. Prof. Hays, State Assayer of Massacbusetts, efter a full anelysis of it, says: \"uIt is the best for foreign or domesti usae.\" After yeers of experimenting. the Medical Profession of Europe and Americ, wbo have studied the efferets f dffrent Cod Liver 011e, have unanimoueli' decided the light straw-colored Cod-Liver 01w to be far superior k ind offthe brown aien. The Three Best ToniTs of the Pharmacopoesa: IRON-PHOSPHORUS-CALISAYA. CASWELL, HAZARD \u0026 Ce. also caîl the attention of the Profession to their prepartion o the ebove eatimable Toni, a combined in their elegant ancý palatable Ferro.pbempheraied Ehixir of Calisaya Bark. a combinetion of the Pyrophosphat. oflron and Céisaya neyer before attained, in which the nauseous inkiness of the Iron and estrinieency ofthe Ceu i Ya are over- lorne, without enyi'njury to their active tonic principles, and blended io a beautiful Amber-olor d CordIal, deaicitus to the aste and acceptable b the most delicate storach. This preparation is made directly from the nssYAy CALI'AYA BAK, not from ITS ALKALOIiS 0 THRI SALTS-beinu unlike other preparations celled IlElixir of Calisya and Iron,\" whicb are siinply a tilr of Quinine and Irn. Our Elixir can be depended upon as beingdaerue Elixir of Calisaya Bark with Iron. ach des- sert-spoonful contains seven and a havf graine Royal Calisaya B ark, and two grain Pyrophosphate of ron. Ferre-Phosp rated Blixir f aiusaya, Bark wi h Stithna.-This preparation contains one grain of Strychnia added t each pint of our Ferro-Phosphorated Elixir of Calisaya Bsrk, grealA intensifying is tonic effect. FerrL-PhsphoraZed Elix o. Calsaya wlth Ba nnth, conttining eight grains Ammonio-Citrate of Bimuth in each table-spoonful of the Ferro-Phosphorated Elixir of Calisaya Bark. CASWLL, CAZARD h CO., CHEMIST AN DUnosTO, New York. T. MORSON \u0026SONY ai1,33 \u0026 124 SOUTHAMPTON ROW, RUSSELL SQUARE, W.C. WORKS: HORNSEY RUAD, X., \u0026 8UMMIELD WORKS, HOIMTON E., LONDON, MANUFACTURERS 0F Pure Chemicals and all New Medicines. MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S MORSON'S SPECIALTIES. PEPSINE PREPARATIONS. (The Original English Manufacturers.) PEPSINE PORCI, Pure. PEPSINE POWDER, or POUDRE NUTRITIVE. PEPSINE WINE. PEPSINE LOZENGES. PEPSINE GLOBULES. PANCREATINE POWDER. PANCREATIC EMULSION. PANCREATIZED COD LIVER OIL. SACCHARATED WHEAT PHOSPHATES. CREOSOTE, from WOOD TAR. (The only English Makers.) N.B.-Test of Purity-Insoluble in Price's Glycerine. GELATINE. (The most economical substitute for Isinglass.) CHLORODYNE. EFFERVESCING CITRATE OF MAGNESIA. ARTIFICIAL ESSENCES for Flavoring. MORPHIA SALTS. CHLOROFORM, Pure and Meth. SP. ETHER NIT.. P.B. SP. AMMON. AR. P.B. GINGERINE and ALOINE. Sold Wholesale and RetaU by ail Chenists and Druggists throughout the World. T. iI THE CANADA LANCE",
         "12 THE CANADA LANCET. DR1 J. COLLIS BROWNE'S CHLORODYNE IS THE ORIGINAL AND ONLY GENUINE. ADVICE TO INVALIDS. If yon wish to obtain quiet refreshing sleep, free from headache, relief from pain and anguish to calm and assuage the weary achings of protracted disease, invigorate the nervous media, and regulate the circulating systems of the body, you will provide yourself with a supply of that marvellois remedy discovered by DR. J. CoLLIs BRoWNE (late Medical Staff), to which he gave the name of CHLORODYNE, and which is admitted by the Profession to be the most wonderful and valuable remedy ever discovered. CHLORODYNE is admitted by the Profession to be the most wonderful and valuable remedy ever discovered. CHLORODYNE is the best renedy for Coughs, Consumption, Bronchitis, Asthma. CHLORODYNE effectually checks and arrests those too often fatal diseases-Diphtheria, Fever, Croup Ague. UHLORODYNE acts like a charm in Diarrha, and is the only specifie in Cholera and Dysentery. CHLORODYNE effectually cuts short all attacks of Epilepsy, Hysterial Palpiation, and Spasms. CHLORODYNE is the only palliative in Neuralgia, Rheumatism, Gout, Cancer, Toothache, Meningitis, \u0026c. 11 Extract from Indian Economist. \"We direct the attention of medical men to a fact observed some years since by oerselves, and corroborated by our C subsequent experience, that Dr. J. Collis Browne's Chlorodyne is in many cases of Low Fever immensely superior to Quinine in curative power. We cannot persuade ourselves that the true value of Dr. J. Collis Browne's Chlorodyne is yet properly appraised in ladia. . . . It may be given with absolute safety even to a child three days old. Were medical mon but to make a fair and exhaustive trial of it we are persuaded that it would work a revolution in the treatment of two- thirds of the disoases to which children are subject. Its curative power is simply amazing.\" \" Earl Russell communicated to the College of Physicians that he had received a despatch from Her Majesty's Consul at Manilla, to the effect that Cholera had been raging fearfully, and that the ONLY remedy of any service was CHLORO- DYNE.\"-See Lancet, Dec. 1, 1864. From W. VESALIUS PETTIGREW, M.D., Hon. F.R.C.S., England. Formerly Lecturer of Anatomy and Physiology at St. George's School of Medicine. \"I have no hesitation in stating, after a fair trial of Chlorodyne, that I have never met with any medicine so e ofca- cious as an Anti-Spasmodie and Sedative. I have tried it in Consumption, Asthma,'Diarrhea, and other diseases, and a% most perfectly satisfied with the resulta.\" From Dr. THomÂs SANDIFORD, Passage West, Cork. \"I will thank you to send me a further supply of Chlorodyne. It was the most efmacious remedy I ever used, afford- ing relief in violent attacks of Spasme within a minute after being taken. One patient in particular, who has suffered for years with periodical attacks of Spasms of a most painful nature, and unable to obi ain relief from other remedies, such as opium, \u0026c., finds nothing so prompt and efficacious as Chlorodyne.\" From Dr. B. J. BOULTON \u0026 Co., Horneastle. \"We have made pretty extensive use of ChIorodyne in our practice lately, and look upon it as an excellent direct Sedative and Anti-Spasmodia. It seems to allay pain and irritation in whatever organ, and from whatever cause. It induces a feeling of comfort and quietude not obtainable by any other remedy, and seems to possess this great advantageo over aIl other sedatives, that it leaves no unpleasant after effeots.\" From J. C. BAKER, Esq., M.D., Bideford. \"It is without doubt, the most valuable and certain Anodyne we have.\" CAUTION.-BEWARE OF PIRACY AND IMITATIONS. CAUTIoN.-The extraordinary medical report on the eoficacy of Chlorodyne render it of vital importance that th# public should obtain the genuine, which bears the words \" Dr. J. Collis Browne's Chlorodyne.\" Vice-Chancellor WOOD stated that Dr. J. CoLLIS BRowNE was ulîdoubtedly the Inventor of CHLORODYNE: that the whole story of the Defevdant, FREEMAN, was deliberately untrue. Lord Chancellor Selborne and Lord Justice James stated that the defendant had made a deliberate misrepresentation of the decision of Vice-Chancellor Wood. Chemista throughout the lani confirm this decision that Dr. J. C. BROWNE waa the Inventor of CHLORODYNE* Sold in Bottles at 1s 1½d., 2s 9d., 4s 6d., each. Noue genuine without the words \" Dr.. COLLIS BROWNE'S CHLORODYNE \" on tie Government Stamp. Overwhelming Medical ta Testimony accompanies each bottle. SoLE MANUFACTUER-J T. DAVENPORT, 33 GREAT RUSsELL STREET, BLooMsBURY, LoNDON.",
         "-HE CANADA LANCET. PUT UP IN I Ib., 5 lb., and 10 lb, CANS. I'teIsret Go NE (PETROLÉO VIRTIS YVALIDISSIMA.) IletM moat eflicacioua virtuefrom Petroleum.\" The Emnient andi iealing prinip(sfc erlu, ihypsye nc ecntrated, wlthout the use of chemicals. Lt has a» aboe a ty for n or perfect biand, soothing i 01ainous substance, applicable to the moit sensitive- con- d ven to the eye, without the Plihtest tation, and yet so homogeneous and dense as to exclude atmosphero action and other mifl influence. IT IS A pERFEC IfAPPLiCAIN WHEN USED AS A SURGICAL DRESsING, and the bandages adhere to the wound, the subseqent applications may be made upon the exterior of the last fold, which it will penetrate at once, thus avoiding the danger of re-opening the wound. Fop BuaNs AND ScALDB it is INvALuAB. It allays the acute inflammation almost immediately, and thoroughly prottcts the injured parts from the action of the atmosphere. If used promptly and ALONE, the wound heals rapidly even in severe cases, without any sloughing, and usually without leaving any scars For enta, lacerated surfaces, ail kinds of Inammation, osoning, and SKIN DISEASES QENERALLY. For Piles and diseases of the rectum, uterus and urethra, by injection. Hundreds of uses for it are suggested to the physician who knows its positive virtue. It is incapable of decomposition. fe.' mentation, or becomins rancid on any sore, in any clmate or temperature. Cosmoline combines readily with White Wax for Ointments, Cerates with Sulphur, Iodine, Bromine, etc., with Camphor, Gum sins, etc. . It does not combine wtht proof spirits, Ammonia or Caustie Alkahes. Coming from the same primitive source as Carbolie Acid, it has a peculiar affinity for that valuable remedy, and forms a superior vehicle for it: on account of itv simple and positive character it is vastlysuperior to Olive Oil, Lard, etc., as a menstruum for other et ternl applications. As an emolient it as superior to Glycerine, especally the Rose perfumed. Its non-affinity for oxygen or moisture ren ers it a perfect protection against rust when applied to surgical instruments. d Prepared exprssly for Medical Purposes 6y i. Fe. ]E: OQU -E T fT 5 wot Fot .et C. Pa lb be had fromt ail Retail Druggists. Samples and Circulars furnished 21SotFrnSretPia lh.P- Elixir Ferri et Calois Phosphatis Co. LACTO-PHOSPLATES. FORMULA 0 DR. DUSART, 0F PARIS. GoMpound ExIir of Phosphates and Calisaya, A Cmenical Food and Nutritive Tonie. THIS elegant preparation combines witb a sound Sherry Wine and Aromatics, in the form of an agreeable cor- dial, 2 gra. Lacto-Phophate of Lime 1 gr. Lacto-Phosphate of Iroïs, 1 gr. of Alkaloide of Calisaya Bark, Quinine, Quini- dine, Chinchonine, and ßlfteen drops offree Phosphoric Acid to each half ounce. In cases convalescing from adynamie fevers, in ail condi- tions of depraved nutrition from indigestion and mal-assimi- lation of food, in nervous prostration from mental and physical exertion, dissipation or bad habita, in chlorotic or anmemie Women, and in the strumous diathesis in adulte and children, -it is a combination of great reliability and efficacy, and it kay be taken for a protracted period without becoming 1pugnant to the patient. When Strychnine is indicated the officinal solution of the ?harmacopoeia may be added, each fluid drachm making the 64th of a grain to a half fluid ounce of the Elixir,-a valuable 0Ombination in dyspepsia with constipation and headaches. 'his compound is prepared with great care, and will be main- tailed of standard purity and strength. Prepared by T. B. WREELER, MONTRaAL, D. C. SOLD'BYALL DRUGGISTS. HORATIO G. kERN, .NUNYACTUR]t 00, SURGICAL AND DENTAL INSTRUMENTS, \u0026c. ESTABLISHED 1837. HEsubscriber would again remind the Medioal and' THDental Profession that he still continues to manufac- ture his celebrated Instruments, in all the varions branches Assiduous attention to the details of the business, which an experience of thirty-flve years has afforded, has enabled him to make many improvements in his Unrivalled Extracting Forceps, Both as regards their quality and adaptation to the purposet for which they are intended, a desideratum which will be appreciated by all wishing to purchase Instrumente, that are reliable and of long and well established reputation. ASPIRATORS. (A newý.Instrument*) Aspirator, No. 1, Six Tubulated Needlies, assorted......$25.00 Aspirator, No. 2, \" \" \" \" ...... 18.00 Aspirator, No. 3, \" \" \" t ...... 12.00 All the Latest Improvements and Novelties. All orders entrusted to his care will b. promptly attended to. Catalogues furnished on application. IORATIO G. KERN, Oct., 1873. No. 21 North Sixth St., Philadelphia. 1 13",
         "THE CANADA LANCET. Electrical Instruments for Medical Use. We respectfully refer to the following Eminent Physicians: NEW YORK CITY. BOSTON. Prof. W. A. Hammond, M.D. B. Prof. Lewis A. Sayre,, M.D. Prof. Francis Minot, M.D. Poof. James R. Wood M.D. H. H. A. Beach. M.D. PHILADELPHIA. CHICAGO. lProf. Robert E. Rogers, M.D. Prof. B. Howard Rand, M.D. Prof. N. S. Davis, M.D. CANADA. Prof. James S. Jewell, M.D. Dr. Theo. Mack, M.D., St Ca- tharines. DETROIT. Dr. Fife FowlerM.D., Kingst'a W Prof. Theo. A. McGraw, M.D. Dr. John R. Dickson, M.D., Prof. James F. Noyes, M.D. Kingston. Prof. Albert B. Lyons, M.D. Dr. B. H. Lemon, M.D., Tho- Prof. Leartus Connor, M.D. rold. Drs. Orton \u0026 Alexander, M.D., J. ST. LOUIS.Fergus. ST. LUIS.Dr. A. Wolverton, M.D., Ham- Prof. J. K. Bauday, M.D. ; D lton D Prof. Jas. B. Johnson, M.D. Galvano-FaraiD MTeanufacturing Company, 1t7 EAST 34th STREET, NEW VORiK. FOR SALE BY LYMAN BROS., TORONTO. Send for Catalogue, with a concise and practical Guide for their use. F. G. OTTO DkSONSs M (Successors to OTTO \u0026 RKYNDERS.) MANUIFÂCTURERS ÂNDY IMPORTERS orF rold SurgicaDrs Ortonens4 \u0026rh pS a AplexaneMD, J TIHE RESEREVOIR THER1NOMETER.-The advantages this Thermometer possesses over ail other'f, consist in the Reservoir B, in which the registering part of the mercury is collected, forming a body of oblong shape. The surface of this body being large in comparison to the contracted bore, makes it impossible to unite the register with the mercury in the bulb A.Ham These Thermometers are well seasoned before graduating, and, consequently, are as correct as they can be =ade. Four inch in flfthsFul, $4.2 Ic Mafourthscturing.Compa 00 Five fi 11 flfths.....................47 167 fourths, NEW.YOR..5 O B In Hard Rubber or Boxwood Case, and will be forwarded on receipt of price. F. G. OTTO \u0026 SONS, PATENT TReSS sas been described in several medical journals, and'has since proved to b bl k far the best oany yet put before the profession. SKELETONS, ANATOMICAL PREPARATIONS,\u0026C 64 CHATHAM STREET, NEW YORK- F. TE ESERVOaIen Tr HERMPaETE R.-Th advntge thRi Themomterpsessovralor SEND FOR PRICE LINTS. Y. G. Otto \u0026 Bon's Patent Truss Pad.",
         "THE CANADA LANCET. 15 UNIVERSITY OF TRINITY COLLEGE. (INCORPORATED BY ROYAL CHARTER.) MEDICAL DEPARTMENT.-WINTER SESSION 1876-'77. E. M. HODDER, M.D. F.R.C.S., Eng.; F.O.S., Lond.; Dean of the Faculty, and Consulting Surgeqn Toronto General Hospital and the Burnside Lying-in-Hospital.-159 Queen-st. West. Prof. of Obstetrics, and Diseases of Women and Children. NORMAN BETHUNE, B.A., M.D., Edin.; M.R.C.S., Eng.; F.R.C.S., Edin. ; F.O.S., Lond.; Physician to To- ronto General Hospital, and Burnside Lying-in-Hospital. 198 Simcoe-st. Prof. of Surgery and Clinical Surgery. J. E. KENNEDY, A.B., M.D; F.O.S. Lond. 68 John-st. Prof. of Materia Medica and Therapeutics. J. ALGERNON TEMPLE, M.D.; M.R.C.S., Eng.; F.O.S., Lond.; Physician to Toronto General Hospital, and Attending Physician Burnside Lying-in- Hospital.- 20t Si à. WALTER B. GEIKIE, M.D., F.R.C.S., Edin.; L.R.C.P., Lond.; F.O.S., Lond. ; Physician Toronto Gen. Hos- Prof. of Medical Jutisprudence and Toxicology, and Asuist- pital.-3 Fleming's Terrace, Elm-st. ant Lecturer on Obutetricu, \u0026o. Prof. of Principles and Practice of Medicine. W. H. ELLIS, M.A., M.B.; L.R.C.P., Lond. Instructor J. FULTON, M.D.; M.R.C.S., Eng.; L.R.C.P., Lond.-- Pf of Chem ofr- ene loP tc 303 Churnh-st. Physician to the Toronto General Hospi- tal, Hospital for Incurables, and Hospital for Sick Chil- H. ROBERTSON, M.B.; M.R.C.S., Eng.-24 Shuter-st dren. Prof. of Anatomy-Descriptive and Surgical. Professor of Physiology and Sanitary Science. J. FRASER, M.D.; L.R.C.S.. Edin.; L.R.C.P., Lond. W. COVERNTON, M.D.; M.R.C.S., Eng. Demonutrator of Anatomy. Prof. of Patbology and MedPcal Diagnosis. A. J. JOHNSTON, M.D. ; M.R..S. Eng., F.R.M.S., Lond., JAMES BOVELL, M.D., L.R.C.P., Lond. ; Conuulting Pathologlt to the Toronto General Hopital. PhysiciPn to the Toronto General Hoopital, and the BurC- Microcopy. aide Lying-in-Hospital.-18 St. Patrick ut. THOM S KIRKLAND, M.A., Lecturer on Chemistry Prof. of General Pthology. Botany, \u0026c., Normal School. The Session will commence on MONDAY, the 2nd of Oetober, 1876, and continue for Six Months. The Lecture\u0026 Will be delivered in the new College building, close to the Toronto General Hospital. Full information respecting Lectures, Fees, Gold and Silver Medals, Scholarships, Certificates of Honor, Graduation, \u0026o., will be given in the OF MICHIG A N. Department of Medicine and Surgery. The 27th annual course of lectures will commence on Oct. 2, 1876. Course separate but equal for women. Matriculation Fee-Residents of Michigan, $1o; non- 'esidents, $25. Annual Dues-Residents of Michigan, $I5; non-residents, $20. Graduation Fee-For all alike, $5. Send for Circular and Catalogue. A. B. PALMER, M.D., DEAN, Ann Arbor, Mich. Toronto Eye and Ear Infirmary. This Charitable Institution is removed from Ade- aide-st. to 153 Church-st., opposite the Motropolitan kethodist church. It is open to the poor of the ?rovince, on the presentation of satisfactory evidence Of poverty, and on the payment of $3 a week for board. Surgeons.-Drs. Rosebrugh, Reeve and Coleman. A. T. McCord, Esq., President. \u0026 W. B. GEIKIE, Secretary. M ROYAL COLLEGE puYSICIANS AND 808080u8, IN AFFILIATION WITH Queen's University, Kingston. facit : J. R. DICKSON, M.D., M.RC.P. Lond. ; M.RC.S. Eng. ; F.\u0026.C.8 Edin. ; President and Prof. of Clinical Surgery. FIFE FOWLER, D. D., L.R. C.8. Edin. Registrar and Prof. of Materia Medica. HORATIO YATES, M.D. Principles and Practice of Medicine, and Clinical Medicine. MICHAEL LAVELL, M.D. Obstetrics and Disea of Women and Children. MICHAEL SULLIVAN, M.D. Surgery and Surgical Anatomy N. F. DUPUIS, M.A.. Botany.* THOMAS R. DUPUIS, M. D. Descriptive and Regional Anatomy. JAMES NEISH, X D. Medical Jurisprudence. NATHAN F. DUPUIS, M.A. Chemistry and Practical Chemistry. ALFRED S. OLIVER, M.D. institutes of Medicine and Sanitary Science. KENNETH N. FENWICK, M.A., K D. KLR.C.S. England. Practical Anatomy. The next winter Session begins on the lt Weduesday of October, 1876. Students attending this College may obtain either the degree of M. D., or the Licence of the College. Certificates of attendance are recognized by the London and Edinburgh Colleges The College building, which is being newly fitted up, is commodious and conven- ient. Unequalled facilities are presented for the study of Practical Anatomy, and great advantages are afforded for Clinical Instruction at the Generr.1 Hospital, and Hotel Dieu. Further information cean be had on application to the Registrar. FIFE FOWLER, M.D., LR.C.S. Edin. * Students attending the Botanical class can also without additional fee attend Lectures on Zoolov. annuaM announcement. E. M. HODDER, Dean. UNIVERSITY",
         "16 TRE CANADA LANCET. UNIVERSITYOFTHECITY OFNEWYORK. MEDICAL DEPARTMENT. 410 East Twenty-sixth St., opposite Bellevue Hospital, Ney York City. TIIRETY-SIXT SJESSIONT, 1878-77. FACULTY OF MEDICINE. REV. HOWABD CROSBY, D.D., LL.D., Chancellor of the University. MARTIN PAINE, M.D., LL.D., Emeritus Prof. of Materia Medica and Therapeutics. ALFRED C. POST, M.D., LL.D., Emeritus Prof. of Clinical Surgery ; President of the Faculty. CHARLES A. BUDD, M.D., Prof. of Obstetrics. JOHN C. DRAPER, M.D., LL.D., Prof. of Chemistry. ALFRED L. LOOMIS, M.D., Prof. of Pathology and Practice of Medicine. WILLIAM DARLING, A.M., M.D., F.R.C.S., Prof. of Anatomy. POST GRADUATE D. B. ST. JOHN ROOSA, M.D., Prof. of Opholmology and Otology. WM. A. HAMMOND, M.D., Prof. of Diseases of the Mind and Nervous System. STEPHEN SMITH, M.D., Prof. of Orthopoedic Surgery and Surgical Jurisprudence. WILLIAM H. THOMSOM, M.D., Prof. of Materia Medica and Therapeutics. J. W. S. ARNOLD, M.D., Prof. of Physiology. JOHN T. DARBY, M.D., Prof. of Surgery. CHARLES INSLEE PARDEE, M.D., Prof. of Diseases of the Ear ; Dean of the Faculty. ERSKINE MASON, M.D., Prof. of Clinical Surgery. WALTER R. GILLETTE, M.D., Adjunct Prof. of Obstetrics. FACULTY. MONTROSE A. PALLEN, M.D., Prof. of Gynaecology. FANEUIL D. WEISSE, M.D., Prof. of Surgical Anatomy. HENRY G. PIFFARD, M.D., Clinical Professor of Dermatology. THE COLLEGIATE YEAR is divided into two Sessions-a regular Winter Session, and a Spring Session. The latter ls auxiliary to the former, and the design of the Faculty is to furnish instruction to medical students throughout the year. A ttendance on the regWdar Winter Session is aü that is demanded of the candidates for duation. Those who attend the other session receive a CUaTipicATE op HoNoR, as having pursued voluntaril a fuiler course than usua. Tm SPRING SESSON is principally of a practical and clinical character, and affords particular facilities to students who have already taken one course in sechools where such practical advantages exist to a less extent. The course consiste also partly of lectures and examnations on the subjects necessary for graduating in medicine, conducted by the Professors of the regular Paculty and their assistants. These examinations will be addressed to both first and second course students. For the purpose of makmng the visits te the wards of the Hospitals as available as possible, the class is divided into sections. One division at a time is instructed in Practice, Diagnosis, Prescription and Treatment of Patients. The course begins early in March, and continues till the middle of May, when the SUMMER COMMENCEMEN is held. During the Summer the College Clinics are kept open. THE PRELIMINARY W r SESSION commences September 13th, 1876, and continues till the opening of the regular session. It is conducted on the same plan as the Regular Winter Session. TUE REGULAR WINTER SESSION occupies four and a half months-commencing on September 27th, and continuing till themiddle of Febftary. The system of instruction embraces a thorough Didactic and Clinical Course, the lectures being illustrated by two clinics ekoi day. One of these daily clinics will be held elther in Bellevue or the Charity Hospital. The location of the College building affords the greatest facilities for Hospital Clinics. It is opposite the gate of Bellevue Hospital, on Twenty-sixth street, and in close proximity te the ferry te Charity Hospital on Blackwell's Island, while the Department of out-door Medical Charity, and the Hospital Post-mortem Rooms are acrods the street. The students ot the University Medical College will be furnished with admission tickets to these establishments free of charge. The Pfofessors of the practical chairs are connected with one or both of these Hospitals. Besides the Hospital clinics, there are eight clinite each week in the Coll e building. THE POST GRDUATE COURSE is to consist of lectures delivered by the Professors of the several departments in the College build- ng during the regular Winter Session, illustrated by clinics held In Hospitals and at the College. Af ter an attendance of one Session ot, these lectures, any candidate who ls already a graduate of a recognised Medical College can obtain a Diploma Certificats, countersigned by the Chancellor of the University and the Dean of the Faculty of the Medical Department, and by four or more Professors of the Post Graduats Course, te the effect that the candidate has passed an examination by them in their respective branches of special medical instruction. The fee for the Diploma Certificate is $30. This course will begin September 27th. The Faculty desires to call attention particularly to the opportunities for dissection. Subjects are abundant, and are furnished free O! charge, and the Professor of Anatomy spends several hours each day in demonstration in the dissecting-room. FEES FOR THE WINTER COURSE. For course of Lectures.... ..................................................... M atriculation............................... ............................................................ Demonstrator's fee including material for dissection...................................................... Gradiation Fee..,....................................................................................... FEES FOR TEE SPRING COURSE. 8140 00 5 00 10 00 30 00 Students who have attended tne M inter Course will be admitted free of charge. Those who have not attended the Winter Course wil be required te pay the Matriculation Fee and $80 ; and, should they decide to become pupils for the winter, the $30 thus paid will be dedOcted from the price of the winfar tickets. For further particulars and circulars, address the Dean. Pof. OEAS. ImuEE PAWii, KD,9 University Medical College, 410 East 26th St.. New York Cit, s Lat, ti",
         "THE CANADA LANCET. 17 GEORGE TIEMANN \u0026 CO., Y. A. STOHLMANN. ESTABLISHED 1826. ED. PFARRE 67 CHATHAN STREET, NEW YORK, MANUPACTURERS AND IMPOUTERS OF SURGICAL INSTRUMENTS, Apparatus for Fractures, Dislocations and Deformties, Latest Instruments for Local Anaesthesia, and for Applica- tions to the Larynx, Posterior Nares, Eustachian Tube, Uterus, Urethra, Bladder, \u0026c., \u0026c. Laryngoscopes, Ophthalmoscopes, Endoscopes, Hypodermic Sy- ringes, Fever Thermometers, \u0026o. Surgical Instruments of all kinds made to order, and the Latent Improvements and Novelties promptly supplied. TWO SILVER MEDALS AWARDED BY THE PARIS EXPOSITION OF '1867, BEING THE ONLY SILVER MEDALS GRANTED TO American Exhibitors of Surgical Instruments. Dr. Garratt's Electrie Disk. for local Weakness and chronic Pains--if worn by night or day, as a flexible pad, self-appUes a constant fine Electric influence, 'of great power to cure weak Nerves, Joints,' Muscles or Organs, as weak Lungs, Throat, Stomach or Back, Sluggish Liver, Rheumatic Hat, Asthma, Cong de tion in Neck, Head Pains, aD 5 by8 lnches, 24 poles, $250. Chldrens 2 by 5, k1. 8Itpie Dif3k 50éte. Greatly ImRrovidd in durabllity.Eah1ska 'oZ~antd' Bac D-,- , ysicans \"«Garratt's Disk is e only thing for thi purpose, hold by Druggists and Surgical Instrument Dealers. ent b Mail on receipt of Price, by A. C. GARRArr, M.D., (Electri- 6 tilton Place, Boston, liAs. OUTLER'S POCKET INHATER AND Carbolate of Iodine Tnhalants A REMEDY for all NASAL, THROAT and LUNG Dis- eases, affording relief in some cases in a few minutes. This instrument is gotten up on an entirely new principle, and in well adapted to the treatment of ail those diseases of the air passages requiring efficient inhalation. It is endorsed by many leading practitioners, and commende itaelf to al desiring an apparatus. Dr. George'Hadley, Professor of Chemistry and Pharmacy in the University of Buffalo, in a carefully considered report upon its merits, concludes in these words : \" On the whole, this Inhaler seems to me, to accomplish its purposes, by novel, yet by the most simple and effectuai means ; to be *philosophical in conception, and well carried out in the execution. Always ready, no danger of breaking or spilling, besides being as safe and eeficient in the hande of the novice as the adept. Made of Hard Rubber, it may be carried about the person as handily as a pencil casé, and used regardless of time or place. Patented in the United States, England and Canada. Over 50,000 now in use in this country. Price $2, including Inhalant for two montha' use. Neatly p ut up and sent by mail free, on receipt of price. Extra bottles of Inhalant, 50c. Liberal discount to the trade. Kept by all druggists. Se'nd your address and receive our descriptive circular, post-paid. W. 9. SMITH \u0026 CO., 402 and 406 Michigan St., Buffalo, N. Y. Samples to Physicians free.by mail on receipt of $1. TO MEDIGAL MEN. TOR SALE, a good Practice, comfortable house, stables, F etc., together with a small Drug Store, in a beautifully situated village within. a mile of a line of railway, on very advantageons terms to a suitable person. Apply to the Editor of the LANCET. .1 DR. REE-E CAN BE COl5ULTED IN REGARD TO DISEASES OF THE EVE AND EMA At the Tecumseh Hou , Lor don, On the First Sgturday o every month. HR BEV ARTIIALFL SURGJCA.L APPLIANCES. PPAR TUS of every description made to order, for Paralysis, Hip- jAlàt iseae, weak Akles, Club Feet, \u0026c. JAMES AUTHORS, 16 King Street East, Toronto. TORONTO, Sept. 17, 1874. I have much pleasure in being able to testify to the skill, ingenuity, and ence of workmanship shown m Mr. Autir' surgical appliances. They will bear comparison with those manufac- in any part oR the world.Uo JAMES H-. RICHARDSON, M. D., University of Toronto, M. R.C. S. England. 1 __ 11, ý u I.P .1 MUM\"",
         "The Ba Fig. No. 18. Improved levolving SPINAL PROP. Unrivalled f0o the treatment of Ângular Curvature, gvsn an restrains no motion, sud akes n show through the dres. ýhe above cut represents Ba- wN's No .F°zcroia 8I.y-AÂ Usa- 1110 Ba\u0026oz Tu«, applied for the. retention of inguinal, femormi sud umbilical hernia. fl\u003ctta upon the principle of removing visceral weight f romn hernial, opeuinga. In light. cool and sell-adJustable, sud is absolutely a Non-Friction Truas. No BANNING TRUSS AND BRACE CO., 704 Broadway, above 4th St. other office or Address. Send for Descriptive Pamphlet W. B.-Tha numbers of the above Figures refer to Pamphlet Nôe., NOT to Descriptive List Nos. nning Truss and Brace Co. Fig. No. 19. Fig. No. 14. S P IN A L P R O P Improved Centripetal APPLIED. SPINAL LEVER, o For lateral curvature of the opine, T* gesnera action In to reverse the gravity of its depressing force. Fig. No. 7. Banning TruA \u0026Brace 's S «Y S T lm M OO MECHANCA\u0026L SUPPORT BU th nqlfed endorsement of over fvé thousaFor ofeacuvtr ofe thein meipm.. o t ontr dEu and has been adopted by PRACTITIO NERS Beéport to the Médical Journals and to ne tht*Mtl SPINAL DEFOREITIES The above cut rrevesents Te ode a ts ad YIEL2D R EAgDLY on 0 rsing fhoe thr systes, or support. \"= thouaan of lietxe leading [eia menu 0f th Ohm u tr practice. uprL iý t t t omaoiin"
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      "label" : "[Vol. 8, no. 11 (July 1, 1876)]"
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   "doc" : {
      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 2, no. 9] (Mar. 1874)]"
      ],
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      "identifier" : [
         "8_05177_21"
      ],
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         "[Montréal : \"Gazette\" Print. House, 1874]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGINAL COMMUNICATIONS. Case of Acep/talous .M1fonster of seven Mfonths' èrtaion. By FRANcIs N. SHIRRIFF, M.D., L.R.C.S.E., Huntingdon, Quebec. In the October number of THE CANADA MEDICAL AND SURGICAL JOURNAL I reported a case of acephalous monster which had occurred in my practice shortly before. I again report another case which I met with a little over two months ago. About the beginning of December last, I was asked to visit Mrs. B., who had been complaining for several hours. She vas in the 7th month of her pregnancy, and on exam- ination I found the os uteri slightly dilated. I remained in attendance six hours without much progress being made, and I determined, as in the previous case, to puncture the membranes as there seemed to be a large quantity of the liquor amnii. I had a vessel ready to collect it. A very great discharge took place, and in half an hour the child was born, precisely as occurred in the former case. On examining the child I found that the frontal, temporal, occipital and parietal bones, as also the brain -and mem- branes were wanting, and that the base of the skull was covered with a thin purple-coloured membrane continuous vith the skin. The child made no signs of life, and I cut the cord without tying it. A stream of blood issued from the cord, and i was obliged to tie it, shewing that the child had actually been born alive, but did not seem to possess",
         "386 CANADA MEDICAL AND SURGICAL JOURNAL. the instinct to breathe. Mrs. B.'s late history is very melan- choly. She lived in this section of country some years and became the mother of a fine healthy boy, who still sur- vives. Her husband and she removed to a distant State of the Union, and last summer, when she was about ten weeks pregnant she found ber husband and his brother smothered in a well by 'mephitic air. Her health since ber return home bas not been good, and for a month prcvious to her confinement she became subject to rather alarming fainting attacks. The cause of the want of development of.the brain of a child in utero, secems like other deficiencies of impor- tant parts, but little understood. The most ingenious theôry I have seen is that of Professor Rudolphi of Berlin, who almost seems to have proved that these cases originate in hydrocephalus occurring at a very early period of the life of the foetus. An account of this theory, a discovery of Rudolphi, is given by Dr. Beatty in the Mcdical Gazette April 17th, 1846. One fact seens to bear out this explana- tion of Ruclolphi's, that in every case there is an excessive quantity of liquor amnii. Sec note in Ramsbotham's Midwifery. I have within the last two years met with two other cases of deficiency of parts,which are worth recording, one a fine sm art boy, now over 4 years old, who bas no hands or metacarpal bones except one thumb, and who bas to hold things by his wrists. One foot is entirely gone fron the ankle, the other foot is all right, except that the big toe looks more like a thumb. The other case bas only a thumb and two fingers on one hand, and these fingers are grown together. _ There is also a great deficiency of ribs, and also part of the sterhum. Case of Fracture of bot/i Famora, and huciri and laceration of Scrjtum. By JohN MoRRisoN, M.A., M.D. Hugh McD , c-t. 4.-strong, stout boy, on Nov- ember 18th, 1873, was standing near a perpendicular shaft in his father's flour milL This shaft was only 5. inches",
         "EPILEPSY IN THE PUERPERAL STATE-DR. BELL. 887 from an upright pillar. The boy's clothes became entangled in the shaft whilst it was making 6o revolutions per minute, and before the mill could be stopped the little fellow had been carried throug- the space of 5-1 inches 15 or 20 times. Dr. Shirriff and myself were called in by Dr. Anderson of Ormston, a short time after the accident occurred. On administering cliloroform, we found an oblique fracture of the upper third of the right femur, with considerable bruising of the soft parts. The left femur also was brôken at the middle third. There was a comminuted fracture of the right humerus a little below the surgical neck, and a fracture of the upper third of the left humerus. The pos- terior half of the scrotum was severed from its perineal attachment, leaving the testes exposed. The right car was partially detached from the side of the head, and slight bruises were to be observed on different parts of the body. Liston's Splint was applied to the lower limbs, but the upper portion of the right femur would not stay in position, so we were obliged to devise or adopt some other appliance. Although a novelty in this section, it was deenied advisable to try the weight and pulley system ; accordingly the weight and pulley were put on both limbs, after the manner aclopted in the Montreal General Hospital, save that we used bags of shot instead of iron balls. The plan was successful in every way, neat, comfortable, and no difference in the length of the legs. In other respects the case did wvell. A case of Epilcpsy in the pieipcral statc. By JOHN BELL, A.M., M.D.. Read before the Medico-chirurgical Society, February 27th, 1874. I met with the following case of Epilepsy in a parturient woman last summer, and consider sone notes of it may be of interest to you, not only from the comparative rarity of this complication, but also on account of t'he field for investigation and discussion opened up by the eiology and",
         "CANADA MEDICAL AND SURGICAL JOURNAL. relations to each other of the whole class of convulsions occurring in the puerperal state. The horrible symptoms attending their manifestation, so painful to behold, and so dangerous to the patient, urge us on to fathom the myster- ies of their causation, and apply effectual remedies for their prevention or relief. Mrs. S., the subject of the malady, was a primipara, 27 years of age, and born in England. Her complexion is dark, and her temperament nervous. In the books to which I have had access I found thc notcs of only three cases of a similar kind, and in all of these the epileptic attacks began at the age of puberty, and in two it is mentioned that they werc connected with irrcgularity in the production of the catamenia. The history of this case is similar, as the epileptic seizures, which at first occurred only during the night, began when she was 14 years of age. At this time menstruation took place only once, slightly, and did not occur again for five years, when it was fully established. As is generally the case in these instances some unusual occurrence is given as the apparent cause of this unfortu- nate weakness, and here the onset of the attacks is attri- buted to fright from having seen the suspended body of a fernale companion who had committed suicide by hanging. This nervous excitement was also said to have been kept up, by her having frequently, late in the evening to carry letters to the post office in a garrison town in which she lived. Until her marriagè,which took place about two years ago, she had two fits in the month, and after that event they became more frequent. During the first few months of her pregnancy she had about half a dozen fits altogether, which, she thinks, were more severe than for- merly, but in the last months she was entirely free from them, and, as she says : \"forgot all about them.\" In the fourth month of her pregnancy she 'was threatened with abortion, th\"e danger of which, however, by the employment of rest and opium soon passed away, and I heard no more 8",
         "EPILEPSY IN TUE PUERPERAL STATE-DR. BELL. 389 of my patient until I was sent for on the 23rd July, when she thought labour had commenced, at its proper time. On making a vaginal examination, I found there existed a pretty free discharge, which was probably leucorrhœal, and also a free band about a third of an inch in diameter extending horizontally across the vagina, from side to side, about an inch ànd a half above its orifice. This band I divided. Although she had numerous pains during this and several following days, labour had not really commenced, nor was her full time apparently completed, judging fron the condition of the os externun and cervix. On the morning of Saturday the 26th July, I was sent for in a great hurry, as she had taken a most violent convulsion, during which, the prolonged spasms of all the voluntary muscles produced extreme congestion of the vessels of the head, with the most hideous hissing, snorting sounds ân. expiration. She had considerable difficulty in swallowing after the fit passed away. Another convulsion took place in the evening, and two or three on the following day. There was not at this time, nor had there been any œdema of any part of the body, nor did the most careful examina- tion show the presence of any albumen in the urine. I at once put her upon gr. xx doses of K. Br. every four hours, and afterwards added the same dose of chloral, to be given every four or six hours. as required. Beginning on the 28th, I find the following jottings of the case, which I will transfer, as giving an idea of lier state until delivery, which took place nearly two weeks after the commencement of this fearful nervous storm. July 28th, morning visit; she had one fit last night (27th) and two shortly after 8 this morning. Slept well all night. Had xx gr. doses 'of chloral hydrate every four hours. Had had several pains of three minutes' duration .without fits. Can drink better than formerly. Had one injection of beef tea at midnight, and an alvine evacuation at 5.30 a.m. Pulse 104 ; temperature 98·6.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Il p.m., 28th.-Was sleeping when I went in. Has had no chloral since 2 p.m. Had one fit about 4 p.m., and now seems more rational than she has been for some time. Pulse 98 ; temperature 99. July 29th, 11 a.m. Had two fits since visit last night- one for three quarters of an hour. Has had several pains. Fits preceded by bearing-down pains. *Had a fit of i minutes duration just before my arrival this mrning. July 3oth, i1 a.m.--Had four fits since last night's visit. Bowels not moved. Is again taking the Bromide of Potass. at the rate 3ij per diem. Pulse 1o6; temperature 98-4. 3oth, 5. p.m.-Had seven fits during the day ; ordered a pill of Zinci Valeriant gr. j, extract valerian gr. iij every four hours. At two or three of my visits I attempted to dilate the os uteri by the introduction of two or more fingers, but on the advice of Dr. Howard, who saw the case with me, desisted, to await the natural advent of labour, which would evidently be not long delayed. July 31St, morning visit.-Slept soundly and had only one fit during the night. Evening visit.-During the day had only two, what the nurse called \" inward \" fits, was not generally convulsed. Pulse i 12; temperature 98-4. August 4th.-Had 4 fits last night. August 5th.-Had only one of the slight \"inward\" con- vulsions. August 6th.-Has not had any fit to-day. Head clear; tongue clean, and better generally. Teipperature 98.4. Genuine labour pains began about 2 p.m., and I was sent for at 11.30 p.m. There was no convulsion during labour, which was com- pleted at i a.m. of the 7th. (The presentation was a vertex in the first position if I remember rightly. 890",
         "EPILEPSY IN THE PUERPERAL STATE--DR. BELL. 391 Is doing very well. Has had no return of the convul- sions. Is rather thirsty, with tongue a little coated. Has a slight headache, and her bowels are somewhat sore, but is otherwise doing well. Is to continue to take gr. xv. Pot. Bromid each day. A small abscess formed in the left labium, which was opened and gave no further trouble. She nursed the child, a girl, and was up and about the house in two weeks from the time of her delivery. There was no return of the fits for nearly three months. Then they again began and have since continued, two, and sometimes three, times a month. The child is now very fat and strong, and has exhibited at no time any tendency to convulsions, vhich took place in one of the cases reported by Elliot in his CLINIC. In the case reported above, neither the bromide of potass nor chloral hydrat seemed to have thei- usual sedative effect on the excited nervous system. The convulsions at once diminished in frequency and intensity after the administration of the zinc and valerian, which were appar- ently more suited fo the irritation of nervous exhaustion. induced by the number and force of the fits. I have little doubt that a full dose of morphia would have had a similar or even more beneficial effect, had it been exhibited. But, again, the comparative freedom fronm fits as parturition approached, might have been due to the direction of the disturbed nerve force into a new channel. The convulsions began, at first, with a disturbance or misdirection of a newly formed nerve force, in the non-evolution of the catamenia. It found a new channel for its action during pregnancy, when its abnormal manifestation ceased-but which was again exhibited when another change was about to take place in the structure and function of the uterus owing to the completion of gestation. 1. BEAVER HALL TERRACE, Feb. 27th, 1874.",
         "392 CANADA MEDICAL AND SURGICAL JOURNAL. HOSPITAL REPORTS. Case of Scorbutus, treated by 1h-on tonics and Dieting, under the care of DR. WRIGHT. F. D.-, aged 33, schoolteacher, a tall well made nan, but looking pale and delicate, was admitted into the Mont- real General Hospital on the 5th February, complaining of pains in the legs, and of a number of purple patches on the limbs. He is quite grey, but states that his hair com- menced to turn when he was 18. He has generally enjoy- ed good health and bas not *suffered from dysentery, hæmorrhoids, or other diseases causing loss of blood, with the exception lately of epistaxis. For nearly a year he bas been living chiefly on bread and butter, eating meat only about once a month. and using no vegetables. About three weeks before his admission he got his feet wet, this was followed by pains in the muscles of the thighs and legs, swelling about the ankles, and the. eruption of a fine red rah, gradually becoming purple. The pains in the limbs increased so as to make him complain when he attempted to stretch out his legs or walk. He had diarrhœa, the bowels being opened three or four times a day, but no blood being noticed in the stools. On admission the pains in the limbs were still present, and he walked lame. His face was pale, tongue flabby, gums spongy, and a large purple patch was found on the inner side of the left thigh, about 6 inches long by 4 broad, looking like a large bruise, dark in the centre, and becoming yellowish-green round the edge. Over the outer ancle which, along with the foot, was somewhat œdematous, was also a purple patch. Patches, similarly situated and nearly the saine in hue, were also found on the right leg, and numerous petechial spots were also noticed on the anterior surface of this extremity.",
         "TYPH01D FEVER-DR. ROSS. He was put on half diet with porridge and milk, beef-tea and chop, and was ordered 6 lemons in the 24 hours, also the following mixture: R. Tinct. Ferri Mur. 3ijs; Quinæ disulph 3js ; Syrup Zingib oz. i. Aque Acid. ad oz. vi; dessert-spoonful in water every two hours, -and to rem-ain in bed. Feb. 7th.-Ordered Potass. Chlor- 3i. Aq. oi., as a drink every day. Feb. 9th.-The ecchymoses are becoming paler, and of a more yellowish color. He has had no diarrhœa since his admission. Gums somewhat less spongy. 12th.-He can move his limbs more freely, his appetite is now good. The patches are fading. I3th.-Ordered 2 eggs. i6th.-The œdema of the left foot has nearly disappeared. He can move his limbs freely ; the pains in the ankles have disappeared. 2oth.-The purple patches have disappeared; the spon- giness of the gums has gone; his color is better, and there is generally a marked improvement in his condition; he is allowed to get up and walk about. 23rd.-Discharged cured. Case of Typhoid Fever. Hmorrhagefrom bowels, and deatIh. Great enlargement and Ulceration of Peyer's Patches found at Post Mortcm. Under the care of DR. Ross. L. A , aged 19, well nourished, was admitted into the Montreail General Hospital on the 5th January, Ùnder the charge cf Dr. Ross. She had been employed in a store and of late had very long hours. For about 10 days before her admission she had been feeling unwell, and complained of headache, loss of appetite and pains in the back and down the limbs. On the Sunday before her admission she was obliged to take to her bed 398",
         "CANADA MEDICAL AND SURGICAL JOURNAL. and the following day came to hospital. On admission her expression was duli, cheeks somewhat flushed, pupils large, tongue furred, with red tip and edges. Some abdominal tenderness but no spots. No diarrhœa. She complained of headache and pain in the back. On the evening of the 5th, her pulse was ,120. Temper- ature 103 2-5. She was ordered Pulv. Rhei. Co. 3i. Milk diet, with extra milk. 6th.-Morning.-Pulse 12o; Resp. 28; Temp. lo1 2-5- Condition much the same; bowels acted once since ves- terday. Evening.-Pulse 120; Resp. 28; Temp. 103 3-5 sleeps pretty well. No diarrha, no head symptoms. 7th.-Morning.-Pulse io0; Respiration 28; Tempera- ture, 102 3-5 ; tongue more dry. She was ordered the following: R. Liq. Ammon. Acet. oz. ijs. Tinct. Aconit. M. xxxvi. Aq. ad oz.vi. Tablespoonful every 4 hours. Evening.-Pulse 130 ; Respirations 28 ; Temp. i04. 8th.-Bowels opened several times since yesterday. Motions loose and rather dark in color. Turpentine stupes followed by poultices, ordered to be applied over bowels. Pulse, 126; Resp. 28 ; temp. 104 1-5. 9th.-Slept pretty well last night; tongue much the same ; bowels opened twice since yesterday. Complains of great weakness. One or two spots noticed. Tender- ness in right iliac fossa. Not much tympanites ; has a slight cough but no expectoration, and no physical signs of any moment discovered by auscultation or percussion. Morning, pulse 120; respiration 26 ; temp 102. 1-5. Evening, pulse 120: respiration 28; temp. 102 1-5. ioth.-Morning, pulse 120; resp. 28 ; temp. Ioi 1-5. Evening ; pulse 120; resp. 28 ; temp. 102 3-5. Bowels. opened twice. ilth.-Morning, pulse 120; resp. 28 ; temp. 101 3-5. One or two new spots. Ordered more milk and corn starch,.. Not sleeping so well at night. Tongue smooth and glazed. 394",
         "FRACTURE OF THE SPINE-DR. G. E. FENWICK. 395 Evening, pulse i2o; resp. 28; temp. 102 4-5. i2th.-Morning, pulse 120; reSp. 28 ; temp. 101 3-5. Ordered a sleeping draught, containing Potass. Bromid, ChloraI Hydrat. aa gr. xv. 7.30 p.m., pulse 120; resp. 28; temp. 100 1-5. Bowels open this morning motion scanty and contain- ing a little blood. .11. p.m.-Sleeping quietly; not up since Dr. Roddick was called to see her towards morning, and found that she had passed a considerable quantity of blood at stool. He gave her gallic acid and stimulants, in spite of which, she sank and died at 8 a.m., on the 13th. AUTOPsY,-Rigor mortis pretty well marked. On open- ing the abdominal cavity no sign's of peritonitis presented themselves. On slitting up the bowel in the neighbor- hood of the iliococal valve, Peyer's patches were found very much increased in size; one being nearly two inches long, and containing numerous deep and ragged ulcers. They were also considerably raised above the mucous surface of the bowel. A small deep ulcer, covered by a small clot was also observed. Clotted blood was also found in the bowel. Case of Fracture of the Spinefrom indirect Violence. Loss . of Sensation and motion below the seat of Znjury.- Death, after cighty-six days. Post mortem appearance of thepats. Under the care of G. E. FENWICK, M.D.- Reported by Mr. J. C. CAMERON,.House Apothecary of the Montreal General Hospital. J. A., æCt 32, a healthy vigorous young man was admitted to the Montreal General Hospital on the evening of Febru- ary ist, 1873, suffering from a severe injury to the back, received while tobogganing. At the time of the accident, he was seated in front with his feet in the \" Hook,\" and. while endeavoring to steer clear of some ladies, who were- coming up the hill, his-toboggan ran. at full speed against",
         "CANADA MEDICAL AND SURGICAL JOURNAL. a mound of ice ; his feet came with such force against the mound, that his body was jerked violently forwards, his back bending so sharply and quickly upon itself that his head almost touched his toes ; the toboggan veered and he rolled off upon the snow. Dr. Fenwick was immediately summoned, and advised removal at once to the Hospital where he arrived about 6 p.m. On examination, absence of the spinous process of the i2th dorsal vertebra was ascertained-neither sensation nor motion below the seat of injury-no bruises no.r signs of violence in any other part; not quite recovered from the shock of the accident. There was obviously injury to the spinal cord, but to what extent or of what nature, was by no means clear. Accordingly, to relieve pressure as much as possible, he was placed face downwards upon a water bed, with an air cushion supporting the abdomen opposite the seat of injury, in order to arch the back; the head and extremities were consequently lower than the rest of the",
         "FRACTURE OF THE SPINE-DR. G. E. FENWICK. '397 body. A gum-elastic catheter was passed into the bladder, tied in situ, and connected with a urinal by means of a rubber tube ; ice-bags were kept constantly to the back. Diet liberal and nutritous. On theSecond day,he became delirious at times. Dr. G. W. Campbell was called in con-sultation, approved of the treat- ment, but gave no hopes of ultimate recovery. As the deli- rium continued, and the cerebral congestion became great, on the Sixtl day, his position was altered, and he was placed on his back. At the same time an injection was given which brought away a copious stool. The urine at this time was thick, alkaline, and ropy. Notwithstanding the water-bed and pads, bed-sores had formed over both anterior superior spinous processes of the ilium, and also on the knees, showing great want of vitality. There was no positive sensation below the injury, aithough at times he imagined that he had slight feeling at different points both above and below. On the Eig-hth day, he was removed into the largest and most cheerful private ward in the hospital. On the Nintk day, a consultation of the entire staff was called, to consider the propriety of cutting down on the depressed vertebra, and -raising it, or trephining, as the nature of the case might demand. But considering the unfavorable statistics of operation, it was decided not to interfere, but to make him as comfortable as* possible; keep up his general strength, prevent or retard bed-sores as far as practicable, and in fact give natureýevery chance to effect a cure. The patient himself was very confident and hopeful, and fully determined to get well, and seemed to hope against hope, to the v'ery last. In spite of all efforts, however, the bedsores increased in extent; the one on the left knee, opened into the joint, so that the eroded cartilaginous extremities of the tibia and femur were readily felt. The legs became swollen and œdematous, and pus burrowed in every direction. The sore on the right hip also opened up the joint, and a sac of pus wa.s formed in the cavity. Wherever there was the slightest pressure, even.",
         "398 CANADA MEDICAL AND SURGICAL JOURNAL. for a few hours, a bed sore formed. The bladder was washed out with salt and water every fifth day, and an injection administered per rectum, about every tenth day, to clear out the bowels thoroughly, although motions to a greater or less extent were passed involuntarily every day. Having no sensation below the fracture, these immense sloughing sores did not trouble him at all: but lie did suffer a great deal from one situated directly over the seat of.injury, and from two others on bis back, the upper margins of which came within the bounds of sensibility. The pain he des- cribed as being sharp and stinging, becoming at times almost unendurable, especially if the slightest pressure was made upon them ; it was always worse at night, but great relief was always afforded when the sores were dressed, and the clothing comfortably rearranged. Pyrexia and delirium supervened towards evening-More marked after the third week. Chloral in 15, 20, and afterwards in'30 grain doses, was administered at night, with good results ; a hacking cough set in, due, probably, to the implication of the inter- costal nerves from the extending loss of nervous power. His memory became much impaired, especially during the last three weeks of lis life ; at first this was noticeable in his losing all recollection of conversations with friends or calils from visitors, although he spoke quite rationally and sensibly ; then his tallk became more rambling, he used to mis-call persons and things, forget what he was saying, and in the middle of a question or answer, wander off into something totally different. He was a great dreamer, and seemed to dwell upon these dreams with a morbid delight, assigning them peculiar'significance. For the last three or four weeks, he was subject to peculiar chills, no doubt pyæmic in origin. They came on regularly about 9.30, a.m. and lasted till i p.m. ; and again at 10 p.m., lasting tilil 2 a.m. The cold sensation he described as seeming to start from his toes, proceeding with a wave-like motion till it reached the head, when another chill began at the toes and ran the same course, chill following chill in rapid suc-",
         "FRACTURE OF THE SPINE-DR. G. E. FENWICK 399 ,cession. The period of cold was followed by one of warmth and comfort. It is a strange circumstance, that chloral had no effect whatever during a chill ; and indeed he became so well aware of this, that latterly he refused to take his draught during these periods, saying he did not wish to waste it. During these rigors, his temperature ranged between 103 - and 104 The pulse was shorter and quicker, sometimes running up as high as 16o. The skin was dry and hot. From a number of observations made, when free from chills, the following record was obtained ; MORNING. EVENING. Temiperature............oo1 to 102° loi, to 103, Puise..................110 to 125 135 to 15o Respirations. ........... IS to 22 18 , to 22 During the last two weeks he kept constantly trying to blow his nose, but seemingly with very little success, pro- bably from paralysis of the abdominal muscles. The paraly- sis at this time seemed to extend somewhat, and then the bedsores troubled him no more ; he folt perfectly easy and comfortable, the cough being the only annoyance. The pus, which kept pouring out frorn the large sloughing sores, and which burrowed in every direction through his legs, was particularly fcetid and sickening ; so much so that the attendants could not remain in the roomi without thor- oughly disinfecting it several times a day. Active deliriuni appeared about twenty-four hours before his death. At 2 p.m., April 27th, a very urgent attack of dyspnœa came on, so severe that his friends were sent for. Stimulants were given freely, and mustard applied to the chest ; he recovered sonewhat about 5 p.m., but at 7 p.m. he was seized with a second attack which lasted till he died at one o'clock the following morning April 28th, 1873. 'The only medicine .administered during his illness, was the ordinary Nitro- muriatic acid mixture of the Hospital, given to stimulate his liver, keep his urine acid, and consequently less irrita- ting,,and serve as a general tonic.'",
         "400 CANADA MEDICAL AND SURGICAL JOURNAL. AUToPsY.-Thirty-five hours after death.. Internal organs quite normal. The spinal cord was removed, and found to be much softened and crushed-almost obliterated at the fracture-quite hard and healthy above the injury, but soft and collapsed below. A preparation was made of the bone, which at once explains the nature of the accident. The engraving at page 396 gives a faithful representation of the specimen which has been placed in the museum of McGill University. A Practical Treatise on the Discases of Clildren. By J. FORSYTH MEIGS, M.D., one of the Physicians to the Pennsylvania Hospital: Consulting Physician to the Children's Hospital, \u0026c., and WILLIAM PEPPER, M.D., Lecturer on Clinical Medicine, in the University of Pennsylvania, \u0026c., \u0026c. Fifth Edition,-revised and enlarged; 8vo. pp. Ioo8. Philadelphia, LINDSAY BLAKISTON, 1874. The work of J. Forsyth Meigs on diseases of children, has been a favorite with the profession for some years past. ,We remember it well in years gone by, and frequentily pro- fited by the perusal of its pages. The present edition, which is the fifth of the series, has received many additions, and a thorough revision. Modifications will be found in such parts of the work, which have been called for, by a change of views on the part of the authors, or by recent researches by other workers in this department of medicine. Several articles which appeared in the last edition have been re- written, and there bas been added to this edition articles on Pulmonary Emphysema, Pneumothorax affections of the Tonsils, Retro-pharyngeal Abscess, Malarial Fevers, and Scrofula.",
         "REVIEwS AND NOTICES OF BOOKS. Other changes in the body of the work will be found, these chiefly with a view of keeping the work within ordi- nary proportions. It is a thoroughly practical work, and will be found of use to the busy practitioner, as its teaching is plain, and the author lays before the reader the results of his experience, extending ~over a quarter of a century. We hcartily recomend it to our readers. T/te Puipe;ral Diseases-Clin ical Lec tures delivered at Bellevue Hospital. By FORDYCE BARKER, M. D., Clinical Professor of Midwifery and the Diseases of Wonen, in the Bellevue Hospital Medical College, \u0026c., \u0026c. 8vo. pp. 526. New York, D. APPLETON, \u0026 CO., 549 \u0026 5,5 1 Broadway, 1874. This work consists in a revision of Clinical Lectures on the Diseases of Women, which the author has been in the habit of delivering before his class at-the Bellevue Hospital School. In his preface the author eulogises his branch of the profession, claiming that \" at the present day, for the \"first time in the hi:story of the world, the obstetric depart- \"ment seems to be assuming its proper position, as the \"highest branch of medicine.\" To this we must take exception, and simply observe that if the obstetric branch of medicine has hitherto occupied an inferior position, the profession has itselfalone to blame. The custom oflicensing' ignorant women to practice that branch is, even in our day, heaping discredit and bringing disgrace on the obstetric art. So that it requires a large share of moral courage for any man to devote his time exclusively to that department, of medicine with the possible chance of being regarded by the public as on an equal footing with the sagefemme. In tinies gone by it was the custon for old and neglected bawds to take up the practice of a midwife, and even at the present time many a retired harlot, who from advancing age finds ber trade less profitable, forsakes the path of misery and sin, to enter on one, at least, more respectable ; Cc 401",
         "402 CANADA MEDICAL AN]) SURGICAL JOURNAL. how, then, can we wonder that the practice of midwifery has been hitherto regarded as beneath the position of a scientific gentleman. Al lovers of the art of Medicine and Surgery see in some one particular branch, which they themselves have selected, a super-excellence ; so that in all charity they arc to be excused if they consider that theirs is the highest branch-the most important branch to society. It is only another illustration of the truth of the doctrines inculcated by the old fable whercin the tanner dcclared that for the defence of the town in which he lived, and which was about to be besieged: \"There was nothing like leather.\" Our author goes on to say \"A man may become eminent as a physician and yet know very litle of obstetrics ; or \"he may be a successful and distinguished surgeon, and be \"quite ignorant of even the rudiments of obstetrics. But \"no one can be a really able obstetrician unless he be both \"Physician and Surgeon.\" Now wc cannot agrce with our author on this point as it does not accord with our expe- rience. There is certainly a growing appreciation of the importance of this department of the Ars Medica, not that it holds superior rank, but because that it had been neglected, and required a mind like that of Simpson and others to stimulate observers to meritorious research. The work before us consists of twenty lectures, in which are discussed the following subjects: Puerperal Convale- scence; Diet of Puerperal Women ; Laceration of the Perinæeum ; Thrombus of the Vulva and Vagina; Albumi- nuria and Convulsions; Lactation ; Mastitis ; Puerperal Mania; Relaxation of the Pelvic Symphyses ; Phlegmasia .Dolens ; Puerperal Thrombus and Embolism ; Puerperal Phlebitis ; and Metritis ; Puerperal Peritonitis; Pelvic Cellulitis ; Puerperal Septicoernia and Pyæmia, and Puer- peral Fever. It is very practical and contains many suggestions of value both to the Practitioner and Student of Medicine, and we cordially recommend it to our readers.",
         "REVIEWS AND NOTICES OF BOOKS. Mfedical L exicon : a Dictionary of Medical Science, contain- ing a concise explanation of the various Subjects, and Ternis of Anatomy, Physiology, Pathology, Hygiene, Therapeutics, Medical Chenistry, Phar- macy, Surgery, Obstetrics, Medical Jurisprudence, \u0026c., \u0026c., with Accentuation and Etyniology of the terms. By ROBLEY DUNGLISON, M.D., LL.D. Late Professor in ,the Jefferson Medical College, Philadelphia. A New Edition, enlarged and thoroughly revised. By RICHARD J. DUNGLISON, M.D. Svo. pp. I131.- Philadefphia, HENRY C. LEA, 1874. Dunglison's Medical Dictionary has been for years past a necessary adjunct to the library of every Medical man, and to the student of Medicine it is indispensable, as it is almost the first book he procures at the outset of bis studies. The late Dr. Dunglison conferred an everlasting obligation on the profession, when soie fortyyears ago lie first pub- lished this work. As time elapsed and changes occurred, fresh and enlarged editions had to be brought out. We are happy to observe that Dr. Richard J. Dunglison, the son of the late venerable and erudite author, has, with his father's spirit and energy, given evidence in fthis new edi- tion, that the usefulness of this work will not be lost; and that year after year, as occasion nay require, the profession may look forward to the publication of more complete editions of this work which has become indispensable to the library of every practitioner. The Science of Medicine and Surgery has received such remarkable additions to its nomenclature during the last few years, that to take up an ordinary work on any subject connected therewith, the reader is at every second line puzzled and embarrassed at the number of terms used which are foreign to the English language. Without such a work as the present, or without a familiar acquaintance with the Greek and Latin languages he would be unable to compre- hend what he read. It is not in our day, considered, that the beauty of cornposition consists in simplicity of style?;",
         "404 CANADA MEDIcAL AND SURGICAL JOURNAL. writers appear to supplement their lack of originality, by the introduction of terns, not commonly in use, and which have been vulgarly called jaw-breakers, which is a most expressive term. We have observed som-ie persons in attempting to pronounce a difficult but possibly expressive term, stutter and stammer over a syllable or, two until \\ve becare painfully impressed with the danger to their jaws nor would we have been surprised had an accident occurred, for the contortions and muscular spasm appeared to be such as would break any ordinary jaw bone, unless made of stuff similar. to that used by Sanpson in slaying the Philistines. We heartily recommend this book, although it is such a familiar old friend that we feel convinced that no amount Df eulogy is required to induce those seeking for informatio.a to secure a copy. It is to be had of Dawson Bros., St. James Street. Toxicology-Poisozing by Coffee. H. Curschmann gives in the Deutisclie Klinik for 1873 (p. 377-380) a careful report of the case of an anærnic woman, who, having a groundless idea that she was preg- nant, took, for the purpose of procuring abortion an infu- sion of 250 grammes of slightly roasted coffee in 500 grammes of water. Two hours and a quarter afterwards, her mind was confused; the cauntenance was pale and very anxious, and there was violent trembling of the limbs ; she had very severe dyspnœa ; the breathing was difficult and quick, while the state of the lungs was normal. 'he puise was frequent and very tense, and the arteries were contaacted; the action of the heart was violent ; there were frequent diarrhœa with tenesmus, and frequent discharge of large quantities of urine of low specific gravity. In the evening, there was an improvement under the influence of morphia: and on the third day the patient had quite recovered.-Centralblatt fur die iledicin. Wissenschaften, Detember 13, 1873.",
         "TUE SIAMESE TWINS. TJhe Siam:se Twins.-Olcial Repyor of thte Autopsy. A special meeting of the College of Physicians of Phila- delphia was held at the hall, Wednesday evening, February Isth, for the purpose of hearing the report of the Commis- sion on the Siamese Twins. Dr. W. S. W. Ruschenberger, United States Navy, in the chair. The bodies of the Siamese Twins being upon the table, the meeting proceeded to hear the report of Drs. Pancoast and Allen. On behlaf of the Commission, Dr. Pancoast stated that the dissection not having been entirely com- pletcd, thcir report would be a verbal one, to be followed at some later date by a memoir upon the subject. He further remarked that it had been agreed that he should consider chiefly the surgical aspect of the matter in hand, whilst to. his colleague had been assigned the demonstration of the anatomical peculiarities. Dr. William H. 1ancoast said : MR. CHAIRMAN, AND FELLOWS OF THE COLLEGE Having been requested, as a member of the Commission, to open the discussion this evening, I will say briefly, in reference to this monster of a symmetrical duplex develop- mentjoined as many of the Fellows now know, at the ensi- form appendix, and also here at the omphalos or navel, that at the investigation which we made on the first occasion at Mount Airy, I made the opening incision of the body on the line for the ligation of the primitive iliac, on the right side: Dr. Allen made the incision on the left. The object was to reach the great vessels,-the aorta and the two primitive iliacs,-and to force the injecting material which we use for embalming (chloride of zinc) up the aorta and down the iliacs until it ran from the incisions made in the",
         "406 CANADA MEDICAL AND SU!GICAL JOURNAL. fingers and toes. It flowed frecly through the blood-vessels of Eng, owing to the ossified condition of his arteries ; the injection in Chang, was, however, not so successful, owing to decomposition in the tissues and blood-vessels, It was necessary to rcpe.ýat the injecting process several times in order to preserve the body. The arteric.s of Chang were found to be very rnuch decomposed-quite rotten, in fact. In Dunglison's Medical Dictiona;y we fnd the scientific name given for the Siamese Twins, in the classification c.f teratology, to be Xzphopages; and in referring to the admirable article on \" Diploteratology,\" of Dr. G. J. Fisher. (published in the Transactionis of lie .Mfedical Society of the Sta/e of New YorIk for the ycar 1866,) it will be found that the twins belong to the class of Anacatadidyma. In his classification of double monsters he makes three orders : Order irst-Terataca tadidyma; derived from teras, teratos, a \"'monster,\" kata, \" down,' and didumos, a \" twiin.\" Defini- tion-Duplicity, with more or less separation, of the cerebro- spinal axis, from above downward. O;der second- Terata- anadidyma, derived·from ana \" up \" or \"above,\" and didumos a \" twin.\" Definition-duplicity, with more or less separa- tion of the cerebro-spinal axis from below upwards, or from the caudal towards the cephalic extremity of the neural axis. Order third.-Terata-anacatadidyma, derived fron ana, \" above,\" kata 4 down,\" and didunos a \" twin,\" Dcfni.. tion, duplicity, with more or less separation of both the cephalic and the caudal extremity of the cerebro-spinal axis, existing contemporaneously. In this order, we think, the monster now before us might be called an Omfplialo Xizho- didymuîs. Thus we have the scientific nomenclature of this monster. Of course, the consideration of greatest interest .to the profession, and one of the main reasons why the Commission made such exertions to obtain this post mortem, was that the American profession might not be charged with having neglected an effort to obtain an autopsy, which would solve the mystery of their union. The feature ofgreatest interest",
         "THE sIAMESE TWINS. is connected with this band-about four inches long, and eight inches in circumference. In addition to this, there are other points of importance in teratology, in regard to the fulfilment of the law of homologous union, in relation to the juncture of the recti muscles, and the fasciæ of the obliquus and transversalis at their point of meeting in the centre of the baild. In regard to the position of the hearts, we think their apices present toward each other: but we have not yet opened the thorax. The livers we have found to approximate to each other and to push through the res- pective peritoneal openings into the band. We extended our incisions to the margin of the band in front. By placing my hand in the peritoneal cavity of Eng and my colleague placing his hand in the peritoneal cavity of Chang, we pushed before us processes of peritoneum, which ran into the median line of the band ; and we could feel our fingers in the lower portion of the band, behind the median line, with a distinct layer of peritoneum between them. demon- strating at once the prolongation of the peritoneum into the band, and the complete separation of one peritoneal cavity from the other at this median line. Above that we felt some traces of vascular connection, apparently running from one liver to the other'; but this we will examine into when we have a better opportunity of carefully dissecting and examining what vascular structures may exist. We also noticed that in turning off the flaps consisting of the anterior walls of the abdomen, the hypogastric arteries, as illustrated by the diagram on the blackboard, ran upwards in each body into the band. We lost them in this way as we think, toward the common umbilicus in the anterior inferior surface of the middle of the band. It is probable that the two hypogastric arteries on each side passed through this umbilicus. Whether or not there were two umbilical veins, we have not yet been able to decide, nor to answer the question whether the umbilical cord was double or single, and composed of the four hypo- gastric arteries and two umbilical veins, or whether the placenta was single, double, or twin. 407",
         "CANADA MEDICAL AND SURGICAL JOURNAL. We also recognized that the ensiform appendix, as shewn in the diagram of each side, was prolonged and united in middle line. On our later examination we find that ere is complete continuity of structure of the cartilages, no true joint at the middle line, although it is possible there may be some small synovial sacs farther up. The motion is mainly due, as I here demonstrate to you by moving these one upon the other, to theclasticity of the connected cnsiform appendices and intervening fibro- cartilages. In regard to the vascular connection of the band, we have not yet been able to make so thorough and careful an examination as we wished ; but still, in throwing coloured plaster into the portal circulation of Chang, it has been found to flow through the vessels of the upper part of the band into the portal vessels of Eng. So that the surgical anatomy of the band consists of the skin and fascia which cover it, the two separate peritonea pouches which meet in the middle, the large peritoncal pouch, the vascular con- nection, to whatever extent that nay exist between the two portal circulations, and the remains of the hypogastric arteries in the lower portion of che band. Thus the main difficulty in any operation [for section of the band would seem to be in regard to the peritoneal processes and the portal circulation. The anastomosis which may exist between the internal mammary arteries and the intercostals. in the integument in the upper portion of the band, of course would present no difficulty. I will not venture upon any further remarks as to the- surgery of the case, while there are so many distinguished gentlemen present more competent than myself to give an opinion. At the same time, operations on the peritoneum may not be considered so hazardous in this day, when ovari- otomv, gastrotomy, and even Cosarean section are so often performed. The peritoneum-pouches themselves would not present so great a difficulty as might be anticipated, under pressure*and acupuncture, by which the sensitiveness of the",
         "THE SIAMESE TWINS. structure might be so altered as to permit of a section. I was informed at Mount Airy, that in Paris, a surgeon had made the experiment of applying pressure upon the band, and it was reported the twins had fainted in consequence. I could not ascertain, however, wh'ether this was from fright, design, or actual pain. As Dr. Ilollingsworth is present it may be proper for me to mention a fact which that gentleman can corroborate, that Eng was the stronger physically and Chang was the stronger mentally. The same difference was observable in their characters. Chang was more irritable than Eng, especially since an attack of paralysis with which he had been afflicted-this being in the side next to Eng. The latter had not only to bear with the irritability of his asso- ciate, but also to support one-half his weight. Among other peculiarities, Chang would sonetimes break useful articles, or throw them in the fire. In conclusion, let me say that when I turned up the skin and superficial fascia of the H incision on the posterior part of the band, I was struck with the developient and the strength of the abdominal aponeuroses. The fibres arched, interlaced, and developed into a strong fibrous band about a quarter of an inch wide, running round the median line, although there was no actual joint in the cartilage. Professor Harrison Allen said: MR. CHAIRMAN : I will probably best discharge the duty devolving upon me by at once proceeding to a somewhat more minute anatomical description than Dr. Pancoast has given, this being in accordance with the understanding between us in reference to the evening's exercises. Perhaps it vould be best to point to that simple diagram upon the blackboard before considering the subject more fully in detail. As'Dr. Pancoast has informed the Fellows, there is a union of the twins at the two ensiform cartilages, which are very firmly joined in the centre, Eng's process being the more robust of the two. You will observe that there is a point of conjunction between the two processes 409",
         "410 CANADA MEDICAL AND SURGICAL JOURNAL. which is not quite in the median line of the ban-1. In the centre of the band is seen an elliptical space, whici suggests the presence of a synovial cavity, with fibro-cartilage. It is probable that the ensiform junction is of the charac- ter of a synchondrosis, with a median bursa-like sac; neither ensiform cartilage is ossified. /E CHANG DIAGRAMMATIC REPRESENTATIONS OF THE BAND. A, upper or hepatic pouch of Chang. E, E, (dotted line.) union of the ensiforn cartilages. D, connecting liver band, or the tract of portal continuity.\" B, the peritoneal pouch of Eng, G, the lower peritoneal pouch of Chang. F, F, lower border of.the band. Below this point in the diagram, you sce a number of differently-lined tracks. The- lower one (C,) immediately above *the umbilicus, is only separated from the skin by a very delicate layer of tissue (so that with the finger intro- duced into the pouch and moved, there is a decided indi- cation of motion in the skin) on the uhder surface (F,F) of the band. This pouch passes across the abdomen of Chang, and is lost ii the duplicature of the suspensory ligament of- the liver cf Eng. The finger passed upward to the band from",
         "TUE SIAMESE TWINS. the abdomen of Eng crosses the band above the pouch just mentioned, and is lost between the layers of the suspensory ligament of the liver of Chang. When the significance of the round ligament at the free border of the suspensory ligament is rememberecd,,the relations of these pouches' directly suggest that they have had essential bearings to the umbilical vein of. the funis, and miglit be provisionally termed the uimbilical poueches. Above Eng's pouch, (B,) and between it and the under surface of the ensiform conjunction, is a second pouch (A) prolonged from Chang's abdomen, which fairly reaches the peritoneal cavity of Eng, but is not continuous with it. Extending up into this pouch from Chang's abdomen is a process which suggested to the Commission the possibility of the transit of hepatic vessels. This view was rendered more probable from the fact that a similar process passed up into the band from the liver of Eng. Accordingly, the plaster injection, ceqlored by uitranarine, was thrown into a tributary of the pdcrtal vein of Chang, when it was observed that the fluid passed freely into the liver of Eng, as well as into the mesenteric veins proper. It is my own hypo- thesis that this bond of union (D) vas the' true hepatic tract; but in its present state, in the absence of evidence of any parenchymatous admixture about the vessels thus crossing the band, we prefer to demonstrate the transit as the tract of portal continuity. In the foetal condition it is very likely that this large space, (A,) the upper pouch, now continuous with the abdomen of Chang only, was entirely occupied by true liver- tissue, which, as maturity was attained became smaller, and left an empty space. Hence I propose to call this upper pouch the Iepatic poucle. The contraction chanced to be greater on Chang's side, in harmony, it may be, with other evidences of a weaker and less developed type, which is so apparent in many of the tissues of Chang. Now, with reference to the demonstration. As Dr. Pancoast has already informed you, the incisions in the abdomen were 411.",
         "412 CANADA MEDICAL AND SURGICAL JOURNAL. made in rather an exceptional manner. By reference to the parts it will be seen that the incision in either individual was located in such a way as to avoid the median line, since it was supposed from the peculiar position of the umbilicus that the remains of the hypogastric arteries would be found extending from the fundus of the bladder upward and onward along the entire length of the anterior wall of the abdomen. Besides, this incision would enable us, by con- tinuing from below upward, to fairly open the abdomen and examine the cord, without violating the conditions by which the Commission was bound. The flap comprises the greater part of the abdominal wall, and can be best observed, from the position of the bodies on the table, in that of Eng. You notice that the tissues are well supplied with fat: and this condition is very plainly in contrast with that of Chang. Eng's side o-f the bandjs well nourished ; Chang's end of the band presents an entirely different aspect. Chang was an invalid, and the wcaker half of this organism, with less strength in the abdominal walls, and in every way less tissue, than was possessed by Eng. You can mark that distinction very plainly in the two halves of the band, prov- ing, if we had no other means of proof, that there could not be any very intimate communication of the vessels between the two. The first point worthy of notice is that of an isolated mass of adipose tissue, evidently sub-peritoneal, which is in the position gf the usual umbilicus, namely in the median line of the abdomen, about half-way up the anterior wall. This is strictly symmetrical, a similar point of about the same size being found in Chang. Another fact equally well pronounced is tmat in Chang the bladder was found very much contracted and contained no urine ; it was deep down in the cavity of the true pelvis. That of Eng, however, was distended with urine; hence there was a contrast in the appearance of the fold under- neath the skin in the two individuals, in consequence of great difference in the actual size of the bladder.",
         "TilE SIAMESE TWINS. My finger is now in the umbilical poich of Chang. (C.) The motion is noticeable in the under portion of the band. On the side of Eng no such motion will be observed. I can very clearly see my finger passing between the two folds of the suspensory ligament. At this point it would perhaps be well to exhibit the drawings which have been made of the views %which wc have been enabled to obtain from this very limited incision. On looking up towards the band with the greatest possible stretch of tissue, we see the arrangement of the remains of the hypogastric arteries converging toward the bond of union. In this lower diagram we show you the livers joined by what is supposed to be the tract of portal contineity. You will observe the limits are somewhat synmetrical. Here is the liver of Chang, with a fore-shortened right lobe: ENG. Uepatic Vein. . CHANG VEHP, L € f~ DIA GRAMMATIC REPRESENTATION OF THE LIVERS PORTRAT- ING THE RELATIONS OF TIE VESSELS, \u0026C. The arrows show the directions iii which the injection passed from Chang to Eng. The remainder of the right lobe is deep within the abdo- men, and of course it has not been seen. Here is the fundus of the gail-bladder,and there the suspensory ligamont, carrying the remains of the umbilical vein. When the finger is passed from Chang to Eng, it is received between the",
         "414 CANADA IMEDIoAL AND SURGICAL JOURNAL. folds of the suspensory ligament of Eng. In Eng the parts are essentially the same, although you see more evidence of adipose tissue. Here is -a little ligament aiding in the support of the liver, to whose convexity it is attached ; it is not seen in Chang at all. You might term it an access- ory suspensory ligament. When the finger is introduced there, it is observed to terminate blindly; showing we think, that this is no more than an adventitious pouch, due to the presence .of.that suspensory ligament. We find some vessels of the portal system, even as .far down as the mesentery, well filled with the blue colouring matter. We of course desired, as far as possible, to examine all the tissues here by these incisions ; hence it vas when the bodies were in this position, the skin was taken off from the wall in order to get a view of the linea alba. [The bodies were here inspected by the audience, and afterwards turned so as to expose the posterior part of the band. Further remarks apply to this posterior aspect.] DR. PANCoAST-while the bodies are being turned, I wil take the opportunity of replying to one or two questions which have been asked me. First, in regard to the common sensibility of these individuals. According to the state- ments we received at Mount Airy there was a line of com- mon sensibility corresponding to the median line of the band. Dr. Hollingsworth says that if a pin was stuck into the band at the median line, both of the twins would feel it distinctly ; but that, even at a siight distance to either side, the point of the pin produced an effect only on the twin of that side. Another question has been asked me as to whether either of them was ever put under the influence of an anoesthetic, I answer it by saying that so far as we know it never was attempted, but that when, on the final occasion, Chang was anæsthetized by death, Eng was for a time unaffected. The story as told at Mount Airy was that Eng waked up and asked his son, \" How is your Uncle Chang ?\" The boy said, \" Uncle Chang is cold. Uncle Chang is dead.\" Then,",
         "TUE SIAMESE TwINS. g'reat excitement took place. Eng commenced crying ont immediately, saying to his wife whom they called in, \"My last hour is come,\" and finally sank away. He was in per- fect health when they went to bed. They had been sittingup in a large double chair made for their accommodation. Eng was smoking his pipe until he became' sleepy, and finally said to Chang, 4We must retire.\" Chang said that be could not lie down comfortably. I understand that wben they went from Chang's bouse to Eng's bouse, where they died, it was against the direction Dr. Hollingsworth ; but with their usual stubbornness, they persisted in riding the distance in an open buggy. To return to the narrative of the night of their death, after Chang had refused to lie down, they walked about .the bouse for some time, and even went out to the porch and washed their hands and drank some water. It was about i o'clock when they went to bed. Then Chang died some time between that and morning; his death not producing any immediate impression on Eng. It was only when the latter woke Up and inquird about the condition of his brother, that he was at all affected. As to the question, \"Iwhat caused Eng's death ?\" I am not able to tell. The post-mortem which bas beeri made does not show the condition of bis lungs. Probably the valves of his heart were in a disorganized condition, and pro- bably also the shock upon that weakened organ caused death. ' Da. ALLEN-In my opinion, Chang died of a cerebrat clot. From inquiry at his home, I was led to believe that the lung symptoms were not due to pneumonia; indeed. were not severe enough to have been so caused. The sud- denness of the death, the general atherona of the arteries, and the fact that there had been previously an attack of paralysis, all indicated that the death was of cerebral origin. Eng probably died of fright, as the distended bladder seemed to point to a profound emotional disturbance of the nervous system, the mind remaining clear until stupor came on-a 41 .5,",
         "416 CANADA MEDICÁL ANI) SURGICAL JOURNAL. stupor which was probably syncopal. One thing to be settled in the making of our examination was to get the bodies in the best possible position, so that we could judge of the true nature of the band. You will observe the great con trast between the anterior appearance of the band and its posterior aspect.' When we suspended them face to face we conceived we had them in the.proper position for study. On the posterior side there was a fold underneath, the skin extending from a central goint in the abdomen of Chang, passing over, crossing the median line, and inserted into the ensiform cartilage of the opposite twin, Eng. It was one of the objects of the exam- ination to determine what was the nature of the fold. I judge it to be the linea alba ; but I leave the Fellows to decide that for themselves. I will also add that, because we had not the privilege of cutting the anterior portion of the band, we were obliged to cut down from the point of which I have spoken to get to the structure, and demons- trate these cuis-de-sac frombehind. Here (referring to the casts), from this point the incisiori is horizontal about midway, and joined laterally by two oblique lines which were directed one upward and the other downward and outward, making a modified letter H incision. Thus we got alil the space we needed. When I raise the skin we sec the scar of umbilicus in the superficial fascia ; and on lifting the other fiap we get a better gencral demonstration. And now we come upon the point of interest, namely, the position of the band and its truc nature. We haie a diagram here. You notice on Chang's side that there is an arrangement of interlàcing aporeurotic fibres, marked here; and there fibres starting in Ch ang, pass across the median line and are inserted into the ensiform cartilage of Eng. Turni ng the lower flap downward, the upper flap upward, and the two lateral tongues outvard; the superficial fascia is exposed. This is abundantly supplied with adipose tissue on either side, but is free from fat",
         "THE SIAMESE TWINS. where it covered the band. Both the lower flap and the fascia are lost in the scar marking the position of the umbilicus. The same dissection exhibits the position of the lower pouch of Chang. Turning down the external oblique, the two recti, and the internal oblique muscles, the transversalis was exposed, the latter forrning a very well- defined layer in Eng, with an interval between the ensiform cartilage and the inferior margin of the thorax. These were much less marked in Chang. Turning forward this layer of fibres in Eng from without inward, the diaphragm is brought into view. Muscular fibres are conspicuous in this position. The peritoneum on either side is now fairly exposed. Incisions may now be made with a view of demonstrating the pouches of the band. The upper pouch of Chang is, you will observe, freely opened on its posterior aspect, and the vessels in the tract of portal continuity are seen to be well distended with the injecting fluid. A small artery is seen crossing beneath this tract of veins, and is probably a branch of the hepatic; but, whatever may be its origin, it evidently could have little effect in infiuencing the nutrition of parts beyond the band, and is probably retained within the band itself. The lower pouch of Chang reveals nothing which was not demonstra- ble from in front, and the same may be said of the single pouch of Eng; thus confirrning the opinions of the con- stryu:tion of the band before the pouches had been opened from behind. Dr. Abrahan Jacobi of New York, being called upon, said : I am very much obliged to the gentleman who has mentioned my name. I do not believe, Mr. Chairman, that I have anything to add to the stock of knowledge in regard to the subject before us. If I were to answer the ques- tion as to how tiis monstrosity originated, especially whether they became connected after having been separate organisms, I should say that that idea has.been given up by those whose-opinions are entitled to weight. It is true that years ago such specimiens were spoken of by Dalton DD 417",
         "418 CANADA MEDICAL AN) SURGICAL JOURNAL. in Holland ; and a number of others have alluded to the idea that two such individuals might in embryonic life become united simply by adhesion, the result of their being located together in the embryo. In truth, it appears to me that at that period such a thing might be possible ; but, of course the union would be a superficial one, not involving the deep organs. We know that the first epidermis is formed about the end of the fifth week of embryonic life, and that after a time it is thrown off, so that the embryo.of about seven or eight weeks is more loosely covered with the real epidermis than in the early period. The epidermis is thrown off a number of times until about the fourth month of utero-gestation, when it is finally perfected and remains intact. Now it is suggested that at those times when the epidermis is thrown off the connection takes place between the two individuals, just as the connection takes place between the prepuce and glans, which we so often find adheient in the foetus and in a number of new-born children. There are evidences which we cannot forget, that such connections have taken place before the final epidermis is formed, and about the time one of the earlier coverings is being thrown off, at a period when the internal organs, frequently implicated in such monstrosities, are already formed. There are few double monstrosities so well developed as this one. I think the records of about four hundred monsters have now been collected in the books and journais ; but very few are of such a complete nature as this. Every one has heard of the Hungarian twins, vho lived to the age of twenty-one years, in the last century. Another pair of female twins, that travelled in Germany about two years ago, were described at the time in the Berliner Wochenschrift. They were of a similar nature. There are two. cases on record in which a division has been successfully attempted, but in those cases the connections were not so well developed as in the Siamese Twins. The connection was in the same neighborhood, but was only",
         "TREAT31ENT OF TAPEoVR31-DR. T. S. CoBBOLD. 419 superficial-of skin and subcutaneous tissue. One of tly cases is recorded by Dr. Braun (Virc/ow's Arhiv.) For- tunately, or-unfortunately, I do not know which, they were his own children. They .were of the female sex. He sepa- rated theni immediately after birth. One lived three and a half days ; and when the case was described in 1866, the other was five years old. In that instance the connection- tIree and a half inches long---extended from the ensiforn process to the umbilicus. The other case is described as early as 1689, by the old German author Kernoch. As far as the origin of twin monsters is concerned, I am certainly of those who are not of the opinion that two individuals could get into such an intimate connection by growing together. Certainly the connection is an original one. I believe that the general opinion is now that one Graafian vesicle may have two ova, or one ovum have two nuclei; and these finally may, like tht two vitelli of an egg, be closed together,surrounded by the sa:ne material,forming a single complete ovum ; and thus it may be that the two are included in the same ovum. I think this will explain why the sex is, always the.same-why they are always both male or female. They are male in twenty or twenty-five per cent. of the cases.--Phiadlpzia M1fedical Times. Addendium o a Lecture on the Trcatmient of Tapeworm. By T. - SPENCER COBBOLD, M.D., F.R.S., Lecturer on Parasitic Diseases at the Middlesex Hospital Medical College. In reply to numerous letters, the substance of which lias been communicated to me, I beg to state that one main object of my lecture was to insist very strongly on the necessity of persistent and careful personal search by the medical attendant of the stools of his patient, until he is satisfied that the neck and entire head were found. To some practitioners, this seems an apparently trivial and easy thing to do. On this score, however, I have reason to know",
         "420 CANADA MEDICAL AND SURGICAL JOURNAL. that it is not easy, and that the duty is frequently, in many cftses habitually, omitted ; and hence we have one impor- tant cause of failure to cure tapeworm. No portion of the fæces should be left uninvestigated. On many occasions I have remonstrated with patients and attendants, who from motives of delicacy, have, prior to my visit for the express purpose of ascertaining results, carefully rernôved ail float- ing matters of a non-faæcal character. I have obtained proof that the head of the worm is liable to adhere to such light material::. Of course, in conducting these researches, one is apt to encounter rather unpleasant experiences. Some of these I recounted to my class with the view of impressing my'hear- ers with the necessity of performing this duty in a thorough manner. The examination should extend to every stool while the patient is kept under treatment. As I invariably employ disinfectants, the disagreeableness of the task is not so marked as many might suppose ; nevertheless I have some times been attacked with nausea, consequent upon several hours' search in a stooping posture. By way of illustrating the proceedings necessary in some cases coming within my experience, I narrated in the lecture which appeared in these columns in an abbreviated form, the, following case. A practitioner of repute having repeatedly attempted and failed to cure his daughter, solicited my advice, byletter. In the first instance, I prescribed male fern extract in the ordinary way, and recommended a search for the bead after the exhibition of the tæniafuge. As, however, at varying intervals, the worm continued to reappear, I at length advised him to send the patient up to town, which he did. I again prescribed the oil of male-fern. The body of the worm came away, as usual. After removing from the stools some ten or eleven feet of the body, including many loose proglottides, I continued the search for about two hours, during which I obtained some fragments of the neck, which were so fine from the part near the head that the transverse lines of segmentation were",
         "TREAT31ENT OF TAPEwOR31--DR. T. S. COBEOLD. 421 barely discernible. Ordering a small dose of castor-oil, with plenty of weak tea and warm milk, I, promised to renew the search next day. I felt confident the head must have been dislodged from the upper bowel. When I called next day, the fresh evacuations had been retained in accordance with my instructions, and the inves- tigationrenewed: Greatly advantaged by the strong light coming through the large hotel window, it was not many minutes before I noticed in the feces four minute dots of uniform size. As these mere specs were placed side by side in a symmetrical mainer, I concluded that they were the suckers of the head of the tape worm. The conjecture proved to bc correct. Much, if not fully half, of the head was gone, whilst the, loose and partially disconnected suckers only remained attached to one another by finely connecting shreds of parenchyma. On carefully trans- ferring them without injury to a small glass tube containing water, the help derived from a powerful pocket lens at once set every trace of doubt at rest. My previous day's exam- ination having afforded proof that only one tapeworm existed, I had now no hesitation in giving the necessary assurances as to the completion of the cure. I must not omit to state that I transferred the corked tube to my waistcoat pocket, and when, after walking a short distance, I again looked at the specimen, the four suckers had separated. The gentle agitation produced by walking had sufficed to break up the delicate connecting filaments. This case explains one of my reasons for insisting upon the carefull and assiduous examinations of the stools. In making such investigations, the practitioner should employ a disinfectant (the solution of permanganate of potash is, I think, the best), diluting the stool copiously with water. He should obtain a powerful light, a strong magnifying lens, one or two glass tubes filled with water, three or four empty basins or other utensils, and a pair of delicate long forceps (ten inches). Armed with these few essentials, he will treat his case after a \" proper method,\" and thus probably",
         "422 CANADA 31EDICAL AND SURGICAL JOURNAL. reduce the relative number of failures in practice. Of course, it is assumed that he must have previously familiar- ized himself with the naked eye appearances presented by the heads of different tapeworms, sufficiently to enable him to recognize any portions of the head that have separated by disintegration. I come now to the question of preliminary treatnent, as to which more details appear to be desired. I said appropriate preliminary treatment, because I consider that the commonly received rules as to \"fasting,\" etc., should vary according to circumstances. It is true, that I did not state what preliminary advice had been given in the particular case referred to ; consequently, the more unsparing of my critics immediately jumped to the conclu-. sion that I desired to conceal something ! If my memory serve me correctly, I not only called attention at the time of delivery of the lecture, to certain points in this matter, but I wrote off on the black board a prescription similar to the one I had employed in that case. In the instance named, I particularly requested the patient not to starve himself, but to take plenty of readily digestible food the day before the emulsion was given. I especially advised this in his case, because the chief symp- toms were marked lassitude and nausea, sometimes amount- ing to actual sickness. I judged that,if I allowed him to let down his strength, by the starvation method, he would, (in spite of retaining the horizontal posture, which I also en- forced) throw up a great part of the male-fern emulsion. In short, it was a case in which I was anxious to deal as gently as possible with my patient, without losing the full benefit of the worm poison. In this view, further, I ordered a mild aloetic pill ; not, be it observed, with the intention of pro- ducing catharsis, or even so much as simple aperient action, but merely with the purpose of softening the fæces, and thus clearing the colon and upper bowel. The result was satisfactory. On referring to a note I made of the case at the'time, I find it stated that the entire worm came away,\"",
         "EXTIRPATION OF THE LARYNX. without any violent action of the bowels.\" There had been been no motion as resulting from the alcetic pills, and no sickness from the male-fern mixture. This, then, was a patient who, as before remarked, had repeatedly taken on e-drach m-and-a-h alf doses of the ethereal cxtract without success, but by the observance of the pre- liminary rules, modified to suit what were deemed to be the particular exigencies of the case, his cure was effected, in the proper acceptation of that much abused term, by the cm- ployment of two half-drachm doses of the same drug. Further than this, the patient was put to much less incon- venience than he had suffered on former occasions, without successful results. Finally, I may say that I have been not a little surprised and hurt at the tone assumed in some of the communica- tions above referred to. I shall only add on this head, that the object of the lecture, and I believe its matter also, were purely scientific and unimpeachable. As to the form I do not pretend to be so good a judge. For twenty-six years, I have been engaged in the study of the entozoa ; and, for the first fourteen years after taking my degree, 1 rejected all but purely scientific labor. During the last eight years in which I have been in practice, a very large amount of my time has been occupied in solving diffi- culties for, and giving gratuitous aid to, my medical brethren. The suggestion, that on this occasion I desired to withhold any useful information, is one which, I venture to think, my labours and my career contradict. I shall take no further notice of it.- British M3iedical oun-taZ. Extirpation of the Larynx withz the Epiglottis. On the last day of the year lately ended, Professor Billroth performed the operation of removing the larynx and epiglottis-a proceeding which had never before been attempted in the human subject, though Czerny had shown 4 231",
         "424 CANADA MEDICAL AND SURGICAL JOURNAL. in 1870, by careful experiments, that it was anatomically and physiologically practicable. The patient was a strong man about 40 years of age, the subject of cancerous growths in the larynx, which had repeatedly, after putting him in danger of death from suffocation, been removed by Dr. Stork with the aid of the laryngoscope. In the beginning of November the new growths extended so far into the interior of the larynx, that their removal from above was no longer possible. As, however, a part of the right vocal cord was present, Drs. Stork and Billroth hoped to pre- serve this, however imperfect ; they therefore opened the larynx from the front, and, after removing the growths, ap- plied solution of perchloride of iron to the inner surface. The result of this operation, which was well borne by the patient, appeared at first to be very promising ; but in the middle of December new growths were detected by the laryngoscope, and at the end of the month symptoms of asphyxia appeared. On December 30 Dr. Billroth and Dr. Stork decided that the whole larynx was so full of malig- nant growths, that it would be useless to repeat the opera- tion of dividing them and clearing them out; and there was no longer a possibility of preserving any part of the vocal cord Extirpation of the part would produce no ad- ditional physiological defect, and might lead to a radical cure, if the disease were confined to the part, and had not reached the glands. Professor Billroth therefore removed the entire larynx. The patient bore the operation very well; he breathed freely through the trachea, in which a. tube was inserted ; the fever was slight and of short dura- tion; and on the 9th instant the wound was healing favor- ably. On the 24th the man was reported to be able to eat and drink, and to sit up for several hours daily.-Bri- tisi Medical ournal.",
         "CANADA M0NTREAL, -MARCI 1874. SMALL-POX AND MEASLES. Are we to have a Small-pox Hospital? again we ask for information on this subject. The Corporation of our city appear to be çlisinclined to take up and discuss the pro- priety of having a special hospital for the accommodation of patients suffering from this disease. As it has become more than ever a necessity, we do hope that the citizens of Montreal will take up this matter and establish an hospital independent of the Corporation. We have heard recently of several cases of actual measles which had been taken for small-pox, sent into the small- pox wards attached to the Montreal General Hospital. Some of these cases have gone through the disease measles, and subsequently the patient has taken small-pox, and we believe in one or two instances the second attack of disease has been followed by death. \"Quos Deus vult perdere dementat prius\" is an old maxin, which does appear to apply in this matter. Our City Fathers, puffed up with obstinacy and pride, refuse the coun- sel and advice of those supposed to be familiarly acquainted with disease and epidemics, and what is the best method of arresting their spread. A new feature of disease arises, the doctors are puzzled ; they declare a disease small-pox which is not small-pox-the unfortunate patient, if residing in a. hotel or boarding-house, or an inmate of a jail, is ordered off by his physician to the only small-pox hospital in this. city, which consists in the half of a small building in the back-yard of our English Hospital. If it were a Mayor, or an Alderman, or even a Councillor, it would not matter so much-in fact, we believe it might possibly lead to the",
         "226 CANADA MEDICAL AND SURGICAL JOURNAL. selection of a site and the erection of a suitabXe building thereon. We would almost regard a visitatun of this nature as a blessing-a blessing on the community, though possibly a special punishment on the City Councillor for having neglected the interests of the peopie. But to return to the subject of measles being mistaken iii the early stages for small-pox. Ve have heard of some gen- tlemen declaiming against thc stupidity of s-uch a mistake but we are forced to admit that it is a mistake of no infrcquent occurrence. We have seen it mare by some of the ablest men in the profession. A mistake of this nature is more liable to occur at a time like the present, when small-pox is epidemic, when men's minds are full of the probability of the disease small-pox breaking out in any quarter or any house in the city, than it would be at a period of compara- tive healthfulness, when the occurrence of small-pox would be looked upon as exceedingly problematical. It is greatly to be deplored that these mistakes have been made, because they have resulted in the exposure of the patients to the contagion of a fearful disease, and in some instances that disease was contracted, and proved fatal, an event which the victim might possibly have escaped, under different circumstances. There are few events which occur in life out of which a lesson cannot be learnt. These unfortunate errors teach us, as physicians, to be cool, reticent, silent; and avoid, as much as may be, jumping at a hasty conclusion. Small- pox, in the early stage of the disease, is not highly conta- gious ; therefore, if the physician has any doubt, let him wait for at least twenty-four hours after the appearance of an eruption before he commits himself by declaring what the disease is. And yet another, and probably more im- portant, lesson we learn as a community. We should in- stantly secure a building, to act as a 'small-pox hospital, wherein the means of having intermediate wards should exist, so that doubtful cases might be saved the possible chance of exposure to a disease which, if the patients do contract, will, in all likelihood, end fatally.",
         "rÆTCAL ACCUMULATION. FÆECAL ACCUMULATION. A case is reported in a recent number of the Britisk Medical %-urnal of a gentleman, aged 6o yéars, who had suffered from gradually incrcasing distention of the abdo- men, of two years standing, accompanied by emaciation, loss of appetite, flatus and constipation.- On examination, his physician, Dr. Cole, of Bath, detected an immense tumour filling the whole of the abdomen, except a small portion of the left lumbar region, which was quite tympan- itic. The tunour passed upwards under the ribs, and downwarcls into the pelvic, cavity ; it was smooth, hard and immovable ; to the right of the umbilicus there was distinct resonance, and a little lower down was felt a coil of intestines bctwecen the tumour and abdominal wall, which was evidently filled with fecal mattcr; firm pressure over the tumour left well-marked indentations, and the superfi- cial veins of the abdomen were much distendcd. The rectum was filled with scybala. The diagnosis was fxcal accumulation. to an unusual extent. , Large injections of warm water were administered daily for three weeks, aided by small doses of Belladonnaand nux vomica, which resulted in the total clisappearance of the tumour, and the expulsion of an almost incredible quantity of focal -matter. The patient was restored to his usual health. The doctor reports that homoeopathy had had a lengthened trial in this case. This reminds us of a somewbat simnilar case which came under our observation a few years since. We were called to see a lady suffering from hystèrical mania. She was a tall, thin woman, unmarried ; exceedingly violent, so much so that she had to be restrained from hurt- ing herself by two strong men who were relatives. We were informed by her mother that her bowels had not been open for over ten days, her appetite was ravenous, and she was in the usual condition of nervous excitement which is so often seen in similar cases. She had been under homoeo- pathic treatment, but her physician obstinately refused to 4 _97",
         "428 CANADA MEDICAL AND SURGICAL JOURNAL. permit the administration of purgatives, or even an injec- tion. The abdomen was tense, and somewhat swollen, although there did not exist any distinct tumour. A large injection was administered, which resulted in the expulsion from the rectum of the largest mass of hardened foces we had ever seen; it was nearly the size of a child's head. This patient had taken up the delusiôn that she had become pregnant to a gentleman of her acquaintance, but who was not in the country at the time, nor had he been for over two years. The following day, at my visit, she accused me of having occasioned an abortion and of having taken away her child, and she threatened me with exposurC, and of handing me up to the authorities on a charge of murder as she believed I had made away with her offspring. She was subsequently sent to an asylum, and after a residence of six months, or so, was quite restored ; still, however, she is deluded with the belief that she had been pregnant, and that I had been the means of bringing away her child prema- turely. I have been informed by her relatives that this fancy is disappearing very gradually, although they never allude to the circumstance unless the subject is broached by herself. TESTIMONIAL TO DR. FENWICK. The public say that \" Doctors differ,\" and it is habitual with many to use this hackneyed expression as a term of opprobrium towards the Profession generally. With such persons the idea is, that members of the Medical profession not-only differ from each other upon matters of opinion, but that they are of necessity jealous and ill-willed, and slow to do justice, one to another; that merit acknowledged by friends or -clients to any physician is but grudgingly accord- ed to him by his confreres, and that on the contrary, medical detractation is the rule, which, if not openly avowed, at any rate is practically acted upon. We repeat this is an unfortunately too common popular notion, concerning the supposed absence of esprit de corps amongst practitioners",
         "TEST1IONIAL TO DR. FENWICK. of medicine. We venture to believe that this is a totally mistaken conception as regards the profession generally, and more especially as regards the nedical men of the city of Montreal; and we take pleasure in drawing attention to any circumstance which may tend to show the existence of cordiality and true fraternal feeling amongst the members of our commôn calling, It wlli be known to many of our readers that for many weeks past, the senior Editor of this Journal, Dr. Geo. E. Fenwick; has been suffering from such severe illness as has entirely incapacitated him for the performance of his customary duties and for practice. When it was undcrstood that Dr. Fenwick had been advised to remove to a warmer climate, for a short time, for the purpose of renovating his health, it was at once suggested to his medical friends that he should not be allowed to go without their having in some way -signified to him their sympathy with him in his illness, together with their appreciation of bis many good qualities, both of heart and head, which render his temporary loss to them so much felt. To the testimonial then proposed, all were more than ready, they were eager to subscribe. On the fifth of Feb- ruary a gift of $ 1,ooo was presented to Dr. Fenwick, accom- panied by the following address, engrossed on parchment: We, bis assistants, congratulate the doctor most heartily, upon being the recipient of such a testimonial, coming as it has done, from the spontaneous good-will of the whole Medical Profession-the signatures including therepresen- tative men of all the colleges, and of all the practising phy- sicians at large. Those who know Dr. Fenwick, will not be the least surprised at the enthusiasm with which bis testimonial list was everywhere received. His reputation as a surgeon is recognized throughout the Dominion, not only so, but some of his leading operations have received most flattering attention from the American and British medical press. His success as a teàcher can be testified to by his quondam students now successfully practising their art throughout the country. His popularity with his class 429",
         "430 CANADA MEDICAL AND SURGICAL JOURNAL. has always been unbounded. His practical and persevering- efforts in furthering the efficiency of our charitable insti- tutions, especially the Montreal General Hospital, have always been fully recognized by the governing bodies of these establishments, and it is well known that it has long become habitual to him to neglect his own.private and per- sonal interests whilst béstowing the most unremitting attention upon the the indigent sufferers in his surgical wards of the Hospital. As a man of very large experience and the soundest judgment,he has always been much sought in consultation, especially by the junior members of the profession. By them, especially, owing to the unvarying kindness, courtesy and consideration with which it is his custom to treat them, is he looked upon as their staunch- est friend. Wc have said enough to show why his absence, even though temporary, is thus felt and regretted by all. We again congratulate Dr. Fenwick upon this outward demonstration of the good-will of the profession towards himself, and we likewise congratulate on the other hand the Profession of Montreal for having. publicly shown that we do recognize and are ready to acknowledge true merit wherever found, no matter how we may \"differ.\" We are sure that Dr. Feivick's numerous friends will join with us in looking, torward with pleasure to the time when with renewed health and strength we hope to see him once more engaged amongst us. We subjoin the address as presented, with Dr. Fenwick's reply To GEORGE E. FENWICK, M.D. DEAR DR. FENWICK,-We, the undersigned Medical practitioners of Montreal, appreciating your valuable services, as Editor of the CANADA MEDICAL AND SURGI- CAL JOURNAL, as well as your efforts in the advancement of the science and art of surgery, and sympathising with you in your present illness, desire to present you with this address, and the accompanying testimonial, as a token of our regard.",
         "TESTIMONIAL To DR. FENWICK, Trusting that you may soon be restoredito the active duties of a profession you have so long and faithfully served. We remain, dear doctor, Your sincere friends, G.W.Campbell,A.M.,M.D. W. H. Hingston, M.D. R. T. Godfrey, M.D. J. L. Leprohon, M D. ' John Réddy, M.D. R. P. Howard, M.D. R. L. MacDonnell, M.D. W. E. Scott, M.D. Robert Craik, M.D. J. M. Drake, M D. F. W. Campbell, M.D. W. P. Smith, M.D. Samuel B. Schmidt, M.D. D. C. McCallum, M.D. Geo. Ross, A M.. M.D. Hector Peltier, M.D. E. H. Trenholme, M.D. W. E. Bessey, M.D. Richard A. Kennedy, M.D. John T. Finnie, M.D. Edwd. K. Patton, M.D. John R. Smallwood, M.D. W. B. Wheeler, M.D. John Bell, M.D. W. Macdonald, M.D. George A. Baynes, M.D. Thos. Simpson, M.D. David A. B. Macbean, M.D. W. Gardner, M.D. J. J. Dugdale, M.D. George W. Major, M.D. Frederic Barnes, M.D. William Fuller, M.D. P. O'Leary, M.D. Mg. C. Macdone]l, M.D. J. A. Rodger, M.D. E. H. Trudel, M.D. L. G. Turgeon, M.D. T. G. Roddick, M.D. Clar. J. H. Chipman, M.D. W. A. Mondelet, MD. William Wright, M.D. R. A. Alloway, M.D. N. L-verin, M D. T. J. Alloway. M.D. E. Robillard, M.D. A. ?roudfoot, M.D. J. Perîgo, M.D. N. Mercer, M.D. P. N. Leclair, M.D. G. P. Girdwood, MD. Dr. E. A, Duclos. A. B. Larocque, M.D. ArthurA.BrowneM.D,, W. E. D. Nelson, MJD. MontreWal, FAb. 5, 1874W REPLY. To R.1ý T. GODFREY, M.D., GEORGE W. CAIPBLL, A.M., M. D., Wl. H. HINGSTON, M.D., HECTOR ELTIER, M.D.,WAND OTH HIERS TO GENTLEEN,-I must beg of you to accept many and sincere thanks for this flattering expression of good will, towards me, and to assure you that this testimonial will be the more highly valued, as emanating fromthe profession as a body. I feel that you are over-estimating any service I may have rendered to the cause of scientific truth, by editing the CANADA MEDICAL AND SURGICAL JOURNAL, nor can I admit that as a practical surgeon I have donc anything to warrant this expression of regard from my confreres. It has been my aim through life to cultivate a.feeling of friendliness with my professional brethren, and to avoid whatever might lead to misunderstanding or disunion. I can only add, Gentlemen, that should a return to health and strength be granted to me, the balance of my life will be devoted to furthering the best interests of our profession. I remain, Gentlemen, Yours, very faithfully, G. E. FENWICK. -1 là, 1",
         "03 M cg u CZ :ta, 0 t.Ic ; . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . a a -. c : 4, O a M I ce E'40 Q g o o. a~ a a a 0a a ci s 'a Co e 0 t-m .0. 1oc e t.m0 cm- o-q - i CO O O1O i? .4 4O ? C ? L I.v5 - St . f e 3 .-f-'u.ece- o- o oo o e e:::: : I co- CoIl Q- ? co ~c't e e se - - T --cosass -ge CeCC CqCCses4 : C C S o o- o I -Q ci.--- c Coo C3"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original L'institut a microfilmé le meilleur exemplaire qu'il copy available for filmng. Features of this copy which lui a été possible de se procurer. Les détails de cet may be bibliographically unique, which may alter any exemplaire qui sont peut-être uniques du point de vue of the images in the reproduction, or which may bibliographique, qui peuvent modifier une image significantly change the usual method of filming, are reproduite, ou qui peuvent exiger une modification checked below dans la méthode normalede filmage sont indiqués ci-dessous. Coloured covers/ Coloured pages/ Couverture de couleur Pages de couleur Covers damaged/ Pages damaged/ Couverture endommagée Pages endommagées Covers restored and/or laminated/ - Pages restored and/or laminated/ Couverture restaurée et/ou pelliculée l Pages restaurées et/ou pelliculées Cover title missing/ Pages discoloured. stained or foxec;/ Le titre de couverture manque Pages décolorées, tachetées ou piquées Coloured maps/ Pages detached/ Cartes géographiques en couleur Pages détachées Coloured nk (ei. other than blue or black)/ Showthrough/ Encre de couleur fi.e. autre que bleue ou noire) Transparence Coloured plates and/or illustrations/ Quality of print varies/ Planches et/ou illustrations en couleur Qualité inégale de l'impression Bound with other material/ Contnuous pagnation/ Relié avec d'autres documents Pagination continue Tîght bînding may cause shadows or distortion Includes ndex(es)/ along interior margîn/ Comprend un (des) index La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Title on header taken from-/ Le titre de l'en-tête provient- Blank leaves added during restoraton may appear within the text. Whenever possible, these have Title page of issue/ been omitted from filming/ Page-de titre de la livraison Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, Caption of issue/ mais, lorsque cela était possible, ces pages n'ont Titre de depart de la livraison , pas éte filmées. Masthead/ Générique (périodiques) de la livraison j Addttional comments / Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous lX , 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "r. OUR WORK = No. IV. Medical Work Amnong the Indians BY A. E. BOLTON, M.D. ITHIN the limits of the Simpson District, British Columbia Conference, there are about 8,000 Indians, the remains of a much larger popula- tion which, until within a few decades, dwelt there in wild, free savagery. A race singularly strong, well developed physically, brave and energetic, but with the peculiar traits of Indian character-revengeful, proud, and improvident. The general state of health was good. Epidemics were unknown ; their out-door life, freely ventilated lodges, and frequent change of residence, promoted health. Such diseases as they were subject to resulted chiefly from exposure endured in quest of food, or more violent causes, as intertribal wars were constant, and slaves lived by the mercy of the master or died at his whim. For such ills as they endured they had no rational remedies. Sickness was generally attributed to some",
         "malicious influence exerted by a supposed enemy, and the treatment consisted in torturing the suspected witch or wizard, and opposing other methods of jug- glery applied to the person of the patient, such as rattles and charms. The nearest approach to medical science being a steam bath followed by a cold plunge, or the prolonged use of drastic purgatives, which they had discovered in native plants. Contact with whites brought the introduction of infectious diseases, smallpox making great havoc on different occasions ; and other diseases, as tuberculosis, more slowly but not less surely, decimating the tribes. The \"fire-water,\" too, has done its deadly work. Civilization at first brought little to counterbalance or cure its own ills, excepting that the strong hand of the law restrained to some degree the former bloody quarrels. A few medicines found on the traders' shelves could accomplish little good, coupled with Indian ignorance-a favorite dose being a whole bottle of pain-killer or two of castor oil. Change in mode of living brought little relief, for when an Indian builds a house in imitation of the whiteman he fails to venti- late it, and suffers accordingly. As long as any tribe remains in heathenism, witch- craft and jugglery continue. I have heard the medi- cine-man's rattle clash over a fevered subject of la grippe, and haee seen an old hag blowing and sucking with unearthly sounds while pressing her lips to the",
         "skin over different parts of the body in a case of pulmonary hæmorrhage. For some years Christian missionaries have been at work among these tribes, teaching Gospel truths by precept and by practice, and so essentially trying to relieve bodily suffering. By the application of a little medical knowledge 'hastily acquired, and the use of some simple remedies supplied by the Government, by advice generally well taken, and by nursing and food usually supplied by the missionaries' wives, much has been accomplished under divine blessing for the alleviation of sickness, often leading to a more ready acceptance of the Gospel. Yet they had to witness a great deal of suffering that they were powerless to relieve, and had to face the fact that the people they labored to save physi- cally and spiritually -were being dininished by the ravages of disease which scientific treatment might stay. ' It is little wonder, then, that the workers on the Methodist Missions there should have asked that a medical missionary be added to their force. The Indians at Port Simpson, the oldest and largest mis- sion, promised that if a doctor came to reside among them they would do something toward his support (a promise they have kept, contributing on an average $200 a year).",
         "In response to these appeals, and desiring to conse- crate a medical education to the best advantpige in furthering the Master's kingdom, the writer came to the field in November, 1889. It seems strange that so recently that step was looked upon as an experi- ment, and a doubtful one, by many Christians and some officials of our Church. However, the faith of those most immediately concerned was soon rewarded by seeing the results of the work, and a constant unfolding of greater opportunities with a correspond- ing development of resources. The Church Missionary Society had already a phy- sician at Metlakatla, and the two of us represent the \"profession\" in a territory of about 100,000 square miles. Under such circumstances one must be as nearly ubiquitous as possible to help the greatest num- ber, and especially among a people of semi-nomadic habits there is necessi4y for a great deal of travel and changes of basis of operation. Port Simpson, by its size and situation, demands greatest attention, and is headquarters for our medical mission for nine months of the year. During three months of the summer, beginning with May, Port Essington, on the Skeena River, is of greater importance, having two salmon canneries, with seven more within a radius of fifteen miles. Not only do the majority of the Port Simpson Indians remove thither in summer, but they come from a dozen other villages, including those of the Upper",
         "Skeena, 150 miles distant, and notalone the able-bodied, for they bring the young and lelpless, and the aged and infirin ; and the sick and inained are not left behind, especially since the medical missionary's pres- ence has become an assured fact. A large number of Chinamen, and a few whites and Japanese, find employment at these canneries. This mixed population, under conditions of frontier life, calls for the exercise of every Christian influence available. Earlier in the spring nearly all the surrounding country congregate along the Naas River for the Oolachan fishing, and usually a few days or weeks are spent there ; and the annual visit of the doctor is eagerly looked forward to by many who find this the first opportunity for medical advice or surgical help after the sicknesses and accidents of the winter. Trips are made, as opportunity affords, to Queen Charlotte Islands, an,l along the coast as far south as River's Inlet.* On one of these trips recently by the Glad Tidings about 150 cases were examined and treated. Patients come to us from distances of 100 miles north and west, 200 miles east and 300 south. These visiting patients, and the difficulty of manag- ing all surgical and acute medical cases, suggested the Within the past year (Dec. 3rd, 1895), I have travelled by steam, sail, and scull, over British Columbia waters, on purely medical mission work, an aggregate of 3,630 miles.",
         "k Me ,k elà el 0 » Ili PUBLIC HOSPITAL, PORT SIMPSON, B.C. nm'~ Ob",
         "8 erection of an hospital. \"Where there's a will there's a way,\" especially when the will is accompanied by faith, and its inevitable product, works. In February, 1891, a child of four years was found suffering from empyema. She lay ou the floor in a cold, dirty house, she was emaciated and feverish, her body crusted with filth and crawling with vermin. The ladies of the Girls' Home gave us a room into which she was taken, and, after a cleansing operation externally, her pleural cavity was opened and three pints of pus evacuated. iHer friends supplied fuel- and some food, but looked on dubiously, and when they heard her expirations bubbling through the drainage tube (for the cavity was found to communi- cate with the bronchi), they said that fatal symptoms were apparent. By careful nursing she recovered, and is to-day a living evidence of the efficacy of hos- pital treatment. The following May we removed to Port Essington for the salmon 'season, and rented an Indian's house of seven rooms. La grippe was epidemic among the tribes gathered there for the fishing. Many of these were heathens, and superstitious fear added to the severity of the disease. Hundreds were ill, and many dying. One man, a native of Kish-py-ax, was given up to die, and, as is customary in that tribe, was being pre- pared for burial. Hopes were held out for his re-",
         "9 covery, but these his attendants scorned, refusing to administer food and medicines. After a time, how- ever, they agreed to allow me a chance to try what I could do for him in residence. So he became our first patient there, and with such good results that Wil-ba- loksh continués to cast his net in the Skeena with his fellow-fishermen, as if his coffin had never been made. His relatives promised at that time that if he re- covered they would all become \" school people,\" and while the powers of darkness, aided by their gross ignorance, kept them for a time from fulfilling this, I believe the impressions. received at the time had some influence in bringing about the alnost complete con- quest of that village by Christianity. At that time we had no trained nurse and few fur- nishings, but individual auxiliaries of the Woman's Missionary Society began to take interest in our attempts, and sent us bales of bedding, etc., and the Board of that Society at its next meeting responded to our appeal for a nurse, wbile locally some help was given to our infant enterprise. The Provincial Government that year granted $500 toward the erec- tion of a public hospital at Port Simpson, which sum was put into our hands, and with as much more raised by subscription we commenced the building now com- pleted, at a cost of about $3,000, and having accom- modation for eleven patients and our staff. In May, 1892, Miss Spence, our present matron,",
         "10 met us at Port Essington, and after a busy summer there we f )und our building at Port Simpson almost ready for occupation. We moved in on October 13th, and the following night a patient reached us, having been brought in a canoe seventy or eighty miles. He had been accidentally shot in the abdomen; his recovery made another initial case brought back from the jaws of death. Space will not allow me to cite more individual cas-s, but I may sum up hy stating that up to the present (De :ember 5th, 1895) we have cared for 179 cases, 144 of whom have been Indians, 26 whites, and 9 Japanese. About 50 have undergone operations of considerable magnitude, under chloroform or ether ; none of these have terminated other than favorably. We have, in a limited way, all the modern appliances for aseptic surgery, and or wards are bright and comfortable. We have now a head nurse and an assistant in training, whose salaries are paid by the Woman's Missionary Society, the positions are admirably filled respectively bv Mi's Minnie Spence and Miss Emily Lawrence. We receive small grants annually from, and make reports to, both Dominion and Pro- vincial Governments. Our institution is locally quite popular, having the confidence and support of the few white people on the coast, and has a representative Board of Management. We keep up spiritual influence by services in the wards, conversation with patients, reading of Scrip- tures and such books as \"The Story of the Bible \" and \" Pilgrim's Progress \" by such patients as can read. We also have a supply of Japanese Christian literature. We try in all particulars to make the institution an interpretation of Christ's blessings to the podr and suffering.",
         "11 The need of a suitable building at Port Essington was long felt, but we had no funds to spare for it. However, last spring we made a special effort and got up a building fit for summer occupation and almost as commodious as that at Port Simpson. The cost, so far, has been $720, but $200 more are necessary to complete it. Against this we have raised, chiefly by local subscription, $600. It was a great boon to us last season; we cared for twenty-one patients in it, all urgent cases, many of whom we could not other- wise have accommodated. In the six years' history of the medical mission, attendances have amounted to over 35,000, individual cases numbering nearly 12,000. There have been four visitations of la grippe, one each of mumps, measles and whooping cough, the latter two affecting Indian children very severely. We have also been threatened by scarletina and smallpox, but both were happily averted, the former by isolating an individual case. - Although our field here is not apparently so wide as might be found in some of the greater heathen nations, yet we find ample scope for our powers. As physician, I am brought in contact with the sick and dying, who are impressionable to Gospel truths; as missionary, L am constantly consulted by natives in trouble or in search of spiritual light ; as Justice of the Peace, I deal with criminals and settle dtsputes, and perhaps help repress illegal traffic in intoxicants; and since becoming conversant with the Tsimpshean language and dialects, and the Chinook jargon,* which * This jargon is understood by all the tribes in Bri ish Columbia and along the Alaska coast. and is very useful among a people of such diversity of tongues; e.g., at one time we had in our hospital seven patients speaking five distinct languages, but all under- standing Chinook.",
         "is of some moment in teaching and leading a people who can read so little, I have opportunities as preacher. The nurses, besides their duties in the wards, visit and prepare food for sick in the village, teach in Sabbath school, lead classes, teach singing, etc. Christian reader, we ask you to remember that \"the promise is to you and to your children and to them that are afar off,\" and that \" you who were afar off are made nigh by the blood of Christ.\" Pray that the same atonement may be efficacious in the case of these long-neglected tribes. But \" how shall they be- lieve in Him of whom they have not heard ? And how shall they hear without a preacher? And how shall they preach except they be sent? \" The command to heal and preach has never been rescinded or disjoined, nor shall it be as long as suf- fering sinners remain in this world. And while all the heathen world calls to us in this age of glorious opportunity, let us give due attention to those at our very doors, whose ills are jointly caused by heathen appetences and the wantonness of members of our own race and nation. In conclusion, I may state that parts of this district, as the west coast of Vancouver Island and the country around the head waters of the Skeena river, are as yet almost out of reach of our medical mission. Published by the WOMAN's MISSIONARY SOCIETY OF THE METH- ODIST CHURCH, CANADA, ROOm 20, Wesley Buildings, TORONTO, ONT Price, 1 cent each; 10 cents a dozen."
      ],
      "type" : "document",
      "title" : [
         "Medical work among the Indians"
      ],
      "published" : [
         "Toronto : Woman's Missionary Society of the Methodist Church, Canada, [1896?]"
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      "identifier" : [
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         "Bolton, Albert E."
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         "Indians of North America -- Missions -- British Columbia.",
         "Indiens d'Amérique -- Missions -- Colombie-Britannique.",
         "Indiens d'Amérique -- Soins médicaux -- Colombie- Britannique -- Histoire -- 20e siècle.",
         "Indians of North America -- Medical care -- British Columbia."
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         "Caption title.",
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         "Original issued in series: Our work / [Woman's Missionary Society of the Methodist Church, Canada] ; no. 4.",
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         "Technical and Bibliographic Notes I Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material I Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w w Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées w7 w Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "rTIE SANITARY JOURNAL. DEVOTED TO PUBLIC HEALTH. VOL. Il.] OCTOBER, 1876. [No. 10. ON THE CAUSATION OF TYPHOID FEVER, By \" MUcoR,\" of Melbourne, Victoria.* How long will etiologists continue to resist the conclusion that the infective agent of typhoid ig derived from a specifle mildew occurring on foecal matter? Must this truth, which may be arrived at inferentially, lie unheeded and unproductive until it shall be demonstrated experimentally? Is it an abso- lute requirement that. every step in the inquiry into typhoid causation should be slowly dragged through the whole field of positive proof 1 Is there no possibility of determining from available data the nature of the typhoid poison-at all events, with an approximation sufficiently near to serve all practical purposes in the matter of prevention ? These questions have been before me for years, but they press themselves with greater force now that the world has een supplied with further definite and important knowledge in the paper of Dr. Klein, \"On Enteric or Typhoid Fever\" in Mr. Simon's Report to the Privy Council (New Series, No. 6). The substance of Dr. Klein's observations has been fore- shadowed by Mr. Simon. The results of his researches have been before etiologists for these twelve months. Ample time therefore has been given to scientific men to form their views as to the general nature, scope, and bearing of his paper. From the first announcement of the discovery of the fungus in the parts concerned in typhoid up to the present date, I have gone through the comments of the principal English medical journals upon it with a curious and lively interest. In all quarters I have perceived that the most implicit trust is reposed in Dr. Klein. Not the least doubt appears to exist anywhere either *From the Medical' Times \u0026' Gazette.",
         "THE SANITARY JOURNAL. as to his perfect fitness for the work, or as to the thorough faithfulness of his performance. Even his drawings are acknowledged to be vere effigies of the things seen. In short, Dr. Klein's facts are universally accepted as truths. Al things considered, this accord is marvellous. The unanimity is so wonderful that it is to be feared it cannot last. When, indeed, it is borne in mind that the fundamental doctrines of certain schools must be hopelessly upset by the confirmation of Dr. Klein's observations, it is incomprehensible how those attached to these schools should have remained quiescent for so long. Is it possible that the speakers who took a particular line in the discussion on the germ theory should have failed to perceive the full significance of this fungus described by Dr. Klein? Have they not yet realized the fact that, if it be established as the specific cause of typhoid, their views, of necessity, fall to the ground ? Let it be de- termined that a specific vegetable organism is the efficient agent, and it follows that the etiological views of Dr. Murchi- son will be destroyed as utterly as will those of Dr. Budd, and that the argument of Dr. Bastian will be as untenable as will that of Dr. Beale. In fine, all schools in which it is taught that the cause of typhoid is, or may be, other than a living reproductive vegetable germ, must inevitably perish. But the end of inquiry is truth. It is doubtless this consideration which has brought all sections of etiologists to receive Dr. Klein's paper with such philosophical serenity. It may be fairly assumed that Dr. Klein has demonstrated the existence of low vegetable forms in the tissues, vessels, glands, follicles, lymphatics, and other parts of the organs implicated in typhoid fever. This being granted, the follow- ing questions suggest themselves:-1. Are these vegetable forms accidental or incidental ? 2. If incidental, is the vegeta- tion the cause of the disintegration ? 3. Are these organisms infective agents or \"carriers of infection\" ? Or will they induce typhoid when transplanted into the healthy human body? 4. What is the precise nature of these low vegetable organisms ? 5. What is their habitat, or the soil on which these parasites last occur before their reception by man ? 1. Are these vegetable forme accidental or incidental ? This question Dr. Klein has answered-whether conclusively or not, I will leave. Of course, there is the obvious objection that his observations are too few in number for safe generalisa- tion. Whatever weight this consideration may have with some inquirers, I would observe that any doubt I might have had upon the point is overcome by evidence extrinsic to Dr.",
         "TYPHOID FEVER. Klein's paper. This collateral evidence is open to those who search, and I shall merely say that I codceive it to be sufficient to affirm the proposition that vegetation is a constant factor in the characteristic necrosis of typhoid. 2. If incidental, is the vegetation the cause of the disintegra- tion? That the masses of micrococci found by Dr. Klein in the mucosa, the bloodvessels, and elsewhere, cause the retro- grade changes of the tissues ending in sloughing and ulcera- tion, is shown, nearly to demonstration, in the text of his paper, and by the plates. That is to say, \" the deposition, probably by exudation from the vessels, of a peculiar dark-colored material\" (micrococci), \"in connexion with and around which the tissue undergoes necrotic changes,\" is almost to a certainty the potential cause of the changes. For all rough purposes it is a certainty that the necrosis is the effect of the deposition of the micrococci; but the subtle dis- tinctions drawn by controversalists in dealing with infection may be brought in here to show that the vegetation in question does not play the important part assigned to it by Dr. Klein. It is admitted that microzymes exist in vaccine lymph and in the fluids from certain infective in- flammations. It is further admitted that those portions- and those portions only-of the fluids containing the micro- zymes have specificity. From this (and from other data) it was inferred that the microzymes are the infective agents. The opponents of the view, however, met it with the argu- ment that, granting the facts, yet the microzymes may be merely the \" carriers of infection,\" and not the infection itself. And this kind of argument undoubtedly admits of extension to the fungus found by Dr. Klein. Though its mycelium, gonidia, and micrococci apparently destroy the tissues, yet they may in reality be the coarse, visible sub-agents of unknown, intangible agents behind. If discussion should enter these or parallel grooves, it may run on endlessly, with exceeding gratification to men of a certain order of mind, and possibly with ultimate benefit to science. Those on a lower plain wil probably content themselves with looking at what is more immediately before them. Taking this contracted view, I conceive that, so far as many present purposes are concerned, it comes very nearly to the same thing whether the vegetation described by Dr. Klein is the prime mover of the typhoid changes, or the subsidiary factor-the ' base second means.\" For if ubi fungus ibi diaintegratio be conceded-if the true agent in the necrosis invariably select the same vegetation as its sub-agent, and if the sub-agent be never found apart from 291",
         "THE SANITARY JOURNAL. the agent-if the two be inseparable-it would seem a tolerably fair conclusion that if you can destroy or preclude the one, you will infallibly get rid of the other. This is admittedly rule of thumb, but it may serve perhaps until the occult powers that employ these ancillary microzymes and micrococci shall be revealed. I submit that (subject to the point reserved) it is shown by Dr. Klein that the vegetable forms he found caused the disintegration of the tissues. 3. Are these organuisms infective agents, or \" carriers of in- fection\" ? Or will they induce typhoid when transplanted into the healthy human body ? The experiments made by Dr. Klein in this direction were of a negative character. He failed to induce typhoid in certain animals by the introduction of the fungus into their systems. The experiments which have been made on man himself by means of the stools of patients, which are shown by Dr. Klein to contain the fungus, are, however, sufficiently numerous to enable us to correct the negative result with animals. I apprehend that the facts connected with water pollution leave very little room for doubt that the poison in the water is particulate, insoluble, indiffusible, living, and reproductive. The inference that it is identical with the fungus in the bowel-tissues of the typhoid patient, or that the two are ejusdem generis, is easily reached. 4. What is the precise nature of these low vegetable organ- isms ? Without intending to be ungracious, I confess to some disappointment at finding that Dr. Klein had done so little on this head. He tells us \" that we have to do bere with a fun- gus which possesses mycelium threads of very unequal joints\"; \"that in some parts of these threads, probably the terminal parts, their contents split into macrogonidia,\" \" or micro- gonidia\"; \" that the gonidia become discharged, the thread having been broken\"; and that these gonidia end in micrococci, etc. He adds that this vegetation corresponds closely with the Crenothrix polyspora found by Cohn in some well-water at Breslau, famous for typhoid. The interesting question as to the indentity of these two forms must here be set aside. With regard to that found by Dr. Klein, it is to be regretted this ob- server had not time to learn something more of the life-history of the plant. This break in the continuity of his investigation reduces the value of his paper incalculably. It occurs to me, as a possibility, that as Professor Cohn seemingly did not cul- tivate the Crenothrix, so Dr. Klein may have thought it un- productive to endeavour to develope the fungus he discovered into higher forms. If this be so, I venture to suggest he was in error; for in order to substantiate the claim of the fungus 292",
         "TYPHOID FEVER. to be the specific cause of typhoid, it is an imperative necessity to connect it with aerial typhoid poison. There are not, pro- bably, any two specific causes for any one specific disease, and if there were there is no room for the assumption in the case of typhoid, because it is well established that patients who catch the disease by way of the air may communicate it through the medium of water. The converse, too, of this phe- nomenon bas frequently been observed. It follows that the typhoid poison, whatever it is, is, under certain conditions, convertible or reconvertible from an air-poison to a water- poison. As a sequence, Dr. Klein is called upon to show that the aquatic plants he has described may under some circum- stances enter the air in such numbers as to create an efficient air-poison. If this were impossible it would weaken the claim of the fungus to the title of the typhoid fungus most consider- ably. But only do I suspect it to be possible, but even to be feasible. Most phytologists would, I think, infer from the description and from the drawings of the vegetation figured by Dr. Klein, that it is the water phase of the plant, and that by proper cultivation on the surface of a fit substrate, it would revert to its original or mildew form. It is highly probable that the gonidia and their descendants are the modified representatives of the sporules of some mould. Nothing is clearer than that most of these low terrestial organisms will not only sustain themselves when they are accidetally immersed in fluids con- taining nitrogenous matters, but will multiply rapidly under the abnormal conditions, owing to the facility with which their organs of fructification will accommodate themselves to the new medium. It is, then, a warrantable scientific inference that the vegetation in the typhoid tissues is in a casual and degenerate stage of its existence, and that its true, or highest, or original form is that of a mildew growing on a free sub- strate. If this inference be verified experimentally, the key to the whole position will be obtained. With it the enquirer may see at once how the transition from an air-poison to a water-poison, or the converse, is effected; and with it Dr. Klein would have advanced the fungus he had made out a long way towards taking rank as the typhoid plant. Ai- though other sets of observations must be undertaken to de- termine the issùe raised, as well as to clear up other points too numerous to refer to, yet I confidently anticipate the verdict of the etiological world, and accept Dr. Klein's fungus as the specific cause of typhoid. I may say I am led to this convic- tion principally because the outcome of Dr. Klein's inquiry 293",
         "THE SANITARY JOURNAL. squares with purely hypothetical views I published a few years ago. Those views, unsupported by original experiment, and depending solely upon work done by others, or upon the well-known facts jin the history of typhoid were, naturally perhaps, looked upon as too speculative to have any value. Nevertheless they are, I perceive, slowly shown to be correct. I submitted, and I submit now with firmer reliance on the soundness of the proposition, that there is no natural or arti- ficial thing, or condition of a thing or things, capable of poison- ing both air and water precisely as the typhoid poison does- except vegetationi; and that nothing that can be presumed or conceived possesses this double property or qualification of the poison but a mildew. 5. What is their habitat, or the soil on which these paraites last occur before their reception by man ? The reply is not far to seek. Granted the (at present hypothetical) mildew, and the conclusion that fæcal matter is the principal substrate *on which it flourishes immediately before its reception into the organism is well-nigh forced. The elimination of all other substances is so simple and easy that I need not detain the reader by detail. Regard being had to the phenomena con- nected with \"sewer-gas,\" and with the atmosphere surround- ing privies, middens, and other collections of excrement, there is hardly any room for doubt as to the substrate from which these parasites are given off to pass into the human substrate. When once the mildew nature of the typhoid poison is ascer- tained, its sources is a certainty. Of course, other animal and vegetable matters may occasionally be overrun by this specifie mildew of typhoid, and may thus cause the surrounding atmosphere to be charged with particles of the mildew. The toxical properties of these particles may be modified by the qualities of the lubstrate; but it is probable they will, if imbibed, cause some one or more of the typical symptoms and lesions of typhoid. Hence, possibly, febriculo, and bastard or obscure forms of typhoid. The one great substrate, however, which has supplied the typhoid mildew in all ages and in all countries is fæeal matter. Let me add, briefly, that the supposition of a mildew grown on fæcal matter is, as I submit, the only possible exegesis of typhoid causation. No other explanation has been, or can be sufficient. By this hypothesis every phenomen which has been observed in every epidemie, and in all isolated cases of the disease, may be clearly interpreted. For instance, the celebrated Munich problem, which has exercised Professor von' Pettenkofer for so many years, admits of the readiest solution 294",
         "ON DIETARY. by this mildew or fæcal matter. Granted that the rise and fall of the ground-water governs the Munich epidemics, and that typhoid rages most when the water is lowest, I submit that, as the water falls in the privy-shafts, the excrement sur- face for the mildew increases, and, as a conséquence, the air is poisoned to a greater extent. When the water rises, the sub- strate adhering to the sides of the excavations is covered, and the mildew swamped. The thing is in a nutshell. Every question raised by every author upon the subject of causation may be resolved by a mildew. If, indeed, any one fact can be shown to be utterly irreconcilable with mildew causation, the mildew hypothesis is unsound. I should be glad to see it submitted to this test. ON DIETARY. By Professor C. VOIT, Munich. We have one additional and ultimate condition to establish for human dietary, the importance of which has hitherto been scarcely appreciated. It has been supposed that when alimen- tary principles are supplied in sufficiency that the food must be nutritious. This is not true; there must also be a supply of other substances which do not themselves contribute anythig' to the maintenance of the material of the body-the so-called condiments. \"Genussmittell.\" If the requisite alimentary principles were supplied to us in sufficient quantity in the form of a mixture of albumen, fat, starch, water, and ash, we would eat it only in case of the most extreme need, and under ordinary circumstances reject it because it is tasteless. Con- diments have been compared to oil in a machine, which neither makes good the waste of material, nor supplies motor power, yet makes it work better. Similarly, condiments render essential service in the process of nutrition and other bodily functions although they are not able to prevent the waste of any substance in the body. Under the term \"condiments\" (\"Genussmittell \") are to be comprehended not only such substances as tea, coffee, tobacco, alcohol, but also and especially all those substances which impart the peculiar taste and smell to our food. In this sense there is no kind of food which does not contain condiment. Frequently it is in the process of preparation that the condi- ments are produced, as in the case of the savoury substances which arise during the roasting of meat. 295",
         "THE SANITARY JOURNAL. Condiments are usually regarded in contradistinction to food, as being non-essential, seeing that they only add to the agree- ability of our food. This way of regarding them is only cor- rect when the term only includes the above named vegetable \u003chinks, or alcohol. Hence it is that the true significance of condiments has been overlooked, which is really as important as the food itself. For a dietary deprived of condiments, a mere mixture of alimentary principles without taste or smell is unendurable, and causes nausea and vomiting. The alimentary principles become food on the addition of condi- ments. Only intense hunger enables us to overlook the con- diments, ahd even devour what at other times would be dis- gusting. These condiments have a great significance for the process of digestion and nutrition. The mere idea or sight of a nice dish makes, as is said, our mouths water, i.e., makes the sali- vary glands pour out their secretions copiously, which trans- forins certain articles of food, and prepares them for absorption. The saine is true of the gastric secretion, as can be plainly seen in dogs by a suitable experiment. On the other hand, un- appetising and disagreeable food produces no such effects, and leads to digestive derangement. Hence all our food contains substances which render it agreeable and excite our appetite. Loss of the sense of taste would produce most serious effects, and we find people actually expend more on these necessary adjuncts than on the food it- self. The very smell of food may do us good, just as the smell of various substances will restore the faint. When some kind of food, which was at first palatable, is supplied in too large quantities or too often, it ceases to please, and may even become degusting. The more pronounced the flavour of an article is, the more quickly does it begin to pall on the appetite. Hence there are only few things which we can eat every day and in any day, as, e.g., our daily bread. Sweet cake, though supplying albumen and carbo-hydrates in the same quantity, could not replace bread. Herein lies the secret of the long misunderstood significance of the change of food, implying a change of the condiments consumea. Hence, from the same alimentary principles and articles of food we prepare a variety of dishes. There are classes of men who live chiefly on meal of cereals, but they do not eat it ex- clusively in the form of bread, but use it to make dumplings, pastry, \u0026c. In the following considerations the supply of water is",
         "ON DIETARY. neglected, because it is usually to be had in abundance; the supply of ash is almost neglected, because our ordinary food contains sufficient, and it is only in rare cases that special at- tention need to be devoted to that point. The non-nitrogenous substances, too, are not taken into consideration, except fats and carbo-hydrates, because they occur in too small quantities in our food, and also the other nitrogenous substances, except albumen, as, e.g., gluten, they usually form but a small fraction of our food. We confine ourselves, therefore, to the question how much albumen, fat, and carbo-hydrates are required for each case. Dietary for a Worcan.-If we ascertain the quantity of albumen, fat, and carbo-hydrates which a workman requires for his daily maintenance, we will have a sort of standard for the average man, from which variations can easily be made. The healthy workman examined by Von Pettenkofer and Voit used up daily- During During Rest. Work. Albumen .. . . . . . . 137 13f Fat ....... .. 72 173 Carbo-hydrates .. .. .. 352 352 Carbon .... ..... 283 356 Dr. J. Forster found in the food consumed the following quantities of the alimentary principles:- Albumen. Fat. Carbohydrate. Workman ...... 133 65 422 Workman ........ 131 68 494 Young Doctor .. .. 127 89 362 Young Doctor .. .. 134 102 292 As a mean from a large number of observations, Voit adopts 118 grammes of albumen and 328 of carbon as requisite for a workman, therefore, as 118 grammes of albumen contain 63 of carbon, 265 grains of carbon are still required to be supplied in fat or carbo-hydrates. If this quantity of carbon were to be given exclusively in carbo-hydrates, it would be necessary to take 597 grammes of starch, of fat, on the other hand, 346. As the question is not exclusively as to the quantity of carbon, these figures are not precisely accurate. But it is evident that the addition of fat or starch alone to albumen would be irrational, because, as already mentioned, only very few could recoil the requisite quantity of either substance. Over 500 grammes of starch should not be eaten by a work- man, as a large juantity is with difficulty utilised by the in-",
         "THE SANITARY JOURNAL. testines, and other conveniences may arise. The remaining quantity of carbon is covered by fat, and if 500 of starch are taken, only 56 of fat will be required. This is the maximum of starch and the minimum of fat which, according to Voit, should be consumed by a workman. He regards it as better to give only about 350 of carbo-hy- drates, and to supply the remainder of the carbon in fat. Formerly it was erroneously supposed that the more work was done the more muscle was destroyed, and that therefore more albumen was required in the food, proportionately to the work done. Voit bas however shown that a man living always on the same dietary does not use up more albumen during the hardest work than in perfect rest, though he does decompose much more fat. It has been supposed that these conclusions are opposed to the fact that certain classes of workmen who accomplish great tasks consume large quantities of albumen. However the op- position is only apparent. The quantity of albumen decomposed in the case of a certain individual is not correlated to the quantity of work he performs, but the converse is true, viz., the possible amount of his work is proportional to the amount of his albumen decomposition, in so far as a strong and hard- working man has a larger amount of organs (chiefly muscles) rich in albumen to maintain in condition, and therefore needs more albumen in his food. But he would require the same quantity on a day when he did no work. If on Sunday he took less albumen, bis organs would lose albumen, and on the next day be unable to do as much work as before. Only powerful muscular men can do heavy labour, and they must consume large quantities of albumen to maintain the mass of muscle; weak-muscle men cannot do the same work however large the quantity of albumen they may consume. Playfair's figures do not prove, as has been often supposed, that more albumen is used up by the same individual at work than at rest. From his compilation it does appear that the amount of muscle determines the amount of work, and that men with large masses of muscle (i.e., those who do large amounts of work) require large quantities of albumen. A heavy draught horse takes more albumen in his food than a little pony. But no one would therefore conclude that it did so because it worked harder, and that at rest it would only eat the same quantity as the animal with less muscle. Everyone knows that the strong horse must eat more albumen on account of its great masses of muscles, and because it bas more work to do with them.",
         "ENTERIC FEVER. Similarly, workmen must not be supplied with albumen pro- portionately to the work they have to do for the moment, but rather proportionately to the mass of the muscle and the pos- sible maximum of work in them. The maximum amount of work to be got out of a man corresponds therefore to the de- composition of albumen and the quantity of it required. The decomposition of albumen depends therefore on the mass of muscle to be nourished, and not directly from the work which is rather determined by the quantity of muscle. But in the same individual the decomposition of non-nitrogenous matter is dependent on the temporary amount of work doing. The man experimented on by Von Pettenkofer and Voit used up, with the same dietary, 101 grammes more fat at work than at rest. The figures given above refer to moderate work. With ex- cessive work the albumen may rise to 150 grammes, and the quantity of non-nitrogenous food called for still more.--The Doctor. IS ENTERIC FEVER SPONTANEOUSLY GENERATED. BY R. BRucE Low, M.D., Medical Officer of Health. In answer to this query, and acting on the advice given by Sir William Jenner, quoted by Dr. Fox in the Journal of March 25th, that \" the best mode of settling this question is to thoroughly scrutinize every isolated case that occurs in out- of-the-way country places.\" I submit two groups of isolated cases which occurred in my out-of-the-way country district. The first group consisted of four cases, all occurring in the same house, about the same time. The house itself was a moderately large one for a cottager, consisting of four fair- sized rooms. The family consisted of four persons, three adults and a boy of four years. The situation of the house was most peculiar. It was built on a hill-side, facing the junction of four wide valleys; a more exposed situation could hardly be imagined. Above the house were miles of moorland; the house was some distance from any high road, and altogether so far out-of-the-way, that it was impossible that any tramp infected with enteric fever could have found out the house, far less the privy which turned out to be the source of the mis- chief. The father of the family was the first victim; within a week his wife was taken ill; in another week the daughter; and, finally, a married daughter, who had come to nurse them, 299",
         "THE SANITARY JOURNAL. also took the disease. All the four persons were ill at the same time ; the little boy escaped (not having used the privy). Two sons came to help to nurse their relatives, and, by my advice, did not go near the privy; also a trained nurse, who also took care of them. The father and the married daughter \u003clied. The other two recovered. The water-supply was ex- amined and found pure; the house was clean and commodious. The privy was found running over, and so full of filth that the seat could not be used The fact that all the sufferers had used this privy, and that those who were afterwards exposed to the same conditions (with the exception of the foul privy), as well as the double danger of the typhoid stools from the four individuals, never took the disease-all this points to some local exciting cause, viz., the privy. In addition to this, when we consider the exposed situation of the house, its isol- ated position, to which a person (a tramp, for instance, who is the vehicle for carrying about the disease, according to the belief of some), suffering from enteric fever, could not have climbed, the road being both steep and difficult to find; when we consider the pureness and abundance of the water-supply, and the entire absence of enteric fever from that district, which is very thinly populated; combining these facts with the circumstance that neither the father nor any of the others had been out of the district for a very long time, nor had they any visitors, we were driven to the conclusion that the disease was generated de novo, and that there could have been no ex- posure to a specific contagion. I may state that the privy was disinfected and cleaned out, and, although a new family has occupied the house since the outbreak, no fresh cases have occurred. The second group also consisted of four cases. Two little boys, attending a day school, had an attack of diarrhœa. One of the boys passed his evacuations in bed during the night, but was able to go to school next morning. The mother of the boys employed a charwoman to assist her in washing the soiled bedclothes. An aunt of the boys resident in the house also assisted. Within a week these three persons were seized with symptoms of enteric fever, which developed rapidly, and proved fatal to the mother and to the aunt. Al three, when engaged in the cleaning of the soiled linen, were nauseated hy the foul smell of the evacuations. The house was a fairly built one, and contained twelve inmates (six adults and six children). The drainage was perfect, the water-supply pure and constant. No csses of enteric fever existed in the district. None of the family had been from home; they had no visitors.",
         "CRIMINALS. The privy was clean, and as wholesome as could be expected. The two boys attended school all the time they were ill (a few days); their appetite and general health were not affected. The school was airy and well ventilated; none of the other scholars were ill. No source of contagion could be traced. Was the diarrhoa of the boys the manifestation of enterié fever in a mild form? If so, then the infection of the three persons is at once accounted for; but it is open to doubt if this diarrhoea was that of enteric fever, for in no way could any source of infection be found which would account for their having taken the disease. In the absence of any proof to the contrary, we must admit that the disease began from the in- halation of the foetid stools of the boys; that the emanations from these stools poisoned the systems of the three individuals who inhaled them, and the \"filth-fever\" was thus generated. I have omitted to mention that one of the children, who re- mained in the sick room with its mother during ber long illness, also took the disease and died from it, the mother clearly infecting the child; but none of the other children or the other inmates of the house suffered from the disease. In conclusion, I may state that the privy in the garden of the bouse was quite inaccessable to any tramps, who might have left in it their infested stools, so that this theory, which meets many of the obscure cases, is not tenable in this instance.- British Medical Journal. THE CRANIOSCOPY OF CRIMINALS. In noticing the last meeting of the German Association of Naturalists and Physicians, we referred to a paper by Professor Moritz Benedikt, on the physical psychology of criminals, and its bearing on their legal status. This remarkable paper has been translated in an English contemporary, and we extract from it some of its results. The aim of its study is to show that a deficient organization of the brain lies at the foundation of the criminal propensity of brigands, habitual thieves, relapsing forgers, and other cri- minals; that the changes in the brains are, in such cases, of a very gross and palpable nature, so as to admit of easy demon- strations in the post-mortem room ; and, what is more remark- able, that these peculiarities of cerebral organization may be recognized during life by a careful examination of the crimi- nal's head. 301",
         "THE SANITARY JOURNAL. The former principally consisted in the unsymmetrical de- velopment of certain portions of the brain. These peculiari- ties he claims may be recognized in life. To convince himself of this, Dr. Benedikt, in conjunction with his former pupil, Dr. Badik, physician to the Illawa prison, hastened to examine the heads of 365 murderers in that establishment. The result was that both these physicians were struck with the peculiar cra- nial conformation of a large number of the criminals, especially with the want of prominence of the external occipital protu- berance, with the flatness of the occiput, the marked shorten- ing of the occipital part of the sagittal diameter of the skull, and a want of symmetry in the two halves of the skull, which far exceeded that which is usually observed. If, in the normal skull, in a straight line from before backward, the distance is measured from the fossa behind the auditory foramen to the most posterior eminence of the occiput, it will be found to amount to two-fifths and more of the straight line drawn from before backward, in the middle line between the forehead and the summit of the occiput (the sagittal diameter.) Now in the skulls of some criminals examined, this is not the case, inasmuch as the first line reaches one-third, or one-fourth, or les, of the second. This deviation Dr. Benedikt calls \" Bra- chycephalia occipitalis.\" Another \" very characteristic \" form of the skull, noticed in 56 per cent. of the habitual thieves in Leopoldstadt, is a con- dition which the author of the paper calls vertex-steepness (Seheitelsteilheit) or rising up from before backward.\" While, for example, the highest point of the crown generally stands a little higher (j centimetres) than the boundry line between the part of the forehead covered with hair, and that which is uncovered, this proportion is altered in habitual thieves; and there are differences amounting to seven centimetres. But not only have the above abnormities been observed in criminals generally, but they are spoken of as varying in character and in frequency according to the class of criminals in which they were noticed. Thus the vertex-steepness just described is said to be peculiar to habitual thieves. The occi- pital deviations appeared in the highest degree chiefly in robber-murderers, next in murderers from premeditation, and lastly in habitual thieves, whilst in normal persons the high- est degree is very rarely found. On the other hand, the lateral symmetry mentioned above existed in a high degree in 37 per cent. of habitual thieves, but in only 26 per cent. of com- mon murderers. This looks very much like a revival of the exploded pseudo-",
         "VACCINATION. science of phrenology. But Dr. Benedikt forsees this criticism, and makes the following distinctions: The fundamental idea of Gall, that the physical functions are localized in the brain, is in a certain degree undoubtedly correct, but the chief defect in Gall's theory is that the latter imagined complicated psy- chical processes to take place in a definite part of the brain. Murder, thieving, forgery, etc., are complicated psychical functions. There is not only often a defect of intellect which is unable to foresee the consequences of the deed to be per- petrated, but the factors of such acts are composed of motor and sensory impulses also. It is, therefore, erroneous to assume for murder, for instance, a definite typographical change in the brain, since that crime is the product of different qualitative and quantitative factors. Another fundamental idea of Gall is that the skull is a model of the brain, and although it has been objected that there are in the skull many accidental prominences which have no counterparts in the brain, his fundamental idea is not shaken, inasmuch as \" no scientific man may, even if he does not altogether agree with Gall, dispute the doctrine that the construction of the skull is remarkably proportionate to the whole anthropological organization in brutes and in man.\" Therefore, the most that the present state of science warrants us in saying is, that the anterior part of the brain is the seat of the life of ideas (Vorstellungsleben), the middle part the seat of psychical action in a motor sense, and the most pos- terior part the seat of sensations and feelings; and that any marked deviations in the general conformation of those parts may be attended by a corresponding amount of deviation in the conformation of the skull.-Med. \u0026 Surg. Reporter. SMALL-POX, VACCINATION, RE-VACCINATION, \u0026c. A few extracts from an article by H. GIBBONS, M.D., in Pacific Med. \u0026 Sur. 7ur. lu the year 1868, during the prevalence of a variolous epide- mic which pursued nearly the same course as that of the pre- sent season, thus far, I published in this journal, a series of propositions relating to this subject, embodying the general experience of the profession, with some shading of my own personal experience. Under present circumstances I have thought proper to re-produce them, with such amendments as are authorized by six years of additional observation. 303",
         "THE SANITARY JOURNAL. During an epidemic aggravation, recent vaccination is the only safeguard. Persons who have had small-pox, or who have been exposed to it in former years with impunity as nurses and the like, are not secure from attack. The mortality of the disease in the unprotected, varies from 20 to 50 per cent. ; in the protected, from 2 to 5 per cent. During an epidemic of small-pox other diseases are more frequent and more fatal. Foul emanations from sewers and so forth have little to do with it. They affect the general health, but do not promote in a marked degree, the spread or duration of the epidemic. Disinfectants, such as chlorine, carbolic acid, the fumes of sulphur, etc., will not destroy the germs of small-pox, unless they are strong enough to destroy human life. Sunlight, air and heat are the best disinfectants. Clothing is perfectly dis- infected by baking in an oven, or exposure for a short time to a heat above that of boiling water. The period of most active contagion is after the appearance of the eruption, and during the process of scabbing. It is questioned by some good authorities whether the disease is contagious at all prior to the formation of pustules. Whenever small-pox shows a tendency to become epidemic in a city or neighbourhood, every individual should be speedily vaccinated, no matter what may be his previous history or experience relative to the disease. The only exceptions are children who have been vaccinated within a year or two: and even these should be re-vaccinated if the disorder break out in their dwelling or in a neighboring house. Vaccination will not take perfectly a second time, in more than two or three out of every 100 persons. A large scar is no evidence of genuine vaccination, nor is a large and painful sore. These may result from a common ulcer or a poisoned wound. A spurious pustule is apt to be worse than the genuine vaccinia. A few individuals will take the vaccination again and again, while a few are entirely vulnerable. The latter are considered to enjoy a like immunity from small-pox. When re-vaccina- tion is not followed by itching or any other effect, it should be repeated. The virus may not have been active. It is well to vaccinate in as many as two places. No other matter should be employed than the lymph or crust from the first vaccina- tion of a healthy child; or that taken from the cow. There is less uncertainty in the former than the latter. The crust should never be kept long after mixing it with water. It developes a virulent poison. There is no ground for the dread of constitutional disease, as the result of vaccination. The extreme cases of inflammation and sloughing which occasion-",
         "EXTRACTS ON HYGIENE. ally follow vaccination, are to be referred to the condition of the patient, rather than to the nature of the virus employed. History tells of deaths resulting from the scratch of a pin. Physicians exposed to the disease should adopt some means for their own protection, and also to avoid carrying the infec- tion in their clothing. The following rules, which are appli- cable to others as well as physicians, should be observed:- Avoid exposure when the stomach is empty or the strength exhausted. Do not enter the room in a perspiration and re- main there till cold. Avoid uncomfortable exposure to cold on leaving the room. Do not swallow the saliva in the room or immediately on leaving it. It is possible that the germs of disease enter the blood partly through the stomach. After leaving a patient with small-pox, avoid entering another dwelling without free ventilation in the open air-say for a quarter or half an hour. Do not, under any circumstances, practice midwifery or visit families where there are children or others, unvaccinated, whilst in attendance on small-pox patients. PRACTICAL NOTES AND EXTRACTS ON HYGIENE (Continued). EXAMINATION OF FLOUR, BREAD, AND MEAT. A good practical knowledge of the qualities and appearances presented by the various articles of ordinary diet, in their wholesome or unadulterated state, is an indispensable qualifi- cation for detecting those which are unwholesome or adulter- ated. The physical qualities of milk have been already given in this JOURNAL. Those of flour, bread, and flesh, are given below. WHEATEN FLOUR ought not to be very white, but should have the faintest tinge of yellow; nor should it be lumpy, or, if so, the lumps ought read ily to give way under the slight- est pressure. When compressed in the hand, good flour will adhere together in a lump, and retain the impression of the fingers longer than that which is inferior; or, if thrown against a wall, a portion of it will adhere, and remain there. It should give no acidity or musty flavor to the taste, nor any odor of mouldiness. If flour is in the slightest degree gritty, it is evidence that a portion of the starch has undergone change, and bread made with it will most probably be sour. Inferior",
         "THE SANITARY JOURNAL. flour which has undergone putrefactive change, is not in- frequently contaminated with fungi, vibriones, and acars farin. Dough made with good flour is elastic and may be rolled out very thin, or drawn into long strips, without breaking, which cannot be done with that made with inferior flour. The pro- cess of baking is the surest means by which to determine the quality of flour. While it is better not to use flour when it is very new, if it be long kept it loses its flavour and sweetness, and also its nutritive value, though it becomes whiter. The greater the amount of gluten it contains the sooner it will deteriorate. Wilson says, the amount of gluten in flour can be ascertain- ed \" by washing carefully a known quantity of flour, made first into a rathtr stiff dough, until the water comes off quite clear. The gluten, when baked or dried, ihould be clean-look- ing, and should weigh at least 8 per cent. of the quantity of flour taken for examination. A good flour will yield 10 to 12 per cent. Bad flour gives a dirty-looking gluten, which is deficient in cohesion, and cannot be drawn out into long threads.\" BREAD.-'« The crust should be well baked, not burnt. The crumb should not be flaky or sodden, but regularly permeated with small cavities. The taste and smell should both be agreeable, and free from acidity. Unless there is a consider- able quantity of bran in the flour,the colour should be white,not dark or dirty-looking. Good flour, well baked, yields about 136 lbs. of bread per 100 lbs. of flour, and adulteration is chiefly directed to increase this ratio by making the gluten hard, and the bread more retentive of water. This the dis- honest tradesman effects by adding alum, copper sulphate, or a gummy mixture of ground rice. The bread may be recog- nized by its becoming sodden and dougby at the base after standing for some time.\" MEAT.-The characters of good meat Wilson enumerates as follows :-On section, it should present a marbled appearance from intermixture of streaks of fat with muscle. This shows that the animal bas been well fed. The colour of the muscle should neither be too pale nor too dark. If pale and moist, it indicates that the animal was young or diseased; and if dark and livid, it shows that in all probability the animal was not slaughtered, but died with the blood in it. Both muscle and fat should be firm to the touch, not moist or sodden, and the latter should be free from hæmorrhagic points. Any juice ex- uding from the meat should be small in quantity, be of a red- 306",
         "PROPHYLAXIS OF APOPLEXY. dish tint, and give a distinct acid reaction to test-pgper. Good meat should dry on the surface after standing a day or two. The juice of bad meat is alkaline or neutral. The muscular fasciculi should not be large and coarse, nor should there be any mucilaginous or purulent-looking fluid to be de- tected in the intermuscular cellular tissue. The odor should be slight, and not by any means disagreeable. An unpleasant odour indicates comniencing putrefactive change, or that the meat is diseased. By chopping a portion of the meat into small pieces, and afterwards drenching it with warm water, any unpleasantiiess of odour will be more readily detected. Another good plan is to thrust a long clean knife into the flesh, and smell it after withdrawal. If the meat is at all suspicious, the muscular libre should be examined under the microscope. The smaller cy8ticerci and trichino can only be detected in this way. The brain and liver should also be examined for hydatids, the lungs for mul- tiple abscesses, and the ribs for pleuritic adhesions. Bad meat is usually sodden and flabby, with the fat dirty or gelatinous-looking, and the smell unpleasant or sickly. PROPHYLAXIS OF APOPLEXY. Dr. I. C. Walker (Amer. Practitioner) quotes \"from Virchow to show that the starting point of atheromatous degeneration is an inflammation of the inner arterial coat sinilar to that which occurs in endocarditis. He is led to infer that this in- flammation is also dependent on an acid condition of the blood, and looks to a correction of this condition for the pre- vention of apoplexy. In the history furnished us by Sir Thomas Watson, of Dr. Adan Ferguson, we find an example fron which much may be learned. He says: \"The doctor experienced several attacks of tempor*ry blindness before he had an attack of palsy, and he did not take these hints as readily as he should bave done. He was a man of full habit, at one time corpulent and very ruddy, though by no means intemperate, he lived freely. I say lie did not attend to these admonitions, and at length, in the sixtieth year of bis age, he suffered a decided shock of paralysis. He recovered however, and from that period under the advice of bis friend Dr. Black. he became a strict pythagorean in bis diet, eating nothing but vegetables and drinking nothing but water or milk. He got rid of his paralytic symptons became even robust and muscular 307",
         "THE SANITARY JOURNAL. for a man of bis tine of life, and died in full possession of his mental faculties at the advanced age of ninety-three, upwards of thirty years after his attack.\" The Peninsular Journal of Medicine, observes, \" If we learn anything from this case,it is that cerebral artei ies may be so frangible as to rupture under great pressure, and that ad- ditional ruptures may be prevented, and possibly the tendency to arterial degeneration stayed, and the already weakened walls strengthened, by the regulation of the nutrition. * * If the doctrine advanced by Virchow be true, that an acid state of the blood favors fatty metamorphisis and atheroma- tous degeneration, and that the condition of the blood is the same as in endocarditis, it would appear that the way is open to prevent endarteritis and its consequences, by preventing the accumulation of the supposed materies morbi in the blood, by the use of agents, the tendency of which would be to maintain its normal alkilinity. Then in the management of cases in which we have cause to believe there is an inherited predis- position to arterial degeneration, fron an acid condition of the blood-and it matters not whether it be uric or lactic-we bave but to maintain its alkalinity by interdicting the use of nitrogenous articles of food, and insisting upon the example of the old Pythagorean,\" 'Eat nothing but vegetables, and drink only water or milk.' DETECTING LEAKS IN DRAINS -E. Slade-King, M.D., L.R. C.P., \u0026c., \u0026c., suggests (Medical Times \u0026 Gazette) the following easy, practical method of detecting flaws or leaks in drains and drain-fittings within dwelling-houses: \"Unfortunately the smell of sewer-gas in dwellings is so slight as to be all but absent, and its intensity forms no index of the quantity or of the danger of the gases; those of foul snell not necessarily proving most dangerous, but resulting from the accidental presence of certain deconposing substances. The smell of car- bolic acid is easily recognized, and, when used as a disinfectant may become also a detector of defects in traps and other fittings connected with drains. With this purpose in view, I am in the habit of directing a branch sewer, serving, say, a terrace or a group of cottages, to be well flushed overnight ; then early the next norning the local ventilators to be closed, and common impure carbolic acid to be poured into the sewer, followed by a few gallons of boiling water. In the course of the day the inspector of nuisances calls at all the houses in the particular section, and inquires if the inmates have lately amelt anything of a peculiar odor. If they answer 'Yes'-",
         "DISINFECTANTS. and in every group of houses there will be some affirmative replies-the chances are ten to one that they refer to the va- pour from the carbolic acid, which has attracted attention by escaping from the drains. If in these suspected houses an effective search be made, some defect will cone to light which has allowed the leakage of sewer-gas from the drain in the house. There are many other methods of detecting flaws in bouse-drains and sewers; but as a ready and practical way, I believe carbolic acid volatilised by steam to be the most generally applicable. And it must also be remembered that if the process were carried out methodically, and at regular intervals, it would insure a periodical disinfection of the sewer-channels, as well as a detection of their structural im- perfections.\" DISINFECTANTS.-The sixth of the new series of Reports of the Medical Officers of the Privy Council and Local Govern- ment Board contains an article on the study of disinfectants by Dr. Baxter. A great number of very careful experiments were made with a view to test the disinfecting properties of the so- called disinfectants commonly used. Evidence was adduced to show that carbolic acid, sulphur, permanganate of potash, and chlorine are all endowed with true disinfectant properties though in very varying degress. The effectual disinfectant operation of chlorine and permanganate of potash appears to depend far more on the nature of the medium through which the particles of the infective matter are distributed than on the specific character of the particles themselves. Aerial disinfec- tion as commonly practised in the sick-room, is either useless or positi vely objectionable, owing to the false sense of security it is calculated to produce. To make the air of a room smell strongly of carbolic acid by scattering carbolic powder about the floor, or of chlorine, by placing a tray of chloriae of lime in a corner, is, so far as the destruction of specific contagion is concerned, an utterly futile proceeding. The practical result of these experiments goes to prove (1) that dry heat, when it can besupplied, is probably the most efficient of all disinfectants; (2) that the old plan of stopping up crevices and funigating with sulphur and charcoal is more efficacious than any other proceeding with more modern disinfectants; (3) that the use of carbolic vapour for disinfecting purposes should be abandon- ed, owing to the relative feebleness and uncertainty of its action.-Med. Times \u0026 Gaz. Each full grown man in effect deposits his own dead, effete putrescible body in the vault of the privy once every forty days.-Segur. 309e",
         "THE SANITARY JOURNAL. COST OF SICKNESS AND DEATH.-The more closely unsanitary conditions are examined the more extensive do their ranifi- cations appear; average short life is but a very small part of the evil. To whatever extent the duration of life is diminished so inuch more productive power is lost, and every community is poor and powerless in the inverse ratio to the average duration of human life. Every death under the age of twelve years carries with it a positive loss to the community in which the individual bas lived, because previous to twelve years of age sustenance involves cost-a direct outlay-and if the life of the individual is preserved a productive iember of society is added and reinuneration rendered. If the probabilities of life in any community are so low as to make the average adult age young, the proportion of widowhood and orphanage is in- creased, and the productive memubers of society proportionately burdened. If a husband dies in the early years of bis married life, lie leaves as burdens on the community a widow or children whom, in all probability, if he had lived, he would have sup- ported. And thus it is that burdens are created and costs entailed upon the industrious survivors of every community in direct ratio with a high mortality. Besides, a high mortality always involves a large sickness rate, and sicknews is always costly.-Rept. of Con. on Iygiene, of N. Y. State Med. Soc. CRUELTY A CHARACTERISTIC OF MAN.-At a meeting of the Oxford branch of the Royal Society for the Prevention of Cruelty to Animals, the Bishup of Oxford in moving the adop- tion of the report referred to the prevention of cruelty to animals as influencing the social life of man. \" Cruelty,\" he said, \"was a character, a state of mind and habit of acting, and although now and then a cruel thing might be done in thoughtlessness, the general commission of acts of cruelty in- dicated a temperament of which cruelty was the characteris- tic, and it was quite certain where there was a cruelty it would not be confined to animals. The tenper and character which produces these acts were just as dangerous to man and woman as to the animals whose cases they had in view; and when they had succeeded in repressing acts of cruelty to animals, they should keep under control and in check that temper and character which mnade homes miserable and led to acts of fatal violence.-Med. Pre88 \u0026 ir. SIONS OF DEATH.-As the result of the prize of $500 offered by the Marquis d' Ourches, for a simple and certain sign of death, the four following are deemed the most impor-",
         "TYPHOID. tant suggested :-(1) Cauterization of the pulp of the fingers during life causes blisters containing serocity, after death they contain steam ; (2) after death a grayish or dusty spot shows itself, first at the external portion of the sclerotie, prior to its fatal invasion; (3) general discoloration of the fundus of the eye; (4) Livid patches which appear shortly after death- they were found in every case on fifteen thousand cadavers.- Medical and Surgical Report. A NOTED FRENCHMAN calls statistics \" the science of natural, social, and political facts expressed in numerical terms.\" A German says that \"history is statistics in movement, statistics are history at rest.\" A Scotchman describes them as \" the means of determining and augmenting the sum of happiness which a nation enjoys.\" Napoleon proclaimed that they are \" the art of making the inventory of a country,\" while Goethe said of them, that \" if figures do not govern the world, at all events they show us how it is goveriied.\"-Med. Times \u0026 Gaz. A PRETTY EXPERIMENT.-Put into a large glass jar a solu- tion of sodium silicate (1: 15) and drop in crystals of various metallic salts, as sulphates of iron and copper. The chemical reaction which ensues results in the formation of a miniature forest, or a growth resembling sea weeds. The semblance of vegetable growth is so striking that it is difficult to believe that the forces at work are simply those which belong to inert dead matter. One cannot help asking the question whether, after all, the difference is an absolute one between the so-called chemical and the vital formative processes.-Detroit Rev. Harvey, the discoverer of circulation, said that \"to main- tain friendship there shall be once in every year a general feast, and on the day of such feast there shall be an oration.\" The oration is to be \" an exhortation to the members to study and search out the secrets of nature by way of experinient and for the honor of the profession, and to continue mutually in love.\" He left funds to provide such an annual feast and oration. The above is very suggestive to medical societies, and if practiced in its real spirit, it would be of incalculable benefit to those participating in it.-Detroit Rev. of Med. BERLIN BOARD OF HEALTH.-\" We learn from the Augsborg Gazette that the Reichsgesundheistamt (State Board of Health) recently installed in Lowsenstrasse, Berlin, has already under- taken its official duties. The general direction of the offices has been given to Dr. Filkenberg, former professor in Bonn, who in- tends to go to London to study the organization and the man- agement of the Department of Medical Statistics, in the Office of the Registrar General.\"-Journal d' Hygiene.",
         "THE SANITARY JOURNAL. Communications solicited from Medical Men and others on all subjects pertaining to Public Uealth. VOL. Il. TORONTO, OCTOBER IST, 1876. No. 10. MEDICAL EDUCATION. It was Lord Bacon, we believe, who said that the science of medicine had been \"more professed than labored and yet more labored than advanced, the labor having been rather in circles than in progression, with much repetition and but small addition.\" While the long and earnest labors of great and good men for the advancement of the science of medicine have unquestionably been attended with a large measure of success so far as relates to most of its branches or departments-as anatomy, physiology, surgery, chemistry, and pathology, and much bas been done in the way of alleviating human suffer- ing-pain, as in the employment of anodynes and anæsthetics, yet as regards that part of the science belonging to the mate- ria medica and the practice of medicine, the treatment of dis- eases, the action, or perhaps more properly the effects, of medi- cines, there is undoubtedly considerable truth in Lord Bacon's pungent remarks. The chief cause of the little progress in this part of the science of medicine we will not now discuss, but purpose mak- ing it the subject of a few remarks on a future occasion. We now desire to draw the attention of the thoughtful to three points, all intimately connected and bearing upon medical education, and which seem particularly to demand the attention of the thoughtful. As to the first: It refers to teaching and practicing. Stu- dents are taught that certain drugs have certain actions, and to give certain medicines in certain diseases, but they are not long practitioners before they find medicines will not even usually produce the effects on the human organization they",
         "MEDICAL EDUCATION. had been taught to expect. Experience, sometimes dearly purchased, so shakes the faith of some that they almost discard drugs in general practice; while others try different or new remedies and combinations, and to this may be partly attri- buted the almost endless and puzzling variety of preparations and compounds for the sick. How many after twenty or even ten years practice carry out the teachings of the schools, of their alma maters, as regards this part of the science ? And this default, if the word may be so applied, is not on account of progress being made in it, for the hoped-for effects of remedies are still quite as unsatisfactory. It may be observed here that a knowledge of the unsatisfactory effects of medi- cines is not the private property of medical men. The public possess it. The former do not conceal the fact. It is public property, discussed in the public press. Some change, some \" re- form,\" seems to be required here, in teaching, as regards thera- peutics and materia medica especially, before satisfactory pro- gress can be possible. The strongholds of the materia medica if it has any, must be brought down. The vis medicatrix natura must receive greater and just recognition. In this way will be razed the strongholds, the foundation, of quackery. As to the next point: Preventive medicine or sanitary science is now admitted by all medical men to be a most im- portant branch of the science of medicine, yet in the schools it receives the least attention of all the departments, and a knowledge of it is not required it seems by any known examin- ing body, either for a degree in medicine or for a license to practice. There is surely inconsistency here which must pre- vent healthful, satisfactory progress. Why cannot the Ontario Medical Council set an example which all other medical exam- ining bodies may follow, and demand from al students evi- dence of a comprehensive and thorough knowledge of this subject before being entitled to registration. The schools would then give it that attention to which it is entitled. It is to be hoped some one of the medical fathers of Ontario will bring this matter before the Council at its next meeting. The third matter to which we desire to draw attention more directly concerns the education of the public. Our views upon it 313",
         "THE SANITARY JOURNAL. so nearly accord with those of Dr. H. B. Baker, Secretary of the Michigan State Board of Health, as given in a paper read in June last before the Lansing City Medical Society, and pub- lished in the Detroit Review of Medicine, that we take the liberty of quoting some of bis words: \" It is plain,\" he says, \" that the best support will be given to that class of physicians who best suit the people. \" The people determine what class of physicians they will support; and it is absurd to expect those who have no conception of the essentials in the special culture of experts to judge accu- rately or well of their qualifications, and that as a rule the physicians chosen are those whose views most nearly corres- pond with those of the people who employ them.\" \" It seems to follow that whenever a physician goes much beyond the aver- age, he becomes less popular with the masses; he is not so well suFported. It also follows that there can be no great pro. gress of the profession except the people consent, and that so long as they can secure persons of that comparatively low cul- ture which they can appreciate, there is no probability of rais- ing the standard of qualifications of physicians.\" \"The only pos- sible way in which the standard of medical education and the qualifications of practitioners can be advanced, is through such education of the people as will enable them to appreciate the need and the possibility of such progress. Is it not clearly the duty of the profession to take greater care not only that their light be not hid 'under a bushel,' but that in all proper and practicable ways the knowledge gained by the physician, and which consists so largely of that which is most valuable to the people, because it teaches them how to live healthful and natural lives, shall be imparted to the people ? This, in my opinion, is the solution of the great problem of how to advance the standard of medical education. It is a movement which requires that some shall advance, and that others shall support them in so doing. The conditions are such that unless the support keeps within easy reach, no progress can be made, The profession is now so far in advance of the people, that fur- ther progress is difficult, if not absolutely impossible.\" The masses have a better knowledge of law and also of divi-",
         "HEREDITY. nity, and indeed of every profession and calling than of medi- cine; hence in the latter abound more than in any other pro- feasion or calling humbuggery and quackery. HEREDITY. While many do not accept in its entirety Darwin's theory of \" Pangenesis,\" there are but few who doubt the influence of heredity on the human organization, that man is made up of his own and ancestral peculiarities. It is well known that constitutional defects may be and frequently are transmitted from parent to offspring; that all chronic diseases, as phthisis, scrofula, gout, syphilis, and insanity, either as a morbid ten- dency or in their general manifest form appear to be transmis- sible. Acquired accidental deformities, or the resulting symp- toms, may be transmitted. Experiments have shown that animals with artificial epilepsy (produced by dividing the ischiatic nerve) give birth to young that also frequently have epilepsy. Hence it is esay to believe that the effects of dissi- pation on an originally good constitution for example will descend to the offspring. The qualities of the mind are sub- ject to the same law of heredity. It is a difficult matter to estimate the amount of evil, the suffering, the number of deaths, produced by hereditary influ- ence. According to Dr. Bowditch, President of the Massachu- setts State Board of Health, there are \"200,000 human beings now annually slaughtered by hereditary diseases.\" But the subject of heredity has a brighter side. Perverted processes, deviations, disease, are subject to limitation in trans- mission, and there is a tendency to revert to natural perfect type under improved and favorable conditions. Furthermore, the type may be improved. Who can know of the limit to which man's physical and mental organization may be deve- loped under proper culture yet partly to be learned ? The influence, for good or for evil, of one generation over the next which is to follow, and the next, is not considered as it should be. We, of this generation hold in our hands, as it were, the 315",
         "THE SANITARY JOURNAL. well-being of those~ that follow. It rests with those of the present one whether future generations of Canadians shall be effleminate, diseased, deformed, manifesting want of intellect, and a superabundance of insane, or, physically and mentally vigorous, well developed, healthy and progressive. Let the people think of this and commence to act upon it. THE INTERNATIONAL MEDICAL CONGRESS. The meeting of this body in Philadelphia in the early part of September, was an important centennial event. A large number of eminent men were present, among whom were delegates from many different countries; Canada was well represented. Papers were read and discussions took place upon the different branches in medicine. It is gratifying to find Sanitary science receiving a fair share of attention, as indeed it does receive at nearly all the meetings of medical men in the United States. Dr. Bowditch, President of the State Board of Health of Massachussets, in an address on Hygiene and Preventive Medicine, said, not a state in the Union has made a sanitary survey of the State, and they would probably think it an un- necessary expense, but in a few years it will be demanded. He gave an instance of a neighborhood which was rendered unbearable by the presence of a number of slaughter-houses, but the State Board of Health was given such authority, and svuept them away, with the result that now the heighborhood is the most beautiful in Massachusetts. He much approved of public abottoirs. In regard to irrigation Salt Lake City is the most notable, they having thousands of miles of ditches; and in regard to bringing water into cities he has in his eye several large cities which, on account of defective systems, will bring upon themselves some disease. We shall never be free from contagious diseases until not only ourselves but all foreign nations shall have adopted a health code on the subject. The dwelling-houses in which the poor in some of our cities are obliged to live are a disgrace. Their abodes are moral pests, and it is impossible for human people to grow up in them except in crime and disease. The only remedy for this is by public law and an authority making regulations for these people, or by philanthropie societies. Our present duty is organization, National, State and municipal. From the highest place in the National Council",
         "ANNOTATIONS. down to the smallest village Board of Health we need organi- zation. This great and beneficent object, the prevention of disease appeals to all. I appeal to the young men of the present hour. Can there be anything more inspiring to a generous hearted intelligent youth than the thought that by the research into the causes of disease, by the discovery of neans for its pre- vention, and by the teaching of these various causes and means to the people, he may help to save a few of the 200,000 human beings now annually slaughtered by hereditary disease. AI- though public hygiene has made but few advances hitherto, it is founded upon natural law. Modern science greets and brings it within its domains as one of its most precious objects for thorough investigation. The following is the report of the Section on Sanitary Science. First.-Every plan for the laying out or extension of a town or city should have, as an indispensable part of it, a corresponding and co-extensive plan for the continuation or the substitution of the natural drainage of the locality and for the proper construction of a system of sewers. Second.-The question in regard to the renoval of waste and impurities from towns is not as to the maintenance of sewers, but as to whether they should be depended upon alone, or should be supplemented, more or less largely, by other measures of conservancy. Third. -Every sewer not supplied with a sufficient flow of water to secure the transportation of its contents is a nuisance, intensify- ing the evils it ought to remove. Ventilation of sewers will mitigate, but not entirely correct such evils. In accordance with a resolution passed at the meeting of the Canadian Medical Association in 1874, a meeting of the Joint Committees of the Conference appointed by the Canada Medical Association and Anerican Medical Associa- tion was held. Present, Drs. J. A. Grant, F. W. Campbell, E. Robillard, E. H. Trenholnie, of Canada. On motion of Pro fessor Gross, Dr. J. A. Grant was requested to preside. TYPHOID AND THE FUNGUS.-Apropos to the first article in this number, on \" The causation of Typhoid fever,\" a writer in the Sanitarian, on the \"Impurities of drinking water,\" ob- serves: \" Neither micrococci nor any micropic plants (outside of fungi,) can produce fermentation or any action on the living organism, except as carriers.\" And again, \" a diligent investi- gation should set all doubts at rest in regard to the presence of infusoria or microscopic plants (fungi excepted,) in disease. They are, in our judgment, more likely to be beneficial than hurtful.\" 317.",
         "THE SANITARY JOURNAL. OBJECTS OF BOARD OF HEALTH, MASSACHUSETTs.-The Board was established in 1869, by an act of the Legislature, which clearly sets forth its objects as follows: \" The Board shall take cognizance of the interests of health and life among the citizens of the Commonwealth. They shall make sanitary investigations and inquiries in respect to the people, the causes of disease, and especially of epidemics, and the sources of mor- tality and the effects of localities, employments, conditions and circuinstances on the public health, and they shall gather such information in respect to those matters as they may deem proper for diffusion among the people. They shall advise the government in regard to the location of any public institutions.\" The Legislature also passed a law requiring that: \" The State Board of Health shall investigate, by themselves or by agents employed by them, the subject of the correct method of drain- age and sewerage of the cities and towns of the Commonwealth, especially with regard to the pollution of rivers, estuaries and ponds by such drainage or sewage ; and to devise and report a system or method by which said cities or towns may be pro- perly drained, and said rivers estuaries and ponds may be pro- tected against pollution, so far as possible, with the view of the preservation of the health of the inhabitants of this Common- wealth, and the securing to the several cities and towns thereof a proper system of drainage and sewage, without injury to the rights and health of others; also, to report how far said sewage may be utilised and disposed of.\" DIET FOR GOUT.-Dr. John Malcolm in the British Medical Journal writes on this subject as follows: My attention has been given for many years to the cause and cure of gout, to which I have a hereditary tendency, my father and grandfather having suffered greatly from this disorder. I soon ascertained that, by attention to diet alone, I could prevent the disease, and for more than thirty years I have steadily adhered to a diet consisting of farinaceous food and fruit, with milk and creani, by which means I have escaped any illness. Among my patients, I have found that. (when I could not induce them to give up animal food), by partaking only of fish, fowl, and rabbit-white meats-their attacks of gout have been of a milder and less frequent character; but in no case have I been able to cure the disease unless I could induce a total abstinence from all flesh-food. FACTs having proven that in schools lighted by windows on both sides children suffer more or less from injured vision, a law has been passed in Germany forbidding such windows in schools.",
         "ANNOTATIONS. IMPORTANCE OF FORESTS.-A convention is to be held this month for discussing the value of forests, and for taking steps to cultivate and protect the same in the United States. The Med ical and Surgical Reporter says: The combined scieitifie and sanitary bodies of this country should enter a protest against the constant destruction of our forests. Quite apart from the loss of the picturesque and attractive, the denudation of the soil has results of the most serious character on national health and national wealth. To refer to the latter first, a most conclusive instance of it on a gigantic scale is the desolation of millions of square miles in the Caspian basin, and Southern Europe. The increa.sing aridity bas there been traced directly to the cutting away of the forests. When it comes to health, the evidence is very strong that a climate tempered by the presence of abundant foliage is every way desirable. The bene- ficial effect of groves on the diminution of malaria is so well known that in many localities in France, Italy and No'rthern Africa, they have been planted for this purpose alone. The Eucalyptus probably does as much through the rapidity of its growth as through any specific powers it may possess. Will the people of Canada take warning and act in time ? THE BRUSSELS SANITARY EXPOSITION.-On June 26th, the International Sanitary Exhibition opened at Brussels. An ex- change says: To athoughtful person the Exhibition is one of ex- traordinary interest for members of every grade of society will there find objects which touch them closely. Who is safe against shipwreck or fire, and who can fail to be interested in the means of averting or escaping from these terrible calamities ? The variety of the objects shown is very remarkable, and one is astonished at the way in which the commonest things are con- sidered as ministering to man's health and comfort, and as tending to prolong his life. The objects exhibited are arranged in ten classes. 1. Means of prevention, help and salvage in case of fire. 2. Means of lessening the dangers on water. 3. Means of preventing railway accidents. 4. Help to the wounded in times of war. 5. Public health. 6. Industrial hygiene and means of lessening the unwholesomeness of trades. 7. Domestic and private hygiene. 8. Medicine, sur- gery and pharmacy in relation to the preceding classes. 9. In- stitutions having for their object the amelioration of the con- dition of the working classes. 10. Hygiene and \" sauvetage in relation to agriculture. THE sanitary legislation of different countries resolves itself chiefly into the broad principle of attempting to provide clear air, clean water, clean food, clean soil, clean houses.",
         "THE SANITARY JOURNAL. UNSEXING OF WOMEN.-In an article on \"Woman's Place in Nature and Society,\" by Mrs. Linn Lynton, recently pub- lished, in referring to \" Women Doctors,\" after drawing attention to the hardship of \"roughing\" it in a country practice, the writer adds: \" This craze of unsexed manliness is a false move; we can only hope that it will pass before it has done much vital damage, though assuredly it has done damage enough already ! In substituting excitement for duty, individualism for love, freedom from natural restraint for the lovely unselfishness of maternity, personal ambition for wifely devotion, it bas eut at the root of ail the charms and virtues of womanhood.\" AT THE EPIDEMILOGICAL Society's meeting in June, (Med. Times \u0026 Gaz.) very conclusive proof, was subinitted by Dr. Squire, of the conveyance of measles from man to the dog. A dog licked the hand of a child in bed with the rash of measles at its height; the dog sickened on the twelfth day after, suffered from coryza two days, and died on the fourth day of illness with most characteristic congestion of the throat and air-passages. AT THE WORSHIP-STREET POLICE COURT, recently, the Vestry Clerk of the Parish of St. Leonard, Shoreditch, attend- ed to support summonses taken out against several dairymen and cowkeepers for having on their respective premises a foul well containing water in such a state as to be a nuisance and injurious to health. SALICYLIC ACID AND CISTERN WATER.-It has been determ- ined, says the Scientiftc American, that the addition of from 0·0005 to 0·001 part of salicylie acid to cistern water, clarifies the same in a remarkable manner, and that which ordinarily, in the space of a nionth, would become foui and unfit to drink, remains perfectly pure and limpid. EFFECTS OF WORRY.-The British Medical Journal, Nov- 13, 1875, reports the sudden death of a health officer, from a serous effusion into the ventricles of the brain. No other cause for death than worry respecting a sanitary report could be ascertained. THE SANITARY AUTHORITY at Oldham reported that the prevalence of typhoid fever in that town was in ail probability largely due to the adulteration of the milk-supply with pois- oued water. THE MEDICAL MEN having seats in the Legislature-39 in the Chamber of Deputies and seven in the Senate-met at Ver- sailles to form thenselves into an extra-Parlianentary Com- mittee to confer on all Bills affecting health and pauperism.\"",
         "THE tANITARY JOURNAL. NOTES, QUERIES AND REPLIES. G. B.-Dr. C. B. Fox says : Red Litmus paper, which has been dipped into a very dilute solution of Iodide of Potassium appears to be the only reliable Ozone test. The Potassium set free in conjunction with the Iodine, when this sait is decomposed by Ozone, combines with the Ozone to form Potash, and the amount of this alkali is judged of by the extent to which the Red Litmus is blued. WEIGHT or LiGHT.-The weight of the light of one candle at six inches distant is now said to be o-00172 grains. The weight of sun- light at 32 grains per square foot, 57 tons per square mile, and 3,000,000,000 tons on the surface of the earth. OLD SoL.-In Sun Baths the naked body is exposed to the direct rays of the sun. The baths are believed by many to be highly bene- ficial to the general health. DEEP.-The water of artesian wells though free from organic matter, sometimes contains so much mineral matter-inorganic saits, that it cannot be used for drinking purposes. Sir Wm. Temple said: \" Soldiers seemed to have the most honour, lawyers the most money, and physicians the most learning.\" IN THE WORDS OF A MONTREAL COTEMPORARY, we wish to say to all delinquents, to whom we again send a statement of amount due. \" We believe that in many cases it is simply neglect, but we hope that now we have fu/flled our part of the obligation our Subscribers will remember what is due us, and send it to us promptly. We beg'to assure them that we actually need il. MAY WE HOPE FOR A PROMPT REMITTANCE.0 MICRO.PHOTOGRAPHS IN HISTOLOGY, normal and pathological, by Carl Seller, M.D., Phila. ; J. H. Coates \u0026 Co. Number five of this admirable publication has reached us. The publishers certainly did not put out the best first ; each number seems to be superiorto its predecessor. The last is certainly exceedingly beau- tiful, and gives plates of kidney of a mouse, injected, chronic nephrites, exhibiting the appearance under the microscope in an inflamed kidney, malphighian bodies, injected, and crystals of urea, with de- scriptive texts. No one has any authority to collect on account of this Journal. IF CITY SUBSCRIBERs having boxes in the Post Office, would kindly send us the number of the same, they would confer a favour,and save us considerable in postage during the year. 3 321",
         "THE SANITARY JOURNAL. CQMMENDATORY LETTERS TO TE EDITOR. The following are copies of, and extracts from, a few of the many letters to the Editor, received from time to time, from medical men and others, regarding the SANITARY JOURNAL, unsolicited, of course, and, with two or three exceptions, the writers being personally quite unknown to the Editor : TORONTO, December 7th, 1875. DEAR DR. PLAYTER :- . Please send me your receipt for the enclosed two dollars, for your valuable Journal. I wish all in the profession valued it as I do. Very truly, JOSEPH WORKMAN, M.D. (Late Supt. Toronto Lunatic Asylum.) TORONTO, February 9th, 1876. To E. PLAY.rER, EsQ., M. D. DEAR SIR :-I am much obliged to you for sending me your very useful, much needed, and thoroughly practical Journal. I gladly enclose you my sub- scription. Truly yours, S. H. BLAKE. (Vice-Chancellor.) BOWMANViLLE, June, 1875. DEAR SIR :-I am much pleased with your journal . . . I look upon it as one of the most useful periodicals with which I am acquainted, and especially to the medical practitioner, who wishes to keep pace with the advancements of science. Yours truly, W. ALLISON, M. D. (Member Medical Council, Ont.) GLANFORD, ONT., November 22nd, 1875. DEAR SIR :-Enclosed you will find $2, to be applied to SANITARY JOURNAL. I think your journal is doing a good work, and that such a magazine was much needed in Ontario. Wishing it every success, I remain, yours truly, ALEX. BETHUNE, M.D. (Member Medical Council, Ontario.) OAKVILLE, March 18th, 1875. My DEAR DOCTOR :-Enclosed please find one dollar for your really valuable Journal. .... Accept my best wishes for the success of your new enter- prise. Yours faithfully, D. D. WRIGHT, M.D DUNDAS, September Ioth, 1875. MY DEAR SIR :-Please receive the enclosed $2 for the SANITARY JOURNAL. Your moderately-priced monthly contains much that is of interest to the reading public of all classes. . . . Much valuable information as well fitted for the general reader as for the professional student. It ought to receive a large mea- sure of support, and I heartily wish it every success. I am, my dear sir, yours truly, JAMES HAMILTON, M.D., (Late Member Medical Council, Ont.) LANSING, MICH., August, î2th, 1875. DEAR DocTOR :-I am much pleased with your Journal. . . . . I read it with interest, and satisfaction, and sincerely hope its circulation may be increased, believing, as I do, that the interests of public health will be advanced thereby. Very respectfully, H. B. BA-ER, M.D. (Sec'y Michigan State Board of Health.) TORONTO, December I3th, 1875. Dr. PLAYTER,-Dear Sir:-Enclosed find amount of subscription to the SAN 1- 'TARY JOJRNAL. I am much pleased with it, and feel that I cannot say too much n its behalf. . . . I hope the publication will receive the support its merits deserve ; it should be carefully studied by every man, woman and child. Vours very truly, DONALD McDONALD. (Sanator Dom. Can.)"
      ],
      "identifier" : [
         "8_05173_22"
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         "[Toronto? : s.n., 1876]"
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      "title" : [
         "The sanitary journal [Vol. 2, no. 10 (Oct. 1876)]"
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      "location" : "http://eco.canadiana.ca/view/oocihm.8_05173_22",
      "label" : "[Vol. 2, no. 10 (Oct. 1876)]",
      "key" : "oocihm.8_05173_22",
      "source" : [
         "Library and Archives Canada."
      ],
      "contributor" : "oocihm",
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         "text"
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      "note" : [
         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée W Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée f Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. Additional comnments:/ Wrinkled p Commentaires supplémentaires: 22X L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. LE] w | LE] E?' | |! Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées | Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison E IVasthead/ Générique (périodiques) de la livraison ages may film slightly out of focus. This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lox 14X 18X 26X 30X Il LiE Ei w2 E 12X 16X 20X 24X 28X 32X",
         "THE SANITARY JOURNAL, DEVOTED TO PUBLIC HEALTH. VOL. I.] NOVEMBER 1874. [No. 3. originial m.n ictn. CIRCUMSPECTIVE REVIEW OF HYGIENE. \"Por varios usus artem exporientia fooit Exemplo monstrante viam.\" At the conclusion of an article on the progressive ad- vance of lygiene I alluded to the good work in the cause by Howard, Lady Mary Wortly Montague, and Jenner; and in- *qtanced some of the reforims accomplished by the former phil- anthropist. Before remarking on the labors of Lady Mon- tague in the cause of suffering humanity, I will briefly refer to the history, as far as it is known, of Small Pox, the fearful scourge of past ages, which this brilliant and accomplishe d woman endeavoured to mitigate by the introduction of in- oculation. It is a subject of dispute whether this diseas e was known to the Ancients, or whether it has originated at a, comparatively recent date. Those who contend for its anti- quity refer us to the account of the plague of Athen, b y Thucydides, which, they say, is as accurate a description of the leading symptoms of variola as could possibly be expected from any historian who is not a physician. Those who hold the opposite opinion call in etymology to their aid; the word pock or pox, they say, is of Saxon origin, and signifies a bag or pouch; the epithet small in England, and petite in France, were added in the fifteenth century. The first author who",
         "THE SANITARY JOURNAL. treats expressly of Small Pox is Rhazes, an Arabian physician. But even he confounded it with measles, and these two dis- eases continued te be considered as a modification of the same disorder till the time of Sydenham. The practice of inocula- t-ig for Small Pox was introduced in England by Lady Mon- tague about the year 1721; her son havmg thus received the disease during her residence in Constantinople. It had long been practised in Turkey and other Eastern countries, and its utility was well known, before its introduction into England, boih in the South of Wales and in the Highlands. Mungo Park also found that it was habitually practised by the ne- groes on the Guinea coast. It was very slowly adopted in England, and it was not until it had been practised on six criminals (whose liberty warpromised to them if they recov- ered, which they fortunately did) that it was generally re- ceived. It was then almost universally had recourse to till the introduction of vaccination by Jenner, but since that time it bas most deservedly fallen into disuse. Indeed, whatever were the merits of inoculation in lessening the severity of Small Pox in the person inoculated, it was probably on the whole productive of more harm than benefit, by introducing the disease-as it certainly often did-into a district previ- ously free froi its contagion; and thus while it saved the life of one person it became the crise of death of many who cauglit small pox from him. At the beginning of this century the practise was prohibited by Act of Parliament. i. Jenner, a practitioner of Berkely, in Gloucestershire, and a pupil of the celebrated John Hunter, first observed that milkers who had been infected with a peculiar eruption which sometimes occurred on the udder of the cow, were completely secure against small pox. Jenner, during his pupilage with John Hunter, repeatedly mentioned this fact, which had made a great impression on him; but even this acute investigator disregarded him, and all to whom.'the subject was broached çither slighted or ridiculed it. Jenner, however, still pursued his investigations. It was about the year 1780 that the idea first struck him that it might ibe possible to propagate the",
         ".REVIE-N OF HYGEINE. cow pox,-and with it the security from small pox, first from the cow to the human body, and thence from one person to another. In 1780 he carried drawing of the casual disease, as seen on the hands of milkers, to London, and showed it to John lunter, Cline and others; but still none would either assist or encourage him, scepticism or ridicule met him every- where, and it was not until 1796 that he made the decisive experiment. On the 14th of May (a day still commemorated by an annual festival at Berlin) a boy aged eighb years was vaccinated with matter taken from the hands of a milk maid; he passed through the disorder in a satisfactory manner, and was inocclated for small por 'n the 1st of July following with- out the sightest effect. Dr. Jenner then entered on an exten- sive series of experiments of the same kind, and in 1798 pub- lished his first memoir: \" An enquiry into the causes and effects of Variolie Vaccine.\" It excited the greatest interest, for the evidence in it seemed conclusive; yet the practise met with great oppUsition, and iLs success seemed uncertain till a year had passed, when up-wards of seventy of the principal physiciaits and surgeons in London sigred a declaration of their entire confidence in it--[see Baron's life of Jenner.] The history of the different epidemics of small pox shows the mortality to be one in four of those attacked who have not been vaccinated, whilst of those who had undergone vaccina- tion the proportion was notie in 450. With such wonderful results it is not a little surprising that indifference to vaccina- tion, and occasionally open hostility, as recently evidenced by Some physicians of Montreal, sh.,uld yet have. to be met, and it would be a great boon to the public ;î our Provincial or Do- minion Legislature would pass an Act rendering vaccination àsolutely compulsory. The Act of the Session before last, if not entirely inoperative, is clearly not equal to the occasion, as systematie Government inspection was not made a provi- sion in the Bill. Dr. Aitken, in his work on the Practice of Medicine, thus speaks on the subjeet : \" The present position of our knowledge, regarding vaccina-",
         "THE SANITARY JCURNAL. tion is ba.sed upon evidence which demonstrates, lst-The protective influence of vaccination, and 2nd-The causes which have combined to impair itz protective powers. 1st--To prove the influence of v acdination± in England, it is shewn that out of every 1000 deaths in the half century from 1800 tu 1850 there were only 35 deaths from sinall pox. 2nd-To prov3 the innuence of vaccination on the Continent, it is shewn that in the various German States sufficient evidence eau be ob- tained to show that ut of every 1000 deaths before vaccina- tion was used, 60.5 were deaths from smail pox; but that out of every 1000 deaths after vaccination came into use, the deaths from small pox were only 7.26. To prove that in coun- tries where vaccination is most perfectly carried out small pox is least mortal, it is shewn that- (a) In this cuuntry, where vaccination has been volunta y, and frequently neglected, the deaths from all causes being 1000, the deaths from smail pox were as follows: London, 16 ; Birmingham, .L,.6; Leeds, 17.5 ; England and Wales, 21.9; Perth, 25 ; Paisley, 18; Edinburgh, 19.4; Glasgow, 36; Galway, 35; Limerick, 41; Dublin, 25.6; Connaught, 60; Al ireland, 49. (b) in other countries, where vaccination has been more or iess compulsory, the deaths from all causes being 1000, the deaths fi.n smal pox were as follows: Westphalia, 6; Lx- 'ny, 8.33; Rhemish Provinces, 3.7; Pomerania, 5.25; Lower Austria, G ; Bohemia, 2; Lombardy, 2; Venice, 2.2; Sweeden. 2.7; Bavaria, 4. Similar corroburativce e ridence of these results lias been ad- duced by Dr. Balfour from the records of the Anny and Navy Medical Department, where compulsory vaccination prevails, For twenty years, namnely from 1817 to 1837 inclusive, ît is shown that in Dragoon regiments and Guards, with an aggre- gate ,trength during that period of 44-611 men, and a total mortality of 627, only three deaths were from small pox. 2nd--Among the trcops at Gibraltar, the aggregate strength being 44-611 men during that period, and a total mortality of 1291, only one death from small pox occurred. 3rd-In",
         "REVIEW OF HYGIENE. the West Indies several epidemies of small pox prevailed du- British or white troops, of whom the aggregate strength ws ring the period, but there were no deaths either among the 86-661, and with a total mnortality of 6,803. Amoug the black troops on the same st ;on, with an aggregate strength of 40,934, and a mortality of 1,645, there was not one case of small pox. Similar results are exhibited by the tables for Bermuda, Nova Scotia, New Brunswick, Cape of Good Hope and the Mauritius, not a death occurred from small pox during the twenty years mentioned. The actual extent of the security against death from small pox e, joyed by vaccinated cumpared with unvaccinated persons bas been calculated by Mr. Simon from various sources, and it appears that the death rate from small pox amongst the vaccinated varies from an unappreci- able small mortality to 12 per cent; that amongst the upro- tected the death rate from sinall pos ranges from 14ý to .53 4-5 per cent. To the protecting and modifying inflaence of vaccination fifty years ago the general assent of the profession was given, now Dr. Aitizen justly remarks, it would seem at firsL sight an insult to hunan understanding to be obliged to collect sta- tisties to prove the necessity fr- -accination. The humiliating fact remains, that but a short time ago phyicians were to be found in Montreal prosesting against its employnent. Mon- tague, in his Essay on Experience, thus speaks of such com- inentators: \" Mpn do not know the natural disease of the mind; it does nothing but ierret and inaqre, and is eternally wheeling, juggling and perplexing itself, and, like silk worms, suffocates itself wiTh its own web; 'Mus in pice-a mot se in a pitch barre],' it thinks it discovers, at a great distance, I know not what glimpse of light and imaginary truth; but whilst running to it, so many difficultics, hindrances and new inquizitions cross it, that it los(s its way and is made drunk with the motion.\" (To be coantiaued.)",
         "THE SANITARY JOURNAL. A BUREAU OF SANITARY STATISTICS WANTED. To the Editor of the SANrrAAry JOURNAL: Sin,-It appears to me to be the duty of every niedical man, both in Parliament and out of it, to exert all the influ- ence he can command in order to bring such pressure upon the Government as will induce it to establish as early as possible a Bureau of Sanitary Statisties. This is a matter of such vast importance that it cannot be too frequently or too forcibly brought before our legislators and the public. During last session, after Dr. Brous- had moved in the House of Con- mons foir a selet committee to consider the propriety of asking for legislation with a view to the establishment of such a Bu- reau, Mr. McKenzie promised to give the matter his attention. and if possible to bring in a Bill for this purpose next session. It is certainly a suijecit not second to any othei. and it is to be hoped that the Hon. gentleman has not permitted other suljects of less importance to render it impossible for him to bring f,.rward such a Bill. It is altogether probable that if he gives it :,uflcient attention he will not fail to see the great benefit sucl a measure would confer upon the public, and would then do al' in his power to bring it forward. The work of Sanitary Reform is the mnost positively bene- ficial, the most beneficient and proftable, which the science of a country can produce. Franklin has truly said that \" pub- lic health is public wealth.\" Unquestionably tbe first step toward Sanitary Reform would be the establishment of a Bureau for the collection of sanitary statistics. We must de- le some means of getting at the precise data of mortality, and perfecting our knowledge of predisposing and proximate causes of disease. Te this end, a Registration Bill, with a clause sufficiently stringent to insure regular and full returns, is indispens'ble. These returns should not only include the age, sex, occupation, and immediate cause of death, but sh3uld aiso give the hereditary tendency, if any, the general condition of surroundings as regards the purity of the air and water, meteorological conditions, whtther temperate in all respects",
         "SANITARY STATISTICS WANTED. or otherwise, general habits, whether regular or othenwise as regards hours of sleep and periods of taking meals, whether abstemious or a free liver, or addicted to the use of tobacco or strong tea or coffee, or whether a bath is used habitually, or what is worn next the skin; and indeed all such information as the medical attendant mnight deem to be useful. And here it is, while dealing with the subtile and remote influences which so greatly intensify the death inte, that the importance of the inedical profession must be recognized. For as Dr. Botsford, of St. John, N. B., at the mecting of the Canada Medical As- sociation in 1873, observed, \" Our profession stands first, and pre-eminently first, in its qualifications for investigating this broad field of causes.\" \"A belief is now gaining ground and aequiring a hold on the popular mind \" says Dr. Aitk.en, in his late work on the Science and Practice of Medicine, \"that advances in the sci- ence of Medicine in future years will be mainly due to a better appreciation of the cau-es of disease.\" If the latter clause of this sentence be true, deep indeed should be the interest taken by all medical nien in all legislation having for its obje.t the establishment of a departmeut for the' collection of complete sanitary statistics. In conclusion, then, I must say that I too should be glad, as you observe in the first number of the SANTArrAY JOUR.NAL, \" to find the next effort on the part of the profession directed toward Sanitary Enactments.\" Then, possibly, there would be fewer insinuations by the vulgar, which are, however, in al probability, more ap-.\u003earent than real, though always un- pleasant to a sensitive ,qind. that doctors revel and - hold high carnival\" when disease is rife and epidemics prevail. Youre \u0026c.. M. D. LoNDox, ONT., Oct. 20th, 1874. A svnsE was recentiy fined 40s. and costs, in London, England, for having conveyed a servant suffering from scaxlet fever to the Fever Hospital in two tramway cars successively.",
         "THE SANITARY JOURNAL. PHYSIOLOGY OF INTEMPERANCE. By A. H. DANA, New York. lu the accomplishment of any great reform there seems to be a necessity for zeal that will not be confined to exact pi oof. We overlook any error in consideration of the good which is sought. The agitation of the public mind in respect to temperance is no exception to the proposition above stated. The tirne has come, however, when the reformation desired should not depend upon highly colored btatements not strictly accordant with sci, atific analysis, but upon sound practical principles. It is often reiterated by lecturers on tenperance, that there is no nutrition in alcohol-that it furnishes neither alimentation nor heat to the bAy ; which statements are professedly be.sed upon chemical t-ts: but they a.re hardly sustainable without considero ble motifications. Alcohol does for a short time accelerate the blood circulation, and during that tine produces increased vigor; but thea follows a relapse -a deritalizing process that diminishes animal heat and vigor of body and mind. That it is not assimilated is tre so far as this, that it is largely carried off by the kidneys, exhaled by the lungs and exuded from the skin; and it is likely that other fluids of the body pa\u0026 off t soie extent with it. Saliva and the gastric juices appear to be dried up in hko manner as by fever. * * * * The true raethod of dea:ng with the subject is by obser- vation of efects rather than deduction frmo a y chentical tlkeory, the latter is in fact of littie more practical use than the hypotheses of monads or atomts insisted upon by Epicurus- or of the rortices naintained by Descarte-- is in explanation of the physical constitution of the world. An argument of chief i.ortan;c is derived from the morbid craving induced b-N intoxicating drinks. A man that takes a dram to-day will ,urely want it to-morrow. Those who drink daily are the most punctual in time-in no business engagement are they so exact-not even at meals. Another incident equally marked i- the desire of a larger potation, consequent upon successive indulgence, and this, when there is not much self-control, ends speedily iii drunkenness----or if a",
         "PHYSIOLOGY OF INTEMPERANCE. man has resolution enough to avoid that extreme he still has a gnawing sensation of uneasiness that unfits him more or less for business. It is almost invariably seen that whoever takes an intoxicating drink daily, becomes a lounger, wasting pari of his time in unprofitable talk ; generally will be a frequenter of bar-rooms or other like places of resort, and thi will grow upon him as he drinks oftener. Aristotle sets down in the class of intemperate men, not inerely those wbo actually indulge to excess, but those who have a desire for such indulgence, and feel a pain for want of it. I. the early otage of intemperance there is sormething exceedingly deceptive. The desire seems not to be very strong; a raan thinks he can easily break off. Nothing is more common than to hear moderate drinkers say they can give up the habit whenever they choose. Let uch an one try it and he vill find that what he thought w-as merely volun- tary is a puwer like that of the many-armed sea monster that fixes a fatal grasp wtile yet the victimn Le at a distance and unconsciüum of the presence of his enemy. Again there is a deception in advanced life, a feeling of security in the formation of a new habit. It is not likely (thinks the respectable elderly man) that at my time of life I should fal into excess when 1 have always heretofore been regular. Yet nothing is wre lilely than if indulgence be yieldcd to at all it will under this false security become excessive, and the instances are not unfrequent of men who were in early yoith exemplary, giving themselves up to unlawful gratifications in later years. Balzac has sharply depicted a proclivity to sensuai pleasue between the ages of fifty and sixty, w-hen is often seen an infatuation wholly beyond cuntrol. This theory applies not merely to the passion of love-whatever may be a man's propensitv is apt at that age to break through restraint. Plat rebuked a man for playing at dice, who answered that he was only playing for a. trifle. But, said Phzto, is the habit a trifle ? Of \u00261 habits none are so controlling as indul- gence in strong drink. The appetite is constantly increasing, while moral energy is becoming weaker. In the .dinary course there is therefore littile bope of reform, and it is rare to see complete recuperation; loss of iortune, pains of disease, misery of hi3 fam.ily, do not reclaim the confirmed inet. ate. The fear of such, restds may cheek in'some degree the mod- elate drinker, but in most cases even this is only for a time. His mind becomnes clouded, his moral perception impaired, and",
         "THE SANITARY JOURNAL. while ho may be conscious of his weakened condition and its cause-still he will seek tenporary strength in the fatal expedient of more frequent stimulant. * * The most interesting subject of inquiry is in respect to the formation of the habit. Reformation after the habit is established is, as before remarked, unusual. The chief good to be acconplished by admonition is to deter the rising generation from exposure to the tenptations which have been fatal to so many in the past. 1. The lowest of all the causes of intemperance is a mere animal propensity, a desire of mere sensous exhilaration, the stirring tip of emotional activity in an organism which is by nature gross and inert. This cones usually by inheritance, in fact it is one of the retributions that by a mysterious Provi- dence is entailed upon the descendants of profligate parents. The sensualist, whether man or woman, will stamp upon his or lier offspring the marks of vice; and especially will intemperance in drink display its baneful influence through several generations. In fact with the increasing power of hereditary proclivity descending from father to son, there would seen to be no hope for a family subjeet to the con- sequences of ancestral vice-and so it would be but for counteractions interposed by a like proeess of nature. There is a warning in the frail constitution which is one of the incidents, and the predisposition to an early death. Greater care is therefore made necessary-yet this is generally insuf- ficient at least during the first generation, to prevent the fatal developnent in early life of the vice inherited from a depraved ancestor. If there should be physical strength there -will be gross indulgence. But whatever the cause may be, whenever there is an inert habit of body without moral refinement, b1utish vices are apt to be developed, especially intemperance, and there is ordinarily no cure for this but what nature lias provided, viz.: the pain of disease-which if unheeded, an early death or a wretched inbecility is the alternative. 2. Another phase of the habit is when misfortune lias imposed a hard condition of life upon one accustomed to botter thing ,-or when by hereditary poverty there is a necessity for grcater labor than there is capacity to bear. In such cases it is -not unfrequent that a temporary support 4s souglht in stim.ulants, or inebriation resorted to as a relief from aspair. In these condit'ons it is obvious thf most effectual method to prevent the habit becoming fixed, or if reclaimed from it after being confirmed-is by respite of the body overtaxed with",
         "PHYSIOLOGY OF INTEMPEtANCE. labor, or by solace to the mind crushed with calamity. Many well-meaning people make a great mistake in addressing harsh rebuke to persons of this class. This is only adding to the intolerable weight that already oppresses them; and although there is a low condition of humanity in the inebiate, yet when sorrow or hardship is the cause, there is still a sensibility to kindness-sympathy will do much even unacconpanied by any other gift; but of course the ill of poverty require additional relief. It is reported that in the English factories intemperance is largely prevalent. It is because the operatives are overworked and hopeless of any change for the better Religious appeal is of little avail witiiout some other aid-or if effectual at all, will be so only as it is addressed to those ex- pecting soon to die. Christian consolation 2s lest administered to sufferers of this class by those who have been subject to like hardships--the poor are the best alleviators of the poor. The general habit of mind induced by poverty and hard work, is disbelief of divine goodness and distrust of human ostentation of benevolence. Modern civilization has developed charity for the destitute, as is shown by hospitals, asylumns, and even by our prisons,-but the evils to be contended with are also vastly increased by the overer, wding of population-especially in large cilVies. * * * 3. Another class of men have a sensitive organism, the usual adjunct of an emotionr1 temperament, or have great intellectuai power which constantly overtasks the bodily capacity. The first is the case of genius in poetry, music, and the like-there must be reaction after great exaltation--call it effort or imspi.ration. There is a collapse-a sense of feebleness-which is unendurable. A stimulant will rouse energy-who will be so rigid as to say there is not some excuse for resorting to such artificial aid ? That it is exhaus- tive and will in the end be fatal to the natural powers of the mind, is well enougli known by those who judge by statistics -but no amount of proof will convince one who is in a syncope and can get present relief even if it be in a mode prohibited by hygienic science. There is a tradition that Shakespeare died prematurely from the effect of convivial habits; this is not sufficiently proved-in fact we know little of bis private life at any period, and more especially after his retirement from the stage. We may follow this out in men of great intellectual power in other pursuits. An ardent devotion to science is exhaustive. There is no alternative but entire abstinence or",
         "THE SANITARY JOURNAL. habitual and in the end excessive indulgence. Great philoso- phers have usually been absteinlous; but they have also been much secluded from the world. The seclusion referred to, was rather privacy-exemption from interruption or intrusion; and it is certain that con- tinuous labor is better endured than irregular efforts. We know now unrmistakably that the great novelist of cur own time who enchanted the world by a power that like Shakespeare seemed e if inspired.-certainly underived from culture-died prenaturely from inebriety at an age but little beyond that of the renowned dramatist.* Can it be justiy argued from such examples that genius derives 'rny of its inspiration from this self-consuming process, or that in any sense this artificial stimulatioA of forced effort is a refocalization of mental vigor. This would be unwar- ranted. On the contrary, the law of nature is that all human excellence is by normal development froin a germinal element. The grand conception of the intellect and the splendor of poetic imagery and diction, must cone from the mysterious, perhaps heaven-born power of the soul in the exercise of its natural functions. No pronethean fire can be brought down in aid of this congenital endowinent. From this source has been derived all that is left to us by human genius. It is only when the natural powver bas been overtasked that the auxiliary has been thought needful-but whatever has been then produced is only by an enforced effort of nature wasteful of its inherent vigor, Great thinkers, or men of great intellectual endowment of any kind, brought into public life, have often fallen victims to too great pressure. Mr. Pitt was undoubtedly intemperate, but in an aristocratic style. Sheridan, who deserves a much higher estimate than that of a mere rhetorician, as he has been conmonly rated-who was in fact a, man of great ability, while he was most affluently gifted w th oratory and colloquial wit, became an inebriate. Our own country has furnished memorable instances of the wreck of statesmen. Who will fail to call to mind as chief in this sad category, the great Massachusetts senator-in inteillectual power never surpassed-but weak in moral resolution to resist sensual pro- clivities. There seems to be a tendency La political life to the sin of intemperance. Our Federal and State Legislature give testimony to this. The present is all-the future is uncared *Dickens ,ied at the age of 56; Shakespeare at 53.",
         "PHYSIOLOGY OF INTEMPERANCE. for. Douglass almost achieved success in his mad effort to gain the Presidency, but obtained instead a drunkard's grave. Poets and other imaginative writers have been prone to physical stimulants These cari not be said strictly to have been overtasked-that is to say not by any continuous labor- their phase has rather been that of irregular activity alter- nated by apathetic depression. If we confine our observation to men not of great celebrity, we shall still find tlhat whoever is overtasked-whether it be by labor too long protracted or by an effort exceeding what bis natural power is equal to, will be likely to resort to artificial aid. 4. Lastly, there is a class who are led into intemperance by mere conviviality. Such men are usually endowed with con- versational attractiveness, and whether they are guests in a private circle or attend the more sensual entertainment of pub- lie dinuers, or becoine the oracles of the club or of the bar-room, the temptation is Qe same. A reputation is to be maintained; where the spirits fla, artificial aid must be used-at least so thinks the brilliant talker or speech-maker, when he is not in his best niood. We have touched upon all the predisposing causes of intem- perance. The lesson to be deduced is, not so much how to re- form (thougI-. this should be sought as far as practicable) as how to guard against the evil in its inception. We conclude with the following aphorisms, which are of generai application-perhaps h yg ieoic rather than roral-but calculated to secure as well eficiency of mind as body--rnens sana in corp,ýore sano. lst. Let every man use the powers which God bas given him strictly in accordance with their natural scope, and be content with that measure of active efficiency and influence appertaining to these powers in their healthful development. To aspire beyond this is to attempt rashly a scheme of life not designed for him, and which if pursued, will be abortive and likely to end in misery and vice. 2nd. Avoid all resorts to artificial aid for the purpose of obtaining a temrporory vigor, either of mind or body. Any thing beyond the natural supply of force by the aliment of healthfui food, only reacts and is followed by depression. Es- pecially is this true of alcoholic exhilaration. It may promote convivial wit an.hour or two in the evening, but it makes a dul and ill-natured companion in the morning. For any seri- ous and continuous labor it is as unfit as thec running of a horse 1p hill in order to get greater impetus-a forced effort result- ng in a more speedy exhaustion.-S'anitarian.",
         "THE SANITARY JOURNAL. MENTAL CULTURE. BY NATHAN ALLEN, M. D,, LL.D. In the advancing knowledge of physiology it has been dis- covered that all mental culture should be based upon the brain-that education should be pursued in harinony with the aws of life and health, and that where these are violated, the advantages of the former afford poor compensation. For- merly, no attention or scarcely any vas paid by school boards and teacher, in the matter of education, to the condition of the body or the developinent of the brain, and even at the pre- sent day very little is paid them, compared with what should be given those great physicial laws which underlie all mental culture. The lives of a multitude of children and youths are sacrificed every year by vicliating the laws of physiology and hygiene, through mistaken or wroing methods of mental train- ing; besides, the constitution and health of a multitude of others are thus impaired or broken down for life. Nowhere else in society is a radical reform needed more than in our ed- ucationai systems. Inasmuch as the laws of the body lie at the foundation of all proper culture, they should receive the best consideration. But in educating the boy or girl, from the agi of five to fifteen, how little attention is given to the growth and physicial changes which necessarily occur at this most important period of life ! The age of a child should be considered; the place of schooling, the hours of confinement and recreation, the number and kinds of studies, together with the modes of teaching. should all harmonize with physical laws-especially those of the brain. The system or mode of treating, in education, all children, as though their organizations were precisely alike, is based upon a false and unnatural theory. Great injury, in a variety of ways, results from this wrong treatment; in fact, injuries are thus inflicted upon the sensitive organizations and suscep- tibl9 minds of young children, from which they never recover. That many of our most independent and clear-hec led educa- tors themselves express so muchl dissatisfaction with the work- ing and results of our schools, affords evidence that some- thin.g is wrong in the present system. As we contemplate the great improvements made in education for the last thirty or forty years, aud are surprised that educators were content to tolers.te the state of things then existir :o will the next gen- tieration, when still greater and moûi dical changes shall",
         "MENTAL CULTURE. have been introduced, look backwith astonishment at this gei- eration, and wonder that it was so well satisfied with its own methods. When our educators becoine thoroughly convinced that physical Cevelopment as a part ofeducation is an absolute ,ecessity-that a strict observance of the laws of physiology and hygiene is indispensible to the highest mental culture, then we shall have vital and radical changes in our education- al system ; then the brain will not be cultivated so much at the expense ofthe body, neither will the nervous temperament be so unduly developed in proportion to other parts of the sys- tem, now so often bringing on a train of neuralgic diseases which cannot easily be cured, and exposing the individual to the keenest and nost intense suffering, which all the advan- tages of mental culture fail, not unfrequently, to compensate. The more this whole subject is investigated, the more rea- son we shall find for making allowances, or some distinction i. scholastic discipline, with reference to the differences i or- ganiza.tiî.\u003en of children, and for adapting the hours of confine- ment and recreation, the ventilation and temperature of school-rooms, the number and kind of studies, the modes of teaching, etc., to the laws of the physical systcn. But anoth- er and still more important change. must take place. Some time-may that time be not far distant-there will be a cor- rect and established system of mrfental science, based upon phy- siological lawrs; and until this era arrives, the modes and meth- ods o\u003c education must remain inconiplete and unsatisfactory. The piinciples of this science, in the very nature of things, must rest upon a correct knowledge of the laws and functions cf the brain; and until these are ý:orrectly understood and re- duced to a general system, all education must be more or less partial, inpeifect and empirical.-Santaran. THE LFFECTS OF WOnr.-That the effects of worry are more to be dreaded than those of ,impie liard work is evident from noting the classes of persons who suffer most from the effects of mental overstrain. The case book of the physi.cian shows that it is the speculator, the betting man, the railway manager, the great merchant, the superintendent of large Man- ufacturing or commercial works, who most frequently exhibits the symptoms of ceberal exhaustion. Mental cares accompani- ed with surpressed emotion, occupations liable to great vicissi- tudes of fortune, and those which involve the bearing on the inind of a multiplicity of intricate details, eventually break down the lives of the strongest.--Chambers' Journal.",
         "THE SANITARY JOURNAL. VACCINATION ;--THE COMPARATIVE MERITS OF LYMPH AND THE DRY CRUST. (BY JOHN MORRIS, M.D., BALTIMORE.) , As the public journals announce a new outbreak of small- pox in the city of New York, and as its appearance there is generally a fore-rinner of zn epidemie throughout the coun- try, it would be well to consider all the causes that lead to its developement and the best means to prevent its dissenina.- tion. Our experierce of small-pox epidemies is tbat the German and Irish, vaccinated in the European mode, are principally the sufferers, and though there is a great deal of careless vac- cination practised in the United States, we suffer greatly less than the people of Europe from invasions of small-pox. The great difference that exists in the views and practiÀce of the profession in this country and Europe in regard to the proper plan of vaccination, bas not heretofore *3een a subject of investigation, nor bas it excited the interest which, in our judgment, it justly merits. It is time that this matter should receive the attention of the profession; and our European brethren, in view of the dreadful epidemic which has for the past three or four years ravaged the continent, would do well to make it a subject of inquiry, and sec if there be not some defects in their present system of vaccination which inay be remedied. At the outset, it may be premised as a fixed fact that a true vaccination is a certain preventive of variola, and'that an out- break of small-pox can only spiiug from defective or iniperfect vaccination. No medical man of education and experience doubts this proposition. This being admitted, il becomes our duty to see that the fullest extent of protection is secured to the community by the enployment of the best and surest neans of vaccination. There are three forms of vaccination at present employed: first, animal vaccination; that is, with virus taken directly from the heifer. Second, human vaccination, as practised in Europe, in the form of fresh lymph taken from the vaccine vesicle, at an early stage of its development. Third, human vaccination, as practied in the United States; that is with virus taken from the dry pustule or crust. As it is our purpose in this paper to discuss only the ques- tion of vaccination by liquid lymph and the dry crust, we shal say nothing in regard to animal vaccination. The thorough",
         "VACCINATION. examination of its merits and deinerits, brought about by the late epidemie of small-pox in Europe, has given every one an opportunity of judging of its efficacy or usefulness, (we may however, remark, en passant, that in this country it has gain- ed no new adherents). The two forms of human vaccination, then, are only to be compared and discussed. Our own exper- ience favors the employment of the dry crust, as practised in the United States, for reasons to be adduced. It is not generally known that there is a very marked dif- ference in the character of the disease produced by the two forms of vaccination, so marked as at once to enforce the most earnest enquiry. The stages of the vaccination are entirely different in the two modes, and the growth of the vesiCle and the period of maturation are entirely dissimilar. In vaccina- tion with liquid lymph, the vesele begins to form on the th'rd or fourth day, and the areola ou the fifth or sixth day ; in vac- cination with the crust, the vesicle does not commence to forin before the seventh or eight day, and the only evidence to be discovered before that time of tihe virc having taken is a few small inflamrnatory points, which make their appearance about the fifth, sixth or seventh day. (The later these points begin to show, the better and more effective is the vaccination). A careful observation of two vesicles produced by the two me- thods of innoculation will demonstiate that the pustule produe- ed from the dry crust possesses different elements of action. and yieids different physiological results. In vaccination with the dry erust, the vesicle does not begin to form, as already stated, before the seventh or eighth day, when constitutional symptoms first become manifest. These symptoms are more gerieral and better mnarked, though the local irritation is not greater than in vaccination by lymph. The true characteris- tic areolar test is always to be discovered when the crust is used, but in the case of lymph, particularly when it is taken. îrom the arm at a very early stage, it is not always to be found, a starved, over-inflamed vesicle taking its place. The matura- tion, too, of the vesicle is different. In vaccination by lymph, the pustule desiccates and îalls off about the fourtanth or fìf- teenth day, or earlier; whereas with the crust this dues not usually take place before the twentieth or twenty-first day, and then freqaently the crust bas to be removed by the opera- tion. The cieatrix, too, is different in the twoforms, and this is importent, for its distinctive marks are always held as a guide to and test of a true vaccination. When the crust is used, we have a deep, cup-like, foveated, indented cicatrix,",
         "THE SANITARY JOURNAL. Wh1en lymph is em1lployed. the indentation is 'uperficial, and the other test marks frequently wanting. Having Lhus stated the difference observable in the two formus of vaccination, we now proceed to give the reasols for our preference for the dry crust. 1. In vaccination withi the crust, particularly if done by scarification, failures are infrequent, indeed exceptional ; where- as with lymph they are exceedingly commion as any one who has read the English medical journals for the past five years cannot have failed to discover. 2. Lymph virus deteriorates more readily and is . \u003et so eas- ily kept as the crust. Dry lymph, when used front tubes or pu.nts, ahnost invariably fails. There cau 1,e no doubt about the deterioration of lymph. Dr. Short, the Superintendent of the Madras Presidency, in au article in the \" Madras Journal of Medical Science,\" says that this fact is evidenced by the more rapid course of the vesicles and the occuri-ence of exten- sive local irritation. 3. Lymph taken from the arm at au early stage of the vac- cine disesse, before fever lhas sut in or constitutional symptoms have fully manifested theinselves, does not contain those mnor- bitie elemenits ncessary to proteet the system fron variola; whereas in the dry crust these elements are found iii an active and concentrated form. If this view be correct, it aflords an explanatiou of the European system of vaccination. In Eng- land they take lymph fron the arm hefore the a-cola com- mences to foi.n, indeed frequently aq farly as the fourth or fifth day. Doctor De Hovel, in a communication to the \"Lan- cet,\" says the earier the period the better: and in the instruc- tions published by the Lords of Her Majesty's Privy Council for the guidance of the piofession, we find the following clauses: \"7. Take lymph on the day week after vaccination, at the stage when the vesicles are fullv formed and plmnp, but when there is no perceptible conmencement of areola.\" Clause \" 8. Consider that your lymph ought to be changed, if your cases, at the usual time of inspection on the day week after vaccination, have not, as a rule, their vesicles entirelv free from areola.\" Here then the old-fashioned, mch-prized areola test, to which Jenner himself attached so much import- ance, is not only iginored but condemned, and a vesicle select- ed concerning the character of which there can be no certainty. In Paris, the employinent of lymph furnished by M. Lanoix, during the late epidemic, proved ahnost an absolute failure. and even pure tnimai lymph was unsucces.,fulin twelve of thir-",
         "VACCINATION. teen cases vaccinated by Doctor C. Paul, at Hospital Beaujou. 4. Sequehe of an unpleasant character frequently follow lymph vaccination ; whereas with the crust they are excep- tional. In three thousand cases of vaucination by the crust in our own practice, only one singie case of local irritation of an unpleasant characr occurred. This point is not sufficient- ly regarded. Evidences of an unhealthy condition of the vae- cinefer's system can be readily detceted by a careful examina- tion of the growth and maturation of the pustule ; but where lymph is taken from the arm at an early day, no such evi- (enccs can possibly be diagnosed. 5. Vaccination by lynph does not protect the patient, but necessitates a re-vaccination; whereas a true vaccination bty the crust affords thorough protection. lu a late number of the \"' Lancet,\" the editoî says, that re-vaccination is urgently necessary ; and Mr. Marson reports that in 751 cases admit- te(d to the small-pox hospital, 618 or 82 per cent, wcre in vac- cinated persons. We are convinced that no such result could follow in this ccuntry. A genuine vaccination lere, in our judgment, affords as mîuch protection as viriola itself. The reasons that have been urged agaist the em.lovment of the crust are very trivial. The theory that blood nay be taken up aud constitutional diseases propagatcd by its use, as suggested by Doctor Anstie, is cntirely groundless, as is also his view in regard to the danger of pus. Doctor Blane's arguments in favor of animal vaccination and the reasons he urges for the use of lymph from the heifer, in preference to humanî lymph, (10 not apply to the crust. None of the evils lie attributes to human vaccination are to be found in the American mode; but as animal vaccination itself has been in some degree a failure, and has, at times, some unpleasant consequences attendant upon its use, we cannot accept it in lieu of the crust, which bas proved so generallv serviccable in this country. It nia possess advantages over human lymph, but the crust is superiol to both. The history of the late epidenic of small-pox in Baltimore confirms the truth of these vies. * * * One word il conclusion, iii regard to the n-unber of punc. tares or vesicles necessary to protect the patient. In Europe, as we have already seen, three or four are usually made, but with us, one is found to be suflicieut. From it w~e get all the constitutional effect necessary without any undue local irrita- tion. Jenner and his followers made but one puncture, and we are content to abide by the decision and practice of the early fathers.",
         "TiE SANITARY JOURNAL. EXPERIENCEsor F OCTORs.-Enricus Cordus, tiree and a half-centuries ago, thus recorded his experience in the heali!g art: \"Tres medicus facies habet : unam quando ragatur, A ngelicam; mox est, cum juvat, ipse deus. Post ubi curato, poscit sua premia, morbo, Horridus apparet, te-ribilisque Sathan. (\" Three faces wears the doctor: when first sought, An angel's;-and a God's, the cure balf wrought; But when, that cure complete, he seeks his fee, The devil looks less terrible than he.\") Pope, thougli not a physician, sang in a like strain \"God and the doctor w c alike adore. But only when in danger., net before The danger o'er, both are ahke iequited. God is forgotton, and the doctor slighted.\" Dr. Clarke, of Princeton, Ont., last year, iin the Canada Law:et, writes :-\" The public is far from being grateful to its best benefactors, but an approving cOnscience is lever unkind. We are appealed to with great fervor when danger is near, and a strong afiection is apparent when disease, or it may b death, is tugging at tie heart-strings ; but when rosy hcalth returns, in many cases sarcasm, irony, and often bit- ter invective take the part of eudearing epithets and words of eternal friendship, especially withe bills are presnted.\" PROPAGATION OF SCARLET FEvER.-The Medical Press and Circular (London, Eng.,) for Septeinber, alludes to a report presentec at the last meeting of the Linolin Board of Guar- dians, by Dr. Harrison, on the above subject. In the course of his remarks, lie said that \" he looked upor village sehools as thbe centres of contagion of scarlet fever in the rural dis- tricts, numbers of cases lie had enquired into having been sent home ilil from school. -Te thought those wbo had the authority to close schools during harvest time should cer- tainlv ex-reise their power, and close them during the preva- lence of contagious fevers.\" \"There needeth not the heUl that bigots frame To punish those who err; m:an in himself Contains at once the cvil and the cure: And all-sufficient nature can chastise Those who transgress her law%-:-she ,nly knows How justly to proportion to the fault The punishment it rnerits.'",
         "THE SANITARY JOTiRNAL, DEVOTED TO PUDLIC HEALTH. VoL.. I. ToRONTO, NOVEMBEF 2ND, 1874. No. 3. SANITARY REFORM. In another part of this number may be found a commu- nication touchingupon Sanitary Reform and the establishment of a Bureau of Sanitary Statisties. The work of Sanitary Re- form-the creation of such a Bureau being regarded as the first step-is certaiuly one of the most important which the Government of the country could enter upon. The expense it would involve would not equal the expense to which its neglect gives rise, and might be paid out of the funds which are now employed for the relief and cure of disease arising from preventable causes, and for the temporary relief of poverty and the punishment of cr:ime arising therefrom. This con- stantly recurring sickness and consequent impaired health gives origin to a feebie population and to more misery and suffering, mental and physical, more degradation and crime, than perhaps any other cause; niot even excepting intem- perance. For who can know the amount of intemperance to which a neglect of sanitary administration gives rise? Who can ever know of the thousands who in cities and towns leave their squalid and wretched abodes of misery-rendered squalid and wretched by accumulations of filth, by foul air and absence of sun-light-of the depressing and degrading effects of which they are probably for the most part in ig- norance-and seek temeporary relief, momentary comfort, and perhaps semi-oblivion, in the stimulus afforded by alcohol. B' 'ding in the work of sanitary reform, those who are",
         "THE SANITARY JOU'RNAL. working so hard and so nobly against intemperance would render valuable assistance to the temperance cause. Toc oftenand too eonmonlyis intemperance regarded as the cause. instead of thie effect, of the unhîappiness and tilth, and con- sequeint sickness, in the uve2rerovded, ill ventilated, and dark abodes of the poor and degraded. A properly organized II:lth Board could reniove these causes, pruvunt thlese dire effects. Wc have our Boards of Health. Whurefore ? What do they accomplish ? The Lieutunant-Goverior may by proclamitionestablish a Central Board of flealth vhnuever the '\" Province or a pari thereof appears to be thruatened with anv formidable epidenic, endmuinie, or contagous disase.\" until it appears wu are threatenud witi such calaimities ? Butter of course to have it evn then tha-n not af a!!. Bu3t it m ht then be alno\u003cL t\u003c ' late for such a Board to act efficaciousiy. Though the eow iant an rmlanent existence of a Central Board of lealth wolld not be able to prevent us being threatened froi withoit the Irovinic. or ev n invaded, by formidable pidmic or contgiou diseases, it minght do verv much in tii way of rendering thi ;r effects îmuch less serious than thev otherwise would be, and very greatly diminish the amount of endemllic disease. If it could be made as effectuai as such Boards are found to bu in certain of the United States-Massachusetts and Minnesota for example-it could at last reduce the average sick rate as mnuch as one-fourth, and the average death rate as mnch as one-fifth; and reiuce the infant mortality one-third, while increasing the health and vigor of ofpring. SHADows FROM THE W.-,LLS OF DEATH.-At the Quarterly Meeting Of the Michigan- State Board, in July last, Dr. Ked- sie presunted sp-eimens of arsenical wall-papers, from various sources, which le had appropriately insciibed \" Shadows from the Walls of Death.\" One square foot of surface of one sample of the papers presented contained 1-16 gr. of arsenic. Hle cited several cases of poisoning from such papers.",
         "BED-ROOM VENTILATION. BED--ROOM VENTILATION. Next in importance to the ventilation of school-houses -a subject noticed in the September number of the SANITARY JOURNAL-iS the supplying of bed-rooms with abundance of fresh air. A large portion of life, nearly one-third, on an average, is spent in the bed-room. During sleep, too, the power of the system to resist the effects of morbific influ- ences is less than at other times, when the body is in a state of greater or less activity, hence there is at that tiîme a greater necessity for carefully avoiding all exposures to insanitary influences. The dulluess, headache, and want of appetite so common in the morning, especially in those who are not vigorous, are usually caused by sleeping in small, badly ven- tilated rooms, and re-breathing, over and over again, the same atmosphere. Some persons, without knowingwhy, have an unaccount- able horror of night air. But it is necessary that it shall be breathed, the whole animal creation breathes it, and the only way in which we can avoid it is by shutting ourselves in perfectly air-tight rooms. These, in order that each indi- vidual shall be provided with a full supply of tolerably pure air, should have capacity for from 20,000 to 25,000 cubie feet per head, or about 3,000 cubic feet per head per hour. This would render it necessary for our bed-rooms to be dt least ten times the present average size. It may be asked, how is it that so many live through the night shut in seven by nine rooms ? It is because such rooms are far from being air-tight. A certain amount of freslh, cooler air is constantly entering through cracks and crevices about windows and doors, while the fouler, warmer air is forced out through other cracks and crevices. But this is very far indeed from being sufficient. The area of inlets for the admission of fresh air, according to Dr. Parkes, should be about 24 square inches per head, in ordinary conditions of the atmosphere. Though obviously the size must vary soiewhat with atmos-",
         "THE SANITARY JOURNAL. pherical vicissitudes. The area c: outlets for the fou! air should be about the saine. Where special ventilating apparatus is not provided, tolerably good ventilation may be obtained by ilowering the upper sash of a window a little.and raising the lower sash, thus providing inlet and outlet. The bed should not stand too nicar and directly opposite the open window, or in a cur- rent of air which would be distinctly perceivable to the oc- cupant. During the day, the bed-room and bedding should be thoroughliy exposed tu fresh air by the free opening of doors and windows. BLOOD AS FOOD. It appears somewhat strange, in this age when almost everý thiig is utilized to the highsc-t degeee, that some means lias not Leon devised whereby the rejected blood of slaugitered aiiinials might he brouglit into more general use as food for man. From oie-fifth to onc-fourth part of the nutrient matter of all animails Flaughtered for the purposes of food is now actually thrown away in the form of blood, and becomes a source of pestilential developement. According to Pareire, blood is about equal in nutritive value to flesh, with which it is almost identical in cliemical composition. It is a constituent to a limited extent of the qesh of animals, and by many is partaken of in this way, or when having escaped from the eut in serving, with particular relish. In some parts of Europe, the blood of the pig is mixed with fat and aromatics, pressed into the prepared intestines, and sold in shops under the name of \" black pudding.\" Does this waste of valuable nutriment arise entirely through prejudice? What other reason can be given for refusing to use as food that blood which just at the moment of death clianced to be flowing in the larger blood-vesseis, while mo:t of that in the smaler vessels throughout the flesh is caten ? If some such means were now employed to re-",
         "BLOOD AS Fool. move all the blood from the flesh, as was by the Jews, it appears, under the requirements of the Mosaic law,-such as first placing the flesh in water for half an hour, thon for an hour in salt, and finally washing it thoroughly with water* -it miglit be supposed that the law of the Old Testament still exerted an influence in this way. If some process could be devised whereby the whole of the blood could be converted into palatable and wlolesome food, the disposal of the refuse of slaughter-houses-about which there is so inucli discussion-would be considerably simplified. DiSPOSAL OF STREET REFUSE. On the disposal of refuse in this city complaints have recently appeared in the Toronto Globe, and certainly not without just cause. It is not easy to conceive of anything more disagreeable aud unwholesome than to have deposited in the vicinity of one's dwelling-under oue's nose-the filth of the streets and lanes, and apparently more plausible and just grounds of actions for damages against the city are thereby created than soie of those upon which actions for damages are sometines based. When the price of manure is taken into consideration, one ewould suppose such refuse would be worth more to the farmers and gardeners in the immediate vicinity of the city than the price of carting it onto the farms and gaidens. Whether it would be or ne, there is no doubt that tue cost in health and life of having it deposited in proximity to dwellings will far exceed the cost in dollars and cents of having it removed a safe distance from inhabited localities. But the point to -which we wish to draw attention is that relating to the improvement (?) of property by filling cavities upon it with this garbage. This is evidently the view of thosewho own the property. But we had hoped the time had arrived when the depositing of such * Allen, in Modern Judaism.",
         "THE SANITARY JOURNAL. matter ùpon land would not only not enhance the value of the latter in the eyes of an enlightened people, but on the contrary, w'ould be regarded as a very serious damage to it for a very long time to cone. Nor do we believe that the mixture of any amount of earth with such garbage would ever render it entirely innocuous or unobjectionable as a site for dwellings. Perhaps it is supposed such improved (?) property would answer for tenement houses. But where is the man who would be willing to have a dwelling-house built upon such filth,-however much it miglit be disinfected with earth -for himself and his family to live in;,-to have bis bed made, to lay himself down to sleep, over such corruption ? \"In towns,\" says Dr. George Wilson, in his \" Hand-book of Hygiene,\" \" a great evil sometimes arises from building on rubbage containing vegetable matter which bas been used to fill up excavations.\" Mr. Crosby reports that a high rate of mortality in the town of Leicester during the autumnal months, was chiefly due to annual visitations of in- fantile diarrhœa which prevailed in parts of the town built on such refuse; and distinctly attributes the disease to this cause. The evidence of Drs. Parkes and Sanderson points clearly to the conclusion that soil of this sort is objectionable. DANGER AND DEATH IN THE MILK CAN. Milk is almost as universally used as water. Almost every farnily is supplied with a greater or less quantity of this fluid. In cities and Lowns, especially during the winter season, the cows which furnish the inilk supply are frequently kept in filthy, badly ventilated stables, deprived of sunlight, and often improperly fed. Under such circumstances it is utterly impossible for the animals to be in a healthy state, and equally impossible for them to yield inilk fit for buman consumption. It is well known that diseased conditions of the female supplying the milk has a marked efflect upon the quality of",
         "DANGER AND DEATH IN THE MILK CAN. this fluid. Tuberculai consumption., for example, greatly increases the proportion of calcium phosphates in it-even to seven times the usual quantity. Milk from diseased cows is sonetimes characterized by a want of homogeneousness and by inperfect liquidity, and also by its manifesting under the microscope certain globules not found in healthy milk. From a dietetical or a sanitary point of view, this subject is of very grave importance indeed. Pure cows milk is of a full white color, perfectly opaque, not viscid, but quite liquid and homogeneous; it is free from any peculiar taste or smell. is without deposit or sediment on standing, and is neither acid nor alkaline; it should yield from 6 to 12 per cent. of cream by volume, and have a specific gravity of at leasi 1.028 ;-if it falls to 1.026, it shows either that the milk is very poor or that water has been added. Dr Letheby gives the following table as indicating approximately the proportion of water-adulteration according to the specifie gravity and percentage of cream: Specific Percentage volune Specific gravity gravity. of cream. when ski mmed. GENUINE M.K. . . .......1030 12.0 1032 Do with Io \u003c water. 1027 ro.5 1029 Do \" 20 1024 8.5 1026 Do \" 30 \" 1021 6.o 1023 When the milk is largely diluted with water, other substances, as chalk, turmerie, salt, \u0026c., are frequently added to improve the appearance and flavor. The use of a tall, graduated glass vessel to determine the percentage of cream, and of a lactometer to ascertain the specific gravity, will usualy enable any one to form a reliable opinion as to whether the milk is or is not genuine. While the manner in which the cows are kept-as regards their housing and the nature of their food, together with the use of a microscope of sufficient power, will indicate the degree of its exemption fron the effects of disease. That specifie disease is sometimes spread through the agency of milk, can scarcely be doubted. In the London Lancet (1870) an outbreak of scarlet fever is noticed, which",
         "THE SANITARY JOURNAL. oecuried in St. Andrews, in which it was conclusively shown that the contagion was distributed either by the milk carrier, or, more probably, Ly means of the diseased cuîticle fron the women and children, who vended the iilk, actually passing into it, and being with it introduced into the system. An outbreak of typhoid fever is also recorded in the Laqicet in the sanie year, which was attributed, by Dr. Ballardl, to the wasl- ing of the niilk-cans with water obtained friom a tank which communicated, through an old drain, with the pipe of a water closet. It was not ascertained that the milk was adultcrated vith the saie ,water, but such may appear probable. In the British Medical Journal (1870) an account, is given of an ontbreak of typhoid Lver in which the specific poison was introduced into several families through the agency of con- taminated milk. More recently, (173), Dr. Ballard, Hcalth linspector to the Government Board, grives The history of a similar outbreak iii the village of Armly, in which there was no room to doubt that the fever was propagated through the agency of nilk. The origin of outbreaks of epidenics of enterie fever at Brighouse and Wolverhanpton, have been traced to the milk supply. At the latter place, the water supply of the farn furnishing the nilk vas obtained fromt a sewage poisoned well. In the Canada Lancet mention is made of a sonewhat severe epidemie of typhoid which last year made its appearance in London, Englaud, in parts usually exempt froin the disease, such as Grosvenor and Cavendish Squares, Hyde Park Garden, and St. John's Wood. Between forty and fifty families were attacked, including those of many eminent inudical men. The imajority of cases occurred anong nursery children, who partook of mnilk fron a certain dairy,-forty of the families being sdpplied by this saie dairy. Dr. Murchison suspected the milk supply, and upon close investigation the cause vs traccable to that and to thtat alone. The w'ater used iii cleansing the milk-cans was highly offensive. Possibly sone of it found its way more directly into the nilk. Many similar cases might be nentioned, but the above suffice to show the great importance of having the milk of",
         "DANGER AND DEATH IN THE MILK CAN. towns ani cities carefully and thoroughly inspected, from its source to its distribution, and the condition of the cows supplying it, and their management, sharply looked after. THE PNEUMATIC SEWAGE SYSTEM. Few (uesti\u003cons have proved to be more difficult of satis- factory solution than that of the best method for the rernoval of sewage from large towns. The water-carriage system was tbought to be the nost complete that could possibly be adopted, but the escape of deadly gases fron the drains into our bouses and streets bas ever been a source of grievous anxiety and a fruitful cause of disease and death. No pro- blem, perhaps, bas given greater perplexity to modern ie- chanies than that of discovering sone efficacious means of preventing the escape of these poisonous effluvia, and the in- genuity of inventive genius bas been alnost exhausted in vain attempts to produce trap-s and valves to comnpletely in- tercent them. A new system-the PNEUMATIC, proposed by Captaini Charles T. Liernur, Military and Civil Engineer, who has had practice in engineering on both sides the Atlantic-is being brought into use in Holland and Austria, and it appears is likely to work very satisfactorily. The pneunatie system \" proposes to draw off fecal matters and the polluted air by pipes connecting with stean-worked air punps. These pumps are attached to air-tight reservoirs be.neath ground, in which, by exhaustion about three-fourths vacuium is constantly main- tained. From these large tanks, pipes are laid along the principal streets, and at intervals smaller street tanks are pIlaced, coin- municating by small,short condu ýts (or pipes,with a sortof valve in each,) with the closets in each house. By partial exhaustion of the air in each of these receptacles for the sewer gas and effete matter without the aid of water to flush the closets, the gas is drawn off from the house pipes and lodged in the main reservoirs, where it is finally disposed of without detriment to",
         "THIE SANITARY JOURNAL. the public health.\" By the use of stop-cocks, this process is also effective in removing the excreta deposited in the house drains. No water is required for flushing the pipes, and it is nid by the use of one-fourth of the water now conmonly em- ployed, the pneuinatic system will do the entire work, and in a muchII more perfect manner than is possible with the water carriage system alone. The city of the Hague, \"after having submitted Cap- tain Liernur's plan tu a committce of professionai iuquiry, resolved at once to give it a fair, practical trial at the public expiense.\" Here, every night a steaim engine comes to the re- servoirs, a vacuum is created in each by an air puimp, and the contents of the house pipes are shot into the reservoirs. When a reservoir has relieved all the houses coinected with it, its own contents, solid, liquid and gaseous, are pumped by steam into a tender attached to the engine. A, fast as these tenders are filled, they are forwarded to the railroad, and their contents are discharged into air-tight casks for transportation to the farmers. Thus, every night the entire city is relit-,ed of its excrets, without disturbance of, or annoyance to, the inhab- tants. The pneumatie sy-tem was tested at the Vienna exhibition last year-being attached to a part of the exhibition building, and was foind to act satisfactorily. It wa- there inspected by the Emperor William, who manifested hi- appreciation of the great value of the process by bestowing upon its inventor the order of knighthood. It has been endo -ed it appears by the International Modical Congress of Vienna, who are convinced, from experiments made in their presence, that \" the entire sys- tem is capable of doing its work completely.\" In Amsterdam and Levdon it has been practically applied to the districts of the poorer classes, whose ranks had been yearly decimated by the poisonous sewer gases incident to the water-carriage sys- tem. It has also been introduced most successfully into the government buildings at Prague, while it has been applied to districts in that city, by a private company, upon the sole con- dition that the company shall have the sewage matter.",
         "AN UNUSUAL DISEASE. One great advantagc which this systein appears to possess is that et absolu te iiidepeiidence of the care (?) of householders and servants; doing its work in spite of negligence or inter- férence. If the systein proves to be as perfect as its advocates claini tliat it is, it certainly oughu soon every where to take the place of the water-carriage system. AN NUUAL DISEASE.--A large number of cases of un- usual sickness are reported- as having occurred at and near four villages situated on the banks of the river Raisin, Mich. Generally, before the attack, the patients complained for about twenty-four hours of being tired and lame, of pain in tie back of the head and down the spine. It usually began with a cold stage or chill. A few of the patients were attack- ed as suddenly as if knocked down. Vomiting was a prom- ment F-nptom before and after the cold stage. About one half of the patients were rational during the course of the disease, wlile some had violent delirium from the commence- ment. There was great tenderness of the body, especially over the deep nerves given off from the spinal column. In many cases the head was thrown back, sometimes to one side. Tie eyes in some cases were effected with squint, and the pupils were usually dilated, with loss of power to wink. In inany cases copper-colored spots appeared on the body. Out of 77 cases 25 proved fatal, and eleven of these died on or before the fourth day of the disease. The water of the river Raisin is quite turbid, and an odor arises from it ss it pours over mill-dams atthe villages. One of the villages is on the site of an old Indian burying-ground, and the best water to be obtained was contaminated with the results of animal decomposition, and, as is suggested, might properly be labelled grave-yard juice. THE AUTHORITIES of the city of Vienna have decided to establish in the cemetery the necessary apparatus for cre- mation, for tLe use of those who prefer this method of dis- posing of the bodies of their deceased friends.",
         "THE SANITARY JOURNAL. MONTREAL SANITARY AsaocIATION -The object of the Sanitary Association of Montreal, referred to in the September numher of the SANiTARY JOURNAL, as given in circulars issued by the Associa- tion, is as follows: \"The study and enforcement of public and private Hygiene, a science the end of which is not only to preserve our citizens from epidemic, indemic, contagious and other diseases which afflict hu- nanity, but also the conservation and development of the physical. intellectual, social and moral faculties of man in his private as well as in bis collective life. To obtain this great and desirable object the association proposes to take into coisideration the following subjects : Civic Cleanliness, Food, Drinks of everv description, Sanitarv Architecture, Epidemic;, Vital Statistics. And in fine everything relative to the preservation of mind and body.\" Provisional Commi/cte-A. H. David, M.D., G. W. Weaver, C. O. Perrault, Robert Thompson, M.D., Edward Stark, N. Robillard, M.D. BOOK NOTICES. PUBuc H EALTH--Hamilton, Ont., Oct. 22nd, 1874.-The Report of Dr. C. O'Reilly, Physician Board of Health. Hamilton, shows marked decrease in the mortality of that city for the quarter end- ing Sept. 3oth, 1S74 ; or 74 less deaths, than in the corresponding quarter of 1873 : Deaths in July, August and September, 1873, 254; deaths in the same nonths of 1874, ISo. The work of removing the accumulations of refuse matter from the streets, alleys and private yards, had been hastened, it is stated, as much as possible, under the direction of the officers of the Board of Health. No cases of small-pox reported in the city, nor has any case been under treatment in the small-pox hospital during the four preceding months. Only four cases of typhoid fever w'ere then under treatment in the City Hospital, three of the number being non-residents of Hamilton, and ailing at the time of their arrival in the city. The want of extended sewer accommodation is said to be much felt in different parts of the city. ELECTROLYSIS in the Treatment of Stricture of the Urethra. By Robert Newman, M. 1). Reprint from the Transactions of the Medical Society of the State of New York, for 1874, p-P. 30, paper. Albany: Charles Van Benthuysen \u0026 Sons. This is a valuable and interesting contribution on the above sub- ject. The author appears to have had an extensive practice in the treatment of such diseases, and gives notes of numerous cases. The treatment appears to have been remarkably successful in his hands, and the modius operandi of it is given. The book ought to be in the hands of every practicing physician."
      ],
      "published" : [
         "[Toronto? : s.n., 1874]"
      ],
      "identifier" : [
         "8_05173_3"
      ],
      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 1, no. 3 (Nov. 1874)]"
      ],
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         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine"
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         "text"
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         "eng"
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      "note" : [
         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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   "doc" : {
      "type" : "document",
      "title" : [
         "Public health magazine [Vol. 1, no. 9 (Mar. 1876)]"
      ],
      "published" : [
         "[Montréal? : s.n., 1876]"
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      "identifier" : [
         "8_05170_9"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PUBLIC HEALTH HIAGAZINE. VOL. I.] MARCH, 1876. [No. 9. SEWER VENTILATION. Paper read before the Public lealth Association, Friday, Dec. roth, BY DR. F. RouIZX. Mr. President and Gentlcmen:- The subject I propose to introduce to you to-night, is one that has occupied the attention of the scientific world for many years, and one w hose extrt me importance has forced itself upon the thinking meds of this community, namely: SENwER VENTILATION. The evil effects of sewer gas are so patent to every novice in sanitary science, that it would be superfluous to refer to them. My object is to expose to you a plan of sewer ventilation, which, I dare believe, is an improvement on any of the systems already tried in Europe; and which have been so productive of good in the saving of human life. To render this ;mprovement intelli- gible, and capable of being estimated, it is necessary to refer briefly to some of these schemes of which I have just spoken. Nearly all these projects had for their basis the traction, or the vIcuum principle. Th,.- ventilating shaft, with or without fire ; the furnace ; the Archimeclian screw with the revolving cowl; the chimneys of factories ; the clock-ton ei of the iiouse of parlia- ment, the street lamps; the rain water pipes fromn the eaves of houses, Mr. P. Spencer's system of combining sewers and flues,",
         "PUBLIC HEALTIl MAGAZINE. by whichl smoke from houses might be carried througlh the severs to some gigantic chimneys; Sir. G. Gourney's steain jet principle of condensation-all these have had their advocates, and, in time, none have been found adequate, and soie have been con- sidered little better than worthless. The ventilating shaft has its imperfections. In summer, when ventilation is so much required, the temperature witlin and without the shaft, as oftentimes so nearly equal, that little ven- tilation cani be effected ; and even in winter, when these con- ditions are so favorable to ventilation, the aqueous portion of the sewer gas, meeting with the cold air and the cold surface of the pipes, becomes condensed. and is again returned to the sewer. The chimneys of factories were condemned, on account of their not bring available except on working days, and, moreover, as their effliciency as chimneys would be affected. The furnace was disapproved of, on account of its enormous expense, and its in. fluence being limited to a short distance. The Archimedian screw attached to the revolving cowl, removed only twenty per cent. sewer gas, and, according to Baldwin Latham, is more of an impediment than assistance in this respect. Sir G. Gourney's steani jet condensing principle, was tested by Mr. Nicholas Wood, who founid it inferior to the furnace. The terrible mor- tality of Croyden* illustrated the dangerous effects of using the rain-water pipes for ventilating purposes. But since t has been demonstrated that the power resulting from the combustion of one pound of coal, would give more ventilation than thirty-eight or fifty potinds consumed in the ordinary way, the mechanical means should bu preferred. The use of exhausters, driven by stean power, for the ventilation of sewers, was first tried iii Paris and Antwerp, and thought worthy of a Parliamentary in- vestigation. This contrivane consisted in placing large fans as exiausts within the main sewer itself at its outlet, the drains and gratings being all trapped, and having m.erely openings at the ex- treme ends for the admission of fresh air. This proved unsuc- cessful, as vas shown by the evidence of Mr. G. W. Bazalgette, C B., and Mr. Haywood, before the Parliamentary Committee. First, on account of their not being able to render the sewers air tighît, because the opening of a bouse trap, the putting-in of a",
         "SEWER VENTILATION. drain, or the accidental openings of a thousand kinds, which may occur iii a large city, would render thern inable to exhaust beyond these openings. But, supposing that the sewers were all tight, and that they were not liable to any of these accidcnts muentioned, the area of the main sewer from vhich they exhausted, was a hundred times less than the arcas of the branch sewers ton- nected with it, so that the velocity of ioo miles an hour, in the main sewer, would not secure a current of air a mile an hour in the branches. But there is another objection to this systeni, viz., that after a certain velocity was reached, the portions of traps within the sewers were relieved of a pressure of the atmospheric air, and the outside pressure caused them to untrap themselves, or in other words, the drag wasso great, that it would force open any drain or house trap. The plan proposed will obviate these objections. It consists of an exhaust connected with a pipe which passes through, or above the sewer which is to be ventilated as its size nay determine through which pipe are openings for the admission of sewer gas at sufficient distances, for the ventilation of a given length of sewer, the openings near the exhaust being smaller than those more remote-care, hoivever, having been taken that the areas of these openings are not in excess of the area of the tube itself, ,except the necessary allowance in area being made for friction: For example, in the profile drawing,* the letters A represent the sewer to bc ventilated, and B exhaust pipe above it, with the small tubular openings, C, entering the sewer and through which the sewer-gas is conducted through the exhaust pipe to the re- ceiver, d, and thence to the exhaust D. F represents a gully with grating of suitable size for the admission of atmospheric air, which would have its purifying or oxidizing effect on the decomposing organic substances and reduce them to thîeir simplest compounds. It is evident that, when a partial vacuum is pro- duced in the pipe B, by the exhaust D, a current of sewer gas is drawn to the tubular openings C, in the exhaust pipe, and also a current of atmospheric air is directed from the grating to fil the partial vacuum there proddced. The sewer gas having been 'See next page.",
         "26o PUnrC uInALTH MAGAzIN. Mi 1 moit \\ - e-M M\", z/zG Sus, Im \u003eso ' s Neil LLr 54-A0 IMM, soc p1 j \u003c/~ ' _______sis,",
         "SEWER VENTILATION. conveved into the pipe is carriel to the receiver and exhaust and finallv forced into the furnace G. to he destroved. Thus is the sewer air removed and destroved as it is continuallv diluted and the sewers ventilated and purified. Atmospheric air travels with a velocitv of r,33C feet per second in vacuo, and dense air vill travel with a proportionate velocity into rare air: thus we sprak of so miny pounds vacuum pressure, meaning the outside at. mospheric pressure, or a partial vacuum. Roots' Rotarv exhauster is estimated the most perfect machine j of that nature known. being positive in blast and in many respects superior to the air pump. A No 7 Roots' Rotary discharges 65 cubic feet 'r revolu- tion and makes i o revolutions per minute, consequently dis- charges 9,750 cubic feet per minute and gives an exhaust power of three pounds to the square inch. Let us assme a section for an approximation (making no allowance for friction) say 28 miles of sewers. draining 14 streets on cither side into a tunnel which measuring a mile long, makes in all 29 miles of sewerç. Twenty- éight miles of these sewers are 2 feet in diameter, the area of which is 3.1416, and the cubic contents is 464,450 feet. But these two feet sewers connect with a tunnel, say3 feet bv 4 feet, a mile long, the area of which is 9.4248, and cubic conents 49,767 feet; the total contents is 514,217 cubic feet. But we have seen that Root's Rotary can discharge 9,750 cubic feet per minute, therefore it can discharge the whole contents in 54.45 minutes, and would require 26* horse power. Let a main pipe 15 inches in diameter, or about i foot square, be laid in connection with the tunnel in the same manner as be- fore described To this let there be connected 4-inch branch pipes which connect with the two foot drain. These pipes will permit of openings at intervals of 2zo feet: There would be 23 openings per mile, or 644 openings of 1 i size in these four inch pipes, each opening receiving about 737 cubic feet per hour. In the 15 inc nipes there would be 23 openings of 3¾ diameter connectirg with )e main tunnel. Through each of these open- ings would pass 2,164 cubie feet per hour. The combined areas of the openinigs are in excess of that of the pipes, to make the necessary allowance for friction.",
         "26z PUBLIC IIEALTII MAGAZINE. It may rcasonably be asked is this systei fcasible? Can sewer air be drawn through so many openings? Weil, it is evident that air zan be cxhausted through a single pipe a very great distance; il then the remote end of this pipe is closed and small openings made through it, so that thcir areas will not exceed that of the original opening, it is clcar that these openings will ail contribute air to the exhaust. However, I have consulted some of the first cngineers, civil and nechanical, sonie of the first architects here in this city, and some othcrs whose reputation stânds high abroad, and they have declared it fcasible, and one stated that lie judged it the only fcasible 7manner of efectually removing sewer gas. But sonie may say, is it possible to exhaust sewer air at such l distance as necessarily exists in a large- citv? Yes, the san t power that is used in the Pneumatic telegraph-that conducts letters, papers, and packages through a net work of tubing over a large city-the sane power that enables Capt. Liernur, as stated in the Lendon Halit _ournal, treating of the sewerage system in Holland, to exhîaust fecal matter through five inch pipes at inter- vals of 4,800, 8,6oo, and 12,000 feet, (and now at Amsterdam they have laid tubing 27,900 fect), yes, the same power should be able, if judiciously used, to remove sewer gas with case fron any distance in a city. Next comes the important question of cost, which should not be considered alone without comparing it with the enormous ex. penses attending the other systems to which I have above referred. Any estimate of the actual cost without measurements, must be defective; however, it is not necessary to enter here into a detailed account of the expenses - this is more the duty of contractors It is sufficient for practical purposes to say, that asplialtite tubing is the most suitable for this plan, and may be manufactured and purchased if required at lower prices than tile piping; that the qualities of the asphîaltum are maintained in the tubing, namely. that it is durable, non-corroding, and impervious to water; that in laying these pipes a general excavation is not necessary, for, where the sewers are not too small, these pipes can be laid within the sewer. The first cost would be the principal, viz., engine, boiler, furnace and piping, with the cxhanst. The expense of maintenance would be trifling.",
         "SEWER VENTILATION. At first siglit the amount required may appear very large, but a how trifling when we consider the great benefit that would I result. Think of what we are losing every year by preventible a' diseases; what we have lost, and what we may lose, from this source of disease, which seems not to diminish-say fron small- pox alone. Let us examine how they compute thcir losses in another city that sufTered during one winter as we have suffered during the last five ycars:- THE FINANCIAL ElqUIVALENT OF DISEASE UN PHILADELPHIA IN DOLLARS THIIOUGH THE EPIDE\u003eLc OF SMALL-POX DURING THE WINTER OF 1871-72. 1 Dr. Lee calculates the loss by diminution of travel and traffie on the railways, loss to hotels, to merchants, to business generally. I He computes the loss due to ,sickness and diminisled production and death. He sums up as follows:-Expenses in care of sick, $203,S79; loss by sickness, (time), $1,072,065; loss by disability, (time and expenses), $xo,ooo,ooo; loss by death, based on the estimate of life to society, $5,o13,ooo; buriai expenses, $74,420- total, $16,363,364. As the disease was due to neglect ofsanitary precautions, and might have been prevented by judicious sanitary legislation, the above represents, in cash, the money equivalent of the disease, which was wholly lost to the community. If we were to reckon our losses here during the years 1872-73 and '74 in like manner, what would the figures be? Have not our finances suffered? Has the maintenance of a small-pox hospital and sani- tary police cost nothing? Have not our merchantssuffered, their goods not wanted, and their travellers almost quarantined? I have been informed, by persons capable of judging, that a large pc tion of trade that naturally belonged to Montreal has been tui.-ed to another course. And you know, gentlemen, that trade, once diverted from its natural channel, is slow to return. What has been the condition of tramfic on our steamboats and railways? Where are the thousand tourists that thronged our hotels? If it be tru. that we have suffered in the falling off of trade and traffic, I think it may be attributed, in a great degree, to our blackened reputation abroad, as a plague stricken city. And terrible as has been our mortality in the past, can we expect the nature of things",
         "PUDIi. itA.rTH NIAG\u0026A2INFi to improve ini the future? With opposition tu vaccmantion, divi. sions in our Council as to sanitary measures, our Legislature is powerless to do anything, and, fallinig from bad to worse, it is fcarful to contemplate the future. In the face of thesc truths, I might ask, where would the expense be in applymng a prmnciple which will effectually renove this sewcr eflluvma which science declares to be the all powerful source of discase? Before concliding, I night speak of the Iwo systenis now being tried in Europe, viz., the open sewer systeim, and the deodorizing system vtlh the charcoal traps. The firbt we have had opportunities of judging ii oui narrow strects and lancs, and to which our mortality can bear too true a testimony. Of ti secoid, wc cannot speak froni experience. I might state tuat it is admit. ted that sewer gas on the whol. is heavier than atmospheric air, and, like carbonic acid gas in cisterns, is slowly dîluted with air, unless assisted by currents, or its own expansion through heat, or its displacement by water. 1 might cite Dr. Biurden-Saunders to prove the tardmcss of the diflisibility of sewer gag giving his experiments in twenty-three observations of the Lierpool sewers, where shafts had been erected for ventilation, but where there was an indraft into the ewcrs, or, in other words, an indraft into the basements of the heated houses, the shafts serving as so mnany open dampers. I night cite Dr. Parks, in reference to the uselessness of making openings into severs vith any regular plan mn view to direct the current of sewer air. I might cite Mr. Willson, in reference to the charcoal traps, how, often they should be reniw- cd in case of moisture, ond the -are required in preparing the trays, that they should never be over thrce inches deep. otherwise the sewer gas would bc retarded. I might cite Mr. Miller ni the Clemical News, who says that every square inch of surface oit- let shouîld have 50 square inches of charoal trays, and Sir Robert Rawlinson's statement, that every zoo yards of main sewer should have its ventilator, and, in fine, the admission of the inventor of the best cFarcoal trap, of its failure to be an efficient vntilator and deodorizer. I mniglt cite these authorities to show that these systens are not without expense, but are much more expensive, being inefficient. But I seek no verdict at your hands by such means. My plan can stand on its own merits. It is simple in",
         "tWwntVf~X1 vrrros. opcration, and not likely to gct ont if order ; it provides capacity for a continued ventilation, at uniform speed, froni ail parts of a city; it docs no: necessardy requirc the trapping of gullies; it admits of the expulsion of sewer air and the supply of fresh air, nt ail scasons It does not impede naturàl ventilation. Opening of% sewers or chorking will not interferc with its efficiency, and, in casc's of tlnoding, it will drain itseli. The escaping sevcr air is so diluted with fresh air as to render it harmless, and the cost of maintenance is trifling. This, Gentlemen, concludes my paper. I have said nothing of the pecuniary gain that would result to the city, or of my readinien to grant it gratuitously. I have said nothing of the terrible mortality froin preventihle diseases in our nidst, the palpability of which has been shown by statistics. I have said nothing of the sacrifices that are daily made froin indifference to,or ignorance of, the laws of nature, from sanitary stand points. Thnow I speak to practical men-I have said nothing of the hssitude, dullness, and sickness that incapacitates the strong, that rob, life of its enjovment, or of the wan cheek. the 'oloom ofhealth having faded frem the less vigorous and weak. I have said nothing of the social circle broken, the stricken home deprived of its first mupport, of the deserted hearth which was the centre of rany a hapepy family gathering, of the father deploring the loss of a promising son, or a fond mother that of a fair daughter, the idol of admiring friends. Who bas not felt the bereavmcncnt as, in taking the last farevell, they saw the iron door of the tomb lockled forever on a dear friend? Aisi orphanage and widow- hood have been too common in this citv. The hecatombs that are raised at Mount Royal and Côte des Neiges are appalling. Gentlemen, I will ask yoa who have suffered-you who have realzed the heartaches and mournings-you again, of the medi- cal profession, who can thoroughly appreciate the value of human life, to enhst yourselves in this service--\" man's humanity to man,\" and, if the principle I have explained here to-night is ap- provcd of b% you and to your minds is feasible, give it the benefit if your intelligence, and your impartial criticismn. NOTE.-Since the reading of this paper before the Public Health Association, Alderman McLarer bas proposed a plan for sewer ventilation, and, at the same time, for flushing the drains with the vater from the roofs of the houses, not unlike, in principle, that which was carried out in Croydon. with such baneful effects. His",
         "PUI1LIC IALT11 MAGAZINE. plan consists in prolonging the house-drains by tubing to the centre of the house, and thcn carrying thrm up to the roof, which roof bemng flat, or shghtly mnclinng to the centre, wouild receive the accumulation of water from the rain, melting ice and snow, and thus act as a flusher, and, at the same time, serving as a ven. tilator for the scwers. To this tubîng he would have conncctcd, by syphon trap%, the dosets, the sinks, the baths, wash-basins \u0026c. That such a plan niight, in wnter, be serviceable in prevcnting accidents from snow-4hdes or ice-falls, there is but little doubt, and some such means might boe used in summer, to serve as a flusher for house-drans ; but under no circumstances could these pipes art as sewer ventilators. Without referring to tic objections drawn from the experience of Croydon, we may question whether such a system would be suitable to our climate. Would not these pipes freeze ? We have been answcred dogmatically, \" No.\" However, declining to accept dogmas in science, without reason or proof, we v ill examine for ourselves. Then, why will these pipes not freeze ? Enther the heat of the house, or that of the sewer-gas, will prevent them. But in two instances within our knowledge, one wherc pipes were so connected within a foundy, and the other where they vere connected with the caves of a house, in both instances. I say, t'e descending water froze, burst- ng the pipes. We must, therefore, conclude that sew.er-gas alone will not prevent these pipes from freezing, and we arrive immediately at an inference, viz. that if this system were in vogue this winter of 1876, when so many houses are uninhabited, and, consequently, without proper heat, there would be great demand by next sprng for disinfectants, deodorizers, and cologne, by intending tenants. Granted, however, for the sake of reasoning, that these pipes would not freeze. In summer, when the heat on the roofs of our houses is often times very great, and, consequently, greater than that in our sewers, could these pipes act as ventilators? The first prnciples of ventilation, the expansion and contraction of air, oni whxh ventilation depends, show plainly that these tubes cannot, under such circumstances, serve as ventilators, more es- pecially as their position deprives them of any aspirating power. Agamn, granting that these pipes will ventilate under such adverse circumstances, let us suppose a rain-storm, and these pipes re- ceiving the accumulated water from the roofs of the houses, 'd the absurd assertion, contrary to reason and common sense, that they are ventilating at the same time. Hlow nay it be in refer- ence to these syphon-traps, in connection with our water-closet, s:nks, baths, \u0026c., for\" the first object to be attained is the preven- tion of sewer-gas from entering the buildings connected with the sewers \" by the above? Well, we know by actual experiment, that",
         "NEW1ER YENT1LATION, watvr so drescending, cither in a constant stream or in waves, will prodre avaruum, which will cause ail such syphon-traps to be untrapped, leaving a passage clear for the free advent of .ewer- gas. But we may le answcred, that compound traps may bc usecd. But would co-mpound traps hc uscd for the smks, the baths, wash-bowkl, \u0026c \u003e-and, if possible, would landlords hcar the epiense P Again, supposing that this desccnding water should meet with the sewer gas in its escape, what wo'uld bc its action ' This, I may answer, in the words of Dr. Carpenter, of Croydon Speaking of water pipes surcharged with water, lie says . \"rhere was no room for the exit of the foul air from the scwers which, therefore, was forced through the traps of the water-closets with, at times, the force of stean through the safety valve of a qteam engine.\" What provision has the worthy Aider- man made to meet this cmergency ? Probably our worthy Chairman of the Health Committee, who, we would infer, has given this subject considerable study, may assist him out of the dilemma. Again, allow, for the sake of argument, that all these objec- tions ran be remedied; that the pipes will not burst in winter; that these pipes without any aspirating power, vould ventdlate in summer, when the outer heat is greater than that in the sewers; that the descending water would not untrap the sink, closets, \u0026c.; and that the descending water, meeting n ith the sewer-gas, would not, as Dr Carpenter, of Croydon, experienced, force the traps of the closets, \u0026c.. with the force of steam through a safety valve of a steam engine; and that the irregular height of build- ings, and the spread of the geims of disease over the community, would not be attended with any detriment to the communty. Will it then ventilate our sewers ? It is painful to say no, it will not; but we must say so. Our sewers are of egg shape, the smaller ends down, the lower fourth of which is occupied by sewage At about the middle fourth, the house-drains enter the sewer. Now, an ordinary shower of rain will raise the water over the opening of the house-drain, and just when ventilation is so much required, the means of ventilation is shut off. We are told that this systen will cost very little. We will sec. Let us examine the distance of one block, measurng 480 ft., having thereon 20 houses, with a frontage of 24 ft. Allow these bouses to be four storeys, which vould cause then to be at lcast 48 ft. high. Now, the required length of tubing, to extend to the top of the roof from the house-drain of any of these houses, would, at the least, measure 8o ft.; but there are 20 houses; which would require 1,6oo ft. of piping. But this is only for one bide of the street; if we included the bouses on the other side, the quantity of piping will be 3,2oo ft.; therefore, the piping required",
         "for the Icngth of one ldréck, wvotld lie~o ft., or nently tvn.thir4q* ef «t mile; %wherean, in my I-Lin. %vhirli ir admniticid tri lie fe.ilile. and rnsirercil a % crv C\\vdlrnt s.vsîcm 1.% -Ir%.. Ukrr Eulwir4r\u003c-, Godfrry and ntherýý, and %va% ij~o cd oi ê.nlv oùac rougit oif its exIrn;c', il wrild nrt rrqîiirc river j\u003eo ft. in thie irnc'L disýtance, nr nrar nr.s-even\u003cth the iniliect of fért #4f iiibng re- quired by '.\\r. plaae'~. .n. Froutil liik 1 mtinfatin thit :hiç vcry rhcaî. plan of Ille %%-rthy Aldcrman isý a verv rl'en-î C pln and exccds, by miny tillac, in tçî~til r-rsýt a stuahlat %vvwad- rnitted ti lie 'ltinqitestinnalîly %rientïiriC' 1 makc fn petty objections ta thlilipn o'f the irîrthv Alder- man: tin the di %ta'.tetfli Mght oif a '%ewer-roil)e rsinning tlirî ntigh the rentre oif one's dnmirile-; tri the evcrbsýtîiîg rci'4 \u003cf tinkering and fixing; to the general dstîfatrnwith the flat rctf. nr in the dcçpntie r.evoltiin in liuIi(ling% it entail,, fi#r the wcîrthy AIder man stated that lie ha\u003cl no p-ronrntiw.,,, l'uit the' gen--ral gond (,f the city. I will, thierefcirc. cdair frnm hirti dite cnidt:rltien of this Tîaopcr, and, ris a citizen, tlie -,.me -cal t-, firmt:rly fosr the wecU-being and bunefit of the community. te us,, an,! aý the 'ubject i. \u003c'ne -.f co.,ra, n-er, t In cenràucti,,n %uîh th~e %ucetiow, of fûod ',upply and it'hole.omýc rnilk. we rcalily ýnc îit i lclT the Editor nf J'i.,lic /k!hSr- earc Ptrnit1à' 1y lxorï Anun\"P e-f Wardour tai cnelot ysuu an extract \u003crom a itir Crcm Mr. L-'b, ifWo~k n Cumrnbrland, tri hi, lord-,hi , having rtfrnc.- vo' the irre't'ticn gr( she îftrici,,n of root-and.mouth, di y hylwp'.-ptitc if Nb. r. L(i ,iyý - M commencement of the catt'Ie plague it wa'. ýuggctçd( by' Tir. iVîVlkin\"'n. cf Sydenhair, that h\u003e-pu!hr f h ihUcrîdufun.' 1N CÀl'l\u003c ifectjrn. lie rc'ýmnCndcd that one tuncv pr day nîîight sal'eAy Le gii6sn tgo cach animal inxoe~ ii tir wvater. 1 advi.cd al] my farnner, alVo ef farmecrq u'.ed it, anl flot one animal tf.\u003ck the complaint, V. hercL evcry tthýr farmt- that 1 hiad ilcn tri, anl %%ho de' hnvd il, Iu',t ail thvir cn.ille. Onc cf our ov.n fairMer, loýt 32, and a ncigt.ixur 7o. Sunce thtn it ha, iýrn gid, ai ,.o far nu animal taking it ha\u003e, had the fcýt-î'ind'xouzh com pi:tint. M\u003cy 'o)n, in Somervîshihre, haN 2o or 3o cattlc, and ha: bren u4ing it ; ai Ihi, catch: arc 'o j'ar well, and round him (t-.c in ii h ncý\\t fiuidý\u003e the catt!e arc ,ufit.r!ng freim foût'and' mouth complint.' Lord Arundeli lias te'ted thi'. remved\u003e II ih hib' oun c,,%%', %vhieh, thoughi surrounded lasi .ummcr mithi animail, -Lffctt:£l Iwîh the fcoiand' mouth dikea\u003ec, have ',o far entircly e'caped. 'Wc zay add tliat: the [rncL' cf hypo-sulphiteisalxout î5s. or î6s. per ct., thit it i,. rt-adidy roluble in watc.', maY bc mi'xed %îth dry (mid, and doc~. flot appear tu bc dita.std'ul tri the nimal.. It is oniy a propcr tribute to.\\Mr. Lo'.h to say that through an invention oft hi\u003e the hypo.sulphite of soda %vas reduced in price fromn 3,.. per pound do)wn go about 2d. pcr pounci, tlîrough the application of a re.,iduum or %%a-,tu in alkaIt %%orks. It is riglit. howveer, te add that Nir. Losh has no intere.st wvhatuvur in *ht prt-ent application of bis valuable invention. -Wc arc, Sir, yours, utc., RAWLENCE AND\u003e SQUAREY.-Sali.sbury, Dccembcr 24th, 187.\"-Piîc Ikcath. Plintic- 111741-Tit",
         "MORTALTf Ritt\u0026ItU . 16 Riuf\u0026rD c PDTf. MORTALITY OF THE CITY AND SUBURBS OF MOINTRZEAL, FOR JANUARY, 1\u003e-76. DisrAsts. t. m ................. 2. Meale..... ................. 3. Scariatina....... ................ 4. Diphtheria......................... 5, Quin............... .. ......... 6, Croup........... ............... 7. W whping Cough.................... S. TyphoidF cvcr, (Infantle Rtcmittent Feveri 9. phu, no, Infantile Fever........... 8o. Rýtc ap n Fe r...................... s. Contnuel Fcvcr ..................... 12. Ery.ipela4.................... ...... 13. Meia, (luerperal Fcvcr).............. 14. Carbuncle..... ..................... :5. Influenza.................... :6. I\u003ecntcry. ......................... 17. Diarrh: ...................... ..... iS. Choiera Infantum .................... 1o. Cholem............................. 20. Agne.. ........ ................... 21. Remittent Fever ..................... 22. Cerebro.Spnal Meningitis........... r. S hil ............................. 2. Il ydrophobia........................ 3. O nders........................... t. Privation............................ 2. Prpura n Scurvy ............... 3. Derium Trcmncsç Alcoholis.m 4. Intem ierance .... i. Thrush1 . ... ......................... 2. W orm,, \u0026c......................... 1. Gout ............................... 2. Rheumatism..................... 3. Dropwv and Anxmia.................. 4. Cancer................ ............ 5. Noma (or Canker).................... 6. Mortification............. ........... I. Scrofula. ..................... 2. Tabes Mescntcnca................. 3. Phthisis (Cons. of Lungs)............ 4. lydrocephalus..... ............. M Carriedforrard.... ... ....... Total by Sex. ale. Femala. 20 24 1 1 2 5 6 4 2 go 2 2 5 Total both Sexe£. 44 2 7 1o 12 2 7 6 .3 9 3 4 I t i g z a I 3 4 2 2 1 3 4 1 r 3 2 5 19 29 48 4 2 6 72 t02 174 . ~ ~.0 O I t mtu \u003c .5. ta3 t: .j1v",
         "PUBLIC HEALTH MAGAZINE. MORTALITY OF THE CITY AND SUBURBS OF MONTREAL.-(Cn). Total by Sex. both Q 0 biale. Female. 3 I Q 72 102 174 7 3 10 2 1 3 2 2 à I o ¤o -Q Carried over.. .. .3 Brought forvard............ 1. Cephalitis............ .............. 2. Apoplexy.......................... 3. Paralysis............................ 4. Insanity..............., 5. Chiorea....................... 6. Epilespsy......................... 7. Tetanus......................... S. Convulsions....... ................. 9. Other Brain diseases, \u0026c.............. i. Carditis, Pericarditis and Endo Carditis.. 2. Aneurism ........................... 3. Other Heart diseases, \u0026c .............. 1. Epistaxis....................... 2. Laryngitis and Tracheitis........... 3. Bronchitis......................... 4. Pleurisy............................ 5. \u003eneunona,....................... 6. Asthna.............................. 7. Other Lung diseases, \u0026c............. i. Gastritis............................ 2. Enteritis............................ 3. Peritonitis........................... 4. Ascites.............................. 5. Ulceration of Intestines ....... ...... 6. Hernia.............. ........... 7. Ileus and Intussusception ............. 8. Stricture of Intestines................. 9. Fistula.............................. 10. Stomach Diseases, \u0026c................ Il. Pancreas Diseases, \u0026c...............I 12. Ilepatitis ........................... 13. Jaundice............................ 4. Liver Disease, \u0026c .................... 15. Spleen Disease, \u0026c................... i. Nephritis........ ................ 2. Ischuria..........................I 3. Nephria (Bright's Disease)............ 4. Diabetes........ ................... 5. Calculus, (Grave' rc)................. 6. Cystitis and Cystorrhoea ........ .... 7. Stricture......................... 8. Kidney Disease, \u0026c.,............. .. I. Ovarian Disease............... .... 2. Disease of Uterus, \u0026c............... 1. Arthritis ........................ 2. Joint Disease, \u0026c................. I3 4 VI.Gen crative Organi VII.Or- motion 162 i69 le 2 3 5 2 1 3",
         "FOREIGN HEFALTII STATISTICS. MORTALITY OF THE CITY AND SUBURBS OF MONTREAL.-(Con). DISEASEs. Brought over................ ... III i.Peg n.............. .....\u002b.i.. mentar.y S-nDsae,\u0026- ...... 1. Durn D..ttio................. * hl - 2. M tr it . .. . .. .. .. 4. O ~ Paramnîis........................ 5. Spina Biiaadother Malformation .... ildoa 2. Childbirth....................... b: WoPl. . l Age ......................... ia Ilutzi. 2. Atrophy and Debility ........ ton. i. N tr. i Fractures, Contusions. ounds.. d 2. Uisn....................... 3. Skin seandSse ........... 4. Droioing........................J 5. Otherwise ....................... e i r. Murder, Ma\\.-nslaughter ... ... ..:..... 3. Execution ......................... S ý ' . oundss........................... 2. Poison ....... .................. . a Drowning.......................... 4. Othrwise ...................... .... IV . Olrurgici ........................ 4. Downin................... 5. Oterw i C ........................ Total otal by Sex. both Sexes. Male. Female. 162 169 328 1 I I I I I 4 2 6 Total..................... 254 258 512 FOREIGN HEALTH STATISTICS. United Kingdom of Great Britain, during four wecks, ending Dec. i ith, 21,500 births, and 15,325 deaths were registered in London and twenty other large towns, and the natural increase of the population was 6,175. The mortality from ail causes was, per i,ooo : In London, 24.9 ; Edinhurgh, 25.7 ; Glasgow, 28.2; Dublin, 3o; Portsmouth, 18.2; Norwich, 21 ; Wolverhampton, 25; Sunderland, 19.2; Sheffield, 24.7; Birmrngham, 25; Bristol, 30.2; Liverpool, 28.50; Salford, 33.25 ; Oldham, 32.50; Bradford, 26; Leeds, 26.50; Hull, 21.50; Newcastle.upon-Tyne, 27.25 ; Leicester, 25.25 ; Manchester, 27.50; Nottingham, 27. Other foreign cities at most recent dates, per i,ooo: Paris, 23.50 ; Rame, 35.25 ; Vienna, 24.75; Brussels, 21.25 ; Berlin, 25 ; Hamburg, 23.75; Calcutta, 38-75; Bombay, 24.50 ; Madras, 38.50; Amsterdam, 32.50; Retterdam, 26; The Hague, 23.75 ; Christiana, 29; Breslau, 24.50; Buda Pesth, 45.50 ; Turin, 27.75 ; Alexandria, 40.25 ; Florence, 28 ; Copenhagen, 19; Munich, 32; Naples, 26.",
         "71 IPUBLtt HEALTIl MIAGAZIN.. SYNOPSIS RAIN AND SNOW FALL FOR 1875. McGILL COLLEGE OBSERVATORY. January ...................................... . . 35 0 1 February............................. o .42 3 129 2 March................................ o.8 2 April ................................. i. i 683 M ay .... ............................. 5.r3 6 . . .. . . . June ................................. 3-26 1 . . .. . . July......... .................. ...... 3.64 14 . . .. . . . August ............... ................ 2-59 14 . . . September ............ ................. 5.IS18t October.............................. 4.74 2 NKovember ..................... ..... 0.50 2 217 6 2 ...... 35-o 1 . Total~~ ~ ~ ~ ra2.9l du2n yeria 81 nhs To6 . . .... .. 20s~ s~ r - Decur..................... ............ 3 84 18 3 otale raifl uinghe yesnarc zas 28. to inchs.vte.Geteiha %vbas y..............0o h 9ho uut;gets od.4 on Feb.9r Sth gi oal ofwfall dauringrth year as 15.i n.ch egs. raetaneothte- moalrin nd meted %snow.was..6 inces.5. N3 3 ot nuvmber ofn day lone wichain fel95, onDcebri3h2.ag ory Aotl .nuber. of... daysin whi. sw f, 8 . e i o Total.number.of.dayson.which.ram.and3.no fl,12........... ota umber of days... on whh ...ain or snow fell o Bomeerreadings.reduce.to.sea.leve 0.5n totmertr 2of 32 Farnet To val n inch Toaing of ercury Iuid7 inches. sauration o ostal r anchestof snow 39a takens. hwe Tal 70 nte of9th on Augusth ratest cod2.o nFbur tgn otal noner monthays 76-5 hihno eember. Gets aoee a 068 otaNmber o2nday; owes was 28.952,n so fece 13t2. agefrya o lnue o dayswfl on 88îc asja or now fel on88ay.Toa.fl Presra of8.a2 ins Total faf snow1ry llu5.7t inceas.aTtaureptation in inchesrwer 39.6 inches. nwaetkna qa oJml fwîr raeiha",
         "TRAPPING OF CLOSEITS, SEWERS, \u0026C. FROM LONDON CORREtSPONDENCE. TRAPPING OF CLOSETS, SEWERS, \u0026.-THE D TRAP. To the Editor of Public Heauli .Magazine: I have been niuch surprised lately, in noticing that several sanitary reformers have strongly advocated the use of the D trap ; also that this so-called safeguard is in such general use. Little do the fathers of families know that this pet trap, in lieu of being ameans of safety. is, in fact, a source of danger; and I think I may, without exaggeration, say that this trap is one of the most fer- tile sources of bad smells, with its consequent morning headache, lassitude, and even fevers and death. The principle of the D trap is good in theory, but in actual practice is a total failure, as I shall endeavor to point out. Of course the idea that, in containing water, it prevents gases, \u0026c., from passing into the house, is not far amiss ; but when we have that water (our supposed safeguard.) itself becoming hie source of pollution and danger, our case is indeed sad-our much- vaunted friend is our bitter enemy, and, worse still, an unsus- pected enemy. I suppose no one will venture to deny that sewage, stagnating in an imperfectly closed cesspool, nust be a source of noxious gases, and their consequent train of ilis. Now, what is the D trap ? Simply a depression, or rather a bend in the pipe, which ought to be filled with water, and which ought to be air-tight, and which, as a rule, is neither the one nor the other. Hence, in not fulfilling the sine qua non of a trap, it fails in being a trap, and results in being always a cesspool, even un- der the most favorable circum'stances. Why do I call it a cesspool ? Because it always contains sil or excreta in different stages of decomposition. You may per-",
         "PUBLIC HXEALTH MAGAZINE. haps say : \" Oh ! I have a high fall for the water, and surely it must flush the trap. as it has, owing to its length of fall, great force.\" In reply. I say the fall is a remarkably short one, a few' inches at the nost. Allow that your cistern is 50 feet aboc the trap, and that therefore the pipe gives a fall of 50 feet into the closet ; does that give a fall of 50 feet into the trap ? No. The water has its force broken first by the basin, and then by the container, and we have now left a mere dribble, with a two-inch fall or so, to flush our trap-a very likely event, especially if we take into consideration its shape. The trap is not, cannot be, thoroughly flushed, and therefore must contain soil to a greater or less extent. We have now, as a result, the water becoming contaminated, and instead of being a safeguard, it beconies itself a source of danger, a generator of noxious gases, \u0026c. We have, in fact, a cesspool containing all sorts of sewage in a greater or less degree of putrefaction, and each time the closet is used, up conez; a rush of foul air, which is soon disseminated througiout the house. Of course, the larger the trap, the lar¿er the cesspool, and therefore the greater the danger. In addition, we have another evil, at least so I am told, naie- ly: plumbers, to prevent syphoning, to a smnall extent perforate the upper side of the D trap. You can easily see the result of this proceeding. A continuous outlet into the house of all the gases generated in the trap, or rather cesspool, to say nothing of those from the drain itself. How often is the main sewer blamed, when the real source of annoyance is in the D trap. How continually the trap getz choked, and we are obhiged to go to the expense and annoyance of having it cleaned out-a pro- ceeding both disagreeablt of itself and trying to the temper of paterfamilias, who has to foot the bill. To those who are un- fortunate enough to have a D trap in their houses, I would say replace them by one that can be depended upon, or else have the trap fitted vith a proper ventilating shaft and coul. For a des- cription of a safe and reliable trap, also of a good and efficient ventilatingshaft and cowl, I must w'ait for a future number. For a more complete description of the above trap and its dangers, I would refer you to the various useful papers on that subject, by R. Barnes Austin, Esq., Banitary Inspector, Banbury Rural District. D. B.",
         "GAS FORN CRUDIE PETROLEUM. MOTREAL, Feb. i9th, 1876. DEAR Sm,-As your valuable journal is devoted to the most important intercsts of the human race: viz., the preservation of health, and the prevention of the introduction of air unfit for respiration into or dwellings, I request you will allow me space in your widely distributed journal to call the attention of your readers to the reports of Prof. Croft, of the University of Toronto. and Prof. Girdwood, of McGill University, Who have during the past week examined the gas works recently erectcd by the Canadian Gas Lighting Co. of this city, in the city of Dundas, for the manufacture of gas from crude petroleum, under Rigby's patented process. Prof. Girdwood writes:- To the .Directors of the Canadian Gas Lighting Co., GEIr ENn ,--aving at your request, examined the gas works lately crected by your Company at Dundas, Ont., I have to report as follows:- That they vere in perfect working order, and are supplying the Town of Dundas to the satisfaction of the citizens. That the gas made from crude petroleum, by the Rigby Excelsior Gas Works, is better than the Standard 14 Candie Coal Gas by 50 Per cent. in lighting quality. That if is perfectly free from sulphur compounds, and consequently the products of combustion will not be so injurious to the consumers as the products of combustion of coal gas. The simp!icity of the works is such that any mai of any average intelligence can attend the works and produce the gas. I thing you have every reason to be satisfied with the Rigby works, as a cheap, simple means of producing gas of a high illuminating power and a gas preferable to the ordinary coal gas; not only as a light, but on the score of health, it may be recom- mended to your friends. (Signed,) G. P. Grnnwoon. Professor Croft, after fully corroborating Prof. Girdwood's report as to the illuminating quality of the gas as produced by these works, adds,- \"The gas derived from the holder was tested for sulphur (as sulphuretted hydrogen), and found per- fectly free from that impurity.",
         "PUBLIC HEALTII MAGAZINE. \"The gas was tested for sulphur (as sulphide ofcarbon) after burning, and found perfectly frec from that inpurity. \"The gas was tested for ammonia or its salts; a slight trace vas detected; but this is, in all probability, derived from the impure water in the holder tank,\" which he recoimended to be immediately changed for fresh. After enumerating the advantages under five distinct hcads, he concludes:- \" On these accounts, I believe the process well fitted for supplying good, excellent gas to small towns, hotels and large private residences. I also sec no reason why it should not be equally applicable to large establishments or towns of large re- quirements. quirinens. \" (Signed,) HENRY H. CROFT. l Feb. 15th, 1876.\" You will sec by this, that the desideratum so long and arduously sought after to produce light free from the delcterious combination of the various impurities incident to all other illu- miKating gases has been thus attaincd. and we may safely congratulate ourselves that we are not far off from obtaining a cheaper, a better and a healthier light. Your Obt. Servt., DUNcAN MCMARTIN, Engineer, C. G. L. Co. A meeting of the Citizens' Public Health Association will be held in the rooms of the Natural History Society, on Friday, the 3rd of March. The public and all friends to sanitary science are cordially invited. Subject, \" House and Sewer Ventilation.\"",
         "REVIEWS. ytbidus. BOOKS AND PAMPHLETS RECEIVED. CANADIAN ILLUSTRATED NEws for February x9th. This contains a good illustration of Alderman McLaren's pro- posed plan ofSewcer Ventilation. We consider the plan good, but we consider Dr. Rourk's plan better for that purpose. We consider Alderman McLaren's plan would be improved if lie would in- troduce two shafts, one for the exit of the gases, and the other for carrving off the solid matter-the one for the gases fitted with a proper cowl. so as ta obtair the full aspirating power of the air, as described by us in a previous nufner. TiHE MONTIILY ABSTRACT OF MEDICAL SCIENCE. A digest of the Progress of Medicine, and the Collateral Sciences. An admirable digest of the conclusions arrived at by the International Medical Congress, as to the Prevention of Chalera, will be found in the january number. L'UNIoN MEDICALE DU CANADA. This, the only French Medical Journal of Canada, has begun its fifth volume We wish it continued success, and congratu- late Dr. George Grenier upon the able manner in which it is conducted. Dr. Ralph Walsh, of Washington, D.C., has forwarded ta us a copy of his new \" Physicians' Conibined Call Book and Tablet.\" It bas many advantages which are wanting in othcr Memoranda Books for the same purpose. It is more convenient in form, not being so thick and short; it is bound in leather 71 inches long, 4 wide and only t/ree-eig/ths thick. The plan of the book makes it good for any year or any time of the year, and need not be thrown aside till filled. It enables the Physician to write the",
         "naine, addrcss, and the nuinber of visits paid cach pj.tient per week on one page and line. It accominodates 35 patientl per u, -k, or, hv imng additional pages, as mran% more as may ie dsared. Two more particular features which may be mentioned b'eside the following contents are,-.n Eras.able Tablet iound on the ir-.ide of the front cover, and a large and commodious po, ket for bills or prescription blanks, etc. ; Calendar. Sign Table, Graduated Table for Administering Laudanum, Table of Props to the Fluid Drachm, Table of Abbreviatîons, Table for Reguiating Doses of Medicine for Children, Table for aster- taining the Duration of Pregnancy, List and Doses of Important Renedie,, List and Doses of Nen Renedies, Poisons and their Antidote'., FormuloL and Doses of Medicines for Hy)\u003e podermh Injections, Formulx and Doses of Medicine for Inhilation, For- mule for suppositones, Formule for Medica.ed Pessarie., Blanks for Obstetrical Engagements, Blanks for Vaccination Engage- ments, Blanks for Nurse's Addresses, Blanks for Cash Recei% A. Mauied, prepald, for $r.50. Interleaied copies, $:.oo. We hcartiy recommend it to our confrères as superior to any of those m use at present. Address Dr. Ralph Walsh, 324 Fouri- and-half Street, Washington, D. C. -o QUININE WINE. We have much pleasumre in recommending Messrs. Evans, Mercer \u0026 Co.'s Qpinine Wine. We have careftully examiied it, and find it contains i grain of Quinine in every wine glassfull. It will bc found an excellent tonic and stomachic. We have tried it in several cases of dyspepsia and general malaise with undeubted benefit. It is a very excellent and clegant preparation, and we have cery confidence in placing it before the public-Adver- tisement. 11Ml I AI.T A f 4/M\\U .",
         "PUBLIC HEALTIi MAGAZINE, MARCTI, 1876. SEWER VENTILATION. We draw the attention of our readers and aldernien to the plan of sewer ventilation, as proposed by Dr. Rourk, and read, in the fori of a paper, Iefore the Citiiens' Public Hcalth Asso- cintion, in Decenber la«t. The Doctor proposes to have, at a given point, an exlhautst power worked by an engine; and froin this centre. he throws ouet a ramification of small piping along the top of the present sewers. At stated intervals, there are minute openings. A the exhaust causes a vacunm in the small piping, it is replaced by sewer-gas through the above-named openings, and as the gas is thus abstracted from the sewers, it is replaced bv fresh air through the uisuail street gratings. The Doctor alleges that it i: much cheaper in the end than Alderman Mc- Laren's proposed plan, by a shaft thrown up through the centre of every house, and doubly as efficacious for the removal of sewer-gas, to which latter conclusion we are decidedly inclined. As to the xpense, we will not attempt discussion. Suffice it to say that the Doctor's conclusions, in that respect, scem logical enough. In Dr Rourk's plan, %% e see three great principles which should never be lost sight of whlen we attempt ventilation-1st. There is the abundant admission of fresh air into the sewers. 2nd.- The extraction of the foul gases ; and 3rd.-The final destruction of them by beimg passed through the furnace. Captain Liernur has, by exhaust power, drawn solid sewage matter great distances most successfully, and how. much easier would it be to dispose of the gases in a similar nianner. We certainly recommend the earnest consideration of this plan to our readers and alder- men. In a future number we will again speak of it. Space will not allow of longer notice this month.",
         "WE arc in rcceipt of a letter from Mr. Alderman MeCord. It is \"ne of great importance ; we heartily endorse the plain anl pertinent matter thercin containcd, and considcr the thanks of the community are duc to the cnergetic Chairman ofthe Health Com- mittce for giving publicity by means of his circular to the ways and means of mitigating the evils of that fell discase, small-pox. Without further prefacce, wc give Mr. McCord's circular, carnestly recommending it to the scrious attention of all : CITY H.ALL, Feb. vst, 1S76. MY DEAR Sin,-As you are aware, the City has provided accommodation in the C:vic Rospitals for its citizens suffcring from small-pox. The Roman Catholic patients arc rcceived in the new building on the Hall property, attended by the Ladies of the Providence, and the Protestant patients, in the stone house on the same property, in charge of a lady of expcrience, assisted by a competent staff; and both hospitals arc attended by Dr. La- rocque, one of the Medical Hcalth Officers, and every care and attention paid to the comfort of the patients. These hospitals..re very favorably situated with a view to the recovery of the patients and, in the new building especially, the wards arc very large and well ventilated. It is very desirable that citizens suffering from small-pox should avail themselves of the advantages thus placed at their disposal by the city, and by going to hospital, and thereby isolating themselves, limit, as far as possible, the chance of coin- municating the disease to others. We have scarcely a doubt that patients are daily recovering in the Civic Hospitals vho should have succumbed to small-pox had they remained in theircrowded homes. Accommodation is also provided for a limited numberof pay patients in private wards, who may he visited by the;r own medical attendants or by the hcalth officer at their option. For terms in private wards, kindly communicate with Di. Dugdale, No. C45 Lagauchetiere street. You are earnestly requested to ad% ise your patients wh1îo may contract small-pox to go into the Civic Hospitals in cases where isolation cannot be obtained in their residences, or when in your judgment it be desirable to do so. The Health Committee, in its endeavors to diminish small- pox in the City, desire the kind co-operation of the medical profession, as it is conscious that any success achieved will be very largely due to such co-operation. You arc, ofcourse, awarc that the Hotel Dieu and the Montreal General Hospital have been obliged to decline small-pox patients. I am, dear sir, your ob't ser-ant, DAVID R. McCORD, Chairman HZealth Committee. PlTitic 11FAITiH MNAOAZIN11.",
         "ftLALTiH Or OTTAWA, \u0026C. HEALTH OF OTTAVA. Through the courtesy of Dr James P. Lynn, City Mcdical Ilealhh Officer, we are indebted for the rnnual hcalth report of the city of Ottawa. This being our capital, we all naturally feel much interest in its hcalthfulness. Unfortunatcly, we sec that smnall-pox has found victims-would to hcavcn we had as few. In all there ivere £24 Lases-43 dcaths, and Si recovered. The greatest number of persons attacked were those who had not bcen previously vaccinated, and the doctor says it is from per- sons of this class that the death list is manly recruited. Ty- phoid feer has becn epidemic, and the health officer attributes it to the defective drainage of Ottawa, and gives some admirable advice to prevent its spread. He also recomnends immediate action as to the disposal of horse offal ar4d garbage. The slaugh- ter houses seem to be very primitive, and therefore defective, and many of them throw all the blood and refuse into Rideau River, at the foot of St. Andrew street, making the water uniit for domcstic use and offensive. From this river, also, the ice supply is obtained Wle quite agree with Dt. Lynn that serious and immediate measures should be taken, or Ottawa will lose many of its citizens. He also recommends the Council to take measures for the registration of deaths. - o Wq have much pleasure in announcing the addition to our Editorial Staff of Dr. Dona' , Baynes, late attending Physician to the Metropolitan Ear and Throat Infirmary, London, Eng , who has hiad the advantage of being for some tiue in partnership with the well known sanitarian Dr. Abbotts Smith, Editor of Public Realth ournal, London. Having entered into partnership with his brother, he will in future, besides acting as co-editor of the Magazine, assist him in his general practice.",
         "COOKING FOR THE POOR. t Ce'ntinudJ ji'-n:i pV .MS- The last we spoke of werc thc breakfast soups, recommendedt by us for the working classes in preference to any tropical bever. ages like tea and coffee. Soups satkfy and are a stay ; tea and 'en cofl'e are no good without othe nourishmenit. aid if that is to bc bought the breakfast becomes an expisiN : affair. Foi the working classes with small incomes alI depends on hon the day is begun. Begvn wrongly it drags on its whole length with 1ev ened vitality and occasional replenishiig of alcohol-if the mone) can bc obtained. Begun rightly, a longing for that is nlot even felt; can we sufliciently imbue our readers, vho have the wiell. beiig of those classes at heart, with the fact, to teach them once for all the rremodelling of their breakfast? Wc gale:- i. Potato soup. 2. Pork-rind Soup. These soups will bc continued. If a etrong bol, going tu work for us ten hours, ha. eaten a gdod soup and a hunch of brovn bread, even with a bit of cheese, l'll not feel faint till dinner time, and if we only knew how faint growing boys do feel, we would pity them and do our best to elip them to sustain life better. 3. Onion Porridge. Boil several onions till nearly donc: mix coarse oatmeal with cold water-and add the boiled onions, flavor with a piece of butter or dripping, and pepper or sait, and simnier till donc. This makes, with a piece of brown bread, an excellent breakfast. Dinncrs.--The poor cannot afford lunchcon and ought to calculate well from meal to meal. A dinner for five to cost six- teen pence. r'viii.1r HTAliiitAM IF",
         "T.îI e t Ilicce of lhreabt ACa nitttcn or pik!cd pork, ccastisig Sd place i eaItccepaw and add two rilioîs for Jd N M c tcgt 0 o twnty niÎîiîe-4 anîd btir in a very lttle (ltir. Nnv cut up a herad efýri~ e \u0026~d., anîd put fn i wth of3lb. or pcecd pûtaines :îîd saIt ;Mnd pcpilcr. If you s'tew gcntly Uic potatocs will rernain whiole .111( Ie in(-t %!.il han brokie: up. Thue expeti-.e is i.. id. ~Lîk dîînpl1.., with i ýd. oaf fllur and a id. oaf -,net: Loi, aaid let thc ciiildren i ait: theni witlî treacle, Id. The cost .3d. XVle Naaw wvc wvilî liîr to draw attention to a ncwv phiabe of work- mnan', Iite. Matîw arc nove said tc, live ont oaf towîî, aiiylrow ilcar Loîîdci. and gon lackward and forivard -.-ithi %ork man's train%; tli cI~ an have a i.unml plot and growv a ft~w cctbs.it niay lac dcill, boitî cI.sc tierc is a serions drawback to fuis. The 'aguily have~ tir, iiiiiiir t'-,grtiîcr, the litsbaîid gctv a poor auJ( ex- punIiivc it-l iii ti,%ii, tie wife and chlldren ~ta toput up wvitil anîrliugat liraie Tog%thecr, a modur.itc sui ay rnake a good mieal: -,eparate. zieithe.r can geL properly iioutishled, and though uv iynt rtcgard it, thoughi it may b)c covcred tip, iv'e (Io sav and mint-tin that Uic grcat outcry oaf insufficient isotiriî,Jinnt ivill vrt%,lîitîln the nation in ime. Tiierc i mucli talk about the wvorking cIats-es l iving better, but it 15 ail deccrekuc-n ; chey înay live Cier, have more tea anîc stigar, rice, \u0026c., but as for down. riglît good Etîglisli îhrc, iL is gettng scarcer evcry day. To see a wvorkman pull çout hib cold, meagre, dried.up izi~- day ni-il away froirn home~ is a pitiable sighit-one that wvili one day cost the couîntry dear.- T.!ic llIcusckcqpcr. LONGEVITY 0F THE JEWISH RACE. The. wi/zchiro.nzcle of this weck contains an article on this subject fromi the pen of D)r. Maurice Davis : \" The marked and unvarying pectuliarity of the Jewish race is a largur proportion of boys aniong the births than arniong Christianw in the saine places. Titis may bc in sonie degre in- fluc-nced by the age of parents at thit turne of marriage, as Jews marry younger than Clîristians. What is most remarkable in",
         "PUBLIC HEALTH MAG3AZINE. reference to the proportion of sexes is the fact (if a fact), as stated by Lévy, of there being a smaller proportion of males of all ages among the Jews than among the general population, the former havinf, uniformly such a large excess of male birthe, amounting to nearly 18 per cent., while the general population have only 6 ù per cent. Yet, notwithstanding this, if all ages be taken in the same proportion, Jews have 3.25 per cent. fewer males, while the general population have only 8 per cent. fewer males than females. This difference is certainly greater than could be accounted forby a difference of emigrants in favor of males, and is probably due either to a greater proportionate mortality among Jewish male infants, or a greater longevity oz their females; probably the latter. Professor Waitz gives-.oo female to 208 male births among the Jews in Berlin ; 100 to 120 in Livorno; îoo to iii in the Prussian dominions generally. \" Immunity from disease is one of the most characteristic and valuable properties of this pure and favored race. Not long ago a paragraph appeared in the Times, stating that the Jews of Roumania escaped all the local diseases by which other im- migrants were attacked, and attributed this frecdom, like Dr. Hough and Dr. Mapother, to their peculiar habits, omitting to take into consideration what, in our opinion, is a most important element-and in this we are supported by the foregoing authori- ties-namely, the well preserved qualities of an tinmixed race. \" Dr. Mapother, of Dublin, in his lectures on public health. says : \" The striking immunity of the Whitechapel Jews in the last as well as all former epidemics (cholera) was due to their timely distribution of animal food, and to their excellent hygienic observances, which have made the longevity of this race one- third greater than that of most European peoples.\" Dr. Hough says, \" They have had in recent times so very marked an immunity from plague that it vas the motive of odious persecutions.\" Tschudi, in speaking of the plague of 1346, says that this malady did not affect the Jews of any country. Frascati mentions the fact that the Jews escaped completely the epidemic of typhus in 1505. Rau mentions the same immunity from typhus observed at Langeons in 1824. Ramazzi insisted upon the immunity of Jews from the intermittent fevers observed at Rome in 16gi.",
         "LONGEVITY OF THE JEWISH RACE. Degner says the Jews escaped in 1736 the epidemic of dysentery in Nimeguen. Michael Lévy renarked that the immunity was common to the French and the Israelite. M. Eisenmann insists on the extreme rarity of croup in Jewish children. Dr. Glatter, in his paper on, \" The influence of race on the duration of life,\" gives the following table, showing the relative frequency of disease among different races in the same locality :- Number ill. Number to ioo inhabitants. Magyars............ 6,034 534 Germans .......... 3,808 223 Sclavonians ....... 1,522 83 Servians ............ 1252 28 Jews.............1,540 ............ 32 \"Jeiws suffer little from intermittent fevers, convulsions, mesenteric wasting of children, and inflammations of the respi- ratory organs. On the other hand, they suffer frequently from non-inflammatory skin diseases, internal stomach affections, and ruptures. Dr. Stallard, in his work on \" London Pauperism,\" says that Jewish children are free from certain hereditary diseases, and have scarcely any scrofula. \" Their greater tenacity of life is therefore due not only to better maternal care and nursing, but to the inheritance of a better physical constitution than the Christian child.\" M. Lévy estimates that the mean average duration of life exceeds that among Christians by about five years. In 1849 Prussia computed i death for-Evangelists (Protestants), 3435 inhabitants; Catholics, 30.18; Jews, 4o.69. According to Stallard, the mortality among Jewish children in London from one to five years of age is only xo per cent., while among the Christians it is 14 per cent. The average duration of life of the Christian in London i.s 37 years; of the Jew 49 years. Lévy states that they lose fewer children than other relgionists. From 1859 to r86r we flnd in Prussia, for too births, the pro- portion of mortality which follows :-Evangelists, 66.37; Ca. tholics, 65.94; Phillipos, 56.04; German Catholics, 56.77; Mennonites, 86.66; Jews, 48.11. \"SUICIDE.-Statistics show that Jews commit suicide much less frequently than other religionists.",
         "PUBLIC IEALTIH MAGAZINE. \" CINiNALITv.-The Prussian judiciary stitistic,, as those of other countries, indicate anong the Israelites fewer infractions of the penal code than among the Christians. The Jews have fewer illegitimate children. \" James Parton, the historian, says of the Jews, 'At the pres- ent hour they are probably the chastest seven millions of people under the sun.' Dr. -Iough now procceds to suggest the causes of longevity, and tu offer other observations--among these the fact of jews being obliged to keep two days of rest in une week, besides Jewish, Christian, and political holidavs, which give them twice as many days of leisure as Christians. They do not engage in minig and other hazardous occupations. The Biblicail and traditional prohibitions of certain aliments are favorable to longevity. The last of the sunmary of causes to which M. Lôgoyt attributes the greatest mean average duration of life of this people is that \"le sent/iment de la famille,\" more developed in then than in Christians, assures to their children, to their aged and infirm parents, a solicitude more active, to the new-born the mother's nursing, to the poor an assistance more efficacious. Their charity is unequalled ; their morality is demonstrated by judicial statistics; firmness and serenity of spirit are the most marked traits of their character, and procced from a profouind faith, from an unalterable confidence in Providence.' They rarely use alcoholic liquors, and almost never to excess; this is universally conceded. They seldom marry out of their own race, and have little hereditary disease. Parton, vho quotes from the organ of the London Society for the Conversion of Jews, con. fesses, ' As to their mpral qualities, the evidence sceins tu show' that the lower class of Jews is decidedly superior to the saine class amoung ourselves. They are far less given to drinking; their religions customs enforce a certain ainount of cleanliness, boch personal and in their dwellings; and two families are never found inhabiting the sane apartient. . Among the tondittons unfavorable to longevity ve may mention their almost unmversal h.thit of residence in large cities ; and the rarity of their engagement in agricultural pursuits.\" Dr. Glatter concludes from al this, that \" under the relation of duration of life the Jews are in a condition much more advantageous than Christians. In effect, the more the mean duration of life augnients in a people, as is the case with the Jews, the more it diminshes",
         "LONGEVITY Or TH1t JEWISH1 kÀACP the number of widows and orphans, the more numerous the active and productive class, the more it diminishes the class of pure consumers......... It is evident from all we have here shown that the nunierical increase of a race depends more on the conser- vation of those already born than in a great fecundity, with less conservation of the issue. The Jews have always taken every precaution to preserve the hife of every individual born. 'hie Mosaic laws prescribe most of these measures-even to the cuen- struction of their houses, requiring balustrades about the roofs to keep children from falling from them. Ancient Rome, with all the jealous care she exercised in the conservation of her c:tizens, did not approach the excellence of the Mosaic dis- pensation in these matters. Jewish subjects would, tierefore, appear to be much more advantageous risks for hife companies than other races.\" Many of our readers probably learn for the first time the degree of their organic greatness, a treasure whii h posterity claims as its right to have transmitted to it, unimpared as the present generation enjoys it. Few would have imagined how great and marked are the physical qualities of the race, yet few can doubt their existence when advanced upon the testimony of the army of independent philosophers whose genius, penetra- tion, industry, and zeal here combine to raise the cloud which has shrouded from the eye of the Jew the rare qualities wîith which lie is endowed. Apart altogether from any spiritual bearing the Jew is shown to possess grave and substantial reasons for guarding with wonted persistence and jealousy his pure inheri- tance from alloy. Dr. Hough has given as one of the causes ot jewisli longevity the possession of two Sabbaths in seven days. Witlh the loss of a sixth portion of tine for work and study the Jew ought to be poorer and more ignorant than his neighbors. Yet the prizes in the race of life. as well as the prizes at school and college, fall at least as plentifully into the hands of the Jew as into those of his fellow-laborers. If, then, the additional rest gives additional life and health without the loss of wealth and knowledge, long may tie Jew preserve his Sabbath with antique sanctity, even as a physical duty, as an offering to his advanced development, and long may the double Sabbath give greater \"density \" to his nerve, and help to maintain the vigor of his perfect organisationî. Other suggestions arc offered to account for the longevitv and greater proportionate number iu tie Jcwish population, such as the absence of dangerous occupations ; but this explanation cannot be accepted in the face of statistics vhich indicate so great a saving of life in early childhood. The Jew knows no caste, le feels hinself destined for a high place, and as soon as the incubus of poverty or intolerance is removed, rises with better fate to a higher grade, even as in many cases before",
         "PUBLIC HEAETH MAGAZINE. improved manners and more ex'ended education (for which ho evnces, as a rule, a remarkable aptitude) haxe qualified him for the more advanced status for whith he pines, and to which in. dustry and laudable ambition shall have carried him. Ilence the Jew occasionally suffers because tested by a standard unfairly, high ; such a man working on the committees of charities, mixng in society, and zealous as the Jew always is in works of utilty, is quoted by his colleagues as a specimen of a Jewish gentleman, nstead of a noble example of irrepressible power and elasticity just emerged from the chrysalis of a small trader. The son of such a man will stand the test of his due gauge, for with fair play it requires but one Jewish generation to slough the exuvla of transition and reach the higher grades of rank and knowledge. The time waen the Jew was first admitted to prac- tise at the bar of England is within the easy memury of a middle- aged man, yet in these 30 years last he has sprung to the front ranks even to occupy the bench. The Jew of Spain, persecuted, oppressed at times and denied all rights, yet served the state in posts of learning and preserved the literature of Europe. Seven millions of men, a inere drup in the ocean of mankind, who can make themsehes seen, felt, and hcard, wherever civilised man is known, and even farther, who in spite of the dark cloud of oppres- sion have far and wide filled the professorial chairs even in places where the cold ,fug bas been darkest, and have corne forth as panters, poets, physicians, philosophers, lawyers, statesmen, and musicians, may be considered to have fulfilled many of the high duties impied in the foregoing statistics and observations. The Jew appears to have ntuitively applied himself'to a passing ser- vitude only to last out the short reign of intolerance or misfor- tune, which he can shed as eabily as the snake casts its skin, a task not to be accomplished had he tied himself to the soil in tilling its surface or groping beneath it. It is his mission to be harnessed and ready to march forward to vorks of usefulness in whatever direction his qualities may tend, not only as an obedient instru- ment in mighty hands but as a volunteer champion. When ev én handed justice shall everywhere prevail, and it is everywhere growîng, then the perturbations will soon cease, and the winnowing process of society will determine who among the Jews shall crop up to the surface, who shall subside to the lower strata, and who shall follow the plough. Ia the short interval let him extract courage from past evil, looking on his misfortunes as so many fires by which he bas been tested and hardened, and renembers in the words of his distinguished brother- \"Wine oozes from the trodden grape, Iron's blistered into steel.\""
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      "identifier" : [
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         "Toronto : [Ontario Pub. Co., 1900]"
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      "title" : [
         "The Canada lancet [Vol. 34, no. 10 [i.e. 11] (July 1901)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "TUE CANADA LANCET VOL. XXXIV. TORONTO, JULY, 1901. No. 10. ORIGINAL ARTICLES. PRESIDENT'S ADDRESS, ONTARIO MEDICAL ASSOCIATION. BY ANGUS MACKINNON, M. D. Guelph, Ont. Laîst year when I was informed that I was the president elect of this, the largest and most influental Medical Association in the Dominion of Canada, I felt that an honour came to me that should more properly have gone to someone more capable than I am, to preside over this noble assemblage, with the ability and dignity that the occasion de- mands. I was content as a worker with my professional brethren to continue my efforts to make these, our annual meetings, both interesting and instructive. I keenly feel that I owe this honour to your very great kindness to me, rather than to any fitness in me to fill the position, or to any claims I had upon the Association. I know too, if I fail to acquit myself in the perfect way that my predecessors have done I shall receive from you a fuit measure of sympathy, When I look at the roll of the distinguished men who have preceded me in this chair it makes me feel all the more that your choice on this occasion might have been more fortunately made. I need scarcely say that I appreciate your kindness and I am very grateful for the distinguished honour you have conferred upon me. I am fully confident that this meeting will be a successful one. I have been enabled with the generous assistance of our energetic Secre- tary to surround myself with earnest, clear-headed men on the various committees, that really do the work which commands success. To them we owe much. They have been untiring in their efforts and when you look at the comprehensive programme which maps out the work. of the meet- ing you will understand they have had no sinecure. If we can make time to carry out the work represented in the programme I am quite sure the meeting will be most interesting and instructive, and I venture to hope, one of the most successful in the history of the Association. Before I go further I wish to extend to.our guests the right hand of cordiality and to say to them that I do not know aright the members of the profession resident in Toronto if by any chance they fail in being made to feel wholly at home. We invite them to take part in our discussions, giving us the light of their experience. [ 571 ]",
         "MACKINNoN: PRESIDENT'S ADDRESS. . Indeed the highest success of such a meeting as this can only be attained when every member feels it his duty to contribute what he can to the discussions. Innate modesty is al] very well, but here we are a band of searchers after truth, burning with desire to know ail that can be known as to the best methods of battling with disease, of relieving suffering, and of saving human life. It is not much short of a crime if any member through modesty keep silent if he has any knowledge to impart. It may not be necessary thus to encourage our brethren from the larger centres to speak in the discussions-they are accustomed, as teachers in the schools or members of the various Medical Societies to discuss any subject. But I do wish that the members from the country be not too modest. Their isolation compels them to be keen observers and necessarily self-reliant, and I am quite sure the discussions will gain in interest if they take a fair share in them. We have entered a new century. Contrasted with the state of Medicine at the beginning of last century what vast advantages we pos- sess. The discovery of anesthesia about the middle of the last certury and qf the proper use of antiseptics twenty years later, and of the real meaning of surgical cleanliness at a still later period, have opened a wide field for advancement in which this century has grand opportuni- ties to make medical histoi y. If we fail to make even greater prooress than ever yet made we must consider ourselves less studious, less obser- vant and less capable than our predecessors. Surgeryisnow almost wholly different from what it was twenty years ago. There are prominent and successful surgeons who affecttodespise the great attention given to antiseptic details which others think essential. But this mucþ is true of all-every surgeon aims at being aseptic, if not antiseptic, in his methods. The mnan who is faithful to the idea of asepsis, even if he laughs at the use of rubber gloves in operations and makes light of other details, is still influenced unconsciously by the teaching of the great Lister . It is true that although the ritual which was once thought essential is fast disappearing the results obtained under present methods are equally good. In Medicine the immense benefit to the human race by the discovery of vaccination at the beginnng of the last century has been almost equalled by the discovery of antitoxin for diphtheria in its closing years. As to tuberculosis although, the bacillus which is looked upon as its cause has been successfully isolated, we are still without an anti- toxin for it. Cancer and other forns of malignant disease from year to year cause much suffering to the human race and claim many victims. From the vast amounts of profound study devoted to these diseases I am sanguine enough to hope that the dawn is not far distant of that grand and glorious day when w e can say to the world that tuberculosis and cancer can both be cured. Is it a dream ? Not more than it would have been twenty years ago to say that a cretin could be cured. Any- thing more absolutely hopeless than the state of the unfortunate cretin till the use of thyroid extract was discovered could not be. Then let us hope that soon a great discovery will enable us to deal with cancer and tuberculosis with the same success that has crowned the use of thyroid extract. 572 [ JULY",
         "MACKINNON: PRESIDENT'S ADDRESS. In Materia Medica the new century opens with wonderful surprises. The improvements and changes follow each other so rapidly as almost to make one's head dizzy. If the pharmacists continue to pour out upon our innocent profession new drugs with impossible names as they have been doing in the past few years it will be a sad time for the future students of medicine. The old Pharmacopeia groaned with the load of useless drugs, but the Pharmacopœia of this century must be immensely larger in case even a few of these drugs win their way into medical contidence. Try, if you please, to imagine what the gifted Abernethy would say if recalled to human existence and you named over to him some of the ne wer drugs, for example, stypticin, dionin, largin, hydro- zone, mercurol, cuprol, nargol, ferrinol, anusol, etc. Whilst I cheerfully give great credit for the elegant preparations manufactured by the pharmacists of the present day I cannot but believe that some large manufacturing firms on both sides of the Atlantic, but chiefly on this side, are doing very grave injury to the medical profession by putting up elegant preparations either as pils or mixtures, according to certain formuhe. For example, a pill for a cardiac tonic, a pill for nenralgia, for malaria, etc. These preparations are on sale at every drug store and I think the medical man is the wiser who writes bis own pre- scription however simple it may be instead of making use of any of these combinations. No medical man should allow any one to think for him as to what his patient needs, nor should he permit any manufacturing druggist to use him as a sort of advertising agent for his products. In many parts of this Province the literature and drugs sent out to medical man by large manufacturing concerns have become an intolerable nuisance. Our noble profession which gives its all to the relief of suffering humanity, has attached to its skirts many things which are not clean. I might mention the advertising cancer-curer, the Osteopath, the so-called Christian Scientist,whose religion in claiming to be Christian. is as much a fake as bis science, the electric belt man, and many others. It is our duty to the public to warn them against these, that they be not deceived. They are all frauds; but there is a far greater fraud. I refer to the manufacturers and vendors of the various patent medicnes. Under a claim that some new medicine of rare virtue is known to them alone, or that they have discovered some new combination of drugs that bas marvellous potency, they push their sales by advertising in the most grossly fraudulent manner. Men's names are attached to testimonials they never wrote, certifying that they have been cured of diseases they never had, in order to lure unfortunate victims of these diseases to use their so called remedies. Not satisfied with advertising like the ordinary business man, they stipulate that their advertisements and testimonials shall appear like the ordinary reading matter of the paper, thus trying to lead the unwary to think that the paper in which the advertisement appears really endorses their impudent claims. The press, I regret to say both secular and religious, with rare exceptions, open their columns freely to these fulsome, untruthful and sometimes immoral advertisements, because they pay well. 573 1901.]",
         "MACKINNON: PRESIDENT'S ADDRESS. [ JULY Here lies a large mission-field for our profession. We must teach the people that wrong, and wrong only, can corne to them from such un- inteligent use of medicine. We must appeal to the manhood of the capitalist that it is in the last degree dishonorable for him to try to make large gains by thus committing a fraud on the sick. And eventually we must strive to secure such legislation as will mark the man a critminal who uses such means to sell drugs. Before such a legislation can be secured, or even if secured, before it could be enforced, the public must receive a very considerable degree of education from the medical profession. To accomplish this end every medical man must look upon hinself as a missionary in the cause of science and truth. He will require to direct his efiorts to enlighten the people as to the properties of the various drugs in common use, the nature of the common diseases, their causes, and that there is no dark secret as to the methods by which he endeavors to cure them. He must show that he is a constant student and a close observer. It must be quite easily seen by the people that the saving of life and the curing of the sick are more dear to his heart than are the shekels that should come to him as a reward of his honest labor. By such a course the influence of every medical man will grow upon the people. The masses of the people even at this day are deplorably ignorant so far as anything relating to disease is concerned. They know nothing be- yond the worse than useless things they read in the newspapers, and quack advertisements. Many men are woefully ignorant in medical mat- ters, in the knowledge of disease and its treatment, who are in other matters fairly intelligent. Clergymen, lawyers and successful business men are often the dupes of the veriest quackery. If the mission of the medical man was fully accomplished these things ought not to be so. I referred to the semi-religious, \"pray-for-hire-healers,\" known as Christian Scientists and allied to them are the Dowieites. This far the medical profe.ssion has treated these people with ridicule or ignored them entirely. If they confined their efforts to the unfortunates who imagine they have ailments they have not, we coild well afford to continue thus to treat them. But when we find theni impudently undertaking to treat infectious diseases, such as diphtheria, scarlet fever and small-pox, diseases which they are unable to recognize, we think we have come to a point where toleration and forbearance become criminal. We have a right to insist, in order to protect the people from the spread of these diseases, that no man or woman shall be allowed to treat disease, by any means whatever, who has not had the training necessary to enable him to know the character of the disease he undertakes to treat. These people deny that disease exists and, of course, do not report to the proper officers any case of infection. ['hey go mn and out amongst the infected and allow others to do the sane; thus criminally and at variance with all health regulations, they are doing all they can to sprt ad these infections. Surely it is time the 2,500 medical men in Ontario raised their voices and used all their influence to obtain from the Legislature such an am- endment to the Medical Act as will put an end to this trifling with human life. Medical men are now compelled under a penalty to report 574",
         "MACKINNON: PRESIDENT'S ADDRESS. every case of infectious disease to the proper authorities, in order that its spread may be prevented. But these people trading under a religious name do not report any case and undertake to treat everything. Why should it be so ? On many questions which affect the relation of our profession to the public the education of the people is of much greater service than legisla- tion, but on the·action of these religious healers who profess to cure the sick by praying for hire, nothing less than very stringent legislation will meet the case. These people must be taught that infectious diseases are not to be spread by them, under a, y cloak, religious cr otherwise. Tol- eration towards religious belief is very commendable, but toleration of a vile fraud, of which the nanie is the only Christian thing in it, ceases to be a virtue. There is another matter on which I wish to speak very briefly befo· I close. For many years there has been a great deal of friction about the admission of cases of acute mania to the asylums. Every medical man, except those in the immediate locality where there are asylum.s, knows about the delay that occurs before a patient eau be got into an asylum, no matter how urgent the case may be. The regulations that are in force provide that a medical man in whose practice a case of insanity arises must apply for a formal application or history paper which must be filled in and sent to the medical superintendent. If the patient has means for his support a form of bond is furnished which must be filled in and sent to the bursar before the medical certificates are issued. If the patient lives fifty miles or further from the asylum, even if the papers are executed immediately on their arrival at each end, the delay by their transmission both ways in the mails will cover from seven to\u003e teelve days or longer. In any case of acute mania this state of things is wholly wrong and surely unnecessary. The regulations require to be looked into and amended in the in- terest of the general public. All the necessary forms for the committal of the patient to the asylum should be procurable at once, and in somte central place in every county, without having to wait days and days for the delivery by mail of, first a history paper; later on a bond; and, by and by, the blank medical certificates. Meanwhile the friends unaccus- tomed to the care of such a case reach a state of mind scarcely more san., than that of the patient himself. I beg to suggest that a strong commit- tee of this Association be appointed to consider this matter ând to confer with the proper authorities in order to obtain some redress. It mig.t be urged against this that the depriving of a man of his liberty should not be too easy of accomplishment. This objection cannot apply because it is not desired to make any important change in the papers for admission and the persons who now pass judgment upon the case would still do so. The needless delay due to the transmission of the necessary papers by mail can and must be terminated. From year to year from this chair reference has beeri made t) the desirability of having a medical act for the wlole Dominion of Cana la, instead of permitting matters to go on as they have in the past-e tchl Province having a separate act of its own, the license to practice medi:in, 1901.] 575",
         "MACKINNON: PRESIDENT'S ADDRESS. being limited to the confines of one province. In view of the many ad- vantages a Dominion act would confer especially on the graduates from Medical Colleges in the Dominion of Canada, at home and abroad, we of Ontario, should be willing to make any reasonable sacrifice to attain that end, excepting always, any course that would lower our present high standard of examination. 1 cannot say that the bill introduced into the House of Commons by Dr. Roddick is wholly satisfactory. I am hopeful that there is in the profession, wisdom enough to draft such a measure as will remove the objections to Dr. Roddick's Bill. If it be thought the best course that each Province surrender the control of medical affairs to a single Medical Council for the whole Do- minion, then such a Council must be representative in character, and largely, if not wholly, elected by the medical profession. It must hold its examinations at least once a year in the capital of each Province. On the other hand if the control of medical affairs is to remain in each Pro- vince some inexpensive scheme should be devised to have the examina- tions exactly the same in the whole of Canada. The degree or the license thus obtained would cover the whole Dominion and would be recognized in any part of Great Britain and would entitle the holder to appointment for the army or navy. The Dominion of Canada, our great country, bas risen to the notice of the whole world in the past few years. There is no possible doubt that ere two or three decades pass, her place in the world will become much more important. And though we may find many things to admire in the great people to the south of us, we are to-day at heart more thorough- ly British than ever before. We are proud to be a part of that great Empire whose flag protects its humblest citizen in all his rights, as to life and property, of that great Empire whose laws are just, and justly ad- ministered by impartial judges. The destiny of this country is clearly to fil a large place in the councils of this mighty Empire. In medical affairs let us seek so to act that nothing shall remain to hinder our graduates from occupying any position for which they are fitted, in any part of this Empire. 576 F JULY",
         "BOYD: LARYNGEAL STENOSIS. A CASE OF LARYNGEAL STENOSIS FROM PAPIL.LOMATA.* By GEOFFREY BOYD, B.A., M,B., Lecturer on Clinical Medicine, Univ-ersity of Toronto. R. W., aet. 6ý years, admitted to the Hospital for Sick Children. Dec· 20th, 1898, with loss of voice. Family history unimportant. Two other children subject to croup. Personal history. Had several attacks of croup. Had measles when 4 )years old ('96) and in following spring ('97) became hoarse. Since then the voice was gradually lost. At the tine of admission to the hospital it was just a whisper, but the cough was dry and harsh, especially after being out of doors. Physical examination. Respit atory, circulatory and other systems n-rimal; white papillonatous patches on anterior part of vocal cords. Tonsils hypertrophied. On Dec. 7th, under chloroform, the larynx was curetted by Dr. Mc- Donagh. While under the anSthetic the patient had a \" spasm \" resembi- ing a carpopedal contraction, followed by great difficulty in breathing and cyanosis (tetany and spasm of the glottis). After operation there was a troublesome, croupy cough and much inflammation of the larynx, which gradually subsided on Dec. 21st. It was seen on examination that the left cord was free of growth. Slight growth on the right. Dec. 28th. Vomited and complained of pain in the stomach. Cough increased, with inspiratory whoop and expectoration of yellow viscid mucus; it became more paroxysmal and assumed all the features of pet tussis. Jan. 5th,'99. Inspiratory stridor was noted with recession of the soft part.- in the upper thorax, and on examination membrane was seen in the larynx. Patient was isolated, antitoxin given, and calomel fumigation was also resorted to. Klebs-Löffler Bacillus was found next day and the child was transferred to infections ward under my care. Here he remained until the 20th,passing through the laryngeal diphtheria without troublealthough there was slight stenosis. On 24th Jan.the note in the history is that there is still a paroxysnal cough and that lie is to go home and return in the spring for further treatment Owing totheabsence from the city of Dr.McDonagh, the patient was again put under my care. Jan. 29th, temperature rose to 1039 with sharp pain in the throat,lastingonly a few minutes, but followed by great dyspnoea. On laryngeal examination there was marked redness extending to all parts of the larynx free from growth. More growths were on the right than on the left side. This acute laryngitis was treated by steam inhalations and expectorants, but the dyspnwa continued, with evidence of increasing stenosis and occasional attacks of laryngeal spasn with cyanosis. Relief from spasm occurred after expectoration of a small amount of blackish mucus. Intubation was therefore done on Feb. 5th as a temporary measure, the tube for a 4-year old child being used. Great relief immediately followed. The tube being small was coughed out sev- Read before the Toronto Clinical society. 1901.] 577",
         "BuO: LAyNEAI, STENOsIS. ral tinies in the course of the next tew davs, and the next size larger could not be introduced without force and therefore greater danger of detacli- nment of portions of the growths. On Feb. 9th, the tube was expelled, ai as t here vas no dyspn\u003cea nor recession of the soft parts of the thorax it was not replaced. Slight attacks of nocturnal laryngeal spasm, with \u003cyspin a occurred, easily relieved by Ste\u003cin inhalations. le was seen frequenttly and was coinfort;ale and the. breathing free. If there was aiy return of the stenosis. tracleotomny was t b)e aperformied. On the ilglit of Feb. 1 Ith, a sense \u003ef h-yngeal spasmî ocui e d and before a tube coulld be inserted le stopped breathing. When a tutbe wvs introduced 5 7,S",
         "BuYD: LARYNGEAL STENOSIS. etforts at resuscitation were emiployed fîr 30 minutes without success, although air entered the chest freely. Post mlortei examination: the usual signs of asphyxia weie pres- ent,-lungs dark and full ot blood, becoming red after exposure to the air.; smnall dark portions of collapsed lung appeared all over the surface, especially at the base of the right lung. Both chambers of the heart were empty. Wall of the right ventriele very thin. No clots were pruesent. Livcr, splet n and1i kidneys congested. Larynx. Large papillomiatous growths are seen ociall on the rigit side in the position of the vocal cors, conipltely covering thm. Papil- loiata are present also in the riglt ventricular band, the interarvtenoid fold and in the infraglottic portion of the larynx. The griowths r larger and more numerous than appeared the case on laryngeal examination. Remiarks. Papillonata are the commonest 3ý) per ceit.) of the benign gro'0wt hs incrr;ng i the larynx and are found frequentlyin children. Tliey spring usual i rIo the vocal cords, especiailv the anterior parts anid the anterior coni issure, but alo fron the ventricular bands, the ary- epi- glottic fis. rarely from the epiglottis and interarvtenoid fohils. As to their cause, they miîay occur congenitallv or as the re-ult of irritation. iln the case under consideration1 the growths appar-eitly were not coli- geni i tai, for tliere Were nO VOiee symptoims until 41, yt ais and then after meas. It is possible, though that they may have been present from birth bu t not in a position to cause symliptomis, and that the attacks of cro1up which lie lid in infancy were a result of the papillwumata. Thiere seems to le no doubt that as tle resuilt of the diphthila and the sulîse- quent laryngitis, the growths increased ini size and number, evidenced both by local examination and by the signs of stenosis present, especially in the latter att ek. The treatient in childrei is unsatisfactory, not oni v froi the ditticulty of operating intra laryngeally but also froi the te n- denlev to recurrence. If there is no respiratory difficulty, operation imay be deferred until the child becoies older and gainîs therefore more self- coitrol, when intra-laryngeal iethods iay he tried, or curretteient under general anasthesia, repeated if necessary, often is suecessrul in eradicating themîî. But if thire is dyvspuuwua, trîaceotoiyv shouli be done, aid at the sane time the renoval of the growths ya thy'rototmy or su1 hidi î phîarvngotomyv, or lse the reioval deferred to a later date and initra-larvneal unethods used. G. H. Mackenzie, of Edinburgh, recom- iiends tralîci tomîy alone and cites cases to show that under the funic- tional rest gainei thereby, the papillomata shrink and fall (1 without any teindener to recul. Intubation has beien recý nnnended to relieve dyspuma and by pressure of the tube to promnote absorption Ii tlis case tracheotomny was always kept in view, but was not done owing to the improvemiîeit following intubation and its continuance after reioval of the tube. It is to be regretted that it was not dlone in spite of the apparently good condition of the clild, then all danger fron the noc! urnal larvng aispasil would have b e-en removed, but this il another illustration o\u003cf wisdom gaiied after the event. 190 1.] .579",
         "MACWILLIE: SEALING IN THE NORTH ATLANTIC. SEALING IN THE NORTH ATLANTIC. JOHN MACVILLIE, M.D., C.M. Ship's Surgeon on the Sealing Steamer \" Algeine.\" For the first time in the history of the sealing industry of Newfound- land. a record rulning back over a century, there was provided this year a surgeon for each of several of the vessels of the fleet. This advance in consideration of the health of the large number of men, over 4,000 on 18 vessels, was due to the untiring efforts of the Rev. Dr. Harvey, of St. Johns, a man who bas done more than any other for the welfare of Newfoundland, and the ex-Governor. The adminis- tration of carbolie acid in mistake for black draught as a climax to a Iong list of deaths wbich have happened through lack of knowledge, was an excellent lever to move the vessel owners to a fuller sense of their responsibility for'the lives and well being of these hard-tried sealing men, and it is hoped that the experiment of this year will be the constant practice, and that the time of septic wounds, so frequently resulting in the loss of fingers, of blue pill and of curses as remedies for all ills, will give way to rational and scientific treatment. The interest in a trip of this kind lies not only in the professional side, with the new conditions in which we see disease-our slums are well kept hospitals in comparison-but also in observing the ways and char- acter of, to us, a new people, of visiting the country which is fast becom- ing the most popular vacation resort in America and of participating in this most exciting sport. Our party of three left Toronto on March 5th and were joined at Sydney by the fourth. Here we rested with rising and falling hopes of soon becoming acquainted with the steamer which was to take us to that land which Burns knew of in his \" Twa Dogs \" as \"Some place far abroad Where sailors fish for cod.\" But the \" Brnce,\" a beautiful Glasgow built vessel of the Reid line, cornes at last, and none too soon, for a few hours later would have given us this seventeen hundred mile journey for nothing. We arrived at St. Johns a short time before the sailing of the fleet on Saturday morning. It is Newfoundland's greatest day. At seven o'clock, as we are enjoy- ing breakfast with our good friend Dr. Harvey, we hear a steam whistle. Then for an hour the din and noise of gongs, whistles, bells and men, make us think we are again in Toronto on Pretoria day. St. Johns is full of it-beautiful St. Johns, but we have no time now to enjoy its beauties, our boats leave at 8 o'clock and we must catch them. Time, tide or sealing vessel waits for no man this morning. We have barely time to say good-bye as we, one by one, turn f rom the main street to the wharves at which our respective vessels lie. Mine is the last, and on reaching it I find the \" Algerine \" straining at her stern line and three or four feet from the side of the wharf, for as 8 o'clock comes every cap- 580 [ JULY",
         "1901.] MACILLIE: SEALING IN THE NORTH ATLANTIC. 581 tain endeavors to get his vessel off first. With a run and a jump and I am aboard, hand bag, camera and all, and then my trunk comes-thrown after me, and with thankfulness I sit down to recover my breath. Soon however one gets in touch with the absorbing interests of the day. Now it is 'our\" vessel and \"our\" crew and the crowded wharves. All St. Johns is here. The church services and the Governor's address of yesterday are over, and now they are bidding farewell to the 4,000 men, on whose success depends the stand or fall of shipowners, of merchants and the food and clothing for these men and their families for a portion of the year. \" Up anchor \" comes the command, and with a jump the wince starts. Then amid the groans of the crew it \" fouls.\" Eight o'clock, an I she begins to work. Soon our starboard anchor appears above the water, but alas, it has caught up a chain which must be cast off. One by one the vessels clear. A little swearing-not nuch, for these people seldom use oaths, more work, and amid cheers for all and three more cheers for Capt. Greene, we are off; last of all but ere night comes we are ahead of all. The day is warm and bright and as we tiaverse the half mile or more to the mouth of the harbor we have an opportunity to enjoy the view of the city and harbor. The harbor is a mile long by half a mile wide and enclosed on all sides by hills some hundreds of feet high, entrance being gained by a channel two hundred feet wide at the northeast end. The city is built on the north side hill, and from the deck the tiers of itreets, as manmoth steps show off magnificently the great cathedrals and other large buildings for which it is noted. As we leave the harbor the vessel becomes the object of my interest. The Algerine is an ex-British war vessel, re-hulled and fitted up for this trade. Those specially built for the work are upwards of two hundred feet long by thirty feet wide, and capable of carryiug six hundred tons, all are single screw steamers, of eight to ten knots, and are assisted by sails. The hulls are massively built, of steel, oak, and teak, and are from twenty to twenty-f.ve inches thick and all is needed, for excepting the first and last two days of the voyage, the ship is constantly pounding through ice, ranging from a few inches to three feet in thickness, an experience which any of the great transatlantic lines would not survive for one hour With steam and sail we speed on after the hurrymng fleet. In sight of land until evening one does not feel too far away from the world, but what a world ! If one were to judge from this shore, cold, bleak, barren, red rock. But this is Newfoundland from the outside. Our course is almost due north and by midnight we enter the great ice field, which ex- tends northward past Belle Isle, and eastward for from fifty to one hund- re i miles, and in this we are to cruise until our cargo is complete, or coal or food runs out. The seals found in this area are not fur bearing but the commercial value is in the skin and fat, and those found are of two main varieties, Harps and Hoods. This is the breeding season and the Harps congre- gate generally near the Funk Islands, in a herd covering an area of fifty to seventy five square miles. The adult is from four to six feet long, and weighs about four hundred lbs. It is covered with a large area of short, stifi, black hairs on the back, and the rest of the body is covered with",
         "MACwILLIE: SEALING IN THE NORTH ATLANTIC. [ JULY grey liair. The pups, which are worth one dollar a quintal more, have a soft white hair until they take to the water, at two weeks of age, they then weigh seventy five to one hundred pounds. The Hoods congregate about twenty miles to the east or outside of the Harps and are a compara. tively small herd, this being the first year in six, that they have been found. It is so terned because of the sack like development of the skin covering the head of the male. An aperture connecting it with the nose enables it when attacked to inflate this sack to the size of a football, and no amount of pounding upon the head can then have the slightest effect. It is the seal commonly known in our zoological gardens as the sea-lion, one of my trophies of the chase was the hide of one which measured nine feet in length and weighed when alive about nine hundred pounds. For two days we pounded through the ice, at full speed. Fiequently we were brought to a full stop as the vessel struck a larger pan* than usual. Many small islands were passed, but night closes in without further signs of the seals. During the night the wind packed the ice more closely and on Tuesday morning we were almost fast in it. Four other vessels in sight are all in a like predicament. One had all her men out on the ice endeavoring to tow her to more open water. After four hours of shoving, ramming and going astern we managed to get clear of thejam and at nine o'clock we strike a skein from the H ood-herd. We skermished with them for an hour, bagging about one hundred, and then went due west to seek the more valuable and more easily caught young Harps. At one o'clock on Wednesday morning the captain came to my stateroom and in an excited voice called, \" We'er into thein Doctor; we'er into the swoiles.t I half dressed and went on deck. Tfie hum of excited voices came from the mens' quarters, while from all directions could be heard the plaintive cry of hundreds of baby seals, some quite close to us, but it was too dark yet to see. There was no more sleep for anyone that night, and, by five o'clock all had breakfast and were eagerly preparing for the days work. THE SEAL HUNT.-It is just daybreak, and a half dozen other ships are in sight. Seemingly having as ourselves just come in, our crew is divided into three watches, or gangs, each under the orders of the \" mas- ter of the watch.\" The men are dressed in top boots made of sealskin, canvas out clothes and hats or caps of as great variety as there are number of men. A rope six feet in length is wound over the right shoulder, under the left arm, a belt to which is attached a knife in its leather sheath, and a steel, a canvas bag containing hard tack, and a gaff of wood six feet long with an iron spike and hook attached to one end, complete's each man's equipment. A few wear green or smoked goggles, and ten or more of each watch carry the ice flags attached to ten foot poles. As the captain orders the first watch to get ready there is a scramble for the sides of the ship. The men climb over the gunwale and stand upon the logs which are hung along the outside of the vessel, j ust above *The whole ice tield is broken into pieces from a few feet up to a hundred or more in diameter. These are called \"pans.\" Icebergs of ail sizes are comnonly called \"islands.\" tVernacular for 4eals. 582",
         "MACWILLIE: SEALING IN THE NORTH ATLANTIC. the ice, looking more like crusaders,with their staves and red and yellow flags,than anything I could think of. Now we brush the sides of a larger pan than usual and the command to jump is given. Sixty men have to leave the vessel in less than one minute-for we are going at half speed -and most of them have to go over the one paw. Some few get their feet wet, one or two up to the waist, but there is no time to consider such trifles. Away the ship goes to drop another watch a mile or two farther on in order to cut off a section of the herd for ourselves, for while it is a fair field and no favor, if one vessel fences off an area hy her men and flags, it is seldom inva led by the others. The men on the ice now scatter in progressively smaller groups until they are all in twos, covering every part of the field. As they go forward jumping f rom pan to pan, some- times crossing four to five feet of clear water, they kill the seals, mostly the young white coats-the bibies-as the old ones, knowing of old what the coming of man means, slide off into the water. A blow on top of the head with the heavy end of the gaff, then the seal is turned on its back. One stroke of the sharp knife through the skin and two inches 'of fat, and from the mouth to the tail, and the carcass is opened. A few more strokes, for these men become very dexterous with the knife-and the skin and fat is separated from the skeleton, and in less than five min- utes from the tine the blow is struck it is being dragged along at the end of the line to the next seal in siglit, to icpeat the operation. When five or six are thus secured they are dragged to the nearest flag, for by this time our ice flags are pl.nte d here an I there throughout the field. If the seals are thick they will continue this until night comes, each man securing anywhere from seventy-five to three hundred, the latter heing an exceptionally large nunber. In the meantime the vessel has gone out of sight, sending on the ice similar groups of men, but on in the dey back she comes, picking up the men and seals here and there. Throughout the day, from the barrel on the mast head, which was my favorite post of observation, one could see men and ships as far as the telescope would carry the sight. Thirteen vessels came into view this day, and upwards of three thousand men were all busily engaged in the work. By night the great white surface looks like an immense battle- field Carcasses, huîntim-like in the distance, patches and trails of blood everywhere. As darkness comes on the gory field is hid from our view and in place of this we see hundreds of lights blazing here and there all over the frozen ocean. They are the torches which have been placed by the flags, and thus the libor of gathering in the work of the day goes on ceaselessly. Though the darkness hides the bloody ice and snow from view, it does not clear the odor or darken the sight of blood from our deck. I was called out at 11 p.m. with the report that a man was dead in the forecastle and walked on seal skins six leet deep the whole length of the deck and found-syncope. The forecastle was stifling, so I had him brought outside, and the only place outside was upon the greasy, bloody, sealskins, and here the skins remain for twenty-four hours until they cool off when they are stowed below. On this, our first day, we killed five thousand seals, and next day ten thousand, but the ice is looser this year than usual and the seals are 1901.] 583",
         "MACWILLIE: SEALING IN THE NORTH ATLANTIC. more scattered. A ship's company of two hundred and fifty men bas in one day killed upwards of thirty thousand, and it took three days and nights to take them on board. In two of the days of our first week out the thirteen vessels within sight killed two hundred and fifty thousand young seals. Killing seals on Sunday is prohibited by the laws of Newfoundland, and this regulation is well observed, but with the exception of two or three masters, they all take aboard any seals which they have panned. By Sunday night we have all our pins aboard, as have most of our com- panions, all the seals to be found having been killed. Stealinîg skins is a very common practice. It is a great temptation to see a larit pile of them on the ice belonging to another, with not another ve\u003esel in sight. But our captain is one of the honest ones, and consequently. though we have killed over seventeen thousand, we have only fourteen thousand on board. Seventy-five flags are missing, which means seventy-tive piles of skins. Early Monday morning we head our bow again eastward to hunt for the Hoods which we left behind a week before. Full speed day anîd night for we knew the rest of the fleet would be in search for them too. HUNTING THE HooD SEAL.-At eleven o'clock on Tuesday morning we sight them. Five other vessels have beaten us in, but they are in a skein, so we cut off the south end of it for ourselves and are soon at work. In fighting the Hood the mode of operation is quîite changed. Here we are after the whole family, the young pup and the male and fema!e, and in them we have game well worth our most careful consideration, for pater and mater will fight for their young, and well does the great sea lion know how to fight. Our men are told off as befoi e, but their appearance has changed. What a difference a gun in the hand makes in the expression of the face. Rifles have been served out to the best shots, arid about one in five is thus armned and now they swarm over the sides of the ship looking like a gang of pirates. The gunners go ahead scattering over the tield, and stalking the gaine is now in order. Dodging f rom lummock to hum- mock of ice, he gets as near as possible, then the deadly Martini-Henri, or Winchester speaks, a bullet int he neck, and two or three men rush up and kill the pup and female seal-- and kill dead \" as they say, the male, for you inay shoot hii a dozen timcs and not kill him. And so the work continues all day long, and many are the tales of interesting fights and narrow escapes we hear on the return of the hunters at night. For one like myself, not being financially interested as the others in the commercial success of the trip, the killing of the Harp seal was no pleasuire, the cry and wail of the little pup was so akin to the human, that it seemed almost murder. Even from the ships deck we could see nany examples of parental love. An old seal seeing one of our men coning towards it, took withi ts right tippers (corresponding to the arm), the fippers of her baby and lifting it twice as though shaking hands, and with one long look into its face slid off into the water, only to protrude its head, showing a face with an almost human expression of anguish ; every few moments. Another shoved her pup into the water and diving 584 [ J ULY",
         "1901.] MACWILLIE: SEALING IN THE NORTH ATLANTIC. 585 herself kept the little one floating bv poking it up with her nose, until the danger had passed, when she shoved it upon the ice again, and in- stinct is so strong that you may carry the young a mile or more from where you found it and in less than one hour the mother will tind it. This is a favorite pastime of the men \u003cn Sunday. So among these I found pleasure and profit in playing with the young ones and observing their ways and brought quite a litter of thein a')oard the boat alive. But now we were arnong mightièr game. One soon tired of sho ning then and then for a few days I had ail the excitement of sport I wished and attacking these immense seals is no mean sport, if one bas only a g - ff as the weapon of offense. The Chief Engineer, as fond of the fight as myself, usually went with me, and when the ship was blocked we could wander over a large area. One day while hunting together with the captain in a field where they were few, we came across a family of them sleeping on the ice, for it was a bright day, the sun shining quite warmly. Getting up quite near to them I happily shot them with my camera, preliminary to the fight, after which I again snapped them at shorter range. As we came nearer, they awakened and growled out detiance. One attacked the female and after some little fight despatched it, while the remaining two together approached the great dog. His head was raised above four feet, the hood expanded to its full capacity, mouth open showing his great teeth, einitting an angry hissing noise. he awaited the attack. I struck him a ringing blow upon the side of the head and he darted forward but ny companion, who had gone around back of him, struck him a smart blow on the tail and he swung round as on a pivot and jumped at himu. Thus we fought for some tirne. Suddenly as the dog saw his opportunity, out went his great fipper with its long p3werful claws and ripped a deep gash in my companions leg, and before he could recover, seized the gaff in his massive jaws and crushing and twisting it, threw it about fifty feet. With a quick turn of his head, leaving hin defenseless, I gave him a smart blow upon the tail and he swung round to face me, but as he turned, I struck him a tremendous blow upon the throat. This for the mom- ent released the air fron the hood and another heavy blow upon the now unprotected head stunned him and he was soon despatched. He was nine feet in length and weighed upward of nine hundred pounds, the largest our Captain had ever seen. He now stands mounted in the show roorns of one of '1oronto's leading furriers. For a week we continued in this work; then for another week we cruised about, corning across small groups of seals liere and there, which had become separated from the main body by wind and by wave. We threw overboard ail the coal we could spare, and took from the men their bunks to make room for the seal skins. We loaded below and above deck with them, until our deck was within an inch of the water. Up to this time our ship has been as steady as in harbour, for the ice, which is death to some vessels, is the safest harbour in a storm to a seal- ing vessel. And now for home. Fortunately the ice was not so -' bard a front \" as the sun had been shining very effectually for some days, for a",
         "MACILLIE: SEALING IN THE NORTH ATLANTIC. On Sunday night we left the ice but found it too rough and went back into it for the night. On Monday we again attempted it and made Bonavista by nine o'clock p.m. A heavy fog coming on we did not ship anchor until five o'clock Tuesday afternoon, this gave me an opportunity of seeing something of the interior of Newfoundland, of which more latter on. Starting from Bonavista under a light wind, we got along very pleasantly until we came out into the broad Atlantic, with the full force of a strong east wind b:owing upon us, and tossing, rolling, plung- ing and sliding, now upon the very crest of a wave, now our deck swept from end to end. We arrived the next morning before daybreak in St. John, gone just twenty-four days. Five of the fleet are in ahead of us. The Hope will never return, her remains lie scattered upon the rocks in the Gulf, and the Virginia Lake was caught near the -north coast in an icejam and did not return for two months. These are but a few of the dangers the hardy sealers takes his chances on. Hardly any with a lengthened experience but have met with ship- wreck, some upon the rocky shore, others in the ice field, as their vessel has been cut in two as by a pair of shears, two ice jams meeting and catching the vessel between them. Frequently the vessels are elevated clear above the water by these ice jams, held there for hours, sometimes weeks, then gently dropped into its home again. In 1897 a most frightful disaster occurred in which forty ]ives were lost and many more have never recovered from the eflects of it. The 21st March, 1897, was a beautiful clear day until noon when it began to look stormy. In the excitement of the chase Capt B- , of the G , had sent out one hundred and fifty men early in the day, then steaming away out of sight kept all hands busy. At four o'clock in the af i ernoon the storn which had been brewing for some hours came upon them in full force, a blinding snow storm and intensely cold. Search was immediately began for those out on the field, but not one was taken up th\u003eat night. Next day one hundred were found alive, and the day after six were rescued, all being more or less frost bitten. Only twenty-four bodies were ever recovered, the remaining twenty-four finding graves in the mighty deep. One of the six became separated from some compan- ions, falling into the water he remained there immersed to the neck for some time, he got out without assistance and was immediately taken with ice blindness, an extremely painful affliction. Groping his way along he came upon a pan of ice about fifty yards in length, and here he walked alone, backward and forward for thirty hours, when he was rescued. l'his disaster is well-termed frightful, because of its magnitude, but heing lost in a fog in a storm,or by darkness,is an every day occurrence, and many are the groups of men we took abroad, they having lost sight of their vessel. With these dangers ever confronting the hardy sealer, it should be a matter of the first consideration to those in authority that he should be kept is the best physical condition: A brief review of the accommo- dations for the crew and of the medical report will show to what extent this is being attended to. For one week after leaving St. Johns the average space allowed each man, taking all the men's quarters, was fifty-five and one-quarter cubic 586 [ JULY",
         "MACWILLIE: SEALING IN THE NORTH ATLANTIC. feet, and on the return trip, was forty-one and one-half cubic feet. In one section there were seventy m'en who had only 29.7 cubic feet of space each, and this in a foul hold, underneath and at one end of which, was filled with seal skins and their oleaginous accompaniments. A hatchway three by four feet was generally kept open to emit the odors. The bunks, six by six feet and three feet from the deck, held six and sometimes seven men and their belongings. This, without any conveniences what- ever Seal, pork, and duff with hard tack for food, and the constant exposure of the men, was not conducive to good health, and it is not a matter of sui prise that among the two hundred and fourteen men on board two hundred and five required medical treatment and ninety sur- gical care. As it is a common experience to get the feet wet, even becoming totally immersed, (one of the many experiences which I did not miss) our epidemic of La Grippe is accounted for. Ice blindness is another common and extremely painful affection. Ab-olute constipation of a week, and even two weeks' standing, and diarrhoea are among the common ailments. Of venereal diseases, onlv one came under rny care. In all, there were twenty of the different diseases to deal with, pneumonia furnishing me with the one serious case. The surgical cases were mostly finger cuts, which in the past have furnished so many \"seal fingers,\" a septic condition which has resulted almost invariably in the loss of the finger. Tuber- cular cases of course we do not neet with, they cannot stand it. But one can very reasonably attribute to the constant exposure and total lack of hygenic surroundings accompanying this avocation, the inroad pul- monary tuberculosis is making among these hardy people, as well as among the inhabitants of presumably more healthy lands. To those of us taught to think of Newfoundland as the land of fog, codfish and \"French shore questio \" it was a delightful' surprise. Montreal with its temperature below zero and many feet of snow gave way on our first day there to barely enough snow to run a sleigh, and smart walking made an overcoat feel uncomfortably warm. The winters are milder than in Ontario, and for June, July, August and September the tempera- ture ranges about 85°, almost chilly when we think of our .00 summer. In our railroad trip across to St. Johns we were impressed with the sublime beauty of its scenery. Newfoundland has been well named the \" Norway of America.\" Its deep fiords, which indent the shores every- where, guarded hy lofty clifis, are on a much grander scale than the famous Norwegian fiords and are not less magnificent. To the lover of sport Newfounidland presents attractions which are probably unequalled anywhere. Its countless lakes abound with trout of the finest description, and are the abodes of wild goose, the wild dnck, and other fresh water foul. The grouse, the plover, the curlew and the snipe, are to be found all over the island. Above ali, the noble caribou or deer, in vast herds traverse the island in periodical migrations from south to north, and furnish the highest prizes for the sportsman. That important considerative, a3commodation, is luxuriously pro- vided for, the railroad equipment being equal to Canada's best, and the fine fleet of steamers running up to Laborador and around the island is as comfortably appointed as our best lake steamers. 1901.] 587",
         "MACWILLIE: SEALING IN THE NORTH ATLANTIC. Our whole party were in \"lucky \" ships. and all returned within a few days of each other with full loads,so we at once escape being jinkers* and \" lousy,\" and after enjoying the hospitality of our medical and other friends for a few days in St. Johns, returned to Toronto after an absence of six weeks, bringing many interesting remembrances of our trip, all with experiences, one with notes in abundance for a good story, t% o of us with skins for mounting, and myself with two live baby seals. SELECTED ARTICLES. AEROPHAGY. BY H. 1). ROLLESTON, M.A., M.D.., F.R.C.P., Physician and Lecturer in Pathology, St. George's Hospital ; Senior Physician to Out-patients, Victoria Hospital for Children. Aërophagy, or the swallowing of air, has been carefully studied by Lyonnet and Vincens (\" Lyon Médical,\" February 10, 1901) in eight cases, three of which were males. The symptoms are swelling after food, loss of appetite, desire to sleep, though there is often some insomnia, and frequent eructations, wfiich are usually noisy, vomiting is only occasionally met with. Gastrie syniptoms may accompanv aërophagy, and appear to be due to it, and not to be merely associated phenomena, since they usually develop after aërophagy is well established. The symptoms described by Bouveret as neurasthenic gastro-intestinal atony may be present. Con- stipation is usually noticed, and may give rise to mucous colitis, while enteroptosis and floating kidney inay co-exist. From incessant aërophagy there may be considerable tympanites. Occasionally the patient wastes and becomes cachectic, so that new growth is suspected. The eructations are usually noisy, but may be quiet. Before these eructations there are rapid deglutition movements; if these are overlooked, an erroneous diagnosis of flatulent dyspepsia may be arrived at. These eructations may occur first thing in the morning, before any food has been taken. Aërophagy usually occurs in hysterical females, and may begin sud- denly from shock or emotional disturbance. Being a neurotic manifesta- tion, the duration is variable. It may be cured by very simple means; on the other hand, relief may be only tenporary, and frequent relapses are very prone to supervene. Aërophagy may be voluntary-a physiological curiosity-or in- voluntary and pathological. There is then elonie spasm of the pharynx. Treatment falls under three heads: (1) The general treatment of hysteria by moral suasion, change of scene, tonies, etc.; (2) counteracting the pharyngeal spasm by keeping the mouth widely open, painting the pharynx with cocaine, and the application of blisters to the front of the larynx; bromides, valerian, and belladonna do good, and marvellous results have in some instances followed \"suggestion\"; (3) for the added * A term applied to all who cone in without seals. There are \" jinkers \" every year at this work. * Naturally two moniths of such accommodations would have its effect. 5 8 8 [ JULY",
         "dyspeptic symptons mineral waters and washing out tne stomach do little or no good. The muscular tone of the stomach requires tightening up, and for this purpose strychnine and ergot are recommended. Food should be given in a sonewhat concentrated form, so as to avoid the bad and inechanical effects of bulky food.-The Practitioner. THE IMPORTANCE OF THE EARLY RECOGNITION OF EAR TROUBLE IN CHILDREN. By MACLEOD\u003e YEARSLEY, F.R.C.S., Surgeon to the Royal Ear Hospital, etc. The discovery of adenoids by Meyer, of Copenhagen, in 1868 gave a certain impetus to the better recognition of the importance of the study of otology, especially in children, as a part of the curriculum of the miedical student, and since that tline the efficiency of the general prac- titioner in both diagnosis and treatment bas slowly but surely improved. In a large majority of cases partial or total loss of hearing in a, child is not noticed by a doctor on first seeing the patient, and, save in a few intelligent instances, is not accepted or believed by the parents. This is less often the case in total deafness, but in instances of partial damage only the condition is often unnoted or neglected until the child is more advanced in years and is at least over the age of four. The consequence is that much very valuable time is lost and treatment hais little or no effect. Let us take an instance-a child is the subject of adenoids and gets attacks of deafness with every cold, from which it recovers with dimin- ishing frequency, until it is in a condition of permanent deafness of sufficient severity to seriously handicap it in its future struggle for existence. This condition is directly due to the adenoids, and if recog- nized earlier and properly treated, would have resulted in perfect recovery. Having progressed to the stage just described, however, the prognosis as to the treatment is far less hopeful. One sees, unfortunate- ly, cases of this class with a too great frequency, and the appearance of the membrana tympani is sufficiently significant to one who bas the opportunity of frequently observing such cases. Whenever I find the drum exhibiting a loss of transparency and a dullness which is best likened to ground glass, I always find without exception that that case has gone too far to obtain much benefit from treatment as regards recovery or improvement., and one can only safely promise that the re- moval of the adenoids will improve general health and act probably as a stay to further progress of the deafness. Even in these days of improved medical education and perfected methods of diagnosis there are still practitioners who have sufficient temerity to assure parents that their children will \" outgrow \" deafness or discharge from the ears. The latter is, of course, a constant menace to life, but it is almost equally criminal to neglect the former since the sense of hearing is to some extent as necessary to the taking of one's place in the community as that of sight. 1901.] 589 AEROPHAGY.",
         "EAR TROUBLE IN CHILDREN. [ JULY It follows therefore that if a child is deficient in hearing, the soonei that fact is ascertained beyond a doubt the better. Steps can then be taken to ascertain the cause, amount and probable curability of the trouble and, if incurable, to at once place the patient in the best position for acquiring education in other ways than through the ears. It is hot always easy to determine satisfactorily the presence or absence of deafness in a young child, simple as it may seem to those who are unaccustomed to dealing daily with deafness. A child may be slow in learning to talk but this is by no means always an indication of defective hearing. Certain mental defects, too, may simulate deafness and nîust be excluded. Should a child otherwise normal, pass its first two years of life without acquiring one or two simple words, especially the \"dada', and 'mamna\" with which all babies quickly learn to greet their parents, it is nost probable the sub- ject of defective hearing. The general practitioner who is in the habit of seeing the child will probably lave his attention frequently aroused at an earlier period, and should this be the case, he should at once take measures to ascertain the accuracy of his suspicions. In any case of doubt I think it is best to examine the child under chloroform rather than risk possible future deafness. Much has been written on the dangers of discharge from the ear in children, and even now there are individuals who allow such cases to pas from bad to worse without making any real effot t to save theim. The significance of earache in children is of equal importance and receives almost equal neglect. So many men seem to lose sight of the fact that the ear may be, the tons et origo mali in many a puzzling febrile attack. Pain in the ear may be described roughly as of two kinds-inflam.i matory and non nflammatory. It is the former that is niost common in children, indeed, the non-inflammatory form is, in my experience, rare, and those who assert that the majority of cases of earacho in children are ' neuralgic\" in character fall in grave error. Small babies cannot make known the seat of their pain and can only di aw attention to it by screaming lustily, a means at which they are singularly proficient. When a child is in pain it requires careful observation to a-certain the spot at which that pain arises. The raisng of the hand to the ear, or the refus- al to lie upon that organ, or the tenderness of the ear to touch in wash- ing, etc., may afford an indication, but such future tiouble and chagrin would often be saved if the ears were examined in every case of febrile attacks, apparent pain, or even fretfulness. Pain in the ear varies riuch in tensity, and while in one case a child may be thrown into proxysms of screaming and possibly almost into convulsions, in another there may be only a condition of fretfulness and whimpering. A \" cold in the head \" in a baby nearly always affects the lymphoid tissue in the vault of the naso-pharynx. This fact affords an easy ex- planation of the frequency of inflammations of the middle ear in early life. The usual resuits of such inflammations and their simulation of meningitis, when they have not given rise to that complication, is suffi- ciently well known to ail practitioners and there is no necessity for me to, dwell upon it. The apparent attack of acute meningitii, pneumonia, 590",
         "EAR TROUBLE IN CHILDREN. typhoid fever or other serious disease which can be cleared up by a timely incision in the drum membrane, bulging from retained inflamma- tory products, must be familiar to every physician who has much to do with children. The importance to the general practitioner of the early recognition of ear-pain in children cannot therefore be over-estimated ; he is the first to see the case and by excluding the ear he will greatly simplify this method of diagnosis, while if he at once localizes the seat of the pain in that organ he will have the sati\u003efaction of sav.ng the patient much possible future suffering, himself much annoyance, and he may-possibly -earn the g-atitude of the parents. The simulation of or connection with other regional diseases was strikingly shown by Hartinann in 1899.* [le called attention in an article entitled \"On the Intestinal Disturbances produced by Otitis Media of Infants\" to the fact that loss of weight and elevation of tem- perature should always demand an examination of the ears, when it would often be found that the tympanic cavity contained pus, and relief would follow its evacuation. That author regards intestinal disturbance in infants suffering from otitis media as the result of the reaborption of the toxic poisons from the exudate in the tympanic cavity, rather than that the ear trouble resulted from the infection entering the Eus- tachian tube during the act of vomiting. It is astonishing how some men neglect their opportunities; one would think that in cases where the cause of a condition could not be ascertained with ease the practitioner would not rest until every organ had been investigated for a possible explanation, for his own reputation's sake if for no other reason. Yet, while engaged on this very article, I saw a case of a child of twelve, the subject of deafness due to adenoids and tonsils and in whom the tonsils nearly met across the fauces and were frequently the seat cf acute inflammations, whose parents had been told by three general practitioners, practising in two of England's largest towns, that nothing need be done as she would \" grow out of it.\"--Pedi- atries. A rehirte of Otology, vol. xxviii, Nos. 2 and 3, 1899. 1901.] 591",
         "5wHAT IS A COLD? [ WHAT IS A COLD? There is something very mysterious about the condition which is commonly called a \"cold.' It is popularly ascribed to a chill, but a brief consideration suffices to establish the fact that chill can only be one, and po-sibly not uhe most important, factor in its production, since it is only under sp3cial circumstances that exposure is followed hy the character- istie symptoms. The view that the condition of \" cold\" is one of repletion has much in its favour. It is when one is not feeling \" up to the mark \" that cold is usually caught, that is to say, when the eliminatory functions of the body are not doing their work properly, thus throwing the ma- chinery out of gear No one takes cold when in a vigorous state of health, a coil is the re,ult of insufficient exercise, the breathing of foul air, an excessive or an inadequate supply of food, or other violation of the eleinentary laws of health. Overfeeding and the consumption of alco- iolie stimulants appear to be particularily prejudicial in this respect, especi- ally if associated with a lack of exercise in the open air. On the whole, ai uiiderled man is in a better physiological state than one whose organs ,nd tissues are chronically burdened with an excess of nourishment not thoroughly assimilated. A starving man, it has been said, never takes cold, ihough this may be an euphemism, merely neaning that the vacuity of his stomach dominates his sensations to the exclusion of minor incon- veniences. Hungry hounds hunt the best, and, within certain limits un lerfed tissues are physiologically more active than tissues afflicted with plethora, and wlhen the bodily functions are actually or potentially active the sy-tem is no prone to take coid. It is suggested that the nasal catarrh represents an endeavour on the part of the organiism to throw off uneliminated impurities through the Schneiderian membrane vice the skin, and if s\u003e it inust be regarded as a very efficient filter in view of the copiousness of its excretion. The important point to bear in mind is that cold is disease essentially of internal origin, lue to defective purifica- tion ofthe tissues, the effects wiereof are brought to a crisis by a fortui- tous chill. The treatment, therefore, shou!d be as far as possible prophy- lactic. To live in the open air as much as possible, or at any rate to breathe as much fresh air as po-sible; to maintain the skin in a function- ally active condition by frequent baths, in the event of a hitch, resort to the more drastie cutaneous purgation induced by a Turkish bath. Com- bined with this, and in opposition to the popular adage, the diet during the acute stage of an attack should be restricted in quantity and simple in kind.-Medical Press and Circular. 592 [ JULY",
         "SOCIETY REPORTS. SOCIETY REPORTS. ONTARIO MEDICAL ASSOCIATION. The twenty-first annual meeting of the Ontario Medical Association was held in the Educational Department, Toronto, on the 19th and 20th of June, 1901, the President Dr. Angus Mackinnon, of Guelph, in the chair. The secretary read the minutes of the last session of last year which were adopted. The reportof the Committee on Papers was presented by Dr, Machell of Toronto, and the report of the Committee on Arrangements by Dr. Bruce L. Riordon. THREE RECENT GALL-STONE CASES. Dr Wm. Oldright, Toronto, said these cases had occured recently in in bis practice. They present features of interest to the profession. The first case occurred in a woman about fifty-.five years of age. He was rather surprised to be called upon to see her in a hurry, to find symptoms of gall-stone obstruction. The late Dr. Little had seen the patient and had endeavored to obtain purgation without effect. Powerful cathartics were unavailing. About nine months previously she had a similar attack, but Dr. oldright had heard nothing about it until this attack. The symptoms were: somewhat elevated temperature (about 100 to 101) constant vomiting, obstruction, and, of course, intense pain. He supple- mented Dr. Little's catharsis, but without any effect. On examination he could map out a distinct tumor, and told her that she had a distended gall bladder ; advised her to go into the hospital, which she did that night. She was operated on in the afternoon, and some gall-stones re- moved and he endeavored to establish patency of the duct. He could feel no stones left behind, but there was some stenosis of the duct. There was a great deal of inflammatory action in this case. The gall bladder was stitched into the abdominal wall and drainage established in the usual method; bile flowed freely, The patient made a good recovery. The second case was one Dr. Oldright saw in consultation with Dr. Mc- Lean, of Woodbridge. She was sixty-five years old. The prognosis was certainly death without operation, and provided there was no malignant trouble she would probably recover. In this case one could imagine the difficulty there would have been had it been his first case of operation, as he could not locate the gall bladder. He came to the conclusion that it was not a cass for further interference. Within twenty-four hours she succumbed to the shock and probably to some hemmurhage. There was no doubt after passing the finger in that it was malignant. If this woman had been operated on some years before, 1)r. Oldright thought that malignancy would not have occurred and her life would have been 19011] 593",
         "saved. The third ease occurred in a woman forty years of age. Upon her the surgeon operated last February. Here was a case in which there had been gall-stone symptois, obstruction, for about eighteen months. She consented to an operation. The obstruction was in the cystic duct. He opened the gall bladder and took out the stones which he exhibited to his audience. The operation occupied about forty minutes. The patient made an uneventful recovery, and left the hospital thirteen days after. Dr. Garrett, of Kingston, said that operative interference in gall- bladder surgery had only recently been brought into prominence. Early diagnosis is very important. We should operate at once when we make a diagnosis. He referred to a case which had been diagnosed as catarrh of the stomach upon which he iad operated and had extracted 170 stones from the gall-bladder. Dr. T. Shaw Webster, Toronto, asked Dr. Oldright if there are not some cases where it would be better to wait for a little while, in cases where there is a strong probability that the condition will disappear in a short time. Dr. Oldright in reply: As soon as we are satisfied of gall-stone ob- struction, as soon as acute symptoms have subsided, we should operate, and not allow repeated attacks to go on until malignant disease is established. EXCISION OF UPPER JAW FOR SARCOMA-WITH EXHIBITION OF PATIENT AND SPECIMEN. Dr. Herbert A. Bruce, Toronto, presented this paper, whilst Dr. G. Silverthorn exhibited the specimen. Dr. Bruce also presented the patient, a woman thirty-four years of age, from whom he had removed the upper jaw for sarcoma. The patient had been sent to him by Dr. Bowles, of Woodhill. The history of the patient is, briefly, as follows: During the last week of January of this year she felt, for the first time, a slight swelling over the alveolus of the left jaw, which she thought to be a gum-boil. She consulted Dr. Bowles at the end of March, and Dr. Bruce saw her about the middle of April-that is less than three months after the first symptoms. Dr. Bruce operated upon her on the 29th of April, exactly three months after she had the first symptom. On exam- intion he found a very hard swelling just behind the second bicusped tooth and extendmg backwards to the full extent of the jaw. Internally it had not extended to the middle line, and bulged externally to the extent of half an inch beyond what would be the line of the teeth. It extended backward toward the antrum, but the latter did not seem to be implicated externally. The growth in the roof of the mouth was covered by mucous membrane. On looking into the nose a polypold mass was seen, and the patient had some difficulty in breathing through the left nostril. The cheek on the affected side was slightly more prominent, and it nioved freely over the growth. No prominence of the eye on the affected side was to be made out. A small portion of the growth was removed under cocaine, and Dr. Silverthorne reported to Dr. Bruce that it was sarcoma. The patient left the hospital on the eighteenth of May and made an uninterrupted recovery. 594 SOCIETY REPORTS. [ JULY",
         "Dr. Silverthorne presented the specimen to the members of the As- sociation. It was the size of a large sized orange, containing spindle cells with a cartilaginous basis. Dr. Bruce stated that the history of the patient showed that a polypus had been removed about eight years ago, and he thought that it must have been a simple polypus. ECTOPIC GESTATION. Dr. R. W. Garrett, Kingston, extended his thanks to the Committee on P.ipers for placing under his care a subject of such great magnitude The subject is one of vital importance to every practitioner, for at any timfe he migit be called upon to differentiate the condition from others with n% hich it mnight be confounded. ''ie responsib'Iity of a life was in his hands and demanided accurate diagnosis, medical acumen and judg- ment and ability to conduet the case to a favotable termination. He enter, d at considerabl.a length as to the causation and earlier changes consequent upon ectopic gestation, and stated that every physician is expected to make a correct diagnosis of tubal pregnancy on the occur- rence of rupture; and in a fairly large proportion of cases, to make a correct diagnosis of tubal pregnancy on the occurrence of rupture; and in a fairly large proportion of cases, to miake a diagnosis before the oc- currence of rupture. Theoretically, the arrest of a fructified ovum may occur tirst in the ovary, second, in the abdominal cavity between the ovarv and tube, third, within the tube, and fourth, between the tube and the uterus. He would direct the attention of his audience to but one kind only,: arrest within the tube, or tubal pregnancy, as all other var- ieties are but merely developments of this kind, owing to secondary inva- sion of the Fallopian tube. These he divided into three groups: First, tubo-aldominal, or simply abdominal pregnancy, .in which there is as secondaiy invasion of the abdomen; second, tubo-ligamentary in which there is a secondary invasion of the broad ligament and subperitoneal tissues, and, third, that sub-division of the tubo-uterine in which there is rupture into or secondary inv- asion of the uterus. At considerable length he discussed the etiology, then the symptoms, pointing out the difficulties that lie in the road to making a diagnosis owing to the absence of many, if not ail, of the classical symptoms generally enumerated. Having dealt in a masterly manner with these he recited a very interesting case in illus- tration of his contention of the difficulties of diagnosis. Dr. J. F. W. Ross followed Dr. Garrett in the discussion regarding the diagnosis as the most important point of all, and especially the diag- nosis before rupture. He thought that we ought to be able to diagnose these cases before rupture had taken place. What are the symptoms ? Generally four or five symptoms. He referred to the pain that is indefinite, not severe, not acute, but a feeling as if something were wrong. He referred to several cases recently seen in practice. Dr. Powell referred to a case where Dr. Ross had diagnosed the condition before rupture had occurred 19()1.1 595 SOCIETY REPORTS.",
         "SOCIETY REPORTS. Dr. Oldright mentioned a double rupture of both tubes. Dr. A. A. Macdonald complimented Dr. Garrett on the careful manner in which he entered into bis subject, and thought it was one of the greatest importance to the general practitioner. He remembers the time when it was stated that no one could make the diagnosis before rupture. He referred to a case which came into Bellevue Hospital, in Toronto, comparatively recently-a case of twins, in which one child was delivered in the natural way, and the other cbild ectopie. Dr. T. S. Webster said that the subject was one that he had taken a great deal of interest in, and bas had to deal with four of these cases. Dr. Prevost, Ottawa, showed a specimen and said that sometimes, in spite of the most accurate diagnosis, we make mistakes. He described the case, the specimen of which he presented. Dr. A. F. McKenzie, Monkton, referred to a case seen in his practice, which went on to fuil term and was delivered of a large child and no trouble. He further spoke of the difficulty in making the diagnosis in these cases. Dr. Machell thinks the interest centres in the diagnosis. Dr. Mackinnon, the President, stated that he had not had niuch experience with these cases before rupture, but had had, a little.experience after rupture. He thought frequently there might be danger in naking a mistake. Hie also cited a case occurring in a young married woman with a little child five or six years old. Dr. Garrett closed the discussion, and thanked the members for their generous treatment of his paper. He considered that discussions of this character were of the greatest moment. Rupture is generally about the third month,and intertitial pregnancy can go on to a much longer term than tubal pregnancy, and in this form we generally have external rupture. FIRST DAY-AFTERNOON SESSION. PRESIDENT's ADDRESS. Dr. Mackinnon delivered a very able address on the opening of the afternoon session. He considered that it was a great honor to be elected president of this, the largest and most influential medical association in the Dominion of Canada. Having referred to the success of the meeting so far, he proceeded to contrast the state of medicine at the beginning f the last century with that of the present, and compared the vast advan- tages we to-day possess over those of one hundred years ago. Anesthesia, antiseptics, asepsis, vaccination, the anti-toxin treatment for diphtheria, the discovery of bacillus of tuberculosis were mentioned, and he looked for the dawn in no far-distant day, of that grand and glorious day when we can say to the world that tuberculosis and cancer can both be cured. He deplored the growth in the employment of new proprietary remedies, and thought that harm was being done to the medical profession by manufacturing firms making up pills for neuralgia, for malaria, etc Hie considered that the literature and drugs sent out to medical men by the8e manufacturing bouses had become an intolerable nuisance. The electrie 596 [ dULY",
         "belt man, the Christian Scientist, the advertising cancer-curer, the osteo- path, and many other such like fakes which hang on to the skirts of medicine, he scored most unmercifully, and regretted that the public press, both secular and religious, opened their columns freely to these fulsome, untruthful, and sometimes immoral advertisements, because they pay well. There was great danger to the public in permitting Christian Scientists, the \" pray-for-hire-healers\" and the \" Dowieites,\" impudently undertaking to cure infectious diseases, such as diphtheria. scarlet fever and smallpox-diseases which they are unable to recognize ; and he thinks that we have come to a point where toleration and forbearance become criminal. The 2,500 medical .nen in Ontario should have influence enough to obtain from the Legislature an amendment to the Medical Act that will put an end to this trifling with human life. He directed atten- tion to the delay that occurs in securing admission to the asylums for people, the subjects of acute mania, and thought it was high time the necessary steps in this department in the practice of medicine should be simplifled. PTLMONARY TUBERCULOSIS-ITs TREATMENT IN SPECIAL SANATORIA. Dr. J. H. Elliott, Medical Superintendent of the Sanatorium at Gravenhurst, read this paper. Speaking generally, it may be said that froim fiftv to seventy per cent. of the incipient cases are restored to health, while from all classes from fifteen to thirty per cent. are reported cured or arrested; in sixty to seventy per cent. a marked improvement. The first thing noticeable after entering the sanatorium, in most cases, is an improved appetite. a gradual gain in weight, and a decline in evening temperature. With this improvement night sweats disappear without medication, the cough and expectoration noticeably lessen, and the patient sleeps until morning. The principles generally adopted are: First, a continual life in the open air, with rest or exercise as indicated; second, a literal, suitable diet; third, medicinal treatment according to indications, and to a great extent symptomatic; fourth, hydro-therapy ; fifth, a strict medical supervision of the patient's daily life. Speaking of the \"rest- cure\" in febrile cases, the object is to reduce muscular exertion to the least point consistent with the ingestion and proper assimilation of a good diet. Referring to medicinal treatment ; with a hygienic life, pure medicines are required. The various tuberculins and seruns are being used both in America and Europe, with the prospects of yet securing a specitic for thost cases where nixed infection is absent. Constant supervision of the patient is the most important point in which the sanatorium treatment must necessarily differ from that adopted by the general practitioner. Living, as he does, with his patients, adopting their mode of life, having his ineals in common with them, the physician is enabled to individualize the treatment, and though on broad lines the patients all receive the same treatment, each one bas to be studied in detail, and the indications met accordingly. The chief point, under all circumstances, is that the patients, wherever they may be, live prudently, and ba under the care of an in- telligent and firm physician. 1901.] SOCIETY REPORTS. 597",
         "598 SOCIETY REPORTS. [ JULY Dr. Price-Brown referred to the advisability of sending patients fir sanatorial treatment, and stated that we have for every disease places to send our patients-hospitals throughout the length and breadth of the ]and-except for tuberculosis. Having recently been at Asheville N.C., he described the treatment which he had seen carried on in that institution. Dr. John Hunter, Toronto, deprecated sending these patients long distances away from their homes, which was formerly the custom, but is not so now. He hoped to see the time when there would be a laige number of these institutions established in this country. Dr. Elliott. in reply, emphasized the point that there should be no exercise when the evening temperature is above ninety-nine degrees; it may be permitted in the morning if it reaches one hundred or one hun- dred and a half, but not in the evening. VACCINAL PROTECTION AGAINST SMALLPOX. Dr. P. H. Bryce, Toronto, the Secretary of the Provincial Board of Health, presented this paper. [n the introduction to his aper he ex- pressed the belief that although the practice of vaccination againt smallpox has existed for a century, there neer was a tme since i was fornally accepted by the profession, when there was a0 much expressed scepticism as there was to-day on the part of the laity with regard to is protective qualities, and never a time when the profession has been so indifferent as to impressing the necessity of its proper performance upon the public. In Ontario, between 1898 and 1899, there were but twenty- two recorded deaths from the disease. He made special reference to the art of vaccination and the quality of the lymph, and thought five separ- ate insertions should be made in each case. The quality of the lymph was very important. He thought that a medical man going out froni college did not receive sufficienit practical instruction on this most im- portant subject. Mr. 1. H. Cameron discussed Dr. Bryce's aper and statedas a matter of fact, he bad no hesitation whatever in seeina a case of smallpox himself, nor would he object to any member of his fainily seeing it, if he knew that they had sufficient protection through vaccination. He warned the profession against laxity in dealing with this most important subject. Dr. Harrison, Selkirk, stated that he had had considerable experience with smallpox, and on account of that experience he entered a vigorous protest against the prevailing carelessness in insisting on vaccination and revaccination in the laity as well as the profession. Dr. John Hunter, stated that in many cases he had failed to secure successful vaccination. Dr. Geikie considered that Jenner's discovery was one of the greatest and grandest achievements in medicine. Dr. Price-Brown referred to a case in the Toronto General Hospital in the year 1866. Dr. Rudolf asked Dr. Bryce whether the instructions given along with lymph supplied by different firms were not partially to blame for the insufficient vaccination among the rofession. He considered that no one should be guided by those instructions.",
         "Dr. Bryce, in reply, thanked Mr. Cameron for taking up the discus- sion. He considered that the profession was lamentably ignorant of the nature of protection and protective qualities of vaccination itself. Dr. D. J. Gibb Wishart suggested that a resolution be passed by the Association expressing its approval of from three to five insertions, and advising manufacturers interested in the matter. Dr. Thistle thought that they should not st-pulate the number of marks, that it would not be wise, as many successful vaccinations had been obtained from one mark. Dr Stewart. of the Ontario Vaccine Farm, Palmerston, thought four or five marks better, so situated that there would be no coalescence. Dr. McPhedran did not wonder that the younger members of the profession were weak as regards the diagnosis of smallpox when facilities for instruction in clinical work was absolutely nil, he had repeatedly asked to be permitted to take a class to the Infectious Diseases Hospital,' but had alw.a.ys been denied. Dr. Noble, Philadelphia, thought as a surgeon that something else might have been said about the care of the vaccination wounds The wounds should be protected, so that there would be no chance of infection. DiscussIoN ON EMPYEMA. Medical Aspect.-This subject was introduced in a well prepared paper by Dr. Ferguson, London, who said that the treatment of this con- dition was essentially surgical, and that the medical aspects of the disease were limited to a consideration of its pathogenesis and prophylaxis. He considered that the conditions of non-purulent or primary effusion were indispensable to an understanding of the pathogenesis of empyema. He gave a description of the pleura and discussed the bacteriological aspect purulent pleurisy, which he divided into four classes: First, those due to pneumococci; second, those due to streptococci (and staphylococci); third, those due to the bacilli of tuberculosis and fourth, those caused saprogenie organisms. In nine cases, extending over eleven years in his practice, three were diagnosed tubercular, three meta-pneumonie, two due to the streptococci, and one undetermined. The prognosis varies with the micro-organism present, the pneumococci being the most benign. It is the only variety of purulent empyema that may possibly yield to treat- ment by mere aspiration espeçially in children. *Tubercular empyema is usually mixed infection. The prognosis here wil l depend upon the general condition of the patient, and the character of the mixed infection. We therefore see the importance of a bacteriological examination as in any other debiliating disease ; supporting and tonie treatment i. essential. With the advent of pus. surgical means inust be adopted. Surgical Aspect.-Introduced by Dr. J. L. Turnbull, Goderich. When the presence of pus is determined it should be evacuated at once, as there is always the danger of abcess bursting into or through the chest wall, or even through the diaphragm and producing peritonitis. Aspiration need not be described; remember not to remove the fluid too rapidly. In this, as in an ordinary abeess, it is not necessary to open at the most 599 190 1.] SOCIETY REPORTS.",
         "SOCIETY REPORTS. [ JULY dependert point. The preferable way, and the one which Dr. Turnbull always uses when a diagnosii of pus is made, is to remove a portion of a rib; an inch and a half may be cut out, preferably with the saw, under strict antiseptic precautions. Dr. Turnbull advises washing out every day when pus is offensive, and the drainage tube gradually shortened until it can be removed altogether. Where a cavity and sinus remains after this operation, the sinus nay become closed and a second empyema estallished. This requires an Estlander's operation, and one of the best ways is to carefully locate size and boundaries of cavity with a probe, and after dissecting up a flap of skin, be sure to remove enough bone. The liard fibrous tissue beneath the ribs, which is always present in quantity there, must be thoroughly removed. Dr. Turnbull advises mopping out with pure carbolie acid, then with alcohol to prevent poison- ing, and then with sterilized water, the part being carefully dried. He puts a drainage tube in the mest dependent part. Dr. J. C. Mitchell considered that these cases should be dealt with purely on the same principles as an ordinary abeess. He has seen more cases in adults than in children. He considers that a good many of them are tubercular. Dr. Powell took exception to Dr. Mitchell styling empyema as being only an ordnary abces.s. He considered that it was something more, because lung was pressing on one side of it. He exhibited an instrument which lie used in the operation. Dr. John Hunter mentioned a case where air entered the cellular tissue in the skin, and universal empyema set up. Dr. Primrose considered it an important point to know whether the case was one of mixed infection. He does not think that we have taken all the advantage we might do of the researches that are made in the bacteriological laboratory. Dr. Thistle said that one point had not been referred to which he considered of first importance in successful treatment-the time at which operation should take place. That is the crucial point in procuring success in these cases. The earlier the operation is done the speedier the cure, and in many of the cases which run into chronic empyemata, this result was due to the lateness of the operation. Dr. McKeown said there were three points of importance to his mind-recognized that pus is present, that we want to get at it, and that we want to get the cavity closed up. Dr. McPhedran considered that these cases should be diagnosed very early, and are easily treated as a rule. One should be on his guard in a case of pneumonia when the temperature falls about the eighth day to near the normal; if ir. commenced to rise again it is suspicious of empyema. Dr. Freel, Stouffville, considered that it was better to resect the rib with proper dressing and tube, than to aspirate. Dr. Rudolf-So 'far it seems to be the opinion of this meeting that where pus is discovered in the plural cavity it should be removed by operation. He thinks there is one exception to that; that is, where an empyema exists along witlh tuberculosis of the lungs. In this condition 600",
         "1901.] SOCIETY REPORTS. 601 where pus is found, it should not be at once removed without careful -consi\u003cieration. Dr. Turnbull, in reply, considered that it was best that the rib should be removed in every case. He does not think it necessary to wash out the cavity in every case; only where the discharge is offensive The tube should be long enough to go into the cavity. Dr. Ferguson, in reply-early diagnosis, with the aid of the bacterio- logist, will add much to the after treatment. FIRST DAY, EVENING SESSION. OPEN-AIR TREATMENT OF DISEASE. By Dr. George H. Carveth, Toronfo, who described his method of treating different forms of disease, first, in the house with wide-open windows; second, in beds on the verandah; thiid, in beds under tents on the lawn. At first he experienced some difficulty in getting his patients to consent to be treated in this manner; but after they become habituated to life in the open air, they returned indoors reluctantly. Some of the cases that he has treated in this way are iritis, cases of fracture, case of radical cure of hernia, rheunatoid arthritis, tubercular disease of he spine, typhoid fe'er, and a case of hysterectomy. His address was illus- trated by lantern slide projections on the canvas, which proved very interesting to the members of the Association. Dr. P. H. Bryce spoke of the value of treating smallpox patients in tents. The tents should be double roofed, and double floored, and double walled, and each tent provided with a stove. The patients lived in these when the thermometor was 20 degrees below zero, being quite comfort- able. Nobody died, although many were seriously sick. Dr. Freel, Stouffville, recited the history of the case of a clergyman, the victim of tuberculosis, who lived in his tent all winter when the thermometer was 20 degrees below zero, and the wind blowing a perfect gale, and he was very comfortable. In a few months' time he ceased sweating, and gained very rapidly in weight, to such an extent that de- livering a sermon would not throw him into a perspiration as it always did-before he took up his tent-life on his lawn. Dr. J. H. Elliott, Gravenhurst, saw no reason why out-door life should not be employed in the treatment of other diseases as well as tuberculosis. It is not specific, and the only reason it is used is to strengthen the organism to resist disease. It is practically j eturning to primitive life, and it is so comfortable and pleasant that you find it very difficuit to get patients to return to the house. Dr. John Hunter referred to the Orphans' Home, Toronto, where they keep about two hundred children. These are admitted about four years of age and they are kept there unLil they are fourteen. Their mortality in that institution is about three in one thousand. They are practically kept out of doors all the time, and comparisons between the children of the Orphans' Home and the children of the weil-to do people of the city are greatly in the formers' favor",
         "SOCIETY REPORTS. [ JULY Dr. Webster said the trouble is not so much to get the patients to sleep out of doors as it is to get them to return to the bouse when they have once been out of doors. Dr. G. S. Ryerson, speaking of his visit to South Africa, said that at Bloemfontein the typhoid fever patients did particularly well in tents. The mortality was much larger in buildings improvised and used as hospitals. He considered that it was well to have the roof of the tent of a material of some dark color, such as green or brown, because the patient, lying on his back, begins to complain of the color of the roof. ON THE USE OF NITROUS OXIDE AND ETHER AS AN ANESTHETIC. This paper was prepared and read by Dr. L. Coyteux Prevost, of Ottawa, and it proved to be one highly interesting, carefully prepared, and ably delivered. He considers that a good and satisfactory anesthetic must possess the following qualitips: First, offer the least possible harm to the patient: second, be rapid; third, complete; fourth, permanent; fifth, followed by as few disagreeable post-operative effects as possible. He then proceeded to relate the results of bis personal experience during the last two years at the hospital in Ottawa, as well as in'his private pragtice; Dr. Carroll, of Ottawa was his assistant in this work. The agent they employ is ether, with which they lately have associated ntrous oxide, which is given at the beginning of anesthesia by the means of Clover's inhaler. He considers this method as absolutely ideal, as much for the rapidity with which the patient becomes anesthetized as from all unpleasant sensations during the process of anesthetization and the diminution of after symptoms so frequent after operations. The apparatus which they have been using for the nitrous oxide and ether is Hewitt's inhaler, which is a modification of a Clover inhaler, with the rubber bag replaced bv a large bag with valvular attachments. Within the past two years they have used this method almost exclus- ively, and the results are as follows: Anesthesia in one minute, twenty- f:ur tines out of three hundred and seven cases recorded ; in one and a half minutes, fifty-five times; in two minutes, ninety-four times; in two and a half minutes, forty-seven times; in three minutes forty-four times; n three and a half minutes, nine times; in four minutes. nineteen times; n five minutes, fourteen times. Dr. Prevost then entered into his obser- vations with regard to the effect of the anesthetics upon the kidneys, and stated that out of 434 observations albumen was found twenty-six times. He drew attention to the fact that post-operative vomiting was very rare. Dr. Prevost was the first surgeon in Canada to employ intro- spinal cocainization. He believes that so long as the old and well-tried anesthetic agents, handled by competent men, continue to give good satis- faction that it will not be wise to abandon them until medullary narcosis has been clearly demonstrated. THE COMPLICATIONS AND DEGENERATIONS OF FIBROID TUMURS OF THE UTERUS, WITH IREFERENCE TO THE TREATMENT OF THESÈ GROWTMS. Dr. Chas. T. Noble, Philadelphia, delivered an able and exhaustive paper under the above heading, an abstract of which will be published in a subsequent issue. 602",
         "SOCIETY REPORTS. 60g Drs. J. F. W. Ross, N. A Powell, Mackinnon, and Clouse discussed the paper, to which Dr. Noble replied. SECOND DAY-MORNING SESSION THE RELATIONS OF NASAL OBSTRUCTIONS TO OBSCURE CASES OF ASTHMA. This paper was read by title by Dr. Arthur W. Mayberry, of Toronto. Patients suflèring from nasal obstruction are frequently coming before the notice of the busy practitioner. Asthma bas a complex etiology, and the close association of this disease with nasal trouble is sometimes very remarkable. Adenoid growths in the pharynx frequently cause asthma and in recent years much stress has been laid on the nasal origin of this disease. The author quoted Bosworth, who goes so far as to assert that asthma, in a large proportion of cases, is attributed to some form of nasal obstruction, the bronchial spasm being caused through reflex sympathy- conducted along the fifth nerve. ON THE IMPORTANCE OF AN EARLY RECOGNITION OF LOCOMOTOR ATAXIA -DO THE EYE SYMPTOMS ASSIST US ? Dr. J. T. Duncan, Toronto, read this paper, and emphasized the im- portance of being able to diagnose this disease in order that prompt treatment might be applied. To do this we must be able to recognize the pre-ataxic stage. What are the-e symptoms? Professor Osler gives them as pains, ocular symptoms, and loss of the knee jerk. What are the ocular symp oms ? Strabismus or squint; ptosis or drooping of the eye lid ; the fixed pupil (the Argyl-Robertson pupil); inequality of the pupils and optic atrophy. NOTES ON THE USE OF ADRENALIN. D. J. Gibb Wishart, Toronto. This is the formula which Dr. Wis- hart bas been using in his office practice, having made several hundred applications, chiefly to the mucous membrane of the nose; one in one thousand, the chloride being dissolved in normal salt solution containing 0.5 per cent. chloretone solution. A 10 per cent. dilution of the above solution, which dilution is equivalent to one in 10,000. bas been sufficient to contract the blood vessels in the membranes in a few seconds, and a repetition of the same, or the use of a stronger dilution, will blanch these membranes; especially is this seen to be marked in the nose, where the membranes will become tightly drawn over the turbinated bones, which show up white through it. It bas proven itself to be highly useful in rendering operations about the nose practically bloodless; it is not found to answer so well in the removal of adenoids or enlarged tonsils. Dr. Wishart mentioned two cases in particular where it acted very piromptly. The bottle in which it is kept must be tightly corked; and the properties of the substance are not destroyed by heat. Since he bas added chlore- tone he is perfectly satisfied as to the stability of the preparation for all practical purposes. In no instance bas there been a tendency in the amount of bleeding. Dr. Wishart considers that the drug is a valuable addition to our armamentarium. 1901.]",
         "SOCIETY REPORTS. Dr. Duncan's paper was discussed by Dr. Wishart, Dr. Trow and Dr. Hunter; while Dr. Wishart's paper brought out a discussion from Dr. Trow, Dr. McPhedran, and Dr. Graham Chanbers. Dr. Wishart and Dr. Duncan replied respectively. DIscuSsiON ON GASTRIC ULCER. Medical Aspect.-This was introduced by Dr. R. D. Rudolf, Toronto. In opening the discussion from a medical point of view, he gave a short historical sketch of the chief literature of the subject, and said during the last thirty years only one important s ymptom had been added to those mentioned by previous writ,çs, viz.: the very common occurrence of hyperchlorhydria. Avoiding the consideration of the. well-known points on the subject, lie propounded five questions in connection with gastric ulcer which seened to him to specially merit discussion. First, is there any relation between gastric ulcer and cancer ? Trousseau believed that an actual antago ism existed b.-tween the two conditions, while Lebert considered that 9 per cent. of all gastric cancers so arose, and Rosenheim states that 5 to 6 per cent. of all gastric ulcers become carcinomat,us. Clinically, the speaker hai1 never seen a case of simple ulcer end in can- cer, nor had he see a case of cancer preceded by ulcer, although such cases undo-ubtedly occasionally occurred. Dr. Rudolf had seen pathological specimens illustrating hoth. Second: Cati we diagnose the site of gastric ulcer ? This question is becoming more important on account of operations. Ewald states that in 90 per cent. of caes it is impossible to tell whether the ulcer is in the stomach or duodenum, and that usually it is hard to diagnose the site in the stoiimach. Most gastric ulcers occur on the posterior wall, near the pyloric end. The site ot the pain and tenderness; the time the pain occurs after food ; the position in which the patient is f ree fromn pain, and the présence or absence of gastric dilatation may help, but these are very unc rtain facts to lean up n. Thus, in Pinel's famous case, mentioned by Abercrombie, where the patient was known to have ulcers near the pylorus, the pain used to occur immediately after-taking food. The tak- ing the food may not only mechanically irritate the ulcer, but by stimu- lating the acid secretion peristalsis nay cause pain without touching the ulcer. It iust further be remembered that there are sometimes several ulcers present. Thir.i question: Does ergot ever stop gastric hemorr- hage? Ntost authorities recomnmend ergot without qtuestion, but we must remember that the hemorrhage tends to be self-limiting from the lower- ing of the blood pressure and the forming of a clot, and ergot may inter- fere with this natural cure by raising the blood pressure. Turpentine and other locil styptics have no such objection, and calcium chloride in- creases the tendency to clotting. Fourth question: Are cases of apparently \" cur d \" gastric ulcer \" first-class lives \" for insurance ? The speaker did not think that they were, because sudden perforation might occur after - ears of quiescence (he had seen two such cases). Ulcers were apt to re- lapse or to break out in new places. The severer the symptoms of the ulcer had been at the time, especially the hemorrhage, and the shorter the 604 [ JfULY",
         "SOCIETY REPORTS. 605 period since its occurrence, the worse the \"life \" was. Fifth question-- as regards operations: As soon as perforation into the peritoneal cavity be diagnosed, operation should at once be performed; as regards operation where no perforation exists the question was not so easily settled. Severe uncontrollable hemorrhage might occasionally call for surgical treatment, but the mortality from hemorrhage is surprisingly small, even when this is severe. Dr. Mayo Robson had recently recommended \" that after a second bleeding, even during the course of the hemorrhage, if the patient can stand it, or as soon after as bis condition will admit, the operation should be done.\" The speaker was glad to see that bis old teacher, Dr. Eyrom Bramwell, challenged this advice (THE LANCET, March 9, ]900, page 687). Operation for the less urgent symptoms of gastric ulcer would occasionally be necessary, but in this direction we should proceed with great caution. Dr. Moymhan, in a recent paper (THE LANCET, April 27, 1901,) gave a summary of all the cases to date gastro-plasty or gastro- gastrostomy had been performed for \" hour-glass stomach.\" They amounted to thirty-eight in all, and nine of them were fatal, while in many complete relief of symptoms occurred. Pathology.-This branch of the discussion was led by Dr. H. B. Anderson, Toronto In his opening remarks he said he would make no reference to ulceration resulting from the breaking down of tubercular foci, syphilitic gummata, or malignant growths, nor of ulceration occur- ring during the course of acute infective diseases or resulting from the action of corrosive poisons, but would limit the discussion to a considera- tion of the commonly designated simple, round, perforating or peptie ulcer. From the similarity in all essential points, however, he included the corresponding ulcer at the lower end of the esophagus and in the first part of the duodenuni. From post-mortem statistics the frequency of gastric ulcer was in about 5 per cent. of cases, cicatrices being found about three times as often as healed ulcers. From bis own experience at autopsies in Toronto he was sure that gastric ulcer did not occur in On- tario so frequently as indicated by the above figures. The condition occurred most frequently in adults from twenty to forty years of age, but was by no means rare at the extremes of life. The mortality was greater from forty to sixty years of age, no doubt from the lessened reparative power at that period of life. Females were affected more frequently thai males, in about the proportion of two to one. The etiological import of other diseases, especially chlorosis, was dwelt upon. . Inju'y was a factor in rare instances, a statement substantiated by certain experimental data. Occupation, race, climate, habits-all had an indirect influence in some cases, and arterial sclerosis, thrombosis and embolism of the gastric vessels were occasional factors in the etiology of the condition. Al these factors were, however, of secondary importance, and were only active in the presence of an altered condition of the gastric secretion. The localtities where this form of ulceration occurred-at the lower end of the esophagus, in the stomach and in the first part of the duodenum- situations exposed to the action of the gastric juice, qs well as the not infrequent occurrence of post-mortem digestion of the walls of the stomach, 1901.]",
         "SOCIETY REPORTS. [ JULY were strongly suggestive of the importance of this factor, and this had received further direct prouf from the discovery of the frequent occurrence of a hyperchlorhydria as:ociated with gastric ulcer from a chemical analysis of the stomach contents obtained after test meals. The failure to find this condition in some cases was not proof that it had not existed at an earlier period in the diseases, for the hyperchlorhydria might after- wards have been lessened as the result of the greater or·less degree of gastritis following on the wake of the ulcer. Ulceration did not occur unless there was a disproportion between the acidity of the gastric juice and the condition of the blood. Normally autodigestion of the walls of the stomach was prevented, not by a single chemical reaction in which the acid was neutralized by the alkalinity of the blood and fluids in the tissues, but by the vital resistance of the living cells'of the part He did not think there was anything to uphold the bacterial origin of this form of ulcer urged by some authors. The pathological anatomy of ga4ric ulcer and its various termina- tions were discussed and illustrated by specimens Healing was the fortunate result in the majority of cases. At other times a fistulous com- niunication was foried with the duodenum, colon or the cutaneous sur- face, or a subphrenic abscess might result. Adhesion to the pancreas, liver, or to the omentum frequently walled the trouble off. Not infrequently however, peritoneal infection from peforation occurred, and the symptoms might be so intense as to simulate irritant poisoning. Gastrectasia or \" hour-glass \" deformity from cicatrical contraction at the pylorie orifice, or in the centre of the organ, at tiimes gave rise to serious results. A specimen, showing the developiment of a carcinoma at the base of an ulcer with a clinical history extending over many vears, was presented. Sargical Aspect.-Dr Henry Howitt, Guelph, conducted tliis part of the discussion and said, did it never strike you as being peculiar that the best remedies, nitrate of silver and so forth, are germ destroyeis ? He first took up the procedures for dealing with the ulcer or its results, in which perforation is noG a factor. In all the operative procedures it was essential to prevent infection of the wound ; stomach should be thoroughly washed with ascptic water, by means of siphon tube, immediately before the anesthetic is administered. It is not necessary to make the abdo- minal incision exteneive, the length of the incision would depend upon the amount of contraction, and it is sutured in such a manner that when closed the line of union is at right angles to the original incision. This gives excellent results when properly done. Adhesions render this ideal operation impracticable. The first successful operation was performed in Toronto, 1894, by Dr. Atherton. Up to last September in the neighbor- liood of 300 operations were reported with a mortality of a little over 45 per cent. Dr. Howitt then referred to cases in his own practice. With regard to the treatment, Dr. Howitt said that as soon as we are satistied that perforation has taken place, referring to acute cases, he believes it is good practice to give morphia hypodermically, and it further lessens the a mount of the anesthetic in the opinion of many. Success largely depends on the shortness of time before operation ; delay is dangerous. It is Dr. llowitt's practice to eviscerate the bowels; one or more small incisions in 606",
         "SOCIETY REPORTS. 607 the prominent cells suon overcomes the distension, and each one is closed berore another is made. Attention is no w turned to the stomach and the part brought into the wound. The ulcer is incised and opening closed with two or three layers of sutures. When the trouble is in the posterior wall it may be impossible to excise it, in which case it can be generally inverted and closed by layers of sutures The abdominal cavity should be thoroughly flushed with a streani of saline solution. When drainage is necessary the tubes or 2auze should not be introduced through a large wouid. The object should be to have primary union to take place in the incision. Dr. McPhedran, referring to the treatment of simple ulcer, said that the treatment for this is one that is not carried out very effectively. If not successful after a month of rest in bed with medicinal treatment, he would advise operation. Dr. J. F. W. Ross referred to a case of catarrh of the stomach in a woman of fifty-nine pounds weight, and where he was satisfied before operation that he had to deal with a cancer of the stomach. She re- covered and rapidly gained in weight until she reached 1\u002b0 pounds. Dr. Bruce referred to a case upon which he had operated. Drs. Rudolf, Anderson and Howitt replied. VAGINAL SECTION, EXPLORATORY AND OPERATIVE. Dr. T. Shaw Webster read a paper with the above title describing several operations performed in that way, one being for the ectopie gestation. He reported good success in them from the vaginal route. Dr. Noble thought that the vaginal route all right for abscesses, but had a preference for the abdominal in pelvic operations. Drs. Bruce, Macdonald, Oldright, Ferguson (London), W. J. Wilson and Clouse discussed this paper, the discussion proving an interesting one, although the members were rather impatient for hot soup, it being past the hour for luncheon. Dr. Webster replied and defended his position ably. Dr. bruce L Riordan now passed through the theatre announcing luncheon was now ready in the dining-car, so there was an immediate bolt for the door, and all were soon enjoying themselves at a very fine spread provided by the Committes of Arrangements. Afterwards, bright and happy speeches were made by several of the members, the audience simply calling for their favorites, and no one being specially set down for any toasts. Amongst others who said some good things were Dr. Harri- son, Dean Geikie, J. C. Mitchell, N. A. Powell, George Bingham and the President. SECOND DAY-AFTERNOON SESSION. THE ROENTGEN RAYS IN THE DIAGNOSIs OF URINARY AND BILIARY CALCULI. This paper, X-ray photos and specimens of calculi, which proved a very interesting demonstration, was presented by Dr. S. Cummings, of Hamilton. 1901.]",
         "SOCIETY REPORTS. Dr. McGillivray, of Toronto, asked if the diagnosis is always positive. Dr. Cummings replied that if any errors, they'are due to operator, not to X-ray itself. There was a demonstration of skiagrams in an adjoining room. PRELIMINARY REPORT ON THE RELATIONS OF HYPERCHLORHYDRIA TO \" BiLIous ATTACKS,\" SOME FORMS OF EczFMA GOUT AND MUSCULAR RHEUMATISM. Dr. Graham Chambers, Toronto, stated that on several occasions he examined the gastric contents of patients of apparently normal digestion and found hydrochloric-superreidity, although in some of them there was a history of \" bilious attacks,\" which were probably attacks of hyper- acidity. He considers that the gastrie distress, which is present in these cases, is more or less due to the hyperesthesia of the, mucous membrane of the stomach, as well as to the excessive acid contents. The commingl- ing of these two neuroses, hyperchlorhydria and hyperesthesia gastrica, makes an investigation into the relations of the former to \" bilious attacks,'- eczema, muscular rheumatism and gout a very definite one, but he cannot but think that a general irritable condition of the gastrie nerves must produce some changes in the sympatheic and cerebrospinal centres which would no doubt lead, or tend to lead, to diseases in other organs. Dr. Chambers' attention was first called to this subject about two years ago, when he observed that the internal treatment, both diatetic and medicinal, which he was accustomed to give in cases of hyperchlorhydria, was approximately the same as that which he was using in some forms of acute eczema, and in both cases it gave very satisfactory resuits. In his experience \" bilious attacks \" are very frequent in cases of chronie hyperchlorhydria; he has also found that symptoms of indigestion are of frequent occurrence in eczema, and are usually of a character which indicates hyperchlorhydria. He has examined the gastric contents of six cases of eczema, with symptoms of dyspepsia, and in five of these there was an excess of HCI, in the gastric contents. He gave notes of cases in illustration of his researches. Acidity is a common symptom in gouty subjects, and Dr. Chambers believes that a thorough investigation of the subject would prove that the \"acidity \" of the gastric contents is not due to organic acid at all, but that hydrochloric acid will be found to play an important part in it. With regard to muscular rheumatisni, we know very little about the etiology of it. Clinically, we have found that muscular rheumatism and gout are in some way related; and in regard to relations of hyperchlorhydria and nuscular rhematism, Dr. Chambers has observed that they are frequently associated, but whether the muscular rheumatism is the result of the hypei chlorhydria, he is at the present time unable to say. Dr. Bryce discussed the paper. MEDICAL TREATMENT OF SURGICAL TUBERCULOSIS. Dr. W. B. Thistle of Toronto, said: It is important to remember this fact, that there is no difference in the nature of the disease, whether con- 608 [ elULY",
         "sidered surgically or medically, and especially is this so when we come to consider treatment. We hear on all sides that it is a curable disease, and complete cure often now happily results from medical treatment. Dr. Thistle has observed that tubercular cases requiring surgical treatment in the great majority receive little or no medical treatment. The subjects of surgical tuberculosis should have the fullest advantage of sunshine an i fresh air as well as those suffering from the disease in its medical aspect. TREATMENT OF POST-OPERATIVE PERITONITIS. By Walter McKeown, Toronto. The paper suggested that this con- dition shoiild be treated by the use of decinormal salt solution, eitlher subcutaneously or intravenously, and enemnata of strong solutions of sulphate of magnesia. The toxins will dialyze; the antitoxins will not. If, then, the toxins can be eliminated with sufficient rapidity, the disease will limit itself as a result of the formation of antitoxin together with the plugging of the peritoneal lymphatics. The blood is diluted by the addition of the sait solution, and this is drawn out into the rectum 1,y means of a higher osmotie pressure carrying the toxins with it. Ile claims that even with a condition of paralysis of the bowel, toxins will dialyze in this way. He suggests that if a patient were placed in a salt bath, the toxins would probably osmose directly through the skin. That osmosis does not take place from without in through the skin, does not prove that the reverse process will not occur. Osmosis is known to take place much more rapidly in one dire tion through the shell membrane of the egg than the other. SECOND DAY-EVENING SESSION. Dr. R. A. Pyne, the First Vice-President, occupied the chair. The committee on credentials recommended the following for member- ship, which was adopted: R. W. Garrett, Kingston; George Sherk, Cheapside; W. A. Scott, Courtright; Daniel Buchanan, Galt; L. C. Pre. vost, Ottawa; Milton Baker, Springfield; Donald McGillivray, Toronto; A. E. MacColl, Belleville; Arthur I. Brown, Holstein. The following constituted the Nominating Committee: Drs. Geo. A. Bingham, A. McPhedran, Burt (of Paris), Powell (of Toronto), Mitchell (of Enniskillen), Harrison (of Selkirk), and Macdonald (of Toronto) Dis. E. Clouse and Price-Brown acting as scutineers. This committee reported as follows, which, on motion, was reccived and adopted: President, N A. Powell, Toronto ; First Vice-President, R. Ferguson, London; Second vice, R. W. Garrett, Kingston; Third, L. C. Prevost, Ottawa; Fourth, R. L. Turnbull, Goderich; General Secretary, Harold C. Parsons, Toronto; Assistant, George Elliott, Toronto; Treasurer, A. R. Gordon, Toronto. The report of the Committee on Public Health was presented by Dr. Roseburgh, seconded by Dr. William Oldright, and adopied. That on Tuberculosis, by Dr. W. B. Geikie, seconded by Dr. B. J. Hamilton, and adopted. 190 1.] SOCIETY REPORTS. 609",
         "SOCIETY REPORTS. That on Hospital Abuse was presented by Dr. Webster, in the absence of the chairman, Dr. W. J. Wilson, seconded by Dr. W. A. Young, and adopted. The Committee on Inter-Provincial Registration had nothing at the present time to report. Treasurer's report was presented by Dr. G. H. Carveth, and showed last year's receipts to have been $376.30, and expenditures $334.66. leav- ing a balance of cash in bank of $35.64. This was audited by Dr. R. D. Rudolf, and, on motion, adopted. The report on Necrology was presented by Dr. George Binghim. It included the names of C. W. Covernton, Toronto: C. E. Martin, Tor- onto; J. D. Macdonald, a Past President, Hamilton; J. E. Eakins, Belle- ville; Isaac Ryall, Hamilton; A. K. Sturgeon, Petrolia; Dixon, Pem- broke; Mennie, Toronto; J. A. Watson, Toronto; T. H. Little, Toronto; Jonathan Robinson, Toronto; J. H. Parsons, Toronto; and Irving, St. Mary's. The Ontario Medical Library was voted $50,00 on motion by Dr. R. A. Reeve, seconded by Dr. H. T. Machell. A notice of motion was given by Dr. Graham Chambers, and second- ed by Dr. H. B. Anderson, that the business session at future meetings be held on the evening of the first day. This will be referred to the Committee on By-laws. Resolution of regret re non-payment of the annual $200 fee of the Ontario Medical Council was introduced by Dr. Ferguson, of London, seconded by Dr. GiUson, of Belleville, that some members of the profes- sion in the province had refused payment of this annual fee. This Asso- ciation regards the imposition of this fee as most reasonable, payment of which should meet with a cheerful response on the part of every member of the profession. This was carried unanimously amid much applause and without a dissenting voice. Dr. Wishart, Toronto, chairman of the Special Committee to draw up a resolution re vaccination. Resolved, That the Ontario Medical Association desires hereby to re- assert the opinion of the medical profession of this province: 1st. That the principles of Jennerian vaccination against smallpox, which have been now attested by the experience of more than a century, are scientitically correct. 2nd. That in order to carry out the protection through vaccination against smallpox it is necessary that the lymph used in the operation be of normal quality, and that this can be shown only by a proper amount of systemic reaction to the vaccine, as determined by the character of the vesicles, and that the absence of a normal reaction, as shown by the pre- sence of vesicles, is no positive evidence of the immunity of the person either against vaccinia or smallpox. 3rd. That this Association emphasizes the urgent necessity that the scarification of the skin be sufficiently extensive to secure such reaction, and to this end recommend that from three to five insertions each of a quarter of an inch square be made in each vaccination. This was carried. 610 [ JULY",
         "SOCIETY REPORTS. Medical Defence Union. On motion of Dr. J. F. W. Ross, seconded by Dr. A. Primrose, a committee was appointed to inquire into this mat. ter, to report at the next meeting of the Association in 1902. Votes of thanks were passed to the Minister of Education for the use or the building, and also to the President, Dr. MeKinnon, for his exceedingly able address. During the progress of the meeting it was addressed by the Honor able, the Minister of Education, Mr. Harcourt, who advised them strongly to keep up the standards of matriculation and the professional exami- nations. Dr. N. A. Powell was then installed in the office of President, and after brief acknowledgment, the 1901 meeting adjourned. MISCELLANEOUS. NiGHT SWEATS -The drugs which have hitherto played the chief role in relieving this condition are, camphoric acid and agaricin Late investigations show these are surpassed by tellurate of sodium, but this possesses a very repulsive garlic-like odor, which will probably militate against its extended use. The dose is eight grains, given in the evening. As the drug pos- sesses antiseptic properties, it will possibly prove effective in ameliorat- ing the severe pulmonary symptoms. It is said to prove equally benefi- cial in other diseases characterized by abundant excretion or perspiration, such as rheumatism, typhus, nervous exhaustion, etc.-Dietetic and fy- gienic Gazette. BROMI DRoSis.-Stockwell (Detroit Medical Journal) says there is nothing equal to a strong solution of sodium bicarbonate for the oblitera- tion of fetid perspiration. The Treatment of Trigeminal Neuralgia with Galvanism. Dubois (Bull. gén. de Thérap.) refers to successes in the treatment of tic douloureux with the constant current recorded by Onimus, Legros, Niemeyer, Benedikt and Dalby. His own patient began to have neuralgic paroxysms at the age of forty. For ten years he was treated with many different drugs, but without relief. At fifty-one he commenced to receive electrical treatments. The positive pole divided into three terminals by means of a divided rheophore, was applied to the supra- orbital nerve, the infra-orbital nerve and at the mental foramen. The negative pole was placed on the neck opposite to the superior cervical ganglion. From twelve to fifteen milliamperes, as it is estimated, were passed for seven minutes. An aielioration of the symptoms at once commenced, and after a week's treatment he obtained absolute freedom 1901.] 611",
         "from the attacks. The treatment was continued three times a week for a year. As a consequence, he has remained free from even the slighest paroxysm for twenty-six years. Besides the above case, three others have been treated by the same method. Oune, the subject of five surgical operations, was not relieved ; in the other two an apparent cure was effected ; at any rate, an extraordinary long remission of the pain resulted. -Brit. Med. Jour Hay Fever. In a paper having the above title and published in the international Medical Magazine, Dr. E. B. Gleason says: \" Somewhat recently the attention of the profession, chiefly through the writings of Bishop, of Chicago, has been directed to the fact that the neurotic condition of the patieit and the hypersensitiveness of the nasal passages were often due to an excess of uric acid in the blood, and that this excess could be eliminated by the ingestion of mineral acids. Probably any mineral acid would prove efficacious, but there are two which suggest themselves as peciiliarly efficacious-hydro bromie acid, because of its sedative qualities, and nitro-muriatic acid, because it is thought to limit the production of uric acid My experience bas been limited to the effects of nitro-muriatic acid, which for the past three years I have prescribed in d ses of three to five drops of the freshly prepared concentrated acid after meals and sometimes also at night. The doie should be diluted with a half tumiblerful of water, and the patient, after taking the medicine, should rinse out bis month and swallow another half tumblerful of water. The results of the remedy are apparent within forty-eight hours, and the relief of all hay fever symptoms is usually sufficient to enable the pitient to remain at home and attend to bis ordinary business engage- ments in iomparative comfort.\"-The Med. Bulletin. Removal of Ear-Wax. Hardened wax in the external ear can often be removed readily by injections of warm water and soap, soda or ammonia. Many cases resist this and require the softening effects of glycerine or sweet oil for a day or two before syringing. Do not bother with these long processes, but use a half-strength solution of hydrogen dioxide in the ear for about five minutes. This will disentegrate the hardest plugs, and they can be re- moved with very little syringing. This process never causes irritation or inflammation. i)o not use too much force with the syringe; wipe the ear perfectly dry with absorbent cotton and apply petrolatum; wear a small piece of cotton in the ear for a day or two after removal.-Phil. Med. Jour. 612 MISCELLANEOUS. [ JUL Y",
         "The Canada Lancet A MONTHLY JOURNAL OF MEDICAL AND SURGICAL SCIENCE, CRITICISM AND NEWS. The Oldest Medical Journal in the Dominion: Established 1867. Editor:-H. B. ANDERSON, M.D. ASSOCIATE EDITORS: W. B. Geikie, M.D. F. Le M. Grasett, M.D. G. Sterling Ryerson, M.D. John L. Davison, M.D. Geo. A. Bingham, M.D. N. A. Powell, M.D. D. Gilbert Gordon, M. D. Allan Baines, M.D. D. J. G. Wishart, M.D. J. T. Fotheringham, M.D. D. C. Meyers, M.D. C. A. Temple, M.D. F. Fenton, M.D. H. C. Parsons, M.D. Chas. Trow, M.D. Chao. B. Shuttleworth, M. D. COLLABORATORS: A. H. Ferguson, M.D., Chicago. Ernest Hall, M.D., Victoria, B.C. Hadley WilHiams, London., J. Coplin Stinson, San Francisco. Al Communications in reference to the Literary part of the Journal, articles for publica- tion, etc., address The Editor, 241 Wellesley Street, Toronto. Articles on subjects of Medi- cal, Surgical or general interest to the profession solicited for publication. Correspondence in reference to Advertising, Subscriptions, Publishers Department, etc., address Dr. G. P. Sylvester, Business Manager. Maike Cheques and Drafts payable to the Business Manager. EDITORIAL. THE ONTARIO MEDICAL ASSOCIATION. The twenty-first annual meeting of The Ontario Medical Association was held in the Normal School buildings, Toronto, on June 19th and 20th. The attendance was well up to the average-about one hundred and fifty signing the register, and a gratifying feature of the meeting was the large representation of younger men. The luncheon was an especially pleasant social feature of the meeting, the speeches were bright, and the whole affair did credit to the excellent chairman of the Comnittee of Arrange- ments, Dr. B. L. Riordan, and his associetes. The officers of the Associa- tion and the various committees worked liard to ensure the success of the meeting and may fairly be congratulated on the results of their efforts. Dr. McKinnon made an excellent president, his quiet, unassuming manner, and fairness commanding the confidence of the Association. Without any desire to indulge in captious criticism, however, may the members not fairly and profitably ask if the meetings of the Ontario Medical Association reach the high standard one would expect from a [ 613 ]",
         "body representing the profession of this province ? Is there not room for - improvement in the character of the work done by the Association ? With 2,500 qualitied practitioners in Ontario, and a membership of nearly 1,000 in the Association, does an attendaEce of one hundred and fifty at the annual meeting and the presentation of some twenty-five papers indicate a satisfactory state of affairs ? There is some good reason for this lack of interest in the Association which it is the duty of the officials to discover, and if possible, remedy. In the first place there is a noticeable lack of originality in the papers )resented, which does neither credit nor justice to the profession of this province. We believe this is largely due to the custom, for some years back, of having symposiums or discussions on certain subjects chosen by the Committee on Papers, and making these the chief feature of the meeting. It would certainly be better to have a man select his own subject-a line upon which he has recently been working or has recently had experience, than to set a topic for him to work up by a rehash of literature. Again, sufficient time is not allowed for the preparation of anything that is of much value after the invitation of the Association to prepare a paper is received. The Committee on Papers should be actively at work at least six months in advance of the meeting, so that ample time for thorough preparation is allowed. The receipt of an invitation to read a paper a month or six weeks at most before the meeting, in itself suggests that nothing much is expected. If live members of the profès- sion in different parts of the province were commnnicated with six months at least before the meeting, they would know that a high stand- ard of excellence was set and would rise equal to the occasion. The matter of publication of the proceedings of the Association is another thing which should iecei ;e most careful consideration. It does little credit to the progressiveness of spirit of a large provincial association that it cannot finance the publication of its proceedirngs. If a number of really valuable papers was read, the proceedings would find a ready sale among the members and this would cover the expense of publication. On the other hand, nothing would have a more wholesome eflect in stimulating more original work and in bringing out a better class of papers than the knowledge that they would be set in cold type for future reference and comparison. The president of the Association for the ensuing year, Dr. N. A. Powell, has had a wide experience in medical society work. He is pos- sessed with the knowledge, energy, progressiveness and a desire to excel which eminently fit him for the high honor he bas received. While the past history of the Association has been very creditable, we believe the [ JULY 614 EDITORIAL.",
         "time for a move forward has come. No one could be better qualified than the President elect to lead in this movement and his stewardship will be watched with interest. Let him and his associates in office take time by the forelock, and we venture to predict that the next meeting will be a record-breaker in the history of the Ontario Medical Association. THE ONTARIO MEDICAL COUNCIL. At the recent meeting of the Ontario Medical Association a strongly worded resolution was introduced sustaining the action of the Medical Council in reference to the collection of the annual assessment. The resolu- tion was unaniinously adopted in general sessicn, without discussion. The sentiments expressed by members of the Association from different parts of the province at the luncheon, and the manner in which they were received by those present left no room to doubt that in opposing the payment of the annual fee the \" Defence \" Association have neither the sympathy nor support of the profession at large. The older members who could contrast the condition of affair before the existence of the College of Physicians and Surgeons were particularly strong in urging loyal support to our governing body. As that Nestor of the profession, Dr. Harrison, of Selkirk said, matters are entirely in the hands of the medical elec- torate and if the present representatives have failed in their duty to the profession, let them be replaced at the next elections for membership in the Council by others, who will carry out our wishes. In our national aflairs if a government fails to carry out the wishes of the people, the remedy lies in electing other representatives, not in over- throwing parliamentary government. The act of the local legislature constituting the Medical Council has given our profession privileges of self-government of inestimable value, which should be properly esteemed and jealously guarded. We believe that these privileges have not been abused but have been utilized for the mutual benefit and piotection of the public and the profession. We do not contend that the Medical Council has invariably pursued a course beyond criticism in the management of matters under their control,but we do believe that they have done what they have considered to be best, and on the whole they have had a keen regard to the responsibilities placed upon them. Nor do we wish to minimize the good effect of a vigorous opposition in any representative body. Complacent acquiescence in everything is a danger to be avoided. But let the opposition be on broad and generous principles, not merely factious criticism, attempting to breed dissention and jealousy in the ranks. 1901.] EDITORIAL. 615",
         "this sort of opposition is a waste of time and energy,and places our govern- ing body and the profession at large in a most humiliating position before the public. It moreoverprevents the consideration of matters of the deepest interest to the profession, as the formation of a medical delnce union, the adoption of interprovincial registration, the establishment of a provincial museum and other affairs of prime importance. Haggling over the pay- ment of a trifling yearly assessment of two dollars for the privileges granted us is not endorsed by the profession and prejudices the \" Defence ' Association's advocacy of other matters wherein they would have the backing of the profession at large as a change in the present over-representation of the Homepathic body, as well as that of defunct medical institutions, anomalies which should be carefully considered and remedied as soon as possible. PROGRESS IN THE COSMETIC ART. According to the London Mail a resourceful American lady has discovered the secret of perennial loveliness, and now upon payment of a fee. the rich, ripe bloom of healthy youth can be indelibly fixed upon the cheeks of all who desire it. Instead of the more or less crude and inartistic applications of rouge hitherto resorted to, requiring frequent renewals,permanent blushes may now be obtained by a process of tattoÂing. The operation, by the injection through a fine needle of a suitable pigment of the nature of rouge, produced such excellent results with the fair American ,who submitted herself to the experiment, that many othe rs in fashionable circles, who were entering the sere and yellow period or who perhaps had never been dealt kindly with by Nature in this respect, fol- lowed her example and now are the happy possessors of a ruddy bloom made to order. Whether this tattooed beauty will be a source of per- manent happiness or not remains to be seen. An equally interesting complement to the above mentioned procedure, has been successfully experinented with by a physician named Gersuny. By the subcutaneous injection of sterilized white vasiline, made fluid by heating, wrinkles in the face and elsewhere may be removed, cavities filled up, and many deformities obliterated. The tissues are quite tolerant to this substance and it is ordinarily quite innocuous. It has also been made to serve more useful purposes, having been successfully injected arourid varices and about relaxed orifices, producing a cure by the mechanical support afforded. The method is easy of application and causes little discomfort. Unfortunately the danger of embolism must always be present, and already fatal results have been reported as following the procedure. [ JULY 616 EDITORIA L.",
         "Of the ultimate effects, locally or generally, in either of these oper- ations, of course nothing is known, and whether we have reached the time when the matter of wrinkles and fading complexions will no longer cause femine heart aches, Experience alone will answer. CANADIAN MEDICAL ASSOCIATION. WINNIPEG MEETING, AUGUST 28TH TO 31ST. 1901. The question now seems to be, how is one to make arrangements to get away at the time of the meeting, for it seems to be universally con ceded that to attend the Winnipeg Meeting is the proper thing to do. The Railways, having granted a single return rate to the meeting, have assisted in breaking down one of the barriers, and now one hears fron all sides of physicians intending to make Winnipeg the central point of their holiday trip, and Winnipeg is making preparations for a great gathering ! Many physicians, it seems, will also take advantage of the offer of the single fare rate fron Winnipeg to points in Manitoba, the North West, British Columbia and North Dakota, after they have enjoyed the hospitality of the Winnipeg profession. The question of Dominion Registration will come up for a full dis- cussion-it is hoped for the last time before this thing to be desired be- comes a realization. The following is a list of some of the papers already promised:- The Address in Medicine-J. R. Jones, Winnipeg. The Address in Surgery-0. M. Jones, Victoria. The Address in Gynaecology-Thomas S. Cullen, Jonhs Hopkins, Baltimore. The early diagnosis and treatment of pulmonary tuberculosis-D. Gilbert Gordon, Toronto. The nose and throat in general practice-John Hunter, Toronto. Remarks on sone interesting diseases of the age-G. H. Burnham, Toronto. Orthopoedic treatment of deformities and disabilities resulting from paralysis-B. E. McKenzie, Toronto. Title to be announced-D. J. Gibb Wishart, Toronto. A practical way of distinguishing between the human and animal blood-G. Silverthorne, Toronto. Infectious pneumonia-W. S Muir, Truro, N. S. Sclerotic ovaries-A. L. Smith, Montreal. Removal of large tumor frou the os uteri after labor had set in-A. Armstro- g,, Arnprior. 1901.] EDITORIAL. 61'7",
         "Tuberculosis in milk-Prof. Russell, University of Wisconsin. , The present outbreak of smallpox in America-H. M. Bracken, Health Officer, Minnesota. Haematology-L. H. Warner, New York. Skin diseases-Lantern Demonstration-F. J. Shepherd, Montreal. The treatment of consumption in special institutions-Dr. Richer, Montreal. Disposal of tuberculous sputum-J. H. Elliott, Gravenhurst. Title to be announced-G. Chambers, Toronto. Chronic ulceration of the stomach simulating cancerous disease- Relation of a case of gastro-enterostomy with M urphy's button-reco- very-J. F. W. Ross, Toronto. Report of cases treated with the hot air bath-W. H. Pepler, Toronto Title to be announced-J. N. Hutchison, Winnipeg. Some Forms of gastric hyperacidity and their treatment-C. P Martin, Montreal. Syphilis as seen by the ophthalmic surgeon-F. Buller, Montreal. On the necesity of a better recognition and isolation of trachomatous patients in Canada-W. Gordon M. Byers, Montreal. Title to be announced-J. L. Bray, Chatham, Ont. Epidemic cerebro-spinal meningitis-A history of some cases-James McKenty, Gretna, Man. Pulmonary tubhrculosis, its treatment and prevention-A. P. Proctor, Kamloops, B. C. Mild smallpox-G. A. Kennedy, Macleod, Alta. Titie to be announced-C. J. Fagan, Victoria, B.C. EDITORIAL NOTES AND NEWS-ITEMS. The Retiring Resident Medical Staff, Toronto General Hospital. Dr. A. J. Mackenzie remains in Toronto, taking Dr. Oldright's prac- tice for a time, Dr. W. A. Kerr begins practice at Ailsa Craig, Dr. A. C. Hendricks opens an office on College St. Toronto, Drs. E. G. Weir and H. R. Snith have accepted positions on the Central Algoma Railway, Dr. G. H. Maclaren goes to Europe to spend some time in post graduate study, Dr. J. Gow has been appointed resident at Mt. Airy Children's Hospital, Maryland and Dr. A. T. Stanton has been appointed Surgeon, R. M. S. \" Empress of China.\" 618 [ JULY EDITORIAL.",
         "Resident Medical Staff-Toronto General Hospital. The following recent graduates have been appointed to the House Staff of the General Hospital for the year 1901-2: E. S. Ryerson, Dun- can M. Anderson, W. J. Macdonald, A. G. A. Macdougall, H. S. Hutchinson, W. G. Collison, J. E. Martin, F. A. Cleland, H. Trout, W. H. Cronyn. Resident Medical Staff-St. Michael's Hospital. The following gentlemen have been appointed for the ensuing year: Drs. P. W. O'Brien, Chas. R. Elliott and H. R. Parent. Provincial Board of Health Reports. The total number of deaths registered in the Province of Ontario for May of the current year was 2,027 as compared with 2,162 in the correspond- ing month last year. Of the total numbers of deaths 210 or nearly 10 per cent. were due to consumption, compared with 239 or over Il per cent. a year ago. There were 2 fatal cases of small pox reported; also 32 deaths from diphtheria and 14 for scarlet fever, a slight increase in both over the number in May 1901. Bequest to Harvard Medical School. J. Pierpont Morgan has donated $1,000,000 to Harvard Medical School for the purpose of providing new buildings. When will some of Toronto's millionaires startle the community by emulating the example of these American philanthropists ? PERSONAL. Dr. Jas. D. Lyness (Trinity '01) is opening an office in Chicago. Dr. H. E. Safford, of Detroit, recently spent a week with friends in Toronto. Dr. Ralph C. Williams (Trinity, '98), of Brooklyn, N.Y., is visiting friends in Toronto. Dr. J. T. Fotheringham returned fron Europe July 15th and has resumed practice. Dr. Laughlin MacKechnie (Toronto '92), of Vancouver, B.C., spent a week in Toronto recently. Dr. F. W. Marlow, late of St. Michael's Hospital staff, is practising with Dr. N. A. Powell for the summer. The many friends of Dr. Adam Wright will be pleased to hear of his return from Europe greatly benefited in health. Dr. R. H. Hoops (Trinity '01) has been appointed House Physician at the Home for Incurables for the coining year. 619 1901.] EDITORIAL NOTES.",
         "Dr. H. P. Martin (Trinity, '98), of Toronto, sails for Europe shortly where he will spend a year or more in hospital work. Dr. Chas J. Levy, of the recent graduating class, Trinity Medical College, has left for a year's post graduate work in Europe. Dr. E. G. Rawlinson, of Toronto (Trinity '99), has left for Europe where he will spend about a year in post graduate work. Dr. Arthur Mayberry, 253 Spadina Ave., will in future confine his attention to special practice-nose, throat, heart and lungs. Dr. H. D. Weaver (Trinity '96), assistant in pathology in the Medical department of Dalhousie College, Halifax, is spending some time in Toronto. Dr. W. H. Marshall, gold medalist at Trinity University at the recent examinations, has taken up practice for a yeàr at Vanderbilt, Mich. Dr. Charles A. Ilodgetts, of Spadina Ave., has returned to the city after superintending the small-pox epidemie in Northern Ontario for some tiie. Dr. Graham Chambers has been appointed Professor of Dermatology and Assistant Professor of Clinical *Medicine at the Women's Medical College. Dr. Alex. Primrose, of Toronto, delivered the address in Surgery at the meeting of the Maritime Medical Association in Halifax, on July 3rd and 4th. Dr. John A. Ferguson, of College St., was presented with a beautiful silver tea service by the officers of the Grand Camp of the Sons of Scot- ]and to mark their appreciation of the valuable services he has rendered the Order. Dr. A. T. Stanton (Trinity '99) who has served on the resident medical staffs of the Toronto General Hoïpital and the Hospital for Sick Children, has been appointed surgeon on the C. P. R. S. S. \" Empress of China\" from Vancouver to Hong Kong. Medical Council Examiners for 1901-2: . Dr H. B. Anderson, Tor- onto, Anatomy, descriptive; Dr. W. G. Anglin, Kingston, Theory and Practice of Medicine; Dr. R. N. Horton, Brockville, Midwifery, Operative and other tian Operative, and Puerperal Diseases; Dr. A. Primrose, Toronto, Physiology and Histology; Dr. J. W. Edgar, Hamilton, Surgery, Operative and other than Operative; Dr. W. Gunn, Clinton. Medical and Surgical Anatomy; Dr. Graham Chiambers, Toronto, Chemistry, Theoretical and Practical, and Toxicology; Dr. J. W. Schooly, Welland Materia Medica and Pharmacy; Dr. J. H. McLellan, London, Assistant Examinér to the Examiner on Surgery, Diseases of Women ; Dr A. Haig, Kingston, Assistant Examiner to the Examiner on Medicine, Diseases of Children; Dr. G. H. Field, Coburg, Second Assistant to the Examiner on Medicine, Pathology, Therapeutics and Bacteriology; Dr. E. T. Adams, Toronto, Homeopathie Examiner. 620 [ JULY PERSONAL.",
         "PHYSICIANS AND SURGEONS OF ONTARIO EXAMINATION OF COLLEGE OF PHYSICIANS AND SUR- GEONS OF ONTARIO. The following candidates passed the final examination :-W. J. Ab- bott, Brockville; D. M. Anderson, Toronto; F. W. Birkett, Ottawa; W. T. Bui ns, Toronto; E. L. Brown, Cliesterville; C. T. Bowles, Ottawa; A. Bourque, St. Eugene; F. A. Clarkson. Toronto; H. L. Collins, Kincardine; A. C. Campbell, St. Thomas; H. E. Clutterbuck, Toronto: C. J. Currie, Toronto; E. N. Coutts, Durham; W. R. Cook-. Fordwich; B. A. Cohoe, Toronto: W. H. Cronyn, London; F. A. Cleland, Meaford; A. Chevrier, Ottawa; H. G. Downing, Woodstock; H. Dittrick, St. Catharines; I. Dixon, Walkerton; D. R. Dunlop, Fordwich; C. C. Elliott, London: J. W. Edwards, Kingston : E. Flath, Toronto; J. I. Ferguson, London; J. W. Fitzgerald, Sanborn; C. C. Grant, St. Thomas; H. S. Hutchison, Teronto; V. A. Hart, Daiston ; D. C. Jones, Brockville; W. B. Kayler, Toronto; T. W. Kirby, Sault Ste. Marie; F. E. McLoghlin, Hamilton; A. K. Morgan. Adelaide ; A. H. M ontgomery, Brantford; A. J. G. MlacDougall, Toronto; W. G. Montgomery, Wroxeter; J. E. Martin, Langton; F. W. Miai low, Blackstock ; M. D. McKichan, Hamilton; W. F. McKay, Beaver- ton: M iss Minnie M cDonald, Hagersville; A. F. McLaren, Lancaster: P. W. O'Brien, Toronto; J. M. Potts, Sterling; H. E. Paul. Newbirg; A. R. Perry, 1ount Forest ; C. T. Pigot. London; A. W. Richardson, Kingston: R. M. Rutherford, Hawkesbury; E. S. Ryerson, Toronto; H. P. Ross, Exeter; E. J. Stubbs, Stratford; W. E. Storey, Windsor; G. B. Snyder, Ridgeway; G. S. Sadler, Pakenham: H. Softley, Feversham ; J. H. Trout, Toronto; C. C. Tatham, Listowel ; W. G. Tyner, Kincston; C. L Taylor, Wardsville: S. Thompson, Strathroy; F C. Trebile.ck, Enniskillen; J. P. F. Williams, Georgetown; J. Webb, Hamilton. INTERMEDIATE. The following candidates passed the intermediate examination :--W. J. Abbott, Brockville; 1). M. Anderson, Toronto; J. W. Atkinson, Avon; W T. Burns, Toronto; W. J. Brown, Lindsay; J. G. Bogart, Kingston; C. T. Bowles, Ottawa; A. Bourque, St. Eugene; F. W. Birkett, Ottawa: A. C. Campbell, St. Thonas; C. J. Currie, Toronto; J. B. Coleridge, Ingersoll; O. W. Colbeck, Toronto Junction; C. C. Campbell, Listowel; W. A. Cers- well, Bond Head ; W. R. Cook, Ford wich ; R. H. Carscadden, Morewood; F. J. Colling, Toronto; F. J. Carrharris, Kingston; B. A. Cohoe, Toronto; W. H. Cronyn, London; F. A. Cleland, Meaford; A. Chevrier, Ottawa; F. P. Coates, Streetsville; H. E. Clutterbuck, Toronto ; J. T. Dixon, Ham- ilton: G. Davis, Cayuga; J. E. Drury. Daiston; I. Dixon, Walkerton; C R. Elliott, Alvinston ; J. W. Edwards, Kingston; W. C. Fawcett, London; C. D. Ferguson, Port Stanley; J. 1. Ferguson, London; T. S. Genge, Halleford; W. S. Grimshaw, Kingston: A. J. Grant, London; H. S. Hutchison, Toronto; John Herod, Toronto; W. T. Hamilton, Motherwell; V. A. Hart, Dalston; R. J. Kee, Stanley Mills; D. C. Joues, Brockville; W. H. Lowry, Guelph; C. P. Lusk, Toronto; D. R. Londsboroigh, Sea- 1901.] 62]",
         "PHYSICIANS AND SURGEONS OF ONTARIO. forth; A. 11. Montgomery, Brantford: A. J. G. MacDougall, Toronto ; W. G. Montgomery, Wroxeter; K. MacKinnon, Guelph, R. T. Mac Laren, Columbus; A. 1). MacIntyre, Glencoe; G. E. R. McCartney, Binbrook; M. D. McKichan. Hamilton ; G. D. Mcllwraith, Hamilton; W. Mclntyr, Rosedale: J. McCulloch, Port Perry; W. F. McKay, Beaverton; J. A. Mc- Collum, Toronto; Minnie McDonald, Hagersville; W. B. McDiarmid, Maxvillc; L. McLeay, Gavenhurst; J. M. Oswald, Windsor; R. N. Par- ent, Windsor; R. Parions, Emery; G. R. Pirie, Hamilton; H. E. Paul, Newburgh ; A. Rannay, 3eoigetown; A. B. Rutherford, Owen Sound; E. Richardson, Brockville; C. H. Reason, London ; J. Rogers, Belmont; A. W. Bichardson, Kingston: R. M. Rutherford, Hawkesbury; W. C. Red- nond, Bethel; %%. E. Storev, Windsor; G. W. Smith, Almonte; J. A. Smith, Hamilton; J. Smillie, Bluevale; A. T. Steele, Orangeville; R. D. Sproat, Milton; G. S. Sadler, Pakenham; A. Turner, Southwold; J. H. Trout, Toronto: C. C. Tatham, Listowel; W. G. Tyner, Kingston; D. G. Whealey, Toronto; C. S. Wainwright, Orillia; L N. Whitely, Londesboro'. PRIMARY. The following candidates passed primary with honors :-J. P. Arrm- strong, London; C. C. Cragg, Brighton ;. W. T. Gemmell, Seaforth: W. A. Graham, C C. Kinster, Toronto; J. D. Leeson, Aylmer; F. C. Neal, Wal- ton; G. E. Wilson, Attwood. The following have passed primary:- Miss Jessie Allyn, Smith's Falls; S. F. Abbott, London; C. T. Bowles, Ottawa; R. S. Brewster, Sun- derland; E. C. Beer, London; M. D. Buchanan, Zurich; J. H. Biggar, Toronto; W. T. Babb, Carlingford; Mi.s Mary Brydon, Ottawa : C. T. Ballantyne, Ottawa; J. M. Baldwin, Toronto; J. V. Brown, Barrie: E. Brandon, Cannington; F. M. Bell, Kingston; A. Bourque, St. Eugene; W. J. Bell, Toronto Junction; F. W. Birkett, Ottawa; T. A. Carson, Orange- ville; K. Colbeck, Colbeck ;- A. H. Cook, Toronto; A. Chevrier, Ottawa: F. P. Coat s, Streetsville; A. H. Campbell, Ailsa Craig; G. E. Chapm an, London; T.V.Curtain,Brockville; H.E.Clutterbuck,Toionto; C.E.Duggan, Oil Springs; I. Dixon, Walkerton; D. Evans, Virginia; J. W. Edwards, Kingston ; P. J. Fleming, Dundas; R. F. Foster, Toronto; E. V. Frederick, Campbellford; G. N. Fish, Toronto; J . Ferguson, London; G. C. Fer- rier, Kingston; W. E. Gallie, Barrie: G. E Greenway, Little Britain; E. L. Hodgins, Lucan; K. H. Holmes, Chatham; B. H. Hamilton, Auburn; C. M. Heydon, Toronto Junction; L. R. Hess, Hamilton; J. H. Hamilton, Nelson, S. C.; C. H. Hair, Lavender; D. H. Hou ston, BelleN ille; W. B. S. Hunt, J. G Hunt, London; V. A. Hart. Dalston; R. Ingram, Ridgetown; D. C. Jones, Brockville; L. W. Jones, Kingston ; D. S. Jolnston, Orillia W. J. Kerfoot, Minesing ; D. P. Kappele, Hamilton: W. B. Kayler, Tor- onto; T. W. Kerby, Sault Ste. Marie; W. D. B. Kennedy, Kingston; Miss Eleanor F. Lucas, Toronto; C. M. MacKay, Woodstock; W. N. Meldrum, Ayr; W. W. Milburn, Peterborough; F. E. Mellow, Sillsville; J. Moore, Trowbridge; L. McLeay, Gravenhurst; H. MeLean, Glencoe; A. McInnes, Bognor; R. P. McLaughlin, Cumberland; W. McTavish, Palmyra. P. McCue, Melancthon; T. O. McLaren, Lancaster; W. B. McDiarmid, Max- 622 [JULY",
         "1901.] 623 PHYSICIANS AND SURGEONS OF ONTARIO. ville; T. H. McColl, Wallacetown; B F. O'Reilly, Toront\"; J. A. Oille, Sparta; J. R. Parry, Dunnville; J. Phillips, Hewitt; H. E. Paul, Hew- burg; W J. Pattereon, Peterborough ; P. F. Quinlan, Stratford; R. M. Rutherford, Hawkesbury; F. A. Ross, Guthrie; Miss Olive Rea, Taronto; J. M. Robb, Stratford; A. W. Richardson, Kingst.on; R. M. R-id, Ren- frew: W. Redmond, Bethel; A. A. Stiley, Wolfe Island; D. T. Smith, Ottawa: W. E. Somers, Waterford ; S. Singer, Toronto; C. B. Stone, Peterborough; N. H. Sutton, Ida; E. Sheffield, Peterborough; D. A. Sin- clair, Toronto; D. J. Sweeney, Caledon; D. M. Sutherland, Norwich; G. S. Sadler, Pakenham; W. G. Tyner, Kingston; F. J. C. Tindle, Peterbor- ough; A. Turner, Southwold ; G. A. Winters, W. A, W. Woolner, Toronto; T. W. Walker, Hagersville; E. M. Walker, Toronto; A. L. Webb, Brighton; W. Y. Young, Toronto. BOOK REVIEWS. EICHHORST'S PRACTICE OF MEDICINE. A Text-Book of the Practice of Medicine. By Dr. Herman Eichhorst, Proressor of Special Pathology and Therapeutics and Director of the Medical Clinic in the University of Zurich. Translated and edited by Augustus A. Eshner, M.D., Professor of Clinical Medicine in the Philadelphia Polyclinic. Two octavo volumes of over 600 pages each ; over 150 illustrations. Philadelphia and London : W. B. Saunders \u0026 Co., 1901. Price per set : Cloth, $6.00 net. Canadian Agents, J. A. Carveth \u0026 Co., Toronto, Ont. This publication by the erminent German author is a welcome addi- tion to standard literature on medicine. If fitness to tatisfactorily per- form the task urged upon him by his students and admirers, and if thoroughness and conscientiousness in carryîng it out by theauthor is any guarantee of success, this work cannot fait to be popular with both student arid practitioner. A perusal of its pages impresses one that it is the work of a cai eful, thoughtful clinician, whose experience has been gained from the study of disease at the bedside and in the morgue, and not from the study of literature alone. It impresses one iu the same favorable way as the publications of the late Hilton Fagge. It is also pleasing to note the extremely practical manner in which the various subjects are dealt with and the attention given to the treat- ment of isease. Such a work will go far to remove, in the eyes of the Entlish speaking world, the stigma of therapeutie nihilism that has long beeni attached, and not without good rea,-on, to the German School of Internal Medicine. For original research and scientific acumen the Germans deservedly hold a first place in the medical world, and now that they are eiving more attention to what after all is the chief end of",
         "r)24 BOOK REVIEWS. [ JULY -our calling-the cure of disease-we may expect rich practical results from that source, of which the work under review is a good omen. Con- sidered froin whatever view-point one may choose, from pathology to treiment, Eichlihorst's Practice of Medicine is excellent and reflects credit ,alike on the author, the editor and the publishers. H. B. A. Uterine Fibromyomata. Their Pathology, Diagnosis and Treatment. By E. Stanmore Bishop, F.R.C.S., Eng. Am. Ed., P. Blakiston's Son \u0026 Co., Phil., 1901. Chandler \u0026 Massey, Limited, Canadian Agents. Many excellent monographs bearing upon the subject of this work have appeared within the last few years. One bas but to compare the technique and the results of the perfected American Hysteronyoictomy with, for example, the plans of operation adorsed and -the imurtality rate given in so recent and so good a work as that 'of Greig Snith to estimate the progress that has been made. It has remained for an English sur- geon to sum up for us the net gain, to present in clear, logical and con- secutive form the advances made by.English, German, French and An- erican Gynæcologists and to seek out and set in order the methods by which uterine fibroids can be most successfully removed. Very few of those who had the pleasure of hearing Dr. Noble's paper before the Ontario Medical Association last inonth wili be disposed to question the statement that in a vast majority of cases, such tumors should be dealt with surgically. Hemorrhage pressure effects and de- generations, singly or grouped, so seriously threaten the lives of patients with fibroids that the older methods of expectant or paliative treatment should give place to something safer and better. The selection of a plan of attack best suited to the varying conditions under which such tumors are found receives full and fair consideration. We may not all agree with the conclusions reached by the author; this reviewer for instance strongly dissents froin his statement that even with a healthy cervix, pan- hysterectomy is preferable to supra vaginal removal, but bis facts are well marshalled and lis reasoning apparently is without bias. If Mr. Bishop's book is honestly and fairly studied we shail hear less in the future of the disappointing appendage rernovals popularized by Ileger \u0026 Tait. and the vagmnal-route-or-everything crank will be less in evidence. Per contra we shall have a more just appreciation of the pirolat fact that the dangers inseparable from the removal of fibroids are great or slight according to the method adopted and to the skill and experience of the operator. Does this not mean, in other words, that the surgeon who neglects bis opportunities for watching critically the operations of others is likely to purchase his own experience at fearful cost to bis patients ? An attractive feature of the volume before us is found in the large number of plates reduced and adapted by permission f rom Kelley's sump- tuous Operative Gynocology. This is an indication of commendable international courtesy. N. A. P.",
         "Atlas and Epitome of Labor and Operative Obstetrics. By Dr. O. Shaeffer, of Heidelberg. From the Fifth Revised German Edition. Edited by J. Clifton Edgar, M.D., Professor of Obstetrics and Clinical Midwifery, Cornell University Medical School. With 14 lithographic plates, in colors, and 139 other illustrations. Philadelphia and London: W. B. Saunders \u0026 Co., 1901. Cloth, $2.00 net. Canadian Agents, J. A. Carveth \u0026 Co., Toronto. This volume is a recent addition to the well-known series-Saun- ders' Medical Hand-Atlases-which are popular with the profession as convenient works of reference owing to the excellence of their illustra- tions. The author does not offer it as a text-book of Obtetries, nor to replace descriptive works on this branch of medical science and art, but rather to accompany such with graphic representations of the various conditions and operations described. The demonstrator and clinician will find it of great value for its exhaustive classification-though this differs slightly from that adopted by American and English writers, while the student will find the plates and figures valuable for reference in his reading, and the general practitioner when hurriedly \u003eeeking information for the management of a difficult case. * The work is divided intu Part A, treating of the Act of Parturition considered from the standpoint of the practical obstetrician, and Part B, of Obstetric Operations. There are fourteen lithographic plates of beau- tiful workmanship, and a series of one hundred and twenty-two figures illustrating in succession every stage in the progress of parturition, and the manipulations required in the various positions and presentations. A. J. M. SAUNDERS' HAND ATLAS SERIES. When we consider how few other than eye specialists use the opthalmoscope (with any degree of satisfaction) and how import;int an instrument it is for diagnosis and to know the extent of some diseases even outside of the many affections of the eye itself, such as brain lesions, kidney trouble, and affections of the circulatory system which endanger life, one wonders how few make any effort to become accustomed to its use. Possibly one of the reasons is that but few general practitioners meet with many typical cases to examine at any one time, and until recently atiases of opthalmoscopic work were not many, and those that were good were of high price. Recently, 1901, a new and enlarged edition of Prof. Dr. O. Haab's work, translated by Dr. G. E. De Schweinitz, has been published by W. B. Saunders \u0026 Co. at the very moderate price of $3. J. A. Carvetli \u0026 Co. are the Canadian agents. As the Professor very aptly states, \"mere verbal descriptions are even more unsatisfactory than they are in other similarly complicated domains of medicine, especially if the student is imperfectly acquainted 1901.] 625 BOOK REVIEwS.",
         "with the subject. Even topographical drawings of pathologie alterations in the eye are extremely complicted and a correct description of the coloring is often extremely difficult or even impossible. Thus a littie more white, or a little more red r gray may make an important differ- ence in the appearance of the optic nerve, and may be enough to show the expert that he has to deal with a serious condition, though to the nexperienced eye the appearance imay be normal.\" And he also states, \"to supplement one's own observations, and profit by those of others, one must use carefully colored illustrationg.\" Not only does Prof. Haab give a great number of beautifully colored plates of the eye ground with good descriptions, but also the microscopie changes cleverly drawn and colored. It is a book well worth the money and should be prized by the surgeon or physician, as it will greatly lighten his labor, and help him in his diagnosis with the opthalmoscope. C. TROW. PUBLISHERS' DEPARTMENT. A LABORATORY FOR POISONS. I's a wonderful laboratory, this human body. Aut it can't prevent the formation of deadly poisons within its very being. Indeed, the alimentary tract may be regarded as one great laboratory for the manufacture of dangerous substances. \" Biliousness \" is a forcible illustration of the formation and absorption of poisons, due largely to an excessive proteid diet. The nervous symptoms of the dyspeptic are often but the physiological demonstrations of putrefactive alkaloids. Appre- ciating the importance of the command, \"Keep the bowels open,\" the physician will find in \" Laxative Antikamnia \u0026 Quinine Tablets \" a con- venient and reliable aid to nature in ber efforts to remove poisonous substances from the body. Attention is particularly called to the thera- peutics of this tablet. One of its ingredients acts especially by increasing intestinal secretion, another by increasing the flow of bile, another by stiinulating peristaltic action, and still another by its special power to unload the colon. 626 BOOK R EVIEWs [ J ULY"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ L Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure D Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: D Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison D Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X. 28X 32X",
         "0O11q ÎJsand ciiviuity, Dr. Se.addiing.. ii of nature versus the rhythmi oi by _a .. .. . .. .. .. . appettrauices of sottul- anti tit- 1 food ....................... re of crvous diseuses .......... 1 iin M~ihigan- inteiesî ilig fiacts .... tion in St. Louis-cssons tt) lie med ... ...................... itreul sialp~ei'i -hpr- Ôw tbe clisease spriîtds ............. ,erpssion of ontbrenks of stuail-pox in [»tava ........... ...... ..... .... od adtltoiîîttiou-Iowv to check it .. aoricari Public Hcalth Assoc'ti mneeting TnTZrS- Not-West canmpa igti-Eleai tii fuiiiess ouf.. i \u003c18 ,rhe public health-NMutiary stuutistic; . . 1î~ Stirgeon-G;ceorai Bergin - Faettory- libor r'eforim............................. 112 TEtitor's Cornr-iNotiey et carit-ri o' cou- tagion-Botti ing, %vitr-Cttidiy ad iitir- tetion - Craniotoîuy - (Jiîeap cioncîes- Stirising bottles-N iglt tiriving-ilealtt reports, and iniaty otiier inew and inter- esting items .................. 115 to 11 R ('trrcnt literatur-Th'ie brotiîeritotd tir inan-Original poctry by .Johu nde I[trose-B.atch or b)ooks............. 120 Bonok îîtcsPbiie'snotices .... 121-12.2 T HE GCIR A.IN aD UNO HOTELIV j O011posiic Ille Crald central 1)epot. Nel' Vorh Cil y. -er.s t«Iracriiersz anti finiiiies-11-iiving cer livilig ill cily go, vieit rttt î.n1r:tciWiit Moîtilitaiî,.1 à lieurSiinrtt s - sup'rtnrW ae'uuntl: iin. il i~rovtŽeiet Eu ropeanu pliiî îtbtr t3Oeit~î fiiiie llet a eNI)ellsol ni \u003cte Millintit)b $ S]1.111(l ptn pirser daly. r- t'iil tîiisied su ies for fiiilies. ;îiid eieguttiiy fiiiiled moins ï4r tliiiiier itu-irties for ter) eiiid i,- fad.Cais;Ite and wittes (et su peýrior- nieri t. Cltafétt u:tit :11( eaudWile Ilnîis sqi îriec( %ville thle bes. binderate pi iue. Tittiet and iaggage Ro tuis, for ladies Il,(, genits wheie cot 's vaIlises aid parceis caol bc f;ty-f.cc. W. L). GNaAR zIcON, Mra;t * e tuat ltU!711/tP lol/.Yri l\" cutie fron\u003et t7itJ -jut ftc ',(/ hi)\"-i \",1,,. ~t\u003cl l 'î)1 tel 111 ,i8 floterî. GENERAL KEER'ilS t' it I Y DI tu t i'JeMark Registered GENERAL KEER'S IMPORTED BY HIM DIRECT FROM INDIA ,Selectedl for lîjuti ivitt g-rcat care ini Calcuitta, the best iuarh-et ini the ivorld for Luidiaxi Teas. Forw'arded to any part of Canada, or the U5nited States in Caddies of from 51b upwards. FOR SAMPLES AND) PRICES APPLY TO y1ajor-Gexieral EMIR, 58 OI3RCH0I Street, TOR~ONTO.",
         "PAGE MISSING",
         "SURGEON GENERAL BERGIN.",
         "MAN, A CANADJAN HOME MAGAZINE. VOL. T. JANLJAIY, 1886. No. 2. TI1ERAPEU1TICS AND DTVINITY. DTDAOTIC USE OP'TRITIIS IN IlYGIENE-TIIEIR ANAILOOY TO IIIGIIER TRUTHS- PHIRASEOLoGY-RESULTS TIIEREFROMf-ljý'. NCES--INTERPRETATI0NS. tV is surely net ,,ithiout significance that in the maturials suppliïed te the Chiristiaà teacher for bis use in the exýorcise of-his office among his fellow- men, se many illustrations and confit- mat qns should be drawn froin consi- derati,-ns con n eted wi Lb humian hecal th and the art of healing. The expeetation evidently wvas, that thle subject rnattcr ef bis teaching sliould be botter unde- stood by mgians of some study gie te therapeutics; that truths of a high transcendental but yet, as we say, vital- ]y important cliaraoter were te be more clearly realized, and more readily 'velcorned, by virtîîe of an analogy perceived te, exist between thein and fiamiliai- cernmoi-place facts cerning %vithin the persenal experience of every eue. WVere it fltting te do se bere, the places miglit be enumcraited in dotai], -wheî'ein phraseology derived frorn considerations connected wvith, huma- beau-h is used by the authorities of the last resort arneng Christian teachers. It hardly needs te *be said that the expression hygieue, expressive ef soi-e- tlinglc relating te wlioleness or sound- ness, iiev beceme a liousehold word amengst us, is ai Most pure Grock) the language in whicli the earliest and Mnost reverenced et the Christian docu- ments have beeni banded down te us. lal these doeumenits it mighlt be shewn that at least twenty-five passages occur which involve the employi-nent of the root part of the word hygiene. Thirty- two at least inight be pointed eut, wlierein wve have the root or stem-part of the ordinary Grock word for physi- clan-flic word used in the mernorable provoivl \"Physicia.n-t (Iatre!) heal thyseif \"-lvhioughi it lias happened that the stem. ef that particular term, bias scarcely found a lodgement in our Englishi speech. (We hiave it however in one or two seldom.-used expressions - as for example, in iatrical-relating to, medicine or physicians, iatro chern- ist-a chemist physician; and iatro- leptie, Ilthat cures by anitn,.in Worcester; an-d elsewliere (Bailey vol. 2), in latromathematician, Il -%ho cou- siders diseases and their cause, mathe. maý,tica,,lly, and prescribes according te mathernatical. proportions \") - Over fifty places might be cited wherein the root part offthe first word at the liead of this paper is employed in the same documents; often indeed only in the sense of useftil service rendered in a general wvay, bùt often aise ini the restricted sense of medical help or service whichi atone attaches te, Ilthera- peutics \" -%vith us now.-Again, there is a Large group of Groek terms applied te didaetic, use in Ciristian teaching, (one might count nerly two hundred of them), which *alse convey along wvith a general idea of soundness or wholeness, a special. ene -nevertliekess of' sotindness ef healthi or restoration te seundness of health ; fren 'which group",
         "THE1RAPEI5TICS AND DIVTNITY. ]ikewise no0 root cleient bas fo011nd its wvay int(i oui' lang\u003e;inge. (fleadcrs of' arctoy liowvevor, it niay bc presurncd, are snl'icieitl iliai' wicLb the naine of Ptolcmiy Sôter, aînd perlîaps also -%ithi that of thec oid Chiristian historiai- ,Sozown, both of w'ilîi eontaiîi the Stein îeofced( to, ais also do suîcl prioi'I naines as So-c'ratcs, So.s-tlieiies, etc. Thec short Grcekz sentence w~hich sup)plies the Pilace of' a refr-ain to the thirdl stanza of' liongýýfellowv's Blind BartimS3us %vii :îlso SL u pp)ly iiiaiiy Englii readers wvith another instance -%vhi!e no observer of, mioder'n avri nients can have fhiledl to take note of' Soz-odoiit, the -%voiiderfîdi sp)eifie foi' preserving sotindcness in the teeth.) he adoption of lîy.gienice or medical terms bv the carliest Chiristian writers wvitîotCdoiibt arose fi'oin thecir faîni- liar1ty with file Ilebrew books or rather with Greek versions of the flebrew boolhs-, iii the hiaads of înlost of' the Iearnîed ar tlie opening of the Chîristian era. Froi these wc learn,- as 'vo abunclantly learn also f*roii! tic E-jngtlishi version-; of' the saine books na de straighit froin the original Ian- g(uage-that. hygqjienie exNpressions were therein often used to convey moral ideas. Who does îîot rernemnber thlat the Divine î'ule, destined as theIebw people believed, one day to be universal wvas spokeon of, in Iilebrew phrase, as \"Gocl's savingr healti atmong, ail na- tions \";and that thc appearance of the generally exJ)ectel IDliverer ,vas to bo as the apliearance of a San rising with healinq in bis win\".s or beamns \"? So completely indeed did the idea, viz: that of saving, pecr'n or- reCstor-ing to whlnseontained in tie, ,econd constituent of the coinpouind pr'opcr naine Jah1-ilo0shea, Pledoiiate, that it seenis to have tliirowni the preceding constituent into the shade. (Out of' this proper name thus wîrittcn at large, it -,vas, that the Grreec xvriters fornied, as WCo kuow, the farniliar pi-oper naine rrîîE NFw Yortii Young Meon's Christian Association ia a recent debate decited that '' pliysiciauîs shioul\u003ci be Tbitan. he Spriiigfield Unîions agrees to the dicision, but tilinkis it a nistîîke, to draw the line at physi- çiaps: their patients shouli be included, Jesus,, for wvhicIî time stifficient inter'- l)retation wvas liclid by St. Augustine also to bc Salvator : thus lie says:- \"Christus Jesus, hîoc est Christus Sal- Af'ter tic Gr-eks, the Latins~ lilce- Wvise in timeir own tongue fhshioned liyienie ternis for use in Christian instruction ; and it is from the Latin forais chiielly that we have obtained the terms of this kind that wve uise in English. 'iihus sanuis, salas, Salvas, Sa! vatoi' have gi von us sane, i. e, sound, sanati ve, saiîatary, sa ni tary, sai ataî'y, saivable, salvation, sailvagie, save, safè, Savîour ; aîll contai ning a notion more or less of' whloness or r-ecover-y of whioleness, even, it mnay be, froin the very vergýre of' dissolution. Them L~atinî impotentes, *agrain, grave us the quaint expressioi \" i impotent foilk,\" now mo- deî'nîzed into tic more intellig)ible and more correct readerin\u0026ç of' \u0026\" thioçe tlîat wvere sickz.\" As to salus in its scondary bu t h igh moral Climi stiansee-A o ,S'lutis, the year of Iîealth or humn salvation, ib almnost as coinmon as Arno .Dornini, ini the dating of' carly books and documents. c In oarordinary Englishi speech at the pi'esent day WC adopt the pliraseology wvhicl lias reccivcd tincture fm'om the Latin ; but oui' Saxon for(ýfatlîers lîa-d plenty of wvords of thieir owa of a lîygienic cast, for use ia Christian instruction. Most of tlem are, fimiliar enoarh. to us still ; such as wvhoIe, wlioleiiess, wvholesome; lîcal, liai e, liealth,) w-itm vhiui is ilistructively conncctcd the general1 tcrm Il boliness\" it:seli* Th *ougtliout an ancient Saxon pocin of' the oartily part of' tho ninth century, tlit' 'ord uscd foi' Jesus is HéIliand, 14 One wv1o heals \" ; vhiich word fturniiýshcs a title to the pocm, the old writer tmanslating the pî'oper namle just as St. Augustine hiad donc, by an epitliet suppo.,ei to be its equ'ivalent. ITENRY SOADDING. TiiE mnuani dunation of Life ia France, ivhich ivas twventy-iae years at the close of the cgtnt entury, and tliirty-nine from 1817- 1831, increased to forty froin 1840-1859, tlianks to fic pro.-rcss of Sanitary sciences,",
         "TIIE RHlYTHM~ OF NATURE VERISUS TRE OrU 0 ART. r lGeelc niaiden, gflorions i phy- f sical strength an d beauty, luck ing the rose, that perfct flower, isth type of thaft energy of' thoughit ini literature wvhie-h is least dependant on language, the symbol of' that poetryv in which Encrgy and Art arc in equlipoise. Poetry is the expression of the hurnan mind in langunge inspired. by im.-gi. nation and emotion. Exepltionail feelincr is chai'acteristic of the poet. H1e is drilled Uvt tùiousand fincts rfe Gretes oth lu art arî li ov tied fat ring theli peton h ae, natu pre sion if y neglecte thel oneh o indvi u r ivascried ont the e cotrost. he yle r, the Rhythm of onthe G,,rek b sculpe peeted bye humanfiues e on u bod Timed god cs, ot aiin brt andinte. rheY put gasginç tie erfcinon ofr nalr 1ivicl seul hece lie r is onel andidulw rre n Tefina-h tion. of beay lirue the Grhyth mod Ih rfJ1ej1 cupscunt on re rced b itîca formrs ntha mnfbuted the timph cfd ntreltc but ileiniators ci maden lasoand etihed the emu-ila dtio s ganesiihee The siniua- tiort n h c-iii ~n btdy pre toin Teir feto f t life.odce tityh iofntre of tii fo m spienorso garentas and moetcf lslfed thes adoit tvemselines there Hn the Greekdua miden in ouis illusratio as opredt percit n ohe aifica aie f ody thugtat vi-akos dio, sentiment Sub,e i the*m ci dis the ugtest cf ilmer and Soehofles:b Sakespr rhm .Dante \"fnyh melody, preci-al sien and force in the wvcrds of the picL ', says IlUski il, 1are iecess.-rlY te his zgî'atncss, but netL the lest eof his grleatness.\" 'l'le vital thongzt taekes preceden(c cf' style. Ouly as good deecis are the outcne cf' beievel ence cf'seul, se elevation of' flmîguage and melody cf' style tIc often bear witness te richness cf* emotion and dic\"niity. cf D)ante is oui' f:îvoî'ite pooL le combines the miglit cf Shîakespeare witl tho meiody, cf Tennyson iii perfect liarmiony. Rlis Paradiso is eu-e cf the wvorld's treasurves naîale i n for-ce and melody cf thotifh t. Witnesshis description of' Ieaven in one line : Aud aIl the lauigliter (if those blooemy shores. Czin splende, oif words lnore per- fectly pictmî'e a s1liii)reck: '£lien rose the i)pop, :til sani\u003c hie tiroir Aud over lis he booiug billoiw closed. or the so;Iwý cf anc\u003eels when 1 1 Voiee inswvers voice. so îilisical and suft. It eau be lnowui bult %vhere dlay eniîdlss slîines. Hec thus deseribes the Pugatorial Pilot: lVponi the lirow% the lîa-nsteersinan rtoud \\Visibly wi'itten * Icýzýer lu ilus laibls. IVattiîîg his %ings b)etveeî suel distant siores Ln. lin%' Qtraight iiià t'j lieai cii lie lîio, tlicii rearcd, W~tinno(întiV He air* %vitlt those eternal I)lîîiief:, Thîit flot liiko iiurîal li.îirs lU off or chiange. ln the(, - 1)rcain of Clarence\"' the peet satys;\u003e The fir3t, that there ilid ince. iny stiaiîger soiji W'as ily great f.ttlîer-ii-hutv, r'eliiled %%a.rw-elz, Wh~lo cricil alid -- hait scoîîgn far per.inry Cao this darlcinoaci afflord f:ilse Clarence. Aidsc lie vaiiislieo. ilieii c.aiiie %vanicruîg by, A shaulow like :îx vîgl.with hrighit hair. Dabblcd in bluood -id lie -:Iriceti olit îloîid Clarenee iq coii! fal'e. fleetiiîg. peijuiircîl Clarence, Timat stabbed Ille on the field of TJelwkesbur3'. Seize ou Iiiin furies, take hina to your torluents The modern peet would have des- cribed this ce by givinz ail the eml)hasis te tue WOI'db, or' appurtc'- natices cf the idea, andi net te the idea itself, thlus: The first to iineet nie at \"lie sable doors Wns iîîighty %laî'sviek blazeiied iii lus shaiae, Ife ericîl aloud iii iîiaddeing Iiiuiry. lie hiovled and gabbletl till tlîe yeollowv féaîîî Steop eoî pis lips. aîîd ail the colrts of lcl Did kiiell like beaten bls. - What fiery. scourge Cao torture Clarence, whlo bas iîou% culîle homie.\" And. se hoe vanished, iluen camne wanrleniing by A slhiiiiiering shadow, with its briglit bronîze iair Staiued in barbarie bload. aiîl suo lie sliriekied \"'Clarenice the iiîîîrderer iliat stabbleul tue oh the field, ]?alse. perjoreul Claîrensce.\" tlîeu the slîoal tf gliusts MWlîeeled iu a liv'ing circle roundic and round Their heads Nvere sktills, their eyus like rubies flained, ,And baud iii haud ferever wheelingeon Tliey sang the riteurnel of dainned seuls!",
         "M4 THlE BIIYTIM 0F NATURIE VERSUS TIIE RHIYTHIM 0F ART. The iythrn of Art is likce tho modern fine lady wlîo ]ives for dress and social posturing, To lier it, is a greater concern liow h% ppav thanî %vliat slue is. Over-r-eline-ment is the first isyniptom- of decay. Shec that wvas once lnpor'atrix is now a slave. Macaulay bas deciared that \"las civilization advatîces, poetry almost necessarily declinies. This is a haif- truthi vbielh may or niay net becomec bistory. IL is certain that nothing wvill sooner contribute, to the deeline of poetry than a civilization wvhich, for- gets to educate those very fttculties of man 's nature, by the exorcise of whichi atone, poetry cari be produced or appreciat cd. To-day, taste, imagina- tion, and intellectual. emotion are ieft eut ini the coid by a universal prefer- enco, for scientifie and meclia-nical pursilits. Tiience, wbcen reason, logic, mnetaphysies, science, and the mechia- nical arts are exclusively cultivated, emetion is sacrificcd. The peet ef to-day is unluekzy cnoughi te exist in a mechanical civilization unfavorable te bis developmcnt. The artificial education, whiie stinvulating mediocrity, on ly i nterferes -vi Lb, and impedes the mnore ori 'ginal gift. The modern poet is flic victim of earthly incompatibility ; lie sings like, the captured bird in a gode cage. lus verses instead of being resonant -%ith. nature are but variations of art. lke the rheterical speaker whese pulmena- ry eloquence may be perfect in style and gramimar, but what lie says is werthless, se the cultured and literai-y poet w'ith an oer.critiý?ait fendncss for the ýmanner of saying wbat Le is geing te say, proves that bis facult is ingraftcd and net original. ]ELe is but a manipulater of words. Take away the elaberate aiid excessive culture, and the peet has vanishied. There are mnen-dressmakers in Paris, architeets in cestu nie, whese, elabora- tiens, the resuit of agonized cogitation, and fitting and trying and turning this way and that. These very niuch resemble.the literary costumier whlo ciothes bis miuse wvith. Ilsamite,\" and puts a \"lcithern\" ini lier hand, and instructs ber in -ail the mannered mimicry of an ebsolete, Engylish. There is ne doubt adainty sort ef deliit in ail this. There is a quaint prettiness, an at-tificial sim pi ici ty, a~ nietrical attitudiîiizing bol-il of the sebeol whicli inistakces acultured eccen- tricity for genius. It is possible that many of thesco writers are inheritors ef real inspiration, but misled by the miiiinery of petie thougbit, they thinlz tbeir Pegasus a kind oi circus herse that must be taught tricks. But no ameunt of imaster:ly manipulation ef the impiemnents of the art wvill ever succeed in givingr us the tiger-likeo spring of the original con ception, the leap in air of the .Damnascus blade, the M1iltonie flash of a inillien swords in biell. The fine lady wvbose aimn in life is te dress well, and look cbarmningr likze a picture, may easily forget that she lias a seul. All ber emotions, bier affec- tions, bier very liUe have run inte drapery, h icethe cuphon ious ai litera- tien of the jugglcr of werds. Yet this very miusie is an essential accempanimient te the bigues t poetry. The meost perfect passages are the mest musical, but te say on this account they arc te dispense wvitih m-eaning, or te undervalue it, wveuid be ridiculeus. \\Ve wvisli at titues tbat Shakespeýare w~as more musical, net less gigantic. We aise wisli Ibat Tennyson was at tinies more significant in sense, but net iess melodieus. The best poetry, the very Iighrlest art ef song, is xvhere nature and art, sound and sense, mceaning and nicle dy, are in perfect equipeise. The best peets at tinies attain thîs excellence, but flic phrase. \"'The fatt iweed That rots jtsceIf on Lotho's wharf.\"1 wvilI bc recegnizcd as Sitakespeareain, and tbe swvan that - Rutiles lier wuro cold plume, anid takes the flood W'ith svzrthly Nvabs2' 15 Tennysonian. The art of geod xritivg either ini prose or peetry lias been dcfined as tgspontaneous thoughit and labored expression.\" Elaboratien cati hardly bc everdene as long as the tboughit that directs -and sustains it is the vrai feu, ýand net the ignis fatuus ef a mnis- taken amnbition. Let tue truc peet grasp the fact as vividly as bis faculties will aliow. Let him charge the fact witb ail the",
         "DISINFECTION BY 1IEAT. fervor-, the truth, the imagination, tho emnotion, tho ins-pira-tion, the rhythmr of soulli ho )ssCsses, thon bis learninr, his command of? w~oids bis invention of motaphor, wi il of thlom-solvoes accurately phiotographi- not thc fact itself, for th-at is pi'ose-but the fact. iri ilb living nioving, thrilling exaltation, and that is poe0tly.~W. Ri. BRADSýIIIW in Lite- rary Life. DISINFECTION BY EIEAT. WBE have often had occasion in these columns te ur-ge the necessity of some skillcd inquiry being made by the Miedieal. Department, of the Governmnent into the somcewvhat empirical înctliods of disinfection' now in vog1cue. It is satisfactory to find from Dr. Buchia- nan's î'ecent annual reports that hie is im1)ressed with the necessity cf investi- irations in this direction; and accor- dingly, a substantial share cf the auxili- ary scientific grant for the last two years has been devoted to'vards study cf the questions cf infection and disin- fection in their varions relations. Scient ific Results attaiined.-With the more scientific branches cf this investi- gation we do net propose on this occasion te dwvcil. Exhibiting some valutable resui ts for i mmodiate practical application, particu larly as concerns the power of' certain gases te destroy an infection that is comnmunicated through tlic atinosphere, and as con- ceras the value cf atid reaction per se te aIl -processes cf disinfection by chemicat agencies, these resoarches yield, on1 the' ether Iiand, an abundance cf cautions against any toc hasty exj)ectation of our finding chemical agrents endowed with the ability te kilt those dangerous particles in which we are Iearningr that infection resides. There, is, however, one noteworthy point vouched for by Dr. Kiein that places these researehes in a promising Iigrht:-When it is possible te recog- nise, as in the case cf anthirax, tubercle, and swine fever, the minute organisms that play an essential part in the discase, and te compar:e themn with other and similar oi-ganîsms wvhich are net se mere infective as putrefactive it 18 found that chemnical agencies which are wvantinfr in destructive effeet upon the putrèfactive organisms have a, power, often wvhen present in extiremeiy m inute quantity, of' arresti ng or destroying the life cf the infective orgranism. The lino cf investigration wvhich is cf most irmcediately practical impol'- tance-viz., the best means of disinfléc- tien by- leut, wvas placed in t'he hands cf Di». Franklin Parsons, one cf the ordinary staff cf the Medical DepaLrt- Ment. lIe wvas careffull te tak-e, destruc- tion cf tho most stable known infoctive matter as tho test cf truc ' di.4infection.' Examining, in conjunctien wvith Dr. KIcin, the suitability for, the purpose cf this btudy, cf the virus of swine plague and cf tuborcalosis and cf anthrax-ail cf which admit cf being, before and after expei'imental hecating, put to the test upon animials-the ebser- vers seon came to tlue conclusion that, cf these infeutions, anthrax matorial wvas the most resistant toecvory formn cf boat, and they wvero able te pi'cced on the assumption that such arrange- monts as would afford a heat adequate te destroy anthrax, net enly in its bacillar but in its spert, ferre, might be truted te dèstrey the potency cf infections matter ge n ral ly. 114avi ng determined by a prelonged series cf exporimoents the degc cf heat te bo attaincd, arnd combinations with mois turc in which the heat wvas best oeora- tive, Dr. Parsons examined the phy- sical conditions for its production in the requircd combinations, and thon continucd bis resear-ches inte practical questions conccrning the mechanism. by which the needful conditions fer heat-disinfection could bo se ebtained. The genei'al. results cf the inquiry are as follovs :-It wvas shown te be necessary se to arrange an apl)aratus that hecat should penetrate bulkzy and non-conducting articles, and s0 that",
         "ISINFECTION BY IIENT. the lient c'ould bc used to dainty fabries ivitlîout injiiry te their appearance or to their texture. Dr. Parsons came te the conclusion that ail inifectcd articles wh ich coulId be treated by boi1i ng water, s0 as to penetrate the su bstance efficicut- ly by this means without injury to tho articles themnselves, could flot bo so *well disinlècted in an3' other way as by simple boiling for a fewv minutes; that infectcd articles w'biich fromn their nature did not ]end themselves to such. boiling hiad best be treated -%vith highi- pressurle steain, wvitLb suchi arrangement as w'ould insure complele penetration of the steamn at 11gbi tonerature, and that such treatmient n1igh,1t bo relied on to destroy any infective qualîty in them wvith the thoroughness and rapi- dity tbat were desired ; and tbat in the comparatively f*ý w cases where the articles te be disinfected w'ould be injured by steain, a dry lient of 240 F. wvould if suficiently prolonged, bring about the desired destruction of in fe c- tion, but that this could not, in the case of most articles, be bad by means of dry heat without an inconvenient length of exposure. Dr. Bucbanan, in commenting on the resu its obtain cd, expresses himself as of the opinion that, ' so far as we are att present informed, there, is no sort of disinfector, or disinfectant that can rankc by the side of heat; and of all methods of applying lieat, the use of high.pressure steam is by J'ar the most generally avai lable.' With the excepition of spore.bearing cultivations of the bacillus of anthrax, ail the infective materials reported on -%vere destreyed by an hiour's e.xposure to dry heat of 220 F., or five minutes' exposure te steam at 212 F. Spores of bacillus anthrax required for des- truction four hours' exposure te dry heat of 220 F., or one hour's exposure te dry heat of 245 F., but where destroyed by five minutes' exposuire te a boat of 212 F. in steam or boilingy water. It may therefore, be assumed that the centagia of the ordinary infectieus diseases of mankind are flot likely te witlîstand an exposure of an heur te dry beat of 220 F., or one of five minutes te boiling water or steam of 212 F. Dry lient penetrates very slowlIy inito bulky and badly conducting articles, as of* bedding anitd clothing ; the Urnle coinînonly allowed foi' the (lisinfection of such articles, being insufficient te aIlowv an adequite degree of hient te penetrate into thc interior. Steam penetrates far more 1'aPidly than dry becat, and its penetration may bc aided by employing it under pressure, the pressure bein 'g i'elaxed from, time, te time, se as te displace the cold air' in the. interstices ot' the material. In bot air the penetration oflheat is aided by the admixture of steam, se as te moisten the air', but bot moist air does net appear to have a greater destruc- tive efl'ect upon spores of anthrax bacilli thau dry heat. The question ivhietieî' articles can be submitted to thue required degree of heat wvithout injury î'equires to bc solved not meî'ely by Iaboratery experiment, but by practical expe. rien ce on a lar-ge scale; which involves techinical kçnowledge of'trade, processes, and is con-plicated by questions of pecuniary inteî'est. The principal modes in whicli injury may occur are these :-1. Scorcbing or partial decom. position of organic substances hy hieat. Iu its incipient stages this manifests itselt' by chianges of colour, changes of texture, and weaizcniti\u003c\" of tstrength. 2. Overdrying, renderi ng mateî'ials brittie. 3. Fixing of stains, se that they wvill not wasbi out. 4. M~elting of fusible substances, as wvax Und varnishi. 5. Alterations in coleur', gloss, \u0026c.. of dyed and finishied. goods. 6. Sluîinkagre and felting together of weollen mate- rials. 7. Wetting. Scorching begins te occur at diffe. rent temperatures -%vith différîent mua- teniaIs, whbite, wool being soonest affectcd. It occurs soonier in woollen materials, sucbi as flannel and blankets, than wvith cotton or linen; wvhile hoi'sehair will bear a higber tempera- turc stili;. in fact the pi'occss of curling it for stuffingr chairs is effected by exposing it to a temporature, of over 300 F. Most matenials wvill bear a temperature of 250 F\". withouit ranch injury, but when this temperature is much exceeded signs of dam age, soon begin te show. Flannel and blankets exposed te steam at 260 for hall ana",
         "DISINFEOTION BY REAT. 1l0111r acquiro, a dlistincet yellow, tinge, adtortextile strongth is somnewhat diminishied. Exposed to a dry hecat of 220 F. for four liours, or a stoamn heat of 228 for haif an bot, wvhite flannel acquired a slighit yellow tinge, but its * textile strengthi ivas not appreciably impaired. *Scorching iS ospecially apt to occur Nvhere the becat is in the radiarnt form. To avoid riisk of scorching the heat should flot bc allow'cd much to exceed 9 50 P.. and even this temperature is too highl for whito wvoollen articles. Linen articles, slbceting, body linon, \u0026c, vhichi have been in contact withi infection, shouild bc disinfected before eorning into the lauindry, sinco other- wise Ùlioy niay infect the washer- wvomen, and possibly the linon of other households. Snch objeets, hiowever, if j oiled wvitb bodily excr-eta cannot be disinfected by hoat, flot even by boil- ing water, witlout indelibly fixing the stains. The only alternatives, there- fore, are, to put up with damnage, to this extent, to allow tho articles to pass thr-oughl the earlier processes of the latndr-y in an undisinf'ected state, or to attempt their disinf'ection by chiemi- cal means, whichi are nncertain and -tnsatisfactory. WVhen the grosset' dirt libas been removed by soaing and ib. * bing in cold or teffid water, the articles May Uc boiled without injury, and are thon don btless effoctually dibinfected. Tho lirnits of' the field of practicat usofnlness of disinfection by hoat may bc ogthored fr-oni wvhat bas -on(, bof'ore. For wvashable articles which wvill stand boiling in water, no other procedurle is eocessary. The difficulty is that, ( -a tin tatlinon may bo disinfected flected state, to the wvash, it n'ay 5 c ommunicate infection to the washer- womecn and to the linon of other housebold s. The best plan is to place the linon on being left off, and before it is remnoved front the inflected precinets, to soakz in a pan of col -water, mhich my contain some chemnical disinfectant, thougli it is doubtful if' much additional sccurity bo \u003c_aincd theroby, unless the solution bc a' xery strong one, in wliich case it may cause injury to the clothing. After the erosser impurities have boen remnovod by this preliminary rinsing, tho clotes may bc boiled without damnage, and (wvith care to avoid t'e- infection) may bo considoed fice front infection and sent away if necessary, to undorgo any further procosses of the laun(lry wbicb may bo required. The articles for which a more toehnical 1 disinfection by 7ieat \" is. ospecially requircd are such as will flot boar wvashing i n boiling water. The mnost common articles of titis sort are blaukets, rugs, carpots, and cloth clothes generally, pillows, bods and inattresses, furs, and droesses. Articles of furnituro, with stnffed soats and backs, as chtairs and sofas, may require disinfoction by beat if they have boon in an infeed room, and isuch articles are often so exposed to heat in order to chock the ravages of motUs. Again, exposure to bocat is often employed in -%vorkhouses and si milai' estaýbli-shm ents to destroy lice in clothing, or tho animai ,ind vegotable parasites ivbich cause, certain skin diseases It may bo nocessary to insist on the disinfection of rags coming frorn places where epidemie diseases prevail, and in suchi cases heat, especcilly in the form. of stoam, affords the most satisfactory means. Letters sent by patients suffering frorn infections diseases, or cominn' f'om. countries in which epide- mies I)Ievailo\u003cl, might readily be disinfected by heat, provided that thoy woro tiot fastenod wvith. sealing-wax, B3ooks whicb Lave boon usod by the qickz or convalescents may bc disin- fected by heat, but the effeet of steam- on loather bindings must bo remem- beî'ed. In somo hospitals the perio- dical heating of pillows and mattresses is pî'actised as a part of the ordinary routine of antiseptie practice, For srne, of these purposes dry beat and steam. are both applicable, provided that in the case of steant precautions are taken to avoid undue, wetti ng. Steam. possesses the advantage over dry heat of requiring far' less time and a lover temperature foi' penetration into bulky objeets, and for destroying contagia: it is on theo grounds os1)0 cifflly adaipted foi' tUe p)urification of beddin,g, bales of rags, large bundles of clotliing, and other. objects difficult of penetration, On the other hand, it",
         "98 PIIYSICAL APPBKAANCES 0F SOUJND AND UKSOUND FOOD. instantly destroys icather articles, se that these mnust bc dfisinfeeted, if noces- sary, by carefai exp)ositre te dry lienit: Theiî cliaracters of a good disinfection chamber are given as fbliovs :-Tlîc unifoin dlistribution of lient iii ail parts of' the cham ber. The constancy ivith whiciî the hient is maitained t any required (icgrc. A trustworthy index to the actuail temperature of flic initerier lit the ime bein.c' TRE P1IYSICAL APPEARAINCE OF SOUND AN)UNSOIJN. .FOOD. ii- attemiptingc to descri be the physical. t siens1 by -%hlicli un1wholesonie food initended for Iumn consainiption may be doected, it will be convenicut to consider tlio ex.amination of tle articles the Public 1batiLl At [nearly13: uniform ail over tlue Arnerica-n continent] cmn- powers sanitary officers 10 examine an1seize under fiveleang, s follows : 1. Animais, carcases, and butchcer's mcat. 2. Poiîltry,goarnu and fish. 3. Fruit and veetables. 4. Corn, brend and flour. 5. Milkz. This arrange ment ineludes ail the foods namcid' in the ,tattute exccp)t fiesli,' which appears 10 bc a super- flaious wvord. It is prol)oscd to dccl %vithi thuse thec gru) of foods by first dcscr-ibing the al)peîanîe.s ea(li food shoîîld prIeseIiL whien sound andl whoiesoi-e, and then the physical signs indicative in the e:-isc of, eaeh of disease or- decompos- itition. The sinîplest language will bc iused niedicai and s cic.nitic tori-ms being11 avoided as far as possible. GOOD 3IEAT is firm and elastie to flic toueh), moist but not met, and exccpt in the caso of pork, veal, and lamb, brighit red in colour. It lias also, if wcil.fedi, a somewhiat nirbled appear- ance froni snizill lIawcrs of' fat in the muscles. It has a freshi, not disa- grlle.abie sel.(To test this, an iron or wocden skcewcr shoaild bc trusiýt inito tie centre and u'apidly Nwithidrawvn and srnel t.) '!'lie meat-juice shouid slig11htiy reciden litmus parier, sliowingr tiiat iL is faintly acid. The fat should con tain no wate-y.juicc or jeliy, and shouid bc irc froi blood stains ; the sut flit shouild be bard and wvhitc. In sait meat the bri ne shoid not bc soin-. A sotund, heaithy carcase shoild bu wclI.set as soon as it is thoroughly cool; it shouid also be wvell bled, ne palrt of iL boing pur-pie, browvn or sp)cclzied. One side or quarter shouid not bu dorkcr than the l'est. It slîouid not bc hruised, nor bile-stained, and not markediy attenuated. The muscle on bcing pressed. vitlh the fingers should flot ' pit,' as tItis. wouid indicate the presence of water, and shouid flot 'cale'as this -would indicmate, the presence of' air. In places wlicrc, carcases arc ias- pccted tIme oIYal also (that is the hcad, fecet, bide, and ail the internmii parts cxcept lihe kidneys) shotild be sub- niitted for inspection. 'fio rnouth and Longue shiouid be froce froin blisters andl biotches, thic hoofs sbould bc tirmly attaicled to tlie f ct, the Iide SlmOtId lic fVCee from SON~S aMd. pîmptes. The lunes shoald bc of a brighllt pink coiour anmd spongy, from cavities, pus (maLter) or wormis. A portion caL off slîould fluat in wvater. Thue, heart should. bc froc fromi biic-stainingr and biotcîies. Tlîc liver shoid bc of a ricli brown colour, siîouid flot break. down casiiy under pressure, shouid be fice frein abs:cesses (collections of matter) and from flukecs. The spleen or meit should bc of a dark colour inside, grey on the oaitside, thin ,and long, and sharp at the edgres. Tfhe stomachs should net be inflarned, the lining ,;Iotiîd not rcadily rab off, and siîouid net -smell of drugs. The boivci.- should hiave as mooth, unia- flanied. Iining, and shoiîid bc froc fromn blotehes or u1cers (ufc oe) MEAT IJNrIT POR FOOD.-In examni- ningr meat it bliouid bc borne in mind that there arc tlîrec conditions owving, towvii iL may bc unfit for food, viz.: 1. It mnay bc partialiy decomposeci tiiîongli iiaving' been kzept too long. 2. It nay bc d-'rived fr-om an animai wvhiuh lias, died a naturai death,,or only beema blaîîglitered wvhen in a dying state. 3. It may be derived from au",
         "PHYSICAL APPEAIIANCES OF SOUND AND UNSOUND FOOD. animal affected wvithi a disease, cither communicable or iii some, other way injuriOus to man, or from a poisoned animal. T. Partial decompition is showvn mainly by the choaacterictie sinell. The meat, too,. loses its elasticity, is soft, and tears readily. On cutting, tho resistance offered to, the kunife va- ries, some parts being softer' than others. The cut surface often sweils from a kind of fermentation or heating.' The out.side is pale and livid, at a lator stage greenish. Litmus p aper is not reddened, but remains neutral, or indicates the juices are aikzaline. 2. MIent from ainimais which have not been killed or only killed wvhcn moribund, is darlc in colour, often * purpie. The meat sets badly, is full of blood, neutral or alkaline, and readily decomposes. The flaying and dressing of such animais is usually done under unfavourable, eircumstances, and oftcn by no expert hands, so that the carcase looki hacked and blood-stained and untidy. * 3. Meat from animais aflècted with discease and thus injurious to man.- The detection and seizing of such mont is one of the most trying duties of sanitary officers. Petermi ning whe- ther meat is sotund or decomposing, or wvhether it is well-bled or lias the blood lu it, are comparatively simple matters, and not beyond the intelligence of mostliouse,,wives; but judgi ng xvhether meati 18 fromn a diseased animal, the nature ofthe disease, and whether it affords warrant for the seizing of the meat wilt tax the officer's capaeity to, the fuil. There are three things lio should do to prepare himself for- this work:-first, ho must acquire the necessary knowledge; next, hc must train himself to observe closely; and thirdly ho must cultivate the judicial faculty so as to be able to interpret rightly what hie sees. Good poultry should bc firm, to the toucli, pik or yellowish in colour, should be fairly plunip, and a strong skin. It has a fresh, net disa.greeable smell. Stale poultry loses its firmniess, becomes bisih ia colour, green over the.* ci-op and abdomen, the )skin readily breaks, and the bird hias a disagreeable oclour, not at ail difficuit to recognize. The fresines of fish. is indicatod by its being firm and stiff. In realiy prime condlition, if lîeld out in a horizontal position by the hand, it ivili romain rigid. Any drooping of the tail shows that it is not quite fresh, and, indeed, the extent of this drooping may not unfairly bo taken as a measu re of want of fresliness in the fish. The fisli usually hawkzed about the streets is wvhat the shops have faiied to soul, and muchi of it is very limp. Ilcwever, before and officet' is justified in seizing fish, itr tb tge b eyond being merely unfresh. If the tish besides beingr limp 18 acetually softened in parts, and if it bas a distinctly disigcreeable odour, there is sufficient: evidence of commencing decomposition to, warrant seizure. lealtby pilchards and herrings, and many other fishes, and mussels and oysters, even when in season, may occasionally, on being caten, produce symptoms of poisoning. Attempts to isolate the poison in such cases have failed and it is tlîought the fish may themselves have been feeding on unwholesome, food. There is cer- tainly nothing to distiuguish such fishi f'rom. others. At times -when the salinon diseuse is prevaleut, it is not unlikzely that lishi affected with the disease might be sent to the market. The disease is due to a parasite, the visible signs of its being a fungus growth, especially about the head, whieh, 80 to speak, eats its way into the sound flesia. A sanitary officer would be warr-anted in seizing a Ilsh thus affected. Fruit may be the subject of diseasýe, or in a state of decay, or it may be Ho unripe (especially in the case of early wvindfa apIcs) as to justify seizure. Piseased or decaying fruit is known by softening, change of colour, and external mould. Fruit may be bird- bitten or inseet-bitten and none the worse, except that it is disfigured. Potatoos and ahl fresh vegetables may also be the subject of diseuse or decay; and either softening or disco- loration, or both, wvill mark the parts affected. Good potatoes are firm, the colour is pale and uniform, and the juicO i8 acid. Inforior potatoos ara best known by their lightnetis: thus n",
         "100 rrTHE INOIREASE 0P NERVOUS DISE ASBS potato, with al specifie gravity of Iess than 1068, niay be regarded as bad. Dry peas on kçcping becoine pale, Shriveiled, and liard; but they kepl better thus than as ineal, whichi is very liable to becorne mou1le.. Whiole or in meat peas are s~usceptible te the attacks of* insects. The accarus, a bort of itch inseet, may be wvel1 defined with a pocket Ions. There 15 good grounid for believing that ail tinned fruits and Vegetables, and alse meat, poultry, and tish, are more or less contaminated with tin, the amount present being from one- tent.h of a grain to about 1* grains per pound, and, according te some esti- mates, mach more. Fortunatcly, the moUdl is flot knowvn to bc poisonous, except in lai-ge doses. Green peas and French beans, and soine other pre- served green vegetables. and pickles. rfrcquently deliberately ýadulterated with copper, and this metal is undoub- tedly injurions te the nealth of the consuner. Tfhe presence of' copper cari be detected by leavingr the blade of' a penkznife in 11he liquor round the vegetnbles for a short time. Th)e COl))pC wvill dep)osît itsclf on the blade. -FRANCIS VACIIER, MED. IIEALTH OFFICE 0F BIRKENHEAD, in the Sa7fltary -Record, London, E. TRE IN-\\CREASE 0F NERVOTJS DISEASES. The peril of the race firom flic increase of the neuropathie diathesis should set us ail to thinkin, and those who have the autbority of acting in the direction of self-preservation and indircctly of the ultimate life ef the nation. The multiplication of hospitais for the insane and inebriftte asylums anid of schools for the feeble-minded, and irnioed methods of* treating nervous diseases and of homecs for impýoVerishcd neuropaths of evcry grade, from the hospital for nerveus disýea«ses propoi. to the ainîshouse where many of tliese wrecks are lodged, dees not cure the cvii, though they serve te hide it sornewhat from public sighit. We best provide ugainst the spread of smallpox by ýgeneral vaccination, neot by iiurer- eus pest bouses, se by general preven- tive sanitatien can we avert the tbreatening spi'ead of the now preva- lent and growing disease of the nervous system. The neurepathiecdiathesis, thie insane constitutien that breeds its likze and burdens the state wvith hereditary imbeciiity, idiecy, insanity, deaf- mut.ism, aind flie lesser degriers of mental defect, m)ust bo inade the subjePt -of statutory enactment and enforced Iaw ; sentimentality miust yeild te flact; the teachings of* nature niust be as decidcd and as sternly enforced as lier own unerring edicts are. XVly should the drunkard and epileptic be permitted te beget a race of'imbeciles. epileptics, idiots or crimi- nis? Why should the life-leng criminal and the pauper be allewed te go en reproducing hiis defective kind, thxe lunatic lilzewise, and ail the mon- tally maimed of whatever degrce, especially wviîen by ferfléiture of liberty they ll under proper custody of the Iaw; and wlîy should generatien after gencratien of these mniserables be allowed te bc broughit into bcing te become citlier bardons upon the state or victims of its misdirected vengeance, %vlien prevention is possible, and better fer the state, and enly justice te the helpless and prenaturely doomed te an unchesen existence Nvorse thar. deathi? If municipalities may lawfully quarantine yellow foyer and choiera, why may net, and why ought net, this greater destructive agcncy tliat plague or pestilence, which nover ceases its ravages-lic reditary descent oî the organically vicieus and defective-be stopped by Iaw? No pestilence, that eý-er ivalked in darkness or destruction tlîat bias wasted at neonday has donc creater harm te mankcind than the talent, over active destructive power of hereditary degeneracy of brain aixd mind. Instead ef visiting punishment on the hieads of these Nveakened victims of entailed disease, let law go te the fons et origo, and stop this vicieus progeny from being -thrown upon et 100",
         "HEALTU IN MICHIGAN- INTERESTINGI FAOTS. 11 wvorld in which they are unfitted to live. More than a century ago Cabannis raid: IlAs the liver seeretes bile and the stomacli gîastric juice, so the braiii ec ntes ingt,\" a proposition exact woknbasis for banitary legisiation Ifor. thoughfl though,,It an d mid are pro0- b -bly somethingr more than secretion of the brain, mind is dependent for its every normal moveient upon the intcrity of thie bi'ain, and wvrong and -the human brain grots out of' order. flr as practicable, we transmnit to our descendan ts heal thy brai ns andvi gorous nervous ýystems, and to this end J personal endeavor and municipal legis- lation should be invoked. À. true ci vilization shonld show development and not degeneracy of brain power, and the proudest monument te Our~ 'visdom we in-iight eret wvould be one of' neurotie regeneracy, a richer Iegacy to the coma 1 generations titan rail- rons o tecgrj)lsphonographs or telephiones, cectrie lights, or auniai navigcation successftlly accomplished, fir wvithoit neurotie regreneracy theso blessingrs wviI1 prove cuses and pr- mYoter., of still further neuropathic deüay, and final extinction of' mind. To injoy tcepowcr of the nervous system and mmnd should be increased, not diminislied; yet in them, and the press, injudiciotusly used, are the seeds and elements of destruction.-C. IL HUGHES, M. D). in Alienist Yeurologist. EIEALTH IN MICH1GA1N-INTERESTING FACTS. of Rpot te the Michiigan state board hf ealth indîcate that, in the month of September, 1885, compared Nvith the preceeding, month, influnza, typho malarial fever., bronchitis and neural- gia increased, and that choiera morbus, choiera infantum, an d diarrhoea de- * creased in pî'evalance. Compared with the average foi, the mnonth of September in the seven years, 18'W- 1t 18$5, intermittent foyer, remittent, fibver-, dysentory, typho*m alarial forer, choiera infatum, choiera moi-bus, diar- rhoŽa, consumption of lungs, and typhoid feoer were loss prevalent in September, 1885. Foir thc monthi of Soptember, 1885, compared -%vith the averagoCr of' cmrsodnrronths for the seven years, 1879-1885, the tempera- ture 'vas lower, the absoluto humidity Ej and the day ozone wvere about the i;ame, and the relative humidity and the nigit ozone wvere more. lncluid- ing reports by regular observers and others, diphtheria wvas reported in M\\ichigan in the month of Soptember, 1F85, nt 56 places, scarlet foyer at 42 places and typhoid fovri at 49 places. For thie month o? October, 1885, compared wvith the preceeding month, the reports indicate that diphitheria increased, and that diarrhSoa, choiera morbus, dysentery, ai choiera infail- tuni decreased in prevalence. Com- paî'ed with the average for the month o? Octoberi'n the seven years, 1879-85, rermi ttent fevet', typho-malarial fée r, diziirioea, consumption of lungs, typhoid feveî', bi'onchitis, dysentery, anýd choiera mnorbus were less prevalent in October, 1885. For the month of October 1885, compared wvith the avrae of conî'esponding months for the sevon yeaî's, 1879-85, the tempera- lui-e Wn-s lowvei' the absolute humidity 'vas less, the relative humnidity was muchi iore, and the day and the night ozone wovre less. Including reports by regrular observers and others, dipli- tiieria iras reported in Michigean, in the month of October, 1885, 59 places. Scarlet forer at 41 places, and typhoid ferver nt 36 places. For the month of Kovember, 1885, compaî'ed îrith the precedling months, the reports indicate that bronchitis, tonsilitis, neuralgia, rheumatism and pn cumonia i ncreased, and intermittent fever deereased in prevalence. Com- pared -,ith thie average for the month of Novem ber in the seven years, 1879- 1885, intermittent I*e;er, diphtheria, remittent forer, typho-nialarial fever, pnieumnonia, consumIption o? lungs, and 101",
         "102 SANITATION IN ST. LOUIS-LESSONS TO B3E LEAIRNED. broncluitis werc less prevalent; ir, No'vember, 1885. For the înonth of November, 1885, compared witli thc average of corresponding months for the seven years, 1879-1885, the tempe- rature and the absolute humidity were about the saniethe relative lîunidity wvas lcss, and the day and the night ozone wero more. lncluding reports by regular observears and otheî's diph- theria was reported in M1ichigan in the mnonth of Novcmber, 1885, nt \u003c33 places, scarlet foyer nt 3D places and typhoid foyer at 34 places.-IL B. BAKER, M. D. SANITATION IN ST. LOUIS-LESSONS TO BE L1EARNED. rma, notice in the Sanitary Record FLof a worlz consisting of a ui e of short articles, prepared fox- the St. Louis meeting of tlic American Public Health. Association, by City officiais and local sanitarians, the foilowing is gathered. The nican temperature of that city for the year is M.o. 4, and on the average there are in the summer twenty-three days when the maximum (in the shade apparently) rises te or above 900, between six and seven days -%vhcn it riscs te or above 95o, and one day when it rises to or above 1O0o. Generally there is but a slight niortal- ity from solar lieat, for the reason that the average d aily humidity of the air is very lowv. The Board of Ilealth of Si.. Louis Consists of the M1ayor (Who is its presîding officer), president of the council,\u003e one commissioner of police (designated by the Mayor), twvo regular practising physicians (appointed by thc Mayor), and the health commis- sioner. The board is investcd with judicial powers; in deteirmining( w.-bat constitutes a nuisance detrimental te, the public health, and on this question their action is final. A complete systein of drains for the removal of waste and surface waters was cern- menced in 1849, se that St. Louis mnay claim te have been ene of the fir.st towns te have attacked this subjeet in any serieus systematie way. The public scwers are dcsigned te carry off a iainfali equal te ene inch per heur frem the wlîole ai-ca draincd, and the :final outiet of the system is the Missis- sippi River. It bas- been estimýated tha't flic provision of proper drainage and an ample water supply, togrether -with other minor sanitary limprove- nients, have reduccd the mertality tÉem 34 te 19,80 per 1,000. The publie water supply is reccive1 from the ri-ce- iii an inlet tower l)laced in deep water, about two hundred feet from the above liue, and is pumped te reservoirs, in tvhich it is allowned to settle, and, after settlement, is agrain pumped into the clistri bution pipes and storage reser-voir. Varions fornis of sti-cet paving have been tried in St. Louis. Wood pave- ments gencrally have proved expensive and uusatisfactory, and flic City authorities purposeý to pave ail streets of hicavy traffle -with granite blocks laid on concrete; and te pave with. asphalte such streets of lighiter traffle in the î-csidence part of the city as will bear tlic exp-Iense of it, leaving the outlying streets to be paved withi limestone.)Macadam laid upon a Telford b a -se. Investigation into the relative moi- tality in différent parts of the town shows that fic niortality in those parts of the town at present unpî-ovidcdwith drainagee and watcr supply is very largely in excess of thuat te be found in districts in which the provision is complete, and demonstrates bcyond question the utility of a perfect drain- age and wvater supply in lewe:-ing tho mertality of large cities. In a historýy of the numerous outbrealis of choIera from which. the tewn has suffered, a careful investigation of the subject leads te flic conclusion that those parts of the eity 'where t.ho people and thii- habitations veî-e cdean, and wvhere ne wells 'vere used foi- drinkcing, vater escaped almost entirely, ai. the whole force of the epidemiù 'vas spent upon those parts where the hiouses and the people wvere unelean and wvell water -%vas in most frequent uise.TH DOR",
         "THlE MOiNPREAL SMALL POX EPIDEMIC-REPORT 0F TRE INVE S- eTIGATING SIJB.COMiM1TTEE-HOlW THEU DISEASE~ SPBEAD. The sub committee of the B3oard o? ilecalth, Messrs. A. Lévêque and llughi Graham, appointcd te investigate the cause of te epidemic o? smallpox hast year, and suggest precauti ens aa s a future visitation, presented its report at the session o? the Board on the 9thi January, inst. Extracts arc given from the registers 0f the Fabrique of' Notre Dame, and the Mount Royal Ccmetery, uvhich show that there were ne deaths from, smýallpox betweea the lst o? Sanuary and lst o? April of last year. The deaths from smallpox in. the course of'this year, untîl the 5tlh of December, ivhen the epidemie seems te have been stýayed 3059. Dr. IRogers, wvho it ,výas said had a considerable practice in the city, stated that hie believed De Cases Of smttllpox had occurred in Montreal for several years pNviouis. Hl. Iaengley, Pullman car enductor on the G. T. R. w-as admitted te thie 11-botel Dieu about midnight on the 2Sth o? Februiury, at the request o? a physi- cian of thie hiospital. Re was imnue- diatcly placed in aI private room, in which wvere two heds. Thiere was already a patientrin the room. The hospital Nvas full, and had bcen se ail the Winter. Longle 'y hadl only a fewv pustules on1 his face and bands. Re said hoe had takeon the fever on the cars, or in Chicago about the lSth of February. A few days zifter the departure of Mr'. Longley, on 'iarch 21, a servant of' the Hlotcl * Dieu, Pélagie Robichazud, feil il] -%ith smallpox. Sho ivas isolatcd in a small moom, et? the corridor Ieading te the inertuary chapel, and tuvo nurses were given ber. This servant had ne intercourse -with M1r. Longley, but sbe -%vas extremecly afraid of thie smallpox. Sue may have coritracted it throucgli holding communication -%vith the servant that wvaited upon flue smallp\u003ex patient, a thinu that wve could flot preven t. Slue died on the first ef April. Her body ,vas immedintely carried te a building outside o? the hospital and put into a \u00261uble coffin. Iber room waq carefully disinfected. The nurses, after bathing and cornpletely changing thieir clothes, -'Nere alovdto return te their appartments. On April 3rd, a Sister of Pelagrie seemed to bc somewhat out of sorts. On tlue Gth a violent fever brokçe out and oïl the ~Ith hoemlorrhagic smallpox was diagnosed. The board ofliealth being informed of the fact and pressed to open its hospital the patient wvas carried thithier on the same day. Dr. Larocque tookz a great de.Al of trouble in getting fihis hospital ready, and succeeded in getting nearly ail the staff hie required, amengst the convales- cents at the Hotel Dieu. The next day, two casses of smallpox were discovered in the wards of the -Hotel iDieu and in the saine îvay transported te the Civie Hospital. On April lOth there were two other cases. The doubtful cases -vere then isolated. The isolation did not rakoe place earlier, because ef the crowvding of the sick in the hospitaI wv:rds. This delay lasted from, April 8th te April 111ih. Prom flue Sth Aprit to the lsthi, there wvere 16 cases of smallpox transporicd from. the 1{otel Dieu te the Civie Hlospital. On April l4th, the Medical Facuilty of the Ilotel Dieu proposecd te the Superior to dis mniss ail the patients Who seemed, to have no syimpltonis of the contagion and who could go home. The Sliperi- oress consented; there seemcd to be ne other mc:îns of assuring, a thorougrh disinfection atnd a comnplote cleansing of the In~.T the Ilotel Dieu, quarantine wvas iMp0ýsible. On April lSth, the epidcmic hiad ceased in the Boel Dieu. The wvards and other d ep«i rtrn n t s %vere carefully subjectcd te diz.infection for a fortnight. Noth- i n- g as neglected in the way of cleaning and washing of the depart- nien1t, and lineti, the disinfectants cm.- ployed ,%,ere the fumiga.tions of suiphur, carbolic acid, chioride- of lime, camphor and suiphate, of iîoii. A portion of tlic efl'ects o? thi srnallp)ox patients were burnt, the rest t.was carefully disin- feced. The wards were reopened on May lOth.h",
         "\" 04TE MONTREAL SiUALL POX EPIDEMIC.* As the sub-comrnittee states, if there had been a house at the disposaI of the Ilealth B3oard toi quarantine these pýatients before illowing them lo circulate in the City and elsewhere, it would have been a -%vise preeaution, and thcy further add, - tvhiatever- precautions xnay be tal\u003cen 10 prevent the recurrenCe of a, calamity such as recently visited lis, WC must not lose sighit ofthe fact thaï: it will always bo dificult to prevent, Cases of Cortion siekness from getting into the eity; an accident can aIlvays happen iu spite of the surveillance of Ille authorities and tlic vigilance of the doctors theru- selves. To avoid as much as possible the repetition of an epidemie, thiere 18 but one sure and practi*aI means to be adopted ; it is the establishment and maintenance by the City itself, with the lezast possible delay, of a permanent hospital fbr contagious diseases. This hospi-tal should always be open, and should be provided wvith a, staff whose menmbers should vary according in circumistances. If the doors of St. 1Roch's, insufficient as it wahad been open to rec-eive the patient Longley, his doctor w'ould not have beeiî under the neeessity ofideïnanding admnittance at the Mýontreal General Hiospital, Ilien at the i-lotel Dieu, anid a grezit publie m isfortuue would proba bly have l\"een avoidec\u003c. We Nvould further recommend the imposition of' an cxamplary penalty on any transport ation jompa«,ny intro- duceing withi 'n the c it imiits or landing on the vhrein front of the city and territory, any case of Contagions dIiselse, Nwit bout hn--ving, iii the iirst plac, obtasiiied perîinisiioti 10 that effect froni the Medical Hlealth Oficer of thc cily. And to avoid any surprise in thc future, the 1lediCal l-lealtlî Oflicer shouild. keep himself posted as ho the sanitary staile of Ille several ci tici of' Northî A meri val situaicd on tlue rai lroad linos communi- cating witlî Montrel, as aho on the Stearoboat lines. Thie clîairmn of tbe board cf bealth, âMr. 1-1f. R. Gray, reports an ouitbieakç, Nvhieb occurred about dIe saine time as fol1lows: 1-1. Shattuck, Puliman car conductor, loft Montreal q.uite iveli on February 7thi and arrived nt Chicago on tho lOth. On the 9th, ho liad a lady on boar'd going to (Jhieagco, wbo, it wvas discovered, had a mild form, of smallpox, and tookc suppor in the dining car wi th others before kznoîving the nature of the disease. Hoe loft; Chicago on February l9th, feit very ill on the 2Oth, and came to Montreai ho his own home on February 25th. The rash aýppezired out well on thie 27tl. lus residence 3vas on Mayor streCet,w~here hewxas attended by Dr. Molson who promptly reported the case to the Medica,,l Health Officer, and it wvas immediately isolated, a sanitairy policeman being detailed for this purpose. Dr. Molson wvas most assidu- ous, and, on his demand, the llealth Department supplied a nur-se and -%vash- erwoman and disfectants. The faxnily being very respectable and -intelligent atssisted Dr». LIarocque, the Medical 1IeaIth Officet', ho the best of their ab*lity. Unfortunately, two young ladies left the bouse as soion as the nature of the disease ivas noticed and before it wvas quarantincd. One of these wentto St. Andrewvs and small- i)ox developed shortly after her arriva]. Luckily, site fell into initelligent hands, and w'as securely isolated and con- valesced without spreading the dit3case. The other- yourig lady also feli sick in a bouse on' St. Catherine street west, but, by the watchfulnes of Dr. Molson, ,%as immediately removed bakto thec infected house on Mayor street. and the De partment, under the direction of' Dr Uaiocqine, at once disinfected the preinises freon which she wvas removed. The cases iu the Mayor street bouse ail shortly got wvell withont a death occarri'ng, and the house wvas cleatied a b'~ine.d and not a single case in the city outside resnlted from it. There is no doubt if a permanent civic smallpox hospital hatd been in rcadiness to receive the patients, the case of SWattuckc as well as that of Longley would have been placed there on arrivaI, and thus the outbreaki in the lotel Dieu would have been avoided. J. A. U1. B. 104",
         "NOTES ON TRE OUTBREAKS 0F? SNIALL POX IN OTTAWA. On the 6th of April last I 'vas made aware of tho existanco in this city of two cases of tima11pox: one being a, littie girl of about seven year.i, in wvhomi tho diseaso in its confluent form wvab fally devoloped ; the othor a young man of about 26 years, the eruption in this case just making its aprearance. The house wvheve these occured, a privato boarding bouse, was ait this timo oceupied by Il aduits and 3 ch- dron-14 inmates in ail, ont of which one haif bore good marks of previous vaccination whilst the soven others, among wvhom were the three children, had nover been vaccinatod. Out of the seven protected by vaccination not one vwas effected by théo disease, whilst five out of the sevon unprotected wvere infeeted during the weck preceeding the 6th of April and developed the disease aiter peri ods of i neubation vary. iug f'roma a week to thirteen days; and two acquired immunit 'y by vaccination immediately aftor the removal of the two flrst cases. 0f these five wvho contracted the disease, two wvere chul- dron and three adulte. The children wero the lîttie girl mentioned abovo and ber littie brother of about five years who thougli vaccinated on the Gth of April dcveloped tho disease in a modified formn. The three aduits were cases of the most fatal type of hSmorr- liagie variola and two died. The third case baroly escaped wvith lifo; tho deeply scarred marks of the disease he wvill carry ail the days of bis life. Isol- ating each case propcrly and otherwise taking ineccssary precautions to, pre- vent the sprlead of infection, the disease wvas always under control, and itbin five weekzs it wvas comp)letely eradicatcd. Betweeîi Septem ber and the latter end of the ycar, .1885, 1 have hiad under any care ln hospitals for con- tagiotts diseases 27 cases of smallp)ox and one case, an aduit feniale, isolatcd at domicil, who lIad neyer been va(!- cinat, J; case fatal within 12 days. 0f thoso trcated in hospital, 15 were French speakzing, 9 1Englisin Und 3 Italians; 6 wvero under 5 ycars of age, 3 botween 5 and 10, 3 between 10 ancd 15, and 15 above that age. Out of the 27 cases, 12 had been vaccinated and 15 unvaccinated. 0f the -vacciîîated) 2 died and 10 recovered; of thé unvaccinated 9 died and 6 recovored. 0f the fatal cases, 6 were under 10 years of age, and 5 were aduits. Ail these cases were iso!ated inimediately after tho first appearance of the eruiption or shortly afterwards, except la 2 cases, one of 'vhichi was wvilfutIy hidden and the other not knoxvn until pustules more fully matured; fumigations with sulphur fumes wvero rcsortedà to, and the linon to ho wvashed wvas soakcd in desin- fect.ants before being wvashed by ordinary procescz. Only in 3 instances did there develope a second case in the saine house aftcr isolation of the flrst in ho\u003elpital;i whilst £rom the cases isolated at doinicil and wvho, died, 3 cases originated b ler infant child, unvaccinated, îvho died; lier sister who staid with her as nur-se, previously vaccinated, who developed tho diseaso in a mild forîn; and this woman's child, unvaccinated, wvho also died. These last threc, are includod in the list of the 27 troated. A. ROBILLARD, M. D., M. 11. O. F00OD APULTERATION-ITS PREVALENGE-HOW TO OIIECK IT. Tn the December number we gave some notes from, the last report on the adulteration of food by the Com- missioner of Inland Revenue, which 'vo propose to continue from, time to, time. -The work nowv bcbg( donc througrh tho deparimnent of the Coin- missioner cannot £'ail, especially if aided by the, press and the public, to check ,thc growing cvii of food adu-ltor- ation. It is indeed strange, in view of' the report plainly showving what tho publie are buying, and consumaing and how tho 'y are being deceived and Swindled, that editors gencrally do not more ifreely discuss this subjeet and assist in cxposing the sale of fraudulent, health dostroying articles of our coramon daily food. In some cases probably the small trader is not avare",
         "106 FOOD ADULTEIRATION. of the extent of the fraud hlie e oin- xnitting upon customiers, but it must be plain to him, from the price qt ,vhich many foods are sold, that they arc net pure. In many intstancei, it is truc, on the eue haud, that the articles are flot esold by the trader. as pure foods; and on the other, pur-chasers of ton know that they are purchasing and cousuming an adulteration. Many do not know the evils which may follow the Utse, ofertain 'adkulteraticnis in foodts, and otiiers who one would suppose must kaow much on this point beeni indifferent, and wiIl purchase aud have consumed in their family an impure article, because they can purchabe it for a few cents less perl pound. They ought to know that to do this is falýse economy as regards getting value, te, bay nothing of injury whichi may resuit tu the health frein censumption of an impure food. Indced there aile doubt- lcss those who wvould pur-chase ail adulterated food at a low price for themselves and their families, w'hile if purchasing food for their herses they wvould be much more particular. Se that in endeavoring te chcck and sup- press the, cvii of food adulteration, there are two distinct obstacles te, overcome, on one hand the greed and craft of the fraudulent adulterating trader and on the othet' the ignoranc.e and apathy of' consumers. Whilc the former must be expesed and puinished, the latter mubt be educated up to a knowledge of the importance of consuming only pure fods, and arou:,cd up te the desirability of acting upon such knowledge. FRADULENT S1?1E-DEALERS IN THEM. Iu Toronto, of the six specimens of \"ci nuamer1\" purchased from A. Il. Carter, 'W. Potter, S. Greenfield, R1. S. King, Mills Bros., and Eastern ton Ilouse, and analyzed by the public analyst, those from the five fillst named consisted of Ilpure Casa\"no cinna- mon at ail, it appears, and that. from the last named, of Il cassia and pea!s.\" Cassia, ail Our reaàders may net '1now is the barki of a tropical, ever-green shi'ub (Laurus ca.ssia), the aroma ef which somewhat resembles that of cinnamon, yielding a pungent, stiinu. lating oil. Lt is uscd as a flavoring in medicines, and beiug muchi more plentifuil than cýinnamon it is muchi lcss expensive. It is probablynot injurious te health. and those wvlo receive it ius3tead cf cinnamon arle only defrauded in peeket. 0f seven 8pecimeons et' ginger- exam- amined by the saine analyst in Toronte, purchased from B. S. King, IL. Kelly, G. Long, S. Greenfleld, E. Thompson, W. G. Boulton and G. B. Toole \u0026 Co., that, frein the first named wtus \",unadul- terated \" and from the last namied it Wva8 Ilmixed with a small quautity of ground rice,\" while the othér five were adulterated xvith fleur and turmerie, three te the extent of 25 p. c. and twe te, the exteut of 30 p. c. 0f feurteen specirnens of creari of tartar examined there, six only wverc pure, and one wvas feund te be baking pewver. The seven ethers, from R. Djunmore, M. A. Car- rick, M. B. Dunu, D. Kilicu, J. Pater- SOn), J. George, J. Foley, Il. Mathiews, E. Manning and J. MicCleary, wvere ail adulterated with from. 25 to 75 p. c., ef gypsum or gypsum and cern starch. Gypsum ie a bulphate ef li me-,' plaster of' Par.is,\" and is a highly injurious substance te takze inte the stomach. Iu London, of four speciniens ef \"ccinnamon,\" 'obtained from D0. Dodd \u0026 Ce., J. C. Trebilcock, H. A. Duggan and C. A. Cenover, and examined by the public analyst there, aIl were either bimple cas,,sia, er cassia, with farinaceous adulterauts. No cinuamon whatever. The four speci mens ofinger examined in that City were good. 0f ton speci. mens of creain ef tartar examined there, only one was pure. The fine other peies were quite as large1y adkeaed as those iu Toronto, and in a bimilar way, They were purchased from Johin Moule, Thos. 0'Oallizhan, Jus. Southeotte, Som- merville and O'Connor, Johin Shaw, Elliott Bres., W. fI. Brandon, Deacou Bros. and Wm. Moore \u0026 Ce. Iu Mentreal and thoe astern cities there would appear te, be no cinu-amon, only adulterated cassia, very little pure ginger, mustard or creain ef tartar, and some foui adulterants wcre used. We propose giving morle details in a futqre number. b TIrE .11DITOR. 106",
         "TIIIRTEENTII ANNUAL MEETING 0F THÉl AMERICAN PUBLIC JIBALTU ASSOCIATION. rpemedical wisdom of many of the ' most important cities in the United States wvas repi'esented at the meeting hast montli at Willard's ilall, in Wlî'Iington, wieî'e the Americani Publie lIalth Association convened in itR thirtecnthi atinual sestsion. Tlie dele gates camne fromi nearly every State in the 'Union ami tlue Dominion of Canada, and is reported to biave been a erfect suecess. It wa.s prosided overl by the Pesident, Dr. J. C. IReeves, of Wheeling, West Virginia. The Lomb prizes hiad bî'ought forth a vast amount of mýatei'ial. There were tbirty-six papers poi Il fealth3 Home andFoodforthe Xorking; Classes.\" Thcere were twenty upon the leSanitary Conditions and Necessities of Sehool-houses and Sehool-life.\" Still in spite of the x'ast numnber of appli. eants foi' the prkzes but one first prize and two second pi'izes were drawn. Dr'. iLincoln, of Boston, rcceived the second prize foir bis contribution to seh ool hygiene. Dr. Ster'nber'g receiv- ed the fiî'st prize foi- his paper upon IDisinfection andi Individual Pî'ophy- laxis against Infectious Diseases.\" A second prize foir an essay on IllHealthy H-omes for the Working Ciasses,\" wvas given to Dr. V . C. Vaughan. A second pî'ize wvas also given te a mech'anie i'rom Spr'ingfield, -Mass., foi' an essay on IlPî'eveî table Causes of Disease, Injuî'y and IDeath in American Woî'k- sheops.\" About half of'the Lomb prize money remains foir prizes te be oft'ercd for the best essays on definite subjects next ycar. Dir. Reed, of New Yor'k, offeî'ed a u'esolution î'ecommending legislation- national, State and municipal - te pî'otect the people from the sale of diseased meat, wvhich was appropriately referî'ed. Dr'. 1-. B. Baker', of Lansing, Mich., discussed the relation of rain- fail and water supply te chelera. Statistical -nomenclature -%vas abiy discussed by D'. Ilunt, of Trenton, N. J. Dr'. J. S. Billings, of Washington, disceus-.d the fo'ms of tables foi' exhibù ing vital statistics. Many otheî' valuable and interesting papers were u'ead and discussed more or Iess. Tho tmeasurer reported more than a thou- sand dollar's in Ghe .treasury. A confér'ence of the repî'esentatives of al the State Boar'ds of llealthi was heid at tho samne time as the Pubîju liealth As- sociation meeting. This is avr m portant body, as it represents the health organizations of ali the States. Presiden3it Clevelandi sent a happily woi'ded lettei megretting that it wa8 quite impossible, uwing te other pressing duties, for him te be present. Aniong other thing:i, hie said, Ilif this, bon eficent om'ganization shalh succeed, as it ought, in impm'cssîng upen muni- cipalities tho duty of sensible and thorougli sewem'age, a plentiful and pure tiupply of water and general cleanliness, together with a proper construction of sehool buildings fer the children of their citizens, it may well point with pi'ide te its achievements.\" le 'vas elected an honorary raember of the association, the first, upen whem this honor lias been conferred. The retiring president, Dr. J. E. ]Reeves, in bis address, urgeti the importance of national aid and interest in publie l1ealth preceedings, and the subjeets of a national health department and of aid in establishing a bielogica laberatery, wvas strongly shown. Cae said, ' fromn the Agricultural Department, the Commnissioner May sond Our distin. guisbed Fellow, Dr. Salmon, into any part of tlue UJnited Stlates to investigate an outbreak of disease among cattle, heorses, 8heep and swine, chickens, geese and ducks-if there should be ne demurrer of States Rights (?) and lie may order an inquiry te be made cencerning the blight of the creps- the potato-rot, for example-and the best method of housing, making healthy' ai.d productive swarms of heney-bees ; but what special, well- organized national department have we which is charged with the humane duty of investigating the causes of diseases among men, women and children ? The passage from ixfancy to childhood, and fromn childhood te adolescence, is a thousand times more dan\u003crerous than the approach te our harbors; but ne central effort is made te savo the chlîdren from, death before they reach their fifth anniversary.",
         "ILLINOIS STATE BOARD 0F HEBALTII ANNUATJ MEETING. T'leh Ninth Annuai meeting of flii ILLINOIS STATE J30ARD 0F IJEALTU bias just (this month) been bield in Springfield. A large portion of the time ofitho board wvas occuîided on the subject of Medical eductation. It was sbown that Progi'eqs in the enforce- ment of the BOARD'S SeheI011e1 Of Minimum iRequirements by the Col. leges lias been salisfactory. Trfi0. has been a. decrease in the number of' inedical students and of' gradîiates, a markcd reduction in the percentage of gnaduates t0 matriculates in some colleges were the proportion wvas formerly very liigh, and an increasing uniforniity- and highcr standard of the requirements of the colleges. A number of cases of outbreaki of small-pox hiad been reported, but there had been no spread of the disease up to the date from any of the cases. In Chicagro there hacd been 12 cases during the quarter; onie grounp 0f seven- contracted, it is believeil, from a Canadi.an tranîp-was con cealed by an unqualified practitioner. F our of the seven were already dead, and the mecdical attendant wvas in the county jail awaiting trial for practising without a license. Dr. Grove, of Galva, -ivho hiad vac- cinated large numbers wvith both humanized and bovine virus, hiad reported to the board that, previous to this campaign hie was extremely partial ho the bovine, but hoe bad completely changed bis mind. \"lAt least 50 per cent of the vaccinations witlî bovine virus liad been fa-ilures,\" and l \"tlîi O.expeience adls to the mnass of proof w'lielî lie baild long rec(-ogniized of thc miperiority of lîumanized virus not too fir remuved, iii ca±mses demand- ing jpromp)tnebs aind certainly of' action.\" In reoference to the epidemnie in the Province of Quebec the secretary, Dr. .Ranchî, reportcd that, fromn personal observation of ail the coud i- tions-having- spent severat. days in the iîîfcctcd regi on andl cornpromised. territory at the invitationî of the Dominion of Canada authorities-Ime Nvas prepared to say that every thing possible under the circumstances wvaq being doue, both for tlic suppression of time disease iii the iufectcd area, and. for the prevention of its spread westwarid. Relating to cliolera, the secretary reported as follows : It is bardly mecessary to say timat this country is not yeh fr'ee from danger of an invasion of choIera simply because there is uow a cessation of alarming reports from. Eur'ope. Per'ods of' remnission, more or less complete, bave characterized every pandemie spread of choiera since, it first invaded the latter country. Until it entirely disappears froni the European continent it ivili not do for us ho relax our vigilance or to remit a single precaution. On the coutrary, this delay in its march should be, wtilized ho strengthen our defenses, and to perfeqt our precautionary systeni. IFEALTIIF*ULNESS 0F THIE NORtTHI-WEST (JAMPlAIGN-VA.LUE 0F PURE AIR. SINCE returning frorn tbe recent N. W. campaigyn, where 1 served with the forces on the medical staff, muich bias heen thouglit of the wonderful lîealthful- ness ot' that expedition, and on îvhat it depended. Not only wvas it marvelously free froni disease of a zymactie type (tîmose diseases formerly tlîougflit to depend upon some ferment, nowv known te be of gerni enigin) but others not depending upon gernis; arising from within the body; and 1 feel fully persuaded that it was due to constantly breatliing, both 'q day and by nighit during the wbole twenty-four hours, an unlimnited supply of free air, pure, un- taiîited an1 tndefiled by the, multitude of causes wvhich seeni to bc iiusel\u003eara-ble froui tîme abodes of civilizeil man. Night \u003cd'ter nighit diii we lay rolleil in our lukets, with iiotliiug aIove us but the starry vault of beavei, wlmere tîvink- linîg stars wvere the last peaceful objects to lul us ho sleep and the first te 'velconie our early waking.",
         "THE PUBLIC HEALTIT-THE LIVING AND THE DEM). 9 lb seemied tihe perfection of s'est, ani one ai-ose fuliy refreshed, feeling capable for any dloties of the day. I shahl isever foi-c't those nlighits, nor tise quoi'ation i which) they caiied Up, \"Anid over us, with .,unstanit, kindiy smile, Vhe sleepless stars kaep everlasting- watuli.\" Thiere ivore no drafts or pent up exhila- tions, ail ivas free and pure. Most of uis know soinothing of îvhat, drafts are capa. ble of producingy in our systpms. By a tlraft is meatit aiur constricted ansd con- densed in a channel îvhici causes its mno- tion to ho accelerated and so altered in quality as to make it disturbiiig ani liarin- fui to our bodies. And this brûlas mo to I consider liow drafts differ front othier air ini motion, îviat changre thiere is, foi, there n.1 mst be so neo alteration to affect us s0 harmnfuhly. It cannot be due to increaseci velocity, for we miay expose ourseives to a * gaie wvhicli alinost bloîvs us off our feet and yet take no harni, nay, are bcnefitod and exhilirated by it-but pass some of the * sanie air througls a passage or windows opposite oacls other and thenl try its effeet. A chili, a sneoze or twvo, and increase of * mucus in the throat ivili follow, ansd 'vo exPerience tisese sensations wlucli are the signalis from within, that telli us tiiat some- tiiig is going wrong, or, as it is cbm moni- ly expressed, we ar-e catching cold. I have, î-sghtly or îvrongiy, associated it with a, 7 (deranogenent of its constituients. We * know too, that, gasse% and fluida, have do- funite laws of diffuîsion whien undisturbod and niay it; not 'ue tihe interference îvsth such iaîvs that s0 aiters the air as to make it affect us so very difféently and more delitoriously than îvhea it is free andl un- trammeled. We aie far too indifférent and careless about thie quality and quantity of tise air WCe breathe. Muais more is thouglit, talked and wvritten about the quaiity, quantity and preparatioîs of our food, whicls is of grent importance, but uvhiah 1 liold is a secondary necessary for our healthy maintenance to that of good air. One constantly iii the opeun air %viti mioderato exercise can eat, relish, fuliy digest and thrive upon thie mnost indiffer- ent food, suai as hoe turns fromîs in disguist wiîen housed iii polluted atrnospho(.,res cf civiiized hiabitationis. This ivas exonîplified in a marked mian- user ii thse recent military expedition- wvhen the moen wvere foI upon the înost monctonous, uiivaried diet, of isard tack, catnned beef and tea-cannied beef, tea and liard tack-tea, liard tack and canned boee, at, meals co, two and threp for uipwaî-ds of four nionthis, yet the resîsit wvas that, the weak and sickiy greiv strong ansd tise bton stonger. 1I(do not mean te imiply th-it these were the only articles of diet used, buit with iittle exception tbey wvere, or tlîat tlîey iriake a, model bill of fître for those îvho wisli to grrow heaithy alnd strong, but to« iii ustrato wliat free air is capasble cf doimîg in sustaining our bodies, in spite ot such a diet. I ain more fuliy convinced tisan ever before, cf tihe prime impiortanceocf free, freshi air in maintaining our bodies in lîeaith and restoring thoeni wlhen diseased. In respirations we have a procoss of feed- in- and assimilation constantlv ,oing,, on nigilit and (iay, wvletlser ive sleep or wake, like tise hieart, our lungs nover cease froin labor, but keep tîsoir constant, faitlifuil, rythmiic motion fromn the monment ive enter this atmosplsere tîi wo leave it. A. J. IIORSEY, Mý. iD. THIE PUBI C RâEALI'II-TIJIE LIVING AND THE~ DEAD. M fost cf our readers know that many a---towvns \u0026 citie.ý tlsroughîout, Canada in accordanco with certain regniationb and provisions mado by tho Govern- ment about three ycars ago, bend to thse Lcpartment cf Agriculture, on the first cf each month i- monthly istatement of the numnbes' of doaths, with theo sexe, ages, cauzes cf death, \u0026c., which had taken place during the pi-evicus nionth, ia the respective cities. These state- monts are tabuiated by cierks in the iDepartment, a wvork which involes a gî-eat deal of labos-and care, and are published, in abstract, in a yearly re- p)ort. But be:iides the yearly report, the .Department publi:she, a înonthly state- ment cf the number of deaths, mentioning tsexes, in each of twoaty citiosi and towns wvhich make returna., rIn England a similar statement, including about thirty cities, is publi8hed wveeiy. From the tables we find that the, 109",
         "110 THE PUYBLIC IALTII-TIIE LIVING AND THlE IYEAD. total number of deaths in tlic 20 cities and towns during the month of Decomnber, wvas 1,336. The 20 cities. contain an cstimnated population of 576,000 This gives a death-r-ate of 27.6 per 1,000 of population, per annum. Montreal with an ostimated population 157,000, recorded 460 denthis, or at the rate of 30_p er 1,000, of population per annuin. Leaving Montreai out of the calculation, the other cities registered a mortality of 24 per 1,000, per annumi. Toronto's mortality for the month wvas at the rate of 23 ]per 1,000, of estimated population, per annum. The niortality of Quebec was at the rate of 38 par 1,000. That of Hamilton was barely 20; 1-lalifa.z, 22; Winnipeg, 23; Ottawva, 24 ; St. John, 22; 1.inzston, 20; Charlottetowvn, 38; Sherbrooke, 19; Sorel, 48 ; Firederickton, 18; St. Hiyacinthe, 417; Gaît, 24. St. Thomas, Guelph, Blelleville, Chatham, and Peterborough recorded only a moi'- taiity of from 12 to 14 per 1,000. One-third of the deaths in Montreal were causect by sinallpox. The mor- tality frei ail other causes was therefore only 24 per 1,000. In Quebec, omitting 80 deaths causcd by measles alone (two fifths 6f the totals) the mortality from ail other causes was likewise 24 per l,000-just the saine as the average of the 20 ciLles, and but little higlier than that of Toronto. Without the sinallpox cases in ChLar- lottetown, the mortality wouid have been but 15 per 1,000, and iu St. Hiyacinthe, 20. From diseases other than sinalîpox, Sorel returns the highest mortality, or about 37 per 1,000 of estimated population, per aninum. It looks as if the returns from those towns showing suchi a low mortality as from. 12 to 14 per 1,000 were not correct. .During the last quarter of the year- October, November and December, thera were 5,359 deaths recorded lu the .,0 cities and towns, sh owing a mnor- tality of 37 per 1,000 of estimated population per annuin. Omitting the large number of deaths from the epidemics of emailpox, in the four cities-Montreal, Charlottetowvn, St. Hyacinthe and Sorel, and measies lu Quebee, amounting in ail te 2,129, thora wore, basides these, a total mortality in the 20 towns of 3)230 or 22-5 par 1,000. Excpting these two epidemiçcs, therefore, the mortality for the quarter wa.s about thiat usuaily recorded in the cities of Great Brita'in. Going back to the third quartor of the yearit-July, August and September-we find that thereo were 5,462 deatlîs recorded in the 20 ciLles and towns, a few mor-e than in the last quarter. Omitting the number of deaths from smaI Ipox and i-aeasles, 1161, thore we-e 4301 deaths from ail ail other causes, showving a mortality of -about 30 per 1,000 of popu- lation per annum ; nearly 25 per cent gr-eater than in the last quarter. The difference, inost likely ivas miade up by the deaths of infiants during the hot period, and principally in the larger cities, as w'ill pi-obally be learned when the tables griving the ages of decedents are made up and published in the annual report. During the six months-JuIy to De- cember, 1885-a total of 10821 deaths wvere recorded in the 20 cities and towns, about 19 per 1,000 of population; or 38 per 1,000 of population per annuin. Omitting flic smalipox cases, the niortality wais at the rate of about 26 per 1,000. rirom sinalipox there were, during the six months, 3,2986 deaths, 3153 in Montreul and 133 in other places. While measles caused 150 deaths. Froir. zymotie diseases, the mortality for the six months in the 20 cities and towns wvas 5,193, or at the ra te of 18 er1,000 of population per annuin. 1oinitting the deaths froru sinalipox, the mortali ty was at the rate of 6-6 per 1,000, per annum, from. this class of diseases; a very high rate. 0f the 10,821 deaths froin ail causes recorded during the six rnonths, 3,286, not mucli less than one third, wvere froni smalipox: alone. Political economists estimate that each indivi- dual addition to the population is worth one thousand dollars, or that ech death represents a loss of one thousand dollars, to the country. Upon this estimate the smallpox epidemie of Iast year was a Ioss of $3,286,000. A weil organized Domi- nion llealth Bureau, net costing per year as mnuch as a one-hundredth part of this sum, miglit have prevented",
         "MISCELLANEOUS2IITE MS. nearly the wvhoIe of this sacr-ifice of human life; te say nothingP of tie loss of time anid m.oney during the days and weeks of sitkfless and sufforing. TuEn Toronto Sanitary Association held its rcgular meeting in the Cana- dian Institute last weekz, the president, Mr. D. B. Diec, in the chair. Mr. EDWARD BURICE, architect, read a paper on \u003c'The Disposai. of inrbgel Toronto.\" IL said the whole city wvas giî't about with foui sinelling dumps, which wvere extremely deleterlous tn health-on the city front, at the propery rehod or adisposGinon garage -and by a crematory. ve of lieuse t od souldbr its w own garbae, bueto eause sen t b cs would bc ae h troube, anthd fohe, assteve, o erea here isho bnt for itba but lo asth muncipal corporainssea with te sbecats Haltono tas the ftrotucitind hr Caa as svnch hadinti tuted an cremtery tim it as ossibler the buningifad croaimais andvery offensive garbagea. Hie would likce the whele question te be placed in the bauds ef a cempetent engineer te report on. Tiiz IIIMALAYAN TEA imperted by General Keer, of 58 Church Street, Toronte, is carefully selected te General Keer's order, and is certain]y a very superior and reliable tea. It is a very ecenemical tea, because it is se pure and strong. Every eue who tries it, almest witheut exception it appears, is very much pleased wîth it and ton- tinue its use. Samples may be ebtained direct from the importer at the above address. ORILLIA in proportion te its popula- jtien, takres more copies of this JOURNAL than any ether town or eity. Orillia is reperted te be a very heaithy place. It has a most efficient and active medical health officers. SANITARY MATTERS IN FRANCE.-A correspondent in the Sanitary Record gives the folliwing: Dit. AILNOZAN, in an article publishisd ini the Revue Sani- taire de Bordeoesx, mentions a, uumbe of cases of pellada, in which, the contagious eloment xvas clinically directly traced te demestic animais. An interne (house surgeon) of eue of thue «Paris hospitals fer s1kir diseases, on tho suggestion of Dr. Aruozan, questiened several of thue patients on it. H1e learnied that they luad fre- quently a pet deg ei» cat which lost its tur. One foinl p jatient reaedta site liad a pet dog, which lost its fui', and limited nalzed areas of skcin remaiuod; the dog wvas always with her, and she. combod it, with her ewn comb. Three meuths aftei'wards she was attaecod by pellada; one spot when she was admitted in the hospital wvas getting botter, tiie other wvas perfectly smeoth. The miscrosporon Audouini was net sought for either in the deg or the human patient. Dr. layet, in a series of articles published in the Revue Sanitaire de Bordeaux, describes the deformities in ehildren wvhich. resuit from the use of badly constructed school furniture. Tie chairs and tables in use ought to be adapted te the conformation of the sehelars, and flot the pupils be obliged te adapt themselves te the furniture. Dr. Layet Lays dewn. the following rules. The children should be able te sit on both buttocks; when seated they should be able te rest their f'eet either on the floor or on the bar of the chai r. The seat of the chair should net be toe small, and the chair should have a back. The writing table ought nearly te rcach the chair; the pupile would thus maintain an upright position, and be supported by the back of the chair. M. Lacaze Duthiers, at a repent meeting of the Academy of Sciences, called attention te, the researches of M. Herman Fol (of Geneva) on hydrophebia. M. Fol bas isolated a microbei whitch he believes te be the specifie element of the malady. Inoculation witb this microbe through the orbit prodluced rabies, and the incubation period wvas sherter than with Pasteur's method.",
         "SURGEBON 6-ENERAL ]3ERGIN-FACTORY TJABOII 1EFORW. ID rominont among that host of ablo, -'and usoful mon wvho liavo boon tho honor of Canada is Dr. Darby Bergin, distinguîshoed not, only as a clevor and industrious physîcian, but as an effi- cient militia officor, an active politician, and a vigorous and entorprising towns- man. Dr. Darby Borgin wvas boril at Toronto in 1826. Hol is of lrish ex- traction. lus fathor IMr. William Bergn, Civil Engineor. wvas a native ofloscrea, in Ireland, -vho sottlcd iii Canada in 1820. Ho, had five chul- dreni; of whom two survive, Dr. Darby and Mr'. John Borgin, the latter a lawyor in CJornwall. The father died in 1850. Dr. Bergin began the serious part of bis oducation at Upper Canada College, Toronto. As an instance of bis sticcoss as a studont it is said that, wvhile ho 'vas in a junior form and undor twelve years of ago, ho carried off tho prizo in a Latin Urammar com- petition open to the wvbolo collego. So fair as its productiveness of distinguish.- ed mon is concerned Tipper Canada Colloge may almost be termed tho Eton of Canada. During bis course there the future Doctor, if hoe had boon gifted witb a spirit of prophesy, might bave lool\u003ced wvîth interest upon many a yonth, unnoted thon, but whom a growving nation bias sinco hiad abundan t roason te regard. Lot us say that one such is the Doctor bimself. The -%vork o? Educatien thus begun ivas continued in niedicine at MeGili (Jollege, Montreal. Mr. l3ergin's course there wvas distinguishied for zeal and ability. In April 1846, at the unusual age of'19 years and seven montbs, ho passed an examination wvbich entitled him to, a license to practise, medicino. In the following April wvhile yot undor- age hoe passed the examinations for the degree of M. D. C. M., to wvhicb ho wvas admitted in September of' the same, year by a speciai convocation. The Doctor thon settled in Cornwall and began the practise of his profession. Dinergy and talent wvith a fair fild do not tarry long on the lower rounds, and Dr. .Bergin soon bari a practice whieh was one of the largest in Eastern Ontario. In the ral)id success wlîich lias attnde biuit wviIl bo only necossary to naine the several distinguisliod p)ositions wvhich lie bas since liold. ln 1848 ho had part charge of the Emi- grant's Typhus Foyer biospital at Corn- wvall. Whien tho small-pox epidomic brokoe ont wvith sncb dostrnetive vio- lence amnong tbe Indians of St. Régis, hoe vas sent by tho Dopartment o? Indian Ait'airs to attend thcm, and xvben bis labours wvero over, roceived tho tbanks of the Goverument for his zoal and dovotion in a not vol-y tompt- ing taskc. Hec -%as prosidexît o? tho Easter-n District Modical Society and vice-presidont of the Association for the St. Lawrenco and Eastern division. Of this latter ho bias been for four years Prosidont ex-oflcio. Ho lias boon vico-president and twico, president o? thîe College of Physicians and Surgeons of Ontario, and at différent, times examiner in surgory, medicine, and othor subjocts. le is at the prosont tirne the ropi-osontative for bis division in the council o? that institution. Di%. Bergin's usefulnoss not only as a rphysician and sur-geon but as an active public man, bias been stoadily rocog- nizod by lus native town. The honours and places of trust -which have beon conforred upon him have boon wisely besto,%ved and f'tf lly eld. The Doctor bias beon the steady friend of Cornwall, in bolping on its industries and providing it with public buildings. The -ne'v Post Office there, t'ho Custom flouse and Inland Revenue Offices, the Stormont Cotton Milîs, the Toronto Paper Milis and the main trunk sewor, a costly construction along the fi-ont of the town, are mainly the work of bis influence. In Cornwall Dr. Bei-gin bas been meniber of tbo towvn Council and tr-ustee of the High Scbool. Hie wvas first elocted to Parliament in 1872, by acclamation. At the general election of 1874 hoe -vas dofeated by Mr'. A. F. Macdonald, being 23 votes behind. Mr'. Macdonald wvas unsoated, but on a ne'v eloction in Septombe- hoe vas again returned wvith a ma-ýjority of 40 votes. lu 1878 Dr. iBergin defeated Mr. D. B. McLennan, but was unseated.",
         "SURGEON GENERAL BETRGIN. 1 In a new election lu 1880 lie wvas a second time victorious wvith an increas- cd majority. In 182 tlie towvn of' Cornwall lîaving been united to the County of Stort; ont, Dr. Bergin wvas nomiinated for, the constituency and wvas clected by a ma.Jority of nearly 500, the opposing canididate being thîe late James Bethuno. The most noticeable workc of' Dr. Bergin in the I-buse lias been res- pecting the regulation of factory laboî'. To this subject hoe lias given a great deal of attention. A few ycars ago hoe introduced a bill for the regyulation of the hiours of labor in worksheps, milîs and factories. In it wvas a clause relating to education, and as it was thoughit this wouid interfere with provincial riglits, the bill was with- drawn. During the I ast session of parliamient (1885) the doctor broughit in anothier bill of' a sin-illar character but without the educationai clause. On the second rcading of this bull, in April last, hie made an cloquent and exhaust- ive speech on the subjeot. Hie wvcnt backc more than a century into the records o? time and picturcd the terrible evils of the days -whîen, after Watts' discovery of steam, and the intro- duction of the mule and the Spinning Jenny, came the monster ostablishi- monts -which suppliod the world, and into which wece crowded the old and the yourig, frorn 6 ycars of age up, the strong and the wcakc. \"lLong hours, over-worki, miscry, and starvation were the rule. Stcepcd in ignorance, thore scemed to be no escape from. pauperism and degradation.\" fie doubtcd flot cimany of the manufacturers wvcre humane; that they wcre flot naturally cruel; but as business grew and de- mands were made for the produets of the loom. and the anvil and tho mine, faster than they could suppiy wvithin the ordinary hours of labor, littie by little, siowly but surely, came about the great evils which it toolz hali' a century to alleviate, if not to cure, by legislation.\" fie fearcd that utiless3 the bill were passcd likce results -might be broughit about in this country. fie said that from the time ho had intro- duced his for-mer bill, the working hours had been confincd te sixty hours per week in ail the large miiltin l thiti country, and that provisions hiad been made for the soparation of the sexes in certain portions of tho milîs, provisions whichi were nccessary to decency. In the American mills, such provisions are flot made, and î'cquests are cons- tan tly sent to the Legisiatures of the different States by tho factory commis. sionerls, askzing for- the saine provisions as are now made haro, under the influence of public opinion croated by the introduction of this labor Bill, in our flîctories. In the United States, tho closots in the milîs are so placcd that nione but the vile grirls use thecin.\" lie desired that no c hild under 13 yeai's of age should bcemrployed in a factory. This -%votild give them a chance to bo educatcd. l-If we grow ui) in Canada a generation of ignorant children,\" the doctor said, wvithout any education, without any knowledge of the Christian doctrines, we are bring- ing up in our maidst a class which will be most dangerous to the commuiiity, -a class whici wiil marry and bring into the world the samne class to be 'vorked from tho saine early age until nianhood and womanhood, as this claýs is beingr now worked, and so it will go on generation after gencration increas- i ng in ignorance, inci-easing in degra. dation, incircasing in everyth.ing wvhich would be a shame to the country, and for these reasons it is necessary that wve shouki have ail the children of this country educated. Dr. Bergrin concluded his able speech in the foll o'ing words: IlJ feel warmn- ly and I have spoken warmily upon this question; I know, Sir, that mariy of the evils wvhich attended upon tAie DInglish system, will creep iute ours if flot providcd against by legisiation. The future of the chlîdrefi is in our ha nds; thiey appeal to us for protection and I feel that that appeal will not be in vain. Their health, their life, their faith, and their morals, are at stake, and they ask us to give them. ail the aid and ait tho assistance which it is in the power of' this Parliament to give. Thiat tlie factory boy may grow up strong and vigorous, full of life an d hiealth, a good Cjhristian and a good citizen and a valuable member of society; that the faotory girl niay grow up an intelligent and a virtueus",
         "114 SURGEON GENEIAL BEIIN. womain, a truc wife and a loiing niother of hoaflthy eildron, devoted to the diofls of lier station ; that thov niay, both boy and girl, not bo kille d througrh over work; ; thalt they niay not girow up puny .and dolicate and dwa-rf- ed in mind and body; that thiey maytý mlot, through cnl)i(ity on the part of thieir miasters, ho maimcie or cripplod for life býy macbinory; thiat their lives mnay not, tbî'ongh thc Iackz of I)Io1or precaitions, bc endangrered by firo; that they m.ay not iii any other %vay bo victimis of the want of care ,and forethoiugbt on the part of thoir stipe- riors; that. thoy May nlot bocome viutinis of the moloch golci. as wvas thc caseo in England; that they rnagy not beconie holocansts on the -iltar of mammon-tneqe are amiong the objects of tîjis Bill. That it may net bo said of' Canada, as it iras saîd of Bngland, and too trutly said, that tho wheols of lier industries are driven by the hieart tbrobs of lier littie children-that no snich iail May go up from Canada's children to.day as ivent up froin En g.- land's children bofore the pass.age of tho Factory Laiv, depends nponý this Parliamoent. Sir, the snows of' winter are fast molting aîvay; the eartb ilh scor ho clothcd in green, there will be bud and blossom and leaf on evory troc, the air ivili bc filhld vitb flie musie of the birds, and the iiowers vllbc forth in Il their 1 beauty, and srnïling in thoir niother earth's old face NviIl sàay all lier chblIrenl shouild have bapli earts.' W h ut miore appro priaite season than thîls springtime to, giyo te these little toilers tho bioon thioy crat«ve, and thus build for ourselves a inonu- ment îvith passionate heart's of* love for corner stones.\" Dr. l3crgin however bas net been contented with diïtinction in medicine and poities; lio is also a vahiable militia officer. lis connettien with niilitary matters began in 1861. At Iiat tiîne a volunteer corlpany was f ornie(l for active gcîrvice hli Ille towin of Corn- wvall, in view of the '1'rcnt difficuhry. and the Doetor iras iiidiuecd takce coinniand. After this lie orc as captaixi in Ille 3rd 1'îovineiffl 13.ttaýlioni at Lpa ' froml iI)coîn ber- 1863 to Ia 164, and a ajor during the Fenian raid of 1866. In 1869 hoe organized the 59fli Storînont and Glengarry Battalion and bocaine its colonel. At the oîîtbrealz of the recent robel- lion iu tho North West the attenîtion of the Governnient ivas early callcd to the necessity of foringc a special miedical ser*vice in connection îvith the Mîf.liti-a Department, and wlien a lead ivas to, bc cliosen -no one iras found mnore thoroughily fitted for tho position thian i)r. ]3ergin. lus appointment was well received by the medical, profession tlirouglioît tue country, and also by the miedical pr'ess, and seeîned to give iuniversail satisfaction. Ife mras hotu a su-reon and a soldier. Considering tlîo short tine at bis disposai, the novelty o? the event and the magnitude of the necds involvcd, Dr. Bergin's coud uct of tbis service in lus cýapacit3, of surgeon-general ivas Wortlîy of ail the praise which bhas boeen bo!stowed upon it. With the exporience which the surgeon general lîad liad, lbis untiring ener-gy and natural habit of doing wvell overything w'hich1 hoe iad to, do, it ivas nothing miore tlîan would have beon expected by thoso %vhio knew him wvoll. Night as well1 as da-ýy, in cessantly, almost ivithout u'est, luis vigorous constitution anid determnination to, do bis duty sustain- ing luim, the Doutor devoted himnself te the work of organization. Dr. Boyd, of London,. Enghand, who ivas sent te, Ca- nada by the Princoss Louise, in charge of stores, declared that Dr. Bergrin's ar- rangements %vere (0a)tOanîd satis- filctory, and thiat lie lîad nover seen «a botter medical service sent inte the field. Dr. l3ergin, du ring,,c bis sehool and colgelf, while standing h ighi in blis classes, alîvays found time to miake lîimself a sociable grenial companien; which lie is stihi, at the present tume. li1e usually bas at band iu conversation some pleasing and amusingr anecdote or stçiry te, enlivon the occa \u003esion. He is therexere an agi-ecable cenpaîlien; ai hoe is aise a îvarmi friend. As a, speaker lie is fluent, pointed, and somotimies cloquent. feis much i,îterestcd in, and is a principail pronioter cf, the proposcd Ontanrio .uc.i ic RaIilway. te extend from Corn- W.-ll te SaIlt Ste. Marie. 111 pelitica lie is a censervativo, and a gonui liberai one. Ho is stili unmarried.néîv 114",
         "EDITOR'S SPECIAL CORNER. MONEY lias orteil iteet referred 10 as a carrier of iea geinti. IL is a1 iliost, widely alla colistaithiy cireuiiatiig iîeditiiîi, .111d il Cati1 liardiy be loutîtei tîtat it \u003cloes uecasiutîaily cuti- vey froixi onie jersoîlt aliuîlîr tlte cultt:gitittus of disease. 'l'iteI tuciî- tsed tauIsor bis lit ointiloi cireillatioti -vosild earry Ilte nitiitie fotitîs of literouetcotiS eii qi'tit aeil ,a kiti ti l llîi i te dirt. grautiliy culditin lie( iîidlexittsl,, * SIîccic.s of baiet tt:il g:e.li Ili tlle store \u003cil Ille tradet pilesj uplier iiitie. , coiitainiiig litittlted-Clý tif his, are d:iily rueiveul troni lîti(d. of difireu p.îeoplie froin vatiotîs locailities, atnd tiiese at-e dcIelositeii iii lte batik, wlierc tiîey ate assortedi attît laidi or:i 0t o .5î1 îîid onI.. Il, cati * iardiy bclilerwist, t1in I liaI. soic of thesej hbis occa-iunal ty corne frii liolibes wlierc tlice aire cases \u003cif iiil*'ehiOtis di.sease, axitl Il, wsoîid ho qitte iii .1icerd.tilc witl Ict ktowii facts i f Llîe inîfection ti sei. suîinct-iîfes carric in lud foidis of tise huil- to te store anîd lîctîce to lthe batik antdt el-scwherc. A gooti xmaîy of our ruaiders are baik maniagers. It -%osild ho iveil for litemi to hear !i mmid the possibility of ais Infections dîscase beiiig cotn nxticated to one oit lîcir clerlis ii tise way abovo iiidicxîtcd; atîc !i titis way iiiiglsit ho exîîlained the Cause Of any sucs an outhroak, whlxi otiterwise inîglit ho Intexplica- ble\u003e1. To suggcesh or provicle a practicai reincdy for prcvoxiting te sprcad of dliscase iti tiis -%.ay woGuldcltin. to ho a- vOrY ditieuit tiig. The \u003clanger cotuld ho greaI.iy iessoeîd hy the ierioti- ical destruction of the old ills11, andi the tiso0rough cleaniîg axîd disiîîfcctixîg ofmnîtai mioncy. Titis cotîld not ho donc hy indilviduais -ind %vouldi have ho be done hy public bodies, as te Govora- mîet or hoard of lîcaltîs. 13OTTLING lias hecotîse a very commn-ons process !i conîsection, Nitls ail sorts of, and xseax-iy ail, beverages. Wliy coulti 1V not bc more gecraliy practisei Ili te case of pure- drinklng ivater for psirciy dritk-iiig pîxrposcs espccialiy iviien flot to ho holieti? 'Water 0f Most excellent quailty as regards minorai lixgredients, ahsolutely froc froin contamination, ean hc obtaincti from sprnugs ln almosI. every section of country. 1V * cotîld bc ffoId andt delilvred anywicre la botties aI. about te cosI. of hottiing anti carrnage,,wl'tch. %vith the lowv price of hottles (wii cossid always bc \"4returseti ) andi sailway raelltîes, %v-ouiti brin- pure hottîcti sprlng -vater wiltltin, te Mcach Of altuosI. evory one. Not far from Toronato, for cxaînpie, at Tornhiil, is tise ilHlav thora Natural Minerai, Sprnîg,\" tise property of ',%r. John LangstaT, whicil wili fusrnlsh an almost unhimited supply of a Most cleiightftilly sparkling water. A pccuiiarlty about this water Is tîxat, those wlto cannot drlxxk ordlnary water, or tixink tiîey canxna, andti Lcre are mnanty such, cai drink large quantitiCs of this wlthout dis- t 01atc ot he Stoirmehl or i neitVlieicliCL orf any k~jild. l)oui.ss il pitre lxii tled singl %vaier cotild bc readi ly obtailti, 11nanly Nvotlu biy .1t1d dr1inik it, in.stend of Ilte 'Vile eouîllîouuids snld evetywitere as titis, 111It. or IlIle ot lier. kitîd of '' adoI' or Il beer,'' or eveti ittsiead of real niait. ait. o: r, .111d as a ritde t leu îîl't\"r wotnld W-: a iititi uîtore sîil glicaltlitii antd less datîgeroits, leverage, onl w1lîiclit Lu tild illuuy. CA IuiF tive beeounv suithuý .l.sîi anîd hostiu y :1i e:i1 of lilplt,l altid t, a1il il, ail] :il tare eslierially of bs lit he yoiii lit t lx\" qîtalily of thoxît 1$ a tuit er ut very greit, 1tiiporlance. Cottaty Io lte lielief of inaliy, the canidies Sold il I tlle large eltivs of canada, it appears, are adiîltcr-aied '-ety h itile. Reeetrcîrstillute Xja'nsttfIîixi Revenue by te publie alialys\u003els front the iir ent divisiotns, dut-ritig- NuÇvciiîler and fl-cemilier last. (Ii aecord:uîee wsittli hi recenit food atîti drinkl Act) witiî wliich wuO lii.v beexi favorud, show a satisfnctory conditioni of lthe Caties SOkI( lin the pirincipal cities. As xîîost'of the canîdies consined !i tlle Domîinioni areciaîu:eu cinl the cilles, parents gcnorally wi1ll bc quite as pieasrd as titeir littho ones to be itîfor*nted thaI tic candies anaiyzed by UIl public na%.lysts are neariy alIl reporteti as belii- IloîxCiitici,1'1oo, unadlteatei,\"\u0026e., atid Colitiiiiiiîg xotliin- more deicterious thati glucose, starci, flour anid minute quatittics of cotnparativiely lirrm iess vegetable colorlng rnatters. Out of eigliteen sampies examlned ln caci of Lue livo divisions, sueh is tue rosulting fact. li IjlalIfaîtx a fowV samples of yeilow varieties cotitainec Icat salIs as coioring maLter. A largo proportioni ln al the divisions consisteti largely of glucose Instea\u0026 of geniiinc cane sugar, but tiîey a7o very lîttie tue «torse for tiîis. It is 'probable that the recont Act above roferreti to lias beon influexitial in prodsîclng Ibis rather satisfactory quality or candies. In New York, îîot long ngo, a iusiber of sanîples of candies woe fotind Io ho aduit- erateti to a very serlous extent A QUESTIOYN Of iauch Inmportance, especlally from a nicdical-icgai poinit, m.nay aI. soxnc future Urne coine up wliici wlil ixîvoive serionis conse- quences rclattng Vo te Justification of taklng oxie life to savo aîotiîcr. 1îot lonig ago te New York dally paliers reporteti tliat cvery Roman Catitolie physîclan ln tîtat clt.ywias Iti rcccipt of a cIretiltr coxitaixiirg a decîxiration by lthe pope tiîat the killIng of' an unborn Infant Is xîevcr riglît, ceiî wlîeiî te lireo0f a niothler Cati bo savctin no ciller way. Tiis bears on tue gut-g- Icasi operation of Craîîlotomy, wiel, as some, of our rendors Many noV kttow, is to cause the deatit of anu norn Infant, andi wblcb is pract- Iceci hy lthe profession Ili csswitere a cliolco il; forceti betwcen ioslxîg vwo, Ilves andi savlng one",
         "116 EDITOR'S SPECIAL CORNER. by lîastcîilng the deat\u003e or the otlxer. A %vriter ln l'T Iite Axooricati Isreic Citaciiiîîît.ti, gives the Rabilblicîdj 'icw on fuis questioni. Iiia Misliîî 011ol0tiî1, vii. Illte ioîîisptde( declisioi Is laid dlowî fith:t' ini case of si datigerous parturi- tion if, ks Juistifiable f0 ]MI flic tiuîborîî Iuifant las order to :ave the moflicr, as lier Ilfe îrccdcs ifs St~''~ ic'li oiierfiloi\u003e Is, liowce'cr, flot. per- init.fed aller f lip infant lias alrcady been part.ly borai, as ii fis ease flic iflaxîim apffiles tiiat one liuman 11Ire must not be set aside on account of another. tugi tis Is a serions subject, we tirc Icipteci to give tic vlev of Dr. Oliver Wcndell Holines, ii lits cliarming pocn- reaâd before tlic .Society for 'Medical Improvernent ln Blostoni, some ycars ago. Uc iwrotc of Craniot- 01103' as- dA trivial d«iaagc, sînce so oft we flnd, Tliat. biibes grow uip, Nvlîo tort tlîeir brains Ihchiiîd.'' OBSERVATIONS AND ANNOTATIONS. S'rATEMENT lias laeea published lia coniac- AMlon witli the selicrne for providing clieap duariers f0 poor childreîî ini lirrniîagfianî, wliich shows tha. the central conînîittec iînd, litp to Clirislin.as, four centres la operation. .Siîîce Oe-!oiicr*, filc ini)ir of dianers supplied vas 27,8:t5. Tite exieuiditutre for food alone rost slilifly liaier, aifdfl t otal cost, ini\u003c'luing coolciaig, n:ssigt3 ov\u003c'r, a liaifpinny pet' liefli. 1zthe hicldreuî's depairfîcuit a. file Unilver- sity Hlosital of 132rliîî (Il Tierapetieic Gazette 1') tiiere is a collection of soiaîe Ilirce lîundrcd iirsia-bott les of varions sizes andc su ls il provided %'itlî a long ruibber tube, -%liicli eniclose a piiece oif litminis paver colored red. No com- ineîitary is îîceded. It Is quille clear thaI. tie lîreseuice of lacle acid in flic tulie suflliccs Io expiain îî uaay obscurte dîsor(lers of file alliment- ,lry tract, l'or wvli lich pliisicians arc ofteîi at a loss fo0I tiid a satishactory exJ)laTatioii. Mottionrs returit b flic Polycliiic and tcstify fo the rapi(l recovery \u003cif tlieir cliildremi aller tvitlilr.tv.l of Ille nursiuîg-botf.lc. TuEn Iowa commînission of Pliairnacy lias made flie I*oiloviti-g reguliîtoits as a safegmard agalist -ire ri*ucstecl If)î alix ai str'ip of rougi\u003e CuîlCry pimper or eîîîry elot fi arotnnd cadi sliolp bottfle, or otiier contaainer, froia wiîic t.ley dis1ense miorphinec anîd nlii îiois\u003c)as. Tite wuidtli of tlîc afocs idlrip) fo lii of iiot less tian one-fourt\u003e of f'lit, alfitude ofIflir dispr'nsia1g imoftIc, anid ln lie ia tnider f lic label 0f contents. Tut: Unitfed ~iî.sCeuistis says f licre are' .503 paientl iwdicinae cs;bilnc inl the counîtry', cinploying .1,01t5 olacrattives,, wvifl ai\u003e agrcgatc ilîvcstineîil of ove\u003e'i fest million aiid a ha-lf of' capital. t! fis fri-lilftl f0 f.liiik of tue liijur3' hi the î)ibflic ralase(I by sw:liwî lac 'Vile coin- pomîids sent uI mi fl iese miorc Mlais 5001 csfaî- lisliuaaents. 111oiF. KICcc ohîmcd f lic liiw coîiise of liyg\"iciie, w1iiicl iIs f'or flicr.~ finif% ai iiegral pîorfionî of f liç- idiical ntids tuthei University of Berima, on Nov. 3, before a crowded aud(itoriuim. In lus int.rodclutory lecture lie (lct on filc vital importance of file lygienlc science, wliicii %vas at nîo finie so fiily apprclatcd as aI. pi-oent, aîad pointcd f0 flic xaeccssify of cvcry inedicai »cliooi flit cesired f0 kecp up wuitli flic progrcss of science estabisluiîg regular chairs oi lygiene. Hie said, \"Ititlihertofore, gentlcemen, you have lueen tauglut 1\u003e0w tociideavotir tocrîire a discase; liencefortb yvois will be f auglit. liov to succcd !l ;irevcnti.ig disease.\"1 A 'Mit. Fnsînum, of Duandce, Scotiaad, lias beeza led by certaini observatins, wliicli proved the defeetive condition of tue footh laii a inajority of scixool elalîdtren, fo suggcst. f lian. sonnie reguilar systena of supervisioni by a dentist, bc adopted as a part of scliool mna gemgnît. 1I% driviuga ail nailit a Pliil.laeip)lila pliysieians attaches ti iaiîfern to the brcast collar- of the liariîess, wliich planî lie says lie lias, tried witlî perfect, saf.isfsîctioîi. lie adds, Il My liglit Is a coîanioui tîibular lanter\u003e, wîifh a rellecter, and a sping for attacliment, f0 fllc dasa. li place of ptt.tiig it on t lie 1ai slilpc'd 1flic spriîîg over flic inifficl of thae breasI. collar, dircctly lin front of flic liorse. Every part. of flic road Ina front 0f nue wvas iiaii3 1en S cotild drive wvitlî as nitici confîidence as li broad d.-yliglit.\"1 S .' adviuiegar, taken is ii iioderation, says fluceI N. 'Y. Mei'lTiane.,\" la(i'.,a.tc the\u003e forma- flon\u003e (if flic gwz'trîe *Jiiice, butI, takeon ini cxccss, tIhey irrifafe filc nat of flic stoniiatli aînd liuder digestion. Oz, Arctice\\]pedlioînis,.a wîifei' lui flic \"'Crytic'' sa3'ys: ''Sticcess, tiiiotii,- fo iaolliitng-. Public iiitei'est anid liraise arc flic rewa.rdl of ,stifrering. De LoîigCD did îiouliug but. sufrcr. Ilc w.asç fllc great licî'o id iil Gi'ceiy i-waiNtliiî hait. sf'r and-lke De L.oîg-lose îiearh3' ail lits moin. Sir.Alian Yotiag î'îî liat tandi la one suiiaics crilse rescued a luarty o' 0f siipwrcckcd oxplorers aid lIroug,-lit. tlîcîn li:ick ln Eniglauid w'iftlioîit losiuig a mn. lus si;ll and juld]MCIlt tool; l'dîiî riglif. to UIc spot, w'hlerc lir, expuctei fo 116",
         "OBSERVATIONS AND ANNOTATIONS. 7 find flicîn, on Nova Zemnbin, and there thley were. lis acievernent wns lost sigflit of. Blut if lie liad losI. bis shlp, anti Ili. own crew had perilhed as well as ftint wlîieli lie ivent, t0 rescues lie would have becomne a faînous hero.\"1 Titîl. Cremiation Societ y of Copenlîngen num- bers 1,400 îicmbers, and the process of crexwation is ziccoînplisliccl ln about an liotir. This mcethod of clisposjng, of flhc dead, It. appears, is greatly on flue inease. The 1Iealtll Department of~ Newî Yorkc eity refuses peLriiits for cremnafion, on flic grotind thant the Sanîiary Code doos îîot provi(le for the ereination of liuman bodies but only for thieir iuternient. ]\u003eu. DA'AÎ,nIalian, lias been endeavour- ing f0 destroy patlîogcnic bact cria by mneais of liact(ria -%vluiehu are liarinlcss iiiidcr the given, conditions. H-e elnjîris ho liave obtained re- înarlzably favcîurable resuilts by adinini.stering \"fl.îttriinnî fernuo \"l(flic agent of putrefaction) in case.. 0f f uberculoîts constiniption. Hec clîns fluat thie hacteriuîîî fcrnio is inoc:uous to the patient, but. it dcstroys flic hacillus of consoimp- tion, and iliat. lie lias found great iixaprovem-ent, ia cases of fis lotractable disease froîn rcgularly adiiiiiisteri og 'inbalation, flue luarmless luacteri tii. TuEi. Soochîow (Cliiiî:) 'Medical Seliool lias cleven îinative stiîdcnfs, and tlie course laid dIown is very coi llef e, cohzilrisinîg a five years' cuirri- cultini, nille miotflis s;ession, and a tiioroufgli îureliiiiiiuary e\\auniiiuatioîi Ilu Cliiocese Cl.sis ,;lîuwni by flie second iiunial report of Soocliow Htospital anud Scliool. Dit. Looiris iii)ls recent, lecture on bacterol- og)y, s.tys: \"ITle erreaf. question ait prescuf. 10 lie sct.tlcd is, wvluclluer,%ve arc about discovering tlle ultiniafe cause or mniy lîitlucrto obscure paf lologieal sf aies, or -whicthuer f lîsc mnicrobes ar oul liceraof licaltl falzilug ocvnfg f iuinsîdviiality t0 developc Nvith iiîcreased rapidify-wliehcr thie3- are fli cause or flhe cavcogcrs of discaise. IL::îîs at is lasi. se.s.sion, in viCw of flhe lirob.ible :uvlvct, of chioiera1 il, i lis conItinent iluring Ilic îîext sommiiier, lias wisely appropri- :fcd( abolit. $3-.0:,000, 10 be uscd ai. tie discret ioni \u003cif tlh e idi. ii case Of a tlire.atcîîed or actual eud oil f cliolera or yellow féecr. Thle Pres- i\u003citi is flcuglif, will auif liorize f lir National Bloard \u003cif Ilcaîfli ho titilize ats ninelii cf tli, iiioiey as is iiecessary fo carry out li desigui of Con-i-.rss. A-r a recent, reforîin icetiîig iii New Yoriz. IL. ta ifd us ai natter 0f fnef. (14 Aiiiericaîî1 -.i\u003c*t'), f lit f lie Staf e of New Vori liad ex- licnced more Iliati one miillinî tlurc litndred tliojusaIidf dollars iil h fl i ppori- of four gencra- f lis or flic oecîdit f onie prostitute. A Npiv building materlal, coîuslsting of a ixture of cork, silica and lime, Is corning into extensive use ln Gerinnny. It lias the ndvant- agof keeping out lient and cold, and Is clalmned ho be an excellent preventive of dninp andi de- fender of sound. If. Is substanttal, hIglut and durable, raid secîns to be espeelally adaptcd for cclinui andi wall lixulng. TirîF autlioritles of Atlainta, Ga., have for- bidden the liotel proliriefors froîn turnlng off thîe gis af. the iiietcrs clîring thie niglut, to save thue lives of guests vhîo furii don» fhîcir gas on going-, 10 bcd, anid bcave It. burniiîg, becauise tMen tMe guits will continue ho buii andi tiiere ivili ho no leakaige. If tuirniet off af. theliceters the jet ,%%,Il bc Icît open, and wvhicn tîîrocd on iii the inorniiîg for tliose leaving by early trains, thie gits will escapie into tlîe sleeping room anid pis- oniog occur. '«Ewouhdlth1ce f0 know,'' aniliag says, wluci tlle litinian race will becoineso civilized h liaIt Ilie Goti of litiinanity wvill be worsluilped iisfead of tMe GodIdess of Justice? '«lieni the ivhole wvorld. wlll recogize. thuat to, be jus, Is oet alîvays f0 lie Iluomne, andi tlia. Justice, lIn tue maini, i.s :rbifrairy, nditihit no0 maniitor collec- tion of meni, can lay ouf. its exact. unefes anid boinds? '«liat is flic exact relation 0f labour f0 capital, ani whiat systenm of sociolo1gy can bo adOpited to insure Maît every inan shial have of crt'ature coinforts a sliarc iii keepitng, witli lits iirustry? W3lien mciiwill reeoguîize thiat- tliere aire many subjects coiicerning wlicli .hiey have nîo righPif. f0 an opinion, vior a, righIit to express tl1inselIve.s, becanse tiley have nlot «witllinl tieîin flie elenits t i mnakie a conclusion Nvlîiclî tliey know is trultli*?'' Tir. lifnlossibilify, by renson of tlîcir soci'al and religions laiws, for the w0iflCi of India to receive fic care of male lulysiciauis Is wcll lzuiowii. A s\u003ciciet-y lias JusI. Imen forîncti lit Iodla for suipllyluig. feîiialc oîusciîs f coin- lilefe edlucatiosi in îiicdiciiie anîd surgcry, io f-liese afllicicd wonicn. Ufi tliis sflcicf.-, Ladly D)nle'rui i-, H1ie lady pre.sidlent, andr flic Vicero3-, Prcs,;il:n\u003ccy U;overniors, anid olierficiI witl tlîcir wives, aire patronis. Tie soely lias thie supîmilort.(if flue native pîrinîces, wiflicuf. whicli îiofluini of ifs ainis wotild le praclicable. Euir- ope andi Aincrica are fo ho calleul iupoti to fîirnish1 ieachiers for iintive wcien wluio wisli to b\"- iiisfrnicted andt fitted for thie pîrofession, andi pccuiiiary aidl i-s pleigeti hoth iii Iiîdla andi Eng-lanti. A S.ý%;iTmzY patrol liab been estalulislied lin Jersey- City by flic police aufliorities. Four liollccmino atre in fict as ilic)etors andi report aîîy violaio oir tiffli s-îiiary laws. It lS ho ho liopeti iii-niy otier cilles 'viii follow flic exanîpie. 117",
         "lis OBSERVATIONS AND -ANNOTATIONS. StEri. Cuî onu subuî'b or moiîtrîeai, lia been shutit. oir hront ail (-ontiinuîîiiti0îî oit viff tirx cl.y. M ttreal, as8 oua or tlie (laily :x.peui's give * it,, lias slaîxtf. su inticli in g-et tiu ri of t lu senialIPox tubaI. il, wouiti bu iiciols. to stio Ste. uiwgoîde t\u003e i ttlie dii5case wvithllin itý borders a.i to inaiît.aiîî at flie saine t.iîîe frel: in1teî'voursc wili the city. 'Moiitreai1 lias 01113 \u003clou1e %Vi Ste. Cuuulegrollide w1mat, it. \u003c11\u003c %l tii Wt qtmai':iîîiiiv\u003cl ils 11wi patienis, iL %w'uuld umui. luovu heen iiccessaî'y fui- Moîîtî'cal to quaî'aiitîiic tli( recenitly pî'enclied a sermn ot the 5tmbjct. o cure by prayer, ilid, acodi to t'lic Il ])ail3 Anrieaii, lic saki: ', N«lien Our 1Pal riarel w'as lM trouble lie (11(1 not trust, aII lus ehlmaîec.4 to prayer, ]lait lie %vent to %voriz. ]le did nl Inkie prayeî' as lthe sole ageiicy 10 soutire saféty. * le lirsi, pl'epai'cc(l «II liOssjIble iieaiis and tliexi cast Ilus Ilopetuu t ilu rhie u of t a iiii Go\u003ci. Iliose seekimg cuire b3 pr:uyer anîd Init: mnay f ake a lesson froit titis.- TjiS IbUiu eiii otinied ;.I od iiuvur pays «i preinitimi to iii\u003clici(' anid ilîe~ \u003ea i i Judaisin is that noble part of' ourî sotil by Nv'lûclm inami is elevated above aimy otiier creatuu'c; it, is the cxîresbioii Of the best disposition 0 f Outr ntature. WVieiiever %ve desire to give tti'unc to Our bcst titouglits, b«,-st seintenits, and be.st cmrotions, we pray, anîd the riciter tise soul Is lu thiose noble c1uaiities wluicli coiistittute a good mati, the nouher is tlîe ofl'eng wc brnm- to, God in the shaple of a prayei'. Prayer ite ruaI n0 mAtc the desire tua. God inay give us wltIa. wve,%v«iit, as thc desire to show our filili dcpendancc on our Helaveîîly Father.\u003e 1RECENTLY Dr. Blacksfock, of Tlioroid, iras cushled to attenid two chlldren wlto hiad becii sud- denly talien El1. Mie found Iliont suti'cning froin thic efl'ccts of minerai poison\u003e but no explutratiou could be givemi as to liow tiîey hind becri poisoiied unt-il a couple of days after, -trîsen lthe iothser's attention %vas called to somne mniiatuîre bronzed gardeu t ols whuicls liad been givemi as a bontus 'wtth somne candies the chlldren liad bouglut. Site Mîen remcenibercd te clîlîdren piatying wiltlt and 8tclng tiiese boys sliortly before tlîey ivere takeni slck. jpon investigation IL wIsS rouitd tlînt tîtese tools are coat.cd or b)roîîzed with a tomnposition contîsimin1g an alhoy of copper anid otiier poisonous xiieral. The ebjîdresi were for sonmie bure in a very dauigerous conditioni. Tlîn ntinber of bacteria per cubic mectre It tic air thtus is about 2,500; Is the air of a cll-y liospîtal Il is aboutt 11,000 cublc pier netre. JUDGE Cii x~,of Detroit, afliniîs thtat pills arecI lso cotise Inispenîsable t0 thue litniats race. s Tin. Ni.-I Yoîiw Sunl cals attention to the L.cUriuuis fact tiot M~arli Twain's artie', ini fli s Dedeînbuî' Centjiry, eiitit1Iý 1,10 PTe rivate Ilistory of a anag litFic, s, by an Odîl coitucidence, a contenilitipoticos supple- nienti 'fhdapter 18 iii the fi'st volunne, just printed, of Gexieral Grauit's iienîoirs. It iappears tht flic 01113'tiiinc tha.t Geniai,,l Grant %Vas real ly scareti was %wlien lie 110(1 lu iîeet the little arniy in ilî:I bis future publisiier was a prival a. At l\u003ealmyra, Grant, tiien a colonel, vas oidercd to iove aginist Col. Thornas liarrîise %wh w~as said bo bu cracaîn pcdl at thec littie town of Floridla, Fonte twe'\u003enty. five miles awaýv. In ]lis incînoirs Geneial Grant tells L how his hueart kt'pt getting bligher and bliglier as lie itppro:tclîed flic eîîenîy, uîllil lic feit ilt in luis tlîroat, buit wheni lie rezielied a point whetre lie expected to sue theicr and found tlîcy lbad Lfl'dy luis lhuart resunied its place. Mark TI'vain 1 vas one of thîe Ilcnemy,\" aîid tliat, le and lus fellow-solcliers wvcre cqually frighitened appears ii, bis frank confession iii thc Deceaitber * Cenitiry. Thîe différent bctwccî thic two soldiers * was that 'Mlark Twvaini was ilirovn, into such trepitation flint lie then and there abandoned forever tlie profession of arnis, wlierea-, Gencral Grant made on tbat occasion thic discovery tluat the enemy were ns inucli afraid of bini as lie liad been of tbem. This, says General Grant, -%vas a vicwv of the question 1 liad neyer takien before, but it wvas one 1 never forgot afterward. DISINFEcTION is a SUbject as yet very imper- fectly understood. We have always urged that there is danger in relyingr Vcry mnuch, upon disinfectants. A Spanisli physician, Dr. Jose de LetamendiC lias recently been rnaking extensive experinients relating to tho effects upon différent formes of bacteria of thc various ceeiical agents used as disinfectants. From his experiments, citiier the microbes have no part in the causation of infections diseases, or, ordinary disirifeclants are of but littie use as Preventives, for they will not destroy the microbes. Dr. Letaniendi reduces tlie mneans of disinfecting to two simple agents, FinE and WYATEit. Thxis means supreme cleanliness and complete creniation. We purpose refcrring t\u003co his experimieats at greater length in our next issue. TnE Germnn Imperial Goverament bas ordered the establishment of chairs for hygiene and bacteriology nut ail universities of the Empire. 118",
         "Oi33E~RVATIONS AND ANNOTATIONS.19 TiUe AnimalI eport of the Tlorolito local boitud or heatli lbas been received, tihowiiig \u003cfiait a gond deal of Saaiitary %vork lias Iteen \u003clotie tR progress mtade. The lî edical officer Ilowe'ver reports that. ', tke large inecrease of aiiortality froini typhoid fevc'r atiff diphith'ria iii thec last year, as compared iitil the lîreviotns y'ear, is a îr.atter foi- scriis vorîsideration Alter tîîakittg dite allowance for iinercase of ptipiilatio\u003et, the clifl'eretic is so great az, to call foi.' i iiiiied iate C otîsiderai ion or f' ia causie \u003cif t i.t mladties.'' %Vu ~Iitijoe aIl u(litg to tlhe report on atiotiier occassioil. FaoMr 01ILrîA (O11t.) theC viglilnt alid a1ctiVe miedival hlealtit othecer, Dr N'I1îott, reports, Altîtougli 1 titi niot able to preseuît quite snicb a ce.iaî bîill oif liatli as last year, 1 arn hîappy' to lie able to repîort tijat. %vu bave aot hail atty eitii.,of e;otitt-u.s or juaféi-tiots diNsc.. 'l'îet:hae ucio 01u 2 ncass fitaîx, Iii s, dit\u003e1, tiieia utr W ll\u003ei ng otigl Wu pitttîtsc chîatwitag swinle u~fî .on front the itteli- genit :mnd vitablu report uf Dr. Eliot for oua iiextist. IN~l cta.S for tlic înonth of Docenîlter, conîîpared witli the pre'-edinig moulu,. reports ini À cate tb.t lo ut i ti.tctiral gia, and Iplît- miii; ittcreased, ait I tvîihoid-fever, typhla- niia lariatl- fuvtr. atid di;irrlicoai. ileueasc( iii prevaleic. Cotîîparetl w~ith the aveî':tgc for thu inoittli uf Dc'etnlivî' iin the -à yc'ars, 187-i- 1.985, pnieu taon ia, reinit tunt- fever, tyltho tiiri;il fevuer, i ntcrii \u003cttenit-fever, fi plitiieria aii conisitnîîttion of lungls wvcre lcss prevaletut. iniD',cîbr 1885-. Elstowliere \"'c have niotetd hikt' rvportsý front) t1iis statu for flic thirce niotis prcviuits to Dcîceritter last. TlHîE 8111al.I îwx eidfein ie lias now about disapjîeared front Montreal. Onily about 25 ifeatlis to'îk pIlate froîn te iliseasc ditring the finst liaif oif tisi îîî\u003cîîtil ; 01- abolit otctttlflic iini ber' dnring, thte firzst hiaîf of Deccttîber. [S Mcutc.~sarragemets ave bccnl xîîad. liva loval Coliiiinittec of the citizutîs of l-lowvelll atigwitlt a Coilniittec of the state Bloard of Ilealîli, foir a ~\"îitîvCoti'ention tiib lilelti iii thiat cif v ont Mar 3rd ai\u003c 4tli, fiint. 1rEADEits cf tIis journial i n Michiganî %vill lie asie lusoswiIl bu: i ni'tfttie iliat. -ltl at titi e:rly day. Ilies.e GIosetis art. iîîiiversally ach iowledigcd to bu thec best mîade. il As itA'iý,Tt\" wotîld cotifer a favor by çeuitaiir lis ad t'c to the puttlisîters of àlati. It lias beeni iiîislaid or lost iii soute iîaccoitl- able way. FROMî AINE~, THE SrctFtrtaY Of the Stgte Boîard report d, Decotaber 23rd, that iiifor*ma- tion roct-ived at luis office inclicatod snrnllpox stilî generafly prevalet in the P\u003erovince of Qucbec. He tiaines 38 towns wiih wvere hknowtî to tuie Board to be, or lalely to have lîcca, effcd wîtli the dîsease. December 29Llî lie reported eiglîty-six places in tliat Prov'itice whlei lind been affected. 'VitE i1udical Inspector of lte New York Associatioti for htnproviîîg the condition of thîe Iloor. relports tMat tiiere are eleven public bals n the City open utigthe stinrr xontiis anid titat thriigbe season of 1884 tliese bats wvere patr\u003ciiid lîy 3,104,785 people, of wvhich 2,182,074 wvere feinal as, anid 982,711 maies. '1liesep)eop)le wcîeciiefly froîn tenementiouses. DunaNr. tho past ycar one buadrecI and ten tlioîtis;tîi peopile it is said occtîîuicd the 613 mons of the Grand t'n.on H-ote], New York citv 'Te charge for rouais is Si and upwards pe'r day, iiicltiditig elegant suites of roorn for fiilies. Ib is kept on the Euirojîoan Plein, and the hest otf everything is supplied at moderate lîricos. 'I'lio-e w'1w h'ava triccî it beliove thie)y ean fliv tîtere better, foir thte saute monney, than at aîîy otlier f'rtehsliotel iii New York. SoiMt Stîbsrribers coipiait tînt certain autîters of Mati nover roaeh tlioni. We can o:î-ly say, tuie fautît ni rst rest wiîlî bte local post office. A eopy is imoariMh, auaifod to eveirî, stib.i- criber. MttPsickness anci otiier causes of delay witii bte Itrintot have maîtde tItis nutaber late, buit Febrtîarv and Mardi tiataers wilI soion f'utlIot, atid weo triust, subscribers wvilI pardon tuie delay'. Aî.L stibicriluers remittitig $1 50 at, once, or .t an etitIv d\u0026y~. before accounit is sentiI receivebte JoviRNAL for onie yuar; butvvemtntst chia'ge$2 0 wlcîîwehav'e toenîd a lilland pei'liaps s'vrîtites. If every one woîîld retait $ .50 tiow we wotil mîîci prafur to, li se paid. iîstead of $2 iateî', and takze it as a favouti. 0OF wlîo 4 tri'd \" every furnittire cstablislî- mnit in Ottawa, atxd purcîîased cotisiderable furaittîre utates vory clearly tîtat lie can get liettur ftuittîre for te saine nioaey at the \".Art\" Il urniture %V,'arerooms (if Messrs Harris k Capbell, tiati at atiy otlier place iii the City. 'I'hîe deatîtis frotnt patent inedicines are cstiniated liv a writer in thte Britisth Mc'dical .Tolirîa'. tg) lie abiout otto huudred arîd ffry thIiousatid itiaii.l ly. 119",
         "CU RRENT LITEU.ATUJIE. (EMîS OP TlIOU\u003cflIT'- WRIiTEN FOR MAN. THE BROTIERIOOI) 0F M AN.- Foonis wII V8rIt-iitý. On sottie fàr totcd JE:î-stort tuA.\"\u003e 'T'wo brothers pirt od long ago; Citle jonirnoeyod toiwrdts te WTstcrni main Tî Vte othor %mçaodored to iltnd fro WVitItii the lîiis of his rice Untitli ho bond a rostioig tplace. il. Thiotigh thr altart our lot bc cist, 1lowo'or otîliko in longu-te or lite, At soilno lime inu tho sadowy tnstý: Our fiathors dtes have said atdieu. Laoh tini in ail the toetioig o.irthi '.Io onole0fond moothor trace titir birth. jolî i AR ]frotor I amake front lhy long Ietltîtrgy Wiilk forthi ioto the ivorld : spa rcli otit the ta-Ak 'lttis allottced theo teir of die mtttas 0f molorbid thiotight, tient evor blinideth theu. God ltatît a1ptointedl 0eh good iliai to ho llis %iarrior mu tho riîglttcotts cauîse ; go, alsk H is hettîsoit itl (ltfltg wratl c2tsîtto M1arclt forth to incol. thle coniiion onomny. JCcmgood dleed dono sitaîl bo a deadit-blowv given 'Umîo a sini coicevodi :o tto %ord si SîtîtI Ie et ja1vel in tient t matî itot speid li vain, its force (lotht cotle froto Ilestven. W'osle not the, tito-mnat's iinost spiit silli, Lifo withottt 1ttrlooso is a Iiogerittg deatti.'' A BA'ICH 01? BOOKs. A MoitrAi. \\NrtIPIfill by Oliver Wendcell tiolmuos, Crown 8 vo. pl). 327. Boston :lotig- toit, Imifiî \u0026 Co. Pricue 1 50 'l'hie autocrat stunotinces on the titl'-p-igc thiat titis volumet is the fitst opeîitîng of thte New, Lomfoico, ne'essarily iinplying that. it is to be follovoc1 by U\"other ôpeuings, while on luis Ikit page .lue caluuly itiformi-s uis that lio Il inay takie ulp the Nev IPortfolio agnin, and consider Nvlîmther it is worthi îhile to open il,\u003e whiclx monoits, presumnlably, that lie w'ont do it illtless lit is elitirely satisfted withl the sticcess of the fir.ït openhmtg, and being anl autocrat tîtere 15 of course 11o possibility of coupeliig hlm %Ve1l, lut tliis bu understood nt the outset If the liew Portfolio coutains itnltingl clse so gond as \" 4 orlal Antipathq,\" Dr liolines' love for his fellow men and desire to advance thecir hest iiitero5t are too wvell knoiva to put uls in any Uncertainty as to ivîmtîter it ivili be opeued iagaini or tuot, for this last %vorki of luis, if riot altogether the best, !S one of tîxe best luis peml lias produced While,:tts iin '' lsie J1,nîeiaie the plot hinges uipon an abnornial phase of human nature, an cxtraordinary attltiflthly to wvonitti ind'in the Itero bcing sutbstitmuted for the ophidiaxi cleniemt in the liroine Nwlîichi lent peculiar fascination to the earlier work there is also in addition the£reto a chatty dis- cursiveness whluih constantly reininds one of theo 't Breakfast Table Sories.\" 'rme story if; n vers, sîimple otie, providcd cif course- yoti tako Vhe Doctor's wvord itîtîtesit- atingly for %vhiat inay ho ternnd thte niodical suhe of it. Maurice Kiikîvood wltile an inifant in amris is iiiintentioîîally givm:-n a terrible frighit by a heautifiti young girl,and so intense is the effect upon Itinii-thtat tluonoe-fortlh theo near p)rOence of a lovel)' yoiing woinati, nitînuattor tinder whiat circtiinsîauceS, serits hini off forthivith inito a doadly swoon. 'lhis coustitutos the mottai. antimatmy, froni whluihtho horoitue, Etithynuia 'lowor, uiltiuuateiy resetteslm niiiia unanttor soi driuatie tiiot we xvill not spoil the ittrest of the.3torýv by revoaling it liero. lies tîtese two chiof actons tluere is at %,et admuirale audf iouposig il girl withi brains \", bliss Letîreda Vincent; a dear ohi Dr Blittis; a niost inter- rosi ing and imiproving Ptîtsolidie.an Society at whicli roînarlahly clever papers are rendl ; an irreptessîle modern il ititerviuwer,\" tuid it score of otlior entertainiug characters who in one formu or another ftumnisli outlets for the wviter'm wise, %vitty, tendon, andi trencîtatit notes and comittos ti mietn and tluing-s. It is not a book to lie haRtily re\u0026td, nor tu be latid aside after a single reading, but like everytliug else Dr. Ilolmes lias ivnitten, b o rond first of ail for the pure pleasoire of the reading, tlîen ru- rend for the profit, and theti takzen tep again and dipped loto bore and t4eo for mental refresli- ,»ent in tine3 (if woariiss 'ite ncxt opening of this woiitierfll P\u003eortfolio ivili lie eagorlv looked for by ail wvhnt rond *4 fi morti u:îîa1.î\u003e",
         "A BATtCII OF BOOKS. Iit'ooEIi umîA\\*ig) by Frank R. Stoekton, illus- tnitud hy A. B, Frost, Crown 8 vo. Newr York: Chles Seribriers' Sons. Price S2.00. Flore is 411s old fiand il such simuptueous attire that if it dlid net fit liiiii 50 wehl ilid becoine Min se adîuirably thers nîight be soe dîlihilty ii recognizing Iini. We have always faIt griitofffl for the chance wvliiclî a few years lige ititro\u003cliiccd us t(\u003e IL Radder rge' l\u003eerhaps it %vould h\u0026ýve been more correct te hiave %vritteîs t Newsbov iustead of il Chance' ihi the last sentenîce, liearîse it wvis ou hoard a train tîrat eue of tliesc irrelîressibles tltiti-g a client)(jnna(lian relîrint of tIe book (hy whielî I ficar tlîe aîîtlîor proitvd little) into oui- lap. l'lie ochd tithe seciire(i thie pur- chase oif tlîa bookl, and a pertisal of t.he first iliahter conviîiccd tlîe reader thiat a most excelioxît itîvestuient liad been îîînde, while a readiiîg of tîîe wlîole svork estmhhishîei the lutherte uinkîowis lraukz Stockton upon a îîedestal froînt ivliel lie lbas not yet decended .îlfronts vhîich, *tiuigin-- by tue excellence of luis Iater %vritings. lie is set likehv tu deeund in a i urry. ffllatever e11îr opîinion îîîay be worth, lierc it is-tliat thie atier of IL Rucdder Grange I is the( mist origz inIl, retimseu, nuraI humnorîst nt prenaent emtertaining the pubîlic, and iiaviug mande thuis confession of fait. il is perlîaps imilîc ssnry te nild mort!. But tiien thir edition et IL Rwdcr Grange couitainr more titan the eriginal stery It is aîîîbellislîed with a wealth of illustration frein the parîcil ef A. B3. Frost, tliero being ovar ene litindredt in ail, svîiicli for aptiiess, accurncy, and syrn îîtletic i uterpretation of the autlîor's \u003clrolery could lînrdhy have been sum1pas3ed1. Fiiiîiiliar as wua were wh th Iudder Grangqe thiese illuîstratiens seduced us inte anothuer reading just tliat we miglit get thîcir finI flaveuir, and haivimîg gene tlîrougls the book iii tlîis way, 'vo ivere at a Ioss te unuherstand heow it coutl ever hiava Lyot cri ivitholît themu se long. flowvever, tt-x-t aîîd il lusmtration se pecuiliarly fitteil for ecch othier hîaviîîg thuis heeru happily wedded uinder the auspices of Messrs. Scribtiers' Sous, they, can neyer agajis be divorcod , îînd :\u0026 Rdder Gra;nge\"I thus w'orthihy equîpped takzes a place ne ether book cati tilt as aL lîrennial source of enter- tain niant.. Bruni WrAYn, by Olive Tl!pie Miller. 16 nie. pp. 227. Boston :l-Diugliton, Mlifilin \u0026 Ce. I\u003erice $1 .25. Thîis dainty little volume iii its clarkz green bimiding, prettily relicved lîy an einpity cage, and Iitting bird stamped i gold on the frent cever, ii prove a genuine reveuitiou to mny a bird lever, ad can hardly 1h11l to awaken interest in. anîd syni- pathy for birds amoîîg tilose whe have hitherte been altogether ixîdilierent to thie charins of the winsome creatuires Mrs. Miller lins dcscribed with sucli delightftil spirit. WVa liad the pleasure of -reading noverai of the papei; iii this bookz whien they appenred in the Allantic Afon1hid and la rper's Magazine, and thuts lînd our appetite whetted for those that now appear for the firi;t tine, and combine to inake one of the best bîooks about birds with whichi we are acquaintcd. Mr.Q. Miller seis to have pos- sessed every qualification necessary for making a caRrteftîl stuidy of these tricksy ariels wli site so grnphically describes for us ; plenty of tirne, infinite patience, entire self-control; grat ingenuitv, aud above ail a profound gympathy wvhich ,enabled lier to rend aq it wvere tha very lîvart of hier littie visitors-for visitors they only were-never captives. 4' The moment one shows a desire for liberty for the worlil olitside my windows, lie is glndly allowed to \u003clepnrt; Il such, wvas lier ride of action. The Robin. 'I'hirushl, Cat Bird, I3lack- bird, Oriole, and Spnrrowv have eachi severaI chîîpters devoted to thein, anci one rises frein a pertigal of thre book, flot enly quite rendy wvith irsq. Miler te Ilrecognize in thý biirds soute- thitng like intelligence and reason,i\" but willing to admit with lier 41that; tlîey too liave their opinions, nnd could express tlîem, if voit coutl only uinderstand their language.\"1 %Vhiie tIse mor-al if; flot; very obtrtisive, there is ouat ail the saine, and it is this cl Be kind te the hirds. They were not msade tn be slaughtered ruthlessly, luit Ie brighten tihe world by their beautv, and charin it witl 'i thieirroug.s,\" and if suy inan or wonîan cani rend \"Birds-WVnys 'l without rcsolving to deal, more considerattely with their littie feathered friends hiesceforth the fultae pisninhnwsnt -hould be relegation te a lîmbo wlîere things are rever.sed, and the birds have it ail their orfl wfty J. M. 0. Tiîi. DECoi.ron %Ni) FutNisinsn for Decenîber ir, one of the most elaborate of aIl the Christrias magazines and one of the best, in an artistic and pmactical qf-nse, that this pumblica- tion bias givéti sq 'Chero is a bealitifiil colored plate, shiowiugi ant apartme nt decorated iii MNoorislh style, and there is a supplcmentgiving the studio of Frank L. Kirkpatrick, the artist. 'Phere is an elegant design for an Entrance liall, a most interesting account of th\" ilraidtce Exchange, svith sketches of its new iuilding, un illustrated paper on Chantilly, design f\u003cîr a lzitchen, decoration of city lieuses, Christmaîs decoratiens, design-, for cahiîîets, miantels, etc Articles on furnishing couutry bouses, pictuire framies, art events, cus'tain hintging, and a vast; numt-ber of other valtuable iînà iuteresting piecvs. The magaszine is puiblished at 32 Enst i4th Street, New Yorkl",
         "122 CURREN\"f LITERZATURlE. 'r CFNTriiY MAGAZINE for J11mnnary iS It ricl nuimber, ftilly susttiining te Idgb reputa- tien of tItis best of inontlîlies WVe are tretlei to et Th'e City of 'leliermn '' (2indI pupur) tatd a i'ery interesting paper, \u0026t Fenflhencil forils cf otîter da;ys,'' liotît lit isuly il'.Lac. Alâu i. 'lypit i tlogs-pcîtiters - anîd t-''lie lessot cif Greek Art.\"' [n al Poein, by Prnof. C2harles G. D. Rloberts, of Rings UCllVge, WVintlsor, Novat Scotia, wve read 0 cîtîlt of natiolîs, criant liribeit, Whoi stalnd'sL aiiii the nations îîow Unhliedetl, îînîuloined, urinlîinned, XVitli unanointed Urov The saxon force, thte Celtie ite These are- tlîy iiiauhuod s lieritage Wlîy ro'st %vith babes and slaves ? ýSel:k highcer 'Tle place cf race anid age Anit in a good airtic;le on ilî Sîuiritulal Pîeachi- iîig of Ounr imles ', hu followiiîîg: Scienîce lias grandly stilitulated imîtlistti' by iîîcîeasintg i ts iewards. The-u [\u003eices (ifi emterprisiiig labor are great, ofte-t glittiritig 'The poNver of wvaltlî i fà.,cilnating. 'I'lîei stiuccînsfi I prodicer or dealer of to-day is il, prince Tiie itttistriotis laborer is ricli. And the rusait tif a1l tItis is that laziness is ceasing to Uc fasîtionable ;-the nobilily of Piîglamîdl are lentiig Lu itiake tîremî- selves tiseftîl. Science scts the wcrl l astir Th'le goal of ils muotioni is gain Tterace is eager. H ence iniiiitîo-%or.s i p. i-ii'e inercanitilIisim, the i tieiititef estimante of -%veitîti; the gta\u003ching cf ailI tlîîugs lit ai value in cash . srtciety gradeit on a ca'li Luitsis ;îidîlty satuilîceud Lt inxteiial gootl vil-tue. paîtriotism, hieroisin, rnanliood couîiting for less, ' noney coiinting for more tvotes, cilices, justice having thecir price. Thtis is iiiercantilism, thte grotît danger to sccîety; gîeater bias mure subtle tItan itliit. It reiititu literature, sciencLe, ait, pitlitics, te statu, Ille cliunch , :nîd lîeî'e arises tîtu deianti foi' that spliritual ftebiîg wliicl feul fnotn the lip!3 of Jésus, thte antidocte l'or inordinatu worldly cane aint worldly Sttiving Ilte 1011Y Vie of .1 lire wliclh is niuc titîc nieut. 'Illie cure fûtr te icantitile spirit is flot allties, bnt faiLli. It is miot ai moral code but thîe divine I\"atlierood. T1HE M MA DO WVALTZ, by Coote, is an arrange- nient of tle niost taking airs fî'oin Gilbert \u0026 Suliivan's latest oper.t Contailning the geins only. Fratise is unnecessany. il M.%uîv D.iiiLi.Nc b1U5T YOU LFAVE lw ? Il by H. P\u003e. Daîuks, is il Yei'y pretty sentimental effusion. 'Te wvords are very nice, thme author and beemns to hlave %vriitLen al Song wliicii will nuîie Itini more filuniotîs tI\u003ean .. bilvur '1'hrcids ailiong Gold Il did. LITTLE Aui SID, [Th'le Cliinese Rh!.] by .1. P. Skelly, is a funny litt'e piece coneerni\u003eg il littie teClIcs Kid \" %vlio \u003c\u003e1 fir, sueing an t\u0026Amnr- - \u003cati Blliible Iuu tales iL t,\u003e bu Mulicitri ltitue fl y, alid\u003c is Si Ii ld cii igy 'l'lie ;IuIblihiieis8 flen tut iiti the aliove tlive iUti s tf lii use lipiti on i cccip or 6M Ot s., (\u003efl.e*liii! the regiil.r îtiui AliitS iiiAii A. SAL.tiî,12 Bible Ilotist, NUNw York. 'l'îl WTEEI of Torontot entens tupon its, third l'eut cf pub liication soilewltat, ai tured aîîd niiineh improved !in aperne whvile its conitenits railler more itan xnîiintain tht- bilti standling- \"'idlin bs (ltneeielthle j1ournal front its cotnuwnccent.IL stîstaitis %vell toc\u003e ifs pi- niised nd tidcein iiolitie8, tout it i.s qutite refreshiing to rend it after ot-e bas rend lte two extreiles i n tlIe ord in:try dai y paupers. Pli - tietal quîestions in Great Imitai n atre Lre:tted by theu ilecl ini ait equtit 1\u003e i n(lpetiident iti;i nier. NeL oîîly is it ioilciati' antd indelpentleît on jtoliî.ical quiestion.,;, butt it is likewvise so on the tenil)tiaic qiîestitn. Thomcnas l itiglies, atitlor onlv one Englisît weekly plier, l/te S,îpclellor, antd onc tanatdian, llie Ile'ek, antd ;s n rit le 1 .Shonil( be I);îtNl to sayt vlîich 1 slîonld mi-ss m'ost.'' Snli Jonlni ritan 81lotld receive, liUeri ecîngcit 'l'ut IN\\DIAN isq a 110W ftlrtnigbitly Jolitîrurd, pub sicd:t JliesilOnt iii thie;iicet of the hIdians. IL is edited by tan Itîditn, Dr. Jones (son of the late 1ev. l\u003eeter .Joues), a nîtdical praetitiotîer, anti anl M. D. of' Qîteen's Cclleg,-. 'Sctne vears agO, lie Stcee.'sftllly urgeil the stroîit- daimus cf the Onîtario Indiins- tii the frnichise. %Ve have rei.ieveci the first two ntinlbtrs of tlie iditin. It is evidently ILbly editeil antd contains papers on Ilistorical, anir.cltîgit a auihtipl itical si\u003ee.s of intîu.it intert-st. %Vu tnict, it ilnay andi bulice it will be of mocili service to the clescendentsa of the once owners \u003cif titis gresit country, and hielp to niakze luway of theun, wltt they give promise in tlieir Journal to becone,\" ý---til citizens. Gniu' toc\u003e lias greatly fimproveit silice the ccniînncîniitof te Voir. It înaliifests at greatvr degic of indejiendience tlIani it acntntslai done, and ks a higlily r'ial conic japer. Ve wisbi it a flill share of 'I'II Pi\u0026so and Swx ~cîN uvrie for sale oiti îîith)tict p-gt ai c lt-.n,t Units., inbtrît- meiits anti a gtiLit bargain. Any o11e ivanting aL Pijano or Suing- Nl.ttliitie votu1t1 bu wvise tu celuni linicate %% ïtl the alvii Liber. 122"
      ],
      "published" : [
         "[Ottawa : s.n., 1886]"
      ],
      "identifier" : [
         "8_04585_3"
      ],
      "type" : "document",
      "title" : [
         "Man [Vol. 1, no. 3 (Jan. 1886)]"
      ],
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      "location" : "http://eco.canadiana.ca/view/oocihm.8_04585_3",
      "key" : "oocihm.8_04585_3",
      "source" : [
         "Library and Archives Canada."
      ],
      "label" : "[Vol. 1, no. 3 (Jan. 1886)]",
      "media" : [
         "text"
      ],
      "contributor" : "oocihm",
      "note" : [
         "Monthly"
      ],
      "lang" : [
         "eng"
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   "doc" : {
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MI,JCAL \u0026 SURGICAL JOURNAL FEBRUARY, 1886. Orviginal So'mmunications. SKETCH OF THE EARLY HISTORY OF ANATOMY.* By FRANCIS J. SHEPHERD, M.D., Professor of Anatomy, McGill University. The origin of anatomy, like that of- many other, sciences, is lost in the mists of ages. The embalmers among the Egyptians must have had some, rude knowledge of the human frame acquiréed in their process of preserving the dead, but, as they belonged to the lowest class, and were abhorred and despised on account of their occupation, what rougli knowledge they may have got concerning the arrangement of the internal organs was kept secret, and so not used for the general good of the coin- munity. It bas been asserted by some that the Greeks of the tine of Homer were well acquainted with anatomy, and that Homer, in describing wounds, showed an accurate knovledge of the struc- ture of the hûman frame; but the fact is, that the terms used by Homer were then the common ones employed by the people, and .had no exact scientific significance. In later times these samà terms were used by alil anatoinists in special treatises on the subject, and conveyed a certain definite meaning ; thus Homer's knowledge appeared much greater than it really was. Eusebius states that Athotis, a traditionary monarch of Egypt, wrote several treatises on anatomy. Hamilton, who wrote a Enlarged fron an introductory lecture delivered before the Anatomical Class of MeGill University, October 1884. 25",
         "CANADA MEDICAL AND SURGICAL JOURNAL. History of Anatomy and Medicine in the first quarter of this century, speaking of this tradition, quaintly remarks that \"when we learn that the æra assigned to this fabulous monarch by the wild and improbable chronology of the Egyptians would carry us back to an age prior by many centuries to the formation of Adam, we can easily estimate the degree of credibility to which such a fable is entitled.\" Acmiton, who flourisbed some time before the advent of Hippocrates, paid considerable attention to anatomy, and is said to have made dissections, principally of the lower animals. Among other things, he asserted that goats breathed through their ears. Hippocrates, who lived four or five hundred years before the Christian era, and who bas been called the Father of Medicine, vas the first individual who wrote a work on anatomy ; his knowledge of anatomy was superficial and often most erroneous, and probably rested more on shrewd analogical conjecture than on actual observation. He, however, had a fairly accurate acquaintance with osteology. It is asserted by Pausanias that he hung a bronze model of à skeleton in the temple of the Delphian Apollo as a testimony of his own knowledge and for the instruction~of posterity. It is highly improbable that he ever dissected a human body. Diocles of Carystius, who lived a century after Hippocrates, and who is called the second Hippocrates, is said to have devoted much of his time to the study of comparative anatomy. He did not, as was the custom in those days, make a secret of his ana- tomical knowledge, but taught publicly, and was the first to write a manual of Dissection of Animals, an art, previous to his tiue, confined to a few families, and handed down from father to son by oral instruction. Diocles also wrote on Cookery, and held it to be as much a science as that of medicine-an opinion with which Plato altogether disagreed. It is with the appearance of Aristotle, the preceptor of Alexander, that we must first date the systematic cultivation of the science of anatomy. To him, without doubt, should be awarded the credit of baving founded Comparàtive Anatomy. Many of his admirers, without much reason, claim for him ai4",
         "EARLY TISTORY OF ANATOMY-DR. SIIEPHERD. intimate knowledge of human anatomy; that he dissected ani- mais is no doubt true, and aiso that he lad a marvellously accu- rate knowledge of marine animais, but to say that he was a profound anatomist is absurd, and is not substantiated by what we find in bis writings. For instance, in his writings he states that the kidney of man r.esembles that of the ox (which consists of many reniform bodies), and is not smooth like the sheep, that. the human uterus is double, that the back part of: the skull is empty, that the brain is without blood, and many other things equally absurd. His know- ledge of osteology was also limited. [He asserted that man had no astragalus (a bone in man forming the keystone of the arch of the foo), \" neither,\" he says, \" have many-toed animais, nor solid-footed animais.'' Now this bone is never absent in mam- malian animais with limbs, and it is evident that Aristotle never looked for it, but asserted that these animais were without it on theoretical grounds alone, for in one of his works, \" De partibs Animalium,\" he gives elaborate reasons-why certain animais have no astragaloid bones. He also stated that the bones of the lion had no marrow, and that the necks of wolves and lions con- sisted of a single bone and had no flexibility. These points ho could easily have made clear by actual examination. He, like Iippocrates, thought that nerves, ligaments and tendons were the same thing ; he gave, however, a fairly accurate description of the great blood-vessel, the aorta, and distinguished the wind- pipe from the gullet ; lie also had some acquaintance with the structure of the larynx, and knew that the ear and throat com- municated. N- doubt Aristotle, for his time, was a good com- parative anatomist, and some of his observations are valuable, but lie so mixed up his facts with fiction that it is not easy to separate the one from the other. He was the first to write a treatise on Comparative Anatoiny. Plato, although ho did not study anatomy practically, fre- quently refers to it in his writings. His references represent, no doubt, fairly well the condition anatomy and physiology lad reached in his time, for ail philosophers were supposed to know mucli of physic, under which anatomy was included, but sup- 887",
         "CANADA MEDICAL AND SURGICAL JOURNAL. position and assertion are so substituted for facts that his anatomy appears nearly altogether fanciful and imaginary. The name of Praxagoras of Cos, the last of the family of the Asclæpiado (B.C. 341), has been handed down as the individual who distinguished the arteries from the veins, and who first asserted that the arteries were air-tubes (hence the name oppa), an opinion which was held for several hundred years by his successors, and to which I shall refer later on. Up to this time all knowledge of anatomy had, been acquired from the dissection of the lower animals, but we now enter upon a new era of great and rapid progress in anatomical knowledge. In the division of the empire which took place on the death of Alexander (323 B.C.), Egypt fell to the lot of Ptolemy Soter. He and his successors, Philadelphus and Euergetes, ardently encouraged the study of letters and the sciences. At Alexan- dria, a great library was established and a school of philosopby founded.* Alexandria, under the fostering care of the Ptolemies, soon outstripped its many rivals not only in literature and science, but in wealth and commerce. Learned Greeks, glad to escape from the dissensions of their native states, flocked to Alexandria, where they were sure, not only of protection, but of a hearty welcome ; thus whilst the rest of the civilized world, distracted by intestine troubles and ravaged by frequent foreign wars, was fast sinking into a state of semi-barbarism, the Egyptian Greeks, protected by the wise and peaceful government of the Ptolemies, not only kept alive the flame of literature and science, but added not a little to its volume. The Alexandrian School of Medicine, participating in the general prosperity and advance, attained a renown far exceeding that of any school which had previously existed, attracted pupils from all parts, and produced many emi- * Ptoleny founded the Museum (or University) of Alexandria, which was an estab- lishment for te cultivation of literature and science. To it were attached hotanicl and zoological gardens for the purpose of practical study. One of the nost important features of tie Museumn was its public library, which was supported with tlie greatest liberality; whenever nanuscripts of acknowledged nerit werc offered for sale, they were immediately purchased, and the wliole known world was ransacked for curions and useful MSS. The list of teachers in the Alexandrian school includes such mîmes as Euclid in Geometry, Strabo and Eratostienes in Geograîphy ,Arclimedes in Phy- sis. Ilipparchus and Ptolomisus in Astronomy, and Erasistratus and Herophilus ii Anatomy and Physic.",
         "EARLY Hl1STORY OF ANATOMY-DR. SIEPHEIRD. 8 nent physicians. Among these were two who did more than any previous individuals to advance the science of anatomy. These men were Erasistratus and Herophilus. They both wrote large works on anatomy, which are, unfortunately, lost, but from which Galen, Oribasius, and others quote extensively. Herophilus and Erasistratus were probably the first who ever dissected the human body, for Philadelphus and Eurgetes gave orders that the bodies of ail criminals should be handed over to the School of Anatomy for dissection. Thus at this early period, when the dissection of a human body ýwas looked upon with horror and as an act of desecration, the enlightened and far-sighted Ptolemies, in spite of vulgar prejudices and religious scruples, enabled the School of Medicine of Alexandria to make a great stride for- wards in learning, knowledge and reputation. It is said that Herophilus dissected 700 bodies, and that both he and Erasis- tratus made a common practice of opening living bodies in order to discover the origin of life. Tertullian, a learned father of the Church, who lived at the end of the second century, charges Ierophilus with this crime; he says, \" Herophilus, that physician, or rather butcher, who dissected 600 men in order to find out nature, who hated man in order to learn the structure of his frame, could not by these means come to a more perfect know- ledge of his internal structure, since death produces a great change in ail parts so as to render the appearance after death different from what it was before, especially since they did not die a natural death, but expired amidst ail the agonies to which the curiosity of the anatomist was pleased to subject them.\" Celsus, who lived about 20 B.C., also says that Herophilus and Erasistratus vivisected hunzan beings ; he mentions it incident- ally, as if it were a well-known fact, and does not appear at ail shocked at such a proceeding. It is very probable that these anatomists did occasionally vivisect a criminal, since human life in those days was considered of little value, and the people were accustomed to see criminals cruelly tortured before being put to death, so that vivisection would, perhaps, be regarded with less horror than dissection of a dead body. It is the custom of his- torians to attribute these charges against Herophilus and Erasis- 389",
         "390 CANADA MEDICAL AND SURGICAL JOURNAL. tratus to blind and ignorant superstition, and to utterly repudiate them as unworthy of belief, but for the reasons .given above the story seems to me a very probable one. Herophilus, whether the charge against him of vivisecting human beings be true or not, was an able physician, an accom- plished anatomist, and a learned man. Galen says of him, \"I He -was an accomplished man in all branches of physic, excelling particularly in anatomy, which he learned, not from the dissec- tion of beasts alone, as physicians usually do, but principally from that of men.\" He discovered the lacteals and the pul- monary artery, and described correctly the liver and organs of generation ; he also described the blood-vessels, and a large blood cavity in the skull is, to this day, called the \" Torcular Herophili.\" It is said that he was the first one who operated for cataract by removing the crystalline lens. Gabriel Fallopius, one of the most distinguished anatomists of the 16th century, said that he would almost as soon think of contradicting the Gospel as the authority of Herophilus. Erasistratus is supposed to have been a contemporary of Herophilus, and to have flourished in the reign of Seleucus (B.C. 300). He was an able anatomatist, and accurately des- cribed, for the first time, various parts of the human frame, as the brain, nerves, valves guarding the orifices of the heart, etc. Ie it was who first divided the nerves into motor and sensory. le believed that the arteries carried air and the veins blood, also that the only use of respiration was to fill the arteries with air. This has been adduced by some as evidence that he had never vivisected human beings, for had he done so, say his de- fenders, he must necessarily have found out that the arteries were full of blood, but, as I shall show later on, this argument can have no weight. Erasistratus was much opposed to bleeding and purgatives, and treated his patients solely by diet and regimen. He con- demned strongly complex prescriptions, and, in fact, left every- thing to nature ; he might with truth be called an \" expectant physician.\" Herophilus, it is said, held opinions- in physic dia- metrically opposed to those of Erasistratus, and believed in actively interfering with disease.",
         "EARLY HISTORY 0F ANATOMY-DR. SHEPHERD. 391 From the time of these two anatomists to that of Celsus little was done to keep alive the science of anatomy. Celsus, who lived towards the end-of the last century before the Christian era, gives in his works, which are valuable repositories of the medical and surgical knowledge of his time, fairly accurate anatomical descriptions, but he himself does not seem to have done any original work in anatom-y. The first Roman anatomist whose name has been handed down to us is Marinus, who, according to Galen, described the muscles accurately, and also mentions the mesenterie glands. Soon after Marinus, Ruffus of Ephesus, a Greek physician, appeared. He vivisected animals and devoted himself to physiology and com- parative anatomy-; he made some discoveries regarding the abdominal viscera, and especially the uterus. Of all the physicians of antiquity, none attained to so great a fame as-Claudius Galenus of Pergamus. His reputation is deservedly great, for none did so much as- he to advance the knowledge of physic. ,He wias born A.D. 130, and was educated by his father Nicon, a mathematician of repute, as well as an architect and astronomer. Nicon .early initiated his son into the mysteries of Aristotle's philosophy, but Galen also studied philosophy in the schools of the Stoics, Academics, Peripatetics and Epicureans. ' With the exception of the Epicureans, whose doctrines he utterly repudiated, he is said to have taken from each what he thought to be the most important part of their systems. At the age of seventeen he began the study of medi- cine ; he soon outstripped his teachers, and early exhibited proofs of the greatest ability. His renown spreading abroad, he was brought to Rome by the Emperor Aurelius, and in that city he practiced till his death at the age of '90 years. Over his contemporaries he acquired great ascendancy, and held the s'ame position in the medical world that Aristotle held in the world of general science. For hundreds of years after his death his doctrines and opinions held sway, and his sayings were re- garded as oracular. Few ventured to oppose his tenets, and up to the 16th century all the medical books were merely com- mentaries explanatory of Galen's work. If any one advanced",
         "392 CANADA MCDICAL AND SURGICAL JOURNAL. a new theory as to disease, or stated what lie believed to be a new fact, it vas quite sufficient to show that it was opposed to the opinion of Galon, to bring down shame-and disgrace upon the- heretical innovator. Although Galen studied, among other places, at Alexandria, it is very probable that his knowledge of anatomy was gained chiefly from the dissection of animals whose structure, was supposed to come nearest to man, hence his ana- tomy is not always the most correct. Previous to Galen's time, it was thouglit the arteries carried vital spirits or pneuma, and so convinced were the ancients of this \" physiological fact \" that, although they were fully aware that when an artery was wounded it bled, they used all their ingenuity and powers of reasoning to explain how it w'as that a tube containing air should bleed when cut. They held that the air first escaped through the wound and thon blood came from the veins by communicating channels, to fill the vacuum. Galon fully exposed the absurdity of this belief, and, by experiments on animals, showed that the puncture of an artery by the finest needle immediately gave rise to hemorrhage, and that no dis- charge of vital spirits took place. lie also placed ligatures on. the arteries at two points, and demonstrated that the portion of the artery between the two ligatures contained only blood. The Alexandrian anatomists said: \" Nature could not have made two kinds of vessels, both intended to contain blood.\" But Galon replied: \" You might as well say that the several stomachs of ruminating animals were not all intended as the recipients of the food, but that one was meant for solids, one for liquids, and one for spirits ; they are all the recipients of the same thing, but each, nevercheless, has its separate use. So it is with arteries and veins.\" (Galen's Opera Omnia, Vol. IV, p. 722 ; quoted by Dalton.) Galen could not explain why two sets of vessels existed to carry blood, but he knew both contained blood, and this he satisfactorily proved by experiment. He did not, as was then (and is now) too commonly the case, start a theory and endeavor to make the facts dove-tail into it, but founded all his theories on experiment and observation, as every -true philosopher should. It is very improbable that there were any opportunities",
         "EARLY llfSTORY OF ANATOMY--DR. SIIEPHERD. 393 at Rome for dissection of human bodies; for Galen advises student's to visit Alexandria in order to study the human.skele- ton, and not to trust to book descriptions. Itis evident Galen hinself had few opportunities of studying even the human skele- ton, for he expresses great delight and astonishment on one occasion when on bis tra'vels he had the opportunity of examining a skeleton which hadbeen exposed by the washing away of the earth which had covered it. Galen added bût little to our knowledge of human anatomy, yet by bis researches and arrangement he brought together all that was known up to that time, digested and systematized it, and made it the basis of a medical education. He was a good comparative anatomist, and most of his original descriptions are derived from the dissection of monkeys. His style is clear and correct, and there is not so much confusion as is seen in the authors preceding him. Many of the names he gave to different parts of the body, especially those about the brain, are retained to the present day. With Galen's death anatomical science declined-nay, was almost extinguished. For many centuries the men that followed him looked upon anatomy as a completed science, and Galen's .works on the subject were regarded as sacred and infallible. It is strange that in ancient times all the great names in anatomy are those of Greeks, the Romans, though rich in soldiers, states- men, poets and orators, never produced any one who was great in physic or any of the sciences. With the fall of the Roman Empire and rise of Christianity, all learning, especially that having its origin in Greece, declined, for it was thought by the Christians to be the cause of all here- sies. Anatomy suffered with the rest, principally owing to the prejudice which existed against the dissection of the human ,body. Dr. William Hunter, in a lecture delivered over a hun- dred years ago, r'emarks that \" when faith was thought to be all that was worth acquiring, and prayer almost our onIy duty, there was an end of liberal education and every ingenious inquiry.\" From the second to the eighth century but little progress was made in anatomy. The names of writers in anatomy during this",
         "394 CANADA MEDIOAL ANI) SURGICAL JOURNAL. period are those of mere compilers, such as Oribasius, Meletius, Theophilus, and Soranus; the last mentioned appears to have dissected the human subject, but he added nothing to what was already known. About this time, what little of science and learning there was in Europe was transferred to Asia; this transference of learning and science from the West to the East is coincident with the capture of Alexandria, which was then one of the chief seats of learning. There the Saracens were first brought into contact with the literature of Europe. When the Northern Vandals overran Europe,they drove from it all that remained of learning and culture, and ignorance was universal. A few monks and quacks practised the healing art in a rude waybut anatomy was altogether neglected. The lamp of science was kept feebly burning by the Saracens, who, although at first despising learn- ing, later encouraged it. Tihe philosophers of the West found refuge in Asia, and were protected by the wise rulers of the Saracens. It bas been for ages a common belief that at the capture of Alexandria its huge library was committed to the flames by the conquerors, and all its treasures, both literary and scientific, destroyed. The only authority for this story is Abulpharagius, who flourished about the middle of the 13th century, nearly six hundred years after the capture of the city. le relates that John Philiponus, the celebrated peripatetic philosopher, requested Amrou, the Saracen General, to spare the celebrated library of the Ptolemies. The General referred the matter to the Caliph Omar, who replied, , If these writings of the Greeks agree with the Koran, they are useless and need not he preserved; if they- disagree, they are pernicious, and. ought to be destroyed.\" Abulpharagius goes on to state that the library, in conformity with this decision, was destroyed, and that the books furnished the Arabs with sufficient fuel to heat the baths of the city for six months. Now, in the various histories of the siege and cap- ture of Alexandria, written soon after the event, no mention is made of the destruction of the library. Besides, it is well known that the destruction of such treasures would be ùtterly repug-",
         "EARILY HIToRY OF ANATO3Y-DR, SIIEPHIERD. nant to the Mohammedan precepts, which distinctly declare that religious books of Jews and Christians should never be committed to the flames, and that works of profane science may be lavfully applied to the use of the faithful. In addition to this,.the Sara- cens took a great interest in medicine, and it is even said that the prophet himself wrote a book of medical aphorisms. So it is mostanlikely that the Saracens would destroy the numerous works on that science which -were contained in the library. Again, it is welt.known that Alexandria preserved its reputation as a sehool of science for a considerable period after its change of masters. Possibly part of the library was destroyed previous to the capture of the city by the mob of Christians led by Arch- bishop Theophilus in A.D. 391, and the rest was gradually dis- persed in varioûs directions, as happened after the destruction of Constantinople. (ffamilton, History of Mledicine.) The Saracens ardently encouraged the study of medicine ; the Caliph Almansor, the founder of Bagdad., offered large premiums to the translators of Greek works into 3yriac and Arabic.; schools, hospitals and libraries were established in Bagdad, Cordova,* Seville, and other cities. At one time Bagdad has as many as 6,000 students. Soon a race of learned Arabians arose, who did much to preserve what had, up to that time, survived the sanguinary conflicts and destructive fires of the dari ages. In the department of medicine, chemistry and pharmacy are most indebted to the Arabians, and many terms employed by them are yet in use, as alcohol, syrup, julep, etc. Littlie or no pro- gress was made in anatomy, as, owing to the strict rules of Islam, which declared him defiled who touched a dead body,† dissection waSz never~practised; nevertheiless, they deserve credit for hav- ing preserved Galens works, and in this way prevented anatomy from being altogether a lost science. , Some anatomical terms remain as the only' trace that anatomy was once in the keeping of the Arabians. Aliakeum establishel an acadeny at Cordova which wab f-equented by all the Christians of the West. Iu the 10th century the library cantai.ned 224,000 volumes: and in the 12th century 70 public libraries existed in the parts of Spairn sub.iet Lo the Moors. t The Mussuhunan faith tauglt tie th soui did not 1-îtke wing at once, but clung to the body afterdeath, Creptfroi liib to limb, andafterwirds took refuge in thechest. 39 5",
         "396 CANADA MEDICAL AND S URGICAL- JOURNAL. The era of Saracen learning extends to the end of the 13th century, when the empire, which was already showing signs of decay, was overthrown by the Ottoman. The Turks, despis- ing learning, destroyed all the schools and abolished every kind of study in Bagdad, aud from this time Europe again became the seat of the little learning that survived. There, the study of the Greek authors was encouraged. and a taste for literature and art was rapidly developed. The University of Bologna now begins to attract notice as a school of literature, medicine and law ; in the 13th century it had over 10,000 students in attendance on its classes. In the early part of the 14th century, the chair of Medicine, which included anatomy, was filled by Mondino di Luzzi, called the Restorer of Anatomy; his is the first name of note in anatomy following Galen's. Mon- dino, in 1315, was fortunate enough to get Royal permission to dissect the body of an unclaimed female subject, the first human subject which had been legally dissected for more than a thousand years. One can well imagine the excitement which must have existed in the old University when it was announced that on a certain day a human body was to be publicly dissected. With what feelings of awe even students and physicians, who had never witnessed such a desecration of the dead, must have regarded the sight, and how such a mutilation of the sacred bodies of the dead would have aroused the animosities and prejudices, not only of the common people, but even the most highly cultured. Mon- dino himself was not entirely free from these prejudices and superstitions, since he declined to open the. head and examine the brain in fear of committing mortal sin. (Fisher.) Martianus, physician to Frederick II. of Naples, induced that monarch to grant permission to allow a public lecture on the actual subject at least once in five years. All the physicians and surgeons in the neighborhood were commanded by Frederick to attend these demonstrations. At these lectures the professor sat on a high chair, with the subject in front of him, and sur- rounded by his pupils. He demonstrated the variòtis structures as they were laid bare with a huge broad-bladed knife or razor by the barber who was employed for that purpose. An engrav-",
         "EARLY HISTORY OF ANAToMY-DR. SHEPHERD. ing of such a scene forms the frontispiece of some of the editions of Mondino's Anatomy. It is said that Mondino dissected two female subjects, and shortly afterwards published a description of the human body, illustrated by rude engravings. The title of the book was \".De, omnibus iumani corporis interioribus mnembris Anathomia.\" This work was very little different from that left by Galen-in fact, most of the errors of the latter were perpetuated. The Government undertook the publication of Mondino's Anatomy, and the statutes of the University of Padua prohibited the use of any other anatomical text-book. Mondino's Anatomy existed in manuscript alone for 150 years, and first appeared in type in 1578, twelve years after the intro- duction of printing into Italy. It went through numberless editions, and for more than 200 years was looked upon as an authority. It is quite a small book of 175 pages, and gives a most superficial and crude description of the various parts of the boly. It is full of inaccuracies, the arrangement is confused, and the meaning often obscure, still it was the best work in anatomy which had up to that time appeared. The first chapter shows how man differs from the animals ; one difference is that man has no tail, \" because, being naturally ercct, lie rests him- self by the sitting posture, and a tail would interfere with his sitting down.\" His reasons for the erect posture are amusing. \"First, man is erect because he is of a lighter, more spirituous, and ï,.rial character; secondly, he contains a greater quantity of heat, which is naturally. lifted upwards ; thirdly, lie has, among al animated creatures, the most perfect form, which he shares in common with the angels and the intelligences which rule the universe ; and fourthly, the sense of sight, through which most of our intelligence comes, needs to be placed at the highest point of the body, like the sentinel on the watch-tower.\" (Dalton.) Mondino divided the body into three cavities*: the upper (head), containing the animal members ; the middle (thorax), containing the spiritual or vital members ;' and lower (abdomen), containing the natures. His description of the heart is singularly correct, and lie seems to have had some notion of the uses of the valves, for he calls tbem ostiola, or little doors. 397",
         "398 CANADA MEDICAL AND SURGICAL JOURNAL. From the time of Mondino to the 16th century, there is little to relate about the progress of anatomy ; during that period most of the anatomists were blind followers of Galen, and learned nothing by actual observation. There were one or two exceptions, men who worked diligently and observed closely, though their oppor- tunities were few and their minds still somewhat obscured by the mysteries of the Arabian school. Among these were Matthew de Gradibus, who first accurately represented the ovaries, and Achillini of Bologna, who discovered the small bones of the.ear and also gave an accurate description of the brain and intestines. Leonardi da Vinci, the great painter, was one of the first who gave an impetus to the study of anatomy by the introduction of anatomical drawings. He not only made drawings of human anatomy, but carefully and accurately described and figured the various parts of the anatomy of the horse whilst modelling his gigantic equestrian statue of Francesca Sforza. His ana- tomical drawings are still extant, and are very correct.* (To be continued.) NOTES ON A CASE -OF ACUTE FEBRILE PEMPHIGUS. BY CHARLES E. GOODING, M.D., ST. PULnP, BARBADOES, W.I. It having been my fortune lately to have under treatment a patient suffering from acute febrile peinphigus, I thought that a history of such a rare case might not prove wholly uninteresting to the readers of the JOURNAL. M. R., negress, aged 31, agricultural laborer, mother of' several children, no miscarriages ; always enjoyed good health; no specific history ; nothing special in family history. Sixteen days ago first noticed several small, slightly raised spots on her chest, which were attended with a moderate amount of itching. Feeling fairly well, she went about her work as usual, but towards evening became somewhat feverish, and complained of slight headache and general malaise. These symptoms gradually increased in intensity, but it was not until the end -of a week *Some are at Windsor Castle, others at the South Kensington Museum, London.",
         "CASE OF ACUTE FEBRILE PEMPHIGUS-DR. GOODING. 399 that sh'e took definitely to bed. About a day after the spots were first noticed, small vesicles appeared on them, and these increased in size until, in a few days, they became large bullæ. During this time new vesicles began to show themselves between the old ones on the chest, and then successively spread to the abdomen, back, face, head, and ,-last of al], the extremities-in fact, over the entire body, except the legs, palms and soles. The builî, originally filled with clear fluid, soon became opa- lescent, then pustular, and finally burst, being replaced by large masses of scabs, from beneath and between which pus kept con- stantly oozing. Such was the account I obtained when called sixteen days from the beginning of the attack. The people being very poor, put off calling a medical man as long as they could. On my arrival I stopped about ten yards from the door, and could even then notice a great commotion among the \" carrion flies'' which were congregated in large numbers outside the 1ïouse. Their presence only imperfectly prepared me for the revolting sight which awaited me inside, for never in my life have I beheld anything half so loathsome. The stench when I entered the door was well nigh insupportable, being aggravated by the intense heat of a tropical sun. A human creature (though she was scarcely recognizable as such) was sitting on a stool in the centre of the room. Her face-so swollen that her features were scarcely distinguishable-was covered all over with crusts. Her body vas in the same condition, only intensi- fied. The .entire surface was, or had been, covered with scabs. These were divided very symmetrically by cracks, giving the body the appearance of being enveloped in a coat of mail. Through the cracks a purulent discharge of a most nauseating -odor was oozing. In some places (especially on the back) large masses of scabs had been detached, leaving raw, bleeding sur- faces. The thighs and arms were found in a similar state, though to a less degree. Here the eruption could be beautifully seen in all its stages, from the small vesicle to the large pustular bleb and its subsequent scab. Some of the bullæ were as large as hen's eggs, discrete in many places, but in others coalesced to",
         "400 CANADA MEDICAL AND SURGICAL JOURNAL. form masses much larger. From the knees upwards, I doubt whether a piece of healthy skin could have been found large enough to place a shilling on. Considerable pain in swallowing was complained of, and the throat was found swollen and injected, while several dark patches, like bits of diptheritic membrane or superficial sloughs, were seen on the pharynx and about the base of the uvula. On detaching one of these, the membrane bled readily. The external genitals were also covered vith crusts, and a highly offensive discharge was issaing from the vagina. At the time of my visit, the pulse was 122, tempera- ture 1030 ; bowels open ; sleeps very little ; slight nocturnal delirium. I ordered all clothes to be removed from the patient, and for lier merely to be covered with a fine piece of muslin to keep off flies, etc.; carbolized carron oil to be kept constantly applied; ammonia and bark internally, with brandy, and plenty of liquid nourishment at regular and frequent intervals. 17th day.-Condition much the same. Passed a very rest- less night. Ordered a sleeping draught of chloral and bromide. 18th day.-Slept better last night. Bowels very free. Sleep- ing draught repeated, and bismuth and Dover's powder for the diarrhoea. 19th day.-Diarrhoa moderated; otherwise condition un- changed. 20th day.-In spite of the utmost care, a large number of the crusts have been torn off the body. Diarrhoa rcturned, and she is much weaker. After this, the diarrhoa resisted all efforts to control it, and she gradually sunk, dying from exhaustion on the 24th day. Renarks.-The main peculiarities of the case are its acute course and rapidly fatal ternination in a previously perfectly healthy individual. The rarity of the disease may be judged from the fact that its very existence is denied by»many writers. The great Hebra is said never to have met with a case. I regard the patches in the throat as identical witlh the eruption on the surface of the body, their appearance being modified by their occurrence on a mucous membrane. I could not obtain",
         "THE CONTAGIOUYS NATURE OF TUBERCLE-DR. WILKINS. 401 permission to make a post-mortem examination, but it would have been very interesting to see whether the gastro-intestinal tract was similarly affected. The marked diarrhoea would favor such a supposition. The fact of the mucous membranes being involved in pemphigus is not generally admitted, but this case, to my mind, goes far to prove it. A PRACTICAL- DEMONSTRATION OF THE CONTA- GIOUS NATURE OF TUBERCLE. By GEORGE WILKINS, M.D:, Professor of Medical Jurisprudence and Lecturer on Histology, McGill University. At the meeting of the Canadian Medical Association, held at Chatham in September last, the entire lungs of two rabbits which had been inoculated with tuberculous sputum, as well as portions of lungs of other rabbits, all showing tuberculous nodules, were exhibited. Ten microscopes were used for the demonstra- tion, several of them with Abbe's condensor. The lenses used were Zeiss' homogenous i-, and also dry systems magnifying from 120 to 600 diameters. In drawing attention to the various specimens, the following remarks were made by Professor Wilkins: June 17, '83.-J introduced into anterior chamber of eye of' two rabbits,by means of hypodermic needle,a tiny drop of sputum which I had previously ascertained contained numerous tubercle bacilli. This was taken from a patient who died shortly after of phthisis. I also introduced into anterior chamber of another rabbit a small quantity of focal matter from a typhoid patient. June-22,'83 .-In presence of Dr. Osler I inoculated-five more rabbits with some fresh sputum from same patient. The rabbit into whose eye I introduced the focal matter com- pletely recovered from the effects within four days, leaving no trace of injury further than a few enlarged vesselis at margin of cornea. The other two rabbits had1 complete opacity of cornea within twelve hours, and in forty-ei. . ,'-ours the chamber was in a sup- purative condition. Five days subsequent to inoculation the 26",
         "402 CANADA MEDICAL AND SURGICAL JOURNAL. cornea sloughed, and on the seventh day ulcer was three mm. in diameter. Four of the other rabbits had complete opacity of cornea within fourteen hours. The other one, a large buck, had very slight opacity ; this had almost quite disappeared within forty- eight hours. In this rabbit, on the fifth day, I thought I could perceive some small tubercles on the iris. About the fourteenth day some slight enlargement of the glands at the back of jaw was perceptible. The -glands of the other rabbits commenced to enlarge about the tenth day ; their temperature, which was taken only twice at this time, was 1020 in the rectum. All, except the large buck referred to above, commenced to waste rapidly. Unfortuately, five of them met with a violent death, having been torn to pieces by dogs. I secured the lungs of two of these, and it is from one of these animals that I prepared the specimens for microscopical examina tion which I show you to-day. Another animal lived to die naturally in the ninth week. His lungs I now show you, completely covered with tuberculous nodules. At about this time I killed the buck, who seemed to be but little affected, as far as appearances were concerned, and also his eating abilities. I wished to use him for normal histological purposes, consequently Injected by the carotid a carmine gelatine mixture. I had not intended to utilize his lungs, as I thought the tuberculous inoculation had failed with this animal, but on taking them out I found them studded over, much to my surprise, with beautiful tubercles. These I show you now, with the tuber- culous nodules uncolored, the injection mass not having entered on account of its non-vascular nature. The liver also contained a few tubercles, but I could discover none in any of the other organs. In the other rabbits, I found tubercular masses in both liver and kidneys. Through an oversight, I did not examine glands in neck. Besides the two lungs just referred to, I show you to-day, under the microscope, the sputum of hospital patient containing bacilli. These have been stained red, after Gibbes method. I",
         "CASE OF CHRONIo LEAD POISONING-DR. SCOTT. show you the lung of the individual by whom this sputum was expectorated. It bas been prepared according to Weigert's modification of the Koch-Ehrlich process. Some portions of this lung are here shown teeming with bacilli. I also show you the lungs of two of the rabbits, containing exactly similar bacilli, prepared after the same method. The bacilli in this case have arrived here through the lymph path. In the anterior chamber of the cornea the bacilli found a suitable nutritive fiuid and another most important condition : they were undisturbed, con- sequently developed rapidly. The lymph cells of the iris and vicinity carried them throughout the system, and permitted them to germinate in those localities in which they found a suitable. nidus, as well as other favorable conditions. The microscopes on the tables show the bacilli all stained red. CASE OF CHRONIC LEAD POISONING. By W. M. SCOTT, M.D., GLADSTONE, MAN. S. T. W., aged 35 years, hotel-keeper, a robust, muscular man, sent for me on the evening of Friday, the 19th of October. His condition, on my arrivai, was as follows: Temperature 100-°; pulse 80, and regular ; perspiring freely ; countenance anxious, restless; vomiting occasionally; abdomen distended and tym- panitic; acute pain in hypogastric region ; anorexia ; tongue coated with a white fur ; bowels constipated ; urine scanty and very high-colored ; considerable headache. lis past history is good, but for the past few years lie has drank pretty heavily, though irregularly. He had been feeling poorly for some time past, his appetite being variable and capricious. He dated his illness from a week before, when lie ate a hearty meal of greens, and lie declared that the greens still 'remained in his stomach like a log, notwithstanding that lie had vomited several times, and had eaten very little since. The day previous to my seeing him lie took a fancy for canned plums, and devoured about half a can. During last week. bowels were constipated and urine very scanty and dark. On examination, I found the abdomen as before stated, but no special pain in left iliac region, and no gurgling. The pain had been in this region the day previous, 403",
         "404 CANADA MEDICAL AND SUROICAL JOURNAL but had moved to above the umbilicus, and I noticed that it was not markedly increased by pressure. The liver was of normal dimensions. Lungs and heart normal, but breathing was rapid and shallow. I took it to be a case of acute gastric catarrh. Ordered an enema, hot fomentation to abdomen, and calomel and opium internally. On Saturday he was much the same, but that the temperature was normal, and the pain inci-eased in in- tensity, causing him to writhe in bed, and it was confined to the umbilical region. I immediately looked at the gums, and dis- covered the blue Une beautifully developed. This changed the appearance of things at once, and though the vomiting of bile- stained fluid still continued, I knew I had a case of colica pic- tonum to deal with. The pain was not in the least relieved by the hot fomentations, so I gave him, hypodermically, Morphiæe Sulph. gr. 1, Atropioe Sulph. gr. 1-150, which quieted the pain in a few moments. And just here let me say, that I have found it a good plan, in giving a hypodermic, to oil the needle, for which purpose a small vial can be carried in the case along with your tablets. It very greatly diminishes the pain of the opera- tion. I never saw this done in hospital, nor is it, so far as I am aware, to be found in a text-book. My instinct led me to try it, and though simple, it is worth knowing. The patient was ordered Pot. Iodid. grs. v. t.i.d., and sulphuric acid lemonade. I had to repeat the hypodermics morning and evening for three days, but for the past two days he has required it only once, as he is improving very rapidly. I find that the man's wife and sister- in-law are suffering from the same cause, but in a mild form. The blue line on the gums is developed to a slight extent, with indigestion and a brassy taste in the mouth. I forgot to mention that my patient has not remarked a metallic taste, though he does complain of the taste being disagreeable. Now as to the source of the lead. I examined the well and pump, but found nothing there. I need scarcely have looked there, for water, for a considerable time past, has been too thin f'r him. I found that he had been in the habit of taking, the first thing in the morning, what is commonly called a \" stone fence \"-that is, whiskey and eider, the latter of which was of the manufactured",
         "OBSTETRICS AND GYNÆcoLOY--UR. GARDNER. varicty, was kept in the cellar, and was connected with a pump in the bar by means of a lead pipe, of which there vas about 16 feet. I analyzed the cider, and got strong indications of lead. QUARTERLY RETROSPEOT OF OBSTETRICS AND GYNÆCOLOGY. By WILLIAM GARDNER, M.D., Professor of Gynocology, McGill University; Gynoecologist to the Montreal General Hospital. The Treatment of Pelvic Abscess in Women by Incision and Drainage.-At a recent meeting of the New York County Medical Society, Dr. P. F. Mund6 of New York city read a paper on this important subject. Inflammations of'the pelvic peri toneum and cellular tissue constitute, according to some authors, t mesí conioni but~one, of the diseases peculiar to women, the exception being eryicalendometritis. There can be no doubt that this statement, if not absolutely true, is very nearly so. A small proportion only, however, end in suppuration. This may, however, be more common than is generally laid down in text- books. A moderate quantity of pus may easily be passed un- noticed from the rectum, bladder,:or vagina. In the majority of such cases the abscess closes spontaneously. In not a few, how- ever, a chronic discharginig sinus persists for months or years, and may kill the patient. Hence the importance of Dr. Mundé's subject, in his treatment of which he, however, did not lay claim to anythiirg new. He believes that abscess far more often follows cellulitis than peritonitis. Certain of those who took part in the discussion did not agree with him. Dr. Mundé gave the histories of ten cases, and at the close of his paper forrulated the follow- ing conclusions: 1. Pelvic abscess in the female is not very common, in pro- portion to the g trea frequency of pelvic exudation, and probably does not occur in more than ten per cent. of all cases, the ma-- jority of exudations terminating in spontaneous absorption. 2. Pelvic abscess may be either extra-peritoneal, the result of cellilitis (by far the most common variety), or intra-peritoneal, the consequence of pelvic peritonitis. If intra-peritoneal, the 4105",
         "400 CANADA MEDICAL AND, SURGICAL JOURNAL. adhesive inflammation between pelvie viscera and intestines may so seal the abscess-cavity as to render it practically extra-peri- toneal. Abscess of the ovary and pyo-salpinx do not belong to the category of \" pelvic abscess \" proper, and do not fall under the same therapeutie rules, unless when, by agglutination to the abdominal wall or to Douglas' pouch, they become virtually extra-peritoneal. 3. Small, deep-seated pelvic abscess, not exceeding a capacity of two ounces, and minute multiple abscesses in the cellular tissue, can often be permanently cured by evacuating the pus thoroughly with the aspirator. The surrounding exudation is then rapidly absorbed. 4. About one-half of the abscesses open spontaneously into the vagina, rectum, bladder, or through the abdominall wall and ischiatic fossa. These cases may gradually recover without treatment, or the sinuses may persist until closed by surgical interference. 5. Abscesses containing more than two ounces of pus should be opened by free incision.along an exploring needle or grooved director, cleared of debris by finger or blunt curette, and drained and irrigated, if necessary, through a drainage-tube. 6. This incision should be made where the pus points most distinctly, which is usually the vaginal vault. 7. In a certain number of cases the pus points through the abdominal wall, generally in the iliac fossa, and the incision should then be ample and free drainage secured. 8. When the pus has burrowed deep into the pelvic cavity, and a probe can be passed from the abdominal incision down to the vaginal roof, mere abdomino-cutaneous drainage will not suffice, and a counter-opening must be made in the vagina, and a drainage-tube carried through from the abdominal wound into the vagina. This drainage-tube may have to be worn for months. In making this incision, care should be taken not to wound the bladder. 9. The .opening of a pelvie abscess which points through the abdominal wall, does not differ from, and is no more dangerous than, the same operation elsewhere on the cutaneous surface of",
         "- ' UOSTETRICs AND GYNGACLDGY--UR. GARDNER. the body. It is not an \" abdominal section \" or a \" laparotomy\" in the sense that those terms are used to indicate the surgical opening of the peritoneal cavity. 10. Chronic pelvic abscesses, which have burst spontaneously and have discharged through the vagina, rectum, or elsewhere for months or years, are exceedingly difficult to cure. This is particularly the case when the opening is high up in the rectum. A counter-opening in the vagina, or enlarging the opening if there.sitùated, the curette, stimulant irrigation, etc., may occa- sionally succeed, but usually fail. 11. A perityphilitic abscess may point through the abdominal Wall, and simulate a pelvic abscess proper. Aspiration ,will settie the diagnosis ; the treatment is the same. 12. The majority of cases of pelvic abscess recover, at least the mortality is small.-(N. Y. lMed. Record.) Shortening of the' Round Ligaments for certain Uterine .Displaceents.-Dr. Alexander of Liverpool read a paper on the operation now known by his name at the meeting, on June 1lOth, of the British Gynæcological Society. Dr. Alexander bas operated in 80 cases, and reaffirms bis great confidence in the value of the operation. H-e gives minute instructions in the method of performing the operation. These ought to be care- fully read by every one who contemplates performing it. After discussing the anatomical and physiological basis of the operation, the author comes to the results, and this part of the subject he discusses-1st, With reference to the mortalty of the operation ; 2nd, With reference to the beneficial results that accrue by its performance to those who survive. As to the first consideration, the mortality, Dr. Alexander said this may be set down as.nil. Some deaths have occurred, but these he claimed were all from preventible causes. He knew of three. One of these occurred in bis own practice. The operation is therefore not to be trifled with. The most important point, then, is the second-the beneficial results. These the author con- siders under two heads: lst, Its permanent utility in correcting uterine displacements; and 2nd, Its effects in relieving the patient's symptoms. In bis own practice, Dr. Alexander bas",
         "408 CANADA MEDICAL AND SURGICAL JOURNAL. never seen a relapse of any backward displacement corrected by the operation. In prolapse, the results in this direction, although good, are not guite so favorable for the relief of the patient's symptoms. It bas been valuable for the relief of these so far as they depend on displacements, and not on complications or associated conditions. Obviously great care in making a complete diagnosis will be necessary in order to avoid disap- pointment. The author concludes by saying: \"l It may be per- formed in any case of prolapse and backward displacement in which the surgeon and patient may wish it to be performed, except those incurable, miserable cases where bed and bandages are the only available remedies. By a more timely adoption of the operation, such extreme cases would never occur. To secure success, the operation must be properly performed, and the after treatment must be very rational, so that no strain be placed on the ligaments until sound union bas taken place.\"-(British Gyn. Journal.) Parametritis Posterior.-At the last meeting of the Asso- ciation of German Physicians and Naturalists, held at Strasburg Nieberding of Würzburg read a paper on this subject in the gynæcological section. The great frequency of certain forms of pelvic cellulitis and peritonitis is tolerably well appreciated, but every consultant must know how often general practitioners fail to appreciate the great frequency and pathological import- ance of the disease now under consideration. Velpeau, Sommer, E. Martin and others have alluded to the subject, but to Schultze of Jena must the greatest credit be given for its elucidation. It consists in an inflammation of the peritoneum of the Douglas's pouch and the utero-sacral ligaments which bound it, structures which contain cellular tissue and muscular fibre. Exudation occurs, and as this is absorbed, very frequently a shortening of the ligaments, with consequent dragging backwards of the uterus, anteflexion of the uterus, retroversion, traction on the urethra, and, as a consequence, frequent and perhaps painful micturition. Nieberding expresses surprise that so little attention has been given to thdis condition, and explains it by the growing interest which all surgical procedures excite in gynæcologists in these",
         "OBSTETRICS AND GYNiECOLOGY-DR. GARDNER. days. This leads to a neglect of many departments of gyno- cology. He has found the condition to be present in 10 per cent. of his patients. He quite agrees with Schultze as.to the genesis of the affection. It arises frequently in the puerperium, but more frequently under other cirèumstances. It is often unac- companied by any acute general or well-defined local symptoms, or if these occur,'they have been of short duration. The whole course is insidious and chronic. The symptoms in the chronic stage are pelvic and sacral pain, of a weaving, aching character increased by exertion, occasional acute pelvic pains, pain in defecation, dysmenorrha and other menstrual troubles, bladder symptoms, constipation, with more or less profound impairment of digestion and nutrition, and numerous reflex symptoms, head- ache of the vertex and other neuroses, and neuralgia. The causes in the lying-in woman are septie, the absorption being through lacerations and abrasions of the genital tract. In the unmarried, young girls and others, it is due to septic infection of fissures of the rectum from hardened fæces, and by extension of endometritis, specifie or other. The diagnosis is to be made by a careful bimanual examination, the patient being in the dorsal position, when the uterus will usually be found anteflexed or anteverted, the-cervix drawn up and backwards, while through the posterior cul-de- sac masses of exudation, or tense, more or less sensitive bands will be felt stretching from the posterior uterine wall in the direction of the sacrum. N.ieberding does not allude to the treatment, which, indeed, is often unsatisfactory. It is that of chronic pelvic in- flammations generally, and that best suited to the impaired gencral health.-(Cent.fuir Gyn., No. 41, 1885.) lutra-uterine Treatment Of Oronic Uterine Catarr.--At the saue meeting, Kugelmann of Hanover related his experience with iodoiorm, whieli he vas induced to try by its good effects on a nasal and laryngeal catarrh in his own person. His method of application of the drug is by insufflation with a metallic catheter, with lateral openings near its beak, by which the pow- der is taken up, and being inserted within the uterus, it is ex- pelled by compressing an elastic ball at the other end. The",
         "410 CANADA MED[AL AN\u003e SURGcAL JOUNAL. applications are made twice a week. The method is painless and free from danger, and has been very successful in the author's hands. Previous dilatation by laminaria or other tents, or by metallic dilators, may be necessary.-(Cent.f. Gyn., 41, '85.) Uncontrollable Foniting of Pregnancy cured by Feeding through an Œsophagus Tube.-Brünniche of Copenhagen re- ports a case. An unmarried woman of 33 suffered from obsti- nate vomiting and cardialgia. She was reduced to extreme weakness, almost collapse, the gums were bleeding, and the general appearance cadaverous. The diagnosis was gastric ulcer. A tube was passed into the osophagus, but only a short distance down the gullet to avoid injury to the supposed ulcer of the stomach. Milk, broths, hare soup, and other soups were thus introduced within the stomach. Nausea and vomiting ceased forthwith. The woman soon learned to use the tube herself. After three weeks she was able to dispense with it. Pregnancy was now discovered. The case is of interest with reference to the sensitive point whence the irritation which ex- cited the vomiting appeared to start, viz., the upper part of the osophagus. The bearing of the case on other forms of obstinate vomiting is obvious. This is not due alone to morbid conditions of the stomach.-(Cent.f. Gyn., 41, '85.) -Electricity as a Therapeutic Agent in Gynecology.-This is the title of a long paper contributed by Dr. P. F. Mundé to the American Journal of Obstetrics for December, '85. The author first alludes to the uses of the faradic current in obstetrics, and especially in the treatment of that most formidable condition, extra-uterine pregnancy, and then proceeds to say that his object in writing the paper is mainly to show that no special talent or prolonged study of electricity, nor the possession of expensive apparatus, is necessary \" to employ the electric current in gynæcology, and in many cases with considerable benefit.\" The following resumé of the most important practical points given by Dr. Mundé will be of interest: 1. Galvanic current the most useful, inasmuch as, soothing, anæsthetic and alterative effects are oftenest indicated. 2. A mild, steady, painless current always to be used.",
         "OBSTETRICS AND'GYNaECoLOUY-DR. GARDNER. 411 3. When a constant current causes pain, or increases existing pain, it is doing harm, and must be reduced in strength or stopped. 4. Always begin with a weak current, and, if necessary, increase its strength. 8. In order to give permanent relief, or do appreciable good, the treatment must.be employed for a long time-at least twice a week, but better three times a week, or daily. In many cases the treatment must be continued over a period of from three to six months. 9. Pain may be relieved or completely removed, but a per- manent cure, complete absorption of exudation, a restoration of the organ to health in hyperplasia, chronic oöphoritis, cellulitis and peritonitis, is seldom achieved. This, however, applies with equal force to other remedies. Dr. Mund6 gives the following list of conditions in which elec- tricity has been proved to be beneficial:- deficient development of uterus and ovaries ; amenorrhoa; dysmenorrha, obstruc- tive and neuralgic; superinvolution ; subinvolution (with or without menorrhagia) ; hyperplasia uteri ; chronic ovaritis and salpingitis ; chronic cellulitis and peritonitis, and lymphangitis; pelvic neuralgia, local and reflex ; uterine displacements; erosions of cervix ; uterine fibroids ; ovarian tumors. The conditions in which the two varieties of the electrical current act most beneficially may be summarized as follows FARADISM. GALVANISM. Deficient dev'elopment of uterus ilyperplasia uteri. and ovaries. Chronie ovaritis and pachy- Amenorrhœa. salpingitis. Subinvolution and menorrhagia. Chronie cellulitis and periton- Superinvolution. itis, and lymphadenitis. Uterino displacements. Pelvic neuralgia, local and Uterine fibroids (interstitial). reflex. Dysmenorrhoa, neuralgic and obstructive. Erosions of cervix. Subinvolution. [toneal.) Uterine fibroids (sub-peri- (Amer. Jour. Obstet.. Dec., 1885.)",
         "112 CANADA MEDICAL ANI) SURGICAL JOURNAL. Cocaine in Gynæcology.-This is the title of a short paper by Dr. C. Hl. Thomas of Philadelphia, appearing in the Phila- delphia Medical News for Nov. 21, '85. After speaking of the well known effect of this drug in producing pallor and shrinkage, as well as anæsthesia of the tissues to which it is applied, the author remarks that the former effect is not so well known. It is also of longer duration than anmsthesia, and in some cases is permanent. Dr. Thomas generally uses a four per cent. solution, but in cases where considerable pain is anticipated lie employs a ten per cent. solution. He bas found it very useful in some cases of cervical endometritis, in which, without much erosion or discharge, there is great tenderness about the internal os uteri, cases in which a probe easily brings blood, and applicationis cause severe radiating and ovarian pain. Cocaine applied with the syringe or cotton carrier prevents pain and bleeding. In the treatment of urethral caruncle and other painful affections of the urethra, it is most valuable. In cases of vaginismus, before introducing instruments and before making applications, its value has also been proved. In a case of painful irritability, with spasm of the bladder, simulating cystitis, entirely unrelieved by the opium suppository and other measures, the author was enabled to afford complete and permanent relief by a single injection of one grain of cocaine thrown into the bladder. A new Diagnostic synptom qf Rupture in -Extra-uterine Pregnancy.--Dr. J. J. E. Maher of New York òity relates a case of extra-uterine pregnancy ending fatally, verified by autopsy, in which he observed a symptom which lie beliéves will be of value in diagnosing such cases, and so aiding'a decision of the sometimes difficult question of whether to operate or not. The symptom alluded to is remarkable abdominal heat, with a subnormal temperature in the axilla. The author reïnarks: \"It was observed that a diagnosis of abdominal hemorrhage had been presumed in my case. It was founded on the follow- ing evidences : The symptoms of shock, accoppanied by great weakness ; the sudden onset of severe pain in, and distension of, the abdomen, and that remarkable abdominal heat ; both sub- jective and objective, presenting so striking a contrast to that of",
         "ORSTETRTes AND GYNÆFCOLOGY-DR. GARDNER. the rest of the body. This symptomatie abdominal heat does not appear to have hitherto attracted any attention in the cases already recorded ; yet if it be remembered that there is beneath the abdominal wall a clot of warm blood varying in bulk from one to two quarts to as many gallons, it becomes an easy matter to appreciate the importance of this symptom in its bëaring upon the diagnosis. Indeed, this symptom- alone, coteris paribus, would seem to be unequivocal in differentiating abdominal hemor- rhage from purely nervous shck.\"-(N. . ilIed Record, Jan. 2, 1886.) Perineorraplty.-The operation for ruptured perineum bas recentlv been discussed in the British Gynoecological Society and in the British iMedical Journal. In the latter Journal for October 24th, 1885, Dr. Fancourt Barnes publishes a note on twenty-seven cases of perineorraphy. Sixteen of these were done by the old method-dissecting off an area of mucous mem- brane and bringing the freshened surfaces into symmetrical apposition. Al :were successful, but, as is usual in all such cases, morphia suppositories were necessary till the sutures could be removed. The last eleven cases were done after Mr. Lawson Taitis method, which Dr. Barnes had since learned. This opera- tion is difficuit to understand without illustrations. The best description of the operation is that in Dr. Arthur Edis' Manual of Diseases of Women. At least Mr. Tait himself gives Dr. Edis thi\u0026 eredit. He (Tait) bad previously described it in a paper read before the London Obstetrical Society in November, 1879. The method differs from others in that there is no removal of tissue, and therefore, if it fail, the patient is in as good a con- dition as ever for successful operation. The recto-vaginal sep- tum is split with a pair of curved, sharp.pointed scissors in such a manner that the lower flaps are opposed and turned into the rectum, while the upper are turned upwards to the vagina and also opposed The stitches are inserted at the point of refdection of the two flaps, made by. splitting the septum. They are not passed through skin at all. By this method it is claimed that no pain severe enough to require morphia is suffered. The bowels are kept open by daily enemata. The operation, Mr. 41 P\u003e",
         "414 CANADA MEDICAL AND SURoIcAL JOURNAL. Tait claims, can be done, splitting the septum and putting in sutures, in from five to eight minutes.--(Brit. Mcd. Journal.) Oöp7torectomy for Bleeding Fibroids.-Dr. Goodell exhibited the ovaries and related the case from which they were removed at the Obstetrical Society of Philadelphia on November 5, '85. There was severe hemorrhage and multiple fibroids; six tumors could be made out. The womb measured 7.5 inches. The ovaries were removed without difficulty. They were enlarged by fol- licular degeneration, a condition which Dr. Goodell had repeat- edly seen in cases of uterine fibroid. The effect of the operation on the tumors, especially the main one, was astonishing. After two weeks the uterus had diminished in length nearly a hand- breadth. Forty seven days after the operation the uterine cavity measured only 3.25 inches, a diminution of 4.25 inches. Dr. Goodell remarked that every successful case- in which he had removed the ovaries for fibroid tumor of the womb had been followed by menopause and rapid diminution in size of the tumor. But in his hands and in those of others the operation had been more fatal than that of ovariotomy. This is doubtless due fo the occasional great difficulty of the operation. During the dis- cussion, Dr. Montgomery stated that in his experience meno- pause did not always at once occur ; in some of the cases not for two years after the operation.-(Phila. Med. News.) In a clinical lecture on Painful Menstruation and Sterility from Plexion, Dr. Goodell of Pliiladelphia reiterates his pre- viously expressed statements of the great value of rapid dilata- tion of the uterus. At the outset of his lecture Dr. Goodell points out the fallacy of conclusions arrived at by certain autho- rities with reference to the effects of certain deformities and dis- placements of the uterus. \"But in the great majority of cases neither anteflexion nor, for the natter of that, anteversion, is pathological. In almost every unmarried or barren woman you will find the womb either bent forward or tilted forward, and resting on the bladder ; for this, in varying degrees. is its natural position. The mistake made is in attributing to this natural position of the womb the various forms of pelvic trouble, espe- cially that of irritability of the bladder, to which women are so",
         "OBSTETRICS AND GYNECOLOGY-DR. GAIRDNER. 415 liable. But the kinship between the brain and the bladder is a remarkably close one. This bas lately been studied by two Italian physiologists, Mosso and Pellacani, who go so faras to contend that ' everv mental act in man is accompanied by a contraction of the bladder.' The irritability of the bladder is, then, one of the first symptoms of loss of nerve control.. Everybody is liable to it. You, on examination day, will be annoyed by it. Many a lawyer, before pleading an important case, and many a clergy- man, just before delivering a discourse, is compelled from shieer nervousness to empty the bladder. So it is with the lower ani- mals. which, when frightened, micturate involuntarily. A ner- vous bladder is, then, one of the earliest phenomena of nervous- ness. Now, a hysterical girl, or a woman whose nervous system lias colIapsed under a strain of domestic cares, consults a phy- sician for such symptoms of nerve prostration as wakefulness, utter weariness, a bearing down feeling, b ackache, and perhaps, above al], an irritable bladder., Upon- making a digital exami- nation, he, of course, finds the fundus of the womb resting on the bladder, and at once jumps to the conclusion that the whole trouble is due to the pressure of the womb on the bladder, viz., to the existing anteflexion or to the anteversion, as the case may be. le now makes local applications, and racks his brain to adapt or to devise some pessary capable of overcomirig the sup- posed difficulty, forgetting that the upward, or shoring pressure of the pessary on the bladder, must be greater than the corres- ponding downward or gravity pressure of the womb. There is, in fact, no pessary but the dangerous stem-pessary, which can meet the end without pressing upon a fold or double thickness of the bladder. But, very fortunately, anteflexion is not often pathological. It is certainly not pathological in the foregoing instance-; for the symptoms, especially the vesical ones, are not due to the pressure of the womb upon the bladder, but to sheer nervousness, or nerve prostration, which is the thing to be treated, and not the womb. There are exceptions to this rule, but not many ; for instance, a womb, heavy from subinvolution or from the pressure of a fibroid, may make un- comfortable pressure on the bladder.\"",
         "416 CANADA MEDICAL AND SURGICAL JOURNAL Dr. Goodell firmly believes that in many cases of uterine flexion there is obstruction to the escape of menstrual blood and other discharges, and explains the advent of dysmenorrhoa some time after a sterile marriage by a thickening of the endo- metrium, with narrowing of its calibre, the result of the conges- tions from sexual intercourse. But we also sec the dysmenor- rhœa of the unmarried increasing with age. \" Nature intends tbat the periodical congestions of the womb should. be interrupted by pregnancy and lactation (during which period menstrual congestion is arrested), and without these interruptions the mucous lining of the womb is liable to thicken, and by its thick- ness to narrow the canal.\" Dr. Goodell bas performed thorough dilatation under ether nigh 350 times, with a large measure of success, in completely curing dysmenorrhoa or greatly relieving it.-(Pliiladelphia iled. News, Dec. 12, '85.) NEW YORK, Dec. 24th, 1885. The medical profession is considerably agitated over the recent verdict of a case brought against two practising physicians. The facts of the case are briefly as follows :-In November, 1879. Drs. A. E. M. Purdy and A. S. Purdy diagnosticated smallpox in a patient named Miss Angelina Brown. The former saw her later in the day with Sanitary Inspector Dr. C. E. Lockwood, who also diagnosed smalilpox. The patient was sent to the smallpox hospital. On ber arrival, the bouse physician, D)r. Bowen, confirmed the diagnosis, and reported to the Board of Health accordingly. le subsequently reversed his diagnosis, and certified that Miss B. was suffering only from eczema, and told ber she need not remain in the hospital. She voluntarily remained there, however, for some days. After leaving the hospital she brought suit against Drs. Purdy, claiming damages to the extent of $10,000. The case was tried last November, in the Superior Court, before Judge Ingraham. The counsel for the defence moved to dismiss the complaint, on the ground that the Board of lealth was responsible for sending Miss B,",
         "to the smallpox hospital. His Honîor denied the motion, and ordered that the trial proceed before the jury. Drs. A. Flint, Keyes and George H-. Fox testified that, from the recital of the symptoms and character of the eruption, as detailed by witnesses, Miss B. was undoubtedly suffering from smallpox at the time referred to. The jury broughlt in a verdict of $500 against the defendants. It is not the correctness of the diagnosis or other- wise that makes the case so important to the profession of this State. A physician is legally bound to report every suspected case of smallpox, or other infections disease, to the sanitary officer. In accordance with the decision of Judge Ingraham in sending the -case before the jury, the physician becomes liable for any damage arising or claimed to have arisen; through the subsequent acts of the Board of Hcalth. The Medical Society of the County of New York have taken the matter in hand. A committee has been appointed, and if sufficient funds can be collected, an appeal will be made to a higher court. To this fund Dr. A. E. M. Purdy has subscribed $1,000, Dr. Agnew $500, and other subscriptions of $100 and under have been received. At the last regular stated meeting of the Academy of Medi- cine, Dr. T. G. Thomas read an important and exhaustive paper on Vulvar and Vaginal Enteroccle.\" H1e drew attention to tlie slighît treatment the subject had received in systemaatic works on gynecology. His own book shares the general criti- cism, which brought a smile to the countenance of many of bis hearers. - He particularly emphasized the importance of making a correct diagnosis, which, lie said, ias enough, if one always exercised due care and kept in mind the probability of the occur- rence of this form of hernia. A case that occurred in his own practice forcibly illustrated the danger that might follow an error in diagnosis. \" A patient called upon me with the follow- ing history She lad had an abscess just below the external ring, which, after poulticing, had been evacuated by ber phy- sician about a month before the time of her visit to me. After this she lad felt well until a week before, when, after a muscular effort, the pain bad retuirned with all the original signs of abscess, and these had continued, although she had painted the part 27 417 CORREsPON.'DEN\\cE,",
         "CANADA MEDICAL AND SURGICAL JOURNAL. steadily with ltincture of iodine, as she had been directed to do in case of such an occurrence. Being in great haste at the moment, I examined the enlargement while the patient was standing, and under a recent cicatrix, which was painted with iodine, I discovered what I supposed to be a re-accumulation of pus. As the patient came to me in absence of her physician, merely for the evacuation of this, I placed her in the recumbent posture, and, lancet in hand, proceeded to operate-; but, to my surprise, I discovered that change of posture diminished the size of the enlargement. This excited my suspicion, and upon fur- ther examination, I found that a recent hernia had occurred under the old cicatrix.\" The paper -mbodied the report of a remarkable case of ex- treme vaginal hernia. About six years before, the patient noticed a small lump at the vulva. This kept, steadily increas- ing in size until it had corne down to the middle of the thighs, on the right side. The patient's life was miserable. She could neither stand, walk nor sit with any comfort. She was willing to undergo any operation that gave promise of the least relief. Dr. Thomas proposed \" to perform laparotomy, with an assistant to keep the hernial sac well within the pelvis by one hand in the vagina, seize the tumor at its most dependent portion, drag it up into the abdominal wound and fasten it there by suture, sus- taining the heavy sac, meanwhile, by two knitting needles passed through and lying flat across the abdomen.\" In performing the operation as above sketched, he found in the pelvis a soft, fibrous. tumor, which evidently had been pushed up from below, on a level with the symphysis pubis, He removed this by splitting the peritoneal covering, tying a number of bleeding vessels, draining the sac with a glass tube, and fastening the sac into. the abdominal wound. The patient made a good recovery, and so far, a month after the operation, there bas been no return of the hernia. Dr. Thomas confesses, however, that he feels appre- hension about the future. NEW YoRK, January 21, 1886. An event of considerable importance took place yesterday within the walls of the Academy of Medicine in this city. Some months ago Dr. James B. Iunter conceived the idea of forming 418",
         "CORRESPONDENCE. an association of those who had served on the resident staff of the Woman's Hospital of New York, to meet twice yearly for the purpose of interchanging ideas and spending a few social hours together. The happy conception bore good fruit, and yesterday witnessed the first semi-annual meeting of the Alumni Association of the Woman's Hospital. Judging from the number of valuable papers read and the good atteidance, the meeting was a great sûccess. The benefits derived from such an organi- zation will not be limited to its members, but will be shared by the general profession. The Alumni now number 56, and each year adds four to the number. These men are naturally scattered ail over the Union. This influence upon the practice of gynS- cology in this country cannot be but great. It will be interesting, as the chairman (Dr. HIunter) said in his address, to note how far the various men have diverged from the original teaching in the hospital. The address of the chairman contained some in- teresting facts, one of which was that the first alumnus was none other than the honored and renowned present senior surgeon, Dr. T. A. Emmet. This incidence, which had not generally been known before, was received vith a spontaneous burst of applause. There is a laughable circumstance connected with this first ap- pointment. At that time it was a law, recorded in the by-laws of the hospital, that the surgeon's assistant or nurse must be of the female sex. In the following year, however, the young assistant asserted the right of his sex. The above by-law was now changed to read: The surgeon's assistant shall be such an assistant as the exigencies may require. The exigencies required that he should be a man. Dr. Emmet's first connection with the hospital dates back to 1857, and fron this date until the present he has been uninter- ruptedly identified w'ith the various vicissitudes of the institution. The success of the hospital owes more to him than to any other one man, living or dead. There was a time when its fortunes were beset with heavy black clouds, when its chief surgeon re- signed, when the general profession would take no interest in it, and when it seemed as if a special hospital for gynocology in the city of New York would be a failure. But Dr. Emmet remained 419",
         "420 CANADA MEDICAL AND SURGICAL JOURNAL. faithfully at his post. By continued perseverance, by getting the leading members of the profession interested in its welfare, by that continued devotion to its interests (even at his own per- sonal loss) which has characterized him since his first connection with the hospital, Dr. Emmet succeeded in extracting the hospital from the mire into which it had fallen and raising it to its present importance and celebrity. It was a fit event that the first alumnus should entertain the Alumni Association at its first semi-annual meeting. The mem- bers of the Obstetrical Society weie also invited, and a most pleasant, enjoyable evening was experienced. The hum of voicés was continuous, the wine flowed freely, the fumes of tobacco curled gracefully from several mouths, and the \" lacerated perineums and cervices \" could be overheard here and there in the conversation ; the general tone was one of pure and simple enjoyment, without any admixture of professional jargon. Another striking proof of the difficulties attending the diag- nosis of pelvic tumors was afforded by a case in whicb Dr. Mundé operated a few days ago at Mount Sinai Hospital. The patient had been suffering from symptoms referable to the pelvic or;ans for some time past, and about four months prior to her admission into the hospital a tumor was detected in the right side of the pelvis. This tumor, immediately before the operation, was diag- nosticated by Dr. Thomas as a sarcoma. Dr. Mùndé did not commit himself as to the nature of the tumor, but felt certain it was a solid growth of some kind. At the operation it was found to be a cyst, about the size of an infant's head, filled with the products of a suppurating dermoid. The operator removed the cyst, cauterized the pedicle with a pacquelin, allowed it to remain intra-peritoneal, and introduced a drainage-tube in the lower angle of the abdominal wound. I learn the patient is pro- gressing favorably towards convalescence. If a mere tyro may be allowed to express an opinion upon so weighty a matter, it would be this : that in diagnosticating pelvic tumors too much value is attached to physical signs and not enougli attention is bestowed upon the patient's antecedents and history. Appropos of this, Jonathan Hutchinson has recently made some apposite",
         "CORRESPONDENCE. remarks (vide American Journal of Medica l Sciences, Jan.\"'86). \"Growths,\" says he, \" have a clinical history which, often, is more characteristic than what the microscope can tell us.\" In the case of pelvic growths, we may substitute \" the sense of feel in our finger's ends \" for the microscope. Through the kind courtesy of Dr. Mundé I was enabled to witness the above operation, as well as, another of considerable interest since. It was an Alexander's operation for the shorten- ing of the round ligaments in an intractable case of retroflexion. The operator experienced considerable difficulty in reaching the ligaments, vhich, instead of taking the usual oblique course, passed almost vertically downwards into the pelvis. Dr. Mundé, in drawing attention to this fact, remarked that writers on the subject had failed\"to mention the occasional occurrence of such a condition. That the profession-here, at least-has lost none of its in- terest in gynæcological matters was evidenced by the large attendance at the meeting of the Medical Society of the County of New York on 28th December last, when Dr. Mund6 read a paper on the treatment of pelvic abscess in women by incision and drainage. He said that in the majority of cases of pelvic exudation following cellulitis and peritonitis, the exudate became absorbed and the 'patients recovered without the formation of abscess. Sometimes the process of absorption might be very long, extending over months. In some cases the exudate broke down and formed an abscess, an occurrence most likely to take place when the exudate was large and formed rapidly, and when the patient's recuperative powers were below par. Cellulitis was the common factor of abscess, peritonitis only occasionally. Of 400 cases of pelvic cellulitis and peritonitis of which be'had records, only 48 terminated in abscess. This percenta-e was thought larger· than usual, becausevmany of the cases (21) were seen in consultation, 23 of the cases opened spontaneously, 8 were treated by free incision and drainage, 6 through the ab- dominal wall, and 2 through the vagina. Al of the cases operated upon recovered. In a suspicious case, he always verified his suspicions by the introduction of an aspiratingneedle.",
         "422 CANADA MEDICAL AND SURoICAL JOURNAL. When the amount of pus did not exceed two ounces, he was in the habit of treating it by simple aspiration. If a number of small abscesses were suspected, the aspiration was repeated until all were supposed to be evacuated. When the amount of pus exceeded the above stated amount, free incision was the better method. When the abscess opens spontaneously through the rectum, the opening is usually too high up to reach and divide. This, even if feasible, is not always advisable, as the contact of the fieces would interfere with healing. Brief reference was made to some of the unusual forms of pelvic abscess. The pus might find its way down to the perineum, or the point of fluctu- ation might be found at the crest of the ilium on one side.- If fluctuation appeared near the crest of the ilium, the aspirator should be introduced, and, if pus was found, the grooved director should be introduced and an incision made with a blunt-pointed bistoury. The reader of the paper condemned the operation of laparotomy for true pelvie abscesses ; it was unnecessary, and and exposed the patient to too-great a risk. In the discussion that followed, some sharp-shooting was in- dulged in, which enlivened the proceedings of the meeting. Dr. Polk took issue with Dr. Mund6 on several points. He thought the percentage of mortality ývas much greater than the reader of the paper had stated. Laparotomy, he thought, was the best treatment for many of these cases. We never can tel] in a given case if it is a uni- or multilocular cyst, and in the latter, laparotomy was the safer and quicker method of treat- ment. Moreover, it was difficult to diagnosticate these cases from pyo-salpinx, and if the latter condition was found to exist, the treatment (laparotomy) adopted would be proper. Dr. Lusk thought that such a paper embodying so many prac- tical points was much needed, as the general profession was still hazy on that subject. He h'ad been recently told by a country practitioner that all such cases in the country die !! He agreed in the main with the reader of the paper. Dr. W. Gil Wylie disagreed with the author.as to the path- ology of these cases. He thought the majority of them started in connection with the Fallopian tubes, the ovaries, and broad",
         "REVIEWS AND NOTICES OF BOOKS. ligaments. le would be in favor of performing laparotomy in allcases that did not point in a favorable condition. Touching congress matters in Philadelphia, an interesting vote was taken a few weeks ago which indicates clearly the feeling of the profession in that city. At a meeting of the County Medical Society for the election of delegates to the State Society, and to the American Medical Association there were two tickets, one representing the Shoemaker faction and in favor of the action' of the Association, and the other, headed by Dr. D. Hayes Agnew, opposed to it. The latter carried the day by a vote of 167 to 36. H.N.V. ~ouicw~ and Rotices of 'ochs. A System of Obstetric Medicine and Surgery, theo- ýretical and clinical, for the Student and Prac- titioner.-By RoBT. BARNEs, M.D,, Obstetrie Physician to St. George's Hospital,'\u0026c., and FNCOURT BARNES, M.D., Physician to the Royal Maternity Charity and to the British Lying-ini Hospital. Illustrated with 231 woodcuts. Phila- delphia; Lea Brothers \u0026 Co. A modern work on obstetrics has an immense field to cover. No branch of medicine bas made more advances than this, and there. is none in which it is of the greatest moment for every general practitioner to find himself thoroughly au fait. The additions to our.knowledge of the causes of suppuration and of septic processes in wounds have been very remarkable, dating from \" Listerism,\" and now used in the various forms of so-called \"antiseptie\" surgery. The same principles have been invoked in the case of the puerperal woman, especially in lying-in hospi- tals, and the success obtained, as. shown by greatly reduced mortality, has been very striking. Dr.\" Fancourt Barnes has' been one of the strongest advocates of\" antiseptic midwifery,\" and has done much to show the superior advantages of some form of antisepsis under these circumstances. This point is merely mentioned as one of the most prominent at'the present day, which is necessarily to be found fully discussed only in the most 423",
         "CANADA MEDICAL AND SURGICAL JOURNAL. recent writings. Many others might similarly be added to this. Dr. Robert Barnes bas long been one of the leading English obstetricians, and his work and special writings (especially upon the obstetric operations) are well knowi in this country. It is, therefore, with pleasure that we draw attention to the appearance of his systematic treatise upon the whole subject. Some of the earlier chapters upon Embryology have been ontributed by Prof. Milnes Marshall. It is a very handsome book, profusely illustrated, and will be found invaluable for the advanced student and for purposes of reference. Acne: its Etiology, Pathology and Treatment. A practical treatise based on the study of 1500 cases of Sebaceous Disease.-By L. DUNCAN BULKLEY, A.M., M.D. New York and London: G. P. Putnam's Sons. This is a treatise on a very common *affection of the skin, which is a source of trouble and anxicty to young people of both sexes. Like the work on Eczema by the same author, it is based on the clinical study of a nuniber of cases, and the whole work is arranged in much the same way. The anatomy and physiology of the sebaceous glands are first dealt with, and then a chapter is devoted to nosology and varieties, of acne. There is also a chapter of statistics and one on the etiology of the disease. It is not till the fifth chapter is reached that the author rcally warms to his work, and describes the different forms of acne and their treatment. These chapters (V and VI) are valuable, and really tell us something about the various forms of acne. The author evidently regards acne as an affection which is significant of a deteriorated state of health. In this we cannot agree with hia, as the most healthy young people are often afflicted with acne, and, in fact, few persons pass through the period of adolescence without having had some form of acne ; on the other hand, the most debilitated not unfrequently have the clearest complexions. Minute directions are given as to diet and hygiene, and these will greatly please \" acne hypochon- driacs,\" who delight in centreing their thoughts- on their own persons and in magnifying their ailment. The common forms 424",
         "RÈVIEWS AND NOTICES OF BOOKS. of acne are peculiar to adolescence, and as Hebra remarks, \" tempus varos curat.\" It is the privilege of the well-to-do to enjoy treatment by alteratives, dieting and local applications, which, at the most, can be of only temporary benefit, The poor arrive at the same result by allowing time: to cure the disease. We confess we cannot seeany reason to magnify such a disease as acne by devoting a book ~of nearly 300 pages to its pathology and treatment. Life is too short and books too many for any ordinary individual to be able to read a large work on such a comparatively unimportant disease as acne, when a much more- concise and useful account can be obtained from any good text- book on skin diseases. To show how it is necessary to pad works of this kind, ive might mention that no less than eighteen pages are devoted to Bibliography, nine to a \" Synopsis of the Classi- fication of Sebaceous Diseases by writers on General Medicine and Dermatology,\" and five to the \" Names applied to sebaceous diseases in the literature of dermatology, with equivalents and synonyms.\" The work is well illustrated and the typography excellent. The book itself tells us all that is known about acne and its treatment, and is, in parts, a valuable contribution to the literatuie of the subject of which it treats, notwithstanding its prolixity. Epitome of Diseases of the Skin.-By L. A. DuuRINa, M.D. Philadelphia: J. B. Lippincott \u0026 Co. This little book is composed of sixteen lectures delivered by the author before the graduating class of the University of Pennsyivania. It is not intended that it should take the place of the larger text-books on diseases of the skin, but is meant to be an aid to students. It is a handy little book, can be easily put in the coat-pocket, and will be very useful to students attend- ing skii dispensaries and the out-door departments of hospitals. It is supplied with a good index. The various skin diseases are shortly and clearly described, and in describing the treatment, formulæ are given. It is a capital little vade recum for students, and very cheap. 425'",
         "426 CANADA MEDICAL AND SIURGICAL JOURNAL. The Management of Labor and of the Lying-in Period. A Guide for the young Practitioner.- By H ENRY G. LANDIS, A.M., M.D., Professor of Obstetrics and Diseases of Women in Starling Medical College; Fellow of the American Academy of Medicine ; Member of the American Medical Association, \u0026c. Philadelphia: Lea Brothers \u0026 Co. Dr. Landis is already well known as the author of \" How to Use the Forceps \" and of \" A Compend of Obstetrics.\" In the first of these works he very clearly expresses his views on the mechanism of the descent of the head through the pelvis, and makes a strong plea for the Davis forceps, which he maintains will fulfill all the legitimate uses for which obstetric forceps have been designed. In the present work, which is intended to serve as a guide to practice, the author sets forth briefly and with clearness his views as to the proper management of labor and the puerperal period. He first treats of the management of simple labor, and then considers the treatment of irregular or abnormal labors. The part of the book calling for particular remark is that which pertains to the use of the forceps. The author still cleaves to the Davis forceps, insisting, as he did before, that the blades shall be applied to the sides of the child's head. From some experience in the use of this instrument, we concur in this essentiali requisite. . For this reason we also think that for the young practitioner not expert in digital examination this instrument is not the best or safest. Its use necessitates accurate diagnosis of the position of the head, and without a clear knowledge of the position, we think that the Davis forceps is neither easy to introduce nor safe to use. The advantages of the instrument are its great head curve, which prevents slipping when properly applied, and also the width of the blades, which enable them to fit closely to the head. The great head curve and broad blades make them, however, more difficult of intro- duction, which is a serious bar to their safe use by a tyro. Tho objections to the use of the Davis forceps do not apply at the outlet, where the head has rotated, so that if the blades are applied on opposite sides of the pelvis they will fit on the sides",
         "REVfEWs AND NOTICES 0F BKooKs. of the child's head, but they do apply when the arrest of the head is at the inlet, where it is situated obliquely, and wherc, if they are properly applied by skilful hands, this instrument gives excellent results, The physician engaged in active obstetric practice will find the pages of this little book, which are devoted to the application of the forceps and the mode .of making traction, well repay perusal. The method of making traction is peculiar, and consists of a combination. of two forces, namely, a direct traction on the hiidles with one hand and a pressing downwards and backwards' in the axis of the inlet with the other hand infront of the lock.' In this way we get \" axis-traction,\" the great advantage of the Tarnier forceps. The old leverage or swaying from side to side movement of tie forceps is very properly condemned. As the author states, \" The practice is one of great antiquity ; it was begun in ignorance of the truc mechanism of delivery, and it is continued only by those who are wilfully blind to its nature.\" The chapter on Cosarean section, Porro's modification of this operation, and gastro-elytrotomy, as -recommended by Thomas, is short and to the point. Altogether, this modest little book is well worthy of careful study, and can be recommended, espe- cially to the young practitioner, as a good general guide in the management of this very important branch of his profession. Practical Suggestions respecting the Varieties of Electric Currents and the Uses of Electricity in Medicine. With Hints relating to the Selection and Care of Electrical Apparatus.-By A. L. RANNEY, M.D., Proftssor of the Anatomy and Physiology of the Nervous System in the New York Post-Graduate Medical School. New York: D. Appleton \u0026 Co. This will be found to be a convenient and trustworthy work on the practical application of electricity in medicine. The author tells us it is the first instalment of a complete work on the ner- vous system. It will be found very useful to those practitioners who desire to have a scientific groundwork for the use of elec- tricity. It differs in this respect from previous American works 4 f,",
         "428 CANADA MEDICAL AND SURGICAL JOURNAL. on electricity in medicine. Were it not for the unexampled greed for money of the manufacturers of electrical apparatus on this continent, the use of the different batteries would be much more common than they are. The prices charged for both faradic and galvanic batteries is practically prohibitory to the majority of general practitioners. There is little use for good works on the use of clectricity when it is not possible to conveniently obtain reliable batteries at moderate rates. A Practical Treatise on the Diseases of Children.- By A. VOGEL, M.D., Professor of Clinical Medicine in the University of Dorfal, Russia. Translated by 11. RAPHAEL, M.D. Third American froni eighth German edition; re- vised and enlarged. New York: D. Appleton \u0026 Co. A work that has been before the public for twenty years, that has been translated into all the principal languages, and of which the translations have run through many editions, requires no further commendation from us. It appears to us to owe this unusual success to its terse, clear and accurate symptomatology. Many of the pictures of disease in chiidren are the clearest we have read. In general, the pathology has been revised, and in most subjects corresponds with recent German thought. The therapeutics are eminently judicious, but the prescriptions are very German-e.g., root juniperi. Of many drugs of recent date no reference is made. Still, we speak of it as an old friend when we say we can cordially recommend it, especially to those who do not confine themselves to only one treatise on this subject. The translation is an eminently readable one. A Treatise on the Diseases of Infancy and Child- hood.-By J. LEWIS SMITH, M.D., Clinical Professor of Diseases of Children in Bellevue Hospital Medical College, \u0026c. Sixth edition ; thoroughly revised. Philadelphia: Lea Brothers \u0026 Co. With the beginning of the new year, the sixth edition of this now standard work is issued from the press. In the preface, the author states that a considerable part of the. book may be",
         "REVEWS ÀND NOTICES OF BOOKS.1 4 considered new. The articles on scarlet fever, cerebro-spinal fever,,pseudo-membranous croup and infantile diarrhœa have been entirely rewritten. That on scarlet fever is a most ex- haustive one, occupying nearly 70 pages, and is well worth careful reading. One recommendation in it we may mention here-the use of boric acid as a preventive and antidote to the scarlet fever poison, as well as in diphtheria. The substance of the additional matter in the other articles bas appeared in recent contributions to the medical journals. Throughout the work, special attention* in the revision lias been given to the therapeu- tics. We know of no work we can recommend with so much confidence to both student and practitioner. Though many additions have been made to it, the book is still kept at its former size. A Text-Book of Pharmacology, Therapeutics and Materia Medica.-By T.. LAUDER BRUNTON, M.D., D.Sc., F.R.S., Fellow of the Royal College of Physicians; Assistant Physician and Lecturer on Materia Medica at St. Bartholomew's Hospital; Examiner in Materia Medica in the University of London, \u0026c. Adapted to the United States Pharmacopœia by F. I. Williams, M.D., Boston, Mass. Philadelphia: Henry C. Lea's Sons \u0026 Co. The author of this work bas been known for a number of years as one of the most active and painstaking laborers in the field of modern pharmacology. When the announcement was made that a work on this subject from his pen was to appear, there was a natural expectation that it would be one of a high order, and we feel confident in stating that these expectations are more than realized. The work is one which will take the first rank as a text-book for students and as a work of reference for prac- titioners. It is divided into two parts-the first dealing with general pharmacological subjects, while the second is devoted to materia inedica and to general pharmacy, together with a des- cription of the actions and uses of individual drugs. This part resembles the majority of text-books on materia medica in its scope and mode of arrangement. The first part is of great value, 429,",
         "CANADA MEDICAL AND SURGICAL JOURNAL. as it is the first complete and systematic attempt in an ordinary text-book to explain fully the methods by which the action of drugs is determined, and the manner in which each function of the body is modified by medicinal agents. Another new feature in this work is the prefacing of the mode of action of drugs on the different functions, by an account of the physiology of the various organs. In the case of the heart and kidneys, this account is very full and elaborate. At times the author discusses also pathological questions. In this way the practical application of scientific pharmacology is made clear. The author, in his preface, laments the amount of pharma- ceutical and other unnecessary details required by the medical examining boards of the United Kingdom. , It is a pity, we think, that lie did not have the courage of his opinions and leave out of his work what he so much and very rightly objects to. Our medical boards in Canada are,unfortunately for our students, just as exactinig in the matter of burdensome and useless know- ledge of the materia medica as any of the English boards. Surely the day has arrived when examinations in scientific phar- macology and therapeutics should take the place of materia medica examinations. We feel confident that Dr. Brunton's work: will do much to bring this desirable change about. The worL - J issued from the Philadelphia publishers is much more convenient for reference and reading than the volume of the English publishers. The therapeutical index at the end of the volume '1 be found of service. There are also copious general ana bibliographical indexes. Manual of the Diseases of Women: Being a concise and systematic exposition of the Theory and Practice of Gynæcology. For use of Students and Practitioners.- By CHAS. H. MAY, M.D.. late House Physician, Mt. Sinai Hospital, New York, \u0026c. Philadelphia : Lea Bros. \u0026 Co. A small work, arranged with chapters upon all the more im- portant diseases and disorders of the female pelvicorgans, and with headings to make reference easy. It seems to'have been carefully put together, and no doubt will be found useful for the purposes intended,",
         "- REVIEWS AND NOTICES OF BOOKS. 431 The Extra Pharmacopœia, with the additions intro- duced into the British Pharmacopæia of 1885.- By WILLIAM MARTINDALE, F.C.S., late Examiner of the Pharmaceutical Society, \u0026c. Medical References and a Therapeutic Index of Diseases and Symptoms by W. WYNN WESTCOTT, M.B., Lond., Deputy-Coroner for Central Mid- diesex. Fourth edition. London: 1. K. Lewis. The appearance of a fourth edition of this work since its pub- lication two and a half years ago shows that it is well received. The present edition opens with an account of the changes in the recent edition of the British Pharmacopeia. The authors con- sider that it wa7s unfortunate, that no working medical practi- tioners or practical pharmacists had a voice in the -production of the pharmacopoia. We consider this little work of much more value to the practitioner than the pharmacopoia. It contains a vast amount of important information on improved methods of administering drugs not obtainable elsewhere. It is a work we think that every practitioner should have. The therapeutical part of the volume has been brought up to date, at least as far as English literature is concerned. We would be glad_ to find references in future editions to foreign literature as well. All that is good in therapeutics does not appear in English medical literature. The therapeutical index would be greatly improved if it contained less empiricism and more science. The description of some recently-introduced agents on page 137, et seq., is too short to be of any value. An Atlas of Clinical Microscopy.-By ALEXANDER PEYER, M.D. Translated and edited by ALF. C. GIRARD, M.D. New York: D. Appleton \u0026 Co. A Manual of Microscopie Technology, \u0026c.-By DR. CARL FRIEDLANDER. Translated by S. Y. HoWELL, M.A., M.D. New York: G. P. Putnam \u0026 Sons. The first of these books is a most useful one to every medical mau possessing a microscope. Most of the substances obtained from the fluids of the body, in disease (except those from tumors), will be found figured here. Nearly-one-half the number of plates",
         "432 CANADA MEDICAL AND SURGICAL JOURNAL. are devoted to urinary deposits and substances found'in urine. Fourteen plates represent substances present in sputum. Other plates are devoted to blood, vomit, contents of stool, etc. ; in all, ninety plates. The American public owe a debt of gratitude to Dr. Girard for the English translation of Dr. Peyer's useful little book. In thé act of translation, however, it has really been TRANSLATED, as it is more than twice the dimensions of the German first edition, with only eleven extra plates. In this condition it certainly makes a much more imposing volume. The plates are all well executed, and reflect great credit on the publishers. Friedlander's manual translated by Coe has already- been re- ferred to on page 227 of this JOJRNAL. Dr. Howell's transla- tion has the advantage of a few foot-notes, but the disadvantage of having no index. Either of these editions would -be a most useful and in many respects an almost necessary accompaniment of Peyer's Atlas. Without the slightest hesitation we advise eVery practitioner or medical student having a microscope to secure both these valuable additions to our literature. Bohs and ?amplets .eceived. BRAIN-REST: Being a Disquisition on the Curative Properties of Pro- longed Sleep. By T. Leonard Corning, M.D. Second edition. New York and London, G. P. Putnam's Sons. PSYCHIATRY: A Clinical Treatise on Diseases of the Fore-brain, based upon a study of its structure, functions and nutrition. By TLeodor Mey- nert, M.D. Translated by B. Sache, M.D. Part L--he Anatomy, Phy- siology and Chemistry of the Brain. New York and London, G. P. Putnam's Sons. BAsic AURAL DYscRAsIA AND VASCULAR DEAFNESS: A New System of Aural Therapeutics and Pathology. Also, Notes on the Deafnesses. By R. T. Cooper, M.A., M.D., Univ. Dubl. London, Baillierè, Tindall \u0026 Cox. LECTURES ON SYPILIS. By G. Frank Lydston, M.D. Chicago, A. M. Wood \u0026 Co. TEXT-BOOK OF OPHTRALMoSCoPY. By Edward G. Loring, M.D. Part i. New York, D. A ppleton \u0026 Co. THE FIELD 'AND LIMITATION OF THE OPERATIVE SURGERY OF THE HUMAN BRAIN. By J. B. Roberts, A.M., M.D. Philadelphia, P. Blakiston, Son \u0026 Co. PUERPERAL CONVALESCENCE AND TUE DISEASES OF THE PUERPERAL PERIOD. By Joseph Kucher, M.D. New York, J. H. Vail \u0026 Co. LETTERS FROM A MOTHER TO A MOTHER ON THE FORMATION, GROWTH AND CARE OF TUE TEETH. By Mrs. M. W. J. Philadelphia, Welch Dental Co. TRANSACTIoNs oF THE ACADEMY OF MEDICINE IN IRELAND. Vol. III. Edited by Wm. 'homson, M.A., F.R.C.S. Dublin, Fannin \u0026 Co.",
         "CHATHAM MED.ICAL AND SURGICAL. SOCIETY. CHATHAM MEDICAL AND SURGICAL SOCIETY. Stated iVeeting, Dc. 8th; 1885. JOHN L BRAY, M.D., PRESIDENT, IN THE CHAIR. (From our own, Correspöndent.) Beirrlus of the Pancreas.-D)R. TYE exhibited this specimen, also portions of~the liver and lungs of the same subject, showing secondary deposits to a marked extent. The duodenal end of the pancreas was chiefly involved, although hard masses were scattered through the entire organ. The gall-bladder was shrunken and small. The stomach appeared normal. The patient, aged 55, had always been a healthy man. When first seen by Dr. Tye he had a tired, worn, anxious look, and com- plained of persistent pain in the epigastric region. This pain, 'which was referred latterly more to the right hypochondriac region, and emaciation were the only marked symptoms he suf- fered from. He rarely vomited or complained of nausea. Bowels were usually constipated, probably due to the opiates required to alleviate his sufferings. There was no tenderness, no eleva- tion of temperature at any time, and no jaundice. Fatty foods did not apparently disagree with him, and the fæces were natural whenever examined. A Case of Placenta Prvia,with Albuninuria.-DR. HOLMES narrated a case of \" central implantation\" at which he had been in attendance during the past two days. He was called to the country early yesterday morning to see the patient, aged 18, a primipara. She had been flowing some during the previous two days, with this exception, there had been no loss of blood during her-pregnancy. An examination revealed a placental presenta- tion, the~cervix being dilated sufficiently to admit the forefinger. She liad slight pains and a fair pulse. Nausea and headache during the past few days led to an examination of the urine, which was found to contain considerable albumen. A tampon saturated with a solution of corrosive 'sublimate 1 to 1500 was at once introduced. Ergot was administered, and pains became stronger and more regular. Towards evening, as the result of a consultation, the tampon was removed, and was immediately followed by a profuse gush of blood. Another tampon was quickly introduced, and the hemorrhage at once controlled. The -loss of blood by this procedure, amounting to not more than a small cupful, made a very marked impression, from. which she 28 433",
         "434 CANADA MEDICAL AND SURGICAL JOURNAL. did not rally for some time. About midnight she had a slight convulsion, became pulseless, and seemed almost in articulo mortis. Two drachms of ether were injected subcutaneously, and had an almost instantaneous beneficial effect. Shortly after, to give rest and quiet to the nervous system, i-grain of morphia was given hypodermically ; this was repeated in an hour, aiid produced several hours of quiet sleep. Nutrient enemata of beef peptonoids and peptonized milk were used every two or three hours, ber stomach not retaining any nourishment. At one o'clock to-day the tampon was again removed and the cervix found fully dilated, and placente about completely separated, there being no hemorrhage. Ergot was again given hypodermi- cally, and pains soon followed ; the placenta, shortly after, ex- pelled into vagina and removed ; forceps, applied, and child extracted. The mother was still alive, but in a very precarious condition. Dr. Holmes remarked in conclusion that he regretted the removal of the tampon in the first instance,. and considered that if a tampon was antiseptic, and there was .no elevation of temperature, it 'should be allowed to remain until forcibly ex- pelled or bulging is pronounced. Report of an Outbreak of Diphtheria.-DR. MicKEoUGIi read a lengthy history of a recent epidemic of diphtheria wvhich occurred in the parish of Pain Court. This district, which is inhabited by about 250 families, exclusively French Canadians, adjoins the Dover Plains, in the County of Kent, notorious for its malaria and ague. The land is low and flat, the soil a rich elay, and the locality an agricultural one. -From one end to the other runs a creek which is the principal source of drainage for the entire district. This creek is a running stream during the spring months ; throughout the remainder of the year it is either dry or contains stagnant water. The greater number of the inhabitants live along the banks of the creek. Malarious fevers. are common to this region ; typhoid fever is-rare ; scarlatina and diphtheria occur sporadically, but there has been no cases of either during the past two years till this outbreak, the first case of which occurred in September. Regarding its origin, in the first family afflicted there were two possible factors in the causation. lst, The fact that two years previously diphtheria ravaged this family, and the poison remaining dormant may have again become active. 2nd, The presence of the stagnant, filthy creek which passed not twenty yards from the house. The most careful inquiry failed to elicit any other possible source of contagion. The second case occurred within a week of the first in a family living five miles distant down thé source of the creek.",
         "CHATHAM MEDICAL AND SURGICAL SOcIETY. Thêre was no communication whatever between the two families. The creek passed directly in front of the infected house, a few large elm trees intervening. The bed of the creek is deeper here than in other parts of its course, and the rain-fall during the past summer being heavy, as a result there had been a pool of stagnant water here some months. In this case the health of the child afflicted may have predisposed it to the disease, having been unwell for some weeks ànd suffered from a \"sore throat.\" Drs. Wood an.d Formand state that the inflammation of an acute pharyngitis is capable of developing the common micrococcus of the mouth into a condition in which it becomes capable of pro- ducing all the characteristic phenomena of diphtheria. It is possible, also, that the germs of the disease in the cases which occurred two years ago may have been carried down the creek and lodged in this stagnant pool, lying 'latent, and becoming active at this time from unknown reasons. Whatever may have been the immediate origin of this outbreak, there can be no doubt that its diffusion was owing to its contagious nature. Con- tact with or close proximity to an infected person was the chief mode of communication. There were instances, however, in which the poison was conveyed several miles to children by a parent not affected with the disease. The first family affected lived on the verge of the parish surrounded mainly by English- speaking people thoroughly aware of the contagious nature of the disease, which ideas were imparted to their more immediate French neighbors. As a result, although five in this house con- tracted the disease, no evidence could be obtained of the disease spreading from this family. On the other hand, the second family attacked were surrounded, somewhat thickly too, by French- Canadians, who did not believe in the contagions nature of diph- theria. Here the disease spread most rapidly and disastrously. Within three months 47 cases occurred, with 18 deaths-16 from laryngo-tracheal diphtheria, 1 from asthenia, and 1 from paralysis of the heart. Only 7 of the 47 cases received medical treatment; 2 of these were seen after \" croup \" had developed, and both died, the other 5. recovered. With the exception of the strong tendency of the disease to affect the larynx and trachea, the epidemic was not of a malignant type. The mem- brane was of a pearly greyish-white color, and thin ; there was but little hyperæmia and odema of the fauces; not much glandular induration even in those cases in which the membrane was limited to the fauces. An analysis of the deaths in refer- ence to age bears out previous statistics. Between the ages of 1 and 5, there were 22 attacked, and 17 deaths; between",
         "436 CANADA MEDICAL AND SURGICAL JOURNAL. the ages of 5 and 10, there were 21 cases and 1 death ; be- tween the ages of 10 and 15, there were three cases and no deaths ; and one adult only sickened with it. Clinical evidence was plentiful towards proving the intimate relationship between diphtberia and the so.\u003c:alled \"truc croup.\" DR. RUTITERFÔRD, in the discussion upon this paper, referring to the constitutiona! nature of diphtheria, related the history of a case in which a father Who nursed a child through a severe attack of the disease, and who at no time felt any throat symp- toms, still, some threc weeks subsequently, had paralysis of the soft-palate. HAMILTON MEDICAL \u0026 SURGICAL SOCIETY. ( Fromn our own Correspondent.) The annual meeting of this Society was hcld at the Royal Hotel, Hamilton, Januar'y 5th, 1886, a large number of members being present. Dr. Cochrane teudered his resignation, whici was accepted. The following officers were elected for the ensuing year President,- Dr. Stark ; Vice-President, Dr. McCargow ;, Secre- tary-Treasurer, Dr. F. E. Woolverton. DR. Siw related a case of Iemorrhage from the Bowels in an Infant, which occurred in his practice. The child was born on the 24th December last. The labor was natural and easy. On the 26th, fifty hours after birth, the child passed blood from the anus in considerable quantity, and looked pale and feeble. It wac nursed on the third and fourth days, but died shortly afterwards. It was the mother's third confinement. There is a history of phthisis in the family. Dr. Shaw, after giving the causes and treatment of this condition, stated that Dr. West had seen 23 cases of hemorrhage from the bowels in infants,-with a mortality of 50 per cent. DR. MACKELCAN said he saw two cases, one proving fatal. Family history good. DR. MALLOc saw a case in Januarv 1880, which terminated fatally.",
         "CANADA MOlaTRRAL, - EBRUtARt 1886. TIE INTERNATIONAL MEDICAL CONGRESS. In our last issue we published gladly a letter fram Dr. Brodie of Detroit, whose opinions on the subject of the International Medical' Congress are doubtless shared by a considerable section of the profession in America, but, in spite of his communication, we still idhere to the position uhen by us in December. We then said that, to attract the workers of other countries, the sections of the Congress must be controlled by the men most eminent in their respective departments, and w maintained that the offBers so far nominated did not, with a few exceptions, rise above respectable mediocrity. In the spirit of the \" Declara- tion of Independence,\" we agree with Dr. Brodie that the gentle- men in question are \" the peers of any member of the profession in the United States,\" but the Congress is a scientiic organi- zation, and the executive and sections have, heretofore, heen composed of the best minds of the country in which it bas met. What we maintain is that many of the sections, as at present organized, are controlled by imen who, evidently, have not the confidence of the scientific workers in the United States, and are unknown abroad. At present, the prospect is that the peers of the men who organized the London Congress will be absent from the Washington meeting--the men who, in the inited States, occupy positions in the medical world corresponding to those held by Gull, Jenner, Wilks, Erichsen, Paget, Fraser, Fiower, and others who made the gathering of 1881 so brilliant. As well may we suppose that the British profession could have made that meeting the success it was without men of this stamp as that the American profession can do without the co-operation",
         "438 CANADA MEDIoAL AND SUROICAL JOURNAL. of such men as Agnew, Bigelow, Hamilton, Da Costa, Pepper, Mitchell, Loomis, Bowditch, Billings, Dalton, Martin, Leidy, Lusk, Thomas, Barker, Jacobi, Wood, Bartholow, and others who remain irreconcilable. Bombast and bluster will not cover up the disagreeable truth which is quite evident to outsiders, if not to Dr. Brodie, that, unless the present executive of the Congress patch up this unseemly quarrel, the meeting of next year is doomed to failure. The recent attempts to effect a com- promise do not appear to have been successful, and we can assure Dr. Brodie that, if matters remain as they are, \"'the most per- fect and elaborate arrangements \" will avail but little to attract foreigners in the absence from the sections of such a number of the men who have made American medicine and surgery what it is to-day. We sincerely trust that at the next meeting of the American Medical Association steps may be taken to secure the needful harmony, without which, we'repeat, it would be better THE ANTI-VACCINATION LEAGUE. We received a few days ago the prospectus of the \"' Cana- dian Anti-Compulsory Vaccination League.\" From the name -we would imagine that the object of 'the Society was only to resist compulsory vaccination, but on -reading further we find, also, the \" object and purposes of the League is (sic) to en- lighten the public mind on the fallacies and perils of vaccination.\" There is the usualf howl about the natural rights of man and liberty. Right to give smallpox to their neighbors, and Liberty to send thousands to an early grave. Why, they might as weil advocate the right of any man to set ßre to his house, and so, perchance, destroy the property of his neighbors ; but it is use- less to argue ivith such people. Their disbelief in vaccination does not arise from evidence, and so will not yield to evidence. Partial statistics from the Civic Hospitals are given of smalipox in the vaccinated and unvaccinated which are utterly unreliable, and garbled extracts are quoted from certain works on medicine. They are careful not to give any statistics of the' comparative mortality from smallpox in the vaccinated and unvaccinated. The usual ridiculous assertion is made that vaccination during",
         "anepidemic of smallpox propagates the disease, and for proof it is said that as soon as the demand for increased vaccination began in Montieal so did the death-rate increase. This is a post-/Ioc argument with a vengeance. But why say more of a prospectus whiCh is full of such assertions ? The fact that the League boasts for its president a person who has made himself notorions by the publication-of circulars of the most unprofes- sional kind-dealing wholly with sexual matters, and carefully calculated to'take in the young, the foolish and the unsophisti- cated-a person who was reported to have deait with the diploma- monger Buchanan for a degree-is suiicient. This man is now posing as the friend of the oppressed and the champion of anti-vaccination. We are surprised to see some respectable names in such com- pany, and associated in a crusade against reason and cominon sense. Of course in every community there are a certain number of eranks, irrationais and fanatics who will join any society which has anti emblazoned on its flag, and so the League will not want for members. The advisory council is composed of no less than four medical men (three French). The advice of such men who are unable to draw proper deductions from the overwhelming evidences in favor of vaccination will, we opine, be of no great value. If it is not too presumptuous, we should like to offer this young society a motto which to us seems very suitable, \"Suppressio veri, suggestio falsi.\" ORIGIN OF THE SMALLPox EPIDEMI.-The sub-committee of the Board of Health appointed to enquire into this matter have made a report, which they have caused to be published. Thev addressed enquiries in writing to those persons whom they believed capable of aidîng in their investigations. Most of these sent replies, and upon them the report is based. The conclusions arrived at bear out in every way the account already given in this JOURNAL (issues for April and July, 1885). This city up to February last was free-from smallpox. On the 28th February, a Pullman car conductor was admitted with that disease into the HFotel-Dieu Hospital (the .former EDIToRIAL. 439.",
         "CANADA MEDTCAL AND SUROICAL JOURNAL. Civic Hospital being at that time closed). No evidence is adduced to show that isolation was carried out. On the lst of April one Pelagie Robichaud died in the same institution from smallpox. This wonian was a servant in the hospital, and there is reason to believe had had access to the patient above al!uded to. \"I Her decease is immediately followed by such a large number of other cases among the persons in the establishment that it is thought necessary, to save the establishment itself, to dismiss ail the patients presenting no symptoms of the conta- gion and who could go home. What must have been the con- sequence for the city.of sending away the patients at the Hotel- Dieu by the decision of the 14th of April, when the Rev. Sister Superior of this house said to us that ' From the 8th to the 18th of April we counted sixteen cases of smallpox removed from the Hotel-Dieu to the Civic Hospital?'\" The folly of this step we have previously discussed. Thus, the report clearly attributes the outbreak to the original focus in the Hotel-Dieu, which, having attaind w s walis a certain force, was allowed to expand itself in all directions by sending to their homes many persons already in the stage of incubation. The Committee then proceeds to make certain suggestions to pre- vent the possible recurrence of a similar calamity in the future. They are sound, and are chiefly as follows :--That a civic smallpox hospital should be always open, provided with such a staff as circumstances may indicate. That the Medical Health Officer should be well posted as to the sanitary state of the various cities on the railroad lines communicating vith Mont- real. That any case of smallpox in the city should be at once isolated in the hospital. That steps be taken to guard the city against contamination from the surrounding municipalities. Finally, they urge the systematic vaccination of all young children, and to this end recognize the necessity for a register of births. The report and the evidence taken are published in extenso in pamphlet form, and is an officiai history of the ont- break. It is to be devoutly hoped that the practical sugges- tions made will never be lost sigit of by our Board of Health. 440",
         "EDTTORTAL. A FILTHY ADVERTISEMENT. In one of the leading dailies of this city of a few days ago, our attention vas directed to an advertisement which, for pure filth and deceit, exceeds anything we have ever seen printed in a paper which finds its .way to the hearths of many thousand families in our land. It is headed in large type-\" _Errors of Youth ! \u0026Sufferers from Nervous .Debility ! Youthful Indis- cretions ! Last fkanhood! Be yoùr own Pnysician\" And to revive the drooping spirits of the afflicted, there is a cut of an anchor, with .the word \" Hope\" written across it. The \" errors of youth \" are to be speedily and certainly cured by the following .prescription Cocaine, - - - 3 ss. Jerubebin,, - - 3 ss. Helonias Diocia, - ss. Gelse min, - gr. vi. Ext. Ignati Am., gr. ii. Ext. Leptandra, - gr. xl. Glycerine, - - q. s. M Make 60 pills. Two to be taken daily. It is adapted for either sex, anid the advertisers are particular in stating that if it cannot be made up by the local druggist, they will be glad to forward sixty such pills for a dollar. As the sixty pills contain $10 worth of cocaine alone, it is plain that it is all a fraud ; but this, unfortunately, is not the vorst feéature of it, as every medical practitioner knows. The amount of harm, mnentally, morally and physically, produced by such an advertisement is very great, and it is a lasting disgrace to the paper that publishes it. It is said these advertisements pay well. Of this there can be no doubt. If some of our news- papers, however, are ready to publish anything and everything that brings them money, it is time that the Legislature should precnt them. We have ,aws to prevent the importation of obscene literature from abroad. Let us, by-all means, have laws to prevent newspapers publishing what is infinitely worse.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. COLLAPSE OF THE LUNG. Dr. Theodor Dunin of Warsaw has recently published in Virchow's Archives an account of the minute anatomical changes occurring in collapse of the lung from compression. This study being almost the only literature on the subject, though pulmonary collapse through bronchial obstruction and pulmonary cirrhosis from extension of fibroid plcurisy, are fairly well understood. Three fatal cases and twenty experiments on cats and rabbits (by external pneumothorax and pleural effusion from repeated small injections of gelatinue solution) have led him to conclude that the essential results of compre --,,ion are at first flattening of the alveoli, compression of their capillaries and degeneration of their epithelium, and, later, that the flattened alveolar walls themselves, their capillaries now completely obliterated, are formed into fibroid strands and meshes. He considers the change a degenerative one, largely due to interference with the blood supply, and differing from collapse througoh bronchial obstruction by the absence of any active catarrhal pneumonia. A small-cell proliferation about the smaller bronchi going on to fibroid change he attributes to irritation from the retained bronchial secretion.. The fibrous tissue both from this source and from the degenerated alveolar walls would have, he thinks, but'little influence in pre- venting the re-expansion of the lung compared with that exerted by external pleuritic adhesions-a theory which certainly accords with the clinical features of these cases, since a lung, even if long compressed, may expand perfectly, provided the pleura be not much thickened. It would be interesting to know how far these changes may proceed without precluding the possibility of complete recovery. None of the cases observed were compli- cated by tubercle. A NEUROTIC FORM OF GANGRENE OF THE EXTREMITIES. Thle rare, but very in\u002boresting, disease known as symmetrical gangrene has been a prolific suiject of debate from the time of Quesnay's description of it in 1749 up to the recent publications of Profs. Pitres and Vaillard. At one time it has been looked A_40",
         "upon as of vascular origin, while at other times its neurotic origin appeared to have most supporters. Ragnaud and Weiss have advanced the theories that the essential starting point is a fune- tional derangement of the vaso-motor centre, through which a permanent contraction of the vessels is brought about-the arterioles, according to the former, and the smaller veins accord- ing to the latter. From the recent researches of Prof. Pitrcs and Vaillard, it appears that these views cai be no longer main- tairied, but that we must look upon the disease as a neuritis of the peripheral nerves. They report in full, two cases of this disease where, autopsies were obtained. The first occurred in a girl 24 years of age, who enjoyed good health up to her eighteenth year. From this out she became weak, and her limbs trembled and contractures of the lower extremities set in. On the 5th December, 1883, she Was admitted into the hospital with gan- grene of both feet (symmetrical). Two weeks later there were two symmetrical patches on the back ; six weeks. afterwards there was spontaneous amputation of the left foot at theankle joint, the right foot hanging by a few threads. In various parts of the body there was superficial sloughs. Death occurredjust two months after the disease was first noticed. At the autopsy, the nerves of the gangrenous parts presented marked alterations. The right anterior tibial nerve had hardly a healthy fibre left. The nerve fibres of ail the affected parts had lost their myelin sheaths, and between them was situated fat-drops and leucocytes. The second case occurred in a woman aged 56. It began with loss of sensation in the soles of the feet, followed, four months afterwards, by vesicles and swelling of the feet. When admitted into hospital in January, 1884, the patient had a nor- mal temperature. There was great odema of the left foot, with ecchymotic patches under the nails. The whole foot had a bluish appearance. It was cold and devoid of feeling. The right was similarly, althoùgh not so extensively, affected, There was neither sugar or albumen in the urine. The patient died two weeks after admission in a comatose state, the gangrene in the meantime having made such progress that both feet were in a mummified condition. The only changes of moment noticed at the post-mortem were the extensive alterations in the nerves of 44à ÉÏ)IToÉIAi,.-",
         "CANADA MEDICAL AND SURGICAL JOURNAL. the gangrenous parts. The internal plantar and the posterior tibial nerves showed the most extensive alterations. In some parts there was complete destruction of the fibres, while in all parts they had suffered more or less. There was no clotting in any of the vessels of the limbs. An account is given of a case of gangrene of both lower ex- tremities in an old man from embolism, where the most careful histological examination failed to find any changes whatever in the nerves of the gangreneous parts. The authors consider that they are justified in coming to the following conclusions from the observations they have made on the three cases just briefly detailed : 1. That there is a form of symmetrical gangrene of the ex- tremities which is not brought about by the commonly recognized causes of this disease, as cardiac and circulatory disturbances, septic infection, or traumatism. 2. That in this form there is in the nerves of the parts deep changes, constituting parenchymatous nephritis. 3. The neuritis is not caused by the gangrene ,as it is.not found in gangrene from occlusion of the vessels. It is probable that the neuritis causes the gangrene. 4. In addition tothe usual form of spontanousgangreno the extremities, there is a so-called neurotic .gangrene .which resembles, in its symptoms and development, other forms of trophic disorders which follow inflarmation or degeneration of the peripheral nerves. THE BOWMAN LECTURE. The Bowman lecturer for the present year was Dr. Huginiigs Jackson. His subject was \" Ophthalmology and Diseases of the Nervous System.\" The address, which is a masterly one, had for its main object the setting forth of the necessity for specialism in medical work, especiallyspecialism combined with co-operation. In scientific as well as in social progress, there were four degrees or stages to.be noted. 'Tie advance of scientific -medicine de- pends upon increased differentation of work and definiteness of observation, combined with increased integratidn of knowledge and co-operation of workers. \" Specialists have to justify them- 444",
         "selves to justify their differentation., Increasing differentation without-increasing definiteness would only be confusion.\" That the ophthalmologists bave justified their differentation there is abundant proof; the lecturer specially ioted the work done by them in ocular paralysis and on abnormalities of refraction. As a justification for neurology, the lecturer instanced Charcot's work. If justification was needed for the neurologists, it would be more than found in Dr. Jackson's own splendid achievements in this field. The address was principally taken up with a descrirtion of idiopathic epilepsy, showing how necessary it was for the full and complete elucidation of this subject to have the special work of a large number of specialists. The neurologists, the alienists, the ophthalmologists and the physiologists will al; find-in this one subject work of a special character, and it is only by the co-operation of such a band of workers that we will be enabled to understand the disease in question. incidentally the lecturer advanced the hypothesis tii t there is atrophy of cells of centres for organie parts, like the atrophy of cells of the anterior horns. Diabetes may be owing to pro- gressing atrophy of cells of that part of the great vaso-motor centre which especiaily goverus the hepatic artery. It was also suggested that Graves' disease and myxœdema have a somewhat similar central pathology. The rich suggestiveness of these and many other hypotheses advanéed by Dr. Jackson will well repay the physician's closest attention. Dr. Jackson's utterances to the medical ,orld are all characterized by great originality and honesty, and this his latest production is no exception. PRESENTATION TO DR. MEWBURN.-Dr. Mewburn, who was formerly resident medical officer in the Montreal General Hos- pital, has served during the past four years as house surgeon of the Winnipeg. General Hospital. In this capacity he has gained the respect of the hospital authorities and the profession generally. le bas now left Winnipeg to take medical charge of the Galt Coal Mines. Before leaving, he ivas presented with an address, together with a gold watch and chain, by the members of the profession in the city, to express the great EDITORIAL. 445",
         "446 cANADA MEDICAL AND SURGICAL JOURNAL. esteem in which he is held. The students of the medical school also made a presentation, with many good wishes for bis future prosperity. We congratulate the Doctor, and wish him success in bis new sphere. Dr. D. W. Eberts, who was serving as resident medical officer at the Montreal General Hospital, lias been chosen as Dr. Mewburn's successor, and has gone West to assume bis new duties. He carries with him the best wishes of his friends in Montreal for bis advancement and sucess. -We observe that Dr. Piffard has retired from his editorial connection with the Journal of Cutaneous and Venereal Dis- eases. The Journal will be continued under the 'sole editorial charge of Dr. P. Morrow. We may remind our readers that this is the only publication in the English.language devoted to skin and venereal diseases, and during the three years of its existence it bas won for itself a high reputation for scientific excellence as well as practical utility. In addition to present- ing all that is new and valuable in these special departments, the colored lithographs and wood engravings with which the original articles are illustrated are worth more than the price of subscription. -At the annual meeting of the Huron Medical Association, held in Seaforth on the 16th ult., the following officers were appointed for the ensuing year:-President-.Dr. Campbell, Seaforth ; Vice-President-Dr. Young, Londesboro'; Secre- tary-Dr. Worthington, Clinton. The attendance at the meeting was gool, and the number of cases presented exceeded that of any previous meeting of this vigorous and progressive medical society. In our next number we hope to give a ful account of the proceedings. ersonaX Dr. Phillippe Wells of Quebec has been appointed member of the Central Board of Health, to fill the vacany caused by the death of Dr. Marsden. Dr. C. S. Parke of Quebec bas been named commissioier of the Marine Hospital of that city, to replace the late Dr. Marsden. Prof. Strümpell, of Leipzig, has been appointed to succeed Leube as director of the medical clinic of the University of Erlangen. Prof. Strümpell is one of the most active and hard working of German physicians.",
         "MEDICAL ITEMS. Me'dical Item S. -The conduct of Dr. Heywood. Smith in reference to the girl Eliza Armstrong bas been investigated by the Royal College of Physicians, and at a meeting held on the 18th December the following resolution was adopted; \".The College having con- sidered the statements made *by Dr. Heywood Smith and his apology through the Censor's Board, while acquitting him of deliberate attempt to do evil, desires to put on record an opinion that he has committed a grievous error in connection with the Armstrong abduction case, which has brought discredit on him- self and the profession to which he belongs. The College, there- fore, regards his conduct as deserving the severest censure, and requests the President to.express the views of the College and to reprimand him accord'ngly.\" MEDICAL FIONORS.-Dr. Paget of Cambridge and Dr. William Roberts of Manchester have received the honor of knighthood. Dr. Paget, who was until recently the President of the General Medical Council, owes his elevation to the active and distinguished part he has taken in founding what is now one of the most im- portant medical schools in the United Kingdom-the Medical School of the University of Cambridge. Dr. Roberts is well known as one of the leading scientific physicians of the present time., His work on the kidneys is a classical production, but in his contributions to the therapeuties of digestion we have a still more enduring memorial of wbat can be done by a physician who who has the will to work. The great practical results that have been already achieved by his method of treating cases of diffi- cuit digestion in the course of acute and chronie disease prove it to be one of the most important therapeutic advances of the past decade. It is to be hoped that both these gentlemen will long be spared to wear their honors and grace our profession. -The Medical Age thus discourses: \"The rectum bids fair to be a bigger bonanza to the doctors than ever the womb has been. It appertains to both sexes and ail ages. From the great-grandfather to the neonatus, the rectum offers itself for inspection and treatment. And the beauty of it is, it suits aIl tastes in its tolerance of attention. The surgeon can cut it, tear it, cauterize it ; blister and burn it ; be can expand it, con- tract it, pinch it and pucker it ; plug it and unplug it. The barber can barber it; the leecher can leech it ; even the mid- wife can anoint it, syringe it and empty it. The doctor can doctor it in any way lie pleases. It takes big doses with com- ,posure and little doses with a quick response. It is susceptible 447",
         "448 CANADA MEDICAL AND SURoICAL JOURNAL. of medication both directly and indirectly, and it is a portion of the economy so universally necessary to the comfort, health and life of every single member of the human family, that in its possibilities there is, so to speak, no end to it. However it may be treated, whether by expert or neophite, it is senseless, car- less, eyeless. Ilowever much the viseus may be damaged, in the course of its experiences, its hapless owner can't see it and be a reliable witness to malpractice in a court of justice. H1e can't by siglit count its scars, measure in inches the depth of his sphinctral misery. Any error in diagnosis or failure in treat- ment, while necessarily fundamental and possibly serious in its eonsequences, is easily covered up, for, with a little alum or tannin properly applied, so far as giving anything away is con- cerned, the rectum may be rendered as ' tight as a drum.' The failure, should.it occur, niay be attributed to a ' cold,' or some indiscretion in diet, or to atmospheric or telluric disturb- ances, to all of which the rectum is highly sensitive. A sudden and unforeseen onset of microbes may upset the calculations and predictions of the most skilful and astute physician, and render negative his best endeavors. To the coling doctor the rectum presents an opening compared to which a malposed womb or dis- located ovary is nothing worth a thought. In a word, the womb of the future is pregnant with golden possibilities regarding the rectum.\" \" MELLIN's FoOD.-This preparation is, in fact, an excellent attempt to give the extractive and soluble portion of Liebig's food, without the cellular and indigestible part of the meal. In other preparations of this class this was partially avoided, but not wholly so, by straining. There is no evidence of starch remaining in this preparation, it having been all converted into grape-sugar and dextrine, and there is no reason to believe that, it is prepared from anything but malt and wheat. As a food for delicate infants, there can be no question as to its great value.\"-Medical Press and Circular, London. LACTOPEPTINE.-We bave used this article for some time in cases of indigestion, and can recommend it as a valuable remedy. Being a compound of the five active agents which are contained in the process of digestiou, it cannot fail to aid the system in preparing the food for assimilation. It is an invaluable remedy in the summer diarrhoa of children. Owing to its great impairment of the vital forces, and feeble powers of the digestive tract, food frequently irritates and increases the difficulty. For such cases we learn of no agent in the Materia Medica as reliable as Lactopeptine.-Cal. IMed. Jour."
      ],
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         "Canada medical \u0026 surgical journal [[Vol. 14, no. 7] (Feb. 1886)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. aledictory Address Io the Graduates in Medicine and Surgery, MoGill University. Delivered on behalf of the Medical Faculty, at the Annual Convocation, heid in the William Molson Ilail of the University, on Thursday, 28th March, 1872. By Josurî MonLr DIuE, M.D, Professor of Clinical Medicine. Osa\u0026NnmuX GRADIeTEs IN MEDIOIm, -It is, believe me, not in mere compliance with an established custom, with no vain formula of idle words that I, on the part of my colleagues and myself, offer you our most cordial congratulations on this occasion. You have just received the highest honour this faculty has to bestow- the degree for which you have so long and so earnestly laboured, and which you have at length fairly and honourably won. May it acquire fresh honours ia the possession of each and every one of you, and thus deserve to be regarded with ever increasing esteem by your successors. Together with that friendly interest and sympathy which all right minded persons must feel, on witnessing the setting forth on life's journey of so many youthful pilgrims. We, as your teachers, experience much personal pride and satis- faction, as we wash our hands of a task, which though laborious enongh at the time, promises a most pleasing reward in the future. Most or all of us no doubt, will watch your career in a spirit not altogether unselfish in its character, triumphing in your success and sympathizing in your trials. With an eamest desire for your welfare, I would wish to offer a few words of parting counsel, which I trust may be neither useless nor aitogetier unacceptable. You have chosen a profession whose duties are indeed arduous and responsible, but a profession which is second to none in point d usefulness, \" Ennobled by endless examples of the most heroic \"self sacrifice, and offering full scope for the exercise of the high- \"est intellect, the purest philanthropy, the proudest ambition.\" There is perhaps no other calling which should in itself tend to BB",
         "CANADA MEDICAL JOURNAL. elevate and refine its followers-to make them ensamples of good to all men--so much as that to which you have devoted yourselves, and indeed it is not going too far to say that in this respect it is incomaparably superior to most other professions. Your prospects of material success depend as a matter of course very nuch upon the exercise of qualities, which are essential to success in any and every walk of life. Integrity, industry, energy, and temperance in all things, must formu part at least of the basis on which to build a lasting superstructure. Without these we have too often seen the most brilliant talents prove useless and unproductive, but possessing these qualities, and with such a knowledge of the prin- ciples of your profession as you undoubtedly have, you may con- fidently expect to achieve a position alike honourable to yourselves and useful to society. That much of your prosperity, and still more of your comfort, will depend upon the adoption of business-like and methodical habits at the- outset of your career, is a statenaent so obviously true, that it must needs meet your approval. Yet unfortunately, though all admit its truth, we are obliged to admit that compara- tively few of us are as methodical as we ought Vo be, and a very large minority, to speak mildly, appears to get along in a \"happy go lucky \" sort of way, ignoring method and business habits altogether. The medical man labours under rather exceptional difficulties in this respect, since he is liable to long and frequent interrup- tions at all times and seasons. le must constantly be prepared to forego bis sleep, bis meals, his business, study or pleasure, ai the calrof suffering, aud must exorcise the most watchful care to avoid falling into slovenly and unsystematic habits ; te say nothing of the very injurious effects which may in ccnsequence, and indeed notwithstanding all care, often do result to bis health, and thus impair bis usefulness, mar bis fortunes, and even shorten his days -the absence of systen or method often leads him to neglect or hastily and discreditably perforn collateral but less urgent duties. For example-his accounts are badly kept, correspondence de- ferred, study neglected, often alas entirely discontinued, and what is of almost equal importance, bis notes of cases are if taken at all; either recorded so imperfectly, or preserved in so slovenly a manner, as to render them practically useless for future reference, and thus the experience and observations of a lifetime, often valu- able in themselves, or rich in suggestions, becorne all but fruitless of result either to himself or others. Take careful notes of alI the cases which come under your care from the very first-regard this as a duty, and not merely as a matter of taste or inclination-",
         "DR. JOSEPH MORLEY DRAKE' S ADDRESS. at first you may find the task rather irksome, but presently it will grow into a confirmed and not unpleasing habit. The importance of this proceeding ta yourselves, and to those under your charge, can scarcely be exaggerated. As a mental exercise, the necessity of accurately and decisively expressing what you observe from day to day, will enable you to form far more clearly defined opinions of the nature and progress of a difficult case, than if you should trust merely ta memory, and having the facts always ready for reference, may obviate the necessity for repeating questions for- merly answered, and save you from the imputation of carelessness er forgetfulness. The value of such notes in legal enquiries which may arise, the satisfaction of being able at any time ta refer ta former details of treatment, or to give precise information as ta other matters connected with past illness, and the scientific value of such records are obvious enough, and besides the possession of a trustworthy health record of the families you attend, becomes often of great practical value in subsequent illness by reminding you of important circumstances which else would have been over- looked or forgotten. It is I trust unnecessary ta caution you ta refrain from conduct which may injure the honour and dignity of the profession you represent, to abstain from newspaper adver- tising in the shape of puffing notices of wonderful operations and miraculous cures, and ta strongly discountenance the well mean- ing, but indiscreet effbrts which your friends may sometimes exert in your favour to induce patients to change their physician. Speaking ta gentlemen, it is also unnecessary ta enter into detail on the subject of what your conduct should be to your pa- tients. Self interest, if no higher motive should induce you to avoid whatever might sully your good name, or injure you in the confidence of those whose lives and honour are entrusted to you- strive to preserve within you that- Y Peace above all earthly dignities, A still and quiet conscience.\" lu your intercourse with the sick you must of course expect much that is annoying, much that is unjust and unreasonable, which you must nevertheless bear with philosophic Christian equanimity, content to know that you are doing your duty faith- fully. It is I believe a very common opinion that the doctor has but little feeling for or sympathy with suffering. That there is nothing either in the nature of our studies, or in the practice of our profession ta warrant such an assertion, I noed hardly say. That familiarity with sudden and frightful accidents, with disease and mnisery of all kinds, enables us ta view such scenes with calinness and self possession, is very true and very necessary also. Dr. S.",
         "CANADA MEDICAL JOURNAL. Johnson who was no great admirer of physicians, and who defined their profession as a melancholy attendance on misery, a mean submission to peevishness, and a continual interruption of plea- sure, was nevertheless pleased to admit that every man has found in physicians great liberality and dignity of sentiment, very prompt effusion of beneficence, and willingness to exert a lucrative art where there was no hope of lucre. Indeed there is no calling which more constantly demands the exerciae of sympathy, and in which it is more freely yielded then in ours, and complaints of want of sympathy are maost commonly heard.from those who least de- .serve it. What can be more trying than to be obliged to listen by the hour-when pressed, perhaps by important business to the lugubrious outpourings of some malade imaginaire, whose chief ailment consists in the fact of bis having no other subject than himself to think about. Wrapped up in himself he lies Il like a porcupine rolled the wrong way, tormenting himself with his prickles.\" But to the true physician, the sufferings arising from a perverted or even from a depraved imagination, are diseases as real as those depending on more obvious physical alterations, and equally demand the exercise of his skill, and call forth that sym- pathy and pity which droppeth as the gentle dew from heaven upon the place beneath, and by its moral effect is of as much real benefit in many cases as more potent medicines. If the physician possesses gentleness of manners, and a compassionate heart (says Dr. Gregory) and what Shakspeare so emphatically calls the milic of human kindness, the patient feels bis approach like that of a guardian angel, while every visit of a physician who is unfeeling and rough li his manners, makes bis heart sink within him as at the presence of one come to pronounce his doom. Towards your brother practitioners you cannot be too scrupuiously careful in your behaviour. Ever bear in mind the golden rule, ' To do as you would be done by.' It willu not uufrequently happenthat youmay be called upon to supersede a fellow practitioner, and then, more especially if he be personally obnoxious to you, the utmost caution is required in order to avoid inflicting an additional injury upon him by seeming to give your sanction to and concur in the com- plaints of inefficiency or ignorance which disappointed patienta frequently make. I do not mean to imply that any consideration should interfere with your duty to your patient, or that gross ignorance or carelessness should go unrebuked, but I do say, be slow'to receive such complaints, remembering that at some tiei or other you may be placed in a similar position yourselves, and endeavour to act in that large hearted spirit of charity which is 'kind, which vaunteth not itself, and thinketh no evil. Aove ail 436",
         "DR. JOSEPH MORLEY DRAKE'S ADDRESS. things scorn with the true spirit of a man to make use of idle gossip or calumnious reports, even against your bitterest foe. Although to-day's ceremonial invests you with the doctor's robe, and puts a period to your college career, I would yet remind you of the imperative necessity of continuing to be earnest and in- dustrious students of all that relates to your profession. Every day additions are being made to the already large stores of know- ledge we possess, and you cannot remain stationary without dis- credit to yourselves and injury to your patients. As a matter of duty, no less than of interest therefore, you must keep pace with the progress of science, and read with care and attention the medical jcurnals and other publications of importance. Hitherto the medical profession of our country has had but little share in furthering the progress of science, and but very few have achieved more than a local reputation at best. There are good and suffi- cicnt reasons for this of course, but we should look forward to the tirne when we may proudly point to names ab great as any that have made themselves renowned in the old world. To our Symes, our Fergusons, Jenners and Pagets. This may appear like boasting, but I wouid ask does any one believe the lields of science are exhausted, or that treasures great as any hitherto dis- covered may not await us in the future? I dare say if a polished Roman philosopher had been told the day would come when his countrymen would be glad to sit at the feet of teachers from savage Albion, he would have listened withdisdain. Astronomers tell us that the face of the heavens is slowly but ever progressively changing. That even those bright stars which by their apparent tixity in space, serve as a type of immrutability, are notwithstand- ing their apparent unchangeableness, pur-auing their solemnmarch through space, towards their ultimate removal from oar view, and that other stars new only visible as faint epecks to the curious eye of the philosopher will take their place. 'S likawise the great universal law of progress seeis to be aethj; ever ii the world of thought. Great luminaries of science which served for centuries as centres around which lesser minds were contented to revolver have passed away and other and brighter constellations have ap- peared from dark distant regions barely known, or even dreamed of in the old time, to enlighten, and instruct, and guide the nations of the earth. May we not then without temerity enter- tain the hope that this great country of ours, but just emerging froma the reign of barbarisn, is yet destined to furnish minds which shall by their heaven implanted wisdon, add new glories to the firmament of science, and yield us truer and more en- larged conceptions of that wisdom and power which climb as 437",
         "CANADA MEDICAL JOURNAL. high as we may we can never fully comprehend, Il because the \"scale is infinite. The prizes which appertain te our profession are not numerous, neither are they in a worldly or selfish nature very remunerative. We do not look for decorations, titles, wealth or ease, or even for the far more deservedly coveted honours which attend the poss- ession of high scientific attainments, unless in very rare and ex- ceptional instances. The lot of by far the greater number of us is cast among the humbler classes, and it is often among the very poor that our charitable and helpful offices are chiefiy needed. The busy prac- titioner wholly occupied with the faithful discharge of his fatiguing round of daily duties, bas small chance of distinguishing himself in the field of special science, however devotedly he inay employ the few heurs of leisure which rerain te him, and however well qualified he may be by nature, education, and taste for competing with those placed in more favourable circumstances. But we may, and we ought te expect te make a fair and competent income, and perhaps te lay up a little for future need, and it should be our ambition te add something however small, te the general stock of knowledge. For the rest, our chief reward will be found in the belief that we are promoting the comfort and well being of our fellow-men, in honestily and maanfully labouring for the advance- ment of our useful and benevolent calling. Gentlemen,-Fare you well. Abdominal Abscess wiik Fidtuous Opening into the Intestines. Re- ported by R. A. KE\u003ciEiEDY, M.D., Professor of Anatomy University of Bishop's College. It was not until the 3rd of February, that I thought of report- ing this case, previous to that the record is from meinmory. On the 22nd of January last, I was requested te visit a boy in 'hilips Street, who had been ill for some time. When I first saw him, he was sitting on the bedside, the hands crossed over the abdomen, and froin his appearance in great pain. The face wore a peculiar expression, somewhat resembling the \"Facies Hippocratica,\" and there was considerable emnaciation of the body. le was 10 years of age. I may premaise further remarks by stating, that the father lias lateral curvature of the spine, with excessive bulging of right, ribs; a very large head and scrofulous features. The mother has, a \"goitre,\" which has existed for many years, and is slowly in-",
         "ABDOMIINAL ABSCESS. creasing; is very deaf and stupid looklng. The family, a large one, having generally a scrofulous appearance. On placing the boy on his back, I found him unable to extend his legs, the whole abdomen being tense and brawny with protru- siens, and slight redness of the umbilicus, but no feeling of fluc- tuation; no difficulty in breathing, but it hurt him to cough; pulse weak, quickened and compressible, net wiry; tongue slightly coated and headache. There was no history of a blow or other injury to the abdomen, but from the evident screfulous condition I judged it to be a case of idiopathic abdominal abscess. I directed a large linseed meal poultice te be applied over the whole abdomen, To have nour- ishing diet, cod liver oil, and syr. ferri iod. A dose of ol. ricini te be given immediately, this latter moved him on the follow- ing day. 26th-Four days after, the abscess had burst at the umbilicus. the pus being thin and extremely fetid; abdomen less tense, but still much pain. 28th-Discharge was altered in character, semi.fluid; of a yel- lowish tinge and very fetid, showing that the intestine was per- forated; at eacli inspiration this substance exuded. As the parts were still inflamed. the poultice was continued. 29th-The umbilical opening larger, and intestinal contents freely passing outwards. Emaciation increased, a slight hectic cough; tongue clean and moist. The bowels net having moved since the 23rd, ordered el. ricini. 30th-Inflmmatorv condition of umbilical opening being re- moved, and seemingly but little purulent matter exuding with intestinal contents, the poultice was removed, an oiled pad applied te opeuing, and an abdominal bandage drawn tight, te prevent if possible the passage of the intestinal contents, but this completely failed te accomplish that object. The ol. ricini net having oper- ated \" per anum \" but escaping at the opening, I directed them to give an injection. February 2nd-Hle appeared brighter in countenance than I had at any time before seen him; tongue clean; pulse weaker, but emaciation greater, takes considerable food, but refuses the cod liver oil. Umbilical discharge more feculant, very offensive, and when he gave a slight cough spurted upwards from the open- ing for over two feet, it was ichorous in character, as the skin was - slightly excoriated where it had been in contact. The enema his father told me had net brought anything away, it was ordered to be re-administered. 3rd-Great emaciation, pulse weak and small, dry hectic cough.",
         "CANADA MEDICAL JOURNAL. tongue dry, and slightly glazed in centre. Still takes consider- able nourishment. As there was still no operation \"per anum I\" and doubting if the injection Lad been properly given, I person- ally administered one of soap and water, this brought away a large quantity of foces. On examining the abdomen, there was but little matter on the cloth covering the opening, even the effort to expel the feces not having caused any to exude; the cloth had not been changed for four hours, the opening appeared smaller and hoping to facilitate its closing, I put on an oiled pad, drew straps of plaster tightly over it, and over all a larger pad and ab- dominal bandage. To be given a dose of ci. ricini, and in addition to diet, half a grain of quinine three times a day. 4th-Ead been suffering great pain in the abdomen all morning. No operation of the oil from the bowels \"per anum.\" On ex- amining the abdomen, found that the pad had not prevented the outward flow, it was removed, and at once over a quart of semi- fluid matter came away, the result of the operation of the oil, the abdominal pain also ceasing. Nothing apparently had passed into the intestine below the opening. Another injection was given but no feculent matter obtained. An oiled pad aüd bandage was applied, but not to oppose the flow from the intestine. 5th-Intestinal contents still continuing to ilow through unm- bilicus, but darker in colour, nothing passed - per anum,\" The boy is gradually sinking. 6th--Death occurred this A.M. His father would not allow a post mortem examination on any consideration, thus preventing me from ascertaining the condition of the parts. From the discharge and rapid emaciation I should judge that the opening was high up in the intestinal canal. Hour Glass Contraction-Unique Case in fidwifery. By P. . SHAvEa, ,M.D., Stratford, Graduate of McGill College. Mr. I. S., who resides a few miles from Stratford, sent for me on the 15th, to see his eife who was in labour with her fifth child. When I arrived about 11 A.M., I ascertained the woman had been in labour some forty-eight hours, and for the last twelve hours there had been no advancement of the head, which was low down and resting upon the perineum. After a careful examiiation of the position of the child, and after a careful investigation into the condition of the mother, .1 found her pulse rather feeble and quick, some thirst, respiration slightly hurried, and the pains vory feeble, in fact absolutely gone. .\u0026fter -waiting some time, [ determined to apply the forceps,",
         "HOUR GLASS CONTR\u0026 CTION. which was very readily accomplished, and the child most easily and expeditiously extracted, the mother declaring that she scarcely felt the child being born. After the child had cried lustily (fine large boy) it was handed to the nurse, and I waited a short time to see if the uterus would resume its action, and in placing my hand over the abdomen, the globe of the womb seemed large and sonewhat elongated, and in introducing my finger into the vagina I could feel nothing, neither placenta nor uterus. I .endeavoured to excite the organ to action, by grasping it firmly and strongly, but never succeeded in getting any contrac. tion of the muscular fibres. I then introduced two of my fingers, thinking I could bypassing them as high as the promontory, certainly be able to detect something, but the result was alike negative. I then waited an hour, hoping the uterus might assume some action after this long respite, but the inertia was as marked as ever. I then informed the patient that I believed there was a second child in the uterus and that it was impossible for me to reach the presentation with my finger, and as 1 had now waited so long, and there had been no action, I deemed it proper to introduce my hand into the vagina to ascertain the position of the child, or in the event of no child, to extract the placenta, as it was evident the uterus unaided could not throw it off. The mother most persistently denied, the existence of another child in the womb, saying she was always as large with her other chlldren before the placenta was detached. However, after re- fusing a long time, she most reluctantly allowed me to introduce my bhad, which I did very carefully and cautiously, and asIpassed my finger high above the promontory of the sacrum, I then de- tected the head of another child, completely closed in a cavity by itself. The orifice through which my finger passed to reach the head was about the size of a half crown in diamieter, and the- fibres of the ring were as rigid and firm as sole leather. I then kept my hand in situ for a few minutes, to fully satisfy myself of the mysterious state of things, and then carefully with- drew it. I then told the friends there was another child, and I looked upon the case as one of the most remarkable in the annals of sur- gery. The case was one of hour glass contraction, in which the- uterus was divided into two compartments, one portion for each child. I then sent for my friend Dr. Frazer,a recent graduate of McGill, and whén he arrived, he thought I might possibly have made a 441",
         "CANADA MEDICAL JOURNAL.- mnistake in thinking I had detected a second child, as it might be a case of hour glass contraction with retained adherent. placenta. Ilowever, I requested him to introduce his hand, which he did, when he immediately exclaimed, \"you are correct in your diag nosis, there is another child with hour glass contraction ~of the uterus.\" Shortly after this some hnmorrhage began to manifest itself, which told upon the patient's constitution, whereupon we admin- istered large doses of ext. Ergot, but it had no effect in producing uterine action, and we then insisted that the patient would allow us to deliver ber immediately, but she 'most obstinately refused, saying-\"there was no second child, and if we would only allow her to remain quiet, she would soon be better, when the after-birth would come away of itself. We urged and remonstrated with the patient on such folly, as her life was now in great jeopardy, and lier only hope was in speedy .delivery; but she would not consent, and\u003e after waiting about 12 long hours she reluctantly allowed us to proceed. Dr. Frazer administered the chloroforn, znd I carefully intro- \u003cduced my hand up to the stricture, and by gentle but persistent pressure, I succeeded in passing my hand through it, and with some difficulty sccured the feet and delivered without much trouble. There were two placento--one in the lower segment, and the other inthe upper chamber. I introduced my hand and found the loweó one detached, but the upper one was adherent, and re- quired great care and patience in pealing it off. The uterus slightly contracted upon ny hand, when I gently withdrew it. There was no post partum' lhrmorrhage, and in an hour tha patient had somewhat rallied under stimulants administered ad libitunand felt Cmfortable. I' may state en assant that the scond child was quite softened and' in a state of decomposition. The patient reiained quiet and calní for seven or eight h6urs when she wished some arrang9me]it to be made with'her' bed, she thentturned her face to the wall* and in a few inutes pasec away to that undiscovered country from whose bourne no traveller retùrns. This was one of the most extraordinary and uniquê.cases which itt:haseverbeen my lot to witness, .for I have not heard, neither have. I erread of such an anornaly.For liere we' have a case of the uterus assumning an hour glass condition, retaining the second child the same as the placenta is retained, in an ordinary hour glass contraction. And here we have the uterus unable to expel the first child owing to its division intotwo chaníbers. I regret to say éthaithe friends would not allow a postmortem.",
         "LONDON PRACTICE. London Practice. By Jmmss PErroGO, A.M., M.D., M.R.C.S., Eng., Denmonstrator of Anatomy, University of Bishop's College. No. IV. At the Samaritan Female Hospital, I had the privilege of seeing Mr. Spencer Wells operate for Ovariotomy nine times. He advises the operation to be performed as early as possible, as then the tumour is less vascular, and consequently there is less likelihood of there being adhesions. le invariably brings the pedicle to the surface,and secures it there by the clamp. M1r. Wells has now oper- ated 400 times, and as Le fnished each hundred, he brought the results before the Medico-Chirurgical Society. In the 1st hundred, 34 died. In the 2nd - 28 \" .nthe3rd \" 23 \" In the 4th c 22 c Of the last hundred, 44 were in the hospital, and 5G in private practice. He has hopes of reducing the inortality to ten per cent. He adds that the mortality in hospital and private practice is about the same. In his his opinion, tappings do not consider- ably increase the nortality, and sometimes is of benefit in giving time for the health to improve, or in lessening shock by having fluid removed a few days before. I may state, that when the pedicle is of sufficient length, the clamp is always preferred. Mr. Gant, who is senior surgeon to the Royal Free Hospital, thinks the probability of success is nearly doubled, where the length of pedicle permits of this arrangement. At the West London Hospital, I saw Dr. Wiltshire amputate the vaginal part of the cervix uteri in two cases. The cervix in each case was enormously elongated, so mauch so, as to protrude to the vulva. They both did well. The instrument employed was the ecraseur, but instead of being armed with the chain-saw, it had a single wire.. It is much' more easily used, makes a cleaner out, and prevents bleeding as effectually. At Moorfields Ophlithalmie Hospital, a person can have every facility in studying eye cases. Every surgeon has on an average 100 to 150 dut-door patients to prescribe för, and there are four of them busy doing so, every morning frem nine to noon, after which there is always some operation to be performed. 'A stranger there is treated with all possible kindness, and every atténtion is shown to him in explaining things in the ophthalmmoscopic'room. ,Thi'rom ls quite a large one, darkened aid fitted up with nine staÉis, each of which is 'furnished with a gas burnner, two chairs, and a sman table: Some-days, during the out-door hours, there is 443",
         "CANADA MEDICAL JOURNAL. hardly one of these unoccupied for a moment. There are many Canadians, who, no doubt will remember with gratitude the great kindness there exhibited toward them; even somuetimes firm and lasting friendships are formed. It was so in my case, and in after life, I shall always look back upon my visit to London with plea- sure. I was fortunate enough to be allowed to examine a case of opaque optic nerve fibres, a condition that is not to be seen every day. Tonics, rest and fomentations, formed the general run of tieatment. Rheumatic Ophthalmia is more common in England than here. It is treated chiefly with Aconite and Colchicum, along with the Bi-carbonate of Potash. Mercury is given largely in syphilitic iritis, just as long as any lymph is formed. Von Grofe's operation for cataract is the favourite method. About 75 per cent. of the cases do well. In visiting any of the London Ilospitals, one is astonished with the neatness and regularity with which everything is done. All the hospitals have assistant physicians and surgeons to attend to the out door work. The posts of house physicians and house sur- geons have to be competed for by examination,. and they are not held longer than six months. All the nurses are trained by the sisters of St. John, and the hospitals, that take nurses from this institution, pay it so miuch a year. Charing Cross pays £500. In addition, there is a sister to each ward with a nurse under her, and over the whole hospital is a sister who looks after the diet and wine cellar. A great deal of the treatient in the London hospitals is highly experimental. Calabar Bean was tried for chorea at the Children's Hospital, Great Ormond Street. As might be expected, it pro- duced no effect on the disease, but strange to relate, it dilated the- pupil. Bromide of Potassium is now given for profuse menorr- hagia, instead of other remedies. Since my return, I have tried it successfully in one case. The galvano-cautery is nowpretty gener- ally employed, and I have seen it used for those little vascular tumours at the ineatus urinarius of the female. Carbolic acid, as a dressing, is extensively used in some of the hospitals, but the- cases are better chosen for its application than I have seen else- where. Holmes Coote will not allow any of it in his wards, and. there are a few others who will not use it. Craniotomy is now being gradually supplanted by cephalotripsy. In displacements' of the aterus, Grailey Hewitt's ring pessaries are ahnost univer- sally used, as they can be bent to any desired shape. Lallemand'a porte-caustique is now improved by Sir Hemy Thompson and Erichsen. Theih instruments are so made, that caustics in a fluid condition càn be apphed. There is very little difference between'",
         "LONDON PRACTICE. Sir Henry's and Erichsen's. Each consista of a catheter, the lower portion being perforated by minute holes. In it is a stilette having at the bottom a sponge fitted on a spring attached to the stilette : the sponge is pressed upon, and the fluid is squeezed out. Some of the professional men in London, after their appoint. ment to an hospital, however small an institution, consider it their duty to write a book for the edification of their less fortunate brethren. The result of this is a vast amount of medical and sur- gical literature that falls still-born from the press. The amount of money given to charitable institutions in Great Britain is almost incredible. Much of it is mis-applied. There is a multiplicity of servants at the hospitals. It takes two or three portera to do work that could be performed here by one, and other items are nearly in proportion. In sore institutions, the board meets once every quarter, and sits down to a sumptuous dinner, the expenses being defrayed out of the Infirmary's income, At one of these board \" feeds,\" of which I was myself cognizant, the wine alone cost £27. There are many other things of a like char- acter that romain unknown to the public. This was also the case with the Red Cross Society; a society that did much good, and yet was much cheated. Some of the London instrument makers were enabled to sel a lot of old stock, useless for any practicàl purpose, to agents of the society who had not the slightest idea what instruments were required. Comparing the profession in Great Britain to that in Canada, I think we have nothirg to be ashamed of. We have everything te encourage us, when we consider the differences of advantages; how wealthy their institutions are, and how poorly ours are en. dowed.. They have one advantage over us, their men are gener- ally botter educated before they enter upon their professional studies, and in proportion to the number of schools, there are fewer testing bodies. There are also botter supporters of professionai periodicals, and so far as I could judge, there seems to be a greater unanimity and esprit-de-corps, in striving to raise the standard of the profession. The various \" pathies \" are let alone. lomoeopathy, for instance, is never mentioned and is not noticed at all. Gratuitious advice at the different hospitals has been abused to such an extent, thatsteps have been taken to have it renedied. Dr. Meadows and others, relate cases where persons have dressed themselves in their servants clothing and hive prèsented them- selves, for advice at the out-door departments. Well-to-dg. far- uers cone to London for the same purpose. I knoiv of some far- 445",
         "CANADA MEDICAL JOURNAL. mers on the Island here, who do the same thing. Recently, a society has been formed. called the Charitary Organization. The committee rooms are in St. George's Hanover Square. Al sus- pected cases are referred to them for investigation. The Univer- sity College Hospital has already referred a good many suspicious patients to the committee, and many glaring cases of imposition have been exposed. When it was discovered that these patients could well afford to pay for medical advice, they were referred -to the general practitioners in the neighbourhood of their abode. Some such arrangement might with propriety, be instituted in Montreal. MEDICAL STUDY IN LONDON. As referring to the above we extract the following letter froni the Xedical and Surgical Reporter of Philadelphia: \"LONDON, February, 1872. \"EDIToRS MED. AND SURGf. REPORTER: \" For the practical study of medicine London, doubtless, excels any other city in the world. The number and varied character of the hospitals, the great amount of clinical material constantly pre. senting itself at these institutions, and the wide reputation of the physicians and surgeons in charge, constitute for the medical student a rare embarras de richesses. \"After ho has made his first grand round of observation, two puzzling questions come up for consideration: in what direction to first turn his attention, and how best to systematize his time, too short for the nrumerous demands upon it. The answers will, of course, vary with the particular objects in view in each individual case. Every one will find abundant food for either special or general study. Access is readily had to the hospitals, lectures, museums and libraries. \" The cost of living in London, for a medical student or prac- titioner stopping here for study, is not less than in Philadelphia, contrary to the general opinion. I doubt, indeed, whether the latter is not the cheaper city. It certainly was before the war. I have conversed on this subject with several American physicians, who have been here for some time visiting the hospitals, and they all agree that it is not possible to lodge and board for a less price than in our own large cities. This fact, to prevent disappoint- ment, should be borne in mind by those who look forward to benefitting themselves by the immense clinical advantages of this great city. \" To the young physician of some years practice, a few months",
         "MEDICAL STUDY IN LONDON. spent in London cannot fail to be of great interest and profit. He- may be quite sure of a cordial reception and open doors. It is particularly in connection with the \"out patient\" department of the hospitals that he will find unequaled opportunities extended him. The \"out-patients\" are those who visit the hospital for treatment, as distinguished from those who have beds in the hospital. They are, of course, therefore, all walking cases. Bach day there is in attendance, in turn, one of the physicians or sur- geons of the hospital to meet them. This physician, who is one- of the most prominent men in his department in London, examines and treats, as if at his own private office, with the aid of his assist- ants, each patient, a task of many hours. An American of indus- trious habits, and possessed of some experience, can readily associate himself with the physicians of a number of hospitals, not as a spectator, but as an assistant. le will thus acquire, in a short time, a practical training, under the best auspices, in investi- gating cases, and a close insight into current therapeutics and surgery, which will amply repay him for his outlay of time and money in crossing the Atlantic. These remarks are especially true of new and venereal diseases, diseases of the eye, of the heart and lungs, and of women. \" The surgical clinics are conducted here, as a rule, with much less attention to demonstration than in our own hospitals and colleges. For instance, at a clinic of Sir Wm. Ferguson's, which I have just attended at King's College Hospital, he scarcely addressed a score of sentences to the class during the hour in which he operated for fistula in ano, hair lip and cancer of the brest. What little was said in each case was after the operation, which was imraediately commenced, so soon as the patient was brought in and chloroformed, without a preliminary word as to the diag- nosis or history. Sir Wm. Ferguson I may mention, en passant, most strikingly resembles, in form and feature, Professor Gross. \"The seats in the lecture and clinical theatres are somewhat differently arranged froma those in our own colleges. In most instances there is no support for the back. , They are all furnished with elevated seats, against which one can lean while standing, the position of most of the class during an operation. \"iDetails in regard to methods of medical instruction and study in London 1 reserve for future letters. \" GEo. H. NAPuiEYs, .LD.f' 447",
         "CANADA MEDICAL JOURNAL Valedictory Address to the Graduates in Metdicine, on behalf of the Medical Faculty of the University of Bishop's College, de- livered at the Convocation held April 4, 1872, by AUnox II. DAviD, M.D., Edin., L.R.C.S., Edin., D.C.L., Professer of Prac- tice of Medicine, and Dean of the Faculty. GENTLEMEN GRADUATEs IN MEDIcINE,-The day to which you have so long and so anxiot.sly looked forward has at length arrived, and you have now attained the acme of your ambition-the investiture of the docterate in that professia-: te which is to be sedulously devoted the remainder of your lins. Yet, a f ew short moments and the link which bound us together as teachers and pupils will be broken; but you are not te suppose we wish you te consider the connection between us as severed-for it is not so. We will ever take a deep interest m your welfare, and carefully watch your progress; and we wish you to cherish a kindly interest in your Alma Mater, a kindly interest in her welfare and progress, and do all the good offices for her it may be in your power to do. It is natural you can little anticipate on this happy occasion the troubles and harassing difficulties which are inseparately con- nected with the life you have chosen; all is present sunhine, and you look forward te a bright and happy future; and that your suc- cess in life may be equal te your expectations, I need scarcely tell you, is our most earnest wish. The period, however, is one of d.eep and anxious concern, and is taken advantage of te impart te the youthful aspirant-as a valedictory, those lessons which expe- rience have taught-to guide him in his future ocurse, with advan- tage to himself and profit to the public. You must always bear in mind the obligation you have this day assumed-to follow an honourable and discreet course of conduct; to practise your profession in a cautious, chaste, and upright manner; to care and do all you can for the safety of those who may trust their lives in your hands; never te divulge the secrets your intercourse may bring te your knowledge; and, lastly, always to keep in your remembrance the University who has received you as her child, and te uphold and advance her inter- ests in every way you can-in the words of the oath, 4\" me in omni grati animi ofcio.\" This last, gentlemen, you will best do by increasing your present knowledge, and keeping pace with the improvements that are hourly taking place in our profession. Your present acquire- ments, the knowledge you have obtained as students, will only be the foundation on which your professional reputation is hereafter te be bulît. You have laboured hard in the acquirement of know-",
         "DR. DAVID'S ADDRESS. ledge, and you will find you have laid in a store that wiIl be of incalculable service to you in the future, and you will have the sati.sfaction of knowing that in practising your art to your own advantage you will be useful to your fellow-creatures. AI the commencement of your professional life your tine wiMl not te fully occupied; opportunity will therefore exist to improve your knowledge on many branches to which, from unavoidable circumistances, you have not been able to devote as much attention as you bave to others. You are not to suppose, because you have gained the highest honours it is in the power of the University to confer upon you at this stage of your career, that your studies are complet.ed; that you are to to be exempted from the labour-I ought, perhaps, to say pleasures-of study ; for if you do, you will soon find yourselves outstripped by your cotemporaries, and deservedly so. You must pay attention to the advancement in the scientific knowledge of your profession and keep pace with its imaprove- ments, and in so doing you will unquestionably elevate yourself and bring credit on our University. You must never forget that you have undertaken a labor and privation-that a physician's work is never done, and that it is one of continual study. The experience of the past and the discoveries of science are at your cormand, and your personal observation and research muat be compared with the research of others. Every case that comes before you should be a subject of special thought; and athough you have learned a great dealfroim lectures and fron books--which will, undoubtedly, be of great asssistance- you will be thrown, in no small degree, upon your own resources. There is no profession in which it is more essential that those engaged in it should combine the talent of observing, thinking and reasoning for themselves, than it is in the medical profession. The best part of every man's knowledge he must acquit e for Iimself. You must spend your lives in endeavouring to add to your store of knowledge, and fromn day to day obtain a clearer and deeper insight into the phenomena of disease-fbr the most irnportant part of your education is that which you have to give yourselves, and to this there is not any limit. Whatever number of years may have passed over our heads; whatever may be the extent of our experience, every day brings its own knowledge-- there is something new to learn, some deficiencies to supply, and some errors to correct. I shall not, gentlemen, occupy much of your time in mentioning the disadrantages of not attending to the improvements that are continually going on around us, for you must be as well aware of Cc",
         "CANADA MEDICAL JOURNAL. them as I am, but will only tell you it is necessary, if yo'u would \" hold your own,\" to keep up with the ever changing and gener- ally improving aspect of the science. A few years of neglect throws one fearfully behind hand, and in recurring to the subject we find ourselves a stranger in the field formerly well understood. This is the case, particularly in those parts of medicine not imme- diately practical-as in chemistry and physiology. Set apart, therefore, a portion of your time for self-culture; for a scholar can no longer repose upon bis academical laurels, and each one should make it the object ofthis life to add something to his medical knowledge. Pursue with ardour and constancy every discovery after truth. The basis on which rests the glory of the medical profession is the sterling truths of its observations. Never employ your talents in aggrandizing visionary hypothesis, as truth is alone abiding. I is not merely the duty of every medical man, but it is his greatest glory and privilege to declare it. Be systematic, patient and atten- tive and clear, in all your statements. Be affable, yet dignified. So much as to your professional studies. Now a few words on your duties to the public: A medical man is eiphatically a public man, and should be a man of the people. lis aim should be to recormend himself to all parties, to inake himself useful to all, and not by active parti- sanship make himself objectionable to any part of the conmunity. le should only be known as the philanthrophist and patriot in the broadest sense of the terms-devoted to the comnon weal and good of his patients. There is one duty you owe to society, which you sbould not neglect, and that is to disseminate, as widely as possible, a knowledge of the laws of Ilygiene-a knowledge of the laws and conditions of health. To you, especially, will the com- munity look to inform and enlighten it in relation to the best means of preserving health, of preventiig the spread of conta. gious and infectious diseases, the influence of trades and occupa- tions, the effects of differeit sorts of food, of dress and amusements, the nature, cause and cure of those diseases which attack the lower animals, and vegetable as well as animal life, the influence of soil and climate and season, of geological formations and geogra- phical localities, the question of quarantine, the best mode of warming and ventilating houses, the establishment and regulation of schools and seminaries of learning. You will be called upon to instruct judges and lawyers and courts of law in relation to many important questions connected with hygiene, medicine and surgery, fractures, dislocations and poisons, and your opinions will, if well sustained, be decisive in turning the scale and shaping the verdict",
         "DR. DAVID S ADIRESs. 45 of the jury. Besides this, you are to act your part as good citi- zens-patronizing every worthy object, aiding in al public enter. prises involving the welfare of the masses, taking a special interest, especially in all impro-vements calculated to benefit the sanitary condition of the people, contributing freely to the support of education and religion-the great bulwarks of safety; in short, doing all that the broadest philanthropy or the most disinterested benevolence can suggest. From ibis you will see what a wide field the nedical man has to f1L, These considerations suggest that there are duties you owe to yourselves, for the relations you are to sustam to the sick and to the publie at large imply the possession, on your part, of certain qualifications that can by no means be neglected. You should never forget that to most persons a i1t of sickness is an important event, the physician is associated with all its recollections, and you will best secure the confidence and regard of the patient and his friends by having helped to make those recollections agreeable, by having aided in beguiling its wearisnomeness, diminishing its tliscomforts, relieving its auxieties, dispelling its fears, and raising its hopes. Your duty to your professional brethren, let me tell you, gentle- men, is not the least part of what is worthy of your deep consider- ation, and the ; hole code of ethics thereon nay be sunued up in the words of the Golden Rule, \"Do unto others as you would they should do unto you.\" Cultivate friendly relations with them. Never, by unscrupulous insinuations, attempt to injure their repu. tation, but do all that lies in your power topreserve it intact; for by so doing you elevate yourselves and preserve the honor of your profession. Therefore, leave nothing unattended to that will promote this end. And now, gentlemen, it only remaains for me to say farewell. Go forth on your mission. May, your manhood be irreproachable and your character unimpeachable; and, for your success and prosperity, you carry with you our most fervent wish. 451",
         "Cperations for Congenital Cataract, on Diferent Plans. Reported by M. O'B. Wa\u0026nD. The object of these operations was to try the relative advantages of performing the operation for cataract by solution, by passing the needle through the sclerotic of Lhro'igh the cornea. Severe inflammation was said to follow the older method, and a plan by which this could be avoided was desirable. The advantages claimed for corneal puncture were: lst. The cornea being less vascular than the sclerotic, the risk of inflam- mation was of necessity less. 2d. The cornea being transparent, the operator could see 4he point of the needle, thus being better able to guide it. Here remark how the operations for hard and soft cataract are reversed. At first, hard cataract was extracted through the cornea, -and solution in the soft variety affected through the sclerotic. Now, the contrary is the rule. The hard cataract is, according to ýGraeffe's plan, extracted through the solerotie, while the soft kind operated on through the cornea. To 'try the efficacy of both plans, and to compare their results, it was determined upon by Drs. Hingston and Desjardins, to operate upon two patients suffering from this disease, each oper- ator to operate after his favorite plan; Dr. Hingston through the solerotie and Dr. Desjardins througL the cornea. The patients were both inmates of the \" Asile Nazareth.\" One was a y9ung girl of about 12, and was Dr. Bingston's. The other, a little boy of 8, being Dr. Desjardin's. . The first operation was performed on the 12th of December. Both doctors confined themselves to operating on one eye each. The following was the result: No Infiammation whatever in the ye oprated upon through the cornea, and severe inflammation in the one operated upon. through the sclerotic. A second operation was performed on thellth of January, Dr. Desjardin repeating his operation on the same eye as before, while Dr. Ilingston operated on the other. The object of the latter for not repeating the operation on the first eye was, as he said, that the lens continued to be absorbed for a considerable length of time after the operation, and by refrain-",
         "REVIEWS AND NOTICES OF BOOKS. ing from operating on it, nature as well as art, had a hand in the cure by allowing it to be absorbed as much as possible. This time Dr. Ilingston tried the corneal method and the result vas most satisfactory, no inflammation ensuing in -either eyes, which fact, as well as the previous one, seemed to be greatly in favor of the corneal plan. The last operation was performed on the 3lst of January. Dr. Hlingston operated this time on the first eye, and Dr. Desjardin on the second. Dr. Hingston tried the new way a second time, but the result for him was not as satisfactory as before, great inflammation setting in, whiceh resulted in the loss of the eye. This left the dssputed point just where it was. The inflammation in the second eye may have depended upon the previous inflimmation, causing the eye to be more vulnerable, but whether this explains matters or not the result was all the same. The slight vascularity of the corzea caused a more severe inflammation than the selerotic, thus proving that the amount of vascularity in the part has veiy little to do with the success of the operation. The remaining eye is now healed, and so are the ones operated upon by Dr. Desjardin. I shall again give the result of the operation on the other eyes. General Surgical Pathology and Therapeutics, in Fifty Lectures; a Texi Book for Students and Physicians. By Du. TEonoRE BILLRoTH, Professor of Surgery in Vienna. Translated from the fourth German edition, with the special permission of the author, by CHARLES E. HALnuy, M.D., Surgeon to the New York Eye and Ear Infirmary, \u0026c., \u0026c., with 152 illus- trations on wood; pSvo: pp. 676. New York: D. Appleton \u0026 Co., 90, 92 and 94 Grand street, 1871. Montreal:-Dawson Bros. The subject treated of in this work is more that of systematic surgery, or principles of surgery, than true surgical pathology; although the pathological part illustrates that accuracy of obser- vation peculiarly German. The work consists of twenty chapters divided into fifty lectures. The author commences with an intro- duction, and draws attention to the intimate relationship between Medicine and surgery ; showing how necessary to ensure success 453",
         "CANADA MEDICAL JOURNAL. is it, for the practitioner to be acquainted with both sciences. Here the author gives us some idea of the German method of instruc- tion, which, if it has not given to the profession generally better practical men, has, at least, brought out and developed men like Virchow, Niemeyer, Rindfleisch and the very eminent author him- self. Chapter lst is devoted to simple incised wounds of the soft parts. This subject is treated of in nine lectures. In the first lecture we have the mode of origin and appearance of these wounds. Homorrhage and its varieties, parenchymatous hcamorrhage, and also that from the pharynx and rectum are considared as also that peculiar condition known. as the hemorrhagic diatihesis. The constitutional effects of severe hæmorrhbge is likewise touched upon. In the next lecture we have the subject of arrest of hoemorrhage dwelt upon. The author resorts to very definite directions, even to the tying of a knot, which is, we have no dioubt, necessary to be understood, but does not speak much for the intelligence of bis ,auditors. Here the autl or alludes to the lack of common sense on the part of non-professional people in seeking to arrest bloed- ing in cases of accident, by the application of spider-webs or other nostrums, instead of using the simplest of all methods- compression. On referring to acupressure the author states that he has in several amputations, even of the thigh, seen no objection to this method of arresting bleeding, but he does not believe that this means of securing bleeding vessels will altogether displace the ligature. He describes a method of applying acupressure which is novel and, we should imagine, original with him. He says: el In amputations I prefer acupressure by torsion. I pass the \" needle transversely through the \" (mouth of the) \"artery, which - ià drawn forward, and, with the needle, make a half or whole \"rotation in the direction of the radius of the surface of the \"flap until the bleeding is arrested, and then insert the point of \"the 'needle info the soft parts.\" Various homostatics are referred to,' and 'also the'subsequent treatment by transfusion of blood. Specific rules are laid down for performing this operation, and the quàntity to be injected should'not be more than from four to eight ounces. The next seven lectures are devoted to the varlous methods followed by nature in the healingý process of wounds and the, means used by^the surigeon to that'desiréd end. These processes are illustrated by mic'roscopic drawings which give a fair concep- ~tioi~i the changes which occur. 454",
         "REVIEWS ANI) NOTICES OF BOORS. In chapter two.we have discussed some peculiarities of punc- tured wounds. In this the subject of traumatic aneurism and aneurismal varix is touched upon. Chapters three and four consist of contused and lacerated wounds. On the latter subject the author mentions several cases which came under his observation where fingers had been torn from the hand, the tendons remaining attached to the severed member. Several cases.of this kind have cone under our own obser- vation. One, the case of a groom to a celebrated stock horse. While taking out the animal for exercise, in arranging the bit the horse seized the man by the end of the thumb, raised him from the ground and swung him from side to side until the member was severed from his hand and he dropped on the floor. On recovery he observod that his thumb had been bitten off, as he supposed. le experienced pain in the hand and a numb, dead, aching sensation in the forearm. On naking search for the frag. ment he found it with two long tendons attached. The first phalanx of the thumb had been fractured about the centre, and the tendons of the muscles inserted into the second phalanx haci been drawn out from the forearin. Amputation had to be per- formed at the metacarpo-phalangeal joint and the man made a good recovery. The end of the thumb,with the tendons attached to it, is in the museum of McGill University. Chapters five and six, with an appendix, are devoted to the subject of fractures. We observe at the commencement of chapter six, and, in fact, as the heading of that chapter \"Open Fractures and Suppuration of Bone.' This term, \"open fracture,- is made to signify what is recognised by all surgeons as compound fracture, a term of time-honoured usage, and whether it is from habit or some other cause we must observe that we.regard it more favourably as, indicating the condition of the injury than the novelty \" open fracture.\" We notice the term \"compound\" is used on several occasions. This is apt to lead to confusion which is to be regretted. The process of repair in fracture is fully treated of and amply illustrated. In the appendix to chapters five and six the subject of ununited fractures is considered, and the various methods resorted to by the surgeon in seeking to relieve false joints. The treatment of malposition in united fractures is also referred to and fully explained. The next chapter is, taken up in discussing injuries of joints having moie especial reference to dislocations and the results of wounds of the articulations. After the discussion of.gunshot wounds, burns, scalds, frost",
         "CANADA MEDICAL JOURNAL. bites and acute non-traumatic inflammation of the soft parts, in chapters eight, nine and ten, the author next considers acute inflammation of the bones, periosteum and joints. The subject of gangrene is next in order, and then follows accidental traumatie inflammatory diseases and poisoned wounds. To this four lectures are devoted. Chronic inflammation of the soft parts is next taken up, in which the various changes or alterations of the tissues, the resuit of chronic inflammatory action is referred to. The author alludes to the empirical notions about diathesis and dyscrasia. Chronic inflammation of the periosteum, bones, necrosis and chronic disease of the joints form the next subject under discus- sion; and, lastly, tumours are considered. Altogether, this work must be regarded as a valuable addition to our surgical literature, and the translator deserves c6mmendation for having placed it within the reach of the English reader. ALCOHOULIC PARESIS AND PARAPLEGIA. BY J. LocKKÃÀRT CLARKE, M.D., .F.R.S, The habitual and excessive indulgence in them\"use of-alcoholic drinks is so frequently followed by partial or complete paralysis of the lower extremities, that no doubt can be entertained that alcohol and paraplegia do often stand to each other in the relation of cause and- effect. Many striking cases that have come under my own care support this inference in a very convincing way, so thatI think Drs. HandfieldJones and Wilks have done service in bringig thesubject prominently before the profession. On examining the bodies of persons who died either in a state of intoxication or during a course of excessive indulgence in- the use of alcohol, particularly in its undiluted state, almost .every organ and tissue is found to be more or lebs altered in appear- ance. The mucous membrane of the- pharynx, osophagus, stomach, small intestines, and bronchial tubes is red and-injected. The liver'and kidneys.the substance and membranes of the bráin and spinal cord, are in a variable state of congestion. In chronic, cases of alcoholism we find more or less atrophy of the cerebral convolutions, and.effusion of fluid ontheir surfaces, with thicken-' ing and adhesions of-the membranes. On examining such persons during life, we find a train of symp toms that are quite inaccordance with these post-mortem appear-",
         "ALCOROLIC P:RESIS AND PRAPLEGIA. ances. The mucous membrane of the fauces is unusually red ani injected; a viscid, tenacious, or cream coloured mucus hangs about the back of the pharynx and soft palate, exciting vomiting on rising in the morning; a sensation of rawness or heat is sometimes felt -along the æsophagus, particularly- on drinking warm or spirituous fluids; the stomach is irritable and vomiting is easily excited, A viscid and tenacious mucus collects during the night on the membrane' of the bronchial tubes, causing more or less, sliortness of breath or oppression of the chest on waking in the morning, and exciting cough, which is frequently attended by vomiting. The skin bas frequently a dirty yellow tint, although sometimes a remarkable clearness and freshness of colour is pre- served, especially in fair persons. The conjunctivæ -are often thick, injected, and dirty yellow. Different individuals suffer from a variety of nervous symptoms -from giddiness.; a sensation of being lifted from the ground, or I taken off their legs,\" as I have heard them express the feeling- an alarming sensation of choking or suffocation on dropping off to sleep at iights ; occasional numbness or pins and needles \" in, the fingers and toes ; or acute pains beneath the nails; a dull, aching pain across the loins, or an acute pain on bending or on rising from the sitting posture; a darting or lacerating pain in the lower extremities during the act of progression. 'The muscular system is more or less affected by weakness, by spasm, or by the withdrawal of voluntary control. The, hands and arms,- and sometimes the whole body, are tremulous, with ·fre- quent librillar quivering of the muscles, particularly about the. face. Voluntary movements are* improperly or awkwardly per- formed. Even when there is no tremor of the bands, delicate- operations-such as writing-are clumsily performed, aqnd are irk- some or distressing. The walk is more or less unsteady; and I have often noticed that in progression each foot is alternately carried inwards, and almost in front of the other. The articula- tion is sometimes peculiar and indistinct from partial loss of control over the muscles of the lips. The individual losses his accustomed energy, is careless of bis own interest, and feels him- ielfunfit for the performance of bis ordinary duties, until he bas resorted to lis usual potation, or obtained from the druggist a \"pick-me-up.\" For this distressing state I have found nothing so useful as full doses of nitro-hydrochlo: ic acid, with a little of Battley's sedative solution; two or three doses, even, sometimes act like a charm . After relieving the bowels by saline aprients, I combine the acid with quinine, perchloride of iron, or small doses 457",
         "CA2NADA MEDICAL JOURNAL. -of strychnine. The occasional use of the Turkish bath is also beneficial. If the individual persists in the excessive use of alcoholic drinks, partial or complete paralysis, and particularly paraplegia, not unfrequently results. I will only briefly mention two or three of the most striking cases out of a number that have corne under 7ny care. A cab proprietor and his wife, both remarkably fine and natu rally healthy persons, between thirty and forty, were addicted to ,the most immoderate abuse of neat spirits. The wife, after two or three years of excessive indnlgence, with many of the -ymp- toms above described, became very fat and bloated, and one lnorning, found that she had complete paralysis of the, lower extremities ; sensibility was also almost entirely abolished. At the end of ten weeks she quite recovered, and I subsequently lost sight of her, but heard, after a renewal of her old habit, she died of some stomach or bowel affection. Her husband, who, as I was told, would drink daily as much as a quart of gin, had only .paraplegia, with great numbness and pains in the legs. Unlike his wife, he became thin and sharp-featured ; and I have seen this :originally powerful and magnificent man, who was six feet two .Juches in height, look down upon his tottering and wasted legs, and burst into tears at the recollection of what he once was; and yet he has straigtway gone to raise his spirits by a repetition of lis accustomed potation. He went to Bath for the waters, and died there. Another striking case was that of an old sergeant who had served through the Peninsularwar-a tall, stalwart Yorkshiremani sevènty-two years of age, who assured me that for the last twenty years he had never taken less than three-quarters of a pint, and sometimes a pint of rum daily, besides sundry glasses of gin and beer. ' He smoked, also, almost incessantly from morning till night. One day he lost 'the entire use of his lower exti'emities -without much impairment of sensibility. 'In six weeks he quite -recovered, and became much more moderate in his habits ; but two yèars after I saw him again with alnost complete paraplegia. He had frequent vomiting, a brown, parched tongue, with that 2peculiar smell of breath which so often precedes dissolution, and .at the end of a week he died.-The Lancet. HARLEY S'REET- W., March, 1872. 458",
         "1UMLEIAN LECTUREs. ES SKETCHES OF SUCCESS AND FAILURE IN MEDICINE. BEING THE SUBSTANCE OF THE LUMLEIAN LECTURES AT THE ROYAL COLLEGE OF PHYSICIANS IN 1862. DY C1ARLEs J. B. WILLIAMS, M.D., F.R.S. Fleurisy, a local i2flannation producing its efects by its effusion, liquid and soli; Varieties; Serous; Eipyena; Euplastic, Cacoplasti, ana Aplastic Lynph-Treatnent of Peurisy-- When, why, and how the chest should be tapped-Cases requir- ing opeation-Sucesssfil cases without operation. Pleurisy has by ne means the same relations te the blood which I have pointed out to exist in pneunonia. Pneumonia is essen- tially % blood disease, although attacking a particular organ. Pleurisy is essentially a local disease; and its relations te the blood are incidental on the extent of the inflammation and the amount and quality of the effusion which it produces. We May further trace out the evils and dangers of pleurisy in connection with these results under four heads, (1) the quantity of the liquid effusion, (2) its quality, (3) the quantity of the solid effusion. (4) its quality. When the quantity of liquid effusion is moderate. it is remark- able how little inconvenience it causes. After the pain (if any be present) subsides, which it comnonly does in a few hours, or in a day or two, the patient often thinks himself well, till he finds on exertion his brea th short than usual. Thus it frequently happens that the existence of the effusion is net discovered until long after it has taken place. Its easy detection by auscultation constituted one of the earliest and most striking triumphs of that mode of exanination.1 But if the effusion is very copious and rapid, the funetional disturbance may be very great, in consequence of the *Note added in 1872.-I take this opportunity to remark that soine of the most recent writers on pleurisy seem neither to appreciate nor te understand the nature and value of the physical signs of pleurisy. which -were, nevertheless, sufficiently explained and defined more than thirty years ago. In my lectures on I The Physiology and DJseases of the Chest,\" published in the Medical Gazette in 3838; in the article \"Pleurisy\" in the \" Library of Medicine,\" vol. iii.,1840; and in the last edition of my \" Pathology and.Diseases of the Chest,\" 1840, (now long out of print), the physical signs previously known were carefully considered, and new ones described with a precision that removed much perplexity from the subjeot, and made the diagnosis of pleurisy, with all ifs result, sufciently plain to anyone whowould take the trouble to mnaster it. Altbough so manyyears have elapsed since the date of those publications, I have met with nothing in my own longer experience, or in the writings of others, to invalidate the statements there Made. There may be found the first complete description of the varieties and signs of partial effusions in the pleura; the true nature and signification of 2erophony; and the first annoancement of trachaal and fubular sounds of pre- cussion, the discovery of which TrousFeau and others ascribe to Skoda; whose retensions to it are of a much more modern date, My acoustie explanations of the noisy bronchophony and loud amphoric breath s ounds of pneumonia are quite different frem thoseof Professor Skoda. They were annually given in my leetures in University College before 1850; but as I hardly published anything on diseases of the chest for twenty years after,. I do not think they appeared in print until I mentioned the subject in a note in the chapter on phycical signs in our recent work on - Pumonary Consumption,\" p. 171. 459",
         "CANADA MEDICAL JOURNAL. extent to which the lungs, heart adjacent organs, and chest-walls are pressed on and displaced. The symptoms are those of oppressed and restricted breathing, quickened, partially impeded, and weakened circulation, and deficient and depraved secretion: and, if these are not soon relieved, they may end in suffocation or exhaustion. Fortunately, in a large proportion of cases, medicinal treatment does bring relief; so that fatal cases of pleurisy with serous effusions are rare, and it is not often necessary to resort to, the operation of tapping the chest. The case is quite different when the effusion into the pleura is either purulent at first or is so charged with protein matter that it becomes purulent in the course of the malady. Pus, when once formed, is rarely dispersed or largely absorbed; and it remains in the pleural sac, not only oppressing and displacing organs by its bulk, as serum does, but also doing mischief, both by its solvent and irritative operation, exciting supurative inflammation in adjoin- ing parts, and tending to find vent through them. and also by its influence on the system through its partial absorption, causing irritative fever and other concomitants of pymenia. It is very obvious, therefore, that the prudent quality of the effusion in the pleura increases greatly the gravity of the case, so that failures or imperfect recoveries are likely to occur if early relief be not given by tapping the chest. It is quite true that recoveries do take place, especially in young subjec's, without any operation, by the matter making its way through the lung into the bronchial tubès, or outwardly through the walls of the chest ; but in the first case there is great distress from the violent prolonged cough and expectoration, which must harass the patient for a long time, and cause much risk of permanent disease of the lungs; and in the latter case the matter often burrows in the valls of the chestr doing them more or less injury, before it is discharged through the surface. I have known several cases of empyema complicated with caries of the ribs ; and in a few of these it has been difficult to say whether the caries was the sequel or the cause of the empyema; bnt in sor4e it was clearly the former, and, by long naintasiing an offensQve wound in the chest-walls, materially retarded the local and general im provement. In different cases of empyema there is. some variety as to the quantity and quality of the pus formed. In some cases the quantity is large and continually increasing, so as to cause much pressure, displacement, and oppression in a short time, and if it does not speedily make its own way out, leaves no alternative between'an operation and a fatal result. In other instances the matter is more slowly formed, with much less pressure and dis- 460",
         "LUMLEIAN LECTURES. placement, giving time for deliberation and hope that the effusion may be simply serous, until after the lapse of several weeks the frequent pulse and hectic symptoms, perhaps with some local signs of pointing in the walls of the chest, give evidence of its purulent nature. Again, in some cases the matter is inodorous- \"laudable\"-not differmg from that of healthy abscesses; in others it is highly offensive, with the rotten-egg or sulphuretted- hydrogen stench characteristic of decomposed pus, quite distinct from that of fetid abscess which I have before described. Some- times this fetor seens to« be caused by diseased bone, but it certainly occurs also independently of that cause. I have known it in several instances follow the operation of empyema, where the admission of air was not prevented; but I can also recall several cases where no fetor ensued, although air was admitted. This offensive character of the matter must be regarded as unfa- vourable, both as applying its instability or proneness to decom- position, and also because the sulphuretted hydrogen evolved it deleterious in its influence on the animal economy. Nevertheless patients do sometimes recover, both where the matter orîginally discharged was offensive, and where it became so after the oper- ation. I have mentioned varieties in the quantity and quality of the solid effusion as tending also to affect the results of pleurisy, favourably or otherwise. When the lymph thrown out is in moderate quantity and of good quality (euplastici as I terma it), it is either absorbed, or forns soft, flexible, membranous adhesions between the pleuræe, which little, if at all, interfere with the movements of the lungs. This is a favourable result. But when the fibrinous exudation is very abundant (1 recollect a case in which it was fron half an inch to an inch thick on the inflamed pleura), it can neither be reabsorbed nor can it be so hghly organised : it has more or less of the cacoplastic or contractile character, shrinking and becoming dense as it is organized -and, binding down the lung and cdrawing in the walls of the chest, causes those permanent contractions which are sequels of severe pleurisy. Again, in highly acrofulous subjects we may have the inflammatory lymph entirely aplastic-thrown out in a curdy mass, devoid of all organsability, and yet in such abundance as nearly to fill the pleura. I remember the case of a boy aged 10, whom I saw twenty years ago, who was attacked with right pleurisy, and lingered for several months without any return of resonance or respiration on the affected side. After the death the plural, sac was found full of soft, solid cheesy matter, not at all purulent,'the",
         "CANADA MEDICAL JOURNAL. lung being partly compressed, as is usual in pleurisy, and in other parts in a state of caseous consolidation. The treatment which is successful in a large proportion of cases of acute pleurisy is chiefly antiphlogistie, and more local than in pneumonia. Venesection is required only in the plethoric and robust. and then only in the earliest stage of the sthenic form: but leeches or cupping may be used with advantage so long as there is pain with increased temperature. lu very many cases there is little or no heat of skin ; and in these I prefer a large blister at once, keeping it on not more than six or eight hours, and following it with a large poultice covered with oiled silk. This promotes the discharge from the blistered surface, and, acting as a comfortable fomentation on the side, may well be continued till the parts are ready for further blistering, should it be required. Of internal medicines, mercurial and saline diuretics are the best for the early stage of the inflmnimation. If there be severe pain, I give a few doses of calomel combined with morphia, till the pain is relieved, and then substitute small doses of blue pill, with squill and digitalis, two or three times a day, until an effect is produced on the bowels, kidneys, or gums. Salivation is by no means necessary or desirable, the best operation of mercury being on the liver and kidneys; and when these are brought to act freely, the effusion, if serous, generally is stayed, and will diminish -quckly in some cases and very slowly in others--without any further active treatment. Saline diuretics of citrate and nitrate, or acetate, of potash are useful iin most cases. In mild forms of the disease mercury is not necessary; blisters and saline diuretics are sufficient, and may soon be changed for iodide of patassium in a bitter infusion, with daily painting the affected side with tincture of iodine. But sometimes we meet with cases of extensive pleuretic effusion, which, either from original intensity or fron not having been treated soon enough, will not yield to any or all of these remedies; and whenever the effusion is so much as to cause such distress in breathing as to interfère with the comfort of tie patient, and especially to prevent sleep, there should be no delay in puncturing the chest. We may be more confirmed in recommending this treatment if the symptoms render it probable that the effusion is purulent, and we may often guess this to be the case when there is general pallör, with partial hectic ilush, altcr- nations of chills and sweats, very frequent puise, much weakness and tremulousness of movement, and more than usual tenderness and puffy feeling of the walls of the affected side. 1 muast admit, however, that I have noticed tenderness and even swelling of the integuments of the walls of the chest in some",
         ". LUMLEIAN LECTURES. cases which yielded to treatment without tapping, and probably was not purulent. Still the symptom is suspicious, and, if in conjunction with others above-mentioned, may be taken in favour of the effusion being purulent. lu doubtful cases the grooved needle may be used to settle the point, if there be any question about the propriety of operating; but I would repeat that when there is great and continued oppression - such as to prevent sleep- I think the operation should be performed, whether the effusion is purulent or serous only. In case of serous effusion, tapping toý the removal of two or three pints may be enough to relieve the oppression; the respiration and circulation being thus set free, the rest will probably be absorbed. But in cases of empyema it is. desirable to evacuate more matter, and we may require repeated operations. As it is impossible to evacuate all the matter, a long time is required for the lung to re-expand, and for the pyogenic membrane to become covered with lympli, which obliterates the cavity by the adhesion of the pleural surfaces. .I do not piopose to dwell on the details of the operation of tapping the chest, but I must remark that my experience is in favour of avoiding the admission cf air if possible. I know that cases have done well where no attempt was made to exclude the air; but these were healthy subjects, in which the matter resists decomposition, and whose constitution supplies a healing power in, spite of difficulties. On the other. hand, I have seen several instances in which serous effusion has become purulent, and- purulent matter has become fetid, with the evolution of sulphur- ,etted hydrogen, so shortly after the admission of air, that it was impossible to doubt the injurious influence of the air in those cases at least. In young subjects the walls of the chest are some- what compressible, and by pressure steadily applied whilst the, fluid is flowing, and continued till the puncture is closed, it is quite possible to prevent the admission cf air without any special apparatus for this purpose. In older patients, in whon the chest is more rigid, this is less practicable ; and of the various contri- vances to prevent the admission of air in such cases, the simplest and most effectual is the attachment to the canula of the trocar of a few inches of a perfectly flaccid tube, such as a rabbit's intestine, or soft; thin mdiarubber, which permits the liquid to flow down- wards freely, but, collapsing as the current flagi, effectually pre- vents any air froe passing upwards.' The treatment after the operation, as well as for all the more * Note added in 1872.-The more modern improvemients in the operation intro- dUced in the last ten years will be noticed in the next portion of the lectures.",
         "CANADA MEDICAL JOURNAL. chronic forms of pleurisy, should be of a sustaining and corrobo- rative kind. The solid products of inflammation are the more in proportion as they degenerate: and they Lxe more likely to be absorbed or to form harmless adhesions if the body is well nour- ished and under salubrious influences. A course of cod-liver oil with a smnall tonie, a generous but not too stimulating diet, and moderate exercise in a bealthy air, greatly conduce to convales- cence, and may prevent many evil consequences. lu cases of empyema with a permanent opening hi the chest, little improve- ment nay take place till the patient goes to a healthy country place or to the sea-side; and then the discharge soon begins to dimainish, and the health and strength are simultaneously improved. On turning to my case-books to illustrate the successes and failures in the treatment of pleurisy, I find the cases successful without operation so numerous and commonplace that it would be superfluous to dwell upon them. As samples, two cases will suffice-one in a young subject, the other in advanced age. The latter and a third oase-which exemplifies an imperfect suecess, which is not uncommon-have been added since, the lectures were delivered.) Case 1.-December 11, 1850.-A young gentleman, aged 13, eight days ago, after long riding in the wet, was attacked (in the country) with sharp pain in left side, sickness, occasional fits of cough, short breath and fever, with quick pulse and hot skin. Two days ago he was brought to town, and has been under the care of an eminent physician, who prescribed only salines. The breathing has become worse, pulse 124, urine very scanty and high- coloured; pain less, and skin cool. Complete dulness and absence of breath and vocal vibration throughout the chest, and extend- ing an inch to right of sternum, including dorsal spines, and pushing the heart two inches to right of sternum. Jgophony in mild regions. Breath-sound puerile on right side. Blister six inches square to left side. Blue pill, squill, and digitalis, and an effervescing saline every six hours. 14th.-Pain and breathing better; pulse 69; urine free, alka- line. Motions being loose and bilious yesterday, grey powder and Dover's powder given thrice daily instead of pilla. Signa the same, except that the heart is three inchea to right of sternum, and tubular voice and breath are heard in left upper front. 16th.-Breath better, but is faint from sitting up; urine alka- line. Dulness and displacerants continue, but Sgophony heard lower down in the back, and bronchophony within left scapula. Another blister six lnches by three inches. Iodide and nitrate of potass in orange and cascarilla infusion substituted for the citrate",
         "LUMLEIAN LECTURES. of potass mixture. The blister rose well, and next day the gums were slightly affected. Fronm this time the patient made a speedy and complete recovery, being convalescent in a fortnight. Examined four years after, the chest showed no signs of disease or contraction. Case 2.-A distinguished Physician to the navy, aged 72, oon- sulted me on November 15, 1863, subject to bronchitis in winter. Ten days ago, after exposure and chill, had sharp pain of right side, cough, short breath, restless nights, scanty urine; pulse 90, weak; respiration 30. Dulness from second rib down whole right front, and throughout side and back below spine of scapula ; no breath-sound or vocal vibration; a-gophony in mid-regions of side and back up to spine of scapula, where, and above second rib, bronchophony and tubular stroke-sound; heart-spex below left mammilla. A blister six inches square to the right side; blue pill, squill, and hemlock three times a day, with effervescing citrate of potass; nutritious diet, with a moderate amount of stimulants. The kidneys soon acted freely, and breath and restlessness were relieved. In a week another blister was applied, and iodide of potassium in a cascarilla mixture substituted for the saline and mercuriaL After this the signs of effusion gradually diminished, and the health and strength were re-established in a few months under tonies, cod-liver oil, and country air. I did not see this patient after 1864, but I heard of hum as pretty well in 1867, although suffering from cough. le died in P-68. This case shows that advanced age is no bar to success in the treatment of sub- acute pleurisy by the recommended means. Case 3.-Master H., aged 10, June 26, 1863; previouslydelicate, but not ill till a fortnight ago, when he fainted at church. Since weak, with slight cough, pain in the chest, andshortness of breath, which has much increased in the last two days, and the left front of the chest is swollen. Complete dulness, without breath-move ment or sound through the whole of left chest and to right of sternum and dorsal spine; heart two inches to right of sternum; bronchophony above left scapula; protrusion and tenderness of intercostals about mammilla. Citrate and nitrate of potass were prescribed, but I considered the case so urgent that I arranged with ny friend, Mr. T- Tatum, the following day, to tap the chest. When he came we found the swelling and dyspnoa less, vnd. as the boy was very timid, it was agreed to postpone the operation, and try a blister in addition to the saline diuretic and a few nightly doses of blue pill. This treatn.ent proved succesful in removing the liquid effusion in DD",
         "CANADA MEDICAL JOURNAL. three weeks, but the side contracted, and the penetration of air into the lung was imperfect. In the following August, under the constant use of cod-liver oil and tonies, with regulated exercise and diet, the lung expanded, and the youth outgrew the defor. mity, so that, in 1865, he was in good health, with little remains of the contraction. He continued well till 1867, when, at Harrow, he had another attack of inflammation of the left chest, which has recurred since repeatedly, and has induced chronic phthisis. He is still living, but in an invalid state.-Med. Times and Gazette. NOTE ON A CASE OF ATHETOSIS(?) By C. CURRIE RrrenI, M.D., Physic!an to the lilme Dispensary, Man- chester. In his treatise on disease of the nervous system, Dr. Hammond, of New York, bas lately described an affection to which he has given the name Athetosis (from 4rcr. without fixed position), and which is Il mainfly characterised by an inability to retain the fingers and toes in any position in which they may be placed, and by their continual motion.\" The following may prove of interest, taken in connection with a similar case under the care of Dr. Clif- ford Allbutt, which was reported in this journal for January 27:- J. G., an engineer, aged 59, consulted me on October 10, 1870, in consequence of his having been for some time previously subject to involuntary movements of the extremities. He was a short, thin man, with sallow complexion and somewhat anxious expression. He had, however, always enjoyed good health till about three years before, when he began to suffer from occasional headache and giddiness. One day in November, 1868, when about to sit down to dinner, he suddenly lost consciousness, and fell to the ground. No account of involuntary muscular movements during this seizure could be elicited. He remainéd insensible for about ten minutes, and was then put to bed, where he continued for five days. His speech was impaired for about three nmonths afterwards. About this period (February, 1869) he noticed a slight sensation of numb- néss in the right arm and leg, accompanied by severe pain, which began to occur in the fingers and toes of the right side; these were at first slight and under the control of the will, but they had gradually increased, and were now quite involuntary. When I saw him, he could net flex the fingers of his right hand. without the aid of his left, and even with this assistance seèmed to\u003e have considerable diflicult in doing so- On desiring him to keep the right hand flexed and still'as long as he could, in a few seconds, in spite of his efforts, his fingers becane extended and",
         "NOTE ON A CASE OF ATIIEI 0SIS (?) assumed a variety of curious movements, which were continuous and somewbat complex in their nature. They began when the patient held out bis arm before him, and took place slowly and deliberately; lie could stop them by placing his right arm by his side and firmly grasping the wrist with bis left hand. The move- ments usually consisted of alternate abduction and adduction, combined with partial flexion and extension; no regularity, how- ever, was observed in their occurrence, and frequently the hand assumed a \"sprawling\" appearande, from the simultaneous abduction and partial extension of the radial and ulnar portions of the hand; sometimes the thumb would remain in a state of extreme abduction, while the little stinger was semi-fixed and drawn across the palm. These movements were accompanied by afe eling of numbness and pain. The toes were almost always in a state or flexion, having their tips pointed to the ground. When he wished to extend lis toes, he had to plant bis heel firmly on the ground, and gradually draw his foot backwards, at the saine time raising his beel. During these movements the muscles of the forearm and calf were bard and rigid. The tactile sensibility of the affected arm and leg, and also the temperature, were less than in the others. He suffered frequently from headache, wbich was always relieved by sleep; tongue tremulous; complained occa- sionally of vertigo, and \" flashes of light \" before bis eyes; articu- lation normal; intelligence fair. He had been a temperate, steady man; ne history of tuburcie or syphilis, congenital or acquired. There was no tenderness or pain on percussion over the spine. Hie was ordered ten-grain doses of bromide of potassium three times a day, and requested to see me again in a week, when, if there was no improvement in bis condition, I proposed to employ galvanism for bis relief. When he came to. me on October 22 (twelve days after I first saw him), he'told me that he had been able to do a little work, which he had not done for six weeks before, on account of the pain in his hand, which was now much relieved ; the movements were not so troublesome and he was able to sleep inuch better. He was recommended to continue the use of the bromide. I regret that I did not see the case again, in consequence of the patient baving changed bis place of residence; but, as it corresponds closely to the description of athetosis as given by Dr. Hamrmond, I venture to' submit these details, imper. fect as they are.-Medical Times and Gazette. 467",
         "ACTION 0F QUININE ON THE UTERUS. M. Monterverdi communicates to the Nuova Liguria Medica the results of a series cf experiments he has made on this subject. He has invariably employed the sulphate of the alkaloid. le £uds that quinine' exerts a general tonic influence on all the organs of the body-, but especially upon the uterus. In the course of half an hour after it has been administered, short contractions occur in the uterus, unaccompanied by pain; and these gradually become longer:and stronger, with distinct intermissions, so as to resemble closely -ordinary pair s of labour, the effect lasting for about two hours.- In order to eflfect the expulsica of the fotus and of the,placenta, he believes that doses of about four grains will be found the most appropriate. Quinine appears to be pre- ferable to ergot, because it exorcises no injurious influence either on the mother or child, because it is very certain, in its action, because the contractions it induces are very regular and natural in their character, and because it is free froma danger at whatever period of pregnandy:hi is administered; or in cases of contracted pelvis,incomplete dilatation of the os -uteri, and antecedent to the escape of the waters. 'He finds that it is of service in the mretrorrhaiagia of pregnanqvy, in amenorrha in consequence f. a torpid condition of the uterus, and in puerperal fever, as a conse- quence of its tohic action. Hie considers quininé to be indicated in ail diseases of the -digestive- organs, and of the urinogenital system dependet:upon atony of the:various organic constituents; ,. Monteverdi gives a cautionin regard to the use of quinine in pregnancy complicated with any disease requiring it administra tion, lest abortion or premature delivery be induced. , In.cases lrhere quinine proves too energetic in its action, he recommends opiaes te diminish its effect. He considers quinine to be contra. ind.icaed as a general rule, in hysteria.-Lancet.",
         "MONTREAL, APRIL, 1872. SANITARY REFORM. We can only look on and contemplate the good things in store for Great Britain, as we observe that Mr. Stansfeld's Bill, _ith certain modifications and suggestions, will be up for discussion before the British Parliament, with every chance of a useful and beneficial measure being adopted. Such action is not likely to be taken by our House of Commons; and if a Bill is submitted it will, in all probability, pass over several sessions before it becomes law. Unfortunately.we are on the eve of a parliamen- tary break-up, and it appears to us that the members of the C.nadian House of Commons are more interested in the possible chance ofhaving to engage in an election contest, than in devising measures for prolonging the lives, health and prosperity of their constituents. That Sanitary measures will be earnestly gone into we make no doubt, but we fear that procrastination will be the role until forced to adopt some definite course in actual self-defence. There are several noticeable features in Mr. Stansfeld's Bill to which we desire to allude. In the first place, it is proposed to appoint a central medical authority, such medical authority te be constituted by Parliament., Iere we have a body, so appointed or constituted, to .regulate and direct the details necessary to be carried out,' and responsible for its acts to the Executive of the country. Its duties consist in.the superintendence of medical relief to the poor, the registration of sickness, improvement in the registration of:births and deaths, and the causes of death, and the qualifications and duties of medical officers of health- and generally to direct the administration and carrying out of Sani- tary measures. Medical officers of health are to be appointed by the localjusticesr súbject to the approval of the Central Medical Board. The duties and qualifications of such inedical officers cf health shall Le deter-mined by a general regulation to be issued by the Governmcnt board. 'Every- medical ,officer of health shall be, required to relinquishb -private practice, and devote the whole of histiie te matters affecting the public health, and report thereon, .to the coanty authority. The Central Government, Board are to have the igeneral direction and supervision of Sanitary matters, and",
         "470 CANADA MEDICAL JOURNAL. should any local authority neglect to carry out prescribed improve- ments which are deemed essential for the public weal, it will simply be done for them under the authority of the Central Government Board, at the charge and eipense of 'the local authorities. It will be readily conceded that such action- is necessary under certain circumstances, and if in Canada there had existed, recently, a central board, with similar powers, we would not have suffered the humiliation of being forced to a compromise in the matter of establishing a small-pox hospitai in our own city. The fact that the usefulness of our general Ilospitals has been marred, by having attached small-pox wards in coinection with these institutions, has been - a matter of great concern. In the Montreal General Hospital .small-pox has, on several occasions, broken out in the general wards, and persons who were afflicted with'other maladies have taken that disease, and in some instances it has proved fatal. Such being the case, the'governors, on the advice of -théir medical board,\"determined to close the sm'all-pox wards, and thereby throw upon the city the onus of securing an isolated building for smill-pox patients. This action on the part of the authorities of the Montreal General Hospital led to a general meeting of the Health Com- mittee of our City Corporatian, presided over by the Mayor. The debate at this meeting was, as, might be expected, iii many respects- undignified; , questions of nationality and creed were allowed to enterinto their arguments, the speakers forgetting that both the Hotel Dieu and -the Montreal General Hospital receive persons,: suffering fromu disease. independent of country or'creed. But, what was the resuit of these deliberations ? , Why, that the saine state of things is, to remain; that the City of Montreal is' to pay the' Comnmunity of the Hotel Dieu, fifty cents a head, per diem, ýfor all small-pox patients - admitted, the Hotel Dieu' taking all cases of 'small-pox sent for admission ; (a like Sam was offeréd by the City to the 'Montreal General Hospital, for similar service but was refused); and to secure, as far as possible isolation, the Ladies of the Hotel Dieu have arranged that the sinail-pôx patients shall to be placed oni an-upper fiat of théir, hospitaL, At a subsequent meeting of -the Health Committee it was ascer7 tained, and the' authorities of ¯the Montreal General Hospital were kiïdzl,in fo-rmd that by the ÀAct 24 Victoria; Chapter 24,\":lNo. \"czarrànt shall hereafter issuè for the _payment:, of any sum of \"money granted by the Legislature to any hospital unless and 'ñüntil a certificate signed by medicaloffcerof such hospital,to",
         "SANITARY REFORM. 41 the effect that there is in such hospital a distinct and separate ýiward set apart for the exclusive accommodation of patients i afflicted with small-pox, has been fyled with the clerk of the ,1 Executive Council.\" There are .many ways of reading or of interpreting the meaning of certain clauses inActs of Parliament, but we take it that this shows absolutely and conclusively that the legislators of that day were fully convinced of the injury and injustice done to other patients by exposing them to the contagion of small-pox; that they expressly enacted what was supposed to be a check, viz., isolation in a separate part of the building. It was never intended to affirm that al] hospitals were to have a small pox department or forfeit their grant, but that the ward for small-pox shall be distinct and separate, so as to guard the other inmates againstcontagion. Is it, then, necessary to isolate and segregate snall-pox patients.? This al hinges on a matter of belief. Some men do not believe in their own existence; they regard themselves and all around them as a myth; but we should imagine it a very unpleasant myth to contract small-pox through the folly andobstinacy of any num- ber of men in power. It was to prevent the chance of contagion spreading amongst the, inmates of 'the Montreal General Hospital that the Board of Governors determined to close the small-pox wards. We regret that .they have -agreed to withdraw froin that position even for a time. But we have cause to regret the action of the iotel Dieu as fraught with greater danger. That hospital claims to. occupy some 175 beds-out ofi this number let us sup- pose they have 30 cases of.small-pox--persons not suffering from that malady are being constantly visitei by thèir friends. There persons go abroad to their houses, after a certain amount of exposure; and although they may not suffer themselves, yet they are capable of disseminating the poison of the disease, carrying it aboutin their clothes. - It is well known that contagious diseases are frequently thus propagated, we need not refer, again to facts bearing en -this subject; we write chiefly for medical readers who' are familiar with this subject; but we doubt not that,, if carefully inquired into; a large propor'tion of tbe cases of siîall-pox in our city,:outside of the hospitals, could be ,traced. to hospital expo- sure, or by having the-disease broughît to then from' the hospitals. lu the case of the Montreal General Hospital the exposureis less than in the lotel Dieu, because the small-pox patients are in a Separate building, and no persons except ý the medical' staff are permitted to enter that building. In the case of the Hotell1)ieu small-pox. patients, until recently, were mixed' with- he'othei patients. We belieye that they now occupy a separate flat; bur 4re ailiinder the sane roof, and hence the danger or contagion to outsider is very considerably augmented.",
         "472 CANADA MEDICAL JOURNAL. ANNUAL CONVOCATION OF McGILL UNIVERSITY. The Annual Convocation of McGill University, was held in the William Molson Hall of the University, on Thursday afternoon, the 28th March, 1872, for the conferring of Degrees in Medicine and Law. A large number of ladies and gentlemen were r'-esent. Shortly after 3 o'clock, the Members of Convocation who niad assembled in the library, made their appearance in order of procedure, and took their seats. The Hon. Mr. Justice DuNnKm, presiding. Ven. Archdeacon LEci opened the proceedings with prayer, after which Mr. Secretary BArNEs read the minutes of the last meeting of alumni, as also those of convocation. The DEAN of the Faculty of Medicine (Dr. G. W. Campbell.) read the following report of the Medical Faculty for the past session - The total number of Students in the past session was 138, of whom there were from Ontario, 73; from Quebec, 55; Nova Scotia, 2; Prince Edward Island, 2; New Brunswick, 1; United States, 5. The number of students who passed their Primary Examina- ions, which includes Anatomy, Chemistry, Materia'Medica, Insti- tuies of Medicine, and Botany or Zoology, was 36; alphabetically arranged as follows:- Duncan A. Alguire, Lunenburg, 0.; Robert W. Bell, Carleton Place, O.; Harry Brown, London, O.; William Caldwell, Brant- ford, O.; Duncan A. Carmichael, Beechburg, 0.; Oliver C. Ed- wards, Clarence, 0.; Saram R. Ellison, St. Thomas, 0.; William Ewing, -Hawkesbury, O.; John J. Farley, Belleville, O.; Lewis McC. Fortune, Huntingdon, Q.; Edwin A. Gaviller, Montreal, Q.; Thoinas F. Guest, St. Marys, 0.; Joseph Hills, St. Gregoire, Q. Richard W. Hurlburt, Mitchell, 0.; William F. J'ackson, Brock- ville O.; Montgomery H. J. Jones, B.A., Montreal, Q; Edward E'. Kittson, Hamilton, O. ; Bernard D. McGuire, Jolliette, Q.; John B.. MicConneli, Chatham, Q. ; James McDiarmid, Prospect, O. ; Joseph D.- -A. McDonald, St. Francis, Q.; : James McLeod, Prince Ed- -ward Island; Robert O'Brian, L'Original, Q. David'- O'Brien, Almonte, O.; William Osler, Dundas,.0.;. Hezekiah R. Perry, Coteau Landing, Q. Peter E. Richmond, New York State, U.S.; Francis John Shepherd, Montreal, Q.; John A. Steverson, Cayuga, O. Walter Sutherland, Helena, Q.;- Andrew W. Tracey,- Island Pond, U.S.; Wymond W. Walkem, Quebec, Q.; George O'Donnell 'Walton, Montreal;Q.\"; William T. Ward, Stanhope, Q. ; James W. Whiteford, Belleville, O. 5'R6bert E. Young, Hamilton, O.",
         "ANNUAL CONVOCATION OF XMcGILL UNIVERSITY. 473 The number of students who passed their first examination for the degree of M.D., C.M., was 28. Their names, residences and subjects of thesis are as follows:- Hamilton Allen, West Osgoode, O.; Arthur A. Browne, B.A., Kingsey, Q.; William B. Burland, Montreal, Q.; George Henry Christie, lachute, Q.; William L. Copeland, St. Catherines, 0.; Daniel C. Cram, Almonte, 0.; George McGill Farewell, Oshawa, O.; George William Gernon, St. Laurent, Q.; Zotique Hebert, St. Constant, Q.; iarry Hethrington, Melbourne, Q.; Robert Howard, St. Johns, Q.; Albert E. Mallory, Cobourg, O.; Louis T. Marceau, Napierville, Q.; Peter McLaren, B.A., Lanark, 0.; John Morrison, M;A., Waddington, N.Y.; James T. Munro, Roxburgh, O.; Wolfred D. E. Nelson, Montreal, Q. ; William R. Nicol, St. Marys, 0.; William Osler, Dundas, O.; Austin J. Pegg, Simcoe, O.; Henry Ross, Embro, O.; Wesley Robinson, Markham, O.; William James Sharpe, Simcoe, O.; Leonard St. John, St. Cather- ines, O.; George A. Stark, Milton, O.; Alexander Stewart, Hamp- stead, 0. Dixon A. Wagner, Dickenson's Landing, O. ; William E.;Waugh, London, O. Of the above named gentlemen, two have not yet completed their twenty-first year, and cannot therefore receive their diplomas at the present Convocation. Their names are Leonard St. John and George Henry Christie. They have, however, passed all the examinations, and fulfilled al the other requirements, and only await their majority to receive the degree. PRIZES. The Medical Faculty prizes are three in number:- 1. The Holmes Gold Medal, (founded by the Faculty in ýhonour of their late Dean) awarded to the graduate who received the high- est aggregate number of marks for all examinations, including primary, final and thesis. 2. A prize in Books, for the best examination-written and oral, in the Final branches. The Gold Medallist is not permitted to compete for this prize. 3. A prize in Books, for the best examination written and oral, in the Primary branches. The Hloimes Gold Medal was awarded to Hamilton Allen, West Osgoode, O. The prize for the Final examination to George ,A. Stark, Milton, 0. The prize for the primary examination to Francis John Shepherd, Montreal, Q. The Faculty has in addition this session awarded a special prize te the Thesis of William Osler,'Dundas, O., which was greatly dis- tinguished for originality and research, and was accompanied by",
         "CANADA MEDICAL JOURNAL. 33 microscopie and other preparations of morbid structure, kindly presented by tbe author to the museum of the Faculty. The gentlemen in order of merit who deserve mention :-In the Final examination, Messrs. Osler, Browne, Waugh, Marceau, Ilebert, Pegg, St. John and Morrison. In the Primary examina- tion, Messrs. Alguire, Hill, Carmichael, McConnell, Ward, Kittson, .and Osler. PROFESSORS' AND LECTURERs' PRIZES. Botany--ýWilliam Caldwell and E. B. C. Harrington; Zoology- C. R. Jones. Prize for the best collection of Plants by a Student of Session 70-71, Benjamin Wales. Practical Anatomy-Senior Class prize, Robt. C. Young; Junior 'Class, A. C. Sinclair. The DEAN then distributed the prizes to the successful students. The Graduates were then called to the front and the \"Sponsio Academica\" having been administered by Professor Craik, the *ceremony of capping was performed by Mr. Principal Dawson, who .at the same time presented each candidate with his diploma. Dr. M\u0026cLAREN delivered the valedict'ory address on behalf of the students. He deprecated the view entertained by some that the medical profession may be considered simply as a means of obtaining a livelihood, and urged that the aims of its professors should be of a farhigher and more philanthropie kind, namely, to heal the sick and afflicted. Professor DRAKE thèn addressed to the graduates some words of parting counsel, urging them to adopt methodical habits in the practice of their profession, to take notes of all cases which came under their observation, and to be assiduous in the discharge of their duties. Referring to the circumstance that Canada had not yet produced medical men of world-wide reputation, the profes- sor asked if we might not entertain the hope that this great country, but just emerging from the region of barbarism, may yet be destined to furnish men who will add new glory to the firmament -of science. This excellent address will be ýfbund in our original department. After the proceedings of the trw Faculty had been gone .through, and an excellent address by the chairman, the benedio- .tion was'pronounced by the Rev. Dr. Wilkes, and the meeting .adjourned. 474",
         "'COLLEGE OF PRYSICIANS AND SURGEONS. THE COLLEGE OF PHYSICfANS AND SURGEONS OF O'NTARI0. The Canada Lancet, for April, contains an article in which, among -other matter, the editor recommends the council to remit all examinationofstudents who go abroad and take out any of the diplo- mas from the colleges of the mother country. We quite agree with the editor of the Lanret in the main features of his argument, but it appears to us that he is placing the diplomas of our own colleges and universities at a very great disadvantage. We hold that Medicine and Surgery are as well administered in Canada as in any country in the world. And we believe that medical studies are as faithfully pursued and taught with us as abroad. It is well known that the brightest intellects amongst us have not all been able te avail themselves of the advantages held out by the larger field for observation in the hospitals and schools of Europe. We opposed the central examining system in Ontario at the time that the Bill was submitted to the Local Legislature, because-we regarded it as an injustice to the schools already in existence. We would, however, advocate a general Bill for the D ominion, but we fear that such an Act is not attainable under existing circumstances. Medical schodis 'ac within the last few years, increased rapidly in Canada, and each one is affiliated with some University holding a Rcyal charter; so that, as far as the Province of Quebec is concerned, we have, at present, five independent licensing bodies. This is to be regretted, as it will tend to induce laxity in examination, and, by opening the door to incompetent men, will thereby lower the standard of medical education. What we really require is a Central Board of Examiners, before whom all comers should have to submit to examination prior to registration. The Canada Lancet observes: \"It is certainly most illiberal to \"force these young men who have a status equal, if not superior, to that of many of their examiners, to pass through the ordeal \" of another examination, with the attendant loss of time, and Il further drain upon their already depleted purses.\" In another portion of the article the editor says: \"Surely the 4' Council shoulid be satisfied with the professional status of Cana- \" dian graduates who have received the additional degree of , M.R.C.S., or L.R.C.P., in London or Edinburgh. We maintain \" that every encouragement and consideration should be shora ' to those graduates who have the ambition, the eneigy and the 4'determination to qualify themaselves so thoroughly for the prac. 4' tice of their profession.\" It will be observed this has reference to men taking out the",
         "4CANADA MEDICAL JOURNAL. degrees of London or Edinburgh. We suppose the editor of the Canada Lancet includes all the licensing bodies in Great Britain, though lie does not so state. This being admitted as an abstract principle, then would it be better for us to close our schools and cease medical education entirely: obliging all medical students to proceed to those halls of high learning in the mother country, where they can obtain, at a trifiing increase of outlay, advantages which we are unable to offer. The whole article in the Canada Lancet grates unpleasantly. We may be, in the opinion of the editor of the Canada Lancel, asses and ignoramuses, we may be far behind our fellow-men, we may have donxe very little for science generally, nevertheless we maintain that the larger number of our Canadian graduates will compare favorably with an equal number of those hailing fromi British colleges, .judging fron the specimens we have come in contact witb, excepting always leaders in medical science and literature, some few of whom it ha been our good fortune to meet. It is unnecessary to grind all this into our ears, however true it may be. And in our opinion it il-becomes a Canadian jour- nalist to befoul and belittie the institutions of his own country. 'Tis passing strange, on turning to the title page of the Canada Lancet, the reader will there behold, \"Edited by J. Fulton, M.D., M.RC.S., England, L.R.C.P., London.\" RULES FOR THE GUIDANCE OF PUBLIC VACCINATORS. We publish the following rules, which were adopted by the Board of Health of St. John, N. B., during the recent epidemic of of small-pox which afflicted that city: 1. That each Vaccinator shall confine himself to his respective District. 2.'That he shall keep a book and insert, under its proper head- ing, the date of vaccination-whether primary or secondary-and the name, age, and sex of eaeb person vaccinated, and the result of the vaccination. 3. That he shall visit every house and room in his district examine the arms of each and every person, and vaccinate all persons who have not been vaccinated, except those who have had snall-pox; re-vaccinate all persons who have not been vaccin- 476",
         "MEDICAL NEWS. ated since puberty, and re-vaccinate those who have not good -tharacteristie marks of previous vaccination. 4. To secure good and efficient vaccination, no lymph shall be used except such as has been taken from a primary vaccination, from a thoroughly characteristic vesicle, and from a perfectly bealthy subject. It must be taken about the eight day, and not after the areola has been completely formed. 5. At each primary vaccination the lymph muet be inserted not less than three tims, and at each re-vaccination once or twice. 6. Each person vaccinated shall be visited about a week after the operation, to ascertain if it has taken; sbould it not have done so, the vaccination shall be repeated. THE EFFECTS GF VARIOUS LIQUORS ON THE KIDNEYS AND BLADDER. M. Kraus, of Vienna, in the Mouvement Medicale, treating on this subject says: \" Sparkling wines are very injurious, but not in respect of their carbonic acid, which assists very materially in the elimination of phosphates. Champagne net only increases the secretions, but, in an extraordinary manner, the phosphates; and the conduct of medical men who advise its use in calculous cases is irrational and unjustifiable. M. Kraus's experience contradicta absolutely the solvent action of carbonie acid on concretions already formed. le considers that old beer is an unobjectionable drink, but that lately brewed liquor is injurious, because the fermenting particles penetrate the mucous membrane and give rise to a greater or less degree of chronic catarrh. English pale ale is open te the same objection in consequence of its richness in alcohol and the great quantity of carbonie acid which it contains; but porter, if of good quality and age, is reported by M. Kraus te be unobjectionable.-Medical and Surgical Reporter. REFORM OF INEBRIATES. The Washingtonian Home, in Boston, designed to assist in- ebriates who desire to reform, has been in successful operation for thirteen years, and during that period nearly four thousand patients have availed themselves of the privileges of the institu. tion, and in a great number of cases men who had been given up by their friends as hopelessly addicted to intemperate habits, have been restored to respectability and usefuliness. Durin*g the past year the number of patients under charge was two hundred and seventy-six, and the average amount of each amounted te forty-three dollars. 477",
         "LA:Al)A ME11CAL JOURENAL. PRESCRIBING DiCUGGISTS. INQUESTS AND TE RATErÂTERs. It would appear that s new element has been iniroduced with respect te the necessity of doing away with drug-sellers prescrib- ing for sickness. According te the report of a late inquest in Bethnal Green, the Deputy-Çoroner shrewdly illustrated the cost of ignorant and unqualified Practitioners, net only in regard te life and health, but also with reference to the pockets of the rate- payers. At an inquest held last week, before Mir. Richards, the Deputy-Coroner for Eastern Middlesex, it was shown that a boy aged three years, was taken to a \" Medical Hall,\" that he was treated for \"booping-cough,\" and medicine given him for the cure of that complaint. The boy after, however, was suddenly seized withL a \"fit of choking,\" and died in ten minutes. The Medical gentleman who was called in (Dr. Bryant) said that the deceased was a fine healthy boy, and if proper Medical attendance, had been forthcoming, he had no doubt, would have been alive now. There was net, in fact, any sign whatever of whooping- çough. Deceased died from croup. The Coroner, in his observa- tiôns upon the case, made some sensible remarks. le said:- IThe extent te which druggtsts infringe the provisions of the Medicel Act is sometimes frightful, having regard to the fact that the lives of mnsuy persons are annually sacriticed through the ignorance of these unqualified Medical Practitioners. The con- sequence is that, at the last moment, a real Doctor is called in, and he refuses te certify the result before a coroner's inquiry and the waste of the county money. The want cf a public prosecutor is here most manifest; but until this crying evil becomes thoroughly exposed through the mediunm of the public press, we may look in vain for any proper measures being taken to check the frauds which are daily perpetrated upon the true Medical Pro- fession by men who know as much of the human anatomy as my inkstand.\" The Coroner's words were fully endorsed by the jury, and a verdict in accordance with the Medical evidence was re- corded. We commend the sensible observations of Mr. Richards te all coroners, niot one of whom throughout the country has not; unfortunately, experience of cases similar te the one reeorded- Jfedical Times and Gazette. THE CHOLERA IN NEW YORK. 1Recently in New York, a= important report fromi the Sanitary Committee of the Board of Health, with reference to the approach of the cholera, was laid before that body. The committee seeks",
         "MEDICAL NEWS. neither to exaggerate nor to underrate the gravity of the situa- tion, but desire to avail themselves of every means at their com- mand, if possible, to prevent its extension. To that end, they recommend a thorough cleansing of the streets and wharves, an application of disinfectants to tenement\u0026 and sailors« boarding houses, and the dispersion of cellar popula. tions to more wholesome quarters. They also urge a reissue of s circular to officers and agents of all vessels conveying emigrants from the northern parts of Europe, enforcing, the necessity of cleanliness, prompt isolation, and treatment of all cases of diarrhoea, together with the free use of proper disinfectants toý soiled clothing, etc. Al classes of citizens here, at home, mean- while, should co-operate for the com-mon good. The comnmittee also say: \"The medical history of the nilitary posts in New York, shows that cholera, yellow fever, and kindred dise.tses have been brought within the city limite by the recruits taken from the vagrant population of other cities. The refusal of the Secretaryof War to require returns to be mada to the depart- ment «of the contagious and infectious diseases occurring among troops at posts within the city limit8, leaves the board powerlesa to protect the city against the introduction of cholera, or other contagious, infectious, or pestilential diseases, through that channel.\" We beg to call attention to the following course of Lecturas to be delivered in June next: To MEicL GiRADUiTs.--Dr. Horatio Robinson Storer (late Professor at the Berkshire Medical College,) will deliver his nth Private Course of Twelve Lectures, n the Surgical Diseaseas of Womaen, during the first fortnight of June, 1872, commencing on Saturday, June 1, at 4 P.M. Fee $50. The Course is intended to cover all that is yet known of Pelvic Surgery in the female, and, while interesting both to general and to special practitioners, it commends itself particularly to those teaching, or desiring to teach, gynocology at hospitalb and medical colleges. Applicants for the certificate of attendance will be required, sa in previous years, to furnish evidence of good professional stand- ing, as defined by the American Medicai Association. Boaroi, March 1 5,1872.",
         "480 CANADA MEDICAL JOURNAL. REGTJER OF THERMOMETER AND BAROMiETER Kept by TaoMAs D. KING; 26 Beaver Hall, Montreal. FEBRUARY, 1872. MARCI, 1872. 1 4 6 3 20 30.27 11 99 2 15 '16 6 17 ',374 5 16 9 3 4 5 3 25 34 3 ,4 1 3 7 4 20 21 15 21 29.70 4 2 4 1 3 6 5 30 31 21 33 94 5 18 7 -9 3o 5 6 19 21 18 34 30.15 7 9 10 9 26 , 46 7 8 1 01 6 2 16 44 9 9 5 7 3 26 42 9 5 0 24 7 10 8 10 '7 23 24 11l 12 14 7 26 09 11 2 30 6 5 8 12 26 28ý 20 24 29 .97 '2 7 8 4 9 30s 13 15 18 14 38 30 .06 14 30 31 23 37 29 .46 1 6 8 1 7 1 15 9 6 32 60 74 16 14 15 11 19 71 1 5 2 ).1 17 7 8 5 20 30.27 1 2 2 1 1 29.96 1 6 7 4 24 20 17 2 4 5 31 - 8 19 -7 8 2 23 17 1 14 15 9 23 54 20 10 13 6 30 207 2 3 2 4 26 6 21 27 31 24 35 29 4 5 58 ' 1 30 .96 22 1 2 1 30 8 5 6 - - 10 - 6 14 23 2 2 -, 2 21 .01 2 8 13 1 8 30.10 24 10 11 9 15 2946 8 6 32 5 2 9 25 30 31 20 30 442 9 8 26 -8 - 2 3 37 30 .10 16 31 24r 23 26 27 1 2 1 15, 29 .9 2 7 30 2953 5 89, 24 3 28 7 2 94 14 16 18 - 17 29 2 3 1 23 30 '15 1p 17 15 3. 0 16 14 1 l 1 1 5 8 5 22 633013 0 731 20 23 21 4 29.96 18 6 7 4 2 2 14 5 14316 8 19 7 2 23 17 1 14 125 9 23j 74 1 2 4 - 18 1 29.05 2 85 2. 6 30 . 8 2 9 - 0 10.5 -8 14 .23 - -2 . 3.0 82 19 16 10 22 9 2 0 l 1 2.6 9 26 27 20 33 97 26 3 2 3 37 0.1 12 31 31 27 3 2. 27 1 2. 15 29.5 12 27 33 26 35 21 S 7 '8 7 219 2 75 89 2 439 3.2 9 2 ' -1 3 3.0 12 2. 26 0l 18 (40 11. 12. 8.514.6160.8 - 12.97 10.5 2. 00 e .15. 1 17 15 34 29. 9 16 5 C 8 2 0.1 --3 2 - 4 m _ 21 0 1 1 30.0 by ths roie5io17o21th5dec5n30.s52 c26 31(33i27ie34r 27 3 3 8 5 2 28 25 292c43 2 In taking the Temperature the decýimals are re.ected for simplificaton If Thermnometer more,-than halfdegree, say 10.7, it is rendered 110, if less/ than half degree, say 10.3, it is rendered 100. The mean is scarcelyaffected,,ý by thea rejection of the'decimals. Thie sign (-) signifies below zero."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL SÛRGICAL JOURNAL APRIL, 1885. original Communications. VALEDICTORY ADDRESS TO THE GRADUATES IN MEDICINE, McGILL UNIVERSITY. DELIVERED AT THE ANNUAL CONVOCATION, MARCH 30TH, 1885. By T. G. RODDICK, MD., Professor of Clinical Surgery. GENTLEnE-GRADUATES,-On- behalf of iny colleagues, I congratulate you on the successful termination of your course in Medicine. The ceremony just completed virtually admits you to all the privileges and responsibilities of the profession of your choice. The document which you have se.verally received from the hand of our worthy Principal is a certificate of your competency to practice medicine and surgery and the various branches embraced therein. It is your just reward for the patient, plodding work and gentlemanly behaviour which have characterized you during the past four years. I dôubt not you prize greatly the parchment which you hold in your hands, but I question very much if you really appre- ciate its full value, I may tell you for your gratification (and I make the statement advisedly) that amdng the many prizes and rewirds open to the ambitious student throughout the world to-day, there are very few the intrinsic value of which is greater than the diploma which this University is authorized to issue on behalf of its Medical Faculty. That you are a \" McGill man \" is a sufficient guarantee to the public of your ability as a physician, and auong your confrères everywhere you will command a more than ordinary share of respect and esteem. 33",
         "514 CANADA MEDICAL AND SURGICAL JOURNAL There are few, then, better equipped than you for the jour- ney of life, and let us hope that you will make good use of the\" splendid advantages you have had, scoring many victories against injury and disease and adding fresh renown to your Alma Mater. Your success will, however, depend very much on the manner in which you apply the knoiýledge which you have gained here. Remember, you are now to be thrown on your own resources. Hitherto the practical work in which you have been engaged, in the wards of the hospital, bas been well supervised by some person responsible for the well-being of the cases allotted to your charge. Hitherto it made no material difference to the patient whether your diagnosis of his disease was correct or not; and in your capacity of dresser it mattered little, beyond the temporary inconvenierice, if your splint pressed unduly on prominent parts or your bandage interfered with the circulation and threatened the integrity of a limb. Hitherto you have been able to leave your patients and return to your respective apartments with a light heart, knowing that your work would be well supervised and the defects therein :corrected. Now, however, things are going to be vastly different with you. The tow-rope bas been cut and you are rapidly floating off from the old ship, whose helmsmen have been doing the steering for you. You must now be prepared \" to paddle your own canoe.\" It will make all the difference after this, both to your patient and yourself, whether your diagnosis and treatment be correct or not. It will not do now to overlook a pneumonia, mistake the eruption of small-pox for measles or to treat a broken bone as an ordinary sprain. Your dressings will no longer be subjected to criticism and correction, and if, through any mismanage- ment, your patient's life or limb is imperilled, you may have no one.now to share the responsibilities with you. I would advise you, therefore, constantly to hold a review of the knowledge you have acquired, adding fresh facts as Medi- cine progresses. Store up for future use the 'practical hints given you from time to time at the bedside. Always have the feeling that you are ready for any emergency, no matter how",
         "VALEDICTORY ADDRESs-DR. RODDICK, grave. The bleeding artery will not cease to spurt while you are looking up your authorities to find where or how it should be secured, nor will the deadly poison stop its destructive work while you are looking up the proper antidote to administer. And here I would take the opportunity of advising you against being stingy with your knowledge. I have known men to go about work as if there was some great mystery connected with our art-as if to divulge any of its secrets, no matter how trifling, would be to commit an unpardonable offence against the dignity of the profession. There can be no greater mis- take, and those who practice medicine and surgery in this way are constantly getting into trouble. Thus how often, especially in country places, has secondary hæmorrhage proved fatal after ampùtation or as the result of a wound, simply from the want of a little knowledge on the part of the attendants. So gangrene after fractures has gone on for days unheeded, the nurse having received the most positive instructions not to interfere under any circumstances; whereas if she had been taught how to test the condition of the circulation, and warned to loosen the dressings on the first appearance of discoloration, such a calamity would not be likely to occur. So with medical cases, after administering a dose of some powerful drug, explain to the person in attendance what the effect of the remedy may be, and thus prevent the alarm which odd and unexpected symp- toms often produce. You will find it to your advantage, then, to have one or two intelligent women in your district somewhat traihed, so that you could entrust to their care any severe cases. You may perform your operations very dexterously, but without proper nursing-all your skill will be of little avail. While, however, I would wish you to be apt in cases of emer- gency, I would advise you always to avoid haste in forming your conclusions. When pushed for a diagnosis in a doubtful case, never be too positive. No amount of knowledge can jus- tify one in becoming dogmatical in his opinions regarding dis- ease. In cases of doubt you need not be idle, however; treat the symptoms that exist while you are waiting for nature to reveal her secret. So with your prognosis ; it should always 515",
         "516 CANADA MEDICAL AND SURGICAL JOURNAL. be guarded. Excepting in the case of pronounced and advanced organic disease, never give your patients up. In the case of children this advice is especially good, because their powers of endurance and recuperation are sometimes maarvellous. We too often give the charlatan a golden opportunity, by allowing him to step in and get for his absurd nostrums 'the credit for the cure which Nature herself had unquestionably effected. On the other hand, I would not have you w*ilfully deceive people. If, after fortifying your opinion by consultation with a confrère (and this you should always do when in doubt), you have serious misapprehensions regarding the immediate ulti- mate result of a case, do not hesitate to state your fears to the friends, and if necessary to the patient himself. This, however, should not be done in a brusque, unfeeling manner, but in a kindly, confiding and hopeful way. Thus, in the case of those having worldly affairs to arrange, you will often do immense service by your frank and manly behaviour, and perhaps save the survivors from the annoyance of years of litigation. In your intercourse with your patients generally, be gentle and forbearing. To the poor, especially, be generous of your professional services and kindly in your manner. The rich man is often ungrateful and exacting, and thinks that with bis gold alone he can recompense you for the days and weeks of anxious care and thought bestowed upon him. The poor man has nothing to offer but his heartfelt thanks and earnest prayers for your welfare. It is true the latter will not enrich you, but the consciousness of having done good without hope of reward should bring pleasurable feelings to the bosom of every right- thinking man. Besides, your experience will be enlarged and your prospects, in many ways, advanced by such disinterested and charitable conduct. I cannot impress upon you too strongly the necessity for cul- tivating the good will and esteem of your fellow-practitioners, especially those who labour in the same field with you. Some of you, doubtless, will be going forth now in search of suitable localities in which to begin work. To you I would say-Do not enter the town or village of your choice with the demeanour",
         "VALED1CTORY AIDPtËS-DR. itODDICK. of one about to steal something. The proper course to pursue is to approach the men who already occupy the field, and in a straightforward but respectful manner announce your intention of settling among them. You will thus often disarm those who would otherwise offer a vigorous opposition, and you will capti- vate the good will of others by your frank and gentlemanly behaviour. Nothing can be more .unseemly than the bicker- ings and discord which prevail among the members of the pro- fession in some places, and too often the impatient young practitioner-the last arrival-is to blame. I implore you not to resort tô any mean or unworthy methods to build up a repu- tation. Should you be consulted by the patient of a brother practitioner, be careful how you criticise his practise in his absence. The fact that you differ from him in opinion does not justify you in vilifying him. Frown down on all occasions any attempt made by designing persons to extort money under the plea of malpractice. There is seldom the faintest justification for such a charge; and what more humiliating spectacle than to see one brother arrayed against another, with an ignorant and often jubilant public looking on. . Let your course, then, be a straight one, just and fraternal, and in the long run you will come in the winner. You will by reason of your profession, sooner or later, become prominent members of the several communities in which you practice, and the temptation will offer to take part in the great political questions of the day. If you are wise, however, you will eschew politics altogether. For one medical man who makes a success as a politician, fifty fail. In all questions, how- ever, pertaining to the health of the people you should be pre- pared to take an active part, disseminating a correct knowledge of those sanitary laws which, when rightly understood, 'are capable not only of mitigating the severity of existing diseases but actually of preventing many of them. In conclusion, gentlemen, I would beg you to endeavour, by your every word and deed, to exalt the reputation and extend the usefulness of the noble profession which you have entered to-day. Be assured that we who have been your teachers will",
         "CANADA -MEDICAL AND SUJRGICAL JOURNAL. not soon lose sight of you, but will continue to take that lively interest in your welfare which has characterized our conduct in the past. May every success attend you. Farewell! COCAINE HYDROCHLORATE IN DISEASES OF THE NOSE AND THROAT. By GEO. W. MAJOR, B.A., M.D. Late Clinical Assistant, Hospital for Diseases of the Throat and Chest, London, Eng.; Out-door Physician to the Montreal General Hospital; Fellow of the American Laryngological Association; and Instructor in Laryngology and Diseases of the Nose and Throat, McGill University, Montreal. In October last, at the invitation of Dr. J. Solis-Cohen, of Philadelphia, I had the privilege of conducting with him in his consulting room an interesting experiment with cocaïne. The case selected was one of hyperæsthesia of the larynx, and occurred in the person of a gentleman, a professor of La- fayette College. The solution used was of the usual 4 per cent. strength, and though it lessened sensibility it did not overcome spasmodic action on the introduction of a sound into the larynx. This was, in point of fact, my first practical experience of cocaïne. Since then I have employed cocaïne solutions of varying degrees of strength almost daily, and recognize in it a most valuable aid to the treatment of disordered conditions of the upper air tract. The great scarcity of the drug, and its almost prohibitive price, have at times rendered it difficult to obtain solutions of reliable strength and purity, and were I influenced by the results obtained from worthless samples occasionally supplied me, I should as unsparingly condemn as I now wish to commend it. The most reliable make is that of E. Merck, of Darmstadt, and if obtained sealed, stamped and in the original package, the alkaloid 'will invariably be found to give good resùlts. Solutions of cocaïne undergo, when a few days old, some slight change, and a deposit of a fungus takes place ; but this, in my experience, does not in any way impair the activity of 518",
         "cOcAINE IN NOSE AND THRoAT DISEASES-DR. MAJOR. 519 the drug. If the cocaïne be dissolved in distilled water, to which a small quantity of salicylic, boracic or carbolic acid bas been added, the solution will remain stable-and for use in the air passages these additions are unobjectionable. The strength of the solution to be employed in the upper respiratory tract depends upon such conditions as each case may present and will vary from 1 to 20 per cent. For all practical purposes of allaying pain the ordinary 4 per cent. solution bas in my hands answered every expectation, but where mere steadiness or lessened sensibility is all that is sought, a one or t*o per cent. will generally be found sufficient. Before applying cocaïne to the nasal chambers or upper throat it is well, for economical reasons as also for efficiency, to wash away the protecting mucus by means of a weak alkaline spray. This simple procedure facilitates its action and saves both time and material. Generally speaking, a period of time varying from three to five minutes is required for the production of perfect anosthe- sia, and this may be maintained indefinitely by repeating the applications at short intervals ; anoesthesia ivill, however, last unaided for ten or fifteen minutes. Cocaïne only protects those parts to which it is directly applied, and does not, in my opinion, exercise any influence on contiguous surfaces. It is therefore necessary for success that all applications should be made carefully and thoroughly. The quantity of solution required for each sitting depends upon the region and the extent of surface to be influenced, and also upon the strength of the solution employed. fBefore proceeding to make painful applications, it is prudent to test the extent of the local anSsthesia by means of a probe; when the sensation is that of pressure only, as perfect anæs- thesia bas been obtained as is possible, or indeed, required, for superficial operations. For the purpose of making applications to the nasal passages, I use small camel hair pencils mounted on long and slender handles ; for the upper throat, brushes of the same kind, but larger ; for the larynx I first apply weak sprays, and after sensi-",
         "CANADA MEDICAL AND SURGICAL JOURNAL. bility has thus been lowered, I employ the ordinary rectangular throat brush. In all the regions under notice several coats are generally necessary. Before dipping the brush into the medi- cated solution it is well, forobvious reasons, to wet it thoroughly in simple water. For operations in the larynx a stronger solution than the four per cent. is called for, as the latter, though it aids very mate- rially any surgical procedure, still does not sufficiently overcome spasmodic closure, and this prevents a clear view. The action of cocaïne as a local anæsthetic is but one of many remarkable properties possessed by it. When applied to the mucous lining of the upper air way it causes at first a slight burning sensation, followed instantly by a numbness resembling the action of very hot water minus the pain ; this is followed by a stiff, leathery feeling, accompanied by a desire to swallow, with at first a difficulty in doing so. The taste is acrid, bitter and very disagreeable, and the odor slightly vinous. Cocaïne unloads the superficial vessels, reduces swelling of the membrane by its very marked astringent action and pro- duces blanching of the surface with which it is in contact. Cocaïne, when administered internally, possesses the same power of narrowing peripheral arteries. This latter property bas been known to laryngologists for years, and various pre- parations of cocoa (erythroxylon) leaves have been employed by them in cases of hypermia and irritable conditions of the pharyngo-larynx where sedatives have been indicated. In cases of nasal disease, this property of contracting the soft tissues on their bones is one of very great moment, as it facilitates the view of parts otherwise invisible, aids very materially delicate manipulation and lessens the tendency to hemorrhage. In the pharyngeal region its action is that of a sedative and astringent, and in the larynx it combines these properties with that of being a powerful voice tonic. No remedy of modern times bas in so brief a'space become so widely and favorably known as cocaïne, nor bas any, so far as I am aware, so well fulfilled all the promises its promoters advanced for it. There are still those who even now regard",
         "COCAINE IN NOSE AND TÈROAT DISEASEs-DR. MAJoR. 521 cocaïne as a doubtful remedy, possibly founding their belief on their experience of a single case or an adulterated or inert sample. The uses to which cocaïne may be applied in the nose and throat are legion. As a local anæsthetic it claims first place, and if properly handled it will not disappoint our most extrava- gant expectations. The sensitiveness of mucous surfaces varies greatly in health and disease, and we must be prepared, if necessary, to increase the strength of our solutions should we fail to produce suflicient anoesthesia with one of lower power. As a local anoesthetic, it may be employed in the nasal cavi- lies to prevent immediate suffering from painful applications, as, for instance, chromic, acetic or nitric acid, nitrate of silver, and so forth ; to allay the pain caused by the introduction of instruments, as probes, snares, forceps, \u0026c. In the galvano-caustic method it succeeds most effectually in controlling pain, as also in the removal of tumors, out- growths and excrescences of whatever kind. Cocaïne also contracts the venous sinuses, and aids diagnosis and manipu- lation by opening up a previously occluded passage. It pre- vents altogether, or lessens, the tendency to hemorrhage or oozing, and thereby does away with one source of annoyance and discomfort. It arrests the tendency to sneeze so fre- quently met with in cases of nasal disorders. In coryza it wilt be found of at least temporary benefit, and will do much to hasten the cure by galvano-cauterization. In nasal asthma, a more common condition than is generally suspected, it must prove a valuable acquisition. In cutting throughï adhesions between turbinated tissue and the septum, [in removing the angles of deflected septa, and in punching the same for correction of the deviation, it has already proved a signal help. In he vault it may be employed in the removal of adeno- mata or other growths, and in fact in any operative procedure in that region. In herpes occurring on the posterior surface of the velum,",
         "522 CANADA MtDICAL AND StiRGICAL JOURNAL. a most painful and obstinate complaint, it affords marked comfort and relief. In the pharynx and upper throat it will be found effectual in removing painful conditions-specially if accompanied by a hyperemic state in the various ulcerations of, the tonsil, pillars and parts surrounding, of such frequent occurrence in syphilis and occasionally seen in tuberculosis; in allaying the pain of cancerous disease and aiding the power to swallow. In rheumatic pharyngitis it lias afforded relief. As an application before operating in follicular disease of the pharynx, it acts with certainty in relieving pain. In uvulotomy and in extirpa- tion of the tonsils it has given fairly good results in my hands. In the larynx it may be used with benefit in tubercular disease, whether characterized by'ulceration.or simply by swell- ing. Its valuable astringent and sedative properties render it particularly advantageous in these cases. Its influence in the prevention of cough is, to say the least, remarkable. In ædema of the larynx I have seen it prove useful. In ulceration of the epiglottis, ary-epiglottic folds or post-laryngeal wall, rendering swallowing painful and difficult, it will allow of the taking of ample nourishment if applied ten or fifteen minutes before the meal. In the various forms of vocal defect, the result of improper tension or faulty approximation of the vocal bands, cocaïne, in the form of a spray or troche, will render the voice more clear and powerful and less likely to break down from fatigue. Trocheà have been prepared to my order by Messrs. Kenneth Camp- bell \u0026 Co., wholesale chemists, each of which contains two milligrammes of the alkaloid. They have been found of much service by singers, speakers and others suffering from painful or relaxed throat. In whooping-cough (though my experience has not been as great with the remedy as I should like, in order to speak authoritatively,) it lias, in the few instances in which I have used it, yielded happy results. The cough lias been completely checked for six or eight hours, and perceptibly mitigated for twenty or more. I believe it will score a great future success",
         "COCAINE IN NOSE AND THROAT DISEASES-DR. MAJOR. 523 in .this malady. In all the endo-laryngeal operations it so steadies the parts that the progress of manipulation can be easily followed in the field of the mirror. Papillomata and growths of whatever nature and however small may be removed with expedition and accuracy. by its aid. For laryngeal use the 4 per cent. solution is not suffBciently powerful-8 or 10 per cent. answers much better, and even a 20 per cent. will probably be required in some cases. In nervous subjects, when either post-rhinoscopic or laryn- goscopic examinations are difficult or even impossible, it will, if used as a spray, greatly facilitate and simplify the undertaking. We must not expect from cocaïne impossibilities; if it allays present pain, we must not regard it as a failure should after. pain ensue. In my opinion it modifies the painful character of wounds, reduces the amount of local irritation, and renders the nervous shock less. My experience of cocaïne hydrochlorate is based on the almost daily use of it for over. five months, and includes its action on upwards of a hundred and fifty individuals, represent- ing quite three hundred sittings. I regret that I have not kept a record of the results ob- tained under cocaïne in all the cases in which I have used it ; but at first I regarded it only from its sandpoint as a local anæsthetic, and so invariably acknowledged by my patients was its effect that I considered it superfluous and unnecessary. Hovever, for the purposes of this report, I have tabulated a number of cases occurring in an arbitrary space of time, and give them in the order of their coming. I wish here particu- larly to state that there has been no attempt at selection or suppression of cases. The list. includes all those in whom cocaïne hydrochlorate bas been used, for any purpose what- ever, from a certain date up to .the time of writing. The cases are given in the order in which they came under observation, many of them, however, were already under treatment, and in some of them cocaïne had previously been used. For the purpose of accuracy a daily register was kept, and from this the accompanying statement has been made out.",
         "524 CANADA MEDICAL AND SURGICAL JOURNAL. The table shows the number of the case, the number of sit- tings, the region in which and the disease for which interferencp became necessary, the strength of the cocaïne application, and the character of the surgical or other procedure. The accom- panying synopsis of the use of cocaïne is compiled exclusively from evidence afforded by private patients of the educated class, and may therefore be fairly accepted as an intelligent expression of the popular opinion of the remedy SI. Strength of Character of Surgical 21.- Region. Disease. oluon or other Procedure. of Cocaïne 1 5 Nose and Pharynx. Foilicular Pharyngitis and .ypertrophyof Turbin-: 4 per cent.. Galvanic Nautery and ated Tissue .......... nitri acid. 4 Nose.............. Meebranu Na8a11\u003c4 . Chromie acetic \u0026 nit. 2Nose................. dnd galv. caut. 4 2 Nose .............. 7 1 Nose............. 8 4 Nose............... 9 2 Nose .........d 4 18 3 Nose ........... . . 1 2 Nose ........... . 4 18 Nose ............... 4 15 Nose ............... 66 4 é .. 4*1 d 5l Pharynx \u0026l -Larynx lEversion of Laryngeal Ven- Atomized, and with tricles16, 43 6 \u0026 10 pNe brushes. 12 2 Nose...........ypertr. of urb. Tissue.' 4 per cent Nitrie acid. 18 1 Nose........... 14 2 Nose............... l 2 Noe.......... 4 16 3 Nose ............... 4 17 4 Nose ............... 4 18 1 Noe............... . 4 19 2 No e and Pharynx. Follicular Pharyngiti. . .Nitri acid and galv. VaricoeVess7sad fer- cautery. 2 2 Nose............trophy.... 20 2 Nosen.... ... Iyp. Middle Turb . .itric acid. 21 3 Pharynx ........ol]. Phar Galvanie cautery. 22 1 Palate ahd Pillars. Inflauied and painful state. 4 Asa spray. 25 4 Nose............urh. Hypertrophy ....... 4itrscacid. 24 4 Nose............... . 25 4 Pharynx........... Phar itis.........4 Galv. cautey. 26 1 Pharynx ...........4 27 3 Noe............Trb. lypertrophy Nitrie acid. 28 2tNose Tie ......... 4 29 1 Uvula .......... . .Relax'd Throat with swell'd and oedematous Uvula 4 Ablation. 30 2 Pharynx......... Foul. Pharyngitis.......... 4 dé... alv. cautery. 31 a Pharynx............ 32 3 Nose..yperroh oTurbinated Hypertrophy \u0026 aeutely deflected septum - 4 Nitrie acid and scalpel. 33 1 NoT ...............rbinated yprtrophy 4 Nitrie acid. 34 2 Pharynx ........ ol. Pharyngins.........4 \". alv. cautery. 35 1 Pharynx ....4 36 1 Nose ...........\"Myxmata ofbotb Nostrils 4 Cold wire .ar., for- teps anid glv. caut. 31 3 Noce.............ight Middle Turb. Iyp 4 \" N..t..gv 38 4 Pharynx and Nose. Foli.Pitr., Polypus ofLowy. Mid. Turb .............4 ...Galvanie cautery. 39 3 Pharynx. Fo\". Pharngitis......... 4 40 2 Pharynx 4 .. .......... 4 6 \u0026 p 41 2 NoeH.......... Middle Turb. Hypertrophy 4 pe cent.. 42 4T urb ........ 4 . .... _ I di",
         "COCAINE IN NOSE AND THROAT DISEASES-DR. MAJOR. 525 06 0 = - Strength of Charater of Surgiea1 S Region. Disease. Solution Crater oeSure. Z of Cocaïne. or otherProcedure. 43 1 Nose.............. Ant. Turb. Hydertrophy.. 4 .... itric acid. 44 4 se ............... 4 45 2 Pharynx........... Varicose Vessels of Pha- te rynx and Pillars......... 46 2 Pharynx........... Foil. Pharyngitis..........4 47 3 Larynx ........... Whooping Cough ......... and 2 p.c. As a spray. 48 1 Larynx ..... ..... Laryngeal Papillomata... 2 4\u0026 S p, 49 2 Nose............urb. Hypertrophy...... 4 pr cent. Nitie aid. 50 2 Pharynx...........Fol. Pharyngitis ..........4 Gais. eautery. 51 2 Nose...........Hyp. Turb.TissueanJ acute Gais. eautery. nitrie . deflection of Septum acidan sealpel. 52 3 Nose and Pharynx. Foil. Pharyngitis ......... 4 .... Ga. cat. and it. acid. 53 1 Larynx......... Tubercular Laryngitis and Aphonia ................. 4 Spray. 54 4 Pharynx anti Nose. Eoil. Pharyngitis and Uyp- 55 Larynx. ertrophied Turb. Tissue .4 Gai. catt. and nit. aeid. 5 1 Larynx ........... T.bercular Laryngitis with ieessant cough. .........4 As a spray. 56 1 Pharynx........... Foil. Pharyngiîtis ... ... Gai. cautery 57 3 Pharynx...... ... \" \" ....4..... 58 i Nose........... Turb. Hlypertrophy. . Nitrie aid. 59 2 Nose............... \" .......4 60 3 Nose and Pharynx. \" \" and Foll. Pihar 4 dé and gais. cautary. 61 2 Nose...........FibroidTum'rsotrightowuî- 4 Coid vira sare, and er Turb. and Ilftoana ga cat. to padiles 62 1 Pharynx........ Fol. Pharyngitis ..... 4... Gav. cautery. 63 3 Nose and Pharynx. Foil. Phar. and Turb. JJp 4 . 'nd uit. acid. 64 3 Nose........... Turb. ilypertrophy .......4 Nitri acid. 65 3 Nse 4 4 4 4 . 60g 3 o e . .. . .. ...... 66 3 Nose .............. \" ....... 4 67 1 Pharynx........... Hypertrophied Tonsils ....4 .... Guillotine. 68 2 Larynx ............ Rh'matie inli. ofArytenoids 2 Spray. 69 2 Nose........... Tuîrb. .Hypertrophy .......4 Gai. cautery. 70 1 Nose .........4 .... Nitrie aci. 71 3 Nose.............. Coryza and Rleadache front pressure .................4 Ga. cautery. 2 1 Nose.... Right 'Mid. Turb. Hyper.. 4 73 1 Nose.............. Turb. Hlypertrophy ........4 .... itri acid. 74 3 Larynx..... .....Papiloinata ........ an 4 p- Spray. 75 2 Larynx .........Neuralgia of» Larynx 2 per cet.. 76 2 Pharynx........... Foil. Pharyngitis and cica- triciai atihesions uof Nasai - tavities ..........4 ...Gais. catit. and scalpel.- 77 1 Noe ...........\" T 78 1 Noe. .............iyp phy 4 \" .... .itr4 i. 79 2 Noe.............Trb. ypertrpy and 4 ci en catricia ahesions....4 \" .... and scissors. 80 1 Noe .... . .. 4 ....Gal.catery. 81 1 Pharynx........Poi. Pharyngitis.........4 \" 82 1 Uvula...........Cronie relaxt' of Uvula 4 \" .... Ablation. 83 1 onsil... .Right Tonsil pcrtroph' 4, \" .... Guillotine. 84 2 Larynx........Woopig Cough.........2 \" . 85 2 Noe..............RightMiddle Turb. Ilyper 4 tri acid. 86 1i ese ............ Rt. Middle Turb. Ilypert. t Gais'. cauit. and nitrie andi Polypotid gro ah n . acid. 87 1 Nese............ Fusion oright midile Tur- biuated and Septum. G4 .... Scalpel an gav. caut . 88 1 Nase. ............ Left lower Turbiuated Eiy- 8 4 npertroph............4 .... Nitrie acid. 89 4Ilaynx\u0026Trachea. Irritable jerking cogh . 2 \".... Frequentiy as aispray. 90) 1 Nose ............ Laft loîar Turb. 11ypart. 4 .... Nitrie acid. 91 1 Noce........:...Itght miidie Turh Hyar r 4 .... Galvano-catery. 92 1 Nose......a.... Lect aower andit binateG cypertrophyt 4 mNitria acic. 93 1 Nase ............ Right lower Turb . Ilyper 4 I 94 1 Noe.............Ucaration ofartil. septu 4 Id .... 5 pcG. sol. chromaie acid 95 .... Larynx..........deNa oir right ary-epi- glottCe foold wir resre pressure of Thyroi\" Cys\"t. a Spray. 96 .... Larynx..........dema uoN Ventriaular bands iu Briht's disease 10imiligra i. .M _________________ Iaay, .... As aTroche. t'Spray.",
         "526 CANADA MEDICAL AND SURGICAL JOURNAL. Of the 96 cases reported, the sittings, 200 in all, were disposed as follows Painful operations on the nose, as the destruction of hypertrophied turbinated tissue by nieans of chemical agents or the galvanic cautery ................................... .............. .127 Painful operations on the pharynx, pillars or neighboring parts by galvanic cautery........................................... 42 Ablations of the uvula........ ................... ...........3 Tonsillotomies ... ......................................... 2 Removal with the scalpel of the acute angles of deviated septa obstructing a nasal passage............................. ... 2 Cutting through cicatricial adhesions or fusions of turbinated tissue and septum nasi .......................................... 2 Eradication of nyxomata or other nasal growths by means of bnares, forceps \u0026c., with subsequent galvano-cauterization of theit pedicles .............................................. 5 Application of 4% solution of cocaïne to inflamed and painful palate, pillars, \u0026c................................................. 1 Laryngeal sprays of from 1% to 10% for various purposes, as allaying cough ; as a local astringent, and as an anSsthetic in the removal of laryngeal growths, \u0026c ................................... 18 In the hypertrophic nasal cases, cocaïne was had recourse to purely as a means of allaying the suffering caused by painful procedures, and in this it succeeded admirably. Nitric, acetic and chromic acids, as well as the galvano-cautery, were employed without causing the slightest discomfort. In fact, more com- plaints were made by the patients when the cocaïne was in course of application than when the caustics themselves were in situ. Regard was, of course, had to the extent of surface operated upon on each occasion. The operations on the pharynx and neighborhood were prin- cipally for the destruction of enlarged follicles and varicose ves- sels. Cocaïne here answered the threefold purpose of lessening irritability, giving steadiness to the parts and rendering the application of the galvano-cautery electrode painless. It also reduced the calibre of vessels in a very remarkable manner. Three uvulotomies were performed in the usual fashion with traction forceps and scissors, after painting the surface with cocaïne. There was no pain during the operation, but the ordinary amount of suffering afterwards resulted.",
         "COCAINE IN NOSE AND THROAT I\u003eiSEASES-DR. MAJOR. 527 In the case of M. R. (No. 29 of the table), the uvula was swollen and oedematous to an enormous degree. - The applica- tion of the cocaïne facilitated the cutting materially by contract- ing and hardening the tissue. He was not conscious of any pain during the operation. In the interval of time covered by the table I employed cocaïne but twice in extirpation of the tonsils (Nos. 67 and 83), my pre- vious experience of it tending to the belief that the immunity from pain bestowed was largely of mental origin. Tonsillotomy is not a very painful operation unless adhesions to the pillars exist, and under the latter condition the use of cocaïne is very beneficial. M. S. (No. 67), a dispensing clerk, came with both tonsils very much enlarged. I painted the right gland and its envi- rons with cocaïne (4 per cent.), but to the left I made no cation; of this the patient was not aware. He characterized the pain as more acute on the left or unprotected side, but was sensible of the cutting of the right 'gland. Cocaïne, however, when applied to the wounded surfaces stopped the bleeding and relieved the pain very satisfactorily. Its næemostatic property is much superior to that of the Gallic and Tannic acid mixture of the Throat Hospital Formulary, and it is neither so disagree- able nor so likely to produce gagging as the latter. In the case of A. E. T., a chemist's apprentice (not recorded above), a very delicate lad, witb enormous tonsillar hypertro- phies, I removed the right gland. after applying cocaïne (he says) painlessly. Some days later I operated on the left side vithout cocaïne, and, if I may judge from appearances, his suffering was severe. It is but fair to state that on the second occasion the tonsil was in a state of acute inflammation. The cases (Nos. 32 and 51)-of anguiar lateral deviation of the septum reported are two in number. Both boys had under- gone treatment by galvano-cautery, etc., for destruction of hypertrophic soft tissues of the nasal passages impeding healthy respiration; one of these (No. 32) had both tonsils removed early in the course of treatment. The angle of cartilage and ,mucous membrane was removed to a sufficient depth to allow of",
         "CANADA MEDICAL AND SURGICAL JOURNAL. the free passage of air. In both instances no pain was suf- fered, and the bleeding was decidedly less than would have occurred under ordinary circumstances. In the cases (Nos. 76, 79 and 80) of cicatricial adhesion, though pain was felt when using the shears it was compara- tively trifling, and was more the result of the lateral pressure exerted by the blades on the septum and lower turbinated bones than from the wound itself. In eradicating myxomatous and other nasal tumours by what- soever means, cocaïne is of material assistance. Its power of contracting the soft tissues on their bones affords an enlarged field for vision and, at the same time, allows of the proper adjustment of the instrument selected. The painless nature of the proceeding also aids accurate manipulation and admits of the active cöoperation of the patient. The tendency to bleed is diminished, as is also the flow of nasal mucus. Sneezing is also well under control. Of the cases referred to; but one need be mentioned. W. C. (No. 36), past middle life, had suffered from bron- ebitis and nasal catarrh for 25 years. Anterior rhinoscopy developed the fact that both nostrils were blocked by myxo- mata. At the first sitting the cold wire snare engaged a large growth in the left nostril, and, despite the gentleman's strug- gles and protests, I suceeeded in removing the great bulk of the tumor.; the pedicle, however, remained, Two days later the patient returned, when I carefully applied cocaïne to the sur- rounding tissue of the left nostril and removed the pedicle-with the snare close to its attachment, which I then destroyed by the galvano-cautery. I then proceeded, under cocaïne, with snare and forceps to clear the right side, and succeeded in doing so. The patient, who was, at the. time of his visits to me, in very delicate and feeble health, assured me that the second sitting was quite free from pain. In the case (No. 22) of a prominent clergyman, who was suffering from an inflamed and painful throat', which rendered articulation difficult, a single application of a 4 per cent. solu- tion conferred such immunity from pain that on the same even-",
         "COCAINE IN NOSE AND THROAT DISEASES-DR. 3IAJoR. 529 ing he was enabled to keep an appointment to deliver a public lecture. He afterwards assured me that he was never in better voice, and spoke with ease. 0f the cases (Nos. 11, 47, 48, 53, 55, 68, 74, 75, 84 and 90) in which laryngeal sprays of cocaïne had been employed, I would like to say a few words relative to those of most impor- tance. N. W. (Case 11), a case of prolapse of the laryngeal ventri- cles, has been under my care for over a year. Under the local use of cocaïne great improvement followed. The ventricles con- tracted much more rapidly than they had done under any pre- vious application, though improvement all along had been evident. The left vocal cord was for the first time visible under the use of cocaïne, and the voice was better maintained and clearer. All these good effects I attribute to the astringent and sedative action of the alkaloid. In this case a 4 per cent. aolution was not strong enough to produce anSsthesia and tolerance, and I required to use a 10 per cent. to have any satisfactory result. I found in this case that the brush would produce violent glottic spasm, and substi- tuted therefor the use of a weak spray, after which the brush, with a strong solution, was tolerated very nicely. -A probe now could be borne in the larynx for several seconds. without distress. In whooping-cough the results of sprays of cocaïne are given in two cases only. In the cases of Mrs. C. (No. 47) and A. C. (No. 84), 2 per cent. sprays afforded great relief. I do not hesitate to say that the cocaïne solution, if properly applied under high pressures to the larynx and trachea, would soorn overcome many of the difficulties presented by this disease. Case No. 89, a lady far advanced in pregnancy, suffering from a short, jerking cough, threatening, from its violent and incessant nature, to induce a premature delivery, was instantly relieved by 2 per cent. sprays of cocaïne. About 20 or 30 minims were directed to be emnployed as a spray every four hours. In this case morphia, counter-irritation and many 34",
         "3u CANADA MEDICAL AND SURWICAL JOURNAL. well-known and generally reliable remedies had failed to afford any relief. In laryngeal tuberculosis, with incessant cough and difficult deglutition it is of great service (Cases 53 and 55). It checks the cough, facilitates expectoration, allays the tick- ling feeling so often complained of, and by lowering sensibility makes the swallowing of nourishment, which before has been difficult or even impossible, easy of accomplishment. In endo-laryngeal operations for the extirpation of growths, I, have but three cases to offer, only two of which have been tabulated. Laryngeal Papillomata.-M. McB. (No. 48) presented her- self with papillomatous growths of the larynx. A spray of cocaïne of gradually increasing strength was used until 8 per cent. had been reached, when the larynx became quite tolerant of handling. At the request of the patient, no attempt was made at removing the growths. Five years ago I operated on this patient for removal of growths below the cords, by open- ing the larynx through the crico-thyroid membrane and cricoid cartilage. They have this time, however, returned above the cords. E. M. (No. 74), aged 7.-Four years ago I did a tracheotomy on this child for extensive laryngeal papillomata, endangering life. The size of the child's larynx did not fairly admit of any attempt at removal by the natural passages. She bas worn a tube constantly since, and with the assistance of sprays of abso. lute alcohol, has succeeded in keeping the growths well under control. I have at three sittings used cocaïne by spray and brush, and have succeeded in removing, by èvulsion, all trace of growths. No pain was complained of during these operations, and the larynx (an abnormally small one by the way) tolerated handling fairly. Fibro-Uellular Cyst of Left Vocal Band.-(Not recorded on table.)-C. C., civil engineer consulted me Dec. 10, '84, for a modified aphonia, or, more correctly, dysphonia. On laryn- goscopic examination, a small bi-lobular tumor was observed springing from the border and under surface of the left vocal",
         "COCAINE IN NOSE AND THROAT DISEASES-DR. MAJoR. 531 band at its middle. The introduction of forceps produced an alarming spasm of the glottis. After applying a solution of cocaïne (10 per cent.), the larynx became tolerant of interfer- ference, and locating the growth by the aid of the mirror, I re- moved it with antero-postelior cutting forceps at the first passage of the instrument. Some pain was complained of at a point below the glottis inaccessible to the application, which was made with a laryngeal brush. The tumor was of the size of a very small field pea, consisted of two lobes, and was attached to the edge and under surface of the left vocal band. Dr. Wyatt Johnston, resident physician of the Montreal General Hospital, to whom it was submitted for microscopical examination (and to whom I am indebted for a report of its character), declared it to be a \" Fibro-cellular cyst undergoing mucoid degeneration.\" This form of growth is, I believe, of rare occurrence in the larynx. In conclusion, I desire to express my confidence in the value of cocaïne hydrochlorate when used as a local anesthetic in thé air passages. In every case in which I have used it to allay the pain attending surgical measures in these regions, it has accomplished its purpose. In order to attain success, let me repeat that not only must the region to be operated upon be pro- tected, but also the surfaces immediately adjoining ; that the application must be made in a thorough manner, and that it must be of sufficient strength and used freely. Many of the reported cases of partial failure with cocaïne in the larynx are directly the result of leaving areas unprotected. The substitu- tion of proper atomization for the method of application by the brush would, I am sure, render success - more certain. I feel that it is unnecessary to refer to the many advantages the use of cocaïne possesses over chloroform, ether, and other anSs- thetics in the minor surgery of the nose and throat. Nor need the cost of applying it be as great, as the market value of the drug would at first suggest, if the few directions I have briefly laid down be carefully followed.",
         "-ANADA MEDIcAL AND SURGICAL JOURNAL. . Srrespondenie. BERLIN, March 18, 1885. To the Editor of the CANADA MEDICAL \u0026 SURGICAL JOURNAL. Berlin, from a medical standpoint, has recently been so ably described in the pages of your JOURNAL that it is with no small degree of diffidence that I venture, upon sending\"you a commu- nication from here. I derive, however, some encouragement from the feature of forgetfulness so common to mankind, and which I hope will prevent a too close comparison between the letters in your journal from BerEn this year and those of last year. You probably will have heard, before this reaches you, of the death of the renowned Prof. Frerichs. He breathed his last on the 14th inst. The funeral was largely attended, and all classes from royalty downwards were well represented. The Crown Prince sent flowers, and the Emperor manifested bis respect for the departed man of science by sending his state carriage--the next greatest honor to bis being present in per- son. With our democratic tendencies, we cannot fully under- stand the significance of such a mark of honor. It is an open secret that Prof. Leyden will succeed to the chair made vacant by this recent death. But the successor to Prof. Leyden is not yet known. It is thought there will be considerable difficulty in making the' appointment. Last week I attanded a meeting of the Berlin Medical Society. The chair was taken a few minutes after the appointed hour (7.30 p.m.) by the President, Prof. Virchow. The large hall was well filled, and the number of gray heads contrasted very markedly with that of similar gatherings on the other side of the ocean. The Virchow of Berlin, like bis representative in Montreal (until lately), set the ball rolling by exhibiting a number of very interesting pathological specimens, among' which was an enormous spleen, weighing over seven pounds, from a case of leukæmia. The specimen was sent from one of the provinces, and Prof. Virchow was unable to say whether the leukæmia",
         "was of a malarial origin. Prof. Kiicher showed two breasts affected by that rare affection, carcinomatous mastitis, that he removed from a woman a few days before. The disease had set in a few weeks before, and made very rapid strides. As there was evidence that the left pleura and lung were involved, he did not expect his patient to live more than a few days. Then came-an exceedingly interesting discussion by Prof. Wal- deyer on the development of connective tissue. He spoke for fully an hour without a note of any kind, keeping the large audience spellbound. Anyone that has attended a meeting of German physicians will know what a diffBcult task that is on most occasions. The arbitrariness of Bismarck has lately made itself felt in a quarter most vulnerable to the pride of Germans. The honor of thcir famous university has been touched. It would seem the man of \" blcod and iron \" began to accumulate within his tissues a less varlike material-adipose tissue. To reduce this accumulation he had tried several means and sought the advice of several physicians, but all in vain until he came across Dr. Schweininger. who succeeded in reducing the corpulent body by several pounds and in maintaining it in that condition. For this, Prince Bismarck awarded him the chair of Dermatology in his University. This Dr. Schweininger has no claims for such a position on scientific grounds, and is decidedly objec- tionable on moral ones. While practising in Munich he com- mitted a grave offence against public decency, for which he was sentenced to a considerable term in imprisonment. None of the physicians here of anystanding will recognise him, and they all keenly feel the disgrace of the appointment. A few days ago Prof. Virchow, in his place in the House of Parliament, drew attention to the appointment in most scathing terms, denouncing it as an arbitrary act, degrading the Uiii- versity and corrupting public conscience. The regular lectures ceased on the lst of March, and will not begin again until the end of April. On the 16th of this month began what is known as the \" Frener Courses \" for prac- tising physicians. These continue for about six weeks, and 533 coR1REsPoNDENoE.",
         "534 CANADA MEDICAL AND sttRGtCAL JoUlMAL. comprise several courses in almost every branch of medicine. A stranger on coming here experiences \" embarras de richesses,\" and does not know which to select. Though they are all given by able and zealous men, they are not all of equal merit. In gynæcology, of course, Prof. August Martin stands at the head of the list. His private hospital provides him with abundance of interesting material, and he performs from one 1\u003e two operations daily. From 11 to 12 he operates;, then he lec- tures on general gynoecology for another hour, and from 1 to 3 is taken up with examinations of patients. The class for the latter purpose is divided up into sections of eight; there are three sections, and each section has two days weekly. Dr. Guttman's course on internal medicine and physical diagnosis, at the Moabist Hospital, is excellent. This hospital is built on the pavilion plan, comprising twenty-four isolated buildings, each of which has from twenty-four to twenty-eight beds. The more. severe and interesting cases are sent to it from all parts of the city. Dr. Guttmann gives an hour-and-a- half four times a week. During the first half hour each mem- ber of the class is assigned a patient, which he is to examine and make a diagnosis. Then during the remaining hour the class is taken round the wards, where Dr. Guttmann makes clinical remarks. Where there is so much material to select from, the same disease can be exhibited in different stages and of different types in different patients. For example, to-day we were shown two cases of hæmoptysis-one at the outset of phthisis, the other in advanced phthisis-and another case of slight hoemoptysis in an acute case of pneumonia. In a future letter I may say something more about the practical courses. The approaching meeting of the German Medical Association on the 8th of April is looked forward to with great interest.. That vexed but interesting subject, \" Tuberculosis,\" is to be discussed, and several papers of importance are on the lists. H. N. V.",
         "REVIEWS AND NOTICES OP BoOKS. *3 Rouicn;s and Boticcs of Boohs. The International Encyclopædia of Surgery: A Sys- tematic Treatise on the Theory and Practice of Surgery.-By authors of various nations. Edited by JOJiN ASHURST, Jr., M.D., Professor of Clinical Surgery in the-University of Pennsylvania. Illustrated with chromo- lithographs and woodcuts. In six volumes. Vol. . New York: Wm. Wood \u0026 Co. The fifth volume now issued leads on towards the completion of this monument of American enterprise. The authors have been selected with great judgment, and the various articles (of which we append below a list) contain each a complete exposition of the subject from the pen of one who is recognized as specially competent to deal with it. It is only therefore necessary for us to repeat the favorable criticism which we have made upon the preceding volumes of the series. When complete, the Encyclo- poedia will present a thorough and exhaustive resumé of all the modern teachings of surgery and the most approved plans for carrying these into effect. The following is a list of the articles in the present volume : Injuries of the Head, by Charles B. Nancrede, M.D. ; Malformations and Diseases of the Head, by Frederick Treves, F.R.C.S. ; Injuries and Diseases of the Eyes and their Appendages, by E. Williams, M.D.; Injuries and Diseases of the Ear, by Albert H. Buck, M.D. ; Injuries and Diseases of the Nose and its accessory sinuses, by George M. Lefferts, A.M., M.D,; Injuries and Diseases of the Face, Cheeks and Lips, by Alfred C. Post, M.D., LL.D.; Injuries and Diseases of the Mouth, Fauces, Tongue, Palate and Jaws, by Christopher Heath, F.R.C.S. ; Surgery of the Teeth and adjacent parts,by Norman W. Kingsley, D.D.S. ; Injuries and Diseases of the Neck, by Geo. H. B. McLeod, M.D.; Injuries and Diseases of the Air Passages, by Solis-Cohen, M.D.; Injuries of the Chest, by Edward H. Bennett, M.D., F.R.C.S.I.; Diseases of the Breast, by Thomas Annandale, F.R.C.S.E.; Injuries and Dis- eases of the Abdomen, by Henry Morris, M.A., M.B., Lond.; Hernia, by John Wood, F-R.S., F.R.C.S. 535",
         "536 CANADA MEDICAL AND SURGICAL JOURNAL. Intestinal Obstruction; its Varieties, with their Pathology, Diagnosis and Treatment.-By FR ED. TREVEs, F.R.C.S.. Surgeon to and Lecturer on Anatomy at the London Hospital, Ilunterian Professor of Anatomy at the Royal College of Surgeons of England. With 60 illustrations. Philadelphia: Henry C. Lea's Son \u0026 Co. This book lias been issued as one of the se-ries of clinical manuals. It is the Jacksonian Prize Essay of the Royal Col- lege of Surgeons of England for 1883. The various forms of ileus, both acute and chronie, are here classified and described with the greatest care and minuteness, ail the principal varie- ties being illustrated by cases and by excellent woodcuts. The various questions of diagnosis are elaborated and studied with care and judgment. The chapters upon treatment are con- ceived in a proper scientific spirit, the modern surgical methods receiving all due consideration, but proper caution and reserve being enjoined before resorting to the somewhat serious proce- dure of laparotomy or resection of an intestine. There are no cases more calculated to call forth one's skill in diagnosis and energy in treatment than those of obstructions in the bowels. The knowledge that these disorders nearly always involve more or less danger to life, and that, as they are better understood, so more and more success is being met with in their management, should lead every one to study the subject anew in the light of modern scientific knowledge. To assist him in this undertaking we know of no book so well adapted as that recently presented to us by Mr. Treves. The illustrations are numerous, nearly aIl from original cases, and of much value. The Ear; its Anatomy, Physiology, and Diseases- a Practical Treatise for the Use of Medical Stu- dents and Practitioners.-By CHARLES H. BURNETT, A.M., M.D.. Professor of Otology in the Philadelphia Polyclinic and College for Graduates in Medicine, etc., etc. With 107 illustrations. Second edition. Revised and rewritten. Philadelphia: Henry C. Lea's Son \u0026 Co. This manual of otology is large enough to contain all the",
         "REVIEWS AND NOTIcES OF BOOKs. essentils concerning the normal ear and the ear diseased, and still not so diffuse that it is beyond the scope of the practitioner who would be well-informed or the student who desires a fair knowledge of this important subject. A great many general practitioners hardly realize how frequently disorders of the hearing apparatus give rise to cerebral and other symptoms of varions origin, which they have failed to account for. Nor do they appreciate clearly the truly grave importance of paying careful attention to acute inflammatory affections and chronie purulent diseases of the outer parts of the ear. As regards the latter., most hospital physicians and those of considerable experience have met with cases where meningeal inflammations have been set up from these causes ; and in some of these instances which have proved fatal there can be little doubt that active, early treatment or surgical interference might have saved life. These ear diseases are certainly even at this day too much neglected, and no doubt any specialist in this depart- ment must meet with many cases of hearing impaired or lost through delay in seeking suitable advice. General practition- ers cannot be expert aurists, but they can, and should, know enough about these cases to treat the simple ones with judg- ment and to refer more difficult ones to higher skill whilst good may yet be done. We have pleasure in recommending Dr. Burnett's work as a thorough and careful exposition of our present knowledge on the subject. Pyuria; or Pus in the Urine, and its Treatment.- By D. ROBERT ULTZMANN, Professor of Genito-Urinary Diseases in the Vienna Polyclinie. Translated (by per- mission) by Dr. Walter B. Platt, F.R.C.S. (Eng.), Demonstrator of Surgery in the University of Maryland, \u0026c. New York; D. Appleton \u0026 Co. The substance of this little book consists of clinical lectures given by Prof. Ultzmann in the Vienna Allgem. Policlinic, Winter Semester 1882-83. They comprise the diagnosis and treatment of acute and chronic urethritis, prostatitis, cystitis and pyelitis, with especial reference to their local treatment. 537",
         "538 CANADA MÉDICAL AND SUOICAL JOURNAL. The sections upon diagnosis are most interesting in connection with pyelitis or pyelo-nephritis, the treatment, however, of the latter being viewed solely from a medical point of view, for the questions of the modern surgical operations for the advanced conditions of this kind are not discussed. The lectures can be read with much profit by every one interested in attaining proficiency in the management of these common and painful disorders. Human Osteology.-ByLUTERHOLDEN F.R.C.S., assisted by JAMES SHUTER, F.R.C.S., M.A., M.B., Cantab. With numerous illustrations. Sixth edition. New York: Wm. Wood \u0026 Co. This is the January (1885) volume of Wood's Library, and is a reprint of the English edition with electrotype copies of the original illustrations much reduced in size. Of course it can bear no comparison with the original English edition as to type or illustrations, but, considering the price (about $1.50), it is a remarkably cheap book. It is useless to say anything in praise of this work, as its excellence has been established and acknow- ledged for many years. It is the best book on osteology which has been issued up to the present time, and Holden's Osteology is familiar to every student of anatomy. The value of this edition is much increased by the valuable notes on comparative osteology which follow the description of each bone. We can heartily recommend this volume of Wood's Library to all those who do not wish to incur the expense of the larger English edition. A Handbook of Diseases of the Eye and their Treatment.-By H. R. SWANZY, A.M., M.D., F.R.C.S.I., Surgeon to the National Eye and Ear Infirmary, Ophthal- mic Surgeon to the Adelaide Hospital, Dublin, \u0026c. With illustrations. New York: D. Appleton \u0026 iÇo. The above is a handy manual, intended specially for students about to undertake the study of the eye, and it has been arranged specially with the view of being useful to them in carrying out",
         "BOOXS ANI) PAMPHLETS RECEIVED. - 3 such studies systematically. Subjects which to beginners are found particularly embarrassing or difficult are thus given promi- nence, and receive careful attention. It contains the essentials without redundant natter, and seems admirably suited to the end in view. A Manual of Organic Materia Medica.-By JoHN M. MAISCH, Ph.D. Philadelphia: Lea Brothers \u0026 Co. This work, which has now reached a second edition, is taken up with a description of the physical properties and chemical constituen.ts of the crude preparations of the organic materia medica. Why it should be recommended to medical students and physicians as a work they should study we are at a loss to see. Surely the day is past for burdening the student's memory with the dry, uninteresting, and, for the most part, useless de- tails of the materia medica. As a work, however, for druggists, we should judge it to be very useful. ncls and ~mh~s 'eud THE INHALATIoN TREATMENT oF DISEASES OF THE ORGANS OF RESPIRATION, INCLUDING CONSUMPTION. By Arthur Hill Hassall, M.D., Lond. With numerous illustrations. London: Longmans, Green \u0026 Co. TRANSACTIONS OF THE AMERICAN SURGICAL ASSOCIATION. Vol. II. Edited by J. Ewing Mears, M.D. Philadelphia: P. Blakiston, Son \u0026 Co. THE PHYSICIAN HIMSELF AND WHAT 1E SHOULD ADD TO HIS SCIENTIFIC RE- QUIfiEMENTS IN ORDER TO SECURE SUCCESS. By D. W. Cathell, M.D. Fourth edition. Baltimore: Cushings \u0026 Bailey. LECTURES ON DISEASES OF THE NERVOUS SYSTEM, ESPECIALLY IN WOMEN. By S. Weir Mitchell, M.D. Second edition, revised and enlarged. With five plates. Philadelphia: Lea Brothers \u0026 Co. 539",
         "CANADA MtDICAL AND SURGICAL JOURNAL. Society Ifrceedings. MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. Stated Meeting, Feb. 6th, 1885. T. G. RoDDIÇK, M.D., PRESIDENT, IN THE CHAIR. Sarcomatous Disease of the Femur and Acetabulum.-DR. RODDICK exhibited the specimen and related the case. The patient, a young man, sprained his hip five years ago by falling through a trap in a hayloft. He appeared to recover completely, but in a few months became lame, and had pain, at times getting better. A year ago he had to take to crutches. Last June Dr. R. found roughness of the bones of the joint, and indistinct fluc- tuation in Scarpa's space. Nothing was done at t'hat time. Hle was sent to the country, where he remained for two months, re- turning to hospital last October. The abscess was now opened. He had hectic fever and lost flesh. He went away, but returned again in January, with suppuration about the joint. Becoming worse, it was decided to amputate at the hip-joint, which was done. There was no hemorrhage of any consequence, but the patient never rallied, and died twelve hours later. DR. SUTHERLAND exhibited the following specimens:- 1. A Gall-bladder containing thirty-two stones. This was removed from a subject (female) in the dissecting-room of McGill College. Three or four of the stones were very large, measuring an inch square. 2. Bladder and Kidneys of a man, from whom two months previous to death Dr. Roddick had removed a vesical polypus by median cystotomy. The bladder was much dilated and exten- sively hypertrophied. The ureters also were seen to be dilated. The kidneys were in a state of suppurative interstitial nephritis, or typical surgical kidneys. 3. Malignant Disease of the Stomach, showing obstruction at the pylorie o2ifice. A portion of the liver, the gall-bladder, ducts, duodenum and pancreas were also shown. Secondary deposits were seen in the latter and in the glands. The bile ducts were pervious. At the autopsy the following was noted ;",
         "MEDICO-CHIRURGICAL SOCIETY. Emaciation and jaundice ; 160 ounces of bile-stained fluid was removed. The liver appeared small and the stomach very large, extending seven inches below the ensiform cartilage. On raising the left lobe of the liver, a large hard mass was felt, which in- volved the pylorus and apparently part of the duodenum. On slitting up the stomach after its removal, the mucous membrane was seen to be pale and anæmic. At the pylorus was a thick ulcerated ring, studded with little red granular ulcerations, and occluding the entrance into the duodenum, preventing the pass- age of the little finger. A mass about the size of an egg was situated in -the pancreas, near its head-probably a secondary deposit, as it was not actually ulcerating. Jaundice was pro- duced by small masses in the gastro-hepatic omentum pressing on the hepatic duct. DR. GEo. Ross said there were several points of interest in the clinical bistory of this case. The gentleman came to him a year ago comiplaining of dyspep~sia ; his general health was not good ; he said hé had been failing. Improvement followed upon treatment. He saw him again in the spring, when he complained of vomiting at intervals of some length. There was no pain after meals, or ever. At intervals of one, two or three days he would have heartburn and an uneasy feeling; he then would get over a basin and empty his stomach. He -would have no nausea, or pain, or retching. On examination, the stomach was found dilated, extending below the umbilicus. Its movements were plainly visible, and splashings could be heard. The patient was anemic, and becoming thinner. Malignant disease of the pylorus, with dilated stomach, was diagnosed. No tumor could be felt. He was advised to enter hospital in order to have the stomach regularly washed out. Coming to hospital some weeks later, no dilatation of the stomach could be made out; it was not subse- quently present. lHe had occasional vomiting of frothy material containing sarcine ventriculi. lHe became more comfortable under treatment, though he lost flesh. There was never any pain. He remaiued in hospital about a month. After this he gradually became jaundiced, and continued to lose weight. At no time were there symptoms of gastric trouble, except the 541",
         "542 CANADA MEDICAL AND SURGICAL JOURNAL. occasional vomiting. There never had been any hemorrhage. A short time before death, an indistinct fulness could be made out at the pylorie end of the stomach. It proved to be scirrhus, as was shown by slides exhibited under the microscope by Dr. Johnston. Dr. Ross said the pylorus would not admit the little finger, and why there was a dilated stomach at first, and not later, was not easy to explain. DR. KENNEDY said that perhaps the circular muscles at the pylorus, from irritation, were spasmodically contracted, but wShen the disease advanced they might have been destroyed, and so relieved the spasmodic closure of the orifice. DR. ROBT. BELL (Ottawa) then read a paper by Dr. Percy W. Mathews, on IlNotes on the Diseases among the Indians of York Factory, Hudson's Bay.\" (See March No., page 449.) DR. O. C. EDWARDS, late secretary of this Society, and now in medical charge of Treaty No. 4 Indians, Indian Head, North-West Territory, being present, made a few remarks on some of the diseases among the five thousand Indians on bis reserve. Syphilis was very prevalent, and one of the most powerful agents in weakening the Indians. Years ago theyled a wandering life, had plenty of food, and were well housed in huts made of buffalo hide. Now, having entered into treaty, they are placed on reserves, making themselves practically prisoners of war. Coming in contact with the whites, they have become infected with syphilis, and as they very seldom apply for treatment, it bas spread. The Indians attribute their present condition to the extermination of the buffalo. The Government has tried to make them agriculturists, with but very little success. Phthisis is a most fatal disease, and is usually accompanied with hemorrhages. They apply for assistance, but it is almost impossible to help them, owing to their being badly housed, and they will mix what one gives with their own medi- cines. Along with this is the noisy \" tom-tom\" constantly.going on outside of any sick man's bouse or tent. Prolongèd lactation is common. A squaw often nurses ber child till it is three or four years old. An Indian bas as many wives as he can keop, often five or six. They appear to be exempt from toothache,",
         "MEDICO-CHIRURGICAL SOCIETY. They are great tea drinkers, and often mix tobacco with the tea. They smoke a great part of their time, swallowing the smoke, which they let out again by the nostrils. They never have inflammatory rheumatism. He has -only seen one case of epilepsy, and that was in -a half-breed. Measles comes as an epidemic, and is almost as bad as smallpox. For snow-blindness, they apply~tea leaves. In the month of March, one must pro- tect their eyes against this. Dr. Edwards said that prior to meeting with the whites, they were very moral and honest ; now they don't know what these virtues are. He has visited Indians who still live by hunting, and far away, whom he found honest and moral. DR. Hy. HOWARD remarked that Butler, in his\" Great Lone Land,\" said there was no sach thing as impurity or dishonesty when he travelled among them. DR. ROBT. BELL'S experience was that the civilized are im- moral. Squaws think they are benefiting their race by having a child to a white man. Labor is effected while on the knees, and is of short duration. Hle knew of one squaw who was draw- ing a load of wood, and who, after a halt of half-an-hour to have her baby, proceeded on with her load. Menstruation comes on when about 12 or 13 years old. They are not very regular, often skipping three or four months, caused by hardships and bad food. As a rule, they lose very little. DR. PROUDFOOT said he had been a good deal among the Indians up by Lake Huron, and found phthisis to be very fatal with them. DR. F. W. CAMPBELL hlad noticed that phthisis had killed a good many of the Micmac Indians of the .Bay of Chaleurs. DR. TRENHOLME said lie knew of a French-Canadian woman in Montreal who was a grandmother at 25 years of age. Stated Meeting, Feb. 20th, 1885. T. G. RoDDIcK, M.D., PRESIDENT, IN THE CHAIR. Abnormal Muscular Blip.-DR. TRENHOLME exhibited a man, aged 45, having an elevated congested-looking mark about 15 inches long, running obliquely, from under the clavicle to the ensiform cartilage. 543",
         "CANADA MEDICAL AND SURGICAL JOURNAL. DR. SHEPHERD believed it to be an abnormal muscular slip from the external oblique muscle to the pectoral. Ulcer of the Stomach ; adhesion to the liver ; abscess between. -DR. BELL exhibited the specimen and DR. RoDDicK related the following history of the case : Mrs. J. ,sent for him three years ago for a profuse hemorrhage from the stomach. Ulcor was then diagnosed. One year later shoŽ had a second bad hemorrhage. A few months after recovery from this last attack she broke her radius, which united well. After a time she failed in health, became blanched, and felt as if she lost blood, though no more ever came by the mouth. On being sent for again, Dr. R. P. Howard was asked to see her in consultation. At this examination, they found the stomach dilated. Dr. Howard concurred in the diagnosis of ulcer of the stomach. The patient would eat, and, after a day or two, -would vomit apparently all the food taken the couple of days previous. Washing out the stomach was suggested, and the case was handed over to Dr. Bell to carry this treatment out. Dr. Bell said that for a time his patient stood the treatment, but afterward she declined to have anything further done. She only lived six weeks longer. He got permission from her friends to allow him him to go to the vault and open her to examine the stomach. On the posterior wall of the stomach, midway between the osophageal and pyloric openings, is an old ulcer-; at this point the stomach is also ad- herent to the liver, and between the two is a sac containing pus, with an opening into the stomach. In answer to questions, DR. RODDICK said the stools never showed signs of blood. He fed her at one time for a month per rectum on peptonized foods. Tie Single Suture.-DR. ALLOWAY gave the following par- ticulars ;-Of the last thirty cases of parturition I have attended in primipar, eight have suffered from laceration of the perineal body sufficiently extensive to warrant the application-of the single suture. In one of these cases, the suture was not applied antil six hours had elapsed since the delivery. Union in all of these cases has been complete and permanent. In all of them I have employed the most perfect antiseptic course of post-partum treat-",
         "MEDICO-CHIRURGICAL SOCIETY. ment, to which I attribnte a large share of the success in obtain- ing primary union. The application of the single suture was suggested and practised by me two years ago for the first time. In the American Obstetrical Journal of. February, 1884, I have given a detailed description of the operation, a short epitomé of which is all that is necessary here. A straight perineal needle three inches long should be used. I have had these needles for this operation made by Messrs. Codman \u0026 Shurtliff of Boston, and they can be obtained at Messrs. Lyman \u0026 Sons, Montreal. No other needle can be used With the same satisfac- tion. I use, absolutely, Snowdori's iron-dyed silk, No. 13. A strong needle holder completes the outfit necessary. During the examination of the wound, sponge it well of all blood-clots with a solution of bichloride. Then pass the needle through the skin about half an inch from the edge, and at a level with the very beginning of the tear. With two fingers of left hand in the rectum, force up the recto-vaginal cellular tissue and make the needle glide rapidly, though steadily, beneath this cellular tissue, as close to the wall of the rectum as possible to make its exit at a corresponding point on the opposite side of the tear. Now sponge the wound carefully again, and bring the edges of the wound together by tying the suture fairly tight. It will be noticed now that there will be some bulging or gaping of the part of the wound between the suture and sphincter ani, and will be very tempting to apply another superficial suture ; but my advice is-don't. it will be frustrating the very object of the operation,-avoid all unnecessary sutures as you would other foreign bodies between the edges of the affixed surfaces. This gaping fissure will shrink away by the third day, and the two edges will comle together in close union. I will now speak of one or two cardinal points which are absolutely necessary in doing this operation. First, Be sure that the needle, in no part of its course, appears in the vaginal wound. The corners of the laceration at the entrance and exit of the needle, where the wound is sometimes deepiy fissured and jagged, require especial care on this point. To guard against this, the thumb of the left hand should be kept always in the wound over the course of 35 545",
         "546 CANADA MEDICAL AND SURGICAL JOURNAL. the needle, constantly feeling for it ; and should you detect the needle in the surface of the wound in ever so small a part of its course, it shon!d be withdrawn and deeper tissue taken up. After the needle has made its exit on the right side, it should not be completely drawn through until the operator has again examined its track and become satisfied that the suture will be completely buried in all its course. If this care is not specially taken, and a part of the suture should gain entrance to the wound, a pus pocket will be very likely to form, and the opera- tion will fail. A suture passing through the cavity of a wouid is a foreign body, but passing around outside of the wound, it cannot interfere with union. The certainty of success of this operation hinges largely on this simple fact, and it should be weil.borne in mind. The suture is removed on the eighth day by dividing it with a scissors, and it will be found to give a loop of about three-quarters to one inch in length if the divided ends are reunited. The second point of importance lies in the after antiseptic treatment ; and I will certainly not hold the principle of the operation responsible for failure unless this point is carried out as advised. I hold this position on the same grounds as a surgeon of the present day vho would not feel inclined to hold himself responsible for the successful issue of an amputa- tion or severe lacerated wound, the after-treatment of which had been taken out of his hands and handed over to the tender mer- cies of an ignorant nurse and a few well economized soiled rags. I cannot conceive why there is so much opposition to the dress- ing of puerperal wounds. The main part of the post-partum antiseptic treatment consists in irrigating the wounded passage with a da mercuric solution once daily. The first irrigation is performed the day following the delivery, and again at each morning visit until the eighth day, when the suture is removed and union found complete. In carrying out this procedure, the patient is gently, lifted, while lying on her left side, to the edge of the bed, the nates hanging just over the bedboard. A small rubber apron (a quarter of a yard square) is slipped under the hips and tied over the crest of the ilium. In this way a gutter is formed which carries the",
         "MEDIcO-CHIRURGIcAL SOCIETY. fluid as it runs from the vaginal passage into a receiving basin on the floor. The reservoir, of the irrigator is then filled with the mercuric solution previously prepared. The nurse holds the reservoir in her hand at theé proper level, and the physician introduces the glass tube into the vagina after he has first allowed some fluid to run into the basin to drive out the air. As soon as the nurse notices that the fluid has become exhausted to about an inch from the bottom, of the, reservoir, she informs the phy- sician, and he withdraws the glass tube from the vagina and allows the remaining fluid to run on and cleanse the external parts. A napkin is then applied, and the patient gently lifted back in the bed and allowed to remain on her back for a short time. I never allow the nurse to touch the parts under any pre- tence whatever. Her duty consists in giving the patient lier prescribed diet and attending to the infant. A saline is admin- istered every morning, and the bowels gently moved over a bed- pan adjusted by the patient herself. I will now illustrate by these diagrams on the board that directly aftcr a bad laceration takes place, and before the suture is passed, the vaginal passage is much elongated and the uterus slightly anteflexed. The uterus cari now hardly be reached by the fingers without introducing the wliole hand. Ve will now pass the sutures and draw somewhat upon the posterior.wall, through which it passes, and you -will find that the vagina shortens, the uterus comes nearer to thé introitus, and as the cervix is drawn slightly forward, the fundus leans back- wards. Draw the suture still more and fix ,it with a firm knot, and on now passing your index finger you will· easily meet the cervix at its tip, and the fundus will have been thrown still a little further backward into what we would call a normal position. This series of facts I have demonstrated to myself on the living subject, and it serves to establish the case with which a uterus may become prolapsed and afterwards retroverted, as it sinks in the pelvis where the perineum and vaginal wall have not been repaired, and -the patient soon assumes the erect posture. I will now, by this wooden model, show how the suture is passed, and illustrate that it thoroughly controls the muscles in the",
         "CANADA MEDICAL AND SUROICAL JOURNAL. perineum (the transversus perinei, bulbo-cavernosus, \u0026c.) which exert any traction power on the laceration. This is independent altogether of the fact. that as the child becomes evolved, dilata- tion is so extreme that there is such calibre tu spare between this extreme dilatation and complete involution, that there can be practically. no side traction upon the wound till the eighth or tenth day, when union will have become fairly strong. So that really all we want are two fixed points-one at each extremity of the wound-and that the cavity of the vound be cut com- pletely off from the vagina (the drain-pipe to the uterus). Draw the suture tight and tie the vent, pass your forefinger down along the posterior wall of the vagina, and you will find no wound, not even a fissure. The vhole laceration is compressed like the mouth of a bag by a running string. The wound below is a cul-de-sac. The sides are in perfect contact, and as no dis- charges from the vagina can possibly enter it, primary union must ensue. DR. KENNEDY said slight tears were very common, and sel- dom could be avoided. These tears appear more at the 'time, and almost always do well without interference. In an instru- mental case, there is much less danger of a bad tear if the forceps be removed when the head is well down against the perineum, allowing the natural efforts to complete delivery. le advocated stitching if there be much of a tear. Unless there were special danger of septic poisoning, he would not use injections. DR. BLACKADER dissented from Dr. Kennedy in leaving even a very moderate tearalone. He always mends such a rent for two reasons. It lessens the chance to prolapse, and it closes an open wound, thereby guarding against septic infection. Here- tofore he has put in two or three stitches; .lately he has tried the single.stitch, as employed by Dr. Alloway, and wYith good results. DR. TRENHOLME believed a common darning needle would answer in this operation. He said that after a day or so the stitch got loose from the tissues being swollen when applied ; to obviate this, Dr. Carson of Detroit employed the shotted suture -that is, a wire suture- held on each side of the rent by a small 548",
         "BRITISH ANb POREIGN JoURNALs. bullet which could be pushed up the wire when it became loose. He (Dr. T.) uses the catgut sutures, and gets perfect satisfac- tion. He thought Dr. Alloway's purse-string suture would shorten the posterior wall of the vagina, and so favor prolapse and retroversion. DR. RoDDIC said that Dr. Alloway's operation had this in its favor-it was easily done. .He believed it to be an admirable method. DR. GARDNER had not yet tried the single stitch. He employs two or three stitches of silk. He intended trying the single ligature. DR. ALLOWAY, in reply, said that Dr. Kennedy's cases, where left alone, had to heal by granulation, not by first intention, as is the case when stitched properly. In reply to Dr. Trenholme, he said that a common darning needle would be very apt to break in the forceps. As to Dr. Carson's shotted suture, he thought it very objectionable to be- interfering with the wound every day. Catgut sutures are difficult to tie, and they may become absorbed too soon. DR. KENNEDY asked what length of tear Dr., Alloway would consider necessary to stitch. DR. ALLOWAY said anything over a quarter of an inch. Extractfrorts andFrig Junls Unless otherwise stated the translations are made specially for this Journa!. Malignant Endocarditis.-The following is an abstract of the first of the Gulstonian lectures on \" Malignant Endocarditis,\" delivered by Prof. Osler. One of the first points to settle is the nomenclature. \" In discussing the subject of endocarditis we are met at the outset by difficulties of nomen- clature and classification. The designation acute may be used to indicate those forms which are accompanied by proliferation of, and exudation upon, the endocardial surface, with or without loss of substance, as opposed to chronic, in which there are sclerotic changes without vegetations. Subdivisions of the acute form have been arranged on an anatomical basis as the",
         "C50 cANADA MEDIoAL AND sURGICAL JOURNAL. terms plastic, papillary, verrucose, fungous, ulcerative, indi- cate. On the other band, from an etiological point of view, the forms of endocarditis are as numerous as the diseases in which it occurs, and we constantly hear the expressions puerperal, rheumatic, scarlatinal, etc. Some speak of prirnary and sec- ondary forms, while from a clinical standpoint they:are arranged in two classes-simple and grave. Anatomically, there appear to be no very essential differences in the various forms of acute endocarditis. Between the small papillary excrescence and the huge fungating vegetation with destructive changes all grada- tions can be traced, and the last may be the direct outcome of the first ; the two extremes indeed may be present in the samne valve. They represent different degrees of intensity of one and the same process. A classification of cases based on the ordi- nary macroscopic characters of the inflammatory products into warty or verrucose and ulcerative will in many instances group together cases widely different in their clinical aspects, and, contrariwise, a clinical subdivision into cases of simple and cases of malignant endocarditis by no means of necessity implies that the lesions in the former case are all of the plastie or warty variety, and in the latter of the ulcerative or destructive. The term ulcerative has come into very general use to describe the grave form, and it expresses well an anatomical feature present in a large proportion of cases ; but in others it is very inappli- cable, as there may be no actual loss of substance, and no more- destruction than occurs in the verrucose form; and, on the other hand, there may be great destruction and ulceration from causes of an entirely different nature. The numerous other terms employed, septic, infectious, diphtheritic, mycosis endo- cardii, arterial pyoemia, while each expressing some special feature, and so far suitable, have never come into very general use. On the whole, it seems to me that the names simple and malignant, which we use so often to separate the milder and severe forms of many diseases, might appropriately be employed in describing the cases of acute endocarditis ; the simple being those with few or elight symptoms, and which run a favourable course ; the malignant the cases with severe constitutional dis-",
         "BRITISI AND) FORÈTGN tOtMNAts. turbances and extensive valve lesions, whether ulcerative or vegetative, the term being more clinical than anatomical. The lesions of malignant endocarditis are by no means uniform, and may be vegetative, ulcerative ór suppurative ; and these various forms may occur alone or in combination. The belief that there is always ulceration bas led to some confusion; and wie must recognise that there are cases with the clinical history of the malignant form in which, post mortem, the valvular condition bas been that of a severe vegetative or verrucose endocarditis. More commonly with or without vegetations there is ulceration, the frequency of the 'occurrence of which bas given the name most often attached to this form of endocarditis. The loss of substance may be superficial, involving only the endocardium, or it may be deep and destructive, leading to perforation of a valve, of the septum, or of the heart itself. On the valves extensive outgrowths usually accompany the process, and may conceal the ulcer or project as fungating masses from its edge,, as is well illustrated by this coloured drawing. In many in- .stances the process appears simply ulcerative, without any vegetations to speak of. In the 'slightest form only a superfi- cial abrasion exists, perhaps scarcely recognisable, in others a process of erosion may go on by which half a valve may be destroyed, or there may be (as shown in this dra wing) a deep excavation extending beyond the valves and destroying the muscle substance of the heart, leading to perforation of the septum or of the wall of the ventricle. These are well-known features, however, upon which I need not dwell. In two in- stances I have seen superficial necrotic changes without ulcera- tion or vegetation, circumscribed patches, the size of a sixpence, opaque yellow-white in colour, resembling the necrotic pleura over a pyemic infaret of the lung or portion of dead peritoneum at the base of a deep typhoid ulcer. Doubtless these would in time have formed ulcers. I find this condition noted by one or two observers. Lastly, the process may be suppurative, in which case the deeper tissues of the valve appear first involved ,and the endocardium only implicated by contiguity. The occurrence of small abscesses at the base of extensive vegeta- 551",
         "552 CANADA MEDICAL ANI StRGICAL JoMtANAt. tions is not uncommon, but there are also instances in which the suppuration seems the initial step. The combination of ulcerative and fungating outgrowths is perhaps the most common condition.\" The variations in the anatomical characters of the vegetations are then described, showing how fibroid and calcareous changes are like.y to take place in them. A word of caution is given, not to mistake for the special changes under consideration either spots of atheromatous degéneration or altered and adhe- rent blood-coagula. The histological character of endocardial outgrowths is minutely traced, and special attention is drawn to the occurrence of an abundance of the so-called Schultze's granular masses in the fibrinous layer which covers the warty growth proper. \"The larger vegetations, more characteristic of malignant endocarditis, consist of a granular material com- posed of altered and dead tissue elements, fibrinous exudation, and colonies ol microcooci ; the deeper parts present the appear- ance of a granulation tissue, while at the attachment in the valve there is always more or less infiltration and increase of the cell elements. The granular substance is structureless, and resembles diphtheritic exudation, the resemblance at times being so close that one can readily understand the application of the term ' diphtheritic ' to the inflammation. ' It may be dis- tinctly laminated, and with a high power fine filaments can be seen, though usually the granules conceal all appearance of structure. Stranels of translucent material may occur through- out the mass, as if portions had undergone a sort of hyaline transformation. In some instances this is very marked. Pale spheres filled with granules also occur, and may be very abun- dant. They have been described as colonies of micrococci, but some regard them as altered endothelial elements. I have seen them too numerous to be explained on this view. At the attach- ment of the vegetation there is a zone of tissue deply infiltrated with leucocytes, and deeper still the tissue elements of the valve present an increase of nuclei and cells. The destruction of tis- sue appears to result in two ways: first, a gradual extension inwards of the necrotic process, doubtless induced by the",
         "tRITISU AN) POEIGN JOURNALS. micrococci: secondly, the softening and separation of valve tissue caused by the rapid' development of leucocytes at the base of the vegetation. The micrococci are constant elements in the vegetations. All grandles of a uniform size met with in the sections are not micro-organisms, nor, indeed, are all which stain by some methods recommended for the detection of these bodies. By far the most satisfactory method is that of Gramm, in which the section, after staining in gentian violet, is trans- ferred for a few minutes to a dilute solution of iodine and iodide of potassium, and then to the alcohol, when it is found that the colour has been extracted from all tissue elements and nuclei, leaving only the micro-organisms stained. They vary a good deal in number and arrangement, and may be scattered singly in the granular substance or arranged in groups. They are usually very numerous at the deeper part of the vegetations, just where the structureless miaterial joins the granulated tissue, and they may penetrate deeply into the substance of the valve. Sometimes the smaller vegetations seem made up exclusively of them. Several of my specimens appear to confirm the view of Klebs, that the micrococci lodge first on the endocardium and penetrate into the substance, often as distinct columus. In their immediate vicinity there is a zone of necrosis, and beyond this an accumulation of leucocytes and signs of reactive inflam- mation. The micro-organisms found in connexion with the malignant endocarditis are not ail of the same kind. Klebs distinguishes two forms-one met with in septic and the other in rheumatic cases. In some instances the micrococci are all arranged in zoogloea-like masses ; in others, particularly the septic cases, they are in chaplets. Some present distinct cap- sules. Smail elongated bacilli have also been found ; I have seen them in one instance-short, stout rods often joined in pairs. Dela'field and Prudden have recently noted the pres- ence of bacilli in the vegetations of a very acute case of malig- nant endocarditis. Cornil, in a recent lecture, stated that the bacillus tuberculosis liad been found in the vegetation on the valves in cases of 1.ptIhisis, and expressed the opinion that before long we should have accurate knowledge of a variety of 563",
         "CANADA MEDICAL AND SURGICAL JOURNAL. micro-organisms in endocarditis depending upon the nature of the primary disease. By culture experiments alone can we hope to have the question settled. \"The local effects of the ulcerative changes are important. Per- foration of a valve segment is extremely common, sometimes there is a clean-cut punched-out hole with scarcely any irregularity of the edges ; more frequently, however, there are great fungous vegetations which completely close and conceal the perforation. Erosion of the chordæ tendineæ is frequently met with, and an entire group passing to the papilla may be destroyed, the ends curled and encrusted with vegetations. Ulceration of the heart muscle leading to perforation of the septum or of the wall of a chamber is a much less frequent occurrence. I have collected notes of eleven instances ; three of the septum close to the aortic ring. Ulcers at the aortic ring perforated the left auricle in three instances, the right auricle in one and the right ventricle in one. In a remarkable case of Dr. S. Mackenzie, the left ventricle was perforated by an ulcer at the apex. In a case of Dr. Curnow the ulceration extended between the coats of the aorta, and then perforated into the lamen of the vessel:; and in one of the Montreal cases there was perforation of an aneurysm of the aorta by ulceration, an instance of extensive ulcerative endarteritis with the production of multiple aneurysms. An- other common result of ulceration is the production of valvular aneurysm. The anterior flap of the mitral is most frequently, affected, and then the aortic cusps. In the records of the cases which I have reviewed I was surprised not to find this condition noted oftener, only in about 12 per cent. of the cases ; but in very many cases the record of the anatomical condition was meagre. It was Sir James Paget, I think, who first referred to the frequency with which sclerotic and malformed valves are attacked by acute disease. Chronic valvulitis is met witli in a large number of cases of malignant endocarditis. The records which I have examined give only a percentage of about twenty-five, but the condition of the valves, except as regards ulceration, was often omitted, and this represents a very much smaller percentage than actually occurs. In more 554",
         "BRITIsH AND FOREIGN JOURNALS. than three-fourths of the Montreal cases sclerotie changes were present, and Dr. Gcodhart found in a series of sixty-nine cases that sixty-one presented old thickening of the valves. In very many of the cases the condition of fusion of two of the aortic cusps was present. This abriormality is almost invariably accompanied by -sclerotic changes, and to the existence of these is probably due the frequency with which they are attacked by ulceration.. In seventeen instances of fusion of two of the aortic cusps of which I have notes there were ulcerative changes in eight, in two or three of an atheromatous nature. \"The cases may be divided into those without any embolic pro- cesses, cases in which the infarcts are simple, not suppurative, those in Which there are innumerable suppurative infarets, and cases in which some of the infarets are simple and some suppu- rative. , It is remarkable how variable these embolie features are. They may be entirely absent in well-marked 'malignant cases. They are not necessarily associated with suppuration ; indeed, in a very considerable number of cases they present the char- acters of ordinary homorrhagic infarets, but in the traumatic and puerperal cases the infarets are invariably septic. They may be few in number, only one or two perhaps in the spleen' or kidney, or they may be in thousands throughout the various organs of the body. When suppurative, micrococci, in my experience, are always present ; but the micrococci may exist in the vessels without inducing this change. In severe forms of the disease homorrhages are very frequent upon the skin, serous and mucous surfaces. The cutaneous ones will be referred to again in connexion with the symptomatology. They appear, in many instances, to be due to the effect of the poison, just as in other infectious diseases; in others they are undoubt- edly embolie, and a minute necrotic or suppurative centre can sometimes be seen. In the membranes of the brain I have twice met with extensive superficial extiavasation. Litten has called attention to the frequency of retinal hemorrhages, particularly in the endocarditis of puerperal sepsis. In some instances, there are innumerable miliary abscesses, more par- ,ticularly in the heart and kidneys. They are often associated 555",
         "556 CANADA AtDICAL AND StRGIcAt JOURNAL. with hoemorrhage, and the smaller ones look like little extrava- sations, but the presence of micrococci and suppuration can be easily determined in stained sections. The spleen is most often the seat of infarction, and next in order the kidneys. The lungs are usually affected when the endocarditis is on the right side, and there may be suppuration or even extensive gangrene, but even with destructive lesions of the pulmonary valves there may be no suppurative infarets in the lngs, as in a case of Dr. Church. Or again, as in a case of Dr. Moxon's, there may be with aortic valvulitis suppurative in- farcts in the lungs, and simple ones in the other organs. The gastro-intestinal canal may present very remarkable chances due to the presence of numerous infarctions, from the size of a pin's head to a split pea. They a're slightly elevated, greyish- yellow in colour, often surrounded by a zone of deep congestion or extravasation, and on section may show a suppurative centre. Micrococci are present as in other miliary abscesses, and in several instances I was able to find small embolic plugs in the arteries of the submucosa. The abscesses may discharge and leave a small ulcerated surface. In the stomach there may be similar minute infarcts, and occasionally larger ones. Carring- ton bas described a remarkable case in which there was a gas- tric ulcer, apparently due to embolic process, in a case of severe endocarditis ; and Magill, a case in which the stomach was in- tensely inflamed, the mucous membrane at the greater curvature being black, almost gangrenous. The liver may present minute abscesses, and in a number of cases in which there bas been jaundice degeneration of the cells bas been observed. The serous. surfaces are often inflamed, pleurisy and pericarditis being not uncommon complications. The pericardium is most frequently affected in rheumatic cases in which endocarditis and pericarditis may occur simultaneously. Pleurisy is met with chiefly in connexion with the traumatic ,and puerperal cases, and also with pneumonia, which, as I shall show, plays such an important part in the history of this form of endocar- ditis. The cerebral lesions are of the substance and of the membranes. Embolic softening, simple or suppurative, is ex-",
         "BRITISH AND -FOREIGN JOURNALS. tremely common, and in very many cases head symptoms supervene and there is paralysis of one side or the other. There may be a single embolus, producing extensive suppura- tion or red softening, or there may be multiple infarcts in various regions. The ineningeal complications of endocarditis have not received much attention. Considering the frequency with which it has occurred in the Montreal cases, five instances out of twenty-three, I was quite prepared to find such a large number as twenty-five cases-i.e., in somewhat over 12 p. et. In the majority of these cases' it occurred in connexion with pneumonia. It is almost always côrtical, but many extend to the base and involve the nerves, leading in one case, which I saw with Dr. Ross at the Montreal Hospital, to strabismus, and also to ulceration of the cornëa from involvement of the fifth nerve. In rare instances the spinal meninges are involved, and the clinical picture may be that of an acute cerebro-spinal meningitis. Acute suppurative parotitis vas noted in three cases. Malignant Disease of the Kidney, with Autopsy.-The specimen under consideration was removed from a man St. 60, an inmate of the Philadelphia Hospital. The first symptom of his malady was noticed about six weeks before death. When admitted to my wards he complained of passing pure blood from the penis, otherwise the urine was physiolegical. He never suffered the least pain ; no dullness could be detected in the lumbar region or in the right flank. There was moderate cachexia, indicating the possibility of ma- lignant disease, but little loss of flesh-. The hematuria con- tinued uninterruptedly until death, prior to which malignant disease was confidently anticipated. The right.,kidney was found to be enlarged, weighing twelve ounces-about one-half its bulk was filled with malignant new formation situated on the anterior portion of the organ. Microscopie examination by the microscopist of the hospital determined it to be an alveolar. sar- coma. The tumor was rich in blood-channels, and part of the bulk of the tumor was entirely made up of clotted blood in a semi-organized condition. According to Zenker, Schroeder 557",
         "558 CANADA MEDICAL AND, SURGICAL JOURNAL. and others, tumors of the kidney frequently do not arise froin the epithelial tissues of that organ. The connective-tissue ori- gin and character of these growths, and their richness in blood- vessels, would assign many so-called carcinomata of the kidney to the group of sarcomata. The prominent symptom during life was hæniaturia, yet in similar cases the condition of the urine is frequently absolutely negative. Ebstein (Ziemssen Cyci.) states that hæmaturia occurred only twenty-four times in fifty cases. Again, autho- rities unite that long intervals may elapse between the periods of homorhage. We can easily understand this since the cavi- ties of the tumor which con tain the blood may not communicate with the collecting tubules even in cases of extensive disease, or secretion of urine may be vicariously assumed by the other kidney. I have even met with eases of abscess of the kidney with only an intermittent discharge of pus. We may assume, however, that causeless and painless hæmorrhage from the genito-urinary tract is a very suspicious, symptom, indicating malignant discase. ]Paroxysms of pain may attend the passage of clots of blood through the ureter; quite resembling those of renal calculus. The rule ordinarily given in hematuria is, that blood escaping from the neck of the bladder or urethra precedes the stream of urine, and whenever ithe blood has accumulated in the bladder in considerable quantity blood-clots will be passed, but the urine first voided vill be clear. In the casé reported in this paper, pure blood was frequently passed almost unmixed iwith urine, so that the previously stated rules differen- tiating the cause of hæmaturia are of relative importance. Paroxysmal hematuria can be recognized not only by its inter- mittent character, but by the abundance of the blood-pigment, combined with the rarity of blood corpuscles. The color of the urine in this affection is said to be due to hæimoglobin. The hæmaturia of renal calculus can be recognizell-by exclusion only, unless renal colic with unilateral localized pain, or some characteristic sediment, be present ; the total amount of urine may be diminished very decidedly, but not otherwise altered. Statements have been made by Heller, Moore and others that",
         "BRITISH AND FOREIGN JOURNALS. 559 discharges of \"flocculi of cancer tissue \" may be found in the urine in this class of cases. The altered epithelium of the renal pelvis and ureters has, doubtless, been mistaken for cancer cells, because although certain combinations of cellular maaterial may excite suspicion in connection with other symptoms, nothing definite can be asserted from an examination of the urine. Recently Dr. Julius Wolf (Deut. Med. Wochenschaft, Sept. 25,) has stated that iodide of potassium is much less readily eliminated by the kidney during Bright's disease than in health, and recommends the use of four or five grains daily for diagnos- tic purposes. Some observations by a student of the Univer- sity of Pennsylvania, Mr. Gregory Guiteras, have confirmed the view-the iodine being absent in the urine in cases of dis- ease of the kidney, but was present in abundance in the saliva. At first sight the test might appear of service in malignant renal disease-but since malignant disease is usually a unilateral process, the test might indicate bilateral disease. Primary malignant disease of the kidney is not always recog- nizable by percussion, as was illustrated by the present speci- men. The bulk of the growth often projects anteriorly, since. the lumbar tissues offer greater resistance. Careful percussion should be made over the lumbar and also the lateral regions; in the latter, percussion should include the space between the lower ribs and the crest of the ileum upward, or forward towards-the navel. When tumors of the kidney are very large, and especially when the disease has involved adjacent viscera, the formation may become recognizable anteriorly by palpa- tion, as well as percussion. These growths are usually adherent to the walls of the abdomen or surrounding parts, and thus become immovable. They may be round and smooth,'or nodu- lar and lobulated, frequently giving rise to a sense of fluctua- tion, or elasticity, on palpitation. They are, therefore, liable to be mistaken for hydatid tumors, and may be confounded with tumors of the liver. In case the growth is situated on the right side, the mistake is particularly possible, but the tumor will not rise or fall with the movements of the diaphragm, and the fingers of the hand can usually be introduced under the",
         "560 CANADA MEDICAL AND SURGICAL JOURNAL. ribs on the right side. These growths, when fluctuating, may indicate puncture with an aspirator as a deciding diagnostic measure, which has been practised. In one recorded case a whitish-red mass cf tissue was obtained, in which the microscope showed a delicate connective-tissue stroma, in which innumer- able nuclei were imbedded, and the operation was followed by no bad results. In renal tumors pain is a pressure symptom, and therefore may be present or absent in accordance with the size and situa- tion of the growth. In malignant disease of the kidney, the cachexia usually noticed in such cases is a late symptom, and in cases of sarcomatous disease is never prominent. Malignant disease of the kidney is more frequent in the early and late periods of life, and is rare as a primary disease, but when pres- ent, the other kidney is usually unaffected, and it is very seldom accompanied by malignant disease of the lower urinary passages, whereas malignant disease of the testicle is often followed by renal carcinoma.-Ewd. T. Bruen, in illaryland Med. Jour. The Treatment of bearlet Fever by Scalded Oatmeal.-As is very well known, the pro- cess of desquamation which follows scarlet fever varies very much in different individuals ; sometimes it is accomplished by particles so fine as to be hardly perceptible, and these are a very frequent and certain source of contagion by means of clothes and otherwise, much more so than the scales as ordintt- rily thrown off. It is evident that this being the fact, it must be much more difficult to prevent contact and consequent contagion with these fine, almost imperceptible scales which are floating in the atmosphere, than where desquamation occurs in large patches of skin. To obviate this danger, Mr. George Smith, of Somerset, England (Bristol zedico. Chirurgical Journal, December, 1884), states that he hàs for several years been in the habit of having his patients well s'onged over the surface of their bodies, commencing, as a rule, about a week after the appearance of the eruption, and continuing the pro- cess until desquamation is' complete, with a mixture of one ounce of oatmeal to a pint of boiling water. The solution to be",
         "BRITISH' AND FOREIGN JOURNALS. made fresh every day, and used. tepid, or at such a tempera- ture as may be comfortably borne by the back of a finger. ilis reason for using this particular combination is that the gluten in it sticks the scales to each other and to the surface of the body, thus allowing of their being removed from one sponging to another without the, ordinary risk of infecting either atnos- phere or clothes, and thus greatly lessening the risk of spread- ing the disease. Secondly, the gluten fuis up the cracks of the new skin and protects it froni cold, as patch after patch of it becomes bare,'and it thus, to say the least, greatly lessens the risk of the dropsy wbich so often follows upon this disease.- Therapeutic Gazette. On the Duration of Contagiousness after Acute Infectious Diseases.-By ALFRED LUDLOW CARROLL, M.D.-The only attempt within my knowl- edge to formulate experience in respect of the duration of in- fectiousness is that of Dr. Miller, of Dundee, whose tabulation is as, follows: Small.pox............14 days after termination of scabbing. Typhus............28 days from inception. Scarlet fever..........7 weeks from inception. 6 weeks from inception. Whooping-cough.. 8 weeks from inception. Meas1es............ weeks from inception. Snall-pox.-As to small-pox, there is pratically unanimity in regarding the danger as existing until all crusts are removed; but a few incline to prolong even further the period of isolation. Typhus Fever.-In relation to typhus, there is less accord. One deems fe:nites the most important factor in the dissemi- nation of the malady, while the rest lay stiess on personal con- tagion. One regards it as \" not contagious after a short interval;\" a second advises segregation until repeated baths have followed the complete disappearance of the cutaneous exanthem ; a third, somewhat indefinitely, would permit return to school \" after complete recovery and disinfection.\" Typhoid Fever.-Those who believe in the direct personal contagiousness of enteric fever are few in nuinber, and I fancy that nearly all of us will agree that the intestinal discharges are 36 561",
         "CANADA MEDICAL AND SURGICAL JOURNAL. ail with which preventive medicine has concern. Whether these retain their infectious properties during the whole process of the malady is a question stili in uncertainty, and rendered more obscure by the apparent demonstration that the disorder may, under certain undetermined circumstances, be generated de novo from ordinary sources of filth-poisoning. At all events, isolation oî the person seems unnecessary as soon as the convalescence is complete. The saine considerations will apply, I believe to cholera, with the further remark that, if Koch's recent observations are correct, the germs of this disease appear to be shorter-lived than any other known species, being destroyed, not only by de- siccation, but by the \" scavenger-bacteria,\" which conquer them in the struggle for existence in the products of common de- composition. BDiphtheria.-Diphtheria affords a wider debatable ground. To begin with, there are many, (among whom my own experience forces me to class myself): who assign the first place in the pathogeny of diphtheria to the filth-poisoning, and doubt its exceeding contagiousness. Of a number of persons exposed to the saine pathogenic conditions, it is not surprising that several should succumb; but this is not convincing evidence of trans- mission from one to the other, and I have seen repeated in- stances where, despite intimate contact, the disease failed to extend after its introduction into places in proper sanitary condition. One of my correspondents, who has long had charge of a large hospital for children, believes this malady to be \" feebly, if at all, contagious,\" and finds it quite safe to remit quarantine \"after the disappearance of membranes;\" a prac- tical sanitarian, of national reputation, excluding fomites and filth in air or water, does not believe in personal contagion ; a distinguished teacher in one of our metropolitan colleges doubts \"its communicability, except by confact ;\" another, equally eminent, declares that contagiousness endures until the last trace of inflammation or infiltration secondary to the diphtheric process has disappeared ; a fourth would protract the duration of quarantine for a month, or, at least, three weeks, 562",
         "BRITISH AND FOREIGN JOURNALS. after all symptomus have abated, and would forbid return to school while any redness of the fauces or any coryza lingers. The discrepancy of opinion in this respect among the leaders of professional thonght suffices tQ show the need of more definite data to guide our deliberations. TPhooping-Cough.-In pertussis, all opinions agree, save one, that contagiousness ends when the cough loses its spasmodie character, the single doubtful view being that, as the danger is wholly fromu the breath of the patient, it can not be determined how long the cough may convey infection. It should be re- membered, however, that a few writers have expressed doubts of the contagiousness of pertussis in any stage. Aleasles.-With regard to measles L find equal diversity of views. One regards its contagium as very volatile, not long adhering to person or clothing, and- permits the return of the patient to school two weeks after convalescence ; a second would defer liberation from quarantine until a week, at least, after desquamation,; a third releases the patient when des- quamation has ceased,or, in cases where no desquamation occurs, after twenty-one days; a fourth fixes eighteen days ; a fifth believes the danger past when the febrile stage and eruption are gone. The majority measure the time of isolation by the process of epidermal exfoliation. Scarlatna.-In scarlatina, also, we have opposing opinions, ranging from that which considers it as a pythogenic disease, slightly, if at all, contagious from- the person, to that which holds the infection to be communicable by the pulmonary ex- halations, the blood, the naso-pharyngeal secretions, even the urine, as well as by the epithelial scales. One of my cor- respondents thihs the infection remains so long attached to the person that quarantine should endure for eight weeks ; another cites an example of transmission after six weeks of isolation followed by a change of clothing; the rest concur in releasing the patient after desquamation bas ceased and the surface been thoroughly cleansed. Most of us, I dare say, have adopted this \"rule of thunb.\"--.Y. Med. Jour.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Intubation of the Larynx.-In the New York Medical Record, of February 21, Dr. E. F. Brush thus des- cribes a case of intubation of the larynx by , Dr. O'Dwyer, which he witnessed at the New York Foundling Asylum, in a child three and a half years old suffering from pneumonia and inflammatory croup :-\" The boy was placed in the nurse's lap, an assistant held the head ; a gag was put into his mouth. Dr. O'Dwyer passed the index finger of his left hand back into the child's pharynx, while his right held an instrument shaped like a small steel sound of the Van Buren pattern, on its distal end a gold-plated oval tube four-sixteenths of an inch in its long diameter and two-sixteenths in its shorter diameter, and one and a half inches in length, collared around the upper extremity except at the anterior curve of the oval. In this uncollared portion was a small eyelet armed with a long silk thread. This tube was carried along the doctor's finger into the pharynx. There was a spasmodie coughing, a reddening of the face, the sound-like instrument was immediately withdrawn without the tube, the boy gave a long, deep inspiration, the thread was quickly withdrawn, and a marvelous change was instantly pro- duced in the patient's whole condition. The intense redness caused by the first irritation gradually faded, a copious perspi- ration broke out over the forehead, the respirations became easy and quiet. I actually thought the child was dead, as the eyes were fixed in a stare of astonishment, and before the'little sufferer had recovered from his amazement, he was sleeping soundly.\" Having mentioned other similar cases which he saw at the Foundling Asylum, Dr. Brush gives a sketch of the history of intubation of the larynx, and concludes that Dr. O'Dwyer's procedure is not a revival of the old methods. From his own observation of the cases seen by him lie states that he is fully convinced that intubation of the larynx is a more simple operation than that of tracheotomy; that the laryngeal tube is worn with greater ease to the patient; that the air which reaches the lungs is heated and moist, which is not the case with the tracheal tube ; that coughing and expectoration are carried on with greater ease and more effectually than is possible with the",
         "31UIIsH AND POREiGN JOUANALs. tracheal tube, and that the absolute care and vigilant watching, which form such an element of strength in tracheotomy, are not called for in Dr. O'Dwyer's method of procedure. -He adds that the most striking feature in this method, and one wbich must be of the greatest comfort to the physician and to the parents, is the entire absence of mutilation or disfigurement. In the laryngeal diseases of infancy, which so often prove fatal under, the very best conditions, parents and friends not infre- quently imagine that it was the operation of tracheotomy that was the cause of death. The unsightliness of a dry, cracked mouth ; the repulsive spectacle of a tube protruding from the trachea, often lined with, and having hanging from its orifice, expectorant matter; the necessity of informing the parents of the hopelessness of their child's recovery, and, of requesting their consent to a desperate surgical operation as a kind of for- lorn hope-all these painful eleme-nts are spared in the method adopted by Dr. O'Dwyer. 1 Palatable Prescribing.-Cough mixtures can be to a certain extent rendered palatable by a selection of pro- per vehicles. The citrate of potassium can be largely masked by the free use of lemon juice. Muriate of ammonia is largely covered by liquorice, provided the latter be added in such quantity that there will be ten to fifteen grains of it for every ten grains of the muriate. The addition of glycerine to a mix- ture containing an ammoniacal or other irritant salt, often has the most happy effect in obtunding the acridity. It must not be forgotten, however, that glycerine throws out of solution most alkaloidal salts. This is essentially important in connec- tion with the fact that the addition of glycerine to the tincture of the chloride of iron is most advantageous from the æsthetic point of view. We are very apt to combine tincture of chloride of iron with salts of quinine, strychnine, or other alkaloids. Even when such solution is very strongly acid, glycerine precipitates the organic principle. Syrup of squills, syrup of ipecac, and most other sweet expectorants, can readily be masked by the syrup of wild cherry bark, provided cyanide of 565",
         "566 CANADA Mt1DICAt AfiÑb SURGICAL JOURNAL. potassium (at least 1-20th of a grain to a dose) be added to intensify the prussic acid taste. The excessive sweetness of these mixtures is disagreeable to some individuals ; this, of course, can readily be obviated by the addition of lemon juice or other acid. There are certain very valuable remedies whose nauseousness in solution cannot be overcome by any combina- tion. Under these circumstances the . endeavor of the practi- tioner should be to give a dose so small and in such form that it can be enveloped in a mechanical coating of some sort. Whenever the material is *a solid, this is readily managed by giving it in the form of a silver-, gelatin-, or sugar-coated pill; for, whatever may be said in regard to the solubility of these preparations, they are dissolved in the stomach with sufficient rapidity for all practical purposes, provided the pharmacist has done his work properly and the pils are at all fresh. It seems to be a tradition of the profession, that all cough remedies should be given in liquid form. We hear continually of cough mixtures, but who ever heard of a cough pill ? Now, there is little reason in this. Squill, ipecacuanha, tartar emetic, all the ordinary expectorants except ammoniacal salts, can be given in a coated pill as well as in a nauseous mixture. When the drug is of such character that it cannot be readily given in pill unless the dose be- very large, it is readily administered in capsules. Oil of eucalyptus should never be given except in capsules. Oil of copaiba has for decades been habitually given in cap- sules for -other than pulmonary purposes; why not also- for chronic bronchitis ? The ammoniacal salts can be given in capsules as well as in mixture. It may be objected by some, that their local irritant effects would be increased by such method of administration, This does not seem to be a valid objection ; but if it is considered so, let the patient drink a half a tumbler of mnilk directly after ingesting the supposed irritant remedy, and the stomach will be protected much more effectu- ally than if the nauseous drug were given in a teaspoonful of water.- Therapeutic Gazette.",
         "CANADA M~ONTREAL, A.PRIL, 1885. THE ADVENT OF SMALLPOX. For the past four or five years the city of Montreal has been entirely free from smallpox, after having been for a long time a prey to that dreaded epidemic disease. This is a fact upon which we have had good reason to congratulate ourselves. But the history of smallpox shows that it comes and goes in waves. It comes, it spreads, becomes widely epidemic, lasts thus for a variable period, and, when it has exhausted all the available material, gradually subsides. Then follows an inter- mission during which nothing is heard of it, and gradually a sense of security is established and people begin to hope that the terrible experiences of former visitations will never be rëenacted. It is during these temporary lulls that the mate- rial upon which smallpox feeds is developed. That is to say, vaccination of children is neglected, and by the time an out- break occurs many are ready to receive the poison and propa- gate it to any extent. As we are certainly threatened with the recurrence of smallpox in Montreal, it becomes the duty of the hour to urge the importance of immediate vaccination upon all physicians within the limits of their own clientele and upon the ]Board of Health to redouble their exertions in this direction. On this occasion the disease has been imported from Chicago, where it has greatly prevailed during the winter. About four weeks ago two railway employés from that city arrived here, within a few days of ea.à other, affected with smallpox. One of these was received at the Hôtel-Dieu Hospital, the other was treated by his own physician at his private house. Both cases communicated the disease to others. From the hospital case, two",
         "CANADA MEDICAt AND SURGICAL 3oûÈÑAUL. nurses took it and died ; a medical student took it at his boarding- house, and also died. Twelve other persons have likewise been prostrated from the same source, and are now ili. From the home case four persons contracted it. One of these had gone to her friends in the country, and was there taken down. The others continued in the infected house, and were there treated. It will thus be seen that between 15 and 20 cases were rapidly propagated from the original foci, and it is quite possible there may be other cases of which we have not heard. There has been here a grand opportunity for the Board of Health to stamp out the disease- at the very outset, and it is but right to say that if smallpox does not now spread in Mont- real, the thanks of the citizens will be due to the prompt and energetic measures instituted by the chairman of the Board the moment the facts were officially reported to him. As soon as possible after the facts were brought to his notice, the Civic Smallpox Hospital was reopened, and now contains all the cases which are known to exist (15). The patients in private houses were strongly urged to be removed to the same place, but refused, and there is no power to compel their removal. Under these circumstances, everything possible was done in the most careful and thorough manner to secure isolation and disinfection. A guardian was placed upon each to warn all persons against enter- ing, the necessary attendants alone being permitted within the building ; abundant disinfectants were supplied and the nurses instructed in their proper employment for all clothing, etc. ; and finally, when the case had terminated, effectual fumigation with sulphur was performed by the sanitary police. The Medical Health officer visited and inspected the entire neighbourhood, and saw that the inhabitants were properly vaccinated. These measures were adopted promptly and carried out with system and energy, and we trust will have proved effectual. In the absence of any information, we do not know what measures, if any, were taken to isolate the patient first admitted to the Hôtel Dieu. At any rate, that these were eminently im- perfect is quite plain from the large number of cases that imme- diately occurred. The Board of Health consider that once the",
         "669 case was received into a hospital provided witn the usual medical staff, they confideui it entirely to them, and could not interfere except upon being requested to do so. This may be quite true, but it is to be regretted that the Smallpox Hospital had not been kept in readiness for the admission of patients. The existence of smallpox in localities in constant railway communication with this city was a standing threat of an invasion sooner or later. Had the Civic Hospital been open, this serious outbreak need never have occurred. T1hereS a law in force callingupon afl medical mon to report cases of contagious diseases (which are specified) to the Health Department. This has always remained a dead letter and, we think, is likely to remain so. Physicians will not act the part of informers concerning the families they are attending, and still the Board ought to get the information. In our opinion, the proper persons to give such information are the household- ers'; and we submit that bere, as elsewhere, every householder should be bound to at once inform the Board of Health when, to his knowledge, there exists a case of (specified) contagious disorder within his dwelling: In the present emergency, how- ever, we believe that if the chairman of the Board of Health were to address a circular to all our physicians, requesting their cöoperation in this matter, they would get an immediate response, and would receive early notice of any case of small- pox which might occur. In d'onnection with this matter, it is with pleasure we notice that two regular public vaccinators have been appointed for the city, who will at once see that this important measure is en- forced in every ward, and will assist the medical officer in other important sanitary arrangements. FIELD HOSPITALS AND AMBULANCES. Fortunately for this Canada of ours, the Field Hospital and the ambulance have been hitherto things unknown amongst us, except in theory. The .rebellion of. the half-breeds in the North-West, and the fact that bands of Indians have already joined the insurrectionary movement, promises however, now bI'IýoRÍAt.",
         "570 CANADA MEDICAL AND SURGICAL JOURNAL. to render them a stern reality. As soon as the Government began sending a considerable number of our volunteers to these districts, it became necessary for them to organize a -staff of Medical Officers to undertake the important duty of providing the best possible surgical assistance in the best possible hospital that circumstances would permit, for the sick and wounded. Dr. Bergin, M.P., of Cornwall, was appointed Surgeon- General, to remain at Ottawa, control the Medical branch of the service, and advise the Minister of Militia. Dr. Roddick, of this city, was made Deputy Surgeon-General, to proceed at once to the Qu'Appelle district and locate base hospitals in such localities as the General in command might designate. Dr. Douglass, V.C., was made Surgeon-Major and director of the ambulance corps; Hon. Dr. Sullivan, Purveyor General ; Dr. Jas. Bell to have the rank of Surgeon, and probably take charge of one of the hospitals ; and six Assistant-Surgeons were to com- plete the regular staff for the present. A number of medical students from this city and Toronto were enrolled as dressers, and have proceeded westward. The whole party left for Win- nipeg and the North-West on the 7th inst., and are now on the site of their operations. These appointments are excellent, and will commend themsejlves to the profession at large ; and we have every confidence that no effort will be spared to render the hospital and ambulance service as complete and efficient as possible. McGILL UNIVERSITY-ANNUAL CONVOCATION. The annual convocation of the Medical Faculty of McGill University took place on Monday afternoon, March 30, in the William Molson Hall. PROF. HOWARD, Dean of the Faculty, read the report as follows The total number of students enregistered in this Faculty during the past year was 234, of whom there wvere from Ontario, 126 ; Quebec, 58 ; New Brunswick, 20 ; Nova Scotia, 11; Uiited States, 8; P. E. Island, 3; Newfoundland, 3; West Indies, 2; British Columbia, 1; Manitoba, 1; Ireland, 1. The following gentlemen, 46 in number, have passed their",
         "IPrimary Examination on the following subjects: Anatomy, Prac- tical Anatomy, Chemistry, Practical Chemistry, Materia Medica and Therapeutics, Physiology, Histology and Botany: Aylen, P., Aylmer, Q. KellyJ. A. A., Durham, 0. Blackader, E. H. P., Montreal, Q. Kennedy, R. A., Ottawa, 0. Boggs, C. W., Wolfville, N.S. Kirkpatrick, R. 0., Montrcal, Q. Boone, S. W., Fredericton, N.B. Lafleur, R. A., Montreal, Q. Campbell, A. W.; Ingersoll, O. Leslie, A. C., Watson's Corners, O. Carter, L. H., Picton, O. Loucks, W. F., Stirling, O. Cattanach, W.. Glen Water, O. MIonald, D. D., N. Lancaster, 0. Cowie, Alex. MacD., Montreal, Q. McMillan, G. A, Dundec Centre, Q. DeCow, D. McG., Dresden, O. Morgan, V. R., Aults-ille, O. Dazó Henri, Montreal, . Dazt, HerNnra, Q. Norman, T. J., Schomberg, O. Dickson, J. A, Trenholinville, Q. Poneroy, L. E. M., Tweed. 0. Earl, E.HR., Pori Hope, O. , 3oole, A., Wakefield, O. Ellis, W. E., St. Catharines, O. Reavely, E. Evans, E. J., Seaforth, O. Richardson, G. C., South Mardi, O. Ferguson, W. D., Cumberland, O. Ross, I. L., Winthrop, O. Fillmore, E. W., Baie Verte, N.B. Ross, L. F., Montreal, Q. Flagg, J. D., Morrisburg, O. Scully, D. J., Lindsay, O. Fraser, J. M., Hawkesbury; O. Sinclair, ., Guildes, O. Gardner, A. W., Cornwall, O. Stephen, G. C., Montreal, Q. Haentschell, W. C., Pembroke, O. Warncford, P. H., Norton, N.B. Hall, Wm., Walkerton, O. Williams, E. P,, Ottawa, 0. Hamer, A. L., Bradford, O. Williams, J. P., Barrie, O. Haythorne, T. J., Charlottet'n, P.E.I. Young, A. A., arton, Vt. JoKnson, J. W., VankleeDh, . The following gentlemen, 34 in number, have fulfiled ail the requirements to entitKe them to the degree of M.D., C.M. from the University. In addition to the Primary sub ots mentioned they have passed a satis[actory examination, both written and oral, on the following subjects :-Princples and Practice of Surgery, Theory and Practice o Medicine, Obstetrics and Dis- eases of Women and Children, Medical Jurisprudence, Path- Iogy atid HlIygiene, and also Clinical Examinations in Medicine and Surgery conducted at the bedside in the .,ospital Ros . . ithoO Arthur, R. H., Brighton, O. Allan, J. H. B., Mentreal, Q. Baird, T. A., Chesterfield, O. Burrows, F. N., Drayton, O. Cassidy, Geo. O., Goldstone, O. Daly, Waler S., Ogdensburg, U.S. Corson, Douglass, Woodstock, O. Darey, J. H., ML1ontreal, Q. Dazé, Henri, Montreal, Q. Doherty, W. W., Kingston, N.B. Elder, John, Huntingdon, Q. Eberts, D. W., Chatham, O. Finlay, F. G., Montreal, Q. Harkin, F. McD., Vankleek Hill, O. Hallett, E. O., Truro, N.S. 1lurdman, ti.,T., Aylmer, Q. Gustin, Smith, London, O. Hanna, A. E., Harlem, O. Hawkins, A. C., Halifax, N.S. Irvine, R. T., Carp, O. johnson, H. D., Charlottet'n, P.E.. Klock, W. H., Aylmer, Q. McMeekini J. W., St. Catharines, O. McGannon, M. C., Prescott, O. McCormack, N., Pembroke, O. McDonald, H. J., Alexandria, O. M1cMillan, D. L., Alexandria, O. Powell, F. H., Ottawa, O. Palmer, G. F., Ottawa, 0: Robertson, A. M., Brockville, O. Shibley, J. L., Yarker, O. Wishart, D. G., Madoc, O. Wilson, J. A. K., Manotick, O. Wood, Edwin Geo., Londesboro', O. ËDrToWt. 571",
         "72 CANADA MEDICAL AND SURGICAL JOURNAL. The following have passed in Anatomy and Practical Ana- tomy: Easton, C. L. Mackinnon, H. The following have passed in Chemistry: Aborn, W. H. Bradley, W. J. Berry, J. A. Bell, J. H. Boyd, Jay Bowen, Wm. Chalmers, W. W. Christie, Wm. Davis, A. H. Edgar, C. J. Ferguson, J. A. Fritz, N. W. Kenny, F. L Kincaid, - Lewis, G. T. Lafferty, A. M. McKinnon, H. McDonald, A. D. Porthier; C.'J. Porter, J.\" H. Parker, W. D. Quance, S. H. Woodruff, T. N. Young, H. E. The following have passed in Practical Chemistry: Davis, A. H. Fritz, H. D. Kincaid, R. J. Kenny, F. L. Lewis, G. T. McDonald, A. D. Parker, W. D. Pothier, J. C. Quance, S. il. Young, H. E. Woodruff, T. A. The following have passed in Materia Medica: Aborn, W. E. Bowen, Wm. Boyd, Jay Brunette, J. T. Christie, Wm. Davis, A. B. Easton, C. L. Edgar, C. J. 'Lafferty, A. M. Grant, A. S. MeKinnon, H. McDonald, A. L. The following have passed in Physiology : born, W. H. Edgar, C. J. wen, Wm. Hall, A. G. Po oyd, Jay Lafferty, A. M. Pa meron, K. McDonald, A. L. Po ristie, Wm. Woodruff, T. N. W aston, C. L. McDonald, A. D. Porter, J. H. Parker, W. D. Porthier, C. J. Woodruff, T. N. cDonald, A. D. rter, J. H. rker, W. D. rthier, C. J. ilkins, H. P. The following have passed in Medical Jurisprudence : Birkett, H. S. Clark, J. L. Craig, M. A. Crockett, W. C. DeCow, D. McG. Duffett, J. L. Earl, E. M. Elder, J. Gairduer, T. M. Gibson, J. H. Gladman, G. J. Graham, J. Grant, J. H. V. Hawkins, A. C. Hughes, P. H. Kinloch, J. A. McCallum, E. P. McCuaig, A. J. McDiarmid, G. A. McGannon, T. U. McKay, J. M. Morgan, V. H. Orton, F. H. Poole, A. Pringle, W. R. Raymond, A. Raymond, G. H. Robertson, F. D. Rowat, W. M. Schmidt, A. F. Schmidt, A. J. Seery, F. J.. Turnbull, A. White, F. J. White, W. W. Wilkins, H. P. Williams, J. F. Wilson, C. W. Wishart, D. J. Worthington, A. H. Aborn, W. H. Berry, J. A. Boyd, Jay Bradley, W. J. Cameron, J. J. Christie, W. A B BC Ca Ch:",
         "EDITORIAL. The following have passed in Hygiene Aylen, P. Birkett, H. S. Christie, Wm. Clarke, J. L. Cowie, Alex. MacD. Crockett, W. C. Cunningham, H. C. Duffett, J.L. DeCow, D. McG. Earl, E. H. Evans, W. H. Fillimore, E. W. Gairdner, T. M. Grd1ne- A. Wz Graham, J. Gibson, J. B. Gladman, G. J. Graham, - Grant,-J. H. V. Hawkins, A. C. Hamer, A. L. Haythorne, T. J. Hughes, P. H. Kennedy; R. A. Kinloch, *J. A. Kirkpatrick- R. C. McQuaig, W. J. McDiarmid, Geo. McDonald, A. D. McDonald, A. L. McDonald, D. D. McCollum, E. P. McGlannon, Tt G. McKay, J. McKay, Eugene McMillau, G. A. Morgan, V. H. The following have passed in Pathology Birkett, H. S. Boggs, G. W. Clarke, J. L. Crockett, W. C. DeCow, D. McG. Duffett, J. L. Elder, J. Earl, E. H. Gairdner, T. M. Gibson, J. B. Gladman, G. J. Grant, J. H. Y. Graham, J. Hawkins, A. C. Hughes, P. H. Kennedy, R. A. Kinloce, J. A. - Kirkpatrick, R. C. Morgan, V. H. McCallun, E. P. McKay, J. M. McCuaig, W. J. McGannon, T. G. McMillan, G. A. McKay, Eugene McDiarmid, G. A. Orton, T. A. Poole, A. Pringle, W. R. Rowatt, W. M. Th followingIhave passed in Physies : Baer, D. E. Bell, J. R. Bradley, J. W. Bowen, W. Berry, R. P. Clouston, J. R. Castleman, L. Chalmers, W. W. Conroy, C. P. Deacon, S. D. Davis, A. H. Dickson, A. Dearden, J. D. Desmond, F. J. Evans, W. H. Fritz, H. D.. Ferguson, J. A. Gunn, D. T. Girdwood, G. W. T. Green, D. T. Goodwin, W. W. Hopkins, H. J. Hubbard, O. H. Hubert, P. J. H. Hewitt, J. Hoare, H. C. Horner, A. S. [rwin, W. J. Kennedy, J. R. Kenney, F. L. Kincaid, R. J. Kiiicard, R. W. Kendell, H. E. Knapy, H. D. Orton, T. A. Poole, A. Pringle; W. R. Raymond, Alf. Reavely, E. Rowatt, W. M. L. Robertson, F. D. Ross, L. F. Schmidt, A. J. Schmidt, A. F. Seery, F. J. Turnbnll, A. Williams, .1. F. Wilkins, H. P. Wilson, C. W. White, F. J. White, W. W. Worthington, A. Ross, L. 'F. Raymond, G. H. Raymond, Alf. Robertson, F. D. Schmidt, A. F. Schmidt, A. J. Seery, F. J. Turnbull, A. Wishart, D. J. White, F. J. White, W. W. Wilson, C. W. Willioms, J. F. Wortnington, A. Wilkins, H. P. Kirkpatrick, R. J. Lewis, G. T. Loucks, F. Lang, W. M. Lafferty, A. McLennan, D. McFarlane, M. McDonnell, A. E. J. McKinnon, H. McCarthy, J. J. McKay, H. H. McKinnon, H. Metcalfe, F. J. Miller, J. T. Morrow, C. Mowat, M. Orr, J. E. 5'l3",
         "574 CANADA MEDICAL AND SURGICAL JOURNAL. Orr, A. E. Parker, W. D. Park, P. C. Pomeroy, L. E. M. Porter, - Potts, J. Pothier, C. J. Quance, S. H. Robertson, H. E. Rowatt, A. R. Stewart, A. D. Springle, J. A. Shepperd, A. A. Telfer, W. J. The following have passed in Botany Baer, D. C. Berry, R. Castleman, L. Clouston, J. R. Conroy, C. P. DaoJ. D. Desmond, F. J. Dyer, R. C. Girdwood, G. W. Greene, H. D. Goodwin, W. W. Hewitt, J. Hoare, C. W. Hopkins, W. J. Hubbard, O. H. Irwin, W. T. Kennedy, J. H. Kerr, N. Kincaid, R..M. Kirkpatrick, E. A. Lafferty, A. M. Lang, C. H. Lewis, G. T. McFarlane, M. Mackay, H. H. Mackinnon, G. W. M\"cLennan, D. McMartin, D. R. The following have passed in Histolo Aborn, W. H. Boer, D. C. Berry, A. P. Bradley, W. J. Cameron, K. Castleman, A. L. Conroy, C. P. Davis, A. W. Deacon, J. D. Dennis, J. T. Desmond, F. T. Easton, C. L. Eleard, J. Fritz, N. W. Gunn, N. D. Goodwin, W. W. Hopkins, H. T. Holden, - Hubert, P. T. Hamilton, A. Hawkins, A. C. Hubbard, O. H. Hewitt, J. Irwin, W. T. Kerr, N. Kennedy, J. H. Kendall, H. E. Kincaid, R. J. Kincaid, P. M. Kirkpatrick, E. A. Kenny, F. L. Lafferty, A. M. Lang, Wm. M. Long, H. Moffatt, M. Murray, W. N. Morrow, C. McDougall, D. T. McFarlane, M. McLennan, D. McKay, H. H. McMartin, D. R. Thompson, J. W. Vernier, H. Wilde, H. Woodruff, T. A. Wesley, R. A. Whitmore, F. H. Young, H. E. Morrow, C. Orr, A. E. Orr, J. E. Park, R. C. Potts, J. M. Robertson, A. G. Shepheru, Rû. A. Stewart, A. D. Springle, J. A. Thompson, J. H. Weagan, A. A. Westley, R. A. Westmore, F. U. gy : McKinnon, G. W. McCarthy, J. G. Orr, A. E. Orr, J. E. Park, J. C. Potts, J. Pothier, C. J. Porter, J. A. Quance, S. H. Reavely, E. Robertson, A. G. Springle, J. A. Stewart, A. D. Shepherd, R. A. Telfer, W. J. Thompson, J. W. Vernier, H. Wylde, C. F. Wesley, R. A. Whitmore, F. H. Young, E. MEDALS, PRIZES AND HONOURS. The Holmes Gold Medal for the best Examination in the Primary and Final Branches is awarded to Edwin G. Wood, of Londesborough, Ont. The Prize for the best Final Examination is awarded to Smith Gustin, London, Ont. The Prize for the best Primary Examination is awarded to Ed. J. Evans, Seaforth, Ont.",
         "The Sutherland Gold Medal is awarded to H. A. Lafleur, B.A., Montreal. The following gentlemen, arranged in order of merit, deserve honourable mention: In Primary Examination-H. A. Lafleur, J. A. A. Kelly, D. L. Ross, E. I:. P. Blackader, R. A. Kennedy, L. F. Ross, T. J. Haythorne, R. C. Kirkpatrick, Wm. Hall and J. M. Fraser. In the Final Examination-F. G. Finlay, H. T. Hurdmann, M. C. McGannon, T. A. D. Baird, John Elder, D. W. Eberts. PROFESSORS' PRIZES. Botazny-Prize, T. A. Clouston. Practical Anatomy-Demonstrators' Prizes: 2nd year. H. A. Lafleur, Montreal. lst year, W. J. Bradley. Clinical Medicine-Junior Class, H. S. Birkett, Hamilton, Ont. PROFESSOR VON FRERICHS.-We have this month to lament the loss of the foremost teacher of clinical medicine in all Ger- many-Prof. Frerichs-who died at Berlin on 17th of March, in the 56th year of his age, and the 26th year of his profes- soriate. -He was Professor of Clinical Medicine successively at Kiel and Breslau, and in 1859 was called to Berlin University. His best known work is his treatisejon \"Diseases of the Liver,\" which was translated into English by Murchison. -It is with great pleasure we learn.that the Index Medicus is to be continued. This periodical, giving, as it does, complete references to what is published in all parts of the world in every department of medicine, makes it invaluable to all who desire to learn the precise state of knowledge in any subject in which they may be interested. To those attempting original work, such a publication is simply invaluable ; and the time and labor neces- sary, in the absence of such a journal, to form any adequate estimate of the work already done is so great as often to deter from the project altogether. It should be on the bookshelves of every public medical library, and among the journals of all medi- cal societies, if not in the private collections of all progressive medical practitioners. 575 EDITORIAL.",
         "576 CANADA MEDICAL AND SURGICAL JOURNAL. Medical ltens. AMERICAN MEDICAL ASSoCIATIoN.-The thirty-sixth annual session will be held in New Orleans, La., on Tuesday, Wednes- day, Thursday, and Friday, April, 28th, 29th, 30th, and May lst, commencing on Tuesday 11 at a.m. PERSONAL.-Drs. W. J. Johnston and Ruttan, (McGill 84') left New York on Friday last, by the North German Lloyd line, for Berlin via Bremen. While there, Dr. Johnston intends pursuing the study of Pathology, and Dr. Ruttan, that of Chemistry. -Mr. Lawson Tait says: \"The amount of worry which is given him by every case of hysterectomy, even when successful, is such as to be almost beyond the recompense of any fee ; and the disappointment inflicted by every death is quite indiscri- bable.\" -Iowa is the illiterate physician's paradise, no requirement being made for the practice of medicine. -'If a man or woman has the gift of gab, lots of cheek, especially if he or she can dress well and make a good appearance, they will succeed in making a practice. The less education he has the better. Little or no moral character required, either. This is the. status of the medical profession in Iowa.-Iowa State Med. Journal. -No nation hankers for the honor of originating venereal disease. The Neapolitans call it the French disease ; the French, the disease of Naples : the Poles call it the German disease ; Hollanders and Englishmen refer it to Spain ; the Orientals lay it to the Franks, the Persians to the Turks; the Portuguesé christen it Castelian and the Chinese call it the disease of Canton. Other peoples follow the same rule as those mentioned. Syphilis has no father who is willing to stand responsible for its birth. -A correspondent of the Journal of the American ifedical Association is impressed with the number of operations for the amputation of the cervix uteri performed in Berlin. He thinks few women in Berlin can have normally preser'ved uteri. He says the students have a saying that there is not a woman living on the street with Martin's Hospital who has an entire cervix uteri. The temptation to resort to an operation for the glory of publishing statistics and for achieving renown is a great one, and is inflicting injury upon gynæcology. Indeed, other depart- ments of surgery are not unscathed."
      ],
      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 13, no. 9] (Apr. 1885)]"
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         "8_05177_153"
      ],
      "published" : [
         "[Montréal : Gazette Print. Co., 1885]"
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      "label" : "[Vol. 10, no. 7 (July/Aug./Sept. 1888)]",
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      "title" : [
         "The health journal [Vol. 10, no. 7 (July/Aug./Sept. 1888)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée D Cover title missing/ Le titre de couverture manque DColoured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) DColoured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents M Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure D Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: | |zTitle page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lox 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "-THE- HEALTH JOURNAL, A QUARTERLY REVIEW MAGAZINE AND RECORD OF SANITARY -PROGPESS EDITED BY- ~ubIIc §altb anb ÏNational tengfþ b E eatb. VOL. X. OCTOBER, 1888. No. 7 COETS: Rise and Progress of Sanitary Statistics, Bacteriology and Engineering within the Pre- giene of Iiphthera......248 sent Century, by Sir Robert Sanitary Convention at Lindsay, Raw'linson, K.C.B..........217 Ont., and Session of the As- An Inquiry into the value of sociation of Health Officers..250 various Disinfectin Appara- Notes on General Sanitary Pro- tus-Steam \u0026 Hot Wa-ter .... 221 rs...........2525 Dissemination of Infection by Misceflaneous Selections \u0026 Items Air........................ 223 -Duration of Tubercular la- The New U. S. National Quaran- fection - Crematories - Chi- tine Law...................226 v. Montreal-Canned Sewage Disposal for Water-closet Foods-Infection Periodsand Towns-Alfred Carpenter...228 other Items..........257-258 Communicable Diseases Common Editorial Specials-The Paris to Man and Animals-The Convention-Prompt Action Papers at the British Medical of the French Government- Association Meeting-Report Another Paper-Educating of the Paris Conference, etc., the Masses-The National Mu- read before the Meeting of seum-A Minister of Health j the Canada Medical Associa- -The One-Man ?ower..259-261 w ~ tion, by the Editor, Sept.,'88, 235 Subscription Price, 50 cts. a year; Single Copy, iS Cents. ADDRESS: TH-E R L TH eJ O t.L5,\" SeTs T oft, CatA . Or UNNIOo SQ GnrE, l SIan YORK, itr P grs .. ........ .25-5",
         "TUE GRAND UNION MOTEL, O l 5eOPPO uMnd Cenra Deps4 New York Cuy, %.evelesss sa~ndliswvlrMg or laying the r to vit Saratog, Long Branb, Whits mo. or aeas, Atted astMsa m ima las, over 00 elegantly fud'p « '-%Wus aïd we of imei ut Stlh. rom Wdssnatsaf e e- '.T a MdP nqp FMII \u0026soslVs Rou upCcifbl.b W. D. oARRiSo, Manager. WGudeMe leba a oendfo ah. m ., p, ,, . ,,ra is, BI, ,,,,pi.g saA., g. Se\". 00 m k iraed Urnha RoasH. St. LAWRENCE HALL R3ENRTJy IJOGAN, ProprIet,11, For the paut 86 yearr this Hotel, famlay knowR as thse St. Lawrence, ha\u0026 been a housl odt l traveller. on thîs continent, and ha: been woro il ail the Royal Personages wbo bave visited tbe City eo Motreal. àW Hlotel Coaches are ln attendance on arriva, of a, Trains and Steamers. Baggage Checks Bhould be given to the Porter lu attendance. fee Ulee'ad Eut 1 Gl Bninn.86 so a eac ioci 0 er-lof lksrboNs ndd*IW 1 Ibsew .1, ompe an oue*s telbos ~ e Who~ bave1t ealdb oo ru eur rot %%M w5aI glon ta~ wtae \"ad\u003ee l nd fteiapou il avpébe oma\"l tolsttbaeaut mele..,bpl r atome Mbse \"i« oa ai b ss.a, alwl motelCartge a e sud rna*ise Pla@bc. aer ila lui o b montéysor Ivue Ibeampes OScs Wsomy at alyoro S4urrslar vit la m\"sS t'at o Oory uml a posale eth on« tbob w ille us sout@ b«1 oat sud after yeu how ail,tf lai *Mnd yonr addressame ' eau pue V.UEI On* or tb bff 8014goï wal= zobe a ur large ln. et Misu M11181 »UIllo' $ TICKETS ISSUED BY ALL LINM EITHER VIA NEW YORK, PORTLAND, MONTR OR QUEBEC, --M ALL PARTS 01- nglandi Iruland, sotand And Ee' AT LOWEST RATES. BOSWELL \u0026 H AC E E' GENERAL TICKET AGENT 237 (Room 7) St.-James 8treet,igon HENRY WATTERS, 214-216 Sparks St. OTTA W. Special attenton given to the Compoun",
         "The Health Journal. A Quarterly Reviev of Sanitary Progress. VoL. X. JULY, AUGUST AND SEPTEMBER, SS8. No. 7. T HE RISE AND PROGRESS OF SANITARY ENGINEER- ING WITHIN THE PRESENT CENTUR\\. BY SI ROnERT R.\\WLINSON, K. C. B. T HE following are tOie most practical extracts from an exhaus- tive paper real before the Council of the College of State Medicine, by this eminent Engineer and Sanitarian, as published in the Sanitary Record of August 15, 1888:- Sound sanitarians must desire cleanliness in all things, but need not indulge in fads. A theorist, if he lets his theory become master, finds all things about him bendmng to suit his ideas. A pure theorist may be compared to a man digging himself down in a well, who, in this condition, necessarily sees less and less of the world and its ways the deeper he gets, and yet he believes he sees the whole, and so long as his fad holds him argument is of no av' .1.... ms to disease in excess during epidemic periods, we do know, by experience, that it may break out suddenly in poor, dirty, over-crowded room-tenements; and, if the great ocean passenger steamers contir.ue to load and overcrowd the steerage passenger, as at pre:senr, we may hear of a terrible mortality on some of these vessels froni foul air, dirt, bad food, impure water. and overcrowding. How is it that these fine vessels swarm with rats and other vermin ?.... PUBLIC Bxrus, DISINxFECT1N, ETc.-Some of the principal improvemnents lu sanitary science, after main-sewering, house- draining, water-supply, and scavenging, have been the establish- ment of Punuic ni-irS and WASHHOUSES with DISINFECTING AP- PARATUS. Some of these cstablishments have, however, been too grand and costly, as also placed too remote from the poor, and consequently have been failures. Washhouses and baths for.the poor should be situated in the heart of poor districts, their management should be economical, the charges the lowest, and for disinfecting beddmng and clothing, gratuitous ; any tedding or clothing requiring to be burned, to be replaced without charge to the poor afflicted sufferers, this being the truest economy for the ratepayers. Punish a man for having disease and he will shrink from you ; treat him kindly and sym- pathetically, and he will respect you.... One improvement is greatly needed in hospital arrangements -narnely, to establish cheap hospitals in the open country in",
         "pure air, where, as a.celebrated physician said, l the greatest bungler cannot kill, in place of having them in crowded parts of towns, where the most skilful surgeon cannot cure.\" Then hos- pitals for the poor should be cheap, and not on the London scale of £1,ooo per bed, plus furnishing and administration, where the cost of a poor patient's bed in interest on the outlay is more in amount than any wages the occupant ever received. SANITARY WORKS AND LOCAL RATES OF DEATHS.-It has becone usual to credit sanitary work, such as sewering, draining, and improved supplies of water, with the observed reduction of deaths in the district, and I arn not inclined to repudiate this, as I beheve that good sanitary works tend to promote comfort, prevent sickness, and prolong life ; but I also see other powerful influences at work on this great and most interesting problen ; namely, education, increase of temperance amongst all classes, better wages to the artisan workers, shorter hours of labor, cheaper food, cheaper clothing, and a wider-spread sympathy of class with class. And woe to those men who, through the press or other means, use their evil influence to set class against class, or to keep them apart. Much has been done in town sewering and in bringing in improved supplies of water, but of what benefit are these to the unfortunate dwellers in single-room tenements ? Because for their occupants, these sanitary works have no practical meaning. Water, to be of practical use, must be within the tenement, and constantly at command. There must, of course, be sink and drain to renove it. Soil-pan accommodation must be near and available, and these, as in solitary prison cells, may be in a recess to be at all times available. When tenements for horiest working men are as well provided for as cells are for criminals we shall be a wide step in advance. But single rooms for families ought to be illegal, as it is impossible to have decency with a family under such con- ditions.... To compare rates of mortality equitably fuller details must be given than are usually set forth. The site of the town, its age, its arrangement of streets and houses, the occupations of the peo- ple, their status in society, and the form of government they are under. Men are very much what their surroundings make them ; paupers perpetuate pauperism ; criminals perpetuate criminals ; and beggars perpetuate beggars, and if uncared for by the govern- ment they are born under, will do so to the end of time. State laws and regulations must er.brace every member of the State, and deal with him equitably. The idle man must be shown that to eat he must work, and the rogue that to have his liberty he must be honest. UTILISATION OF TOWN SEWAGE.-Since 1857 there have been three Royal Commissions appointed to inquire and report 'as to the best modes cf distributing the sewage of towns and applying it to beneficial and profitable uses.' Of the last Commission the Right Hon. Lord Bramwell was chairman. Of the 1857 Com- mission Sir J. B. Lawes, Bart., was a member. Urnder this Com-",
         "-219- mission experiments were carried out with sevcage in producing grass, making hay, feeding milch cows and builocks, many hun- dreds of experiments being made, and recorded in the Blue-book report then produced as to the composition of sewage, and prov- ing the wholesomeness of the milk and butter produced and the beneficial resuits in bullock feeding. In addition to these exhaustive experiments, there have been analyses and reports on town sewage by the most eminent chem- ists in Europe with one result-namely, that sewage containing excreta holds in suspension and solution manurial ingredients ot agricultural value when applied to lands, but that when precipi- tated by chemicals the process -is costly and the sewage is not purified, the abstracted sludge having no commercial value. The Metropolitan Board has paid more money to chemists and en- gineers for advice as to the best and cheapest means of dealing with sewage, and deliberately adopts the most costly and the worst. The only consolation about it being that with time the costs will be found so great and the results so inefficient that the arrangements must be abandoned, and then works approved and sanctioned by experience must be carried out. The river must in fact be purifled. To precipitate the -olids of sewage there must be tanks and machinery, and when the solids have been re- moved, the clarified sewage retains about faths of the salts of sewage, plus some of the salts of the chemicals used, so that how- ever costly and complete the process may have been, the clarified sewage, in summier weather, will ferment and become a source of nuisance so as not to be permissible to pass into any stream. The only practicable way, therefore, to free sewage froi the manure it contains is to put it in a thin film on to land over which it may flow and through which it may filter, when the surface-soil and vegetation at once combine with the manurial ingredients, the water passing away by evaporation and absorption, or along open carriers. In one hundred tons of fluid sewage there vill not be more than from one to two tons of solids which will deposit, and this will be in a finely divided state, so that spread ·over one acre of land it at once disappears. In some of the firstTormed sewage- farms it was thought necessary to allow the crude sewage to rest in tanks so as to separate the heavier solids, but this was soon abardoned, as it was proved that tanks so ûsed became putrid, and then imparted this property to the sewage, experiment and practice showing that the sooner the sewage could be passed to the land the better, as then there was, under judicious manage- ment, no offensive exhalations. I have not time in this paper to go into fuller detail, and can onlygagain remark that the Metropolitan Board will have to aban- don the costly works which they are establishing for subsidence and treatment by chemicals, and cease to barge the abstracted solids to the sea.... The Royal Commission, of which Sir J. B. Lawes was a member, came to the conclusion that town sewage might be worth to a farmer, if compelled to take it all the year round, about one",
         "-220- penny per ton. But twopence per ton miglit be paid, if only taken at intervals, in summer. The sewage of the Metropolis, valued at one halfpenny per ton, would be worth, in round figures, nearly one million pounds sterling per annum. Is it, then, a judicious process to make complicated and costly works to con- tinue a great nuisance, and waste manure when it is of so great value? ie inland towns of England have found out the value of town sewage as a manure when used in broad irrigation, as at Birmingham, Bedford, Nottingham, Doncaster, Leamington, Cheltenham, and other places. On the Continent, Brussels, Paris, Berlir, and Dantzic. .. . It is said that constant application of sewage will corrupt the land. Experiments over sixty or seventy years, and in some cases for two hundred years, disprove this, as it is found that the sewage deposit is so small in thickness, and is distributed so evenly, that it at once becomes incorporated with the natural soil and loses all taint ; the penetration of the sewage leaves all the solids in the first few inches of porous soil. There is no more corruption of the land with sewage than with other manures, as experience proves. Modern sanitary science teaches that the removal of excreta from sites of towns and of houses as rapidly as it is generated is of the first importance. And experience further proves that the inhabitants of towns must be supplied vith water for domnestic uses, this water, after use, having to be got rid of. Sewers and drains must therefore be provided for this purpose, and it has been found in practice that the drains sewers, and waste water will con- vey the excreta imperceptibly from water closets to any distance at no cost for carriage. The sewers and drains of a properly sewered town and properly drained house transmit waste-water and excreta at rates of from one mile per hour to several miles per hour, in proportion to the fall of the sewers, so that in London, if every sewer and every drain were in perfect order, the entire volume of waste-water with excreta will be out of the entire site each day. The excrefta being silentiy and harmlessly got rid of, there are street sweepings and dry house refuse to be got rid of besides, and in no case should street sweepings remain beyond the day or dry refuse beyond the week.... To have sanitarv works and cleansing arrangements in such order as shall promote comfort, prevent sickness, and prolong life, money must be expended and rates must be paid ; and where there is good local managcment, the payment of rates is the best money made by the householder. Some amiable and in other respects intelligent men, members of Parliament, have recently expressed alarm at what they call the dangerously accummulating municipal debts. I can only assure these gentlemen that they are utterly mistaken, as every farthing of every municipal debt will in time be paid, and in the meantime the public enjoy wholesome towns and houses with good streets and cheap traffic. If a debtor and creditor account were made out as to the saving in shoes, in",
         "-221--- clothes, in the use of horses and ca-riages, in transit generally, and this cost contrasted with the rates, the balance will be in favour of smooth and clean streets. SEWAGE IRRIGAToN.-In conclusion Sir Robert says Broad irrigation with fresh sewage is the only economical mode of dealing with the fduid, as the entire volume may then fdow over the land day by day without resting in the sewers or in tanks, and where this cai be done disinfectants are not required, and, if used, they will only be injurious. In crude sewage there are minerals which will warp the land, and salts which will manure it, The weight of the solids to the fluid is only as r to 99-that is, about i ton of deposit to each 99 or ioo tons of fluid. In dry weather three-fourths of the fluid evaporates, and during hçt dry summer weather the centre volume disappears, as no visible effluent leaves the irrigated land. AN INQUIRY INTO THE VALUE OF VARIOUS DISIN- FECTING APPARATUS-STEAM AND HOT AIR. A T the request of the Municipal Commission of Hygiene of Copenhagen some very careful inquiries and experiments have been made in order to ascertain the real value of the various dis- infecting apparatus. The experiments took some five months to carry through. Five varieties of apparatus, in use in the munici- pal hospital of Copenhagen, were put to the test, in addition to one of French manufacture. These represent all the principal forms suggested during the last few years. Ransom's apparatus disinfects by means of hot air; those of Ramsing and Seth by means of a mixture of hot air and steam. The cylindrical and rectangular stoves by Reck employ jets of steam, while the Irench system is based on the effects of steam under pressure. The ex- periments were made on wearing apparel and bedding as well as on microbe cultivations and the organisms of vegetable mould. The authors ascertained by these means that Ransoni's apparatus, like those of Ramsing and Seth, were powerless to effect the des- truction of any except microbes of feeble vitality. The only apparatus which gave- satisfactory results were those of Reck and of Geneste and Herscher (the French) and the latter was by far the most reliable. While the French model effected complete des- struction of all the germs present in twenty minutes, Reck's left a certain number living, even after an hour. The latest invention brought to notice (Sanitary Record, August 15, 1888) provides for a current of steam passing through the chamber continuously, either with or without pressure, and at a rate of passage that can only be obtained by assistance ; hence we are led to infer that a more perfect penetration is made through the materials under operation, and the desired results obtained in less time. But, beyond this, the new invention provides for the admission and penetration of hot air at equal speed, which will naturally leave the naterials perfectly dry and free from that odour usually given to clothing exposed to steam ; indeed the blowing of",
         "-222-- warm air into them has a7 similar action to airing wearing apparel in the dry atmosphere on a fine day, the clothes being then left sweet and ready for imiediate use... . Although many successful experiments have been made by such high authorities as Dr. Koch and his coadjutors at Berlin, by Professor Max Gruber of Vienna, and Dr. Meyer at Utrecht, proving that steam at boiling temperature does effectually disin- fect infected material, we are bound to notice the further advan- tage with greater rapidity in action of steam at a pressure showing a higher degree of temperature, as proved in the valuable experi- ments referred to. The apparatus consists of a steel boiler with disinfecting chamber combined. When in use the lower part contains water, the supply being maintained by a small hand-pump, if the town pressure is not found sufficient. The top part of the casing con- tains the steam, and is connected by suitable valves and pipes to allow it passage into the disinfecting chamber.... A special contrivance, called the exhauster, is fixed on the side, and arranged to complete a current of either steam or air to pass continually through the chamber. A small furnace is con- structed on one side of the apparatus to supply the necessary heat to generate steam, and the products of combustion are conducted underneath the steel boiler.... to a separate chamber which is open to heat the atmosphere, and is thus supplied with pure air to be heated ready for penetration inside the chamber. The apparatus has already passed the experimental stage and is in successful operation at Lowestoft and Fulhani. The surveyor of Lowestoft reported on March ioth, to the council, that he had disinfected beds, nattresses, blankets, sheets, carpets, and wear- ing apparel of almost eveiy description. with satisfactory results. The Corporation of Leicester through their medical officer, Dr Tomkins, and experiments by Mr. J. Gordon, C. E., lave thoroughly investigated various processes in use in different parts of England, and have recommended the adoption of Messrs God- dard, Massey and Warner's Disinfector (the one under notice) in preference to all others. The cubical capacity of the disinfecting chamber as erected at Lowestoft, Fulhum, and Leicester, is about one-third more in capacity than most steam disinfectors in use. The apparatus is arranged so that a division wall may be built at right angles in the disinfecting house and thus allow the clothing to be placed inside the machine in the infected apart- ment and withdrawn through the second door on the disinfected side. When required for rural districts it is constructed in port- able form upon wheels; the weight is no more than can be taken by any ordinary horse. A number of trials were recently made with the apparatus at the Leicester Fever Hospital, when the results vere highly satis- tory. Some bedding was disinfected in the presence of the chair- man of the Sanitary Committee. The steam was kept up at a pressure of 30 lbs., and registered a temperature of 261 0 F. in- side the chamber, and the materials were taken out of the machine perfectly dry.",
         "DISSEMINATION OF INFECTION BY AIR. T HE following practical extracts are from a paper by Prof. Eben Duncan, M.D., Pres. Sanitary and Social Economy Section of the Glasgow Philosophical Society, read at the Annual Meeting of the Sanitary Association of Scotland, July, 1888:- I shall begin by dividing the contagia of communicable human diseases into two classes: i. Those which are shed from the body of the patient in a dry forrn; and 2. Those which are shed from the body of the patient immersed in liquid matters. The first class comprises all those fevers in which the skin is the seat of a copious eruption, such as small-pox, typhus fever, scarlet fever, and measles and erysipelas. Of this class of fevers I observe first, that, ce/eis jbaribus, in direct proportion to the abundance of particles shed from the skin of the patient during convalescence is the danger from aerial infection in the vicinity of the patient. Secondly, I observe that in proportion to the minute- ness of these particles shed from the body of the convalescent is the distance to which they are likely to be carried by air currents, and the area through which they may be disseminated. In the diseases I have named as belonging to the first class, a susceptible person is liable to be at once infected by breathing the air of the room in which the patient is lying. There is, however, an exception to be made in the case of typhus fever. Experience in this disease has proven that if the infectious particles shed by the skin or breath of the typhus patient are exposed to pure currents of air through a distance of a few yards from the body of the patient they are so acted upon by the air as to lose their infective property. In the treatment of the other mernbers of this group, small-pox, scarlet fever and measles, we do not find that the infectious particles shed from the skin of the patient are so easily robbed of their power of self-pro- pagation. In these diseases the whole atmosphere of a house may become infective by the dissemination of infectious particles through the ordinary air currents of a house; and this even where there is such a measure of good ventilation that the standard of purity of the air, as regards its gaseous elements, is well main- tained. But even among these diseases there are differences as to the extent to which the infectious particles may be intercepted and prevented from being spread by the air currents throughout the atmosphere of a -.-\u003euse. In the case of scarlet fever, by isolating a patient in the top flat, and arranging wet sheets at the door of the sick room so as to intercept the particles of infectious matter which tend to escape into the passages when the door of the sick room is opened, I have usually been quite successful in preventing the spread of that disease to the other inmates of the house, who were limited to the lower flat. But in measles I do not believe that any such precautions as I have found to prevent the spread of scarlet fever in a household will ensure the same safety in the treatment of a case in the upper flat of a dwelling in which there",
         "-224- is a direct communication by an open staircase between the flats. I can speak with some confidence on this point, b::cause I have frequently had the opportunity of making a comparative trial, and failed in the neasles to limit the disease to the first affected member of the family, and this even in cases where there was no communication between the members of the family in the early stage of the case before the occurrence of the measles rash. I think the comparative fineness and lightness of the particles shed from the skin of the measles patient may accourit for this difference. These fine particles are not so readily intercepted. There are no facts on record which enable us to decide with certainty how far the infective particles of measles and scarlet fever may be carried through the air without losing their infective properties, but what I do know of the spreaO -f these diseases leads me to believe that they speedily lose the power of infecting in the open air. There is no evidence on record to show that they can retain their virility for any distance in the open air. In the case of small-pox we have facts recorded which justify us in saying that the infective particles shed from the skin of the small-pox patient can be carried by air currents not only through- out the whole atmosphere of a dwelling, but for considerable distances around the dwelling without losing their nfectiv proper- ties. The observations of Mr. W. H. Power on the influence of the Fulham small-pox hospital on the neighborhocd surrounding it, seems to me to justify the opinion which he expressed in his reports to the Local Government Board that \" There is evidence, alike from the experience of 1881 and of 1884, that small-pox has on occasions spread round the hospital to houses at aIl points of the compass in such a way that its spread cannot be accounted for unless its contagiui has been conveyed through the general atmosphere.\" The facts recorded in these reports seem to prove that the infective particles of snall-pox may be carried for at least a mile through the general atmosphere without losing their infective properties. We shall now pass on to consider the second class, i.e., those communicable diseases, the infectious particles of which are usually shed in the liquid or semi-fluid discharges from the throat, stomach, or bowels of the patient. The principal members of this class met with are: Typhoid fever, cholera, diphtheria and tubercular disease of the lungs. The possibility of aerial dissemination of the infective particles, by air currents, in these diseases, depends on the drying up of the liquid matters and the dissemination of their contained particles in the form of dust. As long as the infective matters shed fron patients suffering from such diseases remain in the liquid form, there is no danger of infection by breathing the air in the vicinity of the patient. . . . The real reason why smells from fresh typhoid excreta do not produce disease is that the gases which produce these smells do not carry with them the infective particles; and the true reason why they do become infective after the lapse of time is",
         "that it is only after the lapse of some time that such a mass of liquid matter as a typhoid stool can dry up so as to permit cf the dissenination of its solid particles in the form of dust. We are also able to explain, in this way, the comparative rarity of infection of the nurses and attendants in cases of typhoid fever, and the well grounded confidence which the medical practitioner has in his ability to treat such cases in private houses without danger to the other inmates. The nature of the infectious discharges renders it necessary to remove them at once frcm the sick room. Iii my experience, it is only irx cases where there is such profuse diarrhoea that the patient's linen and bed clothes becomc saturated with these matters that there is any real danger of infection to the attendants. In that case, unless these articles of clothing are at once removed and disinfected, infection is facilitated by the rapid drying up of the infectious material on these articles and its dissemination in the form of dust. I have never seen aerial infection from typhoid fever in a sick roon except under such circumstances. Froni the same cause, there is danger in the vicinity of ashpits and privies, into which such discharges are thrown. . . . The observations which I have made with regard to typhoid excreta apply with equal force to the other members of this group, and the theory that it is only when dried that they have any chance of bein: carried by air currents explains the well known fact that when they appear in ah epidemic form they are now always traced to a contaminated water supply or to a contamin- ated rnilk supply, and not to propagation by personal contact. How far can the infective particles of these diseases be carried by air currents without losing their infectiveness ? and how long can they retain their infectiveness after exposure to the air? These are very interesting questions, but except in the case of typhoid fever I do not know of any recorded facts on which Io found even an approximate opinion. With regard to typhoid excreta, I know froin my own observation that they can be frozen up for several weeks and still ritain their infective properties. With regard to exposure to heat, there is a case recorded by Dr. Beecher in the appendix to the report of the Army iiedical Department for 1868 which seens to indicate that the germs of enteric fever adhering to the walls and ceiling of an unoccupied room in the Fort at Gwaliar in India, in which a person died of this disease, retained rheir infectiveness for at least six weeks. This case, the writer says, \"Seems to indicate that the typhoid poison may adhere to walls, may be undestroyed in a month even with free ventilation, and is not rendered powerless by a high temperature.\" There is, therefore, ground for believing that as in the case of dust particles of small-pox, so dust particles of typhoid excreta may be carried for long distances, possibly miles, by aerial currents without losing their infectiveness. There is also some reason to suppose that the dried particles of the contagious matter of cholera and diphtheria may be carried for long distances in",
         "open air currents without Ibsing their infective properties. A consideration of all the recorded facts of the dissemination of disease particles leads me to the conclusion :- First, That as long as these particles are immersed in liquid media they are innocuous, unless the liquids which contain them gain access to water supply or to the food supply. Sccondly, That when such infectious matters, whether belonging to the first class, with dry germs, or to the second class, with wet germs, are emptied into a water closet and washed into the sewers, they are not likely to be carried back into the houses by the air currents of the sewers, even where the house drains and soil pipes are untrapped. I would guard myself, however,,from asserting that such an occurrence may not happen, although in Glasgow there is a sngular absence of proof that it does happen. Thirdly, Where the house drains and soil pipes are properly trapped with water traps, no currents of sewer air can carry back infectious particles unless they force the trap, an occurrence which should be impossible in the case of properly constructed sewers and house drains. In conclusion, I wish to guard myself from misconstruction, by stating that I am strongly of the opinion that it is a dangerous thing to breathe an atmosphere habitually tainted with sewage gases. It leads to more serious and lasting evils than the passing outbreak of a specific disease. I.believe that the breathing of an impure atmosphere, although not the cause, is one oj the most imfportant factors in the production of the numerous organic degenerations, of which tubercular disease of the lungs may be taken as the type. THE NEW NATIONAL QUARANTINE LAW. As AcTr Tro PERFEcT THE QUARANTINE SERVIcE OF THE UNITED STATES. B E it enacted by the Senate and H ouse of Representatives of the United States of America in Congress assembled, That whenever any person shall trespass upon the grounds belonging to any quarantine reservation, or whenever any person, master, pilot, or owner of a vessel entering any port of the United States, shall so enter in violation of section one of the act entitled \"An Act to prevent the introduction of contagious and infectious diseases into the United States,\" approved April twenty-ninth, eig hteen hundred and seventy-eight, or in violation of the quaran- tine regulations framed under said act, such person, trespassing, or such master, pilot, or other person in command of a vessel, shall, upon conviction thereof, pay a fine of not more than three hundred dollars, or be sentenced to imprisonment for a period of not more than thirty days, or shall be punished by both fine and imprisonment, at the discretion of the court. And it shall be the duty of the United States attorney in the district where the misdemeanor shall have been committed to take immediate",
         "-227- cognizance of the offence, upon report made to him by any medical officer of the Marine-Hospital Service, or by any officer of the customs service, or by any State officer acting under authority of section five of said act. SEC. 2. That as soon after the passage of this act as prac- ticable, the Secretary of the Treasury shall cause to be established, in addition to the quarantine established hy the act approved March fifth, eighteen hundred and eighty-eight, quarantine stations as follows: One at the mouth of the Delaware Bay; one near Cape Chr-les, at the entrance of the Chesapeake Bay; one on the Georgia Coast; one at or near Key West; one in San Diego Harbor; one in San Francisco Harbor; and one at or near Port Townsend, at the entrance to Puget Sound; and the said quarantine stations when so established shall be conducted by the Marine-Hospital Service under regulations framed in accordance with the act of April twenty.ninth, eighteen hundred and seventy- eight. SEC. 3. That there are appropriated for the purposes of this act the following sums, out of any money in the Treasury not otherwise appropriated, for the construction, equipment, and necessary expenses for maintaining the same for the fiscal year ending June thirtieth, eighteen hundred and eighty-nine. For the Delaware Breakwater quarantine: Construction of disinfecting machinery, steam-tug, warehouse, officers' quarters, and expenses of maintenance for the fiscal year eighteen hundred and eighty-nine, sevency-five thousand dollars. For the quarantine station near Cape Charles, Va.: For the purchase of site, construction of wharf, repair of present hospital buildings and officers' quarters, disinfecting machinery, steam-tug, expenses of maintenance for the year eighteen hundred and eighty- nine, one hundred and twelve thousand dollars. For the South Atlantic Station (Sapelo Sound): Construc- tion of disinfecting machinery, warchouse, wharf, small boats, and expenses of maintenance for the year eighteen hundred and eighty- nine, thirty-eight thousand five hundred dollars. For the quarantine near Key West: Purchase of site, con- struction of disinfecting machinery, warehouse, small boats, steam- tug, hospital buildings and officers' quarters, expenses of main- tenance for the year eighteen hundred and eighty-nine, eighty- eight thousand dollars. For the Gulf quarantine (formerly Ship Island), provided for by the act of March fifth, eighteen hundred and eighty-eight, in addition to the amount appropriated by the act approved March fifth, eighteen hundred and eighty-eight: For the expenses for the year ending June thirtieth, eighteen hundred and eighty-nine, fifteen thousand dollars. Quarantine station, San Diego Harbor, California: For the purchase of and the construction of disinfecting machincry, ware- house, small boats, hospital buildings, officers' quarters, and for expenses of maintenance for eighteen hundred and eighty-nine, fifty-five thousand five hundred dollars.",
         "For the quarantine station at San Francisco, California: Hos- pital buildings and officers' quarters, disinfecting machinery, ware- house and wharf, stean)-tug, small boats, expenses for the fiscal year eighteen hundred and eighty-nine, one hundred and three thousand dollars. For the quarantine station at Port Townsend: For the purchase of site, construction of disinfecting machinery, ware- house, snall boats, hospital buildings and officers' quarters, for expenses of maintenance for the fiscal year eighteen hundred and eighty-nine, fifty-five thousand five hundred dollars. Approved August 2nd, 1888. ON SE\\WAGE DISPOSAL FOR WATER-CLOSET TOWNS. AUsTR.\\cr OF PAPERS READ IN THE SECTION OF PUBLIC MEDICINE AT THE ANNUAL MEETING OF THE BRITISH MÍEDICAL ASSOCIATION EN I.ASGOW, AUGUST, 1888. BY A.FRED CARPENTER, M. D. IT having been determined that \" The Disposal of Sewage \" be one of the subjects for consideration at this meeting, I think it right not to allow the most correct way of dealing with sewage to be put out of sight, because of its simplicity. It is twenty-two yeais since I introduced a method of treating town sewage to the notice of an assembly of men of science, specially called to con- sider the subject of town drainage. I have repeatedly followed up the sanie subject at various meetings of scientific, niedical and sanitary bodies, always dwelling upon the points connected with the utilisation of sewage on land by so-called \" broad irrigation.\" At the International Congress assembled in London in SS, I submitted in general'terms a series of propositions for the consider- atior of the congress, and I now venture to re-state them for the consideration of this meeting in terms more explicit and detailed. i. That the application of the sewage of a water closet town to land in close proxiiity to dwelling-houses is not injurious to the health of the inhabitants of those houses, provided the sewage be fresh ; that it be applied in an intermittent mranner, and the effluent be capable of rapid renioval from the irrigated fields. 2. The judicious application of sewage to soil of almost any kind, if it be mainly inorganic, will satisfactorily cleanse the effluent water, and fit it for discharge into any ordinary stream, provided the area trèated is not less than an acre for each 250 persons. 8. That vegetable products grown upon fields irrigated by sewage are satisfactorily and safe as articles of food, for both animals and man. 4. That sewage farms if properly managed do not set up either parasitic or epidemic disease aniong those working or. the farn or aniong the cattle fed upon its produce. 5. That this inmmunity exists because the conditions neces- sary for the propagation and continuance of those disease germs which affect man and animals are absent, the microbic life on",
         "-229- sewage farms being antagonistic to the life of disease germs, the latter, therefore, soon cease as such to exist. 6. That sewage farns may be carried on in perfect safety close to populations. It is not, however, argued that the cffluent water is safe to use for dietetic purposes. 7. That there is an aspect in sewage farming which shows that it is a wise policy for the nation to encourage that form of utilisation from a political eccnony point of view. 8. That to be financially successful such farnis require that the rainfall be separated from the sewage ; the area large enough for alternate cropping, and the capital enployed sufficientto insure a continous and rapid consuniption of the crops produced. 9. That if practicable sewage utilisation by surface irrigation should be, for financial reasons, within the area of its own water- shed, and close to the populations producing the sewage, but it is not a necessity that it should be so, provided it be applied to the land within a few hours, not more than twelve, of its discharge, and that there is no arrest of niovement for more than very short periods before it is so utilised. i. The utilisation of sewage has been carried out on the sanie land consecutively for thirty years, frequently in a bungling man- ner, the area however, being increased as the increase of popula- tion required it. Commencing with thirty-six acres only in iS5, it was all but abandoned as an incorrect proceeding, because the quantity of sewage applied was in excess of the power of the soil to deal with it. Three hundred acres were then obtained about the time that I first becane connected with the farm. These have been increased by new purchases as the quantity of seiyage to be applied from increasing population rendered it absolutely neces- sary to enlarge the area of application, but the land irrigated for the flrst time thirty years ago still continues in use, and effects its object as perfectly as on the first application. The subsoil of the larm two feet below the sarface shows very little alteration, and three feet below is not in any way contaminated by the continued application of sewage. The various crops grown upon the land take out the manurial properties of the sewage, and allow the soil to continue its purifying power even better than at first. To effect this, however, it is necesary that the cropping be incessant and that the land have occasional rest for a year from sewage application. The tendency of the repeated applica- tioû of sewage to land is to silt up the lower portion of the subsoil and prevent it acting as a filter below the plough level, except for a short tiie. It follows, therefore, that the sewage niust pass over the land rather than through it,-and although intermnitted downward filtration may purify the water, t will be teiporry only, unless the soil is turned over frequently, so as to allow of its acration. A sewage farn will bear deep plough- ing better than other land, and grow larger crops in consequence. 2. The second great fact is that notwithstanding the very large price paid for the land at Beddington and Norwood, namely sonietimes as much as £300 an acre, or more for some of it, and",
         "-230-- a total cost of nearly £2'5o,ooo, it has seldom been necessary to make more than a 2d. rate upon the parish to meet all the charges required to be met. The capital raised is now being paid off, but not lost, and in forty'years from the last loan, the whole farm will be the freehold of the borough. Let me take the propositions in turn i. As to the effect upon health. I showed that in iSSi the average death.rate for ten years for the Beddington and Wallington district was 14.3. I reproduce the tables with additions up to the present time. The deaths have not exceeded in number those in 1881, although the population has risen very considerably, and the births are twenty more than in that year. The rateable value of the district in 1861 was £1 i, 700, in 1871 was £2o,671, in ISSI was £41,616, and this year it is returned in the report to Survey County Quarter Sessions as -47,424, a tangible evidence cf the increase of wealth and popula- tion around the sewage farm, whilst the zymotic death-rate last year is o.5. only, and the average on the last seven ysars is only 1.2. As regards its effect upon the health of the borough of Croydon, I showed in iSSi that the average death-rate for the borough was 17.9, and the zymotic death rate 2.79. In 1886 it was 14.5, and the zymotic death-rate 1.53. In 1887 it was 14.7 and 2.2 respectively, the dry summer increasing the diarrhoa anong infants.... 5. The fifth proposition is an important one. It is difficult to prove a negative. I assert that disease gerns are of two kinds, corresponding with active gerns and resting spores, eggs hatched and 2rowing, and unhatched. The hatched eggs are rapidly destroyed by the physical conditions under which they arrive at the farn ; exposure to air, a lower temperature than that necessary for warm-blooded creatures, absence of pabulum, and presence of injurious gases soon destroy their Fie, but the resting spores (unhatched eggs) are more persistent. They certainly arrive on the farm, and it might be expected that they svould do mischief, and so they do (and would) if the sewage is not immediately applied to the land. But then, if arrested, Nature comes to our rescue and destroys theni by the sulphuretted hydrogen which is engendered as soon as putrefaction is rampant ; but putrefaction destroys the chance of a satisfactory financial return from the use of the sewage, and it is not to be encouraged. As soon as-the resting spores cone in contract with the spongioles of plant life they are taken up with avidity, and taken in as food most ener- getically, much as human beings take in oysters when they get the opprotunity. Sone classes of plants, which I have presumed to name \" carnivorous,\" among which I place rye grass, do assimilate these gerns in the most rapid and satisfactory manner, so that no particle escapes their devouring power, tad the effluent, as far as my observation goes, is absolutely free fiom their presence. The corporation of Croydon have at .his moment an estate of more than 700 acres, purchased for sewage farm purposes. Its",
         "-231- agricultural value has been raised five tinies over since it has been so utilised, its power to employ labour correspondingly multiplied to the advantage of the tradesmen and owners of cottage property in the borough, whilst the heusewife has the choi:e of so much more milk and meat than would have the case if no farm had existed. Let these conditions be established in five hundred other districts in the kingdom, including Londorn, and pauperism will be correspondingly lessened, because so much more labour will be provided, at least 40,000 agriculturalists kept on the land, who are not employed, the price of mii!! kept down, whilst thousands will have it who cannot have it now, and a mass of wealth added to that belonging to the country, which ought to recommend sewage farming to all political economists, who study production and its effect upon population. Dr. C. R. Drysdale, in a paper, contended that the only rational and satisfactory way of treating the sewage of cities and restoring the rivers to their original purity was by the method now used in Berlin, Paris, Croydon, Birmingham, Nottingham, and elsewhere, that is, agricultural utilisation on suitable areas and soils. This was the only scientific way, and moreover the only method compatible with economy of food supplies The Metropolitan Board of Works was a glaring instance of vant of all plan in this question. The sewage farn at Paris at the plain of Genneviliers had gradually become a most important experiment since the late enpineer, M. Dufand Claye, alter studying sewage farms in England, abandoned the chemical plans as hopeless, and com- menced to experiment with sonie acres with the fluid sewage. At present ôoo hectares, or 1,5oo acres, were irrigated with the sew- age of Paris, and 20 millions of cubic metres of the sewage were annually used. The prosperity of the plain of Gennevilliers, which was cultivated by snall proprietors, and also its salubrity, had been greatly increased ; for, in the five years ending 1887, the popula- tion of the plain had ircreaEed 34 per cent, and the annual rental of the land increased from 90 to 450 irancs per hectare. The Parisian authorities had been so convinced of the success of this experiment that the remaining portion of the Parisian sewage was soon to be utilised on about 3,ooo acres at Achères, and there was also to be further irrigation by the sewage at the east end of Paris. The amount of niarket-produce obtained on the faris at Gennevilliers was quite remarkable, such as 40,ooo heads of cabbages per hectare (16,ooo per -,cre) and iooooo kilos of beet per hectare (40 tons per acre). The peasants raised a gross ;alue of from £120 to £400 per hectare from the land annually. Vegetables of aill kinds grown for the Parisian markets, and m dry seasons a great portion of the supply was obtained on the carefully cultivated market-gardens.... The Berlin sewage farns employed 2,056 persons and were a great success. The cities of Berlin, Dantzig, and Breslau, with an aggregate of about two million inhabitants, had had excellent sewage farms for the last fifteen years. Berlin had now under sewage irrigation 16,657 acres on the north, north-east, and south of the city. The lengths of the",
         "conduit-pipes used to convey the sewage to these farms from the various districts of Berlin varied from 964 mètres to 18,628 mètres. So perfectly healthy were the farms that convalescent homes had been erected on them. The persons employed on the farms con- sisted of 40 officials, 45 gardeners, smiths, and dairymen, 480 male and 125 female labourers, 966 workhouse hands, continually employed, and 360 men, women, and children, employed from April to October. In one week in October, 1787, 30,000 cwt of cabbage were sent by rail to Berlin from only one of the farms at Osdorf. In 1885 there were about 275 hectares under root crops, 91 under hemp, 1,625 under wheat and other cereals, 44 of peas and beans, 138 under fodder, 696 under pctatoes, cabbages and, the like, 77 in nursery gardens, 1,:67 under meadowland and pasture. On March 31st, 1886, the capital borrowed by the sewage irrigation authorities of Berlin appeared to have been £3,21 1,138 whilst Sir R. Rawlinson had said, at the Society of Arts in 1887, that the sewage experiment at London would cost ten millions sterling for no purpose and no benefit to agriculture. In 1887 Dr. Collingridge, the Medical Officer at the Port of London, said that the condition of the Thames was as bad as ever in spite of the chernicals ; and calculating the value of London sewage with a population of about four and a quarter millions, it had been said it should be worth a £1,oooooo a year and that it might raise fodderenough to feed 2oo,ooo cows annually and thus give milk to London children. Mr. Bailey Denton, an engineer of reat experience, and Colonel Jones,of Wrexham a sewage farmer himself, had a project to convey the London sew- age to an island, Canvey island, 20 miles beyond Barking, where it might be partly utilised on 415,000 acres of land, and the pipe might be tapped on the way and irrigate thousands of suitable acres in Essex, etc. Canvey Island was about 35 miles from London Bridge, and it was calculated that, with a current of three miles an hour, the sewage would reach it in 12 hours. Dr. T. J. Dyke, Medical Officer Urban and Rural, Merthyr Tydfil, said that in iS7 the Local Board of Health of Merthyr Tydil entrusted to Mr. J. Bailey Denton, C. E., the employment of the best known method of disposing of the sewage from the resi- dence in Merthyr, Dowlais, etc. Mr. Denton advised the adoption of the process of Dr. Edward Frankland, known as the Downward Intermittent Filtration process. A site:was chosen at Troedyrhiw, three miles below Merthyr, on the west bank ot the Taff River : there on a gravelly soil Mr. Denton formed filtration areas on sec- tions of land, by deep drainage, levelling of surface, and provision of an efficient outlet for the effluent water. Each area or section .-as flooded with strained sewage for six hours, and allowed to rest, to drain, and to be aerated for eighteen hours. The work was completed in the spring of 1881, and thenceforth from one to three hundred thousand gallons of the strained liquid has daily been passed over and through the soil of the twenty acres of land so prepared. The surveyor, Mr. Harpur,and the superintend- ent, Mr. Baltram, concur in stating that the work has been",
         "-233- carried on without any injury to health ; that the land continues to act as perfectly as at the commencement in clarifying the sewage liquid, that the effluent water is perfectly clear and odourless, that there has been no \" clogging \" of the soi], no bogginess of the surface, and that during the year 1886 and 1887, the work of the farn has been carried on at a profit. The Board had, previously to the adoption of Mr. Denton's plan, obtained powers to take land situate nine miles from Merthyr for the disposa] of sewage by wide irrigation. In 1872 and following years, the surveyor to the Board laid out 262 acres of land, and adapted the surface for this method of disposing of the sewage. The land waý regularly drained, by drains cut three feet deep, the sewage allow- ed to flow along contour lines over the whole surface. The amount during the last four years, which was daily so disposed of, anount- ed to a million and a quarter gallons. The quantity was the out- cone of the excess of sewage not utilised at Troedyrhiw, and the sevage fron Merthyr Vale and Treharris, in the valley of the Taff fromn Aberdare, Mountain Ash, and Penrhiwceiber in the valley of the Cynon, west of Merthyr. Poth the surveyor and superin- tendant of the farms state that this process is carried on without any detriment to health ; and with regard to returns for labour and ma/èrid, that a fair profit has resulted. The total population on the several towns and villages connected with these sewage farns would be not less than ioo,ooo. The total estimated dry weather sewage, 1,350,000 gallons daily, was disposed of on 282 acres of land, prepared by either the filtration or the irrigation method. The crops grown on the lands were, ordinary grass, italian rye grass, potatoes, cabbages, mangolds, swedes, etc. These vegetable growths were perfectly healthy and sound,.... Dr. Wm Whitelaw, Medical Officer Kirkintilloch, said : The works at Dryfield consist of a storage tank, a distributing and screening tank, and the various channels and conduits connected therewith, and several filtration beds, covering at \"present an area of nine acres. The storage tank referred to is situated at the end of the low-level sewer, and holds 107,000 gallons. The principal object of the tank is to store the sewage passing down the low-level sewer during night, and in this way to restrict the operation of pumping to the ordinary working hours. With sufficient machinery the pumping can be limited to two or three hours in the morning and two or three hours in the afternoon, leaving the tank eipty to receive the night flow .... After passing through the screening tank, the sewage will be directed by a number of sluices into the various distributing channels, and by thern carried to the filtering beds. These consist of twelve plots of ground, averaging three- fourths of an acre of area in each, there being four plots in the length, and three in breadth of the fground occupied. Each plot has had its surface brought to a perfect level, and as the ground originally sloped slightly to the river Kelvin, the plots in each division rise:in terraces one above the other. The main sewage- carrier is laid along the upper edge of the filtration area, and branch carriers are laid down between each set of plots, provided",
         "-234- with valves opposite the end of each, so that the sewage may run on to the surface of any one or more as required. The whole ground, wvhen finally prepared by spade-work, forms a series ot ridges and furrows. The sewage lows along the furrows, which retain solid matter ; and a drain laid at a depth of fully six feet is laid along the top of each terrace, to intercept and carry off the effluent. Here the effluent is small and unobjectionable. These subsoil drains lead to a main outfall discharging into the Kel- vin .... Dr. Littlejohn gave a de cription of the disposal of the Edin- burgh sewage, and hle pointed out both the northern and southern watersheds had been drained into iron pipes and the sewage car- ried out to sea, while the old town had for the last two hundred years disposed of its slop water, and ultimately of its sewage, on a sandy waste now well known to sanitarians as the Craigentinny Meadows. This sewage farm was so well managed financially, as frequently to have a revenue of f40 per acre, but at the same time was laid out in a most imperfect manner, and in the hot months became a source of nuisance from the bad odcurs. Such complaints could easily be removed by a little attention to the manner of disposal of the sewage. These meadows had no in- jurious efflect on health of the sparse population of Edinburgh. He could not but regret that so much valuable manurial matter was cast into the sea when the evidence as given by previous speakers vas so strong of the advantages to be gained from the direct application of the sewage to the land. Dr. N S. Davis (Chicago, U. S. A.) said Chicago had made investigations to carry the sewage of 750,000 inhabitants through canals into the Illinois River and thence into the Mississippi River. Several years since the city spent 3,000,000 dollars to deepen the Illinois and Michigan Canal to carry the sewage into Illinois River but it was found to accompilish the work very imperfectly, while it so con'taminated the river water that fish perished, and the in- habitants conplained more or less for roo to 150 miles distant in the central part of the State. Yet at times much of the sewage was washed into the lake, and contaminated the water which formis the drinking supply of the city. In order to get over the difficulty the city tunnelled for three miles under the lake to take the water from a part of the lake still uncontaminated. All the inquiries were still being directed to methods of disposal into the rivers and water- courses which Dr. Davis did not believe safe. The only reliable method, in his opinion, was to return the manural matters back to the soil. One suburban town called Pullman, owned by Mr. Pullman, of sleeping-car fame, disposed of its sewage by irriga- tion. It was carried out three miles before being applied to the soil. This experiment of Mr. Pullman had been quite successful. Dr. Davis advocated that all the sewage of the large American cities should be disposed of on the available lands to be found within fron ten to forty miles of their borders. Lt Col. ALFRED S, JONES, C.E., expressed his pleasure in hear- ing the President's paper regarding Edinburgh, as he (Colonel",
         "-235- Jones) had been appealing to the Craigentinny Meadows for the last twenty years as the parent of sewage farming. He quoted the case of Wrexham, a town of 12,ooo population, which has utilised its sewage, for the last sixteen years within half a mile of the town. He had been tenant of the farm with the obligation of purifying the sewage and gained the £1oo prize offered by the Royal Agricul- tural Society of England for the best managed sewage farm in 1879. All his accounts for seven years were published in the Journal of that Society. Wrexham was now so satisfied with the sanitary results of sixteen year's irrigation at its gates, that it was not afraid to purchase 200 acres two miles lower down the brook which led the effluent into the River Dee. COMMUNICABLE DISEASES COMMON TO MAN AND ANIMALS. N 0 subject engaging the attention of physicians or others interested in the public health, at the preseut time, is of greater importance than this one, of the communicabiity of diseases from domestic animals to the human family. As the British Medical Journal recently stated, \" that domestic pets are capable of taking and spreading infection has been amply demonstrated. The sanie may be said of domestic animals which are not pets ;-from cows, especially, and from horses. And that animais are not only capable of contracting many of the infectious diseases common to mankind and of communicating them to each other, but that they may communicate the sane to man, seems also to be very clear. While it has been long known that hydrophobia and glanders, and suspected that the tubercular and some other diseases, are transmissible from animals to man, it appears it is only recently believed and fairly demonstrated that the sanie is the case with regard to scarlet fever and diph- theria. Wth the view of bringing the subject before this Association and perhaps obtaining further evidence bearing upon it I have brought together a few recently published facts which may also prove of interest and value to the Association. A SoRE THROAT EPiDEriic FRoMi MILK SUPLY.-The following is a condensed report of an epidenic of sore throat in Edinburg and its relat on to the milk supply, from the British Medical Journal of Ju ý 9 last:- At a meeting of the Edinburgh Medico-Chirurgical Society, in June, Dr. G. Sims Woodhead and Mr. J. M. Cotterill read a paper on a curiously limited epidemic of sore throat, and suggest- ed a relationship with the milk-supply. Mr. Cotterill was called to attend successively a large number of cases of sore throat occurring in an educational institution in the city. The grouping of thecases raised the suspicion of infection from a common source, and, after careful exclusion, Mr. Cotterill came to the",
         "-236- conclusion that the mi'schievous factor was to be found in the milk-supply. This was accordingly suspended, when the sore- throat epideniic quickly disappeared. When the milk was recom- menced, sore throats of a similar character appeared again. Then all the milk was boiled before use, when the epidemic similarly yielded. Dr. Woodhead's attention was accordingly called, and he instituted a careful examination into the condition of the cows from which the milk-supply in question was obtained. Most of the animals showed unmistakable signs of cow-pox in the scab stage. One cow, which had been separated fron the rest as specially healthy, and whose milk was devoted to the use of a hand-fed child, showed similar appearances. On inquiry, it was discovered that the child too, as well as other persons who had partaken of the special milk, suffered likewise from a similar sore throat. The clinical evidence thus appeared strongly to support the view that the milk was the medium of infection from the diseased animals. Dr. Woodhead then undertook a series of cultivations and inoculation experiments. He examined the matter from the teats of three of the diseased cows, and found streptococcus pycgenes in all; further, a very snall bacillus in the discharge from two, and several other organisms in that from one. In the matter from the tonsils lie discovered the streptococcus pyogencs, the slender bacillus, and a very small micrococcus. In two intances there was found, in addition, the short thick bacillus. By cultivation from these and froin the milk, no less than fourteen distinct organisms were separated. Of these four were common to the milk, to the discharge from the sores, and to the tonsils, while seven were found cominon to the milk and the sores. DIPHTHERIA INTERCOMMUNICABLE BETWEEN CIIILDREN AND CATS.-In a report on a recent sustained prevalence of diphtheria in Enfield, England, (Sanitary Record, June i5, '88), Dr. Bruce Low, of the Medical Department of the Local Govern- ment Board, incidentally states that during the continuance of the epidemic cats were observed to suffer in considerable numbers from illness; and in December, 1887, and January, 1888, there was a large mortality among those animals, so much so that the attention of the dust contractor was directed to it. He stated that never in his previous experience had he seen so nany dead cats in the dust heaps. Some households, seeing their cats ill, destroyed them. Though there were no known cases of diph- theria occurring in the practice of the veterinary surgeons at Erifield, yet they saw many cases of 'influenza' at this this time among animals. The following is an illustration of the possible connection between diphtheria in children and in cats: A little boy was taken ill with what turned out ultimately to be fatal diph- theria. On the first day of his illness he was sick, and the cat, which ivas in the room at the time, licked the vomit on thefloor. In a few days (the child meanwhile having died) the animal was noticed to be ill, and her sufferings being so severe and so similar to those of the dead boy, the owner destroyed her. During the",
         "-237- early part of its illness this cat had been let out at nights in the back yard as usual. A few days later the cat of a neighbor, w'ho lived a few doors further off, was noticed to be ill. It had also been out in the back yards at night. This second animal, which, however, recovered, was the pet and playfellow of four little girls, who, grieved at the illness of their favorite, nursed it with great care. AIl four girls developed diphtheria, their mother being convinced that they got it from the cat; and, indeed, no other known source of contact with infection could be discovered. It is easy to imagine cats catching an infectious illness like diph- theria, says the Sanitaiy Journal, when we remember how often milk and other unused food from the sick room is given to the cat, or by some people thrown out in the back yard for the bene- fit of the neighbor's cats, if they have none of their own. DIPHTHERIA FRont FowLs.- -In the HEALTH JOURNAL of June last there were some notes of cases from an article in The St. Louis Courier of Medicine, from which it was very apparent that this disease may be communicated from fowls and turkeys, to which I shall here but briefly allude. A physician, named Men- zie, observed at Naples an epideniic of diphtheria which attacked the family of one of his colleagues. Of five children four were attacked and died ; then the epidemic extended to others. He attributed this epidemic to the water, washed from the flat roofs of the houses on which flocks of fowls, turkeys and pigeons lived and roosted, which the patients drank. The servants had been forbidden to use this water for ccoking or drinking purposes, but disobeyed. The one of the five children which did not take the disease, did not drink of the vater. A boy, aged seven years, living in a house opposite, drank warer from the same well, and was also attacked with diphtheria and died. In another house there was a large dove-cote; ail the ordure from its occupants found its way into the well. Among the dwellers in that house a lady and four of five children died. An epidemic is recorded by one Parlinis whicb presents almost the conditions of a laboratory experiment. It ravaged an island on which there had previously been no case of diphtheria; it was brought there by sick turkeys which died of diphtheria clearly and well developed ; some days later diphtheria attacked the children and rapidly extended over the whole island. But here it was the water, which served as the carrier of the virus, not the air. The epidenic lasted five months and of a population of 4,ooo attacked 125, 36 of whom died. Much evidence has been published in medical journals and in this JOURNAL showing the probability that this disease not infrequently arises from manure heaps; from the infection, it would seem, of animals. INTERCOMMUNICABILITY OF SCARLET FEvER. -Relative to scarlet fever and what has been called the Hendon Cow disease, the latest appears to be that published in the HEALTH JOURNAL of June, the chief points of which I shall here but-briefly notice : Dr. Buchanan in the Annual Report of the Medical Officer of",
         "-23-- the Local Government Board, of Great Britain, for 1887, thus formulates the present evidence on this point : i. The disease in man and in the cow alike is characterized by closely similar anatomical features. 2. From the diseased tissues and organs of man and cow alike the same micrococcus can be separated, and artificial cultures can be made from it. 3. These subcultures, no niatter whether established from man or cow, have the property, when inoculated into calves, of producing in them every manifest- ation of the Hendon disease, except sores on the teats and udders ; no doubt for the reason that the milk apparatus is not yet devel- oped in calves. 4. But-and this I learn from Dr. Klein's later observations while this report is in preparation-the subcultures made from human scarlatina and inoculated into recently calved cows can produce, in those cowis, along with other manifestations of the Hendon disease, the characteristic iccr on the teats ; ulcers identical in character with those observed on the Hendon farm. 5. The subcultures established either from the human or the cow disease, have an identical property of producing in various rodents a disease similar in its pathological manifestations to the Hendon disease of cows and to scarlatina in the human subject. 6, Calves fed on subcultures, established from human scarlatina. obtained the Hendon disease. 7. Children fed on milk from cows suffering under the Hendon disease obtained scarlatina. \"The above combine,\" says Dr. Buchanan, \" to form a mass of evidence to show that the Hendon discase is a form, occurring in the cow, of the very disease that we call scarlatina when it occurs in the human subject.\" Dr. J. B. Russell, the able Medical Officer of Health, for Glasgow, who visited this continent two years ago, has issued a report on an outbreak of scarlatina at Garnethill which bears very strongly on the saine question. After a careful house-to-house visitation of the district lie found that therewere ninety.five cases in al), and that each of these cases obtained milk from the one dairy. All the cases lad fallen ill since March 15th. The milk was, therefo)re, the obvious medium of infection. Further investigation led to the suspicion that the milk in this dairy had come froim a farm at which there had been a case of scarlet fever. The son of a farmer who brought in the milk was seized, on March 23rd, with the first symptoms, and the byreman, on March 24th, was seized with sore throat. No other person had been ill. With the view of answering the question: Did the milk derive its infection from the cow ? as in the Hendon case in 1886, Dr. Russell and Mr. McCali, veterinary surgeon, carefully inspected the stock. Two cows were found with scabbed soreF on the teats. One of these was miserably thin and mangy-looking, casting its hair and skin; the other was in good condition, not casting its hair, and the sores on the teats bled frcely. These cows were removed to the Veterinary College for observation. A calf fed on the milk of those cows was almost at once seized with a highly febrile illness, which nearly killed it, but from which it is now (May 5th, 1888, -Brit. Med Jour.) recovering with loss of hair and copious casting of the skin.",
         "-239- INTERCOMMUNICABILITY oF TUBERCULAR DISEASE. Altogether the most important part of this subject is that which relates to the communicability of tubercular diseases between animals, especially cows, and the human family; and this because of the great prevalency and fatality of that form of the disease termed consumption, and the universal use as food of the milk and flesh of the horned cattle. A few months ago a good deal of publicity was given in two numbers of the HEALTH JOURNAL and also in other publications to extracts which I collected from numerous authorities in Great Britain, the Continent of Europe and in the United States, show- ing the identity of the disease in animals and man, its frequency in both milch cows and siaughtered carcasses for sale as food in market, its apparent increase among cows, and its probable frequent communication to the human organism either with the lesh or milk of the diseased animais. In one of these extracts, I may liere just mention, from an exhaustive paper by Dr. E. F. Brush, in the New York Medical Journal, the author made the assertion that, in his \"candid opinion,\" tuberculosis in mankind \"is all derived from the bovine race,\u003e and he sustained this opinion by strongly worked out evidence. In another, from the last A nnual Report (for 1887), of the New Hampshire Board of Health, Prof. D. E. Salmon, D.V. S., of the Bureau of Animal Industries in this country, is reported as believing that tuberculous milk is an exceedingly prolific source of consumption in the human family. And \" that there are clini- cal observations proving the transmission of tuberculosis from animals to man through the use of tuberculous milk.\" In the report of the Bureau of Animal Industries for 1884, it is stated that certain herds were supplying New York City with milk containing twenty, thirty, or even fifty per cent. of animals affected with thè disease. In some districts of New York can be shown large herds with ninety per cent. the subjects of tuberculosis, and in this connection it is asserted that twenty-nine per cent. of the adult males dying in New York City are tuberculosis. Since the publication of these numerous extracts, I have not observed much literature upon the subject. One remarkable case has been recorded by Denune, of Berne, however, in the Medical Press and Circular, in which an infant became infected with tuberculosis through the milk which had been obtained from a phthisical cow. The details of the case are as follows: An infant, aged four months, belonging to a family whose history was absolutely negative in regard to tubercular affections, died of tuberculosis of the mesenteric glands, a fact which was confirmed at the post-mortem examination. The glands alone contained the characteristic bacilli; the latter was not even to be detected in the intestinal mucous membrane, and no bacilli were found in any other part of the body. The child was fed with the milk of a cow which was especially kept for the purpose. The cow for the purposes of examination and inquiry was slaughtered, and a careful post-mortem made of its carcass. The left lung and pleura",
         "-240- of the animal were found to be studded with tubercle, and in the tubercular nodules bacilli were easily found. The milk was then submitted to a minute investigation, but bacteriological examin- ation at first yielded negative results. Finally, however, tubercle bacilli were detected in portions of the liquid expressed from the deepest parts of the mammary gland. As stated in the journal just mentioned, the case is an important one frorn several points of view, and claims attention by reason of its bearing upon the so.called hereditary transmission of tuberculosis. If, instead of a human infant, a calf had in a natural manner fed itself with milk from its mother's udders, we can hardly conceive otherwise than that the calf would have similarly become infected with tubercle. Assuming such to have occurred, the case would obviously have been regarded as one of the hereditary transmission of tubercle. But taking the supposition that a wonien suffering fron phthisis suckles an infant, there seens to be no reason why the saine result should not occur, and why, like the infant and the cow, to which reference has been made, the mother should not transmit the bacilli by neans of her milk to her offspring. As you all probably know, two important m!etings have recently been held in Europe at which this subject has been dis- cussed at great length : namely, the congress of paysicians and veternarians in Paris, july 25 to -i, and the annu,.l meeting in August, in Glasgow, of the British Medical Association. TiiE PARIS CONGRESS ON Ti3ERCULOSIs. A large n umber of physicians and surgeons were present from almost all over the world, including a number from the United States, of whom Dr. Jacobi and Dr. Page were named as honorary members. M. Chauveau was elected President and M. M. Villemin and Vecneuil Vice.Presidents . a peculiar fitness ; for Villemin may be said to have been the pioncer in researches of this kind, having been the first to prove the infectiousness of tubercle ; w'hile Chanveau was the first to confirni Villemin's dis- covery, to demonstrate the transmission of tubercle by the digestive passages, and to show the differences which exist between truc and false tubercle. M. Chauveau in his opening address, reviewed the advances made in the study of tuberculosis in modern times, referring especially to Villemin's views, which had been so strikingly con- firmed by Koch's discovery. M. Verneuil followed vith a short address in which he referr- cd to the scientific co.operation of physicians and veterinarians, as exemplified in this meeting, and hoped that it would be but the beginnng of a series of works in which the two professions would be united in doing battle to a number of diseases comnion to man and the lower arimals. M. Cornil opened the scientific work of the Congress with a communication on tuberculosis of the mucous surfaces. One of the most important facts which had been proven by experiment is that the tubercle bacillus may penetrate the unbroken mucous",
         "membrane. This had been shown in the case of the lungs and of the intestinl tract. M. Nocard read a paper on the dangers from the use of the flesh and milk of tuberculous animals. It was correct, he said, to assume that the flesh of tuberculous animals was always capable of exciting the disease in those who ate it. That there was some danger in eating such meat he adiitted. It was wise to guard against all means of infection, but it was also necessary to proceed with caution, for immense interests were concerned in raising cattle and in preparing food for the market. M. r'-' read a paper advocating the forcible seizure of tuberculous animals. He did not agree with M. Nocard that the danger of infection through the flesh of tubeculous animals was slight. It was true that the bacilli did not long preserve their virulence in muscular tissue ; but it was fair to suppose that a certain number existed in the flesh at the time the animal was killed, and they then would retain their vitality in the deadi meat, and be capable of infecting those who ate of it. The temperature to which beet was ordinarily exposed in the process of cooking had been shown to be insufficient to destroy the bacilli. Experiments made by feeding diseased meat to guinea pigs showed that twenty per cent of the animals became tuberculous. M. Baillet deprecated the exaggerations of the contagionists, and did not believe in the wholesale destruction of the meat from tuberculous animals. If an animals was fat and in good condition the flesh could be caten with impunity even though there were tubercular desposits in the lungs, pleura, and lymphatic glands. M. Butel thought that, in a matter of such vital importance to the well-being of the conmunity no considerations of a coni- mercial nature should be allowed to bias the judgment of the speakers. He believed that the risk of infection from diseased meat was too great to allow of any compromises or fine distinc- tions. All meat from tuberculous animais should be seized, but it was only just that the government should indemnify the owners of the sacrificed cattle for their loss. M. Grissonnanche read a paper on the early diagnosis of plumonary tuberculosis in cattle. 1-is experience as a veterinary surgeon, ractising in the country, had led him to regard the early diagnosis of phthisis in cattle as a much more easy natter than that ofglanders. Pulmonary tuberculous is characterized fron the first by tumefaction of the reotropharyngeal glands ; the inspiratory movements are irregular ; a harsh friction-sound is heard on auscultation, resembling somewhat the sound produced by rubbing the thumb over a tambourine. 'lie cough is short and not easily provoked except by sharp percussion on the thoracic parietes, a procedure which evidently causes pain to the animal. The dis- ease is met with most frequently in cattle living together in herds,' hence the necessity of its prompt recognition, and of the isolation of the affected animal. M. Veyssière opposed strongly the views set forth by M. Baillet, and hoped that the Congress would not endorse theni.",
         "He thought the ditinctions made between localized and generaliz- ed infection were too fine to be followed by the ordinay meat inspector, and existed upon the rejection of any infected animal, whatever its general appearance of health may be. He had seized a very fat and apparently well-conditioned cow on account of a local tuberculosis, and had injected soane of the juice expressed fron the meat into two rabbits. Both animals ýIied, and an exam- ination showed the presence of tubercular alterations in the lungs and liver. M. Moule referred to the danger of infection by eating the flesh of tuberculous poultry, a matter which seened to have been in the discussion hitherto. His observations had led him to believe that domestic fowls were very frequently the subject of tuberculosis, the disease often involving the abdominal organs. M. Thierry said that the inspection of meat in ail the larger cities ought to be most vigorous ; while in the country such precaution was less necessary. Mr. i\u003cobinson of Greenock, Scotland, said that from an ex- perience of fourteen years as meat inspector, he had cone to the conclusion that tuberculosis in animais is comparatively rare, but that when it does exist, even in cases in which it seems to be most limited, a more careful exanination will generally show the presence of gilandular involvement. He urged upon the Congress to pass some very strong resolutions against the use of the flesh of diseased cattle, for he did not think it possible to decide safely, in case of tuber:ulous animals, between those that were fit to be eatien and those that vere not, and it was necessary theretore to exclude ail. M. Guinard called attention to the danger which existed in the practice of drinking fresh blood at the abattoirs. He had seen a lady drink the blood from a fine-looking animal which however, was found afterward to be diseased and was condemned. A resolution was proposed to the effect that, in the opinion of the Congress, ail animais affected in any degree with tuberculosis should be scized and condemned as unfit for food. This resolu- tion was carried with onlv three dissenting votes. M. Degive made some brief reinarks on tuberculous and vaccination. He said that it was the practice in Belgium to kill ail the calves from which vaccine had taken, and to reject the latter if the animal was found to be tubercilous. The president said that this was certainly an excellent rule to follow, but one could easily exaggerate the dangers to be appre- hended from this source. M. Hannot, one of the most distinguished of the agrege Pro- fessors of the Paris School of Medicine, showed that there is a tubercular cirrhosis of the liver, and that many cases of tubercu- lar peritonitis, called ascitic, are simply caused by this sclerosis of the liver. The question of heredity of tuberculosis was studied ; but nothing new stated, if we except that it was found to be rare in animais. The newly born of tubercular cows do not seem to have the mother's disease, but acquire it later probably from the",
         "-243- milk. M. M. Strauss, and Wurtz (son of the late Prof of Chemis- try) had studied the action of the gastric juice on Koch's bacillus and found that it does not destroy the power of the bacillus, and M. Butel thought tubercular infection was more often produced by the way of the digestive tract than by the pulmonary one. M. Robinson, of Constantinople, sent a communication on pulmonary phthisis in Asia Minor. Notwithstanding the fact that the inhabitants of this country lived nuch in the open air, and under the best hygienic conditions, tuberculosis was very pre- valent, and ten per cent. of all his patients were suffering from this disease. The natives recognized the contagious nature of the malady and ahways destroyed the articles used by the sick. The frequency of the disease, there could be no doubt, was owing to the free consumpton of milk and of nearly raw meat by the natives. M. Cartier recommended the flesh of the sheep or goat as most suitable to be eaten raw, as these animals very rarely suffered from the disease. If it was considered desirable for a patient to drink fresh blood, that coming from these same animals should be chosen by preference. The writer had himself drank sheep's blood, and said that with his eyes shut, he would have supposed that lie vas drinking milk fresh from the cow. There was nothing in the least disagreeable in its taste. M. Chantemesse presented the results of experiments, to deternine the persistence of tubercle bacilli in river water. It was found that the micro-organisms were still present at the end of seven weeks. Pieces of tuberculous tissues were placed in the bottom of a lask in which vas maintained a streani of running water of a temperamre of about 6o° F. It was found that the micro-organisms were still active at the end of six weeks. In stagnant water the virulence w.as preserved for seventeen or eighteen weeks. Hereditary,\" \" Uterine \" and \" Family \" Tubeculosis were discussed, and also the pcssibility of the bacillus passing through the healthy placenta. and numero -s other points of less interest to the sanitarian. The German \" air \" treatment was approved of, and the Congress closed to nieet again in two years : The following propositions being first unanimously adopted. I. That there should be placed in the altribudHons of the hygienic counsels (Boards of Health) on the questions relative to the contagious diseases of the domesticated animals, comprising those which do not seeni, for the present, to be communicable to mian. To vaccifñia, glanders, rabies, anthrax, tuberculosis, there might in course of time be added other common infectious diseases requiring equally a common protection. I. There ought to be carried out by every possible means, comprising compensation to the individuals interested, the general application of the principle of seizure and total destruction of the flesh of all tubercular animals, no matter to what extent the specific lesions found in these animals exist. III. Printed simple instructions ought to be profusely circu-",
         "-244- lated in the towns and in the country, indicating the means to be employed to avoid the dangers of infection from tuberculosis by food, particularly milk, and how to destroy the virulent germws in the expectorations on clothing, etc., by consumptive people. IV. All dairies should be submitted to a special surveillance, that it may be ascertained that none of the cows are affected with contagious diseases communicable to man. THE SUBJECT AT THE BRITISH MEDICAL ASSOCIATION MEETIN(;. At the meeting last August of the British Medical Associa- tion, in Glasgow, in the section of Public Medicine, in discussing this saie question, the communicable diseases of men and ani- mals, Professor Willey said, the subject under consideration was, he thought, one of the most important that at the present time claimed the attention of sanitarians. In reference to tuberculosis, in 1872 he had read a paper on the subject in that city. In 1879 lie wrote in a book entitled \"the Four Bovine Scourges.\" Since that time he had, with other members of the profession, frequently drawn attention to the dangerous nature of the disease, and had urged that it should be dealt with as a contagious malady. He might say that up to the discovery of the tubercle bacilli by Koch, the relative position of tuberculosis was not defined; but personally, lie had never, since lie gave his attention to the subject, entertained the slightest doubt as to the nature of the malady, and before 1872 le had consider- ed it as a specific disease. There was, in his opinion, no disease that claimed more earnest attention than this, as it was greatly on the increase, both in cattle and poultry, and thousands upon thousands of the latter were yearly sacrificed to this fatal malady, and what was rather remarkable was the rapidity with which, in view of their high temperature, it ran its course in birds. A few weeks ago lie had occasion to superintend the slaughter of nine cows fron a byre in Edinburgh, in which pleuro-pneumonia had broken out, and out of the nine there were five affected with tuberculosis, two of them being as bad cases as lie had ever seen ; on a more recent occasion he had to slaughter another lot of dairy cows, and the result was proportionally the sanie. The disease was propogated in a variety of ways-by ingestion,'by inhalation, and by innoculation--and there were good grounds for believing that it might be propogated by the medium of the eggs of poultry. Several years ago he had publicly directed attention to a case in which the malady made its appearance in a poultry yard near Edinburgh, under such conditions as to point undoubtedly to its origin through the medium of eggs. Only a few weeks ago sev- eral chickens were sent to limî by Mr. B. Freer, M.R.C.V.S., of Uppingham ; these chickens were about three weeks old, and every one of theni presented the microscopical characters of hepatic tuberculosis; but in order to render his opinion more cer- tain he asked his collegue, Professor MacFayden, to make a mi- croscopical examination of the organs, and the resuit was confirmni- atory of his own conclusions. In reference to the communica-",
         "bility of the disease from animals to man, while they did not possess such positive or direct proof as they would like, there was a vast amount of indirect proof available on the point. In 1871, when he first went to Edinburgh, he lost a child from mesenteric tuberculosis, under such conditions as to point to the milk as the source of contamination ; within the past few years, one of the officials of the Veterinary Department of the Privy Council had lost a child, also in a similar manner, and, had Dr. Fleming been present, he would doubtless have related many similar instances to then. Probably they were all acquainted with the disease fromi which numbers of surgeons had suffered, and from which he himseif suffered, known as pathologist's wart, and that the disease was generally thought to be due to an irritant introduced into the tissues by accident in making bost-morteili examinations. It was now generally understood that this disease was of a tuber- culous nature, and in his own case the originating wound was pro- duced while in the act of dissecting the tuberculous mediastinal glands of a heifer; he supposed that a microscopial exanination of the tissues would settle the matter one way or another. The practical question which in his view should be considered by this and similar bodies was its legislative aspect ; and he thought that before that meetirg came to a close, some expressions of opinion should be forthcoming on this point. As matters were at present, they were in this position, that neither Veterinary or any other in- spectors were empowered to deal with live animals manifestly suffering froni the disease either in byres, fairs or markets. There was absolutely no legislative power given to them ; they were helpless in the imatter. Tuberculous, lie thought, was one of the greatest pests of man, as it vas of animals, and lie had no hesita- tion in saying that more animais had died from this nalady than from all the other zymotic diseases put together, and, looking at the great danger that existed of its transmission to man, lie thought that this and k-indred bodies should do all in their power to strengthen the hands of the Legislature in initiating suppressive legislation. Dr. Farquharson, M.P., had niuch pleasure in seconding the resolution. After the recent lectures by Dr. Sims Woodhead and the able lecture by Principal Walley, it seemed certain that the bacillus of bovine and human tuberculous were identical, that it couid be transmitted through the milk from tuberculous udders, and that evidence went far to show the probability of its com- municability to man. Under these alarming circumstances, he held that it was the duty of the Government to deal seriously with the subject, with a view of including tuberculous among the diseases scleduled under the Contagious Diseases (Animals) Act. Y.r. Ritcnie, of the Government Board, had recently assured him, in icply to a question, that this was now under the consideration of his Department, and the expression of opinion from such a representative meeting could not fail to strengthen the hands of the Board. Dr. Alfred Carpenter said, as to tuberculosis, it iad been his",
         "-246- duty to hear evidence brought before him when an application was made for the condemnation of certain tuberculous carcasses, that if such meat was prohibited it would be impossible to feed such -populations as London. This evidence was given by one of the principal inspectors of the largest meat market in London. This evidence was very staggering, for the inspector stated that some- times as much as 8o per cent. of the meat exhibited for sale was so affected. The second point he wished to draw attention to was the difficulty of getting upon the real causes which lead to the spread of scarlatina. Dr. Carpenter then detailed the particulars of an outbreak which he had investigated, in vhich those children only who attended a particular school be- came affected, although the school had been closed for several weeks. The disease did not spread to other children though living in the same house, unless those children had been to the school in questior.. This immunity was proved to have arisen from the fact that no housè in that district had any direct connection with the sewer except the school-house, and those children only who had inhaled the air of the school-room were liable to take the disease. Prof. McFayden said : With reference to tubercle, he con- sidered it had been proved that the human and bovine diseases were caused by the same bacillus. His own experience enabled him to affirm that bovine tuberculosis was very common, though he did not believe that the proportion was anything approaching 50 per cent., as some of the previous speakers had said. But admitting these points, it still remained to inquire whether human tuberculosis was often excited by the ingestion of tubercular flesh. He thought that only a very small proportion of cases hadIthat origin, for he believed that abdominal tuberculosis was compara- tively rare in human adults, and yet in feeding experiments on the lower animals, the abdominal viscera were almost invariably af- fected in soine degree. WHAT ARE THE REMEDIES ?-I will conclude by drawing attention, in a brief manner, to the necessity for some special preventive measures being more generally adopted, with the view of lessening the frequency of this disease in cows and other domestic animals. Acts of Parhament do not yet in any way or in any country reach the tubercular diseases. In Great Britain efforts have been made during some years past to have an act passed for including the disease in the general \" Contagious Diseases (Animals) Act,\" and doubtless this will soon be carried out, and the question has been referred to in the Agricultural Committee of Parliament in this country. But, in the words of Dr. Littlejohn, Medical Officer of Health for Edinburgh, Scotland, in a most valuable Official Report, a synopsis of which is ih the Sanitary Record for July, '88, words which apply too, to this continent, the delay in action of this kind is chiefly because bovine tuberculosis is essentially a chronic disorder, which may last for years, and which is usually very difficult to detect in its early stages, differing thus",
         "-247- widely from cattle plague, pleuro-pneumonia, or swine fever, all of which are acute diseases, running a rapid course, and easily recognized. However, though the owner of a cow may long remain in ignorance of her having tuberculosis, when emaciation sets in, as it always will sooner or later, he becomes alarmed, and the animal is hurried to the shambles before its leanness becomes so marked as to render its carcass unmarketable. FLOW OF I\\'ILK NOT ARRESTED IN TIHE EARLY PERIOD.- If tuberculosis, like the acute diseases mentioned above, either entirely arrested or sensibly diminished the secretion of milk, of course the dairyman's attention would soon be drawn to the affected animal; but unfortunately this is not the rule in tuberculosis ; the subject of the disease, although emaciated, and even in cases in wyhich the udder is affected, continues to supply milk, and such nilk is capable of communicating the disease to many animals certainly, and presumbly to a man. When the carcass is examined there is commonly abundant evidence of the existence of tubercle in the lungs and other organs, but the flesh is rarely so affected as to attract notice. The public are thus exposed to two risks from bovine tuberculosis-the risk of being served with milk in which tubercle bacillus can often be detected, and the risk of being served with meat from an animal who suffer- ed from tuberculosis long enough to begin to show signs of wasting. Naturally the risk from milk is the greater, if for no other reason than that milk is ordinarily ingested raw, and meat not till after being properly cooked. A GREAT DIFFIcULTY CAUSED EV UNSANITARY CON- DITIONs.-As Dr. Littlejohn, in his report states, this disease differs so widely from other acute diseases, and in its first stages is so difficult to diagnose, that, were the proposal adopted, heavy expense would be incurred by the indiscriminate slaughter that woulk result. Moreover, as tuberculosis is largely depend- ent on insanitary conditions for its development and spread, allowing compensation for animals affected would not tend to improve the state of byres and cow-houses, which at present are rarely what they should be in structure, ventilation, drainage, etc. THE Two QuESTIONS connected with this disease which are of the greatest public importance are (i) the limitation of the food supply from the prevalence of tuberculosis among our herds and dairy stocks, and (2) the risk attending the sale of milk from tuberculous cows. As REGARDS TIIE FIRsT: Dr. Littlejohn believes that tuberculosis is largely on the increase, and that in all cases, except those exhibiting the earliest appearance of the disease, the affected animal should be condemned. . . . There can be no doubt as to the risk run by the community owing to the sale of milk from a dairy containing a single affected animal. Dr. Littlejohn urges the importance of such an enlargement of the acts as to include tuberculosis, and meanwhile the peremptory enforcement of the provisions of the Dairies, Cowsheds and Milk- shops Orders with a view to stamping out tuberculosis by means of improved sanitation.",
         "-2418- STATISTICS, BACTERIOLOGY AND HYGIENE, OF DIPHTHERIA. V INCENZO, COZZOLINO, clinical director for laryngology in Naples, has published an important paper on the above sub- jects, the conclusions of which are summarized as follows, in L'Osservatore, and published in the Pacific Record of Medicine and Surgery: a. STATISTICAL coNCLUSiONS. r. It results froni all recent statistical publications that mor- tality by diphtheria has been on the increase for the last 5 or 6 lustres. 2. Mortality by diphtheria exceeds that by all other feb rile exanthemata (small-pox, scarlatine, measles). 3. The Italian reports from 1881-1883 show that during these three' years there were 6,256 deaths froi scarlitina, 15,Si from measles, 3,158 fron small-pox, 19,588 from typhus, 21,095 'from diphtheria. 4. In comparison with diphtheric mortality in Italy, amountig to 35 per cent, it was in England 14.75, in Scotland 21.53, il Ireland 19.12, in Germany 43.77, in Austria 57.72, in Switzerland 39.47, in Belgium 35, in Holland 9.88, in Spain 24 70. . CONCLUSIONS WITII REGARD TO SEASONS, AGE, SEX, ETC. i. Diphtheria is prevalent in winter and in spring. 2. Mor- tality in the middle of months is greatest in diphtheria, then in typhus, measles, small-pox. 3. Immunity before the end of the first year is only a relative one, not absolute ; children of from 1-5 years of age are most exposed to the disease. 4. There is no narked difference between the sexes with regard to frequency of the disease. 5. The rural population furnishes the principal con- tribution to mortality by diphtheria. c. CONCLUSIONS RELATING TO THE CLINICAL BIOLOGY OF THE DIPHTHERITIC VIRUS. i. The diphtheritic virus (micrococcus, alga or cryptogami) is not dependent on cosmotelluric agents for its vivification, but the influence of humidity as an incidental promoter for the develop- ment of diphtheria is an established fact, and conditions of seclu- sion, atmospheric changes and cohabitation excite its vitality, centuple the influence of the contagion and predisposes for the malignant forms. 2. With regard to receptivity of the virus, there are families vho, in consequence of local conditions, chronic phlogoses or preponderant vascular irritation of the naso -pharyngeal membrane facilitate implantation of the diphtheritic virus. 3. With regard to immunity, the author thinks it consists in a special resistance of thc mucuous membrane in consequence of a stronger vitality of its epithelium or its tissues, in the vascularization and activity of the lymphatic vessels, resulting in a rapid evacuation of the contagion, and also in a very low state of excitability of the vasomotorial nerves. 4. A further considera- tion of the clinical biology of the diphtheritic virus goes to show that, besides its diffusion through the air, there is also a diffusion",
         "-249-- through water, beverages (including boiled ones), through inocu- lation and especially through the naso-pharyngeal membrane. d. CONCLUSIONS RELATING TO PATHOGENETIC PARASITOLOGV GENERALLY, AND OF DI11HTHERIA ESPECIALLY. i The author accepts Pasteur's theory, that it is within nan's power to prevent parasitic diseases and that generatio acquivaca is an absurdity. 2. It is to be expected that, in future, specific medicaments will be discovered against the various forns of para- sites. 3. Diphtheria belongs to the great and still increasing tribe of diseases vith bateriological basis. e. CONCLUSIONS WITH REGARD TO THE PROBABLE ORIGIN OF THE DI1 PHITHERIrTIC CONTAGION. i. The diphtheritic virus of mran is transmissible to animals and from animals to man, as for instance chicken-diphtheria. 2. The sale of diseased chickens is. to be prohibited, and their inter- ment to be confined to remote places. 3. Chickens ought nut to be kept in the house, their dejections being liable to mingle with the rain-water and to taint drink-waters. / CONCLUSIONS CONCERNING PRIvATE AND PUBLIC HYGIENE. i. The virus always penetrates through the lymphatic vessels, through inhalation or through absorption and inoculation into our organism. 2. It may be asserted with certainty that the mother is the first transmitting agent of diphtheria to her children or to those she cornes into contact with. 3. Everything, belonging to a diphtheritic patient, not only his excrernents, is to be watched and disinfected. The best hygienic conditions are to be provided for, in order to protect children from being attacked by the disease. 4. Isolation after reconvalescence ought to be continued for 15 to 20 days. 5. During a diphtheritic epidemic, it is not advisable to perform a bloody operation in the throat (tonsillotomy), to neglect treatment of humid eczemata and serpiginous affections, and to prescribe application of vesicatories and cauteries. 6. In cases of death after diphtheria, the body ought to be washed with a strong solution of chloride of zinc (5.10%) or with some other antiseptic solution. Besides as long as general cremation has not been established, separate burial places ought to be erected for all cases of death from infectious diseases. THE Russian Medical Department has just issued a set of ules for the sanitary supervision of the rag trade. All dirty rags must be transported in strong bags, previously treated vith a dis- infecting solution. The establishment of stores and shops dealing in rags in densely populated localities is strictly prohibited. Pick- ing and sorting rags and all treatment of them generally can be performed only after a most careful antecedent disinfection of the material. All workers engaged in manipulating rags in any way must wear special clothing.",
         "LINDSAY SANITARY CONVENTION AND SESSION OF THE ASSOCIATION OF HEALTH OFFICERS. T I-IS meeting was held August 16, i888, and proved to be a success. The Opera Hall was well filled at most of the sessions with physicians and citizens. After opening prayer, the Mayor gave an address of welcome on behalf of the Corporation and Judge Dean on behalf of the citizens of the town. Dr. Coventry, ex-President of the Association, responded in the name of the Association. The president called upon Dr. C. H. Hewitt, of M\\1 innesota,President of the American Public Health Association and Secretary of the State Board. Dr. Hewitt expressed great pleasure at being present at a Canadian Health Association, and trusted to assimilate and carry home new ideas regarding methods with the view of still further aiding the progress of work in his own State and country. The regular programme was then proceeded with. Dr. Covern- ton presented a paper on a \" Brief Retrospect of the Progress of Medicine, Curative and Preventive, from 1828 to 1888. Dr. H. P. Yeomans, member Provincial Board of Health, presented a paper on the \" Sanitary Supervision of Schools.' Dr. iBurrows introduced the discussion on the paper and remarking concerning the unsanitary condition of many of our public schools, stated that in his opinion it was time that a medical inspector bof schools be appointed. Dr. Hewitt, i\\innesota, stated that some difficulty re- garding the sanitary supervision of schools existed in his state. Theoretically our medical and sanitary views may be correct, but when we are asked to adapt them to the school system, it is going too far. The machine nust not be disturbed. But the radical wrong in the machine must in all seriousness be removed first and here the first, middle, and last difficulty is met. After all, however, schools exist only for one end, sana mens in coyp5ore sano; and if they do not fulfil this end, schools are in whole, or in part failures. Mr. H. Knight, Public School Inspector said. It is, hardly fair to expect trustees to throw out desks supposedly good four or .ive years ago for others just discovered good. Ventilation and heating are much greater difficulties in connection with this ques- tion. Till trustees see that the health of the pupils is more to bc considered than the expenditure of a few dollars, results will be imperfect. There is a real dificulty in obtaining a good water supply for the schools. Dr. J. B. Lundy, Medical Health Officer, Preston, said. The jacketed stove has in some cases served a purpose, but in the withdrawal of pure air he had found difficulties. Dr. Hewitt, referring again to this matter, explained how lie has managed may of the practical difficulties. Especially is it desirable to have floors oiled inasmuch as it prevents the accumu- lation of dust. He further referred to the danger and difficulties arising in connection with the isolation of infectious diseases. Dr. J. Coventry, Windsor, said that the difficulty in most cases lies primarily in connection with the teacher. If the teach- er does not have a high domestic ideal of hygiene they will not",
         "--251- have it at school. In few cases, indeed, had he and even one thermometer, in a school-room. But a teacher must be supported. Dr. Hewitt, Minnesota, delivered an eloquent address on \"PRATICAL SUGGESTIONS ON INTERNATIONAL AND INTERSTATE CO-OPERATION FOR THE PREVENTION OF DIsEAsE AND FOR STAMPING OUT EPIDEMICS.\" He spoke of the necessity of speaking in a popular manner in order that the people and their officers of health should be brought in close, intimate, and friendly relationship and co-opera- tion. What does the subject mean ? Not quarantine. That word has passed and co-operation has taken its place. What is the unit on which we have to act or take action ? It is the family, whether clean or unclean, this is the unit ! Our ideal is a clean and healthy family ; i.e., a clean person. This is not quarantine, as France shutting out Germany against cholera. There is a house- hold disease. It is the cleansing there ; we know that the infection of a disease, say small-pox niay be cultivated, either artifically or externally, indefinitely. Letus discussoneofthesediseasessay small- pox-and we know how easily the municipal mind gets frightened at this. This we can handle, but it is those other diseases, diarrhœa infantum, diphtheria, etc., which are of most importance from their mortality. Forty per cent. of all deaths occur under five years from these causes. Again, take phthisis, which causes 1n per cent. of all deaths, and yet we sit down stolidly as if they were to be. See the difference. Think of the great cholera conference at Rome. There they sat and sat and discussed a disease prevail- ing there only partially and locally, and yet these other diseases pass unnoticed. Now we see the results of sanitary co-operation in regard to cholera and small-pox, in which co-operative and preven- tive measures have usually taken place. Now we would get the sane results if we applied ourselves to co-operation in regard to these other diseases. The ternis of Interstate and International co-operation, etc., are only convenient for classfication, and do not alter in their nature froni that of individual co-operation and isola- tion. The absence of co-operation was illustrated by an outbreak of diphtheria amongst Norwegians in Minnesota. Compulsory isolation and disinfection were evitable, they vera adopted and the disease was eradicated. The speaker thought that the public good demanded placarding and isolation, even though a hardship. Better for the municipality that the expenses of such a case be paid. Another good way is one being adopted in many places, especially in towns the size of Lindsay, i.e., to have a small isolation hospital. Another way adopted frequently in Minnesota is to erect a tent and isolate in that. If the people do good work in the 700 municipalities in Ontario the example will become even more con- tagious than any of these diseases and may.even spread across the line in spite of the protection tariff, and even help people there as you have helped yourselves. Dr. J. J. Cassidy read a paper on \" How to Prevent Con- sumption.\" Dr. C. W. Covernton gave the opinion of Italian",
         "-252- physicians in favor of having isolated hospitals for consumptive diseases. Dr. Yeomans, Mt. Forrest, said that the zymotic origin of tuberculosis affects most practically the question of inheritance and curability of phthisis. Dr. McClellan, of Trenton,. thinks it is a'question, as yet undecided, as to the best practical methods of dealing with this infectious disease. Dr. Griffin, of Brantford, gave a paper on \" Notes on Inspec- tion of Public Milk Supplies,\" Milk inspection he said is yet in a sornewhat immature state. In his district he thinks -there are three difficulties, viz., watering, skimming, and uncleanliness, the latter, by far, probably the most important from the standpoint of health. He is quite certain from experienc and enquiry, that the watering takes place in the rinsing of the pails with water just be- fore milking. As regards skimming, he believes that it is in keep- ing back of the last parts of the milkings or the strippings forcream. The pratical methods of dealing with the inspection in Brantford vas then taken up. A permit is issued to vendors every half year by a printed form, which is signed by the vendor as an agreement If they refuse inspection beyond the limits of the town, the permit is taken from them. The Inspector makes periodical visits, and gradual but great improvements have been made in the condition of the dairies. Dry earth is used in some instances. As regards sickness in cows, there is real difficulty. First, the ignorance of the milkman, another, gross carelessness or culpability in mixing the milk in Massachusetts a standard is supplied and all milk not coming up with it is seized and vendors proseculed. Dr. Griffin thinks that milk not coming up to 1029, and a butter fat of less than three per cent. should be condemned. He would make standards, three per cent., three and a half per cent., and four per cent., and the lowest should be at least maintained. Regarding the tuberculous dangers in milk, Dr. Griffin has no doubt but that in bis country tuberculous milk was even now being mixed with drinking milk. It was most necessary that every cow in a district should be examined by a veterinary surgeon at least once a year, and every tuberculous animal destroyed. Dr. McClennan, of Trenton indicated that the methods of inspection in vogue there vith one or two convictions in the police court, had greatly im- proved the quality of milk. He further stated how inspection by the veterinary surgeon had tended to raise the standard of cows and of milk. Dr. Hutchison, Medical Health Officer of London, speaking, said, Quevenne's lacto-densimeter will detect skimming and watering, but it is imperfect in some respects. His office had 137 chemical analyses made last year, and these served to correct the imperfections of the instruments. Dr. Hewitt, of Minnesota, thought the publication of monthly analyses would be a most im- portant practical method of raising the standard. Dr. Hutchinson stated this had been done in London last spring, and as a result some men doubled their sale while others lost nearly all their custom. Dr. Coventry, pointed out the difficuly in this connec- tion, viz., that the poor will have still to buy the cheap milk : we must fix the standard so that the poor too ivill get good milk. Let it not be too high, but protect even the buyers of the worst.",
         "-253- The address of the president (Dr. Burrows, Health officer of the town) was of sensible brevity, and highly suggestive. Dr. Burrows has given much attention to the subject of education and favors much needed reforms therein. \" We are educating too much in one sample and quality beyond the demands and the necessities of a new country. The evil is noticeable in the over- crowding of the professions and the robbing of the artizan's bench the farn and the factory, and that too, at a sacrifice of health and true physical development from the teacher's desk to the judge's chair. \"' He did not regard with great favor the system of isolation and placarding in infectious diseases as at present insisted upon. \" To make isolation perfect we should provide means for separation and removal of those first attacked. There should be homes or hospitals where a parent or nurse could take care of the sick entirely away fron other members of the family, it should not be requisite to placard dwelling-houses during a long course of sickness, and prevent the wage-earners pursuing their occupation.\" He urged for an uniform system of health statistics, for inebriate asyluns, and for' the education of the public in health subjects by the free distribution of pamphlets. Mr. W. Chipman, of Brantford, read a paper on \" Sewage of small Towns, \" which was commended by several physicians. Dr. Coventry presented the report of the deputation which had been appointed to wait upon the Ontario Government and ask for aid to establish a hygienic laboratory and that the Secretary of the Provincial Board might give his whole time to public work. The deputation was kindly received by the Attorney-General and Treasurer, who listened to the arguments.... The attorney- General promised to give the matter his consideration and spoke favorably of the idea [is this satirical oi serious ?-ED. H J.] The growing appreciation ofsanitary work, the advances in executive health work by Boards and Medical Health officers, make the necessity yet more manifest that the Government should specially undertake the task of lending them assistance in determining the exact causes lying at the origin of disease both of men and animals, experiments in the matters of construction and ventilation, the sources and conditions of pure water supplies, and the discussion of the best methods for our various cities, towns, and villages. This Association, of which there are so many Medical Health Officers willing to work in the interests of public health, would demand that the Government at least lend them such support in this direction as to give them a medical office to which they might refer in difficulty and also give them some one to devote his time to the work. This completed the work of the convention. Ar a recent meeting of the Hastings Town Council, Mr. Councillor Bray moved a resolution of wide public interest, the purport of which was the proposal to establish a system of volun-. tary registration of houses by the Town Council after examination and report by the borough surveyor or nuisance inspector,",
         "NOTES ON GENERAL SANITARY PROGRESS. IN some institutions in England stoves have been introduced which bring in constant supplies of fresh air, warm it, circulate it. and carry out the vitiated air. Dr. Richards, in his own large library, has one which keeps the rooni ail over at the temperature he requires. Sir Spencer Wells uses one for each bed-room. In one hospital some forty are used. A FRENc Colonel has ascertained that lie can wash his men with tepid water for a centime, or one-tenth of a penny, per head, soap included. The man undresses, steps into a tray of tepid water, soaps himself, when a jet from a two-handed pump plays upon him tepid water, and he dries and dresses himself in five minutes : against twenty minutes in the usual bath, and with five gallons of water against some twer.- in the bath. In Germany they have an arrangement, devised by Mr. Grove, under which half a million soldiers are now regularly washed. There is alm an invention, applicable to schools in which it lias been proved a child can be completely wasled in three minutes. IN .amberg, Germany, there has been much pregress in the laws relating to the hygiene of emi.rant ships and lodging houses. This especially in relation to cases of nfectious disease, closets, baths, etc., to the separation of the sexes, and to cubic space and ventilation. IN a factory in Rothan (Alsace), which employs about 700 workmen, it lias been the custom for ten years past to give a cup of coffee to every workman at the beginning of the days wcrk. The expenses, which are borne by the proprietors, amount to only one penny for four cups. IN Glascow, Scotland, there are 16,413 houses of one depart- ment, and 6,617 bouses of two departments, which have metal tickets on the doors, statng the cubic contents of the dwelling and the number of inmates allowed. Inspections are made by the officers cf the Sanitary Department betwixt the hours of 1 1 p.m. and 4 a.m. householders found overcrowding are summoned to the police courts and fined or admonished. By this supervision a marked decrease has taken place in typhus fever. IN the schools of St. Gall canton, a sensible step lias been taken. At the beginning of winter every child brings to school a pair of slippers ; the wet boots worn on the way are taken off and the children keep on during the whole school time their warm and comfortable slippers. Meanwhile the boots have time to dry and can be worn without inconvenience on the way home. IN Berne, Switzerland, prizes offered by the Agricultural As- sociation have brought out 13 essays on the most rational nutrition of the rural population. To three of the essays prizes were given, and the authors are unanimous in asserting that \" our forefathers lived better and cheaper than we do.\" Fewer potatoes and more beans, peas, oatmeal, milk, brown bread, pork and lard were used. ' The children were sent with a piece of brown bread into the stable, there to drink milk fresh from the cow.\"",
         "AT Munchen, Gladbach, a society bas been founded for the purpose of creating cheap, healthy, and well-arranged dwellings for the working classes, and to facilitate their purchase. Up to the end of 1886 the society bad built 291 bouses and in the follow- ing year the number had increased to 315. The houses are built on the Cottage system, and adapted to the family life and habits of the Bavarian working people. A NEW process for purifying sewage has just been made public, in a report of the Royal Engineers. Some proto-salt of iron, it appears, is used, with gentle agitation in perfect darkness. The Sanitary Record (Sept. 15 '88) says : The discovery of this new method of utilising the remarkable properties of iron has opened the door to a wholly novel treatnent of sewage. Down to the present time the expressions 'chemical treatment' and ' precipitation ' have been used as convertible terms ; and 'siudge' is spoken of as a necessary product of sewage treatment. In Mr. Conder's (the new) process there is no precipitation of putrescent matter. The solids subside as a fine black powder, easily swept along by a gentle current, which dries easily on exposure to the air, is entirely inoffensive, and while drying into a fine sharp dust, is indistinguishable fron garden mould. A socIETY has lately been started in England for introducing there the \" Sloid \" system of education, a \" manuel instruction.\" Somewhat like the Froebel system, it appeals to the active and constructive instincts, stimulates curiosity, arouses interest, calls into play the love of usefulness, enlists the will on the side of work instead of against it and gives pleasure. It calls ail the muscles into play and offers great variety of movement, so that no one set of muscles is unduly strained. Both hands are used and thus both sides of the body are brought into play ; a more har- monious growth is attained and the danger of growingup crooked is averted. No other kind of manuel work as a school subject bas ever combined such training of the band to general dexterity, with due exercise of the whole body. A ScHooL OF HY'GIENE lias been established in connection with the Institute of Experimental Hygiene in Rome. Instruction in matters relating to public health and sanitary engineering will be given to medical men, engineers, veterinary surgeons, and pharnia- cists. THE DANGERS OF CITY MANURE are strongly alluded to in the Sanitary Record of August 15, and many instances are men- tioned of outbreaks of disease in rural districts from desposits of the excrement. The Record says :-\" Now that attention lias been thus prominently drawn to the subject, it would be well for the responsible officers of ail districts in the neighbourhood of large towns to make inquiry as to the disposal of city manure. THE PROFITS OF SioKE consumption, as compared with its distribution throughout a city, are illustrated by a report of a firm of dyers in Leeds, England, through :improving the draughts, chiefly it appears by enlarging the flues they saved in fuel £1,ooo stg. a year. __ 2 ID ID -",
         "THE plumbers in England are strongly urging for a national system of registration of plumbers. A public meeting was recently held at Newcastle at which where a large number of masters and workmen froni various towns in the Norti of England, and at which measures were taken toward the formation of a gerieral system of registration. FRosi ANALVES of numerous specinens of Canadian cheese, in a Bulletin issued in August last, the Chief Dominion Analyst,T. Macfarlane, F. R. S. C., reports that, the examinations shew that only pure butter-fat enters into the composition-that nothing approaching in character to \" filled cheese \" bas so far been rnanufactured or even sold in Canada, and that no admixture of foreign fat whatever takes place in the manufacture, of Canadian cheese. In 1887, 62,87S lbs. of cheese were imported into Can- ada from the United States and entered for home consumption. MEDICAL OFFICERs in England are strongly urging that com- pulsory notification of infectious disease be made a part of the law of the country. Now it is only provided that any town desiring to establish such registration may do so. N.\\TIoNAL R .EISTRTION of infectioas disease is also bemg urged. This has for ns object the circulation confidentially among health oflicers of weekly returns of infectious sickness reported in different iocalities. In time this migbt be inade International. Yuî.ow 'EvER, says the NTew York Herald, is a crime. The saine may be said of most other epidemies. MISCELLANEOUS SELECTIONS AND ITEMS. SO.m.: ENPENECE IN MF.xSLs INFEcTION.-Dr. Reichard' of Fairplay, Md.. has closely studied three invasions of measles in that place and gives th following conclusions :-i. Measles are spread by actual contact with the materies morbi. 2. A case in the stage of incubation may inoculate those who are unprotected. 3- It cannot be carried (as usually meant) by a protected person coming from a case of the disease to a susceptible person. 4. It does not spread through the atmosphere. 5. Strict quarantine will prevent. Had the child, when she came froni Washington City, been strictly quarantined, the epidemic might have been prevented. In each of the three invasions we have traced all trouble as beginning with a single person. DURArION OF 'lUIERCULAR INFEcTIN.-The germ of glanders possesses but little vitality; complete drying kills it; putrefaction shurtens its life ; and the chances of infection dimin- ish, and disappear as time proceeds. The germ of tuberculosis. on the contrary, realizes conditions highly favorable for more remote infection, for it survives the majority of microbes usually associated with it. Neither drying nor putrefying, it appears, de- stroys it, while both processes often allow of its being distributed through air or water. MM. CADEAceand MALET (Lyons Médical, quoted in Lancit) have sought to discove the time required to",
         "-257- destroy the germs of tuberculosis in dried, putrefied, or frozen matter. The experiments prove that tubercular matter dried and pulverized riiay preserve its virulence, since one hundred and two days after its preparation it was capable of transmitting tuber- culosis. Schill and Fischer maintain that tubercular matter only loses its virulence after six months. Pietro asserts that well-dried sputa may remain infective for nine or ten months if maintained at a mean temperature of 25 0 C., but it appears probable to MM. Cadeac and Malet that the virulence does not persist after thirty or forty days, unless special care is taken to preserve it. The results show the desirability of completely destroying all the tubucular matter ejected from patients. MM. Cadeac and Malet found that virulence is maintained one hur.dred and fifty days in pieces of tubercular lung exposed during winter to the atmosphere. Pieces of tubercular lung were kept at a temperature from 1 0 to 8 0 below zero, and remained frozen for more than a week; yet virulence was mamtained. When dried pieces have a con- siderable volume, the virulence lasts longer than when the matter exists as fine dust, owing probably to the more ready action of the oxygen of the atrnosphere on the latter condition. As to the influence of putrefaction, one hundred and sixty-seven days ap- peared to be the limit of tubercular virulence in tubercle allowed to putrefy. Putrefaction exercises its destroying effects more rapidly when the putrescible mass is of but little volume. CRE MATORIES-CHICAGO v. MONTREAL.-The Il American correspondent\" of the London Sanitary Record, having stated that Chicago was the first city to adopt the system of cremating its househo)d refuse, Mr. Henry R. Gray, the late energetic chairman of the Montreal Board of Health, writes as follows in the Record of August 15 :-\" Will you kindly correct the blunder your Ame- rican correspondent has fallen into.. . . As a matter of fact, Chicago sent a committee to inspect our systen and report, and our con- tractor got the contract to erect and start their crematories. As early as 1884, when I took my seat in the City Council, I began the agitation in favor of the complete obliteration of the city's filth by fire, and in August 185, I succeeded in having the first crematory for the cremation of night-soil built. The people of Montreal, and more especially the inhabitants of the surrounding municipalities, were so delighted with the result, that I had very little difficulty in getting the contract passed for the erection of the larger crematories the following year. HENRY R. GRAY. Montreal, July, 1888. THE PURIFICATIoN 0F SEWAGE.-This question has lately been engaging the attention of the Belfast Town Council, and at their request Mr. Haddock of Owens College, Manchester, has performed some interesting experiments. (British Medical Journal July., 21, 1888.) In one of these a quart of a patent disinfecting and deodolising fluid was added to a trough containing 1oo gallons of sewage matter, with the result that in a quarter of an hour all",
         "-25S- odour was removed, and'the sewage matter was found to be divid- ed into a solid and perfectly inodorous sediment, and a superna- tant fluid consisting of water in a state of tolerable purity. The experiments were watched by a Committee of the Town Council, among whom were Dr. Whittaker, Dr. Graham, and Dr. Stewart, and we understand that the members of the Committee were favourably impressed with the method. DANGERS OF CANNED Foo»s.-An exhaustive inquiry has recently been made into the characters of canned foods. (Pacific Record of Medicine and Surgery.) All the tins when opened were found to contain microbes, and it was demonstrated that the pro- cess followed both in Europe and America causes at most only the apparent death of micro-organisms, which only wait for favourable conditions to start anew into activity, and possibly virulent. Meat also seems to undergo some change resembling decomposition, the muscular fibres undergoing an alteration that resembles fatty degeneration. The same is true of fish, which seem least fitted for preservation in this manner. Meat apparently was more invested with micro-organic life than vegetables and pine- apples ; asparagus and carrots, gave evidence of suffering least from microbic invasion. TiHE INFECTIOUS PERIoDS.-The duration of the infectious stages of various diseases is thus given by Dr. Pearse : Measles, from the second day of the disease for three weeks ; small-pox, from, the first day for four weeks ; scarlet fever, from the fourth day for seven weeks ; mumps, from the second day for three weeks ; diphtheria, from the first day for three weeks. The incuba- tion periods, or intervals occuring between exposure to infection and the first symptons, are as follows : Whooping cough, fourteen days; mumps, eigiteen days ; measles, ten days ; small-pox, .welve days ; scarlet fever, three days ; diphtheria, fourteen days. EDUcATIoN oP PLUMBERS IN FRANCE.-A School of Sanitary Plumbing bas lately been established by the Council of the Asso- ciation of Working Plumbers in the Department of the Seine, for the purpose of giving these artisans better instruction in the prac- tical part of their trade, and a competent knowledge of the prin- ciples of hygiene relating to their work. IN TuE ExFCUTION of murderers hy electricity, as provided for in the Legislature of New York, it will be well to exercisegreat care that in attenipts to save such criminals fron just and merited punishment they do not prove to be the indirect cause of other deaths, and that the criminals themselves do not escape the death penalty. The New York Medical Journal points out that in apparent death even by lightning stroke the victim has recovered ; and refers to a recent quotation in the Lancet of a letter from Franklin to a friend in 1773, in which he gave an account of his c.wn experience in killing a turkey by electric shock, and in which he very nearly killed hirmself. Dr. Richardson, (hefore the R.S.P.C.A.) in 1869, demonstrated that the process was full of difliculties. Sheep stricken down by the shock, requircd a charge of ninety- six feet of surface, and with every precaution the workmen were exposed to great danger, while the expense was proportionately great.",
         "EDITORIAL SPECIALS. DURING THE QUARTER ending the 30th of Septemiber there were, be- sides a number of annual meetings of sanitary bodies, two very important Conferences of Physicians, at both of which sanitary questions received a good deal of attention, and to reports of which we have given in this number a good deal of space. There is probably no subject bearing upon the public health of greater moment than that relating to the Communicability of diseases from domestic animals to mankind, while tubercular diseases are, of all, the most destructive to life. Of little if any less consequence is the subject of the disposal of excrement and other waste matters of towns and cities. At the International Conference on tubercular diseases in ian and animais held in Pari: in July, some important questions were in a measure settled ; while at the large annual meeting of the British Medical Association in Glasgow in August, the subject of sewage farming received much attention and this method of sewage disposal ivas strongly advocated, and in preferance to al] other mie.thods. As To \"l coNsuM aroN,\" to mankind the most fatal of ail diseases, it seems to be now settled that in animals, especially in milch cons and IoNls, it is identical with that in the human race ; and that it is commor. in bovines, and may be readily, and not infrequently is, conuunicated fromthese animals to the human body. Wihile the temperature of boiling w1ater, or probably a less degrce of heat, destroys the infection, the interior of a piece of coked flesh is often dangerous from not having been sufficiently heated. It was therefore unanimously advised by the Paris Congress that Boards of health be empowered, in all countries, to investigate cases of disease in animals; that all tubercular animals be destroyed ; that special nwatchfulness be exercised in the cases of dairies \" to prevent the contamination of the milk by that from a diseased cow \"; and that every effort be inade to warn and educate the masses of the people in order to prevent the frequency and spread of the disease. The resolutions we give in full on -nother nge. IMMEDIATE AcTIoN vas taken by the French Government upon the advice of the Congress. Relative to this the British Medical Journal (of Sept. 27) says : Il a courageous nillingness promptly to accept the logical conse- quences of scientific discoveries, the French have frequently set an example which can only excite our admiration. Public opinion in this country and in our colonies moves more slowly, and the respect for vested interests leads to the perpetuation of practices which are injurious, not only to the public health, but, in the long run, to those interests which it is irtended to conserve. After referring to the resolutions, the one to the effect that steps he taken to spread information relative to preventive measures among the public, the Journal continues: Without seeking to detract from the value of the other work \"It yet appears that by far the most important work achieved by the Congress was the adoption of these resolutions. An EXHAUSTIVE PAPER on this saine subject was read by Mr. Thomas Walley, Principal and Professor of Veterinary Medicine and Surgery in the Royal Veterinary College of Edinburgh, at the annual meeting in July of the Sanitary Association of Scotland, a full report of vhich we have just received. In our next issue we purpose giving extracts from this valuable and practical contribution to the present knowledge on this subject. Prof. Walley showed",
         "--230 - a large number of specimens of organs of different animals in which were tubercular deposits. He made important statements in reference to the pro- bability of the disease being transmitted by means of eggs, and of experiences confirmatory of the views of Baumgarten, who has succeeded, it is stated, in discovering the bacilli of tubercule in the ova of certain animals. In bis con- cluding remarks Prof. Walley said :-\" In the vast majority of instances the system of inspection and condemnation of ieat, and of milk too, for that mat- ter, is a bad one, inasmuch as it is largely entrusted to individuals who have had no special training to fit them for the office they have to perform, and who have no knowledge of the nature of disease or of its effects upon animals or through them upon mian.\" EDUCE-Educate the masses in health subjects. In this appears to be the best )ros)ect for real progress in public hygiene. As some one has al- ready said : The individual may toil and strive, but he is largely still at the nercy of his neighbor, whose erratic proceedings may upset ail foresight and personal attention to sanitary and physiological laws. The Lancet says : Most people will wish for greater powecs of sanitary control over the actions of their neighbors. There is doubtless nuch in this, but it is universally con- ceded that by the dissemination of a knowledge of hygiene among the masses we can accomplish most permanent good. IN AN EDITORtIAL on the progress ofsanitation, in the Brit. Med. Journal of September 15th uit, we read the following impressive lines on this subject of education :-Public opinion bas for the most part ranged itself on the side of the sanitarian ; but still it is too truc that it is characteristic of the common state of tbe popular information that, while a single death from violence or passion excites general attention, deaths day after day from preventable causes pass without any notice whatever. Filth, whether in the individual or in comnimunities, bas long since been shown to be one of the most fruitful sources of disease and death, with all their attendant misery and waste of hunian energy, and consequently an increase-l appreciation on the part of the general public of the truth of the aphorisn that \" cleanl :ess is next to godliness \" is one of the first vishes of the sanitary reformer. But for the fulfillment of t1is wish we must look to the spread of education and the dissemination of infor- mation. lence every opportuntity of demonstrating the benefits of proper sanitation should be utilised. TiiE NATIONAL ivlus.uM of Hygiene in Washington comprises an in- teresting collection of sanitary appliances with many suggestive specimens of defective drain-pipes, traps, plumlbing etc. ; but as Dr. Billings said at theCon- gress of Physicians and Surgeons last month: \" It is not well housed, it is much overcrovded, and its location is so inconvenient that it receives but few visitors, and, therefore, it bas by no means the educational influence that it ought to have.\" And further \"It should be provided with ample quarters in the imniediate vicinity of the National and of the Armny Medical Museums.\" A few months ago we had the pleasure of visiting this museum, which is now at 1707 New York Avenue, and of spending several hours examining the valuable collection therein ; through the most kindly courtesy of-, and in company with Major Charles Smart U.S.A., and Dr. Wells, of the Navy Department, who was then in charge, temporarily only we believe. THE COLLECTION comprised many varieties of closets, traps and other plumbing exhibits ; ventilating and exhaust cowls, wood carpet and parquette",
         "--201l--- flooring ; veneerings of wood and enanielled bricks, faced in various colors, for walls ; school desks and seats, life preservers, crematory models, models of army hospitals, etc , etc. There are drain pipes with the bore alinost com- pletely closed with hardened deposits, and specimens of others (fron South America) bored through by ants ; corroded and perforated soil pipes, with many specimiens of such pipes and waste pipes with the bore completely closed by solder at the joints from careless plunbing ; fruit cans with the interior badly corroded ; and a great variety of other things of like character. And not the least interesting object vas a model of a Parsee \" Tower of Silence,\" where these strange people dispose of their dead. THE YELLow FEVEiR in the south will prove, it is hoped, another stim- ulus which will induce towns and cities to constantly keep their house in order ; while the \"shot gun \" quarantines will probably \" bring home,\" or ought to, to the apathetic and indifferent in health matters, the value of the ounce of prevention and the great desirability of \"Keeping it in stock.\" 'lie M3em- phis calamity was losing its effect in the minds of those who have in hand the care of cities. Northern cities may take the lesson to heart. If the yellow fever is not likely to visit the cooler climes of the north, other feartul scourages are acclimatized to these regions and are no respecter of persons. Up to September 26th there had been a total of 2,314 cases at jacksonville, with 221 deaths (a low rate of nortality), and a proportionate number of cases at Manatu, Tampa, Fernandina, McClanney and other places. A MINISTER OF HEALTII is aptly pressed for by the Southern Practi- tioner for this nonth (Oct.) in the following language: \" 'The farmers have at last secured a representative in the Cabinet. Froi March 4, SS9, the Secretary of Agriculture will be a member of the Cabinet and will be in a position to sec that thc agricultural interests of the country are given proper consideration and are protected.-Nash. An.' The farmers and those inter- ested in Agriculture may vell he congratulated but something more is wanted ; yes urgently. iimperatively needed. The cry goes up in most emphatic tones of the urgent need of a DEPARTMENT 0F HEALTH, with a Secretary, also a Cabinet officer. Time and again has Congress been appealed to in this regard by leading Sanitarians and Scientists througliout the country, and there is a strong possibility that if an earnest, urgent appeal is now made to our representatives, aided by the sad and terrible emphasis arising from the present epidemic, creating so much consternation, absurd misianagemner ., annoyance. trouble and disaster in the entire South, which can but more or less affect the entire country, a proper recognition of the l'ublic Healili interests may be attained. There is just as much need for a Department of Health, as for the Department of WTar, Justice or the Navy.\" The Practitioner, with other Journals and, especially, this one, has long urged for a MINISTER of Health. THE ONe MAN FOWFR is, after all, far superior to the old irresponsible \"Board \". Let there be advisory boards, but let us have the ONE responsible HEAD. As an illustration, the town of Pullman, Ill., shows just what this power with scientific sanitation, intelligence and honestry can accomplish. With a population of 12,000, the drainage and cleanliness of the town are so complete, the facilities for healthy amusement and instruction so abundant, witlh an entire absence of liquor establishment, that in 1887 the death-rate war per i,ooo, in 18S6 only 8, and this year proportionately still less, against 26 , r,ooo in New-York City. As the New-York Medical Times says.\" TL. secret of this wouderful showing is that \u003eliman is under the control of a one-man power, the Pullmans, who are auto atic in the management of the affairs o the city.\" This is just what we need everywhere.",
         "PUBLISIIER'S SPECIALS. Once more we appeal to those in arrears to remit the amount due, as per account, sent in July and on former occasions. We are providing one of the most practical and useful health journals in the world. but we cannot continue to do so without sonie remuneration. This JOURNAL will now be published only quarterly, for a time. It and THE PROr tYLACTIC together forni the most complete health peýriodicals published : and the two at the low price of one d'ollar a year-INsvAIAILY in advance. PROYZUT YOUR KOMlzJ MARLIN DOUBLE ACTION REVOLVER. Tfiese revolvers are an exact duplicate of the celebrated SMITH \u0026 WESSON. no longer costs .38 Caliber, using Centre-Fire a CJartridges. Automatio PULL NiCKEL PLATED, RUBBER HANDLE. WABRA-S:TE-D EQU0AL IN EVERY RESPECT To THE For sale by Hardware and Gun Dealers everywhere. Manufaotured by TEE MARLI PIRE ARMS 00,, New Haven, Comr.. -EST IN THE .WORLDI A Magazine Rifle. I \u003cr Iaro or small (rime, a! Lees. Tho strongest aootmg rifle made. Perfect tc v--y g;aranteed, and the only atsoloxdy safe zine on the znarket . ALLARD GALLFRY. SPORlTING AND TAR(FT RIFLIZI, wort renowned. Send for cd catalgue. IARLIN F'iiE ARtMS CO.. New [lavena. Conn. IDEAL RELOADING TOOLS WILL SAVE ONE.HALF THE COST OF AMMUNITION. Male fnr all rizcs nf Cartridrs whleh are used in any of the followinLhui I-1.11s or 11:tois: M'irlin, i 04, W iuchester, Ballard. btevens. Renungtun, 9 y-Ke.nnedy, bofitha 4\u0026 W e.ua u; aiso for ail g-tuges and makes of SHOT OUM SHELLS, PAPER AND BRASS. Cz.czPot-and better than any othcr. Send for Price List of these tools to Box 106-1 G. NEw HAVES, Cows."
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w LII Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored andlor laminated I Pages restaurées et/ou pelliculées E' E Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. D Additional comments / Commentaires supplémentaires:",
         "CANADA MEDICAL AND SURGICAL JOURNAL. A UordhhT §icCord 0F MEDICAL AND SURGICAL SCIENCE. EDITED BY GEORGE E. FENWIOK, M.D. PROF ESSOR OF SunGERy, IcG1LI, UNIVERSITY; ONE OF THE GOVERNORS OF THE COLLEGE OF PHYSICIANS AND SURGEONS; SURGEON TO TBE MONTREAL GENERAL HOSPITAL. VO. IV.. Pr!YTED AT Tis.\" GA ZETTE \" .Chonincal: PRŽNiT1xG IIOUSE, NEan TUE POST OrcE, 1876.",
         "CONT.RIBU fORS TO THIS VOLUME1. BELL JOHN, A.M., M.D. BOTSFORD L. B., M.D., L.R.C.S., Edin. BULLER FRANx, M.D., M.R.C.S., Eig. CAMERON JAMES C., M.D. CLINE JOHN D., B.A., M.D. CROTHERS WILLIAM, Mr. DRAKE J05.- M., M.D. DuNcÂN GEORGE C., M.D., C.M. ERERLE H. A., Mr. FENWICK GEORGE E., M.D. FINNÇIE J. T., M.D. LCS Edin. FULLER WILLIAM, M.D. GARDNER WILLIAM, M.D. GIRDwOOD G. P., M.D., M.R.C.S., Eng. IIENDERSON A. A., M.D., C.M. MACCALLUM D. C., M.D., M.RC.S.,Eng. ?MIAçDONNELL R. L.? Mr. McARTncR R. D., M.D.. Moor J. T., M.D. MURRAY CHAS. H., Mr. OSLER WM., M.D., M.R.C..I, Loud. PROUDFOOT A., M.D. REDDY JOHN, M.D., L.I.C.S.I. RITCIIIE A. F., Mr. RODDIcE T. G., M.D. Ross GEORG.E A. M., .D. SHErPHERD FRA.N, M.D., M.R.C.S., L. STARX G. A., M.D. STEVENSON C., Mr. STROUD C. S., Mr. WOOD GEORGE, M.D., C.11. WOIrTnINToN E. D., M.D. WRIGHT HENRY P, M.D. WRGrrW.,~ REv., M.D., L.R.C.S., .",
         "INDEX TO VOL. V. Page. A case off bifurcated foot with eleven tocs..................... 268 A case )f Melano-Sarcoma of the choroid. Dr. Proudfoot......... -9b Address delivered at the cighth nnnual meeting of the Canadian Miedical Association. By L. B. Bots ford, M.D., President of the Association.... ............. 97 A new Hiospital in Paris............. 184 Angina Ludovici..................... 509 Annandale on knock-knee.......... 83 A third dentition at the age of seventy-three years............... :10 Racteria and SepticSmia...... ...378 Bell John, A M., M.D., Case of Leuco- cythiuimia. history and autopsy.. 435 Bell John, A M., M.D., Case of Multi- locular ovarian tumour ......,... 54 B3otsford L.B.. M.D., L R.C.S., Edin., address delivered at the eighth annual meeting of the Canadian Medical Association............. 97 Buller Frank, M.D., M.R.C.S., Eng., remarks on various operations for cataract........... .......... 387 Cases of Acute Articular Rheuma, tisn treated with large doses of Salicylic Acid. Dr. McArthur.. 437 Case of Acute Fibrinous Brunchitis with expectoration of tube casts, Dr. Worthington.............. 531 Case of Aortie AneuriFsm successfully treated by distal ligature.......... 318 Case of Extirpation of the Larynx with the hyoid bone, Nc......... 214 Case of Leucocythomina.listory and - Autopsy. Dr. Bell............... 435 Case of Lithotomy followed by renal Abscess and death. Dr. Finnie.... 291 Case of Peri-uterine himatoeele. By Wm. Gardner, M.D. Professor of Medical Jurisprudence, McGill University....................... 106 Case of Sphacelus of the thyroid gland. recovery......................... 4S2 Case of Sterility frou anteflexion.- eured........... ............... 85 Case of uterine polypus. By. J. T. Moore, M.D...................... 114 Chloral Hydrate in OzSna........... 345 Chronie Aortitis ............... 125 Cline J. D., B.A., M.D., Case of Hlorse-shoe Kidney............. 539 Colotony in Syphilitic Disease of the rectum. Dr. Rosa................ 491 Convulsions their na'ure and treat- ment by Dr.Fulber............ 541 Curicus case of Mutilation.......... 425 Death fromn Ether inhalation........ 26 Defective norve Power a cause of Bright's disease................ 516 Delusions of the insane .............. 470 Page, Diabetes Sulphide of Calcium in.... 30 Diagnosis of Cerebro-spinal Menin- gitis ............................. 380 Duncan G eorge C., M.D,, C.M., on a case of intussusception, recovery. 2 Duration of Quarantine required after puerperal fever ............ 375 EDITORTAL : Citizens' Publie Hlealth Associa- tion...... ....................... 37 Down.with the Dust 1 ............. 40 A Small-pox Hospital.......... . 42 Letter from the Preside-it of the Montreal General Hospital..... 43 Bowker vs. beers for libel......... 46 Publie lealth Magazine.......... 48 Miedical Olicers in tihe Mercantile Marine..... ................. 48 Druggists prescribing and the sale of poisons........................ 88 The Canadian Medical Association 91 Montreal Publii Hlealth Associa- tion.............................. 92 Return of Dr. James A. Grant.... 93 The Snall-pox Hospital........... 91 Licentiates of the College of Phy- sicians and Surgeons of L.C 95 Cincho-quinine, aCard....... ...96 The City By-law to establish a board of health......:.......... 140 The CanadianMedical Association 143 Royal College of Surgeons, England 144 A remarkable case of worms...... 144 Preventive medicine........... 185 Dr. Gilbert Prout Girdwood elected a menber of the Society of Pub- lic analysts of Great Britain.... 188 Sir Duncan Gibb's resignation as Physician to the Westminster Hospital......................... 189 Prescribing large doses............ 190 Zienssen's Cyclopedia of the prac- tice of Medicine................. 191 No Cure no pay................... 192 Medical Ainendment Bill.......... 230 Bill-An Act to incorporate the meibers of the Medical Profes- sion in the Province of Quebec. 231 Obituary W. R. Beaumont, F.R.C.S., England......................... 238 Action of the large intestine....... 272 Bill-an act concerning the Medical Profession of the Province of Quebec......................... 274 Campbell's Norway Cod Liver Oîii. 288 Auerican Centennial Celebration international Medical Congress. 289 Coroners inquests................. 331 Annual Report of Diseases of the Chest.................. ....... 332 The Canadian Journal of Medical",
         "INDEX. Page. Science.......................... 334 Journals returned.... ............ M35 Notions about Clinieil Therno- m eters....... .......... 3.35 International Medical Coýngress 3if Thermometrical changes lor -4 yrs .338 City'Small-pox Iospitals...... 381 Circular of Chairnan of H1eal h Commi ttee...................... .82 Presentation to Charles O'Reilly, Esq., M , ........................ 8 The late George Green Gascoyen, F.R.C.S., England.............. . Nitrate of Sota in Dysentery .... 38d The spread of infectious diseases in schools.... ............. .... ... .431 Athletic Sports ................... 432 To Corresponulents................ 43 Death of Sir G. ). Gibb, Bart.... 43:3 'Tho uterine elevator...............434 Sanitary Statistics................. 474 Annual Convocation of McGil. University.... ................. 477 A Dominion Riegistration Aet..... 52ù Anendmnents to the Act of Incor- poration of the College of Physi- cians and Suirgeons of Lower Cana t.......................... .522 McGill University Medical Faculty SumnierSession................. Obituary. Sir George Duncan Gibb. B art............................. 27 Collee of Physicians and Surgeons L.C.............................. 574 The Canada Medical and Surgical -Journal ......................... 576 United States Cenîtennial Commis- sion ...... ...................... 577 Ergot in the treatnent of increasei muammary secretion and inflan- mntion of the breast............ 124 Extension of' inflammation from the Elpididymis to the urethra.. 430 Extraction of a large foreign body froin the ear..................... 4C3 Fenwick, G. E., M. D., case of Gliomaa of bath Retinmo, extirpa- pation of both eyes ............. 3')1 Fifty-one cases of Lithotomy.- Inquiry into their condition sub- sequent to the operation.... 73 Finnie, J. T., M. D., L.R.C.S., Edin., on a case of Lithotoiny, renal abseess and dleath...... . 291 Forcible dilatation of the os uteri in the obstinate voniting of preg- n ney...... . .......... ........ 33 Fracture of the Epiphysis of the zreat Trcchanter. Periostitis. Pymmia, Dnth. by Dr. loddiek 207 Fuller William. Màî.D., C.M., on con- vulsions their nature and treat- m ent... .......... .............. 541 Gardner William, M. P., case of Peri-uterine hmmaietocele........ 100 Gardner William, M.D., case of col- 'Otomy................ ........... 449 Gelatinous disease of the Syno- vial membrane.............. 511 Gels inu Sen erviren... ...... 347 Gelseminuma Sempervirens as an antineurng..................329 Girdwood. G. P.. M.D,, M.R.C.S., Eng. .ftroductory Lecture . 193 Page. Glanders, case of Acute, by Dr. Reddy ................... 401 Gliona of both Ietinme, extirpation of both eyes. 1y Dr. Fenwick.. 301 Gun-shot wound of the Abdomen. vith visceral injury-Dr. Wor- thington ....................... 211 llencierson A. A., M.D., C.M.. on the uses of the elastie band in tenotomiy ...... ..... ............ M Jlistological character of melano sarcoia of the choroid. Dr. W. Osier ........................... 298 Ilistological description of Gliomla of the retina--Dr. Osler........... PAG Ilistoloy vf Leucocythxnia, remarks «n Pr. Bel's case, hy Dr. Osier. .-9 Rettrn of Dr Bovell to Toronto after a residence of four years in the W cstlndies................. IlsTLREPORTS Cases under the professional charge of Dr. MacCallum. le ported by James C. Cameron. M.D., ouse Surgeon ,Montreail (eneral Hospital : T\u003cd\u003cofori as alocal application... 5 Fracture of the humeras from a powerful wrench of the wrist... 7 Ca.se of Favus ... .... ......... Colica Pictonum. from notes by Mr. C. S. Stroud................ 63 Aortic valvular diseasc.from notes by Mr. R. L. MacDonnell....... 64 Peculiar case of Rheunatism, fromn notes taken by Mr. W. Crothers. 65 Excision of erilarged glands in the axilla. By Dr. Fenwicw, renrorted by .1. D. Cline, B.A., M.D...... 67 Wound opening theli knee joint, sur.cessful result, under the care ot Pr. Fenwick. Reported by J. D. Cline, B.A.. M.D............. GS Primaary Hunterian Sore on lower eyelid. under D\u003er. Fenwick. Re- ported by J. D. Cine, M.D...... 7) Case of Acute Tubereu!jsis Fatal by Meningitis, under the care of Dr. Ross. Reported by Mr. R. L. iacDonnell..................... 117 Case of ulcer of the Stonach.- Death.--autopsy under the care of Dr. Drake. ilported by J. C. Cameron. M.D....... .......... 19 Case of Apoplexy into the Pons Var'lii. under the care of Dr. Fenvick. Reported by J. D. Cline, B.A., M.D. .. .. ...... 121 Case of Morbus Coxam. Death froin Pymmaîia.uuusual situation of head of Femur. tinder Dr. Ross, Re- ported by Mr. R. L. MacDonnell 174 Case of Stone in the bladder. Li- thetom y. Death. under the care of Dr. Ross. lieported by Mr. Il. A. Eberle ... . .... ........253 Case of Abscess between the Craniumi and the dura mater, simulating neuralgia, under Dr. Ross. \"ie- iorted by Mr. C. Il. M0urray.... 30 Case of Cirrhosis of the Liver. Reported hy Mr. R.S. MacDonnell 340 Caîse of Cirrhosis of the Liver,",
         "INDEX. Page. Under Dr. Ross. Reported by Mr. R. L. MacDonnell ...... . ..... 347 Case of Fracture of the bodies of the 4th and 5th dorsal vertebrŽ, Recovery under Dr. Ross. Re- ported by Mr. C. Stevenson..... 350 Case of Papillomatous tumour of the Cervix Uteri, reinoval by (Galvanie ecraseur. By Dr. Pen- wick. Reported by J. D. Cline, - B.A., 1.). ................... . Fracture of the ulna with Disloca- tion forwards of the head of the radius ......... Case of Peritonitis, calcareous con. cretion found in appendix ver- iniformis.... Case of Suppurative Pyelitis sin- uses commnunicatinz wiîth pelvis of Ridney, under Dr. Fenwick, Reported by J. D. Cli e M. D 415 Case of General Tuberculoqis, under the care obf Dr. Fenwiek- Reported by J. 1. Cline, M.D. . 417 Case of Severe injury to fore arim, under Dr. Ross. Reported by J. D. Cline, M.D ..... ......... 454 Case of Acute Rheumatism treated by Salicylie Acid, under Dr. Fenwick. Reported by J. D. Cline, B.A., M.D ............... 456 ,Two cases of Acute Rheumatisn treated by Salicylic Acid, under Dr. Fenwick and Dr. 1Reddy.- Reported by J. D. Cline, B.A., M .D . .................... ....... 505 'ost-partum convulsions, by hypo- dormie injections of Chlora- Reported by Mr. A. F. Ritchie . 171 A case of Phthisis under Dr. ieddy ReportedbyJ. b. Cline,1B.A., M.D.,.................... 559 Ilorse-shoe Ridney, description of, By Dr. Cline.................... 530 Impjerforate Rectum, Colotomy in the region af the sigmoid flexure, Dr. Gardner.... ................ 447 Introductory Lecture at the open- ing of the Session-1875 and 1876 193 Introductory remarks to, and synopsis of, Practical course of Institutes of Medicine .......... 202 Invagination or intussusception- Recovery froin-Dr. Duncan .... 2 Jaborandi in Colds.... ............ 512 Jervia. a new Alkaloid in veratrum viride ......... .......... .. 38U Large veno-cutaneous Nîvas treat- ted by repeated injection with Carbolie Acid ............ ..... 507 Local origin of Cancer............... 380 Letter from Dr. E. D. Worthington.. 356 Letter from Vienna.. .............. 8 AlcArthur R. D., M.D., on Salicylic Acid in Acute Articular Rheu- matism .......................... 497 Massage as a remedy In Surgery. ... 473 Medico-chirurgical Society o f Mon- treai-Annual Meeting............ 229 Moore J. T., M.D., case of Polypus in utero....... ................... 114 Mu'tilocular Ovarian tumour re- moved by John Bell, A M. M.. 51 New method of dilating the usta- chian tube ..... ............ 377 Page. Nitrite of Amyl in Angina Pectoris and heart disease .............. 471 Note on Salicylic Acid........... 128 On a case of nearly complete deaf- . ness of one ear after an apoplec- tic seizure....................... .137 On the treitnent of boat apoplexy 22 On the use of Oleum Erigerontis Canadensis in the treatment of gonorrhoa--Dr. Stark........... 499 On the value of Nitric Acid in the treatient of disease of the neck of the womb............... ..... 321 On treatincît of Convulsions in Infiants...................f.6 Operation under Chloral Hydrate... 123 Osier William, M. 1., L.R.C.P., London, Prof. Institutes of Mcd- icine in McGill University, case ofSearlatinainiharis . ...... 49 Osier William, M.D., L. R. C. P., L ndon. on the histological char- acters of Melano-sarcomaof the choroid....... .......... ...... 29S Osier William, M.D., L.R.C.P. In- troductory remarks to Practical course of Institutes of Medicine. 209 Osier William, M. V., L.R.C.P., on the histological characters of Gliomna of the retinme.... ........ 300 Osler William -... L. R. C. P., Lond., on the Pathology oi miner's lung. ............ ....... 45 Osier William, M. D., L R.C.P., London, recent researches on the pathology of snal-pox.......... 311 Osier William, M. P., L.R.C.P., London, remarks on the histology of Leucocythoemia....., ...... 439 Osseous Tumour successfully remov- cd from the ligamentum patell. 427 Ovarian Compression $in Hlysteria. 124 Ovarian Tumour. tapping, inflama- mation of cyst, ovariotony- recovery.............. ........ 362 P.tinful Points in Neuralgia......... 519 Paraceitesis Pericardii............. 4. Pedunculated fibroid tumour -of the uterus couiplicating preg- nancy, Peritonitis -Death-Dr. Roddick......................... 251 Physie in food......... ............ 12i Posoning by Aconite .............. 27 Polyarthritis theumatica - Endo- carditis - Pericarditis, - cured under the use of Salicylie Acid.. 413 Polyarthritis rheumatica, great local disturbance-cure......... 412 Polyarthritis Rheuimatica, two at- tacks. the first cured in forty- eight hours, the second in twenty- four hours....................... 413 Polyarthr tis Rheumatica - third attack, complete recovery in twenty-four hours under large doses of balicylic Acid......... 415 Practical remarks on Congenital Cataract......................... 464 Preventive measures in Syphilis.. 126 Professional muscular atrophy ....35 Proudfoot, Dr. A., case of melano- sarcoma of the Choroid......... 296 Recent researches on the pathology o snall-pox, by Dr. Osler....... IReddy John, M.D., L. R. C. S.I., 341 on a case of acute glanders.... 401",
         "INDEK. Page. Remarks on the iistology of Leu- cocythemia, Dr. Osler........... 439 Remarks on various operations in Cataract-Dr. Buller............ 387 Report of a successful case of Trsi- cheotony, by Il. P. Wrigh t, M.D. C.M ., \u003cJttawa................... 1 9 l' nvis An No.T:s oF Boogs : Croup in relation to Tracheofomy. by J. Solis Cohen, M.D., Phila- _ delphia, 1874..................... Compendium of Children's diseases by John Steiner. D. Appleton \u0026 Co., New York, 1S74............ 71 The Cholera Epidemic of 1873 in the United btates. The intro- duction of Epidenic Choiera through the agency Of the xncr- cantile marine. By J.cn M. Woodworth, M.D............. 2 3 The Physician's Visting List for 1876..... ........... ............26k Cyclopedia of the Practice of Medicine, Erlited by Dr. . Von Zienssen. Vol. x, on Diseases of the Female Sexual organs:...... 265 A Treatise on Iluman Physiology, designed for the use of students and practitioners of medicine, by John C. Dalton, M.D. ........311 A Text book on Ilurnan Physiology designed for the use of Stuidents and Pravtitioners of Medicine, by Austin Flint, Jr., M.D...-...... all On 1-oisons in relation te Medical Jurisprudence and Medicine, by Alfred Swaine Taylor, 31.D. F.R.S.. .............. ..... 315 A Practical treatise on Fractures and dislocations. By Frank il. Hamilton................... .... 3 7 The histolozy ind histuohemistry of man. By Beinrich Frey...... 35S Annua Reports on Diseases of the chest, under the direction of H1or- ace Dobell, M.D ................ 420 Chemica Coartata ; or the.Key to Modern Chemistry. 3y A. il. Kolimyer,A.M., M.D-........ 421 Vision, its optical defects, and the .tdaptation of' Spectacles. By S. cFenner, M.D A treatise on Surgery, its Princl- pies and practice. By T. lolnes, .M.A., Cantab.. surgeon to St. George's Hospital............... 561 A Manual of Minor Surgery and Bandaging. By Christopher Heath. F.R.C.S.. surgeon te uni- versity College Hospital......... 564 Rçddick, T. G.. MD.. Prof. Clinical Surgery. McGill University, case of Fracture of Epiphysis of great Trochanter...................... 207 Rod'dick T. G., M.D., Pedunculated fibroid tumour of uterus compi- cating Pregnancy............ ... 250 RoddickiThos. George, M.D., on the hypodernic injection of chloral in post-partun convulsions...... 171 Roddick T. G., M.D., Professor 6f Page. Clinienl Surgery, McGillniver- sity-Valedictory Address to the Graduates in Medicine and Sur- gory............................ 483 Ross George, A.M., M.D., Prifessor Clinicali Medicine.McGill Univer- sity, on case of Colotomy in severe Sypbilitic Disease of the rectum. 491 Salicylie Acid in the treatment of Polyarthritis hlieuinatica.... .. 410 ScarlatinaMiliaris. By Wm. Oster. M.D.. L.R.C.P., London, Prof. Institutes of Medicine, McGill University...................... 49 Spina-Bifida treated by the ehastic ligature........ ........... .21 Starke (. A., M.D., on the use of 01. Erigeron Canadensis in (on- orrhoa....................49 Sub-acute Rileumatismi. followed by an acute attack, greatswelling of and pain in certain joints cured within twenty-four hburs........ 413 Subcutaneous injection of Chloroform in Facial Neuralgia. By Dr. W ood-.............. ............ 1 Sulphide of Calciain, a remedy fur diabetes..................... . 330 Syphilitic Keratitis at an unusually - early age.... ......... .. 327 The care of Arthur O'Connor by Dr. Tuke........................ 23 The case of the late Prof. J. Hughes Bennett........ ........ .... 222 The dangers of Ciuoroforn, \u0026c., and the use of Nitrite of Amyl in cases of Narcosis . ............. 26 The dangers of operating on habitual drinkers...... ..... ........ .. _2 The elastie Band in Tenotomy. By Dr. lenderson...... .... ..... 339 The Eucalyptus Globulus as a Cancer rem edy.......................... 569 The pathology of Miner's Lung. By Dr. Osler. Prof. Institutes of Medicine, McGill University..... 145 The Physiological action or arsenic. 328 The sequel to a case of Excision of the two principal joints of the upper extremity ............. 360 The temperature of Drunkards...... 379 The use of Perchloride of Iron in post partum homnorrhago.. .......... 352 Tracheotomny in Croup and Diph- theria, report of forty-six cases. 178 Tracheotomny. successful case of... 169 Treatment of Absccss of the Brcast. 526 Treatment of Infantile convulsions.. 572 Treatment of Tetonus by Nerve Stretchin..... ............ 573 Treatment of Whooping Cough by Carbolie acid inhalations....... 566 Treatnent o Varicose Ulcers by the Tartrate of Iron and Potass. 571 TRANSLAroNS: Treatnent of Polyarthritis Rheu- matica by Salicylic Acid........ 410 Anomalies in the developement of vaccine pustules..... .-......... 449 Enormous air tumîour fromn spon- taneous deli iscence of the mastoîd e i ............... ............. 4 i2",
         "INDEX. Page. Malignant Galloping Syphilis. .... 453 Passage of an unusually large gall stone...... ..................... 500 Open and antiseptic treatment of wounds, results compared.... 503 AsthmaDyspepticum..........549 Treatment of Convusions in children by anSsthotics............... 556 Oxygen as an antidote to poisoning- by Phosphorus.................. o69- The iEtiology of Angina Pectoris. 55S- Iniversity College Hospital..... ...36 Valedictory address to the Graduat.s in Medicine and Surgery, McGill Page. University. By Prof. loddick, M.D... ...... ..................4S3 Wood, George, M.D., C.M., on the treatment of Facial Neuralgia by subcutaneous injection of chlo- roform ........................... 1 Worthington E. D., M.D., case of gun-shot wound of the abdomen, with visceral injury....... ...... 241 Worthington E.D., M.D., case of acute fibrinous Bronchitis.:.... 531 Wright fIenry P., M.D., report of successful case of tracheotomy in membranous croup........... 166",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGINAL COMMUNICATIONS. Subcutaneous Injection of Chloroform iz the Treatlment of Facial Neuralgia. By GEo. WOOD, M.D., C.M. I wish to lay before the readers of your useful journal a new treatment for neuralgia. I have only seen it tried in two cases, and in both it has been entirely successful. I do not claim the discovery of this method of treatment, nor can I give my authoriity. I saw it recommended in some Americani Medical Journal and availed myself of it in the treatment of one of the severest and most obstinate cases of facial neuralgia, that it was ever my misfortune to meet -with. D. C. H. Aged about fifty, dark hair, eyes and com- plexion, very spare, weight 125 lbs, has suffered from facial neuralgia of left side of the face since 1854, has undergone all systems of treatment with littie or no relief. In 1872 had the lower jaw trephined and a section of the nerve removed, this gave him relief for several months, but eventually the neuralgia returned harder, if possible, than ever. He first came under my care in August 1873. I gave him different iron tonics, bark, hypodermic injections of morphia, croton chloral hydrate, and also the different and various neuralgic .pills that I ever heard of, with but temporary success. In August of 1874, I injected 15 minimns of chloroform .underneath the mucous membrane of thé lower jaw, as near the exit of the mental branch of the 5th' pair as I could. It gave liim entire relief in .an hour, but caused. partial paralysis of the muscles of the left che. In a week I .repeated the injection 'and put him upon drachi doses 1.",
         "2 CANADA MEDICAL AND SURGICAL JOURNAL. of the Elix. of Guarana three times a day. In September and December, and also in April, he had a very slight return of the pain, each recurrence being less severe. At each of these times I repeated the chloroform, and he now seems to be entirely well. My partner, Dr. Rose, had a lady patient, unmarried, æet about 45, who had-been a terrible sufferer from the same disease for seventeen years, had consulted the most eminent men in this and foreign countries, and had tried all the prescriptions recommended. The only thing that gave her any relief was the hypodermic injection of morphia. She was obliged to use them, sometimes several- times a day. Her mind and morals were very much disordered. Dr. Rose tried the hypodermic use of Chloroform, and she is now entirely well. Her mind is as clear as of yore, and she seems and acts like a new being. The injection of chloro- form is extremely painful unless preceded by an injection of ten or fifteen minims of Magendie's sol. of morphia. If this suggestion can give relief to others suffering from. this most\" painful disease I shall be most happy. I intend using the chloroform in the first case of Sciatica that cornes into my hands. Faribault, Minn., June, 1875. Case of Invagination or Intussiusceptio, recovery under. the care of 'GEORGE C. DUNCAN M. D.,- C. M. On the evening of May 8th, I was called to see B. McP. aged 17 months. On entering the room I found the patient in hèr fathei-'s arms, very cross and restless, face flushèd, pulse rapid, respiration hurried and stertorous. The nurse informëid Me that the child had been very restless .for several days and would start in her sleep, and had eaten nothing but milk .for which it had \"a great desire, taking 1 rge qùantities during the day. She also stated that the child had vomilted several times to-day, that her",
         "BY DR. GEORGE C. DUNCAN, 3.D., C.N. 3 bowels had been, regular until four days previous, when she had a slight diarrhœa for one day, and had not had any motion for two days, until this morning, when- she passed a few hard masses of fœcal matter. The abdomen was moderately tympanitic, but on account of the child's crying I could elicit nothing by percussion. Thinking that it might be worms, I ordered R. Santonin, grs. vi. ft. pulv iii. One to be taken every 12 hòurs. Also iss of ol Ricini to be given immediately. May 9th, I was called early this morning, the messenger stating · that the child was very bad. Upon my arrivai I found that the bowels had not been moved. The·abdomen more tympanitie than last evening, and the symptoms then found much increased. I immediately proceeded to give the child an injection of soap and water but before doing so on introducing my finger into the rectum about il inches it came in contact with a firm rounded tumor with a depression in-the centre, imparting a sensation to the finger much like the os uteri ; with steady pressure it would re- cede but immediately return on the withdrawal of the finger. I proceeded to administer an enema, but could not get more than a few ounces to enter, but by withdrawing the syringe and forcing the bowel up as far as my finger could carry it and lowering the child's shoulders I succeeded by using firm.and steady pressure in injecting about a pint. On withdrawing the syringe I was surprised to find that no fluid escaped, and upon examining I found that there was-a large mass of hardened-fœces plugging the anus; which by the continued pressure of the fluid above, and the-straining of \u003ehe.child'forced the rectum so low down; that I could exert pressure through the perineum behind the mass, and much to the astonishment ofthe child's fatherr I succeeded in getting out a piece of hardened fœces 2 inches in length and i inch.in diameter, and immediately following it several",
         "4 CANADA MEDICAL AND SURGICAL JOURNAL. small pieces with the enema. On another digital examina- tion the same state existed, but the tumor was much 'smaller and softer and could be returned quite easily as far as the finger could reach. The child appeared much relieved, land I ordered her to be kept quiet, and allowed nothing to eat or drink, except a little cold water and milk to allay thirst. (6 P.M.,) Very restless, respiration and pulse increased since this morning. On examining per rectum the tumor was increased, and is harder than when I left it in the morning, I gave another injection and removed with my -inger two oval pieces'of fœeal matter, about f inch in dia- meter and ý inch in thickness. May ioth. Did not sleep well last night, and is very cross and restless, and appears weak, abdomen still some. what tympanitic. Gave another injection, but did not re- move any fœcal matter. I. then passed a small flexible bougie which met with a slight obstruction about 4 inches from the anus but with gentle pressure it passed easily -some 6 or 8 inches farther, when it was stopped, and fol- lowing its withdrawal there were several ounces of thin fœcal matter, which was suddenly stopped, and followed by violent straining; I then withdrew with my finger two more hardened masses. The. parents and friends becoming alarmed about the child starving, I ordered chicken broth and small quantities 3ss. of brandy every three hours. (6 P.M.,) Much better and wants to walk. May iith. Had a natural motion of' its bowels this morning and seems much better, and asks for something to cat; ordered beef tea, and to be kept quiet. May 25t . Since last date the child has been doing well and has been walking about as usual appearing quite a-ecovered, her bowels acting quite naturally. Cowansville,-May 2oth, 1875.",
         "HOSPITAL REPORTS. MEDICAL AND SURGICAL CASES OCCURRING IN THE PRACTICE OF THE MONTREAL GÉNERAL HOSPITAL. Repor'ted by J. C. CAMERON, M.D., House Surgeon, M.G.H. In Dr. MacCallum's wards, during the :past two months, sev eral cases of interest have been under observation ; from the very careful and complete notes taken by the members of the Clinical Class, the following, brief reports have been arranged: odoform as a Local Application. As considerable attention has been directed of late to the action of Iodoform, and as its results have been described as being but little short of marvellous, Dr. MacCallum determined to try it upon several chronic ulcers which had resisted all the ordinary modes of treatment. CASE i.-J.-D., admitted with a large unhealthy ulcer, evidently of specific origin, situated about the middle of the thigh on its posterior surface. It was three inches long by two inches broad. The edges werè hard, raised, thickened and undermined in places. The discharge was copious and sanio-purulent. Poultices, carbolic wash, red wash, black wash, chloral wash, and nitric acid wash were all tried in turn, without altering much the unpromising appearance of the sore. Iodoform reduced to a very fine powder was dusted over the whole sore, and. in thirty-six hours a lapsing of cicatricial tissue had formed around the edges and the sore was reduced about three-fourths its original. size. The powder was applied on three occasions afterwards and in three weeks from the, first application, the sore was completely healed, the cicatrix being unusually firm and healthy in appearance. CASE 2.-J. D., a laboring man, 40 years of age, engaged in blasting stone for the Corporation, got his leg severely",
         "6 CANADA MEDICAL AND SURGICAL JOURNAL. injured by a blast in January; a large fragment of rock struck his leg inflicting a contused and lacerated'wound in the calf and tearing the flesh from the heel in a fearful manner. The torn edges were brought as closely together as possible, free exit was given to the products of inflammation, and after a great deal of trouble the wound was all healed except a small patch about two inches long by one broad, just in front of the internal malleolus. This resisted every sort of stimulating application, including strapping and blistering. The surface was ash grey in color devoid of granulations, -with haid, raised, thickened' round edges. After five applications of the Iodoform the sore was reduced to about the size of a bean, and in a few days more·it will be quite well. CASE 3.-B. M., Oet 43, admitted with ten or twelve small unhealthy sores between the knee and ankle of the right leg. Eighteen years ago, she scratched her leg with a rusty nail, the wound ulcerated,and since that time she has never been quite free from- those small painful;and irri- table-looking sores, for as fast as some would heal, others would break out. With her,. too, all sorts of applications had been tried, but without any very marked effects; blisters seemed to answer better than anything else in her case. Iodoforn was applied five times and the leg healed up thoroughly. CASE 4.-W. -M., Mt 23, admitted with .two. large chan- croids. Various stimulating and alterative washes were applied, as black. wash, chloral wash, nitric acid wash, \u0026c. ; but the progress of the case was slow. iodoform was applied twice, and the man left hospital almost well. There are several other cases of the Iodoform treatment under observation, but the notes are -not yet completed. Iodoforni seemed in the above cases fo act as a rapid and powerful alterative. About ten minutes after the powder had been dusted on the sore, the taste of Iodine was quite perceptible in the mouth : slight dryness of the- throat was",
         "HOSPITAL REPORTS. felt by -some, nausea by others,; vhile one complained of a continual sour taste in the mouth and throat, which made her unwilling to drink any milk for fear of-souring: it. The action of the- Iodoform seemed most marked in these cases in which a specific taint existed. The unhealthy ash-grey appearance cha.nged at once and healthy granulations sprang up. When too frequently applied it over stimulated the sore, and had to be discontinued. .Fracture of -lie Hmnetus from a Powerfut Wrench of 'te Wrist. A rather curious case of fracture was admitted in the month of April. J. D., a soldier, about 4o years of age, a fine, powerful, muscular man, was testing his strength with a corrade by \"twisting wrists ;'for some little tine neither party seemed to gain any decided advantage, till at last the patient's opponent suddenly raised his elbow from the table .and gave a sharp quick wrench, snapping the patient's humerus about the middle of the shaft. The arm was put .up in the ordinary way, and a good recovery was made in -four weeks. The suddenness of the wrench and the viole'nce of the muscular effort exerted by the patient to recover from it proved too much for the resisting power of'the bone. Case of Favus. T. A., a lad of sixteen, a sailor, applied for admission to Hospital with his, head almost completely covered with 'iavuscrusts. The hair was mostly short, dry and, brittle, and matted with the' discharges, and altogether the case seemed by no means very promising. The crusts and hairs were-carefully examined under the microscope ; the achorion was everywhere very plentiful. -Hew as put upon.five drops of Fowler's; Solution, three times daily; poultices were applied to the head to clear off the crusts, and epilation",
         "8 CANADA MEDICAL AND SURGICAL JOURNAL. decided upon. 'The case \\was then entrusted to Mr. N.. Smith, to whose perseverance and assiduity the favorable termination of the case is largely due. A small patch of the scalp was cleared every day by carefully pulling out each hair with a fine pair of forceps. A wash of Hydrarg, Bichlorid. grs vi, Ammon. Mur. 3 ss., Aquae ad 3 viij. was then rubbed carefully into the cleared surface. Al the diseased hairs were in this manner gradually removed and- the parasiticide applied to the whole scalp. As new hairs grew up, any which had a suspicious appearace were at once pulled out and the wash well rubbed in. After two months of this treatment, carefully and persistently carried out, the patient left hospital without a vestige of disease. The hair was growing well and was quite healthy in. appearance. VIENNA, May, 1875. To the Editor of the Canada Medical and Surgical yournal. DEAR SIR,-Vienna is certainly the place for one to come to who wishes to post himself in medicine, both general, and special. The amount of material is enormous, and the teaching first rate. There is scarcely any organ or part of the body that is not made a specialty of here. In fact, as a friend of mine remarked-the other day, some man ought to make diseases of the navel a specialty to complete the list. : The Medical Department of Vienna University has â world-wide reputation, and justly so, too; while it still has amongst its Professors such men as Billroth, Hebra, Bam berger, Brücke, Carl Braun, Meynert, and many other lesser lights, all of whom teach daily and are-listened to by crowds of admiring students and medical med from. aIL",
         "coRREsPoNDENCE. parts of the globe. The private courses, which are given by the docents and assistants, are the ones most patronized by foreigners;on account of their being less crowded. The great drawback to an Englishman or American is his defi- cient knowledge of the langýuage. Vienna is the last place in the world one would come to study German, on account- of the numbers of English-speaking people here; besides, at the courses, five-sixths of the men are foreigners. The Viennese seem to have a great talent for languages; it is rare to find a man who does not at least speak two. One meets peoplé who speak -English everywhere, and they, unlike the Anglo-Saxon, if they know a foreign language even very slightly, are not at all bashful about speaking.it, and take every opportunity afforded them of conversing in it. The best thing for a man to do, who intends studying in Vienna, is first to go to some small University town irr North Germany, where good German is spoken and there are none of his countrymen near; in this way he will learn as much German in three months as he can in six lir Vienna. In these small University towns he will be able also to attend medical cliniques, and I have no hesitation in saying that his time will not be wasted. In these small towns he will see more of real Germai life, and see the typical hard-working, beer-drinking, duel-fighting German student. I went to Marburg, in Hessen, Prussia, fór two months, and am now sorry I did not remain longer, or rather go earlier. Marburg is a very old University towny and has had some celebrated men as Professors, who after- wards were appointed to larger tUniversities. Amongst those there at present are Professors Lieberkûhn and Roser,-the former Professor of Anatomy and the latter of Surgery. Lieberkühn is known to every student of Anatony and Physiôlogy. I have heard him lecture frequently. ,He makes Anatomy very interesting, and illastrates his lectures beautifully by specimens and draw- ings ; he is very fond of telling funny stories, and is a great favorite Owith the students. The Marburg students are:",
         "10 CANADA MEDIQAL AND SURGICAL JOURNAL. typical German. ones, and . spend four-fifths of their time smoking, drinking beer and:dighting duels. The Medical students do not.indulge in thesépastimes to such.an extent as studentseof Philosophyand Languages, and. Theology. Nearly all the Medical students having passed through the Arts- Faculty, have lived long enough to see the error of their ways,: and really work hard. Almost every other student one sees is disfigured by scars received in duels. These duels are rarely or never fatal, as. they fight always with blunt;ýswords and no thrusting is allowed; every part of the body is protected, except the face and top of the head. The eyes are protected by spectacles, and' the throat by a stock which reaches to the chin. Whilst in Marburg I must have witnessed fifty duels; in fact they are of daily occurrence. and on Saturdays there are generally seven or eight. The Hospital in Marburg. contains. about a hundred beds. It vas here I first saw hypodermic injections of carbolic acid, of the strength of one to fifty, used for erysipelas, and with apparently good results. The injections were made in, the neighborhood of the eruption. They also injected carbolic acid of the same strength into joints. for synovitis. The surgeons spoke highly of this treatment, and certainly, as far as I could see, it did no harm. I. also saw here -the the operation.of transfusion performed in a case of- scarlet fever. The temperature in the axilla was Io6° Fahr.; extremities cold, and pulse. not perceptible at. the wrist. The blood was injected into the radial artery. The opera- tion was followed by a decided rally, but the patient died twenty-four hours after. Hoping that you will pardon this digression, I shall return to Vienna. One great advantage of Vienna is the number of special courses ·continually going on, on diseases of the eye,,ear, throat, \u0026c. On:the ear, by Professors Grubýe and I'olitzer; on the throat, by Professors Schroetter, Stoerk, Snitzler, -\u0026c ;on the. eye, by Professors von .Jaeger,-Arlt, Stillwag, .\u0026c. It is extraordinary the number of patients tliat attend",
         "CORRESPONDENCE. these cliniques, and at them students have every opportunity of examining the cases. Diseases of the-eye-can be studied to great advantage, and courses are being continually given on the pathology, diagnosis and therapeutics of the external diseases of the eye. Prof; Jaeger and his assistants give remarkably good practical courses of eye operations and the use of the ophthalmoscope. The courses in Operative Midwifery and Surgery are surpassed nowhere, not even in Paris. Material for these courses never seems to fail, and may be had almost for nothing. In the Operative Surgery courses given .by the assistants of Professors Billroth and Durnreicher, one has generally, in a. single course, the chance of performing all the operations twice, and some of the minor operations much oftener, The instruction is excellent, and. the teacher sees that each one performs.the operations carefully. These private courses last as a rule about six weeks, and cost on an average between seven and ten dollars, some more and some less. Students coming to Vienna should endeavor to arrive in October or early in January,as most of the classes at this time are commencing. The opportunities afforded here for-studying skin diseases are greater than at· any other school in the world. Four or five lectures are given daily, which are illustrated by numerous cases. Prof. Hebra visits his wards every morn- ing at seven, and lectures from eight to nine. He is a very amusing lecturer to listen to, and his remarks on things in general display a large amount of common serse; his manner is rather rough, and at times he makes use of strong language, but his remarks are very original, and he:generally tells one something new. A beginner would profit more by first taking a course with some of the other-Professors before going to Hebra's clinique, as their manner of teach- ing is more, systematic though not .so entertaining as Hebra's. There are. no less than five Professors of Skin Diseases connected with the University. Drs. Neumann and Kaposi were made \"Extraordinary Professors\" at the end of last term. In 'eczema and psoriasis, tar ointment",
         "12 cANADA MEDICAL AND SURGICAL JOURNAL. (ol. rusci) and green soap (sapo viridis) are used very exten- sively. There have been some very fine cases of pemphigus lately in the wards, one very severe case of which was treated by water baths. In this case, the man was kept in the bath for four successive days. Scabies, lupus and syph ilides are the most common skin diseases here. There was a curious case of tattooing exhibited lately at the Skin Clinique. It was that of a Greek sailor who was, with the exception of his face and hands, completely covered with tattoo marks from head to foot. Looking at him from a distance, one would imagine that he had a tight-fitting suit of clothes on. 0n close examination, the tattooing was seen to consist of a most intricate and beautiful pattern, some of the lines of it being almost microscopic. Curious characters were to be seen on some parts, and on his face and hands (the only parts not completely covered) were birds and beasts. His story was that years ago he was wrecked on an island in the Indian Archipelago. His companions were killed by the natives, with the exception of two, who with himself were subjected to this process of tattooing and dedicated to the gods. His two companions: died under the process, but he, being a very strong man, survived. -He says the tattooing took months before it was entirely co.mpleted. His story, I may say, is to be taken cum grano salis. It is rumored that Prof. Recklinghausen of Strasburg is to succeed Prof. Rokitansky. I believe -the position has been offered to several North German.Pathologists, but none have accepted it. Prof. Rokitansky, it seems, wants to be succeeded by one of his old pupils. One neets at the different classes people from every part of the globe: Russians, Swedes, Poles, Turks, Swiss, South Americans, and even Japanese. English and Americans are very:numerous ; there were at least fifty here last winter. So far I have only seen two female students, and they are both Americans. Foreigners are generally charged for courses twice as much as natives. It is quite common to",
         "CORRESPONDENCE. see a course advertised thus :-Inlän'der (natives), 1o fi.; Auslânder (foreigners), 20 fi. Some of the teachers' are liberal enough to make no difference, but in these cases the course is generally charged for at so high a rate that 'natives ' are virtually excluded. All the University lec- tures, viz: those given by the professors, are of course the 'same price for. ail ; but foreigners to be able to attend them have to prove that they have studied medicine and have to enroll themselves as \"extraordinary\" (ausserordentlich) 'students, unless the Professor has some special arrange- ment,. which, as in the case of Prof. Hebra, allows them to do otherwise. There is a capital Children's Hospital '(St. Ann's) quite near the General Hospital, which is very popular with the foreign medical men studying here. Prof. Wiederhofer has a children's clinique daily, and his course is one of the most crowded. His assistants give very good private courses, limited to ten men, in which numbers of out patients are seen, and the members of the class are daily taken through the wards to look at interesting cases. During the winter session there was a great number of croup cases, many of which were fatal. In ten (io) cases, Tracheotomy was performed, but not one recovered. Rick- ets seems to be the most common children's disease here, and goes by the name of 'Die englische krankheit, (the English disease.) The favorite treatment[of pneumonia is by the wet sheet, as far'as I could see the success of this method was not very great. The Children's Hospital is very well built and ventilated. One thing that strikes you on entering the wards is seeing over every bed a plate with the name of the person who gave a sun sufficient to furnish one bed. Instead of wards being given by one person as in England it'seems to be the fashion for people to give enough to defray the expenses of one, two or three beds. The corridors -of the hospital are prettily decorated with numerous statues representing the various ways' children are carried in'different parts of the: world. Among them is of 'course the Indian Squaw with a 'papoose' on her back",
         "14 CANADA 3mDIOAL AND SURGICAL JOURNAL. and a hatchet in her hand. One is often surprised at the class.of people one sees at the cliniques. It is no uncom- mon thing for a lady to come with a child in a carriage, acconpanied by a nurse. Many of the patients without doubt could afford- to pay a doctor. The doctors here are miserably paid. Legally, I believe (unless they are prof- essors ) they can only collect twenty kreuzers (ten cents) a visit, but one gulden (fifty cents) is the usual fee. In the University there are two Professors of Anatomy, and two sets of Lecture and Dissecting Rooms. Prof. Langer is Hyrtl's successor. .Hyrtl resigned his post last year and is now living a few miles out in the country, where he spends most of his time gardening. He has taken his museum with him, and still continues to put up a few of those beautiful microscopic specimens for which he is famed. His museum, I hear, is soon to go to America, having been sold to a college in Philadelphia. Subjects being so plentiful, dissecting costs nothing. As a rule, they are not injected, unless the student especially requests it. No preservative injection is used, it not being an object, where material is so abundant, to preserve a sub- ject for any length of time. The lectures in anatomy are well worth, attending ; they are beautifully illustrated by specimens and diagrams. The black-board is used a great deal here in teaching Anatomy. A student who wishes to read. anything up specially can always procure as many dried preparations, bones, and 'pickled' specimens, as he needs. Connected with the Disecting Room is a place fitted up with apparatus for preparing-bones.- Any number of bones are .alwaysi lying loose about the Dissecting Room for the use of students. The Prosectors .of Anatomy give private:courses on 4 Practical Anatomy \" which are numer- ously attended by students-going up for examination. They .dissect out- roughly-before the-.class what they-intend to demonstrate, and have a fresh subject every day. The amount ofimaterial' used up is- startling:to -one who'has alvays been accustomed to be: careful of, it on occount of",
         "CORRESPONDENCE. its scarcity. Quite near the hospital is a medical college- called the \"Josephinium,\" founded in 1ý84, by Joseph II, for the education of militarysurgeons. The college contains a magnificent wax anatomical museum, said to be the finest in the world. Some of the models are very beautiful and are the works of celebratediartists. One model alone cost twenty thousand dollars. This museum is open-to medical men daily froffi eleven till one. There has been a great deal of typhus fever here this winter, the patients are put in the wards with ordinary cases of pneumonia, phthisis, \u0026c. Of late, there have been so many cases that they are thinking of building a special hospital for them, a thing which should have been done long ago. Last week a child was born in Prof. Braun's wards, without eyes, the lids were perfect but the eye-balls were completely wanting. Prof. Braun said he knew of but one similar case. During the winter Prof. Braun has shewn his class numbers of interesting cases, among which were two of double uterus. In the first of these cases the diagnosis of fibrous tumour was made and the true nature of the case was not found out till the sup- posed tumour had been cut into, and about a pound of retained menstrual fluid escaped. The woman died six days afterwards of peritonitis, and at the autopsy it was found that;the right horn of the uterus did not communi- cate with'the vagina, but was connected with the right ovary. The right ovary was merely a sac, and both it and the right Fallopian tube were much distended by the retained fluid- When a case occurs in the midwifery war.ds requiring operative interference, and the tirne suits,,it is brought into the lecture room and the operation performed beforethe class. Simpson's forceps are the ones most'used here. When. a patient dies in hospital he remains in the bed and in the ward he.died in for three:hours,:then heis taken to the dead-house, placed in a large room in: bed and has his fingers attached to;a bell.by a string, so that should he máke the slightest movement, the bell rings and the atten-",
         "-16 cANADA MEDICAL AND SURGICAL JOURNAL. dants are aroused. The room contains about twenty-four beds, and looks exactly like an ordinary hospital ward. It is rather a strange sight to see a ward full of corpses in bed. After having remained here twenty-four hours, a post- mortem is made (in every case). Then, if the patient has friends who can afford to pay for his funeral he is delivered to them, if not, he goes to one of the numerous departments requiring material..,There is no case on record in this hos- pital where a patient has ever come to life after baving been nlaced in this room as dead. It is an old custom (and the law requires that they should observe it), to keep a body with bell attached twenty-four hours after death. The weather all last winter was very severe, such a con- tinuous low teni'perature not having been known for years. There was good skating every day during January and February. Snow storms were of daily occurrence. At present it is quite summer-like, the leaves are all out, and everything looks cheerful. In summer the people live almost entirely out of doors. They always, when fine, take their meals outside under awnings and trees which are in the Gardens connected with every 'Restauration.' The Prater is the fashioriable promenade and drive and is full of people every afternoon. The cafés, with the crowds of people sitting out under the trees in front of them drinking coffee, the music of the various military bands, and the gay equipages continually passing, make the place both very lively and causes one to forget the disagreeableness of the past winter. To a man who has had a fair medical educa- tion, Vienna is the place to come to. Even if he is but slightly acquainted with the language there are 'many courses in which he can use his eyes and hands to great advantage. After attending lectures for six weeks or two nonths, and reading at home with a teacher, he will be able to make out pretty clearly al that is said. The expense of .living is about the same as in London. Every advantage is here, offered to m en who wish to study specialities as the eye, ear aind th-oat. Hoping that I have not intruded too rnuch on your valuable space, I am- Sir, yours \u0026c., F. S.",
         "REVIEWS AND NOTICES OF BOOKS. Eeviews andI Mañs of k. Crouep in its Relations to Traclieotomy. By J. Sous COHEN, M. D. 8vo. pp. 78. Philadelphia: Lindsay \u0026 Blakiston, 1874. This is an essay which was read before the Philadelphia County Medical Society, January 14th, 1874, and ordered to be printed by the Medical Society of the State of Penn- sylvania in their transactions for that year. The author states that 4 it is based upon a careful study of the published records of more than five thousand cases of Tracheotomy in croup, performed in-various portions of the world.\" The labour entailed in such a study has been doubtless consid- erable, and the result has been a useful essay upon the subject. The paper is limited to the subject of croup.in its, rela- tions to tracheotomy, and the casualties.- incident to: the disease, independently - of the, operation, such as general systemic infection, diphtheritic paralysis, pneumonia, and fibrinous deposits in the cavities of the heart, are, not. discussed. Statistics are given, taken from French, German, British- and American- sources, which show that the results- of the operation prior to 185o were in the main -unfavorable, and the much greater success -which has attended the operation in the past twenty-five years, the author attributes·to the increased care taken in the performance of the operation itself, and in the details of the after:treatment. Age appears- from an extensive range of statisties to have an important bearing on -the result ofr thë operation. It is seldom sue cessful in, children under tWo years' of age, or over eight or nine, and very seldom or never successful in the adult. Sex does -not: appear to have any influence on the mortality.- 2",
         "CANADA MEDICAL AND SURGICAL JOURNAL. The mortality in private practice is much less than in that of hospitals, for*various reasons. The bulk of the essay is occupied in the consideration of four main topics: i. The indications for the operation. 2. The points of importance in connection with the opera- tion itself. 3. The after-treatment of the disease and of the surgical wound. 4. The casualties which prevent recovery. The authôr gives the opinions of various authorities on Croup as to the indications'for the operation. According to Trousseau and Guersant, each' of whom bases his opinion upon more than two hundred cases, the only insu- perable contra-indication is profound diphtheritic infection of the economy. The symptom pae excellence, which calls for operation, according to 'Professor Heuter, is the marked sinking in of the front of thé chest, especially of the lower end of ,the sternum. When:the want of oxygen in the blood,-or in otherwords the -want of pure air in 'the lungs is strongly felt,: the: diaphragm: and the other inspiratory muscles make violent efforts to draw as much air- as possible into the chest. But jf the free passage of air through the glottis is irnpeded and but little air enters the lung, the diaphragm does not descend .as in ordinary respiration. Its central tendon becomes a fixed point, and its muscular fibres con- tracting, tend to draw its peripheral insertions toward the centre. The insertions .of the diaphragrn into the lower end of tlie sternum and the adjacent costal cartilages are the most moyable, and hence these show most clearly the contraction, which draws these portions in powerfully with each inspiratory effort.. There is also marked sinking above the clavicles: from atmospheric pressure. This, however, upgIlyet;s in later than the depression at the epigastrium. Professor Heuter holds that these phenomena are of",
         "REVIEWS AND NOTICES OF BOOKS. more consequence in determining the question of operation, than the degree of stridor. As.he says, \"a great deal of dyspnoea may go hand in hand with little stridor, and a little -dyspnoea with great stridor. Observation of the entire respiratory act affords a much- safer estimate of the impe- diment to breathing.\" A dark blue color of the lips, and a pale and apparently ædernatous condition of the cheeks, shows the retention of carbonic acid gas in the bloodc. '' I consider that the hour for tracheotomny has come as soon as the substernal tissues sink in a rnarked manner on inspira- tion, and the blhe color appears on the lips.\" As regards the operation itself the author favours the use of anæsthetics, and chloroform is the.anesthetic which he prefers. Anæesthesia need not and should not be pushecd to its full' extent, as the carbonization of the blood, has already produced a certain amount of anoesthetic influence. Most authorities appear to agree with these vievs, and find that chloroform relieves laryngeal spasm,thus enabling more air to enter the chest, while the movements of the trachea are lessened, the child lies ,quietly, and the physician is not intèrrupted by his struggles. The niethòd of ,operating -which seems to carry the greatest weight of authority with it, consi ts in making a careful dissection down to the tra- ,chea. - As a rule there is no such urg'enthurry in perforrn- .ing the operation as tò prevent a dissëctioh 'dowh to the trachea; an by s/odoing the risk 6f wounding the\" sopha- gus, which has 'óccurred in the operation by ïransfixion and :incision ata single stroke, or of not passing the- cnula into the windpipe'\"atail, is avóided. In the opertion by uine- ture and incision, in several cases the canula has bèen found lying on the cellulár tissue in front or at the sid' f the trachea Trousseau strongly disapproves of -ndue h ste in\" per forïnihg\"the operation, and hé said àt- the famoùs'discussióh on theûbject,:'A èentain s~ur'geon has repidached me with operatiinglikea physician and not like s surgeôn'. Well, he .had an opportunity, on one occasion, to operate like a sur-",
         "20 CANADA MEDICAL AND SURGICAL JOURNAL. geon, and with one stroke of his knife he divided the. esophagus as well as the trachea. Sometime afterwards. he lost another patient by hemorrhage during his brilliant operation. Since then he has operated more like a physi- cian, and after a while he will become a very fair tracheot- omist.\" As a rule the author advises all hæmorrhage to be stopped before the incision is made into the windpipe, and this view is supported by most experienced tracheotomists. In making the incision care must be taken not to wound the posterior wall of the trachea or make a counter opening into the esophagus. Sudden death may ensue from the flow of blood into the bronchi. False membrane may be present in the track of the knife, and the point of the knife.may not pierce this, but push it back against the. posterior wall, shutting up the wind-pipe, and rendering suffocation immi- nent. In these cases it is recommended to pass an elastic catheter to tear the substance loose, and through it air is blown to excite cough. Another danger is the falling of loosened pieces of false membrane upon the bifurcation, and their passage into the bronchi. This is to.,be overcome by aspiration through the catheter. Heuter strongy advocates passing a catheter in every case of membranous croup, imrAiediately after, the trachea is opened, and suction should be made through it, to remove all pieces of membrane and blood which may haye lodged at or near the bifurcation. The introduction alone of..the catheter and its withdrawal will cause the expulsion of some of thé blood and membrane without suctioi, which is not always free'from danger to the operator. After the trachea is incised its edges should be held apart by, hooks and search made for thé' false membrane, as if it were a foreign body, and as much of it removed.as possible before thé, introduction of the canula. Causes. delaying theremoval of the canula are treated of, and then the.author goes on. to speak of the after-treatment of tie, disease and the wound.",
         "REVrEWS AND NOTICES OF BOOKS. To this he attaches much importance, and as the statis- tics of tracheotomy show, it is mainly to increased care sub- sequent to the operation, that' the comparative success since 1850 is due. The care of the canula is a matter of primary importance, and the. author is very strict in his injunctions on this head. The casualties which prevënt or retard recovery, as haemorrhage, inflammation of the wound, erysipelas, gangrene, diphtheria of the wound, and emphysema are discussed and their appropriate treatment given. Ir summing up the author draws the following conclusions:. i. That there are no insuperable contra-indications-to tracheotomy in croup. 2. That the administration of an anæesthetic for the pur- pose of controlling the child's movenents is admissible in performing the operation; but that it should be used with _great. caution. 3. That a careful dissection should be made down to the *windpipe, and, hemorrhage be arrested before incising it whenever there is at all time to do so. 4. That the incision should be made into the trachea as near the cricoid cartilage -as possible to avoid excessive hæmorrhage and subsequent accidents which might occa- sion emphysema. 5. That a-dilator should be used or a piece of-thetradhea excised whenever any difficulty is encountered in introdu- Ncing the tube. . That the tube should be dispensed with as soori as possible ; or altogether if the case will admit of it. 7. That assiduousattention shoild be bestwe'd upönù thé ýafter:treatment, especially that of the wound; -and that a ski1ld attendant should be w ithin a moment's call for the 1frat!twenty-four or forty-éight hours immediately following t ie:operation.-",
         "22 CANADA MEDICAL AND SURGICAL JOURNAL. S URGERY. On tlie Treatmzent of Heat Apoplexy. By Surgeon-Major- J. DAVIS, A.M.D. When stationed at Ferozepore in the hot season of 1872. I was called one night to see a patient seized with heat apoplexy. On arrival at the hospital I found the man (an acclimatized soldier) had under the use of the cold douche become partially conscious, and he gave me to understand, by passing his hand across the part, that he was suffering from a sense of constriction around the lower portion of his chest; his breathing was laborious, and he was vainly endeavoring to take a full inspiration. It occurred to me- that this state was due to some oppression of the respira- tory nervous centre, and thinking cupping from the nape of the neck might be of use, I sent for the cupping case and applied as many of the snialler-sized cupping glasses as available from the occiput down thé nape of the neck in pairs, taking blood with the two úppermost, using a temple scarificator ; the glasses were only on a few seccnds, when the man said \"'tis gone now, sir.\" He became per- fectly sensible, breathing natural and easy instead of laborious and imperfect; he recovered without a bad symp- tom. In one or two subsequent cases, the patients being fully insensible wihen the cupping glasses were applied, a similar favorable result took place. I had no further oppor- tunity of testing the value of cupping until last year, when Surgeon-Major Scot.t kindly allowed me to resort to it with a patient of his, a man -of E-8, R.A. On our visitiig the patient we .found him - p'erfectly: insensible; breathing: labored and stertorous; the free use of the, cold douche- failed to arouse him in the slightest degree; he was turned on his side and the glass applied as before described.. In-.",
         "ON THE TREATMENT OF IIEAT APOPLEXY. a few seconds, the man was perfectly conscious, able to answer questions, but inclined to sleep. Here, unfortu- nately, we did not let well alone, but resorted to wet pack- ing, with the object of exciting some action of the skin, which was hot and dry. Coma again set in ; the wet packing was at once removéd, a free douching given, and the glasses again applied, to our great relief, with a similar favorable result. When we consider how oppression of the respiratory nervous centre interferes with the due per- formance of respiration, inducing congestion of the lungs (,o fatal a complication in heat apoplexy), and how sus- pended or imperfectly performed respiration gives rise to oppression of the medulla oblongata resulting in coma and death, the importance of relieving the oppressed nervous centre becomes apparent ;' otherwise a vicious circle becomes established ; the oppressed medulla interferes with the due performance of the respiratory act, and the imperfectly purified blood circulating in the brain in its turn further increases the oppression of the already dam- aged nervous centre. I should, therefore, be glad if those who May have an opportunity of testing the value of cupping the nape of the neck in cases of heat apoplexy would kindly give it a trial and make,knowin the.results. I may remark that the position in which patient lies in heat apoplexy has, I believe, more or less prevented cup- ping the nape of the neck being resorted to, and that to turn an insensible man, keeping him steady;on his side while the glasses are, applied, requires some little man- agement. To recapitulate, I recommend that in a case -of heat apoplexy after the free use of the cold douche the patient should be turned on his side, as many small-sized cupping glasses as possible be applied from the occiput down the nape of the neck in pairs (one on either side of the spinal column) taking blood with the two uppermost. This treat-",
         "24 CANADA MEDICAL AND SUROTcAL JOURNAL. ment need not interfere with the use of stimulating enemas, turpentine, \u0026c., which indeed should in all cases be resorted to, so as to unload the lower bowel; neither should the use of the catheter be neglected. DALnous1E, 5th April, 1875. [Indian ledical Gazette. Spina Bfida, Treated by t/ie Elastic Ligaitre: Recovery. The series of cases of so-called spina bifida, or, perhaps more correctly, menmgoceic, which have lately appeared in the 3'ournal, induce me to contribute one which came lately under my care in :the Leeds General Infirmary ; more especially because I treated it in a -different manner from those hitherto published, and the result was not only successful, but much more speedily attained. M. F., aged 8 weeks,'the child of healthy parents (who had previously twice had twins, one only of the four chil- dren yet surviving, but none having presented any malfor- mation) was brought to the hospital on January 7th, 1875, on account ofa globular bluishcoloured fluctuating tumour in'the cervical region, of the:size, of a tennis-ball; which filled up the hollow between the -occiput and the fold cor- responding to the tops of the :scapulhe. - The tumour was ,pediculated, the pedicle being about the, thickness . of a -man's thumb. The attenuated skin which covered it was too tense -to admit of much impulse being felt when the *child. cried.; but its transparencyenabled one to recognise the arrangement of blood-vessels characteristic of the cerebro-spinal meninges. On pressing the point .of the finger ppon the under ,side of the . pedicle, a small hole could ,be felt corresponding with the deficient arches of *two (perhaps only one) of the cervical .vertebræ, Her-e a .slight impulse was felt when the child cried. The child was puny, and apparently not possessed of mich vitality; but.there -was no paralysis, nor any deformity of the limbs. The parents were told that it would probably die soon in",
         "SPINA BIFIDA TREATED BY THE ELASTIc LIGATURE. 25 any case, and that the only chance for it was the removal of the tumour, but that interference was scarcely justifiable. The child .as then taken away, but in a week was brought back, the parents saying they had \"considered to have something done\" if possible. . In the interval, the tumour had increased, and became More turgid and tense, seeming as if it would burst. I accordingly admitted mother and child, and having passed a fine -elastic ligature four times tightly round the pedicle, enveloped the tumour in cotton-- wool. All the first night, the child was restless, crying, and vomiting the breast-milk. Still it sucked, though the milk was rejected directly. A few drops of brandy in a spoonful of 'warm water given several times, checked the sickness, and thenceforth it began 'to thrive. The surface of the tumour soon became vesicated and -the fluid contents oozed away, ieducing the bulk._ On the fourth day, the sac was sloughing. The ligature was partially unwound and tightened up. On the sixth day the pedicle separated, when no hole was visible, nor any oozing of cerebro-spinal :fluid from the stump. The sac was examined, and found to be.a true meningocele. The wound rapidly healed, and the child gained in weight daily, and was discharged at the end of the fortnight. It may be remarked, that the ossifi- cation of the cranial bones was less complete than usual at the end of eleven weeks. The anterior and posterior fontanelles communicated by means of an unclosed sagittal .suture, and the sphenoidal sutures were aiso irnperfectly united. When. last seen, April '2nd, there was scarcely any scar to be seen, and very slight deficiency in the bones could be felt. The child was plump, and healthy, but it .had a certain idiotic wandering of the eyes. EDWAnD :ATKNixsoN, M.R.iC.P.Eng., Surgeon to' the Ieeds General 'nfirary.",
         "20 CANADX %IEDICAL AND SURGICAL JOURNAL, Death from Ether Inhalatiôn. Unfortunatelv, even ether, it seems, is not to be inhaled always with impunity. A boy, aged 16, was operated on by Dr. Hardie, of Manchester, at the Workhouse Infir- mary, on the 3rd of April, 1875. Four drachns of ether were poured on a piece of lint and placed in a folded towel, which was held pretty close to his face. There was no coughing, and but little struggling. He was· ready for oieration in about four minutes without any more ether. The respiration suddenly ceased, and the pulse at the wrist became imperceptible. The tongue was pulled for- ward and the poles of'a battery applied to the phrenic nerves. Cold water affusion, artificial respiration, and sus- pension by the feet were tried, without avail. The organs were found healthy. The cavities of the heart were enpty. Probably death arose from syncope. Robbin's ether was used. This is a most untoward event, because it may prevent the growing tendency to use ether instead of chloroform from spreading as it ought. Ether is certainly far safer and ought therefore always to be used instead of chloro- form.-The Doctor. Te Dangers of Chloroforn, etc., and the Nitrite of Amyl. MR. C. BADER writes to the Lancet that, some years ago, when nitrite of amyl was first used at Guy's Hospital, he with Dr. Goodhart, studied its effects, when taken inter- nally, upon the blood-vessels in the healthy optic disc and retina. The effect, he says, is as rapid as it is striking. Three or four seconds after taking three drops of the drug on sugar the blood-vessels of the retina (arteries and veins, but especially the veins) become enormously dilated and gorged with blood, leaving no doubt as to simultaneously existing cerebral hyperemia, with greatly accelerated circu- lation of blood.",
         "POISONING FRoM ACONITE. Lately, after observing upon himself the effects of inhala- tion of the vapour of the nitrite of amyl, it occurred to Mr. B. that in cases of faintness or of defective breathing or heart's action, while under the influence'of an anosthetic, nitrite of amyl might be of use. He relates three cases to shcw the encouraging effects'of this agent. CASE i.-Given a mixture of alcohol, ether, and chloro- form. Young man, hydrocephalic, inherited syphilis; iridectomised on both eyes ; suddenly becarne pale, deeply insensible, with pulse and respiration very defective. Lint, -vith a few (three) drops of nitrite of amyl, was placed over nose and mouth. In two or three seconds a deep inspira- tion, followed by others, flushed face, quick. pulse, and return of sensibility, were observed. CASE 2.-Given chloroform, A boy, pale, fat, blue lips and cheeks, became suddenly very faint (blue lips, blood turning black, breathing very imperfect. The same quick result, with vomiting, followed the inhalation of the nitrite of amyl (three drops). CASE 3.-Given chlos oform. A middle-aged woman suddenly became blue in the face and stertorous (tongue falling back.) Lint with ten drops of the nitrite of amyl, was placed over mouth and nose. In a few seconds the blueness and stertorous breathing gave way to .good. colour, regular.breathing, and sickness and vomiting, though no food had been given for several hours. The most striking effects of the nitrite of amyl were the quick restoration of breathing, of a good colour, and the rapid appearance of sickness. It remains to be shown whether injection of this agent will have a still better effect.-Thie Doctor. Poisoningby Aconite. DR. J. E. BLAKE, in an interesting article in the New York 31edical ournal, relates a very important -case of poisoning by aconite and chloroform liniment.. An hour",
         "28 CANADA MEDICAL AND SURGICAL JOURNAL. after the poison was taken \" no pulse could be detected even in the axilla, and she remaiined withzoit 'any trace of 'pulse for a period of over tliree hours.\" Nevertheless, Dr. Blake persevered all day and all night with galvanism and arti- ficial respiration, and was rewarded by complete success. He had previoúsly, within half an hour of the poison being swallowed, used the stomach-pump until fluid returned unimpregnated with it; but enough had been absorbed to do deadly work. This patient became early unconscious, and remained so for many hours. Yet almost all writers assert that in aconite poisoning consciousness continues to the last. Could the 'chloroform account for tuie unusual fact ? The lady had taken \" a little more than a drachm\" of the liniment, which consisted of chloroform and tincture of aconitë root in equal quantities.-The Doctor. M E DI C I N E. The Case of ARTHUR O'CONNOR, by HARRINGToN TUKE, M.D., F. R C. P. The casè of Arthir O'Connor is a striking instance of the mistaken vienvs frequently adopted by lawyers as to the value of medical evidence in cases of insanàity, and also is an exceptionally strong example of the way in which an advo- cate, aiming at success, will, do his utmost to di'scredit a medical witness, evën although he feels -the force of the facts uponý vhich ýthe expert has'founded his ôpinion. In April '872, Arthur was arraigned'for ftëasonh-felony. He had pleadêd guilty before the Grand Jiry; it is quite clear that he did so under a misapprehenàin. ftrme demur on the part of the Court, this plea was allowed to be withdrawn, and the trial proceeded. The case, rested almost .entirely upon medical evidence. 'tis w t, i t éOthin 'Ctiïnùr'hàd long been in iÍ1 héaIth; a ealdÍa i\"civéîd à å\u003cëre njtïry; aînce tat t hibdišýoitibnhad hangd. The\u0026as a st ong",
         "THE CASE OF ARTHUR O'CONNOR. hereditary predisposition to insanity; had had a sudden idea to shoot the Queen, but had abandoned that course for one of intimidation. He had intended to attack Her Majesty in St. Paul's Cathedral on the Day of Thanks- giving for the recovery of the Prince of Wales. Turned out of the Cathedral at two in thei morning, he had returned at eight ; the crovd prevented his reaching it again, or getting near the Royal carriage. Persistently tracking the Queen, he at last got near her Majesty's person, climbing the iron railings of Buckingham Palace ; he had time to present a pistol at the Queen's head before her attendants could ar- rest him. Upon him was found a coherent but insane document, purporting to be a pardon for the Fenian prisoners, and an order for O'Connor's own execution. Other insane documents were produced. These the counsel for the prosecution objected to receive. I had seen the boy, at the request of his father, about three weeks previously, and found him to be clearly of unsound mind, entertaining insane opinions, that rendered him dangerous to others. In this view of the case I was strongly confirmed by Dr. Maudsley, who examinèd the boy with me, and also by Dr. Sabben, who saw him afterwards. The paroxysm of insanity that led to his outrage seems to have lasted about six weeks, leaving him in his normal state of hypochondriasis and almost imbecility, with a ten dency torecurrent attacks, in which he becomes dangerous. The subsequent history of his case entirely corrdborates this diagnosis. While in Australia, this condition ofinsane hypochondriasis continued ; and as to the state of his mind, it may be.enough to'mention that though attimes fairly well, at others he .had paroxysms of absoluté mania. .Among other eccentricities, he wrote letters to Herf lVfajesty one of which suggested that he should be made Poet Laureate, in succession to Tennyson. On the. occasion of the last Drawing-room, O'Connor was found in anexcited condition, waiting, it is supposed, for Her Majesty, near the very same",
         "30 CANADA MEDICAL AND SURGICAL JOURNAL. place at Buckingham Palace in which his former mad as- sault upon her was committed. One of the Queen's physicians, and subsequently Dr. Tweedie, saw O'Connor with me before his arrest. The following is his own written account of his symptoms: \"Physical Symptoms. Back like ice ; want -of ability to swallow food. Sinking in Stomach. In cold weather one moment-deadly cold, the next burning hot-liains in the hcad-completely stupified by cold weather-Mental- want of rest-thought continually revolving upon religion. Visions at night of angels hurling men dowry-precipices to die for ever because they had not given.up all they loved and go and sell Bibles to the unconverted. Sense that -unless I gave up the drana, wkitty and convivial Society, novel writing, and the world completely I should be ever- lastingly damned. In a word, one unceasing mania con- cerning Jesus Christ-the intellect warring with extreme views yet unable to crush the ever revolving mania. Sense of utter want of constitution and energy in comparison to what I ought to be. \"Naturally I am a.poet loving the dramatic writers and poet of nature and at one time of my life, ere I became physically debilitated, quite unsusceptible to the present mania, which leaves me no restday or night. Of late my brain agony has terribly incre'aed I awoke the other night raging to commit suicide; the idea occurred as a very delightful one, and just as I was' about to spring from my bed to act upon it--it passed off and left me trembling all over and uttéily horrified. 'Since then rny feelings have risento absolute madness continually andl I know very wéll it is all physical disease, a dead liver or something of the kincL My home is very ýwretched. it. is in fact a hel to me. \"Naturally I arn devoured by energy, running in my walk, and in everything else, but' when stupified by dys- pepsia scarcely able to drag a foot.\" The apparently unanswerable evidence of the insanity of",
         "THE CASE OF ARTHcUR o'CO.NNOR. O'Connor at the time of his outrage upon the Queen, was demolished by the Attorney-General in bis cross-examina- tion, mrildly clescribed in the Timies as occasionally \" catis- tic.\" This was done with great, but, it must now be admitted, with misapplied forensic ability; and, without hearing a single witness for the Crown the jury stopped the case, and found thàt the prisoner was, and had alvays been, of sound mind. This, perhaps, also stopped the Attorney General's speech-fortunately, perhaps, as i was his first .subject since he had showered vituperation upon the Tich- borne Claimant. The ultimate result of this trial should lead future counsel to pause before they utterly ignore ex- perienced medical testimony, at all events, in the prosecu- tion of cases of treason-felony. They may succeed in gain- ing a verdict, and for the moment overwhelrning the physician with ridicule. But supposing, as time has proved in this case, they are in the wrong, bard labour and stripes, and a short imprisonment as a felon, are not likely to, cure insanity ; and the course taken by the Attorney-General might have imperilled the safety of the Sovér'ign. As it is, it has nearly led to her being seriously alarned by the reappearance of the deranged and wild-looking young man near the royal carriage, in the same place where he bad before eluded tbe watchfulness of her attendants. Another result of the Attorney-General's \"unfortunate\" advocacy, (I have to thank him for applying to my evidence and so \" teaching me that word \") has been that thre' years have been lost.; Arthur O'Connor is at last committed to Hanwell Asylum. Under gentle care and treatment in his first attack,. he might have recovered. He may do so now, but his chances are materially lessened. The characteristic judgment and clemency of Her Majesty Jed to the remission of the hard labour and -whipping to which O'Cclnor had been sentenced, and also to a shorten- ing of the term of his imprisonment. If this had not been so, a curious incident would have illustrated the mistake of the law advisers of the Crown : sone of the Fenian",
         "32 CANADA MEDICAL AND SURGICAL JOURNAL. sympathisers seriously proposed to Mr. O'Connor that a procession should be formed to meet his son on his release, and to escort him with due honour. to his father's home. It should be quite understood that Mr. O'Connor was entirely opposed to this absurd proposal. I havè never noticed the caustic examination of the Attorney-General; nor shall I now, except upon one point-the one by which the jury, and indeed a large section 'of the public, were mainly misled. It is deserving ofcareful attention, because it constantly arises in criminal trials, and was in this of paramount importance. The Attorney-General contrived to persuade the jury that, if they acted upon the medical evidence, the -prisoner would be confined for life in Broadmoor Asylum as a crinm- nal lunatic ; whereas, if they took the legal view of the case. he would escape with a comparatively trivial and salutary punishment. Now, this was trebly \" nfortunate.\" It was purely an ad captandum, argument, and entirely irrelevant to the question of the truth of the evidence, which ought not to be, and was.not, in any way biased by consideration of results. It, moreover, offered a temptation to the jury to do the wrong, that right might come of-it. I was un- fairly taunted with ,attempting to injure, while I was pro- fessing to assistr Now, strippedofforensic tinsel, the plain, truth stands thus :'he parents of the boy, who was then only, T7years of age,.were convinced ofhis insanityalarmed at his evidently dangerous.conition, and most arxious to have for him anytreatment thatm ight permanently cure him; .they were respectable people, yho 'had been in a superior positionand they were averse to their son's being branded as a felon'; it was, therefore, after anxious consul- tation, with. them and their counsel, that the course inyeighed against y he Attorney-General was adopted; .and, in th, event of Arthur O'Connor's recovery at Broadmoo, his parentstrusted to the strong evidence f the. son's previuP good character, and thoroughl -eliedupôn",
         "TREATMENT OF OBSTINATE VOMITING IN PREGNANCY. 33 bis being the subject of the never failing clemency of Her .Majesty. I freely forgive Lord Coleridge for his personal àttack 'upon myself; it was possibly his professional duty to break down, by every possible means a witness hostile to bis own -views ; but he must surely noiv deeply deplore his share in a proceeding which consigned a sick and insane boy to degrading punishment, and to a prison instead of an hospi- tail, thus, perhaps, rendering him a hopelesslunatic; he may also regret that he treated a medical witness with much discourtesy, and ridiculed scientific evidence that bas ultimately proved correct; and he must feel deeply that his unfortunate advocacy very nearly resulted in injury or .alarm to the Royal Mistress whom it was his special duty to protect and defend. I trust the case of Arthur O'Connor may either lead the English Bar to more extended study, or induce them to -receive with greater attention and respect the evidence of 'those who make nedical and other scientific investigations 'the pleasure and business of their lives.-British Medical Yournal. M I D W I FE R Y. ýOn Dr. Copeman's Novel Treatnent of Obstinate Vomiting in Pregnancy. By GRAILY HEWITT, M.D., F.R.C.P., Professor of Obstetric Medicine in University College. I have read the valuable practical paper by my friend Dr. Copeman of Norwich on the subject of the treatment *of obstinate sickness in pregnancy, in.the British Medical Yournal for May i5th, with much interest. Dr. Copeman las described a process which he has, he states, accident- .ally discovered ; viz., the artificial dilatation of the os uteri by the fingers as a cure for obstinate sickness in pregnancy. His results are remarkable, and, stated as they are by a, :gentleman of bis known experience and accuracy, they are",
         "34 CANADA MEDICAL AND SURGICAL JOURNAL. very important. Dr. Copeman, to use his own words, does not \" attempt to explain the modus operandi of the treat- ment suggested\"; and I desire to offer what I ,onsider to be the true explanation. In the year 1871, I read a paper before the Obstetrical Society (see Transactions, vol. xiii) on the subject of. this vomiting in pregnancy. I there enunciated the theory, which I supported by facts and observations, that obstinate vomiting, and indeed ordinary vomiting, in pregnancy are due to a flexed condition of the uterus, the compression of the tissues of the uterus at the seat of the flexion consti- tuting the irritation which gives rise to the vomiting. My view was strongly criticised at the time, and, indeed, Dr. McClintock of Dublin was at the pains shortly afterwards to write and publish a paper, expressly directed to the abolishing of my theory. I have been content to wait until professional opinion was more ripe for discussing the matter calmly, believing firmly that my -view expressed four years ago is in all -essential particulars correct. Dr. Copeman's clinical contribution of three cases has a strong and direct bearing on the above question, and the cases offer to my mind strong confirmation of the truth of my original statement. The three cases occurred respec- tively at six months, two months, and eight months, and in each case the vomiting at once ceased on dilatation of the os with the finger. In the second case, Dr. Copeman says the uterus was \"anteverted.\" He gives no accountof its condition in the other two cases, so far as flexion or version is concerned, Now, it is my belief that all three cases were alike; that there was, or had been, acute flexion in each case; and that the dilatation operation of Dr. Cope- man effected good and removed the vomiting by reason of its also relieving the cramhped condition of the cervix. On the supposition (which I make as regards two, but which is a fact in one of the cases, according to Dr. Cope- man) that th~ere was flexion in all three, the os must have been far back, and, in order to dilate it, it must have been",
         "TREATMENT OF OBSTINATE VOMITING IN PREGNANcY. 35 pulled forwards. The dilatation would and must neces- sarily imply a righting of the os and lower segment of the uterus, and a consequent unbending of the organ ; for I need hardly remark that to draw the os forwards would of necessity tend to tilt the fundus upwards. The uterus, as a whole, is on a pivot; direct p-ressure on or dragging on one extremity of it will affect the other extremity, and thus the process of dilatation, involving as it does the dragging of the os forwards, would practically aid'in the placing of the whole organ in its proper position. It is customary with obstetric authors to' speak of the' gravid uterus as being naturalily' anteverted- in the - first part of pregnancy. This is a stateinent which requires important qualification. There are degrees of anteversion. It is one thing for the body of the uterus to be rather easily felt by the touch through the anterior wall of the vagina, as it undoubtedly is in ordinary casés, but it is another-for the roof of the vagina to be actually depressed by the abnormal descent of the 'enlarged body of the ute-us when it is anteflexed. In the -latter case, the os is always further back than usual, and, in marked cases, the body of the uterus is for the time completely jammed in the pelvis. It is under these circumstances that obstinate vorniting most commonly occurs. Retroflexion is equally operativë in a quite analogous way; but I say nothing further on\" that subject at present, as it does not seen likely that either of Dr. Copeman's cases belongéd to that category.' But it may be said, How do you -explain the cases in which the vomiting persists as late as, the. eighth, month, which vas the fact in an acute flexion-in the early part of the pregnancy,; as the uterus enlarges (if, abortion dojnot' occur), the flexion is in most cases abolished, and -the efféct of this is, thatthe sickness generally disappears ,tnder such circumstancès. 'But the tissues of the uterus at the seat' of the flexion are somùetimes left iri a diseased state, being stiffened and unduly resistant, and, thus' the irritation is kept up.",
         "36 CANADA MEDICAL AND SURGICAL JOURNAL. Dr. Copeman's treatment would undoubtedly tend to remove this stiffening and constraint. He himself says, in his paper, \" I wondered whether the relief to the vomiting so urgent and threaten:ng to her life could have been effected by my having dilated the os uteri, and thus removed any undue tension which might be producing sympathetic irritation.\" Undoubtedly, there was undue tension; this tension was, I consider, situated at or near the internal os uteri, which is the situation of flexion under ordinary circumstaices; and Dr. Copeman's procedure acted pre- cisely in the way he conjectures. I submit to his careful judgment, and that of others accustomed to consider such problems, whether my explanation of the utility of his process is not the sound one. I have been accustomed to treat cases of obstinate sick- ness. in pregnancy by elevating the body of the uterus, and I have found that the same immediate good result follows as was observed in Dr. Copeman's cases: viz., the cessation of the sickness ; but I am quite prepared to hear that trac- tion of the os uteri forwards will produce a like effect. Both procedures have the same result ; the liberation of the tissues of the uterus at the internal os uteri from their cramped compressed condition. There are other details, but at present I forbear to say more on the subject. [Britisk Medical Yournal. UNIVERSITY COLLEGE HOSPITAL. We observe by recent exchanges that Mr; Erichsen, who has served as surgeon to University College Hos- pital for the past twenty-five years, has resigned that office. Mr. John Marshall becomes Senior Surgeon, and Mr. Christopher Heath takes charge of Mr. Erichsen's wards, and succeeds him as Holme Professor of Clinical Surgery. The wards lately under the charge of- Sir Henry Thompson are assumed by Mr. Berkley Hill, who has, in addition, the surgical ward for children.' A vacancy occurs, which is not yet filled,' of Assistant Surgeon to the Hospital.",
         "CANADA MONTREAL, JULY, 1875. CITIZENS'. -PUBLIC HEALTH ASSOCIATION. Recently an association with the professed object of im- proving the sanitary condition of the city of Montreal has been organized. It is composed of many of our leading citizens, and we trust that much good will arise out of its deliberations. There is great need of sanitary reform, and we fully expect that some definite scheme will be pro- posed to improve the assumed unhealthy.condition of our city. If the association will earnestly enter into the work of reform, it will bring such pressure on the city authori- ties as to force them to adopt many needed sanitary im- provements. There are many subjects of great moment to the sanitary weal of the citizens which should engage the attention of the Association. Very great good resulted a few years back by the earnest work of a similar associa- tion, whose hobby at that time was ventilation and cleanli- ness, infact through the personal efforts of a few gentle- men who visited our citizens from house to house, ventila- tion and whitewash, became the rage, which certainly improved the appearance if it did not the sanitary state of many a dingy suburban retreat. We may remark en passant that our water supply is simply abominable. This we think should be a legitimate subject for the sanitary association to discuss. There does not exist in the enòrnously expensive machinery of our water works, any means of filtration. The citizens' are supplied with water reeking with all kinds of animal and",
         "38 CANADA 3mEDICAL AND SURGICAL JOURNAL. vegetable refuse. If compelled to drink water,it is at least a satisfaction to see that it possesses the appearance of cleanliness, but to be supplied and forced to consume water which is in appearance as well as in verity filthy, is cer- tainly anything bu.t pleasant, and -we do not wonder at the custom indulged in by many persons of mixing a drop of stuff with their water to correct it. The waters of the Ottawa, which flow past our city, come down in a continuous stream several hundred miles from what is termed the height of land, receiving in its course the w,aters from tributary streams and rivers, so that it drains the entire valley of the Ottawa. In its course downwards it may be said to remove the refuse drainage and sewage of over half a million of people. We do not object to drink this water, although it is the com- mon lavatory and sewer of this vast crowd, provided it is cleansed by filtration. People are probably not aware-that at each ablution they strip from their bodies several ounces of its epithelial covering. This is in the. form of an impalpable powder ; it readily mixes with the water, is suspended in it, and can ouly be discovered by means of a high microscopie power. Of course we cannot see these scales with the naked eye ; nevertheless they are there, and we swallow, them and fatten on them, as nothing is lost which can beutilized by Nature. This is not pleasant to contemplate,; it is disgusting, though not injurious. There are other substances, however, which, are suspended in our water which are far less innocuous, and which give rise to disease and sometimes death. This is a subject which can be discussed by the \",Citizens' Public Health Association\" with far greater advantage to the citizens than by silly and questionable remarks concern- ing our dirty back lanes. The water from Couir house taps is a kind. of animal and vegetable compoind, almost as thick as pea-soup, though not quite as:savory- and the only-means at the disposal;of the tenant, with a view to improve its condition, is the use ýof a private filter. This isa luxury",
         "CITIZEN'S PUBLIC IIEALTII ASSOCIATION. ,enjoyed by the man of means ; the poor man is forced to drink the water as it is supplied, and thinks his water tax heavy enough without an additional tax for a. filter. Hence as philanthropists and politicgl economists, we should not only advocate but insist on the use of a public filter. It is a matter of fact based on observation, that the drinking water of Montreal is particularly noxious to strangers. Persons visiting our city, either on business or for pleasure, seldom get away without suffering from severe diarrhea or cholera. It is by no means uncommon for these attacks to prove fatah We need only to turn to our mortuary statistics to ascertain the fact that cholera, diarrhœa and dysentery are very often fatal during the heat of summer, and this principally amongst the floating population. The citizens themselves occasionally suffer though not in the ,same degree, as they become as it were accustomed to the impurities. But there are other diseases, equally danger- ous to life, which may be produced by the impurity of our water supply--such as Typhoid fever, and the generation of the numerous family of entozoa, so commonly met with in children, and which are occasionally fatal. On looking over the work of Dr. T. Spencer Cobbold, on Helmintho- logy, with reference more particularly to the internal para- -sites of man, the reader becomes horrified at the numerous -forms, and injurious results of taking into our stomachs the ova or the young of various entozoa which live and generate within us. These affections are known to be preventable, and with :regard to cholera, diarrhœa and dysentery they arise frequently from some irritating material taken into the stomach, some substance which the body cannot utilize, ,and which -is therefore cast :out. Can. we wonder :at :such a result, when we present as a beverage to our visitors .a vile compound of human and animal excrement, :fish spawn, vegetable refuse and :germs of all sorts. Nattirally the stomach -rejects it, and what passes into the lower",
         "40 .CANADA MEDICAL AND SURGICAL JOURNAL. tracts of the intestinal canal acts as an irritant and is; thrown off. Why kill off our children by the host of bowel and other derangements induced by drinking these impuri-- ties ? Our city parents do not like to assume the expense of a public filter, although we believe the expense would be trifling compared to the ultimate benefit to the fair name of the city. To this might aptly be applied the couplet: \" Kill a inan's family, and he may brook it, Bat keep your hands out of his breeches pocket.\" \"DOWN' WITH THE DUSTI\" So we cry inwardly when the parching simoon sweeps. along our streets, searching every cavity of the face, down to the roots of each individual hair, and into every fold. of our garments.-Cry inwardly we say, for who would venture to open his mouth as the excrement laden cloud pours upon him? Bleared and half closed eyes, gritty fingers, and discoloured pocket handkerchiefs testify to the ordeal to which we have been exposed when we \" take our walks abroad.\" \" Down with the dust! \" we say again,. this time aloud, when we have mopped away as much of the deposit as we can with a liberal allowance of the un- filtered element with which we are supplied, and which. it does not do to examine with too critical an eye. Unfortunately our City Fathers appear to be unable to come \" down with the dust \" in another sense, and exorcise- the demon which torments us. Now that the Road Com- mittee have resigned their scavengering functions to the Board of Health, who are supposed to have absolute, power to- appropriate \" dust \"- for sanitary purposes.we look for something decided. , It is stated that all the watercarts- are to muster and engage in the struggle. We sincerely hope it may be so. The irritating nature of the dust in- this city can be- borne witness. to by every resident. Perhaps the organ. most exposed to its baneful influence is-the eye, one of",
         "\"DoWN WITH THE DUST.\" the most delicate of the structures of the human body, and upon the integrity of which the bread of most of our fellow-citizens, depends. The dust· laden with fine par- ticles, many of them angular, makes. its way beneath the lids, and by friction causes severe irritation. Irritation like this repeated every day for a period of three or four months in the year will surely bear fruit at last, in perma. nent weakening of the organ. The delicate mucous membrane of the nose.also suffers Such of us as can walk through the streets with our mouths firmly closed will not be likely to suffer so rnuch from the inhalation of the powder, as children who do not know the danger, and who while at play almost constantly keep the mouth open. The dust, laden with deleterious material lodges on the sensitive mucous membrane of their air- passages, and causes in many instances much uneasiness and cough, while it cannot be doubted that it is a vehicle for numerous disease germs, which, lodging on the mucous, membrane, find a suitable soil in which to germinate and multiply. Not only the germs of fever, but also those cf entozoa maÿ be thus disseminated, although for the latter we need scarcely look farther than our drinking water. The breezes that we otherwise· would hail as cooling and beneficial, we look upon with dread. May we not often see a puff of wind turning a corner, see it not in the- sense that pigs are said to see the wind, but see it in its.. effects, the cloud of dust which it carries with it, gathering strength,. (and dust), as it bears down upon us, until we fairly have to turn our backs to escape the murderous attack? Not only are -we exposed to the limestone shower laden withits quota of disease germs, but we also come in for a share of- finely divided animal excrement. We confess to a liking in a general ·way for the lower animals, and the odòur of a cow-stable is reputed to, be beneficial iri some diseases,- notably in consumption, but we have a decided objection to fecal inhalations of the kind to which we are daily treated. As we belong to thet",
         "42 CANADA MEDICAL AND SURGICAL JOURNAL. class which is habitually clad in sombre colored garments, we say nothing of the damage done to the more delicate fabrics for summer wear, by the searching and penetrating material which floats about in the atmosphere, but were we of the softer sex we think that we could make out a strong-plea for pure air and less dust on that score alone. In conclusion, we sincerely hope that the nuisance may soon be abated by the proper . .eans at the command of the Sanitary authorities, and that ve may before long hear Montreal spoken of as one of the cleanest, as it already is as one of the most prosperous cities on the American continent. A SMALL POX HOSPITAL. We publish below an excellent letter from the columns of the MONTREAL GAZETTE, and from the pen of Peter Redpath, Esq., President of the Montreal General Hospital. 'Coming from such a source we trust it will have due weight in the City Council. Mr. Redpath shows clearly the absurdity, we might say the -insanity, on the part of the city authorities in attempting:to shove off the responsibility of establishing a small-pox hospital. The emergency *has to be grappled with, and if we as a city, honestly desire to improve our sanitary condition, as touching infectious diseases, we must assume without. further delay all reasonable responsibility in the premises. This may be attended with considerable outlay which must be met, and if need be, by a special tax for hos- pital purposes. We cannot but express surprise that a return to the scheme of having two separate hospitals should have been mooted. A hospital for the purpose of aiding .in stamping out a highly infectious disease ought to be under the government of the municipal body. .It is the Corporation of the city to whom!the citizens look -for the enforcement of.rulés and regulatiois which are deemed:ad- visable-for the general welfare-of the community.. If the",
         "A S31ALL-POX HOSPITAL. 4- representatives of the citizens are unwilling to carry out necessary sanitary measures, the government of the -country-should be memorialized to step in and do the work or have it done at the cost and charges of the city. We should suppose the Provincial Legislature has this power, and if the citizens of Montreai cannot succeed in obtaining from the city council common-sense views on this impor- tant subject they had better at once ignore the very exist- ence of mayor and aldermen and go to a higher power for redress. In the last number of our journal we copied from a Boston paper a statement to the effect that during the year ending ist May, 1875, no case of small-pox had been recorded as occurring in the city of Boston, which was the first occasion that such a statement could be made for the past twenty years. On reference to the report of the Trustees of the City Hospital, Boston, for the year 1873- an institution which is supported at an annual cost of over $ioo,ooo by the .city authorities of Boston-it will be found that from April to August of that year, during an epidemic of small-pox, there was disbursed for the mainte- nance of the small-pox hospital $10,219.93. Who vill in all honesty say that that amount was not well spent when it resulted in the proud announcement a few months later that \"not a single case of small-pox was recorded as occurring in the city during the past twelve months ?\" SMALL-POX HOSPITALS. To the Editor of the Gazette: DEAR SIR,-Public attention has been drawn to the necessity for - increased accommodation for small-pox patients, but nothing permanent has been done to meet the emergency, apparently because of uncertainty..as to the best course to pursue. The City Council hasoffered.to the ladies of ·the Hotel Dieu and. to the Montreal General Hospital the .sum of -$25,ooo each, with the conditions of their·erecting isolated",
         "44 CANADA MEDICAL AND SURGICAL JOURNAL. buildings for the purpose, with provision in each for fifty patients at a time, and that they should respectively assume the whole cost of subsequent maintenance. With the view of helping to avoid mistakes in accom- plishing the object, I venture to express the opinion that even if this proposition be accepted and acted upon by those to whom it is addressed, the end will not be adequately attained. The number of snall-pox cases existing at one time during the last two or three winters must, I think, have been much more than one hundred, and if, as I believe, it be intended to remove all cases to the hospitals, the responsi- bility of providing for the excess over one hundred would still rest with the City Council. Among many considerations which the question involves, I respectfully submit:- ist. That the best authorities on the construction of hospitals maintain that the ground upon which an hospital is erected should afford an area of not-less than about five hundred and forty square feet to each patient. Assuming that more is not required for infectious diseases, a building adapted for fifty patients should stand on an area of about twenty-seven thousand square feet. I am strongly of opinion that justice would not be done either to the patients or to the community if a more limited site were chosen. 2nd. The cubical air space provided for each patient should certainly not be less than fifteen hundred feet; two thousand feet would be much better. This estimate demands from seventy-five thousand to one hundred thousand cubic feet of ward accommodation for fifty patients. The offices, service, and administration would probably require at least* half as much more, which is a smaller proportion than the space applied to these purposes in an ordinary hospital. 3. The heating and ventilating arrangements should be on the best possible plans, especially as the resour'es of the hospital would be most taxed during the winter. It is obvious that if a building were constructed on the",
         "A SMALL-POX HOSPITAL. basis of the requirements I have stated, in the most econ- omical manner that could be devised, it would absorb a large proportion, if not the whole, of the proposed grant, leaving nothing for the cost of groiind or for subsequent mainten- ance. The possibility i a future demand for additional belp must, therefore, enter into .your calculation. I have no possible knowledge on the subject, but I have the impression that hospitals for infectious diseases are usually controlled by the municipal authorities. I observe in a newspaper accidentally beside me, an advertisement in which the Sanitary committee of the City Council of Hali- fax, N.S., asks for tenders for the erection there of an hos- pital for contagious diseases. I can readily understand why the duty should be distasteful to the City Council, but it is not the less a duty. You have made an experiment and found it an expensive one, but it has been made under circumstances which did not allow .time for economical arrangements. There is no good reason why an hospital for small-pox patients should not be carried on as economically by the City Council as by any other corporation. The responsibility of it should rest with those who by a vigor- cusland judicious administration of their own laws, can .greatly dininish, if bot entirely extirpate the disease, existence of which is attended with such great expense as well as such danger to the citizens. I believe that a civic hospital constructed on a suitable site, and on principles which I have partly indicated, would best meet the requirements of the case, and would before long be regarded with favor by the whole community. I am, dear Sir, Yours, very truly, PETER REDPATH. Montreal, I7th June, 1875.",
         "46 CANADA 3I2DIcAL AND'SURGICAL JOURNAL. BOWKER VS. BEERS FOR LIBEL. This case has occupied the attention of the Courts for some years past, and is we believe finally settled before the Court of Appeal. It arose out of an article from the pen of Mr. Bowker, in 'which that gentleman condemned the use of amalgam and nercury paste for filling teeth. This article we published in our Journal in the number for January, 1870, being the sixth vol. Canada Medical Journal. Mr. Beers replied in an article to which we gave insertion in the following No. for April, Subsequently Mr. Beers published in his own Journal, \" The Canada Journal of Dental Scien.ce,\" an article in which he \\accused Mr. Bowker of making use of the amalgam of m ¼rcury, in his own practice, for the filling of teeth; and out o\\f this accusation arose the action in ques tion. In the course\\ of the trial very conflicting evidence was given-touching th-question of the possible injury to be done by the use of amalg'm paste for filling the cavities in, carious teeth.- This was a side issue raised by the defend- ant, and, had. nothing whatever to do with the question before the Court, a ruling whichYis evidencedlin the judg- ment which we give below, taken from the GAzETTE-: COURT OF APPEALS-JUD\\IENT. Present: Chief Jùstice DORIoN, and - TuSticeS -MONK TASCHEREAU, RAMSAY and SANBORN. W. G. Beers (defendant in Court beloiv), App lant, and H. M. Bowker (plaintiff below), Respondent. TASCHEREAU, J., dissenting.-The respondent sue' the appellant for libel contained in an article published in.t\"e Canada yournal of Dental Science. The article in question charged the respondent with having used professionally as a dentist a certain amalgam mineral paste for filling teeth. The plea of Beers was that'Bowker had previously in an article published by him in the Canada Medical zour- nal, stated that the use of amalgam, a pernicious compoun d, was encouraged by the Dental Association of Quebec, of which Beers was a member. I would reverse the judgment",
         "BOWKER VS. BEERS FOR LIBEL. which condemned Beers to pay,$io damages, and put the parties out of Court, leaving.each to pay his own costs. DoRION, C. J.-We have not to decide. whether the amalgam was pernicious or not. The question is whether Beers did not libel Bowker in accusing him, of using a substance which the latter had .asserted to be injurious. The charge of using it is not proved, and.under the cir- cumstances there- would be an injustice in putting the parties out of Court. The judgment must be confirmed. RAMSAY, J.-Dr. Bowker is a very fortunate litigant, because by writing in a very lively style he laid himself open to an answer. But the answer was too severe, for it made out that Bowker was using a substance which, by his own confession, was an injurious poison, to fill teeth with. Bowker had - to defend: himself from this charge. There was no plea of compensation fyled, only one of provocation. But the Court says: You went further than the provocation ; we have not to weigh two injuries ; there- fore, we have to say that. some damages are due. The Court has fixed the damages at $io, and I think that is enough, considering the excessive sharpness of Dr. Bowker's article on a scientific question and one of great n icety. SANBORN, J.-I don't see any question of compensation here at all: Bowker's charge was against a body of, men, not against an individual. If you accused all Irishmen of being bad, an individual could not bring an action for that. Beers answered by a charge that amounted to this :- that Bowker was an impostor because he was guilty of using the very same poisonous amalgam that he had condemned. that was the real gist of the charge. Every one knows that therê is a good deal of, disputing between gentlemen con- nected with the healing art,- probably because there are no umpires in.that profession. - In the legal profession there are the judges to décide, and they becomne the objects of criticism. Judgment, confirmed, Taschereau, J, dissenting. Messrs. Carter \u0026 Keller for the appellant, and Messrs. A\u0026W. Robertson for the respondent.",
         "48 CANADA MEDICAL AND SURGICAL JOURNAL. PUBLIC HEALTH MAGAZINE. We have received the first number of a magazine, with the above title, a periodical which is destined, we hope, to do much good in the community. Its mission is educational, and .if conducted in a proper spirit so as to call the atten- tion of the masses to ail subjects bearing on the laws of health, we doubt not that it will be a success, and take'rank as '\" an authority \" in Sanitary science to which it aspires. This journal is edited by Dr. George A. Baynes, a gentle man who has already given evidence of his devotion to Sanitary subjects by a very excellent'. course of popular lectures delivered by him during the past.winter, as also by a brochure on the disposal of the dead, which is worth reading. We.wish the periodical every success ; it is very neatly gotten up, and is issued from the printing estab- lishment of John Dougail \u0026 Son. MEDICAL OFFICERS IN THE MERCANTILE MARINE. We notice that a return 'has been Made to the British House of Commons on the motion of Captain Bedford Pim, of the names, ages and nationalities'of persons who have served, during the past two years, as surgeons in the merchant service. The number returned was 224, none of whom were registered in the United Kingdom. We suppose that some. of these gentlemen are Canadians as it is customary for the owners of Canadian steamships.to occa- sionally appoint a young Canadian Physician and Surgeon to fill the post. , We' may.state that one of the necessary requirements:for that position is that the applicant must be registered:in:the Province 'from whence he: hails-and in· fact no appointment is made without the recommenda- tion of the heads of some of our. educational bodies, The owners are particuiarly careful in the selection of Sur- geons, more especially in passenger ships, and we haveno hesitation in saying that those surgeons from Canada to be met with in any of our Canadiañ uLnes of steamships are thoroughly qualified were and are registered in their \u003cown province,"
      ]
   }
}
{
   "doc" : {
      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 4, no. 5 (May 1880)]"
      ],
      "published" : [
         "[Toronto? : s.n., 1880]"
      ],
      "identifier" : [
         "8_05173_41"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. 'z W W Et W zF Coloured pages / Pages de couleur Pages damaged / Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE SANITARY JOURNAL. DEVOTED TO PUBLIC HEALTH, Vo. IV.] MAY, i88o. [No. . GENERAL SANITATION-ITS IMPORTANCE TO THE PUBLIC WELFARE, AND A PLEA FOR BETTER METHODS. BY HENRY B. BAKER, Secretary of the Michigan State Bogrd of Iealth. (Read 6efore the Grand Rapids Sanitary Convention, February 18). The subject of general sanitation, assigned to me by the commit- tee, is one so wide in extent, and so profound, that I cannot hope to do justice to it as a whole ; therefore, realizing the fact that a long and heavy load is frequently lifted with the greatest ease when only one end is required to be raised at a time, and especially that when one end of a load is already well raised the most important work is the raising of the other end, I have decided to glance at the general character, scope and importance of the work, ask more particular attention to such parts as in my opinion are most sadly neglected in Michigan at this time, and plead for better methods and more methods than are now employed, especially in certain neglected departments of general sanitation. In doing this, it seems almost essential to consider the character, necessary acquirements, and duties of those who are to do sanitary work; aad these are the offi- cers and members of local boards of health, particularly the health officers. The end of the general subject assigned to me, which I propose to lift on at this time, in accordance with the expressed wish of the committee and with my own judgment, relates mainly to the restric- tion and prevention of diseases which endanger the public health, and whose causes and modes of communication and best methods of prevention are not generally well understood. It may be said in passing that the department of public sanitation, which I consider to have already received the greatest attention, is that which relates il",
         "THE SANITARY JOURNAL. to general cleanliness, the removal of filth, in the many disagreeable forms in which it has forced itself upon public attention by reason of its intrinsic power of odor or unsightliness. Such nuisances exhale powerful arguments for their own abatement, and although there is yet room for an immense amount of work to secure this Temoval, those who habitually resist or disregard such arguments are lower in the scale of civilization than they to whon I appeal for the restriction and prevention of communicable diseases, and in regard to other less recognized sources of disease. Some of the dangerous agents to which I wish to call your attention are the con- tagia of disease. These are just as real as are the evident nuisances, but they are as a rule invisible to the naked eye; and though they sometimes generate odors, they are themselves usually without odor. And yet, though their power is not evident to the unaided senses, the earth is strewn with the dead because of these disease germs, and al our paths of life are peopled with crippled victims of the many communicable diseases which we neglect to prevent or restrict. NEW REQUIREMENTS AND DEFINITIONS OF CLEANLINESS. In speaking of the greater importance in the prevention of dis- eases, of other work than that for the suppression of ordinary nui- sances, the question has been asked if I was not forsaking the time-honored doctrine that all our ills are due to filth, and thit the single word deanliness expressed the whole sum and substance of general sanitation. To this I reply that very considerable progress has been made in our accurate knowledge respecting the causes of many diseases, and respecting the conditions essential to different kinds of cleanliness. To illustrate this, it may be sufficient to sug- gest different standards of cleanliness, as follows :-The housewife has one standard of cleanliness, which requires that a dish for the table must be thoroughly washed with soap in hot water, rinsed with clear water, and drained or wiped dry with a clean cloth. If such a clean dish be given to the chemist for his most accurate work, he may object that the dish is not chemically clean ; and he will rinse it in alcohol or in a strong acid, or a strong alkali, according to the particular fori of matter which lie fears makes it unclean for his purposes, after which lie also will pronounce it clean. If this same dish which lias been made clean enough for the chemist be given to the biologist, who is experimenting on the vitality or reproduction 244",
         "GENERAL SANITATION. of bacteria, he will pronounce it unclean for his purposes, and he will not be satisfied until he has submitted it to boiling water for at least five minutes, or in dry air to a temperature of 2400 or 250° F., and then he will require that it shall not be exposed for an instant to the ordinary air, for fear of its contamination by germs which sometimes float in the air. He will insist on these conditions be- cause he has found by experience that ordinary clothes, ordinary air, and ordinary water generally contain germs capable of reproduc- tion under favorable conditions, and sometines contain germs capa- ble of reproduction in the bodies of human beings, and of causing such diseases as small-pox, scarlet fever, diphtheria, etc. The experiments by Tyndall, Burdon Sanderson, Pasteur, and others, on the conditions of life and reproduction of bacteria are of very great practical importance in studies for the prevention of diseases, be- cause they show the facts concerning lower organisms similar to those which are found to multiply in the human body during the course of some of the communicable diseases, and because they tend to reinforce our knowledge of methods of destroying the con- tagia of some of those diseases, such, for instance, as the virus of small-pox, and the contagium of scarlet fever, which are found to be destroyed under some of the conditions just stated-as by ex- posure in dry air to a temperature of 250° F. Further experiment may show that a lower temperature is sufficient; and this is to be expected, because of the comparative infrequency of extensive out- breaks of these diseases in the hot summer weather, and also be- cause of the liability of vaccine virus to lose its activity during the heat of summer. Returning to our clean dish, which, with a little variation, might as well have been a clean article of clothing direct from a laundry, or even new goods from a store, I think it is now plain that what is perfectly clean, according to one definition, may be very far from clean according to this view of the subject, and with great certainty may convey the uns2en causes of disease to any sus- ceptible person. NEW METHOD OF SANITATION DEMANDED. What has just been said makes plain the necessity for new rnethods of sanitation. It may be well briefly to recapitulate these reasons in a slightly different manner, in order that they may more easily be kept in mind. One essential fact to be noticed is that, although the 245",
         "THE SANITARY JoURNAL. causes of the communicable diseases are material, \" particulate\" aS it is said, they are invisible to the unaided eye, and consequently our ideas of cleanliness must be so cultivated that we can in imagination follow the dissemination of the specific contagium which we know exists, whether it spreads through the air and is taken in with the breath, is conveyed from hand to hand in shaking hands, from lip to lip in kissing, from one place to another in clothing, new goods, boxes or trunks, or in whatever way it is carried from place to place or in whatever manner, as for instance by the saliva or expectorations of careless workmen or inmates, it is kept in houses or hospitals. DISEASE GERMS, THEIR SIZE, DISTRIBUTION, ETC. One who has never seen in the microscope the \"particulate\" gerns of disease may be aided in such a scientific use of the imagin- ation as bas been suggested, by fixing his attention upon a form of contagium in mass sufficient to be appreciable to the unaided eye. In the small-pox vesicle we have the contagium of that disease in considerable quantity ; and bovine vaccine virus, as we all know, contains the contagion of cow-pox. If we imagine this to be made up of minute granules, of rounded outline, so minute that twenty thousand of them will be required to extend an inch in length, we shall have an idea which will aid the mind in following the course and spread of disease germs of this nature. We can then easily see how such disease germs may be floated off by the air, carried in a veil, scarf or handkerchief, be stored or conveyed in the clothing, beard or hair, appear as dust in a room, be sent in a letter or a paper, be boxed up and transported to a distance, washed off in water, car- ried into a privy, pass through the entire length of a sewer, or the water-pipes which supply pure water, go in the milk can in its round ,from house to house, or with the delivery man from the grocer, baker, market or laundry. This may serve to give us an idea of some of the problems with which the health officer has to deal, in connection with the restriction and prevention of communicable diseases, and some idea of WHAT A HEALTH OFFICER SHOULD KNOW. An efficient health officer should have clear ideas of the nature of contagia; he must have a good practical knowledge of the means by which, and the manner in which they are disseminated; he should 246",
         "GENERAL SANITATION. know the conditions of their reproduction, within or without the body; he should know the conditions of their existence outside the body; and especially of their destruction, for upon this, in connec- tion with what has just been mentioned, depends his success in restricting or preventing communicable diseases. A MEDICAL OFFICER OF HEALTH. Some of the cities in Michigan do not obey the law which requires that the health officer shall be a physician. No man can be of much use as a health officer unless he has a good knowledge of biology, at least of the general principles. We might better put a blacksmith in charge of a miliner's shop than to choose as our health officer one who does not understand the nature of those vital actions which human bodies undergo in health, and of those processes which are coincident with disease. While much of the knowledge of the phy- sician is entirely inapplicable to the work of public sanitation, and while this work demands of a health officer much knowledge which the ordinary physician has had no occasion to acquire, still the fact remains that in order to become a useful health officer, one must have had a thorough training in the biological sciences which lie at the foundation of the medical sciences. A health officer should be sufficiently familiar with mycology not only to know that certain kinds of fermentation are ordinarily harm- less, and certain other kinds are generally harmful, but he should know how to stop the harmful fermentation. Inasmuch as nearly all the ferments are invisible to the naked eye, a health officer must have an educated imagination in order successfully to deal with his everyday work. This is so because much of his work should be a battle with some of the special ferments. Perhaps I can make this plainer by briefly outlining what, in the present state of our know- ledge, seem to be essential facts in this connection. Active cells in the human body act as ferments, destroying organic matter used as food, and creating special products differing according to the func- tions of the particular organs in which the action takes place. In the healthy adult, the requirement seems to be mainly to get from the food employed force to use in brain-work and muscle-work, very little being then required for growth or development of the body, so that the process is one of destruction through fermentations which yield force, for the purposes of life, and poisonous products which 24/",
         "THE SANITARY JOURNAL. should be thrown out of the body as fast as formed, and which should' not be again taken into the body. A health officer should endeavor to see that ail is done that can be done to prevent their being sup- plied to the people again in the water they drink, the air they breathe, and the food they eat. Immediately upon entrance into the mouth of a healthy adult per- son, starchy articles of food arc attacked by one of the useful body ferments, in the saliva, and starch is converted into one form of sugar. And here, upon the very threshóld as it were, may begin the battle between useful and harmful ferments; indeed it may begin in the food before it is put in the mouth, for the yeast which the cook puts in the dough may contain other ferments than the harm- less yeast plant, and therefore the bread may contain not only the roducts of other ferments than yeast proper, but also the special ferments themselves, multiplied greatly in number since they left their home in the foul air, or well-water. So, also, with the meat, which, however, is not fermented by the yeast-plant, but is decom- posed in a manner somewhat similar, by bacteria and similar low organisms microscopic in size. And here the product is not so fre- quently sugar and alcohol, but sulphureted and phosphoreted hydro- gen, butyric and carbonic acids, ammonia, etc., usually bad-smellinc0 products; and the bad odor of the product should warn us of danger from those germs which produce decomposition. In order better to appreciate the importance of the subject, per- haps some other of the useful ferments of the body should be men- tioned. We have noticed only the first one encountered by the food in the saliva of the mouth. The food meets another in the healthy stomach, another in the secretions from the pancreas, and so on in different parts of the body. Suppose each and every one of these natural ferments in the body has to divide the food with another special ferment which goes into the body with the water or food, or enters the blood in some other way, as is believed to be the case in most communicable diseases. Suppose that special ferment to be the one which causes smail-pox, the one which causes diphtheria, or the one which causes typhoid fever. We can thus see how the gases given off by the lungs, and how the other secretions, and the secre. tions of the body may all contain products not naturally present in them, and a person not only have a fever but be \"sick ail over\" in 248",
         "GENERAL SANITATION. every part of the body. The character of the sickness, from a com- municable disease, depends, as we know, upon the particular special ferment, Lut we need to guard, and tg have our health authority guard us, against danger froin every one of these contagious and infectious ferments. HEALTH OFFICER NEEDED FOR EVERY LOCALITY. It is important that all classes of people understand what needs to be done by the health officer, because he is a public servant de- pendent upon all classes of people, sometime*for his official position, and always for that co-operation which will render his efforts most effective. If the people of a locality do not think of anything for a health officer to do, they will not be likely to employ one, except as a form in order to comply with the State law, and will then endeavor to get the cheapest man. A prominent newspaper in Detroit states the case as follows : \" It is doubtful if any Board of Health, howsoever elaborate and costly, could at present improve the public health of so healthy a city. While therefore we may be compelled to have a health officer, as the law seems to require, to report our vital statis- tics to Lansing, the Common Council shouild take care that he cost as little as possible, and meddle as little as possible with the people's private affairs.\" The writer of that paragraph assumes that Detroit is a healthy city. I know of no way of proving what lie assumes, because the city has no reliable vital statistics ; but the reports of burials in the city cemeteries indicate that the deaths from communicable diseases are about two hundred and forty every year. How long must this slaughter go on before it will attract the attention of the newspapers ? When General Custer's little bnd, numbering about the same as this, was destroyed, the news thrilled the people of this State with an awful anguish ; but here are two hundred and forty deaths from preventable causes in a city repeated every year, and that city so healthy that its only need of a health officer is to report on vital sta- tistics to Lansing, and the Cotncil is asked to hire a cheap man to do that. This illustrates the necessity for more accurate and more general information concerning the deaths and the causes of deaths which are now permitted to destroy people by the hundreds, without attracting sufficient attention to start efforts for their prevention. We need vital statistics, and we also need to act up to the know- ledge we already have as to methods of preventing the communica- ble diseases. To be continued.",
         "THE SANITARY JOURNAL. ON THE CAUSATIOIT AND DISSEMINATION OF TYPIOID FEVER. DELIVERED AT THE ROYAL COLLEGE OF PHYSICIANS OF LONDON, BY WILLIAM CAYLEY, M.D., F.R.C.P., PHYSICIAN TO THE MIDDLESEX HOSPITAL AND TO THE LONDON FEVER HOSPTAL ; LECTURER ON MEDICINE TO TUE MIDDLESEX HOSPITAL MEDICAL COLLEGE. In proceeding to consider the mode of origin and propagation of typhod fever, we are at once arrested by the question, What are the nature and properties of the poison which is supposed to give rise to the disease ? Now, the typhoid poison has up to the pre.sent time eluded all attempts to isolate it or to demonstrate its nature either by micro- scopical examination or chemical analysis ; we are only conscious of its existence by the effects which it produces on the human organism. Nevertheless, some of its properties are known with tolerable certainty : (1) when introduced into the system it muti- plies ; (2) it is contained in the alvine discharges of persons suffer- ing from the disease ; (3) it retains its activity for an indefinite time after it lias passed out of the body, when placed under favourable conditions, these conditions being the presence of decaying animal matter and noisture. Hence its usual habitats out of the body are drains, sewers, cesspools, dung-heaps, wet manured soils. And there are some grounds for supposing that in these situations also it may possess the power of multiplying. Lastly, in all probability it is particulate, and not either liquid or gaseous. The actual nature of the poison-whether it be, according to the hypothesis rnost generally accepted, some kind of fungus, or micro- zyme, or protoplasm, in a word, a ron/agium vivum, or whether, as maintained by others, it is some derivative of albumen, capable of exercising a catalytic action on other albumen,--I do not propose to discuss, as it is a question at present rather of theoretical than practical interest, and it is one, moreover, fpr whose final determina- tion the data are hardly yet sufficient. A subsidiary question to this, but one of considerable practical importance, is whether the poison can be generated de novo from decayi rg organic matter, whether it be pythogenic, as was so ably maintainied by Dr. Murchison, or whether it can only arise by con- tinuous propagation, as was maintained no less ably by Dr. William Budd. The arguments on both sides may be very briefly stated.",
         "CAUSATION OF TYPHOID FEVER. In favour of its origin de novo it is asserted that typhoid fever bas often broken out in isolated situations-as solitary farm-houses, far removed from, and holding no communication with, places where the disease exists ; and many such instances are given by Dr. Murchison. On the other hand, it bas been proved incontestably, by many instances, both in this country and on the Continent, that all the conditions supposed to be required for its generation may be present for an indefinite time-as percolation of sewage into wells supplying drinking-water,-and yet the disease does not sho;v itself till the poison is introduced by the arrival of an infected person, when an outbreak at once takes place. Now, I would submit that this latter argument far outweighs the former; for otherwise, if it be proved that all the conditions neces- sary for the origination of the poison are present, as shown by its subsequent development when the germs are introduced, and yet it does not develope, we should have to admit that the same causes are not always followed by the same effects. The instances in which persons in the latent stage of typhoid fever, or actually ill with it, have carried the disease to distant places, and caused it to spread, are so numerous that I believe that this mode of propagation is now universally admitted ; the communication of the disease taking place not by direct contagion from the sick to those brought into immediate contact with them, but by the ordinary mode of sewage contamination. I will quote in illustration three instances which have occurred in this country. One is the famous epidemic at Over Darwen. The water-supply pipes of the town were leaky, and the soil through which they passed was soaked at one spot by the sewage from a particular bouse. No harm resulted till a young lady suffering from typhoid fever was brought to this house from a distant place : within three weeks of her arrival the disease broke out, and 1,5oo persons were attacked. Another well-marked instance occurred at Calne. A laundress occupied the middle one of a row of three bouses supplied by one well, into which the slop of the laundress's house leaked. She on one occasion received the linen soiled by the discharges of a case of typhoid fever, and after fourteen days cases occurred in all three bouses.",
         "THE S4NITARY JOURNAL. At Nunney a number of houses received their water-supply from a foul brook contaminated by the leakage of the cesspool of one of the houses, but no fever showed itself till a man ill with typhoid came from a distance to this house. In about fourteen days an out- break of fever took place in all the houses. Many equally striking instances might be quoted from foreign sources ; I will, however, only adduce the well-known one of Lausen, as it illustrates some other points of great importance in the etiology and prophylaxis of the disease. Lausen is a village through which, I have no doubt, most of my hearers have passed, as it lies on the railway between Basle and Olten, shortly before coming to the great Hauenstein Tunnel. It is situated in the Jura, in the valley of the Ergolz, and consists of 103 houses, with 819 inhabitants ; it was remarkably healthy, and re- sorted to on that account as a place of summer residence. With the exception of six houses it is supplied with water by a spring with two heads which rises above the village at the southern foot of a mountain called the Stockhalder, composed of oolite. The water is received into a well-built covered reservoir, and is distributed by wooden pipes to four public fountains, whence it is drawn by the inhabitants. Six houses had an independent supply-five from wells, one from the mill-dam of a paper factory. On August 7, 1872, ten inhabitants of Lausen, living in different houses, were seized by typhoid fever, and during the next nine days fifty-seven other cases occurred, the only houses escaping being those six which were not supplied by the public fountains. The disease continued to spread, and in all 130 persons were attacked, and several children who had been sent to Lausen for the benefit of the fresh air fell ill after their return home. A careful investigation was made into the cause of this epidemic, and a complete explanation was given. Separated from the valley of the Ergolz, in which Lausen lies, by the Stockhalder, the mountain at the foot of which the spring supplying Lausen rises, is a side valley called the Furlenthal, traversed by a stream, the Furlenbach, which joins the Ergolz just below Lausen, the Stockhalder occupying the fork of the valleys. The Furlenthal contained six farm-houses, which were supplied with drinking-water, not from the Furlenbach, but by a spring rising on the opposite side of the valley to the Stockhalder. 252",
         "CAUSATION OF TYPHOID FEVER. Now, there was rtason to believe that, under certain circumstances, water from the Furlenbach found its way under the Stockhalder into one of the heads of the fountain supplying Lausen. It was noticed that when the meadows on one side of the Furlenthal were irrigaited, which was done periodically, the flow of water in the Lausen spring was increased, rendering it probable that the irrigation water perco- lated through the superficial strata and found its way under the Stockhalder by subterranean channels inthe limestone rock. More- over, some years before, a hole on one occasion formed close to the Furlenbach by the sinking-in of the superficial strata, and the stream became diverted into it and disappeared, while shortly after the spring at Lausen began to flow much more abundantly. The hole was filled up, and the Furlenbach resumed its usual course. The Furlenbach was unquestionably contaminated by the privies of the adjacent farm-houses, the soil-pits of which communicated with it. Thus from time immemorial, whenever the meadows of the Furlenthal were irrigated, the contaminated water of the Furlenbach, after percolation through the superficial strata and a long under- ground course, helped to feed one of the two heads of the fountain supplying Lausen. The natural filtration, however, which it under- went rendered it perfectly bright and clear, and chemical examination showed it to be remarkably free from organic impurities ; and Lausen was extremely healthy and exempt from fever. On June 1o one of the peasants of the Furlenthal fell ill with typhoid fever, the source of which was not clearly miade out, and passed through a severe attack with relapses, so that lie remained ill all the summner; and on July io a girl in the same house, and in August a boy, were attacked. Their dejections were certainly, in part, thrown into the Furlenbach ; and, ioreover, the soil-pit of the privy communicated with the brook. In the middle of July the meadows of the Furlenthal were irrigated as usual for the second hay crop, and within three weeks this was followed by the outbreak of the epidemic at Lausen. In order to demonstrate the connexion between the water-supply of Lausen and the Furlenbach, the following experiments were per- formed :-The hole I mentioned above as having on one occasion diverted the Furlenbach into the presumed subterranean channels under the Stockhalder was cleared out, and 18 cwt. of salt were 253",
         "254 THE SANITARY JOURNAL. dissolved in water and poured in, and the stream-again diverted into it. The next day salt was found in the spring at Lausen. Fifty pounds of wheat flour were then poured into the hole, and the Furlenbach again diverted into it; but the spring at Lausen con- tinued quite clear, and no reaction of starch could be obtained, showing that the water nust have found its way under the Stockhalder in part by percolation through the porous strata, and not by distinct channels. Besides showing the necessity of the introduction of the specific poison in order to render sewage contamination capable of giving rise to typhoid fever, this case is remarkable as an instance of the extreme dilution to which the poison may be subjected without losing its potency, and also the uselessness of irrigation and any ordinary filtration in separating it or rendering it inert. Here the dejections of two cases of typhoid are thrown into a stream ; the water of this stream is used to irrigate extensive meadows; a portion of it sinks through the superficial strata, and probably finds its way into subter- raneous channels, and passes through a distance of many thousand feet under a mountain, partly, no doubt, by mere percolation ; it then takes an insignificant part in feeding one head of a copious spring, which has another head that is not contaminated, and, nevertheless, it gives typhoid fever to 130 persons out of a population of 8oo. The dilution must have been almost infinitesimal, unless we assume that a multiplication of the poison took place after its discharge from the intestinal canal of the first two cases-possibly in the reservoir at Lausen. The apparently spontaneous origin of the disease in isolated places may, doubtless, be in part explained by the very long time the poison may lie dormant, still retaining its essential properties, and capable under favourable conditions of developing its activity. The poison, too, may be introduced in quite unsuspected modes. It is well known that the typhoid poison by no means always pro- duces what is usually recognised as typhoid fever. In very many cases its only effect is to cause sdme malaise, together with slight intestinal catarrh, which is not necessarily attended by diarrhcea. These cases are only recognised as typhoid when they occur during an epidemic, and among persons who have been exposed to infec- tion; but if we may judge by the analogy of scarlatina, diphtheria,",
         "CAUSATION OF TYPHOID FEVER. and other contagious fevers, where similar slight unrecognisable forms are not uncommon, these apparently trivial cases should be as potent in communicating the disease as the severe well-marked forms. Hence it is quite possible that the typhoid poison may be introduced into a locality by a person whom no one would suspect of being infected with the disease. It has been ingeniously suggested by my colleague, Dr. Robert King, that the typhoid poison is derived solely from decomposing albumen, which is not present in healthy stools, and that it can therefore only arise from morbid stools which contain albumen, as is the case in some forms of catarrhal diarrhoea, and he has published a case where the poison seemed to be generated in this manner. This theory might certainly account for long-continued sewage con- tamination of water without the production of typhoid fever, as the special material from which the typhoid poison is generated might be absent. But it is hardly likely that any such derivative of albu- men would remain undecomposed in a drain or cesspool for so long a period, as we have reason to believe is the casewith the typhoid poison. We have next to consider how long the' typhoid poison can thus retain its activity out of the body in a suitable locality. One of the clearest pieces of evidence on this point is the well-known instance related by Dr. von Gietl. To a village free from typhoid an inhabit- ant returned suffering from the disease which he had acquired at a distant place. His evacuations were buried in a dunghill. Some weeks later five persons who were employed in removing dung from this heap were attacked by typhoid fever: their alvine discharges were again buried deeply in the same heap, and nine months later one of two men who were employed in the complete removal of the dung was attacked and died. Here we have distinct evidence that the poison retained its powers for nine months. Dr. Murchison, in his work on Fever, gives an instance in which six cases were spread over a period of eight years. I have recently seen an instance in which an interval of two years occurred without apparently any fresh importation of the poison. Supposing the germ theory to be correct, there is, of course, no reason why the poison should not preserve its vitality, by continuous propagation, for an indefinite time.",
         "THE SANITARY JOURNAL. On the whole, though the point cannot be regarded as finally deter- mined, I think the weight of evidence is against the de novo origin of the disease. We have now to consider a question about which much difference of opinion still prevails, viz., the contagiousness of typhoid fever. That the disease is communicable from the sick to the healthy is, I believe, universally acknowledged, the point in dispute being the mode in which the transmission takes place, whether directly by ernanations from the patient, or from his fresh evacuations, or indi- rectly from eating or drinking, or inhaling the emanations from the stools, modified by their having undergone some kind of decompo- sition or fermentation outside the organism. Although the point in dispute is a narrow one, it is of considerable importance, and erio- neous views may lead, on the one hand, to t'ie adoption of unne- cessary restrictions, which may seriously incommode the patient and his attendants, while at the same time it is only too likely to cause a iieglect of the really essential precautions. I have myself witnessed an outbreak of typhoid where the belief in its contagiousness-shared, I may say, by the medical practi- tioners-was so strong as to excite quite a panic, so that difficulty was found in procuring attendants for the sick. In consequence I had on one occasion myself to carry a patient from one room to another, and a man who volunteered to help me was regarded as having done something rather heroic. I need hardly say that, at the same time, the utmost recklessness is commonly shown with regard to the real causes of its dissemination. On the other hand, a disbelief in the direct contagiousness of the disease might, if not weil founded, lead to unnecessary exposure of the patient's friends. The arguments against the direct contagiousness of the disease are in the main these :-1. In hospitals we rarely find that typhoid fever spreads either to the attendants on the sick or to the other patients. When it does thus spread, persons in other parts of the building, who have never been brought in contact with the typhoid cases, are attacked about as frequently as the immediate attendants themselves. Dr. Murchison has published the evidence on this point afforded by the London Fever Hospital for a period of twenty-three years, up to I87o. During this period 5,988 cases of typhoid were ad- 256",
         "CAUSATION OF TYPHOID FEVER mitted, and seventeen of the resident staff took the disease, but of these seventeen only five were in communication with the typhoid cases, and twelve occurred at a time when there were serious defects in the drains ; twelve patients also admitted for other diseases be- came infected. But since 1861, when the patients were so classified that the typhoid cases and the patients suffering from other acute diseases, not fever, are placed in the same wards, not a single instance has occurred in which the infection has spread to the non-typhoid cases, though the same night-stools and water-closets have been used by both classes of patients, and the use of disinfectants have been exceptional. This shows pretty conclusively that the emanations froni the recent stools are not capable of communicating the disease. Since 1871, 1,447 cases of typhoid have been admitted and treated in the sanie wards with 692 patients suffering from other diseases, and during this time only three nurses and no patients have acquired the disease. On several occasions, however, cases of scarlet fever lying in other wards have become infected. So far as the London Fever Hospital is concerned, it would seem that the risk of becoming infected with typhoid is rather less in the typhoid wards than in other parts of the building. The experience of other hospitals is for the most part in accord- ance with that of the London Fever Hospital. Liebermeister states that up to 1865, neither at Greifswald, nor Tübingen, nor Berlin, had a single instance been known of the disease spreading to other patients in the hospital or to the attend- ants on the sick. The Hôtel-Dieu and La Pitié at Paris, the City of Glasgow Fever Hospital, and the general hospitals of London show much the same results. During the past year sixty cases of typhoid fever were adrnitted into the Middlesex Hospital, and six nurses took the disease ; but of these six, five were on duty in the surgical wards and never came into contact, directly or indirectly, with the typhoid cases. I need hardly say how unlike this is to the behaviour of a contagious dis- ease. I have no doubt but that in all these six cases the disease was due to the condition of the drains of the dormitory. It is also found that when persons suffering fron typhoid fever are removed to distant places, it is the exception, and not the rule, for the disease to spread ; and when it does spread, it quite as",
         "THE SANITARY JOURNAL. commonly attacks persons who have not been brought into imme- diate contact with the sick, as it does the attendants themselves. It nay, I think, be laid down as absolutely certain that an epidemic of typhoid is never caused by the disease spreading by direct con- tagion, as epidemics of small-pox, scarlatina, and typhus are. On the other hand, it is argued that sometimes, in hospital practice, typhoid does spread to the attendants on the sick or the other patients; and, not at all uncommonly, persons suffering from typhoid, when removed to a distance, do communicate the disease to those brought into contact with thei. Thus, in the hospital at Basle, 1,900 cases were admitted in six years ; and during this period forty-five residents in the hospital became infected, and a large number in addition suffered from a non-febrile intestinal catarrh which in all probability was due to the typhoid poison. But of these forty-five cases many had never been brought into contact with the patients, and of the nurses it was found that those were especially liable to be attacked who occupied a par- ticular room where they were exposed to the emanations from a leaky choked soil-pipe. Probably there is no city in Europe, not even Munich, and no hospital, so saturated with the poison of typhoid as Basle and its hospital; and, moreover, the hospital drains are or were in a very unsatisfactory condition ; and thus there is every reason for believing that the contagion in all these forty-five cases was indirect. The saine argument applies to the spread of the disease in private houses. In the great majority of instances where the fever is imported from a distance it does not spread ; where it does, some defect in the sanitary conditions favouring indirect contagion can generally be detected : and it is therefore almost certain that the same is the case in the other instances ; otherwise we should have to admit that typhoid fever is sometimes contagious and sometimes not-nay, that during the saine epidemic the disease is contagious in one bouse or institution, and not contagious in another house or institution, though they may be situated close together. I have seen many instances of supposed direct contagion, but have generally succeeded in tracing them to an indirect source. A boy was admitted in the Middlesex Hospital under my care, on March 27 of last year, suffering from a very severe attack of",
         "CAUSATION OF TYPHOID FEVER. typhoid. For several days he lay in an unconscious condition, and during this time he had very profuse diarrhœea-twelve to twenty liquid motions daily, which were for the most part passed in the bed. In the next bed was a boy aged six, who had been admitted on April 16, with acute renal dropsy and bloody urine. He was kept strictly confined to bed, and never got up to go to the water closet down which the motions of the typhoid case were thrown. On May i , when he was convalescing, the dropsy having disappeared and the albumen much diminished, he was seized by typhoid fever, and passed through a moderately severe attack, with a well-marked rash and characteristic symptoms. This at first sight appeared to be a case of direct contagion, but I have no doubt that the true explanation is this :-The bedding of the first patient was constant!y kept saturated by his liquid motions, and, though every care was taken to change the linen frequently, it was obviyus, fromi a distinctly fæcal smell which was always present, that the bedding or mattress remained contaminated, and thus time was given for the poison to develope its infectious properties. Another patient in the same ward, admitted for acute rheumatism, was also attacked by the fever. He occupied a bed on the opposite side, and never came near the first case, but, being convalescent, he used the water-closet down which the motions of the typhoid case were thrown; and it so happened that at this time the closet was out of order, the contents were retained, and an offensive smell was constantly present. Hence, I think, there can be no doubt but that he was infected by the emana- tions from the evacuations of the first case. The first case affords an example of a very common mode of infection ; and many of the cases attributed to direct contagion are really produced in this way, especially among the lower orders or where skilled nurses are not employed. The bed-linen or mattress, or the patient's own person, become soiled by the liquid alvine dis- charges. These soon dry, and are left undisturbed, and in a short time the poison developes its infectious properties. Soiled linen is well known to possess very active contagious powers, and to retain them for a long time. If these views are correct, it becomes an important subject of inquiry as to how soon the stools acquire contagious properties. I am not aware of any observations which would enable us to decide 2 259",
         "THE SANITARV JOURNAL. this point with certainty, but the time is probably a short one. The frequency with which washerwonen have been infected by soiled linen points to a very short duration, as such linen is seldoni retained for any length of time. Some facts which have come under my own observation, though not conclusive, are also in favour of the period being very short. At the Middlesex Hospital it was formerly the custom to preserve the stools of cases of typhoid, which the physician wished to inspect, in pans which were placed in the water-closets of the wards. Now, the time during which such stools would be so kept would hardly ever exceed twelve hours ; nevertheless, several instances have occurred in which other patients using these closets have become infected. Supposing the cause of the infection to have been these reserved stools, we should have a period of not longer than twelve hours for the contagious properties to become developed. The expe- rience of the London Fever Hospital pretty conclusively proves that the fresh stools are innocuous. The practical conclusion to be drawn is, I think, this : that we have in all cases a few hours during which it lies in our power to render the poison innocuous, and to prevent the spread of the dis- ease by direct infection. (To be continued.) CONTAMINATION OF DRINKING WATER BY FILTRATION OF ORGANIC MATTER TIIROUGH THE SOIL. READ BIEFORE THE SANITARY CONvENTION AT DETROIT, JAN. 7, I88O, BY VICTOR C. VAUGHAN. M.D., PI.D., LECTURER ON MEDICAL CHEM1STRY IN THE UNIVERSITY OF MICHIGAN, ASSISTED 1Y P. E. NAGLE. There seems to be a wide-spread belief that in disposing of decom- posing organic matter it is only necessary to remove it from sight by burial in the earth. All through the rural districts and in the towns and many small cities of this country, privy vaults, cess-pools and even cemeteries are located in close proxomity to cisterns and wells. A few feet, or at most a few rods of intervening soil are considered as sufnicient to prevent the contamination of the water from these re- ceptacles of decomposing matter. There is a general belief in the power of the soil to retain or to remove in some way all organic m itter from solutions. Not infrequently a privy vault may be seen 26o",
         "CONTAMINATION OF WATER. located within o or 20 feet of a well or a cistern, and often the slope of the land is toward the well or cistern. During the past three months the authorities of a growing village in the interior of this State have, in spite of the remonstrance of certain citizens, located a cemetery within a few rods of a deep well, the water of which is used for household purposes. During the summer of 1878, the sanitary condition of certain prernises in Ann Arbor was as follows: The cistern located at the rear of the house was about 20 feet deep, and about six feet below the surface it leaked. Of course if water could pass out it could as readily pass in. Fifteen feet back in the yard, and slightly elevated, stood the privy. As soon as the warm months of the summer came on, the water of the cistern became so offensive that it could not be used. The odor was that of the privy, and the water swarmed with microscopic animalculie, and with others large enough to be seen with the unaided eye. Ail the water was removed and the cistern thoroughly cleansed. A few days later a heavy rain refilled the cistern, but within a few weeks more the water again became unfit for use, but was not so bad as it had been before the cleaning. During the remainder of the summer and fall the family obtained their drinking water from another source. During the winter season the water of the cistern so inproved that after being filtered it could be used. But as soon as the warm weather of the following summer approached the water again became unfit for use, and was almost or quite as bad as it had been during the previous summer. This is only an illustrative case, and I know of similar ones in Ann Arbor. Such instances as this caused us to doubt the power of soils of completely preventing the filtration of organic matter in solution. We determined to endeavor to answer, by experimental investigation, the following questions : (i.) To what extent are organic substances removed from solution by filtration through soil? (2.) Do different soils differ in their capability of thus removing organic matter ? It must be noted here that the organic substances to be removed are held in solution, and not merely in suspension. The principal object in the filtration of natural waters for the supply of towns and cities is the removal of suspended matter. Again, the waters with which our experiments are concerned, and with which, as we shall en- deavour to prove, drinking water is often contaminated, should be",
         "262 THE SANITARY JOURNAL. designated as bo//uted ivater, i.e., the amount of injurious substances which they contain is sufficiently great to render their direct i se dangerous. The first thing necessary to an investigation of the first question, -was to select some soluble organic substance, for which there are known exact methods of quantitive determination ; for it would be necessary to determine the amount removed from solution by making «quantitive determinations of the amounts in solutions before and after filtration. For this purpose urea was selected, and, in order to have the conditions as natural as possible, the solution selected for filtration was urine. Urea is also easily discomposed, and experi- ments performed with this substance would have the advantage of the conditions being most favorable for the the removal of the organic substance. It is well-known that urea is not far removed from inor- ganic matter and that its transformation into carbonic acid and an- .monium is easily accomplished. One cubic foot of the ordinary gravel soi], from four feet below the surface, was obtained and so arranged that fluids could be poured upon its surface (which was one square foot) and the filtrate collected. The amount of urea in a specimen of urine was then estimated with mercuric nitrate (the chlorides having previously been removed), a neasured quantity of this specimen was poured upon the surface of the soil, and the urine which passed through was collected, measured .and its contanined urea estimated. A certain amount of urine (which was equal to that passed by one person in 24 hours) was poured up- on the soil at one time. The filtrate from this was collected, meas- ured and its contained urea estimated. This was repeated for a number of days or until the filtrate was found to contain as much urea per 100 c. c., as the urine did before filtration. The results of these experiments are given in the lollowing table: 'eu -ramm Grains Grams. Grams. First day........... 1,760 c.c. 938 c.c. 49.28 15.00 3.8 1.6 Second day. . .. ... .. 965 c.c. 740 c.c. 25.7 14.06 2.6 1.9 Third day ........ .. 86o c.c. 600 c.c. 13.76 9.60 1.6 1.6 3,585 C.C. 2,278 c.c. 88.13 38.66",
         "CONTAMINATION OF WATER. The soil, which had now become saturated with organic matter, was removed from the filter, spread out upon a clean board so as to be exposed to the air, left in this condition 24 hours, and then re- turned to the filter. Urine was poured upon this soil, and the amount of urea removed by filtration was estimated as before. In this case it was found that the urine, before filtration, contained 1.1 grams of urea per zoo c.c , and after filtration, only 1.6 grams ; or the soit which had been saturated with the organic matter was so far purified by exposure to the atmosphere for 24 hours that it now removed one half a gramme of urea from every 2.1 grammes poured upon it in solution. From these experiments it is very evident that the ordinary gravel, which constitutes so large a proportion of the soi of this State, bas but little effect in removing or oxidizing soluble nitrogenous sub- stances from solutions which are allowed to pass through such soils. Furthermore, it became evident that such soi soon becomes saturat- ed, and then no longer has any effect upon the removal or oxidation of these organic substances. The arnount of urea necessary to thus saturate one cubic foot of soit was 88.13 grammes, or that contained in 3,505 c.c., of urine. Of course this urine contained a small quan- tity of other oiganic substances, so that we will not claim that the following computations are exact ; but we will be careful not to over- state them. Suppose that the total solid excretions of an adult are 112 grammes per day (this of course is very low), then the solid ex- cretions from a family of six persons each day would be sufficient, when properly dissolved, to saturate over seven cubic feet of gravel soil. From this it is evident that only a few weeks or months would suffice, with a proper amount of rain fait, to saturate every cubic foot of soit to the depth of five or ten feet in a small yard, in which we often find privy vault, cess-pool and cistern or well in close proximity. Of course if these substances are not destroyed by filtration, they will be carried with the water which passes through the soit wherever such water may go. If the water gains an entrance to the well it will carry with it the substances in solution. At this rate it would require more than a few feet or even rods of intervening soil to pre- vent the contamination of the water of wells or leaky cisterns from privy vaults, which often are not cleaned once a year, or from cess, pools or cemet2ries. 263",
         "THE SANITARY JOURNAL. But there is another consideration that must be mentioned in this connection. The gravel by itself forms one of the poorest of filters, because the particles are not all of the same size and shape, conse- quently the interspaces are also of unequal size, and the liquid meet- ing with less resistence in one direction than in others, soon collects and forms streamilets which may convey the polluted water in quantity toward, or even into the source of the water used for house- hold purposes. This brings us to a consideration of the second question proposed to be investigated by experimental investigation, i. e., Do different soils differ in their capability of removing organic matter from solu- tion ? The gravel having been already tried we did not make any further experiments with it ; but we next experinented with sand and loam in the same manner as we had done with the gravel. The comparative results only will be of interest. While urine (3,585 c.c.) containing 88.13 grammes of urea saturated one cubic foot of gravel, urine (4,000 c.c.) containing 89 grammes of urea did not saturate one cubic foot of loam, but, after this amount of urine had been used, the loam still removed four-tenths of a gramme of urea from each roo c.c. of urine. The sand was also better than the gravel but was not as good as the loam, for 88 grammes of urea in 4,000 c.c. of urine did not saturate the sand, which still removed two-tenths of a gramme of urea from each oo c.c. of urine. Thus of the three-gravel, sand and loam-the loam is the most active, and the gravel least active in the removal of organic matter from solu- tion. The explanation of this may be conceived to be as follows: First, the inequality in size and variety in the shape of the pieces of gravel (as has already been referred to) allows the formation of streamlets, and the solution thus passes through the gravel more rapidly than through either the sand or loam. This is the physical defect in the gravel as an agent for the removal of the organic matter. A second cause is the greater porosity of the loam. As was shown by the re- newed activity of the gravel after it had been exposed to the atmos- phere for 24 hours, oxygen is the agent which acts chemically in the destruction of organic matter, or, 1ather, in its conversion into inor- ganic matter. Now the more concentrated the oxygen the more en- ergetically will it act. As is well known, the atmosphere in the mi- nute pores of the soil is condensed. 264",
         "CONTAMINATION OF WATER. Oxygen has been justly termed the scavenger of creation and the free access of this gas is necessary in order to render the excretions of animals harmles ;. This good work is begun in the living body; for the hemoglobuline of the red blood corpuscles carres oxygen to all the tissues, and by the action of this oxygen, poisons introduced from without and poisons generated within the organisimn are ren- dered inert and fitted for excretion. Animals are formed by the agency of plants out of the constituents of earth and air. \"Whatever in our bodies is inorganic originated in the soil; whatever in our bodies is organic originated in the at- miosphere. Whatever in our bodies is inorganic will return to the soil; whatever in our bodies is organic will return to the atmosphere. The carbon of the carbonic acid of the air becoies the carbon of the cellulose, starch, gums, resins, etc., of plants ; it becomes the carbon of our blood and muscle ; and from our bodies it is returned to the air. Thus the changes of matter form an endless chiin whose first link is also its last.\" (Gorup-Besanez.) Now the agent whichl converts the organic tissues of the animal into inorganic substances is oxygen; and this is the proper agent to use in rendering animal excretions harmless. This is the reason why the dry earth closet, with a pipe to conduct the gases into a chinney, is the best method (at least for the rural districts and small cities and villages) of dis- posing of fæcal matter. The dry earth takes up the oxyen, which is then condensed in the pores and acts with double energy. In. stead of burying these substances down in the earth where but a limited supply of oxygen can reach them, it is far better to allow the free access of the atmosphere. Burial siinply ai Is in the preserva- tion of orginic substances, and, as we have seen, they miy be carried under the ground into our wells and thus poison us. Instead of simply burying these noxious substances and then thinking our- selves secure from them, it would be far better to re.der thei inert and even useful, as may be done. As to the location of cemeteries in the vicinity of wells, we think that our experiments show that the decomposing matter from one body would be suficient to pass a long distance, especially through gravel soil, before it would be completely destroyed. We honor the dead as highly as others do, but it is not right that the dcad should be allowed to murder the living. 565",
         "THE SANITARY JOURNAL. TIIE THERMAL AUTOMATIC SYSTEM OF VENTILATION. In the January and February numbers of this journal we discussed the subject of simultaneous warming and ventilation. An analysis of the difficulties involved, and the resources at hand was attempted, and the conviction expressed that the problem would be satisfac- torily solved at no distant day. We submit the following outline sketch of a plan or * device intended to accomplish the end so much desired, viz. : a comfor- table temperature and pure air at the same time in our northern homes. A warm floor is the central thought of this device, at least so far as the temperature is concerned. With a warin floor many of the difficulties encountered in all the attempts hitherto made disappear as if by nagic. A warm floor means warm feet, happy children and general comfort. We propose then to warm the floor, and to do this we provide for sending the warm air from the furnace, under the floor on its passage to the living room. We first construct two air tight rooms in the basement or cellar-rooms air tight when the doors and windows are shut-except as they are opened by air ducts as hereinafter described. We also construct an air vault or chamber under the floor, or if you please, within a double floor, for the recep- tion of warm air. We provide warm air ducts with registers, as hereafter more closely described. These with a suitable furnace and a good smoke flue complete the apparatus needed. One of the rooms above men- tioned is known as the pure air room, and the other as the foul air roon. They are separated by an air tight partition. The body of the furnace (and almost any ordinary furnace nay be used,) stands within the pure air room, while its mouth opens into the foul air room. Each of these rooms is provided with a door and a window, and is 6 x 7 x 8 feet square, larger or smaller according to the size of the building, and the furnace needed. They are miade of brick and well plastered. The chamber under the floor is constructed as follows : Upon the joists a close floor is laid. Upon the floor strips are nailed down, and so arranged as to serve the double purpose of supporting another floor to be laid upon them, and also of distribut- This device is the joint invention of the editor of this journal, (e/ald of Ha//h,, and his brother, Rev. G. W. Gray, D.D. 266",
         "SYSTEM OF VENTILATION. ing the warm air to all parts of the chamber before it is admitted to the living room. Free communication is now opened through air ducts leading from the interior of the pure air room (containing the body of the furnace) near the ceiling to tliis chamber through an opening in the lower floor. To allow the air to pass out of this chamber (in the floor) and up into the living room, registers are opened along the innernost walls through which the air is admitted fi om the chamber. By this time :the floor is warn and the house full of warm air. But to keep it pute it must be withdrawn and re- supplied. How ? In constructing the air chamber in the floor as above described, the strips are so arranged as to leave an air-tight duct along the outermost wall of the house in the edge of the air chamber, and which in fact is a separate part of the chamber. This duct, (or these as the case may be,) extends and leads back to the foul air room (in the basement, into which the furnace door or mouth opens) in the most direct way, and discharges into it, and near the bottom or below the mouth of the furnace. Registers are now opened through the floor into this foul 'air duct. The air, after being admitted as above described, and passing in circling currents across the room, is withdrawn through these registers and this foul air duct to the mouth of the furnace, with which it is in open com, munication. It will now be noted that the ventilating air current sets in from without through a duct of proper dimensions, and enters the pure air room beneath the furnace. It passes about the furnace- is warmed and fills this room, which now becomes a warm air reser. voir, to be drawn upon for supplies. From this room its only escape is through the ducts provided into the chamber under (or in) the floor, and onward into the living room. This living room being in open communication with the mouth of the furnace, and the draft and smoke flue, the air will be withdrawn from it through the foul air ducts, the furnace and smoke flue, and so pass into the open air. Since the combustion of the furnace must feed upon the air drawn from the apartments occupied, all other means of supply having been excluded, the constant withdrawal of the foul air is secured. The foul air registers are placed along the outermost walls of apart- ment occupied, in order that the draft passing out may catch up and bear away at least a part of the cold air which is always steal- ing into the house through crevices, and running down to the floor.",
         "THE SANITARY JOURNAL. The foul air ducts connect with the foul air room by, the most direct way, and deliver the air into it, that it may be subjected to the strong draft of the furnace, which secures the necessary move- ment and change of the air in the living room. The foul air ducts deliver their contents within and near the bottom of the foul air rooni to prevent the possibility of any reversion of the current. An opening is made in the smoke flue, and provided with a register, through which so much of the air as may not be needed for combustion purposes may be drawn off with the current. In the pure air room provision is easily made for restoring the necessary humidity to the air, after it has been heated, and before it is sent forward to be used in the rooms above. When several rooms are to be heated at the same time, the several foul air registers of contiguous rooms open into a common foul air duct to secure equi- libriurn of temperature and warm air in all the rooms. This arrange- ment practically reduces them all to one room. By this arrange- ment we secure the advantages arising from a warn foor, and they are many and great. According to prevailing methods it is im- possible to avoid cold eddies, and a lake of cold air on the floor. The old sanitary injunction to \" keep the feet warm and the head cool\" is reversed. The cold air descending to the floor, and the warm rising, thefeet are kept cold, and the head warm. If young children could crawl upon the ceiling, and people stand on their heads, it would do. By warming the floor this whole difficulty dis- appears. In this arrangement we utilize the direct draft of the fur- nace, as the best avoidable means of exhausting the foul air. The crowning difficulty with all systems of ventilation that we know anything about is found in the fact that the exhaust draft is too weak to effect a sufficiently frequent change of the air. The ex- pedient of sending the exhaust flue up along side the smoke flue, in order that it may be kept warm, and thus increase the draft, was a step in advance, but no draft is so powerful as that occasioned by the d'rect heat of the furnace up the smoke flue. We have succeeded in applying this draft to the exhaustion of the foul air without the possibility of being troubled with the smoke, an advantage which will insure the regular and automatic operation of the apparatus, and any frequency of change and amount of air needed. Another and the last advantage here claimed for this arrangement 268",
         "ON CONTAGION. is the saving of fuel which it will effect. The loss of heat in ordin- ary methods of heating is simply enormous, amounting from 75 to 9D per cent. of the heat generated. By sending the heat under the /oor it is so delayed and expended as to become available in much larger proportion than it can be when it is sent directly into the room. A cold floor is a suitable place for the lodgment of the cold air which is always forcing its way into the house. Neither the floor nor the stratum of air nearest to it can be warmed by turning a stream of warm air into the room, for it instantly flies away to the top and escapes, if it is possible, as most of it usually does. Having passed above the feet, which are always most in need, it is practically lost. A warm floor constantly antagonizes the cold air which finds its way into the room. The heat is expended in warming the coldest air, and precisely that which is giving most trouble, and hence much less fuel will suffice, which as all will admit is a consumation devoutly to be wished.-Herald of Health. ON CONTAGION. BY MR. JOHN SIMON-in British Medical Journa. The social conditions through which, in our own country at the present time, the more fatal infectious diseases are enabled to acquire epidemic diffusion are chiefly such as the following :-that persons first sick in families and districts, instead of being isolated from the healthy and treated with special regard to their powers of spreading infection, are often left to take their chance in ail such respects ; so that, especially in poor neighborhoods, where houses are often in several holdings, and where always there is much intermingling of population, a first case, if not at once removed to a special establish- ment, will almost of necessity give Occasion to many other cases to follow ;-that persons with infeciious disease, especially in cases of slight or incipent attack, and of incomplete recovery, mingle freely with others in work places and amusement places of common resort, and, if children, especially in day-schools, and that such persons travel freely with other persons from place to place in public convey- ances ;-that often on occasions when boarding-schools have infec- tions disease getting the ascendant in them, the schools are broken up for the time, and scholars, incubating or perhaps beginning to 269",
         "THE SANITARY JOURNAL. show infection, are sent away to their respective, perhaps distant, homes ;-that keepers of lodging-houses often receive lodgers into rooms and beds which have recently been occupied by persons with infectious disease and have not been disinfected ;-that persons in various branches of business relating to dress (male and female) and to furniture, if they happen to have infectious disease, such as scar- latina or small-pox, on their premises, probably often spread infec- tion to their customers by previous carelessness as to the articles which they send home to them, and that laundries further illustrate this sort of danger by carelessness in regard to infected things which they receive to wash ;-that purveyors of certain sorts of food, if they happen to have infectious disease on their premises, by carelessness spread infection to their customers ;-that streams and wells with sewage and other filth escaping into them are most dangerous means of infection, especially as regards enteric fever and cholera, and that great purveyors of public water supplies, so far as they use insufficient precautions to insure the freedom of their water from such risks of infectious pollution, represent in this respect an enormous public danger ;-that ill-conditioned sewers and house drains, and cesspools receiving infectious matters, greatly contribute to disseminate con- tagia, and often by leakage into wells. Of the dangers here enumer- ated, there is perhaps none against which the law of England does not purport in some degree to provide. At present, however, they all are, to an immense extent, left in uncontrolled operation ; partly because the law is inadequate and partly because local administra- tors of the law often give little care to the matter ; but chiefly because that strong national opinion which controls both law and administra- tion cannot really be effective until the time when right knowledge of the subject shall be generally distributed among the people, and when the masses whom epidemics effect shall appreciate their own great interest in preventing them. Whenever that time shall come, probably the public good will be seen to require, with regard to every serious infectious disease which is apt to become epidemic, that the principles which ought to be accepted in a really practical sense, and to be embodied in effective law, are somewhat as follows : (i) that every case of such disease is a public danger, against which the public, as represented by its local sanitary authorities, is entitled to be warned by proper information ;",
         "110W TO KILL BACTERIA. (2) that every man who in his own person, or in that of any one under his charge, is the subject of such disease, or is in control of such circumstances relating to it, is, in common duty towards his neighbors, bound to take every care which he can against the spread- ing of the infection ; that, so far as he would not of his own accord do his duty, his neighbors ought to have ample and ready means of compelling him ; and that he should be responsible for giving to the local sanitary authority proper notification of his case, in order that the authority may, as far as needful, satisfy itself as to the sufficiency of his precautions ; (3) that so far as he inay from ignorance not understand the scope of his precautionary duties, or may from poverty or other circunstances be unable to fulfil them, the common interest is to give him liberally out of the common stock such guidance and such effectual help as may be wanting ; (4) that so far as he is volun- tarily in default of his duty, he should not only be punished by pen- alty as for an act of nuisance, but should be liable to pay pecuniary damages for whatever harm he occasions to others ; (5) that the various commercial undertakings which in certain contingencies may be specially instrumental in the spreading of infection-water com- panies, dairies, laundries, boarding-schools, lodging-houses, inns, etc., should respectfully be subject to special rule and visitation in regard of the special dangers which they may occasion ; and that the persons in authority in them should be held to strict account for whatever injury may be caused through neglect of rule ; (6) that every local sanitary authority should always have at command, for the use of its district, such hospital accomation for the sick, such means for their conveyance, such mortuary, such disinfection establishment, and generally such planned arrangements and skilled service as may, in case of need, suffice for all probable requirements of the district. HOW TO KILL BACTERIA. In a lecture given before the Berlin Medical Society, December 3, 1879, Dr. Wernich (who, as our readers may remember, was formerly a medical professor in Japan) offered some interestingremarks, Ueber Bacterientadtung, or, as we have translated it above, on how to kill bacteria, and that as in the lowest of these organisms the only vital function which we can recognise as performed by them is that of unlimited multiplication under appropriate conditions, their reproauc- 271",
         "THE SANITARY JOURNAL. tive capacity must be taken as the test of their vitality. A fallacy, however, comes in here which complicates the problem- -if the culti- vating fluid is not rightly chosen the bacteria fail to multiply. With care, however, this difficulty may be avoided, and after a sufficient preparatory training Dr. Wernich believes that by a modified form of Kleb's \"fractionirte Cul/tir,\" which he terms the bacterioscopic methed, the distinction between living and dead bacteria may be made with certainty. The principle is simple. If, after rigorous exclu- sion of all possible causes of impurity from without,a drop of the bacte- rial fluid to be tested causes cloudiness in an appropriate cultivating medium, which cloudiness the microscope proves to depend on the presence of multitudes of bacteria, and if this experiment can be re- peated over and over again by cultivating the new bacteria in fresh media, the first bacteria were living; if no cloudiness occurs under these conditions, they were dead. We should state here that Dr. Wernich's experiments on this subject were partly made in professor Cohn's laboratory at Breslau, the special organism investigated being the Microcorrus prodigiosus, or blood mould of the ancients. The research is given in detail Virchow's Archiv, Band 78. Assuming, then, that we can distinguish between dead and liv- ing bacteria by the reproductive capability of the latter, how can we kill bacteria and prevent their reproducing their kind ? Accord- ing to Wernich, the bacteria of putrfeaction are killed by a tempera- ture of 130° to 150° Cent. even in three to five minutes. The Micro- coccus prodigiosus is rendered absolutely sterile at a temperature of only 750 to 80° Cent. But some organisms, for example the Bacil- lus s. btis of hay infusion, exhibit enormous resistence even to the protracted action of heat (Cohn), and, at any rate in the case of the hay bacillus, it is the spores which still retain their vitality even after long boiling. The presence or absence of spores will therefore to a great extent determine whether a given species of micrococcus or bacterium resists destruction by heat, chemical agents, etc., or not. It is well known that certain substances-sugar, dialysable albu- minates, and the elements potassium, phosphorous, magnesium, and sulphur-are necessary to the multiplication of bacteria, but Dr. Wer- nich mentions another less known fact, namely, that if any one of these substances be absent from the nutritive fluid, the bacterial spores, instead of multiplylng, pass into a state of rest (Dauerzustand)",
         "HOW TO KILL BACTERTA. in which they may remain indefnitely. Dryness has the same effect, and, according to Koch, the spores of the Bacillus anthracis or bacil- lus of malignant pustule can remain in the dry state for years, be noistened and dried again without loss of reproductive power. Hence, if in any locality these spores have once developed, the chances of the disappearance of the disease there are very small. On the other hand, excess of moisture destroys bacteria with great certainty. The developement of Bacillus anthracis is checked by distilled water, and, as our readers may remember, Professor Virchow, in his lecture on the Plague (Aledical Times a d Gazette, vol. i. 1879, page 286), inclined to the belief that the report was true that \" plague germs\" lose their infective power by immersion in water. The effect of light on micrococci is absolutely nil; they get on equally well with or without it. On the other hand, it is said that at the positive pole of a moderately strong galvanic current they always die, while at the negative pole they develop to a slight extent. It would take up too much space to enumerate all the gases, acids, salts, and organic substances which are reputed to destroy bacteria outside the body. That they do so if brouglt into intimate contact with them is scarcely doubtful ; the important point is to find poisons which will kill bacteria within the human organism without injuring the lat- ter. It is questionable whether at present we possess any such. Dr. Wernich puts the question : Why do bacteria not live for ever ?- why, with an apparent sufficiency of nutritive material, do they die ? Why do infectious diseases like small-pox and scarlet fever, which are probably due to organisms, last only a certain time ? The answer seems to be, that \" it is the products of the tissue change of the living bacteria which causes the ultimate destruction.\" About four yeais ago Salkowski found that bacteria would not propagate in some thre. year-old ascitic fluid which had gone through all the stages of putre- faction. Since then this has been explained by the discovery of carbolic acid by Baumann, of skatol (Medical Times and Gazette, 1879, vol. i. page 154) by Brieger, of hydrocinnamic acid and pheny- lacetic acid by E. and H. Salkowski as products of putrefective pro- cesses, i. e., of bacterial tissue change. These bodies, as well as indol, which also developes under these conditions, are intense bacterial poisons ; and while skatol is the strongest of them all, carbolic acid is the weakest. Wernich bas 27/3",
         "274 THE SANITARY JOURNAL. found that i part indol per ooo of fluid prevents putrefaction, where- as 5 parts carbolic acid per ioco are required ; o-4 skatol per 1ooo prevents the propagation of bacteria, but carbolic acid must be 5 per rooo strong ; lastly, o-5 skatol per 0ooo /ills bacteria, while we must allow a i per 50 solution of carbolic acid to remain long in contact with them to produce the same effect. Yet Dr. Wernich does not think carbolic acid will lose its position as an antiseptic in conse- quence. Its solubility and cheapness will prevent that : some of the other substances just named take 2000 parts of water to dissolve them. The practical question now suggests itself (Dr. Wernich supposes that it is put to him)-If we had a patient ill of a disease proved to be due to the bacteria of putrefaction (Fulnissbatterien) ought we to give him, say, indol ? Dr. Wernich answers, \" No; our know- ledge of the diffusion and action of it and similar drugs within the body is at present as good as nil. We can scarcely conceive that the intimate contact of drug and bacteria necessary, as experiment shows, for the destruction of the latter can occur there.\" Is there no hope, then, in this direction ? Dr. Wernich thinks that we should investigate the conditions of development of those bacteria which can enter and live in our bodies ; and, secondly, that at present we should devote our chief attention therapeutically to keeping the bac- teiia out of the body, rather than attempting to destroy them when they have once entered it. As in surgery so in medicine, exclude the germs if possible ; and if skeptics say that there are no germs, we can fall back on the dictum of the great botanist Naegeli (Die niederen Pilse in ihren Bezie/iungen zu den Infectionkrankheiten ; Munich, 1877), that the poisons which produce disease cannot be gases or simple chemical bodies, and must be some sort of organized naterial. The above is but a brief abstract of Dr. Wernich's lecture, yet we hope it may be found not altogether wanting in interest or suggestive- ness.-Medica/ Times and Gazette. WHEN a death occurs in Fiji, it has to be registered ; and the native scribes not unfrequently fill the blank left for \"cause of death\" with the words \"I edicine supplied by the missionaries.\"",
         "SANITARY SCIENCE-COURSE OF STUDY. SANITARY SCIENCE- -COURSE OF STUDY. To a young man proposing to enter the field of sanitary science, Dr. J. S. Billings gives the course of needful study as follows (Sani- tary Engineer, March i, i88o): (i) He should have a thorough practical knowledge of microscopy and analytical chemistry, and become practically skilful and accurate in analysis of air and water, food and drink. (2) He must study the principles of construction of buildings, both private and public, so far as sanitary questions are concerned. This will involve methods of heating, lighting and ven- tilation, house plumbing, so far as relatQs to sinks, traps, etc., and house drainage and sewerage. (3) He should study engineering so far as relates to drainage and sewerage ; should be able to make a topographical sketch of a given district, and should have a sufficient knowledge of geology to understand the position of strata and their influence upon sanitation. (4) He should study the nathematics of statistics, and especially the application of vital and sanitary statistics and medical logic. (5) He should study the subject of legislation with regard to the prevention of disease, and should be familiar not only with the laws of his own city and State relating to such matters, but with the methods tried and the results obtained in other States and countries in sanitary legislation. (6) He should study the dan- gerous trades and occupations which, by the production of dust, of noxious gases and vapours, or by the contamination of water supply, have a tendency to produce disease either among the workmen or among the residents of the neighborhood, in order to know in what the danger consists and how it may be best avoided. Thus it will be seen the study of sanitary science is far reaching, and, in many respects, different from the study of medicine proper. Doubtless, the study of medicine will ever, as hitherto, prove the best introduction of sanitary science, but it will be only an introduc- tion. From Dr. Billings' outline of study it will be inferred that the sanitary engineer needs to be a man of broad culture and capacity, able to meet many emergencies and qualified to perform duties hith- erto delegated to, but not performed by, physicians, engineers, plumb- ers and householders. To increase the interest in the study of sani- tary science, we learn that the Michigan State Board of Health pro- poses to examine students of the same in its different branches, and to give those sustaining the proper examination an official certificate. 3",
         "270 THE SANITARY JOURNAL. It is hoped that in this way physicians may be induced to so supple- ment their present knowledge as to specially fit themselves to act as health officers. The first of these examinations will be held next July. Assuredly we trust that the hopes of the Board may be fully real- ized, and in the end we doubt not that they will be. But we serious- ly doubt whether the people are at present so educated as to appre- ciate the value of the services of a competent sanitary engineer suffi- ciently to pay an adequate price for services rendered. Still, for the love of science, humanity or official position, there will be some who will enter upon these studies, and so, littie by little, progress will be nade. If it would, the medical profession could do much to advance the interests of these sanitary studies. It could encourage ail bouse- holders to have their premises oveihauled by an expert, and convince .them that a proper compensation to such an expert for such a work would rebound to their pecuniary interest. As the profession of itself is unable to do this work, let it lend a helping hand to ail efforts of others to do it. The reaction of such studies upon the profession will be healthful in every way. Principally it will tend to educate ,the laity to the belief that ail diseases come from a violation of natural .law, and that ail cure of disease comes from an obedience to natural Jaw ; that the science of medicine requires for its mastery and prac- tical operation the most learned and skillful minds. Having this special education, the laity will cheerfully patronize the honest and ,competent doctor and pay him well for service rendered ; it will give us proper dissection laws ; it will admit us into closer legislative and legal relations to the ruling powers, and it will afford ail the help needful to best develop the capabilities of the healing art. Our personal hope for the elevation of the medical profession, trests solely upon an increased culture of the people in those things .needful to practically appreciate the most highly trained medical talent. Hence, we unhesitatingly give our individual influence to any measure that tends towards this result.-Detroit Lancet. DANDY AND BULL.-Punch gives an illustration of a spindle-legged dandy, with eye-glass, cigar, etc., meeting a handsome bull. Dandy says to bull, looking closely at him, \" Well, you're a splendid fellow, ar'n't you ?\" Bull replies, \" Yes, and so would you have been, if your parents had been selected with as much care as mine were.\"",
         "DISINFECTION. DISINFECTION. Recent experiments made under the direction of the International Cholera Commission have shown that the ordinary methods of dis- infection are inefficient, and, in practice, they have often failed to arrest the spread of infectious diseases. As it is impossible to experiment directly upon the unknown low organisms, which are thought to be the means of transporting the various infectious diseases, the effects of chlorine and sulphurous acid were studied upon known living organisms ; the probabilities being thought to be in favor of the theory that complete disinfection should destroy at least all known forms of life, although it may be true that the tenacity of life of the infective matter of various dis- eases differs, just as the degree of cold necessary to put a stop to yellow fever is much less than that required to arrest the spread of cholera. Chlorine and sulphur fumes, in sufficient quantity, were found to be efficient in killing insects, fungi, bacteria and infusoria; the ob- jections to chlorine in houses being that it is more costly ; that its use is more difficult, and that it destroys metals, textile fabrics and colors. The burning of ten grams of sulphur for each cubic meter of air- space, tightly closed, was found not to kill bacteria, infusoria, or all insects ; twenty grams, however, were proved to be sufficient for that purpose. One volume of water, when saturated at 59' F., absorbs thirty-seven volumes of sulphurous acid-enough to kill all the low organisms found in putrid urine. The following articles were found uninjured after several hour!' exposure to an atmosphere in which twenty grams of sulphur had been burned to every cubic meter of air-space: a clock of steel and brass ; rusty and clean nails ; gold and silver money ; a military epaulet; various colored silk articles ; a colored rug; calico; down- pillows; a gilt-framed looking-glass; books; water in an uncorked bottle; flour ; meat; salt; bread; apples; cinnamon ; vanilla; ci- gars ; wall-paper ; oil paintings; varnished articles ; gas fixtures ; water fixtures ; a highly polished razor had a slightly cloudy appear- ance on its upper side, but that was easily rubbed off. The flour and meat were cooked and eaten, and the cigars were smoked, without any abnormal taste or smell being observed ; in the bread not all of 2'7'",
         "THE SANITARY JOURNAL. the observers noticed a slightly acid taste ; the inside portion of the apples was unchanged, the skin was slightly sour ; the water, after standing, had an acid reaction, but no decided taste or smell. Lit- mus paper placed between the leaves of books and under the carpet was turned bright red. Many of the articles exposed had a decided smell of sulphur at first, but that soon disappeared. The experiments seemed to show that clothing, bedding and other articles may be disinfected without being changed chemically or injured ; and it should be added that practically this method has ap- parently accomplished perfect disinfection, as tested in Berlin. If we may judge from these results, effective disinfection, by burn- ing sulphur, requires eighteen ounces to each space of one thousand cubic feet. The sulphur should be broken in small pieces, burned over a vessel of water or sand, so as to avoid danger from fire, and, if the room is large, it should be put in separate vessels in different places. The room should be tightly closed for six hours, and then aired ; it is better that the room should be warm than cold. Of course, efficiently disinfected air is, during the process of disinfec- tion, irrespirable. Most articles may be disinfected in this way, if hung up loosely in the fumigated chamber, although it would be an additional safeguard to expose anything thick, like a bed-mattress, to prolonged heat at a temperature of about 240° F.; and, indeed, heat must, with our present knowledge, be considered the best disinfec- tant. With this end in view, local boards of health are advised to procure furnaces and laundries, as is commonly done in other coun- tries, to be used for the sole purpose of disinfecting articles which have been exposed to the infectious diseases, as recommended in the Ninth Annual Report of the State Board of Health, and described by Dr. A. H. Johnson, in an exhaustive paper on Scarlet Fever (pp. 255 et seq.), in that report. Of course, a much simpler disinfecting furnace than that described will answer every purpose. For ordinary use, in disinfecting houses, the sulphur process is the best. A solution of chloride of zinc (one part of Burnett's Disinfecting Fluid to two hundred of water), very quickly kill bacteria which have been placcd in it, and arrests putrefaction. Caustic lime serves equal- ly as well (i to i oo), but leaves a sediment not always easy to remove. Carbolic acid in sufficient strength to be effective (i to roo) is more expensive and of disagreeable odor. 278",
         "GENERAL ITEMS. It is needless to add that \" disinfectants\" used in sufficient quanti- ties to destroy bad smells do not necessarily kill microscopic living organisms; and it is not supposed that they directly influence the so-called \" germs\" of the infectious diseases, unless concentrated to the extent which has been mentioned. Finally, fresh, pure air acts as one of the best \" disinfectants\" by enormously diluting the infectious matter, and, under certain condi- tions, including time, must render it inert to all effect, even if not quickly destroying it, as many thinks is the case.-Cîrcular from Mass. State Board of Healtk. NICOTINE IN HER SMACK.-I wonder how any woman who has ever kissed a clean man can go through the pretense of ever kissing a tobacco-chewer. Did you ever see one suffer the penalty ? This is how she does it : There is a preliminary shudder, and then she sets ber teeth hard, holds ber breath, and muakes a little pigeon dip at the foul lips of the grinning beast, and then, pale with horror, flies to the kitchen, where, if you follow ber, you will find ber disinfecting with soap and water. Many of the blessed little hypocrites pretend that they like the smell of a cigar, but even hypocrisy is powerless to force from a woman the confession of a fondness for hanging like the bee on a flower to a tobacco-worm's lips.-Mrs. Garrison. COURAGE is a wonderful agent in throwing off disease. A walk of five miles would cure many an occupant of the lounge. Will- power will surpass pill-power in nine cases out of ten, if not in every one. To hold a bottle of smelling saits in the hand on account of a head-ache may be just the thing, at times, but to fling a pound of fruit cake out into tic alley, and then walk a furlong as a reward for not eating the compound, is nearly always a much better thing.- Sanitarian. LEAKS IN GAS PIPES.-To deteet leaks in gas pipes, apply soap suds to the suspected leaky joint. The formation of bubbles will show an escape. This is safer than trying the joint with a lighted match. If the leak occur in the branch of a bracket or chandeler, it is repaired by soldering with plumber's fine solder; if it be a very small one, heat the piece first, with a spirit lamp, and fill the aper- ture with cement.-Saniarian. CONCLUSIVE.-Lodger.-\" I detect rather a disagreeable smell in the house, Mrs. Jones. Are you sure the drains-\" Landlady.- \" Oh, it can't be the drains, sir, whatever. There are none, sir ! \"- Punch. 279",
         "THE SANITARY JOURNAL. [MEASLES NOT A TRIVIAL DISEASE. Since January i, 188o, says \" the Prceedings,\" there have been 1,864 cases of measles reported to the Brooklyn Health Department ; this is probably less than half the number which has actually occur- red. During the same time there have been 73 deaths from the sanie disease, while during the entire year 1879, measles caused but 40 deaths ; should the present rate of mortality continue throughout the year, the record will show 24o deaths from measles for the twelve months of 188o. While measles has thus far caused 82 deaths, there have been but 65 deaths from scarlet fever. In New York last year, measles caused 244 deaths. It is a common impression that measles is a trivial disease which every child must have at some period of its life ; that the younger he is the more mild the attack, and therefore the sooner he has it the better. This is the popular opinion, and some physicians hold the same views. From practical local observation and careful investigation of the subject, together with the experience of Brooklyn physicians obtained from their answers to a series of questions sent them by the Board of Health, we believe, says Dr. J. H. Hammond, Sanitary Superintendent, Brooklyn, that the gencral impressions referred to are entirely erroneous, and if permitted to go uncontradicted, liable to do great harm and injury, even to the degree of sacrificing life. ACTION OF THE BOARD OF HEALTH. Measles being so prevalent in Brooklyn, and its mortality so great, the Board of Health has included this disease in the same category with scarlet fever and diphtheria, and requires the following action : i. Reports to be made to the Health office by physicians, of all cases coming under their care. 2. The exclusion of the sick and of others residing in the same house, from the schools of the city, both public and private, until a permit for their return is obtained from the Board of Health. 3. These permits to be given when the patient is no longer in condition to spread the disease, and when the rooms, clothing, and other infected materials have been properly fumigated. 28o",
         "ANNOTATIONS. 4. The fumigation prescribed by the Board of Health is by the burning, for five hours, of sulphur, one pound to each thousand cubic feet of space to be fumigated, the apartment being tightly closed. 5. Certificates of physicians that these requirements have been fulfilled will be sufficient evidence, and on their presentation to a sanitary inspector or at the office of the Board of Health, the school permit will be at once issued. THE NATIONAL BOARD OF HEALTH--At the recent meeting of the American Public Health Association, Dr. Fulsom said he had been directed by the Advisory Committee to offer the following preamble and resolutions : Whereas, the National Board of Health has, in accordance with the law which created it, requested the advice of the American Pub- lic Health Association regarding the form of a permanent national health organization of the United States, including its relations to quarantine, both maritime and inland, and, W/zereas, the opinions of the Advisory Council of the Association, upon the subject of health legislation, collected and presented to this body through Dr. J. M. Toner, Chairman of the council, have been duly considered ; therefore, Rejoved, That, in the opinion of the American Public Health Association, the present National Board of Health has been of such vast service to the country that it is not expedient to make any essen- tial change in its organization, and that any minor improvement in details should be left to the Board itself. 2. That the investigations which have been commenced by the Board are approved and should be continued, and that sinilar inves- tigations should be undertaken by it into the consideration and pre- vention of other diseases as well as yellow fever. 3. That Congress should appropriate sufficient funds to enable the Board to employ the best talent and apparatus in such scientific and practical inquiries.-The sum of $300,ooo (half a million), had been granted by Congress. THE FOLLOWING TESTIMONIAL of a certain patent medicine speaks for itself: \"Dear Sir,-Two months ago my wife could scarcely speak; she has taken two bottles of your 'Life Renewer,' and now she can't speak at all. Please send me two more bottles at Is. îyád.; and very cheap it is at the money. I wouldn't be without it for the world.\"",
         "THE SANITARY JOURNAL. POPULATION STATISTICS OF FRANCE AND GERMANY Some interest attaches to the population statistics of two large countries like France and Germuany, and the returns which have recently been published show results which are not without impor- tance. In France the attention of statisticians has of late been directed to the steady and serious decrease in the population, as evinced by the gradual decrease in the birth-rate. In 1878 the nun- ber of births was 937,211. The two causes accounting for the de- creases are the fewer nurnber of marriages and, what is far more important, the decline in the number of children resulting from these marriages. In fact, the proportion of children to each marriage is dwindling more and more all over the country, except in Brittany, and in some of the departments in the centre and the south. In the class composed of petty tradesmen, or the well-to-do peasants, there is seldom more than one child per marriage. and M. Baudrillart has stated that in one of the rural communes in Picardy he ascertained the number of children among the best-off of the peasants to be thirty-seven for thirty five families. To a certain extent the decrease in population is kept in check by the decrease in the mortality, which numbered 839,036 in 1878, or 2·26 percent., whereas in 1864-68 it was 2-34. But the question nevertheless remains as to what will be the ultimate destiny of France if the decline of population still con- tinues unchecked. In Germany, on the other hand, the estimated population of the Empire at the end of 1878 was calculated in round numbers at 44,211,000 ; the number of births during that year was 1,785,080, and the deaths 1,228,707, giving an excess of births over deaths of 556,473, or an annual increase of population amounting to more than r25 per cent. For every 1000 of the population 15·4 were married, 40·4 were born, and 27-8 died, so that the births were more numerous than the deaths by 12·6 per rooo. ENGLISH RATES OF MORTALITY. At a recent meeting of the Statistical Society, (Med. Times Gaz.) Mr. Welton read a paper on \" Certain Changes in English Rates of Mortality.\" In opening this subject he remarked that while the leading facts in relation to the statistics of mortality is the regularity 282",
         "VITAL STATISTICS. underlying every variation of death-rate, it is well, on the other hand, to examine from time to time the data for long reriods, and to con- sider the stability or changefulness of the phenomena. Tendencies may thus be discovered, which, in a protracted series of years, would bring about unmistakeable results. Mr. Welton based his compari- sons on the six quinquennial periods extending from 1846 to 1875. On this basis he found that, according to the death-rates given by the Registrar-General, the mortality of both sexes at ages from five to twenty-five had certainly been reduced ; but this abatement had been attended by an aggravation of the mortality at higher ages, putting aside epidemic years, and that such aggravation had been far more considerable among males than among females. Mr. Welton next referred to different'sets of tables prepared by him as compared with Dr. Farr's English life table,and he showed that the period of years before the persons who are born are reduced to half their original number was, according to these tables, as follows :-By Dr. Farr's table-males, 44-4 ; females, 46-4 : female expectation greater by two. By experience of 1856-6o-males, 46-5 ; females, 48-9 : female expectation greater by 2·4. By experience of r87 1.75-males, 45-8; females, 50·9: female expectation greater 5-1. In conclusion he adverted to the causes of the increased mortality among males aged thirty-five to sixty-five, the result arrived at being that this increase had not been largely due to epidemics, to consumption, or to diseases of the stomach and liver, but to disorders of the lungs, heart, brain, kidneys, and to cancer. THE DECEMBER RETURN OF THE REGISTRAR-GENERAL FOR IRELAND. The return of the Registrar-General in Ireland for the fourth quarter of the year 1879, records the registration during that period of 30,668 births and 24,497 deaths. The births were equal to an annual birth-rate of 22-9 per roo of population, as against 34-2 per rooo registered in England ; the deaths represented an annual rate of 18-3 per rooo, as against 21-4 in this country. It is remarked in the return that the birth-rate in Ireland is again under the average of the corresponding quarter of the previous five years to the extent of i per ooo of the estimated population. The death-rate is above the average for the same period, the excess being 1-6 per iooo, and is the 283",
         "THE SANITARY JOURNAL. highest registered in the fourth quarter of any year since registration of deaths commenced in Ireland the year 1864. As some explana- tion of this latter fact, it has to be considered that although the wea- ther during the first two months of the quarter was comparatively much more favourable than it had been during the preceding por; tion of the year, During September it became unuasually severe, and contributed much to increase the mortality amongst the very young and very old. The suffering caused by the extremely bad harvest, and through the depression of trade, is also, no doubt, responsible to some extent for the excessive death-rate of the quarter under notice* but it is stated that during that period none of the registrars return any deaths as attributable to starvation, although some of them admit that want may have led to increased sickness and liability to disease. The deaths from the seven 'principal zymotic diseases were slightly under the corresponding quarter of 1878, but above the average mortality for the fourth quarter of the three years 1876 to 1878. Scarlet fever has been steadily increasing throughout the whole of last year, and after the three months ending December, was credited with having caused 589 deaths. Measles and whooping-cough were the next most fatal, the former with a mortality of 319 and the latter with 459. Of the 24,497 deaths registered during the quarter, 3968, or 16-2 per cent, occurred in public institutions. VITAL STATISTICS OF THE PAST YEAR IN GREAT BRITAIN.- Accompanying the return of the Registrar-General for the last quart- er of the year 1879, (Med. 7ïnes and Gazette) will be found a brief summary for the whole of that year. From this we gather that in the United Kingdom I,144,57 1 births and 707,379 deaths were register- ed during the period-equal to rates of 33-5 and 20.7 per ooo res- pectively of the population estimated to be living in the middle of the year. The natural increase of population, by excess of births over deaths, was 437,192, against 436,36o in 1878. In England and Wales during the past year the birth-rate was equal to 35-1, and the death-rate to 21 per 1ooo persons living. The birth-rate was o·6, and the death-rate o·8 below the average rate in the ten preceding years. The death-rate in 1879 was also o-7 below that which pre- vailed in 1878, but somewhat exceeded the rate in 1877, which was the lowest on record. The annual death-rate in England and Wales 284",
         "VITAL STATISTICS. averaged 25-4, 22-2, and 22-4 per iooo respectively during the three decades 1841-50, 1851-6o, and 1861-70. Notwithstanding the marked increase of density of population in urban districts, English mortality may be said to have remained stationary during the thirty years 1841-70. Last year was the ninth of the current decade 1871-80, during which the average annual death-rate in England and Wales has not exceeded 21-9 per ooo. This decline of mortality, which, the summary says, may be accepted as evidence of improving sanitary condition, implies that during the past nine years more than 150 000 persons have survived in England and Wales, whose deaths would have been recorded had the average annual rate of mortality in the previous thirty years been maintained. The deaths from the seven principal zymotic diseases in England and Wales during the year 1879 were 60,157, and were equal to an annual rate of 2-39 per rooo, against 3·44, 3-11, 2·71, and 3·32 in the four preceeding years. Compared with the numbers in 1878, the fatal cases of measles showed a slight increase, whereas those of each of the six other diseases had considerably declined. The decrease of deaths referred to diarrhea and small-pox was specially marked ; the fatal cases of small-pox were, without a single exception, consider- ably fewer than those returned in any previous year since the estab- lishment of civil registration in 1837. The death-rate from fever (principally enteric), which was equal to r1i per 1000 In 1865, has since declined with but slight fluctuations, and in 1879 did not exceed 0-30. In the past rine years the annual death-rate from fever has averaged but o-51 per 1ooo against o'9r and o-88 in the two preceeding decades--a very satisfactory sign of santary progress. VITAL STATISTICS OF BROOKLYN, N.Y., FOR 1879.-The actual mortality in Brooklyn during the year 1879 was 11,569. The total number of births reported was 10,169; of still-births, 889; of mar- riages, 3,222. Of these three classes the returns are incomplete, whereas the deaths are fully reported. Estimating the population at 564,448, the annual death-rate was 20.49 per 1,ooo persons living ; while in 1878 the rate was 20.40 per 1,ooo. This latter may be signalized as the lowest death-rate this city has experienced since our mortality statistics began to be fully registered. Next to that, however, stands the low death-rate of 1879 ; so that the health 285",
         "THE SANITARY JOURNAL. of the city, as measured by its roll of deaths, was considerably above the average of recent years. A comparison of the total nortality during certain years, and of the rates proportional to population, may be instituted by means of the following exhibit : Years. Deaths by Differences. Population, Death Rate All Causes. (Census or Est.) per ooo. 1879................. 11,569 494\u002b 564,448 E. 20.49 1878 ................. 11,075 287- 542,739 E. 20.40 1877 ................. 11,362 972- 521,864 E. 21.77 1876................. 12,334 136- 501,792 E. 24.58 1875 ................. 12,470 482,493 C. 25.84 Average io years ...... 11,329 455,Ro E. 23.78 There were no deaths by small-pox, and no serious epidemic pre- vailed. Yellow fever occasioned two deaths (both imported cases), but it secured no foothold. Diphtheria caused 689 deaths, an increase as compared with the previous year. Scarlet fever, 344, a falling off as compared with 1878. The number of deaths by certain other of the principal causes was: by whooping-cough, 204; measles, 40; croup, 250; typhoid fever, 59; cholera infantum, 68o; all diarrheal diseases, r,258; all diarrhœal diseases under five years Of 1,076 ; malarial fevers, 150; erysipelas, 64 ; intemperance, 67 ; rheumatism, 67 ; cancer, 231 ; marasmus, 353 ; consumption, 1,665 ; hydrocephalus and tubercular nieningitis, 189 ; meningitis and acute diseases of brain, 372 ; apoplexy, 229; convulsions, 241 ; all dis- eases of the nervous system, 1,238; diseases affecting the heart, 505 ; bronchitis, 479; pneumonia, 975 ; all diseases of the respiratory system, 1,632; Bright's disease, 256; puerperal diseases, 182 ; old age, 239; infantile asthenia and premature birth, 257 ; suicide, 37; in public institutions, 637. By the five principal classes of causes of death, the number of decedents was : I. Zymotic diseases, 3,283; Il. Constitutional, 2,574; III. Local, 4,379 ; IV. Developmental, 1,017 ; and V. Violence, 316. By seasons, the record was: For the first quarter, 2.832; second, 2,478 ; third, 3,398 ; and fourth, 2,861. By sexes : Males, 5,823; females, 5,746. By nativity: born in the United States, 8,341 ; foreign born, 3,228. Under i year of age there were 2,881 deaths; under 5 years of age, 5,201 ; and at 6o years of age, and upwards, 1,684. 286",
         "VITAL STATISTICS. VITAL S'IATISTICS OF NEW YoRK.-During the year 1879 there were 25.573 births, 8,446 marriages, 2,191 still-births, and 28,342 deaths (14,807 males, 13,535 females, and 442 colored), which took place in this city, reported to the Bureau of Vital Statistics of the Health Department ; this shows a decrease of 150 births and i still- birth, and an increase of 817 marriages, and 1,334 deaths when compared with the number reported during the year 1878. The annual death-rate of the city to every 1,ooo of the population, which was estimated at 1,097,563, in the middle of the year, was 25.·82, which bears the following comparison to the preceding ten years, viz. :-1878, 24.93 1877, 24.50; 1876, 27.62 ; 1875, 29.47 ; 1874, 28.94; 1873, 29.68; 1872, 33-76; 1871, 28.26 ; 1870, 28.84; 1869, 27.13 ; 1868, 27.25. The total deaths from diarrheal diseases (which include cholera infantum, cholera morbus, diarrhea, dysentery, entero-colitis, diar- rhoeal enteritis, and gastro enteritis) was 2,965, 1,151 males and 1,414 females ; of this number, 2,592 were under 5 years of age ; it will therefore be seen that although the total mortality was higher than either of the preceding two years, the deaths of children under 5 years of age from diarrheal diseases was less than the number that occurred during any of the preceding 10 years. As usual the highest number (1,079), occurred in the month of July. Phthisis Pulmonalis continues to cause more deaths than any single disease reported, the number of deaths attributed to it being 4,343, (2,280 maies and 2,063 females, 4,244 white and 99 colored), which was 123 less than the number reported from it during the previous year. The deaths of children under 5 years of age were 12,777 (6,879 males and 5,898 females); of this nurber 205 were colored. The death rate of children under 5 years of age to the 1,ooo of the population under that age, according to the N. Y. State Census of 1875, was 99.70. The proportion of deaths of children under 5 years of age to the total deaths was 45.44, which was less than that of any of the preceding 10 years. Contagious or infectious diseases caused 2,601 deaths, small-pox 25 deaths, scarlatina 1,477, diphtheria 671, whooping cough 537, and typhoid fever 78 deaths. Of suicidal deaths there were 117, roo males and 17 females; 40 were single, 51 married, and 1i widowed; 50 were natives of Germany, i of Ireland, 2 of England, and 29 of the United States.",
         "No -n 00 W N m..f. r4fý \"-o \u003cr -DI p!oqdXj -- N- - -S'a IlaH ~ CI O\\\\ ri.~ t' O \\Dr-~~\\ UqO- r- '- f rnO r - Oý e, e0 t - cN C4 N' rr--.r\\o I co S!S!qwlad C,-~o cn ci \\O 00O J ~AO ~SE~flUJ .Ioj sq~i~~ JO 0N 11~OI z o u C', Lf N Nt ~ 0 NIt M r-, (4 moc)C4 M 0 ina\\ É-1rý10 0 ýt -oo m r ýt ,0 t r c\\ Il-IeC ..................n (4N i . . . . . . . . . . -~ Z . . . . . . . . . . ;~.\u003c . . . . . . . . . .04- . . . . . . . . . .~ ,-e .........................ein ..........=...0.. .. Cu M v L: u",
         "C%~ ~ ~ -t C', Oqf - ýÇoc *l\" tilt\\ i0 0ý C\\ 0N -t a., 0 - 0 .q .j ' 00 -'t ,0 \\ Z C *n tiI n c q ci 0 C ONOOt'I~NNO ~r'i ON \\ rq *q * CI ritNO O -0 N0'ý tl)N l' ON' un El . . . N ri II - -l ML N m Mt-4 NOc'NOO..O ý\\ N cN 00 'qt Ni c* Nq M a', O '0 ÎN NU ~' Ne",
         "THE SANITARY JOURNAL. THE DEATHS REGISTERED IN 1879. On other pages is a table showing the returns of deaths in Ontario for 1879 ; for which we are indebted to the Registrar-General's De- partment. A few townships have not yet sent in their returns. There will be a slight increase in the returns of 1879 as compared with 1878. Of the 39 Counties, 19 show an increase in their returns, and 20 show a decrease. Of the 9 cities, however, 6 give an increase and 3 a decrease; giving a total increase from the cities, over 1878, of 84 deaths. It should be observed that the decrease in the returns of deaths is chiefly from the Counties of York (329) Stormont, Dundas, and Glen- gary, (united 139) and Northumberland and Durham, (united 89); while Wellington, Muskoka, and Oxford show a considerable falling off. The decrease in many of the Counties is very small; as in four of them it is only one each. The increases are much more uniform. OF THE CAUSES OF DEATH. There is considerable improvement in giving the causes of death. During several years a large number had been registered as dying from \" old age,\" many of these at less than 70 vears of age. It was a very convenient cause to give. In 1878, 1722 were registered under this head ; while last year only 1204 were so registered. In In 1878, 121o were registered under the liead of Infantile debility, a very unsatisfictory cause to give for a death; in 1879, only 210 were thus registered. Convulsions is another unsatisfactory cause to give, and is properly only a symptom of several diseases. In 1878, 454 were so registered ; last year, only 255. We have on several occas- ions in this JOURNAL drawn attention to the objections of this loose method of registering a death. The report of the Registrar-General too has taken strong exceptions to it during the past three years. We are pleased to see the improvement and trust it may continne. There were in 1879 the usual large number of deaths from con- sumption, 1992 ; just two less than in 1878. Consumption is a preventable disease, and this appalling death-rate which shows piobably only about two-thirds of the actual number, for the returns are not complete, might be largely reduced by the proper administration of public health laws, if there were some system in the province for such administration ; as there is in our educa- tional system and other less important matters. The education of",
         "REGISTRATION RETURNS. the public in general health subjects too, would doubtless help much to lower the death-rate from consumption. In 1879, there were 97o deaths registered as from inflammation of the lungs (pneumonia), against 826 in 1878. From heart disease there was an increase in 1879 of 59 deaths over those of 1878. There were not nearly so many deaths registered as from diphtheria last year ; 635 against 986 in 1878. From scarlet-fever, 292 deaths in 1879, and 368 in 1878. From typhoid fever, 343 in 1879, and 379 in 1878. ON THE REGISTRATION RETURNS IN ONTARIO. The returns of vital statistics from the cities, towns, and villages in Ontario, show a satisfactory increase and may be regarded as nearly complete as possible. The want of completeness in the returns from the townships, is no doubt largely owing to the distance many of the people are from the division registrar, who frequently lives at one side of the township, or possibly outside of it altogether. We suggested some time ago that this might be remedied by making each school district in the townships, a division for registra- tion purposes. A death, birth, or marriage could hardly occur in a school district without the teacher soon becoming aware of it, and if he were paid a small fee for each registration, and made liable to a fine for neglect, it would doubtless add much to the completeness of the returns. He could make returns to the present division registrars. During school vacations he could get some one to act for him. After all it is of the first importance to awaken the people to the importance of these returns, to teach them the value of having them complete. In England much has been done by educating the people in regard to these matters, and by circulating thousands of weekly statistical reports. BOOK NOTICES. REPORT OF THE MEDICAL SUPERINTENDENT OF THE ASYLUM FOR THE IN- SANE, TORONTO, for the year ending 3oth September, 1879. The Superintendent, Dr. Daniel Clarke, has kindly favoured us with a copy of the above report, and we have read it with nuch pleasure and interest. In addition to the usual statistical matter the report contains considerable which closely concerns the well-being of the general public, and which ought to be very generally read. This relates chiefly to the principal causes of insanity noticed. The report reads :-\" In looking over the tables of Asylum Reports from year to 4 29I",
         "THE SANITARY JOURNAL. year, the thoughtful reader cannot help being alarmingly startled at seeing such a record of large percentages of cases of insanity being attributed to these three causes, viz. :-. Hereditary Taint. 2. Worry from over-work. 3. Intemper- ance. The hereditary cause may at a low estimate be placed at 45 per cent. of the insane population. It is worth while in a Report of this kind to make in- quiry into the iadical cause of such a dire calamity as that of insanity. Nothing new can be written about it to medical men, but if the public can be made to pause and consider in the midst of the hot pursuits of every-day life, some good may result from a cursory glarice at the subject. What is this hideous ogre which is working such woe in our midst ? To say that a disease is hereditary means, in the community, that it is incurable, although such is not absolutely the case.\" After noticing hereditary diseases, physical forms and features, and mental traits, the Doctor continues :-\" The epileptic, the consumptive, the scrofulous, the syphilitic and the insane marry without knowledge or reflection, and, as a result, fill our hospitals, asylums and prisons with their degenerate progeny, or bequeath them a brood of ailments which makes a fruitful soil for a crop -of de- teriorated constitutions, which to the unhappy.victims of parental folly, makes life not worth living for. The lower animals are carefully assorted and mated be- cause it pays to raise superior herds of domestic production, but no pains is taken to elevate, ennoble, and improve physically, mentally, socially and morally the human race by taking rational steps to eradicate this evil. Morality rightly for- bids law to interpose its arm in this matter, because of the freedom of choice which must be allowed to the subject, but here is a plague spot to root out, against which moral suasion might be used with good effect. It would be startling to say how much indiscreet marriages lie at the root of our social vices and national sins. The friends of humanity-more especially parents-might by judicious advice and discreet exposure of consequences following rash selection, do more for their children and generations yet unborn, than were they to endow them with the richest legacies.\" Yes, parents might, if there were some means of instructing .them in regard to such matters ; few at present know the consequences of \"rash .selection,\" \u0026c. \" The redeeming feature is,\" says the doctor, \" that when such ,unions take place judicious living and intelligent obedience to nature's behest may do much to avert untoward results to themselves and their posterity. The vitiated system always makes gallant efforts to recuperate from its fallen condition, if ,eçonded by intelligent conduct and habit.\" It is worthy of notice that, in the Asylum, \" During the year only five drams of morphia, four ounces of opium, and three and a half ounces of chloral were administered internally among an average of 765 persons (patients and attend- ants).\" FOURTH ANNUAL REPORT OF THE STATE BOARD OF HEALTH OF WISCON- SIN. This is a valuable addition to Sanitary Literature, containing 165 large pages, of useful and practical information for the people. It contains practical papers on \" Homes for the People,\" \" Our Public Schools,\" \" Ground air in its rela- tions to health, \" The adulteration of foods,\" and other subjects, together with numerous extracts from special correspondents. ,ELECTRICITY IN MEDICINE AND SURGERY, WITH CASES TO ILLUSTRATE, By John J. Caldwell, M. D., Baltimore, Karyland. Practice limited to Diseases of the Nervous System. Electricity is becoming a therapeutic agent of considerable importance in the treatment of disease, and doubtless ere very long investigation will cause it to be better understood. In this pamphlet of 40 pages, numerous cases are given in order to illustrate tlée va4lue of theç agent."
      ],
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         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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         "eng"
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      "key" : "oocihm.8_05173_41",
      "label" : "[Vol. 4, no. 5 (May 1880)]",
      "pkey" : "oocihm.8_05173",
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   "doc" : {
      "type" : "document",
      "title" : [
         "The Canada lancet [Vol. 9, no. 8 (Apr. 1, 1877)]"
      ],
      "published" : [
         "Toronto : [s.n., 1877]"
      ],
      "identifier" : [
         "8_05199_80"
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA THE LANCET Gtritisi5m and §jws 1\u0026 } TORONTO, APRIL 1, 187 Price 30 Cent CONTENTS.--(Index next page.)_ d Ui o E4 0\u003e g4 \"I 'I gNeaOtbly iBiournalt uf etåtrt and ,îurgtcal Jtttnct,",
         "2 THE CANADA LANCET. INDEX TO CONTENTS. Original Comrnunications. Case of Gun-shot injury of the Brain-Recovery-by J. A. Fife, M.D., Hastings ........ Vesico-Vaginal fitula with retroversion of the Uterus-by P. O'Keif, M.D , Oconto, Wis................................. Correspondence. Double Undergraduateship and Double Graduation-M. D. Surgeons in the Allan Line-Dr. Hockridge ........ .... Selected Articles. Revaccination .. .... . . . . . . . .. ... . . . . . . . . Subcutaneous Section of Neck of Femur ..\" \" \"'.............. Injection of Ammonia into Veins in Collapse ...........'''-* Moderate Drinking-Sir Henry Thompson . '\"............ Fracture of Cervical Spine, Puncture of Bladder.. .. .... .. - Therapeutics of Headache ........................... Orchitis treated by Puncturing the Testicle........... Case of Extra-uterine gestation................... Chronic Ovaritis and sub-involution of Uterus, (Thomas).* Thoracentesis in Pleuritic Effusion ........................ Death of Gordon Buck........................... Secondary hemorrhage after Esmareh's bandage .........''\" Laceration of Female Perineum ....... ............... Remedy for Whooping-Cough-Sulphurous-Acid as an Anti- septic Injection of Iodine in Suffocative Goitre-New Disin- fectant ad Antiseptic-Therapeutics in Great Britain-Bro- 225 mide of Arsenic i. Epliepsy-Ovarioton.y at the Samaritan Hospital-Suggestions for the Cure of Aneurism-Dangers 226 from Santonine...................................... 42-4 Nedical News and Items ............................2456 227 228 Editorial. Hunterian Oration .................................. 247 Colored Light in Treatment of Disea e...................249 Uriversity Affiliation................................ 250 Disinfection..... ................. 251 Application of Nitrate of Silver to Ulcers -Ieaths from Small- pox in Moutreal -Farewell Compliment-.Improvement in Montreal Hospital-Removal of Large Tumour from the Thigh--Coll. Phys \u0026 Surg. Kington-Remedy for Whooping Cough-odine Staine-An Explanation-Professional- Award to Billings, Clapp \u0026 Co.,-Whittier Son \u0026 Co.,- Obituary-Personal....... .................. 251-4 Reporte of Societies. .......................... Births, Marriages apd Death .......................24 MOÖL LE R'S $\u003eW 8T NOAWE:AN 0D-co .tvt Ott DI BUCa, Physician in ordinary to H. M. the King of Sweden and Norway, says * It the very best ever prepared for medicinal purposes.' ABBOrS SMITH, M.D., M.R.C.P., North London Consumption Hospital, says: \" It is more eaaiiy assimilated and is productive of more immediate benefit than the other kinds of * oillare.\" DR. RUDDocas, M.D., L.R.C.P., M.R.C.S., says: \"We are glad to be able to give our ei- phatic recommendation to so pure a preparation.\" J. MARION SiMs, M. D., New York, says: 1 have prescribed it almost daily, and have every reason to be perfectly satisfied with it.'' DR. L. A. Baa, New York, says: \" Moller, of Christiania prepares an'Oil which is per- fectiy pure, and in every respect all that can be wished.' N. B. SaxDs, M.D., New York, says: \" It je remarkably free from Impurities' W. H. Schieffelin \u0026 Co., NEW YORK. Sole Agents for United States and Canada. HBRST PR] O RTIFØIA Lfa AND SURGICAL APPLIANCES PPARATUS of every description made to order, for Paralysis, Hip' pjoint Diseme, Weak Ankles, Club Feet, \u0026c. JAMES AUTHORS, Lr IV 16 King Street East, Toronto. 1 o- TORONTO, Sept. 17, 1874. x oI have much pleasure in being able to testify to the skill, ingenuity, and excellence of workmanshp shown Mr. Authors' surgical appliances. They will bear comparison with those manufac tured in any part of the worldR JAMES H. RICHARDSON, M.D., University of Toronto, M.R.C.S. England DR. REEVE ICAN BE CONSULTED IN REGARD TO DISEASES OF THE EYE AND EAR, At the Tecumseh House, Londozi, On the First Saturday of every month. Residence and Office, 22 Shuter, St., Toronto. M BELMONT RETREAT, QUEBEC. This Institution opened in 1864 as a Private Hospital fo the Insane has recently baen considerably enlarged, and nor furnishes excellent accomodation for this class of patients. A separate department is also furnished for Inebriates. Patients are admitted on the certificates of two medical men.-Terms from $6.oo to $îo.oo per week quarterly iO advance. For further information apply to G. WAKEHAM, Proprietor. P.O. box io4r, Quebec, P.( or W. WAKEHAM, Resident PhysiiaO'",
         "THE CANADA LANCET. 3 WILLING \u0026 WILLIAMSON'S LIST. PHYSICIAN'S VISITING LIST FOR 1877. Of the following Sizes, bound in the best manner, with Tucks, Pockets, and Pencils. For 25 Patients weekly .....Price $î.oo Jan. to June Price, $2.50 t 50 i \" ···· · \" -25 For 50 Patients weekly, 2 vols. July to Dec. t 75 fi \" ···· 1.50 Jan. tojune e 100 il ...... 2.00 î00 t f July to Dec. 3.00 INTERLEAVED EDITION. For 25 Patet For 50 Patients weekly, 2 vols Jan. to June et5 t f ... i -51For 5o Patients weekly.PriceIS..5 July to Dec.j ... . Price, $3.o00. W'COPIES sent by mail, postagepaid, upon the receibt of thejprice as annexed. This list has now been published twenty-six years, and has met with the hearty and uni- form approval of the Profession in all parts of the country, and is considered an indispensable companion for the practising Physician. Ringer's handbook of Therapeutics, 4th ed., (1876). $4.35. Playfair's System of Midwifery. (1876). $4.00. Roosa's Ophthalmie and Otie Memoranda. (1876). $1.00. Balfour Brown on the Medical Jurisprudence of Insanity. (1876). $5.00 Meadow's Manual of Midwifery. 3rd enlarged and revised edition. (1876.) $3.25. Holmes' Surgery; its Principles and Practice. 1 vol. of 1000 pp. $6.00 and $7.00. Hammond's Diseases of the Nervous System, 6th edition, revised, re-written and enlarged (1876), $6.00. Loomis on the Respiratory Organs, Heart and Kidneys, $5.00. Beard \u0026 Rockwell's Medical and Surgical Uses of Electricity, 2nd (edition, enlarged, $6.25 MAILED POST FREE ON RECEJPT OF PRICE. GET OUR FULL OA TALOGUES. (gratie.) WILLING \u0026 WILLIAMSON. Medical and General Booksellers and Importers, 12 King Street East, Toronto.",
         "THE CANADA LAINCET. CODMAN \u0026 SHURTLEFF'S Atomization of Liquids for Inhalaion, Local Anæsthesia, \u0026c. B Y the Atomizer, any medicated liquid nay be converted into the finest spray. In this state it may be inhaled into the smallest air-celis, thus opeuiug a new era in the treatmeut of ail diseases of the tbroat and lungs. (Fig. 15). It consist of the sphere-shaped brass boiler A, steam outlet tube B, with packing box C, D formed to recei e rubber packing through wih the atomizing tube D passes, steam tight, y and by meas of which tubes, of var*ous sizes may be tightly held against any force of steam, by screwing (low the cover while the packing is warm; the safety-valve E, capable of gradua- tion to high or lom pressure by the sprig or screw ln its top, the non-conducting handle, by whih the boler ay be lifted while hot, the medicament cup and cup-holder G, the support i A Ul, iron base 1 1, the glass face-sbield J, witb oval xnoutb-piece connected by tbe elastie band K with the cradle L, whose slotted staff passes into a lot in the shield-stad M M, where it G H may be fixed at any height or angle required by the milled screw N. hat The waste upmedicament cup and lamp are beld in their places in such a manner that they canuot fal out when the apparatus is carried or used over a bed or otherwise. a its aints e bard oldered. It cannot be injured by exhaustion of water, or any attainable pressure of steam. It does not throw spirts of hot water, to frighten or sald the patient. Is compact and portable, occuples space of one-sixth cubie foot only, can b carried fron place to place without removing the atomizing tube or the water, can be unpacked and repacked witbout oss of time. Will render the best of servic:e for miany years, and is cbeap la the best sease of the word. Price $6; brasil Fig. The complete Steam Atomnizer. parts, nickel plated, additional, $2 50. Neatly made, strog blaek walnut box, with convenpent handle, additional $2.50. B The înost desirable baud apparatus. Rubber warranted of very bas A quality. Valves mperishable, evary ona carefully fitted to its seat and work prfectly iu ail psitions. The bulbs are adapted to all the tubes made bY us for Local Aestbesia ln Surgical Operations, Teeth Extraction and In- Calaflon. Price $400. Eac of te above Apparatus is supplied with two ecarfully made anealed glass atomizing tubes, and accompanied with di- actions for use. E CoDMAN SHURTLEFF, DEverysteam Apparatus is tested with steam, atvery high pressure. Each apparatus is carefully packed for transportation, and warranted perfect. Also RAND BALL APPARATUS, (Fig. 5, without shield) with two glass tubes. 1. . . . . . . . . . . . . ...$350 - ~THE BOSTON ATOMjZ .R ith two giass At i'g 'tubes . 2 50 Fig. 5. Shurtleff's Atomizing Apparatus. I TREMONT 2E it 2t00 Pat. March 2r, 18t. GLASS ATOMIZING TUBES, to fit any of our Apparatus, warranted PERFUME ATOMIZER, nickel plated, for toile use 15 SILVER SPRAY Il \" Il ........ ........................ .. ... . .. .. .. 50 NICKEL PLATED TUBES, for Local Anæsthesia and for Inhalation7.. . 00 RHIGOLENE for Local AnSsthesia, best quality, packed .................................-.........75e. to 2 00 NASAL DOUCHE, for treating diseases of the Nasal Cavity, eight dfe ·····..... 1.00 N ~ ~ ~ ~ ~~ $.0 B.0 erent vareted eac wihtonzle5akd$.0 N.B.-To save collection expenses, funds should be sent with the order eiter ln form of draft, $1.50, 2.00, 2.50 and'3 50 etter. For complete i lustrated priceîlist of Apparatus, Tubes, \u0026c. se pamphlet pot-office order, or registered WiIl @end by mail (post-paid), on application, a pamphlet containing two articles, by distinguished foreigu autbority, On SInhalation of Atomized Liquids,\" with formule of those successfully employed. Also, au article by Dr. L. W. Thudichumi MR O.P., on \"A New Mode of Treating Diseases of the Nasal Cavity,\" with is formule. Also an illustrated description of the bt Aparatus for the above purposes, and for producing Local Anuesthesia by Atomization of Rhigolene. Instruments made to order, Sharpened, Polised, and Repaired. An Illustrated Catalogue of Surgical and Atomiziiig Instruments sent by mail, postpaid, on application. CODMAN \u0026 SHURTLEFF, Makers and Importers of Surgical and Dental Instruments, 13 and 15 TREMONT STRtEET, BOSTON. R. J. ROSE, corner Queen and Yonge Streets, Toronto, Agent for the Instruments, also thR Pamphlet mentioned. Mrs. Pearson's Abdominal Supporter. (Patented Oct. 1870.) The attention of the Medical Profession is called to the great value cf Mas. PzAnsoN's Abdominal Supporter in the treatment of Uterine complaints. It i especially adaped to the treatment of partial procidentia uteri, ante or retrover- sion, and i Leucorra, depending on these defect ; by removing the cause it quickly cures the discharge. It is also Of great service in a lax or pendulous state , of the abdomen and during pregnancy, by giving the much needed support. A perineal pad can be attached to the supporter when required. The underigned, having tested its value in their practice, kindly allow reference to them as to its excellence and efficiency . E, M. Hodder, M.D., F.R.C.S, E.; Toronto, R. Blaekstock, M.D.. Hillsdale. N. Bethune, M.D., F.R.C.S., Ed. Toronto. J. Wilkinson, M.D., Woodbridge. Augustus Jukes, M.B., St. Catharines. Edwin enwood, M.D., oatbilton. Dr. Rowand (M.D., Edin.); Quebec. Uzzil Ogden, M.D., Toronto. W. W. Ogden, M.B., Toronto. UzzHelWge, M.D., Toronto. J. Mackelcan, M.R.C.S. E.: H amilton. H. H1. Wright, M.D., Toronto. D. Henry J. Rid , Hamilton. *Dr. G. L. Mackelcan, Hamilton, Dr. Haery J. Riday, iasilton. Dr. McDonald, Hamilton. M. Lavell, M.D., Kingston. Edwin Goodnain, MN.B., St. Catbarines. Price $7 9e $10. Please send meaeurement aroun(d lorgest port nf h G , h. Mis Pa RsoN also Danufactures au UMBILICAL PAD or support of the greatest value in the treatment of cases of Til.ilical lernia ailso SHOULDER BRACES of the miost modern and alppoved styles. MRS. J. E. PEARSON. 316, Adelaitde St. West, Toronto.",
         "THE CANADA LANCET. · 5 * * * * Sugar-Coated Pills are more soluble than Gelatine or Compressed Pills.-Prof Remington'spaper read before American Pharmaceutical Association, Boston, 1875. WARNER \u0026 00'S PIL\u0026,I. PHOSPHORUS is an important constituent of the animal economy, particularly of the brain and nervous system, and is regarded as a valuable reniedy for the following diseases : LAPSE OF IMEIORV, I IMPOTENCY, SOFTENINGI.OF THE BRAIN, LOSS OF NERVE POWERIPHTIHSIS, PARALYSIS AND NEURALGIA. The Pilularform has been deemed the most desirable for the administration of Phosphorus. It is in a perfect state of subdivision, as it is incorporated with the material while in solution, and is not extinguished by oxidation. This method of preparing Phosphorus has been discovered and brought to PERFECTioN by us, and is thus presented in its elementary state, free from repulsive qualities, which have so long militated against the use of this potent and valuable remedy. This is a matter requiring the notice of the physician, and under all circumst.nces the admin- lStration of Phosphorus should be guarded with the greatest care, and a perfect preparation only used. Its use in the above named complaints is supported by no less authority than Prof. Delpech, Prof. Fisher, of Berlin, Dr. Eames (in the Dublin Journal), Dr. Burgess and Dr. Hammond, of New York. The special treatment Indicated in these cases is-lst. Complete rest of the mind, especially abstention from all occupations resembling that upon which the mind has been overworked. 2nd. The encouragement of any new hobby or study not in itself painful, which the patient might select; Srd. Tranquility to the senses, which expressly give in these cases incor- rect impressions, putting only those objects before them calculated to soothe the mind ; 4th. A very nourishing diet, especially of shell-fish. 6th. The internal administration of Phosphorus in Pilularfwrm, prepared by WILLIAM R. WARNER e CO. W PILLS 8ENT BY MAIL ON RECEIPT OF LIST OF PRICES. -M Phosphori, 1-100 gr, in each Phosphori, 1-60 4 \" Phosphori, 1-25 '* \" Phosphori, Comp. Phosphorus, 1-100 gr. Ext. Nuc. Vomice, i gr. Phosphori, et Nucis Vomic, Phosphorus, 1-50 gr. Ext. Nue, Vomicoe, j gr. PhoEphori, et Ferri, et Nue. Vom. Phosphorus, 1-100 gr. Ferri Carb. (Vallet) 1 gr. Phosphori, et Ferri et Quinie, Phosphorus, i-100 gr. Ferri Carb. (Vallet) 1 gr. Phosphori et Ferri et Nue, Vom. et Quin, Phosphorus, 1-100 gr. Ferri Carb. (Vallet) 1 gr. Ext. Nue. Vom., 1-8 gr. Quinia Sulph., 1 gr. Price per 100. $1 00 1 00 1 00 2 00 2 00 Ext. Nuc. Vom , gr. Quinia Sulph., 2 gr. 2 00 2 90 2 90 Treatise on \" PHOSPEORUS; Its claims as a Theraputic Agent,\" Furnished on application. Address, WILLIAM R. WARNER \u0026 CO., Manufacturing Chemist, No. 1228 Market Street, Philadelphia. Warner \u0026 Co's Standard Preparations for sale by ELLIOT \u0026 CO.,Wholesale Druggists, TORONTo, CANADA. qy:*à C\u0026Im Ê% CU% jr.\"L a Immm'm- %J \u0026Lw)",
         "THE CANADA LANCET. Elixir Ferri et Calcis Phosphatis Co. HORATIO G. KERN, LACTO-PHOSPHATES. MANUFACTURER OF FORMULA OF DR. DUSART, OF PARIS. SURGICAL AND DENTAL Gompound Elixir of Phosphates and Calisaya, INSTRUMENTS, \u0026C., A Chemical Food and Nutritive Tonic. Established 1837. Selegant preparation combines with a sound Sherry HE subscriber would again remind the Medical and Dental Pro- TR1Iseln t prprTo cobnswtf on hry ession that he stili continues to manufacture bis celebrated Wine and Aromatics, in the form of an agreeable cor- Instruments in ail the varios branches. dial, 2 grs. Lacto-Phosphate of Lime 1 gr. Lacto-Phosphate Assiduous attention to the details of the business, which an experi ofIron, 1 gr. of Alkaloids of Calisaqa Bark, Quinine, Quini- ence of thirty-five years has afforded, has enabled hin to make many dine, Chinchonine, and fifteen drops offree Phosphoric Acid to nniprovements in his each half ounce. Unrialled ExtraclinR Forceps, In'cases convalescing from adynamic fevers, in all condi- Us rUial d Exratin oreps, tions of depraved nutrition from indigestion and mal-assimi-. Both as regards their quality and adaption to the purposes for which lation of food, in nervous prostration from mental and physical tise are intendcd, a desideratumns whic will be appreciated by all exertion, dissipation or bad habits, in chlorotic or anSmic established reputation. women, and in the strumous diathesis in adults and children, PRIZE MEDAL AWARDED TO -it is a combination of great reliability and efficacy, and it eay e taken for a protracted period without becoming HORATIO G. KERN epugnant to the patient. When Strychnine is indicated the officinal solution of the INTERNATIONAL EXIIIBITION 1876. Pharmacopoeia may be added, each fluid drachm making the All the Latest Improvements and Novelties. 4th of a grain to a half fluid ounce of the Elixir,-a valuable ombination in dyspepsia with constipation and headaches. Ali orders entrusted tn his carh will be promptly attended This compound is prepared with great care, and will be main- to. ained of standard purity and strength. Prepared by fit Catalogues furnished on application. T. B. WHEELER, MONTREAL, D. C. HORATIO G. KERN, SOL D BYALL DRUGGISTS. Oct. 1873. No. 21 North Sixth St., Philadelphia. Electro-Medical Instruments GEORGE TIEMANN \u0026 CO., and Batteries. F. A. STOHLMANN. ESTABLISHED 1826. ED. PEARCE FLEMMINC \u0026 TALBOT, o. 814 FILBERT STREET, PHILADELPHIA. 67 CHATHAM STREET, NEW YORK. AVING largely increased our manufacturing facilities, we are now prepared to furnish the finest work, with AND IMPoRTERS 0F latest improvements, on reasonable terms. Portable Galvanic, Faradic, and Caustic Batteries, with mplete applying apparatus. and Electrodes and Conduc- s, in ail their varieties, constantly on hand. Contracts made for the erection of permanent batteries in , gt, p a e o ices. A full supply of Electro-Medical Books always in store. communications by mail promptly attended to. Send for catalogue. SURGERY TO LET. No. 1 Mary Street, Cor. King, Hamilton. N THE RESIDENCE OF 'THE LATE DR. O'REILLY; OR has been used as a Surgery for over 32 years. Apply to Dr. C. O'Reilly, Toronto Hospital, or to Mrs. G. O'Rielly, Hamilton. .$3000 A YEAR. A Medical Man wishes to dispose of his property and good will of practice, worth $3000 a year. Tie property consists of a good dwell- g house, outbuildings, \u0026c., and will be sold at a reasonable price. l- Villaioe r surrounded by an excellent farming district. No oppo- sition. F raddress apply to IlLancet Office,\" Toronto. RECEIVEDs 2 Awards at Centennial Exhibition 1876. 2 First Medals and i Honorable MentiOO at International Exhibition, Santiago' Chili. 1875. 2 Silver Medals and i Bronze Medal at International Exhibition, Paris, 1876. Wr Our Catalogue, numbering 462 pages and containing 1575 engravings, handsomely bound in cloth, cn .e obtained for cost of binding, 75 cents ; postage 22 cents. r t N H] he col tor hos",
         "THE CANADA LANCET. 7 HARVARD UNIVERSITY. MEDICAL DEPBRTMENT-BOSTON MASS. .Ninety--Fourth Annual Announcement, 1877--78. FACULTY OF MEDICINE: CHARLES W. ELIOT, LLD., President. CHARLES B. PORTER, M.D., Demonstrator of Anatomy CALVIN ELLIS, M.D., Prof. of Clinical Medicine, Dean. and Instructor in Surgery. JOHN B. S. JACKSON, M.D., Prof. of Pathol. Anatomy. FREDERIC I. KNIGHT, M D., Instructor in Percussion, OLIVER W. HOLMES, M.D., Prof. of Anatomy. Auscultation and Laryngoscopy. HENRY J. BIGELOW, M.D., Professor of Surgery. J. COLLINS WARREN, M.D., Instructor in Surgery. JOHN E. TYLER, M.D., Professor of Mental Diseases. REGINALD H. FITZ, M,D., Assistant ProfeJsor of Patho- FRANCIS MINOT, M.D., Hersey Professor of the Theory logical Anatomy. and Practice of Medicine, WILLIAM L. RICHARDSON, M.D., Instructor in Clinical JOHN P. REYNOLDS, M.D., Instructor in Obstetrics. Obstetrics. HENRY W. WILLIAMS, M.D., Prof. of Ophthalmology. THOMAS DWIGHT, JR., M.D., Instructnr in Histology. DAVID W. CIIEEVER, M.D., Prof. of Clinical Surgery. EDWARD S. WOOD, M D., Assistant Professor of Chemistry. JAMES C. WHITE, M.D., Professor of Derinatology. HENRY H. A. BEACH, M.D., Assistant Demonstrator of ROBERT T. EDES, M.D., Prof. of Materia Medica. Anatomy. IIENRY P. BOWDITCH, M.D-, Assis't. Prof. of Physiology. WILLIAM B. HILLS, M.D., Instructor in Chemistry. Other Instructors: GEORGE H. F. MARKOE, Instructor in Materia Medica. FRANK W. DRAPER, M.D., Lecturer on Hygiene. THE FOLLOWING GENTLEMEN GIVE SPECIAL CLINICAL INSTRUCTION FRANCIS B. GREENOUGH, MD., and EDWARD WIGGLESWORTH, Ja., M.D., in Syphilis. JOHN 0. GREEN, M.D., and CLARENCE J. BLAKE, M.D., in Otology. WILLIAM H. BAKER, M.D., in Diseases of Women. CHARLES P. PUTNAM, M.D., and JOSEPH P. OLIVER, M.D., in Diseases of Children SAMUEL G. WEBBER, M.D., and JAMES J. PUTNHM, MD., in Diseases of the Nervous System. PERSONS who hold no degree in arts or science must hereafter pass an examinationfor admission to this School in Latin in the elements of Physics, and in English. French or German will be accèpted instead of Latin. The admission examination will be beld in June both at Boston and Cincinnati; in Sept. at Boston only. Instruction is given by lectures, recitations, clinical teaching and practical exercises, distributed throughout the academic year. The year begins Sept. 27, 1877, and ends on the last Wednesday in June, 1878; it is divided into two equal terms, either of which is more than equiva- lent to the former \" Winter Session,\" as regards the amount and character of the instruction. The course of instruction bas been greatly enlarged, so as to extend over three years, and has been so arranged as to carry the student progressively and systematically from one subject to another in a just and natural order. In the subjects of anatomy, histology, chemistry, and pathological anatomy, laboratory work is largely substituted for, or added to, the usual methods of instruction. Instead of the customary hasty oral examination for the degree of Doctor of Medicine, held at the end of the three years' period of study; a series of examinations on all the main subjects of medical instruction has been distributed through the whole three years; and every candidate for the degree must pass a satisfactory examination in every one of the princi- pal departments of medical instruction during his period of study. DIVISION OF STUDIES. For the First Year-Anatomy, Physiology and General Chemistry. For the Second Year-Medical Chemistry, Materia Medica, Pathological Anatomy, Clinical Medicine, Surgery and Clinical Surgery. For the Third Year-Therapeutics, Obstetrics, Theory and Practice of Medicine, Clinical Medicine, Surgery and Clinical Surgery. Students are divided into three classes, according to their time of study and proficiency. Students who began their professional studies elsewhere, may be admitted to advanced standing; but all persons wbo apply for admission to the second or third year's class, muet pass an examination in the branches already pursued by the class to which they seek admission. Examinations are held in the following order:- At the end of the first year-Anatomy, Physiology and General Chemistry. a \"i second year-Medical Chemistry, Materia Medica, and Pathological Anatomy. d i third year-Therapeutics, Obstetries, Theory and Practice of Medicine, Clinical Medicine, and Surgery. Examinations are also held before the opening of the School, beginning September 24th. REQUIREMENTS FoR A DEREE.-Every candidate must be twenty-one years of age; must have studied medicine three full years, have spent at least one continuous year at this School, have passed the required examinations, and have pre- *ented a thesis. CoURSE oa GRADUATEs.-For the purpose of affording to those already Graduates of Medicine, additional facilities for ursuing clinical, laboratory and other studios, in such subjects as may specially interest them, the Faculty has estalished a course which comprises the following branches :-PhysiologY, Medical Chemistry, Pathological Anatomy, Surgery, Auscultation, Percussion and Laryngoscopy, Opbthalmology, Otology, Hygiene, Dermatology, Syphilis, Pyscho- logicai Medicine, Electro-therapeuties, GynSecology and Obstetrics. Single branches may be pursued, and on payment of the full fe, also the privilege of attending any of the other exercises of the Medical School, t he use of its laboratories and library, and all other rights accorded by the University will be granted. Graduates of other Medical Schools who may desire to obtain the degree of M.D. at this University, will be admitted to examination for this degree after a year's study in the Graduates' Course. Examination on entrance not required. FEEs.-For Matriculation, $5; for the Year, $200; for one Term alone, $120; for Graduation, $30; for Graduates, Course, the fee for one year is $200, for one Term, $120; and for single courses such fees as are specified in the Catalogue. Payments in advance. Members of any one department of Harvard University have a right to *attend lectures and recitations in any other department without paying additional fees. For further information, or Catalogue, address DR. R. H. FITZ, Secretary, 108 Boylston Street, Boston, Mass.",
         "THE CANADA LANCET. SAVORY \u0026 MOORE, 143, New Bond Street, London, beg to cali the attention of the Profession generally, to some of the later preparations brought out in England, the purity, and uniform strength of which can be guaranteed, GENUTN E PANCREATIO EMULSION and PANOREATINE. ne reputation of these preparations is now so thoroughly established, that they may be said to be the only remedies of the description recognized and prescribed by the leading members of the Medical Profession. No small portion of their popularity is to be ascribed to the fact, that t oey are palatable to the most fastidious, keep good in al climates, and are readily miscible in water, milk, \u0026c. l ale cases where Cod Liver Oil fails to afford relief, or cannot be retained by the stomach, Pancreatia Emulsion and Pancreatine are the only remedies to supply its place, increasing weight, and ensuring atrength an4 appetite ; whilst in many cases they prove a mot valuable adjunt to the Oih, which they assist in digesting. PANCREATINE W INE. A most pleasant vehicle for administering Cod Liver Oil, with which if shaken, it readily forma an Emulsion. This preparation when presribed by itelf will be found to be a powerful assistant to digestion, and as a remedy for this purpose is largely PANCREATISED COD LIVER OIL: A reliable combination of Pancreatine with th, PEPTODYN, the New Digestive Digests al kinds of Food-the FARiNA OUS, FiBioUs, 9and OLPIÂGiNoIJs, (being a combination of the several active principles of the digestive secretions, Peptic, Pancreatic, \u0026c.) Five grains of the Powder digests--100 grains of Coagulated Albumen, 100 grains of Fat, 100 grains of Starch. BEST FOOD FOR INFANTS, As Supplied to the Royal Familes of England and Russia. eFeding Infants on the best, i. e. the most ssouri8hing and egu5 digested Food, bas recently occupied much of the attention of the Profession, and the fallacy and danger f employing Btarch, in the form of Corn Flour and other high-sounding titles, has been repeatedly poined oct. This Food resembles Mother's Milk more closely than any other kind, containing the ighest amount of nourishment in the most digestible and convenient form. DAiTiURA TATULA, for Asthma and Chronie Bronchitis. Reommended by the Profession as a remedy of great power and usefulness in cases of short and difficult breathing, spasmodjo ooughing, \u0026c. Orown only by Savory and Moore, and prepared in ail forms for smoking and inhalation. Wholesale of Messrs LYMAN, CLARE \u0026 Co., and Retail of the Principal Druggists in the Dominion and America. WHITTIER, SON \u0026 WHOLESALE 00., Mannfacturing Chemisîs and Drugg|ists, 102 Front St., West, Toronto. John Reynders \u0026 Co., (Late of Otto \u0026 Reynders,) No. 309 Fourth Avenue, New York, TO THE MEDICAL PROFESSION. (UNDER THE COLLEGE OF PHYSICIANS AND SURGEONS, stre have inaugnratedi extensive premises running through from Manufacturera and Importera street to street the manufacture )f SUGAR-COATED PILLS AD GRANULES. SURGIÇÂL 137 kinds of labels now n use. Sufficient to say the usual formulas Used ln practice and such as have been made by the difierent makers Fn the United States and will make 3000 pills of any desired formula. AND FLUID nXTRAghc . Tinctures, Syrups, active principles, nearly every thing whic might be asked for; we have in use over 150 labels and will make four pounds of any extract ordered. We have reliable agents in the great European centres and New York, Cincinnati, and otomiü i t= zt St. Louis, te select for us the best roote, harki, herbe, \u0026c., a new we get lu Canada, which iiumber we wîll lucrease. SOLID EXTRACTS. Some twenty o the more commonly used SKELETONS sorts we make, the reet we import from England. t Star dard Pharmaceutical Preparations.AN Eli8i Cinchona Calisaya, (Yellow Peruvian Bark), lizir Cal- isaya, Ferrated, àixir Calisaya, Iron and Bismuth, MIir Cal- isaya, Iron and Strychnla, MilBrom of ]Poteulun=. E1rkrlA T M Pyrophosp of Iron. EhUifr Ta=sacum COMP. SYruP 0f NRY- on \"\"ANATOMICAL PO]phoshltes3, Lime, Soda aud Potassa, Syru]p LaeCI-?k«. of fron, ny pLacto-]Phosphate of Lime with Pepelu. tyre « ftos- R PA A IO Ir0ePoun (an s Fowler's Chem. Food). ua r f PREPARATIONS. We have every facility, bestfresh material, skilled labor, and invite the profession t caîl when visitiu g the city, and asure themelves. Te Manufacture and Importation of every To introduce our manufactures we will be glad te receive your orders for ay of our manufactures which embrace over 400 articles. Send article used by Physicians and Surgeons our Specialties. for price Liste or trial orders, our preparations have the mcedi- Seilis cal properties, ueýja1 doses, priuted on each article and cao ha depended onuto u e nen t n oeind all ansea do ustated Catalogue and Price IÅst We ask Canadians tP support home manufactures, as by frserentiart -duties we cannot ship auythiug to our neighbo-m.-Cfl and see us mailed on application, enclosing twelve cents for Postage. of y,",
         "111E CANADA LANCET. 22~ IE CANADA LANCET. A MONTHLY JOURNAL OF kI)ICAL AND SURGICAL SCIENCE. TORONTO, APRIL IST, 1877. No. 8. 0F GUN-SHOT INJURY OF THE BRAIN-RECOVERY. JOSEPH A. FIFE, M.D., HASTINGS, ONT. f oOwing interesting case is, I think, worthy ei 1g placed on record. see the 14th December, 1876, I was called to Sanes Anderson, aged fourteen years, (son of aId Anderson of this village,) who was injured e explosion of a gun. He had gone out on ho enthe river to shoot ducks, having an old it g which he had very much overloaded both b Owder and shot. When he fired, the gun tel burst leaving the breach-pin fast to the About eight inches of the breach-end of be -barrel was blown away so that it could not fee fd. The rest of the gun-barrel, over two ite e g, was projected backward, and the end of b ered his forehead just above the left eye- The broken end of the barrel passed inc- . his skull, and penetrated about three soirnt! to the brain. The boy instant'y fell, and se perons who were looking at himwent to so at had happeied, and found the-gun-barrel a yfastened in his head thaï it stood up like e planted in.the ground. In a few minutes the rke, of this village,-arrived and extracted to, 111 barrel, which he said required firm traction rea arrived on ihe spot immediately after its brain . fron the wound. A large quantity of and bisubstance that was broken up bulged o ut hi Ood flowed freely. The boy was carried to, brokters house. The quantity of brain that was ad oth ep and removed, was estimated by myself we rebers present to be at least half a tea-cupful. t ea ved several fragments of bone that were soft ctaoy detached, made a pad of a piece of nd ir011 Cloth, laid it over the bulging brain, aMled a bandage around the head. His 1 pulse was very weak, and appeared as if it would soon cease. There was quivering of the body, and the legs moved convulsively. The explosion occured at half-past five o'clock, p.m. I remained beside him all night. During the night his pulse became stronger and fuller, and in the morning had increased to roo per minute. I then removed most of his hair, and applied snow in a bladder, and cold cloths to his head; this had the effect of lowering the pulse to about 85. We continued to make cold applications to his head, being careful to avoid chills. We used no other dressing to the wound than a cloth wet in Water. At subsequent dressings four fragments of bone were removed. His room was kept at a tempera- ture of between 6o and 65 degrec s. During his recovery he was kept on light nutritious diet, and occasionally, when required, a saline purgative was administered. For several days at first, when fast asleep or when arousing from sleep, the patient talked in- coherently, but this passed of as soon as he was spoken to. I might here state that the patient was, previous to the accident, a strong, healthy, active boy. Jan. 8th, 1877.-He was able to get up, dress himself, and walk about the house. At this time the integument was rapidly forming over the wound, and further attendance was discontinued, Jan. 31st.-I was again requested to see hin, and found him in bed, suffering from severe head- ache. The skin had formed quite over the wound, which was now full, or bulging, instead of de- pressed, as it had been when there was an opening for the matter to discharge. I made an incision through the integument, and then passed a probe one and a quarter inches into the brain substance in the sane direction as the gun-barrel had entered. At the depth indicated a small abscess was found, and more than a teaspoonful of pus escaped. Thii afforded immediate relief to the pain in hii head. Matter continued to escape for several days, and he steadily improved. He is now going about the village in good health, and as far as I cai see, without any injury to his mental powers. The skin has again formed over the opening, and thé margin of the bones are forming thick and smooth edges as if they would close, at least partially, over the opening. At the time of the explosion there was consider- THE CANADA LANCET. 225",
         "326 TEE OANADÂ LÂNCET. able powder lodged in the patient's face. On the fourth day after the accident the particles of pow- der produced suppuration; most of the skin peeled off, and with it much of the powder came away, but there is still considerable left, which will mark his face. It is now twelve weeks since the acci- dent occurred, and he is apparently well except that the bone has not yet formed over the opening. VESICO-VAGINAL FISTULA WITH TROVERSION OF THE UTERUS. RE- BY P. o'KEIF, M.r., OCONTO, WIS. Mrs. L. at 38, called at my office about July ist, 1876, on account of an incessant dribbling of urine, which she said commenced after her last confinement, July 1874. She was in labour thirty. six hours, arm presenting. The physician in attendance delivered her, using a corset lace as a.tractor. In about two weeks after her confinement the urine began to trickle away constantly. Her physician treated her for paralysis of the bladder and continued to do so for more than a year, of course without the slighest benefit; he then advised her to give up treatment as there was no hope of cure. She consulted some others however, but they all deemed to agree with her former attendant. On making a digital examination I found the os uteri directed forwards, showing retroversion of the uterus ; passing the finger over the cervix it passed through an opening into the bladder high up in the anterior cul de sac. On introducing a speculum and replacing the uterus, a vesico- vaginal fistula, half an inch in diameter, circular in form, part of its circumference being formed þy the anterior surface of the cervix, was exposed. I explained to the patient her condition and proposed an operation. I heard no more from ber until October when her husband called to tell me ahe was prepared to have me operate. On the xîth October, ether being administered, the patient was laid upon the operating table in Sim's position, and my modification of Sim's speculum introduced. I began to operate by paring freely th edges of the fistula, with a long-handled tenotome. After hemorrhage had entirely ceased, five double threads of fine silk were introduced by means of short fully curved needles held '0 Sim's needle forceps. A piece of fine silver WO being hooked into each of these, the thread 10 drawn through leaving the wire in its stead. b edges of the wound were now brought in apPO' tion, the wires twisted, cut off half an inch fro1 the wound and bent down so as not to wound the opposite vaginal wall. The operation being 0o completed, the bladder was syringed with Wa water, and a sigmoid catheter being introduce\u0026 the patient was put in bed, where she renaiw for eight days, when I allowed her to refflOve the catheter and sit up or walk about the ho'O cautioning her not to allow the bladder to becor1c distended. On the twelfth day after the oPe tion the sutures were removed and union fo1 complete. I was kindly assisted in the operati by Drs. Coleman and Paramore of this City. In a few weeks after the operation I redt\u003e the retroversion of the uterus and applied Albe Smith's pessary which keeps it in its propd position. The following is the modification of Sim's SPee lum above referred to. It consists of three bla5d One of these, similar to a Sim's, is fixed tO handle. Across the convex surface of the base this, at its junction with the handle, a piece metal is bent so as to form nearly a semi4\"'1 Its extremities are about two and a half inches a and from one of these to the other, it is grOOw to contain the bases of the other two blades, ;W. are fixed to slide in the groove, but can onlY$ out at the ends, When the speculum is which it is for introduction, these plates n'g on the back of the first plate, so that the sp in this condition is only the width of the blade, but by means of a thumb-rest attsC to each blade it can be slid outward in the gr above described so as to form a speculum Of width from i ;\u003c to s inches at the base a corresponding width at the apex. The b are held in whatever position they are P by thumb-screws, and the instrument is Wi before traction is made on the handle. London is threatened with a severe SDo epidemic. To encourage re-vaccinatiol her subjects, the Queen has caused all ie of her household to be re-vaccinated, and the to be published by the press. 926 THE CANADA LANCET.",
         "THE CANADA LANCET. 227 1OUBLE UNDERGRADUATESHIP AND DOUBLE GRADUATION. (To the Editor of the CANiDA LuxcuT ) tI As so much has been said by par- al evidently ill-informed in regard to the dis- lwane of Double Graduateship and Double gr'aduateshipÉ in British Universities will you ettY Publish the following short extracts from n ers frorn a large number of these seats of learn- ne question put to each University addressed e same, viz : whether a student might not Sthceed at the same time to his degree in it and lb the j Plyi e University of London-he of course com- q dwith the curriculum and passing all the re- examinations in the respective Universities. hee reply from the University of Edinburgh to S thiect that \"no University, or examining body Cndid Country (Great Britain) would object to any ate for its degrées, taking also degrees or techý es from other \" examining, or examining and th, ng bodies,\" has been already published in Y Papers. S lversity of Cambridge, England, February, $ 187 7 Y to nothing to prevent a student who is Dr .àg to a degree in this University from It also,\u003earipassu, to a degree in London. equently donc....... (Signed), J. D. LIvxING. S.'ersity of Oxford, February, xi, 1877. % tp au far as I know, no reason against the ngrAdating in Oxford and at the same time \u003e ktuing and graduating in London do\" (University) he has to go through a teft t use, which he can 'do certainly, consis- *ith the Oxford course. . . . (Signed), H. M. ACILAND.» \u0026 niversity of Glasgow, Feb. I3th, 1877. es Sthi Uqualifying himself for the 1Xedical i of this University, may at the same time hsits. r the degrees of the London Uni- T. MoiR, Reg'r.\" \" University of Aberdeen, Feb. 14, 1877. A candidate could therefore pass his matricu- lation examination at the University of London, and thereafter study here, and take our degree, and the degree of the University at London besides. (Signed), JAs. S. BRAZIER. \"University of St. Andrews, Feb. 13, 1876. We require our graduates to reside two years at a University,-as, however, the University of Lon- don does not require a residence, I think it would be possible to take the M. D. of London and St. Andrews at the same time. . . . (Signed), J. B. PETTIGREW.\" \"Queen's University, Dublin Castle, 14th Feb., 1877. I do not think a student could find any diffi- culty in arranging his curriculum so as to fulfil the requirements of both Universities, and thus qualify himself to take a degree in both universities. . (Signed), JOHNSTONE STONEY.\" Comment is unnecessary. Our national Uni- versity cannot, if it would, pursue a narrower or more exclusive course than the University of Lon- don, on which it is modelled. Yours, \u0026c. Toronto, March I5th, 1877. M. D. SURGEONS IN THE ALLAN LINE. To the Editor of the CANLDÀ LUC. SIR,-I have just rectived this Month's number of the CANADA LANcET. I see it is quite an im- provement on former ones; and contrasts very creditably with the miserably \"got upn \"LOOW Lanedt. Some of our physicians, to-day, were coar. plimenting the CANADA LcAC*T én ita Very rpec- table appearance. I see you have an article on the \" Surgeons in the Allan Line.\"; I held an appointment in the Line during the last twelve months ; but wheu I came home last time and learned how matters were shaping, I was so disgusted that I determined on resigning, if I could get something that would al- low me time to read for M. R C. S. Fortunately my ship laid up for repairs, so I came down to Lon- don a perfect stranger, and in a week, through an advertisement in the Lancet, I secured the House- (Signed), 6baa..-",
         "228 THE CANADA LANCET. Surgeonship in the North Kensington Providen Dispensary. I saw a communication from th( \"Board of Trade\" to the effect \"that if a ship took a sufficient number of passengers to put hei under the 'Passenger Act,' or more properly the 'Merchants' Shipping Act,' that Canadian surgeon of recognized colleges would be allowed to take niedical charge.\" But where the difficulty arose was when there were only a few passengers the ship was not put under the \" Act \" previous to sail ing, then, in that case, the Candian surgeon was disqualified from taking charge ; the \" Board ol Trade\" considering him capable, it appears, ol taking charge of four or five hundred, but not ol thirty or forty. When I came home last time, I found this to be the state of things, as stated and undstood by the authorities in Liverpool. The Allan Co'y were then waiting for a reply from the \" Board of Trade \" as to the truth of the difficulty I have just mentioned, viz., \" whether Canadian surgeons from recognized colleges could legally take medical charge of a ' short ship,' that is one carrying an insufficient num ber of passengers to put her under the 'MerchantShipping Act.\"' The reply had not been received when I left, but it appears by your Journal to have been an unfavorable one for Canadians. You must understand, that in a \"short ship\" the company do not go to the ex- pense of putting her under the \" Act,\" because it it is not necessary, although they may do so if they like. This often occurs in winter, with few passen- gers, so it was intimated to me when I came home last time, that if I wanted to go again, I should have to pay £3. o. o., to put the ship under the I Act,\" as she was going out as a \" short ship.\" I was informed that the .surgeon who sailed the pre. vious week had done this. This, you will agree with me, was monstrous for the Canadian-for he could ill afford it out of his £ o. o. a month. I is quite time Dr. Hodder's motion was pushed by the Canadian Government.. Yours truly, T. GRANVILLE HoCKRIDGE London, Eng., Feb. 21st, 1876. Dr. H. A. Martin (Boston MedicalJournal, Feb. 1, '77,) says that, duririg the sixteen years in which he supplied humanized vaccine virus, he was con- tinually troubled by the complication of erysipelas. Sinct he has supplied only the bovine virus pe as had no complaint of erysipelas. . h as t $tltc¢gtt i{g REVACCINATION. r Is it necessary to revaccinate every seven years? s Is there such a thing as \" experimental testing\" O susceptibility or non-susceptibility of the systen tO small-pox by revaccination ? Does the failure Of revaccination signify that the person in whom the operation has failed is insusceptible to small-poX? Such is a sample of questions which have of late been sent to us from various sources- questiofil which, judging from the columns of several of 0u1 f contemporaries of the daily press, would appear tO f exercise at the present moment certain of the gel' eral public as well as of the profession. It is 90o quite easy to understand how any doubt should exist on the several matters to which these que'' tions refer, seeing the abundant and ready source of authoritative information (notably Dr. SeatOf'5 \" Handbook of Vaccination \") accessible with re gard to them. The fact remains, however, and we proceed to answer the questions categoricall- First, there is no evidence to show that reVac' cination, once efficiently performed at or after P\"' berty, need ever be repeated. On the other hani the frequent repetition of revaccination which ho! become common during 4larms of small-po], 0 distinctly to be deprecated. Such repetitions e, as a rule futile ; they are wasteful of vaccine lyrO when lymph is most precious; they tend to unsetle the niinds of people regarding some of the best- established facts as to the preservative power O vaccination ; and (which ought to be all-sufficieo\" for the profession) they are unnecessary. Tb official memorandum of the Local. governieht Board on revaccination says : \" Revaccination oltW properly and successfully performed does 4t of pear ever to reguire retettion.\" The nurses ao\" other servants of the London Small-pox HosP when they enter the service (unless it be cer that they have already had small-pox), are iflve bly submitted to vaccination, which in their e generally. is.revaccination, and is never afterwad repeated ; and so perfect is the protectiOn t though the nurse live i.n the closest and most CO0 stant attendance on small-pox patients, and thOu also the-other·servants are in vaious waysexPOS to special chances of infection, the resident-surg of the hospital, during his forty-one years of 0 there, has never known small-pox affect Ore * these nurses or servants Some thoughtful Pa\u003c tioners are of opinion that the occurrence of sef. general diseases after revaccination, such as ete fever, may weaken the protective influence 0' vaccination, and that where this has happened, '0 génerally where, long after revaccination, a Pe is brought into immediate contact with small a second revaccination is desirable. This iS, ever, a very different thing from the promniscolo",
         "reaccination which has come into fashion in pe- lods of epidemic small-pox; and, although proba. bly an unnecessary precaution, it need not be dis- couraged- .Next, as to the success or non-success of revac- C'nation as a means of determining the suscepti- iit of an individual to small-pox, the notion is W y fallacious. Revaccination succeeds equally Well Upon the well-vaccinated as upon the ill-vac- ci.ated, and vaccination is as successful after trnaipox as revaccination after primary vaccina- rol' uThe local effects of revaccination may be .duced again and again in the same individual. obtiSeaton says on this subject, \" The local results 2tned by the revaccination of any individualgive sti'rolutely no information whatever as to the con- tuasonal condition in w/ioh the revaccinatedperson tWit regard to liability to contract small-Aox. as frequently been argued, and is indeed often t be heard said now, that if a revaccination can- t be made to take, or if it take only in a modified Way, it is evidence that the constitution would not at the time take small-pox; whereas, if a complete local result follows, it may be assumed that the -Protection of the primary vaccination had worn eu , and that the person was in danger, or at all takins in more danger than in the former case, of ths variolous infection.\" The erroneousness of evacW is proved by certain facts derived from areinations in the Wurtemburg and or own rect nd which show if the view had been cor- had, at 319 out of every thousand persons who had bdsmall-pox, 310 out of every thousand who thI een well-vaccinated, but only 281 out of every sentand who had been ill-vaccinated, were in pre- detrilianger of small-pox; and of the soldiers (not reprits) in our own army, 541, 485, and 237 would hich ent the ratios iii the three classes respectively, 'Ch is clearly a reductio ad absurdum. Our ingledge that revacination exhausts the exceed- or gy lmited liabihity to small-pox that may exist, Sbroay recur after primary vaccination, rests upon 0a. basis of observation. but we are unable in liabilven case to judge of the existence of this oprty from the effects or non-effects of the on----The Lancet. BCXJTANEOUS SECTION OF THE NECK OF THE THIGH-BONE. Mr. * rdrtco c . Brodhurst contributed a paper (Clin. Zondn), in which two cases were fully re- e andseven others, also operated upon by were referred to. In each of the two a~d the right thigh was flexed upon the pelvis, he1Cc aknee was crossed over the opposite thigh tere aitmanner as to close the vagina and to in- re with the evacuation of the bladder. AS a 6bib..- consequence of this position excoriation of the - thighs, with considerable discomfort, constantly occurred ; whilst the shortening of the limb in one instance to the extent of seven inches, and in the other to the extent of four inches, rendered it necessary that artificial support, such as sticks or a crutch, should be used in walking. In the first case the patient's age was eighteen when she first came under Mr. Brodhurst's care in 1864. As the resuit of an accident at eight years of age, hip- joint disease had been established, followed by suppuration, and eventually by bony ankylosis, with the the thigh flexed and adducted. Mr. Brod- hurst divided the neck of the femur subcuta- neously. The external wound was an inch and a-quarter in length, and the knife was then passed down to and over the neck of the femur ; it was then withdrawn, a small strong saw was introduced, and the bone divided immediately above the tro- chanter. The saw was then reapplied,and a small portion of the bone removed. The wound healed by first intention. The limb was placed semiflexed on an interrupted splint. In six weeks the patient walked with help, and bore some weight on the foot. Fair motion of the limb in all directions resulted, and still remained, twelve years after the operation. In the second case the girl was aged 16, and had bony ankylosis at the hip-joint, with great flexion and inversion of the thigh. Inflam- mation had commenced nine years previously, and was followed by abscess. Mr. Brodhurst, in this case, made the external wound only just large enough to admit the small saw with which the neck of the femur was divided. The bone was exceed- ingly solidified and thickened, felt like ivory, and twenty minutes were occupied in completing the section. There was some hæmorrhage. After section the limb could be fully extended, but ex- tension was painful, and consequently, for several days the thigh was kept slightly flexed. Suppura- tion took place, and an abscess formed at the junc- tion of the upper with the middle third of the thigh. The splint was removed, and extension was then made by means of weights. In about three months the patient could walk and bear her weight on the limb. Mr. Brodhurst had done eight similar operations, some with the smallest possible opening, others with an opening about an inch in length, and he \"had always found that where the opening was small, and there was, in consequence, stretching and bruising of the adja- cent soft structures, suppuration followed ; but that where more room was allowed for the necessary movements in dividing the bone, healing took place very rapidly.\" A large opening was there- fore desirable to prevent injury to the soft struc- tures, but it need not be placed so as to corres- pond, when the operation was complete, with the section of the bone. \" The subcutaneous charac- ter of the operation did not depend so much on THE CANADA LANCET. 229",
         "230 THE CANADA LANCET. the size as on the position of the wound.\" In any moverent of the imb. The operation some cases which had been recorded, afTer opera- an antiseptic one; the opening in the skin was R tion, the deformity had remained. The wound small as possible, and the wound was dressed anti- should then have been enlarged, and either a septically. A good deal of suppuration at firt wedge-shaped or circular piece of bone removed, occurred at the site of the operation, but a fre or the operation of Mr. Gant, of division below drainage was established, and the patient then Co1- the trochanter, should have been chosen. Where tinued to improve. Now there was firm boul the bone was -ery hard, it should be divided with union at the hne of section. The case was intefr the saw; the chisel of Volkmann, as used by Mr. esting from the nature of the operation. It WO Maunder, should be reserved for cases where the unique in being an operation done with the saf bone was tolerably soft. ahere the ankylosis was below the trochanters in an adult. Probably, g fibrous the bone was soft and divisible with the the wound had been closed hermetically directly chisel; but it was undesirable to resort to a cutting after the operation, there would have been no Sup- operation when deformity might be removed with puration. The saw and knife which were used the use of the knife were both dipped in carbolic solution before the operation. ANKYLOSIS OF HIP-JOINT: SUBCUTANEOUS SECTION Mr. Barwell regarded the employment of anti 0F SHAFT OF FEMUR. septics as of great importance, and cited two cases in neither of which did suppuration or pain eXist. Mr. Croft exhibited a patient whose case, he With respect, however, to the choice of insUw said, bore upon the question of the respective ments, he thought that the dust left from the use merits of dviding the fenur above or below the of the saw was liable to irritate the wound and Set trochanter. The man was a clerk, aged 22. In up suppuration. As the operation was one of June, 1875, he felt pain at the hip. Until then, he convenience merely the percentage of deaths Ws had fet quite well, except that three months pre- too high to warrant its adoption. But with the viously he had contracted gonorrhee. The dis- use of the chisel and the antiseptic method the charge ceased soon after the pain at the hip began, ri9k was reduced to a minimum, and with antise' and neer reappeared. Two months before the tics the subcutaneous method was not so imper- pain cofemenced, he feil from a height of about tive. Mr. Barwell then referred to the variOOO five feet on to bis hip. There was swelling about modes of operation that had been adopted, a16 the hip and thighg at the end of June: and in the said, that whatever might be the ultimate result of groin at the end of July. In August, there was a any operation its value must depend upon the great pain on moving the hip, and no starting pain presence or absence of suppuration. at night; the end of that month there was a large Mr. Gant thought the views taken by membed abscess. In October, the abscess was punctured, were too mechanical, the most important point and a large quantity of greenish pus was let out. being the conditions that were most favourable to The discharge lasted until February, 1876; it then the operation. Adam's operation was not adapted ceased and a sound scar formed. In March he to two conditions of the disease-viz., where there walked about with the help of a chair. On May was scrofulous disease of the joint, in which C3e 29th, he was admitted into St. Thonas's aospital ; the neck of the thigh-bone was gone, or was no he had neer had rigors nor cough. Onadmission sufficiently vascular to unite ; and, in the secOfl6 he was thin and prespired easily; his appetite and place, where the neck was much enlarged by de secretions were natural. The thigh was rotated posit due to chronic rheumatic affection. These outwards, to that the neck of the thigh-bone facts induced him in 1871 to recommend divisioo touched the rim of the acetabulum. On June of the neck just below the trochanter, and tWO 23rd, the ank e formed by the thigh and the mid- cases were referred to in which this measure * die ,ne of the trunk was 14 degrees. On July followed by success. As to the operation, neither 3rd, the patient was examined under chloroform Barton's nor Sayre's could be called subcutaneoge by Mr. Croft and Mr. MacCornac. No motion The saw could not be set aside for the chise could be produced, and it was concluded there His operations had been recently successfully Pe was bony ankylo8is. On July 2th, the shaft of formed by Prof. Pancoast, and Mr. Maude the femur was divided below the trochanter by Mr. agreed with Mr. Gant in not regarding Mr. BrOad Croft, in the presence, amongst others, of Messrs. hurst's case a subcutaneous one. He thought the Adams and Gant. This operation was chosen rivalry between the chisel and saw a wholesl0 because, had section of the neck of the femur been one. In his opinion, the saw was preferable for adopted, the incision must have been made section of the neck of the thigh-bone when it W through old scar-tissue, whilst there were also ad- desirable to establish a false joint by simple lin hesions in front of the bone which would have section of the boue, and on account of the PO formd obstacles to the use of the saw at that bioity of suppuration, he thought this Wo spot. Further, Mr. Croft did not wish to obtain ultimately be the only case in which the sawWOe",
         "THE CANA be 1sd r.Cots orsed. Mr. Croft's case did not appear a fav- 0'able one for the use of the saw ; and in onl 91le onl ofy s~tru f his own eight cases did he use that a notent, and the patient, though done in June, Wa uot well yet. In nine cases where the chisel Msed suppuration had only occurred in two. first . Furneaux Jordan stated that he was the of t perform subcutaneous division of the neck Ot fenur by Adam's method. This was in a With 'Woman with strumous disease of old date, linb. eat flexion and adduction of the affected of A punctured wound was made and the neck opetie bone was divided with a strong saw. The o ant 'was not strictly subcutaneous, and less atheptic precautions were used, but, neverthe- .the case did well. )sr coryant also thought that Mr. Brodhurst's a %eo cold not be called subcutaneous. He had f1\u003e0d Opinion of the subcutaneous operation, and ay Cses in which he had performed it with a a al successful. No antiseptics were used, a c e alvular incision was made, the operation tiPied only two or three minutes, no suppura- Sacncurred, and the recovery was rapid. Mr. er toten said, that when the neck exist, Adam's trtiQl was better than division below the to, anter, but if it were present, Gant's or Bar- that t With regard to the instrument, he thought e the oice of chisel and saw seemed to depend r the fancy or whim of the operator. could breodhurst said that none of the operations tter strictly subcutaneous, and that tt did not quaer whether the incision was one or one and a th iches in length. He had also operated e ha Sall wound, merely a puncture three times. aperated on nine cases in all, in three with le incision, n the others with one of about e ent. A full incision gave greater freedom of rto elut and prevented any suppuration arising n rusing of the parts. ouldb alender suggested that the operation a es e called \" valvular,\" as \" subcutaneous\" d Wcei.y an incorrect definition.-Med. Press CTION 0F AMMONIA INTO VEINS IN COLLAPSE. THE recent occasion, I injected ammonia in a been elapse from scarlet fever. The patient e Unconscious and at the time of sts'; there was no perceptible pulse at the ,ti the respirations were about six to the min- as t arms up to the elbows were livid and re also the nose, lips, and ears. After ijec Of the liquor ammonie fortior had ousiaied into the median cephalic vein (pre- ' id bare and separate from surrounding DA LANCET. tissues), the patient gave a cry and threw up his arms ; the pulse returned to the wrists ; the natural hue and temperature to the nose, lips, etc.; and consciousness returned, so that he could hear, understand, and give int'lligent replies to my questions. Three hours afterwards he was again in a state of collapse ; and this time I injected eight minims into the median vein, with the same result as before. In an hour and a half, he was again in a state of collapse, and died before I could find a vain to inject. In this case, the un- diluted liquid ammoniæ was injected, although Dr. Halford recommends now to dilute with equal or two parts of water. The effect after each injection was almost instantaneous-certainly under one minute after each. Although life was not saved, it was prolonged for six hours ; for I am satisfied that the patient would have been dead within five minutes of the time I first injected. The case is instructive fron a medico-legal point of view, for there was perfect return of conscious- ness after the somewhat prolonged period of per- fect unconsciousness ; and this might be an im- portant thing in the case of signing wills, identifying murderers, or giving last instructions to relatives summoned from a distance, etc. There was no appearance of sloughing, although the undiluted liquor ammoniæc fortior (B. P.) was used ; and I am convinced that the danger of sloughing need never be an impediment to its use in ordinarily skilful hands ; and if, after baring the vein, a few drops of oil be poured over the wound before inserting the nozzle of the syringe, that danger is reduced to a minimum. My case was a lad aged 15, weighing over i n stone and measuring 6 feet i inch. He died on the 7th day of the fever. The eruption had been well marked ; but on the fifth day it began to assume a livid hue, and severe jactitation set in. There was no suppression of urine at any time, and the throat was unaffected. The highest tem- perature recorded in the case was 103.4 deg. Fabr. R. D. PINNOCK, M.B., Melbourne, Victoria.- Brit. Med. Journal. MODERATE DRINKING. Sir Henry Thompson presided at a public meeting of the National Temperance League on the 7th of February, and gave his opinion against moderate drinking. \"Our controversy;\" he is reported to have said, \"is with the great mass of people who believed that alcoholic or fer- mented liquors were good and necessary articles of diet for men, women, and children ; \" and again, \"lhe doubted whether, in many cases, or perhaps in any case, alcohol was valuable in the dietary of healthy people.\" Men of a convivial turn will attrò 231",
         "232 THE CANADA LANCET. bute such cord views of the use of alcohol and less objectionable forms of food. That such driOk fermented liquors to dyspepsia or some other ing produces drunkenness has yet to be proyV physical inability to enjoy them. But they are the as it bas yet to be proved to be essential to views of a man of large special experience, and 1health.-yze Lancet. should have great consideratio . Sir Henry ad ith that for purposes of very exceptional work, mus- cnlar or nervous, a man might use alcohol, and, further, that the effect of it on persons is so differ- FRACTURE OF CERVICAL SPINe ent that no dogeatic rule can be laid down for STRICTURED URETHRA; PUNCT everybody. There is a moderatio in this language OF BLADDER ; POST-MORTEM hich befits a medical speaker, and which, in our PEARANCES. opinion greatly adds to its strength. Sir Henry's views on the use of these articles in what he con- (Under the care of Mr. Christopher Heath.) sidered moderate quantities in diet have long been For the following notes we are indebted tO 1 before our readers, and constitute a rnost valuable Gouid, surgical registrar. rt contribution to the study of lithiasis, one of those G. P aged thirty-si, a very intepe errors of assimilaiion which we believe to be at the man, --, tge tepsa run ne t rootof grat ealof isese n mddl ent te mn, fell down twelve steps while drunk on SePt root of a great deal of disease in middle and ad- 2nd, 1876. He was at once rendered unable t vanced lIfe. Dr. Richardson refuted the notion imove his arms or to walk, and was carried to be that alcohol gave warmth and strength. By accele- After about half an hour he \"fainted,\" and ' rating the action of the heart, it gives rise to ex- mained unconscious for about fifteen minutes. cessive muscular action and easte of tissue. then continued restless and sleepless until the date There is a difficulty in defining \"lmoderate\"I of his adm ission, Sept. 3rd. drinking, as Sir Henry Thompson said. And it is On admission he was quite conscious. 3de almost equally difficult to be moderatein speaking found to bave complete motor paralysis of the about this subject, though we are convinced that leg and of the extensor muscles of both atis snedicai men wiil do good in proportion as their forearms, his respiration was entirely diaphragmnae5 speech is jud icial and scientific. We doubt whether he complained of a little numbness in the han it is right to say that oderate drinking is the and left leg, but there was no distinct paralysis parent o? excessive drinking. But what is moderate sensation; he had a sense of constriction round.t drinking? We can best get at a notion of it by upper part of abdomen; priapism only partea saying what it is not. Drinking early in the day pupils were equal and acted to light , no fa is fot consisient with moderate drinking. The man paralysis; some tenderness all down spine, who begins the day with \" a soda and brandy I most marked over the sixth cervical vertebra, das very littie respect for his constitution ; and if dispacement was detected. Dr. Gowers saW t he does not aiter bis habits, they will alter his patient, and noted, in addition to the loss of Pow health. Odd glasses of beer and glasses of spirit of the extensors of the arm, that the power intii in a forenoon do not come within the range of deltoid and flexors of the elbow was good moderate drinking. They will shew thernselves in side; that there was the slightest possible o c some rotundity of feature or figure, or alteration ment of the flexors of right fingers, none Of1 of colour, some dyspepsia, or lithiasis, or rheu. left; decided loss of faradaic irritability in de matism. That is not moderate drinking which ulnar nerve, and in aIl the muscles suppied bY he adds fifteen or twenty beats to the pulse, or which not in the right; littie change in the other dmusb' flushes the face. Finally, all casual drinking is the reflex action much diminished in the left usc bad, presurnably, and not moderate drinking. The There was invountary passage of feces and l system will not receive food merely as a matter of tion of urine. On passng a catheter, two strit conviviality at all sorts of odd hours. Stili less wil were found, the posterior of the two only adn' it receive with impunity drink in this way. Drink- a No. i. Thirty ounces of urine were drawfi ing which disturbs sleep, either by making it heavy, the urine was acid, and free from albumen or by driving it away, is not moderate. For want sugar. Ordered five grains of calomel as a Plbme of thought on these points many people who would ge remained in the above condition 1til t e be shocked to be considered immoderate, charge night of the 5th, when he became noisy l restlt their blood and tissues with drink so continuousy and delirous. A chlorai and morphia sreste t that the system, thougb never saturated wito, is administered. The urine dribbled away, but0 never free from, alcohol. Moderate drinking is the 7th a catheter was passed to relieve ret that which consists with a clean tongue, a good He also had another dose of calomel (five een appetite, a slow pulse, a cool skin, a clear head, a He had now gained a little power in bis aran' tw steîdy hand, good walking power, and light and could bend and extend bis elbows more rs refreshing sleep. It is associated with meals, and Priapism oniy sligatn y marked. On Sept. e is entirely subordinated to more convenient and compiained of pain starting from his toes, and",
         "THE CANADA LANCET. 233 tPren all over his body, but especially running and white substance broken up, and mingled with to t back of bis neck; the pain intermitted small extravasations of blood. The microscope isdeath. minutes, and continued to do so until showed abundant 'granule corpuscles.' Thischange to hS ea was equal in the two sides of the cord, and extend- Pu t.Ith.-Temperature 102.2°. Unconscious; ed from the seventh to the eighth pairs of nerves. bein regular, size of pin's head. Mr. Heath, A littie higher, opposite the sixth pair, the cord was bg ddable to untroduce a catheter, punctured scarcely damaged, slight irregularity in the out- wb and troughthe rectum m the ordinary lines of the anterior grey cornua being the only ti) and tied in the canula The urine was abnormality. Lower down, between the eighth .0Oy, ammoniacal and very offensive. Instruc- cervical and first dorsal pairs. the left anterior cornu Were given to have the bladder syringed out alone was damaged, the right side being normal in a1ar3h water twice a day. appearance. Below the first dorsal pair the cord rosePatient cisn a drowsy state, at once appeared healthy. All the anterior roots of the by a touch or by being addressed. nerves appeared healthy to the naked eye, but on teth an Quite conscious. Lies with arms at right microscopical examination those of the seventh td ovr trunk. Numbness on back of left hand pair were degenerated on the left side, almost ft Oer left eg; elsewhere the sensation is per- healthy on the right. In the first dorsal pair the to tr. Gowers examined the patient, and found degeneration was slighter, and was also chiefly on an the electric irritabiîity of the abductor indicis the left side. This left-sided affection of the erv he interossei of left hand and of left ulnar anterior cornu in the lowest cervical region, and delt o had quite disappeared. The biceps and left-sided degeneration of the anterior roots, cor- ,e rritilitMuch weaker, but presented no loss of responds with the loss of electrical reaction in the the l- Pupils contracted, the left being a little left ulnar nerve observed during lifera There were Siealler; slight ptosis of left eyelid. Breath- two strictures in the urethra. The bladder was gue o cyanosis ; chest resonant; no râles. greatly hypertrophied and congested; the puncture dry, was seen to be exactly in the centre of the trigone. the n the 23rd it was noted that the movement in Ureters dilated; kidneys large, deeply congested, ntracte had decidedly improved; pupils slightly and swollen, with numerons whitish streaks of com- bdr acted The canula was removed from the mencing suppuration scattered through the cortex. h ext a'd replaced by a gum-elastic catheter. Recto-vesical pouch of peritoneum normal, not hft day he said he felt weaker; he refused wounded by the trocar. Heart, liver, and spleen hdandin the afternoon vomited: healthy; lungs emphysematous. There was slight es otMuch weker, tongue dry and brown; superficial collapse of the posterior part of the eest ronn but brandy. No cyanosis; no râles; lower lobes; no sign of recent bronchitis. ry bloant to base; extremities cold; urine In some clinical remarks on this case, Mr. sie ody. Profuse perspiration, limited to right Heath referred to the rarity of recovery in cases of fno face, was noticed. He died just before injury to the cervical spine, death occurrang ether tl from bedsores, ulceration of the bladder, or, most Sta yeperature was taken daily, and was con- frequently, from congestion of the lungs due to im- t Y raid2 bu. t only slightly, ranging from 99.20 perfect aeration. The above case was an example îoo .2 On one occasion, being generally under of diaphragmatic respiration, the chest-walls being The pulse was never over 72. paralysed; but the opposite condition had been rtebra Spine : The body of the sixth cervical witnessed by the students in a recent case of pistol- Slers crushed in front, and the right anterior shot lodged in the spine, where the diaphgram was ftp rocess broken from the body, and the paralysed, ar at least did not work, whilst the other steriorught articular process fractured. The inspiratory muscles were intact. As the strictured ose iuri C mon hlgament was partially lacerated. condition of the urethra rendered it impossible to fo '.rwardes allowed the fifth cervical vertebra to relieve the bladder by catheter, Mr. Heath had no elcrnWards n the sixth. The spinal cord was hesitation in tapping the distended bladder per t is:-\" D Gowers, whose report is as rectum, thereby making a dependent opening, by thiwt.h di s ura mater of the cord firmly adherent which the urine flowed away as fast as it was kee eD r cervical vertebra, and a little secreted, without decomposing. Mr. Heath said on. at the spot ; no other sign of inflamma- that he regarded the result as so satisfactory that ew v etravasations of blood outside dura he would be inclined to adopt the practice in any ter an ucuiay of adhesion; mnner surface of dura other case of spinal injury of a hopeless character tr I ItYofadhsi thnere beifac o diurta llisdficlisad agr.rh a terna a Mater normal., The spinal cord, on rather than have recourse to constant catheterism ac Zeraio asect, was natural, there being no s'ign with all its difficulties and dangers.-The Lancet. to ratn wa, ho tusion Opposite fracture ; the Rev. Mr. Talmage says that King Asa had the hee s, ho wever, slightly lessened. Sec- gout, and the doctors killed him (2 Chron. xvi. 12, showed extensive dusorganisation; grey 13-) 2",
         "THE CANADA LANCET. THE THERAPEUTICS OF HEADACHE. simple but nutritious; let the sleeping-room b' large and well ventilated ; in short let the patient Clinie by Prof. Smith, New York. be surrounded by the best possible hygienic ' fluences. These general remarks wlll applY to GENTLEMEN,XVe take up to-day the therapeu- almost ail forms of headache. tics of certain forms of headache, a very important subject. Head-ache may be divided into organic SJCK-HEADAcHE. and functional; but I believe you will get a better SICK-HEADACHE idea of the treatment by dividing the cases accord- I usually recognize two forms of sick-headache, ng to the causes. (so called), the one neuralgic in character, hou will remember we took up purely neuralgic hemicrania and trifacial neuralgia, the other a eadache at the last lecture. dyspeptic headache. In the neuralgic varicty the A headache, when due to nervous disturbance, pain in the head precedes the nausea, while in the uch as occurs in hysterical or excitable subjects dyspeptic variety the pain in the head succeeds the f associated with plethora, often yields to a saline dyspeptic symptoms. In the neuralgic, vomitinh athartic. The most agreeable is the solution of does not relieve the pain, while in the dyspeptic ao itrate of magnesia, and should be given, a full emetic or laxative often removes the pain in the ottle of it on an empty stomach. In addition, it head by removing the cause. In addition to the s well to give one of the bromides combined with treatment given in a previous lecture for neuralf aerian. The following prescription I frequently headache, which often occurs at intervals of a feo se: days, or a week or two, sometimes coming o1 R. Sodii bromid···..--...3 vi. sunrise and disappearing at sunset, I have go Ehx. valer. amm. ......... results from the use of guarana, or paullîifnl sorbillis, as it is sometimes called. I give it usUal M. Sig. 3. i. every hour until relieved. in powder, grains fifteen every fifteen minutes, u If such nervous headache be associated with six doses have been taken. It is best given I nemia, after relieviug the i a e_ aLLtc wi Ll the bromide and valerian prescription, give iron and give it for weeks, until there is a decided im- provement in the patient's condition. Always give the iron after meals. In these anæcmic cases it is often advisable to stimulate the heart's action. For this purpose I have found the following useful R. Amm. muriat .......... Tinct. actea racemos. Aquæ.aa. . il]. Sig. à ij. after meals in a wine-glass of ere be despondency and depression of phosphorus, with nux vomica, is a good ation. The unpleasant taste of the phos- has been overcome by being made into ated or gelatine-coated pills. I frequently e a pill containing phosphorus gr. lg, with vomica, gr. 5r t. i. d., with the happiest The pills can be obtained of any reliable This despondency is apt to occur in ho have been overworked mentally, or are by business cares, or who suffer great anxiety. If, in addition to these symptoms sleeplessness, I employ the following pili: Camph. pulv................gr. xxv. Ext. cannab. ind..........gr. x. Ext. hyoscyami.........gr. xx. Div. in pill No. x. One at night. Repeat in two hours if necessary to produce sleep. It is important to attend to the general health of the patient. Remove all causes of excitement * encourage exercise in the open air; let the food be lime sweetened water ; and if six doses do 1» relieve, do not continue it ; it will probably n0o relieve. It is well to give these powders in au headache (not malarial) of long standing and proe to return at certain intervals. MALARIAL HEADACHE. Malarial poison may produce pain in any P0 tion of the head, but the most frequent locatiO1 are the sub-occipital region, the frontal, and 0O either side (hemicrania). Begin your treatdIe by the use of quinine. If distinctly periodicd give ten or fifteen grains two or three hours befoi the expected attack. It may be necessary tO Pi the quinine in divided doses until cinchonismn produced, and kept up for several days, and theo gradually diminish the dose. If the pain still c0 imues to reccur, and it frequently will, resort irsenic and belladonna, five-drop doses each Fowler's solution and tincture belladonna, neals, increasing the Fowler's one drop each j intil œdema arsenicalis is produced. This eldom fail to give relief. HEADACHE FROM GOUT. I have found the following prescription icial in a headache dependent on gout: R. Vin. colch. sem.--..·..-. 3ij. Lithii bromidi........... ss. Syr. zingib . ........ss. Aq. cinnanomii, q. s. ad. M. Sig. 3ss. in a tumb!er of Vichy waterev-4 four hours.a .6 s i c c . i u a M. water. If ti spirits, combin phorus sugar-co prescrib ext. nux results. druggist those w harassed mental there be R. M. Sig. 23I4 bcot,",
         "bc \"rt 1 to e c t RHEUMATIC HEADACHE. Th headache of rheumatism is characterized cstalsY by tenderness of the scalp, which is in- faraed on pressure or motion. Use the mild fo de .Current on the scalp, and internally the Wing : . Potass. iodidi, Amm. muriat.........aa. 3 iss. Infus. humuli... . . .... before each meai for several days. If there be sieeplessness give : l. Sodii bromid..ss. Chloral hydrat ·3 ss. Syr. aur. cort ·······.ss. Aque ................. iiiss. M. Sig. ý ss. at night, repeat in two hours if necessary to produce sleep. * DYSPEPTIC HEADACHE. Vf i. ss. four times a d Dyspepsia is a frequent cause of headache. f fater. day in a ine-giass If there is indigestible food in the stomach, and it has been there for some time, give an emetic, as fl not y cases of rheumatic headache, which mustard and warm water, or sulphate of zinc gr. xv., eve'r bro ode he amove twent ave and remove it. If there is evidence of indigestible S o of ammonia in twenty grain doses food in the alimentary canal, beyond the stomach give gr.xx. of rhubarb and magnesia each, and re- UREMIC HEADACHE. move it from the bowels. If the headache be here afrontal, and the pain is located immediately over reat i another form of headache which is of the eyes, give dilute nitro-muriatic acid in ten-drop he portance as a symptom of serious disease. doses, well diluted, after meals. If the pain is P1 bain in the head may be the first evidence you located about the roots of the hair, give an alkali Ou aln that there exists renal disease, and that before meals. as gr.xx. bicarbonate of soda or mag- he redci have to deal with uræmic headache. nesia. The dyspeptic headache oftentimes is con- îor i dici plan of treatment in such cases has fined to these regions, but spreads over the entire of urine bJect the removal of the abnormal amount head. In such cases I combine an acid with an nia from the system. To accomplish this,- you alkali, and add to these nux vomica, as in the tY uc nto action one or all of the three great following prescription: \"nd tories of the body, the kidneys, the intestines R. Sod. bicarb....... 3 iss. kid in Make the kidneys act if you can, Ac. nitro-mur. dii. aternal h cup over the region of them, and give Tinc. nuc. vom...... . s 'y phe folowing: Syr. aurant. cort....... . - otass. acetat.. .. .3 vi Aque, q. s. ad...........3vi. Sinfu s. digitalis........ .. vi M. Sig. ý ss. after meals in a wine-glass of Sig. 3ss every three h ours. water. leavev, fusion should be made from fresh English If there be gastric pain, a mid counter-irritant ive this until the kidneys act freely, if as a mustard plaster to the epigastrium, will often THE CANADA LANCET. 235 Such patients will be benefited by the regula- you can make them do it within twenty-four hours. o f the hygiene, tonics, a partial discontinuance You cannot always rely on this, however. If the 'f stmutb s, particularly those which have been kidnevs do not act freely and the headache is not to b y experience to aggravate the gouty symp- relieved within twenty-four hours, give a saline cathartic. A treatment almost domestic, and often SYPHILITIC HEADACHE. very effectual, is to put an ounce of cream-tartar in th is hiardly necessary that I should tell you that a quart of water, and have the patient drink this in ne headache of syphilis is more severe at night, eight or ten hours. ay is quite apt to awaken the patient after twelve Y Its increasing severity. The use of calomel in ALCOHOLIC HEADACHE. in e-tdith grain doses every hour, for twelve hours * The headache of acute alcoholism, or inebriety, p'3nediately preceding the time that it awakens the follows a debauch. The first indication is to Catient, gives more rapid relief than the ordinary remove the alcohol from the intestinal canal. For Itutional treatment. The calomel treatment this give of rhubarb and magnesia calcined, each stY be continued for two or three days, then half a drachm, then give as follows: bPped and iodi-e of potassium given. I usually IL Spts. amm. aromat..... .3 an the iodide in fifteen grain doses, after meals Tinct. camph... alid 3is . gradually increase it until iodism is produced, Tinet. hyosciami.... .-3 iss. r irritation of the stomach occurs, provided the Spts. la. comp. q. s.·ad. ··· iIj. Yfptoms do not yield earlier. It may be neces- . Sig.3jevery hour until theheadacheis relieved the to push it to 350 or 400 grains a day before adt.Sive cadci symptoms yield. and then give capsicum gr.ij. and quinine gn.îî.",
         "236 THE CANADA I relieve the pain in the head as well as the pain in the stomach. If flatulence be a troublesome symptom, give the following: B. Bismuth subcarb.--- 3 iss. Tinct. nuc. vom........ ..3 iss. Tinct. card. co., Spts. lav. comp. aa q.s.ad. . .. iv. M. Sig. 3 ij. before meals in a wine-glass of water. If there be constipation, the following pill may be given, one in the morning : I. Aloes pulv........·· .... ....3 ss. Ext. nuc. vom......... ..gr.v. Ext. belladonna ..........gr.iv. M. Div. in pill No. xv. In some forms of headache associated with sto- mach indigestion, I have found small doses, often repeated, of tinct. nux vomica effectua. I give a single drop every fifteen minutes, and continue this two or three hours, if necessary. In other cases, where the headache comes on soon after a neal, and seems to depend on stomach digestion, large drops of pepsin are effectual. Give a half drachm saccharated pepsin in a wine-glass of sherry wine, t. i. d., and let it be taken during meals. HEADACHE FROM CONGESTION. Cerebral congestion as a cause of headache may be divided into two varieties, active and passive. These claim almost directly opposite plans of treatment. In the active variety the patient should be kept in a darkened room, perfectly quiet, cold and evaporating lotions applied to the head. A saline cathartic may be given, and the following prescription : 1. Sodii bromid.......---- .- .... -3 iiss. Fl. ext. ergot. . .·· .... iiss. Syr. zingib.. .............ss. Aq. aurant. Flor. q.s.ad. ... iv. M, Sig. ý ss. every two hours. If the skin be hot and dry, and the pulse full and rapid, give Fleming's Tinc. Aconit. Rad. gtt. ij. every two hours until the heart's action is sensibly diminished. Sometimes a hot mustard foot-bath will give relief. The passive congestion variety demands a different mode of treatment. In many cases this variety is found associated with cardiac disease, and most frequently where there is cardiac dilata- tion. Hypertrophy gives rise to the active variety. Improve the condition of the blood by the use of iron, quinine, bitter tonics, alcoholic stimulants, good food, and stimulate the heart's action by the use of the following . 1. Tinct. digitalis. ... ....... m Spts. amm. aromat........3 vi. Spts. lavand co., Syr. sinip. aa q. s. ad...... iii. M. Sig. 3 i. every four hours. ANÆEMIC HEADACHE. Cerebral anemia produces a headache, which is. often mistaken for the passive cerebral congestive form. It is often associated with general anæmia, nervous exhaustion, and may occur in heart dis- ease in consequence of enfeebled heart power, such as is met with in enlargement with dilatation, fatty degeneration, and myocarditis. Improve the general condition of the patient, and stimulate the heart's action as recommended in the passive cerebral congestive variety. Nitrate of amyl will relieve the immediate headache. Let the patient inhale three to five drops of it on a piece of cotton, placed within one nostril while the other is held closed. When associated with nervous exhaustion, I employ the following: IW. Strych. sulph ............gr.ss. Tinct. ferri. chlor. . . . .....3 i.i Glycerin.......... . . ... 3 ss. Infus. gentian q. s. ad........ vi. M. Sig. ý ss. after meals, in a wine-glass Of water. A word as to alcoholic stimulants. These are beneficial in headache dependent on cerebral anomia. Champagne is specially a favorite forroh and is much relished by those who suffer fron' nervous exhaustion. You should use caution in recommending it to such patients, as it may lead to senous results. Give it always as a remedy, and not as a beverage. A safe plan is to recomnend brandy, a tablespoonful after each meal, and lirni the champagne to one glass, and let it be take1 with the dinner.- Western Lancet. ORCHITIS TREATED BY PUNCTURING THE TESTICLE. The treatment of acute orchitis by means of puncturing the testicle having within the past twelve months attracted a considerable amount of attention, the following notes, for which we are il' debted to Mr. George Shaw, will doubtless prOVC of interest. The subjoined cases, as far as they gO' certainly seem to present very satisfactory eviden¢e of the value of puncture, while, according to ' Macnamara's wide experience, such instances. are by no means rare. CASE i.-H. C-, aged forty-one, a gold rC finer, was admitted on Oct. 17th last with acnte inflammation of the left testicle. He was a tenrW erate man and a hard worker, but out of health '0 consequence of being constantly exposed to nitro-hydrochloric acid fumes. On Oct. 11th he strained himself while at work, and shortly after- wards his left testicle became swollen and verl painful, so that he was quite unable to continl.e his work, and, as the treatment he received at his 1 LANCET.",
         "THE CANADA LANCET. 237 house did not relieve him, he was taken into the grooved needle into the inflamed and injured 3spital. Ice was kept constantly applied to the testicle. The relief in his own case was not only 'nflamed gland, and the ordinary saline purgatives instantaneous, but permanent, and for these and Were administered. Under this treatment the other reasons he said he had never hesitated to 8ytptoms subsided, but on the 24th, without any employ the same treatment on his patients. He known cause, the orchitis returned, and, on the himself had never seen any but favorable results follwing day, during his visit to the hospital, Mr. follow this mode of treatment, though, of course, acnamara ran a grooved needle into the testicle, he was not prepared to say it was always curative. eand allowed a few drops of serous fluid to escape He added that he felt himself under a personal e\"ternally along the groove, after which the instru- obligation to Mr. Henry Smith for having intro- d ent was withdrawn. The relief was both imme- duced into modern practice the plan of puncturing diate and permanent ; the inflammatory symptoms the testicle in cases of acute orchitis, and he could pa ssed away, and the patient left the hospital with confidence recommend his pupils to follow Nov. 3rd, perfectly cured. this treatment in similar cases, because there are CASE.--Thomas W--, aged thirty-five, was few diseases in which pain can be more effectually admitted on Nov. 4th, suffering from long-neglected and speedily removed.-The Lancet. eonorrhœa and acute inflammation of the right esticle, the latter having come on suddenly on gre t29th, from which time he had been in very CASE 0F EXTRA-UTERINE GESTATION. pain. Immediately after admission, the e -surgeon, Mr. Poynder, passed a grooved Mr. Thomas R. Jessop, F. R. C. S., Honorary 0f e into th testicle, and, after a small quantity Surgeon to the Leeds General Infirmary, reports Oeeluid had escaped externally, withdrew the an interesting case in the Lancet, November 4th, thieedle. The patient alleged that within five minutes 1876:- ag-Pain had entirely gone, and did not return The patient was a married woman-mother of again from that time. He left his bed on Nov. one child, twenty-six years of age, and of previous 12th, and left the hospital cured on Nov. 2oth. good health. * * * * * * ln refrence to these cases Mr. Macnamara re- The diagnosis of extra-uterine fcutation having prod ed that they were fair examples of the effect been ascertained, and the case admitting of no oOduced by puncturing the testicles in acute further delay, Dr. Jessop, on the morning of Orhitis. So far as he was concerned he was un- August 14th. 1876, and near the thirty-third week able to determine in any given case if the inflam- of utero-gestation, performed the operation in ques- lntion was confined to the epididymis, or affected tion. oeeY the proper structure of the testicle ; but it The patient was placed under ether, and, after tir)med to him scarcely probable that inflamma- emptying the bladder, an incision was made in the tto, if attacking one of these organs, would not linea alba, six inches in length, with the umbilicus itftend to the other, and under any circumstances in the middle of the wound. On reaching the ab- fuid owed, almost of necessity, that an effusion of dominal cavity the back of the child was seen, in fmom the distended bloodvessels would escape covered with cervix caseosa, with the omentum lying to the tunica vaginalis, and perhaps, also, into like a cape over the head and shoulder. The cord, tuctuhica albuginea. Every surgeon who had which was in full view of the wound, was tied, and ob tured the testicle in acute orchitis must have a large well-nourished female child was removed idd that the escape of a small quantity of from the abdomen. The child at first breathed so fre Ialong the groove of the needle was not un- feebly as to give rise to some alarm, but an hour and ently followed by instant relief of the pain later it had acquired normal respiration. Its sub- an diminution in the hardness of the testicle, sequent history is of importance no further than t had always appeared to him that the relief that it revived and flourished, until, in its eleventh tensanalogous to that afforded by diminishing the month, it died of croup and pneumonia. aco Of the eyeball in acute glaucoma. Mr. To return to the mother. The placenta was to arnara further remarked that he could claim found lying like a coverlid over the entrance to to SPeak with some degree of confidence on this the pelvis, and especially attached to the rectum si1bject thro t, for, some years ago while riding, he was and posterior abdominal wall. This fact was as- ijr forward on the pommel of his saddle, and certained with the most jealous care, lest any rude soilnrd his left testicle. Symptoms of orchitis manipulation should detach any portion of it. In his fset m. Happily having been informed by the abdominal cavity some serum (a pint) was prilend, Dr. Herbert Baillie, only a short time found, and feeble bands of lymph here and there tesi0usly of the case of an artillery officer whose distributed upon the intestines. The wound was bl'cre had been punctured for orchitis after the dressed with six silver wire sutures, with as many Coll ecommended by Mr Henry Smith of King's intervening of silk, and the lower part of the ge, Mr. Macnamara got Mr. Culcliffe to run a wound, from which the umbilical cord was per- * i t,. i J t 4 J 2; I., F iii",
         "238 TE CAADA LN--T mitted to protrude, was dressed on the principle of the pedicle in ovariotomy. The clamp used is the invention of Mr. Gough, and while it is not described, its excellence is commented upon by the surgeon. The care bestowed upon the case in the after- treatment is deeply interesting. The patient was left in the operating room, and upon the very table used in the operation, for four days, lest removal should diminish the chances of recovery. She was nourished by judiciously administered enemata for a week before the stomach could retain anvthing but bits of broken ice. Morphia was given hypo- dermically for about six weeks. )uring the month following the operation the character of the dis- charge from the wound betokened the removal of the placenta, but during the second month the character of the discharge gradually became normal and small in quantity, when, at the expiration of two months, it healed, and the patient was soon dismissed. [The article is quite lengthy, and enters into the literature of the operation, and will repay a careful perusal. Lest any one should ascribe the recovery to the skill displayed in the management of the case, the eminent surgeon is particular to point out that there were no complications to embarrass him.]-Medl. and Sug. Reporter. CHRONIC OVARITIS. CLINIC BY PROF. THOMAS, NEW YORK. The first case to which I invite your attention this afternoon, gentlemen, is Mrs. Ann S., colored; over thirty years of age, and sterile. On ques- tioning her, we find that she has been married eleven years, but that up to four years ago there was no symptom present in her case, except the sterility. At that time she began to have a fixed pain in the right side, which has never left her, and we find that, in addition, she is now suffering dysmenorrhœa (the pain coming on before the ap- pearance of the catamenial flow), back-ache, leu- corrhea, and marked irritability of the bladder. Now what is the diagnosis? This can only be ac- curately determined by physical exploration, in order to see whether there is any condition present that will account for the above symptoms. On making an examination per vaginam,* the patient being on her back, we find the cervix uteri normal in character and position, but that the body of the organ is bent forward ; and by the use of conjoined manipulation (one hand being placed on the lower Ptients are never examined before the class at Pro- fessor Thomas' clinic, unless there is some condition présent which can be readily distinguished at a distance, such as an ovarian tumor or procidentia of the uterus. part of the abdomen), we can distinctly map it out in the position of well-marked anteflexion. We are utterly unable to straighten this uterus ; but just why this should be so, is not very evident. O\" continuing our examination we find on the right side of the uterus a hard mass, about the size of a horse-chestnut, which is movable, and excessivelY tender to the touch. The ovary cannot be felt o the left side. Now, placing the patient on her side, and introducing the uterine sound, bent to the proper curvature, we find that it is still quite impossible to reduce the flexion (or, at least, not, without using more force than we would be justi- fied in doing). The diagnosis is, then, chrolic ovaritis, with displacement, and irreducible ante- flexion of the uterus. The anteflexion has probab- ly existed ever since the patient was a young gir, but seems to have given rise to no trouble (excePt the sterility), until four years ago, when she mjust have had an attack of acute ovaritis (right) accOm panied by displacement of the organ. We have then, quite enough to explain all the symptoIs o which the patient complains, viz.: dysmenorrho' pain in the right side, back-ache, leucorrhoea, and irritability of the bladder. Now, as to the prognosis. This is very impor- tant when you are able to cure your patient, but t is of tenfold greater importance when you cainot do this. Why ? Because it prevents the individual, if your advice is taken, from undergoing a 1o1g course of useless treatment and incurring much Ul- necessary expense. It is always the best course' in such cases, to tell your patient frankly that yot' cannot cure her; though sometimes this is a dis advantage to the physician, as she may go to soIIe other medical man who will promise great thin5 for her, and for the time being you will be thoughe to know very little about your profession. In tht present instance nothing can be done excePt tO regulate the patient's life, and warn her to avoid treatment which would probably. do her a gret deal more harm than good. She should be \" structed to make use of warm vaginal injectioîn! and ;o remove all weight from the flexed uterus bi wearing ber clothing suspended from the shouldee In addition she might take such general tonics are indicated, and she ought, if possible, to have complete rest at the time of ber monthly periods UTERINE SUBINvOLUTION.-Mary M., aged 5 a native of France. She has been married Bio than three years, but has never given birth to child at full term. Ten months ago, however, had a miscarriage at about the fourth month, she says she has never been well since. The P cipal thing that she complains of is a pain, seat as she expresses it, \" over the womb and runl'o through to the back.\" She never misses a monthîl turn, but the menses do not always appear exac on the day anticipated (a matter of no consequen whatever). She looses less blood now than foliý ti b3 p] a t' 't c 1I b i fi t] a t tt i THE CANADA LANCET. 238",
         "TUE CANADA LANCET. 239 erly at her periods, and immediately after the flow ceases she suffers from a severe pain, which con- bYnes for two weeks, and it is always accompanied t .a leucorrhœal discharge. This post-menstrual an, You will find, is very rare indeed. There is nother form of so-called dysmenorrhea, in which i e Pain occurs at a certain period between the t catarnenial epochs, but this intermenstrual pain is 1 1 reality a neuralgia, and ought to be classed as ch. She suffers from constant irritability of the t .adder, and has to get up two or three times every rIght to void her urine. An examination per vagi- n reveals the fact that the uterus, slightly ante- 'lerted, is in a much lower position than normal, ai 1s pressing forward upon the bladder. We th at it is also very large and flabby, and that the external os is quite patulous. Anticipating rat fungoid degeneration of the mucous mem- ance of the uterus might be present, one of my astants has carefully explored the cavity of the t gan with a copper wire curette, but with a nega- te result. tere hen is a patient who was perfectly well, to ten months ago, when she had a miscarriage, Which has been followed by the above results. tu1 volution is, therefore, our diagnosis, by which t I Would have you understand a statement of the condition which gives rise to, and satisfactorily ti ounts for, the phenomena present in any par- cular case. Many authorities would say that this patient is suffering from chronic metritis, but that gs a expression which covers almost as much aurnd as hysteria, and ought to be discarded. Sor sOne reason or'other, which it is impossible 11W to determine, the involution of the uterus after he in'scarriage was interrupted, and the organ re- toned permanently enlarged, with its lining mu- alss rembrane engorged with blood. The ovaries, th , Were left much congested, and on account of ebo 1»fcreased weight both have fallen down into flas' cul-de-sac, where they can be distinctly th ,0omewhat enlarged and extremely tender to the touch; a fact which was not mentioned when e results of the vaginal examination were stated. Subinvolution is a very difficult condition to Core, but we will put the patient on the following Qurse of treatment: ail superincumbent weight inust be removed from the uterus, and she must be ducted to attempt no heavy work, and to rest torng her menstrual periods. She will be ordered taimake use of hot vaginal injections whicn con- enta a small quantity of some appropriate astring- wh not for the purpose of curing the leucorrhœa Ih has been noted, but in order to prevent the th from becoming more flabby and relaxed an t is, and thus permitting the uterus to fall r down. Internally she will be given ergot, f8rall doses (to avoid the nausea which it so avSently Produces); though I must confess I e not Inuch faith in its efficacy in these cases. Ergot, as you know, has a marked effect on uterine ibroid and in arresting hæmoptysis. and as it is he only drug whose action is directly upon the iterus, it is worth while to give it a trial, at all events. In addition, she will wear a soft-rubber ing pessary, to act as a splint to the uterus, and ake off some of the strain from the ligaments; and ater on in the treatment a current of electricity, from a constant battery, will be passed through he organ (on account of its tonic and alterant effect), one electrode, in the shape of a cup, re. ceiving the cervix uteri, and the other being placed on the abdomen. Relief in this case will neces- sarily be slow, but may perhaps be complete. For a perfect cure, however, we can only look to an- other pregnancy. The uterus would thus be given another chance for itself, and it is probable that, under more favourable conditions than before, complete involution of the organ might afterwards be accomplished.-Mfedical Reporter. THORACENTESIS IN EFFUSIONS OF THE PLEURA. Dr. Beverly Robinson read a lengthy paper on thoracentesis, in which he drew from the literature of the subject the advantages derived from it, and the cases in which it was indicated. He directed attention also to the subject of sudden deaths fol- lowing this operation. The deductions which he arrived at were as follows : Thoracentesis was im- peratively indicated where there was danger to life from pleuritic effusion. It should be performed at an early date, when the effusion was large, for the reason that it may prove fatal, if not by dyspnoa, by syncope, by twistimg the aorta and impeding circulation, and by givng rise to odema of the lungs. Thoracentesis was also a justifiable operation in moderate effusions, even if they were not purulent, for the reason that a lung compressed by an exuda- tion may become involved in caseous pneumona, or it may be invaded with miliary tubercles, and, moreover, the effusion may result in adhesions which will bind down the lung and permanently cripple it. The pressure of the fluid on the lym- phatics niay prevent them from exercising their functions of absorption, or absorption may be im- possible, from the fact that the pleura costali§ and pleura pulmonalis may be so coated with lymph as to shut out the lymphatics completely. In regard to the objection which has been offered that if fluid be removed it will return, Dr. Robinson re- erred to a French authority, showing that, in twenty-five cases of aspiration performed in simple pleurisy, the fluid returned in only six. Reference was made to the influence, as a diuretic, which aspiiation produced, and a case was cited in which 239 THE CANADA LANCET.",
         "240 TH1E CANADA LANCET. two gallons of urine were passed in the twenty-four a long and useful career. He was born in thiS hours following the operation. city May 4. 1807. He graduated in the College In respect to thoracentesis during the febrile of Physicians and Surgeons. stage of pleurisy, it would seem that it does not, as In 1837, he was appointed Attending SurgeO a rule, increase the temperature, but, on the other to the New York Hospital, which position he helu hand, does, at times, lessen the intensity of the up to the time of his death. On the death O fever. Several observations have been made in Kearney Rogers he was made Attending SurgeoO which the operation of thoracentesis has been per- of the New York Eye and Ear Infirmary, which formed to estimate its effect, and it has been found, position he occupied for nine years. When the both in animals and man, that the puncture of the St. Luke's Hospital of this city, was being foundedt i chest-walls with a sharp instrument is innocuous. he was the trusted adviser of the managing board In regard to the danger of converting a sero- and the subsequent perfect administration of thiS fibrinous exudation into a purulent one, Dieulafoy noble charity has been in no small degree due to considers it a coincidence, and not the result of his individual exertions. After its organization h aspiration ; and, in proof of this, cites several hun- was appointed Attending Surgeon, the duties O dred cases in which the operation had been per- which position he continued to discharge ulti formed. 1868, when he resigned to accept a similar can' th In regard to the relation of thoracentesis to sud- nection with the Presbyterian Hospital. He re ti den death, some important facts were adduced : mained in active connection with this institutiol f first, that such deaths occurred in pleurisy when until a few months ago, when his rapid failinga no operation had been performed ; second, that health rendered him unfit for duty. the operation did occasionally bring about a fatal As a surgeon Dr. Buck was remarkable for bold termination, but that such unfortunate accident ness in operating and. for thoroughness of detail i might have been avoided if proper safeguards had after treatment. His patient study of his case' been taken. The principal cause of death was was one of his peculiar traits. To cases of frac embolism, caused by the dislodgment of emboli tures he was particularly attentive, spending nOt from the pulmonary veins ; and, strange to say, unfrequently the greater part of the day in the this dislodgment took place not during the aspira- wards of the New York Hospital in dressing thero- th, tion, but in washing out the chest with injections. As a result of such pains-taking he was enabled The inference as regards the performance of the to revolutionize the prevailing system of treatmUen1lt- o operation was to perform it before thrombi had To his personal study and exertions were du', formed, to inject fluid into the pleura with much more, perhaps, than anything else, the enviable care and in small amount. reputation which this hospital so long maintained bil The following post-mortem conditions have been for the brilliant results of this class of injuries' found in patients dying suddenly : Vegetations of The improvements which he made in the then e st, the valves of the heart, fatty degeneration of the isting apparatus are matters of surgical histOry. heart, thrombosis of the heart, pulmonary, cerebral, His method of treating fractures of the thigh bY th; and spinal embolisms, acute œdema of the lung, the weight and pulley was at once recognized by k pulmonary congestion, ulcer of the stomach, ulcer surgeons throughout the civilized world as the th, of the duodenum, and ulcer of the gastro-epiploic establishment of an original principle of the artery. The final deductions by Dr. Robinson utmost value. were that, inasmuch as the puncture of the walls Dr. Buck was not only a bold, but an origiJ 8e of the chest by an aspirator-needle was a harnless operator. The various capital operations which operation, and any amount of effusion may become are describèd in the periodical medical literature0 dangerous, it is justifiable, in all cases of pleurisy the past thirty-five years abundantly prove the lat where fluid is present, to aspirate the chest, unless ter statement. Among these, what is now kno 8, the patient be very feeble, and the effusion be as Buck's operation for edema of the glottis holdo thy small; in such case it may be wise to defer the a deservedly high rank. But in no departrnentt operation. Again, if the effusion be extensive, it did he gain more laurels than in autoplastic 'Ur he may be judicious to puncture the chest more than gery. His devotion to this branch, during the once, and draw off a moderate amount of fluid latter part of his life, amounted to a passion, tie each time ; so that all danger of acute œdema of his marvelous successes roused in him an enth' t% the lung, of syncope, and of dislodgment of throm- siasm which mocked the increasing infirmities 5 t bi, be avoided.-New York Med. Jour his age and his rapidly declining health. work on \" Contributions to Reparative Sur'e'y issued only within the last year, fully embodiesl h DEATH OF GURDON BUcK., NEW YORK.-The remarable experience, and may be looked upori ale painful anxiety concerning the health of this dis- the crowning effort of a most notable and distiß th tinguished surgeon has at last culminated in his guished career. * * * death. This sad event occurred March 6, encfing For the past year or more his health began se'",
         "THE CANA 8ibl Ih hto decline, and grave symptoms appeared, oubi were for the most part referred to kidney !ibg e Finally the symptoms of uræmic poison- n ecame more and more marked, until he sank Coma, in which state he quietly passed away. la bie was faithfully and lovingly attended to the br by his trusted medical friends and advisers, James R. Leaming and Alonzo Clark. intega man, Dr. Buck was noted for his sterling al hoity of character, his high sense of profession- the or, his consistent Christianity, his charity to Ca Poor, and his quiet devotion to his family. CcoMore of good be said of any one ?-Med. ESP NDARY HEMORRHAGE AFTER THE USE OF the Ch S BANDAGE.-Prof. Esmarch thinks that tions vere secondary hemorrhages after amputa- operat and the frequent hemorrhages after other tributbls in which his bandage is used are at- cst e, in many cases, to the use of too firm a are t ition. The rubber tubes usually employed erted 0 thick and hard, and too much force is ex- sequenen applying them. The necessary con- rerves Ce is a complete paralysis of the vasa-motor terovaland hence obstinate hemorrhage after the tOval Of the tube. For some time past Prof. tearch has only used the tube in operations at e Oulder and hip-joint, and has found that he 0Perathtain quite sufficient constriction in other \u0026 0ons by means of the elastic bandage alone. I theother cause of these secondary hemorrhages bieed. imPerfect means employed to check the erojillg after operations. In operations for ne- stict, Prof. Esmarch, before loosening the con- \u003ehieg band, fills the cavity in the bone, tLht always makes trough-shaped, with charpie as been soaked for a long time in carbolic the dead. applies Lister's antiseptic dressing. If o 0iresng is well applied, not a single drop of e chl .oze through it after the tube is removed. ecthsarpie is left in situ for several days. In re. eitsIos the tube is loosened before the wound is pu . and all spirting arteries are tied. In pir ltons Prof. Esmarch lays great stress on the as to neof a circular cut through the muscles, e li voId cutting the arteries obliquely. When ne aris removed he seizes the gaping vessels Ie leatl another with a bull-dog forceps, which erd es hanging to the stump until he has es teevery vessel that he can see, and he then the l.therr with cat-gut ligatures. He applies %t Watire to both arteries and veins, and believes ondan the veins, are ligated the danger of t4bber 'Y hernorrhage is greatly diminished. The t4edi tube or constricting bandage is then re- seed strapidly as possible.; if it be gradually e bo he hemorrhage will be great, because 'fll beOd Wil be pumped into the arteries, but t unable to flow back through the still DA LANCET. 241 constricted veins. He then takes an irrigator filled with a weak solution of carbolic acid, iced, and douches the surface of the wound. The smaller vessels that still bleed are in this way easily seen, and seized with forceps, which are left hang- ing to the stump. When no more bleeding vessels can be seen, he proceeds to secure those that have been found with catgut. If the operator wait to tie each vessel as he seizes it, much time and much blood will be unnecessarily lost. Prof. Esmarch always has from thirty to forty pairs of forceps on his operating table, and all of them are sometimes in use before he begins to apply the ligatures. Finally the iced douche is kept up until the capillary hemorrhage ceases, and the stump may then be dressed without fear. For several years none of his amputations or other capital opera- tions have been followed by secondary hemorrhage. -Med. Record. LACERATION OF THE FEMALE PERINEUM.-Dr. D. M. Stimson records (Archives of Clin. Surg., July, 1876) the following case of this in which he successfully operated by a procedure devised by Dr. Willard Parker, who has employed it in seven cases with perfect success. \" Mrs. V., æt. twenty-eight, during first labour had her perineum torn completely through into the bowel, the rent extending two and a half inches up the recto-vaginal septum. The labour was instru- mental and exceedingly difficult, her pelvis being contracted at the sub-pubic arch. An operation was performed two months after the accident, but it was unsuccessful. \" On May 10, 1876, I operated upon her, assist- ed by Drs. Geo. A. Peters, and Willard Parker, Jr., Willard Parker, Sr., being also present. The patient, having been duly prepared fcir the operation by warm douches and attention to diet and bowels, was etherized, placed in the position for lithotomy, and the parts were shaved. The sphincter ani was divided subcutaneously close to the coccyx on either side and the muscle stretched. I then dis- sected, from below upwards, the cicatrices from the ruptured surfaces, leaving the flaps thus obtained attached to the vaginal surface; and split the edge of the recto-vaginal septum so that raw surfaces might be obtained without loss of substance. Next I made a slightly curved incision, three inches in length, parallel to and three-quarters of an inch from the edge of the wound on either side, and carried it deeply enough into the ischio-rectal fossa to enable me to press the deepest part of the fissure together, by my fingers passed to the bottom of these cuts. \" A doubled silver wire was then carried from the bottom of one of the side cuts through the angle of the wound at the split septum to the.side cut oppo- site, and the ends secured around a piece of elastic 'i t.",
         "242 THE CANADA LAINCET. catheter. The edges of the split septum were united by fine sutures both in the vagina and rectum ; two more double wire sutures were placed in the wound and twisted over bits of catheter, one three-quarters of an inch nearer the surface than the first, and the third through the centre of the perineal mass. The cicatricial flaps were now trimmed, and brought together so as to form a valve of protection from vaginal discharges, after the idea of Langenbeck. Fine sutures were used also in bringing together the mucous membrane of the rectum; and lastly, the more superficial parts of the perineum were united by the ordinary silk suture. \" The patient was now placed upon her back in bed, her thighs separated widely, and a single thickness of sheet made to be the only covering over their upper parts. A Jacque's gum-elastic catheter was passed into the bladder, with conduct- ing rubber tube; and a dose of morphine admin- istered. The deep sutures were removed on the fifth day. The bowels were moved by castor-oil and enema on the tenth day. The catheter was retained until the tenth day. \" I have to-day, May 30, examined the patient, and find the recto-vaginal septum complete, the perineum entirely restored, and the patient can centrol the sphincter perfectly unless the bowels are loose. \"The distinguishing features of this operation are: First.-That the deep sutures draw in a straight line and a more secure coaptation of sur- faces is thereby obtained. Secondly.-The side cuts relieve traction by dividing the transverse perineal muscles as well as skin and fascia. T/zirdly. -Air is admitted freely to the wound, and 'poultic- ing' to a certain degree prevented.\" A REMEDY FOR WHOOPING-COUGH.-In twenty- five cases of whooping-cough, the author has been so exceedingly successful with his topical medica- tion, that he has no hesitation in recommending it very warmly to the profession. His remedy is the following powder: I. Quin Muriat., '.0 ; Ac. Salicyl., 2.0; Sacch. Alb., Sod. Bicarbon. aa, 0.5, (i gramme= 15 grains. See JOURNAL AND ExAM- INER,, February, 1877, p. 172.) This powder is applied to the affected larynx by means of a laryngeal insufflator; the insufflations are made twice daily, and the above quantity of the remedy will last ten days. Consequently, at each applica- tion, about 0.05 quinine and o.1 salicylic acid are used. The small dose of the powder being put in the open end of the insufflator, the patient is told to put out his tongue and to take a deep inspira- tion. At this very moment the tube of the insufflator is quickly put into the mouth far ewugh to get its curved end behind the epiglottis, and the powder is blown into the larynx. Although the children naturally struggled, they could be managed by one person who had them on his 1e and held their hands. Small children, of course' would not inspire just at the demand of the Su' geon, who then had to wait and watch for the desired moment to insufflate the powder. But, fo all this difficulty, the whole manipulation nev occupied more than three minutes. When the powder actually was blown into the larynx it caused an attack of suffocation, so that this phenorneloo may be taken for a proof of the successful 19 sufflation. The beneficial effect of the treatment noticed within one week by a decrease of the attacks in violence and frequency. The ti requiretl for a complete cure varied from one four weeks; in general older children and adule were cured more quickly than young childree And the writer thinks that the time necessary a cure could perhaps be essentially shortened more frequent insufflations of smaller doses, and improving upon the modus operandi.-ChieaO Med. Jour. SULPHUROUS AcID WASH AS AN ANTISEPTIC COUNTRY PRACTIcE.-Mr. John Balfour, strOn recommends (Edinburgh Medical Journal, Ma 1876,)sulphurous acid wash originally advised by Dr. Dewar, as a valuable antiseptic for the use O the country practitioner, who may be called 011 any moment to operate in slight cases without assistance, and to perform a capital operation such aid as may on the spur of the moment available. He says he has now used it \" for Il years with great satisfaction in all cases of factol accidents, cuts, and lately in a case of amputatioo at the shoulder-joint. In the proportion of one te twelve of water, I find that it at once allevie pain, minimizes suppuration, is easily applied' facilitates dressing the wound, while it costs alto nothing. When the fingers are the parts injuredje have a large teacup filled with the wash put bOy patient's side, and into this the injured part, Ce 0 ed with the thinnest rag to be had, is dipPedy often as desired. Should the injured part bert hand or any other part of the body, it is suppo on a pillow covered with gutta-percha tissue or skin, and the wash applied by means of a littlet which is allowed to remain in the cup.\"-Af' Med. Sciences. TREATMENT OF SUFFOCATIVE GOITRE 13Y JECTION OF IODINE OR THE USE OF SETo Mr. Lennox Browne, of London, advises stro5 against excision of the thyroid, which he raniks a highly dangerous operation, from the .t e which has been shown to be associated with ' 0 in such skilful hands as those of Dr. Watsol- C' finds that a much simpler procedure will bc cessful, cause the disappearance of the turo sif at worst only leave a slight scar; and he giyes tiI ab Set tir1 ter wh toc we el r eig bki tht 'y et 242 THE CANADA LANCET.",
         "mTTT' fi A ~T A T~ A T A ~TI1TI~fli .1. KiL ~J.LI.L~ liJJiI. liIiL'4 ~JL I. tsof his own in support of his statements. The of malaria, but the explanation was both interest- edi byr of iodine may be injected, as recommend- ing and simple. The various species of pine or abs .ucke, of Berne. In some cases it produces fir trees all secreted oils, which might be consider- setorption, and in others suppuration; when the ed as turpentine, and which, if allowed to remain lot, 1s used it is left in situ, so as to produce very in the tree, volatilised in great measure, and under- inve Suppuration. In one case where the tumor went oxidization in the atmosphere. In pursuing a\"g Ved the isthmus and left lobe of the thyroid, his investigations he found that when turpentine tctWas as large as an orange, injections of the was exposed to a current of air in the presence of tertautre of iodine were practised three times on al- water oxygen was absorbed, part of the oi resini- ,urate days, about thirty drops being used. Sup fied, and the rest was oxidised into a compound, ben011 was then invited by fomentations, and, unstable in the presence of water, and splitting up ere the abscess formed, two further injections thereby into peroxide of hydrogen and camphoric to 'niade into the side swellings. The discharge acid, the former of which had long been acknow- 'We Place spontaneously, and continued for four ledged to be one of the most powerful disinfec- Wou, Pledgets of lint being introduced into the tants known to chemists. The result of his ex- Ab ut, so that it might heal from the bottom. periments in the direction of the oxidation of tur- either ine months afterwards there was no sign pentine was the discovery of a solution which he wo r Of tumor or scar. In another case, a young had christened \"Sanitas,\" and which he claimed to largen aof twenty-two had a general fibrous en- possess a power of preservation and disinfection dificenlet of the thyroid, Swallowing had become superior to that of its own components taken ueioCt and breathing was embarrassed. An in- singly, and to that of any other known antiseptic kir oiodine was made at the first visit. Great or disinfectant, the presence of canphor and other less . as Occasioned, and the patient passed a sleep- bodies being conducive towards securing the d alght. On the next day a seton was introduc- result sought for. By a similar process Mr. Zuglei re ak retained one month, and the effect was and himself had also been able to prepare a blood the tu edlY beneficial, free discharges ensuing, and albumen of a whiteness and quality comparable ta Or diminishing in size most remarkedly. A egg albumen, the use of which would restore a 40 thi cater all discharge had ceased; there was large amount of food to the market. Tnis was the ere -ening perceptible, and the cicatrices were first instance on record in which a natural process p4ÞroPo1nts. Her general health had also much of atmospheric purification had been imitated to Ved. Mr. Brown has obtained very little perfection ; until, in fact, there could now be re- iht age from electrolysis in these cases. Of peated on a commercial scale, that which in pine enfitCases thus treated, one only obtained real and Eucalyptus forest constituted one of the most ends*the As auxiliary to the treatment he reconi- efficacious processes of nature's hygiene.-Med. d W e patients to finish up by a course of baths Press and Circular. r. aters at the Bromo-lodine Spa of Woodhull. of cas wn says it is dificult to say in which class THERAPEUTICS IN GREAT BRITAIN.-In review- setor dine is to be preferred and in which the ing a recently published treatise on the Theory and yspy When the tumor is substernal and causes Practise of Medicine, Dr. W. Bathurst Woodman, the ra ,it is the extension of the disease behind of England, says: \" As might be expected from tublCea and œsophagus that is the cause of the Dr. -'s antecedents, pathology and prophylaxis kre a.* These bronchocele are usually small, and are most carefully rendered and form a distinguish- 1y eIlbays fibrous. The cystic bronchocele rare- ing feature of the work. As in all modern works. ec. 3arasses the respiration.-Br. Med. Jour., on physic, the treatment of disease receives less , 1'876.--(Detroit Med. Review.) attention in this treatise than its diagnosis and a AN XT p - post-mortem phenomena. We think this is to be eetinW DISINFECTANT AND ANTISEPTIC.-At regretted on more grounds than one. The neglect Ont 9 8Of the Society of Arts on Thursday last of treatment on the part of orthodox practitioners d b8oe Processes of Nature's Hygiene \" was is the stronghold of quackery. The self-dubbed a Ž r. C. T. Kingzett, F.C.S. The paper Dr. Smellfungus, graduate of a college in nubibus, -Y nteresting one, and suggested impor- rovemlTents in the production of antiseptics, nts, and albumen of commerce. The researches had for their immediate object dation of the nature of the active princi- is formed when turpentine and other iststances underwent atmospheric oxida- 1Strating the results by certain chemical .t had been at first difficult to under- vilrtues of the Eucalyptus as a preventive sees a patient, relieves his pains, gives him tranquil nights, and at least a few days of enjoyable life, whilst the graduate in honours of the old and cele- brated universities, who is perhaps, in addition, Member or Fellow of the Royal College of Physi- cians or Surgeons, sends the patient away, or leaves him, after making an elaborate diagnosis, with some peppermint water, or some other equally futile pre- scription, which affords no relief either to his body or to his mind.",
         "244 THE CANADA LANCET. \" Dr. - 's book is no worse than some others in this matter. It is perhaps rather better. But unless something be done to advance the study of rational therapeutics, quackery must and will flourish on our island.\"-New Renedies. BROMIDE OF ARSENIC IN THE TREATMENT OF EPILEPSY.-Dr. Th. Clemens, of Frankfort-on-the Main, has employed bromide of arsenic for twenty years in the treatment of diseases of the nervous system, and especially of epilepsy, and claims that he has obtained astonishing results with it. He uses the liquor arsenic. bromat., and gives one or two drops in a glass of water once, or, if necessary, twice daily. These minute doses may be given for months and even years, without pro- ducing the usual unpleasant effects of a long continued arsenical course. All his cases of epilepsy have been markedly relieved and improved by this remedy, but in only two cases has it pro- duced a complete cure. In many cases of incura- ble epilepsy, complicated with idiocy and deformities of the skull, the fits were reduced in number from twenty in the twenty-four hours, to four or even two, a result that has been obtained by no other treatment. In connection with the bromide of arsenic, an almost exclusively meat diet is advised. The patients should be as much as possible in the open air in the daytime, and their windows be kept open at night. Unlike bromide of potassium, this remedy does not require to be given in increasing doses, and instead of interfering with digestion, improves the nutrition and strength. Dr. Clemens has employed the following formula since 1859, and thinks that it ought to replace Fowler's solution, which is irrational in its composition and uncertain in its action. This solution becomes stronger with time; the chemical union of the bromide with the arsen- iate of potash becoming more and more perfect.- R. Pulv. Arsenic, alb., Potassa. carb. c. tartar., aa dr. i.; coque cum aqua destil. lb. ss. ad solut. perfect. ; adde, aq. evaporat. restituta, aquæ distil. oz. xij., dem adde brom. pur. dr. ij., refrigerat. stet per sufficient. temp. ad. decol., S. liq. arsenic. bromat.-Alg. Med. Central-Zeitung, May 24th. was refused the operation, however bad the Po( nosis, provided the patient still wished to have last chance when the extra danger of ber case been fully explained to her. We believe these the best results yet published, either in hospita private practice ; and if there are any memberI the profession who still have doubts as to advisability of ovariotomy, we commend the cases to their consideration.-Med. Times \u0026' SUGGESTIONS FOR THE CURE OF ANEURIs1-\" Dr! Horace Dobell (British Medical ou makes the following original suggestions for safe and rapid cure of aneurism: \"Stop the culation above and below the aneurism, and 0 stitute for the fluid contents of the sac a substai insoluble in blood, solid at the temperature of t blood, fluid at a temperature low enough to al of its being safely brought into contact with li tissues, and changing from liquid to solid with fail and with great rapidity, and which at the time is light, innocuous, and unirritating.- these conditions are completely answered either spermaceti, melting at 120 deg., or stea melting at 130 deg.; and I submit to the coe eration of surgeons whether there is any practj reason why an aneurism should not have itsou contents withdrawn by an aspirator, andtw place filled by melted spermaceti or stearin. of these substances would so rapidly and per ently solidify en masse as to be absolutelY foi from the danger inseparable from either 'act or ' passive' clots being washed away whe w blood-current is again allowed to flow ; and t time occupied in their solidification would short as to remove all danger of damage arrested circulation in the parts below the anetliM I need scarcely add that the subsequent blOcki of the artery above and below the aneurista of course go on as usual.\"-Louisville Journal. DANGERS FROM SANTONINE.-In using s ine, it is well to bear in mind that comparatócV small doses have produced convulsions of a 50 what grave character ý-10 .lr c %ni àd lately reported a case in which poisonous e OvARIOTOMY AT THE SAMARITAN HosPITAL.- were produced in a child two years old, by the The year 1876 has been the most successful on gestion of so small a dose as a grain and a record at the Free Samaritan Hospital-the opera- Convulsions commenced in the face, and exte tion of ovariotomy having been performed fifty- to the extremities, while the respiratory actioi# five times with only five deaths. Forty of these greatly impeded. Under warm baths, eIer were performed by Mr. Spencer Wells, with four and artificial respiration, the patient recoteJ deaths; seven by Mr. Bantock, with one death; and The physician in charge of the case then ri si eight by Mr. Knowsley Thornton, without a death a series of experiments on the lower n W The fifty-five cases include many in which both found that chloral and other inhalations cOfl on ovaries were found diseased and removed ; and the convulsions produced by santoninIe. many of the operations were most formidable from naturally argues that the same treatment shot the extent and nature of the adhesions. No case pursued in the human subject when a Po50 in wbich the diagnosis of ovarian tumour was made 1 dose is taken.-Med. Press and Circular.",
         "THE CANAD £\u003c4\"ALATION OF IODINE.-Dr. Seguin remarks: eas leave to say, also, that for more than fifteen f4' usually prescribe the inhalation of iodine drs whose formulary may be found in many frrstores in this city. The most usual of these s being that of a pillow containing aromatic ts ay seaweed, black walnut or fern leaves, pili according to secondary indications. In this %a is introduced a little bag or satchel contain- S rach or so of iodine, in as much of bran rPevent the too rapid evaporation of the odirie .When the satchel does no more smell of el, tt is refilled, and when the pillow begins to herbs pus-like odor peculiar to those cases, the t at are also renewed. Let us remark en passant 8t e alteration of both is in proportion to the %d b f the affection. The pillow must be soft, 4o it ad enough for the head and chest to remain to be t during the night tossings. The urine has e cested for albumen duringithis treatment.\"- Rocord. ogfDICAL CURE FOR PILES.-Dr. A B. Bowen, Uf ;\u003ellketa, Iowa, writes: \"In a recent number tatr erd. my attention was directed to the ror th for nævus by hypodermic injection. fthe e similarity of the anatomical structure 14du 'enævus to hemorrhoidal tumors, I was bolic to try the remedy. In the latter I used tc acid and ergot (fluid extract) in equal tti? 'Jecting from ten to fifteen minims of the or into the spongy, vascular hemorrhoidal re 0qThis was repeated about once a week for e times when the tumor has entirely dis- ts ik' I have tried this in several cases, and e a specific.\"-Pacific Med. 8 Sur, Your. îj IVN~TION OF AFTER-PAINs.-Dr. Le Diber- de Gynecolog.) believes that ergot, suitably . .ed has the power of preventing after Ctli ae gives half a drachm in divided doses, teafter the expulsion of the placenta, with 0t Of bringing about a firm and consistent %Itrction of the uterus in place of the alternate Pkis re0fns and relaxations to which he says after- 1t 8 ame due. The Dublin Med. Press and Cire., th e - t1g upon this statement, calls attention IsP'rion of Sir Charles Locock, that after- f Wre due to the retention of coagula, and e teanual pressure upon the uterus to pro- P -s. rexpulsion was never followed by after- uthern Med. Record. do01isot . epIdcet. Is threatened with a severe small-pox ects, TO encourage re-vaccination among her 4s.hlhe Queen has caused all members cf her sed b to be re-vaccinated, and the fact to be ed by tbe press. A LANCET. INCREASE OR UREA BY EXERCISE.-Dr. Pavy, from observations on Weston during his pedestrian feats in London, has found that during muscular exercise there is an increase of urea excreted. This increase, however, is inadequate to account for the work done. It simply accounts for the wear of muscular tissue. The work done repre- sents the oxidation of carbo-hydrates and the pro- duction of carbonic acid and water. It will be re- membered that Dr. A. Flint, from observations on Weston, some years since, reached conclusions supporting the doctrine of Leibig, that force- muscular, nervous, etc., results from the disintegra- tion of the particular tissue in action. Flint and Pavy both found increase of urea during muscular exercise. The former maintained that this in- crease represented a force equal to the work per- formed ; the latter maintains that this increase only accounts for the wear of muscular tissue. From a careful study of both series of observations, we think that Pavy is correct.-Detroit Medical Jour- nal. LOCAL TREATMENT OF PUERPERAL FEVER.--- Dr. Fritsch, of Halle, strongly recommends the in- jection of large quantities of a carbolic acid solu- tion (2 or 3 per cent.), so as to thoroughly wash out the uterus and vagina, and to completely dis- tend the latter. To this end he throws in two, and sometimes three litres, i. e., from four to six pints, the temperature of the water being at 250 R. (89° Fahr.). The uterus, after a thorough cleansing out, need not be injected oftener than ihree times in the twenty four hours ; and after three or four days this need not be continued, but the cleansing and distension of the vagina must be repeated much more frequently and persisted in for a much longer time. Under this treatment not only are the local lesions soon ameliorated, but the febrile action, as indicated by the temperature-curves, abates. Prof. Schroder, on the reading of the paper, mentioned that Dr. Hildebrandt employed for injecting the vagina a glass tube, about as thick as a finger, each patient being provided with her own, which is broken on her recovery.-Med. Times and Gaz., Nov. 18, from Alg. Wien. Med. Zeitung, Oct. 24, 1876.-Ibid. SULPHITE OF SODA AS A DRESSING.-Dr. Min- nich, of the Venice Hospital, prefers the employ- ment of the sulphite of soda to carbolic or salicylic acid, not only as a dressing for wounds, but also in erysipelas. It is much less inconvenient to use, and much cheaper. He applies it in the same way as Prof. Lister does the carbolic acid, and the solution employed consists of one part of the sul- phite and one of glycerine to nine parts of water. Its beneficial effects have been proved in a great number of cases.-Med. Times and Gaz., Sept. 23, from Gaz. des HÔJ., Sept. 7.--Ibid. 245",
         "246 THE CANADA LANCET. CHOOSING A PHYSICIAN-\" To choose a phy- sician,\" as Lady Mountcashel has well remarked, \" one should be half a physician one's self; but as this is not the case with many, the best plan which a mother of a family can adopt is to select a man whose education bas been suitable to his profession, whose habits of life are such as prove that he continues to acquire both practical and theoretical knowledge, who is neither a bigot in old opinions nor an enthusiast in new; and, for many reasons, not the fashionable doctor of tlie day. A little at- tention in making the necessary enquiries will suffice to ascertain the requisites here specified; to which should be added what are usually found in medical men of real worth-those qualities which may serve to render him an agreeable companion ; for the family physician should always be the family friend.\" CLEOPATRA'S NEEDLE.-ThiS celebrated obelisk, which was many years ago presented to the Eng- lish nation, is about to be removed from the sands of Egypt and erected on the Thames Embankment. The expense of transportation will be borne, it is stated, by \"a distinguished and public-spirited surgeon,\" who does not wish his name made public till the work is accomplished. It is stated also that Mr. Erasmus Wilson is the public-spirited surgeon aforesaid. COURT APPOINTMENT.-The vacancy caused by the lamented death of Sir William Ferguson, Sergeant-Surgeon to the Queen, has been conferred on Sir James Paget, and the appointment of Sergeant-Surgeon Extraordinary to her Majesty has been given to Mr. Prescott G. Hewett, F. R. S., President of the Royal College of Surgeons; and Mr. J. Eric Erichsen, F.R.S., has been appointed Surgeon Extraordinary to her Majesty. EXTRACT OF LOGwOOD AS A DISINFECTANT.- H. Mallory, of Ohio, says, for twelve years I have used Extract of Logwood for a disinfectant and deodorizer in cancer. I use it in the follow- ing manner :-Powdered logwood and hog's lard, of each, two ounces. To be mixed and made into a pomade, spread on lint and applied to the slouching ulcer ; the effect is magical, all the odor will disappear in half an hour. The astringency of the logwood will suppress the discharge. No other known agent will fill the indications so well, and yet I have not found a single member of the pro- fession who had any knowledge of the agent until I suggested it. Will some of your numerous read- ers give it a trial and report the results. Dr. Warlomont, of Brussels, states that, out of more than ten thousand children vaccinated with ¿nimal virus, not one was attacked with small-pox during the severe epidemic of 1870. NEW INSTRUMENT IN DIAGNOsIs.-Dr. Ed Holden, of Newark, introduces in the NeW Medical Record a new instrument for the early tection of disease of the lungs when the symlPtov may be shown. It consists of a soft rubber t'l 58 of an inch in internal diameter and two long, with simple end pieces of thin metal. blown into with a little force a rushing n produced at its extremity. Forced inspirat' gives the same sound. The ear of the physici being applied to the chest, the patient is direct to respire through the tube. The respiratory j mur is singularly magnified. The exaggeration the internal sounds in their persons is such K comparison of the two sides is necessary tO vent misinterpretation. Local consideratiolS sound cavities are easily detected. The iJ ment is called a \" resonator.\" TREATMENT OF SCABIES BY CARBOLIC SOAF, During the past six years, Dr. BuchanafrI Chatham, has been treating patients in the. ge way Union Hospital, suffering from scabies,î1Ite following manner. The clothing is disinfedh The patient is put into a hot bath, and thoroughly soaped with carbolic soap (I t6 the lather being allowed to remain on for a q e of an hour ; at the expiration of this timje, 00 washed off and the patient thoroughly dried 1 application is often sufficient to destroy the a but generally it takes three washings to effect cure. In private practice, this treatment la preferable to the old one by compound sur ointment, that remedy being almost as offenis the disease. NEW THERMO-CAUTERY.-Dr. Paquelin cet, January 20) has devised a new appa for thermo-cautery, which is simple, handy aJlaô ficient. It consists of a hollow handle, inS with wood to protect the hands from the heat is furnished with movable platinum heads, Cie ponding in form to the cautery irons found ge0e ly useful. Into these cauteries, which are ho after they have been heated to blackness I flame of a spirit lamp, a blast of benzoline Va? introduced by means of an ordinary spray be which at once raises to and maintains thef r state of vivid incandescence. The heat thW #t duced can be kept up for an indefinite ti slightly compressing the bellows occasion Med. Record. The gathering of the profession at bo Station on Wednesday evening last to do hOtb to the remains of Sir William Ferguson 011 transmission for entombment in Scotland ias ¢ l large-estimated from 1,500 to 2,o Th also a strong contingent of students chieflY men. c c t t 246 THE CANADA LANCET.",
         "THE CANADA LANCET. 247 HE CANADA LANCET. lnthly Journal of Medical and Surgical Science 18Ued.Promptly on the First of each Month. ei4 Omunications solicited on all Medical and Sci- C ei 8ubJects, and also Reports of Cases occurrinj in tap»1 el- Advertisemtents inserted on the most liberal to AUl Letters and Communications to be addre8sed e 7ditor Canada Laneet,\" 'Toronto. AWSoN BRos., Montreal ; J. \u0026 A. MCMILLAN, St. John. J . BALDWIN, 80.5 Broadway, New York, and BALLIERE, q)Li \u0026COX, 20 Kig William street, Strand, London, England. TORONTO, APRIL 1, 1877. HUNTERIAN ORATION. a recent English exchange we noticed an hccUnt of a large and brilliant assembly that horured the members of the Royal College of ýt1reons with their company during the delivery of the iltnterian Oration by Sir James Paget. The theaitre of the college was overcrowded long before del. ite when the oration was announced to be o red, and among the visitors were the Prince iWales, the Duke of Argyle, the Duke of West- doSter, Mr. Gladstone, M. P., the Bishop of Lon- u\", Dean Stanley, Sir William Gull, Professor Acland, Professor Huxley, Professor Tyndall, Barry, \u0026c., \u0026c. Upon the entrance of his aUighness with the President of the College, a rescott Hewitt, the whole assemblage rose warnly cheered, and when Sir James Paget fe.ered the cheers were renewed. Sir James, be- '\u003ci commencing the oration on Hunter, said denta ýit please your Royal Highness, Mr. Presi- tt MY Lords and gentlemen, I have no doubt the members of this College of Surgeons and ry frupany present, will feel with me that it is srst duty to offer to your Royal Highness our hs thanks for your presence to-day. In thus the memory of John Hunter your beial Iighness makes us more than ever proud of eiore guardians of his museum and reputation ; tic than ever anxious to promote the true scien- fosurgery of which we reverence him as the Ser and we shall venture to believe that your le e forghness approves the efforts of this Col- the 5 the public welfare ; for the promotion of tio lnCe by the cultivation of which our reputa- grofnd usefulness are maintained-on all these s, and on many others that need not be told to-day, we venture to tender your Royal Highness our very respectful and grateful thanks.\" Sir James then proceeded with his oration, and in commencing said that when he was favoured by his colleagues on the council of the College with the request to deliver the oration, he thought it right to study afresh the character of John Hunter, chiefly to sec what were his motives in entering upon the work of his life, what his method of work, and to note some of the achievements to be read in the story of his life. The motives that first urged John Hunter. to be- come a student in the ranks of scientific investiga- tion were the necessities of earning his livelihood. He was the son of a Scotch farmer, and up to nearly the age of twenty years, he had shewn no inclination to follow any kind of study. At about the age of 17 it was proposed that he should be- come a cabinet maker, but the relative to whorn it was proposed could not take him, or a cabinet maker he would probably have been, and his brother William being then a prosperous anatomist in London, John offered to assist him in dissection, with the proposal that he should go into -the army, if he failed in this task. Thus from mere idleness, and by chance, John Hunter drifted into the career in which he was to become the greatest among the great, and the most renowned among the renowned men of the science. It was most remarkable that, with so vigorous a mind, John Hunter should not have felt and displayed in his younger days something of its power. He did not live in darkness, for his father was a shrewd man, his mother was an intelligent woman, his brother was a gifted man, and he had lived ail his life up to the time he came to London, amid some of the greatest wonders of the organic world; but he passed everything by unheeded, until he came into the presence of men of science, when he found in his brother's work, the study for which he felt naturally fit. He first came to London in the year 1748, and his brother William was then a very keen observer of nature, a laborious collector, the first teacher of anatomy, and the founder of a school, second only to that of his brother John. Coming from a Scotch farm to London was to John Hunter like being born into a new world. He had a natural fitness for the study of living things, and this fitness was wholly intellectual; but he had no motive power until he had set to work, and then THE CANADA LANCET. 247",
         "248 THE CANADA LANCET. his desire for knowledge gradually became an in- for he was a comparative anatomist of the highes' satiable passion, and then he became possessed of order, one of the best physiologists, and a great a passion for collecting-a natural instinct for col- practical surgeon, a surgeon of one of the larg lecting and keeping-and his first great ambition hospitals of London, and enjoying too a large prac' was to have a great museum. He collected a vast tice. In all he did he was successful, and he PU' number of things which must have been entirely sued no study the area of which he did not enlarge, useless to him, works of art, stuffed beasts and and in which he did not leave newfacts upon record- birds, until his house in Earl's Court must have In harmony with the character of Hunter's wore looked like a huge curiosity shop. No man of was its simplicity, in the accumulation of facts an science ever restricted himself in collecting, and the building of them up. He was a man who kne* this extensive collecting'led John Hunter to a nothing of logic, he worked with all his mind, but wider a-nd de eper range of knowledge, led to, his without art. His was a living force. He was gathering around him the collection in that college, only a great discover, but an accurate one. t a collection which formed the greatest and best would indeed be difficult to find an inaccuracY 10 museum of anatomy in the world. Another mo- Hunter's facts, and if there were any inaccuraciO tive now pressed John Hunter forward in pursuit they would be of reasoning, not of facts. Whenl be of a scientific life, beyond that which had caused generalized he gave the equivalent of-I believe him to enter that life. He was now master of all but he never added to that by the force of his o1 the arts in surgery, and he felt impelled outwards opinion, for he knew that strong conclusions wef in a scientific career which he pursued with purity altogether apart from true scientific knowledge of life. He subordinated all things to study, and He used to say to his pupils : \" Don't take notes 0 with a constant presentation of new objects, he this; I dare say I shall change it before next year became an ardent lover of nature. In him nature speaking on a matter still under investigatioo' inspired no poetry, as in many men ; he had a Hunter was slow in publishing. He was f0 social love for nature, and bis chief love was for three years of age before he published his the stores of truth which were hidden behind the work, that on \"Teeth \"; and his great workon \"4bC veil of nature. To him the evidences of design Blood,\" at which he might have worked for fol1 in nature were clear, and the infinite variety of years, beginning at his first studies, he only be forms in which nature was presented, added fresh to print at the time he died. His patience motives to his study. Passing on then, to speak of only equal to bis caution, and although he some of his characteristics, the orator said that the aware that he was in danger of sudden death, first thing that struck one was, the vast quantity of he would stand as Abernethy had recorded of hie work Hunter did. engaged for hours on a single dissection, watch It was recorded of him by one of bis pupils, and patient for the truth to come and to clear t that he rose with the dawn of day, and allowed some mental cloud. The character of John Hunte himself only four hours sleep ; by another, that he was one of strong will, combined with strong made an appointment at four o'clock in the of truth. If there was one kind of truth that b morning. These were Hunter's habits for the loved best, it was that which could be ascertaine4 last thirty years of his life. Then his amuse- His chief renown in surgery was as the founider ments were what most men would call work. He scientific surgery. There had been excellent s said, \" I will amuse myself with bees,\" and bis essay geons before him; but surgery as a science sto taken even at the present time, was almost fault- by itself and had little connexion with nedic1io less. In his investigations regarding the develop- Between the two was Physiology, and ment of the embryo in birds, he watched almost brought the scientific method into practice hourly for a long continued time a flock of geese surgery, welding the lessons of science With which he kept, and the result of bis studies in this lessons of experience-with bis mind he plauo particular, were fot well-known until many years with bis hands he did the work, and he left beCh after bis death. The range of bis work came up to him untold facts, illustrative of is thoughtsc he devoted to it, and neyer before or since actions. He was very cautious in making d the time a det i w a r e o s . tions, for he knew the danger of reasoning was there a student in s0 wide a range of science, physiology into practical surgery.",
         "THE CANADA LANCET. 249 is teaching was, that we should néver reason expect to make some very rapid strides in the then general principles, ]et alone practice from treatment of mental derangements in the near his p and it was an instance of the wisdom of future. While Dr. Ponza in Europe has been con- Principles in this respect, that it was difflcult ducting experiments of this kind with encouraging to dicyover in his surgical work that he was at all results, it is announced by the American press that thysioogist. Sir James touched upon nunerous about eight years ago, the suggestions recently folhr subjects, inter alla, tying the common femoral made to Dr. Ponza by the great Roman astrono- S eurism-.but want of space must prevent us mer Padre Secchi, had been made by General giving further extracts from this able essay. Pleasanton, of Philadelphia, U. S., who had tried _ _ the experiments of mixed white and blue light in the construction of his grapery with marked re- \"-ORED LIGHT IN THE TREATMENT sults. Its good effect upon the development of OF DISEASE. , plants, had been proven by manv others to whom T it was recommended by the General, and its influ- drae attention of the profession has lately been ence being so remarkable, he next determined ex- feren to the consideration of the influence of dif- periments upon animals prior to trying its influence eent Coored rays of light in the treatment of upon the human family. Qelntal and bodily derangements. The experiments upon animals with mixed rays Sinlight consists, as is well known, of three of light were to secure more rapid and perfect de- h arY colors red, blue and yellow, each of which velopment. Pigs weighed heavier, calves grew more The distinct and characteristic properties. rapidly and matured more quickly, and broods of b Wl rays give us light; the red, heat, and chickens showed more rapid development, in- der hee, actinic or chemical influence. It is un- crease of strength and activity. tVege influence of this ray that germination and Satisfied by experiment, of the stimulating influ- to teri life is sustained, as seeds are found not ence of mixed blue and white light upon plants oerb ate under the influence of light deprived and lower animals, General Pleasanton appears to a ded blutie ray. From a consideration of this fact, have directed his attention next to experiments of the uction has been made by certain observers in this kind on invalids, and tried to induce hospital e aratter of the treatment of diseases of a germinal attendants to make experiments with the sick un- br. p * .der their charge, but without success, the uniform , haonza, director of the lunatic asylum at answer being Quidquid innovare nolumus. Ex- e as been making experiments at the sug- periments were made, however, in private houses ti 1 Of Padre Secchi with a view to test the ac- and among friends with satisfactory resuits, and a g certain colored lights upon patients suffer- brochure upon the subject is expected from the pen Ly th mental alienation. The results attained of General Pleasanton. bese of the blue and red lights were remark- In an article which appeared recently in an the former quieting and soothing the patients American paper, numerous facts are given which 0lenmc m condition, and the red exciting to point to the beneficial action of colored light in de- r tIn this connection it is not a little re- bility, nervous exhaustion, and in mental derange- e brie that red colors have the effect of exciting ments. steair, anmals into a frenzy of rage, as has often Thus far, however, on this continent, no attempts er P nnthe action of red sashes and shawls have as yet been made in the treatment of mental e Wpos bulls ; also in the case of the male or bodily ailments by this system, or by the use of Whose ire is at once aroused by the ap- of colored lights as an adjuvant to other treatment ýrhe Of a child or other person in red apparel. by scientific men, but experiments of this kind are actounts received of Dr. Ponza's experi- expected, for the results of which we look forward abl t eir results, are not sufficiently full to with some interest. ever, tO judge of the matter. It is believed, In England happy results in the treatment of , be bornshould the results attained by Dr. small-pox \"for the prevention of pitting,\" have e out by future experiments, we may . been attained in this way, but here the blue ray-",
         "250 THE CANADA LANCET. so rich in its stimulating influence on the growth of mon observation. It is well known that delic- bodies--has been found prejudicial as favouring \"pit- persons have better health when occupying apae ting.\" For the benefit of our readers, we give ments on the south side of the house, and childre verbatim a statement of the results of experiments thrive better when their nursery and playroonms ao made in this direction as given in an English paper flooded with plenty of warm sunshine. It is aso as being, at least, suggestive in their character, and a notable fact that in school-rooms and colleg9 therefore worthy of perusal and consideration by which are lighted from the south, the children ar those of our profession likely to be placed in charge brighter, healthier and make better progress in thea of patients suffering from this loathsome disease:-_ studies than a similar class of scholars pent UP '0 \" May I be permitted to say, and give my reason cold, shady class-rooms looking north, into whic for sayng, that \"pitting,\" the sad and permanent the sunshine never enters. result of small-pox, ought rarely to be seen in any We trust that some of our Canadian professiO civilized country-or, at least, in any country pos- may be found ready to test the efficacy of colOr sessing an advanced knowledge of natural science. light in detail in our hospitals and asylums, Wh Three things are facts. First, that poor people are \"pitted\" least, higher class people are \"pitted \" only such experiments can be satisfactorily coo' most, and no class of people are \" pitted \" under ducted. On a future occasion we may have sOIC' their dress. Poor people have less light in their thing to say upon the merits of this plan of treo homes, the higher class and patients in hospitals ing disease. have plenty of light, and under the dress there is less light than in either case. In the ratio of light is the ratio of pitting. . . . . It is the actinic influence of the blue rays which, causes \" pitting.\" Yellow blinds drawn over windows will absorb ail UNIVERSITY AFFILIATION. the actinic rays.\"' AI Of course the above is from an unprofessional contributor, and may not be regarded as authori- tative, but it must be remembered that from the peasants of .Gottingen, and later from the milk Aerds of the midland counties of England, the sugges- tions as to the protective virtue of vaccina were first drawn. Common observation goes to show that children and weak people thrive better in the sunlight. Bedrooms, nursery and sitting-room, or those in which the greatest portion of time is spent, should be on the south and eastern aspect of the building, so that the morning and noonday rays of the sun may shine into the apartment. This should be particularly observed and carried out in the case of persons afflicted with rheumatism. Sun- baths are also valuable aids in the treatment of sorne forms of disease occurring in delicate women and children. In some instances sand-heaps have been arranged under glass shades, very much like hotbeds or graperies, in which delicate persons are allowed to bask for a short time daily. It is'stated on the authority of Sir James Wylie, that the cases of disease on the dark side of an extensive barrack at St. Petersburg have been uni- formly for many years in the proportion of three to one, to those on the side exposed to strong light.\" This statement is in strict accordance with com- l lie question or u niversity affiliation still attr- a considerable share of public attention. Oldright is out with a flysheet on the subject, 0 paragraph of which is worth reproducing a specimen of the kind of policy he and his frieP'i would force upon the country. Speaking Of the number of students who graduated in medicine Trinity College last year he says \" why should 0 the Legislature, the Nation adopt such a policy would have obliged Trinity Medical SchoO\" send those whole 18 men up to strengthen National University\"? We can tel] Dr. O., hO ever, that whatever respect they may have the National University, the young men of On are not to be coerced in these matters. The members of the Senate of the State versity who have been instrumental in raisi this controversy, feel by this time that they placed themselves in a false position, and ' no doubt, be glad of some pretext to cover tP inglorious retreat. It must be apparent to al. their position is untenable. The Legislature the country will insist upon the Provincial versity being open to ail students, no matter W they have been educated, nor of what otherO versity or Universities they are under-grad The Senate of Toronto University will be very plainly that it has nothing on earth to",
         "THE CANADA LANCET. 251 bthe status of students of other universities. doned, owing to the relative feebleness and uncer- tsoim, is to determine the curriculum fron tainty of its action.\" To these medical conclu- e t time, appoint examiners in the different sions the experience of a wise nurse adds: \"No ties and confer degrees and honors upon patient who can positively be removed should Young nan who wishes then, s long as he spend night and day in the same apartment. One r5m to its curriculum and passes a satisfac- room may be thoroughly ventilated while the other e'aiain The Senate will find plenty to is occupied.Maynpnshndrcitad Vg thin its own legitimate sphere, without attack- other articles which are sent to the wash-tub, t iter institutions engaged in similar work. should go into the fire. Every particle of foui ti cu its own house in order by increasing matter should be instantly removed from the sick *Iculum and raising the standard of educa- room and all scraps of food should be at once taken et here is much need of improvement in that away when the patient has finished his meal.k enCt The standard is at present, and has t 8 several years, much below that of some of THE APPLICATION NITRATE F SILVER TO i erled rival Universities. Then may Toronto ULCERS.Dr. James Cuthil says (Edin. Med. laersit, expect to reap some advantage from L tin, and draw to herself many young men 7ournal) that, when solid nitrate of silver is freely QZ% be proud to acknowledge her as their applied to an ulcer, a tough film is immediately . formed, and the ulcerated surface is for the time the tater. We stil have every confidence being apparently sealed up. The benefit to be Soate as a whole, and when the isubject derived from such a proceeding, however, as most Corbst be thoroughîy understood in ail its bear- surgeons who have seen a little practice well know done ae discuit hehigas tkng ple is only temporary, the pellicle becoming detached e r The discussion which has taken place has by the ulcerative process, leaving a sore frequently e o tgrat deal in awakening an interest i larger than the original one. A better plan, which oo 00d results. he has practised in some cases with excellent results, is merely to score the ulcer with a finely- pointed pencil of the nitrate, or only to dot it lightly at intervals on the surface. The discharges re CTIoN.-An English exchange says : getting free vent from the non-causticated points; e of the medical officers of the Privy no sloughing occurs, and a healthy pellicle spreads edit d Local Government Board throws from the touched portions, just 'as ice forms on a SUpon popular notions of disinfection.\" pond of water. onclusion reached is that the aerial disin- er as comonly practised in the sick room, DEATHS FROM SMALL-POX IN MONTREAL.-- te less or positively objectionable owing Deaths from small-pox from 14th January to March Se ense of security it is calculated to 3rd, 1877 (exclusive of city hospitals) were 173. T anake the air of a room smell strongly Of these 15 were vaccinated, 57 were unknown and tebOlic acid by scattering carbolic powder doubtful, and ior unvaccinated; 27 refused vac- e -1to a001, or of chlorine by placing a tray of cination from the public vaccinators. Nationality: o f lime in a corner, so far as the destruc- French-Canadians, 156. British Canadians, 14; PtPecif contagion is concerned, is an utter- English, i ; Irish, i; United States, I. Sex-84 oents r ing. The practical result of ex- males, 89 females. No death from this disease e goied to prove that dry heat, when it can has taken place where vaccination has been made 4t ld Il the most efficient of all disinfectants; by the public vaccinators, nor has anyone died OPlan of stopping up crevices, and who has been re-vaccinated. This report was 4*ith suiphur and charcoal, is more effi- furnished by Health Officer Radford. anY other proceeding with more The above accords with the following from the foriuifctaits ; and that the use of carbolic Londen Lauet, July 27th: \" The Registrar-General di8fecting purposes should be aban- calculates that but one death from small-pox was",
         "2r2 TUE CANADA LANCET. registered last week among 114,000 vaccinated the operation, and the patient made a safe e persons, whereas the proportion among the unvac- The excision of the femoral vessels without cOg cinated was one death in every 7,000 persons.\" quent gangrene is an important fact. A FAREWELL COMPLIMENT.-At a meeting of COLLEGE OF PHYSICIANS AND SURGEONS, medical men held i1 this city on the 6th ult., STON.-The examination in connection with for the purpose of bidd ng farewell to our fellow above college, was finished on the 22nd ult. citizen, Dr. W. F. Coleman, who is abDut to remove following is the list :-Finals-Messrs. L. to St. John, N. B., it was unanimously resolved: Miller, E. M. Higgins, S. S. Scovel, D Phe* -\"That we embrace this opportunity of expressing T. Dumble, H. Hubbs, Jonathan Day, A. our regret at parting with our esteemed friend and gan, M. C. McNicol, G. Bowan, F. L o. professional brother, Dr. Coleman of placing on Hospitals-Messrs. W. B. Kennedy and Clinto record our high esteem for him, and our apprecia- Pro-dissectors-Messrs. T McArthur, B.A., tion of his professional attainments and social Dennis Lynch. Primar -Messrs. T. qualities ; and of wishing him every success in his Kidd, Lewis and Evans. future field of labor, where we feel assured that he A~ REMEDY FOR WHOOPING-COUGH.--Dr. sJeediy establish himself and make many N h) re friends. inski (Deutsche Med. Nochensahr), re¢ mends the following as a topical applic IMPROVEMENTS IN THE MONTREAL GENERAL in whooping-cough. IL Quin. Mur. grs. xv., HOSPITAL.--The recent improvements in the Mon- Salicyl, grs. xxx., Sacchar Alb. Sod. Bicarb treal General Hospital will greatly increase the grs. viii, to be made into 20 powders; t usefulness of this institution. In the new basement applied to the lungs by means of a larynge are the kitchen, milkroom, laundry, the servant's sufflator twice or thrice daily. The bene dining-rooms, \u0026c. To the rear of the Hospital effect of the treatment was noticed withil and in the range are located the surgery, the dis- week after it was commenced, and a cure pensary, waiting, consulting and medicinal store- effected in a short time. rooms. All the passages in the basement are o JODINE STAINS.-The stain caused by tbe concrete and well lighted. The private wards are ternal application of iodine may be removed by ncreased in size, and present a light and comfort- tlo tion of idi mals reove able appearance. The operating theatre and lecture color of tincture of iodine without destrOYlî% room, which for a long time was sadly in want of therapoftictreofioud some alteration for the comfort and accommoda. peutic pp tion of medical students has been greatly improved. AN EXPLANATION.1n regard to th Ail the improvements have been carried on with treatment of Dr. Jenks, of Detroit refer\" an eye to economy, comfort and usefulness. in our last issue, it is due to Dr. Danie President of the Ontario Medical Council, t1 REMOVAL OF A LARGE TUMOR OF THE THIGH.-- that he was fot the member of the We have received a short account, with photograph, luded to. Dr. Clark had no part nor lot of a large tumor of the thigh, removed by Prof. matter, in fact knew nothing about it Ulti' McLean, of Ann Arbor, Mich., on the 7th of time after its alieged occurrence. February last. The patient, a widow, was about 43 years of age. The tumor, which was on the PROFESSIONAL.-The medical men If' left thigh, extended from Pouparts ligament to within four inches of the knee. It measured 36 inches in circumference, and weighed 14 lbs. The femoral vessels passed through the tumor, and were excised along with it from, Poupart's ligament to Hunters canal. Eighteen ligatures were applied the last of which came away on the r i th day after purpose entertaining their fellow-practitiO\"ners are members of Parliament, at a dinner,.on the 2nd of April. Sir Hugh Allan has been advised that the Cr lation respecting surgeons with degrees -fr nadian colleges not serving on board shiP9 ing the British flag has been rescinded.",
         "oV coog hti to¢ t o 0 t\"' of group W De Wilde, E. gner, Charles A. F. A. GENTH. [Signature of the Judge.] of fudges.-J. Lawrence Paterno, F. Kuhlman, Dr. Joy, J. W. Mallet. TIER, SON \u0026 Co.-This is the name of a wholesale drug firm recently established in an1 this city. The premises which are aIch capacious, are situated at 102 Front St. chinery required in the business is run by They are now prepared to manufacture, ds o sugar-coated pills equal to. anything of ra*nany part of the world. Pharmaceutical satl0n of all kinds such as extracts, elixirs, tictures, alkaloids, \u0026c., will receive spe- tteition. It is the intention of the firm to. eanfladian roots and herbs instead of import- en frorm the United States. The Podophyl- Ot to be obtained in Canada is equal, if not e tf any other, and why not utilize it. - The 'e Of this enterprising firm is one whose im- ce can not be overrated, as- it promises not ýO flrish retail chemists with artici es o edarlufacture which they have hitherto been td ofto .import, but to build up an export t 'f Canadian products that have hitherto 1red to go almost entirely to waste. pag the Hunterian Oration delivered by Sir enst ifn the theatre of the Royal College leos of England last week, it is computed east a couple of hundred were unable to S e ittance; whilst to those who were for- b fLOugh to get inside it was an uncomfort- SQ Li à%,%-- THE CANA] sO MESSRS. BILLINGS, CLAPP, \u0026 Co. product The undersigned, having examined the t s a herein described, respectfully recommend o fl' to the United States Centennial Commis- or AWard, for the following reasons, namely: carbo fine display of Chemicals, esecially hi de Acid, Propylamine (Trimethylamine), itde f Propylamine, and also of Pharma- QQinaia Chemicals, such as Citrates of Iron and t Io Citrates of Iron and Manganese, Ci- 0fo Bimuth and Ammonium, Pyrophosphate Bromide of Potassium, Bromide of Am- C Chromic Acid, Valerianic Acid, and Others. Commended for fine display and Of Chemicals. )A LANCET. 253 OBITUARY.-Dr. Hamilton, of Dundas, the subject of this obituary, was born in Lanarkshire, Scotland, in 1797. He was educated in Edin- burgh University and receiveu is diploma from the Royal College of Surgeons, Edin., in 1816. In 1818 he came to Canada, and after visiting different parts of the country finally settled in West Flamboro', where he died. Dr. Ham Iton held a very high position in his profession, and was one of the most prominent men in his locality for many years. He took an active part in rail- way matters, having been at one time a director of the Great Western Railway, and up to his death was one of the consulting physicians for the com- pany. He was also vice-president of the Canada Life Insurance Co., and held many other positions of trust. In politics he was conservative and once contested the county of Grey for parliamentary honors, but was defeated by Mr. Hogan, who was robbed and murdered on the Don bridge, Toronto. He was the recipient of many handsome testi- monals from his fellow-citizens, for the eminent services he had rendered then in different situa- tions. From 1869 to '72, he held the position of member of the Medical Council of Ontario, and will be remembered as having a kindly, social, and genial nature, which endeared him to all those with whom he came in contact. One of his sons, Dr. A. W. Hamilton, of Melbourne, Que., died about a year ago, and now he himself has gone to his grave full of years and honors, res- pected and revered by all who knew him. He leaves a wife and family of two sons and three daughters. At a special meeting of the Hamiltpn Medical and Surgical Society, which was held on the 3rd ult., the following resolutions of regret and sym- pathy were unanimously concurred in by the mem- bers present:- Moved by Dr. Rosebrugh, seconded by Dr. Case: --\"That the members of the Hamilton Medicaland 3urgicalSociety, having heard of the deceaseof theii ate brother, Dr. Hamilton, of Flamboro', desire to express their great regret at the loss which the pro- ession and the community have sustained by the death of one who has been so long a faithful and vorthy practitioner and a useful citizen ;\" That this ociety tender their sincere sympathies to the ereaved family of our brother ;\" \" That this ociety do attend in a body the funeral of our",
         "r o p S m w re B of for Fr 12 to ta An rep tha aut tha side nuir tion 254 TRE CANADA LANCET. deceased brother,\" and pthat the Secretary be of the population. The city was entirely exC0lP instructed to forward a cop of these resolutions frm any epidemic diseases during 1876. A ta the family of the deceased, and also a copy for cases of small-pox appeared in the early party publication.\" the year, but were prevented from spreading bI We feel the deepest regret in noticing the death prompt action. of Dr. McCol, Who was an intimate personal APPOINTMENT.-Denis Nunan, M.D., of GuelP friend. J-e was a man of rare talents, of a kind to be an AssociatConefrheouyofwl and amiable disposition, and gave promise of a lington. te Coroner, for the County of long life of usefulness. He graduated in Trinity ngo College, in 1871, and has practiced in Wallace- COLLEGE OF PHYSICIANS AND SURGEONS, town since that time, with marked success. -The professional examination in the aboyt college will take place in Toronto and Kingsto\" PERSONALS.-Dr. G. S. Ryerson, of Trinity Med- commencing on Tuesday, the roth inst. ee cal College, Toronto, lately obtained the L.R.C.P. matriculation examination will take place 011 oe sr S., Edin., and has since been appointed clinical 3rd. ssistant to Mr. Soelberg Wells, at the Moorfield A SAD CASE.-WC regret to learn that Drpthalmic Hosptal. McGeachy, of lona, who had the misfortufe to Dr. C. S. Murray, L.R.C.P., Edinburgh, bas get his hands frozen during a cold night last wifl eturned to Toronto after four years study of his while on a visit to a patient in the countrYp asi rofession, at the Medical Schools and Hospitaîs lost ail the fingers of bath ands. f London and Edinburgh. He has commenced The f g of ot hands. ractice in Toronto. The new building of New York Hospita NTICE .- b Toronto anni5th Street, was opened with great ceremolyo0 NOTIÇE.-We beg ta announce that detective the i 6th uit. It is tbe largest and best Pi-*w mith is not our agent. Those who have paid himt Hospital in existence at present. Ail the oi oney on our account will please communicate colleges are equay represented on its actin ith us at once, stating amount paid and date of ceipt. paeo !\u003c-port% id IOtitfep. In Toronto, on the 7th uIt., M. E. Hodde0 TOLEDO BOARD 0F HEALTH. of Dr. E. M. Hodder, to Minnie Frederika, daughter of Dr. A. M. Ross, ail of Toronto. The regular. monthly meeting of the Toledo On the a2nd uIt., B. Walden, Esq., M.P.1 ard of Health, was eld on the xst Friday Kincardine, to Miss Ettie, only daughter of Februa\u003eP 187'7. The total number of deaths Kennedy, Esq., of Delaware. January were 42 ; so males and s, females. At Beaverton, on the 7tb uIt., Charles T om zymotic causes, 9; constitutional, 8; local, M.D. of Georgina, to An, daughter of.Cae ; developmental, 13 ; under one year, za; o.e Robert Johnston, Esq., of Beaverton. five 6; five to ten, 3; ten to twenty, 2; twenty nraty, 7; fOrtY ta aixty, 6; sixty and upwards, 8. At Springhiî, Flamboro' West, on the rs nual ratio per 1000 inbabitantsi zo.8o. lames Hamilton, M. D., in tbe 8oth yeaS f )r. Fisher, Health Officer, presented his annual age. ort for 1876. In his general remarks he stated At Wallacetown, on the 4tb uit., Daniel t the normal death rate as fixed by the highest Coll, M. D., in the 35th year of his age.l horities is 17 in every rooo inhabitants, and At Ottawa, on the yth uit.\u003e Dr. Beaubie , t the death rate for Toledo in 1876 was con- denly of heart disease. rably below, being about 14.80. The total ber of deatbs amounted to 740 in a popula- * Tle cAargefor notice o/ BirtAs, Ma n isfifty cents, whoee should beforwarded in Pstagt of aoutSoooor ne eat toevey 6.56 Witte communication rit 4 t4i",
         "THE CANADA LANCET. 9 PURE COD-LIVER OIL, Manufactured on the Sea-Shore, by HAZARD \u0026 CASWELL, from Fresh and Selected Livera. The universal demand for Cod-Liver void of color odor, and flavor-having a Oit that can be depended upon as strictly r bland, fish-like, and, to most persons, not pure and scientifically prepared, having unpleasant taste. It is so sweet and pure been long felt by the Medical Profession that it can be retained by the stomach we were induced to undertake its manu- when other kinds fait, and patients soon facture at the Fishing Stations, where the become fond of it. fish are brought to land every few bours, The secret of making good Cod-Liver and the Livers consequently are in great Oit lies in the proper application of the perfc tion. proper degree of beat; too much or too This Oil is manufactured by us on the little will seriously injure the quality. sea-shore, with the greatest care, from Great attention to cleanliness is abso- fresh, bealthy Livers, of the Cod only, lutely necessary to produce sweet Cod- without the aid of any chemicals, by the Liver Oit. The rancid Oi found in the simplest process and lowest temperature marketisthemake of manufacturers who by which the Oil can be separated from are careless about these matters. the cells of the Livers. It is nearly de- Prof. Parker. of New York, says: \"I have tried almost every other manufacturer's Oit, and give yours the decided preferene e Prof. Hays, State Assayer of Massachusetts, after a full analysis of it, says : \"It is the best for foreign or domestic use.\" After years of experimenting, the Medical Profession of Europe and America, who have studied the effects of different Cod Liver Oits, have unanimously decided the light straw-colored Cod-Liver Oit to be far superior te any of the brown Oils. The Three Best Tonics of the Pharmacopœia: IRON-PHOSPHORUS-CALISAYA. CASWELL, HAZARD \u0026 Ce. also cati the attention of the Profession to their preparation of the above estimable Tonics, as combined in their elegant and palatable Ferro-Phosphorated Elixir of Calisaya Bark. a combination Of the Pyrophosphate of Iron and Caàlisaya never before attained, in which the nauseous inkiless of the Iron and astringency of the Calisaya are over- come, without any injury to their active tonic principles, and blended into a beautifut Amber-colored CordIal, delicious te the taste and acceptable to the most delicate stomach. This preparation is made directly from the ROYAL CALIMAYA BAILK, not fron 1T ALKALOIDS OB TUiE1B SALTS-beine unlike other preparations called \" Elixir of Calisaya and Iron,\" which are imply an Elixir of QuinIne and Iren. Our Elixir can be depended upon as being a true Elixir of Calsaya Bark with Iron. Each des- rt -spoonful contains seven and a half grains Royal Calisaya Bark, and two grains Pyrophosphate of Iron. Ferro-Phespherated Elixir Of (alisaya Bark with Strychuia.-This preparation contains nue grain of Strychnia added o each pint of our Ferro-Phosphorated Elixir of Calisaya Bark, greatly intensifying its tonic effect. Ferre.Phospherated Elixir of Caliaya with Bismth, containing eight grains Ammonio-Citrate of Bismuth in each able-spoonful of the Ferro-Phosphorated Elixir of Calisaya Bark. CASWELL, HAZARD à 0O., CHMIISTS AND DRUGGISTs, New York. CU=LER'S POCKET INNAL ER AND rCarbolate of Iodine Inhalanta A REMEDY for aIl NASAL, THROAT and LUNG Dis- q*ses, affording relief in some cases in a few minutes. This instrument la gotten up on an entirely new principle, and i welt adapted to the treatment Of 11 those diseases of the air passages requiring efficient inhalation. It i endorsed by many leading praetitioners, and commende itseif to ail deiring an apparatus. Dr. George Hadley, Professer of Chemistry and Pharmasy i the University of Buffalo, in a earefuly oonsidered report apon its merits, conludes la these words: \" On the whole, this Inhaler seems to me, te aeeomplish its parposes, by novel, yet by the most siaple and efeetual means ; to be philosophical in eoneeption, and well earried ont la the exe.ution.' Always rady, no danger of breaking or spilling, beolides beig as- safe and egeient lu the hande of the noviee as the ldtpt. Made of Hard Rubber, it may be earried about the person as handily as à penat case, and used regardless of lime or place. Patented in the United Sttas, England aed 0aad8.! Over à0,000 now in use in tht. country. Pries $2, ineluding Inhalant for two months' use. Neatiy put up and sont by mail free, on recelpt of price. Extra bottiez of Inhalant, 50o. Liberal discount to the trade. Kept by al druggists. Send your address and recelve our descriptive circular, post-paid. W. H. SMITH \u0026 CO., 402 and 406 Michigan St., Buffalo, N. Y. Samples to Physicians free by mail on receipt of $1. In Pres : GYNECOLOGICAL TRANSACTIONS. Volume I. being the Transactions of the American Gynecological Society at its first Annual Meeting, held in New York Septem- ber 13, 14, 15, 1876, is now in press, and will be published In a few weeks by H. O. HOUGHTON AND COMPANY, ' solnaswr \u0026rMMr, Boerox; EU»RD AD noUGHToN, 1 Asao PLAcaM, New Yoax. JOSEPH DAVIDS \u0026 CO. CHEMISTS \u0026 DRUGGISTS, Wholesale and Retail Derers lra DBUG, CHEM1AL8, TRUSSE, SURGICAL APPLIANCES, \u0026c., \u0026c. PROPRIETOR or DAvins' MOTH-PROOF LINEN BAGS. QUEEN'S OWN BOUQUET. 171 KING-STREET EAST, TORONTO.",
         "lu THE CANADA LANCET. THE IMPROVED TROMMER'SF XIRIJT 0F 1111[11 This Extract is prepared from the best Canada Barley Malt, by an improved process which prevents injury to its properties by excess of heat. It is less than half as expensive as the foreign extract; it is also more palatable, convenient of administration, and will not ferment. Attention is invited to the following analysis of this Extract as given by S. H. Douglas, Prof. of Chemistry, UNIVER- \"ITY 0)F MICHIGAN, Anii Arbor: \" TROMMER EXTRACT OF MALT CO.:-I enclose herewith my analysis of your EXTRÂCT Or MALT: Malt Sugar (Glucose), 46.1; Dextrine, Hop-bittor, Extraative Matter, 23.6; Albuminous Matter (Diastase), 2.469; Ash-Phosphates, 1.712; Alkalies, .377; Water, 25.7. Total, 99.958. \" In comparing the above analysis with that of the Extract of Malt of the GERmAN PRAMAAcoeIA, as given by Rager, that has been so generally received by the profession, I find it to substantially agree with that article. \"Yours truly, SILAS H. DOUGLAS, \"lProf. of Analytical and Applied Cbemistry.\" This invaluable preparation is highly recommended by the medical profession as a mot effective therapeutie agent for the restoration of delicate and exhausted constitutions. It is very nutritious, being rich in both muscle and fat-producing materials. By many American physicians, and among others by such foreign authorities (German, French, and English) as N.emeyer, Trousseau, and Aitken, the Malt Extract is extolled in the treatment of impaired, difficult and \"irritable\" digestion, boss of appetite, aick headache, chronic liarrhoea, cough, bronchitis, asthma, consumption, the debility of females, and of the aged, in retarded convalescence from exhausting diseases, and indeed most all depressing maladies, in whieh it bas been found very'sustaining and strengthening, and admirably adapted for building up and invigorating the system. It is often well borne by the stomach when every kind of food is rejected, thus actually sustaining life. The presence of a large proportion of Diastase renders it most effective in those forms of disease originating in imper fect digestion of tAe tarchy element. of food. A angle dose of the Improved Trommer's Extract of Malt contains a larger quantity of the active properties of Malt than a pint of the best ale or porter; and not having undergone fermentation, is absolutely free from alcohol and carbonie acid. The dose for adults is from a dessert to a tablespoonful three times daily. It is best taken after meals, pure, or mixed with a glass of milk, or in water, wine, or any kind of spirituous liquor. Each bottle contains Oua AND ONs HàLl PouNDE of the Extraot. Price $1.00. In addition to the Igtract of Malt with Hop@, the attention of physicians is invited to the following combinationu: I d LroL 'vevçA TROMMER'S EXTRACT OF MALT, ERRATED. Each dose contains four graine of the Pyrophosphate of Iron. Particularly adapted to cases of ansemia. PaxcE, Improved - ~ TROMMERS EXTRACT OF MALT, WITH CITRATE OF IRON AND QUINIA. Appropriate where Iron and Quinine are jointly indiested. Very beneficial in the ansemie state following autumnal fevers in ohlgrosib, oniargod :spleen, etrbunpleso ýbQils, \u0026s. It is a pleaaant tonie, the bitter taste being very. effectually disgaised. Each dose contains four grains of the Citrate of Iron 4ad Quinia. Paros, $1.50, Improved TROMMErS EXTRAC 0F MALT, with HYPOPHOSPHITES. Far superior te any of the \" Syrups \" of Hypophosphitea, and invaluable in anoemia, scrofulous, tuberculous, aud other cachectic conditions. In the various affections to which acre- fulous children are liable, as marasmus, rachitis, caries of the spine, \u0026c., it is very efficacious. This combination i, in certain caaes, even more efficient iL exhaustion from undue lactation than the Extract of Malt with Hops. Paicn, $1.50. Improved TROMMER'S EXTRACT 0F MALT with the IODIDES OF IRON and MANGANESE The experience of the late Sir J. Y. Simpson and others in the use of this combination of salta bas been fully conflrmed by more recent experience. Particularly recommended in anmia dependent upon scrofula, phthisis, cancer, the sypbi- litic cacbexj, enlarged aplbon, and in chi 'orosia where ron atone bas failed. Each dose contains one grain each f i Iodides of Iron and Manganese. PaicE, $1.50. ImproVed TROMMERS EXTRACT OF MALT, fflth ALTERATIVEs Each dose contains the proper proportions of the lodide of Calcium and Iron, and of the Chlorides and Bromides of Magnesium, Sodium, and Potassium. This- comiinatiôn of the most potent alteratives with tonics and restorattes has been successfully employed in the different forme of diseasé dependent upon the ' modified scrofulous diathesis,\" as general perverfed glindular action, disease of the bones and cartilages, catarrhal affections of the eye, ear, and naso- pharyngeal mucous surfaces, ecsematous, and other onta- neous eruptions, in rheumatic arthritis, acrofulous rheuma- tism, \u00260. PaxCE, $1.50. PREPARED BY TROMMEP'S EZTAOT OF LT 00., For Sale by Wholesale Druggists throughout the United States and Canada.",
         "THE CANADA LANCET. il McGILL UNIVERSITY, MONwrREAL. F-ACULTY O~E' VIEDICI]SEE. SUMMER SESSION-MAY Ist to JULY 21st, 1877. The Medical Faculty established Iist year the first regular summer session, in which practical and demonstrative courses, and systematic clinical instruction were given. Forty students availed themselves of the advantages offered, and the diligence with which the classes were followed showed how much such practical teaching is ap.. preciated. The Faculty fuels that the time is corne, when the intermittent system, at present in vogue, of six months' work and six months' vacation, so prejudicial to the steady and continuous progress of the student, should be abandoned and that at least nine ionths of each year should be spent in regular organized study. It is with this view that the sumner session has been establis4hed, and the hope is here expressed, that all students will endeavour to take one or more of these extra sessions, the fees for which have been purpos-ly placed so low as to be almost nominal. As is only natural, the advantages offered by the city of Montreal, for the practical study of Medicine and Surgery are unequalled in the Dominion. In the wards of the General Hospital there are always, and more particularly in the summer months when navigation is open, a large collection of interesting medical and surgical cases. In the out-door department, there is a dail) attendance of between 75 and 100 patients, whicn afford excel- lent instruction in minor surgery, routine medical practice, and discases of children. The Eye and Ear department lately established, will afford an opportunity of studying practically, under skilled direction, these important branches. The attendance of the Medical officers is systematic and punctual. At the University Lying-in Hospital. Obstetrical cases are furnished to the students in rotation. The Faculty has much pleasure in announcipg the following cours s for the summer session of this year. CL1NICAL INSTRUCTION at bedside, in the Montreal General Hospital. Daily DRS. DRAKE ai MAcCAL- 12.30-2. LUM. A limited number of dresserships and clinical clerkships, may be obtained on appli- cation to the attending and out-door Physicians. MINOR SURGERY.-Bandaging, application of splints, homostatics, cathet.rism, \u0026c. G. E. FENWICK, Professor of Six demonstrations of operative surgery on the cadaver. Wednesdays 10 a.m. j Surgery. DISEASES OF WOMEN.-,Methods of exanining patient. Use of Speculum and D. C. MACCALLUM, Professor uterine sound. Disorders of Menstruation. Leucorrhoa. It causes and treatment. of Obstetrios and Diseua of Tumors of the Uterus. Displacements of the Uterus, \u0026c. Mondays 11 a.m. Woem . CLINICAL MEDICINE.-Lectures founded upon cases in the wards. Physical Ex- GEO. ROSS, Profesor of Cli- amination of Heart and Lungs, with demonstrations. The Urine in disease, Tues- eas Medicine. days 10 a.m. DISEASES OF CHILDREN.-Anatomical and physiological peculiarities of infancyl and childhood. Infantile Hygienics. Peculiarities of symptoms. Therapeutics WM. GARDNER, Professor of and Dosage. Consideration of the more common and important diseases of child-, Medical Jurisprudence. hood. Thursdays, 10.30 a.m. J OPHTHALMIC MEDICINE AND SURGERY.-Methods of diagnosis (with ophthal-) moscopic work) Commoner forms of diseases of the Eye and their treatment. F. BULLE R, Lecturer on Oph- Wounds and injuries of the Eye. Practical instruction in operations. Mondays thalmic Medicine A Surgery. 9 a.m. MEDICAL AND SURGICAL ANATOMY, demonstrations on Brain. Sympathetic F. SHEP system. Thorax and Abdomen. Hernia-inguinal and femoral. Surface markings. H RD, Demonstrator Triangles of neck. Bladder. Urethra. Perineum. Larynx, \u0026c. Fridays 10 a.m. J of Anatomy. ELECTRO-THERAPEUTICS.-Electricity, varieties of Batteries. Animal Electricity and Electro-Physiology, Electro-Diagnosis. The induced and constant current. WM. GARDNER, Professor of Modes of application. Medical Diseases in which Electricity is useful. Electrolysis Medical Jurisprudence. and Galvanic cautery. Saturdays 10.30 a.m. PRACTICAL PATHOLOGY.-Consisting of 20 demonstrations in the Autopsy room of) the Hospital. Students will make the post mortems in rotation and receive practical WM. OSLER, Professor of Phys- instruction in the manner of performing them and keeping records of their observa- , iology and Pathology. tions. Bi-weekly, 1 p.m. AIl students desirous of attending the above course will be expected to register their names with Prof. Craik, (Registrar of the Faculty,) on or before the 15th of May, 1877, and pay in advance a fee of $10. The fees will be de- Voted to the improvement and extension of the Faculty's Library and Museum, to which students can always obtainacosas. Certificates of attendance on the various courses will be given. The following special courses will be conducted during the summer, and may be taken by enregistered students. PRACTICAL CHEMISTRY-Including blow-pipe manipulations, qualitative analysis,) toxicological investigations, \u0026c. This course is the same as, and may be taken in G. P. GIRDWOOD, Professor lieu of, the sessional course during the winter. Fee $12.00. Monday, Wednesday, j of Practical Ghemistry. Friday, 2-5 p.m. PRACT1CAL HISTOLOGY-Normal and Pathological, a course of 24 lessons. Micro-) acopes, reagents and material provided. Fee $20. Tuesday, Thursday, nad Satur- WM. OSLER, Professorof Phi- day, 2.5 p.m. Extra hour for Laboratory work, Monday, Wednesday, and Friday, , uiology sud Pathology. 5-6 p.m. J For further information, or Catalogue, address, ROBERT CRAIK, M.D., Registrar, 2 Phillips Square.",
         "THE CANADA LANCET. The attention of the melcal profession is ivitei to this instrumeut as the most perfect ever invented for treating Prolapsus Uteri, or Failing of the lVoînb. Lt is an Abdominal and Uterine Supporter coînbined. The Abdoinal Support is a broad norocco leather belt with elastic straps to buckle around the hips, with concave front, so shaped as tO hold up the abdonsen. The Uterie Support is a cul aid stem made of very bigbiy pblisbed hard rubber, very light and durable, shaped to fit the mouth of the womnb, witb openings for the secretinss to pass out, and wIicbý can be bcîst to any, curve desired, by heating i n vers- bot water. The cup and stem is suspended to the belt by two soft elastic Rubber Tubes, wi h are fasteed t the fiit ofttig e beit by simple leops, pass down through the stem of the cul) and up to the back of the belt. These soft rubber tubes beteastie adapt themselves toal the vary, ing positions of the body and perform the service of the ligaments of the wonsb. The Instrument s very cofortable to the patient, eau be renoved or replaced by ber at will, can be worn at all times, wiIl flot iterfere with nature's necessities, will not corrode, and is lighter than metal. Lt will answer for ail cases of Anteversi on,' Retroversion, or any Flexion of the Womb, and is used by the le-ading Physicians with never failing succeas even in tie nost difficut cases. Price-to Physicians, $8.00; to Patients, $12.00. Instruments sent by mail, at our risk, on receipt of price, with 90 cents added for postage ; or by express, C.o.D. ur. MCINTOSH'S NATURAL UTERINE SUPPOR=ER CO., 296 West Lake Street, Chicago, Ill. Our vainable pamphlet, \" Some Practical Facts about Displacement of the Womb,' will be sent you free on application. BETHESDA THE LONDON HOSPITAL OF WMEDICAL COLLEGE. 0F WAUKESHA, WISCONSIN, ----------- lq\u003e--The London Hospital situated in the east end This Minerai Water has been highly recommended In the treat- ment of ail diseases of the Kidneys and Urinary Organs, such as of London in the immediate vicinitv of the Diabetes, Brigbt's Disease, Inflamnmation of the Kidney, Renal Calculi †..ofuLordonranethe immediisttheicinityrofcthe d uur Gravel, Stone mn the Bladder, \u0026c., \u0026c. Ia has been tboroughiy tested in thetreatnent of Urdemie diseases and bas given aimost universai satisfaction. Professor W. Parker, M. D., of New York, says Having seen the happy resuits from tbe Bethesda Waeer, im Diabetes, and from reports whicb bave reacbed me, I wisb you would furnisb a suppiy for tbe hospitals and profession of the city.\" REFERENCES KINOLY PERMITTED: Ven. Archdeacon Fuller, Toronto. J. H. Ricbardson, M.D. Toronto* Rev. M. S. Darling, Toronto. J. D. Smitb, Esq., Toronto. .Ei General HARD OWEN, Agentfor the Dominion of Canada, 7 VONGE STREET, Toronto, Ont. TO INVALIDS. A medical mans wbo is preparing an outflt to travel over tbe plains o Colorado, in order to benefit bis healtb, is desirous of the Company of three or four otbers wbo may have a similar object in view. T e trip la likely to hé higbly enjoyable assd well caldulated to restore those suffering from pulmonary disease. REFERENCES AND ADDREss, AT TM~ 'LANUET \" OFFICE, TORONTO. OPENING FOR A PHYSICIAN. A PhysicianWho has a well established practice in a thriving Village pn western Ontario wishes to dispose of his residence and good will of Practich, Spiendid Country surroundmng. This is a good opening for thoroughly relabie maR. For the address apply to the Editor of the CANADA LANCET, TORONTO. Docks, contains 8oo beds, and is the LARGEST GENERAL HOSPITAL in the United Kingdom, Canadian and American graduates are admitted to Perpetual Practice, Medical and Surgical, including Dresserships for W TE N CU IN E AS..29 Apply to the Secretary, Medical College, London Hospital, Mile End, London, E. BRIG HXA H A L L, CANANDAIGUA, NEW YORK, AN ASYLUM FOR THE INSANE OF THE PRIVATE CLASI, INCORPORATED BY SPECIAL ACT IN 1859. Inquiries may be addressed to DR. D. R. BURRELL, Reident PhysicisI- NýE 8 U P P 0 RTje.",
         "THE CANADA LANCET. 13 Established 1846. B. A. MITCHELL \u0026 SON, 114 Dundas Street West, North Side, LONDON, ONT. We beg leave to draw the attention of the Physicians of Ontario to our preparations of Tinctures, Elixirs, Fluid Extracts and Syrups, Which we warrant as good,. if not superior, to American preparations which flood our markets. Our laboratory is managed by a practical chemist, who is also a graduate of medicine, and knowing the wants of the profession, we ask for a share of their patronage, knowing that our goods will compare with any, not only in regard to quality but in price. Physicians will confer a favour by calling on us when in London. Correspondence promptly attended to; private formulas prepared. We also have in stock a full line of TRUSSES, ELASTIO GOODS, SHOULDER-BRAGES, SUPPORTERS, SURGICAL INSTRUMENTS, at New York prices. PETROLEUM geSend for quotations ; price-list and catalogue sent to any address. JELLY VASELINE The attention of physicians, druggists and hospitals, is called to this article, and to the fact that it is favourably regarded and extensively used both in the United States and England, by the profession, and by pharmacists for OINTMENTS, CERATES, \u0026c. As a dressing for WOUNDS, CUTS, BRUISES, BURNS, SPRAINS, PILES, RIHEUMATISM, SKIN DISEASES, CATARRH, SORES or ERUPTIVE DISEASES, and all contused and inflamed surfaces, it is not equalled by any known substance. In the treatnIent of COUGHS, COLDS, CROUP, DIPHTHERIA, and of THROAT and CH EST complaints, the best results are obtained. 25c., 50c. and pound bottles $1.00. VASELINE was awarded a Grand Medai and Diploma at the Centennial Exposition, Philadelphia, 1876. Report of Judges. «Novelty great value in pharmacy, unequalled purity, and superiority of manufacture.\" Professor Wm. Odling, F.R.S., Great Britain; Professor C. F. Chandler, New York; Prof. Rudolph Van Wagner Germany; Prof. F. A. Genth, Pennsylvania; Prof. 1. F. Kuhlman, France; J. W. Mallet, Virginia. Pomade Vaseline, Vaseline Cold âream, Vaseline Camphor Ice, are all exquisite toilet articles made from pure Vaseline, and excel all similar ones. 25c., 50c. and $1. 00. ACENTS-Lymans, Clare \u0026 Co., Montreal, and Lyman Bros., Toronto. J. H. GEMEIG, MANUFACTURER OF AND ORTHOPoEDICAL INSTRUMENTS, * 109 SOUTH EIGHTH ST., PH1LADELPHIA. Aspirators, Axilla Thermometers, Hypodermic Syringes, Nelaton's Catheters, Plaited Satin Sewing Silk for Surgical purposes, HawkEley's Metallio Stethoscopes, Elastic Stockings, Apparatus for Club Foot, Bow Legs, Spine Diseases, \u0026o. Illustrated Catalogue and Price List sent on applioation. AN INDISPENSABLE REQUISITE For every Teacher, Advanced Student, Intelligent Family, THE BEST ENGLISH DICTIONARY: Webster's Unabridged. The best practical English Dictionary extant.\"-Londou Quarterly Review, Oct., 1873. Froms the Chief Justice of the United States: Washington, D. C., Oct. 25, 1875.- The book has become indispensa ble to every student of the English language. A Law Library is not complete without it, and the Courts look to it as of the highest authority in all questions of definition. -MoRnisoN R, WAITE. FOUR PAGES COLORED PLATES. Published by G. \u0026 C. MERRIAM SPRINGFIELD, MASS. SOLD BY ALL BOOKSELLERS",
         "THE CANADA LANCET. Electrical Instruments ior Medical Use. We respectfully refer to the following Eminent Physicians: BOSTON. Prof. Franeis Minot, M.D. H. H. A. Beach. M.D. CHICAGO. Prof. N. S. Davis, M.D. Prof. James S. Jewell, M.D. DETROIT. Prof. Theo. A. McGptw, E.D. Prof. James F. Noyes, M.D. Prof. Albert B. Lyons, M.D. Prof. Leartus Connor, M.D. ST. LOUIS. Prof. J. K. Bauday, M.D. Prof. Jas. B. Johnson, M.D. NUW YORK CITY. Prof. W. A. Hammond, M.D. Prof. Lewvi A. Sayre, M.D. Poof. James R. Wood, M.D. PETYADM-PHIA. Prof. Robert E. Rogers, M.D. Prof. B. Howard Rand, M.D. CANADA. Dr. Theo. Mack, M.D., St. Ca- tharines. Dr. Fife Fowler, M.D., Kingst'a Dr. John R. Dickson, M.D., Kingston. Dr. B. H. Lemon, M.D., Tho- rold. Drs. Orton \u0026 Alexander, M.D., Fergus. Dr. A. Wolverton, M.D., Ham- 1lton. - Dr. J. Fulton, M.D., Toronto. Galvano-Faradic Manufacturing Company, FOR SALA YT.V LYM TN W ~'~ii, 4KU t la S Send for Catalogue, with a concise and rti - t %*0 UTTO \u0026 SONS, (Successors to OTO \u0026p (REYN D IrERS.) MANUFACTURERS \u0026 IMPORTERS OF Surgical Instruments and Orthopedical Appliances, TI E PATENT SPIRAL SPRING MING PESSAOR. Tne engraving below shows the manner of manufacturng the Ring Pessary. In a spiral spring f brase wire about eight colis of thia rounded qhalebone are inserted, which is bound tooseiy by the spiral spring, thus aiiowing the cols of whaiebone to revoive around them selves, gi. ing, as vill readily be seen, more elasticity than they would were they bound tightly by a soft wire of any material, the onds of thie spring are then screwed together, and the whole covered with soft rubber of exceedingly smooth surface. We manufacture in the above manner t.ýe Bow Pessary, Albert Smith's and all other shapes MSUUfaOtued oinly by F. G. OTTO \u0026 SONS, 674 CHATHAM SiTREET, NEW YORK. WARRANTED NOT TO BREAK. Cannot be surpaed N.Y ;ELASTICITY AND DRing Pessary, . . . $075 Bow Pessary, . . . . 10 For ale by DRUGGISTS AND INSTRUMENT F. 0. Oto \u0026 Sons' Patent Tru\" Pad. DEALERS. -N BROS,'TORONTO. p - a Quide for their use dm",
         "THE CANADA LANCET. 15 BELLEVUE HOSPITAL CITY OF NEW YORK. SESSIONS 0F 1877'-7S. THE COLLEGIATE YEAR in this Institution embraces a Preliminary Autumnal Term, the Regular Winter Session, THE PRELIMINARY AUTUMNAL TERM for 1876-77 will commence on Wednesday, September î9, 1877, and continue until the opening of the Regular Session. During this term, instruction, consisting of didactic lectures on special subjects, and daily clinical lectures, will be given as heretofore, by the entire Faculty. Students designing to attend the Regular Session are strongly recommended to attend the Preliminary Term, but attendance during the latter is not required. Dur ing the Preliminary Term, clinical and didactic lectures will be given in precisely the same number ana order as in the Regular Session. THE REGULAR SESSION will commence on Wednesday, October 3, 1877, and end about the Ist of March 1878. ISAAC E. TAYLOR, M. D., Emeritus Prof. of Obstetries and Diseases of Women, and President of the Faculty. JAMES R. WOOD, M.D., LL.D., Emeritus Prof. of Surgery. FORDYCE BARKER, M.D., Prof. of Clinical Midwifery and Diseases of Women. AUSTIN FLINT, M.D., Prof. of the Principles and Practice of Medicine, and Clinical Medicine. W. H. VANBUREN, M. D., Prof. of Principles and Practice of Surgery with Diseases of the Genito-Urinary System and Clinital Surgery LEWIS A. SAYRE, M.D., Prof. of Orthopedic Surgery, Fractures and Dislocations, and Clinical Surgery. ALEXANDER B. MOTT, M.D., Prof. of Clinical and Operative Surgery. WILLIAM T. LUSK, M. D., Prof. of Obstetrics and Diseases of Women and Children, and Clinical Midwifery. EDMUND B. PEASLEE, M.D., LL.D., Prof. of Gynæcology. WILLIAM M. POLK, M. D., Lecturer on Materia Medica and Therapeutics, and Clinical Medicine. AUSTIN FLINT, Ja., M.Û., Prof. of Physiology and Physiological Anatomy, and Secretary of the Faculty. APLPHEUS B. CROSBY, M.D., Prof. of General, Descriptive, and Surgical Anatomy. R. OGDEN DOREMUS, M.D., LL.D., Professor of Chemistry and Toxicology. EDWARD G. JANEWAY, M.D., Prof. of Pathological Anatomy and Iistology, Diseases of the Nervous System and Clinital Medice. PROFESSORS OF SPECIAL DEPARMMENTS, ETC. HENRY D. NOYES, M.D., Professor of Opthalmology and Otology. JOHN P. GRAY, M. D., LL.D., Professor of Psychological Medicine and Medical Jurisprudence. EDWARD L. KEYES, M. D., Professor of Dermatology, and adjunet to the Chair of Principles of Surgery. EDWARD G. JANEWAY, M.D., Professor of Practical Anatomy. (Demonstrator of Anatomy.) LEROY MILTON YALE, M. D., Lecturer Adjunct upon Orthopedic Surgery. A. A. SMITH M.D,.'Lecturer Adjunct upon Clinical Medicine. A distinctive feature of the method of instruction in this College is the union of clinical and didatic teaching. All the lectures are given within the Hospital grounds. During the Regular Winter Session, in addition to four didactic lectures on every week-day, except Saturday, two or three hours are daily allotted to clinical instruction. The Spring Session will consist chiefly of Recitations from Text Books. This term continues from the first of March to the first of June. During this Session there will be daily recitations in all the Departments, held by a corps of examiners appointed by the regular Faculty. Regular clinics are also given in the Hospital and College Building. Fees for the Regular Session. Fees for Tickets to all the Lectures during the Preliminary and Regular Term, including Clinical Lectures............ 140 Martriculation Fee........................................................................... 500 Demonstrator's Ticket (includimg materialfor dissection).............. ................................10 00 Graduation Fee ............. .............................. .................................. 80 00 Fees for the Spring Session. Matriculation (Ticket good for the following Winter)..........................................s 5 00 Recitations. Clinics, and Lectures.................................................................................. 35 00 Dissecting (Ticket good for the following Winter) .......................................... ...................... 10 00 Students who have attended two fuil Winter courses of Lectures mnay be examined at the end of their second course upon Materia Medica, Physiology, A notomy, and Chemistry, and, if successful, they will be cxamined at the end of their third Course upon Practice of Medicine, .Surgerj, and Obstetrics only. For the Annual Circular and Catalogue, giving regulations for graduation and other information, address PROF. AUSTIN FLINT, JR., Secretary Bellevue Hospital Medical Colleg",
         "THE CANADA LANCET. Dr. J. Collis Browne's Chlorodyne IS THE ORIGINAL AND ONLY GENUINE. ADVICE TO INVALIDS. If you wish to obtain quiet refreshing sleep, free from headache, relief from pain and anguish to calm and assuage the weary achings of protracted disease, invigorate the nervous media, and regulate the circulating systems of the body, you will provide yourself witn a supply of that marvellous remedy discovered by DR. J. COLLIS BROWNE (late Medical Staff), to wbich he gave the name of CHLORODYNE, and which is admitted by the Profession to be the most wonderful and valuable remedy ever diseovered. CHLRODYNE is admitted by the Profession to be the most wonderful and valuable remedy ever discovered. CHLORODYNE is the best remedy for Coughs, Consumption, Bronchitis, Asthma. Cr LORODYNE effectually checks and arrests those too often fatal diseases-Diphtheria, Fever, Croup, Ague. CHLORODYNE acts like a charm in Diarrha, and is the only specific in Cholera and Dysentory. CHLORODYNE effectually cuts short all attacks of Epilepsy, Hysteria, Palpitation, and Spasme. CeiLORODYNE is the only palliative in Neuralgia, Rheumatism, Gout, Cancer, Toothache, Extract from indian Economist. L\" We direct the attention of medical men to a fact observed some years since by ourselves, and corroborated by our subsequent experience, that Dr. J. Collis Browne's Chlorodyne io in many cases of Low Fever immense y superior to Quinine in curative power. We cannot persuade ourselves that the true value of Dr. J. Cellis Brmwne's Chorudyne ri pet properly appraised in India. . . . It may be given with absolute safety even to a child three days o rd. Wre medical mon but to make a fair and exhaustive trial of it we are persuaded that it would work a revolution in the treatment of ti- thirds of the diseases to which children are subject. Its curative power in simply amasing.\" IEarl Russell communicated to the College of Physicians that he had received a despatch from Rer Majesty's Consul at Manilla, to the effect that Cholera had been raging fearfully, and that the ONLY remedy of any service aes CHLORO- DYNE.\"-See Lancet, Dec. 1, 1864. From W. VESALIUS PETTIGREW, M.D., Hon. F.R.C.S., England. Formerly Lecturer of Anatomy and Physiology at St. George's School of Medicine. I have no heitation in stating, after a fair trial of Chlorodyne, that I have nover met with any Medicine se efflea- cious as an Anti-Spasmodic and Sedative. I have tried it in Consumption, Avthma, Diarrhmet, and other diseases, and a mont perfectly satisfied with the results.\" From Dr. THoMAs SANDIFORD, Passage West, Cork. \"I will thank you to send me a further supply of Chlorodyne. It was the mont efficacious remedy Iever used, afford- ing relief in violent attacks of Spasme within a minute after being taken. One patient in particular, ho Ias suffered:for years with periodical attacks of Spasms of a most painful nature, and unable te obtain relief from other remedies, sud as opium, \u0026c., finds nothing so prompt and efficacious as Chlorodyne.' From Dr. B. J. BoULTON \u0026 Co., florncastie. \" We have made pretty extensive use of Chlorody'ne in our practice lately, and iook upon it as an excellent direct Sedative and Anti-Spasmodic. It seems to allay pain and irritation ln 'hatever organ, and from whatever cause. It induces a feeling of comfort and quietude not obtainable by any other remedy, and seems te possess this great advantage ever all other sedatives, that it leaves no unpleasant after effects.\" From J. C. BAKER, Esq., M.D., Bideford. \" It is without doubt, the most valuable and certain Anodyne we have.\" CAUTION.-BEWARE OF PIRACY AND IMITATIONSe CAUTION.-The extraordinary medical reports on the efficacy of Chlorodyne render it of vital importance that the publie should obtain the genuine . which bears the words \" Dr. J. Collis Browne's renirodyne.\" Vice-Chancellor Woonistated that Dr. J. COLLIS BRoWNR was undeubtedly the Inventer of CHLORODYNE: that the -whole story of the Defepdant, FREEMAN, was deliberately untrue. Lord Chancellor Seiborne and Lord Justice James stated that the defendant had made a deliberate misrepresentation of the decision of Vice-Chancellor Wood. Chemists throughout the lani confirm this decision that Dr. J. C. BROWNE was the Inventor of CHLORODYNE. Sold in Bottles at 1s l½d., 2s 9d., 4s 6d., each. Nono genuine without the words \"Dr. J. COLLIS BIOWNE'S CHLORODYNE \" on the Government Stamp. Overwhelming Medical Testinony accor mpanies each bottle. SOLE MANUFACTURER-J T. DAVRNPORTF, 33 GREAT RUmSELL STREET, BLOOMSBURY, LONDON.",
         "TiE CANADA LANCET. 17 RENJhRY f OSE, WHOLESALE AND RETAIL DRUGGIST-CoR. QUEEN AND YONGE-STS.. TORONTO. The following prices of a few of the leading requirements of the profession will serve as a guide to intending purchasers, subject to Iarket fluctuations, quality being bsteemed of the first importance. Tinctures, Syrups and Liquors are kept in 8 oz bottles, and the prioe joted includes the bottle. gF Terms Cash less 5 per cent. discount. Corrected to Apl. 1st, 1877. Acid,Carbolic.............. oz. Sulph. Ar.........8 oz. bot. Hydrocyan .........1 \"i Ammon. Carb...... ........lb. .\u0026ther, Nit.. .. .. .. .. .. .. .8 oz. bot. \" Sulph.......... \" \" Ce........ \" Antim. Pot. Tart...........0o. Argenti Nit. fus......... Balsam Copaib.. ........8 oz. bot. Bismuth, Car.............. o. Cerri Oxalas................ \"i Chloral H\u003e rate .. Chlorodyne ................ \"d Chloroform................ lb. Cinchon, Sul............... OZ. Ergot, pulv........ .... Emp. Lyttæ...............lb. Ext. Beliadon..............oz. Colocynth o. Gentian ............... \"i ' Hyosciam, Ang........ \"u ' Sarza Co., Ang........ \"d Nucis Vom......... 'Taraxacum.......... \" Fol. Buchu............ \" Senna................. Gun, Aloes Soc......... \" \" \"pulv... \" \" Acacia, pulv.......... Glycerine, pure............. lb. Ferri, Am. Cit........ ......oz. et Quin. Cit. \" Citro,phos......... FerrumRedact.......... Ilydrarg, Chlor......... \", C Creta.......... $ c 0 20 0 07 0 23 0 25 0 22 0 33 0 28 0 08 1 20 0 55 0 20 0 30 0 13 0 15 1 20 0 50 0 15 1 25 0 20 0 12 0 os 0 20 0 30 0 75 0 07 0 50 0 30 0 90 1 10 0 60 0 30 0 12 0 65 0 18 0 15 0 10 0 07 Iodine, resub .............. Z. Jalapin.. ............. Lin. Saponis.. ..........8 oz. bot. Liq. Ammon.. .......... Arsenic ............ \" Bismuth........... Donovan........... \"OpiiSed............. \" Potass............ Mist. Ferri Co............8 oz. bot. Morph. Sul. ...............Oz. \" Mur............ 01. Crotonis............ Jecoris Asselli..........lb. Olivie Opt.......... Opium................... OZ. Powd............ Pil. Aloes ...............gros. et Ferri.......... \". Assafotid.......... \" Cath. Co., U. S. Hydrarg, Mass........ lb. \" y \"d Subchlor. Co. gross, Rhei. Co.......... Podophyllin, Co. Plumbi Acet............... lb. Potass. Acet............ \" Bicarb .. .... .. .. . \" \" Bromid.......... \" Iodid........... Pulv. Creta Co.. .... .... \" \"C Oplo . * \" Co Ip a ... .......... \"é \" Jalapa......... .. Quinæe Su..................0z. 8 c. 0 40 1 75 0 24 0 17 0 20 0 40 0 28 1 30 0 17 0 20 4 00 4 00 0 15 0 25 0 30 0 65 0 75 0 30 0 30 0 38 0 30 0 45 1 00 0 30 0 35 0 40 0 25 0 60 0 35 0 85 5 00 0 75 1 00 2 60 2 25 1 50 390 A full assortment of Trusses, Shoulder Braces, Supporters, \u0026c., \u0026c., at the lowest rates. supply of reliable Vaccine-Scabs, $2 ; Half-Scabs, $1. Enemas from 75c. Rad. Rhei. pulv............ lb. 20c Santonine .................oz. 1 25 Soda Bicarb................ lb 4 \" Potass. Tart.. 14 Spir.Campor..0 32 Spir. Camphor............ 8 oz. bot. 0 2 Ammon. Co.......... \" 0 Syr. Aurant .. 025 Codeia .0 Ferri lod .............. 90 Strych. Phos. Co 40 Hypophos ...--...... ) O 70 Phosph.Co............ 0 46 SenegS . . 40 ScillS . 38 Tinct. Aconit . 20 Arnica .. \" 024 Calumb...............:\" 0 24 \"Camph. CO ...... .. .... \" 0 20 Cardam. Co . « 2 Catechu 0 24 \" Cinchon Co ........, 20 \" Colch.em.... 0 Digital.. 0 20 Ergot............. 040 Ferri Perchlor....... \" 0 18 Gentian Co.. . . . 0\u003e20 Hyosciam............. \" lodine . 2 \" Nucis Vom.. ... 0 -1 (\u003e24 Valer .............0 'VRea V0............o. 5\u003e0 Zinci.. . 0 40 Vin. Ipecac.... ....,.,..,8 oz. bot. 030 \"1 Antim ................. 0 20 Arrangements have been made for a constant DR. MARTIN'S COW-POX VIRUS Absolutely Pure Non-Humain ed Vaooine Virus. Obtained by the method of TRUE ANIMAL VACCINATION, Instituted by Prof. Depaul of Paris, in April, 1866, from the famous case of Spontaneous Cow-Pox at Beaugency, in Prance, and inaugurated in America in September, 1870, by Dr. Henry A. Martin, with virus and autograph instructions from the hand of Prof. Depaul. Our establishment is by far the largest and most perfect in the world. LARGE IVORY \"LANCET\" POINTS, PACKAGES OF 10...................................$2.00. PRIMARY CRUSTS (SCABS), MOST CAREFULLY SELECTED ......................$5.00. Al Virus in fully warranted efficient. It will be packed to go with perfect safety by mail. Pull directions for use accompany each package. Remittances must accompany order. Safe delivery of Virus insured. DR. HENRY A. MARTIN \u0026 SON, Boston Highlands, Mass. ESTABLISHED 1836. NEW YORK. INTERNATIONAL ERXII ION, PHIL., 1876. For \"General Excellence in manufacture.\" H1. PLAN TEN \u0026 soN. 224 William street. GELATINE CAPSULES OF ALL, KIjNDS. ALSO, Empty Capsules (5 sizes). New Preparations added continually Samples and Price-Lists sent on application. A NONTHLY JOURNAL OP MEDICAL AND SURGICAL SCIENCE, CRITICISM AND NEWS. The independent organ of the Profession, and the largest and most widely circulated Medical Journal in Canada. lssued promptiy On the lst of each month. Subsoription $3 per annum in advance. Single 0pies 30 Cents, for Sale by WILLING \u0026 WILLIAMSON, TORONTO. Offoe at Dudley \u0026 Burns, Printers, Colborne Street Rear Canadian Bank of Commerce. Ail Communications containing Remittances, Drafts or Post-office Orders, to be addressed to J. FULToN, M.D., Manager, Toronto.",
         "THE CANADA LANCET. (KNIGHT OF THE LEGION OF HONOUX-PRANCE; KNIGHT OF THE ORDER OF LEOPOLD-BELGIUM.) LIGHT-BROWN COD LIVER OIL. SELECT MEDICAL OPINIONS. Sir HENRY MAIRSH, Bart., M.D., T.C.D., Sir. G. DUNCAN GIBB, ELtrt., I.D., LL.D Physician in Ordinary to the Queen in Ireland. Physician and Lecturer on Forensic Medicine, dI have frequently prescribed DR. DE JoNGH's Light- Westminster Hospitalc. Brown Cod Liver O. I consider it to be a very pure Oi, thThe experience of many years bas abundantly proves net likely to create disgust, and a therapeutie agent of the truth of every word said in favor of Dr. Dz JoNGOn'd great value.\" Light-Brown Cod Liver Oil by any of our firt Physicians and Chemists, thus staping himany a high authority and an Dr. JONATHAN PIERERA, F.R.., able Chemist whose investigations have rerained unques Author of \" The Elements of Materia Medica and i Therapeutics. Dr. LETHEBV, \"It was fitting that the author of the best analysis and Medal Ojîcer of Heath and Chief Ana/y Investigations into the properties of Cod Liver Oil should London. st t the City himself be the purveyor of this important medicine. I \"In ail cases 1 have found Dr. Du JoGH's LightBrown know that no one can be better, and few so well, acquainted \"In l l asessI n wiht the physical and chemical properties of this medicine Cod Liver Oi possessing the sanie set of properties, arong as yourself, whom 1 regard as the highest authority on the which the presence of choleij compeund, and of odine in a aubject. The Oil is of the very finest quality, whether ton- state of organic combination, are the ost ren arkabe n It sidered with reference to its colour, flavour, or chemical pro- is, I believe, universally acknowledgod that this Ol has erties; and I am satisfied that for medicinal purposes no great therapeutic power; and, fron MY investigations, nor Oil can be procured.\" have no doubt of its being a pure and unadultiratd article. Dr. EDWARD SIMITH, F.R.S., Dr. LANKESTER. F.R.S., Coroner/for Centra? Midalesex. Medical O#cer to the Poor-Law Board of Great Britain. 1 conider that the purity and genuinens of this it \" We think it a great advantage that there is one kind of are secured in its preparation by the personal attention of Cod Liver Oil which is universally admitted to be genuine-- so good a Chemist and intelligent a Physician as Dr. Di the Light-Brown Oil supplied by Dr. DE IONGS. It has long JONGH. He has also written the bet Medical Treatise o been our practice, when prescribing the Oil, to recommend the Oil, with which I arn acquaited. enc I deei on. tis kind, since, amidst so much variety and uncertainty, Cod Liver Oil sold under bis guarantee te dprferable to we have confidence in its genuineness.\" any other kind as regards gnuinens and medioina eficacy Dr. BARLOW Dr. BANS, Senior Physician to Guy's Hospital. King's Professor of the Practice of Physic at the I have frequently recommended persons consulting me University oDublin. to Make u e f D Dt J s joe. ONGHs8 Cod Liver Oil. I have been well satisfled with its effecta, and believe it te ho a very pure O, well fitted for those cases in which the use of that sub- stance is indicated.\". Dr. PROSSER JAMES, Lecturer on Materia Medica and Theretics atte London peulcs a th \" I have in the course f MY practi4, extonsiveîy omplcyed Dr. DE JONGH's Light-Brown Cod Liver O, and I have noe houitation in stating that I consider it the bout of ail the apecimens of Oil which have ever cne under m te he fact of so able and accurate an observer as Dr. Dic JONGE subjecting the Oil to careful analysiseves te Da oxposure for sale, is a sufficient guarantee of iLt pur ty ad. aI have always recognized your treatise on Ced Liver Oil Dr EDGAR SHEPPARD a tb. bout on the subjeot, and adopted its conclusion as teo/so ofPyhigia Aeiie igs e London. the superiority of the Light-Brown over the Pale Oil. 1 Dr. Shoppsyrdhoobas mede c ie have the Iss hositation in ex ressing myself in this sens ' Light-Brown Ced Livr O , and bas great pleaure in testi- sian twenly edorsing Pre opinion sent t you more fying to its superiority over every other preparation tes t than twonty yearse ago-by Dr. Pereira, my illustrions pro- met with in this country. It bas Lb. rare exceloence of boing docessor in the chair of Materia Medica at the London well borne and assihilated by storarh which rojet the RempiLai.\" ordinary Oils.re DR. DE JOl*CH'S LICHT-BROWN CODTLIV-R OIL* l supplied ONLY in ImPERIAL Balf-Pint, Pints and Quarts hlh are seaed wth E IV E o L lrnpressed on the top withl DR. DE JONGH'B Stanip, and oni thecaide With his Signature 'a lusit X*aecausell under the PIuk Wrapper wlth his Stamp and Signature, ad the Sarnature id whiaee Id WITHOUT THESE MARKS NONE CAN POSSIBLY BE GENUINE. Sold by all Respectable Chemists andDruggiss throughout the World. SOLE CONSICNEES ANSAR, HARFORD \u0026 CO., 77, STRAND, LONDON."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "FORMERLY \"THE CANADIAN JOURNAL OF MEDICAL SCIENCE.\" A. H. WRIGHT, B.A., M.B., EDITORS AIND PROPRIETORS: M.R.C.S. England. J J. E. GRAHAM, M.D., L.R.C.P. London. W. H. B. AIKINS, M.D., L.R.C.P. London. SUBSORIPTION, $3 PEU ANNUM. U Literary Communications may be addressed to any of the Editors. r Ail Exchanges and Business Communications should be addressed to DR. W. H. B. AIKINS, 40 Queen Street East. TORONTO, OCTOBBER, 1885. Q 4iigita mronnrintiotto. PUERPERAL MANIA. T. K. H1OLMES, M.D., CHATHAM. That form of mania following and depending upon childbirth and the puerperal state is of much interest, because of its frequency, danger, and liability to become chronic. The object of this paper is not to enter into a discussion of the subject very fully, but to invite attention to some points that I have found of much im- portance in the successful management of some of these cases. The views advanced are the result of the clinical observation of twelve cases of the disease which I have either had under my own care or have seen in consultation. Only those cases that have been examined with sufi- cient care to enable them to be of use in estab- lishing the views advanced in this paper will be reported. The chief causes of puerperal mania, as given by all authorities I have been able to consult, are hetedity, moral influences, dystocia, anæmia, and eclampsia as predisposing; while as exciting causes are mentioned moral emotions, toxemia, albuminuria, and exhaustion. Clinical obser- vation of a number of my cases leads me to the conclusion that there is another etiological factor of frequent occurrence that I have been unable to find mentioned by any writer. I refer to laceration of the cervix uteri. Doubt- ýess it wvill occur to everyone that, as this acci- dent, happens so frequently and no mania Vresults, little reliance can be placed on it as a cause of puerperal mania. The same, how- ever, is true of all causes mentioned above, the conditions existing without the supervention of inaniacal symptoms. The explanation of want of uniformity in results from unifom causes lies in the great diversity of material upon which these causes act. What would excite mania in one person might produce bysteria, melancholia, or neur- asthenia in another. It may also be objected that a large number of these cases of insanity recover without having the laceration cured. This is true, but it will be admitted that the great majority of lacerations heal spontaneously in a few days or weeks, corresponding in time to the recovery of sanity in most of these cases; and even where they do not heal, they undergo change and become covered by mucous mem- brane, which lessens very much the local sen- sitiveness and favorably modifies the condition of the torn surface. There are circumstances, moreover, con- nected with this form of insanity that lend plausibility to the view above stated as to causation. Dr. Bucke has pointed out, in his book on \"Man's Moral Nature,\" the strong probability that this has for its physical basis the sympa- thetic nervous system, and that disease of those organs exclusively, or almost exclusively, sup- plied by that system leads to perversion of the moral and emotional nature. This only re- quires to be done to a sufficient degree to constitute a form of insanity. He also calls attention to the fact that disease of the stomacb,",
         "CANADIAN PRACTITIONER. ovaries, suprarenal capsules, and uterus, organs CAsE Il. Mrs. I-, aged 25, was free entirely-or almost eutirely-supplied by the from lereditary tendency to insanity, and had sympathetic system of nerves, produces disturb. had a excellent personal and family history. ance of the moral and emotional faculties Her lealth during rgnancy was exceptionally altogether disproportionate to the gravity cf good aud ler labor was apparently easy and the disease, while other organs receiving a very natural. small supply from the sympathetic-as the The child was born on the 9th of Jan., 1874, lungs-may be fatally diseased, as in phthisis, and on the 13th she shoved signs cf melan- without causing even much depression of spirits, clia and ccmplaiued that ler friends 1 ad lest so that the hopefulness and cheerfulness of the aIl affection for ler. She was me. ose and fre- consumptive have become proverbial. quently cried, but no marked change was The well-known changes that take place iu noticeabIe for three montls, vhen she became the composition of the fiuids of the body during wcrse, expressing berseif doubtful of tle legiti- pregnancy and the puerperal state, and the unacy cf ler child and becoming suicidai. Other constant demanda made upon the emotional means failing a uterine examination was made, nature by fear, anxiety, and domestic cares and a laceration detected. It lealed rapidly during pregnancy, are sufficient predisposing under appropriate treatmeut, wlen all mania causes to render easy an outburst cf mania disappeared, and lier health lias remained ex- upon the supervention of an exciting cause. cellent. She bas borne two chl dren since. The fuel is ready, and only requires the match CAsE III. Mrs Js. la- had ler fourth to inaugurate the conflagrationf It is not un- child on the 28th cf Oct., 1877, and was el] reasonable te suppose that an accident s0 uutil the 3th, when she suddenly became serions as a cervical laceraticu in an orga violently insane. Celoral was given to secure almost exclusively supplied by the great syni- sleep, and at the end of two weeks she regained pathetie 'should acb as the match and set the sanity, but eontiuued iu bad liealth and very system ablazeg nervous and despondent for the next two years The foregoing censiderations would lie value- when I was led to examine the uterus, and dis less unless confirmed iy clinicala experience, covered a stellar laceration. This was mured and it is with the hope of contributing con- and er lealth has been robust since. Tw firmatory evidence of this kind, and se adding subseque t confinements have n t caused an soniething-wowever slight-to the knowledge reture f the symptoms of hervcusness e of this subjeet, that the fellowing cases are nsanity. reported:- CASE I. Mrs. Jos. F-, of good family and personal history, was delivered of her first child on the 17th of Nov., 1869, and be- came maniacal on the 20th of the same month. I saw her first on the 14th of Jan., 1870, and then learned that she had not been sane since her child -was three days old. She showed no love for her baby, took no interest in her do- mestic duties, and required to be kept under some restraint. There was a multiple laceration of the cervix, which, under the plan of treat- ment then practised, would have required sev- eral months to cure. Circumstances prevented this prolonged treatment from being carried out, so she was sent to an asylum, where, I be- lieve, she died about two years afterwards without having recovered sanity. CASE IV. Mrs. Joseph B- , a primipara of good history, was delivered in November, 1877, and became maniacal within a week. I saw her first on Dec. 5th, when the disease had lasted about a month. An anSsthetic was administered and an ex- amination made, revealing a bilateral laceration of the cervix uteri. Copious douching of the torn parts with hot water produced almost in- mediate improvement in her mind, and by the time the laceration was cured the maniacal symptoms had entirely disappeared, and her health has remained good up to the present time. 'My friend, Dr. Murphy, also saw this case. CAsE V. Mrs. Thos. M-, of good history, was confined on the 29th of Jan,, 1883, and within ten days became morose and silent, dis r",
         "CANADIAN PRACTITIONER. 291 regarding her child and refusing to converse witli lier friends. During the summer she be- came worse, and several times escaped from home, and on one occasion spent the night wandering in the woods. I saw ber first on Sept. 2nd, 1883, and found lier morose and dis- inclined to conversation or to any domestic duties. She was emaciated and sleepless, and could not be persuaded to take medicine of any kind. A uterine examination showed a cervical laceration which, although slight in extent, was slow in getting well, owing to irregular attend- ance, as she lived a number of miles from town and could not be s-en as often as necessary. Treatment was continued until Dec. 5th, with gradual improvement in her mind and in her general health, and as the local ailment was now well, the subsequent treatment was medicinal and hygienic, and by the end of Feb., 1884, she was as well as ever, and bas remained so. CASE VI. Mrs. F. G-, a patient whom I saw in consultation with Dr. Murphy on the lth of Jan., 1877, and found lier with a young baby and violently insane. A uterine examina- tion was spoken of at the time, but it was not made owing to lier unmanageableness. Dr. Murphy pursued the usual plan of treatment recommended in these cases until April 24th, when lier husband, on his way to the asylum with her, called at Dr. Murphy's office. By the doctor's courtesy I saw her again at that time, and we succeeded in making an examination of the uterus, and found the cervix quite badly lacerated. The doctor informs me that the contemplated asylum treatment was abandoned, and that as soon as lie cured the local lesion she regained sanity and has had no relapse up to the present time. CASE VII. Mrs. Wm. T-. Was called to see this patient on the 16th of Nov., 1884, with the view of obtaining lier admission to the London Asyluim, and did obtain permission from the authorities there to have ber sent. At the time of my visit I explained to ber husband the possibility that lier mania, which began three months previously, and very soon after child-birth, might be due to cervical lacera- tion. Before a vacancy in the asylum occurred, I examined her and found, as I had surmised, that the cervix was lacerated. The laceration was cured, and with the result of a complete res- toration of ber mental faculties, which has continued till the present time. CASE VIII. M. D-, a primipara, age 21, unmarried, was confined in a Detroit hospital on the 3rd of May, 1885. The labor was didi- cult, and on the fourth day she became maniacal and escaped from the hospital, but was found two blocks away and brought back. She re- mained very insane until the middle of July, when improvement began. Dr. McKeough examined her on the 28th of July, and found a small laceration, angry in appearance, and there was a copious cervical discharge. These have now been nearly cured, and while she is still rather morose, she has resumed her usual domestie duties and is in fair bealth. CASE IX. Mrs. J. R-, age 20, a primi- para, was confined on May 3rd, 1884, and be- came insane on the 6th. Under moral and medicinal treatment, she became mo-e sane, and was able to be brought into town, a distance of fourteen miles, on June 7th, when an examina- tion made by Dr. McKeough and myself revealed laceration of the cervix. This was cured, and her health, both mental and physical, has been good since. CASE X. Mrs, H. E-, age 24 years, of good history, was delivered of lier third child in March of the present year, and remained well, but sleepless, until the eighth day, when she suddenly became violently insane. She received careful and attentive treatment from the medi- cal attendant, but made no improvement, and required constant watching and restraint. I first saw her on the 14th of June and performed trachelorrhaphy. Improvement since bas been steady, and s:e is now in perfect health, both mentally and physically, (able to do most of ber household duties.) CASE XI. Mrs. J. R-, age 39 years, was delivered of lier fifth child seven years ago, and became insane soon after, and was for some time an inmate of the Toronto Asylum. Since that time she bas been well about one-third of the time, the attacks of melancholia lasting about four or five weeks, when there would be an interval of two or three weeks when she would be quite cheerful and apparently well. Her",
         "292 CANADIAN iP1~ACTITIONER. brother is in the asylum, and her father was insane and died so. On July 33th, 1885, I performed trachelor- raphy. The laceration was bilateral and ex- tended nearly to the vaginal junction. The case is still under treatment. CASE XII. Mrs. E. R -, age 34, of good family history, had a miscarriage eight years ago, and was confined at full term, Aug. 18th, 1880. There was a small cervical fibroid tumor that rendered the labor difficult, and which I removed on the 8th of Nov. following. She became gradually more and more melan- choly after the birth of the child, and was still worse after the removal of the tumor, being unfib to manage her household duties, and a source of great care and anxiety to her friends. There was a cervical laceration which slowly got well by the use of topical applications, and her mind recovered cheerfulness in part. In June, 1883, she was again delivered, made a good recovery, and has since remained quite weli. A clinical study of these twelve cases leads me to believe that cervical laceration is not an infrequent cause of puerperal insanity, and that until its etiological influence is known and settled the subject is well worthy the considera- tion of medical men. The appointment of a specialist as consulting surgeon to each of our asylums would aid very much in the solution of this question, and if the views advanced in this paper be proved to be well founded and correct, it would be the means of restoring some to health and to their families who might otherwise spend their days in an asylum. MODIFIED FORM OF TYPHOID FEVER. BY G. L. MILNE, M.D., C.M., VICTORIA, B. C. Some discussion has taken place lately as to the source and cause of typhoid fever and its various modes of attack, especially the recent outbreak in Plymouth, Pa., and its modified form in the beginning as described by Dr. L. K. Taylor, in the Medical News of May 16th, in which he states: \"l It broke out with great virulence, and some diversity of opinion existed ; it was variously declared typhoid fever, typhoid ma- larial fever, typho malarial, meningitis, until its true nature was made manifest.\" Af ter reading his paper, I thought to submit this article on a modified form of typhid fever which was prevalent in this city from last October continuing until the middle of April of this year, with a slight intermission in the month of December, when three weeks' frosty weather seemed to arrest its progress for a time. The fever in the majority of cases was severe, especially in the first week; prominent symptoms of typhoid fever were absent, and if present, not severe; the most notable feature was that the death rate was low. The number of cases I have kept record of is forty-four, with three deaths from fever, one from phthisis following the fever. As to the cause of the epidemic various theories are advanced. No investigation was made by the authorities, but it may be safely attributed to the usual causes-impure water, contaminated milk, surface drainage, which is the systen adopted here. No doubt the early wet fall, together with occasional sunshine and the mild weather which continues through the winter on the Pacific coast, all tended to pro- pagate the disease. I will give the history of a case which may be taken as a type of the disease: Jan. 9th, 1885. M. N., a married lady, aged twenty-one. Two or three days previous to my visit complained of pain in back and limbs, headache. The day before I saw her, she had chills. Temperature at first visit 103¾ in the morning; pulse, 105. Eveningtemperature,104; pulse, 110. Skin hot and dry. Tongue coated and moist. Bowels constipated. Wakeful. 10th. Morning temperature, 103ï; pulse, 100. Stools dark and offensive. Evening tem- perature, 104'; pulse, 108. Slight deafness. Slight gurgling over right iliac fossa. No delirium. llth. Morning temperature, 1033; pulse, 100. Tongue moist. Bowels constipated. Even- ing temperature, 104; pulse, 108. 12th. Temperature and pulse continued the same for remainder of the first week. 16th. Temperature, 102½2; pulse, 85. Even- ing temperature, 103ï; pulse, 90. Bowels still constipated, although stools lighter in color. CANADIAN PRACTITIONER. 292",
         "CANADIAN PRtACTITIONER. No rash visible, deafness still continues, head- ache almost gone, sleeps better, slight pain in bowels, although not tympanatic. Patient renained much in the same condition during the second week with slight fluctuations of tem- perature. 23rd. Teiperature morning, 1011; pulse, 85. Evening temperature, 102I ; pulse, 90. Bowels constipated, sleeps well. No delirium. Tongue red, but moist. The only change worthy of notice during this week was the greater remis- sions in the morning temperature. 29th. Fourth week. Temaperature morning, 99; pulse, 78. Evening temperature, 101¾; free perspiration. Bowels constipated. No tympanites. At the end of this week morning temperature stood 971 ; evening, 98g. The teniperature in a few days returned to normal. Patient very weak. Convalescence slow. In comparing the usual course of typhoid fever with the history give, which may be taken as a type of the majority of cases, we find the' absence of some of the prominent symptoms of typhoid fever, namely, delirium, tympanites, dry tongue, diarrhœa. Having in these cases high temperature almost from the beginning, and in the majority of cases a low pulse rate as compared with range of temperature. The temperature also declining about the tenth day instead of being at its height, as in true enteric fever. I may state that delirium occurred in only two cases; epistaxis, 4; hæmorrhage of the bowels, 2; rash, 10; peritonitis, 2; dry tongue, 3; diarrhoea, mild, 4. Complications were as follows: Bronchitis, 12; pneumonia, 2 ; phlegmasia alba dolens, 1; coma, 1 ; phthisis, 1. Deaths from the following causes: Heart failure, 2; coma in child, second day of fever, temperature in axila before death, 105; peri- touitis, 1 ; one of phthisis, six weeks after the fever, had been phthisical previous to the fever. Relapses took place in two cases. As to the treatment, cold sponging with an occasional antipyritic dose of quinine when fever ran high, but quinine had no control over the disease-its action only being temporary; cold sponging when the fever exceeded 102, and good nursing with fever diet, seemed the most essential. Treating other symptoms as they arose. I have seen some good effects of calomel in the beginning cutting short the disease in some cases after free action of the bowels was obtained. By way of prophylaxis thorough disinfection was maintained. No doubt, in various parts of America a dißiculty often occurs in the diagnosis of fevers, especially where malaria exists, as in iany of the Southern and Western States. But have we not epidemics of typhoid fever in non-malarious districts where typhoid is so modi- flied as to change its usual course, in which case it mty pass for remittent or simple con- tinued fever 7 Of late, authorities have endeavoured to introduce into the nosology of fevers, sewer gas fever, septic fever, etc., and no doubt upon good grounds, as these cases do occur. From sewer emanations a fever exists similar to a continued fever, and septic fever is no doubt of the same character. The duration of the fever is shorter than that of enteric fever. In an editorial, the Mediccl News of Sept. 22nd, 1883, it reads, referring to septic fever, \"as a form of fever arising from decomposing organic matter received into -the system of man.\" The occasion of the above article was due to an epidemie which occurred at Rye Beach, in which it is assured that ther e was absence of any source of typhoid poison having reached the inmates of the cottages. Thus we have, at least, two kinds of septic fevers, which have been recognised of late as a cause of continued fever. Then we have the various forms of malarial fevers, which are said to produce continued fever, which are worthy of further investigation as differences of opinion exist. At the meeting of the Maine 2Medical Asso- ciation last year, Prof. J. T. Dana spoke upon undeveloped typhoid fever, taking the ground \" that whereas in former years typhoid fever was definitely typically developed, it has now, in the greater part of the State, become of less severity, not so well developed, in fact, \" a- typical.\" And also I quote from the report on medicine by the Wisconsin State 3Medical Society of 1883, which states as follows (Mifed-",
         "294 CANADJAN PRAOTITIONER. ical News, Sept. 29, 1883): \" The character of the fevers in the North-west were discussed at length, whether these were typhoid, typhoid malaria, or simple remittent. The conclusions being that they were chiefly of malarial origin, evea though there may be intestinal hemorrhage and cases may reveal softened or disintegrated intestinal mucous membrane, or even some form of ulceration of Pyers' patches.\" One would hardly come to any other con- clusion under our present knowledge, from the pathological condition 'referred to above, that typhoid fever was the true cause of such lesions; and it is generally conceded that typhoid fever supplants malarial fevers if they co-exist, hence the mistakes in diagnosis. Dr. Bartholow maintiins that typhoid sup- plants malarial fevers during the period when populations increase in districts. He also states that typho-malaria is a misnomer and should be abolished, and assumes that where typhoid poison exists, malaria ceases to be active. Where malaria exista it is evident that diffculties arise in diagnosis. Intermittent, remittent, and simple continued fever would all tend to confound the diagnosis of typhoid fever. In the Middle States of America, malarial fevers have been by some authorities classified intermittent, remittent and continued malarial' fever. The profession, no doubt, would accept the first two named as being properly attributed to malaria; but continued malaria, in which it is self-limited and cannot be shortened, should be properly classified as typhoid fever. Maury, on \"Fevers of the Mississippi Val- ley,\" in the American Journal of Medical Sciences, April, 1881, maintains that continued malaria is distinct from typhoid fever; but as he was unable to obtain autopsies of bis cases, cannot give the pathological condition in his fatal cases, but the abdominal symptoms were absent, and'concludes that these would seem to bear no relationship to typhoid. I quote the above to show that in various parts of the Continent fevers exist in a modified form, and that many authorities differ widely on the question of causes and classifica- tion of fevers. I believe differences exist on this coast as to the kinds of fevers prevalent. Recently, I have seen patients in this city who came in search of health, from San Francisco and California, that had been treated for typho- malarial fever,^ where considerable deafness remains and is likely to be permanent from the excessive use of quinia in this disease. I have taken these extracts for comparison, in aà geographical point of view, namely, from Maine on the Atlantic, and several Middle States, in order that we may compare themi with the Nor hern Pacific Coasý. No malaria exists here, as this city may be said to be built upon a rock, being almost surrounded by salt water-the Straits Juan de Fuca. But still we find the same condition in the non-malarious districts, the samle vacillation in the forms of typhoid fever. In conclusion, the following are the chief points which I wish to draw attention to in this communication:- 1st. The peculiar mode of attack in this epidemic, the temperature being the highest on the second or third day of fever, and be- ginning to decline about the tenth day, with mild enterie symptoms and low mortality. 2nd. Although the sanitary condition of the city was unfavourable, the typhoid poison did not seem to cause a virulent form of typhoid fever. 3rd. The epidemic referred to was similar to the continued malaria of some writers who live in malarial districts; but as for this city and district, the presence of malaria must, Le' dis- pelled as now exists. 4th. That the so-called typho-malarial and continued malarial fevérs are misnomers, as in the presence of the typhoid poison malaria ceases to exist, and the continued malaria of some writers are no doubt cases of modified typhoid fever, as quinia, even in large doses, has no control over the fever, nor does it seen to check its progress. 5th. That epidemics of modified typhoid fever occurs in all parts of the Continent- the Atlantic coast and Middle Sta'es where malaria exista; and also on the Pacîfic coast where malaria is unknown. Taking the subject in a topographical and geographical point of view, the study of typhoid fever in a modified form is of the utmost importance, especially as to treatment. CANADIAN PRACTITIONER. 2,94",
         "CANAIDIAN ?RACTITIONER. 295 6th. That the treatment of all continued fevers should be conducted as if true typhoid existed, no matter how modified the symptoms may appear. The death-rate under these cir- cumstances would be very much reduced. ON THE OCCASIONAL LATENCY AND INSIDIOUSNESS OF GRAVE SYMP. TOMS IN CONNECTION WITH THE PUERPERAL STATE.* RY W. 0. PRIESTLEY, M.D., LL.D., F.R.C.P., ETC. When serious disease attacks the puerperal patient, it commonly declares itself within ten days after delivery, and indicates its presence by signs which are either unequivocal, or which at least are sufficiently marked to arrest the attention of the medical man, and to cause him to bestow more than ordinary care upon the symptoms. In reliance on this fact, women who have been delivered in maternity-hospitals are, if no notward symptcms have appeared, allowed to leave after ten or fourteen days of convalescence. But there are cases not unfrequently met with, in which 'the progress of puerperal disease is much more insidious, and in which the indi- cations of what bas being going on in the way of morbidity are not apparent until a much Ihter period. I have extracted from my notes the record of three or four cases, the details of which were jotted down long aga, but which were written out vith more care than others of a like kind which have occurred in my later experience. CASE I.-Mrs. J., a young wife about 20 years of age, was delivered of her first child on January 21st, 1868. She had not been well before her confinement, but suffered then from no very definite symptoms. She was of lymi- phatic temperament, somewhat lethargic, and all the functions of the body were performed in a somewhat sluggish fashion. Her appetite was indifferent, her speech deliberate or slow, and, although she endeavoured to, take exercise * Read in the Section of Obstetric Medicine, at the Annual Meeting of the British Medical Association, held in Cardifi. as a duty, there was no natural tendency to the cultivation of those active habits which, from an insurance point of view, are con:idered necessary to vigorous health. When parturition came on, the pains were sluggish, and the labor lasted from early morn- ing to half-past five in the evening; but there was nothing abnormal about it, nor was there any undue loss of blood afterwards. The uterus appeared to contract well enough to prevent hemorrhage, but it remained high in the eb- domen, and, notwithstanding some manipula- tion, it continued to feel somewhat flabby and ill-defined in outline for some days afterwards. The patient was very anxious to nurse, and attempted to do so for some days ; but the quantity of milk secreted was small, and event- ually a wet-nurse had to be procured. She vas on the sofa at the end of eleven days, and on the eighteenth day after her confinement was removed to another room on the same floor. There were no special symptoms up to this time, but she lost all appetite, and was listless in manner. She had occasionally an indefinite kind of flying pains about her, and a frequent sense of nausea, which culminated on the twen- tieth day in an attack of vomiting. At the end of the third week, when it was thought she might begin to move about, she was indisposed to put down her feet and at- tempt to walk, saying she felt as if she had lost all power of walking. About this time she became impatient of light being admitted to her rooni, and preferred a darkened apart- ment. This phase passed. On the twenty-eighth day she seemed better, and her monthly nurse left her, ber engagement being at an end. Soo'n after this she-began to experience sharp pains in the limbs, and one wrist began to swell. Then other joints were affected, and she had indications of a general attack of acute rheumatism. The digestive organs also became thoroughly deranged, and there were repeated slight attacks of sickness, with nausea, consti- pation alternating with diarrhea, and flushed face with quick breathing. The temperature rose, and the pulse was habitually 120. There were no signs of pelvic inflammation, but eventually the ,abdomen became excessively CANADIAN PRACTITIONKER. 295",
         "296 CANADIAN PRACI ITIONER. tympanitic, and no remedies gave more than temporary relief. Dr. Playfair kindly. took part with me in at- tendance on the case, when it became a more anxious one, and night as well as day attend- ance was required. Various consultants were called in, and among others the late Sir J. Y. Simpson was summoned specially from Edin- burgh. All efforts Lo save the patient proved to be unavailing, and she gradually sank and died on March 17th, about thirty-eight days after the birth of her child. CAsE Il.-Mrs. W. was delivered of ber second child on May 25tb, 1868. Her con- finement was natural, and she made, on the whole, an apparently favorable recovery after- wards. She failed, however, to nurse her'baby, and seemed depressed and weak during her convalescence, complaining, from time to time, of flitting pain in her limbs, and being disposed to be somewhat hysterical. I took leave of her at the end of the month, thinking her fairly well, but not strong. A few day s later, on June 27th, I was asked to see her again. She liad been out, and had resumed her household management, but now com- plained of severe rheumatic pains in her limbs, and she was so mentally depressed as to be quite unfit for her usual duties. I prescribed some quinine for ber, and saw her twice afterwards. Finding her not im- proving, I urged her to go out of town for change of air. This she did, but got no better, and the subsequent history proved that the seeds of mischief were slowly and insidiously developing in her circulation. She had not been long out of town before one eyeball began to swell, and it became the seat of excessive pain, from which there was no relief niglit or day. Afte: a time there were evidences of suppuration being established, and eventually the eyeball burst, and entirely collapsed, thus entirely depriving the patient of the sight of one eve. After this she slowly recovered, and had no further indication of purulent infection. This poor patient died in a subsequent la- bor, as the result of placenta previa. OAsE III.-Mrs. R., aged 23, was delivered of her first child on October ý2nd, 1865. The labour was tedious, and the medical man in attendance, after allowing the second stage to go on as long as he thouglit wes compatible with the safety of the patient, summoned me in consultation, and I delivered with forceps. The uterus contracted fairly well after the re- moval of the placenta, and there was no great hemorrhage. Two or three days after delivery, it was noticed that the uterus was inordinitelv large, but there was no tenderness and no fever. At the end of a week the patient had slight rheumatic pains in the limbs and chest. These were attributed to neuralgia, to which she was lable. No other symptoms raising the suspicion of pending mischief were no'iced until a fortnight after delivery, when, in at- tempting to leave ber bed, the patient coni- plained of acute pa'n in the calf of one leg, and had to go to bed again. That evening and afterwards she was feverish, and had inte-mit- ting and throbbing pain in the back of the leg, with accelerated breathing. I saw her in consultation on October 26th, and found that for two or three days previously she had suf- fered from slight rigors towards niglit, and her temperature and pulse were bot'i higher than normal. On examining the calf of the leg, it was found to be the seat of a phlegmonous swelling, and I thought I could detect fluctuation in the centre. The late Mr. Campbell de Morgan made an incision on the 28th, nearly a month after the date of delivery, and a large quantity of pus escaped from a- deep-seated abscess. After this the patient recovered, and lad no further untoward symptoms. OAsE IV.-A. E. T., aged 23, was delivered of her second child on December 12th, 1870. The patient was of lymphatic temperament, and disposed at all times to be inactive in lier habits. During the early part of her preg- nancy, she had suffered a severe mental trial in the sudden death of her mother, to whom she was tenderly attached. As the result of This, she had become depressed in spirits, could rarely be induced to take proper exercise, and grew inordinately stout for her years. She went to ber full time, and her labor was natural, except that the first stage was tedious; from sluggish and irregular uterine action, and she was not delivered until forty-eight hours CANADIAN PRACTITIONER. 296",
         "CANADIAN PRACTITIONER. .297 from the commencement of the pains. There was no undue loss of blood, and the uterus contracted fairly well, but was somewhat large and flabby. The after pains were slight; but, three days after delivery, she complained of sharp pain about the right hip, which was re- lieved by an opiate and a poultice. After this all seemed to go on well, except that it was remarked her feet were habitually very cold, and occasionally there were neuralgie pains down the back of the right hip and front of the thigh, for which quinine and an anodyne lini- ment were prescribed. At this time, frequent examination was made to ascertain if there were any tenderness along the crural vein, or in the calf of the leg, but none was found. There was no rigor, and no indication of fever- ishness ; but, three weeks after the confine- ment, I noticed, on passing my hand over the hypogastrium, that the womb was larger than usual for the time that had elapsed since de- livery. It was not tender, but gave me the impression of being imperfectly involuted. At the end of the month, the patient began to take her meals in an arIjoining room, and to go about as usual, with no other inconvenience than apparent recurring neuralgia, and a ten- dency to hysteria. In the middle of the fifth week, when dressed to go to the christening of her cbild, she be- came very faint, and was got to bed with dif- ficulty. An attack of vomiting followed, and she was sick the whole day. These symptoms subsided, and she seemed to be progressing favorably, when, about a week later, either in dining out or in going to the theatre, she got her feet wet, and complained all the following day of being ili, and was very cold, although she did not shiver. On Monday, January 31st, just seven weeks after the birth of her child, she was seized with agonizing pain in the right groin and front of the thigh. She became flushed and feverish, and was obviously suffering acutely. On being Sunnoneed, I sent her to bed, and, on making an examination, discov'ered an inflammatory swelling, of the size of half an orange, in the right iliac fossa. The pulse was 130; the tem- Perature 103°. The urine was dark-colored, scanty, and loaded vith urates. Two or three days later, there was rheumatic swelling of both ankles, and the muscles of the legs were so painful and sensitive, tjiat the weight of the bedolothes could scarcely be borne. Warm fomentations and sedatives relieved this condi- tion of the lower limbs, and they were begin- ning to be movable again, when the wrists began to swell and redden, and the extreme sensitiveness was thus transferred to the upper extremeties. The two hands were rarely equally affected. There were constant varia- tions in the relative amount of suffering in them, and an apparent sudden metastatis, with- out obvious cause, in the course of a few hours, from one side to the other. Both hands were wrapped habitually in cotton-wool, and some- times one could be moved, sometimes the other. This variable condition lasted a week, when, having complained of pain and stiffness in the neck and shoulder the previous day, the patient was seized with a stitch in the right side of the chest, and could not drav a deep breath with- out crying out. Sir William Jenner, at this stage, saw the patient with me in consultation. Characteristic symptoms of pleurisy set in somewhat rapidly. There were immobility in one side of the chest, dulness on percussion, and absence of respiratory sounds. The tem- perature was now 105°, the pulse 140, and the aspect of the patient betokened serious illness. The treatment consisted of full and frequent doses of opium or morphia, the strength being supported with bark and small doses of nitro- hydrochloric acid; and sufficient nourishment and stimulant was pressed at stated intervals. The pain in the chest was soothed with large poultices. During the pleuritic attack, the pelvic swelling ieceded somewhat, and seemed likely to disappear; but as the chest symptoms improved, which they did in a few days from their onset, the inflammatory tumor again be- came more prominent, and gave indications of pointing. At.this period, the general condition of the patient was grave in the extreme. The temperature was rarely below 104° or 105°; the respiration was labored and hurried ; the countenance indicated great anxiety; the body was often bathed in profuse sweat; and the pulse was so rapid and running in character, as to be unaccountable. Sir William Jenner re-",
         "2~8 OAINADIAN PRAOTITIO~ER marked that it was an awful pulse. He had fears that the patient might die suddenly; and Mr. Butt, the familymedical attendant, stayed in the house at night, while Sir William Jenner and I made frequent visits in the day. The propriety of opening the abscess, which was obviously forming above the left groin, was fre- quently debated, and was on the point of being carried out when spontaneous bursting took place through the skin. This was on March 27th, and a large quantity of purulent matter escaped. This proved to be the crisis in the patient's condition. From that time onwards she began to improve; all untoward symptoms gradually subsided; and she went to lier country-house convalescent on April 20th. The practical points, so far as our present knowledge goes, are to be able to recognise, at the earliest possible moment, the indications of mischief in these obscure cases, and not to be thrown off our guard by underestimating the importance of symptoms, which, apart from the puerperal state, may be of trifling consequence. 1. Perhaps I may be permitted to dwell on the importance of securing a full and perfect con- traction of the uterus after delivery, as a pro- phylactic measure. In many cases going wrong, it has been observed that the uterus was inor- dinately large, thus indicating a dilated cavity, in which clots or fluid, which ought to be dis- charged, are retained, and which may thus be- come the nidus for the possible development of diseased germs. Further, in an imperfectly contracted uterus, the sinuses or large veins re- main. full of clot, or of fluid blood, which is more or less apart from the general systemic circulation; and is thus, like the back-water of a stream, stagnant, and ready to become a source of peril. Olots should, therefore, always be carefully removed from the uterus, as they form for some time after delivery; and pres- sure, with other means, should be conjoined to promote full contraction. 2. The occurrence of a rigor at any part of the puerperal period should never bc disre- garded. It is nearly always the forerunner of some less or greater commotion in the system, although the mischief it portends may not be observed until the suspicion excited by its ad- vent has well-nigh died out. 3. The presence of rheumatic or obscure pains in the joints or muscles, even if they be flitting or transient, should be taken as indicat- ing a possible contamination of the blood- current; and the case should be watched the more closely if the patient be depreted in spirits, or if she be prone to be apparently hysterical. If, with these symptoms, there be no evidences of deviation in any special organ, the heart should especially be watched, with the view of ascertaining if there be any indica- tions of deposits in its valves. The sudden appearance of a bruit with the heart-sounds may be the precursor of embolism either in the pulmonary or in the general systemic circula- tion. The temperature should also be carefully recorded, as it is probable that, in all cases of insidious puerperal disease, the thermometer will indicate some rise of temperature. 4. It should be remembered that patients who are inert in temperament, and who lead inactive lives during pregnancy, are more prone to puerperal ailments than others of more ac- tive disposition, and thus require more careful supervision. 5. The treatment of suspected cases should consist of putting the patient in the best possi- ble hygienic conditions, and improving vitality by the administration of quinine and a good but judicious diet. 6. As it is probable that all germs of disease are imported from without, and that those of a less virulent character only find an opportunity of developing themselves in the bodies of women whose vitality is below the normal standard, it may be possible in many cases to prevent dis- ease altogether by improving the health of the patient, and by the proper use of antiseptic precautions both during and after delivery. BRoMIDE oF ARSENIC FOR PIMPLES.-It Will be a great relief to suffering thousands to learn, on as good authority as Dr. Piffard, that the bromide of arsenic is a cure for pimples. -He recommends a one per'cent. solution, of which one or two minimas are to be taken in a wine- glassful of water three times a day\u003e on an empty stomach. The dose is to be diminished as the pimples begin to disappear.-Med. Ageï CANADIAN PRACTITIONER. 298",
         "CA14ADIAN PRACTITIONER. OVARIOTOMY IN BATTEY'S INFIRMARY. We are satisfied that a large number of our readers have no idea of the magnitude of this special work done by Dr. Robert Battey, of Rome, and a detailed description of it will, we are sure, be of interest to them. gWhile in Rome some weeks since, we visited this infirmary, which is located on an elevation on South Street, overlooking the Etowah river. It consists of seven neat cottages of five rooms each, with beautiful gronnds surrounding themn. The place presents quite an attractive appear- ance. The furniture is plain, but neat. The bedsteads are brass with woven wire mattresses. Since January 1st of this year, Dr. Battey bas averaged one ovariotomy each week. These tumors, after being removed, are preserved in arsenic, stuffed and carefully put away. In the collection we noticed twenty of very large size, the largest one weighing, when removed, fifty- six pounds. The success that has followed the removal of these large tumors has been, something wonderful-not one of the cases having died. The doctor attributes this success, in a great measure, to the antiseptic precautions that he observes with every case. The operation we witnessed was in a patient 32 years old. She had been remarkably stout and healtby up to September, 1884, when she noticed an enlargeinent of the abdomen. This continued to enlarge rapidly, and very soon she 'was treated for \" dropsy,\" with drastic pur- gatives until her general health began to fail, without any diminution of the enlargement. Since December lst, she has not menstruated, She was admitted to the infirmary four days prier to the operation, and the only preparatory treatment given her was a compound cathartie pill, given two days previous to the operation and an enema of warm water given on the morning of the operation. She was not allowed any food the night previous to the operation or the morning of it. It will be seen that at the time of the operation the stomach was empty. The patient was placed on a short table with her feet resting in a chair, and was etherized 'with Squibb's ether by Dr. George R. West, One of the assistants. The strictest antiseptic precautions were observed throughout. From the time the patient was etherized and the abdomen exposed, until the operation was completed, a spray of carbolic acid 1 to 40 was kept constantly playing on ber from a large steam atomizer. The incision was made in the median lino with an ordinary scalpel, down to the sheath of the rectus muscle, when the remainder of the tisues down to the peritoneum were divided on a grooved director with scissors. When the peritoneum was reached, all cutting was sus- pended until the bleeding points had been secured by forceps, after which the peritoneal sac was opened and a trocar thrust into the tumor, when four and a half gallons of fluid almost as black as tar escaped. There were numerous adhesions to the abdominal walls which were broken up with the hand, after which the pedicle was· ligated with a stout silk ligature and the tumor removed. It weighed 47 pounds. On account of the adhesions there was considerable oozing of blood into the peritoneal cavity. This was arrested by pack- ing the cavity with sponges, after which the cavity was thoroughly washed out with warm water and the wound closed with silk sutures. No drainage tube was used. The dressing con- sisted of a small piece of old linen spread with carbolic cerate placed over the wound, with a compress of uncarded cotton. Over this was placed an abdominal bandage of flannel, which completed the dressing. The entire operation, from the beginning until the patient was removed from the table, consumed one hour and five minutes. The after-treatment, as we are informed by Dr. Battey, consists chiefly in doing notbing. He says that the only thing required is an occasional anodyne enema, and a great many do not require that. Dr. Battey is ably assisted in this work by his son, Dr. Henry H. Battey, Dr. George R. West, Mrs. Battey and his two students, Mr. Harry Huzza, of this city, and Mr. Glover. Mrs. Battey has entire charge of the nursing and general management of the patients after the operations, and, in our opinion, it is to her good nursing and kind and gentle treatment, more than to the strict antiseptic precautions, that the great success of the operations is due.-Atlanta Medical and Surgical Jouzrnal.",
         "300 OAYADIAN PIRACTITIONER. JACCOUD'S METHODS OF TREATING PFITHISIS. Professor Jaccoud is a unicist, believing all forms of phthisis to be tubercular. Clinically, however, he makes the usual distinctions of pneumonie or caseous phthisis, chronic miliary phthisis, or the ordinary form, and acute miliary tuberculosis. Leaving out the last-named type, the forms of phthisis which are most curable are, first, the pneumonic, and next the chronic miliary phthisis. The different types of chronic phthisis may be arranged, as regards possibility of cure, as follows: First of al], arthritic phthisis, or plithisis in rheumatic persons; next, the primary, then the scrofulous, the innate, the hereditary, and finally the diabetic form, which is always incurable. M. Jaccoud announces a certain novelty in his conclusions and views on treatment. We turn, therefore, with special interest to this latter subject, which he, aside from his chapters on prophylaxis, divides into four heads; the hygienic, medicinal, climatic, and the treatment with baths and mineral waters. But little stress is laid upon anything but the climatie and medicinal treatment, these including, of course, ordinary hygienie measures. M. Jaccoud lias stflied personally and with care the subject of climates. He makes but two classes of climates, and his views are simple, clear, and, so far as they go, correct. Climates are either high and cold, or low with a steady and mild temperature. High climates have a positive therapeutic effect, low climates are simply negative in value in that they only enable the system to be put in good general condition. The subject of the medicinal, hygienic, and dietetie treatment is naturally most interesting, since, after all, in the vast majority of cases the victims of phthisis must depend upon these. In the initial period of phthisis, Jaccoud recommends as a general course of treatment milk or kumyss twice daily, cod-liver oil or glycerine, and arsenical granules. Three ounces of oil daily is the least amount that will do any good, according to Jaccoud. This is certainly an important statement, since all over the United States cod-liver oil is given in doses of only two to four drachms. Arsenic should be given in the form of granules of gr. z. \"Of these two are taken daily, and the number in- creased up to eight or ten. Glycerine may be substituted for oil, in doses of three to four tablespoonfuls daily. A drop of essence of mint and two drachms of rum or brandy may be added to it. So much for general medicinal treatment; but our author attaches very great importanS also to local indications. Counter-irritition over the affected part is always necessary, and the specially important thing is that it be kept up continuously. Jaccoud prefers to use Vienna paste. When cough is accompanied with habitual expectoration, pure creasote, in small doses, with the oil or glycerine, is recommended, and is believed to act upon the catarrhal as well as the pulmonary lesions. Pyrexia is perhaps the most important single symptom to be opposed. According to Jaccoud this pyrexia is, generally speaking, either inflam- matory or septic in origin. The symptomatic or inflammatory fever is usually best treated with quinine, about fifteen to twenty grains being given daily. In the absorption or septic, or as it is ordinarily termed, the \"hectic \" fever of phthisis, quinine is believed to be of no use, and in its place salicylic acid is very strongly recommended. Thirty grains are given on the first day, then twenty or fifteen on the second or third days. We have not space to go further in descrip- tion of Jaccoud's methods. In fact we do not find in them anything radically new. His judg- ment upon the value of inhalations and com- pressed air is on the whole favorable, and in accordance with present views. With regard to pneumonie phthisis, a strong point is made as to the necessity of early, continuous, and vigorous stimulation. Throughout the course of treatment the use of alcoholic liquors is advised.-N. Y. Afedical Record. To PREvENT BUZZING oF EARS P.RDUCED BY QUININE.-The di3tressing ear symptorns produced by the administration of quinine or salicylate of soda, are counteracted by the addi- tion of small doses of ergot to the mixture.- American 3iedical .Dige8t. CANiADIAN PRACTITIONER. 300",
         "CANADIAN PRACTITIONER. MILK DIET IN TIHE ALBUMINURIA OF PREGNANCY, Tarnier's treatment (Medical News) of the ~albuminuria of pregnancy by an exclusive milk diet has counted in his hands, as well as in those of others, many successes, and it has re- ceived a very strong endorsement from Carpen- tier, among recent obstetrie writers. Inder this treatment it is usual to see the albumen lessen, in sore cases disappear, and the symp. toms which threaten eelampsia, such as head- ache, dimness of vision, indisposition to exer- tion, and drowsiness, cease, or become much mitigated. In some cases, however, it is im- portant to conjoin with milk diet a hot bath once in three or four days. The temperature of the bath should be from 98° to 100°, and while in the bath or immediately after it, the patient should drink a tumbler of hot milk. A profuse perspiration usually follows, and the relief is prompt and positive. In one case, however, now under observation, a primigra- vida noe in the eighth month, who has had albuminuria for at least four months, and who derives marked benefit from the hot bath, has also a very serious discomfort following it. There is unusual and violent activity of the fetus always occurring lfter the\u002bbath, so that she is for some hours unable to sleep-a very serious inconvenience, as the usual and most favorable time for the bath is just before re- tiring. Valuable as most practitioners regard the milk treatment of the albuminuria of pregnancy, some entirely reject it. Pajot, for example, in a recent discussion held at the Paris Obstet- rical and Gynecological Society, and reported in the Journal of d'Accouchements, May 5th, refers to it as a bitter pleasantry. One of his arguments against the milk treatment is that infants from six months to the end of the first year are peculiarly liable to eclampsia, and yet they are then on milk diet. Gueniot very well answered this argument by saying that those infants that have eclampsia are not al- buminuric, and the milk diet in albuminuric pregnant women does not act upon the eclamp- sia, but upon the albuminuria; it is only in- directly by curing the albuminuria that it renders eclampsia much rarer. It is impossible to attribute infantile and puerperal eclampsia to the same cause.- Weekly Med. Review. FRACTIONAL DOSES. Dr. J. Lewis Smith recommends the follow- ing remedies as preferably given in small doses frequently repeated :- Chlorate of potash, in large doses, sometimes causes dangerous nephritis ;. given in doses of 5 to 10 centigrammes (1 to 2 grains) every half- hour, it is safe and useful. Croton chloral acts infinitely better when given in 6 to 7 centigramme doses every half- hour in cases of neuralgia. Quinine hydro- bromate and napelline, in small and frequent doses, spare the stomach and cure the neuralgia. 5 centigrammes of caffeine, every 20 or 30 minutes, relieve cases of migraine. Tincture of digitalis, in drop doses, every hour or oftener, acts well in beart troubles. Liq. pot. arsenitis, in drop doses, relieve alcoholic vomiting. Ja- borandi, in large doses, in Bright's disease, is dangerous; the fluid extract, in drop doses, hourly, gives relief without danger. Dr. Smith hesitates to use this remedy in urxemia ; but the nitrate of pilocarpine, 5 millegrammes, re- peated every 15 minutes until salivation and sveating ensue, may be safely used. If depres- sion be too great, we can give stimulants. One drop of tinc!ure of nux vomica, given after meals, every tenminutes, relieves the head- ache when not due to central nervous causes. Flatulence and epigastric pulsations of females at the menopause give way to centigramme doses of extract of' Calabar bean every balf- hour. Tincture of balladonna, in small doses every balf-hour, act well in cases of nasal ca- tarrh and bronchitis, with abundant secretion. Feebleness of the heart in pulmonary odema is also relieved by this remedy. Calomel, a centigramme every hour for 10 or 12 hours, causes syphilitic cephalalgia to cease. Regur- gitations of milk, in nursing children, cease when we give every quarter of an hour a tea- spoonful of mixture containing 0-065 mille- grammes of calomel in a glass of water with a little lemon juice. To combat urticaria, salicylate of soda, 10 or 12 centigrammes in a spoonful of water is the best remedy, and does not disturb diges- tion. The eruption is sometimes due to large doses of copaiba, which would not have acted - 301",
         "302 CANADIAN FRACTITIONER. thus if given in drop doses every half-hour. An excellent remedy for acute urticaria is veratrine -half a millegramme every half-hour. -Journal de Médicine de Paris. R. Z. A VALUABLE REMEDY FOR HEAD- ACHE. The Physicians' and Surgeons' Investigator desires to call the attention to a simple, and at the same time wonderfully efficient, treatment for many kinds of headache. \" We lay no claims to originality, nor do we know who the originator was, but having used it for a year or more, and in many cases with re'narkable results, we feel disposed to give it our indorsement, and desire to make it more ge *nerally known. The remedy is nothing more nor less than a solution of the bisulphide of carbon. A wide-mouthed glass-stoppered bottie is half-filled with cotton or fine sponge, and upon this two or three drachms of the solution are poured. When occasion for its use occurs, the mouth of the bottle is to be applied to the temple, or as near as possible to the seat of pain, so closely that none of the volatile vapor may escape, and retained there four or five minutes, or longer. For a minute or so nothing is felt, then comes a sense of tingling, which, in a few minutes-three or four usually-be- comes rather severe, but which subsides almost immediately if the bottle be removed, and any redness of the skin that may occur will also quickly subside. It may be re-applied, if neces- sary, several times in the day, and it generally acts like magic, giving immediate relief. \" We believe this was the basis of a once popular nostrum. The class of headache to which it seems specially adapted is that which may be grouped under the broad term of 'ner- vous.' Thus neuralgic, periodic, and hysterical headaches are almost invariably relieved by it. True, the relief of a mere symptom is quite another thing from the removal of its causes, yet no one who has seen the distress, and even agony, caused by severe and frequently recur- ring headaches (and who bas not) but will rejoice to be able to afford relief in so p' ompt and simple a manner ; besides, it is sure to seçure the hearty gratitude of the patient if he bas suffered long. As to the modus operandi we bave nothing more definite than a theory to. offer, and that is, that the vapor being absorbed through the skin produces a sedative effect upon the superficial nerves of the part to which it is applied. We know by experiment that its influence is not due to its power as a counter- irritant. We, however, know that it does act; and if we do not clearly see in what way it acts, that is no more than can be said of several other remedies which are firmly established in professional favor and confidence.\"- Weekly hied. Review. PHOSPHIDE OF ZINC IN DYSMENOR. RHRA AND STERILITY. In Matthews Duncan's lectures on Sterility in Woman, he places dysmenorrha in the list of the best demonstrated sources of, or at- tendants on, such conditions. But, even if we consider dysmenorrhœa the cause of the sterility, the question of the treatment of the menstrual difficulty does not in many cases admit of ready answer. Certainly there are cases of dysmenor- rhea which may be rapidly and satisfactorily treated by dilating the cervical canal, this dilata- tion being by double-bladed dilators, rather than by other means. But there remains a large number of cases that present no indication for this method of treatment, and which, of course, are not benefited if it be tried. Now, some of these may possibly be cured by the use of phos- phide of zinc, as recommended by Decoux in a recent number of the Gazette des Môpitaux. Having found this medicine useful in many cases of dysmenorrhs and of amenorrhcea, Decoux narrates a case where it twice proved effective in curing sterility associated with the former disorder. In addition to the success of this medicine in dysmenorrha, amenorrhœa, and sterility, he has found it remarkably useful in cases of hysteria, ataxia, anSrmia, and neuralgia. He gives two granules of four millegrammes each, morning and evening. Only the crystal- lized preparation should be used, as the powder is inert. He states that its preparation is so difficult that, with a single exception, one scarcely finds in commerce any but an impure product, which is partly or completely ineffec- tive. -Med. News,",
         "CANADJAN PRACTITIONER. 303 IPECAO IN PNEUMONIA. Dr. Veiadini, chief of the Bologna Grand Hospital, has made a careful clinical study of the depressing effects upon the circulation of ipecac in true pneumonia. He concludes and formulates as follows :- 1. That large doses of ipecac were given em- pirically in fibrinous pneumonia by the leading physicians of the past century, on account of its depressant, antiphlogistic power. 2. That the employment of ipecac in large doses (2-4-6-8 grm.) does not have any evil effects, such as circulatory stasis, heart paraly. sis, and that nausea and vomiting seldom follow. 3. It is beyond doubt that such doses have a salutary influence in moderating the pul- monary congestion, in facilitating resolution, and that, too, without any risks to the patient. 4. The large doses produce effects directly opposite to the emetic doses or principles. Ipecac so given produces, as stated, pulrmonary ischemia; while emetics, as experimentally proven, are attended by congestion or active hyperemia. 5. This comparative action of ipecac and of emetics on heart and lung can be demonstrated experimentally on animals with induced pneu- monia.-Weekly Med. Review. TINOTURE OF IODINE IN DIPH- THERIA. Dr. Edward Adamson states that he bas treated fifty-five cases of diphtheria by the internai administration of the officinal tincture of iodine, and has come to value it most highly. le claims that it promotes the separation of the membrane, checks the formation of new exu- dation, lessens the secretion of offensive saliva, destroys the fetor of the breath and cdrrects the morbid condition of the fauces, tonsils, etc. In the course of thirty-six hours lie says there is generally such marked improvement as to be apparent to the patient. The dose for adults was five to seven minims every one or two hours; and for children six to twelve years old two to three minims every two hours, in syrup of orange and water.- Practitioner. LAPAROTOMY FOR INTESTINAL OBSTRUCTION. In conclusion, I venture to submit to you these rules for your guidance in opening the abdomen for the relief of acute intestinal obstruction. 1. Make the incision in the middle line below the umbilicus. 2. Fix upon the most dilated or the most congested part of the. bowel that lies near the surface, and follow it with the fingers as a guide to the seat of obstruction. 3. If this fail, insert the hand, and carry it successively to the coecum, the umbilicus, and the promontory of the sacrum. 4. If this agairi fail, draw the intestine out of the wound, carefully covering it, until increase of distention on congestion, or both in one of the coils, gives an indication that the stricture lies near. 5. If there be considerable distention of the intestines, evacuate their ccntents by incision, and suture the wound. Never consider an operation for intestinal obstruction inside the abdomen finished until the bowels are relieved froi over-distention. 6. Be expeditious, for such cases -suffer seri- ously from shock. The whole operation ought to be concluded in half an hour.-fr. J. Grrey Smith, British Medical Journal. OUTANEOUS PoISoNING. WITH RHUs ToxIco- DENDRON.-Aqua ammonia, diluted with water, is a useful application and an aqueous solution of corrosive. Sublimate has also been recom- mended, but recently I attended an extreme case which did not seen to yield to any of the popular remedies. I used the following:- I Oupri Sulph. ..........311. Aqua. ............... viii. Apply to the surface of the body with a piece of sponge or soft linen three times a day. After one or two applications the pain and burning begin to subside, and in a few days all the alarming symptoms disappear. Il have since used the same preparation on similar cases with good results.--Peoria Medical Monthly. CANADIAN PRACTITIONER. 303",
         "304 ()ANADIAN PRACTITIONER. THE DIAGNOSIS BETWEEN INDU- RATED CHANCRE AND HERPES. It sometimes happens that herpes of the penis presents itself under the form of a single patcli of superficial ulceration, accompanied by some induration of the underlying tissues; there may be also a swelling of the inguinal glands, so that the diagnosis between this so-called chancriform herpes and some forms of indurated chancre is very difficult in the early stages. M. Leloir, however, calls attention (Journ. de Connaiss Méd., April 2nd, 1885), to the fact that when a herpetic ulcer is pressed between the fingers a drop of serous fluid is squeezed out. This manipulation can be repeated several times with the same effect; in the case of chancre, on the contrary, a little fluid is seen on the surface, but the quantity is not increased by pressure. When the base of the herpetic ulcer is indurated, the hardened tissues can be flattened between the fingers, while, in chancre, no amount of pressure can change the shape of the nodule. This difference is explained by the fact that in herpes there is a localized odema of the tissues, while in chancre the chief lesion is a hard infil- tration, sometimes accompanied by sclerosis of the connective tissue and of the vessels.-Brit. 3fed. Journ. Dr. Brown-Sèquard bas been awarded a prize of 20,000 francs by the five French Academies. It is the custom to award such a prize every two years successively to a scientist, a man of letters, a philosopher, an artist and an archeo- logist. Every second year one of the five Acada- mies selects a candidate, and, with the consent of the other bodies forming the Institute, award him the prize. This year it was the turn of the Académie des Sciences to choose the candidate, and M. Brown-Sèquard was selected.-St. Louis Courier of Medicine. PERFORATING ULCER OF THE HANDS. At the Surgical Society of Paris, June 10th, M. Terillon presented a mould of a case of perforating ulcer of the hands, similar in every way to the well-known perforating disease of the foot. These ulcerations rapidly healed when the hands were not used, but soon re- turned when the patient went to work. The patient was twenty-five years of age, syphilitic and tabetic. It was supposed that there was some central trophic lesion of the upper part of the spinal cord. All the symptoms of loco- motor ataxia were present. Also complete anosthesia about the ulcerations.--Journal de ]Médicine de Paris. R. Z. Foa FRECKLES.-Equal parts of lactic acid and glycerine make an efficient and harmless wash. MOSQUITO BITEs. - A solution of atropine (1 in 1,000) relieves itching and shortens the duration of the papuhe. Nothnagel is quoted as saying that when salicylate of sodium fails in acute rheumatism, the benzoate of sodium will of ten succeed. Genkin recommends the use of turpentine, ten drops to a teaspoonful of castor oil, in the treatment of dysentery, and states that he has produced better results than by using opium. Dr. Oushing writes from Berlin to the Boston MAfedical and Surgical Journal, that vaginal injections after normal labors are now abandoned in all the institutions of repute in Germany. Belladonna, combined with iodide of potas- sium, prevents the headache and coryza caused by the latter. In the case reported 80 grains of icdide were given daily and one grain of extract of belladonna at night. INODOROUS IoDoFoRM.-The Lancet says that, according to M. Gillette, iodoform may be ren- dered inodorous by adding 1 part of sulphate of quinine and 3 parts of charcoal to 100 parts of iodoform.-N. Y. Medical Journal. In subacute rheumatism, fluid extract of mauaca in doses of half a drachmn to a drachm every four hours, is said to be a remedy of value. No unpleasant effects followed except slight dizziness in two cases. CANADIAN PRACTITIONER. 304",
         "CANADIAN IPRACTITIONER. 305 CoCAINE HABIT. - Dr. Love reports in the St. Louis iMedical Journal a case of opium habit cured by cocaine, but found that when the cure was complete, the cocaine habit had been formed, which vas as troublesome as the original disease. Dr. Shattuck reports another case of cure of multiple sarcoma of the skin by hypodermic injections of Foster's solution. Four minims diluted with an equal quantity of water were first given, injected deeply in the thigh once a day. This was increased to six minims. The growths gradually disappeared, and a year after no return was noted. Dr. Fordyce Barker's pill for hemorrhoids: R. Extract colocynth co . ...... g,-. 1¾. Extract hyescyami ......... gr. i. Pulv. aloes socot. ........... gr. n. Pulv. ipecac .............. gr. A. Podophyllin .............. .gr. T. i. At pilula. Take one at bedtime and repeat in the morn. ing if necessary. COCAINE IN SEA-SICKNESS. - The following, according to the Lancet, is Dr. Manassein's (St. Petersburg) prescription for sea-sickness: Muriate of cocaine .......... 0.15. Rectified spirits of wine. . . . . . q.s. Distilled water ............ 150.0. UL. A teaspoonful every two or three hours as a prophylactic. A teaspoonful or dessert.spoonful every half- hour or hour during sickness. BUTTERMILK AS A REMEDY FOR VOMITING.- Dr. J. H. Owings, of Deer Lodge, Montana (Maryland .4edical Journal), states that he bas used buttermilk for the purpose of checking vomiting for ten or twelve years past-in as many as fifty cases, he thinks-without a failure. He knows of no other remedy equally satisfactory, and regards it as especially ser- viceable in cases of severe vomiting after a pro- longed debauch. FoR EPisTAtis.-Introduce into the nostril for a considerable distance upward, a piece of fine sponge eut to the size and shape necessary to enable it to enter without difhiculty, previously soaked in lemon juice or vinegar and water. The patient is to be kept lying on the face for a length of time, with the sponge in place. This, says-the Lyon ilfedical, '\"is the procedure employed by M. Sirederg for controlling epistaxis in typhoid fever patients.\" SEDATIVE COUGH MIXTURE.-Dr. H. O. Wood recommends the following as the most efficient sedative cough mixture lie bas ever usedc: 1 Potassii citratis ................ Succi limonis, .......... ..... .. . Syrup. ipecac., ................. -ss. Syrup. simplic., .......... q. s. ad :vj. M. Sig. A teaspoonful from four to six times a day. When there is much cough or iriitability of the bowels, he adds a sufficient quantity of paregoric.-Therap. Gaz. Dr. Cagnoli mentions in the Moniteur Thera- peutiquethat, having as a patient a little boy with rheumatic fever, in whom salicylates produced severe gastric disturbance, he had recourse to compresses saturated with a ten per cent. solu- tion of salicylate of soda and covered with oil- skin bound round the most inflamed joints. The next day pain and swelling had disappeared froi theEe, and the power of motion had returned to them, while the joints which had not been so treated remained exactly in their previous con- dition. These latter were afterwards relieved in a similar manner.-London Lancet. SALix NiGRA AS A SEXUAL SEDATIVE.-Dr. F. F. Paine, of Comanche, Texas (Mfedical Age), speaking from five years' experience with tbis drug, states that during a pi actice of fifty years lie has net used a remedy that bas yielded more satisfactory results. He recommends it par- ticularly as an anaphrodisiac and as a remedy for dvarian irritation, including certain cases of dysmenorrhea. He gives teaspoonful doses of Parke, Davis \u0026 Co.'s fluid extract of the buds three times a day. H1e thinks it bas something of a specific action on the nerve supply of the sexual apparatus in both men and women. CANADIAN PRACTITIONER. 305",
         "306 CANADIAN PRACTITIONER. LACTATE OF QUININE.-This is said to be the most useful salt of quinine for hypodermic in- jection. It is very soluble, and is richer in alkaloid than any other salt. According to the Lyon Médical, at 15° cent. it is soluble in the proportion of one in three, while the sulphate is soluble 1 in 755 of water. The following formula is given - lR Lactate of quinine 1 gramme; distilled water 4 grammes. Dissolve by gentle heat and filter; the solution should be neutral. Each syringeful contains 20 centigrammes of lactate of quinine. It causes neither pain, inflamma- tion nor abscess. iR.Z. IDOIZED PRIENOL IN THE TREATMENT OF WHooPING-CouGH.--Rothe (Memorabilien) an- nounces his continued satisfaction with carbolic acid as a remedy for whooping-cougb, after fifteen years' experience with it. The formula employed is as follows: Oarbolic acid, } each.. Alcohol, Tincture of iodine.... . Peppermint water .. . . Tincture of belladonna Syrup of diacodium. .. 1. 7 grains. .. 5 ..750 .. 15 ..150 drops. grains. \"c \"c A teaspoonful is to be given every two hours, the administration being continued until the paroxysms entirely disappear. In the Vierteljalrschrift f. Dermatologie und Syphilis, a report is made by V. Watraszewski of seventy cases of recent syphillis treated by subcutaneous administration of calomel. The amount used in each injection was 0.1 grm. of calomel suspended in mucilage. Only in a few cases was double the above amount given. The injections were made in the gluteal region, at intervals of seven, ten to fifteen days. The interval is determined by the degree of stomati- tis developed. As a rule three injections sufficed to cause all manifestations of the disease to dis- appear. A fourth injection was, however, generally inade. The seventy patients in all got 257. Only four abscesses developed. It is advisable to direct complete rest for several days. THE Canadian Practitioner. WORMERLY JOURNAL OF MEDICAL SCIENCE.) To CORRESPONDENTs. - W1e shall be glad to receivejromn our friends everywhere, current medical news of general interest. Secretaries of County or Territorial Mdeical Associations will oblige by forwarding reports of the proceedings of their Associations. To SUBScRIBERs.- Those in arrears are requested to send dues to Dr. W. H. B. Aikins, 40 Queen St. East. TORONTO, OCTOBER, 1885. THE SMALL-POX IN MONTREAL. This disease which has been present in threat- ening proportions in Montreal for over three months is now making a harvest of deaths in that ciby, at the rate of fifteen or twenty a day. The Chairman of the Montreal Health Com- mittee, Alderman Gray, says that there are about 800 cases at present in the city. Con-. sidering the magnitude of the outbreak, the equipment of the 3Montreal Board of Health appears to be of a very meagre description. The railway and steamboat corporations have appointed and pay three physicians, who attend at trains and steamers. Another physician has also been appointed to look after the interests of the \" Wholesale Clothing Association,\" and is paid by them. So that the actual force em- ployed by the Montreal Health Committee, and paid by them, in connection with the stamping out of small-pox in Montreal, are, one medical health officer-who, however, was not appointed to look after small-pox--two assistant health physicians, the hospital doctor, seven vaccin- ators, two placarders, and one disinfecter. The difficulty of the situation is made more appar- ent when we learn that in Montreal there are tens of thousands of unvaccinated persons, and that in many instances the people have strong prejudices against the performance of vaccina- tion on themselves or children. Isolation of cases of the dià ease, or persons who have been exposed to it, is not properly attended to. According to the admission of Dr. Larocque, ex-Medical Heaith Officer of Montreal, there are eight or nine thousand uncleaned cesspits in the city, The City Surveyor has also pub 306 CANADIAN PRACTITIONER.",
         "CANAPIAN RRACTITIONER. 39'T licly admitted that there are any number of old foul sewers reeking with abominations, which cannot be \"flushed.\" We are also informed that unlimited quantities of filth have been piled up at the border-line of St. Jean Baptiste village, where a large proportion of the cases of small-pox hasbeen found. Under these circumstances a \" Central Board of Health \" bas been recently formed, and cer- tain regulations to prevent the further spread of small-pox have been framed and published in the Offjcial Gazette, of Quebec. These regula- tions provide that Local Boards are to be organized, subject to the control of the Central Board, in all that pertains to the public health. The Central Board is to be notified when a case of small-pox occurs within the limits of a municipality. All streets, lanes, yards, privies, and public squares must be thoroughly cleaned at once. Cases of small-pox are to be isolated either at home or in suitable houses. A placard bear- ing the words \"Picotte-Small-pox\" is to be placed in a conspicuous place on every bouse where there is a smalli-pox patient. It is strictly forbidden to convey a patient affected with small-pox, or any other contagious disease, from one municipality to another without a written permit from the Medical Health Officer of the municipality into which it is intended to convey the patient. Funerals of small-pox patients must take place within twelve hours after death. The corpse is to be conveyed directly to the cemetery, and the funeral must be private. All places infected with small-pox must be disinfected according to the directions of the Central Board. Persons authorized by the Board of Health will have the right, within the limits of their respective municipalities, to visit all bouses, factories,hotels, educational establishments, etc., to enquire whether or not cases of small-pox exist in them. Local Boards of Health are to provide tem- porary lodgings for persons suspected of having small-pox. They are also to procure a suitable supply of vaccine, which they are to offer gratuitously to those who are not vaccinated, and those who need to be vAccinated, The Provincial Board of Health of Ontario have found it necessary to take special precau- tions against the importation of small-pox into ourmidst. An Orderin Council has been passed, giving them powers, to deal with the disease in the most thorough and effective manner, so as to prevent its appearance in any of our municipalities. They have sent six physicians to Mon- treal, whose business it is to observe passengers by rail or boat leaving that city for the west. These gentlemen are instructed to board trains and steamers leaving Montreal, to observe where the passengers come from and their destination, to vaccinate unprotected persons, to detain cases of small-pox, and to cause the vaccination, isolation and detention of all per- sons entering this Province who bave been exposed to the danger of infection, until the period of incubation be passed. These precautions may appear severe, but a little reflection will convince everyone that in the management of this the most loathsome of all the zymotic diseases the safety of the people reposes on the enforcement of vaccination, isola- tion and disinfection. And we feel quite confident that although enforcing these regulations with all due strin- gency, the Provincial Board of Health of On- tario regret that the commercial prosperity of Montreal should have received so rude a shock, and that, in common with all the people of this Province, they will be pleased to see all measures of precaution rendered unnecessary by the com- plete and effectual stamping out of the epidemic. LAWSON TAIT'S OVARIOTOMIES. Mr. Tait bas published in the PÀiladelphia Medical News, Sept. 12th, a report of a remark- able series of one hundred and twelve con- secutive operations for ovarian and parovarian cystoma without a death. The achievement is a marvellous and brilliant one, and is a credit alike to this distinguished operator and to modern abdominal surgery. A few years ago they used to tell us in Lon- don that Mr. Tait's reports were unreliable. They persistently sneered at the young \"radical upstart\" from Birmingham. They first pre- CANADIAN PRACTITIONER. 3.07",
         "CANADIAN PRACTITIONER. tended to ignore him, and then attempted to extinguish him; but still he lives, and now even bis strongest opponents will scarcely deny that he stands in the front rank of abdominal surgeons. In the present report, the residence of the patient, the name of her medical attendant, age, disease, nature and date of operation, are given. In the series he used no antiseptics, which he thinks by poisoning the patients do more harm than good. 11e attributes his success to the foilowing : The non-use of antiseptics, increased personal experience, increased attention to all the minute details, cleauliness, and discipline in bis hospital. The series included- Dermoid cyst................ Cystic sarcoina.............. Abscess of ovary .. .......... Cystoma of one ovary .......... Cystoma of both ovaries........ Parovarian cysts .............. Among the most serious cases were 2 49 38 21 some cf parovarian cysts, where the structures of the broad ligament had been lifted bodily out of the pelvis, and tumors presonted neither pedicle nor free surface. They had, therefore, to be treated by Dr. Miner's Method of Enucleation. Mr. Tait thinks that parovarian cysts have a peculiar tendency to rotate on their axis and to become strangulated and gangrenous. This furnishes a strong argument against the old method of tapping such tumors. One of the most satisfactory features connected with the report is the fact that the operator did not leave incomplete any operation begun for ovarian or parovarian eystonia. NEW NATIONAL MEDICAL ASSOCIA- TION FOR THE UNITED STATES. It has been proposed to organize in the United States a Medical Association, corres- ponding to the Zurich Academy of Medicine, limited in nuimbers, and so honorable a body that membership in it would carry the highest reward that American physicians would have to hope for. The proposal, which is beartily endorsed by the N. Y. Medical Journal, has been made on account of the unpopularity of the American Medical Association. Its position has not been strong for years, but its recent action at New Orleans has capped the climax ; and the consequence is that a strong feeling prevails that this association \" must go \" if it be not thoroughly reorganized. PROF. HANSEN-GRUT AND THE INTERNATIONAL MEDICAL CONGRESS. Prof. Hansen-Grut, of Copenhagen, who was President of the Opthalmological Section at the last meeting of the Congress, has been express- ing bis views on the muddle in a letter to a New York physician, which appears in the N. Y. llIed. Jour. H1e thinks the Congress has no intereat in Aierican codes, but that the profes- sion as a whole should be admitted to all its rights and privileges. He gives a very delicate hint that the mem- bers of the profession of the old world may not, under existing circumstances, attend the meet- ing. As he expresses it: \"the way across is long, the fear of the sea is strong.\" THE DOMINION MEDICAL ASSOCIATION. The recent meeting in Chatham passed off very successfully. The members of the Associ- ation are greatly indebted to the profession of the town and vicinity for the great liberality shown in the arrangements made for their entertainment. No expense or trouble was spared in the getting up of the dinner, and private hospitality was extended on a most elaborate scale. All the members present appeared to enjoy the meeting thoroughly, and all carried away with them pleasant recollections of Chatham and its inhabitants. We congratulate Dr. lolmes on lis election as President. We are convinced that the choice is an excellent one. le will do honor to the Association which bas so signally bonored him. Quebec is to be the next place of meeting. We publish elsewhere a short report of the proccedings. Dr. Covernton will deliver the opening lecture in the Trinity Medical School. 308",
         "CANADJIAN PRACTITIONEIR. 309 MANAGEMENT OF THE MEMBRANES IN NATURAL LABOR. In most of the standard works on obstetrics we are taught that the'membranes have fulfilled their physiological mission'when cervical dilata- tion is completed, and that their persistence after this only retards the progress of the labor. If such be the case, the rule follows of necessity that they should be ruptured by the accoucheur if nature be unable to accomplish it. During the past year some protests have been entered against this theory, especially by Byford, of Chicago, and Moses, of St. Louis. It should not be overlooked that, before the completion of normal labor, not only is dilata- tion of the cervix required, but also dilatation of the vagina, vulva, and perineum. This pro- cess is not perfectly understood ; but to one who watches intelligently the process of parturition it will be apparent -that the perineum and all soft parts superficial to the cervix become gradu- ally changed. They become soft, ædematous, and dilatable, while a copious secretion of mucus is poured out from the mucous mem- brane of the vagina, before they are stretched diiectly by the child or bag of membranes. If this condition of softening and dilatability does not occur before the membranes are ruptured, we are apt to bave rigidity of perinSum and vagina, and as a consequence a rupture of one or both during delivery, because they are not prepared for the stretching of the advancing head. We believe, therefore, that it should not be considered that the usefulness of the membranes has departed when the cervix is dilated, but rather that it continues until the perineum and vagina are dilated or dilatable. Our rule should be to leave the membranes intact, if it is our good fortune to be able to do so, until this con- dition exists, and then we can proceed to rupture, if necessary, at once. It is true that we may save time by valiantly adopting vigorous measures at a more early period, such as puncturing membranes, and applying forceps and dragging the child through an unstretched vagina over a rigid perinmum; but in so doing we are apt to produce serious injuries to our patients. We should ever watch nature's efforts and methods, and only endeavor to assist her when such assistance becomes actually necessary. THE INTERNATIONAL MEDICAL CONGRESS. The new committee met in New Yorlk, Sept. 3rd, and made some concessions to public opinion, though not so many as we hoped to see. They amended the rule of membership so as to give representation to societies in special 'departments, and allow the so-called new code men to become members of the Congress without the privileges of holding any offices. There was apparently no direct effort made to bring back the eminent men who have withdrawn from theý organization. Jntil this is done it is hardly possible for the proceedings of the committee to command the respect and confidence of the medical world, which is look- ing on with fear and trembling. Among the most important acts cf the last meeting was the election of Dr. N. S. 'Davis, of Ohicago, to the office of Secretary- General. This will meet with general ap- proval. The committee will get a fair support in New York, particularly from the Bellevue men. The name of Austin Flint, sen., 'will be worth much among the shattered frag- ments that remain. Many able men in different parts of the Union will assist. We may derive what comfort we can- from these considerations; but, after all, the broad, sad fact remains that the cream is principally gone, and we are left to feast on skimmed milk. TORONTO SOHOOL OF MEDICINE. The extensive alterations in the school build- ing are quite completed, and the large addition is now ready for the work of the session. Among the new roins now available will be a large dissecting-room, well ventilated,.and well equipped. It can scarcely be surpassed in any part of the world. The new inuseum will be none too large for the really fine collection ,of specimens now contained in the building. We fear that graduates and other friends of the school do not fully appreciate the magnitude and character of the collection, nor the great value of the work done by Dr. Oldright during the last fifteen years in connection with this niuseum. The laboratories and other new CANADIAN PRACTITIONER. 309",
         "310 CANADIAN PRACTITIONER. rooms are well furnished, and exceedingly well arranged. As we go to press preparations are being made for a conversazione, to be held in the school building on the occasion of the opening of the new wing, on the evening of October 1st. The programme is to consist of an opening lecture for the session, by Dr. W. W..Ogden, a concert under the direction of Mr. Theodore Martens, music by a string band, refreshments, etc. it promises to be a brilliant and suc- cessful affair. PRIVATE HOSPITAL FOR WOMEN. On the 9th of Sept., St. John's House, 44 Lumley St., a Private Hospital for Women, was forrually opened by the Bishop of Toronto. It is one of the several branches of work now carried on by the Sisters of St. John the Divine, a sisterhood of the Church of England, estab- lished here about a year ago. After the short opening service, the friends of the hospital were shown over *the building, and for comfort, cleanliness, and a certain home-like air about it, nothing more is to be desired. There is nothing suggestive of the ordinary hospital; on the con- trary, it reminds one of a large, airy, well- arranged, and hospitable private house, the Sisters having the happy faculty of making friends, as well as patients, feel perfectly at home. During the summer months, while the Sisters were ministering to the wants of the wounded in the military hospital at Moosejaw, the house was rearranged and done over thoroughly, so that our medical friends outside of Toronto need not have the slightest hesitation in advising their patients, when sending them to the city for medical or surgical treatment, to enter St. John's House. Two fair-sized rooms on the ground floor are set apart for free patients. These rooms will accommodate six or eight beds, some of which are already endowed. A large room upstairs is for patients who can pay a small sum towards the expenses of their food, attendancs, etc., while the rest-of the housc vill be-private, for patients who are able to pay from $7.00 to $15.00 per week, according to size, location, etc., of the room selected. This is, of course, exclusive of fees for medical attendance, or surgical opera. tions, each patient being at liberty to select her own physician. Contagious, infectious, or incurable diseases will not be admitted. Any day between three and ive visitors will be shown over the hospital by one of the Sisters or the Mother-superior, to whom all letters, as to admission, price, etc., should be addressed. A private hospital, and especially one for women, has been spoken of for several years. We are the more convinced of the success of this one, from the fact of the Mother-superior having been specially trained for this work during a long residence in some of the'hospitals of New York. SUPRA-PUBIC LITHOTOMY. This method of cutting for stone has gained a new and powerful advocate in Sir Henry Thompson. The Medical News in referring to it very properly claims considerable credit for America in connection with this mode of oper- ating. The papers of Dr. Dulles on this subject, which appeared in the American Journal of Medical Sciences a few years ago, excited great interest in the Profession of this continent. In properly selected cases it is now recognized generally as a good method of operating. Sir Henry asks :-\" What is the best cutting operation for hard calculi (urates and oxalates) which weigh from about two ounces and upwards, as well as for those not quite so large, which are so peculiar in forn (as occasionally but very rarely happens) that the lithotrite fails to grasp or retain themi I think there is no doubt about the answer, viz., that it is the supra-pubic and not the lateral operation.\" In this connection we are reminded that the old countries learned an important lesson in rapid lithotrity as first systematically carried out by Bigelow of America. In both instances it required years for Sir Henry to fully learn the lesson, and, like a wise and practical man as ho is, he finally did learn it; but after a style perhaps not peculiar to himself he takes care to give as little credit as possible to others, and reserve as much as possible fors Sir Henry.",
         "CANADIAN PRACTITIONER. 311 DRUINK OR DYING. The British Medical Journal reports an unfortunate mistake which recently occurred in London. A drunken cabman, having fallen, was taken to St. George's Hospital, and then to the workhouse in Buckingham Palace Road, but no serious injury being detected, lie was refused admission at both places. The man was then taken to the police station, where Mr. Samuel Benton found that his pupils were uneven, and concluded that he bad sustained serious injury. The man died in a few hours, and a post mortem examination re- vealed a fracture of the skull. The coroner's jury attempted to censure the house-surgcon of St. George's, but were prevented by the coroner. It is sometimes impossible at once to decide as to the gravity of an injury to a drunken man, but the possibility of making a very grave mis- take should always be borne in mind, and should make us extremely careful in making an exami- nation and giving a decided opinion as to diag- nosis or prognosis. Dr.Goodell, at a recent meetingof theObstetri. cal Society in Philadelphia, said lie had performed the operation of rapid dilatation of the cervical canal, with his uterine dilator for dysmenorrhea and sterlity in two hundred and nine cases, without a dangerous symptom in any instance, and with a large average of success. HIGH.-TONED HOME FOR INEBRIATES.-A new home for inebriates was opened last month in England. It is situated in Twickenham, a vil- lage on the Thames, about ten miles out of Lon- don, in the old building known as \"High Shot House,\" built in the reign of Queen Anne, and at one time the residence of King Louis Philippe. rhe number of patients will be re- stricted to twelve, and none but males shall be allowed the privilege of entering these royal precincts. BRITIsI DENTAL AsSOCIATIoN.-The meeting of this association was opened at Cambridge, Eng- -land, on August 27th; there are 562 members. The next meeting will be held in London, August 19, 20 and 21st, 1886, under the presi- dency of Sir Edwin Saunders. jýedkid ctt THE DOMINION MEDICAL ASSOCIATION. The eighteenth annual meeting of the Do- minion Medical Association took place in Chatham, on the 2nd and 3rd of September. The meeting was opened on the morning of the 2nd by the retiring President, Dr. Sullivan, who spoke of the change of place of meeting rendered necessary by the recent trouble in the North-West. le then referred to the Medical Department of the Expeditionary Force, and spoke in high terms of the bravery and - self- sacrifice of the Ambulance Corps. Dr. Sullivan then introduced Dr. Osler, the President elect, who took the chair amid applause. Letters of regret were read from Dr. Bergen, Surgeon-General of the Canadian Militia forces, and Dr. Brodie, President of the American Medical Association. Dr. Bray, of Chatham, then came forward and read the following ad- dress of welcome: \"Mr. President and Gentlemen of the Canada Medical Association: \"Te-day it is my pleasing duty, on behalf of the medical profession of Ohatham and vicinity, te welcomeo you on this your first visit te our town. I can assure you, while I appreciate the honor thus conferred on me, I cannot con- ceal the fact that te some one better able to do se should have been allotted this pleasant task. But while there are many who would perform this duty much better than 1, there is net one who appreciates the honor more, or extends to you individually and collectively a warmer welcome. \" It will be in the recollection of those who attended the meeting in Montreal last year, that by some it was thought presumption on the part of myself, and those associated with me, te ask you to come to Ohatham, and I now begin to think that perhaps they were right, knowing the character of the receptions that have been accorded te this Association by such cities as London, Hamilton, Toi onto, Kingston, Ottawa, St. John, Halifax and Montreal, and all I have te offer in apology is, that while",
         "312 CANADIAN PRACTITIOINER those cities have more facilities for making the visits of the Association pleasant and the enter- tainments on a grander scale than we can hope to do, this faut remains, that in no place that you have ever met did you receive a more heartfelt or genuine welcome than we offer to you to-day; and I assure you the pleasure afforded us medical men by your visit will only be exceeded by the honor you have conferred on the town; and while Chatham has on many occasions extended a welcome to distinguished visitors, never before lias she had the honor of securing such a body of representative men as are now assembled, embracing as they do the most distinguished members of the inedical pro- fession from all parts of the Dominion, as well as the United States. Particularly are we fortunate at this time in having amongst us those medical officers who have so lately been engaged in overseeing the medical department of the army, ministering to the sick, and bind- ing up the wounds of those gallant volunteers, of whom Canada has so much reason to be proud. Gentlemen, I will not detain you longer, but again bid you welcome.\" Mr. R. S. Woods then read an address in be- half of the citizens of Chatham, which was warmly received. A number of medical men were then elected members of the Association. Dr. Yeoman's report on Climatology and Public Hiealth was read by the Secretary. The first part of the programme in the after- noon was the address by the President, Dr. Osler, Prof. of Clinical Medicine in the Pennsyl- vania University, Philadelphia. The following resumnè is taken from the Chatham Planet:- \"It was an exhaustive and elaborate, buthighly interestiiig sketch of the history and progress of medical education in Canada. He urged that every effort should be made to elevate the stand- ard of Canadian medical education. The matricu- lation examination should be made more strin- gent and a thorough knowledge of each subject should be demanded. There should be uniform- ity in the curricula of the different schools, and a complete control of the licensing power should be held by the members of the profession. There should be but one portal through which every candidate would have to pass. The example of Ontario in having one niedical board before whicli every candidate must appear might well be followed by the other Provinces of the Domin- ion. The greatest care was necessary in select- ing examiners, who should be men thoroughly and especially qualified in the subjects for which they were chosen. He urged continued interest in maintaining the thorough equipment of our medical schools. He could not see the necessity for establishing and iaintaining the medical schools for women, and predicted their early failure. In conclusion lie briefly traced the history of the Canadian Medical Association from its first meeting in Montreal in 1867, and from the continued interest and increased atten- dance he felt confident of its future success.\" Dr. Grant, of Ottawa, in an eloquent manner, proposed a vote of thanks to Dr. Osler for his interesting address. The Association was then on motion divided into sections. THE MEDICAL SECTION was organized by the election of Dr. Harrison (Selkirk) as President, and Dr. Duncan (To- ronto), Secretary. Dr. J. A. Grant (Ottawa) then read a paper on Aartic Aneurism, showing the specimen. The paper was discussed by Dr. Osler, Dr. Ross (Montreal), and others. Dr. Ross drew particular attention to the importance of the dragging upon the trachea in thoracic aneurisms as a symptom of great value. Af ter adjournment for lunch, Dr. Worthing- ton read an account of a case of Epidemie Cerebro-Spinal Meningitis, extending over one hundred days, ending in death. In the discussion which followed, Dr. Mac- donald, of Hamilton, remarked that the course of disease in this case much resembled that of purulent infection. Other members agreed with the essayist; some, however, considering it malarial. Dr. Arnott, of London, read a paper on the Sources of Malaria, and, after discussion, was fol- lowed by Dr. Holmes, of Ohatham, on Puerperal Mania. Dr. Holmes considers that many cases are caused by laceration of the cervix. In many of the cases he quoted from his own ex- perience, the healing of these lacerations, CANADIAN PRACTITIONER. 312 1",
         "CANA DIAN PIRACTITIONEIR. 313 whether by operation or otherwise, was followed by the disappearance of the mania. Unfortu- nately, there was no discussion on this paper, as the Section adjourned for the evening at the close of the paper. SURGICAL SECTION. Dr. Edwards, of London, was elected Chair- man. Dr. Carstens, of Detroit, read an account of a fibroid removed by laparotomy. Dr. Fulton, of Toronto, read a paper on Subperiosteal Amputation, and cited a number of cases in which he had practised this method of amputation during the past six years, both in hospital and private practice, with most satisfactory results. This method -was first advocated by Walther seventy years ago, but was first put into practice by Ollier in 1859. With the introduction of antiseptic surgery the operation was revived, and now promises to take a prominent place amorgst surgical operations. Dr. Fulton described the operation in detail, and stated its advantages, the chief of which are: 1st. The cut end of the bone is covered by the tissue physiologically fitted to protect it. 2nd. The bone does not become adherent to the end of the stump. 3rd. The medullary cavity is closed in rapidly and effectually by new bone. 4th. Danger from the spread of inflanmation or suppuration to the bone is guarded against. Experiments on animals have shown that a fap of periosteum rapidly closes the medullary canal and prevents the occurrence of osteo-myelitis. The operation is especially adapted to cases in which the medullary canal is in a soft and un- healthy condition, such as frequently met with in amputation for diseased bones and joints. The reader of the paper was strongly convinced of the utility ar.d value of this method of amputation. Dr. Shepherd, of Montreal, read a paper on Excision of the Tongue by Scissors, with pre- liminary Ligature of the Lingual Arteries. Ie said that in excising the tongue for malignant disease, besides the necessity for avoiding hemorrhage, it was important that diseased structures in the neighborhood should be removed, and he held that the operation of excision of the tongue with preliminary ligature of the linguais facilitated this removal without adding much to the risk of the operation. It was now the opinion of surgeons of experience that whatever operation for excision of the tongue was practised the mortality was the same, the result of the operation depending more on the after-treatment than the particular method of operating. Still, certain operations enabled the surgeon to more completely remove the diseased structures than others, and thus the disease was less liable to recur. He con- sidered that in excision of the tongue it was as important to remove diseased glands in the neck as it was to remove diseased axillary glands in extirpation of the breast, and felt strongly that the operation of the future was the one which provided for the removal of the diseased glands. The reader of the paper then descriLed the operation, and particularly dwelt on the various steps in the ligature of the lingual artery, and described the difficulties and dangers that the operator was liable to pieet with. Three cases of malignant disease of the tongue with involvement of the sub- maxillary and cervical glands were reported, in which the operation described had been put in practice. One died of gangrene of the lung, the other two made good recoveries, case three living for nearly a year and a half after a most extensive dissection of the neck and sub- maxillary region. Dr. Shepherd said that the after treatment was most important. In his cases the patients had been fed entirely by the bowel for four days after the operation, and the mcuth in all the cases was drained through the neck incisions by a large rubber tube. Billroth's method of stufling the mouth with iodoform gauze was strongly recommended as offering the best chance of escape from the great danger in ex- cision of the tongue, viz., septic disease of the lungs. The advantages of the operation were summed up as follows : 1. The disased structures, and especially the glands, are easily discovered and removed through neck incisions. 2. The removal of thie tongue is bloodless, and there is little fear of secondary hemorrhage. 3. Drainage of the mouth can be more thoroughly carried out. CAN ADIAN PRACTITIONER. 313",
         "314 OANADIAN PIRAOTITIONER. 4. The tongue is more rapidly and com- pletely removed by scissors than by any other way, and the tissue is not bruised, as when the ecraseur is used. 5. Few instruments are required, and these of the simplest kind. Dr. Wm. Gardner, of Montreal, then reid the report of a case of Double Uterus with' Atresia and Homatometra of the Left Chamber. The patient, a tall, thin, delicate-looking girl of eighteen, was admitted to the gynocoi gical service of the Montreal General Hospital with a history of intense periodie pain in the loins, hip and hypogastrium, extending over nine months. She had been fairly healthy till two years previous, when she began to grow rapidly and to menstruate. Flow moderately painful, scanty; one napkin; intervals thrce to six weeks. The periodic pains alluded to came on each afternoon or evening, and lasted several hours, with an interval of complete relief. Had noticed for some time a swelling of the lower part of abdomen; no bladder symptoms; appe ite smaLl; no vomiting; constipation troublesome. Pal- pation of the abdomen detects an elongated, smooth, very firm tumor, extending from the anterior superior spine of ilium of pubes. Two smaller projectives attached to the larger one extend towards the right side of the pelvis. Internal Examination Conducted under Ether. -Hymen entire, but perforate. Immediately on entering the vagina the finger meets a very firm, smooth, at one point slightly elastic mass, evidiently the lower part of the hypogastric tumor already described. On the left side the vaginal wall is pushed down by the tumcr te near the orifice. On the right side, and behind, the finger can be swept around the tumor te the upper part of the pelvis. No trace of vaginal partition can be detected. The only sign of an opening is a very faint linear furrow. A small aspirator needle was pushed into the tumor, and a small quantity of thick chocolate-colored blood escaped, thus clearing up the diagnosis. A bistoury was introduced, and a free incision made. Fifty fluid ounces of thick, tarry blood escaped. After partial emptying of the sac it was easy to feel the os of the left patent cham- ber of the uterus. Double drainage-tubes were inserted within the opening and stitched to the edges, the ends protruding from the vagina. Irrigation every two hours with weak carbolized fluid was ordered. Within the first twenty-four heurs the temperature ran up te 1030, but at the end of another day became normal; very little pain. Patient did perfectly well for a week, but on the eighth day the tubes ulcerated out. Within twenty-four hours the tempera. ture rose to 101°. Patient being again ether. ized, a portion of the wall of the sac was excised, the tubes again inserted, and irrigation resumed. But the temperature and pulse continued te rise. Three days later a rigor, followed by profuse sweating; then increase of pain, ab- dominal distension, left infra-mammary pain, and pleuritic friction; vomiting, at first of mucus, then of coffee ground-like fluid; death nineteen days after operation. At the autopsy, recent general peritonitis with profuse exudation of lymph. Bicornuate uterus; left chamber measures one and three- quarters inch ; the interior of the right chamber of the size of a hen's egg, its lining stained with thickish brown fluid. Right ovary somewhat enlarged, otherwise healthy. Left fallopian tube sacculated, the saoculi containing the same tarry fluid. Another similar sacculated collec- tion of the size of an orange, situated at the outer extremity of the left fallopian tube, its walls formed by the fimbriated extremity, broad ligament and faIse membrane. Other hoemato- celes were found about the left broad ligament and left border of the uterus. The left ovary could not be distinguished. Dr. Gardner remarked upon the great rarety of the case. Exactly similar ones had, however, been described by Professor Olshausen, of Halle, Dr. Galabin, of London, and Dr. John Homans, of Boston. The diagnosis must of necessity be attended with difficulty much greater than when menstruation is entirely absent. The prognosis of all such malformations is grave. The mor tality hitherto has been very great. The treatment resorted to in this case, ho believed te be (so far as it went) the best that could have been adopted, but he regretted that when the condition of the patient became se desperate he had net opened the abdominal cavity, re- moved the lef t fallopian tube with its sacculi opened the other hoematocele collections, and 314 ÜANADIAN PRACTITIONER.,",
         "CANADIAN PRAOTITIONER. .315 pu in a drain. In view of certain recently publisbed remarkable cases of acute and chronic peritonitis from various causes, similarly treated with success, ho believed it to be possible that the patient might have been thus saved. Olshausen's case was treated by three succes- sive tappings of the tumor through the vagina. Mild poritonitis followed the third tapping, but the patient recovered perfectly, subsequently married, and bore three chlidren. In Dr. Homan's case, being in doubt as to the nature of the tumor, Le opened the belly, clamped and removed the closed uterine chamber containing the altered menstraial blood together with a diseased and distended tube and ovary, and introduced a drain. The patient recovered. Dr. Galabin's case was treated similarly to Dr. Gardner's, but less efficiently, on account of the intractability of the patient and her friends. She died within a fortnight. The specimen was exhibited to the section and excited much interest. The evening was taken up by a dinner given by the medical profession of Chatham and vicinity to the Association. The attendance was large and au excellent feelirg prevailed Dr. Holmes performed the duties of chairman with his usual ability, and the addresses were listened to with delight by the large audience present. On Thursday morning the Association opened its session with Dr. Sullivan in the chair. The report of the Nominating Comwmittee was read and adopted without change. Meetings of Sections then took place. MEDICAL SECTION. Dr. Graham presented a specimen of Dissect- ing Aneurism, and gave a short history of the case. Dr. Wilkins then read a paper giving an -account of some experiments he had made in innoculating rabbits with tubercle. The experi. ments were all successful. A number of beautiful preparations were shown under the microscope, illustrating the various steps in the process of lnoculation. Dr. McKeough then read a paper on the use of-Pilocarpine in Puerperal Eclampsia. We hope to give the paper in our next issue. A very interesting discussion took place on the treatment of Puerperal Convulsions. Two points were prominently brought out. 1. That cases varied in character, and that consequently no set rule for treatment could be laid down. 2. That the principal object of treatment should be to remove the source of irritation. Dr. Stewart, of Montreal, read a paper on Anterior Polio-Myelitis Chronica occurring in children, in which he related a case of this rare condition. He gave the points of diagnosis between this disease and the ordinary infantile paralysis, and the different courses pursued by the two diseases. The prognosis in the former affection is very favorable if proper treatment be eniployed. He recommended the use of the Galvanic and Faradic currents. Dr. Bethune, of Wingham, exhibited an in- teresting specimen showing a parasite removed from an abscess in the thigh. *Dr. Osler made some vEry interesting remark s on Typhlitis and Perityphlitis, giving the re- sults of a number of post-mortem examinations. Dr. Whiteman, of Shakespeare, read an ex- haustive paper on Pelvic Cellulitis, in which he gave the history of several cases. 'SURGICAL SECTION. Dr. Park, of Buffilo, made a verbal report of a very interesting surgical operation, the removal of the larynx for carcinoma. The patient, an elderly man, a physician, had suffered for years from laryngeal trouble, which ended in epithe- lioma of the vocal chords. On Jan. 28th, Dr. Park removed the larynx. The operation was successfully performed, and the parts afterwards healed up rapidly. Gussenbaure's tubes were afterwards inserted, and the patient can now speak quite easily and distinctly. Dr. Park exhibited the specimen as well as Gussenbauer's tubes. Dr. Atherton. then read the notes of two successful cases of Laporotomy performed for the Removal of Uterine Myoma. (The paper will be published in next number.) Dr. Rutherford, of Chatham, read an in- teresting paper on Supra-pubie Urination. The Association then adjourned- to meet in CANADIAN PRACTITIONER. 315",
         "316 OANADliAN PRACTITIONER. Quebec next year. The following are the officers elected for the coming year: President--Dr. Holmes, Chatham. Vice-Presic7ents - Ontario : Dr. Sloan, of Blyth; Quebec: Dr. Colin, Lowell, Quebec; New Brunswick: Dr. Earl, St. Johns; Nova Scotia: Dr. Wickwire, Hialifax; Manitoba: Dr. Brett, Winnipeg. General Secretary-Dr. J. Stewart, Montreal. Local Secretaries - Ontario : Dr. Wishart, London; Quebec : Dr. Bell, Montreal; New Brunswick : D -. Lunan, Campbelltown; Nova Scotia: Dr. Almon, Halifax; Manitoba: Dr. Good, Winnipeg. Treasurer-Dr. Sheard, Toronto. DERMATOLOGICAL NOTES. Dr. G. H. Fox, in his remarks at the recent meeting of the American Dermatological Asso- ciation on the treatment of psoriasis, dwelt upon the excellent results which he obtained from the use of chrysopharie acid. He only used it when there was an absence of redness in the psoriatic patches. If a case presented much congestion he restricted the diet, cutting off meat altogether. He at the samý time used purgatives and diuretics, if necessary. Under the preparatory treatment the patches would lose their congested condition, and chrysopbanic acid could be used with success. He thought that much of the ill success of the chrysophanic acid treatnent was due to its being used when there was much congestion of the patches. -He bas abandoned the tar treatment altogether. The chrysopbanic acid he applies either in collodion or liquor gutta-percho co. Dr. Heitzaan spoke of the good results which he had obtained from the tar treatment, and thought that in some cases it was more prompt in its action than chrysophanic acid. Dr. White read a very interesting paper on the treatment of lupus vulgaris by the use of parasiticides. He first asserted his belief in the identity of lupus and tuberculosis, so far as their causation is concerned. He thought that the experiments of Koch, in producing tuberculosis by the innoculation of lupus bac- cilli, confirmed this theory. He was thus led to use parasiticides, and had found very benefi. cial results from the uses of bichloride of mercury, applied locally, either in solution of two grains to the ounce or in the form of ointment. Dr. Hardaway, of St. Louis, to whom is due the credit for introducing electrolysis as a treatment of port wine mark, read a paper upon that subject. He now uses one instead of a bundle of needles. His success in some cases bas been very satisfactory, while in others little improvement resulted from this form of treatment. It was generally conceded that t'le treatment of dilated vessels in rosacea was much easier and more satisfactory than in superficial nSvus. Dr. Sherwell, of Brooklyn, read a paper on the etiology of psoriasis, in wbich he gave the views of the various Schools of Dermatology. He did not advance any new theory. The general impression produced by the dis- cussion was that we bave yet to learn the etiology of this very common disease. The only facts yet made out are (1) its being hereditary; (2) its being produced by irrita- tion in those who are predisposed to it. Dr. Robinson read a very exhaustive paper on the histology of tinea tricoplytosis and favus. The principal point he made vas that in tinea, the parasite was frequently found in the rete, having undermined the corneous layer, whereas, in favus, the growth takes place on the surface of the corneous layer and does not appear in the rete unless the corneous layer bas been destroyed by pressure and ulcer- ation. The paper showed a very large amount of accurate work. Dr. Denslow, of St. Paul, read a paper in which he reported several cases of the cure of acne by the dilatation of the urethra by Founds. In his cases there were contractions of tbe urethra. Dr. Heitzman introduced several practical points in the treatment of skin diseases. He1e spoke of the advantage of using LeClanche's battery in the electrolytic epilation of super. fluous hairs. Dr. White recommends for seborrha of th scalp the following: 1 Acidi salicylic, 3ss-3 sulph. precip., 3ss-3i; vaseline, gi.-To be ap- plied each night. CANA-DIAN PRACTITIONER. 316",
         "CANADIAN PRACTITIONER. 317 Dr. Heitzman spoke of the treatment of freckles with the following ointment: 1W Precip. a1b. Mayisterin bismuth, 3-50; glycerin, 30. Dr. Stellerwagon, in an exhaustive paper, demonsirated the uselessness in dermatology of many of the oleates. In the discussion which followed there was a general consensus of opinion that the oleates of mercury and copper were the only preparations of this class of any value. The latter is very much inferior to other parasiticides, and the former is of value only in certain conditions of parasitic disease. For general use ointment is much superior to the oleate. eo-O. Tie Technology of Bacteria Investigation.- By CHARLES S. DOLLEY, M.D. Boston: S. E. Cassin \u0026 Company, 1885. European investigators have hitherto done the lion's share of the work in the study of bacteriology. Dr. Dolley urges upon his Ameri- can confreres the necessity of being up and doing, if they wish to add their quota of dis- covery in this important study. He gives ex- plicit directions as to culture, staining, mount- ing, etc., and describes the methods followed by all the eminent foreign pathologists. The literature of this subject is briefly but fully given, and a valuable chapter on \"I Formulary\" concludes the book. Microscopists will find it very useful for reference in their investiga- tions. A Treatise on the Science and Practice of Mid- wifery. By W. S. PLAYFAIR, M.D, F.R.C.P., Professor of Obstetric Medicine in King's College, etc. Fourth American from Fifth English edition. With notes and additions by Robert P. HARRIS, M.D. Philadelphia: Lea Brothers \u0026 Co. Playfair's Midwifery is the best known work on this subject among Canadians. As a text- book for medical students we think it the best available. It is useful not to students alone but also to obstetricians, among whom it is a favorite. Five English and four American edi- tions show its popularity in the Old and New Worlds better than any words of ours pos8ibly can. The American editor has made some ad- ditions, especially as to the use of forceps, with patient on her back; describing American in- struments; objecting to the use of stimulants for wet-nurses and convalescent paturient pa- tients; and favoring the more frequent resort to CSsarian section by the Germani methods. A Practical Treatise on Urinary and Renal Disease8, including Urinary Deposits. By WM. ROBERTS, M.D., F.R.S. Philadelphia: Lea Brothers \u0026 Co. The fourth edition of this very valuable work is now before us. It is one of the most exhaustive treatises in our language, and will be of great value to the general practitioner as a book of reference. In these days, when disease of the kidneys is of such frequent occurrence, it is of great im- portance that the physician should have a thorough knowledge of the subject, so that he may be able to diagnose the condition early, and thus treat it with greater success. This work is divided into three parts. The first part is devoted to the physical and chemi- cal properties of urine, and to the various alterations which it undergoes under different circumstances of health and disease, in so far as they seem to have a practical bearing. The second part treats of a number of affec- tions whic½ may 1e put under the head of urin- ary diseases, viz: diabetes insipidus, diabetes mellitusý gravel and calculus, and chylous urine. The organic disease of the kidney forms the subject of the third and largest part of the work. This edition contains the very latest infor- mation with regard to parasitic disease of kid- neys and micro-organisms in urine, Under the heading of Bacteruria, a description is given of the organisms sometimes found in recently voided urine, HRe divides these cases into three groups, (1) Bacteruria, associated with incipi- ent putrefactive changes in the urine; (2) Bac- teruria, with ammoniacal fermentation of the urine; (3) Bacteruria, without decomposition of the urine. Cases of the latter condition Dr. Roberts thinks are not at all infrequent. The book is well got up in all respects, and should be in the hands of every practitioner.",
         "CANADIAN PRACTITIONER. The following is the very favorable criti- cism made by the Brit. Med. Journal of Dr. Robinson's work on \"Dermatology,\" notice of which will be found in our advertising columns: \"Another substantial book on dermatology, in the shape of an octavo volume of upwards of 600 pages, reaches us from America, afford- ing additional evidence, if that were required, of the zeal and energy of the school of derma- tology which has sprung up in New York during the last decade. The author has already earned the reputation of being a sound pathologist, and the memoirs from his pen on dermatological subjects are invariably referred to by European writers, who discuss the questions to which they refer. The part that he has taken in discussions regarding the so-called dysidrosis, and the pathology of psri- asis and sycosis, have marked him out as a writer of force, and as an observer of consider- able originality. His name is suffcient to call attention to any work on dermatology of which lie is the author. \" The book before us is characterized by con- ciseness, clearness, and, we must add, occasion- ally, dogmatism. It is remarkable for an entire absence of repetition-a featare alone which distinguishes it from many other similar works. This special quality renders the book useful to the general practitioner, who will find the chap- ters on treatment clear, precise, and short, but yet embodying the results of extensive reading and considerable experience. There is so much original work in the book, that it is impossible to do more than to indicate a few points which are of spécial interest from the pathological side.\" Tabulæ .Anatomice OsteologiS. Editæ a CAnoI 0 H. VONKL N. Artium Magistro Medicina- rum Doctore. Editio Emendata. Cincin- nati Lithographic Co. MDCCCLXXXV. This osteological atlas, dedicated rather pedan- tically in Latin t: bis \"Amicissimo Collegoe,\" Carolo A. L. Reed, Editori, Ephemiredis, \" Clinical Brief and Sanitary News,\" etc., etc., comprises thirty-two plates each containing a greater or less number of figures representing every portion of the human skeleton. There are nearly three hundred illustrations accurately showing every bony elevation, depression, ridge, hollow, muscular insertion, foramen, tuberos- ity, fossa, impression,sinus or canal ever imagined and described by the anatomist. The work is a hand atlas, and many of the illustrations are necessarily much less than life size, but the engraving has been beautifully done, and is much truer to nature than the almost diagra- matic woodeuts found in some anatomical text- books. Even the sesamoid bones, and phalanges have been as minutely delineated as the larger and more important parts of the skeleton. The student will find it a reliable guide when lie begins his study of anatomy, while to the surgeon it will prove no less useful for reference. The dentist too will find it valuable. The references are all in Latin, the author being ambitious to reach \"every physician, surgeon, dentist, and medical student in the civilized world,\" as lie states in lis introductory, in order to do which it is necessary to sell the work at a trifle. We hope Dr. VonKlein will succeed in his object; he has evidently devoted great pains, patience and money to the work, and secured accurate and beautiful engravings by the best artists. Dr. OliverWendellHolmesreachedhisseventy- sixth birthday in August. Dr. Paul Vogt, Professor of Surgery at the University of Greifswald, died in July. Dr. Osler, of Philadelphia, will deliver the next course of the Cartwright lectures. Dr. Horace Bascom (Toronto) and Dr. D. Gow (Trinity) have been admitted Licentiates of the Royal College of Physicians, London. Dr. Charles O'Reilly, of Toronto, has spent the last four months in Great Britain and the Continent. He has combined work with plea- sure, and made a careful inspection of the principal hospitals of the old world. He ex- pected to sail for home with hio family, Sep 17th, and reach Toronto about Out. Ist. 318",
         "CANADIAN PRACTITIONER. 319 e$$u$ There are 11,249 members in the British Medical Association. A new edition of the British Pharmacopeia was published Sept. lst of this year. SquibbsEphemeris saysit costs about six cents a grain to manufacture hydrochlorate of cocaine. The tenth annual meeting of the Ame ican Gynecological Society was held in Washington, Sept. 22nd, 23rd' and 24th. The New York Board of Health furnished vaccine virus to vaccinate people ail along the Canadian border of the State. The Atlanta Medical and Surgical Journal reports three deaths in Baltimore which occurred from trichinosis following the eating of uncooked ham. The honour of nobility bas been conferred on the eminent surgeon, Dr. Richard Volkmanîi, Professor of Surgery in the University of Halle. DEATH OF LORD HoUGHTON.-The sudden death of Lord Hou.ghton, which recentlyoccurred in England, is said to have been caused by angina pectoris. Miss Alcott remarked during a trip on an ocean steamer: \" They name ships Asia, Persia, and Scotia, I wonder why it doesn't occur to somebody to name one Nausea.\" To REMOVE THE PAINT SMELL.-Place a few pieces of charcoal in a shallow dish in the painted room, and no sniell of paint will exist in a few hours time.-Medical Summary. A case of dorsal dislocation of the femur of six weeks' standing was lately reduced under chloroform by Bigelow's method after several trials; adhesions had first to be broken up. FissURED NIPPLEs.-Dr. Du Bois, of Phila- delphia, says the application of balsam of Peru to fissured nipples is very beneficial. It should be applied after nursing, about four tinies daily. Mr. Lawson Tait has joined the army of anti-vivisectionists in England. Ie says \" that vivisection is not only useless in solving riddles, such as we have to deal with, but that it is absolutely misleading.\" Dr. Buck, of London, says that if a patient be not-thoroughly under the influence of chloro- form, any irritation of the fifth nerve will pro- duce slowing of the heart and fin.l stoppage, through the pneumogastric nerve. The Boston Medical and Surgical Journal re- ports Dr. Partington as saying, on hearing of the wholesale withdrawal froi the International Medical Congress, that he feared that the Con- gress was likely to be merely a sexual one. One of the orders recently issued by a lead- ing Russian rai;way company is, that one of the guards on every train sha'l always be a Feld- scher, i.e., a party who bas had some surgical training, such training being received general'y in the army. A DEATH FROM HYDRoPoIA.-The British ]fedical Journal reports a death fron genuine hydrophobia, carefully investigated by Dr. Dan- ford Thomas, in a laborer, aged 54, in which the period of incubation was between four and five months. We have a royal medical practitioner in the person of Prince Ludwig Ferdinand of Ba- varia, son-in-law of Queen Isabella of Spain, who obtained the degree of Doctor of Medicine at Munich last year, and is now practicing at Nymphenburg, Bavaria. Chatham has the honor of furnishing two medical presidents; one being Dr. Tye, presi- dent of the Ontario Medical Association; the other, Dr. Holmes, president of the Canada CANADIAN PRAOTITIONER. 31.9",
         "320 CANADIAN IPRACTITIONER. Medical Association. It is said also that there is still much excellent material for presidents left. Baron Léon de Leuval, of Nice, has offered a prize of 3000 francs for the best instrument (easily carried), constructed according to the principle of the microphone, for improvement of hearing. The prize will be awarded at the fourth international Congress for Otology, to be held at Brussels, in September, 1888. A FRUITFUL WoMN.-In the Lyon Médical, July 12, is recorded the case of a woman who had had 27 children, 25 of whom were living and healthy. In one year this woman had five children: 3 born January 2 and 2 on Dec. 27. Out of 27 children, six only were girls. The woman was 68 years and the husband 63 years old. Three daughters are married and following in the steps of the mother: one aged 34 bas nine children, another bas five, two of them twins. The chair of Practice of Surgery in the Col- lege of Physicians, of New York, is about to become vacant through the resignation of Dr. H. B. Sands. There are several applicants for the important position, and it is proposed that they shall enter a conipetitive test for the honor, each to deliver a course of lectures, and a com- miLtee of the faculty to decide on their compara- tive fitness. This is a hopeful sign of the times, and the profession will greet it with joy.-- med. Age. BooMING DoCToRS.-An example of a new style of working up the doctor in a western town has come under our notice. A druggist gets out a printed fly-sheet, extolling the quali- ties of his drugs, dye-stuffs, paints, oils, etc., and also the transcendent abilities of the doc tor who has \"rented the office over my drag store.\" This is said to be done entirely with- out the knowledge of the doctor, who, however, shows his gratitude by giving a certificate, which appears in another fly-sheet, highly recommending the druggist's \"Cream Flake Baking Powder.\" The following combination, recommended by Dr. Fothergill, will be found a useful diuretic: 11. Pot. citrat., ................ 3iiss. Spt. juniper co., ............. .. j. Tr. digitalis............. .. 3iiss. Inf. buchu ad.,................ . viij. M. Sig.--One or two teaspoonfuls three or four times a day.-ifedical and Surgical Re- porter. A DRIGGIST'S MISTAKE.-An extremely sadý case recently occurred in Hoboken through the mistake of a druggist who had had a large ex- perience, and was usually extremely careful. A prescription was presented with ten grains-of quinine to the dose; but sulphate of morphine was substituted, and two young women lost their lives thereby. When such mistakes recar so frequently, it seems strange that drug- gists are not compelled by law to take steps to avoid them. All medicines which are poisonous in large doses should be kept in separate com- partinents, and also in bottles of a peculiar shape and color. A correspondent narrates the following as an, actual occurrence: A young man, fresh from« college, whence lie came with h mors and med als, was sent by his father, a practitioner of fifty years' standing, to atteid a case of labor The woman was in the throes of labor, but the young man on making digital examination found the os undilated. After waiting an hour,' another examination showed no improvemente\u003c He then applied belladonna ointment, and sought to use forcible dilatation. But another. hour passed by, and in spite of faithful work on the part of mother and doctor there was no dilatation. Becoming alarmed, the young man went after his father for assistance, but before he returned with the old man the child was born. -He could not understand how such a thing could bave happened. The old gentle- man on examining the child discovered how it all was. The child's anus was red and patulous, and was liberally besmeared with unguentumn: belladonn. The worthy son of the noble sire had struck a breech presentation, and had ctu ally mistaken the anus for an undilated os Med. Age. CANADIAN PRACTITIONER. 3290"
      ],
      "identifier" : [
         "8_05187_34"
      ],
      "published" : [
         "Toronto : [W. Briggs, 1885]"
      ],
      "title" : [
         "The Canadian practitioner [Vol. 10, no. 10] (Oct. 1885)]"
      ],
      "type" : "document"
   },
   "version" : "0.4",
   "request" : "http://eco.canadiana.ca/view/oocihm.8_05187_34/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1"
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{
   "doc" : {
      "published" : [
         "[Toronto? : s.n., 1876]"
      ],
      "identifier" : [
         "8_05173_16"
      ],
      "type" : "document",
      "title" : [
         "The sanitary journal [Vol. 2, no. 4 (Apr. 1876)]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material I Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei ri Coloured pages I Pages de couleur Pages damaged I Pages endommagées D Pages restored and/or laminated / Pages restaurées et/ou pelliculées Elr nl Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression E Includes supplementary materials / Comprend du matériel supplémentaire E Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "SANITARY JOURNAL. DEVOTED TO PUBLIC HEALTH.: VOL. Il.] APRIL, 1876. [No. 4. PRACTICAL NOTES AND EXTRACTS ON HYGIENE. (Continued.) VENTILATION-INLETS AND OUTLETS-ARTIFICIAL VENTILATION. In the Tobin system of natural ventilation, with a notice of Which the last article on this subject was concluded, no special 0Utlet, it appears, is provided, and it may be said to be appli- eable only to rooms provided with open fire-places, as grates, Which would act as outlets. POSITION, DESCRIPTION, \u0026C., OF INLET AND OUTLE.-The 'elets should be a few feet above the ground, where the exter- ral atmosphere is usually most free from impurities; more or less exhalations are constantly floating in the air which is 4ear the earth's surface. This is an important point to attend to, thoug.h it is not infrequently disregarded, especially in dWellings fitted with basement-furnaces for warming the air or roons above. \" The air must be taken from a pure source \"nd there must be no chance of any effluvia passing in. As a r11e, the inlet tubes should be short, and so made as to be asily cleaned, otherwise dirt loiges, and the air becomes im- Pure. Inlets should not be large and single, but rather numer- 0 and small (from 48 to 60 inches superficial), so that the %r may be properly distributed. They should be conical or rQumpet-shaped where they enter the room (the base or large end toward the room,) as the entering air, after perhaps a 8light contraction, spreads out fan-like, and a slight back-cur- rel:1t from the room down the sides of the funnel facilitates the ing of the entering air with that of the room. To lessen h e risk of immediate down-draught they should turn upwards, ithey are placed above the heads of the persons. Externally he inlets should be partly protected from the wind; other-",
         "THE SANITARY JOURNAL. wise the wind blows through them too rapidly, and, if the current be strong, draughts are felt; an overhanging shelf or hood outside will answer pretty well. Valves must be provi- ded to partially close the openings if the wind blows in too strongly, or if the change of air i8 too rapid in cold weather. If cuvered with wire-gauze, it must be frequently cleaned. \" Sometimes an inlet tube must be carried some distance to an inner room, or to the opposite side of a large room which is unprovided with cross-ventilation. In this case the heat of the room so warms the tube that the wind may be permitted to blow through it. \" The position of the inlets is a matter of some difficulty. If there are several, they should be, of course, equally distributed through the room, so as to insure proper mixing of the air. They should not, however, be placed too near an outlet, or the fresh air may at once escape; theoretically, their proper place of entrance is at the bottom of the room, but if so, the air must in this climate be warmed; no person can bear the cold air flowing to and chilling the feet. . . . \" If the air cannot be warmed, it must not be admitted at the bottom of the room; it must be let in above, about 9 or 10 feet from the floor, and be directed towards the ceiling, so that it may pass up and then fall and mix gradually with the air of the room. The Barrack Commissioners have adopted this plan with half the fresh air brought into a barrack-room. The other half is warmed. It answers very well. \" In towns or manufacturing districts the air is so loaded with particles of coal, or, it may be, other powders, that it must be filtered. Nothing answers better for this than muslin or thin porous flannel, or paperhangers' canvas, spread over the opening, which then should be made larger. This cover- ing can be moistened if the incoming air be too dry.\"-Parkes. As organic impurities in the air of inhabited rooms- even- tually gravitate toward the floor, it has been urged by some that the most perfect ventilation may be obtained by placing the opening for the outflow of impure air low down in the wall, as at the floor. But notwithstanding the fact that the organic matters tend downward, and that the carbonic acid is soon diffused, the tendency of all is undoubtedly upward until the expired air cools, and certainly that method appears most simple and practicable which takes advantage, so to speak, of this upward movement, and aids in continuing it until the foul air escapes from the building above the roof; to which point, in any case, it should be conveyed. For good evidence of the upward tendency of breathed air, one has only toascend to the upper part of an unventilated",
         "PRACTICAL NOTES AND EXTRACTS ON HIYGIENE. roon in which a large number of people are congregated, whein the atmosphere will be found to be warmer, almost \"'respirable, and suffocating, unmistakably more foul and 0ffensive than the lower stratas. On this point, Parkes, than whom we have no better 1 uthority, observes:- \" During the last few years it bas been argued that it is better that the foul air should pass off below the level of the Person, 80 that the products of respiration may be immediately 4%'wn down below the mouth, and be replaced by descending Pure air. But the resistance to be overcome in drawing down the hot air of respiration is so great that there is a consider- able waste of power, and the obstacle to the discharge is somInetimes sufficient, if the extracting force be at all lessened, to reverse the movement, and the fresh air forces its way in through the pipes intended for discharge. This plan, in fact, \"\"'Ft be considered a mistake. . The true principle is that 8tated long ago by D'Arcet. In the case of vapours or gases the proper place of discharge is above; but heavy powders, %risilg in certain arts or trades, and which from their weight 4Pidly fall, are best drawn out from below. aOutlet tubes without artificial heat should be placed at the highest point of the room; should be enclosed as far as Possible within walls, so as to prevent the air being cooled ; should be straight and with perfectly smooth internal Sulfaces, 80 that friction may be reduced to a minimum. In hpe they may be round or square, and they must be covered 4 ûve with some apparatus (the cowl, hexagon tube, \u0026c.), hich may aid the aspirating power of the wind, and prevent the Passage of rain into the shaft. The louvred openings are not the best. «'The causes of down-draught and down-gusts in outlet hos are these ;-the wind forces down the air; rain gets in, 4nd, by evaporation, so cools the air that it becomes heavier an the air in the room; or the air becomes too much cooled Y Passage through an exposed tube, so that it cannot over- qutle the weight of the superincumbent atmosphere; or ainother ~tlet shaft, with greater discharge, reverses the current. Arrangements should be made to distribute the down- uugit, if it occurs; flanges placed at some little distance 0 as to throw the air upwards again before it mixes the air of the room, or simple contrivances of a similar , may be used. Valves should be also fixed to lessen the 4 of the outlet when necessary. If there are several outlet 4 in a room, all should commence at the same distance the floor, be of the same height (or the discharge will be %equal), and have the same exposure to sun and wind.",
         "THE SANITARY JOURNAL. \" The discharge of outlets is much more certain and constant if the air can be warmed. The chimney and open fire is an excellent outlet-so good that in dwelling-houses, if there are proper inlets, no other outlet need be made. When rooms are large, and more crowded, other outlets are necessary; the heat of the fire may be farther utilised by shafts round the chimney, opening at the top of the room, or, in other words, by surrounding the smoke-flue with foul air shafts. \" Gas, if used, should in all cases be made to warm an out- let tube, both to carry off the products of combustion, and tO utilise its heat. The best arrangement appears to be to place over the gas-jet a pipe to carry off the products of combustion, and to case the pipe itself with a tube, the opening of which is at the ceiling; the tube carrying off the gas products is bot enough to cause a very considerable draft in its casing, and thus two outlet currents are in action, one over the gas, and one from the ceiling round the gas-tube. A modification Of the lamp proposed in 1846 by Mr. Rutter answers very well, and is now coming into use, as arranged by Mr. Ricketts. \"In various other ways the heat of fire and lights may be taken advantage of. There will be seldom any difficulty iO arranging the inlets and outlets, and in obtaining a satisfac- tory result, if these principles are borne in mind, viz., to havO the fresh air pure, to distribute it properly, and to adopt everY means of securing the outlets from cold or of artificially war0- ing them, and of distributing the air, which, in spite of al precautions, will occasionally pass down them. \" In hot climates, when outlet shafts are run up above the general level of the building, it would be of advantage tO make them of brick work, and to colour them black, so that they may absorb and retain heat.\" The outlet opening in the wall of the room should always, when possible, be on the side of the room opposite to that Of the inlet. And the higher the escape flue extends, the greater will be the extractive force, the less the atmospheric pressuO. ARTIFICIAL VENTILATION.-This is carried on either bY extraction, drawing the air out of a room-the vacuum 8y8teen or by propulsion, forcing the air into and through a rooin-- the plenum systern. Ventilation by extraction is produced by the application Of heat, so as to cause an upward current, by a steam jet, or bY a fan or sorew, which draws out the air. Of extraction by heat the common chimney, above referred to, is a well known example. When the tire is burning, there is a constant current up the chimney, in proportion, 0f course, to the size of the chimney and the anount of fire-",
         "THE SEWAGE QUESTION. 'The usual current up an ordinary chimney, with a fair fire, 18 said to be, as measured by an anemometer, from 3 to 6 feet POr second. When air enters equably, and is well distributed, the movement of air from the inlets is gently toward the fire- Plce. In a tight room unprovided with inlets, air is drawn wn the chimney, and a double current is established to 8PPly the fre. This is the cause of smoky chimneys, and 'ay be at once cured by making an inlet. In dwelling-houses it has been proposed to have a central eMimney into which the chimneys of all the fires shall open, and to surround this with air shafts connected with the tops rf the roomsi. kines are ventilated by lighting a fire at the bottom of the Shaft. And in theatres, etc., the gas lights are used for warm- g an extraction shaft. Screws and fans for extracting air 4ave for the most part been abandoned, and propelling fans substituted. Ventilation by propulsion was proposed in 1734 by Desa- eliers, who invented a fan or wheel enclosed in a box. In %6 form or another this fan has been used ever since. Large ows are sometimes employed for a like purpose. The plan Propulsion by fans is adapted for cases in which a large ount of air has to be quickly supplied, as in crowded halls, * St. George's Hall, Liverpool, is ventilated in this way. e air is first washed, by being passed through a thin film Ilater, warmed in winter and. cooled in summer. AS to the relative value of natural and artificial ventilation, arkes observes :-\" Circumstances differ so widely, that it is %Possible to select one system in preference to all others. Itemperate climates, in most cases, especially for owelling- Qses, barracks, and hospitals, natural ventilation, with such p7wers of extraction as can be got by utilising the sources Warming and lighting, is the best. Who, in fact, would attemnpt to make use of these vast powers of nature, ch are ever ready to serve us? Incessant movement of the 1a a law of nature. We have only to allow thç air in our and dwellings to take share in this constant change, ventilation will go on uninterruptedly without our care.\" go.et SEWAGE QUESTION.-At the request of the Medical ety of Munich, Prof. v. Pettenkofer is about to give a course of lectures on Sewerage and Sewage Removal, which doubt will be of unusual impoitance, seein that the Pro- o4r iS not merely a theoretical savant, but has done some Slboratoble experimental work on the subject in bis hygien- brtry. 101",
         "THE SANITARY JOURNAL. VAPOUR BATHS. EXTRACTS FROM A TREATISE ON BATHS BY JOHN BELL, M.D., \u0026C Under the head of vapour bathing we include immersion of the body, in whole or in part, in a medium consisting of air in which water is suspended, or of dry air simply heated. The first is called a moist, the second a dry vapour bath. Either of these may hold in a state of suspension, or be impregnated with, various substances, volatilized or dissolved; and it is then called a medicated vapour bath. The use of both moist and dry vapour, for the purposes of hygiene as well as for the treatment of disease, was known to the ancients. The hygienic effects of vapour bathing have been observed on a large scale, as when both dry and moist air baths (laconi- cum and vaporarium) were used by the Romans, the dry air ones by the Turks and other people of the East, and the moist vapour by the Russians. Refreshment and. invigoration- removal of the lassitude and aches incident to long travel and fatiguing exercises, and ability for fresh efforts-are common effects of vapour baths, when of a temperature corresponding with that of the warm water bath, and more especially when they are succeeded by cold or tepid affusions. The extreme softness and suppleness of the skin, one of the hygienie effects of this kind of bath, result from the detach- ment of the outer epidermic scales, which peel off in quantitieS surprising to those who perhaps but a short time previously had subjected themselves to thorough ablution and cleansing in the warm water bath. The reader has been told, in former chapters, how much the internal membranes and organs sympathize with the skin, both in its healthy and morbid states. Of course, it cal easily be understood how the vapour bath, which places the skin in the very plentitude of its functional activity, should exert such agreeable hygenie effects on the entire organism-- the nutritive, sensitive, and locomotive apparatus-and impart both mental and bodily vivacity and strength. Incalculable benefits might be enjoyed by both the young and the aged, in whom nutrition is not well performed, and whose skins are dry and harsh, and digestive functions slug- gish, by the use of vapour bathing. Inequalities of growth of particular parts or regions, bY undue developnent of some and weakness of others, might be greatly corrected,-especially if appropriate gymnastic exer- cises be resorted to contemporaneously with the vapour bath.",
         "Irregularity of certain functions, as of menstruation, and derangements incidental to this state, whether at the age of Puberty or later in life, at what is called the critical age in feuales would be removed by the means now under notice. It has also its value in certain cases of pregnancy, in which the female suffers from nervous disorder and irritability of the vascular system ; and also, after child-birth, where the lochia are defective, and the secretion of milk tardy. Predominance of the lymphatic system, amounting to a ind of plethora, measured by fulness and yet softness and unffiness of the sub-cutaneous tissues, and engorgement of the 'Ymphatic glands of the neck, associated too often with a sFimilar condition of the bronchial and the mesenteric glands, calls for vapour bathing. The preventive or preservative operation of the vapour bath is often manifest when it is resorted to by those who have been chilled by recent exposure to extreme cold, or to cOld and moisture, and who, in consequence, are in imminent danger of violent inflammation-pleurisy, pneumonia, bron- ehitis, rheumatism, \u0026c.,-supervening. The more geneial and extended prophylactic powers of this 8.gent may be readily understood from a knowledge of its PhYsiological effects. Its judicious employment will go far to ward off hysterical and other convulsions, and varieties of lervous disorder. Equally efficacious in this way is the vaPour bath against rheumatism and various forms of neural- gla, catarrh, \u0026c. . In recommending the vapour bath under the circumstances Just specified, I must be understood to have reference to the rflist vapour, except in the instances of lymphatic plethora, a1d a predominance of the lymphatic temperament,-or when the skin is habitually cold, and lacks activity of circulation. these cases, the hot dry air sudatory will be preferred. 'henever we have to do with persons of great sensibility, anid whose systems are in a state of almost continual irrita- bility,-the moist vapour will be chosen for its soothing eflècts. When, on the other hand, we desire to stimulate and to increase the activity of the circulation of the skin and mucous mem- branes, we should direct the use of the hot air bath. QETTING WET.-If the clothing becomes even a little damp, the warmth of the body converts the dampness into steam, Which carries the heat from the body with great rapidity, leaving it chilled, with all its dangerous results. Hence, if the f'eet or-clothing become damp in the slightest, don't wait an 'ratant ; keep on walking until you get to the fire.-Ball's Jr. GETTING wET. 103",
         "THE SAN1TARY JOURNAL. LONGEVITY OF BRAIN WORKERS. Extracts from an Essa By GEO. M. BEARD, A.M., M.D., of New York. (From the Health Reformer.) Thomas Hughes, in his life of \"Alfred the Great,\" makes a statement that \"the world's hardest workers and noblest benefactors have rarely been long-lived.\" That any intelligent writer of the present day, and especi- ally a writer who, like Mr. Hughes, is a thoughtful student of mental hygiene, should make a statement so absolutely untrue, shows how bard it is to kill an old superstition. Between 1864 and 1866, while preparing a thesis for grad- uation, I obtained statistics on the general subject of the rela- tion of occupation to health and longevity that convinced me of the error of the accepted teachings in regard to the effect of mental labor. The views I then advocated, and which I en- forced by statistical evidence, were:- 1. That the brain working classes-clergymen, lawyers, physicians, merchants, scientists and men of' letters-lived very much longer than the muscle-working classes. 2. That those who followed occupations that called both muscle and brain into exercise, were longer-lived than those who lived in occupations that were purely manual. 3. That the greatest and hardest brain-workers of history have lived longer on the average than brain-workers of or- dinary ability and industry. 4. That clergymen were longer-lived than any other great class of brain workers. 5. That longevity increased very greatly with the advance of civilization; and that this increase was too marked to be explained merely by improved sanitary knowledge. 6. That although nervous diseases increased with the in- crease of culture, and although the unequal and excessive ex- citements and anxieties attendant or% mental occupations of a high civilization, were so far both prejudicial to health and longevity, yet these incidental evils were more than counter- halanced by the fact that fatal inflammatory diseases have diminished in frequency and violence in proportion as nervous diseases have increased ; and also that brain-work is, per se, healthful and conducive to longevity. I have ascertained the longevity of five hundred of the greatest men in history. The list I prepared includes a large proportion of the most eminent names in all the departments of thought and activity. It would ho difficult to find more than 2 or 3 hundred illus-",
         "LONGEVITY OF BRAIN WORKERS. tri'ous poets, philosophers, authors, scientists, lawyers, states- Inen, generals, physicians, inventors, musicians, actors, orators, o' philantropists, of world-wide and immortal fame, and whose !Wes are known in sufficient detail, that are not represented 'l the list. My list was prepared, not for the average lon- gevity, but in order to determine at what time of life men do their best work. It was, therefore, prepared with absolute \"¤partiality; and includes, of course, those who, like Byron, aàphael, Pascal, Mozart, Keats, etc., died comparatively young. 1ow the average age of those I have mentioned, I found to be 64.20r. The average age at death at the present time, of all classes of those who live over twenty years, is about Iîfty. Therefore, the greatest men of the world have lived longer, on the aver- age, than men of ordinary ability in the different occupations by foui teen years ; six years longer than physicians and 'ýWyers ; nineteen or twenty years longer than nechanics and day laborers ; from two to three years longer than farmers ; ad a fraction of a year longer than clergymen, who are the 0logest-lived class in our modern society. A few years since I arranged a select list of one hundred 'arnes, comprising the most eminent personages, and found .St the average longevity was over seventy years. Such an lIlvestigation any one can pursue; and I am sure that any chronology, comprising from one to five hundred of the most ernlent personages in history, at any cycle, will furnish an average longevity of from sixty-four to seventy years. Mad- den, in bis very interesting work, \" The Infirmities of Genius,\" es a list of two hundred and forty illustrious names, with their ages at death. The average I found to be sixty-six and Sfraction. In view of these facts, it may be regarded as established that \"the world's hardest workers and noblest benefactors\" Ve usually been very long-lived. To work is to grow; and grOwth, except it be forced is always healthful. It is as much the function of the brain to cerebrate, as of the stomach to digest ; and cerebration, like digestion, is normal, physiological, ed healthful. In al organizations of force, the exercise of force developes more force; work envolves strength for work. orry is the converse of work; the one developes force, teother checks its development, and wastes what already ex- * Work is growth ; worry is interference with growth. iBry l to work what the chafing of a plant against the alls of a greenhouse is to limitless expansion in the free air. 1 the successful brain-worker, worry is transferred into work ; 111 the muscle-worker, work too often degrades into worry. 105",
         "THE SANITARY JOURNAL. Brain-work is the highest of all antidotes to worry; and the brain-working classes are therefore less distressed about many things, less apprehensive of indefinite evil, and less disposed to magnify minute trials, than those who live by the labour of the hands. To the happy brain-worker, life is a long vaca- tion; while the muscle-worker often finds no joy in his daily toil, and very little in the intervals. Scientists, physicians, lawyers, clergymen, orators, statesmen, literati, and merchants, when successful, are happy in their work, without reference to the reward, and continue to work in their special callings long after the necessity has ceased. Where is the hod-carrier, that finds joy going up and down a ladder ? and, from the foundation of the globe until now, how many have been known to persist in ditch-digging, or sewer-laying, or in any mechanical or manual calling whatsoever, after the attainment of independence ? That precocity predicts short life, and is therefore a symp- tom greatly to be feared by parents, bas, I believe, never been questioned. In poetry and in science, the idea has been variously incorporated that early brilliancy is a sure indica- tion of a feeble constitution and an early death. This view is apparently sustained by analogy, and by facts of observation. Plants that are soon to bloom are soon to fade; those whi ch grow slowly live long and decline slowly. Observing these facts, we naturally adhere to the opinion that the same principle should hold good as regards men; but in making the analogy, we foraet that it loses its force, unless the objects implicated start in life with the same potential force and are surrounded by the same external conditions. It is probable that, of two individuals with precisely similar organization, and under similar circumstances, the one that developes earlier will be the firse to die; but we are not born equally endowed and similarly circumstanced. Not only are men unlike in organ- ization, but they are very widely unlike; between the brain of Shakespeare and the brain of an idiot is a measureless gulf, and we may believe that difference of degrees may be found between the greatest and simply great men. We may believe that some are born with far more potential nervous force than others. There are millionaries in intellect as well as in money, who can afford to expend enormous means without being em- poverished. An outlay of one hundred dollars may ruin the mechanic, working for his daily wages, while the royal mer- chant may spend a thousand, and barely know it. There are those who can begin their life-work earlier, toil harder and longer, than the average, and yet attain a very great acge. The average age of 500 illustrious men, including those who 106",
         "LONGEVITY OF BRAIN WORKERS. did not exhibit any special precocity, was about 64.20. Of these, about 500 individuals, among whom there were twenty- five women, 150 were decidedly precocious, and their average age was 66.50, or more than two years higher than that of the list of 500, that included the precocious and non-precocious. So far as I could ascertain, the instances of extraordinary lon- gevity were as great among the precocious as among those who were not. My investigation in this department fully confirm the remark of Wieland, that \" an almost irresistible 'npulse to the art in which they are destined to excel mani- fests itself in future virtuosi-in poets, painters, etc., from their earliest youth.\" The more closely I study biography, the more strongly I becone convinced that the number of really illustrious geni- uses who did not give early manifestations of their genius is Very limited. The manifestation of genius in childhood is as normal and as healthful as its manifestation in maturity; but in child- hood, as in extreme old age, the effects of overtaxing the Powers are more severaly felt than in maturity. Petty smart- ness is often times a morbid symptom ; it comes from a dis- eased brain, or from a brain in which a grave predisposition to disease exists. Such children may die young, whether they do or do not early exhibit unusual quickness. The one requisite for great success is \"grit;\" and, more uniformly than any other single quality or combination of 9,ualities, it is found in those who attain high distinction. ne does not need to practice medicine long to learn that men die that might just as well live if they resolved to live; and that myriads who are invalids could become strong if they had the native or acquired will to vow that they would do so. Those Who have no other quality favorable to life, whose bodily or- gans are nearly all diseased, to whom each day is a day of ain, who are beset by life-shortening influences, yet do live y. grit alone. Races and the sexes illustrate this. The Pluck of the Anglo-Saxon is shown as much on the sick-bed as ill Wall Street or on the battle-field. During the late war I had chance enough to see how thoroughly the black man wilt- ed under light sickness, and was slain by diseases over which his white brother would have easily triumphed. When the nlegro feels the hand of disease pressing upon him, however gently, all his spirit leaves him. The great men of history are as much superior in their will-power to the average of their fellows, as are the races to which they belong to the in- ferior and uncivilized races. They live, for the same reason that they becone famous. They obtain fane because they Will not be obscure; they live because they will not die.",
         "THE SANITARY JOURNAL. MILK, IN ITS MEDICO-LEGAL ASPECTS. BY PROFESSOR R. OGDEN DOREMUS. Aostract of address before New York Medico-Legal Society, Jan. 26th, 1876. Revised by the author. Next to the attainment of pure medicines, perhaps it might be considered desirable that we should have pure articles of diet, and from tiie immemorial we have found a difficulty in milk. The chief diluent is water, and, whether we apply to the vendors or to the fountain head, we are told that no water has been added. In our city we have attacks constantly made upon those who distribute the milk chiefly in small quanti- ties, and we fail to go back, step by step, until we reach those who perhaps really do interfere with the pure article; and I can state from actual knowledge, having paid many visits to the country and neighbourhoods of the city whence our supply is brought, I have found that the method we adopt for criticising milk is rather a premium on dilution, for the removing of the cream and the addition pf water is, I believe, chiefly due to the employment of the lactonieter. I propose to show where this is in error, although it is so popularly re- ceived as a test of purity, and then to demonstrate how, by the employment of thia instrument, it becomes a very profit- able business first to remove the cream and fabricate butter from it, and then send the milk to market diluted with water, which takes the place of cream and brings the milk to the proper standard. And first we can never judge of milk by its gravity. If milk is perniitted to stand there is a light por- tion of it that rises to the surface, which we will call cream, thus showing that it is lighter than the rest of the fluid, and it is this cream that interferes with the working of the lactometer. In chemistry we test the gravity of fluids by different means, one of the best being the little phial called the thousand grain phial, and if we try milk by this it gives us the gravity, but is not at all a test of purity.-The Profes- sor then experimented with the lactometer in milk which, he said, had been taken from the cow an hour or so previous, and that he knew to be pure, and the scale showed 105 degrees. In cream alone the instrument marked 70 degrees. He then continued: If we place it in milk diluted with water we find a similar result, namely, that it will sink in the milk that is diluted, hence we may have two samples, one rich with cream and the other diluted with water to a certain point, and the lactometer will give the same result in each case; hence, as will be evident, it is impossible to determine by the",
         "MILK, IN ITS MUDICO-LEGAL ASPECTS. 109 ?ravity whether the milk bas been enriched with cream or argely diluted with water ; therefore we cannot trust the lactometer; it is no guide to indicate to us the purity of the article. He showed by experiment how the \"alcoholmeter\" would test the degree of dilution of alcohol with water, because water is heavier than alcohol; and on the same principle how the \" acidometer\" would determine the amount of water in sulphuric acid, for here the diluent is lighter than the acid ; how the \"oleometer \" and \"urinometer\" are scientific aids Where the substance we are seeking for are uniformly lighter or heavier than the liquid tested. That since cream and water are lighter than milk, while caseine, milk sugar and the salts are heavier, it is impossible to judge of the purity of milk by its specific gravity. Mr. Wanklyn, a celebrated English chemist, announces in a work upon this subject that the lactometer is one of the most untrustworthy of all instruments. If the lactometer sinks to an enormous depth we can judge that it bas been very largely diluted, but not otherwise, and in fact its use is a bid for adul- teration. I tried the other day milk which stood at 113 de- grees; the cream was removed, and it stood at 135 degrees. A gentleman in Orange County said to me, \" Let the City of -New York adopt the lactometer as the test of the purity of rlilk, and I shall go into the business; but I shall start a but- ter factory at the same time.\" I took samples of twelve dif- ferent kinds of pure milk, and five out of the twelve were be- 10w the standard of 100 deg.-98, 95, 94, 92 and even tri 90 deg. Now, bringing that milk into the city and subjecting it to ehemical analysis, I found this result to be due to the rich- Iless of cream. I remarked that to have brought that milk into the New York market would have subjected the dealer to a fine. So the purest milk must not be sold here, but if they will take off the cream then it will rise to 120 deg., 130 deg., or more, and then it is sure to pass the test of the laco- Ineter. The great difficulty in the Board of Health is, \" What shall we do ? What instrument can we employ ? \" Of course a Complete analysis will at once indicate this, but this is a process tedious and expensive. That the microscope is apt to lead us to erroneous conclu- Sions he showed by placing several drops of the same milk in different slides, and covered them with thin pieces of glass- each showed a field containing different amounts of oil glo- bules, for the thin plates were attracted to the slides, some With more foice, others with less power, and consequently pressed out more or les of the fat globules.",
         "THE SANITARY JOURNAL. I recommend, he said, medical students to place milk, say from different wet-nurses, in narrow test-tubes to observe their relative opacity, then to allow the cream to rise, and judge of its quantity by the thickness of the layer, and lastly to coagu- late the milk with a little acid and a gentle heat, to learn the amount of caseine. The Professor next exhibited a convenient water bath, with graduated glass tubes, as, arranged by the celebrated instru- ment maker of this city, Mr. G. Tagliabue, accompanied with a diluted alkali, and a diluted acid in bottles. He tested sev- eral samples of milk variously diluted, and showed that by agitating them first with the alkali, next with the acid and then raising the temperature to about 190 degrees Fahrenheit, and then immersing the tubes and their contents in cold water, the depth of the various coagulations of cream and caseine indicated their comparative richness in these impor- tant ingredients. But his experiments with this method were too liniited to decide on the full value of this arrangement; he would report further at the next meeting. He also had pas- sed around among the members a small French instrument for ,showing the opacity of milk. His chief object in presenting this theme to the Medico- Legal Society was to solicit the discussion of the propriety of seeking legislative interference to prevent the introduction of skimmed milk, or milk otherwise diminished in nutritive value, into our city. That the lactometer was a premium upon fraud ; that the custom prevailed in the surrounding country of denuding the inilk to a greater or less extent of its cream, whereby the buoyant power of the milk was increased, and it responded generously to the lactometer. He had tested very pure cream where the lactometer sank to 32 degrees, at 60 degrees Fahrenheit; whereas one sample of milk, before skimming, stood at 113 degrees; after remov- ing the creani it lifted the lactometer above its graduation, es- timated at 135 degrees-hence a very liberal dilution with water was necessary to bring it down to a reasonable point. He stated that he had tested samples of milk which he had seen taken from the different cows in Orange county, and that five out of twelve, when cooled to 60 degrees Fahrenheit, indicated many degrees below the standard adopted by the Board of Health-100 degrees ; one sample was as low as 90 degrees. He took these specimens to his laboratory and subjected them to chemical analysis, which demonstrated that their low gravity was due to their richness in cream.",
         "NIGHT MEDICAL ATTENDANCE. He said, in conclusion, that the lactometer had been discar- ded in every part of the civilized world. In France it ,was Used only as a preliminary test, the method of analysis which he had showed being the test upon which punishment was based. There ought to be some protection against the adul- teration of so necessary an article, and as the law stood now the dealers, in their own defense, were compelled to defraud the public. He thought it was the special task and oppor- tunity of this Society to obtain proper legislation upon the 8'ubject. The President rose and thanked the Professor for what he had said and shown them, and endorsed emphatically all that had been urged. The subject was then opened for discussion. Dr. A. N. Bell, in agreeing with what had been expressed in regard to the unreliability of the lactometer, observed, how- ever, that diseased cows had sometimes given milk extremely rich in oleine, especially those fed on swill. During the pre- Valence of the rinderpest the milk was observed to be almost buttery. He feared that the analytic method they had seen ly exhibited the richness of milk in oleine, not its healthful- ue8s. Professor Doremus replied that this would be beyond the power of analysis, which could only show how much Gleime, how much caseine, how much lactine was contained in any given specimen of milk. He was most desirous, however, that the question of swill-milk should be taken up at some future meeting, because he believed that there was considerable Uisunderstanding upon the matter, even among doctors; and he was unwilling that any popular view should be held by 'nedical men without its truth having been demonstrated. A-fter some further discussion a committee was appointed with Professor Doremus chairman, to report at the next meeting.- \u0026\u003eIfitarian, for March. NIGHT MEDICAL ATTENDANCE.-In Paris they have a nice arrangement, which might be useful in all cities, by which the attendance of a physician is secured in case of severe ill 'es at night. Death undoubtedly sometimes supervenes on account of delays and difficulties in obtaining the services of a PhYsician at this time. At the police-offices in Paris, doctors 'ho are willing to get up at night inscribe their names. The Puble inay see the list there all night, and choose any name they please. A policeman will immediately proceed to the doctor's house, return with him, and hand him a ten-franc fee. This fee will be reimbursed to the Municipality by those who 5rý able to afford it, but those who cannot pay will receive Uedical succour gratis.",
         "THE SANITARY JOURNAL. SMALL-POX CARRIED BY A LETTER.-In the February num- ber of the Pacic Medical and Surgical Jounal, a case is given in which small-pox was apparently, indeed without doubt, conveyed from Indiana to California in a letter. A man in the latter place received, on the 14th or 15th of December last, a letter from a sister in Indiana, informing him that she, ber husband, and three children, had small-pox, a babe had died, On the 27th Dec. the man became ill, and the disease de- veloped into a well marked case of discrete verida. A SCHOOL OF PHYSICAL CULTURE.-Dr. Rothrock, a most accomplished botanist, a thorough physician and surgeon, ac- customed to camp life, is to institute a school of physical cul- ture, to be located at a beautiful spot in Luzerene county. The school will be open from June 15 to October 15. Subjects of culture: systematic excercises, the use of firearms, how to meet emergencies and sudden accidents, lectures on physical geography, geology, botany, and the general natural history and meteorology of the region. PERCHLORIDE OF IRON.-It is not generally known that this perchloride preserves meat and fish admirably when plunged in water dosed with it in a very dilute form. A few drops added to milk preserves the serum, as well as butter, for a long time. It has further proved singularly useful, not only, as is well known, externally as an hæemostatic, but also internally, in suitable doses, as an antiseptic, and generally as a disinfectant.-Nuova Liguria Medica. ANTI-VACCINATION.-Dr. H. F. Fermann, Prof. of Medicine, University of Leipzig, has just published a ponderous volume of one thousand pages on the subject of compulsory vaccina- tion. Among other things Prof. G. claims that the scientific side of the vaccination question has not been so fully investi- gated as to justify any compulsion.-N. Y. Medical Record. DURING THE inquiry into the opinion of the epidemic of typhoid which broke out at Croydon in the autumn, it was stated that out of ninety deaths, seventy had been the deaths of the servants and children who might be presumed to live in the-upper parts of houses where sewer gas could obtain ac- cess. An Irish gentleman wished to convert his uncle, and he wrote to him, \"Dear uncle, do give up drink; I'm sure it will lengthen your days.\" In about a week he got an answer to his letter to this effect: \" Dear nephew, I am much obliged to you for your advice. I have taken it. You were quite right when you told me it would lengthen my days, for the day I gave up drink was the longest day I ever spent in my life.\"",
         "THE SANITARY JOURNAL. Communications solicited from Medical Men and others on all subjects pertaining to PubUc Health. OL. IL. TORONTO, APRIL IST, 1876. No. 4. THE HEALTH BURBAU. An important advance has been made toward health legislation in the carrying, by Dr. Brouse, in the House at Ottawa, of a motion for a Committee to enquire into the ex- Pediency of establishing a Bureau of sanitary statistics. The committee are preparing a report to submit to the House before the close of the session, and it can hardly be doubted that good results will follow. We should be glad if space permitted us to give the doctor's sPeech upon the subject before parliament. It sets forth the 'alue, in dollars, of Public Health legislation, shows the mil- lans of dollars that would be saved to the Dominion, the thousands of lives, the most important of all, though seemingly \"'ith the masses of secondary consideration, that would be saVed to the country-lives more valuable, as it were, than the lives of the immigrants, in the bringing of which to the con8try so much expense is necessarily incurred, all by a M0derate expenditure in the enacting and carrying out of upnblie Health laws. We may draw a veil over-we cannot hide, the desolation and lamentation caused everywhere by death, the anxiety and suffering, the ill effects-often far- e.ching, upon the mind, upon the stamina and vigor of the people-of disease, and just notice the fact so Pai'nly set forth by Dr. Brouse, that according to his esti- Mation, fifteen millions of dollars could be saved to the Domin- ' of Canada annually by means of legislation in this behalf. Other members of the House spoke of this estimation as very '0derate, Dr. Tupper said it was not exaggerated in any degree. Over a year ago a similar estimate, upon a like basis, though rived at somewhat differently, was made in this JOURNAL.",
         "THE SANITARY JOURNAL. From that it appeared that thirty millions of dollars could be saved to the Dominion yearly by means of such legislation. Now, how much longer are we to go on literally squandering this immense sum of money, these lives, 15,000 in number, as Dr. Brouse puts it, but probably double that number ? A system of complete statistics, of deaths and of sickness, and the causes, necessarily forms the basis of health legislation. The returns would be a guide as to where insanitary conditions, whether climatie, or relating to soil, or to other causes, of human creation, most prevail, while they would indicate the most common and prevailing causes of disease and death. And as we have before contended, the system ought to be under the control of the central authority, with branches and health Boards in the Provinces. As the Government of the Dominion, or of any country, desires to, and should, know the number of immigrants and emigrants, so it should know the numbers, yearly or quarterly, or oftener, of those coming into the country and going out of it, by births and deaths; besides, it should have knowledge of the quality of its people as well as of the quantity. A complete system of sanitary statistices would enable the Federal Government to point out to the Local Boards of Ilealth, through the Local Legislature, those localities showing the largest death or sickness rate, or a rate larger than ordinary, when remedies could be applied for removing the causes. Health officers would vie with each other in re- ducing the death rate in their respective localities. While the returns would become with the masses interesting topics, as is found to be the case in Great Britain, and the subject of public hygiene would become of general interest, and more attention would be paid to it. More attention two would then, it is believed, be given to individual or personal hygiene. We again say, that the thanks of the entire country are due Dr. Brouse for his work in this matter. It is difcult to over- estimate it. Would to God some medical man in our Local Legislature would rise up and move in a like course. We want, like many States in the Union (U.S.), which we are quite behind in this respect, a Provincial Board of Health. This must come from the medical men in the House. As Dr.",
         "HEALTH BUREAU. 115 homas, President of the Georgia State Board of Health, says: \" If men of our profession, when elected to the Legislature, VOýuld only devote themselves to the interest of their profes- 'ion, and the public good, instead of giving themselves to be eOntrolled by petty politics,what great advances public hygiene Would make in a few years.\" There are several able physi- c-lans in the Ontario Legislature, competent to deal energetic- ally and effectually with this important subject, we trust they soon take action in the matter. CONTAGION AND INFECTION. In the air and water, all around us, we have an invisible World inhabited by untold numbers of organisms which live 1ove and have a being; we have vegetable life of more or le8s luxuriant growth. They all have a commencement of ife, a growth and development, a maturity, a decline and an ienId. There is no doubt that in this great theatre of action there is on a miniature scale the same struggle for life which we see in ail animated nature. Doubtless there exists among these low forms of life the same variety as to strength and 'itality which we observe in the animal and vegetable king- d4o)8 with the naked eye. Some are healthy, others un- healthy; some are short-lived, others longer; some are clean, others unclean; some are benign and affect nothing they come 'n'contact with, others are malignant and poison everything e ýi11ng within their influence. Wherever there is life, there \"1Ust be something to sustain it. These low organisms require food, and probably they mostly prefer to feed upon what we 14y call wholesome diet; if, however, such be not provided, thY consume whatever may be within reach. We know that flany animais would prefer to live upon pure food, but in the absence of such will readily take to decaying matter. How- ever, as we have certain kinds of animais and birds which Prefer to feed upon carrion, so it may be supposed there are %imnong these invisible beings, certain species which find their Itural food in the decomposing organic matter floating in the '' and water. Now, in this decomposing or putrefying mat-",
         "THE SANITARY JOURNAL. ter we may have a specific poison, or simply a poison arising from the putrescence. In either case, the germs, by partaking of it, become likewise poisonous. Low and degraded organ- isms will rapidly multiply when they have putrefying matter to feed upon. We (see a carrion on the plains, a few days after death of the animal, and it is instinct with maggot-life. Likewise among;the air-germs, there are certain forms which rapidly spring into texistence when food is supplied of the right sort for such development. And now we come to the practical point. What is the most likely source of food for· these degraded germs ? It will not be found in the open country, although even there low forms of life may exist, as in malarious districts. It is in towns and cities, wherever there is an aggregation of dwellings; unless measures be adopted to remove the excreta and offal, before the process of putrefaction commences. It may, and often does exist in suburban and rural places of abode. In close rooms, in cel- lars, in the yard where the kitchen slops are daily thrown, this poisonous material may be found; but it is in the larger towns and cities where it is supplied most abundantly. The emanations from the sewers, and lanes and backyards constitute the food, in rich quantities, for the organisms of which we have been speaking. These organisms no doubt exist in swarms, and move here and there as the air may carry them. When the air is at rest, and the aggregation great, the air is correspondingly impure. Any motion of the air is unfavourable for the increase of the germs; but free motion, as a wind, will scatter the organisms and the food they are consuming at the same time. We often see this taking place in the insect world. On a hot, still day, clusters of flies of different kinds may be seen cloud- ing the air; but a stiff breeze springing up, they are soon scattered. It would seem that it is when there is an aggrega- tion of organisms, that the most danger exists of infection. If the air, when crowded with them, is taken into the lungs, it is more likely to infect the system. The air-germs, no doubt, often lodge upon different objects. It may be something inanimate or living; it may be a fixed substance or a moving",
         "CONTAGION AND INFECTION. Onle. Anything passing through the air crowded with these germns, may be as it were covered with them. If it be some- thing with a rough surface, or with a porous texture, these little beings may find a secure lodging-place, and be carried geat distances. For instance, a dog with a shaggy coat, or a human being with his garments of wool or other coarse '4aterial, may pass through a space numerously inhabited by gerns, and they thickly fasten to bis body, and may be then c-aried far, as well as near. Or some object of a portable nature, as a trunk, or satchel, or umbrella, may be within reach of the germs and they settle upon it; and when it is taken by human means, the germs lodged upon it are trans- Ported wherever it may go. It is in this way many contagious disBeases, as well as infection, are disseminated. Scarlet fover, or some other contagious disease appears in a family; its origin cannot be traced; the child has not been exposed to the disease; it is not even in the neighbourhood, and it is a '\u003cYtery how the disease was contracted. But the disease had not arisen spontaneously; the seeds had been brought by some en'ans. It may have been some garments borrowed, while eut, to protect from the cold or wet; it may have been some isitor, whose clothes contained in their meshes the germs of the disease, requiring only to be shaken out into suitable soil, 'r' order to show their vitality. Possibly it may have been a dog, which had in some distant part received in its hairy covering the disease germs. The seeds of many contagious diseases, especialy scarlet fever, may, like grain, be preserved for an indefinite length of time. Hence the importance of disinfecting clothes, and rooms where contagious diseases have existed. LIFE INSURANCE AND PUBLIC HEALTIL There 8is no class more deeply interested in the subject of Public health, for obvious reasons, than life insurance compa- ]lies, including, in mutual companies, every one whose life is ibsured therein. We earnestly desire to enlist the co-opera- tion and assistance of all such in this vital subject. We have 117",
         "THE SANITARY JOURNAL. been requested, on several occasions, to add to the SANITARY JOURNAL a life department. Although our space is at the present time very limited, we shall in the future devote some attention to this branch. Life insurance has developed t» such an extent, that the public, the companies, and medical examiners are alike interested. In this connection, it may be observed, that our attention has been drawn to an interesting article, by Dr. Theodore Parker, of New York, in the Medical Record, N. Y., to which belongs a « Medical Department of Life Insurance.\" Dr. Par- ker draws particular attention to the relation of medical examiners to the companies. He declares it has been believed by some that medical examinations were of little use in life insurance. \" In every case,\" he says, \" the examiner should consider himself as representing the company, and not the agent or applicant. In passing upon applicante, he should know no friendship, and should give the company the benefié of all doubt.\" As, in cases where a necessarily rather hurried examination fails at the time to discover any organic disease, and yet the general appearance suggests a doubt as to the safety of the risk. The correctness and justice of this can hardly be questioned. The relation of the examiner to the applicant is no doubt often peculiar, he may be his regular physician; nevertheless, he may, if he gives the applicant the benefit of a doubt, do injustice to others of his patients who may at any time, if they have not already, become appli- cants, as well as injustice to the Company. ISOLATION AND CONTAGION.-The Briti8h Medical Journal asserts that medical health officers are constantly bringing to light revelations of the spread of disease, resulting in death, through carelessness in respect to isolation. The Journal mentions two instances as showing \"how much misery is occasioned which might be prevented, would the people but exercise those principles in the way of precaution which are called into play when property is at stake from fire, or the lower animals are threatened with extermination by cattle- plague, and discharge that duty to society which the moral law demands.\"",
         "EDITORIAL NOTES. REALTHINESS OF THE PAST UNUSUAL WINTER. - In the February number of this JOUNRAL was an extract on the Wide-spread popular error that \"a green Christmas makes a at church-yard.\"' On this subject the Med. and Surg. Re- Porter, Feb. 19, 1875, observes:-\" The health of this city (hiladelphia) is much better than during the same season last Year, which was very cold. Such is also the case generally.\" On' the same topic Dr. Snow, of Providence, Rhode Island, re- rýarks, in his last monthly report :-\" It is a popular idea that Very mild weather in winter is very unhealthy. Let us ex- ahnie this theory. January, 1875, was remarkahly cold; Jariary, 1876, was remarkably mild. The first January was 'Older, and the last was warmer than any corresponding month fr many years. Let us compare the mortuary results. The 4eaths from some prominent causes in the two months were a follows 1876. 1875. Whole number of deaths...........115 159 Pneumonia ........................ 15 35 Consumption....................... 22 31 Croup............................. 5 10 iBronchitis ........................1 6 Scarlatina ........................4 19 *This shows a large decrease in the warm January of the Present year, not only in the whole number of deaths, but a1so, especially, in those causes of death which might be sup- Posed to be influenced by the winter weather. e This resuit agrees with my observation for many years Past. Extreme cold, or extreme heat, if continued for a week Or More, increases the mortality; while more temperate Weather, whether in winter or summer, is favorable to health. \" The population of Providence, by the census of June 1, 875 was 100,675. The mortality last month was, therefore, the annual rate of only 13.7 in each 1000 of the population. January, 1875, calling the population the same, the deaths were at the rate of 18.9 per 1000.\" Dr. Whitmore, Medical flcer of Health, Marylebone, Eng., in his monthly report for November last, says the deaths from bronchitis, pneumonia, E'id heart disease, have increased with the advent of the cold Weather. .\" INSTRUMENT has been invented in England for deter- rafliug the velocity of sewer-gas, so that the result of the stepa 'g taken for drawing out the gases aud ventilating the aWOer in large towns can be ascertained. A velocity has been \u0026ttained of a mile per minute; and it is believed that a stili 86ater extracting power will shortly be effected. 119",
         "TE. 8ANITARY JOURNAL. EARLY TREATMENT OF DIPHTHERIA.-Dr. Garraway, in a communication to the British. Med. Jour. (Feb. 19th, 1876,) endeavors to forcibly impress upon the public that the sever- ity and mortality of diphtheria' are regulated and controlled ac- cording to the period at which the disease comes under medi- cal supervision. \" Whereas ten or fifteen years ago,\" lie says, \"I looked upon these cases with a sort of horror, seeing that they were generally far advanced in blood-poisoning before medical aid was sought, now that my patients have been taught the importance of early treatment, I could well regard the disorder, save for here and there a grave exception, as one of the most trivial of throat-affections. But what is the first stage ? That in which the germ or parasite, having lighted on its appropriate nidus *(most commonly one of the tonsils,) has begun to multiply and spread over the adjacent mucous surfaces, like mould upon raspberry jam, to which it is not very dissimilar. It has not yet taken root enough to impreg- nate the constitution with its baleful influence: the pulse is not quickened; the temperature is not raised: the tongue, perchance, is not furred. In all cases of illness, when diph- theria is prevalent, it is expedient to look into the throat, as occasionally when there is not even ground of suspicion, the characteristie spot or layer of mouldiness, like an irregular patch of white kid, will be discerned. Now is the time when we are enabled to say, ' Thus far shalt thou go and no further.' Now is the time when one single painting with a strong solu- tion of nitrate of silver will effectually destroy the parasite and rescue the patient. Twenty-four hours after this applica- tion, the \" white leather \" is seen dark and shrivelled, and the following day it lias dropped off and disappeared. Contrast this with the same disease three days later on. I need not describe it; the picture has been only too vividly impressed upon the minds of all of us; the layer of deposit spreads more or less over the fauces, perhaps entering the larynx, when re- covery can scarcely be looked for; the rapid pulse, the exalted temperature, the extreme nerve prostration, the blood more hopelessly poisoned than in typhoid fever, and death more im- minent.\" EFFORTs are being made in London, Eng., to get a clause in- serted in some Bill in Parliament to compel the builders of al houses to be erected in future in the metropolis to construct a ventilation-pipe, to be carried from the drain of the house above the roof of the building; so that the sewer-gases, instead of entering the house through the drains, will be carried off at the top of each house.",
         "EDITORIAL NOTES. EFFECTS OF RESPIRED AIR.-Dr. De Chamont, Professor of Military Hygiene, in his late work, \" Lectures on State Medi- eile,\" declares that the changes in the atmosphere which Ocur through combustion are 'coinparatively insignificant by the side of respiration, including transpiration, which is really the most serious and constant source of impurity,' as the Oxygen is greatly diminished, the carbonic acid largely in- creased, a larger amount of watery vapor produced, a consider- able quantity of organic matter and ammonia evolved, and a Tlotable quantity of suspended matter set free. He believes that this fact has not received the attention it deserves, as along the rich and poor the most constant condition is ill- lentilated dwellings,' and that consequently phthisis, (con- BUmaption), which causes about 108 per 1,000 deaths, takes the frst place on the death-rate; that bronchitis, with 87 per 1,000 deaths, takes the second; atrophy and debility, with 61 Per 1,000, the third ; and old age, which should occupy the arst place, only obtains the fourth, with 55 per 1,000. That the injurious effects of air vitiated by respiration and trans- Piration are not confined to these above-named diseases, but extend also to zymotic diseases; and that if we could get rid of the effects of crowding, and provide a supply of pure air to the community, we might diminish the mortality by more than one-fourth. INSPECTION OF DAIRIES.-The Sanitary Record announces the outbreak of another distressing epidemic of typhoid fever at Eagley, which is distinctly traceable to the milk-supply. 1pwards of 120 persons who were supplied with milk from a Particular farm in the neighborhood were attacked with some- What peculiar symptoms, stated to be a hybrid of typhoid fever 'and ordinary blood poisoning. The drainage on the farm Whence the milk was supplied is stated to be of the worst pos- Sible character, and the inference is that the milk was mixed With the poluted water, which was also doubtless used to wash the utensils on the farm. The epidemic has also made its apearance in Bolton in those houses which were supplied with the milk. This very serious outbreak of epidemic disease fol- 'Owing on various others of the same character, says the Record, shows the absolute necessity for the systematic sanitary inspec- 1on of all dairy farms. In Canada there are no systematic in- Vestigations as to causes of typhoid and such like diseases, and eOlosequently no.knowledge as to the amountof disease produced bY.poisoned milk. Foul milk and disease germs are swallowed ad no questions asked. 121",
         "THE SANITARY JOURNAL. ARTIFICIAL INFANT DIET.-On this highly important subject, Dr. Dawson gives some valuable suggestions in the Obstetrical Journal. Regarding the dilution of cow's milk, he says: The addition of water alone does not improve the digestibility of the casein, for it does not dilute it; and when milk is intro- duced into the stomach, diluted with water, the water is soon taken up and the casein is left as undiluted and unchanged as before the food was given. Nor does the addition of sugar make the coagula any more easy of digestion. The admixture of farinaceous articles with the milk also leads to disastrous consequences. Good cow's milk diluted from one-third to one- half with barley-water, forms one of the best articles of food that can be used for infants when it is necessary to bring them up artificially. If barley cannot be obtained, oatmeal may be substituted, and answers nearly as good purpose. This article produces a real dilution of casein, and renders the coagula much fluer and more like the coagula which is found in milk from the mother's breast. THE SANITARY BuRiEA.-After having attempted, at two previous sessions of the House, to carry a like measure, Dr. Brouse has at length succeeded in getting the Dominion Government to consent to a motion for a Select Committee to consider the expediency of asking legislation, with a view to constitute a Bureau of Sanitary Statistics, in connection with one of the Public Departments. The committee is composed of the Hon. Messrs. Holton and Robitaille, Drs. Brouse, Lan- derkin, Forbes and Christie, and Messrs. Blain, Dymond, Burpee (Chas., N. B.), Scatchard, Flynn, Young, Kerr, and Fiset. We are much pleased to find the members for West and North York are on the committee. Such a Bureau, as proposed, would lay the foundation for, and is essential to, prac- tical and efficient public health laws. The returns of vital statistics, too, would soon, as in Great Britain, become popular topies, and public health would feel a resulting favourable change in public opinion. AT A MEETING recently of the Northern Counties (Eng.), Association of Medical Officers of Health, Mr. Elliott, the presi- dent, said, longer life and better health simply meant an increase in this world's comfort and happiness. That human life could be extended and human health could be improved could no more be doubted than the fact that human life could be shortened or life deteriorated. They all knew that human life-like the quicksilver in a barometer-rose and fell accord- ing to certain rules and under certain influences.",
         "EDITORI\u0026L NOTES. VITAL STATIsTIs.-In the United Kingdom, 1,112,295 births and 726,351 deaths were registered during the year 1875; these nIumbers give a birth-rate of 34.0, and a death-rate of 22.2 per 1,000. The excess of births over deaths was 385,944; 33,778 less thana in the previous year. In the last quarter, however, the birth-rate was above, and the death rate below the average. The deaths registered in England and Wales from all causes dutring the year included 79,259 which were referred to the seVen principal zymotic diseases, showing a decline of 5,860 *rom those so returned during 1874. These 79,259 deaths included 1,000 from small-pox, 5,973 from measles, 26,165 roIM scarlet fever, 3,078 from diphtheria, 13,435 from whoop- 'g-cough, 12,545 from fever, and 23,063 from diarrhoœa. The rate of mortality from these seven diseases was 3.3 per 1,000, against 4.5, 3.8, 2.9, and 3.6 in the four preceding years. The fatal cases of whooping-cough and diarrhœa were more 11%erous than in 1874, whereas the deaths referred to the f'e other zymotic diseases showed a decline. The deaths Ifom small-pox were less in number than in any year since civil registration was established in 1837. . MOST HUMoRous and outspoken health report is being no- ticed by our exchanges. The health officer of Westhouton Ocal Board, Dr. Gregory, reports as folows:-\" One-fourth of the deceased ought to have been alive, and would have been alive now, had your board, or inspector, or prede- 3e4gors, or all of you, done your duty. When a man has ived forty or fifty years in a fairly elevated house, and is then eflmoved to a house the basement of which is on a level with the earth, no wonder that bronchitis or some other internal dis- Order deprives him of the residue of his years.\" Dr. Gregory omPlains of the indefiniteness of the sub-registrars, and gives a examples 'suspected heart-disease ;' 'probable cough,' pro- able vomiting;' and considers they might as well write' pro- ably from sneezing.' He says, as regards these 'causes of tdeath' that he would prefer having such a one as the folowing, e invention of the inimitable Tom Hood the elder: She had two bad legs, and a badder cough, But her legs it was as carried her off. . LANDERKIN stated in the House at Ottawa, the other day, that some time ago an epidemic of small-pox broke out in t.e Place where he resided (county of Grey), and as the Muni- CiPal Council were unable to appoint a board of health until a 1oelanation was issued, in accordance with our present Public ealth et, the epidemic made headway, and many lives were oIt before the board was organized. Comment is unnecessary. 123",
         "THE SANITARY JOURNAL. A NEw UNIVERSAL DISINFECTING POWDER is being brought into use. It claims the approval of health officers and others, on the grounds of its cheapness, its great effliciency, its con- venient form, its perfect solubility, its absence of colour, and its freedom from all unpleasant odour. It is rapid and effective in action, and may be used freely in powder or solution for the disinfection of drains, sewers, cesspools, for urinals and closets, and for all the purposes of disinfection in houses and hospitals. It is composed chiefly of calcii chlorid., zinci. sulph. and sodii chlorid., so that when water is added to it a partial decompo- sition takes place by which chloride of zinc is formed in the solution. It acts powerfully as a deodorant and disinfectant by stopping those changes in organic matter which give rise to pu- trefication and to disease. It is analogous to carbolic acid in its action and can be used in all cases where that unpleasant smelling disinfectant has hitherto been employed. ARSENICAL RoOM-PAPERS.-Dr. Hodges, (Sanitary Record,) at a late meeting of the Chemico-Agricultural Society of Ulster, referred to a case of arsenical poisoning in Belfast, in which a paper-dealer was sued for damages in consequence of the serious illness and expense for medical attendance occasioned in a gentleman's family by poisonous room-papers purchased fromn the dealer. The danger was fully proved, but the Recorder ruled that, as there was no proof the freedom from arsenic had been guaranteed, a verdict must be given to the defendant. In Germany and France the use of such papers is prohibited, with severe penalties, and should not be permitted in any country. Dr. Hodges stated that both light and dark green papers may be coloured with arsenical pigments. TiHE MORTALITY in the liberties of the city of London, (Brit. Med. Journal), within and without the walls, was equal to 430 per 1,000 in 1665, the year of the great plague; whereas in the cholera year 1849, the most remarkable English epi- demie year of modern times, the death-rate in London did not exceed 30 per 1,000. This represents remarkable sanitary progress, although the range in the death-rates during the de- cade 1861-70-between 15 and 39 per 1,000 in the 600 dis- tricts of England-conclusively proves how much sanitary work wanted doing in 1870, the bulk of which still remains to be done. IN LONDON (Eng.), all the cabmen's shelters are now thrown open, free of charge for admission.",
         "EDITORIAL NOTES. VALUE OF PROLONGED BATHs.-Kisch thinks it is a subject for regret, says The Doctor, that prolonged baths, i.e., in which the patient remains several hours, or even a whole day, seem to be dying out of notice. Prolonged baths of 37-38 deg. C. are an admirable means for soothing irritated nerves, and influencing the skin by imbibition and saturation. The excretory organs are also stimulated by them, and the process Of healing of open wounds and ulcers greatly assisted. They 8upply an admirable anesthetic in cases of neuralgia and hyperæsthesia, or exposure of the cutis, and further, are a ileans of promoting the general metamorphosis of tissue and the expulsion of unhealthy materials present in the body. . A NEW DISINFECTANT has been exhibited at a recent meet- lug of the Medical Society of Victoria, by Dr. Day, an article 3y whom, on the \"Disinfecting Properties of Certain Substances In lEvery Day Use,\" we published last year. He had been long lia search of an agent capable of purifying the hands after post- 'rortem examinations, and for the use of persons in attendance 'Ipon the subjects of puerperal fever or other infectious diseases. le has found that a most effectual disinfectant is produced by the combination of a drachm of etherial solution of peroxide of hYdrogen (erroneously called ozonic ether) with an ounce of rimmel's toilet vinegar. THE MORTALITY OF MONTREAL, according to Mr. Workman (recent debate on Sanitary Statistics at Ottawa), is not so eat as has been represented. He computes it at 39 per 1000. e says a large number of children, many of them in a dying state, are brought from neighbouring towns to the charitable Ilstitutions of Montreal. The mortality was most largely colfined to children under four years of age, during July and August, which was \"really appalling.\" The adult population, he said, was as healthy as in any town on the continent; and the water supply was as pure as any in the world. . SUBSTITUTES FOR SPIRITs.-The Wrexham Board of Guard- lans have for years past ceased to administer stimulants in their workhouse, and the guardians of St. George's, have just had a discussion on the advisability of adopting a similar Oourse. Milk and eggs are given instead of stimulants, at an alnual cost of about £20 a year, and £100 are saved annually. The inmates of the workhouse are said to like the change, and tO be better in health since it has been adopted. It is said luuch mischief has been done by the amount of stimulants taken under medical directions. 125",
         "THE SANITARY JOURNAL. THE PRESIDENT of the State Board of Health of Georgia, Dr. Thomas, who is also a member of the Legislature, in a communication recently received, informs us, that notwitb- standing efforts were made, on political grounds it would appear, to repeal the law of last year creating a State Board of Health, he succeeded in carrying a further measure for establishing at once Local Boards in every county in the State, whose duties shall be to advise the ordinaries with regard to registration, and to supervise sanitary affairs in their counties. A COMMUNICATION ON THE PRESERVATION OF MEAT has been made to the Paris Academy of Sciences, by M. A. Reynoso. The means employed are compressed air, oxygen, nitrogen, hy- drogen, etc. M. Reynoso says he bas succeeded in preserving meat, fresh and with the blood in it, in the case of beef, in pieces weighing 63 kilogrammes, for periods ranging from one month to three and a-half. So long as it remained in the appa- ratus it remained fresh and full of blood, and when taken out it kept a longer time than fresh meat from the butcher. MANAGEMENT OF TYPHOID PATIENTS.-In a late discussion on this subject at the Dublin College of Physicians, Dr. Grim- shaw remarked that his practice was to leave the patient as much alone as possible. Unless the diarrhoea was excessive, we should be cautious about checking it. He had tried the cold-water treatment, but thought the temperature could be more safely reduced by quinine, which would also act as a tonic. His views were approved by most members present. THE LOCAL GOVERNMENT BOARD, according to the Dublin Gazette, have empowered the Belfast sanitary authority to make regulations arranging the number of parties who shall occupy a bouse, or part of a bouse, also to register ail bouses let or occupied by lodgings, for the registration of those houses, and for the purpose of enforcing cleanliness and due ventilation. The corporation by these powers can enforce the regulations fixed by them by penalties. IN THE DISCUSSION on the question of a Bureau of Vital Statistics in the House at Ottawa, March 20, '76, Dr. Christie stated that he believed a greater number of lives were sacri- fied in Canada, through preventable diseases, annually, than there were immigrants brought into the Dominion during that period. No doubt, to save those lives, would cost much less money than is spent in immigration.",
         "BOOK NOTICES. TRE IS A METROPOLITAN and National Nursing Associa- tion, for providing trained nùrses for the sick poor, in London (Eig.) Much interest is being taken in the association by aledical men, the Duke of Westminster and others. Great .8Mistance is declared to be derived from the nurses, and there is evident improvement in the rooms of the poorer tltients attended by them. A CLIMATIC* AssocIATION, for the benefit of invalids and ilsurance companies, has been proposed by Dr. Denison, of benver, Col., to be composed of physicians, especially repre- sentatives of health resorts, \" devoted to the prolongation of hie, and the adaptation of climate to the needs of invalids.\" A part of its labours would be to collect statistics of all limates. BOOK NOTICES. FIRST ANNUAL REPORT OF THE BOARD OF HEALTH OF THE STATE OF GEORGIA, U.S., for the year ending Oct. '75. This is a volume of over 200 pages, though it covers but a few rlIOnths of work, and it is said is only intended to foreshadow to the people what the Board propose to do in the future. Besides many forms, the law creating the Board, constitution and rules, address to the nedical profession, etc., there is a report on each of the follow- 1ng subjects, viz., endemic, epidemic and contagious diseases ; hy- g1ene of schools; influence of trees on health ; sale of poisons, etc.; and on the most effective means of preventing small-pox in Georgia. . To one special point in the address to the medical profession, seem- 'ngly suggested by the \" deplorable prevalence of female diseases,\" We wish to draw attention, as touching the important subject of vital statistics. It refers to the etiology and the consequences as affecting the Mother as well as the offspring, as relates to the registration of pre- flature births. Forms are prepared for the accurate inditement of these. Having marked some parts of this interesting report, which We mntend to draw upon on a future occasion, we must conclude the present notice with the following truthful lines from the report by Dr. Campbell :-\" Public sanitation is the last, the grandest, and nOst benevolent gift an enlightened government can bestow upon its people. Though not so proudly contemplated by the people of a State as would be the acquisition of a territory, nor so highly valued as the removal of an impost or the reduction of a tax ; yet, in its efiicient operation, preventitive medicine enhances the population r4Ore than the one, and enriches the people's treasury abundantly tnore than the other.\" 127",
         "THE SANITARY JOURNAL. INSANITY IN ITS MEDICo-LEGAL RELATIONS. By A. C. Cowper- thwait. Philadelphia: Stoddart \u0026 Co. This is a neat little volume, consisting of seven chapters, on the pathology, classification, and diagnosis of insanity, crirninal respon- sibility of the insane, epileptic insanity, and treatment of the insane. As the author observes in the preface, he is not bringing forward any strikingly new ideas, but endeavoring to incorporate in as little space as possible the ideas, \u0026c., of eminent physicians, with his own some- what extended experience; essential facts which should be familiar to every physician. In the treatment of the insane, the author mentions three impor- tant elements :-no restraint ; open air; association with healthy minds. Neither of these being \" attainable where hundreds of invalids are assembled under one roof, and the whole atmosphere is saturated with insanity.\" TO CORRESPONDENTS. SOMNOLENCE.-The benefits of early rising have long been thought to be great, but it seems more than probable that the advantage is derived from going to bed early, instead of \"night watching \" until 'midnight or later, rather than from \" Leaving the easy couch at early day.\" Long-lived people have usually been early risers, but they rose early and lived long because they were vigorous and had good con- stitutions ; they did not live long because they were \" Up at early dawn.\" The air in the early morning is said to be less pure than it is after the sun has been shining for a time. We shall endeavor in our next to give Hufeland's reasons for -believing that sleep before midnight is much more beneficial than after that period. IRIs.-The color of the eyes does not change, though the shades do. There are said to be, strictly speaking, only two colprs, blue and brown ; these together, produce hazel. Very light color of the iris indicates constitutional weakness and early dissolution. It is also said that most persons of eighty have hazel eyes, few have blue, and none brown. OZoNE.-Mix very gradually three parts of strong sulphuric acid with two parts of potassium permanganate ; according to Bettger, the mixture will continue to give off ozone for several months, and may be used for the purification of the air of hospitals, public halls, rooms, etc. SPEcIALITY.-The ancient Egyptians, who were greatly advanced in the science of medicine, only permitted each physician to practice his own peculiar branch. Not a bad precedent. J. G. T., Ga.-Very much obliged for your interesting corn- munication. Would be glad to hear from you often. 128",
         "THE SANITARY JOURNAL. SUBSCRIPTIONS RECEIVED since March rst. :-Dr. Osler, for ('75 and '76), and Dr. Ross, ('75,) McGill University, Montreal; Dr. Theodore Parker, ('76), New York; Dr. J. G. Thomas,('76),Savannah, Ga. ; Dr. Brouse, M.P., ('76), Prescott; Dr. T. Christie, M.P., ('76,) Lachute, Q.; Dr. Baxter, M. P. P., ('75), Cayuga ; Messrs. P. Patterson, M.P.P., ('76), Patterson; K. Chisholm, M.P.P., ('75). Brampton; Wm. Brown, ('75).; S. McColl, M.P.P., ('75), Vittoria; J. McGowan, ('75,) Alma; J. Watterworth, ('75), Wardsville; Dr. C. T. Noble, ('75), Georgina; Dr. Geo. Hodge,('75,) and Dr. Hornibrook,('75), Mitchell; Dr. Burdette, ('75), Belleville; Dr. C. Freeman, ('75), Milton ; Dr. Ghent, ('75,) Priceville; Dr. T. K. Holmes, ('75), Chatham ; Dr. Fraser, ('75); Messrs. E. Martin, ('76) ; and Robt. Wilkes, ('76), Toronto. THE PUBLISHERS desire to apologize for the late appearance of the JOURNAL this month ; caused by the Editor being absent, in Ottawa, in the interest of Public Health. WE SHALL FEEL MUCH OBLIGED to any of our readers who will send us articles or items of interest on any subject connected with Public health. . THE ALDINE is now published in 24 parts, issued fortnightly. It 1s growing constantly in elegance and value, and is educating the taste in the beautiful. The ndpendent, N.Y., says it is a much better fine art serial than has ever been started or sustained in the United States, and that the issues for 1876 show it will be even better than ever. Louking back a little we find in a number for January last, \"Shooting the Rapids,\" from a picture of the well. known Canadian artist, Mr. Verner. IN THE APRIL NUMBER OF THE Canadian Monthly appear the opening chapters of a new novel entitled \" As LONG AS SHE LIvED,\" by F. W. RoBIN.Sso, a well known English novelist, the author of l Little Kate Kirby,\" \" Second Cousin Sarah,\" and other notable Works of fiction. The new serial is published by arrangement with the author, and is expected to be completed in about ten numbers of the Magazine. A DEFENCE OF ERIE B. SPARHAM ; being a Medico-Legal Inquiry into the cause of death of Miss Burnham, late of Brockville. The writer contends in this, that abortion may not have been pro- duced in the case of M'tiss B., and if so, that it was not caused by the acts of Dr. Sparham, especially with intent ; that the instrument used was a speculum; that while Miss B. in her depositions, \" described every incident of her trouble with surprising minuteness of detail,\" Yet in \"no instance does she say that Dr. Sparham said he gave Medicines with the intent specified in her deposition,\" that \" in the absence of any certainty of diagnosing pregnancy, it is held by many cOlscientious physicians, legitimnate and proper to prescribe for amen- orrhSea.\" The defence is intended, and does tend irresistibly in the Mind of the reader, to throw a doubt in favor of the prisoner. Truly inedical men are, more than any other class, sometimes placed in most Peculiar and trying circumstances. 3",
         "TUE SANITARY JOURNAL. THE HEALTH Lirr, advertised in this JOURNAL, is highly spoken of by some of our exchanges. The Sanitarian says, to those who are well and would keep so, brain workers, office-keepers, \u0026c., it is a boon. It is also a valuable means for obtaining systematic ëxer- cise, for the nervous, the debilitated, the dyspeptic. See advertise- ment and send for circular. OBITUARY.-DR. PARKES, the well-known writer on Hygiene, and so frequently quoted in this JOURNAL, died, March i 5th, near South- ampton (Eng.) His life was devoted to his country and to science, and to within a short time of his death, it is said he was engaged in correcting proof-sheets of a Manual of Hygiene. THE OPEN-AIR FLOWER SEASON is at hand; flower-pots, in any quantities, wholesale and retail, may be had at the Davisville Pot- tery, Yonge st., one mile north of Yorkville. For $4, Vol. i, neatly bound, and vol. 2, for the current year, will be sent, postage paid, to any address. Contributors to the SANITARY JOURNAL :-Drs. JOSEPH Wo\u0026KMgAN, WN. CANNIFF, C. V. BERRYMAN, WM. OLDRIGHT, GEo. WRIGHT. THE PURPOSE OF THE SANITARY JOURNAL is to diffuse a knowledge of sani- tary science-a knowledge of the causes of diseases and of the means of avoiding or removing these causes ; to arouse public attention and the attention of the medical profession to the vast amount of preventable disease prevailing; to advocate Sanitary Legislation; to discuss, in short, aIl questions pertaining to public health, water supply, ventilation, drainage, food, clothing, bathing, exercise, \u0026c., \u0026c. 00UMN.DATORY LETTEBS TO TEE EDITOI. The following are copies of, and extracts from, a few of the many letters to the Editor, received from time to time, from medical men and others, regarding the SANiJrARY IOURNAL, unsolicited, of course, and, with two or three exceptions, the writers being personally quite unknown to the Editor : ToRONTO, December 7th, 1875. DEAR DR. PLAYTER :- . . Please send me your receipt for the enclosed two dollars, for your valuable Journal. I wish aIl in the profession valued it as I do. Very truly, JOSEPH WORKMAN, M.D. (Late Supt. Toronto Lunatic Asylum.) BOWMANVILLE, June, 1875. DEAR SIR :-I am much pleïsed with your Journal . . . I look upon it as one of the most uselul periodicals with which I am acquainted, and especially to the medical practitioner, who wishes to keep pace with the advancements of science. Yours truly, W. ALLIsON, M.D. (Member Medical Council, Ont.) GLANFORD, ONT., November 22nd, 1875. DEAR SIR :-Enclosed you will find $2, to be applied to SANITARY JOURNAL. I think your journal is doing a good work, and that such a magazine *a much needed in Ontario. Wishing it every success, I remain, yours truly, ALEx. BETHUNE, M.D. (Member Medical Council, Onario.)"
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         "Technical and Bibliographic Notes/Notes techniques et bibliographiques The lnstitute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction. or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Z Covers damaged/ Couverture endommagée r Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée D Cover title missing/ Le titre de couverture manque D Coloured maps/ Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) D Colourea plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents D Tight binding may cause shadows or distortion along interior margin/ Lareliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure J B!ank leaves added during restoration may appear within the text. Whenever possible. these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais. lorsque cela était possible. ces pages n'ont pas été filmées. Additional comments:/ Commcntaires supplémentaires: L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite. ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured. stained or foxed/ Pages décolorées. tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence ZQuality of print varies/ Qualité inégale de l'impression Includes supplementary material/ Comprend du matériel supplémentaire Only edition available/ Seule édition disponible D Pages wholly or partially obscured by errata slips. tissues. etc.. have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata. une pelure. etc.. cnt été f!mées à nouveau de facon à obtenir la meilleure image possible. Continuous pagination. This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "THE SANITARY JOURNAL, DEVOTED TO PUBLIC HiEALTH. VOL. I.] SEPTEMBER 1875. [No. 9. ®rigilll (ff1111111cnto11. THE VENTILATION OF DRAINS. BY WM. OLDRIGIIT, M. A., M. D., LIECTURER O SANITARY SCIENCE, TORONTO SCIHOOI. OF MEDICINE. [The following remarks vere read, under the above title, in conjunction with a portion of the paper published in our last issue, at the recent meeting of the Canada Medical Association at Halifax.-ED. SANT. JOUR.] Proceeding now to consider the means taken to prevent the poisoning of districts from sewer gas (when, indeed, any means at all have been taken), we find that they gencrally consist of efforts to ventilate sewers, occasional unscientific efforts to ventilate howe dîrains ilnto sewers, and the use of traps. It would take too long to refer to the various kinds of traps that have been invented. The two most common kinds, the syphon and the bell, are, I presume, suffliciently familiar to most persons. Many of us, however, are so rigidly exclude, by the laws of Queen Biddy, from the realms of the kitchen, and scullery, that we know little of her triumph over the bell trap by a simple removal of that grating, -% proceed- ing which at once unseals the trap. A less common method of unsealing is by evaporation, and this we should bear in mind the night ve return and re-open",
         "THE SANITARY JOURNAL. our house after a prolonged visit to the country. If we do remember that the drain has been unused, we wîll at once pour water into our traps, and then open all our doors and windows for a few hours. Another method of unsealing is by suetion. When a drain or pipe is running full bore, and with great rapidity, the water from small connecting traps, emptying into t'Le side, will be drawn out as by a piston syringe. This may obtain, in a hotel or other house of several stories, with a main soil pipe and a number of connecting traps. I believe that the forcing of traps from the expansion of sewer gas is a most common, and often undetected, cause of disease. It will readily be seen that this forcing may be obviated by providing a vent in the wall of the drain. The best place will, of course, be as near as possible to the trap on the sewer side of it (inasmuch as this is the highest spot between the trap and street drain), and of course at the top of the arch, the highest point, and also that at which it will not be sealed by water. The remarks in this paragraph may be better understood by a reference to the accompanying cut, representing ronghly a vertical section of a two-story house, with water-closet (O), trap (T), house drain (H H), street sewer (S), and ventilating shaft (V V) rising from the house drain just outside the house on the sewer side of the trap. 258",
         "THE VENTILATION OF DRAINS. The vent is made by means of a tube leading up from the drain to the top of the bouse or other convenient and safe spot. These last words \" safe spot\" were not duly taken into consideration in the English town of Croydon. In that town a bye-law was passed, compelling householders to run their rain-pipes into the sewers, and this effort at drain ventilation was followed by fearful inortality rates. It was soon discovered that the rain pipes, opening, as they did, under the cornices of the bouses, conducted the sewer gas straight into the open windows. This was rectified, and the beneficial results of the original intention were soon apparent. A similar caution bas to he observed in respect to bringing the pipes .too clos.e to chimnies, down which there is some- times a powerful current, when not used for their original object of smoke conductors. Then, too, cistern water has been poisoned by a too close proximity of sewer ventilators. In this connection I may refer to the mischief that is often insidiously going on froni the over-flow pipes of cisterns, whether untrapped, or whether they are forced or unsealed by suction or evaporation in the ways I have before mentioned. Water saved in tanks for drinking purposes, has been thus inade the vehicle of disease. But to return to my ventilating tubes, for it is often better to have two, and we may thus have a diluting process, the tubes taking turns in acting as inlet and outlet shafts, admitting pure air as well as expelling foul. The two small tubes can often be used with less caerangement of artistie effect, than one large one. It is almost useless to remark that the single tube sometimes acts as an inlet also, and I may here say that all ordinary calculations as to inlet and outlet shafts more frequently \" gang agiee\" in sewer ventilation than in ordinary ventilation, owing to the drains being close, and to other modifying circumstances. Hence v:must put every shaft in such a position that it can do no harm. It is an iu :ovement to place a charcoal tray in the top of the ventilating tube. In passing now towards our street sewer I wvould merely refer for a moment to the plans of attempting 259",
         "TUE SANITARY JOURNAL. to ventilate from the house drain into the streéit drain, (a down-hill ventilation,) for the purpose of pointing out how the most common natural laws are sometimes outraged. In this connection, my reason for saying before that the house ýrain ouglit not to empty into tho top of the arch will be apparent. The bouse drain would then act as a ventilating shaft to the street drain. Far more attention has been paid to the ventilation of street drains or sewers, and as less has been left to the private individual and his medical adviser, owing to the existence and aid of the city engineer, I will devote less time to this portion of the subject. Varions have been the devices, fans, furnaces, hot-air shafts, making use of factory chimnies, \u0026c., \u0026c. These have been found costly and unsatisfactory, and sanitary engineers now rely upon frequent openings to the surface, passing the air through charcoal trays of various forms, and keeping as far as possible from the sidewalks. It is a good plan to make - sort of collecting piac - for foul air in the vicinity of the ventilating shaft (4), as shown in diagram (A), or to make a break in tbe line of the sewer at the point where it gives off the ventilating shaft (2), as in diagram B. 2 A C There are many things to which I would have liked to allude, sucli as the evils resulting from soakage in the course of the drain, and the means to prevent it; the prevention of deposit, by making the streams join in diagonal currents instead of at right angles; the precautions to be observed in lay- ing and joining pipes; the proper shapes of drains under vary- ing circumstances ; flushing apparatus, \u0026c. But as time is so brief I cannot trespass on it,. but must defer the considera- tion of these points to a subsequent occasion. 260",
         "DISPOSAL AND UTILIZATION OF EXCRETA. There is, however, one point which is of such importance to nearly all our city families that I cannot pass it by in this paper. It is the uttering of a protest against that abominable nuisance which is commonly called the pan closet as shown in diagram C. The two most serious objections to it are, first, that tho side of the receiver is soiled every ime the pan (P) which is hinged at H, drops fcces on to it, and it cannot be cleaned. The second is, that overy time the pan drops, the trap (formed by it) is unsealed, and permits a volume of sewer gas to pass into the house. In conclusion, gentlemen, my apology for submitting this paper upon which I have bestowel so little preparation is my desire to bring before your attention a matter so much overlooked, and yet of such great practical importance, and to ask you to use your influence to remedy the existing state of ufnings, and to make this one among your efforts in the exercise of that trust which God has committed into your hands. DISPOSAL AND UTILIZATION OF EXORETA AND SEWAGE. In the first part of this paper, published in the last number of the SANITARY JOURNAL, I noticed the different methods of removing excreta from the vicinity of dwellings, and the dan- gers arising, through water contamination, from inefficient modes of removal; alluding more particularly to the advan- tages of immediate deodorization with dry earth-of what is called the dry-earth system of removal. I will now notice the three principal methods of disposing of and utilizing exereta and sewage after it has been removed from the im- mediate vicinity of dwellings; namely :- 1. That of discharging it into water, as of a river or lake or the sea, and wh'.ch is the two general, and on this continent universal, method in the water-carriage system. 2. That of carbonization, in retorts; the products being",
         "THE SANITARY JOURNAL. various gases, aninoniacal liquid, a tar-like substance, and a residiuum of animal charcoal. 3. That of employing it as a fertilizer, either after certain processes of nianufacture or by applying it directly to the soil, as in irrigation-the passage- of liquid sewage over and through the soil-or in the form of a deodorized powder. Of the first method, I think nothing eau be said in its favour. In seaboardtowniî:sewage in y be allowed to flowintothe sea,but as Dr. Parks says, \"In inland towns it cannot be discharged into rivers.\" It nut only destroys the fish, silts the beds of streams and creates palpable nuisances, but it is impossible to say when or where its pernicious effect,. upon the health of com- munities will end, thrvugli contaminating the drinking water and fouling the atmosphere. Thouglh the water becoms puri- ieu in a d by the influence of water plants and by oxidation, the purificatioi imiust be an exceedingly .low process. Aceording to experimenits of Frankland*, the water in the river Irwell, which reeeives the sewage of Machester, after a flow of 11 miles and falling over six weirs, showed but little impruvement. Dr. Letheby t considurs that purification takes place more rapidl3, and that if sewage is mixed with twenty times its bulk of water and flows a distance of 9 miles it will be coupletely oxidisud. On the uther hand, however, Parkes says, \" Average London sewage diluted with nine parts of water and syphoned fromn one vessel into another so as to represent a flow of 96 and. 192 uiles, gave a percentage re- duction in the organie nitrogen of 28.4 and 33.3 respectively.\" He fond unchanged epithelium in unfiltered Thames water after a transit of 80 miles in a barrel, and after being kept five months. It is satisfactory to knuw that this \" barbarous\" method of disposing of sewage is gradually going out of use; and 't is most desirable that it should be abandoned at an early period. Britain, it is generally known, is at this time greatly exercised * Reports of the Commissioners appointed to inqure into the Pollution of Rivers, 1870. † Report ofEast London Water Bill Cornmittec, 1S67. 262 ,",
         "DISPOSAL AND UTILIZATION OF EXCRETA. over the Rivers Pollution question, and while laws are being enacted to prevent further pollution, meetings are being held and coimittees appointed to enquire into the best means cf purifying rivers. The mnarvel is that the polluting process has been permitted to go on for so long a time. Will Canada benefit by the lesson conveyed? Furthermore, not only is this mode absolutely and directly injurious to the publie health, but the soil is impoverished, and the means of obtaining our daily bread is thereby ren- dered less eßlicacious, because we do not return to the suil those ingredients taken from it by our crops. Probably the earliest traceable atteinpts at utilizing sewage by applying it tu the soil, are thuse of the Israelites at the period when Jerusalem was a prosperous and flourishing city. Their large and costly aquaducts, still extant, provided abun- dance of water with which to flush their sowers and convey their sewage to large tanks, whence the liquid part could be drawn to be used for irrigation, aud the solid sediment em- ployed to fertilize in another forin. The great fertility of China has been largely attributed to the care with which the inhabitants return tu the soil that which they have taken from it. The following fundamental laws of national economy laid down by Professor Thudichum, are exceedingly important and should be universally carried out. \"1. The basis of human life, the very root of all society, is to produce food in such quantities, that a surplus of it may be exchanged for cominodities resultingfroin the labours of other people unable to produce food. « 2. This capacity to produce food must be rendered perna- nent by a strict observane2 of the laws of nature regulating vegetable life, the knowledge of which is the basis of agricul- tural science. \"3. The first and most important of these laws is, that we must return to to the soil the mineral ingredients we take froin it in gathering our crops. The atmospliere furnishes the nutritive eleinents, and the soil the minerals, out of which vegetable fibres, vessels and structures containing food are built up. Without these mineral engredients no harvest eau possibly flourish. 263",
         "THE SANITARY JOURNAL. \"4. These mineral ingredients are continually ejected from human beings and animals in their excrements, by returning which to the soil we furnish it with building materials for new crops, at the same time keeping ipure the atmosp.here we breathe, and the water we drink, and thus preventing epidein- ics and death.\" F. C. Krepp, in his work on \" The Sewage Question,\" says: \" It has appeared that human exerements have a very high value indeed, containing as they do the very minera], indis- pensible to the production of the new crops serving for ouir food, with also certain organic nitrogenous substances, besides greatly assisting in the formation of the uutritive elements of breadstuffs and other vegetables, and evolving certain fer- tilizing gases, which will largely increase the harvest if only made to penctrate the soil instead of polluting the atmos- phere. \" The best authorities value focal matter at 10s. sterling at least as the annual product of an average individual, giving an increased yield of crops worth £1,000,000 for every million inhabitants; a national wea1th, which as yet, in most countries, is nearly all wasted or utterly lost. \"We have found that, to make good this enormous loss, guano, bones and other fertilizers are imported, and all sorts of temporary make-shifts em ployed, involving a continual seri- ous drain of capital and diminution of national wealth. We have noticed besides, that the guano-beds of Peru are nearly exhausted, and have asked ourelves, What is to become of our agriculture when this foreign supply of manure is cut off'? \"Again, we have noticed that, in spite of ail the capital continually wasted on these poor palliatives, the soil almost everywhere diminishes in fertility, a given number of acres yielding no longer the sane produce they did in former times; that this astounding fact is especially striking in the United States of America, a country acting, with regard to her agri- cultural interests, somevhat like a fast young heir, squander- ing in a very short time resources intended and sufficient to last him foi- his whole life. \"l We have seen how bountiful the reward, if we obey the divine Laws of Nature, by applying to our agriculture the most valuable mineral or organie substances daily ejected fron our bodies, and how severe the punishment if we neglcct to do so, and allow foecal gases, fluids and solids to pollute our atmosphere, infect our soi] and poison our wells\" and other water sources. 264",
         "DISPOSAL .AND UTILIZATION OF EXCRETA. To every one who gives the subject due consideration it niust be evident that for two grand reasons, one as affecting public health, the other a matter of econoiny, it is absolutely essential to utilize human excreta by disposing of it in the earth. The carbonizing process has not been very extensively tried. A Mr. Hickey, C. E., of Bengal Presidency, in 1859, proposed to carbonize sewage in retorts, either with or without previous admixture with charcoal. It is similiar to the plan referred to in the last number of the SANITARY JOURNAL, now in use in Glasgow, and which was proposed by Mr. Sanford about the time of Mr. Eickey's proposal. The great cost of the necessary apparatus and the low price obtained for the resulting ammoniacal products, are said to bave been unfavourable to the success of the plan in India. In Great Britain, however, Parkes says, it niay be conmercially successful ; and, that \"there can be no question that it is an excellent plan in a purely sanitary point of view.» It does not, however, return to the soil that which has been taken from it. This leads to the consideration of the third method of dis- posing of and utilizing sewage excreta, namely, that of em- ploying it as a fertilizer of the soil. A good many nanufac- tories have been established and carried on in different coun- tries for manufacturing from excreta and sewage manure that would be easy of transport and readily applicable to the soi. None of them, bowever, appear to have been very profitable, and the works have for the most part been abandoned. In England, one inanure nianufacturing company was obliged to wind up partly by reason of actions for nuisances, on account of the efluvia created. Now if the excreta can be disposed of by the dry earth plan, or any of the dry methods, this difliculty vill usually be in a large degree obviated ; and then too the amount of sewage water will be very materially lessened and the sewage nay be treated and manipulated -with less ex- pense. The C'orentry Scwage lorks appear to have solved in a great measure the difliculty of disposing of sewage. The town 265",
         "THE SANITARY JOURNAL. of Coventry, England, contains about 40,000 inhabitants, and the sewage amounts tu 2,000,000 gallons in the twenty-four hours. The sewage difficulty had long been an insuriount able obstacle, and the corporation had purchased land. for a sewage fariii, but abandoied it ou accout. of the estiimiated cost of the necessary pumlping and distributing works. A comnpany caie forw ard and offered tu relieve the corpoiation from all liability as to the bewage, and their offer was accepted. The conpany erected works at a cost of £11,000 stg., and the annual expense is between £1,000 and £5.000. The works have been in opeiation since April, 1874; they are situated on the banks of the river Sherburne, about 1. mile bclow the to-wn, whence the sewa-c is delivered by gravitation. After being passed through a solid sewage extractor, the sew- age is chemically treated, is allowed to subside in tanks, and is finally filtered throughî a bed of earth 4. acres in extent and 5 feet in depth. This reiiders the affluent water of \"a good standard of purity ;\" it has no perceptible sinell, and is almost free from color, and is allowed to flow into the river. It is said the inhabitants can now see the bottom of the river, though for eight years previously tbey had been unable to do so. According to Prof. Voeleker the precipitate which subsides in the tanks bas a manurial value, when dried, of from 35s. to 40s. per ton. By an improved method of treating this \" sludge,\" as by mixing it when in a semni-fluid state with ground iiiineral phosphates, a chemuical affinity taking place, and the \" water of the sludge becoming crystalized,\" a manure can be produced of any desired value, or worth £7 or £8 per ton. It is said there is nothing offensive in any part of the works, and the town, fron the latest reports, July 1875, is in a good sanitary condition, \" few deaths or illnesses have occurred froin zymiotic disease.\" The question of the value of the manure and the profits of the process is of ninor iiportanîce in comparison with the health of towns, which must in some way get rid of the sewage. 266",
         "DISPOSAL AND UTILIZATION OF EXORETA. Now as regards sewage farmning as a means of disposing of sewage, Dr. Alfred Carpenter, of Croydon, bas a theory that all vegetation, especially rye-grass, has the power of assimilating organic matter through the spongioles of the roots. As far as rye-grass is concerned, according to an extract from the Popular Science M1onthly in the SANITARY JOURNAL for July, the theory appears to be confirmed by practice. The attention of Dr. Carpenter bas been largely occupied for many years past with a sewage fari at Croydon, and I cannot do better thain conclude this paper with a history of it, as given in the extract below froi the British .iledical Journal, June 19th, 1875. I shall endeavor on somte other occasion to give the ianurial or agricultural wlue of the earth excrement of the dry earth sys- tem, the facility of transporting aud means of applying it, \u0026c: \" A paper read by Dr. Alfred Carpenter before the Society of Medical Officers of Health, a short time since, on the power of soi, air, and vegetation combined, to defecate sewage, and the power which plants possess of assimilating organic matter, gave rise to a somewhat lively discussion. The opponents of sewage-farming stoutly declared that a sewage-farm was neces- sarily a pestilential marshx, which gave rise to malaria and nausea, and that the produce w as not only innutritious, but unwholesone ; whilst the size to which the root-crops attained was only a proof of the dropsical character of the produce, and formed no test of the nutritive properties. Finally, it was stated that cattle could not thrive upon suchi fodder, and a challenge was given to prove the contrary. Dr. Carpenter took up the gauntlet thus t.hrown down, and pledged himself to convince any gentleman who would take the trouble to visit the Beddington Farm, that not only was the farm wholesome in its surroundings, that it was not a pes- tilential swamp, but that cattle did thrive upon the produce during their lives, and made excellent meat when killed; and a dejeuner was promised, the solid portion at least of which was to consist entirely of sewage-farm produce. Pursuant to this invitation, a large number of gentlemen visited the Bed- dington Farm last Satarday, the 12th inst. The Beddington Farm bas, for the past fifteen years, recei- ved the sewage of about 52 thousand inhabitants of Croydon daily, in quantities varying from a minimum of three millions to a maximum of ten millions of gallons per dien. The smaller 267",
         "TUE SANITARY JOURNAL. quantity would probably represent the sewage proper, and the larger the increase due to storn-water. In an agricultural district like Croydon, the amount of sewage proper would seldom vary to any appreciable extent. Under a proper sys- tom of sewering, storin-water should have, as at Reading ,supa- rate and distinct channels provided. As it is, the sewage tlows un to the farin in the varying quantities mentioned; and, after buing strained through two of Bal'dwin Lathain's 'patent ex- tractors, which take out lumps of solid matter, dead animals, and other miscellaneous articles, which always find their way into a town sewer, the strained liquid flows onward to the farm. The Latham's extractors, which art in general use in al towns, resemble gigantic sieves, revolving on their own centres, and strain effectually all the coarser solid impurities from the liquid. This solid matter is nixed with ashes and other re- fuse, and the compost finds a ready sale at 2s. Gd. per yard or load to the neighboring gardeners and farmers. The liquid sewage then flows on to the farm, which is about 480 acres in extent. Of these, there are from 150 to 200 acres generally laid down with ryo-grass ; 50 acres are meadow, and used chiefly for cleansing the stormu-water; 82 are laid down as market-gardens; the remainder being used for mangolds, roots, and cereals. From the great absorbing power of rye- grass, that plant will always be the best adapted for sewage- farning. It can be cropped seven and in some cases eight times yearly. One plot of ground under this cultivation re- cently produced flfteen and a half tons per acre, and th. amount realized by the sale of several successive crops pro- duced £111 : 13 : 6 during the past spring. The grass finds a ready sale in the neighborhood.* The acreage under sewer-irrigation is found to be amply sufficient to purify the liquid. Dr. Carpenter calculates that in about six hours from the tine the sewage enters the receiv- ing house, and nine hours from the time it leaves the Croydon dwellings, the efiluent water flows into the Wandle in a puri- fied state, or colorless, odorless, and almost tasteless. The very slight brackish taste which is perceptible may be partly ascribed to the knowledge of what it really is. It is not, howr- ever, recoinmended or intended that tjiis water should be used for domestic purposes. The cattle on the estate, numbering about one hundred head, consists of ordinary nixed breed, not of the best pedigree *One field of whcat last year yielded 54 bushels per acre. A crop of patatoes yielded £19 per acre, and a plot of rhubarb £26 Ios. per acre. 268",
         "DISPOSAL AND UTILIZATON OF EXCRETA. or quality ; yet they all look healthy and in good condition, and many were born and bred on the farmîî. In fattening then, it is of course necessary to supplement their ordinary food with cake, as in all other cases. The nican death-rate of the neighborliood imnediately sur- rounding the farni for four years has been 13 6325 per 1,000, and this nay be fairly considered as the normal rate. What,, however, may be taken as a most critical test is, that the hcalth of the children in the Infant Orphan Asylum, which abuts on and overlooks the farm, is renarkably good. As long as sewage exists, of course there must be sone un- pluasant snells, which will, unider any system of defecation, make theinselves apparent; but, as far as it is possible to be, there is an alnost entire absence of any offensiveness in the Beddington Farni. In any case, it is only the snell of fresh sewage, which, if unpleasant, is certainly free from the delete- rious qualities of stale sewage. Of the luncheoi, which was cntirely produced on the farn, we can, in common with ail the other guests, speak in ternis of the highe.,t praise. The beef was succulent, tender, and fat, such as Front de Beuf or Milo himseilf would have delighted in; and the saine standard of excellence applied to the bread, pastry, salads, and other, edibles. We should have been glad to have had a reliable set of figures, in order to see properly the actual profit or loss on the farm, and the amount of capital invested in laying it out. Fron a rough disection of Dr. Carpenter's figures, ve should estimate that the receipts were about equal to the expenses, but it appears that capital charges have been paid out of cur- rent expenses, so that the year's deficit is not really a deficit in the proper sense of the terni. In a corporation also their is not the same ainount of personal responsibility, management, econony practiced as on a private farm. Colonel Jones, of Hafyd, and Mr. Morgan of the Lodge Farni, Barking, both show a profit on their sewage-farms; and we cannot believe but, that the same result should be attained at Croydon, notwith- standing the exorbitant rental which they have to pay of £10 per acre; the value of the land being, before the local board took the farm, twenty-two shillings per acre. Mr. Maclagan has, however, stated that lie knew of lands whose value lias been raised by sewage-farmis froni thirty shillings to £48 per acre. These facts point conclusively to the inference that, wlere practicable, a sewage-farm is the proper solution of the sewagc 2V9",
         "THE SANITARY JOURNAL. diflicnny, when the surroundings are favorable. In large manu- facturing towns or in places where land suitable cannot be obtained, or, if obtained, a heavy pumping expense is necessi- tated, of course soine other system of defecation and disposal must be adopted. Croydon is exceptionally well situated in this respect. The sewage flows of its ovn gravitation, where- ever required, all over the farm, and with such force as to supply motive power through tribunes to the double Latham's extraetor, which would otherwise require an engine of about two-horse power to accomplish. The land is naturally of very poor quality, consisting mainly of a gravel and boulders. The farm utilises the whole of the sewage of Croydon in a satisfactory manner, and bas raised the town from being erst- while one of the worst, into one of the best, sewered towns in the kingdom. If there be any deficit in the balance-sheet, the inhabitants can fairly look upon it as a modification and lin- proved substitute, which it really is, for a sewers rate. The health of towns is the prime consideration, to be secured at all costs, but there can be no objection to make use of the best systeins extant, and utilising the dirt by carrying it to the right place, and thereby make two blades of grass grow whcre one only grew before. ToRoNTo, Aug. 1875. M.D. THE PREVENTION OF INFECTIOUS DISEASES. The common people in most country districts have a fixed belief that the doctors \" take something\" to prevent them contracting those diseases of their patients which are \" catching.\" Physicians are not unfrequently asked what it is they thus take, and their unsatisfactory replies are charitably attribvted to a natural unwillingness to diminish their income by keeping all their patrons in good health It were just as~well that medical men were more prompt in offeriug information on preventive precautions, and in no direction were it better worth while to instruct the laity in some of the knowledge peculiar to our profession. In Great Britain, the Society of M1edical Officers of Health hav e lately published a pampblet containing rules for the guidance of families and persons who are in the presence of infecetious diseases. Thougli there is little novel or peculiar in their recommindatious, we believe an abstract of them will not be amiss in this connection : They first of all urge separation '270",
         "PREVENTION OF INFECTIOUS DISEASES. of the sick from the other members of the fanily as soon as illness appears, and advise that the sick person be placed, if possible, in an upper room, w'here all carpets, curtains, and unnecessary furniture must be removed. Fresh air is to bo admitted to the room by opening the upper window-sash. The fire-place to be kept open, and a fire lighted, if the weather be not too hot; whilst fresh air is to be freely admitted through the whole house by means of open windows and doors, with the object, of course, of diluting the contagion. The advice is then given to hang up a seet outside the door of the sick room, and keep it wet with a mixture made either with a quarter of a pint of carbolic acid, or a pound of chlorate of lime and a gallon of water, the floor to be frequently sprinkled with similar disinfectants, and cloths wetted with them should be hung up in the room. Everything that passes from the sick person should be received into vessels containing half-a-pint of solution of green copperas, made by dissclving one pound in a gallon of water. Every sinli, closet, or privy should have a quantity of one of these disinfectants poured in daily, and the greatest care should be taken to prevent the contamination of wells or drinking water by any discharges from the sick. All cups, glasses, etc., used by the sick should, it is advised, be first washed in the above solution of carbolic acid, and thon in hot water, before being used by other persons, and no article of food should remain in the sick rooin, or be given to anyone else after being in the sick-room. The linen of the bed and that worn by the patient should, as soon as it is removed, be put into the carbolic acid solution, and remain in it at least half an hour, afterwards being boiled in water. Instead of handkerchiefs, small pieces of rag are recommended, which can be burnt when soiled. It is advised that all persons attending on persons with infectious discases should abstain from the use of woolen garments, as they are apt to retain infection ; they should wear cotton or linen dresses, which can be washed. The nurses, too, are directed always to wash immediately after attending to the sick person, and to use carbolic acid soap. Itis further well urged that no visitors should be allowed to the sick, save those absolutely necessary, as the clothing of visitors is apt to carry away infection. This ma.y well remind us of the arguments often so strenuously urged as to the necessity of all practitioners who attend many labors entirely abstaining from attendauce ou cases of scarlatina or other infectious fevers as long as attending obstetric practice. 9,71",
         "THE SANITARY JOU.RRAL. With regard to scarlet fever, it is advised that the scales and dusty powder which peel from the skin in this disease and the crusts in small-pox, as they are highly infectious, may be prevented from escaping by smearing the body of the patient over every day wfth camplorated oil. This practice, subjoined with the use of warm baths and carbolic acid soap, is most essential. With regard to the date of convalescence, it is well remarked that the sick person must not be allowed to mix with the rest of the family ntil peeling off lias quite ceased, and the bkin is quite smooth again ; and all clothes used during the time of illness,or in any way exposed to infection, must not be worn again until they are properly disinfected. When the illness is over comes the disinfecting and cleans- ing of the Eich-room. Tliis should bu done in the following way: All articles of clothing and bedding should be spread out and hung upon lines. The fire-place, windows, and other opnings are to be clused, and half a pound of sulphur is to bu put iii an iron dish over a pail of water, and there burnt, so as to lut the fumes of the sulphur attack every part of the room, etc., for tweuty-four hours. After this the room is to be thoroughly votiiated by opening the doors and windowýs widely, the ceilings are to bu whitewashed, and the paper stripped off the walls and burnt, whilst the furniture, and all wood and painted wurk, is to be thoroughly washed with soap and water with a little chlioride of lime mingled with it. In addition to this, beds, mattresses, and articles which cannot well be washed should, if possible, be subjected to the action of heat in a disiufecting chamber, provided, if possible, by the local authorities. Some excellent advice L giv en about the danger of children attending school. Nu child fruni a house where there is an infectious disease should bu allowed to attend school, even though the child is itself wull, as it may carry infection, and thus spread the disease to many. And no child should be allowed to re-enter school without a certificate from the medical attendant allowing it to do so without danger to the rest. Finally, in case the patient die, it is recommended that the body sbould not be removed from the roum unless to carry it to a public mortuary. The body should be put into a coffin as soon as possible, with a pound or two of carbolic acid, and the coffin shuuld be fastened down and burial take place without any delay.-liedica n and Swrgical Reporter. 2729,",
         "AERATED BREAD. AERATED BREAD. A New Invention ; fron the Sanitary Record, July 24. 1875. That our present state of bread-making is in aw unsatisfac- tory state is a fact which we think few people will be disposed to deny. The unpleasant circumstances which occasionally come to light through the medium of the prdice courts, as our columus have shown on more than one occasion, leave an un- favourable impression on the public mi 1. The incidents of the dough being miixed by manual labour in a close under- ground cell, by perspiriny men in a seri state of nudity, are not comfortable to contemplate. From time to time the remains of insect life may be dise' 'ered in bread which lias been purchased even in first class localities. These circumstances all point to the necessity which exists for abolishing in toto the primitive and objectional method of making bread by hand labour, whilst there is that inevitable danger of the \" baker's plague,\" roby bread, being caused by the constant use of the old-fashioned wooden troughs. BesideQ these evils there is also another important reason why the present reason for manufacturing the \"staff of life\" should be changed, and that is the loss of nitrogenous and nutritious qualities through fermentation. It is by no means improbable that 10 per cent. of the flesh-forming constituents of flour may be lost by being converted into carbonie acid. When we look at an ordinary piece of bread we see that the vesiculation varies from the minutest size to that of more than an inch in diameter. The very large vesicles being caused by a copious evolution of carbonic acid through sundry patches of flour. If this process were carried out long enough, there would be very little food value left in the bread. A worse result than this happens occasionally when lactous and other acids are caused by false fermentation from the use of putrescent or highly impure yeast, the effect of using the or- dinary baker's yeast being to give rise to a species of fermen- tation of which at present very little is known. One thing- however, is very certain, that some of these ferment growths resemble in a marked manner the ferments .found in certain diseases of the blood. Whether, however, the one has ever conduced to produce the other is more than can be positively affirmed, but there is at least a probablity that the one may be the result of the other. Various methods of vesiculation have from time to time been attenpted to obviate these dangers, such as the mixture of 273",
         "THE SANITARY JOURNAL. hydrochloric acid and carbonate of soda, and several other effervescing mixtures; but the best of these are liable to con- tain impurities to a considerable extent, which are not always free from danger, and must inevitably produce a larger propor- tion of salt than can be considered advisable in an article so Jargely consumed as bread. Al endeavours to raise bread without importing fermenta- tive matter propose to accomplish the object by the formation of carbonie acid within the dough. This can only be properly attempted by adopting al the necessary precautions. In the first place, the gas must be produced in a separate generator, then it must be washed and purified, and finally introduced into the dougli from a receiver at a perfectly con- trollable pressure. It must be obvious to anyone who examines a piece of pro- perly aerated bread that a much greater certainty of thorough vesiculation can be obtained by this method, whilst the noces- sity of this impregnation beinig accomplished by machinery has led to the perfection of that system of bread-making by the Aerated. Bread Company. If no other result has been accomplished by this cornpany than the introduction of ma- chinery into the manufacture of bread, and the superseding of the oid dirty, foul, and laborious system of bread-making, that would have deserved our best appreciation. The best food value in the flour being secured, no waste or destruction of any of its most important constitutents eau occur in any of the processes adopted in making aerated bread; and as the wheat is ground, dressed, mixed, aerated, and baked without the possibility of polution either in dangerous fer- ments or disgusting manipulation, bread so made can alone he considered really pure. As we said before, the present primitive, dirty, aud uncer- tain systei of bread-making is a disgrace to our civilization, and we gladly welcome any method -which will insure a cleanly and wholesome compound and effect a much needed sanitary reform. Several ladies in Nashville have signed an agreeimnt to abstain from all outward adorment on Sundays, wearing only the plainest sort of apparel. Ruin is thus threatened to tb nillinery establishinents, there being no place left in which to display the last sweet thing in bonnets.-HeaWh Reformer. 274",
         "FACTORY POPULATION. THE EFFECT oF LIGHT, regarded as the revival of life in the vegetable world, has just been illustrated by the observa- tions near Athens of Prof. Hendreich under very curious cir- cumstances. The mines at Laurium, concerning which of late years there have been such active diplomatie procedures, consist for the most part of the scoriS produced by the work- ings of the ancient Greeks. These still contain a great deal of silver, vhich can be extracted by the superior appliances of modern times. Beneath these scorio have lain in a doormant state for at least 1,500 years the seeds of a papaveraceous plant, of the genus Gtaacism. But since the scoriS have been removed to the furnaces, this plant has sprung up with its pretty yellow petals, over the whole space which they covered. Unknown in modern times, it wîas described by Pliny and Dioscorides, and had disappeared from the face of the globe for'fifteen or twenty centuries.-Union Miled. PRESERvATIoN oF Foo» ny COMPREssED Am.-Professor Paul Burt communicated to the Academie des Sciences some of the results of the experiments which he bas long been engaged in conducting with compressed air. Specimens of meat submitt- ed to a compression of forty-four atmospheres were found at the end of three weeks to be in a state of perfect preservation. Cutlets were declared to be in as good a condition as when quite recent, a little more tasteless perhaps. Eggs which had been beaten up and exposed to the compression on May 28 were found to be on June 28 as fresh as at first, while others beaten up at the same time and left in open vessels were frightfully stinking. Oxygen, then, at this strong tension either kills vibriones or at least prevents their development in organie matters. Fruits, as strawberries, cherries, etc., com- port themselves in like manner, as also does moistened bread. The coagulation of milk is not prevented by compress- ion, being only retarded. It thus seems that in oxygen of high tension we possess an agent for the preservation of animal and vegetable substances, which may prove of utility in scientific investigation, and perhaps in commercial pur- suits.-L'Instittut. DEGENERATIo 0F THE FAcToR PoprLATioN.-In bis evidence before the Royal commission on the working of the Factory and Workshops Acts, Dr. Ferguson, who has held office as certifying surgeon under the Factory Acts at Bolton for four- teen years, stated as the result of bis observations that there 27 5i",
         "THE SANITARY JOURNAL. is a steady degeneration going on among the factory popula- tion. He did not believe that it was so much the factory labour that operated prejudicially-the mills being more healthy to work in now than they were in years gone by-as the habits and mo.e of life of the factory 'workers. By free indulgence in stimulants, and in many cases excess in smok- ing, parents debilitated their own constitutions and transmitt- ed feeble constitutions to their children. Again, children were often fed on tea and coffee after they were weaned, instead of getting good milk. Another cause of degeneration among boys was that at least one-half of those over twelve years of age either smoked or chewed tobacco, or perhaps indulged in both vices. There is no doubt that the excessive use of stimulants and tobacco is very general in factory dis- tricts, and is to some extent the cause of degeneration of the population; but as the chairman of the Commission observed, the remecdy for this unfortunate state of things is searcely within the reach of Parliament. We hope to return to the subject after the Factory Commisioners have concluded thoir labours.-Jled. Times and Gaz. THE FORTHCOMiNG SOcIAL SoIcE CoNGREss.-Among the several questions selected for discussion in the health depart- ment of the forthcoming Social Science Congress, at Brighton, are :-I. To what causes are to be attributed the il construc- tion and want of sanitary provisions which exist in the dwell- ings of the upper and middle classes ? and what is the best method which should be adopted to remedy and rectify the same? 2. What are the advantages or disadvantages of -water-supply being lodged in the hands of local authorities? IMIPROVED DRAINAE.-The Artizan's Laborers', and General Dwellings Company, of England, is devoted to the general purposes of improving dwellings of the laboring classes by the erection of houses w ith the best sanitary arrangements, suited to tenants of moderate means, and purchasable on easy terms. In making the drainage of their bouses, the company invariably *and asailxed rule,avoides carrying the drains under any portion of the houses. A drain is arranged at the backs of two rows of houses, runuing lengthwise in the garders, and into the main drains. The drain pipes are led froin the backs of the houses instead of beneath themn, and hence into the street, as is generally done in all other modes of house drainage. It has been found that the death rate in houses thus drained, when",
         "DEPOSITING REFUSE. compared with that of a similar number of ordinarily drained houses, has been much less. A WESTERN JOURNAL, probably wishing to do the handsome thing by the local doctor, recently announced \"that Dr. C. was called *n, and under his prompt and skillful treatment the young man died on Wednesday afternoon.\" To the Editor of the S.amAn JouRxA. DErn SIR,-Will you kindly inform me through your journal, as the information may be useful and interesting to many of your readers, if there is not some remedy for, some means of preventing the depositing of refuse and filth upon vacant lots in this city, in order to frl cavities and low places. By so doing you will confer a favor upon Yours truly, A SUFFERER. Toronto, August 21st, 1875. [We think the followng, now in force, should apply to and reach the niatter in question.-En. SANZT. JR.] An Act respecting the public health, 36 Vic., cap. 43. i. The health officers of any municipality or police village in Ontario, or any two of theni, nay, in the day tine, as often as they think necessary, enter into and upon any premises in the place for which they hold office, and examine such premises. 2. If upon such examination they find that the premises are in a filthy or unclean state, or that any matter or thing is there w'hich, in their opinion. may endanger the public health, they or any two of them, may order the proprietor or occupant of the premises to cleanse the same and to remove what is so found there. 3. Such health officers, in case the proprietor or octupier of the premises neglect or refuse to obey their directions, may call to their assistance ail constables and any other persons they think fit, and may enter on the premises and cleanse the same, and remove there from and destroy what in their opinion it is necessary to remove o destroy for the preservation of the public health. 277",
         "THE SANITARY JOURNAL, DEVOTED TO PTBIIC HEALTII. VOL. I. TOBONTO, SEPT. 1sT, 1875. No. 9. CREMATION AND BURIAL. This is the subject of a lengthy paier by Dr. J. F. Adams in the last annual Report of the State Board of Health of Massachusett ; it is the subject of numerous articles in medi- cal journals; in June, F. S. Hayden, F. R. C. S. E. addressed to the London Tines his final and longest letter on the sub- jeet of disposing of the dead, and as the ellclical Times and Gazette observes, certainly the fact that that journal devoted, at that season of the year, three full columus of its pages tu Mr. Hayden's letter, is as strong proof as can be obtained of the wide spread interest taken in the subject; our contem- porary, the Canada illed ical ancl Surgical Journal, of Mon- treal, in the June number, contains an article on the same, strongly advocating creniation; and we have recently received a pamphlet on the \" Disposal of the Dead,' being the last of a series of lectures on \" Hygiene and Public Health,\" delivered in Montreal, last winter, by Geo. H. Baynes, M. D. So tbat the wide spread interest may be said to be taking root in Canada, and a discussion of the question to be springing up. We have not given the subject a great deal of attention, not regarding it as, at present, one of the most iniportant inatters connected with public health, but so far as we have been enabled to learn, we cannot think there is any necessity, either on sanitary or even economic grounds, for change in the present method of disposing of the dead; though there certainly appears to be a necessity for improvements, indeed for very radical reform, in the present manner of burial.",
         "CREMATION AND BURIAL. After sending out circulars of enquiry to nearly 500 physi- cians in the United States, Great Britain, and Ireland, who were supposed to take special interest in sanitary matters, and receiving 171 answers, Dr. Adams, in the report above men- tioned, says, \" We must confess to being greatly surprised at the small amount of evidence we have been able to gather of any positive injury known to result from burial grounds.\" Yet Dr. Baynes in his published lecture says, in effect, that by the adoption of cremation the bill of health -will advance rapidly, and the frightful return of death perceptibly diminish ; and again, \"it is impossible to calculate the immense revolution that vould take place in the bill of mortality.\" Depend upon it, it is against decomposing filth above ground, and perhaps in sewers beneath, specific contagion, over-crowding of the living, defective drainage, intemperance, and such like evils, we must wage war, these are the chief removable causes of disease-and to combat which requires the exercise of our best and greatest energies. It is not su much against tlie slowly deconiposing body of our friend or neighbor, properly bui ied a depth of six or seven feet in \"natures great deodorizer\" and dis- infectant, that we need contend. Unquestionably, in nany instances injury to health has arisen through the present method of disposal of the dead, but it must be attributed to the improper mani ner o)f burial and not to the system itself; to the proximity of drinking water and dwellings to burying grounds, or to intramural sepulture, which may now be said to be al- most entirely abandoned. Burial, \" Earth to earth,\" certainly appears to be the most natural niethod of disposa]. The great purifying power of fire is spoken of; but there is no api ech in nature to any pro- vision for consuming by fire of .ead organic inatter. And it is generally admitted that it is always best, and safest, to fol- low as far as possible the indications of nature. Undoubtedly the great fire of London in 1666 did purify that city, and it nay have been a providential provision, or interposition. So fearfully bad must have been the sanitary condition of the city, so reeking with corruption, that one could almost imagine L)79",
         "THE SANITARY JOURNAL. it approacliing a condition of spontaneous combustibility ; there, collected among the living, was the dead and the filth of centuries. Only fire could purify it in time to save the remaining inhabitants. But let us bury the dead in proper coffins, a safe distance from dwellings and water supply, toward that quarter whence winds least frequently blow, (inToronto,for example, to the north-east) and a good depth, and not too near together, in suitable soil, and it cannot be conceived possible for any harm to arise to the living from the dead. The earth would undoubtedly destroy or render harmless all the elements or matters arising from the slow and gradua decoi- position before ià would be possible for thein to contanudnate either the air above ground or the drinking water. The most rapid increase of population, after the lapse of centuries, would not be likely to require a change in this mode of disposal of the dead. Mr. Seymour Hayden estimates that, allowing for the increase of population and mortality-for a probable mean of prospective annual mortality of 200,000-for the city of London, a field of 2,000 acres will bury its dead forever; allowing the entire resolution of the body to take place in from three to seven years. One important and essential reforn that is needed in con- nection with our burial system is, that all places of burial, cemeteries, \u0026c., be as soon as possible placed under the super- vjsion of a competent superintendent, or be regulated by boards of health, and not be entrusted to speculative associa- tions. As to the economical aspect of cremation; it has not been shown that there would necessarily be anything saved by this system. The undertakers paraphernalia and display are not essential to burial; cremation would not necessarily do away with these. That they are superfluous, and indeed ridiculous, few will deny. On this point, a London exchange, the Medical Times \u0026 Gazette, says: \" For some years there has been a quiet and gradually in- creasing revolt against the tyranny of the undertaker ; and ordinary funerals have, during the last ten or fifteen years, 280",
         "DISPOSAL OF EXORETA. been conducted with much less expense and undertaker's dis- play. For this change we are, in part, indebted to the burial guilds that have been established in connexion with what is called the High Church party.\" The Canada Medical and Surgical Journal mentions a known case in which $25 or $30 were borrowed to bury a re- lative, where \"half a cord of wood, at $8 per cord, would have reduced his remains to ashes \" in a Sieman's furnace. Add to this the labor and attendance on the furnace, and a body might be decently and properly buried for less. Perfect cre- mation requires quite a complicated apparatus, and more skilled labor than burial, and while it would consejuently be more likely to be imperfectly accomplished, it would seemingly be more expensive than burial. Dr. Holland, in his reply tu Sir Henry Thompson, naturally questions the seriousness of the latter in his estimatus of the manurial value of the ashes and boue earth resulting from cre- ination, and thinks it amounts to a suggestion, as in fact it does, \" that we use our father's ashes as a turnip dressing.\" FLOwER MissION.-In the August number of this JOURNAL, in an item on the \"Flower Mission\" in London, for sending flowers to the sick in the Hospitals, a belief was expressed that if some one would move in the matter in Toronto and elsewhere, there would be enough ladies to render suFicient aid to make success certain. It is pleasing to observe that a move has been made in this city to establish such an agency, and that large numbers of bouquets of flowers, were last Saturday (Aug. 28) distributed in the wards of the General Hospital. Many books were also sent to the patients. It is to be hoped that the Mission will extend to other Charitable Institutions; and that the ladies in other cities and Towns will go and do likewise. OTTAwA MATTERS.-Dr. J. P. Lynn, Medical Health Officer, Ottawa, in a letter to the Tmes, Aug. 23, gives some valuable suggestions regarding the disinfection of privies. Like other cities, Ottawa has its stagnant pools, and household refuse, 281",
         "THE SANITARY JOURNAL. kitchen slops, etc., scattered over back yards; hence, foui at- mospheres and stenches. The doctor complains of the laws, which being yet elementary, they require the aid of private exertion. He wisely suggests the necessity of daily throwing intu the privy vaults, which should be properly ventilated, \"-a quantity of dry earth, or coal ashes, a shovelful of lime, or a couple of handfuls of cupperas. It is made most thorough by the combined use of dry earth and copperas, experiment hav- ing shewn the last tu be the best chemical disinfectant for privies. He further says, however, \"Your readers doubtless well remember the revoltingly filthy condition of many por- tions of the city prior to the organization of the sanitary bureau, and will, I venture to believe, readily acknowledge the improvement that has since manifested itself under the action of its officers.' SLmL-P\u003eOX AND PAPER RAGS.-Two outbreaks of small-pox from contact with paper rags have recently been recorded ; one in a Boston medical journal and one in the \u0026\u0026'itairy Record. Some forty cases occurred in the one and over twenty in the other. One person well pitted from small-pox was attacked and died. In the Boston report, about one-third of those affected died, and it vas said \" in no case did vaccination ap- pear to prevent.\" It is submitted (Dr. Robinson, M, H. O., in \u0026\u0026nita-ry Record) that this illustrates \"the potency for mis- chief of mediate sources of contagion-to wit, infected clothes;\" and urged that rag-dealers be required to purify their obnox- ious wares, as by dry heat or sulphurous acid fumes. STATE MEDICINE. - The Universities of Oxford and Cam- bridge have each made arrangements for an examination in subjects bearing upon Preventive or State Medicine and publie health, and to grant certificates for proficiency therein. The examinations take place in October. The Lancet heartily wishes success to this effort to supply a long-felt deficiency. MARRIAGE OF COUSINS.-Mr. G. I Daiwin has recently read a paper on this subject at a meeting of the London Statistical Society, and the investigations he has made, by means of cir- 282",
         "A SUGGESTION. culars of enquiry sent to members of the upper and middle classes, and to heads of asylumus for the insane, and by dili- gent study of Burke's \" Peerage,\" have failed to show any evil resulting from the marriages of first cousins. He acknow- ledges that the opinion of prominent inedical men is against such intermarriages, and says: \"My paper is far from giving anything like a satisfactory solution of the question as to the effects of consanguineoùs marriages, but it does, I think, show that the assertion that this question has already been set at rest cannot be substantiated.. The subject still deiands atten- tion.\" THE Lancet notices two instances in which disease was un- doubtedly transmitted from hunian beings to domestic animals. In one case dogs took small-pox from human patients, and in the other the whooping-cough was communicated to a cat from children. Might not animals communicate such diseases to human beings ? A SUGGEsTION.-We beg to suggest to the Montreal Health Department that possibly the most effectual (and economical in view of the late proceedings there) method of overcoming the anti-vaccination propensities of the habitants would be one similar to that adopted in India. There, where the practice of vaccination is said to be making fair progress, the medical officers state that one great obstacle, the religious scruples of the natives, are now overcome by the pay- ment to them of one auna (three cents) per child. This would, probably be much more likely to succeed than a plan proposing to make a charge for vaccinating. A Cunious FAc.-In a lecture by Dr. Moore, Diplomate in State Medicine, on \" Meteorology in its bearing on Health and Disease,\" in the lecture hall of the Royal Dublin Society, a fact came out about measles, which appears to corroborate the conclusion of Dr. Ballard, that a temperature below 420 F. is as unfavorable to the spread of the disease as a temperature above 590 F. 983",
         "THE SANITARY JOURNAL. ANOTHER PoisoNors DYE.-The green flannel which lines gum boots is said to have given rise to severe local symptoms, attributed to arsenious salts used to give it its color. THE Bombay Gazette states that proposals have been made, and will probably be carried into effect, for establishing sani- taria on the bills for the wives and families of European soldiers. It is said this want has long been felt. OVER-CRoWDING.-Dr. Russell, of Glasgow, in his invaluable reports upon the health of that city, has conclusively shown that the death-rate, in its various statistical subdivisions, is invariably governed by the proportion of families living in single rooms. THE Lencet notices two instances in which disease was un- doubtedly tiransmitted from human beings to domestic animal. In one case dogs took small-pox fromn human patients, and in the other the hooping-cough was comimunicated to a cat from children. Might not animals communicate such diseases to human beings ? Two SUBJECTS FOR CONSIDERATTION.-Dr. H. B. Baker, Sec- retary of the State Board of Health, Michigan, reported at the July meeting, that, at the meeting in May, at Louisville, of the American Medical Association, Dr. Bowditch, of Massachusetts, spoke of the ventilation of sewers, privies, etc., by shafts con- veying the gases to the tops of the houses. le suggested the question whether the gases are properly disposed of in that manner, and related a case where the upper rooms of a dwell- ing had a disagreeable odor frorm that source. And that a paper was read by Dr. Thoms, of New York, on \"Floating Hospitals,\" advocating this method of giving the children of cities fresher and purer air than they can obtain in tenement-houses. Dur- ing the discussion, Dr. Wilson, Medical Director of the United States Navy, remarked that his experience led him to believe that \" malaria \" would never pass a continuous surface of water of one mile in width; tb. a river two miles in width, even though passing through a deadly malarious region, might be traversed safely if one did not go ashore.",
         "POISONOUS CANNED SALMON. SEwER GAS AND TYPHOID.-A case of typhoid fever has been reported in the Practitioner by Dr. Carroll. The patient was a chambermaid in a carefully kept country seat on Staten Island. The case was well marked, and death took place on the 27th day. The house had all practical provisions for all hygienic needs. Every precaution had seemingly been taken by the plumber as to traps, ventilating pipes, etc., but on close investigation the leaden soil pipe, leading from the servant's water-closet, was found to be \" corroded with numerous pin-holes\" through which sewer-gas escaped. The most careful inquiries failed to elicit any other cause for the disease. The writer thinks this case strong evidence against Professor Tyndall's alle.ged \"direct continuation of a diseased intestine\" cause. It is also, we think, good evidence against the water-closet system for the removal of excrement. POISoNOUS CANNED SALMoN.-A corlespondent in the Sani- tcrian, Dr. Balch, says he was called, June 22nd, 1875, to a family of five persons, all of whom -were affected with vomit ing, and (all but one) purging severely, about three hours after eating canned salmon. Al recovered, though some were nauseated and had griping pains for eigliteen hours. The can had been opened two days previous, and some had been eaten at that time without unpleasant results. Putrefactive change had most likely taken place; as many are aware, fish is liable to this change and may then when eaten give rise to poison- ous symptons. RESUsCITATIoN ExTRAoRDINARY.-Mt the July meeting of the Michigan State Board of Health, an interesting case of ce- suscitation of a girl supposed to have been dead from drown- ing was reported by the Rev. Mr. Brook, of the State Univer- sity. Efforts vere continued for six hours before signs of life appeared, but the patient was finally restored to life. A SANITAY QUESTIN.-Why could not each one of our subscribers aid the cause of Preventing Medicine, and enable us to make improvements in the JoURNAL by getting a friend to suubscibe for it, or even by sending us a few good names to whom we might send specimen copies? 285.",
         "THE SANITARY JOURNAL. SPECIAL NOTICE, to all whoi it may concern. Since the cunmencemiient of the publication of this JOURNAL, large num- bers of copies have been sent to medical men and leading men of all professions and classes throughout the country, with a request that if they did nut desire to become subscribers they would kindly signify this by returning the number. We can- not conceive of any better, simpler or fairer method of placing Such a journal within the reach of the public, and thus extend- ing its circulation and usefulnes.s. It gives those receiving it an opportunity to examine it at their leisure, without having their more valuable tinie occupied by the solicitations (somle- times too urgent and unpleasant) of a canvasser. To simnply advertize is not satisfactory. Peuple, before subscribing for any paper, wish to see it; in this plan they are saved the trouble of sending for a sample copy. The success or result of this nethod has been about as follows : A few (nany thanks to them) sent the price of the copy, 20 cents, saying, they did not like to return the number, but had so much other reading matter, or were not prepared to subscribe at pruseit, xpress- ing admiration of the journal and wishing it aIl success. Much the largest proportion of those who apparently did not wish tu subscribe returned the first number sent, for the most part in good order, a few of these omitting to send the naine, it not being in all cases oun the journal, we did not of course stop sending to them; the next largest proportion returned the secon1 number sent, or did not take it frum the post-office, whence it was returned. Of this we have not the least com- plaint to make. A few, however, a few fiom whom we had expected quite differently, inembers of Parliament and Sena- tors, more laymen than physicians, some possibly from over- sight, received from the post-office dwee, four and five num- bers, and then returned one, refused, without a cent, or a line of explanation. Of these we have just reason to complain. We are publishing a journal which is very generally acknow- ledged to be a public benefit, publisbing it at a loss of valuable time and a good deal of money, for it is yet, partly on account of the large numbers of copies sent out, far from being a pecwniar'y 286",
         "SPECIAL NOTICE. Iuccess, though we, of course, trust in the future, and we can- not well afford to send so many numbers to these gentlemen for nothing. We are constrained and inclined to believe they have not given these little details, small to them but not to us, any consideration or thought, or they would hardly have done as they have. To those who continue to receive the JOURNAL, and have done so from the early numbers, and we suppose intend at some future time to pay for it, we have only to say, pardon us for writing so much about ourselves and about what uues nut con- cerrn them, and do not, in the busy details of life, forget our little matter. We require and need the anount of subscription from each, in order to continue the publication of the JOURNAL No doubt their intentions are goud, but being a small matter to each, it is put off from time to tine. POISONING BY ANILINE DYES.-Several cases of poisoning by the use of stockings and undershirts dyed by coralline, have been reported. The illed. \u0026 Surg. Reporter mentions a case, reported froin Stettin, in which a gentleman had bought a bat in a shop there, and, after having worn it for one or two days, was troubled witli unbearable headache; at the same time little ulcers formed upon his forehead, his eyes were in- flamed, and the whole of the upper part of his head was much swollen. It was evident that these symptoms were caused by the hat, and upon examination by a chemist it was found that the brown leather in the inside of the hat was colored with a poisonous aniline dye. It appears, says the Reporter, that inflammation is unavoidable when this dye is in contact with any part of the skin. THE GERMAN PUBLIC HEALTH AssOcIATION meets this year in Miunich, September 13, 14, and 15. The subjects laid down for discussion are as follows :-1. Determination of a plan to study epidemics of typhus. 2. On the hygienic requirements of new buildings, especially in the new quarters of large cities. 3. Requirements of the diet in orphan asylums, barracks, 287",
         "THE SANITARY JOURNAL. prisons, and alo in common life. 4. On the objects, means and limiiits, of the inspectiou of bread and meats. 5. On public slaughtetr liouses, with special reference to the duti es of coi- munities toward butchers. VAcciNATio.-The Saiitary Conunissioner for the Punjaub, (Jd. Th \u0026es f Gaz. July 31,) reports, for the period ending May 15, 1875, 593 deaths under the head of small-pox. Of this numuber, 426 occurrUd in the district south of the Sutlej, and only 167 In the districts north of that river. The population of the two lucalities being in the ratio of nearly two to one, it results that the less nuncrous .opulation on the south is suffering, a, a consequeiic of it prejudice against vaccination, far more sc urely than the less numerous population on the north, who have taken to vaccination with comparative readiness in the last few years. According to the annual report of the Medical officer of Aberdeen, Scotland, 92 sinalli-pox cases were treated in the small-pox hospital during the year, of which 11 died. The mortality was in the following ratios :-well vaccinated, 1.75; indiffently vacciiated, 27.2; unvaccinated, 29.1 per cent. Of all the patients adinitted, only one, a fenale, had been re- 1accinated, and she had the disease in the muildest possible form. As OT HERS s.r. U.- The SAxITARY JOURNAL, edited by E. Playter M. D :-This valuable journal, since its new forn of issue, seems to increase in efficiency. The papers are written on all important subjects connected with publit. health. The slcItions'are made with special reference to every day matters of household hygeine. We can only say, as w e have said before, that for this alone the serial should be in every household.-Leader, Aug. 9 1875. THE SANITARY JoURNAL, published in Toronto, and edited by Dr. E. Play ter, is a very excellent magazine, and deserves to be sustained by liberal patronagc. It is doing a good work in instructing the peuple on many important questions pertaining to public health.- Hal Reformer, August, '75. 288"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing I Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material I Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-étre uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées D Pages restored and/or laminated I Pages restaurées et/ou pelliculées El Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "KINGSTON MEDICAL QUARTERLY VOt. m. JULY, i89). NO. 4. 'the KINGSTON MEDICAL QUARTERLY is presented to the Medical Profession with.the compliments of the Edito'ial staff. Contributions·will b:gladly received from iembers of the Profession.igx1 Wil1ingly published. JoNÈHar , Editor. MEDICAL ASSOCIATIONS. T rümy be said to be an age of Conventions. We have then.,of all kinds-religious,,political, business, philanthro- pIC, professional. The medical :profession has. nôt escaped the general tendency to form Associations or Conventions. In. this -ountry we have Dominion, Proyincial, District and:City Medi- cal Associations. The .question. might well be. asked, what is the practical utility of al these gatherings? It has seemeù ta us that the benefit to be derived by anyóe altending· these assodi- ation meetings will depeñd: primarily upon the the character of the vork taken up at these meetings, and sëendarily upon the individuali himself. If the subjects :presented for corisideration- are of a practidal character and. if the individual takes an intelli- gentinterest in theproceedings,he must of necessity be benefited thereby. If on the other band the sùbjects umider consideration are not of a practical.natureor if the. individual does not beConi personally interested in:the proceedings, then:assuredly his atten- dande at thé rüeetings will be pioductive of vëry littie ;gQod to hini. But assuming that the sibjects pr-sented for consideration are of a practial nature and of interest to thë general prac- titioneï· and assumring that the individual members- of the associ- ation take an active ànd intelligent interest in the discussions what :are thé benefits to be derived Speaking in general ternis, we wuld sav that the benefits ta be- derived from attendarice at such- associations are varied and may, perhaps, be classified: as educational, professional, social and physiçal.",
         "KINGSTON MEDICAL QUAR rERLY. At these meetings papers are read and cases and specimens are presented. It is to be presumed that those reading papers or presÉnting cases have devoted special attention to the subjects they bring to the notice of the members. Thus the prepar- ationiòf a paper becomes an educational stimulus to the individu- al preparing it and as the members are notified beforehand.as to the questions which are to be up for conrideration, they have ample opportunity of prepariàg themselves to take an intelligent part in the discussions. In the- counsels of many, it bas been said, there is:much wisdom. HIowever that may be, true it is that in our own profession, the best read and those of the greatest experience may often obtain newer and cleaier views upon the subjects discussed at these meetings from those who have not had as great òpportunities as they. To him whô goes to an association meeting with*the determination to obtain the greatest amount of information possible, whether he reads a paper, presents a case, takes part in a discussion or merely listens intelligently, educational benefits must accrue and for this reason, if for no other, such meetings are to be recomrnended and encouraged. At these meetings, too, questions affecting the welfare and advancement of the profession are usually discussed. In. fact it is at these meetings, as a rule, that the views of the profession upon questions of this nature first find utterance and the decisions which the profession arrives at upon such subjects atthe meetings are afterwards embodied in the laws affecting and regulating the profession. As instances we might cite the course of studies necessary to be pursued in order to obtain a license, the law re- garding actions'for mal-practice, the standing of medical officers in the militia, Inter-provincial or Dominion registration. Any member of the profession who has any idea that the standing or efficiency of the profession could be improved in any particular bas. ample opportunity of bringing his views before bis .brethren, and if they meet wih general approval, he may rest assur-d that they wilLin the near futurebecomeeémbòdied in theIawof:thie;land. But it is not only in this direct way that the standing of the pro- fessioù, is raised bythe discussions which take place at these associ- ation meetings. Ail aré brought into close contact. The younger and 'less-experienced:meet on an equalfooting the older and. more '298",
         "MEDICAL ASSOCIATIONS. experienced. We come to know personally the recognized lead- ers in our profession, for ours, like all other callings, has recognized leaders. New and more exalted ideas of the dignity and import- ance of our profession are insensibly acquired and the members. go back to their labours with a. determination to live up to the. ideal they have forimed. and to become more and more worthy of the noble profession-they have chosen. Man lias been described as a social being. Social recreatiôn is to hir. a necessity. To the busy practitioner of medicine the opportunities for social recreation are very limited. He is liable at all hours to bé called uponi by some suffering member of his clientele. Many a time the doctor makes his arrangements to attend and take part in a social function and at the last moment his plans are all disarranged by some one whôourgently requires his services. Not only so but even when he can, as it were, steal time forsocial enjoyment he is never free from the·cares and responsibilities of his professiòn, and ie knows full well that at any moment he may be hurried away from. a sceneof festivity to one of suffering and, perhaps, of :deáth. Whien, however, lie sets out for a meeting of his Association he lays aside his carës and has a delicious sense of freedom-a feeling that none but the busy practitionet can fully realize. He knôws that his time is noWbis own-that no importunate patient is able to break in upon his enjoyment or rout him out in thé middle of thé night. It istrue that such freedom from care may be .obtained by simply taking a holiday trip but it bas seened to us tliat men, as a rule, can more fully realize the plëasures of social intercourse with those who are engaged in the same dalling than they can. with those whose interests are different. The Médical Association Meetings thus present all the advantages of a 1holiday trip together with those to be derived from social intertourse with those Wvhose interests are simpilar. Every practitioner knows that the life ôf a doctor is a 14bor- ious one-full of work--burdened with care-lieavy with respon. sibilities-wearing upon the physical powers. To getclear for a few days each year from thèse cares and responsibilities is a necessity if one is to preserve lis inental and physical powers in their fllvigour. After such a vacation one feels that lie has taken a new lease. of life-that he. lias reewed. his strength=-that 299",
         "KINGSTON MEDICAL QUARTERLY. lie is able to resume the daily conted- with disease with redoubled en..-gy and with increased hope. auch a holiday bas been good for the doctor and will be good for his patients. These, it appear-s to us, are some of the advantages to be derived by the busy practitioner fron attendance at a medical association, and it is, therefore, in our opinion, the duty of every practitioner to attend some such meetings-a duty to himself- a duty to his patients. Which of the nany associations shall he attend ? That will depend largely upon circumstances. The items of time and expense must be considered. Every practitioner is not so situated that lie can afford mucli time or much expense. Having a limited amount of time at his disposal, the nearer the meeting to his hone the better for him as less time will be con- sumed in travelling to and from the place of meeting, and more time will be left for the meetings themselves. 13y this standard the district association will be the best. But withjut disparaging these associations, we feel safe in asserting that the educational and professional benefits to be derived fron attendance at these, are not comparable to ·those to be derived from attendance at the larger meetings, such as the Provincial or Dominion Associ- ations. The time, however, required to travel to and froni these association meetings, to say nothing of the expense, is a disad- vantage. The Dominion Association ·endeavours to overcon.e these disadvantages by holding its meetings at a different centre each year. In this way, all may have the opportunity of attend- ing the Dominion Association at least once every few years, with- out the loss of:much time, or the -butlay of much. money. The Provincial Association, on the other hand, always holds its neet- ings in the same place. To those who live in, or near that place, this is a great boon, but ta those at the extreme limits of the Province it is a great disadvantage. We believe that every doctor should attend his district association-we believe that every doctor should, if possible, attend the Provincial or Dominion Association, but we believe that such attendance shouldlbe made as easy as possible to all practitioners. This the· Dominion Association attempts to do. Now, it lias occurred to us that iii a Province as extensive as Ontario, -we might very well have two Provincial Associations, a Western and an Eastern. We also believe that these Associations, like the Dominion Association, 30o0",
         "MÉDICAL ,ASSOCIA''IONS. should eachyear meet at a lifferent centre and thus periodically bring the Association as near as possible to the door of every practitioner. We believe that ià this way a greater number of practitioners would attend the meetings and thus the benefit would accrue to a larger percentage ôf the profession. We have expressed these views mainly in the hope that some of our readers will communicate through the columns of the QUARTERLY their opinions. We trust they will do so. We would also suggest that the formation of a separate Association for Eastern Ontario would be a.'proper subject for discussion at the meetings of the District Associations. EXAMINATION OF THE PREPUCE IN CASES OF DEFERRED DIAGNOSIS. A LTHOUGH limiting rny practice to Diseases of the Eye, Ear, Nose and Throat, my first years were spent in ad- ministering to the public ills in general, and it was while thus engaged, many apparently minor points were forcibly impressed on my mind; among them I give first (?) place that which I have chosen for this article. The practitioner is \"a necessary evil\" in the minds of most persons (outside of the profession) and, as a rule, when called, the case in hand is too obscure or lias passed beyond the point where Teas and Patent Medicines rendér the necessary thera- peutic action, and for once in the life of some wise friend or .neighbor-failed to cure. A thorough and carefül exainiaiátion on the part of the physician fails to bring out anything of value to aid in.diagriosis; aIl he finds is possibly one of the following conditions or a com- bination, e.g., he patient is suffering frôiîn, a neivous condition, such as palpitation of the heart, a nervous chill, even a mental aberration, or-has a fever which may reach tô 04ó0, or is troubled with a pruritis,. nocturnal enuresis, has had or is having con- joi",
         "KINGSTON MEDICAL QUARTt-RLY. vulsions, lias been gradually losing flesh, lacks ambition and is easily fatigùed, due to the lack of physical developmenti any of which symtoms cannot be attributed to a discernible cause. Such a case vould seem a puzzler, but, if the physician vill stop to think of the many cases of Reflex troubles, lie can readily imagine why lie should invariably defer diagnosis until he lias examined the Prepuce. We find the greater number of cases with symtoms above described in mJe children and I always made it a rule (when I had something for nothing) to examine the Penis, expecting to find at least one of the following conditions, viz.:-an Elongated Prepuce, possibly with very small opening, an adherence to the Glans, a short Frænum or a narrow Meatus. To make clear the above and impress the importance of the subject of this article, I think I can do no better than to state some of the cases I had during the time I was engaged in general practice. Case I.-C. R., age 5, of healthy parents and good surround- ings, was taken suddenly with convulsions; on my arrival the little patient was just recovering froni one; I -made inquiry of the family in hopes of obtaining a clue; some corn that had been eaten two days before being the only likely cause, my diagnosis (to myself) was Intestinal Irritation ; gave Calomel in small doses repeated often until the bowels moved and followed it with Saits; sure :enough undigested corn was found in the stools. I ordered hot bath, to be repeated if another spasm was imminent; this with sedatives was the principle treatment. In about four hours I again visited the house and found my patient in the hot bath, convulsions still persistent ; took him out of the bath and administered chloroform till lie relaxed, continued with the chloroform from 8 a.m. tili 12.30 p.m. Saw the patient frequently during thit time. On my way to the house after noon hour it occurred to me that my diagnosis was somevhat-faulty. I determined-to examine the Prepuce, whiclh I did, finding an adherent condition which I- broke up, removed several pieces of Srnegma,. cleaned and grëas. ed the parts, took away the chforoform ; that was his last attack. The prepùuce rëeeding sôme after-attention, I directed. the parents how to.care fo- it and left it in their charge; there lias been no recurrende.although several years have passed. 302",
         "UXAMIN4ATION OF THÉ PRÉPUCE. Case II.-R. A., age 45, came for consultation in July, 1893; lie complained of being nervous and greatly debilitated, but thouglt otherwise was in a normal condition; his family history was good, no bad habits, married, had several children ail healthy. As nothing definite could be elicited from thë subjective exanination, the Prepuce was examined and found. to be elon- gated to the-extent of frôm one to one and a half inches, the open- ing small; I advised circumcision; patient at once objected, said he had been told by others never to take chloroform on account of his heart trouble for which he was drawing a U.S. Pension; examined his heart, found a nervous condition,so readily agreed to take the risk. The operation was made the same day and patient went home, returned the fourth day and had the stitches renoved, directed him as to diet (he complained of Stomach trouble) and told him to return in about a week, which he did ; reported with confidence that he was much irmproved in every way. Some six months later lie came to my office in a troubled state of mind- lie had gained in weight, had rio trouble with bis Stomach, slept well, but was afraid lie might lose his pension as bis heart had not given him any trouble since. Case III.-P. N., age 8, only serious sickness was Cholera Infantum about five years previous; the parents had noticed him scratching the buttocks and pulling at the penis through his clothing, had punished him frequently for wetting the bed, as they supposed it was due to carelessness or was too much trouble to get up. This treatrnent failed -to make any improveinent in the case and as the child :had aiot been feeling well the past few days I was sent for to fathom the inystery for them. Finding no òther symptoms than those already given I pro- ceeded to examine and found an elongated, tight, adherent Pre- puce;. broke up the adhesions after dilating as. much as possible, cleansed and replaced the fôreskin, advising a circumcision, operated on him the following day, recovery took place quickly, all symptoms immediately disappeared:; no recurrence. Case IV.-J. Si, age between 9 and îo, was taken iII with Fever. On my arrival I found histemperature to be 104¾°, pulse rapid, high tension ; 'somewhat inclined to nervousness, no other symptoms; I immediately éxamined the Prepuce,, found it ad- 363",
         "304 'INGSTON MEbICAL QUARTtRLY. herent to the Glans, separated them with some difficulty, cleansed the parts and restored to former position ; gave small doses of Potash Bromide, told the parents how to care for the case and left with instructions to let me hear from the case next day ; the report next morning was, féver gone and patient all riglt. Case V.-J. A., age75, consulted me for a condition whicli lie called \"Nervous Chills\"; said his feet were always cold, in fact could hardly judge the amount of heat in articles placed to them; body was well nourished and lie was apparently healthy. I asked to examine the Penis when he said, \" Doctor, I guess I an not just like other men,\" and although lie lad been married four times, imagine my surprise to find the Prepuce adherent almost to the Meatus ; I explained to him that here was where his trouble lay and advised separating the parts. I easily gained his consent, and after about one hour's faithful labor with traction and a probe I was enabled to- get a füll retraction; the case re- quired considerable after-attention but finally assumed a natural condition, giving the patient and myself the satisfactory know- ledge of disappearance of nervousness and a better circulation- no more cold feet. Case VI.-K., age 8 weeks, had been cross and nervous from time of birth, physical development seemed at a standstill. I gave sedatives, also.employed systematic feeding with no improve- ment, finally concluded to make a circumcision; this was done with the result that the little one slowly but gradually grew better and is now a strong, healthy, appearing baby. In this case drugs seemed to have absolutely no effect. Case VII.-A. W., age 52, had been confined in an asylum for two years, was hore on furlough but a short time when his aberration assumed an aggravated form, required constant at- tention as bis tendencies were both suicidal and homicidal ; the family had about completed arrangements to have him -etnrned to the asylum. The attending physician-asked for consultation withi Dr. J. B. Greene of Mishawaka (this state). It was held, and patient's trouble was diagnosed reflex, as there was an elongated, adherent Prepucé with narrow opening; also a very small Meatus. Dr. Greene advised an operation, at which I assisted some .three days later; the Prepuce was Ioosened from the Glans, a circumcision, made and the Meatus dilated to full extent.",
         "tXAMINATION OP IFi PR1,PIfCLE On the following day the patient's mind was much brigliter and continued to improve; lie left the hospital with a perfectly clear mind. About seven or eight months later lie came into my office \" simply to call \" as hie was in town looking up men to assist him in caring for his harvest; this occurred in 1893; he is still man- aging his farm. Many more such cases might be cited, but as I have already taken up rmuch valuable space suffice it to say, that although the above relates to the male Prepuce only, the same is true of the feniale Prepuce as corroborated by Dr. Greene, who bas for many years given special attention to Abdominal and Pelvic surgery. He assures me tlat he has relieved and cured many cases of a Neurasthenic nature, and gives as a proof, the case of a young lady twenty-six years of age who had been confined in an asylum for over five years,.who was completely restored to a \"Compos Mentis \" by a circumcision aided by suitable tonic after-treatment. A. E. BARBEIR, South Bend, Ind. CLINICAL DEMONSTRATION IN OPERATIVE GYNECOLOGY. G ENTLEMEN :-This patient comes to us for treatment, with a history of pain and disability gradually increasing, so that for the past few months she lias not been able to do any work. She is a married woman lias had four children, the youngest is two years old. She tells us that she did not make a good recovery after lier last labr, .and that she has since been suffering fron pain in lier back-evere headaches-an irritable weak stomach and a more or less continuai vaginal discharge. The patient has had liquid diet only for 24 hours-; the intestinal tract has been. thoroughly cleared ; she has had a full bath, and vaginal douches. We will now complete the preparation by scrubbing the eXternal geñitals-and vagina with green soap and sterile water. Under full anaesthesia we thake a bi-manual exanination and find the uterus -in normal position-somewhat enlarged-and",
         "106 llitGSTON MÉDICAL QUARTERLY. freely niovable. The tubes and ovaries arc apparently healthy. With an Edeboluls'-Speculum we retract the perineum and expose an hypertrophied and congested cerv't You will note that it is deeply lacerated on both sides of the os. The mucous membrane is everted and eroded. There is a whit- isli purulent discharge through the cervical canal. Evidlently this is a case of chronic endoinetritis, depending no doubt in some measure on the laceration. To relieve these conditions we must curette the uterus-and repair the cervix. The case is of special interest, because it is characteristic of what you will frequently be called upon to treat and you will derive rmore benefit from the study of these matters of every day occurrence than from those of great rarity. If we catch the anterior lip of the cervix with a vulsellum, we can draw the uterus down and steady it; before using the dilator it is well to pass the uterine sound to determine the di- rection of the cervical canal and the length of the uterine cavity ; in this case you see the canal is normal in direction, but the cavity of the uterus is longer than it should be. With a small Wylie's dilator we will stretch the cervical canal sufficiently to allow us to use this large G'3odell dilator, the blades r which are corrugated and parallèl.when open. You will please note that, first:-we hold the cervix and the dilator firmly to prevent the blades slipping backward ; second :-we_ change the position of the dilator turning it from side to side so as to dilate equally in ail directions;, third :-weapply thë force intermïittently as nature does. Having dilated to the requisite calibre, say an half inch, we select a medium sized sharp curette and beginning with the anterior surface we scrape away the granulations and diseased endometrium down to the firn healthy tissue; in the same way vë go over the fundus and posterior surfaces. Next we take this small sized sharp curette and clear out the cornua-the lateral sulci-the granulations around the interal os and the cervical canal. Care niust be exercised not to let any portion of the endometrium escape the curette. This part of the operation:being complete, we proceed to wash -out the cavity of the uterus with sterile water-for this purpose. have found this dull douche curette very useful as it breaks up clots, loosens up the debris and at thé same time irri- gates. For this case we will use no astringent or caustic rem- 306",
         "OPERATËIVEt GYNECOLOGY. edies. Our chief purpose in curetting is to uincover and.open up the diseasedi utricular glands so that the purulent contents May be freely drained away, and a healthy reaction induced. The effect of astringent and caustic applications would be to close up and cap over these glands, shutting in tlheir contents. Our next duty is to repair the cervi\"n By grasping the anter- ior and posterior lips with tenacula, the cervix rnay be drawn well down into view. The .cicatrized tissues ta be cut away, from the edges and angles of the lacerations are marked out by an incision with a scalpel and removed by curved scissors, The edges of the laceration are now brouglit together by means of cumol cat-gu't ligatures, the. suture at the angle being placed flrst, and passed deeply through the tissues to prevent ,the possibility of hemorrhage from the circular artery of the cérvix. Three or four sutures are usually sufficient forneach side. We expectzthese lacei'ations to heal and these sutures to absorb within twoweeks. To keep the endometriuni clear and encour- age free drainage of its glands, we will pack the uterine cávity .with long, narrow strips of iodoform gauze. The end of each strip is brought down into the vagina to ensure patency of the cervical canal and'to facilitate removal of the gauze. The vagina may nov be loosely packed with gauze, an occlusion pad applied held in place by a T bandage. The after treatmen is simple ; the vaginal dressing must be removed daily. The uterine packing may remain from 4 to 6 days, provided the temperature continues normal, when removed the cavity should be irrigated and repacked if the discharge be at all purulent. Some ofyou will remember that in a recënt clinic we curret- ted a case of puerperal enidometritis, due ta sapraemic infection, after abortion. It will beinteresting for you to contrast the treat- ment of that acute pueiferal case with the treatment of this chronic non-Puerperal case, and- in doing so I would asi you to note the following-:- ist.-I1 the puerperal case dilatation vas not necessary, the canal being as it usually .is quite patenti in this non-puerperal case forcible dilatation was necessary and somewhat difficult. 2nd.-In the puerperal case we used a dull curette passing it lightly over the surface. In this non-puerperal case we have used 107",
         "t\u003cINÔSTON MbIlCAL QtITARTEkLY. a sharp curette actùally cutting away the diseased surface of the endonetrium. 3rd.-In the puerperal infective case we used antiseptic irrigation, followed by caustic applications to the endometrium to-day we have used sterile irrigation only, and no astringent or caustic medication. 4th.-In the puerneral case we used no gauze for either pack- i, -or drainage ; to-day we have packed the uterus firmly with gauze. ISAAC WOOD. THE COMPLICATIONS ÔF SCARLET FEVER AND THEIR TREATMENT. Read at the Kingston Medical Association. IN considering the complications of scarlet fever, we will refer not so much to those cases of the disease, often rapidly fatal, and due rather to excessive quantity or virulency of 'the poison introduced', as to the various organs and tissues of the body implicated during the progress of the disease or the period of convalescence. Some cases of scarlet fever are so rapid in their onset, and so malignant in their nature, that little or no time is allowed for diagnosis, and specially is this the case if the eruption be delayed or if it be modified by associated circumstances. These cases are due mainly to the introduction into the-system of an intensely malignant virus or excessive quantity of the poison. The vital processes are as it were overwhelmed and paralyzed either by direct action upon those organs or through the nerve centres. The complications of scarlet fever are associated with either streptococcus infection, or the action of the toxines produced during the progress of the disease;. and these complications -are best considered in relation to the various organs .and tissues which suffer fro. - the interference with their functions. Almost every case of scarlet fever, if not every case, is associated with changes in the throat, usually called either pïimary or secoûdary.",
         "COMPLICATIONS OF SCARLET FEVER. The primary sore throat occurs about the first week of the onset of the disease. The secondary angina shows itself about the second or third week, and is undoubtedly a true complication, due to growth and development of the streptococcus. Either the primary or the sec- ondary angina may be but a simple erythena, local, in no way causing alarm and occasioning but little inconvenience to the pàt- ient; or the inflammation may be so severe as to produce ulceration and sloughing of the parts, and in some cases may produce fatal results; and, in fact, all degrees of inflammation may be met with, from the simple characteristic erythema to necrosis of the parts affected, depending upon the virulency of the disease. It is usual in throat complication of scarlet fever to divide the angina into three stages, corresponding to the degree of inflammation I. Erythematous, H. Membranous, III. Gangrenous. The erythematous scarcely comes under the head of a com- plication, being only an aggravated condition of the usual angina found in scarlet fever. The membranous or pseudo-membranous usually shows itself first ýupon the tonsils, grey in color and glistening in appearance and resembling very much true diphtheritic membrane, and like it leaving a raw, bleeding surface -When brushed forcibly off. In many cases this membrane is confined to tietonsils àlone,, but in others it may spread to pharynx, larynx, posterior nares, soft palate and other adjacent structures and under these· con- ditions may readily be mistaken for diphtheria, the absence of the diphtheria bacillus and the presence of the streptococcus serving as the basis of diagnosis. This membrane lasts.between five and ten days, when it gradu- ally :peels. off, leaving the parts swollen and congested, and resuming in about two weeks their normal appearance. When this membrarious complication arises, its develop- ment is usually associated with increase in temperature and rapid pulse and al: the signs of infection, the involvement of the glands in the vicinity: stib-maxillary, parotid and cervical chain being a characteristic feature. They become enlarged, swoh len, tender, either terminating in resolution in à few days or pass- ing on to abscess,. and should the pus4orming elements penetrate the abscess wall, they are liable to set up extensive cellulitis with 309",
         "KINGSTON MEDICAL QUARTERLY. involvement of important and even vital structures by the sub- sequent burrowing. Of course ihe conditions just mentioned are in direct pro- portion to the severity of the disease and in grave cases may re- sult in intense septic intoxication. Now, while these conditions may be and are present in the absence of the diptheria bacillus, yet it does not follow that diphtheria is never found complicated with scarlet fever. On the contrary they ere frequently associated with one another. The tendency for the membrane to spread, as also the erythe- matous condition, gives rise to the involvement of adjacent organs and structures. For example, the ears are very fre- quently affected both in the erythematous and membranous varities. All degrees of inflammation may exist, from a simple catarrhai condition of the Eustachian tube with or without occlusion, purulent or otherwise, of the internal ear, and in some cases may even extend to the brain through the meninges or cause thrombosis of the large veins. Deafness is so common a sequela of scarlet fever, due. to extension of inflammation along the eustachian tube, that in every case of scarlet fever, be it ever so mild, special attention should be directed to any symptom pointing to involvement of the auditory apparatus, and .treated accordingly. Occasionally we find that the inflammatory condition has spread :to the -posterior nares, giving rise to symptoms so well known that we will not dwell upon them here. The gangrenous form is very rare happily and consists in the iapid death of the parts. The lymphatic glands are among the most frequently in- volved structures during the course of scarlet fever. The inflam- mation of these glands nay be due to either primary or second- ary infection. In almost every case of scarlet fever and in all cases where the throat is involved we have inflaimmation of the lymphatic glands in the vicinity, differing in degree with the intensity and virulency of the disease. The secondary inflammation is undoubtëdly due to strepto- coccus infection or the toxines produced during the course of the disease, and here as in the throat any degree of inflammation 310",
         "COMPLICATIONS OF SCARLET FEVER. may be met with, from some enlargment with tenderness to ab- scess and even interstitial destruction, often terminating fatally. The glands most commonly affected are parotid submax- illary, cervical chain and the glands at the angle of the jaw. The primary infection of the lymphatic glands, that associ- ated with the onset of the disease, is as a rule not serious. But great care must be taken when secondary infection arises. This usually occurs between the third and fourth weeks. In fact, care- ful, timely and judicious antiseptic treatment of throat complica- tions should largely if not entirely prevent secondary infection of the lymphatic glands at least. Of course when secondary infection does occur, it is naturally associated with the usual signs of sepsis, elevation of temperature, rapid pulse and other symptoms corresponding with the degree of involvement. The affected glands consist of hard, movable masses, swollen, enlarged and tender, either passing ön to resolution in two or three days, with decline of temperature and slowing of pulse and return to normal, or passing on to abscess, with possibly rupture into the surround- ing tissues, resulting in septic absorption and intoxication, sometimes leading even to fatal processes, accompanied by, the usual symptoms of this condition, rapid weak pulse, variable temperature, chills, profuse sweating, delirium, convulsions, coma, albuminuria witli toxic nephritis, these being associated with mucli enlarged and tenderglands rapidly forming into abscesses, often com pressing and involving the 'large vessels and nerves in the vicinity, or the larnyx or other vital parts. In these grave cases death is the usual result. We find that the kidneys are by no means. the least =fre- quently involved in cases of scarlet..fever and, in fact, of all'the zymotic diseases scarlet fever is the one most frequently com- plicated by nephritis. -So miuch so is this the case, that no mat- ter how mild the case, the kidneys should require careful and· constant attention throughout the. disease, for much more can be done in the initial than 'in the later stages of this insidious complication. The occurrence of nephritis in scarlet fever seems to differ in differerit cases and in different epidemics, and the degree of intensity or the malignity of the virus does not in all, though in a great .number of cases, seem to be in direct propor- tion to the number of:casesassociated with nephritis. 31-",
         "312 KINGSTON MEDICAL QUARTERLY. Usually, however, a severe and prolonged attack of scarlet fever will include involvement of the kidneys. Where there is intensity and malignity of the virus and elimination of toxines, there are bound to be changes in the kidney, and many severe cases apparently free from nephritis would show this complication, mild though it may be, on careful clinical and microscopical examination. On the other hand, many very mild cases have developed nephritis when the very innocent character of the epidemic would lead us least to expect. But it is not a safe or reliable rule to lay down that mild cases are more liable to neph- ritic complications than severe. The epidemic we are now pass- ing through, though very mild and widespread, is associated with but very few cases of nephritis. While we have no lesion in the kidney characteristic of scar- ]et fever, yet glomeruliseem to be the parts most constantly and frequently involved. Many causes are at work to produce nephritis and among these may be mentioned the following : i. The elimination by the kidneys of the scarlatinal virus or infection, the introduction of which into the system produced the disease. 2. The elimination by the kidneys of toxic products, pro- duced during the.progress of the disease. 3, The increased functional activity thrown upon the kid- neys by deficient or absent elimination by the skin. For the swollen, hardened and harsh condition of the skin points to feeble elimination. 4. Probably an involvement of the lining membrane of the uriniferous tubules, similar to that upon the lining membrane of gastro-intestinal and respiratory tracts. The theory has been advanced, that as nephritis is a com- plication rather of convalescence than of the disease proper, it is more frequently due to catching cold, thus producing congestion and the associated phenomena. No doubt mild cases are much more exposed to atmospheric changes and changes in the body heat than the severer ones, and this may account for the frequency of occurrences of nephritis in mild cases. There is no doubt that catching cold at a time .when the kidn eys are weakened down by over work, or it may be by disease, will either produce a nephritis or unmask an obscure one. So also",
         "COMPLICATIONS OF SCAlLET FEVtR. any patient with weak kidneys, or the victin of diseased kidneys, is more prone to this complication than one whose renal system is active and unimpaired. Scarlatinal Nephritis is most commonly noticed about the third week, though the physician should examine the urine from time to time from the very onset of the disease. Sometimes the renal involvement is'ushered in by an abnormal increase in the amount of urine, due to excessive secretion caused by irri- tation of thç - poison being eliminated, but most frequently this complication is announced by a gradual diminution in the a- mount of urine, while at the same time the quantity of urates and the amount of albumin are increased,and an examination of a sam- ple of urine will show besides the abundant urates and albumin, red blood cells and casts of epithelium, fat and blood. The color is heightened due to concentration, and smoky fronm the pres- ence of altered hemoglobin; the gradual diminution in theamount of urine may terminate in complete suppression or the gradual return to normal amount, the kidneys regaining their usual. tone. Often the presence of albumin is associated with increased temper- ature and rapid pulse, though this is not the rule, for the tfenperature is usually low. To recapitulate: the gradual diminution of urine, the gradual increase in the amount of urates and albumin, the smoky, high-colored urine and the presence of blood casts on the one hand, and thé pain in the back, the frequent and painful micturition on the other are conditions leading to but one conclu- sion, andthat is nephritis. Associated with the diminution in the amount of urine we have the still further complication of uræmia, the symptoms of which all are familiar with. The diminution of urine is later on associated with ædema, local at first in ankles and under eyes, but. very rapidly becoming general. In no disease is the ædema so abundant and wide3pread as in scatlatinai nephritis, no cavity escaping. Under certain circumstances we may have instead of the smoky urine, a urine red in color and consisting almost en- tirely of blood; this hematuria is a grave complication and must call f#a guarded prognosis. In nephritis, cure is the rule, though, as has been mentioned before, ifthe poison to be eliminated is abundant and the kidneys are weak, t ia the prognosis becomes very grave. - 3f3",
         "KINGSTON MEDICAL QUARTERLY. The heart is the seat of frequent complications during the course of scarlet fever. Associated with the nephHitis we have enlargement of the right side of the heart with Tachycardia and diminislied tension of the blood vessels, and this enlargement exists in ail cases of nephritis. If the case is of short duration, then this enlargement disappears and the heart resumes its nor- mal size and tone. If the disease be prolonged, then compensatory hypertrophy results with permanent enlargement and other changes which necessarily follow in its train. Often in scarlet fever an endocarditis, a pericarditis, or myocarditis may be found, but these are rare, and many cases of endocarditis are due ratier to rheumatism than to true complications of scarlet fever. This condition (rheumatism) so frequently follows scarlet fever that it is held that scarlet fever directly pre-disposes to rheumatism, probably through the lowered tone of the joints from blood and nutritious changes. Other boue diseases may also show themselves. If patient be phthisical then tubercular dis- ease of the joints may follow; this and septic joint disease are common sequelae following severe cases of scarlet fever. As another complication of scarlet fever might be mentioned the condition of purpura hemorrhagica, sometimes met with, modifying the ordinary erythema. Here ve find patches of ecchymoses varying in size and color, the hemorrhage often being excessive and the patches large. The prognosis in these cases is grave in proportion to the extent and severity of the hemorrhage. As the gastro-intestinal tract is involved in the same way as the skin, we find disturbances of this tract quite common, so that nausea, vomiting, gastritis, diarrhœa, dysentery and even enteritis may show themselves, depending of course in their severity upon the degree of inflammation. Catarrhal conditions of the respiratory tract also are met with, producing laryngitis, bronchitis, and not 'uncommonly catarrhal pneumonia. Any involvement of the respiratory tract calling upon the heart for increased energy is a dangerous complication. Already the heart muscle and centre has: beën weakened by the virus, and the toxines, and the diminished nutrition, so that it is in no condition to respond to the increased labor of sending the usual supply of blood to the congested .pulmonary apparatus, and collapse may be looked for. 314",
         "COMPLICATIONS OF SCARLET FEVER. Lastly, among the complications of scarlet fever may be mientioned tlhe occurrence of this disease in combination with other of the exanthemata, as measles, typhoid fever, chicken pox and even small pox. Here the grouping of characteristic symptons of both diseases and the modified conditions of skin- make the diagrosis in nany cases extremely difficult and it is only on careful study and close clinical watching that the con- dition of affairs is realized. TREATMENT OF COMPLICATIONS. If fever be above 102 0 F. and the pulse strong 'nd full and patient healthy, then the coal tar products niay be employed, always however in combination with some cardiac stimulant, as caffeine or strychnine. These coal tar products are well known heart depressants and are always more or less dangerous. After the onset of the disease, when the toxines are liable to.affect the heart and specially if the heart be weak, then they are to'be avoided. A much safer and more effectual method of lowering the temperature in private practice is by means of the sponge bath, using tepid water and alcohiol, sponging one part at a time, rubbing well and covering with flannel, thus encouraging active, cutaneous circulation and loss of heat by both conduction and radiation. In throat complication antiseptic applications should be used from the onset of the disease even in the very mild forms. Sprays, swabs, gargles, washes all have their advantages and disadvantages, though probably in children the best results follow the use of the spray and in adults that of the swab when lightly and thoroughly applied. . Many substances are re- commended in the, angina of scarlet fever; among the most effici- ent are peroxide of hydrogen, pot. chlor., pot. permang., boracic acid and any alkaline anti-septic preparation. If the throat be very irritable the previous application of a 2-4 per cent. solution of cocaine will relieve the distress to the advantage of both physician and patient. If the diphtheria bacillus be found then anti-toxin is indi- cated as well as the local and constitutional remedies usually employed. If streptococcus infection, then the anti-streptococcus serum 315",
         "6INGSTON MtEDICAt, QUARTElRLV. may be enployed though, so far, results irom the use of this sub- stance have not been as good as anticipated. In extension tothe olose the use of the above remedies by means of either spray or douche are indicated ànd to be treated in same way as in the throat, As the car is so frequently the seat of inflammation constant attention should be directed to this organ throughout the disease. If painful, use hot antiseptic and anodyne solutions. If bulging of the drum, use the lance and wash out very gently and cautiously with very mild unirritating solutions, such as a saturated solution of boracic acid, peroxide of hydrogen, \u0026c. If involvement of mastoid cells, then open and drain and use an anti-septic wash. Should the glands (lymph.) become enlarged, swollen, and tender, use cold application of liquor plumbi subacetatis and Tincture of opium, in combination to promote resolution. If signs of suppuration present themselves, open at once, thoroughly drain and use anti-septic wash, i-iooo Bichlioride followed by sterile water. Keep open and aseptic. When suppuration exists in any part give sulphideof calcium, ¼ grain every 3 hours until system becomes saturated, and open freely. When nephritis appears give a strictly milk diet and enforce rest in bed. If anomia give Tincture of Ferri Mur. with appro- priate tonics. Diuretics are almost useless, the only one and the best being large quantities of water to flush out the kidneys, diluting the toxines and thus diminishing their severity upon the tissues of the kidneys. Lemonade is cooling and grateful and aids elimination. En- courage activity of the intestine by rochelle salt, seidlitz powders or other salines. Should uraemic symptons show theniselves, then attention should be directed to improve the embarrassed elimination fron the skin. Pilocarpine hypodermically is of great value in causing dia- phoresis, but must be cautiously used as it is very depressing to the cardiac muscle and centre. Correct this depressant action by using strychnine with it or giving acohol by the mouth just before or 16",
         "TREATMENT OF COMPLICATIONS. 317 Caffeine, spirits of chloroform, or aromatic spirits of ammonia. If bronchitis or broncho-pneumonia be a complication then hesitate to give pilocarpine, as much of the action of the drug is spent on the respiratory apparatus, greatly inureasing secretion. Give patient hot bath ten to fifteen minutes in duration, rub well to redness, wrap in blankets and apply artificial heat and thus promote free diaphoresis and the elimination of the waste products and poisonous substances which are causing the uroemia. If the skin does not respond readily pronote free catharsis by the exhibition of elaterium, croton oil, salines, \u0026c. Atthe sanie time, with the view of modifying the disease, the following drugs have their advocates: veratrum viride, chloral, Morphine, chloroform, \u0026c. In oedema where the cavities are filled to the great disconi- fort and datnger of the patient, aspiration is indicated In heart complications the ordinary remedies are indicated. For simple enlargement in a case of short duration no remedy is required. Should the heart become irregular, weak and rapid, use digitalis, or better still digitalin. As the digitalis is slowly ab- sorbed and of a variable strength and action, Strophanthus may be employed. If surface of the body show diminished peripheral circulation, with contraction of the blood vessels, then use nitro-glycerine to increase the peripheral circulation, and relieve the strain on the heart and other organs. In all casesof weakness of the heart, we should use strvch- nine, depending on the degree of weakness and involvenent, for effect it should be pushed, -e of a grain every three or four hours, till the physiological effect is produced. In some severe cases it may even -be given oftener. It is a dangerous drug,.and must be closely watched. Alcolhol as a general stimulant is contra-indicated in scarla- tinal nephritis. As the.great part of the weight of the disease is thrown on the kidneys, and as alcohol is eliminated largely by the kidneys and irritates them, it would be but aggravating an already existing inflammation. Endocarditis calls for ice bags to chest, rest in bed, and the above remedies as already indicated.",
         "318 KINGSTON MEDICAL QUARTERLY. In rheuniatism, soda salicylate, soda bicarb., lilthium citrate, wine ofcolchicum are to be used,as in ordinary cases of rheumatism For vomiting pieces of ice swallowed gives great relief. Milk and limewater often control the irritabili'y. Bismuth salicy- late and subgallate are frequently employed. For diarrhoea, if moderate, no medicinal agent is required; if excessive, give chalk mixture, bismuth, catechu, and other mild astringents. These are often greatly aided by the combination with them of the sulpho-carbolates or salol. For gastro-intestinal and respiratory involvement the treat- ment is the sanie as in ordinary cases, and calls for no special remedy only as symptoms show themselves. For general infection, it has been lately suggested that much of the harm in the system produced by the virus and toxines might be much lessened by introduction into the system of large quantities of normal salt solution-(sterile), either by injection into the serons cavities or by intravenous injection. In those grave cases where the system seems to be, as it were, overwhelmed, it would be worthy of a trial. J. W. CAMPBELL. EXTRACT OF SUPRA-RENAL CAPSULE. T HE first preparation of supra-renal capsule with whiclh I ex- perimented was quite inert, so far as any local action on the conjunctiva or nasal mucus membriane was concerned. Af- terwards I secured some of Armour's dessicated supra-renal capsules, and the extract made with this lias proved to be very active, and quite remarkable in its local effects. Taking five grains of the dessicated gland to each drachm of water, I shake the solution well and allow it to stand for ten minutes, and then filter through filter paper, pouring the solution back to pass through the powder for a second and a third time. The result is a clear amber colored fluid, which decomposes rapidly, unless glycerine-be added to make at least 25%. The glycerinated ex-",
         "EXTRACT OF SUPER-RErNAL CAPSULE. 31C tract is, however, not so active as the freshly prepared aqueous solution. When a few drops of the aqueous solution are put into the conjunctival sac, it causes slight smarting for a moment. The astringent effect cornes slowly in five or six minutes, and the con- junctiva assumes a peculiar lustreless color. The blood is almost entirely driven out of the superficial vesseis so that an operation for pterygium or for strabismus may be done without a drop of blood corning from the conjunctional vessels. It has little or no anaesthetic effect, so that I employ cocaine with it. If any hyper- aemia or inflammation is present the effect cornes less rapidly and the bleaching is the less noticeable, the more intense the con- gestion. The deep ciliary vessels are influenced by it to some extent. In a mild iritis the ciliary congestion disappears entirely, while in-the very intense conditions of the ciliary region no effect wlatever is to be seen. It is, however, as a haemostatic in the minor surgery of the nasal cavity that I find it specially useful. The chief trouble ir operations for removal of spurs and out- growths from the septum and in turbinotomy is the hemorrhage. ItLseens scarcely credible that these can be rendered absolutely bloodless and at the same time the danger of secondary hemor- rhage overcome; and yet this is accomplished by a t horougli appli- cation of the extract 'of the supra-renals. I apply the solution either by swab or by a saturated plug of absorbent cotton and this may be done either before or after the cocaine is used or the cocaine and supra-renal solution may be combined. It is difficult to realize how effective this method really is unless one has tried it with a good extract. I llave also used it to a lirnited extent in the pharynx and larynx., mainly for the relief of congest- ive conditions, and the results so far go to establish its value. There is no doubt whatever that the extract of supra-renal cap- sules is a valuable addition to pharmacopocia. J. C. CONNELL.",
         "TUBERCULOSIS PROPHYLAXIS. T HE prophylaxis of Tuberculosis is a question which at the present time is engaging the attention not only of leading Medical men, but of the humanitarians and scientists the world over. When we consider that 1-7 of all deaths are due to Tuberculosis some idea of the importance-of the subject Iiiay be formed. Nearly every Medical Journal at which we look, con- tains either the reports of societies formed for the stamping out of the disease, or the opinions of learned Medical men on the subject. Every gathering of Medical men contributes its quota of literature on the prevention of Tuberculosis, and Boards of Health, wherever formed, are bending their energies in the same direction. The knowledge thus obtained must be carried further, for the work will not be complete until the laity are fully seized' with the importance of.how valuable their assistance must be in stamping out this terrible scourge. We all know that.Tuberculosis is not inherent in the consti- tution, but is derived from pre-existing causes. It is contagious, communicable from man to man and froni animal to man. If it is contagious, there must be some means of preventing it and if preventable, why not try and prevent it ? As long as the preven- tion of this wide-spread disease is left to a few only, no progress, worthy of the name, can be assured. But when the movement becomes general, when the laity understand that in self-defence they must lend their assistance and work hand in.hand with the medical profession, then only can we expect any appreciable degree of success. What then. can we do to prevent the spread of the disease? (i). We must educate the public in the way of prevent- ing the spread of the disease and avoiding the sources of its contagion. (2). We must strive to extinguish the disease in cattle. (3). We must advocate the isolation of Tuberculous patients, either in Hospitals, sanatoria or by some other means. Thanks to measures already taken, the mortality has already been reduced betweén the periods'51--'60 and '91-'95 by thirty",
         "TUBERCULOSIS PROPHYLAXIS. per- cent. This decrease has been due chiefly to the steps taken to stamp out the disease in cattle. From this it cari be seen what a great decrease must take place if we successfully fulfil the other measures, viz.: the education of the laity, and the erection of Sanatoria. The education of the laity on the Eubject will be the most difficult and the most important to be attended to. Means should be taken at once to inform the public of the sources of danger. This can be donc by pamphlets, through the columns of the daily press, which should be constantly invoked, and by public lectures. I hold, too, that our children should be taught in our ýpublic schools, the danger and frequency of this disease, and the means adopted for its extermination. It should be made clear to all that the sources of this disease are :--pêrsons suffering from Tuberculosis, infected air, infected milk, infected meat. Since the sputum is the chief distributing agent of the germn, afflicted persons should be warned of the danger of spitting pro- .miscuously about cars, carriages, pavements, or in their own homes. A little care exercised in this way would be the means of saving numüberless lives. In fact, it is a question if the· time has not corne when compulsory care should be exercised. Persons suffering from Tuberculosis, should carry some one of the numerous receptacles now on the. market. These, when- necessary, should be either emptied into a furnace, or left until the contents are thoroughly disinfected before being emptied. While indoors, too, Tuberculous patients should expectorate intô a receptacle containing a disinfectant-5% carbolic acid. Con- sumptives should avoid the tôo common habit of spitting on a handkerchief, which is then carried in the pocket, or placed un- der the pillow. This is- a most pernicious habit. Eating utensils which have been used by phthisical patients should be thoroughly disinfected: beforë being used by others. Likewise, all bed clothes, sôiled linen, and other ai-ticles of dress should be thoroughly disinfected. The public should also be warned of the danger of over-crowding, bad air, intemperance, darkness, dampness, colds, sore throats. These refer particular- 'ly fo those prédisposed to the disease, for they weaken the con- stitution, render the tissue-resistance less, and thus a suitable nidus for the gerrn of Tuberculosis is' formed. We. cannot be too",
         "KINGSTON MEDICAL QUARTERLY. careful in impressing upon hereditarily predisposed, the absolute necessity of their avoiding the sources of the disease, and of keeping their constitution in the best possible condition. -Consumptive patients should sleep alcne. Nurses hereditarily predisposed to plithisis, should not attend Tuberculous patients. After death from Tuberculosis there should be a thorough disinfection of all bedding, linen, and furniture whicli have been used by the pa- tient, and also of the rooms occupied by the patient previous to death. There should be a regular sanitary inspection of prisons and asylurns,.and phthisical patients should be isolated therein. Those affected with phthisis should not be permitted to work in factories, or crowded workshops of any kind, and periodical dis- infection of such places should be carried out. Marriage should be discouraged in consumptives, as where there is such close relationship there is grave danger that the disease will be com- municated. Cities and corporations should enforce compulsory notification in fatal'cases. With regard to the stamping out of the disease in cattle we have only to enforce more rigidly the laws already passed in inost countries. Infected cattle are one of the chief sources of infection in man and have long been recognized as such. The greater part of the measures already tàken have been aimed at stamping out the disease in cattle. If we could secure the thorough disinfection of all tubercu- lous sputa and the killing of all tuberculous cattie the disease could be practically annihilated. All dairy cattle should be regularly inspected and subjected to the tuberculin test.; all cattle found to be affected should bé killed. In order to encour- age the carry ing out of these measures, cornpeñátio shoiôld bë paid to the owners of diseased cattle. The laws regarding the cleanliness, cubic space, etc., of cow sheds should be rigidly en- forced. Milk from tuberculous cows, especially if the udder be affected,. is such a common source of contagion that all milk should be boiled before being used. The nourishing quality of the milk is in no wise altered by being boiled. Tuberculous meat is highly dangerous and shuld not be eaten. I think there should be no exception to this rule. The establishment of Sanatoria has been proved to be the Most successful form of isolation..and prophylaxis. If it were '3 22",
         "TUBERCULOSIS PROPHYLAXIS. possible all cases of Tuberculosis should be placed therein. We would then be in sight of the end of this great scourge. Isolation wards should, at all events, be set apart in our hospitals and all advanced cases should as far as possible be treated there. It is only in such places that the proper prophy- laris can be carried out. E. RYAN. SOME CLINICAL NOTES OF SURGICAL CASES. DISEASE OF CARTILAGES FOLLOWING TYPHOID FEVER. A TTENTION has lately been directed to the surgical compli- cations and sequelae of typhoid through the works of keen, Park, Parsons, and others, and, according to these authorities,, one striking feature of the bone lesions is the length oftine that often elapses after typhoid, befo'e they manifest themselves. The bacillus of Eberth has a special affinity for the marrow of bones, and, just as it has wonderful longevity outside the body, so it may remain latent in the tissues for an indefinite time, as seen in a case reported by Van Durgern, where the typhoid ba- cillus was found in the gall bladder 14 years after ·an attack, and in the case of Sultan, who noted; the bacilli in a sinus leading down to the clavicle 6 years after typhoid. Granted the pres- ence of the bacilli in the bonüs, an injury received months or even years after an attack may start into activity the dormant organism.;. (hence the importance of warning patients against .too early resumptiôn of occupation after typhoid fever). Witzel claims that the cases reported are more numerous now than formerly, and ascribes the increase to injuries received during the bath treatment. As to the pathology, soine of the· cases may be due to a mixed infection, (typhoid bacilli and pyogenic cocci); but, the majority depend on the action of the Eberth bacillus alone. In 51 cases examined bacteriologically, 13 contained pyogenic organisms, and 38 pure typhoid. Bone sequelae occur twice as often in the mal as in the female, probably from the greater risk of traumatism in the former than in the latter ; and the bones 3",
         "KINGSTON MEDICAL QUARTERLY. of the extremities are more often attacked in the young, whereas the ribs and cartilages are the favourite seat of the disease in the adult. Keen states that, \" out of 216 cases of bone disease, 40 were confined to the ribs and cartilages, and of the 40 cases, 35 were over the age of 35, and 5 under.\" The part of the bones attacked is shown by the same author to be \"out of 237 cases, periostitis was present in 11o, caries in 13, necrosis in 85,\" and lie also notes that whereas, in tubercular osteitis, the general health suffers, in typhoid osteitis, on the other hand, the patient may enjoy first class health. Chronicity, indolence and a tendency to recurrence are the three striking peculiarities, as pointed out by Osler and Parsons (Johns Hopkins' Reports), and Paget lias reported a case in which five operations were done and Keen one in which lie operated four times, the disease recurring each time, and in which he removed a considerable portion of the ste-num and of the ribs of right side. During the last two years we have had under our care three cases following typhoid-two having disease of the costal carti- lages and one, the lower end of tibia. In one patient, æt.35, there was disease of the sixth left costal cartilage; this was partly removed but recurring, required a second operation removing the 6th and 7th and part of the 8th cartilage before final cure. The tibial case involved the outer third of the lower end of tibia and the thorougli removal of this demanded opening up the ankle joint, from which, however, the patient recovered without untoward symptoms and returned home entirely well. The last case was kindly referred to me by Dr. Tovell of Sydenham, who suppli- ed the following history :-\"Wn.---,aged 38, enjoyed good health up to Oct. 1897, when he contracted typhoid fever. After four weeks illness he had a severe pain at junction of 8th rib of right side-and cartilage which continued until about Jan. '98, when a slight swelling appeated. Under treatment the swelling and soreness improved so much that during the spring and sum- mer he was able tô follow his occupation of farming, but in Oct. '98, a soft area formed in the centre of the swelling which on open- ing yielded a small quantity of a thin purulent fluid.\" He was sent tô me about March ist and on examination I found a sinus whicl at operation led down to a small spot in upper border of eighth cartilage, about thesize of a pea. This was",
         "SOMË CLINICAL NÔTES ÔÈ SURGICAL CASES. 325 thoroughly curetted but the wound not healing, a more extensive operatfrri was done May î6th, uit. I then *hqund the. wliole of the eigitfh cartilage diseased, whicli I remóved, along with portions of the i, nth and seventh-the disease, central iecosis, having involved)the articulations between these cartilages. EMPYAEMA. Our method of procedure in this condition is,;after using a large hypodermic needle, to have a culture made of the pus. Should it be due to-the pneumococcus or tubercule bacillus then aspiration, repeated if necessary, will frequently cure: Should, however, the effusion be due to pyogenic organisms ve prefer thoracotomy, or exsection of the tibs if needed. Along with this we generally advise lung gymnastics (blowing water out of a bottle, the cork of which contains two glass tubes with rubber attach- ment, into another bottle), as there is always possibility of per- manent compression of the lung. When. this occurs, as the lung cannot expand to the chest wall, removal of some of the ribs is necessary, as in two recent cases where I had to do a partial Esthlander operation for the above condition of collapsed lung. HEMORRHOIDS. I generally employ the silk ligature by transfixion for hem- orrhôids, and in using this method there are two essentials to the successful carrying out of the operation: first, as perfect asepsis as can be secured in this region, and secondly, the proper use of the ligature. As to -the latter, there is-danger of opening up a venous sinus in the transfixion by the needle, and then, when the divided ligature is tied, the bleeding would be free, since each half would hold open the sinus. To prevent this it is advisable before tying the one ligature, to include one of the ends of the other ligature in the first loop, thug closing the sinus. INGUINAL HERNIA. In a recent case of inguinal hernia in a female on whom I did Bassini's operation for radical cure, there were very few symptorns of rupture, and.even these were poorly marked. There",
         "KINGSTON MEDICAL QUARTERLY. was no decided protrusion, though there was a slight feeling of enlargement as compared with the other side, and ·somewhat more appreciable on coughing. There was complaint of alnost constant pain, however, sufficient to justify an exploratory in- cision. On operation I found an unobliterated canal of Nùck, about as thick as a lead pencil, and four inches long. On in- cising it the inner opening was found to be of the same calibre as the rest of the sac, but there was no intestine in it. It seeni- ed to me that the explanation of the pain was that of a condition approaching that rare forni of hernia-Littre's, where only a small margin of the bowel engages in the sac. She made a perfect recovery, and has since been free from suffering. D. E. MUNDELL. HAY FEVER. T HIS is the season of the year when the victims of this an- noying trouble present themselves for relief. In the cold season they are few and far between. In the majority of cases the treatment I adopt either checks the condition or keeps it un- der control. Those that prove intractable are such as have been neglected at the onset. A close study of my cases confirms the belief that tiere are three distinct factors in each case. First, tiere is the predisposing neurotic condition with diminished vasomotor control; second, there is a hyperaemia of the nasal mucus membrane; and third, there is the exciting agent which varies with the individual and locality. These three factors are present in varying proportion in different cases, and I find that if treatment be effective in over-coming any one of the three factors the combination is destroyed and the patient lias relief. The neurotic condition should be looked after for some time pre- vious to the date of the annual attack. There are patients who have an annual attack which comes on a certain day of a certain nônth, and they tell me this has been so for years past. Others expect the attack to come during a certain week, and still others, during a certain month. The usual story i's that for a few years 326",
         "IAY FEVER. the attack was limited to a definite time, varying fronia few days to a few weeks, but as the time passed. the period has become prolonged. These are the patients who get relief from niedicinal treatment carried on for a month or six weeks before the expect- ed attack. Many of these patients are slightly anaenic and iron and arsenic are of great benefit to them. Where this indication is absent I prescribe a tonic mixture of strychnia, or valerianate of zinc or sometimes a simple bitter, while for all of them I order lithia in tablet foim. This, in a fair percentage of the cases, has prevented the attack, while in a larger proportion it lias greatly modified its severity. As to the second factor, the local condition, everything possible should be lone to remove any focus of irritation from the nose. This may be no more than a simple hyperæmia of the nasal mucus membrane or it may be a hypertrophic rhinitis, a polypus, a spur on the septum, or a deviation of the latter. The third factor, the exciting agent, varies with the indivi- dual and locality, and it is not by any means always pollen of grass or flower, though it is sometimes impossible to determine its na- ture. City patients who are shut up in offices ail day get better as soon as sent out to the country, and have a recurrence when they return to the dust and odor of the office. Two patients have an attack whenever they drive behind a horse or enter a stable. When an attack comes on I depend nainly on two remedies-one for internal use, the other for local application. The former is ammotiol, (ammoniated-phenylacetamide,) of which I give eight grains in powder once or twice a day. A few get ample relief froni one powder taken each morning, but usually a second powder is taken in the evening. The other preparation is stearate of zinc with aristol as prepared by MeKesson \u0026 Robbins. This is used as a dusting powder in the nose, where it is perfectly non-irritating. This may be used as a §nuff if the nostrils are patent ; and. wheñ they are not, it is to be introduced by a powder-blower of any convenient form. In this way my patients are made confortable and the attack is shortened. NOTE ON SOZOIODOL OF ZINC. Sozoiodol, or di-iodo-para-phenol sulphonic acid is composed of 54 per cent..iodine, 7 per cent..sulphur and 20 per cent. phenol. 327",
         "KINGSTON MEbICAL QUAI EkLY. It has been combined with potassium, zinc, sodium, ammonium, lead and mercury. These are ail suggested by Merck as odor- less substitutes for iodoform. The zinc sait is particularly useful as a non-irritating astringent and antiseptic. Where an astrin- gent is required in the nose and throat it answers admirably in solution varying from 2 to io per cent. The potassium sait I have also used in the saine porportion with stearate of zinc as a dusting powder in atropliic rhinitis. J. C. CONNELL. FÎECES AND THEIR EXAMINATION. . A LL physicians in their routine of clinical work examine more or less cursorily the stools of their patients, particu- larly those suffering from lesions localized in the intestinal tract and acute in character. It would be advisable for the physicians to study more carefully faeces in ail vague or well defined lesions localized in the abdomen, including gastric, hepatic and renal de- rangements. Take those very vague and common disorders of children classed as \"Worms:\" would it not be advisable to demon- strate the parasites or their ova before deluging the patient with vermifuges, for when parasites are present tlieir ova at least will be found in the stools. No definite plan of exainination can be laid down to follow as physiological stools differ so much in their composition and character, both macroscopically and microscopically, varying with age, amount and character of the food taken, the exhibition of nedicines and like factors. With these variations it is essen- tial that the physician be acquainted so that he may more readily determine pathôlogical -characters in a stool. Naturally for the majority of physicians the macroscopic examination-is all that can be attempted. This examination includes such points as the forma- tion of the foeces, (scybalous, firm, ribbon like,ýpultaceous, watery, etc.) ; the presence of mucus, and if so, is it present in flakes, shreds, or cylinders ? the odor, whether more offensive than usual, as in 328",
         "P2ECES AND THEI1 EXAMINATION. gangrenous dysentery; the color which varies greatly in pathologi- cal conditions depending on absence or excess of bile, presence of blood, exhibition of such medicines as Bismuth and Iron, etc.; the presence of masses of undigested food, particularly fats, starches, and curdled milk-; and lastly, the presence of blood or jus. While these are the general characters which are to be noted in all cases, other nethods of examination are required for special cases. In all attacks of colic in adults, more particularly when local- ized in the hepatic region, the stools should be broken up and passed through a fine sieve so as to secure any biliary calculi that may have passed. At times enteroliths may be mistaken for such calculi, but a chemical test for cholesterin will at once clear up this point. The passage of shreds of mucus points to a catarrhal con- dition of the lower bowel. Complete casts of parts of the lower bowel, consisting of mucus are at times seen without serious intestinal disturbance, but more commonly the passage of such means a severe colitis. Casts of the bowel are also seen in gangrenous dysentery, but are here accompanied with blood and pus, and are made up of the gangrenous portions of mucous membrane, together with the fibrinous exudate upon its surface. In cases of suspected amoebic dysentery the mucous flakes and shreds should be at once examined, for the living amoebia coli (dysenteriae). But our sporadic dysentery of this section is only exceptionally due to this parasite. In examining for the ova of the animal parasites, it is best to select any mucus shreds for examination first. Or break up the faeces in a .5 per cent. formaldehyde solution and allow to sediment in a urine glass. Examine this sediment after two hours. Tape worm segments can be readily detected with the eye, but in all cases the ova of these parasites make their appearance in the stools before these ripe segments themselves. The formalin destroys the odor and preserves the faeces very effectively. Amongst the vegetable parasites which miay appear patho- logically in the intestine Cholera spirillui, Bacillus typhosus and Tubercle bacillus are the chief ones of interest. For the former parasite we fortunately have no occasion here to examine. The Tubercle bacillus is thus the main parasite ofÎnterest. It may 329",
         "330 lCINGSION MEtDICAL QUARTÉRLY. be found in intestinal tuberculosis or it may be demonstrated in the faeces as the result of swallowing the sputum in pulmonary tuberculosis. Practically, however, its presence is diagnostic of the intestinal lesions of tubercle. It is at times hard to demon- strate it even in true cases as might be expected from the nature of the lesions, so that more than one examination is needed before we can positively exclude these parasites. In examining for the Tubercle bacillus the stool should be received in 1-40 carbolic acid, or i per cent. formalin solution and thoroughly broken up. The solution may then be allowed to sediment or may be centrifuged. Films are prepared from the sediments and stained in the usual manner. The presence of either blood or pus is always pathological. Blood may be suspected from the coloring of the faeces, but when the haemorrhage is high up in the bowel, only rarely can blood cells themselves be detected. It is only in severe haemorrhage (as in Typhoid) or when the bleeding is low down as from the sigmoid or rectum that the corpuscles are seen. A certain test can be made by examining the watery er'tract for blood pigment and demonstrating haemin crystals. Pus (dead lencocytes) is found in all forms of inflammation of the bowels. When pure its presence usually signifies rupture of an abscess or some suppurative condition low down in the bowel. Regarding the presence of particles of undigested (and di- gestible) food, minute amounts of such food may be found normally, particularly meat fibres, starch granules, and fat, (crystalline forms). When these are present in larger amount than traces, then we must consider the condition pathological, (unless excessive amounts of such foods continue to be eaten.) Excess of starch means a disturbance in the digestive func- tions of the small bowel, the so-called amylaceous dyspepsia. Commonly we find a catarrhal condition of the small intestine, but occasionally the condition is associated with lesions in the pahcreas, or obstruction of its ducts. Fat, either in crystalline form, or more rarely in globules, may be present in excess. Fat is seen most commonly in biliary obstruction, the stools being clay-colored. Fatty stools are also seeu in diabetes, and rarely in disease of the pancreas. Starch,",
         "FAiCES AND THEIR EXAMINATION. fatty acids, muscle fibres, and milk globules (fat), are readily ex- amined for, by spreading out the faeces, if watery, on a slide; if not watery, break up in a little water and examine under tlelow and high dry lenses. No attempt lias been made to treat of the character of the stools in the various diseases. They differ as much in the course of these diseases as do normal stools in character. While cer- tain stools are most comnonly seen during the course of certain diseases there are no essentially diagnostic characters, c.g., the so called. \"t'yphoid stool\" nay be seen typically in some protract- ted diarrhœas or in intestinal tuberculosis. Rice water like stools, are seen not only in cholera asiaticae, but in cholera nostras sorme cases of piomaine poisoning and in poisor ng by arsenic or antimony. This list might very readily be widély extended. W. T. CONNELL. TO THE EDITOR OF THE KINGSTON MEDICAL QUARTERLY. D EAR Sir,-I was much interested in Doctor Mylks' able ar- ticle-\" Pathology of Acute Pneumonia \"-in the April Quarterly. The Doctor'spathological evidence seems to sustain an opinion that I have held for a numbers of years, viz.-that acute pneumonia is a much more common disease, particularly in children, than generally supposed by the profession at large. Had Doctor MyL.s not put the cases which, \"presented throughout somewhat misleading clinical signs \" to the micro- scopical investigation, lie, as many others have done, might have arrived at an erroneous diagnosis, or had the doctor been positive as tà the nature of the disease, a consultant possibly would. have differed with him. It is sometimes difficult to corivince even members of our own profession, that the seat of an obscure ail- ment is located in a certain organ, because such viscus is sup- posed when affected to exhibit a strictly conventional list of clinical manifestations. Doctor Mylks points out a truth, however, when he says, 33t",
         "2 KINtS'TON MIEDICAL QUAËTtRLY. \"Variations in cliiical signs obviously depend upon differences in the pathology, either as to situation, or kind of lesion.\" In my experience I have not found acute pneumonia, by any means, a self-limited disease, except whe\u0026e a large portion of lung becomes suddenly involved. Under such conditions, if a fatal result is prevented the disease usually terminates in crisis. But such is not the case, even when the initial ailment is pul- monary; if the disease manifests itself throughout the lung, or lungs, in widely disseminated patches. There is no doubt but acute pneumonias possess and exhibit distinctive clinical signs that vary but little in different subjects; but if an entire lobe or more of a lung be affected the signs are not the same as when pathological lesions are minute and scattered, no matter whether they are deep seated or peripheral, or whether they finally coalesce or not. This patchy form of pneumonia was prevalent here a few months ago during an epidemic of La Grippe, and was entirely independent of whether there was or had been any bronchial difficulty or not. In many subjects there was almost an entire absence of cough except at rare intervals, thien only sufficient to enable the patient to raise a small amount of characteristic pneu- moni -sputum. In children I have many times found this same patchy form. of pneumonia when there was no history or other evidence of an antecedent disease. In little ones of tender years there is of course no expector- ation to guide in diagnosis and sometiies less cough than we often find in. simpler ailments entirely independent of the lungs. In such cases as these if the physician lias not pneumonia in mind he is in danger of overlooking it, and his results may not be as satisfactory as if lie had pronptly recognised the difficulty with which he had to deal. After a somewhat extensive experience in treating children, I feel sure that acute pneumonia is not an uncommon disease amongst them. It frequently remnains unde- tected because it does not exhibit the stereotyped sigas we have been taught to base our diagnosis upon. My practice is to examine the chests, both back and front, of all children who present the sliglitest symptoms of a lung ail- ment. Usually if there is any trouble it cari be detected by the 332",
         "LETTER TO THE EDITOR. ear better than in any other, way with which I an familiar. It nust :e remainbered that pneunonia is sonetitmes.,complicated, as well: as being a common complication of other diseases. I think habits:and environment may have something to do with this, still I believe the disease will be much more frequently found everywhere if carefully looked for, and the finding of it will reniove an unpleasanit elernent of doubt in the mind of the at- tending physician. It will also be a mighty solace to the members of the family and all the curious old ladies, who are so anxious to knov \"exactly what's the matter with the child.\" Thanking you for the use of your columns. I am, yours truly, J. D. DUNLOp, Alpena, Mich. KINGSTON MEDICAL AND SURGICAL SOCIETY. 'THE regular Mlay meeting vas held May gth. Dr. Hera!d. President, in the chair and 15 members present. Drs. E. C. Watson, A. R. B. Williamson, A. W. Richardson, and Robert Hanley were elected members of the society. Dr. Oliver then opened the discussion on small-pox giving a clinical description of the disease and its diagnostic characteristics. Hegave a resume of the cases he had seen in the past 42 years of practice in Kingston and elsewhere. As these cases are inter- esting as showing something of the history of small-pox in Kings- ton over that period they are appended. In 1857 one case was in the General Hospital-one in 1858- 1859, two cases; 186o, one; 1861 two. In 1862 and 1863 Dr. Oliver was attached to the Federal Arrmy as surgeon and saw over goo cases of small-pox, chiefly in hospitals about Washington. In 1864, four cases were attended ; 1865 three. In 1866 there were upward of 40 cases (epidemic year). 1867 eighteen cases ; 1868, three cases ; 1869, free ; 1870, 1871, 1872, each one. 333",
         "334 KINGSTON MEDICAL QUARTERLY. From 1873 to 1887 there were from one to three çases annually in the hospital. Since 1889 the only cases were an \"A\" Battery- man in 1894, referred to Dr. Oliver by the Board of Health, and the recent case which occurred here in April. The disease had never spread here except in 1866, as in all cases isolation was strict, and the community was guarded by vaccination. When death occurred it was almost without ex- ception in the unvaccinated. In 1875, a child was born in the Hospital, of a mother who had just previously nursed a small-pox case. This child was still-born and covered with pustules (? vesicles) when born, though the mother was unaffected. The mother had lad small-pox some years before. Speaking with regard to the recent case, Dr. Oliver had diagnosed small-pôx (discrete) from the character of the vesicular eruption, the head- ache, pain in limbs, temperature, and the peculiar odor. Hon. Dr. Sullivan had seen the case and diagnosed varicella. There had been no lumbar pain, the eruption was typically ves- icular, there was almost no maturation as only 3 vesicles had had become pustular, there was certainly no fever of maturation, and the vesicles had dried and crumpled away. Dr. Wood had had charge of the case previously, and had carried the child and a younger member of the same family through a typical attack of scarlet fever. Seven days after he had given over visiting the cases, he was again called iand found the child with headache, pain in the limbs (feet), temperature of 102 ° F. and covered with a vesicular eruption. This eruption had not to him the characters of a varicella, but was more like that of small-pox. Dr. Oliver was called in and pronounced thé case one of the latter disease. It was at once transferred to the medical health officer. Dr. Herald had seen the recent case by Dr. Wood's per- mission. At the time of his visit, which was after that of Dr. Oliver, he had found: the child with a temperature of i02¾° ý F. complaining of no pain, nor headache. There was no odor. The vesicles werê unilocular, being readily evacuated, and when so, did not refill. There was no umbilication of the vesicles. Several were becoming pustular on the 'fore- head, evidently from being scratched. Dr. Herald was certain this case did nôt çônform to small-pqx as he had seen it,",
         "KINGSTON MEDICAL AND SURGICAL SOCIETY. 335 N.B.-The after-history of the case seems to prove clearly that the case was not one of small-pox. Tiere was no maturation, but vesicles dried and crumbled away. None of the other members of the house, including children, freely exposed, and unprotected by vaccination, acquired the disease. Again, thlre vas no ·history of exposure in any possible way, either to varicella, or small-pox, and as these diseases do not generate sui generis, it is reasonable to, suppose that the case was a vesicular eruption the probable result of the ac- tion of scarlet fever toxin. For it is well known that in this fever the kidneys are often attacked during convalescence, and why not in like manner the skin which is also an emunctory. Clifford Allbut recognizes an impetiginous eczema as one of the complications and as a sequela of scarlet fever. This eruption would not corne in the category however. The regular June meeting was held on the 6th. Dr. Herald, President, in the chair, and nii members present. Dr. Platt, warden of the Kingston Penitëntiary was unaminously elected. an honorary membe'r of the society. Dr. W. T. Connell shewed nicroscopic specimens of the blood from1 a cow dying of Splenic Fever; the blood containing large numbers of bacillus anthracis. The cow was from a stock farm near the city. Dr. Jas. Campbell then read a paper on \"Some ofthe complications of scarlet fever, and their-treatnent.\" This paper is found elsewhere in this issue. Dr. J. C. Connell spoke of the necessity of treatment of the naso-pharynx, as a preventive measure against middle ear com- plications. He advised the use of the ordinary medicine dropper, and mild antiseptic lotions, as, weak permanganate of potash solutions for treatment, via the. nose. Dr. Connell spoke of the necessity of early and iapid treatiment of the middle ear compli- cations, which when untreated often assumed a necrotic form. Dr. Oliver referred to the mildness of the present epidëmic, and the small number of complications, presenting. The other members present joined in. the discussion. This meefing being the Annual one, the elections of -officers for the ensuing year was next proceeded with, and .resulted as follows:-Dr. Herald, rë-elected President, unanimously, Dr. Ryan, Vice-President,. Dr. W. T. Connell, re-elected Secretary- Treasùrer. The meetings were adjôuriied till September.",
         "KI7NGSTON MEDICAL QUARTERLY. NO. 16. DISTRICT MEDICAL SOCIETY. We are pleased to note that District, No. 16, comprising the Counties of Leeds, Grenville and Dundas, has organized a Medical Society at a meeting called by the district represent- tative, Dr. Lane, at Brockville, on June 8th. Most of the day was taken up with organization including election of officers, drafting of by-laws, etc. The officers selected were: President, Dr. J. W. Lane, Mallorytown ; ist Vice-President, Dr. W. Young, Prescott; 2nd Vice-President, Dr. Brown, Chest- erville ; Secretary, Dr. Moles, Brockville; Treasurer, Dr. Horton, Brockville. Under the energetic management of these officials there is no doubt but that this District Society will p-ove.a live organization. The first meeting is to occur early in November, and will be held at Brockville. Drs. Herald and W. T. Connell of Kingston Were visitors at this organization meeting and were honored by being elected Hon- orary members. In the evening the newly organized Society sat down to din- ner at the Revere House where after full justice had been done to the excellent menu provided, speeches and stories concluded the day's work. The speeches were mainly on the pros and cons of the fifth year course, and the lengthening of the session, and also on the subject of Interpi-ovincial or Federal registration. On the former question, there were as many opinions as speakers, but the gefieral opinion, so far as could be judged, was toward ýthe retention of the shorter (six months) session, and the fifth year. It would be well for the other districts of our Province to follow the lead of District No. i6. Outside our larger cities, and several districts, no local sociëties exist. Their benefit will be manifest to those acquainted with their workings, and is more fully referred to by our editor elsewhere. 336",
         "A TYPICAL OPERATION FOR THE RADICAL CURE OF OBLIQUE IItGUINAL HERNIA. L AST October, wlien visiting Chicago, it was my privilege to see a good deal of the surgical work of a distinguisled Canadian, who, by virtue of his undoubted skill and enthusiastic devotion to his profession, is rapidly attaining the front rank among the surgeons of the West. I refer to Dr. Alexander Hugli Ferguson, (M.D., Ç.M., Trinity), Professor of Surgery, Chicago Post-Graduate Medical School. Among othei suggestions as ta new prôedures in surgical operations, Dr. Ferguson very kindly detailed to me the steps of a new operation for the radical cure of inguinal hernia, and I have very much pleasure in giving the readers of the Quarterly the author's description of the various steps. Dr. Ferguson says: \" In investigating several relapses of the rupture after different methods of oprating, the first important observation I made was that the return hernial protrusion began at the upper and outer portion of the seat of operation above the cord, and usually near Poupart's ligament. This I recollected had been referred to by other surgeons. While operating on these relapses I found a slit in the aponeurosis of thë external abdominal .muscle through which the sac and usually some -fat protruded. Determining upon a search for the causes of these failures, it was thought advisable to make a semi-lIar incision and raise a flap of skin, fascia and aponeurosis of the external oblique muscle, in order to bring into view the whole sac, and deeper structures with their relations. To my astonishment, I found an angle between the lower border of the :internal ab- dominal oblique muscle ánd inner aspect of Poupart's ligament wholly unprotected by the internal oblique. and transversalis iuscles. in the sixth case the unprotectëd angle extended up- ward and outward to the anterior superior spine of the ilium, there being no connection whatever between Poupart's ligament and these muscles, thë spacé being occupied by some fat and a hernial sac. This is how I made the important discovery that a deflcient origin of the internal abdominal oblique and of the trans-",
         "KINGSTON MEDICAL QUARfERLY. versalis muscles ai Poupart's ligament is a direct cause of the rup- ture returning in this angle after operation for the radical cure. I then (January, 1898) began the semi-lunar incision in every hernial operation, and to look for the deficient origin of the in- ternal oblique and transversalis muscles. They were always deficient in origin. FIRST STEP. Semi-lmar Skin Incision. Begin the in- cision over Poupart's ligament, one and a half inches below the anterior superior spinous process of the ilium ; extend inwards and downvards in a semi-lunar manner, circumventing the. in- ternal abdominal ring, and terminate it over the conjoined tendon near the pubic bone. Cut carefully backwards with a very sharp knife and expose the vessels and pick them up with forceps be- fore severing them, and thus prevent blood-staining of the tissues. Having passed through the skin, two layers of superficial fascia, fat between them and superficial epigastric vessels down to the aponeurosis of the external oblique muscle, it will be noticed that it is not necessary to cut the superficial circumflex iliac, nor the superficial pudic vessels. Take a pledget of gauze and with it turn the flap of skin, subjacent fat and fascia downwards and outwards over the thigh. This procedure brings into view the aponeurosis of the external oblique muscle, thé external abdomin- al ring, with its pillars and intercolumnar fascia, the hernial sac, if it has descended through the external ring, external surface of Poupart's ligament, the under surface of the flap covered by the deep layer of superficial fascia, and the superficial vessels. SECOND STEP. Ct4. through the externtl abdominal ring .and. intero.lumn r fasci- Pnearate the-longitudinal fibres of the aponeurosis of the external oblique muscle directly over the inguinal canal, far beyond the internal ring, over the surface of the internal abdominal oblique muscle, and up under the skin, to a point nearly opposite the anterior superior spine of the ilium. Delicate transverse fibres are encountered-and severed. Retract the aponeurosis of the external oblique muscle and thereby bring into sight the deep structures, viz., the contents of the inguinal canal, the whoël sac, with its adhesions, the spermatic cord, ilio- inguinal nerve, internal abdominal ring usually enlarged, frequent- ly an accumulation of subserous fat, the cremasteric muscle, con- joined tendon, internal oblique muiscle, and its deficient origin 338",
         "OBLIQUE INGUINAL HERNIA. at Poupart's ligament, transversalis fascia, and the internal sur- face of Poupart's ligament. I consider the congenital deficient origin of the internal oblique and transversalis muscles one of the most frequent and important causes of oblique inguinal hernia. Inspect tiese structures carefully, and now determine whether the òperation is to be typical or atypical. When the structures are well defined and not too much weakened by pressure atrophy, a typical operation can be proceeded with. THIRD STE P. This step deals witt the sac and its contents; the cord, cremasteric muscle, and subserouS lipomata. Sac. The sac is carefully dissected from the cord and inter- nal ring; it is always opened, contents inspected and dealt with, and ligated higli up over the inserted finger, cut off, and the stump dropped. In atypical operations the sac is usually pre- served, as recommended by Macewen. If the sac be congenital, divide it in two, the distal lialf to form a tunic for testicle, and the proximal to be treated as above mentioned. Omentun. When onientum is found within the-sac it is liber- ally withdrawn, tied en masse, cut off, stump covered with its own peritoneum, and returned within the abdomen. This decreases the intra-abdominal pressure and lessens the tendency to a return of the hernia. At the stage of the operation when the sac is opened, it is frequently found advantageous to place the patient in the Trendelenburg position to prevent protrusion of and in- jury to the intestines. Oorl. The cord is not disturbed. I have never been satis- fied with the raising and transplantation of the cord. In m'ore cases than have been recorded. the testicle has come to grief by this uñneèeësay procedure. Tearing the cord out of its bed is without an anatomic reason to recommend it, a physiological act to suggest it,. an eitiologic factor in hernia, congenital or acquired, to indicate it, nor brilliant surgical results to justify its continu- ance. Leave the cord alone, for it is the sacred highway along which travel vital elements indispensable to the perpetuity of our race. The veins in the cord are not disturbed, unless a varicocele complicates the hernia. If the cremasteric fibres are unduly thickening the cord, they had better be removed along with ad- ventitious tissue that is not unfrequently present. LiPomata. An abnormal quantity of subserous adipose tissue 339",
         "340 KINGSTON MEDICAL QUARTERLY. is so often deposited around the sac and cord and along Pou- part's ligament that are etiologic factors in hernia, and if not re- moved tends to cause a return of the hernia. A systematic search should be made for fatty aggregations and remove them. (Sec \"Adipose Tissue an Etiologic Factor Hernia,\" May, 1899, Illinois State Med. Soc., by the author.) FOURTH STEP. Restore the structures to their normal positions. Transversalis Fascia. It forms the internal ring. In hernia its fibres have become more or less stretched above and around the cord. The; ring in consequence is abnormally large and the fascia bulges outwards. To rectify this condition take up the slack in the fascia and make an accurately fitting ring for the cord by ineans of a suture interrupted or continuous. Do not injure the deep epigastric vessels, nor pass the needle too deeply in the di- rection of the large iliac vessels. Internal A bdominal Oblique and Transversalis Muscles. Suture these muscles to the internal aspect of Poupart's ligament, and restore their normal origin. I usually freshen the lower border of the muscles and scarify the surface of Poupart's ligament to in- sure firm union, and extend' the sewing fully two-thirds down Poupart's ligament, which is the normal origin of this muscle in the female. Take care not to split Poupart's ligament by grasping with the needle the same longitudinal fibres each time. It is sur- prising how easily thesetwo structures corne together without the leart discernible tension, and it is gratifying to observe how per- fëctly these muscles cover and protect the internal abdomina1 ring and inguinal canal. Aponeurosis of the External Oblique Muscle. Bring together the separated edges of the apóneurosis of this muscle. Restore the external abdominal ring. Flap. In bringing the skin flap into a normal position be sure and coapt all its structures, like to like, especially the deep layer of the superficial fascia. COMMENDABLE FEATURES. I. The different structures in the abdominal wall are placed in their normal relationship. (i) The tying of the sac restores the normal rotundity of the peritoneum. (2) The suturing of",
         "OBLIQUE INGUINAL HERNIA. the transversalis fascia forning a new internal ring at the same time obliterates the;liernial infundibliform process. (3) Sewing the internal oblique and transversalis muscles to Poupart's liga- ment secures a normal origin for theni and they can find perfect protection to the internal ring cord and canal. (4) The sutur- ing of tie separated fibres of the aponeurosis of the external ob- ique protects the underlying muscles and cord, while the skin flap covers all. IL. The four lines of suture are not opposite each other thus securing an averlapping of the weak parts (Unes of rep-ir) by normal tissues. III. The semi-lunar incision has great advantages. (x) The hernial area is.uncovered as in no other way, thus affording an accurate observation of structural relationship, etiologic factors and pathologic conditions. (9: Theré is less tendency of skin infection, extending to the deeper structures. (3) Should, un- happily, a return of the rupture occur, there is no scar over it and a truss can be better borne. IV. Of all the operations that I have performed, it is the simplest and easiest to execute. There is a good scientific reason furnished for evëry step in the operation. V. Results are excellent. The· eighteen months I have performed my 'Typical Operation' 64 times, counting each case of double hernia as two operations. T here have been no relapses so far. I do not wish to say that recurrence cannot take place. The ages of my patients varied from 5 to 76 years; station in life, from poorhouse cases to the most affluent. Seven hernias in four men were complicated. with enlarged prostate, where at the same tiñae I performed gonangiotomy; 4 were strangulated ; i (double) had chronic gonorrhoea ; 3 cases had non-descending testicle; 4 had varicoccle ; 2 had a fermoral. and umbilical hernia ; i case had an epigastric and a femoral hernia as well, all three operated at the same time-; and î had oblique inguinal :congenital, and on the same side an acquired direct hernia. There was one death on the fourth day after the operation- an old' man, 74 years old. He had'enlarged prostate chronic cystitis, diseased kidneys, etc., etc. The effect of the anæsthetic was most likely the cause of death. Three cases supputated. Two had chronïic gonorrhoea and the third had. chronic cystitis. 341",
         "342 XINGSTON MEIDICAL QUARTERLY. In 61 out of 64 cases primary union occured. All the strangu- lated cases healed by first intention. Rubber gloves were used in 3 cases only (6 operatioxs). In doing the rest of these oper- ations witi bare hands, the fingers were not allowed to touch the tissues, but as littie as possible. Wound usually cleansed with salt solution and skin with bichloride solution (1-2000). In about half the cases chromoform catgut (No. o, 1, 2, and 3) was used in skin (as well as in deep- er structures). The last six months I have discarded No. 2 and 3. If additional strength is deemed necessary the catgut is used double. Horse-hair and silk worm gut were the other niaterials used for the skin. Different stitching methods had been employ- ed, viz., interrupted and continuing in the deeper structures, and for skin I used external interrupted, subcutaneous interrupted ; external continuous and subcutaneous continuous. Half the stitches were removed on sixth or seventh day, and rest removed within tento twelve days. The patients were kept in bed from twenty-one to twenty-eight days, enjoined not to assume any work for six weeks after operation, and advised to wear a broad support (no truss) for three or four months. Measurements. With a special, flat, ruled probe accurate measurements were made on the operating table to ascertain: i. The length of Poupart's ligament. 2. The length of origin of the internal oblique muscle from Poupart's ligament. 3. Size of 'Ferguson angle' and position of internal ring. In the sixty-four operations the origin of the internal ab- dominal oblique and transversalis muscles was deficient in every case. To differentiate between the border of the internal oblique and the fibres of the cremasteric muscle a blunt dissector or pro- tected finger is pas'ed underneath the conjoined tendqn and made to travel rapidly to Poupart's ligament, well under the border of the muscle, thus sending the cremasteric downwards and hugging the main muscle to its origin, and ther the meas- urements are taken. The origin (which is the main thing) of these two muscles was deficient in every case, the average length being ij -inch. It was rare to find an origin of 2 inches } inch and i inch was more common.\" W. G. ANGLIN.",
         "ONTARIO MEDICAL COJNCIL EXAMINATIONS. The following students of Queen's University have passed thé examinations of the Ontario Medical Council:- PRIMARY EXAMINATION. I. G. Bogart, H. M. Cowen, F. F. Carr-Harris, W. S. Grimshaw, A. D. MacIntyre, H. .V Malone, J. McCulloch, E. Richardson, C. de St. Remy, E. C. Watson. INTERMEDIATE EXAMINATION. C. H. Amys, E. G. Cooper, W. S. Fadden, H. V. Malone, E. C. Watson, A. R. B. Williamson. FINAL EXAMINATION. C. C. Armstrong, E. G. Cooper, W. N. Condell, I-i. H. Elliott, W. S. Fadden, R. Hanley, R. D. Menzies, C. A. Morrison, C. E. O'Connor, E. C. Watson, A. R. B. Williamson. The QUARTERLY extends its congratulations to these gentle- men, and trusts that they will one and all be as successful in the future as they have been on this occasion. BOOK REVIEWS. Practical Bacteriology: Dr. W. Ti Connell, M.D., M.R.C.S., Eng., British Whig, publishers. T HIS littie work designed by the authlor as a guide to the student in the laboratory, is admirably adapted for the purpose. Part I. consists of XX demonstrations of how to pre- pare specimens for examination, including the formulae for various staining fluids, the methods of examination and the use of the incubator. Part Il. deals with the preparation of culture media, the sterilization of bacteriological utensils and the exami- nation of water and milk. Part III. is the practical application of bacteriological examination to diagnosis of disease. Under this",
         "MINGSTON MrD1CAL QUARTERLY. heading we find the methods o- examining sputum, stomach contents and the blood and urine. While the work was designed by the author as an aid to his students in their work in the laboratory during their college course, it will be found to be of great value toc the general practitioner. Especially is this true of the third part. While, it is true, a diagnosis of such disease, as pneumonia, tuberculosis, diphtheria, gastric ulcer or cancer and many others may be made by the clinical history and physical examination, even in well marked cases this diagnosis may be confirmed by bacteriological examination and in doubtful cases the doubt may thus be removed and the nature of the diseased confidently affirmed. The author does not pretend to give an exhaustive treatise upon bacteriology and the application of bac- teriological methods to the diagnosis of disease, but merely an out- line of how to conduct those examinations and of the use that may be made of them in the diagnosis of many diseases. In this we would say he has succeeded, and his work will be found to be of great value as a guide to the student and as an aid to the general practitioner. Discases of lite Shin :-Prof. Dr. Franz Mracek, Vienna-W. B. Saunders, Philadelphia, Publishers.-J. A. Caveth \u0026 Co., Toronto, Canadian Agents. This work consists of two parts. The first part contains the text, and includes an outline of the anatoniy and physiology of the skin, a consideration of the etiology of the diseases of the skin, the general therapeutics of such disease together with the internal and external treatment. The classification adopted is that of Hebra modified. The second part of the, work consists of 6o coloured plates, and 39 full-page, half tone il- lustrations. Each illustratiôn is accompanied by a short clinical history of the case from which the illustration was taken. This to the student is a most valuable aid in the study of diseases of the skin. While, no doubt,. the best way to study these discases is from actual cases, yet in the absence of such facilities, coloured plates taken from life make a fairly good substitute. Of the work in gene-al we feel like saying we wish there was more of it. We would have preferred to find more upon the anatomy and physiology of the skin, more upon the etiology of skin diseases, and a fuller description of the primary",
         "BOOK REVIEWS. and secondary lesions of the skin. The author, however, appar- ently felt that a full consideration of these would unduly enlarge the scope of his work. Notwithstanding these defectsi if defects they be, we most heartly endorse the work and unhesitatingly recommend it to the student. or practitioner who desire_ to make hinself conversant with diseases of the skin and their rational and successful treatment. Forest Lilly : James Donald Dunlop, M.D.; F. Tennyson Neely, publishers, London and New York :- We do not intend, as a rule to call our readers' attention to works of fiction, but we feel that in this case we will be pardoned for so doing as the work is by a gentleman of ont own profession, a Canadian by birth and education. Dr. Dunlop is not the only medical practitiotier who has sought and won fame in the realms of literature outside the purely professional field. The story is Canadian in its scene and character. The author deals with the early days of the north-western part of our Province of Ontario, when the pioneers of civilization were pushing their way into the primeval forest. The aboriginal inhabitant of this country plays an important and conspicuous part in the story and the author gives us an insight into the character of the Indian before he was con- taminated by contact with the advance guard, of the conquering white man. Throughout the book the author keeps the readers interested by the exciting scenes through which he makes his hero and heroine pass. 345",
         "CONTENTS OF VOLUME I1. ANEURISM OF THE AORTA. JOHN WEBSTER.. ........................193 BOOK REVIE.WS..........................200 244 293 CRANIAL INJURIES. G. F. EMERY........... ................. .. .......,175 CURETTE IN OBSTETRIC PRACTICE. I. WooD......................237 CHRONIC GASTRIC AFFECTIONS. ToHN HERALD....................260 CLINICAL DEMONSTRATION IN. OPERATIVE GYNECOLOGY. I. W oOD ..... ...., .... ...... ............. ............ 305 COMPLICATIONS OF SCARLET YEVER AND THEIR TREATMENT. J. W . CAMPBELL. .... ......... .............................308 DOM1INION OR INTERPROVINCIAL REGISTRATION. TIE EDiTon..205 DISPLACEMENT OF THE APEX BEAT OF THE HEART. JoHN HERALD .......................................................... ...241 EARACHE. J. C. CONNELL ................................................225 EXAMINATION OF GASTRIC CONTENTS. W. T. CONNELL...... .....268 EFFECTS OF TEMPERATURE ON THE IIEART BEAT OF THE FISH EMBRYO. A. P KNIGHT............... ....................284 EXAMINATION OF THE Í·R.IPUCE IN CASES OF DEFERRED DIAGNOSIS. A. E. BARBER. South Bend, Ind........... .............391 EXTRACT OF SUPRA-RENAL CAPSULE. J. C. CONNEi .. ............. 1 FÆECES AND THEIR EXAMINATION. W. T. CONNELL..................328 GREETING. THE EDITOR ................................................203 GRADUATES -IN MEDICINE. THE EDITOR ........................ ...251 HAY FEVER. J. C. CoNNELL.. ............................................326 INTUBATION IN CUT THROAT. -J. C. CoN:;ELL ........................167 INSANITY AFTER TYPHOID FEVER. J. M. FORsTER ...............206 LOW BIRTH RATE IN ONTARIO. THE EDITOR.........................I63 LETTER TO TEE EDITOR. 1. G. DuNLCJP,.Alpena, Mich. ............i.331 MEDICAL CURRICULUM. THE EDITOR............................ 203 MOVABLE KIDNEY. D. E. MUNDELL .....................................286 MEDICAL COUNCIL ELECTIONS. THE EDITOR........................:Iz66 MEDICAL ASSOCIATIONS. THE EDITOR ...................9...........729 NOTES ON OPERATIVE SURGERY IN SOME OF THE NEW YORIC .HOSPITALS. D. E. MUNDELL....................................i88 NOTESON SURGICAL CASES. W. G. ANGLIN ............ ...........230 OPEN MEETING OF KINGSTON MEDICAL AND SURGICAL SOCIETY .............. . . .................272 OBLIQUE INGUINAL HERNIA. W. G. ANGLIN...........................337 ONTARIO MEDICAL COUNCIL EXAMINATIONS*.................343 PRESIDENT'S ADDRESS. JOHN HERALD................................ 177 PATENT ON DIPHTHERIA ANTITOXINE ...............202. PRINCIPALS OF THE DIETETIC TREATMENT OF DIABETES MELLITUS. C. W. PURDY ........... ................................213 PATHOLOGY OF ACUTE PNEUMON1A. G. W..MYLKS..............,, 253 PERSONALS..... .... ...........................................294 QUARTERLY. THE THÉ EDITO...................... ..................163 QUEEN'S MEDICAL CONVOCATION...... ............ ...295 RODENT ULCER. W. G. ANGLIN...... ....................................I69 REPORTS OF SOCIETIES............ ; ............... 200 243 29 REPORT OF KINGSTON MEDICAL AND SURGICAL SOCIETY......333 SPASM OF OESOPHAGUS. J.C. CONNELL................................I68 SOME POST MORTEM NOTES. W. T. CONNELL..........................172 SOME CLINICAL NOTES OF SUR'ICAL CASES. D. E. MUNDELL.....323 TUBERCULOSIS. PROPHYLAXIS.. E. RYAN ......... ... ......*.....-320"
      ],
      "type" : "document",
      "title" : [
         "Kingston medical quarterly [Vol. 3, no. 4 (July 1899)]"
      ],
      "published" : [
         "[Kingston, Ont.? : s.n., 1899]"
      ],
      "identifier" : [
         "8_05203_12"
      ]
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGIN-AL COMMUNICATIONS. On the Pathology of finer' s Lung. By WM. OSLER M.D., Prof. Institutes of Medicine, McGill College. (Read before the Medico-Chirurgical Society) Situated as ýwe are, at a considerable distance from mining centres, it is only occasionally that cases of disease resulting from the inhalation of coal dust are brought before our notice. Having lately had such a case, I take this op- portunity of laying it before you, together with a hitherto undescribed specimen from the Museum of the College, and also, other specimens illustrating the pathology of lung pig- mentation. The man from whom I obtained the lungs of the first case I am about to describe was a powerful, well built Scotchman, 36 years of age, who died under my care in the small-pox departnent of the General Hospital of Variola maligna, after an illness of five days. Throughout the at- tack there were no symptoms referable to disease of the lungs ; the breathing, it is true, was greatly accelerated, but not more than is usual in cases of hæmorrhagi small- pox. Post-mortem examination, four hours after death--On opening the thorax the lungs appeared very full in volume, and instead of collapsing, projected slightly forward. The lower lobe of the.right lung was adherent to the pleura in front and laterally by thin, delicate bands, apparently not of old date. Left lung and upper part of right free. No fluid in the pleural cavities. On removal from the'chest both lungs presented over their whole surface a uniform, deep blue-black colour ; so general was it, that not a trace of the 10",
         "146 CANADA MEDICAL AND SURGICAL JOURNAL. natural hue of the organ remained.. At the apices and irD front the colouration was not as intense as in the posterior regions, but here it was exaggerated by the hypostatic con- gestion existing in these parts. Both lungs were crepitant throughout and floated in water. Cicatrices existed at the apices. Several patches of collapse were noticed along the anterior free margins. Pulmonary pleura somewhat opaque,, and thickened to such a degree that even with a lens the air cells could not be seen through it, except at one border where they were much dilated and emphysematous. At spots, probably corresponding to the interlobular septa, the colour was darker than at others. On section the organs presented an intensely black colour, and the serum which flowed from the cut surface 'was of an inky hue. The pos- terior lobes were sodden and œdematous, but still crepi- tant, and floated in water. Here and there throughout the substance small patches of apoplexy-the largest the size of a walnut-could be seen. When squeczed a fluid like ink could be expressed, which left a dark stain upon the hands. Repeated washing of a portion of lung dimiinished consider- ably the intensity of the colouration. On the surface of a portion thus treated different shades of pigmentation can be seen. Round or linear patches, ranging in size from a pea to a hazel-nut, of an intensely black colour exist in large dark, slate grey areas. In many of these spots the air cells can still be detected, in others they appear to be obliterated, and the section in this case is uniform, nct porous. On. careful dissection I was able to demonstrate in nearly every instance that these spots had a small bronchiole penetrating them, and this can be seen in several of the specimens. These patches when excised and placed in water always sank, even when air cells could be seen in them. Many such existed just beneath the pleura and their situation was easily told, not only by the deeper colour at these localities, but, also, by the fact that a slight superficial puckering some- times existed. To the feel they were also firmer, more solid, than the other parts of the lungs, not so much so,",
         "PATHOLOGY 0F IINER'S LUNG--DR. OSLER. however, as the apoplectic spots. The portions of lung tissue intervening between these intensely pigmented areas were of a uniforrm slate grey colour. studded with the hæ.morrhages already mentioned. The fluid expressed from these pieces was -very dark. T.he air-cells when examined with a lens appeared almost uhiversally emphysernatous, more especially those in the upper and anterior regions of the lungs, occupying a superficial position. Certain limited sections of the lungs, generally situated superficially, appear denser than others, the air cells are visible but very snall, and the amount of alveolar tissue in proportion to the air space is abnormally great. This may be due, of course, either to collapse or to an increase of the fibrous elements in the walls of the air cells. I am inclined to think it due to the latter frorn examination of the air cells, and also after comparison of it with several genuine patches of collapse, which existed at the anterior free borders. Several small cavities, the largest about the size of a pea, containing air were met with, probably large emphysematous cells, as they were quité devoid of any definite wall, and the air vesicles opened directly into them. The tissues of the larger bronchi preserved their natural colouration, but as they reached their ultimate ramifications, when diminished to the size of a crow-quill, the mucous membrane became of a deep black colour, and the surrounding elements of the walls were very generally pigmented. The bronchi were filled with a frothy mucus, but the mucous membrane was not .thick- ened, nor were there any evidences of chronic bronchitis. The twticaadventitia of the blood vessels-large and small- was impregnated with the dark particles and the transverse section of an artery presented three zones of colouration, a dark one corresponding to the adventitia, a white fibrous one to the Media, while the red central zone occupying the lumen of the vessel is made up of the bloodcorpuscles. The bronchial glands were firm, not enlarged, and presented an excessively black surface on section. Microscopical examination : first, of the dark coloured 147",
         "148 CANADA MEDICAL AND SUIIGICAL JOURNAL. serum, which can be so readily. expressed. A variety of cellular elements are here met with, and the colour is seen to depend upon black granules, partly free, and partly inclosed within the cells. A difference would seem to exist in this respect as to whether the drop examined was furnished by one of the darker spots, or from the intervening greyish portions ; in the former case there are more free granules, in the latter they are generally inclosed within corpuscles. These carbonaceous partîcles range in size from almost imperceptible molecules up to portions the 1-12000 of an inch and over. The latter are, as a rule, angu-lar and do not exhibit the Brownian movement. In addition, pieces are occasionally met with of an elongated form, and of a brownish red colour at the edges, or, if thin enough, over the whole mass. Some of these can be seen with the naked eye, and I measured several more than 1-250 of an Fig. z. x zoo. inch in length (See fig. 1). Other very peculiar forms were noticed, which, from the regularity of their outlines, I believe to be structures connected in some vay with the coal, but upon this point I lack the necessary knowledge to decide. The cellular elements found in the expressed serum may be arranged as follows I. Groups of flat cells each with a distinct nucleus, the boundaries of the cells, in many instances, being ill-defined, or sometimes similar cells are grouped together upon a portion of membrane. Free in the field are others identi- cal with the individual ones composing the above groups. They are about the 1-1200 of an inch in diameter, nucleus large and sharply marked, borders often indistinct, cell sub- stance granular, friable, often broken away in part, leaving the nucleus exposed. The free nuclei of these cells also are present in numbers. Carbon granules are only occasion- ally met with in these corpuscles, and I think they must be regarded as the original cell elements of the alveoli, and perhaps, to a large extent deriviatives of them in a slight catarrhal process.",
         "PATIIOLOGY OF MINER'S LUNG-DR. OSLER. II. White blood corpuscles, distinguished from the for- mer by their smaller size and less distinct nucleus. They only occasionally contain dark granules. III. Corpuscles in which the bulk of the carbon is con- tained, and upon wVhose presence the black colour of the expressed juice in most instances depends. These are very variable in size, and may, on the one hand, approach the colourless blcod corpuscles, and on the other, attain to five or six times their diameter. See figure 2 (a). Fig. 2. In shape they are usually round, sometimes oval, oc- casionally irregular, very rarely approaching the spindle form. Inside all of these the carbon particles exist in extraordinary numbers, filling the cells in different degrees. Some are so densely crowded t4at not a trace of cell sub- stance can be detected, more commonly a rim of protoplasn remains free, or at a spot near the circumference, the nucleus, which in these cells is almost always eccentric, is seen uncovered. The contained carbon particles are, for the most part, angular, and when ,not too thickly massed together, a reddish brown colour can be observed in each. In a few of them comparatively coarse portions of coal are found imbedded, stretching the cells to their utmost limits. At fig. 2 (b and c) such cells are represented, and in the latter the corpuscle has evidently accommodated itself to the shape of the piece of coal. One most curious specimen was observed : on an elongated piece of carbon three cells were attached, one at either end, and a third in the middle; so that the whole had a striking resemblance to a dumb- bell. I could hardly credit this at first, until, by touching 149",
         "150 CANADA M3EDICAL AND SURGICAL. JOURNAL. the top-cover with a needle and causing the whole to roll- over, I quite satisfied myself that the ends of the rod were completely imbedded in the corpuscles, and the middle portion entirely surrounded by another. So strong was the attachment that I failed to separate any of the cor- puscles by pressure on the top-cover and other manipula- tions. Another corpuscle was seen entirely surrounding the end of a small rod, forming a miniature druni-stick, the handle of which was twice as long as the diameter of the corpuscle. IV. Decolourized red blood corpuscles, which are very numerous in all the. specimens examined. Many of them are aggregated together into masses, casts, probably, of the air cells pressed out of the apoplectic centres. V. Amyloid corpuscles, of which a few well-marked specimens were obserived. We come now to the examination of the lung. sub- stance itself, and first of the small dark areas. On teasing portions of these, unless done very finely no structure can be made out, uniformly dark masses present themselves. If, however, the elements are more minutely separated a dense interpenetration by small dark granules of all the textures is observed. We have not here to deal with cellular bodies containing the pigment, for it is free in the interstices of the tissue, and few or no cells can be detected. So thickly is the pigment scattered over the structures, that even an isolated fibril of elastic tissue is with difficulty seen, on account of the granules attached to it. The air cells seem obliterated by the excessive accumulation of pigment and the great increase of the connective tissue, and hardly a trace of them is met with. As before mentioned, the fluid expressed from these parts contains only fine granules with an occasional cell. Thin sections show very well how intense the pigmentation is, but yield very little information as to its distribution, for a uniform black surface is presented, which only here and there in irregular spaces is penetrated by the light. To-",
         "PATHOLOGY OF MINER'S LUNG-DR. OsLER. ýwards the borders, where the tissues are not so densely infiltrated, some of the carbon is seen to be contained within round corpuscles, and also confined in very irregular, .somewhat spindle-shaped areas, but whether these latter .are connective tissue corpuscles or not is difficult to decide. From .their extreme irregularity and the number of their processes it is probable they are not, but only represent the' arrangement of the carbon granules among the elements of the tissue. All the coats of both bronchioles .and vessels in these areas are impregnated in the same way, but I have not found any of the latter obstructed by .accumulations of coal dust. In passing to the consideration of the histology of the less pigmented and by far the largest section of the lungs, it may be mentioned that a considerable part of the col- ouration in this is due to carbon granules retained within the cells already described. These exist in abundance throughout the whole substance, and are everywhere pre- sent, both in sections, and in teased preparations. They are found chiefly in the interstices of the stroma and along the course of the alveolar septa, occasionally, also, lying free in the air cells. Nothing further need be added to the description previously given of them. Fig. 3. (x 450.) Secondly, isolated particles of carbon are tolerably m:nerous, even in situations which, under the microscope, loo: on superficial examination to be quite free. The meibranous walls of the alveoli are constantly seen dotted oveitvith black granules, though it is rare to see any occu- pyin.the cells upon it, and in the same way the interstices of thý fibrous stroma contain them in abundance. The",
         "CANADA MEDICAL AND SURGICAL JOURNAL. riianner in which these small particles gain entrance into the stroma may sometimes be observed, as sketched in figure 3, representing the margin of an air cell. Particles of various sizes are there seen, some attached to the free margin, others imbedded in its substance, while others again occupy positions a considerable distance in. A third situation is the point of junction of the fibrous septa, where, in many instances, quite a dense accumulation is met with in the form of fine granules, as is seen at fig. 4. Fig. 4. (x LOO.) A fourth and most favourite locality is the interlobular connective tissue, which cannot be considered apart fiom that of the vessels and bronchi. Here, as can be seen with the naked eye, the deposit is excessive, and the blood ves- sels are readily followed as dark, irregular branching lines. The examination of sections of vessels show that in most instances the adventitia alone is effected, while the media and intima remain quite normal. Similarly it is only the loose fibrous coat of the bronchi in which the pigment op curs, though occasionally a transverse section of a bronchice is seen pigmented throughout. With regard to the alveoli themselves no very greatle- viation from the normal structure was noticed, save hat in many places an increase in cellular elements, the rsult of a catarrhal process, had taken place on the membr,'oUS wall. In some situations, also, a marked thickening f the 152",
         "PATHOLOGY OF MINER'S LUNG-DR. OSLER. alveolar septa had occurred, which was perceptible to the naked eye and has been already referred to in the descrip- tion of certain areas in which the air cells were much dim- inished in volume. This was rendered very evident by comparing specimens taken from these areas with others from a healthy lung, or even from more natural sections of the same one. In.one or two localities isolated air cells, or small groups, were found fiiied with colourless te nacious plugs (very similar to those of croupous Pneumonia), con- sisting of an extremely delicate fibrillar network enclosing various cellular structures, among which those described under (i) and (3)'of the elements found in the expressed serum of the lung were the most numerous. The large ones, filled with carbon granules, in some instances gave a dark tint to these small masses. The most superficial layer of the pleura, composed of a fibrillar membrane upon which the pavement epithelium lies, can be stripped off as a clear transparent structure quite devoid of pigment. Immediately beneath this, how- ever, there is a fibrous layer densely crowded with carbon granules, both free in the tissues and contained in the large round cells, which latter are very abundant in this situation. Oddly enough, just in teased portions from this sub-pleural region some of the coarsest particles of carbon were ob- tained. I have been fortunate enough to procure for examination several other specimens illustrating different degrees of pigmentation in the lungs. The first of these, comprising the lower lobe of one lung, was obtained from a Cornish miner who died under Dr. Howard's care some years ago in the General Hospital of Pneumonia. The notes of the case have unfortunately been mislaid so that I am unable to state the condition of the other parts of the organ. Su.. perficially, the whole lobe is of an intense blueblack colour, due to the accumulation of the carbon beneath the pleura, and this. deposition varies in thickness in different parts, in some forming a very thin layer, while in others it has a 153",
         "154 CANADA MEDICAL AND SURGICAL JOURNAL. diameter of from two to four lines. At one or two places it is absent, one spot especially, near the root, and through these the light coloured portions of the lung can be seen. On section, irregular spots of an exceedingly black colour are seen scattered over a very pale lung substance. The relation between these two areas of colouration is not the same throughout; towards the root and in the portion of the lobe which rests on the diaphragm the dark exceed the light, while in the posterior and lateral regions the reverse holds good. Closer examination shows that the favourite localities for the pigment are about the vessels and bronchi, and the interlobular connective tissue,which can be seen as dark bands stretching from the pleura into the substance. Very many of the dark arcas are firm and indurated, pre- senting a smooth hard surface on section, with occasionally the remains of a bronchus or vessel in the centre ; while others of the sarne pitchy hue are made up of emphyse- matous air cells with thick hard walls. The portions of the lobe free from pigment look healthy, the air cells are how- ever emphysematous at the margins and beneath the pleura. Many bronchi and vessels are wholly devoid of any pigmentation at their circumference, others of the former have somewhat thickened walls and from several tenacious plugs were extracted. The bronchial glands, three in number, attached to the root, are firm and of an intensely dark colour. In the microscopical examination it was found exceed- ingly difficult to tease up pieces from the dark indurated ,areas, on account of their extreme hardness and brittleness. They are composed entirely of fibrous and elastic elements, in the interstices of which the carbon granules are so densely arranged that it is only from the margins, where the fibrils project, that any idea of the structure can be obtained. Sometimes, near the borders, or in a less 'dense portion, a :trace of an air cell is found, but as a rule, all remains of them are obliterated by the overgrowth of the fibrous tissue. Very few cellular elements are found in these localities,",
         "PATHOLOGY OF MINER'S LUNG-DR. oSLER. 'and those present are small and do not contain many car- bon granules. On the other hand, in and about many of the less indurated areas, the cellular elements are present in'abundance, though not so large and »more angular in shape than in the former case. This may.be accounted for, how- ever, by the fact that this specimen has been in spirit for *over. ten years, while the other was put while fresh into i per cent. solutior of potassium bichromate. Cells, large %and small, containing coarse particles of carbon or even dis- tinct fragments are numerous. In some instances a pro- cess of atrophy, or shrivelling, appears'to have gone on in these cells, for elongated portions of carbon were seen en- closed in a contracted mass which bore some resemblance 'to the remains of a cell ; or again, others were imbedded in -a yellowish coloured substance with irregular hard outlines as though a deposition of inorganic matter had taken place about them. Free in the field were many small angular black particles, also others much more ,minute. In this case coarse particles of silex were quite as common as those of carbon, and in one place an aggregation of 15-20 at- tached to a piece of lung tissue was noticed. None of these were observed within cells. The dark emphysematous Io- calities, which usually have a small bronchus in immediate connection with them, are cómposed of a variable number of dilated air cells, all of a jet black colour, and with hard fibrous walls. I dissected out a small spot about the size of a cherry stone containing five emp-ysematous air cells and teased it up very finely, but was uniable to find anything like an alveolar membrane, onlv fibrous tissue everywhere covered by dark granules. In other regions where the pig- mentation was less profuse, a definiteincrease in the fibrous elements in the walls of the air cells can be seen. Instead of the isolated fibres of elastic tissue which in the healthy lung run across the alveolar wall and serve to strengthen it, we have here in many instances a.perfect network. Nor are these to be mistaken with their sharp hard outlines for the collapsed capillary vessels, of which traces in the form 155,",
         "156 CANADA MEDICAL AND SURGICAL JOURNAL. of irregular lines can be seen in normal alveoli. The infil- tration of the pleura in this case, also, is limited to the deeper layers, the uppermost-basement membrane and epithelium-remaining free. The bronchial glands are un- usually hard and fibrous, and microscopical exa'iination shows an enormous overgrowth of the connective tissue with a corresponding diminution in the cellular elenients. The few which are present contain numerous carbon granules. The third and fourth cases do not properly come under the heading \"Miner's lung,\" but they serve to illustrate several points in connection with the subject, and aid, also, in the understanding of the general pathology of lung pig- mentation. The third specimen was obtained, like the second, from the Museum of the College, and of it I have un- fortunately a still scantier history. All my information is confined to the brief record on the label, \" Melanosis:\" It is a piece about the size of the fist, representing, I take it, a portion near the apex, and is of a bluish black colour ex- ternally. The pleura covering it is thickened, in places whiteý and fibrous, at others intensely dark and fully one- fourth of an inch in thickness. The colouration is very uniform, but on section is seen to be chiefly superficial, ex- tending, however, into the interior in the form of bands, be- tween which the lung tissue retains its natural hue. To the touch the whole mass is firm and indurated. The bronchi are thickened and in some cases surrounded by circles of pigment. Several small caseous masses en- capsulated in fibrous tissue, deeply pigmented, occur at fhe apex. The microscopical examination shows that the pigment is chiefly interspersed as small granules among the fibrous elements of the thickened pleura, and in the bands that pass from it into the lung substance. In the former situation sections demonstrate that the pigment is distri- buted linearly, often in alternate layers, or interspersed between fasciculi of connective tissue. There is a marked absence of the small angular particles of carbon, and very few pigmented corpuscles were met with.",
         "PA'THOLOGY OF MINER'S LUNG-DR. OSLER. 157 The fourth specimen is from a man, 65 years of age, who died of Bright's disease in the General Hospital under Dr. Ross, to whom I am indebted for the portions of lung. As far as could be ascertained this man had never been em - ployed in mines, nor in situations where, he would have been exposed to a sooty atmosphere. An interesting point in connection with this case is that the pigmentation of the skin was derariged ; he presented several large patches of Leucosis. In the portions of lung given to me for examination, the pleura certainly is abnormally pigmented for a man of his age. In parts the' dark colour is almost uniform, but the general arrangement is in round, often irregular shaped spots, which are tolerably closely set over the surface and do not correspond to the interlobular septa. On section they are seen to be quite superficial, in most instances confined to the pleura, though sometimes dipping into the lung substance in the form of bands, or else involving the air cells immediately beneath, in which case, these are in- variably emphysematous. The lung substance itself is but little affected, only here and there presenting a dark appear- ance, due to the accumulation of pigment about the vessels and in the interlobular connective tissue. The dark sub- pleural areas contain a tolerable number of the large cellu- lar elements, but most of the pigment is free among the fi- brous tissue. Where the pigmentation extends into the subjacent air cells the septa are dark in colour, and occa- sionally the alveolar wall was seen to have irregular pàtches of pigment upon it. Cells containing carbon are also very common in the alveoli, which have bèen involved in apneu- monic process, and are filled with cellular elements. Sec- tions made parallel to the pleura in these situations show very well how the alveolar septa are covered with pigment, partly free and partly intra-cellular; while the air vesicles are filled with a fine granular substance and cells, many of which contain carbon and are identical with those in the alveolar septa. Small angular particles of carbon are com-",
         "158 CANADA 3EDICAL AND SURGICAL JOURNAL, mon in the field, but no coarse ones, like those in cases i and. 2, were met with. An interesting fact, which will be referrèd to hereafter with reference to the probable origin of the, pigment in this case, is that extravasations of blood were seen in the sub-pleural region, and usually in the vicinity: of the dark areas. On several occasions I saw at the edges: of small teased portions of an intensely black colour the reddish brown remains of an extravasation. The small pigmented areas in the lungs presented nothing remarkable, they were chiefly in connection with blood vessels. 'From the description of the two first cases it is evident· that we have here to deal with the early stage of the dis- ease known as Miner's Lung, or, to give it the scientifi\u0026 appellation, Anthracosis. I say the early stage, meaning. that the degenerative process can hardly be said to. have, commenced, and had not these men died of intercurrent affections, they might have lived for years under favorable hygienic conditions. No doubt, however, the point had.- been reached where further exposure to the impure air of the mines could only have resulted in bringing about, serions lung trouble. Ultimately, as the records of post: mortems show, there arise extensive areas of consolidation- carbonaceous Pneurnonia, as it is called,-with numerous cavities containing an inky coloured fluid, and at last death takes place with many of the symptoms of chronic Phthisis, a peculiarity in some cases being the expectoration of a dark colored mucus. In the cases under considération the intensely black consolidated spots .may be regarded as the- first step in a series of degenerative changes. Such gen- eral infiltration of the tissues by a foreign matter cannot be without a strongly irritating action, the final effect of which would be a proliferation of the epithelial and connective tis- sue elements, with the result of obliterating the air cells and the formation of firm indurated areas. The larger these become, the more the cellular elements partiéipate in. the process, so much the more likely will .they be, to soften at the centres, and finally form. cavities.. The indùrated'spots.",
         "PATHOLOGY 'OF MINER'S LUNG-DR. OSLER. in our specimens were remarkable by the absence of cor- puscular elements, and the same would probably hold good in larger areas,; still, even in these, as occ'urs in Cirrhosis of the lungs, a molecular degeneration goes on in the centre, with the formation of a cavity. In the lungs of al individuals who die of this disease these cavities, which. are no doubt often'bronchiectatic, are described, surround- ed by indurated areas, while the comparatively healthy sections are intensely black and emphysematous. Several. cases I find recorded of miners having died of intercurrent affections, in whom the lungs presented an appearance similar to what has been described, viz: uniformly dark in color, but with patches of variable size of a much more intense hue, the lung texture itself being healthy, or a little emphysematous. In some instances the continual inhala- tion of the dust in mines would appear to produce very little effect, for cases are mentioned of miners exposed for years to the same influences to which others succumb, and yet who were but slightly affected. Predisposition to lung disease is an important factor here, and it has been found that where this exists, they die at a much carlier age than those without this hereditary weakness, which need not, however, necessarily be a true tubercular diathesis. Indeed,. in reading over the records of the post mortems in this disease, one is struck by the absence of any mention either of true tubercles or caseous masses, and in neither of the cases before us do these elements occur. It was suggest- ed by Dr. Wilson Fox, at a discussion on this subject at the Pathological Society a few years ago, that exposure to the irritating substances in the air of the mines might directly induce the production of tubercles, and that the fibroid masses represented the final change which these had under- gone. Against any such view the cases here speak strongly. There is nothing in these lungs which would be called a tubercle by a follower of Lænnec or of Virchow, and yet, if the process was one in any way connected with tuberculosis, weý should expect j'ust in this early stage to find traces of it ;. 159l",
         "160 CANADA MEDICAL AND SURGICAL JOURNAL. but instead, we fnd at the outset of the disease what is spoken of as occurring at the close, fibroid consolidation; the difference consisting in the extent to which it has gone, and in the absence in the former of secondary changes. In its essence the whole disease would appear to consist in an overgrowth-a hyperplasia-of the fibrous tissue of the lungs, induced by the chronic irritation to which they are subjected by the inspired particles of coal dust, a veritable Cirrhosis, or, as it might appropriately be called, the black Cirrhosis . of miners. This certainly is the most natural. view to be taken of these two cases, and accords best with their general and histological characters. From the fact that in many instances snall bronchioles are seen in con- nection with th( :oid masses we may infer that about them the process begins, and spreads to the surrounding alveoli. In other places the adventi/ia of the blood vessels, and the interlobular connective tissue furnish starting points. We are still in the dark as to how all this takes place, how the air cells become converted into firm, hard areas-fibroid substitution as Dr. Bastian calls it, or why, again, in the same lung, some of the intensely dark spots are solid, while others are emphysematous. Before referring to the other specimens, which do not, I believe, come in the same class, a few words must be said upon the generai subject of lung pigmentation. . Briefly, two sources must be admitted, an internal and an external ; in the former, the pigment is transformed hematin, and the affection is termed Melanosis; in the latter it is inhaled carbon, and the resulting disease is Anthracbsis. It is only within the'last ten or fifteen years that unanimity bas been reached on this point. Up to this time many of the lead- ing German and French pathologists refused to recognize the latter source. Even Virchow as late as 1859, basing his observations on portions of miner's lung sent him from Edinburgh, came to the conclusion, though he describes angular particles of carbon from the same cases, that a transformation of the colouring matter of the blood",
         "PATHOLOGY OF MINER'S LUNG-DR. OSLER. in repeated small hæmorrhages would account for the whole pigment. The English observers (and with them several French), one and al], as* far as my- reading goes, from Pear- son, who in I813 first described the affection, took a more practical and common sense. view, and attributed to it solely an extraneous origin. Having many more oppor- tunities of observing the conditions under which miners worked, and knowing the foul, sooty atmosphere of the mines, they were led to connect cause and effect, the dust with the disease, and so arrived at the truth years before the Germans, tQ whfom, however, the credit is due of hav- ing placed the fact upon an histological and experimental basis. They demonstrated the presence of dotted cells and other structures characteristic of vegetable tissue in the coarser particles obtained from the lungs, and, also, proved that the lungs of animals might be made of a dark color by exposing them for a length of time to a sooty atmosphere. I have been fortunate, also, in these cases to obtain positive evidence of the external origin of the pig- ment. At fig. 5 a portion of coal is represented which Fig. 5. (x 300.) Fig 6. exhibits the characteristic appearance of scalariform tissue. This was a very thin flake with distinct cross bars, thrce of which o.ccupied the whole breadth of the piece, while one other is less evident. The thin spots between the bars were of a brownish red colour. By manipulating .1 man- aged to break it acrossjust below, the third bar, and was then able to obtain the transverse section, -which is given at 161",
         "162 CANADA'MEDICAL AND SURGICAL JOURNAL. fig. 5 (b), and makes it more than probable that this was a portion of a scalariform duct rendered prismatic by pressure, a common structure in ferns, and also plentiful in cannel- coal. Another piece, seen at fig. 6, with two round holes, represents a portion of a dotted cell of fir wood. To consider now this subject of Anthracosis more closely, and endeavour to obtain an insight into its rationale. A comparison of the lungs of a child with those of an adult, or, better still, of an old man, shows that the natural colouration of these organs undergoes a change as age advances, the rosy tint of childhood givingway to a marbled slate-grey, interspersed with patches or lines of an intensely dark colour. Similarly the lungs of an animal present a marked contrast to those of an adult man ; and there can be no doubt whatever that in great measure this change in colouration depends upon the inhalation by him of the products of imperfect combustion of fuel of various sorts, gas, \u0026c. 'l his has been called physiological Anthracosis, in contradistinction to the more extremé condition met with among those who work in mines, and other situations in which the air is charged with soot and coal dust. Against the entrance of these noxious matters into the lungs the nasal orifices are furnished with numerous hairs, which, to- gether with the mucus of thesepassages,.retain a consider- able quantity of the dust andcoarser particles met with in the air. After a lengthened'sojourn in a smoky atmosphere how common it is to see the nasal secretion quite black upon the handkerchief. Still, even if the particles escape retention at the orifice, as they all do when the breathing is carried onper orein, a further provision is made for their expulsion when they reach the bronchiai membrane, the cilia of which are in constant motion, producing currents which set externally, and slowly. and surely.. convey the mucus with the contained granules' towards the larynx, whence they are readily coughed up. In ordinary inspira- tion the volumeof tidal air does not probably reach further han the larger bronchi, and the coarser particles in this",
         "PATHOLoGY OF MINER'S LUNG-DR. OsLER. case, if they reach the alveoli at all do so by the force of gravity ; but in the stronger respiratory efforts, just such as miners by the very nature of their work must constantly make, many attain this situation, and, as here no provision is found for their expulsion, nature provides that they shall at any rate be placed in less injurious localities. In what way this is effected, how the srnall angular particles which can be seen on the alveolar walls penetrate into the interior, has not yet I believe received a satisfactory explanation. Sharp, angular bodies are said to have a habit of working into soft textures, especially if there is any impelling force, however slight, behind; but what of the infinitesimal par- ticles that we find throughout these lungs, can, the, same, apply to them ? Certain it is, however, that once fixed in the alveolar wall they resist all attenipts at removal, and they may be seen, as at Fig. 2, in all stages of progress towards the interior. In their further distribution they fol- low exactly the course of the lymphatics, and the tissues in their immediate vicinity; where these are most abundant there the pigment is in the greatest quantity, as about the connective tissue of the vessels and bronchi, the interlobu- lar septa, and, above all, just beneath the pleura. Once in- side the lymphatic vessels a large proportion of the granules is carried on to the glands at the root of the lung, and is there permanently fixed in the cellular elements, hence the intensely dark colour of these in most persons over fifty. This fixation of the carbon granules in dellular bodies is very remarkable, and must be regarded as an effort of the economy to render harmless what might otherwise be very irritating substances. In the greater part of the lungs in the first case the pigment was contained within large cellular elements, belonging to the amoboid class of connective tissue corpuscles, and in the other cases they were by no means uncommon. These were unusually large, twice or three times the size of the colourless blood cor- puscles, and very abundant, as if the supply had been equal to the demand. This pathological infiltration of corpuscles",
         "164 CANADA 3EDICAL AND SURGICAL JOURNAL. with carbon appears to interfere just as little with the per- formance of their functions as does the physiological, so common to many connective tissue corpuscles of man and the lower animals ; for in the air cells which had been in- volved in a pneumonic process, and among the epithelial elements with which they were filled, these same large cor- puscles occurred, evidently having migrated froni the sur- rounding tissues, in which sections demonstrate them to be plentiful. To show the remarkable aptitude of cells to take up granules of various sorts, and, also, to demonstrate the rapidity with which the lymphatic glands are affected, I per- formed several simple experiments, of which I shall mention two:- Experiment I.-Into the axilla of a two days' old kitten m iii. of a strong solution of Indian ink were injected, and into the right lung of the same animal a similar quantity was injected through the pleura., The kitten was killed twenty hours after and the parts carefully examined. In the axilla there was a spot the size of a marble of a dark black colour, composed chiefly of connective tissue and fat. On examination of teased portions it was seen that the par- ticles of Indian ink were either free in the interstices of the tissue, or else contained vithin the numerous leucocytes, white blood corpuscles, with which the tissue was inundated These were specially abundant along the course of the. puncture, and in this situation all the. leucocytes were loaded with the dark granules. The spindle shaped con- nective tissue corpuscles did not contain any. On removing the sternum a dark lymphatic gland was seen, and -close to it a much smaller one. Nearer the manubrium was another black spot, apparently only an ag- gregation of dark granules. Where the point of the syringe had penetrated the thorax the layers of the pleura were united by a dark round band about two lines in diameter. Under the dark spot on the pulmonary pleura was a portion of inflamed lung substance the size of a large pea of a dark red colour. Examination of the Clark spots on the pleura",
         "PATHOLOGY 0F MINER's LUNG-DR. OSLER. and the intervening band showed tissues everywhere infil- trated with small and large cellular elements, ir. which the bulk of the pigment was held. The small corpuscles in ap- pearance and size correspond to colourless blood corpuscles, which modern pathology has demonstrated leave the ves- sels in large numbers in the early stage of inflammation. Among these some were sparsely, others densely, crowded with dark granules. The larger cells were more than twice the size of the ones just described, and belong to the group of connective tissue corpuscles. Many were rounded or oval in outline, and these contained the greatest number of granules, while elongated, spindle shaped ones rarely con- tained any. Changes in outline, ameboid movements, were seen in most of these corpuscles. In a portion of the pul- monary pleura which was under the microscope a small net work of lymphatic vessels was rendered beautifully clear by the number of dark granules inside them. Unfortunate- ly I was unable to sketch it, as on changing the object-glass for the purpose I accidentally let it fall upon the slide and damaged it for any further use. The curious phenomenon was seen in teased portions of the inflamed. lung of cells containing red blood corpuscles. A considerable number of these were met having from six to ten corpuscles in their interior, others presented'only a diffuse colouration. Experiment V.-Into the right thorax of a four weeks' old kitten m x of a solution of Indian ink were injected, and the animal killed thirty-six hours after. A dark spot on the costal pleura corresponded to the point of entrance of tie needle, but the layers of the pleura were not adherent. The lower lobe of the right lung presented a dark firm mass, about the size of a walnut, occupying its interior, and scat- tered round it were several other small dark spots involving both pleura and lung substance. The sub-sternal glands were slightly coloured, and those at the bifurcation of the trachea were dark superficially. Examination of the dark mass in the lung showed the air celis in a condition of in- flammation, and everywhere crowded with leucocytes, in- 165,",
         "166 cANADA MEDICAL AMo SURGICAL JOURNAL. side which almost all the Indian ink granules were con- tained. So numerous were these cells that even in very thin sections hardly anything could be seen. At the mar- gins of the healthy and inflamed portions larger corpuscles occurred, which were also filled with the dark granules, and a few were noticed containing red blood corpuscles. The lymph corpuscles of the glands, sub-sternal and bron- chial, especially in the superficial region, contained numer- ous pigment granules. These experiments serve to show how quickly irritating materials are taken up by cellular elements.; and it is in precisely the same way that the carbon granules which reach the parenchyma of the lungs are fixed in the connec- tive tissue corpuscles and so rendered harmless. In ex- periments 2, 3, and 4 the substernal glands were also more affected than the bronchial, as in these cases the pigment was chiefly about the pleura, and adhesions having taken place between the layers, the lymph bearing the Indian ink granules was conveyed in the vessels of the parietal layer to the glands under the sternum. In cases three and four the pigmentation is not so exten- sive, and there is not the saine certainty as to its source. In the absence of any history it is hard to say whether in the former case we have to deal with a condition produced by the inhalation of dust, or whether it is an excessively pig- mented piece from an old man with chronic lung affection. The general firmness of the piece, the thickened pleura, the existence of caseous masses, and the absence on micros- copical examination of large particles of carbon favour the the latter view ; and if so, the pigment is to a large extent melanotic, i.e., proceeds from the hæmatin of the blood. Of course in all these cases a double origin may usually be at- tributed, for the process of physiological Anthracosis goes on constantly, whether there be disease in the lungs or not; but we have learned to regard the pigmentations occurring in the indurated areas about cavities or caseous masses as specially of blood origin, in as much as they are met with",
         "PATIIoLOGY OF MINER'S LUNG-DR, OSLER. in young children, in whom an Anthracosis is out of the question, -and, also, because the extravasations are found in all stages of transformation from yellow up -to a jet black. In the last case I think there is still less room for doubt. Here the irregular distribution of the pigment in circular patches, not following the interlobular septa leneath the pleura, to-which.situation it was in great part confined, a situation, moreover, shown by Virchow to be specially prône to extravasations, but, above all, the détection of extra- vasations in and about some of the pigmented areas, make it tolerably certain that this is a melanotic process. Whether this had any connection or not with the derange- ment of pigmentation in the skin, as was suggested, may'be questioned. Melanosis as it ordinarily occurs is a very different thing from the physiological process of pigmenta- tion. For the former to take place there must be either long continued congestion, amounting almost to stagnation, or else extravasation, under which circumstances the colour- ing matter of the corpuscles infiltrates the tissues, and there gradually undergoes a granular precipitation, forming the little particles known as melanin. If in a tissue con- taining cellular elements the bulk of the hematin finds its way into them, it may - occur in. them only ; but if the extravasation takes place in the region of a fibrous tissue, like these indurated areas in the lungs, the colouringmatter passes by imbibition among the various elements, and we find it there as a granular precipitate. In the normal process, as it goes on for example in the rete mucosum, the cells obtain colouring matter from the nutritive plasma, without any stagnation or rupture of ves- sels. One pathological condition, met with in.the pigmented Sarcomas, adheres to the physiological method, for the cells of these derive their. pigment, in great part, from the plasma irrigatihg the tissue, but according to sore observers, also from small capillary hemorrhages. It is interesting in this connection to refer to the -cor- pusdes côntaining r-ed blood corpuscies Which Were fohd 167",
         "168 CANADA MEDICAL AND SURGICAL iOURNAL. in the lungs of several of the kittens experimented upon. Here we have to do with an intravasation, or rather an in- gestion of the coloúred corpuscles within others. Many deny this, but as far as my observation goes there can be no doubt of the fact.' In these corpuscles as many as six to ten were seen, in others again the outlines of the red corpuscles could riot be detected, as if the cells had absorbed only the colouring matter. Nuclei and granular protoplasm were also seen-strange constituents, if, as some suppose, the appëarance of a cell is caused by the separation of the filrin round a group of red corpuscles. I have sketches in my possession of amoeboid cells from newt's blood crowd- ed with blood corpuscles 'of the guinea-pig, which were abundant in the serum with which the newt's blood was niixed for examination; and it is not at all unlikely that other amœbold cells, even in the tissues, should do the same thing. This is, not a \u003ecommon way for cells to be- come pigmented, but there can be no doubt that these would rapidly have become so; and would then have been undistinguishable from nany of the larger corpiscles con- taining Indian ink granules. To sum up- I.YThe histological exarnination of thesé two.specimiens of miner's lung favours the view that in the early stage thé process is confined to an increase in thé fibrous elements about the bronchioles and vessels, and in cei-tain emphyse- matous areas-a genuine Cirrhosis, or, as some would pre- fer to call it, an interstitial Pneumonia. II. A considerable proportion of the éarbon is contained in large cellular elerments, which are specially iabundant l the less' pigmente d healthy portions, and in tÉese it pro- bably remains without much injury to the lung parenchyma. Another large part-öf the pigment lies free among the ele- ments of the tissues, this being specially the case in the' l- durated spots; in the thickened pleura, and at the junction of the alveolar septa. III.. The extraneous origin of the carbon is proved by the detection in the lung of portions of' fossilized'vegétable tis- sue in the-form of scalariform and dotted ducts.",
         "TRACHEOTOMY IN BIEMBRANoUs CROUP-Da. WRIGHT. 169 Report of a successful case of Tracheotomy in Membranous Croup. By HENRY P. WRIGHT, M.D., C.M., Ottawa. Peter -Hogan, æt 7. On the night of August 5th. 1875, I was called to see the above ;who was supposed by his parents to have been suffering from a. severe cold for the week previous, at-length however; they thought the symp- toms sufficiently alarming to have medical advice. I found the child to be suffering from all the symptoms of membranous croup. Voice whispering, cough frequent and tiring, breathing stridulous, pulse full and regular, tem- perature 102 0, skin moiEt. They said he had been suffer- ing much in the same way for the past 48 hours. I gave him at 'once, half an ounce of wine ;of Ipecac, emesis was soon produced, ridding him of a good deal of viscid mucus, but no false membrane. I ordered two grains of Iodide of Potassium every two hours and the compound tincture of iodine to be painted over the larynx every six hours. Aug. 6th. wi a.m. Found him a little easier. To con- tinue the same treatment. Towards evening the symptoms again grew worse and at midnight'the father brought me such a report that I deemed delay dangerous and sent him at once for Dr, Church to assist me in performing the operation of Trachéotomy. On- our arrival ve found the symptoms less alarming.than we had been led to suppose, so we determined to give medicine and time a further trial. We adrninistered two drachms of. powdered alum, this produced full emesis and gave slight relief. :We waitedfor a couple of hours and finding there was no increased aggravation of the symp- toms, left with word to continue the Iodidé of Potassium. Aug. 7th. Synmptoms continued much the same through the day only the child was evidently getting much weaker. I gave him at intervals an emetic dose of sulphate of copper. At night the symptonis again became worse and at 2 o'clock the dyspnœa was so great as to threaten suffocation. The",
         "170 CANADA 3MEDICAL AND SURGICAL JOURNAL. pulse became weak and irregular, inspiration stridulous, lips and tongùe blue, skin moist and extremities cold. Auscul- tation revealed almost'inaudible breathing, the chest walls buigixig above and strongly retracted below. We now con- sidered tracheotomy necessary and proceeded to operate without chloroform. I performed a slow dissecting ope- ration, in doing so however I was unfortunate enough to wôund a large-venous trunk whichwas followed bythe most alarming gush of blood and was arrested by inserting the finger into the wound and pressing against the sternum. As soon as I withdrew the finger the bleeding recommenced, it was at läst controlled, after several ineWéctual. attempts to ligate, by stuffng up the place till now occupiéd by my finger, with a piece of sôft muslin at hand and then I pro- ceeded in the usual way and reaching the trachea divided three of its rings when brought nearer the surface by an act of inspiration. The tube was inserted at once as I feared the'entrance of too much blood into the trachea. I then removed the stuffing and though the bleeding con- tinued for some time after, yet it was not enough to cause any alarm.. I feel satisfied that the vein divided was the transverse communicating branch between the anterior jugulars its course being higher up than usual. The child losï about eight ounces of blood. Aug. 8'th. Six hours aftér operation, respiration easy and regular, has had a calm refreshing'sieep. Has had a feed of bread and milk, a good deal of the milk enters the trachea, and is coughed up through the tube. Skin moist and warm, extremities warm, lips and tongue red, countenance devoid of anxiety. Continued nicely through the day. Diet, bread and milk, cornstarch and beef tea. The inner tubé to be cleaned out every .3 hours. Aug 9th. Rested well through the night. Pulse respi- ration'ratio normal, temperature normal, deglutition and in- clihâtion for food good. The edges of thé wôund aré rather prominent and have- an ashy grey appearance. Applied nitrate of silver and in-",
         "TRACHEOTOMY IN MEMBRANOUS CROUP-DR. WRIGHT. 171 serted beneath the canula plate a piece of soft cotton satu-- rated in carbolic oil-1-16. Aug. ioth. Slept well, in good spirits. Ail the synptoms. continue.favorable, same diet. Bowels moved by an enema. Aug. i 1th. Steady improvement. Symptoms continued good and on the 14th, finding the pulse respiration ratio normal, temperature the same, and having taught him to whistle for two days before, I withdrew thé entire tube and dressed the wound with carbolic oil, .-8. He had no diffi- culty in bieathing after the'withdrawal of the tube though. he felt a little nervous from want of confidence in himself. The wound healéd rapidly, no untoward. circurnstance inter- fered with his conipiete recovery; Remarks.-The case though highly satisfactory was un- conplicated, the age was favorable and the disease was limited to thelarynx. The only difficulty was the hæmor- rhage,.and, in connection with that we concluded that on future occasions, when it was necessary to extend the inci- sion it would be wiser to cut up towards the larynx than towards the sternum, and that when bleeding did occur no method of arrest could be more effectual than compres- sion by stuffing up the wound with soft muslin or cotton. The whistling which he was made. to practice seemed to thoroughly exercise his respiratory apparatus, an exercise so entertaining to the little patient as to be frequently re- sorted to and well done, and to it I arn inclined to attribute a great portion of the ease hé experienced after the removal of the tube. Post-partum Convulsions ireated by the Hypodermic injection of Cloral. Under the care of DR. RonDIc1c, at the M'onfreal University Lying-in-Hospital. Reported by Mr. A. F. RitcHIE. F. M., a native of Canada, 26 years of age, short in stàture but well -proportioned, complexion dark, disposition quiet, personal and family history good- was admitted to",
         "172 CANADA MEDICAL AND sUIGICAL JOURNAL. the Lying-in-Hospital pregnant of her second child, the first having been born in natural labour some five years since. On Friday, July 3oth, at 3.30 a.m., after ten hour's labour she was delivered of a healthy child, weighiug ten pounds, six ounces. The head presented in the fourth position but was readily changed to the first, and the birth accomplished without difficulty. Nothing special was observed in the case- till about twenty-four hours aftèr delivery, when she complained of violent frontal headache with nausea, followed by repeated vomiting -of 'bilions fluid. This continued till 2.30 p.m. Saturday (thirty-five hours after delivery), when a slight but unmistakable convulsion seized- her. In the absence from the city ~of Dr. D. C. MacCallum the regular attcnd- ing physician of the institution, Dr. Cline, of the Montreal General Hospital, was called in, who ordered her urine to be examined and found it to contain about ten per cent. of albumem. - He accordingly prescribed a brisk purgative and a mixture: containing the acetate of anmonia and in- fusion of digitàlis. The first fit was followed at intervals of ten minutes by two others-increasing in severity, and the patient rapidly fell -into a comatose condition, which became more profo-und with each attack. Thie lochial dis; charge was now entirely suspended. After the first dose' of the mixture there was an intermission of about tvo hours. The convulsions lasted- about a minute, the inter-' vals being about ten minutes, although sometimes the fits were almost continuous. When she received the second dose in three hours, an intermission of an hour occurred, .after which they returned at short irregular intervals during the night. Brandy and water was ordered, but was swallowéd' only in small quantity and with great difficulty. The urine seemed to be secrefed freely but was voided immediately. Aug. Ist, 7.30 A.M.-Dr. Roddick has been hurridly called in, as 'her condition now seem s to be most alarming; pulse 140, temperature ioo·:6. He explained to the stu- dents present that it was'desirable in such' cases to eimploy",
         "POST-PARTUM CoNVULSIONS-DR, RODDICK. an anesthetic, but on the present occasion from the urgency of the symptoms he preferred the administration of Chloral by hypodermic injection. A solution in which twenty minims contained seven grains of the salt was at once procured and thrown under the skin of the arm. A convulsive seizure followed immediately upon the with- drawal of the iieedle, but this proved to be the last, the- total number being sixteen. Notwithstanding the cessation, of the convulsions the- injections were continued at inter- vals of an hour, the amount being subsequently increased to ten grains. -At 2.30 p.m. the coma was less profound; she could feel the needle and tried to remove it, while the- eyelids resisted any attempt to separate them. 3-45 p,m- an injection per rectum of turpentine and castor oil brought away a small quantityof fœcal matter; pulse. i6o, resp. 30. 5.15-very restless, gr. x hypodermically. 7.35 p.m.-- pulse 140, resp. 24, bowel well relieved by injection. Aug. 2nd, 7 A.M.-Has been regaining consciousness, rapidly during the night and now swallows beef tea and: brandy readily. 3.30 p.m.-Very dull and stupid; but will open her eyes when called in a loud voice and protrude her tongue. No albumen in urine. 1i p.m.-Being very restless and slightly delirious, a draught of gr. xx of chloral was given. Aug. 3rd-The patient to-day is quite rational though very feeble and easily excited by noise. The cries of an- other patient in labour in the neighbouring room disturbed her very much. A draught of chloral was again ordered to be given at bedtime. Aug. 4th.-There is. a marked change for the better to- day, being perfeetly quiet and rational; takes abundance of nourishment. There is a hard lump in the cellular tissue of the size of a pigeon's egg where each injection was given, and below the clavicle in the situation of one is a. small superficial slough of the size of a ten cent piece. None of them cause her any pain or uneasiness. Aug. 14th.-She is to leave the hospital to day, and withthe exception of two or three brawny swellings and the renains of the small slough referred to, there is nothing. to mark the-positions of the.injections. , She. is in perfect health. 173",
         "174 CANADA MEDICAL AND SURGICAL JOURNAL. MEDICAL AND SURGICAL CASES OCCURRING IN TUE PRACTICE OF THE WJNiREAL GENERAL HOSpITAL. Case of Mlforis Coxae. Death fron Pynia. Unusual Si- ituation of Head of Fenur. Under Dr. Ross. Re- ported by Mr. R. L. MAcDONNELL. Daniel Fitzpatrick aged 8, was admitted\" into the Mon- treal General Hospital in the latter end of the month of June, 1875 and was placed in Dr. Reddy's wards. He is a weak, unhealthy, cahectic boy, thin and emaciated. His limbs are wasted, the abdomen puffy and large, and the head of abnormal dimensions. Previous to his admission hle was aninmate of the St. Bridget's Asylum. The little that could be gathered from bis family history revealed the following facts, that his father and two brothers were alive and healthy, that his mother had died of phthisis, that none of the family had exhibited a scrofulous diathesis. Nothing reliable could be obtained as to bis own history. He was admitted suffering from pain in the right knee and left shoulder joint. Little could be done in the way of examin- ing these articulations, inasmuch as, even the approach of any one to his bedside caused him most excruciating pain. He was by Dr. Reddy, placed on alkaline treatment, which gave him no, relief. An abscess was soon detected in the left shoulder, pointing on the anterior aspect of, the joint. This was opened, and a quantity of pus evacuatèd. He then, on the 1st July camé under the care of Dr.Ross, who discovered a large bag of matter'on the upper and inner part of the left thigh. The abdomen was also svollen in the left iliac region, and in both situations fluctuation could easily be made out. The patient was anaesthetized, and the needle of. an aspirator inserted into the femoral abscess, ten ounces of dirty, unhealthy and very foetid pus were",
         "HOSPITAL REPORTS. drawn off, the abdominal enlargement disappearing as the fluid came away. While under the influence of the chloro- form a thorough examination of the joints was instituted. The legs were equal in length. Rotation of the left thigh showed great roughening of the cartilages, and grating could be felt and.heard. In a few days, as no discharge came from the puncture made by the aspirator needle, and as the sac of the abscess again became filled with matter, an incision was made into it with a Symes' knife, and a quantity of matter allowed to escape. A few days after this a second inéision was made lower down the thigh and a drainage tube was inserted. July i5th. The patient complained of pain, in the wrist joint, and on examination that structure was foundswollen and excessively painful. Motion was absent, the tissues around the carpus were thickened. He carried the joint' in a curious manner, the carpus was extended on the radius, while the hand from the carpo-metalcarpal articulation drooped. Dr. Ross ordered a small anterior splint, as well as blisters above the seat of disease. The constitution is very much involved, the pulse has been frequent, small and weak, the temperature is also ele- vated. Diarrhoea has been present at several periods in the course of the disease but has been checked by M. Cretae Co. combined with Extract Rub. Villos. He is taking tonics with wine. July 17th. His left thigh is abducted, the leg and foot everted, the thigh is flexed forcibly on the abdomen and the leg on the thigh. The abscess is discharging freely and is daily injected with a weak solution of carbolic acid. -Carbolized tow is applied to the wound, and exercises a great influence in suppressing the foetor. July 2oth. Complains of pain in abdomen, which is tender to the touch and tympanitic. M. Cretae Co. however gave him relief. July 24th. 'A large abscess was noticed for, the first time, to-day. The situation is over the right hip, and its sac ex- 175",
         "176 CANADA MEDICAL AND SURGICAL JOURNAL. tends upwards and inwards over the right buttock almost to the sacrum, downwards as far as the insertion of the tensor vaginae femoris. Chloroform was administered, the matter removed, and a drainage tube applied. The matter evacu- ated resembled that from the other side but if possible was more foetid. A similar dressing was ordered viz., carbo- lized tow and carbolic acid injections. July 25th. Both abscesses are running freely and the dressings require constant change. Every now and then ,there is fullness in the left iliac fossa which disappears on the application of a poultice to the openings- in the left thigh. July 27th. Pain is complained of in the right knee. The limb is flexed, and any attempt at extension'causes intense pain. The joint is hot and tender. A pillow was placed under it and warm fomentations applied. This gave great relief. July 29th Affairs in much the same state. The consti- tutional disturbance seems greater, tie patient being very much debilitated by the constant drain of pus. Diarrhoea, with foul evacuations is present. Aug. 23rd. The condition is alittle improved. The right knee was extended, and after no little resistance the patient was induced to retain it in that position. There is now great atrophy of the forearm. A splint is still applied to the wrist joint. Aug. 4th. Pulse and temperature high. The former is very weak and compressible. The patient was delirious during the night and there is a great deal of perspiration. Cutaneous hyperesthesia is present, and even the insertion of a thermometer into.the axilla seems to cause.pain. Aug. 5th. Delirium persistent. At 4 30 p.m. had an at- tack of convulsions and died at 6 p.m. Post Mortem Examination.-Eighteen hours after death. On manipulating the left thigh, there was great roughening found and the head of the bone felt quite loose in the'ace- tabular fossa, there seeming to be nothing whatever to retain it in its place. The.head of thé right femur moved quite",
         "HOSPITAL REPORTS. freely about and by no means could roughening of the joint be detected. The left leg was shorter than the right by about an inch. 7'ie Brain, vas very large and well developed for a boy of his age, it weighed 48 oz. The arachnoid was thickened and opaque though no distinct deposit of lymph could be seen. The opacity was greatest on the upper surface of the organ, but under the fissure of Sylvius, in the vicinity of the island of Reil there was a small area ofyellowish discolour- ation. Under the arachnoid there was extensive effusion (3* oz) of a sero-purulent fluid. The convolutions of the hemispheres were distinctly marked and widely separated. The vessels on the surface of the brain were slightly con- gested. On section, the centrum ovale majus was preterna- turally white. No central softening could be discovered, the formix however, seemed a little too friable. The ven- tricles contained a small quantity of fluid. Tliorax.-Heart healthy with a firmly contracted left ven- tricle. No effusion in the pericardial sac. * The lungs were adherent to the chest walls in several places. The base of that of the left side was hardened and collapsed, and fragments of it would not float in water. The right lung and the upper lobe of the left were healthy, though a little deficient in pigmentary material. Liver slightly enlarged. The capsular ligament of the left hip joint was entirely obliterated. The cavity of the joint, as well as adjacent structures were bathed in pus. The upper end of the femur, exceedingly necrosed, rested in the acetabulum. This cavity was enlarged, oval in shape, and extensively diseased but was not perforated. On extending the incision back- wards the epiphysal extremity of the head of the femur was found lodged in a fossa behind the brim of the acetabulum, resting on the great sacro-ischiatic ligament, which was par- tially disorganized. The bony part of the epiphysis was intact but it was stripped of its investing cartilage. I at- tribute this extraordinary state of affairs to the position in",
         "17S CANADA MEDICAL AND SURGICAL JOURNAL. whch the patient used to hold the limb, and advance the idea, that in the extreme state of flexion in which the femur was retained, there being no capsular ligament, the head of the bone passed partially over the brim of the acetabulum, and that, while in that position, the pressure of the brim on the disk of cartilage joining the epiphysis with the neck of the femur, caused its disorganization. The epiphysis ·then, separated from the neck in this way, dropped over the brim and became lodged in the great sacro-ischiatic notch and found a resting place in the pulpy and disorganized tissues. The remaining ligaments of the joint could not be found, and the bone was held in its place merely by the action çf the muscles adjacent to the articulation. On the inside of the pelvis on the left side there was a large bag of pus, lying between the iliacus muscle and the iliac fascia, and communicating with the abscess on the inner and upper part of the thigh through the great sacro-ischiatic notch. The capsule of the right hip joint was entire but fulland tense. On making incision into it, a large quantity of pus escaped The ligaments on that side were not diseased, with the exception of the ligamentum teres which was en- tirely destroyed. The cartilaginous covering of the head of the bone was slightly eroded and caries had just com- menced in the fundus acetabuli, in the situation of the Y shaped piece. The wrist joint contained a small quantity of pus, mingled with its synovia. There was great lack of motion in- the joint. SURGERY. On Traclcotomy iii Croup and Diphtheria. By GEORGE BUCHANAN, M.A., M.D., Professor of Clinical Sur- gery in the University of Glasgow. The prevalence and fatality of diphtheria of late years, as may be seen by a perusal of the Registrar-General's returns, has drawn the attention of the. profession to the.etiology of that disease, and has recently given rise to a controversy",
         "TRACHEOTOMY IN CROUP AND DIPHTHERIA. as to the identity or non-identity of croup and diphtheria. Many able papers have appeared in the pages of the British Medical and other journals on this subject, and to them I refer those interested in the question'; but there is one point of resemblance which iâ of the utmost importance in. a practical point of view. Although the two diseases may be as distinct as to cause, course and sequelS, as scarlet fever is from simple tonsillitis, yet both are characterised by the effusion,on the mucous membrane of the air-passages, of a tough false membrane. This membrane may differ in. its nature andin situation, at least at the commencement, but the tendency in both cases is to obstruct the breathing and cause suffocation. This seems so self-evident that I must almost apologise for mentioning it; but I have been so often met with the objection that, because the primary disease'causing the effusion is diphtheria and not croup, therefore it is hopeless to interfere, as the operation will not cure the specific dis- ease, that I have considered it not out of place to introduce it. We might as well refuse tQ open an abscess of the tonsil which was about to choke a patient suffering from scarlatina, because the operation will not cure the fever, as refuse to relieve a.patient from instant death from suffoca- tion because the operation is not a cure for diphtheria. Now, the point I wish to bring out is, that there is. a stage both in croup and in diphtheria at which it becomes evident that recovery is hopeless and death from suffocation certain. It is quite true that it is exceedingly difficult to sày when that stage has arrived, and mistakes may sometimes occur; but I believe practically it is better to err on the safe side, and acknowledge the inefficacy of treatment, rather than delay till it is too late to resort to the. last resource. Tracheotomy per se, though a difficult, is not a dangerous operation ; and I, for one, would be inclined to urge its per- formance before the strength of the little sufferer lias been brought to the lowest ebb' by the struggles which result from the approaching suffocation. 179",
         "180 CANADA MEDICAL AND SURGICNL JOURNAL. I wish, however, clearly to guard myself from being sup- posed to advocate tracheotomy in all circumstances of approaching death from croup or diphtheria. I have else- where explained my views on this subject, but I cannot avoid referring to them again. The diseases in question, but especially diphtheria, when they prove fatal, cause death in one of two ways .; either by exhaustion or by suffocation. Hence, we may say there are two varieties, viz., the asthenic and the sthenic. In the great majority of instances, croup is a sthenic inflammation attended with effusion of lymph in the trachea; and proves fatal by. suffocation. In some cases, however. the attack is attended with such a depression of the vital powers that the patient sinks apparently from the virulence of the disease. This, however, is a rare case. But in diphtheria there are two well marked types: the sthenic, which closely resembles an attack of sthenic croup, except that the effusion of lymph begins on the fauces and extends through the glottis into the trachea ; and the asthenic, which more closely resem- bles scarlet fever, and in which the effusion covers the whole of the mucous membrane of the fauces, tonsils, and even the pharynx, and in which the false membrane soon becomes foul, putrid, ichorous, and contagious. In the former of these types, the danger is suffocation; in the latter, it is vital depression, death from asthenia. Now, with regard to the treatment of these affections at the early stage, I wish here to make no reference ; the scope of my remarks is the duty of the medical attendant, when medical treatment has failed, or is clearly failing to arrest the disease. And I think that it is very important that medical practitioners, especially those commencing practice, should be supported by t4he opinion of those qualified to advise them in such a delicate matter as this, seeing it is a most painful and disagreeable task to advise parents to sub- mit their children to such a repulsive proceeding. I believe, then, that I am justified in calling on all those who have seen much of these diseases to unite with",
         "TRACHEOTo3Y IN CROUP AND DIPHTHERIA. me in asserting that, when medical treatment has been fairly tried and when it is proving unavailing, and when death seems imminent from suffocation, not from vital depression or exhaustion, it is the duty of the medical atten- dant to perform, or advise tlie performance of, tracheotomy. I know that here I shall be met with the objection that some cases which seemed hopeless have ultimately recover- ed ; but these isolated examples are very few in number, and are counterbalanced out of all proportion by others in which delay, owing to repugnance to the operation and a hope that syinptoms will improve, has deprived the patient of that chance of life which the surgeon can offer. In pressing this view on my medical brethren, I am aware that I am adding nothing new to what has been frequently advanced by those who have had occasion to operate much in croup and diphtheria, but every year convinces me that it is the duty of those whose experience qualifies them to speak with authority on the matter, to reiterate their con- victions, even if it be in nearly identical terms. Last December, I was callecd to a case of croup, and when I arrived I found the child, a girl seven years of age, in the last stage of suffocation. The two medical gentlemen in attendance declared that the patient was beyond the reach of surgery. One of them, who had never seen the opera- tion, strongly dissuaded me from making the attempt ; the other, Who had at one time been one of my clinical students, on hearing my wish to give the child a chance, persuaded the parents to consent. The little patient was livid, and though I did not use chloroform, as I usually do, it did not wince when I made the incision through the skin. The result was that the child is now alive, and in the enjoyment -of excellent health. To one who sees the operation for the first time, the -hopelessness as to the attempt is only equalled by. the. sur- prise and gratification at the result. But,.while I am so strongly.advocating the operation in.the circumstances referred to, there is one condition in",
         "CANADA MEDICAr AND SURGICAL JOURNAL. the -uffocative'form of those-diseases which contra-indicates trachèotomy, arjd which, if -discovered, shóuld prévent any one from performing it. When the suffocation depends not only on obstruction of the trachea, but -also on effusion of false membrane or the -glutinous fluid which precedes it, irito the smallér bronchial tubes, then the case is not one for operation. The difficulty, then, is -to discover when the false membrane which causes the obstruction to breath- irig is limited to the trachea ·and larynx and when it has invaded the bronchia. Percussion and auscultation ought to 'assist in the diagnosis, but the restless tossing of the child and the' noise of the breathing always make this a difficult proceeding. There are two signs which appear to me to be valuable guides ; one is the amount and'loúdness of the stridor, which is always great in proportion to the patency of the small tubes and obstruction in the trachea. But the most valuable test is a viewof the naked chest. When the obstruction is in the trachea, while the bronchial tubes are free, the respiratory movements are continued with exaggerated energy, but the chest -will not respond to the hmuscular efforts. The result is that at each inspiration the flexible parts of the thoracic walls are -drawn in with great force, the intercostal sþaces-ate hollowed, and the en- siforin cartilage sucked back. Bût when the small bron- chialtubes, and, perhaps, the 'air.cèlls, are stopped-with the viscid or nembranous effusion, the muscular efforts 'are more fèeble and the chest ieniains puffed out, and the-whole asýect:is. that'f a child thirsting for breath, but with the laàgs -aheady !fult and theniselves unfit for respiration. In thisiatter case, I;never 'operate ;; inthe formér,-withevery hope of success. This -is\" not the'place to enter into details with regard- to the' opeiaton which vary in rnany respects in differerit ,cases ; but one thing rày·be impressed ori: the yôung-oPer- ator -by oné'who 4has -had cnsiderable-experiërice,; iid that isithàt tràcheotomy is not thensiinpileplunge-of aknife-into. 182",
         "TRACÙÉOTOM- :IN CROUP AND DIPHTHERIA. the tracheathat many suppose, and that can be easily effect- ed in the bloodless neck of a.subject on a dissecting-rooni table. It requires cooleëss and patience on the part of the operator. Sometimes the trachea can be exposed by very little dissection; át others, nuünerous obstacles comne in the way, especially in young children. Aniongst these rnay be mentioned overabundant cellular tissue and.fat, turgid veins, isthmus of the thyròid gland, which is very large in infancy, and protrusion into the wound from below of the thymus gland, a frequënt éause of surprise and annoyance.to those who are not forewarned. In consequence of these possible complications, the operation must be done slowly and sys- tematically,obstacles turned and held aside bleeding vessels secúred ; and the golden rule is-that thë trachea is never to be opened till its white rings are seen clearly at the bottomn of the wound. The following table contains an account of my opera- tibns of trachëôtômy in croup and diphtheria, and the respective results. CASE 1. Croup; aged 6 . Cured. \" 2. \" \" 3 . Death in three hours. 3. \" \" 3 . Death immediately. 4. \" \" 1. Death in sixteen hours. d 5. Diphtheria; \" 2 . Death immediately. \" 6. c l 2ù. Deäth in sii houis. * 7. Croup; \" 1 . Death in eight hours. 1 8. \" . \" 3 . Death in twenty-four hours. \" 9. Diphtheria; \" 4 . Cuied. 10. \" 2k. Cuied. IL. \" \" i¾. Death in twenty-four hours. S2. Crouþ ; \" 5. Cured. 13. Dinhtlleria-; \" 2j. Deáth in fôrty hours. 14. Cip ; \" 5 . Cured. \" 15. Diphtheria; \" 5 .- Death in twenty-eight hours. \" 16. \" \" 5 . Death in five days. \" 17. \" c\" 6 . Cured. 18. \" 3 . Death in fotü days. 19. \" \" 3j. Death in seven days. \"e 20. Il \" 2 ý. Death in fiÏ days. si 21. -\" \". 2j. Cu'éd. 22. \" \" 6 . Death in two days. \" 23. \" 5 . C«ed. te24. \" 8 . Death in thirteen days. 25. Croup; 1. Death in six bours. \" 26. et \" 5 . 'Cured.",
         "184 CANADA MEDICAL AND SURGICAL JOURNAL. CAsE 27. Diphtheria; aged 5 . Death in five days. 28. c ' ' I 7 . Cured. 29. Croup; - ' 5 Death in three days. 30. Diphtheria; \" 5 Cured. 31. \" \" 2 Death in two davs. C 32. Croup; \" 2½. Death in two days. \" 33. Diphtheria; C 5 Death in six davs. 34. Croup ; C 9 Cured. C 35. - CC 4 Death in three days. C 36. Diphtheria; \" 8 Death in eight days. 37. C C 7 Cured. 38. \"7. Death in-three days. C 39 . C 5 Cured. C 40. \" 5 . Death in two days. C 41. CC 4 Death in three days, ' C 42. C . C 6. Cured. C 43. \" C. 4 Death in two days. C 44. Croup ; C 7 Cured. C 45. C C 9 Death in four days. C 46. Diphlitheria; \" 6 Cured. Total cases of Tracheotomy...... ..46. Cured 17: Died 2a. Tracheotony in Croup,... .......... 16. Cured 6; Died 10. 14 20. Cured il ;Died IÔ. CC Diphtheria ......... The average result is precisely the same, viz., one child is saved out of every two and two-thirds operated on ; and, as the operation, was always donc when there seemed no hope of recovery otherwise, it may safely be stated that the lives of these seventeen children were saved by tracheotomy -British lledical Yournal. A NEW HOSPITAL IN PARIS. A new hospital, to be named'the M'nihnontant Hospital, is to be opened towards the end of the year in the part of Paris from which it derives its name-one of ' the poorest quarters. It is situated between the Lariboisière and Saint-Antoine Hospitals, and will contain i5o beds. It consists of isolated pavilions. The wards are large, and none will contain more than twenty-two. beds; there are numerous rooms with one, two, three, or four beds. Each ward has its own staircase: and in the centre of each pavilion is a separate staircase for conveying provisions. The pavilions are surrounded with open galleries, for the use of convalescents in fine weather. Independent of the hospital, there is a lying-in institution consisting of isolated wards.-British Medical 7ournal.",
         "CANADA MONTREAL, OCTOBER, 1875. P.REVENTIVE MEDICINE. The object of the science of preventive medicine is not the treatment of disease when it occurs, but the prevention of the occurrence of disease when threatened. In this country, Canada, much has to be donc to give us the means of ascertaining facts with regard to the prevalence of dis- cases. Before these facts are attainable we must introduce or inaugurate a system of observation. This system of obser- vation is comprised in a definite system of registration. The Government calls upon thea people of this country to contribute large sunis to keep up its various establishments. This money is cheerfully accorded, because the machinery of the Governmental system is felt to be a necessity. In the various citiesthroughout this country sanitation is attracting attention, the people themselves feel. that something ought to be donc to insure at least, public con- fidence, but what that something should be is indefinitely understood. Improved Governmental organization, or the inauguration of a defiite system. of :oservation wouki render valuable the efforts of-the authorities of cities and towns so that they might be of advantage to local improve- ments in various necessary directions. .It is not by a few spasmodic, efforts on the part.of certain communities that general. benefit is to be expected. If we take-as a.warning the experience of Great Britain we will find that sanitary legislation becarme cumbrous and entangled. Sanitary legislation appears to have taken its",
         "CANADA MEDICAL AND SURGICAL JOURNAL. rise in Great Britain some thirty years ago when the Im- perial Parliament passed an Act, which was generally com- prehensive, to promote the health of towns. Since the passing of that Act, niuerous other Acts, some twenty-nine in number, have supplemented it, so that experts in hygiene and law became bewildered, as the accumulation of sanita- ry legislation was such that they were comparatively inoperative. Some year or two since, this being an acknow- ledged evil, a Royal Commission was issued under ,the presidency of Sir Charles Adderley, a codification or con- solidation of all the Acts resulted, and during the past session the priesent Government of Great Britain repealed the Acts of previous years, and introduced a consolidated statute, containing ail the points of value in the repealed Acts, which becaine the law of the land. TrIiCanada we are without any sanitary legislation. The Government of this country has recently introducëd and passed a law in reference to the adulteration of food, liquors and drugs, and we believe that public analysts have been or are about to be appointed. This is all very well and very necessary but is a mere item in the many legisla- tiW'e enactine'ts which are required for this country. In looking iito thi's subject we must be fully preparêd for its vastness and if wisdom guides our counsels we will try and take ladvantëge of the teaching which legislation in other- parts of the world affords. Laying aside all theory, We know as a Tact, diseas'e of whatever kind, Will become more prévalent, more virùl'ent, more fatal, and ibre per- ïfnennt, in locàlfties, wh'ere sanitary laws aie ignorèd It àËþéprs to be thë scourge for the 'nelect of those ordihary ialès Ôf cleaxdliriëss which contribute to our cóifort, if thèy do höt iiýProve our health. Wherever s'anitation is làid aside, èpidenfùic aisease will affsé, aña With the sWord of the destroying angel do its dèadly wôrk uo estution, untii ,appeà¥edeby 'ahiT½ to a 'poper sé s É the \"evil f rrégTéè't, la bWétèi1cöidition 'of things ang'st th\" suf- ~ferers. 186",
         "PREVENTIVE MEDICINE. Certain epiderniés haiè seemingly' disaþpPârd 'by the imprveIûnents of modern niodes of lFving. Thle plágúe which spiéad over Europe some two hidi-ed yèars ago decimnating 'whole -coimninities ;has apyarently bée shut out by sanitafy barriers of modern times although it is a disease still knoWn to the inhabitants of tie East, ähd is'still'as fatal- and ·as contagious as of òld. In the iatter of- small-pox, it has been remarked that this disease occurs, in the -épidenie form very freqüently, every four or five years. From 1837 to 1842 sniáll-pox was prevalent in a very vii-ùlent fofín throughout Europe and indeed 'ex- tended to our own side of the Atlantic. The'mortality fîom snall-pox during this epidemic was consideriably high- er in the United Kingdom than in continental countries. Vaccination had been voluntarily sunbmitted to, and very generally practiced up to this Èeriod in Britain, but in cin- šëquence of the virulénce ánd general prevalence of this epidemic, a reaction occurred and persons were numerous who absolutely refused to submit their children to the pro- tective influence of vaccine. This led' to legislative inter- ference and by a succession ofActs, coïpulsery vacciiiation was 'at length introdifced into the United Kiilgdom. ?revious to the inti-oduction of these laws thréeefourths. of the cases =of death froin smrrall-þox ôëccurred -amongst children under five years of age. In the epidéinic of i80, less than onš e third of the deaths froin smallpox in Englaiïd and coiisidei-ably unddr ône foùrth of 'the dèeths froin this case in Scotland and Irela\u0026d Were öbbeivedin children under that age. Let it be státed fùrthèriore that 'ihn the'epidemic'of 1870 occuried à large :pi-öpöition öf ýthe- children under five years of age Were unñrôtected byvac- cination. Another significant -fact has been established in rêspect to'the recent epideric of-sniall- px. D-\"ing pre- ii6u flide'ics éontiniental Enii-'oe'suferêd less :in :pö- peitio 'tlan Great'Britain; in uthe èPideihic lof -i8yo the 'Pfoortin- of-deáths 'fro inell-pôx i erïsôwe of 'tlië af-e towns on the ·dontiÏeht wàs in'wäñy-inrsfaãües six te ofe",
         "188 CANADA 3mEDICAL AND SURGICAL JOURNAL. .of towns of the same size in Great Britain. To sum up ve may give the figures of the late Sir James Y. Simpson in an article which appeared shortly before his lamented death, as proving the beneficial influence of Dr. Jenner's great discovery, in saving from death from .small-pox, some 8oooo persons annually, provided the same rate of mortality froni that disease existed as did exist at the close of the last century ; whereas, the present annual average ,mortality in Great Britain is about 5000 souls-all too many when it is conceded on all hands that small-pox is a prevent- ible disease. We have illustrated small-pox in this connec- tion because it is prevalent throughout this country at present, but the same may be said of other contagious dis- eases. On a recent occasion the Right Honorable Dr. Lyon, Playfair, M. P., in speaking about the House ofCommons and sanitary matters, stated that, \"the distinguished man who is now at the head of the Governiment \" had said to that bouse 4 that the keynote of the parliament was to be 'Sanitas Sanitatum omnia sanitas' relating to all sub- jects connected with the social welfare of the people, he (the speaker) had ahways admired this, that the House of Commons, of which he hac the most experience, forgot alto- gether that it was dividedinto two great political parties, .and acted as one body in trying to frame measures most productive of good for the public interest.'' We can only utter a fervent hope:that the Government of this Dominion will take a leaf from the British House of Commons and.in legislating for the people cast aside all the littleness: of party politics and engage in the earnest and much needed reform of sanitary legislation. We have great pleasure, in announcing that our friend and colleague Gilbert Prout Girdwood, M.D., M.R.C.S. England, Professor of Practical Chemistry McGill Univer- sity, was on the 26th:August last elected.amember of the Society of public Analysts :of Great Briti.n",
         "AS OTHERS SEE US. We observe with regret that our old and esteemed friend Sir Duncan Gibb of London, England, has resigned the of- fice of physician to the Westminster, Hospital in conse- quence of the state of his health. Sir Duncan has we believe, recently suffered from an attack bof pleuro-pneumonia, but we sincerely hope that rest from the arduous public duties of physician to a large hospital will enable him to rally from bis attack of illness and that many years of usefulness may be added to his career. AS OTHERS SEE US. The British Medical Journal of September 4th in an ed- itorial item under the h'eading Anti-vaccinators at Montreal says-\" Montreal has been recently the scene of some dis- \"graceful rioting on the part of anti-vaccinators. It appears \"that of late years, small-pox has been very prevalent in 4'the city, especially amongst the French Canadians; and \" in consequence the Provincial Government passed an Act \"to empower the municipalities to enforce vaccination. \"This, however, has been strenuously resisted by the French \"section of the community, under the leadership of a Dr. \"Coderre and other savants and a mob of 7000 roughs as- \"sembled a few Sundays since, who stoned the aldermen \"'and gutted the house of one of the vaccination supporters, \"and in other ways conducted themselves in an irrational \"manner. The police were utterly powerless against the \"rioters, whilst, as a natural collateral incident, severe \"small-pox still prevails.\" There are several inaccuracies in this brief account, but it is sufficiently correct to show how we deserve this reproach. It is to be regretted that there should be amongst us men willing to excite to opposi- tion a few fanatics,to that degree as to lead to a serious breach of the peace. For the information of our contemporary however, wé would state that the \" French section \" alluded to, are a very small part of that nationality in our city, anti-vaccination views are by no means believed in by the large majority of our fellow citizens of French descent. 189l",
         "190 CANADA MEDICAL AND SUBOICAL JUURNAL. The more educated portion of our.French Canadian citizens .are as firmly impressed with the value of vaccination as a means of lessening, at least, if it does not actually stamp out small-pox, as are their fellow citizens of British extraction. The riot in question did not so much arise, so far as we can learn, from a desire to oppose compulsory- vaccination, as it was a forcible condemnation of a by-law-which was about to be submitted,but which we believe never would have been accepted by the City Council without such modifications as would have deprived it of many objectionable features. We abstain from saving more on this subject at present. We understand that the matter is before our criminal tribu- nals and we suppose that the rioters will be equitably dealt with by the law. We may moreover state for, the benefit of our contemporary that Dr. Coderre did not, wye believe, lead the mob of 70co roughs at the time they stoned the aldermen, and gutted the house of one of. the medical health officers. PRSCRIBING LARGE DOSES. At the Pharmaceutical congress held at Bristol on the 25th and 26th August Iast, the President Mr. Groves in his opening address observed in substance as follows That it was to be regretted that in prescribing extreme doses the prescriber did not indicate by some, sign that such dose was intended. There should certainly be a means of indicating to the dispenser that the prescriber knew he was ordering an unusually large dose, and that he meant it. This would prevent the assumption on the part of the dispenser that there must be some error, and that in the exercise of his own discretion he should dispense a smaller dose. For instance, quite recently we heard of an apoth.cary who exercised his own discretion in dispensing a dose of quinine, that :had been ordered for a patient with typhoid fever, and instead of giving the patient twenty grains which was prescribed by the physician, he gave two, of course the two grains failed to produce the expected lowering of the temperature which would have followed",
         "ZIENISSEN'S CYoLOPEDIA. 191 the exhibition of the larger dose. The physician suspected the cause, procured the quinine and-dispensed it himself with a very different result.- This we mention, as we think in justice to both parties, some means should be adopted to give the dispenser notice that -the prescriber is in earnest in prescribing a larger dose than usual. ZIEMSSEN'S CYCLOPEDIA OF THE PRACTICE OF MEDICINE Many of the subscribers to this great work are aware that the Volume's of the German Edition are not being issued in regular succession-some of those treating upon subjects of greatest interest having the precedence, although num- bered to conform to the plan of the entire work. It has been concluded to follow the same course with this transla- tion; and in compliance with the expressed wish of many subscribers, Volume X., SCHROEDER'S \" DISEASEs OF THE FEMALE SEXUAL ORGANS,\" is now published. Volumes IV. and V. will follow, the former to be published in December next and vol. V. in March, 1876. Vol. X., is issued from the press amply illustrated, the wood cuts, one hu.ndred and forty-seven in number are of superior fin- ish and add considerably to the value of the work. They are not a repetition of cuts to be found in other books on this subject, but are new in design and give a tolerably cor- rect view of cases which have corne under the authors observation. We eongratulate Messrs Wood \u0026 Co., on the excellent finish of these books so far as received, and we believe that at the completion of the work, those sub- scribers who have secured a copy of these volumes will possess an invaluable cyclopedia, one which few real stu- dents can afford tQ be without. The publishers have announced their intention- to refuse the supply of single volumes. The work will be published alone for, and issued to subscribers. Let all desirous of supporting this vast undertaking send in their names forthwith to Messrs. William Wood \u0026 Company, 27 Great Jones street, New York.",
         "192 CANADA MEDICAL AND SURGICAL JOURNAL. We have received from a friend in Chicago the copy of a circular which we understand is being distributed from door to door in that city. We should not take any notice of this thing vere it not that there are some inacuracies contained therein which demand contradiction. The circular reads as follows:- NO CURE., NO PAY. I. R. BIGELOW, M. D. of McGill University, Montreal, and of Laval University, Quebec,' late lecturer on Nervous Diseases at the Indiana State Medical College, can -now be found at 253 W. Madison St., cor. Sangamon where he will examine all who inay cal at above place FREE OF CHARGE. ' TAPE WORMS REMOvED IN THREE HOVRS. As one of the staff of the Lying-in Hospital, of Montreal, lie has hiad large experience in the treatment of female complaints, to which he gives especial attention. Ladies suffering from Flexions of the Womb, Leucor- rhea (Whites), Prolapses, etc., can obtain positive relief. Whites cured in three days. Now, with regard to this circular we inay statc that no such person as H. R. Bigelow holds the degree of M.D., from McGill University, nor is lie a graduate in any of the faculties of that University, nor does there appear the name of H.R.Bigelow on the list of graduates of Laval University, Quebec. In this advertisement the person calling himself H. R. Bigelow, M.D., states that \"as one of the staff of the Lying-in Hospital of Montreal, he has \u0026c.\" Now, ve do not know to which.lying-in hospital H. R. Bigelow formed one of the staff. It appears to us he is lying in the face of it as no hospital in this city ever had any connection with any such person, as a member of its staff as H. R. Bigelow, M.D. We might request our medical exchanges to pass this round, as H. R. Bigelow, M.D., may be a travelling doctor, and may in all likelihood appear in some other city than Chicago, but perhaps our contemporaries may think with the countryman, \" what pleases him, doesn't hurt I,\" and therefore where the use of circulating this man's un- blushing advertisement ; we.agree with this in principle, but as this choice morceau, contains lies with regard to the con- nection of H. R. Bigelow with some of our Canadian.Insti-- tutions we deem it a duty to give them a flat denial."
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         "Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la marge intérieure D Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression E Includes supplementary material/ l Comprend du matériel supplémentaire Only edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X Il 12 X I I I I I il 2 2 12X 16X 2X24X 28X 32X",
         "TRANSACTIONS OF THE CELTIC SOCIETY. OF MONTREAL. COMPRISING SOME OF THE PAPERS READ BEFORE THE SOCIETY DURMNG SESSIONS 1884-85 TO 1886-87. MONTREAL: W. DRYSDALE \u0026 C0.) 1887. ........ '.......",
         "THE CELT IN THE NORTH-WEST. BY THE REV. PROFESSOR BRYCE, LL.D., Winnipeg. It lacks but a year of a century since the daring and successful combination of the fur traders, known as the \"North-West Company of Montreal,\" was formed to secure the trade of the Indian Territories. It was twenty years before this that, in 1766, the first British trader-a Scotchman, named Thomas Curry.-followed the route of the French voyageurs, which had been deserted since the capture of Canada in 1759 by the English. Curry penetrated to Cedar Lake on the Saskatchewan, and was so well recom- pensed by his one season's trade that he never needed to venture on the \"watery ways\" again. The next season another Celt, James Finlay, perse- vered even farther up the Saskatchewan, and re- turned to Montreal with a rich cargo of furs. The enterprise of the Montreal merchants began to tell upon the supply of furs which had for a century been carried down by the Cree and Chippewyan Indians to the shores of Hudson Bay. In 1774 the Hudson's Bay Company had abandoned its policy of timidly clinging to the sea-coast along the Bay, and had thrown down the gauntlet of opposition byý building the Cumberland House on the Saskatche-",
         "-135 - wan river. Pond, an American, Wadin, a Swiss, and the brothers Frobisher, Englishmen, aIl mer- chants from Montreal, had, in the year 1775 and succeeding years, carried the fur trade by their canoe route even to the distant Lake Athabasca. So early as the year 1783 we find that well-known Nor'wester and leading Celt, Simon McTavish, making an effort to combine the Montreal traders into one company. His was long one of the names to conjure by among the fur traders. Another firn of Scottish merchants in Montreal-Messrs. Gregory and Macleod-assumed an independent attitude, and undertook, like \" Ta' Phairson,\" of the Highland legend of the flood, to have a \" boat o' their ain.\" It was in July, 1787, that the combination we have .nentioned was formed among these Montreal merchants to trade to the Nor'west; and it is quite surprising to find the large number of Celts in the enterprise, Some of the Montreal Highlanders were Jacobites; a number of them had even fought as Rads. in the battle of Culloden, and had, after the '45, fled to New France to find new homes. More of them, however, were disbanded soldiers and their families, of the 78th and Fraser Highlanders, who had settled in Canada in 1764. Others, again, had been connected with the Montgomery High- landers, and some even with. the 42nd, or \" Black Watch.\" When, according to Lemoine, we' know that \"Fraser's Highlanders are now settled all over Lower Canada, and their descendants number more than three thousand,\" it is not surprising that such 125847",
         "- 136 - names as McTavish, McGillivray, .McLeod, Mc- Donell, McKenzie, Campbell, Cameron, Murray, and Fraser occupy a leading place in the fur trade, and that these adventurers were raised to positions of command by their daring, and by the \"perfervi- dum ingenium Celtarum.\" Archbishop Taché, in his \"North-west Sketches,\" says : \" At that time two great rival companies com- peted for the fur trade. The North-west Company, formed of, or, at least, directed by, Scotchmen, required that its niembers should speak French, and all its junior employés were French-Canadians, so that the company appeared to be a continuation of that formerly established in Nouvelle France. The Indians, when referring to this company, always spoke of it as ' the French.' The English, on the contrary, was the designation universally used in referring to the members of the Hudson's Bay Company, although its officers were generally Scotch, and its employés Orkneymen. Although the Montreal merchants had united in 1787, yet, having been so long accustomed to a life of freedom and independence, they found it impos- sible to preserve their combination. Accordingly, in nine years after the union, viz., in 1796, a divi- sion took place. The offshoot took the name X. Y. Company. It was carried on with much vigourand posts were built in many places contiguous to those of the Nor'westers. Two names stand out promi- nently among its leaders -one the Hon. Edward Ellice, the other a notable Celt, worthy of fuller notice. This was-",
         "- 137 - SIR ALEXANDER MACKENZIE. Born in the Highlands of Scotland, Alexander Mackenzie came as a lad to Canada. In the year 1779 the young Celtic adventurer entered the count- ing-house of Gregory and Macleod, Montreal; in 1784 he joined the firm as a partner, being in charge of an expedition to Detroit. In 1785 the young partner pushed on through Lake Superior to the Grande Portage, and on the union of the different fur interests became, in 1787, a partner of the North- west Company. This comnpany was an extensive concern. It employed, at this time, fifty clerks, seventy-one interpreters and clerks, one thousand one hundred and twenty canoe-men, and thirty-five guides. As already mentioned, most of the partners and clerks were Celts, the employés French-Cana- dians. In 1789 Mackenzie was stationed at Fort Chippewyan on Lake Athabasca, and in that year undertook his great journey of discovery to the north. With four canoes, containing his mixed crews of French-Canadians and Indians-both men and women-he discovered the great river which bears his name, and by it, about the end of July in that year, reached the Arctic Seaî. On this voyage the young adventurer was without books or neces- sary instruments, and knew nothing of the sciences f astronomy and navigation. With great perse- verance, on his return, he undertook a journey to Great Britain, and spent the winter of 1791 in Eng- land perfecting his knowledge for future.enterprises. Having returned to Lake Athabasca, in October, 1792, the fearless explorer undertook his celebrated",
         "- 138 - voyage, through the Rocky Mountains. to find the Pacifie Ocean. He ascended the Peace River, spent the winter in trapping, and was ready on the first approach of spring, in 1793, to pass through the mountains. After incredible hardships, and amidst hostile Indians, he reached the Pacific Ocean, and, in token of bis suécess, inscribed on a sea-side rock, with vermillion and melted grease-\" Alexander Mackenzie, from Canada, by land, 22nd of July, 1793;\" the first white man to cross the Rockies north of Mexico, and the first to set foot in British Columbia. It was but a fitting tribute to the Celtic discoverer, and the leading Celts of the North-west Company, that the country west of the Rocky Mountains should be called New Caledonia. A few years after Mackenzie's return to Lake Athabasca and Canada, he retired to Britain, where, in 1801, he published bis interesting book of voyages, re- ceived the honours of knighthood on account of bis great discoveries, and spent bis renaining years. Another of the daring kings of adventurers was a Scotchman-David Thompson-who held, with great credit, the position of \"ASTRONOMER\" AND SURVEYOR OF NOR'wEsT COMPANY. He was one of the hardiest and most enterprising explorers ever in the North-west. He had come from Britain to the Bay in the service of the Hud- son's Bay Company, but had given up bis position, in a few years, on account of the unwillingness he had found, on the part of the company, to prosecute exploration. In 1796 Thompson, on the expiry of",
         "- 139 - his former engagement, placed himself in communi- cation with a leading Celtic trader of the Nor'west Company, Alexander Fraser. He was gladly wel- coned by the Montreal traders, and entered their service in the capacity mentioned. Leaving Fort William, on Lake Superior, in August, 1796, Thompson passed by the Grande Portage to Lake Winnipeg, then to Lake Winnipegoosis to the upper Assiniboine River, down this river to the Souris, up the Souris and overland in a south-westward direction to the Missouri, back again to the Assini- boine (this Missouri journey being accomplished in the dead of winter), down the Assiniboine to Red River, and on March 7th, 1798, reached the junction of the Assiniboine and Red Rivers, where the city of Winnipeg now stands, but where, in that year, there seems to have been not even a fur trader's post. Ascending the Red River to Red Lake, Thomp- son found the sources of the Mississippi much south of what the Commissioners in the Treaty of 1783 had supposed them to be. The hardy adventurer reached Lake Superior in the month of May, 1798. He continued in the service of the Nor'west Com- pany years after this, being a most capable official, and succeeded in fixing the latitude and longitude of most of their posts. In July, 1811, we hear of Thompson arriving at the mouth of the Columbia River, and one of the rivers of the Pacific slope bears his name. On the occasion of this visit his work was the location of a fort for the company on the Columbia River. A journal of Astronomer Thomp- son, in manuscript, is known to be in existence.",
         "- 140 - The hardy explorer, after his days of service, spent the evening of his life at Williamstown, County of Glengarry, Ontario. NOTED PIONEERS. Of the adventurous race of Celtie pioneers in the lur trade was Peter Grant, who, probably, about 1790, built the first fort on Red River, very near the boundary line (49° N.), between Manitoba and the United States. From the Grant stock, and from an Indian intermarriage, sprang a very distinguished half-breed leader, of whom we shall afterwards speak-Cuthbert Grant. The McGillivray family rose to great ýprominence in the.fur trade. There was a Donald McGillivray, a John, a Joseph, and a Simon McGillivray, but the head of the clan was Hon. William McGillivray, who was a Colonel in the Militia of Canada, a man of much local and political influence in Montreal, with strong connec- tions in Britain, and one whose name preserved in Fort William at the mouth of the Kaministiquia on Lake Superior. Another noted Highlander, who was a daring Nor'wester explorer, was Simeon Fraser. In 1806 he crossed the Rocky Mountains by the same route taken by Sir Alexander Mackenzie. On the head- waters of Fraser River, named after him, and on Lake Fraser, he erected the first fur trader's post, on the west side of the Rocky Mountains. During the same period the most noted trader of Northern Minnesota was a Celt, named Cameron. Numerous incidents remain of his generosity and hospitality. He died in 1811. The spot of his",
         "- 141 - burial was long sacred to the voyageurs, and was known as \"Cameron's grave. THE PACIFIC FUR TRADERS. Early in the present century the North-west Fur Company had pushed its trade, as we have mentioned, beyond the Rocky Mountains. Shortly after, in consequence of the celebrated overland journey of the American captains, Lewis and Clarke (1804-6), John Jacob Astor, of New York, undertook to establish a fur company at the mouth of the Columbia River. It is quite surprising to note the number of Celts who were selected in both these companies to carry out the purposes of the traders beyond the mountains. One of the most prominent of Astor's Company was Alexander Mac- kay, figuring so greatly in Washington Irving's \"Astoria\" and other works of the period. It is said he had accompanied Sir Alexander Mackenzie on both his voyages. The ship \" Tonquin,\" which afterwards met so sad a fate, sailed from New York on Sept. 6th, 1810, under the command of a harsh and blustering American officer, Captain Thorn. From Ross Cox's account we learn that-\" Four partners of the Astor enterprise, namely, Messrs. Alexander McKay, Duncan McDougall, David and Robert Stuart, embarked in her, with eight clerks, \u0026c., all destined for the company's establishment at Columbia.\" Capt. Thorn played the tyrant, \" but,\" ontinues Cox, \" Messrs. McKay, McDougall, and he Stuarts had too much Highland blood in their eins to subnit patiently to -the haughty and un- ivil treatment of the captain.\" Irving describes,",
         "- 142 - with graphie effect, the loss of the \" Tonquin\" by the attack of the savage natives, and we know from other sources how Partner McKay was cruelly put to death. Another of the Astor fur traders was one well- known afterwards on our oywn Red River. This was ALEXANDER Ross, the Sheriff of Red River. He was a native of the Highlands, and caine to Canada in 1802, having been born in the year 1781. In 1802 three vessels sailed from Fort William, in Scotland, to Quebec, laden with Highlanders. Many of these were Mc- Donell's Highlanders-a regiment largely of Glen- garry men-who had served in repressing the Irish rebellion of 1798. There were among these people colonists from Glenelg and Kintail, and elsewhere in the Highlands. There were some thousands of these settlers. They chiefly settled in Glengarry County, Ontario, and they have given a backbone to that part of Canada at every crisis in its history since their arrival. Among these Celts was Alex- ander Ross. He taught school in their settlements for a number of years, and at about the age of forty, in 1810, entered Astor's Company. On the transfer of the affairs of the Pacifie Fur Company, in 1813, to the Nor'westers, he accepted service in the latter, and was placed in charge of Oakinagau, a post on the western slope of the Rockies. Here he obtained his Indian wife, the daughter of a chief; she died in Winnipeg only a couple of years since. In 1816 Ross was placed in charge of the Nor'west post at Kamloops, but in 1825 he left the fur trade, crossed",
         "the Rocky Mountains, and took up his abode at a spot since included in the City of Winnipeg. He was for a number of years Sheriff of Assiniboine. He wrote a number of books on the country: \" Red River Settlement,\" \" The Fur Traders of the Far West,\" \"Adventures on the Oregon and Columbia,\" and it is said an essay on \"Agriculture.\" Sheriff Ross was a principal mover in obtaining the appoint- ment of the late Rev. Dr. Black, of Kildonan. Two daughters of Sheriff Ross were married to clergy- men, Dr. Black, and Rev. George Flett (Indian Missionary). One son of the Ross family-James -took high honours in Toronto University, and was one of the editors of the Toronto Globe. Numerous streets of Winnipeg are named after members of the Ross family. Sheriff Ross died in October, 1856. OTRHER NoR'WESTERS. In addition to the well-known Simon McTavish, eader of the fur traders already mentioned, there as the redoubtable John George McTavish, as also Donald, an Alexander, and a James McTavish, ctively engaged in the fur trade. There was a artner, Angus Bethune, and a trader, McMillan, a ourageous man, who maintained himself among the latheads, a treacherous tribe on the Pacific. Trader cMillan afterwards became a chief factor of the udson's Bay Company, and was put in charge of he great experimental farm begun on the Assini- oine by Sir George Simpson. He did not succeed n farming, however, so well as he had done in the ur trade among the Flatheads. Alexander Stewart, - 143 -",
         "- 144 - Alexander Fraser, and Alexander McKenzie were also among the energetic Montreal fur merchants. A GooD MARKSMAN. Another noted Celt on the west coast was a partner, Donald McKenzie. He had been one of the adventurers of the Astor Company, but after- wards joined the Nor'west Company. \"1He was an experienced trader, and possessed an accurate know- ledge of the fur trader's country. He could, with his rifle, drive a dozen balls consecutively, at one hundred paces, through a Spanish dollar, which accomplishment alone was enouigh to secure him the respect of the Indians. To the most cautious prud- ence he united the most dauntless intrepidity; in fact, no hardships could fatigue, no dangers intimi- date him.\" Mr. Mackenzie was afterwards Governor of the Red River Colony for eight years (1825-33). THE GREAT SMALL-POX CHIEF. Duncan McDougall was one of the four partners mentioned by us as entering the Astor Company. He was a somewbat petulant and selfish Celt, it is said, but was evidently a man of action and decision. We learn, from \" Astoria,\" that when the ill-fated ship \" Tonquin\" sailed up the coast, McDougall was left in charge of their fort. The massacre of the crew of the \" Tonquin\" inspired the natives to make an attack on the ill-prepared fort. McDougall had but a handful of whites with him. He adopted a most daring expedient. Knowing the extreme dread of the natives for the small-pox, the trader assembled the chiefs of the neighbouring Indians;",
         "- 145 - told them he had heard of the treachery of those who had attacked the \"Tonquin,\" and declared he would have vengeance. Raising before them a corked bottle, he said-\" The white men among you are few in number, but they are mighty in medicine. I have but to draw the cork of this bottle and the scourge will sweep man, woman, and child from the earth.\" The chiefs believed him; they implored him not to carry out his threat, and asserted them- selves friends of the whites. McDougall kept the vial of his wrath sealed up, and was ever after known as \"the great small-pox chief.\" In the course of time McDougall entered into wedlock with the daughter of Comcomly, the Chinook chief. McDONALD \"GRAND.\" One of the most daring of the Nor'westers who went to the Pacific slope was a partner, John Mc- Donald. He was well-connected in Scotland, and had, with his family, emigrated from Inverness- shire to Canada while a lad. His first language was Gaelic, he had learned English, and in Canada, French, while he was a proficient in half-a-dozen Indian dialects. \" He was six feet four inches in height, with broad shoulders, large bushy whiskers, and red hair, which he allowed to grow for years without the use of scissors, and which, sometimes falling over his face and shoulders, gave to his countenance a wild and uncouth appearance.\" On the Pacific coast he married an Indian woman of the Spokane tribe. McDonald was feared as well as loved by the natives. He had a most uncontrol- lable temper, and in his rage would indulge in a 10",
         "- 146 - wild medley of Gaelic, English, French, and Indian objurgations. The name given him, \"le grand,\" was certainly suitable. Another Nor'wester, John McDonald, was known as \"le prêtré.\" This name was given because Mr. McDonald, a rigid Roman Catholic, bad insisted on the observance, on the voyage, of the Church fasts by his French-Canadian employés. He retired to the Ottawa, and there spent his declining years. Another Nor'wester, McDonald, was also known as \"le bras croche\" (crooked arm). This habit of giving soubriquets was not uncommon in the North-west, as, indeed, it seems to be customary in all Highland communities, where many of the same name are found. 0f the Nor'west Mackenzies, for example, there were four well-known-\" le rouge,\" \" le blanc,\" \"le borgne\" (one-eyed), and \"le picoté\" (pitted or marked). A BRAVE MACKAY. Another man distinguished, even among the better-known Nor'westers, was Colonel William Mackay. 'He came west to trade about 1793, along the rivers tributary to the Mississippi. He was a brother of the unfortunate Alexander Mackay, already mentioned, killed in the attack on the Tonquin.\" After much wandering he took up his position at the great trading post of Michilimac- kinac. When the war of 1812-15 came on between Canada and the United States, he entered heartily into it, led the voyageurs, and distinguished him- self in the battle of Lacolle Mill, on the St. Law- rence. During the war Mackay is said to have traversed the whole country lying north of Lake",
         "- 147 - Huron,and tohave travelled nineteen thousand miles. As Major of the Michigan Fencibles, he co-operated with Colonel Macdouall in the bloodless capture of Prairie du Chien. On this expedition Col. Macdouall, a Celt, held Michilimackinac; Major Mackay, who, for his success on this occasion, was made Colonel, commanded the mixed *party of whites. and Indi- ans; while another Highlander, Lieutenant Duncan Graham, had the immediate leadership of the Sioux and Chippewas, those staunch friends of the British. Colonel Mackay married from the family of Judge Davidson, of Montreal, and on retiring from the fur trade became Indian Superintendent, and spent his last days in Montreal, dying of cholera in 1832. Judge Mackay, of Montreal, is one of his sons. A CELTIC COLONY. It is an oft-told tale, the coming of the expatri- ated Sutherlandshire crofters, under the patronage of Lord Selkirk, to the banks of the Red River. The enterprising colonizer, Lord Selkirk, was not a Celt. But while a student at College in Edinburgh he had, in common with his friend, Walter Scott, formed a passionate attachment for Highland life and customs and for the Celtic race. In 1792 he had undertaken a tour through the Highlands; he was able to speak the Gaelic language, and for his benefactions to the Celtic race, he deserves adoption or affiliation at their hands. Of that forced emigra- tion, from 1811-15, we may not now speak at length. In the presence of their burning homes, all the Celtic attachment to their native. glens burnt forth more fiercely'; driven from their native shores,",
         "- 148 - they went forth with a calm despair somewhat akin to the desolate determination with which the Israel- iteish captives went forth to Babylon; burnt into their hearts, the recollection of the \"lHighland clearances\" of the first quarter of this century blazes forth in the memory of tens of thousands of Celtic settlers all over America, and the wrong is treasured up in their bosoms, and remembered as only a Hligh- lander can remember. The inhospitable shores of Hudson's Bay; the iron-coast in winter; men and women trudging over the ice and snow with bleeding. feet; the starving wives and children; the wearying journey of six hundred miles from the Bay to Red River; and the arrival at a destination houseless and without suffi- cient food. These, and the subsequent hardships, are but the successive scenes of the gloomy pano- rama of the early Selkirk settlement. Sutherlands and McKinnons, McKays and Coopers, McLeods and Smiths, McPhersons and McLeans, Mathesons and McEacherns, McBeths and Frasers, Macdonalds and Campbells, Livingstones and Polsons, Bannermans and Gunns, Munroes and McIvors, were the com- ponents of this Celtic movement; for, though a few of the names given are Norse, yet these families had all intermarried with the Celts. Something less than three hundred was the number of the four bands who, iii four successive years, proved the Hudson's Bay route feasible. A CELTIC FEUD. No Greek can meet Greek with more spirit in deadly conflict than Celt meets Celt. Lord Selkirk's",
         "- 149 - Colony was in charge of Celtic officers, and they found in the Nor'wester traders \"foemen worthy of their steel.\" It matters not for our present purpose who made the onset. There are two sides to this question. Miles Macdonell, one of the Glengarry men, who had been a captain in the Queen's ]Rangers, was in charge of the Selkirk Colony, and seems to have been in Niagara.in 1798, where he was mar- ried; and in 1808 was Sheriff in York. The Nor'- westers looked with jealousy on an agricultural settlement in the fur traders' country. Governor Macdonell made a proclamation forbidding the ex- port of pemican, and seized a portion of the stock at one of the Nor'west forts. This he did to pro- vide food for the settlers, and he offered payment in full for the quantity seized. The Nor'westers resented the seizure. In 1814 the partners of the Nor'westers met at Fort William, and determined on reprisals. They appointed two Celts to proceed to Fort Gibraltar, their fort, within the present site of Winnipeg. These were DUNCAN CAMERON and Alexander Macdonell. Of these, Cameron was the more noted. He was crafty and determined. He lived at Fort Gibraltar with a considerable state. He wore a captain's uniform-a red coat, and a for- midable-looking sword. He signed himself Captain Commanding, Voyageur Corps. He seemed a man of much importance to the Indians. To the Selkirk Colonists he devoted his attention. Speaking, as he did, their own Gaelic tongue, he reached the hearts of many of them.' He fared sumptuously every",
         "~150O- day. The colonists, none too well provided with food, were welcome at his hospitable table; and in the spring of 1815 the skilful diplomatist, with true Celtic warmth, provided three-fourths of the colon- ists with farms in Western Ontario, on Government land, and gave them free transport down the canoe route to their new home. Blood proved, to these Highlanders, thicker than water. The remaining colonists, reinforced by new arrivals from Britain, had another Celt, an officer of Lord Selkirk, to whom they were much indebted. This was Colin Robertson, who afterwards became a Chief Factor of the Hudson's Bay Company. In 1816 the Nor'- westers success of the previous year induced still greater exertions, and now the Bois-brûles, or French half-breeds, with their Celtic leaders, came sweeping down from the west to destroy the colony. They were led by a Scoto-French half-breed h- bert Grant. This man, who had command of the Ldparty which killed Governor Semple, was, on the whole, humane. He had much influence among half-breeds and Indians. He was a stout, and yet «. -\\_%energetic man, who rose to a prominent position in late years. His home was at White Horse Plains, twenty miles or so west of Winnipeg. When the Council of Assiniboia was organized in '1835 he was made a member of it, and bore the high-sounding, but somewhat vague, title of \" Warden of the Plains.\" This was probably a reference to a leader- ship among the plain hunters, who chased the buffalo. For the better carrying out of the hunt certain rules were needed, and Cuthbert Grant was t seemingly a judge and leader among the wild spirits",
         "- 151 - of the Prairies. His children and grand-children are well-known to the old settlers of Red River. AN IRISH CELÎT. But few of the Irish Celts have made the North- west their home. They do not seem, as a class, to have taken hold of the fur trade, and few of them ha've come as settlers to this country. It is well that we are able to flnd one who stands out so prominently, and for so long a period in the affairs of Red River, as Andrew McDermott. He was born in the Green Isle in the year 1791, and embarked at Sligo in the first ship of Selkirk Colonists in 1811. He is said to have been so Celtie as to have been able to trace his lineage back to the celebrated Dermot McMurrough, the Leinster Chieftain. In the service of thecompany he was active and pushing. He became more familiar with the use and structure of the Indian language than even the Indians themselves. We are told that he was \" an excellent walker, ran like a deer, and could endure cold with any Eskimo dog-\" Leaving the Hudson's Bay Company in 1824, he made his first adventure as a \"free trader.\" He became an extensive merchant, and was' on good terms with everybody. His business was multifarious. \"I He could lend a horse, change an ox, or barter a sleigh dog, as circumstances required.\" lie gradually obtained control of the main freighting business of the country. When the Canadian immigration set in, the Celtic trader was ready for the change, and lent a helping-hand to many a new comer in begin- ning business in the then little village of Winnipeg. . 5847",
         "- 152 - Mr. McDermott had, in 1835, become one of the Council of Assiniboia, and was a favourite with the Governor as with the people. He possessed a large fund of information about the early settlement and condition of Red River, and was somewhat given to venturing on that very uncertain task of foretelling the weather and the seasons. In 1881 the portly form of the Celtic merchant, who had reached the age of ninety, and had actually spent three-score and ten years, save one, in business on Red River, passed forever from our view. A CELTIC EMPEROR. One of the most striking figures in Montreal society, forty years ago, was the bustling, short- statured, rather domineering, man, Governor Simp- son, of the Hudson's Bay Company. A native of \" the land of the mountain and the flood,'' he first saw its heather hills in 1796. Like so many Scotch- men, he had gone to London to seek his fortune. A successful clerk in a counting-house in the capital, he came out to Canada at the instance of London fur traders, to complete, if possible, a reconciliation between the Nor'westers and Hudson's Bay Com- pany, who, by their feuds-on which we have shortly touched-had both succeeded in bringing themselves to the verge of bankruptcy. The young commissioner was a born diplomat. McLean, in the second volume of his \" Twenty-five Years' Service in the H. B. Territory,\" has given an account of the means adopted by the young officer in 1821 to effect the coalition, and organize the new company. Difficulties begirt the new Governor on every side.",
         "- 153 - Red River affairs were in confusion; the fur trade was demoralized; the partners were quarrelsome; and nothing but an iron will and consummate skill could bring order out of such a chaos. But it was done, and the word of the Governor was felt as powerfully in far-distant Mackenzie River as the Czar of Russia's commands in any part of his empire. Forty canoe journeys up the lakes, and by the Grande Portage, are said to have been performed by the little Emperor. -His canoe was the best, his men the most athletic, and his speed in excess of that of any travellers by the canoe route. Leaving Liverpool in March of the year 1841, he sailed to Boston, came up the lakes, crossed the Rockies, reached San Francisco, sailed to the Sandwich Islands, then N. E. to Sitka, in Russian-America, across to Siberia, passed by the overland route through Siberia and Russia, and reached Loiidon October, 1842. Sir George was likewise a friend of exploration, and did much to assist travellers on their way through the country. He approved the expedition which tracked the coast of the Arctic Ocean from the Mackenzie River to Point Barrow, and from the Coppermine to the Gulf of Boothia, in 1836-39. It is stated that it was for this suc- cessful work that he received the mark of knight- hood, although the task was planned and performed by Thomas Simpson, Sir George's relative, and the explorer Dease. Many incidents are met with all through the Territories, in the mouths of the old residents, of the impulsive, energetic little Governor during his career of well-nigh forty years. He died near Montreal in 1860.",
         "- 154 - Closely associated with the Hudson's Bay Com- pany magnate, just described, is the career of his kinsman, already named, THOMAS SIMPSON, noted in the records of exploration. This discoverer was born at Dingwall, Ross-shire, July 2nd, 1808, the son of a magistrate of the county. Intended for the church, young Simpson, at the age of seven- teen, entered King's College, Aberdeen. At the close of his academic career he carried, off the \" Huttonian\" prize, a high distinction, and received his Master of Arts degree. He gave up the inten- tion of studying for the ministry in 1829, having taken one year in the study of theology, and on the invitation of Governor Simpson, entered the Hud- son's Bay Company service. As second in com- mand, his senior officer being Peter Warren Dease, an experienced officer of the Hudson's Bay Com- pany, Thomas Simpson explored the coast of the Arctic Ocean. He completed the survey between Mackenzie River and Point Barrow, explored the \" barren grounds\" between Great Slave and the Cop- permine River, and in 1838 performed a remarkable pedestrian journey along the sea-coast. In 1840 Simpson left the service of the Company. He left Fort Garry in company with a band of half-breeds to cross the plains of Minnesota, and his death is one of the most melancholy episodes of North- western exploration. On 13th or 14th of June, Simpson shot two of his companions, an.d whethei this was an act of insanity, or was done in self- defence in a quarrel, cannot be determined. His",
         "-- 155 -- body was brought back to the Red River settlement, and is buried in the St. John's churchyard, in the City of Winnipeg. The British Government, in the very month of his death, intimated its intention of bestowing upon him, for life, a pension of £100 per annum, and the Royal Geographical Society presented him their gold medal in 1839, which, however, never reached him. During the forty years of Sir George Simpson's regime, many Celts rose to prominence in connection with the fur trade or exploration. Shortly after the flood on the Red River, in 1826, by which a number of cattle were destroyed, a considerable French trader, Joseph Rolette, living at Prairie du Chien, on the Mississippi, sent in a large herd of cattle for sale in the settlement. For the manage- ment of this enterprise a Celt was at hand. This was Duncan Campbell, a most agile and enduring traveller. So ubiquitous was he among the settle- ments of the west, that he was commonlyknown as the \" Wandering Jew.\" Another most indefati- gable explorer, who was for many years in the Hudson's Bay Company service, and Well-known to us, is Chief Factor Robert Campbell, now of Strath- clair, in this Province. He was a favourite of Governor Simpson, who was fond of his officers who were not deterred by hardships. The retired officer has frequently recounted to the writer the details of his journeys. With but few supplies, trader Campbell wandered off to the country west of the Rockies from the Mackenzie River. To Chief Factor Campbell belongs the honour of really discovering the Yukon River. He erected the fort now marked",
         "- 156 - on the maps of the region near Alaska as Selkirk Fort, which was long known as Campbell's Fort, .and would have remained so but for the modesty of the founder. Another officer worthy of notice in this same region, and during this period, is Chief Trader Murray, from whom Sir John Richardson obtains so much information about the Yukon coun- try, and who retired to the banks of Red River to spend his last days. Time fails to tell of more than the names of Celtic Hudson's Bay officers, such as Roderick Ross Macfarlane, Ross, Mackenzie, Mathe- son, Macdonald, McIntyre, McTavish, and many others who have, in later Hudson's Bay Company times, worthily sustained the fanme of the Celts-a fame unapproached by any other class in the history of the fur trade and exploration. REGENT CELTS. The immigration to the North-west in the last fifteen or twenty years has had a very large Celtic strain in it as well. We have had nothing to do in this paper with the Lowland or Orkney elements, so large and powerful a part of the Scottish people, nor of the Irish people of English or Lowland descent. Recent immigration has had a large pro- portion of its strength from these sources. It could not have happened, however, that so large an influx of people from the Counties of Huron, Bruce, and Perth, in Ontario, from Central Canada, from Nova Scotia, Cape Breton, and Prince Edward Island, and from Scotland itself, could have taken place without many Celts being included. I can but call your atten- tion to a point or two, and then leave the matter.",
         "- 157 - In these later years have come to us, among others, many Scottish and Irish Celts. They are strong among the clergy of all the churches, and, no. doubt, the fervour of the Celtic nature has some- thing to do with this fact:-Machray and McRae, McLean, Gordon, Mackay, McKellar, Mackenzie, Matheson, O'Meara, Farquharson, McLaren, McFar- lane, Munroe, Robertson, Cameron, Ross, Campbell, McWilliam, Urquhart, Sutherland, and many others whose Celtie origin is masked by their bearing Norse and Saxon names. The lawyers and doctors have McDonalds, Mc- Leans, McBeth, Macarthur, Sutherland, Fisher, Mackenzie, Bain, and Archibald, O'Donnell, Fergu- son, Dawson, and McDiarmid, all of whom have, I presume, Celtic blood in their veins. The bankers and business men have an endless round of Highland names among them. These are: McKeand, Macarthur, Mackenzie, Murchison, Mc- Intyre, MeKilligan, McNee, McNab, McFarlane, Macdonald, McPherson, McMicken, McLellan, Mc- Bain, Alexander, McColl, MeVicar, McCharles, Mc- Neil, McCrossan, MeKercher, McCracken, McCreary, Campbell, MeDougall, McKechnie; while the farmers include all these names, and many more, as. Grant, Fraser, McFayden, Mawhinney, McGurn, Cameron, McCabe, McKay, McOuat, McAlpine, Mc- Ewen, McIntosh, McQuarrie, McCausland, Calder, \u0026c., \u0026c., McQueen, McCorquodale, Shaw. CONCLUSION. Our City Council has a considerable Celtie element, and this may account for its thrift; while,",
         "158 - in building up our new Canadian nation, we wel- come, with equal warmth, Celt and Saxon, Teuton and Frenchman, to our broad prairies.",
         "I ~ I ~\u0026gt; I t ~ r i"
      ],
      "type" : "document",
      "title" : [
         "The Celt in the North-West"
      ],
      "published" : [
         "Montreal : W. Drysdale, 1887."
      ],
      "identifier" : [
         "14665"
      ],
      "key" : "oocihm.14665",
      "creator" : [
         "Bryce, George, 1844-1931.",
         "Celtic Society of Montreal."
      ],
      "label" : "The Celt in the North-West / by Rev. Professor Bryce.",
      "location" : "http://eco.canadiana.ca/view/oocihm.14665",
      "collection" : [
         "hbc"
      ],
      "subject" : [
         "Celts -- Canada.",
         "Fur trade -- Canada.",
         "Celtes -- Canada.",
         "Fourrures -- Commerce -- Canada."
      ],
      "lang" : [
         "eng"
      ],
      "note" : [
         "Caption title.",
         "Cover title: Transactions of the Celtic Society of Montreal, comprising some of the papers read before the society during sessions 1884-85 to 1886-87.",
         "Title from title screen.",
         "p. [134]-158."
      ],
      "media" : [
         "text"
      ],
      "contributor" : "oocihm"
   }
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         "0 .\u003c\u003c^ \u0026 CIHM/ICMH Microfiche Series. CIHIVI/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductions",
         "historiques Technical and Bibliographic Notes/Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. L'Institut a microfilmd le meilleur exemplaire qu'il lui a 6t6 possible de se procurer. Les details de cet exempl\u0026ire qui sont peut-dtre uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la m6thode normale de filmage sont indiqu6s ci-des« /US. D D n Coloured covers/ Couverture de couleur I I Covers damaged/ Couverture endommagde Covers restored and/or laminated/ Couverture restaurde et/ou pellicul6e I I Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes gdographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) D D D D D Coloured pages/ Pages de couleur Pages damaged/ Pages endommag6es Pages restored and/or laminated/ Pages restaurdes et/ou pellicul6es Pages discoloured, stained or foxed/ Pages ddcolordes, tachet^es ou piqudes Pages detached/ Pages ddtachdes r^T^Showthrough/ I I Transparence □ Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur □ Quality of print varies/ Quality indgale de I'impression n Bound with other material/ Reli6 avec d'autres documents □ Includes supplementary material/ Comprend du materiel supplementaire n n Tight binding may cause shadows or distortion along interior margin/ La reliure serr^e peut causer de I'ombre ou de la distortion le long de la marge intdrieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ II se peut que certaines pages blanches ajoutdes lors d'une restauration apparaissent dans le texte, mais, lorsque cela dtait possible, ces pages n'ont pas 6t6 filmdes. n Only edition available/ Seule Edition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement cbscurcies par un feuillet d'orrata, une pelure, etc., ont 6t6 filmdes d nouveau de fa9on A obtenir la meilleure image possible. D Additional comments:/ Commontaires suppldmentaires; This item is filmed at the reduction ratio checked below/ Ce document est filmd au taux de reduction indiqu6 ci-dessous. 10X 14X 18X 22X 26X 30X y H 12X 1 16X 20X 24X 28X",
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         "6 r (j fN^. V",
         "I Medical and Surgical ErXperiences in the South African War Beinc addresses to the r Toronto Clinical Society and Canadian Medical Association by Lieut.-Colonel G. Sterling Ryerson, M. D. haMy Britiah and Caaadlaa Red CroMM CommlsMloaer wUt Lord Roberta* Hoadqaartan In South AMca, fia",
         ". n Impressions of the Medical Side of the War in South Africa By O. STBBLIItO RTUMOM, M.D., L. R. C. S. (Edla.) LlaateDkBt-Colonel Canadian Arm)' Medical HUM— lately Brit- Ifh and Canadian Red CroM CommiMioner with Laid Kob- eitt' Beadqaartera. (Stenograplilc Report.) ■^ A meeting of the Toronto Clinical Society was held in St George^s Hall, Toronto, on Wednesday evening, Octo-ber 3d,Dr. W. H. B. Aikins,thc Presi-dent, occupying the chair. President's annual address: After thanking the Fellows for the honor conferred on him in his election to the presidency, he referred to the honor brought to the Qinical Society by Dr. G. S. Ryerson's work in South Africa. Dr. Ryerson by his devotion to the Red Qoss organization, had brought great credit to the Clinical Society as well as to the whole profession in the Dominion of Canada, and had advanced the profession of Canada in the eyes of the world. * * * Dr. G, Sterling Ryerson gave an interesting address upon '^The Medical Side of the South African War.'' Nearly a year ago Dr. Ryerson appealed to the public as chairman of the Red Cross Society, for aid to the sick and wounded, and in doing so stated that the sick apart from the wounded would, upon an ordinary calculation, amount to at least 16,000 to 17,000. His view was looked upon as chimerical and overdrawn, yet statistics prove that there",
         "have ' been sent to England, up to July 25th, 18,374 sick officers and men, while no less than 31,305 have been treated in the base hospitals at Capetown, with 362 deaths, or 1.15 per cent\" These figures do not include those of Declfontein, Nauwpoort, Kimberley, Bloem- fontein or other places in the western colony or in Natal, so that it is not far from the truth to say that a hundred thousand men have passed through hospital from disease alone. This emphasizes the fact that in war the physician is more required than the surgeon, which is quite in opposition to the popular notion. 4,867 officers and men have died of disease up to July 25th, the principal causes of death being enteric fever and pneumonia, whereas only 3,463 were killed in action or died of wounds. The statistics of this war, so far as they are available, compare most favorably with former ones, a fact which redounds to the credit of the Army Medical Service. For instance, in the G-imea, 4,602 were killed, while 17,580 died of disease ; in the American civil war on the Union side 93,969 were killed, but 186,216 died of disease ; in the Spanish-American war 454 were killed and 5,277 died of disease. I have already alluded to the very small percentage of death at Capetown, namely, 1.15 per cent.; that at Bloemfontein, where the epidemic of ■ 4",
         "■ enteric raged, was naturally larger, 21 per cent* In Loncion hospitals it is 20.04 per cent, and in Indian hospitals 26.04 per cent. G)mpared with former campaigns it makes a most favorable showing; thus the death rate from enteric during the Chittral cam-paign, 1895, was 28 per cent. ; Nile campaign, 1898, 28 per cent ; Matabele war, 1896-97, 32 per cent. ; Soudan campaign, 1884-5, 39 per cent., and the Dongola campaign, 1896, 50 per cent Two hundred and forty-five medical officers and orderlies lost their lives in this campaign. These statistics are ver/ satisfactory in view of the attacks which have been made upon the medical service. In this connection it may not be out of place to say that these attacks will prove a blessing in disguise, for he felt perfectly confident that an impar-tial investigation will result in the greatest credit being given to our profession. As Dr. G)nan Doyle said of Paul Kruger, he should be given a public monument for unifying the British peoples ; so may it be said of Mr. Burdett-G)utts, that the profession should be eter- nafly grateful to him for affording an opportunity for public examination of its merits. The epidemic of enteric fever which raged in South Africa can be traced to the three months the army",
         "lay at Modder River. The soil of that place is of the lightest character* Having been trampled and pulver-ized by thousands of feet it formed an impalpable powder* This^ mixed with the excreta, was wafted in dense clouds into the men's tents, into their mouths, food and drink* He observed that, in many cases, the latrines were but a very short distance from the wooden frames on which was hung the fresh meat for the men* The meat was uncovered by cloths and was often literally black with flies* The flies were everywhere, and nowhere were they thicker than in the hospital tents* Where men were unconscious the flies fed on the saliva, as in many cases sufficient mosquito-netting was unobtainable* The water was muddy and drawn from the Modder River, which may have been defiled by the Boers further up* Once started, it is easy to understand how large bodies of men thrown together became infected* The camps contained from five hundred to thirty thousand men, in the ordinary position, close together, with nine or ten men in a tent* More than that, there is the fact of urination and defecation after dark* The men will not take the trouble to go one hundred or even fifty yards to the latrine, but urinate and defecate in the neighborhood of the tent* This",
         "is wafted into the dust and thus becomes mixed with the food He spoke of the circular dust storms» during which it was impossible to keep the dust out of the tents. This was the way in which infection was carried; and then, the men were exhausted after long marches; on many occasions they had had little food, and that often of imperfect character, living on one or two biscuits a day. Under these conditions the men were thoroughly used up and in a position to acquire any disease that might be going. Regarding the disease itself it seemed to present the ordinary appear-ance, no special characteristics to be observed. The blood test was used in many cases. Regarding the question of immunity after inoculation, or by the hypodermic injection of serum, very careful accounts have been kept in the hospitals of those inoculated and those who were not; and while statistics have not yet been published, where they were inoculated once or twice, especially twice, they avoided the disease, or had it mildly. Dr. Ryerson mentioned the case of an officer who had been inoculated twice who con-tracted the disease but recovered. The opinion is that inoculation is preventive. With improved serum we may yet be able to prevent this great scourge of armies. In addition there is endemic enteric,",
         "espe- cially in Bloemfontein, therefore there are local causes also. The treatment of typhoid was practically the treatment which is adopted in Toronto and every-where else* Disinfection of the bowel either by means of LiSTERiNE or boric acid, taken internally, or ene- mata, were considered in many cases to be remark-ably successful* Another form of treatment was that of starvation* They were starved for seven or eight days. He considered that in some cases it might be dangerous, because a number of the men were ex-hausted when brought in* Nothing whatever to eat for seven days was their treatment ; nothing at all ex-cept water, and all of that they could drink* The medical officer in charge of these cases, and under whose supervision this plan of treatment was carried out, informed Dr* Ryerson that he had fewer deaths than in any other hospital in Bloemfontein* Dysen-tery: this was another very prevalent disease, and you hear of a great many men affected with this dis-ease when they merely had ordinary diarrhea. Dr. Ryerson said that during his service as surgeon with the troops engaged in the suppression of the North- West Rebellion in 1885, he had observed the good effect of several drachm doses of Listehine in treat-ing camp diarrhea and dysentery, caused by drinking",
         "• the alkali water of the plains. The treatment of dys-entery usually employed in South Africa was pretty thorough purging by means of castor oil, followed by Dover's powder, and in many cases it was found to work extremely well Syringing, etc., did not work so satisfactorily. Sulphatt of magnesia in drachm doses, frequently repeated, was successful — one in an hour or ore in two he iS. An ^tausion of geranium roots, a native remedy, was ur^d with success in Natal These forms of treatm^^uc Tvere the most satisfactory of anything used there* Txie tenesmus, etc., was always causing a great deal of annoyance. This was chiefly treated by free encmata and some form of narcotic. Another special form of fever, which is endemic out there, was a form of fever resembling Malta fever. Dr. Ryerson believes this to be really a form of malaria, because it was ushered in with a chill followed by high temperature — a rising tempera-ture at night and a falling temperature in the morn-ing, attended sometimes with diarrhea, afterwards attended by pain in all parts of the body and followed by intense prostration. It seems to demoralize the red blood corpuscles. The patient is as white as a ghost when he comes through it; the pallor is intense, and the prostration ?jreat which follows it Another",
         "form it! li! of fever and that is continued fever^ in which there is a very slight rise at night and fall in the temperature in the morning, and which lasts usually three weeks, constitutes a very large proportion of the cases going to hospital with fever. No case has ever been fol-lowed by death, and it is not followed by that intense anemia of veldt fever. Referring to the medical orderlies in time of war, Dr. Ryerson stated that there was no duty which was so disgusting, and at the same time so trying and tiresome, as that performed by these men. Dealing with the cases of enteric fever, for instance, when a man has seventeen or eighteen motions a day, and an orderly has twelve to twenty men to attend to, the duty is very trying in-deed, but Dr. Ryerson believes that these men per-formed their duty well. The treatment of the surgical case, as compared with the enteric, is simply fun for the orderly. With the modern bullet wound there is very little dressing required; but, of course, when there is destruction of the bone there is more to be done. The conduct of these orderlies has been of the most noble character. Answering an inquiry. Dr. Ryerson stated that pneumonia was not common during the early period of the epidemic ; but later on, when the wet weather set in, pneumonia became a",
         "10 very constant accompaniment. Then, ten or twelve men would be carried out during the course of the day as a result of that complication* Dr* Ryerson was asked regarding a report in the British Medical Journal as to whether there were any cases of typhus fever. Dr. Ryerson said that was a mistake; there was no typhus. He referred to the absence of small-pox. With an enormous army of 200,000 men, nothing proves more definitely and more emphatically the importance and power of vac-cination when there never was a single case of small-pox in the entire army. There was small-pox among the blacks, but not a single case among the white soldiers. Replying to a request for further information re-garding inoculation. Dr. Ryerson said inoculation was not compulsory. The serum was supplied by the Imperial Government authorities. The symp-toms are practically those of typhoid ; severe pain in the abdomen; temperature runs up to 102® or 103°* morning fall and evening rise, accompanied by pros-tration, furred tongue, loss of appetite, and general malaise. This condition lasted about a week. Some suffer more than others. There were no undesirable results that he heard ; no mortality. Riprfnted from the Canada Lancet, November, 7900.",
         "u ■1fl@™mg»g»L^Lil|llH",
         "HiBUJIil^fpill Some Surgical Experiences in the War in South Africa.* By O. Btxhliko Rykbson, M.D., Li. R. C. B. (Edin.) Utatenaat-Colonel CanadtsB Army Hadleml 8Ufl-Ut«ly Brit- ith and CanadUn Red Crou Oommliiioncr with Lord Rob- •itt' BMdqnutan. A great war necessarily presents many phases and points of view, and as the time allowed for the reading of papers by associations, such as I have the honor to address, is limited, I shall only deal briefly with one or two phases which I hope may prove of interest The war in South Africa is interest-ing surgically because of the experience which has been gained of the effect of modern arms of precision, and of antiseptic methods on the field of battle and in the hospitals. It is too early yet to draw deductions from the statistics of the war, but it may be noted in passing that while 936 officers and 11,701 non-com-missioned officers and men have been wounded — 12,637 in all — only 732 have died of wounds re-ceived in action, an infinitesimal proportion, which may be fairly ascribed to the aseptic character of the bullet, to the prompt application of a first aid dressing and to the able and eminently efficient treatment which the wounded received at the hands of the medical officers in the hospitals. The Mauser bullet has justly been described as a merciful one. Its action *Bead before the Canadian Medical Associationt Ottawa meeting, Septem-ber, 1900.",
         "13 upon human tissues depends, however, upon the range at which it is fired. It has been noticed that when it is fired at short ranges, within two hundred yards, it has an explosive character. The nickel case seems to expand and become detached, causing a severe, lacerated and contused wound, which heals but slowly. If it strike bone it crushes and destroys it* If fired at longer ranges it makes a clean drilled hole in bone, and if it strike soft parts only a very small wound is made, there being little difference be-tween the wound of entrance and that of exit, which bleeds but little unless an important vessel is injured. In the case of the soft-nose or dum-dum bullet the wound is much more severe, for even where the soft parts only are injured, the expansion of the lead causes great destruction of parts and a huge wound of exit, the wound of entrance being small When it strikes bone it pulverizes and disintegrates it. If the range is very long, 2,000 yards or more, the soft-nose bullet ^' mushrooms ^^ and causes an extensive flesh wound. It has been alleged that poisoned bullets were used. I have seen many of these so-called poisoned bullets. They are simply green with verdi-gris, which in all probability is burned off in the rifle while the bullet is in transit through the barrel I have",
         "14 heard of no case where poisoning by a bullet could fairly be said to have occurred* It has been charged that explosive bullets have been used. I very much doubt the fact The explosive character of Mausers at certain ranges has already been referred to. It is probably this which gave rise to the statement. When a Mauser bullet strikes a hard substance at a short range the impact is terrific, and causes the bul-let to fly into a thousand pieces. Besides Mauser rifles the Boers made use of many thousands of Mar-tini-Henrys. As is well known, the bullet is a heavy one, and where wounds are inflicted they are in strik-ing contrast to those inflicted by the Mauser. Great destruction of soft parts or bone follows, necessitating amputation in many cases. It is remarkable how few amputations have been performed during this war. Dr. Kendal Franks told the writer that in Iiis experience not more than twenty amputations had been done in 3,000 cases, which must be attributed to the character of the wounds and to the conservative spirit of the surgery of the day. I had the opportunity of examining a good many Boer wounded and found that the bullet of the Lee-Metford rifle inflicted a wound very similar in character to that of the Mau-ser. It is not necessary, therefore, in this place to say",
         "15 11 ■. Pi anything more on that head* The effect of shell-fire was interesting^ if not destructive. The Boers say it is no good and only makes one keep one^s head down. The lyddite shells are not nearly so destructive as was supposed. When they strike soft ground they do not explode. When they strike a rock they explode with great violence, but our friends the enemy were so cleverly entrenched that but few were injured by them. I remember seeing one man stained a bright yellow from head to foot and apparently not much the worse for it They said the escaping gas made their head ache and they found that a few drops of vinegar taken inwardly relieved it. Every Boer was provided with a small bottle of vinegar to ward off the ill effects of lyddite. I have said that I had the opportunity of seeing a good many Boer wounded, and as their condition presented special features of in-terest, I will venture to detain you a few minutes by referring to some of the cases I saw. When I was at Kimberley we had 147 Boer wounded in the rol-ler rink, which had been converted into a temporary hospital. They were of all ages, from fifteen to six-ty-five, and bore their captivity and sufferings with dignity and patience. They had been wounded at Paar^burg chiefly, and in many cases the",
         "wounds had been undressed for sixteen and seventeen days* I remember one man who had been shot through the elbow joint His only treatment had been the universal Boer remedy^ tobacco juice. The arm was enormously swollen and almost erysipelatous in ap-pearance. Mr. Roberts, civil surgeon, opened up the joint freely and removed considerable masses of bone, and found a large piece of shell so firmly imbedded in the humerus that it could not be removed. The wound was very offensive. It was freely drained and douched with bichloride, dressed antiseptically and supported by a rectangular splint This man made an excellent recovery, with a movable joint Another man was shot through the body by a round ball from a shrapnel-shell. The projectile entered four inches below and to the left of the heart and came out through the sixth intercostal space on the right side and posteriorly. He had been wounded sixteen days previously, and at the time that I saw him he had practically no symptoms. This is the more remarkable when the character of the missile is considered. I have seen a good many penetrating wounds of the abdomen which have produced little immediate disturbance. One was the case of a med-ical officer who was shot through the stomach. He",
         "17 i^ i«21 I had little to eat for twelve hours before his wound* When he was wounded he had the sense to abstain from drinking^ notwithstanding the urgent tliirst; and further, he lay still where he was for twelve hours. He made an excellent recovery, but I observed that some three months after his wound had healed that he complained of dragging and discomfort in the neighborhood of the wound, and was eventually in-valided home. Two of his companions who had been shot through the abdomen at the same time were so unwise as to drink water and died in a few days from neritonitis. This may have been caused by the filthy water. It was generally understood in South Africa that abdominal section in wounds of the intestine was inadvisable, judged by the results; but I know of one case where an excellent result was ob-tained* It was surprising how great joints like the knee could be pierced by Mauser bullets with impun-ity. I remember the case of an officer who was shot through the knee joint at the battle of Korn Spruit* In six weeks he was walking about without a crutch, and had returned to duty* Ten days later this of-ficer, with his squadron, was ordered to take a kopje* His brother officers were killed beside him, and he was shot again in the same knee* The wound",
         "18 proved to have been caused by a spent bullet, and was unimportant, though the missile had lodged in the patella tendon* Wounds of the chest by Mauser bullets were comparatively innocuous, and healed readily* In some cases there was a considerable hemorrhage into the lungs, with marked difficulty of breathing. If the obstruction was not so great as to seriously interfere with respiration, these cases re-covered* Wounds of the head were necessarily more serious, but I observed several in which there was considerable destruction of brain tissue, which after-wards made good recoveries* One case was that of a boy who was shot in the left side of the skull, close to the coronal suture, the wound running anteropos- teriorly, and who had right hemiplegia, from which, after removal of fragments and depressed bone, a good recovery was made* A young Boer was shot through the mastoid, the ball coming out just above the zygoma* He made an excellent recovery, with impaired hearing* I noticed that many apparently minor cases of grooving of the outer table of the skull were accompanied by reflex symptoms* Wounds of the eye were of frequent occurrence and in most cases were most destructive* I saw two cases in which both eyes were lost, the bullet passing through",
         "the i^ orbit and cutting the optic nerves. Another man had the optic nerve cut on one side, and» strange to relate^ on the nerves of motion^ cut on the other. There was almost complete ophthalmoplegia and mydriasis, but the vision was otherwise unimpaired* Cases of injury from fragments of shell and sand, thrown into the eye by exploding projectiles, were very com-mon. Altogether, wounds showed a surprising ten-dency to heal rapidly, even under the most trying circumstances, which was due to the character of the bullet, the early application of an antiseptic dressing, enforced temperance among the troops, their general good health, and the careful and painstaking work of the Royal Army Medical ODrps. Before closing I wish to make a very few brief re-marks upon the hospital administration in South Africa — a subject which is occupying a large place in the public mind because of the attacks which have been made upon the administration under the guise of philanthropic interest in the welfare of our soldiers. The position was this: The Orange Free State is a land which produces little towards its own support in food for men and horses. Its main artery of com-munication is a narrow-gauge railway, of the length of 725 miles, between Capetown and Bloemfontein,",
         "I w where the alleged atrocities are said to have taken place. Suddenly a hundred thousand soldiers and twenty thousand camp-followers arc thrown into this country, already bare and hardly able to feed itself. Add to this forty thousand horses, mules and oxen, all of whom, men and animals, have to be fed by this narrow-gauge railway. In addition there arc munitions of war — horses, mules, guns and soldiers to be carried, besides miscellaneous hospital and per-sonal stores, passengers, as well as food and mer-chandise for the residents of the country. It may, perhaps, give some idea of the pressure upon the railway transport when I state that the food supply of 100,000 men for six months comprises 8,000 tons of preserved meats, 8,000 tons of biscuits, 100 tons of tea, 1,500 tons of sugar, 4,000 tons of vegetables and other things in proportion. The 40,000 horses and mules eat 440 tons of hay and oats a day. With a limited rolling stock I leave it to you to imagine how difficult was the problem which confronted our army; a problem which was rendered still more difficult by interruption of communication by the blowing up of bridges. Then almost without warning, a great epi-demic of enteric fever broke out. In one day upwards of a thousand men were admitted to the hospital.",
         "21 Vi Ma! r Ik tm- m Would it be surprising that beds and bedding were hard to find, or that orderlies and nurses were over-worked? Naturally, under the circumstances, the field hospitals had to be utilized as stationary hos-pitals, though they are neither equipped nor intended for such work* The officers and men of the Royal Army Medical Corps rose to the occasion, and did magnificent work, heroically sacrificing themselves on the altar of duty, as is proved by the death and dis-ability returns. In short, everything was done to meet the requirements of the emergency that circum-stances permitted of, and there did not exist the neg-lect and misery so graphically and glibly set forth by certain writers. No one was more keenly interested and sympathetic than the Commander-in-Chief, Lord Roberts, and I always found him most willing to grant every reasonable facility in getting up stores and comforts, and in aiding our work in every way. The history of this war redounds to the credit of the medical officers, civil and military, who worked so faithfully, so energetically, and so successfully to alleviate suffering and assuage pain. The medical organization of the army is by no means perfect, and will require readjustment when the war is over. The medical officers should be given entire control of their",
         "22 supplies of medicines and drugs. They are now sup-plied by an ordnance department. Could anything be more absurd? There should be less red tape and more latitude in the purchase of comforts for the sick. A sufficiency of transport should be always available for the sick and wounded. The orderlies should re-ceive higher pay and be recruited more carefully. The sanitary arrangements should be mere directly under control of the medical department. These are a few of the changes which will enable the medical department to more thoroughly and ef-ficiently carry out its work of mercy and relief. The Royal Army Medical Corps contains some of the ablest and most capable men I have ever met. It is a credit to the army and an honor to the nation. Reprinted from The Canadian Practitioner and Review, Oct., rpoo.",
         "mm^ Caiualties up to December. London, Dec 18.— Total reduction of the field forcct South Africa, due to cosualties, to end of November: Officers. Men. Killed in action, 311 3^118 Died of woucds, 93 952 Died in captivity, 4 92 Died of disease, 163 6,566 Accidental deaths, .... 4 176 Missins and prisoners (excluding those who have been recovered or have died in cap-tivity), 14 1,230 Sent home at involids, . . . 1,551 35,548 Total, 2,140 47,588 49,728 Rhi9\\uU Loss to tbe ilrniy. Officers. Men. Deaths in South Africa, ... 575 10,804 Missing and prisoners, .... 14 1,236 Involids sent home who hove died, . 4 231 Left the service as unfit, 1,314 Total, 593 13,585",
         "14,178"
      ],
      "type" : "document",
      "title" : [
         "Medical and surgical experiences in the South African War : being addresses to the Toronto Clinical Society and Canadian Medical Association",
         "CIHM/ICMH microfiche series ; no. 12908"
      ],
      "published" : [
         "[S.l. : s.n., 1900?]"
      ],
      "identifier" : [
         "12908",
         "FC 02 0203 no. 12908"
      ],
      "key" : "oocihm.12908",
      "creator" : [
         "Ryerson, George Sterling, 1854-1925"
      ],
      "label" : "Medical and surgical experiences in the South African War",
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      "lang" : [
         "eng"
      ],
      "note" : [
         "1 microfiche (16 fr.).",
         "Caption title: Impressions of the medical side of the War in South Africa.",
         "\"Reprinted from The Canadian Practitioner and Review, Oct., 1900\" -p. 23.",
         "23 p. ; 20 cm."
      ],
      "subject" : [
         "South African War, 1899-1902 -- Medical and sanitary affairs.",
         "Guerre sud-africaine, 1899-1902 -- Services médicaux et sanitaires."
      ],
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         "text"
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   "doc" : {
      "label" : "Medical cases",
      "key" : "oocihm.01876",
      "creator" : [
         "Ross, George, 1845-1892."
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      "location" : "http://eco.canadiana.ca/view/oocihm.01876",
      "subject" : [
         "Medicine, Clinical -- Quebec (Province) -- Montréal -- Hospital reports.",
         "Médecine clinique -- Québec (Province) -- Montréal -- Rapports d'hôpitaux."
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         "1 microfiche (17 fr.).",
         "Cover title.",
         "\"From the Montreal General Hospital Reports, vol. I, 1880.\"",
         "Tables.",
         "Includes bibliographic references.",
         "25 p. ; 22 cm."
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         "'1\u003e^ CIHM/ICMH Microfiche Series. CIHIVI/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductions historiques",
         "O^ Technical and B'bliographic Notes/Notes tschniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. 0 Coloured covers/ Couverture de couleur I I Covers damaged/ D D D D n n D Couverture endommagie Covers restored and/or laminated/ Couverture restaurie et/ou pelliculie I I Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes g^ographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) r~~| Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other materiel/ Relii avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La re liure serr^e peut causer de t'ombre ou de la distorsion le long de la mc\u003c ge intirieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ II se peui que certainos pages blanches ajouties lors d'une restauration apparaissent dans le texte, mais, lorsque cela itait possible, ces pages n'ont pas iti film^es. Additional comments:/ Commentaires supplimentaires; L'Institut a microfilm^ le meilleur examplaire qu'il lui a Hi possible de se procurer. Les details de cet exemplaire qui sont peut-dtre uniques du point de vue bibliographique, qui peuvent modifier une image reprodiiite, ou qui peuvent exiger une modification dans la mithode normaie de filmage sont indiqu^s ci-dessous. □ Coloured pages/ Pages de couleur I — I Pages damaged/ D D Pages endommagies Pages restored and/or laminated/ Pages restaur^es et/ou pelliculies r~~~\\ Pages discoloured, stained or foxed/ Pages ddcolor^es, tachetdes ou piqu6es Pages detached/ Pages d6tach6es Showthroughy Transparence Quality of prir Qualiti inigale de I'impression Includes supplementary materia Comprend du materiel suppldmentaire Only edition available/ \\ Seule Mition disponible I I Pages detached/ ryl Showthrough/ I I Quality of print varies/ nn Includes supplementary material/ r~~| Only edition available/ Pages wholly or partially obscured by errata slips, tissues, etc., have been refiimed to ensure the best possible image/ Les pages totalement ou partieilement obscurcies par un feuillet d'errata, une pelure, etc., ont 6t6 filmdes A nouveau de facon d obtenir la meilleure image possible. This item is filmed at the reduction ratio checked below/ Ce document est filmd au taux de reduction indiqud ci-dessous. 10X 14X IdX 22X 26X 30X ^ ' 12X 16X 20X 24X 28X",
         "32X The copy film«d hare hat b««n raproducad thanka to tha ganaroaity of: Medical Library McGill University Montreal Tha Imagaa appaaring hara ara tha baat quality poaaibia conaidaring tha condition and lagibility of tha original copy and in kaaping with tha filming contract spacificationa. L'axamplaira film* fut raproduit grica A la giniroaiti da: Medical Library McGill University Montreal Laa imagaa auivantaa ont tt^ \u003e jproduitaa avac la plua grand aoin, compta tc^nd da la condition at da la nattati d« raxam!;i't:.ira film*, at an conformity avac lar cifT.idltiona du contrat da filmaga. Original coplaa in printad papar covara ara fllmad baginning with tha front covar and anding on tha laat paga with a printad or iliuttratad impraa- aion, or tha back covar whan aopropriata. All othar original copiaa ara filmad baginning on tha first paga with a printad or IMuatratad impraa- sion. and anding on tha laat paga with a printad or illustratad impraaaion. Laa axampf:iiraa originaux dont la couvartura an p^r-:'' «**t ImprimAa sont filmte an commandant par la pramiar plat at •n tarminant soit par la darnlAra paga qui comporta una amprainta d'improaaion ou d'illuatration, soit par la sacond plat, aalon la caa. Toua laa autraa axamplairaa originaux sont filmis an eommanqant par la promlAra paga qui comporta una amprainta d'impraaaion ou d'illuatration at an tarminant par la darnlAra paga qui comporta una talla amprainta. Tha laat racordad frama on aach microficha shall contain tha symbol —^(moaning \"CON-TINUED\"), or tha symbol V (moaning \"END\"), whichavar appliaa. Un daa aymbolaa suivanta apparaftra sur !a darniira imaga da chaqua microficha, salon la caa: la symbola — *• signifia \"A SUIVRE\", la aymbola V signifia \"FIN\". l\\Aapa, plataa. charta, ate, may ba filmad at diffarant raduction ratios. Thoaa too iarga to ba antiraly includad in ona axpoaura ara filmad baginning in tha \u003cjppar iaft hand cornar. laft to right and top to bottom, aa many framas aa raquirad. Tha following diagrams iilustrata thd mathod: Laa cartaa. planchas, tabiaaux, ate, pauvant Atra filmAa h daa taux da rMuction diffArants. Lorsquo la documant aat trop grand pour Atra raproduit mn un saui ciichA, ii aat filmi h partir da I'angia aup4riaur gaucha, da gaucha h droita. at da haut an baa, an pranant la nombra d'imagaa nteaaaaira. Le^ \u003cj!agrammas suivanta illustrant la mAthoda. 1 2 3 1 2 3 4 6",
         "6 M«. ^Rer»\u003e^ I Cb ' MEDICAL CASES, BY. GEOEGE R0S8, A.M., M.D., Professor of Clinical Medicine, MoGill University ; Physician to the Hospital. (From the Montreal General Hospital Reports, Vol. I.,",
         "1880.) M PRINTKD BY THK GAZETTE PRINTING COMPA.NT, MONTREAI-. •^^ ^,. ! •f",
         "I V CI MEDICAL CASES BY GEORGE ROSS, A.M., M.D., Professor of Clinical Medicine, McGill University; Phj'i-ician to the Hospital. I.- •Cme of Extreme Dilatation of the Stomachy caused by Pyloric Stenosis, resulting from the Contraction of an Old Ulcer. Mrs. D., aet. 37, a Swiss woman, was admitted into the Montreal General Hospital on the 10th December, 1878, complaining of uneasiness in the stomach, heartburn, and frequent vomiting'. Patient has always been strong and healthy until lately. The only illnesses she has ever had were ague 20 years ago, and small-pox about 15 years ago. Her youngest child was born 16 months ago. She says she was in her usual health at that time — a good appetite and no trouble in digesting her food : still she was obliged very soon to wean the infant because there was so little breast-milk. Since then she has menstruated quite regularly until three months ago. There is no reason to think that she is pregnant. About three months airo she began to suffer from dis- turbed digestion ; the symptoms which then showed themselves, and have since continued gradually increasing, were as follows : first a \" squeezing sensation,'\" as she de- sc ribes it, at the pit of the stomach. It would seem as if a sense of distension were meant to be also implied. Other uneasy feelings were also experienced, but at no time anything of the nature of actual pain. A severe and constant burning in the stomach and up the throat. Nausea was often felt, and she frequently induced vomiting",
         "pur- 2 DILATATION OF THE STOMACH. posely by irritating\" the fauces with her finger. Vomiting- also spontaneously occurred at irregular intervals, but was uninfluenced by the taking of food. It would sometimes be absent for a period of 2, 3, or 4 days at a time, when she would bring up large quantities of sour-tasting fluids and food. Her appetite is good : she can eat meat or any other kind of food, and finds that she does not suff'er more from one kind of food than another. Bowels have been extremely constipated, and have sometimes failed to act even after doses of strong medicine. Has been steadily losing flesh and strength. Present Condilifn. — Much emaciated; skin harsh and dry. Tongue roated with a whitish fur, red at the tip. Pulse slow, soft, and compressible. On examining the abdomen, lineoe albicantes are well marked. Superficial veins considerably enlarged. The abdomen is distended, chiefly at its lower part. It is resonant, giving a decided amphoric note, except at the depending portion, which is dull. This dulness changes with the position of the patient. On palpation, it feels soft and elastic, like a half-filled bladder. There is no tenderness anywhere. When rapidly handled by both hands, a A'ery loud-resounding splashing of fluid is heard. On exposing the abdomen, and watching the surface for a few minutes, it is found that, at irregular intervals, certain very distinct and constantly-repeated moveiaents of a creeping or vermicular character are to be witnessed. A kind of Leaving of the left side is first to be observed, which, whilst becoming more pronounced and rendering the part unduly prominent, gradually extends downwards and round to the right side, where it is lost. Now the contraction is at its height, and the bagpipe-like outline of the stomach is clearly traceable through the abdominal parietes. If the hand is placed on this, it feels hard and firm, like a contracted uterus, but not so solid. The greater curvature seems to extend to the pubes — the lesser to enclose a small space, which is much",
         "depressed, BY GEORGE ROSH, M.D. 3 and lies just beneath the inner margin of the left hypo- chondrium. This state of contraction remains for a few moments and then again rehixes, leaving the parts as before described. In this state, if deep pressure be made to the right of, and below, the umbilicus, a small, rather firm, and somewhat irregular lump can b(; made out. This, which seems to ocoupy the seat of the pylorus, is not at all tender upon pressure. All the other organs were carefully examined, and no evidence of disease was anywhere discovered. The day after admission she vomited about 3 pints of what proved to be composed principally of fluids, with a small quantity of undigested food ; there was also in it a little stringy mucus. It was brownish in colour, very strongly acid, and covered with a thick layer of yeasty or frothy greyish scum. The odour also resembled that of yeast. Under the microscope it was seen to abound in sarcina3. She was fed by small quantities of milk and wine, fre-quently given, and small pieces of ice to allay the thirst, which was usually much complained of. In addition to this, enemata of beef-tea were administered every four hours. Sulphite of soda was also given to check the fer-mentative processes. Besides this, the stomach pump was regularly employed At the first evacuation, about a gallon of iluid, similar to that previously thrown up, was removed. The stomach collapsed into a very small space, and the tumour could be raised and thoroughly explored. It was found to be the size of a large hen's egg, very firm and slightly irregular on the surface. Under this manage-ment at first the patient's condition decidedly improved. Vomiting entirely ceased ; heart-burn disappeared. T\"he bowels acted sufficiently of themselves ; but thirst and great weakness continued to be felt, and in spite of the temporary alleviation of the more distressing symptoms, it was soon evident that the nutrition of the body",
         "was 4 DILATATION OF THE STOMACH. daily losing j2:round, in spite of diligent attempts at pre-venting this by rectal alimentation. The patient gradually became thinner and thinner, with a drawn, pinched, and haggard face. The greatest possible muscular prostration and feebleness were witnessed ; the mind showed evidence of a starving brain by a mild delirium, and, finally, she died exhausted on the 2nd February, 1879. Autopsy — Body extremely emaciated. Belly slightly protuberant. Skin rough and harsh, and presents a few petechia?. On opening abdomen, an enormously dilated stomach is seen almost filling the entire cavity, occupying all the regions except the right hypochondriac and part of the umbilical. The organ is placed somewhat vertically, and passes down to within 4 centimetres of the pubes, where it turns into the right inguinal region, and termi-nates in the pylorus, about 5 centimetres to the right of the navel. The greater curvature is, of course, the most pro-minent — only a small part of the lesser curve is seen, the upper portion being covered by the left lobe of the liver. The only part of the intestines to be seen are the transverse colon, wedged between the stomach and the pubes, the caput ccBci, and the first portion of the duodenum. Stomach removed and laid on table measured 45 cm. in length, 19 cm. in breadth at the middle, and 21 cm. in breadth in the pyloric region. It contained 5 pints of a dark grumous fluid, in which were 35 large plum stones, numerous orange pips, two date stones, and a number of smaller seeds. Capacity of organ, measured with water, about 8 pints. (Esophagus dilated in lower two-thirds. When slit open, upper part natural-looking Ked muscle- fibres extend down from pharynx fully three inches from cricoid cartilage. The mucosa of lower half, particularly on posterior side of the tube, presents a number of irregu-lar losses of substance, the transverse muscle-fibres are exposed, and there is scarcely any normal mucous mem-brane, the strands between the ulcers being firm and cica- f!m",
         "MkiiAHiMilili BY GEOROE H(X\u003cS, M.D. tricial-lookiiiii'. Stomach itseli' preserves its normal shape and (•ok)ur, and numerous bands of niusclo-lihres can bc! seen I'rom the outside, tiio majority passing transversely, some long'itudinally along grt'ater and lesser curves. At the pylorus there is a lirm, puckered mass, the tissue being white and cicatricial. The muscular coat is considerably thickened, 5 to 8 m, most so at the pylorus. On turning the organ inside out, the mucosa is pale, thin, and cuticular in character in fundus\" and cardiac regions ; thicker and more natural-looking in pyloric half, where it is also mam- millated ; at the cardia it is easily torn ; at the pylorus it is iirrner. Thickness varies from 2 to o m. Through the mucous membrane numerous mus\u003c'le-fibres can be se-:'n crossing each other in all directions. Immediately at end of lesser curve there is a semi-circular ulcer 4-3 cm. in length, '^ cm. in breadth ; its convex border towards the cardia ; edges shelving and smooth ; base iibrous and hard, and the tissues beneath and around it are much thickened. It is situated close to the pylorus, and has puckered the mucous membrane in such a manner that several folds appear completely to close the orifice, but the index linger can be inserted as far as the ilrst joint. The entire ring is involved in a cicatricial thickening, particularly in the i)art nearest the ulcer. From the duodenum the orihce also appears closed by folds of the mucosa. On the peritoneal surface of the pylorus, and about the base of the ulcer, the tissue is fibrous, and a constriction is seen at the anterior surface. There was nothing of note in the other organs beyond the extreme pallor aiul wasted condition. Examination of teased portions of the mucosa of the stomach shows, in the cardiac region where the membrane is cuticular in Character, scarcely any trace of normal gland tissue, only irregular groups of cells, in a condition of fatty degeneration, sometimes arranged in tubular form. In the thicker portions, the tubules are distinct, but the cells arc",
         "U o DILATATION OF THE STOMACH. very '.Taimlnr and Fatty; some of tho tul)iile.s apparently are made uj) ot '.othini\u003e' but a granular debris Remarks. — The diajjnosis oi this case, as far as regards the dilated stomach, was of course easy. At the time of admission, the deoree of distension was so great, and the peculiar alternating contractions of the organ so marked, that the stomach was plainly mapped out in a manner that made it impossible to mistake it for anything else. It was easy enough, also, to arrive at the conclusion that pyloric constriction was the proximate cause of the changes wit-nessed in the gastric walls. The fact that this is by far the most freqiuMit cause, and that we had an evident lump at or near the pylorus, both pointed clearly in this direction The only remaining c^uestion therefore was : the nature of the stenosis. I may say at once that after fairly examin-ing the case, the conclusion I arrived at was, that it was one of Fibroid thickening of- the Pylorus. The autopsy confirmed the fact that the pylorus was narrowed by the contraction of a new growth of fibrous tissue, but it showed us also, what we did not know, that the origin of the fibrous growth lay in the formation of such tissue for the cicatrisation of an old gastric ulcer of very considerable size. Now this patient was most carefully questioned with reference to her past history, wath especial reference to this A^ery point. She denied ever having sufiered from gastral- gia, or vomiting, or other dyspeptic symptoms in former years. This being the case, I excluded ulcer. It would, as I now see, have been wiser to admit the possibility of a long-previous ulcer, which had declared itself by no symptoms — another proof of the possible latency of this disease With reference to the treatment of these cases by the stomach-pump, or, perhaps, preferably, by the stomach- syphon, I should say that I am impressed with the correct-ness of the views expressed by Kussmaul and others on this subject. I am convinced that this woman was greatly re-",
         "*\u003e5 BY GEORGE ROSS, M.D. 7 lievod olmimy distressinu; feelings by having her stomach freed from a great load of fermenting lluids, althouuh I chink i^ may fairly be doubted whether in^this ease life was actually prolonged. These eases of distended stomach are generally of a most hopeless nature, even apart fiom the too-often malignant nature of the obstructing cause. This being so, we should certainly be ready to employ all mea-sures calculated to ensure greater comi'ort to the patient, althouuh these do not enable us to modify the ultimate prognosis. IT. — Case of Cirrhutiia of the Liver ivith f^reat Enlnrg-emenf, characterised hy Jaundice, Fever and IIccmorrha!2:e.s. — Death . — AiUopay. Margaret Macaulay, a?t. 22. was admitted into the Mont ^nl General Hospital on the 21st October, 187H, with intense jaundice, and complaining oi vere abdominal pain and vomiting. Her family history is good. There are no indications of tubercle, cancer, or syphilis. Patient is a medium-sized, tolerably well-nourished Irishwoman. Has been married for 2^ years, but has had no children. Has always been regular up to 4 months ago, since which time she has \" seen nothing\" ; but does not think she is pregnant. With the exception of the usual diseases of childhood, has always enjoyed excellent health until the month of June last. She has, however, been addicted to considerable excess in the use of alcoholic liquors. About the time just mentioned, she was observed to be somewhat sallow, and especially was there yellow-ness in the ocular coujunctiva. Her urine also was dark in colour, and she vomited a little, more i articularly in the mornings. Several times the vomited matters contained blood, and once in July, according to the statement of her husband, as much as a large bowl-full of black",
         "clotted T 8 HYPERTROPHIC CIRRHOSIS. n! i ! blood at once. Thus she t-ontiiiued during the remainder of the summer — sallow, rather weak, without appetite, and with occasional vomitina' ; urine scanty, dark in colour, and frequentl}'^ voided. Did not lose Uesh to any material ex-tent. About the 1st October i'elt w^orse, and vomited pretty frequently, princix)ally iluid matters (she calls it w^ater- brash). On the 0th inst. she had several chills, and w^as very feverish in the intervals ; vomited bilious-looking fluids constantly. Jaundice soon became well marked all over the body. There was also very great pain, princi-pally across the upper zone of the abdomen (the situation of greatest intensity being in the epigastrium), but felt more or less over the whole abdomen, and sometimes also between the shoulders. The pain was constant, not par-oxysmal, and aggravated by movement. The symptoms as described — pain, thirst, vomiting, jaundice and fever — have persisted from their commencement until the time of her admission ; but there have been no more chills at any time. For a few\" days previously, also, she has had a troublesome, dry, hacking cough. Patient feels dull, heavy, and w^eak, but has no headache. She has never been troubled with itchiness of the skin. Thinks she has grown slightly thinjier since this illness began. Upon examination the folio vvinu' notes were made : In-tense jatindice of deep, bright yellow colour. Abdomen full and rounded, markedly more so upon the right side. Some large distended blue veins tire seen ramifying over the right lower costal cartilages, and also on the sides of the abdomen. Linetc albicantes well marked. By palpa-tion and percassion it is Ibund that there is great enlarge-ment of the liver, its lower edge extending below the umbilicus, and down to the anterior iliac spine. The sur-face is smooth, and feels hard, but the lower margin seems slightly indented. It is everywhere tender upon pressure, but most so at the epigastrium and on the lower edge. There is also great teiulerness in the splenic region. The i",
         "^: BY GEORGE ROSS, M.D. 9 dull area is very extensive, occupying- from the fifth rib to below the umbilicus, across the epigastrium, and through the lower costal cartilages on the left side, but not below them. The edge of the spleen cannot be felt. There is no sense of fluctuation in the abdomen, nor any dulness in dependent parts. The bowels are constipated, and she says the motions haA'C been black. The tongue is very slightly furred in the centre ; ver red at the tip and edges. The urine is scanty, high-coloured, and turbid, and de-posits, on standing, a copious sediment of a brownish-grey colour. Sp. gr., 1020 ; contains ^th by volume of albumen. On applying heat and nitric acid the urine becomes of a decided o/ive tint, and the albuminous deposit is deeply stained of a dirty green colour ; no sugar. Decided rea\u003c'tion for bile-pigment. No reaction with Pettenkofler's test. Under the microscope, great numbers of scattered epithelial cells and broken-down debris, togeth^^r with numerous epithelial tube-casts. All these foreign matters are deeply stained of a bright yellow colour. Her pulse was 120 ; skin dry, and temperature 103\" F. The chest was examined, but no abnormal physical signs observed. To avoid detailed report, the following extracts from the record may suffice : The fever continued for one week, the temperature ranging from ODo\" F. to 102\" F., after which it gradually ll'll, and became even slightly subnormal. The alvint^ evacuations weri^ regular, and always greyish or almost colorless. Very much abdominal pain con-stantly complained of, with persistent tenderness. The vomiting was soon checked by effervescing alkalines. Cough became very troublesome, and destroyed rest at night, but no physical signs ever appeared in the chest. On the 28th she became aphonic, with noisy laryngeal breathing, for which an inhalation was given. On Nov. 2nd urine was scanty (8 ozs.), though she was taking",
         "digi 10 HYPERTROPHIC CIRRHOSIS. I ■ talis, and was bloody, also containing a few clots. Sharp epistaxis occurred, necessitating plugging with tannin. In the evening, sudden suffocatiA'e symptoms showed them-selves. A laryngoscopic examination revealed the fact that a lirm, dark clot of blood was lilling the larynx. A sudden expulsive effort brought this away entire, with complete relief to the breathing. She had been, however, getting very prostrate ; epistaxis recurred ; there was some hnematuria, very little urine being passed ; a little blood passed by the bowels, and she gradually sank and died on the mornino- of November 8rd. Autopsy. — Liver much enlarged ; flattened from above downwards. Colour, pale yellow. Firm to the touch, and on the surface a number of radiating veins. Weight, 3080 grammes. On section, it cuts with remarkable firm-ness, considering its colour and manifest state of fatty de-generation. The surface of the section is of a light yellow-ish-brown colour. No trace of lobular blood-vessels, large or small. On examining with a low-power lens, each lobule is seen to be surrounded by a zone of light-greyish trans-lucent tissue about -.5 m. in thickness. The centre of each lobule is of a brown colour, from accumulated bile- pigment ; the periphery of an opaque dead white, from the present e of fat. Here and there an entire lobule is seen to be in this last condition. There is no puckering on the surface of the organ, nor are there any areas where the fibrous tissue is more abundant than usual. Biliary ducts free, and of natural appearance throughout. Gall-bladder contained small quantity of dark, viscid bile. ' Kidneys were large, soft, and mottled ; dark red in colour. Section u'reenish from bile-stainino-. Substance remark- 1 On mil TDScopic ixiuiiiiiiition L\u003er. Osl'- toiind a condition of advanced cinhosis ; tlic new growtii ln'inj;- \u003e lii( tly aliniit individual lobulos — monolobu- lar — and in many instances extending; into tin; acini between tho cords of liver cells. There is no special divelopinent of bile canaliculi in the new tissue. Liver cells",
         "fatty. BY f^EORGE ROSS, M.D. 11 Sharp tannin, ed them- the fact ynx. A ire, with Lowever, 7-As some le blood died on n above e touch, Weig-ht, \u003ele firm- ;'atty de- yellow- Is, larg-e h lobule h trans- ?ntre of ed bile- rom the 5 seen to ;' on the lero the •y ducts bladder colour. remark- advanced nonolobii- L' cords of the new ably swollen and llabby : outlines of the pyramids not distinct. General colour, reddish. \"Whitish lines of fatty degeneration aiv seen along the tubules and extending- into the cortex, ilie pyramids are of deeper colour than the cortex, and in these also groups of tubules are filled with granular matter. The intestines contained dark tarry matter, like meco-nium The larynx contained a quantity of sticky blood-stained mucus, some of which can be washed nway by a stream of water. There was then left behind an extensive super-ficial clot extending- from above the false vocal cords to the bifurcation of the trachea. Nothing of importance was observed in any of the other organs. Remarks. — The pathology and clinical history of Cirrho-sis of the Liver with enlargement, as compared wath those of ordinary contracting cirrhosis, are not yet thoroughly established ; and this is my reason for contributing a case which must certainly be looked upon as affording a good illustration of many of the principal characteristic features which have been observed in connection with it. When first this patient came under obserA'ation, we had great difficulty in making a diagnosis, owing to the im-possibility of obtaining correct data from herself concern-ing her past history. She refused entirely to admit of drinking habits, and insist^'d that, having had a slight attack of jaundice, lasting three or four days, in the month of June, she had bi'cn perfectly well until the commence-ment of the last illness in October. It was only some days after that, having procured an interview with her husband, we were able to substantiate the facts as given above. ProA'iously to this, the opinion held was that it was pro-bably a i-ase of suppurative phlebitis of the liver, arising from some unknown cause. This idea w^as based upon the (then supposed) iicute nature of the attack, with",
         "chills 12 HYPERTROPHIC CIRRHOSIS. and lever ; the enlarged liver, with great pain and tender-ness ; and the jaundice, vv'ith absence of ascites. When, however, we learnt of previous hoematemesis, with an ingravescent jaundice of some mouths, cirrhotic enlarge-ment was confidently diagnosed. Murchison says that thest' casos frequently die with jaundice, htemorrhages, and symjHoms of blood-poisoning. This was exactly what was observed in this case. It is now generally admitted that this disease is essen-tially different from chronic atrophy or contracting cirrhosis. Certainly the course and character of the symptoms, as here exemplified, were entirely different from that seen in the common a. oholic disease. In the first place, its rapidity was much greater. In six months from the first indications of hepatic disorder, the patient died from its exhausting effects. In the other, usually many months or years elapse. Ascites is one of the prominent and almost constantly present -vmptoms of the small liver, whereas here it was entirely ; sent, although the changes in the liver existed to a marked degree. Of course this may have been exceptional here, as it may be equally in the disease with shrinking. I have recently been shown by Dr. Osier the liver of a woman in a most advanced condition of fibroid atrophy. She had died of pneumonia, and there had been no ascites or other symptoms referable to the liver. Marked jaundice would seem to be the rule in the one, whilst in the other it does not occur at all, except from casual pressure u])on the excreting ducts by contracting nodules. In consequcMice, also, of the blood-changes in-duced by the intense jaundice, tendency to h;emorrhage in distant parts (not mechanically produced, like ha?ma- temesis, \u0026c.,) are more frequently met with than in the common disease. In this case, fever was a prominent feature at the outset. The reason for so much febrile dis-turbance I do not quite understand. Dr. Murchison speaks of symptoms of blood-poisoning, but I read this to",
         "mean BY GEORGE ROSS, M.D. 18 . tender- AVhen, with an enlarge- lys that rrhages, tly what s (\\sseii- irrhosis. :oms, as lat seen )lace, its the first 3d from months I almost whereas ^ in the lay have ) disease by Dr. ondition nd there e to the le in the ept from tracting' iiii'cs in- orrhaijo ! hfcma- i in the eminent \u003erile dis- II speaks to mean such as we see in choh^mic states during Jaundice from various causes (which are essentially non-febrile), and not such as would occur from any septic derangement of the blood from the entrance of septic matters. I think, possibly, the renal disease, of which there was abundant evidence, was to some extent accountable III. — A Case of Athetosis, or Uni/ntera/, Slowly-moving, S/msm. Frederick T., let. 20, was admitted into the General Hospital on the 28th September, 1878. He was sent from a town in Ontario to be treated for some trouble remaining in his chest after an injury. It may be as well to mention the facts concerning this shortly now, as it is desired to draw attention specially to the nervous affection of which he was found to be the subject. About four weeks pre-viously he had, through the accidental explosion of a revolver, received a bullet wound in the sixth interspace of the left side, beyond the nipple. There was no wound of exit. He did not lose very much blood, but had suffered from a good deal of pain in that side. For some time before admission he had had occasional chills, followed by feverishness, and had occasionally sweated. His appetite was very poor, and he felt weak. Physical examination of the chest determined the presence of a considerable quantity of fluid. Its traumatic origin and the subsequent febrile symptoms indicated the probability of the occur-rence of suppuration. After waiting, therefore, a fev\\^ days for the purpose of observing the patient, with the assist-ance of my colleague. Dr. Roddick, the left chest was opened by incision, and about 20 ozs. of very foetid, somewhat sanious pus removed. A drainage tube was passed, car- bolized and other disinfecting injections were regularly employed, and complete recovery followed, with, of course, some retraction of the side. He was (■'\u003c ^rved to be the subject of an unusual spas-",
         "2 14 CASE OF ATHET()SIS. modic condition of the right limbs. The following- history was therefore taken of the case : — His father is alive and W(dl but a drunkard. Mother died when he was an infant. Has only two sisters, both of whom are healthy. As far as can be ascertained, there is no account of neurotic disease in the family. As long as he can recollect he has been lame in his right leg and weak in the right arm ;, has no idea how or when this came on, but says he has always been so. Has, in consequence, never been able to do any heavy, manual labour, but was employed to do the light work about a house. Knew that his right leg w^as shorter than the left. The limbs of the right side, he states positively, were only loeak ; there never were any movements or twitchings in the muscles. Apart from this he has always been hearty and well. Has never had any illness except smallpox, two j'^ears ago. Four weeks ago he met with the accident above related. Ten or twelve days subsequently, and whilst he was suffering a good deal from the side, his right arm and leg were suddenly seized with active, continuous spas-modic movements. He says that the limbs jerked violently and continuously in this way for a length of time, so much so that his friends were alarmed, and endeavoured to re-strain the limbs by fastening them with bands to the sides of the bed. He never lost consciousness, and is not known to have had any kind of fit. This condition of clonic spasm gradually wore off, and then for the first time he began to notice that the peculiar motions of fingers and toes about to be described were more or less continually present. On examination, the following notes were made : Patient is a rather delicate-looking and pale lad, somewhat marked by smallpox. It is evident that the limbs of the right side are shorter and somewhat less developed than those of the left side. This fact is better shown by the following mea-surements :",
         "— BY GEORGE ROSH, M.D. 16 IIIOHT ARM. Hnnicnis 1 1;{ in. Ulna 8* '• Girth, Mid. Humerus 7.', \" \" Fort'iuni Hand— Longtli G\\ \" RKiHT LEG. Antr. Spine to licad of Fibula. \\Gl in. \" \" \" inner Maleolus 31^ \" Girth, Mid. Thigh llf \" \" \" Calf 9 \" LEFT ARM. iJnmerus 12^ in. Ulna 9j \u003c! Girth, Mid. lliinienis 8;| \" \" \" Forearm 7,\\ \" Hand — Length VJ \" LEFT LEG. Antr. Spine to head of Fibula. 17J in. \" '' •' inner Maleolus. 33 \" Girth, Mid. Thigh 13 \" \" \" Calf l()|- \" Whenever this patient is awake, peculiar slowly per-formed movements are j^oing on in his rig-ht arm and his rig-ht leg. These occur independently of his will, but can be partially controlled if the limb be held steadily quiet for a short time. Consequently, it is common to find him constantly holding his right hand with his left in order to keep it quiet. These motions cease entirely during sleep, except during any change of posture, when similar, but slighter, contractions are observed. It has been also noticed that at times very little motion occurs if his attention has been entirely distracted from it, but is immediately re-newed by merely looking at or thinking of it again. The commonest position for the hand is that of strong ilexion at the wrist, with alternate flexion and extension of the phalanges. The tendons and ligaments of the hand appear very lax, and permit of extended bendings in almost any direction, and notably backwards. The spontaneous move-ments, when watched, appear to consist of a series of muscular contractions, beginning in the extensors of the phalanges and, passing thence up the arm, along the muscles of the anterior region, Hexing the wrist and fore-arm, and rotating the hand from within outwards. At the same time, there is a movement of abduction in the phalanges, all the oilier lingers being drawn away from the middle finger. The muscles of the arm and",
         "forearm 16 CASE OF ATHETOSIS. can be felt to contract, especially the biceps. The muscles of the shoulder and the pectoralis major also participate. All the movements are done slowly and deliberately : no jerking or hurried movement ever taking- place. AVhen directed to shut his hand, there is first extension of the finsrers and flexion of the wrist ; then the thumb is flexed and drawn into the palm of the hand, and the two middle fingers slowly and imperfectly close over it. The index linger remains extended, and sticking straight out; the little finger also is only capable of being partially bent down. \"With any degree of effort of the will, it is only possible for him to retain the hand thus closed for a few moments, for, in spite of himself, extension of the fingers begins again — slowly, and, as it were, with a dragging effort. And so it goes on — a similar rhythmical series of movements taking place, perhaps twice or three times in a minute. He has much more voluntary control over the muscles of the forearm and arm, and can perform all ordi-nary evolutions with them, such as bonding the elbow, putting his hand on his head, \u0026c. Tactile sensibility in the limb is normal. The right leg lies flat upon the bed, the foot extended and somewhat inverted. He can, with difficulty, make an attempt to flex the toes, but can readily perform any movement with the leg. In-voluntary spasmodic contractions are observed to oct^ur at short intervals in nearly all the muscles of this extremity, but not at all so strong or marked as in the upper ex-tremity. Here there is simply a slight, but perfectly appreciable, muscular contraction, generally not suffi-cient to move the leg or foot. The great toe is the only part which moves much — passing slowly from extension to flexion, and vice versa. These movements are quite in-dependent of, and occur at different times from, those of the arm. Sensation is unaffected. Reflex movements normal. Tendon-reflex exaggerated, and ancle-clonus present.",
         "feaUiMHIMflHMIIM BY GEORGE ROSS, M.D. i7 This condition remainiid permunontly, us iil)ovo de-scribed, until his di.schtirge Ironi the hospital, alter a stay of some weeks, which was required for the cure of his empyema. One notabh? exception, ho\\V(^ver, must be made to this statement. For the performance ot the opera-tion on his chest, he was given ether. Previous to this his pulse had been rapid, rather small, and weak ; during- the incision, unfortunately, an intercostal vessel was wounded, and bled very smartly, so that alarming- syncope took place, and we were obliged to invert the patient and take other measures for resuscitation. As soon as the auiusthetic effect was complete, all movement ceased in the affected limbs, and did not return when he regained consciousm.ss, but gradually re-appeared at the end of a week, and did not resume its custoniarv strenath and frequency for several days after. It should have been stated that the intelligence of this patient is of a low grade. He can neither read nor write ; is somew^hat shy and backward ; still, all his answers were clear and straightforward. Remarks. — The condition described clearly belongs to that to which Hammond gives the name of Athetosis. Before the description by this author, this kind of derange-ment of motor function had already been observed, but had not received any particular appellation. It is probably useful to have some one word to designate this special condition, provided it be always understood that it is applied only to a symptom — one which may be common to several dilterent pathological conditions. Dr. Gowers, in a most interesting paper, ^ describes a number of varieties of post-hemiplegic disorders of motion, several of the cases presenting features closely resembling those of this one, and I should like here to quote the views ex-pressed by him of the lesions likely to cause such mani- 1 Royal Medico-Chirurgical Society's Transactions, Vol.",
         "LTX. 18 ACUTE SPINAIi I'AHALYSIH. festatiouK. \" The symptoms,\" ho says, \" clearly point to (lamao-e of the ^rey matter of the brain — to local perverted nutrition of nerve-t-ells, in eonsejjucnce of which they overact, either spontaneously or on the additional stimulus of volitional imi)u]sc. which is, by their over-action, per-verted or irregularly distributed.\" In all, or nearly all, the cases where Athetosis has been observed, there has been hemipleL,na, or, at any rate, some den:reo of hemi- paresis. In the present instance, it would app'^'ar that some cerebral trouble had occurred in early infancy, the nature of which it would be impossible now to say. but which led to partial loss of motor power in th«» limbs of the right side, and to arrest of their growth and develop-ment. It is clearly cerebral, and not the result of infantile spinal paralysis, because of the general and even distribu-tion of the paresis and the entire absence of wasting or complete paralysis of any muscle or group of muscles. A r'^markable feature is the fact of the onset of the athetosis only after the chest-wound. I can only explain it by sup-posing that the shock of the accident, together with the very considerable pleuritic pain he afterwards suli'ered, so acted upon the damaged portion of the brain and its immediat(\u003e surroundings as to set up first a condition of genuine clonic spasm, without epileptic loss of conscious-ness, and then left behind it \" a state of i\u003eer verted nutrition of certain nerve-cells,\" which caused this over-action which is productive of these determinate movements. IV. — A Case of Acute Spinal Paralysis in an Adult {Polio-myelitis anterior acuta). E. L., set. 20, machinist, was admitted into the Montreal General Hospital on October 15th, 1878, with paraplegia and emaciation. His family history is good. His father was killed in an accident. His mother and several brothers and sisters all enjoy good",
         "health. BY GEOR(JE ROSS, M.l). 19 Patient was always strong\" and vig-oroiis as a boy. Has novor had syphilis. At ten years of ago had smallpox. With this t'xcc'plion had no illness whatever, but continu-ous good health until eleven weeks ago. At thi.s tiuK; ho felt, for about two days, that ho was not very well, but did not complain, and continued his work as usual. On the third day he was taken ill whilst at work, and was obliged to return home and Ho down. He suf-fered then from rather severe headache (principally frontal) with general pains, considerable fevt'rishness and complete loss of appetite. Alter two days he felt a numb-ness in the soles of his feet, which sensation kept increas-ing until it was present in a high degrcM'. After some days longer similar numbness was i'elt in the palms of the hands and inside of the fingers, and he thinks his len's were getting waniker, but he could move them about freely in the bed, and was able to stand and walk until about the twentieth day, when he had a fit of som(^ kind, fol-lowed at short intervals by several more, so that within about eighteen hours he had six fits. During the lit he is described as first stiffening up his limbs and then pre- sentino- much clonic convulsive movement. He was quite unconscious during the attacks, and is said to have breathed heavily for some time after, as though stertor had been present Thinks he first noticed after this that his legs were so feeble that he could not stand upright ; is sure that if then the attempt had been made he would have fallen to the ground. Noticed also that his arms and hands soon became markedly enfeebled, so much so that he could not grasp or hold even a very trifling object. At the same time, moreover, a marked change took place in the sensations experienced in his hands and feet. These parts, from having previously, as stated, been feeling numb, became now the seat of severe darting pains — these w^ere much worse in the feet than in the hands — sudden stabs of a most excruciating nature would",
         "dait TTTl 20 ACUTK Sl'INAI. I'A1!ALY.SIS. from th(! solos of his i'wt up the backs of his legs, and cause him lo scroum with pain; but the hands still felt somewhat numb. If auythiuy touched or struck aj^ainst the cuds or insidcs of the Hngers, ho would ex[)crieuco violent shoot iny- i)aius all tht! way up to the shoulder. But the pain rarely occurred spontaneously in the upper limbs. The soles and sides of the feet also evidently became excpiisitely hypm-jcsthetic, for he says he could not permit of eveu the liii'htest tou\u003c'h upon these parts without a sense of •\u003ereat sullerino-. During this time he had been riii)idly losinu; llesh. Has throughout had com- plett; control over both bladder and rectum. After lying in bed in this hi'lpless and painful condition for about two weeks longer (ic, about the tilth week of his illness), it was first observed that his knees were becoming some-what drawn up. He soon began to improve, and thinks he has much more ])ower in the limbs now than he had some weeks ago. The pains have gradually subsided, and are now nearly gone. On admission his condition is as follows : — He is very much emaciated, somewhat i)ale, and wears a look of pain upon his face. He lies upon his back, with both legs moderately Hexed at the knees. Any attempt to strain-hten them gives pain. He can, in bed, move the limbs in any given direction — the knees can be only partially extended owing to the contraction mentioned — but with this exception he can use all the muscles of the thigh and leg. The movements are very much weakened. The grasp with either hand is extremely feeble. Tactile sensibility is everywhere normal with the following exceptions: — the skin of the sides and soles ot both feet, and a considerable portion of the dorsums as well ; in fact, all but as mall area just in front of the ankle- joint, are markedly hy;; eruisthetic. The skin of the ends of the fingers feels somewhat numb, and it hurts a little still if they are struck. On scratching the soles of the",
         "feet, HY (lEOROE UOSH, M.l), 21 there are liv«^ly rcllcx m()v«'mt'nt.s; it is not easy to Judiye how much of this is voliiulary on account of th(^ sensibil-ity of the parts, but thc^ patient declares he does not draw them away because^ of ])ain. There is no increase in the tendon-rellex, either at the li\u003c^amentum patellie or at the tendo Achillis. Chest origans sound. Heart only weak. The urine is pale, somewhat alkaline, deposits a ftood deal of white sediment ot ])h,jsphates. There is no fever. Pulse 90. Dr. Bullei kindly examined his eyes, and found no defi- nih' pathological ai)pearance, but noted a somewhat turbid stale of the margins of the optic disks, which he thinks might be the precursor of an optic neuritis. Since admission, I may state that up to the i)resent time (81. st October) this patient has improved very materially. This is most marked in the hands. Power of grasping has increased with great rapidity, being jilmost noticeable from one day to another. lie can move the le^i's with greater freedom, and can also extend them much more than before. The hyperiesthesia has l)ecome much lessened, and numbness has almost left the tips of the lingers. He has a good appetite, and sleeps fairly well. He has been taking — Potass, bromid, r,iv. ; Tr. ferri. mur., .\",iii. ; Aqua? ad,, .ivi. ; .-,ss. ter. die., and has had lin. belladon. applied to the feet. The principal outlines of this case might, I think, be condensed in this way. A young and previously healthy man is all at once taken down with a feverish attack pre-senting no very special features — a feeling of sickiu?ss, headache, and pains in the back and limbs. Very soon there is added the first distinct indication of some disturb-ance in the nervous system in the form of paresthesia, numbness in the lower extremities. The fever continues, and the numbness invades the upper extremities. After twenty days occurs a series of iits of an indefinite char-acter, but apparently accompanied by loss of",
         "conscious- 22 ACUTE SPINAL PAHALYSIS. II ness. Immediately after {i.e., as soon as consciousness returns) he experiences pains in the previously numb parts (espeeially in the feet) ol' a very excruciating characti^-, and it is soon found that he is paraplegic. Great loss of power in the arms occurs soon after. lie gets rapidly thin. The soles and sides of the leet become excessivi^ly hyperiesthetic, and the lingers are affected in the same way to a less extent. He comes under observa-tion eleven weeks after the commencement of his illness. There is then great emaciation of all the extremities, and especially the legs. An incomplete paraplegia but no definite paralysis of any i)articular muscle or muscles, legs somewhat contracti'd at thi^ knees, great deficiency of power in the arms. Tactile sensibility normal every-where except on the soles and sides of the feet, which are markedly hypenesthetic, and some numbness in the fingers on being touched. The ordinary reflex movements increased. Tendon-reflex not present. Much improve-ment had taken place as to power over limbs ; and this improvement has continuiMl since admission. Intellect clear. No cerebral symptoms. No implication of bladder or rectum at any time. This series of symptoms is in itself sufficiently remark-able. I think there can be no doubt, from the })ara- plegic charai ter of the attack, from its involving finally all four L'xtreraities, and from the absence of all symp-toms of a cerel)ral nature, beyond the single attack of a spasmodic nature, that the lesion is situated in the spinal cord. Then whether, as I have been asked, the paralysis be consecutive upon ty])hoid fever or soijie other specific unrecognized febrile disease, I think the fact of the very early occurrence of the altered sensation in the limbs precludes entirely this idea. If this position, therefore, be correct, we have here had an acute spinal disorder, commencing with marked febrile symptoms, leading to a rapid and extensive paralysis of",
         "motion, HY GEORGE ROSS, M.D. 23 accompaniod by certain disturbances of sensation, but still leaving the general sensation in the aifected partfs intact. There is no allection, as far as I know, which presencs a similar symptom-picture except that disease which is the analogue of the one long known under the title of Infan-tile Spinal Paralysis. It is a recognised fact, in the present pathology of the spinal cord, that organic (-hanges of an exactly simi..4,r nature and locality to those found in infantile spinal paralysis may develop themselves in adults; and though quite common in the former, it is exceedingly rare in the latter. It is described under the name of A(;ute Spinal Paralysis of Adults, and by Erb (in Ziemssen, vol. xiii.,) it is designated, from an anatomical point of view, Poliomyelitis anterior acuta. With a view of substantiating the similarity of the case I have reported to those referred to this category, I may be permitted, as briefly as possible, to sketch from the descriptions of Erb, Hammond and others the main features of this allection of the anterior gray horns as seen in children and in the adult. Which done, I shall only add a few remarks upon som(! very striking symptoms observed in my patient which do not belong to the typical and uncomplicated disoraer. It is remarked that in adults, as compared with child-ren, the manifestations are esocntially the same, but merely modified by the fact that the brain of the adult offers somewhat more resistence to the initial disturbances, that the general organism is not so highly disposed to fever, and that the growth of the bones is alreai-'y completed, and the firmness of the joints is greater. It is said to begin wnth a general ill-feeling, with fever which is often introduced by smart pain in the back and limbs, and not rarely with pancsthesia (formication, a feeling of numbness, \u0026;c). : cerebral symptoms are generally wanting. General convulsions have never yet been observed, but severe headache, dullness,",
         "somnolency 24 ACUTE SPINAIi PARALYSIS. and even slight delirium occur. Well-marked gastric symptoms have been frequently observed. In some cases the fever reaches great intensity. Then paralysis devel-ops rapidly— in one night i)erhaps, or in a very fev^ days. It is complete, widespread, and the muscles quite fla-:' ^'d. Iveilex action is lowered or exlinguhhed ; though, in some (\u003eas('s (Erb), it may be retained, at least in those muscles which are not permanently or not completely paralysed. Then, as in children, follows rapid commence-ment of improvement in the paralysis, until linally it may entirely disappear, or at any rate some of the muscles quite recover, leaving only certain groups or higher muscles permanently affected. There is said to be no trace of dis-turbances of sensation. The patient is rarely sick enough to go to bed. The general nutrition soon gets quite good again. We are more familiar with the current of events in children. With them the first is often fever. Not seldom convulsions, and , sometimes other A'ery severe cerebral disturbances, such as deafness, coma and delirium. Then a pretty sudden paralysis of variable extent, with flaccid limbs and without disturbance of sensation, or implication of the sphincters, or bedsores. Then arrest of ^he paralysis and a gradual improvement, some special parts, however, remaining permanently pav'^lyzed. In these we have the reaction of degeneration. The development of the bones is retarded, contractions take place, and many varieties of deformities are thereby produced. It will, no doubt, be observed that the points in the case which do not agree with this description are the following : 1st. The tits. 2nd. The hypenesthesia. 3rd. The pains, and the increase in the reflex movements. 1st. With refertmce to the convulsive spasm, with unconsciousness, which is mentioned as having- occurred on the twentieth day of the illness, I may say that we iiad much diiliculty in getting any clear account of",
         "the BY GEORGE ROSS, M.D. 25 attack. His mothor has once described them as distinctly- epileptic ; on another occasion as entirely wanting the characters oi' epilepsy, but being- rather tetanic. On the whole, however, I think they must be looked upon as having been of an epileptiform nature, especially from the accompanying unconsciousness. As I have stated, Erb says that general convulsions ;,r. 3 never been observed in this disease, and they are not a. .ded to by any of the other authors I have consulted. Still, they do occur pretty fre-quently in children at the outset of the disease and before the occurrence of paralysis, which might be used as an argument (although admittedly a poor one) in favour of a possible similar occurrence in an adult. Besides, this case would appear to have been of an exceptionally severe nature. 2nd Tlie hi/perccsthesin. — In the typical disease, sensa-tion is unaltered. It must, therefore, stand as proof that other parts of the cord are all'ected than those implicated in ordinary acute paralysis. It would, perhaps, bo very difficult to hazard an opinion as to what part this is, as the manner in which hyperesthesia may be produced is certainly not well understood. 3rd. — The occurrence of severe excruciating pains after the onset of the paralysis and the increase of reflex movements may^ be taken, along with the exalted sensi-bility, to prove that some factor is present beyond the lesions ascribed to anterior grey myelitis, because it is painless, or nearly so, and the reflex acts are nearly al-ways unalfected. The question that has arisen in my mind is, Would extension of an acute tissue-change, going on in the ante-rior horns to the posterior horns, account for these extra-neous manifestations? If so, then we might be justified in looking upon this case as one of acute myelitis of the anterior horns of gray matter, plus some subsequent disturbances in the gray matter of the posterior horns."
      ],
      "title" : [
         "Medical cases",
         "CIHM/ICMH microfiche series ; no. 01876"
      ],
      "type" : "document",
      "identifier" : [
         "01876",
         "FC 02 0203 no. 01876"
      ],
      "published" : [
         "[Montreal? : s.n., 1880?] (Montreal : The Gazette)"
      ]
   }
}
{
   "doc" : {
      "title" : [
         "Pulpit criticism [No. 46 (Nov. 25, 1882)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_05108_43"
      ],
      "published" : [
         "[Toronto : s.n., 1882]"
      ],
      "text" : [
         "November 25th, 1882. No. 46 TRINITY COLLEGE CIJAPEL. QUEEN STREET, WEST. A city tradesman bas announcedi \"]ulpît Criticism,\" aithougli, so to his friends that \"he: bas gi-yen far as circumstances admit, he up religion, and joined the Church pays oc\"asional visits to the Epis- of England ;\" in view of tÙhat nurn- copal Churcb, bas not on that ac- erous crowd -who p5ut on the cloak count, necessarily Ilgiven up re- of religion for business and kind- jligion.\" One can hardly visit a red purposes, the throuig off Me College, the principal objeet of dloak, on the part of this gentle- -%whichl is to educate men for the mnan, for the like purposes, and I xinistry of the Episcopal Ohurcl, joining the Church of England, without reflecting on the beari-ng plate. Owing to the nature of ents themselves, and on those this gentleman's vocation, there among wý«hom the students will ulti- can be littie -doubt that the course mately min gle ; in young countries he has pursued, has resulted in 'isespecially, t he bulk of the commun- having establislied the most friend- ity rnay be said to have been large- ly relations with tbe mammon ly educated by the circuinstances, of unrigbteousness. There are Iin the midst of -wbich, they move; those, probably -who will conclude \"Iron sbarpeneth iron; so a man that a man wbose mental condi- sbarpeneth the countenance of bis tion leads to bis giving up religion, friend'\" Prov. xxvii, 17. In pro- and joining the Churcli of Eng- portion as this m~ay have been the land, should be ostracized, sent to case, will men realize that 'the ef- the small-pox hospital, or possibly fect of a College education is to to the other hospital, where tbey alienate and estrange the recipi- are in greater need of subjecs ; and ents of such an education from it is within the bounds of possibili- themselves ; they for their part, e ty that this living,' and doubt1ess owing to the enchantment whtch loyal subjeot of Rler Majesty miglit distance lends to views are be of greater benefit to the coin- prone to assume that the edu- munity ini a dissected than in an cation of a Colle g is some- undiesected state ; if the disorder tbing prodigious, and the gradu- of giving up religion sbould, be- ate, if he be replete with nothing corne contagious, we shaîl proba- else, is generally bloated with con- bly soon hear of it resulting in ceit; the practical outeoxue of sucli meon relinqushing it, in order to a condition of things appears to bo join the Methodists ; we must an ever--widening brahbetween cherish the hope meanwhiie that the class of Divinity students, and the Professor of Homiletics of this ail classes who have been taught College, when hie relinquisbed to take their estimate of mon and \"the errors of Metbodism,\" Ilin things, by daily experience. order to join the Ohurcli of Eng- The test of the value, or land,' did not necessarily at the the worthlessness 'of a Collegze saie tme givo up rlgion -'l curriculum which is afforded b;y we trust also that tlhe Editor of the teachings of the College-tauglit,",
         "undeniably serves to show that the influence of such teachings is of the nature of a dissolving view. As one enters the building of Trinity College, one is confronted by that ornamental extinguisher, the mitre, in conjunction with an amusing modification of the sym- bolical cross-keya. of Rome; the diocesan coat of arms substitutes a crosier for one of the keys, and intimates thereby that the bishop will do his feeble best to conduct erring and straying sheep to the abodes of bliss, without pretending to the infallible authority involved by the possession of the double keys. As the writer sought to \"improve the occasion\" while waiting till the service com- menced, he opened a hymn-book, wherein he observed, on printed label, \" The third commandment obliges us to use both the name of God, and ail things that are con- secrated unto it, having His name and stamp upon them, with all due regard.-Bishop Cosin.\" lie consequently would pay \" all due regard\" to the following couplet which commences a verse in the hymn No. 476 :--\" Truly Jerusalem name we that shore, Vision of peace, that brings joy evermore !\" The Society for promoting Chris- tian knowledge has enriched the hymnology of the age with this contribution, and another, (No. 586) in which the congregation sung of \" yonder ransomed nation,\" what- ever that may happen to mean ; the petition to \"illuminate the Bishops,\" anl to \" forgive the ig- norances\" of their Lordships, came with the more force as the Bishop of the diocese happened to be pres- ent; His Lordship, and the rest of th3 congregation, with the ex- ception of a protestant or two, wheel- ed round to the South/, s.o soon as the Apostles creed was read; the \" dimn, religious light \" from the windows possibly prevented their perceiving that they were not fac- ing tke East; another ludicrous change of posture was observable when, as the offertory money was placed on the table; they rose, pos- sibly in order to witness the re- markable spectacle. One may presume that there is no\"professor of . elocution among the Collegiate staff, as the mode of reading the service by the three professors who officiated, was singularly un- fortunate; one of them was appar- ently so unfamiliar :with the ser- vice, as to guide himself by the aid of a be-ringed finger, until he reached the Lord's prayer, when he ventured to run alone; he who read the lessons, did so in an Ec- clesiastical drawl which is but too characteristic of such a proceed- ing, and the gentleman on whom the reading of the litany devolved, discharged the duty in a tone be- fitting \" a miserable sinner.\" Of the hundreds of thousands in all parts of the world, who would on the 19th inst., hear the third chap- ter of Amos read, without any at- tempt at explanation, who among them would have any idea of its meaning ? the same enquiry will, of course, apply to the psalms, and all the other portions of Scrip- ture read in the public worship of the Episcopal Church; the per- petual ringing of changes between confession, and \" absolution,\" (with the demonstrable unbelief of the latter) which characterizes the whole service, suggests that, so far as the ministerial order is con- cerned, \"as it was in the begin- ning\" of the Reformation, \" ever shalh it be,\" unless (which is not altogether improbable) compara- tively enligh-Gened laymen step in and prevent it. The Bishop deliv- ered an essay on the passage \" Learn of me,\" Matt. xi, 29. It is possible, one may presume, that the surpliced young men who formed the majority of the congre- gation, would be more likely to learn a lesson of meekness from",
         "his Lordship, than woiild a corres- ponding nuniber of artizans ; such artizans as might be the possessors of that trinity of graces, faith, hope, and charity, would find them ail brought into reqauisition by the Bishop's written discourse. Coin- mendations of meekness, when filtered through a medijum of black satin, fine linen, and gold, would b e apt to, make a demand on the artizans' faith ; the more so, if they refiected that froin that s ame shere, and froni the saine prelate, had fallen counsels to «\"'the infer- ior clergy \" of Ilstreet recogni- tion \" of men who, ini point of cul- tivated intelligence are those saine c1ergymen's superiors ;--these ano- malies notwithstanding, the artiz- ans inight possibly bring the anchor of hope into play, and ex- press the pious aspiration on be- haif of the Lord Bishop-\"l Wouid L to, Goci the gift to gie us, to see oursels as ithers see us;\" their charity also would, one may trust, exceed that of the Editor of \"lFui- pit Oriticism,\"- iead themn to throw a veil over the Bishop's misquota- tion and bad grammar, and club together to send Ris Lordship to the Evening School for\" M. A.s. \" EVENING SCHOOLIFOR 'M. A.'s.' [NO. 2.] .! As we have ascended, as it were by the pulpiù-stairs, among11 \"the occidental stars \" of this Domin- ion, we find the society of our ex- alted associates so congenial, that we are loth to relinquish it. Among the teachers of teachers who may be expected to crowd -our school, are those Professors of Colieges and editors of newspapersj who have yet to iearn the distinc- tion between a Oo]lege and an University. That numerous class of educational body-snatchers, 'who have iîad the hardihood to -exhume the corpse of the late la- nented debin,\"f aid parade it, wake-fashion, beforeý the astonish. ed crowd Of bystanders-that num- erous class will, of course,, contribute to swell the already surging crowd of seholars. The principle of reciprocal instruc- tion which, will be adopted in the school, wiil doubtless be at- tended with the most auspicious resuits, for when the Lord i3ishop of Toronto takes his seat on the first forni, by the side of Ilthe metropolitan \" bishop, they wili at once arrive at an understanding with regard to mutual \"lrecogwd- tion ;\" the Lord Bishop wili hand over to \"the metropolitan\"- Ris Lordship's essay on \"meekness,\" that the essay may, when served up again, be ciless productive of yawns, and \"the metropolitan \" will transfer to the Lord Bishop the subjoined verses froni the hymn (225 new book) which hé' commended to the adnîrîng crowd at his conventicle as Ilone of the sweetest that was ever wrote \" IlThere's a wideness in God's mercy Like the wideness of the sea; There's a kindness in bis justice Which is muore than liberty.\" IlFor the love of God is broader Thari the measure of man's mind, And the heart of the Eternal Is nîost wonderfully kind. \" Whether the Lord l3ishop wilI 1recognize \" the teachers of the Evening School, (as hie does the Tutors of Trinity College) as il comimissioned by the Ailwise,\" is among the probleins of the f u- ture. Archbishop Lynch will pro- babiy visit the school, in order. to ascertain the progress his brethren are making, and the combination of the three illuminators mnay be exà,pected to eventuate in the or- ganization of an Agnostics' Aid Association. Last, but confess- ediy not least considerable, an4 with the, comnbined loy.. t vide Il Rvenzinq Tekmearn.\" / 'j",
         "H alty of Globe and, Mail be it certainly avoid saying that CC the whispered, that distinguished~ remembrance of that day she will patroness of tlie education of wo- ever remember.\" men, Rer Most Gracious Majesty the Queen of Great Britain, and - Empress of- India, who at the sarne The subjoined paragraplis, ex- time is acknowîedged by certain tracted from a synlopsis of the coný- persons to be \"1Defender of the fession of faith of Alexander Faith, and Sùpreme Governor of Campbell, the principal founder of the Ohurcli, withjn these lier Do- the sect known as the \" Disciples minions \"-that exalted and rever- of Christ,\" may serve to account ed lady will, with lier cliaracter- for the impression which prevails istic readiness to promote good in certain quarters, as to the views works, whenever she may visit of the above-named community, thîs portion of lier dominions, set in relation to the Holy Spirit. The the example of taking lier position paragraplis are taken from \" The in the school; one of the lessons .American Cyclopoedia,\" Vol. vi, which Rer Majesty will have p. 182.: ]ived to learn, will be, that \"don't\"' \"lT believe in one God, as inani- when substituted for \"doesn't,\" is fested in the person of the Father, a violation of the Queen's Eng- of the Son, and of the Holy Spirit, lish,* and wlien Rer Majesty may, wlio are, therefore, one in nature, after quitting the school, next ad- Power, and volition.\" dress lier loving subjects, in rela- ccI bt.iieve in the operation of -tion to the mod in which she lias the Holy Spirit tliroughi the word, been receiyecl in public, she will but not with out it, in the conver- * Sce IlLeaves fromn the journal of our lire in sion and sanctification of the sin- the Highlands.\" nier.\"e 8\u0026'\u003e In the event of any irregularity occurring in the delivery of this publication, the Editor requests that lie may be addressed respecting it. MEDIQAL OEIIISM, by the same Author, sold at Hawkins \u0026 Oo.'s, 67 Yoge5.J ftatt. Prie*, 50 Cents. ýr-- I I"
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      "label" : "[No. 46 (Nov. 25, 1882)]",
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         "University of Western Ontario, D.B. Weldon Library, London."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. D Coloured covers/ Couverture de iouleur D Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque D Coloured maps/ Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these hav3 been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, nais, lorsque cela était possible, ces pages n'ont pas été filmées. L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, onq qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ i Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison D Masthead/ Générique (périodiques) de la livraison Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. loX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "JOURNAL DE MEDECINE DE QUEBEC. OCTOBRE, l823. PREMIERE PARTfl. Manucl Médico- LéUgal ds Poisons itroflduilç dans Z' E stomac, et des moyens thérapeulimoes qui Lur conviennent ; par C. A. II. A. BERTR.L D, Docteur M1decia de la Faculté de Paris, \u0026c. \u0026c. D ANS la vue de donner à notre travail autant d'utilité et d'étendue que possible, nous avons juwqu'à présent dévoué cette partie de notre ouvrage à Panalyse de divers traités qui embrassent des sujets essentiels à la connaissance de nos lec- teurs ; il nous reste maintenant à nous occuper d'une science qui intéresse également le Jurisconsulte et le Médecin. Quand nous serions moins redevable aux Messieurs du Bareau pour laccueil généreux que les plus éclairés d'entre eux ont bien voulu donner à notre publication, le besoin de Médecine Légale. se fait depuis trop longrte:ns sentir, surtout pou- ce qui regarde les Moy'us d'établir des preuves, dont le Médecin se dispense quelquefois, mais qui sont nécessaires à la punitiou du crime ou à la protection de l'innocence, pour que nous ne tardions pas d'avantage à donner à ce sujet l'at- tention qu'il mérite. Le soulagement des souffrants et les consolations qu'il verse dans le sein de la misère, ne sont pas les seuls devoirs de celui quise dévoue à l'exercice pénible de la Médecine. La société attend encore de lui un service non moins important, celui de travailier à la sureté de ses membres. Sans l'aide des lumières que cet art lui dévoile, le Magistrat ne peut",
         "AmALTsZ CurlTIWt. exercer evec fruit la plus noble des prértzatires dont le? hommes réunis lui aient confié le précieux eépôt. Chez les peuples qui ne connaissent d'autres lois que la volonté de leur chef, ces lumières sont nuisibles à l'ordre établi en créant des mécontentemens, puisque la -conscience de son étai qui fait ie vrai supplice de l'esclave, suffit pour lui faire rompre ses chaines. Mais sous lEmpire glorieux qui nous gouverne, le secours que nous pouvons prêter surtout à ceux pour qui l'étude de la Médecine n'est pas absolument indis- pensable, devient pour nous un devoir d'autant plus impor- tant qu'il est intimement lié à la juste administration du pou- voir judiciaire. L'ouvrage que nous avons sous les yeux est un traité élé- rentaire sur les empoisonnemens, et nous en av'onas fhit chix pour servir d'introduction à d'autres beaucoup plus considé- :ables dont unus nous occuperons bientôt ; mais avant que d'entrar dans le mérite de ce livre, nous dirons un mot des circonistancer, dans lesquelles PAuteur s'est trouvé lors de sa, p~ubî!:cation, M. BERTR.ND s'est aOpliqué d epis l'an ISI aux re- cherches toxicologiques qu'il a réunies dans son ouvrage, et a rurtout donné rue attention particulière à remploi de l'albu- mine délayée dans Peau, et dela poudre de charbon de bois en solution aqueuse ; et cela, dans le même tems que M. Orflajettait les fondemens de son immorte! ouvrage sur les poisons (le tous genres. Mais des motifs particuliers ayant retardé la publication du sien, M. Bertrand croit devoir faire cet aven qui nous parait d'autant plus raisonable que les premiers indices en sont donnés dans le Journal Général de Nlifjecilic pour ISOS, 1810 et 1511, époque à laquelle notre auteur publia dans le mènie Journal quelques observa- rinrs sur l'utilité d:t charbon de bois dans ccains cas d'em- poisonnement. Mais nous verrons par la suite que pendant que ces deux Médecins interrogeaient dans le même teins l'expérience, chacun parait avoir obtenu des résultats diffé- rens dans quelques-unes, et c'est ce qui nous a engagé à nous arrêter un instant sur cet objet pour mettre nos lecteur plus à porté de juger du raérite de l'un ou de l'autre, daus les dif- fPrens points de contact que nous ferons observer, lorsque nious passerons à Pouvrage de M. Orfila. DèNon introduction, M. Bertrand s'attache à faire voir \" que Ya'ctinn des poisons a de; relitions spéciales avec la sen8ibihité pro. j e au ditTérent espèces d'animaux, et avec les organta decha- que tspèce. Lcs c,..chons se ncurrissent impuuénctt de jusqua.",
         "Ax.LTsr. Caiiteer. I .) cme ; les clevre5, de ciguë a1quIatirpte. dle titlvude : elles ian- gent au5ss, ii; faut eu croi e quelque botanises, I niuit tue-loup; et la reine des prés (spirala ulmaria, L:xs. ), que r-jettent les Veaux, fait leurs déhves. Les oiseaux s'lintnt de la pimipe -qui entoure le no,eu du laurier-cerise, dont leau distillée et celle de ees feuilles sout un isonso pour Phomme- Les esilled-. s. lent avect de *l'wlébore. Les vhevaux ne peuvent supporter les feml!es de imeris.er (i)runus padus Lixs. ). L'arsenic est seule- tint un dra.stîu. pour les t.biens et les loups; l'alcës f£ait périr les renlards et inê.e les chiens à faible dose ; les amandes douces qui servent à nos divers usages tuent les chats, les renards, les roui- ties et 1.; famille des galInacées, le poivre les cochons, les amai.. des lmtères leS chiens, le persil les perroquets. Quand à leur moede d'action il n'importe pas autant, com- me l'auteur le pense, de savoir si leurs propriétés délétères se portent essentiellement sur le principe de la vie organique, suivant Bichat ; ou si d'après les expériences de Legaiuis, elles se dirigent sur le principe commun des deux vies.- Cette considération ne doit point trouver place ici puisqn'dl est avoué par tous deux que les poisons agissent sur le même appareil d'organes, et que la solution de la questiun se réduit a décider si la moi.le de l'épine cst le siège de la vie organi- que seulement ou le centre commun des deux vies. Dans des sujets qui demandent autant de clarté et d'exactitude que celui qui nous occupe, on ne saurait trop se tenir en garde contre le penchant si naturel qui nous porte à chercher dans des hypothèses ce dont la raison ne peut se rendre compte par l'observation, surtout si l'ou envisage combien il est quel- quefois facile d'établir par leur moyens, des propositions es- sentiellement opposées les unes aux autres, et dont les con. s%,quences conduisent souvent à l'absurdité. La mort produite par les poisons ingérés arrive, 1. par in- flanmation de la surface de l'estomac et des intestins, et ses suites, 2. par asphyxie ou annéantissemiient de la respiratior. 3. par syncope ou cessation des mouvemens du cœur ; entn par apoplêxie ou nullité des fouctiors du cerveau et des nerfs. Tels sont les différeus genres de mort qui résultent de Pac- tion des poisons, et quelquefois du concours de plusieurs d'en- tr'eux. Mais Paptitude à recevoir leur impression dépend \u003cle plusieurs circonstances, dont la plus rmarquable est Pé- tat de vacuité ou de plénitude de lestomnac. Morgagni rap. por:e que dans un festin, dont les mets du dessert avaient été apprêté-s ascc de l'arsenic au lieu de farine, ceux de, convives qui avaient bu et mangé abondamment furent sauves par le vomissement, tandis que les autres mourureat en peq A i)",
         "196 AXAr.se CamT ur. de tems. Ma.ona fat la méme olser7ation.. L'anteur Te. marque de plus qu'une substance vénéneuse interposée- entre des alimeus aura une action moins pernicieuse sur les tissus organiques de l'estomac, que lorsqu'elle iera en suspension dans an liquide qui eta favorisera i'absorpton, si.elle est dis- soluble. \"I rapf dit que les .cides, l'esprit de vin, rean de vie. l viii. r'eau miellée ou-sucre., contribuenît à renutee be.aîuaup pha1 vê- néiaes un grand nombre de p 1:intes ie la 4mi.c dc iltissencula- 4cis, telle estl'inifutionJà deuences de.la piotutt.a éknee (dà- tura str:monium, ',das. dit vita. Après ces niodons intrcductoircs, nous allons suivre M. Bertrand dans la considération des aq;us particuii:s qu'il divise eli trois elasses. La première comprend tous-eux qui agissent par corrosion ou par léublon je tissu organique ; la seconde renferme les suatacas qui entr.iuaent 1:a mort par un excès d'irritabilité et de sensibilité-cr;aaiique ; la-troi:ième de celles qui occasionnent lastuperaction ou le sarcotisme. Cette classificationi est celle que suivuit Bicitat dants-ses cours de Matière :uedicale, et 11nus son:cs porté : croire que quand elle ne siait pas la plus scientifique, elle est au moins la plus avantageuse pour ceux qui diSirent acquérir les élé- mens de cettecscience. C'est poaur cela qu'elle comcient amieux que touteautre au but que '. utéur ze propose dans cet ou- Je Ciiapitre premic*r traite des empoisonnencns par les arits i:rique, ri.oriatique, sulft.;ignae et pbospborique. Nous et:pru:erc ptur c cunner uu apperçusidèle, liaroles uèmtes d!e;'.ACieur; ** ::-..1..:: ...a:, î¡s:el'n ex:tine pou coea.'tUer r'exia:ence de l re l'il Si: t-e:t:puar l'n::e îata:qa:e :cau-fe., vit escure, et (;i.e I'9Sn!* a se pse urt\u003c~ ur.. ts t:u-1,gian u i naatièreiadu ~emn;\u003cSias, I. lt teit:te pî:.îre desIévres. \u003cdes dents, du foand dj, la fr;r, dua men:tonî et dsiu:sa; 2. l'.acidatédes aiaatières vo- 3t:es '.;z'î fe.:ïervescenice iiec. les ciarbionte, a;kslins en- déga., j;. an ~ g :v: car bnigue, 'et qusi exsdesít lës;vanuaislli. q.ags; $. ha ii oiorondes fregetuux en:reuge; . d.:a noea peeécipa- itao e \u003cistig aaderd.: Isate, *'e piln.la et oisi'ea't Par he ïuairSe% aam;enselC:s, .soigikiuscmett.reesieillies et-lvées ; e. la déromyc:lition secipaaoquse qui a iieu aveo:une-rive ehlerves. cec taitré acide .itsigne et Thuiie volatile dej' dur1be18ine, de laqiscile 'rdilte 'au résit:u-a odeur de ai.usc; O. la issolis qui sulê:eé:;ament avec efeirvesene et déggesentt degia nitreux, eia useit:aa ne laied'ai'git ireape \u003cteaa, les liquídesreadu on trouves \u003c:i;üfesta tfiac..uisenèosu de Paide.'itrique,;;7. le pro praete ena cet a010us.de caguerlaàusemine du blasi d'oeufen fer..",
         "AN.LSE CrTIQU . mant d'abord un précipité b:nc très abondant, qui tic tarde pas à'deveiiir jaune ; d'enfiammer, à l'aide de la chaleur, le haribo, le phosphore et le soufi're, cil ci uléga.reant des vapeurs orige. s de gaz acide nitreux, seroit autant de caractères essentiels pour délerminer 1a nature de ce gente d'empoisoiieient. Lors3que la mort suit de pies l'empoisonimen t par cet avide, :1 n'y a point d'alPeration sensible des forms extérieut es du corps; le bord libre des lèvres est cautérisé, racorni et teit enjaue oin- té ; on voit quelquefois des tacies de mie couleutr aux maimsnC sur dPautres parties du corps ; il sort de lu bouti:e oit dlu liez un liquide j.titre; la nembraie nitiquense le la catité bccale. et les dits, oit auîi teintes ci jaunie ; l'S.sophage est enduit u'une cuche denise, jatnî:tre, fet uie et gra\u003ebc ; Is part;es sous-jacentes s*mtît é liviné es . le %ente est m:tornsé ; g..ind l't tonac iest ' .:s perre, il est tiistet:du par des zaz que 'oit dit inir l'o.:cur d'mndels amères ; ses tn:ques sOi.t entiu.imées, et otIren:t mén.e des Iebes gaigrénenses sur un for.d d'tuin j.mine vercttre avec en- dmt låteu. et grein de mmixie coî:înir ; Ca face péritoîié.e e't adhiérente aux organes voisins, tes r:dts de sa membrnie muuq·.a- se se résolveit en) uin liquidetmnilagineux, soni ouverture pylonr- \u003cute est r: tiécie. L'iiitérieir dud'udemiiî présente dcs aîttie - rious analogues. La surface interne des autres iiies:m, su, tout cellesdes iitestinsgreles, est plus ou moiis plîlogoste et alhi.rcntc. On observe uit paichementsanguinolent dans les cav ités du tbe alimentaire. Lorsq.ie l'estomac est perc, on remarque, que le- bords le l'ouvert ture sont circulaires et mmliecs, et que l'épanche- ment dle la isatière épaisse, jaune, floccontieuse, s'étenid jusque dans la cavité abdominale : la surface extés heure drs viscère-s coi- tenus dans cette capacité oil're des traces de l'actionî directe ou ci.- naque de l'acide initriqtie: elle est teinte en ja:e. 1uand l.i mort arrive longtems aprés lempoisonne:nent par l'.:cide iitrailue, etn rem:îrqtue mie nigîireur extrenie le tout le corps ; les organes son.t flé! ris, de.zécités, le casal a'i:nentaire t st prodigieusenit'nt re, 'treei, surtout le py!ore ; l'iitérieur dc l'estomac prseentc drs ta- ch's d'un ronge vernmel, indice de la formation d'une nouvelle metibran3 muqueuse ; les trous q:e l'on d:ige à lestomac, stit quelquiefois bouchés par les adhlétenices qte ce vistére con- traete avec les parties voisiies. La présence de lacide sulf::rique se recon:iaitra, 1. à la teinte noiràtre, 2. à la propriété qu'il a dle rougir la ttii:îre de v:olette et de tournesol, et de former, par le iitrate d'arget. le titrat: le mercure et l'acétate de plomb liq itie, un précipité laclti pesatit et non liquéfiable dans les acides.; 8. à la faculté qu'a la poudre de charbon de bois de lui enlever son oxigène, à l'aide de Li cha- leur ; 4. à celle qu'a le nercutreluirsquî'oin le fait bouîlir avec cet acide, de lui enlever son oxigène, de â'oxider et de dègager uit guz acide sunlureu x La démuonstration dle l'acide muriatique est rendue sensible, I. par la couleur biancle qu'i dleterinitie sur les mat;ères animales ViYantes ou mortes ; 2 par la comoratioiu d'un blanc jauniiàtre q'dhi 197",
         "A AL3L. CirIQur. opère .iur les couleurs bleues végétales; 3. par lesprècipités blancs on mnlri ties insolubles, qu'il forme atec les seli de plomb et d'ar. gent \u0026'nlcment ; 1. par un coaguluru épais avec le lit ; enfin par son déf.int d'action sur l'eiu de chaux. Suivant Bergnanni, le iii. triste ni'ar:zeni décèle la présence d'eiviroit c,-ut ndhioèmises d'acide imîîriatqigse dans les liquides, par un précipité argenté; d'aprés Scheele, de petites lames d'or ou des feuilles de ce métal, jettées d!anîs de l'acide truriatique oxigéné, s'y dissolvent sans ef'erves. :eoce en les agitant, et colorent le liquide ent bea;i jauie.\" Dans le Chapitre second, qui traite de Peiet des alcalis, on lit ce qui suit :- Quand ces substances sont prises à une certaine doFe, elles prcduisenit une chaleur brûlanite dans Pl.otérieur de la bouche, du pharinx, de l'estonac, une douleur vive à l'épigastre, des nausées, des vominssemesns répétés de matières mèlées de stries sanguino. lentes, Flangoise de l'estomnac, des coliques violenteb, des selles li. fluides et saigusties, ou la constipation ; enfin ue sorte de trem- blenent conivulsifdeb iînàchoires. On observe ans.si une agiiationa cuntmnucUe, un nialaise iierprimable, des syncopes, des sueuis fro.Jes, des nouvemens convulsifs, de l'altération d.ns les traits du de la diliculti dans la respiration, des hoquets ; les parois dus bas ventre se distendent, le pouls est petit et irrégulier, les for.. ces s'àffoiblissent, et finissent par se perdre entièrement. \"On trouve à l'ouverture des personnes mortes à la suite de rnmpoisoinenient par les acalis, les terres sub.alcalines et les sels alcalis, les parois du piarmsx, de l'oesophage, de l'estomac, cunitractés sur eux.mèmines, entlammés, cautérisés, de couleur hiait hàtie, et noire par la potasse et la soude caustiques ; l'on. iertîmc py lbrique rét récie,ainsi que le canal intestinal, qui est dans inaétat de leision, de resserreniem, de cautérisation, de perforation ; la m:ebnhr:mîîe interne du tube alimentaire est plissée, phlogosée et recoiverte d'un enduit visqueux semblable à du sang séreux et Iole atre, ou réduit en une sorte de bouillie. L'on reconnait la présence des alcaI:, des terres sub.alcaliies et d;e leurs compusés, à la propr:été qu'ils ont de verdir le sirop de - t le Fin rouge, à leur saveur àcre, brulante et lixivielle. Si usi cree de l'acide sulfuriqefe sur les solutum aqueux des ma. niè.es alcaîlcsce-ntes rendues par les vomissemens, ou sur celles qui sont con: et; uesduns les preniières voies, il be fait uie effervescence, zt il en résulte teu sel neutre de la base.\" Certaines préparations d'antinoine, d'argent, de mercure et d'or, qui font le sujet du Chapitre suivant, se recounais- sent, pendant la vie, aux signes ci-dessous: \" Soif ardente, chaleur brülante de tout le trajet du tube diges- tif, douleur déchirante à la tegion épigastrique, qui bintôt se p-,page aux initesîims ; cautér:sation de couleur variée, du bord libie les lévies, de l'intérieur de la cavité buccale, rougeur ou y åle.nr du visage, goût de cuivre dans la bouche, agacement des deats, aleine exhalant une odeur fétide particuhère, gontlement M98",
         "ANAILs CRITIQUr. des gpincives et des glandes salivaires excrétion copieuse rune salive écumenle, quelquefois écoulement de Saag par la bunjhe et les narines, resserrement spasmodique de la gorge, nausées, vo- missemens de diverse nature, saveur métallique des niaitières di- vumissemnacrs, hoquets, colique:s airot.es, déjections ailviunes abon. danstes, et fort souvent stua nolentes, hti,on et météorisne des parois de l'abdomen. Tronihie général, convulsions afi'reuse\u003e, inquiétudes, respiration gênée, anxiétés. syncopes, prostration des forces, sueur froidr, pouls petit, serré et irrégulier, foiblesiw toujours croissante, et qui détermine k- mort la plus prompte, rEl ie survient pas des vomissemîen:s naturels ou sollicités par l'art.\" On recotnaitra la p:ésence du sublimé corrosif dans les matières des vomissemens ou des selles, à sa saveur àcre, acide, caustique ; à la vapeur blanche qui s'exhale, lors de sa combustion sur des charbons ardens, avec une odeur pé- nétrante, étouiTante, et qui forme sur des lames de cuivre, de fer ou de zine, exposées à son contact, une tache qui d'abord est terne, mais qui devient blanche, brillante, argentine, pnr le frottement ; la même chose a lieu quand il est en solution, laquelle prend elle nêmne alors une couleur verdàtre. . Nous ne suivrons pas l'Auteur dans ses détails sur le mu- riate d'arsenic sublimé, le nitrate neutre de mercure, le sul- fate acide de mercure, le turbith minéral, la poudre fulmi- nante d'argent, l'or et l'étain et leurs. composés. Ces subs- tances sont rarement importées dans notre tays, et nous pen- sons qu'il serait même impossible de s'en procurer chez au- cun de nos Pharmaciens. Nous nous contenterons de dire un mot de l'oxide rouge de mercure, avant que de passer aux. moyens thérapeuthiques qui conviennent aux différens poi- sons de cette première classe. On reconnait cette substance à son rouge brillant ; a sa saveur a :re, au précipité briqueté qui a lieu lors qu'on met du carbonate de soude dans une dis- solution de cet oxide, par l'acide nitrique. Si on le fait bouillir avec l'eau de chaux, il se dissout en partie, et l'ci% obtient par le refroidissenent, des petits cristaux tran:,parens d'une couleur jaune. Pour diminuer la causticité des acides minéraux, M. M. Buquet, Fourcroy, \u0026c. recommandent la magnésie, l'eau de savoni et l'ammoniaque (alkali volatil). D'autres ont eu cha- cun leurs neutralisans, niais ou avoue presque partout au- jourd'hui que la méthode la plus sure et la seule eicace con- siste dans l'évacuation soit par le vomissement ou par les selles, en s'attachant à calmer l'irritation plus ou moins grani- de que leur séjour plus ou muins prolongé a produit sur l'o - ganisime. Apràù li vomissement, l'auteur recomnaude avec 199",
         "A4.uLyz CarTcaUr. chaleur l'eau tiède en abondance, comme délayant et adnu- cssant. M. Casimir Renault a inventé un orocédé mécani- que pour produire le vomissement, mème lorsqu'il y a tri,- mus (màchoire serrée). I introduit dans la bouche ou les larinles, et nièmne quelquefois jusque dans l'estomac, une son-Je dc gomme élasti.que adaptée -1 une seringue, et par ce moven intreduit dans l'estomac les substances convenables qu'il retire aussi par la même voie. A cela pré;, N. Ber- trand ne fait que prescrire, dans de longs détails dont il aurait sans doute pu se dispenser, le traitement antiphlogistique, q'îi et celui qui en e.iet est le mieux adapté à ces sortes dl'accide:s. Mais ce qui méirite ici toute notre attention, c'et l'usage qJ':l recomimande de l'eau de charbon qu'il Sie ena a capab:e, apré\u003e le vomissement, demolifier l'ac- t:on per:ücieuse de tous les poisons qui agissent en corrodant, et en \u003c.ésarganisant la texture de l'estomac et se combinant avec lei parties détruites, \u0026c. Il prescrit aussi l'al- rinin:e pure du banc d'.ruf comme possèdant la mè:ne pro- p:i-ét que le charbon de bois. Le premier Chapitre de la classe 11, traite des efiets de l'arsenic. On le recon ait aux symptômes suirans :- \"L~ne irri:atirn vive de l'estomac ; une denleur aiëiE, déchi- r-ntr, de Cvscère: une Chaleur extrème de l'esoph:ie et dei r4 s:e dit canal alimentaire; des nansées, des vomissemens excesirs; i.:e soi;iipnxtinzUle, un senitinicit d'ardeur'et unesaveur anstère 1 ias l'in'érieit de la bouche ; ni ag.tcement des dents. titi pt'.a- lisme on crche'ement continuel et involontaire ; une évaratoion 'in~z:usolente. qui s'extide de la menibraie nuiqienc de l'est'- mn i#, et g-in sort par le liant e: par le bas ; l'lé.matie des pin- p érCs supérieures, la lividilê dui pourtour des orbites ; des dé- jertions noires et infectes, des contractions partielles des muscies du .as en:re: le nétéorisme ou bomsisonlenenit des paro:s de c ii 'té ; des taches noires répaindes sur la pèau ; et, suiisint 'éré (.iid:c.lg. tom. 11, p. 206., une déman;eaîson de toen? i war ice di corps. q1i se recouvre de tachesjanniîes ou roussïtre,. T.is sont les phénor.ènes locaux ou caractéristiques qui so manifestent dans à'cmpoisoinement par les composés arseni- Caux, et par Vaeidie arsenieux. Des mouvemens convulsifs, des anxitég le tétanos, une agitation continuelle, des lipo- thymies, deî si eurs froides ; le pouls petit, concentré, irré- gulier ; la perte générale du sentiment, quelquefois celle di mouvement ; des vertiges, le délire, la lenteur de la respira- tion, un ahattenent général, une odeur cadavéreuse, qui s'ex- hale de tout le corps, et qui annonce un commencement de putréfection ; la chute facile des cheveux, des poils ut des",
         "M. BiETrAND sur les pois gér-é'z. 20. bngles : teïs sont les syntomlne généraux ou sympatique, que l'on observe dans ce genre d'empoisonnement. On connaitra la présence de l'arsenic, en jettant le mé. lange contenu dans l'estomac ou les intestins sur des char- bons aròens, par son odeur d'ail, ses vapeurs d'un blanc sale et . propriété de rougir les couleurs bleues végétales, et de blanchir légèrement une lame de cuivre décapée. De tous les procédés que l'auteur indique pour s'assurer de la nature de l'arsenic, nous ne rapporterons que celui de M. Hume, qui nous parait le plus simple et en même tems très assuré. \" Mettez trois grains de la poudre suspecte dans une bouteille de verre blanc, avec huit onces d'eau dîsni!e, et f.-:es cha:di-r jusqn'a êbulitioîn; remuez et ajoutez alors deux grains de carbu- nate de potasse sursaturés, en agitant coutirinneilenent le mélange. Versez deux cniilleies à bouche de cette dissolution, dans un petit verre ; pui:, préseuezâ lasàrface du liquide un mrc.u de i- trate d'argent sec ou de pierre infernale: s'il existe de l'arsnesuc blanc, il se fera sur le champ un bea'î précipitéjaune, qui partira du point de contact du meiircte d'argent avec: le fluide, et se pré- cipitera, vers le fond du vasr, sous forme de flocons abondans, que 'on ne pourra jamais confondre avecaucune autre substance au point de laisser du doute duas l'espnît.' Un grand nombre d'exemples sont rapportés qui consta- tent les effets pernicieur de l'arscnic. appliqué sur la surface de la peau, soit sous la forme d'onguent ou en solution.- Telle est la fameuse Jqua Tfana dont les femmes de Rome et de Naples se servent avec succès pour guérir radicalement leur maris de la manie de leur reprocher leur infidèlité.- Telle est encore cette drogue connue en France sous le nom de poudre à mouchcs, que qaelques charlatans ont introduit depuis peu parmi nous en solution, comme possédant la pro- priété de détruire ces insectes et d'autres vermines, qui n'est qu'une composition d'arsenic, et dont M. Bertrand a obser- ve les funestes effets dans plusieurs occasions. Nous ne sa- vons pas que notre Police se soit encore occupée d'arrèter la distribution d'un poison aussi subtil et qui se vend sous nos yeux, quoique la Législature, dans un Bill qui a malheurcu- sement échoné, eut sagement pourvu que les personnes auto- risées par la loi à distribuer ces sortes de drogues, fussent obli- gées de les conserver dans un endroit séparé de leur labora- toire, avec la défense, sous peine d'une amande, de n'en li- vrer à quiconque ne serait pas muni d'une permission spécia- le d'un Magistrat Notre Auteur a -u de semblables résultats par l'aprlica- tion de l'arsenic aux caunzrs. Cetté pratique meurtrière est B",
         "UC 1ÅNALYst CirrUttE. encora en grande vogue dans notre pays, et il est peu de Mé- decins Canadiens qui n'aient été témoins de plusieurs casd'enm- poisonnement par le même moyeu, mais nous n'en dirons rien ici, nous réserrant d'en parler plus au long dans un au- ire article. Le cuirre comme métal n'est pas un poison, mais il lest à un haut dégré quand il estoxidé, tel est le 'vert-de-gris. Ou reconnait cet accident aux signes suivans : \" Grande sécheresse de l'intérieur de la bouche et du conduit alimentaire, un sentiment de stypticité mélalliqte, des nausées, des rapports cuivrrux ; des vonissemens de malières vertes, qui 'illiguent pas la cardialgie qui les a précédés ; une soif ardente, un crachotement mnvolontaire, l'abdomen tendu et dou!oureuix au toucher, un tésiesme opiniâtre; altération des traits du visage, une oppression considérable, selles séreuses et sanguinolentes. spa-. mies, couvulsions, petitcase et irrugularité du pouls, des deîaillan- ces. sueurs froides, \u0026c.\" Quand ces substances ne produisent pas la mort inconti- nent, elles laissent quelquefois des toua opiniàtres, des para- lysies ou !a phthysie pulmonaire. \" Le carbonate de cuivre ou vert-de-ris naturel, qui se forme pntanémenît à la surface des matières cu:vreuscs, sera reconnsais- sable, i - à sa couleur verte; 2.à son indîssolublit idans l'eau froide et chaude ; 3. à sa facilité à se dissoudre avec effervescence dans a plupart des ac.des, ct surtout dans le sulfurique, mènmeaffaibl - 4.àsa prompte et facile dissolution, dans i'ammonia que, à laquelle il communique ue belle couleur bleue : 5. à sa reductiun métal- lique en le chaufTant fortement avec du charbon ou de la graine. Voici les symptômes que l'auteur a obserrés dans un cas d'empoisonnement par le tartre émétique. \"Le malade ft atteint d'une irritation vive de lestomac, de mouvemneîs convulsi:d, de spasmes, de roileurs comme !étamques de vains eforts lde vomisemens, d'agitat:ons, d'nquétus, , da SUtiurs pa2rtieiles et gé:érales, d'un état vultueux de la face; son pouis était plein et concentré. Des vomissemenas bliecux abondans se déclarent après 1'usage de ,.au tiède doiiéc à profusio::, et des téjections alvines de mene nature furent entretenues par 1'enploi du bouillon d'ier.. bes; nai; ces éracuatioins, par le haut et par le bas, se perpetué- vent à un tel point, cle je fus contraint, pour Is faire cesser, d'emplover la limonade fortement ch:aree de suc de ci!roni.' Morgagni affirme que deux gros de ce remède n'ont pas produit la mort quand le vomissement a eu lieu. C'est ausii la remarque qu'a faite M. Majendie. On peut le reconnaitre à sa précipitation en blanc par Peau de chaux et lacetatz de plomb *n dissolution.",
         "M. BxaTiat D sur les poisons ingiris. 103 Le tartre de potasse et d'antimoine, projeté sur des charbons ardenis, noircit, se déonppse et laisse pour résidu de l'antimoine spétallique, que t'on sait être d'une couleur d'un bl-anc, tiraut un peu sur le bleu, d'un brillant argenté, d'une grande fragilité, se 'rn!:!aliant en aignilles; en plosigeanît une lame de fer décapée dans une dissolution d'émétique par l'acide muriatique foible, on -\u003ei i'antimoine se décomposer ta flocons noirs à surface. Leplomb de même que le cuivre n'est un poison que dans on état d'oxid.tion. Les symptômes sont: \"1 veur miîét.illigne douceàtre dans l'intérieur de la bouche, épigastralgie. nanscsýe, vomissemens glutineux et d'une matière biiieuse d'un jaune verdâtre, et quelquefois de matières stercora- les ; douleur abdominale sourde et peu durable ; d'autres fois coliques iirupportables au moindre mouvement, avec un se:ti- -i-nlt de torsion particulbéremnent resse:iti vers l'ombilic, et qui obligent les malades àe se rouler en divers sens, afin de trouver inie position avantageuse ; visige pile et d'un jaune plombé, veux saillans, respiratioi gênîée, sentiment de strangulation, apî- p.lisàement et dureté du ventre (dureté, qui est spécialeniit due à la coitracticn spasmodique des muscles de l'abdoraen, et aurtout à-cetl deastrni-puuaens); constipation opinliàtre ; ma. tières excrèmentigicles rendues sèches, de forme arrondie et d'un très petit volume ; enfoncement de l'ombilic, resserrement de 1'anus, céphalalgie, malaise général, état morose, anxiétés, insom. nies, trouble dans toutes les sécrétions, isclurie, dy-uiie, convul. sioos ; doilrur dans les membres, seiîblable à celle d'une affec.. ,ion rhumatismale aig-é ; quelquefois paralysie d'niie des extré- mités, pouls lent, dur et teudu; sentimeut de formication aux extré:nités des doigts, et autres symptômes nerveux très variés; vertigcs, défaillances, stupeur, altération diverse de la vue ; dé- lire, qui quelquefois s'approche du dé!ire maniaque ; syncopes, sucurs froides, \u0026c. A l'ouverture des cadavres après l'empoisonnement satuirnii, on trouve ordinairement l'estomac et le canal intcstîtmal, surtout le coloi, dans un état de contracture, (le rétrécissement, de sé- cheresse reiarquable, et quelquefois même d'oblitéialion, d'où s'cis4i. un mzaras;uc plus ou moinis fortement prononcé, On y oubserve, en outre, des traces d'isfla:niatiun, et méie de gan.. grène, et quelquefois des invaginations intestinales.\" On le reconnait par quelqu'un des procédés suivans: Eu trempant une lame de zinc dans une dissolution de plomb, celui-ci se pricipite en état métallique. \"Si on soupçonne qu'un vin soit sophistiqué par la litharge. on peut s'assurer de sa prs:nce ent versant quelques gouttes de sulfure ic potasse liquide ( foie de soufre), ou de la liqueur pro- batoire d'lahiimaniii, 'dans le vin suspecté et étendu d'un peu d'e.m dlistillee : à l'Instait le mélange devierit d'uns soîr plus oi moilsi oincé. et le précipité est d'unjauie rouge, ii le vim lie coig teit pas de p'lomîîb.\"",
         "AALTsr CmITIQUr. Quand à l'empoisonnement par la zinc il ne présente au- cun phénomène particulier pour ce qui est des symptômes et des létions, qui ne soit renfermé dans ce que nous avonc vu des autres minéraux. Il suffit de remarquer que le sulfate de zinc est précipité en blanc un peu verdàtre par l'amnmoni- aque, et en blanc légèrement bleuàtre par le prussiate de potasse. En fondant, à l'aide d'une forte chaleur, tons ces précipités bien dessèchés, avec de la poussière de charboq et du cuivre rouge, l'on aura du cuivre jaune. Les signes qui se présentent dans l'empoisonnenient par les cantharides, sont une ardeur extrême de tout l'intérieur dc la bouche, qui, en se propageant, produit un resserrement de la gorge, lequel s'approche de la suffocation ; un ptyalis- me continu, des douleurs épigastriques très-vives, des nau- sées, des vomissemens quelquefois saiguinolens, des selles dyssenterques avec tenezue, une chaleur douloureuse des voies urinaires, le priapisme, une dysurie cruelle, l'hénatu- rie, des coliques affreuses qui forcent les malades à s'agiter violemment, le regard fixe, farouche, la rougeur de la face, le grincement des dents, des auxiétés, des syncopes, des agi- tations continuelles, des mouveinens convulsifs partiels et gé- néraux qui s'accroissent très-rapidement, d'autres fois des accès de manie avec fureur, auxquels succèdent le délire ou -un assoupissementprofonl : le pouls est peu ou point fébri- le ; enfin, la mort termine assez souvent tout cet appareil de tourmens horribles. A. Paré a vu cette substance produire la gangrène du pé- ni«. On sait que l'usage qu'en fout quelquefois les libertins pnur exciter leur érotoniaine, a plusieurs fois causé la mort. L'Auteur en cite pl:.icurs exemples.. S'i avait été pris en substance, ou le reconnaitrait par la fumée d'odeur fétide, semblable à celle des matières anima- les, qui se dégag. rait en les mettant sur des charbons ardens, et laissant un charbon animal pour résidu ; par la coloration jaune-verdatre qu'elles formeraient avec l'éther sulfurique. 'alcohol de cantharides, d'une couleur jaune plus ou moins funcée, se recunuaitra au précipité blanc qu'il formera avec l'eau de fontaine, à la propriétè qu'il a dc rougir les couleurs bleues végétales, au précipité d'un jaune p\u0026le qu'y forment le3 acidessulfurique et muriatique, au précipité jaune plus ou moins foucé qui a lieu avec les hydro-sulfures alcalins. Au surplus, on reconnaitra toujours l'empoisonnement par les cauthairid'e, en substance ou en teiuture, à l'état des voies e204",
         "M. BalrntuD sur es poisons ingirés. urinaires, et au priapisme, qui est un synptome pathognomo, nMique à ce seul genre d'empoisonnement. M. 13ertrand a employ'é avec succés, dans un accident de cette nature, l'huile d'amandes douces, 'usage réitéré et pontinué des sangsues au périnée, des délayans, des émul, sions camphrées ou opiacées, et des bains de siège. Nous sommes parvenu à l'endroit où Pauteur traite des poisons végilaux âcres, irritans. Il range de ce nombre plusieurs plantes monocotylédones et dicotylidones, dont plu- sieurssuivant lui\u003e ont été improprement classées parmi les poisons. Outre les symptômes communs à tous les genres d'empoi- sonnement, on remarque, dans celui dont nous parlons, des vomissemens bilieux, periistans et douloureux, et quelquefois sanguinolens ; des hoquets; un tiraillement et des coliques, avec tenesme et flux de sang ou déjections séreuses ; des an- xiétés; la respiration gênée; l'ictère ; une chaleur brûlante générale, . laquelle succèdent des tremblemens, des sueurs froides, des convulsions, le trismus, des vertiges, lassoupis- sement, le délire, une prostration extrême des forces, le «pouls petit, serré, intermittent, et d'une lenteur remarqua- ble, surtont par les eflets de la digittle pourprée ; la pâleur cadavéreuse du visage, le rire sardonique, des palpitations du cSur, des taches noires sur toute l'habitude du corps, la livi- dité des ongles, une bouffissure générale, la paralysie, le froid glacial des extrémités, ciin tous les sig:'es avant-coureurs de la mort, si la quantité prise est grande. Mais les signes cadavériques que ces accidens nons offrent sont extrêmement variés et quelquefois nuls en apparence, sinon Pinflammation de l'enveloppe de la moëlie épinière que l'auteur a observée souvent.. La chimie elle-même ne nous fournit aucun moyen d'identifer, soit par Panalyse ou par la synthèse, la plupart des substances végétales qui produisent un effet délétère sur notre organisation.. L'acrimonie et la propriété irritante que nos sens déccuvrent dans plusieurs d'entr'eux, ne sont que des caractères physiques, résultant de certains rapports d'assimilation entre ces substances et nos organes ; et s'il est -vrai, comme quelques-uns l'ont pensé, que ces propriétés nesoient que l'effet d'un certain arrange- nient de leurs molécules, on n'a pas lieu d'espérer que l'on puisse jamais arriver à la connaissance identique des végé- taux par aucun procédé chimique. Ce qui constitue la varié- té dans les plantes étant, comme nous venons de le dire, l'ef- U.5",
         "ONALZTs. CRiTiQUES fet de l'arrangement des parties entr'elles, et cet ordre étant- détruit par la décomposition qui a lieu dans l'estomac et les intestins, il ne nous reste à recourir qu'au procédé synthéti- que pour le reproduire. Mais comme nousne connaitrons jamais la nature de cet ordre, on voit qu'il .est illusoire, pour ne pas dire ridicule, de songer à le rétablir lorsqu'il est perverti. Nous ne nous permettons ces observations que dans la vue de faire voir combien il est peu raisonable de chercher à met- tre en oeuvre ici un procédé qui ne peut s'appliquer avec avantage qu'aux substances qui agissent c'nimiquement sur no tissus. Ce sont aussi ces raisons qui ne nous permettent paq de suivre notre auteur, dans tous ses détails sur le modui operandi des différentes substances, pour en puiser des con- naissances pathologiques sur lesquelles on puisse fonder une évidence. l nous suffit d'observer les effets délétères que chaque espèce en particulier entraine, afin que l'expérience devienne notre guide. L'Auteur s'accorde à recommander avec plusieurs Méde- cius distingués, l'emploi de la glace, dans la vue de calmer, par une soustraction de calorique, les coliques et la chaleur vive que produisent les poisons, (ce que I. Orfila considère comme une pratique injurieuse) ; mais le charbon de bois et le blanc d'oufs étendus dans l'eau, que l'auteur recommande avec instance, sont fondés sur des expériences don t nous ne pouvons douter. Il a lui-même avalé cinq grains d'arsenic le matin à 7- heures, et par le moyen du charbon de bois, il ne ressentait plus le moindre inconvénient à midi. Il prit son diner avec le même appétit qu'à l'ordinaire, et n'éprouva par la suite aucun dérangement dans ses fonctions digestives. Un Comité chargé par la Société de Médecine de Paris, de faire rapport sur ce point de thérapeutique, est d'avis que les expériences de M. Bertrand sur l'action salutaire du charbon de bois dans l'empoisonnement parle muriate de mercure sur- oxién5 et l'acide arsenieux, ne sont nullement concluantes. 3. Orfila est aussi du même avis. Un écrivain, I1. Boullay, a çoutenu cette position dans le bulletin de Pharmacie pour Février 1814. Quoiqu'il en soit de ces témoignages, nous osons soutenir que dans des cas comme ceux dont il est ques. tion. où l'on est contraint de se borner à des secours pure- ment palliatifs, il n'est aucune considération qui puisse absou- tire le practicien de ne-pas employer un moyen qui parait avoir réussi à quelques-uns, dût-il n'avoir qu'un effet. limité; car £CG",
         "M. B;AmsD sur les poisons ing érés. 2C7 personne ne l'a considéré comme injurieux. Mais on aura le soin de u'en faire usage g«'après avoir eu recours aux éméti- ques, purgatifs etautres prescrits en pareil cas. Le sucre en substance on en solution est un puissant antido- te du vert-de-gris. L'auteur a encore fait des expériences pour constater les heureux effets de l'albumine du blauc d'oeuf contre les composés murcuriels et cuivreux. L'acide citrique (jus de citron ) est un puissant antidote du tartre éinétique, et quelques uns regardent l'opium et le mer- cure combinés comme le meilleur moyen à opposer à la coli- que deplomnb. Pour ce qui est des végétaux narcotiques, uous citerons seulement ce qui suit :- \"Il est certains phénomènes q.ui doivent servir de base fonda- mentale pour caractériser lempoisonnement par telle ou telle substance stupéftante. C'est ainsi, par exemple, que l'écoule- ment abondant de s-ilive se remarque particulèrement dans l'en. pusinnmente li par la douîce-anére ; que la paralysie de la pupille et une propension irrésistible au sommeil sont le ré6imitat des pro- priétés délétères de la morelle et de la pomme épineuse.; que le délire gai, d'après la remarque judicieuse faite par le doctcur Gi- ranidy, a lieu surtout par l'action de la belladone ; que le regard farouche, le rire sardonique. une sorte d'ivresse et d'horreur pour toute espèce de boisson, sont les attributs de la jusquianme; que le resserrement spasmodique de la gorge est essentiellement alfeet.. aux propriétés vénéiteuaes de l'agaricus strangulatus : qu'enfin. la paralysie. et surtout la gahrène sèche des extrémités, désguée sous l'épithète d'ustilagiieuse. sont spécialemei produites par le seigle ergoté pris abondamment, tandis qu'il ne détermine que l'er;rotismne convulsif quand il est pris en petue quantité.' Eutr'autres moyens que l'auteur indique pour reconnaître la présence de ces différentes substatnces, dans les liquides rendus par les vomisseiens ou trouvés dans l'estomac, celui qui nous parait le plus digne d'être mentionné, est le nième qu'il prescrit en parlant des végétaux en géunéral. Il consiste à examiner si le résidu de l'évaporatiou donne lieu d'observer une matière résineuse, extractive, gommo-résinieuse, \u0026c. qui sont les principes génératifs des végétaux. Plusieurs Médecins ouît observé que le café annihilait les eliets des narcotiques, surtout quand il est préparé à L'eau. On peut citer ici ces deux vers de Berchoux Le café vous présemnte une heureuse liqueur, Qui du vin trop fumeux chassema la vapeur. L'auteur recommande de plus l'usage de l'eau à la glace, par la bouche et par l'anus, et sur toute la surf.ce du corps.",
         "108 SUKaraCr Lxcruits On peut aussi essayer la respiration artifcielle, eomme la sug' gère M. Brodie, et qui, suivant M. Orfila, s'oppose à l'as- phyxie. Nous avons essayé de mettre sous les yeun de nos lecteurs tout ce que l'ouvrage de M. Bertrand présente d'intéressant au praticien ; et si notre dessein eut été de nous attacher moins à signaler ce qui est utile, qu'à censurer ce qui ne l'est pas, nous eussions peut-être trouvè matière à la critique. Le reste de l'ouvrage eat consacré à la considération des devoirs du médecin juriste, mais comme il.n'existe parmi nous aucun ordre dans le département judiciaire, pour ce qui re- garde les évidences médicales, ces considérations ne peuvent être d'aucune utilité pour nous. Quoique le code pénal An- glais qui nous régit, fasse l'admiration des plus sages 3 uriscon- suites, le Canada est encore bien en arrière des nations peu policées de l'Europe sous ce rapport. C'est ce qui nous en- gagera à dopner à ce sujet une attention particulière dans un article subségueut. Surgical Lectures delivcred by Sir AsnLE!Y Coomt, nt the 'heatre, St. 7homas's Hospital, Extracted from the Lahcet. LECTURE FIRST. October (5, 1823. IRRITATION. [WV feel much pleasure in having it in our power to grace ,,one ofour paes ivith the lectures of this eminent Surgeon. The limita of our work preclude us from giving more than one in eacht number, psi ticularly as we wish to afford room, for those of Dr. Armstrong, which will also bc found of the greatest utility to the Physician. This part of our Publication wili not be the Ieas il- teresting of he whole, and for this reason we will abstain front any remarks on either of them.] The subject of this erening's lectureis irritation, which being one of the most important topics in surgery requires to be at- tentively studied, and its effects carefully watched, before any one can practise in his profession with credit to himselflor advantage to others.",
         "-Br Sut A. Coozn. Irritation is cither local or general, and its effects are 6om- nunicated from one part to another, throughl the rediuin of the riervous system, sa tliat the heart, brain, and stomach, almost immediately after an ihjury lias been sustained, even in the remotest parts of the body, wil! have their fonîction.s more or less distuirbed in proportion to the ext.'nt of the iin- jury, and the importance of the part injured. Ail the actionz of the body are excite!d and sust.ined byinternal and external impressions, whch are called stimulants : the hicod, for iris- tance, being the stimulus to the blood vessels ; the bile to tho intestines ; and caloric in a certain degree, a stimulus to the whole systein. Between all the differeînt parti of the human frane there exist intimate relations, which correspond With each other, and carry on a reciprocal intercourse of actions. The beautiful harraony produtc, by these conrurrent pheno- mena is called synpatiy. This; impressions not only produ- ce effects on the part on whiich they are directly applied, but in consequeice ofthe freedo of communicatioi between tlie nervous system, parts of the body situated at a distance from those in which the original rmischief exists become ai- fected by them : the real nature of synipathy is yet unknown, but we are acquainîted with muny of ifs eiïects. Thus nume- rons examples of symîîpathetic actions niiay be adduced ; the co.municattion wiich exists between the arteries and breasts is a striking instance of it. Sneezing is a sympathetic action ;et.ecen the nose, velum palati, and the abdominal muscles; aiso cougiing, breathing, aud the expulsion of the fæces, are a few among th- numero- examples wihch miglt be enume- r-ated. But symrathetic action ii also thle r.sult of injury and di- sease, becoming the cause of restoration on the one hand, or of destructiait on the other, anld tais state of the body I call Irritation. Irritation, gentlemen, may be deuned ta be an altered action, excited in the systeiî by an luinatural impres- sion. The sympathetic pain is experienced in the knee and foot fron diseased hip, and at the extremity of the peuis when there is stone in the bladdur. The passage of an urinary cal- culus through the ureter occasions retraction of the testicles and pain in the thigli ; disease of the prostate causes pain on the inside of one or both thighs. A disease of the liver occasions pain in the shoulder; a diseased testicle, pain in the loins ; irritation of the intestines, an itching of the niose, These sympathetic effects which we have been just des- cribing do tinot consist of morbidi actions in the parts thus af- 209",
         "Sxztcac.tr. Ltc-cnar fected, but of disordered sensatione. But morbid actions are also, sometimes, excited in parts near it, or at a distance from those originally affected. Inflammation of the testicle is fre- quently the consequence of irritation in the urethra; and swellings of the breast, of amorbidaction of the uterus: but there is no organ so ruch affected by irritation, or sympa- thetic influence, as the stonach. For instance, if a blow is received on the head, causing injury to the brain, vomiting is one of the first and most constant symptoms, being im- parted to the stomach through the cighth pair of nerves,and by this we are led te detect the injury. Vomiting is pro- duced when the testicles are injured, or intestines burst, wounded, or strangulated, and from a gall stone passing the biliary duct ; and an obtuse pain in any part of the body wili occasion sickness. The consequences of irritation are sn humerous and im.por.. tant, gentlemen, that I shall relate to you the medium of its communication. Irritation is generally communicated through the medium cf the nerves, of which there are two grand di- Tisions in .the body. The first composed of the brain, spinal marrow, and their nerves, which naturally convey sensation and volition ; the second consisting of the grand sympathetic eierve, the centre of which is behind the stomacli, in the se- milunar ganglion and solar plexus. The modes of sympa- thetic communication are various. In some instances, the course of irritation is from the irritated part to the nerve, as the vain experienced in the kne2 and foot from a disease of the hip. Ia other cases the course of syzm.pathy is from, the affeictd part to the or-gin of the nerve, as in pain in the loins consequeit on diseased testicles. Irritation on the nierves of the grand sympithetic is communicated te the stomach, pro- b.h;y through the nedium of the semilunar ganglion and al! injuries to the stomach are attended with serious effects. I could relate to you several instances in which in jury to this organ had proved fatal. A man walking through Fleet-street, one day, happened te quarrewiwith a roman, when another came up, and gave him a blow in the region of the stornach, which caused almost instantaneous death. On dissection, no cause could be found to account for his sudden death. A. man belonging to the India louse -was attempting to lift a weight, when another ctmne up, and Iocosely said, \" Here, stand on one side, and let an abler man attempt it ;\" and at the same instant gave him a slight blow on the stomach, ýi 1Y",
         "jar Si A. CoOPER. seheh the poor tellow dropped down and expired. lisbody, upon being opened, showed no marks of violence. Irritation is either local 6r constitutional. Sometimes it is local, affecting only particular parts; atothers,attacking the wvhole systen. A decayed tooth will produce an abscess, antd the matter escape by forming an opening through the cheek. This ulcer will be very difficult to heal if the tooth remain ; but extract it, and the disease will quickly disap- pear, the cause of irritation being rernoved. Many cases of this kind have fallen under my observation, and I will relate a few by wray of illustration. Cases.-Somae years since, two persons came to me fron WISBEAcH, (Withuut being aware of each other's situation, or of what surgeon each had consulted,) both having an ex- tensive abscess near the aileolar process, which had produced an opening through the cheek. The disease in both had been of long standing, and the pain extended to the surrounding parts of the jaw. I directed a diseased tooth. near the ulcer, in each person, to be dre.wn, which being doue, the patients rapidly recovered. A lady in Ess.x had, for a long period, been axiicted hy a fungoid granulation, which protruded through an ulcer in the cheek, and which had resisted the use of every means.- Upon stating one day that a tooth near the part wvas occa- sionally painful, she vas recommended to get it drawu ; the tooth vas extracted, and the fungus quickly disapeared. A gentleman of ny acquaintance had, for manyyears, been exceedingly annoyed by an ulcer on the chin ; every attempt to heal it having proved ineffectual, li fact it was considered incurable. At length, onie of the teeth opposite the wound becom.ing painful, it was extracted, when, te the delight and a:,tonishment of the patient, his malady disappeared. These cases are raentoned, to show the importance of endeavouring te ascertain the causes of diseased sympathetic actions, as the reinoval of their etfects will depend on the cure of their causes. If the causes be undiscovered, the effects arc likely to continue in spite of every means that you nay employ. The coustitutional or genîeral effects of irritation are fre- quently produced by the most trivial local causes, A per- son, ont having a bougie passed into the urethra for the first tine, feels faint, becones sick, looks pale, and, unless you prevenit it, will fall on the grounid. On placing himx in the recunbent posture he soon recovers his senses ; but constitu- tional irritation frequently cornes on iu the evening, which 211",
         "Senatic.i. LEc'rCR5s however, soon ceases. From the irritation of the urethra you sec, gentlemen, that the stomach is influenced, the ac- tions of the beait suspended, and the powers of the mind gone. The symptoms of constitutional irritation following injuries, are best exenplined in compouud fractures. li these cases, the irritatio runs verv high, and the heart, bi ain, and stomssach, are much ailected. A per.on recrires ais in- jury to the leg, producing coupound fracture of one or both bones ; constitutional irritation commences generally in twentv-four hours ; the patient consplains of pain in hib luius, extendinsg up the spinal chord, and pain in the head. Ila then becones restless, andi his countenanice arixious ; the tongue at fist .s dry, aid cotered with a whiti.is fur ; but, as the symptoms irScreae, it lieccmces yellow, and lastly coated with a thich brown fur. There is loss of appetite, the sto- Mach becomes irritable, nausea and voniting supervcuisg - The secretion, are diminished, and the stools are white. As the severity.of conplain:t increase, the pulse 'ecoIses quick, hard, irregular, ::sd aternately intermittent. The respi:a- lion is hurried, intellect deranged ; ali impressions on the seuses are painful ; subsultus tcndinum, Iiccoughs, voniting and tensions of the abdomen, cone ou ; the patient sinks inito ailow muttering- dlirium, and soon expires. Tisus in constitutional irritation, whether from inJury or discase, every part of the syste:ml is aiected by it, and this elTect ap. pears to be produced iln tie following manner. Vhieu any part of the body receives an injury, tihe nalrres coney to ail the im;portant £ rganscf the Lody, pinal narrow, le.rt, stü- .achî, c. an iprssbon of thsat injury ; Nature inmsed.- tely comnre::ces t..e restolative process, by ::tp.isg ail the cu:tou.ary :ecriicus ; the various outà,:ts beisg thus closed, e bloou co;!ects ic large qua:.hies in the heatrt and great God vee ..hi:h propci u.* blood àwith increased force to th . wound- i part ; th:is iveb lihe to :ome form of inllammirsa- zison, tihe one bet suited to accomplish the desired efTect-.- Here is an i!!ustraiin of the manner in which Nature- con- rends for e-ure ; during the battle, she occasionally requires to hase ler rdiour checkec, or calis for support in propor. tion to ier putvetr; ive nu:t watch her proceedings with ealie's te, and be exceedinigly cauti...us in ail ourown pro. ceedinigs ; for if ire should open the various sluices of the body, and rettore the secretions too sooi, we may', by ab- itractinig blood froms the injured part, prevent the restorativ» process ; or by increasing the excitement, di3turb Naturc's operations-",
         "Br Sia A. .CoOPE. The' degree of constitutional irritation, resulting from in- jury, depende onseveral ca.ses ;-these are the importanmce of the part injured ; the extent and nature of the injury ; the state of the constitution, age, and previous habits of the patient. 'Thus we see, that constitutional irritation is very difeèrent li eome persons to what it is in others; so that a wound, which in une inan vould be attended by the most dangerous consequences, might not, in another, disturb the funetions of any important organ ; this greatly depends on the state of the system at the tirne of the injury ; thus, many gentlemen present wvould probably now overcome a disease, that in the spring would have overcome them; that is, if they have been paving proper attention to their professional stu. dies, by devoting their tine to aiatomical pursuits. 'T'le following cases are important, and put, in a strong light, the dreadful constitutional etiects thatoccabionally re- suit from very slight local causes. A niat who had lived intenper:tziy was bled by the late Mr. SAUNDEiRs on a Tuesday ; on Thursday (having indulged in the inlerim in the pleasures of the table,) the wound in the arm w-as inflamed ; on the Saturday the inflammation had considerably increased ; on Sunday gangreue commnenced ; and on the Monday I was asked to see him, I found him with delirium, hiccough, and- subsultus tenidinuum ; and on thie following day he diei. On dissection, the skin, to a great extent round the wounrd, was founid nortified ; the cel- lular membrane intlamed and suppurated, but the vein which lad been opened was uninflamed. Dr. LUILOw, of CalIe, Iwhen out shooting, pricked his hand vith a tlicrn in getting over a iedge ; the part soon be- came inilamed, and though lie procured the best surgical as- sistance, yet lie died of tetanus within a week after the ac- cident. Another remarkable case vas that of a brewer's serv.ant, who, ii rernoving some casks on a Sdturday , had a small splinter of wood forced under the thiumb*nail; at the mnomert he did not regard it, but in the same night lie awoke in wonderful pain, antd requested his wife to get up and niake a poultice ; this lie applied, but it did not afford him any re- lief. On Sunday he becatme worse ; Tuesday the pain had extended up the arm, and his haud was considerably swollen. Ont Thursday I was requested to see him, and on examina- tion, found that matter was formed in the hiand ; I made aci opening iviti a lancet near the part where the selinter had 1213",
         "SunarcicAL LxcruEES entered, when a large quantity of pus was discharged. The man appeared greatly relieved, and I thought that he would do well ; but upon hearing a noise as I wvas about to quit tha room, I looked round : the man, by a convulsive effort, had raised himself in bed, bat he immediately fell back and expired. Case.-An instance of a totally dilerent nature from those just rmentioned, which shows that a great degree of injury may be incurred, and the persun yet do vell, occurred in anoiher brewer's man who ivas run over by a dray. There was compound fracture cf the elbow joint, extensive lacera- tion of the integumentz, aud a large wound communicating with the joints. The man was admitted into Guy's Ilospitai; an operation was proposed, but the patient ivouldi not con- sent. The wound was therefore dressed, and in ashurt time it completely healed without any unfavourable symptoin showing itself. Irritation ie greatest in children, and .cast in agced per- sons; the former are -very nuch affected by operation:s, whîilst the latter are very slightly so. Children under tio years of age, upon having stones removed from their bladders, will be frequently carried off by convulsions ; therefore, if you can possibly avoid it, never perform the operation on a very young child, at all events not under tbree years of age. One of the worst kinds of irritation is that occasioued by the absorption of morbid matter during dissection; it is there- fore impossible that you can be too careful of the instruments vou use in dissecting and opening bodies, as carelessness o.n ti:s point Las caused the loss of many a valuable life, Lr:tures on the Theory and Practise of Physic, deli:cred at the Theafre of Arctomy, Lonldon, by Dr. Aanmoxa. LECTURE FIRST. Tfhe malad.:s to which the human body is liable, minght be convenently divided into Iwo great cl-asses: the first rompre- liendinz acute and subacule affections, the second comprchen- ding thronic affections. Acute and subacute afections are those which commence quickly and terminate in a short time ; wrhereaz the chronic 9.14",
         "B Da. AnsTaoxa. 21 are those which commence slowly, and which have a protrac. fed courne. Bach of these efasses of affections arise from cer- tain agents, which are technically termed remote causes, and these have been subdivi'ded intopredisposing, exciting, and proximale. The predisposing causes are such as produce the teudency or liability to disorder or disease. The exciting causes are such as can prodice either the one diease or the other, according as the person may be predisposed. The proximate cause, according to the language of the school, is nothing mee or less than the disease itself ; when it is pre- eent, the disease is present ; when it changes, the disease changes ; and wheu irmores, the disease is removed. Noir as this can only be the affection itself, I shall in these lec- tures not use the term proximate cause at all, but in its stead I shall substitutepathological condition, to dcote that state of pa-tç on -hich the symptoms mainly depend. Theremoie causes of the fdrst class are common and pecu- lia-. The peculiar causes are, 1st, malaria, or what is com- manrly terned marsh effluia ; d, other atmospheric infec- tions ; 3d, human contagion ; and 4th, animal, vegetable, and inerail poisons. The common causes are distinguished from the peculiar, because they produce' no specific effect, and are only the mere ordinary agents of nature. These are aiso divisible into four classes--depressants, stimulants, irri- tants, ard interruptants. Depressants are such agents as di- mini\u003eh the heart's action, the animal heat, and the muscular power. Stimulants are those agents 'which increase the heat. Irriants are those which increase the sensibility, and produce a redness of a part. Interruptants are such as impede the flow of blood either through the arteries or tnrough the -eins, or through them both simultaneously. Nowv the affections of the first class, proceeding from the common remote cau- ses, whether depressants, stimulants, irritants, or interrup- tants, I designtate by the mild term, commonferer. If we examine minutely the particolar varieties of common fever, we shall find that it will admit of a further division ; that each of these particular effects may be referred to sume ultimate efect or principle ; and that there arc, 1. common congesive fcrer, 2. common simpleferer, aud 3. common infanmmato33 fcer. I use the term, commnon congestiçe fever, to denote its leading variety, as it proceeds from a common cause, and is attended by congestion in some parti- cular part. I use the term common simple fever, to distin- guish it from the congestive and iuflammatory varieties ; and 21 5",
         "SURCIciT IxcTuari I use the term cormon inflammatory fever, to denote the cause by which it is produced, and the inflammation with which it is attended. And I shall appeal to facts, to morbid disspctions, and to the operation of remedies to show, that ail the common agents of nature produce either one or the other of these tbree forais of fever. I shall first describe the nature of common conigestirefever. Its remote causes are predisposing and exciting. The great predisposing cause of conmon congestive fever is debility, which is either general or local : when it is general. all the functions of the body are languidly performed, and this de- bility may be either hereditary or acquired. But it may a1bo he local, and the individual may have the appearance of the florid vigour of health, and yet carry about with him so- me local defect ; so that, when the exciting cause shall be .pplied, he wil! be inicapable of resisting its action ; and when the shock is received on the debilitated part, it yields to its influence, and an accumulation of blood in the part is the result. It is mentioned by Dr. Cunnr, that those indi- vidu.ls are the strongest, vho can resist the greatest varia- lions of temperature, and that those persons possess more excitability of the nervous system, by which tley are able to resist the influence of a low temperature. Infants, old per- sons, and recent convalescents, have very little power to re- sist low temperatures ; but men may be made temporarily weak, by eracuation or by fastening, or by excess of exercise, by which they would become liable to congestive fever. All the e.citing or remote causes of common congestiefc-cr ane dep -ssants, which operate by diminishing the heart's action, the animal heat, and the muscular power. These are, 1. what is popularly called cold or loir temperature ; 2. bodi'y shocks procceding from accident or operation ; 3. mental de- presion ; 4. any thing which offends the stomach; 5. exer- c.se carried to exhaustion. It is important, to consider the predisposing and exciting causes of any affecton ; because, knowing them, we may, in a great many cases, prevent the occurrence of disorder or disease. This is the only department of physic which can be practically useful te the public; because the practice of phy- sic requires a great deal of elementary information, as a knowledge of anatomy, physiology, pathology, \u0026c., and can tlcreforenever be ob:ained by the public; but they are per- fectly capable of appreciating the influence of predisposing and exciting causes, and ly knowing them, they may preent 2id",
         "By Dx. ARSTaONa. n17 the occurrence of various disorders. And I tlink that much good might be donc to the public, if a book were judiciously written on the subject of avoiding the causes m hici predispose to disease. There are three objects which present themselves for the prerention of co~mmon congestive fevers. Ist. By minaîtain- ing the general strength, by a nutritious diet, by a proper portion of sleep, and a tranquillity of mind. T.he 2d point in the prevention, is to give toue to the surface of the body, and by thus maintaining the general strength of the systemn, will support the strcngth of a1l its parts. This may be ef- fected to a considkrable citent by the frequent use of the t!pid bath, com:ne::cing at 96 0 and graduaily lowering to 6) , and it will bc very much improved if you add one cunce ofsalt to each gallan of water ; by this practice yoa beco:na enabled to withstand liw tenpratures, ani thus ire- quently avoid thze liability ta diseas-. Tac 3d mode of pre- Tention is to avoid the exciting causes, and this is of great i.mportansce ta be attended to b, debilitated individuals. The attack of common congesti7e fever having once com- menced, it is known b'y thz appearanc2 of certain syli.ptoms. These follow in genriccal order, and tieparticz:Ir symptonç relate ta the mo:ijiations of this fever. T generica sympto:ns mny bc arranged under ivea heads. lst. Tihe di- minutin iof animal heat, the general range may be estimated as . 6 a instead of, , , bein; a dimiaution or about 20 . 2,1 y-npto.n is a di.idnution or :ppressioni of the heart's ac- tion; the pulse mnay be considered as th- stroke of the heart o. the column iof t circu.ating fluid. The pulse. therefore, in the most perfect form of congestive fever ii eitier ditmi- nished in force or oppressed, and in the mild::r forn of the disease, it is generally more fcehie than, natural. The 3d sy-npto:n is a diniuution of nervous and mazzular power, and this is a very permanent symptom. 4th. There is a diminU.. tion of th? general sensibility ; or, in common language, the patient feels starred, and there is less excitability than natu- ral. lowever, there are cases in which this is not so d *ci-- sive ; there is alsoat the same time, disturbance of some in- ter.al organ ; now when the function of an orgau is disturbed, -that disturbance points aut that the organ itself has undergone some disorder or disease. The parts which sutier most in this form of fever, are th brain and spinal marrow ; the heart and primitivo Tessels ; the mucous membrane liaing the broachia and the substance D",
         "Msricr, LFcmsitEy of the lungs ; the liver and its associated ireins. That these are the parts which suffer in this variety of fever, I shall be able by-and-by to show you. Again, the particular symp- toms are different, according to thestructureand functions of the part in which the couigesüien may be seated. In one person, the brain nay be the seat of congestion, in another the lier, and yet the disease is essendally the sane. The- external characters of the commoncongestive fever, are mu- dified by its seat. In the brain the congestion is detectei by the following symptoms : First, by giddiness, confusion of intellect, heavi- ness approaclhing to sleepiness and !ometimes coriplete stu- por. In less severe cases, the patient complains of giddi- ness, aud has some confusion in his head, and occasionîally? finds a difficu!ty in directing his steps with precision ; or in still slighter cases, he complains of weight or pain in his head, more frequently of giddiness or some confusion. In the most severe cases, there is loss of sight and stupor, so that you can with didicuity rouse the patient. Secund4j, it is more distinctly denoted by an intoxicated and fatuous expression of the countenance. Tiirdly, by a blanched cor.junction, usually attended by a glassy appearance of the cornea and dimness of sight. Fourthly, by a staggering walk, or by a complete prostration of the muscular power; mn more severa cases, he reels about as if intoxicated ; and in still higher de- grees of this affection, he falls down, and can only ba borun along by sorne other persons, his head haugs down, his arms fall by his side, and his legs are dragged after him. It is de- r.oted, in theffth placc, by the pulse being weakened or op- presseJ. Now it is to be recollected, that there is a very close connexion betveen the brain and the respiratory func- tion ; the comnon rongestiva fever may commence rith the symptomrs of congestion in the brainand in its progress, the respiration may alSo become disturbed. This may happen through the medium of the Sth pair of nerves ; for it is knoawn that wfhcn the:e nerves have been ditiC.d, the respiratiol ha\u0026 ceaced. When the spinal cord is the seat of congestion, it is gene- rally known by the presence of convulsions of the 1:ppe-: or lower extremities, and the patient usually complains of a numbness, with pain aud tingling of these parts. Now it often happens, that the brain is affected at the samne time with the spinal cord, and then you cannot get any account of the patient's symptoms, and you general!y fnd him under con. fulsions. [o be continucd in our next.]",
         "PART SECOND. Substance of Foreign Journals. A31ERICAN JOURNALS. T/w 2orth Anerican Mkdical and Surgical Jour:al. [[n our last number we delivered our opinioni of the merits oi is new puiatson, aid we do iot hesitate to express our behef .hat s: stands unrivalled even ii the old Continent, and it is our ardint wih tiat ithe kniown taents of its Editors nay continue to ia:ztm-it its unportance and utility ; we cannot therefore, too strongy crniemtl lts perusal to the practiti-oner in Catnada. It 2 hiut jusdce to acknowiedge tit our neighlbours have now alitained a degrec of con:sideratoi in the scien:fic world, wh:clh co:nands our admiratîui, and which raises then to the level of the most ancient and civi1zed nations of Europe.] Gangrenous sore mouth of Cildren.-Dr Coafes report3 C:u.it about 120 cases of this malacv fell to his care in the C:d-en's Asylumni, Philadelphia, where it appeared to rage ps an epdemic. He remarks that thediscase commences im- .1d:aeyiv at the edges of the gumns, in contact with the neck of tie teeth, and, most generallv, of the two lower incisors. *W'hen ut reaches the edges of the bony socket, the tooth be- concs loose, and when drawn, exhibits portions of the fang; and it is while in the act of rapidly spreading, that it occa- sioni gangrene. The greater number of cases occurred bet- wvren'2 and 5 years of age, but sone as late as 8 or 10. No ciid ever lost a tooth of the second set ; and, indeed, the second dentition seemed often to cure the complaint. The disease is not coitagious, and the use of bitters has proved a preventive agency. Mercury bas not been injurious, bot4 before and duriug the disease- In the treatment of the sore; Dz",
         "t2o AMERICAN JOUnNAI.S. Dr. Coatei obtained ne benefit froa honey and myrrh, witk a.um or bark, nor from caustic potassa, ar.d nitriate of silver. Pvro!igneooUs, muriatic, nitric and sulfuric acids proved en- tirely useless. It was found necessary and beneficial ta extract asi afiected teeth, as soon as they became loose. Drs. M itchell and Be;I on the rarioauzs disease.--I a long but interesting paper containing a detailed account of this contagion, we find the foilowirg statement of deaths as con- nected with the sate of the consutution of the atmosphere for the !ast four years in the United States. ThE amrocat of .a vir which fL i: rai and sna:, D::ring the four years. fror 1,'22 to 1S25. inc!usive. was. 18122. 18S23. -22 9 in:hes. 35.20 1 45) I 5.8 3 :( Px.w Er.rwA-Dx hs by Fever3. Erysipei.as. 31Ieasles. SiI.ai:-pox, 1822 3\u003e 4 0 1S23 758 24 156 1G IS24 G54 283 1t2 321 1825 373 1 38 6 s NEw-Yon:---Deaths by FeTers, Erysipelas. Measles. Smail-rOI 1SQQ 3593 6 1 0 1523 HI91 13 117 1 1.z 2 4 i i 14 1c 9 1iS5 445 20 53 4.\u003e Is BÂzs:r mor-Deaths by Fevers. rysipelas. leasie'. Small-pox. 332t 400 0O 2 21 1522 4.30 1 4 12 1824 at:4 2 175 2 3823 138 O 3 Cholera Infantun.-Dr. Parrish of Philadelphia after an extensive exoerienceand attentive observation on the mana- gement of children aîiected with this complaint, h s anived to the follo;ing conclusion : that the only cause of cholera infantum is ieat, connected with contined air, lie therefore strongly rccommiends the cooling regimen such as cold water",
         "AusnICAN JoLTnmAs.9t internally, and ex.ternally upon the skin. Wheh it happe.1s during the process of detlitioti, Dr. P. has obtained the io.st decide.d betelial results froni the application of bisters be- hind the ears. le was led to this practice by the fact tit the eruption, which, during dentition, is r.pt to niake its ap- pzarance behhid the ears, often proves a most saluary effort ofnature. le alo prescribes aromatics as preventive aiutsL, sach are cinnamon, ginger, pepper, the clove and the nut- zieg, and advises that after weaning, animal food should always enter into the diet of a child. Tic-dudom cu,' cured by Acupuncture.-Ln a case of th: kind which had resisted ail applicationis durig eighteen imtonths, Dr. T. Hunter Ewing eflected a complete and apeedy cure by this operation. 'lie neiediles %vert' introduced about an inch fron each oither. Tiwo in a line pareliel witvhl the itifecior edge of the orbit oif.ihe t* e, and î.tf an inch below it ; and a third below. and equi'4sh.1:t fron the othsers. h'lie first two nezre in1iodtuced ait the depti ci :bîree-fourtis of an inch ; lite last, a iui meh. They were iie.- led very gradually and with a rotatory niotton. 'The secoid needle was scarcely introduccd, before the patr:t exclaitied, ' the pain lias entirely lel me.' Whîetn tle hardt wr as introdtced, site experietced a sttifneas in the muscles of the Chwtkr, and a crecpmîîg sensation, as ifa spîde's web aid becn dran i acros the face ; but nto painfii sensation wihate ver.\" - The needles should be removed two hours after introduc- tion, as their rewaining a longer time might occasion some :nisclief. Tiae New-Y.2ork; edical and Physical Journa. rWe have been politely favoured witlh this Journal fromn one ' tlie Ehîtors througi the iandsof P:cf BEcs-, the rcnownued au- itur on Medical Jurisprudcnce, duritg lis shtort visit tu lthis cous- try a.d were îlot its credit \u003eo well establisied, and tlie ner:s of the Etlitors so universally acknowledgei, vie migt veuitîret to cx- press our regret tiht it should be so neglected in this country, if we consider the facility vitih whichî it can lie obtainied. \"rite work is conducted by Dry. Johîn B. Brcr, John BFr.r., and Daniel L- M. PaFixoTro. Thie two first have been cali.d to fill sotme of the chairs renidered vacant by the resignt;îliot of the furmer Professors of the University of New-York. This inior- tant trust is a flatteringtestiousty oftheir Professional ennuence.] The first object which commands our particular attention in this excellont work, isai a.ddress delivered before the Mi.",
         "AMERICAN JOUnrAL. dical Society of the State of New-York,'by the President Dr' J. IA.ANLEY of New-York. This elaborate production is a chef d'Suvre of reasoning and jud.gment ; and laying aside the purity and elegance of its style, the richness of expres- sions and elevated ideas which make it a masterly piece of litterature, it embraces the most important tnpics of-edcal Police, and the ar:uments vhich the Dr. adduces in corrobora- tion of his views, are entirely underniable and admit of no answer. The principal features of a lav regulating thic prac- tice of the Medical Profession, as it should be franed in order to ensure to the public the due exercise of the pr o:.fes of life and death vested on the Physician, are preset.tcd i t.e 'arious lights in vhich they are susceptible of beir; cons. *trued. Our linits and the absence of incorporation in ttis Counztry, as wicl as the varicties which the différence o\u0026 Constitutional Government must naturally impart to the la.ws, preclude our giving a fuil account of it iii our pages. We shal., however, extract some parts of it. Thus, when speaking of a section which only imposes a fine recose:able as directed by our ojwn laws, against the practitioner wilhuut li- cence, but çhich exempts from penalty those who shall not receise any fee or reward for the saine, he observes : \" Tis clauzc, save one to which I shall preseliy refer, is pe r- 1iaps. t he io.,t extraof-odiary pros, ion b lich ever founid a place ini a st.iate book ; it niakes hie pcialty atuachi, nos to tie irac- lce of piysic withuut tIe evidenice of pruper quahiiicasîmnî, but 1,, tl: rc.:espt of a fee therefiu ; it makes no accounît of the ihs::.. a: coseqeces of uilieised . ignor.:nce, but sersouisly attacks Ihe peutv eIoluieiits of its rait ; iin '-tiect, pulishth% ie r.A R - E iJle It acqIlS t Ee eco 0 IlluC ! n meeo. .h ..; pr. ho, can serve no purpose iii preventimg quackery aid sis- ...ture from: batteninîg on the crtdulitv of the publie, froi Ilte ,:heuities attendm.tlt ils excetltui: an1d wit, . it place of bemiîg l, n oieralcs a- .1 bounty ; lur lie mist: be stupid in:ced iwio, s,-;:: î:s .!b:saofe, has Iot ;.eliiy suùicl-:a.t lu eluide Ihe pe- n.siut. Il tere be aIv ser'ons :ittl.niln lu protect lte public !:t.-t nit: IUî;s o sil so fre-nsît-i îIl raclied by isen: n. ho ai. ,.îe wîihout narrait Ihe tlharacter luf lhysicianls, hlie 'îlienvce ài.ouil lie n.Ia:e a isdenennour, to be p.ruscuted by mGiimnt, and p:isai.l I :it ste discretliun i he cctîrt, vi:it: a reasonaii.e ji.t of:e er.; y :ioilsog less ihani ti.s, Ulers Ile sligterst c:-, SZrUement :o expetl, ihiat the iu;sani.e cau eser be :fl'ectually ccrr.ted. On that which would provide that those also shall not be liable to penalty, wbo vill only use for the benielit of the Sic. any îoots barks or herbs, the produce of the Country, ho r marks :",
         "AndX.cÀ JOUanALS. . \u003c8 Thàat tie former proviso inteuded to restrain unlicensed prac- titioners, wio professed to be physicians ; this patromtises every pretrnder to the iealing art. be his merils what they may, pro- vided that lie restricts himself in the choice of vegetables. Telie on- presumiei-that ' a igi lcarning is a dangerous thing,' and ins- 1'r'rets its exercise; the otier grants a complete iinuii to ilhose w1hu have sone at ail ; - for it cannot be made conîstent witi itself wvithout assumirsg thtat aIl these professors ofa vezetable na- tvri imedica are s ave,Ti sos. or that there s no vegetable posson. Dilji cull und painful illenstruaion.-Dr. U1ammietley, lAte Professor of Clinical Medicine at the Universitv of New-York, speaks highly in favour of the administration of mauseating and purgative medecines in these coipla.ints. In the conclusion the author mentionsî the use of ergot as laring succeeded in cases where a powerfui stimulus vas required on the part of the uterus 'Though ha acknowledges its fai- lure in the only case in which he seems to ha-e euployed it, still lie invites attention to the benefits it may convey, whensu employed in the class of diseases which forms the subject of his remnark?. Ve would here also request attention to the hint afforded in our last number by our judicious correspon- dent, Dr. Taché, of St. Thomas, for its use ii cases of lie- norrhage, whichi we arc not aware iaving,being as yet coi- firied by the e.perience of msany. Dr. lamnersley gives xv grains of ergot for a dose, and equal quantity of jalap conbined vith it. 1Population of the Ste of -NewYork.-Dr. T. Romeyn Beck, lecturer ou Medical Jurisprudence, lias drawn the fol- lowing conclusions from a census taken of the population op to 1825. The resuits are that the population of the State of New-York amounsts to 1,61G,456 ; the proportion of Degf and Dumnb to the whole population, is one in c2,506 ; that of Idiots, is one in 1,137 ; that of Lunatics is one in 1,973. ''ie proportion of deaths is one in 69. Tihe mean proportion of deatisi in Great-Britain in 1811 was 1 in 49, and that of ail the Couinties of Wales one in 63. C ls taking our leave of tle American .Iournils, we snust bie ii- d.s.tred to oîïer cur seintimensts of gratitude to their Eistors awl.i Pbhuslsher, 'or hlie approbat:on vh hi tisey liave su generosly amt unahniously conferred os our pusbliratiosn, und for their wishes for its susccess. The Qebec Medical Journal beil. tie first pers- othcal publication on imiedical science ever altempted ini Bratish North-Amncrsea, it cannssot be expected to possess, in its counets. cemnctit, all the sîterest ofwicl n work of this nature cati be re'- dered susceptible. The Editor does not claim merits vhich nis age ant expericnce would certaiily desy : the credit of tbe un-",
         "4LoNnon MEDICAL J0RAI. dertakig beinghis only tille to public favour. However inro,1 siderable the work niglt appear nt present, lite Editor flatters himself that il vill prove ain incitement to his Professional conn. lry-ntii to display Ilheir talents and skill in the cause of sufferisg ham:n.inuitv. .should he succeed in this expectation, Le wili con- sidler h.imnself amplv rewarded for his labours. V- ano acknuwedge with cieatpleasure, the receipt from our rneh reperted friend Dr. Felix PÀSCALIS of New-York, of tiree 4 ry intlereitinig papers, ote of which has already appeared in one of the Anrican Journtals, anid which were politely lianded to us bv neueral STUART of Baltimore, on his laite visit to Quebec. We w.l tai:e the liberty to inisert one of theln unider the bead of nr Correspondence. nle m . rEconn r, of Philadelphia, bas been annonne ced to this .urnal, but, ve are sorry to say, is not yet received.] 'c Lcondon Medical and Physical Journal. Digitalis in Dropsy,--Ttwo cases, one of ascites and ano- tiher of anasarca, are reported by J. Davy, M. D. to bave been cured by the use of digitalis in powder and in some what larae doses. The irregularity of the reporter's accouit, and the i.nmense number of other remedies acting upon the kîd- n %V which he lias made use of in these two cases, induce a supicion i Our mind, that the virtues of the digitalis in this case might have been exagerated. Contagious nature of Crop.-In the Number for January, cases are related by dilferent persons to prove, some the con- t:gious nature of croup, and others the contrary. We beg leave here merely to suggrest that if the contaminatirg cause were sought for some,-hat farther than the bedside of a pa- tient or the wards of an hospital, experience would perhaps cease to prove such contradictory results as are sometimes improprly attributed to it. l!cd-ache cured by purgatives.-Dr. A. B. Granuille de- tails a case of severe head-ache which he cured by a judi. clous use of purgatives. le observes very properly tiat this mTriit have been mistaken for tic-douloureux, but a due at- tantion to the state of thc digestive organs will remore all rusp'itns. This sucucess of Dr. Granville reminds us tif the faliurite piactice of 1. Abernethy, and would seemi, in our humble opinion, to corroborate the view he has taken of the cause of a number of maladies, as having theirseat in the ali- .mentary canal.",
         "PART THItD. Domestic Intelligence. AND FOREIGN CORRESPONDENCE An attempt Io a lcer!.ite value ofthe VÂsCZNt, ViRus, ar a means of Mssning the susceptibility to variolous diseases, with remarks on the mostprobable origin and nature of tA smnall-por Read before the County Medical Society of New- York, April 11, 1S25 ; and comnmuoicated to the Editor of this Journal, by FEUX PSCALIS, M. D., F.l- low of the College of Physicians and Surgeons, President o the Acaiem:1y of Medecine aud of the Linuaa Society, Ne w-York~, \u0026 c, \u0026c. Nec pluribus impar. Tw.T-FmIV years have elapsed since the process of vaccination was firstsuccessfully employed in this part of the icw vorld, as a preservative against the smtall-pox. Its ha- ing already been approved of by several European govern- ments, Vhich successively adopted it, concurred to place it bevond the control of prejudice or of individual opposition; in.eed, it may justly be said., that the snaninous opinion of the niedical and civil authorities have long since enjoined it upon ail civilized nations. The public con:idence in this prophylactic bas thus far never been shaken, because no ap- plication of the vaccinal virus has been made in the way of experiment since the period of its introduction, and af!er- wards t-sted by the artificial small-pcsx, without its virtue.s b-i-g fa.ly acknowledged. On the other haud,the few ex- i uenticed froms year to year in the general reports of J.--I.erian institutions, were always brought forward with satisfactory explanations of their occurrence. Among the few last cppouents of this admirable discovery, there were simply doubting physicians, and others, whose strongest ar. E",
         "D1. FaL x PniclI;. gument against vaccination was, that its co:stitulional infu- ence must wear out by age ; meaning, either that it could not be depended upon in the human system, but for a certain. period of years, or that the virus itself, after circulating through a great number of persons, becomes'inoperative or inert, and should be renewed froni the animal which first furnished it. Notiig can furnish strougev eîdence of the value of this benèficial process, than a reference to the bills of mortality, in the dense population of London and Paris. Philanthropic minds haee, in consequence, rejoiced, and sincerely congratulated our profession on the subjugation of one of the most terrible anid loathsome disense. lefore I proceed in my investigation, i must tit der- ic; the iong period just mentioned of the estaishe.d success of vaccination, a few exceptions have occured which haTe given just cause for public aarm:î. These were partial or ge- ueral epidemin attacks of the small-pox in some2 of our popu- lous cities, as Philadelphia in isù2 and 183l, Baltimore in 1822, New-York in S15 and IS21, besidrs other seaport towns, and the inland cities of Lancaster, in Pe.nsylvauia, and Albany the seat of government of this State. Nor are there many capitais of Europe which hare been more fortunate, or mnore exempt from such vibitations. That of Norwich in 1 S Q ai described by Sir John Cross, was 2ppalling by its mortality. Other epidemics described by Dr. Monroe, and Mr. lenien, and by Dr. Thompson of Edinburgh, during the succeeding years, were also very severe, and like our raqt epidemic, were attended by other kinds of modifed variola. A like pre- -valence has also taken place in France, the authentic ac- -ounts of which from Marseilles and Bordeaux are in our possession. In each of these recorded and recent occur- reuces, some kind of -aricella, or other rodified furm, has simultaneously prCvailed, suchi as the chicken-poz, the szinz- vor, aid'that which lias been called varioloid. Of the ap- pearance of the two firstwith the snali-pox, we have the fol- lowing documents. Ist, A report drawn bv order of our medical society, and pu'blished in 1816. 2td, A report to the Royal Medical Society of Bordeaux in 182. 3d, A very interestirg uiarrative of the epidemic in Albany, 1824, by Letwis C. Beck, M. D. Of the last forn of midgated varie- la, we shall hereaftergivesufficient documents, It has been also !atisfactorily proved, that wviti whatever aggravated symîîptoms the snali-por has broken out, it was, with hardl7 an exception, am3ng.subjects unprotected by pro-",
         "Oc VLiUoLoos DisrIIii. vious vaccination, or by inoculation, while the accessery va- riolous diiease always obtained amonig a great proportion of individuals who had been subje'cted to either one or the other of these processes. These events have of course placed the preservative power of the kine-pnx in a very different point of view from that with which we heretofore have regarded it, and even con-. tended for its uni7ersal adoption. We have been in a great measure discouraged, froin the fact that by a fair retrospect since the year-1S09, to this timxe, it appears that the pro- portion of cases of snall-pox, succeeding vaccination, receiv- ed and treated in a London hospit-d, has been at least as one to three and a half ! [Vide G. Gregor.~ There are nany vho have supposeýd oiuît the varioloid after taccination, and the chickenî-px, were discases different from the small-pox, and not at ail to be controlled by it. Others perfectly versed in the etiology of both kine-por and variola, bave confined the indUence ci the forrer in the constitution to the nitigation of the indlanimatory symptoms of the latter. A few Euronean authorities have contended that the vario- loid of our d.ays could not have cxisted before the cow-pox, like the chickeu-pox and swine-poc, two sorts of varicella auciently kaown and analogous, and that there couid be no hesitation in recognising the varioluid as the swine-pox, in- stead of being a nodification of the small-pox. Setting aside, therefor , ail hypotheses, and the opinion, aise of the degeneracy of the properties of the vaccine virus by age, let us examine whether our difficulties, and the mys- tery of the Jeunerian prophylactic, are not to be accounted for Ly the twofold character which appertains to the small- pnx, vi z. that of an ar!(ficial, and that of an epidemic disease. This has neer been adverted to in relation to the influence of vaccinition. A few questions on the natura of the small-pox, in order to elucidate its adventitious epidemic form, and distinguish it froms th:t which, by our instrwnentality, can be renewed at pleasure, are at present indispensably requisite. 1st. Is the frequenit reival of the small-pox, or its conti- nuation in populous countries, governed only by the common laws of contagion? 2d. If this fomes can long romain latent and inert, can it ever be destructible during any period or tiine ? 3d. Would it iot be rational to suppose that the variola; .nke tny diseases of a malignant or pestilcntial naturel ori.",
         "Da. FILIX PASCIL1s giuates from certain comnations of animal eP-u;ia, suc], =a tiiose titat are a5certained la generate féb\u003erile cijisiht:maloui, discases, \u0026-%c. ? Sont of these problematic questions have ever beeui re-% solied. The affirmatire of the first, -which cluiing 50 nalîy ages, bas been irnplicitely belicved, is no doubt the mit~ un-~ plhilo!ophical. Theintroduction of the sriil-pom b\u003e' the- 'ýarace1s, 'ia bail received it from the natiies of Arabia1 whlen Chey inryadcd the Christian states on the eti'.raar coasts of Europe, twalve cr thIf--tetn hundred Ytars -, oe is uot a proof thlat the Sanie -Vrus couid not Sirice havre ofitn beci hoyae-engcndered, in other parts of -the world, raid me.n be imporied irito the bosorn of any azicuit or nioderti ntion o( vitber lenper.Tkat bifwic! so excIusiziy poitts out the torrid zone, or the biiîulà-phiace of «-ilahornt, as the~ origýir of the srrnali-i-oz, appears absurd eraoughl, m' hen %ve ai- (eriairds iind, thaiby its cc'ntaiious nature. it nui ber,-à pro- ipazýated not on;y Lj\u003c.uhte tcmirperarc ein but bas lbc- corne cor.;en;.al ta the joJ clinate, 'whcre it o.z:ce 1lev2%Nttd -ke peninsula cf Ramnschrti and \u003clie islacJ of lctla:d-- Frour tinie ina orI.it nori-.iver ajpceari Io ha;-e :3iiri ii thre Eoutherair.ost parts Qif Tartary aud C;*.-ia, auci tu fiate proved a scourge ta ail race-, of me%, in cezy Iit:tude oùl the earth. The aiifirmatir;e ofthIe iecond çuestien, ixmphrg 114e C315- leuce of. the variz!ous virus durang an ind-vLiite len-th of 1inie, and ini a «la\u003ccuit state, as mrust hiave been 't: czte dur- iisg thc long -ird Lsealthy L- ic.wn pt-iriodbleu~s ti thirttti c.iic in i etrc'nce ab:c.luie1y contUaTy tu \u0026.e~ lan1S cf uazure ;if t.pooîasindentical;y the sanie badclsha its Grrrna in 370, bow could it bave becn ciifutd ati over the ivur!ù and exiZnte\u003c titis day, unlless 1\u003c5 tonits is ola. nature iasdrurctile V\u003cTery ps~becircuwcsiance _' (a td il:en, itL cudQ ahîays jT.Tai et 4sti..e -we Lk.W, destr\u003eys ceayi tkir. g. To thti i7rn;atiçe of the lasL question, 'wre can casilyyield cur TatiLnal consent and belief. Neîer w-as [lie doctrine of spoi.tatieous z-cncration of iseases bctter eviaccd by\u003e obser- Tratioi, £0 -wfLli ceteced in atmo!pheric, gascons, or impure cxhaitions frc'm lue earth, or froni othcr source:s, aud illus- trated ly pucumnatic pIhiloiopl:y, than it liaS bCeen lu our Ld3Yg ail over rte vi Id. lu relationu to the small.poxe facis are Dot iranting to provei tbat iu endenii preTal.ence bzs sonuefurnez fcI!oiwed tht rno;t",
         "0. -V*al.Lu IGLOszis Ii.aldiy seazons arnoilg lieuse populations; in con5equence of Oisturbecl graves, prostrated ai-mies, field3 o! slauglitrr, and in harbours aud ports frum crowded bate ships. '%Vhether it ari.zes iroin local cacses, orfro»t iÊs dormant or latent frme:, the smail.pox constitutes an epidJemic, -whose primitive chi.- i-acter postcszes MIl the -,iruiect arnd ma'.ignity beloning to the distase ini any situation. It differs tiierefore froin that ran'L wic: s rctii~y retrd y noultin.Tht mild and! btiigl . arcix of this arciuicial smali-pox, is ot a m'atter of Chance. 17be saftfty whLh -ehich it rues its stages, bac! aa- ciel, dv caozed its a-:\u003eio1mong tirose Asiatic uations, -who, nioiv wii!te pz%.* aricpc-;:vtli iiégi the ù f the natu.ral or epideriîz disense, but _.±jflsL the Zijutila(iüsi or t;; fac au compîl-xîun. I3esides the Gcor- gicas -' ail Ciz-casiiras, %ve iid, thai from lime imnlemorial, the Clieeprûterted thernuselies iii a like niatiner by the practice 0f uaocu,',tiun. Thea Eu-lisha nation borruvîed it !rom TLtrkkey, at the coiurneuceinctit0 o ailhe 18th cetitury, anad spread it in Europe aud in their colo:sie:g, whcre it has beerit uttiçer.dity resorted tu and er.coura-ed by medical, as vweli as bv civil authority due.cg cighty yca.s. The L-:ueticial. re- suits of this pracuixze, were aud haye hecen ackuois-iedged and! exîolLed inecvery point or vieriw; and! its uaortalîty, coinpar.!d ia tisat of tIre natural or epidcn4ic suali-iàox,, ua4 long ago ascertaied ini London to be as une deatiout af 1003 is Io oneont of 5. IL was ultimately supers;eded bytht procesof 'Taccination, which was expzcoted ta do awa-y every po\u003esible source of the contagious poison of the sniall-Poi; but the Tvictor-ous pirupb3ylac-dc cfr Jeuner wzrs oniy tested against th= -rtifici.al diseast ! TXhe -vari-oloub, foules can also, exist nder differentand zoo- dified for-ms ; tirese hase bcd'i designaied i\u003ey the generic na- me or vtaricelloe; twaofa them, ralletl thc chickc;.1 ox and! the J':i-ohavfe been logsince dezcribeil by I1et-erdeu, .Hlsxiam, Vogel, and by 'ions. Gandager de Foigni, as spe- cilic 'Jiscases difiering, from the smuli-poi, especially tiecause they ar-e attended with na clifficulty nor daisger before nor after au attack, of sin-d1.-pom. This opiniou has riot alu-avs obtain\u003c1 ini modern titres. Au American physician, Lîr. ILcwb: C. l3cc, of Albaîtl, his amoug aIliers batisrfactoriîy proved tire incIeriaity at least of Ut varicela chic!:en-po -%çirlr the sniall-pox. lie have seen ini this city, inany suc- cessîci attempis at conamuoicating, hjy inoculation, the chic- ).en-puz 'vhieh prevailed with the sulall-r.ey tlu-.ili- the au:$",
         "Dit. TrIX PÀseaui tumn of 1815: and it is now admitted, that a case of varicella may be so far aggravated, as to be similar to an ordinary dis- tinct and benign small-poi. We must then make one clais of the varicelle, or of the more or less modified variolous di- seases. This mode ofreasoning is so far proper and correct in the present investigation, since a new form of modified smali-pox, or rarioloid, has of late years much engaged the attention of medical observers in Scotland, in the United States, and in France, who have not hesitated to declare it a form of the small-pox, nodified by pretious consiiutoija! in- fl:ence of the taccine Virus. This opinion has also gained great support among us, and we might infer, I thnk, that from soine striking similarity between the two named varicelle, this new forn could be classed under the same gencric nare, as a third kind ; per- haps the highest in the scale of zaricelle, and the nearest to the artificiai zariola ; indeed a strilkinig parallel can be made of the varioloid with the swine-pox, the first differing only in deg-ree from the latter. Again, as it will appear from facts liercafter to be rclated, the inoculated small-pox (or the ar- titicia!) is not a sußficient protection against the epidc:mic: 1 beg leave to otier the subjoined table of ariolous diseases, aranged undler two classes. chickenl-pox, 1 artificialinoculated ncr. wine-pox, VAntOL small-pox, varioloid. epidemicsmall-pox, It is vith ibis scale in view that we can be better able to point out the variety on which the influence of the vaccinu disease is expected to be partial or conplete. Of he tivo first, which are transient and do not indore Mortality, i was never a desideratuni to ascertain whether vaccination is a prophylactic. Experience has ievertheless sbown that. thev are of rate occurrence among vaccinated subjects, unless they exist simultaneously with and epidemnic small-pox, and become a modified form of the same, which ail protected subjects still remain liable to receive. The third, which is now denominated the -arioloid, it is contended, was ot noticed before the existance of vaccination ; but it is so far under the control of this preservative, that ii is a part of our investigation to prove, that it is epidemic small-pox itself, perfectly moditiei by tise benclicial influence of the vaccine diseasc.",
         "On YArioLous Disiust. These remains, therefore, but the inoculated variola or ar/fficial small-pox, which could:after long observation vindi. cate the efficient and preservatiîe power of the vaccine virus, because in it there is not that greater proportion of malignity and virulence which ia iaccinated subjects can still produce the varioloid. To account for this pathological phenomenon in variola, we need but to advert to the variety of pustules by which it iso -asy to -rognosticate the farcurable isue, or the fatality of the small-px, There are r sorts of variolous pustules, besides certai4 aggravated symptoms which are sometines connected with therm. We dirird thenm into two orders ; all possessing the character of small-pox, or of the vario'ous diseases, while those of the second order are restricted to the cidemic va- riola. nUs-r ozor.n. No. 1. The most ordinary kind of pustule is the czianeous; consisting of two varieties, the disinct and confluent : it ris from the cutis vera, and not froi the epidermis, is of sphe- roidal form, filling with a transparent lymph, bat rapidly be- comni:g purulent and ora yellowish co)lour ; it flattens as it progresses, presenting a depressed point in the centre; if pricked, it discharges a white gelatinous iluid ; if a too great uumber of these pustules are clusteced in masses, and run ito each other on the face and breast, they take the name .nd have all the danger of the cailfluent small-pox, and may be injurioaus to the eyes, featur--i, and couplexion, if net de- cid.-ly fatal. N . The tubercu'lar pustule, rises also from the skin or c3tis, and deeper than the preceding ; it is smiller, elPrated, opaque, hard, and encircled vith redness ; it is conical, ani shows a. vesicle on the apex, which fills aud extends down- wards, frequently drying before it is full. These pustules are unequal, and do not d-esquamate at their base ; they stain the skin- of a brown reddish colour, and are nixed with the cutaneous pustules, chiefly on the face, and on the hands and feet ; they predominate in the artiicial small-pox, and were seen ia almost alt cases of the varioloid of Nev- York ; they give no diffliculty ia the treatment, nor proguosticate auy danger. No. 3. 1s the dry-pock, thus called from its dryness, and the rapidity with which pus is formed. It is spherical, noyer",
         "Di. FZr.X PISCILes flattenied nor dimpled, nor is it in any case exposed to rop. tures or oozing, nor attended with secondary eruption ; It mizes with the cuticular pock, and is said to have appeared eften in the varioioid of Philadelphia. The same is common in the artificial smalL.pox, especially on the limbs.penctured by inorulation, and in the parts czpcsed to extemal air, it is also of the most benign nature. SECOSD or.DR. The folowing pustules being of a bad character, are the Most danzerous, and occur in the epidemic variola oaly. They have been noticed by the abore named writers, andby Dimsdale and Sutton in Engiand. No. 4. The miliary pustules, are preceded by targidness, pain, and dark redness of the skin. Thtey Igradually apprar like innsumerab:e raised points, giving to -. close touch of the hand, the harsh feeling of a piece of shagreen. So many pus- tules pressed arainst each other, are ohiously checked in their progress ta maturity. A dulness of perception, and a vemarka!;le degree of torporsoon pervades aIl the functions of animal life. No care nor remedy can avert impending death on the 7th or Sth day, which leaves the body already gan- grenous in propartion ta the raising of tie pustules, which may have taken place. I once saw a case of tise ind etTec- tually relieved by a spontaneous vesicular eruption over the Miliary pustules, of large bags of lymph, which are kan-va by the name ofpcnmphiguisorpompholyx. Not a few victims f--l1 under it during the last epidenic of New-York. i fore- saw the same fate in the person of . female aged 20 years, hI.a!thy and robust, vhose fever was moderate, and the erup- tI.an rather sinilar ta prickly hent, or to that of erysipelas. No. .5. Is the resicular pustulc, derivin. its nane from the sii;zularity of its formation ii masses or clu:ters of smili ve- sicles, which slowly proceed to mlaturity, and although they are seemingly coniluent, do not communicate with each other, ench forming a separate celi, from which no adhering bag can, by pricking, be emptied. The fluid is here clogged, and its maturation is slow and difficult. Hence that kind of eruptison is fuil of danger, and frequently proves fatal, bat, like the preceding, is seldom prnduced by the artificial small. pox, and ve have never neen it in the varioloid. (To be continued in our nct.\u003e",
         "Dit. MIrIr.jU. os Scnorui.t. An Iafzugural Dissertation on the Syniptoms, Causes, Put'iw3- Ig.\u003eg and treatment of Scrofuta.--By JAer BAITri: ErAlr.un, M. D, Member of the Medical and Philos- phica~ Society. of the State of Vermuaont, \u0026c. Conmuni.- cated iu a letter to Dr. Tessier, Editor of this Journal. Aiud est discipulu, aliud nagistrum esse, (Erasmus.) November, 1824. OTIra's ideas and theorie; become our owu, wlhen, after deliberate investigation of both, and a full couviction of the rectitude of the one and ai the plausibility of the other, we sec fit ta adlopt them ; wz may. therefore, venture to Mo- diFy and commiunicate them ini such a way and manner ai may appear most proper, persuaded that it is as much our riglit to do so, as it is our duty ta support and defend them, after their adoption.-But, before we avail ourselves of anty, i:1 this dissertation, let us attempt ta give the definitioi and symptom.s of the disease which we are -about to consider. Dejinition and specfic Symptons.-Scrofu-a tskes its zana fron Scrofa, a swine, because this ani-nat is said ta be subject to a similar disorder, though the correctness of the ety-mology is questionable. Scrofula is also vulgarly called King's evil, from the former custom o fsubmi tting patients labouring undr it, to the supposed beneficial effects of the royal touch. fu a qualiiied sense, Scrofula may be defined to be a chronic inflammation, attended with more or less fever, and ~king its muost conspicuous appearance in the formi of soft, doughy swellings, which, in time, assume the character of liard indolent tumours, gererally situated in t1he conglohale .ands of different parts of the body, but ncre especially in those of the neck, axill:, inguines, behiitd the ears and under the chin. These tunours remain stationary and harmless for inonths and even for years ; but, at length, after havinsg be- come larger and more fixed, if not timely and properly a.- tended ta, they slowly and rather imperfectly suppurate and ulcerate, discharging, at first, a somewhat puriform matter, which, by degrees, changes into a kind of serous oozing, in- termixed with white particles resembling the curd of nilk. They, however, generally require ta be opened artilicially, as sqon as a fluctuation of fluid withiu is evidenît ta the feel. Tis practice is particularly recommuended wlen they are si- tuated about the ucck, and wien the patient is a feuatle, as F",
         "U i IYt. IIETLLrIJI'. the artificial openIng is less apt to leave an ugfy and indeli* ble scar than the spontaneous one. From the age of six months to that of ten or twelve and above, the disease most cormonily rainifests itself in the me- Senteric g!ands. The patient then, complains ofa lancinating pain, decp scatcd wiidn the abdomen, but which is of a short duration. resembling more the common gripes, than that wvhich attends inflammation ofinternal parts. There is, also, a gradual enlargement of the abdomen, and a general emaciation of the rest of the body. The features of the whc- le look and countenance are, altered in a remarkable degree. The eyes are glassy and sunk; the upper eye-lid drops down more than natural, and the pupil, owing to general debility, is much diated ; the nose appears large froi the fahing of tihe cheeks, which are of a marbly wihiteness, excepting wien ilushed with fever; the parts about the mouth are inz.ined to swell and are of a peculiar dul and pallid colnur; small but painfui ulcers surround the angles of the mouth, and., some- times, the who!e lip is divided by troublesome fissures.- The state of the bowels, though variable, is most commcon!v relaxed. In the early stages of the complaint, there is a disinclination to inuscular exertion, though the vigour of the mind dces -ot seem to be impaired. In the more advanced stages, the patient becomes fretful andI peevish, and his men- tal faculties become inert and dull. The sleep, although rot much interrupted, is, however, attended with profui- sweats, especially upon the breast and foreheadt. Toward.s the evening. there is usually an accession of fever which is net accomnpanied with any inclinatioin to sleep. The puis-, ;n ihe evenirg, is generally about one hundred and twenaty, and i, at no time of the day, less than one hundred in a iniuute. Aihough the tongue mcst commonly lias a natural apea- rance, yet it is sometimes observed to be streaked with a white Une on each side. To continue and terminate tie phy- slognnmonic symptoms, \"the appearance of the countenance is really that of delicacy and languor; though to the common observer, from the fulness, the peculiar smoothness, and beau- tiful colour of the cheks, it is oftei that of the highest and rnost complete health. If, ho\u003ewever, it be attentively ob- served, it wili be found that the cheeks, though red and tuxid, are softer and more flaccid thans is natural to health ; and that,instead of being fixed and firm, they bang, as it were, loose in the face. There are ierertheless, persons who",
         "ON SCROFULA. ha.ve the greatest tendency to scrofula, in whoin noue of these apparent signs af health exist, biüt whose complexions are peculiarly dull and pallid; i these, the appearance of deli- cacy~and languor is even greater thun in the former. In the former state, the lips generally partake of the fulness of the face, and are of a beautifil red ; while iu the latter, they are pale.\" Scrofulashows itself, also, in the membranes, muscles, in the mucous and salivary glauds, and in the lungs and liver, iu the form» of tubercles, in theliganents, cartilages and can- celiousstructure of the bones of the joints of the hyp, elibows, knces, and aukles, or those of the ungers and toes, in which instances, we do not find any movcaan: swellii, but, on the contrary, -a tunior ahinozt uniformly surrounui.g the joint and interrupting its motionis\" Besides, it is not uncommon for scrofula to affect dt skin, in general, anud even the eyes, which becone ailicted wvith whac is catled scrofulous oph- thalnia, giving rise to an obstinlute ilcinaUationî,supp)uration and ulceration of the tarzi and counjunctive palpebrx, fre- quently terninîating in an opacity of the transpareut cornea. Scrofulous ulcers often heal upon the appearance of the di- sorder iu other parts; thus, it is not uifrequent forthe disease to be removed iront the glands to the juints, and from these to tite lungs. It thc two last cases,a tc fever most gele- rally ensues, which puts a speady etit t the miserable e.x- i-r.ence of the patient. The nalady muost commonly attacks children of a fceble and lax habit, but it is by no means particulartu themn. Itseldon makes its appearansce before the second ycar of age, but ge- neralv from the hird year to the age uo puberty, and from -this, but more rardy, to about thirty. While at Monttreal College, i kuuw a contempiorary studcnt, twenty cight years old, who, t mv knowiledgc, was troubled sincc several vearsi, nIithaa berofulous iiillnamnation, suppuration an d ulcerauon of the various g!ands about the neck, alternaîtelv. Scrofula mîay be said to bei hereditary ; but it is not coin- rnunicable fromt one person to another, ncither by coutagion nor by inoculation of its mnatter.. Drs. lKortum, Lepelletier and Alibert have endeavoured to eiyect its communication by various well coducted experiments, but without succe3s. crofu!ous tumouis are said to be tiispoàed to subsiJe i the v, inter, ai.d to recur at the appruaca et taie sua.ner ; but this is obsered aut to be invariaulv the casc. È i. 235",
         "Dit. MEI!.rL.t:a Diagnostic .Syniptvn\u0026s.-Scrofulous tunnurs niay be antin- guished from the glandular swcllings.which occur iii syphili., by the pain attending them being less acute and more duil, by its admitting a spontaneous cure, but more especially by its early symptoms taken collectively, which baye no restni- blance wvith any form of the venercal disease. Scrofulcus swellings may be distinguished from carcinomatous tumours by not haiing that peculiar lancinating and darting pain which accompauies these last, and by manifesting a rmore decided displosition to suppuration and ulceration ; and7from eukistcd turrours, by their being stationary, aud finally tending to .bup- puration and ulceration. But there is no danger cf anv one confounding these disorders, except he is a very tupr t*icial observer ; for, by taking them in the agregate, Paî ticuIJriv the carly and the then present symptoms, he .i:1 ;lways bc able to find and point out their respective character. The scrofulous affection of the imesenteric glands. aliudcd to under the specific symptoms, may be distinguiited in the following manner : from acute peritonitis and enteritis, by tiere being but litle pain feit on pressure upon the abdonien ; by there being scarcely any hardness or tension of the pul1c, little or no vcmiting, and no difhiculty in procuring eNacuatt\u003c.cs vith the ordinary quaitity of purgative medicines. The scro- fLIous affection of the Mesenteric glands nay be distinguished f.oan chronic peritonitis, by there being no superficial piic.- ing pain, !o tendency to Tomit, scarcely avy costimez:css ra'r tension in the pulse ; by the peritoneum appearing ecually .istended with the skin of the abdomen ; by the i egular ev - nling accession of fever, aind by the gencral look of the cour.- tanance, as already described. Fron the Jcbris i:izntm n. - ,nittcns of Pemberton. by the fever being attende% sth rest- Csr.ess, by tie excretions from the bowe..,s not being parti- tularly changed from their natural apearance, and by :he duration of the complaint. .Prognotic Symptoms.-Tle degree of danzer at!erdant en scrofula, depends on the particular part of the body which is the seat of the disease. The earlier in life the alIcctions of the mesenteric glands, with the more danger it is -ttcdcè. The Most unrfarorable symptoms are, \" the emaciation rapidly incrcasing ; the evenin.g accession o fever very sett re, .%nd contiiiuing al:most through the wh.ole ligla ; thge culile reci- ir.g t-l? anid becurning dày a.d Lab, and the aLdoui.tn moe elîlarge d an-d tunc.\" . \u0026236",
         "OS SCaorL. 3 Those scrofutuus tumours which-are situated near the ccn- tre of the circulation, as other local disorders, heal more easi- ly than those which are more remotc. Chronic scrofulous sores, accompanied vith fever, are always. to a certain degee, dangerous, as the fever generally assumes a hectic formn and type, whith insensibly underinue the constitution. As, in def:ninîg scroful, 1 have anticipated the assertion of its being an inliamm:atory disease, contrary to the opinion of so:ne publie writers and private practitioners, in every respect w.îrthy of a high degree of confidence, niay perhaps veuture tu e4ahish, hre its nature as being evidently inflamnmatory. A otherc, Dr. Guod, as a cunspicuous author, places scrofuLa i his class ILlmaticu, order Istheticu, the given character of whirh conîitutes a palp.lble relict oi the humoral Im:ûa:uoy. But without saying any thiîng of lie slight basis on % hici their theory is pretended to be founded, and with- out being at ail scriule nor paitial Io their decisions, I nust be allowedl to assert, iith that confidecue wh:ich self-eîident truth inspires. that scrofula is an infiammaîtory disorder of the whole Iympiatic systen in particular., and of the corporeal fIraine iii general, which disorder, i consequence.of the agen- ey of the aidditional causes to be cnunerated hrerafter, is in- duced to locate in some une of the parts before mentioncd, and there to nake its appearance in the form of a chronie in- ilamumation, which can easily be recognizcd by every one. M. Johnu Burns says : \" scrofulous inifiammation is marked by a soft swelling of the affected part, whiici very frequently is one of the lymphatic glands.\" -M. Cooper remarks: \"I ie scrofuious diatheis, m herever it exisis, usually gives more or less of a chronic character to local inliamimitory affections. [in another place, speaking on the same subject, the same au- thor observes,\" lthe discharge is watery, lie pain is very con- siderable, and the surrounding skin innamed. \" Dr. Tlhomson also says: \" g'reater or less degrce of local infflammation oc- curs, t ani iniclined to believe, in every furim and stage of scro- fuious discases ; the sweltings are very often, froin the first, atcnded with a sensible increase of heat and redness, and the pain, though seldom acute, is always present in a greater or less degree ; pressure on scrofulous swellings, never fails to create pain ; and the temperature of the skin covering thent is usual!y two or th:·ee degrees higier than that of the conti- guous pi.rts; \" and aithough 1)r. Cullen lias placed scrofula intu tlie order )mpeigins, yet uot only this disease, but most 237",
         "2\u0026Dri. Mru1LLEU Y\u0026 of thosle ineluded in the order Marcore:, ervdcftly belong ici iii this disord.-r, Dr. Cullen observei: \"for scroficcis t. mours sometimes spor.itarîeoutly disiappeair, but eer \u0026fie.r zoy degrec of inflt]mation bas come upon tbeoe.' buch ii the laoguage of stierai of the u\u003eost diffrsed niedical writers. Iudeed it cazinot bc doebted tbat ne Iev- jied medical marn, endued with a reflecting and unbiaaaed r.iiud. u-ould dare to asser:,with any degrec of confidence, tha± z complaitit which causes a living part to swell, suppurate and ettu ulcerate, is not of an inflammoatory nature. 1Ibc opiniion zdi;atced by sorne, andi even by Dr. Good, that utcerati 311--y and does take place withiout prerious suppurationi, is sa piy liîur.-be opi-nion, not oniy fl'ase but evea absurd. ltln-am- u-.atiosn inay take place ivithioit an ensuing suppuration, su ýsuVpuratiou may takec place without an ensuirig ulceration, but ne;îlier of these: tivo last can exist as a priciarv diseaýc, and iii:îisani)ioit irîust bc the necessary preced-ent, the Colnia:ît £,-reruîîner, as -%l as the iu.di--perîisible excitiîig cau2c dJ éher ; and 1 thiul, that atny attempt te proye t1Jty ..îy thing contrary, iuust be totall.y abortiee and uusucccs.u\u003cut, 'orà it e r be made to appear probable mor ec:s. poi, a3ll. Leut the acceptationi or dufinition of ulcerztion bc,%tat a dicIjîrýc of pus from any part cf the b\u003eody, or - hetUci it vunly uicati5 aue.capc of pu:, frein any unitural c.2'rity, in a iiîgpart, iniiunniation anîd suppuration inuit bc au:.niticti io bc the infallible precuriors as weU as the eascritu cau.ses JÇ u1ceration ;asud the gratuitous a!ýbertioû of a ciiertsît opi.- 'Pdon Ss îC.S tu 51heN a grcat 'Aaa of lnoilcdigc ut WC ntial*u of t!,«ttis. On ciobe inîvestigation, ticrlyu ci fata4vt 1.0 a- izuic ti irritatiom, \u0026ndmnto, uprio d aitzralzi are, to Uc colîidered as caUD'es and edecUt w:ih Zr-ad îucat.e v'tLer ; andi pe:rsua-dcti t.Uat an effcti may, and in lact occri\u003e, tile causc of another clkect, lit i3 ic4% to bclietcà and to e t zcrordtcly, that irritation in theca~use of indarmatior: -. n ;axu tho te efiect of irritationu and the. cuse ot5upîra\u003cion, aitl suppuration the eilect of jidaimmation zrd thes Cau\u003ec of ialceratiull. .o rcason, comrnon sesise, andi ùaiIy obserçatiuos con- ,jiciig hinu, in a forcibie, oanticr, thati. uot oue tif thise càrz ptossibly exist, as ant cilect, without tLe pretuious ocaieuxce ziud irilluence of the active caubes ini the order iîerteu.te:. 311c- 2 3 S",
         "ON SCeOULA. cified1, low can ie conceive, with any share of propriety, that ulceration can take place in the least degree, without c pre- vious inflammatioh \u0026 suppuration, except he indulge himself in the unfounded belief that an effect can take place without the previous agency of its appropriate cause, which, in my mind, is as physicaliy impossible as it would n:aturally be for radiant light to produce darkness, or for free caloric to give the sensation of.cold. We might as well believe with Dr. Good who asserts it, that in the first stage of \"healthy in- flammation,\" the \"process consists in the eilusion of congu- jable lvmph, which binds the wveakened organization into a. doser bond of union, creates new vessels, and consequently introduces neir life !\" In the first place, I wvould question, and I think witii propricty, the assertion that any in:tmrni- tion whatever, either idiopathic, traumatic or symitomatic, is, in any degree healthy, in the strict sense of the terni. We well know that in lesions and lacerations, and in excessive ir- ritation of parts, a disordered action follows, and inflamia- tion most gueerally ensues in spite of every thing that cither nature or art can do; but vhether it is absolutely necessary, for the restauration of these parts to theih natural and pris. tine state, is yet a matter of great, anti I think, just doubt, It is, however, only in case that it should be, to accomplisî such a purpose, that we could be justiliable to call heaithy, an action wYhich must be unnatural and incongenial to the parts, and, of course, morbid, since it never takes place in these, when they are sound and heaithy, and free from ex- cesssive irritation, and vhen their assigned functions are all perforied in a regular, easy and perfect manner. Indeed, it vould appear to be an insoluble paradox, that a diwased ac- tion should be necessary for the continuation or preservation of a healthy one. This seems, however, the natural inference which cari be fairly dravn from Dr, Good's \u0026 e:hers reason- ing on this subject, since we cannot possibly conceive any morbid state in injured parts, before that disorcder of action and inflammation have actually taken place, which are conse- quences of the injury or excessive irritation, and not a pro- cess cf their removal or cure. WTe might as well attempt to prore, ar! it would be with a; much hope of success, that fever promotes aspeedy and favorable termination of inllamn- mation, because it atways accompanies it, in a greater or less degree. But, as the fact that fever is the usual concomitant of inflaumation, gives us no kind of evidence that it is in any",
         "Si Dt. MF:LIJXR i'ç1igm,..iizagrneraly crascs rnech.snirtl Isr or r-et- si Vc. ira itatiou dnes îho~tnwards proin, with any clei-rae cf satisfaction, thit it is at2'I impcriant crever? adjetmnt, in t!ho cure of the injur or removal, of :h.t escxtswe initatirs A1 Élit is ratiorial loi u-s ta bclieyr, il, thit in f2siota, and meclianical injuries, it mnuy require in inrrzicd vizoor and enerzy of heuaùhy action, in the p:uls iujur.cd, ta efficct ih~r arcunion ; ara(] titat t heïr cure nsay take pi-ice witJýo«t =y in- fi immauioit xviatcrer ; and -'%r. l3uritz e,.àikcs it ippear- or thani probable. Ili o\u003eh'iiîate chiralic iflarntnatiio, -.\u0026- are crp~l1 indtuct! :L nlew action in %.'e part cIc C.1. , is, to i t :r ol),tita.te inflamnmation inta a niore c.î;tnnwt(aîlle on al jt!,.s cndj j, accornplisliedcl by the prolicir a:nitration nl c.-r- taing rernedies whose iniPressihii ii strca.. inough tO uîc-rcoî,'- S~ pPc:iiic: poivcr of the dise-,cl andit to: e-sta.-Mi-d a -w na.- witicli ii cnànmony nii more ,Uceptible of tt oj\u003ecraiuu er the ordi.iary râmucdial agenîts. liere, anîd peh1.h\"rt 0!11%, it Maly bic riglit to nîia*«e use of retative anud co:ninarai- tive termc, calling Luec 0b1\u003e4ina.L ita mannat:n morbid, atid 1 Il e-ic ittaucedl by art IwaltIh co:up:rin; togetimer their rtezicc- tirc yit:llil'z dk.ýpqiti1\u003eiis to the~ cierts of îudciî' .1 a, ini the second PlL. I amn ilctlieLd tu believic. Ct!12th-_ proeCCýk of iittnnlindturs not colisil' -'il) the eÏ,inof atu- blie lvnpli , but. radier, in the incrensed artion of the ti- VCG ammd vessels of te parîts, lite eciruzion of coaguihi ivmuîpc la*ngTirCiy lme CnOtiSeOque.ICC of that incrmzased aetioi.- à . ide. it as certain as Dr. Cooci asse.rts it, titat th-_ co-- guule lyrnplibîî. te iveak-:eie or,;. ait iota i., a c!,u- sbr bonud of union, cretcs tne% vessels, anld coil-eiuitly in- I r;idmacesllIîQW lire? iinlee\u003c, I thi:mkg% tàèis tu h ervr m.rr'hi- iuoiîicai,) one right -sty, wildrcoîimz d (Vi~ce uimîwurthy the beli et of a ratiolial .lifd umîiiact. i'îiJ. flv coagiflable lynifli, our wvriter in;ea.tz, il suplinçc, Fudt .21 mi.ccs!ariiy l\u003eecoreS no(agTUlatedl or curilleil, as thc lioix is, [slert eliiu-\u003cCC in the interstices of parts, or %l, lien tunnzilg sir 4-ozii, out of divided vesst-ls-, iL cornes inito actual contact witll tt atinozohterie air. If se, as 1.0 hociy will liretcndt to denly vuint cva.ruiated or curdled lynîph ks a dea-1 aile inc\u003ergznie mat- ter, liov cait it, I %vould azl, Dr. Goud, prove to bce atly meamîl1 of closer union bctwreen living parti, a'141illnrcoter3 create rietv VesselIJ aud imtroduce .a ulew lite. ? LI l e culînziietif inOur next.] 21.)",
         "DU. VALLEE SUR LE CANCER DEL'UTrrUS. 241. Dissertation sur le Canrer de l'Utérus, préscntée et soitcnuc à la Faculté \u003cle Médecine de Paris, le 10 Mai, 1S26, ct communiquée à l'Editeur de ce Journal, par GU LAut E J. L. VArLL.r; de Mont-Réal, Bas-Canada, Docteur en Médecine; Bachelier ès-lettres; Chirurgien et Médecin du Canada ; Accouchcur ; Chirurgien du Cullégo Royal d'Edimbourg. Nous avons lu avec le plus vif intérèt cette production d'un jeune compatriote; et geoique les limites do notre ouvrage nous obligent de méîîager, nous croyous rendre justice à son auteur en la placant à côté de celle du Dr. Meilleur. Ces deux dissertat.ions sont des exemples frappans de ce que peu- vent les talens et Passiduité, surtout chez nos jeunes Méde- cins, dont 'ducation est malheureusement trop négligée en ce pays. Ces premiers essais du génie sont encore des indices certains do ce que leurs auteurs pourront contribuer vers l'a- vancement de l'art, lorsque l'expérience aura perfectionné leur jugement, et étendu la sphère de leurs connais::ances. Nous n'entrerons pas ici dans le mérite de chacune d'elles en par- ticulier ; il nous suffira de présenter quelques remarques, lors- qu'elles seront en entier sous la vue \u003cle nos lecteurs. Nous croyons cependant pouvoir dire par avance de ces deux jeunes compatriotes, que leur production rait mieux leur éloge que le meilleur panégyrique, et nous pensons qu'elles méritent à chacun d'eux uie place distinguée dans leur profession, en mòme teins qu'elles leur promettent d'ètre un titre durable à la faveur de leurs concitoyeus. ITROnucTO.-Parmi lelsfTctions atxqtu lIes ç'uterns se trouve exposé, il e est p:Is de plus uncavc 1:1 de plus frmil.sNe. que le cancer. Soumis durant la plus granide partie de l. v;e à une excitation périodique, et jcuissanst d'aipeurs d'iune grnde ac- tivité vilale, exposé à une fouile de causes d'irritatiois soit directes toit symp.tliiques, l'uteris est souvent le s:é d'un surcroit d'ac. tion c! de phlegmasies chroniques inaperçues à leur début, obs- cures dans leurs progrès, nais dont les sites sont souve!t atals. Pour écrire aur une maladie aussi importante, et qui n'est pres- que connue que par sfg efTets funestes, il faudrait sans doute une expérience plus lorgue que la mienne. N'ayait encuI'ore coivarc que peu d'aynées à l'étude de la siience médicale, j'ai moits coit auité me5 forces que le désir de bien faire ; et si par ion zèle et un tr;aail assidu, je ne suis pas parvenu au but queje m'étais pro. pr.2é, du moins ne blamera-t-oi pas nies efforts, si oit nt loue pus nies succès.",
         "c24ý2 Da. VALLEt Dant celte dissertation; jé ne me livrerai pasà cef esprit qui : pla:t toujours àcréer des liypoéèiea, et à les mettre à la place de la vérité. Je me bornerai à exposer ce qu'apprennent l'observa- lion ci les écrits de nos auteurs modernes. Je vais donc essayer de traiter fl'istoire du cancer de l'uterus; elle conprendra: 1. l'ex- posîtioni succincte de ses causes ; 2. !a description de lamaladie; S. enfin son traitement. Le cancer de l'uterus épargne constamment les deux pé'riodes extrènes de l'ùge. Il est même ràrcde le rencontrer avant vingt- cing ans et après soixante: maisasn époque d'élzction est de tren- te à cuiilante ansc, car c'est ordinairement Jàrsque la menstrua. tion est arrêtée, que l'on voit paraitre cette cruelle maladie. Je pairai soussilence les opinions variées qui ont été émises par les d.Térens auteurs, sur la nw ure du cancer ; ent effet, partout je ne trouve qu'un assembizge da suppositiois arbitraires et d'opiiii- ous erronéc, qui ont survécu aux théories ancieur;es qui leur a- vaient donné nissanca. C.Jsr.s-Il exite un si grand nombre de causes capables de donner naissance à cette terrible maladie, qu'il serait impossible de pouvoir les énumérer toutes. L'extrnie sensibilité de l'ute- rus ; la nature compacte îa son tissu ; la constitution lympatli.t queet ierv'euNe si commune chez les femmes ; les affections mora- les ; la suppression d'une évacuation naturelle comme les mens- trucs, accidentelle comme les liémorroides, artificielle comme un ancien ulcère, ont toutes été regardées comme des causes prédis. pa'aistes. On a remarqué que les femni:esujettes an floor albus y sont céiéraleenicit plis exposées que lcs autres. Le genre de'vie semble aussi infiuer sur cette cruù.!le affection ; ainsi les femmes des granides villes et surtout celles des cisses inférieures de la so- ciéte, ent sont plus souvent aflectées que les habitantes des campa- gues; et comment pourrait-on expliquer cette funeste préférence, sice n'est par lagrande dissolution des meurs chez les pre.ières. On a encore dnné comne cause l'oiaiismc, la privation abso- lie l'abus prèmaturé ou l'usage immodéré des plaisirs de lamour. Mais les causes occassoielles les plus fréquentes sont les plhlegina- .Sica .us on chroiîques. Il faut avouer aussi que três souvent le .î.: a'st développé spontanément CL sans qu'ou puisse l'at- trns.:er .1.ie cause pl.mible. S-'-PTrò. -s.--Chez les jeunes personnes, la maladie s'annonce ordiinairemcit par un dérangement dans la meistruation, qui est alors plusabondante, plus fréquente et dure plus tong-tems. On observe subitement des pertes etTrayantes. Chez cellez qui ont passé l'àge critique, il survit-t dans certains cas une ëvacuati=n plus nu moins copiensc et prolongve, cessant pour reparaitre de mois ego no;s avec unie périodicité trompeuse. D'autres fois ces pertes tie se reprntliiieit que de loi en loin, à 'occasioi du cor-- cubitus au de quelqie vive émotion de. e me. A la nine poque il nî'est pas rare de vuir survemîr une sorte de pesanteur, de gie, de tiraillement dlas les louibes, les hanîches, une nrdeur inconm- mode au rond du va-¿ , unaratiutoui de la vessie et du rectum. ui",
         "Sur, L. CNcER Dr L'UTaus. £ ,écoulement blanc, abondant, âcre et félide. On voit mérmte des femmes déjà sous l'influence du cancer, d'éprouver d'autres 1*.., iomêènes morbifiques du côté de cetorgane, que l'écoulenteîîl b;:I1ne et ur sensation doulou.reuse avec utn léger suintement sanguino. lent %_\" moment du conicubitus. Lorsque cessymiptôros existent, on doit pratiquer le toucher pour s'assurer de l'état des part:es. Lorsqu'on introduit le doigt dans le vagin, on trouve le col de l'u. terus molasse dans toutesouî étendue, ou seulement dans quelques parties ; dur, iniègal dans les autres, l'ouverture de forme irrégu. lière eà plus large que dans l'état ordinaire. Si ou comprime la partie appelée Mlusean de Tanche, on enî fait sortir un liquide sé- reux ou sanguinolent, et le doigt qui le presse est retiré teint de sang.D'après M. le professeur l3oyeî,ce symptôme est plus propre que la douleur à caractériser le coniencement de la maladie. Tels sont les premiers symptômes du cancer de l'utérus. A mesure qu'il fait des progrès. les douleurs deviennent plus perua. neittes, plus vives, lancinantes, po:gst:ves, qnelquefois inlrnt.. tantes ; du col de cet orgaue elles se propagent à l'anîus, aux aines, aux lombes, et à la partie supérieure des cuisses. Hippocrate avait également indiqué ces douleurs, yjoignant celles de la tète, et l'embarras de la respiration, que les observateurs ont en grande partie attribuées à la tcusion des ligamnus ronds. On voit quel- quefois, au contraire, des cancers parcourir toutes leurs périodes presque sans douleurs. Tel le cas cité datns le Dictionnaire des sciences médicales (Article Cancer de la Matrice). Ce sont, ena général, les moins redoutables; car plus ils sont dôuloureux,pluis k-ur marche est rapide. Des hémorragies se manifestent ac~com- paginées ou précédées de l'exacerbation des accidets, suivies de suulageinens mr.omeitaniés; l'\u0026-oulceit purulent est de plus en plus fétide; bientôt Poi verra s'y mêler des flocons grish:res, forms par les parties détclhées dn caticer. Dlans ses progrès ceLui.ci s'éteid à la totalité de la matricr, il envaint le vagitu, le reclun, la vessie, et forme au iniliril de ces parties nits cloaque dégoûtünt, à travers lequel se fait habituellemleiur un écoulen.etît infect de sanie, de matière fécale et d'uriie. Si l'on emploie le tpeculum uteri pour reconnaitre l'état de la maladie, on verra la partie qui eni est le siège, tan!ht tumîtéfiée dans certains endroits, ramollie dans d'autres, couverte on lion de ve- gêtations fougueuses représentant une sorte de champignon, d'où découle une sanie putride. Tantôt cette même partie est rongéa par uie ulcératton plus ou moins étendue, une plaie dont la sur- face est ordinairement inègale, enfractueuse, et parsemée d'ex- croissances dont la couleur varie depuis le rouge blatT\"ad jusqu'. brun livide, en passant par toutes les nuances intermédiaires; dans quelques cas, la surface est saignante. Les bords présentent des dif'érences uou moins remarquables; ils sont tantôt très épais, grisâtres, et renyersés de dedans ent dehors, tantôt rouges et taillés perpendiculacement. Dans Ics derniers temps de la imaladte, l'ulcère est presqure toujours recouvert d'une couche molle, surte ae putrilage qui paras se rentouveller sans cesse aux depeas de la tropre substance des parties. (à contiuucr) 243",
         "RÂ\u0026PtuUT MNLDICAL. 24-1 pIWoUt- dc ' FJ'ii laSa*Plis m arz « -Trois.R ii Cse scs cn il depai\" s3 qS5t wi- lieu 4eSflibT Dàr. TeMîs.ier, gditCeI de -ce Journal, Èâr Il. k Decgmeu je rCL-tre Blr. YE -ditcur, \u0026'être bbli de me postes i:ic éi.qU ,euè,pour continuer inop M.ppon delem\"6 .î\u003eiqCdans cette vII e t ses cuvIrons. Cm, eiô t t3zïccà iwprievuesm ont emCn\u0026hé de-le faire plutdL ~ puissesialence lCspace- de twoi ou quatréemoisi sala lr è reSiauia Uq\u003c-él sie nU Offiitpluid ie.-Mtières à observer. .DeputilÇ milieu c a U q 5 CO 1 le tcs a Cié froid et humide, -et sujeï à des \"vaatis aît- z~oîuue4lCSp.rOiDItes.et conIsi4erabl5. C'et ipuimat ctt:spC eteni qu lfluenza, (Rhume, ou athari Epidinilue. ) a préslilugéfl@flhltémCut, et a attaqué près déks tîrois quartsdes- habitant de-cette-viileet de ses enviros.-i Cct!c nuidesszIn1¶~,cmeil arrive le pl@5'uU- vcn, ~èdeSY *uus e fièvr-e neriéuàoe, dans iim di- .gré liicn !udérà.* Un traitcement aPt;phkltueau-i com- nenccen,e ler puiratifs, efflivi5par\u003cI5d~l~ ede anoeins, u'oui pj\". quýd'opé\u003crapDCe ir!Mpi c!n~s prçgies , tonal\"eS ms etje na 3 pm eooCàciSu~e cette n~X~.qu até±cunik ait\u003cefae à amcau de Cem ylotCu rccn0r5 .i Li nudeèice; La C~,gZuC~ cntiUe de se faime sentir jamm , la ~ d.I:i eis auquel ',heeeoqbi ôtaat deveUS plus i1:. l u:l~\u003ci~ crt:\u003cru er. dbaU ~1\u003c5S f tpr~l it ur~ ilèue\" Lis e ors dU mous d'Arfl, ce qui ct; ~re attril'é ur.c à auvFams \u003cpusti9 'deo dcr. car z~ir rt\u003cdu ,o I~8fSîl qu'e S a 'es~t a :ssa«snUSJMP' Sude Mie à ~:CiLmr l .l~tr uni ' ç ermrér ue.e u~e if~s~1C~i5'buiçOpde *h s,ia' Imm Muucs a PriiC urbtil 'tCI5lust~Uae el matière iurrôl qqu. s vmtm p.sel lm fel êcrvtif ouquele -1 tt que rumaas b. £a R.owC@k a l'-liz'WUWDispr uedu le Mis di Mai, temsatiit i la d.acur a.uacUta atu5U",
         "Du Da. TALnoT, relâche jusqu'au commencement de Septembre. C'est pen- dant la grande sécheresse que nous avons éprouvée que toutes les maladies dont nous venons de parler sont disparues. Quoique le nombre des morts ait été grand, relativement au petit nombre de maladies, il est à remarquer que peu de versonnes du moyen age sont mortes de maladies aiguiës, et le vieil àgc est celui où la morts'est plu à exercer son empire. Les dérangemens gastiques, les voiissemens bilieux et pituiteux ont été fréquens, ainsi que la diarrhée. * Les jeu- nes enfants sont ceux qui ont le plus souffert de cette mala- die, et il en est mort un grand nombre. Il est vrai que les Médecins n'ont pas toujours été rcquis de préter les secours de leur art à la plus grande partie de ces jeuncs êtres, qui sont devenus 1es victimes de cette maladie toujours très sé- vère, surtout pendant le procédé de la dentition. Le Cholcra-Morbus n'a pas été aussi fréquent qu'il l'était l'unr.ée dernière, et j'ignore qu'aucun adulte en soit mort. Nous avons maintenant quelques cas de Synochus, ou liè- vre continue. J'ai entendu dire que la Fièvre Typhoïde fait beaucoup de ravages dans la paroisse d'Yamachiche et dans la Rivière du Loup, ainsi que dans la paroisse de E3écancour. Li ièvre Intermittente estfréquente maintenant dans cette Villc. Beaucoup d'ouvriers et autres personnes qui ont été clans le Haut Canada, en sont revenus atteins, et il y a peu de çes personnes qui ne l'ayent pas contractée durant le séjour qu'ils y ont fiit. On m'a aussi assuré qu'un homme qui habite près des bords du Lac St. Pierre, et qui n'a jamais été lans le Haut-Canada, a contracté cette maladie, mais je n'ai pu avoir de détaih circonstanciés sur ce cas. La chaleur qui a été bien grande, dans cet endroit, depuis le commencement de Mai, et qui a été excessive dans les mois de Juillet et Aout, a été accompagnée d'une sécheresse ex- traordinaire. C'est, je crois, à cette causequ'est due la santé presque parfaite dont les habitans de cette Ville ont joui, presque sans interruption, durant la dernière saison. Il est a présumer que le grand changement de tens que nous allons avoir bien vite, nous produira beaucoup de ma- ladies. L. TALBOT. Trois-Rivières, 14 Sept. 1826. 245",
         "a46 Hgiène Publique. Rapport de l'état de la Santé Publique, durant la dernière Saison. Nous aurions désiré qlue cette partie de notie travail devint Plouvrage de tous ceux à qui une pratique plus étendue que la nétre, fournit tant de moyens de rendre notre tableau des maladies de la saison plus étendu et plus fidèle. Dans cette vue, nous n'avons cessé d'inviter tous les practiciens de cette ville à se joindre à nous, et noils aider de leurs observations, et quoique toits aient accueilli avec plaisir notre invitation, peu ont eu jusqu'à présent le loisir de s'y rendre. Cet-aveu, que nous ne témoignons qu'à regrèt, suffira sans doute pour nous absoudre de quelque erreur que nous aurions pu com- mettre dans les rapports hygièniques que nous avons donnés jusqu'à présent, sinon pour ce qui regarde la nature des nma- ladies, au moins pour le nombre. Mais nous nous flattons qu'en commencant une nouvelle anné¶, nos concitoyens Ycr- ront Ldans les membres de notre Profess3on, se renouveller ce 2èe et cette ardeur pour Vavancement de leur art, que nuls antres que les %Iédecins aient jamais témoignés en Canada. Le genre d'observation par lequel lg Practicien, en remar- quant la marche ordinaire tic chaque maladie que la saison amène, peut prévoir dans l'avenir quelles seront celles qu'il aura à traiter lorsque les mmes circonstances les feront re- nitre, est un travail qui ne demande qu'un peu d'ateinion. La connaissance de leur nature et de leurs nuances principa- le i.oe e-n:uite l'idie de leur traitement : ct le Metecini mettant ain::i a protit, jusqu'à ses erreurs, se familiarise bien- tôt avec les causes lue:des qui impriment un caractère parti- culier aux maladiera du climat qu'il habite, et pour lesqucles la thérapeutique cesse d'ètre stérile. Ces considérations nous donnert lieu d'espérer que notre rapport d'hygiène ne sera plus à l'avenir le travail d'un seul homme, encore trop jeune dans la pratique pour le rendre aussi intéressant et aussi utile qu'il le serait, si ceux qui ont plus d'occasions que lui, voulaient se donner la peine de \"'ettre la main à un ouvrare qui doit tourner à leur avautage",
         "IITG1EzE P11BLtQUEO futur. Ce sont aussi ces motifs qui nous font attacher le plusgrand prix aux contributions que nous avons reçues de quelques-uns des plus zélés et des plus éclairés dans noire profession, et particulièrement de notre judicieux correspon- dant, le Dr. Talbot les Trois-Rivières, à qui nous sommes redevable d'un rapport des maladies qui ont prévalu dans iba District durant toute l'année qui vient de s'écouler. Déjà ses observations nous fournissent des données d'après lesquelles nous pouvons établir la coïncidence des mêmes maladies dans les deux villes ; les variétés dans leur marche et leurs carac- tères que la différence si marquée dans la position topographi- que e- si peu sensible dans la constitution atmosphérique, leur impriment; enin les moyens de s'assurer des circonstances qui peuvent nous faire appréhender le f!éau de la contagion par- mi nous, et ceux de les éloigner ou de s'en préserver. La description des maladies qui ont prévalu à Québee depuis notre dernier numéro, va nous en fournir l'exemple. Nous nous sommes abstenu, jusqu'à prêsent, d'entrer dans aucun détail particulier sur l'état de la saison ; la table Mé- téorologique dont nous avons toujours accompagné chacun de nos rapports, présente sous un seul Point de vue les variations qui sont survenues à toutes les époques ; c'est-pourquoi nous ne dirons rien de particulier sur chacun des changemuens at- mosphériques, qu'en autant qu'ils auront paru influer sur le tempérament. L'état de chaleur et de sécheresse continuelle qui a règné durantla plus grande partie de l'été, a été plus préjudiciable à la végétation qu'à la santé des citoyens. Aussi n'avons nous remarqué aucune épidemie particulière à la saison, quoi- que le nombre des maladies n'ait.pas diminué d'une manière sensible. Les morts amenées par l'ge, les accidens et autres cirtonstances indépendantes de Pétat de l'atmosphère, sen- blent avoi' été plus fréquentes qu'à l'ordinaire. l est permis de croire que la chaleur excessive de lété a pu occasioner ou du moins favoriser un dégré de débilité à ces sortes de ma- ladies, qui les aura rendues plus fatales, sans qu'elle ait été capable de les faire naitre. Le Ch/olera-Yorbus a règné pendant la plus grande partie d'Août, et a immolé un assez grand nombre de victines. Mais il a rarement été fatal après trente ou quarante heures de durée, quoique dans bien des cas il se soit prolongé au de- là de ce terme. Les fomentations, les bains, n'ont pas auszi bien réussi que l'opium donné à fortes doses, pour calmer les convulsions. S47",
         "IIYCIENE PUDLIQUEr. La Rougeole a continué d'être plus rare que dans les sai- sons précédentes. Nous ne savons pas même quelle ait ét6 funeste dans aucune occasion. Depuis le millieu d'Août, il a paru une maladie dont le siège était particulièrement dans le canal alimentaire. Elle parait avoir pris la place \u003clu Cholera-morbus avec lequel ell'. a beaucoup de ressemblance sous quelques rapports. Unc irri- tion continuelle (le l'estomac accompagnée le nuses, diar- chée, avec une chaleur et sécheresse extrême de la peau, et douleur à la tête, ont été ses caractères principaux. La sai- gnée a généralement réussi à rappeler la transpiration et di- minuer l'irritation, lorsque tout autre moyen avait échoué. Dans quelques occasions Pirritation s'est portée au cerveau, ce qui a rendu 'a maladie plus fatale, quoique la déplétion et les évacuans aient généralemens produit d'excellens effets. La Coqueluche, (Pertussis) vient de paraitre dans le mois dernier et fait beaucoup de ravages ; elle parait même pren- dre une marche ép'démuique parmi les enfans. Nous avons le plaisir de pouvoir ajouter notre expérience à celles de plu- sieurs Médeciens distingués d'Angleterre et des Etats-Unis, pour constater les effets merveilleux du vitriol blue dans cette terrible maladie. Dz.as plusieurs occasions nous avons opéré par ce moyen une guerian complète en peu de jours, et nous n'hésitons pas de dire que ce remède peut tre considéré comme le plus puissant et le plus efficace que l'on connaisse pour la maladie dont nous parlams. La saison a été pluS particulièrement fatale aux enfans, surt-ut durant le travail dc la denti:ion, qui a été grénérale- ment difficile et accompagné de dérangcmcns conudrables dans les intestins. Nu. wirs encore a parier de la Pctite-Vircle qui, depuis næro !erner -pport, n'a pas cessé de partre, surtout dlans le mois dernier. Plu=icurs adultes en ont éti attcints, et dans bien d- occasions elle a été fatale, surtout durant la grande chaleur. Nous n'avons cessé dle recommander la propaga- tion de la vaccine, et si nous n'avons pas réussi autant que nous le désirions à en faire apprécier les avantages, on doit espérer que la Législature ne manquera de prendrelies moy- ens d'en zarantir les bienfaits à la ..énération qui nous suit. Instruite par l'expérience, on doit espérer que ses appro- priations seront désormais règlées de manière à produire l'ef- fet que l'on en doit attendre. Nous laissons à la sagesse de ses membres à tracer la marche qu'il convient de suivre pour arriver à ce but si déscé. 248",
         "TKanssSn-ros E£ Auzrociac. 2 Changencnt du Corps IhIuin en une substance particulière; Dans le cours du mois d'Aout dernier, la curiosité, publi- que a été éveillée par la découverte que l'on a faite d'un corps humain transformé en une substance à laquelle Four. croy a donné le nom d'adipocire ; et comme cet événement a donné lieu à un grand nombre de conjectures et de spécu- lations que la nouveauté du fait en ce pays n'a pas manqué d'accréditer, nous croyons devoir nous y arrêter un instant. En fesant lx levée des corps dans un ancien cimitière, dans le voisinage de cette ville, on a trouvé le corps d'une per- sonne que l'on suppose avoir été enterrée depuis près de 45 ans. Le bruit s'en étant aussitdt répandu à Québec, notre zèlé Naturaliste, Mr. Chasseur,. après s'être muni d'une per- mission de la part (les autorités compétentes, civile et ecclé- siastique, se rendit aussitôt sur les lieux dans la vue de le transporter à Québce, co::e un objet de curiosité naturelle, Mais ii. se désista de son entreprise pour céder aux instances d'une famille qui le reclam it comme étant le corps de quel- qu'un de leur famille. Cette circonstance nous a privé d'en faire nous même un examen aussi étendu que nous l'aurions désiré. Cependant M. Chasseur a en la politesse de nous faire Darvenir une des extrémités supérieures dont nous allons \"onner ici la description, (lui nous porte à croire (lue ce chan- gement ne diffère en rien de ceux que 'on a souvent remarqués en pareils cas, Ce n'est en etTet qu'une substance d'une couleur grisatre et d'un blanc terne, graisseuse, friable et qui n'a point d'odeur. La peau n'a point subit de ch::.gement particulier dans sa couleur ni dans sa texture, sinon qu'elle est entièrement des- séchée et fermement attachée au tissu cellulaire adjacent. Nous avons observé la même chose quant aux parties fibreuses blanches, telles que les aponévroses, les tendons et les liga- mens. Le périoste est aussi assez bien conservé. Mais les muscles, toute la membraita cellulaire et la graisse, sont chan- gés en une substance, d'une couleur grisâtre et d'un blanc sale, graisseuse, friable et inodore. Les os mêmes ont éprou- vé aussi ce changement, mais ce qui est digne de remarque, c'est que leur surface extérieure adhérente au périoste a con- servé sa dureté avec une couleur plus foncée que les muscl, mais cette couche dure n'a que peu d'épaisseur, après quoi on trouve tout le reste de leur intérieur'dans l'état de dé- composition dont nous parlons, La cavité qui contenait la il 29.4",
         "0 TnANSMUTAToS moelle, est cohfondue avec cette substance même, en nna miatière graisseuse, friable et d'une couleur un peu plus fon- cée que les muscles et la graisse. Cette décomposition se rencontre dans toute l'étendue des os cliyudriques, en sorte, qu'il est facile de les presser entre les doigts après que l'on a enlevé la couche osseuse mais ramollie qui fôrme leur surface extérieure. Enfin on pourra se former une idée assez par- faite de l'état des os en les comparant à la canne à sucre des Indes Occidentales, telle qu'on la trouve dans les bon- - ats de sucre du commerce, excepté que leur enveloppe extérieure a conservé plus d'élasticité, et que l'intérieur n'est pas dis. posé en fibres. Il n'existe presque aucune trace des vaisseaux sanguins et des nerfs. La gaîne qui les renfermait est vuide et offre une plus grande capacité que dans l'état naturel. Les seuls in- dices qu'on y trouve de leur existence, sont quelques couches libres, d'une couleur noire, d'une odeur de bois pourri dans un lieu constamment humide et où la lumière ne pénètre pas. Ces couches n'ont aucune consistance, et cèdent J la moindre pression entre les doigts. Mais pour les nerfs, il nous a été impossible d'en trouver aucune trace. Les membres parais- sent avoir perdu environ un tiers de leur poids naturel. Nou3 n'avons pu examiner l'intérieur du tronc, mais nous soupçonnons qu'on n'y trouvera que peu de vestiges dci or- ganes qui y sont contenus. Enfin tel est l'état de la masse entière qu'il est impossible de déterminer le sexe du sujet, avant un examen complet de l'intérieur du tronc ; c'est ce que nous prendrons occasion de faire, aussitôt que nous en auro=s les moyens. Jusqu'au teins de Fourcroy on avait regard ce dégé- hérescences comme une espèce de uncératico, parce que jus lu'alors on les avait presque toujours obseriées sous le passage d'eaux limpides et courantes. Mais une circus- tance favorable donna occasion 1 cet habile Chimiate dc constater la nature. . , Vers l'an 1765, à la levée du cimitière de l'Eglise des In- nocens Z. Paris, où l'on avait déposé les corps depuis plus de trois cens ans ; et t'expérience ayant appris combien les éma- tions qui s'exhalent de ces lieux bout funestes, M. Fourcroy fut appointé par le gouvernement pour surveiller ce diriger les travaux. Parvenu à. une ancienne charnière où une grande quantité de cadavres étaient amoncelés, il remarqua qu'ils etaient tous transformés en te substance qu'il nomma adi-",
         "EN ADIPocinn pocire, parce qu'elle participait dé la nature de la graisse et de la cire, sans qu'elle fut ni l'une ni l'autre. Soumise à l'analyse chimique, il découvrit que cette ma- tière graisseuse était un espèce'de savon ammoniacé dont il retira, au moyen d'un acide, les deux substances dont nous venons de parler. En poursuivant ses recherces sur le sper- maceti et les calculs biliaires, il en retira des substances crys- tallisées, qu'il regarda comme une variété de la même ma- tière que l'adipocire, à cela près qu'elles étaient fusibles et solubles dans Pesprit de vin. Mais M. Chevreul, dans un mémoire qu'il lût à l'Institut de France en 1815, et qui est inséréau long'dans les Annales de Chimie, vol. 95, Juillet, même année, a combattu cette dernière propositon, et si nous en croyons les expériences qu'il rapporte et qui nous pa- raissent très concluantes, pour ce qui regarde le spermaccli et les calculs que Fourctoy considère comme entièrement semblables à Padipocire, on devra convenir avec lui que non- seulement ces deux premières substances sont différentes l'une de l'autre, mai- iu'elles n'ont point de ressemblance avec cette dernière; \u003c dil réprésente comme un composé de plu- sieurs substance. raisseuses qu'il nomme margarinc et une huile-orangé.ce, transformées en une matière suponacée par l'ammoniaque, la chaux ou la potasse. On voit dans cet exposé combien les résultats qu'ont ob- tenus ces deux chimistes expérimentés sont différens. Suivant M. Fourcroy l'intervention d'un acide, émané du corps hu- main, est nécessaire à la transmutation en adipocirc, tandis que dans la théorie de M. Chevreul, ce changement est le ré- sultat immédiat d'un alcali,-formé dans le corps même, ou sorti de la terre environnante. Il ne nous appartient pas de décider, pas même de hazarder une opinion sur un sujet qui a occupé des hommes aussi justement célèbres; nous laissons aux maitres de 'a-t à résoudre une question que de nouvelles tentatives pourront conduire à de plus heureux résultats. En terminant nous rapporterons ici un fait semblable à celui dont nous avons parlé, et qui est consigné dans le Neo- York Medical Repository, vol. IV, page 103. \"1n digging a ground behind the gaol, where blacks were for.. merly buried, the entire aud large body of a woman was found in the %andy ground, and at a fcw feet depth. By uoving and lifting it, il was divided into parts. Ou closer inspection it was foundl wolîly changed into hard fat or adspocirea substance solid, 11 2 251",
         "but greasy and briltle, of a mixed grey and yellow colour, emit. ting uo kiid of fator ; and, when softened between the fingers, had a vapid smell. Se.veral thick paris were divided wv:iih a kimafe, and thereby the tendons and all apouevrotic nembrasîwaippcared to have undergone no aiteration, but that of exsiccat:oa. The sanie preservation was observed of theexternal cuticle. .AUl the bones were natural. The black matter, or animal pigment, - btich conrntutes the colour of the negroes, on the rcte mucosumi, was ail over preserved i its natural state.\" Réflexions sur la Mort Subite. (Continuées de la page 125.) Dans ce qui a été \u003clit précédement sur ce sujet, nous nous sommes efforcé d'établir que le cœeur est le siège des accidens qui entrainent une mort soudaire; aujourd'hui nous allons nous attacher à mettre sous les yeux de nos lecteurs la nature de ces accid'ens, les moyens que nous possédons d'en consta- ter l'existence sur le sujet qui en porte avec lui le germe, et les ressources de guérison que nous counnésons. Voyons d'abord ce qu'est le cour. Situé au milieu de la poitrine, ayant sa pointe un peu à gauche, le cSur est un muscle creux qui se divise en deux parties égales qui n'ont aucune communication directe l'une avec autre. L'une regarde à droite et l'autre à gauche, et chacunese ccmpose d'un ventricule et d'une oreillette qui, en raison de leur situation, se nomment ventricule droit ou -ventricule gauche \u0026c. Cet organe a pour unique .nsage de faire circuler le sang dans toute letendu du corps. e! pour en concevoir une idée tifa:ante on peu recourrir à la défini- tion ,;ue nous en avons donné à la page 1c3 de ce volume. La:,zturc d-s lé!ions nraniues auxquelles le cceur est su. jet. découle de la nature même de ses functions. L'exercice continuel qu'exige de lui le maintien de la vie, l'expose comme tous its autres nmuscles, a acquérir un plus grand dévelop- pement, tant que sa force physique est capable de vaincre un sureroit de résistance que lui opposerait la masse du fluide qu'il reçoit et qu'il repousse. Si au contraire la résistance de ses parois cède tant soit peu à l'impétuosité du-sang- sur le quel elles agissent, il résulte un état d'affoiblissement de son tissu qui, cédant à l'obstacle qu'il ne peut surmonter, se re- làche, se distend, et par conséquent devient plus mince. Ce sont ces deux états que Pun nomme anévrismes du cœur, ci £ 52 REFrLEIoÑS",
         "SUR LA MORT SUBITE. Corvizart appèle anévrisme actit, celui qui est accompagné d'un épaississement de ses parois, et anévrisme passif celu; qui résulte de leur amincissement. Ce savant Médecin est le premier (lui ait donné une aitention particulière aux lésions du cœur dans un traité qui lui assure l'immortalité. Jusqu'à lui, on n'avait jamais pu constater la nature des affections auxquelles il est exposé, de manière à établir les signes pa-. thognomnoniques qui les font distinguer l'une \u003cle Pautre. Le cSur est encore le siège d'une variété dVrutres affee- tions qui toutes présentent des signesqui leur sornt comnuns, mais pour les distinguer entr'elles, il est besoin d'une délica- tesse de tadt et d'un iugement sûr dont peu d \u003e personnes sont douées. Le pouls eýst le miroir lidèle dans lequel on recon- nait les caractères qui indiquent la présence des maladies du cSur. Les traits du visage de celui qui en est atteint, ont en- core quelque chose de particulier, mais qui est très difficile à saisir et encore plus dillicile à peindre; enfin la respiration nous offre des dérangemens qui, quoiqu'ils ne soient que d'u- ne utilité secom\u003cnire pour le diagnostic, méritent aussi toute notre attention. Mais comme il nous faudrait des volumes entiers pour suivre en détail chacune des maladies dont le cœur est susceptible, et que d'ailleurs notre intention est de ne nous y arrêter qu'en autant qu'elles peuvent toutes aine- ner une mort sondaine, il suflit à notre objet \u003cle présenter les signes qu'elles ont le commun entr'elles : ce qui dans un tra- vail subséquent, pourra nous conduire à les identifier, lors- que l'expérience et les travaux \u003cle nos contemporains auront porté plus loin les connaissances que nous possédons aujour- d'lui sur ce sujet. Les causes des maladies du cœur sont ouhéréditaires ou acci- dentelles. Il est maintenant hors de doute que nous appor- tous en naissant une prédisposition plus ou moins prononcée à ces sortes de maladies qui avaient leur source dans quelque vice organique, ou une prédominance de quelque appareil d'organes, dans ceux dont nous tenons immédiatement notre e-dstence ; et le premier jour de notre vie étant aussi notre premier pas vers la mort, ces lésions dont nous portons en nous le germe, n'attendent qu'une occasion favorable pour se développer. C'est ainsi qu'une vive émotion \u003cle l'nme, un transport de colère, un excès de joie ou de douleur, en por- tant leur influence directement sur le cœur, dont ils accé- lèrent les pulsations à un dégré capable de vaincre Péquilibre péccssaire entre la force et la résistance, jettent les prmiers 253",
         "fondemens d'un dérangement dans les fonctions de cet orga. ne, qui finit par les annéantir entièrement. Les causes accidentelles sont celles q'i agissent indépen. damment d'une prédisposition quelconque. De cette nature sont encore les mouvemens de l'âme dans leur plus haut dé- gré d'action et de durée, une contusion sur la région du cœur, ou toute autre cause physique qui agit de la même manière. Lorsque le cœur est atteint d'une maladie organique, le su. jet éprouve d'abord des palpitations, .ommunemen t nommées bailemens de cSur, qui sont d'abord légers, fugaces, mais qui deviennent ensuite sensibles au toucher et à la vue pendant l'isp51)ration, et qu'il est nécessaire de bien distinguer de ces sortes de palpitations, de resserremens et de tréioussemens qui ne sont -asibles qu'au malade même, et qui sont purement spasmodiques. Il ne peut monter une hauteur, sans ressentir un sentiment de sulocation et de resserrement le la gorge, avec des palpitations très accélérées lu cœur. Le pouls varie considérablement et présente des caractères particuliers à tous les grenres d'alfections dont le cS-ur devient le siège. Dans tous les cas il est irrégulier. Ainsi quand chez un individu sain d'ailleurs, on trouvera une irrégularité du pouls, soit dans sa force, sa fréquence ou sa durée, ou tout autre déviation de son mouvement natureli et si à ceia se joignent les déran, gemens dans la respiration dont nous venons de parler, on peut dès lors accuser le cSur comme le foyer d'un vice ca- Ché qu'il est d'autant plus important de découvîir de bonne heure, qu'après un certain teims, lorsque la maladie est con, firmnée, l'individu zticté peut raisonnablement s'attendre à une mort certane, que ni les secours de l'art, ni l'attention la plus scrupuleuse de sa part, nes.uraient détourner, et qui nième l'expose à être tout--ceup privé de la vie dans la jouis4ance apparente d'une santé assez parftite. En cfet, on erve lue dans ces sortes d'affections, l'appétit n'est point diminué, l'estomac et les inteshins continuent leurs fonctions comme auparavant, et le malade qui souvent ne se croit pas tel, conserve toute sa force, et même souvent un surcroit le viueur. Quand la maladie a fait quelque progrès, la figure présentei des apparences remarquables. Elle devient bouffie et ;ul* iucuse, sans avoir ces couleurs luisantes particulières que l'on observe dans les inflammations aiguës de la poitrine. Il y a bien il est vrai un soulèvement de la peau, nais sans décom- position des traits du visage qui est alors d'un utige violet, surtout les lèvres, le nez et le peurtour des yeux. Toutes 254 R lE EL EM$",
         "SUR LA MORT SUBITE les veines sont gorgées de sang, et les jugulaires paraissent battre comme les artères, surtout quand l'obtacle à la circu- lation est dans le côté droit du cour. Dans les tempéramens sanguins, le visage se couvre de couleurs subites et passagè, res ; et dansles lymphatiques, il conserve une pàleur bleu- âtre et violette accompagnée d'un état de bouflissure. Un autre moyen que les modernes ont fait revivre avec avantage, dans toutes les maladies de la poitrine, est la percussion de cette cavité qui, lorsqu'elle renferme un vice organique dans son enceinte, résonne mal, et ne donne qu'un son mâa iz- quan percussifemoris, dans la région qui en est le siège. Bi- chat recommande de comprimer le ventre, afin de causer un refoulement du diaphragme : ce qui causera une angnisse in- supportable, s'il existe une maladie du ccur. Enin le dia;- nostie se tire d'une foule de circonstances qui sont en plus ou moins grand nombre, et à un dégrè souvnrt ditf.rent, mais qui demandent un jugement bien exercé pour en déterminer la nature. 'foutes les lésions organiques du cSur sont du nombre de celles contre lesquelles l'art le plus consommé ne peut faire autre chose que d'en adoucir les douleurs et en éloigner le ter- me. Valsalva, considérant que toutes ces ipaladies sont dlues à des faibilesses de tissu, avait proposé lapplication du froid sur Ia région du cœeur. D'autres ont pris une voie diCirenite, mais tous s'accordent à regarder les saignées fréquentes, ma.s en petite quantité, et la \u003ciète la plus sévère, comme les seu«s moyens et les plus efficaces pour prolonger l'existence \u003clu imîa- lade. Tous les agens capables de ralentir la circulation, te!s que l'opium, la digitale et d'autres, ont été mis en usage, et sont recomm:ndés \u003cle nos jours comme de puissans auxili:C- res. Le repos absolu est aussi de la plus haute importance. Nous terminerons ici ce que nous avons à dire maintenant sur ce sujet, et nous serions fdatté que quelqu'un de nos cor- respondans voulùt y donner une attention particulière. Il est étonnant que sur des milliers de volumes qui ont été écrits sur les différentes parties de l'art de la Médecine, personne n'ait encore parlé de la mort su'ite d'une manière satisfatisante. Ce sujet qui reste à exploiter, ne ianque pas d'intéresser ce- lui qui sait apprécierla vie. C'estee qui nous a eng.géù nous en occuper, moins dans l'espoir de le traiter dignement, lue dans la vue de diriger l'attention sur ce point, etsurtout d'in- diquer la marche qui nous parait la seule capable deconduire à des résultats satisfaisans dans la recherche des causes qui le plus souvent occasionnent une mort prompte, en les rappor- tant à une lésion. ou un vice organique du cœur. C2, d",
         "DI2a To Dn. LATERRIEnr. DINNER To Di. PIERRE Dt SALES LATERRIERE. The Pl.ysicians 2.A Surgeons of this city and neighbour- bond, entertained their countryman and confx'..e with a dinner at 31îalhiot's lotel, on the 2!'t Augrust last, on bis retura for England. vhere he intends to renain. The two Senior Medical Praccitioners presenttook the chairs; and after partaking of an elegant repast, during ivhich the greatest hurnony and cheerful conviviality prevailed, the President, DR. FUs. BLANCHET proposed the followir.g pu- blic toasts, accompanied with appropriate airs by the band of the 71st regiment. Th'e jing, the Royal Family, the Arny and Navy. Theý 1-ealth uf Ilis Ex£ccllency the E.tRz oi DAL110t'SIE %avs irait. wi:h 3 times 3. Ilere the Pr:sident rose and said that, the toast which lhe was about to propPsy, was one in which hc took a lively in terest, as the object by 'which it was dictated, recalled to his memo- ry the mosýt pleasing recollections. le oberred that not above thirty -ears ago, there bad never been in Canada orne lOedical man a native of tie country. The present meeting chiefly corposed of Canadian Practitioners, some of who:i ad already acquired a merited celebrity in the Profcbtion, vas a triking proof of the rapid improviemcnts of the coui- trv. whiIkt he could trace the period when lie was the only nate Prcrf: szional man, after the death of two of bis con- tempmiarie-. who had d-parted this life a, an carly age. It was particilarif gratifying to bis fee. ags, to have lived to see the day when he could be surrounded by such a res- pectable number of 3edical Gentlemen wbo had all been brou:-ht to the Profession since that pcriod, one of vrhom bad] de.erved bv bis talents and zeal for its welfare, a tri- bute whh.. had been paid to nonc before bim. ile would not entrr into a detail cf al the circumstances which had il- .!t:-atnid (te life of their orthy Guest. Iis strenuous and tr.reritinz effortsin contributing to t~ie preseot flourishing state of the Profe:sion amion- us; the part be had taken in the foundation and improvement ofour charitable Institutions;his dit.:rettedness in sacrificing the advantages of an extensive practire in the defence-of his coc..try, were too well known to all his felluw-citizens to require any encomwum In tcndering him the wishes of the meeting for the pros- perity of hbimself atd his family, lie then proposcd the health 256",
         "DIN-a re Da. LDr rtrat. 257 of their guest, Dr. Pierre de Sales Laterrière, which was drank amidst the miost universal shouts of applause.-E i.n- g7eterre nous irons \u0026c. The guest returned thanks in the following words:- Mr. President and Gentlemen. I cannot find expressions adequate to the feelings of gr iti- tude under which I labour, for the distinrguished manner with which you wIelcome me ta this my native land, ihere, for thespace of thirteen ycars, I have had the honour of exercisin the Medical Profession, and of contributing vith yau to the relief of suffedng humanity; and allow me to espress that wili always hail as one of the happiest days cf ii life, that in which i: am thus sit .n: among you; and whilst it awa- kens in my breast those iigh sentiments of respect which I have always cherished for my Confrères and Fellow-citizensz, the Physicians and Surgeons of the city of Quebec, it also enforces on my ni, d the grateful rccolicction of their impor- tant services in rescoing me from ine-.itable death, which must have folluwed the long and dangerous disease under wvhich 1 laboured before my departure for England, and perm~t to tender you my humble thankis for your unremittingattention%. to me on these several occasions, which will 'never be crased from my menory. I would niot trespass longer on your kind iudulgence, but it is so seldom that- we can meet in a body-, that 1 wi not allow the opportunity ta escape, without ofiering a fewv ob- servations entirely directed to the velfare of the Profession, in which every onc feels so deeply icierested. The rapid inmprovements which have but lately taken place in the Medical Profession in Canada, and for which the coun- try is indebted ta the many sacrifices incurred by heads of families in order to procure Medical Education to their chil- dren ot of its limits, uught to iipress on the public, and particularly our Legislature, thei.Aispensible necessity of some Medical Scauol being established among us, -where the student might acquire in bis native country, that Anatomical and practical knowiedge which is the only fo:idamentai ba- sis of Medical Science, and wbich have ta this day, beer. ac- quired at such an enornous Cxpeuce, as must have in some ins- tances precluded the entry in the Profession, to many who smight bave becorne its oruaments, and coutr;buted to its ai- vancement. I ain aware that new establishments iave been erected, but which do not apnear to answer the purposes iuten- 1",
         "DINNEn To Dn. LizrtrEnE. ded, nor to meet the views and approbation of the Iegislature., I am also informed that a committee of medicalgentlemen in this city, is appointed to enquire into the most convenient and proper steps towards the establishment of a General Hospital in Quebec,\u0026 tbat the necessary appropriations have been made by the House of Assembly, to obtain plans and deçices for its erection; but I question much the success of this undertaking, aithough I wish U;rit ih amy heart. Unfertunately the Legi.- lature has already expended immense sums, without, I beliere, sufficiently taking in.toconsideration the means of encouraging and protecting Medical Science. Why, for instance, did it not insure certaiu priviieges to the Medical Attendants of the Hotel-Dieu, when the sum of nearly nine thousands pounds were bestowed on that establishment. Montesquieu has very properly observed, that the number of Ilospitals is a burthen on the public, and I verily believe that the wealth of a poor house is a sure criterion of the po- verty of the state which maintains it ; butas it is the duty of every citizen interested in the velfare and prosperity of his country, to keep a -watchful cye over the expenditure of the pubiic monies, and without censuring an appropriation which ias been dictated by the most honourable motives, I cannot but regret that such a considerabie sum sbould not bave been granted at certain conditions, by which the lhysicians and Surgeons of the Institution might have insured an aqylumn for Medical Science, whichin alil couutries, is conisidered\u0026s the Mo\u003et beneficial to mankind. It would nat become me, gentlemen, to carry farther my observations on this subject, but I sincerely wish that, finding yourselres mroreinterestcd than I am now, y-au may make it the object of your most serious reflections, and I humbly sug- gest that the necessary representatiens should be made 1o the Lugislaure, if new grants are prayed for; for rest as- sured that a :etter opportunity will never offer itself for the faundation of a 31edical Scbol, without at all intrudie-g on the lights of the Dmes '.zIzeuses. Those members of the Profession who hure had the advantage of completing their education in Europe or in the United States, must appreciate the necessity of au establishment of this nature; and no one ivili deny that the natural dispositions of the Canadian youths displayed in the various branches of industry, would seem to partake of the nature of thesoil which, wben properly cul- tivated, does nut fail to afford an abundant harvest, 258",
         "DiYNEE TO Dr. LATERIERE. This assertion may be proved in two individuals who, wvith- ,out having obtained their Medical Education in Europe, are still an ornanient te their Profession: the one a Physician in the city of Quebec, and the other a Surgeon in the city of Montreal. It would not be delicate for me to say more to their praise, but-I have no doubt that their merits shail be duly appreciated. It is also with infinite satisfaction that I have read the Quc- bec Aledical Journal. This work, although in its infancy, is extremely well conducted; and I do not hesitate to say that the talents and activity of its young but indefatigable au- thor, imperiously point out the interest which the Profession should place in its success, and I sincercly wi:h ih:t the country at large may give him ail the encouragement and sip- port te -which he is entitled for such a laudable udertaking. Being about leaving again my native country, without, al- together deserting it, allow mue, gentlemen, to assure you that nothiug will gratify me so nuch as t liave an opportunity of being serviceable te you, in the place where I am te Temain. But I cannot leave you withaut taking the liberty of recoim- mnendingyou aprescription, which experience has pronounced the only specific for individials or corporations. It only im- plies one word, Union. This word has lately been, very po- pular, and is not altogether new to us. No one can better appreciate than yourselves, the lieneficial advantages resulting from a perfect understanding and constant union among the members of our Profession. The spirit of party wthici un- fortunately pervades ail classes of society in Canada; the per- sonal animuosities and petty jealousies wlhich sormetimes are te be met with in practice, may be reckoned the most insu- perable barriers te the honour and interest of the profession, ehich otherwise wvould acquire the utmost importance, parti- cularly since the influerice of intruders seems te have consi- derably dininished, and when the public, and also the head of the government, seeua disposed te contribute te our ad- Tancement. Under such favorable auspices, I cannot too carnestly urge the necessity of cultivating a constant harmony, and I would bumbly suggest, that this daywhich I nevercan forgetshould Imark the epoch of an anniversary dinner, as is costumary in all popalous and -well regulated cities, in order te procure to .the Members of the Medical Profession, ain opportunity of meeting in a body, and thereby cemneuting a friendly and du- rable union. It is in the cujoyment of a good repast, and whcc 12",
         "260 DINNER. TO Iïth LT-RK1ERK. hiiariy prerails, that the least explanation will frequently prove suficient ta reconcile persons who are enemies without often knowing the subject of their animadversion ; and these party recorciliations always tend to a general good. In conciuding, allow me, gentlemen. to thank you once more for the gracious and polite mainner in which yon have acted towr.rds me this day, wishing you health, bappiness and prosperity, and requesting you Io join me in a bunper. To the Physicians and Surgeons of the city of Quebec and its vicinity, and to alt tlat may contribute.to improve and promote the cause of Medical Science in Canada. ole, mon cour role, \u0026c. The Presidcnt offered the following toasts: To the memory of Joii i eNTER, an;d thé Medical Insti- tutinns of Great Britain.-Naional March. To the memory of Xaviva BicitAT, and the Medical esta- blishrments of Fra nee.-French Marrh. To the menory of BEsæns Rusu, and the Medical School of the United States.-Jaik Loodlc. To all the Charitable Institutions in Canada.-Canzadian March. To the Countess of DAî.uousrr, and the Canadian Fair. Lods 31ary RamsaY's Reel. To Mrs. P. DE SALEs LaTr.uXEnR, and ber family.- Can:diAn :!ir. The Guerst reterned hi; thrnks in behalf of his wife and family, and prooosed th- ,ollowing toasts: The Board of EBxzaminers.-flas il continue Io be composed rf men =ho =il cl=ays harc at hie rt \"the respc'ctabilit3 of Ihe Prfruson in this G.nry.-Canadian Country-dance. D. PEuaACLT, a meiher oi \u003che Board, returned thaiks iu a neat and appropriaTe di-course. The Ilotel-Dien of Quebec, an Asylurn for the tndigent ick- 31u3y it aso becomne the 4syum for Medical Sciencc x.: C:nada -Canadian Air. Dr, PAiNcuar;, one of the Phvsicians of the lotel-Dlieu, offcred thaiks in behalf of the Establisboent. - The Emigrant RIospital, where the Indigent sick Emigrants receive the berefit of Medical assistance, uutif they can be able ta provide for themselves.--Patricks .Day in the iMor- vmng. DR, Couir.lnA, one of the attending Physicians of the Enigrant Hloqptal, made a few remark.s with regard to the attention which uns paid to that Institution.",
         "DiNEa *so Da. LATERRIERE. UG The GousT then rose and proposed to drink to the success of the Quebec Medical Journal. He said he could not suffi- ciently express his conviction that this undertakiig, which was an orcament to the country, must have been hazardous, considering our limited resources ; but from the able mannee in which it ivas conducted., he felt confident that the enlight- ened class of our countryien would, by the confinuance of their support, insure its future success. He considered this publication of the highest importance, and as marking a me- =orable epoci in the scientific history of Canada. T he Quebec Medical Journal. May the Physicians and Sw-gcons qfthis country, anil the public in general gire to this zaork the degrec of encouragemeut to lich it is entilcd. -A lu claire fontaine, \u0026c. Du. TESSI Eit in returning his thanks to the meeting for the Tnflnv complirents which had been paid him during the even- ing, observdt that this testimony of their approbation of the mn-anner in which lie had endeavoured to bo iseful ta his pro- fession, vas as gratify ing to hin as it wras a sufficient proof that he had not laboured in vain. De filattered himself that bis Confrères wnould continue to favour his work with their influence and protection, whilst ho assured the'm that notbing would be wanting on his part to deserve that encouragement. The interest whieh the Guest seemed also to take in its wel- fare, made him * pe that he would promote its cause on that side of the Alantic, wlere lie intended to retire. Several Toluntary toasts verh also drank, and songs were given by Drs. Laterrière, WVhitel.w, Tessier, \u0026c. The whole of the evening passed with the greatest conviviality; and the party retired at a reasonable hour, after havinig paid a tribute of respect to one who had deserved so much of his country, both as a zealous and respectable citizen, and as a worthy and distinguished member of the Profession. P. S.-The above was in the uress when ve discovered an er. ror in the translation of the President's Address; instead orsaying that both his conteniporaries iad dicd at an earlv age, wve should have said one ouly, the otier being yet alive. See page 256, iu this nunber. TRIAL FOa TLpE.-The Reader -vili recollect the pledge 7e made in our preface, of conformiig our publication to those of Great Britain,in the various topics wvhich nay fail vitlin'tle reach of thA Physician, in as mliuei as tlhe resources of our country could permit; and as the public norals have now attained among tz a degree of corruotion which threatens to shakle the most az.",
         "À5e T.iTALs roR \u0026 R.\u0026E. cred bonds ofsocial union, it becomes a duty incurubent-on our Profession to conitribite Our share -owards arresting the pro- pag-itio, by communicating to the other classes of sociely, the sneans which Medical Science pussesses or identifying crime açd delineating ils nost obscure features. But as this obligation br- rows its importance from the end to which il is apphed, it also imposes on us the task of protectitng innocence, wherever it may be exposed ta fali a victian to mnalicions and criminal purposes. No conusideration, therefore, foreigi to this object, wili ever de. ter us from raising our voice in tIhe cause of justice, or influence our judgcnent wihenever trutih shall appear to require elucida- tion. Such is however the painful task we have Io perfori ivlh re.. gard to the n:ase of J. B. Drolet, who has becn convicted uf rape ai tlhe last Crtiminal Terni. We say painfil, becaiise we conceîve that tise omission vhich scems to have determineise the verdit t of tie Jury, is one whici tIhe common dictates of justice imperiously call for. We allude to the absence of Nedical evidence; anid in order ta illustrate our assertion, ive wili only cail ftie reader's attention to a few particular poilas, by vhich tIse veracity of tise accuser's accoint may is some measure be questiosed. 1h is neediless to advert to the gross contradictions whirh ap- pen:ed inl hr testimony, nor to the posilive asse: tion of several credeitiail witnesses, that the prisoner was emsployei at 3vork wiih them, at tise time that tIse act is aliedged to have taken place. Tlie degree of confidence wh:ch roay be placet in the coutradictory slatenents on boih sides, is also a matter which it is compelent for every mais to determsine. We will not even call il questiln the fact of the violation iaving beei comimilted by soie :erson, whether by the prison-er imsetf or by aiotier; the siasie of the parts as reported by tise wormien who examiied the ac- ,nwer, appears to place il beyond doubt. Btst as we ste sufficieit reasons to convisnce ourself cf this ract, ue: ziso find two particular ieads in the yousng grl's dep'osition, -which confiri our opinion that the act was a a certau degree volusitary ois ier part, and thsereby the prisonser': oTeuce is very msai.tri.iv .-tcred. Tise tirst ls the resistancc vhiclh was opposed on the part of the piimtitT, and whs:ch by conparissg lier physical powers witi the age and boddly size of the prisoner, vouild niot leave a great balais -e is his favour. it is evei aliedged by the msost respec- table writcrs on this suobject, that it is physicalls? impossible for tIse mosàt powerful mais to ravisi a woanai without her conisent, unliess she has first been thrown into a state of stupDr by the ac- tion cf snome very active narcotic. This bears strongly in favour of the priçoner, particularly nhen the comparative streîglth of both is takesn mio accouit. The sext is tIe assertion on the part of tise accuser, of her ha- visg remained in a slate of iisensibility, during the whole time, vhich she said was three quartèr ofan hour. it wasnever men.",
         "TatLI ron MizURDEr,it fioned nor even suspected that rec-urse had been had to any agent capable of induîcing a state of stupor, which in that case would have lasied much longer. On the olher hand, our knowledge as a Medic:l mn,'conpels us to deny the possihdlity of its taking- place under thecircunstance of ani attenpt being made to deprive! a wonan of her chasthty, whether it be considered as the efftct of an overcse~rtioa or of an amsourouîs extasis. Thse state ofinîsen- sibility approaching syncope which is apt ta follov these kinds af prostration, are never more than a few minutes in duration, and verv seldoni sueh as to occasion a total loss of the powers of thte imiind or of tIe body, as contended for in this case. The Jury lierefare have certainly followed tie dictates of their conscience, by returning a vcrdtct of guilty againsst tiais unfoartir. niate yonîth:t but we alie feel no hesitation ni saying thî:at, lad preper .leulical evide*nce hecs called, in order to point out the inmerous divrepaness abeh appeared iii the evidence of thie wiiniesses on botl sdes, tiy miglht have takea a vrry different vsew af thf e case, :iui tlereby s1ischarged their soble functions vith all tihe knowledged which it was incombenit on thsein to possess. A, respectable number ofcitizens are r.ow praying for a coiimn- tation of p#unislmilet(, and we snacerely wish ileir praver may be acconl)libised. TaauAL oa MeR ER.-A case of this kind vas aiso tried at the last Crimin.il Court, and as it involved a question not obten ta lie met wsshs, we vill give it some attentio:n. It apspeared in evidence that Ihe prisoner inflicted-a wound wiIlh a knisfe in the tliîh of the deceisd. by whiclh the enioral urterv vas divided a httle below the crurai arch, aud which provedl inortal. Both wer\u003ce iii a state of mntoxication, it vas concstdci by the Counsiel for thse pr:soner, that, as there was no ground for :uspecting thar tuy kind of provocation had taken plaee an the part ofthe decease, to deutrnine the prisoser ta attempt at the lire of ane wlc liaU iwva.-s b ien has mst:matce friend, the woundsl could not have been intictcd wahsl tIhe isîtennuon of killinîg, by' tlhe fact of his having osly struck him inm tie tlitgh, anîd accidentally vouni- ded tie artery; vhilst it could not be supiposed trat a man, with- out a sufficieit knowledge of Anatorv, could at ail sus1.ect that a wound ini the tihrglh night occasion death. Medicul evidenice was hîad reconurse to, ii arder to prove this asserios. Dr. GrIas- set, Surgeoin to Ilis Majesty's Forces, was called on tie part of Crowa, and Dr. X. Tessier. the Editor of iis Journal, on tIe part of the pirisoier, who boll agreed in stating that a woundis ini tIhe Iligh W.îs on1ly simrtal, vlhii it intvolved the ariery; it cosli not therefore be extec(ed (hat a mavin, not conversant with tIhe anateny of tie paris, u ould think af occasioningdeafb by awound at that place. The Jury accordiogly bouglit in a verdict of Maislaughuter.",
         "RETOUR DE LHOTEL-DIEU. XLtour des Maladies admises dans rNIotel.Dieu, depuis le 1er. Juillet jusqu'au ier. d'Octobre, 1826. Ñombre resté en l'Hapital le s0 Juin, 27.-Nombre admis 1 durant les trois moi, . . . î, . . 146 Déchargés, Guéris, 1IlG.-Déch:argés, Soulagés, s. do. pour irrégularité, 2.--Morts, . . . -. -6 31aiitenait à l'HÔpital, . 15. Catholiques, . . . 107,-Protestan, 3. . 146 MALADIES ADMISES. Fièvre 1nternmittenîte, . 1 Deliriumn Ticmens, .......... 1 Contiin ue, ............ 13iSurdite, ...................... Inflarmmatioi des Poun:oîis,.. 5'onsoiptui, ............... 4 du Fuie Aige,.. 411)ébiité Sénile,.............. .4 Chromique, 2Iractures du( des lulestinis,.. Simple de la Jambe,. des Yeux,.....2 Comosée. Rhumatisme A iguë,...........2 de 1a Rotule... Chro e. du Bras cipose,.. Erêsipèle.............. L1!céres................. ('att.rrie.................. 3031estirezj................. . 2 Catarrhée .................... . ................... Dyseiîrie................. 5 Fis.le. ' ac riiure..........13 chera.................... . îouverture itui euse de m.l Hystérie,................. 4 vessie aprCs pccouei.i. Ail,éisorrliéc............ ..4 iirture de !'Urètre,........ 1 Ictère,............... anaris, .................. i Aitarque............... cros,................. A tes.................... 'taralysi................. 5 Hydro-tilorx ...............3 JOS. MORRIN, Médecin. Hydrocle.................il JO. PA..ANI, Clitrurgiei. Les deux cas de Fracture dii Cràie sont mort aPusitôt .pès leur Odmiusioiv. NoYrîCE TO OUR CORRESPO'NDENTS. ù::ý- M'e bc- Ieave ta inforei osir Corèespodents and ail those wilo take à part in tlie 4velfare of th Medcal Profrssion id e li COIIIitry. thit WC ilieîid levoimu our t.e.,dý number clisrfiv to nint- ters of local interest. This: xTilleenibrace ail conniîfrraisioîs amld refitclmol*s ieiidiuê to improve the s.ate o. our Charitable. ..i Me. dicite lustiions, s. . . necestv of aieiorain i.e ge..eral con. ditiot or ,e .'r.fcssi.e ise, ad ail m iRens iviiih may coin!ru. bute towards ay k.d of improv .nent in Medial Police, in order t.o .esdsit te Legislature a d thn next Sessont, ili providisig forèhes iLýi a more effectuai raanster thasi lieretofore. (C ilerefore invite ain perons aCd paricuarly sie member of wt pedical Profession, ta toinunuuuicatc to the public tleir senti. conts on ay of th e ntve subjets tliro ..t the nmediiii of : s pu blication, lalever ay be ilir oirions alnd pritictea; provi ded shey be cousnait iiprv thie siaLt of our constiaution. The ditort the eslatvriters iot desiroissof being knovd to the pu bic, wil favour lia bet their iiaine and p pddres.",
         "METEOROLGICAL TABLE. QUEBEC. 126. MONTREAL. - INS. ATMuSPHERIC VARIATIO. THERMOMETER. BAROMETER. WI0 - .- ATMOBPaERIC s 8à. \u003c. sr.M. 9.H .8 *. \". ' '* . o . . 7 A. . '. 7e. VARIATIONS. 6278'71 N E S W N E clear clear clear t .2I,12 × 7 × 13 30 .17 668072N E N E S WV clear clear clear ?j 221 l 83, 30 , 19,30 , 15-fair 8 60~' N E N E S E clelea r e c 2370 80 î, 30 , Q9 30 , 02 -fair Z 2.3 168-S7N.ONESE ceaIla 1o~J2, 24 6S'87 N E S W S E rain shovery 4in $ 2465 ,, 68 ,, -30 05 29 , 96 -rain. I641N E N E N E rain cloudy clear ..5.67 ,, 83 , 29 97 29 , 93 showers 64 N 72 E E raini ran ram 2664 ,, 70 ,, 29 , 84 29 , 76 -raa 9623i4-N EN E N E1ril'linp i s 76 70 g W )Ys W Wclotidy shiower clear tJ 37,65 » 76 , 29 , 65 29 , 70 -fair 27 ;s eois Wlul-J27 28 f667466S W S WS W cloudy cloudy clou 2870 ,, 72 ,, 29 , 83 29 , 79 -rajn 29 [6668,68S W N E S E cloudy rain rai 1 29170 , 75 Q 9 75 !29 , 72 -rain 930 676170S S W S E cloudy clear ram 3067 83 , 29 , 9 56 -fair 30W S W cloudy Iclody clear t 2Ji U , 2 --f -- 0 g WWW W cloudy a clear~ I20,, 84 ,, 29.-, 79 29 , 13hfair * W S W cloudy clear sho --. ito ,, 77fa 4 66-74 i cloudy co , 7 95 29 -rain \u003e . ® 64 N W N W N W clear showern clear 5,66 , 80 ,, 29 76 showe r 16 S W S W N E cloudy clear clcar 6i77 84 83 29 , 8-hoir 'tarJi S 29 , 83 29 , 8ç- fair 6 6S S .. S S W clear storm shoT 776 » 88 ,, 29 , 90 29 , 93 - 8 6S02-2, W S W clear clear clear 8076 8 , 30 07 30 95 -fair w s w cear clear c, 9 30 15 -fair 6 WIS M S WW clenr clear clear 11,85 95 30 , 1 30 ,1 -fair 4 0 58 VS WS W clear clouady ,ciar 1I 5, 94 ,, 30 , 18 30 , 16 -fair 12s WS WS W clear clear clou. 3 ,,. 96 , 30 , 16 30 ,- 12 -\"fair 13 7).S2)2s V.S E N W clear showery' coUI 13;71 8- , 29 98 29 93 -showers 1 ' N WiN W N W cloudy cloudy cleal 14G8 ' 97 , ,, -fair 14 2 1 N WIN W N W clear clear clea 81 30, 0930 06-fair 16 567 O N EIN E N E cloudy clear clou. 1664 80 , 29 99 29 92 -fair 6 il S E W S E cloudy showery ram 17,74 ,, 86 29 90 29 ,. 91 -thun.\u0026rain S is 70 73 68S WIN W N W clomdy clear cear 1869 J 77 ,, 29 , 87 90 , 03 -fair 19 -8 Ib1 N WS W S W cloudy clear clear 1966 » 79 30 , 21 30 , 21 63S4 -6s WiS W S WE cld cor clea 2068 » 2,, , 30 , 28 -fair 20 -- S4!6S W ¡S E S E clody clordy ra 268 » 87 ,, 30 , 27 29 , 28 - air 22- .2S4 S E S W!S E showery showery show ' 7 84 .,, 29 à 86 29 , 81 -rain 4~ 'XIN\\1 cl\"d sey Si.a . Ji 23 70726 W S WyN , cl showery cea 2â67 78 29 84 29-, 87--ir 23 4 0 7266 N W1S W S W clear shoverv cclea 24'60 » 78, ,, 29 , 19 . 30 , 0 --shower, 25 607468N WiS W S W clear clear clear 2562 76 ,, 0 30 , - 62787O WIS V N F clear clear CIE 261 75 ,, 30 17 30 19 -fair 27 67767W S WiS W clear cloudy clC 7 » 8 , 30 ,23 30 , 25 --fair S66842 W W S clear cloudy cle 84 30, 2830 ; 30 -fair 8 6684.76S Ws W S W clear cler clar 2267 86 » 30 26 30 24 -fair 30 s s W s W clear cear clear 90 ,, 30 21 30 , 19 - fair 31 709070S W ! S W W clar l clo d C 318 8 14 30 , l - th .\u0026 ran 70'7 E iS E E rain cloudy ci * I 79 » 2 ,9i29 , 87 -shower -W N W clear clear cle 9 , 86 29 cLN IN W W clear cler clea 5 73 30 , 13 30 17 fair",
         "305617260 IV NM W clear clear clea 56 30 13 30 7 -fuir 4 57467N W1 WN W clear clear clear 458 80 21 30 24 -fair. 5 6018274 N W WS W clear clear cloM 5'61 8 ,, 30 , 27 30 , 21 -fair 6 0S472 WS WS W cloudy cloudy c 1 61 ,, S2 ;, 30 , 30 07 -thun.\u0026rain 6862jN E N E E riin clo 760 ,, 67, 29 91 29 96 -rama 8 60764N WS S W clear clear cleo i ,, 80 ,, 30 , 09 30 13 -fair 9 78 \u003e W s ES W clear clear cled 957 ,, 32 , 2 , 27 -fair 10 5628 70S W N E N E clear clear cleà 3 , - 30 , 33 Ji , :2 -r P_ 6470NE NE NE clear clear clou, 15 , 85 ,, 30 , 28 30 . 2' -f-.tr 12 '70761S W N E N E cloudy clear co 1263. , 88 , 3 27 i I~cjjj 1263» 8 30,2 3 1 f 13 7 90'74N E S W N E cloudy clear cleai 1368 , 92 30 , 25 30 . 23 r 14 7284 7S N E N-E N E clear clear c'ear 14172 ,, 91 ,, 30 , 23 30 , 19 fair 7 15 7488 N E S WTS W clear cloidy clear 15174 , 92 30 , 17 30 13 16 74922S E S WS W clear clear clear 1675 , 91 ,, 30 12 30 ;04 r 17 78888 S WS wN clear clear clear 1777 , 91 , 3 , 30 , S 8. 769278 N E N E N E alear clear cloud 1879 ,, 94 ,, 29 ,99 29 , 3 fair ' 9 728474 N E N E N E cloudy cloudy cloud 1976 , 9 29 ,9 2 9 atun 20 728070 N E N E N E cloudy cloudy cloud 976 ,, 91 29 99 29 ,92 fur .21 6470 66 N E N E N E cloudy rain rain 2174 ,, 79 , a 81 29,972fair 22 6668 6?S W S W E cloady cloudy clod 2265 ,, 68 ,, 99 , 83 30 r fair 22 58670 6SI WS W S W clear cl clear 283 3, 74 30 16 30 a 1-fair 24 6076 S WS WN E clear clear clear 2 , ,, 30 , 15 30 f12 air 25 ( 64S066N E N E N E clear clear clear 257 -' 85 ,, 30 , 10 fair 26 -648470S WS WS W clear clear clear 2664 , 83 ,, 30 ; 13 30 0 thun.raln 27 668074S- WS W S E clear Iclear clear 27 63 ,, 81 ,, 30 , 0n29 95 ra 28 727270N E N E N E rain rain rain 2867C », 73 ,29 , 98 29 8 9 rair 29 - 7955 29 ,7929 8,q Si a * 029 66068S WS WS W clear cloudy cloudy. 296 , 29 96 30 a 3 fair 30 4 74,66S W S W S W cl clelea r 30 , 96 21,-fair cVI 5 6a Si a c 63 c0 c e 6474708 W S N E clear clear cloudy e 869 , 7 , 54 666 66N EN ES W rai tain clou1 , 82,, 29,9 986 -rain 5 707866S WS W cloudy cloudy jcoudy 72 , 81 ,, 29 89 S 586458N E N E N W cloudy clear clear 2663 ,, 70 ', 0 , 16 30 2 -fai r ? 61700 W S. W clear clear clear 758 , 73 30 , 21 30 , -f 4 6 8 58P746 S S W clear clear cloudy 861 9 75 ,, 3 , 98 -rain 9 667464S WIS S W cloudy cloudy cloudy 967 ,, 75 ,, 29 8 9 , 10 647462 N E N EINE cloudy clear clear 1063 ,, 76 , 29 86 29 87 --fair 6 627470N E N E N clcudy clear clear 1159 ,, 83 , 29 96 29 , 99 --fair 12 6674608 S W N Wclear clear clear 1261 , 80 ,, 30 , 09 30 , 17 ---fair 13 556658 N E N N E clear clear clear 1354 ,, 77 , 3 13 30 ,9 ---fair 14 586458S E S WS W cloudy rai clear . j 1455 ,; 60 , 29 93 2n , 96 --rair 15 53652N TN W N clear. cloudy clear 1551 , , 30 ,0 30 , 29 8 ---fair * 16*5036148N WN WIN Wshowery showery clear 164 ,,-s 60 ,, 30 ,. 21 30 , 39 ---fair 17 6850 N WN WN W cloudy clear cloud a 1744 ,,1 65 ,, 30, 4 30 9, -05 fair 18 526056S S WIS W cloudy rain cloudy 1861 ,, 73 , 30 15 30 , 169fair 19 526456S S WS . clear clear clear 1956 ,, 72 , 30 07 30 16 .- fair 20 46 66548 WS W N clear clear clear 2051 , 73 30 , 26 30 ,7 ---fair 21 50681625 S WS W clear clear clear 2158 · 75 30 , 18 3 9 --rain 22 566I50S r11 -, 67 ,, 3 , 3 17 16 0 wN M cloudy clar cloudy 12î61. 15 I 7, 0 0 12.ra \u0026t74, j 5 l0 .fi"
      ],
      "type" : "document",
      "title" : [
         "Quebec medical journalJournal de médecine de Québec = The Quebec medical journal [[Tome 1] (oct. 1826)]"
      ],
      "published" : [
         "[Québec : X. Tessier, 1826]"
      ],
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         "8_05171_4"
      ],
      "key" : "oocihm.8_05171_4",
      "source" : [
         "Numérisée à partir d'une microfiche contenue par Hannah Institute for the History of Medicine"
      ],
      "label" : "[Tome 1] (oct. 1826)]",
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05171_4",
      "pkey" : "oocihm.8_05171",
      "note" : [
         "Trimestriel"
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         "fra"
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         "text"
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      "contributor" : "oocihm"
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   "version" : "0.4"
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{
   "version" : "0.4",
   "request" : "http://eco.canadiana.ca/view/oocihm.8_05178_93/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1",
   "doc" : {
      "label" : "[Vol. 24, no. 9 (Mar. 1896)]",
      "key" : "oocihm.8_05178_93",
      "source" : [
         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine."
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05178_93",
      "pkey" : "oocihm.8_05178",
      "note" : [
         "Monthly"
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         "text"
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      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PHOTOGRAPI OF LIVING HAND SHOWING. BONES.",
         "MONTREAL MEDICAL JOURNAL. VOL. XXIV. MAROH, 1896. No. 9. righ3tmd 0mmxnutrations. THE NEW PHOTOGRAPHY WITH REPORT OF A CASE IN WHICH A BULLET WAS PHOTOGRAPHED IN THE LEG.' By J. Cox, M.A. Wm. C. McDonald Professor of Physies, McGill-University,.Montreal. AND ROBT. C. KTRKPATRICK, B.A., M.D., Demonstrator of Surgery, McGill University.; Surgeon to the Montreal General Hospital. Everyone is familiar with the phenomena produced by.discharging an induction coil through -an ordinary Geissler tube. The vacuum -of such a tube corresponds to a pressure of about one-thousandth of an atmosphere, or something less than one millimetre of mercury. On closer inspection the negative electrode, or Kathode, is seen .to be covered. with a velvety -glow. Next conies a short dark space from which a.faint violet cone spreads along the tube; ithe rest, and by far the larger part' of the tube, is filled with a cloudy light whose colour depends on the gas within: the tube. This light is generally arranged in regular patches or strio and extends right up to the anode or positive pole. Some twenty years ago Crookes showed to the British Association, a'number of, tubes in which the exhaustion was carried to, the nillionth of an atmosphere. In these tubes the phenomena, as had been previously observed by Hittorf, are entirely different. As the- vacuum increases the dark space spreads from the Kathode till it-fills the whole tube, and the faint violet cone of rays from the Kathode excites brilliant fluorescence in the walls of the tube or any mineral or screen placed to r'ceive them. Crookes exhibited experiments to 1- Demonstrated before the Montreal Medice-Chiriigiel Society, Feb. 7, 1896... 43",
         "COX AND KIRKPATRICK-TÉE NEW PHOTOGRAPHY. prove that these ' Kathode Rays' not only cause fluorescence, but (1) proceed in straight lines independently of the position of the anode, (2) violently heat the glass or the ôbjects on which they impinge, (3) can set fans in rotation by fheir impact, (4) are deflected by a magnet, and (5) repel each other when two streams are sent in. parallel directions. Three views have been held with regard to these Kathode rays. Crookes maintained that they were streams of the remaining mole- cules of the rare gas, which having conveyed the positive charge to the Kathode left it with a rush which carried them far down the high vacuum before the rare collisions with other molecules brought them back to the usual state of confused motion in all directions. To the gaseous particles in this high vacuum he gave the name of \"radiant natter,\" or matter in the fourth state of aggregation. Dr. Puluj, of Vienna, controverted Crookes' opinions, and made careful researches to prove that the rays were streams, not of gaseous molecules, but of particles actually torn from the Kathode itself. Finally Hertz and Lenard came to the conclusion that they were not matter at all, either gaseous or belonging to the electrodes, but \" Processes in the lEther,\" i.e., vibrations or radiations of some kind analogous to ultra-violet, or infra-red light. Three years ago when Prof. Hertz and Dr. Lenard showed me these rays, for the flrst time brought outside the glass wall of the tube, in Dr. Lenard's rooin at Bonn, they spoke of then as \" iolecules,\" but in the later part of his research Lenard proved that when once excited they could travel across the highest vacua, and for this and other reasons concluded they were phenomena of the Æ ther.1 Dr. Lenard placed an aluminium window opposite the Kathode, and the rays passing through the metal caused fluorescing bodies to shine at dis- tances of 6 centimetres in air, 4 in- carbonie acid, and as inuch as 30 centimetres in hydrogen. Lenard found they affected a photographie plate, and even obtained some shadow photographs by their. means. It was not till last December that the next step ivas made known to the world by Dr. Roentgen in, a paper conimunicated to the Academy of Wurzburg. It appears that while experimenting with a Crookes tube, which had been coverëd with black -cardboard, in order to see if the eye could. detect any rays emerging from the tube and capable of penetrating the opaque covering, Dr. Roentgen noticed that fluorescence was being excited in a screen painted*With fluorescing material at some distance from the tube. Following up the' hint, he obtained the effect up to distances of two metres, and by means of 'Lenard Weidemann's Annalen, 1894. 662",
         "COX AND KIRKPATRICK--THE NEW PHOTOGRAPHY. the shadows cast on the screen, soon determined the relative trans- parency of many substances to the \"l rays ;\" he concluded that they were not the Kathode rays themselves, but emanated from those parts of the glass that were caused to fluoresce; that they were probably in- capable of refraction, or of iregidar reflection, though he found evidence that metals and glass could produce a scattered reflection, as a white vall does with ordinary light. The paper, which is a inodel of scientific caution, condensation and accuracy, details researches on niany other points, such as the susceptibility of the rays to magnetie .and statical electrie influences, to polarization and to interference, and ends with the very interesting but guarded suggestion that we. may here be at last in presence of those longitudinal vibrations of the other which many physicists have held must accompany the trans- versal vibrations (i.e., those at right angles to the ray) which consti- tute ordinary and polarized light, though hitherto they have not been detected. Near the end of this admirable paper about twelve lines are devoted to some curious photographs or \"silhouettes,\" obtained by making use of the fact that certain substances are much more transparent 'than others to the Roentgen rays. It happens that metals and bones are much more opaque than ebonite, wood, paper, flesh and liquids. .Hence, Dr. Roentgen says, he has obtained pictures of wires upon a bobbin, weights inside a box, and the bones inside his hand ; and he modestly suggests.that there will be useful applications in surgery. Lead being the.netal usually fired into human bodies, is fortunately one of the niost' opaque; sub- stances and casts a very black shadow. . Hence the possibility of locating bullets, or observing malformations or fractures in the bones. It is this startling aspect of the discovery which has seized on the popular imagination, and led to all kinds of wild speculations on the: part of those who failed to understand the first brief reports of Dr. Roentgen's results. When further research shall have inci-eased' the sensitiveness of this process as much as the modern dry plate exceeds in speed and brilliance.the slow and misty daguerrotypes of the early photographers, there is no reason to despair of obtaining pictures, at leastin outline, of those organs of*-the living body (and their contents) which are not hidden behind too great. a thickness of bone. For the present we must be content to obtain, by a long exposure, a shadow of the bone or foreign substances divested of the surrounding flesh. The process simply consists -in placing the object. to be pictured between a Crookes tube and a sensitive plàte enclosed in an ordinary plate holder, or, better, in 'black and orange- paper. -The operation is 663",
         "6j64 COX AND KIRKPATRICK-THE NEW PROTOGRAPHY. carried on in ordinary daylight, since the plate is never exposed to it. The plate is developed and fixed in the usual way. Nothing has yet been done, beyond what was accomplished by Dr. Roentgen himself, to elucidate the nature of the new rays, but his photographic experiments are beginning to be repeated. With the splendid McDonald collection of apparatus at hand, I found no diffi- -culty in reproducing them at the first attempt, in which I was aided by Mr. Nevil Evans. Wasting no time over photographs of coins or other' small objects, we have obtained the pictures of hands now exhibited. What will mainly interest your Society is that within four days of our first attempt we have made two trials of the process as applied to surgery. On Wednesday Dr. Armstrong kindly brought me a case of injury to the hip; but I am sorry to say that after one hour's expos- ure we obtained not a trace upon the plate (22 in. x 18 in.). I am inclined to attribute this failure to the presence of lead in the black paint of the dark slide kindly loaned by Messrs. Notman, as lead even in a pigment bas been found to obstruet the rays. This morning (Feb. 7th) Dr. Kirkpatrick was good enougli to give me the opportunity of trying to locate a bullet which had begun to cause trouble in the leg of a patient. As this is probably one of the earliest cases of the successful application of Roentgen's rays, espe- cially in penetrating such a thickness of flesh, the negative, which clearly shows the flattened bullet lying between the tibia and fibula, will Le seen with interest. The plate was a Stanley (sensitometer 50) and the exposure 45 minutes. It is clearly under exposed, and should have had ab least an hour and a half. Near the top of the plate may be observed a copper wire tied round the leg, 3 centimeters above the entrance to the wound, from which .to measure distances. (This wire does not show clearly in the print, although quite apparent in the negative.) The bullet was 6 centimetres below the wire, where indeed it had been suspected to lie. It inay be said that in this case the new process converted a surmise into a certainty. The tube which I have found by far superior to all others tried at present is a Puluj tube containing a brilliant fluorescing sereen, and hence called the. \" Schirm-Lampe.\" It is No. 3080 in the catalogue, of Geissler, of Bonn, (price 15 marks). This tube was excited direct from the secondary of the large Kukenkorff coil (10 inches spark) fed with 4 ampères at 8 volts on the primary. The very perfect photograph of the hand showing sesamoid bones was taken with the same arrangements (excopt that the plate was wrapped in orange paper instead of being placed in a dark slide) by",
         "PHOTOGRAPH OF BULLET LYING BETWEEN TIBIA AND FIBULA.",
         "COX AND KIRKIATRICK-THE NEW PHOTOGRAPHY. Messrs. King and Pitcher, of the McDonald Physics Building, on the evening of February 7th. The exposure was, in this case 30 minutes. A photograph of the arrangements in the Physics Lecture Theatre will inake clear any omissions in my account. I must leave Dr. Kirkpatrick to explain the medical aspects of the case. The patient was shot in the leg on Christinas night last. He entered the Montreal General Hospital at once, when efforts were imade to find the bullet. These having proved. ineffectual, the wound was cleansed and an antiseptic dressing applied. The wound healed in a few days and the patient left the hospital apparently well. However, February lst he began to suffer pain, and a tender point developed on the inner side of the leg, just behind the tibia and 3 c.m. below the point of entrance of the bullet, which w;as on the back of the calf toward the outer side. On February 7th the bullet was photographed and our surmise as to the location of the bullet was proved to be correct. He re-entered the hospital, and the next day I 'Made an incision parallel to and just behind the tibia, and found the bullet lying against the outer edge of this bone. The bullet, which was flattened, weighed sixty- four grains, andi measured twenty-three mm. in length by fifteen in breadth. A groove ran longitudinally along the surface of the bullet showing where it had rested against the edge of the tibia. Although the plate was so much under exposed that it was with great difficulty that a print was obtained froin. it, btill the location of the bullet was plainly indicated in the negative, and any doubt which I had regarding.its situation was at once removed. The patient recovered rapidly and left the hospital ten days after the operation. 665",
         "AMPUTATION OF THE UPPER EXTREMITY,' TOGETHER WITH THE SCAPULA AND OUTER TWO- THIRDS OF THE CLAVICLE.1 By GEo. E. ARMiSTRONG, M.D. Assistant Professor of Clinical Surgery in McGill University; Surgeon to the Montreal General Hospital : Attend'ing Surgeon to the Western Hospital. Mad. X. Y., aut. 34, married, III-para., was admitted to the Montreal General Hospital on the 2nd of January, 1895, complaining '\u003ef pain, swelling and partial fixation of the left shoulder joint. She states that for lifteen years she has suffered more *or less froin rheumatic pains about the left arm and hand. Two years ago, when pregnant at the eighth month, she fractured the left huimerus about its middle during an eclamptic seizure. At this time, before the splints were removed, a small lump the size of a hickory-nut appeared in the anterior part of the axilla. The lump was liard, painless and disap- peared in about a year, but. the shoulder has been more or less stiff ever simce. In August, 1894, she accidentally struck ber shoulder against a door, and three days afterwards she was unable to move the left artm without the aid of the right hand. The shoulder became rapidly swollen and painful, especially behind. About two months ago a dis- tinct nodular swelling appeared in front of the shoulder, which was stony liard at first, but afterwards became softer, and two weeks ago it was aspirated, a reddish-yellow gelatinous substance being obtained. These swellings have persisted, increased steadily in size and been very painful. There is considerable fixity at the shoulder joint.. She says that she has lost flesb. Her family history is negative. She is~fairly well nourished. The whole shoulder is enlarged, the upper end of the humerus, neck of the scapula and acroiion end of the clavicle being involved. The density varies, being in some parts semi-fluctuating, in others of bony hardness, and in one spot egg-shell crackling is very distinct. There is no tenderness. Fixation of the joint is complete Vascular, respir- atory and urinary system normal. The diagnosis was myeloid sarcoma. On, the 12th of January, 1895, the whol3 upper extremity .was re.moved by the method described by Paul Berger in 1887. An incision was made over the clavicle, from the outer border of the 1 Read before the Montreal Medico-Chirurgical Society, December 27, 1895.",
         "r ,,goï -'4. AMPUTATION OF THE UPPER EXTREMITY, TOGETHER WITI THE SCAPULA AND OUTER TWO-THIRDS OF THE CLAVICLE.",
         "AlRlSTRONG--AMPUTATION OF THE UPPER EXTREMITY. 6e7 sterno-iastoid muscle to the acronio.clavicular joint. This incisiou extended down to the bone, and the periosteum over the clavicle was incised longitudinally, and also a circular incision of the periosteuni was made at each extremity of the longitudinal incision. The peri- osteum was then separated froni the bone by a rugine an'd the clavicle divided by a saw at each end of the incision and the middle third removed. The subelavius muscle was then separated at the inner ex- treinity and turned outward, thus exposing the subclaviian artery and vein. Two strong catgut ligatures were passed around the artery and vein and tied, the artery being tied first, that as little blood as possible might be left in the arin. The vessels were then divided between the ligatures. An antero-inferior and postero-superior flap was then fashioned and the iemaining soft parts divided. The operation pe- formed in this manner is practically a bloodless operation, the only hiemorrhage .heing fron the supra-scapular and posterior scapular arteries. The brachial plexus was divided high up. There was no shock following the operation, because there had been no hoemorrhage. ' The patient made an uninterrupted recovery and was discharged seveniteen days afterwards. She remains in perfect health up to the present. She is strong and active. There is remarkably little deformity noticeable when she is dressed, in fact if met on the street one would think that she had lier arm under ber cloak. The dangers of the operation, homorrhage, entrance of air into the sub-clavian vein, and sepsis, can all be controlled by Berger's method.",
         "A TRIP AMONGST THE GYNÆCOLOGISTS OF NEW YORK. By O. L. PREVOST, M.D., Ottawa. (Continued.). Quite close to Mie Central Park, at the corner of 106th street and 8th avenue, is situated the New York Cancer Hospital. Rather young, this hospital, scarcely eleven years in existence, and still, similar to Corneille's hero, valour has not awaited the number of years. You inay judge for yourselves by the following statistics out of the tenth annual report of this hospital. From Janary, 1894, to January, 1895, 751 patients were treated, 688 operations performed, including 142 abdominal sections, 21 abdominal and 16 vaginal hysterectoinies. Mortality after all operations 4-15 per cent. Remem- ber that in spite of its nanie this hospital is not exclusively destined to cancerous affections: it iS an institution similar to all others and where all kinds of patients are admitted. A post-graduate course for nurses is attached to it aud has been unusually successful. The gynScologists attached to the New York Cancer Hospital are Dr. Coe, one of the editors of the remarkable treatise of Clinical Gynocology you all know, and Dr. Paul Outerbridge, whom it -was my good fortune to see operate several times, and of whom I want to say a few words. Socially speaking, Outerbridge is a most charming man, obliging, affable and always ready to give any explanation required. As an operator he is neither fast nor sloiv, and therefore just right. Above all lie is endowed with a truly angelic patience, which I envy with all my heart. I saw him at work in a case of intra-uterine tumour occurring in a woman of 38 years, on whom he operated -before us. At the examination the point of the fibroid could be seen protruding through the os. The tumour appeared to be .very large, and Dr. Outerbridge would very willingly have performed hysterectomy, but the patient, unmarried, retains still some hopes, quite legitimate after ail, and she is anxious to keep her uterus, even be it only a second-hand one. Therefore the extraction will be attempted per vaginum by morcellement of the tumour in the uterus. In these cases of intra-uterine fibroids the authors advise that kind of operation if the operator is satisfied that he possesses a iore -than ordinary amount of patience and endurance, and surely they àre right. Never have 1 seen such a laborious piece of work. During two full hours the operator was busy cutting up and removing pieces of the",
         "PREVOST--TiE GYNiECOLOGISTS OF NEW YORK. fibroma, which, judging by the fragments piled up in the dish, must have weighed over seven or eight pounds. Sim's speculum placed on the posterior commissure and a retractor on the anterior wall, dhe operator seized with a large vulselluin the part of the tuiour which pro- truded, and with. the finger lie would detach the uterine wall all around and then cut out a fragment with strong curved scissors, to begin again the saie manSuvre. At the end of two hours the morcelle- ment was not over, and in spite of the number and the size of the pieces which he. had succeeded with such trouble in cutting and removing there was still some more to extirpate. The libroid filled the whole uterine cavity and was inserted on the very bottoni, as wel1 as on the lateral walls. The cervix was not divided, but off and on Outerbridge would introduce 'the large 'metallic dilator called after him, and whieh is after all but a modification of 'loodell's, and with that instrument he would divulse the cervix, which contracted again owing to the manipulation on the fundus of the uterus. During the whole operation an assistant kept pressing the uterus downwards through the abdominal wall, but adhesions prevented the organ from coming dôwp the pelvis and rend the the operation still more difficult. Some symptoms of collapse decided the operator to leave the operation incomplete and made him -regret not having pursued the course le generally adôpts in simi.ar cases, that is, do a cSsarian operation- .open the, 'abdomen, split. the uterus, enucleate the tumour, and then suture the uterine. walls. I saw also in the same service a woman who had her womb removed four years. ago for cancer of the cervix. She felt well ever since and began only lately to complain of some pains in the pelvis. She -was examined and a small mass was felt on the right side of the vagina. Dr. Outerbridge made a vaginal incision and removed a tube adherent to the bowels and the seat of a neoplasm, which might- be a return of the primitive malignant affection. After the operation a vaginal dressing was applied upon the same principle 'as the Mikulicz; a large piece of iodoform gauze was pushed up to the bottom of the vagina and filled with long band's of the saine material: At last, the very day I left New 'York, I had the good luck of seeing .Outerbridge extirpate by the vagina a large fibromatous uterus in a state of complete prolapse. Nothing simpler than' the manner in which this hysterectomy was performed. The whole operation hardly lasted twenty-five minutes. ''No retractors, nothing but a Sim's speculum on the posterior wall of the vagina. The Douolas's pouch was opened with' scissors, no' gauze was introduced; then incision of the cul-de-sac, always with the scissors, rapid separa- 669",
         "PREVOST-TH E GYN;ECOLOGISTS OF NEW YORK. tion of the bladder, and pening of the vesico-uterine fold of the peritoneum ; fundus of the uterus brought down through the anterior rent; broad ligament grasped between the thumb and fingers of the left hand and pierced by Cleveland's passer, armed with a double cittcrut strand which was eut in the loops and laid above and below. Sanie maneuvre on the other side-section and extirpation of the uterus, no guaze applied, no clamps used, only a slight plugging of the vagina with iodoform ganze, and that is all. Such is, gentlemen, in ny humble opinion, the ideal method of doing vaginal hysterectomy. I an well aware that this -operation does not always present such facility of execution as in the case just cited, where the prolapsed uterus protruding through a large vagina allowed the surgeon to operate, as it were, out of the vulva. Stili, even in less favourable cases, I fail to see the great advantage of placing on the ligaments clamps, which, to begin with, are far froin being so easy to apply as it has been -said, and which expose the operator to many inconveniences, certainly not void of certain dan- gers, such as pain, pinching of the intestine, and even gangrene by p.r'ssure, either of the vulva or the bowels, in spite of all precautions taken to surround the clamps with gauze. Boesides, the operation seemns unfinished when the patient is put to bed with ten or twelve long forceps hanging out of hier genitals. Why not use good and strong ligatures? With a little dexterity they are rapidly applied, and if the catgut is of good quality, aseptically prepared and snugly tied, the danger of heSmorrhage is not any greater than with the clamps. I know that by this confession I repudiate a mode of operating which is universally adopted in France. In fact the clamps are ex- clusively used by Rein, Segond and Richelot in Paris, Doyen in Reims, and Jacobs in Brussels. *The latter went through New York lately and has performed in several hospitals many vaginal extirpa- tions with clamps. His immènse experience (more than 400 cases) and his skill would permit, it is true, his completing the whole operation within a few minutes; however, in spite of the luminous trail left by his passage through the great American city, his method does not seeni to have produced a very deep impression, since the majority of American gynocologists continue to do their hysterectomies by the means of ligatures. There are sone exceptions, I know. For instance, I saw at the Post-Graduate, Prof. Dudley extirpating through the vagina a fibromatous uterus without a single ligature. He opened the cul-de-sac with Paquelin's thermocautery, applied clamps on the uterine arteries, brought down the fundus of the uterus through the",
         "PREVOST-THE GYN..ECOLOGISTS OF NEW YORK. posterior cul-de-sac and applied again two clamps, one on each side, upon the ovarian arteries, on the superior border of the broad liga- ments, reversed below by the soinersault of the uterus, and then removed the latter. But, I repeat it, even in this case it' would have been just as easy to apply ligatures, and the operation would not have been prolonged in a very noticeable manner. These facts, however, demonstrate the general tendency now-a-days to perform by the vagina operations which a few years ago were uhi- versally done by coliotomy. The route is safer, the shock infinitely less, almost nil, the dangers and inconveniences of abdominal section avoided. The lesions of the appendages have become amenable to surgical interference per vaginam; purulent collections of the pelvis are daily opened by the incision of the cul-cie-sac; the degenerated tubes or ovaries are removed by the saine way, and even uterine' fibroids, when they are not too voluminous, are extirpated through the vagina. We are going still further. When deep and incurable lesions have rendered the - extirpation of appendages necessary, why not remove at the saine time the uterus ? In fact, what is the use of that. organ to a woman deprived of tubes and ovaries ? Hereafter totally useless, this uterus is often diseased, it is even in the majority of cases the starting point of the disorders which led to the removal of the appendages. Badly cured, if at all, it will sooner or later surely pro- duce further annoyance and necessitate perhaps a new operation. Therefore, why not *perform a complete operation at once.? The mutilation is hardly more considerable, and experience bas already taught us that the results are infinitely more satisfactory. But let us return to New York. I long to acquaint you with the Germnan Hospital, situated on the corner of Park avenue and 77th street. : This hospital has been in operation for twenty-five years, and still one would think that it was built yesterday, so modern is the disposition of its waids and the working of its operating room. Although opened to all nationalities, we can easily see that it is above all a refuge designed to relieve Germanie sufferings. Everything is German-the inscriptions at the entrance of the wards, the charts, the operators, the assistants and the nurses, for there also exists a train- ing school-for nurses founded ih 1894. Here agaýin they try to carry out the principles of strict antisepsis, and certainly they succeed in doing so in a most admirable manner. The operating room is large and well lighted from above. The floor is of' cernent and on aslightly inclined plane to allow the easy flowing of fluids ; therefore they take it easy. No recipient is used at the foot of the -operating table to receive, during irrigation, the fluids which runfreely on the floor. The nurses and assistants wear rubbers and the operator old-fashioned wooden 671",
         "PREVOST-THE CoYNÆCOLOGISTS OF NEW YORK. shoes, and after the operation water, bood, etc., is swept away. It may be expeditious, but it reminds one to miiucl of theslauohter- house, and therefore I consider it an offence against Sstlietics. The dressings, instruments, ligatures are prepared with greatest care in immense steam sterilizers. Everyone niinds his own business during an operation, which is done witli great regularity and in ,the nidst of deep silence. The operator has on each side basins of water, where lie puts the instrument he lias just used. The assistant at once cleans it and places it amongst the others to hand it back to the operator when wanted. I assisted at operations performed by Dr. Krug, gynoecologist, and Willie Meyer, general surgeon.. Willie Meyer! Here is a man near vhom physicians and students must derive the greatest benefits. He teaches while operating, and by clear explanations makes us follow the course of his scalpel. He was doing that day -Bassini's operation for the radical ure of hernia, extirpation of the astragalus for an old dislocation of that bone, and removal of hoemorrlioids. After lapar- otony le closes the abdoiinaF walls with a continuous catgut suture, taking care to interlock each stitch by passing the needle under the superior loop. To reimove hænorrhoids he uses the clamp and cautery, like almost every other surgeon in New York. But instead of snip- ping the top of the pile on the clamp before applying the cautery, he sears the' whole of it down to the clamp withôut. using any scissors. It takes longer, but the process-is safer and guards more surely against further hSmorrhage. Only the prolonged contact of the fire rapidly raises the temperature of the clamp, and if the latter is not supplied with ivory plates we must not forget to lay between it and. the skin a piece of moist gauze. In spite of this precaution in tlie case operated on before us, the clamp, entirely metallie, deeply burnt the left buttock of the patient; they· had 'neglected to keep the gauze sufficiently moist during the operation. Dr. Meyer 'recommends to apply the clamp in the direction of the'radiating folds of the anus. . For instance, diagonally on éach side below, the point of the clamp directed upwards towards the centre of the anus, and diagonally on each side above, the clamp pointing downwards. Four applications of the clamp are sufficient. Should there be any prolapsus' of the rectum, some of the skin at the margin of the anus is included in the instrument with the pile. IodofornC powder is dusted on the parts and the bowels kept confined for three days, Before I introduce you to Dr. Krug, and while we are dwelling on that interesting part of our economy, let us repair, if you please, to the Post-Graduate; we shall come back bye and bye to the German Hospital. (To be continued.). 672 9",
         "A CASE OF GENERAL INFECTION BY THE BACILLUS PYOCYANEUS. By KENN CAMERON. B.A., M.D., Assistant Surgeon, Montreal General Hospital; Assistant Denionstrator in Clinical Surgery, McGill University. H. P., a male child, was born at the Montreal Maternity Hospital on August 4th, 1895, was nursecl by' his mother for twelve days, and left by her at -the Montreal Foundliug and Infants' Nursery. 'The infant weighed eight pounds and was well nourished ; the stools were in good condition, yellow and free from curds. He was then fed upon a mixture consisting of imilic, lime water and water,- each one-thigrd, with sugar of milk 3i to Ev. After the first week the stools' becathxe loose and watery, and- contained more or less curd. This - indigestion never.improved, thouigh the proportions of the mixture were frequently changed, and he gradually ·lost weight. The temperature, taken every four hours, ranged from 97° to 100°. In no way did the case differ from -one of atrophy with indigestion until September J30th (the fifth week) when a 'bhie papule; 6 mnm. in diameter, was noticed on the abdomén a little to the left of the umbilicus. A purulent dis- charge from the right ear was observed the same day. Two other snfall spots appeared on the -abdomen. Later on, the whole surface of the body became slightly ey.anotic.' The muscles of the ,legs were rigid, but not markedly so, nor were the thighs flexed on the abdomen. The child died on September 23rd, or six weeks after birth. The temperature during the last week ranged from 94° to 99°. .A -note was sent' with the body. to the pathologist asking hin to especially look fQr the bacillus pyocyaneus,-as some, but not 'all, of the symptoms of infection by thât organism had been' present. In the absence of Dr. Martin, the requisite observations were .made by Mr. E. W. Haminond, of the McGill Pathological Laboratory, under the immediate supervision of Dr. Adami. From his notes it will be seen that the bacillus was found generally clistributed throughout the organs: This case is the third of .a series of cases of general infection by the bacillus pyocyaneus, observed among the hifants'in the Mont- eal Foundling and Infants' Nürsery during the past sixteen months'. The first two cases have been very fully reported elsewhere' by the late Dr. E. P. Williams and'myself, but maybe briefly repeated here for the sake of coinparison. CASE I-A Male child, nursed' by his mother throughout his life. 1 Read before the Montreal Medico-Chirurgical Society, November 29, 1895. Journal of the-American Health Association, July, 1895.",
         "674 CAMERON-INFECTION B THE BACILLUS PYOCYANEUS. Hie gained steadily in weight until the twenty-second .week of age when he becanie restless and ill, and began to lose weight without. assignab!e cause. Five weeks later diarrhœa, set in, accompanied by abdoinnal pain and tenderness, and slight fever. After a week, a, group of purple papules, 3 to 7 mm., appeared on the abdomen on eaci side, midway between the umbilicus and the flank; they then spread over the abdomen, chest and legs. The lower limbs becamne rigid, the legs were flexed on the thighs and thighs on the abdomen, and any attempt to straighten them out caused pain. Two days before death there was a profuse epistaxis and, bleeding from papules between the toes, on the right thigh and on the back. A purulent discharge was also noticed fron the left ear. The autopsy was perforned very shortly after death, and fron the kidneys and spleen-pulp were obtained pwtre cultures of the bacillus pyocyaneus. Microscopical examination showed the capilliaries every- where to- be crowded with b'acilli, which here and there forned emboli, and in some instances the micro-organisms had passed through the walls of the vessels infiltrating the surrounding tissue. CASE II.-A small poorly nourished female child was left in the Nursery, without her mother. She had a purulent discharge from both cars. Tiere was a gain in weight for the first week, whèn she began to haýve diarrha and lose weight. She soon developed a runeral lividity of the whole body of a most pronounced type, and several pustules on the hcad, but no purpuric spots or cutaneous hemorrhages were observed. Two days before death there was rigidity of the muscles. Cultures taken fromi the kidney, spleen and liver showed a p wre growth of the bacilluspyocyaneus,-anI - the micro- scopical appearances were identical with those seen in the first case. Inoculations were inade into rabbits from cultures taken from each. child, and both the animals died within twenty-four hours -with all the- synptoms and lesions of acute pyocyaneus infection.. Very similar cases have. heen reported by- Ehlers. (Hospitals Ticliende de Cjopenhague, Mai, 1890,) and H. Neuman, (Archiv. f. Kinderheilkunde, Bd. XII., 1890). I am not, however, acquainted with original observations upon general. infeebion with the 'bacillus pyocyaneus in children other than the cases by-these two' writers. \"The effects of the bacillus upon animals have been studiedby several observers, notably Charrin, Ruffer and Babiisky. Charrin found that lie could, - by subeutaneous or intravenous injections of cultures, produce in rabbits. a . very characteristic 'çliease,, ending fatally, the symptoms and d uration 'of the illness vejing with the quantity and quality of the virus introduced. ^If a large dose, 0.50 to 1.00 cc., be injected into the vein of a rabbit's ear, the animal will",
         "CAMERON-INFECTION BY TUE BACILLUS PYOCYANEUS. die in from twelve to twenty-four hours, the symptoms being loss of. appetite, elevation of temperature, followed by a fall before death, diarrhoea, albuminuria, drovsiness increasing to coma, and sometimes convulsions. If, on the other hand, sinall repeated doses are given, a diflerent train of syinptoms appears. The disease becoies more chronic. Besides the albuminuria, diarrhœea, and fever, there occur rapid emaciation, cutaneous linorrhages and a peculiar forni of spastic paralysis affecting usually the hind legs only ; the thighs are flexed upon the pelvis and the legs upon the thighs, which condition relaxes under chloroform ; handling the liuibs gives the animal pain ; the muscles do not waste nor do they loose their electrical -reaction. A few hours before death the paralysis becomes general. The post- mortem examination shows homorrhagic infarets in all the organs and the specifie organism may be eas!ily denonstrated.\" -The close resemblance between thie symptoms of this more or less chronic disease, produced experimentally in rabbits, and those observed inthe infants, is very striking, and suggest that the cases reported are examples of the very rare condition-truc pyocyaiic disease. Tfie cardinal symptoms of this disease appear to .be.: 1. Wastinq. This is usually very marked and rapid, and for it sonietimes no cause can be assigned. In the.case reported by iEhlers there was also mental depression. 2. .Diwrhea. Symptoms of gastrie and enterice catarrh are always present and appear early. . The stools are usually green,. watery, and, in babies fed on milk, full of crds. * Treatment sceins to produce but little effect. 3. Fever. This is .not high-the range being usually only two or three degrees, with a decided fall, often much below normal, before death. 4. Albwninwurita. This is always present in rabbits, but no record can be found of .this symptoni in the human subject. . This is probably due to the great difficulty of obtaining samples of the urine of very young babies. In 'the three cases. here reported, repeated attempts were made to obtain a specimen but were unsucces9ful. 5. Rash. In all the recorded. cases there has been an eruption,of bluish or purplish papules, chiefly on the abdomen, but also on the chest, limbs, head and mucous.surfaces. The spots vary in size from 2 to .7 mm. in diameter, and there inay be only a single one or a very great number. Sometiines they become pustular or' bullous, the côn- tents being of a bluish or brownish colour, aid from them the bacillus can be cultivated. Sometimes a lividity of the whole body nay be observed. This rash is the most characteristie symptom of the disease. Of the 68 infants that'have died in the Nursery and have 675",
         "676 CAMEIRON-INFECTION BY THE BACILLUS PYOCYANEUS. been examined, but three have had such an eruption, and these are the three cases, here reported, of generalized infection. 6. M.scular disorders. These take the form of spastic paralysis, alnd occur late, after the develonment of the rash. The lower limbs seejm to be the only parts affected. The thighs are flexed on the pelvis and the legs upon the thighs, and if straightened will return to the same position. Haidling will iake the child cry as if in pain. Before death tiere is gencral muscular relaxation. BACTERIOLOG ICAL NOTES UPON DR. KENNETII C \u0026MERON'S THIRD CASE OF G ENEllAL INFECTION BY T11E BACILLUS PYOCYANEUS. By E. W. IAIM3IOND. [From the Molson Pathological Laboratory, MeGill University.] I an indebted to Dr. Adani for the opportunity of publishing the IflloWincr notes: The post-mortem in this case was made by Dr. Adami and myself. At the autopsy the infant was found to be smtall and greatly emaciated, the skin in general had an earthy, sallow appearance, and over the abdomen there was a small hoemorrhagic eruption, with, in addition, two larger, rather faded purplish spots. The abdomen was greatly distended and tympanitie, and upon opening it the bowels had a dark congested appearance. There was no fluid in the abdominal cavity, but the bowels were moist. There were no signs of any subseroui hmiorrhuges, and neither in the intestines nor in the other abdominal organs, save the stomach, werc there any conditions noted differing from those seen in marantic infants. The abdominal organs in gen- eral had a dark cungested appearance, the spleen was soft and relatively large, the lungs were also congested. In the stomach there were submucous hmmorrhages similar to those observed by Dr. Williams in the cases mentioned above, and similar to those seen also in the rabbit upon inoculation with B.'pyocyaneus. I may state that I have seen several cases of such subinucous homorrhages, both in animals inoculated in the pathological laboratory here and in animails inoculated by Dr. Ruffer at St. Thomas's Hospital in London. I made cultures in beef broth from the subcutaneous tissue beneath one of the large purplish spots in the abdominal wall, fron the heart blood and fron the kidney, liver and spleen. Of these the culture fron the abdominal waliUesulted in a pure growth of the B. pyocy- aneus, thit from the kidney became turbid,'but showed no character- istic greenish colouration ; the heart blood and the liver developed slowly the characteristics of pyocyaneus cultures, but upon micro. scopical examination presented cocci along with the bacillus; the spleen showed adnaixtùre with cocci and putrefactive bacteria to an even greater extent. It may be added that the weather was distinctly",
         "CAMeRON--INFECTION BY THE BACILLUS PYOCYANEUS. warm. The autopsy was not performed until at least twelve huurs after death. As above stated; putrefactive bacteria vere present in the cultures from the softened spleen. Whether the cocci found in the heart blood represented a post-mortem growth or the existence of a mixed infection I am not competent to determine. Their existence renders it impossible for me to state absolutely that this is to be classed as a case of pure pyocyaneus infection. It is, however, to bo noticed that from the most characteristic lesion present, namely, Irom the purplish hSmorrhagic patch in the skin of the abdomen, the B. pyocyaneus was alone obtained. It was to be noted further that the greenish colour appeared more slowly in those tubes in which there was a mixed growth than in the culture from the subeutaneous tissue in which the pyocyaneus only was present. It would seem, there- fore, that the presence of other micro-organisms had a retarding effect on the growth and colour production of the bacillus. I noted also that the character of the pigment production and the intensity of the peculiar odour developed by the cultures changed with furtier growth outside the body. Thus the first broth cultures direct from the organs had a more purely green coloration and slight odour. After making plate culturés on agar the cultures from the separate colonies made in beef broth assumed the more typical blue-green appearance, that usually seen. In fact the colour of the first growths was very similar to that of the non-pathogenie bacillus fluorescens whben grown in broth. The odour also became very strong. That I was dealing with the B. pyocyaneus was, .however, shown by the appearance of the micro-organism under the microscope and by the results of inocula- tion. Upon November the 25th I inoculated a three-months-old rabbit intravenously with 1 ccm. of a broth culture twelve days old, made from a colony upon an agar plate fron the original culture froni the heart blood. The animal died in fourteen hours. At the autopsy, with death in so short a time partaking of an intoxication rather than an infection, it vas not to expected that the animal would show iany gross lesions. There were, however, hoemorrhages in the car at some distance from the seat of inoculation, and hSimorrhages again in the mucous coat of the .stomach, as also interstitial hSnorrhages in the lung. Sections of the spleen and liver showed the bacilli present. I should add that a microscopical examination of the organs -of the child showed the characteristie small bacilli to be present in the spleen, liver and heart wall. From the heart, liver and spleen of the rabbit I obtained again pure cultures of the -bacillus giving a rich pale blue colour. 677",
         "A CASE OF PRIMARY CANCER .0F TIE GALL-BLADDER. By O. F. MAnTIN, B.A., M.D., Assistant Physician, Royal Victoria Hospital. The points of interest in the subjoined report are as follows: 1. A very incipient primary cancer of the gall- bladder. 2. Cholelithiasis and perforation of gall-bladder 3. Presence of gall-stones free in the abdominal cavity. 4. The absence of any special localizing symptoms. 6. The riglit hydronephrosis induced secondarily to the cancer of the gall-bladder. Glinical Report.-(Notes by. Dr. A. A. Robertson.) The patieùt, Mrs. T., aged about 65, who was admitted to the medical wards of the Royal Victoria Hospital, manifested great weakness. Her only remarks were that she was \" slowly sinking awày,\" and nô further his- tory could be obtained from her or her few friends. She was appar- ently uncared for and would seem to have been il for some weeks previously. On admission she showed much emaciation. Pulse 120 ; respira- tion, 28; temperature, 101°. Physical examination revealed almost total -consolidation of the right lung with a few crepitations and prolonged expiration at the base of the left. Pressure over the abdomen eused pain in all regions, though most marked in the right iliac fossa ; there was no- palpable tumour. Fever continued for forty-eight hours; some diarrhœa ensued and weakness progressed till on the third day after admission- death supervened. The Atopsy (made 18 hours after.death). Anatomical diagnosis.-Acute lobar pneumonia; cholelithiasis; perforation of gall-bladder ; primary cancer of gall-bladder and localized peritonitis inducing right hydronephrosis ; secondary cancer of liver and dilatation of the bile ducts ; general arterial selerosis; subacute parenchymatous nephritis. Body was'that of an emaciated elderly woman presenting-the usual post-mortem changes. On opening the abdominal cavity, which was dry, the duodenum was seen to be markedly distended and irregu- larly bent upon itself in the first and second portions and matted together with surrounding tissues, moderately recent adhesions being forined to gall-bladder, liver and abdominal wall. .There was further",
         "MARTIN-PRIMARY CANCER, OF:.THE GALL-BLADDER. a-slight sloughing of tissue in the- imidiate neighbourhood of the gall-bladder. The hepatic flexu'eof the colon was collapsed and pushed downwards. Four black.. mulberry-like gall-stones, each 6 mm. in diameter, lay free in the abdominal cavity amid the sloughed tissue below the gall-bladder and seemed here loosely held amid the mass. The spleen was small, soft and atrophied. The left cidney showed evidence of subacute parenchymatous inflammation. The right kidney, as it lay in situ, presented a thickening of its capsule, chiefly in the upper and anterioir- portion, with infiltration of the adipose and other neighbouring tissue. There was, however, even lower doivn, considerable inflammatéry adhesion of the parts. The organ itself was fluctuating to the feel, evidently hydronephrotic, while the ureter itself was normal from pelvis to bladder- opening. On removing the kidney, adhesions were found binding down the pelvis to the adjacent parts, evidently inducing a damming back of urine and thereby dilating the calices and causing great thinning of the kidney tissue. Average diaineter of dilated pelvis was 10 cm., its walls much thickened. The fluid was slightly turbid and bile-stained; the mucosa injected, no stone could be detected. The bladder presented some signs of slight chronic cystitis. The orifices of thè ureters.normal. The liver and gal-bladder weighed together 1425 gins. The com- mon bile duct, as well as the pancreatic and cystic ducts, were pervious; the latter greatly thickened. The liver itself small, very soft and rather'paler than normal. The gall-bladder was much diminished in size. The wall of greyish- white colour and very much thickened. especially near the attached margin. Towards its lower and outer portion was a perforation 1 cm. in diameter with smooth rounded edges, and through this evidently the gall-stones had escaped. The tissues about it showed localized sloughing where the organ impinged upon the duodenuin. Where the gall-bladder was thickest there was much new tissue formed, connect- ing together the gall-bladder and the liver substance. It extended irregularly into the adjacent liver substance, being apparently con- tinuous with and arising from the similar conditions of the wall of the gall-bladder itself. The average diameter of this· irregular area was about 4 cm., while the liver tissues in the immediate vicinity presented a few smaller nodules of the same character. Elsewhere the liver contained about nine or ten greyish-white rounded nodules of com- paratively small size, all firm on section and not penetrating deeply into the tissue of the organ. On section the liver vas soft, many of its 679",
         "680 NIARTIN--PRIMARY CANCER OF THE GALL-BLADDER. bile ducts were greatly distended in both lobes, though apart from any evidence of cancer or tuberculosis. The periportal glands vere enlarged, soft and somewhat pigmented. The portal vein and vena cava were free. Throughout the alimentary canal, beyond moderate congestion, there was no evidence of discase. Thoiacic cavity--In the lu-ngs bilateral adhesive pleurisy, with double lobar pneunhonia. The heart was both dilated and hypertrophied, showing evidence of fatty degeneration and interstitial nyocarditis. The coronary arteries were atheroinatous. Cultures fron the consolidated lung gave the diplococcus lanceo- latus. From the kidney and spleen were obtained the staphylococcus pyogenes aureus. Cultures from the liver pulp remain sterile. MicRoscoPic EXAMINATION - Gall-bladder - The walls showed chronie fibroid thickening, the inucosa in somne parts much necrosis, in others deep irregular proliferation of epithelial -cells of a distinctly glandular type. The adipose tissue external to the gall-bladder was likewise infiltrated. There was, in addition, some heniorrhage, with thickening of the vessels in the neighbourhood. Sections of the cystic duct show involvement similar to that of the gall-bladder. Exainiuations of the nodules in the liver showed the ordinary con- dition of metastatic glandular carcinona. There was no evidence of tuberculosis anywhere in the liver sub- stance. The periportal glands were distinctly cancerous, glandular epithelial cells lying amid a moderately abundant fibrous stroma. Large niasses of dark green or orange pigment of a granular charac- ter were distributed throughoUt the sections. There was elsewhere no evidence of carcinoma and'the microscopie examination confirnicd, in the other ,organs, the macroscopie appearances.",
         "UPON TWO CASES OF PYOCYANIC WOUND INFECTION. By H. S. SHAw, M.D., and D. P. ANDERsoN, B.A., M.D. Resident Surgeons of the Royal Victoria Hospital, MontreaL The condition of blue pus in wounds is perhaps sufficiently uncom- mon now-C.-days to miake the following two cases deserving of being placed on record, the more so as, while the observations of Dr. Ken- neth Camarc and the late Dr. E. P. Willians have.shown that the bacillus pyocyaiens has been causing a general infectious disease in sundry infants in Montreal during the last two years, we have not during the same period encountered or heard of- any examples of this more coinmon wound infection in the general hospital practice of the city. CASE I.--W. M., St. 15, entered Dr. Bell's wards upon, September 26th, with synptoms of acute appendicitis of about four days' dura- tion. He had suffered from a previous attack lasting for four montlis during the spring of the year. Dr. Bell operated upon the following day, and the operation revealed a densely infiltrated abdominal wall with dense adhesions about the cæcum ànd a pin-point perforation of the bowel. The appendix was not sought for, on account of this per- foration and the consequent danger of infecting the general peritoneal cavity. For a week subsequent to operation the. condition of the patient remained good; there was, however, a small amount of yellow fæcal discharge. The patient then began to complain of epigastric pain with some fever, and the amount of focal discharge w as increased. Upon October 12th, two weeks after the operation, the patient was suffering severely from abdominal cramps, and the temperature varied between 99° and 101°. There was a profuse discharge o' greenish fluid from the wound, vhile the dressings were also noticed to have assumed a bright bluish-green colour. The cultures made from the fluid showed the presence of. the bacillus pyocyaneus. We'hoticed that the colour did 'not show itself well in the bandages until the second day, that is to say, that bandages left ou just over the wound for twenty-four hours assumed only a yellowish tinge; twenty-four hours later, however, the dressings werie very characteristically blue, and what is more, they gave off the same strong and peculiar odour (said to -be that of trimethylamine) which is so noticeable in connec- tion with pure growths of the bacillus upon various media. The subsequent course of this case has been marked by the persistence of",
         "SHAw AND ANDERSON--WOUND INFECTION. the fistula and the intermittent appearance of the colouring matter on the dressings. CASE II.-J. S., S-t. 19. This patient entered the hospital under Dr. Bell in May last, with a very foul-snielling discharging wound in the right chest, which had been opened -some weeks previously for the relief of empyema. In June the condition began to improve, a rib was resected for better drainage, but the pus continued to flow very freely, and on October 3lst Esthlander's operation was undertaken, and cultures made from the pus on that occasion denionstrated the presence of bacillus pyocyaneus. The dressings since then have been noticeably of a bluish or greenisfi colour. From this case also one of us (A.) isolated also a non-pathogenic formn which is not or has not been unfrequently isolated f rom water and other media, but concern- ing which we have been unable to come across any record as having been found in connection with wounds, or indeed with the surface of the body or mucous membrane. This is the bacillus ramoss. This is characterized by the peculiarity of the growth of stab cultures. in gelatine n'edia; from the central track of the aeedle there passed out- wards and slightly upwards fine secondary lines of growth, most extensive towards the upper free surface of the gelatine, so that as one authority described it, the cultures have the appearance of little white tir trees that have been inverted. In both these cases there were several forms of micro-organisms present in the pus, an'd the B. pyocyaneus could not in any way be regarýded as the primary cause of the suppuration ; it is evident from the clinical history there was only secondary infection by this micro-organism. It is of sone little interest to inquire how this bacillus found entrance into the wound. In both cases there was always the possi- bility that it might have entered from the surface. The B. pyocy- aneus has been isolated on the healthy skin, and especially would seem to be present not unfrequently in the region of the axilla. In the second case it is difficult to explain any other mode of entrance or to put it in other words, such a mode of- entrance affords the most satisfactory explanation. In our first case, where the bacillus appeared connected with -the abdominal wound, there is another possi- bility which must not be left out of account, for the B. pyocyaneus bas been isolated several times from the feces; thus it is quite possible that in this case, in which there was a fecal discharge and foecal fistula of some considerable duration, the infection had origin- ated from this discharge and not from any contamination from without. 682",
         "PAROTIT1S IN PELVIC DISEASE. By W. S. MoRnow, M.D. Lecturer in Physiology-McGil University. There is a variety of parotitis whith receives little notice in our medical text-books, but which is-to say the least-rather interesting. It occurs in connection with disturbed functions of the male and female generative organs, and also in pathological conditions of the urinary and digestive systems and abdominal parictes. Most texi- books which mention it at all refer back to a paper by Dr. Stephen Paget, in the British Medical Journal, for March 1887, which, as far as I know, contains the most-complete account of this affection to be found anywhere. Ino the paper referred to, to which I acknowledge my indebtedness for a number of facts mentioned belowý, Dr. Paget has collected 101 cases of parotitis in connection. with -derangernents, more or less serious, of the abdominal and pelvic organs; and of these the genera- tive organs were the seat 'of the original trouble in no less than 50. These cases are important, firstly, because their correct diagnosis saves our patients the inconvenience of isolation and the humiliation so inseparable from a verdict of mumps, and, secondly, because they open up the i.ateresting question of connections between distant organs. The following three cases observed by the writer were of pelvic origin. The first occurred in the course of pelvie peritonitis. In March 1893, I w'as called to a case of pelvie peritonitis. It ran a moderately severe -course, the temperature keeping up for about three weeks. A, fôrtnight after the onset of the peritonitis one parotid gland became'swollen, tense, and very tender. After a couple of days the infiammatory process extended beyond the capsule of the gland, and the face became puffy up to the middle of the forehead. . A free incision into the gland was followed by somewhat alarming hmorrhage, but no pus was seen. After this the inflammation rapidly subsided in b.oth the gland and the pelvis, so that the patient was'able to be up in a«little over a week. The second case was one of parotitis after. suppression of the menses. In Sept; 1895, I was called to Miss O., aged about 25, ·and found her suffering tvith a painful swelling in the position of the right parotid. As far as known she had not been exposed to -mumps, but a week before coming under obseration, she went for an evening walk while menstruating and thought she had caught cold,, as the flow stopped",
         "84 MORROW-PAROTTTIS IN PELVIC DISEASE. ' and she «was seized with pain in the pelvis. This was followed in a day or two by pain in the left parotid, and this again by pain and swelling in tlh gland on the right side. By the time I saiv lier, the onec first affected was better, and under simple treatment the other becamie vel ine a few days and.the pelvie pain disappeared. The third case I have to relate was a very similar one. Miss E., went to mnidnight mass on Christmas Eve last while menstruating. She feit at the -time that she was catching cold and the next day the fluw stopped prinaturely. The following day the left parotid becane sore aund swollen and tliat evening she caie to see ine. H{er tempera- ture wias 100°, and there was a well narked tender swelling in ·the region of the left parotid gland. .It was paintecd with iodine and she wasgiven a dose of calomel, and thirty-six hours after ·this she felt quito well the pain and swelling were gone and her imenses had started again. She had noL been exposed to numps as far as known, and no one in the house with her lad caught it. Moreovrer the whole duration of1 Lie parotitis was only 48 lours, so that it did not run the usual course f' the specific disease. The course bas been found to vary very mucl in these cases and, acco'ding to Dr. Paget, the severity of the gland inflammation depends largely on the systenic condition at the tiue. Where it ends in sup- puration it is because the powers of resistan~ce have been dirninished by some oter disease, so that alnost atry intlanmnatiòn would tend to Mun an unavou rable course. Cousiderable interest centres about the question of how parotitis is set up hy mnorbid processes having their seat in the ibdomen. A certain numiber of cases ·may be due to bac- terial inrfection through the blood or sec'retry. duct, such as occurs in mnauy of the infectious and septie fevers anl almost invariably goes on. to suppuration. But there is a Croup of cases, often milder'ini type, and especially frequent in coniction with pelvie disease, which do iot admit of any sucl interprettion. For those we have to choose between the metabolic tileory and the nervous. Against any meta- bolie theory we have the great nùmber' of tissues which may be the seat of the prinary affection. Parotitis Ihs been reported by Paget and others as accomnpanying or following pregnaney, delivery and abortion, nenstruiation which it sometines replaces, pelvie cellulitis and humatocole, operations on the vagina and uterus, ovariotomy and oöphorectouy, the use of the catheter and sound, blows on the testicle, operations and diseases of the bovo], gastritis and gastrie ulcer, dis- ease of the pancreas, and injuries'and diseases of the abdominal wall. 'Ilhis varied origin excludes almost absolutely any metabolie theory and favours a nervous one. And there is not wanting considerable 084M",
         "MOIRROW-PAROTITIS .IN PELVIo DISEASE. cireumistantial evidence that the nervous systôm is the niedium through which the effeet is produced. Some cases, like the last one roported in the present paper, seein to he rather transitory hyperæmias than truc ilainnmations and suggest a vasomotor chaùe as the primary one. Ve know too that both the pelvic and the other abdominal -organs have a powerful influence on the vasoinotor centre, as seen in the flushes of menstrual irrcgula'rity and of dyspepsia. Moreover there are o'ther facts which seem to indicate a nervous connectioti through unknown paths between the parotid glands and the generative and digestive systems. .Among these facts may be rnentioned the salivation of pregnaucy, the dry mouith fron which some .women -suffer during menstruation (Goodell) and the changes in raalivary secretion observed in so many affections of the stomachi and bowel. The nervous theory is supported by those wlio have \"given most attention to the subject, and while more facts are being obtained, it uay be taken as the most probable hypothesis. .685",
         "CLINICAL LECTURE ON TWO CASES OF MULTIPLE ARTHRITIS DEFORMANS. DELIVERED AT THE ROYAL VICTORIA HOSPITAL. JAMEs STnrT, M.D. Professor of Clinical Medicine, McGill University; Physician to the Royal Victoria HIospital. The first case which we will consider to-day is that of S. G., aged 26. He was admitted into. the Royal Victoria Hospital on the 26th of September, complaining of enlarged joints, difficulty in walking an(d weakness. His present trouble began three years ago with stiffness and pain in the shoulder joints. A few montls afterwards the joints of the tingers became swollen, stiff and painful. He lias frequently coin- plained of a sensation of burning and tingling in the extremities. About six mnonths later the knees became involved, and the trouble here progressed so rapidly that in a few weeks he .was only able to get about with the aid of two canes. About the same time he lost rapidly in flesh and colour. The elbows soon afterwards were found to be stiff and painfnl. As to his past history, there is nothing to note except that -lie had diphtheria when eight years of age, followed by abscesses inthe neck, one of whicli was opened and discharged. His occupati'n is that -of a clerk. He has used stimulants in small amounts occasionally. Present condition-You will notice that he is pale, the general state of nutrition being poor. There is beginning general arterial selerosis. The pulse is règular, 72 in the minute ýand of Iow tension. When adiitted a soft systolie murmur was heard at the pulmonary area, but lias since disappeared. The tongue is flabby and slightly coated, appetite good, bowels regular. The abdomen, liver and spleen normal. Mental state rior- mal. There is wasting of the thenar eminences, interossei, flexors and extensors of the forearms, and to a less extent of the muscles' of the upper armn, the inotor power is diminished in the upper . extremities, thore is slight wasting of the supra and infra spinati on both sides, fibrillary twitching of the muscles is observed; sensibility to. touch and pairi norLnal, musculax reflexes slightly increased. There is wasting of the adductors of the thighs and. flexors of the leg, the feet have apparently escaped, but there is slight hyperexten-",
         "STEWART-TWO CASES OF ARTHRITIS DEFORMANS. 687 sion of the lesser toes on both feet, sensibility is normal. Knee jerks are considerably exaggerated, ankle colonus present. Motor power somewhat diminished. There is considerable fibrillary twitchi'ng ; electrical reactions are normal in the muscles of both the upper and lower extremities. The spine is normal. There is limitation of. abduction at the shoulder joints, the elbowjoints cannot'be completely extended, and there is also limitation of all movements of the vrist and finger joints. The fingers are deflected to the ulnar side. There is a pseudo-crepitus in many of the joints. The knee joints are uniformly enlarged, and complete extension is impossible without great pain, the ankles and toes are not deformed. Ail the muscles are soft and flabby. The patient is able to walk when supported, bût does so with the knee seii-flexed. Blood examination, red cells 4,120,000, homoglobin 68 per cent., no leucocytosis. The urine is normal. CASE I.-W. B., aged 46, admitted complaining of pain in the joints and inability to walk. Born in Canada. Had typhoid at 16 and gonorrhœa about nine years ago. Has used alcohol until about a year ago. Works as a last maker. Father alive, aged 86, subject to cough all his life.. Mother alive and healthy. Has two brothers, one said to be phthisical; three sisters, none of whom are strong. Present i Unss-First symptoms set in about twenty years ago. Patient was out driviùg and felt a severe pain in the leftknee, had to be lifted ouït of the carriage, and was confiried to bed for three months. The knees became red, swollen and hot, and the left hip appeared to be somewhat painful also. After this attack he was able to go about with the help of a stick. About two years later he had another attack and went to Caledonia Springs, but did not derive much benefit from them. About this time he noticed that Iis left knee was gradually. becoming enlarged. There also gradually set in a stiffness in the fingers of the left hand, so that he had diffieulty in closing them. He had a number of such attacks every few years, until about nine years ago, when he had a speci-l1\",bad one, having pains in krees, feet and hips. After this attack h. \\d not .work for. three years. Up to about -a; year ago he was able alk with the .aid 6f two sticks. A year and a half ago contractio , Vhe fingers of the right hand set in and gradually increased. The rí'\u003eSt. knee then began' to enlarge and both knees became semi-flexed, so ti!at he could not stand. Patient is a man of medium height, dark complexion, somewhat anoemic. Is unable to walk, but can raise himself in bed and use his .arms. Has been accustomed to use morphine for a year and a half,",
         "STEWART-TWO CASES OF ARTHRITIS DEFQRMANS. taking as much as two grains a day on some occasions. Has very frequently to change his position in bed. Pulse 66. Some arterial sclerosis. Cardiac dulness normal. First sound is a little weak at the apex, being short and sharp like the second sound. Aortic second is possibly a little accentuated. Tliere is narked wasting of certain muscular areas. -In the riglit hand *the interossei, thenar and hypothenar eminences are markedly atrophied and the muscles flabby. In the right forearm the muscles are also considerably atrophied. The ßngers look thin on account of the inuscular wasting. In the left hand and forearmi the con- dition is similar, but to a much less extent. The fingers of the right hand are deflected greatly to the ulnar side. The inetacarpo- phalangeal joints are flexed and the phalanges are extended. There is contraction of the muscles so that the distal joints cannot be flexed. The second finger is ~also hyper-extended at the junction of the second phalanges. On the left hand the fingers are slightly deflected. There is inability to shut the fingers in the palm tightly. The second finger is hyper-extended at the junction of the second and third phalanges. Elbows and shoulders seem to be free. In the feet the toes are extended at the metatarso-phalangeal joints, and flexed at the distal joints. On the dorsal surface of the first and second tocs of both feet there can be seen and felt what appears to )e snall sharp spicules of bone, not iovable with the skin. Apparently no atrophy about the muscles of the feet. The muscles of the legs are extremely wasted in all groups. The thighs are also considerably wasted, more especially the quadriceps muscles and the adductors. There is some tenderness on pressure over inner side of the right hurnerus. Patient hias only perception of light. Marked arcus senilis. Cornea is steamy. Dr. Buller reports old plastie iritis with occluded pupil. Marked enlargenient of the ends of the tibia and femur forming the knee joints. Contour of .joints is lost. Knees are kept semi-flexed and cannot be further extended. There is some enlargement of the imetacarpo-phalangeal joints and slighter of the phalangeal joints. Moveinent of the hips is fairly free. Tongue clean, appetite good, b~owels constipated, liver and spleen normal. Urine acid, sp. gr. 1013; no albumen, no sugar. We have here to do with two well marked cases of general arthriti, defornians, the first case being one of the ·idiopathie variety ; the second in all probability being secondary to an attack of scute rheunatism. It is important to inquire into .the causes whici induce 688",
         ".STEWART--TWO CASES OF ARTHRITIS DEFORifANS. this disease. First as to the influence of sex-it it; much more common in feiales than males. Sir A. Garrod, in a series of 500 cases, found that there were no less than 411 females and only 89 males affected. The liability to the disease is greatest between 40 and 55, but no age is wholly exempt. Cases have been recorded in children under 10, and a local form of the disease is more frequent in men over 60 years of âge. It is mucli more- conmon in women in the two or three years succeeding the menopause. Direct heredity, no doubt, plays an impor- tant role in the causation of the disease, indirect heredity of nervous diseases also being an important factor. The following may be men- tioned as the more important exciting causes of arthritis defor- mans: lst, overwork ; 2nd, worry ; 3rd, acute, severe illness ; 4th, insufficient food and bad hygienie surroundings. Excessive work, especially when combined with worry, is the most prolific cause. It is not unconmon to meet with the disease after severe attacks of diphtheria, typhoid fever and influenza. In a general way it nmay be said that any disturbance that tends to lower the resisting power acts as an exciting cause of the disease. In this respect arthritis deformans differs markedly from gout. I will not detain you with a minute account of the morbid changes'in the affected joints. It will be sufficient to say that the chief 'structures entering into their formation all suffer ; the cartilage, the synovial membrane and the bones. The cartilage covering the joints becomes soft and finally disappears, leaving the ends of the bones bare and in consequence of friction the latter become smooth and hard. Along the margins osteophytes form. The nature of the discase is still a .problem. Soime contend that it is simply a forni of chronic rheumatismn, hence the naine rheumatoid arthritis ; others consider it to bu a mixture of gout and rheumatism, hence the naine rheumatic gout.. Sonie consider it to be owing to simple wear and tear of the joints, while aàin others think it simply a senile change. All these hypotheses completely fail to account for the morbid changes and symptoms. The causes leading to arthritis, the clinical features of the disease both articular and abarticular point very strongly to a nervous origin. The view nost commonly.held at :the present time is that it is brought about by changes in the nervous mnechanism which presides over the nutrition of the joints. Although this is yet a mere hypothesis, positive proof of such changes being -wanting, there is much to be said in its favour. First we have very similar changes in certain diseases of the spinal cord which we know are attended by grave degenerative changes in this part of the central nervous system. In tabes dorsalis, a marked 689",
         "0 TEART-TWO CASES OF ARTHRITIS 'DEFORMANS. feature in some cases is distrophic joint changes. Anatomically and clinically there is a resemblance between such changes and those met with in arthritis deformans, the changes in the synovial membrane and articular cartilages being very similar in both diseases. In tabetic arthropathy the onset and course is more acute, and there is but little tendency for osteophytes to form. Further, the ,destructive process is more marked than the reparative process as exemplified in the formation of boue. In the disease known as syringomyelia a some- what similar destructive arthritis is met with as in tabes. We also meet with arthritis in cases of progressive muscular atrophy of spinal origin. (A photograph illustrating-such changes was passed around.) The peculiar symunetry of the joint affections in multiple arthritis deforinans is another reason for ranking it among nervous affections; sucli symmetry is, however, not universally present, 'but it is met with in a great majority of cases. Symmetry is the rule in arthritis deformans, while it is the exception in gout and rheumatism. In arthritis deformans the nost peripherally situated joints are first affected, this being characteristic of nervous affections. Another important feature of arthritis deformans, is that it does not tend to implicate the visceral organs as does rheumatism and gout. The alniost invariable presence of muscular atrophy and of sensory nerve disturIance, point to a neurotic origin. There have been as yet, how- ever, no changes demonstrated in the central system-changes have been found in the peripheral nerves, but such are so frequent in all severe and exhausting diseases-that they cannot be considered as a, cause of arthritis deformans. Clinical Featzres of Arthritis Deformans.-The disease may be ushered in with all the features of an acute rheuinatism,-this was the case with our second patient·; such a mode of onset is more frequent in old than in young people. The usual mode of onset is of a. subacute or chronic character, swelling and pain.being present; but the latter is seldoin so acute as to compel the patient to rest. In the course of a few months, however, the joints become seriously crippled; in the very chronic cases the course is very slow, years elapsing before profound alterations take place in the joints. Bone Lesions.-The trouble usually begins in the small peripheral joints ; in the 'great majority of, cases it is symmetrical. , In the general form of the disea-e the hip-joints are.least' often affected, while in the senile form, the morbid changes are generally mono- articular and often limited to the hip-joint. There is hardly a joint in the body that may not be involved in general arthritis deformans, the temporo-maxillary joints, as well as those of the spine, being not infrequently affected. 690",
         "STEwART-TWO CASES OF ARTITIS DEFORMANS. Muscular atrophy is a striking feature of nearly all well mnarked cases of arthritis deforimans, this symptom being well marked in both cases before you; it is not due to disuse of the muscle, neither can its origin be explained on the ground of reflex disturbance. There is every reason to suppose tliat it is cither due to central or peripheral changes. It is accompanied by fibrillary twitchings and increase of the tendon reflexes, not only in the neighbourhood of the affected joints, but in distant muscles. Tremors. reseibling the tremor of paralysis agitans aie met with in cases of arthritis deformans. The reaction of degeneration is also met with in advanced cases of atrophy. lu all stages of this disease minor sensory disturbances, as numbness and tingling are complained of. Subcutaneous nodules in, various parts of the body, especially on the back and flexor surfaces of the forearms, are now and thon met with in arthritis deformans They are more frequently met with in young adults and resemble in every respect. the subeutaneous nodules met with in acute and subacute .rheumatism of childhood. The general state of nutrition is lowered, especially when the disease comes on early in life, anomia being a frequent accornpani- ment, of the disease; altlough there is general pallor in both of our patients there is not much diminution in the number of red blood corpuscles or in the amount of· hieroglobin. Persistent rapid action of the heart is commonly present. It is often an early symptom, being present before any special joint changes are present, the pulse usually ranging between 80 and 100 a minute. It is independent of pyrexia, for as a rule there is no elevation of teinporature except when there is an acute arthritic exacerbation. Pigment spots on the skin in the neighbourhood of the affected joints are considered by Kent Spender bo be of diagnostic value. The skin is often glossy and atrophied; trophic changes in the nails and local s woatings are unusual manifestations. A negative symptom of importance in arthritis de- formans is the absence of any organic changes in the visceral organs. Prognosis-Athritis deformans if uninfluenced by appropriate treatment tends to' become worse and worise until the patient is left a helpless cripple. In the earliest stages of the disease thore.can be no question that the morbid process may be arrested by judicious treatment. If, however, the changes in tha-joints have gone on to the destruction of cartilage nothing can be 'done exeept to give relief to the distressing symptoms. Patients do not die directly from the disease, but fron some intercurrent affection. Diagnosis-It is important that an early diagnosis should be made. .Frequently this is far from an easy matter. The following are theé more important synptoms of the disease: 691",
         "STEWART-TWO CASES OF ARTHRITIS DEFORIfANS. 1. Pain and stiffiess in the joints. These symptoms are especially suggestive if occurring in anomic females, about the menopause, and who have been overworked and worried. 2. Numnbness and tingling of the extremities. 3. Rapid pulse without pyrexia. 4. Pigmentation of the skin. 'Flic above symptomns form a clinical grouping which may be taken as practically diagnostic of arthritis deforinans. It is often impossible, at any rate during the acute stage, to diagnose correctly those cases )eginning with sudden -and severe arthritis. The resemblance to acute rheumatisn is too close to admit of anything but a probable diagnosis. With ordinary care there is no difficulty in making a differential diagnosis between arthritis deformans and chronic articu- lar gout. Treatment--Until quite recently the treatment of arthritis defor- nians received no serious attention; it was too frequently placed in the list of chronie incurable maladies which might be relieved a little, but could neither be arrested nor cured. When any treatment was employed it was too frequently of a lowering character. At the present time there is not a general recognition of the danger attend- ing such treatument. When the disease is in an early stage and the patient comparatively yonng much can be done to stay its progress or in favourable cases to entirely arrest it. The means to be used in order to obtain this end are: 1. The rcmoval, if possible, of all existing causes, such as improper and insufficient food, overwork, worry, etc. 2. The inployment of agents which help to increase the general state of nutrition. If the patient can afford to reside in a mild, dry climate in winter, he should do so. The food should be the best obtainable, and every possible meaus should be taken to promote the appetite and aid digestion. Iron, cod liver oil and arsenic are all agents of great value; they should be given for prolonged periods. Sir A. Garrod considers the iodide of iron. especially valuable. Iron and' arsenic may be given during the su -umer months and cod liver oil during the vinter. It is not \"yell to continue arsenic for too long a period in advanced cases, for, as pointed out by the late Palmer. Howard, it tends to aggravate the arthritis. The thermal bath treatment of arthritis deformans is of undoubted value. At Bath a course of douching with massage has a deservedly high reputation. In Germany and France there are many resorts also where this mode of treatinent is carried ont with more or less success. At Banff, in our own country, every convenience is procurable for the proper treat- 692",
         "STEWART-TWO CASES OF ARTHRITIS DEFORMANS. ment of sucl cases. It is well, however, to make the patient under- stand before resorting to thermal baths that no measures should be employed that tend in any way to weaken his resisting powers. The patient during his stay at a bathirng place should be under constant medical supervision. The local treatment of the diqease calls for the relief of the pain and spasms; the former may be combated by lotions of iodine and bella- donna, the latter by fomentations; at the same time the patient should rest. Quiet should also be enfreed during an acute exacerba- tion of the arthritis; salicylic compounds may be found of value also in such cases, and in those cases where the onset is that of the acute or subacute rheumatic type; at other periods of the disease salicylic acid should pot be given, as its continuous employment tends to depress and therefore defeat the main object of treatment-increasing the resisting power. 45 .",
         "qp emWerîi.des, 1895. By WLTAM OSLER, M.D. Y. ACUTE GOUT IN THE UNITED STATES. The comparative infrequency. of acute gout in this country is a matter of every-day comment. In hospital statistics, and in bills of mortality the disease is mentioned but rarcly; thus, it does not occur anong the causes of death in the Report of the Medical Officer of Health of the City of Baltimore for 1894. During the past year I asked al] private patients most particularly about the occurrence of attacks of gout, and have examined in each instance the ears for tophi. Therc were only three cases in which gouty arthritis had occurred, and in only a single instance vere tophi presenL about the joints or ears. During the session of 1894-95 I had in the wards four cases of gouty -arthritis at one time, a unique event in ny hospital experience. Considering how careless Americans are about their diet, and the enormous amount of animal food which they consume pei- capita, and the widespread prevalence of the sc -'alled acid dyspepsia, the absence of the severer manifestations of gout is very remarkable.. The aver- age American of the upper classes is a very much more temperate man than his trans-Atlantic cousin. The club man, too, -who drinks to excess, prefers as a rule whiskey to the malted lijuors or the stronger wines. I have sometimes thouglit that in the gout of this country the question of alcohol is of minor importance; the thrce patients referred to who iad acute gouty arthritis w;ere quite tem- perate. In considering the apparent infrequency of gout the failure to recognize the condition mnust be taken into account. I have known cases to be mistaken for rheumatism, even with well characterized chalk-stones on the knuckles and tophi on the ears. The importance of asking very specially about the occurrence of gout is well illustrated by the following case: A physician, aged 44. who had been for fifteen years a very hard- working man in one of the tenement districts of New York, consulted me May 21st, 1895, complaining of shortness of breath on exertiong, which had first developed in October, 1894. .In his fainily and personal history there -were apparently no etiological factors of any great importance. He had never bad syphilis or rheumatism. He had",
         "OSLER-EPEMER1DES. been an abstemions man, but had worked very hard. He presented ail the features of advanced arterio-sclerosis, with hypertrophy of the heart, and the usual accoipanying changes in the urine. There was no retinitis. I had finished the examination, and, as he knew quite well the serious nature of the trouble, was. discussing with him the possible cause of his kidney and arterial changes. I had forgotten for the moment to feel his eatrs, but on doing so found on one car three small white nodules on the edge of the lieux, towar.:ls the tip, most sugges- tive of commencing tophi. I then' asked him particularly about attacks of arthritis, and lie said that, five years before he had had a furious attack of acute gout in the big toe, which had laid him up for aweek. He had entirely forgotten- about it, and did not regard itFs of any momemt in his history. The tophi and the history of an acute attack of gout leave no room for doubt as to the cause of the renal and arterial changes. One sees here occasionally fainilies in which gout. is liereditary, and even quite young members may have severe attacks which lay the foundation of serious renal and arterial changes. During the past two years I saw at intervals witl Dr. Hollyday, Miss X, aged about thirty-five, unmarried, in whose family on the fathier's side gout was very pronounced. Wlien I first saw lier she had all the features of advanced gouty kidney; the urine was of large amount and low specific gravity ; the arteries were'selcrotic; the pulse of high tension; and the left ventricle greatly hypertrophied. She had been a very abstemious Woman, in easy circumstances, who had done a great deal of church and charity work. She had had three attacks of acute gout, the first when'she was about twenty-seveny ears of age, which hegan in the big toe of the right foot. In the second attack, three years latir, the tarsus was involved as well as. the big toe. The third attack, last year, was. in the same situation. She never had involvement of any other joints. The big toe joints on both sides were somewhat thick- ened. * There were no deformities of the bands ;- no tophi on the ears. She had very extensive albuminuric retinitis. She died in uraemic coma in June, 1895. While.gouty kidney,'either as a sequence of acute attacks, or as an event in chronii, irregùlar gout, is certainly less common in this couûtry than in - England or Germany, cases such as the two T have just given occur more frequently, I think, than has been sus- pected, or than we might gather from the writings of authors in thisî country, 695",
         "6 OSLER-EPHEMERIDES. VI. CALCIFICATION OF THE AURICLE. Tophi along the margin of the helix, or in fact anywhere on the auricle, are distinctive of gout. Has calcification of the cartilage of the ear the same significance?. Within six months three patients were seen with calcification of part of the auricle of one ear; without the presence of tophi, without arthritis, and in each instance without any history of acute gout. The first case was a vigorous, iuscular man aged 64, who had angina pectoris. He had beenaccustomed to take stimulants in nod- eration, chiefly French wines. The heart apex was outside the nipple line; the arteries were stiff ; the pulse tension was a little increased. The upper half of the right pinna was unusually stiff and firm, and the cartilage quite hard and calcified. The skin was not in any way affected, and there were no tophi along the margin of the helix. The patient had never had gout.. The second case was a- man aged 55, strong and, vigorous, who came, for the purpose, as he expressed it, of a 'general overhauling.'. e had been a very healthy man, and for years hâd had large and important interests to control. He had not had syphilis. There was no special increase of tension, and the superficial arteries were not selerotie. There were no tophi and no enlargement of the joints.. The cartilage of the upper third of .thé left ear was completely ealcified. The third case was a man aged: 63, .who complained of dyspepsia. He had never had symptnis of gout or of rheumtism. He had been a vigorous healthy man, accustomed to take a good: deal of exercise. The pulse tension was not increased. The apex beat.of -the heart was a little outside the nipple line, and he had.a soft.but well.marked diastolié murmur at the secoud righ costal- cartilage, \"which, was* propagated down the sternum. There was one small Heberden's node on the ring finger of the left hand. TPhe cartilage in the uppir: third of the pinna of the left ear was calcified. In the right ear the cartilage of the tip of the helix was calcified, and there were several small nodular bodies along its upper edge, which did not, however, look like ordinary tophi. Whether calcification of the cartilage of thé auricle is. dueto the deposit of urate of soda I cannot say. -I ean find but scant references in the literature, and my attention bas not been previously called to the subject.L",
         "RETROSPECT OF * CUIRREN-T LITERATURE. Serum Treatment -of Sarcoma- and Carcinoma. COLEY. «\" The treatment of inopeiable malignant tumours with the toxin of erysipelas and bacillus prodigiosus.\"-N. Y. Medical Record, January 19 and May 18, 1895. Since Koch attempted to cure -tuberculosis by the subeutaneous injection of a culture :of the tubercle bacilli, other -members of . our profession -have been earnestly working, ,investigatipg, and testing the applicability of the principle to other diseases than tuberculosis, withxmore or 'less success. The serum treatment of diphtheria is an assured success and thé serumn treatment - of cholera and anthrax is full ofpromise. The same, to a lesser. degreé.so far, holds true in the sérun treatment of syphilis:. -Dr. Coley claims ithat by thé, hypodermie injection of'the toxin of erysipelas and bacillus prodigiosus, òancerous and sarcomatous growths may be retarded.in their grôwth, and. in certain cases made to'dis- appear altogether.. A brief summary àf his. cases is as follows : Up to May 31,.1894, he had treated with.mixed toxin twenty-five .cases of . inoperable 'sarcoma, eight of inoperable carcinoma, and three of sarcoma or carcinoma. ~ ·n the cases of carcinoma hie had. marked improvement in a number of.cases, but' no cure. The casés -were ail very advanced. recurrent tifmours. There were six cases of carcinona in which he considered that there was a reasonable hope of cure. ',Six months have elapsed siice -then, and none of 'the-six cases. have shown any- recurrence. - Since May 31, 1894, he lias treated twenty-four cases of.malignant tumours, all inoperable- and mostly recurrent, with thé, mixed toxin.' Of these cases thirteen were sarcoma and eleven car- cinoma. In many of the cases of carcinoma,.' thie injections had an undoubted retarding influence, and in some of the 'cases the improve- ment - was extraordinary, but\" in: no case did the 'tumour entirely disappear. . In the sarcoma cases the effect was far more marked,,and",
         "SURGERY. although in a number of cases the disease was so far advanced that there could be no possible hope of recovery,.still the powerful con- trolling influence of the toxins was demonstrated, and had the patient's general condition permitted a prolonged use of the injection, the result m'ight have been otherwise. In three of the thirteen cases the sarcomas have entirely disappeared, and although no great length of time has elapsed, the results i his older cases make it improbable that relapses will occur: Of his total of thirty-eight cases of inoperable sarcoma, therefore; nine cases promise to be permanently successful. Emmerich and Scholl report several cases in which marked improve- ment followed the injection of erysipelas serum, but unfortunately the result in the hands of many surgeons has not been encouraging. - Czerny statès that accidental erysipelas sometimes has no effect on, cancer, or may even hasten its course, but reports two'cases in which recurrent growths were accidentally inocula~ted with .erysipelas, and in cach case the cancer masses 'disappeared. The writer used a, pre- paration-of the toxin prepared by Dr. Coley in. a case of recurrent sarcoma of the upper jaw without obtaining any improvement or retardation so far as could be' observed. The - case, however, was one of very rapid growth 'and far advanced before the treatment was begun. Dr. Coley at first used cultures of the strieptococcus of erysipelas and bacillus prodigiosus, rendered sterile by heat, so that there was no danger of lighting up a true ·erysipelas. -He found that the com- bination was more effective than. either alone. The bacillus prodigiosus seems to cause a softening and breaking, down of the mass.: The injections are followed by elevation of temperature, and in some.cases. by a condition of mild sepsis, apparently due to thd=lireaking down and absorption of the growth. Lately Dr. .Coley uses a serum obtained from a horse immnunized by the injection of a virulent culture of the steptococcus of erysipelas. Emmerich and Scholl obtained their serum -from sheep previously injected with erysipelas. cocci. They think the serum derived from sheep ismore effective than -that obtained from any other animal, and- seem to have a preference for certain races- of sheep. The reactioi following the injection of the. serum is less than that', following the use of the sterilized toxins. Small doses produce no' pain. Aftei repeated injections there was a slight drawing pain, lasting only a few hours.. After the injection of small doses of 'an active serum, either at -once or after a few hours, there appears a false erysipelas, an aseptic",
         "SURGERY. 699 erysipelas, consisting of more or less swelling of the skin with slight redness. The degree of rediess is always less' than that of true erysipelas. It does not spread, and disappears in twenty-four 'or forty-eight hours after the injections are discontinued. It is difficult to harmonizé the different -results obtained by different observers. The results obtained by most surgeons have been far less promising than'those clainied by Dr. Coley. However, this'nuch can be said, -that in inoperable and recurrent case, the serunm, as'prepared by Dr. Coley, may be used without fear of doingany harm, if used. at first in small' and 'then gradually increasing doses, and with a chanc-i of retarding the growth of tIhe malignant mass and a possi- bility of causing its total disappearance. Glenard's Disease. TREVES. \" The treatment of Glenard's -disease by abdominal section.\" -British Medical Jouéna, January 4, 1896. The curious abdominal disorder known as abdominal ptosis, viscero- ptosis; or Glenard's disease, has only' attracted attention during the last ten years. Glenard's monographs appeared in 1885 and 1886. A very excellent accounti of the condition is grien in the Traité Pratique des Malacies'du Système Nertveux by Grasset and Rauzier. The disease in question; depends, in the'main, upon a relaxation of - the abdominal wall and of the sùpporting ligaments of the viscera; as a result of which the more conspicuous organs are found to have. dropped to a lower. levelV inthe .abdomen. The affection is usually met with in wonien. --No definite causes have been assigned to .it. although-some attach an etiological importance to repeated pregnan- 'cies, te undue exertion, and to injuries., I is stated that tlie right bend:.cf the -transverse colon is the fii-st to descend, the stomach is then drawn down;,with the result that thé pyloric opening is comnpressed, and .the passage of food. hindered. In. due course' the rest of. the transverse colon' descends, the jejuno- .,duodenal orifice is narrowed: and a' .further obstruction is 'offered to the passage of alimentary matter.. The :whole -mass- of- the small intestines becomes prolapsed,.the:ldwer-part-of.the abdomen is promi- nent and possibly pendulous, while the upper part is flattened. -The liver and'kidney become loose and are~described as \" floating.\" Thé results of this' general ptosis are' manifold and distressing.. There' are, ,in the frst.'place, certain asthenic .syinptoms, general depression, and genéral- ill-health. The patient becomes an invalid and is unfit for any exertion. She is only comfortable when reeum- bent. There is a sense of \" weight' in the abdomen and.of a sickening \"dragging.\". There is- pain in the baek and' a continued sense of.",
         "weariness. Gastrie symptoms are prominent ; the most conspicuous are a sense of burning in the. epigastrie region, vomiting, pain; loss of appetite, distress after food, and more or less detinite dyspepsia. The bowels are -irregular ; there may be diarrhœa, but more usually there is constipation. The movements of the bowels are attended with pain; aperients cause , distress, and., relief has .to be sought by means'of enemata.. The stomach and intestines are very apt to be found dilated ; -pressure upon the. bladder . may be complained of. . The symptoms usually accredited to. movable kidney may be present. .Colic is common and may be now and· then acute. ' In neurotic sub- jects these syinptoms are exaggerated. Another important symptom is that .more or less relief is obtained by pressure upon the lower abdomen with the two hands or by the wearing of a supporting belt. 'Many patients 'are unable to move about until they have adjusted their suports or bands. The kidneys are found to be movable, the liver and stomach are prolapsed .and return more or less to their normal position when the patient is recumbent. Mr. Treves reports a case which, throws some light upon this con- dition . A young lady, about 22 years old, had been ill for six -years with distressing but somewhat indefinite abdominal troubles. * There was a history of tuberculosis in the family. - The patient was highly cultivated and intelligent, and had never exhibited 'any symptoms which could be considered \"'nervous,\" nor did she in any way conform to the.conception of a neurotic subject. Her troubles began six years ago with an acute abdominal dis- turbance,. which had been ascribed to an- ulcer of the stomach or to ulceration' of the small intestines. She was never well after the illness. .The symptoms were in a general-way in accord with .those associated with Glenard's disease. Abdominal pain was almost constant. Vomiting was common, and the vomited matter was usually iiten'sely» acid. The patient became enfeebled. Her abdominal troubles were increased 'by movement and by the erect position; indeed 'she was only confortable . when in.,the recumbent position. The right kidney was found. to 'be floating and was fixed by suture by a - ellknown continental. surgeon.' The operation was performed three-years ago, and was entiiely successful. The kidney has ever since ;remained, accurately in place, and the symptoms to which it gave rise have entirely v'anished. The patient was continuously under .treatment. Every form of diet was tried,'and a series of presçriptions was .accumulated,,which 'for number and variety could liardly be- equalled. Many spas and healthresorts in various parts' of Europe were visited but-with, no .700 SURGER.,",
         "other than temporary or doùbtful benefit. She had subnitted for the prescribed time to the Weir-Miitchell treatment without deriving any benefit therefrom. . -When Mr. Treves saw her she was wearing a very powerful belt, composed of a shield-shaped plate of metal, to which two steel levers were attached, and by ineans of which the plate was made to bear pressure upon the abdomen. When examined in the recumbent position the area of hepatic dulness was normal, but when the examination was made in the erect position.the liver was found to have descended about 2 inches. The stomach also, and the whole mass of intestines, appeared to fall downwards. The spleen shared in the general ptosis. The left kidney could not be felt. As apparently every other available means of obtaining relief from this distressing condition had been resorted to, Mr. Treves advised an abdominal incision. He.opened-the abdomen in the median line below the kiphoid eartilage. The liver prosented and could be dragged down to quite a 'remarkable ·degree.' The stonach could not be brought forward to the external wound. Upon introducing his hand the great omentum Was found rolled up into a round and rigid cord, and was fixed to a mass of stony hardness in the upper part of the right iliac region. A second incision was made- over this mass, which was found to be made up of a collection of tuberculous glands situated in the mesentery of the ileum. The glands wëre at once removed. Two of them were dry and caseous and presented calcareous focci ; the third gland ivas wholly caleareous,; and .ivas. indeed practically. a stone.. It was to these glands that the end of the omentum was adhérent. On returning to the median wound, it was found that the stomach could now.be drawn up. Sutures were then-passed between the fibrous structures at the side of 'the xiphoid cartilage and the falciform and round ligament. The patient. made an excellent .recovery, was entirely relieved of her symptoms, and left England for South Africa five-months after her ope-ation. As anya.xamination of abdominal viscera is usually made when the patient is recumbent, it is difficult to say if this ptosis of the viscera 1s common.. I the sam'ë, paper, Mr. Treve reports two very interesting, cases of intestinal .nuroses, in whichthere seemed to be .a consciousness on. the part df.the patient of the intestiial peristalsis. . In..oue case: he patient:thought that she had swallowed asmall plate with teeth, and in the other the movements gave the .iipression that a snake was in thé intestines. In each instance the relief after. abdominal incision was complete. - .G. B. Armstrong. 701 SURGERY.",
         "-On the Treatment of Hnmiorrhage. WRIGHT, A. E., (Army Medical School, Netley). \" On the treatment of the hoemorrhages and .urticarias which are associated with deficient blood coagulability.\"-The Lancet, January 18, 1896. ROGERS. \"Some clinical aspects of the coagulability of the blood.\"- Indiacl/n Lancet, Dec. 16, 1894. '/he*Lancet, Jan. 4, 1896. In communications which have extended over the past .four years, Dr. Wright has càlled attention to three important methods by which the coagulability of the blood can be -increased, and hSemorrhage dependent upon this condition arrested. These methods are : 1. The internai adniinistration, and sômetimes the local application of calcium salts. 2. The local administration of carbonic a.cid gas. 3. The local application of a solution of cell nucleo-albumins to bleed- ing surfaces. Referring to the first' method he records the results obtained in two honophiliac boys from the internal administration of calcium chiloride. Date -of lst Time \u0026re- Amount ad- Date of 2nd Time re- Patient. blood exam- quired for iinistered of blood exam- jqired -for blood coagu- calcium chlor- . ood coa- ination. lation.. ide. .. ination. gulation. Boy aged 9 April 13,1894.54 binutes.. Two 30 gr. doses. April 14, 1894 25 ninutes. yrs, case - 1 - Two 30 gr. doses. April 15, 1894.13J minutes severe ... Sept. 28, 1804.14 minutes... Twó 10 gr. doses. Sept. 29, 1894. 6 minutes. Boy aged 7 April 13, 1894. 7 minutes... Two 30 gr: doses. April 14,1894. 4 minutes, yrs, less severe.....j Scpt. 28, 1894. 91 minutes..-. One 10 gr. dose.. Sept. 29,-1894. 5.1 minutes. brother of case 1. 'Normal blood coagulates under similar conditions in from twd to fÔur minutes. This increase in coagulability produced. by the lime éalts is not, however, a permanent one. Their continued administration in large* doses results in a diminution of coagulability beloiv the original con- dition, but the augmentation- is sufficiently prolonged to .permit hSmorrhage to be arrested. In some'eases.the. increàse inthe coagu-",
         "PHARMACOLOGY AND THERAPEUTICS.. 703 lability produced by this means is insufficient. A blood coagulabilityl of 6¾ minutes is no bar to the ýoccurrence of: very severe capillary hiemorrhage, and in such a case we -niust have recourse to other measures. In some instances thé' internâ« administration -nay be supplemented by- the application- of one .of. the .less soluble: calcium saits to the bleedingsurface. Dr. Wright reconmends finely powdered chalk iixed into a paste with a half per cent. solutiori of calcium chloride. - ie' quôtes- a case aisO where severe homophiliac bleeding from the gums.\"had been arrested by the application of calcium plios- phate, after eschaiotic styptics had failed. In this connection, he draws attention to Dr. Wickham Legg's statement that hroohiliac children aré not infrequently addicted to' eating plaster, inortar and similar substances, and says he has con- vinced himself of its truth. In other cases we may supplement the internal administration of calcium chloride by the local ùse'of carbonic acid gas. This method Dr. Wright has employed.on two occasions and secured cômparatively. prompt' 'arrest of hémophiliac hmodrrhage. He mentions; also, another case which occurred in thé, Netley Hospital, in'which the blood coagulability had been impairéd'by prolonged tropical- fever, and the patient had been brought into a precarious condition by. continually recurring epistaxis. A stfeam of carbonic acid'gas, obtained from an ordinary gasogene7 'was conveyed .into the - nostril through a rubber tube passed well up. i this case, also, the administration %'as invari- ably followed by a prrpt arrest of the hoemort hage. In this. method, an- excess of carbonie acid should·be ýavoied, as his experiments on animals. would' make it .appear that its -eect in augmenting the coa- gulabiliiy is only manifested in presence of a sufficiency of oxygen. Dr. Wright suggests the inhalation of carbonic acidin the treatment of hoemoptysis.. The'stream of as.should be turned on veryslowiy at first se as to induce arnisthesia of:theinuous membranes. As soon as this has.been effected large quantities of the, gas can be toleraied without discoMfort. Thla aient shotil not, however, be in any degree asphyxiated.a ±hi bin itself Would militate against the efficiency -of-the-miethôd.' - By. a somewhat .extensive series servations on the blood of 'hemophiliac patients and of theirfeémale ascendants, Dr. .Wrigit has convince'd himself that it is charaétefized u\u003ey a notable paucity of the polynuclear whitè blood corpuselés. -In other woi;ds homophiliac blood is' deficient: in the cellular. elements which contribute the nucleo- albuminous còmponent in the formation of fibrin. Àn addition of'the nucleo-alburnins in such blood is therefore essential to the formatin",
         "704 PHARMACOLOGY AND THERAPEUTICS. of a sound clot. Dr. Wright proposes that, when practicable, a solution of cell nucleo-albumin should be employed locally, and in two cases of hrmorrhage from cuts in the hands of homophiliacs this local appli- cation led to the formation of an enormous mass of clot round the wound. In closing 'he directs attention to the treatment of urticarias assoc- iated with defective coagulability of the blood. The urticarias result- ing from the ingestion of ripe and acid fruit, of certain molluscs and crustaccans. arnd froin the injection of anti-diphtlieritic seruni, are, he considers, all due to a \"diminislhed coagulability, and can be much mnodified, if not arrested, by the administration of calcium chloride. The urticarias sometimes occurring during the course of tuberculosis, should always be regarded as an important therapeutie indication, and a demand on the part of the system for the administration of the lime salts which, as Metchuikoff lias shown, are employed by the system in the encapsulation of the intra cellular tubercle bacilli.' Dr. Rogers, wlo was a pupil of Dr. Wright's, states that he can reduce the coagulative time of his own blood froin 51 min. to 3¾ min. by fifteen grain doses of the calcium chloride. As a result of his ex- periments with various drugs usually considered to have hemostatic properties, lie shows that several of these, such as gallic acid, ergotine and potassiuiim iodide, have 'no effect in increasing coagulability. On the other hand, the administration of oxygen and of, alcohol retard coagulation. As regards the practical clinical application of the results of [these researches, Dr. Rogers refers to the use of calcium chloride in homo- ptysis, in some cases of which he used it successfully in fifteen grain doses. Its use is also indicated in hæmatemesis and in vesical hSmor- rhage. His experiments do not tend tO support the asserted value of the present treatment of aneurism by ,iodide of potassium, except in so far as it reduces the force of the circulation. He thinks ·an increased coagulability in the blood can to a much greater extent. be induced by the use of calcium chloride and the administration of -car- bonie acid. Addison's Disease. OSLER, WILLIAM. \" On six cases of Addisons Disease with the. report of a case greatly benefited by the use of the supra-renal éxtract.\" MURRELL, WILLIAM. \" A case of Addison's Disease treated unsuccess-- fully with supra-r'enal capsules.\"-The Lancet, February. 1, 1896. Speaking of the pathology of this disease, Dr. Osler states that recent studies render it very probable that thé original view of",
         "PHARMACOLOGY 1 THERAPEUTnS. Addison is correct, namely, that the symptoms are produced by loss of function of the adrenals. On this view the disease is analogous in all respects to myxoedema. In both there are distinct histological changes in the tissues: in the one, an increase in mucin, in the other, an increase in pigment; in both marked nervous phenoniena; mental dulness or a progressive dementia in myxedemna, a profound asthenia in Addison's disease. The analogy will be complete if it be found that in suitable cases the use of the supra-renal extract curies Addison's diseasé in the saie renarkable way thât the thyroid extract relieves myxœedema. Addison's disease is so rare that every opportunity should be seized to try this method of treatment. At the saie tiMe caution shouldi be exercised, on the one haud to select only well characterized cases, and on the other band to exclude cases in which the condition is a concomitant of vide spread tuberculosis. After giving a -resumé of the notes of five cases of the disease lie details the history of a patient recently under treatment in the Johns Hopkins Hospital; for pulinonary tuberculosis, with well marked symptoms of Addison's disease. He entered the hospital May3, -1895, and after a fortnight's rest, during which careful records were kept of his condition, the treatment with supra-renal extract was begun. Thirty-six pigs' supra-renals, obtained at the time of slaughtering, were cut up finely. and thoroughly powdered with pestle and mortar; to this mass about six ounces of pure glycerine were added, and the whole allowed to macerate for thirty-six hours in a refrigerator. The mixture was then filtered several times through meshed gauze. The filtrate, amounting to thirty-eight drachms, consisted of a reddish- brown syrupy liquid of a rather disagreeable odour. The patient began with half a drachm of the extiact (eqaivalent to about half a capsule) three times a day. Eight days after beginning the use of the extract the following note was made:- The patient looks brighter and says lie feels better. The pulse, which had ranged from 120 to 140, is now 100. He has gained three pounds in weight. In a fortnight the amount of the .extract administered ýyas increased to one drachm .three times a day. In the following week the ,patient gained five pounds 'and a half. 'The pulse had now fallen and - its range for the week was between .84 and 104. The amount, of sputum was diminished to one-fifth of what it. was at the commencement of the treatment. The patient felt bettér, and looked brighter, and the physical signs showed an improvement in the lung. He left the hospital four months after the- commencement of the treatment. The change in his condition had been very remarkable. When admitted .he was profoundly asthenic and emaciated, and he 705",
         "PHARMACOLOGY AND THERAPEUTICS. could searcely walk to his bed. His general appearance had improved wonderfully. fHe was bright and active, and said lie felt vigorous. During his stay in the hospital, although it was during the heat of suimmer, he had gained in weight as imuch as nineteen pounds. Four months later lie was seen by Dr. Osler, who deseribes his con- dition as follows: \" The colour is good. To me his face looks a little less pigmented, but Dr. Thayer, who iad Lie patient in charge during-the summer, while he was in the ward, doos not think that there is any material change in the face, but thinks the discolouration is less intense on the trunk. It is stili of a very advanced grade, such as is only seen in the most typical cases of the disease. The snall patches of pigmenta- tion on the palate live (lisappeared. The local conditiori in the lung lias cleared and there are now only a few rales to be heard occasion- ally on coughîinîg. The change in the patient's general vigour is remarkable. IHe walks briskly, is active, energetie, in very good spirits, and says that he is as well as he ever was in his life.\" Dr. Murîrell does not view this nethod of treatment so hopefully. Iu a simninary of all recorded cases given by Dr. inger, where siini- lar treatment iad been employed, out of nine five had shown improve- imient, bat sufticient tine had not elapsed to determine whether the beneit was permanent or not. In two cases no improvement followed; in one only a limited trial of the treatment had been given, and in another death supervened. Cases of Addison's disease often improve, although no treatient is given, so that deductions should 'not be drawn fromn a few cases. In Dr. Murrell's case death occurred after lie lad been in the hospital fifty-thrce days; forty-t yo -dùys of this period lie lad bLeei under treatment by supra-renal extraci. Tabloids were used at first, but où proving ineffective, fresh adrenals finely minced were given on broad and butter,'one drachmthree tines a day.- Severe vomiting followed their administration, there was rapid loss of weight and strength, the patient became gradually more listless and shortly afterwards died. Fromnihe account given it would appear that the amount given per day of adrenal extract was nuch less in Dr. Murrell's case than in Dr. Osler's. Therapeutic Items. CA FFETNE IN DISEASES OF THE RESPIRATORY ORGANS, The- Prac- tiUone*, April, 1895.-According to Dr. Skerritt this drug besides possessing therapeutic .value as a cardiac tonic and diuretie, appears also to have considerable virtue in respiratory affections, especially in those where the element of spasmn is prominent. It is in asthma 706",
         "PIIARMACOLOGY AND THERAPEUTICS. especially tha.t Dr. Skerritt lias obtained good results, and ailthough failures Io occur, they are fewer witi caIetine than perhaps,witlh auy other reniedy. Its action as a heart tonie as well as a relaxer of bronchial spasn make it particularly-useful, and it gains additional value by its influence as a general stimulant to the nerve centres in cerebrum, cord and medulla. The drug is to be given in five-grain doses repeated every four hours until relief is obtained. TiE TRIEATMENT OF Ruus POISONING. . 1. Medical Jowrnal, January 11, 189.-Prof. Penhallow, writing to the -Garden and Forest, remarks that the poisonous principle is more or less common to the entire famnily. Aftier suffering several times,hiiself he could always tell at once wlhenever he caime into an atmosphere charged with the poison by experiencing a well-defined acid taste in the mîouth and a slight somewhat acute pain dire'tly betwen the eyes. These invariably proved prcmonitory symîptomns of wlhat was about te follow, Mr. Penhallow.reconeends fre application of the following solution: Sodium hyposulphite, half an ounce ; glycerin, threc ounces ; carbolic ac.d, sixty drops; water, ten ounces. Mr. Lodeman and Mr. George Beriiger both state that the synip- toms are apt'to reappear at about the saine tine of the year for sVral consecutive years. The latter writer in speaking of the treat- nient reconmmends ewashing the face and- hands with asolution of hydrogen diox ide as a. preventive mesure, and as a topical applica- tion the following solution: Sodium siulphite, one drachm ; glycerin, half an ounce; camphor water, up to four fluid ounces. STRYCHNINE AND CHLORIDE OF - GOLD IN TIE TREATMENiT oie PnTarsis,-University Mledical Ma4qgaziine, December, 1895. Dr. Pepper records the case of a woman with a strong taint of. here- ditary tuberculosis, who at the age of 21 ropidly, developecd phthi- sis of an acute type. The sputum, amounting to eight fluid ounces daily, contained numerous tubercle bacilli, and there were signs of consolidationi at the right apex and left base. She was placed on a, diet of egg albumen, which was forced, so that she was soon taking daily the albumen of. two dozen eggs. The mediejnal treatnent con- sisted of T gr. of strychnine nitrate with å gr. atropine suIphate hypodermically every two - hours, and ïlr, gr. strychnine nitrate with. - gr.· double chloride of gold and sodium, amid J-gr. of a vege- table digestive .every two hours by the mouth. She avas given cod iver oil inunctions and general massage with 'passive movements once daily. She sutfered at first fio incipient strychnine poisoning, but after a while caine to tolerate the drug, which was pushe'd to the border line of its toxie action: She rapidly gained weight and in two 707",
         "708 PHARMACOLOGY AND THERAPEUTICS. nonti)s almost all the symptons had disappeared. She remained in good health for two years, when all the symptoms of the previous il!ness followed an attack of pneumonia. She was placed on the same treatinent as before, and in a month was sent to the mountains well. Pepper calls particular- attention to the sudden onset, quite like acute miliary tuberculosis,.the immense number of bacilli found in the sputuni, the rapid cure, with acute reappearance after two yêars as the result of a pneumonie attack, the speedy disappearance of bacilli and consolidation in this recrudescence, the absence from the treatment Of aill cough medication and antiseptics, and the large doses of strych- nine nitrate, anddouble chloride of gold and sodium, with which the systemn was kept saturated. A. D. Blackader.",
         "On the Identity of Variola and Vaccinia. JUHEL-RENoY AN Drpuy. \" Recherches expérimentales sur l'identité de la vaccine et de la variole.\"-Arch. de méd. exp, et d'anat. pathol., 1894, p. 425. LAYET. Bull. de l'Acad. de Médecine, December 3, 1895. (Abstract Britisl Medical Journal, January 11, 1896.) HimE. \"Successful transformation of small-pox into cow-pox.\"- British ilIedical Journal, IL, 1892, p. 116. COPEMAN. \"Variole. and vaccinia in the lower animals.\"-Journal of Pathology, Vol. IL., 1894, p. 407. CoPEMAN. \"Pathology of vaccinia and variola.\"-British Medical Journal, Vol. I., 1896, p. 7. \" They,\" wrote Dr. Edward Jenner, \" who are not in the habit of con- ducting experiments, may not be aware of the coincidence of circum- stances necessary for their being managed so as to prove perfectly decisive; nor how often men engaged in'professional pursuits are liable to interruptions which disappoint them almost at the instant of their being accomplished.\" This passage appears in the first edition of the famous \" Inquiry into the Causes and Effects of- the Variole Vaccine,\" and immediately follows a statement of Jenner's belief that the source of cow-pox is a peculiar morbid matter arising in the horse. Jenner owned that he had not been able to confirm this belief by actual experiment con- ducted immediately under his own eye. He had sought opportunities to this end, but they had failed him; the necessary \"coincidence of circumstances \" could not be attained; he was'therefore compelled to register his belief unsupported by direct proof. He was led by circumstantial rather than by direct evidence to regard. both small- pox and cow-pox as originating from a common source. In the absence of full investigation he confounded two morbid conditions of the horse's heel, namely, grease and horse-pox.- Failing to determine any but a spontaneous or atmospheric origin for the grease (horse- pox) he regarded this às the primitive disease, vhich transmitted by milkers to the cow became cow-pox, transmitted to man, under some peculiar And unknown train of circuinstances, developed into small-pox. 46",
         "PATHOLOGY. Now-a-days we attach little importance to this theory as a whole, weakened as it has been by Jenner's mistake. What is all-important to us is this assumption that snall-pox and vaccinia (and horse-pox) are modifications of one and the same disease, for upon the correctness of that assumption must depend our conception of the nature and import of vaccination. If the assumption be correct then vaccination affords an example of what Pasteur and numerous other bacteriolo- gists have repeatedly proved, namely, that the miild disease produced by the experimental inoculation of an attenuated virus is capable of protecting the organism against the inroads of the more iitense virus. Vaccination is broùght into line with the ancient experience that a mild attack of sundry infectious diseases is capable of protecting the organism against later infection by thé saine. If the assumption be in- correct then,appreciating, as we must, the benefits f vaccination, we are impelled to see in it an example of one disease (and its causative micro- organism) protecting the system against the ravages of another. The matter then becomes more complicated' and less easily grasped. Nevertheless, a protection of this nature is not outside the bounds of possibility, and bacteriological study has afforded cognate examples. Woodhead, for instance, years ago obtained from the soil a perfectly harmless bacillus, which when inoculated into the small animals of the laboratory protected them against anthrax, and several of the slightly different microbes of homorrhagic septicæmia acting specific- ally upon sundry of the lower animals, when inoculated into other animals render them refractory to invasion by their own peculiar and specific microbes. Only within the last two years Klein has pointed out that such widely different organisms as the. typhus bacillus, the micrococcus prodigiosus and the cholera spirillum, with their products, exert a temporary protective effect against, each\"other. While this is so, Jenner's belief in the causal relationship between small-pox and cow-pox, is that which has 1ý'ppealed to our profession, and investigator after investigator has endeavoured .to establish the connection as something more than a mere assumption. Time after time it has been announced that small-pox communicated to cattle has resulted in the developinent of veritable vaccinia pustules. And yet that ' coincidence of circunstances necessary for (experiments) being managed so as to prove perfectly docisive,' has very, very rarely been gained. Ninety-eight years have passed since Jenner published .his pamphlet with the lament which every pathological investigator must in essence ofttimes have repeated, and at the end of this time it cannot be announced that the inedical world in general, which for those ninety-eight years has busied itself with vaccination, is assured as to .the exact nature of the virus it emp loys, 710",
         "PATHOLOGY. 711 Half a century ago there was a greater assurance than thei-e is to- day : the experiments of Thiele in Kasan, of Ceely of Aylesbury, and of Badcock the Brighton chemist, appeared conclusive in favour of the identity of the two diseases. * Al these observers succeeded .in. inocu- lating cattle with small-pox and in obtaining from the variolated cattle a lymph which induced a typical vaccinal- eruption in man. 'But .when, in 1863, a French commission at Lyons, with Chauveau at its head investigated the subject results were reached strongly opposed to the earlier observations. - *The variolous and the vaccinal eruptions in cattle were declared to be distinct and to remain distinct when inoculated through a series of cattle. It may tiuly be said that the'influence of Chauveau has dominated our appreciation 'of the subject until the present time, and despite strong arguments and. examples brought forward in other countries, Chauveau and the French pathôlogists following him, adhere to the opinion% that the conditions are distinct. Thus Juhel-Renoy and Dupuy (1894) still urge that where variola- tion of *cattle is snacessful the papules have a specific appearance distinct from those of vaccinia, and. that after two or three generations the disease dies out;- and they make the further, somewhat bold declaration that the. age of the animals, age and virulence of the variolous lymiph and region of inoculation are without effect in influencing the transmission of the small-pox. yirus...Only last year Layet, as the result of inoculating heifers -witlh the blood and lymph of small-pox-patients gained, it is.true, an eruption in each case, which, while vesicular and pustular,. lie :held to be distinct froma vaccinia. The lymph from this eruption reproduced the disease on other heifers Notwithstanding this, and the further fact that~subsequent vaccination was either abortive or wholly without result, he holds that we have to deal with distinct diseases. With rogard to these two casés it may be stated in connection vith the former that in the discussion which followed the reading of the paper at the Société Médicale des Hàpit- aux, Chantemesse;:a Most capable observer, objected that the conclus- ions were based upon insufficient material' and in connection with the latter, that the series' of inoculations'of heifers was not carried faà, enough to establish duality. In short, it appears that now; just as thirty-:iiiwo years ago,. the upholders. of the dual theory are satisfied with incomplete results,. At first employing aged cattle and obtaining no satisfactory eruptions they either denied that sinall-pox .could be conveyed to ruminants, or inoculating children directly from the abortive papules upon the first animal of the series they iÙduced lIn the published paper the authors are evidently uncertain as to the value of their results and write very cautiously concerning the duality of-the two conditions.",
         "small-pox on them. Next, when it was found that occasional vell marked eruptions resulted, not taking sufficient care to collect the lymph at the right period, they concluded that the disease could nlot be conveyed tlirough cattle in series, and now when other observers have pointed out that calves can under suitable conditions be easily inoculated with small-pox, they fall back upon the fact which all workers appear prepared to admit, namely, that the eruption produced during the first removes of variola froi man to beast is somewhat aberrant in appearance and time of appearance and in efiects, and upon this, without carrying the investigation further they are ready to state that variola and vaccinia arc essentially distinct. But if the opponents of the belief in the unity of the two conditions cannot be regarded as having proved their contention, the same has to be acknowledgéd in connection with alinost every individual attempt to prove the unity. The number of these attempts is larger than is generally thouglht. From Gassner in 1801,' through sundry Egyptian physicians in or before 1828, we pass to Sonderiand.of Bar- men (1830), Thiele of Kasan (1836), Coely (1839), Badcock (1840), and in more recent times, since the Lyons commission in 1863-5, to Voigt of Hamburg (1881), Fischér of Carlsruhe'(1886-90), King of Madras (1889), Eternod and Haccius of Geneva (1890-91), Sinpsbn in India, Hime, Klein and Copeman in.England (1892), and all these claim to have obtained positive and satisfactory results. Yet when ve examine into their statements, with few and recent exceptions, there is the same want of the \"l perfectly decisive.\" What. we know of Gassner's work is, for example, of the vaguest; of the Egyptian physicians we have only the second-hand report of Dr. McMichael to the Royal College of Physicians that several of them had succeeded in variolating cattle, and so ·had gained a good lymph for inoculation. Sonderland declared that he had gained vaccinia by covering dows with the bed-clothing·of s mall-pox patients, but nunerous observers failed to confirm his results. Ceely gave a fall and admirable account of his inoculations of cows with small-pox lymph, but like not a few of his successors, as for instance Voigt, lie vitiated his results (for present purposes) by simultaneous or:almost simultaneous inoculation with ordinary vaccine lymph elsewhere on the cow's body. Badcock, although he succecded in variolating 37 out of 200 cows experimented upon, and though he\" is said to have vaccinated personally no fewer than 20,000 individuals with his \" variolo-vaccine,\" bas given the most meagre glescription of his modus operandi, and lias passed over his technique without statenent of the precautions taken, and conse- quently his evidence is robbed of uiuch of its value. And even among '1801 according to Crookshank ; 1807 according to Oeely. 712 PATHOLOGY.",
         "the most recent workers there is a lack of due precaution. Thus Dr. Hime, of Bradford, employed clear limpid variolous lyinph from a small-pox patient of the fourth day of the eruption and inoculated it into the shaved and 'disinfected abdominal wall of a ten-weeks-old bull calf. For the incisions he enployed a sterilised knife. The calf was only placed in its stail when the infected scarifications and incisions were dry, and then it was tied up with a short halter so that it could not lick itself. As a result there was slight constitutional disturbance and the development (as is most usual in' these cases) of a not very perfect eruption, and on the eighth day Dr. Hime 'collected minute quantities of lyniph froin the pocks. In a second calf similarly treated every one of the 29 insertions of the lymph from calf I took, and on the fourthday there were beautiful and typical pocks. . A third calf inoculatel froin the second also developed perfectly typical vaccinia. Children inoculated from the second and third calves of this series exhibited well devloped vaccine pocks and were found later to be refractory to ordinary vaccine lympli. The example appears thus at first reading to be an absolutely decisive proof that variola passed through the calf assumes the characters of vaccinia. Only, unfortunately, reading between the lines it is found that Dr. Hime is the director of a calf-lymnph supply establishment,'and evidently the experiments had been undertaken in the place where the usual calf lymph inoculations were performed, ·the calves placed in the stalls usually dedicated to vaccine calves, and fed and groomed by the ordinary attendant or .attendants. Andj while I myself have no -doubt that Dr. Hime succeeded in the transmutation, I cannot regard the investigation as flawless; there was the chance of con- taminationwith ordinary- vaccine. This weakness in Hime's case vitiates the observations of Eternod and Haecius at the Swiss Vaccine Institute at Geneva, who on eight separate occasions gained useful lymph by variolisation of cattle and successive passage through calves. At the conclusion of.the series the only difference recognisable between this and ordinary lymiph was its slightly greater activity. Nevôrtheless similar results 'have been obtained by Copeman un'der conditions in whièh there was no possibility of contamination. He inoeulated a calf at the Brown Institute in London, with variolous lymph froni a girl suff'ering frorm discrete small-pox. The instruments and table werc sterilised: the env'ironment of the animal were such that there was no likelihood of vaccinia being conmunicated to. it. Yet a shotty vesiculo-papalar eruption appeared both along the scarifications and as in Hine's case in other regions, while by the PATHOLOGY. 713",
         "third remove the effects on the calf were undistinguishable from those of ordinary vaccine lymph. Copeman proved that the variolated animals were refractory to subsequent ' vaccination,' but unfortunately he never employed his ' variolo-vaccine ' lymph to inoculate buman beings. Here again then, is a step in the complete proof omitted. There are only two cases on record which appear to be thoroughly satisfactory and conclusive, namely, one of Fischer's experiments, and the recent studies by Klein conducted for the Board of Health of the Imperial Government. Unfortunately'I cannot speak - definitely con- cerning these for I have not been able to consult the original articles. With these two possible exceptions it would seen that we still are without the perfect individual experiment with every condition ful- filled, frce from hiatus, or failing, decisive, teres atque 'rotundus. Nevertheless by a summation of the results gained by such investiga- tors as Ceely, Voigt, Haccius, Hime, Simpson, Copeman and Klein, the failings in some being balanced by due precautions in the others, it is scarce possible to arrive at any other conclusions than the following: 1. Transparent lynph obtained from small-pox patients during the vesicular st»d;e of the eruption is capable of in'ecting a large percent- age of young calves. Older cattle are infected with less certainty. 2. Just as the inoculation of cattle with horse-pox or the retro- vaccination of calves with ordinary vaccine lymph which has been carried on in series through human beings, leads frequently either to abortive or aberrant eruptions in the Lirst animal inoculated, sé the inoculation of calves with small-pox virus is usually either abortive.or induces an atypical eruption in the first-calf of the series the papules tending to be small, vesiculation and lymph production scanty, the crusts irregularly developed. 3. With further removes the eruption in calves assumes more and more the characters of ordinary vaccinia, until it becomes uidis- tinguishable from the latter. 4. While the lymph from the earlier removes tends occasionally to induce generalised eruptions in the 'vaccinated individuals,' from the later removes local pustules at the region of inoculation are alone developed, and these are not to be distinguished from the eruption induced by ordinary vaccine lymph, save by. their regularity and peculiarly \" typical \" character. 5. Individuals- inoculated with such 'variolo-vaccine' are rendered insusceptible to inoculation with ordinary vaccine-lymph. 6. Consequently it is not possible to distinguish bétweeh vaccinia and its results in the human being-and variola which has been carried through a sufficiently long écries of calves, and its results in the human economy. 714 - PATHOLOGY.",
         "PATHOLOGY. 7. Vaccinia would therefore appear definitely to be variola modified by transmission through the bovine species. The last conclusion is perhaps inverted; the constancy of the char- acters of cow-pox, i.e., of the results of vaccine lymph inoculated through à series of calves or of hunan beings would indicate a stable form of virus. We know from botailcal observations that varieties tend to sport more frequently than does the original stock. It isi rarely that vaccine sports and induces a general eruption comparablk with ordinary small-pox. On the other hand, variola communicated by natural means is most pleomorphic in its results, varying from the mildest discrete vesicles--the old \" pearl-pox \"-to the'confluent and hSmorrhagic forms, and the inoculation with small-pox, so common during the eighteenth century, demonstrated that passage of this virus through a series of healthy individuals tended to the assumption of a mild type of the disease, sometimes so mild that, as noticed by Dimsdale (1768, 178-1), there was developed only a local pustule, with no general eruption, and nevertheless the individual was thereby pro- tected. A little-known work by Adams (1807)' gives several ex- amples of selective inoculation from mild cases of small-pox resulting in the development of such local pustules without sign of general eruption; so similar in fact vas the eruption to that induced by cow- pox that the patients and their friends thought that they were being imposed upon, and Adams had to cease using this strain of lymph. There is not a little probability therefore that \"vaccinia\" from its stability represents the original or parent type of a disesse common to man and several animals, and that variéla represents a series of degrees of exalted virulence of the same, brought about by passage through a succession of human bodies under conditions favourable to the propagation and activity of the virus. What these conditions are we shall not know until the micro- organism of vaccinia (or variola) has been isolated. Every- few months we hear that this has been successfully ;ecomplished ; now it is a protozoan (Guarnieri), now a bacillus (Klein and Copeinan), now a micrococcus (Maljean, etc.) But unfortunately after the discoverers .have published their preliminary notes on the matter we hear little more. The time is not ripe to make. any statement concerning the bacteriology of these conditions. * At most it may be said that vaccinia and variola aypear to ;range' themselves with diseases of which we know the microbic origin, and appear to afford examples of variation in virulence and effects, brought abott by cultures of a germ through a series of organisms. of one -or other species. J. a. -4 da,iýÀ. * A popular view.of Vaccine Inoculation, abstracted by Crookshank, History 'and Pathology of Vaécination Vol. 1, p. 287. 1889. 715",
         "Night-Terrors. COUTTS, J. A. \" Night-terrors.\"-Amerrica'n Journal Qf the Medical Sciences, February, 1896. This writer, after reviewing the conflicting opinions expressed by previous writers on the causation of this cómplaint in children, sums them up under two groups. In the'first are classed the opinions of those who hold that.the trouble is either reflex in its origin, or due to partial asphyxia owing to abdominal disturbance, nasopharyngeal trouble, or ill ventilation of the sleeping apartment. In the second, he places the views of those who thirik night-terrors. are -central in - origin, manifestations of present corebral disturbance, and harbingers of possible further neuroses in the near or distant future. These two widely differing views arise from a confusion, under a common name, of two classes of cases which have the' occrrence of friglit during the early. hours of night as a promihent symptom com- mon to both. In the first class, come cases which are fairly frequent and of little import, where the terror is reflex and due to abdominal or nasal trouble. In the second class, come cases of comparative infrequency but of grave inport where the malady arises fromi central cerebral disturbance. * Dr. Coutts suggests that different names shoiil\u003cibe applied to these widely differing conditions. For the first class ne proposes the familiar name of nightmare, reserving that of night-terrors for the second. As a cardinal point of distinction between the two complaints, Dr. Coutts insists that in night-terrors it is essential that the little patient should \" see visions ;\" in nightmare, it is sufficient that he merely «dream dreams.\" Although there· are many other points of distinction, this difference is, he thinks, a fundamental one. In night-terrors, the vision is eminently réal to the child, and is generally of a threatening or terrifying nature, in which not infre- quently the ·color red plays a prominent part. Although seemingly wide awake in the attack, the child cannot be made sensible of its surroundings, and generally after being ldid down, goes off into a deep sleep without recocrnizing those around him. In the norning, ifIcare- fully questioned, he will be found to have little or no recollection of",
         "DISEASES OF CHILDREN. what occurred during the night. Whatever the nature of the vision, it is liable to be repeated with almost the same features in each attack. Comparing with these the symptoms of nightmare,, inaportant differences may be .observed. In nightmare the sleep is generally disturbed from the outset, and, the attack is merely a culmination of the state of unrest. The child becomes -%vide awake, recognizes those around him, and his fears and fancies will be found to be meiely the remnants of a troùbled dream. Even after his fears are allayed, excitement prevents sleep. coming on at once ; and in the morning the child will be found to have a fair recollection of che occurrences of the previous night. Nightmare is of little ïnonent, but is often associated with chronie ill-health in its subject. Night-terrors will be found, according to Dr. Coutts,, to have been not infrequently preceded by infantile convulsions. There is generally a distinct neurotie family history, and if the, after history. of the patient is followed- up, it will be, found that night-terrors are fre- quently the precursors of such grave neuroses as migrainè, hysteria, epilepsy and insanity. The treatinent of night-terrors inay, if the attacks. are frequent and cause much distress, 'call 'for .appropriate doses of potassium bromide given at bedtime. If the attacks are infrequent a prolonged course of. the bromides would be inadvisable. IÉ al] cases any undue mentai or nervous strain must be avoided.- ' A. D. Blackader.' Empyema in Children. KOPLIK. \" The bacteriology of empyema in children. CAILLÉ. The dangers and peculiarities of pyothorax in children.\" WINTERS. \"The treatment of empyema in children.\"-Archives.of Pediatrics, February, 1896. The three papers were read before the Section on' Pediatrics of the New York Academy of Medicine. Koplik, after enumerating the various sources, fromi which micro- organisms can enter thé pleura, divides all cases into 'four natural groups. These are: Pirst. Metapnuemonic-following. or compli- cating simple pneumonia--in which the diplococcus pneumonia is the etiological factor. Exceptionally the 'pneumonia may be so sli'ght that lung symptoms are absenf and the chest is found full of pus on the third day after the initial chill. In a small percentage of cases the :streptàcoccus is also present. The second group in which 'the staphylococcus pyogenes, or a strepto.coccus, or both, are present occa- 717",
         "DISEASES OF CHILDREN. sionally follows Lung infection, but more commonly tonsillitis, and even a slight infected wound. The third depends upon the bacillus of tuberculosis either pure or with streptococci, and the fourth comprises putrid or fetid empyemas, in which perforation of the lung gives access to saprophytie bacteria. A small number of cases due to the typhoid bacillus and the bacillus coli communis are not included in this classification. To the first group belong 60 per cent. of all cases, and probably over 75 per cent. are non-tubercular a much higher proportion than in adult life. . Caillé points out that cold and damp weather, is a strong predis- posing factor in empyema, the great bulk of cases being severe in February, March and April. The differential diagnosis between a purulent and serous fluid, he thinks, can only be made by the aspirat- ing needle, hence the physical signs of fluid in the chest in general must be considered. Ordinary subacute cases of pleurisy and cases following pneumonia are not difficult to recognize; the puzzling cases are those in which, after an acute onset, (1) \" critical defervescence takes place with dulness on percussion continuing, or (2) a continued irregular temperature curve extends over the second and third week of illness with marked dulness persisting.\" Two cases are reported, in which, during a week and ten days respectively preceding the operation, entire absence of fever was noted, and yet one, a lad of seven, had two pints of pus in the thorax, and the other, a child of three, had one pint. After enumerating the \" rational signs\" obtained by inspection, palpation, auscultation aÂd percussion; Caillé takes each up in detail, and shows that it may be absent in special cases; the most constant is perhaps the flatness and marked resistance -to the finger on percussion. He insists that the only sure method of diagnosis is the aspirating needle, which has the 'added advantage of determining the character of the fluid as well as its presence. The puncture is made under strict antiseptic precautions with a rather large needle, and where all thé signs point to fluid and none is found, it is repeated a second and even a third time. The exudate obtained is examined microscopically. Winters sums up the indications for treatment to be removal of pres- sure from the lung and perfect drainage with antiseptic precautions. He advocates early operation once the active pleuritis has subsided, as the longer the delay the less complete will be the re-expansion of the lung owing to thickened pleura, adhesions, etc. He believes that in recent cases as the pus escapes the tension is*redieved and the lung expands, and insists that careful auscultation before and after making the incision, will convince any one that he is correct. Caillé on the",
         "DISEASES OF CHILDRE. other hand, states that \"the reinflation of a collapsed lung exposed to the presence of the atmosphere through an opening in the pleural cavity is a paradox.» -Winters favours simple incision rather than resection of the ribs, especiallyin children under two years. He makes his incision two inches in length. and at least two inches above the base of the cavity to allow of proper drainage, as the diaphragm rises, and prefers chloroform to ether; anesthesia should not be complete so that the crying and coughing will forcibly expel the pus. After opening, careful irrigation of-the cavity with hot water is carried out, and a drachm or so of w.hiskey given. The factors which lead to oblitera- tion of the cavity are expansion of the lung, ascent of the diaphragn, and falling in of the chest wall, which latter in neglected cases can be brought about by resection of a rib. G. Gordon Campbell. Infantile Intussusception. WIGGIN,'F. H. \"On infantile intussusception-A study of one hun- dred and three cases.\"-New York iedical Record, Jan. 18, 1896. CLUBBE. ' Laarotomxy for intussusception in very young children.\" -A.ustrlasian. MedicalGazette, No. 10, 1895 ; British Medical Joarnal, Feb. 1; 1896. Intussusception in Infants.\"--The Lancet, Feb. 1, 1895. The treatment to be adopted-in 'cases of intussusception occurring in, infants has, for some years, been much debated. The papers before us are a strong plea for operation at the earliest possible moment. Dr. Wiggi expresses the hope that the general profession might be impressed with the facts that acute intussusception is in reality a form of strangulated hernia ; that the subacute variety is an irreducible hernia ; that enemata are far from being devoid of danger in their administration ; that abdominal section performed under modern conditions, and during the first forty-eight hours of the disorder has a chance of success represented by 78 per cent., which, if thIcases were operated on during the first twenty-four hours, would sp.dily rise to 90 per cent. Dr. Clubbe, from his own experience, strongly urges laparotomy as in itself not a difficult operation, and one ·comparatively well borne by even very young children. The Lanret, in commenting on these cases, writes as follows : If carefully. carried out, and if employed within the first forty-eight hours after the commencement of symptoms, inflation and injection are harmless; if they fail, laparotomy may be at once performed withoùt the likelihood of its success having been at all diminished. 719",
         "DISEASES OF CHILDREN. That distension eau effect a cure in nany cases of intussusception no one will deny, but it is equally certain that distension, if employed for too long a tine or too energetically -or at too late a stage, when the intestinal wall has been weakened, may result in the rupture of the bowel and death of the patient. With inflation it is very difficult to esti mate the pressure employed, but with injection, if a funnel be used, the pressure exerted by the liquid depends on the height to which the funnel is raised, and it is important to reinember that each foot of height is equal to a pressure of half a pound per square inch of bowel wal: the funnel should néver be higher than 2 feet., causing a pres- sure of one pound per square inch. If, also, this mnethod be limited to cases seen within forty-eight hours of the onset of symptoms, and be not applied for more than, say, half an hour, the child will not be injured at all, and the chance of success of the laparotomy Nvhich should imrnediately follow if the injection be unsuccessful will not be in any way impaired. It can hardly be doubted that abdominal section in infants does causé a great amount of shock, sufficient in sone cases to Icad to death, therefore it is not advisable to have recourse to such a treatment until slighter and safer inethods have been given a fair trial. A. D. Élackade'r.",
         "au egies \"n otces o 010s. An American Text-Book of Obstetrics\"for Practitioners and Students. By James C. Cameron, M.D., Edward P. Davis, M. D., Robert L. Dickinson, M.D., Charles W. .Earle, M.D., James H. Etheridge, M. D., Hon ry J. Garrigues, M.D., Barton (. Hirst, M.D., Charles Jewett, M.D., Howard A. Kelly, M.TL, Richard 'C. Norris, M.D., Chauncey D. Palmer, M.D., Theophilus Parvin, M.D., George A. Piersoi, M.D., Edwaird Reynolds,- M.D., and Henry Schwarz, M.D. Richard C. Norris, M.D., Editor. Robert L. Dickinson, M.D., Art Editor. Published by W. B. Sainders, Philadelphia. 1895. This is the latest of the series of American text-booka published by Mr. Saundors, and it may be fairly said to- eclipse all its .predecessors. Its distinguishing as well as its- most striking. feature is its wealth of illustration, some 900 cuts in colours and half tones being scattered through the work. Most of them are original, and whenever old ones have been used they have been retoiched or redrawn. As far as possible the cuts have been drawn to a uniform scade of one-sixth or one-third, and great attention has been paid to anatomical accuracy, as well as to artistie effect. In the older books students were often puzzled by the plates representing right sagittal sections in some places,. and left sagittal sections in others ; but in the American text-book, left sagittal sections have been shown whenever possible in order that one eut may be more easily compa.red with fanother. Instruments, too, havo been drawn to a uniform scale, and it is possible here to compare one witlh another and obtain an intelligent idea of their actual iand relative size. Dr. R. L. Dickinson deserves great credit for the mianhei- in which he bas carried out this important part of the work. In a composite work, it is impossible to avoid more or less overlapping in the different sections, as well as occasional conflicts of opinion, but it is remarkable how well Dr. Norris has succeedced in harmonizing the various parts so that scarcely any important difference of opinion or treatment can be found in the whole work. In a text-book prepared for students as well as practitioners, it is bard to strike 'the happy mean so that it may be deep and comprehensive enough for the practitioner, and at the same time clear and concise enough for the student. Perhaps greater difference is noticeable in this respect than in any other in the work of the various contributors. Sone enter more into detail for the benefit of the practitioner, while others condense and illustrate for the benefit of the student. The sections on the anatomy and physiology of the female generative organs, to which 143 pages are devoted, are clearer",
         "REVIEWS AND NOTICES OF BOOKS. and fuller than in any other English text-book. The description of the structures of the perineum, the lymphatics and the development. of the embryo are especially good. The illustrations are numerous and add greatly to the value of the article. The.diagnosis, hygiene and manage- ment of pregnancy are then treated concisely and practically. The next section of 133 pages is devoted to the pathology of pregnancy, including abortion and extra-uterine pregnancy. Dr. Howard Kelly's description of ectopie gestation, its symptoms, diagnosis and treatment, is scholarly and practical. The chapters on the physiology of labour and the conduct of natural labour are thoroughly up to date. Diagnosis by abdominal palpation and pelvimetry are well described and illustrated, and also practical riles are given for carrying out antiseptie treatment. Stress is laid upon the proper management of the third stage of labouïr, the author maintaining that this stage is not complete until uterine retrac- tion is fully established. Lacerations of the pelvic floor are next con- sidered, the proper and improper methods of repair being described and illustrated. In lacerations of the cervix, immediate suturing is recom- mended only when there is severe hiemorrhage. In the absence of troublesome bleeding, the advantage of the primary suture is considered doubtful. Episiotomy for the prevention of perineal laceration is highly extolled. In describing the method of operating, the author says that the cuts should be made parallel to the long axis of the mother's body and not to the vaginal axis, else the very. tissues may be invaded which the operation aims to save. The chapter. on the mechanism of labour is well written, taking account of recent contributions by continental authors. A number of excellent diagrams, some of them quite ingenious, illustrate the mechanical actions described. The. writer of this section overlaps somewhat the work of other contributojrs by considering the, management as well as the mechanism of labour. The section on dystocia takes up 156 pages ; ilirst describes and illustrates the-various deformities of the pelvis and the fotal m-ilformations which obstruct labour in an exhaustive manner, while Parvin and Schwarz treat of dystocia due to accidents aid diseases. The physiology, diagnosis and management of the puerperium are satisfactorily treated by Jewett, while the important section on the pathology of the puerperium is contributed by the editor, with the exception of the chapter on puerperal infection, which is written by Garrignes. This chapter, occupying 51 pages, is a masterly exposition of the modern views respecting fever in the pier- perium and the modern antiseptic treatment. No stronger proof of the value of antisepsis can.be brought than theç statistics of the New York Maternity Hospital quoted in this article. From 1875 to. 1883, the average maternal mortality was 4.17 per cent. ; in 1883 it reached 6.71, per cent., being 20 per cent. in the last month, 15.69 per cent. from sepsis. Then the antiseptic treatment was introduced, and during the following three months there were 102 deliveries without a deatb. * Prom 1884 to 722",
         "REVIEWS AND NOTICES OF BOOKS. 1893, the average mortality has been 0.87 per cent., the percentage from sepsis being0.18. The pathology, symptome and treatmont of the various forme of septie infection diring the puerperium are treated exhaustively. The physiology and pathology of the newborn infant occupy 60 pages, and the concluding section of 110 pages is devoted to obstetric surgery, divided into instrumental operations, manual operations and coliotomy for sepsis in the child-bearing period. Taken as a wliole, the American text.book is the best work we have on obstotries for the advanced student and general practitioner. It is. Up* to date ard practical, embodying the'clinical experience of many. of the best teachers on thé'continent. J. C. C. A Text-Book on Nervous Diseases. By American authors. Edited by F\"ANcis X. ]DERCoM, A.M., M.D., Ph.D., Clinical Profes- s\u003er of Nervous Diseuses ir the Jefferson Medical College, of Phila- delphia; President of tho American Neurological Association. With 341 engravings and 7 coloured plates. Philadelphia : Lea Brothers \u0026 Co. 1895. This volume, of upwards one of thousand pages, adds another to the alrcady long list of works on nervous diseases. The contributors, twenty- two in 'number, include many of the leading -physicians in the chief medical centres of the United States. It is generally admitted that the multiplication of systematic works in different departments of medicine is already greatly over done. There can, however, we think, be no question that in the work under considera- tion the great majority of the authors have given much care and attention to the task allotted them, and have produced a work which, on the whole, will redound to the credit of American modicino. Many of the contributors to this volume are well known for their work in neurology, and for the most part the articles are very complete, and represent fully the present knowledge on tine subjects dealt with. The first chapter, by 'Woir Mitchell, is devoted to certain general considerations relating to the examination of nervous cases. This is followed by an excellent account of the relation of changes in the eyes to nervous diseases by Oliver, of Philadelphia. The articles on neurasthenia and hysteria, by Drs.'.Dercum and J. Hendrie Lloyd, are very exhaustive. Di. Osler contributes the .section devoted to the diseases induced as the direct or indirect result of infec- -tion. Under this heading are described cerebro spinal meniogitis, tetanus tetany, hydrophobia and diphtheritic paralysis. The articles on cerebro-' spinal meningitis and tetanus are particularlygood. The seventh chapter, treating of the various choreiform affections, by Wharton Sinkler, is an excellent contribution. The chapters on the general and focal diseases of the brain,' by Dercum, C. X. Mille, C. L. Dana and. Allan Starr, deal fully and clearly with these important groupe of affections. 723",
         "REVIEWS AND NOTICES OF BOOKS. The chapter on the anatomy of the cerebral cortex and the localization of its functions, by C. K. Mills, is a good summary of our present know- ledge of this subject. The spinal cord affections are dealt with by J. H. Lloyd, Morton Prince and F. Peterson, and the peripheral nerve affections by Sinker, De Schweintz and Herter. ft is needless to say that all these articles. show proof of careful study and intimate knowledge of the subject, coming as they do from men who are careful and conscientious observers. Dr. G. W. Jacoby writes a short but valuable chapter on the myopathic affections. One of the most valuable chapters in the work is that on the disorders of sleep, headache, vertigo, \u0026c., by J. C. Wilson. The Editor was fortunate in securing the services of W. W. Keen, of Philadelphia, for a description of the surgical measures called for so frequently at the present day in many nervous affections. Few surgeons have had more experience than Dr. Keen in this department. His article will be welcomed by all who are called upon to undertake cerebral surgery. J. S. Die Erkrankungen der Nase, des Rachens und des Kehlkopfes. Von Prof. Karl Stoerk -in Wien. 1895. Alfred Hoelder. Diseases of the Nose, Throat and larynx. By Prof. Karl Stoerk, Vienna.. This work, from the pen of one of the ablest of European laryngologists, is the result of years of careful investigation. The chapters on the ordinary affections of the nose, throat and larynx are written so a- to be of interest to the general practitioner especially. The chapter on sclerosis of the larynx and trachea is a very exhaustive one on a subject the symptoms of which were first observed by the au'thor himself. It is a matter ofregret.that thiè work is accessible only to tho student of the German language. H. S. B. 724",
         "· ocre2t3 ŠrDe22cdiigs, MONTREAL MEDICO-CHIRURGICAL SOCIETY. Statedl NMeetiig, December 27th, 1895. A.. D. BLACKADER, M.D., PRESIDENT, IN THE CHAIR. Dr. E. N. Chevalier, of St. Johns, P.Q., and Dr. F. X. deMartigny were elected ordinary menbers. Removal of the Upper Extremity far Sarcoma. Dr. Geo. E. ARMSTRONG exhibited a woian. from whom he had removed the whole upper extremity one year previously. (See page 666.) Dr. BELL said he was glad that this case had .been shown to-night, as it emphasized what he had urged at the previous meeting, that this was a suitable operation for the radical cure of some advanced cases of cancer of the breast. 'It removed all the glands and gland tissues, and as recently done by Mr. Arbuthnot Lane the operation could be so modified as to bring a large flap from béhind to cover the area laid bare by the removal of the tissues in front. It was really in many cases the only operation which would radically remove all infil- trated axillary tissue. As Dr. Armstrong had pointed out, it was a very- simple operation, although requiring, of course, organized effort and skilled assistants. Dr. Bell referred to a case in which he had done a similar operation in July last for sarcoma of the neck of the humerus encroaching upon the neighbouring tissues. Dr. A. LAPTHORN SMITH referred to a case on which he had operated two years: before, removing the pectoralis major and minor muscles, as well as the glands in the axilla, most thoroughly, and yet within a few-ihonths the arm became oedematous, swollen and painful, doubt- less due. bo recurrence of the disease, for the patient subsequently died in great pain. He felt that the procedure recommended by Dr. Bell would bave held out a better chance of a radical cure. Ophthalmological Specimens. Dr. G. H. MATHEwSON presented the following preparations from material derived from Dr. Buller's clinic at the Royal Victoria Hos- pital: la. A preparation showing a complete bony. cup in the fundus arppn4 the optic nerve in a case of phthisis bulb. 47",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. 1b. Microscopical preparation from the same eye, showing the bone cells lying-in lacuno and sending out prolongations into the canaliculi. The specimens were shown because, though it lias long been known to specialists that true bone was found in the eye in such cases, it was thought that the fact might be new to some of the general practi- tioners. Bone in the eye in cases of phthisis bulbi was first mentioned by Schoeder, of Prague, 1839, and since his time by Alt, Berthold, Bou cheron, Furnari, Jeaffreason, Knapp, Stellwag, Ziegler and many other authors. 2a. Two microscopical specimens of melanotie sarcoma of ·the eye. 2b. A mieroscopical preparation from one of the above. 8. Eye with foreign body (fragment of iron) in the vitreous. Dr. F. BULLER described the cliniéal histories of the cases. Discussion on Cancer-(Continued). DR. F. BULLER further stated that his experience of cancerous diseases was necessarily limited to those which occurred in the eye and about it. With regard to the. eyelids le stated that cancerous growths here were not at all infrequent, and were usually of the epithelial type. Early diagnosis was usually easy, and a radical cure effected by operation when the growth had not reached the periosteum and bone: where however, this occurred, cases were, apt to go from bad to worse, and terminate fatally. Dr. Buller stated that the wider his experience becamne the more firmly he was 'convinced that cancer vas primarily a local condition and that metastases were as apt to occur from soft cancerous growths, as from the harder varieties. On the hypothesis that the cancer began necessarily as a single aberrant cellular-element, it was easy to understand that with a growing tissue, soine of thesé elements may enter the circulation and be carried in their germinating state into some other part of the body and there fori new \"\u003cfoci.\" That growths occurring within the eye-ball itself, and not invading surrounding tissues were not apt to recur elsewhere after extirpation,. if this be done at a very -early period. Where however, sarcoma growing within the eyeball has come to occupy a considerable portion of this space, removal of the eye is nevertheless almost certainly followed by the occurrence of metastases in other organs within a few months. When we come to enquire what constitutes a cancerous growth, whether it be of the carcinomatous or of the sarcomatous type, we naturally begin the, enquiry by searching for common factors, or for phenomena which belong to and are never absent from any new 726",
         "- MONTREAL MEDICO-CHIRURGICAL SOCIETY. growth of a malignant nature. Of these there are, so far as I am aware, only two which are characteristic of, and inseparable from, the cancerous groups. 1. There is the incontinent and inordinate development of primi- tive cellular elements. 2. There is the irrepressible tendeney'to invasion of adjacent nor-; mal tissue. The second characteristic is, however, merely a corollary of the first. If in any given case we follow the process backývards to its very beginning we would necessarily arrive at a period where the original growth consisted of only a few, and finally of only two un- physiologieä1 cellular elenients. It goes without saying that nopatholo- gist could ever hope to meet with the very beginning of a cancerous growth, or to recognize it even though the two first cellular elements were actually brotight within the visual field of his very.best micro- scope, and yet- every cancer must be that and nothing more, at the very beginning. I think that in view of this fact it is not difficult to understand that there must be one principle or 'one .law which deter- mines the nature and the beginning of every cancer. There must be a time when a single cellular element secedes from its environment and begins to develop a tissue ¯ on' its own account. From the momient this cell produces another one like itself the cancer has a de facto existence \"as a separate autonomy. These two. cells and all the .others -which spring from .them have ceased to perform any physiological function; they are parasites to the rest of 'the animal economy, or if you like, so soon as the arterial vascular supply is developed the growth is, properly speaking, autositic. It seems to me that whoever would find an explanation of any can- cerous growbh will have to seek. for it rather in physiology. than in pathology, as a modification of the vital process, or whatevei it is we call life. I may be wrong in the assumption, but so far as I am aware, all the morbid growths, for which a known cause exists in the form of .certain specific micro-organisms, possess certain characteristics which at once and absolutely separate them from cancerous growths'; the tendency to inflammation, degeneration and disintegration charac- terizes all 6f them. The opposite is true- of the cancerous process, excépting under certain special conditions. A single trachoma nodule in the conjunctiva is :as mùch a new. growth, as the largest osteo- sarcoma. The life. history- óf the one depends\"on the presence, or .at least the active ageney, of certain .micro-organisms.; that of the other is the life history of the individual, of the whole being with which it is associated. It does seem to me that the new growths so far recog-- nized as associated with and probably dependent upon'micro-organisms 727,",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. for their development differ so obviously from cancerous growths, that. this difference in itself becomes a strong evidence against the micro- organism theory of cancer development. The differences which exist between cancerous growths themselves undoubtedly depend upon the vital properties in other tissues from which the growth origin- ates though they may be, and I may say undoubtedly are, all subject to one fundamental law for their origin and subsequent growth. In the human eye we have perhaps a better field for the study of cancerous growths than in any other part of the body, for although only two forms of malignant growths are frequent enough in the eye to afford useful material for study, they both represent highly malig- nant forms of cancer, and in both we can sometimes watch the growth from a very early stage of its development. In both the observer who studies a specimen of sarcoma from the interior of the eyeball, whether from the retina or choroid, will be struck with the fact that the early cancer cells are to all appearances identical with the normal elements of the tissue from which the growth takes its origin. The sole difference that we can be certain of is the incontinent and the invasive nature of the cancer cells. Dr. RODDICK agreed with the other surgeons that cancer was at first a local disease and could be cured by sufficiently early removal. He looked on local irritation and chronic irritation as the two great causes, and considered that any condition which tended to lower the vitality of the tissues was a strong predisposing cause. To illustrate this, he instanced the fact that hospital patients, who after operation were subjected to poor food, varying temperatures and in general bad hygienic conditions, were much more liable to recurrence than those of the better class living under more favourable conditions. He thought that age and heredity also could not be gainsaid as predis- posing causes. The statistics of cases bore this out, and it was universally recognized in questioning patients with regard to their family history. He felt that if pathologists could show thiat cancer vas a parasitic disease they would help the surgeon very much in the treatment and methods pursued - in regard to it. His own belief inclined towards the parasitic theôry, which was borne oiit by many clinical facts. The infectious nature of cancer had been pointed out by Mr. D'Arcy Power, who had reported three or four cases occurring very often in the same house, and-Dr. Roddick himself had had one instance of this, in which an epithelioma of the hand had been followed by the same form of growth on the face of the nurse in charge. Though experiments in inoculating cancer had been unsuccessful, he thought the method used might be at fault, Plummer had succeeded 728",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. in giving cancer to anim\u0026ls by placing portions of cancerous tissue in the vagina. He agreed with Dr. Shepherd in condemning the use of causties in the treatment of cancer, but considered escharotics as some- times of service to complete the cure after operation. By the use of Bougard's paste he had often succeeded in remoring small growths when the patient refused to submit to the knife. 'He thought that escharotics should be used only when it vas the intention of the surgeon to complete the removal of the growth by that means. The mere application to the surface only irritated. In excision of the tongue lie preferred Whitehead's operation, as recommended by Dr. Shepherd, but differed from him in believing that in certain cases the removal of the lateral half of the tongue was followed by entirely satisfactory results, always provided, of course, the disease was limited to one side. He referred to a case of his own in which epithelioma, veritied by histological examination, had been cured by an operation of this description, eight years having now elapsed without a recurrence. Nunnelly's operation, which lie had performed several times, was to be recommended when the growth was at the anterior portion of the tongue and when one was not well assisted. It consisted in introducing the ecraseur through an incision in the middle line of the neck into the floor of the mouth and passing through that opening the chain of the ecraseur and then around the tongue.. He felt that septic pneumonia had not been so frequent during the days when Dr. Fenwick and lie had used the ecraseur in preference to the knife and scissors, although they had not taken the precautions to prevent sepsis, now so well understood. - The reason for this was, that the bruising of tissues effected by the ecraseur closed the lymphatics and blood vessels, and thus prevented the absorption which so readily takes place after the· knife and scissors. * Until granulations had formed and protected the parts it was now his prac- tice to feed his patients entirely by the rectum and thus help to prevent septic infection. Dr. Roddick agreed with Dr. Bell that the removal of all doubtful tumours of the breast was imperative. Recurrence in these cases was usually in the scar, not in the muscles, which he rarely considered necessary -to remove ; the glands of the axilla, however, should always be extirpated. He did not think that the removal of the whole. upper extremity, as referred to by Dr. Bell, was at all practicable. Cases which seemed to require, this should be left alone. He recommended operation at once in every case of local recurrence, and cited two instances in which the growth recurring locally .had been removed four ci five times without general infection having taken place. 729",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. Sir WILLAM HINGSTON thought the gentlemen who introduced the discussion had gone over the ground fully. Speaking of the nature of cancer he felt disposed to agee with Dr. Adami, as clinical experi- ence had led him to look on it as commonly the result of inflamma- tory action. He cited several cases to bear out this view of the nature of cancer ; one especially, in which, after twenty years or more, a sinus at the back of the knee had developed malignant action. He also quoted Jonathan Hutchinson as holding the same opinion. With regard to the parasitic theory, he did not feel qualified to speak; but on general principles he thought it likely parasites would show thenselves here, as they did elsewhere, 'during the course of the disease. He referred to the common experience of benign tumours, especially about the face, taking on malignant action ; and said he made it a rule on this account to remove them after the patient had reached a certain age. Predisposition, Sir William said, he could not understand, and in this disease lie did not know what heredity meant, as, if a cancer subject inherited the tendency from his father, that father must have inherited from some one else, and so back from generation to genera- tion. If the matter of heredity was admitted too fully it would paralyze all efforts. With regard to the tongue, Sir William thouglit that partial re- moval was wrong in principle. While stating this as bis general belief, ho thought that there were cases where a less extensive opera- tion might be practiced and advocated the occasional removal of half of the tongue when the disease was localized to a small area. In cancer of the breast he operated early, and especially as patho- logists were of the opinion that simple benign growths here might also become malignant. He did not, however, hurriedly resort to the knife in all cases, and related instances in which lie had declined to operate twenty or thirty years ago and where the tumour still remained harmless. Sir William recollected the tinie when it .was unusual to operate a second time, and contrasted with this his present method of operating early, as soon as he was satisfied that the, growth was malignant, and of repeating the operation again and again if necessary: as many as five times in one case cited. The disease recurred, lie thought, generally in the cicatrix and in the skin; less frequently in the muscles, and. rarely in the glands of the axilla: for this reason it was not his practice to remove the glands of the axilla in the first instance, unless they were diseased. Another objection to removing the glands during the first opération was that it added very greatly to the sufferings of the patient and very largely to the mor- 730",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. tality, while not unfrequently pain and edema of the arm followed. ie did -not feel warranted either in removing the pectoral muscles unless they, were diseased. The operation of renoving the whole upper extremity for cancer, as suggested by one of the speakers, it was not necessary to - speak against, as the patient herself would never submit to it. In conclusion, Sir William refeired to the various operations for removal of cancer of the rectum and claimed that colotomy gave as much comfort in the end to the patient as any attempt at removing the disease, as unhappily cases were rarely seen while the disease was still confined to the bowel. Dr. A. LAPTHORN SMITH was firmly convinced that cancer was a contagious disease, and felt quite sure that pathologists would yet come to that decision. He had seen at least three cases of - cancer occurring in people who were not related in any way to other cases of cancer, and yet who attended those casès as nurse or friend. Dr. Smth said that thougli most of the speakers had referred to the great importance of thoroughly removing all traces of the diseased tissue, none had laid enough stress upon the importance of disinfect- ing the field of operation after the diseased tissue had beei removed. In a case of cancer of the breast, for instance, where every portion. of the disease had been removed, if one smeared the edges of the wound with cancerous tissue and the clisease was a bacillus disease, recurrence locally was to be expected. Dr. Smith referred also to the nethod of Dr. Byrne, of New York, for removing cancer of the uterus. He cut out small pieces at a time by means of the galvano-cautery until only the mere shell of thé uterus, was left. His statisties showed that his cases were free froin return for a much longer period than usual, andi he attributed his success. to destruction of the bacilli by heat in the tissues beyond that portion which was removed. The fact that cancer usually, if not always, commenced in unhealthy or scar tissue,the speaker, thought showed *that the bacillus of cancer, like that of tubercle. would not attack healthy people or healthy tissues. . Dr. A. PROUDFOOT advocated the use of causties' in the early stage of epithelioma of the lip and cited cases to show its efficacy. Of epithe- lioma of the ear, which was not as common as in the eye, he had seen several cases within the last few years, and found that early removal of the affected part was followed by good results. Dr. SHEPHERD in reply said that he preferred removal of the whole tongue ' in cancer and that unless the disease was well forward partial excision was of little avail. Formerly it was his custom to feed for several days by the rectum, but now he never did it, preferring feed 731",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. ing by mouth with a tube and funnel and allowing the patient to go about on the second day. In reply to Sir Wm. Hingston's remarks regarding heredity, he wished to say that lie did not believe in the her'edity of cancer, but lie did believe in an inherited vulnerability, and that this vulnerability increased with age. If all were vulner- able every one who smoked should get cancer of the lip. Dr. Bell advised amÈutation of the arm in certain cases where cancer involved the axillary vessels, but Dr. Shepherd said that if such heroie meas- ures were necessary to remove the local disease, the case was past operating on at all. No account is taken in these very extensive operations of the involvement of the mediastinal glands. At present Dr. Shepherd had under his charge no less than three cases of recurrence or continuance of the disease in the retro-sternal glands, all other parts being free; in one of the cases the patient had been apparently free for four years. In very few of his cases lias there been local recurrence ;'in two the cancer recurred in the bones, and in many in the liver, and soine in the cervical glands. One case under care at present was free for six years, and then the cervical and other glands became involved. In another case, first operated on eight years ago, there was local recurrence four or five times, for which operation was performed early; now the patient is still alive and has been perfectly free for four years. In reply to Dr. Roddick, Dr. Shepherd did not think that locality had anything to do with recurrence, and thought that people living in poor localities resorted to the surgeon later for the primary operation than the well to do, hence the greater frequency of recurrence. As to recurrence being due to the implantation of cancer cells, Dr. Shep- herd did not place much credence in this, for in all the modern opera- tions the knife goes so wide of the disease that the cancer cells are not disturbed. The statisties usually given are .very fallacious, the results of old and new methods being contrasted when any one wants to emphasize the superiority of his own operation. He thought a great many cases were reported as malignant which wcre benign, and the speaker would not admit any case to be cancerous without a careful microscopic examination; hence the success of caustics, especially in the hands of quacks, for every case was said to be one of cancer. Caus- tics were strongly objected to, for their use often postponed operation by the knife until it was too late. Th' ,only cases in which the speaker used caustics were those of the cheeks and side of the nose; here thoroughi scraping and subsequent application of the actual cautery often proved beneficial. Dr.. BELL said, If we assume-and I have heard no dissenting 732",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. voice-that cancer is at first a local disease and spreads by infiltration of surrounding tissues, by extension along the lymphatics and only later by metastasis; then the treatment is clearly indicated; when we have metastatie cancer in other organs of the body, of course oper- ation in the hope of effecting a cure is useless. If we accept these statements as facts, the logical inference is, early and wide and coin- plete removal, quite regardless, of the deformity resulting or the inability to close the wound over. If the cancer recurs in the scar it shows that it was not removed sufficiently widely at the outset. So far as my experience goes I am surprised at Sir Win. Hingston's state- ment that recurrence is generally in the scar and rarely in the axilla,- my experience is, that it is generally in the tissues of the axilla ! It is, I think, utterly impossible to determine before operatiôn for cancer of the breast that the axillary glands are not involved,-hence the rule that the axillary tissues, especially the lymphatic tissues, should always be removed. Of course I would not sacrifice the breast, nor dissect the axilla if I were sure that the tumour was a benign one, but in case of serious doubt, I think it is much better to sacrifice the breast and dissect the axillary space than to run the risk of early recurrence. The explanation of recurrence in the scar is to be found in the fact that when tihe disease is advanced, infiltration takes place down to the bony chest wall and it may be impossible to remove the tissues deeply enough to reniove the whole of the disease. I think therefore that all the tissues down to the chest wall,-below the lower border of the pectoralis major muscle, and the fascia covering the muscle should always be removed. I do not recommend the removal of the pectoral muscles unless they are actually infiltrated or for the purpose of effecting a more thorough removal of the diseased lymphatic tissues. Many of the cases which present themselves for operation are seen only when the disease is far advanced. In them we have no choice. If we operate it is to remove the whole of the disease,--not a part of it,-and in order to do so it may be necessary to remove portions, if not all,a of one or both muscles. And going still further,-when we dissect out the axilla,-often dissecting infiltrated glands from the very walls of the vein and artery, I am sure no surgeon can feel that in such cases lie has removed the whole disease, and it is in those cases that I say I believe the upper extremity should be removed, in the hope,-or rather with the certainty of removing all diseased tissue as f ar along the vessels as the border of the -first rib. Froni a purely anatomical standpoint I am sure that in many cases the operation will remove every particle of diseased tissue and that there are very many cases in- which no lesser sacrifice will do so. 733",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY.' I cannot agree with Sir Wm. Hingston that the swelling and ædena of the arm is due to the dissection of the axilla. It does not follow immediately upon the operation but it follows later on, in such cases as I have been describing, and is due to a cancerous mass forming about the vessels and pressing upon the axillary vein. When we come to the still further advanced extensions along the lymphatics such as those described by Dr. Shepherd, in which the mediastinal glands were involved,--I. believe them to be infinitely rare among cases presenting thenselves for primary operation and of course under any circumstances such cases could not be eured by removal of the upper extremity or any other operation. Dr. Proudfoot lias spoken of \" keeping cancer in check by escharo- tics !\" . Now I do not see why we should aim at keeping cancer in check. It is bound to extend and endanger the patient's life and should therefore be renoved. Witl regard to the use of escharotics I do not think they have any place in the treatnent of carcinoma, except for palliative purposes or when it is impossible to reinove the whole of the disease with the knife, as about the eyelid, extending to the base of the skull, or when it would be injudicious on account of the great deformity produced by the operation. Dr. ARMSTRONG said:--One point lias not been inentioned which was worked out in Germany, that is, that the lymphaties from the breast pass to the pectoral fascia and the lymplatics of the pectoral muscle run forward to the same fascia and therefore it is necessary only to reinove the pectoral fascia unless there is some special reason for renioving the muscle. But I think these iethods of operating have been pretty well worked out and understood for some time ; any one can find informa- tion upon then in the standard text-books and journals. My idea was to specially establish the fact that cancer is a local disease and, consequently I thought to bring out evidence or new symptoms which wo.uld enable us to recognize cancer in an earlier stage than we have been in the habit of doing. We can operate al] right when the diag- nosis is made, but we warit to be able to recognize malignancy in a manmary tumour at the very beginning, and the same with stomach cancer; to get good results, we should interfere as soon as the disease is initiated, to secure a permanent cure; and that is why I feel that the discussion has gone in a different direction from what I intended it to take. However, we have established the fact that cancer is primarily a local disease, and the early symptoms will be gradually worked out. When cancer of the breast is diagnosed according to the standard text-books of to-day it is too late to obtain perfect results. When 734",
         "MONTREAL MEDICO-CHIRURGICAL SOCIETY. you get a hard lump with retracted nipple and enlarged lymphatic glands the day is gone by for getting good results. I think Sir Wmi. Hingston takes a very serious responsibility when he advises the leaving alone of tunours of the breast in women ap- proaching the climacterie. They are easily enucleated, and if left alone, may receive an injury, dhange their character and become inalignant. I recently operated upon a malignant tumour of the breast that existed as a simple tumour for thirteen years and then changed ,its character and becane malignant. It is good practice to enucleate these growths while small and simple in character. Stated Meeting, January 7th, 1896. A. D. BLACXADER, M.D., PRESIDENT, IN THE CHAIR. Removal of a Cyst from the Brain for the Relief of Jacksonian Epiepsy. Dr. G. E. ARMSTRONG showed the patient, the report of which will be published later. Dr. F. G. FINLEY stated that the boy had been in his ward and had had sev.eral seizures during the first few days he was under observa- tion. After that there lad been none for a month. Dr. Finley had witnessed-one of the attacks, which affected the head and eyes only. There had been no loss of consciousness. There was lateral deviation of the eyes and of the head to the opposite side, rapid motions of the eyelids, more marked on the riglit side, the right eyelid opening and closing more forcibly than the left. In other attacks witnessed by Dr. Byers the movements had spread to the right arm and right leg. The attacks were distinctly Jacksonian in character ; they had a local commencement and were not accompanied by loss of consciousness. The question of localization had not come up, as the depression settled the point at which to trephine. The lesion found raised the question as to localization of this area. Dr. Finley had mapped out the p'osi- tion of the cerebral fissures and found that the depression corresponded to the supra.marginal convolutions and angular gyrus: Lesions here were known, by experiments in animals, to produce certain move- ments. of the eyes. In a case reported by Ross, of Manchester, the skull had been driven in over this area, and several weeks later the head was drewn to the opposite side and the eyes turned up and to one side. An operation had been successful in relieving the symnp- toms. During Dr. Armstrong's operation they had 'been unable to produce the same effects by electrical stimulation of the cortex, and so had not any confirmatory evidence of localization. Replying to Dr. Wesley Mills, Dr. Finley said the electrodes had 735",
         "MONTREAT; MEDICO-CHÏRIJRGICAL SOCIETY. been placed about an eighth of an inch apart and that the current was too strong to be borne upon the lips. Primary Cancer of the Liver. Dr W. F. HAMILTON read the clinical notes and Dr. C. F. MARTIN the pathological report, which will be published next imouith. The Treatment of Inebriety as a Disease. Dr. O. C. EDWARDS of Ottawa, read a paper on this subject in which he endeavoured to show that the hypodermie administration of gold was a specific. He gave the results of two years' experience, during which he had treated over fifty cases, and always with benefit at first. The treatinent lie considered, presented four principal indi- cations as follows: (1.) To subdue the overnastering appetite for liquor, whether con- stant or periodic. This was donc by giving hypodermic injections of the chloride of gold and sodium three or four times a day, using. Wyeth's tablets of -1 of a grain for the first two days and then diminishing the dose to - of a grain for the rest of the time the treatnent was kept up. The injections were continued for a period of over three, but usually under four weeks, and in some cases it was thought advisable to substitute 1 of a grain of nitrate of stryehnia for one of the daily hypodermics. The solution of gold used, could be made by dissolving three grains in an ounce of boiled water; ten minums constitute a dose, but the tablets had been found less irrita- ting and more reliable. (2.) To give a hearty appetite for nourishing food: This was accomplished in the usual manner with vegetable bitters, any prepar- ations of which were suitable, provided they contained no alcohol. For this purpose Dr. Edwards had had prepared by Wyeth non-alcoholic tinctures of cinchona, cal umba, gentian, etc., which he used in conjune tion with some preparation of kola. (3.) To procure healthy refreshing sleep: Bromide of soda and chloral hydrate were nainly relied upon; where these failed he had resource to the hydrobromate of hyoscine hypodermically; but hyp- noties were never needed except for the first two or three, nights. Sleep after that was calm and refreshing, and Dr. Edwards considered that the gold was nainly responsible for it. (4.) Nervine tonics:-The following formula was recommended: Quinina3 sup................................gr. 1 Strychnino nitrat. .... ....................gr. ; Olei resini Capsici .:........................gr. Zinci oxidi .................................gr. 2 Acidi arseniosi................. ....... ...gr. V Ferri reducti................................gr. 1",
         "MONTREAL MEDICO-CRIRURGICAL SOCIETY. Sig: one three times a day after meals. In some cases it was thought advisable to leave out the iron. At the outset of the treatment a purge of calomel was given, and where liquid foods were necessary, as was often the case, beef juice or beef jelly. . The administration of the gold, the bitters, and the nervine pills was continued throughout the wlhole time, and often the nervine pill was given alone for a couple of weeks, after the hypodermies were stopped. The usual precautions in regard to sterilizing the hypoder- mie syringe were carried out, and on account of the corrosive nature of the salt,a platinum needle vas found necessaryto prevént clogging. The administration of alcohol was regulated according to the wishes of the patient at the outset. If a man was drinking when treatment began, lie was allowed to have a limited quantity as long as he had any desire for it. As a rule, the taste was gone after a few days After the habit was once broken off the patient was warned against even-taking the sinallest quantity, either' socially, in medicinie, or in any other way, as one taste of alcohol could at any time awakon the appetite again. Dr. T. J. W. BURGEss said lie agreed.with Dr. Edwards that inebriety was a disease. but ho went even further in that he considered it a disease long before the stage at which, he (Dr. Edwards) set it down as.such. It was a disease of which the most prominent symptom was lack of will power, and the majority of its victims were inheritors of an unstable nervous organization. Such men knew what the inevitable result of their conduct must be but they had not the will power to resist. As regarded the gold treatment, he .knew that similar results were got by cutting off the patients' liquor supply and building up their system generally. Such patients would tell you, like Dr. Edwards' that théy had lost all craving for drink. In some cases the effqct produced was permanent, but in the majoi-ity it was only tempora'y, the patient yielding when again placed ivithin the reach of temptation. Dr. JAs. STEWART said he had no practical experience of anygOf. these forms of treatment, and he had no faith in this more than another. A certain percentage of cases were fallowed by ' cure in anything making a. powerful impression on the nerve centres. . He did not think that Dr. Edwards had proved his point. Hypnotism had been found equally good. The disease was due to paralysed control. Dr. J. B. McCONNELL agreed with Dr. Burgess in looking on the inebriate as a neurotic. He himself; in a paper read befqre the Society a couple of years before, had reported identical -results from the use of strychnia. 737",
         "-rHE brnJred 4euCaI ¶4LTuxuad. A Ionthly Record of the Pregress of Medical and Surgical Science. VOL. XXIV. MARCH, 1896. NO. 9. ROENTGEN'S DISCOVERY. It is with no little pleasure thàt 've call attention to the article .in this nunber by Professor Cox, describing as. it does and illustrating the first application, to diagnostic purposes, on this continent, of Roentgen's remarkable discovery. Appealing for the moment to local interests, it is to us most gratifying to be afforded this eaxample of the benefit to be reaped by a University in possessing well-directed and well-equipped laboratories, most gratifying to read these early fruits of Mr. W. -C. McDonald's princely munificence. Professor Roentgen, in his original paper, gave so full an account of the character and properties of the new rays, that the researches made all over the world during the last two months have added little to our knowledge, have accomplished scarce anything beyond amply confirming the original and most modest statemeaônts. At most Professor Salvioni, of Perugia, by an instrument which he terms the- iristoscope would seem to have been able to render the, \" shadow effects\" recognizàlble -directly» to the naked eye, and at Toronto;it has been observed tliat the rays may be concentrated.to a certain extent by reflection from surfaces relatively opaque to the rays. Wc congratu- late our sister ciLy very heartily upon this advanceé. But as to the. exact nature of.the rays-whether they are the longitudinal vibrations foretold years ago by Lord Rayleigh, or whether. they consist of peculiarly small and frequent transverse -vibrations of the ether,.as Professor Schuster, of Manchester, and others have suggested-we as yet do not know, nor does it apper likely that .we shalhl gain further informatioi until researches of another order throw light upon the mattei. Mere photography, or \"radiography\" as Professor Goodspeed, of Philadelphia, would term it, is incapable of solving the problem. In the meantime this new \"radiography\" has already proved",
         "4t\\ n 4; g: t *%~t '~~' * '-~g7 v.;' c 'j.... -. t' J r. 'I 's .4 t', I tjjt i j0 Lt Ar . t tit tis,",
         "itself of surgical use. The number of. cases in which it can be applied may be few, névertheless they dertainly exist,.and it is for us to hail with cordial welcone each advance towards more, perfect diagnosis, however limited be its application. THE POST-GRADUATE COURSE AT McGILL We would again draw attention to the announcement in our adver- tisement coluinns of the forthcoming Post-Graduate course at McGill University. A study of that announcement will show that while the evening lectures are intended to illustrate the recent advances that have been made in medical and surgical sciences, such advanced lectures form but a snall portion of the course which, in the main, is arranged so as to be essentially of a practical nature, clinical instruction and instruction in modern inedical and surgical methods, (wherein are included the methods of the more specialized. branches of our profession), occupying the foremost place. The aim of the Medical Faculty has throughout been to inaugurate a thoroughly useful course, and with the admirable hospitals of Montreal, the abun- dance of clinical material, and the excellent laboratory accommodation at McGill University; the aim ought to be fully accomplished. The Canada Medical Record is now owned and edited by the. Medical Faculty of the University of Bishops. College. Dr. J. B. McConnell is editor-in-chief. In Paris it is proposed to issue to medical men, upon payment of a small fee, a card called a coupe-fid. This will give them the right of way across processions or other obstructions. We believe that in some American cities a similar system is in vogue. NEW BOOKS, ETC', RECEIVED AND NOTED. Cholera in Calcutta in 1894 and. Anti-cholerale inoculation. Reprint from the Health Ofqicer's-Annual-Report. Annual of the Universal Medical Sciences, Sajous. Philadelphia: The F. A. Davis Co. 1895. Transactions of the College of Physicians of Philadelphia. 1805. Report on the Scientific Study of the Mental and Physical Conditions of Child- hood. London : Committee of Parkes Museum. 1895. Nephritis of the Newly Born.. By A. Jacobi, M.D. Reprint from the New York Medical Journal, Jan. 18, 1896. The Journal of Experiniental Medicine. Volume I. No. I. New York: D. Apple- ton \u0026 Co., January, 1896. Anti-Cholera Inoculation. ,Repori to th Government of India. ByWm. Haffkine. Calcutta: Thasker, Spink \u0026 Co, 1895. . Transactions of the Medical Society of the State of North Carolina .1895. EDITORIAL. 739",
         "740 EDITORIAL. The Natural Arsenical Waters of La Bourboule. London : The Sanitary Publish- ing Co. Changes in Lepra and Eczemia. By J. L. Milton, M.R.C.S. Reprint from the Edinburgh Medical Journal, July, 1895. Hypertrophic Rhinitis. Reprint from the New York Medical Times, February, 1896. Rhinological Don'ts. Reprint from the Texas Medical Journal, May, 1895. By Edward J. Birmingham, A.M., M.D. Surgical Treatment of Laryngeal Tuberculosis. By J. W. Gleitsmann, M.D.- Re- print from the New York Medical Journal, October 19, 1895. The Prophyla:tic .Clothing of the Body chiefly in Relation to Cold. By W. F. Cleveland, M.D. London: H. K. Lewis. 1895. Sleep in its Relation to Diseases of the Skin. By L. Duncan Bulkley, A.M., M.D. Reprint, from the Medical Record, Nov. 20, 1895. Lewis's Nursing Chart. London.: H. K. Lewis. The Nature of Family History and Personal Condition in Estimating a Liability to C .sunption. The Mutual Life Insurance Co., of New York. 1895. An American Text-Book of Surgery. Philadelphia: W. B. Saunders. 2nd edition. The Anerican Year-Book of Medicine and Surgery. Philadelphia : W. B. Saunders. The Treatment of Pulmonary Consumption. By Vincent Dormer Harris and Edwin Clifford Beale. London: H. K. Lewis. a"
      ],
      "title" : [
         "The Montreal medical journal [Vol. 24, no. 9 (Mar. 1896)]"
      ],
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      "identifier" : [
         "8_05178_93"
      ],
      "published" : [
         "[Montréal : Gazette Print. Co., 1896]"
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   "doc" : {
      "title" : [
         "The Upper Canada medical journal of medical, surgical and physical science [[Vol. 3, no. 5] ([1854])]"
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      "type" : "document",
      "identifier" : [
         "8_05166_26"
      ],
      "published" : [
         "[Toronto : A.F. Plees, 1854]"
      ],
      "text" : [
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         "tI\u003eIER (XVN.ÀA [iI JO JNAL, Iffeffical, Suwgical and physical Science, ORIGINAL COMM UN[CATINS. FOU It1'il SEWTION. ,mle bloon, %vwli contains~ail thec enents froin wxhielî Ille tis:,ues Carec dc vel opcd. n-ay organ i xc i lqd fIrninc ae 11 iito u IIL 110IO C1 ecesa' Ihat il, slîonfl bie \".xud(ed tlîroughi tie \\vflIs or the Iosel bConstruet. neC\\ tissues. [fui ter aissertcd the possi b ii y of Ille i mrmd lae convion~~~ of blood inb tissue, bnt laticr-ly thc 1tac(t bas beon almnosi. untircly overlookzcd, and 1 bI)eVe 1 was ilime ihrst to prove [bis transforniation by ni eroscolpie observation. Blood maay experience al tran~sformnation into tsicas ?eadily xvii Iiri as exîcrior Io thec vessels, occlirring, ii l] e first case, in 'a very trilling degree ilu stasis of the blod ; in sccon(I, hi blood ixn'vsacd o the surromidimg Parcnchyrna, -,çlieii the vcssctl3 arc toil. [l the organizatiort of blood corpascles, xviti ibm tu vascu- Uar sys;teun îhey aso iat i gmolips of' tei- Qi' more, -and ilîoîm becomlne cinvctopcd,( xvlit gey albmmnoid mnalter, ?-Olulbl ini acetic acid, wxvhîeh aftcrxvar(s c~dne and 11111.3 coflstitutes a, col[ nmembrane. Th'îe blood corpusciles at first. retain tlhcir hematine, am Play eftiier proserve ihecir origina'l size or may under-go iti oi i.j~j After the ccli is 1loýrMcd l'lie red colot' gradaifly iSpc mî. ad is t.kn observed fillcd xvilhi iierous da'iý ?aîls(nuciecol i), xvhich enjlof l'ai\u003e a pî'oteille qlll- or pigme nt.",
         "ORIGINAL COMMUNICATIONS. Sometimes, before tle cell-wa:ll is yet visible, a large clear spot appears in the centre or the groups, whiclh is tie nucleus of Ilo future cell, and oceasionally two such niuclei are formed. This metamorphosis of blood-corpuscles into lammation globulcs and cells cannot always be traced Or proved, because frequently when the cxamination is made, the red color lis already disappcared fron the mill- herry-forned globules. Howeer, be it as it may, hIe existence of these inflamnation globules within a vessel is Ilhe onlv certain sign tlat a columnî of blood had stagnatel during life. The length of time intIervening between the commencenenît of stasis of tIe blood and the formation of the structures above described, according to my observa- lions, is several days. Thlie explaniation of the process cau lardly be given with cert aint.y. To form the globules, it appears as if fron each constituent blood-corpuscle a port ion of albumen and fibrine exuded, and another portion of these with fat remained. The mode of transformation of the corpuscles into pigrient granules is problematical. At first of a red color, they then become of a rust or yellowish color, and finally blackish, and are also diminiished in siz. TIhey no longer givel up iheir coloring matter Io water or acetie acid, ior are they soluble in these; so tlhat a chemical transforma- tion lias taken place in the proteine as well as in the former substance. Besides this change in color, and diminution in size of the blood-corpuseles,4 iii which, for hie most part, Ile heniatine remains in an aliered condition, the formation of masses of pigment granulcs have hematine, which las exuded fromn blood-corpuscles without a change in iheir form, is also observed. A fuirther metamorphosis of inflammation-globules, or of hie cells, with many nucleoli, I have not observed ii blood w\\ithin the vessels. In the organization of the fibrine wilhin vessels, it coa- gulates into fibres, which at first branch in an arboresceLIt manner and arc snootl, and at a later period becofmie rounded. According to my observations, these libres are never preceded in their origini by colls. Ili other casePs, by Ile .eparation of fat intho globules, inflmation-corpuscles, or celils of Ie second form, are prodneed in the fibrine. - I munit Parti ( in tihe ol inrn of vny h înoîr-l fi is-nd Dr. Trb rt, Ilat I i color *irpuseOi-s are ne'ver blood-corpieles \u003c-s Kolliker monei de,), but are nm*wvly formn(41 IniO the hematile. i have too often amîi distinely obseoryî\u003c th transition irnw. 'iiTatper Ireservei pali blood.corpiueles are ( .ryed wit hem atine globules in oii b14 lood-C qu1:itei erre'ct.",
         "arolitil iliciti siteatlis or aa whivIî îe n iaï . : u itl livie ti' ;n les eliairie Ut, ai i .iw îlc ',c .bTute rgiiai fbilem ini flno and eci, a- ila ter or direct observ.iijoî ; troni vlbun) tuie ice :ypears tiever Lo octitr p)riinitivelyV ; su( iîtat liiiît'lpp1ýi- inaties m-ore the fibrotis i issues yielIditigý,t -eIeiîîe, iimuî 1I)lhmeîc dcs. i eincercîus deoTeleraticiii and ciolioid ceils are eon limes developed in coagniated hiood witiiîi n lin blond vcs'saroulid p)Ls rju-is Tite albove arc the offiy iiistllgieailme uotl oiu biood in te large bods~~ WVitimiî the capiticiries, in a siutiair inanneir, int stagnationi of te blond, the biood-corpluscies hvorne anoeat d u are cotiverictd into ;nlmmmio-iine and if thee-aei tonitilues, time wvalls or tihe eamiaisdissolve, ande ilut hiqtor saniguiuuis, mixed wiîhti e fienimnîn~Toue e.Xstvsates jInit lme 1rm hyaof te orgati. 'Pii faei, itowcver, is otily iirdand not direuly prov'e1. A conversion or fibrine itit libres 1 have neyer yul obevdwi ti n capillaiaes. iun ore nunicrous and inanifold are the tranisl'rtuat- lions of blood wiii lias escaped int the roudig îîareneclylla of lace.rated vosseis, ait(d lias ni bucit re:sorbcd, Iliti oceur ini thlat wilîiitu the veýsels. As in the latter case, blood-corpascles also 1'orm rud, anid tlil1ti uucolored itîtaiammation corpuseles and cetis ; bebideus wliclii tliby rricxLetiy are clcvelopud. iiito pmgica lent , Ortenl fihlnd w~illi black gatl-,inisoluble iniitierai acide-. TVite silail corputscles result ing fromi the tratasiorniatiotn et thei blood-corpu)tscles, iîowver, do uio atxvays becoimu Clteloscci in colis, but frc'qucntty reomain accuinuLatcd in large irugl ases. In te coagulated, fibrine, colis origitiate by flice two tharacteristie inodes, and aiso fbeareolar bissuc, adipo)se liesue, and eveta osseous tissue. Il i:s by 1ite t-eitntorpliosis alonc of Iiis fibrille, dm1a wounids hucai pur rrimrat itatetiolicîn, and nI h)y a new exudation. -Metatiotie tutneors,, sarcorna, -and osteoid, sometiimes owv 'leur origin Io bloLt whichl lias escaped frora the vessels. FlETII SECTION. PJoetica. Pyoemnia cotisisîýs iii a conaitigliiîg of pus wviiilite cir-",
         "ORIGINAL CoMMUNICATloNs. eulating blood. The pas is eier hIe result of a Irans- mation of a portion of hie latter, or it oblainis entranîec jino the circulation tlrough veins accidenîtally oneiicd. Tihe consequenuce of thue admixture ahnost always, tiough not necessarily, is siasis in the capillaries aud the conver- sioni of the blood of tiiese into pus wiI hIe formation of abscesses ; and in this muannter the laUer may originate in grealer or lesser number in the liver, spleen, kidneys, lungs, brain, and more rarely iii ohier organs, as benîeathl the skin, ii the mueles, and int joints.' This traisformatioii of ihe blood into pus, is nost frequently induced by Ilhe spoitaneous conversion of coagulated blood into thai muaterial. 'he definitioi above given of pyamuia is not the usual one, but I hope the following explanation will justify its adoptioni. On examining cases which have died after extensive surgical operations, and more espccially where suppurating wounds have existed, frequetly abscesses are found inI te luangs, liver, sometimes in the kidneys, spleen, other or internal or some exiemal organ. This faer, long known, since the last century, las beenî the subject of numerous theoretical and cxperimental researches to determine ils cliaracter. These investigations, which have always borne the inpress of the limes, and hie id ýas Of the prevailing school, evidently are not only of scientific interest, but au of practical importance, as upon. the exactness of our kinow- ledge of the production of sucli abscesses, ve ean alone depend for precautionary measures to diminlish i great imortality which still follows amputations. The first idea whicl obtruded ilself as an explanationi was that tIe pus of a suppurating wound became absorbed, and was depositcd in) the orgals above indieaed, costi- tuting the so-called metastalie abseesses. This vicw was supported by the usual diminution of suppuration in thc wound, the absence of evident iunmatory symptomns ini the organs which had become the seat of the metastain abscesses in so short a period, and tie presence of pus il) tIe veins and lympatics, frequcnly ihlemiselves u flamed. But to this explanation, latterly, the objection lias becl advanced, that as pns consists cf a liquid with solid co- puscles, which cannot be resorbed through capillary walk Serlhaiýi. le tirmo is niot far off wln w- Iull return t-- Ille -inw D )o nfrDo il ,' m;uidere'd tha~t, under rrtnin c'ircumstance.us î'us ou!d form:x m Lte ilid, na dWo~ Ulu the: phzysilgical condition.\"-..nrdral. 196",
         "iD.t'i'IIOLOGICAL lII5TOLOLx5£. 11Le pu-~ corjpIoScles ini tlhe circulation alnd aîb.\"cessýe\" oould uio liave het'n (Icrived frotn t1le s\u003ep)urating wolind. Anollier idea becaînc prevaleilt, thlat hIe. absesseis xver tuie result of local iintlanîîra1iow.s, and ttic pus withix ihe veins -was ilivre fornied îliron-g iîiflanîmnatioîî of tIIesýe vCsý-kýv (Danc:e). Sonme autiiors, but cspccialty 1Blaiul ati (3ruveillnier, atlvpîed piebitis as the eàise il -ntaaiv abs\"iSsscs, and hIe latter even a \" pIlýlbie capillaire.\" IlI lias beenu proved by strietly physicalepelet\" ýays Cruveiliier \"that pus cclaigwiflh tJxc blood Stag -nates ini varions parts of Ille capillary sysierri, cvcry- wlhere inducing inflammration of the venonzs capillarics oï circutimcribed inflainm-ations, -hic more or less rapidly run ticir course to tlle formnation ofabcsc. F'ilîudly, Sédillot very correctly remnarizcd ihlat pvoeiaz is the resuint or commingliiig pas-corpuiscles wvitl thie blood, wiliihtra \u003c i n Ille -ascular e\\treitiies, eîo ai lary circulation, and induce Ille formation of simalf foci tj! iliammnation. hL lq flot thle Conisetneie of ail admixture of a puîrid serous liquid .vit I i he blood, as silpposed by Bérarud, for titis wvouldI ratier operate ini Ille production o 'Ihat pus may bc introduced tlirong.h open veins imine uiaiely mmt hIe circulatinig blood and becominerngl wiii h is, and i lducencasai abscesses, is nut presclnt no# a,-,bject of doubt. Thie occurrence of tiiose rare cases i wllich such al)sccss!s forrn Nvithout plîlnbitis, and t1ic circumstanee Iliat usnally a coaigtilkii of blood incloses Ili(. pus Nvithin Ille velus, is variotl:y cxplainled by uutlors.j The con-alnm, by înost of thc la!ter, is considercd inisufli- tilent Io prevent Ille entlranice 0f pas iulio tlle circulation, ziîud Rihnosi al agrret' that pli is strpara-tetl fron Ille iliner surf-ace of the wen;xhivih idea, so gelnerally prevalei, i's til rzit CiI ,IIY Ille th' VIole proeess of piebitis as weil l:a pyatilia) lias bueîi nisuier.ýlood, ntimsaiin olîn telleliî anaîonnical researchevs. But ilii what foioî. 1h0pe ho prove thai pyZenna oFigillalCs by tr(fom )Joîo 11-- blotît wihhin Ille vcs-els, \\vý n bout liccess-ary parlii.pa lion orf their walls, and thlat his. 1 rauisformai,!,io!î Irnay eu troiU J)reedingzstasisof blood ln te venevein witliotit titi Previons existence of abseesses. Iti~an l..t\u003c' t,\u0026.iQ ln ti.-. ii =1id ('f~i ni11 0f! w.îeti, l'uiîaîîî t IL Lý b,,ts uîot tcn proîel, iiiid ini th,~ îe mizlir).t i u vrtaisly le u(t.! tc.",
         "ORIG1NAL COMMUNICATIONS. 25. Cowflition oflQ Pyemia'. 1. The irritation of the imer membrane of veins iby means of foreign bodies, according to niy experimetis, neitiier induce rediiess in nor deposit upon it, and the samne is ite case with the lining membrane of the arteries Daily the veins are cut in bleeding, and nevertheless suppuration does not occur in them. 2. On the contrary, the more vascular external 'tnie of veins is frequently the seat of exudation, and less so of suppuration, as well fror exterior irritants as from thie influence of these il their imimediate viciniity,-primitive phlebitis. The pus, which is forrîed under tiese circum- stances, cau peneirate only to the lining membrane of Ile veins, iii whicih position it can induce secondary stagnation of the blood withinî the latter, as in the reverse case stagna- tion of the blood within a vein readily induces inflamnation of its cellular tunie, bceause the venous nutrient vessels which open directly into the vein are impeded by the closure Of the latter. 3. This pienomenon does not in ilself determine pyemia. 4. 'Tihe introduction of substances into the veins which cannot pass througlh the capillaries, as, for instance, when mcrcury is injected into the jugular vein, induces the formation of minute abscesses in the lungs around aci srnall globule of the inetal, vhich, however, do not contain pus, as formerly believed, but inflammadon-corpusces.. in a simillar mcchanical manner pus-corpus.cles operate in the capillaries, destroying the circulation, and causing hIe convCrsion of thcir blood into pus. 5. Injection of a small quantity of pus into the veins does not determine the formation of abscesses, but ilese are always produced wlien a considerable portion is iltro- duced. Nor does the injection of liquor puris inito veiIts produce metastatic abscesses ; but the introduction, in this way, of a large quantity of pus-corpuscles always induces the formation of abscesses surrounded by ecchymoses, and accoipanied by rapid destruction of the parenchyna. 6. The principal cause of py:mia is co:igalaion of biloOd in the veins, vhich thon undergoes conversion int0 pUS, and is ihus conveyed into the capillaries.‡ * Se Arteriix, PaIh . Ani vt. 14, and Virlcw s Archàiv. Simill.r results we oblaita by Meine, and hw hais arrived at the san. vew as t\u003e the causEL fy-mia, for an i accOun'e whiich. .'ee vî ilunehichs Archiv, 154$, IPmniai, l'axth. A natS. pt, vI. : To the exoin ,of two rmsof phihtiei-in tho first ofiwhichi hlie intexnammation Off vexions cats le porimiry and the caxulation the resu in the ieond, the latter U itii essential,.nndi the fiîmner sie*indary;-attentioîn was first dixrreted by Tikinîtan....-.... the tirt tit I consider the pus launîd in th icius li the both ces !o .C directly fro\" rront thie blood, dio I differ fron the c. cellcnt Winvce xaatomi; 1191-",
         "PATHOLOGICAL 1IiSTOLOGY. 7. Thiis coagulation of tIe blood is indtuced especialt under the following conditions:- a. Through inflammatory thickeninug of the external tanie of veins from contact writi fibrinous exudation and pus. b. Througt pressure of tumors upon the veins. c. Through the accidental entrance of pus into veins fror withoui, as in the suppurating woundsoframputation, aid after ulceration of the venous parietes. d. Tlrough contact of thin-walted vessels withi exudation undergoing dceomposition, as in tie case of the inner sirface of ic inflamed uterus after clild-birth. Inflamnma- tion-corpuscles arc found upon tbe inner surface of lie tterus after every delivery, particularly in tIe position whichi was occupied by tie placenta. If tis is not expellcd or decomposed, stasis next occurs in the neigh- boring vessels, and Ibis is tie truc source of the pus in the phlebitis of lyiig-in women. How, otlerwise, could so large a quantity of pus in a few days trainsude into the veils throngh their tlick walls ? e. Siasis of tie blood in a large number of capillari\"s of m organ frequently determine coagulation in ils arteries aUd veins, as in pneurmonia. Olther observers, instead of viewing tiis pienomnenon as a natural consequence, have ensidered it a cause of the inflammation of the lnags. ln le saine manner nephritis may determiine coagulation and 'e formation of pus in the veils of hie lower extremilties. f. Even continued pressure upon a part in whieb Ie irelation is lesw iavored, as in the foot, some-tiics induces 'aignation of the blood in veins of the vhole extremity, snaetines giving rise in iheir vicinity to rapidly destrue- 'ir absesses, wbichî appear to proceed fron a conversion ,Ihe blood in the capillaries into pus. g. The introduction of organic matter iii a state al composition into the capillary sysien operates in pro heing coagulation of the blood in Ithe veins. il tlhis ann1ler the poisonous material of dcead bodies and tIe a1t(er of glanders give rise to metastatic abscesses, at firs; 1the incrior part of the body, and subsequently in Ie al organs. . This coagulation of Ie blood, whlose miosi important s1 have now been indlicated, lwise in itelf doios 4 determ-ine pyxmia. if veins feel h-ard and become Mini, Ic case is usually considerecd as mne of phle bitis, bul Orrectly, for a vein may be filled wiith firi coagula, and limb be deinatous and painful witliot a trace i",
         "ORIGINAL COMMUNICATIONS. existing inflarnmatory cxudation, as I have observed in phliegnasia alba dolons. 9. If blood is coagulated in the veins, it may again become liquified, and the circulation be thus restored. This is not a cured phlebitis, but flte coagula of blood have again become fluid, and the production of abscesses through exudation from the capillaries has becu prcvented.\" 10. Or the stagnated blood undergoes transformation. It cither forras inflammation-corpuscles, or ils hematine undergo0e .onversion into pigment granules or cells, whieb, as before reliarked, are the safest signs that co agulationî of the blood in the vessels had occurred during life. Thie fibrine, under such circuinstances, adheres firmly to tle imuer surface of the veins, and becomes converted into an irregular fibro-us tissue, from which the vessels, with or without previous inflammation exudation into their external tunics, arc tranformed into fibrous cords. 11. Or the coagulum is converted into pus. 12. I have already proved that inflammation-corpuscles and fibres may forrm in Ile blood itself; and it only romains to show the possibility of ils conversion into pus. 13. It is a fact known to all who have made frequent autopsies, ihat in case of abscesses and suppuration gen- erally, veins vith their parietes entirely uninjured occur filled with pus, and that this latter may be fourid withini blood coagula, even in the heart itself. In such an instance the introduction of pasfrom a suppurating surface cannot admit of a thought. Cases also occur in which a vein is visibly filled with mingled blood and pus, and ye1 ils -walls are unbroken, and an abscess is nowhere to be found.† Such an one I shall hcreafter describe. 14. The pus-is formed at the expense of the fibrine of the blood, and not direclly from blood-corpuscles, which, however, undergoes solution. In the process Ihe fibrille becones soft, grayish in color, and in it appear miite nuclcoli, often surrounded by a clearer substance disinlcIy defined, which are \"0 constitute the future pus-eorpusics 15. 'Tie coagulum is rarely tranisformed into pus witdQ eoming into immediate contact with pus introduced iito the veins, as after amputation-wounds, or unless the vnfloUs * su:ch reiquefacxvtion ? of c uinted blod in, tihe cilaties i fr.quenltly oiM*rtl n ..qperintents ..n the. wtlb of the. frog.N f'on, nndi iia in mn aifter Venei ecti'n. j.rni frogi. noo'rding t i my obs'ervaUansi' :aî.1 ti.-e. of Web1er, a~ r utarkaîb q ivinîîh-corpuscl. ihrm in.s î»tagnated bilood. IL hs :thvady been mentom d tiit ; puserpurelo have un absolute distinctive, ciaratct.r., yet the-y are readily NN M ihl posies sev'r mncleoli, frmi thi e smoth. r, indli.stiocty nuclolat d Jymph\u003cor in wichr vi. w i e'ntirely corr-espond wiith Dr Ihr 2 00",
         "PATHOLOGICAL HISTOLOGY. parietes are in contact with exudation and pus. In the case of arteries, the thickness of their parietes serves as a protection against the conversion of coagula into pus, and probably is the reason why this is so rarely found within 16. Iow pus in this case operates upon the blood is unknown, but the old maxim \" pus produces pus,\" liera finds its full application. 17. Even yet the morbid process of the production of pus may be local, for a portion of coagulum may close it off from the blood above, or below and above. Pyaimia may thus not occur, though this is rarely the case. Of this description Cruveilhier* mentions one of phlebitis of a superficial vein of the mammary gland, froin which he had enptied the pus, which was reproduced for a fortnight, whein it terminated without further consequences, with the closing up or obliteration of the vein. 18. But usually the plug of coagulum is useless, and the pus derived from the transformation of the fibrine passes into the circulation. Sometimes, according to the observations of Blanidin, Sedillot and myself, the coagulum is entirely absent or is imperfect. Inthose organs in which foreign substances introduced into the circulation,† arc usually depositcd accumulations of pus form, surrouinded by ecchymoses, which bear the impressions of a suddenly arrested circulation in the capillaries; in w'hich, as in gangrane, when the latter occurs, the tissues quickly die and become mingled in fragments with the pus; hence the Peculiar appearance of these metastatic abscesses, which ae deep, of a dirty gray color, and surrounded by dark cclymoses. 19. These abscesses I do not view merely as the result f lte transmitted and accummulated pus, for pus-corpus- des eau very well pass ihrough certain capillaries; as, for $stance, the large capillary vessels of the liver; but under e influence of the transforming fibrine, yet in a flocculent Wndition, stasis of the blood occurs, and a new formation 4pus is the consequence. 20. Pus may directly enter a gaping vein by aspiratin, a the same manner as air does. Tlhis is, however, rare ; -eause, in amputations, usually the vcins become closed fore the suppuration is considerable. It is not the intro- ced pus which forns metastatic abscesses, for there is y ) ,YerL. lx remindid þf mv û,irimients, and t1se of Thierneme, of nourihing n oil and injecting thi linto thu vcins; niso to the reerches of cruvenlhier. C 2 201I",
         "ORIGINAL COMMUNICATIONS. nothing to indicate that the quantity is suffliciently large for such a purpose; but il is the stasis and transformation of the blood induced in the capillaries of the organs reaclhed by the pus, which produce them. 21. The reception of the serum of pus by resorption into the blood- for we have no evidence that pus-corp uscles can pass through Ine parietes of capillaries without previons liquefaction-does not induce pySmia. This is proved by the frequently observed disappearance of pus from serons cavities after inflammation in the lover animals, or after injections in the same. The undecomposed seruminjected in a considerable quantity does not produce pyæmia, as has already been proved by Sèdillot. 22. Pyæemia then consists in the transformation of the blood into pLis within the capillaries and veins. It is not pus-corpuscles wvhich form metastatic abscesses; but, witli fibrinous floculi, they give rise to stasis and transformation ot the blood in the capillaries, and exudations from these, which result in the abscesses. 23. Analogo i to this is the transformation of lymph into pus, which, in Ilhe -o-called inflammation of the lympha- tics, is certainly not separated from the walls of the latter. For pyomia to originate by absorption through lympha- tics is not possible, becaùe the pus-corpuscles cannot penetrate iheir partietes. 24. Suppuration in some position of the body usually precedes pySmia, but this is not essential. 25. Prom what has been above stated, it can be under- stood why every injury of veins, inducing coagulation within, and suppuration -in the vicinity of those vessels, is usually so dangerous. 26. The danger of pyoemia does not arise fromI the influence of any malignant property of normal pus upon the blood ; for it is well known large accumulations remain a long time in cavities of the body, but fron the mechanical impedinents in the capillary circulation, to which it gives rise by inducing stasis, particularly when coagula imûper- fectly converted into pus are simultaneously carried alonvg with the circulation. The mechanical operation alone of pus, however, is not sufficient in all cases of pyonia 10 account for death. Such cases occur, on the contrary, 3i which the blood bas lost ils capability of coagulatQfil apparently the result of contact with pus in the act of decomposition, and no simultaneous production of pus induced in other parts of the body. 26. On thCPurulent dyScrasia. All surgeons are acquainted with the fact, that frequletlYi 202 Q",
         "THE 111P-JOINT. without evident cause in various exterrial and iniernal parts of the body, numerous abscesses gradually or sirmul- tanceously form. The name of purulent dyserasy iay he retained for such cases, as nothing indicates that the blood is converted into pus within the vessels'; and we must, therefore, admit a general disposition to the formation of pus through exudation from the blood. (To be continued.) ART. XLIII.-The Hip-joint--Considerations on ils injunes and discases, dcduccdfrom te ./Inatony; by S. J. STRATÏORD, M.R.C.S., Eng., Toronto, continuecdfrom .Yo. 3. INFLANM3ATION OF THIE LI0A3IENTS OF THE HIIP-JOINT. (/7cntinued.) In a preceding number of the Journal, we pointed out the anatomical nature of articular cartilage, and demonstrated that a knowledge of its structure and function was neces- sary to enable us to comprehend the phenomena of inflam- mation when it attacks this portion of the joint. Wc indicated that in inflammation of cartilage the destruction ofthe cell apparatus and the solution of its fibrous element, was that condition which lias long been spoken of as UIeeration of articular cartilage, and that the absence of nervous filaments sufficiently accounts for the little irritation k this complaint, while the nature and character of its iflammatory action has not been understood for the want of the minute anatomical knowledge necessary to enable 43 to comprehend it; but nov that the microscope has exhibited the true condition of the part, the solution of this dilicult point was readily obtained. It must be clear, from the foregoing facts, that this disease of the cartilage which we have been describing, nay at My moment, when it bas amounted to any considerable !xtent, invoive the structure of the synovial membrane from lProximity, the inflammatory action will extend o it, and ýhen inflamed, eaci and every symptom and result of sueli ksease will be speedily developed, such as the effusion tsrum, or of coagulable lymph into the cavity of the hip- nIMt. This inflammatory action however may not be so 'Ite as to produce any extreme results, while the disease aY continue to extend in the structure of the cartilage, ýfmetimes involving the whole cartilaginous coverinm ofihe ur, and largely implicating that which lines the c iyloid aity. This is certainly the history of the progress o the",
         "ORIGINAL COMMUNICATIONS. complaint long since pointed out by Sir B. Brodic as a distinct disease, and described by him as ulceration of the articular cartilages. Again: the efflsion of fluid blastema, which takes place from the conjested ampullh of the cartilage, may be so extensive, that i. may take on the changes to which this substance is liable as a result of inflaimatory action, it may soften, and the pus corpuscle may be developed; this is certainly rare in inflammation of the cartilages, but nevertheless it does occur, and would secm most frequently to happen around the vascular apparatus, hvich connects the cartilage to the synovial membrane. When this morbid product has been softened and the pus corpuscle formed, its effects will commonly extend to the neigh- bouring tissues, the calcarions salis will be dissolved by the liquor puris, so aiso mny the fibrous element of the cartilage, until by degrees we find a considera- ble cavity to result, and progressing, this abscess may extend to the cancellaied structure of the bone, and by degrees find ils way through %he periosteum into the areolar tissue surrounding the bone, or burrowing down among the muscles, may obtain an exit through the skin; again,it may destroy the basement membrane of the synovial tissue, and escape into the cavity of the joint. When the disease bas commenced on the articulating surface of Ihe cartilage it will cornmonly indvce disease of the several textures of the joint, which will in nowise differ from lte changes already detailed, as the ultimate resut of inflamma- tion ofthe synovial membrane. The diseasewill l)e subnit- ted to the same chances of recovery, or produce the same ultimate results, always ending either in deformity or deah. It is a fact worthy of remark, tiat although we ray wlh sufficient accuracy diagnose the primary symptoms iat indicate inflammation of the separate tissues of the hip-joilit, but as soon as matter lias been developed ii the joint all chances of distinction are finally lost, for all the structures become similarly effected, and al! the symptoms are co* founded in a general result. In acute inflammation of the cartilage the changes progress with such rapidity that il speedily involves all th textures of the joint, and it can seldom be recognized as. distinct disease, while the state of chronic inflamnation continually presented 1o our view, and may be recognizi with comparative ease. The most usual period of the advent of chronic ifle mation of the cartilage is after the age of pubertY 'l' 204",
         "TrE re1P-JOINT. passed ; it may occur in children, and vill occasionally happen in old people. It nay sometimes be traccd to a blow, or injury, or nay be developed by inordinate exercise, while il not unfrequently appears without any known or recognized cause. The disease may be 'confined to the hipjoint, or il may simultancously appear in other joints at the same lime. The first symptoms which mark tie approach of this insidious discase is a sligh t degrce of pain in the joint incrcased upon pressing the boues together, and more or less inability in tie use ol the joint; this may continue for mothls, and is unattended with any appear- ance of swelling or effusion within the joint ; these arc the chief symptomatic indications of clronic inflammation of the cartilage in ils earliest stages, and witlh the absence of any sensible disease in any of the otier structures of the joint, nust alone guide our judgmenl. After a time, how- ever, the pain greatly augments in severity, and motion vastly increases it, while the patient is continually roused from his sleep by spasinodie starting of the limb, pressure upon the trolianter, or the forcing the thigh-bonc into ils socket, causes great complaint. We not unfrequently find the lyipliatic glands in the groin become tonder and swelled; they may inflame and suppurate: this is doubtless dependent upon a low irritative inflammation viich lias followed the course of lymphatie vessels from the diceased joints, and, mnay be dependent upon the absorption of the dissolved tissues within the joint. From the absolute necessity of perfect rest in the diseased joint, the hip lias become less prominent, lias considerably lost its usual convexity, while tie muscles feel Ilaccid, hang loose and gabby; Uie same necessity also for the fixed position of the joint, causes a change in the position of the pelvis, and Ile signoid flexure of the spine is not of unusual occurrence. These symuptons liaving progressed for an indefinite period, Ile sudden advent of inqammation of the synovial mem- bane may be added ; the acute pain and swelling of the Pift, which so decidcdly marks the appearance of this sease, may be present itself, and nay rapidly go on to ti those changes incident to acute disease of this structure s5uch as the effusion of scrnum, or the deposit of fibrine, or of Iastema into the cavity of the joint ; should matter tow be lamed in the joint, the progress and course of events will 'ar a strict analogy, with ail the consequences previously ,tailed, as resulting fron acute inflammation of the ?niiovial membrane, such as, ulceration of the cartilages, Ities of the bones, and destruction of the capsular and 200",
         "1ORIGINAL COMMUNICATIONS. round ligaments, while the disease will eventually end iii dislocation of the coxo-femoral articulation, followed by anchylosis or death. The treatment of this disease should be regulated by the principles indicated in the cure of chronie inflammation of the hip-joint, such as local bleeding and Ilie employment of contra-irritation. The remarkable tardy progress of the malady would indicale in the earlier stages the inapplica- bility of active means ; seatons, issues:or perpetual blisters will be found far the most useful, and also, from thc chronie nature of the disease, will in ail probability have to be continued with unremitting perseverance. Another means peculiarly applicable Io this disease of the hip-joint is the employment of the splint to the discased limb, so as to preserve lhejointfree from all possible notion,and so toallay the irritation of structure which friction and, pressure must necessarily keep up in the part; it is an indication of nature, and deserves to be strictly and patiently attended to. The employment of alterative medicines, and the strictest attei- tion to general health, should not be overlooked. By sucli means we may occasionally accomplish a cure of the disease ; but should inflammation of the synovial membrane rake its appearance and be attended vith the formation of iatter in the joint, the general principles advocated 0 the treatment of that disease must be strictly adhered Io- such as a free, and early opening for the exit of matter- and the prompt excision of the head of the femur; when destruction of the cartilages, ulceration and carries of the bones is clearly established. Inflammation of the head and ncck of the thigh-bone. Inflammation of lie spongy or cancellated structure of the head and neck of the thigh-bone may occur; as -an acute and idiopathic disease, its attack may be compara- tively sudden, and ils progress extremely rapid. It will be attended with severe deep-seated pain in the region of ihe hip-joint, that will not be increased by motion of the parts one upon the other. The neck of the thigh-bone may appear tender, upon direct pressure. The constitution Wll be evidently greatly alarmed, as evinced by the Violenlt inflammatory fever that accompanies ils advent, a strong indication that severe mischief is going on in the part, and, with evidence that is afforded upon our examination of the hip-joint, will readily point to the seat of the complaint. To comprehend the changes which occur m t complaint, the character of the structure reqries due consideration, before we can appreciate the vaioUs 206",
         "THE IIIP-JOINT. alterations which occur in it. The licad and neck of the thigh bone consists of dense external plates, or laminoe of bone, superiorly covered with cartilage; betwecen which numerous cancelli, or small hollows bounded with very thin plates of bone, and lined vith an extremely vascular membrane, which communicates with the medullary canal ; thesc cavities arc filled with a peculiar adipose matter. The Haversian canals traverse the bard substance of the bone. These canals run for the most part in the direction of the lamino and carry the blood-vessels which serve to nourish the bone and support the life of the part. The size of these canals vary from 1-200th to 1-2000th of an inch. The smaller carry but one capillary vesse], while several may be observed in the larger ones, and to iese is added a quantity of adipose matter. Around these caials the bony matter is arranged in concentric circles, and these circles are marked by a series of stellated points, they are cavities or lacuno of a particular form, and run in the course of the laminoe ; they are so placed that one of their sides is turne - towards the Haversian canal, and the other towards its fellow in the circle beyond it. They are of a Ienticular or oval form ; their long diameter is generally from 1-2400th to 1-1600th of an inch, while their thickness is about one sixth of their length. These canaliculi com- l1eely traverse the substance of'the bone and communicate ïregularly with one another-in this manner a perfect communication is kept up between the Haversian canals and the most external concentric lamino of bone. The can- aliculi which form this junction are infinitely snali, being Only from 1-1400th to 1-2000th, on even 1-60,000 part of an mei in diameter. The blood, in the normal state of the Parts wvi1l penetrate the Haversian canals and cancelli; but il is obviously impossible for the red globules of the blood tO Penetrate the canaliculi,-consequcntly only the more flid parts, containing the salts of the blood in solution, leep up a sort of circulation through the osseous substance. This apparatus presents a means, whereby the eartihy 'atter of the bones may be deposited on cach portion of the bous structure, of which the primary element of bone is Composed. Here then we find a condition of parts, which Pimits a free circulation of healthy arterial blood into the Centre of the most dense structure of bone ; a condition of 5ition which certainly presents considerable peculiarity t ils character, insomuch that the deposit of the inorganic Oaterials of the blood required to give that hardness and Uability to the bone has a facility of operation that could not",
         "ORIGINAL COMIMUNICATIONS. otherwise be obtained ; for by means of this apparatus, the canaliculi carrying but a serous fluid with the car- bonate and phosphate of lime and the other salts of tie bone in solution, are conveyed to the part; the deposit of earthy matter is accomplished with great case, and is continually under the influence of this; circulatory apparatus. The fibrous element in which this earthy material is deposited is comparatively of low vitality, requiring but to be moistened to preserve its normal condition; the carthy matter of bone continually varies in amount, and this is the means by which these materials may be deposited, and enables them to be so constantly changed in health and in disease ; presentiug the ever varying amount of the earthy salts, so evidentat different periods of life : thus in Mollities ossium the bony matter is found deficient, so ihat the bones arc soft aud casily bem, while in old persons it is superabundanti amount, and the bones have become abnorrnally britile. From this condition of the part also, and the nature of the nutrative apparatus in bone, we cau readily comprehend the peculiarity of its diseases; we can understand tit should inflammatory action occur in this structure, tiat ils unyielding character would in al[ probability cause if speedily to run into stasis-the collection of blastena in the laversian canals and the other capillary vessels of boue might give rise to the formation of the pus corpuscles, but that the chief peculiarity would be the rapidity with whicih this stasis of the circulation is accomplished, and frorn the unyielding material witl which it is surrounded, it rapidly causes the death of the part. This state of things also accounts for the intense pain and great constitutiolial irritation which is so rapidly developed ; so that on the VerY first advent of acute inflammation of bone, this condiioln of stasis is speedily recognized by the intensity in thec amount and duration of the cold shivering which is ahvays a most prominent symptom. The general*ty of long bones derive their capillary ) nutrient vessels cither from the p)eriosteum or meduillaY cavity, but the neck of the thigh-bone is very peculiardY situated ith respect to its circulation. This portiOl the bone is in the first place surrounded by dense fibrous structure, a reflection of the capsular ligament ; and thlis i again covered with synovial membrane, which embraces i as a glove covers a finger, while it is aliost entilrl, lacking that periosteum which carries the blood-vesels the outer lamina of bone ; this complication makes the 208",
         "THE IIIP-JOINT. whole extent of the neck of the thigh-bone more liable to be implicated in the complaints which originale in the varions structures of the joint, or, should disease occur in the bone, as a mater of course, it vill early implicate the adjacent tissues of the hip-joint, and soon involve all in indiscri- minate discase. From the position of the neck of the thigh-bone, we find the ,ascular periosteum by which the hard lamina of the eircumference of the shaft of the bone is nourished is absent, and the blood-vessels are necessarily derived fromn the nutrient apparatus of the sparsely nourished capsular ligament which surrounds it; hence in cases of death of this part of the bone, the impossi- bility of any attempt at repair. In the next place, the cancelli of the interior obtain their circulating material [rom the medullary canal,-this is doubtless greater in amount, and more fully supplied, than the Haversian canas; so also the more yielding and comparatively lax structure of the cancelli permits a greater amount of hvperomic action, causes a far redder appearance in this part of the boue, and affords a much greaier latitude for the deposit of blastema than can be expected to occur in the more dense structure of the shaft of the bone ; so that we fld thAt inflammation is more apt to cause the death of the bone in the latter than in the former structure; so aiso we find y experience that nccrosis is nmueh more common in the lard shaft of the bone than in the more loose and open tnure of the articulating extrermities-these however are 2ot entircly exempt frorm sucli a result of inflammatory 1Ition, and as a consequence of chronic inflammation it will ecasionally be found to occur. Thirdly, the head of the thigh- tfle is supplied with blood-vessels which take their course ding Ihe ligamentum teres ; these dip down into the Éueture of the bone, and supply a considerable portion of ce cancelli of the superior part of it ; doubtless they hosculate freely with the other portions of this circulating Wparatus, or else the head of the bone would invariably bifer whenever dislocation occurs, as this ligamentum res is always torn aeross. 'lie first step in inflammatory action is an increased brply of blood sent to the eirculating apparatus of the aqe-the capillary vessels in the IIaversian canals.-The 'sequent stages of inflammatory action are followed up; inereased amount of serous fluid is given out to th', !Uliculi and lacuna, giving ris to solution of the earthy ltier and its removal from the fibrous clement, whichl become swclled and morbidly softeued; and this Dn2",
         "OrIGINAL COMMUNICATIONS. is followed by the effusion of albumen and fibrine, and the deposit of blastema into the cancelli, so that this structure is completely filled, and the circulating apparatus compressed and blocked up. Thiis condition occurs far more readily in the unyielding structure of the Haversian canals than in the free and open texture of the cancelli; but even here it readily occurs, causing a complete stasis of the circulation and producing the death of hie boue. As soon as this condition lias taken place, the dead bone takes on the character of a foreign body, and produces alil the effects of such a substance on the surrounding parts. Should this condition be the result of acute inflammation of the head and neck of the thigh bone, the probability is that it speedily involves the whole bony structure ; but if it should be partial and chronic in its action, a portion only of the bone may be destroyed. In the first instance, the whoIle of the hip-joint would without doubt be rapidly involved in one general disease, but in the other variety, the structu'es of the joint might not be so quickly implicated, taking up its various actions but as a secondary resulh. The blasiema deposited ito the cancelli undergoes the same softening it wouid in other positions, and the pus corpuscles arc formed in greater or Icss quantity, according to tie amount of lie deposit, but from the unyielding nature of lie structure this is gencrally not very C ,ious but when the formation of pus does occur in this parl, il is always atcnded with symptoms of extreme constitu- iional irritation, much greater than mark its occurrence in most other parts of the body. The cold shivcring is cOm- monly intense, and is followed with great inlflanimiatory fever, hence we have a diagnostic symptom of great value in these cases. As I have before said, it seldom happenS that acute inflammation of the bone lias arrived at tlis staige, witeout the various textures cf the joint participating in the disese. Tlie circulating apparatus of the cartilage and of the synovial membrane have become implicated, and the successive stages of inflammation may rapdVl follow aci other, involving the whole joi t i idiscanr. nate disease, suppuration and destruction, followed by ulecration and consequitive dislocation, which alone stoPS the progress of the complaint and gives nature a chance 0 set up a proeess of repair. If lie amount of dead bone should be but small,i matter formed among the cancelli, nay find its waV ou' by ulecrative absorption into tie joint ; or being locited iear' 11he shaft of the ihigh-bone, it may pass down amnonig 210",
         "THE IIIP-JOINT. muscles, and arriving at the skin be evacuated tlrough it, leaving sinuses behind it. 'Tie precise process by wiici Ibis uleerative absorption is arrived at in the living bone lias beei previously dwelt upon, it consists ii the solution of Ihe s-dis of the bone in the liquor puris or ,erua of the blood ; the fibrous element itself may, whixen dcad, be softened and dissolved, until it likewise is renoved fromn its connection with te living system ; so thiat by degrees we not only find a new passage formed for the pus, but also that the dead boue is isolated fron the living structures ; and if a probe is introduced into the sinuses, we may find the bote dead and rongh, and perhaps discover that il is separated and noveable iii the cavity vhich it lias formed for itself ; and, was it not for the peculiar posi- tion and connection of lthe head and nieck of the thigi-bone, we right have hoped tihat the dead sequestrium mnight evenually be removed from the living structure, and the disease be cured by nature. The faillaey, however, of such a hope must bc evident, from the isolaiecd position of the bone, whilch nust clearly show the little chauce of a natural cure, and that this chance, if any at all, must entirely depend upon lte position of the dead portion ; for did the sequestrium approachx the head of the bone, it is impossible that the various stages of this disease should progress wvithout inlluencing the other structures of the joint and involvùig all in one common disease ; but was il situated pwncipally ai lte trochauterie extremity, we might be more lilkely to find a favorable termination to the cOmplaint. This condition of the bone, dead fron inflam- Matory action, must not be confounxdcd with the result of the éposit of tubercular matter in lte icad and ncck of the iigh-bone; to do so, vould bc to confounid two perfectly different conditions and possibly to substitute the treatment ofoeue, that cani be but partially relieved, for another that May be cured by nature, and vastly assisted by art. Should we be able to examine the diseased structure at Sis period of lime, ve should in all probability find one T more cavities containing portions of dead, perhaps ýetahhed boue, surrounded with pus, wvhich may or may \\ have communicated with uhe cavity of the joint, or i)ssibly vitl the external surface, by means of a fistulous ening. lThe cancellated structure of the bone surround- tle cavity appears natura 1, save that it is much redder a \\-ter than usual ; the cavity itself is linxed vith red vaseular Þnutions; and should the pus corpuscles have been txovCd, and the blastemia have been exhausted, a thin torous abnormal pus, consisting principally of areddish or",
         "ORIGINAL COMMUNICATIONS. brown-red fluid, will be evacuated. This is for the miost part the serum of the blood coloured by hinnatine, holding in solution dissolved or broken down corpuscles, the various salts of the bone, and the dead fibrons elenents of the sane. This material is in fact the active agent in the ulceraive process now going on ; so that this action, by the great and cxhausting discharge whicih it produces, even should the disease not spread to the joint, may so debilitaie the con- stitution, and destroy the heahh of the patient, as to dematid our active interference for the reroval of the sequestra. The question whicih next presents itself is that when the dead bone is renoved by ulceralion or dissolution, can the cavity again be filled up, consolhdated, and become normal bone ? From analogy we are bound to expect that it mnay. When we see the long sequestr-m of the shaft of the necrosed bone completely replaced, we apprehend that the process by which it will be accomplished is the same. In the regeneration of bone the pre-formation of cartilage is undoubted, an amorphose cyto-blastema, whicli is liquid ai firsi, afterwards soli , is yielded by lhe neighbouring blood-vessels; in this cartilage cells are formed-the original proteine conpound of the cyto-blastema is converted into chondrine-by degrees the cartilage corpuscles are enlarged in size and increased in numbers and collected together, lake on a peculiar arrangement. From these groups of cells cavities are formed, the future nedullary canals, the cancelli and the blood-vessels are developed. The fibrous texture of the intercellular tissue gradually undergoes a chang1; it becormes ossified by the d'epositiol of thc salts of the bone, which constitutes the future OSsOus lamina, while the organic bases have becn converted into common gelatine, having lost the chemical characters of cartilage in the full development of the bone tissues. From these facts ve learn that the unassisted powCers of nature are able to cure these diseases of boue; consequently, in ai] our attempts ai relief, we nmust follow in the footsteps of nature and remove the deal sequestrum as soon as it is loose and completely separatel from the living parts. In the first place, however, shouldl wec be able rightly to diagnose ibis disease in its earlies9 stages, when we find the patient complaining of veryusevcil pain in the :rochanter major and hie head of lic tihigh-ho'- this pain not bein.\u003e rncreased upon pressing the surfacesOfthe joint together, or on considerable motion, or on retracti0îO the thigh-bone out of the cotyloid cavity, jnstructing a that neither the synovial membrane, the ligaeto1 12",
         "T1E HIP-JOINT. strucinres, nor lthe cartilage were the seat of the disease ; while the great inflammatory fever, which tiis disease always presenis, indicating an intense amount of inflammatorv action, which neither the carti- lages or the ligaments of the joint commonly produce at their first outset. This condition of things clearly indicates the intense sympathetic influence with vwhici the constitution views titis affection of the bone ; and, should we now malke pressure behind the trochanter upon the neck of the diseased bone, the patient will in ail proba- bility complain of soreness of the part ; if so, we may justly conclude that inflammation of the neck of tIe thigh-bone lias occurred, and w,1l demand a most active treatm.at to subdue it,-free genîeral and topical bleeding, combined with active purgatives and antimonials, must be employed, -should these means fail and the advent of cold sluvering indicate the positive formation of inatter and the probable death of a part of the bony struetnres, wC cease to use such active means ; now the use of opiates to allay the painuis ail tiat ve can expect to accomplish in. Ihe present stage of the disease-keeping a sharp look out that the inflammatory action dots not extend into the joint; and if il does, by immediately combatting it with the most approved means, we mnay hope Io restrain ils extent and the bainful amount of its influence. Should we be so fortunate as to prevent the complaint from extendinginto the hip-joint and the further stages of the disease be in (lue lime accomplisied, the pus may find its W ay1 the surf.ace, and by neans of a probe perhaps wc mav clearly distinguish the sequestrum, and be assured that il is loose. We must now direct our attention to ils Temoval; this nay be done by enlarging the cpening in the soft parts either by following lte course of the sinuses Or making a direct opening into the part, when the dead lOne may perhaps be removc d vith the forceps ; or il may k tnecessary to enlarge the opening in the bone with a rharp chisel before we cati get it away ; ai ail events the sîmoval of lie dead bone is abolutely required and may l- accomplistted ai alniost any risks. Should il have so happeued itat, notwithstanding ail the etans we have uned, this diseased action ias estended othe joint and malter have formed within ti capsular aiament, our first object will be Io evacuate the pus, and as n1t as we shall have become convinced that there is no d11ance of saving Ihe joint, our best plan will be to -ut ýQwR and remove the head and neck of the thigh-bone. 21 1",
         "ORIGINAL COMMUNICATIONS. This operation vill at once remove the irritation that causes the continuance of the conplaint by separal.ing the diseased surfaces of the joint, and it will enable us Io remove the sequestrnm with facility ; after which, by perfect rest and the application of proper support to the liib, iii all probability, we may acconplish the formation of a false joint. without any great arnount of shortening or deforitny, and at a great saving of time and irritation to the constitu- tion of our patient. (To be continued.) BOOKS RECEIVED FOR REVIEW. Fanctional and Sympathetic Affections of the Head.-A Paper read before the Society of Statistical Medicine of NeV York.-By JOHN W. CORSON, Esq., M.D., late Physician to the Brooklyn City Hospital, and Physician to the New York Dispensary.-Ilolhnes, Gray \u0026 Co., corner of Centre and White Streets, New York, 1854. A well written, and Scientific Paper. We may mention ihat Dr. Corson was formerly a Student of the Toronto School of Medicine, and bids fair to gain considerable repulation in the city of New York. 214",
         "REVIEW. PIINCIPLES OF PHYSIOLOGY, GENERAL AND COM- PARATIVE.-1B W.ILLAM B. CARPENTER, M. D., F. R. S., Eminer in Physiology and Comparative Anatomy zn the Univcrsity of Loudon: .\u003eProjèssor of Medical Juisprudence in University College, 4c., 6-c. (Condnued from No. 3). PitUMARIY TISSUES OF ANIMALS, CONTINUED. In the last portion of our review of Mr. Carpenter's beautiful and elaborate work, we ventured to disagree with him when lie declares that \" nexv cells originate in plastie or formative material without any direct intervention of pre- existing cells,\" and we ventured to affirm, that from the nuclei elaborated in tIe epithelial structures of the lym- phatic glands we have an abundant source from w'henîce, not only Ihe cell formations contained within the blood, may bave their origin ; but we would even now add, that those cellselaborated in all the other structures of the animal frame, both in healih and under disease, may proceed from hie same source. ln the observations ve offered in the previous number, ve ventured to point ont that the albumen prepared in the alimentary canal, and absorbed in the blood, vas the pab- idum fron which the nucleaed epithelium of the lymplhatie ?lands obtained their formative material. In the egg of the 'hiek we have a rernarkable illustration of the fac, that in 'is instance a very large amount of this food is stored up kî the use of hIe cell formaions, that arc speedily to be lled into operation, in the production of the different tiimal structures of whirh ithe bird is composed. This Usrial having been collected and elaborated iii tle cesses of digestion in the human stomach, is absorbed 4the blood, and passing into the current of the circula- is by means of it applied to the perfect nourishment I developmîent of the varions cell formations, not only Yihined vithin the liquor sanguinis, but operatingin other uts of the body. In the egg, before it enters the circu- fluid, nay, within the blood itself, and even when",
         "effused through the blood-vessels during disease, this albumen still continues fluid, and only coagulates at a temperature of 1580 ; not so with fibrine, arrested compar- atively but for a moment in any portion of the circulating system, it immediately begins to coagulate ; while effised from the blood-vessels under disease, it rapidly becomes solid, and what is more, can nover again enter the circulat- ing system without being re-dissolved : on the contrary, when albumen is poured out into the meshes of hIe areolar tissue, it may again be readily taken up by the absorì ns, and carried into the circulating system. i re plainly exisis a marked diflfrence between these two substances. To quote Mr. Carpenter's own words,* \" lIt, is evident from these facts, that some peculiar agency must exist within the vessels, by which the claboration of fibrine from aibn- men is effected.\" This point is a great desideratum in physiology-the kuowledge from whence the fibrinie is derived, as vell as the source from which the nuclei of the animal cell developements originate, have lately clained great attention, and in the observations which we presumed Io inake in our last notice, it will be observed that we cnunciated a fact, which in our humble opinion is perfectly sufficient to explain these points-points which at no distant period we hope to prove by experiments. lt is really curious that a physiologist of Mr. Carpenter's acumen and experience could advocate the possibility of \" new cells originating in plastic or formative material without the direct intervention of cell nuclei.\" In veget- able cell developments the sporule may bo easily wafe in the atmosphere, and falling into positions favourable for its re-developmeni, may appear to grow without the visible influence of a nucleus, in such a case these merely escape observation from their minuteness; not so in the animal cell-such a condition could not precede their formation il] the mass of the circulating blood, the pre-existence Of a nucleus must absolutely exist. It cannot be disputed thata simple cell, exhibiting all the attributes of life I to be bora, to grow, to arrive ah maturity, to die, and ho be deconposed into original elements from which it sprang,\" exists in, ilis position, are abundantly present in the circulating current; and although it cannot always be shewn that these. Post tivcly produce their like, still their growth and destructin amply testify to the existence of that condition we call life. It is clear that many animal cells, after they are produced, *Principles of Hum-nu Phylisology, Philadelphit, p. 300, 150. 216 REVIEw.",
         "PRINCIPLES OF PHYSIOLOGY. are applied to particular purposes, and by their growth and development fulfil hIe purpos;es for which they were iii- icnded ; like tie epidenic and epfithelial cells, for example, ieir independent condition must plainly point to a nucleated origin, derived from a parenicell ; an\u003cl, although the uses for wilch they arc individually intehded are ditfer- ent, and the attributes and destiniies various, still we main- tain that position and local circumstances are suflicient to produce the variations in character and expression, such as we may constantly observe to happen in the wide ranges cf animated existence. It is, morcover, certain that if the attributes of life are possessed by the simple cell, and it is elcar fromI the obser- vation of these phenomena in their growth and develop- ment, that they mustdîlïer from the nature of the cell growthi, advanced by Archerson, such cells are only artificially pro- hieed by a layer of albumen surrounding a globule of fat; sucli cells as Gluge has justly said are as diflfrent froin the living products of \"vital agency as a corpse is froma a living body* sucli artificial cells are always non-nu- eleated and undergo no kinds of transformation,\" and we might add, cannot prodice their like. We then think il will be readily granted that the various corpuscles formed in the blood must have a nucleus for their origin, and we are infinitely indebled to Mr. Jones for bis rescarches clearly show that the various corpuscles present il the blood are but the several stages of development of esame mcleus, and point to lthe fact that wc are endeav- Ming to establish, that froni the epithelial cells produced ithe lymphatic glands originate the whole series of cor- iseles that exisis in the sanguineous fluid. These absor- -nt glandul placed either upon the lacteals on the ýesentery, or upon lymphaties in other parts of the body, bYe lte sanie gencral conformation, and are intended for rgilar purposes ; this purpose lias long been hid in inextrie- e mystery, but which the powers of Ihe microscope are ýely to urravel. 'T'lhe lacteals aid lymphatic vessels, single cylindrical canais ; accumulate and become aiged wh~en they reacli a gland ; are here dilated into teravities or eells,forming convolutions, while they are r'losed in a strong fibrous structure, derived fromn the c lar tissue ini their neighbourhood ; wihtn tIhis structure, 4 among the convolutions, are many capillary blood- set, but tihese do not open into the dilated lymphatic 1 dhey merelv ramify upon their coats and nourish the htelial structure'contained witinu them; as in other glands, E 2 217",
         "the exosmuotie action of dite capillary vessel supplies endos. mote inaterial to lie glaidular structure, t is a curious fact iliat in no instane cati we find that the circulatinig system in which the blond is contained lias any direct com. mnication with the structures it is iniended to nourish, further thai by transfusion throutgh the coafs of the blood vessels; that in fact Ithe whole circulating system of vessels, to all intents and puriposes constitutes a shut-sac, is lined with a serous membrane, ihis is endowed xvith a bascment membrane and epithelial cell formation. The epithelium lining the lymphatie vessel is minute, flat and scale-like, forming but a single layer upon the basement membrane, but as soon as it enters into the gland it is composed ol many sphcrical nueleated cells, whicli are easily detected and may be constantly seen floating in elyle.* These fori the nuclei of the blood-corpuscles ; they are firsit nourished by the exosmotic matter furnished by the capillary blood- vessel in the gland, but as soon as liberated, their pabulum consists of hIe albumen absorbed by the lacteals, and appro- priated by the endosmotie action of the nucleus, until il becomes developed into the white corpuscle of the blood. This act of appropriation is continued until the whole Cor. puscle arrives at full maturity-the contents of tlie ceil now consist of a large nuclcus and an elaboratcd product. the fbrine; and when the white corpuscle lias terntinated ils fuill period of grovth it opetis, and sets frec both Ile fibrinc and the nucleus. By degrees the nucleus continues by endosmotic action to grow, and is developed int the celli-form nucieus, lie red corpuscle of the blood.- These red corpuscles of the blood are believed to be tIhe carriers of oxygen from the lungs to the lissues, and of Car. bonic aeid from the tissues to the lungs, and that the gcne- ration of animal heat is mainly dependent upon the copoW supply of oxygen, which it is iheir function to supply, - that, excepting this duty, they have little other direc concern in lie functions of nutrition. Having then indicated the normal developmnent of som of the animal cell formations, let us consider the abno0innaJ the formation of tlie pus-corpuscles for examnple--hre W think that a diseased condition of the cells which had pIJ viously existed in the blood may be seen; we fiid i varieties of pus-corpuscles described in, pus bomIifl laudabile; the one is evidently a netamorphosis of lie *Sce Mr. Good.ire Analomical and Pathalogical aaearche, p. IV118 REvIEw.",
         "PRINCIPLES OF PHYSIOLOGY. corpuscle of the blood, as slown by Gluge--the inflan- imation corpuscles, consisting of the red corpuscle which lias swelled by cndosmosis, and has within it nany minute globules of olein, while it has lost its hmomatine by exosmotic action. The true pus-corpuscle would appear to be the white corpuscle of tIe blood, -submitted to a similar operation, granular matter, or corpuscles of olein, am certainly present and may clearly be seen ; and, if we apply acetic acid to the dense cell wall, we shall discover one or more nuclei contained within this pus-corpuscle. The mode in which the blastema is deposited, from whicli pus s formed, is alnost always by rupture of the capillary aid effusion from ils coats, or it may exist in ihe vessels themselves from stasis; at all events, the presence of the blood-corpuscles, both wbite and red, mustclearly be 1)roved. Tiese corpuscles are surrounded by the fibrine and albumen present in the blood-as softening progresses the pus-cor- puseles are developed. That these abnormal cells are pro- duced from the normal formation is evident, insomuch that tIe development of pus ceases as soon as the blastema lias become exlausted, and we would set it down as a fat that tie pus cells can be formed only from the blood- corpuseles, and their nuclei effused from the blood ; while it is also clear that the character of the ingredients effuscd fron the capillary vessels with the corpuscles have considerable influence in hie complete development of the pus-corpuscle. Should it happen that Ihe material effused with the blood-corpuscle is not perfectly suitable to the proper growth and dcvelopmnct of these cells, then w shall fnd but degraded and disintegrated cell formations tooecur, perhaps mixed with cytoblasts, as in tubercular deposits; and this condition would seem mainly to depCed Upon a deficiency of fat. So, again, if these materials are too rich in fat, an excessive amount of nourishment is sup- plied to the same effliused blood-corpusclCs, so tbat they gam an enormois size,and take on irregular forms ; this is dependent uponi local circumîstances; these saine cells con- lai1 a very great number of largely developed nuelci; such are cancer cels, and tie abundance of oil would in iese '%ses appear to have considerable influence in tis abnor- 'ial development. I has been said that these cancer (ells imiay reproduce thejir like, from the nucci contained witlhlin thiemuselves ; in the formation( of Ilie nucleated pus- tcopusrcle, kt is certain Ihat reproduction from Ihie nucleus es not take place, nor is it probable that Ihe nuclei of the 41cer cellCau procluce their like. If we are correct in show- 1)9",
         "ing that the nuclei werc originally intended for a diffrent purpose, the formation of the red corpuscle of the blood, but having experienced a change of their natural habitat, by an inordinal supply of nourishmen, which has produced thieir abnormal condition, it is not likely that they should sub- serve to another purpose, such as the re-generation of the cancer cell. Still further to follow out this subject, did iot time and space forbid, we should endeavour to show that the organs of secretion, iii which are an abundance of animal cell, such as the epithelial and epidernic cell formations, constituting le coverings of the mucous membrane and of the skin, are also derived from a sirnilar sou rce-the nuclcar formationsin the blood. The great peculiarity of all these cells is that they contaiti nuclei; and wcn wc reflect upon the various offices they perform, in which, as organs of excretion, they absorb within themselves the different materials to be removed fron the blood, and by bursting pour out the Con- lents into an excretory duct, so that it may be removed froin the systen-heinselves dying and being disintegraed without a chance tiat the nucleus contained withn thein shall produce ils like-we naturally ask ourselves liat is the reason that all these cells contain oneor more nuclei? In the epithelial scales tiese nuclei arc most distinct, and are evidenty shed vith the parent structure, so tiat it is certain they are not intended for reproduction-whence then, do iliese cells obtain their origin, if not by theirowii reproductive powers, it must be fron the capillary blood- vessels, and that these celis are derived from the inuclear structures of the blood, whieh being deposited in the sub- stance of basement membrane, instead of becoming the nucleated cell, the white corpuscles of the blood, in the new location it is developed into tIe epithelial or epiderlie scale. If we cannot at preset. perfectly substantiae Ile faci that the epithelial scales aie derived from the nucleus developed in the lymphatic glands, we ilink that we have said enough to prove that these cells are not reproduced from Ie nuclci developed within themselves-nay, their general histological progress for bids such a conclusion, but it shall be our duty to reconsider this matter ut bomne future period. While considering the history of the cell formatiolnS i\" the blood, we maintained that the fibrine of the blood was gcnerated iii the white corpuscle ; that it was albumen submitted to the operation of cell life, from which il attained a low degree of vitality. It is clear that in the formation Of 200 REVIEW.",
         "PRINcIPLEs OF PHYSIOLOGY. false membranes, all that exists is fibrine, vitallized, fibril- laied fibrine, in which a certain number of capillary vessels exist to afford the fibrous clement an amount. of moisture, which it absorbs tlirough the coats of the blood-vessels; this is all the nourishment, all the change that occurs in the varions fibrous clemenisof the body during a long period of existence. These fibrous structures are comparatively in- organie , the beautiful basement membranes of the mucous and epidermie structure, form striking examples of their character; while in other instances 1wu find the sanie naterial, endowed, apparently, vith only physical proper- ties binding together the varions structures of the body. The tendons, the ligaments and the strong fibrous mem- branes, arc examples of it; and the properties these structures exhibit, would arpear to be entircly dependent uponthe mode of iheir confocmatiou-the way mn which these fibres are woven together; thus we have some tense and untyiciding, and others again endowed with considerable elasticity. and this appears to be the principal dis- tinctive character between the white and yellow fibrous tissues. The white fibrous tissues, under the microscope, present the aspect of flattened bands, with numerous longitudinal markings, these must be regarded as an aggregation of the fibrous element ; whein we attept to tear theni apart from eaci other, tihey have a peculiar tendency to falt into undu- lations, and are perfectly inclastic. The yellow fibrous tissues may be seen in the form of long single clastic branching filaments with a dark decided border, individu- ally much more distinct than the white, having a tendency to curl, and evidently possessing great elasticily. This treture is constantly present in ail parts, requiring grength elasticity, such as the ligamentum nucho, and the vocal cords. The chenical composition of these two fibrous elements Zpears to present a considerable differencc-the one may k entirely resolved by long boiling, into gelatin or glue, while Ile other appears to undergo scarcely any change by %e same operation. According to Mfulder gelat in consists 13 carbon, 10 hydrogen, 2 iitrogCn, and 5 oxygen. The illow fibrous elcment. is compound, according to Scherer, f48 carbon, 38 hydrogen, 6 nitrogen, and 16 oxygen. In teliv:ng body tiiese tissues are little susceptible of change; sillh0wever they require a certain aumount of vascularity p1cserve them in a noist condition, and to enable them ýPerform the functions required of them, If thmeir blood-",
         "vessels are destroyed, the fibrous structure dies, and has to be removed from the living body. In tle tendons these vcssels are very few, in the ibrous membranes and liga- ments they are somewhat more numerous ; but even here, they seldom admit, in a siate of health, of the entrance of hlie red corpuscle of the blood. A varicty of the fibrous structure is the areolar tissue; it pervades most of the animal body ; it is continuous with the librous membranes, and would appear ta be this same structure greatly expanded by the continuous increase of the body, and afterwards to be disteided with the fat cells. It possesses a certain amount of blood-vessels that traverse its structure and permits thec eseape of a luid containing flic chloride of sodium and albumen into this network of fibres; some are compound of the yellow or elastie kind, but the majority are of the white fibrous tissue. The fluid contained within the meshes of areolar tissue serves to lubricate and moisten the fibrous element, permitting free- dom of motion in every direction. This fluid is continually collected by lhe transparent absorbent vessels carried through the lymphatic glands and poured into the veins, again forming part of the circulating system. In the course through the lymphatic glands, it affords pabulum for the further development of the epithelial structure, which, when passed into the blood-vessel, is eventually to constitute ils corpuscular structures. It has been shown that ihe base- ment membrane whiich exisis in the skin, in the mucous membranes, in the synovial and all serous membranes, is likewise formed from the fibrous clements; the white and yellow fibrous tissues may be distinguished in tlen-the latter being peculiarly abundant in the skin and in the lunugs, wvhere it is endowed with evident elasticity, while the mucous membranes yield gelatin abundantly upon boiling. This basement membrane is easily distinguished in soime parts, especially in the tubuli uriniferi of the kidniey; while in the skin it is with difficulty made out. Ii tle serious and synovial membranes this structure is smo-h1 and even, but in the mucus membranes and in ihe skini, it is vastly extended and uneven, coverinug the villi aid lining the mucous follicles. Imnediately undcr this s1trie turc, the basement membrane, wu fiid a collection Oe arcolar tissue ; it is of varying thickness in the difirtl tissues ; in the skin and mucous membranes, it constilutes the c-bief thiickness of tlcir structures. The blood-vssel, nerves and lymphatics are largely distributed Io the base- ment membrane, and to arrive at it permeate this variell 222)2 REvIEw.",
         "PRINCIPLES OF PuYs OLoGY. r2J Of arcolar tissue ; in the serous membranes the capillary blood-vessels tiat traveise this atrolar structure, give ouit the material, whieh, transuding through their coats, passes the basement membrane to nourish the epithelial cells, and to supply, the flnid, which is given ont into thesecavities, as seniu in Ihe one instance, or of synovial fluid in the cavities of the joints. Il the skin and mucous membranes, the dis- tribution of these capillary vessels in immense loops are collecte(l in the villi, or they line the mucous follieles; in both cases they serve to extend the amount of surface and increase the facility of secretion; ail these folds of structure are covered vithî basement membrane, and layers of epithelial ccli formations ; while they are supplied by the vascular apparatus vith the fluids necessary to their growth, nid Ie perfection of their seretions-these sectionis being elearly dependent upon the power of selection inherent in Ie peculiar variety of celis that eonduce ho ils formation. The nerves are also largely distributed in this structure especially to the skin, endowing il with the necessary sensi- bility, while the absorbents, and espccially the lacteals, are particularly numerous in the mucous membrane of£ hie small intestine\"; a fact worthy of particular notice is, that iii the skin both vaseular and tactile palpilla may be founîd -a certain number of tlem containing vascular loops, while to others are distributed nerve lubules, ending iin oval corpuscubum lactis. 1 Another point of'great importance, w hiei should nlot be ove t- looked inthe librous elecmentsis, tlat the ibrous tissue hasithe peculiar power of combining with caleareons inatte whicih appears ho be incorporatedin ils structure ; hence we fmid it consolidating and forming the shells of the echino- dcrmia, while it is frequently found deposited in the fibrous texture of Ie periosteum, forming by successive lavers additions to the surface of the bone. Ili the dura mtluer, and il the heart of man], wC ofteu find this structure abnormally calcified, while in the carnivora or ruminan- lia thiq bony deposit occurs as a natural and necessary for- mation. Such also is the case in normal bone ; the vessels of the liaversian canals are merely capillaries carrying blood blit the serons fluid of thle canaliculi and lacunoc trans- Ilded from the blood-vessel, carries tIe caleareous matteroi bone, which is deposited in its fibrous element. ( To be continul)",
         "EDITORIA L DEPA RTMENT. PROCEEDINGS OF THE CANADIAN INSTITUTE. On Satirday Cvening, the 7th of January, the proceedings of the Canadian Institute were marked with a considerable amount of .interest Io the Medical Profession. After the business of the evening h ad been disposed of, the President, the Honorable Chief Justice Robinson, delivered the animual address to a numerous asserbly of the members of the Institute, in whicli he congratulated therm on the very large accessions to their numbers during tlle past year, and also upon the very prosperous condition of tlie finances ; parti- cularly calling their attention to the erection of a building, whiclh should be commensurate with the growing impor- tance of flte Institute, an d suitable for all the purposesof the improvernent in Science and Literature, which it was the especial aim and intention of the istitute to foster and encourage. After Ihe President had concludcd his very interesting adcress, Dr. Bovell was called upon to rcad a paper which he had promised to the menibers of Ihe Canadian Institute, on the Functions of the Kidney. T he Doctor showed that the functions of the kidney wcre of a two-fold character, and that cach function iad an apparatus peculiarly adaped to the duty it had to perforn ; that to the one belonged the secretion and removal of the watery parts of the blood frolm the systern; while to the otlier was devoied tle duty of excret- ing the effee and uscless matter from the blood; that hIe one carried off 1he superabundance of tlie aqueous fluid, while the other purified the blood from the matter, vhich, if per- rnitted to accumulate, would surely poison Ie wIhole systen, and perhaps cause the death of thi individual. Th'lie Doctor made many long extracts and quotatiolis from Carpenter, Golding Bird, and many of tie first Piysiolo- gists of hie day, in which he endeavorcd to prove that the",
         "PROCEEDWJGS OF THE CANADIAN NSTITUTE. 225 opinions entertained by themu were erroneous as to the true fuimetion of these different structures in the kidncy, whicl were engaged in the operations above alluded to. To our knovwledge, at one lime, Dr. Bovell, afier Bir,stated that ie circulation of blood in the kidney was directly the reverse tothe received opinion of hIe present day. He dleclared that the emulgent vein carried the impure blood Io the kidney, and that the renal artery returned il lnto the circulation, blood depuriated and freed from tIe matters intended Io be excreted by the kidney ;-buit in the present address lie appears to have considerably modified his ideas upon the subject. To enable his bearers to understand the circulation of blood in the kidney, subservient to the pro- cess of secretion and excretion, the Doctor had to explain tIe minute structure of Ie kidney ; in doing so, he showed that it was a gland of the most elaborate character, and beautiful construction ; that the blood was conveyed to the kidney by the renal artery, a vessel of very considerable size, which passed off from the aorta-, almost at an acutle angle, and cntered the fissure of the kidney, where it divided into very many branches ; that these branches were ubdivided into smaller t.wigs, and that tlcy eventually become minute capillaries; that the extremities of ilise capillaries were contorted, convoluted and folded upon themselves, so as to form a kind of ball of blood-vessels, whicl in anatomical language were called the Malpeghian tufis. That these vascular tufis were each enclosed in aampulh or pouch-like portion of the tubuli uriniferi; 'hether Ihie delicate cxtremity of this tube vas reflected ecr lte tufi as a covering, so tliat the tuft might be said to h Without the tube, at the saie time that il completely Orrounded it, or whether il actually penetrated the tubuli -2 was free l its expanded extremity, could not exactly 'emade out ; suffice il 1o say, that the tuft vas completely snmounded by the tubuli uriniferi. In this portion of the :uli uriniiferi, and surrounding the tuft, vas located a ;\"Y considerable development of epithelial ceils; iliese \"le round or polygonal, and of considerable amount and tCkness, immediately around the tuft ; and, where the FP2",
         "EDITORIAL DEPARTMENT. neck of the tube became larrowed, a certain amount of ciliated epitheliumn were located in this situation, and wVhenl the tnbuli uriniferi regained its natural size, layers of pave, ment epitheliui covered its internal surface. [t had long been maintained by Physiologiâts that this structire secreted the fluid parts of the blood, but it was the opinion of Dr. Bovell Ihat they were mistaken, and tiat this beauti- fuil apparatus was intended to exerete the solid matter of hIe urine, .he urea, the creatine, and creatininîe, \u0026c.; ihat these matiers were selected by the polygonal epithelial cells fromu the arterial blood contained in the convoluted capillaries of the tufts, and that ihey had the l power of absorbing their matters into these structures from the blood- vessels by endo:smotic action ; that as soon as each individual cell had donc its dutv it opencd and perimied its contents to flow out, and that those excretions Wiew prevented from accumulating in the neck of the sac by the beaut iful ciliated cpitheliun, whose constant and indepew- dent movement continually directed it down the course of the tube, until it vas finvlly emptied intr. the expandc tubuli urinife.ri, to be poured oui of the system with the watcry parts of the urine. Having shown that there vas an afferent vessel going to the tuft, he also explained that there was an efferent vessel going from il, and that this cferent vessel was to all intents and purposes a capil- lary vein ; that it joined t.h large plexus of veins thai surroun(led the blind extremities and bodies of the ntubi uriniferi. These portions of the tubuli uriniferi arc of cn- siderable size. of ifinit tenuity, and are covered on tW inside with a layer of most delicate pavement Cpitheliutn around this delicate structure and to this part the large plexus of veins is frecly distributed, and pours out the thin ad watery parts of te blood by exosmnotie action, whiclh passes rapidly through the coats of the tubuli uriniferi by endot mosis, and descending the tubular portion of the kidneY meets with matter excreted by the tufts, and wilh it is pour out into the ureter, to be removed from the systeim. ready secretion of thle watry paris of the urinc is read affected by this apparatus, so ihat when ihe biood becoall 22 6",
         "PROCEEDINGS OP THE CANADIAN INSTITUTE, 2Q7 100 full of water, a stasis or ranora occurs in the enulgent veil. Blood flows backwards fromi the vena cava, and distends the venous 'plexus whichi surronnds the tubuli uriniferiî; il passes by these mcans into lthe tubuli uriniferi, anid is oftel poured Vith great velocity out of the system. I)r. Bovell also raintained, that there wnas a direct route fron the veins of 4ie maesentery, through Ihe portal systemi, 1o the venacava,whuich vas able to account for the speedy man- lierin which tie urine was often excrtecd ; and ihat ihere wvas a peculiar arrangement of imuscular fibres i the structure of the venîa cava, ait Ihe point froma whicih tIe emulgent veins were given off, that facilitaecd the direction of the blood into the emulcent vein, and assisted in this peculiar ramora of the blood. At the termination of Dr. Bovels Iearned disquisition, whichi, for want of time, was scarcely more Ihan epitome oflthe paper lie had inciustriously collated, and which it is impossible for us to do full justice to in so short a space, Dr. Richardson asked Dr. Bovell how he accounted for tIe rapid exeretion in the urine of the chloride of sodium afier ithad been-t injected i to the mesenteric vein. As there was 'idently not sufficient time left to enter into any argn- menits upon hie subject, from the late hour of the evening, itwas resolved to postpone hIe discussion of the subject util Thursday evening ; when il vas agreed that tIe Medical members of tIe Institute should meet, the paper khOuld be again read, and ils merits discussed. Suchi we Mieve vas tle case, but we werc unfortunately not able to ieînd, and therefore cannot give the particulars of the ieeting It was suggested bv some of the members of hie Institute, atit would bc well to divide the meengs of tIe Institute classes, and thai one of tiiese classes should constitute eOhemical and medical departmnent ; that such individuals t belonged to, or took an interest in these sciences, Ild have separate meeingz for the discussion of sucli tels sbeloged t lieir departmeet that the Id be coninued througi the sîmnier, wIcn tie meet- 4Swould in all probability bring togethler the Mcdieal",
         "P.DToRia, DPATMENT. gentlemen of this eity, and enable themu Io know each other; while, perhaps, the influence of science might serve to ruh down some of those crude asperities of feeling that so unliappily exists among ihem,-we liail it as a step inI the right direction, and should be delighted to see it accom- plished. Witlh respect to Dr. Bovell's paper, we tlink it an inmprovement inI the Physiological knowledge of the fune- lions of the kidncy, and believe tiat his ideas are correct, for the following reasons :-Ist. That tIe size of the ernulgemt vein is ont of proportion Io that of the artery, and muuch larger thaîn w'ould be required to retuirn the blood of that vessel, especially after a frec elemination of water fromu its coats. 2nd. That the size of the emulgent vein clearly favors the occasional regurgitation of blood froi Ile voa cava 1o Ie plexus il the kidney, which are situated around the tubuli uriniferi, and may rapidly pour the fluiid parts of the blood into the tubuli witiont traversing the renal artery. 3rd. From tie location of the kidnies, ai the passage of the emulgent veils, almost at an acue angle from the vena cava, so tlat tley are nearly horizontal, particularly favoring this ramora of the venous blood in the kidney. Ithj. That the casts of the tabuli uriniferi that are shed in the urine have, for the most part, Ie bluff termination of the blind sac of these structures-and that we have never secen a cast of 'the bulbous extremity of tihese tubes. 51h. The pavement epitheliumn whicli ines these casts are intended only as a natural organie defence to the basernent membrane, and are not designed as secretory organs-whiich lias been assigned to them as a function. 6th. We have ofien secn abundance of Ie flat epitheliunm il' the microscopie examinations of the urine, but never have observed hIe ciliated varicty above mnentioned ; consequncitlY do not think that they are shed under disease. A fact thIat should be rcmembercd is, that the lefà spermatie vein enters into ic left emulgent vein, so also the veins from the capsula renîalies, and sometimes evcl a lumber veîn ; this would at first sight appear to be ail objection to the idea of a ramora of the blood iu the enul a28",
         "TO TITE IEDICAL -PROFESSION OF CANADA WEST. 009 gent veins, and it shiould be a point of observation, whetlher the left testicle is particularly subject Io disease of the veins, wlen the let kidney is labouring mder an y comnplainit. TO THE MEDICAL PROFESSION OF CANADA WEST. The absolute necessity that exists for Ihe incorporation of Ihe Medical Profession of Canada West, lias induced us to akidrcss a Letter Io the Honorable J. Rolph, the President of IIer Majesty's Executive Council in Canada, on the subjeet, in which we have endeavoured to set forth the reasons that should induce him to tale Ihis matter in hand,-make a Government question of it ;-and endeavour to obtain tha justice for the Medical Profession of this section of the Province which lias hcen so long denied it. A terrible example of Ihe want of confidence of the Medical Profession, in the public generally, came ho our knowlecdge a short time since; we will not mention thIe names, or the locality where il happened.-A wealthy mechanic, vho had lived in the place some eight or len monthîs, had the misfortune to have lis wife in a state of great danger, frorm a miscarriage ; suddenly in the middle of a cold night, lie was called uipon to seck Medical assist- ance, he called at the house of six or eight Practitioners, and every onle of tlem refuscd to go withl him, because lie as not known to thuem. A nurse had to ofIiciate, and, fortu- nately, the woman did well. The shameful way in which Ile Medical Profession is constantly treated by a very large Portion of the publie, who omit to remunerate them for their services is, doubtless, Ile cause of this want of con- eilence. Then, again, we continually see the \" Quackl\" Referred to the regular Practioner; a certain proof of a Cirocal want of confidence ; it must be obvious to all, Aat this is a state of things, alike adverse o the good of the Pblic, and detrimental to the interes of the Profession, aInd il loudly demands a speedy change. [We shall publish lithe Letter and the Reply in our next.j",
         "E I BC2. OTE D M A 1.111 i UINIVAL LECTVURE o45 Till. IILii\u003c ANl I) B~I'E I Ei Till }9I'' 1 4i' l'lit.eI.' KOWN DY'I.îîI~ 11111, \u003c 0, ]svîî-îr I.LI d.:. %t' IisI t NTO 'rir' IIllSiITAI, ïuit Sî. '!ft i 1:1u0e~,I J?àqpincay qf Sirrlp J)isesc. oizteu f ï\u003cwi, ui .ra'P h (pit of Mie. Ut\" 111M Tifi el. (f 141w re/d j~ 'am of Ii J,arSi Ffin'eilî, Tinmi TI-1cura,.3, 'l'nfa D'r rllne, 'lct (îsr 'î,î' and Simua, 'is occupîî di ly, 1. J'azrtzs,*. j\u003einfe fboii,' \u003cnudî ,m*,h lh .11airs iii thas rz', re-aapa. k'iilti\"l î on(' tf M/w I\",rii.w uî t/he .Di.seaàr. (leneral principl\"s., (f 'fré alznIn. l\u003eTîtî'îms '1,/t ws , .Sulphurfflis ..Cid 21111ffirateî l'y Its ifi cCts iii th, Tit i .it'.s jiul c'Ise tif Tince: In'osa. GI:TLîinY-Su1iof yon as have attentleil ila the ou-ptiîis rî, aie aware that dliseases (if Llie Skin aîe- amang the Inoa:t colfimun tif tho'se wve hkîve thiere to treat :alid o\u003ef skiie iliseas.es, ditI thozîe aftigthe \u003ee:îlpb ce,e perlîaps, the nst frcijue:îtly iraider o111- noîtice. I hiave ol\u003eserve'14 th,îtstiiiît, ani (weiVC 3'ulul pP.tctit-i1cir3, aile ttn extreIncly pizvied tu di-aiiose tlîesc diseases of the sl.Tis difficulty isa parti:\" duc lu the, re'n'nnilaace tof soine orf themi te cacli odher, and 1)attly te, the blct, that, iîiile Somte writel,; hlave given bthe Saille nlaine bu diffécrent things, otIiers hanve g-,ivwi dliff..reiit naines to the salie t1inlg. SeveraI of these Scalp affectionis -ire popitlarly called -,iîîgnvorin ;\":id yi)u MUSt 11aVe xaytilneS olbueerved t'le aîixiety w di wliici bte mier ask whfiber lier chiild lias the ringormn. The cause utf lier aiîxiety is, diab site understands by the tersa sue ciapicys, a very ybstinate and a vcry coît:tcgious disease. 'Lo-dny 1 propose to coîisiiler certalti of blînse drscaseiî of bhe scalp IvIiih bear a higýlily hîîipurtant patheîlogical, etioluogical andî tiîerapjeutic;î rehlai tu cadli oti.er, aItl'îll.,I tla(Y dillîei very grc:îtly iia tlieir rea-iiil.y îeoîia l)!ysicai eîai'acters. i. shalh show Y\u003c,u Severat1 case.; uf lcSeý diseases, -lit(, read yulu the noîtes uf one calse iiiîI mîrt the huospital an 'Short tilue iîe, (i sli:tl speakz of their trcanmeut as ilustn'teil l'y tîw of tiiese CIas.es. ?non are aware, binat on the imcoiis membrîane oif the mlluti, inî olne fîritî of the \u003chseaise terîned api ine nicrîîscîpic.il paî'asitic plant.; aie iýeclOped hli cuiorinous cquantity. s-iîd tlhaît, in the stoumacli, uîut iîîcouiîiun veg,,Ctibie grovbhs are snrcine Goodsýirii and tombe erevsia It Ilis been shiol'în, tiîat parasitec plants are also s'atîn,îeve'iapei 11 the skia1 and i pelgs anti in several ,etalp affeCtiolls 'Co uichiel filc popular aine of rigworwi lias been SCill qîiîl(eas thcy frc obstinate, anti conitagiolns (liseaIses, linvliîg a beilîlitey bo spread ini cirelesjî tiiese parasitie vegetaibles aire fmnînîql ini or arouind the li:îiig. Wha:t 15 popullarly aneant hy rilîgwvorîn'w as by s\u003ciiîîe of bhe otîber vriteri 011 skia glisea-ses expres-cil b)v tihe ird tienc : but th.s tceulic:Imîî îî fonald, as Our knowledige ativanccd, te\u003e have ni, lelitiii te significationi. tîillY feul iuîto disuise. e .. It liuis heen, recciffl' proposeil t'\u003e erniphîy tlîi uord tinca. agailaid 1.) give tb it a1 precise signufliatîiîî. 12'ideî' the geîîerfc imnc ie is prj pSe 1î'aî~Io lîrclu(îlea allise of, the hiairs Pruulîîucef], kept up, îr attenigied, l'Y* tle tleveltpiiicîît of uairaisitie plants. * Basin lZeclîcrclîîs de là Naîture, et le TSraitemnîît ties Tin",
         "Ili tilt,' g lire iilili lue 'll uiu auct ''inva 1*.Içl\u003e-5. It i-ý t\" tluj' gets, hues, tia to tlh\"- f1uiut' flint g('111i4 tdut 1 dtule t-day ~ ~ ( r'jv'ihl %t rid i uîr titteutigéli :îîfai nulu f'ui l in ht ir 3 \u003cli r' il(.u' tta lit, (it t heu's u le tiî''u I havei' j u.t reu'îe.i. il 3'u lký,iii it )l1lt 1 i ila ui la tit po t U tut hu-c-Ii'ii- andi\u003ci - well tile titliîu I ]Pl îau-rîul.y i fW Yu, the' reiit:tittiîug nut notire t uiîioni îhiestu ltute he aliu wçill lt' liuaaereil in a very - i h'taiut-,r \u003etient iii tige outt-paticît-' reAl. J -hul it i'i, Vl'îî itrivty O'ItUi erau fie elî.waeers uit cai of tlucs four qwie:i4 the f:'aî ilmat. 7T1ii'I I i'u.' llail51 Ilyliui 101Pt , t\u003eliiitectitly ief, w'ard 'l,vu ý11I1Crîîg i hi- adlnîi'-'iuuî fi'n tint-a 1 , ut--. .1l't, cill tua tiid titi'- aupelur- ailce \u003ct:g ii ralis scîid tntk tand \\teiil' tuu- yu vrill the iitari re.lily fiffliîw 1î13 gt-ui'î'at li.-iîu i licu(ti l it poîints tile tilitiui Lu eu t'a i V a y3 jl' tue tii h W wue. Tii ax iii.' lei, frotî tile cuutiege' lint-ktill, antd file-(- platest- ie Mr. Wul:ttî, aiii :1i-uî a:' ist y'tut it titwii i tienj\u003e~ fatvet linut t.Cotîuuittiifectb tht' lihiiry calp, but hiunrv atiti tiiet it us futlitlý il cther pairts ot the leau-ae. Lt j: lirtrzul 1\u003e3 thick, dry-~, YP1iuV; cr-a--il, v% l~chî, if' -tait e oirttlàir iniiial'iiîc andi detjPre.sacul ii tht' ecittie, Ciliu -illei. Iis1.'iig luritugli lt(- ceutre t it' vacu ut tlit.e eriats is n leuir. Crtists uit t'i i kmIn %yeru' Ju-etit onî the\u003e truîk and i .,treittdtie-i o ircu Mau1 hlin;lu t-ui) ie et m nte wseîe extiruity siiiai he ]MIMÉ-a hlaa di'unitri- tut oitun il of an tit-h tie lingevr t t file t'ireuhr cruaits ofteiî SN\"îu~r w, tlutigliitue up oft cmweeati tiig'- :ulyriatly yd.Itwm Midt br'cwa iiiuulttî'. 'Ilî-3 wnx)t hi theu Ceu s t refe'd ta. If tht- ert-.t-i atrc Verý\u003e lange, as tht'3 a-ve-e titi .Jcobta scalp. the3 have til irregalai' chiape; but t they iuticate fieli' tîrigil frot tli\u003etiiiet centres 13' AIt seîn'cit'cuar outîliue of flie ina-e5s lh purujett truain thi-r ata.r«i ii- TIiese uni. itun-l's ieti-t.-, are îuitt-il uuî the tifieandu frouîu th(-jr tuueli-e-ýei!îiaiet fi.) the et suirface uof a piece of Igiyt uti, the' (lisease lias recehel t-le malle cf ftivis. The iia:îr;gii tuf the- lai'ge erttta tics eoicùuidlAyh abuuve the li-e'l of tlie Ctltîs; îîîternally, ti(y \u003eeeii a- tîughaii l utrieul in bie aiutie of Mie ClUti t'aieufîuil3 iii-tach tute crtait, fnuuin the t'utib, a1u1(1taulitilit layet' uif epiîlielhtili ik fouiut helow t-Uam: exatue tdie surface tif the silillei' c'ut-, ,niI y'uî luiit aiaye-r of elpithiihaa Cuyier filenit. Tite haïr, ahl at earl' iet-itut ot' thuueaue ean lum pnlefl tît frMl tMe «tahi-c et: alittie crutt vitlî gre:ut f.tciiiiy -.t sii'e.jaeî-itly it railîs off freîîî tt~ heae pata, anti peniaiueit italib-s restilte. li' hiave ait1 exalifflîe \"f this n the girl Low IIO, voîit en 1t1.t biaye rcjueatCuIV scei i fic tuetit- The' tanas, tht-a, of tiîea, f:rrn)Qt arec-aaiktI fur tht-jr tluiciiess, drj'- tas iî'itleîe-'s, inu tl ira culueitit. iincu tat s' neitt a pîîatfla- butaa , i l , j-s nid, i tua.' wli have U-i iui cf it (it i.- a, aire tliscasc kt Lvuuii\u003e 4t lue cfci os aiîseaniive tun erzt-ei:, îiiurtjt, eiuwîi icimu, uit hurjaes CirVillatiî-. piitlces are '-\u003ctiihttitiC fi'ltlieu atiuut1hiClit3 luo tlitc tiiiCtt hvo.sit. Ili oeaejii f tlle m6wdîiiaiîî halelIy tdm cinats, anti fle injiw, iljcteti ci the s-calp tiy rti i. Tii:ît tilma ftuis:tj iscuuattiuua vva-a p!:me.1 îceytiîd a l u 3 byrcinak, Ire htnla ct'îîa î'eîuuvweu frein a patleiut sh'e-a frutus tis uli:seae att te hîis 'ni ril; «Pci leiv day'-, tlic c-t and lftanuhige Caille off, itld tlit're- ras a- pttraîlice cf unî3 effuct hiaviîîg luceit piuncC. Buit, fairitecit tays goh-r lie IR Mhe liat iteli :iiu in au Sistit fui, a cria- At tiia un-a a rueut t-,ih t. r' ''inea, fe-vusa: je Saillint oct-t-r du i'iii fl sth\u003eI-afuluitis, thase tentally ii t-ah, andî thtose iii tuad iieaiti. ,Jau'a-lu vias certaiîuly neuthîer acr- %S urt iîiat:lly ircaî, and iuls iteaitit vas exellent. 2'ltca 1Ttaisiîrauiî is ofteil xautttkea fer hierpes eit'ciriattts of: the sclpll 'aitti DISEASES Ole Tllk.",
         "$1ELEtCTED MATTER. whiich it is now and then conjioined. IL is characterisel by pallor, dec-loriza- tion and brittleness of tie hair', 111 te pr nee tt thm wlite powdIery scales aroluiil the ia r of the iairs, uild 'n tite skin: betweein tlen Tl dliseased Iair, have beenm likene' t'o \"l tow.\" They are,\" Mr. Wvilsn say \"remarkable for their Lhit and twi'ted shape, 1 resmibhlaiec to the lie. of heup in colliur aidl apparent textulre\" Lheir brittlenens is somletiimea suichi, that ever.- hair o1n the alfectel si\"t i; broken oitfjuit above the surface tif the skin. Tisi, ap-Ipeaurance s well seen in the girl wlo' is no\"w going ru 01nl the room for you to inspect; whlile the'deoloization if the liair is equîalily well sven in the boy. tl rve, that the iiseased pitcies are cirenlar in both ehibircn. IL is oniy when toril by the iails of tb patient, so as t be iadIe to bleedi, or wiein, fromît nieglect, oir the application tf topical irritants, they inflame, thiat crusts are forned on11 the p\u003eatcheit of tinea tonstirais. lu Tinea J)enleans the hair falls out rapiiiy frou one or irc circelar spots letavinlg a snCth h ald surface. There i, no eruption of any kind- t) crusts, no seales This little girl alf\"rds a gond illustration of the disease. Observe, liere is a Siall, circular, smooth, bald spot, here \u0026 larger one, m hile here is a very large, irregvlarily-shapedi, bald surface; but note the outline of the latter, and yon will see froi its scallopel edges, the tendency of the disease t4 spread in circles inanifested. The rapility with whiich the air coees off the Iead in this diseaîse is often singulirly great. The first hald patch n this girl's head was observed by her mocthier l)about six nonths since ; but it is only Iaely that the disease has spread much, and now yo. sec nearly half lier scalp is uncovered by hair. Tåii Sycosa is charAterisei by illaiimation (of the hair follicles. Soie- times the inflammation leads onl]y to the effusion of Serosity. and the exudation of lynph around and into the capsule of the hair. At otlier times, and more comconly, pus is formned, aind then, when the pustule breaks, a brownish scab is fornied on the surface. flic usal seat of tinea sycosa i the chin, upper lp anda sides of the chicek. I iad a case lately iunder nmy care in which the pustules occupied the inner surface of the nares-thait part front whici the hairs spring that protect the orifice of the nose. Tinea sycosa rarely occurs 011 the scalp, and it does not spread circularly ;s fIr as î know, the natoe of rigworn hias never been applied to it. U niatien it to you, althougli I have ne exalple of it amxong mîy patients to show yoii, becayse of its relation to the species of tinea of wlich we have examples before us. You will have reiarked, then, froma the characters off the species of tine I have mnentioned, that- Tinea favosa is especially characterised by its crusts. Tinea tonstrans is especially characterised by decolorization antd brittie- ness of the hair. Tinea decalvans is especially characterised by baldness, not preccded or accompanied by an cruption. Tinea sycosa is especially characterised by inflammation, tendernss, hardness, and suppuration of the hair follicles. I told you that these diseases are arranged together in one genus, becaue in all a parasitie plant is developed in connexion vith the hairs. oW tie plant present is diflferent for each species Of tintea; and the situation occipid by the parasite is also different in cach species of tLat geinus. In tilea favosa, the parasite is the achorion Schinleinii. This plant has myceilun, sporule-bearin.g branches and sporules. Te sporules are routd cir ovl, and thxeir diaineter varies, according to Gruby, fromi 0.003 n1111, to 0.01 im. The vegetable growthx is first perceptible between the layers of the epithe lium, just at the orifice of the hair follicle; fron titis point it may Spjread downwards between lthe hair and its capsule, and upwards arond and in the substance even of the hair. Such of you as visited Ivard 4 during the Lime Jacobs vas in the hospitat had frequent oppcrtunities of seeing the nyceliun, Vhe sporule-beau'i",
         "DISEASES OF TIE SCALP. tanehe, tand the sporules of the inchorion ,e'leimi. You will recognise tin these very excellent drawinigs of Robiin. In tinea tonsaurans, the parasite is the trricophyton nonsurans. This plant î composed of spores onily; the spores, however, are oceca ionally souewhiat d-ngatedI and arrangedt in a lnlcear serie. They are round or oval, and thir diameter varies fromt 0.00::i min. to 0.01 mm1. The priiary seat of the trichophyton tonsurans is the rout of the hair: cloCuîeqetly, it extends up into the substance of the hair, and oven outwards, acording to Bazin, on to the skin between the hairs. I have under the nicroscope sote hairs remnoved fron the head of oe of these children. You till see in one specimen the spores in the lair follicle ; and, in another, the tir split up with the spores among the fibres, as figired ii this plate by Bain, and in this more highly nagnified drawing by Robin. la tinea decalvans, the parasitie vegetable is the mnicrosporon lndoumrî. his plant is formed of branclied filanents, on whicli the spores are developed. Thespores are very small-from 0.001 mmu1. to 0.0015 mmn. The seat of the pawth is the outside of the hair; it formis a sort of sleath aronîd the ihair, tsm the surface of the skin upwards, froua 1 num. to 3 mmi. Gruby first biribed this plant and its relation to tinea iecalvans; and Robin says, hie w confirm the acicuracy of G ruby's description. la tinea sycosa, the parasite is the iîcrosporon 71enlagrophyte. It is also caposed of filaments and spores; but the spores are larger, and the filanents Ider, thau those of muicrospornn Aulouini. The seat of the growth is hie hair folliele between the hair and the capsule. lhave told yous the naies I would luave you eimploy to signify the diseases lbaie described and deionstrated to you ; but yo ouglt also to know the tes employed by the vriters on skin diseases most-popular lui this country, ndignify tle sane things. Tinea favosa, then, is called porrigîî favosa hy Willan and Bteman; favus ,YDr. A. T. Thoiipson, Siion, aud imany otier writers. Tinea tonsurans is called porrigo seutulata by Wilain, Batemuani, and Dr. A. tihomsoi; herpes tonsurans, by Cazenave; and trichinosis furfuracea by lir. Wilson. Tinea decalvatis is called porrigo decalvans by Willans and Iatenau ; vitiligo filhe hairy scalp by Cazenasve. tinta sycosa is called ientagra by Wilain and Blatenan ; sycosis by Mr. As to the etiological relation of the parasite to the disease, it appears, tlat ibapores of the vegetable growtli require for thteir developient a peculiar 1 say so, because ail persons vio mix witl ehildren suffering fromt 15a do not bave the diseases. But if a soit liglily favourable to thîeir 5'thl exists, then a spore haviig found its way on to that soil developes f fenns other spores, and so the parasite spreals over the sulrface of the Ial anore or lcýs rapinly, according to the inore or less fatvourable e of the soli. le¶twitl observe, liowever, that the abnornity of tie secretion tcessary the developmencuat of these spores is not appreciable by our senses, nor by ensatiois of thie patient, for Remiak did not know, elii e applicd Uie strast to his own armi, that his skin was not in ail respects lealtly; ,*s lie aware, wlen he remîaoved the erust, that the secretions of his :afollieles differed fromt those of the mlost lialthy individual ; and it vas tila fortniglt after, tat lie was consciious thant his sa was diseased. experin'it of Renak, then, proves, tiait a secretion in whiei these ites can grow amay be fortied by tlh hair-follieles, and the patient e himself to e it perfect liesîti, not only generally, but even so far acrns lis skin; atnd that it is otnly when the parasite lias developed in retion, tlat wliat we call the disease begins ; then ià is that the Of the hair is itpieded, that it is altered in colour and in intiiate that ulitimtiately the hair fallb out, and the iair-frming apparatus damaged by the fotiaigni body, thiat it fails to construct even hairs, and balduess results. G 2",
         "234 SELECTED MATTER. IL would appear, froin the fact of a large number of ehildren whose oeat are supposed to be healthy, sutrering fron tinea tonîîurains, when placed in situations where the spores of icr hyton toniiiurans are Iloating in thLe atmosplere, that many persons. whose scalps are considered Iealthy, have in their hair-follicles a secretion suited to be the niidus'c (of this plant. The patient sufrring fromt tiniea cormes niiider ouiir enre for the pîerceptik lisease, and will be iell contenitel if we can cure iiim of that: but it wnt11î be better if wve could ailso destroy the susceptibility to the disease,-if e coi0, t bring the liair-follicles into a state in w hich thevy nu longer secrete a nidus in vhich the plant can grow. Struimous and weakly chibiren, especially ifl dity iii their persns.a re more frequently than others the subjects of tinea ; therefore it has beu inferred, that struna, debility and dirt favotur the formation of the secretim in question. ln the treatnent of tinea, then, we strive to enforce persmi cleanliniess, to strenigtlien the patient and imîprove his genieral health, andi' destroy the parasite. As to the first and secondl objects, they are to ie efectel by attention to hygienic rules, ablution, air, exercise and diet; tonic inedicin and cod-liver oil especially ire in, some cases useful. But you many kill îte parasite in all cases, and in nany cases eire the disease, by topieil appliE. tions alone. Agents. the effect of which is to destroy directly Ile paraî are called \" parasiticides.\" Several agents laving sueh an action h:vebe broughît before the profession. Soie physicians use a solution of corrosin sublimate. Acetate of copper has been also eiployed ; but these agents ar not sufficiently powerful parasiticides for the snall quantity of thems tit finuls its way into the hair-follicles to kill the growths occipyinîg that situatiùn Therefore Bazin, who is one of tie great advocates of their employmient, wiit the especial object in view ofkilling the parasite and not modifying the secreti1, says, that it is essential for their efficient action that epilation be periormndi: that is, that the liairs be forcibly reonved fromn the affected parts. lie says, that only two or thrce hairs should be taken hold of by the pincers at a: same moment; and that, if this rule he observed, and diseased hairs sae be operated on, the patient suffers no pain fromt what seemz on paper a nrtt terrible operation. From the details of twi) cases 1 am about to give, yVI will observe that it is highly probable that if sulphurouîs ncid be eniployd as a parasiticide, epilation wvill be found to be altogetier unnîecessary toi? complete action. This agent was first introduiced to the notice of tIh mledl officers of the hospital by Professor Grahan, as a possible remîedy fi cholera, at the time that disease was said to have its origin in the presfl of an entophyte in the intestinal canal. IL was first employed by myself» check fermentation, and to destroy the tortuhe cereviscite and satreic Geo'i sirii.* When iecturing on thîis subject, somie timue sinîce,† i expressed msyse thus: \"Considerable benefit may be aniticipated fron the emsployment dl sulphurous acid in all diseases attended with the emîploymnent of prsi.ci». plants. I w«ould especially mention porrigo.\" The case I am about to read to you, of T nyman Jacobs, proves, that,O regard of tinea (porrigo) favosa, these anticipations have becn filyrealli*j while the case of the girl now in the rooni, aud wlio is stil under treatme5 renders it hîighly probable that tie beieficial effects of this parasiticide ei be as manifest in tinea decalvans as they arc in Linea favosa.‡ In some forns of thrush, too, I may mention that it acts most rapi, application of a solution of stilphite of soda (a draclhn to an ouIce Of sufficing to remove the disease from the maucous membrane of the mDodt9 * Several medical men have lately amlîinistered the hyposulphite of soda, iited sulpitice; but the latter is the preferable salt, and for this reason, thliat when iyi phite is deconposed by th hydrochiloric acid of the gastric juice, not onuly is sulphuro gencrated, but sulphur is precipitated,-a substancc it s very undesirable to haTe stomachi In somte of theso cases. † edclvTmes and Ganzette, Auîgust, 1851. This case of tinea decalvans bas continued to progress most favourably. x fallen ont sinco teia first application of the acid, and hair well formed and of good replacing the little down that scantily covered comte of the patches; while on otber [le which were absolutely ncmooth hiairs are sprimging up.",
         "DISUASES OF THE SCALP. 235 twenty-fiour hour\u003c. The sereitns of the mouth being acid, the sait is decomn- jAe, and the suilpfhulross acid is set free; in Ihis, sas in ail other cases, the *aihurous acid i, the active agent in the destruction of the parasite. Iitas:sn Jacoba, agedi 27 yesars, a Jew pedlar, a native of Amsterdam, and r4ienit ini Liondont fifteen montlsq, was admitted into the hospital ont March '1, 185. lie wma, ias msaant of yout miiu'st reumenher, a man of cheerful disposition, aisk complexion, rather short, mucslar, moderately stout; in fiact, he 1il genCrally in ro.bust eailth. Ilis habits were those of his class; he Elpt in\u0026 tise low commun ldging-house, fîarei iadi, rarely eating mient, and afintg rom his app..rance, was not very cleanly in his person. lie allirmssel, and i iClievel hims, that he was temperate in regard of the \u003ee f ialcohihlsc liqussor. lias general health, he said, had always been good. The scalp affectiun waiss ut iumsse years' duration at the tine he cane into aLe iacîpit.al. le had beena in many lospitals, but had never derived any trkdi benetsfit froms treatmsent. Wisen Jacobs caine under observation, hi. etndition ias as follows: Cerebral, circulatory, respiratory and digestive fanctions healthy'in all prticulars. The whole of the scalp, excepting the margin, vas covered iith the crust attiaa favowia. The largest crusts iere of a greyish yellov colour, of the istence 'of dried putty or mortar, and brittle. Their thickness generally ru cmbiderable. Where thickest, the surface of the crust iras below the etel Qf the Cutis ; so thiat it looked, at the firet glance, as if the latter had tea partially destroyed by ulsceration. Tie surface of these crusts iras ary irreguliar; it had a pittei, rm-eaten, or eroded appearaxce. At the *;;e of the large, irre'cgularly-aisaped crusts, were many small circular crusts, ýiressed1 in tie centre. A hair passed through the centre of eacit o' tiese a'1il cru:ss. Wlhent the crusets were forcibly detacled frni the scalp by 5tameal means, the exposed surface of the cutis iras very red and raw. The iead itched isich; nsal, though scratching gave considerable pain, it ra erident, fromn the traces of blond on the surface, that ie had been apply- ils ils to the part. The odour o the head was very offensive, sonething like that cmitted by Lasa, enly, as one of yon rermaiked at the tinse, swreeter and more naualseous. ,5ttered over the trunk and extremsities were a very large nssauler of circular his crausts. 'Ilere were as mssansy as forty osn tie back alone. The snallest attese appeared, hien scen throuagha a les, to be constituited thus: in the CZt ias a iair, around and toucdsng that a browniislh-yollow crust, and 4wil that againa a dusky-red halo ; the diaueter of the ihsole not exceeding T\u003ethirds of a lisse. Oi the back no crust vas more tian one-fourth of ass dia diameter; ont the leg there was one-third of ais inch in diameter. e-ta crusts were circular, rasisel about a lisse above the level of the cutis, lasi, dry, and appeared as though made up of concentric rings of pale, ishyeliow and brown colours alternating. Tie surface of these crusts rssecsaily detacled, and then a cup.slhaped cavity was exposed, filled with r stone-yellow powder. The base of the crust beisng removed, the ý2%e (if the cutis, fromn wihich it lad been dctached, was raw. ee sawr, yo may remember, the smlyceliumn, sporuile bearing branches, r1e\u003c,orules of the Ichurin ichainleiii, when portions of the crusts, or of sYE1ow psowder, were placed under the smicroscope. 1\u003e trea(amcnt :aas alopated for soame lime afier the man's admission. Ons April 'listslaie w'as exactly he samaae as Whei lie entercal the hospital. ' RagS, Wet %Cotlution of sulphurous acid, cre now or r'cabe ic aept constantly ont the 5\u003c; the head il to hlcore w apith an on-silk cap. \"5APril lith, large quantities of the crust lad separated fros the scalp, tl,4et renaincsl attached had enarely lost their yelloaw hue ; they were of a ouaar1I colour. Ali iteinsg iof the scalp ceased shortly after the applica- iacf the suliphluru cs iaid. No sulphurouas acid iad been applied to the ocan the trunsik and ext'remaities, and they had \u003etill the characters they \u003ecaled on the mans's admuissiou inito the hospital.",
         "236 , SELECTED MATTER. A piece of lint, wet with sulphurous acid lotion, was applied to one of thej largest crusts on the leg. On the 22nd April a mere trace of the favus crust remained on the scalp: but the surface of the eutis w.as red, aid there Vaîs an iiflmed papulanear the vertex. Thinking this etndition miglit be partly due t the acid, hiiclh wis a 'Very strong solution, I îîrdered its use to be liscontinued for tweitv- four hours. The crust on the leg to vlichi the sulpliurous acid was aiîplit.l on the 39tl, liad separated; the exposed surface was red, but lot rar. Tico favus -usts wc/hich icre med inh vieciy of that Io which the .cid tras Upplicd (o1 tlie 1h, trere obserel lobe urnhing brouen ; subsc:uently they dryprl of sponaneousily. The effecct of the sulphurous acid gas on1 these two patches is of grent intercst, as illustrating tie mode of action of the solution. The crusts on tie scalp turned brown shortly after the acid -vas applied to them and befure tley separatied from the entis. On the 29tli April tie lotion vas discontinued, and zinc ointment applied to the scalp. On May 2nîd the hcad was frce from crust-, but the scalp was still re, and several inflamed pnapule were seated on it. On May 9th the skin of the scalp was liere anid there more natural in hue, and one or two ptipule had suplqpurated; the pus w1as healthy ;i appearce, and there wras no trace if the parasitic plant to le detected by the microsc\u003c On tlc 18tth tie liead eontinued free froa favus; the scalp was mnuchi ! red; the hnir was growing. l Uie crusts on the trunk and extremitie, were still in the sanie state -Iî on the patient's admission lito the hospital,he was immîersed about niiie in the cvening, for hall' an liur, in a full-sizcl tepid bath, contaiinîg \u003eixtecn ounces of saturated solution of sulplhuîrîis acid ; nu friction wis employel. During the night all the crusts save tine feu froma tle surface. On the 2Otl lie was againî immîiîerscd in the acid bath, and the next day ne trace of a crust was to be foxuid on the trunik or extremaities. My Iotessay: \"No fresli crusts on ead ; a umall piu iitle occasionally appears and dire up in two or tlirec lays, andi then disappears entirely ; the skin of the heal generally is uuel p:ler sunmre henithy in aspect.\" 3Ist.-The scallp w:az stilil aler thain at the previous report. Tlere wer\u003c only two smill iutstuls tn tie :-alp. By the microscope, no trace of 1le liarasite coluld be letected. The skin generally appeared liealtly ; and, tu .1 ne 2ntid, Jacobs left the liiospital at lis own desire to retnt t) lulland. I camot conclude ivnhout expressing iy confident belief, that a ery great ailvanie was milade in patuhology wluen thle vegetable nature of t\u0026 diseanses 1 have to-uday referreil tii, as -well :s of some otiers, was demo strated; and miiy eqlually confident helief, that the foundlatim for a ryi great advance in tlerapeuties was laid when Prnfessor Graham inutrodulice t notice the power (if suîlphîouus acid to destroy vegetable life, nd eplir how il. could be given internaliy witiout injury to tle patient. Nonu.-The solution of sulpliiuus :niid I have used is made by pa5Si1m streamîx of.Lte gµs througlh water till the latter io 'aturated. Uf tlis satiniiî solution, tIwo ounces may be added to six ouices of water to ake teiP London: Lancet, Dccimber 1853. A nuulyfical Examinaion of all the Ca(ses A dàmited, duîring Sixteen Tean, el Siill-poùx and iaccinaiocn loital. lîadif a v'iew fo ills Patho1lo\u003egy of Smiiall-pox, and the Proer!ie hßuce of Vaccinai joni. P. Mainsos, ResidOnt Surgeon tio Ile Small-pox ald Vaccinlation 1105l' Londlou. I)uring the period comnprised witlinî this analysis, seal-pox ad epidenic foui- times-in 18K8, 1M, »11 151 ; -id rather mre thaSt",
         "PATHOLOGY OF SMALL-POX. ZwYI of the patients admitted into the hospital had been previoizly vaccinated- The analysis referred principally to the following points:- Y. Natural sîmall-pox. ri. Smîall-pox after smiall-pox. a. After iatural simill-pox 6. After inoculation. m. Snall-pox after vaccination. a. Number of cicatrices. b. Character of cicatrices. c. Vaccinated, but without cicatrices. iv. Febrile eruptive diseases inistaken for snall-pox. A reimarkable difference was observed between the vaccinated and ivac- cinated patients, and also between the vaccinated cases theselves; s(ile patients laving the snall-pox in a iild fori, whrolly devoid of danger, whilst others hîad it in great severity, scarcely, if at all, lessened by the prevou's vaccination. le author thought tiat the causes of this reniarka- le diterence miglt be sought for aiong the antecedents in respect to the vaccination of each individual admnitted, witl a view to explain the extreme mildness of some cases,-the danger, unmnitigated course, anid even death, ofotiiers. Small-pox, iii the unprotected. remains as virulent as it ever as. Vaccination. wlci perfornmel in infancy, affords almost complete secirity against the fatality of small-pox, up to the period o puberty; aud tle general experience of the Small-pox Hospital shons that sm:dl-pox did ot usually occur after vaccinîatioii, unitil scveral years hadl elapsed. Th most trustwortly evidence of the perfection of vaccination was to beobtained from the cicatrices. The analytical series consisted of six tables. Observations on the results accoupaniedacii table; and it appeared that 2,09-1 patients with small-pox reportedi tieiselves to have been vaccinated at sone periol of their lives 1,?57 had oune vaccine cicatrix; and of these, four and a quarter per cent dlitil with a good cicatrix, and twelve pier cent. with an indifferent cicatrix: aman, seven aînd a hialf lier cent. and a fr.ctioni MS lad cicatrices, two mid a hialf per cent diied with good cicatrices. ?Meaii mortality, four per cent, and a fractionî. 27- atients hand three cicatrices. Average mortility, one atdr thrce quarters. 26S patients hiaid four cicatrices; and there died writlh good cicatrices initier oe per cent. ; vith. indifferent cicatrices, ione, the average being only thrce-fourths of ane per cent. Tihe author described a good vacciine cicatrix as distinct, faveated, h ettd, or indented, iii some instances radiated, aid laving a well, or tolera- Ly well, definled edge: an iidiffercnt cicatrix as indistinct, simlooth, withîout Mdentatioin, anild with an irregurlar edge. The autltrs opportuinities of txniiiiiiig the foreigners adnitted vitl smuall-pox at the hospital, and conparing tlcmî with each other, and ,witlh the saine class of persons in thtis romiitry, had led hiim to the coiiclusioii that vacviaation s perforied in the best nanier generlly by th Danes, Swedes, Norwegians, and Gerns. Tien came the italians; at, fromi tue ew he had seen, tle epaniards; then tht -citch ; then te Irish; anid, lastly, thie Engli aud French. Thiere tMt exist some grave anid lamcitable evils (iiore espîecially affectiig the humibler classes) connected witl the circumstances under whieli vacciiatioii inlCountry districts uas performed. There could lbe io justifiable reaso rl'hy thie rural iiiabitanits of England anl Wales shmould be less vell vic- Mateil thau the rural inhalitants of Deniiarl, S wecii, and Prussia. The Zort-dity, severe as it vas betwveeni the iilifferenltly andwell vaccinated, was mût the oily evil result of bad vacciiation. Propnortioiate to the mort:dity s til, -severity ai Ihe disease ; and, to thoqe who escaped death, there was hmiageil health, disfigurement for life icrliaps, aid iiiirleservedt discredit as brouglt on vacciiatinii. Greaut judgmeîcnt nul caution sould be extercisei iii the selectio of vaccine lympl. Lymph for usc was in its best state on the seventli day of the progress of the vesicle, the day wveek from lteVaccination.",
         "238 SELECTED MATTER. The author's conclusions were- Ist. That natural small-pox destroyed about one-third of all whon it attacked. 2nd. That small-pox after sinall-pox was of comparatively rare ocurrence; tiat a second attack of natural smsall-pox was rare, but not often fital, and tiat protection seeied to be the larw. That after inoeulated smalljox, an attack of snall-pox lad more frequently led to fatal resilts; but tiere is reason to presume that the virus uscd for inocuilation-like a great deal of the lympli used at the present day for vaccination-was oftna taken at too advanced a period of the disease, and thus did not afford the full measure of protection it was capable of affording if taken at a iroper tîsinw. 3rd. Tiat vaccination performned in infasncy afforded almost comaplete Protection against tie fatality of snall-pIx, to tihe period of puberty t; tat a variety of circunstances conspired to make it ahmust imnposilble t.o ascer- tain exactly in what proportion to the vaccinated cases of small pox subsequently occurred, or might occur, if all persons lived to an advanïced age. 'th. That, as a natter of safety, it would e well for LI persois wio were vaccinated ini infancy to be revaccinated! at puberty ; thsis measure beinsg more especially requisite for those w1ho were eier indifferently or dlubtfidly vaccinated mn infaLncy, and stili more nleeessary for thse Vho, though vaccinated, had io cicatrix remaininîg. Fiaally, as a matter or precaution, it would be desirable that all persons should be re-vaccinated, on smtall-pox existing in the house wh1ere they vere residing. Mr. Streeter would suggest the niecessity of attending to tie health if the skin before raccinationi was perforssmed. lie belieý ed tiat the exlausted state of the skin in tropical climates iwas one cause of the inperfectvaccina- tion in themn. About thirty years ago, li the practice vith whicl lie was connected, out of more thai a hundred children vlo had been vaccinated. mnot one lialf returnled to show the arm and the effects of tce operatioi. lie lad only seen one fatal case of small-pox after vaccination, on the fifth day. ie alluded to one source of danger in cases of small pox-.nely, n profuse flow of the catamenia, swhich occasionally occurred in the sec'onadary fever. Dr. Webster entirely concurred with the opinion stated, respecting tie great fatality of smal-pox amnong youig people compared with tlsuî,e in iore advanced life. Por instance, during 1887, mwhen upwards of -1.201) persots died by variola througlout England and Wales, more than three-fourths 'were undcr five years of age-the sexes being eqully divided ; while vers few iad passed tieir forty-lifth year. thgin, tie faut ilat death very rarely occurred in cases whsere the individual hail been properly vaccinated in three or four places at the saie timne, vas likewise most iiportalit, ai showed, if the systen vas once properly imîbued witi true vaccine viris, little danger of the suîbsequent sumali-pox need le apprehended. ln lis (Dr. Webster's opinion, many of the deaths reported fromî varla after co-M pox, occurred 'whsere the party never iad been correctly vaccinated, especially tiroghiout rural districts and country towns, wiere mnumbers reamh unsprotected, owing to the prejudices prevailing in ignorant inds againzt vaccinlation, wh1o obstinately object to the operation, \" as an impious atteipt to arrest the vill of the Almighty.\" Dr. Choiwne, h-aving been a frequent visitor at the Small-pox ]Jospitl, could corroborate manuy of the statemnents made in the piaper. Tie fact mentionsed in the paier, of the number of persons aficeted vil smallpo after vaccination in the country, was nost important. The failure Of vaccination in country districts was iost laientable; but it awas Inot tie fitult of the practitiouners-it wars the fault oif the iloards of Gua.irdianig (f the Governienît, by whon no efficient arrangements for vaccination wCie made. ansd consequenstly thousands lost their lives. Mr. Marsoi said tihat, muchels (if his paper being taibular, it coul] not le iear'd before the Society. lie wished, however, just briefly to alifude te tie numaber and quality of cicatrices. The difference observed awas cnmarkable.",
         "TRANSFUSION OF BLOOD. 239 Thus, amoîcngst the pcrsoins whIo baid only been raccinated in one pl1ace, and the cicatrix was iiperfect, twenty per cent. took the smnall-pox; whereas, whena tihere were four cicatrices, and these were good, the iniinber who took small-pox after vaccination ias onlly one per cent. The Imelicai public had relied upo tlih chircinistance of Jenner having at one time vaccinated in only one place: but 1w ('Mr. Marson) knew that .lenner did not confine hinself to tne, for lie had seei a patient W0hom1 Jenner badil vaceinated in 180G, and the per:an had four eicatiues.-Assoc. Med. Jour.-IN. Y. Jourail of Mhdicine, .Vorcbeîl«r, 183. TP.ANSFUSIO.N OF BLOoD. Ii this mcemoir, Dr. l'olli collects twenty-threc cases in which the opera- tioniaq beenpractisel in the ordinaryivay, thatis, with hman blood. In liive of tlese. death happenied, cither because the operation 'iwas too late, or bcauise death ias about, tu happen fromt soie independeit a nd iievitaLble cause; in all the rest, life wias savel-in many, from the very jaws of deatl. Il i one case dlid the cperation give rise to ay serieus inceience.- Thc îînajority of the cases were thîose of paîrturient femnales, reduiccd te death's loori by looiig; the rest, those of persn sufl'ering fromt other kinds of iIeorhage, induced upon the leerrlagic diathesis. Dr. Polli aio enminierates soie cases in which the blood of animals ias Sccessfully substitutcd for thiat of man. Pour of tliese are on the authority of M. Denis, iho wrotc his Letres Sur la Trainwfusion at Paris, in 1617.- Another is takeit froin ai Italiani work by Dr. Manfredl of Lucca (1)c Nor a fi Iniludeta idkico-Clir. Operi'ne, îc., Rommc, 166s). Anlother, by M.L Tower and King, fromi the Gar. MIeilicale de Paris, p. 65, 1818. The particulars of the last tio experimients arc niot, giren, anld I re onily tol thiat the blond off a lamîb iwas emîiployei in the one, and that of a caltf in the ther, and that the resuit ias successful. The particulars of M. Denis's ex- perîiments arc as follow': Exp. .-M. Deniis tok ten uinces of blood froma the ari of a strong and healthy butchbr, aged forty-five, nid injectcd throuigh the samie opening twenty culices of t lie arterial blood ofa lamnb, after ilich the batcher, wVithout anîîy alteration in his mainners and feclinga, proccedel te kill and dress the anîimal whiel liad firiiishtel the blood, aind then 'weiit t the public liuse to dispose ,f the gratuity whcliieli liad been given him by the operatur. The nîext day, accordig to his owni acconuit, lie felt in better lealth than usual, and lie underwent the samne operation withe csaie results. Exp. 2.-Nine ounces of the arterial blool of a lamb were iijcct ' into the ara cf a youth, aged sixteci, whîo had stiffered during two mîonth fromt feer, niid who, fromt this cause, and frin Iavinmg becn bled twenty tinies, by in a. mîîoribuind state, ilei lie iminiediately cahiel ald slept, and this allyinig eventuated in comîiplete recovery. 'p.:1.-A madaiino ecight, ears' .stanling, ihose madiess shiowed itself I atiacks 'f completc rcstlcss;ess and wiakeflitess of ciglt or teniî montlis' ilratioi. was treated with trais'fusion ini the fourthmionthi of such an attack. Ten 'ucnices of blood'u were abstracted, aid six onces cf the arterial blood of a calf injectel in thelir stead, with iuch relief to the isyiiptoms. After- rards a pound of Uic samîîe blood was injectel. The himdiate result of the nd transfusin was vomiting, purging, und sweatiir. Tliese ended in a i',und 'ileep, which liibruglit about a favorable crisiz, for fromt this tme the patient conitniiued to improve uniîtil he ras quite iell. Ex'. d-The patient in this experiiiient ias lethargic, convulscd. and liStuilseles, in consequence of a violent and protracetd attack cf ivomit- 1g anîld purging. M. Denis injected cight ouices of blood (of ilnt aniiiial",
         "240 SELECTED MIATTER. is not stated when the convulsions ceased, the pulse arose, and consciousness returned, the bystanders were recognized and spoken to, and some food vas taken. This stato continued for twenty-four tours. The transfusion was then repeated, but the vomiting and purging returned, ami the patient sunk cleven hours afterwards. Serions intussuception of the small intestines vas found after death. The conclusion to which Dr. Polli arrives is, that the operation of trans- fusion is simple, efficacious, and safe. Ie recounends it only in cases of excessive liemorrhage under ordinary circunstances, but in cases vhere there is a strong hemorrhagic diathesis, as likely to produce a beneficial change in the crasis of the blood. Ie recommends it also in cases of extreme inanition, where there is not time to introduce food in the ordinary vay, or strength to digest that food. He suggests it nsa possible mens ofinducinga beneficial change in the constitution of the blood in chlorosis, rachitis, and scorfula, and insanity; and lie thinks that defibrinized aerated arterial blood iniglt bc a powerful nicans of resuscitation i cases of asphyxia and other kinds of apparent dcatl.-Ialf-Yearly Abstract, vol. xvii. We have perforned this operation but once, and vith only partial succcss.-EmDITOR, Philadclphia ledical and Surgical Journal, January, 1854. coPoUNi\u003e COMMINUTED FRACTURE OF HUMNRUS, NEAR SIOULDER-JOLNT, wITH WOUND OF BRACHiAL ARTERY; AMUTATION AT SIIoULDER-JoINT; lirEcovERY. CIristopi.r Fricke, zut. 35, a healthy German, of temperate habits, wbi admnîitted on the Ist of July, with -a comminuted fracture of the humnerus, atl its surgical neck, accompanied by severe bruising of the surrounding part, and occasionetd, a few iours previous to his adnmission, by the falling of a building, at 'wlicih lie vas employed at work. Onite f the fragments of the humgrus had been forced througli the integuments on ft inside of the arUms near the ailla, ]acerating the soft parts extensively, and vounding iho brachial artery. The limb -was much infiltrated with blood; its temperatu was nucli lower thain that of the opposite side, and nîo arterial pulsatio could be detected below the seat of tlie injury. No hemorrhage. On th folloving day, reaction laving taken place, a consultation vas called upo to explore the extent of the injury, and, if possible, to endeavour to save th limb. A ligature vas accordingly placed beneath the axillary artery, Aft the administration of ether; ami the incision thlus made was prolonged lownwards, over the brachiial artery, into the original wvound. Seve arterial points were secured, but thc comminuted state of the boite, nd l extensive infiltration of the blood amtongst the injured parts, rendered t remnoval of hlie limb evidently advisable, and this ivas accordingly effectedb means of anteroeposterior ilaps. Setious collapse followed, fron wlhich ti patient rallied in a few hours under stimulants, and subsequently recovere, vitiout a serious sVmptot. He wias able to Icave his bed within th wveeks fron the operation, and was discharged, cured, on the 1thi Auguist- N. Y Mcd. Tfimci."
      ],
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         "eng"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE CANADA MEDJCAL 31 il}϶~ [ÇDunrnal of Rsbitin, furgsrg~ nk fîtWrumn. ~DITwORs: FRANCIS W. CAMPBELL, M.A., M.D., L.R.C.P., LONDON, EDIT' R AND PROPRIETOR. R. A. KENNEDY, M.A., M.D., MANAGING ELITOR. .ASSISTA2NT ErDITOS: CASEY A. WOOD, C.M., M.D. YOL. Ociober, GEORGE E. ARMSTRONG, C.M., M.D. XIV. 1886. PRINTED BY JOHN LOVELL \u0026 SON. 1886. lo Seyten:ber, *~ RECORD:",
         "CONTENTS. ORIGINAL COMMUNIOATIONS. PAGE A . C. E. Mixture. The ........................................... 337 Bright's Disease. Chronic.......................... 401 Ephemeral Fever. W eid or .................................... 403 Gynecological Report............................................ 313 H om optysis. .... ......... ..,........................................ 579 Lecture at the Pennsylrania Hospital, Philadelphia. Clinical........ ........................... 361 Lecture. Clinical.....................441, 505, 529, 553, 579, 607 Medical Association, Presideits Address. Canada ..,. 583' Medico-Chirurgical Society of Montreal.............. 484 M yalgia............................................. ........................ 581 Prostitution and its'relations to the Public Health. The Question of......................................... 289 Sciatica.................................... 607 Tongue. Amputation of the..................................... 444 Val edictory Address to Graduates ................ 481 Whooping Cough. The Quinine Treatment of........... 605 Yellow Fever. Report of the Etiology and the Preven- tative Vaccination of............................................ 577 SOCIETY PROCEEDINGS. Canadian Medical Association ..................... ........... 593 Medical Association. Canadian... ...... ............ 589 Montreal Medico-Chirurgical Society. 314, 445, 531, 555, 589 PROGRESS OF SCIENCE. Aborticn at the Fourth'or 'Fifth Month, with retaiued Placenta. Treatment of..........,...,................... 376 Abscess. The Prevention of Mammary............... 521 Acue. Bromide of Arsenic in......... ................ .......... 418 £sopihagus. Foreign Bodies in the................... 423 Alopecia. Prescription for..................................354, 602 A m enorrh ea ........ ................................ ....... ......... 494 Amenorrba and Dysmenorrhoœa. Santonine in......... 381 Anoemia and Atrophic Conditions. The Therapeutic V alue of A rsenic in ............ ....;.............................. 351 An-esthetics, C . ............................. 364 Angina Pectoris by the fodide ofSodium. Treatment of 349 Ani. Nux Vomica in Prolapsus........,.................... 550 Antimonials. Notes on the Use of................. 405 Anus without O peration. Treatment of Painful F issure of the....................................... 548 A phasia.................................... .............. ............. 327 Artificial Respiration in Cases of Stillbirth and of Ap- parent Death after Tracheotomy. Some Points in the P ractice of .................................................... 520 Asphyctic New-Born Children. Schultze's Swinging M otions to Revive........................................ ....... 495 Asthma. The Cure of............................................ 549 Asthma. The Prophylaxis of................................,.... 544 Aathma. The Tceatmeut of....................... 380 Baldness. The Prevention of................... 517 Belladonna and Iodide of Potassium..... ....... ........ ... 381 Belladonna. Some of Its Therapeutic Uses......,......... 454 vAGE. Biliary Colic. Jaundice and Pain in........... 380 Bleeding. Novel Method of..................... 422 Bowel Diseases in Children. Irrigation in.................. 538 Breast. Iodide of Potassium in Infiamed..................... 331 Breech Presentation. Management of............. ........ 546 Bright's Disease. The Elements of Prognosis in ........ 375 Brigbt's Disease. The Treatment of Chronic............. 347 Bronchitis. Treatmuent of Acute Infantile............507, 535 Cæesarean Section afterDeath of Mother, Living Child Rem oved. Case of ............................................. 379 Calcium. On the Therapeutic Value of the Chloride of 372 Cancer of the U terus................................................ 378 Carboncle. Tannin as a Speciflc for.. ............ 330 Cardiac and Renal Diseases. Nitro-Glycerine, Nitrite of Amyl and Nitrite of Sodium in................. 357 Cardiac W eakness. On.................... ....................... 307 C atheters.............................. .............................. 423 Catheter A Painless Method of Introducing the......... 550 Cerebral Hemorrhage, Thrombosis and Embolism. The Use of Carbonate of Ammonia in............................ 353 Chancroid. Treatment of the................. ................. 516 Cholera Infantum. Therapenties 0f.......................... 369 Cholera. Treatment of............................................- 496 Chorea Successfully.Treated with Hyoscyamine..... ... 493 Constipation. Cascara and Chronic Punctional......... 460 Constipation Habit,......, . .........................., .......... 419 Consumption. The Curability of ............................ 367 Consumption. The Influence of High Altitudes upon Pulm onary......................................................... 324 Consumption. Treatment of Pulmonary............ 498 Corpulence on Physiological Principles. The Treatment of . .... ........... ....................... 350 Coryza. Brief Notes on the Treatrment cfJAcute......... 374 C ough ............................ ....................................... 488 Cough of Children. The Nocturnal............................ 497 Cough Mixture. Efficient Sedativ . ................ 624 Croup. Biehloride of Mercury in Diphtheria and.....,... 346 Croup, Diphtheritic Croup, True Croup. Membranous. 353 Croup. Pilocarpine in.......................... 356 Croup. The Specific Treatmaent of Diphtheria and..... 456 Croup with Muriate of Pilocarpine. Treatment of....... 421 Cystitis. Chronic........................... 616 Dernatology...... ..... ........................................574, 625 Diabetes Mellitus Successfully Treated with Boracic A cid................................................... 520 Diarrhea and Dysentery in Children.......................... 514 Diarrhœa and Feeding Bottles...... ........................... 549 Dietary in Acute Diseases. The................................ 622 D iet for the Sick..................................................... 462 Digestion. Disorders of........... .......... ................ 304 Diphtheria and Croup. Bichloride of Mercury in. 346 Diphtheria and Croup. The Specific Treatment of....... 456 Diphtberia. Instructions concerning the Management of 355 Dislocations of the Hip. A New Method of Reducing. 379 Diuretic. W ater as a............................................... 496 Doses. Memorizing. ............. ........... 624",
         "CONTENTS. I PAGE Dover's Powder and its'Modifications ......... .............. 522 Dover's Powder. Modifications of................ 523 Dysentery in Children. Diarrhœa and........................ 514 Dysmenorrhœa. Santonine in Amenorrhea and........ 381 Dysmenorrhea. The Treatment of Membranous......... 418 Earache. A Liniment for...... ........... ,........... 550 Ear. A New Method of Applying Remedies to the...... 417 Ear of a Child. A Cherry-Pit in the........................ 459 Eczema. Treatment of...... ....... ................... 358 Epilepsy. Drunkards'.......... .................................... 554 Epilepsy. im o .................... ......................... 345 Epilepsy. The Importance of Shampooing and Gym- nastic Exercise in the Treatment of........................ 326 Epilepsy. The Treatment of....................... 550 Epilepsy with Borax. The Treatment of..................... 549 Epistaxis. Bleeding from the Nose or .......... ............ 618 Epistaxis. The Treatment of........................ 331- Furuncles. On the Treatment of.....................,.... ..... 513 Gall Stones. The Surgical Treatment of.............. 352 Gastric Disturbance. Gl.ycerine 1.................. 350 Gastro-Intestinal Indigestion..................................... 462 Gonorrhoea. Belladonna Injection fo r...................... 351 Gonorrhea Easily Cured...................... 348 Gonorrhea in the Female. How to Diagnose....... ..... 355 Homoptysis. Opium in..................................... ...... 349 Homoptysis. The Treatment of Profuse.................... 515 Hemorrhage. To Arrest Nasal......... .................. ..... 572 H om orrhoids.......................................................... 381 H eadache......... ................................... .................. 511 Headache. The Treatment of................................... 602 IHeadache. The Treatment of Sick............... ............ 358 Heart Disease. The Treatment of Chronic.................. 623 H eart. W eak .................... .... .............................. 457 Hepatic Disorders. Fotheigill on.............................. 372 Hiccough relieved by Nitro-Glycerine. A Case of Obstinate.................................... 371 Hip. A New Method of Reducing Dislocations of the. . 379 Hysterical Attack. Treatment of the ........................ 623 Incontinence of Urine in Children. Remarks on..329, 356,614 Indigestion. Carbolic Acid in......... .......... 331 Indigestion. The Dietary in .. ............................. 539 Ingluvin......... ............................. ... ..................... 613 Inhalant. Useful......... ............................ 352 Insomnia. ColdBandaging of the Leg in.................... 571 Intermittent Fever. Nitro-Glycerine in the Cold Stage of...... ......................................................... ....... 519 Iodoform . Deodorized.................................... ........ 461 Labor. Induction of Premature ......................... .... 550 Laryngitis. The Treatment of Acute........................ 373 Lecture. Clinical. .............................. 486 Leucorrheal Diseharge from Roller-Skating......... 380 Liver. Medicines which stimulate the.................. ..... 331 Lupus. Treatment of.............................................. 416 Medicants. Oa some new.......... .... .......... ......... 377 Meningitis cured by Iodoform. Tubercular................ 521 Menorrhagia. Hazeline in...... ......... ........................ 346 Metrorrhagia. Hydrastis Canadensis in..................... 571 Migraine. On the Treatment of.................. ............. 328 Nasal Diseases, On the Therapeutics of...................... 414 Nasal Douche. A Simple Form of................ ........... 420 Naso-Pharyngeal Catarrh. Report of a Case of........ 355 Neuralgia. Iodoform Collodion in..,. ...... ........... 352 Neuralgia. Sootbing Application in.............. 381 Neurasthenia. Food in the Treatment of.................. 541 PAGE Nightsweats. Treatment of....................... 459 Nipples. Cocaine in the Treatment of Inflamed.......... 308 Nose. A New Method for the Removal of Foreign Bodies from the............................................................. 517 N ursing ....................... ......................................... 620 Obstetrie............ .................................................. 547 Otorrhoea. The Treatment of... ....................... ........ 601 Peritonitis Treated by Abdominal Section. Acute. 330 Phthisis between Man and Wife. Transmission of...... 381 Phthisis. Inhalations in.......................................... 547 Phthisis. Modern Methods of Treatment of............... 410' Pigment Spots of the Skin. Treatment of;....... ......... 624 Placenta Prævria. The Management of.................516, 548 Pneumonia, Massive Doses of Digitalis in Lobar........ 520 Pneumonia Treated by Intraparenchymatous Injections 519 Potassium. Belladonna and lodide of... .................. 381 Poultices ever be used after an Abscess or Whitlow bas been opened, or to aid the separation of Sloughs ? Should....... ....................................................... 619 Prostatitis. Hot Water in Acute.. ........................... 522 Pruritus of W omen........................... . . ............. 332 Pruritus of Women-Local Treatment........................ 522 Pruritus Vulva .............................. 601 Psoriasis. Boroglyceride in.................... 351 Puerperal Hemorrhage. Vinegar in........ ............ .... 381 Rectum and Hemorrboidal Tumors. Safe, Simple and Effective Mode of Treating Prolapse of the........ 570 Rectum. Feeding by................................... 491 Rectum. The.. ................................ 354 Rénal Diseases. Nitro-Glycecine, Nitrite of Amyl and Nitrite of Sodium in Cardiac and........................... 357 Rheumatism. On the Treatment of Acute.................. 363 Ringworm. A Hint on the Treatment of. ................. 521 Salve. Delacour's Lip............................................. 381 Scabies. Treatnent nf................... ......................... 550 Scarlet Fever. Desquamation in ................... ........... 346 Sciatica. Hypodermic Injections of Cold Water in...... 522 Sick. D iet for the.................................................... 462 Skin Diseases. The Contagions.................. 357 Skin Diseases. Turpentine in.................................... 349 Sprains. A New Method of Treating......... ..... ........ 422 Sterility from Flexion. On the Treatment of Painful Menstruation and ................ ........... 566 Stomach. Buttermilk in Sick .................................. 343 Surgery. Chiene's Contributions to Practical............ 518 Sweating Feet. Bismuth in the Treatment of............. 497 Sweats. Local Applications for Night............... 307 Tapeworm. The Treatment of.................................. 343 Therapeutic............ ..................... . ............ 545 Therapeutic Hints and Approved Formul:e ................ 460 Therapeutic Notes............ ...................................... 306 Tonsils by Caustic Applications. How to Shrink Hy- pertrophied ........................................................ 331 T orticollis............................................................... 458 Tracheotomy. A Year's Experience mu....................... 342 Typhoid Fever, especially with reference to Prognosis. O n..................................................................... 300 Typhoid Fever The Treatment of............... ........... 421 Ulcers of the Leg. Treatment of............................ 345 Urethra. Removal of Foreign Boüy in the.................. 497 V accination........................................................... 517 Vaccination, the Preservation of Lymph and other Points. A Few Practical Observations on......... 543 Vagina. Foreign Bodies in the ................... 319",
         "III CONTENTS. 1A( E Varicose Veins Treated with Hamamelis. Notes of Four C ases of........................................ ................... 370 Venesection.................................- 522 Vomiîting. Ice to the Spire in Obstinate...............346, -197 Vomiting of Pregnancy........................................... 382 Vomiting of Pregnancy. Another Treaiment for......... G02 Vomiting of Pregnancy. 1lydrochlorate of Cocaine in the................ .... .................. . . 2 V ulva. Pruritus................ .................................... 601 Whooping-Congh. A Mixture for......................... 382 Whooping-Cough. Iodised Phenol in the Treatment of 373 Wounds of the Fingers. How to Treat................ ..... 377 EDITORIAL. Alexander's Operation........................ 525 Bishop's College. Fifteetli Annual Convocation of the Medical Faculty of.... ............................. . ........ 498 Blood Plague. The.............................................. 500 Bovine Yaccine Points ............. .............................. 383 Canada Medical Association................. 310, 552, 574. 602 College of Pby3sicians and Surgeons, Province of Que- ýec............................................ 309, 525, 551, 572, 625 Correspondence..... ........................336, 562, 575, 608, 611 Epidemic. The Origin of the................................... 382 Famous Books., Mrs. Soutbworth's............ ............ 335 Flint. M.D., LL.D., Austin......... ............................ 4G2 Hospital. Montreal General .... ............................... 523 PAGE International Medical Congress. Oflicers of the. 626 odoform. New Application of.............. ,............... 576 lodoformirum Absoiutum........................ ......... 311 Items. Toronto.................... ......... 626 Lactopeptine ............................... 383 Local and General..................311, 333, se, 463, 502, 528 Malt. W yeth's Liquid................... .............. 574 Marsden. Quehec, The Late Dr............. ......... ....... 358 Matrim onial.......................... ............................ 11 M eGill Faculty of Medicine........................... ........... 310 Medical Association. Canada...............310, 552, 574, 602 Medical Society. Toronto........................ 552 Monthlv. New York Medical ................... 574 New York Medical Month1ly....... .. ...... .. ............ .74 Obitiary......... ..... ........................ 312 Ontario Medical Association, The.................. ........ 552 Personal... ..... .... . . ............312, 335, 384, 500, 527. 627 Peterson's 25 cent Series.....- . ... . . . ............. 335 Philadelp\u003ehia Medical Items......... . . .................. .. 575 Quebec College of Physicians and Surgeons. Proposed C hange in the...... .................... .................. ........ 524 Scarlet Fever. The Origin on.................. ........ 626 Smallpox Ep:idemic. The............................308, 335, 424 Toronto Medical Society......... ........................ ......... 552 Yellow Fever and its Prevention................. .............. 603 REVIEWS. Reviews.........................................312, 360, 384, 500, 627",
         "TH CA.NAD MEDICAL RECORD. VOL. XIV. MONT RREAL, OCTOBER, 1885. ORIGINAL COMMUNICATIONS. The Question of Prostitution and its relations to the Public Health... 289 PROGRESS OF SCIENCE. On Typhoid Fever, especially with reference to Prognosis.............. 300 Disorders of Digestion ................ 304 Therapeutic Notes....................... 306 On Cardiac Weakness................. 307 Local Applicat'ns for NightSweats 307 Cocaine lu the Treatment of In- flamed Nipples................ 308 EDITORIAL. The Small-pox Epidemic ...... ... 308 College of Physicians \u0026 Surgeons, Province of Quebec ........... ..... 309 McGill Factulty of Medicine......... 310 Canada Medical Association......... 310 Matrimoial......................... 311 Iodoformiium Absolutum.............. 311 Local and General...................... 311 Obituary.................................... 312 Personal ................................ 312 REVIEWS. The Technology of Bacteria Inves- tigation. ................. ... 312 THE QUESTION OF PROSTITUTION AND ITS RELATIONS TO THE PUBLIC HEALTH. By CASEY A. WOOD, C.M., M.D., M.C.P.S.O., Attend- ing Physician to the Western Hospital, Professor of Pathology in the Medical Faculty, University of Bishop's College. The revival of the old question-what shall we do to prevent the spread of syphilis?-seems probable. Twenty years ago the advisability of adopting restrictive measures in the treatment of prostitution was discussed with some warmth. The majority that carried the Contagious Diseases Act and that applauded the licensing system is dvindling down, and the belief gains ground that it is more by indirect and moral means that the desired object is to be attained than by legislative ineasures. Several papers lately wYritten, notably that by )rs. Allison and Ashton (\" The Failure of Legisla. tion in Limiting the spread of Venereal Diseases,\" read before the Philadelphia County Medical So- ciety, April 22nd, 1885), will be likely to provoke discussion of the whole question. The following article is reprinted as a contribution to such dis- cussion, and as the writer has not since seen fit to chanr1e or modify views expressed when it was first written (November, 188o) it is given entire, withùýa .her apology. Whatever action may be taken regarding them by the people at large, whatever influence may be subsequej tly exerted by public opinion, ques tions of hygie. are primarily the property of the med- ical profession. For example, it is rarely that we have to thank the priest, with his time occupied with matters of another world, and caring little for things of earth ; nor the statesman, with his atten- tion taken up by affairs apparently more important; nor even the laity, who have ever exemplified the proverb, \" what's everybody's business is nobody's business \"-we have seldom been indebted to any of these for the inauguration of whatever progress has been made in a single department of sanitary science. No fact could add more to the dignity of our profession, because, in consequence, it must prove to all candid observers that, as a rule, medical men really hope and work for a per- manent lessening of the diseases tha.t infect the race. The statement that the primary discussion of' any measure to improve the health of communities and individuals has almost always been introduced by medical men might be supplemented by show- ing that the conclusions arrived at by them have always formed an important factor in determining action taken by the authorities to remedy the trouble under consideration. It is a fortunate cir- cumstance, perhaps, that such is the case in the questions about to be ventilated in thîs article, for the same spirit of false modesty which prevents a proper discussion by the laity of many a vital question affecting the social econoniy has relegated the treatment of prostitution and its attendant evils to whomsoever cares to occupy himself with it. With this double warrant there can be no rea- son why the matter should not be freely and fully discussed in the pages of a medical journal, no reason why the medical scientist should not decide what measures will have the greatest influence in No. i",
         "290 THE CANADA MEDICAL RECORD. limiting the spread of prostitution and in neutral izing those moral and physical maladies it so uni formly gives rise to. \" Fornicatio aitem nec nominetur in vobis sicut decet sancios,\" wrote Paul to the little church at Ephesus, but probably he never imagined that in later times a whole people would arise who, while tacitly ignoring the spirit, would scrupu- lously insist upon its literai obedience ! But only in these latter days, for, \" in the good old days when George the Third was king,\" Fielding was the popular novelist, and everyone read and openly discussed 1he questionable ways and doings of his heroes and h2roines. Nobody then saw harm in reading Richardson (who, by the way, was a clergyman), nor is it probable that any great harm came of it because of that very fact. There were no \"expurgated \" editions of Shakespeare then, because it was held that to call a \" spade\" by any other than its proper name was quite un- necessary and likely to mislead. The author of \" Vanity Fair\" frequently draws one's attention to this change in public sentiment. For instance : \"Ladies, I do not say that you are a society of vestals,-but the chronicle ýof a hundred years since contains such an amount of scandal that you may be thankful you did not live in such dan- gerous times. No, on my conscience, I believe that men and women are both better ; not only that the Susannahs are more numerous, but that the Elders are not nearly so wicked. Did you ever hear of such books as 'Clarissa,' 'Tom Jones,' ' Roderick Random;' paintings by con- temporary artists of the men and women, the life and society of their day? 'Suppose we were to describe the doings of such a person as Mr. Love- lace, or my Lady Bellaston, or that wonderful ' Lady of Quality,' who lent her memoirs to the author of ' Peregrine Pickle.\" How the pure and outraged nineteenth century would blush, scream, run out of the room, call aivay the young ladies, and- order Mr. Mudie never to send one of that odioùs author's books again ! You are fifty-eight years old, Madam, and it may be that you are too squeamish, that you cry out before you are hurt, and when nobody has'any intention of offending your Ladyship. Also, it may be that the novel- ist's art'is injured býy the restraints put upon him, as many a harmless honest statue at St. Peters and the Vatican is spoiled by he tin draperies in which eccleistir-al old women pave swaddled the fair limbs of the maije. But in your prudery there is reason. So there is in the state censorship of the Press. The pages may contain matter injurious to bonos mores. Out with your scissors, censor, and clip off the prurient paragraph !\" * While we may believe with Thackeray, that people now-a-days are '' of a cleaner conversa- tion,\" ve cannot close our eyes to the fact that, if we do not-hear of and see so much moral unclean- ness it is, to some extent, because it is disguised and hidden. and not because it has ceased to exist. It is tolerated, but nlot recognized, or at least only recognized under certain conventional forms. Society is quite candid in this matter. One is not positively commanded not to eat of the forbiddeni fruit, but the meal must be taken en règle and' respectably. Shakespeare's poems, the tales ofï Boccaccio, and the wonderful adventures of Gulli- ver \" smell to heaven,\" and are altogether detest- able-ce/a va sans dire-but, without giving: offence, you may (if you judiciously avoid particu- lars) discuss the merits of Alexandre Dumas and' Emile Zola. Or, if it happens that you have a taste for lighter literature, what popular novels will more quickly satisfy that literary appetite than the entrées and dessert served up by Rhoda Brough- ton and ' Ouida ? \" Nor need you pay much attention to the abuse they have received from the discontented few, for has not Madarie Grundy taken these productions under her protection ?. Is not \" socially author- ized \" stamped on each title-page? What right then have men like Goodell to call them \" nambypamby trash \" and \" printed erysipelas ? \" This attitude of society towards open discussion of the evils that threaten to undermine the found- ations of its structure, bas a more practical bearing, upon attempts to remedy the evils themselves than is apparent at first sight, because, while it very pro-. perly negatives gross and immodest conversation, it bas always displayed an unfortunate lack of dis- crimination in including in the proscription agita- tions having for their object the eradication of the, maladies. And this absence of a becoming discernment is. nowhere more marked than when the trade of the strumpet is under consideration. Here prudery night be forgiven if honest investigation were per- mitted. But it is not, and has not been, and we are consequently obliged to believe with Char- lotte Bronté that \" to such grievances as society Thackeray's \" Virginians, chap. xli.",
         "THE CANADA MEDICAL RECORD. cannot readily cure it usually forbids utterance on pain of its scorn ; this scorn being only a sort of tinseled cloak to its deformed weakness.\"* * Starting out then with the premise that the endeavor to solve the problem of the social evil nmust not be hampered either by the opinions or prejudices of the classes for whom the work is undertaken, or by the neutrality of other classes whom we might have expected to have been ardent workers with us, it is yet pardonable to say without the slightest feeling of bitterness, and al- most without a sentiment -of disappointment, that there is an additional reason why the profession should not shun this particular labor of mercy, for is it not one of its daily functions to minister to the despised, the wretched and the unclean in every shape'? Bearing in mind the story relateil by a P hysician who in his day had seen \"pass by on the other side \" the priest and the Levite, we need notwonder that the \" cry of those who have wounds without cause \" should still insuit their sanctified ears; that it should still be left to less fastidious hands to pour in the wine and the oil-to less worthy brains to work out the poor enigmas of our lot! In the case of the man of Samaria we may comfort ourselves with the reflection that his charity probably did not seriously diminish lis income, and that there was ne contumely connected with his act of mercy ! 'Three queries, it appears to the writer, cover the whole ground included in the heading of this article. Side issues, important' from other stand- points, force themselves on one's notice and, while it is impossible always to avoid or ignore them, be- cause they are so intimately bound up with the causes and effects of every social disturbance, they can receive but a passing mention in the space so necessarily limited as the pages of a journal devoted 'to medical science. (1) Is ir possible to repress in to/o houses of ill-fame and assignation ? (2) If it were possible to suppress les maisons des dames, would it be wise to make the attempt ? (3) In the event of prohibition failing to accomplish its object, what measures are most likely to limit the evil of prostitution and to curtail'the misery and disease it engenders ? It is difficult to separate the first two questions, and they may be answered together. The history of every nation that has reached a higli state of civilization furnishesus with stories of endeavos * \" Shirley.\" made by the State to wipe out the immediate sources of prostitution, and these attempts are both interesting and instructive. In the early history of the Greeks we find that one of their laws, incorporated in the code of Draco, imposed the death penalty on adultery. If severity could have accomplished the desired end it ought to have done so in this instance, but so powerless did it prove that Solon, seeing the futil- ity of the measure, established by law houses of prostitution at Athens, and filled them with slaves bought by the public money. These Dictera, as they were called, being in a sense public servants, handed over their miserable earnings to the State, and naturally assisted in increasing its revenue. The Romans, wiser in their generation, and profiting, in all probability, by the experience of their Grecian neigbbors, seem never to have atteinpted to wipe out the calling of the harlot. Tacitus tells us that long before his time the prostitute was obliged to register herself at the edile's office, where she re- ceived a license-stuj5ri licentia-in a similar manner and almost upon the same terms as those imposed by existing French laws rcgulating brothels and their inmates. It must be observed, also, that the Romans exacted in their code the penalty that modern society imposes by its unwritten law upon the unfortunate erring one ; it closed every avenue to reform. \" Once a prostitute, always a prosti- tute,\" is a Roman pioverb. Passing to more modern times an instructive lesson may be learned from early attempts to sup- press prostitution in France. - Sanger, in bis admir- able work on the subject, tells us that Louis IX. made the first serious endeavor to stem the rising tide of evil in his dominions. \" His edict, which dates from 1254, directed that all prostitutes, and persons making a living in- directly out of prostitution, such as brothel-keepsrs and procurers, should be forthwith exiled out of the kingdom. It was partially put in force : a large number of unfortunate females were seized and imprisoned or sent across the frontier; severe pun- ishients were inflicted on those who returned to the city of Paris after their expulsion. A panic seized the customers of brothels, and for a few months public decency was restored. But the inevitable consequences of the arbitrary decree of the King soon began to be felt. \"Though the officers of justice had forcibly con- fined in establishments résembling Magdalen hospi- tals a large proportion of the most notorious pros- 291",
         "292 THE CANADA MEDICAL RECORD. titutes, and exiled many more, others arose to take their places. A4 clandestine trafc succeeded ta the former open debauckery, and in the dark the evils of the disease were necessarily aggravated. More than that, as has usually been the case when pros- titution has been violently and suddenly suppres- sed, the number of virtuous women became less, and corruption invaded the family circle. Trades- men coniplained that since the passage of the ordinance they found it impossible to guard the virtue of their wives and daughters against the en- terprises of the military and the students. At last complaints of the evil effects of the ordinance be- came so general and so pressing that, after a lapse of two years, it was repealed. A new royal decree re-established prostitution under rules, which, though not particularly enlightened and humane, still placed it on a sounder footing than it bad occupied before the royal attention had been directed to the subject.\" * Charles IX., in 1560, published an edict pro- hibiting the opening or keeping of any house of reception for prostitutes in Paris. Here was an instance, it is said, of the actual suppression ofthe ttaffic in a large city, but the cure was infinitely worse than the disease, for secret debauchery and seduction took the place of open sin. Society became at last so corrupt that a prominent Hugue- not clergyman nanied Cayet, advocated the re-open- ing of the brothels in th1e interesis of public morals. Twenty-eight years afterwards Henry III. reaf- firmed the ordinance established by Charles, and in 1635 the law was made still more rigorous, but it does not appear that the illicit commerce was ever seriously diminished or the interests of morality sensibly advanced. These French prohibitory làws bave a melan- choly interest for us, because a wise, paternal gov- ernment at home (in answer to an urgent request for female emigrants was enabled. through their pi ovisions, to present the cclonists in Canada with wives fresh from the brothel-houses of Paris ! The edge is taken off this reflection, however, when we consider that the officials who so considerately furnished the colonials whh this class of helpmates were but little better off than their customers ; since the adultery and seduction that followed the forced emigration affected in no slight degree the class it wvas expected to protect, and in many instances penetrated to the families of those who had been guilty of so vile an outrage on the virtue of the * History of Prostitution, pp. 95, 96. colony. So m.ay wrong ever recoil upon the heads of its perpetrators ! In Spain the profligacy of public morals had at one time reached a height hitherto unprecedented, and this state of affairs has been ascribed almost altogether to legislation of the Draconian kind. The history of suppressive measures in Italy tells the sare story. Our word bagnio, expressive of a house of ill-fame, originated in efforts to root out brothels and punish their inmates. When driven from their usual haunts, loose women were obliged to frequent places of public resort, so that in a short time every keeper of a bath became also a brothel-m aster. The laws of Hamburg passed through the sev- eral phases of suppres3sion, toleration and regula- tion, until now they present a fair sample of the manner in which most European cities manage their rakes and harlots. A local writer, arguing in favor of the laws now in force there, speaks thus of repressive measures, and his assertions undoubtedly apply to all other cities: \"Suppression is absolutely impracticable, inasmuch as the evil is an unconquerable physical requirement. It would seera as if the zeal against public brothels implied that by their çxtinction a limitation of sexual intercourse, except in marriage, would be effected. This is erroneous, for reliable details prove that for every hundred brothel women there would be two hundred private prostitutes, and no human power could prevent this.\"* The Puritan Fathers were in the habit of dealing directly and sharply with social shortcom- ings. Their laws against adultery and fornication were stern and unrelenting. Their policy of re- pression is well depicted in Nathaniel Hawthorne's \" Scarlet Letter,\" and the plot of the novel rests upon an instance of its failure to keep in the straight path a shepherd of the people and one of his flock. When the mythical deputy of the Duke of Vienna issued a proclamation, dooming all sub- urban bouses of resort, the decree is made the subject of conversation between a clown (whom Sliakspeare usually puts forward as a wise man in disguise) and a noted procuress, in this wise: Bawd.-\" Why here's a change indeed in the commonwealth ! what shall become of me ? Clown.-Come; fear not you .good counsellors lack no clients: though you changeyour place you need not change your trade; l'I be your tap- * Sanger on Prostitution, p. 197.",
         "THE CANADA' EDICAL RECORD. ster still. Courage, there will be pity taken on you: you that worn your eyes almost out in the service, you will be considered.'t And this has been the result of all attempts to eradicate an innate social evil. So long as present conditions obtain among members of human com- munities, j ust as long will they give rise to their pre- sent results. Driven from the \" suburbs,\" the harlot will ply her trade in the city, and if, after infinite pains, she be banished altogether, we resurrect the twin demons of seduction and adultery to fil1 her place. (3) In the event oftrohibitionfailing to accom- plish its object, what nicasures are most likely to limit the evil of prostitution, and to curtail the muisery and disease it engenders 2 Before attempting to furnish a direct answer to this important\u003equestion it is necessary to deal with the arguments of those who condemn all regulative measures. The laisser-faire idea has a great many advocates, and in reference to them some terse sentences from Dr. Beardsley's article will not be out of place:-\" The importation of cholera is intercepted, variola aborted, yellow fever vigilantly patrolled, pestilence- of any form no longer stalks among us without being hotly chased, but a disease ivhich Jacks not a whit the type of a plague, and which, upas-like, infects nation after nation, contributing generously to their charnel- bouses, nestles among us' and travels on friction wheels. Hundreds are honest, ardent in their re- searches after some antidote to this virus, but never essay to stop or modify the eviL Prophy- laxis against venereal suffering sounds to these but balderdash. To quarantine a syphilitic is passing strange. The experiment is ridiculed as if the evil was self-limited, or repudiated as contend- ing against a dispensation from heaven, to meddle with which was to befriend a crime. The stench of this leprosy already fills our nostrils, but no mettle is sounded in our legislators to face the railings of those who hate truth, and are timid at at every revolution. To qualify a wrong is not to endorse it. The health and longevity of the race are paramount to the defence of ethics or rude platitudes in morals. If life is jeopardized, sacri- fices are inperative. Individual prejudices, dog- mas however dearthe faith of ages, all most unloose their hold when the perpetuation of a perfect spe- t \" Measure for Measure,\" Act 1, Scene 2. cies is called in question. If the arm of the law is powerless to stay the gratification of our pas- sions, if the admonitions and misfortunes of others do not dissuade us from the same snare, if the whore will ply her vocation, is it criminal to disarm her of her sting ? Is it not conniving at the prac- tice to suffer that foul doxy to parade her goods and pollute a neighborhood? The time is' nigh when this vapid sentimentalism in religion-this morality which dubs every dissenter fron creeds an anti-Christ, and translates the license of prosti- tution as free love, should be undone. The social evil cannot be remedied without sorne compromise. It is a monster too huge to be snothered, and we must curry favor with it to lessen its depreda. Mr. Solly, whose reputation as a surgeon is not confined to his native country, at a meeting of the Royal Medico-Chirurgical Society some years ago, gave utterance to sentiments that, more than any other, have inspired the vehemvent opposition en- countered by reformuers in their efforts to meet this evil by legislation. Said he :-\" Far from consider- ing syphilis an evil I regard it, on the contrary, as a blessing, and believe that it was inflicted by the Ahnighty to act as a restraint upon the indulgence of evil passions. Could the disease be exterminated, as I hope it cannot, fornication vould ride ram- pant through the land.\"' It is quite within the limits of truth to say that this doctrine is responsi- ble for the barbarous refusai to admit syphilitic patients into the public hospitals of London, not a great while ago, and prevented the erection of special hospitals for a still longer period. It is this same enunciation ofthe Creatox's \"intentions,\"' that condenned the use of aniesthetics in midwifery, and like interpretations of God's \" will \" carried to their legitimate conclusions, have obstructed many a needed reform in social custons. At one period in its history the Royal Free Hospital magnanimously devoted the whole of 26 (1) beds to diseased prostitutes, but, says the report, \" the venereal wards have been for some time untenanted, owing to loss of funds occa- sioned by the outcry raised against this hospital in one of the medical journals.\" This issue is now almost a dead one, but, it might be4 asked, if we followout Mr. Solly's argument, is not pneumonia a disease inflicted by the Deity upon the indulgence Chartered Brothels,\" Nvew Orleaus fled. andSurg y7oural for Sept., 1880.",
         "294 'IYE dANtA MEPICAL RfCORt3; in thin slippers and low-necked dresses? Are not typhoid fever and diphtheria penalties imposed by God on civic uncleanness ? Are we justified then, in view of the fact that it is hardly poss1ble to do away with their causes, in trying to cure these serious troubles ? Rejecting the theory that syphilis was inported from the newly-discovered American continent by Columbus, we may sup- pose it first showed itself in Europe about the beginning of the fifteenth century. How, then, did the Lord punish licentious Europeans before that time ? What penalty paid the worshippers at the shrine of Venus Mucheia, or of that beastly old god Priapus? If Mr. Solly's followers declare their intention of going into mourning were a drug discovered capable of ensuring illicit intercourse without the dread consequences of syphilis, surely their grief would find some solace in the knowledge that it would no longer be possible to hand that awful disease down ta the third and fourth genera- tion; that innocent children could no Jon;r be made to suffer for the wrong of a diseased father or mother. Another fallacy contained in this so-called argu- ment is that the fear of acquiring venereal disease acts as a check upon the wrongful indulgence in the anatory passion. That this is a grave error the experience of most physicians will prove. The man who conmits any offence against bis physical or moral nature is either careless of the conse- quences, or lie hopes ta be one of the fortunate few who escape contamination. But in discussing this matter are we not intro- ducing into a question purely scientific an elenent essentially religious? What lias Hygiene to do with \"a monstrous outrage on religion \"? How does this \"rupture of moral law \" affect Sanitary Science? Theological dogrmas and problems .in science may run in parallel lines, but any attempt to make them intersect should be cried down. Without dismissing the subject, as sonie writers have done, with the assertion that in any conflict between Religion and Science the former must go to the wall, it night here be mentioned that a way out of the difficulty has been indicated by no less an authority than the Anglican Bishop of Carlisle. Writing in a late review bis Lordship says: \" It sceins ta me we want a new word to express the fact that all physical science, properly so-called, is conpelled by its very nature to take no account of science. If I mighlt coin a word, I should say that science is alheous and therefore could not be ateislic; that is to say, its investigations and reasonings are by agreement conversant simply with observed facts and conclusions drawn from theni, and in this sense it is a/lious or without recognition of God. And because it is so, it can- not treiîch upon thieism or theology, and cannot be a//iestic, or in the condition of denying the existence of God.\"* Tlie melancholy fact (folloiving the foregoing lne of thouglit) in Sanitary Science is that a wide- spread and terrible contagious disease is in our midst, and the conclusion we draw fron a careful investigation of its nature is that it is possible by taking certain precautions, to prevent ta a very considerable degree, the extension of the nalady ; consequently objections born of theological dognas or religious creeds must not beý allowed ta have weight in, determining either the aniount, kind or extent of these prophylactic measures. Sanitary science, as such, is necessarily beyond the pale of religious faith, as such. Living in a country ivhere the policy ofi aisser- faire holds sway, one is forcibly reminded, in reading of the occasional descents by the police upon houses of ilI-repute, of the story told of an old gentleman ivho endeavored to ward off diph- theria from his household, by disinfecting the sewer that ran past his residence. Every niorn- ing before proceeding down town le gravely carried a piece of chlorinated lime ta the street ventilator, and, holding bis nose with the disen- gaged hiauid, dropped the germ-destroying morsel into the filthy waters beneath. This solenin duty performed, he felt himself and bis family quite safe for the following twenty-four hours. No doubt a sinilar feeling aninates the authorities when they make one of their periodical raids upon the inmates of brothels that are not subject ta furtherregulation. With some slight and unimportant modifications Beardsley's description of 'the spasmodic repres- sive method in vogue within the limits of the city of New Orleans wifl apply to the action of the police in Montreal:-\" There is no deternined nor concentrated movenent against brothels as against a nest of counterfeiters, Now and then a raid is made on some disorderly bouse after the, neighbors have become exasperated, and de,, the being of God: as soon as it does this, it * \"God and Nature,\" Nineteenth Century for March, trenches upon theology, and ceases to be physical 1880.",
         "- TRE CANADA M3DICAL RECORD. inanded sternly an abatement of the nuisance. These descents are limited-four a month is about the average. In the interval the traffic flourishes and loses nothing by the interruption. As the time approaches for another sally, for they corne with mathematical regularity, the proprietor with the girls, if cunning, prepares to vacate the premises only to return as soon as the official in- truders have quit. If a fev mopies are nabbed, one dollar and costs the next morning purchases a reprieve, and they at once steer straight for the same den to greet their comrades in arms. It is another corlmentary on our police systeni that these houses are not, after the arrest, shut up and the property confiscated. The business is tacitly recognized as contraband, else the storming of the place is not justifiable. The intent of the law seems gratified, however, if only the tenants are ousted. The building is not cleared, as it ought to be, of its appointments, and its character publicly arraigned-the owner is not fined nor im- prisoned for his conniving at the business. No ordinance directs the rent to be forfeited-nor are bonds set.to the landlord for the healthy use of the property thereafter. The machinery of the con- cern is not disabled, it is merely stopped for a few days.\" * The high-level purist does not believe in either digging up or pruning the social Upas tree; he would occasionally pick off, here and there, a few green leaves, or at most restrain a too flourishing branch. This policy of indifference has been tried again and again, and each time it has been found wanting. Indeed it is based on the assuiption that we are powerless to deal with the social evil, and consequently it would be idile to attempt it. Turning from those who deny the right of governmients to interfere with prostitution because such interference involves lits.\" recognition ; \" fron those who are governed by ignorant apathy, and from those who would institute a vigorous crusade without quarter against all kinds of broth- els and brothel-keepers, we are led to enquire what ineans, if any, are likely to restrain prostitution and limit its attendant diseases. When we recollect that most European cities, Paris, Vienna, Madrid, Hamburg, Berlin, Brussels, etc., have instituted systenis of regulating the in- mates of les maisons de dames, and that for certain New Orleans Aled, and Surg. 7ournal vol, viii, pp. 203, 204. 295 military and naval towns of Great Britain an Act was passed (The Contagious Diseases Act, 1866) with the sanie object, we have abundant. legisla- tion to choose from. The French laws (represent- ing continental legislation) and the provisions of the Contagious Diseases Act may first be con- sidered, their good and bad points referred to, and then an attempt will be made to show that, with some material modifications in the direction of allowing prostitutes greater freedom of action than is possible under the latter law, a Bill might be framed applicable to Canadian cities, or, at aill per- sonals, more consonant with Canadian ideas of liberty. In Paris le Bureau des Moeurs has charge of ail prostitutes within the city. This office eniploys a body of police which in 1870 comprised twenty- four inspectors and three superior officers. This service is alogether charged with searching for those connected with clandestine prostitution (pros- tituées insoumises). There is a sanitary depart-, ment attached to the bureau which superintends the health of the women, and for this purpose en- ploys ten superior and ten assistant surgeons, who examine ail prostitutes subject to police surveil- lance. All women found diseased are at once sent to the St. Lazare Hospital, where they are detained until cured. They are then allowed to resurne their occupation, subject to certain regulations. All courtesans over sixteen years of age are registered at the Bureau des Mieaurs, and are divided into two classes; ist.filles des niaisons, who live in houses of ill-fame and are subject to weekly examination at their residences : 2nd, filles a carte or isolées, who occupy furnished houses by thenselves, and are obliged to present themselves at the Dispen- sary for medical inspection every fifteen days. Each of the latter class carries a carte or 4 bill of health,\" dated and s igned by the surgeon who examines her. On the back of the carte are printed certain regulations to which she is ordered to con- form. These orders refer to her conduct in pub- lic, forbidding her to ply lier trade in daytime or after in p.m. She must be simply dressed, walk quietly along, and she cannot approach within a radius of25 yards any church, chapel, the Palais Royal, Jar4lin des Plantes, etc. It is needless to say that clandestine strumpets resort to all sorts of artifices to elude the police, and the registered prostitutes evade, by all means in their power, the regulations intended to control their conduct. M Prn-i,4tp-- nr-plr.tc rd tke~VsrI",
         "296 THE CANADA MEDIOAL RECORD. of the French laws against \" those who abuse a girl not yet arrived at the age of discretion, and the severe punishment inflicted on those who promote this prenature debauchery,\" shows how this severity makes it difficult to bring home the crimes to their perpetrators on account of the secresy en- ployed, and hence he says \"these young persons are the greatest destroyers of public morals and health.*' That is to say, the law does not recog- nize prostitutes under sixteen, so they are ail the more sought after. It will at once be seen that French laws are too tyrannical, too costly and too elaborate to intro- duce into Canada. Here, as long as she behaves herself decently, a prostitute bas as good a right to walk during daylight on the public streets, to go to church, to attend the theatre, and dine at hotels as any other woman, and nothing would justify her forcible removal from any of these places on mere suspicion of her being there for the purpose of ply- ing ber trade, Again to hunt up clandestine wonien involves an arbitrary search of private bouses which public opinion would not tolerate. That there is something radically wrong in the system is proved by the acknowledged fact that out of the 30,000 loose wornen in Paris in 1870 only 4,000 were registered and subject to sanitary inspection, and this in spite of a strict application of the almost despotic powers possessed by the police. Notwithstanding this, hygienic measures have wonderfully reduced syphilis among the registered prostitutes, as may be seen by the follow- ing table,* in which is given the proportion of diseased to healthy women anong both the regis- -tered class and the clandestines captured by the police. Registered Prostitutes Unregister- Year. in brothels Ditto in the ,Ditto in pri- ed prosti- inside of the suburbs. vate lodging tutes. walls, 1845 1 in 142 1 in 59 1 in 261 1 ini 6.40 1846 1 in 152 1 in -53 I in 183 1 in 6.37 1847 1 in 154 I in 52 1 in 351 1 in 6.46 1848 1 in 126 1 in 37 1 in 182 1 ir 5.66 1849 1 In 128 1 i11 44 1 in 201 , in 5.76 1850 1 in 148 1 in 47 1 in 142 1 in 5.31 1851 1 in 199 1 in 6o 1 in 180 E in 5.47 1852 1 in 184 1 in 76 1 in 349 1 in 5.64 1853 1 in 183 1 in 123 I in 402 1 in 5.12 1854 I in 176 1 in 102 1 in 377 1 in 4.26 * De la prostitution dans la ville de Paris, 1857. * American edition of Westminster Review, vol. xciii. A similar proportionate reduction bas likewise been effected in other continental cities, but, as will be seen by the above table, the dislike of forced imprisonment in St. Lazare has had the effect of making unregistered harlots hide their diseLýses more than ever, bringing about a frightful condi- tion of things among that class. The proportion of syphilitie to healthy women increased from i in 6.4o in 1845 to 1 in 4.26 in 1854 and in 1866 it had risen to one in every four. The Contagious Diseases Act in some points resembles the French laws. Of course it was limited to certain naval and military stations wîth their suburbs. One feature of these enactments provides that aIl prostitutes shall be registered and regularly in- spected, and that when information is made on oath that a woman is a common prostitute a jus- tice may issue a notice to such woman, through the superintendent of police, to appear for surgical examination. Certified Lock hospitals are pro- vided for ber if she is discovered tw be ill. It pro- poses a heavy penalty on any brothel-keeper who harbors a prostitute knowing ber to be diseased. Health tickets are issued to prostitutes ; they are punished for evasion of the inspection, and the hospitals are supported by fines and taxes on the business. These provisions, after much opposition were passed by Parliament, and many were in favor of extending them to the civil population. Mr. Wm. Acton, in his exhaustive work,* writes that he considers it very desirable that the Dis- eases Act sbould be made general, and a very high authority, Dr. Parkes, says, \" The Act at these large stations bas done great good; but, as framed and, administered, it is far too feebly drawn, and too partially carried out, to cope entirely with the evil. The prostitutes are not thoroughly under inspection ; many are not inspected at ail; neigh- boring towns send in prostitutes; hospital accom- modation is insufficient ;-it is clear that the evil is too great to be dealt with piecemeal; it is inevit- able but that the Act must eventually be made compulsory over the whole country, and the entire system of prostitution dealt with carefully and completely once for all.\" † The agitation for repeal of the Contagious Dis- † Manual of Practical Hygiene, page 503. * Prostitution considered in its Moral, Social and Sani- -tary Aspects. Third Edition.",
         "TIRÈ CANAA MËDICAL1 REdORD. 29' eases Act has brought out all sorts of objections to it, some of which appear quite valid and still more of them absurd. Dr. Birkbeck Nevins, of Liverpool, has written one of the few pamphlets against the Act that are worth perusal.‡ Besides the evidence collected by Dr. Nevins and others, the zditor of the !Vestminster Review has bravely laid aside those feeling of false delicacy which had bitherto prevented the Press fron arousing and in- instructing the people concerning the extent and malign influence of the social evil; and in a num- ber of articles and reviews furnishes his readers witi unanswerable arguments against the extension of the Act of 1866, and its anendments in 1869. Without attempting to particularize the evidence furnished by these writers the chief points may be briefly indicated as follows: (r) Such acts legis- late for man, but treat woman as if she were only an instrument to satisfy his evil passions, and they subject lier to a moral degradation below that of ordinary prostitutes not subject to the enactments. (2) The law compels women to commit them- selves absolutely to a life of infany, whereas before they iad it in their power to turn back and reform. There is ahvays a class (in some places a large class) of females who are driven to adopt prostitu- tion temporarily as a means of gaining a livelihood or to support others dependent upon them. These unfortuiates, if they wisely keep their own counsel, may resume their ordinary position in society ; but never if they are forced to register themselves and become public prostitutes. (3) The enforced exanination by a public officer wipes out any sense of modesty or delicacy they iay have retained, and confirms theni in a life of prostitution. (4) The whole system places serious obstacles in the way of atternpts to reform the erring ones. When in hospital they naturally regard any advice or instruction as a part of the compulsory pro- gramme. They are bound to listen to it, and for that reason derive little benefit from it. (6) It is impossible to carry out the provisions of the acts in large cities, when conveniences for clandestine prostitution are so many and so varied. (7) It is asserted that 4 in towns where registra- tion and forced examination are introduced the effect upon the morals of the rising generation is exceedingly injurious. * Statements of the Grounds upon which the Contagious Diseases Acts are Opposed, 1875. * Report of Royal Commission on Contagious Diseases How to avoid the evil effects of govenimental regulation, and yet do something towards lessening the diseases arising from the social evil, is the question that must not be considered. To begin with, the seduction by a man come to years of discretion of a girl under sixteen years of age with or without her consent, should be made a crime and severely punished. There may be some excuse urged for the satisfaction of the sexual passion when the female is of age and already a prostitute-it may be that \" prostitution in man is an'irregular indulgence in a natural impulse, \" as the Royal Commissioners have put it, but to take advantage of the ignorance and inex- perience of a mere child is inexcusable, and the offender should be rigorously dealt, with. Such a law would strike at the root of one of the most fruitful sources of subsequent prostitution. Then \" Homes \" for the reception of women reclaimable by such an agency ought to be pro- vided, and above al], voluntary lock hospitals should be establisied, where diseased females could be properly treated and cared for, and women should be encouraged to enter them with- out beingforced to do so. The absence of opportunities for adequate treatment has always been one of the reasons why unclean prostitutes persist in their career after be- coming diseased. In hospitals of this kind the patient should be surrounded by all the moral, intellectual and sanitaiy influences that would tend to elevate her from ber degraded position, and perhaps induce lier to abandon her evil courses. The wards should be graded, so as not to confine in the sanie room the hardened prostitute with the girl who is new in crime and comparatively redeem- able. For other reasons this gradation is necessary. To quote Parent-Duchatelet [op. cit.]: \"It is difficult to convey an idea of the contempt which, according to the class to which she belongs, each woman manifests for those of the other classes. Those woman who associate with men of wealth or of high position look only with disdain upon women as are only sought after by men of merely ordinary fortune. Woman of this class, again, contemn, in like manner, the unhappy creature who only appears in the rags of the most disgust- ing imisery. This distinction which prostitutes establish among themselves is avowed by all, and is specially remarkable when circumstances cause them to meet eacl other at the same.place; they",
         "IIE dAlADÀ MEDICAL REdOËR). avoid each other; they do not sit down on the sanie seat; they form isolated groups, and do not mix together in conversation. It may be said generally that these classes do not intermingle ; that is to say, the girls do not pass imperceptibly from one class to another, and successively from the highest to the lowest; they remain till the end in that class in which they began their career, or out of which they have been unable to go; and thus it is that very beautiful girls may be seen to begin and end their life of prostitution in the most infamous places. Each of these localities being frequented by a particular class of men, the woman there acquire a tone, habits and manners, the result of which is that the girl destined for the artisan, the laborer and the mason finds her- self misplaced with the officer, and is devoid of the necessary attractions for the latter. The sane is true with respect to the woman who bas contract- ed the habit of living with the educated and eleva- ted classes of society : she shrinks from associating with coarse, vulgar people, who themselves are unable to appreciate the qualities which distin- guish ber. This rule may be considered general. A girl who makes her début in one class would believe herself to be losing caste in leaving the class she occupies for one immediately below it. This is partly the reason why so many girls with- draw themselves from prostitution a short time after they have entered upon it.\" As these hospitals are essentially charitable insti- tutions there is no reason why the inmates should not pay a weekly sum proportionate to the kind of accommodation received and the patient's ability to pay. It is cxtremely important that the nurses and medical officers should be especially respect- fui, kind and gentle. On this point the philosophic Duchatelet is very decided. \"Experience,\" he says, \" bas proved the utility, indeed the necessity, that the medical officers should observe great gentleness, both in their speech and procedure; prostitutes overwhelmed with humiliation, treated with the utnost disdain, and feeling acutely their abjection, know how to appreciate a method of treatment less rude, and feel grateful for the kindly feeling it indicates. * * * * * * This gentle- ness, far removed from familiarity, and which is not incompatible with the reserve, gravity, and dignity which indeed it is necessary to emphasize under the circumstances, enables the physicians to command the respect and deference which are due to them, and which the women are eager to ren- der. Such a hospital should. be overlooked by a matron of tried skill, and she should have under her nurses upon whom the greatest reliance could be placed. These officials should have full charge of the sanitary and moral regulations of the insti- tution. The medical staff should have charge of the medical department ; and should advise with a com- mittee of management when required. From these remarks it will be seen that we contendfor a hospital supported principally by public charity and certain fees (the source of which will be hereafter referred to), because anything like governmental regulations of the internal economy of such an institution should be avoided, if possible. The charitable contributions of the community to aid in the support of these hospitals will be all the more readily forthcoming when it is understood that the cure of disease and the alleviation of suf- fering are their main objects, and not the render- ing of fallen women fit to co-habit with male pros- titutes. Carried out in a proper spirit, such refuges for diseased females would effect a vast amount of good. The work of social and moral regeneration might be carried on with an effect impossible in lock hospitals under the regulations that obtain under the Contagious Diseases Act. Dr. Nevins gives the following significant extract from the Metropo- litan Police Report of 1874 :--\" Women come from unprotected districts, and insist on signing the voluntary submission form, in order that their names may be placed on the register, and that by this means they may gain admission into hospital.\" * How much more readily would diseased unfortu- nates seek a shelter where they would meet with sympathy, where they would not be looked upon with disdain, and where they would be assisted tG recover their lost place in society, than if they had to incur the degradation and penal consequences of registration. But there is another side to the story, which justice and the public health demand should receive attention. A diseased prostitute, whatever else she may be, is a local centre of contagion and a dan- gerous member, of society ; and means should be taken to prevent her from spreading the disorder from which she suffers should she persist in doing so. When a woman bas a venereal disease, and in that condition knowingly gives it to others, it behooves the authorities to step in and, if possible, * Capt. Haris's Report, see sect. io, par. 7.",
         "THE CANADA MEDICAL RECORD. prevent the infection. The same' arguments that justify removal to civic hospitals of cases of small- pox and cholera apply to syphilis and gonorrhoea. In the interests of the public health such cases should be isolated. It has been suggested that physicians should have power to communicate to the chief of police the names of those prostitutes from whom any of their patients has contracted disease. The medical man should satisfy himself that the patient is in a position to state positively when, where, and from whom, he caught the con- tagion, and that the female is in the habit of dis- tributing her favors promiscuously or for money. Where there is any doubt about the last two points the suspected woman should have the benefit of it, but in the majority of instances the police would be able to settle the question satisfactorily. Hav- ing satisfied himself on these points the Chief should have power to serve a notice on the wo- man to forward to him, within 24 hours, a certifi- cate from a regular practitioner of ber being in a healthy state, or else, if she be a common prosti- tute to present herself at the hospital for treat- rnent. In the case of those who are not \" com- mon \" in the ordinary acceptation of the term, i.e., who do not practice their trade openly, and do not live in brothels, it would be justifiable to ac- cept a certificate from a regular practitioner that the woman is under .treatment by him, and that he would use every means in his power to prevent ber from co-habiting until she recovered. In this way(for all these proceedings would be kept secret, and neither the name of the male sufferer nor of the female patient would be divulged) scandal would be prevented in the case of occa- sional and otlierwise \"respectable\" females. For the other class, those who are generally re- cognised strumpets, neglect or refusal to furnish a proper certificate, or to undergo treatment of disease, would justify their arrest and forcible detention in special wards of the hospital for a time discretionary with the officials in charge. Action of this kind would encourage the voluntary system and leave coercion as a dernier ressort. It would incite women to apply for treatment at once, and not wait until they were compelled to quarantine themselves by the strong arm of the law. It would respect the respectable, but punish the guilty. Voluntary patients might be allowed to leave the hospital when they desired, but they should be warned that any attempt to ryturn .tg their trade until fully cured would involve their semi-imprisonment in the \" coercion \" wards of the hospital, and cut them off from all the privileges of the voluntary side. Examinations should be made voluntary in a Dispensary attached to the hospital, and a small fee '(in Hamburgh, where the regulation system is in vogue, it is only a mark) should be charged. As soon as the intention of periodical examinations was known they would begin to be appreciated and, in time, the great majority of the prostitutes in the city would be likely to present themselves for medical inspec- tion. A larger fee might be charged for attending the prcstitutes at their houses. Certificates of good health might be issued if asked for by the women, but it must be understood that they are not considered necessary. It would, of course, be out of the question to admit students to any part of the hospital except to the coercion wards. This portion of the institution, being in some sense a city house of correction, would have a good claim for civic support, and in that case might be overlooked by a local inspector. In the event of a hardened sinner persisting in spreading venereal diseases instead of applying to hospital for relief, and necessitating repeated arrests, it would be justifiable to have ber registered and examined by the medical officer not less frequently than once a week. This would be a greater punishment to her, in view of the treatment of her other sisters in vice, than imprisonment. To conplete these suggested regulations it ought to be made possible for an inmate of a house of ill-fame to abandon her life of infamy free of any claim for board, liquors, clothes, etc., the brothel-keeper may have upon her. It is, of course, to the interest of procurers and keepers to exert as great an influence upon their stock-in- trade as possible, and for this purpose many of them try to keep the girls in debt, so that they are compelled to continue in their old ways. It would be a good idea, also, to subject brothel- keepers to a heavy fine, if it be proved that they allow any of their women to remain in their houses after becoming diseased. The proceeds of such fines would go to defray the expenses of the hospital. The advantages of the measures above specified recommend themselves, because: (i) the legislation involved is not a one-sided treat- ment of woman as if she were made for man sirm- ply to gratify his lust upon ; (2) they leave a way open to those erring ones who desire to reform; 299",
         "THE CANADA MEDICAL RECORD. (3) wo'men are not compelled, except as a last resort, to undergo a degrading periodical examina- tion by public officers; (4) the system does not condemn to a life\"of hopeless infamy those who err temporarily, or who are seduced by designing men ; (5) they provide for clandestine prostitution; (6) they are voluntary to a very great degree, and attempt to do by kindness what coercion has, over and over again, failed to accomplish ; and, lastly, (7) they do not violate the sanctity of private houses, as the system of forced registration is sure to do. An enumeration of the benefits to be derived from Magdalen hospitals would not be complete without a reference to that noble band of religious women belonging to the order of les Surs de la Cempsion; who have charged of l'hôpital de Lourcine in Paris. These devoted woman have caught the true significance of Christ's teaching when He stepped in between the woman taken in adultery and her accusers, the stern Scribes and Pharisees, and rebuked them for their self-right- eousness :- \" Woman ivhere are those thine accusers ? Hath no man condemned thee ? She said, No man, Lord. And Jesus said unto her, Neither do I condemn thee: go, and sin no more. \" * And these considerations bring us back to the old ques- tion, When shall we sec prostitution itself abol- ished ? and while the discouraging and too ready reply is, not vhile society exists in its present state, one is inclined to believe that a great deal of the difficulty arises from the unjust and despi. cable manner in which society treats wornen who lose their virtue from any cause. A man sins, and social custom either excuses or forgives the trans- gression. A woman goes astray, and every avenue of hope is at once closed against her. The escapades of the rake bear such social inter- pretations as \"sowing bis wild oats, \" ''young men will be young men, \" and so on; but upon the temple of the barlot's shame, as over the por- tals of Dantes Izferno is carved the dea'd anaglyph:-«All ye abandon hope who enter here.\" If society expects to abolish prostitution it must first insist upon meting out the same measure of condemnation to bùth sexes for of- fences committed by 'iher, October 20; i885 »John viii, Io, Z i. of Jeetiee. ON TYPHOID FEVER, ESPECIALLY WITH REFERENCE TO PROG- NOSIS. Delivered at ie Hospia2 cf tie University oj Pennsylvania. By WILLIAM P iEPPER, M.D., LL.D., Provost of, and Professor of the Theory and Practice of Medicine in the University of Pennsylvania. GENTLEEN,-The patient before you to-day was admitted to the hospital seven days ago. We could obtain no definite history, but, as far as could be learned, the man had been sick for two weeks before admission, with delirium, continuous fever, hemorrhage fron the bowels, and, for a day or two before he came in, with cough and rapid respirations. From this account it is probable that he was admitted at the beginning of the third week of an attack of typhoid fever complicated with pneumonia. The course of the case during the past week is indicated by the following notes: january 3 (day of admission). There were no evidences of blood in the discharges from the bowel. The face was flushed, the tongue was dry and coated, and there were sordes on the teeth. Jan. 4. Had some delirium; belly moderately distended ; several spots of typhoid-fever eruption ivere detected. There were several liquid stools, dark yellow in color. Shortly after admission the temperature was 103.4°. After this the tem- perature fell and continued to diminish until two days ago. January 6. More delirious, plucking at the bed- clothes. Temperature not so high. Dulness over the right lower lobe of the lung posteriorly, and over the dull region the characterístic crepitant râles are heard. There is retention of urine, it be- ing necessary to use the catheter. Temperature between 1o01. and 102°. January 7. Still further fall of temperature. The dulness over the posterior portion of the chest is extending upward, having now reached the third rib. The restlessness, delirium, and plucking at the bedclothing have continued. These symptoms continued through the 8th, but during the night of the 8th the temperature began to r.ise, and yesterday morning (the 9th) it stood at 1o1. Last night it was 102.5,° and it is the same this morning, so that there lias evidently been a renewal of the fever. The treatment bas been one of active stimula- tion. He bas taken as much milk as we could get him to use, giving it in comparatively small quantities, repeated every hour or hour and a half with a small quantity of whiskey, so that he bas averaged one ounce of whiskey every two hours since admission. In addition he bas taken turpen- tine. I would mention that, since admission, the bowels have been open only once each day, with the exception of one day during which there were four stools, and again, three days ago, wlien twenty- 300",
         "i01 THE CANADA MEDICAL RECORD. four hours passed without any stool. He has borne the turpentine mixture very well. For the exces- sive restlessness which he has presented he was last night given nine grains of musk. We find our patient, then, this morning, at the be- ginning of the fourth week of the attack, delirious, with from time to time rolling of the head, with very little intelligence, with the mouth partly open and the teeth and lips coated with dry sordes. These sordes are nothing but the foul secretions of the mouth dried by the passage of the air over them. When a patient with typhoid fever bas no obstruc- tion of the nostrils, and retains sufficient intelli- gence to breathe through them, and keeps this up during sleep, sordes do not form so much ; but when the patient sinks into a typhoid state, vith dulness of mind, breathing is carried on through the mouth, and the secretions are rapidly dried and form crusts. This is largely owing to the fact that, as a result of the high temperature and the pervert- ed state of the secretions, all the buccal secretions are thick and viscid, and readily dry, svith the for- m ation of crusts. When told to protrude the tongue, he does so bet- ter than he did a few days ago. It is coa ted with a grayish-brown fur. As I have already stated, the temperature this morning is 1o2.50. The pulse is very small, compressible, and 140 per minute. The temperature is well kept up ; the hands and feet are warm. For the last day or two the distention of the abdomen has been very great, and in order to remove this tympanitic condition, turpentine stupes have been used every couple of hours during the night, and this morning the distention is some- what reduced. I shall not disturb him to demonstrate the sign of pneumonia. The dulness, however, does not extend anteriorly, and over the front of both lungs auscultation reveals the presence of vesicular murmur mixed with coarse râles, chiefly bronchial, showing that there is considerable bronchial irrita- tion of both lungs, with consolidation of the poste- rior portion of the right lung. This case illustrates the difficulties attending the treatment of typhoid fever in hospital practice. This man, having received no medical care, no proper nursing, and improperly fed, was admitted to the hospital at the end of the second week, by which time his vital powers had been exhausted and his digestion totally broken down, with diarrhœa of from four to six loose stools daily, which had been allowed to continue ; and, worse than all, with a pneumonia which very likely developed on account of his want of treatment. The late period at which lie comes under treatment, the gravity of the nervous and abdominal symptoms, and the grave complication of pneumonia which he presents, make the prognosis unfavorable, and I expect this man to die. At the same time, the decrease in temperature which has taken place dur- ing the past four or five days until night before last, the subsidence of the diarrhoa, and the absence of vomiting, are favorable symptons, and hold out a hope of his pulling through. The great danger is that the weakness of the heart, which has resulted from want of proper care and proper sustenance, is such that it will be unable to stand the strain, and that we shall have symptoms, of heart-failure, increasing pulmonary engorgement, disturbed capillary circulation, deepening stupor, and di ith. Forty-eight hours will settle the question. The complications of typhoid fever ma be divided into the nervous, the abdominal, and the pulmonary. It is curious how different cases will present these complications in different degrees of severity. Scarcely ever will they be found equally well marked. As a rule, when the nervous symp- toms are marked the abdominal are not. The comn- bination of marked nervous and pulmonary symp- toms is more common. In some of the worst cases of the abdominal complications of typhoid fever, such as copious and intractable diarrhœa, hemor- rhage, and great distention of the abdomen, the brain is perfectly clear. In the present case the abdominal symptons seem to have been marked in the early stage. The man had more or less diar- rhœa ; but this may have been due to want of pro- per care, for as soon as he came under proper treat- nient the diarrhea ceased, and now he ha3 but one stool a day. We estinate the gravity of an attack of typhoid fever, in the first place, by the range of temperature. If the temperature is not above 1040 it is not an unfavorable sign. If it reaches 105° but does not remain at that point, it is not serious. Anything above 105° we term hyperpyrexia, and this is a dangerous sign, particularly if the temper- ature remain almost continuously, day and night, above 105°. When, however, as in the present case, the temperature ranges between 1oi0 and 104 0 , and does not exceed this latter point, it does not become a source of much added danger. In children and in sensitive women a temperature of 105 0 is often reached and maintained for some time without serious danger. It is important to recognise this fact, for it will save the necessity of resorting to powerful measures to reduce the temp- erature. Far too much importance-or, rather, far too exclusive importance-is now a days attached to the study of the temperature in febrile diseases. It is important, and should be carefully watched, for it aids both in prognosis and in treatment ; but the ease with which thermometric observations are made, their accuracy as contrasted with the manner in which many other symptoms have to be studied, and the certainty which they seem to give in studying the course of the case, are apt to divert our attention to too high a degrce from the study of the pulse, the nervous system, and the digestive organs ; whereas, as a matter of fact, the tempera- ture in many cases is less important than informa- tion drawn from the other points to which I have re- ferred. Particularly I am sure that we allow our treatnent to be governed too exclusively by this question of temperature, and are too prone to re- sort to powerful antipyretics, which sometimes are depressing, irritating, and disturbing. Many cases",
         "THE CANADA MEDICAL RECORD. of typhoid fever do perfectly well without severe antipyretic treatnent, even though the temperature be high. It is only when the nervous symptoms and the condition of the heart indicate that the high temperature, in the absence of other compli- cations which would account for the symptoms, is acting as a disturbing element on the brain and the heart that it calls for active treatment. Then ve should resort to any plan of antipyretic treat- ment vhich is efficient, as large doses of quinine or the external use of water. So long as the high temperature is mnaintained without manifest injury being inflicted on the brain or the heart, it is better to avoid powerful antipyretic measures and to allov the case to run its normal course. This is particularly applicable where there are complica- tions which are of themselves suflicient to main- tain the bigh temperature and account for a cer- tain amount of nervous irritation. Under such circumstances these pow-erful remedies often do more harm than good. Among the indications to be considered in the prognosis I have mentioned the heart and the pulse. This is exceedingly important. I think that the study of the sounds of the heart-of the strength of the muscular or first sounds of the hcart, the strength of the impulse, the way in which the artery fills at the wrist, how it resists pressure, the quality of the beat, the frequency of it, and its regularity-is of «the first importance in the prog- nosis of typhoid fever and as a guide to treatment, particularly in regard to the important question of the administration of stimulants. You have a patient with a dry, brown tongue and marked ner- vous symptoms. It may be difficult to decide whether he needs remedies of a sedative character, and perhaps counter-irritation, to quiet the nervous restlessness and draw the excitability from the nerve-centres, or whether he requires stimulation to raise the tone of the circulation and cause a healthier tone of action in the nerve-centres, and thus bring about a secondary quieting or sedative effect. The best test of this is the action of the pulse and the influence of stimulants on the pulse. In a case where the pulse is from 120 to 140 per minute, very compressible, so that it collapses under the slightest pressure, with an exceedingly weak first sound, so that it assumes almost a val- vular character, stimulants may be given freely ; and, under their use, as a rule, the temperature will fall, dryness of the mouth will lessen, and the nervous symptoms will improve. These results indicate that the stimulants are doing good, and encourage us to continue or to increase them. This man needs free stimulation, and if he can stand one ounce of whiskey every hour ie will not hesitate to give it to him through the next two or three days, to tide him over this crisis, for unless the heart is kept up I fear.that he will die in the way which I have mentioned. Symptons referable to the abdominal organs afford sone help in prognosis, but they are not as religble as the evidence presented by the tempera- ture and the circulation. The amount of diarrhea which the man has had has not been very serious, but yet I think that diarrhea in typhoid fever is not a good thing. I do not regard it as an evid- ence of the efforts of nature to eliminate the poison from the system. On the contrary, it is to me an evidence of active disease in the intestinal canal. of imperfect digestion of the food taken, of the presence in the intestines of putrid, irritating secretions. It is undoubtedly better that such irri- tating secretions should be discharged than that they should be locked up in the bowel to undergo putrefaction and probably furnish fresh poison to be absorbed. If, however, by regulated diet, by the avoidance of irritating remedies from the earliest moment that typhoid fever is suspected, and by the use of remedies suitable for the disease of the glands which is certainly going to develop, we can render the matters which enter the intes- tine so easily digestible and assimilable that they will not putrefy, we-may keep the secretions in a less putrid state, and thus diminish the diarrhea. I think that the early treatment of a case oftyphoid fever has more to do with the state of the bowel than anything else. It frequently happens that when a patient presents himself to a physician in the early stage of typhoid fever lie is given a lax- ative, vith the idea that he is suffering fron a slight catarrhal attack frorm irritating matter. As you know, one of the diagnostic signs in the early stage of typhoid fever is the remarkable effect fron a laxative. It will produce several loose stools; and when the physician secs this his attention is directed to the possibility of the case being one of typhoid fever. But I do not know that much is gained by this therapeutic test. Suppose the case were only one of catarrh of the intestine, allowing the bowels to remain quiet would prolong the case only twelve or twenty-four hours, the irritating matters would be discharged, and the patient would have taken nothing to increase the trouble ; but if the case is going to be one of typhoid fever, the patient has on the brink of ulceration a num- ber of glands throughout the intestinal canal, and then I think that even the mildest laxative is un- desirable and may be directly harrmful. I have no doubt that many cases of typhoid fever bave this intestinal eleinent, and are made serious by injudicious management during the first forty- eight hours. What is wanted is absolute rest, absolute diet, and absolute avoidance of direct medication until the disease indicates what it pro- bably is going to be. When diarrboea is present, it ;s to be checked, not by the use of opiates to lock up the howel, but by reducing the food taken until we obtain that which can be absorbed. The ordinary principles of alimentation are as true in typhoid fever as they are in health. It is not that which is put in the stomach that does good, but it is that which the stomach is able to absorb and appropriate and put in such a condition that when it enters the intestinal canal it shall be read- ily absorbed. h is gseless to pour three ounces 302",
         "TIHE CAI4ADA MÈDICAL ÈECORD. of milk one hour and three ounces of beef-tea the next hour into a patient who is not really absorb- ing more than half an ounce in the twenty-four bours. The more food is Liven under these cir- cumstances, the more is digestion deranged. Fermentation takes place, and the abdomen is greatly distended from the accumulation of gas. i should try to check the diarrhœa by reducing the diet to a point where the patient is able to as- similate it, by the use of remedies directed to heal the irritated mucous membrane, and by the use of opiates only in small quantities. Opiates to check the diarrhœa of typhoid fever usually do as much if not more harm than good. A continuance of diarrhea is often well borne, particularly if the stools come from the lower bowel as a result of the discharge from the ulcers, and do not come from want of absorption of the nourishment which is taken. If they are not associated with grcat tympanitic distentioin of the belly, or with marked failure of the pulse, or with severe nervous symp- toms, a certain number of loose stools may be borne without particular harm. When, however, there is continued diarrhcea, with frequent copious stools, particularly if discharged unconsciously, with distention of the abdomen, showing that the intestinal muscles and the muscles of the abdominal walls are paralyzed, the prognosis is extrenely had, for such diarrhea is apt to prove uncontrol- lable. Another symptom referable to the abdominal condition of the intestines is hemorrhage. Hemorrhage from the bowel often occurs as a hemorrhoidal discharge and means nothing seri- ous. Slight hemorrhages occurring early are not of evil omen, and henorrhages occurring at the time that the sloughs are cast off may not be serious ; but where the bleeding is frequently re- peated and the amount lost is large, and where it is associated with diarrhea and great tympanitic distention of the abdomen, it indicates such pros- tration of vitality and such dyscrasia of the blood as to render the prognosis very unfavorable. The tympanites .which this man bas had amounted to a serious trouble ; and sometimes the tympanitic distention goes so far as to consti- tute an important element in the prognosis. It indicates, in the first place, a paralytic state of the muscles of the abdominal walls ; and in the second place it indicates fermentation of the ingesta and deficient digestion and absorption. This disten- tion, by its pressure upward, causes marked inter- ference with respiration and adds greatly to the effects of any pulmonary trouble which may co- exist. Distention of the abdomen in typhoid fever should be studied in this way'so as to be traced to its proper cause. If it is the result of muscular debility, it will be helped by stimulating applica- tions. Strychnia is particularly useful in these cases. If it is the result of fermentation of the ingesta, it may often be diminished by peptonizing the food and by the internal use of carbolic acid and creasote, whicli will lessen fermentation. 803 Where the accumulation of gases interferes with the action of the diaphragm, an attempt should be made to draw off the gases by a rectal tube. This operation usually has to be repeated, and I have even been forced to puncture the abdominal wall with a hypodermic needle to draw the gases from the intestine; and I have seen patients recover where I have had to do this on several successive days on account of interference with respiration. As a rule, however, when it cornes to this point death follows. I shall add to the large amount of alcohol which this man is taking one-fortieth of a grain of strych- nia four times a day. This will be dissolved in weak alcohol and water and thrown under the skin of the abdomen. The pulnionary symp toms of typhoid fever afford very important elenents in prognosis. We should never let a day pass without examining the lungs and heart of our typhoid-fever patients. A cer- tain amount of bronchial irritation is an almost constant element in typhoid fever. Usually by the end of the second or during the third week we find hypostatic congestion, with a little impair- ment of resonance, weak vesicular murmur, and crepitant râles on inspiration over the lower lobes behind. This we consider an almost inevitable feature of the disease ; but when, instead of mere- ly a hypostatic congestion, the disease, as here, goes on to consolidation, and, as you observe, is unilateral, niot symmetrical as is hypostatic con- gestion,-not limited to the lower lobes, but in- volving first the lower lobe and then extending to the upper lobe, with bronchial respiration and with coarse, crackling rales,-we know that it is not merely an exaggerated degree of that conges- tion incident to the disease, but that it is a real complication, a croupous pneumonia. As I have said on another occasion, the typhoid state and pneumonia present different relations to each other. Pneumonia may be present and run into the typhoid state. This really is typhoid pneumonia. Again, there may be typhoid fever and pneumonia occurring as a complication ; but this bas nothing to do with typhoid pneumonia. It is typhoid fever. The pneumonia is a purely intercurrent, accidental phenomenon, a true com- plication,-and it is a complication of great grav- ity. Sometimes it takes the form of catarrhal pneumonia; and this is even worse than croupous pneumonia. It is apt to be associated with exten- sive collapse of the lung. The areas affected multiply and spread, and exudation and softening occur: so that, on the whole, catarrhal pneumonia complicating typhoid fever is even more unfavor- able than croupous pneumonia, except the extent of the latter be very great ; but cither of them is a grave complication and adds largely to the mor- tality. If it comes upon a patient with bad ty- phoid fever, already reduced by other symptoms, as diarrhea, and who presents evidences of nervous exhaustion and failure of cardiac power, the chances are that the patient will die. The prog-",
         "TIE dANADA MiÈDICAL - RËCOi)4 nosis is rendered graver by the existence of the serious pulnonary complication, and this is an indication for vigorous stimulation. The amount of alcohol should be increased, as much concen- trated nourishment as the digestive organs will stand should be given, and carbonate of ammonia and turpentine administered internally. In this case iurpentine in the dose of ten drops in emul- sion every three hours has been given for th e tym- panitic distention of the abdomen, and has been found to act satisfactorily. It will therefore be continued. Lastly, this case is instructive in regard to the nervous symptoms, which are always valuable in prognosis and treatment. We expect a certain amount of nervous disturbance in these cases, and rarely is it wanting. Occasionally it is absent, and this year particularly I have seen an unusually large number of cases of typhoid fever which were, characteristic in other respects, but presented no nervous symptoms whatever. Another - curious fact is that in many cases during the past year the abdominal symptoms were wanting, and many cases presented constipation, so that it was neces- sary to use an enema every third or fourth day. In some cases I'gave once a week a grain of calomel in one-tenth of a grain doses, followed by an enema. As a rule, however, we expect some ner- vous disturbance. As long as it is only a little night delirium it is not ac evidence of much dan- ger. This is, of course, more marked in those of a nervous temperament. When it deepens into marked hebetude with tendency to stupor, or, still more, when it takes the form of constant, restless delirium, with quick suspicious glances of the eye alternating with dulness, with constant twitching even when the patient seems to be as- sleep, with plucking at the bedclothes, it -is a symptom of gravity. Other grave nervous symptoms are struggling constantly to rise and slipping down in the bed as from muscular debil- ity. I need not say that profound stupor and convulsions are very serious symptoms. This man has presented twitching of the tendons, picking at the bedclothes, and almost constant delirium in a marked degree ever since he had been under observation. As a rule, the nervous symptoms of typhoid fever are evidences of de- bility and call for a stimulating plan of treatment. When in the early stage of the disease they are present, with marked arterial excitement, flushing of the face and injection of the eye, they are indic- ations for counter-irritation and a sedative plan of treatment. In ' the present case the nervous symptoms have been such as to call for stimula- tion, and as he has been stimulated the nervous symptoms have diminished. Here, then, is an important guide for treatment. If, under the use of stimulants, the nervous symptoms diminish and sleep becomes more natural, we know that the stimulants are doing good. This patient is bearing stimulation very well. The only question is whether or not we can stimu- late him enough to tide hiin over the next twenty- four hours. He will be given eighteen to twenty- four ounces of whiskey in the twenty-four hours, ten drops of turpentine every three hours, and one-fortieth of a grain of strychnia hypodernically four times a day, and if he is restless at night the musk shall be repeated. [This case was again presented to the class two weeks later. An abscess of the parotid had formed and opened, but the patient was greatly improved, and had been free from fever for sever- al days. At this time the quantity of stimulus, which had been reduced, was still further reduced, so that he received half an ounce every two hours. He was also ordered a mixture containing one- fortieth of a grain of strychnia, two grains of quinia, five drops of dilute hydrochloric acid, ten minims of compound tincture of cardamom, and sufficient water to make one drachm. This was to be taken four times a day, and constituted the only treatment. The patient made a rapid recov- ery. REP. DISORDERS OF DIGESTION. From the London Med. Times, February 7, 1885, we note the following extract from Dr. T. Lauder Brunton's lecture: In the first lecture, the lecturer had stated that the function of digestion, like health generally, might be strong or weak. A strong digestion was- capable of withstanding all- sorts of adverse influ- ences, while a weak digestion remained undis- turbed only under the most favorable circumstances. When any disturbances occurred in the digestive function, no matter whether it were strong or weak originally, the first step towards restoring it to health was to remove, if possible, any disturbing causes which might still be acting upon it. One of the commonest of these was imperfect matica- tion. This frequently arose from too short a time being allotted for a meal, or, from the mind being occupied during the meal with the idea of some- thing to be done afterwards. Persons who took their meals alone very frequently read during them. But a solitary meal should be avoided if possible, for the mere presence of a companion, and, still more, occasional conversation, acted as a pleasant stimulus, and tended to maintain the nervous acti- vity referred to in the first lecture as an important factor in perfect digestion. Another cause of imperfect mastication was the condition of the teeth. Sometimes the teeth and gums were tender, or one or more teeth might be decayed, and the discomfort or pain occasioned in them by mastication led people to bolt theirfood, or to masticate on the other side of the mouth, if the tenderness was limited to one side. When all the teeth were gone, the person might chew perfect- ly well, not only by means of artificial teeth, but also without them. The_. effect of thorough mastication upon the food would vary a good deal ,according to the nature of the food itself; and tough sub- stances, which could with difficulty be comminuted, 804",
         "THE CANADA MEDICAL RECORD. would be more indigestible than those which were readily broken up. The fine subdivision of fatty food was of great importance in regard to its digestion. The more minutely the fat was subdivided, the more easily was it digested. In regard to butcher's meat, also, there were great differences, depending both on the kind of meat used and its condition at the time of cooking; meat which was cooked before rigor mortis ap- peared, or after it had passed off, was tender ; but meat cooked while rigor mortis still existed was sure to be tough. In the case of game, the practice of keeping the meat until it was actually commencing to decompose, was not without some danger; for not only migbt the products of decomposition formed in the meat, before it was cooked, be injur- ious but decomposition would be rather apt to occur more readily in the intestinal canal. The gastric juice, no doubt, had a considerable antiseptic power, and so had the bile; but these powers might be overtaxed, and eating high meat was one of the ways in which this might be done. It was, how- ever, rather extraordinary to what an extent the consumption of decomposing food could be carried' without any immediate injury, as was seen among the Esquimaux and Icelanders. After referring to the importance of good cook- ing, and observing how unappetizing badly-cooked food was, the lecturer spoke of intemperance. The proper way to abolish drunkenness, he said, was to remove the thirst that led to it. The malnutri- tion which gave rise to a craving for alcohol might be a consequence of imperfect digestion, as well as of an insufficient supply of food. But, besides cooking and mastication, a most important question had to be considered, viz., the kinds of food a person might eat. In a healthy man the best guide, both as to quantity and quality, was the appetite. Food eaten with a relish was. as a rule, wholesome. Too great a regulation of the diet 'was sometimes very injurious. But the palate. and appetite alone would not serve as reliable guides to the quantity and quality of food. They had to be regulated by experience. Dyspeptics might be regarded as a peculiar class of people, r.equiring fuller instructions as to diet than healthy people ; and a few-general directions, to them were by no nieans out of place. Thus, they might be directed to avoid new bread, but- tered toast. muffins and pastry, all of which were difficult to disintegrate. They might be.told to eat fish, or to prefer meat which had a short fibre, like inutton, chicken, or game, rather than take those meats where the fibres were !org and tough, lke beef. There were some substances taken with food, which were utterly indigestible. Most seeds, when whole, were indigestible. Even when broken, like the kernels of nuts or almonds, they were spar- ingly. digestible; and the sanie was the case with the skins of fruits, and the harder fibres and stalks of vegetables. Where the intestines -vere slow to 805 act, such things as strawberries, raspberries, figs, nuts, prunes, and apples, might be allowed and even recommended ; but where the intestines were irritable, all such things must be forbidden. Acid fruits were not only indigestible in themselves, but were apt to leave irritation behind. Some drinks were peculiarly liable to cause indigestion ; for instance, sour wines, some kinds of beer, and tea. Tea was better borne by the stomach, when taken vith bacon or tongue, i.e., with cured meat than with fresh meat, and it was partly owing to that fact that many people*could drink tea at break- fast who could not take it at any other meal. When taken two or three hours after lunch, tea brought on acidity, probably because the contents of the stomach were much more acid at that time thanat any other. Amongst the poor the tea was so.made as to con- tain a large\" proportion of tannin, which had an irritating effect ; then, again, it was taken very hot, heat was a stimulant to the heart, but in this case, the heat would -reach the heart directly through the thin diaphragm. Coffee had not such an irritat- ing effect as tea, and cocoa was still less irritating. Another cause of imperfect digestion was fatigue. \" How often,\" said the lecturer, \"do we find that the meal taken by a person immediately after a long railway journey disagrees with him, and either causes sickness, diarrhoea, or a bilious head- ache. Forty winks after dinner is by no means a bad thing, but forty winks before dinner is frequently much better.\" Effects, somewhat similar to those of fatigue, might be produced by depressing or dis- turbing mental emotions or bodily conditions. Dif- ferent emotions appear to affect specially, not only different organs, like the heart and intestinal canal but different parts of the digestive apparatus. Thus disgust affected the stomach, causing vomiting ; fear was seen, in some of the lower animals, to affect the rectum, causing defecation ; compassion affected the small intestine producing borborygmi; worry and anxiety, although they worked upon *the stomach and lessened appetite, appeared. to have a very. special influence upon the liver. They sometimes produced jaundice, and not un- frequently caused glycosuria; indeed, most of the cases of diabetes in middle-aged persons appeared to originate in worry and anxiety. In treating cases of indigestion, or thé conse quence due to injurious mental influences, the de- pressing cause must be removed, if possible. If this could not be done, change of air and scene, with exercise short of fatigue, and in the open air, were serviceable. Bromide of potassium, either alone or combined with bromide of ammonium, was very useful, both in lessening the sensibility of the nervous system to worry, and in procuring sleep. Gastric tonics increased the appetite, loosened flatulence, and tended to diminish the discomfort and languor which were apt to accompany indi- gestion. Another class'of remedies was that of carminatives, which tended to disperse flatulence.",
         "306 ~PI1J~i CANADA AtEDIdAL IIECOItD. Amongst the most powerful of these were ethers and volatile oils of various kinds, charcoal and sub- nitrate of bismuth, which, however, produced their effects in a totally different manner. Closely allied to carminatives, he placed stimulants, including alcohols and ethers. He was not opposed to the use of alcohol, provided always that it was used in moderation ; the infirm and aged required a little wine. Treatment might also proceed on other lines the products of waste had to be removed; purga- tives were used with this object. A regular action of the bowels was important, not only by removing the indigestible residue of food, and thus prevent- ing fecal accumulation, but by getting rid of some injurious products which had been formed during the process of digestion. Where the bowels were habitually constipated, a most useful thing was to give a small aloetic pill before the last food of the day, dinner or supper as the case might be. The use of such pills might be continued for very many years together, without the least impairment to the general health. The saline natural waters, or the salts obtained from theni, were best given the first thing in the morning, and should be either warmed or given along with warm water. There were two kinds of biliousness, i. e., bilious- ness with two different conditions of biliary flow. In the one kind, the stools were clay-colored, from the absence of bile ; in the other, the stools were either normal or dark-colored, from excess of bile. Certain bodies belonging to the aromatic series had a very remarkable action upon the secre- tion of bile-some rendering it much more watery than before; others, agaîn, making it so thick and viscid that it would no longer flow through the biliary capillaries, whence jaundice resulted. A blue pill and black draught always proved useful in such conditions. Closely connected with cholagogues and hepatic stimulants, there was another important class o'f drugs, narnely, alteratives. Nitrohydrochloric acid -was a favorite remedy, and a very useful one in biliousness, and chloride of ammonium was much recommended. Another class of remedies was .also useful in indigestion, viz., diuretics. By the frequent use of water as a diluent, either alone or *vith salin s. the consequences of indigestion, in regard to the lungs, heart, and head, night be often averted or remedied. One of the most important methods of treatment consisted essentially in passive exercise and abun- dant feeding. Treatment by massage increased the nutrition, both of the voluntary muscles and of the internal organs ; and under its use patients, apparently hopelessly incurable completely recov- ered. The lecturer concluded with a briefreference to a case in which this treatment had proved emin- ently successful. THERAPEUTIC NOTES. Taken from Lectures in N. Y. Polyclinic, by E. L. FRIDEN- BERG, M. D., Peoria, Ill. VARICOSE VEINS. Fluid extract hamamelis (Bullard \u0026 Cren- shaw's) in teaspoonful doses three times a day. This treatment should be kept up for at least four months, and will give relief in every case, and in a majority of cases will effect a cure. ERYSIPELAS. Wash the parts with buttermilk every three hours, and give internally tinicture of iron and quiine. GONORRHEA. Take sol. corrosive sublimate, 1-500 (holding tight the urethra so as not to allow solution to enter the bladder) and inject two or three times, then wash out excess with pure water, and then give Vichy salts. Generally one sitting will per- fect a cure. In the more chronic form of gonor- rhœa use the following: R Liq. plumbi subacet dil. 7 Ozs. Zinci acetatis: 5 grs M. -fl. sol. Sig. Inject three times a day CONDYLOMATA ON TONGUE IN SYPHILIS, Treat the same with the following : R Corros. sublimate. .15 grs. Ether, 2 oZs. M. fi. sol. Sig. The physician himself should apply this. , STONE IN THE BLADDER. R Acid benzoici, 34 to i br. Soda bicarb, z to 3 dr. Aquae, 5 ozs. Sig. Teaspoonful 5 times a day. TO DELAY HARDENING 0F PLASTER PARIS. Add beer or milk. If plaster is old, put in a pan over fire. HOW TO PREPARE ANTISEPTIC GAUZE. Take ten yards of cheese cloth, boil in water, and after it is dry place in a solution of liq. Sodæ chlor. (i pt. to 2 pts. water), and allow it to re- main in this solution for forty-eight hours, after which time it should be taken out, dried, and placed in a jar of sul. corros. sublimate (1-5000) until wanted, when it should be taken out and wrapped in protective. Just before using it should be put in a sol. of corros. sublimate (1-ooo), and then squeezed out, when it is ready to be put on the patient. IODOFORM GAUZE. Dip dry gauze in sublimate solution (1-5000) and pepper it well with iodoform. TO MAKE SOLUTION OF CORROSIVE SUBLIMATE: R Corros. sub., 30 grs. Glycerine, 34- drm. Water, 1 oz. Salt, 20 grs. Sig. Two teaspoonful to pint of water equals 1-2000. -306 Mt CAleADA MEDIdAL UECOËD.",
         "TuË dA1NADA MEDIéAL 1IECOÈÙ. ABSORBENTS. Take clean cotton, boil it, dry it, and then place it in a 1 to 5 Labarrque solution, and put it in a solution of boracic acid, 15 grs. of boracic acid to i oz. of water. HOW TO PREPARE SPoÑGES. Get nice spojnges, string them, and whip thor- oughly until sand and dirt is out of them, then put them in a solution of liq. sod. chlor. (r to 5), and allow them to remain for forty-eight hours. Then dry them and keep in a glass jar. ilfethod No. 2.-Whip, put iii sol. permanganate potassium (- grs. to i oz. water) for one half hour. Take out, wash in clear water, then dip in a solution of oxalic acid (1 oz to 40 ozs. water) ; leave in one-half hour, then wash out in clear water and let them dry in sun or hot oven. CATGUT SUTURES. For majority of operations four sizes of cat gut are needed-E, A, and G violin strings and minor harp. For amputation G strings. Take the strings, cut off the ends, and place themr in bottle contain- ing either alcohol or ol. juniper berries. DRAINAGE TUBES. Take chicken bones, place them first in ether, then in a 33 per cent. solution of hydrochloric acid for twvelve hours, after which put in alcohol until needed. ON CARDIAC WEAKNESS. The functional disorders of the heart presenting theinselves so frequently and in so varied expres- sions to the practitioner are not infrequently a severe tax upon his diagnostic acumen and his capacity to afford relief. Aside from the cardiac depression resulting as an expression of sympathy from some existing patho- logical condition in the system, or some definite organic lesion, there is a functional weakness of the heart, due to faulty innervation of that organ. Dr. Seeligmuller, of Halle, speaking before the last meeting of German physicians in Madgeburg, held ihat this form of cardiac weakness could always be traced to two causes, viz., habitual sexual excitement without corresponding satisfaction and continued intense brain-work with insufficient allowance of sleep. In the more definitely developed cases we find general weakness, excitement, and palpitation of the heart, pains in the epigastric region, profound reaction after even moderate physical or mental ex- ercise, deepening occasionally almost into coma, persistent insomnia, hyperchondrical depression, failing nutrition in spite of good appetite, pallor, and slight cyanosis of the extremities and naso- labial region, and occasional fomication in hands and feet. If we examine the heart at different ties of the day we can always note the weakness of the apex-beat and the heart-sounds, and the smallress of the pulse. The state of inanition is 307 most favorable to present all symptoms of cardiac weakness. After arising, such patients usually have a pulse of about 40, after breakfast of abôut 50, and do not obtain a pulse of 6o before taking some wine or eating some meat. The normal fre- quency of the pulse is scarcely ever or only tran- siently reached. In very pronounced cases we meet with steno-cardiac paroxysms. Next to this persistent extrenie cardiac weakness there is a mild, intermittent form often connected with great excit- ability of the heart (irritable weakness). Every excitement causes palpitation, tea or coffee insomnia, in these patients. It is difficult to decide in the single cases whether the seat of the neurosis be in the pneumogastric or sympathetic nerves or in the medulla oblongata. Intense mental impres- sions, no matter whether of a pleasant or unpleasant nature, tend to aggravate.the existing evil. Per- sisting pains, neuralgic in especial, and traumatic accidents, cause likewise a frequent aggravatiori of the afiction. Woien having passed ·through confinements often complain of this ailment, pos- sibly on account of the concentration of the blood in the abdomen. Improvement is generally obtainable in these cases by the wearing of a suit- able abdominal bandage. In persons ofan advanced age abnormal dilatation of veins in the lower extrem- ities often leads to cardiac weakness. The therapeutical measures to be employed are chiefly related to proper physical exercise, regula- tion of diet, and change of air. A sufficient allowance of sleep, especially before midnight, is to be insisted upon, and resting during daytime, even if sleep is not obtainable, is to be recom- mended. All violent physical strains are to be strictly avoided, while methodical, moderate gym- nastical exercises, especially walking, are salutary. Forced cold-water cures are injurious, while warm baths, taken several times a week, are indicated. The diet ought to be strengthening and abundant. Coffee, tea, alcoholic stimulants and tobacco are to be entirely avoided. A prolonged stay at the sea- shore or in the mountains has often proved a beneficent measure. The thermo-baths of Gastein enjoy an especial reputation for this affection.- Th/erapeutic Gazette. LOCAL APPLICATIONS FOR NIGHT SWEATS. London MedicalRecord (abstract) Dr. Radakoff found Tinct. Belladonna very successful. His rules are : Apply freely so that the skin remains moist a lotion composed of one drachm of the tincture and one ounce of water. Undertake the rubbing not earlier than one or two hours before the usual time of occurrence of the sweats. This plan suc- ceeds in 49 out of 5o cases. Dr. Nikolai recom- mends sponging of the entire body with a solution composed of 2 drachms:of chloral hydrate in 2 glass- fulls of equal parts of nates and brandy at a temp- erature of about 7o' F. His best results were obtained in children suffering from non-phthisical night sweats.",
         "THE CANADA MEDICAL RECORD. COCAINE IN THE TREATMENT OF IN- FLAMED NIPPLES. The limits of usefulness of cocaine do not seem to have been reached. The sphere of its therapeu- tic activity, is, on the contrary, constantly increasing. One of the peculiar features of the remedy is the promptness and constancy of its action. Its latest employment is that advanced by Unna in the treatment of inflamed nipples, in which affection he holds it has no rival in marvelously removing both pain and soreness. Every physician knows how troublesome and difficult it is to cure a fissured nipple if a baby is nursing it. To afford prompt relief, even while the child nurses, has not been hitherto accomplished. Cocaine is said to have succeeded in all cases tried by Unna and others. The nipple is to be brushed every ten minutes, in the intervals of nursing, by a weak solution (one- half to one per cent.) of the hydrochlorate of cocaine. Within one or two days the fissure will have healed completely, and all pain consequently will have completely disappeared. The bitter taste of the drug does not prevent the child from nursing, nor is there any danger of its absorption and consequent untoward effects in the child. It ,would even possibly benefit the child when irritable and restless.-Thierapeutic Gazette. THE CANADA MEDICAL RECORD A Monthly Journal of Medicine and Surgery. EDITORS: FRANCIS V. CA MPBELL, M.A., M.D., L.lt.C.P. LOWiD. Editor and Proprietor. B. A. KENNEDY, M.A., M.D., Managing Editor. ASSISTANT EDITORS: CASEY A. WOOD, C.M., M.D. GEORGE E, ARMSRONG, C.M., M.D. SUBSCRIPTION TWO DOLLAIS PER ANNU31. Afl communication . and LBxchanges muet be addressed to the ,gditors, Drawer 356, Post Ofice, Mont-real. MONTREAL, OCTOBER, 1885. THE SMALL-POX EPIDEMIC. The epidemic of Variola which is playing such terrible havoc among the French-Canadian portion of our population, at the time we write (Oct. 26) shows no sign of abatement. The deaths are in the neighborhood of fifty a day, the large per- centage being children under, 5 years of age, who have nev~r been vaccinated. The City of Mont- real, somewhat late in recognising the possibility that the disease would take a strong hold on here has at last realized the serious state of affairs, and, assisted by a most energetic Citizens' Committee are working vigorously to stay the disease. Mount Royal Hospital, capable of holding some 300 beds has been opened on ground outside the city and is almost full. Additional accommodation is being rapidly added, and we have every hope that by the time this article will be read not less than a iooo beds will be ready for occupation. An Isolating Comnittee are at work and are meeting with a cer- tain degree of opposition. This is, however, fading away before the determined attitude of the Health Authorities, and we have every reason to hope that within a mônth every case in the City of, Montreal will be effectually isolated. This done, we may reasonably hope that the disease wilP with- in another month be completely under control and rapidly disappear. The large amount of material which Montreal has susceptible to the disease, is due to the fact, that since the last epidemic-some five years ago-vaccination bas not been carried on to any extent among the children born of French- Canadian parents. This is due largely to the most extraordinary antipathy which, as a class, they have against vaccination, but also to apathy of many of the physicians and nidwives who attend them. The latter are greatly blameable, and are, in our opin- ion, responsible for the state in which matters now are. Some of them are anti-vaccinators at heart, which discreditable position makes them the scorn of the civilized world. Others, while believing in the efficacy of the operation, have not the courage to face the torrent of superstition and ignorance which surrounds them. We hardly know which to blame most. Although largely con- fined to the poorer French Canadian element the disease bas appeared to a limited extent among the English-speaking population. A small number of deaths have occurred among them, but, as a rule, the cases are mild. In most of the cases where death has taken place the evidence of a primary vaccination was poor, and re-vaccination had never been performed. We have not heard of a single case occurring after a recent re-vaccination. We need hardly say that the damage to the busi- ness of the city is enormous, almost beyond cal- culation. We regret to add that some persons in sister provinces have attempted to make money out ofUourý misfortunes. Good luck can hardly 308",
         "THE CANADA MEDICAL RECORD. follow money so obtained, while the scorn of all honest men will surely follow such contempt- ible efforts to obtain business. For the moment the City of Montreal is bowed down with sorrow, but the shadow will soon pass away, and the energy of ber people will rapidly restore to her that trade wbich bas made her-not only the chief trading city of the Dominion, but one of the most beautiful cities on this continent. Fifteen years ago the writer of this article-then a public vaccinator for a large section of the city of Montreal-drew the attention of the Health Committee to the constant danger of small-pox which beset. the city from the yearly increasing number of unvaccinated children, and suggested the speedy adoption of civil registration as the best means of securing the vaccination of the greater number. This advice was repeated on several subsequent occasions, but it was deerned a boon impossible to obtain in this Province, owing to the system of religious registration in use. We are, however, pleased to state that the present epidemic is not without its bright side. It has shown those from whom opposition to civil registration was said to be sure to arise, that if small-pox is not to have constantly waiting for it thousands of victims, this can alone be accom- plished by a thorough system of registration such as is on the statute books of England and of France. They now admit this fact, and wbere opposition was seen ten years ago, we now believe we may expect cordial support. In the meantime we hope that some of the practitioners who live in our suburbs will realise the obligation which science has imposed on them-and, by example and pre- cept, proclaim to their misguided countrymen that in vaccination and re-vaccination we have an all but absolute preventive of \" La Picotte \" or Small- Pox. COLLEGE OF PHYSICIANS, AND SUR- GEONS, PROVINCE OF QUEBEC. The seni-anniual meeting of the College of Physicians and Surgeons of the Province of Que- bec was held on the 3oth of September in the Medi- cal Department of Laval University in the City of Quebec. The chair was occupied by the Presi- dent, Dr. C. E. Lemieux. A resolution of condo- lence was passed with reference to the death of Dr. Alfred Jackson of Quebec, who for many years had been one of the Governors of the College. Dr. Simard took his seat as one of the repre- sentatives of Laval University. The Board had been duly notified of his election. The report of the Preliminary Examination Board was read. It showed that 56 candidates presented themselves, 23 of which were rejected on certain subjects while 5 were rejected for general deficiency. Two gentlemen who were in the North-West doing military duty, and wbo were therefore unable to go up for their Preliminary examination in May last (as they intended) made application for a favor. In September each was rejected on a single subject. They asked that if successful in passing these subjects next spring, that they be allowed to count the commencement of their studies-from September of this year. Upon a division this was granted them. The report of the. Treasurer from September, 1884, to September, 1885, showed a balance on hand of $1155.68. The report of Mr. de Lamirande, the Agent of the College, showed that he had not been idle, and that several convictions for illegally practising had been obtained. The report of Committee on the financial condition of the College, presented at the last meeting of the Board was on motion adopted, with the exception of the recommendation to re. duce the salary of the Registrar, which continues- as heretofore. This report provides that there may be only one meeting of the College in the year, and raises the fee of the license to $25. These changes cannot come into force till adopted by the Legislature. A Committee composed of Drs. Lemieux, George Ross, F. W. Câmpbell, Hingston, Lachapelle, Austin, P. E. Mignault, Marcil, Marsden, Desaulnier, Ladouceur, Lanctot, Roger, Guay and L. La Rue were named to take into consideration the suggestions named at the last Tri-Annual Meeting of the College, with regard to the method of electing the Gover- nors. The notice of motion given at the previous meeting, anent a Central Examining Board, as in Ontario, was referred to this Committee, which is to meet in Montreal. A resolution affirming the Board's opinion as to the incontestible value of vaccination, as a safe- guard against small-pox was unanimously adopted. The following gentlemen took out the License of the College : Graduates of Victoria Coliege-- Hilaire Gen- dreau, Alfred Laurendeau, Alfred Morin, Ferdi- 309",
         "M1U TEE CANADA MEDICAL RECORD. nand Simard, T. Daniel Caisse, Lucien Proulx, Arcadus Toupin, Joseph Jetté, Hormidas Bro- deur. Graduates of McGiil College.-Henri Dazé, W. A. De Wolff Smith, W. Galt Johnston. Graduates of Laval.-Chas. F. X. Prevost, Hector Palardy, Chs. N. Gauvreau, Louis A. Gagné, Gaston G. Smiltes, Louis F. Lepage, Leon O. Noel, Louis P. Picard, Joseph Houle, Jos. N. Legault. Graduates of Bishof s College-jabez B.Saund- ers, Frank R. England. If was decided to print yearly the additions to the Register. McGILL FACULTY OF MEDICINE. The Medical Facilty of McGill College opened their new building on the 22nd of October, when there was present many friends of the School, and a large number of students. Representatives were also present from other Medical Schools in the city. D. R. P. Howard, the Dean, occupied the chair. Dr. Osler, formerly a Professor in this Faculty, but now of the University of Pennsylvania, and Dr. Pepper, of the same school, were present, and ad- dressed the students in eloquent and appropriate terms. The new building is in every way admirably adapted for its purpose, and we wish the Faculty every success in their new quarters. In the evening the Faculty entertained a number of friends to a dinner in the Ladies' Ordinary of the Windsor Hotel. The gathering was a very plea- sant one, and it was two o'clock in the morning before the paity separated, the Venerable Chan- cellor of the University, Hon. James Ferrier, re- maining to the last. CANADA MEDICAL ASSOCIATION. The Eighteenth Annual Meeting of this Associa- tion was held at Chatham on the 2nd of Septem- ber under the presidency of Dr. Osler. The atten- dance was good, and several papers of interest were laid before the meeting. It was decided to meet at Quebec next year. The following officers were elected for the year 1885-86: President-Dr. Holmes, Chatham. General Secretary-Dr. Stewart, Montreal. Ireasurer-Dr. Sheard, Toronto. Fice-Presidents-For Ontario, Dr. Sloan, Blyth. Quebec, Dr. C. Sewell, Quebec. New Brunswick, Dr. Earle, St John. Nova Scotia, Dr. Wickwire, Halifax. Manitoba, Dr. Brett, Winnipeg. Local Secr-etaries-Ontario, Dr. Wishart, Lon- don. Quebec, Dr. Bell, Montreil. Ne,v Bruns- wick, Dr. Lunan, Campbellton. Nova 8:otia, Dr. Almon, Jr., Halifax. Manitoba, Dr. Good,\u003e Win- nipeg. COMMITTEEs. On Publication-Dr. Kennedy, Montreal ; Dr. Fulton, Toronto; Dr. W. H. B. Aikins, Toronto. Medicine-Dr. Cameron, Toronto; Dr. F. W. Campbell, Montreal; Dr. Saunders, Kingston. Surgery-Dr. Kerr, Winnipeg; Dr. Kains, St. Thomas; Dr. Waugh, London. Obstetrics-Dr. Holmes, Chatham; Dr. Mc- Kay, Woodstock ; Dr. Campbell, Seaforth. Tier-apetics-Dr. Oliver, Kingston; Dr. Sloane, Blyth ; Dr. Tye, Chatham. Necrology-)r. Fulton, Toronto; Dr. Graham, Toronto; Dr. J. C. Cameron, Montreal. .Education-Dr. Pyne, Toronto; Dr. Sheard, Toronto ; Dr. Adam Wright, Toronto; Dr. Bots- ford, St. John; Dr. Allison, St. John; Dr. Arnott, London. Public Halth-~-Dr. Yeomans, Mt. Forrest; Dr. Grant, Ottawa; Dr. Harding, St. John ; Dr. Robil- lard, Ottawa; Dr. Laberge, Montreal; Dr. Bots- ford, St John; Dr. Playter, Ottawa; Dr. Covern- ton, Toronto; Dr. Oldwright, Toronto ; Dr. Boyce; Hon. Dr. Parker, Halifax; Dr. Kittson, Winnipeg. THE melancholy. death, by drowning, of Mr. H. P. Gisborne, manager of the Canadian branches of the New York Pharmacal Association, the Maltine Co., and Messrs. Reed \u0026 Carnrick, of New York, will have been learned with regret by many of our readers. Deceased was accompanying two friends to the Island in Toronto Harbor where one of them resides, but failing to gain access to the boat-house of the Argonaut Rowing Club, where a boat belonging to one of the gentlemen was kept, an attempt was made to enter the build- ing by a window whicl was several feet distant from an adjoining wharf. Mr. Gisborne's com- panions passed over in safety, but, in making the jump, that gentleman must have missed his footing, and, in falling into the water beneath, struck his forehead on a . projecting beam. The water wn'as only about five feet deep, but it is saiW that de-",
         "THE CANADA MEDICAL RECORD. ceased never rose to the surface. It was some twenty minutes before the body was found when life was pronounced to be extinct. The occurrence took place on the evening of August 16th. His brother is the well-known superintendent of the Government Telegraph and Signal Service. As a business man Mr. Gisborne vas well known. He nade many warm friends and bis loss will be deeply regretted. The management of the busi- ness bas been, meanwhile, placed in the hands of Mr. R. L. Gibson, who bas heretofore been acting as the representative on the road, and bas been carried on as usual. MATRIMONIAL. Dr. Perrigo, Professor of Surgery in Bishop's College, who is to be married early in Noverber, was entertained at a Dinner given by bis profes- sional friends at the Windsor Hotel, on the 29th of October. A number of unique presents was presented to the worthy Doctor whose health was heartily toasted. The chair was occupied by Dr. Kennedy and the vice-chair by Dr. Rodgers. IODOFORMIUM ABSOLUTUM. The Chemische Fabrik auf Aktien, Berlin (late E. Schering) bas recently taken out a patent for the manufacture of iodoform by electrolysis, and bas given the name of lodoformium Absolutum to the product. The iodoform thus produced is absolutely pure; it is a mild smelling, silky, delicate, and soft scaly powder of a pure citron yellow color. It can be easily reduced to a fine powder by trituration. It is no higher in price than ordinary iodoform, al- tbough iodoform as sent out now is a very different article in its physical properties from what it was a feW years ago. There is still room for improve- nient, and those who are in the habit of using it înuch will welcome the advent of the new pre. paration. LOCAL AND GENERAL. I suppose there is no escape from discussing the issues that arise out of the small-pox epidemic, but I must confess that it is a subject fraught with slight interest for the Montreal medical man. He Sees the ordinary means of arresting the-plague neglected until it is too late, and tben looks on while they are enforced with an enthusiasm worthy cf a better cause. Beyond vaccination and the isolation of patients in fairly well vaccinated districts I don't see that anything worthy of the name bas been done to prevent the infection of the whole city. It is infected now, and, beyond the use of the small- pox hospitals for those who cannot be properly looked after at home and the vaccination of those who are not already protected, I do not see that it is worth while wasting money on such measures as isolation and placarding. Thirty sanitary policemen to isolate two thou- sand cases of small-pox ! If there were not something extremely pathetic about the feeble eighteenth century notions of sanitaticn prevalent in this city one might consider this the joke of the season, but the idea of initia- ing genuine bouse isolation in this city at this stage of the epidemic with anything like twice thirty policemen is to invite the contempt of those who really do know something about the way in which the disease called variola attacks a city. I have said this city, and by that I mean a city of (with its suburbs) 150,ooo inhabitants, fully one half of which were not vaccinated effectively when the plague broke out, fully one-quarter of which are unvaccinated now,-probably the majority of these are opposed to and will resist vaccination in the future. I refer to a city the majority ofwhose inhabitants beLong to the same class intellectually and physically that fell victims to cholera in the South of France, in Spain and in Italy-who are indifferent about sanitary matters, who ascribe, with apathetic fatalism, the visitation of the disease to le bon Dieu, and do not quarrel with His wise decrees; who rose, like the corresponding class in Barcelona during the cholera, and attacked the Health Office, and who wield just enough political influence to fetter the hands of men who, if left free to act, would conduct themselves like men, and not make the name of our city a term of re- proach. \" They do these things better in France.\" When small-pox reaches other cities, the majority of whose citizens are of a different intellectual cal- ibre, genuine isolation, genuine disinfection, and prompt vaccination are sternly insisted upon. No waiting for a small-pox hospital to be re-opened and furnished; no wasting of valuable time; no bandying of words; and no stupid consulting of the whims and wishes of the patient and bis friends. P. A. LAvERoS, M.D. S11",
         "THE CANADA MEDICAL RECORD. OB'i'UARY. Dr. H. L. Vercoe (M.D., McGill, 1865) died at Toronto on the 28th of July last. He had prac- ticed in Seaforth, Ont., for some years and gained the esteem of a large clientele. Dr. J. R. Vicat (M.D., McGill, 1867) died lately in South Carolina from phthisis. He practised for many years at Richmond, Que., and was greatly esteemed. Dr. W. G. Metcalfe, who died last August from a wound inflicted by a patient in the Rockwood Lunatic A sylum, Kingston, was a graduate of Toronto University, 1872. PERSONAL. Dr. John J. Gardner, Professor of Anatomy in Bishop's College, has been appointed physician to the Protestant Small-pox Hospital in Montreal. Dr. Wolfred Neilson, (M.D., Bishop's, and M.D., McGill, 1871) has been appointed Medical Inspec- tor for the New York Life Insurance Company for South America. Dr. F.W. Camapbell, of Montreal, returned to Can- ada by the Allan SS. Parisian, on the 27th of Sept. Dr. Wyat G. Johnston, (M.D., McGill, 1884) has been appointed Pathologist to the Montreal General Hospital. Dr. F. R. England, (M.D., Bishop's College, 1885) has returned to Canada-after six months passed in London, and commenced practice at Point St. Charles, Montreal. The Rev. J. B. Saunders, M.D., Bishop's College, bas been appointed Professor of Botany in his Alma Mater. Dr. J. Wolf. Smith, kM.D., McGill, 1882) after some service on the line of the Canadian Pacific IRailway, bas commenced practice in Montreal. Dr. C. O. Reilly, Superintendent of the Toronto General Hospital, after spending three months in Europe, returned to Canada by the Allan SS. Pari- sian, September 27. - Dr. McNeece, (M.D., McGill College, 1869), bas been appointed Assistant Health Officer for Mont- real. Dr. Major bas returned to Montreal after spend- ing seven months on the European continent. Dr. Buck (M.D., McGill, 1862), Superintendent of the London Lunatic Asylum, bas been granted four months' leave of absence, to recruit his health, which is somewhat broken down. Mr. Keith, of Edinburgh, the celebrated Ovar- iotomist, lately paid a flying visit to Boston to consult with a surgeon of that city. REVIEWS. THE TECHNOLOGY OF BACTERIA IN- VESTIGATION. Containing explicit directions for the stua'ý' of bacteria, their culture, straining, mounting, etc. According to the methods emiPloyed by the most eminent investigators. By C. S DOLLEY, M.D., published by S. E. CASSINO, \u0026- Co , Boston. The Author presents this work with the hope that its perusal will stimulate careful study of the Schizomycetis by American investigators, and assist them in adding their share to the mass of facts concerning bacteria. If a condensed compilation of most that is known regarding the methods for investigating bacteria, presented in a conipre- hensive and convenient form, will accomplish this purpose, the Author's hopes should be realized. The subject is considered in three divisions: In Part First general directions are given of the methods of obtaining bacteria from air, earth and water, and from the tissues of healthy living organ- isms, the methods of making microscopical pre- parations of bacteria, the various methods of staining, and the preparation of bacteria for photo- graphy are described. A description is then given of the methods of conducting culture experiments, how to prepare culture media, the various sterilization methods, etc. How to conduct inoculation experiments, and methods for biological analysis, such as ascertain- ing the effects of sunlight, cold, heat, electricity and upon bacteria. The determination of their chromo- phyll, assimilating power, and the effects of antisep- tics and poisons upon them, concludes this Part. Part Il. describes the special methods for investi- gating pathogenic bacteria. The various diseases in connection with which bacteria have been found are considered seriatimi, and the methods for studying the organism fully described. Part III. gives formularies for the preparation of the various staining fluids. Culture, media, mounting media, etc. To the working student in bacteri- ology, or those intending to become such, this book will be found invaluable, the only want felt in perusing it is that of illustrations, in the way of plates, cuts, etc. There is an entire absence of such; tbey would make the book more attractive, and greatly assist the student in comprehending the ñumerous descriptions. A useful feature of tie- book is the references t, the literature on the subject under consideration, which appear at the end of each section; the names of the writers are, given, with the title of the -article and name and date of the journal in which it appears."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL Griginal Sommunications. CANCER OF THE LIVER; GALL STONES; OBSTRUCTION OF THE COMMON BILE DUCT 1 ENLARGE1fENT OF THE GALL-BLADDER; ATTACIHMENT OF THE GALL-BLADDER TO THE PELVIC PERITONEUM; RUPTURE OF TIE ATTACHMENT; HlArORRHIAGE INTO THE GALL-BLADDER AND PERITONEUM; PERITONITIS-DEATH. B JoUN BELL, A.M., M.D. Read before the Medico-Chirurgical Society, Montreal, March 30th, 1877. Mrs. T., the subject of the pathological conditions, whose history I shall briefly describe died on the 12th March, 1877. She was then 58 years of age. Until the commencement of the illness which ended in her death, she had always been remarkably healthy. She was married when 25 years of age and had six children in nine years, wben her husband died, and she remained a widow since. One of the children died in infancy,' and the remaining five are all strong and healthy. Hier hair vas grey, and the children have a tendency for the hair to turn grey carly. They are all of highly nervous tem- ,perament. Until the time of her last illness she never required medical assistance, except at the birth of her children. About fourteen years ago she first felt a tumour in the right inguinal region. About that time a lady in Brantfo:d had had an ovarian tumour successfully removed. This determined her to consult Dr. Henwood of that place, about the tumour she had found in her own person. Dr. Ienwood pronounced the tumour 28",
         "434 CANADA MEDICAL AND SUROICAL JOURNAL to be ovarian, and said that the only remedy was the knife, but that she was not to let any one interfere with it, until she could suffer it no longer. At that time it caused her no inconvenience, and she dismissed the matter from. her mind until last August. Her health had not been so good as usual, and she was suffiring from pains in the back and side, the right, if I recollect cor- rectly. She complained very little at any time, but she seemed to be more or less distressed. Her complexion was rather pale and somewhat sallow. She mentioned the existence of the tumour to me, and on examination externally and per vaginâm, I found the tumour to be very much as she described it. It was about the size of a hen's egg, quite movable, firm and symmetrical, and apparently connected vith the right side of the uterus. I considered it to be a fibroid or fibro-cystic tumour of the right ovary, and advised her still to follow Dr. Henwood's instructions. For ber general condition I prescribed the citrate of quinine and iron. The position of the tumour was about the brim of the pelvis. The tissues about the vagina uterus and rectum were in a healthy condition. Her health must have improved from the treatment, for I heard little or nothing about the pains until the 19th of December last. Her health was then not so robust as usual, and she was suffering severely from pains in the back and principally in the left side above and about the middle of the crest of the ilium. She was not able to go about so much as formerly but remained lying down a considerable part of the time. Her gen- eral appearance was very much the same as usual. Various liniments and plasters w'ere 'used to endeavor to alleviate the pain, but nothing proved effectual excepting hypodermic injec- tions of morphia. About the 25th December, Mrs. T. became jaundiced, the colour deepening in a few days to a dark gamboge-yellow, and she complained of uneasiness and pain increasing in severity and persistence in her right side and epigastrium. After most careful and repeated examinations by percussion and palpation the area of the liver was found to be not larger than usual, indeed rather smaller ; the breadth of hepatic dul-",
         "CANCER OF THE LIVER.-BY DR. BELL. ness was about three inches, and the edge of the liver seemed to correspond with the edge of the costal cartilages, as a tubular note was elicited on percussing below them, and no free edge of the liver could be discovered lower down or rounded outline of a distended gall bladder. The tumour which formerly had. occupied the lower rigbt side of the abdominal cavity, had lately increased, symmetrically, so much in size as now to reach the lower surface of the liver ; and when she was lying down, the dulness on percussion was centinuous from the liver to the tumour. A tubular note could still be elicited from w'hat seemed to be the transverse colon overlapped by the upper end .of the tumour aid the lower border of the liver. The feces now became white like mortar, and the urine of a -dark brownish-yellow colour. These excretions had hitherto .always been quite normal. As Mrs. T. had recently removed to a large new bouse, which was somewhat irregularly warmed, and as ber appetite and general health were poor, I thought, in all probability, she had \"cauglit cold,\" and the case was one of catarrhal jaundice. A careful diet was therefore enjoined; poultices, hot turpentine stupes, blisters, etc., were applied around and over the liver; :and various alkaline and acid medicines were administered, but without any effect in relieving the symptoms. I miglit remark that my patient had the strongest aversion to taking medicine of any kind, and it was only by great persuasion I could get lier to persevere with any remedy for a short time.' Her bowels moved regalarly every day, and continued to do so throUghout lier illness. She began to be more restless and uneasy, espe- cially at night-sleeping onily for short periods at a time. The pain vas always worse at night, becoming perfectly excruciating 'during the last few niglits of ber existence. Her strong dislike to taking medicine prevented lier using as freely as she ought the chloral draughts I prescribed for ber. Her skin became very itchy all over, but this was entirely relieved by sponging the surface with a weak solution of carbolic acid in water. By the 3rd February the tumour had increased to about seven inches in length and nearly as much in apparent breadth, and I 435",
         "CANADA MEDICAL AND SURGICAL JOURNAL. thouglit might press strongly against the lower surface of the liver. The tumour was still symmetrical in form. A ridge, however, could be felt extending horizontally across it at the level of the umbilicus; this had been perceptible, but less distinctly, for more than a month. Simpson's uterine sound could be introduced into the cavity of the uterus in a retroverted direction for only two inches. Moving of the tumour did not -seem to alter much the direction of the sotind. On examining per rectum, the tumour did not seem to encroach on the region of that bowel. In front, the tumour could be traced distinctly narrowing down to a neck or pedicle underneath ths arche of the pubes, and vas attached to the right'antero-lateral surface of the uterus, or lower part of the broad ligament. I now began to think that this hard foreiga body pressing against the lower surface of the liver might be the cause of the jaundice and of its persistence, either by producing irritation and swelling or by direct pressure or by adhesions formed and put upon the stretch causing compression of the common bile duct. On reconsideration, however, it was deemed improbable, as jaundice seldom occurs in pregnant females, and the absence of bile from the stools would not have been so complete and continuous. The possibility of the tumour being cancerous, and the jaundice due to secondary growths had occurrod to me, but the*idea was dismissed as seemingly not supported by the facts of the case. About the middle of February, what seemed to be the en- larged or displaced left lobe of the liver could be felt extending two or three inches below the left costal cartilages, the tumour became irregular in outline, and some small tuberosities could be felt between it and the edge of the liver, in the median line. While manipulating the masses in this region I thought I several times perceived a soft crackling, which it occurred to me might be caused by gall stones striking against one another. During all this time my patient had continued to become more and more emaciated, her appetite failed, the color of the - skin continued dark yellow (as yellow as a duck's foot, as she laughingly remarked,) the urine brownish yellow and the foeces 436",
         "CANCER 0F THE LIVER.-BY DR. BELL. light grayish white. For about a week she had had a small attack of diarrhoa, which was ended by the passage for two days.of bilious stools. On the 3rd of March I again carefully examined the lower part of the tumour, with a vie.w to decide in my own mind as to the propriety of that dernie resort-its extirpation, which seemed alone to -b left to give the patient a chance of life. I thought I felt fluctuation in the lower part of the tumour, and as I was continuing to press it intermittently it suddenly gave way, producing an impression that might be conveyed by the bursting a tough wet paper bag full of water or air. The inguinal region, which had previously been filled by the bard and well-defined outline of the tumour, was now soft and flaccid. I thought I had ruptured a cyst in the tumour, as the hard main part of the growth could still be felt in the upper part of the abdominal cavity. No pain was experienced for about twenty minutes, wlien it began with considerable severity, but was at once completely removed by a hypodermic injection of one-thiri of a grain of morphia sulph. No great pain pain followed, but there was slight pain or tenderness over the whole belly. On making slight examination the next day (4th March), I found the low-er point of the tumour had returned to its old form or place, which I presumed to be due to the refilling of the cyst it had ruptured. During the whole of lier illness up to this circumstance the pulse and temperature continued at or below the'normal stan- dard, since-then the temperature bas been about 101°, and the pulse a few beats over 100 per minute. On the 19th March, inst., Drs. G. W. Campbell and R. P. Howard met me in consultation over the case and finding the conditions such as I have stated, decidedly advised no inter- ference, as there was a strong probability of cancerous disease implicating the liver. No operation was attempted. The ,patient died in three days afterwards. AUTOPSY 30 HOUoRS AFTER DEATH BY DR. OSLER. Body, that of a well-made, but spare woman. Skin intensely *aundiced ; conjunctivS yellow. Rigor mortis absent. 437",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Abdornen.-On opening this cavity a few ounces of slightly turbid, and sanguineous fluid were removed. The liver is seen, to be somewhat enlarged, and extends fully 31 inches below the margin of the ribs. Projecting from the under surface of the right lobe is an enormously distended gall-bladder which reaches within two inches of the pubis. The upper surface is free, but to the left side it is attached by loose and somewhat fresh adhesions to the pushed up omentum *and stomach. The apex, which is rounded, presents an irregular surface, as if it had been attached, and on the side of the broad ligament, at a. point a little to the right of the uterus is a round space, covered on the surface with decolorized fibrin, hænmorrhagic below, which looks very much as if here the gall-bladder had been adherent. Behind it is firmly attached to the transverse colon. Traces of peritonitis in the forn of thin flakes of lymph exist over the coils of intestine. An extravasation of blood has taken, place into the tissues, about, or rather upon the peritoneum in the pelvic cavity, especially between the uterus and rectum. The corpuscles have subsided, and left a pale-yellow, fibrinous layer above, iwhich is firm, and quite adherent to the parts about. JKeart and Lungq, quite healthy, a few ounces of fluid in left pleura. Slight atheroma in aorta and aortic-segment of mitral. Spleen not enlarged, and of a deep brownish-red colour. Liver looks a little larger than normal, and is of a dark- greenish colour. Scattered over the surface are a dozen or more. tuberculous masses, ranging in size from a cherry to a walnut, -white in colour, the larger of them with depressed centres. The anterior portion of the right lobe is separated from the rest of the organ by a shallow groove, the position of whieh on the body was just below the costal border. The left lobe is flattened, and its anterior margin notched. On section the liver substance is deeply bile-stained, the lobules are not very distinct. There are only a few of the cancerous nodules in the interior. On opening the distended gall-bladder it is found occupied by a large coagulum, the upper part of which owing to the sinking of the blood corpuscles, is decolourized. HFardly any serum was 438",
         "SUPPRESSION OF SALIVARY SECRETION.-fBY DR. BAYNES. 439 present except that contained in the meshes of the clot. Nine or ten gall stones, about the size of marbles, and with numerous facets were found. At the neck a small irregular mass of cancer projects into the cavity, and completely blocks up the cystic duct. The walls of the bladder are thin, not cancerous, and at the posterior part just where the transverse coloin is attached, there is a portion .infiltrated with blood. On close inspection it is seen that here ulceration and destruction of the wall has taken place. There can be no doubt that by this process a vessel bas been opened, and the hæmorrhagc caused. The glands in the hilum of the liver are enlarged and cancerous, and compress the hepatie ducts. The portal vein does not appear to be interfered with. Dr. Charles Murchison in his work on diseases of the liver, says that \" tumours of the uterus and ovary have, in rare instances, been known to compress the bile, duct and cause jaundice. It is sufficient here to mention the fact, as the diag- nosis of these diseases from other causes of obstruction of the bile duct can seldom be difficult.\" CASE OF SUPPRESSION OF THE SALIVARY SECRETION. By DONALD BAYNES, M.A., M.D., L.R.C.P. Edin. Late Clinical Assistant at the Hospital for Diseases of the Throat, London. The following case came under my observation last Novem- ber. It is the first of the kind I have seen, or, in fact, have either read or heard of. The subject of this curious malady, J. B., aged 32, an hostler .and driver at a livery stable, came to me November 10th, 1876, ýcomplaining of great dryness of the mouth, inability to swallow food, unless washed down by a draught of fluid, and a desire to spit in order to clear his throat but inability to do so. He said that he felt as if the tongue was too large for the mouth and as if his mouth was filled with bird-lime or tallow. He was continuously obliged to wash his mouth or drink both night and day. He",
         "440 CANADA MEDICAL AND SURGICAL JOURNAL. was unable to slcep more than Oe hour at a time owing to his mouth and throat getting so dry that he thought he would choke. On examining his mouth I found the tongue swollen and covered with a thick white fur ; at the junction of the lips with the gums miglit be seen a substance resembling the roc of a fish extending quite round and on boti jaws. This I at first thought was a growth of a vegetable or- fungoid character, it, however, on examination by the microscope, turned out to be composed of starch granules, \u0026c., and was, in fact, simply tie detritus of his food, which had collected there owing to the want of saliva to wash it away. On- examining thc ducts, Steno's and Wharton's, they were found open, and no obstruc- tion existed in them to account for the 'singular phcnomenon. The man's health otherwise was excellent. He, however, about the 20th of October, lad been suffering from a severe cold, in an attack of tonsillitis, which yielded to the ordinary treatment. The suppression of saliva lasted about threc wceks, during which time I gave various stimulating gargles, together witi pot. iod. and nux vomica and quinine and iron, with an occasional aperient, but to no avail. Nov. 28th.-I passed a probe into Steno's duct, and connected it vith the negative pole of a galvanic battery (zine-carbon, 12 cells.) The positive pole I applied to the nape of the neck, this seance I kept up for about ten minutes frequently reversing the current. The battery hardly ýwas in use for 3 minutes when lie said, \" Oh, my mouth is much moister.\" He returned next day and said lie had slept al! night, and his mouth felt better. I repeated the electricity, which was followed by a copious flow of saliva, since which time he lias lad.no rcturn of his previous symptoms.",
         "nOSPITAL REPORTS. giospital Sprs MEDICAL AND SURGICAL CASES OCCURRiNG IN TUE PRACTICE OF THE MONTREAL GENERAL HOSPITAL. Acute Bright's di3ease, accompanping pregnancy ; miscarriage, peritonitis, ceath, autopsy. Under the care of Dr. Ross. Reported by MR. C. L. COTTON. M. D., 27, servant, admitted November ad, 18î7G, for dropsy. Iistory.-Family history good. She was married last February. She always enjoyed very good health before her marriage, occasionally suffering from indigestion. Her cata- menia were always regular. Since first of last May lier menses have ceased. During the month of June she vomited every morning on rising. After that she felt.heavy and indolent, but she always had a good appetite. About two months ago ber legs were very stiff for three days, but this disappeared. About the middle of last summer she perceived lier abdomen getting enlarged, and she thought she vas pregnant. It did not increase very rapidly until about four weeks ago. IIer face, feet and abdomen became puffed up. In about three days it disappeared from the face and feet, but the abdomen did not lessen in size. During this time she did not notice lier urine appreciately diminished. The abdominal swelling has gradually increased iir size until the present time. She never perGeived any movements of a foetus in utero. Since h st Sunday the swelling lias corne into lier feet again. Present condition. - Sallow complexion. Abdomen im- hiensely enlarged. Umbilical girth 44 in. From ant. sup. spinous process to umbilicus on both sides, 11 in. From pubes to umbilicus, 8 in. Umbilieus to ensiform cartilage, 8 in. Abdominal walls very tense and shining. There are numerous dark purple lines, about 4' broad, on the inferior abdominal zone on both sides, corresponding to the lineam albicantes. The small superficial arterioles are injected in several places.",
         "442 CANADA MEDICAL AND SURGICAL JOURNAL. Fluctuation very distinct all over the abdomen. Sides and inferior part of abdomen dull on percussion. Ant. and sup. part from umbilicus to ensiform cartilage gives an amphoric note. Umbilicus on a level with surrounding surface. Meart.-Apex beat in fifth interspace ; very apparent. Area of præcordial dullness normal ; action of heart very rapid. A systolic murmur at base. Ileard best at mid-sternum. Lungs.-Physical signs give negative results. Breasts. - Enlarged. A distinct dark areola around the nipples. Nipples turgid and prominent. Vaginal examination.-Os uteri odematous and patulous. Finger can be introduced into the cervix. Legs, from knees down, odematous. Con3iderable anasarca over the hips. Tongue clean and moist. A good deal of soreness on the right side-the side on which she always lies. Back is very œdematous. Urine.-Only 5 oz. during last 24 hours. Turbid, smoky and opaque. About 75 per cent. albumen; no sugar; numerous epithelial and granular casts, and a large quantity of epithelial cells and numerous blood corpuscles. She vomited once during the morning. Had no sleep last night. Complained of a pain in the pit of the stomach,. which was relieved by vomiting. Ordered : Pulv. jalap2 co., 3i. ; pot. bi. tart, 3ss. sum. nocte and pot acet, xx. grs ; infus digit., 3ij., to be taken every four hours. Plenty of diluents and dry cupping to the back, to be followed by poultices. November 4th.-The powder moved her bowels four times. Very little urine besides that passed at stool. Slept very well. Superficial veins of the abdomen and chest distended and very apparent. Vomited last night. Abdomen feels very sore. Tongue slightly coated. Not much appetite, but a good deal of thirst. Pulse very quick and weak. Feet and legs anas- arcous. Urine presents the same appearance. November 5th.-Did not sleep. Had severe pains in the bowels, and complains of a soreness over the midsternum at base of heart. Had two movements of bowels last night; 5 Oz.",
         "449 HOSPITAL REPORTS. urine besides that passed at stool, dark and' turbid. Abdomen very tense. Right loin very sore-the side on which she lies. Tongue slightly coated. Appetite rather better, and not so much thirst. Pulse very quick, 140 ; small and rather weak. Vaginal examination shows very little bulging in Douglas' cul- de-sac and ballottement is very distinct. Left loin gives a tym- panitic note and right loin tympanitie with a certain amount of dullness. The abdominal dallness is on a level with the umbi- licus. Yovember Gth.-Slept well. Feels sore over the abdomen. Appetite better ; no vomiting; not troubled quite so much with wind. Pulse, 136, weak. Abdomen very tense and shining. Feet rather more odematous; no soreness. Tongue clean. Two movements of bowels last night; 5 oz. urine ; about 50 per cent. albumen. November 7th.-Slept pretty well, but had severe pains across the bowels, as if from wind. Bowels moved twice ; 10 oz. urine ; about 25 per cent. albumen. Not much appetite. Tongue slightly coated. Urine not so smoky-looking ; quite clear when passed abdomen slightly less tense ; casts still present in urine. Novenber 8th.-Slept very well. Bowels moved three- times. An occasional pain in abdomen; girth, 44 in. Appetite better. Abdomen still tense ; 7. oz. urine ; a heavy deposit of lithates; numerous casts ; not more than 15 per cent. albumen;. urinates often, but only a small quantity at a time. Noveber-9tlt.-Slept very well. las a frontal headache.. lad severe pain in her bowels last night ; bowels moved four times ; 5 oz. urine. Pulse still very quick, 132. She is a good deal more swollen, especially the right foot and leg. Appetite still very poor. Vomited twice last night, after taking the Medicine. Casts in urine, but no blood corpuscles. November 10th.-Only 43. urine. Two stools, at which only a very small quantity of urine was passed, with a heavy deposît of lithates. Troubled very much with nausea and flatulence; no appetite ; amount of albumen increased. iVovember 11th.-Vomited twice last night. Pulse rather",
         "444 CANADA MEDICAL AND SURGICAL JOURNAL. slower, 116, and. stronger. Temperature normal. Feet still very much swollen. 3Bowels moved twice this morning; 7 oz. urine ; 25 per cent. albumen. November 12tt,-No more vomiting. Right foot more swollen. November 13tl.-Severe pains in abdomen last niglit and to-day ; girth, 44r- in. very tense. No appetite ; very anxious. Tongue clean. Bowels moved once by a powder; 7 oz. urine, besides that passed at stool; clearer than it vas ; a smaller deposit of lithates ; about 40. per cent. albumen ; casts still present. Ordered: Pulv. jalapo co., 3i ; pot. bi-tart., 3ss. Novenber 14th.-Abdomen more tense and very painful. Superficial veins fuller. A large mass of cedematous tissue on right side. Appetite improved. Medicine pperated twice freely, and bosides that 7 oz. urine ; albumen samýe ; girth, 46 in. Noveinber 15th.-A good deal of pain in the bowels last niglit from flatulence and retching, but no vomiting. Had chloral, which gave her a good night's rest. Some erythema- tous patches on lower part of abdomen. Pulse, 124, weak. Bowels moved twice; 8. oz. urine ; about 25 per cent. albumen. Right side still sore. Mixture stopped, and ordered: Spt. eth. nit., 3i; tr. scillo, 3I. I. scop., ýj., 6, q, h. Novenber 16th.-~0.dered a bot air bath. Novenber 17t7i.-HILd the hot air bath for ten minutes yesterday, at 3:30, P. M., and about ( o'clock perspiration broke out on her face, and during the niglit she perspired very freely-drenched in perspiration. Slept well, and since 6 P.M. she has passed 46k- oz. urine, much clearer. No pains, but. much soreness in back and loins. Much more cheerful. Girth, 43ý in. Feet about same.- Abdomen not quite so tense. Tongue cleaner. Pulse stronger, 120. Appetite very good. Feels altogether better. Urine acid, 50 per cent. albumen. Casts still present. November 18th.-Slept badly. Had severe pains in right side and in bowels. Had a hot air bath this morning, but it has had no effect yet. Urine, 20 oz. ; same qualities ; girth, 44ý in. ; abdomen very tender.",
         "HOSPITAL REPORTS. Novenber 19tt.-Yesterday afternoon a profuse perspiration broke ont over the body, and lasted until about 3 A. M. this morning. She slept weli ; 30 oz. uïrine. Bowels moved four -times. Novenber 20th.-Passed a good night. A pillow placed .under the right side supported it, and since then she has had no pain in it. Girth, 44 in. ; 21ý oz. urine, Appetite better. Abdomen not so tense. Superficial injection not so extreme as it was. A vaginal examination shows the uterus low down in the pelvis. The os dilated to the size of a shilling. The bag of membranes protruding and distinct uterine contractions. No bulging in Douglas' cul-de-sac. November 21st.-Last night, about 6 o'clock, she miscarried of a male foetus of about six months. Dead apparently some time. A footling presentation. Very small quantity of liq. amnii. Placenta, battledore, friable and slightly fatty., The uterus contracted well; no hemorrhage. Skin of foetus a good deal discoloured. Feels better to-day, and is quite cheerful. Slept pretty well during the latter part of the nighLt. Abdo- men apparently in mueh the same condition ; girth, 43 inches. Fluctuation very distinct. A good deal of tenderness in left side, with edema. Feet about same. Very odematous. Appetite good. Pulse 120. Temperature normal. Tongue clean. iBowels moved twice. Urine contains about, 15 per cent. albumen, and a few casts. Novemier -22nd.-Yesterday, about 3 p.m., she had a-very severe rigor, followed by a rapid rise in temperature to 102-2. Pulse 160. Vomiting, great pain in abdomen, and tendernes- Morphia 'was given, but it could not be retained. Vomiting continued the greater part of the night. In the morning she fell into a state of collapse, and died at 9 a.m. AUTOPSY, BY DR. OSLER, EIGHT HOURS AFTER DEATI. General Appearance.-Body that of a medium-sized woman. Rigor mortis has not yet come on. Face swollen, and a dirty- yellowish fluid oozes from the mouth. Pupils of moderate size. On pressing the breasts a milky fluid flows from the nipples. 445",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Abdomen enormously distended ; the skin near the hypogastrie legions thickly set with lineæ albicantes. Thighs and legs ode- matous, the right more than the left ; both of alabaster whiteness. Thorax and Abdomen.-Twenty pints of opaque, somewhat milky serum, mixed with flocculi of lymph, were removed from the peritoneal cavity. Both visceral and parietal layers of this membrane of a bright rosy colour, due to the intense injection of the finer vessels. Thin flakes of lymph covered over the coils of intestines, in many places matting them together. The liver was closely united to the stomach by a tolerably thick layer of greyish-white lymph. The pelvic peritoneum also involved ; the ovaries are dark in colour and coated with exuda- tion. The stomach and intestines are much distended, their coats infiltrated and easily torn. No effusion into the pleural sac or in the pericardium. feart.-Right chambers gorged with blood, and in removal -over 30 oz. escaped from the cut vessels into the pleural cavities, and there speedily coagulated. Right ventricle: no ante- mortem clots. Tricuspid and pulmonary semi-lunar valves healthy. Left ventricle firmly contracted and liard to the touch. Cavity small. No clots. Anterior segment of mitral valves thicened, and aortic valves competent. T'ngs.--Right, adherent posteriorly, and at the apex by a few bridles. Organ crepitant except at base and hinderpart of lower lobe, which is very dark in colour, collapsed, and almost airless, and contains a large anount of blood, Left.-Upper lobe, with the exception of the extreme apex, in a state of engorgement, the section bathed with much blood, and the tis- sue almost airless. Posterior parts were also much congested, -and six small apoplexies are present. The anterior portion of the lower lobe alone presents a natural appearance. Spleen.-Firm, dark in colour. A fissure exists at the ante- rior border. A fresh hemorrhagic infarction presents in this situation irregularly wedge-shaped, 1½.\" long by 4\" in width, colour reddish-yellow, with a zone of hyperemia about it. Left Kidney.-Capsule easily detached (except at one spot) and thin. Organ soft, rounded, and swollen. The surface Of 446",
         "REVIEWS AND NOT[CES OF BOOKS the cortex is smooth, the venæ stellatoe small but uniformly filled. On section, not much blood exudes, the cortex is pale, opaque, and mottled ; the Malpighian tufts are distinct, but only here and there are the loops of vessels passing down the cortex, full. The pyramids are of a uniform dark red colour. 1Right. Presents the same appearances\". The pelves of both are injected, and about them is a moderate amount of fat. Bladder contains hardly one drachm of turbid urine. Mucous membrane appears healthy, the smaller vessels injected in places. Stomach.-Much distended with gas, and contains about a half pint of dirty-yellowish fluid. Mucous membrane looks natural. Intestines.-Beyond the swelling and infiltration of the coats, there is nothing special to be observed. A single ascaris found in the duodenum. Liver.4-Consistence good. On section lobules distinct, and much blood flows from both large and small vessels. Brain.--By request, not examined. Seuiciws and notices of fbooks. -Cclodia of the Practice of iledicine.-Edited by Dr. -. VoN ZIEMssEN. Vol. vi. Diseases of the Circulatory System, together with the chapters on Whooping Cough, Diseases of the Lips and Cavity of the Mouth, and Diseascs, of the Soft Palate. By Professor Rosenstein of Leyden; Prof. Schroetter of Vienna; Prof. Lebert of Vevay ; Prof. Quincke of Berye ; Dr. Bauer of Munich ; Dr. Steffen of Stettin ;- Prof. Vogel of Dorpat, and Professor Wagn'. of Leipsic. Translated by G. W. Balfour. M.D., of Edin- burgh ; E. G. Geoghegan, M.D. of London ; Thomas Dwight, M. D., Boston ; J. H-. Emmerson, M.D., and G. G. Wheelock, M.D. of New York; and J. Solis Cohen, M.D. of Philadelphia. Albert 1. Buck, M.D., New York, Editor of American edition. 8 vo. pp. 1014. New York, William Wood and Company, 27 Great Jones Street, 1876. This important work is fast approaching completion, the voumns so far have come out with regularity,-that is, not Precisely in- regular order, but stili the translators have done their work well, and the publishers fulfilled their engagement to 417",
         "CANADA MEDICAL AND SURGICAL JOURNAL. give the volumes almost with as great regularity as they have appeared in the original. In this volume, the sixth of the series, the first' article is from the pen of Professor Rosenstein of Leyden. The author begins his article by an introductory chapter on general anatomy of the hea rt, the changes in form and position and the origin of heart sounds. He then touches upon the method of examination., the physical signs or symptoms of heart disease. In treating of the pulse lie illustrates the subject by several sphymographic tracings show- ing alterations in the pulse vave in a vareity of conditions. The author then passes on to the consideration of diseases of the endocardium, giving at the outset à short historical sketch of the subject. H1e shows that inflammations of the endocardium terminate either in ulceration, thickening of the membrane or villous formations, which, in course of time undergo further change, andhe discusses the subject under three heads: \"1. Acute, ulcerative or diphtheritic endocarditis. \" 2. Acute and subacute verrucose endocarditis. \" 3. Chronic sclerotic endocarditis.\" The author then passes on to the consideration of diseases of the valves of the heart as resulting from these conditions. The next paper is from the pen of Schroetter, on the changes in the position of the heart, and also diseases of the heart substance. In respect to change of position, the author mentions some very unusual cases, which have been reported, and he remarks that \"in spite of opposing statements it is now settled beyond all doubt, that in changes of position of the body the heart follows the laws of gravitation.\" We were not aware that this ever was ques- tioned, as it is customary in making an examination of the heart to lean the patient forward so as to' bring the organ as near to the chest -wall as possible, but besides these cases of changes of position of the heart -we have others of greater moment to the patient, such as changes which are caused by pressure, as in pleuritic effusions of any kind, or again changes in position Of the heart in spinal curvature, or in thoracic or abdoninal tumours, due to contraction, or diminution of the size of the lung, resulting from previous existing disease. In such cases, accordinog 448S",
         "REVIEWS AND NOTICES OF BOOKS. to our author, the change in position of the heart, is often very considerable. These changes in position, although they may be qujite noticeable, and vill aid the observer in his diagnosis of the condition present, yet they seldom give rise to symptoms refer- able to the heart itself, the alterations are gradual in their develop- ment, and the heart itself rarély suffers. The author then passes on to diseases of the heart-substance, taking up seriatim hypertrophy and dilàtation, atrophy of the heart, inflammation of the heart-substance and the formation of abscess, partial aneurism of the heart, fatty degeneration, colloid degeneration, spontaneous rupture of the heart, wounds of the heart, trau- matic rupture, foreign bodies entering the heart substance. New growths and parasites of the heart form the next sub- jects of discussion, and he concludes this most interesting paper with a short account of heart clots, and nervous palpitation of the heart. We have next a short description by Prof Lebert of congeni- tal malformations of the heart. In this paper the author follows the classification of Kussmaul, who has done more than any other writer to elucidate this subject. There is considered con- genital narrowing or closing of the mouth of the right side of the heart ; stenosis and atresia of the pulmonary artery, with closure of the septum; stenosis of the right conus arteriosus with an opening in the interventricular septum ; stenosis and atresia of the pulmonary artery, with an opening in the ventricular septum; and combined stenosis and atresia of the pulmonary artery. Trie author points out the connection between- these congenital conditions and the development of tubercle. In sten- osis of the pulmonary artery the circulation is greatly disturbed, and in very many of tiese cases there is -found imperfect devel- 'opment of lung substance. The author states that direct dis- turbance of the supply of blood going to a part-an unequal distribution of the blood-is more liable to give rise to irritation, .And is more conducive to inflammation, than an excessive but reguilarly increasing supply, and he remarks, \"it is a difficult question to decide how much the excessive supply of arterial blood to the lungs eventually disturbs their nutrition.\" 29 449",
         "450 CANADA MEDICAL AND SURGICAL JOURNAL. Diseases of the arteries, voins and lymphatics form the sub- ject of the next article from the pen of Prof. Quincke. Morbid affections of the external, middle and internal arterial coats are taken up and discussed seriatim. Acutc and chronic affections and their consequences, resulting, in many cases, in hypertrophy of the arterial coats, atrophie degeneration, fatty degenertion, calcification, amyloid degeneration, \u0026c.. and ho points out that these various conditions have been found to exist in syphilitic subjects. General dilatation of the arteries, \u0026c. after which the author discusses the subject of aneurism. After giving the various methods of treatment he observes, \" that of all the local methods of treatment, next to ligature and compression, galvano- puncture is most deserving of confidence.\" Narrowing of the arteries is the next subject under discussion, and he closes this part of his paper by the consideration of rupture and perforation. Diseases of the veins and of the lymphaties form the subjects of the balance of this very excellent paper. Dr. Bauer in the next paper treats on diseases of the peri- cardium. Commencing with malformations, such as absence of the pericardium, the formation of diverticuli and tendinous spots, or milk spots as they have been termed, due apparently to local pericarditis with exudation, although this is denied by some writers. He thon treats on inflammation of the pericardium, tubercular pericarditis, adhesions botween the visceral and parie- tal layers of the pericardium, pneumopericardium, hydropericar- \u003cdium, hSmopericardium and free bodies in the pericardium. The remaining papers in this volume do not properly belong to it, but the editor in a note intimates that 4 owing to the great size of volumes VII. and VIII., it bas been deemed best to incorporate the article on whooping cough, as well as those on diseases of the lips, cavity of the mouth and soft palate, into this volume.\" These several- articles are written. by Dr. StCffeix Prof. Vogel-and Prof. Wagner, and are full of interest. * The Cyclopædia maintains its position as a work of importance,-and readers will find in it subjects treated of, which are not to bc found elsewhere. It is of great use to the real student of the science of medicine, and its practical teaching is by no means deficient.",
         "BRITISII AND FOREIGN JOURNALS. Extracts fro~m E3ritish and Foreigyn Jocurnals. Unlesa otherwise stated the translations are made specially for this Journal. Surgical Electrolysis.-Tile Progrès Medical gives a very interesting resumse of the history of this valuable application of electricity, and the results of its use up to the present time. The decomposing action of the pile on water and on salts had just been discovered, when Bru-natelli, Dumas, and others studied also its effect upon animal matter. Plunging a piece of flesh by its two extremities into two vessels full of distilled water, each vessel vas connected with the electrodes: there was found in the negative vessel, potash, soda, lime and ammonia ; and in the positive vessel sulphuric, hydrochloric, phosphoric and nitric acids. . After several days, during which the current was pass- ing without interruption, it was found that the piece of muscle was completely deprived of its salts. In another experimaent, Davy introduced two fingers into' the vessels, which were in connection with the piles, he equally established the presence of the acids in the positive vessel, and of the alkalis in the nega- tive. Therefore the action of the currents is the same on the living tissue as on the dead. In 1860, Cinisslli (of Cremona), conceived the idea of ufilizing the' properties of the clectric currents for the destrdc- tion of morbid tissues. In facc the alkalis and the acids generally by the currents in the substance of the tissues, react in their turn on the neighboring elements ; they cauterize them as wlien one applies caustics to the surface of a sore or to the skin. It is to this chemical action of the currents in the tissues, that the .name electrolysis bas been given, a term employed first by Faraday to designate the action of the pile on water. The needles used for electrolysis are of platinum or copper gilt, in order that they may not be attacked by the acids or the bases which result from the decomposition of the tissues by the electric currents. 451",
         "452 CANADA MEDICAL AND SURGICAL JOURNAL. Sometimes one needle is introduced into substance of the tissues, sometimes both. The action of the two poles is differ- ent: at the positive electrode are the acids, at the negative the bases ; around the former an eschar, hard and dry is produced ; at the latter it is an eschar, soft and moist, 'which appears, as when a part is cauterized with potash ; later, there is a cicatrix, fibrous and retractile, or slight and not adherent to the subja- cent tissues, according to the pole which has acted. It is easy in practice to utilize these different properties of the two elec- trodes ; it suffices to render one of them inactive, and reduce its r8le, merely to serve for closing the current. This application of electrolysis, wishich is called chemical galvano-cauterization bas been used with great success in the treatment of fistula in various situations, and for the cure of strictures of the urethra, and nasal duct. Thus far we have only spoken of the application of electrolysis to the chemical cauterization of the tissues; it has another r8le equally important. When a curent is passed through a solution of white of egg, the acids produced coagulate the albumen. An analogous result is obtained by the action of the currents on blood which has just been drawn from the veins. Two English doctors, Fraser and John Duncan, have recently analysed with more care the effects of the currents upon the blood. At the positive pole, is formed a greyish mass of small volume, but of very firm consistence. There appears on the contrary, at the negative pole a sort of mass of foam composed of gaseous, viscous vesicles, and of a volume greater than that at the positive pole. A third product is fornied with great abundance ; it is a liquid having the colour and appearance of fluid tar. For a long time the cure of aneurism bas been attempted by electricity. Dr. J. Duncan only bas determined the different actions of the two poles. According to him, if the currents of which he indicates the intensity and nature are used, at the positive needles (in aneurisms of considerable volume, several needles in communication with the positive pole. can be intro- duced) there are formed hard fibrinous masses. H1e also estab-",
         "BRITISII AND FOREIGN JOURNALS. lished in several autopsies, that after a certain time, the masses formed by 'the galvanic action assurned consistence, became decolorized and stratified like the masses which are obtained by intermittent digital compression. The aed'Ints which have followed the application of the curreets are, infla.'mation of the sac, the formation of an eschar along the track of the needles, principally of the negative needles, and on the separation of these eschars, a fatal hocmorrhage, gangrene of a part of the walls of the tumour, and finally the displacement of the masses and embolism. To avoid the most of these accidents, Dr. Duncan has used since 1866, needles insulated by a coating of vulcanized caoutchouc. Ciniselli tried, by the aid of the current, to produce 'first a mass of moderate volume at the end of the needles; this, ho thought, acted as a foreign body, and became the cen- tre of an abundant coagulation of blood. Duncan, on the con- trary, endeavors to fill the sac as rapidly as possible, in a small number of sittings, with the products of electrolysis ; with his. meedles insulated, lie affirms that lie has no grave accident to fear, and particularly lie avoids the eschars along the track of the needles and inflammation along the walls of the sac. Also as he las recognized the special action of the positive polo in the for- mnation of resistant masses, he introduces the two poles at the saie time. fe utilizes the special action of each of the two electrodes ; he produces at the same time firm clots and soft elots, and rapidly the tumour is filled with a large solid mass. If4he first application does not produce satisfactory resuilts is is.well to wait some days ; for it is possible that the clots formed Primarily may be the origin of secondary coagulations. Lot us add ,that ho employs batteries of considerable electro-notive force; if the two ncedles are introduced, lie uses six cells of moderate size ; if he introduces only one needle, in small aneu- risns and in fusiform aneurisms, a large number of small cells are ùsed. In 37 cases of aneurism of the aorta treated by clectrolysis, ix complete cases have been observed ; three deaths only were 'attnibuted to the operation, and these iwere due to the fact that 453",
         "454 CANADA MEDICAL AND SURGICAL JOURNAL the needles used were not insulated, eschars formed in their track, and a fatal hæ3morrhage occurred. We ought to remark with Dr. Duncan that, in the six patients cured, in no case were observations followed up for more than nine months after the operation. But if, without regarding the pretended complete cures we consider the effects of the mode of treatment- we find that always a notable improvement followed the opera, tion ; not only a lessening in the violence of the pulsations, but also a complete arrest in the development of the tumour, a notable diminution in the pain, or the disappearance of alarming attacks of suffocation. There are recorded for aneurisms of the innominate, carotid and subelavian, thirteen operations, yielding three complete cures, six deaths. The external iliac artery, two cases, one cure. The femoral, popliteal and brachial arteries, twenty cases, sixteen cures, three deaths ; smaller vessels, cight cases, six cures. Total: 89 cases, 12 deaths. In cirsoid aneurisms the effects produced by electrolysis are much more favorable stli to the employment of the method. In four cases there are three absolute cures. The needles in this variety of sanguincous tumours cauterize the valls of the vessels, coagulate the blood, and easily induce an obliterative retraction. Dr. Duncan has treated by electrolysis two aneurirnis by anastomosis. He lias reduced considerably and arrested in its onward progress a vast tumour of this kind occupying the neck, the temple and the parotidean region. He bas had the same success in a case in which the mass covered the inferior part of the neck and the clavicular region ; it communicated, however, with the subclavian vein. In all these tumours, by reason of the· large communications of the arteries and the veins, it is neces- sary to destroy them littlc by little by the electrolysis ; thus the- eschars and the consequent hoemorrhages are avoided. Nævi only become dangerous when they tend to progres in surface and to increase in volume. Electrolysis can be utilized in two ways it cauterizes at the surface, and in the interstices of the tissues, but if it is advisable to avoid the eschars of the Bkin, -which are apt to follow, it is necessary to use insulated needles and to introduce then obliquely.",
         "UITISH AND FOREIGN JOURNALS. It has fiaailly been pretended that electrolysis could cure mnalignant tunmours; but this is not the case. Sometimes, how- ever, inàterstitial cauterization by means of insulated needles lias removed the intense pain which allowed no rest to the patients, and which eoinpletely disappeared, A vascular sarcoma of the thigh has beii very much reduced in volume ; several goitres, very rich in vessel, have also lost their pulsations. The uses of Pepsin in medicine, and its preparation.-Physicians are now falling more and more into the habit of employing in practical therapeutics those substances which are produced in the healthy organs for effect- ing digestion. Anongst these pepsin must always preserve the most important position, because others, such as pancreatic juice, bile, \u0026c., must, wben administered by the moutb, pass through the stomach, which by its acid secretioris modifies or destroys their efficacy as ferments. There have been some attempts to employ the peptones as therapeutical digestive agents. These are, however, open to very serious objections, and have great disadvantages, by reason of the readiness with which they decompose into those very dis- agreeable substances, leucine and tyrosine. It is unnecessary to speak of their very disagreeable physical character ; these products of the decomposition of the peptones are incapable of supporting the nutrition of the body ; and as the object of the pdministra'tion of the peptones is to make them readily available for such absorption, the promptitude with which they enter on the stage of decomposition is a very serious drawback. There is also great difficulty in preparing them in a state of purity; and even if this be successfully achieved, I believe it would still be much better to entrust the work of preparing the peptones to the stomach, and aid it in the task, when necessary, by the administration of pepsin. I believe that the field of usefulness of pepsin in practical therapeutics is very great ; and that it may be still further ex- tended with very great advantage. But the success of this",
         "456 CANADA 3EDICAL AND SURGICAL JOURNAL. remedy has been greatly hindered, and the result of clinical and of scientific experiment as to the results which may be obtained have been much confused by the number of compa:atively worthless preparations which have been employed, and by the instability and uncertainty of some of those preparations, which in their most active states have from time to time yieclded ex- cellent results, and have thus attained a goo.d reputation. The uncertainty of a potent remedy is almost as injurious and cven more misleading than the inertness of a popular remedy, and the treatment of disorders of the digestion by pepsin hias suffered greatly from both these drawhacks and from both these sources of fallacy. Besides the cases of obviously defective and imperfect diges. tion, in which the use of an effective and reliable form of pepsin is directly and clearly indicated, there are various classes of disease in which the nature of the imalady tends to produco imperfect digestion ; and in vhich this defective digestion reacts so as to intensify the disease, by impairing the general nutrition of the body. lere pepsin may often be employed to break the vicious circle, and by artificially restorng the digestion and improving the nutrition, to facilitate the introduction and reac- tion of remedies, or otherwise assist in the process of recovery. Thus in chlorosis, digestion always suffers ; the blood not being in a hcalthy state, the deficiency of blood-globules prevents the healthy hyperSmia of the stomach, which should result from the stimulus of food ; the nutrition of the blood is injuriously affected, and the chlorosis is aggravated. It is found in practice that, as we would anticipate physiological observation from the admin- istration of an effectual preparation of pepsin; by breaking the vicious circle, it becomes a powierful agent in the cure of chlorosis. The process of cure of chlorosis by preparations of iron is net always, I believe, if indeed it is at all, that which it is commonly held to be. The quantity of iron contained in ordinary well- arranged dietaries is sufficient and more than suflicient to supply the wants of the blood an'd the tissues. The doses of iron which are administered therapeutically are of course enormously in",
         "'BRITIsH AND FOREIGN JOURNALs. excess of what is required for the purposes of absorption and nutrition. We have in chlorosis a relaxed and atonic state of the intestines, and absorption goes on imperfectly. The effect of the various preparations of iron is to astringe and give tone to the intestinal coats, and by this action to facilitate the pro- cesses of digestion and intestinal absorption. For this purpose iron has a more advantageous action than the bitter tonics, because its action is more extensive upon the intestinal tract, and less easily destroyed and neutralized by the preliminary influence of the gastric juices. Thus also in the exhaustion succeeding typhas, measles, and other debilitating diseases, the inanition is due to the impoverish- ment of the blood, and to the defective power of digestion. Hence it is necessary to administer food with great precautions. Strength is slowly recovered ; and any excess of diet is punished by symptoms of dyspepsia. The condition is one of anomia, and to this is due defective digestion. Pepsin may be employed in the convalescence from all exhausting diseases with excellent effect. It facilitates nutrition, and at the same time directly quickens the restoration of natural digestive power. Without dwelling upon this class of cases, of which the vari- eties will at once suggest themselves to the practitioner, I would refer to another series of cases, those in which imperfect diges- tion has for a time been successfully stimulated by the use of irritating condiments, pepper, mustard, vinegar, curry, or by the use of alcohol. Here the digestive powers presently become enfeebled, and do not respond to the peptic stimulus. These cases are of very ordinary occurrence in practice. The food rernains in the stomach; and after undergoing only a partial digestion, enters one stage of putrefaction. In such cases, if Vomiting occurs, it will be found that the matters vomited are of foul odour and alkaline reaction. So when children, after over-eating, vomit from indigestion, the matters ejected are of bad odour and evidently semisputdid: On the other hand, when Vomiting occurs during healthbYAigestion, as in sea-sickness, the contents of the stomach are acid, and have no putrid odour. The ordinary symptoms of this kind of dyspepsia are depression 457",
         "458 CANADA MEDlCAL AND SURGICAL JOURNAL. of spirits, flatulence, fouil evacuations, headache, distension after eating. In a great many cases the diarrhoa of, children is due to defective digestion by the stomach ; the imperfectly-digested and partially putrefying mass of food gives rise to irritating sub- stances, which produce intestinal diarrhoea by reflex irritation transmitted from the nerves of the stomach. The occurrence of diarrhœa from this kind of reflex irritation may be illustrated by the well-known and prompt purgative action vhich is often found to follow the drinking of a glass of cold water in the morning before food. The water has not any inherent or direct purga- tive action, but it produces peristaltie action by the reflex trans- mission of the impression produced on thé mucous membrane of the stomach. In all the above cases the use of pepsin is strong- ly indicated, and for the prompt and happy cure of this class of infant diarrhoa, which is often found to be very intractable to remedies, I know of nothing which is better worthy of trial than pepsin. There are certain contra-indications of the use of pepsin, to which it may be well to refer. Among them are carcinoma and ulceration of the stomach. Where there is an ulcer of the stomach, it is an object of treatment to afford a smooth covering to the ulcer by bismuth, or by the administration of nitrate of silver ; to administer pepsin is to incur the risk of bastening the process of thinning, which there is already too much reason to fear from the action of the normal pepsin of the stomach. To fulfil the therapeutical indications of pepsin it is, however, necessary to have a pure and reliable pepsin. There are vari- ous methods of obtaining the article. Thus there is the method of Brûcke, by treating the gastrie juice(obtained by well-known methods) with a solution of cholesterine in ether; the cholester- ine being precipated, enters into mechanical combination wih the pepsin, and pure pepsin is obtained by removing the chole- sterine by the further addition of ether. This form of pepsine is absolutely pure, and from it may be learnt the qualities and powers of pepsin. But the method is too costly for general use, and its advantages are mainly for scientific purposes. There are various dry preparations of PeP'",
         "BRITISH AND FOREIGN JOURNALS. sin in powder and cake, which are well known, and, I believe, much used in medicine. But these preparations are very far from stable or reliable, and however-active some of them may be 'when perfectly fresh, they do not remain active, and a large part of the pepsin powders prescribed are absolutely inert. Pep- sin, although an. albuminoid, difers among other things from ordinary albumen-in being soluble in diluted alcohoL Advan- tage bas been taken of this to prepare \"pepsin wines ;\" but the alcohol does not prevent the ferment from undergoing change, and if a \" pepsin wine \" be examined after some time it will be found not to cont.ain a trace of pepsin, and to be absolutely de- void of digestive power. I have found, many years ago, that to preserve the ferment of pepsin there is only one reliable agent, that is glycerine, the powerful preserver of vaccine matter and other animal ferments. My first researches on this subject, made many years ago, have been amply confirmed by a great number of observations, and for all scientific experiments on digestion, I have now for many years employed only these solutions. I strongly recommend practitioners for all therapeutical purposes to employ such a solution., In this way they will avoid the fallacies and disappointments due to the employment of deceptive and unequal preparations, and they will the more readily define the truc limits of pepsin as a therapeutie agent, and its place in the armory of medicine. It is not to be reckoned among the most powerful and heroic remedies. but it is one which is of very agreeable and efficacious action ; which very frequently gives exceedingly good results in large classes of ordinary and trouble- some complaints, and which may be employed with confidence and advantage when its powers are stable and reliable.-By Oscar Liebreicht, ]M.D., Professor of Tiherapeutics in the Uni- versity of Berlin. Mode of Union of Amputation Flaps.- ý(Reaa at the Congress of Lyons, by Dn. AZAM, of Bordeaux). M. Azam bas long since removed the chimera of immediate union-chimera, because there is one part of the stump, the bone, for which immediate union is impossible. He has chosen 459",
         "CANADA MEDICAL AND SURGICAL JOURNAL. a method which consists in uniting certain elements of the stump, and leaving others to suppurate.l Here is what it con- sists of: he makes his amputation by two flaps nearly equial, arrests all hoemorrhage as complete!y as possible, passes, in bottom of the wound, in front of the . bone, a very large drainage tube, previously washed in Varm water; then, this drain being fixed, coapts the flaps, applies, to hold the muscles, two or three points of deep quill suture, with silver wire ; ho then coapts exactly the edges,'and maintains them in apposi- n by a superficial suture, made with great minuteness, with as much care as in the face. We get thus a union by first intention of the skin and muscles : as to the bone, this mode of union would be chimerical; to try it would be dangerous. Tho dressing consists in applying cotton over the end of the stump, and enveloping the whole by a tight bandage. At the end of tliree or four days we take off the dressing and remove the superficial sutures; the adhesion of the skin is perfect. As swelling of the subcutaneous tissues is pro- duced, we untwist one of the deep sutures to allow of the development of the tissues. The drainage tube remains. M. Azain lias completely renounced the use of injections. It is bad to introduce water into a wound : (1) because this water cannot be pure; (2) by reason of the mechanical effect, dis- tension and pulling of the drainage tube, with injury to the neighbouring parts. Generally, everything does well. In some cases there are complications, the most common of which is secondary hSmorrhage. If a slight hæemorrhage occur from the fifth to the seventh day, it unglues the flaps, and pus is produced in the deep parts of the wound ; it is sufficient thon to destroy the deep part of the suture. M. Azam has secn a stump absolutely healed on the eleventh day; the greatest number from the twelfth to the sixteenth; some from the twentieth to the twenty-fifth day. That is a good result. Assuredly this method, which belongs, for the rest, to several surgeons of the hospital Saint Aridrò, of Bordeaux, is only a 460",
         "BRITISI AND FOREIGN JOURNALS. resumò of certain previous practices ; that which constitutes its originality is the addition of the drainage tube, which assures the escape of the pus from the deep parts. We apply closely the subcutaneous parts, and assure this thing if neces- sary, the repose of the flaps.--4Revue 3édico-Photographique des ifopitaux de Paris, Nov. 1873. A New Sign.-A new sign, from inspection of the Ear, indicating respiration in the new-born.--(By DR. GELLE.') We draw particular attention to this vork of M. Gellê, which furnishes to the medical jurist a new means of recog- nizing, in the case of infanticide, if the new-born infant has breathed, and which makes a useful adjunct to the signs fur- nished by the lung test. In the fotus the middle ear is void of air, and filled with a gelatinous magma. By the act of respiration this magma disappears, and in its place air invades the tympanic cavity. This transformation takes place in the following manner: under the influence of respiration, and the derivation of blood towards the new vascular region opened to the circulation, the contents of the tympanic cavity become absorbed. This red- dish, thick mucous matter, becomes pale and thin, and leaves only a surface. The cries, and the efforts at suction, favour the aeration and the circulation of the cavities. The time necessary for the complete establishment of these two functions is propottionate to the vigor of the respiratory function; it averages three hours. On the contrary, if the respiration languishes, if asphyxia, slow or rapid, take place, the aëration of the cavities is incomplete, often only unilateral; it can be ibortive. In this case, one fnds, at the autopsy, an intermediate con- dition of the intra-tympanic contents, in which the foetal state manifèsts itself clearly, notwithstanding the certain presence of air. When the lung test is impossible, or if it gives doubtful results, the expert can find, by inspection of the ear, signs 461",
         "CANADA MEDICAL AND SURGIcAL JOURNAL. confirmative or negative of the penetration of air, and of the respiration of the infant. Furthermore, this examination of the middle car of the new-born infant will enable one to judge of the kind of death, of its cause, whether by hoemorrhage or by asphyxia, \u0026c., \u0026c.; and also of the period at which death bas taken place, before or after birth, before or after the first inspirations. Death by hæmorrhage can, by anoemia, bring about the artificial production of the auricular vacuum: it is sufficient to state this cause of error. To the question, Has the child breathed ? the expert can reply in a satisfactory manner, verifying the conclusions of the lung test by the results of inspection of the car. In late investigations, undertaken a long time after the period of the crime, or of the burial, the lung test giving no evidence, one will be right in reckoning upon the persistence of the auricular sign of the fotal state. Thanks to the resistance of this gelatinous magma to the causes of decomposition and putrefaction, justice will yet know the truth, and the absence of respiration will be susceptible of a demonstration clear and precise. In a word, when the expert finds the imiddle ear free from air, and filled with this gelatinous magma, ho is authorized in concluding that the infant bas not breathed ; when the magna has disappeared, and air has penetrated the cavity, ho should conclude that the infant has lived the extra-uterine life. Inspection -of the middle car, thon, of the new-born, is expected to render great services to legal medicine.-Mouve- ment Médical, March and April, 1876. Four Cases of Movable Spleen.-(1.) A boy 15 years oC age who had suffered for seven months from intermittent fover. The spleen was very hard, upper end extending in the left hypochondrium, the lower in the right upper abdominal ragion. The fissure vas plainly to be felt, with alterations in position the tumour also changed, while in the normal situation, the splenic dulness was absent. The symp- toms complained of were sensations of pressura on the stomach, and loss of appetite.",
         "BRITISH AND FOREIGN JOURNALS. (2.) A woman 39 years of age, x para, who had formerly suffered from typhoid. The spleen -lay at the left of the pubic arch, readily movable, and not painful. The change in position followed an injury. (3). A woman 43 years of ag;e viii para. The spleen was situated just above the navel, and could be easily pushed up. (4.) A woman 48 years of age, nullipara, who had long suf- fered with ague. The spleen is absent from the usual position, but can be felt between the navel and anterior superior spinous process.of the left side, and can be pushed up. Except in the 2nd case, in which there was apparently a traumatic luxation, the condition appears to depend chiefly upon the increase in size of the organ. The spleen is supported by the phrenico-lienale and gastro-lienale ligaments, lying upon the first, which by stretch- ing, adopts itself to enlargements of the organ. If such takes place without this ligament yielding to it, the spleen being no longer fixed, becomes movable. The extent of movement will depend upon how far the gastro-lienale ligament also yields ; the more it does the greater will buo the motion, but the less the traction upon the stomach. The great relaxation upon the ab- dominal walls in women who have borne. many children is not without influence in the production of this condition.-(Muller, Pest. Med. Chir. Presse.-Ctb. Med. Wis. No. 3, 1877.) Use, of Chloral Hydrate in Laboim.- Dr. Polaillon has employed. chloral in labour in thirty-two cases in the form of clysters 2-3 grmn. (30 to 45 grains) to 60 grmm. of water, (-ij). 4 to 5 grmm. of chloral generally used. It diminished the acuteness of the pains without destroying their force or frequency in some cases. In the majority of cases, however, whilst it diminished the pain it lessened the contract- ing power of the uterus, and the labour came to a stand-still. Dr. P. only recommends it where there is excessive 'muscular contraction of the uterus, and where the pains are very severe. He strongly objects to its use in normal labours.-(L' Union, 45, 1876.) Quoted in Scnidt's Jihrbüchi er, Bd, 172, No. 11, 1876. 463",
         "464 CANADA 31EDICAL AND SURGICAL JOURNAL. Peritonitis in Children.-By Dr. S. KERScO, of Prague (Menorab xxi. p, 251, 1876.)-The difficulty of the diagnosis of peritonitis is in the inverse ratio of the age of the child. . The younger the child the more difficult is the diagnosis. The following points are worthy of notice. A child suffering from peritonitis always has its legs drawn up, respiration is shal- low, rapid, and is not abdominal but costal ; the child can't cry out loudly. The cry itself is pathognomonic of the disease, it is singie, long-drawn out and suppressed, the pauses between the cries are long and filled up by a number of short inspirations. The prognosis of peritonitis in children is more favorable than in adults. All the female children treated by Dr. Kersch, that recovered were in after years sterile. Treatment consists in local bloodletting, cold applications, and the abdomen must be carefully corered with gutta percha paper. Morphia to be used as soon as the bowels have been completely emptied. When there is a good deal of fluid exuded, the early use of the trocar is advised. Dr. Kerseh relates a case which. was serions and which recovered after several punctures. - Quoted in Schmidt's Jahrbaeclher, Bd. 172, No. 11. 1876. Treatment of Pityriasis by Solution of Chloral.-(DR. MARTINEAU.) - Dr. Martineau has had much success in the treatment of Pityriasis Capitis, by using a 5 per cent. watery solution of chloral; of this he takes two spoonsful and washes the head every morning but does not dry the washed places. By this treatment he says the disagreeable symptoms soon disappear and the case is cured sometimes in a few days, but generally in about a month. If the disease has lasted some time it generally returns, but can agama be cured by the chloral solution. If the Pityriasis is accompanied by erythema or papular exanthem, he recommends a mixture containing 500 parts of water, 25 chloral hydrate, and 100 parts liq. Van Swieten, (0.1 Hydrarg bichlor. corros.; spirit vini rectif und^ aq. ana 50.00).-Bull. de Ther. xc. page 49, Janv. 1876,- Quoted in BSemidt's Jahrbi cher, Bd. 172, No. 12, 1876..",
         "BRITISUl AND FOREIGN JOURNALS. 405 Peroxide of Hydrogen.-Peroxide of Hydrogen for the prevention of the spread of Scarlet Fever and Small- pox.-By John Day, M.D. In October, 1875, by request of the Mayor of Melbourne, I drewi up a report which vas sub.equently published by order of the local Board of Health, on fifty-one cases of scarlet fever which had been treated by me between April, 1873, and April' 1875, These comprised all the cases of scarlet fever which had -come under my charge during that period. They were all treated in a similar manner. Each patient was freely rubbed over the whole surface of the body three times a day with a preparation composed of one part of ethereal solution of per- oxide of hydrogen (erronously called ozonic ether) and seven parts pure lard, well incorporated with the aid of heat. The inunctions w'ere continued for about three iveeks. No other :remedies were prescribed, except in a few cases where the throat :symptoms were severe, when a gargle composed of two drachms of ozonic ether in eight ounces of water, was ordered to be used every second hour. These fifty-one cases occurred in thirty-eight different bouses, ,and in four houses only was there any extension of the disease. There were no deaths. Since the above-named period I have attended sixty four cases, occurring in fifty different houses, and in three houses only was there any extension of the disease after I had commenced my treatment. I have been less fortu- nate, however, in my results, having had six deaths. Peroxide of hydrogen contains a larger amount of oxygen than any other known substance, and moreover, one half of its oxygen is loosely combined. and in a -highly active condition, ready to combine with any organic matter with which it may be brought in contact; so that it would appear to be an agent Specially.suited for the destruction of the poison-germs of scarlet fever, small-pox and other epidemic diseases. Dr. William Squire, in an excellent paper \" On Sanitary Precautions against the Infectious Eruptive Discases,\" read before the National Association for the Promotion of Social Science, says-\"It [infection] cannot be carried far in the air, for fresh air oxidates 30",
         "466 CANADA MEDICAL AND SURGICAL JOURNAL. d destroys it, so that for the most subtle disease the infecting distance is small.\" Now, the loosely combined atom of oxygen in each molecule of peroxide of hydrogen is infinitely more potent as an oxydiser than the oxygen of the atmosphere ; con- sequently I think it is reasonable to infer that by coating the body of a person suffering from scarlet fever or small-pox- diseases in w)hich most of the poison is eliminated by the skin- with peroxide of hydrogen in combination with lard, cacoa butter, cold cream, or any other substance vhich will conveniently retain it, we are reducing the danger of infection to a minimum. I have recently slightly modified my formula for the external application, and now generally prescribe it as follows: Ozonic ether, four drachms ; pure lard, four ounces ; benzoic acid, twenty grains; otto of roses four drops; to be carefully mixed without the aid of heat. The benzoic acid, in addition to its being a powerful antiseptie, possesses the property of allaying cutaneous irritation, a symptom often very distressing to scarlet fever patients. The otto of roses gives an agreeable odour to the preparation. I now also prescribe, throughout the whole course of the disease, a mixture composed of two or three drachms of ozonie ether in a half a pint of water ; the dose ranging from a tea- spoonful for a child twelve months old, to a tablespoonful for an adult, to be taken every second hour. This is used for the double purpose of benefitting the throat symptoms, and disinfect- ing the breath. I have so much faith in the disinfecting properties of peroxide of hydrogen that I recommend all my friends and patients who are in a position to afford it to use freely, that vhich for want of a better name, I call oxygenated pertumery. It is made by adding ozonic ether, in the proportion of about a drachm to the ounce, to any kini of perfume, according to individual taste. I give the preference cither to Rimmel's toilet vinegar or eau de Cologne. Letters, newspapers, and articles of clothing may bO disinfected by sprinkling them over with oxygenated eau de Cologne, or with any other oxygenated perfume. With regard to any poiwer that peroxide of hydrogen may",
         "BRITISU AND FOREloN JOURNALS. possess of destroying the poison germs of small-pox, I must confess myself to be mcrely a theorist, for we have not yet lad small-pox in its epidemie formn in Australia. In 1871 a vcssel ariived at Meilbourne with small-pox on board, and shortly after the passengers were landed a few: cases broke out in different parts of the-colony ; but through the energetie ncasures adopt- ed by Dr. McCrea, our Chief Medical oflicer, the disease was soon stamped out. At that time, howcver, it first occurred to ie that it might bc possible, by a process of oxidation to destroy the poison-germs of small-pox as rapidly as they are given off from the body, and in a paper \" On a Means of Arresting the Spread of Small-pox,\" read before the Medical Society of Vic - toria, July, 1871, I suggested the use of peroxide of hydrogen for that purpose. From a theoretical point of view it might be supposed that peroxide of hydrogen would act more powerfully as a disinfect- ant in small-pox than in scarlet-fever, in consequence of the curious property that pus cells possess of exalting its chemical activity and giving it the oxidising powers of ozone.-Geelong Australia.-Hledical Times and Gazette. Diet and Exercise.-It has been for some time a subject of dispute among physiologists whether muscular force is produced by the oxidation or combustion of the muscular sub- stance itself, or whether the muscular tissue merely serves-as, §o to spealk, a sort of furnace where the alimentary matters are burnt or oxidised, and thus produce force. The bearing of the question on the subject of diet is evident. If during exorcise the.muscular tissue undergoes rapid destruction, it is plain that the food most suitable for ingestion during prolonged muscular effort is that wlose composition is as nearly as possible identical with that of the muscles-.. e., the food should be largoly nitro- genous. If, on the other hand, the muscles are not themselves used up, but only serve as the site of other tissue changes, whicl other tissue changes are the source of the force set frec in this Case, it is equally evident that the food need not necessarily be 407",
         "ÇAN.\\DA MEDICAL AND SURGICAL JOURNAL. nitrogenous, but may be of any nature adequate to go through the metamorphoses required ; i. e., it may be noi-nitrogenous, and be chiefly composed of hydro-carbonaceous substances. If the muscular tissue is disintegrated, theý uitrogen contained in it mustbe eliminated in some fori or other ; for modern physiology teaches that w'aste muatters are not allowed to remain in the organism. but arc iven off tlrough soma channel. The onlv channels through which it can pass are the skin, lungs. alimern- tary canal, and kidneys. It does not appear that any appreciable amount passes out by the skin and lungs. That passing out through the intestinal canal is derived from the unabsorbed intestinaljuices and undigested food ; it has, therefore, no rela- tion to tissue destruction. The urine is, therefore, the only channel \" througli which the exit of nitrogen arisi ng from the metamorphosis of nitrogenous matter can take place.\" Most of the nitrogen in the urine is in the form of urca, and the way in which experimenters have endeavored to settle the question is by measuring the amount of urea contained in the urine passed during rest and exercise respectively. Fick and Wislicenus were, we believe, the first to make satisfactory experiments on the subject. \" They ascended, fasting, one of the high moun- tains of the Bernese Alps, measuring carefully the quantity of urea eliminated by the kidneys during and after the ascent. In the case of one of them, the labour developed by this ascent may. h- represented by 181,287 kilogrammtres ; yet no increase in the urea was observed, either during or after this very severe muscular exercise. We sec, thus, that the muscle (as the source. of labour or heat) consumes only hydrocarbons and fats, and not albuminoids\" (a) Voit, Drs. E. Smith, Parkes, and Austin Flint,.jun., have also experimented on the subject ; and all, except the last-mentioned experimenter, have arrived at conclu- sions substantially the same as those arrived at by Fick and Wislicenus. Dr. Pavy has recently-published .in the Lancet (Nov. 25th, Dec. 16th, Dec. 23rd, and Jan. 13th,) the results of the investigations made by him on Weston and Perkins, during their pedestrian performances at the Agricultural Hall. lis conclusions may be briefly summarised as follows:- 468",
         "BnRrisa AND FoREXUN JOURNALS. 4C 1. Dr. Pavy fourid that in every cas2 the amount of urea (and hence o nitrogen) eliminated during the days of working greatly excede that luring the days of rést, the amount being nearly doubled. 2. The nitrogen ingested he also found to be greater. thougli not to such an extent, during the days of walking and during tiose of rest. Putting-these two things together, Dr. Pavy says \"The average daily excess in the nitrogen eliminated, during walking, as compared with that eliminated during rest, is 222.54 grains.\" He says it is evident that we have an increased alimen- tation of nitrogen to deal with during the days of walking which i8 not to be accounted for by the nitrogen ingested. We can only, therefore, refer this increase to the effect of the exercise; but is it the result-is it the expression of the action which has given rise to the power evolved ? This is the question that pre- sents itself for solution, and I will attempt to solve it by ascer- taining whether the force liberated by the oxidation of muscular tissue corresponding with the nitrogen discharged is sufficient to account for the work performed.\" We have not the space to give the nethod of calculation adopted by Dr. Pavy. (Thos3 who wish for details may consult Lancet, December 16th.) He arrived, however, at the conclu- sion that the force obtainable from the nitrogenous matter disin- tegrated is totally inadequate to supply the power for the work done. Dr.Pavy says:- Ihave been argug as thougi the nitrogenous matter disintegrated represented muscular tissues oxidised. This how- ever, is undoubtedly by no means the case. There can be no question, from what we know upon the su'bject, that a large, if not the chief portion of the urinary nitrogen eliminated is deri- ved directly.from the metamorphosis of the nitrogenous matter iDgested without pasing through muscular tissue. Again, I have only takèn into accotint the power expended in the mere act of getting over the distance walked. I have said nothing of the muscular power expended in maintaining the circulation and respiration and the movements of the body occurring during",
         "470 CANADA MEDICAL AND SURGICAL JOURNAL. walking, supplementary to those actually concerned in affecting passage over the ground. These must form an item of consid- erable significance in relation to the whole muscular action tak- ing place, and serve to bring out more strikingly the coLlclusion suggested by the figures which have been furnished.\" Hence he concludes that even allowing a large margin for error in -calculation, iL is utterly impossible that the force pro- duced could have been producod by oxidation of muscular disease. Dr. Pavy says \"It is not, indeed, surprising, looking at the increased activ- ity of the circulation and respiration, that there should be an increased metamorphosis of nitrogenous inatter throughout the system, and therefore an increased wear and tear of the muscles as part of the general action occurring. The oxidation of nitrogenous matter, furnishes, it must be remembored, a source of force, for after the separation of its nitrogen as urea, an oxidisable residue remains ; but this bas no intrinsic association with the view which ascribes the source of muscular power to the direct oxidation of inuscular tissue.\" . We nay remark that Dr. Pavy says that Dr. Flint has adopted a wrong method of calculation, by which the results obtained appear widoly different to Dr. Pavy. Dr. Pavy bas, however, verified many of his ceterminations of urea by actual combus- tion analyses of the quantity of nitrogen. Dr. Pavy's results certainly appear trustworthy to us, while Dr. Flint's figures certainly offer a fair field for criticisn, and his inaccuracy detracts considerably from anîy force his argun'ient may have. -Doctor, March lst. Treatment of Hydrocale by Electricity. Von Friedenthal has used electro-puncture in this affection with good results. Ie uses gold needles, and only sticks theni under the skin (not into the sac of the testicle). The needle of the negative polo is put in the skin of the scrotum, and the positive somewhere in the neighborhood. Ie passes a current for three minutes and repeats the operation every second day. Five or six sittings are generally enough to produce complete absorption of the hydrocole. In some cases the hydrocele returned, in others it did not. Th-, same thing occurs vith the injection of iodine.-(No. 28. Prager iMed. Wochenschr.).",
         "BRITISIH AND FOREIGN JOURNALS. The Night Cries and Night Startings of Children.-Caspari attributes them to frightful dreams. In children under a year old, and especially in delicate, anæmic children, they are associated with mild or severe convulsions. Ie uses as a specific, bromide of potassium, and according to the age gives 0.5 grmm. to 1.5 grmm. (gr. 7L to gr. 23f) a day. (Gr. xxv. potass. bromid., aq. šiss-3i 4 times a day). According to Edlefsen's experience bromide of potassium :always causes quiet and peaceful sleep in young children, but does not act so well in older ones. It acts well in convulsions, teething and meningitis. He gives a strong six months old child 0.5 grmm. (7j- grains) 3 or 4 times in the day, or once or twice in the evening. Younger and less robust ones, he gives 0.25 grmm. as .a dose. In older children he often increases the dose to 0.75 grmm. several times a day. (Deutsche. Ztsch. f. Prakt. Med 28. p. 234, 1876,. und a.a. 0.38, p. 412, v. Dr. Edlefsen in Kiel.) Quotod in Schmidt's Ja7rbcer, Bd. 172. No. 11, 1870. On a new Treatment in Post Partum Homorrhage.-Although not an obstetric practitioner, I have recently been consulted in two cases of severe post-partum hoemorrhage. In both cases every means had been adopted but unavailingly. It flashed across my mind in the first case to try the effect of the other-spray, and accordingly I directed a large spray over the abdominal walls, along the spine and ovèr the genitals ; the uterus at once responded, and the cessation of the hæemorrhage was almost immediate. In the second case I lost no time in adopting a similar treatment, and with an equally successful result. I have consulted several eminent obstetric practitioners in Dublin, and am informed by them that they are not aware that this treatment has been heretofore pro- posed., The advantages of the ether-spray over the application -of cold water and the other means usually adopted in these cases Must be patent to every practitioner of midwifery.-By 'W, £fndsel GrUliths, PT.D., L.R. C.P.E. 471",
         "CANADA MONTREAL, APRiL, 1877. RECOGNITION OF CANADIAN DIPLOMAS. We have received the following letter from Sir Hugh Allan- in reference to the'subject of the recognition of Canadian quali- fications for the emigration and passenger service on board of British ships: ALLAN UNE OF ROYAL MAIL STEAMSHIPS, HUGH \u0026 ANDREW ALLAN, AGENTS. Sir Hugh Allai. MONTREAL, 16th Mareh, 1877. An2drew Allant. .' DEAR DR. FENWICK,-Our Liverpool letter to day advises us that the' Board of Trade have rescinded the regulation respecting Canadian surgeons, who are now at liberty to sign articles on their own diplomas. I congratulate you un the successful result of the opposition made to it. Yours truly, Dr. FENWYcK, Editor iUGIl ALLAN. Canada Medical and Surgical Journal, Montreal. This is gratifying so far as it goes. Nevertheless the position must be regarded as unsatisfactory. Canadian surgeons, by this action of the Board of Trade, are permitted to serve.in their professional capacity through sufferance and no-t by rightt It is an admission-a permit-on the part of the -Board of Trade, but not, by any means,.a recognition of the qualificar- tions of the holders of Canadian diplomas. The London Lancet of March 3rd, in alluding to an article which we published'in the February number of our periodical, remarks :--\" The Medical and Surgical Journal, published in, \" the Dominion, in its issue for February, deals at considerable ' length with the ineligibility of surgeons other than those-",
         "ENOR31OUS ABDOMINAL TU3MOUR. \"possessing British qualifications for appointments on board 'emigrant and passenger ships sailing from British ports. It strives, and we think successfully, to show that the educa- \"tional tests by which admission is gained to the profession are \"as comprehensive and exacting ir Canada as those imposed \"in England ; and submits that Canadian surgeons holding qualifications equiv.alent to those conferred at home should \"not be excluded from serving on board vessels which are '! identified with the progress, enterprise and wealth of the \"colony. * * * We believe that the Canadian Govern- \"ment will be asked to make a representation on the matter.\" We hope that this subject will receive careful consideration and be settled definitely. We have not heard that the Canadian Government has been requested to make any representation. It is very desirable that some explanation should be entered into and some definite line of action decided upon. The matter cannot be allowed to rest in its present- shape. If Canadian graduates are admitted through sufferance, at any moment the Executive of the Board of Trade may enforce the wording of the act in respect to qualification to be deimanded of ship's surgeons, and we shall on some future day have the grievance of which we complain repeated. ENORMOUS ABDOMINAL TUMOUR. At a meeting of the Medico-Chirurgical Society of Montrea1, held March 9th, Dr. Osier exhibited for Dr. Malldch, of -Ham- iIton', a solid abdominal tumour weighing 35 ibs. The following history accompanied the specimen: \" The subject of - the disease was'a gentleman, aged 47., When first éxamined, 14 month's before his death, a hard nodular, tumour, about the size of a foetal head, was noticed on the right side of the abdomen. This had been growing for three or four months, causing irritability ôf the bladder and pain in the right thigh. It was considered malignant, and the advice was to leave it alone. Subsequently he consulted the leading physicians in Toronto, Montreal and New York, and finally fell into the hands of the 47j",
         "CANADA MEDICAL AND SURGICAL JOURNAL. quacks. At the autopsy the body was extremely emaciated and the abdomen grEatly distended, the lower ribs being pushed out. It was found to be attached to the abdominal wall in front, to the omentum and to one or two coils of the intes- tines, which were pushed upwards and to the left. It had an investing membrane (the stretched peritoneum), and was very easily turned out of the abdomen. It appeared to spring from the neighborhood of the right sacro-iliac syncliondrosis, and the external iliac artery and ureter of that side were attached to it below. Secondary nodules existed in the vertebral column, the liver, and right lung.\" The tumour is divided by a num- ber of deep fissures into tobules ; it is white in colour ; of good consistence. Histologically it is composed of elongated fibre cells, and, from their general arrangement, it would appear that their growth, thougli originating in the retro-peritoneal glands, belongs to the group of encephaloid cancers rather than the lympho-sarcomas, which more commonly attack the lymph- atic glands. The term \" Lobstein's Retro-peritoneal Cancer\" lias been applied to tumours arising from the glands in this situation. ANNUAL CONVOCATION OF McGILL UNIVERSITY. The Annual Convocation of McGill University for conferring degrees in the Faculties of Medicine and Surgery, and Law, was held in the William Molson Hall of the University on Wednesday, the 28th March, 1877. There was a large assemblage of the friends of the University present. Shortly after three o'clock the members of the Convo- cation, who had assembled in tho Library, entered the hall and took their seats. The chair was taken by Peter Redpath, Esq., the. senior governor present, in the absence of the Chancellor of the University. The proceedings were commenced by the customary prayer by the Rev. Professor Murray, after which the Secretary, W. C. Baynes, Esq., B.A., read the minutes of the last meeting of Convocation. 474",
         "A.NNUAL CONVOCATION OF MCILL UNIVERSITY. The President asked Geo. W. Campbell, A.M., M.D., Dean of the Faculty of Medicine, to read the report of the Faculty. Dr. Campbell alluded to the action of the English Board of Trade in relation to surgeons holding certificates from McGill, being refused the right to practice *.on board of certain vessels, and was happy to know that the order had been rescinded. He was varm in his thdnks to other universities, Sir Hugh Allan, the press and the Government for the warm interest manifested in the University's behalf, and having again expressed himself glad that the order of the Board of Trade had been rescinded, and sensible of the compliment paid to the University by those who had defended it, asked Dr. Scott to read the report of the, result of the year's labour. The following report of the Faculty of Medicine.was read by Dr Scott: The following gentlenen, 27 in number, have passed their primary examinations on the following subjects: Anatomy and Physiology, Chemistry, Materia Medica and Pharmacy, Insti- tutes of Medicine and Botany and Zoology, thoir names of residences are as follows: Names. RZesidences. Becksted, Morris ............................Grantly, O. Bell, Robert ...........................Montreal, Q. Cameron, John D.......................Glengary, O. (Chisholm, Alexander ......................Lochiel, O. FraEer, John R...............................Hawkesbury, O. Gardner, Henry I............................Orillia, O. Gibson, William B ...........................Dunham, Q. Greenwood1, Fred. S.....................St. Catherines, O., Guerin, Janie F................... ..Montreal, Q. i Hutchinson, John A..........................Bluevale, O. lowey, William H..........................Dehi, 0. Irwin, John L................... ...........Ottawa, O. MeCann, John J., B.A........................Millbury, Mass. MeCrimmon, John...........................Woodville, O. MKinley,John K............................Perth, O. MONeill, Ernest........................Montague, P.E.T. Mills, Thomnas W., M.A................... Hailton, O. Neilson,,W illiam J. .........................Perth, O. Pinsoneault, Bernard.........................Montreal, Q. Riley, Oscar l.. ............................Franlin, Vt. Rutherford, Martin O....................... Waddington, N.Y. Setree, Edward W............................Prescott, O. Sinith, Daniel F..............................Listowell, O. Stafrord, Frederick J..........................Montreal, Q. Vineberg, liram N...........................Monreal, Q. Webster, Arth r D ....... ...................IKentville, N.S. Wright, John W .. ..A ......................cressy, O. 4175",
         "476 CANADA 11EDICAL AND SURGICAL JOURNAL. The following gentlemen passed in everything but the Institutes of Medicine: Kirk, George W., Cornwall, O. ; Mc- Crimmon, Milton, Ancaster, O. ; Macdonald, Malcolm C., Glencoe, O. The following gentleman, 19 in number, have fulfilled all the requirements to entitle them to the degree of M.D., C.M., from this University. These exercises consist in examinations both written and oral on the following subjects: Principles and Practice of Surgery, Theory and Practice of Medicine, Obste- tries, and Diseases of Women and Children, Medical Jurispru- dence and Hygiene, - and also Clinical . Examinations in Medicine and Surgery conducted at the bedside in the Hospital. NAME. RESIDENCE. TESES. Armstrong, George B... Montreal, Q...........Hospital Reports. Bell, James............North Gower, 0........Pathological Reports. Boyle, A lbert........ Charlottetown,P. E. L...Surgical Reports. Brodie, John...........North Georgetown, Q...Hospital Reports. Burland, Samuel C.....Philadelphia, U.S.A....AcutelBronchitis. Cannon, Gilbert...........Almonte, 0............fleurisy. Cameron, Duncan H...Perth, O...............Tubular Nephritis. Cotton, Coderic L......Cowansville, Q.........Hospital Reports. Farley, James F.......St. Thomas, O.........Bloodless Opérations. Fraser, Alexander 0....Wallaceburg, O....... Malaria. Gillis, John A. F.......Summerside. P.E.I....Hospital Reports. Greaves, Henry C......Barbadoes, W. I.......Hydrophobia. [System. Jamieson, Alex.. B-A..Lancaster, 0......... The Mind and the Nervous Lane, John A.........Prescott, O ...........Surgical Cases. Law, William K. Richibucto, N.B......Typhoid Fever. Miner, Frank L........Abercorn, O............Placenta Provia- Oakley. William D.....Plattsville, O..........Urinary Deposits. Park, George A .......St. Marthé, Q..........Sanitary Science. Smellie, Thos.S.T., M.A. Fergas, O........... Pathological Reports. Students who have passed their examinations in Botany,: CLASS I. G. Dibble, (1st Prize) T. L. Brown, R. T. Maas, L. Mignault, (2ýnd Prize) 1B!mal, HB.Poe D. T. Inksetter, B. L. Riordan, T_ C. MoArthur, W. McEachran. James Catahan,* G. T. Ross, W. K, Dalmage, S.,M.. Lofe-vre, T. Gray, CLA5SMr. R. Prime. T. C. Brown. L B rvoes, A. C. K. MeCorkill, A, Rattani B. W. PRdlford, D. K. CroW.ey, T. O. Steward, G. C. Hart, 11R. t Ma, T. J-, Churcb, NI. P. Frime, P. W..Ch'nrc, W. Le e Molpied, R. T. B. MacDonld. A. K. TMrler,",
         ". ANNUAL CONVOCATION OF OMCGIrLL UNIVERSITY. CLASS II. M. MT. lty. W. T. Musgrove, C. T. Glass, T. W. Serviss, . Il. Suider, S. D. Holcomb, W. C. MeGillis, E. A. McGannon. The Medical Faculty Prizes are threc in number: 1st. The Holmes Gold Medal, awarded to the graduate who received the highest aggregate number of marks for the best examinations, vritten and oral, in both Primary and Final branches as also for an inaugural thesis. 2nd. A prize in books awarded for the best examination, written and oral, in the final branches. The gold medallist is not permitted to compete for this prize. 3rd. A prize in books awarded for the best examination, written and oral, in the primary branches. The Ilolmes Gold Modal vas awarded to James Bell, North Gower, O. The prize for the final examination was awarded to William Donald Oakley, Plattsville, O. The prize for the primary examination was awarded to Hiram N, Vineborg, Montreal, Q. The following gentlemen arranged in the order of merit, deserve honourable mention :-In the final examination, Messrs. Cotton, Armstrong, Fraser,. Gillis and Brodie. In the primary examination Messrs. Neilson, Gibson, Mills, .Srnith andGreenwood. PROFESSoRs PRIZEs. : PACTICAL CHEMISTRY - - - - - BoTANy-------,-- Dibble and Mignault. PRACTICAL ANATOMY. D.3mn9lstrator's Prize in the Senior Class, awarded to John Androw MacDonald and Thomas W. Mills, M.A., equal. Those deserving honourable mention for care and assiduity, 477",
         "478 CANADA 31EDICAL AND SURGICAL JOURNAL. Brown, Hart, Lawford, McCrimmon, equal, and Stevenson, and Webster. Junior Class prize awarded to Thomas Gray. Honourable mention, Messrs. McArthur, Gurd, Inksetter, Small and Groves. The graduates were then called forward and the Sponsio Academica was administered by Professor Craik, M.ID., and each in turn presented to Vice Chancellor Dawson, who performed the ceremony of Capping, and delivered to each candidate his diplonia of Doctor of Medicine and Master in Surgcery. At the conclusion of this ceremony Dr. Smellie delivered a valedictory address on behalf of his associate graduates. Dr. Gardner, Professor of Medical Jurisprudence, then addressed the graduating class on bohalf of the Medical Faculty. After the proceedings of the Faculty of Law, and an addres3 from Sir Francis Hincks, the benediction was pronounced by the Rev. Professor Murray, and the convocation adjourned. Shiftuary. JAMES HAMILTON, L.R.C.S. Edin. We regret to have to record the death, on the 1st of last month, of one of the oldest and one of the best known medical men in the Dominion, Dr. James Hamilton, of West Flamboro', Ont. lie was born at the village of Douglass, in Lanarkshire, in 1797. Receiving a preliminary education at the parish school, he pro- ceeded to Edinburgh as a medical student, and, after four years study, obtained, at the carly age of 19, the diploma of the Col- lege of Surgeons, the date of which is 1816. Thus qualified, and being anxious to sec something of the world, he came to Canada as surgeon on a vessel, and was induced by friends to begin practice in Montreal. After enjoying himself for four months, and doing, as he told the writer, very little practice, he returned to Scotland. In 1818 he again visited Canada with the intention of permanently settling, and after visiting many localities, began practice in Ancaster, a small village about 5 miles from the head of Lake Ontario, and, at that time, the chief place of business",
         "THE LATE DE. JAMES HAMILTON. between York (Toronto) and Niagara. Ilere, as the only medical man at the head of the lake, he quickly obtained an extensive practice, so extensive, indeed, that the greater part of the day was spent in the saddle. 1-lis district at that time lay between the Grand River and twenty miles down the lake on either side, an area about 60 miles by 20. In 1820 le moved across the valley to West Flamboro', about two miles from Ancaster, having purchased one of the most beautiful sites in Western Canada, immediately above the town of Dundas, and overlooking iBurlington Bay and Lake Ontario. Here lie con- tinued to live until the time of his death. Dr. Hamilton pos- sessed qualities of mind and body vhich fitted him in the highest degree for his profession, while the strict and conscientious atten- tion -which he paid to ail cases, early secured for him a lucrative practice. Unfortunately in later years lie engaged in some commercial enterprises which proved far. from successful, but an indomitable energy enabled him not only to tide over reverses, but to make provision for old age. In all public matters Dr. Iamilton took a deep interest, but had no great desire for parliamentary honours. Though a staunch conservative and a leading man of his party, he was only once induced to contest a county, and then unsuccessfully. He was one of the original promoters of the Great Western Railway, of which he was for many years a Director, latterly holding the position of consult- ing Surgeon. At the time of the Rebellion he held a com- mission as Colonal of Militia, and took an active part in its su'ppression. By bis professional brethren Dr. Hamilton was held in the highest esteem, and most deservedly so, for one by one he had welcomed them heartily into his district, holding out to each the hand of good-fellowship. He took a deep interest in the Ontario Medical Council, and represented the Burling- ton and Home districts from 1869 to 1872. It is much to be regretted .that Dr. Hamilton bas left us no record of bis medical experiences, whicli, extending as they did over a period of sixty years, would have formed a most valuable contribution to cana- dian medicine. To the end he maintained an interest in the progress of the art, and frequently, in conversation, would refer 479",
         "c0 ANADA MEDICAL AND SURGICAL JOURNAL. to the great improvements in medicine and surgery. Possessed of an accurate memory stored with interesting incidents both medical and social, he vas a most delightful companion, and iwill greatly be missed at friendly gatherings in Wentworth. To within a year ago, Dr. Hamilton enjoyed an unusual measure of health, indeed in his long career, he was only once laid up by illness. From his boyhood he was a most enthusiastic curler, and had been for some time past President of the Ontario branci -of the Royal Caledonian club. For nearly a ycar before his -death symptoms of declining vigor were apparent to his friends, and signs of grave disease of the liart were discovered. The -death last year of his son, Dr. Andrew Hamilton, of Melbourne, Que., was felt very keenly by him, and he never fully recovered from the fatigue of a hurried railway journey undertaken at the time. To the end, however, lie was cheerful and resigned, thougli loth to depart, and on Christmas day, when the writer of the present sketch saw him for the last time, and on leaving spoke of his long and honorable career, he replied that nothing would please him better than to exchange his rusty old body for a young and active one, and work on for another eighty years. .Award to Mtessrs. Billings, Clapp g. Co., Boston. The undersigned, having examined the products herein des- -cribed, respectfully recommends the saine to the United States Centennial Commission for award, for the following reasons, namely A very fine display of Chemicals, especially Carbolic Acid, Propylamine; [Trimethylamine], Chloride of Propylamine, and also of iPharmaceutical Chemicals, such as Citrates of Iron and Manganese, Citrates of Bismuth and Ammonium, Pyrophosphate «of Iron, Bromide of Potassium, Bromide of Ammonium, Chromic Acid, Valerianic Acid, and many others. Commended for fine display and excellence of chemicals. F. A. GENTI, [Signature of the Judge.] Approval of Group qf Judges. J. LAWRENCE SMITII, DR. Y. WAGNER, P. DE WILDE, CHARLES A. JoY, E. PATTERNO, J. W. MALLET. F. KULMANN. 480"
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         "Canada medical \u0026 surgical journal [[Vol. 5, no. 10] (Apr. 1877)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "DR. GODFREY'S CASE OF PLASTIC OPERATION. (See page 225 \" Canada Medical aid Surgical jounal\" fur December, 1874.)",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGINAL COMMUNICATIONS. Extensive Destruction of the Soft Parts near the Angle of the Mouth,from Slougling afterFever. Plastic Opera- tion; Recovery. By ROBERT T.. GODFREY,. M.D., Professor of Surgery, University of Bishop's College, Lennoxville, Attending Surgeon, Montreal General Hospital. (With an illustration). The following case was admitted into the ,Montreal General Hospital on the 13th July, 1874, and as it illustrates the beneficial results of plastic surgery, I deem it of suffi- cient interest to lay before your readers. The history as given by the patient himself is as follows: William Bouchet, æt. 19, a French Canadian: a strong, well proportioned yourg man,-some two years ago suffered from an attack of 'Typhoid F.ever.\":' He was ill for' several weeks. In the course .of: his illness, and towards the close of the fever, his face:became inflamed, he suffered muchpain of a,-burning\u003e character, soon.:an ulcerated spot occurred, and he whole of the 'cheek separated and fell out ; subsequently his.teeth.loosened, both in the uppèr and lower jaw; and, were taken away by his doctor, together vith several pieces of bone ; he made a very slow recovery. Upon examination I ascer- tained that nearly the whole cheek on the lef t side had sloughed. The buccal cavity was conpletely absent. The molar teeth in' the upper and lower jaw were gone, as well as a large portion of the alveolar processes. The integument 16",
         "242 OANADA MEDICAL AND SURGICAL JOURNAL. was adherent to the bones of the face, and there existed a large opening the size of a crown piece, through which could be seen the tongue and the soft palate. The motion of the jaw was limited, and although he was quite able to pass into his mouth a good sized ball of food he could not masticate properly. He experienced great difficulty in guiding his food, when masticated, into the pharynx, as it would pasà àt through the opening uniess prevented by his hand. This rendered him very miserable, as anything like liquid food would run down his jaw and the side of his neck, and occasionally prod.uce excoriations. The lips were entire; the angle of the left upper lip was curved ùpwards and in'wards and w'as attached to the superior maxila, vhile the lower lip curvèd downwardà and was attachéd t' the inferior n axilla At the upper and outer part of the gap there existed an opening into the antrum, which 'ias quite visible. Looking at him from the injured side his appeaiance vas veiy revolting.' The poor fellow had to keep the part covered with a pad of linen to prevent the saliva frorm flowing down the side ofihis face and neck. On the 21st of July I performed the following operation. The .patient was placed under theinfluencei of chloroform, and with the able assistance of my colleague Dr. Mac Callumn I commenced by,paringvery freely the ,edges of the aper- :ture. The integuments, were then separated from their attacliments to. the superior and inferior jaw bones. The ;angle of the upper lip. was freed, and, the lip itselfseparated from its attachrhent- to the incisive fossa, this, gave, ample room' and thelip came down to its natural position without any dragging or strain on the, nose. A large flap, semi- lunar:. in shape, was then taken from the, integument situated over the body of the inferior maxilla and sub- maxillary space, this was perfectly freed and came up and fitted 'the aperture, The angle of the. flap sonewhat V shaped, filled a·similar shaped space which was left after turning the upper lip dovnwards. The angle of the mouth",
         "SLOUGHING AFTER FEVER-REOOVERY-DR. OoDFREY. 243 and the angle of the flap- werc fixed in their places by hare-lip needles with the figure of eight suture. The edges of the rest of the wound 'were retained in situ by wire sutures. The flaps were so freely separated from their bony attachments that there was no straining of the parts, which greatly conduced to the success of the operation. On the fourth day the needles were removed, the sutures were; however, allowed to rernain. He had on the following day à slight attack of erysipelas, which was relieved by the usual means. Fromthis time all progressed favorably. The sutures were not removed until firm union had taken place. The patient left the hospital on the 8th August, eighteen days after the operation. The accom- panying engravings are from photographs by Notman, and give a most faithful representation of the appearance of the patient both before and after the operation. A Case of Popliteal Aneurism in a T4oman cured by Dzçïtat Compression in twelve hours after faiure with Carte's Compressors. By JOHN REDDY, M.D., L.R.C.G.S.I., \u0026c. Physician to the Montreal General Hospital, \u0026c. Aneurism in the female is of such rare occurrencé that .I desire to record the following which was. situated.-in 'the popliteal artery. I am indebted to Mr..Hugh U. Bain for the notes of the case to July ,first. Mary Annu Foy, aged 59, was admitted into the Moñitreal General Hospital on April 6th, under the care of Dr. Reddy suffering from a large popliteal aneurism. Is a stiong.well built'woman ; has been married and has had, two children. On questioning her found a satisfactory family history. Her father died in his Ioist year, and her mother is still:living and in her'iooth yearf; has.had six brothers and four sisters, three brothers and one sister still living. One brothef died of dropsy, another of phthisis, the third one died very sud- denly, cause of. death could not be ascertained. One sister died of phthisis. Husband died 38 years ago. Both",
         "CANADA MEDICAL AND SURGICAL JOURNAL. children died; one dying when aged 20 of phthisis, and the other of scarlet fever. Previous general health has always been good. -Has worked hard most of the time, and for the most part as a general servant. Twelve years ago had an attack of acute rheumatism, was three weeks ill, had great pain during this attack about her heart, and had -\"robably some heart com- plication. At present, however, her heart is perfectly healthy, this is the only severe illness she has ever had. Menses have always been regular. Present illness. About five weeks ago she felt a pain in her right foot and leg. Pain increased and foot and leg swelled considerably. One day when scrubbing, was seized vith what she thought was a cramp, attended with much pain ; this soon disappeared and she felt quite well for a few days. These pains returned, running from the knee to the toes, and especially in the calf and side of the leg, pains present night and day, she applied pain killer, alcohol, and camphor, \u0026c., but with no benefit. Then, three weeks ago, when one day sweeping, she felt a sensation as if something had burst or snapped in her leg, and would have fallen but for the broom in her hand·; pain now was most intense.' Be- fore this, could walk, but was unable- o place right heel to the ground; couldnot now walk at all, could not rest at night ; continued to get much worse, and was admitted into the Montreal General Hospital on April 6th, when a large sacculated aneurism was discovered, filling up most of the popliteal space. Apriïl 8t.-To-day Dr. Reddy. applied two of Cartes compressors over the femoral artery, one at- the apex of Scarpa's triangle, the other two inches below Poupart's ligament. By means of these, pulsation in the tumour was easily controlled, and could at will be obliterated. The leg was also carefully ban'daged with flnnel from the toes to the knee. For the first iew hours suffered intense pain from the compressors. Pressure was made alternately with 244",
         "POPLITEAL ANEiURIM-RECOVERY-BY~DR. REDDY. 245 the upper and lower tourniquets, changing them every five and ten minutes. Was given chloral grs. xx, which gave her some relief. .Complained most of the lower tourniquet which, .Dr. Reddy, about 7 p.m., lad replaced by another one. This relieved her a great deal, and the pulsations were now more easily controlled; at 12 p. m., given Potass. Bromide a drachm. April rot/z.-Pulse weak, 88, suffered much during the night, vas given two draughts of chloral, but got very little sleep, complains now of great pain in foot and calf of leg, which are much swollen, a good deal of venous congestion; feet, very cold, were wrapped up in cotton wool. Has no appetite and feels much exhausted. April i1th.-Slept tolerably well, pulse 88, temperature 97',; given two draughts chloral during the night. Instep and side of leg are very sore to-day, bandage reapplied and gave much relief ; swelling in leg less, and tumour has a much firmer feel, especially on its outer margin ; appetite fair,-given milk diet, and a pint of milk extra. April 12th-Pulse 8o; skin cool ; still much pain; less pressure now required to control the pulsation, and pulsation felt now chiefly towards the centre of · the tumour.- 14th-Beginning to feel quite firm,and coagulation is appar- ently taking place. At 8 p.m. pain very severe, was given hypodermic injection of morphia, pulse now 84, tempera- ture 991. April 16th.-Pulse 120 and weak. Little change up to to-day, has suffered a good deal but has been able to get several hours sleep each night. To-day the pulsation is much stronger and little progress towards a cure seems to have been made. Apil 26t/h.-Leg not so much swollen, pain for the last few days has been not so great, sleeps well and has good appetite. Tumour to-day seens much harder, pulsation wben tourniquets are removed is however still very strong. May 28th.-Patient has continued in much the same",
         "246 CANADA 3mEDICAL AND SURGICAL JoURNAL. state up to the present time ; pulsation apparently not much lessened, althougih the pressure has been steadily kept up. Has at times suffered much pain, very often re- quiring draughts of chloral or morphia, sleeps freely, and appetite good. Pulsation has for the last few days been gradually getting less, and tumour has now quite a firm feel. To-day, for the first time, the clamps and bandage were removed, and on examination scarcely any pulsation was perceptible. The tourniquets have now been on exactly seven weeks. Y7une iotf.-Patient, up to this date, has made little or no improvement ; the pulsation varies much, at times quite strong and again almost imperceptible; very little pain bas been complained of, and can eat and sleep well; leg is still much swollen. To-day Dr. Reddy ordered reapplication of the tourniquets. 7uzy Ist.-Up to this time, when I ceased taking notes there has been no change worth noting, there is still quite strong pulsation in the aneurism. I would remark here that owing to the restlessness of my patient the compressors had to be laid aside on the 28th May, when it is probable that only a few days more were necessary to ensure complete consolidation of the sac. From June ioth till the day digital compression was begun, she had the compressors on but chiefly uuder her own control. August 5th.-On examination to-day I was forcibly struck with the appearance of the aneurismal tumour, it had with- in a period of forty-eight hours become suddenly enlarged, much softer to the touch and the pulsation was nearly as strong as at her admission ; tying the femoral artery ap- peared to me now to be the only safe course to adopt. The measurement of the tumour across patella was 22 inches, opposite side 141 inches. August 6th.-At a consultation to-day it was decided to try digital compression for a period of 24 hours, that failing,",
         "POPLITEAL ANEURISM--RECoVERY-BY DR, REDDY. 247 to tie the artery, the staff of the hospital and students attend- ing kindly volunteering to assist. This treatment was co m- menced at i o'clock p.m. and at the- end of two hours slight consolidation was nianifest ; at i a.m. the 7th, (just 12 höurs from the commencement) neither pulsation nor bruit were distinguishable. Gentle compression was, however, kept on till i o'clock p.m., to render the case (if it were possible) a more perfectsuccess. Measurement of the tumour to-day, same as before. A flannel roller was applied and the leg wrapped up in cotton wool, when compression was com- menced a few hours afterwards, she suffered from retention of urine, which I relieved with the catheter ; during the night she had a few doses of morphia and a hypodermic injection to allay the pain and restlessness caused by the constant pressure which hardly produced an abrasion, great care being taken to use occasionally fnely powdered chalk over the part. A gradual diminution had taken place in the tumour of a quarter inch a day, from the 8th to the 16th of August, this has been steadily but slowly going on since that time, and the measurements are now (13th November) round side across patella 14 inches ; around tumor, sanie place, 171 inches. She is not able to walk yet, nor can she press her heel firmly to the ground; all pain and tenderness are, however, entirely absent. I desire to express my thanks to the hospital staff, and to the following students: Messrs. Tunstall, Burland, Davis, Ritchie, Livingston, Levi, Fenwick and Bain, and Drs. Cameron, Mines and Cline, who gave me such valuable assistance, and thus rendered the case a complete success. 877 St. Catherine st., Nov., 1874.",
         "CANADA MEDICAL AND SUAGICAL JOURNAL Can Anything be done to stop the Increase of Insanity and Zinbecility ? By HENRY HOWARD, M.D., Medical Supýrintendent of The Provincial Lunatic Asylum, St. Johns, P.Q. The importance of the foregoing question will be at once admitted, when we see that by the last Census, there were in the Dominion of Canada 9,423 persons of unsound mind, and that in the 'Province of Quebec, alone, there were 3,300. All scientific men agree that the question is assuming grave importance ; but the difficulty is to .see what can be done. I believe the best way to arrive at a sound conclusion would be for those who have the treat- ment and management of the insane to honestly express the views that observation hàs enabled them to arrive at ; and believing this I have prepared the following remarks, and, as some of my statements maybe wilfully misconstrued, I beg at once to state that my only object is the advance- ment of science, and to do my best to arrest a disease that I consider worse than death. With this object it is neces- sary that I draw a distinction between the adult and the in- fantile population. To the first I must appeal to themselves for themselves. For the latter I must appeal to parents and teachers. I fear there would be no use in my speaking of the marriage question, for I believe men and women will continue to do as men and women have ever done, .and that is marry for love, without any thought of what the offspring of the marriage will be. Well love, after ail, is about the best guide, and certainly no one should marry without love, but I'do hold that if it be at all possible, a man or woman who has had insane parents should not marry. Insanity is a mental disease produced by some abnormal state of part or whole of the mental organization ; whether the moral or intellectual faculties, or both. If body and mind are not one, yet so close is the connection between them, that one cannot suffer without the other suffering",
         "INCREASE OP INSANITY.-BY DR. HOWARD. also, therefore the immediate or exciting causes, and they are many, that produce this disordered state of the mental organization, may be either mental-pr physical. Observa- tion, however, shows that no man can go mad from any amount of mental suffering, unless he has in him an insane neurosis, that is, a pre-disposition, whether hereditary or otherwise ,to go mad. It is an established fact, founded upon observation, that in all cases of insanity there is more or less devitalisation of the mental organization; and again, that all suffering, whether mental or physical, diminishes vital power, or more correctly speaking, vital force. Scientific men have established the fact that there are no two thingsin nature exactly alike, not even two blades of grass. We -,may therefore conclude that there are no two beings -in the worid whose mental organizations are exactly alike; indeed it is not very difficult to come to this conclusion, seeing how very few' there are who think alike upon'any subject, and this is nothing extraordinary, when thinking is so very independent of the will. Every man knows how frequently it happens that he thinks of the very thing he does not wish to think of, and that he cannot think of that which he wishes to think of. In this paper I do not mean to speak of insanity from physical causes, such as apoplexy, softening of the brain, head injuries, \u0026c., \u0026c. I will confine myself to the more general cases that have come under my observation'- those that occur from mental suffering. Is it possible for a man to know whether or not he has in hin an insane neurosis; and if he has, what precaution he can take to avoid exciting causes, or to bear up against the exciting cause when it comes, independent of any act of his? I think the best rule is, for every man and woman to believe they have in themselves the insane neurosis. To live as if they had, can do them no harm. Let each and every one avoid pride, covetozisness, lust, anger, gluttony, envy and sloth or idleness. Let all practise humility, liberality, chastity, 249",
         "250 CANADA mDICAL AND SURGICAL JOURNAL. meekness, temperance, brotherly love and diligence. Let theni do all they possibly can to preserve good bodily health and a conscience void of offence. If leading such a life does not keep a man from going mad, I do not know what will. But there are those who, even with the observance of these rules, will not stand the storm when it comes upon them. It will be said no man could lead such a perfect life without the grace of God. To speak of the infantile population it is necessary to classify according to mental organization. Some children are born into the world of strong, healthy parents, physically strong, and of a mental organization healthy, strong and well balanced, that is, well balanced with regard to intel- lectual and moral faculties. These are fortunate children, that God and nature has done well for. A child of such a stamp, under ordinary training, becoines a great man, great in the true.sense of the word, no matter in what position of life he may be. Whether statesman, professional man or mechanic, merchant or farmer, that man will do right, beL cause it is right. He will grow up strong in body and mind. No amount of mental suffering will break him down. He will never find his way into a Lunatic Asylum. Some children are born weak in body and in mental or- ganization, but at the same time with the intellectual and moral faculties well balanced. Such a child having wise parents and teachers, who will attend properly to his physical and mental education, will have his moral and, in-, tellectual faculties well developed, as he will have his physical force; and although never equal to the other, he will nevertheless be a great man, andnever likely to become, deranged. But should he be neglected or badly treated in youth, God help him when a heavy trial comes on him. He won't stand very much. Next we have the child, perhaps physically strong, with high intellectual and low moral faculties, that is, a badly balanced mental organization. If his moral education is",
         "INcRBASE OF INSANITY.-BY DR. IIOWARD. 251 not well attended to in his youth, and by such education his moral faculties developed, he. grows up a bad- and dangerous man, and the more dangerous that he is smart and bright. Such a .man is easily known by his moral crookedness and egotism. It is such men that we find sharpers, swindlers; gamblers, \u0026c., men who worm them- selves into the confidence of families, and make their homes desolate. These are men who do not know what honor means. They are mean men, vho by detraction destroy the good name of their neighbors, men who are always wishing to make fortunes in a day, and sneer at their betters who are content to do their duty in that state of life to which it has pleased God to call them. These men are generally too clever to be caught in the meshes of the law ; men who as a rule are the very curse of society. And when the storm comes on them, not having any strong moral faculties to fall back upon, in the end they break down, and become insane. Next we have the child of high moral but low intellectual faculties. If such a child gets a fair chance, his moral faculties will stimulate his intellectual, so that he may rank in time, with ordinary men. But if his intellectual faculties are not well attended to in his youth, he will grow up a religious fanatic, a \" one-idea man.\" He will try to crarm his opinions down everyone's throat. A man that Vill be willing to be persecuted and made a martyr of ; a regular pest to society, one of: those men that O'Connell called a religious fool; he generally ends in becoming a re- ligious nianiac, and a pest to whatever Lunatic Asylum to which he happens -to be admitted. The next in classification are Imbeciles. These are children of very low mental organization, differing, however, in degree. There are some that can, by great perseverance on the part of parents and teachers, be brought to learn much, yet under no circumstances will they ever be of a strong mind, and very little trouble at any time will drive",
         "252 CANADA MEDICAL AND SURGICAL -JOURNAL. them into a Lunatic Asylum. It is from this class, when neglected in youth and brought up in a state of moral de- pravity, that our most vile criminals come, and it is an extraordinary fact that they rarely ever go mad as long as they can carry on their carcer of crime. It is when a check is put upon their criminal acts, and they are obliged to live according to prison rule, that reason forsakes them. It would appear as if crime itself were the very safety-valve that s saved them . from - becoming, lunatics. It rnust be remembered what the peculiar class of persons I am speak- ing of is. I am speaking of the Imbecile, neglected in youth; one that has never learned anything but evil. As a rule these creatures are the children of debauched and drunken parents. Some imbeciles are so very low in their mental.organizations as to approach the idiot, They are not in reality idiots, but they are not responsible beings, and should never be at large, but under proper surveillance. They are a most dangerous class of beings, as they will gratify their animal passions without any compunction. It is such creatures that commit the most revolting rapes and most horrible murders. The next order of classification is the congenital idiot. He is generally, but not always, the offspring of imbecile parents. He is a creature so low in his mental organiza- tion that it is sometimes hardly possible to teach hin how to put food into his mouth, he will more readily lick it off the ground like a dog than make any use of his hands. Sometimes it would appear as if they appreciated kindness but they are always vicious and treacherous. They are in appearance more like the monkey than the man. Fortunately procreation stops with the idiot, for they are both sterile and impotent, female and male. Let it be borne in mind that Lunatics can descend through all the different degrees of imbecility, till they arrive at the state of idiotcy, the only difference between them and the congenital idiot being that one has lost what the other never had.",
         "INcREASE OF INSANIT.-BY DR. HOWARD. From the foregoing facts I consider that it is selfevident thatýthere can be no general system of educatiori, either physical or mental, suitable for all children; consequently I hold that much of the increase of insanity and imbecilfty is due to the pr'sent system of education, I would say the present high-pressure, forcing system. Out of four hundred patients admitted into the St. Johns Asylum, over two hundred were at the time of admission imbeciles, so of-these I take no account ; of the two hun- dred lúnatics over one hundred and fifty had more or less education, that is, could at least read and write, and rnaný of them were what might be called well educated. Two were first-class educated schoolmasters, both got well but did not return to teaching. A third was educated for a school- master, he got well and went to farming. Then I had four female teachers; two got well, one returned to teaching and is now in an Asylum in Upper Canada, the other is working in her father's house, who is a farmer; the other two are still in the Asylum, with but little chance of re- covery. Then I have had a large number of clerks, half educated; some got well, some did not, and from the his- tory of all these cases I have no doubt but that the exciting cause of insanity-was overworking the mental or- ganization, trying to force the mind into obedience to the will; and I believe it is this forcing of the mind at schools that is destroying the mental organization of so many, and is one of the great causes of insanity. It must be remem- bered that the mind is always acting quite as indepen- dently of the will as the liver, the heart and lungs, and the stonach. The- power the will has over the mind is limited. In sorne organizations the will can direct the mind in a very great degree, but not altogether; in others the vill can direct the mind in a very small degree. One boy can so direct his mind as to commfit to memory a page of history in a few minutes ; such was the power of the late lamented D'Arcy McGee. Another boy by no amount 253",
         "CANADA MEDICAL AND SURGIcAL JOURNAL. of his will can ever commit much to memory,.and the greater his effort the more he tires out his brain, and the less he-knows. I would ask how can there be a general system of education for such opposite mental organisations ? Every man in the world knows how difficult it is sometimes to call to mind the name of a person or place by an act of his will. Every manalso knows how difficult it is to keep his mind fixed on any one subject for five or ten minutes. Certainly by mechanical means we can keep the mind fixed, that is, by employing our hands at any mechanical work; and perhaps it is because of this that we find so very few mechanics become insane, if they do it is because they break some natural laws, become drunkards, \u0026c., and no man can break any of the natural or moral laws, and not suffer i consequence. There is no difficulty in knowing when a man or a boy bas muscular fatigue from manual labor or over exercise; but it is not always easy to know when the mental organization is fatigued. I think, however, that it can be known; for example, when a man reads a couple of hundred pages of any book and finds that he-remembers the first pages better than the last twenty or thirty, he may be very sure it is time for hini to stop,; he will retain nothing of what he is reading, and is only injuring his brain. So with a young boy at school, he re- peats his lesson to his teacher tolerably well, the teacher is not satisfied, the boy is sent back to study his lesson again ; the second time he repeats it worse than the first, although, poor boy, he has donc his best, but his brain was tired, and very probably he is punished for what was no fault of his. I think the foregoing clearly establishes two facts ; firstly, that where children are of such different physical and mental organizations, there can be no general system of either physical or mental education applicable to al, in fact, that Avhat is good and wholesome to one is death to the other; secondly, as in all schools there is a general system of education, the only classification becomes 254",
         "INCREASE OF INSANITY-BY DR. HOWABD. the ages of the scholars, and it must of necessity follow that our present system of education is injurious to the physical and mental growth of the scholars, and consequently that we have so many of our youth of both sexes growing up weak in body and weak in mind, and that there is such a terrible increase of insanity. There is no doubt that teachers are much to blame for this state of things; but then parents are much more blamable. In infantile life mothers as a rule -ieave their children too much to the care of servants, because they are either too lazy or too fine to take care of them themselves, in fact, because it is not fashionable. The last thing a child should feel at night is its mother's kiss, and it should go to sleep in looking at the mother's loving eyes ; but instead of this the child is left to the tender mercy of a servant, who frightens it to sleep that she may have a chat with John, while the fashionable mother is gone off to hear that dear man Mr. Balderdash lecturing upon Physiology of Man, or some other equally interesting ology. Then, as children grow up, they are packed off to boarding-schools--firstly, to get them out of the way; secondly, because it is fashionable ; thirdly, because the pride and ignorance of the parents are so great, that they fancy because they have money their children must have brains, and must be educated to the highest standard. So children are sacrificed to the -laziness, pride and ignorance of the parents. Another fault of parents from which the children suffer is that they do not know how to choose the proper teacher and when they have one they don't know how to treat him. They begrudge to pay an educated gentleman as well as they would pay their servant, and treat him with half the respect, and then, poor souls, they expect the teacher to take an interest in thçir children, and they expect their children to love and respect the teacher, and in time they find themselves disappointed in both their expectations. Let parents pay a teacher vell that he may live as becomes 255",
         "256 CANADA MEDICAL AND SURGICAL JOURNAL. a gentleman, and let them in every other respect treat the teacher as their equal, then they will have some claim upon him, and if he is a true teacher he will do justice, to their children, and the children will not only love and obey him while under his care, but will love and revere him during their lives ; he will always be to them \" THE MASTER.\" It is a melancholy fact, from which great evil has resulted, that men and women fancy when they can do nothing else they can teach ; now there never was a greater mistake; no person, no matter how well educated he may be, can teach, unless he is actually born a teacher ; no act of the will can make a man a teacher, any more than an act of the will can make a man a poet. It is not necessary that all teachers should have the same degree of education, but all teachers should have the knack, should be capable of im- parting the knowledge they possess, in part or whole, to those they attempt to teach, depending of course upon the soil they have to sow the seed in, whether it be of a high or low mental organization. A teacher should be naturally of a cheerful, mild, amiable disposition, loving and lovable, one that would rule by love and not by fear. I have no faith in obedience to God or man that is given through fear; cheerful, loving obedience is what can be depended upon, and this is impossible with the present system ofeducation. The true teacher will make it his study to know his schol- ars thoroughly, to know their mental and physical capacity and treat their mental and physical powers accordingly. He will be able to say to parents whether their son is or is not fit for the highest order of education, and thereby prevent many poor boys from losing unnecessary time trying to learn what they never can learn, ending in disappointment and being disgusted with themselves and the world. I have thus endeavored to show.that the present system of education is bad, is radically wrong, and is the cause of one of the great causes of the spread of insanity. Some one more capable than I am must show how that system",
         "IIOSPITAL REPORTS. can beimproved. I will merely say there is too much study on the part of the scholars, and too little teaching on the part of the teachers. It is all books, books, morning, noon arnd night ; no end of books. The books that a boy is expected to go through in eight or ten years, lie could not go through in thirty. Let al! this book learning be stopped; let there be more black-board and chalk, and lecturing from teachers. I believe a child should be taught its alphabet on the black- board, to spell on the black-board, arithmetic on the black- board, geography, history and mathematics all on the black- board, globes and maps, and from the mouth of the teacher; and instead of sticking every day for a certain time in badly ventilated school rooms, let the master frequently take his boys for a day out into the country, and there in conversa- tion and amusement and good healthy exercise teach his pupils from Nature, lecture to them on the mountains, vales, rivers, trees and rocks. Thus will youths be truly educated ; thus will they. grow up strong in body and strong in mind. HOSPITAL REPORTS. case of Excision of the Hip; Opetion. By DR. D. C. MACCALLUM. Reported by Mr. W. H. Burland. James Anderson, agod 6, was admitted into the General Hospital, under the care of Dr. Ross, on the 22nd of May, 1874, in a state of high fever, and having a large abscess on anterior aspect of left thigh. He was weak, much ema- ciated and restless, and complained of severe pain. For the previous history of the case I am indebted to Dr. Ross, who saw the boy for the first time in August, 1872, when he was suffering from pain in the left knee, which was painted with iodine. There was slight flattening of the corresponding hip, and he limped in walking; his health had been failing for the last month, during which time the lameness was noticed. Latterly had been restless at night, 17 257",
         "258 CANADA MEDIcAL AND SURGICAL JOURNAL. and would occasionally scream in his sleep. Dr. Ross diagnosed Hip-joint disease, and soon after put the limb up. with a long splint, extension being made by a weight. This was kept up for three months, after which the long splint was replaced by a gutta percha splint and starch bandage. He was now allowed up on crutches, but sooner than was advised, as the parents would not leave him in bed any longer. The joint was at this time free from pain, but stiff. Through bad nanagement and want of care the pain soon returned as bad as ever, and he screamed a great deal at night. The long splint with weights was replaced and left on for nearly three months longer. After this the case was lost sight of, and not again seen till his admission in- to hospital. The abscess was opened shortly after admission. In a few days a rather severe attack of erysipelas set in, which extended down the thigh and up the side for some distance. This caused the doctor to postpone operative inter- ference at this time. Accordingly extension was kept up and thé child was put upon nutritious diet to improve his general condition. He was treated in this way, getting also half a pint of porter daily, till the latter end of July. All this time the openings made to evacuate the abscess remained as sinuses communicating with the diseased bone. Dr. MacCallum, under whose care the case had been since the beginning of July, now determined to excise the joint. The boy's general condition by this time had improved con- siderably. He was fatter and in better spirits; suffer- ing no pain unless the limb was moved ; not -restless. There was no cough, nor lung complication; and although there were signs of a hectic, febrile condition, from the prolonged suppuration as shown by his frequent pulse (12o), high temperature (101.4°), and the readiness with which he perspired, he was nowi, in as favorable a condition for operation as could be expected. Yuly 3oth.-To-day the operation was performed. The patient having been put under the influence of chloroform,",
         ". HOSPITAL EPORTS. Dr. MacCallum made a straight incision of about 3½ to 4 inches in length, over the greater trochanter. Cutting to the bone and freeing all attachments, the head of the femur was dislocated by rotation and sawn off. The head was greatly eroded. The extreme end of the bone formed a large fragment, which, with several smaller ones, was re- moved. It was not found necessary to remove any of the acetabular portion of the joint. The bleeding was incon- siderable. The~wound was washed out with carbolic lotion and filled with lint saturated with carbolic oil (1 to 2o). After the removal of the patient to his bed, extension was made by a weight of 3 lbs., and the leg kept in position by sand bags. His temperature on the night before the opera- tion was 101.40, and on the morning of the operation 100°. On the night after the operation it was 103.2°. Next morning it had fallen to 100.4°, rising again on that night to io3°. On the following morning it was 99.40, and for the next two or three weeks it ranged between this or 99° about and 100.4°. His pulse varied in same ratio with the temperature. On the evening that temperature was 103.4' pulse vas 148, falliïig next morning to 128, and after this it ranged between roo and i2o for two or three weeks. By the 4th or 5th of August the wound was granulating nicely and discharging freely. It was dressed daily with fresh lint and carbolic oil. Boy's appetite is good; he is getting chicken broth and half a pint of porter daily. 4ugust rot.-A slight diarrhœa set in for which he got Pulv. Cret. Co. c. opio. gr. x, every 4 hours. August 13t-14t.-The wound is filling up from the bottom and sides rapidly. Patient is able to move hinseif in bed with less pain. Has slept better the last two nights than previously. A bedsore is forming over the sacrum. To relieve the pressure on this spot a pad was made with a hole in the centre. The sore was painted twice a day with a solution of Hydrarg. Bichlor gr. v to the oz. 2 oz. brandy was substituted for the porter which he had been taking. 2059",
         "260 CANADA 3IEDICAL AND SURGIcAL JOURNAL. Sept. 9th.--'Notwithstanding; the diarrhœa which obsti- nately persists, the boy is getting on very well. Hisappetite is good, ànd he is fatter than he was.. The wound has been progressing very slowly lately. Red wash is now substitu- ted for the carbolic lotion, and theedges are drawn together by adhesive plaister. He is now taking cod-liver oil. The old sinuses have not closed. About the middle of October the extension was given up, and at the end of the month the boy was allowed out of bed. He left the hospital on the 8th of November, at which time his condition -was as follows: The actual shortening of the limb by measurement is but one inch,, though apparently it is much greater, from the position in which the leg is kept. The knec is flexed, and the pelvis drawn up on that side. The toes also are inver- ted. When the boy is placed, flat on his back, there is noticed a bulging of the affected hip. The circumoference here is i 1- inches, while at the same part of the opposite leg, it is 1o inches. . The adductor muscles are tense, and there is considerable induration of the parts around the wound. One of the old sinuses is still discharging, and one has appeared at the bottom of the incision which had been made at the operation, which had but lately healed up entirely. The rest of the incision is cicatrized. There is no pain complained of, and with slight support the boy can walk, the toes only of the affected leg reaching the ground. His general health is excellent. He eats and sleeps well and is in good spirits. Case of LithotoMy in a Child, by Dr. D. C. MACCALLUM, reported by Mr. J. DORLAND. J. F., a French child, 4 years old, was admitted into hospital on the 16th of September, 1874. Was .born of healthy parents, but eighteen months ago began to suffer from occasional and sudden stoppage of urine, to be restless and fretful, and to show a constant desire to",
         "HOSPITAL REPORTS handle the end of his penis. These symptoms, increased steadily, till the mother brouglit the child to the hospital to consult the medical men there.. The restlessness and suffering -of the child had inpaired its appetite and gen- eral health somewhat latterly. Dr. MacCallum examined the child with a sound and detected the stone, which, from the difliculty of finding it, the very slight click, and the sensation communicated to.the instrument, ie concluded was very small. 'It is, perhaps, worthy of notice that a cousin of this child, of about the saine age, was operated on for stone by Dr. Ross three or four months ago. September 1Sth.-Preparato;y to tMe Operation.-To-day an injection was given to the child. Its bowels had not moved for 36 hours. After the introduction of a curved, groove staff, and the detection of the stone to the satisfaction of all present, the incision W as begun abou halif xvay betwcen the anus and scrotum, a little to the left of the median line, and extended downwards and outwards with the usual precautions. , The staff was readily found and incision extended into the bladder. Now the operator experienced some slight difficulty in getting hold of the stone, the bladder wvas so easily pushed up and the stone was so small. At last, however, he got hold 'of it between a scoop and his index finger and brouglit it out. The stone was of uric acid, having the appearance verv much of a coffee bean in size, shape and color, having even the groove along the centre. There was a good deal of oozing, which was checked by application of ice in the wound. The child was now put to bed and a large sponge applied under his buttocks to absorb the urine as it dribbled away through the wound. Barley water and one pint of milk were ordered as diet: Towards noon next day lie had a chill, after which his temperature rose to 1000 and pulse to 140. By the next day pulse and temperature fell and the child was very coin- fortable, sleeping and eating well, but, naturally, irritable,",
         "262 CANADA MEDICAL AND SURGICAL JOURNAL. The oozing had returned occasionally from the wound and rather freely, but was always stopped by application of ice. On third day was taking chicken broth and beef tea. The urine gradually began to come away by the urethra and less by the wound until the 26th, that is, seven days after the operation, urine came through the wound. The wound is granulating nicely, and on the 3oth, as all the urine was passing by the urethra and everything progressing favor- ably, the child was taken home. Case of lalignant Disease near the Cardiac Orifce of the Stomac/--Cancerous Enlargement of the Head of the Pancreas--Perforation-Death--Autopsy. Reported by Mr. S. J. TUNSTALL. M. M., aged 25 years, was admitted under the care of Dr. Godfrey, into the Montreal General Hospital, i th Sept. 1874, complaining of obstinate vomiting and cramps. She had been employed for a number of years in one family, as a tablemaid, and has alvays maintained the repu- tation of being an active, faithful and sober person, ' Her family history is unexceptionable, while quite young, she seemed to enjoy perfect health, although she has always been afflicted with occasional attacks of Vertigo. Some five years ago, she began to be troubled with severe pains in the back and side which have continued more or less ever since. The pain is described as bearing down and dragging in its character. Two years ago, she had a sharp attack of what was called muscular Rheumatisn; while more serious symptons set in about one year ago. Vomiting then was for the first time noticed, and profuse salivation with occa- sional attacks of pyrosis supervened--Dyspepsia was soon added to her troubles,-so severe at times that she .was unable to make the slightest exertion. Up to this time she was a strông, healthy, well developed young woman; but enaciation has ever since gone on slowly but surcly, till now, her face is drawn and pinched, she is sallow, wcàk and",
         "HOSPITAL REPORTS. reduced almost to a skeleton. The heart sounds are quite normal. A distinct bruit can be lieard at the epigastrium. Upon deep and firm pressure a round solid tumour.in the epigas tric region can'be made out, which gives to the fingers the sensation of pulsation. She complains of severe pains extendingfrom the lower lumbar to the sixth dorsal vertebra, and pains somewhat less severe in the cervical region. These pains are increased by exposure to draughts of air. Obstinate vomiting has persisted for some days, which however does not seem to cause much nausea or distress. She complains of dyspepsia and cramps in her stomach-malignant disease of the cardiac drifice of the stomach vas diagnosed. Counter irritation vas applied to the Epigastrium by means of a blister: the following pill was ordered to be taken three times a day: Ext. Bellad. Argent. Nit. Pulv. opii aa gr t She was put on milk diet ; lime water being used with the milk. Under this treatment, the irritability of the stomach seemed to disappear, gradually moderate quantities of liquid food were kept dowxn and after a time a piece of roast chicken was relished and retained. On the 13th of October the pills, which had been persevered with steadily, were discontinued, and a pill containing half a grain of Valerianate of zinc was ordered instead. On the i7th diarrhoea set in, accompanied by severe pais and cramps in the stonach and bowels. This diarrhcea with cramps continued with more or less severity tili she died. The evacuations were light, varying from a light Clay to a dark chocolate color ; they were thin, and at times very slimy, containing ropy curdy masses and flocculi; they were always most offensive. Various remedies were tried, but nothing seemed to check the diarrhcea, remove -the pain, or change the unhealthy nature of the stools.",
         "264 CANADA MEDICAL AND SURGICAL JOURNAL. Castor Oil and laudanum, chlorodyne, a pill of opium, a pill of sulphate of copper and opium ; injection of starch and laudanum, a mixture of port-wine and decoction of logwood were faithfully and repeatedly tried, but none of them afforded permanent relief. On the 9th of November, she sat up for a while in the morning, and seemed to be more free fron pain and in better spirits than usual. At 12. 30. she complainecd. suddenly of a sharp severe pain in the stomach, and faintcd : restoratives were at once administered ; she recovered iii a few minutes, and calling for the bed pan she passed a large quantity of blood. Her face became quite blanched. her breathing rapid, her pulse irregular ; she comnlained bitter- ly of excruciating pain about the Epigastrium, and at 1. p.m1. she died in great agony, with all the symptoms of collapse. Auztopsy-Twenty two hours after death. Rigor Mortis-Well marked. The body was much emaciated, and the muscles greatly wasted. Abdo!nenI-On opening the abdomen, a large quantity of blood, along with portions of the contents of the stomach, was found in the peritoneal cavity. Stomac-A large cancerous mass existed close to the cardiac orifice of the stomach ; perforation had taken place in this mass, leaving an aperture, with ragged, thickened edges about three fourths of an inch in diameter. The cardiac orifice was not constricted to any serious extent by this mass as the little finger could be easily passed through it. The pyloric orifice was quite healthy. The stomach itself was distended with a clot of blood and with some liquid food she had taken a short time before death. Pancreas--The head of the Pancreas was much enlargedi and the seat of extensive malignant disease. Upon cuttiig into it, a large cavity was found filled with old fibrinous masses and a recent clot of blood. This cavity was largest",
         "· REVIEWS AND NOTICES OF BOOKS. in the head but it extended also throughout about three fourths of the body of the Pancreas. Its walls were ragged thickened an .1 irregular. The- duct was quite, pervious throughout. The coats of the arteries were quite thickened and atheromatous, and all the vessels were much enlarged. A bristle was passed through a large branch of the Pancrea- tico-Duodenalis, into this large cavity in theheead of the Pancreas proving that the coats of this vessel had been caten through ; this, in- all probability, caused the hemorrhage which proved so rapidly fatal. Duodenum-A clot of blood was found between the coats, in the concavity of the descending portion as it curves round the head of the Pancreas-otherwise quite healthy. The other viscera were quite normal. Essays on Conscrvative MLedicine and .Kindred Topics. By AuSTIN FLINT, M. D., Professor of the Principles and Practice of Medicine and of Clinical Medicine, in Bellevue Hospital Medical College, New York: Phila- delphia. Henry C., Lea, 8 vo. pp 214. 1874. We have perused Dr. Flint's modest little volume .with very considerable interest-an interest principally engen- dered by the fact that the topics discussed are really the most important in the practical medicine of the present day. Nothing probably assists us more in understanding and appreciating the bent and genius of the medical mind of this living generation than such reflective essays as these. The scepticism and doubt produced by our finding on retrospec- tion how completely medical practice has been revolution- ized, how few teachings, and methods and theories have been able to withstand the test of even a comparatively short space of time, is apt to give rise to an uncomfortable sensa- tion of uneasiness concerning the soundness of the views of 265",
         "266 CANADA MEDICAL AND SURGICAL JOURNAL. the present day. Such however should not be the case. The firm foundations being laid for rational and scientific medicine cannot be shaken, and although we know that our Art must always be progressive,yet we should be glad to know so much and be hopeful for the future. . The tera conservative has for some years back been very commonly used in Surgical parlance, but we remember to have heard it but very seldom in medical-and vhilst there is amongst Surgeons a clear and distinct and ever-present idea that what they do must be done conservativcly, we are not sure that with all medical practitioners this idea is at all so clearly presented to their minds, and yet there can be no doubt that the one is just as important as the other. There is a great deal in the constant and habitual use of a termi of this kind. The mere employment of the word tends to direct the thoughts towards the principle underlying any line of action. Every surgeon of the present day prides himself upon the conservatism of his practice, and so also, as indeed all the great triumphs of the medical art have been accomplished by conservatism, should the physician take delight in showing how his practice has conformed to the doctrine of the conservation of thevital forces. In olden times the surgeon would boast.of the number of his ampu- tations and the skill with which they were performed, now he tells of the number of times in which, by skill and management, he has preserved limbs otherwise doomed. So again used the physician to parade the boldness with which he would attack diseases by bleeding and depletion and nauseant prostration, now on the other hand he shows how lives are saved by holding his hand from these violent measures and by hoarding -the vital energies and fluids, trusting then to them to oppose the forces of disease, in fact by Conservatism. The conservâtive physician is thus defined. \" He shrinks from employing potential remedies whenever there are good grounds for believing that diseases will pursue a favorable",
         "REVIEWS AND NOTICES OF BookS. course without active interference. He resorts to thera- peutical measures which must be hurtful if not useful, only when they are clearly indicated. He appreciates injurious medication and hence does not run a risk of shortening life by adding dangers of treatment to those of discase.\" It is then briefly shown hov, with the progress of niedicine during the last twenty-five ycars, these conservative prin- ciples have been ge.nerally developed until now they have become of paramount importance, The first Essay is entitled Conservative Medicine. Be- sides this, there are seven others as follows, on Conservative Medicine as applied to Therancutics. Conservative Medi- cine as applied to Hygiene-Medicine in the Past, the Present, and the Future-Alimentation in Disease-Toler- ance of Disease-The agency of the mind in Etiology, Prophylaxis, and Therapeutics. Divine design as exempli- fied in the Natural History of Diseases. All of which contain much that is interesting presented in an easy and unstrained style which suits the subject. Although these Essays have separately appeared before in some of the American periodicals, we dare say rnany of our readers have not seen them, and to those who have not we recommend them as well worthy of perusal. Thierapeutics and Matcria Medica. A systematic treatise of the action and uses of Medicinal agents, including their description and history. By ALFRED STILLE, M.D. Professor of the Theory and Practice of Medi- cine and of the Clinical Medicine in the University of Pennsylvania; Physician to 5th Joseph's Hospital : \u0026c., \u0026c. Fourth edition. Thoroughly revised and enlarged. In two volumes. Philadelphia, Henry C. Lea, 1874, pp 1644. The profession generally is deeply indebted to American authors for excellent works on pharmacology. No better ones, for what they profess, have been issued anywhere than those of Beck, Harrison, Mitchell, Tully and Wood. With them we have much pleasure in associating the production '2 67",
         "268 C.1NADA 31EDICAL AND SURGICAL JOURNAL. of Stillé, above named, for comparing it with them, whether as a vell digested compijatin or an the record of the writer's own experience and views, it is entitled on the whole to at icast equal favor and in some particulars to preference. The more familiar title \" Materia Medica and Therapeu- tics,\"-- is transposed in the present treatise to \" Thera- peutics and Materia Medica.\" This inversion of the old order accords with the design of the author, which wvas to devote by far the largest part to Therapeutics, or to the effects and employnent of medicines, and the smallest to Materia Medica proper, or the consideration of medicines in their physical, chemical and pharmaceutical relations. . In bis preface he expressly tells the reader he has purposely devoted less of his space to the strictly scientific portion of the subject, and bas sought to illustrate more copiously than is usual in similar works its practical bearings. To the student, therefore, who wants all parts equably treated, it is not so well suited as to the physician who requires a reliable guide that he can consult in matters of actual busi- ness. The latter [wvill find that upon the uses of drugs these volumes are particularly full of information. If he desire to know the authority on which a remedy rests, or what it can do, or the account to which it may be turned, he has but to inquire within,and to facilitate reference- there is not only an index of medicines, but also an index of diseases with the remedies adapted for them, named under each head. Nor has Dr. S. contented himself with giving merely the modern application of medicines, but, as a laborious antiqua- rian he has drawn largely upon olden times. Under \"Med- cal history,\" he bas gathered in what Hippocrates, Dioscor- ides, Galen, Rbazes, arcd other fathers of physic, did with remedies that are stili prescribed, and advancing onward from them, notes the estimation in which they were held",
         "REVIEWS AND NOTICES -OFý BOOKs. 29 by others, among the Italian,French, German and English, in succeeding ages. In treating his subjects, we couldhave wished our author had been less conservative. We will explain what we mean. Writers on Therapeutics who have preceded him in describing the classes of medicines e.g. Astringents, Refringents, \u0026c., delight in interlarding their rernarks with details which are either strictly physiological or belong to some other branch of science rather than the one they have undertaken to elucidate. They go out of their way to say something about the minute structure of an organ, or its functions, or the changes its secretions assume in various morbid states, or the effects of these upon the system gen- erally. Too often, again, they plethorize their accounts with what is effete, with what is curious indeed as theory, but which has long since ceased to harmonize with more modern developments. From these faults Dr. S. is by no means exempt. He lhas run too much in the old groove. We have felt in reading him, it would have been better had he avoided repeating these mistakes and confined himself more to the question. The description of a class of reme- dies should be confined to what would be a gradual unfold- ing or explanation of the definition, so as to exhibit some- thing of the demonstration of a problem. To introduce matter that is irrelevant, where much else might have been brought forward to directly elucidate, is to burden:a subject unnecessarily and.make it jejune. Let us illustrate these remarks by Dr. S.'s chapter on Emmenagogues. It may be laid down as averitable truism, that, if these agents (as they are usually deflned) be medi- cines which can restore the menses when absent from cer- tain morbid causes, they can only do so by reproducing menstruation as it occurs naturally or without their aid. They must accordingly act upon the same organs as those upon which the influences act that bring about the return ,of the catamenia in health. These organs are primarily 269",
         "270 CANADA MEDICAL AND SURoICAL JOURNAL. the ovaries. Emmenagogues therefore must excite these same structures, the ovaries. And they must also induce in these parts the same train of occurrences as are known to ensue during normal menstruation or where they have not been previously used. In turning to a book on Ther- apeutics it would not be too much to expect to find the state of that science in accord with the light that other depart- ments cast upon its co-related subjects. In the instance adduced it would not be too much to look for an accord in the explanation of the zodus opcrandi Of Emmenagogues with the present knowledge of obstetric physiology concern- ing menstruation. And such expectation seems the more justifiable in examining a work so recent and so compre- hensive as Dr. S.'s. But what is the fact ? Like his precle- cessors, who have written books before hirn and treated on the same subjects, his explanation of the action of Emmena- gogues leaves out of consideration altogether the all-im- portant ovaries. It is like the play of Hamlet with the character of Hamlet left out. Instead of referring to them, we are carried back to the dark days when menstruation was laid solely to the account of the uterus. It and it alone is mentioned as the organ which is the special seat on which these agents exert their power. They are in the words of Dr. S. \"all medicines which are employed to influence the uterus.\" As in other cases, this error, besides leaving the un-in- formed reader in ignorance,Ieads tofalse impressions. For example: Admitted that the menses are secreted by or extravasated from the inside of the uterus, it might be sup- posed that this was a proof of the influence of the emmen- agogue on that very part. As a fact, however, it is not so. The medicine has no such influence on the uterus. The influence that causes the latter to secrete is from an ovuni descending through its cavity. And the only influence of the remedy is upon the graàfian vesicle from which that ovum has escaped. Any effect upon the uterus is, therefore,",
         "REVIEWS AND NOTICES OF BOOKS. a secondary, and subordinate, and dependent one. So essential is the primary or ovarian influence that without it no influence limited to the uterus would be of the least avail. And this brings us to another mistake which such a definition of emmenagogues, as Dr. S.'s suggests. From it, one might infer that any rernedy that can influence the uterus would be an emmenagogue. Just the opposite, how- ever, is the case. There is one agent, ergot, in particular, which can very powerfully influence this organ, but it is not a restorer of suppressed menses in the same degree or cer- tainty thatit is an exciter of uterine contractions. Indeed, it is very doubtful if it has any emmenagogue virtue at all It is true a few have reported success after its use in Amenorrhoea. But we are sure, most practitioners do not prescribe it in that disorder, and, those who have tried it have not had from it the same positive results that have attended its administration in cases of powerless labor. The appearance of the catamenia after its use an odd time or so proves nothing at all. Since the occurrence may not have been due to it in the least,-but may have been the effect of concurrent circumstances re-establishing the patient's health, or removing some hinderance to the menstrual function. It is well known that no other secre- tion is more likely to be influenced by the state of the con- stitution than the catamenial. A medicine, moreover, like Ergot, that acts upon muscular fibre could not be ex- pected to act locally upon the ovaries which are destitute of such texture. We will now illustrate from Dr. S.'s, further description of Emmenagogues,-what we have above said about the irrelevant treatment of Therapeutical subjects. After the first few lines,-he proceeds to enlarge upon the import- ance of the function of menstruation,-then upon the relation of the disorders that follow its cessation,-next upon the groups or categories into which\"cases of menstrual",
         "272 CANADA MEDICAL AND SURGICAL JOURNAL. derangement, may be divided, with more or less account of them, What are these ? if they be not beside the strict question of the action of Emmenagogues. Yct, they take more than half the space allotted to the discussion of the latter in the introductory chapter. And what, in this special instance, is worse still, is that the want of precision as to what these remedies are is still more plain in the little left. Determined to stick to his flag that they are \" all medicines, which are employed to influence the uterus,\"-he makes no separatiôn, nor mention by the name, of Ecbolic or Abortive agents,-but runs them all as one with the rest. Nay, he even includes with them, Ether and Ciloroform as relaxants of the Os uteri. Nor is this all, even such beggarly things as \"c mifoil,\"' \" tansy, \" I' dittanzy,\" \" mueigwvort,\" \" lzorehouind \" and \" chamomile \" are laid under contribution, and taken in as members of the class. And yet more; without any division of Emmenagogues into Absolute and Relative, the umbrageous \" all\" is made so accommodating as to include with the foregoing \"'sedative emetics,\" \"saline cathartics,\" \"revulsives,\" and \"most of the aromatic plants.\" Finally, multifarious though these be, there are still more to come which, as stated by the author, are general bleeding, mercury, iron, baths, cupping, leeches, electricity, air, exercise, food, \"and finally marriage.\" Before such a pot pourri of emmenagogues, surely, the offending ovaries, or as he would say, \" the uterus,\" must give up the strike and go back to work! These are instances of the blemishes in Dr. S's work which, as we before implied, spring from too great conser- vatism, from his having been too diligent a collector of simples, and too successful a reflector of statements made by others before him. Had he re-cast the whole matter and adhered more closely to his subject,-had he usednecessary prunings, and indulged more in a philosophy au courant with the advance of science generally, he would have been",
         "REVIEwS AND NOTICES OF BOOKS. more original and have donc better work in the vast fields of Therapeutics. If, however, we regard his treatise as a compilation solely, we must adpnit that it, is a lasting monument to his extensive learning, deep research, in- domitable perseverance, and laborious painstaking. The present edition is a careful revisal of the former work. In it has been added about 250 pages of new matter. Several new articles have been introduced, and the chapter on electricity almost entirely re-written. We think it would have been made still more useful had the preparations of the British Pharmacopœia been insert- ed, and distinguished from those of the United States Ph. We would respectfully suggest that the omission be supplied in the next edition. To Canadian Physicians who follow the first, this addition would do away with the necessity for turning to another book for information upon these subjects. T HIE R A P EU T I C S'. On Various Therapeutic Uses of Cafabar Bean; Especially in Tic. By W. MUNRO, M.D., C.M., Cupar-Fife, late District Medical Officer, St. Kitts, West Indies. Having in 1871 pointed out the probability of Calabar bean being useful in cholera, * from the power which Dr. Fraser has shown it to possess of expanding the peripheral blood-vessels, I have since then thought it might be useful in many other diseases, in which, from one cause or another, these blood-vessels are contracted, but was prevented by various circumstances from applying my ideas in practice \" Edinburgh Medkcal 7ournal, October.-I nay here say that, from what has since become known of the doses which may be given, I would be inclined ta begin in cholera with one-third instead of one-cighth of a grain of the extract, as is mentioned in my paper ought to be injocted 18 9-73",
         "274 CANADA MEDICAL AND SURGICÂL JOURNAL. until October last. Calabar bean had, up to that time, so- far as I am aware, only been used in tetanus, although it has rec-ently been used in general paralysis and acute mania. (BRITIsH MEDICAL JOURNAL, January. ioth and 17th). Tic Dodouneu.-Believing that in tic the blood-vessels of the part affected are in a state of contraction, I have made use of the bean in several cases with exceedingly satisfac- tory results. Very short notes of the cases are appended. I may say here that Cupar is a rather low-lying place, in which tic of an intermittent form which disappears on the person leaving the town, even for a time, is not uncommon. Fever and ague in those who have had it abroad is apt to return. There is, in fact, a slight malarious' influence evi- dently present in the atmosphere. CAsE i. October 16th, Mrs. D. had tic on the left side of the head. I applied one of Streatfeild's ophthalmic squares to the eye. In about five minutes, she expressed herself as decidedly relieved. This was not a very severe case, which may account for only one square being sufficient. CASE II. November 6th, Mrs. X. had severe tic, with intense photophobia, brought on by reflex irritation after several days' severe uterine pain, which had now passed away. I used one square, in the right eye;. In ten minutes. she was able to open her eyes and converse cheerfully. In half an hour,'I used another, relieving the pain entireiy, only leaving a \"slightly bruised feeling,\" which was almost entirely removed by another half. The pain did not ieturn, and no more Calabar bean was required. The pupil was never contracted. CASE III. Miss J. K. had severe intermittent tic, with anærmia. At present, it was almost remittent. She had very severe pain all over the left side of the head, and some on the right side.. The pain was intense over the left eyebrow. The pupils were much dilated. She was first seenlon December xoth, at i1.15 A.M., between which time and 4.30 P.m., three squares and a half were used (from half to two at a time) in",
         "TIHERAPEUTIC USES OF CALABAR BEAN.-BY DR. MUNRO. 275 each eye.. At 6.45 r.M., she had no pain. At 8.30 P.M., I found she had had a very slight short pain about 7 P.M. Both pupils were still dilated. December rîth, pain re- turned at 3 A.M., and continued almost constantly until I.30 P.M., when I used two drops of a solution of extract of Calibar bean* (i in 4o) in the right eye (that being the side most affected). In fifteen minutes, the pain was much re- lieved. At 3 r.is, I found her asleep, but on awakening she felt slight pain on both sides of the head. I used two drops in the left eye and one in theiright. In;ten minutes, the pain was quite gone. At 9 P.M., she was sitting up, and felt quite well. From this time until December 26th, when I ceased attending, she could at any time stop the pain at once with the drops, which I found it convenient, however, to make of the strength of i in 32 afterwards. I treated her at the sane time (from the 13th) with quinine and car- bonate of iron, with decided benefit. I used the thermome- ter frequently in the armpit in this case, but observed no decided change of temperature attributable to the use of Calabar bean. CASE IV. Miss T. had long standing tic, yielding to no treatment. It was only relieved by leaving Cupar for a time,. and came back on her return. The pupils were generally much dilated, especially -during an attack. I thought of using croton-chloral-hydrate in this case, but preferred the Calabar bean as being only local in action, as I think local remedies are alvays to be preferred for local diseasès, when there is a choice. December 3 st. When called, I found her suffering froni intense pain over the eyebiows, mostly on the left side. I used two drops of a solution of T in 30 (partly lost) in the left eye, and one in the right. In about ten minutes, she said thé pain was not quite so severe. I then used one drop more in each eye, I had to abandon the use of the squares, as i found that three or four vere required at one tine: but, could I obtain squares containing physostigmnatin, I would much prefer them, the drops being a clumsy substitute at best, and not allowing of anything hke t'he precision attainable by the use of squares, as well as being more troublesome to the patient. In ex- periments on the healthy human eye, I have found it necessary to use five and even six squares to produce contraction of the pupil and temporary congestion of the surrounding parts.",
         "276 CANADA 3IEDICAL AND SUROICAL jOURNAL. with the effect of relieving still more, according to the patient's statement, the localised pain ; but, on my return half an hour or so afterwards, I found her suffering from severe pain in the left eye, the pupils being contracted. The patient, being very reticent, had not mentioned to me that tic could be set up in the eye by even a drop of water getting into it, and even now said nothing to let nè under- stand that the pain, was that of tic (which unfortunately she was too well able to distinguish from other pains). Seeing the rather strong contraction of the pupils, I used at once one-third of an atropine square to counteract the effect of the Calebar bean, thinking 'the pain was caused by the contraction. The atropine acted only too well, evidently being assisted in its action bytthe tic, and the pain immc- diately became more severe. The dimness of vision common after the use of atropine remained in this case for three or four days, and frightened -her, she being rather hysterical, so that she refused to submit to further treatment. Thus, in this case, the only one which had not been per- fectly satisfactory in its results, although the patient was not really benefitted by the use of the Calabar bean, the pain was, in the first place, according to her own statement, re- moved from its primary seat ; and, even although set up in the eye by the cold drops, it was evidently kept in check by the action of the bean, until the latter was counteracted by that of the atropine. In such a case, outward application of the tincture (which I suggested, but the patient would not use it) or the use of stropg Calabar bean,-or physotigmatin would be advisable. CASE V. This was a case of obstruction of the nasal duct, complicated by tic, which was relieved in fifteen minutes by a little.solution of Calabar bean (i in I5) applied with a camel's hair brush. It returned in six hours, but was relieved in ten minutes by the bean. It caused the eye to become more injected than formerly. The tic did not return, and the obstruction of the duct ultimately required operative",
         "THERAPEUTIC USES OF CALABAR BEAN.-BY DR. MUNRO. 977 interference. The patient had been suffering from tic for two days continuously when I first saw her, CASE VI. J. B., a man had severe tic on the left side of the head. -He was seen on March 16th at 3 P.M. He had been suffering since early in the morning. This case being four miles from town,-I used three squares and a half (they being in my pocket). In about ten minutes, there was almost total relief. In twenty minutes, two squares more relieved him entirely. The pain came on again during the night; but, having sent him a solution (i in 30), he.used a drop, and it relieved him immediately. CASE VII. On May 4th, I had intensely severe tic over the right eyebrow, caused by want of sleep and wearing a tight hat all day. Having no stronger in the house, I had to use a solution of one grain to the drachm. Of this, two drops relieved me slightly; and two more in half an hour removed the pain entirely. CASE VIII. Mrs. W., on May 16, had severe pain in the right side of the face, and was relieved in about half an hour by two drops (one first, then another) of a Solition of i in 30. CASE IX.-July 22nd, 12.30 P.M. Mrs. P. had tic in the left side of the head and face. There had been severe pain since 3 A.M. I used a half-square (one-tenth of a grain of extract in each square). * Relief was obtained in ten minutes. At 7.50 P.1,., there was still a bruised feeling, \" but no sharp pain.\" I used a half-square. The pain en- tirely ceased in ten minutes.-July roth. The patient came back for more squares. This is the second patient who has done so. CASE X. Mrs. M. had severe tic in the left side, recur- ring every evening for a week past.-5-45 P.. I used a half-square (as above). She was relieved in five minutes. At 6.30 P.M., she was free from pain, \"though there was still a bruised feeling.\" Both these cases were afterwards permanently cured by quinine. In them, as also in myself, * These strong squares were very kindly sent me by Mr. Squire for trial.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. and others in whom Lhave used the strong squares experi- nientally, the pupil always becomes dilated., These squares are very hard, and this may account for such an action, as they îrritate the eye for about two minutes when used. Squares containing physotigmatin, could they be obtained, would be much better. CASE XI J. A. had syphilitic paralysis of the right third nerve, probably from a tumor, with external strabismus, ptosis, dilatation of pupil, and neuralgic pains on the side of the face. I used one square on July 4th. The pain was relieved.-July 5th. I applied one-tenth of a grain of the extract in the eye, causing congestion of the conjunctiva relieving the pain, and producing contraction of the pupil. In this case, the fact that the pupil became contracted is very noteworthy, as the third nerve could not play its ordnary part. Possibly the congested state of the vessels may have acted as a cause of contraction. In none of these cases did I observe decided contraction of the pupil, except in Cases IV. and XI. In Case III., the pupil became smaller than usual, though never contracted to any great degree. In no case was vision interfered with by the Calabar bean-except slight temporary confusion in Case III., lasting about two hours. In the experiment re- ferred to in the first note, vision was temporarily confused (after six squares had been used), but the confusion soon passed away. No general symptoms were ever observed- I am quite hopeful that anyone giving Calabar bean a fair trial will find it an usefui and safe immediate remedy fo- tic, leaving-time, in cases requiring such treatment, for the use of quinine and iron, or other medicines calculated to have a permanent effect. For my own use.'I intend to obtain, if possible, stronger gelatine squares; that being, in rny opinion, the most convenient mode of application, being easily applied and certain in action. The idea is a very in- genious one, and does credit to the inventor. Derangenent of he Heart.-CAsE. December i2th 278",
         "THERAPEUTIO USES OF oALABAR BEAN.-BY DR. MUNRO. 279 1873, A, R., a mill-worker, suffered from continuous pain in the left side, with occasional extra severe spasms. She was offlorid complexion. Her lungs were healthy. The liver was normal in size. She sometinmes suffered from flatu- lence, but not at present. She had been in constant pain for three days. The-pulse was 88, irregular, intermitting, easily altered in number by exertion, sometimes increased, sometimes decreased in frequency ; there were sometimes twenty beats in one quarter minute and twenty-four in another. She had palpitation. There was a rough bruit at the base with the first sound. As I liad the patient under observation until March 21st, my notes are much too long, to be reproduced here. Suffice it to say that I began with one-sixth of a grain of the extract, giving immediate relief. This was continued night and morning for two days, the patient being relieved from pain. She increased the dose to a quarter of a grain, with good effect, but this I then only allowed once a day. For continued use, one-eighth of a grain twice a day [after larger doses at first] seemed sufficient. The bruit became much softer, and the pulse fell to 68 under the use of the medicine. On one occasion, being five days without the medicine, she became so ill with the pain in her side, [at tme apex] that she had to leave off work. She was sometimes very irregular in visiting me, coming only when it suited herself, and, wiien she required a new supply of medicine; but I saw enough of her to con- vince me that the bean had a decidedly good effect. The case being one apparently of constriction of the aortic orifice, the bean would act directly by relieving that condi- tion. Such a case in an hospital under hourly observation would be very valuable'; as I saw it. the results obtained only point hopefully to further use of the drug in similar cases. Febricula.-CASE. December i2th. My own child, a boy four years of age, was attacked by fever without any .apparent cause. At 4.40 P.M., his temperature in the axilla",
         "280 CANADA MEDICAL AND SURGICAL JOURNAL. was 102 ; pulse, 128. I gave him one thirty-fifth of a grain of extract ; and again at 5. 50.P.M., the same dose. At 6.30 P.M., the pulse, was i 18 ; teinperature 99.6; the skin having, from be ng dry, become quite moist to the touch. A favorable opportunity has not occurred lately to me to try Calabar bean for the purpose of reducing temperature, but the result obtained in this one case, agreeing well with. what could be expected from Dr. Fraser's experiments, viz,, expansion of the semi-contracted peripheral vessels, points to its use and cases in which reduction of temperature is desired and where there is nothing special to prevent it from being used. BiliouslRemittentFever.-CAsE . R. A. This was a case of \" bilious remittent \" fever, in which I gave cautiously up to half-grain doses, one grain being given in a day, pro- ducing slight drowsiness, and profuse sweating; and, independently of the ordinary course of the fever, bringing down the temperature from 105, at 7.45, P.M.,to 103 at 11.oo, P.M. When the remittent character of the fever showed itself distinctly, I treated the patient with tincture of iodine, in doses of from ten to fifteen minims, thrice daily, which I have for some years used in preference even to quinine in such cases. From this and other cases, I believethat, if tkestrengthi of the extract can be depended on, the doses given in the British Pharnnacopeia [one-sixteenth to one-fourth of a grain]. are too small for an adult. To produce any decided effect, one-sixth to one-half of a grain, and, with great caution, even higher doses should be given, of course beginning with small doses. I am fully convinced that, in Calabar bean and its anta- gonist atropine, the Pharmacopia possesses two remedies equally valuable with opium, if not more so. This value is not at present appreciated, but would soon be so were their actions made, more fully than they ever yet have been, the subject of observation in all diseases in which it may be desirable either to expand or to contract the vessels, by some hospital physician, whose position gives him the power of closer observation, and more accurate deductions than. one working in private practice can ever hope to obtain.- Britisli Medical Yournail.",
         "CANADA MONTREAL, DECEMPER, 1874. INSANITY AND ITS INCREASE. Amongst our original matter this month will be found a paper from the pen of Dr. Henry Howard, the superinten- dent of the Provincial Lunatic Asylum at St. John's, P.Q. The question propounded by the author is whether any- thing can be done to arrest the increase of Insanity and Imbecility. The author says that in the Provinceof Quebec, there are 3,300 persons suffering from these mental con- ditions. This is alarming, and worthy of grave consideration, it is a most important topic, and as the authortruly observes, the best way to arrive at sound conclusions is for those in- terested in these matters to express their convictions, if based on personal observations. The editor of this Journal has, on more than one occasion during the past twelve years honestly expressed his views on this subject. He has sounded a note of warning to the government of the day but without effect, as the old and effeie law respecting in- sanity still exists without amendment. This law will be found in the 14 and i5 Vic. Cap. 83, and by its provisions \" any person who is lunatic, or dangerously mad, shall by warrant of any two, or more justices of the peace be appre- hended and kept safely locked up in some secure place within the District or County where such City,Town,Village Township, Parish or place lies, as such justices under their hands and seals direct and appoint.\" In this act we find that the unfortunate who is lunatic or dangerously mad is subsequently visited by, or brought",
         "282 CANADA MEDICAL AND SURGICAL JOURNAL. before, two justices of the peace and two physicians, and upon their joint certificate the poor wretch is sent at last to a Lunatic Asylun. We have before pointed out that this unwieldy process, this inhuman treatment of persons suffering from mental disease is certainly followed by con- firned insanity. The brain is the organ of the mind, and although Pathological research has not been able «in every instance to point out undeniably the lesion which exists in the lunatic or person dangerously mad, yet reasoning from what is observed in diseases of other organs, we infer that there must be some structural change sufficient to occasion the conduct of the person so afflicted. As scien- tific truths gradually unfold themselves man becomes cog- nisant that he is subject to certain ills.and derangements of his body which are in a great measure due to his folly and error. Preventive medicine is now unfolding facts, which, had they been announced a century or so ago, would have been regarded as sacrilege and followed by condign punishment. The brain is as subject to derangement as other parts of our body, and being of more delicate structure is more liable to be seriously injured, hence, it may take months to undo what has been done in a few hours, but this undoing- demands scientific and prompt measures. Shutting up insane persons in a cell of a common jail and feeding them for weeks on skilly is neither a reasonable nor scientific method of treatment,-but the reverse,-and is certain to be followed by confirmed madness, which gradually lapses into imbecility. If we desire to lessen the number of cases of induced imbecility, we should first alter the present law. Having\u003e done so, then all those suffering from acute insanity should be removed without delay to an insane hospital, there to remain a reasonable time, when, if in the opinion of the medical officer of such Insane hospital, their case becomes cànfirmed or is no longer hopeful, they should then be removed to a proper asylum. Of course, this might be at",
         "INCREASE OF INSANITY. the outset, an expensive undertaking, but, in the end it would be a great saving, as the present system is every year adding to the number of permanent lunatics, many of whom would, we believe, have been restored to the industrial population, if judicious measures had been adopted at the outset of the disease. With regard to Dr. Howard's paper on the educational errors of parents and teachers, we believe every word he utters ; and furthermore, deem it is a matter of regret that his valuable observations will not reach the public eye, as our Journal is read by few other than profes- sional men. THE PROPAGATION OF TYPHOID FEVER. The prevalence of typhoid or, as it is otherwise called, enteric fever is unusually great at the present time ; its rapid and alarming increase in certain localities is attract- ing much discussion on the nature of the disease and its mode of propagation. . That typhoid fever is generatëd by a special poison or contacrious principle is daily becoming more positively demonstrated ; but if it is developed by a certain thing,. seed, fungus, or special contagious principle, it would appear that it requires an appropriate soil in which to germinate. Hence we have in certain localities whole communities stricken with the malady, whilst others subject to a like exposure (as far as wc are able to judge) escape the ravages of the disease. It is of great practical moment to ascertain if possible in what form resides the germs of this disease. There is mucli conjecture on this subject, but very little agree- ment, on any point, in the ranks of the devotees of science. Some hold that neglect of ordinary cleanliness of premises vill be sufficient to create typhoid fever, whilst others state that no amount of stench, foul gases, or noxious effluvia from decomposing animal or vegetable natter, will generate the disease typhoid fever unless the germs of typhoid fever be there to act as a leaven. 283",
         ":?84 CANADA MEDICAL AND SURGICAL JOURNAL. From the observations of Dr. William Budd it would appear that typhoid fever is alone propagated by con- tagion, and he advances so many arguments on this head as te almost render fruitless any attempt at contradiction. He states that typhoid fever is never spontaneously ger- minated-any more so than is small-pox, scarlet fever or measles ; that it is propagated through a special virus or poison. We will not in this place pin our faith to the doctrines of Budd or to what has been termed the pythogenic theory, but will simply say that in this city of Montreal there exist at the present time those very conditions which lead to the spread of the disease typhoid fever, and that those conditions have been created by the want of supervision of those whose duty it is to supervise and look after the public hcalth. We have a Board of Health who err either from not knowing better, from being ill- advised, or fron being powerless. Some weeks ago the annual work of emptying out the: Craig street sewer was commenced. From the peculiar engineering skill exhi- bited in the construction of that sewer, which is one of the largest in the city, the soil from the upper parts of the city, from Cote à Barron downwards, lodges in the Craig street sewer, and almost fills its capacious cavity with a black muck of various compounds. We learnt with surprise that this vile mass, after removal from the sewer, is utilized to fill up certain streets, as in Ontario street, which; from having been recently opened, requires raising at certain points. When we were informed of this fact, we doubted it ; although willing to admit that oür Corporation authorities were blind to the interests of the public, nevertheless we did not think that such a monstrous iniquity was being perpetrated in our midst. Let it be stated that the Craig street sewer receives the drainage from both General Hospitals ; these two institu- tions have withn them small-pox wards, and laying aside",
         "TYPHOID FEVER. the question of typhoid fever, small-pox is known to be readily prôpagated by exhalations and excreta from the bodies of those afflicted with that disease. Is it, then, to be wondered at that small-pox is at present alarmingly on the increase ? But if we examine the records of our hospi- ,tals. or our mortality tables, we shall find that typhoid fever is likewise very prevalent. Now, with regard to the generation of typhoid fever, we care not which horn of the dilenirnma the Board of Health are placed upon, for certainly spreading on our public highways the filthy exuvia from our typhoid fever patients and small-pox patients is a nost insane proceeding, and is undoubtedly followed by the very condition witnessed in this city at the present time-the rapid increase in the number of cases of both these diseases. Have the Board of Health any powers in the matter? or do their suggestions, if they have made any, fail to produce the desired effect in the stoppage of such iniquity ? We are told that the matter removed from the sewers is not offensive ; that it is sweet and clean, and rather a desirable substance for the purpose for which it used. Can our Health authorities inform us whether the germs which propagate small-pox or typhoid fever possess any odour. -Do yeast germs in minute division possess any odour ? Yet the smallest particle is sufficient to produce fermentation. To say the least of it, it is filthy, revolting, abominable and dangerous. It matters not whethcr these diseases are occasioned by a special seed or by decomposition : both conditions are here produced, and as matter is indestructible, we need not suppose that the covering up of this compost with snow, or its being exposed to the rigour of our winter, will in any way lessen the evil. The summer's sun, aided by the rains of spring, will liberate all kinds of gases, to be wafted into our open windows, and later on, this mass of filth will dry, be reduced to a fine powder, and be blown about by the wind into every quarter of the city. 2805",
         "286 CANADA 3mEDICAL AND SURGIQAL JOURNAL. It has been said that 4 the health of the people of any country should have the irst and highest claim on the Government.\" Unfortunately in this country sanitary legislation is not even in an embryonic state. We are absolutely without the very first principles of sanitary legislation. In fact, we are in as bad a condition in that respect as were the people of England during the reign of Henry VIII. In those times, when d:se.5se and pestilence did occur, it vas looked upon as an evidence of Divine wrath, which drove the superstitious to their knces, instead of stimulating them to ascertain the cause of the plague, with a view to its removal. BOARD OF HEALTH. MONTREAL, NoV., 5874. DzAR SIR,-WiIl you please report the total number of cases of Typhoid lever and Small Pox you have had under your care, during the month of October, and make the necessary remarks on the cause of these diseases. REPORT :--Please give the residence of the cases reported, in order to know the unhealthy localities, and take the necessary precautions. The above is a circular which has been left with every medical mari in the city, and we believe a sanitary officer is detailed to make a personal application for the information sought. We question very much whether the profession will comply with this request, and if even the returns become general, whether any good will result. Although it may be desirable to obtain correct informa- tion on this important topic, yet the Board of Health are powerless and cannot enforce their demand. Typhoid fever is very general in ail quarters of the city,but more especially where there exists a state of overcrowding of buildings for the accommodation of the poorer class. The system of covering every inch of ground with inferior residences, and filling them with tenants, which is to be seen in aIl",
         "BOARD OF HEALTH. parts, of our city, is very injurious to the health of the community ; it not only affects the community where such residences exist, but also those of the better class even to considerable distances. But is tie Board of Health in a position to enforce compliance of speculators and builders, in common-sense principles in the creation of tenements. Public health, is not to be preserved by the various means adopted by our Health Board.. Statistics are all very well and useful if they can be relied upon, but to be useful, they should be general, not a few desultory remarks from a few individuals. It appears to us that the Board of Health is beginning its work at the wrong end. Let us have a comprehensive public health act, and then will the Boards of health in our various cities be in a position to cope with the difficulty. The indication of the residences of individual patients, as is requested by the above, will not point out the unhealthy localities, and what is meant by \" taking the necessary precaution \" is utterly beyond our comprehension. What necessary precaution is the Board going to take supposing it be reported that the wife or daughter of one of our merchant princes is lying danger- ously ill with Typhoid fever. The Board of health has lamentably failed in its mission : if instead of sending round silly and useless circulars, it took upon itself to supervise the sanitary state of the city generally, we would not have to complain of the many evils which exist amongst us, not the least of which is the spreading of sewage matter on oux roadways. VACCINATION AND SMALL-POX. We extract the following from the Gazette of the 2nd instant. It speaks for itself, and is identical with the observations and returns of the London (England) small- pox hospital, which we published some months ago :-ED. A grossly false and pernicious statenent has of late been somewhat widely circulated by the opponents of 2s7",
         "288 CANADA MEDICAL AND SURGICAL JOURNAL. vaccination, and not a few credulous persons have been misled. It has been asserted boldly that vaccination in- creases the liability to take small-pox, instead of being the great and only safeguard .against its attacks. These and similar statements are freely made and persistently cir- culated, although no facts or figures can be brought for- ward in their support. But reliable facts should be the best answer to the ignorant prejudices and to the absurd and criminal representations of such people. The follow- ing statistics have been compiled from the books of the Montreal General Hospital, and 'any person can assure himself of their correctness by calling at the Hospital and enquiring for himself. During the past twelve months there have been 55 unvaccinated persons admitted into the srnall-pox wards. All of them except five have had the confluent form of the disease, i. e., the serious form ; and out of the 55 who were admitted 28 died, showing a mortality in the unvaccinated of over 50 per cent. On the other hand, among those who had been once vac- cinated and had two good marks on the arm, there were only four deaths. Only seven had more than two good marks, and those seven had the mildest form of the clisease, and made a rapid reco~very. Only two cases were admitted during the past twelve months who had been successfully revaccinated, and in theni the disease was so mild that they might have been permitted, except as a'precautionary measure, to follow their, ordinary avocations. And what conclusions would any sensible man make from these data ? In the unvaccznated, the mortality was- over 50 per cent.; among those who had been properly vaccinated in their infancy, but who had neglected to be revaccinated, there were only four deaths, while only 2 cases had been admitted where revaccination had been successfully per- formed, and they were of the mildest description.\"-Mon- treal Gazette. MEDIcO-CHIRURGICAL SocIETY.-The fourth annual meeting of this Society was held in the Library of the Natural History Society on Friday evening Oct. 16th, 1874, when the following office-bearers were elected for the ensu- ing year: President, Dr. Reddy; Ist Vice-President, Dr. Craik; 2nd Vice-President, Dr. Godfrey; Secretary-Trea- surer, Dr. Roddick (re-elected); Council, Drs. Scott, Fenwick and Gardner."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGINAL COMMUNICATIONS. The Elzastic Band inz Tenotomy. Successful Case of Opera- tion for Tatipes Vars. By A. A. HENDERSON, M.D., C. M., Ottawa, Ontario. A shcrt time ago, I was sent for to sec Willie T. a healthy, well developed child, aged twenty months, perfectly formed in every respect with the exception of deformity of the right foot. I 'vas informed that an operation .had been performed upon the foot eleven months previously, and that the usual kind of boot for such cases had been worn by him, but without any beneficial result. Condition Previous to Operation.-Upon examining the foot I found the heel well depressed, the tendo Achillis having been divided at the previous operation. The inner margin of the foot, however, was drawn upwards and the anterior portion twisted inwards to such an extent that at any attempt to walk, the dorsum of the foot pressed upon the ground. I then examined the tendons with a view to operation and found that the tendon of the ti.bialis anticus was the cause of the deformity, and that in this case it could be divided most easilyjust above the ankle joint. On Dec. 3rd 1875, assisted by Dr. Sweetland, I operated without chloroform. The foot was firmly held in position by Dr. Sweetland while I divided the tendon of the anterior tibial muscle above the ankle joint in the usual manner. The puncture was covered with adhesive plaster, and the foot secured in position by means of a broad strip of plaster placed around it just behind the toes, having a smaller strip inserted so as:to form a loop at the outer mar- 22",
         "340 CANADA MEDICAL AND SUROICAL JOURNAL. gin of the foot, just at the root of the small toe. Another broad band of plaster with a loop formed at its outer por- tion was placed around the leg above the knee. These loops were then connected by an elastic band, composed of two pieces of rubbcr tubing, attached by means of a hook to the loop at the root of thessmall toe, and by means of a loop with tape attached to the plaster above the knee. The tape was founda great convenience as a means of regulating the amount of tension required frorn the rubber. No boot was worn for fourteen days, and during that time the child was not allowed to walk. The sticking plaster was renewed from time to time as it became par- tially detached, and the tension of the rubber was carefully regulated. At the expiration of that time the child was allowed to walk, but instead of putting on a Scarpa's shoe, I selected a light boot such as is ususally worn by children, and still keeping the band of sticking plaster around the foot, I passed the loop out through an incision which I made at the outer margin of the boot, and hooked the elastic tubing into it. By this means the foot was prevented frotn turning in the boot. The other end of the elastic was se- cured to the back of a belt passed around the waist, and kept in position by passing through a keeper situated at the outer and posterior part of a band passed around the thigh. This enabled the child to walk without the possi- bility of displacing any of the fastenings, and exercised a proper amount of traction, and in the right direction. The child walked readily with the toes everted, and the sole of the foot placed properly upon the ground. The result of the operation is very satisfactory, and al- though the elastic is still worn as a precaution, yet without it the position of the foot is quite normal, and its movements are such as they ought to be. Remarks.-The advantages of the elastic band in the treatment of muscular contraction are marked, and its action in this particular case is very satisfactory. The age of the child necessitated a moderate amount of traction in order",
         "THE PATHOLOGY OF SMALL-POX. to retain the foot in a proper position, and this was managed by using double tubing. Having tape attached to one end of the rubber is a de- cided advantage, as by means of it the power exercised as a tractor can be perfectly controlled. The position of the foot treated by the clastic band can be kept more perfectly under control than can be donc by a boot, as any amount of traction required can be obtained in any requisite direction. . The elastic must be worn until the cure is perfected, and .apparently but little inconvenience is felt by the child, as the power of standing, walking, or even running seems to be but little interfered with by it. Ottawa, Jan. 5th, 1876. .Notice of the reccit Researchcs oi the Pathology of Small-pox. By Wýu. OSLER, M.D., L.R.C.P., LOND., Professor of Institutes of Medicine, McGill University. The laudable endeavours of Pathologists to obtain -evidence of the presence of some of the lower forms of vegetable life in connection with the infectious diseases are being yearly rewarded. In Splenic fever of animals, in Diphtheria, Relapsing feverTyphoid, and Erysipelas organ- isms have been discovered which are supposed to have a casual relationship to the diseases in question, though by opponents of the germ theory they are regarded as patholo- gical results or accidental accompaniments. Within the last eighteen months two investigators, one working at ovine, the other at human small-pox, have shown that this disease must be included in the list, since definite organisms occur in connection with it, and the following brief account of their investigations, chiefly in the author's own words, may be interesting to the readers of this Journal. Dr. Klein (Report of ifed. Offccr of Privy Couincil), experimenting upon sheep, produced both a general and local eruption: in the one case by the injection of the virus into the veins, in the other by the inoculation of it under",
         "342 CANADA MEDICAL AND SURGICAL JOURNAL. the skin. The lymph used contained many transparent spheroidal bodies, arranged in groups or in necklace-like chains, together with Micrococci and ordinary rod-shaped Bacteria. On keeping the lymph for some time at incuba- tion temperature (98 O Fahr.) the transparent spheroidal bodies divided and sub-divided, producing chain-like aggre- gations, or long, smooth filaments ; the product in either case bearing a striking resemblance to the dense net-work of filaments forming the mycelium of the common fungus. Dr. Klein describes the process in the local eruption as beginning in the rete zzcosunz and papillary layer of the corium by an enlargement and germination of the cellular elements in these localities. Then the lymph spaces in the corium became dilated, more distinct, the lymphatic vessels originating from thern being readily traced owing to their distension. About the third day, spheroidal bodies like Micrococci, and branched filaments made their appearance in the dilated lymph vessels of the corium, and in a few days the process had advanced to such a degree that almost all the lymphatics in the affected part werc filled with a fungus-like growth, consisting of a dense felt-work, or my- celium, the undivided filaments of which broke up at the ends into conidia or spores. While this was going on a pre- cisely similar growth took place in the cellsor cavities which form in the rete mucosum at the time of vesiculation. The process attained its height before pustulation came on, and was identical in the pocks of the general eruption. Dr. Weigert, of Breslau, working at the subject in man, describes first the appearances in the skin, and then in the internal organs (Centralb/att, f. d. Med. Wiss. Feb. 27,-- Dec., 1875). In the former situation Bacteria were always found in the neighbourhood of the pocks, sometimes direct- ly under the central degenerated parts, occurring in sharply bounded tubes with an endothelial lining; but whether these were lymph or blood vessels could not be decided. In addition larger and smaller colonies, more diffusely arranged, vere present. They were only found in the early stages before profuse suppuration came on.",
         "THE PATHOLOGY OF SMALL-POX. In the internal organs, Liver, Spleen and Kidneys, the author describes small, sharply bounded, tubular structures filled with Bacteria, identical with those found in the skin. The cells in the neighborhood of these degenerate, their nuclei disappear, and small group-s, about the size of miliary tubercles are forn-red. This is in the early stage of the disease. Suppuration takes place later with disappearance of the Bacteria. Dr. Weigert is inclined to regard these as structures analagous to the pocks on the cuticle, and believes that for the first time proof is here offered in an acute exanthem of a process going on in the internal organs similar to that in the skin. As far as can be gathered from the account, the Bacteria correspond rather to the Micrococci occurring in Diphtheria than the rod-shaped forms of putrefaction. The author is of opinion that the destructive effect of the Bacteria is due to some chemrical action on the tissue caus- ing necrosis of the cell elements, while inflammation with suppuration follows as a secondary effect. The two accounts which we have here of the pathology of ovine and human small-pox (in their essence similar) are by no means concordant. In the one we have a remarkably full and clear description of the development of an organisn going hand in hand with the development of the lesions characteristic of the disease, and it seems hard to believe that the relationship between the two is not that of, cause .and effect. In the other, human small-pox, the account is much less complete, and though tube like aggregations of Micrococci occur, like those described by Dr. Klein in the ovine diséase, we have no record of the growth, develop- ment, and fructification of these bodies. Nevertheless these form most valuable contributions to our knowledge of the intimate Pathology of this disease, and Dr. Klein's re- search especially places the germ theory on a basis which heretofore it has not possessed. 343",
         "344 CANADA MEDICAL AND SURGICAL JOURNAL. The Antipyretic action of Salicylic Acid. Dr. Füirbringer (Centralblatt, f d. MeZcd. Wiss. No. 18, 1875,) found that the administration of this remedy in health to guinea pigs and men caused no deviations in the temperature. In septic fever, artificially produced in guinea pigs, sali- cylic acid caused a marked reduction in the temperature, the effect in most of the cases being evident in from 2-6 hours after the administration of the m.'edicine. In inflam- natory fever produced artificially in the same animals the results were not so striking, but the experiments were few in number. Dr. 3uss (Ccntraiblatt, NVo. iS, 1875,) in a short notice strongly recommends salicylic acid for its antipyretic action, alone, and in combination with quinine ; and states that it possesses no unpleasant peculiarities, such as causing col-- lapse, delirium, \u0026c. He gives it in doses, according to the intensity of the fever, from 4-8 gms (31-311) at a time, and has so employed it with the best results in typhoid fever, erysipelas, and acute rheumatism. Moeli ( Berl. klin. Voclensclhr, quoted in Centalblatt, No. 53, 1875,) states that the sodium salt of salicylic acid, which according to Kolbe's investigations does not possess, antiseptic properties, acts in a remarkable manner as an antipyretic, both in infectious and inflammatory fevers. 4-5 gms is sufficient in light cases to produce a great re- duction in the temperature; in severer cases it is necessary in order to obtaina temperature reduction of 1. 5-3 0 C to repeat the dose in a few hours (4-16). The action is more intense if the remedy is taken at the time of the sponta-. neous temperature reduction. Commonly the antipyretic effect lasts 24 hours, and in about half the cases the fall in temperature is accompanied with copious sweatings. The author has never observed any evil consequences fol- low the administration. Occasionally transitory vomiting came on, but no furthur· gastric or intestinal troubles.",
         "THE ANTIPYRETIC ACTION OF SALICYLIC ACI. The medicament proved active also whens given by the rectum in larger doses, less so of course than when ad- ministered by the mouth. A prompt effect was evident with subcutaneous injections, in spite of the inconveniently large quantities which had to be'injected. Of six healthy persons who had each taken 4 gms in concentrated solution, thrce vomited, the rest remained wholly unaffected ; like- wise three others who had taken similar doses per anum. Wolff berg (Dcutsch Arc/i. f. kin. Med. qzuotcd in Cen- tralblatt No. 53, 1875) finds, from experiments in Ziems- sens clinic, that in typhus the salicylic acid, taken in single doses of 4 gms, only exceptionally reduced the temperature with 6 gms it did so as a rule, but only transitorily; while the continual use of 2 gms daily in watery solution had no effect whatever. From these results the author ventures to conclude that to salicylic acid only a slight and untrust- worthy antipyretic action must be ascribed. The author advances a number of facts to show that the administra- tion of salicylic acid in substance, cither in powder or sus- pended in water is not, as Buss (see above) maintains, without risk. One patient to whom 2. 5 gms had been given in powder, so that it was with difficulty swallowed showed on the next day a hamorrhagic Pharyngitis. The post mortem examination of two typhus patients who had taken the powders revealed numerous hæmorrhagic ero- sions in the mucous membrane of the stomach, which in one of the cases extended into the duodenum. Similar ap- pearances were found in the bodies of three patients who died of phthisis, to whom, cxperimenti causa, in the last period of life salicylic acid in powder had been administered. A dog also to which 2 gms of salicylic acid enveloped in bread was given, and in addition an injection of 2 gms to 40 of water, had after death numerous hemorrhagic ulcers in the stomach, duodenum, and rectum. Choral-hydrate iin Ovena. A solution of chloral-hydrate in water in the proportion of 2 parts to 250, is highly recommended in Ozena. It is ernployed by irrigation.-Pacific Med. and Sur. urnal. 345",
         "CANADA MEDICAL AND SURGICAL JOURNAL. MEDICAL AND SURGICAL CASES OCCURRING IN THE PRACTICE oF THE MONTREAL GENERAL HOSPITAL. Case of Cirrzosis of Liver. Under DR. -Ross. Reported by MR. R. L. MACDONNELL. P. M., æt.61. Admitted Oct. 31, 185, avery stout, ple- thoric individual. For last 3 months has had swollen feet, cough, dyspnœa, and brickdust deposit'in urine. A month ago had ascites, which was soon followed by icteroid dis- colouration of skin and conjunctiva. Within the last two or three days bas had hœmatemesis, and last night was de- lirious. Bowels have been rather loose and urine scanty. Family history excellent. Has never had syphilis. Has been a very hard drinker for last five years. Dull and stupid manner, voice thick ; not at all inclined to answer questions or impart informafion. Skin and con- junctiva moderately jaundiced. Respiration hurried and difficult, little cough or expectoration. Moist rales over the right lung and base of left, dulness at both bases. Pulse 124, moderately full and very compressible. Heart healthy ; tongue moist and brown ; no appetite; frequent hæmatemesis, but not involving much loss of blood. Bowels loose, fæces greenish and watery, lower extremities œdema- tous. Abdomen much enlarged. Fluctuation well marked from side to side. When supiné position assumed clear percussion in umbilical and hypogastric regions. Dulness varies with position, superficial abdominal veins enlarged. Passes urine and feces involuntarily. Urine is scanty in amount, of a dark colour, acid reaction,-sp. gr. 1020, and deposits very little sediment at all, contains no albumen, blood or bile pigment. Ordered. t Inus. Digitalis 3ii every 4 hours. .Nov. 1st. Delirious last night. Breathing becoming stertorous. Frequent vomiting of blood. .Pupils contracted. 346-'",
         "HOSPITAL REPORTS. Involuntary passages of urine and fæces. Pulse 120, weak and compressible. Ordered Pulv. Jalapae Co*3i statim. Nov. 2nd. Died at 4 A.M. Autopsy. Eight hours after death. Heart and pericar- dium healthy. Pleuroæ adherent at many points. Right lung intensely congested except at upper lobe. Left lung congested at lower lobe. Mucous membrane of stomach reddish and congested. Abdomen contained five quarts of ascitic fluid. Liver capsule opaque, closely adherent. Sur- face light yellowin colour, covered with small protuberances of different size. Organ itself hard, tough, and leathery, much reduced in size and weight (2 lbs. 10 oz.) Gall blad- der partially filled with greenish bile. Spleen enlarged and congested (weight 14 oz.) Kidneys, slightly congested. Capsule non-adherent. Surface mottled, with minute echy- moses. One or two small cysts. -Case of Cirrhosis of Liver.-Under DR. Ross. Reported by Mr. R. L. MAcDONALD. Jacques Archer, St 42; admitted October 28th, 1875, a painter. Has never been ill until about a month ago, when he noticed slight puffiness about the ankles, followed imme- diately by progressive enlargement of the abdomen. About twelve days ago the urine became scanty and of a bright red colour, with a large deposit of lithates and lithic acid. Four days ago had a slight attack of hæmatemesis. Has never suffered any pain. Now and then bas had a little bleeding at the nose. Coughed a good deal before admis- sion. Bowes have been irregular. Had gonorrhoa and syphilis about twe.nty ycars ago,, not followed by evil consequences. Family history excellent. Though he strenuously denies it, he bas probably been a very intem- perate man. Present Coudition-Skin dark but not jaundiced. Pulse 92,ssnall compressible; cough trifling. Expectoration 347",
         "348 CANADA MEDICAL AND SURGICAL JOURNAL. small in quantity, mucous. No dyspnoea. Lungs healthy. Heart quiet. Cardiac dullness normal. Systolic murmur rough in character, loudest at base and prolonged up the aorta. Pulsation at wrist barely visible. Tongue clean. Appetite fair. No nausea or vomiting. Bowels rather con- fined. Abdomen immensely distended. Superficial abdom- inal veins prominent. The swelling fluctuates, bulges at sides, and is dull on percussion, except at upper part, where a tympanitic note can be elicited. This area of clearness changes its site with the patient's position. ~ Hepatic clulness normal. Spleen not perceptibly enlarged. Urine scanty, bright red wvith a large deposit of lithates, acid in reaction. No blood. No albumen. No bile pigment. Sp. Gr. 1020. Ordered pulv. Jalapoæ Co. Si statim. Oct. 3oth.-Has been thoroughly purged by the Jalap. Abdomen morelax ; more comfortable. Amount of urine passed in 24 hours, 24 Oz. Ordered : Infus. Digitalis 3ii ter in die. Also 4 oz. Claret. Oct. 3Ist. Tongue moist and slightly coated. Bowels conflned. Urine 16 oz. Nov. 3rd. - Ordered: P.. Potassæc Ascetatis Siv Tr. Scillae 3vi; Infus. Digitalis ad 'vi ; i ss ter in die. Nov. 41h--Bowels loose. Urine 16 oz. Deposit consid- derably diminished. Nov. 5th-Urine 27 ounces. Nov- 7th-Two friends of the patient came to sec him in the afternoon, and brought him two pint bottles of claret. He hid them in his bed, ana at about 10 p.m. draii about a bottle and a half. He became extremely drunk, went out to the watercloset, and on his way back to bed was attack- ed with profuse hæmatemisis. le died a few minutes: afterwards. Post Mortem.-Twelve hours after death. Cadaveric rigidity extreme. Face livid. Conjunctivae injected. Nose flattened from previous fall. Membranes of brain conges- ted. Small quantity of subarachnoid effusion. Brain normal.",
         "IIOSPITAL REPORTS. Pleurae slightly adherent above and below. No effusion. Lungs moderately congested, particularly at right base. Crepitant, throughout. Pieces from all parts floated in water. Red, frothy serum exutled from cut surfaces. Peri- cardium contained a fev drachms of fluid. Heart flaccid. Auricles full of dark coajulated blood. Left ventricle hy- pertrophied and alittle dilated. Mitral valve slightly incom- petent, and thickened. Aortic valves healthy. A flattened plate of calcarcous rnatter, as large as a five cent piece, attached to.inner surface of aorta, immediately above one of the semilunar valves ; similar calcareous plates along the- thoracic aorta. One, particularly large, at origin of the subclavian artery. Abdomen ascitic, the fluid measuring cight quarts. Peritoneum pinkish and congested. Long strings of lymph floated free in the fluid. LIVER (weight à lbs). Capsule thickened and whitish, adherent to dia- phragni and adjacent viscera ; vessels of broad ligament en- larged and gorged with blood, one vein being particularly prominent. Surface of the gland of a moderately dark brown colour, studded with hard protuberances which com- bined to give it a puckered appearance. Hepatic substance on section hard and tough, shining white lines of connective tissue between irregular masses of dark brown lobules. The surface of a section altogether reminds one somewhat of the appearance of a slice of dark-coloured castile soap. SPLEEN (7 oz.)-Capsule extremely thickened, with large white indurated patches. Substance congested. Omentum gathered together into finger-like lobules, binding the liver, stomach, spleen and pancrèas-into one mass, render- ing it a difficult matter to separate one organ from another. STOMACI empty, contracted. No sign of congestion or inflammation except at cardiac orifice, where there was- rather deep capillary congestion. Intestines healthy. Appendix vermiformis unusually long. Kidneys (6 oz. each).. Capsule non-adherent. Surface smooth. Deep red on, section, congested. Pyramids widely separateci. Left kidney of an unusual triangular shape. ?\u003e49",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Case of Fracture of the bodies of the 4th and 5th dorsal Vertebrae-Conplete paraplegia - Recovery. Under Dr. Ross. Reported by Mr. C. N. STEVENSON. Louise L. aged 17, housemaid, was admitted into the Montreal General Hospital on 28th Sept. 1875, with loss of power in the legs, the result of a fall. It ·appears that on the 26th Sept. she was engaged washing windows in the second story of a house looking out upon a garden, when the ladder on which she stood gave way.and she was pre- cipitated to the ground. She thinks she was not stunned or renderedunconscious, and insists that she fell face down- wards, striking violently upon something directly across the pit of her stomach. She tried to rise but could not and had to be lifted and carried into the house-She was very shortly. after seen by a neighboring physician who found her com- pletely paraplegic, the bladdler also being involved. He had fly-blisters applied on the spine and to the backs of the legs. On admission, there was complete loss of sensation and motion in both legs-there vas also paralysis of the blad- der and consequent retention, which had already necessi- tated the employment of the catheter. On examination of the vertebral column, very decided prominence was to be observed opposite the situation of the 4th and 5th dorsal vertebraæ. Pressure in this situation was found to be ex- -ceedingly painful, causing at the same time.sensations as ,of pins and needles running. through the body in different directions. She has large blistered surfaces down the back and on the calves of the legs. These sores were dressed with zinc ointment-she was ordered an air bed, and to.be cathetered twice daily. Sept. 3th-Rested badly. Suffers a good deal of pain in the back. Pulse 125. Oct. 3rd-Has had no movement of the bowels, still re- .quires daily catheterization. Pulse 108. Ordered an enema. Oct. 6th.-In spite of the air-bed, a slight bedsore is form- ing on the left nates. It was dressed with soap plasters.. Pulse io8.",
         "HOSrITAL REPORTS. Oct. 1oth.-'Pulse 1o8. Temp. 100 5 a.m., 100 5 p.m. Oct. i i th.-Early this morning had a rather severe rigor. Temp. 102 3-5 a.m., 100 4-5 p.m. Pulse 130. Rather more pain over seat of fracture. Ordered Emp. Bellad. to the back. Oct. 12t/i.-Pulse 1o6. Temp. 99 1-5 a.rn. 100 p.m. Has sone incohtinence, urine escaping involuntarily in bed. Oct. 16th.-Pulse 88. Témp. 98 2-5. Has regained power over bladder and passes water voluntarily. Has also begun to regain some degree of power in ber limbs. Oct. 18th.-Improving. Is now able to turn over herself on either side-can move the toes and slightly raise either leg fron the bed. Has more power in the left leg than the right. Oct. ot/i.--Urine passed easily and voluntarily. Bowels, moved naturally without assistance. The bedsore and all the blistered surfaces are quite healed. Oct. 25th.-Rapidly regaining power in the limbs. Was allowed to sit up in a chair for a short time to-day. Was ordered Pil. Rhei Co iij. From this time improvement was steady and continuous in every respect, and by the 20/h Nov. she was able to stand and walk with slight assistance. Rapid advancement followed this and she was soon able to walk firmly without assistance and feels perfectly well. The vertebral promin- ence is as distinct as it was at first but free from all tender- ness and quite consolidated. The deformity gives an odd appearance as though the shoulders were unnaturally square and the head somewhat sunk between the shoulders- was discharged cured 24th December. Case of Papillomatous Tumour of tlie Ccrvix Uteri, Removed by Galvanic Ecraseur. By DR. FENwICK. Reported by J. D. CLINE, B.A., M.D., Assistant House Surgeon, Montreal General Hospital. A. S., aged 28, married, by occupation a laundress, tall, stout, well-developed woman, was admitted into hospital on 351",
         "CANADA 31EDICAL AND SURGICAL JOURNAL. Dec. 2oth, 1875. Had always been strong. Never knew what it was to be sick. Had one child four years ago, and never been pregnant since. Had always been regular in menstruation until two months ago when she became unwell and rernained so ever since. Hæmorrhage had been so great lately that she felt herself getting weak, and was subject to fits of giddiness. She had never suffered any pain till lately ; she had pain in her back and down her thighs. On examination with the finger inmediately felt a mass as large as a hen's egg, fiat in surface, which was rough and tugged, growing from the anterior lip of the cervix, its attachment being broad and sessile, the whole lip being much enlarged and thickened. The posterior lip and os uteri could be felt behind the growth by tilting it forward. The examination caused no pain. Upon introducing Sim's Speculum the growth was brought into view. The surface of it was covered with a bloody and slimy discharge, the removal of which disclosed a rough, ragged-looking surface 352",
         "HOSPITAL REPORTS. not so from ulceration but from enlarged papillae. The tumour lay somewhat obliquely across the bottom of the vagina, completely hiding from view the os and posterior lip. Dr Fenwick judged from its appearance, the age of the patient and her'general condition, that it was not malig- nant, but - a benign papillary growth, and decided to remove it. This he did by the galvanic Ecraseur. Passing the loop of platinum wire around the tumour as high up as possible, he connected it with the electric conductors of a four-celled battery. The tumour carne away in about two minutes, leaving a smooth, charred stunip, without a drop *of blood. The sides of the vagina werc a littie burnt, by the heat of the canulla through which the wire passed. This on another occasion could be avoided by winding silk around the canula. The patient had no bad symptoms after thz operation. Now, at the end of three weeks, the sloughs have separated and the stump is rapidly healing. The discharge is very slight. It was rather offensive for a time for which injections of Condy's Fluid were used. The -tumour was examined by Dr. Osler who pronounced it to be not malignant but to consist of hypertrophied papillæ, connective tissue and blood vessels. Fracture of tMe Ulna, witht dislocation forward of lead of Radius. W. S., aged 22, was driving a butcher's cart, when the horse ran away and he was pitched out against a hydrant, the fore arm, which vas flexed, striking the hydrant near the elbow. When brought to the hospital we found a frac- ture of the ulna, about two inches from the point of the olecranon, and a prominence in front of the point on the radial side. The patient could not flex the forearn. The head of the radius was readily returned to its proper posi- tion and retained there as long as the arm was well flexed. A posterior splint of gutta percha was applied, bent at an .angle of about 5o 0, and a straight anterior splint was ap- 353",
         "354 CANADA 31EDICAL AND SURqTCAL JOURNAL. plied to the forearm. The hand was kept to the opposite shoulder by a triangular sling, and the whole arm steadied by a broad bandage. The patient was found to be syphil- itic. He had a large serpginous sore on left leg, and another on the fractured arm, and sores of the sanie charac- ter on his head, and nodes on both tibio.- He had contrac- ted the primary sore four years ago, and eight months afterwards secondary eruptions and sore throat, with noctur- nal pains in his bones. Proto-Iodide of Mercury Mixture was ordered for this syphilitic affection. In three weeks the splints were renoved altogether, when tolerably firm union was found at the seat of the fracture. Passive motion was used, and in another week the motion of the joint was very good. He was now discharged with instructions to use the arm and apply friction. The syphilitic sores were by this time almost healed. Case of Peritonitis. Calcarcous concretionfound in Appendi: Verifonnis wit/i pe;foration of it. W. S., aged 22, an ostler by occupation, was admitted into hospital on the evening of Tuesday, January 18th. He was a thin, spare man ; had been in the habit of 'getting on sprees ' frequently. On Saturday had had a chill, having been perfectly weil before this. The chill was followed by a good deal of fever, pain in head, back, and thighs, and sick- ness at stomach. He had also complained of pain across lower part of abdomen, not well defined. On examining hirm after admission, found his tongue a good deal coated; pulse, 104 ; temp. 104 2-51. A good deal of tenderness in right illiac fossa, where no swelling was detected. Ordered a draught of Liq. Morph., and a linseed poultice over abdo- men. Jan. i9.-This morning found him very uneasy with pain in the region of bladder and extending down into testicles, and a great tenderness in sanie region, and frequent desire to micturate, but passing small quantities of urine, which.",
         "HOSPITAL REPORTS. was very dark and with no dsposit. Pulse 96, and -soft; temperature 1oi0. Poultice to be continued, and the draught if necessary Towards night the pain and tender ness was becoming excessive, and he vomited several times. The symptoms of geùeral Peritonitis were now evident. I stopped the mixtdre, and ordered pulv. opii. gr. i. every three hours, and gave him at the time a hypodermic injection of gr. 4 of Morphia. Evening temperature was 1020 ; pulse 120, short and sharp. 2oth.-Morning temperature 101° ; pulse, 130, very wiry; expression of countenance very anxious ; cold sweat on his forehead ; vomiting worse, vomited matter being yellowish green. Tenderness of abdomen very great, and abdominal walls very hard; could scarcely bear the weight of poultice. I now gave him instead of opium, by mouth, Morphia gr J, hypodermically every two hours ; ordered a sinapism to epigastrium, and ice by mouth with milk, which had been his only diet throughout, in small quantities frequently. At i p.m., Dr. Fenwick saw him, and ordered cham- pagne by mouth, but made no further change in the treat- ment. His arms were now cold up to the elbow. The champagne he sometimes retained, and sometimes rejected. Towards night I gave him Sod. Bicarb. grs. 5, and Acid Hydrocyanic dil mij every two hours, and continued the morphia injections every 2 hours. Temperature this evening 99 2-5° ; pulse 140. 21st.-Towards morning he vomited very little and slept some. Temp. 198 2-5° ; pulse 140. His pupils, notwith- standing all the morphia he had taken, were not very mucli contracted. Through the day he became at times slightly delirious and would attempt to get out of bcd, but was easily quieted. At 5 p.m1,, just after I had left the ward, he sud- denly became furiously delirious, could scarcely be held. Snapped at my hand with his teeth. At the same time his pulse became almost imperceptible and his pupils widely dilated. After a furious paroxysm of about two minutes, he sank back and died at 6 p.m. 355",
         "356 CANADA NIEDICAL AND SURGICAL JOURNAL. AUToPsy 36 hours after death. Found a quantity ofpuru- lent fluid in the cavity of the peritoneum, and signs of inflammation of. this membrane all over it, particulary in the neighborhood of right illiac fossa, where the intestines were covered with a very thick layer of fibrinous exudation. appendix vermiformis was adherent to* the wall of abdo- men, where there were the remains of a small abscess. On detaching the appendix found a sloughy perforating ulcer about the middle of it, and the lower half black and gan- grenous. Just above the ulcer could feel a bard mass about the size of a bean. This mass when examined was found to consist of layers of what appeared to be liard fæcal matter, with a hard, gritty nucleus about as large as-a split pea, which effervessed on the application of an acid. There was great venous conjestion of the membranes of the brain, which itself appeared normal. SHERBROOKE, Jan. 22nd, 1876. To the Editor of the Canada Medical and Surgical Journal. SIR,-I send you for insertion in the JOURNAL the fol- lowing paragraph from a letter written by a Medlcal Prac- titioner in the Eastern Townships, and published over his signature, in the columns of a local newspaper of large cir- culation. Being so published I think I am right in regard- ing the suggestion it embodies as professional property. \" Within a short time it has, I find, been industriously rum ored that at the time of the accident which caused his death, Mr. C. was intoxicated. Now, I can nost positively assert this is not the case ; I was the first medical man who saw him and dressed his wounds, and in order to convince myself of the nature of the injury the brain had evidently received, I carefully examined (twice) the patient's breath, and though I am glad to say my sense of smell is patricularly acute, I was unable to detect the slightest trace of alcoholic flavor.\" I have heard of\" smelling a mice,\" but I never heard of",
         "REVIEWS AND NOTICES OF BOOKS. any of the great Fýthers of Medicine, suggesting the examination of the breatih, in order to ascertain the nature of an evident inýjmny of the brain ! It was reserved as the crowning glory of the last days of 1875 to promulgate, thus modestly, this inestimable discovery. The idea is an original one, and deserves to be carefuily examizied ( twice ) 1\" Of course a particularly acute sense of smell is indispensible ; to ascertain the exact nature of the brain inj ury,and to distinguish between it-and alcoholic \"fiavor ! I am, \u0026c., E. D. WORTHINGTON. MCVIIV5and 1O'ti(C~. ,of -ffl s A Practical Trcatise on Fractures and Dislocations. By FRANK HASTINGS HAMILION, A.M., M.D., LL.D., Surgeon to the Bellevue Hospital, New York, Consult- ing Surgeon to the Hospital for ruptured and cripples, \u0026c., \u0026c. Fifth edition, revised and improved ; illustra- ted with three hundred and forty-four wood cuts ; 8 vo. pp. 831. Philadelphia, Henry C. Lea, 1875. This treatise first saw light in 186o, and since that period has deservedly occupied a promineht position as an'athority on the subject of Fractures and Dislocations. It is undoubt- edly the most reliable treatise on this subject in our language. Throughout it will be seen that the author has been a care- ful and painstaking observer, a faithful and conscientious seeker after truth, The record he publishes is an accurate and unvarnished tale. In keeping before the professional vorld this very excellent treatise, the author has been no idler, the subject has been to him one of more than ordinary interest, and from what he has produced we judge that much time has been devoted to the sulject. It is no mere book compilation, while the author gracefully gives to",
         "358 CANAÏDA MEDICAL AND SURGICAL JOURNAL. others their proper share of recognition, he at the same time records the observations he has himself made both in hospital and private practice. The present edition has been considerably enlarged and has received an addition of twenty two illustrations on wood. The author has brought the work down to the present time, embodying many observations of practical surgeons, both European and American. , In his report the subject of the diagnosis, and treatment of fractures and dislocations has received some modifications. Dr. lamilton very properly remarks that \"there remains much to be accomplished, so much indeed, that no one who thoroughly understands the facts, and feels an iriterest in this branch of our science, will rest satisfied with what has. been done, and hereafter cease to labor.\" ' Indeed the per- fection in aparatus for the treatment of fractured bones has not been fully attained, nor is it attainable, although mechanical skill has done much* to the imprrovement of aparatus for these lesion. To the practical surgeon this work is an indisputable necessity, its teaching is reliable, and the style plain, clear and very readable. The Histology and Histochenistry of Man. By H ETNRICH FREY. Translatedfrom the fourth German edition by ARTHUR F. J. BARKER of Dublin. With 6o8 illustrations. 8vo., pp. 683. Appleton \u0026 Co., New' York. This is another of the many valuable translations of German medico-scientific works that bave within the last five years issued from the English and American press. The author, Prof. Frey of Zurich, is well and widely known as an able and original investigator in Histology, and for some years past German students have had the advantage of two excellent nianuals from his pen. One of.these, \" The Microscope,\" also translated into English, is a coni-",
         "REVIEWS AND NOTICES OF BOOKS. plete hand-book of microscopic manipulation, entering fully into all the modern methods which have aided so much in the advancement of the science, and is nioreover copiously illustrated. The other, the subject of the present notice, -deals only with -the chemical and histological elements of the body and the, structure of the compound tissues, giving an exhaustive account of each, without touching upon the details of preparation. The work opens with a short history of the origin and progress of microscopical science, containing useful refer- ences to the chief investigators and their wo-ks. The consideration of the elements of composition is first taken up, a description of the members of the different groups being given in order. This part of the volume wýil1 be specially welcome to English students, as it contains a short plain account of the various organic chemical com- pounds, accompanied, where needed, by excellent figures.. There is nothing calling for particular comment in this section; the views given are those current among physio- logical chemists, and the author has wisely refrained from recording any but the essential facts relating to the subject. By far the largest portion of the book is occupied with an account of the elements of structure and of the tissues of the body. A description, one of the best we have ever read, is first given of the cell, its modifications, characteristics, and methods of increase. The subject of the blood receive-s the consideration that its importance demands, and is treated physiologically as well as histologically, the process of coagulation being fully described, and an excellent account of the developmrent of the corpuscles given. The tissues of the body are then taken up in order, full justice being done to each. The explanations are clear. the figures abundant and very well executed. The section relating to the structure of striped muscular fibre contains references to the numerous recent theories, and the illus- 359",
         "CANADA MEDICAL AND SURGICAL JOURNAL. trations are remarkably good. We are glad to see that, with very slight modifications, the views of Mr. Bowman are adopted. The organs of the body are considered last, and dealt with in the same admirable manner. The kidneys receive particular attention, and this portion of the work is pro- fusely illustrated. With reference to the wood cuts we may remark that there is a great deal of needless repetition. Many of tbem occur two or three times, and in the description of the lymphatic glands we actually have within eight pages four duplicate figures, two of which face each other. The work as it stands is the best text-book of Histology we now possess, and one we can cordially recommend to those wishing to acquire a thorough knowledge of the science. SURGERY. The Sequel to a Case of Excision of the Two Principal Yoints of the Upper Extremity. By WILLIAM MAC- CORMAc, F.R.C.S., Surgeon to St. Thomas's Hospital. In the Medico-Chirurgical Transactions for 1872, vol. 55, will be found some particulars of, I believe, an unique case, in which, during the war of 1870-71, I performed resection of the shoulder and elbow-joints in the same arm. The'\" patient, a man called St. Aubin, was one of the corps Chasseurs d'Afrique, the third regiment of which took an active part in the battle of Sedan, under the command of the 1Marquis de Galliffet. St. Aubin was shot both through the shoulder and.elbow of the right arm, as well as receiving a bayonret-thrust in the face. I performed second- ary resection of the injured joints twelve days afterwards, removing a large quantity of bone. Eighteen, months sub- 360",
         "CASE 'OF ST. AUBIN. sequently, I was able to describe to the Society the then condition of the limb in the following words. \"The elbow is thoroughly healed, and the ulna so far reproduced that there is scarcely any appreciable deformity or loss of shape in the joint. He can flex and extend it, and also pronate and supinate the forearm. The power of the hand is being rapidly and completely regained,\" The shoulder was not, however, in so satisfactory a condition, as the upper part of the humerus had become necrosed. St. Aubin wrote to me from time to tite, and told me it was proposed to remove the dead bone, but he wished me to perforn the operation, I therefore invited him to come over and be a patient in St. Thonas's HIospital, which he did. When, however, I arran- ged.to extract the sequestrum, he alleged violent home sick- ness, and returned abruptly to France-taking, in fact, French leave of us. At the end of the communication. already quoted from, will be found the following sentence. \"I can entertain no doubt that, as soon as the necrosed piece of hunerus is removed,the sinus in the region of the shoulder will close, and the usefulness and power of the linb become greatly increased.\" This forecast has recently received a gratifying realisation, as shown in the acconpanying trans- lation of a letter on the subject, which M. Serazin, under whose able care the man has lately been, has very kindly sent me.* \"I wish to complete, in a few words, the case of St. Aubin, related in your Recollections of an Ambulance Sur- geon, translated by Morache. This man was sent to me to Bourges sone weeks ago by my friend General the Mar- quis de Galliffett. I found, in the upper third of the arm, at the outer border of the biceps, a fistulous opening leading to a cloaca, whence flowed an abundant and' fœtid suppuration, kept up by a sequestrum. This sequestrum appeared immovable ; but, considering the nature and duration of the lesion, it was evident this immobility was * St. Aubin wrote me at the same time to express his gratitude in a hand writing which excited my envy. saying, he was returning home the following day, a cured man, and prom- ising to send me his news every New Year's morning. 361",
         "CANADA MEDICAL AND SURGICAL JOURNAL. only apparent. The lower part of the arm was red and swollen. I made an incision of 8 centimètres (3½ inches) along the outer border of the biceps, which allowed a trephine to be applied twice to the surface bone below the cloaca, and when the window thus formed was trimmed with the gouge, a sequestrum 11 centimètres long (4î in.) was withdrawn. It formed an osseous tube, bevelled obliquely at both extremities, rough on its surface, perfor- ated in places, and formed of the internal layers of the compact tissue of the shaft. A glance suffices to show that the sequestrum is the result of a suppurative myelitis, which has probably caused the death of the inner layer of the diaphysis throughout the greater part of its length; for, as St. Aubin says himself, a sequestruin quite similar in appearance, having the form and dimensions of a pipe Belge, was 'extracted some months before at Bourbon Lancy, and this presented, at its upper extremity, the traces of having been cut with a saw. The result of my operation has been most satisfactory. At present, the suppuration is insignificant and free from odour. I believe that this courageous fellow is for the future free from any chance of surgical interference ; and he preserves, thanks to you, a very useful (forte utile) arm.-SAZARIN, Ex-Pro- fesseur Agrégé de la Faculté de Strasbourg, Médecin en Chef du Huitième Corps.-Bourges, Dec. _ ith, 1875.\" I need only, in conclusion to this very interesting com- munication, echo the belief of Professor Sazarin, and express my sincere hope that this really brave fellow will, for the rernainder of his life, enjoy, as he well deserves, the advantages of a useful limb.-British Medical /ournal. Ovarian Tunoutr; Tapping; Inflammation of t/le Cyst; Ovariotomy; Rapid Recover. (Under the care of Mr. JOHN CLAY.) QUEEN'S HOSPITAL, BIRMINGHAM. The following case, for the notes of which we are in- debted to Mr. J. Spofforth, resident obstetric assistant, is interesting as illustrating-first, the liability of the occur- S6 2",
         "OVARIAN TUMoUR. rence of inflammation of the cyst after the operation of tapping ; and, secondly, the comparative safety of ovario- tomy after the supervention of inflammation. It must, however, be borne in mind that this case, and others like it, are exceptional, and must be regarded as such-that is to say, the fact that inflammation may occur after tapping is not an indication that the major operation of ovariotomy should in such cases be practiced in the first instance. - A. S-, aged fifty-two, widow, was admitted on Nov. 9th, 1875. The, patient, always enjoyed good health until the present illness. She has had three children, the youngest nineteen years of age, and no miscarriages. Menstruation was regular till two years ago, when it ceased. About eighteen months before admission, while in the en- joyment of perfect heaith, she perceived a small iiiùvable substance in the right iliac region: This swelling, however, she said, disappeared. In February, 1875, she had a some- what sudden attack of severe pain in the right side of the abdomen, for which she obtained medical advice. After this the abdomen rapidly enlarged, and an ovarian tumour was diagnosed. In August this tumour was tapped by her medical attendant, and a pailful of clear, gelatinous fluid withdrawn. Towards the end of October, the abdomen had .become as large as when tapped, and she applied for admission into the hospital. When admitted she was emaciated, the face was'pinched and of an anxious expression; she complained of anorexia and nausea, difficulty of breathing, a constant cough, and edema of the lower extremities. The abdomen was enor- mously distended, the superficial veins enlarged, the surface smooth and uniform, and there was tenderness on pressure in two or three spots. There was dullness on percussion in front, and resonance in the flanks, with distinct fluctua- tion. The fluctuation could be felt within a number or limited areas only, which showed the cyst to be compound. The abdomen measured at the umbilicus 41½ inches, and two inches above this 40o inches in circumference ; from 363",
         "CANADA MEDICAL AND SURGICAL JOURNAL. the umbilicus to the ensiform cartilage 81- inches, to pubes ii inches, to right anterior superior spine 12 inches, to left anterior superior spine 13 inches. Urine was healthy, sp. gr. 1030. A vaginal examination proved the uterus to be of its natural size. slightly drawn upwards, and anteflexed. Temperature of body normal. On Nov. 17th she was again tapped, and 16o ounces of straw-colored gelatinous and alkaline fluid of sp. gr. 1021, removed. Subsequently the chest symptoms were much relieved, and the ædema of the legs disappeared, but she complained of an acute pain in the right iliac region, and of great tenderness on pressure. The abdomen again became distended to about the same size as on the 17th, before she was tapped, The pulse became more frequent, and the temperatüre increascd. Suspecting inflammation of the cyst, Mr. Clay deemed it advisable to remove the tumour as soon as practicable, and on Nov. 27th the operation was performed. Ether having been administerèd, an incision was made five inches in length, below he umbilicus, in the median lne. There was considerable hæmorrhage from some superficial veins, but it vas arrested before the peritoneun was opened. The walls of the cyst were very thin, and gave way unIer the traction made by the hooks of Wells's trocar. The patient was then turned on her side, and the fluid evacuated by pressure on the abdomen. After securing' the slight adhe- sions that existed on the right side and in front, the pedicle, about four inches in length came into view, was fixed with a clamp, and cut. A large cyst remained, which gave way, whilst being withdrawn with the vulsellum forceps, and its contents, about 18 oz. of purulent fluid, escaped, but fortu- nately, owing to the patient being on her side, none was allowed to enter the peritoneal cavity. The tumour was then freed from the remaining adhesions, and easily with- drawn. The tumour proceeded from the right ovary. The wound having been closed with deep- and super' 364",
         "MUSCULAR ATROPHY. ficial sutures of silk and wire respectively, the patient was removed to bed. Reaction was slowly established, and she was several hours before she recovered from the effects of the ether. The pain, occasionally, very severe, was soon relieved by morphia administered hypodermically. It is not necessary to record the daily progress of the case. The temperature only on two occasions exceeded. ioo\" F., and the pulse averaged about 90 per minute. There was cystitis and incontinence of urine, so that, in spite of every pIrecaution, a small bedsore formed over the sacrum on the tenth day, but as the patient was able to lie on her side, it gave but littie trouble. She was well enough to sit up on the fourteenth day, although it was deemed advisable to delay doing so till the seventeenth. The cyst weighed 2 lb. 173 oz., and the fluid contents: whicB during the operation had been evacuated measured 250 oz. It was multilocular, consisting of two large cysts, with a dense mass of smaller ones. The largest cyst con- tained a quantity of purulent fetid fluid, with flakes of lymph of a dirty yellow color; its wall was thin, injected, very lacerable, with severai hmrrhagi p s oits. surface.-The Lancet MEDICINE. On Professional Muscular Atophy. By DR. E. ONIMUs, Laureate of the Paris Academy of Sciences, member of the Paris Society of Biology, etc. Activity of muscles determines the development and' energy of muscular fibres, and the general law is that the more a muscle works the larger and the more powerful it gets. This law, however, has its limits, and I have just observed a certain number of cases in which the exaggerated work of certain muscular groups, far from producing hyper- trophy, induces, on the contrary, a condition of consider- able atrophy. These cases are observed only in individuals who, through",
         ":366 CANADA MEDICAL AND SURGICAL JOURNAL. the nature of their trade or work, are obliged to contract ,the same muscles constantly. Through excess of activity, irritations of the muscular fibres supervenes. Thus, in a man employed in a draper's establishment, and whose business was to replace the unfolded goods on their shelves, their supervened, little by little, a most remarkable atrophy of the deltoid muscles of both sides. And, indeed, it was these muscles which were constantly actively employed in performing this special work. In a workman emyloyed in a tannery, who was every day for eleven hours at work, and always felt aching and fatigue after his day's labour, there likewise supervened marked muscular atrophy, confined to certain muscles. In order to prepare the skins, he was to perform with both arms a forward and baekward movement, which necessitat- cd especially the action of the muscles of the shoulder, so ýthat thes'e were the first to bei'ffected, and are at present -almost completely atrophied. The wasting away is almost the same in both arms, as both were in action during the man's work, whereas, in respect to the legs, the right one ,alone was obliged to support the whole weight of the body. Consequently, with the lower limbs, the right leg is the only one that has wasted ; it is one-half smaller than the other, and the affected muscles are those the action of which was ,the most constant, -such as the rectus femoris, vastus externus, and vastus internus. . In the beginning, the patients complain especially of prostration, of weakness even in the morning on getting -out of bed. They feel-particularly at the outset of the disease-intense, darting, intermittent pains. Before *atrophy is well-marked there always exists more or less temporary contraction of the muscles. When wasting has once begun, it follows a most rapid ..course if the patient continues to fatigue his muscles. Almost always this affection is mistaken for progressive * muscular atrophy, but it difiers from it in its course and in .,a great many-symptoms. Ist. The musclcs which are the",
         "GELSEMINUM SEMPERVIRENS first to be affected are generally the largest ones, and par-- ticularly those in the neighbourhood of the shoulder-joint. 2nd. The pain and cramps at the.outset are also a distinc- tive sign. 3rd. These cases of wasting amend rather- rapidly under the influence of.rest and the use of constant: and continuous electric currents. Recently I observed one case which it was not difficult to differenitate from progresssive muscular atrophy, as the- atrophied muscles were the same as those which are the first affected in this latter affection. They were the muscles of the thenar eminence, and chiefly the adductor pollicis. The patient was an enameller, who had to hold an object all day between his thumb and index-finger. He first got cramps in the thumb, which suggested the idea of scrivener's palsy, then tremor of the thumb, on account of the fibrillar contractions, and, lastly, atrophy. Under the influence of treatment there was a rapid amendment, which showed that the case was really one of professional muscular atrophy,. and not commencing progressive muscular atrophy.-Tze- Lancet. On Gelseiniuim . Semnpervirens. By SYDNEY RINGER, M.D.,. Professor of Therapeutics at University College ; and WM. MURRELL, L.R.C.P., M.R.C.S., Demonstrator of Physiology at University College. This powerful drug has long been employed in America,_ and a few years ago was introduced into this country as a. renedy for neuralgia by Dr. Wickham Legg. lis state- ments have been amply verified by Dr. Sawyer, Dr. Mackey,. Dr. Spencer Thompson, and others. It is said to be espe- cially useful in non-inflammatory toothache and in neuralgia. in the nerves supplying the.teeth and the alveolar processes of the jaw. In. large doses it produces general paralysis.. Several cases of poisoning are recorded, some ending fatally. We extract fromthe Proceedings of the American Phar-- maceutical Association (vol. xxi., 1873) the following ac--",
         "368 CANADA MEDICAL AND SURGICAL JOURNAL. count of the effects resulting from a toxic dose:-\" The symptoms by which its effects manifest themselves in the animal economy seem to indicate that its energy is primarily exerted on the cerebro-spinal centres, and secondarily on the respiratory apparatus and the heart, the functions of the former ceasing before those of. the latter. 'The motor nerves of the eye are attacked first ; objects cannot be fixed, dodging their position ; the eyelidsbecome paralysed, drop ,down, and cannot be raised voluntarily; the pupils largely .dilate ; there is a feeling of lightness in the tongue ; it as- cends gradually to the roof of the mouth ; pronunciation becomes slurred; then the extremities refuse to support the body, and erect motion without support becomes impos- sible ; the pulse gradually becomes more frequent, rises to 120 or 130 and more beats pcr minute, is small but-regular; respiration then becomes laboureci, the mind remaining clear, however. This state will set in about an hour and a half after the ingestion of an overdose of the drug. All the symptoms will disappear after about two hours, leaving no unpleasant effect or derangement of the organism.\" In many cases of poisoning the patients have complained of double vision, and dimness, even loss of sight, and the breathing is slow and sometimes irregular and shallow. In the Practitioner for October, 1870, Dr. Roberts Bar- tholow published an account of some experiments made on frogs, pigeons, and cats. He concludes that gelseminum (a) acts chiefly on the motor portion of the cord ; (b) its paralysing effect is due to its action on the motor centre, and not to an action on th e peripheral nerve fibres ; (c) it acts also on the sensory portion of the cord, producing at last complete anoesthesia, but this effect in warm-blooded animals and in man is toxic only, and follows the paralysis of the motor functions. As this drug is now attracting considerable attention in this couutry, and has been largely used in America for fevers, including ague and influenza, hemicrania, sperma- ;orrhœa, dysmenorrhea, \u0026c., we were induced to make these",
         "GELSEMINTJM SEMPERVIRENS. investigations, vhich will be seen in many respects to cor- roborate the conclusions of Dr. Roberts Bartholow. At first we used the liquid extract prepared in America, which contains some spirit, but afterwards the alkaloid dissolved in water, extracted by Mr. Gerrard,.teacher of Pharmacy at University College. We now proceed to give a short general account of the effects produced by the drug on a frog. A medium-sized German frog was injected with the drug in the neighbourhood of the posterior lymiph hearts. In this, as in all our èxperiments in which injections were given, special precautions were taken to ensure cleanliness of the apparatus, and freedon from contamination by other drugs. Soon after the administration of the drug the ani- mal became extremely apathetic, and it was found that there was considerable impairment both of voluntary power and reflex action. When placed on its back the frog made no attempt to assume its normal position for a minute or two, and then slowly turned over, often, however, stopping half- way and lying motionless on its side. On touching the eyes they were chsed, but some minutes elapsed before they were again opened, and even then the movement was per- formed with abnormal slowness. The loss of voluntary power and reflex action gradually increased, and the ani- mal soon became perfectly motionless. When placed on its back no attempt was made to turn over. The whole body vas limp and flaccid, and the limbs remained in any position in which they were placed, cither flexed or extended. On pinching firmly any part of the body, a very feeble and in- effectual attempt to escape was made, the animal in its un- availing efforts, falling over on its back or sides. The ap- plication of the poles of the battery to the limbs excited, in addition to the muscular contraction, faint reflex move- ments. Pari passu with these changes in the nervous system, the breathing became hurried and superficial, and as the paralysis increased, the respiratory movements be- came more and more shallow, and, finally, with the total 369",
         "370 CANADA M.EDICAL AND SURGICAL JOUlNAL. abolition of voluntary power and reflex action, entirely ceased. The heart continued beating for a. considerable time after the cessation of the respiratory movements. The rapidity with which these symptoms presented them- selves, and the ultimate termination of the cases, varied with the dose administered. Thus twelve minims, of the liquid extract injected under the skin of a large frog pro- duced such an impairment of voluntary power thàt in three minutes the animal was unable to turn over, and in two and a half hours death ensued. In doses of five minims or less, some hours usually elapsed before the establishment of complete paralysis, and the animals frequently remained alive, but perfectly helpless for many days. In one instance, in which a five-minim dose had been given, life was pro. longed until the tenth day. Towards the close of this period there was considerable improvement both in voluntary power and reflex action ; the effects of the drug appeared to le passing off, and hopes were at one time enter- tained of the ultimate recovery of the animal. A five minim doFe of the 2 in 20 solution of the alkaloid gave rise to decided symptoms cf poisoning in four minutes, and in five minutes later the full effects of the drug wereexhibited. With some frogs there occurred for a short time a pecu- liar mixed state. Thus, soon after voluntary and reflex power was completely abolished, on irritating one of the limbs, the hind extremities were sometimes shot on;t, and all their muscles, with those of the back contracted. This happened only occasionally. Thus, generally, on applying the electrodes to an extremity, only the muscle touched contracted, and none others ; but sonietimes there ensued the tetanoid condition just described; in a few minutes this ceased. With other frogs there occurred only a slight tremor of some of the muscles of the legs, chiefly those of the thigh. This tremor was at once excited by moving or jerking the body. It was apparently caused by the suc- cessive contraction of the muscles of the limb, giving rise to a peculiar flickering, which was readily perceived through",
         "GELSEMINUM sEMPERVIRENS. the skin. Supposing these phenomena to be due to the: influence of the drug, they must be caused by its action on the spinal cord, for they occurred in the posterior extremities after ligature of the abdominal aorta.. Another circumstance also attracted our attention. When the electrodes are applied over the lower part of the spine of a live healthy frog, the hind legs are shot out much in the manner before described. Now it appeared to us that after poisoning by gelseminum the posterior extremities were more forcibly extended, and remained so for a longer time. We then performed the following experiments to as- certain whether gelseminum paralyses by its effect on the brain, the cord, the motor or sensory nerves, or the muscles. The paralysis of reflex and voluntary power is certainly not due to the action of the drug on the muscles; for after poisoning, on galvanic stimulation the muscles contracted as energetically as those of an unpoisoned animal ; more- over, on several occasions we tied the abdominal aorta or the femoral artery and vein, and twice we severed the thigh, leaving the leg attached to the trunk only by the nerve, and then poisoned the animal, and we found that the muscles subjected to the action of the gelseminum con- tracted as energetically and retained their contractility as long as the muscles protected from the poison by ligature or section of the vessels. Neither is the paralysis due to the action of gelseminum on the motor nerves. This, indeed, is proved by the ex- perimentsjust mentioned, which we now proceed to describe more fully. We tied the femoral vessels on several occa- sions, and twice we cut through all the structures of the thigh, except the nerve, which alone connected the severed leg with the trunk, and then poisoned the afiimal by in- iecting the drug under the skin of the back, in the neigh- bourhood of the lymph sacs. The paralysis occurred as soon, progressed as rapidly, and became as complete in the iimb protected -by ligature or section from the action of the",
         "CANADA MEDIOAL AND SURGICAL JOURNAL. poisoned blood as in other parts subjected to the influence of the poison. After complete paralysis we found that the nerves unprotected from the action of the poison conducted as freely as those protected by ligature or section. These experiments show that the poison does not act by its effects on the ends of the motor nerves ; but the trunks of -the nerves in the abdomen, and above the ligatuie in the thigh might be affected, and the paralysis produced in this way. We therefore on three occasions ligatured the abdominal aorta, just above its bifurcation. and then poisoned the animal in the manner described, and we fou'nd the paralysis progressed in the hind protected limbs as in the anterior, and as in the case of frogs whose hind limbs are unprotetced by ligature of the aorta. There remain, then, to consider the brain, cord, and the afferent nerves. We shall treat of the loss of reflex power separately froni that of voluntary power. It is obvious that the destruction of reflex power cannot be due to the effect of the poison on the brain, and as it is not due to the para- lysis of the motor nerves or muscles, it must depend on paralysis either of the afferent nerves or the cord. It is not due to the paralysis of the afferent nerves, for after tying the abdominal aorta before administering the poison, and thus protecting the hind extremities from its effects, we could not excite reflex action by galvanic stimulation of the hind legs. It therefore appears that gelseminum abolishes relex action by its effect on the cord. Does it thus affect the reflex function by its direct action on the cord, or indirectly by stimulating the inhibitory centre for reflex movements ? It does not act through Setschenow's inhibitory centre; for, firstly, the abolition of reflex function is too complete to be produced in this way, and, secondly, after producing-complete loss of reflex action, we beheaded the frog, and so divided the cord below the in- hibitory centre, which is situated in the neighbourhood of the optic lobes, and yet the loss of reflex.power remained as. complete as before. We therefore conclude that gelsemi- 372",
         "GELSEMINUM SEMPERVIRENS. num destroys refezpower by its dirret action on the spinal cord. We have next to explain how the loss of voluntary power is produced. 'We have shown that the paralysis is not due to the effect of the drug on the muscles and motor nerves, and it is obvious that the loss of voluntary power cannot be produced by paralysis of the sensory nerves. It must there- fore be due to the action of the gelseminum either on the brain or the motor tract of the spinal cord. We have no experiments to decide this question, but we offer the follow- ing reasons in favour of the view that it acts through its influence on the cord :-(a) The loss of voluntary and reflex powerproceedparipassu. (b) The abolition of reflex power being due to the effect on the cord renders it to sone ex- tent probable that the loss ofvoluntary power also depends on affection of the cord. (c) In the case of accidental poisoning where the voluntary power was so complete that the patients could not move a muscle could not even raise the eyelids, it is recorded that on recovery they asserted that their consciousness was not at all affected. It nay be said that if the loss of voluntary power is due to paralysis of the motor tract of the spinal cord, it should not conduct electric impression.s But we may remark that a great difference of opinion exists among physiologists respecting the conducting power of the cord of electric irritation, and it appeared to us therefore unnecessary to perform .this experiment. We have scen that the afferent reflex. nerves are para- lysed. Are the sensory nerves affected ? If the sensory nerves are also the afferent reflex nerves (the view generally held by physiologists), the, question of course is answered in the negative. Still we suppose that though some afferent nerves may have this double function, yet there are others which are simply sensory. Are these paralysed, or are the sensory perceptive centres paralysed? In other words, does gelseminum destroy sensation as some writers have sup- posed, and if so, does it act on the sensory nerves or the 373",
         "374 CANADA 3mEDICAL- AND SURGICAL JOURNAL. sensory tracts of the cord, or on the sensory perceptive centre? These experiments do not enable us to answer. these questions, but we may state that as long as voluntary movement remained, the frog seemed to feel pinching and galvanic stimulation, for on the application of either kind of irritation, the animal made voluntary efforts to escape, though after paralysis was marked it required'considerable pinching to induce voluntary movement. Was this due to defective feeling or from the paralysis requiring a greater effort to cause movement ? We shal return to the effect of gelseminum on sensation, when we treat of its effects on man. The foregoing experiments prove that gelseminum abolishes reflex, and probably voluntary, movement by its influence on the spinal cord. It may, however, in addition, to a slighter extent, and late in the poisoning, affect the motor nerves. This is the case with Calabar bean, which paralyses the spinal cord, but also slightly the motor nerves. To learn whether gelseminum in any way depresses the motor nerves, we performed the following experiments on three frogs. We tied the iliac artery, and then poisoned the animal; and, after the loss of reflex and voluntary power, we tested at frequent intervals the conductivity of the sciatic nerves to electric stimulation, and we found that the gradual loss of the power of conduction was equal in the two nerves, but that after some time the nerve protected from the action of the poison required a rather stronger current than the unprotected nerve, due, perhaps, to di- minished nutrition from.arrest of the circulation. Hence we conclude that probably (for our experiments are not numerous enough to settle absolutely this question) gelse- minum exerts no influence on the motor nerves. We may here state that in each experiment in which an artery was tied we ascertained by a post-mortem examina- tion that the operation had ·been successively performed. -The Lancet.",
         ". QURANTINE APTER PUERPERAL FEVER. On the Duration of the Qztarantine iequired after Puerperal Fever. By J. BRAXTON HIcKS, M.D., F.R.S., Obstetric Physician to Guy's Hospital. It has been asked in the Britishli fedical 7ouinal, and I have also been frequently and earnestly urged in the same direction, that an opinion should be authoritatively pro- nounced, for a guide to the profession generally, as to the length of time an accoucheur should abstain from midwifery practice after attending a case of puerperal fever. It has come to my knowledge, from several sources, that somehow the public have acquired an idea that it requires tlree months' purification before a niedical man is fit again to attend confinements. From whence this idea has origina- ted I am at a loss to understand ; no statement ofthekind can have originated from the profession., Indeed it is self- evident that midwifery practice wouid not be possible on such a basis. If we suppose the same rule to exist after all cases of zymosis, the impossibility of practice is clear. It is possible, indeed I think it highly probable, that assisted, by the manipulation of midwifery, contagia would continue for a longer time influential than is usually observed in the attendance on the ordinary zymotic diseases. Yet the dif- ference cannot by any means be so great as is indicated by fixing the time at three months. It does seem to me, therefore, verydesirable to have some kind of rule as to the time, which on the one hand, would secure our patients from risk ; and, on the other, would serve as a protection to our profession from the extravagant demands of the unlearned. And, indeed, there is another point very important to the public, namely this: that if the quarantine extends beyond a practicable time, women vill find a difficulty, and, perhaps, an impossibility, in obtain- ing aid in their hour of trial. I am not now alluding to the time required in those rare cases where puerperal fever haunts a practitioner for months ; these though well authen- ticated, are very rare ; our rules. for every day life are not based on exceptions,.but on ordinary conditions. 375",
         "376 CANADA MEDICAL AND SURGICAL JOURNAL. The speakers in the recent debate at the Obstetrical Society, while admitting that there should be an interval, have not fixed its duration ; except the President in his late address to the Society, when he expressed his opinion that a week should elapse after the last day of atterndance on a single case ; but, in the event of a series, thén a month. The readers of the Yourtal could, therefore, render no more valuable service than by communicating in its columns facts bearing upon this very practical question. For myself, I have always held three weeks' abstinence and purification to be the best approximation to the re- quirements of the case,*giving ample time, probably more than actually necessary, to discharge the poison from the system and clothes. I am indebted for this belief to my teacher and predecessor in the chair of midwifery at Guy's, the late Dr. Lever. The soundness of this advice bas been borne-out by long experience over very large fields of observation ; for I am not aware that it has been found to fail to cut off the spread of the disease, if we except those rare instances above-alluded to, which probably have their origin in some conditions to which the medical man is ex- posed unknowingly in his house, etc. Three weeks may be thought too much by some ; but if a rule is to be laid down, it must cover all reasonable contingencies ; for when we bear in mind that in an attendance on a case lasting, say a week, with frequent and prolonged visits, manipula- tions, washing out of uterus, the hands and clothes become saturated with the contagium, we could scarcely expect to evolve this wholly in less than twelve or fourteen days; and, 'therefore, an extra week does but give a complete security in the matter. There is also another view ; the extra week of obligatory rest from heavy midwifery practice is beneficial to the medical man, liarassed and depressed as he would be after continuous attendance on these distress- ing cases. Of course, the state of the weather makes much difference as to the time during which contagium lingers on the clothes. No doubt a brisk walk in a gale,",
         "oATÉETERIZATION OF THE EUSTAHIANTUBE. with a thorough drying of the clothes before a fire, coupled with a brushing afterward, will, if the visit be short, pro- 'bably go far to remove the poison ; yet it would be univise, as a rule for every case, to act on this view. Taking everything into account, I would give it as my opinion that, if three weeks' abstinence be adopted as a rule after the last day of attendance, the medical man should be held to have adopted all reasonable precautions, and not to be guilty of culpable carelessness.-British Medical Journil. A New Methiod of Dilating the Eustackian Tube and Venti/ating the Cavity of Mhe Tympanum. Prof. Gruber, of Vienna, has recently made public a new -means of obtaining the good effects of catheterization of the Eustachian tube without incurring any of the difficul- ties or dangers of that operation. Prof. Politzer has, as is well known, devised a method having the same object in view. The patient holds some water in his mouth; he introduces into the nose the end-piece of a kind of syringe made for the purpose, and holds it in the nostril air-tight with one band. He then swallows the water, and at the command of the surgeon injects the air in the syringe into the nasal cavity and onwards. Air can by this means be driven into the Eustachian tube. Lucœ proposed toeffect the same result by replacing the swallowing of water in Politzer's experiment by directing the patient to pronounce the vowel a (as in father) and then injecting air. Prof. Gruber finds that pressure of the root of the tongue against the most posterior. part of the palate during a strong expiration presses the soft palate upwards and backwards and thus completely closes the fauces, and thus the exit of air through the nose and mouth is entirely prevented. This requires, however, in some persons a little more care than in others, and consequenitly,- instead of a simple expiration, it is often desirable to make the patient try to 317",
         "378 CANADA MEDICAL AND BURGICAL JOURNAL. pronounce, during vigorous expiration, the sound kck or kck, introducing between the consonants various vowels, as hack, heck, hick, hock, huck, \u0026c., until the sounci is got which most effectually produces closure. During this manouvre air enters the tube, and the tympanurn will often be felt affected, as in Valsalva's experiment. Prof. G. utilises these facts as follows:-The surgeon places himself before the patient, introduces into bis nose the end of the nose- piece of the syringe, and closes the nostrils over it her- metically with two fingers.,, At the word'of command the patient pronounces one of the syllables (iick, \u0026c.,) as above, and at the same moment the surgeon injects air. It is preceived at once to enter the tube with a distinct sQund, which can be ausculated by the otoscope, and in cases of perforation, produces the usual sound. These and all other signs of the entrance of air into the tube are present, and prove the success of the operation. If the head be bent well to one side during the operation, the upper ear is almost always the one into which the air enters, and it does so more easily than when the head is erect.-- Vide Allg-em. Wien. Med. Zeit., Nos. 42, 5 i.-The Doctor. Bacteria and Septicænia. *In an elaborate experimental paper (New York Medical Record). Dr. T. E. Satterthwaite arrives at the following conclusions: i. Bacteria are certain vegetable organisms which belong probably to the algæe; they are found abundantly in nature, but chiefly where there is moisture. .2. They exist in the body in health, covering the mucous membranes from the mouth to the anus, and sometimes appear to penetrate a certain distance into the system, without causing symptoms of disease. 3.. Theyf also exist in putrefying fluids, and in various disease-processes, occurring in hot and cold abscesses,in the-blebs of erysipelas, and in simple blisters.",
         "THE TEMPERATUaE OF DRUNKARDS. 4. It is doubtful whether the virulent principle of infec- tive diseases is albuminous. 5. This principle does not reside in the perfectly clear fluid -that passes through porous clay. In putrid infectious. .fluids this appears to be certain. The poison is rendered less virulent by repeated filtrations through common filter- paper. 6. The virulent principle may be boiled for hours, fil- tered numbers of times in the ordinary way, boiled with alcohol, and again filtered and dried, and yet the watery extract of such a dry residue will produce septic symptoms. -It is therefore soluble, or at least suspended in water. 7. The liquid which is thus poisonous may be clear to the eye. but contains granules under the microscope. 8. These granules have not produced bacteria in a num- ber of instances when they were placed in a suitable con- dition to do so. 9. We cannot, therefore, feel that satisfactory evidence has been brought to show that, in any of the diseases or processes enumerated, minute organisms are the sole and sufficient causes of'disease.-Medical Times, Pila. The Temperature of Drunkards. The De7utsche Apck. f. Kn., Med., vol. lx., p. 12 con- tains avery important paper by Reincke, of Hamburg, on this subject. In his recent Cantor Lectures on alcohol, Dr. B. W. Richardson referred to the power of diagnosing dead-drunkenness from other causes of coma by the fact that the temperature of drunkards is diminished. Reincke- has found that the internal temperature of drunkards ex- :posed to cold may fall to an extent hardly conceivable. The rectal temperature will commonly fall to 95 deg. F. or -93 deg. F.; it may descend to 82 deg. F., or even as.low as 75-2 deg. F. The subject on whom the last was observ- .ed recovered and regained his normal temperature after 23 hours.--The Doctor. 379,",
         "2180 CANAIA MÉDIoAL NAD SÈÉGICAL JOÙUNAL. local Origin of Cancer. Virchow's Archives, No. lxiv., côitaihs an article by Fredun, of Breslau, on the \" Primitive Seat and Mode of Extension of Pelvie Carcinoiia in Wometi.\" He relates several casés of pelvic carcinoma occurring in virgins or vomen with atresia vaginoæ. In these cases the cervix uteri, which is the commonest seat of the disease, escapes, ,r is only secondarily affected, there being an absence of il' sources of irritation. It is around the rectum or bladder, or in the connective tissue of the cavity of the pelvis that the disease originates in these cases. The author admits the insufficiency of his materials, but his opinion is care- fully stated.- The Doctor. The DiagnQsis of Cerebro-spinal Meningitis. In a recent clinic Dr. Richards remarked that, while pain in the head, vomiting, epileptiform attacks, disease of thë optic discs, emaciation, eruptions, involuntary micturition, were symptoms found in many head-affections, the sudden onset of symptoms, pain in the back of the neck, the stiff- -ness of the muscles of the neck, and retraction of the head, were sufficient to separate cerebro spinal meningitis from hydrocephalus acutus, basilar meningitis, and tumor of the brain, diseases to which, in its symptoms, it was nearly al- lied.-[Phil. Med. \u0026 Surg. Reporter. .ervia-A AVew Alkaloid in Vratruin Vitide. In the Aizer. Your. of Pharmacy for Oct., 1875, Charles Bullock describes the aikaloidjervza, known for a number ,of years as existing in the root of veratrum album, but now found by him in the American species, viride. Its physio- log1cal properties are described by Prof. H. C. WooD, Jr., as producing general weaknëss, without vomiting or purg- ing, lowëriLg arterial pressure and slowing of the pulse\u003e pro- fuse salivatixi, and finally coniulsions6 The character- Of the convulsions is xery peculiar and ve-y constant.",
         "CANADA 'ýMX ld illcd u~a MONTRAL, FEBPVA1Y, 176. CITY SMALL POX HOSPITALS. We have received the following circular from Alderman McCord, Chairman of the Health Committee, and are -happy to be able to announce to our readers that at long last. we are, in this good city, provided with two Small Pox Hospitals, both under civic control. One under the -naagement of the Ladies of the Providence Nunnery, intended for Roman Catholie patients; the other under the charge of a lady of experience, we presume a Protest- ant, and exclusively intended for the Protestant community. Bath hospitals are under the professional care of Dr. La Rocque. This, if we might make a suggestion, could be slightly improved upon. Our French-Canadian fellow citizens have forced upon the city the establishment of two separate and distinct hospitals. We were opposed to sectarian or national distinctions of any kind, and should have gladly seen but one institution, but since we have two we are quite satisfied, and shall second the efforts of the Health Committee in their laud- able attempts at isolation. But with regard to the profes- sional services alone of Dr. Larocque, why, might we askL, is the Protestant Small Pox Hospital not under the Professional care of Dr. Dugdale? That gentlemen was, we believe, selected as Health Officer by the City Council, .to represent the English speaking part of the community. If, then, he occupies the very important post of Health.",
         "382 CANADA MEDICAL AND SURGICAL JOURNAL. Officer to the Protestant side-of the city, why does he not assume the charge of the Protestant Small Pox Hospital? The French-Canadians have their own selection in Dr. La Rocque. The British Canadians will, we feel certain, expect to be treated by a professional man of their own nationality. We regret to inake these allusions ; still, we think it a duty. We have understood that Dr. Dugdale does iot desire to attend the City Small Pox Hospital. If so, there are many others who would gladly do so ; and we do believe it would conduce to a feeling of greater confidence in the success of both institutions, if they were under separate and distinct professional charge. We do not consider it necessary that the Health officers should attend the Small-pox Hospitals, as it is a separate and dis- tinct service for which those gentlemen should receive a separate afid distinct gratuity. But since the city, at con- siderable outlay, havé establislied a Roman Catholic and a Protestant Hospital, separate and distinct as to internal management, let the theory be carried out to the full, and give us a French Canadian Catholic Physician and a British Canadian Protestant Doctor!!! We subjoin Mr. McCord's circular. CITY HALL. Ist February, 1S76. MY DEAR Sig, As you are aware, the City has provided accommodation in the Civic Hospitals for its citizens suffering from small-pox. The Roman Catholic patients are received in the new building on the Hall property, attended by the Ladies of the Providence, and the Protestant patients, in the stone house on the same property, in charge of a lady of experience, assisted, by a competent. staff ; and both hospitals are attended by Dr. Larocque, one of the Medical Health Officers, and every care and attention paid to the com- fort of the patients. These hospitals are very favorably situated with a view to the recovery of the patients and, in the new building especially, the wards are very large and well ventilated. It is very desirable that citizens suffering .fron small pox should avail themselves of the advantages thus placed at their disposal by the City and by going to hospital and thereby isolatingthemselve' limit, as far as possible, the chance of communicating the disease to others- We have scarcely a doubt that patients are daily recovering in the Civic Hospitals, who sho'ild have succumed to small pox, had they remained",
         "PRESENTATION. in their crowded homes. Accommodation is also provided for a limited number of pay patients in private wards, who may be visited by their own Medical Attendants or by the Health Officer at their option. For terms in private wards, kindly communicate with Dr. Dugdale, No. 645 Lagauchetiere Street. You are earnestly requested to advise your patients who may contract small pox to go into the Civic Hospitals in cases where isolation cannot be obtained in their residences, or when in 'your judgment it be desirable to do so. The Hcalth Committee, in its endeavours to diminish small pox in the City, desire the kind co-operation of the medical profession, as it is conscious that any success achieved will be very largely due to such co-operation. You are, of course, aware that the Hotel-Dieu and the Montreal General Hospital have been obliged to decline small pox patients. I am, dear Sir, Your obedient servant, DAVID R. McCORD, Chairman of lealth Committee. PRESENTATION Of a Service of Plate to Charles O'Reilly, Esq., M.D., on the occasion of his retirement from the office of Resident Physician, City Hospital, Hamilton, Ont:- Last evening His Worship Mayor Roach entertained the members of the Corporation this year, and those who had seats at the Board during 1875, together with the city officials and a' few other invited guests, at dinner at the Royal Hotel, on the occasion of a presentation by the Aldermen of the city to Charles O'Reilly, Esq., M.D. After the customary loyal toasts had been given, The Mayor said that he had a most pleasing duty to perform. One of the objects of our gathering together this evening is to do honor to one of our rising professional young men, who has been our Resident Physician of the H-ospital for nearly nine years, during which time he bad gained the respect and esteem of all with whom he has come in contact-who by his energy and ability has obtained the management of one of the largest hospitals in the Dominion. Dr. O'Reilly. We congratulate you on the appointment for nany reasons, for I believe you stand higher in the estimation of our citizens than You have ever done. To-night we have met to.give you this presentation to testify the high respect and esteem we entertain for you. I regard it a privi- lege to be entrusted by the subscribers with the discharge of a duty of such an agreeable character. In handing it to you I can assure you it is offered by us as a tribute of our high regard and admiration, and I am sure I 7m only 383",
         "384 CANADA MEDICAL AND SURGICAL JOURNAL.. echoing the sentiments, the sympathy and the desire, and uttering the worda of all present, when I say I hope God may prosper and bless you.. He then read the following address: To Charles O'Reilly, Esq., M.D., late Resident Physician to the Hamilton City Hospital, and Medical Officer to the Board of Health. DEAK SIR: We feel that we ought not to allow the occasion of your retiring fi om your official position as Resident Physician of the City Hospitat and Medical Officer of the Board of Health, to pass without expressing both our regret in partirg with you, and our entire satisfaction with the manner in which you have discharged the duties of your offices. Under your manage ment as Resident Physician, during the past nine years, our Hospital has acquired more than a local reputation as a model institution, and your attention and courteous demeanor to all who have been brought in contact with you, either officially or otherwise, has gained many ardent and admiring friends; we beg you will accept, as a token of our kindly feelings towards. you, and of our appreciation of your past valuable services to the city, the accompanying Service of Plate, and in saying \" Good-bye,\" we assure you that you have our warmest wishes for your success in the new sphere of duties upon which you are about to enter. Signed on behalf of the Corporation, GEO.ROACH, Mayor. (The present consisted of eight pieces of silver service, onsisting of salver, urn, coffee pot, tea pot, sugar bowl, butter cooler, slop bowl and cream jug, all of the latest pattern and most beautiful design. They were procured at Crystal Hall, Hamilton, from Mr. Thomas Egan, and reflect the greatest credit upon both dealer and manufac- turer.) The health of Dr. O'Reilly was then proposed, received with three times three, and enthusiastically drunk. REPLY. Da, O'REILLY replied as fcliows.; MR. MAYOR AND GENTLEMEN,--Allow me to assure you I had no anticipa. tion that, on my departure from Hamilton for another sphere of professional labor, you intended to pay me so high a compliment as you have done s evening by the presentation of the beautiful and costly testimonial of your regard and esteem as that before me now, and of your appreciation of my ser. vices in connection with the Hamilton City Hospital. Nearly nine years ago, when comparatively a mere boy, just fresh from McGill College, you eonfided to my care the responsible position of Resident Physition of the Hamilton City Hospital. During that period it was my sole aim andistudy to discharge rny officiai duties for the best interests of the city, to meet the approval of the",
         "City Conndil and for the relief of the suffering and- afflicted committed to my care. I am proud to know in retiring from the City Hospital, that it has been so well and efficiently managed as to merit and reeeive the heartv cemmenda- tion of all those competent to form a correct judgment on the subject, both here and elsewhere ; but at the same time I must remark that little credit conld be laid at my door, had I not been constantly aided and assisted in every possible way by the untiring energy and judicious advice of the Chairman of the Hospital Committee, Tr. Fitzpatrick, and the harmonious co-operation of the various Hospital Committees that have had charge of the institution during ry incumbency. I am hippy to state as a pleasing coincidence, that Mr. Fitzpatrick entered upon his duties as Chairman of the Committee in the same year that I myself became resident physician : but I regret to say that he too, retires from the position he has so long and honorobly held at the same time as myself, though I have no doubt that his successor, Dr. Crooker, will prove a most efficient officer. Personally, gentlemen, I feel confident of your friendship and your good wishes for my success, and officially, I am sure a greater compliment could not have been paid me than that of which you have made me the honored recipient this evening. I expected to leave -lamiltou quietly, but this you have now effectually prevented by your great kindness and liberality on this occasion. I can assure you it is a hard task to leave my native city, and to say good-bye to those whose friendship has stood the test of so many years, but whose kindly and heart-felt wishes will go with me I am sure, to my new home. Mr. Mayor, and Gentlemen, in leaving Hamilton I required no such substantial proof to make me think of the past and of the many happy years passed among you and in your employ, but I can assure you that I shall always feel proud to look upon this magnificent and splendid souvenir, which you in your generosity and kindness, have presented me with this evening, and through all my coming years I shall look back upon this as one of the red letter days of my hife. Mr. Mayor and gentlemen, I again repeat, and I trust you will all accept, my most heartfelt thanks for the honor you have conferred upon me this evening. The doctor was cheered on taking his seat. We believe that Dr. O'Reilly has received the appoint- ment of Resident Physician to the Toronto General Hospital; and, from what we know of the Doctor, we believe that he will be a thoroughly efficient officer. We wish him every success in his new sphere of duty. THE LATE GEORGE GREEN GASCOYEN, F.R.C.S., ENGLAND. It is with a feeling of deep regret that we record the death of George Green Gascoyen, one of the Surgeon's to St. Mary's and the Lock Hospitals, London, Our per- EDITORIAL. 38e",
         "CANADA MEDICAL AND SURGICAL JOURNAL. sonal acquaintance with him was slight, yet we were impressed with his earnest and fervent manner, with his sincerity, thoughtfulness, and lack of selfishness. We first met in the summer of 1872, when Mr. Gascoyen visited this country, seeking health in recreation and tem- porary relief rom the arduous duties of a London hospital surgeon. His stay in this country was very short, and we saw less of him than we should have desired, as he was a most interesting companion. Two years ago we met again in London, and we regretted to see a marked change in his appearance; he looked fagged and weary and markedly ,thinner, and was on the eve of a trip to the Continent. In parting he intimated.his intention of visiting Canada in a year or two, and expressed a hope of our again meet- ing. He was recently elected an Examiner in Anatomy at the Royal College of Surgeons of England, and we learn from an exchange that, although in ill health, he attended two meetings of the Examining Board the week prior to his death, so that he may be said to have died in harness. The immediate cause of his death was pleuro-pneumonia; he died on Sunday, the 23rd January ultimo, at his resi- dence Queen Ann Street, Cavendish Square, at the age of 46 years. We observe it is stated in the Medical Times that \" with him, unfortunately, dies a vast accumulation of knowledge, especially relating to syphilis, the result of many years labours in the Lock Hospital.\" Nitrate of Soda in Dysentryt Several Gerrman physicians extol the use of nitrate of soda in dysentery. When the small intestine is involved, €\u003eo to oo grains are given in 24 hours. When the disease is confined to the colon and rectum, the quantity given during the day is much greater-from three to six drachms. It is given in an oily emulsion, and warm.-Pacfic Medical and Surgical 3ournal."
      ],
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         "Canada medical \u0026 surgical journal [[Vol. 4, no. 8] (Feb. 1876)]"
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         "Technical and Bibilographic Notes/Notes techniques et bibliographiques The institute has eattempted to obtain the best original çopy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usuel method of fllming, are checked below. Coloured covers/ Couverture de couleur Cevers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur D Coloured ink (L.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Plànches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion aong interior margin/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la margeintérieure Blank leaves added during restoratton may appear withirthe text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été filmées. L'institut a microfilmé le meilleur exemplaire · qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-étre uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale da filmage sont Indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Includes supplementary material/ Comprend du matériel supplémentaire Only edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. D Additional comments:/ Commentaires supplémentaires: This item is filmed et the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. lOX 14X 18X 22X 26X 30X 1 2X 1 1111 24X 21X132X 12X 16XX 24X 28X 32X",
         "INDIANS 0F QUEEN CHARLOTTE'S ISLAND. 27 A YEAR AMONGST THE INDIAN$ OF QUEEN CHAR- LOTTE ISLAND; OR, AN OPEN FIELD FOR MIS- SIONARY LABOUR. INTRODUCTIO2. Is an article'in a former number of ' Mission Life' (vol. i, p. 222) an account was given of the work of Pastor Harms, a German clergy- man, and of the manner in which he succeeded in infusing a Missionary spirit intp the villagers under his charge, and how without any externa aid he and'bis flock' actually originated and supported a Mission on no insignificant scale. They trained their own Mission- aries, selected from their own body colonists to accompany them; they built their-own Mission vessel, and constantly recruiting their ranks from home, they founded one Mission after another until their stations numbered no fewer than twenty-four in the land of their adoption, There are not many mnen like Pastor Harms-at leuat, not in their power of influence and organisation. But nany in our own beloved land do not come one whit behind him in their deep and all-absorbing love for souls and wish to extend their Redeemer's 'kingdom upon earth. And why should not some one, at least, be found to emülate the noble example-thus set to them ? A high aim is the secret of success in all things. The arrow which is not pointed high can never reach the distant mark. Why should not some English village or district or congregation plant its Missionary colony in some heathen land? Half the -indifference tp Missionary efforts which prevails around us may beattributed to a want of reality, almost inseparable from the want ofrconcentrated interest in particular spheres of work. The bare knowledge that 10,000 people are dying of starvation in some before almost unheard-of district of a distant land, does not create half the feeling of sympathy naturally excited by an acquaint- ance with al the particulars of a single instance of the 'lingering horrors of such a death. So in the case of those who are starving for lack of the bread of life. It is ail very well to say that people should act upon-principle, and not from feeling ; but- wbo shall say that it-is not better to act from feeling rather than not act at all, or that many who begin to aet upon lower motives may not end in acting on the highest? Who is there whose experience of his own actions and motives will not lead him to acknowledge, and that with the deepest thankfulness, the manner in which God's Providence has often turned",
         "28 MISSION LIFE. [ IMe,' the dross of selfishness into -the gold of a noble purpose ? May God grant, for his dear Son's sake, that the appeal made in the following pages may not be in vain, but that the bread thus cast upon the waters may come back again, even though it be after many days. The Indians on Vancouver Island and on the main-land of British Columbia are diminishing so rapidly by contact with the white people that in a very few years they must become very rare. I do not, there- fore, propose to write much about them. It is too late. But the tribes on \" Queen Charlotte Island\" are much more numerous, and of a more noble race. The habits and characteristics of the one race do not differ much from those of the other-the causes which have had so fatal an effect in the one case will have the same effect in the other. Queen Charlotte's Island is about 200 miles in length, and varies in breadth from 10 to 60 miles, with an area of 4000 square miles. About one tenth is rich land, so far as discovered ; the interior is not known, being impassable oiwing to the abundance of very heavy timber. Game, fiSb, and fish oils, are obtainable in quantities sufficient to supply all the wants of the American Continent. There are magnificent and safe harbours. This island is divided by Queen Charlotte Sound from the main-land, the average width of the sound being about fifty miles. The natives of \" Queen Charlotte,\" named Skittagets, have been con- sidered the finest specimen of the Indian race on the Pacific. They are naturally savage and warlike, but, at the same time, are quite dis- posed to be friendly with the \" white settlers,\" and wish the latter to live amongst them. They are very ingenious, and apt to adopt the customs of civilised life. They are nearly as white as Europeans. They number about.4500. . Many are very degraded, though occasionally a few are to be met with who are very industrious, especially those who have for a short time visited the capital. I lived in the ranche of a family belonging to the \" Strid-ga-tees\" tribe, who were al generally employed at some handieraft, such as making carved ear-rings out of pieces of lead found on the shores after soýne wreck; cutting out pipes and flutes from a soft bituminous slate found in their neighbourhood. These are all beautifully carved and ornamented, and would do credit to a European mechanic. I have purchased two of these fIutes for a dollar each. They are about eighteen inches long, in one piece, the extreme ends being inlaid with lead, giving one the idea of being \" mounted in silver ;\"",
         "Mission L IfN, O I May 1, 1887. J INDIANS 0P QUEEN CHARLOTTE S ISLAND. 29 the keys were stationary, and each represented a frog, of which the eyes were of lead. A better specimen of workmanship I never àaw before nor since. This same family had many curious images exquisitely carved out of wogd and bone; their boxes and wooden kettles were inlaid with select shells and pearls gathered on the shores. These m n had been to the capital for a few months, assisting in blacksmiths' hops. The majority of males and females are but slightly clad, their cov ring being a blanket, obtained from the Hudson's Bay Company. This is loosely thrown over their shoulders, more for the sake of warmth t an from any sense of decency. The majority of them have a great dislhke to hard labour. Sometimes, rather than take the trouble to go a d hunt or fish for food, they will remain for several days without eatin anything in the sàhape of food, and it is only when they are exhaust that they will crawl into their canoes and go fishing, existing for the most part on halibut, salmon, and shell fish, of which there are im- mense quantities to be found in small round cavities in the rocks on the shore ail round the iajand. Crabs they do not like, though some of them eat them in quaikities. There is a kind of spider-like crab frequently met with on the island (never seen in any other part of the globe) ; these the Indians will not touch. At the close of the fishing season they dry the fish in the sun for food during the winter months; but, being such gluttons, they manage to run short several weeks before the commencement of the fishing season in the following spring, and have recourse to roots or bulbs, which they find a little way in the interior of the bush. Fish eaten in its dried-state is very hard and tasteless; hence they dip the pieces in fish-oil, as we sometimes do bread in treacle or honey; and if they are without this oil they dip the pieces before eating into salt water, which certainly improves the taste. Many of the tribes collect large quantitier of berries, which tbey also dry for the winter's provisions, but even with this additional stock they are always completely out of food in the spring. Their personal appearance is not attractive. Intermarriage between the Indians and the whites is not uncommon. The offspring of the female half-breeds, especially, are really extraordinarily handsome, and many of these, if well dressed, would vie with the handsomest ladies seen any day in Regent Street during the fashionable season. These are facts incontestable to those travellers who have visited the half- breeds of British Columbia, and they pridé themselves on their good 163~789",
         "30 MISSION LIE. [May 1, 1557 \"looks an\u0026 figure.\" Not an unfavorable indication, perhaps, of the possiility of their future civilisation. I have long felt what a pity it is there are no Missionaries sent here to save those beautiful creatures from the awful fate that awaits th'em ; it is but a few hundred miles from the. capital, and yet there is no sympathy shown-no one sent amongst them to instruct themin u the duties of religion, and the result is immorality of the most loathsome kind-such that were I to state only facts which I have been personally cognisant of, not once, but scores of times, I could not but be accused of falsehood. A white man can purchase awife for the value of six whole blankets, on the strange conditions that if he does not like her after a month', trial he can return her, and demand backiis blankets; and if he declines to take the blankets, her family will keep them, and call him a very good man. When an Indian takes~ a girl to wife, he keeps her till the age of twenty to twenty-five, and then returns her to the ehief, who provides for her during the rest of her lifetime, and she undergoes the horrid mutilation of getting a canoe on her lip, as a sign of retirement from, wedded life. A \" canoe on the lip\" means two pieces of ivory or boue, each the size of a halfpenny-piece; one is put on the top of the under lip, and the other underneath, and these are riveted together. Somi-- times it will be one solid piece, causing the under lip to project out for a distance òf at least an inch and a half from the under jaw. To this is sometimes added a large ring through the nose. I Ifave seen them two and a half inches in diameter. Then they have three or four large holes in each ear, each large enough to allow the little finger to be inserted up te the second joint, in which she has either rings or strips of coloured rags. Many of thein have rings round their wrists and legs immediately above the ankle. Sometimes these latter are put on whben they are young; and as they grow up the rings will be so tight as to be invisible, owing te the flesh hanging over; nor do they seem to suffer any pain fromi it, though all walk very lame from this cause alone. Their breasts and arms are tattooed with figures representing chiefs and fish. Many of the native women go down to Victoria during the winter and return in the spring loaded with blankets, beads, tobacco, fire- water, \u0026c. These they distribute amongst their tribe lu the following manner :-Perching themselves on a rok or stump, they will tear the blankets in strips, about eight iuches in widti; and throw themu as far as they can in the crowd, to make a general scramble, and they who get the most gain the highest honours. Sometimes a woman will",
         "Masl,1w J INDIANS OF QUEEN CHARLOTTE'S ISLAND. 31 make ber busband a chief by this means ; nor does she lose by thus throwing away everything she 'possesses, as a tribe will build ber a bouse, and all the tribes, after a few months, will pay ber a visit and make presents to ber husband, the new chief, when he will have received more than double what had been previously thrown away. The men are much disfigured, having rings through their noses and ears, their breasts and arms tattooed, and rnany of their bodies showing numerous marks, all over their person, of pieces of fßesh having been bitten off in soine savage ceremony. The more bite-marks he can show on bis body, the greater the \"brave.\" They are diminishing very fast, disease and smallpox sometimes carrying off hundreds in a single week in onetribe. There are no \" flat-heada\" on these islands, fiat-heads being confined to the main-land. The .Queen Charlotte islanders say it is a very foolish custom, while those who adopt it think the opposite. The system adopted is to strap the heads-on a board while the children are young, and sometimes simply to compress the head with a hand- kerchief. In one of my expeditions on the main'-land, among thé \"Bella-bella\" Indians, 1 met with a whole family having long, white, silky hair and pink eyes. One of the chiefs invited me Vo go and see them ; they had very large heads, full faces, and clear white skin. 'The Queen Charlotte islanders sometimes use barks and roots for, sickness, but the most common medicine is salt water. For a long time I was at a loss to account for the quantity of water that lay about, till one day a chief asked me for the loan of one of my buckets, which he took down to the sea-side. After filling it, he there and then drank up all the water; and after retainiig the same for about two bours, opened bis huge mouth with little exertion, when out went about half the salt water, as if running from a hose. After waiting about ten minutes longer, with equai ease and unconcern he got rid- of the remainder. This be called \"washing himself inside out.\" It is a common practice amougst both sexes. , It appears to .me that this is. the principal cause of so many deaths amongst the Indianis during thie last few years, particularly when they-have the smallpox. The Indians have many feasts durmng the year. In preparing them- selves, they first wash the old paint off their hands and faces, and repaint figures of men, fish, and birds, with vermilion, which they pur- chase from the whites; also with a black stain, which they obtain from burnt wood. To make the colours stick to the skin, they first grease the same with fish grease, or candles if they have thein ; after",
         "-32 MISSION LIFE. m 'T e, they have painted their hands and faces they grease their breasts, and then, over all, scatter fine down taken from the duck or goose. The men then squat down, and with sticks, which they hit one against the other, keep good time to the singing of both men and women, some of the latter -at the same tirm dancing (?), by shaking and twisting about their heads and bodies in every possible shape and position, at the same time scarcely moving their knee-joints or legs. Sometimes a woman will throw in a new motion, accompanied with a little wit or slang, which will cause a very lively animation amongst the crowd, and encourage them to keep up. the excitement for a whole day and night. The following is one bf their most common, songs : \"I, Ee, Ha; l, Ee, Ly-ab ! ha oü ha ha la , E, Hay: (Repeat the above four times, and finish with-j Chaoru-I, Ee, Ha; I, E, Ha.\" There are certain characteristics common to the Indians all along the Pacific coast, the style of the Mexican Indians and the Hydahs being very similar in many of their dances and habits. The Indians of Queen Charlotte Island believe they were originally \"Klay-e-Gulla-gulla\" (Black Crows), hence the black paint; they have good memories, and often talk about Captain Cook having visited their forefathers at the head of the island. Al the Indians in this colony are passionately fond of gambling; but there are .always a few in each tribe who are \"experts,\" and I have always observed that these experts are the very worst and most dan- gerous of all Indians. In reforming Indians, it would be necessary to put a stop to this class, otherwise ail religious instruction would be in vain. What a splendid field there is on these islands for Missionary opera- tions, if bravely and judiciously managed ! Every man likes the world to know and see the good he bas done. Here there is a rare chance-a clear field and no opposition. Without attempting to give any direc- tions at length, I will venture to suggest here such a plan as T believe might be carried out successfully and cheaply. Let four Missionary members be appointed, and, let them take ont with them from England, say, fifty families, many of the younger branches being boys or young men, whose presence and numbers will prevent hostilities on the part of the Indians. Engage six young Canadian bushmen accustoméd to the axe, and able to instruct the new settlers in building log-houses. On landing at Victoria they would apply for a free grant of land, say",
         "]sI, sex. ] INDIANS OF QUEEN CHARLOTTE'S ISLAND. 33 fifty acres each (this would be granted with pleasure by the Colonial Government) in\" Skidgate Channel.\" The necessary tools and outfit could be purchased at Victoria more cheaply than in England. They would proceed to Skidgate Channel, select the best site for settling on, in the centre of which they would first erect a large square Mission- bouse. This could be built in a couple of days, and when completed al the families would take shelter there, and then commence to erect bouses for each family, completing one house at a time. With all hands at work, in two months every family will have a house to them- selves; then let B, C, D, \u0026c., help A to dig or plough 'and seed ten acres of A's land; then A, C, D, \u0026c., help B to do the same, and so on till all have ten acres planted and fenced off. This would take about three months to complete, and, then every family would wdrk alone and at bis own time in future, while the four Missionaries would begin their labours amongst the Indians in the immediate neighbour- hood; and as they favorably progressed and lightened the amount of work, one would remain, Ône go est end settle ix Harriet Harbour, the third go sath among the Incians of Gold Harbour, and the fourth settle amongst the Indiana at the very head of the island. y this means there would be a connecting link between each Mission station, and easy communication with the nearest Mission station on the main land at FortSimpson, accessible by canoe. On the voyage out from England all could perfect themselves in the Indian language, a man of ordinary intelligence being able in a few days to make himself acquaijnted witb the some 300 worde which constitute the language. Bush life sounds harsh and rough. But the amount of, physical labour is no greater than involved in farring in England, the only difficulty being in cutting down timber with the axe; but this is easy\" and rather pleasant work after a month or two's practice (Canadian bushmen prefer the axe to any other farming tool).- It now only remains to be klnown the amount of funds necessary for each family (the Government might contribute, but independently of them). £40 fQr each family of say six members would b~e ample; and if they had not enough, the money might be safely advariced to them, the chief Missionary acting as banker or trustee; this mone~y would pay the fare out, and leave sufficient in hand, on arrival at Victoria, to purchase outfit there, and once a month vessels would be sure to call at the stations for orders and to discharge goods. A famile who have settled are always sure of getting credit, if required, their credit being VOL. III. 3",
         "34 MISION L . [\u0026aM IW. always considered the best and surest, being on the strength of th'eir trops when taken to market. This is the way every poor settler gets on in a new country. I would recommend that every family should be members of the Mission, and give a little help when not otherwise en- gaged on farm work. Of such an expedition I should be only too glad to become an active imember, doing my share of wor.k. In all kinds of transactions entered into with Indians it is abso- lutely necessary never to make a promise without fulfilling it strictly to the letter, and to insist upon their doing the same. By all means have no white man on the island for a single day to counteract the good which may be done. One bad man in a single day will undo the wvork of months ; it would be, tîherefore, advisable, on the arrival of any ships, to keep an eye on the crew, i. e. a very close watch. If these instructions were carried out, Queen Charlotte's Island wouid become the most prosperous island in the Pacific .within a few vears. After the Mission members had settled there, say two years, then other families might be introduced from England. There is nothing I should like better than being connected with such an enterprise, and I would freely give my knowledge and time for such a good purpose. The position of the island is good, and on thç future Australian route; and a better prospect and brighter field does not present itself for a Mission, and for families seeking a future and independent home, than this said island at the present day. It may be well also to say something about the quality of the land and its capabilities. l many parts it is rich, black, loamy, deep soil; while in others there is sandy prairie land, capable of producing the finest potatoes in- the world (free frorm disease). I have seen them not uncommonly six inches in diameter, and al sound in the centre.; woile four inches diameter is the most common size-nice, dry, mealy potatoes. Soil that grow such' can produce anything. The *oil is such as to render manure unnecessary for many years. Good timber is now getting so scarce in Canada that the well-known Giror and Co. will have to begin operations in this -colony; and here they will find abundance of the finest timber in the world for length and strength, being without joints or knots. A common specimen of the timber is used as a flag-pole at Kew Gardens, London. To enter rather more fully into the particulars of the probable cost of rmaintaining a small Mission colony, and the cost per man or per family of so many : A man with a fatily of six 1ould e -îpportd bL one u lishng.",
         "] INDIANS OF, QoUEEN CRAR1LOTTm'S 1LAND. 85 tackle, and a few acres of ground; for example, he could catch enough game and fish on a Monday morning to last aIl the week, and during the followîng days of the week could attend to his farm, the expenses of which would be only for seeds, tools, clothing, \u0026c., which are to be ehad at the capital at London prices. Fish and game being so very plentiful, it is no hardship to obtain any quantity within a mile of where you start from. Girls from ten to fourteen could attend to the traps and fish-lines; one working for ech family an hour each day would produce enough. A man who does not work himself, or let any of his children, would find the cost of living about the same as in England. At the capital a merchant's clerk can live on twenty shillings per week. Missionaries, not having time to fish, hunt, or farm, could lîve in the farm districts at about six shillings per week per head, as they could buy enough fish and game from the Indians to lest a week for the value of a few pins, tobacco, buttons, or say one shilling. Flour, potatoes, \u0026c., could be bought from the farmers or at the capital at a les cost than in England. By trapping far skisi or trading with the Indians a large profit is to be made; for example, a bear-skin could be purchased from the Indians for about a shiling's worth of trinkets, and sold at the capital for four or five dollars. I will only add a few words about the elimate:-It is much milder than at Victoria; the summer not quite so warm; the winter much warmer, with les snow, but more rain. The winter of 1862-63, the Indians al say, was the \"coldest in their recollections,\" yet the frost was never severe. The autumn is the most pleasant season of the year, being mild and dry. The temperature is never as low as 8\u0026 below freezing-point during winter, and higher than 80c in the shade during summer, with very little rain, often less than ten inches during the whole summer. I only once heard thunder and saw only two elee- trical diacharges during twelve months, and they happened during the month of January. Norn.-If necessary I could supply a tracing of the island, and write out the language, Any questions I will with pleasure ans'ver without delay."
      ],
      "title" : [
         "A year amongst the Indians of Queen Charlotte Island, or, An open field for missionary labour"
      ],
      "type" : "document",
      "identifier" : [
         "15916"
      ],
      "published" : [
         "[S.l. : s.n., 1867]."
      ],
      "label" : "A year amongst the Indians of Queen Charlotte Island, or, An open field for missionary labour / [by F.P.].",
      "key" : "oocihm.15916",
      "creator" : [
         "Poole, Francis."
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.15916",
      "lang" : [
         "eng"
      ],
      "subject" : [
         "Indiens d'Amérique -- Missions -- Colombie-Britannique.",
         "Haida Indians.",
         "Indians of North America -- Missions -- British Columbia.",
         "Haida (Indiens)"
      ],
      "note" : [
         "Caption title.",
         "Running title: Indians of Queen Charlotte's Island.",
         "Signed: F.P.",
         "Title from title screen.",
         "Excerpt from Mission Life, May 1, 1867.",
         "p. 27-35 ; 22 cm."
      ],
      "collection" : [
         "nas"
      ],
      "contributor" : "oocihm",
      "media" : [
         "text"
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   "doc" : {
      "type" : "document",
      "title" : [
         "The medical chronicle [Vol. 2, no. 8 (Jan. 1855)]"
      ],
      "published" : [
         "[Montréal : Printed for the Proprietors by Owler \u0026 Stevenson, 1855?]"
      ],
      "identifier" : [
         "8_05182_20"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "T H E MEDICAL CHRONICTE VOL. Il.] JANUARY, 1853,. No. 8. ORIGINAL COMMUNICATIONS. ART. XXVII.-Contibutons to 6'linical Medicine. ByJas. CR\u0026wroIn, M.D., Professor of Clinical Medicine, McGili College. W. D., a master baker, age-d 49, of temperate, active and industrions habits, of spare make and thin visage, had been in the enjoyment of good health till about two years ago, when he bega a to suffer from dys- pepsia, with gastric and abdominal pain, distention aud fitulence, espe- cialiy after meals, but without any impairment of hisappetite ; or rather the sensations generatly felt in the stomach lie mistook for hunger, and which induced him to indulge his appetite beyond what was requisite or prudent ; and for a long time he yielded ta this propensity, supposing he was merely gratifying au unusually good appetite. The inconvenience which generally followed he very reasonably attributed ta the repletioni rather than ta the rorbid state of his stomach, as it did not amount to pain. .e was able to continue the superintendence of bis business till July lat, when the visitation of cholera so alarmed his workmen that some of them left hirm, which necessitated him to undertake the labour of baking, which frequently occupied him most part of the night, as wel us the day, and so much overtaxe i bis powers that his strength failed rapidly, and the pains of his stomach became very severe,-his bowels being generally torpid; but his appetite did not fail, and hi morþid sensations frequently tempted him ta eat, which indulgence in general ws followed by distention of the etomach and an augmentation of hie sufiering, ta relieve which, he was occasionally induced to take a little gin and water, or ginger infusion Fancying that inuch ai his distress and suffering was owing ta his late over-exertion, ho left off a)l work, and went to the sea coast and to different places for change. In May 1853, he had a very severe attack of colic, which he always disposed to connect with his present complaint, bit neývPragain had a",
         "124 OUCiÂ%-LCOU1Ki%. ~tîîr of it. !Until Septemboe 1854, thoe cm)y treatnieut lac lind ivnâ s ôccnionial znild aperient, to regulate lais bowcvls, and enie il dloses oCqui, iie. At tisat turne ho aubrnutted to un cx.4nination of the nldotnein, -%vhcn a %%cll.mnwked tumor in the cpiggastuititn us very inanifest, stretchîing fromn the enaiform cartiloge io the aînibilictie, ani cxtendiîîg kîterally seven incheu, it *as firm aîd liard, espci:îlly nt is lomer edge wkich was irregiar and lobuilated; it aîppareil Co pi p uudf-r thtu tile rilis, cspecially at the riglit liypoehloildritiiin; Diicrc iras a sLroi; «r- f Lrt! sl tustotru h lutI ole trnwr, bet ivilitout any anclirysmal bruit; cxamnîatioîî causcdl rnuch pain, andi à cotild nut lie Icrsevcred in, tron» the s11 Wring it entailed ýafterwvards ; thero was a biilionsi tinge of the tuiva rlutî n kbtthc3 asitut tlie leaden color of ima- lignanit dîseaso, îîor did the. couîîtcnaîcic iiidi.caîct aiiy gre:it suiffiéring, and althouîgh ie felt convinced thant lie labored nder a *fa.tl ieuse, lie wis very ch 'eerftu-l ad rcsignled. lu1s fuid înieared to pass frcely, and %withlit Cansiîîg auiv pain, labo and out of the Stoniach, and thesfIiu itftcr eating ho attribtited -Iriiicip-.lly to repletion, and flatillent distention lis evacuations were geîierally dark andl oWîeasive. F'or a lotg peried licinae Ia,, quantity ofiurline, buit fur Somle timne it wzas scanty and* lîigh-colored, depositing a dark yod? sedinient. le also Said Ihat lie hàd tnfll!red froîn Itmbar pain for a longý tirne. lis dectibittus ivas lil latoly on thec rigflt side, latterly 'tic l)rferred the loft; ini either position lit eqiually feit a dIragging, sensation, evideiitly fri the iveiglit of thie Tnn. he abdominal pain wvas flot coîîfined to the tumor) altl ougli cbistat!ty feit there, iauJ ïvas liable ta exacerbationzs; it Sornctiînes wvai Ibt in tbh pgsru ; latterly li;s strengtl. lîad, faled rapidly, anld-ho was confinvàr aînioàý wiîolly te the blotuse, and iii a great mnsure to bedj lusurineýdic1 not atflbrd any inîdicationî of aliueti. At this time (Sep- ternber), I vs avo nil consufitàtion. witlî the aid af Dr. Camupbell. Trhe jaundciced appcnarance -of the îxatielit, anîd evident cotnetioîl of the tmnor wiLhi tlîp riglit hýpcchondrum, and, easy paasageo fiha fvod int\u003e anid ont ôf t'le stomiachi, led lmi WL the opinion tlîat the liver was, the- principal organ îiivol'ved, wliilc ttic pcctlJidr irregular liard lobulated -edgc of the trner, extendiii- d3watvïir(s to 1 le umlbilictus, an\u0026d seven inehesÉ across-tIe spine, and graduaî.lly Iosihg ils nîlost marked character, as it sceedd made nie iîncIiiied to assign Uhe principal seat of disese .to thie pancrens. The- Jr ranigod coiiltion i-,o the stonacli îiiglît mnai- f~s1v ais frnrhu 1rz.ýsire of* :ind syînpa,.tluy witli, the iieighIbouring ,Iiatidllrt organ--, ir'llk- -were ina: sLtc of liypcrtrolîy, Tf Uie strnaéh wiCrc thîý sent olsn~,it clý, Ilctly w-as u't Ui lia-rdscîrîhuits of éither orifici,i whaichi, if 1 i-t rLd. ist laC« cnuciOd more imeiot u the oasg f ftltnd thrvotiglîtle' rlc 'lî l\u003eilioust lingv of the couinte-,",
         "V R WF f-CNTIIBTINSTO CLI.XIC AL !iIFt)IC INE. :9 :~eaiul 1dvend con filitionaal derangcana'îat uf tiue Lavvr, or olystruc- ~iran to the p*v;,iý of thlable throngh the nc' ofivil a c'Onsequenre of carrhus îîaawewu. Attuntioli -v irtit ln tl stati of tue lîowls ; a hite pull ordered to lie t-tkei cvere îaa.gliiat a. iiaxtiir.' i)t ,d adc oCiran tuaid qiineiii wa j_ pre- wM'ada a luauît oif itidckl( of niereitry ordcrud to bc r:il.bd over t tev Ado: i.' la diai!y. A lu r oi ae ulas laie liati se veraIoi'\u003c lii litis eva- jatîiiv, and t \u003cry oUsimv. lie 2icadnally anad rcpidlv iaan' hie- cn ifi ,rtaî)Ltv lStîaac di4stressecd blaa aiiteia; liut, rely rejcctcd theigst ali1 Ira'qlut'ialy tiarvw lup a froillav set iwliiCIi Wt-S oc- c»SM!iiI nid. IN~ :apqx.te anad sirengath rapit:EY i lit, la \u003cied on. dhe %hi N\"v. Sn:c1T0 C.AnAvns.-Tlie hoty zippe:aredl natac'aiacaad On open- oza Uwi tîal'ani. a irzc la.rdîwcaus [hîokin,- nmass appeareal, oecuipying the~ senat f t iiitl(r, p.e-fxy îutc, and withoaat uiv appearance of v:ascUi:ri-ýy. '1lii,; wv'aq Imud to be the stcamech, tlie coats of lalichl were hkinciaea, as w titi- :iý lard ; ir' nass Mit hard, irregtal:ire and smwa 011btad tn ttianpllilL nL. t draw% it fira,.tlau stoiaeliab vas .erated in\u003c iîm\"- liaIsu a l.nc qajnaatiy of alark fluid, like coll-rte grounds, was lae h. rda' iaii E iia i smo ii v S r d ariag zIi fc beuaa ejected from tlae stoinat'. Seeara tn or3na santjilar. appaxaratace hung loo)sely ixato the caa'itv of Ilio saoan:ach. thae Iocayzst of Cilîi appa:ared a liard roll, aibout four itaClis lauiz and as thl('k tii a ehild's Nvript covaŽred hy the rrnicous rmlintc, and sîaspellded laxa'niy hv ils duliiicatire to te lc.'sc'r curva- warq ek an austiiie by At niewuîtery. Searl ma1ler tumiorsofa like appetaraitei entiruly taaairýledl Ila pylcariias, formirag togretlier a muass, the su:'e of a lîuii' Cr , uhaé'l rare c.,-X a attaclied by bauids air pedai- vies, wlii'li allaawia thiiia Io fluat freely in. the stomach. The mnorbad zyoxvh ppli a to bave ori2in;atei ina tlie t;itbmioolis texiture, aid ai- taahit faŽlt haTI l 111 10 11%acl it ax'adily lira ke dora1II or partiaily dissoi- veid orn beiaz '%Vl)ltiial air hliffadu, anlt btecaie lika' saafîa'îîe brain. The lîver j.roja2'da b 1ax iteruc anald pî ovur thoe tiiiaor, Io whlaih it hiad, a stonribyliii ait rîiaaio attaehtnialt. l'le palncra'as, in ak =xIinier, aailnrîto1 te Iiara.r\u003cr caxrvatua'i' uC tw ii'aaaaea appa- rentiv was iiot fartiaer iivolvod in the ds:s' Tis very rare far t aigatdsaeltslca:ioaasl- liaîac'd aaad dcsecribed l'roin its lier utiar aliîeiarance, rcdtiliary k rana.uîlaa iîai r- daaceotvs luior, oir tho iiit-lake, taumniar, aa'aniad by ATîairona'Th 'flcîra'sunt Mcas Posse'\";i aaaaay \u003cif fla elînra'-ler. îiescrtled bva 'iti Çwtz' l lauXî . lion of its pitrey ichi\u003c colrar tîad ;ta4 'ne:- ' ailtl tiJt:* raîae1 ri-diai-'it V~se1tiao r illailii'ialiiry iiîialai); l ei i rîî%vtl li'alie subnnaiîsîisîrî, aîîarittlv iaa iaii''îai :,i 10r'îî",
         "ORIGINAL COMMUNICATIONS. break down or melt away are al) noticed by him. The coats of the sto- mach were in an atrophied state, and were readily rnptare. The-e wsL~ nl' op r:inh oi îlcer un. inee the îrnss has heen put m t a n is a' pired a drce et Wraess a h-is dumi[ he11idl iii z(. Th- \u003cii 'h y or impo'buhty of fermunz a correct diaznowilap1 -ar easily aunted fbr, imi consequence of the ininnate connectîon of tne Lamor to thc liver, and also to the pancrea. The freedomn to the passage of iood tirouigh tlhe stomUach, while the inrezta were seldomr or never re- jected, nor the appetite. nor function of uhtrestion, aprarently iiiterfered with to any degree, diverted attention fromn this organ I the soldi viscera s thefons et o'go mali. ART. XXVUL--On small-pox and Baccinaton Jy Wit. MARanEN M. D., Gov. Col. Physicians and SLrgconis, L. C., \u0026c., \u0026c., \u0026c. There are none of the laws of pathology so lhttle nderstood, or so Constantly set ut defiance, both by the mnedîchl and non-medical subject,, as those which govern contagion and infection. Variola in al) ifs furmis lias prevailed in this city latterly to an alarm- ng extent, so much so indeel. as almot to gave it an epidemic charac- *er. All axes and all classes have suffTered« from the soldier in the gar- 1Non to the senator at his parliaenntary pcet, and the humble citizen at his fire Fide, but the young of al classes have sufflèred nostseverely. I have not in the conrse of the previous quarter of a century seen so much smtallo a:: drung tFe past four nontls. Among the causes assigned for this munon of sickness whether founded or not, (and this is a point for the serious corsideration of the pathologic-l enqurer,) is the open- ing up of the old intra-tmural cemeictery, known as the \" Cilnetière du J'icotees,\" fur thes desîruble purposes of sewcrage and water-works. H1ow fhr tlhs circum-tar.cL May have originated or contunbuted to the extenion of the disea1e, 1 dc not pretend to say; or whether the work- nen emiployed may have carried it hoine to their families in different parts of the city and suburbs, and will merely state the fact that in the imnediate vicinity of this burial ground, after t was brok-en up for the purposes befure named, to a deptlh consideraLly below the level empluy- ed for interneits, small-pox Moke out in its vicinity, and was more se- vere and fatal there tian in ohier parts of the city and suburbs-equally arnong the rich anud tle pour, and that among the military, the first cases that oeenirred wcre froa Ilope Gate gînard-house which is also in the -Licinity.",
         "M.ARSDEN-SSMA LL-POI A:ND VAeCYATWoN. it is now two hundred and fourteen years since this cemetery wl ppened as a small-pox burial-ground, during the severe and fatal visita- tion of the disease in 16-0, where, it appears, by an extract from ffHis- toire de lHotel-Dieu, written by a Dun,-that small-pox was so preva- lent that the hospice wards could not contain ail the cases, and a piece of ground adjoining it was fenced in with pickets, and bark huts erect- ed within the enclosure to receive the sick Indians who were severe sufferers. Again the same authority says, in 1708 \" la facheuse picotte désola toute la Nouvellý-France. Il n'y avait point de maison épargné dans la ville. Ceux qui conservaient leur sauté ne suffisaient pas pour soulager lc malades. On portaieut chaque jour des corps dans l'Eglise de la Basse-Ville ou dans la Cathédrale sans aucune cérémonie, et le soir les enteraient ensemble quelquefois jusqu'. quinze, seize et dix- huit.\" And she adds \" cela durait plusieurs mois, \u0026c.\" Recent experience has shewn us that specific infection n:ay be domi- nant and innocuous for an inconceivably long space of time and then þecome developed, but as It is not my intention to discuss this point at present, I will leave every one free to draw his own conclusions frorn the facts above stated, and proceed to the consideraiion of another one connected with the subject of vaccination. The circumstances above-mentioned have had the erfect of giving an extraordinatry impulse to the practice of vaccination and re-vaccination, the former of wvhich bas of late years been neglected, or bas fallen into disuse in consequence of the extraordmnary immunity from small-pox that bas been enjoyed, and they lave enabled me to make certaîr ob- servations and deductions which may not be uninteresting nor entirely unprofitable to your medical or other renders. I wili premise by saying that I have met with vothing in My recent experience to shake my confidence it the practice of vaccination as a prophylactic against small-pox for a certain time, and among the adult faes, particularly of small-pox that have core under my observation, they had occurred where vaccination had been neglected and in some ases where innoculation had been practised. It is now an undisputed fact in medicine, that small-pox may occur more ihan once in the life- time of the sane person, and this coupled with tle plysiological fut that a constant change of substance is laking place in the an iumal tissues, justifies the practice that is becoming not uncomrnon of re-vaccination about every seventh year. With reference to this point, two principti çircumatances ought to be attended to ; firstly, the charncter of the Virns; and secondly, its mode of application or introduction. On the first point I am indebted for some valuable and interesting light from my esteemed friend and benefactor Dx. Morrina who roccuty",
         "*nl!(. J i.v .Ittei tiît tht' flic( t tHti, v:c\"tI î''- îrs t'l'tUaiîîeli Il tj,. l'~lIttf V bv trannî cs.sîc'îî tlictiLli 1 a rit -Il pur-ons ,t last siiddi.iv l'y it'su 'Ii' , îrcc ild Il vý er \"f r' 'h rti 0 I, zlil Il(,[ct fI-I1,'e rc'rs,, * *'iru ' lnr r'nfirmecd t1i l c'î Il le ztIcct îvtr-cecsici i.cccl svcrti (('l~''UcV limes~ ini výe'it';n- Irot'ii~'ut't\u003cc' a fllei, 1:ire., soliîîcl, hîlflîi- 'r or '-' !I ; citli oni tice cthr'r 1c:ic li;cxcj,r ~itic'tdii a -lii 'l ('tcS'-'s cin~'t'~îf froî,cý a sîtiall i 'trlt looking truist, Lut 1 w fil Il lia:bt t'f rIttrlltrIitii,~ uI ct-e III 11j',L kirncc'r casc tI oct riîîc ai ases il) flî pa tien t, or t u ' i' tIJ ct;L- criisti cad beenti 10 lon- or irnperfecliyv revd Onc Ucs sill cect 1 m-cil, w-tIoîtcnîict,1, reliec the rcst cf iloy 1 ci 'riice i n 02le jarticîîlitr ilîicitit e. 0ic 31ou ia y, Ili- 11 Ii P( Veiuber, 1 jcrociîred iu lrt'sli unil fccc r t thle armi LÀ vt ILoely, litcailly c'bild of ciglit mrin.is o)i1, 'cbi libail %achd '!tll Ilit nso tIlitv , nithotigIt 1 haci ncct vacecinu tif fi îcîxse f, frore tlie fat C ai utili .cc, MIlO were yoilliz andtibe.citliv as wte]i Iv; flic elliid, lî fi ýL t,'1 rit prsîssive teriîn, haic- stffi'r'd fromi titprx l'iing (,ie o f I lle la rL, s' tii, Iillest 1 eVer sicw. Btci î'clvthe 12Lt luid Illetx lut' 1 instant, I vcccîatvd iiî iîtcen îîcrohîc trri ibs\u0026M't-ccit'îd -t ic. tlc2nen-eliilt ''n anti an -IIIt~ tt i li mnon±z tlic hetft1-liicts ipot of' flic somnciinity, and it (JctP .Sc'i ?I'ridual tc/2/b, c/l ' (t)JI thue otbtar hcaud, ris lruc ci prclporticont f casc's as iisiml v:Icc'îî ct( L)w I i 'iruls tironi uticer sourices dîtiiig tll 1î~su' c'rcod t'oIc i-cl' One circl1) ufllîlice ccciic,tcd ' IIl h ailti r-c-iccîmc f aI s nicti 1artîicilariy e'icitiiy tîcs wlistut r mlroîts ur uiaids, stîckIlle as reniarkulte, % ci.. t fic-' c ctiîlu ancd inuistal of(ti tn 3 stt'ncati irrîttitiil auiticai u iiî,iatliî tluct liais vectirred, Ilce ltter Ir( rjiiîiv 1xts'tdiiir îgîIll il Ilie siiccîi1dt'r andu icîto Illce ctmlla ntlsctcng thle gliiiicls,, ant ili suffie ilsuilci S fitist coisuleraiy below flie lb j uit. Stcîlias beu tir'ý c'Ise iniituy ictîit'' vli're 1 bave tulso v~ac'cinatec] -otng uccs'xrcbc'rs Ocf the tFalCot :i, aucd frocîî tue sanue v'cmns, sol ihiat it cunîti (cti ýy be uctirl\u003e\u0026i13Li to u et.tcicnu cruîses. li ic-tioct nowx Ict lsccts ' s1'%%ith rc'ferencc to the ebonracter of tict ic\" v. hi'thc'r il liai1 iust its spccircc avtcoui or uîot previous tu its lise mic Iic' 19 r\"- rsuîs ti o -wicca 1 tried i t, and M-iiether it, %vouid a prophy- Lîi'tic to le, ý,imiIli-jct' fic the etuild i 'om vwlcichl 1 procureti it ? T1ilîlc wii icut î'uri i te enlarge uî'on thc stihjec't ut present, but J trust thit tL'* lîcudits 1 hacve îiiroin ont inaybeofllervicendlead tosoime useful coclusions ad lracticai res,,its. As to the mariner of introdu zing ni a ppli' zng flie virtis, the pla xi1 ridopt is so painlesa that infants sen I- ( - Il. fi . 1 \\ 1 1. ( ( ) '-I %I t S 1, * ý. 7 IL) 1ýN .",
         "WRIGH T-CLINÇICAL SELECTIONS. 298 rely cver feel it. I firstprepare the vaccine by crushing down a smallpiece f ace ine crust and rubbing into a paste with a little water ; then bav- lng only removed the epidernis by genty rubbing the flat point of a good lancet, baekwards and forwards until blood just appears but does uot 1kw, I také the virus ou thie point of Ihe lancet I rüb it in, in the sme manner as before until the blood and matter become incorporated and then allow it to dry before covering it up. I always endeavour to avoid a flow of blood as the virus may, in such case, be carried away with it, and so fail in eflecting its purpose. Qitche, December, 1854. r T\"0 XXIX, C-nical Selections. By WM WaGrT,.D., L.R .C.S' ProfQssor Materia Y\u003c]edica. University McGiU C:llége, \u0026e. il. Sypñilis in Canada as denocd by Sib\u0026nj. Mrs. D-., a rspectabIegand virtuous wonian, about two months married, has been affected with secondary syphilis for three weeks ignorant of its nature or of the occurrence Of any primary symp toms, and lier husband positively denied ever haviu had syphilis but acknuwledgd tlat he once had a sore mouth from srnmking strange pipes. On being exaimined, his throat and inside of lips present marks of scçndiîry syphilis; the siu of both his re- arms exhibits the cicatrices of foirner ripia, which ho refeirred to a se- vere attack of smnall pox, \"the sures\" fromn which became so bud that they had to be burned before they wotld heal! On the exterior of the pre- puce is a small soft swelliug ovcr the site of a former chancre, and on the mucous lining, near its junction.vith the cutaneous coverinig is an \u003cýen Sore, answering to Mr. Wallaee second variety of supwrficial primrLry syphilis. Mrs. D. lias an affectio\u003en 4« the scaly, which has bten pustukax but the contents have dried. anid it owv cònsists of a muuber of sll crusts dotted over lier head ; hair faits out when combed-theso were among the first signs she saw of ili health; a pa.pular criipitionî over the whole body, which has only appeared within the last two or thre day; a granular rcddish tudacrcle, discharging pus the size cfa hazel nut, h'oking exactly like a sibbens, on the left side of the face, behi.cl th c'mad:.- sure of the lips, wlero lier husband had been in the habit of kissing lier i on tie corresponding side of the neck, below the angle of the inferior max. illary bone a swelling as large as a pigeoi's egg, from an indamed! lyni. phatic gland. it is hard, slightly painful, though int tender, ntot ind:ctt,",
         "ORIGINAL CRMaUNICATIONS. ed by any discoloration of the enveloping skin, and it has been slowly augmenting. These last two commenced about three weeks ago, and she did not notice that one preceded hie other. She also has severe pains, in the course of the tibia, invariably worse at night; suft palaet., with sides of throat tumid and congcested ; a punched ont ulcer on the ri±glt ton il ; on left side of hard palate, behind last molar tooth, an ulcer the size of a silver threepenny piece, surrounded by red areola, 'nd covered bl, lardaceous substance; gencral ill health ; and superdcial chancres on inside murîth la- bia majora. October 9, 1850.-R Mist. iodm. co. 3.s. sunend bis die. Ungt. hydr. biniod., to be used on scalp and tuberele on check,night and morn- ing. Painted throat vith soi. arg. mit. No. xxx., and bubo in the neck, with tinet. iodine f. These applications were repeated the next two oi thre3 mornings. 13th.-Pains not so great ; inflammatiin in throat and oind the ticer on palate lessened. X Pil hyd. ant. vt Opii-1 'umnend nmane nocteque. Cont. mist. bis die. The centre of tuberele is ashy a nd depressed ; asiick ofnitr. silver was applied to it, and by a little pressure overcoiming a slight band entered into a larer cavitv, nearly a quarter of an mch dee'p, .o keep a bread and milk poulItice over il, instead of on\u003cmuen'. Apply S. A. N. to ulcers every other day. 17th. Tubercle rather smaller. H1as been discharging a arcat deal; centre still ashy, but not panfiul nr iender. lep. app. arg nit-pouiltice for another day, and then resume the uintîumenît. 21st. Slough enitirely reioved. Ar( uit lihlyml apphed to the whole surface; over this lint sneared witi ointment. Gujms have becorne ten- der and swollei; copperish taste and] mercuirial breah. las had no pains for last few days, and tle papular eruption has wholly di'\u003cappwared. Crusts have nearly ail fialen off tlie scalp, and no prospect of renewal. Pergat in usu medie. 23rd. Surface of tubrele dry and covered with a scab, mnder which there seems to be no matter. Bubo mn neek reduced more than one-third its original size, and has decliried most rapidly during the past few days. Skin, including scalp, quite cean ; no redness nor humidity of soft palate and ulcers all but well. Frei frcm pain, and feels her apetits and strength returning. Site of ulcers within labia marked by a white lym- phy spot. Has finished pills and mixture. To take sol. hyd. bichl. in snall doses four times a0av. 26th. Matter has been collecting beneath the scab, and was removed by poultices. 27th. Former tubercle now appears as the size of a shirt bu..con, and",
         "WRIGHT-CLI'ÇICAL SELrCTIONS. gnirounded by a ring of healthy skin, slightly elevated. Apiied solid arg nit and dry lnt. 31st. Scah reformed. Bubo in neck not larger than an alniond ker- nel, RIept. mist. Nov. 7th. Cauiltt cold yesterdaày. To-day matter issued fron beneath scab, and its base is redder. Cataplasm,contd applied solid arg nit. R. hyd. biniod. gr ij, potass iodid 3i, aqu:e. 3viij, 3ss 3d. 1Ith. The sore continues to discharze; its surface is not larger than a split pea, rather raised and of a 1ceaîiar pale fungons look. 12th. PiL. hydr. iod. (gr. j, in v) bis die, in lieu or mixture, vhich she thinks thaigreeable. IIas hnad imorning sicknies;; tiigling and en- largeent olf breasts. 14th. Seah amuin furned, but without hard ring or base, and no sore bubo in niek feel, like a smnall bean. IliN caiused corisiderable heatand griping, thuse first takei substituted Iý,r ibemi; only one every day, and two everv other day. 19th. Scab fallen off. and no diw4-harco. cicatrix thin and level, with surrounding skia ; thickeiied by cov, ng of collodion; round this is a white ring, and round this a copper-eolored areola. Has felt very well the last few days. No apqearance ufsecondary. R. Mist acid nitrici, 3ss sunend ter \u003cLe. 26th. 'Merest trace of bubo in neck. llealth good; looks verv mnch improved. .ept. iuîst. 9th )ec Ceitmues vell; no tra2e of syphilis ; experiences symap- toms of pregnancy . In the ensuing spring she brought lorth a child, which survived its birth only a ie , hours; it wýas puny and delicate, but had no outward mark of svpilis. In the fMI of 1851 she had a relapse of secondary, sl.ewing itsclf in sore throat and pain im the limbs, malaiseand cutaneous erulptioi, eut sie speedilt recovered under treatment,and froin that time te this, Dec. I54, has renaiied perfectly well. OBSERVATIONS. This case affords an illustration of Syphilis in Canada. It is not adduîced ae a type of the disease in this country; but rather as exhibiting a forin in which it is now and then seen. Our acquaint- ance with endemic syphilis generally is exceedingly unsatisfactory and probably there is no modification less recognized or known than that which the poison rnay have undergone in this part of the world. .ud- ging hy analogy, we should infer that intercommunication between the aborigines and colonists must have impressed the materies syphilis with ome new feature which gave character to its external manifestations. So little information, however, of a positive kind, have we on this point,",
         "crN UN. CO n A Tic. NrS. and kindred matters,that xe must almost admit the justness of the remark made by an eminent phywlezi- of the English metropolis, who, hearing Canadi, 'gge:d as ai tapropriate r.sidence for an invalid; pertly re- p'iied \"' kuow noth n;o of Cdua hndeed ha end it sI ted ;il an aptretl learned r rtfhîsagitary stâte i.4 Upper Canaa, bearinxg å ~dru àe, that syphis tnknown iËi thdrenite part of the haL i0 0 ! Sueit mi 'ù gra ce, hI1w:e\"ail; as this, il for- tmatelynot u:rsl. Benj. B ihs work on venereal, published in 1793, hde. a section entied aio somr peculiarities of forrm under which hles venerea lias appeared in Scotlad and Canada.\" le is very laconic about the characteristics os the disease in Canada, bat the little said is rather Lavorable to the conclusion that the case above rgodda was one Of Canadian syphils. 1lis prineipal .tatelnent refrrinD t i snbjcct isNhat lues veneiea lias :ppeared in otir c.untry (Can# a) : the same rhauuer and nuner the s.ntile fourn as it had in, Sctlaù. another place he asserttIxht theilisease la the latter cotntry irme sSbbens ni the llighlans and yaws in Ditnfries-hire and Galw . I ost chara teristic symptom a s tated to be \"a sft spon r seen iù Size and.culur resemigI a 'ommoa asp, which is ;pt toapëar on ail suci parts as edier becoie a leerated or that are attacked with any kind of eruption; hence the nijne sibben or wild rasp. This spongy substance may rise to a considerabkl height, nor cau it be kept down by any of the coinmot escharoties-2il entirely removed it soon returns un- less the virus be reioved by meeury.\" Now, this description identi- fies the diseuse seen Pq Jepj Be with the Tubercle which existed in thC aboVecase And tie natura di the latter thus becomes estabtshed Since wve have te duhority of this-eininent Surgeon for saying ther can be no question about its having been venereai, because its mode of occur- rence wasby direct communication; its evolution the sequence of blood contamination ; and mercury was the only remedy which was capable of effecting a radical cure. In the case upder notice, there, were furiher evidences of consect- tive syphilis in the eruption on thé entaneons surface afLection of the inucous menibane, lksi oU hair, hdbonic enlargement \u0026co 1ach so unmistakable a to lave nu room la dOubt Is to the pro.xi:iate cause of their conjoint developrnent. la view of this fact the case sheds additi- onal light on the history ut sibbens by showing that the latter may co-exist with other symptoms or syphilitic infection and need not necessarily be sulitary. Thereby maintaining a still closer bond of connexion be- tween the Canadiai and Scottish modifications of syphilis-fer sibbens in North Britain liai been qbserved with every form under whioh lues venerea usunlly appears. This, however, only applies to the con- 302",
         "NiL~E~-~.~fis*tNSrINA DIF'jDA, -,i tutional sprcctsu ýinice s;bbens li.,ç never been steni asai Ji itli kxtti 'n tif i l e priixnrr aisorder. 'lhis elipibenonieron ors svîlî il lis ct fi equeifl y M.rv C11na Cf ilie few cosesz 1 lave Fcw i ilie abovû is- ilie lt st ,Illt!-siliin. A eIl analogous afietion i,ý ohservedl in Ilrelanid wvlere it Ný rorril ilv lye lLittUfl sc:'rvv, and in thciru~ InJia 1sil isl and A lfi -.1 m lilI'l î'ý tchrni- cally nat-ned i r:b\".'isi iiljiqtttous dili'tsoCn is uii ilîurta:îit circaînistancc in srvI to jrn;ý1iîl t!tît thcreý . artr aIl. iloillin V, r\\ national ill t:.o (cicnîstî'Itnl unc (J~ and ilitI1r!uvta instalîus ul- its oce riiice i n Canad-i wiii be co inc o 1 i zant. i ave not Vel So-Lo1 i t iMalmnative or lun the dc:lnî fc4onlts. '11P if the -.v a~v~ sW 1-,: l'it ]:shu 1 i% !\"I-1 n;iu \\-t'or, IiC. à T -X -c mlUîZ]N 01 ijiii the01 -j LondonZ coreSpo2icrcue. B3YLINNitlrL( M. D). Ili thtc -Xox'erulîcr .- i r ù]' i lie 1~,~ol find tinder tbe conrxlizn- tion of'i te Lontloit crspnlneN(.. 3, a new plan of treatinent of spina hiidu by Mlr. Paget, 1 ul,y lv te ir:iilation of the ligattnrc enided lotir Jays atter tUie operation iii dealh. I oiily want to makie a fi-ýw re- markis on tie foiiowing passage :- Presse rt' iupon th e tumour does iet la aity way effect the cerebrril funicticmis of the chiild,tlîerefore the 1tening cf cominunication betw\\ecni the cyst and spinal cord is very srnali.\" I can tell Mr. Paget exactiy tlic contrary, azid any person mnay notice flic fM~owilig tahing place by suifficiently liard Ipressure upon the tîniour. The child gels stiddetn]y corniakise, flice large fontanel gets elevatcd the more so the more yon press. Why 1 bccaiise yoit press the water of the tumeutr tlhrough the fourth ventricle uuidcr the pons Sylvii throtigh, the aqttoeductnts Sylvii in the third ventricle throughi the foramen cf Mon- re ut the riglit and Ieft sides in the luteral ventricles; whose ceiling, the centritn serni-ovale Vieussnii is expanded bythe viater. The cern- niunication between the cyst and the spinal cherd bas tobe naturally very mn.ali, but stili large enotigh, te admait of what 1 havejust denionstrated, becaiÀse I have rayself made this experiment twice. Ia the sanie way 1 account for the suciden deail of eilidren, if the tuxnour Nvas opened -it once by a large incision, not only the water of the tun'our but the uor spiralis and cerebralis was coming away by this samne conînînni- Aon between the cyst and brain. In conclusion 1 wotild say, that the .xpression Ilspitta bifida\" nppers te nmeeto beradicaly wrong, it means",
         "3u4 REIVIEWS AND BIBLIOGRAPHICAL NùTICES. spina in duas partes fissa, but that does not imply that there is a collec- tion of water. I think, Hemirhachis says what it means, a fissure of the columna vertebrarum ; and Hydrohemirhachis combines the malfor- mation of the spinal canal togetber with a collection of water. REVIEWS AND BIBLIOGRAPHICAk NOTIC ES X XIV.-The Microscopic Anatomy of the Iluman Body, in health and disease.-Illustrated with nmierous drawings in color, by AR- THUR IIILL HAssai.L, M. B.-Author of a e listory of the British fresh water aigte ;\" Fellow of the Linnean Society ; Member of the Royal Cullege of Surgeons of England, \u0026c., \u0026c., with addi- toins to the tex-t and plaes, and an introduction containing instrliet.ons in nerose mn ipuîlation, by HENRY VANARSDALE, ,\\I. D., in twov so:ums. New York: Sanuel S. \u0026 W. Wood. Mlontreal: B. Dawson. During the past quarter of a century no other branch of medical literature has undergoue so many inarked improvements as Physiology. The science of the present day, might, without any violation of truth, he called a novum organum for we fail to recognize between it, and that oý former times, the fanilar Imucaimients tlat characterize the ancestral structure. Of the dissini1darities tiat subsist, the review, now in progress of composition, only requires a notice of one in particular. 1 is, how- ever, one which not merely occupies a salient position among an assemblage of indications, but one upon which these evidences aýe closely dependent for their applicability and integrity. It may stili further be even considered as the one that constituites the foundation, upon which the whole architecture is superinposed, and without which the superstructure becomes incoherent and unstable, tottering to the grour.d and laying strewn there in disorderly confusion. Modern Physiology is based upon Microscopy and the initiatory part ofite study is the ascertainment cf the construction, properties and uses of the tissues of the body. These are first to be learned in their elemen- tary existence as constituting ultimate entities, and next in their state of conbination as forming compound struclurea. This department of knowledge is called Physiological Anatomy gr Histology, and is not to be found elucidated in works upon Physiology, bearing an antedate of 25,",
         "aEVI£WS AsD biBLiOoRAPHICAL NOTICES. years. Of its importance too much cannot be said-wiathout it aill des- criptions ofthe component parts of the body must be merely conjectural, and fron it alone can an insight be obtained into the mechanism through which the individal fonctions are acconmihsed. Its inquiry is one of intense interest. and the ardent student will find few subjects better calculated for awakening that lively curiosity which is the motive apring to action, and for enhsting tho-e intellectual exertions which are the sure harbingers of success. Mr. Hassall's work consists of two Yolumes, one oftext the other of plates. The volume of text contains as complete an accouut of Microscopy as the present state of the science admits. The aithor has been at great pains to avail himself of the many valuable contributions, that up to the ehte of publication, had been given to the world both by English and iLreign observers. Viewed in the light of a compilation, it will be found to be a faithful and succinct account of all that is known upon the many subjects to the discussion of which it is devoted. For this reason its value cannot be too highly stated, and it enjoys the enviable pre-emi- nence of being the only separate work which embodies the results ofthe labours of the various observers in the important field of inquiry, which it describes--these results, before its time, having becn scattered through different I'handbooks\" and \" manuals\" of descriptive anato- my and general physiology. As an illustration of the nature and novelty of the information conveyed, we make a few qotattons frorn the description which is given of a new form ofi non striated muscular fibre, discovered by Professor Koliiker. The smooth muscles, according to this savant, are composed of contrac- tile fibre cells. These are more or less spindleshaped, but according to the precise form they are arranged into three groups, the short, long aild narrow. \" These cells are composed of soft light yellow substande which swells in water and acetic acid, in which last it becomes'o!a paler color. There is no appreciable difference between the outer'and- inner parts, though in acetic acid it would seem as if -ach fibre ceil had a delicate covering. Their substance is homogeneous with longitudinal atripes, and they often contain small pale granules, sometimes yellow globules of fat. Each fibre cell has, witliout exception, a pale nucleus' sometimes only perceptible in acetic acid. Its form is peculiar being like a small staff rounded at each end. The substance of the nucleus is homogeneous . . . . The contractile fibre cells lying side by side, or end to end form the smooth muscles as they appear to the naked ey. .. They may be divided into, 1. Purely smooth muscles containing no other tissue ; such as those of the nipple, corium, of the interior of thi",
         "'3e fthe ittneoft.ir~ lýrsp r-tfcry glandls, of te axifl11. of tle coîn. Mon glands of' the ~:r ftiAatl of* potae of tdie va-'ia, of thle sniall arterics, offtlie und '2tiîî\u003eit~.~ . Mixed smiootli mus- ele, Mlhieh eou'tains neiv~te \u003céutjieliIe libre, celis, cellular tissue. mielr fibre ami ciastie: libre suh rc the tfabeCUI2 Of the Sîieeit aud rorpora ca-,vertiosl of butix sle-xs. Theyq are also loumid iin tlie tunica ~artros al\u003cash fLbrcs of the trizoillln ecate irua fi1brv's of the lar2 arter jes and vejus, the long and transverse fibres of prostate, urethra, fallopian tLubes, and Gf the womb ; they change by imperceptible tr:isitions into the first forrn ; this is the case iluthe trachea bronchii, Lorethra, thý- uirwr muscular laver of tleý testiCles. semlinal duc~ c.» le thîm ro-n d to p~ of t'liecuirt of'the tissue in theëse situations,, and while upon ti-1at of the intestines, observes that the celis \" present a kîwotted appearaulce with etud¶- runiningr ont mnto fine $pixals.\u003e Héc thiviks thât it is not itoprobl\u003eIlte that Oie knoLts are due to a. Coûtutin 6r the fibre. Th!e fibre éelhs'of' t'di intestine scem to be strip d, as if they xvere corrnpg.sed of an envelope alid 'SOmI hionoefrn 11 WS striped ccntcînts. No r'su: fibre is f\u003cuud( amnngst th-emu, but they- arec erd- ànd bounld t,ýtther Uv celUîlar miembirante.\" The Amiericean cditioia o! Il Micrscopi An:itory I3 a decideti iinprovenicnt on the Lonclut (\u003erigri\u003e lual ; for besidos additions on) Ilistologi- enl fiacts. it c ;1ta i'i 'uitducinhDr. Va ~ulin whiich %wii bic fotinkd verv ittl istrtction ina 1iiroscov). 4na\u0026Iplation :; en thut 'We TC, i thjs editioti flot mnl US os.sîg the great rits ofits Pro. totype btit iiisn~s it b)y also beilig a g(uitb.ýto the uise of the miclus- coe Lt istict mercly a sitic btit it is :Ùirtheaîiore a pnticud trVsutiîf, rmid iiu both ehtaracters it C-qually Silstaimm Il higyh clairacter. Of the volume o[lae ve 11avo tu remark tliat tht'y illuritrato nli the protuinent descripitions ini t1w text. 'rhey are 79 ina nu:iabcr ( 10 of wlaich arc American additionîs), und cacli contuins [rolil ti tu 7 or niorc Iltrlren. 'éu' exten4ivo Ilave l\u003ee\u003cm the Ob)jtet ci Ut tlitt no urdinary :01 hall boeiu omnitted ; alid the prtictitiotier m-11, froin lieuessity Ur illahilîis 111lbl ta hiîy a miern'9rojOie îuid thoe recjître( pjr ,atuus, wvifl hà : the ileXt beit thillg t(\u003e fbetttr Il1 g4eo V'oluims, viz their exact ireprc- sentftiosis. 'Ile mettilng 111 vJ t1icse illtistrtttiutis,lotii plain und Mtorel, i.i c'xqllhite, and et(eh ono. fûhrm1 Il pe(rrect lictître. It is cnîough to know ttitit th\"ny fuiy sutii t ie repti.tton of 'éle piîbIisliers !ti Amerivft of Cruvillh~r, XîrsellI ljw, ~uaii, ~aicJscltoîî\u003eael, Vidial, ilid ci hoat or Othffl illihîtr4atcd 'vurks, et.eIi of Mwhich as iL i.«suc.- f'rui tho r'strblitih. ment or the Ms%r.Wud, of Ntew% York, wcttit. al perfet chef dmiwuvril To thms whot huvr înieroscolirm, we eonside.r theme Ibokm iiîîdiixenéribe at itnhoritiew aîîdi fi:~orir %without thecir n1d tihev may ftil À N D B",
         "REVI~WS A ND ~DiOG~ i'IIICAL N(TTICES. 3e7 oùt~caI ilito iniiltifar;otus ptc illtisions, and bc, constaitfly tori!ncitedc( by rincer- taintîes in iieir observations. Tr.,achr o\u003c\u003e1. iiediviine and of j)hy$sý- 0.,ogy in 'partieul.nr, ibis worK wîii ber gilàndly eCil tle, text solving w;any a ptlemj~I;nîtr nltepae iZriglLsmiosw1lîclî, by enlarg(xne , ~w ho se4t ilif the pIîrp1ý\u0026S Ù1 t1leir leetures. An, Iastly. to evrymebe thec p ofrsso; 'l\u003c iiO elat n e thie micro scopire strucur L f L 1ewnfrd e'l tenl iii xe ho re,,iQes, ive Say buy this din ' Is.1wok ~V.iWbWi\u003cyf AI#\u0026,.CfifI~O. Dental Smrc~ andltie cdkictral Scienccs. BY CHAPIN A lRi.MD ... 1'rofes*)sor 'the ]?rinciples of' Dental Stirgery h,. the flaltimoei CtÂlege ; Member of the AiixQr1(*zin MMdcu '~oito ; Mem- ber ofthe MdoChrril :e]yof Mrld; Athor of ]?rincip1es and Pr.ietire tcf Dentid Sîirzerye\u0026. e Sens\u003end Edi'-, tion, careffilly revised md irs liacpi ida Blakistoý.. Moutreal:13.Dueup. S00.18. This vrlblabhe work cîn\u003eede , vat a.rnunt eÇý inC1,intzon i tech- riolog~ :tndts recotnrnùncisisl \"ts ;tsuýe\u003c ilcassu h medcalpro~2si()l. t eutais he eriatiîiILMI deffhîitieîî u1ý wry all teriiallexicoais of' tiieteitisw ul Arr, 111bli15'4hed iii the Engi~h~ndFrnw'h1uuîiut.lit evvry instauie ti1w Anithsr hani en- de.tiuurd te iuk tllV 111IQflhiiii;v its larilCIII uIs W'is pmreitiret, flid4: in îilest, c ses to gLiVe thù! signrtifttititn vteelra word luinaaeht~cne tion with tlicm, litiît.tt rts1èrtita fiyst to one. aiii thten tu whe n ariotlier %y gu'Y uir # itn USm- 1)111% N'o\u003e 0(t4eïa tho v~ nwrs\u003c I Dvuttis'try Itru trctted. 4.11 the ~aje~involved in tls\u003c. ho vi 11its1d fticWlut in4a il allaevitîc't ieceoit, of, the intc»nlieli stnietitrom~, i':5 trmitt'iit, îuî ;er1tiîi on ti iiiolitli to -tdjilclit îv.arts. 111 t1hus aIu. (i ýdiing n stiiiiiîtrY () i111fhrînaation on therkiu ina jxttauat 111aaue(rmo it km wll hII1jtit ta\u003e IiWe'L tuet wilts offtho (lCfltUl t4rgeoil initi nej ii îîaîîer. Tue 4ot)d \u003c'ditioi ix IL a dc'Cid\u003c'd imfproeiauo'at mi thielm ts, eetuiulillt ilbutit $000 aulcitiunoi, wvrds-the îîîalter of tige rwbrt- hupolxrttt lirtieio\u003cx SC7",
         "atjvIEI AND I1BLIOGRirlilALNov1er. has been condensed, and otier changes of a desirable kind likwise iu troduced. We can therefore with great propriety advise our friends what have not already a work of th is nature to possess thenselves of Dr. Hlar- ris' Dictionary, feeling sensible th-it in excellence it has not yet been sur- passed. XXV I.-Report of the Seit -t committec of the Senate of the United States on the Sickness and 'frtaluy on board Emigrant Shtips Augustt 1854, Washington i ~3cverly Tucker. Pp. 147. It is usually believed that lie health of those \" who go down to the sea in sh ips \" is rarely invadeJ by diseasc, and still less often annihilated by death. Mortality on sI ipboard is therefore, coimparatively speaking, a subject posscss!tîg barely a passing interest to the pubc moud. The circumstanccs, hwLuver, tiuat have signalhzed the voyages ofrecent years are calculated to reiove ti ese erroneous conceptions, and tu instigakte active inquiry. Thc spirit of inditrercuce las been disturbed, and alaroe has been awakcned to the pcrception of unaacertaincd perils to iumair life. Fromn flie Report before us it appears that doring the last four nonths of 1853, 312 vessels arrived at New York fron Europcan ports, with 96,950 passengers. Of these vessels, 47 were visited by cholera; and 1933 died at sea, while 457 were sent to the hospitals on landing, there to tc-rminate in a short time their miserable existence. On board the 47 vessels atticked by cholera, the nunborof passeugers was 21,857, of whom 1821 died on the passage and 284 were landed sick, naking nearly 10 per cent of dead and diseased in au average pa=sage of 39 days. These data are sufflciently powerful to call for a diligent inquiry into the sanitary capabilities of enigrant vessels. The most appalling scourge which presents itself to observation is cholera, and upon this we will refer to some of the chief facts that have been elicited by the Se- nate. It bas been shewn then that only a portion of the vessels carrying emigrants were nffected in the same scason, the greatest being in those that sailed from London and Liverpool; 25 per cent. of those that left the first port, and 23 * of those that left the last named. From some European ports that are unspecified 41 per cent. of the vessels were visia ted by the pestilence. lence it pi -.as most in the great thoroughfares of commerce and international intercourse, whdle it alnost overlooks the bye-paths along which nankind pursue their way in smaller groups. The infected vessels were found to be those that were most ciowded with passengers, and in strict relation to the extent of crowding was the de-",
         "gree of sickness and mortality. These circumstances have a Strong bearing upon the mode of propagation of cholera. If it be adnmitted the poison which produces it be in the air, the natural inference would be that the sarne cause would affect all ships within the same limita simai- larly situated on the boson of the ocean in the same way,and that sick- ness would be produced on board ôf all.alike. But the above faet, as well as many others contaired in this Report, prove that this is nut the case. The cause must, therefore, originate either in the persou or LÙ the property of the individual; haviig beea engendered here, it, by a species of catalysis, contamidates the air of their residences. Whef, thejrefore, this is pent up and not renewed by accessioris of a fresh at- mosphere, or purified by ventilation; it becomes higidy poisonous; ahd hence the want of fresh, wholesome air on board of passengcr shipot thus becomes bne of the most promnent causes, if not ther most so, of the sad mnortality that has prevailed. Any one who has evýr seen 3 or 4001iv- ing beings huddled together in the orlop or lowed deck of a peaiager ship, can readily comprehend the feasibdity of such an expenumaie. 1ï- rious expedients have been resorted to for the object of ensuring effebui ventilation, as tubular ventilators, windsails, \u0026c.; and the Report ofthe Senate dilates upon them ; but of all that have yet been practised, it inay be said none bas been successful, probably because the aii, which is loaded with exhalations from the hurnan body, finds its way into the holes and recesses formed by the per.manent structure of the ship, the berths (placed as they generally arc transversely, and having small spaces underneath them, and the luggage of the emigrants,recesses wbich can- not be materially affected by any ordinary current of air passing gently through the apartuent, and can ouly be reached aid cleaused of their contents by the operation of some appliance which shall cause the vo- lume of fresh air to be distributed to every portion of the apartment oc- cupied by the passengers. Another rife cause of the spread of disease exists in the imperfect quahty of the food upon which the passengers subsist, and the objectionable manner in which the provisions are cooked. Independently oftle limited variety in the nuuber of dietetic articles, their coarse state,and frequently eremac-ausic condition, its preparation before ingestion is an important consideration i:, the present natter. The apparatus for cooking un board of ships of the largest sizc, consists ofa caboose in the proportion of i foot long to I4 feet ide fort very -20D people. liere all the victuaIs must be cooked at certain boars. la ut- tempting to accoinplish this the sick 'te broaight into conflict with the healthy, and the weak with the strong. 1he sick bave no cha.nco in such a conte.st, and are li.ced to retun withut cookig their food ut.\u0026I, or after prepariug it, n % such a nranner as tO m.ak i tie esùae of",
         "iu REVIZWS AIND B OGRAH'AL Nr g sickncss, and perhaps death. Even with tIe robust and stron,. thî tm of half cooked food is almost sure to produce indisposiron ; but when invalids, laboring uder affections of the atomach and bowels,are obbigedl to take it, the ine .itable consequence is serious, if not fatal disease. So far as cholera is concerned, experience has shewn that nothing will pro- duce it in cases of predisposition sooner than the constumption of meats or vegetables improperly cooked. The Senate in concludimg their R e- port, make several suggestions for the improvement of the coniort and health of the emigrant on shipboard, most of which have reference to the obviation of the two great causes of pestilence ipon which we have been reniarkirg, viz., mephitic air and bad food. They recommend that a space be reserved on the upper deck and kept elear for the enjoyment ofair and exertise by the passengers; a limitation to tne numberofpasa Sengers received-two to every five tons registe!. in order to prevent! the crowding that now takes place of vast numbers in one ship; not keeping passengers on two decks,a lower and internediate ; and that the victuals be cooked and furnished ' y the ship. Appended to the Repoit are let- ters addressed to the chairman, ftul of interestiig narticulars and sug- gestions concerning its immediate subject. XNVIl. - he Dulin Dissector. or Ml1anual of.Ana.omy; ronprismng 1 description of tie boues, musce, nervrs aind viscer ; also the re- latî e analomy of the different regionis of the huan-i bodv, toge- ther with the eh:nts of pathology. By RoBERT HARRISON, A. M., M.B.. T. C.D., Moember of and one ofthe Professors of Ana- fnmy m the R ooll C Ml of it Srgeniis in Ireland, and one of the Surgeons of the Cilv of Dublin Ilospital. Third American, from the Fifth enlarged Dnbhbn Editon. With additions by RoBar \\V,1Tv, Jr., lu.D., Profe-or tf Artonfy in the College of Phy- qicians and Sur ins n the Ci\u002bv of New York,\u0026c. \u0026c. Pp. 591. New York: Sanuel S. \u0026 W. WoOd. The' Diuibh Diî-.'- i'r has loig matintainied a foremuosat position anong works de-ignd to ?Sist t hie ýIu[elnJIt iii thr prosecution of hi' study of practical r y ' 'a on fN lV railii'enmm-id it as a tristworthy guide to thi dion ofth hn limi Ib-. Dr. Watts has added muîch new nd uniportani niliuftr'r to the Amîuîerî'an edition. Hle has, for instance, mi r\u003cdm-i m elnsîIeon of the rnuitîçe.,; the w-eight and dim- enons ' th dIl reii org. ; thve variqties of the artcries; a few Ilix-",
         "REVfEWs AND BIBLI.GRAPHICAL NOTICES. ations not mentioned in the Dublin edition, and some additional remarks on the injection ofsuîbjects. 3 XlVIL---Prtncipld of P\u0026ysidogy ; designed for the use ut Schools. Academies, Colleges, and the general reader; comprising a fami- liar explanation of the structure and ftuictions of the orgna of man, illust-ated bv coijiritive reference to those of the inferior animals. AI-o an Essay on the preservation of hiealth, with four- teen quarto plates, and over eiahty engravings on woo ; making in all nearly two hundredl figures. By J. C. CoMaeroc, and B. N. ComINrs, M.r. lp. 110. New York: M.essrs. Samuel S. \u0026 Willamn Wood. Of the pop'lar works on physiology which have cone beneath our no- tice, this is certainly one of the best. The information it containa ap- pears to have been carefully collected froni recent and reliable sources, and nay be dependled on. The plates and engravings are very credit- ably executed, and serve to fully illustrate the subject matter. Although we di aut advocate the use of such works in schools, beliiving as we do that a \"littie knowledge in these matters is a dangerous thing,\" rather than otherwise, 'we are of opinion that those schools in which popular works on physiology are employed, conld not do better than to select for their purposes the p.esent edition of Comstock and Coming's Principles çf Physiology. XXIX,-Transactions of the \\edical Sociey of the State of Pennsy- eania, at its Annual Session hel4 in the City of Portsville, May, à854, Published by the Society. 'Iis volume of TransaStions contains imany things interesting to the profesion, and exhibits the talents arnd industry of the menibers Of the society in a very favorable light. We cannot agree with the President, Dr. Heister, in the opinion, that quackery wouhl rece2ve a severe checlk if the masses were instructed in the výiences of anatony and physiology. We have invariably found the most enthusiastic snflorters of the diffe- ent pathies-those who bluster and \" talk by the hour\" on the evils of the regviar pactiçe, and applaud to the very heavens a system of medi- cine revolting to common sense-to be persons who have by some meanus",
         "ÇLIXIC\u0026L LZCTURI. or other obtained a saatering of physiology, who knrw enongh of ana- torny to speak authoritatively on the womb, liver, Ings and kidney, and who are capable of pronouincing that the tracheftand rectum are not (né and the same tube. Quackery, in one forn cr other, has always existed, and will, we believe, always exist. The public are credulons to a fault, and there are always to be fotind a sufficient nliber of unprincipled nen who, for purposes of gain, will minister largely to their credulity. CIINICAL LECTURE. (From Medical Times and Ga~ette.) Case as observed among the out patients at the Sanaritan lrpital.-By T. Spencer Wells, F. R. C. S., Surgeon to the Hospital and Lecturet on Surgery at the Schooi adjoinring St. George's Ilospital. I do not know whether it has been generally remarkeC in otýer Ilos- pitals, or by private Practitioners; but I and some of n y friends wvho pracuce in this part of London, have certai:ly ubserved, dluring the sea- mon of the epidemie which is now happily nassnt.g ofi, o very unusia prevalence of boils, and of a low form of diffuse celluiar infilammatio\u003en. and one of my colleagues have been peisonal sufferers, and we bave seen a great nany ca-es of boils among the patients here, especially about the buttocks, . ,ulders, hand and face. I1l-conditioned abscess- es in the axille, and paronychia, have also been nimerous. l ail such cases, there has evidently been a deranged state of the gene- ral health ; a state of general depression, a tendency to sallowness of the face, ligh.-colourèd stdois, high-coloured urine, and sense of fullnesi in the region of the liver, with indications of fnctional hepatic disorder, and occasional attaçs of polic, flatulerice, or diarrhœa. i am disposed to regard this.as one mauifestatioq of the prevailing poison. Just as cholera has been preceded, accompanied, or folloved in this and former visitations by what we may ahnost call epidemics of influenza, and ofa peciliar low form of aguishi fever, I amr convince d that, in this district ut least, it has certainly been accompanied by a prevalence of a formn of furuneular, or low, unhealthy, local mflamnia!ioii, and that pecubar de- rangement of the gcuerat health wlich I have just described. I do not suppose that any very cor ect infeience can be drawn as to the prevalence uf a disease fron the number of deatþs from diseases of a similar clas recorded by the Registia;-General ; þut glance at the folowing Table may not be uninteresting. i shows the number of deaths in the Metropolis froi. Erysipolas, Abscess, Carbuncle, and Phleg- muan, for July, August, and September, during the last five yegrs, and",
         "i.mn C-r .Z. 313 that tis year the tuimber of deatlhs fr'm threce eausc is considerul4y wgerensedl- 1850 1851 1852 1853 1854 Erysipelas . 65 ... î6 ..54 ..80 . la Abscess .. 17 .. 23 .. 27 .. .. Carbimcle .. 9 .. 4 .. 1t .. 17 .. 19 Phlegimon .. 3 .. 6 .. 2.. 3.. ; Total .. .. 94 .. 109 .. 98 .. 136 .. 166 1 nay refer to a very interesting Lecture pubished in the lledtcol Gazette in 1851, by Dr. Laycock, of York, upon what he terms an \" Epidenic Exnnthem.\" He describes a more matrked devree of whnt we have seen iere, and koks upon it as esentially a blood disease, caused by some sfecific poison, and gives some curious facts in surport of the theory that it may originate with tlie lower animais, and is ceu- tagious. T have not heard of any epizootic being prevalent, or affectoig horses and cattle, of late ; but a more extensive inquiry among the ve- terinary surgeons night afiord further information on this point. Dr. Laycock has suggested. that microscopists should seek to deterinime whether some Ektozoon is pot to be found in the skia or subjacent t- sues, and his suggestion is well wort hy of attention. I need not re fer to cases in detail, as the general description will suf- fice to all. One case, however, may furuish lesson of caution. A Middle aged wonani suffered fron this form of low cellulitis in the left side of the neck. Leeches bad been applied, and purgatives given be- fore I saw lier. I found the whole left side of the neck, the jaw, and the subclavicular region swollen, duskv red, hot, and painful, with th, unmistakeable feel of diffuse cellular iý flamrmation. The woman's face was dusky, her luise scarcely perceptib,. , her breathing hurried,-in a word, she was evidently in extreme danger. I at once znade an inci- sion along the lower border -of the jaw, a great number of light lancet punctures on the side of the neck, and some deeper and larget pues be- low the clavicle. Brandy, wine, eggs, and beef-tea were given fZeely, and turpentine dressing applied locally. Suppuration Va profuse ; sti- mulants were required for many days, to the extent of ight ounces of wine atd eight ornces of the mistura vini gallici of the Pharmacopia daily ; but ultimately the woman recovered. I did not sea ber after she was out of dangcr, and unfortunately sufficient care was not taken tg prevent contraction during the healing process ; so that, when the poor woman came here a few days ago, I was shocked t. see that she was as much deformed as if she had had a sevee burn on the neck. None cf the skin had been lost; but so much of the cellular tissue had been dest.oyed by suppuration, that contraction followed. In ail such case, great attention should be paid lo position during the healing process, and any tendency to deforming contraction prevented by counteracting extension. In this case, a stiff collar worn round the neck, keeping the head erect, or even pushing it over to the other sid'e, should have been worn. It would have caused pain at the time, but rauch subsequent trouble would have been saved. As it is, as soon as we have seen what gmdual extension is capable of doing, I shall probably make a subout-",
         "CLINICAL LP.c'TURE. neous division of the cord-like bands which now piass froni the claicle, towards the jaw, and which cause the defornitv. i shall now pass on to some of the cases of stn-bisrhins upon which I have operated lately. There liarebeen five, and it has so happened that I i ave had tu divide the internal rectus ofthe lefl eye in all these cases, The result bas been satisfactory in every case. In one, I told the patient before operating that I should have to deal with the better eye also be.- fore the eyes wojuld become completely parallel, and, lhough the left .eye bas become much straighter than before, and she can see better with it, yet it does net so exactly corespond with its fellow as it will do when I have divided the internal rectuis o! the opposite eye, which I shall.do in a few days. Now, this is a point of practical importance. A squinting patient wishes to know if she can be cured by operation. Yoit think she can ; divide the faulty muscle, convince vomnself that you have done it coin- rletely, and yet the eye squints as badly as ever. rh patient is dih- appointed; you are annoyed ; and the chances are you never see her again ; whereas, a little observatiou beforehand might have enabled You to tell her. that the first operation coulii not succeed, but that a second would. How are you to know beforehand then, whether a second oper, ation will be necessary ? Nothing can be more simple, if you bear in piind certain riules. You muîst regard the degree of nobilhtyof the ,eyes, the difference of visual power, the amount Cf convergetice, and the alternation of distortion on c!osing one eye and calling the other jnto action. In some rases, you may have but slight distortion, yet the piotions of the eyeball are very nnch impeded. Such z, case is not likely to be perfectly cured by operating even on both eyes. In almost all cases you will find a great difiference in the visuel pewer of the two eyes. The distorted eyr is the weaker. In ali the cases we have lately seen, this has been very marked. In one woman, the distorted eye was perfectly useless ; she could net read ordinary type at all with it. It only served to render vision indistinct, so that she always elosed it when Xhreading a needle, or looking intently at any object. You take a book, and find that a patient can read with the straighter eye at a distance of two feet, while she cannot read with the other, the straighter one being closed, at a distance of six inches. In other cases, the diffierence is Pot so great, but there is almost always more or les. Then, as to the amoant of convergence; if the distortion be slight, the ilegree of Mo, bility not diminished, an-1 the visual power of the twa eyes neLply equal, you çeed not operate at all. You can cure the case by making the ps, tient wear prisnatie spectacles. I may epis.rge on this more hiereafter, in the meantime referring te a paper of mine on the subject in the b. dicdl Times and Gazette last year. (See Medical Times and G4sette Vol. VII., p. 216.) If you figd the vision of both eyes god, but the de- gree of convergence considerable, in all probability two operations will be required, and you had better prepare the patient for it. If, with a cosderble degree of convergence, you have, as I have said you alnot always will have, very unequal visual power in the two oyes, the gene- rat rule ii,that one operation will be sufficient; but, to be on the fo side, in forming your prognosis as to a second operation, yvu must deter-",
         "ttiNfCAL LECTURE. mine the power yod have of producing an alternation 4f distortion. Yon know that cases of strabisaus are distinguished as alternating and non-alternating. L. the one case, when both eyes are open, the same eye is always distorted. In the other, the distortion is observed now in thie right eye, and now in the left, although more frequently in one than the other. In the great majority of cases, by closing the better eye, the disterted eye becomes straight, and reverts to its abnortnal po- sition, as soon as its fellow is opened again. If you raise the closed lid of the straightened eye suddenly, yout will probably find that the eye is distorted, but it becomes straight as the opposite eye returns to its old position. You have produced an altercation of the strabismus by clos- mng the better eye, and calling its fellow intò netion. You may do the sane thing by curing one eye by operation; P id, in that case, may have to perform a second opetation and, if the distortion you produced was very decided, you had better prepare the patient for the probbility. I do not say more; because you will often find that, after a few days, a distomtion of the straightet eye which bas supervened after qperation disappears spontaneously. You will find it laid down as a r.ile in some books, that when the distortion shifts to the better eye after operationi both eyes should be operated on at once ; and sone Surgeons go so far as to say, that if aft-r having thorotigIly divided the faulty muscle in one eye any distortion is appairet in either in looking straight forward, the second eye should be operated on without de!ay. My experience bas donvinced me, that these are seriouns practical erlors. If you acted upon these principles, you would often perfbrm a second operation quite unne- ceessardly.and would run into great danger of con'verting . cur'vergent into a divergent squint, for which the patient would be reverse of grateful. I have seen more than one case in the practice ofother Surgeons where the interiialrectiasof the eye has been divided ; the eye not becomingstraight, the corresponding muscle of the other eye bas been cut at once, with the effect of causiig divergent strabismus in one case immediately, and in others within two or thrce days. I would say, therefore, never petform your second operation until you have had time to observe the effect of the first. You would be tolerably safe if closing the sound eye still caus- bd the eyte operated on to become straight: but it is better tu be quite afe, and I advise you, therefore, always to wait, rather than run the sightest danger of leaving your patient worse than you found him. It is curions and interesting to observe how very rapidly the vision im. proves after divisiqp of one of the muscles of a squinting eye. In some er .es the improvenent is immediate. This vas first pointed out to me by the late Mr. Adams, who wrote some papers on what he called mus- calar amaurosis. I never agreed in his opinion, that compression of the optic nerve by the recti muscles was the cause of the inpaired vision ; ibr, looking to thte anatomical arrangement of the nerve and muscles, I' do not see how this compression could be exerted. I think it much more reasonable to believe that the muscle which produces distortion alters the form of the eye-ball, or makes such unequal pressure upon it as to alter the natural relations between the cornea, lens, vitreous huimour, and re- tina, so that the rays of light are not refracted in the same degree or with the same regularity as they are in the healthy eye. Admitting this, we",
         "CLINICAL LECTtRE. can understInd the instantaneous improvement of vision we often ob. serve as soon as a mises has been divided, and the gradua] iiprove- ment still more frequlently observed as %e eye assumes and maintains its normal position. There are many other po'nts to which I might allude with regard to strabismus, the mode of prfbning the operation, the after-treatmeiit, und so on ; but, ut present, oth'er cases reqnre notice. Four cases of zæri have been cured here latelv. Three of these 1 cured li gature, and one by it galvaie cautery. Tic last case was just on the tip of the nose, and within the right nostril--a troublesone situation fur ligature. Tv o appirations of the cautery comrpletely re- noved it. I an iniclined to tbîk that this mode of treutmenit mnav su- persede the ligature iii very nany cases; but 1 have not had sqtficient cxperience as yet ti speak witli coniidence. It is certainly less :'inful tr the child. I ho -e, however to see some improvement made in the formi of battery. The une wc have liere is a Grove's battery of eight snall cells. it is portable; but the fumes from thc stroig nitrie ueid nsed are unpleasant, nud it is scarcely powerful enough. iot heating more than an inch ofthii platim;m -wire. Mr. Meinig vus hero two or three weeks since, and brought a very powerful battery, which he hiad made at my suggestion. Tiideed, it was too powerful, fbr it fused wire as thick as we over want to use, and raised a piece a foot long to a brilliant heat -1l'ast instntaneously. He assured me that it wuuld retain this power for thirty-six hours without renewing the solutions. There are only six cels. 'They are surrounded inside by a zinc pluie, are fillcd with a so- lution of commuon salt, and contsin a porous cell, which is filled with ni- tVie acid, into which a eylinder of antimony is immersed, and the cou- nexion is made as in a Grovc's battery. Tlihe cells are covered with gut- tn percha caps, so that none of the fumes of the acid escape, and the whole is closed in a box, so that the patlant secs nothing but the wires. These are grcat advantage.; ul, if the battery can be made more port- able, it will be very conveL . ror private practice. It answers exceed- ilgly well for liospital practc. as it is. To return,however,to the cases of nævi. I tried the subcutano'us lature in one. The nævus was about the size of a walnut, on the scalp of a child four nonths old. It aþpeared to he ahnost, if not er.uirelp,subcutaneous. I passed a threaded ctuved needle through the sound skin, just beyond the circuiference of the nævus, carriJd it round for about u quarter of the circle, and brought it ont again with the thread, leaving one end of the 'thread, however, hanring from the first point of puncture. Then I re-introduced the needle through the puncture it had made just before, and carried it in- wards as at first, pessing it ont and in again through the same points. until at last it was brought out at the spot where it was first inserted, and ihe two ends of the thread hung out at this saine spot. Of course, a loop of thrcad was thus carried beneath the skin all round the nSvus; and, on tightening the ends, the æavus was strangulatcd. If .t næevus be small, this is sufficient ; but, if large, the knot should be tied over a piee of bougie, which can be twisted each day efter the opeatiqn, unti] the thread cuts its way through the base of the næevua. In this case the thread came aw-iy on the fourfh day, the tumoi felt ft ohy, some fetid",
         "TItRAPUTICL rICOUD. 317 purLunt matter oozed from some of the points of puncture, and so it went on for about a fortnight, until the punctures beg-mn to ulcerate, and the child's mother to be impatient, and I thought it Ietter to tie the tu- mor in the ordinary manner by passing two pirs across its base at right angles to each other, and tying thread arovnd between the pins and the skin. This answered perfectly, as it always does. The prts included in the ligature died and came away on the fourth day. The more ex- perience I have of other methods, the better I am satisfied with this. it destroys the skin, it is true; but, even in cases where the nevus is al- most entirely subcutaneous, attempts to save the skin by subcutaneonS ligatures are often not successful, and we are obliged, as in the case we have ji st desc ibed, to perform a second operation, if the patient does not go tw sone othe Surgeon to have it done. It appears a cruel sort of thing toe ti up the skin of a young child until the thread cuts its way through ; but sf the skin be just divided with a lancet in the line of the ligature, this part of the process is hastened. The proceeding cannot be very painiful; for children take the breast and remain quite cheerful un- til the slough separates. A healthy granulating surface remains, which only requires simple dressing, or at most an occasional touch of nitrate of silver. I have succeeded with the subcutaneous ligature; but it has more frequently disappointed me, and I am almost inclmned to discard it, except in some rare and peculiar cases. THERAPEUTICAL RECORD. Albugo. Electro-puncLure -Dr. D. TÂVIoorT (Bull. de Thér., Juillet, p 49) relates the following:-A young girl, of 19, was aitacked with catarrhal conjunctivitis, with enormous chemusiî, and infiltration of the cornea with lymph, and a central ulceration occurred, then resolution took place, and finally central albugo was left. After sim ple acu-punc- ture, in order to accustom the eye ii. some mensure, the electro-puncture was used. After four sittings, of some minutes cach, at least two-thirds of the exuded matter were removed, but the pain was so sevcre at each application tnat tlie patient would not continue the renedy. Chlorofdrm, or ita vapour,has been used frequently since l rdy's asper in the Dublin Journal, in Nov. 1853. The resuits have been varia ble, but in many cases insensibility has not been caused. Figuier has used warm chloroform vapour, a little apparatus being used, with a smiall spirit lamp, over which chloroform vapour is driveni. Anasarca (Renal.) Spartium Scoparium.-Dn. ALVAREY (Bull. de Thér., Avril) has employed the infusion of this plaun, as recomnended by Rayer, in one case. In fourteen days the dropay tand the albumi.u- ria had both disappearei.",
         "THERAPEUTICAL RECoRDV. Castor Oil.-Dr. GEORGE JoHNsON (Medical Times and Gazette\u003e Sept.) speaks in high terms of castor oil. He administers half an ounce every half-hour in water; gives cold water ad libiturn; employs exter- nal warmth, but gives no stimulants pr opium. Ont of fifteen cases of collapsed cholera lie saved twelve. In the 'Tuiies of Sej\u003etemIber 2ht is a Report, preserited to the Board offHealth by the Medical Concil, in which Dr. Johnson% plan of treat- ment is reported on. It appearu that it has been unsniccessful in the hands of others. Out of 89 cases tteated by fourteen difierent practi- tions, no less than 68, or 764 per cent., were fatal. Crot\u0026 Oil.-Dr. STARK (Lancet, Sept.) recommends croton oil in cho- lera :one drop with colocynth every hour, \" till a fuill evacuation of bilious matter is procured.? Diluted silphuric acid, with a little sulphurous acid, is sometimes simultaneously employed to check the vomitinrg. Production of Artificial Dropsy in Cholera.-Mr. RicHARDSON (ASSOc. Med. Journal., Sept.) proposes to inject fluid into the peritoneal cavity of the' cellular tissue, under the idea that it will be absorbed readily. Some experiments are related to show how easily and how safely the plan may be carried out. We are not aware that it has beei tried on any cholerà case. [Unfortuately, vc are afraid that thiLsingenious suggestion will like othere plats, not succeed. Strychnine, iodide of potassium, and other remedies, Lave been injected into the cellular tissue, but have not been absorbed.] Sulphuret of Potassium.-Dro FRoENrrTr.F. (L'Union, Aout) dissives tins substance in water,4with or without sugar, and gives a tablespoonlul in cholera every halif-hour or hour. Sulpiuric .4ci.-Dr. F ta (MvcL Times and Gazette, August) re- peats the favourable opinion he frnerly expressed ot te tility of this remedy. One ounce uf the dilutu icid of the ' Plirma'ci ia' is added to cleven ounces of wUter nnd one onWe anid half tire given every twenty or thirty miniutei, aecrdin tu the severity of tho case. Six or eight dues altugether are glivei. Lrysiilas. Tinrture nf Jdine.- - )r. DenKEE ( Amer. Journ. of Med. Science, .July, p. 10s) recomnnends the local application of the rutierial solittiun ot iodin, poured in quintitie of tweity or thirty dropsp 11on the part, tid ismmediUtly stpread over tho stfalce with a brush. Thu skin h to l made rently blWek witl the io\u003eine. has bein employed by Di. $em'maln (Schmidt's JahJrb., 1854, No. S, p. 29s) wilti gooud tWret, lic dissolves two grains of phuspliurus in thren draihMs., o th(ei i and gives filleca drops every hour. (;oinrdoie;. Su/itetic of 1?ismuth.-oth icuto and chroni lonnurrhisri Dr. li %v i mplùys, t bre times ditly, an injection, cumpused 'rf wate'r ui.r! wIlt b us much triaitrate of bianoth as can be suspended. It 1- to b, n'Y i tiv ivo nu . ; it cVai.w no pain. /II rmnv , ~z. (:u//û. --\u0026 .lne f .4paks hlighfly (Allg. Méd. Ccn- tri.l Zeit., A .'I 11 w b, .11ini») of Ih effee ut cuGiom in hemicrunin, iti (toset- e 'tn t r I Mid u bialnli every I wo or threc htours. li Iasal",
         "t'ERISCOPE:. 319 ernployed the citrmte of caffii. On account of thue dearness ofecaffein he bas used withi good effeet the extract of coffee, four grains of which are ýq imi to onie grain or caffein. PERISCOPE- ENLSI flltd-C~sthzairr..--L.Teichninn luis sizeeeded in cbtiîingi ,crystals froni blood witlîcut anv preparatury evaporation,by flhe adki t îit oif four, five, or more parts of water to one of biood, and flo ilhe fiuid to stand sîufficient1y long. lit this wviy, anud by t1w iiwsiertioui oet a small piece of cork uuider one of flo ic o uthe coveriuig -lass3, lie hasu produced citysta1ization iii thie bluoil of all thc aiuuia1, hoe cxaîuuuîed, and in al! the blco\u003edvessels iindisciimiiinddy. Ilisol'scrvatioiu'i'twc'rv con-l ducted on tlie bloed of niait, oxc'u, s-wiuic, r. bbit:s, z)uî~ iii1 lisli ; trogs' blood, for a tine, thriiid tLe ouily excelLoii. Th'Iis )bsývrvcr bc- Lieves that the crýstalliz.able suý,s ance is cuntoj'ied iii thue blood-vor- guscles; he bas procitred crysu ais frorn thie fi1tered ovsig f iie ]ood-cake, and stat-q thuat lie fouînd theni more pcrfert thue nure thue 'coruscles -\\veru fieel. frin serilni and fibriii. With regard to fit influ- ;-nce of tîînipirtîro, lie ha.- observed ilint the sIewer the *vîrho takes place, fli,! more coniplotc wvul the vrystiils le ; but if t lie rqlr ed to pruducc thein quickly, the tcmpeijr;itiî\" miay tie sliglilly bd ut it must,,t luot be earrind to flie piit at %viuich t ho aibunin :ii îiîs In subsequcuut cxpieriinents ou frogs' llodlc proriîred crysta!s 1,y flic adili- ion ot* a verv considerablc quauîtity cfl water, at a very low IcuiperCIa- turc the quantity of thue crystals wvas propîortiouuate1y suîîîillcr tlian in ofl'er specunucans of blood, and they are aliways colourless when flinis ob- taunî'd. Froua 1-lood four inonthis old, anl aiso frora dried blood, lue bas succeedcd ini lbrming crystals.-Brit. and For. Mcd.-Chir. 1tev. April, 1851, fromn ZcitsvLh fur Rat. Med. B3d. iii. InJZacnce cf Cod Liver C\u003ed\u003cud Cucoa--'Vu* (\u003eiÎ vu the Dioo.-Dr. Thco- phulus Thoînpson rend beforc thue lLoyal -Sýociety (April 27, 1854,) a pqijcr oin this subject. He foittid, that ditruuug the aduiuîiistrativii of coci-iiver oil to plithisicaul patients theil- bluud grew riclier in red curptîsch's, andi he roiers to a pre- VIOIIs observationi of Dr. î-rair, -Siiion to thue saine elfect. The libe cet almnond-o:l anud oliu-uul wvas im.t [l'dlowed by any reuneniai cffect , but froin co#-.'a-ntit oi, resits Nwcrc obtaiîîcd itirnost as deuided as trilu flue oi cf flue liver et' the cod, awl thL, athulr be1icvcs ut miay ttr out ic b",
         "PERISCOPE. a useful sibstitute. The oil employed was a pure cocoa oleine, obtain. ed by pressure from crude cocoa-n,.t oil, as expressed in Ceylon and the Malabar coast from the Copperah or dried cocoa-nut kernel, and refined by being treated with an alkaliand then repeatedly washed with di;lled water. It burns with a faint blue flame, showingacomparatively small proportion of carbon, and is undrying. The analysis of the blood was conducted by Mr. Dugald Campbell. The whole quantity abstracted having been weighed, the co- gulum was drained on bibulous paper fcr fort or five hours, weighed, and divided into two portions. One portion was weighed, and then dried in a water-oven, to determine the water. The other was macerated in cold water until it became colorless, then moderately dried, and digested with ether and F.lcohol, to remove fat ; and, finally, dried completely, and weighed as fiirin. From the res- pective weights of the fibrin, and the dry clot, that of the corpuscle was calculated. The following were the results observed in seven dif- ferent individuals affected with phthisis in different stages of advance- ment:- Red corpuacles. Fibrin. First stage, before the use Female 129.26 4.52 of cod-liver oit Male 116.53 13.57 First stage, aller the use Female 136.47 5.00 of coddiver oit Male 141.53 4.70 Third stage, aflter the use Male 138.7 2.23 of cod-liver oiM Third stage, after the use Female 139.95 2.31 of cocoa-nut oil Male 144.94 4.61 Med. Times and Gaz. June 10, 1854. Successfud mode of treating Mercwrial Salivation.-Dr. Normand Che- vers stateb (Indian Annals of Medical Scence, April 1854), that he has met with uniform and apparently certain succesa from the use of iodine gargles in the worst cases of mercurial ptyalism. He has found that a gargle coutaining from two to five drachms of the compound tincture of jodine to eigit ounces of water, exerts an absolutely prophylactic or curative influence. He states also, that Mr. Burgess has applied the pure tincture to the whole interior of the mouth, in cases of severe mer- rurial salivation, with speedy and perfect success. D-. Chevers, among other cases, quotes the following, in illustration of the benefit of this treatment :- \" Curc of ordinary case: of Salivation.-In February 1852, I attended an officer, ætat 48, m an attack of cholera, which was then raging epi- demically in Chittagong. The disease was generally attendedwith ex- treme danger, and this - .se was one of remarkable severity. During the first sixteen hours, 1 administered seventy-five grains of calomel. On the third day the sputa became tinged with blood, the gums were swollen and tender, and the spaces bctween the teeth were filled with coagula. A gargle, containing two drachms of compound tincture of iodine, to eight ounces of water, removed all traces of salivation so effectually within about two days, that my patient, although a very i-",
         "PERISCOPI. ni telligent mni. and a rather active dabbler in physic, neverappeared to be aware that he had been subjected to mercurial treatment. \" Early in last year, I was called to attend a lady, about thirty-four years of age, who had been suddenly attacked with an excruciating pain across the umbilical region, which appeared to be associated with a sud- den check to the catamenial fonction, resulting from exposure to a draight while very thinly clad. The symptoms were extremely urgent, and a dose of ten grains of calomel was among the first remedies em- ployed. Relief was obtaiued almost at once ; but on the second day, the tongue was foind swollen, and clots occupied the inter-spaces of the teeth, but little uneasiness was complained of. The iodine gargle was employed with such rapid success, that the patient scarcely referred a second tine to the condition of her mouth. I Employment of lodine as a Prophylactic.-Of late, I have been in the habit of begining to employ the gargIe in all cases where the quan- tity of mercury given has been such as to render the occurrence of sr...- vation probable. Judging from a confessedly very limited experience of this ineasure, I apprehend that its early employment will anticipate the occurrence of 8alivation in all cases where the constitution is goodand there is little or no visceral disease; that, even urder the worst circum- stances, it will greatly limit the severity of the action ; and that, for the most part, the original disease, on account of which mercury was admi- nistered, will have its decline rather favoured than otherwise by the absorption of iodine from the mucous membrane of the mouth. A cer- tain degree of doubt will, of course, attend nearly all details of prophy- lactic treatment, but I think that the following cases may be regarded as encouraging. 'I Early in the last rains, I was requested to visit a medical officer suf- fering extremely from an attack of ileus, whici I attributed to the sud- den outflow of a quantity of a highly vitiated bile, acting as an almost corrosive irritant upon the mucous membrane of the snall intestines. When called to him, I fouid him greatly weakened by intense pain and obstinate vomitting, and by ooring from the bites of several Iceches which he had himself applied to his abdomen. le had already taken three or more five-grain doses of calomel, which, however had nt actbd Upon the bowels. I administered a ten-grain dose alnost imnediatcly ; and, the disease remaining obstinate, a scruple dose was recomiieided by Dr. Mdler, who met me in consultation, and was given on th-- fol- lowing day. The iodine girgle was employed early ; and, although it was nearly certain that a lirge proportion of froU forty-five to fifty grins Of catornel must have fully entered the system, ptyalism did not oc,:ur. \"In October last, I attended the children of an European for niImamp, which wa.s then rather prevailent in Howrah îia its viniuty. A i thiese c!hildren lad suffered from hoopin-cough during the precediig winter. Ti elder boys did vell, but tie two yttngcst, aged respectively ah l two 'nd four years, were suddeuly attacked witli lIryngitis as the swel- ling of the paroti.Is begau to decrease. Althouglh very, acti'ely treated, the younger infaut died in lttle iù re than twenty-four hours fron th, Onset of the laryngcal sym1ptoms, i iound the larynx an.l trachea ahbu'- lutely occluded by an e irlugv tenacious croupy depost. The otle child's symptoms were eli dly voont, but he recovered M~",
         "PERISCOPE. vere treatment, a part of which consisted in the administration of 6fteeri grains of calomel withln as many hours. In a day or two, one or two ;1pthS appeared on the tongue, yet it could scarcely be said that saliva- tion was present. The gargile was used freely and no ftuther annoy- ance was experienced, although the tongue bas ever since presented that patchy appearance not unirequently no ticed among delicate chil- dren in India. New Testfor Sugar in Diabertes. By John Horsley.-If a freely alka- line solution of chromute ofpotass be nixed with urine suspected to cou- tain sugar, and boiled, the liquor will assume a deep sap green coloi, arising fron the decomposition of the chromic acid, the reduced oxide of chromiumn being held in suspension by the potassa, Such is the sensitiveness of this test, that five or six drops only of' vc- charine urine diffused through water is sufficient to show the effect, whA is infinitely more striking than even Moore's potassa or Trommer's l'est. I would, therefore, recomnend a mixture, in equal parts, of a solution of the neutral chromate of potassa and liquor potasso, to be kept in the Chemical Cabinet of every chemical practitioner, labelled \" Test for Su- gar.\" The following two experiments beautifully illustrate the value of this process in the detection ofsugar under any circumstance.: First Experiment.-Take a small test tube, and having put do it ten or twelve drops of simple syrup (cane sugar) ard diluted it \\with we- ter, add a fe.- drops of the test mentioned, and apply the heat of a spari: lamp. No effect will be p;oduced. Second Experiment.-Tak-e another test tube, and hiiving put the ame quantity of simple syrup diluted with water, and two or thre\u003c drop- of acid, sulph. dil. and boil for a few minutes ; this will convert the cailo* into grape sugar. If we now .dd a few drops of the test and apply beat, the effect becomes striking, developed in the change of the color of the liquid to an intense green. When the quantity ofsugar is very small, a piece of white paper al the back of the test tube will show the color more distinctly.- London chenist. G ERMA N. PISONING BY STaVnCII' NP..--Poljuta, assistant at the Veterinary School at Chartrow, publishes in tIe Rulsan Medical Times his experiiments on horses, in which le shows that these animals ean beàr large doses of strychnine when an openiíg has been made into the trachea. Tle cause of death from strychnine is interruption of the respiratory process by I . uic spasn of the glottis, hastened by over-activity of the heart. For le general spasms of the other muscles, Pojta enploys chloroform with success.-[Medizini c lie Neuigkeiten for October.]",
         "PERISCOPE. lRùN AND COLLODION IN ERYslPELA.-Dr. Aran employs equal parts of tcture of iron and collodion (sclution of gun cotton) in this affection. This application possesses many advantages over simple collodion, among otners, in being tlinger tud more equally distributable, and in not fall- ing off on mioveinent of tue part.-lbid. PROLAPStS OF THE TUNIS LMBILIcALIS-n Seanzonis contributions to obstetrics, Seyffert offers a few remarks on the actiology and :nanage- nient of this cornplication, so fraught with danger ta the unborn infant. After very great experience in the obstetric art, lie comes to theconcia- sion that no general rules can be laid down for the management of pro- lapsus funis, lIe denounceq the use cf mnost instruments as of little worth. land and forceps well employed will meet inost exigencies. lie su-gests the followiig as the causes of prolapsus : 1. Narrowness of the pelvis, abnormial position or size of child. lI head presentations, well formed pelves, and not too much lq. amnii ; the child,~at an carly stage, lies low in the uterus; but in a nara pelvis, large head, mua[i liquor arnii, and where the prornontory prcjects too far, or unequally to either side, the child's head does not becoe.e enga- ged in the pelvis, but lies on one side, leaving abundance oi roon on the ather for the prolapsus. In such cases, reposition, by means of the hand, shiould be attenpted (rarely by means of instruments), and the c'ordl placed in its proper position, and kept there until a few pains cii- gae the hcad. il the accoucheur fails in this, the directions of Siebold, Blisi, and \\Viegaud, will not influence the result; for if it cinnot bc inaintaineil in situ by tie land, it cannot by a sponge ; to alter the po- sition of tlie head is alike ineifective. 2. Oblique Position of the Fotus.-In one case Seyflert was lorta- liate euough to returu the cord, and retain it there until the com plete evacuation of the \" waters;\" in two others the childrL i were renoved by forceos-alive. 3. Presentation of ai Upper Extremity with the Head, whcrelby the bead is prevented descenidmg, and flic cord slipped down alongside the hand. In two cases, in which the vater had already tlown, the hand only coîld be returned, and delivery was coipleted by the for- ccps. The children were apparently dead, but revivcd. In two other cases, the hand and head were returncd bebre tlic diseliarge of -' wa- ters.\" .. Large quantity of Amnial Secretion and Leungtliv Curd. In six such cases delivery by the forceps ; ciildren born alive in 1im . 5. Low Position of Placenta, in neighbourhood of Os. Four such cases were observed by Seyffert and Naegele. In two cases were lve -hildren brouglit forth by forceps ; in two, still-born. 6. Breech Presentation with Prolapsus. Four such cases were observ- ed In three puisation was not interfered with as long as the cord did not rest below the buttocks. In three of those deivery of ivin g cliii- dren was accomplislied vith the forceps.-[Scanzoni's J3eitragen zur Geburtshilfe.)",
         "PER 'QCOPBL FRENCH. Purgatifs contre le chdéra (Gorlier).-Selon moi, dit M. Gorlier, le pur- gatif est indiqué contre: Les premiers prodromes, même les plus légers; Contre les évacuations stomacales ou intestinales, existant enssmble ou Sépaément ; Contre tons les accidents nerveux quels qu'ils soient. Il est bien entendu que le purgatif n'est plus indiqué quand il s'agit d'un agonisant. On fait alors ce qu'on peut: Ad extremos extrema. Jamais je n'ai eu recours aux boissons alcooliques pour arrêter le vomis- sement: mon purgatif m'a toujours suffi. C'est la limonade au estrate de magnésie, boisson fort agréable, quand elle est bien préparée, le pr- mier verre est quelquefois rejeté, nais les autres son. constamment gardés. Je la préfère au sulfate de soude. dont la saveur est désagr-ble, et qui est ordinairement mal accepté par l'estomac. Comme moyen prophylactique,au sulfate de qninine,je préfère encose ma limonade, qui nettoie, qui débarrasse; mais je trouve à ces médicaments l'inconvénient d'endormir dans une sécurité trompeuse le client qui, se croyant à l'abri, négligera des symptômes, qui, dans tcute autre circons- tance, le feraient recourir au médecin. Vinaigre, potion, bainsferrs artifciels (Lambossy).-La puion ferrée est destinée a faire prendre le remède à l'état naissant. Pour cela on prépare deux bouteilles. La premiière contient; Sulfate de protoxyde de fer pur..... 10 gram. Eau destillée..;.................. 250 - La seconde contient : 3icarbonate de soude.............. 15 gramn. Eau distillée...................... 150 - Le malade prend trois fois ie jour, avant le repas, une cuillerée à car de chaque remède dans na deni-verre d'eau et l'avale immédiatement avant que le dépôt bianc verdâtre de corbouate ferreux ait eu le temps de changer de couleur. On peut augmenter progressivement les doses. Le vinaigreferré est destiné à préparer les bains ferrés artificiels ; on prend pour cela de la limaille on de la tournre de fer que l'on dépose dans ue bouteille de vmnaigre irt. Au bout de quelques jours, l'acétate de fer est formé; cet eétate, versé dans un bain tiède, constitue le bain ferrugineux ordinaire, iais on peut en alugmenter la force en ajoutemt an viniure un verre d'acide ehlorhydrique qui agit avec plus d'énergie sur le fer, et ajoute ait bait un nouveau principe, le chlorure de fer. Ces moayens îI\"uvent êftre employés dans le cas où le fer ne peut être supporth cit auiiune par les voies digestives.",
         "PERIsCOPE. Elixir de Villette.-Dans un vase suffisamment grand, faites macérer pendant un mois. Résine de guiac pulvéris.. ......... 1,500 gramm. Rhum .......................... 37 kilo 500. Décantez ou mieux filtrez. D'un autre côté, faite digérer pendant un mois également: Ecorce de kina jaune concassée........ 3 kilo. Fleurs de coquelicot.................. 1,500 Sassafras, en copeaux.................. 750 Eau-de-vie.......................... 25 kilo. Eau pure........................... 100 - Filtrez comme ci-dessus. En troisième lieu, prenez: Salsepareille fendue ou coupée ........ 500 grain. Liqueur de la seconde opération.. ..... 12... ,500 Faites bouillir pendant deux ou trois heures, passez à travers un linge, et avec : Sucre............................. 6,250 Faites un sirop marcinant 31. degrés bouillant. Réunissez toutes les lilueurs et le sirop dans un même vase, agitez le tout de temps en temps, et, aprés un mois, décantez ou filtrez, et mettez en bouteilles. Cet élixir, désigné encore sous le nom d'Elixir de gaiac dulcifié, com- bat avantagcuseneit les alf.etiors goutteuses et rhumatismales. On le donne à la dose d'un ptciit verre à liqueur (15 grammes) le matin à jeun pour les auduil os. d'une cuillerée à bouche pour les femmes. Les enfants faibhl s et délicats se trouveront bien de son usage. Pour eux, la dose sera d'une cuilerée à café. -Seigle ergoté centre les écoulements blennorrhagiques passés a l'état chro- mque (Antoine Lazowki, d. i. m.).-J'ai, dans mes précédents Annu- aires, indiqué plusieurs applications du seigle ergoté. En voici une qui peut se rattacher à celles que nous avons déjà fait connaître, et paraîtra peut-être intéressante aux praticiens. \" Quand l'écoulement est entretenu par un état d'atonie de tout le système ou seulement des organes génitaux, la vessie, la prostate ou le canal de l'urètre sant isolément ou simultanément frappés d'un relâche- ment qui entretient la blennorrhagie. L'emp!oi des moyens qui ont une action excitante spéciale sur ces organes est parfaiteinent indiqué : dans cette classe se trouve le seigle ergoté, dont l'action devient plus manifeste quand on l'associe aux ferrugineux. \"L'expérience m'a démontré pleinement la justesse de ces vues théo- riques; aussi ai-je pu guë- par ce moyen un grand nombre d'écoule- ments qui avaient fait pendant longtemps le désespoir des malades et des médecins. Bien plus, certaines blennorrhées chroniques, compliquées de rétrécissements de l'urètre peu intenses, ont cédé quelquefois à l'emploi du seigle ergoté, ou tout au moins ont rendu la guérison plus facile et plus prompte. \" La formule que j'emploie est la suivante:",
         "EDITORIAL DEPARTMENT. Seirle ergoté, récemment pulvérisé...* 4 gram. Safran de mars apéritif.............. 5,50 centigr. Foudrè de vanille................. 0,- Camphre pulvérisé................0,5 - Mêlez et divisez en paquets, que l'ont doit prendre: un le matin à jeun, et un autre le soir en- se eouchant. \"La durée moyenne du traiteMIent est de dix à vingt jours, pendant lesquels il est inutile de soumettre les malades à une diète trop rigou- reuse. D'ordinaire je prescris simultanément une décoction légère de quinquina gris. \" Jusqu'à présent, je n'ai pas mis en usage l'extrait aqueux de seigle ergoté, que M. Bonjeau a improprement nonuné ergotine. Il est à sup- poser cependant qu'il agirait de la même manière que la poudre d'ergot de seigle. Quoi quil en soit, je désire vivement que les praticiens veuil- lent bien expérimenter ce nouveau mode de traitement; je: suis per-t suadé quils trouveront, comme moi, dans le seigle ergoté, un médica- ment précieux pour combattre les écoulements blennorrhagiques anciens ehez 'homme et chez la femine.\"-(Rerue terapeutique du Midi.) LICET OMN1US LIC T NOBIS DIGNITA\u0026TEM ARTIS MIEDICA TUERI. LSANE IN CANADA. Some tine ago we wrote an article with the viev of calling the atten- tion of Governument to the urgent necessity which exists for the imme- diate erection of additional Asylums for the reception of the lunatie population of the Province. The simple announcement by t he publie press, that the Superintendant of the Toronto Asylum had signified his determination nfot to admit the name of another patient on his already overcrowded list of inmatés, was sufficient warranty to uÀ to speak; plain- 1r and decidédly on the ubjcct. We were aware, at the same time, that Beanport could nonconveniently accommodate another lunatiei and that our common Gaol contained within its walls a number of those unfortunates. The total number of insane in Upper and Lower Canada was a point on which, from the absence of all reliable information, we could not speak with any certainty, and we were thus deprived of a strong argument. Since thon, however, the seoond por- tion of the Census Report of Canada has made its appearance, and we are now in a position to lay before our readers the actual number'of per- sons laboring under mental alienation, with the number which are i 3 2 6",
         "EDITORIAL nUP.' AIF.\\T. present enjoymug theý bencfits oif proper trcatmr nut la AylIms. Wc nre certain the people of Canada need onîly to e onv ini i of the ex istin g shamefilly insuflicieit acconimtlt i to dem:a] from tin. Legislature the approprit ion oi a sum necessary j let, at least, i we good it als for the insane. Publie attentlin înec fillv roused to hlie. iihsraeofiil .i:te which thiigs are, lwi remedv wIi not lon w he frthcomîing. Accordîng to the Censuis Report there are inw in rper Canada 1069 pefsons of unsouind mind ; in Lmw er Canada ienre are 1 733, mnaking a total lir the Province of*-2.02. (if tiese, 141t0 are nuies-1392 feiales. 'lle whole population, acl rting t the samne Rep rt, is 1,S1.,103 ; the eastern section containing SO.-26 1 ; the uwestern, 95 1,1.2. The propor- tion of Imalies to the entire popllatIon wil tierefore he 1 to 657. This is it ratio greater thai obtains iin most enountries. In England, France, United States, Belgini and Prussm, the ratio is 1 to 1000. In Scotland and Norway, however, the ratio is greater. li the former it is 1 to 573 in the latter. I to 551. It would apar that the tenperature of a eli- mate lias an influence over the mental lcalth of individuals,-cold elintes hbing more lavorahle to the development of insanity than either warii or teiperate chiates. zSunny Italy lias but 1 Iunatic to 4,787 persons of sound iniid ; temperate England and France have 1 tu 1000 ; but cold Norwav, Scutland and Canada have 1 to about 600 A comlîparison of t0 be prevalence of insan4y in the two sections of tho Province. favors this opinien. Il Upper Canada the climate is iore eqnalc throuîghout the ycar, and is mueh more temperate during tlie vmnter montlhs than iii Lower Canada. l the former the numbers of in- rane and entire population are respectively 1,069 and 951,742, the ratio being as I to 891; in the latter the numbers are 1733 and 880,261, the proportion being as 1 to 50S. Ilere is a disparity not easily to be account- ed for. A greater number of the population being engaged in agricul- tural pursuits-the quiet, retired habits of the French Canadian habitan, and the intense cold of the long vinters, are probably the reasons why the diflrence is so groat between Upper and Lower Canada. IIaving placed these statistics before our readers, we now proceed to inform them of the provision which the public-spirited and philanthropie Legislature of Canada lias made for lier 2802 lunatics. We blush for our country as we send forth these statements to the world. There is the Provincial Lunatie Asylum at Toronto, built for the reception of 250 patients, althougli now containing nearly 400 ; and the Beauport Asy- lun at Quebec, capable of accommodating about 150 patients; accom- modation being provided by Canada for only 400 of her 2802 in- saie population. This is surely an evil of no ordinary magnitude. Not- vithstandine- that these facts must be known to those in atthority, Par-",
         "EfDIToSIAL DEPARTMENT. li ament is allùwed to assemble and separate, yet not a solitary voice is raised dur;ng the session, to solicit the adoption of measures whereby this foul blot on our character, as a civilized and Clristian conmuity, might be viped away for eier. Monies are voted, and voted freely too, for the furtherance of varions objcects, but for the cause of the pour hmna- tie, the cause of hin- whom un inscrutuble Providence has allowed to becomne the muost pitiabie ad hielpless of maen, not one penny has buen appropriated. P. rsuns who have made insanity the subject of observa- tion. mnust 1 paii:ilidiilly iipressed with tac iihtuiianity of our Legislature, kiowinxgas they do that a. large propKortion o insane cases, ifsubmitted to proper treatment at an early perîud, will be restored to their original vigour ofrnind ; but the sane cases allowed to be confinéd and watched over by friends or the employes of a commun gaol, wdl certainly result in incur- able insanity. It is a question pregnant with sorrowful and distressing reflections-how nany of the 2,802 Iunatics, at present within the bor- ders o Canada, if pruperly treated, would be rejoicing in the possession of an unclonded reason, who are now furious maniacs, stolid melancho- ies, or drivelling idiots 1 We must have, as we said before, tv good Hospitals for the Insane,- cach tu accomimlodatu 2.50 patients, and to include all the improvements introduced into modern asylums. One of these should be crected in the vicinity of Monireal. Government now own twenty-nine acres of land near the cty, adnirably bitnaied for an Insane Asylum. Tis property lies between the Tanneries defRolland and the city,and is on the elevat- ed plateau which extends from the Tanneries, in one direction towards Lachine, in, the uther towards Montreal. It possesses ail the advantages sought in the selection of a site on which to erect an Hospital foi the Insane. It is airy and elevated-the land is dry and fertile-the scene- ry is diversified-it is easily accessible fron the city at all seasons of the year, and above al], an abundant supply of water might be obtained by having a large branch pipe laid down from the tube of the new water works, where it attains the summit of the ridge, after passing through the Hon. Mr. Quesnel's grounds. The property, moreover, extending down the hill, offers excellcnt facilities for thorough drainage and sew- erage. The only objection that can be raised against this site, is the li- mited extent of the grounds. This objection may be readily obviated, as an additional quantity of adjoining land, we bave been given to un- derstand, can be easily obtained. It was originally purchased with a view to the erection of an Asylum for the Insane upon it, and the purchase was made as far back as the time of Lord Senton's admi- nistration. This nobleman, with his privy council, appointed a commis- sion, consisting of the late Dr. Robertson, Dr. Crawford, and Mr. Lunn,",
         ".. D.:PARTMElNT. to take steps towards establishing a tenporary Lunatic Asylum, and £2,000 were nppropriated to assist in carrying out the objects of the formation of the commission. In addition to the purchase of the proper- ty, the commission received plams for the clevation of the building, two, of vhich were approved .nd paid for. Mr. Ostrll, of Montreal, and Dr. Luther V. Bell, President of the - American Association of Medical Su- perintendents of Institutions for the lu-ane,\" were the successful compe- titors. The plan subnitted by the former gcntleinan wt pia ýed first, and he received £50 ; that of the latter, second, and he was paid £25. Ve earnestly hope to see active steps taken in this matter imme- diately. The country wants these Institutions for the Insane-a coinmon hurnanity denands theni ; and the country, for the sake of un- foitunate humanity, must have them. MEDICAL MEN Foa EMIGRANT SHips.-By the 15th and 16th Vic., cap. XLIV, sec. 38, every passenger ship is bound to carry a duly qualfied Medical practitianer, in the following cases:-1. When the duration ofa voyage exceeds in a sailer 80 days, and in a steamer 45 days, and the number of persons on board (including crew) exceeds 50. 2. When the voyage is to North America, and the passengers exceed 100 adults, and the space for each is less than 14 feet. 3. When, whatever the desti- nation or the space, the number of persons on board exceeds 500. Penal- ty, £50. But by the Merchant Shipping Act (1854) clause 219, to come into operation lst of January, 1855, it is provided that the following ships shall carry on board, as part of their complement, some person duly authorized by law to practise as physician, surgeon or apothecary:- 1. Every foreign-going ship having 100 persons or upwards on board. 2. Every ship having 50 persons or upwards on board, which is bound on a voyage from the United Kingdom to the eastward of the Cape of Good Hope, or to the westward of Cape Horn, or to any place on the west coast of Africa, or the east coast of central or south America, or to the Falkland Islands. Penalty, £100. IMPROVEMENTS IN MODERN.SURGER.-We have received from Henry Smith, Esqr., a copy of the Oration delivered by him, March 8, 1854, before the Medical Society of London, at the eighty-first anniversary. In this oration, Mr. Smith, after a passing tribute te the worth and talents of the late lamented Frederick William Barlowe, notices in suc- cession ome of the leading improvements which have, of late years,",
         "EDITORIAL DEPARrMENT. been iuntroduced into the science and art of surgery. The Grst mn thi, lhst is the simple water (retssinJg of Liston, whieh is now enployed to the comiplete exclusion of thu unctuous envelopes and complcated bandages of former days. Nlr. Ilenry Lee's vahable researches on Pyuniia ; Mr. Luke's suispentlmbg splint in cases of fractr~ ; Si Benj. Brodie's investigations into the true pathology of diseased joints ; Mr. Guy's practice of mnaking a free inciîsion into disorganized articulations; Dr. Little and Mcssrs. Tamplin \u0026 Blop's imnprovenents iii Orthopu-die Surgcry, by which nynv defornmties of ihe body may be successfully treated ; Mr. Ferguîsson's iethod of dividng the fibres of* the levator palati muscle in lct palate ; Drs. 1liutton, Cusack and Bellingharn's cele- brated treatment of anieurism ly compression ; Symc's amputations at the joints, and excision of diseased Lune, iii certniu cases, in preference to rermuval ut the limmb ; and histly, Siinpson's great discovery of the an- n-sthetic propertiws of chlorofurmi are the i:improvements particularly dwelt upoi. Altugether, it is a very creditable paper, and exhibits, on the part of the writcr, a famniliar acquaintunce with the literature uf modern surgery. More anduition amowng the extra collepiates.-Dr. Valois' Bill, printed in a late iu.nber of our journal, liaving proved, as ne une doubted, a faîlhire, is noJw seeing the corruption of decay. From its ashes, however, which app.ear to be more turbulent ihan peaceful, a phSnix-like crea- ture is arising; the fostering elucking over which devolves on Mr. Tacié. Just as we are ;iiug to press, and this nust be the apology for our brevity, we have scen the ùnotice of an address te the Imperial Go- vernment, praying for authority to pa..s a bil to subject to an examina- tion by the Provincial Board of Medicine, all candidates who are the bearers of Diplomas frorn the different colleges and Universities. This grand evenit completes the personification of the extra collegiates by the inan who, when he could not raise his edifice te the eminence of an adjoining structure, set about thinking how he right pull down the eye- sore to his bwn level. Montreat Pharmacetical Association.--At a meeting of the Druggists' Assistants and Apprentices, held on the 17th Novembei, with a view of organizing a society for improving themselves in their profession The society being constituted and named the I Montreal Pharmaceutical As- sociation,\" the following gentlemen were elected officers for the present year:-Johnston Beer, president; Richa±f Jonnet, vice-pres.; Charles Vanfelson, sec.; Kenneth Campbell, tkeas. TO CORRESPONDENTS. Professor Robb will receive our tbanks fbr his attentions. Inqe r will appear in our next. Dr. Nezmier will hear from us privately.",
         "QtARTERILY REPORT Of t1ie MÍON1RI.Al. GENERAL lliSPITA L, 11dinq! 3 lst October, 1854. Remainiing from last Quarter.. * , ' Itècharged cure-.......... ....... 311 A dmtitted ......................... 3 D ieà ........... ... ............. e ........................ 118 4 -18 ln- Dour JPatîunt. Out- Iodr Fateünis. MaIlts........................... 178 es.......................... Feina.e ..........................l j U.¯ emaIles.......................... 34') 333 696 lllSE.\\SES AND ACCIDENTS. I1 . A bct ssri : prid-rrit tib 1 N i bis. G, dis Aene 1ll ATia iiirrlii-a 2 :t Anta,ac Acttest I (hitis 21ti î I si is 3i i .:dpr Paroryia 1 ' I i tliiis utir! . cin ainut i PI i-c 1'jiî.IIQa I ' ronm et :oni 1 Pîrcîsmonia, 1 2olera A i ca I Fistili I Prolapsu Ai 1 (' rdii j 1 (;9 i rrr a 41I Rheumatismîts 13 (fl'tîli u.i ('tebn I 1 j llcnîiîpiasîn I 1 Scabies 2 C p I leriîtnrhroido 2 Scalatia 'it.ji cv is it lbi ir 1 Sclerotiîis ossiierp I Spermatorrhoa i H.jl s Synnvitis 3 Cotrivo dte - 2 Syphilis IL' 1 Coup de Soleil Il leteris 21 Syphilis cum varia 1 i bcîn: tas 6 il Inebitas I Tic Douloureux Delirium Tremens 12 I Iritis U I us Diarrhoea 31111 Lelra I Varices ysetera ariola Eczema Maxasmua j Vuuîtos 3 Emesicom etIco In addition to the deatba meritioned above, there were 33 who dîed within tbree days afler admission, and whose namnes titre consequently not erirered in tbe ordinary registema Thtis makes rte total number cf deaths during the quarter ta be 59. t There were 29 additîonal casps of choIera which proved fatal within three dsiys aller admission, makicg thie total number cf cases durirtg the quarter, 56; anid the itumber o deaths, 40, Operations during the Quarter. Major amputation of leg, 1; cancers excised, 2 ; encysted tuor re moved, 1 ; circurnision, 2. Total, 6. Fractures and Dis locations-Simnple fractures, interx., 6 ; extern., i cummon fract., 2 ; comp. and comrnon, 1 ; Dislocation, 1. Total, 11. Minai'; Biecding, 3; cliping, 10; leeching, 6, issue, 1; wounds drcssed, 3; hot harrower, 8 ; Acupuncture, 2 ; AbsceÉÉes opened and dress4ed, 21; vwetL cxtracted, 59. Total, 108. Attcnding Physycians, Dh. WnrIH \u0026 JONES. RouEnT OSAIS\u003e M.D., 1mwi'« Surgeon.",
         "MEDICA.L NZwS. BCOKS RECEIVED FOR REVIEW. Haoall's Microscopical Anatomy. 2 vols. 1854, ublitn Dissector. Tliid American. from fifth and enlarged Dublin Edition. Comstoek's Pultilar Physiology. From Messrs. Samuel S. \u0026 Wm. Wood, New York. Hiarris' Dîctionary cf Medicine and Dental Surgerv. From Messrs. Liunds-.by \u0026 UbIkistvn, l'hiladelplia. Jones and Seiveking's Pathological Anatomy. First American Edi- tion, revised. Cross on Foreign Zodies in the Air Passages. 1854. «est on the Pathologctal Imtportance of Ulceration of the Os Uteri. 1854.. From iers. Bianchard aun Lee, Ph ladelphia. Nw tar' n D . ao, an.1 otur WiiIniigs. Fron Musrs. Ticknor and Fields, Boston. Kirkbride on lospitals for the Insane. From the Anthor. Galt on Insanity iii Italy. Froi the Author. Report of the Seect Committee of the Senate of the United States on the Sickness und Mortality on buard Eiugranut zhips. Fromt Hon. Ha- Milton Fi.sh, Chairman of Comniittece. Positive Medical Agents : A lkaluids and Resinoids. From Messrs B. Keith and Co., Americai Clhenical Insttute. CATALOGUE OF BooKs.--Ve have reviexwed Messrs. Wood and \"'o.*\u0026 Ca.talogue of Bocks fbr 1854. It icludes, vith recent works, many o'd and rare volumes on muedical science. Aiy book ordered direct froni this house will be sent through the 'ost Offico frec of expense. The address is:-Messrs. Samnuel S. and William Wood, 261 Pearl Street, New York. MEDICAL NEWS. Dr. West bas reeigned the office of Physician to the Hospital for Sick Children, London, and Dr. Kirkes is a candida:e for the post.-The Medical Society of Virginia offers a prize iedali of $50 for the best essay \" on pneumonia,\" to be presented before March 1855. --The Boyleston premium for 1854, oi$60 eacb, have been awarded to Suas Durkee, M.D., of Boston, for the best dissertation 4 on the constitutional treatment of syphilis,\" and to George H. Lyman, M.D., \" on the non-malignant diseases of the uters.---At a meet- ing of citizens of Savannab, on the 14th October, the Mayor presiding, a service of plate was presented to Drs. Redwood and Hamulton of Mobile, and Dr. Cross of New Orleans, in token of gratitude for their services dunng the late epidemic of yellow fever.- Drs. Dow. ler and Gibson, one of New Orleans, and the other of San Francisco, publish descriptions of viviporous fish seen by thern. Dr. Dowler's was caught in the New Orleans Canal, and measured two inches and three-quarters in circumference.--At a General Board of Go- vernors of the Rotundo Lying-mn-Hos8ital, Dublin, held on the 3rd November, Alfred H. McClintock, Esq., M. D., M.R.I.A, Fellow and Examinerof Midwifery in the Royai College of Surgeons in Ireland, \u0026c., was elected to the office of master, in the place of Dr. Shekelton.-A final blow bas been struck at the moustache movement. The lecturers ai the Charing Cross Hospital School, London, are said to have sent to a candidate for the honor of be rfming a colleagne, an intimation that he could not be received until be had sacrificed a favorite moustache.--Dr. Thomson, to whom was assigned the hazardous but honorable duty of tending the wounded Russians on the plains of Alma, and whose melancholy death from cholera occurred on the 5th uit.. after rejoining the camp, was a native of Cromarty, in the North of Scotland. Dr. Thomson entered the army in the month of February, 1848, and at the period of bis death was in the tbirtieth year of bis age."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORIGINAL COMMUNICATIONS. Chlronic or Mummfißed Gczgrene of the leg occurring during an attack of Acite Mania.-Ampitatio--Recovery. By Tiios. SIMPsON, M.D. Miss --, aged 19 was seen by me on the evening of the 15th October ; three days previously she had been in attendance on a sick friend and since has felt weary and generally \" out of sorts.\" She had. been low spirited for eight or ten days owing to a comparatively trifling family trouble.. At my first visit she complained, of general malaise, loss of. appetite,. inability to sleep at night and seemed depressed and melancholy, speaking .to her friends in a gloomy and.sometimes confused manner. She con- plained of-a dull aching pain in the region of the heart and a sense of oppression, and answered questions in a dejected, hesitating, unsatisfactory way. On an examination of the heart no organic disease or derangement could be dis- covered. . Pulse i 1o, regular but small, pupils natural, skin cool, bowels tolerably regular, tongue slightly coated, menstrual flow (she is now.unwell) has regularly occurred every three weeks, and is. usually copious but without any other. peculiarity., I am told that she has always been a he;thy active girl, with a keen enjoyment of life,. of a determined disposition and a more than average flow of animal spirits ; she is over the medium height, large boned and spare. The only departure from health since she was H H",
         "CANADA MEDICAL AND SURGICAL JOURNAL. four years of age, when she had small-pox, was an attack, on two occasions some years ago, of hysteria induced by fright. These attacks were of short duration and the recovery complete. Her father-up to the time of his last illness being a hale hearty man-died at the age of sixty- two years, of congestion of the brain. Her mother is alive and in good health, aged sixty-four. It is well to'mention here that during the second week of her daugbter's illness she was suddenly seized late in the evening with a severe epileptic convulsion which recurred, with interivals of semi- consciousness, several times during the night. This is the only attack of the sort she has ever experienced and was no doubt occasioned by over exertion and want of rest added to her extreme anxiety on her daughter's account. She recovered completely on the third day. This seizure in the absence of a satisfactory family history, which could not be obtained, is of a certain value as regards her'daugh- ter's derangement. The patient has two brothers and one sister older than she, all of whom have always been healthy. She was ordered to bed, to be kept quiet and to have a dose of morphia at bed time. October 16.-Slept comfortably for several hours during the night. Is much excited. Conversation disconnected aind rapid. Does not complain of pain or any inconvenience. Answers questions rationally but immediately relapses. Pulse still rapid and weak. Pupils and skin normal. Ordered Potas. bromid. gr. xx. terindie. i7th October.- Consultation with Dr. Craik. Symptoms of mental disease all increased. Great excitement. Hys- terical in character. Dwelling on love and kindred subjects. -No sleep last night. Ordered Chloral hydrat. gr. xx. to be given at bed time if necessary to procure sleep. She con- tinued much the same until the 22nd when violent mania was developed. It required the united force of three strong persons to restrain her and on the 23rd a strait waistcoat and bandages had to be used. She remained in this state until the evening of the 26th when the fierce delirium 482",
         "GANGRENE OF THE LEG-DR. SIMPSON. abated. Though still in a great degree unconscious she was calmer; pulse weak and rapid. On the following morning I was summoned to see her and told that she appeared to be dying. I found her in a state bordering on collapse. Beat of the heart and pulse almost impercepti- ble. General surface, but especially the lower limbs, cold; voice weak. Hot wine was plied liberally during the day in addition.tosstrong beef tea, and quinine and phosphoric acid were substituted for the bromide. : Towards evening she rallied. On the morning of the 28th she complained of severe pain in the right foot, on examination it was found cold, and three or four pale purplish patches of small size were remarked on the toes and dorsum and attributed to bruises received during her struggles. There was no swelling or ædema. The purplish patches gradually coal- esced, became darker in colour and ended in perfect dry gangrene of the foot, which retaining its shape becamé as hard and dry as horn. The subcutaneous veins of a darker colour than the surrounding parts could be distinctly traced as small hard cords. The dry gangrene extended abové the ankle joint and merged into an ordinary slough at the line of demarcation which formed irregularly a little above the middle of the leg. The process occupied several weeks, during which the patient remainedconstantly insäne, talking in a most incoherent manner for hours together, then breaking into snatches of song ; sometimes tractable, at others fierce. and controlled with difficulty, attempting to tear and destroy everything within lier reach ; no lucid interval ; no convulsion. Ordinarily there was no fever but at times there was a slight.flush and temporary increase of temperature. Pulse always extrenely weak and rapid, ranging from 120 to 140. Pupils natural. Musculâr strength remarkable, considering the state of the circula- tion. Urine free from albumen. Fæ-ces and urine passed in bed without notice. No menstrual discharge since the first week of her illness. Appetite capricious ; bowels irregular; wakefulness. Towards the middle of December 483",
         "484 CANADA MEDICAL AND SURGICAL JOURNAL. she gradually sank -into a low typhoid condition., The raving became muttering delirium. The tongue was dry and fissured ; sordes formed about the teeth and gums- everything pointed to a speedy dissolution. From this state she slowly emerged ; her mind began to clear; she became cognizant to sone extent of the state of the leg. Her appetite improved ; her sleep became natural ; the menses returned, and she made known her desire to evacuate the bowels and bladder. About the middle of January the gangrenous parts had separated from the living down to the bone, and the calibre of her mind might be compared to that of a child of six years of age with a certain amount of cunning added.' The amputation was delayed until the 3 1st of January owing to the extremely rapid state of the pulse and in order to allow of improvement in her mental condition. On that day, assisted by Doctors Craik, Hingston and Roddick, the leg was removed at a point immediately below the knee joint. Chloroform was administered, and Esmarch's bloodless method success fully employed. The stump healed slowly but without any untoward symptom and the patient is now able to sit up in an arm- chair. lier mind is still weak and capricious but there is every reason to hope, from the progress of the last month, for steady improvement. The quinine and phosphoric acid treatment adopted on the 27th of October was continued until the end of December with occasional short intervals during which she refused to swallow medicine. Morphine in gr. î doses was given at bed time and acted most beneficially, soothing the patient and encouraging sleep. The state of the pulse seemed to indicate the necessity for stimulants but on trial it was found that even a small wine glassful of porter had the effect of flushing her face and rendering her more restless and excited. The local treatment consisted in swathing the affected limb in cotton wool, and in gentle frictions to pro- mote the circulation and endeavour to limit the gangrene.",
         "GANGRENE OF THE LEG--DR. SIMPSON. The diet consisted of eggs, milk, beef tea, oysters and a quantity of fresh fruit, such as grapes, oranges and apples. The precise cause of the gangrene in this case is some- what obscure. Dr. Howar d examined the heart early in' the disease and was- unable to detect any organic lesion. It was noticed that there was no. arterial pulsation discovera- ble in the affected limb, even in the femoral at its upper part, whilst the pulsation in the artery of the opposite side was quite apparent. It was also remarked that the pulse in the right arm was extremely weak, being scarcely per-- ceptible-a mere tremor-in the radial at the wrist. Shortly befor.e the operation, pulsation of the right femoral could be traced for two or three inches below Poupart's ligament-probably at the point at vhich the profunda is given off. Dr. Craik who kindly saw the case with me on several occasions, noted these peculiarities. The circulation in the stump at the time of the operation seemed to be sufficiently active. The larger vessels were tied before the removal of Esmarch's elastic band, but on its removal two small branches situated in the posterior flap spouted vigorously. Dry gangrene has been met with as a result of constitu- tional adhesive arteritis terminating in occlusion of the vessel at the site of inflammation or at a considerable dis- tance from it, by the washing away by the blood of the fibrinous formations and their impaction in smaller branches -embolism. The arteries most liable to this form of inflammation are, it is said, the iliac and the axillary. It is possible that the gangrene in the case under con- sideration was occasioned by the obstruction of the femoral artery to a greater or less extent by a fibrinous plug or fragments, originating in some part of the course of the iliac. This case was reported and discussed at the last meeting of the Medico-Chirurgical Society. MONTREAL, April 6th, 1874. 485",
         "486 CANADA MEDICAL AND SURGICAL JOURNAL. Case of dificuilt labout, failure to de/iv-er witl forceps. Ver- sion successfully peifonzed. By T. HOWLEY, M.D., St. John, Newfoundland. Perhaps the following case may be deemed of sufficient interest to your readers to render it worth publishing. I think it offers a fair type of a class of difficult cases not infrequently met with in practice, and there can, I think, be very little doubt that many children are lost by the sacrificial operations in cases of moderately contracted pelvis, who might have been saved by a timely resort to turning where the forceps has been fairly tried and found insufficient to effect delivery, as advocated by Dr. Robert Barnes in his work on obstetric operations. CAsE.-Called out of town about six miles at 3 a.m., Dec. 18th, 1873 to Mrs. W., multipara, eighth pregnancy at about 40. On enquiry I learnt that she had always had difficult labors, having been on every occasion delivered instrumentally, viz: four times by forceps and three by craniotomy. She has two living children, both girls ; had never brought forth a living male child so far. I found that the patient was very short, almost dwarfish in stature, and had evidently a contracted pelvis, though without any evi- dence of distortion or spinal deformity. Labor was in full progress, having got so far as the second stage, with strong and frequent expulsive pains ; head presenting but not being able to enter brim. Having the previous obstetric history of the patient before me, I applied the forceps without delay after having chlorôformed her, and suc- ceeded in locking them without much difficulty, thus shewing: firstly, that the case was a fit one, for their trial.; secondly,that the contraction of the pelvis was not excessive. I kept them on for over an hour using all the tractive force I dared, but without causing the head to descend or engage in the brim. I then came to the conclusion that delivery was not to be effected in that way, and in the absence of a consultation which was not easily to be had, I had to",
         "CORRESPONDENCE. decide between craniotomy and the attempt to deliver by turning. Having but recently been reading Barnes and been struck with bis remarks upon the value of turning in similar cases, I determined to put themto the test,and accord- ingly, with a good deal of difficulty, succeeded in getting hold of a foot, and after long and exhausting efforts at length effected version.. The liquor amnii had pretty nearly all escaped and the uterus 1was consequently closely moulded around the fœtus, hence the difficulty. It was surprising how comparatively easily the head, which could not be either coaxed or forced through when presenting by its rounded globe, 'passed the contracted brim when .coming base first. There was not certainly five minutes delay or detention of the head, and the rest of the labor was effected without trouble or accident. Considerably to my surprise, seeing. the hard usage to which it had been subjected, the child a full-sized male, showed signs of animation, and with care and a good deal of attention came to all right. The sex of the child, no doubt just made the difference in the size of the head iwhich rendered delivery by forceps impracticable. I have only to say further that mother and child did well and have continued so ever since. The time occupied altogether in the delivery was four hours. The want of assistance is a great drawback especially where chloroform bas to be administered and kept up for hours. ST. JOHN, Newfourdland, April 8, 1874. '(To te Editor of tMe CANADA MEDICAL JOURNAL.) MONTREAL, March 28, 1874. DEAR -SIR,-In your issue for February, 1874, 1 find your editorial observations upon the article in the Britisk Medical 7xmi7zal of January 17, 1874, upon the \"West 487",
         "488 CANADA MEDICAL AND SURGICAL JOURNAL. Haddon Tragedy.\" With the verdicts of the coroner's juries in the case I have nothing to say, the evidence put before a jury may be of two distinct characters, moral and medical, eithcr of which may be sufficiently strong for the jury to come to a conclusion upon. In this case it is upon the medical evidence that I wish to occupy a small space in your columns. In your comments, you mention that \"the famijy physi- \" cian found a high temperature of body, and that this \"induced the Chemical expert, (Mr. J. D. Rodgers, of \" London) to state that he was of opinion that deceased had \" died from some volatile noxious substance, given to her 4immediately prior to death, but which he was unable to \"detect ;\" on reading this text, and your criticisms thereon which would be very just provided the text were correct, and on referring to the Briuisiz Medical 9ournal, I felt there must be a mistake somewhere. I therefore wrote to My old teacher, and fellow labourer in Chemical science for an explanation of what seemed to me not to be the whole truth; from his reply received since your last issue, I make the following extracts : After giving the facts of the' case as proved in evidence, constituting the moral evidence in the case, and which the jury took into their deliberations as well as the medical evidence, MR. J. E. D. RODGERS says, \" under all the circumstances you will not be sur- \"prised at the exhumation. I found the oesophagus \"distended with the same matter as was in the stomach; \"I found no cause for immediate death, but I found morphia \" assuredly, but I could not estimate tËie quantity as I had to \"go over much ground, with little to work upon, and had \"nothing to guide me. \"What I said at the inquest was as follows: I have \"found no mineral poison whatever ; I have found an \"alkaloid, a trace, and by that I mean a quantity that will \"enable you to determine the nature of the substance but \"f not its weight ; it is morphia, without a doubt; morphia would account for the symptoms on the Saturday but was",
         "CORRESPONDENCE. \" clearly not the cause of death. I have.discovered no poison \"to account for the immediate cause of death. That I was \"not in a position to state what was, but that I considered \"that the high temperature of the body militated ajgainst \"the heart disease, being the cause. \"Being asked if in the course of my experience I could \"suggest any poison that could cause death, and after a \" month not be discoverable ? I replied,-that was a ques- tion that I had hoped would not be put, for I had a great \"objection to speculate as to the cause of death vhen I \"had found no poison to account for it, but in answer I \"said that a dose of prussic acid and certain other volatile \"poisons would cause death and .would not be discovered \"after a month's burial, but I added, I repeat that in this \"case I have found no poison or trace of any poison, to 4account for death.\" His statement of evidence given by my friend Mr. Rodgers materially alters the aspect of the the case as far as the medical and chemical evidence as to the cause of death is concerned, and also takes away the basis of your criticisms thereon. I crave space in your columns for the above to counter- act any injurious opinion your readers may have been led .to form from your article upon the evidence of my friend, erroneously reported in the British ZIMedical %zurnal. Whilst sympathizing with the unfortunate sufferers in this case, and observing the good old.maxim, \" De mortuis nil nisi bonum,\" we have stil·i a duty to perform towards the living, to be just to them, and not blame the-medical experts for foolish or knavish evidence which they did not give. By inserting the above in your next number you. will do an act of justice towards my friend, and oblige Yours truly, G. P. GIRDWOOD, M.D. Prof. Practical Chemistry, McGill University,. 489",
         "490 CANADA MEDICAL AND SURGICAL JOURNAL. Cliuilcal Electro-Therapeutics, inedical and Surgical. A Hfand-book for Physicians in the Treatncut of Nervous and other Discases. By ALLAN McLANE HAMILTON, M. D., Phiysician in charge of the New York Hospital for Diseases of the Nervous System, Fellow of the New York Academy of Medicine, Member of the New York Neurological and County Medical Societies, \u0026c. With numerous .illustrations. New York: D, Apple- ton \u0026 Co. 8 vo., pp. 184. The author tells us that \" he endorses Electricity only as a very valuable remedy in certain diseases, not as a specific for all human ills, mental and physical.\" This statement certainly encourages us to receive the book with all the greater degree of favor, for nowadays the general failing with the supporters of electro-therapeutics has been to claim for electricity the possession of virtues far beyond those ever actually proven to belong to it. The pathology of diseases of the nervous system is confessedly often ex- tremely difficult, and many of these being but little under the control of other remedies, from the commencement of the enployment of electricity as a remedial agent, great things have always been looked for from it. Abused as this agent was at first, and as it is even yet by charlatans' and imposters, its true and proper place in the practice of the healing art is at last graduaily coming to be fairly and definitely settled. Everyone now admits the undoubted efficacy of the employment of this means in a variety of nervous disorders, but from the fact of little being taught about it cither theoretically in our medical schools, or prac- tically in our hospitals, manual treatises on the subject for the use of students and junior practitioners are especially valuable. It is divided into four parts, which treat respect- ively of electro-physics, electro-physiology, electro-thera-",
         "BOOKS RECEIED FOR REVIEW. peutics generally and, special electro-therapeutics. The first three of these parts are coinpressed into less than one half the entire volume,,the whole 'of the remaining portion being devoted to special electro-therapeutics. Under this head we are introduced to a great variety of diseases, almost all, of course, of the nervous system, either organic or func- tional, and the -various modes by which they have been successfully treated by electricity are explained and illus- trated. The chief affections thus treated ofare the following: paralysis-central, spinal, peripheral, hysterical, infantile, facial, \u0026c., besid'es allied diseases, such as progressive locomotor ataxy and progressive muscular atrophy ; next, nieuralgia in all its varieties, facial, cervicobrachial, ::ciatic, \u0026c. ; next convulsive diseases, under which heading we have chorea, Scrivener's palsy, epilepsy, tetanus, torticollis, \u0026c.; and, lastly, we have two chapters on the surgical applica- tion of electricity by means of·electrolysis and by galvano- causty. Whilst agreeing generally with the statements made there are certainly a few expressions from which we must beg to dissent. \" It is the general opinion of dermatologists now-a-days,\" it is said, ''that skin diseases are simply neuroses. Newman and Barensprung and others unite in this conclusion. Numerous experiments substantiate the truth of this assertion and have proved that nearly all skin diseases are amenable to electricity.\" Against this we think there is still a general feeling that many affections of the derma are produced by a process of inflammation, and many others by a condition of depraved nutrition, and not merely by such a disturbance in the normal state of the nerves of the part as would permit of their being called neuroses. No one will deny that such diseases as urticaria and Herpes zoster are of nervous origin, but we find the assertion of Dr. Hamilton too general and sweeping. In these troublesome functional disorders, chorea, epilep- sy, paralysis agitans, \u0026c., our author has nothing encour- aging to - say, eleciricity having proved only of doubtful value in a very few cases. 491",
         "492 CANADA MEDICAL AND SURGICAL JOURNAL. The neuralgias and some forms of local paralysis are the affections in which electrical currents have produced the most satisfactory results.. .A considerable number of cases which have fallen under the author's notice are quoted in illustration of the various points, but, considering his extended opportunities for ob- servation in connection with the State Hospital for nervous diseases, we think they might have been considerably aug- mented, especially as it is professedly a clinical and prac- tical treatise. We cordially recommend this book to every one desirous of acquiring information concerning the applicability of and the modes of applving electricity in the cure of disease. Tlie Sphygmograph: its physiological and pathological indications. The essay to which was awarded the Stevens' Triennial prize by the College of Physicians and Surgeons, New York, April, 1873. Two hundred and niiety illustrations, by EDGAR HOLDEN, A.M., M.D., 8vo. pp. 169. Philadelphia, Lî1nsAY \u0026 BLAKISTON. The field adopted by Dr. Holden is, as he himself remarks, pathless and virtually unexplored. It is but a very short period since the invention of the sphygmograph of Prof. Morey, and the observations recorded having as yet been too comparatively linited, it follows that all the results here given are entirely original: and when we consider that we have presented to us nearly three hundred plates of pulsatile tracings, representing specimens from all con- ceivable kinds of disorders, we may form some idea of the amount of time and labor necessarily bestowed upon their investigation. The Essay begins with a necessary description of the mechanism of the instrument. Dr. Holden's sphygmograph is a modification of that invented and used by Prof. Morey. In the latter the plate or surface which first receives the impulse from the artery is so arranged as simply to lie upon the Vessel in close apposition with it, and to rise and fall",
         "BOOKS 5RECEIVED FOR REVIEW. with every pulsation. Measurements of the elevation moverment alone, are, however, according to Dr. Holden, quite fallacious. He believes that to get a correct idea' of the real changes taking place in the blood-current in circulation, it is necessary ;to guage the expansion move- ment of the vessel. In accordance with this view the author has confrived a spring, which, possessing a hollowed portion in its under surface, thus embraces the artery, and- in consequence measures by its attached levers the amount of displacement which takes place at every cardiac stroke. Other minor diflerences there aie between the two instru- ments, but only in matters of detail which do not effect the principle of their action. From this subject we pass to the consideration of the translation of tracings, wherein are explained the terms employed in describing sphygmographic writings, and the significance of each portion of the hiero- glyphic. Every cycle which embraces a complete pulsation is divided into four events-as they are termed, and it is upon the relative proportion, shape and other characteristics of these that depends the interpretation to be placed upon any given specimen. This occupies three or four chapters, aud with one upon the compressibility or tension of the arteries, and the importance of ascertaining the exact character and extent of this, completes the first part. In part II, is then taken up the consideration of the normal character of tracings, and the deviations produced in thern by disease. Great pains is taken by the authofin *the en- deavor to establish the variations consistent with health, and the abnormalities produced by minor disturbing causes. Illustrative cases are then shown from patients suffering from a great variety of diseases. such as Heart-diseases, Delirium Tremens, Epilepsy, Asthma, Phthisis, \u0026c. Part III. is occupied by a series of drawings illustrative of the various effects produced npon the pulse by medicines, especially those of the narcotic type, and the whole is com- pleted by several conclusions based upon the numerous observations made.",
         "494 CANADA MEDICAL AND SURGICAL JOURNAL. Up to this time this instrument has not been acknow- ledged as one of the diagnostic aids necessary for medical practice. But we believe that it is one that is yet destined to be of great service to medical science, and the thanks of all inust be due to any one who gives time and energies for the accomplishgnent of this object. That its usefulness will not cease with its elucidation of various scien.tific physiolo- gical and pathological problems may also be fairly'expected. It is not a mere toy for the amusement of the scientist, or the researches of the physiologist, but it seems to give pro- mise of being a very valuable and faithful guide in many im- important ways, and in the most practical manner possible. Some of these our author has not failed to point out ; for instance, he remarks, \" It is at once evident, that .could we satisfactorily determine the variations compatible , with health, the sphygmographic record of an applicant for life insurance would be the safest record he could present us as a test of his condition, and this single feature could hardly fail to be of great pecuniary value in the country where the assurance of life is almost universal.\" We cannot do better than conclude by another quota- tion from the essay itself. \" The ability of any instrument to indicate the departure from perfect health, whether capable of indicating the precise character or not, would stamp it of practical value, just in proportion to its power to do this alone, or more certainly, or better than could be *done by any other means. There are many reasons for believing that the sphygmograph will do all of these.\" This study is certainly well worthy the attention of every physician wishing to keep up to the knowledge of his times, and we therefore cordially recommend Dr. Holden's essay, ,to the merit of which we have already borne witness, and which is confirmed by the bestowal upon it of the honora- ble Steven's Prize, by - the College of physicians and -Surgeons, New York. The typographical part of the book is well executed, and the plates (white on black ground), are elegantly finished.",
         "PYMIA-PRESCoTT HEWETT,. F.R.C.S. We are glad to learn that one ofthese instruments accord- ing to Dr. Holden's. pattern has already been ordered from Boston for the Montreal General'Hospital, for use by the- Attending Staff and Clinical Classes.. An Address on Pyvnia in Private Practice. Delivered before the Clinical Society of London. By PRESCOTT HEWETT, F.R.C.S., President of the Society, Senior Surgeon to St. George's Hospital, \u0026c. (Cancludedfrom April Nimber.) Some time after the occurrence of this case, the late Dr, Bence Jones happened to mention to me that he had been summoned into the country to a young gentleman who was suffering from well marked pyæmia, without, as far as could be ascertained, any previously existing suppurating surface, I then told Dr. Bence Jones. of the above case of pyaria, after gonorrhœa, and begged of him to ascertain, if possible, if his patient was suffering from gonorrhoa. . The patient died before Dr. Bence Jones saw him again, but at the post- mortem examination the existence of gonorrhoa was clearlyr proved. A third case of a. similar nature, and in a young gentleman, was also mentioned to me by Dr. Guéneau de- Mussy. Such, gentlemen, are the cases of pyæmia occurring in: private practice, to which I wished to direct your attention. They are twenty-three in number, and twenty-one of them. feill.under my own notice ; the remaining two, the last being well authenticated, have been alluded to simply on account of their extreme rarity. . And now, if we proceed to analyze the circumstances under which pyemia occurred in these twenty-three cases, it will be found. that an operation was performed in six 495",
         "496 CANADA MEDICAL AND sURGICAL JOURNAL. instances only. In four of these (the first tour) the opera- tion was of the most trifling nature-a single-thread seton, a small wart on the heel, a small wart on the scrotum, a small sebaceous tumour of the scalp ; and it was only in the remaining two that the operation was of a somewhat severe character-amputation of the breast. Moreover, the first four were all in different years, and. not in the same locality. The last two were in the same year, and within à month of each other ; but one was in town and the other in the country. And here let me note that the third case is also mentioned among those of recovery, this, patient having had two attacks of pyemia at several years' interval, and in different localities. Of the remaining seventeen cases, in which no operation had been performed, there was a broken surface in eleven, and in six there was not even an abrasion. Of the eleven cases in which there was a broken surface, it was but small; in ten, ulceration of a small sero-cystic tumour of the breast, of abscesses in two, of tonsils in two, of bowel in typhoid feveb in three, a needle broken in the leg, a small splinter of wood in the great toe. The eleventh case was the only severe one-compound dislocation of the elbow. The six cases in which there was no abrasion were-a slight injury to the foot followed by suppuration, inflammation of the lateral sinus and internal jugular vein in connection with discharge from the ear after measles, abscess after parturi- tion, and gonorrhæa in three. Of these seventeen cases none occurred at the same period or in the same locality. As to locality, of the t'wenty-three cases, sixteen occurred in town and seven in the country. Of the sixteen in town, all, with one exception-that of the young girl who, after running a needle into her leg, was admitted with pyæcmia into the Hospital,-were in the best parts of the town, scattered about, in good houses, and in good sized, well ventilated bed-rooms, and well cared for, in fact, to all ap- pearances, under most favorable conditions. The country cases-seven-were in different parts, and widely separated",
         "PYiEMIA-PRESCOTT HEWETT, F.R.s 49 from each other, and their conditions, too, were in all re- :spects apparently excellent. As to age, the youngest patient was six, and the oldest close upon eighty. Of the remaining twenty-one, eleven were between fifteen and twenty-five, and ten between thirty -and fifty. As to local treatment, it was out of the question in several of these cases; and in several cases, too, all possible care and supervision on the part of the surgeon would have beén of no avail. Of the twenty-three cases, eleven were undér such circumstances. In conclusion, pyæmia, it has been said, is caused, for the most part, by hospital air, by foul air consequent upon the aggregation of surgical cases in the wards of our large hospitals; but pyemia occurs also in cases, even when placed under the most favourable conditions-perfect isola- tion, large airy rooms in the country, with plenty 'of fresh air, and in every way well cared for. Pyæmia appears, too, .at times to be connected with atmospheric conditions; several cases occurring without any apparent cause, at or about the same period, in different places. The two cases of amputation of the breast, which were within a month of *ach other, followed exactly the same course, one, however, being in town, and one a few miles out of town. And at the same time that these cases were under my care, other cases of pyæmia, which occurred in private practice at the ýsame period, subsequently came to my knowledge. Moreover,- cases occur in which patients are apparently prone to pyoemia ; the case of a gentleman who recovered from an attack of pyæmia, and a few years afterwards died of another attack. The truth is, the causes of pyæmia are still to be worked out ; and this, gentlemen, is a problem, the working out of which I would strongly urge upon the Clinical Soiety.- Medical Times and Gazette. 497",
         "CANADA MEDICAL AND SURGICAL JOURNAL. Observations on Hare-Lip and Cleft Palate. By SIR WIL- LIAx FERGUSSON, 13ART., F.R.S., Surgeon to King's College Hospital. It may seem recurring to an oft-told story, to refer to hare-lip as giving opportunity of saying anything new or good on such a familiar subject. I fancy that, in my time, I have seen considerable changes for the better in regard to the treatment of such cases, that even 'now, after the experience of many hundred examples, I think that I can make some observations worthy of consideration. The operation for this malformation was one of the first I ever performed on the living body. It was doùesome forty-five years ago, and ever since I have taken interest in it, both in my own practice and that of others. I have repeatedly, in public hospital practice, operated on two or three cases in a single day, and I have read most that has been written on the subject throughout my professional life. It may perhaps, be claiming more than I am entitled to, to say that, prior to the publication of my first edition of Practical Sur- gery, there had been little written regarding the anatomical condition of this malformation. There were few men, if any, alive who could state positively, or could show by specimens, what was the nature of the substance of the intermediate hard material in the midst of the two gaps in the upper alveolar ridge, in the case of double hare-lip. It was not known positively whether it was single or double. So far as I know, it was never even conjectured how it was held in its place; its relations with the vomerwere unknown. The number of teeth likely to be developed in it, or their future quality, were little thought of, and the mass itself was found, in most instances, to be specially in the way of any contemplated operation. Until within these few years, therewas not a skeleton of such a part in any museum in this country, and, in as far as I know, the specimens pre- sented by myself to the Royal College of Surgeons are still the chief, if not the only, examples of the kind in-our anatomical museums. Our knowledge on most such",
         "HARE LIP-SIR WILLIAM FERGUSSON, BART. matters is now so precise, that the intermaxillary bones are now spoken of as familiarly as those in lower animals, vhereas the actual condition of the human subject had rarely, if ever, been either described of demonstrated. The difference of connection or attachment, in the cases of single or double fissure in the alveolar ridge, seems to have been entirely overlooked; for there was no description which told how, in thre double fissure, the intervening mass was held in its place solely by being suspended from the point of the vomer and the rest of the columna of the nose. The development of the teeth in these cases has also, in my opinion, attracted less attention than in the normal condition of the upper jaw; but it is less my intention to refer to such anatomical and physiological matters than to some points in surgery, which I think specially worthy of notice as part of the result of my long experience in such cases. First, as to the date or age when operations for hare-lip are most eligible, there is no doubt in my mind that an early period is now most preferred. The custom of delaying until after thé completion of first dentition bas now almost passed into abeyance and the once prevalent idea that 1îants were specially liable to fatal convulsions after su:h operations may be said to have faded away. Experience has shown that they may be performed with safety at any period from a fev hoursafter birth. Even at that dreaded period, first teething, harm is no more likely to happenthan at any other time, provided always that the chId be in good health. My own favorite date is from three weeks to three months after birth. Healthy-looking children at birth often pine and languish within the first few weeks, especially hare-lip cases, and particularly if the palate be implicated. I think it best to wait in such instances to see that health flourishes. A few weeks will give the requisite proof, and then;, for many good reasons, I am of opinion that an operation shiould riot be further delayed. I have a strong iinpression, from my experience, that the older ,a 499",
         "500 .ANADA MEDICAL AIZD SURGICAL JOURNAL. patient is, the more is the effect of the operation perceptible on the constitution, bodily and rnietally ; and I.m equally convinced that, if it be performed at an age when there can be no subsequent recollection of the circumstance, so much the better for all parties. The parents and others interested in the infant are almost invariably in an unhappy state of mind until the operation is satisfactorily over. - Maintain- ing, as I do, that the younger the patient is after the first three weeks, the safer and better is the operation, I con- sider it disloyalty to surgery to delay such a decidedly advantageous proceeding on doctrines which will not bear the smallest scrutiny. I have learnt facts regarding such matters that may appear more akin to romance than reality. I have been asked to see an infant, a few weeks old, with a simple single fissure in the lip, and, on my advice, the operation has been performed shortly afterwards, with the best results. Then it appeared that there was an older child in the family in a similar condition, which had been secluded in the nursery attics for several years. Happily, the experience of this younger family event was the means of freeing the poor child from seclusion ; for those who had advised against the operation took heart of grace, and put the senior on a par with the junior; as far as the operation went. I have known an instance of a child being kept in the recesses of the nursery for eight or ten years for a severe deformity of the kind. It was never allowed to play with other children beyond the family, it was never allowed\"to leave the house without the face being muffled in thick foids of veil ; and, for long, the neighboring nursery maids had the idea that this poor girl, whose face otherwise was unusually handsome, was an example similar to the lady, famous in nursery story, with the pig's face. The opinion previously given, in regard to this case, had been based upon great ignorance of what was going on in surgery during the life-time of the poor sufferer. But, to come more closely to the purpose of this paper, being of opinion that the intermaxillary portion or portions,",
         "HARE-LIP-SIR WILLIAM FERGUESON. BART. 501 is or are very frequently the cause of much annoyance to the surgeon, often, indeed, being almost the direct cause of failure in operations, I am desirous of recording my experi- ence on this subject. in the case of double hare-lip, with double cleft in the alveolar ridge, there may be great projection, or little or none. In the latter case, particularly if the columna and lateral portions of the lip be of good size, there may be no need for meddling with the intermaxillary mass. If, how- ever, the projection be considerable, or what may be called great, and if the columna and side portions of lip be scanty, there ought then, in my opinion, to be no hesitation about taking away the projection at its junction with the vomer. The attempt to push this part back by gradual pressure is troublesome, or well-nigh impossible, in most instances, even if, as has been proposed, its narrow neck be broken. In either instance, it has never been told from experience in what direction, the teeth come in the part thus displaced. In either or both instances, I have no doubt in myodwn mind that the teeth, if they came at all, would so slope backwards as to be of no value either for show or for use. There is, however, indubitable proof that, without thus meddling with the part, there, are only two incisors of respectable size, after all, and these are of such indifferent quality, that they had better have been dispensed with at the earliest date. I, therefore, never hesitate to remove the intermaxillary mass when it seems the least in the way of à satisfactory operation. The advantages of doing so seem to me greatly to preponderate, and, if there be cleft hard palate at the same time, there is far greater chance, in after years, of the gap becoming narrower, whilst in adult life, there will be greater facility for the assistance of the dentist But I imagine, there is less hesitation or difficulty in the surgeon's mind in the case of capacious double gap, than when there is only a single one with considerable projection, of the intermaxillary margin. It is to such cases that the chief object of these observations is directed. If it be",
         "502 CANADA MEDICAL AND SURGICAL JOURNAL. difficult to apply compression on the intermaxillary portion in double cleft, it is still more so when only one side projects ; for its base is broader and firmer. The instances where there is no special projection are common, and require no comment, as there is then, as regards this matt;er, no obstacle to a satisfactory and successful operation ; but when there is a projection, if considerable, it is a morie serious obstacle to these results than those inexperienced may imagine. I believe that this condition is a frequent cause of failure in the ordinary operation, particularly if it be done without the truss-compressor on each cheek to push the lateral portions of the lip towards the mesial line. In such a case, the surgeon is naturally anxious to leave the alveolar ridge untouched, and in accordance with a common practice, when it is desirable to secure union by first inten- tion, when the stitches or needles are withdrawn, strips of plaster are carried from cheek to cheek to hold the union firm. Scarcely a greater mistake can be made, for, the line of union in the lip being generally, under such circumstances exactly over, or opposite to, the sharp angle of the projec- tion of bone, the young cicatrix is pressed against it, and gradually thins away, until it is fairly split open, when the operation proves a failure. This I have a strong impression is an explanation of the failure of many cases that do'not seem, in any special way, complicated. I do not mean that straps always conduce to this effect, and that, therefore, they should never be used. On the contrary, I have ver-y frequently seen them of much.service. But, if the single projection alluded to be conspicuous-in which case, there will always be a somewhat sharp, angular margin-it is, in My opinion, best to get rid of it at the time of the operation. In my own practice, I was at one time in the habit of cutting the projection away with sharp small bone-forceps, dividing gum and bone at the same time, and aiming chiefiy at getting rid of the projection. This usually involved all the intermaxillary bone on that side, and implied, perhaps, little heed of what damage might be inflicted on the sound side,",
         "HARE-LIP-SIR WILLIAM FERGUSSON, BART., although, latterly, I always passed the blades into the mesial line between the intermaxillary bones, so as to secure this -side from material injury. In the course of my experience I fancy that I refinedon this- practice. I found that it was well to detach.the portion as high up towards the nostril as could, conveniently be reached, and here I discovered that, in all young subjects there, was only cartilage to be divided. This could easily be done with the knife or scis- sors, and so, for many years, I have used only one or other of these instruments. Usually, I have passed the scalpel through the mucous membrane, under the frenum, itp between the bones, and divided the cartilage, periosteum, and gum, to sever the part ; and thus the use of cutting with the bone-forceps has been dispensed with, for, to say the least, such an instrument is coarse-like and clumsy in an .operation for hare-lip on an infant only a few weeks old. Whilst I can offer little objection to this proceeding, I fancy that I have recently fallen on one equally efficacious and void of certain objections which, I think might be urged against it. Instead of this sweeping wholesale .abstraction, I content myself with making an incision, vertical, sloping, or horizontal, with a scalpel through the mucous membrane and periosteum, over the projecting piece of bone; with a few touches with a knife, or a little squeeze with finger and thumb, I so separate these tissues as to permit the entrance of a gouge of a quarter or three- eighths of an inch in breadth, with which I scoop out the body of the milk incisor-tooth in as far as it is formed, tak- ing no heed of the cyst or of that of the permanent one, and even cut out such wall of bone as may be there; usually, at four or eight weeks, only small plates of be-ne. In this way, the hard projection is removed, and the tissues thât remain offer no obstruction to the union of the junction of the lip in front, whilst the operation, as it appears to me, is less destructive, therefore more conservative, in character. There is thus left only the mucous membrane, with possibly some periosteum, which forms a soft cushion behind the 503",
         "504 CANADA MEDICAL AND SURGICAL JOURNAL. wound in the lip, and so the remaining intermaxillary bone- is not divested of covering so thoroughly as when cutting instruments are passed in the mesial line to take all away on the offending side. I have now adopted this plan in several cases, and have been much pleased with the effect and result. In one instance, I used a silk stitch to hold the edges of the wound in the mucous membrane together, but I doubt if it be- needful, and I have, not seen any spurt of blood from the deep part of the wound, such as that which I have often foVnd, in other instances, has required the application of aý pointed heated cautery. The wound .has healed without: attracting special notice. In the case where the stitch was- used, the thread came away spontaneously, and, in the end, the gum appeared as if there had been no projection, and, th'erefore, no such operation. It is now more than thirty years since I proposed the application of the practice of myotomy in the operation for cleft palate, Excepting in a few instances, objection has never been taken to the theory. There are instances where division of the levator palati muscles need not be resorted to, and union may with confidence be anticipated, but these are the exceptions ; and doubtless it is owing to this preliminary step, that I can boast of a success well nigh equivalent to the usual result in hare-lip operations. Half- a-dozen iistances of non-union are all. that I can number in between two hundred and three hundred operations. The result contrasts favourably with that of Roux, who, as is recorded, was well content with success in two out of every three cases on which he operated-amounting to about.one liundred and twenty operations in all. My theory, I main- tain, is as sound as that in the operation for strabismus; yet.I congratulate those who have succeeded without its application, and I freely admit that there are instances where the operation may and does, succeed without this preliminary to the ordinary process. Since the above date, when I drew attention to the remarkable success of Dr.",
         "HARE-LIP-SIR WILLIAM FERGUSSON, BART 505 Mason Warren and some other.American surgeons in this operation, particularly that of Warren, in dealing with cleft in the bard palate, I an not aware of any material modifi- cation in regard to the rmechanical process of closing the cleft in the soft palate, but in cleft in the hard palate there have been many ; and, iný other matters respecting the operation, I know of no more interesting story than that of the gradual steps of irprovement which have taken place in regard to this operation, within ry own experience of professional ýractice. In early, days, more than forty years ago, I believe it was the custom, in all cases, for the surgeon to sit or stand in front of the patient, with a light on the palate as favourable as could be secured. The strain on the surgeon's neck back, and hands, was considerable; but, worst of all, he usually got bis face so bespattered with blood that his fea- tures could scarcely be recognised. In the course of time, the operator gradually edged to the side, until, .like the dentist, he came to do his work standing on the patient's right side, whereby he avoided the splutter incidental to such a spasmodic ordeal as the patient was of necessity subjected to. In my own practice, I soon preferred the re- cumbent position for the patient, whilst standing on his right hand. Every facility vas given to sit up, spit, and gargle with cold water. The necessities for both these means of relief seemed urgent; more so, perhaps, in the operation which I myself practised--viz., the division of the levator palati muscles-a step which induced a more free escape of blood than simply paring the edges of the gap Then came two inestimable advantages-introduced by Mr Smith of St. Bartholomew's Hospital-the gag and chloro- form.,* The association of these two agents seems imperative; and, by their aid, Mr. Smith -proved that the * An admirable paper on these adjuncts was written by Mr. Smrth in i869, and published in the 5rst volume or the AMedico-Chirurgical Tran- s6cions.",
         "506 CANADA MEDICAL AND SURGICAL JOURNAL. operations on the palate could be performed in childhood- as readily as after puberty. With such adjuncts, I have myself operated at all ages, from one year up to adult life. Chloroform without the gag would be worse than useless; the gag, without chloroform, would, in my opinion, add to the sufferings and miseries of the patient. Until I recog- nized the advantages of the gag, I supposed that the operation under chloroform would be specially hazardous ; but when I found that, with the use of the gag, the blood could be readily sponged away, and the proceedings other- wise much facilitated, I fancy that the operation had reached a stage of perfection which left littie to be desired as regarded art and science. With good assistants, skilled in chloroform, the use of sponges, and otherwise, it seemed to me that-littlè was left for the surgeon to devise in regard to this difficùlt and formerly painful proceeding. I claim to be the first in this country to have drawn special attention to Dr. Mason Warren's method of dealing with fissure in the hard palate. The proposal of that sur- geon to peel the soft tissue off the bone on each side of the fissure in the hard palate has been extensively acted uponý with varied modifications,-but with very indifferent success. For myself, I may say that I have tried perhaps every plan that has been suggested, but I have been sorely mortified with the results. Some cases, after one or more operations, have turned out admirably ; but in a large number the result has been such as to have made me despair of closing these openings by operative means. There are instances where such hopes should never be entertained, owing to the wideness of the gap and configuration of the parts; but there are probably as many as one half of the cases amena- ble to operation which have such slight deficiencies in the hard palate, that I have always acted on the idea that closure in the mesial line would or might be effected here as in the soft palate. -Experience led me to give up the plan of Mason Warren of trying to close the gap in both soft and hard parts at the same time, even in instances",
         "EARE-LIP-sIR WILLIAM FERGUSSoN, 3ART. where the defect in bone was but.slight, For many years latterly I have ceased to meddle with the front part of the gap where the bones have been implicated, reserving the attempt for a subsequent operation ; but, -to facilitate the approximation. of the margins of the soft palate, î have often foillowed the plan followed by Roux, of making transverse incisions, so as to divide the soft parts from the posterior margin of the osseous palate.- Whilst I have had reason to feel sátisfied with this step, I have in no way 'found my, efforts -to close'the hole in the hard vault more successful. From time to time, on subsequent operations for the express purpose of closing such openings, I have been highly satis- fied with Mason Warren's plan of separation-that of paring the soft tissue from the hard, by working from the margins outwards to the alveoli, sometimes, in -addition, makin-gthe lateral incisions proposed by Mr. Field of Brighton or by making these lateral incisions first, and separating the soft tissues towards the mesial line. In sorme instances, I have had good results from a sort of gliding process, facilitated by separating'the front end of one of the'flaps from-its con- nections; but, altogether, the success of these operations has not been eqal to my anticipations or desires. Since using chloroform, I have been solicited by patients, again and again to try further operations, but the results have led me to give little encouragement to such proceedings. Latterly, however, a dawn has opened on my hazy views in this respect; and my chief object in putting these observa- tions on cleft palate together is to draw attention to my latest experience on the subject. My impression is, that the frequent failure in this latter kind of operation is induced by the contraction of granula-, tions, whereby the latefal portions are so drawn towards their original positions, that the union in the central line is either prevented or broken, and thus the gap remains when the side-flaps have resumed their original positions. An, idea came into my mind years ago which, however, I thought so wild, that I could not dare to bring it into practice. 507",
         "508 CANADA MEDICAL AND SUROICAL JOURNAL. Repeated failures, however, by usual methods, brought it more forcibly into my thoughts, and I at last resolved to put it into execution. My project was that, instead of making the separation between the soft. tissue and bony palate, for a quarter of an inch or so, I should divide the palate, soft tissue, and bone, about a quarter. of an «inch from the margin of the gap on each side, cutting the soft tissue on the roof of the mouth with a scalpel, and the bone, with mucous membrane above in nostrils, with a chisel, by means of which I could push the margins towards the mesial line; so that, having been previously made raw by removing the mucous membrane, they might be brought into apposition and held so by stitches. This project was carried into execution in King's College Hospitàl on November 22nd 1873, in the following manner. J. H., aged 18, had the soft palate closed two years ago; a small aperture remained in the hard, which had been twice operated on unsuccessfully by the ordinary proceeding. 0 The patient was placed under the influence of chloro- form, and the mouth held open by Wood's gag. The (i) aperture was about this size ; the edges were made bare by dissecting off the mucous membrane; then, by means of a small scalpel, an incision was made on each side to this extent (2). The back part of these wounds penetrated the soft palate, and in front they were close to the bone. Then the point of a chisel was forcibly, IO but carefully, pushed upwards through the bone. into the nostril through each wound, and, by slight (2) lateral movements of the blade, each lateral portion could be readily made to meet the other in the mesial line, whe reby theraw margins made at first could be placed in apposition. The parts were then held together by a single stitch introduced in the usual way, passing on each side, through the soft tissue, so that it might remain steadily in onë place. At the conclusion, the conditions seemed much as after the operations formerly effected. Subse- quently, granulations filled the lateral gaps as on previous,",
         "HARE-LTP-SIR WILLIAM FERGUSSOIN, BAR'r. -occasions ; but, when the stitch was removed; union in the centre seemed firm, and was not disturbed by any dragging power, such as I supposed had, in carlier operations, drawn the flaps upwards and outwards towards the bone. The result was perfect, and I have heard nothing to the contrary since the patient left the hospital. On the same day, I repeated similar proceedings on a patient who had had a successful operation on the soft palate, but on whom I had been unable, after four different attempts, to dose (3) a fissure in the hard. Here the opening was larger, being about this size -(3). Similar steps were followed, and, to all appearance, during the first eight days, with similar results. Two stitches were employed, but, on removal, the edges, where one had been, seemed to fall asunder. Two days afterwards, a new stitch was put in, by means of an ordin- ary aneurism-needle, and the margins made raw by a gentile scrape. The hole was thus closed; and, on removal of the stitch, eight or ten days later, union was perfect.ý Since this patient left the house, a small separation has taken place, which has left an opening a little larger than a probe. I have recently had made, by Matthews Brothers, a modifi- cation of a most ingenious needle suggested long ago by my friend Mr. Brooke of Westminster Hospital, for introducing stitches into the soft palate in operations on cleft in that part. The point of his needle was sharp; and I have often used it with much satisfaction. The point here, is blunt, like that of a common aneurisnvneedle. Soon afterwards, a third case carme under notice in pri- vate practice, wherein, after closing the soft palate, I had' failed to succeed with thehard, by the ordinary proceeding. Here the opening was midway in size between the tases above related. The steps were much the same as in the first, excepting that I passed the thread through the lateral apertures without fixing it in the soft tissue. -After the knots were-,tied, they never ·slipped froma their position. These were left some dayslonger in sita than in the previous cases, and on removal union in the mesial line was perfect. This union I have recently heard, remains perfect. 509",
         "510 CANADA MEDICAL AND SURGICAL JOURNAL. A fourth case has recently come under my care at King's College Hospital. The gap here 'was larger than in the three preceding cases. It was an inch long, by more than a quarter of an inch wide. The lateral incisions were of proportionate length, and when the parts were brought together, a gap into each nostril was visible. Here three stitches were used, and, as in the case last related, they were passed through the side incisions, without piercingthe soft tissue. A fifth case is now under notice. Here the ordinary operation was performed on the soft palate in June 1873: and the front part, which involved a small portion of the hard palate, was left untouched, in the conviction that it vould be better to leave it alone until a future date. The aperture left was at the end of the healing process, of this size. Here the scalpel and chisel were used as ( above described, andthe parts were satisfactorily placed for union in the mesial line. From the experience already obtained, as also from care- ful consideration of the subject, I feel justified in calling attention to this addition to what is already more or less familiarly known to those who have studied this complicated subject. At first thought, several strong seeming objections arise. It might be doubted if the osseous palate could be cut and moved in the way described. If an experiment were made on a ,roof of bone in :the natural condition, it would be impossible; for, if the chisel were pushed through the bone a little on each side of the mesial line, it would be impossible to move the intervening portion towards the middle line, because the spaceis already filled, up. This objection does not hold, however, in the malforrnation; ,for the space is not filled up, and the vacancy permits the osseous -margins to be approximated. Then,. division of bone on the two sides, and breaking the front part of each, seems so rude, rough, and destructive,that the:idea arises that caries or necrosis. might ensue. Bµt in reality the process. is, in my opinion, less hazardous than -when.the",
         "IARE-LIP--SIR WILLIA31 FERGUSSON, BART. 511 flaps. of soft parts are dissected or forcibly pushed or diawn off the bone. Besides. the fact that these parts do not always unite, one flap or both will occasionally slough, and so things are rendered worse than ever. In favor of the proceeding about which I now write, I can state from experience that the loss of blood is- much less; and on that account there is less trouble in mopping out the pharynx, and consequently less hazard in the use of chloroform ; that the tissues on the lower surface of the bones are not so much disturbed or divided as by the older process; tha.t the periosteum and their tissues belów are less. disturbed than otherwise ; and that, from all these circumstances, there seems less risk of sloughing of the semi-detached parts. As to the healing of the lateral wounds, I am of opinion that the gap will invariably be closed, and that in the bond of union there will be a firm cicatrix of soft tissue, and pos- sibly bone ; that the vault of the mouth will be as firm.as in a normal condition, and probably firmer than where a fortunate result has followed the process of Warren, Field, or Langenbeck. These observations apply solely to- instances where the surgeon, in a first operation, has not attempted to closeý the gap,. or has failed in a design to secure union throughout. They will apply, however, with equal, even. greater, effect to instances where heretofore, in my own experience, I have left the front part of the cleft untouched. -Irememiber scores of instances of the kind, wherein I now feel confidenýt the whole gap could have been closed by.the process above described, with as I imagine, as much success as attended the operation on the soft palate. In case of defective hard palate, after the usual preliminaries, and having bared the edges of the gap in the front, in hard as well as in soft, I would now *make the additional wounds, with scalpel and chisel, as: above recommended, thereby hoping to. avoid a second operation by doing all at once, under the beneficial influence- of chlorofoim.",
         "512 CANADA MEDIcAL AND SURGICAL JOURNAL. Since the above was written, I have had an opportunity of passing these latter views into- execution. A youth-of eleven years of age, on whom , had operated soon after birth for wide hare-lip, was brought under my notice, with a fissure extending from the lip to the uvula. A year ago, I had advised delay of a proposed operation on the gap in the soft palate, which was very wide. Now; I thought 1 should venture to test the proposal in an unusually severe case. Under chloroform, the usual incisions' for dividing the levator palati on each side were first made ; then the edges of the gap were pared as far forwards -as to within half an inch of the front-; next the scalpel andchisel were used in the way described ; and, finally, six stitches were introduced-two through the hard part, without piercing the tissue; and four through the soft parts, in the usual way. Unfortunately, the first two stitches' slid together, so that practically they acted only as a single one. The effect was, however, highly satisfactory. There wàs no tension inthe front of the gap in the soft palate. The approximation of the bones took off all drag, such as is common under ordin- ary circumstances ; and the result has been- equal to my anticipations. The whole ofthe gap in the soft palate. was united, and even a considerable part in the hard. With another operation in front-a repetition of this new process -I an convinced that the gap may be closed up to the alveolar ridge. I have no doubt whatever that, in instances where there is only a slight fissure in the hard palate, the surgeon, by use of the chisel, will thus be enabled to close it, and that in the soft with a certainty hitherto very que5; tionable. In ry anatomnical knowledge of such maalformations there is one condition which I fancymight prevent these viëws being carried into effect. In the generality of severe eleft in the hard roof, the lower and back part Ôf the vomer is' incomplete ; but in some cases the vomer' is entire; although perhaps swayed to one side ; and it remains",
         "CARBUNLE-PETER EADE, M.D. attached by its lower margin to one side of the hard palate throughout. Here would be a difficultywhich might puzzle; for, although the chisel might permit the approximation of the edges, it would be'difficult to introduce stitches ; but even here there would be a? redeeming quality in the new process, for pushing the parts toýthe· mid line might lay them so together that, though union should not occur, they would lie so close that a fissure migh t elude ordinary obser- vation. In one of the cases above recorded, I have found that entire union in the mid-line has really not taken place. The margins are, however, in such close approximation that the want of union can be ascertained only by slipping the point of a probe through the suspicious-looking part. With these remarks, I leave the subject for the present, under the conviction that I have touched new ground in a most complicated field of anatomy and surgery, and in sin- cere hope that I have added to, if not completed, the power- of surgery in such cases of malformation.-British Medica( %nurnal. On1 the Local Treatment of Carbuncle. By PETER EA n M D., LONo.:F.R.C.P., 'Physician to'the Norfolk and Norvich Hospital, etc. In a recent nunber of th-- Lancet the attention of th'e profession has again. been called to the subject of'carbun- cular disease, with especial reference to its peculiarities when mànifesting itself on the face. As I have had quite recently under my notice and care an example of this serious form of the affection, in which I happily succeedëd in cutting short its progress, and to all appearances aborted it in its early stage, I wish to record the treatment.adopted and (from the.experience I have had in several instancesof carbuncle located elsewhere' to express my conviction that this method offers greater advantages than perhaps any other in the management of these important disorders. 513",
         "CANADA MEDICAL AND SURGICAL JOURNAL. In a short communication published in the Lancet for Dec., 11 th, 1869, I recorded the particulars of a case of extensive carbuncle of the back of the neck which I had treated by the free application of carbolic acid to the diseased part, and especially by its free. insertion into the holes and sinuses which had formèd, as is usually the case, over the central portion, very early in the course of the disease. An experience since that time of two or three cases of large carbuncle and of many cases of carbuncular boils, treated by the same method, has proved to mec that the action of this remedy is so definite and so -constantly beneficial that I have no hesitation in recommending it to the favorable notice of the profession. My recent case was this :-A gentleman of seventy years of age, but still strong and hale, had suffered for 'some weeks from asthmatic Bronchitis, from which he had in a 'great. measure recovered, when he was suddenly attacked (nOW some five weeks ago) with pain and hard nodular swelling of the lower lip near'to its right extremity. Almost immediately a double festering pimple formed over the centre of this swelling, and the painful induration rapidly éxtended -past the corner of \"thè mouth to the'adjacent cheek, and, to a less degree, aloiig:thé substance.of the lip, causing also considerable œdematoils swelling of the whole of this part. On the second day .severe constitutional symptoms manifested themselves, and féelings of extreme illness were complained of. During this day and the next the tumefaètion and hardness continued to increase, the festdrs over the centre of the original spot opened, and Nvere moist with dirty pus, the whole of the lower lip and right corner of the mouth and the adjacent cheek became tense and swollen, and it was quite evident that a carbuncle was forming on the right side of the face. Into the centre of the two holes which had formed I now pressed with a probe some threads of lint soaked in a strong solu- tion of carbolic acid in oil, (one part to four), and I also laid a piece of lint wet with the same over the apertures, so 514",
         "CARBUNLE-PETER FADE, M.D. às to supplement the Cmall quantity which the shallàw sinuses would contain. - A little smarting was complained of, but the application was repeated after a few hours, and again the following day. Almost at the end of twenty-four hours it could be perceived that a check had taken place in the morbid process, but by the next day it was plainly evident that the inflammation and induration were really beginning to subside., The carbolized lint vas still care- fully and scrupulously thrust to the very bottom of the small holes, and'from this time no further spread of the rdisease.took place, but, on the contrary, there was a tapid subsidence of the oedema, and in two or three days more little remained but some diffused swelling of the lower lp, some tender induration at and around the seat of the original pimple, and the ragged discharging opening which had formed at the site of the primary festers. The disease was therefore stayed, and in a few days more the patient *was convalescent. He is now quite recovered. I should scarcely have veritured to instance this case as proviiig the aborting power of carbolic acid over carbùn- cular or furuncular inflammation-seeing that the disease never attained to very, formidable dimensiois, and' that 'possibly it might not under any circumstances have incrëa- sed to a very serious size or extent,-had :1 not witnessed precisely the same effects iti other cases as was here pro- ýduced by the application of the acid. My conviction, neverthelessis that the' carbuncle was not only. rapidly extending, but that it would quickly have become böth large and important. And I cannot help contrastingIts ýcourse with that of one which I had the opportunity .-f seeing, in its latter stages, some three years ago, where the disease attacked the same parts of the face, where onlythe usual treatment by poultices, \u0026c., was adopted, and where, (instead of a duration of about one week for the- severe symptoms, and of about ten days more fdr recrudescence) the :suffering patient passed through a morbid process which took many weeks to complete its course, and which 515",
         "516 CANADA MEDICAL AND SURlGIc\u0026L JOURNAL. not only caused great and prolonged suffering, with great temporary disfigurement, but even at one time appeared to threaten life itself. As I have stated, I have now used carbolic acid in this way in several cases of carbincle; and in all of them its application has been followed by a uniform and immediate check to its increase, and a speedy amelioration of the local conditions. When it has been applied early, it has plainly gone.far to abort the disease ; and when it has been com- menced later, wherever it could be brought into contact with the inflamed and hardened tissue, there at least no further spreading has taken place, while swelling and tension have diminished, and dirty suppurating slough has quickly given place to fiorid healthy granulation. And, from observation of its action, I entertain no doubt, that if it could be brought sufficiently early into contact with the spreading disease, it would be quite competent to prevent its extension beyond the degree to which it had already advanced. Unfortunately, the acid appears to have little or no influence when applied over the unbroken skin ; but directly it can be brought into contact with the diseased mass, either by being-inserted into the sieve-like holes, or by being applied to it after being laid open by incision, itr beneficial action becomes at once manifest. Much credit is, I think, due to the late Mr. Startin for having suggested that both boils and carbuncles might be due to the growth and spread in and beneath the skin of a parasitic development ; and the efficacy of the treatment he was in the habit of adopting, the remarkable effect ofcarbolip acid in checking its increase, and the almost certainty witb which boils in their early stages may be aborted by apply.- ing freely to the core of the festering pimple the acid nitrate of mercury, go far to prove the truth of this opinion. 1 It is extremely unfortunate that the carbolic acid caniiot always be brought into sufflcient contact with carbuncles in their early stage-partly because of the insufficiency of the sieve-like openings, and partly because the parasite-studded",
         "CARBUNLE-PETER EADE, M.D. \u003c.?) growth may have already extended beyond the central portion over which these are situated. : But even with a very imperfect application I have observed a distinct retard- ation of the circumferential spread when the acid has been carefully introduced into the holes, conveying to my mind the impression that some destructive influence had been exerted upon the central root or stem of the diseased mass; and in all cases which I have hitherto observed, no exten- sion of the disease has taken place from any part to which the acid bas been fairly applied. Hitherto I have only applied it through the natural openings, or' after the mass bas been exposed by incision or caustic ; but I think it extremely probable that a beneficial effect would be pro- duced by the subcutaneous injection of a watery solution of the acid around its edges (after the manner in which it has lately been employed in the case of spreading erysipelas, and some other diseases), or possibly the spread of a large carbuncle might be stayed by drawing through it some small loop-holed drainage-tubes, and allowing the carbolized fluid freely to percolate through these.* The strength of the solution of carbolic acid which I have employed has been about onepart of the acid to four or five of the solvent (oil of glycerine), and its efficacy, I would repeat, has appeared to be limited almost absolutely to those parts with which it could be brought into actual contact; and although it appears occasionally to have pro- duced injurious effects when used in large quantity, yet I have kept a large sloughing and granulating surface for days together constantly covered with the carbolised oil, without any harm arising, although the urine soon presented the peculiar blackish colour which has been several times observed during its employment. I will only further add that in looking over the various methods of treatment which have from time to time found favour with the profession, there seems to have been a con- stant under-current of feeling in favour of such remedies as have a more or less caustic or antiseptic (? parasiticide) 517",
         "518 CA NADA MEDICAL AND SURGICAL JOURNAL. influence. Terebinthinates, resinous applications, caustic potash, and several other caustics have been held by vari- ous competent authorities in high esteem, and their partial ùsefulness would seem to fortify the theory of the vital,the living nature of the disease-a theory which I think is greatly supported by the decided influence upon it of car- bolic acid, a substance so well known to possess à special power of preventing the increase and development of low forms of life and cell-growth.-Lance\u0026. Ct'enation: The subject of cremation is again taken up by Sir Henry Thompson in the pages of the Contenporaiy Review. In this article he replies to various criticisms that have, appeared in different journals, and gives a detailed account of the process he would suggest as* most appropriate for the object in view. Sir Henry states, and it is certainly a somewhat remarkable fact, that the only formal opposition to cremation has been made by the present medical Inspec- tor of Burials for England and Wales, Mr. Holland ; and in reply to the observations of this gentleman, Sir Henry refers to the evidence obtained by Drs. Southwood Smith, Waller Lewis, and others, in regard to the largec amount of gases produced in the decomposition of the body, and the impreg- hation of soil, water, and air to a considerable distance. Such impregnation by the dead, and consequent danger to the livng, cannot, we presume, be questioned for a mo- ment, and. is fully borne out by the statements of Mr. Bowie and the general experience of the profession. We must also fully endorse Sir Henry's remarks in regard to the elimination of ammonia, or at'least of carbonate of ammonia, from decomposing animal tissues, and are at a loss to un- derstand how any doubt can exist about the point. Turning to the second part of Sir Henry Thompson's essay, he re- marks that he has personally superintended the burning of three bodies of animals, one weighing 47 lb., another 140",
         "CREMATION. lb., and a third no less the 227 lb., with the most satisfac- tory results, the residue in the first. instance weighing only i- lb., and in the second 4 lb. In the last case the body was placed in one of Dr. Siemen's furnaces, the interior of vhich was heated to about 2000 O F. The inner surface of the cylinder, w.hich was about 7 ft. long by 5 or 6 ft. in diameter, was smooth, almost polished, and no solid matter but that of the body was introduced into it. The gases, which were at first abundantly given off, passed through a highly-heated chamber, among thousands of interstices. made by intersecting firebricks laid throughout the entire. chamber, lattice fashion, in order to minutely divide - and delay the current, and to expose it to an immense area of heated surface. By this means they were rapidly oxidised, and not a particle of smoke issued by the chimney. No, second furnace was therefore in this instance requisite, though, under certain circumstances, the products of com- bustion might be transmitted through another, and the fumes froth this into a third and so on, each being made available for the combustion of one body. The process was completed in fifty-five minutes, ahd the ashes, whichweighed about 5 lb., were removed with ease. Sir Henry meets the objection that has been raised to the practice of cremation, that it will lcad to an increase of crimes of poisoning, by suggesting that a public verificator of the causé might be appointed, whose duty it should be to ascertain and.ertify thé cause of death, whilst the stomach might be kept -for some years. In reference to the expense, he still thinks it would be far within the present cost of a funeral As re- gards ourselves, we have already expressed our opinion that it is an eminently satisfactory mode of disposing of the dead -sale, speedy, wholesome, and economical;· but we rather doubt whether ancient custom and popular prejudice can be so easily overcome and altered as Sir Henry Thompson appears to believe.-Lancet.",
         "520 CANADA MEDICAL AND 'SURGICAL JOURNAL. Obstetric Memoranda.-Treatment of Post Partum Ham, orrhage. By ALFRLD GODRICH, M.A., M.R.C.S., \u0026c. The means of suppressing post partum hoemorrhage have- been most ably discussed in the pages of the Yournal; but I think scarcely enough attention has been paid to the means for its prevention. Altbough I never had a fatal case, yet, in my early prac- tice, it was my lot to meet with two very. alarming ones. Subsequently, I noticed that, although there might be no, large loss of blood, the sudden evacuation of the contents of the uterus, especially when there was a large quantity of liquor amnii, was often followed by death-like faintness. Even in tapping for ascites, it is always laid down as a rule to apply a bandage, which is gradually tightened as the fluid escapes, to assist the abdominal muscles, and to com-. pensate in some measure for the loss of pressure sustained by the large vessels and viscera of the abdomen. If, then, süch precautions are necessary in a case where the evacu- ation of the fluid is entirely under control, why should not similar precautions be taken in the emptying of the uterus ? Most practitioners, no doubt, apply a binder, but not till the uterus has emptied itself, and the large blood-vessels of the abdomen have become turgid with blood from want of that support to which the' have for mônths been accus- toied. I was led by such considerations to adopt the plan of using the binder, not only after, but during labour ; and, as since then, I have not had a single case of post partuitm hamorrhâge, or even of that sudden exhaustion which I had before so often witnessed, I am induced to describe the plan which I adopt uniformly in all labours, and- which I have found successful. I select some stout material, wide enough when doubled to reach from the fundus of the uterus to two or three inches below the crista ilii. This, as soon as the woman is confined to her bed, is pinned as tightly round her as can be borne, thus giving support to the abdominal muscles, and keeping the child in the axis of the pelvis. As soon as. true expulsive pains commence, the binder is unpinned; and the upper fold given:into the hands of the nurse, with the directions that, during each pain, she should draw it as. smoothly and tighfly as possible across the patient's abdo- men. There is no fear of the lower fold slipping, as it is kept in position by thé weight of the woman's body, and",
         "MOVABLE KIDNEY. therefore should be left quite alone. As soon as the head begins to emerge beneath the pubes, the pressure should be continuous and as strong as possible, and never relaxed for a single instant till after the child is born and the pla- centa expelled, when the binder should be pinned as tightly as possible by the surgeon himself, and not left, as is too often done, to thê nurse. I venture-to think that, if some such uniform planwere adopted in all cases of labour, we should heàr much less of fost partumn hæemorrhage, and be often spared the using the i any hazardous, if not dangerous, expedients suggested for its suppressi*on.-Britisli Medical Yozrzal. Clinical Mémoranda.-Movable Kidney. Mrs. H., aged 27, of good figure, and the mother of two healthy children, the youngest six months old, consulted me on March i8th. She strained herself in 'trying to open a windovw about a month' ago. Since theri she has had pain, more or less, in the abdomen, below the right costal margin. She thought she felt a swellinig. When young, she was subject \"violent attacks of pain in the bowels.\" I found a bard tumour reaching from the umbilicus, upwards and outwards, nearly to the, ends of the last two right ribs. The fingers could easily be.passed bçtween the costal mar- gin and the tumour. The mass, slightly painful when handled, felt exactly like the kidney, the convex border of which was the lower edge of. the swelling. The tumour, which 'was covered by intestine, moved downwards, about an inch and a half on inspiration, and upwards on expira- tion. It was also freely movable in all directions by the hand. Beyond the fact that the urine had been scanty, and loaded with urates, since the strain, there was no other symptom. My diagnosis was movable kidney, and my advice was, that the patient should wear an abdominal support, with a pad to keep the kidAey in its place as much as possible. I may add, the bowels were thoroughly evacuated before my decision. TuoMAs COLE, M.D., Lond., M.R.C.P., Bath. -British Medical 7ournal. 521",
         "CANADA MONTREAL, MAY, 1874. A CENTRAL BUREAU. We notice with great pleasure the introduction into the Dominion House of Commons, of a motion by Dr. Brouse to provide for preliminary steps being taken for -the estab- lishment of a central controlling body for the whole Dom- inion with regard to Sanitary matters. The idea is, to begiin by forming a bureau- of Sanitary statistics in immediate connection with some one of the Governmental Depart- iments, and under the control of such departmental chief. The gentleman who brought the matter before the Houise, urged in very strong terms the desirability of the immediate institution of such a body as a permanent part of our political machinery, adducing amongst other arguments the undoubtedly ·favorable impression which would be created abroad by the publication of Canadian vital statis- tics, and the good which niust necessarily ensue from our being able to compare, correct mortality returns from -different parts of the.country, vith the view to investigate and correct the causes giving rise to any excessive, or -unusual degree at any particular 'place. It was also urged that such a Bureau would be of great service in suggesting to the educational department the adoption -of regular instruction in the important elements of Sanitary science in all our public schools. Of course it is uriderstood that .for the purpose of obtaining such statistics .the general",
         "EDITORIAL. 52. Board or Bureau would require to be assisted byLocal Boards in every part of the country, the manner of appoint. ment of which would be fixed by subsequent legislation and it is here that we arrive -at the practical part of the, whole thing. It is high time that we, as a country, should show ourselves süfficiently civilized to legislate in a rational manner for the preservation of the health of the community at large. We think that no one will dispute with us the. fact that the feeble attempt hitherto made, and now making by the present .civic organization for the regulation of hygienie measures in this city have resu!ted in miserablef failure. The most entire dissatisfaction, with a want of con- fidence in the present so-called health office is universally felt, and we do not believe that matters are a bit better in other cities of this Dominion ; and every one who knows anything about the matter will say the sooner it is done away with the better. What every medical man, and evéry intelligent citizen has a right to know is what is being done by those charged with the all-important matter of looking after the health of the population of whom he is one, and whether such work is being done well. Such information can never be had, nor the results of hygienic management made known until they are officially1aid before an author- ized public Bureau. It would be a work of supererogation to argue further concerning the importance of immediately establishing a Sanitary Board, because it was universally admitted by those who spoke upon Dr. Brouse's motion for a committee. The only question raised was the ability of the House of Commons to deal at once with the matter, it being suggested that possibly this would be trenching upon the functions of the Local Legislatures. As the matter. stands at present, however, the Premier. has promised that the matter shall not be lost sight of, but the jurisdiction of the fHouse shall be investigated during the Parliamentary recess, and if possible (of which we have but little doubt) a bill for the establishment of a Central Bureau will be brought in.",
         "CANADA MEDICAL AND SURGICAL JOURNAL. *We should all thank Dr. Brouse for having brought the subject forward and placed it in a fair way to receive the attention it deserves. It is a measure which was long. ago advocated by this Journal, but which until the present has been sadly neglected by pur Legislative men. The Medical profession is well and ably represented in the Cçmmons, and we trust that they will at the next session of Parliament push this matter to a successful issue, and that before many years we shall be able to point to the successful workings of our Sanitary System as a proof of the advanced civilization of our country. ANIMAL VACCINE. When Jenner published the results of bis observations on vaccination at the commencement of this century, he expressed a belief that it was an absolute and complete protection against sniall-pox, or at least as much so as small-pox itself. That a person who had been efficiently vaccinated was not more liable to contract small-pox than an individual who had-gone through the disease naturally or by inoculation. These views have long since been proved correct and have been corroborated not only by statistics, but by the experience of the most eminent writers on this subject. In the report of Mr. Simon to the British House of Commons in 185 1, that gentleman states that \"if vaccination were universally performed in the best known manner, deaths by small-pox would be amongst the rarest entries in the register.. This is as much as-can be said in favour of vaccination as it cannot be regarded as a greater preventive than the disease- itself; secondary small-pox is well known to occur tnd has. been observed in some rare cases, to be confluent, and occasionally proves fatal. In Marseilles during: the epide- mic of 1828, 2000 cases of small-pox occurred. Twenty",
         "EDITORIAL. 525 persons had the disease for a second time, and of these four died. In the year i86o we had two cases of secondary small-pox under our professional charge, and one ,of them died during the secondary stage of fever. It is stated in Reynolds system of medicine on the authority of Dr. Seaton, that \" the present average death rate from small- pox is scarcely, in any European country, one tenth part 'what it was prior to the introduction ofvaccination, and in \"those countries in which vaccination has been most care- \"fully carried out it is much less than one tenth part of what \"it was at the end of the last century.\" This ought to be evidence sufficient for any reasonable person. Some years ago the subject of the communicability of syphilis and other contagious diseases by vaccination through the use of humanized matter engaged the attention of the profession and the public, which gave rise to a systematic denuncia- tion on the part of some.fanatics against vaccination. It was condemned as worse than useless, as it did not afford an absolute protection and that the hazard of spreading a disease like syphilis was a greater evil than small-pox. The protective influence of vaccination efficiently performred has been fully proved, but again the possibility of com- municating syphilis by the use of impure humanized vaccine matter rests on high authority and cannot be gainsayed. These facts led to a seriesof experiments conduct-ed by M. Depaul under the auspices of the Academy of Medi- cine, Paris, who, in his published report arrived at the following conclusions ; that the transmission of cow-pox from heifer to heifer could be obtained without difficulty ; that -the progress of the eruption after inoculation was more rapid in the heifer than in man. The pimple appeared on the third day and commenced to suppurate on thc seventh. This was the result observed in healthy animals, very littla constitutional dis- turbance occurred ; occasionally diarrhoa, with slight fever was noticed during the first few days, but never to any considerable extent, and in the, majority of cases nothing",
         "526 CANADA MEDICAL AND SURGICAeL JOURNAL. was observed. If the heifer was out of health, the vaccina- tion failed altogether, or was slow in being developed. Depaul employed matter from Beaugency, and also from Naples, and from a series of experiments he arrived at the conclusion that the bovine species were incapable of being inoculated with syphilis. It was noticed that matter taken from a healthy heifer at the proper period, succeeded quite as well as the humanized vaccine matter. That the em- ployment of animal vaccine rnatter appeared to be more marked in its effects, the re-action was greater at the period of suppuration. - Tha,- the pustule is more voluminous, sometimes irregular as to form, and unequally developed, and sometimes the inoculation of a single point would give two, three or four pustules in the immediate vicinity. This latter circumstance, adds M. Depaul, is occasionally seen in the inoculation with humanized vaccine matter, but it is a rare occurrence. Another circumstance noticed in this report which is worthy of record, is that occasionally the eruption after the vaccination will be delayed from the ninth to the twelfth day, and if a second inoculation has been in the mean time practised, all the pustules will become devel- oped and run their course. Wé have been induced to dráw attention to this im- portant subject, and to epitomise M. Depaul's report, because the subject is not generally understood, and also because the quality ·of vaccine matter in general use amongst us in Canada, is far from being good ·or sàtisfac- tory in its resùlts. There can be no reason why in -our country districts, where healthy heifers are always attain- able, the local practitioner should not adopt the practice of having at hand fresh and reliable vaccine matter, which ifècarefully protected from the atmosphere has been found effectual severai months after being collected. But failing to procure the matter from this source, which requires only a little attention, we would direct our readers to the adver- tisement which apears elsewhere of Dr. Henry A. Martinf \u0026 Son, of 'Bôston Highlands, Mass.",
         "EDITORIAL. 527 These gentlemen fully alive to the importance of this subject commenced their vaccine establishment in the year 1870, and since that time have-supplied large quantities of animal vaccine virus. From a private let ter we learn that during the year ending 3ist March, 1874, upwards of 40,003 points of vaccine virus have been distributed throughout the United States and Canada-This ought to be sufficient evidence of its reliability. Besides ivory points well armed, the Messrs. Martin offer to supply crusts, and tubes filled with fresh lyrph.- UNIVERSITY OF BISHOPS COLLEGE. LENNOXVILLE. The annual convocation of Bishops College for conferring degrees in Medicine and Surgery was held at the College Buildings Lennoxyille, on.Thursday 9th April uit. There were present the Lord Bishop of Quebec. Mr. Chancellor Hale and members of the Faculties in Arts, Divinity and Medicine. The Dean of the Faculty of Medicine, Aaron H. Davià M.D., D.C.L., made the following annôuncements. . In thé Botany and Zoology examinations six students passed viz., .Messrs. Lane, Davis, Rose, Lemieux, Gravely and Shee,-the names being placed in 'order of merit.\". The following gentlemen passed their primary examin- ation, their names being given in order of merit. Messrs. D. A. Hart, J. Lemieux, E. Rose, P. A. Shee, J. A. Pigeon, Victor J. A. Venner, Wm. H. Hunter,. D. A. Hart, J. Lemieux, P. A. Shee, G. Rose, Chas. lafontaine, J. Eneas, E. A. Duclos, J. McKay, and Valmore St. Germain. The names of the following gentlemen were presented as worthy of honorable mentioh, Messrs. Victor J. A. Venner, Wm. H. Hunter, D. A. Hart. and Israel Lemieux. Dr. Hart delivered the valedictory address on the part of the graduating class and Dr. Leprohon addressed the graduates on behalf of the Faculty.",
         "MONTREAL OENERAL HOSPITAL. MONTREAL GENERAL HOSPITAL. Dr. T. G. Roddick has resigned the House Surgeoncy of this Institution to enter upon private practice in the city. This responsible office bas been he:ld by this gentleman for the past two years, and we know that during the whole period he has enjoyed the most entire confidence both of Governors and Medical Board. We are quite sure that tlÊe ability and skill evinced by Dr. Roddick whilst medical head of our most important charity bear testimony to the possession of such talents as are certain to enable him to be successful in his future career. We, along with all his friends, express our warmest wishes, that every prosperity may attend him. The vacancy thus made has beeri filled by the nomination of Dr. C. J. H. Chipman, formerly Assistant House Sur- geon, to the more advanced post, and by the promotion of Dr. James Cameron, formerly House Apothecary, to the office of Assistant House Surgeon. Both these appoint- ments will give much satisfaction, and we beg to congratu- late these gentlemen upýon having obtained such deserved recognition of the faithful performance of their duties. The Apothecaryship has not yet been filled, but we expect to be able to make the announcement of the success- ful, candidate in our next number."
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         "MANITOBAN. A Monthly Magazine arid Review of Current Evente. VOL. I. WIlVNIPEG, MANITOBA, AUGUST, 1892. No. 9. ---- ---------- ----- --------- --- - ----- --------- -- - ---- ---- ------- ---- ---------------- Notes and Comménts. UGUST is the month during whieh the fiarmer sits on the anxious seat. To be or not to be is the question- frost or no frost-whether or not his whole season's labor will be ruined, or if he can safely harvest and garner the golden grain. This is the sub- ject and the all-absorbing question. From the latest advices received it would appear that the crop as a whole is a little liter than that of previous years, but as we are now nearly past the time for the average frost which nips in the bud a year's work, we can almost count for a certainty on a fair crop being gath- ered. The scarcity of farm help will retard harvesting operations to a certain extent as with but a few exceptions no one farmer can care for his crop within himself in the time in which it should be attended to, but by judicious methods and keeping at it the greater part can be accomplished. OWING to the existence -of Small- pox in our midst, and the alarm which it has occasioned it may not be out of place to give a few hints as to the care which should be taken by the public in guarding against the attacks of the fell disease. The first tItingone naturally turns to is the pr( %ention. This is easily obtained by vaccination, for no in- telligent person who has been suc- cessfully vaccinated within a given time need have small-pox. A few years ago the virus was obtained from the arm of a healthy child, which had recently been vaccinated but this ba8 been done away with as bovine virus is preferable. The reason of this is that, by the use of the bovine virus there is secured a more perfect or typical develop- nient of the vaccine disease; and hence it may fairly be inferred a greater protection against small-pox. Again, with the bovine virus there is no danger of communicating syphillis. The bovine virus is also more effective than the humanized virus in re-vaccination and is less susceptible to small-pox, and as greater care can be taken in the propogation of it a greater sup- ply cau be always at command mand in time of danger and people thus vaccinated have a better guar- antee, that they are vaccinated with genuine pure vaccine virus. Hav- HE",
         "THE MÀNITOBAN, ing the prevention we now come to the question who should be vaccin- ated ? Everybody, old and young for his own interest, should be vaccinated, even those who have had small-pox, as it bas been proved, that a larger proportion of those who have small-pox a second time die than of those who have the disease after vaccination. As to when a person should be vaccinated, the sooner the better, for by thus taking advantage of the protection afforded, the protection of the dis- ease is stayed. Owing to the prompt action of the authorities in Manitoba this loathsome disease has been near- ly stamped out and with a little care and watchfulness on the part of the public we shall soon have heard the last of it-.we trust- for soie time to corne. * * * . WE see by the. Vancouver papers that they have an island out there on purpose for small-pox patient\u0026, which is called \" Dead Man's Island.\" Thisshould settle the re- sultsofthediseaseasfar as Vancou- ver is concerned, for a patient who was at ail nervous would not stand a very good chance to recover when he found he was on an island with such a gruesome naine. If the mind has any control over disease, as the high- est medical authorities affirm,. then the people of the coast should change the name as soon as possible. It would at least make the patients feel more at home. *** WE called attention in 'our last issueto the water supply of the city, dealing wfth -the gravify of thé question from a sanitary point of view. in writing what we did we had only our autumnal fevers and dreaded small pox in view which then seemed hovering on our west- ern and southern borders. We now learn of astill more dreaded scourge the cholera, which has reached Germany from Russia, and may be from Hamberg disseminated to this continent. The Dominion Govern- ment are preparing to spend $100,- 000 on quarantine improvements, and as it behooves us tÔ take every possible precaution, especially as to the purity of the water we drink, it is with pleasure we learn that the eity authorities are taking active steps through their efficient engineer, and that the testing ofthe flowing wells is being proceeded with. Should that source of sup- -ply be found pure and sufficient we will have gone a long way towards balking the grim spectre which has been stalking in Russia and has started on bis dread westward mardh through Germany. * * IN a recent issue of the Northwest- ern Miller, published at Minne- apolis, appears an excellent likeness together with a short sketch of the life of W. W. Ogilvie, of Montreal, one of Canada's most prosperous sons. Froi- it we learn that Mr, Ogilvie,' together with his brothers Iton, A. W. Ogilyie and John Ogil- vie, erected in 1892 the Glenora miill on the' Lachine canal and at subsequent dates the Goderich, Seaforth, Winnipeg and Royal Mills. These mills together with the Montreal city mills recently ac- quired, make a total capacity of 7500 barrels of.flour or 33,000 bush- 318",
         "THE MANITOBÀN els of wheat, which is supplied fron 40 elevators in Ontario, Manitoba and the Northwest Territory. Mr. Ogilvie says, the MILLER was the pioneer wheat buyer in Manitoba, and bas contributed largely to the development of the province. An idea of the.magnitude of the busi- n ess and of its rapid growth may be had from the fact, that their first shipment of wheat in 1876 was only 500 bushels while it reached last year over 4,000,000 bushels, while the amount spent in wages alone foots up the nice little sum of $226,000. A great portion of the success that has attended Mr. Ogilvie is per- haps due to the fact that he spares no pains or expense in procuring the latest improvements or keeping his mills in the most iniproved and ïinodern condition. He was one of the first to ship wheat ont of Mani- toba, bringing it up the Red River by way of Fargo and from there by the Northern Pacific- Railway to Duluth. But all this is now 4changed and so great is the change that Mr. Ogilvie says \"one can hardly realize what has taken place in the Northwest during the last 35 years.\" To all Winnipeggers the Ogilvie's are well known and as the C.P.R. trains from theeast with their loaded cars of humanity cross 'over the Red River on their entry into the prairie city the first thiug to greet them is the Ogilvie mill and elevators towering aloft like a huge monument of industry and labor. THER E is a gregt deal of discussion throughout the Dominion in refer- enee to the Retaliation Bill which the A nierieans have recently passed through Congress and which only awaits the President's signature to become law. .Ss our readers are no doubt pretty familiar with the objects of the bill by this time we will not go into details but believe that if the Yankees think they can by their bluff and bluster intini- date the Canadians into giving into them they will find ont their mis- take. Should the bill become law as it undoubtedly will unless some adjustment is speedily made, Mani- toba and the Northwest will be the greatest sufferers. The farmers will not get as much for their wheat and the increase in the price of coal will place that hrticle beyond the reach of ordinary peopte. But it will only be temporary. We will 'ere long have our own canal com- pleted at the Soo-and with the Welland canal owned and operated by us we eau carry the \"[Retaliation Acf'' as far as tiheAmericanslike to go. . There is 'nothing that will bring about Free Tradq with Brit- ain 80 quick as this last move of the Aniericans. The Yankées are a great nation for bluster but John Bull can stand a good deal of such antics as they will find out. We are only a small country as it were compared with thein but we seem to be a great source of envy. * ** ONCE more 'the Greenway Gov- ernment have been returned to power, and judging by the immense inajorities all over the country and especially in Winnipeg, it was \" keep the rascals out.\" To the Hon. Mr. Greenway the people of Manitoba owe an immigration policy .2319",
         "THE MANITOBAN. which is doing more and botter work to secure settlers, for not only Manitoba and the Northwest, but for the whole Dominion, than all other policies or schemes put to- gether. If the Dominion Govern- ment would only put their shoulder to the wheel in the same manner we would have such a tide of emi- grants coming into the country that would cause the next census returns to tell a different story. To the pre- sent Government we owe much, for not only the immigration policy, but several other acts as well have been passed and carried out by them for the benefit of the people. We trust that the next four years will prove a term of prosperity and that the Province of Manitoba may continue to lead as in the past, in all things pertaining to the advancement of our country. It is an old saying, and one which is being every day verified, that \" you cannot check Manitoba.\" Throughout the Do- minion Manitoba is being gradually looked upon to take the lead in re- forms and although it may appear presumptive on her part yet she can teach her older sister provinces a good many things which they are only finding out. THE Winnipeg Free Pres8 in a local the other day said \" let the boys swim in the river if they want to, they can't hurt the water any.\" This is probably as near the truth as you can get it but should be re- versed in order to fully understand why the boys shouldn't swim in the river. It is the water that hurts the boys and not the boys the water and herein lies the mischief. To the bather or swimmer who ven- tures into either the Red or Assini- boine Rivers, and is seized with cramps there is not much hope for escape, as he is sure to be suffocated or choked to death by the terrible stuff he has to swallow and death is inevitable. WHEN visiting the recent Indus- trial Exhibition, held in this city, we were particularly struck with the exhibits from the different lu- dian Industrial schools. The man- ner and quality of work shown was something which set people think- ing, and in it we could almost see the solution of the Indian problem which has been a great deal written about and which has bothered Uncle Sam so much that their solu- tion of the question seems to be that the only good Indian is a dead one. In looking at the specimens of work by the little Indian boys and girls we have a different view of the case, and believe that in them we have the means whereby our Indians can be taught to be self- sustaining and a benefit to the coun- try instead of otherwise. The teachers and instructers deserve the greatest of praise while the many excellent specimens of handiwork doue by these children of the Red men put to the blush work done by our professedlv skilled workman. It was a wise move on the part of the Goverument in thus teaching the children, for in this way they learn the future genera- tions. There is no reason why the Indians should not be taught to be as useful as their white brethren; and we question if our children were 320",
         "to grow up in the manner the child- ren of the forest do whether they would be any better. It is an old saying \" as the twig is bent the tree is inclined,'' and the same can be applied to the human family whether they be Indians. negroes or whitemen. The little Indian boys and girls certainly deserve great praise, and we trust to see a full collection of their work at the World's Fair as it would without a doubt be as interesting to those wvho are ignorant of their aptitude, as any exhibit which could be shown. ** * - THE large majority of ballots in favor of prohibition cast in the last election was a pleasant surprise to the many friends of temperance, for while a great many expected there would be a majority, yet no one looked for such an immense one. This- should be encouraging to Prohibitionists who will doubt- less get a bill put through the next legislature to prohibit the sale of liquors. As to the constitutional means which may be employed and its operative legality there seems to be some doubt. The moderate drinkers claim that no one has a right to deny them anything they may desire in the way of meat or drink provided they pay for it. Just where to draw the line seems to bother a great many of our tem- perance workers. But the consen- sus of opinion is that the only way to strike at the evil of intemper- ance is to prohibit the sale of it all- together. In the City of New York the drink-question is causing consider- E THE. M ANILOAN. 321 able discussion. Dr. Rainsford, a celebrated New Yorker, in a recent article said: \" Thesaloon has come to stay, you might as well legislate against the tides. The saloon is the working-man's club-room and it has got to be managed as a philan- thropic effort.'' The Dr. is quite right the saloon is the working- man's club-room or the club-rbom of any other individual who gets a glass too much. This may not be what the Dr. imeant but the saloon is generally regarded as the most fitting place for the persuader which in the hands of a person stupified by drink generally does considerable damage. But look- ing at the matter seriously we would like to ask the Dr. if he could conscientiously recommend the saloon as a Sitting-room or reading- room for the Young men and boys of any country. Would he like his children to spend their spare time in such a place, where nothing but drinking and profanity with coarse subjects for conversation were the recreation. If so, then God pity the intellectual recreation thus obtained. * ** IT must be gratifying to the dir- ectors of the Industrial Exhibition to see such a handsome result from their first experiment of a summer fair. The roceipts were far in ex- cess of that Of last year, while the attendance was over 40,000. The exhibits were really excellent, the stock especially being far ahead of he most sanguine expectations. [he display of implements and farm nachinery was equal to a Toronto xhibit while the manufactures",
         "THE MANITORAN. and other artieles were equally as good. The main building presented a tasty appearance but was not quite what 'it ought to be. But fhis can be remedied and for a venture from a financial point of view was a big success. But while the fair it- self was successful in a way tliat pleased the directors it did not sat- isfy the merchants as their trade was very little if any increased. We are of the opinion that the fall is the best time for holding a fair iunless it is an art show or some other attraction gotten up to \"please the public. To be sure we had fine weather for the July show but we might be equally as fortnnate in October. We trust that next year the directors will change the date from July to October so we can have a proper display of the season's products. ' It is our products both grain and cereal that we pride our- selves on and we ought to display them at the best season for doing so. Another thing about the summer fair will be that foreigners will think our seasons are so cold and wintry that we can only show any- thing in the warm weather. As there is plenty of time before the next one takes place lor discussion, we hope to see the public express themselves on the subject. ACCORDING to the last census of Newfoundland the right little, tight little island has a population of 197,934 of which 363 are foreigners, principally Americans. The males number 3,200 in excess of the females which should be gratifying news to the Newfoundland maidens. Of tre population engaged in farm- ing there are only 1,545* while '53,- 502 are engaged in the fisheries. An Incident. BY MRS. L. E. CHITTENDEN. WO girls came into an evening party with their father and attracted the attention of two rather elderly gentlemen, standing near the entrance, one of whom said: '- Ah! there is my old friend B and his two lovely daughters, who are such favor'ites in society this season. What a striking 'contrast they pre- sent; one so fair, and the other so dark. The golden-haired one car- ries off the palm for beauty, do you not think so 1'' \" Wait and see. To my eyes the character and self-pose in the darker one's face, more than equals the pretty face and lovely coloring of the other,'' said his friend. Later in the evening the two sis- ters and a young gentlemen escort came into the refreshment rooi, and were seated very near the two gentlemen who had spoken about them on their entrance. Wine was passed, and with a slightly flushed face the young man refused it. \" Ah,'' said the golden-haired sister, \" are you afraid to take wine, Mr. C ? I always admire any one who is able to do all such things and yet not be conquered by them ; able to use wine when one wlshes it, and to let it alone just as easily. Carlyle says, \" Man is the only tool-using animal.\" and I think it should be added, he is the only one who can conquer his appetites.'' \" Very likely you are right,\" answered the young man. \" I own I have heretofore never dared to touch wine, lest I should develop a latent appetite, which I fear I in- herit, but you put it in a new light to me. I have perhaps been guilty of a species of moral cowardie which I ought to overcome.'' \" Shame, Adelaide! '' cried out the other sister, her dark eyes blaz- ing. \" That is the worst possible advice, and you know it, if you would only stop to think. Mr. C, 322",
         "THE IAN1TOBAK I lnpe you will cling to that reso- lattion ofyouirs, io) imatter what the tenitation mîay be. Promaise ute that you will never allow onie drop of winte, or anythinig of that kind to pass your lips, if there is any danger, whatever that it will be- a fix.- habit. Adelaide spoke thigh tsly, and( believe me,. she al 1 everyonîe will rnesmet and ad- mire you ail the more for your firm :adherenice to a pbrinciple.' The voinung mian turnted loward lier with -a look of reverence on his face. I will prontise you, Miss Rrnice, and yout may rely ipion in1e k..eping ny pronsise. If women tnily kie - the -influeaee they juri- se-\u003cs for good, and if they realized the strength of a tmani's appetite, the world would be better. I thank you for your word.\" Adelaide's face was flushed and her eyes were full of tea rs. \" For- give uIe, Mr. C, I did wrong I know, but I di) nlot sceemi to be able to jadgo of rigllt or wrung so well as Bernuice, who is muy iîenttor,\" she Sa id. \"I aim sure your faults can never he grave or deliberate ones,\" said the younig pan. \" You err simply, aS I s-id, because yotu do not know -what it is you trifle withI.\" As the- two gentlemen Who lad beeni involuntAry listers to thtis conversation arose to leave, the one who had said, \" Wait and sec which is the fairer,\" said, \" Was I not riglht 1 \" The Qthîer answerel heartily, Youi were indeedt.\"-The Hfouse- keener. The British Freedom. 1E news that cornes across the ,wires every day from the old land illustrates in many strik- ing ways the breadth and inanliness of the typical Briton and the great- ness of lits empire. Great Britain is the only country under heaven that dareq to throw open its ports and challenge the world to trade, Great Britain is the onfly country strong enougi to allow any muan to take a seat in Parliamient who eau persuade the electors to give hiimi one. Amnong the members recently elected there is the former editor of an Alericant newspjaper. There is also a Parsee froim lHombay, and a Jrentchiman. There are several Je ws and one or two pronounced Social- ists. Just fancy the howJl about loyalty that would be raised in Can- ada if people of that kind tried to get into Parliament. John Bull knows very weli tlat the way 'to keep them iharialess is tokeep then free. What electors other than Britons would vote against a mem- ber of the Royal family. If the Queen's son-in-law were running in somte conîstituencies we know every man who dared to vote against him would be called a rebel and eharged witih disloyalty, treason and a host of oiher crimes. As likely as not he woubl be mobbe-d. * The Marquis of Lorne was defeat ed for thesecond time the other day, and no English- man paid any special attention to the eire;umstances. They don't vote in Enîglanid for a candidate's wife or mothe-in-lw--they vote for or against the camididaite himself. A Canidian feels proud when lie sees the I rue British qualit ies displayed in the great fight across the water, but his feelings suddenly change when he look-; nearer home.-Knox- onian in Canada Presbyterian. HERE is an incident of the late elections: Two gentlemen, of oppo- site polities, meeting, one inquired the address of some political celeb- rity, when the other indignantly answered, \" I am prond to say, sir, that I am wholly ignorant of it.'\" \" Oh, you are proud of your ignor- ance, eh, sir \" \" Yes I am,\" re- plied the belligerent gentleman, \" and what then, sir ¶\" \" Oh, nothing, sir, nothing ; only yoi have a great deal to be proud of, that's all.\"",
         "d THE ]WANITOBAK., Beatrice Canreror. Or, Poetry the Happy Medink.. A Story in Two Books.. (Pr the ManiUobn\u003e BY F. OSMAN MAEER., Book Two.-Ohapter 3. {CbutiwuedC Tes,7eq- indeed is ligtt from Heaven; A spark oo that imymortal fire Wlth angels shared,.by Allah giem, TolIft frenrearth or lowdesire.. Devotion, watts the mi n«rabove 'But Heavewitself d'escends in leve; A*feellng fromthe oWdhead'caught To wean fromr self each sordithought,. A ray of fim who formed the whole A glorycireling rotm«the s.d. -TIe Gontr. W had this my narrative been what is vulgarly tered, \"a neveI,' it wouId undoubtedly have been meet, iight and necessary te relate the downfall of'the hero, and bis rescue from the lowest ebb of despendency and despair by the heroine. But this being a history, true and law- ful to nature : not iction, but fact: I cannet but feel sorry that a con- trary result has to be narrated. The deepest, humblest, sincerest and most reverent apologies are therefore made to the reader. Immediately after Vane Helmore received the invitation to the mar- riage of Beatrice he departed for Winnipeg. His uncle, aunt and cousin were very sorry to see him leave. Vane was, without doubt, in a matter of bewilderment and per- plexity. He Ioved Beatrice with all his heart. Her actions therefore confounded him. That she should have taken sueh a step in such a hurried manner somewhatsurprised him. He knew that true love could not be the cause, and was sufficiently acquainted with the every-day affairs of life, the *fickleness of nature, the follies and flippancies of the world, and the bewildering coursingfof human existence to sup- pose that pride and jealousy were the only causes. And his suppos- itions were remarkably near the truth ! He had also his own indi- vidual musings and private affec- tions to eontend with, which as we- Inew were sober and prefound. It might of course with truth be said that lie had ne publie eause to feel ast.nished at the actions of Beatrice, for what was she te him? Ah! W'hat ? If he had been lher lover, had she not rejected him? Most assnredly, rejected him withont hope r Yet, somehow, deep down in the recesses of his heart he heard the low murmur of an approaching- sterm ; the eireling of the whistling eyclone whose efeet he would ex- perienee. But that its fury would be se awful, so disastrons as it after- wards appeared, he could n.et, evén in his moments of wildest excite- ment have dreamed or imagiined.. Had he done se we all know what his movements would have been. In due course be reached bis des- tination. Instead of proceeding to, the Camerens' he took lodging at a hotel until the date of the wedding. On the appointed day he could have been seen seated in the midst of the congregation, seeing all-himself unnoticed. The whole scene was viewed by him ; the beginning, the middle,. the end. He, with 'the others, heard the words of the con- stable; witnessed the arrest ; the surprise of the audience, and heard the last heart-reuding seream of poor Beatrice. Then, for the first time he felt sure of her love ; then, for the first time was he aware of ber agony, despondeney and despair. For if she loved him not, what, en this, ler day of trouble could make her call him by name 1 Nothing but love! Surely nothing else? Was this not a proof of it, the truest and grandest of proofs ? Conld any- thing show it more disinterestedly ? He believed not, and as we know, oh ! reader, was exact in his con- elusion. When Beatrice was carried home he did not think of following.",
         "'InE 111IÀN131X4 Althongh his noble heirt burned with pity for her he knew that at that particular moment his presence would be undesirable. Besides he 0could wait. He had waited for her, :she shoald wait for hira. Then again he had no right to interfere in this matter. For althonugh Wal- lace might be a scoandrel, a liar, a blackgnard, a coanterfeiter, a for- ger, a bigamist, ai idolator, or even a murderer, Beatrice was to all ap- pearences his wife, She must obey him in every way and sabmit to his guidance,-or at leaat, she had promised to do so at the altar but very recently,. But would she? Is a promise, given nader such circum- stances as was hers, binding f This 1s a question for the learned. For ourselves we would say it is not. As we know, however it woald not be necessary te test her courage and character. But more of this anon. In consequence, Vane proceeded direct te his lodging. There in deep bat silent brooding hours passed. Ris love for the poor girl was strengthened by the reverie ; he sympathized deeply with her under her great misfortune, and would have given worlds (did he possess them) to have eased her burden. He neither blamed nor rivaled her : her actions were under- stood; her very feelings and emo- tions were evident to him. \"I will call and see her in a few days,\"l he muttered \" it will un- doubtedly be best,\" I cannot bear to think of her suffering without doing my utmost to relieve her. She has at last received a lesson ah, nie, what a lesson ! Ah! a hard one it is, the lesson of a lifetime, one she will never forget ! But she needed it ! No more will folly hold possession of her brain ! Yes ! she is cured ; but at what a cost ! Yet why should I speak thus ! I will cease, and away as a hard-hearted wretch !\". After taking lunch, our hero, therefore, stroled about the city. Everybody seemed to be -talking of the marvelous occarence that had taken place. Gossips ejoyed them- selves be the'r heart scontent, .For At least once in their lives they could wag untìI exhansted, Vane soon heard that the trial *as to take place ìn three days as the session was then sitting, le determined to attead. Accordingly he was ptesent at that importait event in the annals of Winnipg, Throughout the whole Proceeding he Was a silent observer; then immediately after the termination thereof he proeeded to visit Mr. Cameron. The latter was very pleued te see him, \"I had expected to.;see you before\" lhe said: \"l Hw is Miss Beatrice queried Vane, \"I have heard she is ill 1 hope from the bottom of my heart it is not very serious.'\" \"My boy, my boy, she is Il, very ill, s0 ill that I am afraid she will never recover, In a wild fever she is raving and tossing,. How I'd like to get at that scoundrel Wallace or Buxton, whichever it is.\" \" Were you at the trial \" enquired the old gentleman, \"1 intended to have been present myself, but could not raise my spirits sufficiently to do so. I therefore sent my attorney. He has not returned yet, but if you were preseit yourself youn can in- form me of theTesuIt instead,\" \" yes, sir, I was, and have happy news to relate. It appears that Buxton was married, and athough the scandal of tho case has sOm- ingly increased Miss Beatrice is freedw She is not his wife. Ris truei\"e was a witness at the trial.\"1 a Mr. Cameron could scarcely con- tain is Joy. Arising he paced once or twice up and down the room, thon suddenly turning, shook hands with Vane both heartily and length. ily, thereby showing his cordial belief in the young man's sincerity and lonor. Besides, the tWo were, as w kow, in hearty sympathy with oach other. Mr. Cameroli wag",
         "THIE MÂNroBÂnM aware that.Vane had once wished to marry Beatrice, had in fiact giyen him advice upo)u the subject, but whether he still wished it, was a question not to be decided in haste. The young maun's future actions would prove his lionor, honesty, purity and manliness. \"Vane,'' exclaimied Mr. Cam- eron, \"JI have something to tell yoi.,, \" Upon the morning on which Beatrice was to have bein married she retired to her rooni, and there, as I have reason *to believe, gave way to a flooud, of despairing tears. She really did not wish to marry Wallace, but had forced herself 1o it by means of whilh I know not. but which I fancy were connectesi with you in some way or otler. At, any rate while in her room sie wrote something to yon. I have not opened the envelope as I can fully trust you, and now hand you the letter. I will leave the roon while you peruse it, especially aus I hear my attorney just entering.'' \"Do stay,'' said Vane, \"I wil] read it aloud whatever it may be.'' \" No ! I must leave '' Mr. Cam- eron articulated, as he walked ont of the room, closing the door be- 'hind him. Vane was now left alone. With wonderment he opened the letter before him. Then he read. Let us glance over his suoulder. A IIEART'S CONFESSION. My heart was but a fickle pare With thoughts ofnauight but fun : With smiling eye my beaux passed by I made my choice of one. When I was tired i threw him o'er, I made another choice; I looked again I saw ainain A man of better voice. So long as they had money much And thought not how it went; So long asthey with spirits gay On pleasure were intent; So longs they with honeyed words My loveliness did praise I kept their side with joyous pride For five or six long days. But when that tine had come and gore, And all their coin was spent, My foolish heart feared not to part And seek another gent. My foolishness bas now been cleft. My spirit well nigh er. shed, No sudden start now thrills my heart,. For folly's voice is huahed. You came along, your look was fair, Your wealth was counted high, One more Pli seek to hold a week, Then I will bid him bye. The stated time again appeared, The sixth day had been reached, I bid you go as well you know, My message I had preached. Your tongue was silent as the dead, No anger brrshed your lrow, A letter came, it bore yourname, 1 have it with me now. Oh, my own love, My life my lost, Oh, well may I entreat You left my side, my wounded pride Has felt the forced retreat, For I can now with sorrow plead A cause of abject woe, Icast away your love for aye; It was a coquette's bL\u003ew. I thought you'd plead, and plead with zea I I thought you vould persist, I thought again supreme Id reign; A ruler Id exist. But no! no second time you spok e, No second prayer was breathed, 1 might havc been your earthly queen, But with my pride I writhed. And now my heart bas ceased to beat, My blood it runneth cold. The coquette's strife bas ceased its life No more is pride so bold. Oh! that I might recall the past And live it o'er anew, Fool's pride so bold, the coquette's gold Could no¢ keep me from yeu. O' Vane, O' Love, O' Vane ny life Oh Vane my one and all, Forget the past, Pm lost at last, Remnember not my fali. The letter fell from the hands of Vane as he finished reading. \"The poor girl,' lie muttered munst indeed have suffered terribly. or she would not have written thus; above all in poetry. But poetry is the only language of the heart! lu it only can our wildest feelings be expressed ! ~U 326",
         "\"« The poor girl, the Io, girl ' and Vane arose withî a look of de- termination upon his couiiteinanmice. CHAPTER IV-TEE lIsPOsAL. Three weeks had passed. Bea- trice was almost recovered. She was sitting in the drawing-room reading when there came a knock at the door. Looking up she saw Vane who entered. A glad look of recogni tion crossed the face of Beatrice as she arose to greet her visitor. l Well, Beattie \" (she noticed the tenderness in his tone as he uttered ber naine \" Beattie \") said Vane, \" I hope you are at last en- tirely recovered. I must take this mny tirst opportunity of expressing iny sorrow for your troubles.\" \" Thank you, Mr. Helmore.\" Vane looked surprised at this,- but nerely remarked \"J received your poetry, you are a genius.\" \" Beatrice blushed, faltered, and sank deep into her chair.\" \" You received my letter,\" she whispered, \" where did you get it, I did not wish Vou tosee it, I wrote ij ierely to relieve my feelings.\" \"You did not wish me to see it i Beattie! Beattie! what! what! you (iid not wish to tell me of your love ! Yon did not wih ne to think you fickle! I do not.\" \" O Beattie, I love you, I adore you more than ever, you love me 1 know, you have written it, your looks show it, but let me hear it from your lips. Tell me Beattie, tell, oh tell me of your love, tell me you will be my wi1e, tell me that ify passion is returned.\" Beatrice had not yet answered iis passionate appeal. she was sil- ent, first from love, second from de- light and last froi admiration -in- termi ngled with sorrow.\" What a noble man Vane must be'' she thought, \" that after the ate oce currences he still loves 'nd be- Hieves inme.\"1 \" Answer me Beattie\" Vane passionately continued, tell me oh my darling, tell me from your lov- ing lips t hat you love me,'' taking both ber hands and looking into the deep eyes of marvellous lustre \"speak I entreat, I implore, i pray answer at once ere my soul is con- sumed by the ravaging lire of love that burns within me.\" In an almost inaudible whisper the answer issued from her lips, she did love him, h ad known it from the first. \" My darling. my darling, you have said it, you love me, you will be my wife\" pressing her close to his manly breast and raining kiss after kiss upon her cherry-like lips; ' you love me, I knew it my treas- ire, my life from Heaven, my all.\" Neither noticed that the room was filling with smoke; neither heard the key turn in the lock be- hind them. For many moments the lovers en- joyed the frst joys of united love, Beatrice was nestled cosily by her hero's side when suddenly drawing closer to him, she exclaimed: \"Look, Vane, look ! Fire! lire! Then Vane looked and beheld, darting through the floor at many points sheet after sheet of fiery adame. TH1E END. A POSTC(RIPT RY THE AUTHOR. I had just handed in the above at the office of publication, and was passing out through the doorway, when the worthy editor with a bound cleared the counter, and catching me by the ears led me to his desk. \" Sit down\" lie said \" and finish this what do you mean by leaving it in this incompleted state 1 Do you think you will escape in this way Xot if 1 know myself. We want the remainder of the story.\" \u00264But,\" 1 remonstrated, I in- tended only to show how Poetry became the happy medium \" and I have done so. What more can I say ? i THE MANITOBAN. 327",
         "THE MANITOBANv, \" Nevertheless '' was the re- sponse,\" you will finish the nara- tive before leaving this room.'' I was in a bad fix, but I had to do what I was told. It being nearly supper time, and the inner man feeling the need of replenishment I must hurry. James Buxton had not been long in prison before he determined to escape. Bold daring man that he was, his end was soon accomplished. At the jail his occupation was to attend the head-keeper, that is to say, under the latter's guidance to do all the necessary work about the prison. Buxton by his pleasant and agreeable manner soon found favour in the eyes of his jailer. One night the prison employees determined to have a lively hop, and great preparation was made for the occasion. This the keeper, in a fit ofjoviality informed lis prisoner who then and there determined that the night of the ball should be lis last night in confinement, and 80 it was ! The keeper in his eagerness for the dance left with- out attending to the locks, and the prisoner departed, without any trouble whatever, Through the large front door.* Buxton bad all along determined to revenge himself upon Beatrice. He blamed her for his troubles and imprisonment. Arriving at Win- nipeg on the night upon which our lovers were met together, he with a large can of oil in his hand creeped into the house while the host was absent. He saw Vane enter the drawing-room, and it was he that locked the door. Carefully satur- ating the floor of the hall with the oil ho set light thereto, and the place was soon in flames. But alas ! in his moment of triumph he was doomed ! The avenger and not the \"I am informed by a resident near Stonewall that there was sueh an escape as thie from that jail. The escaping prisoner robbed a citizen of his garm ts, stole Into Winnlpeg, bought a new suit a the store of one of the noble Sons of Israel, and quietly departed for the State, where he Was lost in oblivion.-F. 0. M. would-be victims was the sufferer ! For as the fiend was about to fiee from the fiery element. he stumbled and fell, right into the -midst of the raging flames. There bis accursed soul left this earthly life to stand before the throne of its outraged Makei-; while Beatrice and her love safely de- scended the fire-escape amidst the thunderous applause of an admir- ing throng into the street below, In a short time, as you my read- ers may well guess, the church was again filled, the grand old organ was again thundering forth its strain of melody and charm,-but whether or not this wedding was a repetition of the first I leave untold-the u'ise only nust conceive for themselve8. Au revoir. DEFINITION OF AN IRIsH BULL. -Two gentlemen walking along a public road in Eastern Perthshire one day engaged in conversation got to disputing as to what constituted an Irish bull, but had not been able to arrive at a proper definition of the term when they came to a field by the roadside, where an I.ishman was engaîged at digging a drain. Said one gentleman to the other- \" Here's a true son of the 'Emerald Isle\" whom I know to be intelligent and ready-witted. We'll ask him lis opinion on this ticklish ques- tion.\" Hailing the drainer, the gentleman inquired-\" What would you term an Irish bull, Paddy 1\"' Paddy, leaning over lis spade for about a second, replied-\" Troth, your honour, that's aisily towld. If you're drivin' along the highway, and yez see three cows lyin' down in a pasture, and wan o' thim's standin' up, why, that wan is an Irish bull.'\" THERE is an old adage that if en- ough ropp is given to a fool he will hang himself with it, but it appears that ever since the world began there has been a scarcity of rope. il r 328",
         "Smudging as a Preventative of Frost. rWe hnv rutIthe following letter in fvor oftjmudgos. whierh \"e publish for~ the bunefitforrae,.E. or ou r reders.-E.] To the Editor Manitoban: Dear Sir-In your first editorial note in the July nunher of the Manitoban you refer to the manager of the Nortlhwest experinienital farm as concluding \" after numerous ex- periments that smudges or smioke is ofno use in protecting grain against rrost,'' and that after repeated testi he finds that \"the temperature is not much effected, and $iat it is un- certain as to just where the smoke will gob when you want it.\" That last chiuse shows at once the weak- neas and unreliability of his cou- clusions. It is no longer a inatter of \" theory'' as to whether a canopy of mist, sioke or an artificial cover- ing will prevent radiation. It has for many years been an established scient ifie \"fact.'' The trouble arises from tie difficultyfound in adjusting the different conditions of a given case so as to secure the best results. In Spain, France, Italy, Switzerland, California, Australia, and many other phces smudging is regularly resorted to to save both the grain and fruit crops, with perfect success, varied only by local conditions and the intelligence of those manipulat- ing the same. A farmer last summer declared *'Smudging was no good.'' When enquiry was made it was found he had not fired his smudges till the thermometer had fallen to 27 deg., -5 deg. of frost. Allow me to give you, not an ex- perimental, but an actual demon- stratton of the value of smudging to check radiation. The Portage Farmers' Institute last year (1891) had smudge material arranged all over the plains, very few refusing to co-operate, and a 136 candle power electric light placed on the cupalo of the Farmers' eleva- tor, and placed in- charge of the ANITOBA3N. 29 writer, who had four standard gov- ernment thermometers. When dan ger of frost was imminent the light was turned on in the evening, then when the freezing point was neared it was flashed-turned off and on about four times a minute. Take now the third and lasttime that the ight was flashed, viz-, Wednesday, Sept. 2nd, 1891. The grain was nearly all ct. Some late wheat and oats twis stihi unent to the west of the town. The warning light was put up at 21.20, when the thermom- eter registered 41 deg. Here is an extract from the register kept: DATE. TIME. TiEMp. REMARKs. Sept. 2.3.0 410 Ordered warning light. 22.O 390 Sky clear and bright. 22.30 35o 22..35 34·.25 Ordered light flashed. 2-..45 34 0 Smudges to the west of town. Calm. 23..00 350 Light smudge over sta- tion. Wind west. 23..15 32--75 Wind south. Smoke all \u003e3 3 - cleared off. ..30 34--5 Wind west; good smoke over station. -23..40 370 Smudge extra good ; al- most otscured light. midn't 24--00 1360 Srnudge thinning. Sept. 3 0.15 360 Smudge thinning. 0..30 35I Smudge thinning. 0..45 33--5 Smudge jiearly gone. 1.00 33--25 Smudge nearly gone. 2 330 Smudge nearly gone. 2-.00 320 Smudges all gone from station; frost found ion prepared places. The tefperature had dropped to 32-75 t before the smudges spread over the thermometer station, and in 35 minutes the temperature rose 4-25 t or to 37 and remained near there til the smoke cleared off, then dropped to 32 dog. Many other practical tests could be given, but this must suffice for the present, and is sufficient to dem.- onstrato the value of smudges to prhvent the radiation of terrestrial heat. Dom. Meteor. Observer. Portage la Prairie, Aug. 12, 1892. THEcr M",
         "THE MANITOBAN. Vi2cant Lands around Winni- pcg and their Settlement. IN our last issue we spoke of the excellence of the land which surrounded the city of Winui- nipeg, and the desirability of com- bineti effort to have these Lands sel - tied. Hieretofore a variety ofcauîses have combinîed to prevent, this. First Ihere was the fact that these lands had been, by the Dominion Government, allotted to the child- ren of half-breed residents, and it was necessarily a long time before a valid title could be jrocured from such minors. Seconidly, when this initial dimlculîty had been overcome and the lapse of time rendered these minors of an age to legally transfer their lands, it was found that much of the property had been heavily mortgaged and was in dispute. Sufficient time has now elapsed foi the settlement of conflicted titles by the Torrens system under which we believe most of these lands are now held, and the encumbrances have been got rid of, either by paymîent to the creditor, or the lands them- selves have past into the hands of the mortgagees, so that we now have about 25 or 30 niles area of land around Winnipeg which should be at once thrown open for sett le- ment at moderate prices. The land itself is shown by the crop last year and is being shown by the indica- tions of the crop this year, to be of the very best. It is all land where good water can be had by wells, which owing to the absence of rock, can be bored instead of dug, and water obtained at a depth of -from 20 to 40 feet. The district men- tioned should be a desirable one for emigrants for several reasons ; a thoughtful emigrant must take into consideration not only the quality of the soil necessary to produce good farm and garden crops, but the question of whether he can dis- pose of these to advantage. This question is at once settled by i.ts nearness to Winnipeg, the largest city and best market in, the io- vince;· so that, while not wishing iii any way to prevent lie filling up of the whole of this jprovine, we feel t hat in fairies to tle in- coming settlers we should ask their coisiderat ion to the foregoing facts; on the other haînd we appeal t. 1 lie hotlders of land iii the vicinity of Winnipeg fo combine in sone way as will carry out thegeneral scheme of settlemuent, and the rendering if possible for the small emigrant who only wishes a quai uer section, of the advantages which might be ocrurred Io the larger one who de- sires a block of 15(0 to 2000 acres. We may renark for hIe interma- tioi of the intending enigrant ihat, should hoiders of land in the vie- inity combine in the way we inii- cated, such a conpany would be in position differing from any other company in Manitoba or the North- West. The railway companies are only able to sel the settler aller- nate sections. The Hudson's Bay Company van only sell the sections specially reserved for them. The varions colonization comîpanies can only, as is the case with the railway companies, sell ilternate sections; and this prevents the possibility of obiaining through any one of the:,e sources a larger quantity of land Shîan 640 acres, whereas in the case of a company which held the lands originially granted to the half-breeds, would be in a position, in some cases, to sell two or three thousand acres in solid blocks from the faet that when distribution was made to half- breed children, the odd and even numbered sections were given alike. The Expedition Boats of the Early Days. . IT may interest our readers to learn soinething of the kind of boate which were built by the British Admiralty for some of the Arctic expe(itions for explorations along the Arctic coast of this cou- Linent. The problem which they di0 c",
         "THE M, à Avnoin -had in niost cases to solve was th\u003c building of a boat which could b transported froin London to York Factory, and brought by the labor o mon up the rapids and other rapid of the Nelson and Hayes Rivers t the north end of Lake Winnipeg thence across the foot of the lake to the Saskatchewan, up its rapids to Cumberland, and from Cumberland northward to a nine-mile portage, variously called the ''Methi Port- age,\" \" Long Portage,\" or \"Portage la Roche ;\" thence down the Clear Water River to the Athabasca, and thence by that river to the Atha- basca and Great Slave River to Great Slave Lake, thence by the Mackenzie to the Arctie Sea. Two of the expedition boats meas- ured 30 feet from the fore part of the stem to the after part of the stern- post, 6 feet in breadth of beam, and 2 feet, 10 inches in depth. Each of them weighed 6j cwt., or, includ- ing fittings, masts, sails, oars, boat- hook, anchor, lockers, and tools half a ton. The other two boats measured 28 feet in length, 5 feet 6 inches in width, 2 feet 8 inches in depth, and weighed 6j cwt., or with movable fittings and equipment, 9 cwt. They were all clinker built of well seasoned Norway fir planks 5-16 of an inch thick; ashen floors placed 9 inches apart; stem, stern- posts, and knees of English oak; and gunwales of rock elm. To admit of their stowing the requisite cargo, they were necessarily very flat floored, but screws and bolts were fitted to the kelson by which a false keel might be readily bolted on before they reached the Arctic sea, so as to render them more weatherly. The larger boats when quite empty drew 7f inches of water, and when loaded with two tons, but without a crew, 141 inches. They were constructed of two sizes, but the smaller might stow within the larger ones during the passage across the Atlantic. Their description as given for one ' 331 of such voyages in the early part of this century is as follows : f iThe stores consisted of 198 can. f isters Of pemican each weighing 85 lbs. 10 bags of four, amounting in ail to 8 cwt., 5 bags of sugar, weigh- ing 4 cwt., 2 of tea, weighing 88 lbs., 3 if ehocolate, weighing 2 cwt., 10 sides of bacon, amounting to 4½ cwt., 6 cwt. of biscuit; also 400 rounds of bail cartrige, 90 lbs. of small shot, and 120 lbs. of fine powder in four boat magazines. In the arm chests and lockers of the boat, there were stowed a musket fitted with a per- cussion lock for each man, with a serrated bayonet that could bc used as a saw ; also a complote double set of tools for making or repairing a boat, a tent for each boat's crew, tow lines, anchors, and one seine net. Why Manitobans are Progress. ive. ITHIN the last two years àManitoba, by the enact- ment of sucb laws as The Public Schools Act, and by its strong prohibition sentiment ex- pressed in the vote on the plebiscite, has suddenly attained the exalted position of leader of thought among the Canadian Provinces. As yet that thought has been confined to the framing of what may be called Domestie Legislation, or legislation relating to the homes of the people ; but from domestie legislation it is bound to spread to other fields of thought and action. The questions naturallv arise, How are we to ac- count for this sudden exaltation? What causes led to its attainnent and is it a natural position for the province to occupy t The population of Manitoba con- sists largely of. the restless young spirits of other lands, more espec- ially of the older provinces. The vast majority of the inhabitants being young men who have come hero fron a desire to advance their position in life, but a great many of",
         "THE MANITOBAN. whom have come simply from a love of change and a fondness for specu- lation. This spirit of fondness for chlange and novelty has diffused it- self throughout the entire popula- tion and penetrated every walk of life. The business man who has been in business five or six years be- comes restless for a change of occu- pation and location; the mechan- ic who has been employed for a year or two in one place desires to move to some new sphere of operation; the teacher who continues to teach for over two years is a rare specimen of the knight of the rod; while the preacher who in the east would spend a life time with one flock without either flock or pastor becoming desirous of a change, here seeks fresh fields and pastires new at least every four years and the flocks rarely raises any serious ob- jections to the change; even the fàrmers, who would be expected to settle down and become attached to one locality as they do in other lands, are here given to roam. This inate desire for novelty has led the youthful population of the prairie province to desire to manage the the public affairs of the country differently to the manner in which they are managed elsewhere. The popular deniand has found ifs lead- ers who have carried into effect the wishes of the people and brought Manitoba to the front as a progress- ive land. But as the years go round, is this spirit of unrest not likely to sub- side ? Are the inhabitants of the Province not likely to gradually develop into a quiet easy-going class of toilers of the soil, satisfied with following the thought of the outside world instead of leading it ? We must expect this restlessness to de- crease as the mass of the population gets more older heads imbued with ideas of conservativeism amongst it. Besides it is a well established fact in Etanology that man, in every stage of civilization and in every quarter of the globe, is influenced by his geographical surroundings. In a level plain like this prairie province of ours, the hardy and daringmountaineer, with his strong imaginative powers and superstition tainted religion, would be an anom- aly. In this northern plain we would naturally expect to find the grave northener tamed and sub- dued to a monotonous level of thought and action by the monotony of his physical environnent. The flatness of the land does not afford any opportunity for the develop- ment of the imaginative faculty and of superstitious faith, such as are found in the rugged mountain regions. And as inventiveness is a direct result of imaginative power, we can never hope to remain a pro- gressive people as we advance in years, unless some other causes can be found which tend to counteract the effects of the level nature of the land. This country does not possess the luxuriant and varied natural growth incident to the tropies and which tends to make the inhabitants of those regions idle and lethargie. The plants whieh serve as food for man and beast are cultivated with labor, for, although the region is f.igid, still \"in the sweat of our brows we have to eat our bread'' and as a result activity and physical strength is a prime necessity for the inhabitants of the land. The clear, dry, invigorating atmosphere also tends to produce a buoyant, active spirit, and with bodily activity and strength,, mental activity and vigor will come as a matter of course and must have free exercise. Separated as they are from their eastern * fellow citizens by long stretches of uninhabited wilderness, and from their western compatrio~ts by almost impenetrable mountain barriers, the Canadian dwellers of the plains are to a certain extent isolated from the densely populated regions of older Canada; couse- quently the ideas common to the other provinces will not readily",
         "THE MANITOBAN, diffuse amongst the mass of the prairie population. The only out- side influence likely to operate in the original thought of Manitobans is that of our neighbors to the south, but even that is, to a certain extent, precluded by the restrictive trade relations existing between the two countries, owing to the high protect- ive tariffs imposed on both sides of the line. Being thus isolated from all ont- side centres of population, the vig- orous, buoyant, mental activity of the people of this province is com- pelled to find an outlet in its own originality, and as there is not like- ly to be any change in its physical relationship in the near future, Manitoba is bound to keep its lead as a progressive and aggressive province for many years to come. Glimpses of the Past. MONG the interesting pro- ductions in print of the Rupert's Land Industrial School Press is a pamphlet lately published, entitled \" Glimpses of the Past in the Red River Settle- ment, 1805 to 1836, coutaining a glim pse of the daily life of the early settlers; the Church under the Rev. Mr. Jones; the great flood of 1826; the moral tone of the settle- ment, building St. John's cathedral and other interesting matters. In glancing through these valuable letters, there are early indications of the commercial enterprise in this conntry, and it is quite evident that wild cat companies were in exist- ence even in that early day, for we have account of the Tallow com- pany, and the Buffalo Wool com- pany, the first of which proposed, apparently, to put their produc- tions in competition with tallow imported into England from Russia and elsewhere. The stockholders being in apparent ignorance of the transportation fact that over forty breaks in navigation occurred in the place of production and the place of sale. The Buffalo Wool company seemed, if possible, to have been a still worse visionary seheme. It was quite true that the inner cover- ing of countless herds of bison in the winter was a soft and fleecy sort of wool, and the proposed method of obtaining this wool was by pick- it up on the prairie in the rubbing places of these animals when they rid themselves of it in the spring, It is needless to say both companies ended in financial disaster. Pro Patria. In days primeval, 'ere this ponderous world Forth on its heaven-appointed path was hurled In fields of space, a formless mass it lay A realm of night that yet had known no day. Shrouded from sight in gaseou mists that round Its mighty bulk, like writhing serpents wound. With hill and valley, lake and river blent In strange confusion-sea and continent Yet undivided. From lis cloud-girtthronee Where through eternal years Ife reigns alone, The great All-Father looked. Before His eye He marked the might - mass of chaos lie In idle hideousness. He spake. His word Even to its farthest verge of mist was heard; The vapors parted at Hishigh command The obedient sea rolled backward from the land. Thus the Creator Ris great work began And fashioned wisely the abode of man. Here, in mid-ocean, placed a rock-girt isle, There, bade the boundless prairie bloom and smile. Covered the Arctic wastes with stainless snow, Rude dwelling-place for ruder Esquimaux. Spurt the Great Desert's lone and trackless wild For the fairer sons of Hagar's outcast child. Gave Araby ber gardensreathing baln. Her sun-bright waters, and her groves of palm. Then, too, creative wisdom shaped and planned The wave-washed boundaries of our own fair land. Stretched, like a royal guardian at her side The lone Superior's rock-embosomed tide Bade proud old Huron under homage meet, While Erie and Ontario kissed her feet. St. Lawrence Queen of rivers, even thee He gaveher handmaid bight and fair to be.",
         "THE MANITOBAN. Bade the old ocean for thy coming stay, And sent tbee, laughing, on thy sunlit way. O Wisdon Infiniie, wbose eve could see Thro'the thick mists of ages*yet to be The mighty race, of toilers who should come From lands afar and call these lone wastes \" home.\" Yet so it was, when came the appointed time, God called His chosen. Gallia's sunny clime Sent forth ber bravest. Britain's skies of gray Grew gloomier as ber children sailed away, And many a home in German \"Father- land\" Mourned long and vainly o'er its broken band. Hither they came. The wild Canadian shore So long a waste is wild and lone no more. The blue bills echo to the oarsman's song In whitened fields the armed reapers throng. Garden and cot adorn the prairie fair And happy childhood laughs and gambois there. The sombre pine and ivory-mantled oak Fall prone to earth beneath the woodman's stroke. From morn to silent eve the plough they guide And lay the long straight furrows side by side. All honor to these fearless sons of toil For us they felled the forest, tilled the soil. For us they raised old Freedom's flag on high And swore beneath its folds to live and die. To them we owe our nation's honored place, Those rude forefathers of a mighty race. Untaught by man, but guided by their God, They laid the sure foundation deep and broad, Whereon our country's templed structures rise 'Like index fingers, pointing to the skies,' Our schools of learning and our righteous laws, That make the poor man's cause, the nation's cause. Their hope, fulfilled, of wide-extended sway All these they left us 'ere they passed away. Canadians! To your sacred trust be true The mantle of your sires should fall on you. In peaceful homes, in Legislation's halls' Wherever, in her need your country calls, There be your place and there undaunted stand* The living bulwarks of your native land. Winnipeg, June 17. ISABELLA SINCLAIR. Our Checker Department. CONDUCTED BY ED. KELLY. [AIl Communications for this Department must be addressed to Ed. Kelly, 454 Main Street Winnipeg.] *Reference Board for Beginners. BLACK 1 V/F2 UP3 5 6 7 8 9 II10 11 12 WHITE Solution of Position No. 3. Black on 7, 13, 21; king on 24. White on 15, 30, 31; king on 9. White to play and win. 15-10 13-17 18-14 31-22 7-14 31-26 27-31 9-13 9-18 24-27 14-9 W. wins. Position No. 6 BY Eh. KELLY. White on 15, 21, 23, 24, 26, 27, 28. Black on 2, 8, 12, 13, 14, 16, 20. Black to play and win. The above position appeared in the last issue of the Scottish-Can- adian, with a solution resulting in a draw, of which we take exception, and will endeavor to point out a win for black. 'meMn FZ/ g *EE N SM' M ra UM 0 E -FA a a a rE lile 4 334 y",
         "YTrE' -u (AME NO. 11-DOBLE CORNE.. 16-20 22-17 9-1.3 18-9 13-22 24-19 26-17 8-11 6-22 28-24 30-26 *Forms position 11-16 26-17 10-14 17-10 7-14 29-25 4-8 25-22 3-7 31-26 7-10 22-18 1-6 18-9 6-13 .32-28 10-14 No. 6 as above. The following are two games play- ed by correspondence between Ed. Kelly, Winnipeg, and Thos. Hogg, Oak Lake: GAME NO. 12-DOUBLE CORNER. Kelly's move. 9-14 25-22 10-28 22-18 28-32 22-18 11-15 25-22 1-5 19-16 5-9 27-24 6-10 18-9 7-11 24-19 4-8 22-19 5-14 16-7 11-15 *30-25 8-11 29-25 14-18 18-11 15-18 21-27 2-7 23-14 8-24 22-15 11-16 27-24 10-17 28-19 12-16 26-23 16-20 21-14 7-11 19-12 9-13 32-27 3-21 Black wins. *32-28 is the proper move to draw point. GAME No. 13--DYKL Mr. Hogg's move. 11-15 24-15 3-10 14-10 22-17 *7-10 24-15 9-14 15-19 25-18 10-19 18-9 24-15 10-19 29-25 5-14 10-19 17-14 6-10 10-7 23-16 4-8 18-14 11-15 12-19 30-26 10-17 7-3 26-22 9-13 21-14 14-18 8-11 32-27 1-6 3-7 27-24 2-7 25-22 18-22 11-15 27-24 6-9 26-17 22-18 7-10 22-18 13-22 15-22 14-7 8-11 7-11 White wins. *19-13 at this point is strong. at this 15-18 11-15 19-23 15-19 23-26 31-27 26-31 19-15 31-24 28-19 Tikm of a Canadian Tournament. The following item has appeared recently in one of our Canadian papers : \"There is some talk of ar- ranging a checker tournament for Canadian players. Such experts as Dykes, Forsyth, Kelly, Fletcher Labadie, Pickering, MacNab and *At the commencement of a game the black men occupy the squares numbered r'om 1 to 12, and the white men those numbering from 21 to 32. Place the men on the board and play over the games in this department, and In a short tirme you will consider yoursell a flrst class play- er. Black alway moves first. '9-14 22-18 5-9 25-22 11-16 Shepard would likely be found as competitors. As my name appears among the list of experts, I wish to state that I do not take any stock in checker tournaments as I do not -consider it a fair test of skill. The draw and knoek ont system probably would be all right; but if players are al- lowed to remain in the contests throughout, some of them get so far behind that to win the balance of their gaies would not give them a position, so it becomes an easy mat- ter for them to favor a player in advance by throwing gaimes. ED. KELLY, Draughts Champion of Canada. The Dangers of the Combine. A PUBLIC WA RNING. The public will do well to be on their guard to frustrate and nulify \" THE COMBINE,\"' of whatever name, or by whomsoever represent- ed. They are wholly evil, and that continually. Their object is to crush enterprises, either in the in- dividual or the community, and their endeavor is to keep up prices to an extent that is unjust and ex- orbitant. Many an honest man, and many an enterprising bouse has been ruined by \" the combine,\" but there are men, and there are estab- lishments, that the combine cannot harm! They live, and move, and have their being in spite of all com- bines, and even grow and expand the more they are interfered with, Such an establishment is that of Frank S. 'laggart \u0026 Co., of Toronto. The combines have tried to crush hem, but they grow and flourish ike a green bay tree, all the more o that they are persecuted. Why? Because the public, whose eagle eye nd voice is ever on the side of in- lividual pluck and enterprise, is gainst the cruel combine, that has 1either body, soul or conscience ! Lnd another reason is, that Frank",
         "3«ThEi MïNrr11OnÀK.. S. Taggart has what is equal in power to any combine-hard cash and plenty of it-with which to pur- chase at the cheapest market,. and sell at the fairest price possible. All honor to them in their noble fight against combined oppres8ion ; that ultimately means fair play to the purchasing public. I$terary Notes and Reviews. The Great Divide for August is a magnificent number, and is of more than passing interest on account of its being dedicated to the Knights . y. The illustrations are many and varied, while the letter press is excellent. Evidently the Greatfivide is bound to be ahead. If our readers have not seen it, they should send for a sample copy. It is published at Denver, Col., by the Great Divide Publishing Company. Subscriptions $1.00 a year. Single numbers 10 cts, T H E Dominion fllustrated for Aug- ust is to hand and is a capital num- ber. 'Among the contents which go to make up this first-elass magazine are, \" A Day on Alberta -Plains,\" by Ed. W. Sandy, will prove very interesting to sportsmen, while \" Port Arthur and Lake Superior ' by H. S. Woodside, is a well writ- ten article on the Queen's high- way ; \" Cricket in Canada,\" by G. S. Lindsay, will prove attrac- tive to lovers of the game as the writer deals with the subjeet in an intelligent manner. \" Historic Can- adian Waterways '' which is con- tinued by J. M. Le Morice is of interest to everyone who are at al] faniliar with ihe different places inentioned.\" The History of a magazine,\" by George Stewart D.. C. L., \" A Plea for Shelby by T. A. Haultain, M. A., \" Modern Instan- ces\" by Chas. G. D. Roberts, M. A., and several other articles make up one of the best numbers yet issued. As the subseription is only $150 a year, it should be found in every home. We notice the pub- lishers offer a special rate for the balance of the year, of only 50 ets. Sabiston Litho \u0026 Pub. Co., Montreal and Toronto. T4e Verdict. THE WINNIPEG TRIBUNE Is endorsed by all General Advertisers as the Best Ad- vertising Medium in the Northwest. It bas the larg- est Advertising Patronage of any newspaper in Mani- toba. It gives the best value for the money expend- ed. Two Editions each day of the Daily, and Weekly every Thursday. The Tribune Pnblishing Co., WINNIPEG. The Hmmer Wash Boiler 1RICE~ $6.oo A. F. KEMPTON ara Alexander %treet, WINNJIPEiG, - -MN ~- ,4 - - - - 41 1 1M"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PUBLIC HEALTI MAGAZINE. VOL. I.] NOVEMBER, 1875. [No. 5. (01 ill (11)lll(iil5 -o-- CLAIRVOYANCE AND SPIRITUALISM. BY F. J. AUSTIN, M.D. (Contnuedfrom page 97.\u003e It will probably tend to throw some light on the subject, and, I trust, interest the reader, to enquire more particularly into the subjects of Catalepsy and Ecstasy, states allied to and forming the basis on which the so-called \" clairvoyance \" or mesmeric trance is founded; and thus giving ourselves all due latitude, seek to determine how far scientific in,. estigation will allow us to go in our endeavors to reconcile the vagaries of the mesmerist and medium with scientific facts, and, if possible, decide and draw a line at that point where the reasonable and natural end, and humbug begins. Sir Thomas Watson* defines Catalepsy to be \"a sudden sus- pension of thought, of sensibility, and of voluntary motion ; the patient renaining during the paroxysn in the position in which she (for it is almost always a female) happened to be at the n- stant of the attack, or in the position in which she may be placed during its continuance ; and all this without any notable affection of the functions of organic life. , The patient so affected, with open staring eyes often, and outstretched limbs, looks like a waxen figure, or an inanimate statue, or a frozen corpse. That catalepsy depends on nervous influences, is shown by its beng brought on by sudden or long continued mental exhaustion or *Vatson's Lectures on Physie, Vol. I., pp. 714 and 715.",
         "PUBLIC HEALTH MAGAZINE. emotion, by its occasional alternation with hysteria, and by being frequently more or less artificial,-that is, induced i oluntari- ly or by slight external causes. Those inclined to this condition, and who too easily yield to it, soon lose control over themselves, so that it is possible the cataleptic state may be indu-ed in them by others, su that they become, as it were, puppets in the hands of a showman. The celebrated Mesmer first turned this faculty to account in producing the artificial or induced mesmeric trance. He has since iad many imitators, \"but,\" as Dr. Chambers says,* \" the unfortunate subjects of it have brought to their masters so much 'gain by their soothsaying ' that deception has largely adulterated the real phenomena, and i. is difficult to get a genu- ine patient.\" The artificial catalepsy of the mesmeric trance differs from the true in that, although the subject of it is apparently motion- less and unconsc:ous, he can be made to exeLute movements and articulation in accordance with the commands so given. This state or condition is called \" clairvoyance;\" not, as we now know, that the subjects of it are able to see particularly clearly, but that all the faculties of the mind are so concentrated and ob- livious to exte nal objects-so i3olate.d, aad at the same ti-ne, ' sensitive tu impressions brought within its range,-that the brain is in a condition to elaborate and amplify suggestions and im- pressions of so slight a nature that, at other times, it would not take cognizance of them at all. So much so, that a word, a look, a sign, a glance, an inflection of the voice, \u0026c., which under or- dinary conditions would convey little meaning to them, in this exalted nervous state reveals much. In this way the credulous or superficial observer imagines it is possible for the intelligence to fcrsake the brain and concentrate itself in some distant part; and believes that the clairvoyants, though with-bandaged eyes, can read writing when touched with the tips of the fingers, or when plaued on the soles of the feet; can discern diseases in others ; describe scenery in places never visited by them, and even prognosticate coming events. This faculty is soon acquired by practice, so that charlatans have little difficulty in obtaining and:training their subjects. *Reynolds System of Medicine, Vol. Il., page l9.",
         "CLAIRVOYANCE AND SPIRITUALISM. Ecstasy may be defined as a peculiar state of the nervous system, in which the person being wholly absorbed and wrapped up in some object of the imagination, the balance between the mind and the body is upset, and he becomes lost to all external impressions; or in other words, the mind, temporarily losing con- trol over the body, runs riot, conjuring up visions and-fantasies in accordance with the nature of the object which strikes the imagination. Meanwhile, the body either remains motionless, as in catalepsy, until the balance between it and the mind is re-es- tablished, bringing to mind the picture of Balaam, the Midiani- tish prophet, who, \"falling into a trance, but having his eyes open,\" had revealed to him the future of Israel-or, as is not un- common during periods of intense religious or other exLitement, an enthusiast is seized with an irresistible desire to communicate to others his pent up thoughts and feelings-or when the over- wrought nervous system is impelled to exhaust itself in song, as in the Italian Improvisatore-or in violent muscular moveuments, as in the Shakers and Dancing Dervishes. The difference between true catalepsy and ecstasy is general- ly well marked; the most striking distinctive feature being, that In the former a.1 recollection of events occurring during the at- tack is lost, while in the latter the visions of the excited imagina- tion are afterwards vividly remembered. On the other hand, it is by no means easy to distinguish between the artificial or ac- quired form of catalepsy and ecstasy, as they frequently present many phenomena common to both. Regarding the subject from a scientific point of view, it is well known to physiologists that there are states of mental ab- straction capable of being artificially induced in many persons, in which the attention is so concentrated upon the subject pre- sented to the mind that the will is suspended, while at the same time there exists such an intense susceptibility to, or receptivity of, suggestions conveyed to the mind through the senses from without, that the individual is capable of doing, suffering and say- ing things of which he is incapable in his ordinary condition, and of which he has no recollection when the condition in ques- tion has passed off. In these states, the mind may be placed un- der the dominion of one idea by the slightest suggestion or lead- in'g question, as well as by a positive assertion; so that the sub-",
         "PUBLIC IEALTIt MAGAZINE. ject of them shall feel hot.or cold, taste bitter or sweet, hear ex- quisite harmony or jarring discord, sec angels or men, \u0026c.; shall assume and maintain painful or awkward postures , manifest no feehing while undcrguing a painful uperation , exert unusual mus- cular strength or vocal powers, and su on, in accordance with the suggestion or commands made to him, and will feel perfectly assured of the reality of the sensations, ideas or emotions thus produc.ed in his mind without his own co-operation , and with. out the power of recalling them when the mental state in ques- tion has been removed. , The phenomena of \" mesmerism, \" clectro-biology,\" \" clair- voyance,\" \u0026c., when witnessed by persons unacquainted with mental physiology, unduubtedly appear mari ellous, and it may bc even admitted that sume of them require a profound know- ledge of psychology for their comprehension. Thus far we may go, though in doing so it must bc confessed there is often su inuch deception mixed up with what is real, that we are going near the line, if not actually overstepping it which divides scientific facts from humbug. For as we have seen it is quite pussible for a person so to imitate or induce in himself or others a condition simulating one of these rvruus states some- times, but rarely, met with; and so to cultivate the habit of em- pluyinb bis powers of observation and intuition, aided by uc.r in- born love and fondness for the mysterious, as to take suli a strur, huld on our mental organization as to induce us to over- luok the impusition, and fancy him to be a being supernaturally en- duwed. On this point Sir Thomas Watson, whom I have already quuted, than whom no more eminent, clear-headed, or unpre- judiced obseri er ever wrote, says . \" Do not suppose, from what I have just said, that I ignore the glaring facts of mesmerism. I have seer and scrutinized too many of them to doubt their genuineness, or ascribe them to mere imposture or collusion, Of the brain and nerves there are many and various strange con- ditions which we reckon as manifestations of disease or dis- order. I have given you several wonderful examples of such un- natural and morbid states under the heads of hysteria, chorea, catalepsy, ecstasy, trance. Now, -att.er condition of this kind may arise thus spontaneously, mayalso, I believe, be produced in some persý ns under the mesmeric practisings; not, however,",
         "CLAIRVOYANCE AND SPIRITUALISM. through any material or occult influence emanating from the mesmerizer, but subjectively, from the mental attitude (if I nay usa that expression) in which the person mesmerized is led to place hinielf; but the experiments of Mr. Braid show clearly that the agency of the mesmerist is not essential. Any one hav- ing the requ.iMte çsceptibility may puthimself into the mesmcric sleep or trnce by fixing his cycs and bis attention steadily and unremittingly ipon an object made to projcct a little way from the centre of his own forehead. The determining influence is from within as much as, or even more than, from without. De- rangements surh as sometimes occur thus in disease, may also sometimes occur under the mesmeric atmosphere; butno other or more mysterious derangements-thus much I perfectly believe, but I go no further. All the transcendental phenomena-the miraculous diagnoses and revelations, the clairvoyance, the pro- phecies-I class with the spirit-rappings and table-turnings, as evidences of imposture on the one side, and of miserablc cre- dulity on the other, and as alike scandalous in an age and coun- try which vaunt themselves to 1 e enlightened.\"* Unless Sir Thomas Watson's assertions are too sweeping, I fear Canadians are still benighted, though for that matter we are not niuch behind our neiglibors across the border. It is astonish- ing iov many of these charlatans flourish on this continent. If it were only the ignorant who patronized them, we might possi- bly understand it ; but when we find men, who, from their posi- tion in the State and in society, must necessarily be expected to have some amount of intelligence and education, firn behevers in their miraculous powers, we are lost in astonishment, and can only account for their infatuation on ane grounds of the attrac- tion possessed by the marvellous acting on a mind imbued from earliest infancy with superstition and mystic lore. For example, only a few months ago, a grave and worthy legislator of the Dominion had so much confidence in one of these clairvoyants, a man who did not pretend to know anything bout medicine, that upon receving intelligence that a member of his family, then in England, was dangerously ill, and, I sup- pose, not having a lock of hair at hand, he immediately sent this *Extracts from Watson's Lectures on Physic, Vol. Il., pp. 717 and 718.",
         "1J4 PUBLIC UIALTI[ MAGAZINE. man to England to invcstigate the case. Again, an astute, clear- hcaded ex- Cabinet ministcr, brought the samL man along distance to sec a niember of his family who was sick-of course in both instances at considerable expense. Other similar cases could bc givcn, besidcs numbers of others in which locks of hair had been sent long distances to some celebrated operator for his opinion of the case and treatment to be cmployed. As might bc expected, the patient occasionally at first impruves under the ticatinent, es- pecially if the disorder is one of the nervous system, but only sooner or latcr to return to his former condition. -o VEGETARIANISM. BY DR. ALFRED J. Il. CRESPI. (Con fmnued fromii page ro\u0026) To return from this long digression. Let me show why ab- stinence from animal food is compatible with vigorous health and with longevity. Foods are divided into two classes-the organic and the in- organic. The latter are of service in the metamorphosis of or- ganic foods in the human economy. They consist of saline mat- ters and water; according to some vegetarians they would not be of use, and so for our present purpose may bc dismissed. By the way, organic food always contains large quantities of water and salines; so that, do what the imprudent vegetarian lec- turer mentioned above could, it would be impossible for him to avoid, as he said le had donc, taking fluids and salines into hlis system for a month. The organic articles of food may bc divid- edinto several classes; but, whether obtained from the animal or from the vegetable world, or from both, they would always comprise carbonaceous and nitrogenous compounds; the former would again be subdivisible into fatty and saccharine. Now as the phenomena of nutrition depend principally on the interchange of oxygen with nitrogen and carbon, it is also possible to consi- der the nutritive values of foods according to the quantity of car-",
         "VEGETARIANISM. bon and nitrogen in them. But since the value of the carbona- ceous constituents of sugar is much less than that of those of fats, it is necessary to calculate carbon in such a way that, whether contained in fat or in sugar, it should be reduced to some com- mon measure. Starch is generally adapted for this purpose. The nutritive values of different foods may now bc correctly rcprc- scnted by the number of grains of carbon and nitrogen a dry pound of then contains. The consideration that at once pre- sents itself is that, if it be known that at least 200 grains of nitrogen and 4,000 of carbon must be contained in the diet daily consumed, would any wholesome food, whatcver its source, pro- vided that it contained these quantities of nitrogen and carbon, meet the requirements of the human body ? We can now answer that it vould; but I question whether the discussion of this ques- tion would not have orcpied the advocates of vegetarianism on the one side, and those of a m'xed diet on the other, till Dooms- day, had not the attention of the scientific world been drawn to another matter Tt waý this, that all foods contain certain ali- mentary principles which are identical, whether derived from the animal or the vegetable world. It is on these alimentary prin- ciples that the humaà body depends , to their being suplied in pro- per proportions the maintenance of life and health is due. Let me endeavor to make my meaning clear. There would have been nothing easier than to arrange dietaries, consisting of flesh alone, or of vegetables alone, or of both mixed in proper porportions, all of which would have contained almost exactly 200 grains of nitrogen and 4,000 of carbon. But interminable disputes wouid have arisen whether the vehicleb in which these quantities of carbon and nitrogen were conveyed into the body were wholesome or not. Nor does it appear probable that this controversy could ever have terminated. So much could have been said on both sides that each party wuuid have remained of the same opinion. We now know that ordinary articles of food contain nitrogenous compounds, such as albumen, legumen, fibrir- syntonin, gluten, casein, gelatine, and carbonaceous com- pounds, as sugar, starch, and cellulose, and-this is the all-impor- tant fact-not only is the chemical composition of some of these constituents nearly the same, whatever their source, but some are precisely the same. The casein of milk is said to be indistin-",
         "guishable iom that in peas and beans, the fibrine in meat from that in aheaten flour and the cauliflower, and the albumen of the cabbage from that of the white of cgg. The ablest chemist might be unable to tell the source, animal or vegetable, from which pure specimens of these principles wcre obtained. Should, thcreforc, attcmpts be made to supply the body with the proper quantities of fibrine, albumern, or cascn so maintain it in health and vigor, it scems immaterial from a physiological point of vicw, whether this albumen, fibrine, and cascin come from the animal or the vegctable world. A dcath-blow, on the one hand, is struck at any objections to a purely vegetarian diet; and, at the same time, on the score of its being less wholesome, vcgctarians secm unable to objcct to a mixed dict. At any rate, the question is in such a condition that grcat caution is required on both sides. The construction of wholesome dietaries, how. ever, whether mixed or vegetarian, becomes apparently easy, but the construction of cheap dietaries, quite another matter, must be undertaken on other principles. We have consequently seen that there is no possibility of de. nying that a vegetable diet, whether it includes milk and eggs or not, -an be wholesome, and can supply the body with everything it can need. That is tantamount to saying that health and strength can be kept up upon it in full vigor and as well as on a mixed diet. All theories must be brought to the test of experience to make them of real serv ice to mankind. Experience shows that per- sons who keep tu a vegetarian diet enjoy vigorous health. There seems no reasor to belicve indeed that there is any part of the world where this would not huld good, anU, nihether near the poles or near the equator, a -egetable diet, varied according to the different requirements uf the system at different temperatures, would undoubtedly sustain life and vigor. One of the great arguments in favor of a vegetarian diet might, one would imagine, Le its undoubted chleapness when carefully constructed. But this argument dues nut meet with the support of all vegetarians ; some whom I have talked to having denied that there was any saving. They were right if they only substituted expensive fruits and puddings for meat and game. But, care- fully constructed, a vegetarian diet is exceedingly economicai, PUIILIC HECAI,Tilt MAGAZIýNE'.",
         "VECETARI ANtSt. and 'night in any family, rich or poor, be a considerable saving. It is, however, indispensable that young people, if ticy arc to have a cheap vegetarian dict, should be trained up to it from in- fancy. There are many nutritious and wholesomc foods, as oat- meal, maire, and barley flour, which, from a certain harshness of flavor, require to be caten from childhood to be agreeable. If the palate is accustomed to thern early in life the habit is formed, and there is small difficulty in doing without meat. Indeed, young people brought up as vegetarians care little for animal food. Sometinies they actually dislike it. Soen of the vegetarian bills of fare I have scen have becn rich and expensive, and have lad little to iecommend them on the score of econony. Certainly they did not err on the side of v great simplicity or frugality. Thpt a vegetarian diet should be both wholesome and palata- ble it appears certain that considerably more care should be given to cookery than is usually now the case. Those of us who know something of the vaste caused by imperfect and careless cook- ing could not complain that something should be donc to remedy a great defect in our household economy. Vegetarianism could easily be practised in a household in which every one keeps to it. There would be some hardship, not to say impossibility, in attempting it alone. At any rate, it would be much casier and pleasanter if every one in the house gave it a fair trial; then the food could bc well prepared, pro- perly cooked, and pleasantly varied. A young man, I once read, determined to become a vegetar- ian. His mother and relatives objecting to imitate him, he had to cook his own food, and his amateur cooking appears not to have been of high quality Under such circumstances vegetarianism would be a great hardship. The simplest rule that could be given to a person anxious to try- in his household, the advantages and economy of a vegetar- iai. 'et, is to leave off meat and bacon for breakfast, tea, and supper, and at dinner to reverse the usual order of the courses. Begin this nical wiith plenty of tarts, fruit, and puddings, and when every one has had a sufficiency place on the table the meat, poultry, or fish, which usually cornes first. If the pastry and puddings are nice, no one will care for meat, and in a week the latter can be altogether omitted.",
         "138 'UnILIC I1EALT1I MAGAZINE. Therc it one kind of vegetable -ood the dcliciousness and fiagrance of whkih arc above all question grcatcr than thtse of any othc foods-I mean fruit. Evcrywhcre peuple gredily cat fruit. Children and savagcs cat it adliitium. Wre fruit abundant in this country thcre wouid bc little necd fur an cla. borate dcfcncc of a vcgctarian dict. All who could get strawber. ries, grapes, and plums in large quantities would soun çcase tu ask for meat. 'Unfortunatcly the cost of fruit is aliaist prohibi- tivc. When good chcrrics arc cightpcnce a pound, strawbcr:ics tcnpcnLc and a shilling the quart, and oranges-as they arc at this moment at Plymoith-threc halfpençc a picue, who can speak of fruit as being likely tosupp:antimeat? Wercany vc,:tariangene- rous enuugh tu supply me with all the fruit-fresh and prescrved-I should requirc, I could promise him nut again tu touch animal food. Let us ask our vegetarian friends, as a proof of thcir gratitude to scicntific. men for proving that the cascin, albumen, and fibrine of ý egetablcs arc quite as wholesume as, and identical in çhcnical composition with, those of animal food, tu give their attention to the importation of fruit from abroad, or to its cultivation in much larger quantitics in this country. Then would they effectually and certainly preparc the way for the spread of their own princi- ples, and all who could, would gratefully :nd cheerfully kecp to fruit and give up flesh. In the last place, the sanction which religion is assumed by many vegetarians to give to a ' eget.trian dict vill, it scems tu me, hardly bear investigation. That abstinence from flesh is sanc- tioned or rather actually commanded by the Christian religion seens insisted tipon by many vegetarians. That English Chris- tians arc to be bound by whatever the Jews did or arc supposed to have donc, is ridiculous. If vebetarianism, however, is right it should be practised without any refcrence ta the customs and opinions of the ancient Hebrews. It certainly is unfortunate taat the Bible should be summoned as a witness in favor of a vegetarian diet, for there can not only be.no reasonable doubt that the Jews ate flesh, but that they did so at certain seasons in obedience totheir religion. If meat is always and necessarily injuri- ous, if it îbwrong to take life to obtain food, then it would have been wrong to cat flesh under any pretkt. Nothing can alte-: the eternal principles of right and wrong, not even Jewish rites ahd ceremonies could do that.-The Sanitary Review.",
         "nTrS ON HNt1HL hNNITAIZY MATTERE NOTES ON HOUSEHOLD SANITAR MATTERS. Ey JAS. H. 5SR1NE, All tCT AND CIVIL ENnINEER. (C'ninued fron jge 103. ) NOTE 4. H1aving, in the last number of the HEALTH Ma;AzîNE, de- scribed the ronditions and requirements of a proper vwater-closet and ventilated system of house drainage, I will now give a gcn- cral idea or the duties of an Inspector, to whose strict supervision all surh matters should be entrustcd, and perhaps these duties may be most intelligibly cxplained by d .ribing the workls them- selves. In the first place, it is of great importance that house drain pipc be properly inserted into the common sewer, and the brick work cf the latter be carefully made good round the drain pipe. Careless workmen, when opening the sewcr, requently let bricks drop into it, which obstruct the sewage, and may in time choke the sewer. Next, every joint of the carthenware pipe ahould be cmbedded -n a collar of puddled clay, carefully t ompressed round the pipe joint to prevent the fïossibility of leakage, and the cntire range of piping must be laid to an uniform inclination; so it is scarcely neccssary to say that somt. experience and care or, the part of the workman is required to do this work in a propcr man- ner. At prescnt, any laborer capable of digging the trench is considered competent to set the drain piping of abuilding, and the result is the pipes are laid with little or nu .'agard to inchnation; the joints are simply stuck together, without any attempt to make them water-tight. Frequently imperfect pipes are used, or they are broken in the laying, and as the pipes now in use are far too large to admit the possibility of flushiig, they soon become nea.- ly filled with sediment, while the syphon traps, if any such are inserted, become choked, and sometimes, in gravel or sandy soil, the waste water of the house never reaches the common sewer at all. These large pipes, again, are frequently brought up only to the front of the house, instead of being brought through-the walls, as they ought to be, to receive the vertical soil pipe; and as this latter is rarely more than four and a half inches diameter, the",
         "140 PUBLIC IIEALTH MAGAZINE. space=between the large and smaller pipe (unless the architect watches closely) is left open, and may thus render useless all the other precautions taken to prevent sewer gases from entering the house. Inside the dwelling, also. after the junction of the metal suil pipe with the earthenware drain is completed, we encounter fresh and altogether different risks and difficulties. It is necessary to see that the joints and junctions of the soi] pipe are properly soldered together. Frequently they are not. Sonetimes the carpenter, in casing over this pipe, carelessly drivt s a nail through it, which thus becomes a peg to suspend the miscellaneous refuse which servants are in the habit of thrusting into the water-closet. We hai e known sev ere sickness, and a frightful amount of trouble and damage-arise-from the choking of a soil pipe by this cause. Sometimes, also. in laying the basement floor, the soil pipe will be reduced to half its size by the carpenter driving his work against it, and occasionally the junction of-ihe horizontal and ver- tical soil pipes will be completely severed by similar carelessness. In such eases the space under the basement floor becomes the re- ceptacle of the water waste ofthe house, which would otherwise have passed off to the common sever. Again, it is necessary that the waste pipes of all baths, wash-basins, \u0026c., have proper air traps-there are hundreds of houses, which are said to have ah the modern impro-.ements, in Montreal, without air traps-and that all waste pipes are properly secured to the under side of said wash-basins, sinks, \u0026c. Frequently, they are not secured at all, but propped up with a bit of wood. Moreover, the waste pipes of all sinks which receive hot greasy water should have at least twice the diameter of the others, and have sludge taps in their bends to empty the air traps in case of choking. It is equally important to have the overflow pipes of all cisterns, baths, wash- basins, \u0026c., either to terminate in the air traps of these appurten- ances, or else to be separately trapped. The air of some houses in Montreal is poisoned with sewer effluvia from these overflow pipes alone, and persons have beei made sick Ly using wash- basins the overflow pipes of which c:2mmucated directly with the soil pipe, without any air trap whatever between. Now, all these works can be properly executed by artificers of ordinary experience. They are, in fact, comprised in the plans and specifications of all architects. The one thing reedful for ther proper execution is the supervision of some competent im-. spector, having municipal authority to enforce the execution of",
         "NOTES ON IOUSEHOLD SAN1TARY MATTERS. his requirements; for it unfortunately happens that the works which we have described are rarely comprised within the linits of one contract. Ordinarily, the bricklayer does the excavation and puts down the earthenware pipes ; then the plumber cornes on and completes his vork, and gives it over to the carpenter, who cases it in and covers it up out of sight. What may have happened to it during this latter process is neither seen nor known, unless some leakage shows itself in the ceilings or walls, and failing this, nothing is known by the occupants of the condi- tion of the works until sewer effiuvium makes its appearance, or perhaps some outbreak of disease takes place, as the natural re- sult of the utter want of supervision over that portion of the es- sential works of a homestead, on which, above all other, the san- itary well-being of the inmates is dependent. I will close these notes on ventilated house drainage with an outline of the mode of testing the drainage service of a dwelling house. I have already stated that the first length of earthenware pipe between the inside of the wall and the syphon trap should have a movable cover for the proper examination of the work. After the drain and all the works c:\u003ennected therewith are ýcom- pleted according to the instructions of the inspector, the cover should be removed from this length of pipe, and the following tests made before permission is given by the inspector to use the drain. First, for flushing. Let al] the wash-basins, sinks, bath and cistern be filled with water; then let all the plugs be removed together, and the passage of the united stream be watched at the uncovered pipe, which should have a small bank of clay round it to prevent overflow. The inspector will easily detect any serious displacement or damage to the soil pipe by the volume md ve- locity of the current, and if the pipe flows ful, it will snow that thesize of the waste pipes is sufficient to flush the drain when- ever required. Next, let all the basins, sinks, \u0026c., be filled as before, and let the water from each be run off separately, and if the water passing from each is, in the opinion of the inspector, about equal to the quantity let off above-and a little experience will enable the inspector to judge with sufficient accuracy-then the cover may be cemented on to the drain pipe and covered with some puddled clay, and the whole is finished and ready for use. All these duties may be efficiently perforied for the whole city by two inspectors, and if an average fee of five dol 4rs were levied for each new house, which is a little more than is levied for every house furnace, the inspection would be self-supporting, and although no direct revenue would perhaps accrue to the city, the direct and indirect benefits which must result from a per- manently efficient system of house drainage and ventilation would be beyond all price. (To be con tinued).",
         "PUBLIC HEALTI MAGAZINE. MORTUARY STATISTICS FOR AUGUST, 1875. Popula- No. of Deaths. Total tion. Male. Femaie. Deaths. In Richmond, Va. White.............. 33,452 35 28 63 Colored ............ 27,213 6o 50 110 In Norfolk, Va. Vhite.............. .2,coo .. II il Colored ............ 9,5o00 13 8 3 In Lynchburg, Va. White.............. 7,060 6 il Colored ............ 7,ooo 14 22 In Mobile, Ala. WVhite.............. .8,î5 17 7 24 Colored ............ 13,919 29 24 53 Selma, Ala. White.............. 3,500 I 2 3 Sem, l. Colored ..............4,000 4 7 Il 'Making a total, from these five chies, of 339 deaths, male and female, whe and colored. ]3esidcs this, there WCre 26 stilM boa cDiiedren. The causes were as follows: Abscess, 3; Accidents, Suicides, \u0026c., 8; APOPlexY, 3; Ascetis, Dropsy, Ici; Asthma, i ; Births, premature, zo; ]3right's Disease, i; Cancer, 8 ; Can. crurnoris, i ; Childbirth, 3, Choiera Infanturu, 42; Cirrhosss H-epatica, 1 ; Con- gestion of Boweis, \u0026c., 10, Consumption, 35 ; Convulsion-~, 22; C. Puérperai, i ; Diarrhoea and Dysentery, 29 , Enteritis, 9 , Epilepsy, i; jEevers (Congestive, 4,; Intermittent and Remittent, 2, Puerperal, i ; Typboid, 6 ; Typho-Malarsal, 3;) Fiooding, i ; Gangrene, 1 , Ga.itis, i ; Heart Disease, 13;i 1-CMOPtYiss, 1 ; Hydrocephialus, 2, }Iydro-Fericardilu, 2; Old Age, 14; Intussusception, 2; jaundice, i , Kidncy Disease, 2, Marasnius, 3, Meningitis, 5 ; Paralysis, gene. rai, 4; Peritonitis, i ; Pneumonia, 5; Rheuznatism, 2 ; Scarlatina, i ; Sun- stroke, 1 ; Syphilis, 3 ; Teething, 1 ; Traumatic Tetanus, 2 ; Trismus, 9; Whooping CoUgh, 2 ; Worms, i ; Unknown or Ill-Defined, 39. -Virginia Mledkal ilfonthy.",
         "SMALL-POK ItÔSPITAt. - :o:* SMALL-POX HOSPITAL. To the .Editor of te Public .Iealih Magazine:- DEAR SIR,-In your September number, you had a few most timely remarks on the above question in your really useful publica- tion. Allow the writer to make a few further remarks on the saine subject. There can be no question as to the great importance and absolute necessity for the erection of a small-pox hospital, per- fectly isolated, at least as far as that is possible, where those affected vith this loathsome and infectious disease may be pro- perly treated without the fear of coming in contact iwith others. In our present hospitals, viz : the Hotel Dieu and Montreal General Hospital, it is alnost impossible to prevent contagion spreading among the patients being treated for other diseases. Those who are in the habit of attending to the institutions abovenamed,knowhow true this is. Many are the sad instances that could be mentioned of the truth of this assertion; and thus, although the utmost care is exerted to prevent contagion by the medical gentlemen having the care of this department, is it not very sad to know that, when a patient has been cured of another complaint, notwithstanding all precautions, the poor convalescent should be attacked by this fell disease, and, from a weakened system, thus become an easy prey to the attack, and die ?-yet, Mr. Editor, as you well know, this has often been the case. In one of the institutions above named, every effort was made to isolate small-pox patients, yet occasionally infection would occur, and with fatal results. What should be done in the name of suffering humanity, is the question that should engage the utmost attention of every lover of his kind? Permit me to offer a few suggestions as to this question, as follows :-An inexpensive building, in an isolat-",
         "MUfLIC IIEALTH MAGAZINE ed position, ought to be erected as a hospital for the speciaf treatment of this disease, where all suffering may be sent, and be under the care of medical men appointed to this duty. This hospital, in the judgment of the writer, should be under the control and maniageient of the Council of the City of Montreal, the medical health officers of that body having its control and management. There are differences of opinion, we know, as to the nursing of patients in such a building ; some taking the ground that the good sisters, the nuns, should perform this duty, while those of a different faith think differently, only being anx- ious, irrespective of creed, that the nursing should bL of such a character as shall best promote harmony of action and the cure of the patients, whether Protestants or Catholics. Why such feelings of disagreement should exist in a mixed community as ours, on such a subject, it is hard to conceive. Yet such is the fact, and it is a great pity. Now, such being the case, in order to meet the prejudices of these excellent people, and to secure the desirable result we seek to obtain, we would suggest in the erection of such a hospi- tal: let there be two wings, one for Protestants and one for our Roman Catholic fellow-citizens, the one having Protestant nurses, the other to be attended to by those nurses desired by our friends of the Catholic Church. Surely this would meet the case and secure united action, and heal the division that seems to exist as to the whole question of nursing. Enough has been said on this part of these remarks, which, I trust, will commend thenmeh es to the thoughtful attention ofany who may oppose the erection of a Small-Pox Hospital under civic. control unless under the care of the good Sisters of Charity. Mr. Editor, the writer would take broader views of this great question, and be only very anxious that such measures be adopted as shall savi life, and arrest in the best possible manner this fear- ful disease that has during these past months taken away so many of our population by death. Shall we not make an effort in the wisest direction to rid our fair and beautiful city of this scourge? Would that some of-thos.e who oppose the above suggestions could sec the great importance of this question, and know, as the writer has known, how many have been cut down in youth and early manhood; often, it is true, fxom non-vacination, or imper,",
         "SMALL-POX HOSPITALS. feet vaccination, but oftener from contagion from others, simply for the want of having a completely isolated building. Al honor to those members of the City Council who have provided a building for the treatment of this disease, and for all their efforts to stay the progress of disease; but that building is too small- especially has it been so durihg the last fearful epidemic. Now is the time, then, to take action, as we know not how soon it nay break out again and find us still unprepared for such an exigency, should it occur. Thanks to kind Providence, it lias now ceased to be epidemic; but should we not be ready to meet it by judicious forethought and timely arrangements for the fu- ture? Al who have studied the matter will, I venture to affirm, say, yes. As I have already trespassed too much on your columns allow me, in conclusion, to wish ihe success of your well-con- ducted Magazine, with the hope, aiso, that yo. may have the very generous support of your fellow-citizens. Very respectfully yours, CHARLES ALEXANDER. -:: To the Editor if hie Public Heali Magazine. DnAR SiR,--The loss of life from accident alone is sornething appalling. Can nothing be done to stop it? I do not know if it comes directly under the sphere of work you are undertaking, Mr. Editor, hygienically, but a word from you in your unrivalled magazine would, I an sure, carry weight, and thus effect good. Take that class of accidents from fire alone. Every daily paper you take up seems to give us a warning in this respect, but we seem to think nothing of it. \"We are used to it,\" I suppose. Would you please inform me what tuie particular virtues of the chemical fire extinguisher are, and would you advise its use? Yours, sincerely, A SUBSCRIBER.",
         "PUIILIC IIEALTI MAGAZINE. --o- A REPoRT oF TE IYGIENE 0F TIHE UN11ED STATEs ARMi, with Description of Military Outposts. This is Circular No. S, froni the War Department, Surgeon General's Of- fice, Washington, May 1, 1875. This is a valuable codtribut.on to medical, gcographical and sanitary science, containing descriptions of the ditTerent mihitary posts of the United States arm\u003e. A. thesc are scattered uver a very extensic range of territiy, and inlude .imust ccy condition of climate and altitude, it is especially %aluable to nedial ofi. cers ordercd to posts w% ith N hikh they are unacquainted by actual observation or experience, and to those in ciil life vhi, have oc. casion to investigate clinatic sanitary tonditioins. Many of the reports fron post surgeuns in this solumC cuntain very servi%.eCable information in regard to the cquipment, .lothing, \u0026c., of the sol. dier, with plates of those recommended. The work also contains plans of many of the hospitals, among vhichi may be fuund the hospital at Soldier's IIome, Washbigton. There is also a napof the western military departnents of the United States, showng the occupied posts, discontinued cities and tonis, railroads an(l common roads. This volume n, ill be found very usefl to every scientific phy sician into whose hands it may come. THE NFw STANDARD ATLAS OF rIHE DoMsiNION OF CANADA; compiled, by special permissij of the General and Provin- cial Governments, from the latest official maps and surveys, and comprising a corret and complete series of the topo. graphical, geological, postal, railway and timber land maps of Canada, with lette-press -descriptions of the Provinces, cities and chief towns, the railways, and the geology of the Dominion, and lists of the towns, post-offices, etc. Also a complete list of the banks of the Dominion, their -capital, branches and-foreign agents, arranged from special reports. Published by Walker \u0026 Miles, Montreal and Toronto. We have received the above Atlas for review,and having care- fully examined it we must place it in the position it deserves. It",
         "THE NEV STANDARD ArLAS. certainly stands foremost in every respect to every other map w'e have scen of the Dominion. As a \" Standard Atlats,\" it is in- valuable to any one wio desires a thorough acquaintance with Canada. The printed matter consists of fifty pages, double column-of most important information-arranged for ready reference under appropriate hcadings. Among other things treated of are imports and exports, marine, fisheries, banking, canais, post-of ice, land system and regulations, population, militia, revenue and climate of the Dominion. Ail this informa- tion has been culled, by authority, from the gencral departments of the Dominion at Ottawa. The maps arc most beautifuilly arranged. The world hi lemi- spheres-an emigration chart, shewing the distances and routes of the different steamships froni the Old World-maps of the Pro- vinces of Quebcc, Ontario, Nova Scotia, Prince Edward's Island, New Brunswick, Manitoba, the North-Vest Territory and British Colunbia. Maps of the principal cities; among others, of Montreal, Que- bec, Ottawa, Toronto, Halifax, \u0026c, shewing the streets and public buildings. Geological maps, from the Geological Survey, shewing the coal fields of Pictou, N.S., Springhill, N.S., Grand Lake, N.B.; aiso the timber lands of Quebec, Ontario, New Brunswick, \u0026c., all occupying three and four sheets each, the Canadian Pacific Railway and the Dawson Route (6 pages.) One feature of par- tieular interest and value, is th.t in these new maps all the dis- tances are marke: i pjain figures fron town to town and station to station, not forgetting the post and money-order offices and telegraph stations. So as to secure accuracy, every map in the Atlas was submitted for revision to the Governmental Department to which it belonged for additions and correction. When we consider the amount of most valuable information contained in each map, we are only surprised at the short time it took to deliver it in its present formn to the public. It is impossible in a sfiort review such as this, to do the work justice. But we can assure our readers that a perusal of it will fully repay them, and make then anxious to possess such a fund of information, so compact in itself and so moderate in price. Messrs. Walker \u0026 Miles deserve the highest praise for the real services they have rendered the public, and we hope they will receive the generous support which they merit.",
         "PUBLIC HEALTHI MAGAZINE, NOVEMBER, 1875. SCHOOLS AND SCHOOLHOUSES. s Education is not a science but an art, which depends less on its absulute value than on the judgment with vhich it is emi- ployed. \"The human flower is that which must needs the sun.\" Children kept indoors arc hot-huuse plants, and what has been said of the suii ma\u003e be said of the air also, for without this no guua physical education can bc accomplished, for goud air is as necessary as guud food. Air, vater, light, these threc elements of hcalth which Nature has su buuntifully givýen us with liberal profusion, ought to be supplied to every child. Froebel says the \"Instructor is the highpriest of nature,\" vhich is unl a paraphrase of what Iippocrates said many cen- turies befure, \" Àedicus nature minister et interpres.\" People in thuse da3 b had a high opinion of the teacher, but in this utili. tarian age of ours it has sadly retrograded; not that it is less honorable, but that Iharacter and attainme nts aie put into the balance agaat the solid elements, which \" may be grasped at,\" and so talent, assiduity and ability retire into the cold and de- pressing shades of poverty and neglect. \u0026 The showy charlatan who tells ignorant parents that his child can be made a prodigy, and , puts on \" ail kinds of ' extras \"for the purpuse of shuwing the care and attention bestowed on him, is usually what is called successful. \"l Hygiene is sacrificed to ambition,\" and God only knows vhat klad of men these debilitated, nervous, used-ujp Children promise fui suciety, for whom everything has been donc, excefl to make them vigorous and healthy. Reform is urgent. It begins already to fill the horizon, and soun there must be a more equitable arrangement between the work of mind and muscle. Mons. Raoul sums up the ordinary ,hygienic cnditions of schools thus:-",
         "SCHOOLS AND SCHOOLHoUSES. \"Iealth,\" lie says, \"is the last pre-occupation of a school. master at present. Narrow rooms, low, damp, deprived of sun, saturatcd viti bad odors, sometimues too hot and close, or subject to draughts, flat desk-, seats too high or too low. clothing tight round the neck, the waist, or the legs, positions dangerous for the lungs, the stomach and the circulation, the spinal column and the brain, restraint in one position too long, brilliant colors, dazzling reflections of light, cither in quantity or direction-these are the conditions in the midst of which the great majority of children are brought up at schools, and even under the roofs of private fanilies.\" Statistics innunerable can be given of the dcath rate attendant on these circunistances, if required. It is an incontestable fact that one-half of the children die before they are ten years of age. It would be quite another question if we speak of the incur- able debility, chronic affections, germs of mortal illness, or of premature old age, brouglit on by the continued violation of the clementary principles of hygiene. In our day, every one follows his own personal wish in the education of his children, and is per- fectly indifferent to the principles of philosophy and hygiene. Our officers of health should have access at ail hours for pur- poses of inspection. The New York Tribune says. and we quite agree with it: \" Even our public schools, held in buildings con- structed for their especial use and supposed to be under the watchful and enlightened care of the public authorities, are, as we have often shown, generally models of ail that schools ought not to be; overcrowded and unventilated ; poisoned, not only with the pent-up exhalations fron the inimates, but frequently with adventitieus sewer-gases; and very many private schools, wholly exempt from any semblance of ufficial supervision, are in worse case. One or two rooms in an ordinary dwelling-hîouse, barely suited for the sanitary needs of a small family, are hired by some speculative pedagogue who knows no limit except that imposed by the dimensions of benches and desks to the number of pupils whom he is anxious to pack therein. Ven- tilation in warin weather depends on madequate windovs, and in winter these are shut, and the scholars wedged stili closer together to make rooma for an air-tight stove; and in such pens in every town, hundreds of ahildren stifle half the day",
         "1.50 PuBIc uLALTII MAGAZINE. and sap the foundations of their hcalth. More particularly does thla apply to the yuunger classes of 1 upils, who at the most sus. ceptible age too frequently fail into the hands of persons with just suffictent knowledge to tcach the lowest rudimeits of learn. ng, butaitogcther ignorant of the simplcst and most csscntial rules of hygienc. In a mattcr so nearly concerning our national welfare it is time that some action werc taken, and we might treat our school children vith at lcast as much consideration as we show our convicts, by requiring certain specified sanitary conditions in the places of thei confincmcnt, and fixing tic mini- mum allotment of cubic space for eac.\" o- DWELLINGS FOR THE POORER CLASSES. The great difficulty in supplying houses for the poorer classes, isthe building of them with a due iegard to hygienic princi. ples, combined wNith a low rental. In towns we find another diffi. culty, in obtaining good sites at a low figure, and in the country building is as expensive; su that the poor man is unable to pay a rental commensurate with the expenditure. Where the ground rent is low, a very good laborer's house or cottage may be put up on the followng plan: First a living room for general every-day use, a bedroom for the laborer and his wife, a bedroon for boys, a bedroom for girls, a wash-house and closet-at a cost of from four to six hundred dollars. But supposing the ground to be large enough, two could be budît together at a very much less cost. In large towns very excellent house accommodatior may be given to the laboriign.an in nv hat are called tenenents, thus mak- ing the ground rent cheaper for cach individual tenant. This,of course, applies tu newly built houses, but a far more difficult prob. lem is the repairing and improu ing of the unhealthy abodes which increase the annual murtality to an extent that is appalling. Our iaws should pruhibit the ;niabiting of dwellings which are dark, damp, and underground. There arc many habitations such as these w.hich it is impossible to improve or alter, where the only other alternative is that of immediate demolition. They are situatcd in narrow dingy alleys, or huddled together in courts, so as to bc practically unventilable, and the internal structure and",
         "arraigeiments are so faulty as to be leyond rernedy. h is in these Verv dwellings that the filth and poisonous effluvia are constantly accumulating, and that the germs of discase find a fitting soil for their developmeit. Ilitherto, saniitary legislation has achieved. comparatively little in abating the enormous cvils arising froni unt- healthy dwellings, over-crowçditg, and filth accumulation; but it is to be hoped that as the requirements of public hcalth become more widely tppreciated, these eUs iwill he grcatly mitigated, if they cannot be entirely remo- cd. But never mind how strenuous the cxcrtions of our sanitary oflicers, the evils of surface crowd- ing, as it is caled. nust necessarily fur many \u003ecars to corne, throw great obstacle, in the way of acaping to the fil extent the advan- tages to be etined from lessening the in-door crowding. We may cotngratulate ourselves that w e are not-in as bad a plight as those in Liverpootl, where a tioasand persons have been known to be huddlted togetier it one are ofgioun(l; Glasgow anîd Green- ock tell the same tale in some districts. All the sartitary regtlna- tions and ventilation in the w urld would ne% er make hcalthy such a congregation of small pens packed together in so liinited a space. Demolition of old houses, and the displacement of the popu- lation into new blocks of model dwellings, and the opening of newstreets, arc all necessary. It is impossible for a corporation tu g o, ide houses for its poor citizens. It would be merely oflering a premium for pauperism ; but great aids may be given to those who can provide bouses, by two measures which may be properly cari ied out by the principal authorities: I That tle houses should be- construt.ted tinder the immediate supervision of a properl instructed officer of the corporation, as regards drainage, ventilation, and general plan ; and, IL. That they should be maintined in sanitary repair under strict regulations. By the observance of these two simple ries, and perseverance vith the measure in force, a great improvement would, withn a few years, take place in the 'entilation of the houses, in the crowded quarters. And we are confident that there would be a commensurate and material improement in the health of this most important class. DWFLLNal'OR THE POoRERCLS1",
         "152 'ltI.tC IIALr1rtI MAcAZI9. In connection with the displacciaent of the population thcre are questions which scriously affect the poorer classes. The demolition of thcir humes by, widening strcets, cunstruction of railways, and other cxtensiNe undertakings in the .ruwded dis- tricts, only tend to ncrease the crowding in ncighboring parts; for families are thus rendercd homcless and scek the ncarest shelter, rents arc raised in consequence of the ini.reascd demand for accommodation, and such as cannot afford to cxpend more than the\u003e did previously, must be content ivth homes even less hcalthy than thosc which they havc becn .ompelled to Icaie. The question naturally, thcn, resolves itsclf into two altcrnattivcs, that of listlcss apathy, and the lcaving of the vorking classcs to certain death or ultimate degcnerai.y,ur, as a compensating meas- ure, the running of workingmen's trains morning and evening bc- tween the suburbs and the town. -o- VENTILATION AND WARMING. At this season of the year we do not think a few general remarks would bc out of place. In this country, whe we require this combination toperfe\"tion, it is most difficult to acomplish. We are obliged to protcct ourseles froin the inclemency of our seerce v inters 'ov double v indon s, and c% en then we sometines find the are not suflicient without stuffing them to keep out the inordinate cold of from 15' to zo\" below zero. What vith our stoves using up the little oxygen in the houses, and the ill-con- structed drain pipes allowing frec access of malarious efiluvia with carbonic acid, and the stufling uf our n. indu.s tu exclude the great ý i% if) ing propert\u003e, ozone, ,ve su much need, can any une be surpsised that in winter wc are %isited b\u003e such fearful epidemics of small-pox and typhoid fever? The tith is, wc actually court them and invite them to feast upon oui dear oncs, and it is only after we iealize the great loss that has visited us we then look to the removal of the cause. It amounts to culpable negligence, and nature punishes us %% ith a just recompense for our apathy in neglecting to provide ourselves with tCose protections vihih arc now known to be specifics. Artificial ventilation is c4rried on by two methods, that of",
         "VENTILATION AND WARtMZNIN. 8 plenum,\" which is forcng the air into and thro' the room: or by \" vacuum,\" whîich is drawing the air out of the room. The two ncthods are more commonly known as that of Éropuls/on and extraction. In this country, where both warmth and ventilation are to be combined, it is a most considcrable difliculty, although the simple ventilation of a room where warmth is not required is comparatively easy, although this is no easy n.-;tter from the peculiar architectural character of some buildings. Where an open fire-place is used constantly, it is found to be the most easy and desirable means of ventilation, especially if you have other modes of heating as well. The heat being- too small for this latitude, ve niust have the addition of a stove, hot vater, steam, or hot air; but supposing the scason ofthe year being such that a fire-place is sufficient, it acts in this wise: The lieat is oltained by radiation from the incandescent fire, also by reflection from the different parts of the gratc, while ventilation is carried on by ti nnstant current ofheated air rushing upthe chimncy. Even when no fire is made the chimney acts as a very efficient ventila- ting shaft. When the doors and windows are closed, the air finds its way through every chink and opening, if no special inlet ispro- vided. So that the very plan of stuffing double windows is defeat- ing the very o-ject we wish to obtain. But vhere this is the case, the opened fire-place is found to establish fair ventilation, by a double current in the chmney, one up or out, and one in or downward. But unless the fire-place is made in the most approvcd style, the amount of fuel that may be %.onsumed unnecessarly is wilful vaste, and the temperature not equable. It is established that the per centage of heat that passes up the chiiney is about seven -eighths ofthe whole amount generated, along with from 6 to 20 thousand cubic feet of air per hour. Thus it is evident that a single chimney will give an efficient ventilating shaft for a room containing from ;,to.6 or more persons. But unfortunately by far the greatest portin nf the fuel is wasted. So, as a heating medium for Canada's wintcr, it ez'iId be useless. You may very easily heae and ventilate at the same time by hot air, water, or steam ; but by all these modes you must have inlets for fresh air and outlets for the foul, vitiated atmosphere. Ail the air passes through or round the heating apparatus, and from thence it is distributed to the roos in the building, the foul air being",
         "PUBLIC HEALTII MAGAZINE. carried out by flues, as fast as -it can- reach the top of the bouse or ceiling. Ifyou do not'have fresh air constantly supplied from without, you are sure to cause the air of the house to-become so dry and vitiated that njury is certain to follow. The natural moisture must also bc kept up b, causing the air to pass over water basins. This remedies the evil partially. Large buildings, such as hospitals, asy lums and prisons, can be efficiently warmed by hot water pipes, air-passing t1irough the coils of pipe befole entering the rooms and wards. The vitiated air is extracted by means of coils of pipe in the extraction flue or shaft. This shaft may also be heated by the furnace-in the ground flat and branch flues leading into the main. This is admirably adapted for prisons. All large mines nearly are ventilated in this way by extrac- tion. A furnace is placed at the bo.tom of the up shaft, the air is drawn down another shaft, and made to traverse the various galleries. In this way as many as 2,000 cubic feet of air per head per hour can be supplied. F 0 0 D. As some- of ou. readers may be desirous of trying the ,ege- tarian diet as recommended by Dr. Alfred Crispi, we give the accompanying table as a guide and help to Lhoose what xege- tables may be used to make up the requisite amouant of carbonr aceous and nitrogenous substances for subsistence. Experience teaches that three ineals daily are best suited to the wants of the body. Dr. Edward Smith, in his physiologiLal diet of 4,300 grains of carbon and zoo of nitrogen, distributes the amounts as follows:- Carbon. Nitrogen. Carbonaccous. Nitrogenous. Grs. Grs. Oz. Oz. For Breakfast......... 1500 70 6.62 1.04 For Dinner........... 18oo 90 7.85 L.à4 For Supper......... .. 1000 40 4.52 0.59 4300 200 18.99 2.97 The reason for \u003cstimating the amount of Larbon and nitrogen in different articles of diet, is that the phenomena of nutrition depend mainly on the dIemical interchangès of nitrogen and carbon with )xygen. (We will explain at length the phenomena of digestiou and nutrition in our next number.)",
         "A FEW FACTS ABOUT ALCOHOL. ,Splitpeas Indian mea!l Barley mal. Rye me.l Seconds flour Oaameal.. . Baker's bread Pearl barley Rice Potatoes.. Turnips Green vegetables Carrots .. .. Parsnips. . Sugar Treacle Buttermilk . Whey .. Skinimed milk GRS. PER POUND. Carbon Nitrogen 2699 248 3016 120 2563 68 2693 86 2-OO m6 2 31 136 1975 88 2660 9! 2732 68 769 22 263 13 420 14 508 14 554 12 2955 - 2395 - 387 44 154 13 438 43 New nilk Skim cheese, Cheddar chcese Bullock's liver Mutton Beef Fat pork Dry bacon Green bacon.. White fish Red herrings Dripping Suet Lard . Salt butter Fresh butter Cocoa Beer and porter GRS. PER POUND. Carbon Nitrogen 599 44 1947 483 3344 306 934 204 1900 189 1854 184 4113- 106 5987 95 5426 76 871 195 1435 217 5456 - 4710 - 4819 - 4585 - 6456 - 3934 140 274 1 - A FEW FACTS ABOUT ALCOHOL. The popular plan of administering alcohol for the purpose of sustaining animal warmth is an entire and dangerous error. and when it is brought into practice during extremely cold weather it is calculated to lead even to fatal conbequences, from the readi- ness with which it permits the blood to become congcsted in the vital.organs. We cannot too forcibly impress the fact that cold and alcohol ac*, physiologically, in the same manner, and that, combined in action, every danger resulting from either agent is doubled. Whenever we see a person disposed to meet the effects of cold by strong drink, it is our duty to endeavor to check that effort, and whenever we see an unfortunate person under the in- fluence of alcohol, it is our duty to suggest varmth as the best means for his recovery. These tacts prompt many other useful ideas of detail in our common life. If, for instance, our police were taught the simple art of taking the animal temperature of persons they have removed from the streets in a state of insensibility, the results would be more bene- ficial. The operation is one that hundreds of nurses now carry out daily, and appliea by our police-officers, at thèir stations, it would enable them not only to detect the difference between a",
         "PUBLIC IEALTH MAGAZINE. man in an apopletic fit a.J a man intoxicated, but wvould suggest naturally the instant abolition of the practice of thrusting the really intoxicated intu a cold and damp cell, which tu such persons is actually an ante-room to the grave. The sleep of apoplexy and the sleep of drunkenness may be distinguished by a marked diffErence in the animal temperature. In apoplexy the tempera- turc of the body is -, in drunkenness below, the natural standard of 98° F- We would alst .gest that the systematic administration of alcohul for the purpose of giving and sustaining strength is an en- tire delusion. WC do not say that occasions do not arise wlen an enfeebled and fainting heart is temporarily relieved by the re- laxation of the xessels which alcuhol, on its diffusion through the blood, induces; but, that spirit gives any persistent increase of power by which men are enabled to perform mole sustained N-urk, is a mistake as serious as it is universal. In proof of which we give the folloving experiment of Dr Rithardsun's, ,when lie sub- mitted muscle to the test.-He gently weighed the hinder limb of a frog until the power of contraction was just overcome; then, by a measured electrical current, he stimulated the muscle to extra contraction, and determined the increase of weight that could thus be lifted. This decided upon in the healthy animal, the trial was repeated some days later on the same frog after it had received alcohol in sufficient quantities. The result wvas that through every stage the response to the electrical current i as enfeebled, and so soon as narcotism was developed by the spirit, it was su enfeebled that less than half the .Neight that could be lifted in the previous trial, by the natural effort of the animal, could not now be raised even under the electrical excitation. The muscular excitement which passes for increased musculai power is only due to alcoholic disturbance The muscles are then truly more i apidly stimulated into motion by the nervous tumult, but the niiuscular power is actually enfeebled. We must also draw attention to the fact that alcohol is in- capable of fattening the body; for if we could successfully fatten the body, wve should but destroy it more swiftly and- surely ; inas- much as the fattening which follows the use of alcohol is not con- fined to the external'development of fat, but extends to a degene- ration through the minute structures of the vital organs, including the heart itself.",
         "CUPE1OARD VENTILATION, ETC. i57 -o- CUPBOARD VENTILATION. In the construction of old houses, and in too many instances of new ones also, a great defect is to be found in the absence of any mode of ventilation for the cupboards. This omission is a serious one in all cases, but especially in those which are devoted to the reception of food or of dirty linen. In such cases these closets, with their contents, become laboratories for the manufacture of pol- luted air, which from time to time escapes into the living rooms, and,makes itself unpleasantly apparent. The remedy for this is not difficult; a few perforations in the deors will be found ser- viceable, but if practicable, the wall of the cupboard should also be perforated, so that a thorough draught could be obtained. For damp closets and cupboards which generate mildew, a trayful of quick lime will be found to absorb jne moisture and render the air pure, but of course it is necessary to renew the lime from time to time as it becomes fully slaked. This last remedy will be found useful in safes and strong rooms, the damp air of which acts frequently most injuriously on the valuable deeds and, documents which they contain.-Sanitary Record. ROYALTY AND TEMPERANCE. The gratifying announcement that i-fr Majesty the Queen would become a patrou of the Cnurch of England Temperance Society is followed up by the almost equally gratifying statenent that the Rev. Babil Wilberforce has received a letter announcing that His Royal Highness Prince Leopold will become President of the Oxford Branch of the Church of England Temperance Society. The Church of England can do no higher-service to this country than by enlisting the sympathy of Royalty and rank in the temperance movement. It is high time that the amount of drinking which goes on, not only in Liverpool, but in all",
         "158 PUBLIC HEALTIH MAGAZINE. parts of the kingdom, should be abated, as something intenscly degradmng and disgracful, haiing nu foundation cither in sense o1 morality, as it certainly lias none in physiology. Let us hope that ve are at the beginning of a great religious and patriotic effort to increase the temperance of cvery section of the com- munity. Mere patronage vill not do it. But we shall have more assistance in this enterprise from the Royal Fanil than is implied in mere patronage; -md not the least glory of the Vic- torian reign iill be the perception of a great social vice by ler Majesty, and the desire personally to help in its removal.-T e Lancet. TOBACCO IN RELATION TO HEALTH-. Dr. Richardson, F.R.S., delivered a lecture on this eubject before a very large audience at Birmingham on Vednesday evening, the i5th ult. The lecture was deliN ered in connectiun with the Lanvs of Health class of the Midland Institute. Afte speaking of the introduction of tobacco to Eui upe, and its enoi - mous consumption at the present time, the lecturer said: The nature of the luxury forms a subject of discussion on which the extrenest views preail. On one side tobacco lias been held -n as the most harmless of luxuries; and on the other side it has been denounced as the originator not only of mere functional, but ofsome of the worst forms oforganic disease. Follon ing out the researches made b\u003e hinself, lie show ed the constituents of tobacco smoke and their results upon the hunan body,- and pointed out the effect exerted by d:fferent kinds of tobacco. Speaking of the influence of smoking on the mental faculties, lie said . When mental labu1 is being commenced, indulgence in a pipe produces in most persons a heavy dull condition; but if mental labor be continued foi a long time, until exhaustion is felt, then .the resurt to a pipe gives to some habitués a feeling of relief; it soothes, it is said, and gives new impetus to thouglit. This is the practical experience of almost all smokers, but few men become so habituated to the pipe as to commence well a day of physical or mental woik on tobacco. Dr. Richaidson carefully discussed the question whether the practice of smoking could be considered, fairly, as a Lause of those fatal diseases, consumption, cancer and",
         "A CAUTION FOR LADIES. apoplexv. The argument, he stated, was conclusive against this extreme view. The sane conclusion was arrived at in re- spect to insanity, epiliepsy, St. Vitus's dance, heart disease, and chronic bronchitis. At the same time, immoderate smoking cannot be carried on without danger, sometimes even to life A CAUTION FOR LADIES. Women of the present day are happily too strong-minded to paint their faces or dye their hair (says the Pall Mall Gazette), even vere such proceedings necessary to heighten their attrac- tions. They can therefore afford to smile at a warning conveyed by the Sanitary Record against the use of cosmetics and hair dyes, which frequently contain lead, and consequently produce disastrous results on the inner system, hardly compensated for by their pleasing effects on the outer system. It seems a patient was lately admitted into King's College Hospital, suffering from all the symptons of lead poison. On enquiry, it was found that the sufferer was a ballet dancer by profession, and, as is usual with ballet dancers, was in the habit of using flake white freely as a cosmetic. This powder proved on analysis to be composed chiefly of carbonate of lead. When applied to the face, the pow- der becomes partly absorbed through the mouth and nostrils, and thus enters the circulation and pervades the whole system. A friend of the patient was, according to her account, suffering from the sane symptons as herself, and there is, it is stated, nothing unusual in the case, as symptoms of lead poisoning have often been traced-to the use of cosmetics and also to the habitual em- ployment of hair dyes containing lead. In short, when Beauty with paint competes with Beauty without paint, she does so at the risk not only of defeat, but also of death.",
         "PUBLIC IIEALTII MAGAZINE. Wvc have nlow for sorte timne bccn prescribing Dr. F. B. Whicelcrs IlE1ixir Ferri et Calcis Phosphatis Co,\" and we Mnust in justke. tu the Doctot, statezthat it is-qutite equial tu if flot supe. riur to an% compound of thc kiriJ. Wc have uscd it in the first stages of Phthisis withi inarked bencit, as also in t.ascs uf âvr D\u003ebspcpbla ýýherc cverything eise haJ failed, and in maxny othcr aflectiunb. It is a pleasant preparation, andi nay bc takcn for a long time without Ilpal!iR,\" on thc stomnach. -- Promi the Canada Akedical and Surgical Yourna4 rLBIALt 1ILALIJII.A.LN.W have rer-eived the first nurnbcr of a maga.~ zinc, tvith clhc abuvt. tit1c, a pcriudical svhAth is Jcstmnied, %vc hupe, tu du inuch guud in -tih w.umznunity. Itb mÂ\u003ebiun L~ c-Jatativi-al, and if ýiiduý.tcd i a pro. pt. -iii u ab tu all the attention uf the inabbr- tu ail bubjen..3 bearing un the Liws uf hcalth, we duubt flot chat it lI bc a sucess, and cake rank as \"an authmity \" in Sanitary science to ivhich it aspires. TIài. jurnal à. edited by Dr. George A. Bayneb, \u0026 gentlem,.n ivhu hab already, giýcà i cn uf hi devutiun tu Sanitary àubje.~ by a vt-ry ta--client tourse c( pouluai leotures, delivered by him Juring the. pa~t ALICa\u003e ýaL by a brochure un lic-t dbjAs-al ut the dead, ivh\u00261.h i:, wurth readiùg. %We ivAh the periodicai eiwry I I. tery r4eatly gutten \u002641,, and is Aààbued frurn the. printing estab. lijliment of John Dougali \u0026 Son. Promx Me Canada Medical Recoed. PULIc HEALTII MAGAZIN\u003cE. * * In genecral appearance, it is very ,rudlt\"Lk,, ar,l chu. 4,untuiera .irnerubtingi..id itruatkîe. i hu bubjett of sanLaAy 1Af.. un, W hQtta..Ag art» igIad Lu*AY, a ýunbidexable .imuuntuf public attentàjiî at thç. jre-surit, ind it ià meet chat saititary it.raturc: àiutld, ernanie fru1à th-_. NlctujulÂ. ut the DunnAfliun. Dr. flaynes hab fur sornc trne back de- 'iuted niuAAAJ Itituur tu tht aubjot ut, hygnene, and aà edAluz uftheI nuv -Health Magazine lie has our wannest %visites for iLs succeas. Pr-oin the Sanitary fournal, Toronîo. PL. IIL 11ALIR MAk.AZîN.L -This is a new mnagazine, conbsating laigely oif rtpurtb anid utigAnal papers un important b.anitary bubjectb. The field for .,.ÂAiaar\u003e Libur Iâ aAgt anJdui d .Atny laburt.rs, at Murntcal At apiJearb tu necd viguruu3 hubandry. We twAsh uur contcmporary tht sui.ccss At merith. From the Daily WiI,:css, Ofonfe4a4 Tht; great intcrebt whiLh AS flov gcnerally feit --unccrning heahLh matters rendç-r\u003e tii... a faîud4bIe tirnc. fui tht. pbitiA.3LAI ut a rnunthly magazine of sa'I."
      ],
      "title" : [
         "Public health magazine [Vol. 1, no. 5 (Nov. 1875)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_05170_5"
      ],
      "published" : [
         "[Montréal? : s.n., 1875]"
      ]
   }
}
{
   "doc" : {
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "PUBLIC HEALTH iiAGAZINE AND LITERARY REVIEW. VOL. II.] FEBRUARY, 1S77. [No. S. DISSEMINATION OF ZYMOTIC DISEASE AMONGST TIE PUBLIC BY TRADESPEOPLE* By CORNEL1us B. Fox, M.D., M.R.C.P., London, Medical Officer of Health of East, Central, and South Essex. The subject of this paper will, doubtless, be regarded as one of an alarming character by the public at large, as highly objec- tionable by tradespeople, as very important by medical men in general, and as one of the highest interest and concern by medi- cal officers of health. The necessity of preventing trades from being so conducted as to be injurious to prblic and private interests is admitted on all hands. We have not only Acts of Parlianient which regulate the employment of dangerous substances used in trades-such, for example, as the Petroleuni Act, the Pharnacy Act, the Acts relating to explosive compounds, as gt.noowder and nitro-glycer- ine-but we have Acts which, although iniperfect in their nature, regulate to some degr2 factories, coal-mines, bakehouses, work- shops, \u0026c. The employment of labor ir sucli trades as lucifer- * Read before the Public Medicino Section at the Annual M.eeting of the British Medical Association i Sheffild, August, 187t.",
         "2 ý. I*nLIC IllEALTH*r GAINE nati h u niakiag, fuasLdn-utting, the manufacture of minerail acidq of eartlenwaîre, glass and metals, of percussion.raps, cartridges, palier, ,taining of prints. bleaching and dieing, 'c., il to a cer- tain extent controlled. The first-named Acts, as also the Aikali Act, are designed to shicld the public at large from the risk of an exposure to hurtful and poisonous substances, whilst the other are directed more especially to the prevention of injury to the health of those engaged in them, and to the non-enploy- ment of those who are physically unfit to bc exposed to such unwholesome avocations. The protection of the public liealth by the regulation of offensive trades, such as those of blood, bonc, tripe and soap-boiling, and tallow-melting, is relegated to the Public Hcalth Act of 1875, under which power is also given to conpel the consumption of smoke in certain cases. The existence of all these legal enactments shows conclu- sively that the principle of the regulation of trades lias been deined by the Legislature to be sound, wholesome and ex- pedient. Legisiation has proceeded on the assumption that, if a trade be so managed as to be injurious to the health of those engaged in it, or to the public generally, or in such a manner as to be a nuisance, alias an excessive annoyance or danger to the public, the best practicable means of preventing the evil shall be adopted. The several Rivers Pollution Bills have been drawn with this self-evident desideratum steadily in view. The Rivers Pollution Bill that will sooner or later succeed in running the gauntlets of the Lords and Commons will undoubtedly be thus framed ;* and the Air Pollution Bill, which, I fear, is in the very far distance, must be supported on this basis, if ever it is to be a reality. The liberty-loving people of this free country would never be able to submit to such interference with, and control over, their modes of carrying on business for less important con- siderations than those of national health and wealth. Admitting, then, the facts (i) that, in the interests of the * Since writing the above, tho Act of 1876 has, by the consent of au par- ties, been allowed to pass with a view to a settlement of the questiun. It in- sists un the adoption of \" the best practicablo and available means\" for coun- teracting the evils with which it is supposed ta war.",
         "lIlul31;NATiMN OV /VMOTIC IIsfE. 13 public, it is highly desirable that trades should be supervised for public health purpnses, and (z) that certain legal enactments at present exist of a very inperfect and limited character, having for thxeir obct the regulation of certain trades, so that they shall not lie injurions to health, is it not a matter of logical ne- ce.ssity that, if it can le shown tliat there exist other trades not yet provided for, which are actively enix 'ged every nnw and then in sowing broadcast the seeds of preventible disease, some remevdy for such an anomalous state of things cannot be with any sense of crnsitency and justice longer withheld ? To prove to medical men, and especially to those amongst theni who are engaged in the public health service of the country, that zymotic disease is disseminated by tradespeople amongst their unsuspecting custoners, is really to waste time and to assume an ignorance of facts which they are constantly deplor- ing. My object in addressing the Association on this subject is rather to suggest to and consult with those medical men who are attending this gathering, as to the best mode in which the exist- ing sanitary law could be so altered and modified as to protect the public from the dangers to which they are exposed in this direction. As these lines will be read, however, by many who do not belong to the medical profession, it will be useful for me to narrate briefly a few instances of the spread of zymotic disease by tradespeople amongst those whom they serve, which have come under niy immediate notice. C ASE I. Scarlet Fever in a Public-house.-Scarlet fever was exported from London into a public-house in Essex. Whilst the children of the publican lay ill of this disease in the bedrooms, their mother, who was in constant attendance on them, descended to serve each custoner who called to partake of refresbment. I, as Medical Officer of Health, advised the temporary closure of this house of call, but ny recommendations were unheeded. From that house, as was naturally to be expected, the fever spread into the surrounding parishes, and deaths resulted. There was no legal power to compel a cessation of business during the presence of this communicable disease in the house. It was found that the publican could not be punished under the Clause 126 of the Public Health Act of 1875.",
         "14ù i'Ulli.C 11EALTil StAGAZ1Nt-. C %.Y II. Out/brrak of 7'†hoid Fevrr fron Pwited Hik.-- An outbreak of enteric fever occurred in a portion of the town of Jjrentwood. Whilst the houses of the familie, afflectel vere provided with different modes of disposal of excrement, some draining into private cesspools and others discharging into the town sewer, and whilst the water employed by all, vith one ex- ception, proved on analysis, although derived from different sources, to be very pure, there was one condition in common. They ail, with one exception, drank milk from the same dairy, and the dairyman washed out his cans with vater which was most offensive sewage vater. The exception to the rule vas the casc of a young man who did not deal with this dairyman, but who drank of the same water as that with which he manipulated his nilk. I could not learn that any one besides this young ian employed this water for drinking purposes. I myself saw the niilk-vendor milking his cows into a pail which recembled a fiithy pig's bucket. His dairy, where the milk was stored in large pans, was situated virtually in a bedrooni redolent of organic matter. 'My surprise was great to find that milk could be pre- served for even a short time in a sweet state in such impure air. Why, I ask, should the lives of our children, who are great milk consumers, and our own lives be exposed to suci dangers when nothing would be easier than to have dairy establishments under proper sanitary control, in the same way as we at present have slaughter-houses ? C ASE II. A Village School distributib jIeasics.-Measles appeared in a parish under may supervision. On investigation, it was discovered that the day school was the centre fron which it spread: for the children of the schoolmaster, ivho lived at the school, fell sick of the disease one after another, and imparted it to the children who daily attended the school. I recommended that the schools which were busily engaged in infecting the parish should be tempoiarily closed.* The managers refused, on the * The mere exclusion of the children belonging to an infeeted fanily from school will sometiies prevent the spread of such diseases as measles and sear. let fover. Whon several families of a parish are infected, the closure of the public school will be generally found the most effective method of limiting their diffusion.",
         "\u003c11SIN F /XMorleC rOF l''. 241 plea that they should lose the Government grant, to securc which a certain ninber of attendances are necessary, although, when a school is closed by reason of the prcscnce of epidemic discase, a reduction in the number requisite to secure the grant is allowed. There existed no legal power to compulsorily close the srhnls. Contrary to my advice, they were kept open, and they dissemi- nated the disease: in a most successful manner throughout the whole parish, which suffiercd sevcrely. C Asr IV. Sma//-f'x in a Public-house and Resaurant.-A traveller who vas temporarily lodging in a public-house exhibited an eruption, which proved to be that of small-pox of a confluent kind. Qn cntering the door of this house of public resort I could ditinctly recognize the peculiar smell characteristic of the disease. In the bar where men were drinking the odor was still stronger. Trade was going on as usual. No remonstrance had any effect on the publican. There was no exposure of the sufferer, and it could not be proved that there was any exposure of infected articles. From this house the disease spread, and no legal means existed whereby the calamity could be prevented. The public were frightened some time ago by a report of the discovery of a bad case of small-pox lying in a shake-down bed in the kitchen of an eating-house in London. Some strong feel- ings were aroused as to the dangers to which people are exposed ; but the cirrumstance was soon forgotten, and made no lasting impression on the public mind. C AsE V. Eneric Fever spread by a Tailoring Establishment.- A case of enteric fever appeared in the family of a tailor who lived in a small four-roomed house in a terrace. This tailor was employed by the fashionable and principal tailor of the town, who displayec. his goods in a large and handsome shop situated in the best street. The assistant tailor, whose four-roomed cot- tage was his place of business, where clothes were made and re- paired, employed under him a journeyman tailor and a semps- tress who lived near. On my visiting the assistant-tailor's house I found that work was procceding as if no fever existed upstairs. Clothes were being nianufactured there for the fashionable tailor with the handsome shop, who would soon distribute them to the unsuspecting public. The journeyman tailor and the sempstress",
         "242 1'1\"111 ic 111Ai-T11 MA%/INL. brth rcccivcd froin the assistant-tailrr soie rlothscà tut be re- paircd. Dnth becamc infcctcd vith the fevcr, and commnunicatcd it to others. Cmr. VI. Scarict FZc- in a Vi//agc Groyv Busines and Po½/-vffice.-A child of a village grocer, who -,vas the postmaster of the district, b-ccanic infected with scarlet fever, the poison of which was conveyed into the house from a distance. On asccr- taining that the housc was a small one, and that the iother and father pascd from the bedside of the sick rhild into the shop to serve custoners, and fcaring, niorcover, that the poison of the disease miglt be circulated through the agency of the post-o3fice, I reconnended the temrporary closure of the business. My ad- vice was disregarded, and nc, power cxisted of compelling com- pliance. 'lie discase, of course, sprcad throughout the village. C A s1: V 1. JVhoping-cough in a Villae B«r-s/wp.-Whoop- ing-cough of a fatal character being very prevalent in one part of ny extensive district, destroying in about four months forty- children, attempts were made to prevent the spre, d of the dis- case froni any casts imported into other parts of the district. A case was convey ed into a beer-shlop, and infected all the claidren of the publican. This beer-shop was daily frequented ly many of the fathers and mothers of the village, or their children. I myself saw children entering it, having been sent with jugs for beer by their parents. I recomnimended the publican to tem- porarily close his house of public call, pointing out the danger to the whole village which a refusal would involve. He quite acknowledged the risk to his customers, but assured nie that be could not afford to temporarily close his business. This assu- rance would have been received by me cuw grano salis, had I not good reason for knowing that he spoke the truth. I asked the legal adviser of the sanitary authority whether some compensa- tion could be granted him by the authority, if the publican agreed to close his house, but found that the auditor would not sanction an outlay of this kind, as the law does not provide for such an expenditure of public money. The disease, as was only to, be expected, spread amongst the customers and occasioned three or four deaths. The absence of any power to afford compensation lias re-",
         "il -5 1NutsWY rF /VM1. r iei i -l'%. 24 scntly b:cn authoritatively derl.u.cd by the Liorai Govtyerniment X1-nard in the following case. Srarlct fever of a mild description was imported in.to the failics' of soime \"Pcculiar People,\" liv- ing in a village, who kcpt the matter secret. The childre.'n at- tendcd tbc Nation.l and tDame's Scionls during the ç1..squama- tive stage of the disease, and, through these scho!h, infctcd a portion of the village. I rccommcndcd that both of the schools should be tempîîorarily closed. The clcrgyani.tt of the parish, who haid the contro.l ni the National School., consented. The peri- odit al inspectioin and examuination of the children had just leen completed, ..nd therc was no danger of losing the grant. The nld dame who taught ti e very young children of the parish. anad who' had to maintain her :till older husband (ahove eighty) out of het weekly earnings, aiso closed lier school; but .ery natu- rally looked for nre compensation, as she could nîot afford to he deprived of her weekly pittance. The legal adviser of the Sanitary Authority wrote to the Local Government Board, ask- ing, whether the Sanitary Authority could compensate the poor dame for the loss she would sustain b)y the closure of her schooi. The Loe:il Government Board replied in the negative. In a former case of this kind I was obliged to compensate the dame out of my own pocket, as it was impossible to allow the poor creature to suiffer. If village dames refuse to close their schools wien engaged in propagating disease, then exists no power to compel therm to do so. To detail more cases of this description is needless. Dozens, ail telling the ame tale, are to be found published in medical and sanitary journals. Perhaps the most recent in the recollec- tion of sanitarians vill be that of the distribution of the scarlet- fever poison through the medium of cream, at a West-end party ; and that of the discovery of a case of small-pox in a milk-shop at Manchester. A cottage, used as a laundry or as a butcher's shop, nay lodge in its bedrooms cases of typhus fever; a private school may disseminate scarlet fever through a district by means of its day scholors ; a grocer's shop or public-house may be served by those who have just come from the bedside of persons dying up- stairs of small-pox ; the cottage of.the village postwom in mày",
         "244 PUBLIC HEALTH MAGAZINE. contain some communicable disease, the poison of which she may distribute with the letters ; and yet there exists no power to temporarily close such disease-sprêading establishmerts. I have written enough to show what dangers surround the public, and as to the state of helplessness in which medical offi- cers of health find themselves, when they wish to prevent a tradesman from disseminating the poison of some disease with his wares, be it the milkman with sewage in his milk, or the schoolmaster who distributes a dose of the poison of measles with a knowledge of the three R's amongst the village children, or the sempstress belonging to some drapery establishnent, whose lodging may contain children laboring under malignant scarlet fever-a fact which may be unknoivn, in the absence of an Act for the compulsory registration of communicable disease to any sanitary official. That our children should be subjected to the risk of being poisoned with sewage in their milk, because some milk-vendor chooses to wash out his cans and manipulate his milk with sewage-water; that our wives and that we ourselves should be exposed to the chance of infection from wearing clothes ordered at some respectable shop, and made in some garret full of fever or other contagious disease, the existence of which is kept a profound secret, is simply intolerable. If the liberty of the subject, about which we in this country hear so much, is to be maintained at the expense of a quiet submission to an exposure to such perils, 1, for one, vould pray the Legisla- ture for less liberty. The question now arises as to how this evil of the dissemi- nation of zymotic diseases by tradespeople can best be prevented. On this point, Ï doubt not, there will be some difference of opinion. My own view is that it can be averted: i. By placing the regulation of all trades under the control of the sanitary authorities and their officers (the power to com- pulsorily close a school or public-house, \u0026c., when necessary, would be of course comprehended in an enactment of this kind); 2. By enabling a sanitary authority to grant compensation out of the rates in cases of temporary closure of business for the",
         "DISSEMINATION OF ZYMOTIC DISEASE. 24.5 protection of the public, when the sanitary authority bas reasons for believing the truth of an allegation of inability to -sustain pecuniary loss on account of'poverty; . By extending the provisions of Clause r26 of the Public Health Act (1875), by inserting one making it a misdemeanor for persons to endanger the lives and health of their fellow crea- tures by wilfully spreading communicable disease in any way- an amendment which lias recently formed the subject of a peti- tion of the health officers of the country to both Houses of Par- liament. The proposal to place trades under the control of the health authority of the district in which they may be situated must sooner or later be carried out. It is merely a question as to the time when the public will become as fully alive to the import-nce of the subject as medical men already are. There can be nothing unfair in expending public.money in giving compensation to a very poor and struggling tradesman, when a sanitary authority compulsorily closes for a short time his business in the interests of the public. Sanitary authorities already possess the power of giving compensation to the owner on account of bedding, clothing and other articles exposed to in- fection which they wish to have destroyed. Again, when schools are closed under the advice of the health authority, in consequence of the presence of infectious disease, a certain compensation is granted to them in not requiring the same number of attendances as is usually needful to secure the Governmen.t grant. o: THE KITCHEN.-iUntil the kitchen becomes thoroughly and systematically organised, and is regarded as one of the most im- portant of household departments, there can be no such thing as habitual health in the family. Bad cooking poisons more per- sons than all the nauseous drugs ever administered to poor humanity, and it is the remote cause for the employment of two-thirds of all the divorce lawyers in existence.",
         "ON PERSONAL CARE OF HEALTH. By E. A. Parkes, M.D., F.R.S. London: Society for Promoting Christian Knowledge. If this little book could make its way into every home in Mont- real, and be carefully read by the inmates of each household, the services of a physician would be but seldom required. The lamented and gifted author, of whom we soirowfully wrote a notice some months ago, ivas called away from his labors a few weeks after lie had read the proof-sheets of this, his latest work. It is written on a subject to which he attached the hightest impor- tance, and is composed in language so clear, and in a spirit so benevolent, that it is a positive pleasure to scan its pages. After explaining that health is not merely freedom from bodily pain, but that it is the capability of receiving delight from all surrounding things, and from the employment of all our faculties, he remarks on the strange carelessness with which this precious boon is squandered. He then points out - that the secret origin of many diseases lies in the neglect of obvious rules of morality and common sense, and that, if he will, it lits in the power of man hinself to erase from the world a large portion of those sufferings, the sight of which we have daily to lament. In the removal of these blots from a world which was originally pro- nounced good, Christianity and Science must be the chief agents. The sanitary legislation cf the present generation bas done much to ameliorate the conditior of the people generally, but legislation cannot effect all necessary reform. Personal hygiene must supplement its efforts, and it was to put forward for the benefit of the individual the main rules of the personal manage- ment of health, that Dr. Parkes wrote this valuable little treatise. He bas not touched on the subject of the health of children. This task he bas left to others; but, without entering into details, he unhesitatingly asserts that at present the frightful difference between the infant mortality of the rich and of the poor classes",
         "REVIEWS. 2k7 is chiefly owing to the ignorance and careiessness of the latter, and is attributable only in a minor degree to the poverty of their circumstances. He begins his subject accordingly with the period of puberty in both sexes-that is to say, about the age of fourteen or fifteen in girls, and a year later in boys. When growth is completed, about the twenty-first year, manhoed and womanhood commence, lasting for about forty years, more or less, and succeeded by old age. We have, therefore, the three natural divisions of puberty manhood and old age, for each of vhich Dr. Parkes gives the rules of health, as they necessarily differ somewhat in each period. After remarking on the great importance of the period of puberty or growth, inasmuch as in it the foundations of health may be firmly fixed, or, on the contrary, undermined, he proceeds to give, under different headings, the rules of health for this division of life. Upon these, at present, we have no space to dwell. We must content ourselves with saying that he offers most valuable and practical suggestions on tha varied topics of exercise, solid food, drinks, smoking, clothing, the care of the skin, teeth and bowels, fresh air, pure water, healthy houses, and unhealthy trades. He lays great stress on physical education, especially for girls. They ought, in his opinion, to have strong, firm muscles, and v'ell-developed chests and haunches, as a race depends largely for its stamina on its mothers, and must degene- rate if these aie feeble, and want bone and muscle. He strongly advises every young man and woman to be a total abstainer, and gives his reasons, which we may briefly state as follows :-i. Alco- hol cannot do any good to healthy persons in the period of growth. It contains no particle of nitrogen, and cannot, there- fore, assist in building up the tissues of the body. 2. It does not aid muscular force, for its apparently reviving effect is transient, and is succeeded by increased languor. 3. It does not aid n.r- vous force, for, though it may increase the rapidity of thought, it lessens the real power of the mind. 4. It does not increase animal heat, for it has been frequently shown by experiments that it depresses the temperature of the body ; instead of keeping cold out, it lets it in. 5. A young man or woman who takes alcohol is laying the foundation of a habit which has a most",
         "Z\u002b PUBLIC HEALTH MAGAZINE. dangerous tendency. Prudence. then, counsels us all to abstain in youth from what is by no means \" a useful friend,\" and may easily become \" a deadly enemy.\" On smoking, lie remarks that a young man, without any good to himself, is forming a habit which may become very burden- some, and that, if lie is a poor man, lie is spending money for which there are fifty better and more pressing applications. At any rate, it is a practice which brings with it doubtful good, and, imi most cases, very certain harm. Dr. Parkes is of opinion that, in a physiologice.1 point of view, early marriages are the best. When people marry at about two or three and twenty, the children are likely to be more vigorous than when the parents are older. The parents are better able in the period of comparative youth to undertake the care and maintenance of children, and will be generally relieved of their charge before old age incapacitates them for the responsibility of superintendence. In the two chapters on Manhood and Old Age, the sane topics of food, clothing, exercise and sleep are suc- cessfully handled, with a scientific discrimination as regards the changes which are naturally rendered necessary by these different periods of life. On the question whether alcohol should be taken daily as an article of diet in manhood and old age, Dr. Parkes may at first seem to differ with Dr. Richardson, who condemns alcohol in tolo. But the difference is more apparent than real. Dr. Parkes, as ve have seen, has said that it is not \" a useful friend, and may easily become a deadly enemy,\" during the period of youth. Surely there·can be no limit to this statement, and what is true of youth must also be true of manhood. Under any circum- stances, lie considers that one and a half ounces of pure alcohol in twenty-four hours form the limit of moderation, and that the scientific uncertainty at present prevailing on the whole question, coupled with the difficulty of saying what dietetic advantage is gained by using alcohol, turns the scale in favor of total absti- nence instead of moderate drinking. The last chapter in the volume is a somewhat hopeful answer in the affirmative to the question, Will men follow the rules of health ? Dr. Parkes shows plainly that the amount of physiological know-",
         "REVIEWS. 24.) ledge which it would be necessary for young people to have, in or- der to understand the importance of the rules of health, is very small. The bulk of the people, of course, cannot be taught techni- cal physiology. Nor is this requisite. Certain points can easily be learnt in a few days, and, properly illustrated by a few models, would give a general view of the wonderful mechanisin of the human body. After these simple lessons have been clearly un- derstood, the reason of the rules of health would at once become transparent, and at last all would learn to treat their bodies with due care and respect. As Pallas says to Paris in Tennyson's poem of Œnone:- \"Self-reverence, self.knowIedge, sei.control, These three alone lead life to sovereign power.\" The last few pages of the manual contain a few simple sani- tary hints for workingmen, who would do well to follow closely the admirable rules laid down for the bettering of their physical, and consequent moral, condition. On the whole, there is very little in Dr. Parkes' volume to which any scientific man can take exception, and the general reader cannot err if lie conforms to every hygienic direction that it offers for his benefit. VENNOR'S WINTER ALMANAC. By H. G. Vennor, F.G.S., of Geological Survey of Canada. (Dawson Bros.) The love of the marvellous is so ingrained in the human sys- tem, that when once a name is up as able to feed this mental taste, the success of the purveyor is in the ratio of faith to fact, with always this in favor of the prophet that every one wants him to be right, for every one loves to peep into the future. When favored with \"Vennor's Winter Almanac\" we found ex- actly what we expected, the system of prognostication reduced to common sense principles. We were reminded when we read it through of Miss Edgeworth's story of \" Byes or no eyes, or the Art of Seeing,\" which pretty tale lays the foundation of a lad's future character for observation. Two boys go the exact same walk; one pronounced it the most stupid saunter he ever took, the other returned with a pocketful of, notes and facts of deepest interest. Such is Vennor's Almanac; it is constructed on the marvdlous, we admit, but the marvel is that only one out",
         "2oPUnueC IIEALI;l MAGAZIN1. of one hundred ever see anything. Vennor's Almanac is essei- tially a book of probable facts founded on observation. The author is an \" out-of-door\" man, and writes about \" out-of-door\" facts; lie has, as stated, lived in the wcather, and Weather and the author have become very familiar with each other for a num- ber of years, and no wonder then that, baving watched her eccen- trie courses, hie has made sound prognostics of what she is at\u003eout. There is also in the Almanac a very telling feature, and one that will enlist a goodly number of admirers,-wc allude to the scheme of inviting his readers and observers to become fellow meteor- ologists, and write on the memoranda page the record of the weather, the wind, and the thermometrical observations of their locality; then, by comparing the line with the past character of the corresponding day and year, a barometrical analysis is insti- tuted. This is very interesting, and will give a scientific and useful bent to those interested in weather predictions. It is easy to observe the mould of the author's mind,-he has the propaerties of a thorougb naturalist; lie loves the creation, whether in the heavens above or on the earth beneath; the habits of both bird and beast are pressed into the service, and consulted as to what they think of the weather, and their habits are registered, show- ing that wild geese, like other geese, make mistakes. We can cor- dially recommend this interesting little book as a cheap and use- ful (two important items) present for the New Year of 1877. 0: TWENTY-FIRsT ANNUAL REPORT npon the Births. Marriages, and Deaths, in the City of Providence, for the year 1875. By Edwin W. Snow, M. D. This Report is very concise and clear, and reflects credit on the compiler, and shews that Providence is as healthy if not healthier than the majority of American cities. There was but one death from small-pox, and he a man of foreign parentage. This grand result is obtained by vaccination. Evidences of full protection from small-pox are required of all children entering the Schools of Providence. When will this be the case in Montreal ?",
         "PUBLIC [EALT[ MIAGAZINE AIND LITERARY REVIEW FEBRUARY, 1877. \"GOD MA)E TIE COUNTRY AND MAN MADE THE TOWN.\" As we were returning from the country into town, the other day, this old saying of our forurathers was strongly impressed upon our minds from a sanitary point of view. It was not alone the contrast that struck us-of the beauty of nature, with its hill and dale, its lr.d and water, its forests and its fields, compared with the close array of tall narrow streets, with their narts for merchandise, the imposing buildings of successful enterprise, and the crowded quarters for housing the sinews that labor in the nidst of it. But in another view it struck us, that ad- nitting the necessity of town as well as country, political economy should press upon the governing power that wise control which, while it provided and encouraged, cared for and secured the supply of labor for the demand in towns, should avail itself of the inexhaustible drain the country affords for disposing of a superabundant and suffering population. Emigration has been the successful channel for providing for the surplus population of the Mother Country, and her colonies have been evidently reserved by a wise Providence to form an outlet for the incredi- ble increase of lier population. Men of large and foreseeing philarthropy have lent themselves actively to this great work of guiding the stream of population to the vast fields of suc- cessful industry which colonization affords. And had the saine wise policy met the tide of immigration and assisted and en- couraged the free settling in Canadian forests of the multitudes",
         "PtillIC 111-LTHI MAAZ1NL. that have passed throuigh tn occupy the vast tracts of the States, we might base seen a far larger area of well cultivated land to-da) than we are likely to do for years to come. And while on this head, it is not uninteresting to mark what has pr*oved the most fruitful source among the many hindrances to the o cupation of much larger extent of our surrounding country than is at present under cultivation. Among these and foremost vas the mistaken policy of supporting \" Land Companie,\" who for cer- tain proposed benefits in the formation of roads into the heart of the lands they were to monopolize, were given for a nominal ,value vast tracts of land. These, instead of inviting the emigrant. who anticipated a free field for his labor and occupation, put him into the power of a :oinpany that exacted the uttermost farthing, and kept him a poor drudge for ye.,s and years, paying its ce- actions out of the increase of his few head of cattle, at such a price that the hay the animal consumed scarce met a quarter of the cost that raised it. Was it any wonder that the poor enigrant finally abandoned the land ? Too great inducemer.ts for the occupation and colonizing of a country cannot be given, for the most short-sighted politician can sec that the possession of a vast uninhabitcd territory is only a source of weakness, and its true value consists in making it an inducemrent to mankind to occupy it. We boldly assert that the man who has put the strength of his loins and the patient endurance of his labor in chopping down an acre of forest trees, piling and burning them, clearing and cultivating it, has., in a country where the object is to colonize it, earned of that coun- try an indefeasible right to the possession of it ; and those who doubt it we recommend to go and try it. But to return to the point that we would urge as a true relief to an unhealthy and densely crowded town, let inducements to the unemployed to take up land be liberally held out to them; let the benefits of agri- cultural life in this country be shown them as affording a certainty of an honest livieihood; and this may be done by a free, liberal spread of short tracts on emigration and its advantages; and first aiong these advantages let health and the immunity from disease that surrounds the close-packed herds of human families in unhealthy suburbs be urged on their notice. It is a wfll-known",
         "GOD MADE THE COUNTRY AND MAN MADE THE TOWN. 253 fact that the statistics of population taken in the Eastern Town- ships of the Province of Quebec, show nine families out of ten, with the three gencrations alive in the same locality. Small-pcx, diplitheria and typhoid fevers are almost unknown, and when found arc invariably traced to importation by some one or otler coming from towns. Living, by which we mean the support of a family, is half as cheap a-;ain as in town : the abundance of milk and wholesome grains raise families of endurance and muscle. The habits of the people induce a healthy organization. \" Early to bed and carly to rise, Make a man healthy and wcalthy and wise,\" is proved true in agricultural life. If it be asked, but how com- mence a draft so as to case off the pressure ? Our reply is, com- mence as they arrive with the able-bodied youth from thirteen and upwards ; they can all be placed out among farmers for their board and clothing and winter's schooling. Every trade requires apprenticeship, and farming is not an exception; the lad learns his business and the use of his axe, and lie can get on to land, when experience lias tauglit him the use and management of it. Any trade combined with agricultural employment is a sure success, for exchange of work and payment for labor in grain or meat is the easiest and most common truck system. Then, you do not find the jealousy of successful labor in farming as you do in other employments-farmers as a rule are gliad to help squatters, and encourage their location among them, as they forma by colo- nization the supply for help when needed. Tliere is more mutual sympathy in the wants of the poor in agricultural dis- tricts, and it is patent that no one in the country is what is termed a \"beggar.\" But it will be asked how, under present circumstances, recover our millions of acres ? First then, by avoiding our former policy of giving tip territories for sup- posed benefits which have only proved a snare and a delusion. Second, let an Act of Parliament enforce on Land Companies the same rules they do on individual squatters-\" unless so many acres are cleared in five years, the claim on the land ceases.\" But if ever on these grounds we are unable to provide territory for retaining in our midst the continual tide of emigration that flows to our shores, let us aid in passing thei on where they may",
         "254 MYnfLiC ItWALTII MAGAZNE. live like men, and du not die like shcp. We will jus. add that an im- mense source of lucrative employment and traffic could be carried on in cord-wood cut in our dcnse forests for town consumption, but for the refusal of the Grand Trunik to transport it. Cord- wood can bc delivered on the sidings at $1.50 to $2.oo a cord, and what is to hinder open platform cars bringing this into townl at $x.oo a cord, and the Grand Trunk retailing it to the towen at $4.oo. One of the general inducements to farmers to give right of way through their farms was the promise, \" We will carry your cord-wood into Montreal and Quebec for sale.\" It is certainly a reproach to us, to see forests rotting où their own stumps, and thousands of acres unoccupied around us, while the tide of emigration. passes us to happier and frec soils. -Poor Canada ! : o THE ACT OF AMENDMENT RELATING TO THE PRACTICE OF MEDICINE IN THE PROVINCE OF QUEBEC. The changes in the act are very important; and if carried out as intended, will lead to great good. The schools still have the power of granting diplomas, but no one can practice without having passed the required examinations and obtained a license. We are glad that a stricter course of preliminary studies is en- joined upon candidates for the Study of Medicine. But vhat pleases us most as Sanitarians, is, that the very point we have been advocating for months and months, that of a compulsory course of Hygiene, is at last required for qualification to exani- ination. It is gratifying to know that our Professors have re- ceived some degree ofliglit in this respect, and we forgive the hasty censure that was at first meted out to us for insisting on such a course being pursued in our universities. They are still, how- ever, one material point in the dark, but we hope that time will enable them to receive that degree of light which teaches that prevention is better than cure, and to institute a more extended instruction than a three months course. While on this point we would recommend the adoption of a course of Hygiene in our public sehools. We cannot make a people healthy by act of",
         "ME CM LEGISLAT014. 233 Parliament, but if we bring up our ynuth to understand the advantages that would acrue from attention to Personal Hygiene, future gencrations would reap the benefits. Every child should be taught the necessity of daily washing; how filth is removed from towns, and why; what is the use of pure air and water; the objects of the scavenger's cart, the dustbin and ashpit ; why the streets arc paved, swept, and watered ; the reason there arc drain traps to our sewers; that the refuse of our food becomes unwhole- some, and must be removed from the air we breathe; the respon- sibility of the individual to his family and neighbor. Wc cannot too strongly urge upon'our School Commissioners the great im- portance of such a course. Plant the seeds of such knowledge in such soil and it would bear its fruit in good season a hundred- fold. Let any one visit the suburbs of our beautifut towns and there he will see our population, increasing daily, crowded into pens; so avowedly ignorant of the elements of healthy conditions that they are worse off than their very cattle. The ignorance of the people in such matters is positively alarming, and it is not with our poor alone; the middle and commercial classes the aristocratie and wealthy, are as badly off for instruction and in- formation in such matters. These reforms we tre never tired of advocating,-last month we published a paper by E. B. Ellice Clark on Sanitary education; the principles of which we invite our readers to spread broadcast; lie testifies as we have done above, in similar terms but more forcibly. :0: PUBLIC DINING HALLS. Glasgow is pre-eminent for its public refreshment places, from the refined restaurant to the halls for the working classes. In the former good Scotch dishes are blended with high-class English cooking, adding thereto a touch of the French and German cuisine. Scotch collops and Swiss tart, hotch-potch and stewed hare, yellow turnips and Germant sauerkraut are of the same \"carte\" and present, with many other preparations, a diversified régime of cooking. The Scotch people take pains with their food, and anyhow give us more than one kind of bread.",
         "2S6 PI'ULC It A LT11 MýArAiNf. tlre1vh and snupîs are daily nei, àro are ctews of all kinr, por- ridges and rakes. Sweet puddings replace the large amount of pastry in England, and the use of milk is morr abundant than with us. There is a want of spicing abrout many dishes in middlc houses, showing that aromatic flavours, which do ,0 much for mir finer ;astc, are not fully uaider:,t\"od, bu upon the whole the Scrtch people are fat letter t oriks than wè,, both as to using more diversùied matcrial and making more nourishing com- binations. Mr. Corbitt, morc than 14 yzars ago, established these public dining halls. We should say, haing. oursclves visited rnany of these establishments, that these dining rooms are at present the maximum of cheapness and comfirt, and a boon of inestimable value to the work-peiole of Glasgow. The whole range of meals, the goodness and freshnaess of the food materials, the spaciousness of the halls, the agrecalle influence of sur- rounding cleanliness and sobriety; all .hese partic ulars contribute towards creating an imprcssiun, as if an honest and sympathetic man had here erected something above al charity. These halls strengthen the moral purpose of thore who enter them by contributing to their comfort in cheapi food, rather than lessening self-dependence by charitable meals never paid for and never earned. The temperance principle is mainitained throughout al' the branches, of which there are now twenty-six. There is one .entral store where all gouds are supplied to the branches and balanced monthly. It takes 15o cows to give the required quantity of milk. iooo people visit the various branches daily for their meals, and at all branches the daily papers are supplied. Our illustration shows the girls' roon while they are at dinner; such an agreeable light as it represents should encourage us to try and introduce something similar in Montreal. Our space does not permit us to give in full detail the various meals, and the way they are prepared in the prinr:ipal rooms, but we subjoin a bill such as represents the general prices of the halls. Ve have it on good authority that fi.nancially it is a",
         "258 PUBLIC HEALTH MAGAZINE. perfect success, and the concourse of customers daily; viz: ro,oco is sufficient evidence that they are appreciated. GREAT WESTERN COOKINQ DEPOT FOR THE WORKING CLASSES. .Prices. Bowl of Broth.........One Penny. Bowl of Soup............One Penny. BowI of Porridge........One Penny. Plate of Potatoes.........One Penny. Cup of Coffee............One Penny. Cup of Tea ............One Penny. Bread and Cheese........One Penny. Boiled Egg .............. One Penny. Lemonade...............One Penny. Suda Water..............One Penny. Ginger Beer .............One Penny. Al of the Besi Quality and alvays ready. PUBLIC BREAKFAST EvERY DAY, Conzsisting of te folowing Dishes Bowl of Porridge, Bowl of Milk, Cup of Coffie, Roll and Butter, Fixed Charge, 3.d. PUBLIC DINNERS EVERY DAY. Consisting of the follnuing Disia:- Bowl of Iroth or Soup, Plate of Beef-Hot or Cold, Plate of Potatoes, Plum or Rice Pudding. Fixed charge, 5d. Roast Beef, Corned Beef; Minced Collops, Steaks. \u0026c. ALL THE DAILY PAPERS. THE ALIMENTATION OF INFANTS. The health of children depends in a great measure on how the mother's milk is administered. Too large quantity and too fre- quent repetition should be carefully avoided, for over distension of the stomach is almost as bad as giving indigestiole food. During the day the infant should not have the breast more than once every three hours, and only once or twice at night, and not have more than just sufficient to satisfy its appetite, after which it should at once be removed. If an artificial dict be judiciously selected, there is no reason why a child should not thrive as well upon it as upon the breast, but to this end it must consist of a liquid food possessed of heat and fat-producing properties. Cow's milk should in general be preferred to that of other animals, and, when properly prepared, answers all purposes. To this end it must be diluted, and for this purpose water is usually employed. But in far the greater number of cases mischief results from this, for the addition of water does not improve the digestibility of casin, inasmuch as it",
         "THE ALIMENTATION OF INFANTS. 259 does not dilute it ; and when milk so treated is taken into the stomach the water is soon taken up, leaving the casin unchanged. Nor does the addition of sugar make the coagula casier of diges- tion, while skimming the milk deprives it of one of its most important constituents. As the mother's milk contains propor- tionately more fat than other milks, it may be that the finer coagula produced by it are due to the presence of this fat, and it would be better to use other milk from which casin had been removed than that which had been deprived of its cream. The admixture of farinaceous substances also leads to disastrous results. Barley- water, however, is an article that contains so small a quantity of starch that it may be advantageously employed for dilution. Good cow's milk diluted with one-third to one-half of barley- water forms one of the best articles of food that can be used for infants when it is necessary to bring them up artificially. When it cannot be procured, oatmeal may be substituted with advan- tage. By these a real dilution of the casin is produced, render- ing the coagula much finer and more like those produced in human milk. OBITUARY. It is our mournful duty to chronicle the death of our esteemed friend and fellow-citizen, J. H. Springle, C. E. As an engineer few were his equals. As a sanitarian, Montreal could ill afford to spare him. All his articles on Household Sanitary Matters (many of ivhich he gave our readers the benefit of) were the contributions of one who had made a life long practice of endeavouring to perfect sanitary architecture to a science. His statements were worthy of the greatest confidence, for he never ventured an opinion without havinç proved its truth from practice. We deeply sympathise with his family in their great bereavement.",
         "PUBLIC HIEALTH MAGAZINE. CIIEESE AS AN ARTICLE OF DIET. As an article of diet cheese presents some curious anomalies. It is one of the most nutritious of all food-stuffs-so far as one aliment by itself can serve nutrition, whilst at the same time it is one of the most indigestible. And yet, again, if taken in very snall quantities it materially aids the digestion of other fonds taken with it. Of home-produced cheese in its ordinary con- dition few except the most hearty eaters will be disposed to partake at ail largely at one sitting. The flavour of i- is not sufficiently inciting to provoke appetite of the \" cut and come again\" character. But our tendency, as we have already remarked, is to become gourmets rather than gourmands. In the present day \" man wants but little here below, but wants that little strong.\" This tendency has extended even to the matter of cheese, and we have, unhappily, begun to refine also upon that standard dish of everybody's dinner. We must eat, amongst other things, some superfine cheese. The delicacies of this kind most in request are the Camenbert, the Gorgonzola, and the Roquefort, to nante thern in the probable order of indigesti- bility. Ail are more or less creamy, and unwholesomely rich; and all of them when \" ripe,\" that is to say, in the most tempting condition as regards flavour, have become to a greater or less extent delighfully decomposed, and correspondingly upsetting to the digestive organs. And yet, unhappily, they are at the same time most banefully suggestive of another slice, and most tempt- ingly provocative of yet another. When shall we resort to such simple and healthy kinds of food as the Biftec à l'Anglaise, Ponmes-de-terre au naturel, and thé homely cheese called Glostère? The time may be yet far distant, but some day the reaction will inevitably come.-Medi- cal Examiner.",
         "RECEIPTS. 261 RECEIPTS. The following receipts have been sent us:- CHICKEN PIE.-Cut a fowl into pieces; place at the bottom of the dish two pieces of bacon, and place the fowl over it, fill up and flavor with nutmeg and a little mace, pepper, salt, a hand- ful of finely chopped parsley and a little fine shalot or onion; over the top cover some pieces of stenk. Just add a little water and cover with crust. Crust to be made of two-thirds butter and one-third lard; let this melt to boiling point in the oven, then mix with flour, beat up well with fork, moisten with hot water, and beat into a paste. Never touch with hands; roll out quickly, and your paste will be digestible to a child. VEAL OLIvEs.-Take veal stuffing, very fine sweet herbs, suet well chopped, bread crumbs, seasoning of pepper, salt, and nutmeg, mix with a couple of eggs. Divide into several por- tions; roll round it veal cutlet, cut into thin slices, and outside a piece of fat bacon; tie up with string. Place into frying pan, and gently frizzle till done. Place into dish, and trim with-parsley and lemon slices. RISSOLEs.-Liver; chop up liver, mix with bread crumbs, fine parsley, fine onion, pepper, salt, nutmeg, fine suet, and bind with two eggs. Roll up into flour and frizzle gently in lard. Also take Australian Rissoles, and when finely chopped use the same; trim both with endives and beetroot, so as to make a salad. SANwI1cHE.-Never make commonbeef or ham sandwiches. Best sandwiçnes are made with potted meats or potted ham. Cut tin loaves and butter thinly, spread delicately mustard over but- ter, then add potted meats, and over this again bread and butter. Too much mustard is disagreeable, and tough meat not nice; sand- wiches for evening parties should only be made of potted meats. MAIZENA CHOCOLATE.-Take maizena flour, mix with cold milk and add boiling milk, amalgamate with sugar, and simmer gently for twenty minutes; then turn out into buttered shape. Now take Cadbury's or Fry's chocolate, mix with cold water first; add then boiling water and amalgamate, stir an egg into it and a piece of butter and make into a kind of paste; boil up once, and pour over the maizena shape that has been allowed to cool and been put on a dish; strew over hundreds and thousands.",
         "BOARD OF HEALTH. The City Council elected the new Board of Health, as directed by the new Health By-Law, Sec. 2, at their deliberations on Friday, the i9th January, with the following result :--His Wor- ship, Dr. Hingston, Chairman; Alderman McCord, Vice- Chairman; Aldermen Mercer, Grenier, Childs, McLaren, Brunet, Roy, Rivard, McCambridge, Doctors, Girdwood, Mount, Rottot, G. A. Baynes, Lachapelle, Messers. C. 0. Perrault, Shelton, Weaver. Space does not allow of more than a passing notice, but next number we will enter more minutely into the working of the Board itself. We have to announce thai a Public Meeting of the Citizens' Public Health Association will be held in the rooms of the Natural History Society on Friday, the 2nd February, at 8 p. m. Alderman Mercer will address the Association upon the new Health By-Law. BARNJUM's PATENT PANTS STRETcHER.-This most useful contrivance is intended to obviate the unsightly appearance caused by the 4 bagging\" and wrinkling up into numerous creases round the knees of trousers which have been at all worn, and also by maintaining them always of the same length, to prevent the un- pleasant necessity of letting out additional holes in the suspenders, accompanied by the wretched sensation always experienced when trousers are not \" well up in the fork \" as the tailors express it. The machine is most simple in its operation ; the trousers only require to be folded, and placed in the clasps, which are closed in an instant, a lever is then dravn down a latchel, and the operation is complete, excepting that with thick materiai, it is necessary to pass a damp sponge over the legs of the trousers after these are fastened in the machine. It give us pleasure to speak in terms of commendation of this invention, as we have tried it ourselves, and find it fulfils all that the inventor claims for it. Agent, Mr. J. B. Wray, 235 St. James Street.",
         "RAIN AND SNOW FALL DURING 1876. McGILL COLLEGE ODSERVATORY. o 0 . .2 Month. January.......... 1.87 7 27.4 16 4.61 3 20 Februay ... .... 1.12 4 27.5 15 3-87 3 16 March .......... 0.74 5 45-6 17 5.30 3 19 April ........... 1.03 io 12.0 7 2.23 4 13 May ............ 3.45 21 0.3 i 3.48 I 21 June ........... 3.21 15 ....... ... 3.21 ···... 15 July ........*. 4.33 17 ...... .... 4-33··. 17 August ......... 1.98 9 .......... 1.98 ...... 9 September ...... 5.51 16 ····.. ...5.5 ..... 6 October......... 2.64 17 1.0 12 2.74 I 17 November ...... 1.76 12 0.7 5 1.83 I 16 December ....... ...... ...... 23.6 19 2.50 ...... 19 Total rainfall during the year was 27.64 in. Total snowfall during the year was 138.1 in. Total ain and melted snow was 41.59 in. Total number of days on which rain fell, 133. Total nunber of days on which snow fell, 82. Total number of days on vhich min or snow fell, 198. Total number of days on which rain and snov fell, 17. SYNOPSIS OF METEOROLOGICAL OBSERVATIONS FROM McGILL COLLEGE OBSERVATORY, FOR THE YEAR 1876. Barometer readings reduced 1o sea level and to temperature of 320 Fahrenheit. Humidity relative saturation îoo. Greatest heat Vas 92.2, on the 6th of August ; greatest cold was 21.8, on the 17th of January ; giving a range of teniperature for the year of 114.0 degrees. Greatest range of the thermometer in one month was 6o.5, in January ; greatest range of barometer was 2.223 in February; highest barometer reading was 30.989, on the 5th of February ; lowest was 28.766, on the i5th of February ; range for year, 22.23 inches. Least relative humidity was 29, on the 27th April. Rain fell on 133 days. Snov fell on 82 days. Rain and snow fell on 17 days. Total fall of Rain, 27,64 inches. Total fall ofsnow, r38.1 inches, Total precipita- tion inches vater 41.6 Greatest mileage of wind during year, in one hour, was 51 on February- 2nd, when the velocity in gusts was 6o m. per hour.",
         "'(4 PLUIL1C IIEALTII MAGAZINE. MORTALITY OF THE CITY AND SUBURBS OF MONTREAL, FOR DECEMBER, 1876. DîSEASE~s. r. Small Pox........................... 2. Meales............................. 3. Scarlatina....................... 4. Diphtheria...................... 5. Quinsy........... .................. 6. Croup...... ........... .... ..... 7. Whooping Cough................. S. Typhoid Fevcr,(InfantileRemittentFcvcr) 9. Typhus, and Infantile Fever........... Io. RelapsýingFee............. xx. Fevers ......................... 12. Erysipelas....................... 13. Metria, (Puerperal Fcver)........... 14. Carbuncle........................... x5. Intluenza............................ x6. Dysentery......... .............. 17. Diarrhœa ....................... IS. Pyomia........................... 19. Cholcra Infantum .................... 20. Cholera............................. 2r. Ague............................. 22. Remittent Fever................... 23. Cerebro.Spinal Meningitis. ........... r. Syphilis..................... 2. Hydrophobia..................... 3. Glanders............................ i. Privation..................... 2. Purpura and Scurvy ................ 3. Delirium Tremens 4. Intemperance .... . Thrush .............. 2. Worms, \u0026c.................... 1. Gout .......................... 2. Rheunatism..................... 3. Dropsy and An:emia.. ..............I 4. Cancer.......................... Noma (or Canker).................... Mortification....... .... ...........J 5. Scrofula ........................ 2. Mesenterica................. Phthisis (Cons. of Lungs).............. 3. Hydrocephalus.................. 5- Tubercular Meningitis................ Cartidforwvard........ ....... .. Total by Total Sex. both Sexes. mate. Female. 73 58 131 1 2 3 2 2 17 17 34 15 4 rg 3 5 S 3 3 6 2 5 7 1 I 2 I 2 3 I I 3 3 2 2 t I I I 2 x5 x8 33 2 2 3 3 144 118 262 ei cx .t, ~IV -Pa rastc s I 0~ Iv-r",
         "MORVALITY RETUnNS. 265 MORT LITV OF TUE CITV AND SUTURIS 0F MONTREAL-(Cw. Total b .Sex. bo.th J Matc. Female. 1 944 IIS 262 2 5 7 3 5 s Mid o f, Orgau VIT. O . .s 0 motton Bsroim.fn rd.................. r. Cephaliitik .. . ..................... 2. ApopIexy....................... 3. Paralysis...........,,...............I 4. Iksarity............................. 5. Chorea ................................ '5. Epilepsy............ ............... 7. Tetanus.............................. 8. Convulions.......................... 9. Other Brain diseases \u0026c............ r. Carditis, Pericarditis and Endocarditis... 2. Aneurrism.................. ........ 3. Other Heart diLeases, \u0026c ............. 1. Epistaxis...................... 2. Laryngitis and Trachitis..... ...... 3. Bronchitis ........................... 4. Pleurisy.............................. 5. Pneumonia ....................,.... 6. Asthma ....... .....,............... 7. Other Lung diseases, \u0026c.......... I. Gastritis ............ ............... 2. Entcritis........................ 3. Peritonitis.... ................. 4. Ascites.............................. 5. Ulceration of Intestines........... 6. Hernia .............................. 7. Ileus and Intussusception.............. 8. Stricture of Intcstines.................. . 9. Fistula .................. ............ zo. Discases of Stomach and Intestines, \u0026c.. ii. Pancreas Diseases. \u0026c ................ 12. Hepatitis........................ 13. Jaundic ......... ............... 14. Liver Dis e, \u0026c..................... 15. Spleen bisease, \u0026c................. i. Nephritis............................ 2. Ischuria........................ ..... 3. Nephria (Bright's Disease)............. 4. Diabetes.... .... ................ 5. Calculus, (Gravel, \u0026c)............... 6. Cystitis and Cystorrhoa ............... 7. Stricture.,. .... .................... 8. Kidney Disease, \u0026c................... r. Ovarian Disease.................. 2. Disease-of Uterus, \u0026. ........... .. . . Arthritis ............................ 2. Joint Disease, \u0026c ..................... Qami(1 ov.................**.. 202 170 372 8 3 9 4 5 4 I I 9 4 o S I 3 3 '3 2 2 5 2 2 .",
         "166 P'ULIC IlriAtTI MAGA21NË. MORTALITY OF THE CITY AND SUBURBS OF MONTREAL.-(Cen), Total Total by Se%. both :Sexes. r.. O State. Vemnale. IRrélngåti o r ....................... ... SA ...................... Integu 2. Ulcer........................ 3. Skin DLeass, \u0026c .................... S r. ............ ............... Child. 2. Premature Iirth ................... ' 3. Infantile Debility..................... 4. Cyanosis............................ 5. Spina Bifida and other Malformation.... During entition...................I 1101r 1 2. Childbirth .......................... poople. 1. 1Ol Age .. ...................... IV. Oc. r Nutn 2. Atrophy and Debility................. :ztion. . . Fractures, Contusions, Wounds. ....... 2. Burns and Scalds..................... 3. Poison:... ... .................... 4. Drowning......................... 5 Othewise .................. ....... r. Murder, Manblaughter............ 2. Execution......................... . Wounds......................... 2. Poison......................... 3. Drowning........................, 4. Otherwise........................ . . Chirurgici.......................... Not known.........x................ Infection purulente................... Emesis............................. Lock Jaw.......................... Total................... - 0 202 170 372 3 2 3 5 5 3 8 5 6 n 251 223 474 FOREIGN HEALTH STATISTICS. United Kingdom of Great Britain, during two veeks, ending November 4th, 11,900 births and 6,478 deaths were registered in London and twenty other large towns, and the natural increase of the population vas 5,422. The mortality from all causes was, per 1,ooo: in London, 20; Edinburgh, 14.50; Glasgow, 21 ; Dublin, 19.50; Portsmouth, 18; Norwich, 22.50; Wolverhampton 22.50; Sunderland, 18; Sheffield, 26.50; Birmingham, 20; Bristol, 18.50; Liverpool, 22.50 ; Salford, 35-50 ; Oldham, 29 ; radford, 23 ; Leeds, 23; Hull, 19.50; Newcastle-upon-Tyne, 21.50; Leicester, 21; Manchester, 23.50 Nottingham, 21.5.-Other foreign cities at most recent dates, per i,ooo; Paris, 24; Rome, 19; Vienna, 22; Brussels, 22; Berlin, 26; Hamburg, 23; Calcutta, 24; Bombay, 26; Madras, 35; Amsterdam, 22; RotterdamT,, 29; The Hague, 22 ; Christiana, 16 ; Breslau, 24 ; Buda-Pesth, 34 ; Turin, 18; Alex- andria, 46; Copenliagen, 18; Munich, 36; Naples, 20.-The Sanita, ian.",
         "MRTAT.LITY RETIIkNS. 261 TOTAL MORTALITY BY AGES. Undcr 1 year ............ 157 From t ta 5 y........ 157 \"5 to 10 ........... . . . . . ....40 \" loto 15 \" ........4 \"'15 to 20 \" ........9 20t40 . ......................................... 48 «40 t 6o\"................................................... .27 ot7 .. .......................................... 5 7t . ......................................... 20 30t . .......................................... 5 \" to 4o\" ................................................... 4 Ion yea and over .................................................. Not known ..... .................................................. 2 Total .\"................... 474 TOTAL MORTALITY BY NATIONALrXY. French Canadians .................................................. 309 B yritish aradoe ...................................................129 Irish ... ..................................................... r Engisht............................ ...................... 4 Scotch .Canadians .................................................. 3 Other Countries ... ............................................... 5 Not .....kno ................................................... Total ......................474 TCÎL'ALj BY WARDS. St. Anns -- rd ................................................. 55 Sth Antoine ................................................ 94 St. Lawrence ............. ..................................37 S Louis ......... .................... 33 St. JaMes \" ................................................. 92 St. Mary ................................................ III W eSt. ...Lawenc ................................................... 2 Centre....Lo................................................... 4 Fast........................................................ 13 Not kno ......................................................... .. 441 City Hospital............................ .......................... i Hotel ....Dieu ................................................... 9 ontreal General Hospital.......................................6 Other Institutions ..... .............................................. 7 Foundlings.......................................................... 53 Outside City Limits ................................................ 139 Total..... ................ 666 N. B.-The foundlings and deaths outside city limits are not included in classification of diseases, ages or nationalities.",
         "- - - ~ 54fDN ci -l Co.4 UfVZ t-f icc-:a,- \"I C4 î t-Ci i co .n n -q=i ci i w~ng3 liq WOJJ Rfvap JO 10AOJ -mo g sipuu wqiw-a"
      ],
      "type" : "document",
      "title" : [
         "Public health magazine [Vol. 2, no. 8 (Feb. 1877)]"
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         "[Montréal? : s.n., 1877]"
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         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine"
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         "eng"
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         "Monthly."
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         "text"
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      "location" : "http://eco.canadiana.ca/view/oocihm.8_05173_36",
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         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine"
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      "label" : "[Vol. 3, no. 12 (Mar. 1879)]",
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         "text"
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         "Monthly, July 1875-July 15, 1883",
         "Bi-monthly, July 1874-May 1875"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "~S~IARY J RN4 L * INDIVIDUAL HYGEI;~ Edward ?l1a yuer, D. - - VOL. 11. O19T A9_Ç-1 1879. No,. 12.. \"The Crying 'Want d~ûr~uai~6 te publie in hygicne.\"-.3fd. -nd Su Re riea, Ph iladd*h i, \"To prevent dlizsense is the niost important -aimni 6'fhe --endécat1ec THiE purpose of this jouriffl is to diffbsc a L-nowledge of the Laws-of Heaiih among the pcople. To rhak-o p~no bIiiexjhan cuýre Ahe flstgbject Jf both the Physician daid'the *bi,î., \"tos;pcr'mttas ý1sbtance.r _MCdfi1 ~Zl~trom ail wl-o ar. interested in tje fuur wel-èég ofjhe Canadizn ~~je. .'M'llyctâissist in j tils f-portant )fork ? Fî f' U\" ýn L ..... * = oftar To em..... .... . . .. nigS2 . . ...... 419 - c' «AirsoTb ................. 415 1pc - 4in Tht m ag ne'g.........1 ............... Ektracts froni a eof mayjnse foF C ommendetor' '*fit çoulId-bctit i hbu uo.a4i.tce~udb ~ l ~ b -£Wit rte x D \"à A raiable =Wes, which qught to bc là -the. ha=d o! r y)ao, dc.n osnoIC1'T .aA e f-mao7Reo aE1cd",
         "DbEVOTE È TOj PUBLIC. HAtT I; Vol- III.] MAC,179 1jNo. . RELLECTIO-NS ON 'TU1E HIGRERE ED.VCLTION 0F 7WO ERO,1 A.11EQTCAL ]POINT 0F VIEW:; S1U,ÇGESTEPjY Tge' IIEAT 0F 1?PIL TE- ACHFRS. .BY A. HUGHES BE_-NNIT, \u003eP FROM TRE SAK1TARY 41ECOYDs 'I'hough this paper islengthy, thL- subjéc, efi'e«ting, as it does ýthp the generâtions-of «the futifre,.is of such vasit -i!pprtance, and; br. Bennettis s«Uch -high;,author4ty, ýthat -we give ît- in- fui.' Ainông. the large and,*in'creasinýg-llocks-oýf patienith1ôc*roivd'thé outdoor departments.of outr nètropol,'.tan, bospitars, thère-is a.,class of persons ývho- ofIate years ýhave-,rendere7d theinelVesiconspicuous blydeman'ding medical'.asâistance.ý 'ýlhesë;are wonien-iwh6 2haýve-to gin Îtheir livelihood by -the exerion of their ifitélleétià 'facu1tie, and -who follo*w calflngs which.-tequire.the constant exorcise o-f théiî mental, ndwe-s. MxÉ excample of thisis thesô-ëàled' puih.adê ývhose-.caéee.we shaI1-endeàýoht.bnily to sketch, A youpg.sèl-cô girl bf-about4thiteenbyearâ, of ageîs~eakd o euisà~~d telligenr Itisusgested. tô -her -'paitntqthàt àh-hudbc4 teac:heri. -lhy\u0026setnthé -child is ai oxce plated uudâi training. Atodn oifrntbideie rm4eepplUe -routine ôfiefrtenx i~or -seven-yeais is asfolows---T-hey bave, fiâst; tci:.continue;tb-eir !edocation, by iecenving fromà -ôthe*r% several 1ours of s'\u003eei1, itution ;every dey, ind a cônsideibIL propoirtion .of iheir.'enings ~p ~ Se~igtèuevsrrui~ .Secondlv, thty--therâselti-vts~ to-tèàch thê.yâungëi elildreiï -ii6hè -school for frôumfive toSix iours daily.! Thirdly, :thê_Iiavxe to,'pas* aGovernment-examination at fthe ed'- of eath- er wliich e;tll -frherspecial:pHvati2 study. Thiis tourse \u003côf istrubtion -coùitinues :fr-five years,-7 and 3Eeing- satisfactorily -tzoncludéd,;, theppil bcon an assi!stant- teacher, Dnigtétet wyasse'ither \"*e:1\u0026h in -a colege ani .theretundergÔes-:a specià'1 anci ýYtçîaiccôute d£f si-uey-- iùr, -ifir zpeètd7h !ite h* fn'Iedy describedat scho1,.ànÈt furfher prépares hýit lf;foYafal exâmins\u0026- -tion.- atét-whfxcb, if bhezcqfuit--kersé1f in aunéffic13it anrs6 -becornes a. full teacher.-and. as suchli'scer-tified -by Govenieht",
         "THE SANITARY JOURNAL. Such a career may be said to represent the intellectual life'of an ordinary student, in which there is considerable strain, a constant exertion to acquire and retain kn5wlèdge, anxiety as so results, and possibly worry and irritation in details. In consequence there is diminished exercise, Ioss of frpsh ai. and generally deficient hygienic suroiuidings. We have said that numbers pf ý4chjyoung women are, c6nstantly applying to the liospitals for medical assistance. They.complain of physical debility, anamia, dyspepsia, and loss of appetite ; their functions are disordered and irregular, and they pre- sent the usual conditiorns of bodily weakness and depression. Their nervous systein and mental' .faêulties are ,lsJ affected. They are irritable, nervous, depressed, and melancholic; they do not sleep at night, .partially lose their mernories,, .hey suffer from violent head- 'chessänd cannot settle to woik ; 'they have all kinds of ne-rvous and subjective pains, hysteiical symptoms, and in short all. the phenorrrnta ofnervous and mental as- ivell as 6f physical exhaustion and debility. 'If our patientš be asked the cause of these ailments they will with one accord say that it is» the\u0026hard and constant brain work combiied ýwith wory and perpétual anxiety. From, teachers let us turn aside for a moment to woren who follow other intellectual employments.. If we e amine :the-natter we shall fnd, a certain number of exceptionsalwàys being allowedi, that as'.a-rule whein females are- subjected to severeand prolonged mental exertion,..more especially if it be associated with anxiety and -physiçal fatigue; .hey break down under -the ordeal. How- many excel1ent and clever women have we knoWn! who, éither from neçessit or fron love of study, have dagerly embracéd-.ard dis- inguished them-selves in literary, scientifit, andêducational pwrsüits. ;Burning the midnight oil, contending it may bê with diffituliéa, harassed with.doubt-and anxiety,.:debilitated frtrú want-of lest and .bodily. fahgue, they struggle' on, their circumsainces or their ,enthusiasm impeing tnçmr bu- at last tbey, like tliepupil teachers, giyp way an4 suc\"cmb fior sheer:'exhaustion. The bjects-of this Ëaper: ae to end.avour-to :explainiwhy this deterioratcn of health should.so frequently take place in w.oen when subjectêdto bôdily nd mental strain,. in disiincti.on to mnn, in wh.om understhe saine .çixcumstances it is .çomparatively pnusuolt. and with the ýview of elucidating this to discuss the physical and:intellectuailcapacities of thysexes,,and. to asçertain. whether. in these respects. the male and female are uponwan.egyal foot.ing. That tbesepropositions may be .rendered intelligible,,so.meý preliminary .observations are pecessary. Tje Physical Coiformaoion of Wonmn.-It will be igenerally con- ,ceded that woman is physically weak.er and lss powerfully. built than..man. With few exceptions,this distinction- between the sexes s imiversal throughoui the entire animal kingdom. From the slowest to the;i ghest species, thé gëeral structure-of thenaie .ditTers from, that.ofl e feniale in the size and strength of bis hones .and rmsclës,. the form of his head, thorax, -and ,ibs; ad in the posses- sion of speciljweap s o- f offence and defente. . . the, human 39,3.",
         "THE HIGHER EDUCATION 'OF WOMEN. being, althotigh this to a certain extent is:modified by circumstances, the sane geheral 1aÇi ho1ds.good. Owing. to his cronfopniation, .th\u0026 man is ,capable of:performing -andeof enduring more physicaHlabour and' fatgue, and: hence on him.frôm time immemorialhas fallena the share of mùanual. toil, and of suppoting and protecting. th othe. and Weaker sex. It is..true we -sométimes meet with- DaugLers of thé pionigh; stronger than 'men, Iluge -womeri-blowzed- withs health, atici wind and ktain And 1ahýour. Such, alli iil admit, aie exceptions, aid -by no nieas repreeint- the standard woman. .1 'T'he geiei-ative ogansform a most impoftant dišti'nction betweeïî the sexes, and must, tc-a gteat exteût inôdify. the-habits and, tareé of the -female,. In 'theiatui-al course of evenfS, iáy ÿ.ars of thè niogt vigoraus ind active period of :à woman's lifé aie spent id geriinating and südkling het offspring, durindwhich tiine-she ls physically capäble of littléelse. If she has'not .hildren, frequently recunrig periodic pÉoceses take place, yhich under' thè best circumstances rendei her specially liable .to derangciièéñt 'of hei general-áhea'lth, and undet adverse -conditiotis sfie is almosf certairi to fall:a vidtim. 'This was -démôistiated in the days of'lavery whenthe awners, either not knowing or iaring about these physiós logical laws, forced ther wién to labour-continúously-in thè,fields in consequence of-which housnàds of théñÉ died- of those numeoús ils to which female flesh 's heir. \\Ve dannot Iiei-e ënter-at leng t into this ve:y important subject, but nierely indicate that the whole' sëxual system of woriün haš a profound influence oi her 'àhiysical nature, which does it existsto'the-same extent i nan, andà1lthotigh for conventional ieasóns such 1uestións are *ug1ly suppresse d i public controversies-on the 'advàùèeincnt of 'hë- sex, ihère cài te' no.doubt that.they should not bé foigotten, bearing- as tey.dô :Ç Most impc::tantiand practica'l ifiluence on- the subjec. From these corisiderations the conclusion nay b d'rawn Thât woman is structurally less powerful and vigoraus than-nan, that'shë is lesscapable of performing acts of physical exertiôn, of .enduing fatigue 'and exposure, -anti of aoiñliàtirig against adverse rtirc.Li stances. That-inoreover the natüral- functions of ier sex,-wheit thêy do not -actually incapaciate her fiofn' actioni ten'der hèr sptcihly liable under disturbing conditions, to deterict\u003eatian~of general' iheáltb ThIe eivous Gonfonniatiåt; of Woïäh hoe -n ieivbü å system, :Cctrommoin with -the .othëî- structurés, óf:the;bbódy, is smallet and less voluminous in thé -ferrile'than in the mle. Its fuetiïis characterihd' by compaative weaËness, as eridénced by great susceptibility.and instability, and also b\u003eprompithess là esdint to ail kinds of.stimuli. lIñ.' oinen there is lessrer'us capàdify and vigour, diminished powei\"-'of control, anid a greater-readiness tô break down under-physical and- itental straih. t \"s otOribustliàt the conditions termed nervous 'and -hysterical aré -alñtf é tiely conflned -to the female se, inwhich âfiy- ae-êtidinelj c''inoñ 399",
         "400 THE SANITARY JOURNAL. Every physician at a hospital who treats out-door patients knows, that for every hundred men he prescribes for, he is called upon to treat at leaàt 500 women. On the other hand, the male wards are always full, while many of the female beds may be vacant. This simplyindicates that serious disease is most common in men, while trifling nervous ailments are almost universal in women. Most women are naturally so predisposed that, when subjected to fright, grief, anxiety, pain, and other such circumstances, they feel (in addition to the direct distressing effects) various remote subjective phenomena in the forni of suffocations, spasms, bodily pains, faint- ing, convulsions, and a general liability to violent and explosive emotional demonstrations. If tl.e causes are permanent their effects may become so, and deteriorate the. general health, and there are thousands of women wvho are hopeless invalids, often for life, froni conditions acting on their susceptible and mobile nervous systems, which in the other sex would have produced no appreciable results. There are, of course, in this as in other things, numerous exceptions to the general rule, many women having their natures mucli modified and approaching the male type, and in the same way there are some men who are of a nervous and hysterical temperament. We may then assert as a fact that the nervous .vstem of the average woman is more susceptible and impressionable than that of the average man, that it is in consequence more readily ùnhinged by mental and physical distress or fatigue, and that when thus disordered it reacts upon the system, so as to cause permanent disease. Tue Intellectual Conformation of Woman.-The cranium of wvoman is smaller than that of man. The*weight of the avçrage female brain has been estimated at from fiye to six ounces less than that of the average male brain, and a general inferiority in size exists at every period of life, from. the new-born infant to old age. Not only has this comparative decrease in size been determined, but it has I)een ascertained that the female brain is relatively smaller than that of the male, as conipared to the weight of her body, and researches on this subject have shown that while the encephalon of the female is io per cent. less in weight than that of the male, her total bodily weight is only 8 per cent. less. The brains of different races vary greatly in size, but whether it be in the most highly civ.-ilised n- tions, or in the lowest savages, the encephalon of the female is always com- paratively andrelatively smaller than that of the maie. These facts show that the difference in size and weight is obviously a funda- gnental sexual distinction, and not one which can be explained on .he hypothetis that the educational advantages enjoyed either by tie individùal man or by the male sex generally, operating through a long series of generations, have stimulated the grow.th of the brain -n ene s. mr th9anX the oter. A, uther circumstances being alike, the size of the brain appears to bear a general relation to the ental power of the individual. There are doubtless exceptions to is rule, but unquestionably the general axiom holds good in large",
         "THE HIGER :EDUcAUTO_ OF wViMEN averages.; therefore as -e prgan of intellect in the. femjale is smaller, and lighter thaâ that in. the. male, we may, fairly assumé that it is less capable of such *high ahdI -;xtended meital tpoWersj It is.justly stated that quality as well as quàntit should be considered, but Qfl this we can only judge by results, in which case it must alsp-be con- ceded that women are at a disadvantagd. Thbis assu'mption, if it cannot be anatoniically demonstrated, is, amply pièvetl .by facts. From the beginning of the. ;vorld, as man.-has been.baracterisedi by his physical force as .compa#éd .to woman, so -has ,hè been, re- markable for his superiority.'of intellectual poveu - Atsevery-agé,-.in- every country and climare, and umder every circumsta'nce, we -findI that in the highest qxIalities or tuind,-of regson, judgment, genius, in- ventive power, capacityfor aquiing and utilizing knowledge, nian- stands pre-eminent. It is, true that4here have been-. sone noble and. illustriotus woten who :have proved themseélescf thehigheht mental capacity, and who have risen to the first rank intrariodi departmients of intellectuil cultue, but it must be admitted that these.are rare4 exeeptions, and that êven they in, every particular have.been -enor- mously: 'utnumbered and suypassed by men. It mey then be- reasoned that the female has hitherto not had the opportunities orî education, necessary to fit br .to place herself on an equality with the'other sex. This argument of itself proves t'nat she has not been bori with the Mental- force to, assert -her pretensions, for itcannot be, maintained that physical strength alone could have forced her into au seconda y intelledtual. position. \"Besides, it is not so : for in literature; poetry, music, art, and ininurirousother braches of study' in whichshe has had as many if not more opportunities of pérfecting herself than iian; she has ra-rely proved hiselual and never his superior. The intellectual'powers of womfen not only differ in dégree from- those of man but also in èharacter, Her mind participates with béb physicil cotistitutioi in beitig endoived with greatsensibiliy, and. hence her acuteness, perception, and' tact. She-seizes withurapidityi objects -which cone bèfore her, and observes; by instinct an -iqinity of shades of rneaning in detai!ý which migbt escape the\u003e iSt obsei- vant of men. She oftea artiyes at conlusionswith great, celeity. and adroitness, but -then her tesuits are as fiequen't1ywrong as ight. Her.percepti6n is fine and peretrating rather:thanettendUd or .pro, found. She' readily occupiesthers'elf with small impressions.and de- tails, b'ut is arresited there, being lèss capable of- grsping-genem.prin cipfes. ' Altôugh-her nind -may thus embrace à variety off partidu- lars, it is t little practical putpdse, from.an intelleçn-al'poirit kf viewv4 as she catiot iix her attertidn on *any idea. or ttain .of..idéas-for anyi length of tihie, and reason oùt -a. logical: cÔnclüsion-. .Weman dis-. likes and a-ô ida that hard %work which -requires lohig. and prcfountL mediuitoni rer cha.acter 'eing adverse.-to me study:.Oi ausnRa science. Her thoughts wandet-, shé beceies-4mpatient, dnd her-to- mobile irxiagination is unable to rivet the-attention on O.- dry details: of a piactiele sùbject. She enterS with enhùsiapm.and- oftep %witl,",
         "402 THE SANITAIRY JOURNAL. unnecessary vigour at first, into any new project, philanthropic, edu- cational, or otherwise, but rarely carres it steadily out to a success- fui termination. Her opinions are formed by her feelingG rather than by the operations of reason. Her forte is that species of knowledge which requires more tact than science, more vivacity than force, more imagination than judgment. Her chief moral philosophy is directed to the study of individuals and society, and the sagacity of a wonian in acquiring traits of character and penetrating true motive, is what the logic of à ian rarely acquires. Wise women-the so-called blue- stocking-know nothing profoundly. Their natural acuteness of perception enables them to seize a number of details and isolated particulars, they fancy they understand themi thoroughly, they con- found theory with fact, the real difliculties they do not surniount, they cannot fix the attention long and deeply, or persevere im over- coming obstructions, and they feel no pleasure ini habits of profound ieditation. They therefore remain with their acquired superficial. knowledge, pass rapidly froni one thing to another, and there only rests in their minds certain crude ard incomiplete notions, with which they are quite satisfied, and of which they make the most, but which in consequence lead to false and illogical conclusions. These observations are not for the purpose of merely lauding one sex at the expense of the other, but for a defni.e practical object as will subsequently be seen. They serve to indicate that the average woman has been by nature endowed with a brain and nervous sys- tem of inferior anatomical construction to that of man, and that in consequence her intellectual powers differ from his, both in degree and in character. Yhe Disposition of WVomezn.-Voltaire bas said, 'le physilue gou- verne toujours le morale, which is strikingly illustrated by the present inquiry. In the lower animais there is a marked difference in the disposition and character of the sexes. The males are of .a comba- tive nature, and h'ave a great tendency to fight. They are bolder, fiercer, and more untamable. The females have more highly exalted perceptive faculties, they are cautious, artful, and cunning, as is abundantly seen in the ingenious methods they adopt in the hiding and protecting of their young. These properties serve them to some extent in lieu of physical force, and they are altogether more gentle and more tractable in their nature. The same, in a different degree is obvious in the humati female. Every mother knows that a male infant is more troublesome to rear than a female. As children grow older the difference becomes more marked. The girl is less boister- ous, wilful, -md imperious than the boy. She is more delicate, im- pressionable, and artful, pleased with attention, solicits admiration, and is readily moved to tears at suggestion of sorrow or pain. He courts danger, is bored with solicitude, and, more blunted or careiess laughs at what she weeps. She, with ber doll, already anticipates the gentle duties of maternity. He, with his sword and trumpet. mimics the glory of war. On the disposition of the fully developed woman poets have written volumes. We, however, have",
         "TUE HICHER EDUCATiON OF WOMEN. to take a more matter of fact view of her than they have done. \\W'hen Hamlet said, - Fraîlty, thy naine is wvomian,' lie Vas scieitifi- cally correct. in more senses than he intended. Her natuiral muscular feel\u003eleness and delicacy of constitution, renders violent exercise and labour distasteful to lier, and lier inferiority of intellectual power mnakes severe and conztant mental exertion a task. While the ian, full of bodily and mental vigour, goes forth, seeking and braving danger and labour, proud in the responsibility of tiose dependent on him , the woman fulfills a welcome tas. at home, ir the less active duties of mnatrimony, and of domxestic and social observances, equally happy in tle possession of strong arm and head to protect and Suppon h ber. Suen an existence, however, fosters a great suscepti- bility of character in addition to her natural conformation. Fiers is often a mixture of e:streme happiness or of prof misery. She feelpain, grief, and anxiety acutelv. To these she readiiy gives way, and as iapidly revives from tleir effects. Sensations of all kinds act on her powerfully. These she cannot control, but exaggerates into extrenes, and manifests bv violent deionstrations. If she feels acutely it is not for long, her sentiments at the time being easily re- placed by new ones, and her mental distress, if rapidly induced is mîîore poignant than deep. \\Voman is essentially impulsive and emotional ; her sensitive and changeable nature is iecessary for the part she las to playin life. She feels more than she thinks. A man forces lus way by pjower of body and intelligence. She acts on him hv tact and bv ail those weaknesses in vliich uith him lie her chief power. Her flexibility of ch.aracter gives rise to caprice which con- s' oý a br :sque passage from one sentiment to another totally op- posed. Her habitual feebleness and delicient vigour inspires her viili iess conndence ; and as a wonîan cannot tierefore act directly, he einpli oys indirect neasures to effect her ends. Hence the natural desire to please, inherent in the sex, the artfulness, the dissimulations, the litie inmanageeniets and intrigues, the graces, the coquetry and usiler seductive ways, which to a certain extent have always been ceeded tu by intellectual and physical to:ce. For the saine reasons, and from the same cause. her w-eaknesses and vices aie greater, and no mai can comnpcte witlh a reallv bad w omnan in petty jealousies spitefui actions. revenge, and eve., iii the ingenuity and vindictive ness of crime. It is tlis affectability which, if it be a cause of lier frailties. is equally eflicacious in givng lustre to lier virtues. It is this wlich constitutes the cief charm of the motlher, who instinctively detects tie slghtest desire or change in her offspring and impulsively actb for its benent ; of de wife who sympathises withi and encourages her huusbanud, iaggcd and anxious for the common weal : and of the nuîrse wh1)o takes in at a glance all the details and wants of the patient and niîsters to his reqtmîreoiints with pitv and devotion. It is this which gives rise to tlat conpassion, symupathy, piety, and nu n~o dispositonhich arc th~ ief characteristics ot a woman. It is the feeling of poverlessness vhiiclh niakes lier identifv herself with the unfortunate and unhappy, which natural pity is the base of all Scial virtues.",
         "THE SANITARV JOURNAL. The,, Efects ,, Social Life .ut Educiation on Women.--There can be little doubt that social ilanners, educattion, and an infin ity of cir- cumstanes ·ay affect the qualities voman derives from her material org.miîszatîon, and cven efiace the original character vhich nature has given her. in the snplest condition, the man lanour with bis ha-nds and with his vils for nuitual suppjort and protection ; the wonan rears ber children, tends the sick. and conducts domestic atlairs. Such, if the most primitive, is probabIy the heailtiest -and bappiest coiduoni for the feiale. Her sympathetic and usceptible nature has here e\\ ry scope for action without being shaken by rude and ott-repeated siocks. In civilized lif . esp)ecially amongst the upper classes, everytbhng seems combined to foster and increase the natural atfectaility of wLoman's nature, and society renders her, aiready un- fortunate by organzatît n, the victnum of the imost painful and varied series of moral and corporeal affections Nedical philosophers have declaimetd. and vill long entinue to do so, in vain, against the whlbse sy stem of tbe education and. bringing up of wonen, n hich is rt solely b the ot tiitm eni attractive, and sub- seqiuently securing for them lriiiiant settlinents for life, at tbe ex- pense of their health. Much mi;;ht be written on this subjeet, suffwe i at present to state tbat the useless and insii)tl ives that most younc ladies lead, tie tot i want of an intelligent interest ard occu- pati n. and the unnatural and artiticial existence pursuetid, .re highly calculated t\u003e inji;i usly enhance that n.tuîrai aftectabiity with viLch she has b'ee' in . The system oi fashionable boarding scbhoois, whose anxietv to render th ir- pipils accomplished and fascinating at ail costs, results in a forud and m the samie tine imperfect training, which. combined vith ]uxsnous living, absence of exerzise. and other healthy circumstances, tendk t increase the irritability of the nervous s stcim and to foster a psrecciouîs e-voluton of character. As this is increised, tone and energyv ame dimmishied. The girl returns front school a wvîvayaid, caprieious, and hyvsterical vouing lady, weak and unstable in inidi, h: it-, and pursuits. She enters into society, and there bei wholc node of hfe further contributes to ber unfortunate condition. The Coispentns, tisa. pointed atection anti anity, the artitRi.b excitements of bals, pîbne entertaîanents, late hours, and all the frivoitis ain leasures oi fashion tend in tbe samle direction. ie ciltî atlon of insusi*. poeitrv. novels and other iniiammatory literature furnish nluisions contrar to tle acttal state of societv. ler ver dress seems made n purpose to interfere wu h fie heaitby fuinc- ion of her most vital organ, a;nd to prevent the free play ofl muscular action esenal to a soundi constituon. Girls sLujected to such a reme, when their minds ani bodies shoiuitd Le directed in a totaliv oppsite direction, haite one orsder of iacilties alone exercised, and iese tnrdoinating over zhe reasoning powers, cause a host of ner- vous, harous, byste cal, ani hochsndïical disorders. Thus w'omen fr m. their arîest day- i constantly subje:ted to the voke of prejudices, are under the necessîty of a perpetual state of acting and deception, of dissemnbling their desires and real inclinations for",
         "THE HIGHER EDUCATION OF WoMEN. 405 the sake of propriety, of keeping to theiselves the most )m\u003eveifutl passions and the strongest propensities, and of fVigning a caironess and indifference when they are devoured by a burning fue. As to edtcation, ve have already pomted out the general unsatis- factory nature of the intellectual sttdies of most vomen. That idleness, and the absence of suitable and substantial occupation for the mind which so comnonly exists in the higher ranks of socîety, are the sources of great evils no one wIli dcnv. Fur the frivolous andi luxurious so-called duties of fashionb.tle hife, aithough exh .uting and fatiguxin, cannot be saidt constitute ial health.y exercise of ming or body which is desira ble for young women to stave off disease and maintain sound healti. Study and occupation, at thue same time positive, useful, antid attractive, are the' best coirectives of an imagination ardent and disordered, of a nervous system susceptible and hypersensitive. These considerations beingz made patent, mnany wonen, with the impulse characteristic of their sex, have rushed to the opposite extrene. They wish fen.tles t receive the saine edu- cation as maies, anId to com.pete with themn in the ntellectual struggle for existence. We have, however, see i tait both the vonan's body and nind are inferior in \\ igour and power to those of the man, and accordingly if pitted agmunst one another in a phy'sical or mental race she, to use a sporting phrase, would be heavily handicapped. She will not. as a rule, reach lis standard, and if she endeavors to do so, it wIl Uc at the expense of her heualth. The brain and nervous sys- tein, like other organs, if overvorked, becone the cen res of activity, and] are fatigued this in.reases cxisting susceptibility,- and hence arise symptoms of nervousness, hysteria, hypochondriasis, and insanity. These acting on the body produce emaciation and other diseases, the offspring of an exiusted constitution. The conclusion, then, to be drawnu from this section is, that in addition to the nataral atfectabilitv of her character, this condition mn w'omaI is fostered and augmented by t .e artilicial exigencies of civilized life. T'hat whercas illeuess and want of occupation are the greatest sources of m tny diseases peculiar to the sex, the opposite extreme of mental strain is equally prejudicial. Co'd/uson.---We have endeavored, ini the brief space allotted to us, to point out the physical and itellectual capacities of women, an iii consequence the disposition and instincts which nature has implanted in her. This iundanental'difference between the sexes we have seen is not due -o education or spocial cultivation, but to a primary development of :he system, each having those peculiarities best fitted for the part it h is been born to fultil. Thîere can therefore be little doubt that the most natural and heaithy condition for a woman is a properly assortedi marmiage, in which she has children, with wihoi she has usefi and congen*-al occupation. and by whom ail her sympatIh èes and lest instincts arc developed. In modern timn grent .and laundrale fferts are being me,.to ffect inmr ment in the higher edvea ion of women, and as there are nany who either fron choice or c.rcumstances cannot occupy that position",
         "THE SANITAIRY JCURNAL. which it is the pride of most to possess, a movement has been made whereby they rnay earn an independent livelihood by the exercise of their mental facùlties. We are informed by energetic and doubt- less well-meaning speakers from the plaff nn, that women have hitherto\" been undler subjection, that they .,nould emancipate them- selves, that their inte!llect is as good if not better than that of men, and that they are as capable as they are, of the highest mental culture, and of prcfiîting and distinguishng themselves therebv. It is unquestionable that suitable occupation and education are ot the highest importance to tl)e well-being of women, and that all due encouragement should be giver. to those wyho endeavor to provide for thern an intelligent interest, in life. But in avoiding Scy lla1care nusit le taken not to drift into Charybdis. To say that the majority of wornen are fit to co - successfully with men in the intellectual wofld, would, we belie e, for the preceding reasons, be a most in- jurious doctrine, and lead to disastrous results. Our text, the pupil teacher, is an exanple. A young gil, between the ages of fourteen and twenty-one, the nost anxious and inportant period in ber whole life, when ber mental and physical constitution is undergoincg devel- opment, is put under a severe intellectual strain. She is irritated and worried all day by teaching children, she is fatigued by bard study, and is rendered constantly anxious by the frequently recturring exam- inations on which her repuLtion, and it may be ber living, depends. Such a career does not as i rlie break down the young man, but in a large number of cases it completely unhinges the woman. She, in fact, is compelled to perform ithe work-of a man without having his organic lasis to depend on, and hence, as a consequence, ber entire system suffers. So it is with women who follow other pursuits requiring severe mental application ; they age before their time and finally succumb. It is truc that men occasionally give wav under the saine ordeai, but these are comparatively the exception, and this is as ofiten brought about by the assistance of other circumstances as by vork alone. It is also a fact that thurc are some women who, overcoming all ditìicultnes, have fully acquitted themselves of the highesi mental exertions without injury, thus provimg themselves to be of masculine capacity. .Whether for these the Church, ihe Bar, and Physic are to throw open their ans. I leave for others to decide but that the majority of the sex wouid be benefited by a systematic encouragement to follow learned professions and othier laborious callings, would be, we think, physiologically and practicaly an error. How unmarried women who require to earn their living are to do so by the exercise of thir intellectual faculties, is one of the greai problems of the day, and by far too extensive a subject to discuss.at present. Our aim) has been to point out that in controversie s on the question the medical aspect of tho case is frequently lost siglt of, and it is forgotten that in the com)etitior. for liz', wonan is the weaker vessel, and liable to be broken when to ugily handled. Sage piniosuphiers niay speculate what age may eulect evolution, but taking woman as we flud her, we believe tiat ber welfare is to be 4o6",
         "PAINLESS DEATH. consuîlted, not by encouraging her to take an independent position in life and by fostering a contempt for marriage, vhich is now the professed tendency of the strong-minded voung lady ; but by edu- cating her in sucb a iudicious and senoible manner as will make ber a good wife, nother, and useful member of society, wbich is unfor- tunately not the inclination of the present áge. If this were more systemnatically carried out, there would be fewer single wonen under the necessity of working for their own living ; the outcry in behalf of these unappropriated biessings would be modified, and on enter- ing the married state, which is the happiest as well as the healthiest condition, they w id place themselves in the position that it is in- tended by nature they should occupy. Seeing cither sex alone 13 half itseif, and in true marriage lies Nor oqual, nor unequal ; each fulfils Defect in each, and always thought in thl ., Purpose iII urpose. will mn will, they grow, . lThe ,ingle pure and perfect animal, The two-celi'd heart heating with one fuil stioke Lîfe. PAINLESS DEATI. (Fromn the National Medical ReN jew.) in one of his lectures Prof. Tyndall spoke of the probabilities in favor of the entire absence of pcin accompaiiyinîg death by light- ning. It is popularly :upposed that ai impression made upon the nerves-- a blow or puncture-is felt at the precise instant it is infiicted. but such is not thè fact. The seat )f sensation is the brain, and intelligence of the injury must be transmitted to this organ througb a certain set of ner-.es, acting as telegraph wires, before we become conscious of pain. This transmission or telegraphing from the seat of injury to the brain requires time, longer or shorter, ac- cording to the distance of the injured part from the brain, and ac- cording to the susceptibility of the larticular nervous system operated upDn. . Helmboltz, b- experiients, determined the velocity of this nerv- ous transmission in the frog to be a little over eighty-five feet per second ;n ithe whale, about one hundred feet per second ; and in nî al, an average of two hundred feet per second. If, for instance, a whale fifty feet long were wounded in the tail, it would not be con- scious of the injury till half a second after the wounid had been inflicted. But tl-- is not the only ingredient in the delay. Itis believed that to every act of consitousness belongs a determinrte miolecular arrangement of the brain, so that, besides the interval of transmission, a still further time is necessary for the brain to put itselt in order for its miolecuies to take up the motions or positions necessarv to the comni.ktion of consinisnes Hl4mholtz considers that one-tenth of a second is -required for this purpose. Thus, in the case of the whale, there is, first, half a second coinsumed in the 407",
         "THE sANITARY JOURNAL. transmission of the intelligence through the sensor nerves to the brain, about one-tenth of a second consumed by the brain' ii con- pletinqt the arrangements necessary to consciousness, and, if the velocity of transmission from the brain thr ugh the motor nerves be the same as that through the sen5or, abo.:t half a second more is consurned in sending the message to'the tail to defend itself. There- fore, one second and one-tenh would elapse before an impression made upon its caudal nerves could be resonded to by a whale difty feet long. If we regard as correct the calculations representing the average velocity of transmission in the human nerves, and if we estimate the distance from the origin of the flanients in the lirain to their termi- nation in the foot, as five feet, the time required in case soine one steps on your favorite corn, for the news to be telegraphed to the brain, for the brain to prepare a message, and to telegraph the same to the muscles of the leg to draw the foot away, would be about one-twentieth of a second. Now, it is .quite conceivable that an injury iight be inflicted which would render the nerves nnfit to be conductors of sensation, and if this occurred, no matter how sciere the injury might be, there would be no consciousness of it. Or it might happen that the pow'er of the brain to complete tIe molecular anargement necessary to consciousnes; would be wholly suspended before there would be time for the transmission of the intelligence of the injury. Ià such a case, also, although the injury might be of a nature to cause death, this would occur wit hout feeling of any kêid. Death .in this case wouli be simply the sudden negation of life, without any intervention if consciousness whatever. Doubtless there are mnv kinds of de'ath of this character: the passage of a rifle-bullet 'througlh the brain is a case in point. The time required for the bullet in fuil velocity to pass clean through a man's head may be roughly estimated at a thousandth part of a sec- ont'. Here, therefore, would be no roomn for sensation, and death would be painless. But there is another action which far transcends in rapidity that of the rifle-bail. A flash of lightning cleaves a cloud, aple-ri:g -idi disappearing in less than a hundred-thoustindth part of a second. and the-velocitv of electricitv is such as would carry it in a single second of time over a distance almost equal to that which separates the earth and moon. . A luminous impressiz n once made upon the retina endures for about one-sixth of a second, and Ibis is whv we sec a ribbor of light when a glowing coal is c.aused to pass rapidly through the air. A body flluminated by an instanitaneous flash tôntinues to be seen for the sixth of a second after the flash has become extipct ; and if the body thus illuminated be in motion, it appears at rest at the place where the flash falls upon it. The color-top is firiliar to mnost of us. By this instrument a disk with d fferentiv-colored sectors is caused to rotate rapidly ; the colors biend together, and, if they are chosen in th-e proper proportions, 4e8",
         "PAINLESS DEATH. the disc will appear white when the motion is sufficiently rapid. Such a top rotating in a dark room and illuminated by an electric spark appears motionless, each distinct color being clearly seen. Prof. Dove bas found that illumination by a flash of lightning pro- duces the sane effect, During a thunder storn he put a color-top in exceedi ngly rapid motion, and found that every flash revealed the top as a motionless object with its colors distinct. If illuminated solely by a flash of lightning the motion of all bodies on the earth's surface would, according to Prof. Dove, appear suspended. A cannon- bal], for example, would appear to hav'e its flight arrested, and would seem to hang motionless in space .as long as the luminous impression which revealed the ball reniained u.pon the eye. If then, a rifle bullet passing througrh the brain moves with sufficient rapidiry to destroy life withuut the interposition of sensation, rnuch more is a flash of lightning competeit to produce this effect. We have well-authenti- cated cases of people being.struck by lightning, who, on recovery, had no recollection of pain. The Rev. Dr. Bartol, who was lately nearly killed by lightning, ex- préssed the belief that if the stroke proves fatal it must produce the nost agreeable mode of death ;. but to be stunned; as he was, is verv unpleasant. As soon as consciousness returmed lie exierienced a terrible serse of cppression and an irresistible weight seemed passing through hin, while his mind.was da2ed so that for a while it seemed he had suddenly beens precipitated Into w'onder-land. His recovery was attended by headache, continued for a week. The folloiving case is described by Hemmer: On june 30, 17SS, a soldier in the neiglborhood of Mannheim, being overtaken by zain, stationed himselfunder a tree, beneath which a wom-m had previ- ously taken shelter. He looked upward to see whether the branches were thick enough. to shed the rain, and in doing so vas struck by. lightning, and fel senseless to the earth. The woman at his side expenenced the shock in her foot, but was not struck down. Some hours afterward the man recovered, but renmembered nothing about what -had occurred, save the fact of his looking up at the branches. This was his iast act of consciousness. and he passed into the uncon- scions condition without pain. \" The visible marks of a lightning stroke are usually insignificant, the hair being sometimes burnt, slight wounds occasioned, or a red streak marking ihe track of the electric discharge over the skin. Prof. Tyndall relates, standing in the presence uf an audience, about to lecture, that lie accidentally touched a wire leading fron a charged battery of fifteen large Leyden ja:n and the current passed through his body. He says life was absolutely blotted out for a very sensible interval, without a trace of pain. In another second or so consciousness returned. Ee .saw hihyself in the presence of the audi- ence hand in contact with the apparatus, and inimediately realized ibat be had received the batterv discharge. The wte/cclual consciousness of hsis position was restored with exceeding rapidity, but not so the p:ical consciousness. To prevent the audience being alarmed he",
         "THE SANIt'ARY JOURNAL. stated that it had often been bis desire to receive, accidentally, such a shock, and that his wish had at length been gratified. But while making this explanation the appearance which his body presented to himself was that of being in separate pieces. His arms, for example, seemed to be detached from his body and suspended in the air. Memory and the power of reasoning and speech were complete long before the optic nerve recovered fron the electric shock. The Prof. dw\u003clt uponi the absolute painlessness of the shock, and believes there .afint be a doubt that to a person struck dead by lightning, the passaqge from life to death occurs without consciousnes:,. It is an abrupt stoppage of sensation unaccompanied by a pang. SANITARY REFORMN1. In a paper under this heading, in the Sanitaîy Record (Jan. 3. '79). Mrs. Judge discourses very intelligently, and t-akes opportunity tu hit the doctors pretty hard in reference to not giving hygienic advice to their patients. The following are extracts from the paper. 'In ihis age of advancpd civilisation it is asîtonishing to find how little attention is directed to a question which, mure than any other affects the interests and well being of the community- thè question of sanitary reformi. Instead of being regarded as one of the most serious of our time, it is luoked upon by the generality of people with at least indifference, and considered irrelevant to the ordinary needs of life ; with illness there is, as a rule, only one means of re- medy associated, and that is, the medical profession. This. people are content to go on overstocking, simply because they will not see that it is better to abolish the cause of disease rather than to wait and cure the result. Ahhough great progress has been made of late in respect of sanitary matters, there yet remains a vast amount of work and teaching to be done before the sanitation of this country will be as it should be. 'Public health authorities are, happily, becoming more impressed with a sense of the importance of sanitary laws, and do much that is commendable towards carrying them out; but, nevertheless, their efforts w'ill not be of much avail until the value of them is recognized in every household, and people become convinced that illness is principally caused by non-compliance with them. Therefore the main thing to be accomplished in the first place, in the work of sanitary reformi, is the education of the people on the subject. In a work rccently published on Sanitation, allusion is made to people 'who wish to conformi to sanitan regulations, if only they know wh at those are.' Now how are they to know unless they are taught, ai.d what provisions are there anywhere rmade for such teaching? Wiose fault is it that even a woman whose position in life is such as to' de- mand particular knowledge of the laws of health, very rarely knows anything about sanitary regulations? It is tréading on .dangerous groaund to approach the question of «Woman's Wt'rk' and 'XWoman's Sphere,' but surely it wili be 4to0",
         "SANITARY REFORM. admitted-even by the most ardent admirers of ' womanly women ' -that of all other sciences, sanitary science is specially adapted to the capabilities of women. upon whom the rearing of the human race devolves. To those women who realise the sacredness and respon- sibility of the office entrusted to their care, the highest aim in life must surely be the successful accomplishment of this important work for upon it.the future of the world depends. It is, however, a fact that although women have the bringing up of the future generation, the najority of therm among the middle a d lower classes are deplor- ably ignorant of the laws of health which should guide and govern their lives; they surround themselves and their children with condi- tions totally oppeosed to sanitary requirements, and resort to the aid and advice of some neighbouring doctor,'when illness, the simple and unavoidable result of the neglect of.sanitary laws, occurs. Despite the exertions that women have for sone time past made to gain the right of entree intovarious professions hitherto monopolised by mien, they have yet to assert their claim to what is obviously a most suitable profession for them, viz., sanitary science, the profession of preserving health. Women are eminenly fitted, both by their nature and their position in life, for sanitary work. Do the members of the medical profession recognize the inipor- tance of sanitary science? It may be that they do among them- selves, but why do they not preach it, and teach-sufferers the value of it ? Over and over again does it happen that doctors prescribe and prescr ibe and do no good, siniply because sanita.ry laws are not obeyed. In illustration of this, take but one case, which recently oc- curred. A child was seized with a fit, and the medical man, one of some eminence, was summoned. The child was teething, and re- quired nothing but pure air, bathing, and simple and wholesomie diet to enable it to pass safely through the ordeal generally dreaded by mothers. What had it been getting? A wash now and then, no systematic bathing, a diet totally unfit for a child, confinement in- doors, and, finally, sleep in a small bedroom occupied by four other persons, two children and two adults ! The doctor arrived, made no questioning, merely lanced the child's gunis, and departed with the announcement that he would 'send a powder,' and with the deport- ment of one who had acquitted himself well in a ' dangerons case,' as he described it. Ndt a word was breathed about the neglect of sanitary laws, no advice was given as to the necessity of pure air, no reference was made to diet, and bathing vas altogether ignored. This last was, perhaps, nfot so much to be wondered at, for most of the faculty seem to shrink froi the use of water as they would from poison. Apropos: a patient lately after going throuigh a perfectly heilthy and natural process, horrified the surgeon by asking for a glass of water. % Not water,' he said: ' you must have brandy and water, or 1 cannot answer for the consequences.' The patient, how- ever, undertook to answer for the consequences, and these proved to be nothing more serious than feelings of relief. The antipathy dis- played towards water, and the incredulity with which it is regarded",
         "412 THE SANITARY JOURNAL. as a preserver of hei[hh and p.ower in the cure of disease, is exceed- ingly difficult to account for. Let us hope that sanitary science will succeed in dispelling this strange and foolish prejudice. DR. DRYSDALE'S VIEWS ON TIE DISEASES OF TOBACCO. Nicotine, which -is contained :n infusions of tobacco, (Quartery 'fownal of Inebriety) is a very deadly poison; and hence'chewing, which introduces small quantities of nicotine into the. blood by means of the absorbents in the mouth, is likely to cause more iapidly any ofthe diseases produced by tobacco than smoking. On one oc- casion, while attending the practice of the London Ophthalmic Hospi- ta], I saw within a short time two cases of atrophy of the disc, of which the origin, in men under thirty, seemed clearly due to the fact that both patients had been continually in the habit of chewing to- bacco. Then, with resp--t to smoking, Melsens, a chemis't, collected 30 grammes of alkaloids from 4,500 grammes of tobacco-smoke passed through water. Alkaloids are almost as poisonous as nicotine, and are used by gardeners to kill insects, who fumigate their plants by burning tobacco in closed houses. . The effect of smoking is to act on the nerves by absorption or the alkaloids mingled with the saliva of the mouth, and to cause dilation of the small vessels by the para!yzing effect of the drug on these. Dogs may be killed by giv- ing them quantities of tobacco-of course larger as compared with that taken by persons who chew or smoke. Men who smoke are often plagued with palpitation of the heart, etc. I once made inqui- ries concernimg two hundred patients at the Metropolitan Free Hos- pital, who were great smokers, consuming at least half an ounce of shag daily, and found that most of them were more or less chronic mnvalids. Dr. Kestral. physician to ihe Royal Tobacco Factory at Iglau, nearVienna, tells of ico boys from twelve to sixteen, recently enter- ing the works, 72 fell sick in the first six months. Idost of them had symptoms caused by tobacco-poisoning. The work-girls are fre- quently subject to amenorrhea, or chlorosis. When pregnant, abor- tions, caused by the tobacco-poisoning, are frequent among narried women; and of 5o6 births, 206 children soon died, the majority at from two to four months of age, when their mothers returned to the factory and breathed the air charged with nicotine, which poisoned their milk. The intelligence of young men is greatly affected by tobacco. Bar- tillion's statistics of the Ecole Polytechnique in 1855, show that 1o8 of Ihe scholars smo;ked and 52 did not smok-e. Yet of the first twenty ,who obiained honors at the school, fourteen were non-smokers and six smokers. This caused the Minister of Public Instruction in in France in 1S6i, to prohibit the use of cigars and pipes among young students.",
         "DUTY OF PHYSICIANS.' DUTY OF PHYSICMNS We are pleased to find one other journal besides the Sani/ary Youirna/ boldly take the position that a large part of the duty of the physician lies in efforts to prevent disease, and advocate practical manifestations of the exercise of such duty. The one other journal to which we refer is a new and handsome monthly, the St. -ouis Courier- of kedicine and Coliateral Sciences. The remainder of this article, which has a ring about it which we so much like, we extract from the second number of the Couier, and hope it may. interest our brother practitioners. 'The health. of the people is the supreme law,' and this should be, must be enforced. We are in a condition to undertake the initiation of a movemenft that, if we commence in the right .mode and unceasingly and unitedly endeavour to advance will in time attain a force which I feel satisfied ivill overcome ail he obstacles which now frown se threateningly in opposition --obstacles of custom, obstacles of ignorance, obstacles of prejudice, obstacles of intention. We must ' take up arms against this sea of iroubles, and by oppos- ing, end them.' ln this journal we purpose that one of the chief departments shall be devoted to matters- relating directly and practically to public hygiene, urging the importance of the formation of local societies and boards of health, and this départment will give constantly the latest results of the effect of attention to local causes of disease in this and foreign countries, and, in connection with this, instructive essays-simpile, so plain and easy, that he who runs may read and comprehend ; often of so popular a character that the secular journals, the daily and weekly newspapers shall copy them, and so commence the education of all people who-read. W7e feel sure they will be read. Farmers and villagers are concerned in understanding drainage, the neglect of which has wrought. sad disaster in our country. A ditch is cheap, and ditches are cut on every farm, but they need to be cut intelligently, and every country doctor ought to be able to tell his patients where one is needed, and where.it had best lead. Wells are dug to formn dépôts for drainage from cesspools, when a little needed knowledge would as easily avoid the lurking danger, that is only concealed by ignorance. Infected bedding and clothing have carried illness and death, by reason of expensive economy or death-dealing charity, because the infectiousness of filth or disease has been urknown, or the value of time as a purifier, ignorantly 'estimated to be great ; agd even in this city are found men and women, some unfortunately with the cacoe- thes scribendi, who make themselves heard, and exert baneful influ- ence against the blessed protection of vaccination. Oh ! that we could vaccinate against wilful ignorance. 413",
         "THE SANITARY JOURNAL. THE MUCH-MALIGNED PIG. A perusal of some recent local reports (Sanitary .Record, Jan. 24, 1879) in vhich that despised animal, the pig, lias infinite abuse and contumely heaped upon hini as a quadrtuped of the most vicious and degraded propensities, induces us to say a word or two in favour of dite much-maligned porker, and to ask that he, as well as animals of better repute, may have fair play. The fact is that the pig has a bad name as an unclean animal, whose habits are essentially and naturally filthy, and who will feéd on disgusting f,,ud, irom which other animals will turn away. He is thus left to revel in the refuse that he is supposed to prefer, and for the most part no pains are taken to teach him better. A little knowledge of his intincts will, however, show that so far from the pig being naturally an tnclean animal, lie is naturally the reverse: and this view is strongly borne out by Dr. Ballard, in a report which he some time ago presented to the Local Government Board on the 'Efiluvium nuisanc,:s arising in connection with the keeping of Animals.' 'When the pig wallows in mire,' says Dr. Ballard, 'he merely follows an instinct implanted in him, in common with some other pachydermatous creatures, the object of which is cutaneous cleansing. The mud stands to him in the relation.of soap to a human being, but instead of washing it off with water lie ajlows it to cake anâd dry upon the skin, and then rubs it all off, mud and cutaneous débris together, upon some sufficiently rough surface. Loose hair and cutaneous scurf irritate him, and he takes his own way of cleansing his skin frorn them. Cleanse his skin for him and he will rest in contentment, without offending the eyes of his supercilious betters, often less scrupulous in this niatter than lie is, by his wallowings, scratchings and scrubbings. It has long been known that a pig thus cleansed vith soap and water, not only becomes less objectionable, but grows fat more speedily than if left to clean himself in his own way. Similarly as respects his focd. Garbage is not the food that the pig selects by preference. In fact a pig which bas been fed for any time upon sweet food will turn away from sour and disgusting food. If left to pick up his living where he can find it, lie will eat anything be can find that is eatable, but even then will eat acorns, fallen fruit, or roots in pireference to garbage; and hiuman beings in similar straits will act preciselv in the same way.' It may be econ- omical, and perhaps even desirable, to convert into pork matters which can in no other way, or in no way more convenient, be made subservient to the subsistence of mankind, and the pig is possibly properly utilized in this manner. Our only desire is to vindicate his character as a cleanly feeder, if only he has the chance of cleanly feeding vouchèàfed him. ANY INSENSIBLE PERSON, who, having been left undisturbed for from ten to thirty minutes, bas contracted pupils, which dilate when he is shaken, without any return to consciousness, and then contract again, is suffering from alcoholic coma. 414",
         "COOKED AIR. A clever writer in the .Philadelphia Ledger, writes the Scieuiz/,c American, very happily characterizes the air which most city people breathe indoors in cold weather as \" cooked air.\" The lower down the thermometer goes the higher the burning coal is piled; all the chinks and cracks are stopped that would let any fresh air in, and its main chance, indeed, is when the front door opens for twenty seconds, or when. the beds are niade in the sleeping rooms. In the living rooms of the famili there is no occasion, many people think, to raise the windows ever, except to wash them on periodicai cleaning days, or to close the shuiters. So carpets and furniture and people, lungs and skin, are dried and baked in the hot, dry roons, until ingenious persons can bring out electric sparks froni their finger ends by sk.ating rapidly up and down the room in their woolien slippers. These breathers of cooked air are often extremely particular about wearing their own clothes, and- would, by no means consent to take the cast-off garments of a neighbor; yet ooe and all of them are perfectly conifortable to breathe over and over again the. cast off and soiled air from each other's lungs, when it is cooked especially ; for in summer time they do insist on a change of it, and do get their houses ventilated. Janitors of public buildings, in a short-sighted economy of fuel, vill shut up all the apertures by which fresh air might get in, lest they should suffer some heat to escape thereby, and are rewarded by sleepy audiences, especially when the gas burners are at work, also draining the cooked air of what little life it has. There are some people.--many, it is to be hoped-w'ho open an inch or two of their bedroom windows every night to insure a modicum of fresh air to sleep by. But these do not in the least care to have fresh air to be awake in, it seems, for they are content to have their furnace draw all its supplies froi the tightly sealed cellar, and fromu the stale atmosphere of the ash boxes and vegetable bins in that subterranean .apartment. And these breathers of cooked, sealed, devitalized, and debilitating air, wonder why it is they take cold so easily ! The writer suggests that when people learn to live in fresh air within doors as without, with its proper proportion of moisture for the skin and breathing apparatus to keep up their healthy tone, it is I kely they will have found out one w.vay at least of how not to take cold. EARLY VACCINATIoN.-Dr. Russell, of Glasgow, lias recorded an instance of an infant born into a small-pox atmosphere being vaccin- ated within twenty-four hours after birth. The child was born the day after its father was removed to the hospitalwith.smnall-pox. The vaccination did iell ; the child was not in the least distuz:bed in general health, and escaped a disease which would almost certainly have proved fatal. When small-pox is iii the bouse or family, no age musi be considered too early for vaccination, which appears to be qu.te as sate and quite as successful directly after birth as it is at a later period.-Sanitary Record. COOKED AIR. 415",
         "THE SAeITARY JOURNAL. SEWERAGE OF ANCIENT ROME. Dr. W. Essie, C.E,,F.L'S., (Sanit. Rec., Dec. 27, '78, in Detroit Lancet) reportstheresults of investigations into the sewerage of ancient Rome. The main sewer was composed of three semi-circular aches enclosing one another. These concentric rows of enormous stones are piled above each other and fitted in place without niortar or cem'ent. The average width of the sever is twelve feet innermiost diameter, and the-average height about th.irty-tvo feet. It was con- structed of peperino blocks, some of which are over five feet long and three feet thick. It was built about seven centuries before Christ and intended to drain the lake that surrounded the \"ill upon which the city was built and the contiguous marshes, thus permitting the Romans to have free intercourse with the Sabine town on the hills across thé lake. As the city extended, new severs were built connecting distant points with the great sewer. These sewels conveyed to .the Tiber the storm waters from the hilis, the overflow of the springs and marshes, and the overflow of water brought to the ciry by the stupendous aqueducts; they removed the %vastes froni the public fountains, the fiow fron the streets, the fish reservoirs, the wastes from the magnifi- cent baths, and the slops from the houses. It is probable that they began to be used as sewerage about four centuries B. C. When it is remembered that in the time of the emperor Augustus the city contained over two millions of people, it will be seei that in no other way coulid the city be kept in a tolerable condition of cleanilinešs. As a huge landmark in the path of progress the clo.ca maxima still remains. Estimated not only by its vastness but by its purpose, it transcends in rnagnitùde the pyramids or the great wao of China. VACCINATION. In a recent report (in te Proceedings, Feb. 1879) of the committee on hygiene of the Medicad Society of the County of Kings, N. Y., on vaccination and re-vaccination, the followicg conclusions are ar- rived at: Vaccination is the only means of preventing small-pox. Vaccination ought, m ordiuary cases, to be done not later than the third month. Vaccination does not endanger the health of the child ; the mor- tality is 35 times less during the three w'eeks which follow the vac- cination. There is no protection for adults without re-vaccination. Re-vaccinations should be done about the tent;Zz year, not later than thefiten/A. Vaccinations and re-vaccinations should be made regularlV, and recorded as regularly as birt1s; with date, and date of inspecdon. A small-pox hospital, properly located, is encirely safe for those living m the vicinity. The number of patients does not, increase the danger, and the nortality in hospital is less than in private practice. 426",
         "MEDICAL INSPECTION OF SCHOOLS. MEDICAL INSPECTION OF SCHOOLS A good deal bas been written and said in different countries. about the necessity for medical supervision of schools. It is time some attention were turned to this subject in Canada, as it is one of much impoirtance. The- members of the Liverpool Medical Institution (Mied. Timzes and Gazette) have lately presented a petition to the President of the Local Government Board in favour of a systematic sup.ervision and inspection of public schools. They say-' We consider this a necessary measure, and hope that the recomnimendation of it will meet with your ap'proval, particularly since niedical supervision lias been made obligatory in anaîlogous conditions, viz., under the Factory Act, and in the Emigration Service. Your memorialists suggest that the duties of'the proposed medical inspectors of schools should chiefiy consist in preventing children who have been suffering from in- fecticus diseases from attending school before the infective period ha: passed ; in visiting the houses of children absent fron school in consequence of illness; and in making strict ioquiries into the general sanitary condition of the respective families. Undel existing arrangements the warnings sent to schools by medical officers of health generally came too late to answer any practical purpose, and it must further be considered that such oflicers by no means obtain information of all infectious cases. The duties of the proposed niedical inspectors should further consist in ascertaining and certify- ing that the children secking admission have been properly vaccinated, and are free from contagious skin disease. There should be also medical inspectior of the school premises and of the children in attendance, carried out in such a .way as to interfere as little as possible with the work of instruction.' And they add-= Your memorialists are aware that they must limit their request for medical inspection to public schoois which are under the control of the Governient; but they feel confident that managers .of private schools vill very soon not only not object to, but court, medical supervision ' HYBRIDS OF TVPHOID FEvER WITH RELAPSING FEVER.-In the bluod of one typhus and four typloid patients, whose symptoms pre- sented some of the characteristics of relapsing fever, Borodulin (Peters- burgh, Med. Voch., Nov. 28, '78 ; Mced. Timnes and Gazei/e) suc- ceeded in discovering Obermaier's Spirllum, and thus proving that these cases vere truly hybrid. The peculiarities which' directed attention to relapsing fever were irregular variations of temperature, perspirations, and the fact that cerebral symptonis were but slightly mîarked. Phvsical examination .revealed very decided enlargement of the liver and spleen, and petechiS of vermillion colour occurred at the very onset of both the typhoid and typhus fevers. One case died, and the pathological changes were essentially those of typhoid fever. The spri!la were more abundant in the blood the nearer the disease appeared related to the pure form of relapsing fever. 417/",
         "THE SANITARY JOURNAL. THE DISPOSAL OF SEWAGE. In. one of the Public Health lectures recently delivered at Glas- gow, (Sanitary Record Jan. 17, '79) Dr. William Wallace pointed out that sewage was a very mixed liquid, and that that was one of the chief difficulties in the way of the satisfactory disposal of it. The question to be solved, he afterwards remarked, vas how to get rid of it in the most convenient, least injurious, and least expensive manner. Underground sewers generated gas. If sewers could be kept on the surface, and the supply of water was plentiful, there would be no danger from this cause, aithough that might be more or ìess offensive to sight and smell. Perhaps the most perfect town from a sanitary point of view would be one in which a small streani of water flowed down the centre of each street, with the stream con- nected with the houses and a fall of water sufficient to prevent the lodgment of niatter. Water per se, it was pointed out, had no purify- ing quality whatever. In ordinary cases the air more than the water had to be depended upon for oxidation, though in the river Clyde there was a sufficient quantity of water to dilute the actual sewage with 1,4oo parts of water. The first step and the onl; manner by which sewage could be satisfactorily disposed of was by the appoint- ment of Conservancy Boards. There could be little doubt that it would be of little use to introduce for the purification of the Clyde a system which did not embrace the upper reaches of the river, and this could only be accomplished by neans of a Conservancy Board. Proceeding to discuss the nerits of ihe two systenis of disposing of excreta-ihe dry systen and carnage by water-Dr. Wllace described the former as the nost rational and nost consistent with public health and national prosperity. WIIOOPINtG COUGli AN1) FUNGUS. Some years ago (Scieniific Amerùan) M. Sentzerich made the assertion that whooping cough was caused -by a certain fungus. This assertion seens lately to have been confirned by the researches of M. Yschamer, who says lie found \u003ccertain lower organisis in the spittle of whooping cough patients-organibms not niet with in any other disease accompanied by cough and expectoration. Examinîiiig the spittle after it has been a short time suspended in water, there are found corpuscles about the size of a pin's head, of white or slightly ycllowish hue, and these show, besides apathetical cells, a network frame of polygçnal meshes, wnith rounded greenish sporules at a more advanced stage, colorless hyphe aie seen, and large sporules, yellowish or brownish red. soietimes even ramiified. It is interesting to learn that the charnpignons in question are quite identical with those which, by their agglomeration, forni the black points on the skins of oranges and the parings of certain fruits, especially apples. Thus, M. Ysclaner, 'by inoculating rabbits with this dark matter, or even causing it to be inhaled by men, produced fits of coughing several days in duration, and presenting all the characters of .he convulsive whooping cough. 418",
         "DRAtNA.GL DRAINAGE. Since the first issue of the Sanitary . gournai it bal. repeatedly drawn public attention to the importanç of th6rough drainage of the soil. Damp, und-ained soil is one of the mosf fruitful sources of preventable disease, Imperfect drainage, or damp soil, is said to give rise to nine-tenths of all fevers that occur. The fevers .most conimmon in undrained, districts are intermittent (ague) and remittènt, and in more southern latitudes, ye1ll'w fever. Nuiero'us instances have been recorded in which in certaa loéalities fevers had been const;mtly prevalent for many years, but'.eïitirely disappeared after thorough drainage of the s'òi. It may be that in a locality no't very well drained, the:e will be a very tolerable degree of healhh among the people, other conditions being favorable to health ; but the most perfect freedom from disease can only be obtain,:d by good drainage. It is well known that the bešt products of both the animal and vegetable kingdoms---the best sheep and cows andlhorses, the best grains and roots, are the pro- ducts of the. best drained soils. The records of the Registrar General of Great Britain show that in well diained districts the people suffer less than half the average amount·o.f sickness and. disabflity, and their life is prolonged from 20 to 25 per cent. The death-rate from consumption has been reduced in localities 50 per'cent. by proper drainage of the soit. Bronchial and rheu- matic affections are well known to be much morè common on un- drained'soil. The agriculturist often spends large sums of money in draining his fields, yet leaves his cellar and grounds arpund his dwelling damp and most detrimental to the health of lis family. NQt thinking or knowing, or if knowing, not caring, that the health of those in bis house would be at least as nuch benefited as that of hi- plants or his cattle by dyness of soi]. Villages and towvns, and even cities,*are frequently built on damp retentive soil, without any attenpt being rinade at systematié drain- age. Here. and there an' iniperféct drain perýùits the. superfluous water to flow from somé excayatiokn lhi e grouÀpd, called a çellar, but which is often, far from being as iry as it should 'e. The time will probably come when it will be' to the'direct pecuniary interests, of proprietors of village lots to 'ihokughly 'underdiain their lots before offering thèm for sale for b'uilding purposes ; and. when th'ere' will be an Act of.Parliamuent against houšes being bpilt on soil not perfectly drained. It is the duty of the corp6rati.ou of .towns arnd villages to see that the heilth of the people of the locality overWhich'tbey preside does not suffer from dampness of soil. SUSPENDED.-We regret that -a-ývery welcôtnei and valuable ex- change, 'Yhe Doctor,' has been suspended fot a time, until; ôutstand- ing accounts can be collected. We hope soon to see it commenced agtin. -",
         "420 THE SANFTA-RY JCU1RNAL. DIPHTHERIA AND MILIK. In response to the appeal niade by us in our last week's issde, we (Sanitary Record) have already received information which appeárs to show that ah extensivê epidemic of diphtheria, investigated by a Government ispector some time ago, was probably spread by means of niilk spectifica ly contaminated with the infection of diphtheria. We learn from oui informant that diphtheria broke out first at a public house irn a village three milés fromi the town in which it after- vards became so fatal, and that next door to this house lived a cow- man, whose two thildren caught the disease. The cow-mati in, question had to nurse and attend to his siek children, aid as'his duty was to milk the cows belonging to his employer, and afterwards sell the milk in the town, the theory is that the infection of diphtheria was distributed by him along with the milk. We are informed that on the houscs supplied by this milkman the incidence of the epidemid chiefly fell. PARKDALE, we believe, is entitled to the credit of beinàg the first village or corpôrated placé of any sort in Canada, or even probably on this continent, ta adopt the 'interception ' or ' dry' systen in the disposal of excrement. It will not permit any accumulations of fecal matter to take place on any premises within its boundaries. Ail such mattérs must be disinfected, or in other words destroyed at frequent intervals, and none will be allowed to iernain as fecal matter to foul the air and water. We hope to be able to give more particulars in referelce to the working of the system on future,. occasions - and trust we shall learn of many other villages and towns in Càiada reached, and it is to. be hoped influenced, by the SANITARY JOURÑAL, following the example of Parkdale. Many towns in England have long ago put into successful practice a siroilar system. Doubtless there are many medical practitioners in Canada who if they would but set resolutely about it, might induce the councils of the respective towns and villages in which they live to adopt a like practice. It would probably, if carried 'oui, 'lessen their income somewhat, but medical men are not usually made of such stuff as to let a consideration of this sort deter them from what they learn to be their duty. We hope we shal\u003e hear of .some of the readers of this journal making the effort referred to. ENGLTSH BOAkDS or HEALTH.-The English sànitary regulations emanate from a Central Board of Health, created by an act of 1875, with very extensive powers. It controls ail local boards, and these aiso take charge of 'varietd interests;. for example, the construction and maintenance of sewers, the cleaning of streets and eountry roads, and thc removal of impurities frQm private enclosures, with measures of precaution in view of epidemics, the visitation and arelioration of tenements, and in general, a minute and constant surveillance of the cleanliness and salubrity of the district under their nanagLmeot,",
         "SMAL-.110X IN ONTARrO ' and of the health of its inhabitants. They alone can authorize the establishment of slaughter houses and certain kind of factories ; thet;y have the power to open and widen streets, and to create park, rad squares, and they must see to it that an adequate supply of ga ,and water is forthcoming. Much of this work they are..permiîzd, and in soin- cases required, to let out to contractors, bot they cannot free themselves from responsibility and the duty of supervision. . Nol only the maintenance, but the security of. the public. thoroughfares, té a large extent, falls within their functions. It is for the health boards to make regulations regarding public vehicles, and to de'iver licenses to hacks, and' it is their business to enforce. penalties for e number of petty delinquencies, such as obstruction or the highway; the discharge of firearins, or any species of disorderly conduct. Ina a word, Boards of Health in England, at present, engross, or en. croach upon, powers distributed in other countries among at least half a dozen distinct organs of government. The local Boards of Health are at present forced to obey the ini- tiative of a, central bureau, to register its orders and carry out its plans. The expenditure is under the control of men appQinted by the national Executive and representing the whole people. A Discussio; ON SMALL-POX IN CANADA tooik place recenify in the Senate at Ottawa, arisingfrom the following enquiry, by Hon. Senator Haythorne:-'Whether thie attention of the Government had beer. directed to the subject of the prevalence of small-pox in Canada, with a view to arrest the spread of that disease by a general systern of vaccination or otherwise.' A lengthy discussion followed in which it was stated that a serious and'alarhiing outbreak of.sm-all pox has occurred in Prince Edwerd Island,.pXroving fatal in many instances. The advantages of vaccinatian were dwelt upon. and illustrated at piuch length by Hpn. Mr. Haythorne. A member of the gvernn'ent, Hon. Senator Aikins, statèd tiài tfie ratter did not Come within he purview of the Dominion Government, except as regards quarantine, but was a subject for Provincial Legislatures. Hon. Sena.tor Dr. W. H.. Brouse,0yho.has giver, so much. attention to public heahth legislation, took occasion, to speak .t consideTab1e length on the subject in gençral. H1e referred tò the fact that all civilized nations [except Canadians} are striving to legisiate Tor the health of the people, and to the extent to which the dathWrate had therebv been reduced in many countries. , Wea Lrust this. distission will be of service to the country, and intendto refer to it tnore.fuilly on a future occasion, as we have not space enough for ii, În this number of the journal, which is just going to press. DRUNKLNNEss.-According to the'Be/on IJed-al and Surgical /urnal the French have the fo1lowin li gw., ' Evry peIn who nay be condemned by the police twice for the crme of open drunen- ness, will be leld incapable of voting, of elective'eligibility, and of being named for the jury or any public office.' 4.25",
         "THE SANITARY; JOURNAL. BEwVARE OF HURRY. From the London Lantd.-The maxim of safety-to avoid physical and mental hurry alike-is, prepare, deliberate; in a word, adopt an orderly method. The man with a- weàk heart who endangers his life by hurrying to catch the train, unless under altogether exceptional circumstances, is probabiy the victim of a defect in early training, which leaves him at the mercy of impulse without order ; or he is striving to fill a place in life for which his chief qualification has been the faculty of accomplishing by effort more than can be achieved naturally by steady labour. Some persons tre ever hurrying after their engagements ; others are goaded onward by the pressure behind therr. ; but however the *hurry' is produced, it is full of peril to happiness of mind and health of body, and in the -nd. exhaustion, if not prematurely by accident, it kils. LAUNDRIES AND THE SPREAD OF D!SEASE.-The public should be reminded that contagious diseases may be spread by laundries. Such establishments may, the proprietors not being aware of it, receive the clothing from the bodies of those who had suffered from cuntagious disease; for there are, doubtiess, individuals thoughtless enough to send such clothing to a laundry. SPECIAL NOTICES, AS TRIS IS THE LAST NUMBER OF VOLUME III, we hope tjose in arrears will kindlyremit the arnount due without delay. T ALL IN ARREARS for MORE than the last volume, AFTER THE 25th MARCH, we purpose sending accounts, for collection, by-express. BILLS WILL NOT BE SENT with this number, as they have been sent several tines already, but the amount due will be fourid marked on FIRST PAGE OF COVER. ARRANGEMENTS ARE ABOUT TO BE MADE whereby it Is hoped the next volumeof the SANITARY JOURNAL will be greatly superior to any of its predecessors.. The first number may be delayed however. ANY REQUIBING TITLE-PAGE for binding Volume III, will please seand address by P. O. card. SOME NOTICES OF BOOKS and Journals received will appear in next number. 422'",
         "INDEX TO VOLUME III. PAO!. Air we breathe ......................... 4 Alecohnl and cold. ........,.... ....... 44 Ærted brad . . . .. 45 Aged opinm caters..... ..... .......... 217 Abuse of drugs...............,........ 223 Antiseptic ndwifery.................... 224 Advice to maotters and nurses. ........ 249 Arsenic on walls and dresses ........ 20 Amowt q' f ood necessary.. .. .... .. ..307-841 Adulteration of sugar.........r.......... 851 Artifieal suckling and food, lifants. .... 212 Amuscîemnts of groat men .,............ 864 Antidote to had air ..................... 394 Arsenical colora... ............ 284 Bible hygiene... . 1-3 Blue glass.. Boards of healt .. . . 45- Boards of health, ,.rovincal ............. 18 Book notices ... .. .45913.22924-19.44 Ilacterh in cbarbon ............ .24 Bacteria ........... ........ ............ 76 Bridal tours .. 31 Baking po ders......................... 889 Bath, the............................. 9 lack and front d raineage.. . . .......... , 278 Bre d daiy ............................ 178 Consuniption, luevention of ............. 274 Consumption, preventible ............. 44 Consumption. hyene of.. .. 36 Causes o dcse, Tydal.............. 70 Choroa ........., ...................... 76 Court r»ons and judges . ........ .... 79 ital nishtntl.. ...............84 r4ornlorn ............... ............ 8 Cookery ........... ........... Cigar noker... ............... Cholera inantuin ..................128 Croup .und miasilata...............17 Chinese legislatiot on opiim..........217 Canada medical assocIatIon.... 22 Contagious diseas.................259 Causes of dise in Ontario..........274 Coclvrs . .......... 86 Cellars, hygien cf................... 3m1 Cbilt!r rare o!. .............. 1 Cvasece........................ 7 Contagiuni virtin, doctrint o! ....19 Candan ines. ..................... 18 Clofhin ...... ................... 78 Celuus, origin 0 wor............. ... 218 Costa or ickness anà t!esth In Ontario.. .. SOI Chlrenncare on................ .....86 anacnivetine. .. ..l.ingi.............. 120 Cistnfeing .---, .rao ................ 87 Dnuevingi ntv ofMwo .............254 Diptheia, causes o! de. i ....36143 Piphtheria............34-130 Punionn f lir .. ..................83 Drin cleits . ...................,.8 Ilihterla leier................... Dietand exercise.................... 74 DamIpness ln bouscs................. 31 Drinking at meals...................,. 1f2 AGE. Dressingrwounds....................... 123 botnesticùaonomy congres............. 158 Disteuper and paint.... ........... 176 Disease our own causing................ 257 D iet............................... .... MS Dinners and dining......,.............. 801 Disease geris, destruction of........... 3837 Death rate reduced.................... 116 Diarrhoa, infantIle........ ........371 Disinfectliot, On................ .....51.285 DIsinfectant, now.................. MO Disease, its causos.. ...............269 Isease, spread! 0.................. s Extracting bodies from throt... - Eucalyphus, value ...............17 Epidenics, to prevent................. 42 Exerciso, effects of or. 'ungs..,....... m Exercise, wystematio.................... 376 Fermentation.............,,,........ 101 Funeral refcrm........................ 124 Fat, formation cf.... .............. 165 Flowers, to preserve ............,...... 174 Fover, how' spread...... ............... 227 Freah air for little ones............. 287 Fresh air und consumption.............. 283 Fever, yellow.......................... 309 Forreetry ,schools f................... 810 Fatality ..mong inebriatea ........... 295 Flîter, spongy iron as..............229 Geri theory,\u0026tc................177-27 Glass wol. ....................... a2 Gers, Tyndai on.. ......... .... ..l Germs ln 1Bod3y.......................8 59 Gas. elfects of.. ..., ........... 309 Goitre, cause cf....................... 165 German school children. clenlincss a... \"b Bouse drains, vntilation cf............ i Hyiene e. c¥es.................... 28 Houses unin eabitabl.. .............85 Ilealth boards.. N ..-...............115-183 Bealth lessotis.... ...-.. .... ..... .. 11 Health, minister f.................... 382 Halth la Ontario...................... M byper-Ventilation...................... 231 Health and v eetation.................234 Hygiene of ben ....................... 279 Ilygiene, practical.... .............277 fygiene cf dinner..................... 88 Health in Grear Britain............. 314 Hereditary diseae...................... 3S How to live long........................ 33 Hygiene and consumption....,,....... 356 liyger.e, value 01......................26 Plonger, pleasures o!.................. 256 Infantile deaths, prevontioa cf......... 34 Infantîdiet.............,.....,. . .... Infant maortality...... .....,.... 216 In.niy iucreasect¾.....,.,......,,.. 124 vy, Es 182 independene not natural............225 Impure r.. .................... 257",
         "INDEX. PAGE. Infectious diseases, preventing .322.346 Index nedieuc.... 3906 Inebriety ...................... ....... 251 Light, electric... ...................... 396 Light, what to use.......,.............. 77 Landiords and manslaughter ........... 89 Longevntg............................. 88 Laws of health ........................ 12 Lead poisoning......................... 220 Life, prime ot ............,..... ...... 367 London, aire of.. ....................... 176 Moderate drinking.. ................... 22 Mcdical mon .nd-publie................. 35 3 l i K,,................................- 44 1ilk, preservation of .................. 121 Millk and bread.......... .............. 342 Mil% inspection.. .2 Mili. and typhoid....................... 42 Milit, nithers substitute for ............. 313 Milk., tubercles in................. .... 203 Measies, prevention e t................ 56 Measles and disinfectants .............. 285 lieasles ir Figi ......................... 118 lierococci and bacterta................. 76 Medical edicatio...................... 176 Medical associations....... ............ 222 Movements of brain.................... 177 Miarriago and heredity.....,............. 305 Mlonth, open, bad.............. ........ 124 Medical association address.............. 356 Omnivorous nmamn....................... 37 Opium poisoning....................... 119 Opium habit............................ 266 Onte. nedical council....... ......... 131 Over-population.... .................... 88 Public health, Ontario.................. M Public lealth legislation................ 892 Public health, on.................... 1 6 Public sanitation....................185 281 Population on, Dr. Farr................ 207 Plaguae, extension ot.................. 117 Public shools, air i n. ................ 125 Percheloride of hydren.............25 Physicians and publie.................. 9 Physicians in education................. 3= Population, movernent of...............227 Population, over................. .....388 Paris atmosphere organliimr.......... Physician. the......................... 88 Portable bath......................... 87 Portable disintfecting chest.............. 134 Poisoning by gau.. ... ............4 Pleasures of hunger.................... 226 Prevention and cure...............290 Parkdale, health of ............ .316 340 Primenf life.......................... 367 Princes Alice, death of, and diphtheria, 384 Quack modicines....................... 134 Quaok medicineu, eompositionof........ 216 psw meat dict........................ n Registration, causes of death in......... 181 Royal colleges of physiciens..........225 Rthcumatism, mathematics \u003cft...........8 Report of medical oficers, Eng. Report on vitrstaistics............40 Renedies, now........... 86 Registration cf disease...... ....... 128 Rochdale pail cyst-m .................. 185 Ilouf grdons........................ 212 PAGE. Science, advance of.................... 207 Sewer ventilation.......,........... 24 Sewer gas and typhoid......,...'........ 123 Sewer gases.........................123 199 Sewage cortereriee.....:................ 83 Sewage of towns....................... 226 Sanitation in Norwnay.... ...........32 Sleep and health....................... 80 Science and religion .................... 84 Sickness and death rn Ontario, cost of.... 91 flnoke nuisance........................ 265 State medicine.. .................258 Sleeping iith open mouth........... 124 Scarlet lever........................257 258 Scarlet lever. eontagion of .............. 258 Scarlet fever, preveution of.. .........67 Spread of discease....................... 118 Sudden death in typholid................ 136 Sewyage, requWiites of.....................365 Staff of life.... ..................338 Sailtary asscciation.................... 86 Sanitary association, »ubliu..........228 Sanitary institute, France.,...... ...... 22 Sanitary institute. Grent Britain........ 238 Sanitarv legislation..................... 272 Sanitation rural....................25 Sanitation in Persia................ 228 Sanitat.pn in Bulgaria.................. 215 Sanitary science.........,.............. 171 Snokers, a hint t .............. 121 Schooî hygiene......... .......122 168 School, age for......................... 124 School, Inspecuin of..... .............. 132 School of forestry....... ..........310 Sunaight and health.................... 120 Stimulants....... .............. 122 SuIcides and beer drinking.............. 215 Sanitary door, twin .................... 43 Sunlight in disease...................... 285 Staff of lite............................. 38 Survival of fittest............ ......... 343 Statietical bureau..................... 868 Tobacco, effectecf...................... .267 Tobacco. use of ....... ............38 175 Teeth, preservatio: of ....... .......... 358 Typhoid epiudemic...... .. :.......... 72 Typhuld lever........................ ls Typhoid lever and water............... 31 Typhoid lever, food in.... .........25 Typhoid, encouragement o!.......... 247 Turkish baths....................177 True temper.nce....................... 354 Testn.g air and water.................. 395 VentIlation e water-closets............. 262 Ventilation........ ..............291 Ventilatio*, exhaut cowles, .......... 265 Vaccination..'.... ................ 269 Vegetation and heaith.................. 234 Vital statistics...........40 130 135 225 276 Whcat s food.......... .............. 180 Water supply........................... 47 Water closets....... .................. 214 War and charity............ ......29 Winc, use o......... ............317 .Wc:, the progressing........... ...... 35 Women's dres.......................... 77 Weil drainage........................ .339 Zymsotic4\u003cieCases...................228"
      ],
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         "The sanitary journal [Vol. 3, no. 12 (Mar. 1879)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. W Additional comments / Commentaires supplémentaires:",
         "T HE CANADA LANCET A MONTHLY JOURNAL -0F- MEICAL AND SURGICL SCIENCE% CRITICISM AND NEWS. EDITED BY J. L. DAVISON, B.A., M.D., C.M., M.R.C.S., E. CHARLES SHÉARD, M.D., C.M., M.R.C.S., E. VOL. XXII. TORONTO: DUDLEY \u0026 BURNS, PRINTERS, 11 COLBORNE STREET. 1890. i",
         "LIST OF CONTRIBUTORS TO VOL XXII. David Inglis, M.D., Detroit. C. R. Dickson, M.D., Toronto. A. Groves, M.D., Fergus, Ont. J. Workman, M.D., Toronto. H. S. Griffin, M.D., Hamilton. A. McPhedran, M.B., Toronto. Chas. M. Smith, M.D., Orangeville, Ont. B. E. McKenzie, B.A., M.D., Toronto. R. W. Bruce Smith, M.D., Seaforth. Price Brown, M.D., Toronto. Sir James Grant, M.D., F.R.C.P. Lond., Ottawa. V. H. Moore, M.D., Brockville. G. Sterling Ryerson, M.D., Toronto. F. Winnett, M.D., Toronto. S. Keene, M.D., Brooklyn, New York. J. C. Mitchell, M.D., Enniskillen, Ont. Charles F. Stillman, M.D., Chicago. Wm. Britton, M.D., Toronto. J. Algernon Temple, M.D., Toronto. J. E. Pickard, M.D., Thamesville, Ont. James Newell, M.D., Detroit. J. L. Addison, M.D., St. George, Ont.",
         "INDEX TO VOL. XXII. P Abdominal DiseaseS Early operations, i j. C. mit- chell, M.D., EDniskillen ont ..... . Mit- Abortion, Threatened ............ ..... Acetanilide. ....... '******* Acne, Borax in Address on Medicine, Abstract ·· '-.--- Advertising, Unprofessional .. ··...· .. Age of parents, Influence on offsp·ing ............ Albuminuria......................... 86, 27, Albuminuria of Pregnancy ................... Alcohol, Action on Stomach of . ... Alcoholic Indulgence a - - .. AGE Boric Acid as an Antiseptic .................... 228 Boxing the Ears............................ 61 Breast, Common Diseases of·.................. 387 Breech, New method in.. ·········.·......... 297 Bright's, Buttermilk in. 377 British Diplomas...................... 60, 122 Bronchocele, Tinct. lodine in................. 22 Buboes, Treatment of ···**. ·... 359 Burns.. .···············.. .......... 320 Burns of Face. 2Q OQfl 362. 213 139 282, 349 330 362 187 94 126. 378 186 22 288 360. 382 29 296 286 31 294 232 115 1'20, 191 350 182 210 95 95. 26 213 179 138 384 361 156 360 93 ?84 323 328 90, icohOlis', Chronic ' ........................ 127 Cancer, Inoculability of...................... Alcoholism, Strychni '- - in ........................ 24 Cannabis Indica, Uses and Effet .............. Alcoholism, T h nine ' --.-.-.-.-.-. - . -........ 360 Carcinoma cia P tretary Factor in ............ 243 Carcinoma, Sign of ......................... ,, 1...-..........119 Catarrh of the Rectum .. ................................ 120 Cement, Rubber............ ................. Altitude in Chet Affections ....................38 Ceren, Rubertion, .. - **.......... Amenorrhea 8 Cervix, Laceration, Immediate repai Ammonia, as an antiseptic .···*..362 Chancres, Indurated by urine................. An sthesia, hloroform, E ec f.'''.-.-.-.-.-.-.- -.....56 Chancroids, Treatment of.. ·····*****......... Analgesics, The Newer. t of prolonged....... 22 Cheyne-Stokes Respiration ........... ....... .........................1 ChThaes.......................... Analysis of Wate, simple ····· ...............1i ............. Anatony Examinations 101 Chloralamide .....at ******...... ....... Anatomy, Study of........................... 175 Chloreform, Commission, Repo t of..........201, Annual Banquet, Trin. Med. ..... 289 Chloroform, Death at commencement .............. Autipyrin Habit... . **********. 123 Chloroform, Effects of prolonged AnSsthesia . Antip as a Hypnotic for Children ·.... · 181 Chloroform, Pathological effects of.............. asP a Cot o tic f***....*...... 210 Chloroform, Physiological action of.............. Atseptic Cotton. Aethma, Treatment of ..... .... ...... .... 158 Chloroform, Pupil a guide to the administration of.. xiChloroform in........ .....90, 213, 328 Cholera Bacillus, The. e m.n.strat.on.o.. Ataxia, Latency of sympto* *.******** 149 Cholera, Salol in............ ................ 52 Chorea Antipyrin in........................ Bacilue Another Cigarette Smoking .......................... Balanits, New variet of****** 62 Circumcision ........... .... ................ Baldnes, Lassar's cure .... . 247 Cirrhosis of iver .............................. Baldness, s ar' cutre for............. ........ 47 Clinic, by Wm. Pepper, M. D., Philadelphia .... 103, B le cr ion u ···.. · · ...90, 121 Coccidiu m i Eggs of Fowl ..................... Black Eye... ··········.-... 156 \"Cold\", Salicylates in ..·....... ...... Bladder, Washing out ......................... ls Law..................................... Boiledu Milk, Digestibil.. ·. · ·.......... 182 Conception, Probable period of................ Bone edulla deen, of................... 180 Congestion of the Lungs. What is it?. ,Medulla and Spleen, Pathological relations be. Congestive Neurasthenia tBeen, Ue - S M.D., Orangeville-.. . - 69 Constipation.......'.''''.-..-.. . Boacic Acid, ues of-......................... 177 Consumption, Chest in 31, ............................................. .... I",
         "INDEX TO VOL XXII. PAGE Contagious diseases, Personal Disinfection in..... ..19 Convulsions, Infantile.................. .... .29, 321 Correspondence- James Russell Hamilton........................ 7 London Letter..............................7, 336 Edinburgh Letter.................... . 38, 73, 104 M edical Education............................. 167 Philadelphia Letter........................230, 274 Dr. Stark, Hamilton........................... 232 Clarence H. Chipman....... . ................ 275 Medical Education in Ontario, Walter, B. Geikie. 367 H. S. Bingham, Cannington, Ont................ 372 Coryza.......................................... 64 Cosmetics for the Physician............ ........ 318 Creasote, Formulæ for............................ 118 Credé's Method.................................. 327 Creolin in Gynæcology .... ...................... 297 Creolin in Obstetrica............................. 91 Croup, Chloroform in............................ 297 Croup, 01. Terebinth in.......................... 61 Croup, Turpentine in............................ 178 Cystitis, Chronic................................. 62 Dandruff........................................ 24 I)eafness, Pilocarpine in........................ 114 Diabetes, Antipyrin in ....................55, 92, 122 BDiabtics,Bread for.............................. 124 Diabetes Mellitus.- ........................118, 216 Diabetes, Pancreas in...... ..................... 294 Diarrhea, Glycerine in......................155, 297 Diarrhea, Infantile..... ··...................... 21 Diet, Normal..................... .............. 214 Diphtheria, Cyanide of Hg. in ................... 62 Diphtheria, lodoform in ......................157, 158 Diphtheritic Sore Throat ....................... 126 Dislocation of Hip, Simple method of reduction..... 119 Doctors' Fees to the College of Pharmacy.......... 154 Doctors' Strike, a.......... ................... 220 Doctor, The, at home............................ 209 Dont's in Consumption-....................... 317 Dropsy, Renal, Pathology of ................... 169 Dyspepsia, A. McPhedran, M.B., Toronto......... 65 Dyspepsia, Flatulent...... -...................61, 63 Dysentery....................................93, 152 Dysentery, Hg. C12 in ...*...................... 189 Dysentery, Salol i........................... 29 Dysmenorrhœa, etc................................ 339 Dysmenorrbea, Formulæ for................191, 223 Dysmenorrhea, Hydrastis in.................... 150 Dysmenorrhea, Pulsatilla in...................... 180 Earache, Atropine in............................214 Eclampsia, Microbe in....................... 327 Eczema .............. ..............82, 150, 211, 329 Electricity.in Medicine, A plea for, C. R. Dickson, M .D., Toronto...................... ........ 4 Empyema, Bulau's Method...................... 112 Endometritis........................ ........181, 127 PAGE Enteritis.--- -....... . .......................... 246 Enuresis.. ........ .......... ......30, 96, 127, 223 Epilepsy, Antifebrin in.......................... 100 Epilepsy, Biborate of Soda in ..................... 381 Epilepsy, Cortical, David Inglis, M.D., Detroit.... 1 Epilepsy, Study of ..--.......................... 241 Epilepsy, Treatment of ...... ................... 77 Erysipelas, Microbe of..................... ...... 290 Erysipelas, White Lead for...... .... ......125, 216 Extension of the Spinal Cord, Charles F. Stillman, M.D., Chicago, Ill..... .................267, 304 Eye and Ear, Suggestions on Treatment .......... 375 Fever, Slight continued.................... ..... 208 Fibroids, Electrolysis in ........................116 Fistulæ, Bloodless treatment of ................290 Fistula in Ano...............................62 Foods for Invalids and Infants..................236 Food, Wood as..............................320 Fracture of the Neck of the Femur...............80 Fractures, Ununited................ .......... 180 Gall Stones.................................. 63 Ga.tric Ulcer, Diagnosis and treatment of........ 9 Gatro-Intestinal Catarrh....................... 94 Glauconia, V. H. Moore, M.D., Brockville, Ont.... 193 Goitre, Strophanthus in....................... 116 Fra Cause of..nuie........................... 149 Gonorrhoea........... ...... ......... 5, .329. 354 Gouty Diathesis, Clinical remarks on ............. 277 Hmatemesis ................................ 95 Hmorrhoids ....... ..........95, 106, 15, 222, 342 Gair Recipesh n.......................,330, 362 Hay Fever .. ................................ 31 Headache, Gelsemium i..................... 3... 120 Headaches, Alcoholic.... ...................... 158 Headache, Some causes of, by G. Sterling Ryerson, M.D., etc., Toronto........................ 196 Heart Disease, Cactus Grandiflorus i............354 Heart Disease, complicating labor ................ 321 Heart, Position in exami ig ................. ..0 Hemiplegia....*........................... 3 Hepatice Abscess .............-............... 20 Heredity ..........Ac ......................... 120 Hernia, Coughing te redues ... .................. 87 Herpes............. .........................3 Honor to Sir Joseph Lister......... ............ 384 Housemaid's Knee .................. .......... 32 Hydrastinine in Gynecology .................... .353 Hydrastis Canadensis ......................... 24 Hydrocele ................................... 31 Hyperidrosis..... ......................... 20 Hypnotic, Another............................. 159 Hypnotic, Paraldehyde a a......... ........ .. 32 Hypnotic test...................... 285 Hypnotics, Choice of.....- ....................... 359 Hypnotism......--........... ................. 151 L",
         "INDEX TO VOL. XXII. 6 Hypnotiam at Home and Abroad.............. 6 Hysteria, Infantile·......................... Ichthyosis.. ....... 1Illustrations ' -'-''- . ' . ---- . . . An Improved Urethrotome ................ Amputation at Hp Joint.................. Infant Feeding .... ........................ 7 Infectious Diseases, Table of. Inoculation, Preventive ..................'13 . Insomnia ......... ...---............... 6 Insomnia among Children. ....... Instruments Preserve ......... 4 stin Obstruction. .. ....159 248 Intestines, Medical treatment of ..... Irrigation by Sublimate solution, Death from . Irrigation of Uterus ......... 6 Jaborandi in Labor .......... J a u n d ic e , F u n c t io n a l . .*.* . . . ..* . .. . . . . . . . .. . . . . 0 Jaundice, Pilocarpine in .. . ........ ....... 2 6 Labor, Antipyrn in ......... Laboratory, New ............-..........1. Leucorrhea . .... ......... 0 Leukoplak Treatment .........31 iver, Surgery of ···............-.- Locomotor Ataxy, Forcible Flexion in ......... Lyng.in Toilet................. 9 Malaria............... 4 Mamiary Absces . Prevention of ... ......... 3 Marital Selection r. Masseur, the .' ·'....... 6 Mastitis, Treated by Pressure...............191. 9 Meat and Drink e.... ..... 191. 4 Medical Associations. Ontaio Medical Association. 187 Medical Education ............... 85 Medical Emergencies.. ....... 5 Medical Expert Testimoy.... . .... 2 Medical Men, Carlyle on ....................... Medical Notes1a' '·· ·..- ··.......... 2 Nen 19, 53r 84, 113, 146, 176, 244, 318, 2À MembaneTQ pani, Artificial ........... Membranes upture of. 0 Menstruation Brominde in................. 8 Menstruation During Lactat..- . . . . . . . ..... Metrorrhagia, Diagnosis and Treatent............ Microbic Life in Sewer Air reatme........... 44 6 Migraine, to Prevent .. ·...... .......... 4 Milk in Wonen, Alimentation .................. 1Milk, to Sterilize'' ' ' -----'---··.. MikteSerlie......................... Modern Medication Tendencies of ............. 0 Morming Sicknes ****.... 4 Morphia Habit Casto reum in.... ''' Morphia Habit' Treatment of . .-............ Morphie Eating MusicalDe.e.T....·....-..... . ... .... usical Degrees, Trinity, in England.... 3 NavaN l Board, How to ass Nerve Exha 't'o n 0 .' ·'''-*..... 4 N u o n O imervousi Diseaes H. *. ···u ........... . .... 7 Nervour es, . C. ood, M. D., Philadelphia. Neuralgia. ...... ......63, 94, 143, 3 Neuraîgia, Theine in ............. Neurasthenia, Gastri Tr....n-..... Night Sweats C . . ..... ............ 2 Night Sweat, Camphoric Acid in ..... 4 Night Sweats, Remedies for . ··..--........ 4NiPples, Chapped. . .... . ... --..--..-. . .. ... .. .. .. 9 N trous Oxide, Fatal . .'. **. ···....-.--.......... S Noteso 6 o fCasea, by Sir James Grant, M.D., F.R.C. 5.L., Ottawa ........, ... ... Obesity*............. PAGE P . 310 Obstetrics, Bichloride in ..................... . 88 Ointment, Anti-Pruritic...................... Ontario Medical Council................... 354 . 184 Ontario Medical Library..................... Ontario Medical Library Association............ . 85 Opium Poisoning ........................... 147 Orillia Hospital........................... 353 Os, Chloral in Rigid........................ 157 Ovarian Cystomata, by S. Keene, M. D., Brooklyn, 39 N. Y .................. 361 Ovarian Pain, Codeine in ......--............. 376 Ovaries, Results of Removal. --.-.... ··.......... , . . AG E 27 297 355 155 386 87 124 296 271 246 156 329 Paralysie, Facial........ .............·· · ....---. 280 53 Patella, Fractured ............................24 152 Perineum, Lacerations of, H. S. Griffin, M. D., Ham- 182 ilton................ .................... 36 . Peritoneum, Drainage of...................... 287 87 IPeritonitis, Acute Idiopathic, by James Newell, M. 61 D., C. M., etc., Detroit, Mich............ ... 161 211 Peritonitis, Salines in......................... 322 Peritonitis, Septic Germs in ..................... 384 63 Perspiring Feet....-- ......................191, 216 153 Pessaries, the Use of....... .................... 27 354 Phenacetine ....... . ......................... 387 2e21 Phebitis, Treatment.. ............... ........159 155 Phlegmasia Alba Dolens .............215 178 Phthisis, Contagiousness of......... .1.....117 54 Phthisis, Creasote in...-.-.......... ........ 83 Phthisis, Curability of ........... .. ......356, 385 159 Phthisis, Dissemination of ...................119 60 Phthisis, Night Sweats of ..................... 127 290 Phthisis, Prophylaxis of...... ................23 152 Physical Education, E. B. McKenzie, B.A., M D. 297 Toronto... ......................... 97' 134 60 Physician's \"Fad\"........................... 383 Placenta Prvia ........................ ...... 89 293 Pneumonia, Acetate of Lead in....... ..........245 217 Pneumonia, Ergot in, F. Winnett, M. D., M. R. C. 239 S., Eng., Toronto...... ................... 197 218 Pneumonia, Cold in . .......................... 247 20 Pneumonia, Hg. Cl. in ........................290 351 Pneumonia, Treatment of, by J. L. Addison, M.D., 206 St. George, Ont.......................... 365 190 Poor, Gratuitous Services to ..................... 25 288 P. P. Hiemorrhage, Iodoform Gauze in............ 183 320 P. P. Hæmorrhage, Turpentine in. .......... 127, 296 373 Post-mortem, Wonderful, J. Workman, M. D., Tor- 75 onto................... .................33 22*2 Potassium Bromide, Accumulation of, in Brain .. 54 119 Pot, Iodid. as a Cardiac Tonic.................. 158 63 Pregnancy Cystitis.................... ....... 382 111 Preputial Contraction, Reflex Nervous Phenomena 379 Due to, R. W. Bruce Smith, M. D., Seaforth.. 101 61 Presidential Address, Ont. Med. Association, by J. 3! A. Temple, M. D., Toronto................... 331 330 Private Hospital.............................387 291 Prostatic Hypertrophy......................... 28 Pruritus ......... ....................23, 328, 362 283 P -..................................... 215 178 Psoriasis, Formula for ........................384 72 Psoriasis, Treatment of ........................ 1 216 Puerperal Eclampsia...................... . ... 245 212 Puerperal Fever, the Prevention of, by Wm. Britton, 380 M. D., Toronto............................ 299 3b2, Pulmonary Respiration...................... - 383 188 Purpura Foudroyant, by J. E. Pickard, Thames- 62 ville, Ont ..... - -.......................... 384 125 Quinine, Oxytocic Action of ..................... 221 363 Quinsy ..................................... 95 147 Registration of Doctors as Druggists.............. 361",
         "INDEX TO VOL. XXII. Renal Calculi, Belladonna in ............... Renal Disease, Chronic ..................... Renal Function, Influence of Nervous System on ... Reports of Societies- Canadian Medical Association .................. Hamilton SocietY ............... Ontario Association.............337, Retroflexion................ Rheumatism, Formule for ..................23 Rheumatism, Miasmatic Theory of ............. Rheumatism, Treatment of ................... Rhinitis, Hypertrophic, Price Brown, M. D., Toronto Rigors, What they Indicate ................... Ringworm of Scalp ...............--........... Roach Destroyer ................................. Royal College of Surgeons, England............. Saccharin to Acidify the Urine ................. Sait in Neural ia........................... Sane, M oode o . . ............................ Santonine, Administration of .............. Scabies, Carbolised Oil in .................... Scarlatina, Eucalyptus in... .................. Scarlatina, Prophylaxis of ..... ......... -...... Scarlatina, Salicylic Acid in .................. Scarlet Fever and Puerpera ................... Scarlet Fever, Eucalyptus i................... Scarlet Fever Patients, Disinfection of . . ..... Sciatica, Rational Treatment of................ Scrofulous Glands............................ Sea Voyage, Advantages of ...··.................. Shingles . · - - - -. Shorthand for Medical Students ................... Song of the Knife........ -.................... Sprains........ ......................... .. Spurious Pregnancy........................ Stammering................................ Stomach, Dilatation of....................... Stomach, Diseases of, Differential Diagnosis ... . Stomach, Irrigation of....... ............... Stools, Colorless, Significance of................ Strangury.................................. 3 Stricture, Treatment of........................ 2 Su ar in the Urine.......................171, 1 Su[phonal ···· . --··..---- ...7 1 Sulphonal, Death from ....... -- ................ 1 PAGE 246 Sulphonal, Large Dose of ....................220, 324 Sulphur, Palatable .......................... 88 Superstition in Medicine..................... Susp)ension Treatment Contr-Ta,-Ii ti t , upnin ramn Cnt,~T a;~. ons .. .. 8 -'''-.. -.... -. -···············.......... 95 308 Syphilis, Treatment of ........................244 357 60 Tape-worm.............................117, 228 221 Teeth Cleaning..............................289 85 Temperature, Spray to Reduce.--................. 151 28 Tetanus, Bacillus of...........................21 129 Thermo-Palpation .......... ................... 181 20 Thorax and Lungs, Anatomy of. ....... ......... 345 158 Throat Affections, Turpentine in................ 15b 330 Thrush and Sordes...........................220 188 Tonsillitis.......... ..-..................... 387 Toronto University ............*............... 325 242 Tubercle, Bacilli, Persistent Prevalence of......... 362 214 Tuberculosis............................159, 216 47 Tuberculosis, Creasote in.......................1 158 Tuberculosis in Children..................... 297 Tuberculosis, Prophylaxis of....................57 211 Tuberculosis, Salicylates in Fever ............... 222 86 Turbinated Bones, Hypertrophy of .-............. 221 29 Typhoid -'-··............................. 59,92, 329 319 Typhoid, Abdominal Distention in ..............344 14 Typhoid, Abortive Forma of, by A. McPhedran, M. 189 B., Toronto ...................-.- ·.......... 164 118 Typhoid, Opium for Hoemorrhage of .............. 2a 118 189 Ulcer, Chronic, Indolent......................286 159 Ulcer, Gastric...........................94, 183 219 Urethrotomy in Stricture.......................59 352 Uterine Bacilli .............................. 362 92 Uterus, Drugs for............·· ................. 94 84 Uterus, Extirpation of.........................93 .91 73 Vaginal Hysterectomy, A. Groves, M.D., Fergus, Ont. 6 60 Vermifuge.................................. 158 49 Vesical Calculi, Large..............--........... 360 17 Virginia Medical Examinations................. 295 28 Vomiting, Obstinate...........30, 55, 88, 214, 222, 289 87 98 Warts.................. .................. 86 Whooping Cough, Bromoform in.................93 91 Whooping-Cough, Renal Troubles in........... 150 PAGE 282 157 149 1",
         "'89j THE CANADA LANCET. TiE CANADA LANCET. A MONTHLY JOURNAL OF MEDICAL AND SURGICAL SCIENCE, CRITICISM AND NEWS. VOL. XXII] TORONTO, SEPT., 1889. [No. 1. CORTICAL EPILEPSY-A CLINICAL LECTURE. BY DAVID INGLIS, M.D. Professor of Men lege f Metal and Nervous Diseases, Detroit Col- ege O Medicine. Member American.Neurolgical Association. (Continued from A ugust Number.) You see then, gentlemen, that a case of cortical epilepsy serves as a pathological experiment. We demonstrate the fact of special cerebral centres, and it serves also as a physiological experiment to explain in part the mode of action of the brain atter. It i s by such uses that we get the real value of strange phenomena. Leaving these gen- eral, but by no means secondary considerations, and confning our thoughts more particularly to the special points about cortical epilepsy, we ask frt in regard to its causation. The causes may be grouped into two classes: lst, those to which I have already alluderi as located in distant parts of the body, commonly called reflex; let me reiterate that you should in every case search diligently for these, bearing in mind both the fact that the irritant point may be located in the most unlikely place, and at the same time the irritation may be \"0 slight as to give littie notice of its particular location. Hence you must search, for instance, the entire length of the alimentary canal. Delayed or irregular, or- even simple dentition, irritants in the stomach or bowels, or perhaps an anal fissure, any of these may be sufficient to cause the cerebral trouble. In like manner you must make a complete examination of the generative organs. By the way, I mean in males as well as females. The medical profession runs so much to gynSco- logy, that the male sexual organs are oft-times neglected. The prepuce, especialîy in children, must never be overlooked, and I have become satisfied that quite a number of obscure cases of nervous disturbance depend upon abnormal con- ditions of the testicles. A varicocele causes but very trifling distress, yet I am certain that many cases of marked nervous depression are due to nothing else. I cannot go into detail further, but am reminded of that grand old teacher, Professor Traube, of Berlin. He used stoutly to maintain that to make a proper diagnosis, we should make a complete phy- sical examination of our patient from the top of his head to the soles of his feet, not figuratively, but actually. Indeed he used to compel us to make a diagnosis of a case before the class in that manner. We had to make a diagnosis, as the advertisements for the recovery of stolen goods sometimes read, \"No questions asked.\" And the wisdoin of his advice every old practitioner knows. For instance, none of your patients will ever vol- untarily complain to you of her high-heeled shoes, but you may not infrequently cure a lame back of long standing by cutting down the heel. Patients will not think so lightly of you as to so much as mention such an ignoble thing as a \" corn,\" but you need to search even for corns. The second class of causes of cortical epilepsy are those which directly affect the nutrition of the brain substance. It would lead too far to enter to-day upon the subject of the nutrition of nervous matter ; let me only say that a large and im- portant class of nervous diseases are what we term functional. By that we simply mean that a post- morern examiuation reveals no change in the brain substance which is visible either to the naked eye or with the aid of the microscope. Mentally, we cannot conceive that there is no change in the brain cells, but we are obliged to believe that the processes of nutrition in the cells are in some way affected, even if we cannot see evidences of the change. Still it remains true, that the causes of nervous disorders, such as corti- cal epilepsy are, thus sometimes nutritional or, as it isoften called, molecular. In other cases we find a certain area of the cortex visibly affected by lesions within the era- nium. The cause may be traumatic, and this is by no means rare. iHere again you will be compelled to search diligently, for patients often forget an injury long",
         "2 THE CANADA LANCET. [SEPT., past, not realizing ihat siowiy increasing patholo gical changes may follow an injury at a late date. Traumatisms may be either in the nature of fracture with depression or an immediate hæmorr- hage within the skull, or, and this is by no means uncommon, the injury may set up slow inflam- matory processes in the membranes, or a thicken ing of the skull, or the formation of a thorn of bone. These processes may, by pressure or con- gestion, set up the irritation which results in the epileptic explosion. They very commonly, how- ever, act by shutting off the circulation to a cer- tain extent. If you will recall your anatomy you will remember that the cortical substance of the hemispheres receives its nutrition by means of a vast number of minute short arterioles which penetrate from the pia mater for a distance not much greater than just the thickness of the cor- tical substance. If now a slow inflammatory pro- cess (with its usual result of a deposit of new con- nective tissue) takes place in the pia mater the induration which finally occurs in the new tissue, shuts off materially the free flow of blood to the cortex. In this way one can easily understand why it is that the symptoms follow not always immediately, but often after the lapse of a con- siderable time after the injury, hæmorrhage or other exciting cause. Another cause of cortical epilepsy deserves mention particularly, that is sunstroke. This cause is apt to be overlooked be- cause the subject does not always have a history of being totally overcome by the heat. Quite often it is only by special questioning that you will learn that the patient has been to a greater or less ex- tent affected by intense heat, and yet I arn certain that a sunstroke, even a partial one, may set up lasting changes in the cerebral, more particularly the cortical circulation. The fact sometimes brought up in objection to this conception, to wit, that the po8t-mortem examination shows no ade- quate change, can be answered by this. Varicose veins of the leg, even of great extent, disappear at death. At the post-mortem you may find a chronic ulcer, while the varicose veins which caused the stagnation and starvation, resulting in the ulcer, may not show at all. So, too, perma- nent dilatation of the superficial vessels of the cortex, with the consequent slowing of the blood stream and resulting impairment of nutrition, can readily disappear after death. Besides these local causes, I must mention general causes, such as the various constitutional infections, especially syphilis and tubercolosis; also causes which tend to mark- ed anvemia, as for instance, severe hæmorrhage. Again, we must not omit to look for various toxic disorders, notably uroemic poisoning. Dol not forget that this search for causation is not an idle curiosity, but that often the removal of some such cause, when it has been found, may lead to the restoration of your patient. In the case which we present to-day, the cause seems to lie very clearly before us. A severe blow upon the left side of the head is fol- lowed, after an interval of about four months, by a cortical epilepsy which is very distinctly local- ized as originating in the ascending frontal and parietal convolutions of the same side. But again I must warn you not to hastily accept even such a clear case as this. It is the universal tendency to take easy and short views, but if you neglect to loook farther than the surface phenomena, you will often fall into grave errors. For instance, in this case, you attribute the epilepsy to the blow, to a pachymeningitis consequent upon it; but what bearing upon the case then do you attri- bute to the profuse hæmorrhage at the time of her miscarriage; to the fact that it was at the next menstrual period following that the seizures first began, that the next seizure then occurred at the next menstrual period I Again, let us not forget that from about the time that the second seizure occurred she has had a pretty continuous head- ache, not upon the left, but on the right side ; also, that since September8th shehas had a paresis of the right abducens. You have said nothing about the nervous wear and tear of a wretched married life, nor of the using up of vital force involved in her frequent child-bearing and miscarriages. Youl see, gentlemen, the thing is not simple after all. Not to delay too long over this point, I will simply say that the striking limitation of the con- vulsions leads me to believe that only a small area of the cortex is involved, and that while the causes last mentioned have ,probably all had their share in getting her ready, that I think it alto gether probable that the blow at Christmas wa$ the factor which determined the localization. PROGNOSIS AND TREATMENT. These points can, very conveniently, be taken' up together, because the one depends so cloself",
         "T., sthe hilis iark- e. ious Do t an ome d to %use vere fol- by \u003ecal- and çain ih a y to t to you ace, the it; ;tri- her ext irst the get uré ad- Iso, the out ied her gill on- 'al the eir to- en '89.] THE CANADA LANCET. upon the other. In Vry many of the diseases of the skull, on Wheh you wi be called upon to treat, the think such a c gnra tendency s dstinctly toward a natural painful suspici notee d youpoan nrake a prognosis which does that some zeal not depend upon treatment. but in the case of for conditions the other directione y is in general markedly in tion and hygi is likely to contineA case of localized epilepsy quite as suces ostly continue indeed it is likely to involve a come. To the constantly increasing area, 80 that what is, at first, commend the p ance, tends to approac igy slight motor disturb- resorting to se, Severe form ogeral in character the more milder ones. selvee of gnl epilepsy. This, in turn, in- warn you again Here the expect of mental deterioration. medicinal and uiie. epectant plan of treatment is never patient's condi Justifiable Indted 0 marked is this tendency to the probable en the establishr t of a convulsive habit, that you tainly justified ought to use the utost promptitude in your tions if they ho Araenay fIf then the sou A case iay, for instance, occur in which the ovaries, their r Înost distinct relationship can be traced between even if their re soae local irritant and the convulsive seizures. the epilepsy. Can you Promi. moval of the cau patient that upon the re- best we can. Of fo cause the convulsions will cease I No; for unfortunatey the cortical rnechanism TRE may have set up the habit of periodical tempestu- It is but a few; ws discharges t bs a good deal like a horse ing the skull w sudden fri he reen a steady driver, if from serious of sùrg watch himn; but if hns away once, You need to that feeling h you had better sel, hi un away a second time changed. The strong that he will ultfor the probability is very profession rema The longer the eiultimately break your bones. so. Changes g er t excitin cause is allowed to act slowly adopted. the greavr the liability that, even when you suc- antiseptic surge eed coinr u Itbe, cause the convulsions may results already stil continue It becorne evident then that that adopted. Neve part of the treatent which consist in the re- practice of antiE olong hne lectd an important one, not to be the estimate put you ongweeeen 1 cannot forbear to caution If antiseptic su You hever, cetin Whie. urge You to prompt more it would and decisive action Seek diligently for any ex- opened up the p iany instances it, if Possible, early. In consideration oi norma cnt i You wiJl do well to remove some limitations of ce certain that itioh even if you are by no means vince to discuss an elongated pr the exctng cause-for instance, duce the subjec ral tethPuce can be renoved, or some ab- consideration, a genee or Siiar conditions rectified to the gentlemen, Wil afecting o e patient even if not surely free from the con 8,n thit yoiau d yo7ptoms. But my caution hampers many o ths, that You do not Perform any of the graver for many years. ,uch as removal of an ovary or opening great rashness. such insufficient grounds. You may aution quite needless, but there is a on in the minds of the profession ous surgeons have removed ovaries which a thorough course of medica- enic treatment might have cured sfully and with much happier out- zealous among you therefore, I lan of judging carefully and before vere measures to try faithfully the To the conservative among you I st too long delay. If after thorough hygienic treatment you find your tion unimproved, then in view of d of a case of epilepsy, we are cer- in performing even grave opera- Id out a reasonable promise of help. rce of irritation seems to be in the emoval is justifiable, and that too moval does not successfully relieve We are charged simply to do the This brings us to the subject of PHINING FOR EPILEPSY. years since the operation of open- as looked upon as one of the most ical procedures, and I find that as, by no means, been generally great mass of the members of our ins always conservative, and wisely in methods of procedure are very Hence it is that the practice of ry has, in spite of the marvellous achieved, not yet been generally rtheless, it remains a fact that the septic surgery has entirely changed upon the dangers of trephining. rgery had accomplished nothing still be glory enough that it has ossibilities of cranial surgery. The the methods, precautions and rebral surgery it is not in my pro- with you. Let me simply intro- t to your attention and further rid give again a caution. You, enter upon your professional work servative bias which unavoidably f those who have been in practice Your greatest danger lies in too Remember the old saw, that",
         "4 THE CANAD \"fools rush in where angels fear to tread,\" and while you go out prepared to carry out the results of the latest progress in medicine and surgery, carry with you a determination to use careful judgment. In this matter of cortical epilepsy, the operation of trephining has already accomplished certain de- finite results, and the next few years will probably add to the accuracy with which successful results can be achieved. At present we may consider the following points as established : 1st. That the operation is a legitimate one. It is howevur to be presumed that this, like any other of the graver surgical operations, ought not to be done until the failure of less dangerous me- thods and the severity of the case renders further action necessary. 2nd. That the operation should not be done un- less the patient presents symptoms which, with a reasonable degree of certainty, point to the lo- cality of the initial point of discharge. 3rd. That the operation is most likely to prove successful in cases due to the presence on or near a cortical area of something which acts as a for- eign body. This may be a depressed portion of the skull, a spicula of bone, a localized thickening of the skull or membranes, a blood-clot or some neoplasm. 4th. That in case the operation reveals no or- ganic or removable lesion, it is still justifiable to remove a portion of the cortical substance. Such a procedure brings about a corresponding loss of motor power, but even in case the paralysis thus produced remains permanent, it is nevertheless better for a patient to go about with a partial pa- ralysis, rather than with a convulsive disorder which tends, ultimately, toward dementia. As with the removal of reflex causes, so with the removal of intracranial causes ; bear in mind that your prognosis, as to the result of operation, must be guarded, for the epileptic \" habit \" may still continue. I bave thus, gentlemen, utilized this patient as a text for some of the considerations bearing on cortical epilepsy. There remain still other points of interest, which we must leave for the present, for instance, the matter of non-surgical treatment. Let me simply say that while medicinal treat- ment seems, for the present, to control the fre- A LANCET. [SEPT., quency of the seizures of our patient, and we con-i sequently delay any operative interference, that with such a history and such a definite group of localizing symptoms, if our patient gives evidence of progressive cerebral disorder, I shall advise the operation with great confidence in its affording help. 21 State St., Detroit Mich. A PLEA FOR ELECTRICITY IN MEDICINE.- BY DR. C. R. DICKSON, TORONTO. That the subject of electricity is not well un-. derstood by the mass of general practitioners none will deny ; that it does not occupy the position ino therapeutices it deserves nany will question ; tha its field of usefulness may be greatly enlarged, and that it may be relied upon to act with reason- able certainty many doubt and will continue ty doubt. Why should this be so i The answer is plain. Our profession is one in which haste ij made slowly-often very slowly-andperhaps it ik- better that caution should mark our path, at least,1 safer for our patients. Where are we to learn the fundamental princi ples of this agent that bas been until recentll; enshrouded in such a cloud of mysticismi Th8a instruction given in our colleges is most meagre ig this direction, and patient study in books, all OC which are most disappointing, often assuming a acquaintance with the subject which they ar4 trying to teach, proves very irksome ; and experi, ment, the best method of all, takes much time au means, neither of which can well be spared by thr majority of us; and so a faradic machine is pu chased and a book of instructions, and \" fools rus in where angels fear to tread.\" All goes well a\" the new broom sweeps clean, but the applicati takes up too much time, and finally the fara machine is left in charge of the patient, wh allows the zinc element to remain in the fluid the time perhaps, and when the battery arriV home it may be a thing of beauty still, but by means is it a joy, but rather a decided vexatio and finally is sent to the instrument-maker repairs. This process is repeated until at last unfortunate article is one day thrust aside *Read before[the Ontario !Medical Association, JO 1889.",
         "con hat \u003e of mnce the ling E. that e . , \u003er 1\u0026î ei it ast, ~ el .f are )r ir th e in a a th a, ii1 wh8 i of puf 1THE CANADA LANCET. 5 accumulate the dust of ages, and electricity voted treatment of such hitherto intractable diseases as a failure. Orperchance, our practitioner is more diabetes mellitus, whle it would account for its aspiring and a galvanic battery is purchased; but power over indigestion, dspepsia, and that every it would take too long to even imagine all the prevalent complaint, constipation. Nasal catarrh cishaps tht may befall it, as it was formerly con- and several forms of skin disease are frequently structed with a view to getting out of order with amenable to this treatment. In the field denoted the greatest facility on the slightest provocation, by that convenient though vague ter, neu- and in that respect was a marvel of perfection. rasthenia, as might be easily imagined capital Even machines of recent construction leave much results will follow the use of electricity, and in to be desired and in secondary batteries which that rare disease para-myoclonus-multiplex, it is proinised so much we have been greatly disap- also of value. POinted. Whether the Gassner dry cell will prove The preceding observations apply mainly to satisfactory, remains yet to be seen. The foregoing galvanism. I will barely allude to the use of ifot exaggerate in any respect. Another source electricity in the many forms of paralysis, as to Of trouble is a very dirty sponge, which when re- do more would materially lengthen a paper which ioved from its metal electrode displays a fine it is my desire to keep as short as possible, and illustration of the process of oxidation, a process here its use has been more frequent. which electricity encourages to give it an excuse for And now a few words as to the faradic current. fot working. No wonder that disappointment Perhaps the quickest resuits from its use will be But look with e-on t experienced in hypochondriasis and hysteria,.in Blu hask it 1 me on the other side, for every both of which diseases it may be combined with cloud has its silvery lining. The man in this case advantage with the galvanic current. The power is fortunate in having obtained a knowledge of the of faradism to excite muscular contractions and clemistry and construction of batteries, and care- thereby increase muscular nutrition may be taken fui reading and patient experiment have extended advantage of in the treatment of phthisis, where ho acquainta e. He courted electricity, and the accessory muscles of respiration may be though at first she played the coy maiden and strengthened by its use, and much comfort given made fun of his efforts, at last lie won, and now thereby. they are firm friends; and while lie keeps lier In aphonia, whither hysterical or not, its use is house well stored and the path bright and clean, attended with speedy and beneficial results if there she wil walk or run in it at his bidding, in lier is no organic lesion present. In disorders of the Own mYsterous fashion. And where will lie find alimentary canal dependent upon lack of muscular her scatter lier sunshine most freely? In the tone, its use is productive of good results. haunts of pain will lier work be most apparent. I have by no means exhausted the list of diseases Neuragia wil fiee when she comes, be it supra- in which electricity, galvanic or faradic, has proved orbital, infraorbitah intercostal, epigastric or palliative or restorative in my own practical ex- ovarian, and even that major form, sciatica, perience; nor have I laid down the special line of acknowledges lier rule, and headache, in the procedure to be adopted in each case, as to do majority of its varities, also owns lier sway. The either would occupy the time of this Society. ame appliegs to many forms of rheumatism. Even It also leaves the field open for discussion should the pangs of that dread foe, angina pectoris, may such be desired. My object is to excite a greater in hany instances e alleviated. interest and stimulate investigation in a rather But she is ot content with merely the relief of neglected though prolific branch of therapeutics. pain, for lier work is also curative. Her wonderful Power Of exciting absorption may often be utilized NEw CHAIR FOR A MEDICAL UNIVERsITY.-Dr. with telling effect in chronic articular rheumatism, Charles F. Stillman, author of a [recent work on as also, in the treatment of indolent ulcers. The Life Insurance Examinations, has lately been ap- action of electricity upon the sympathetic system pointed to the Chair of Physical Examination for is productive of 'the most satisfactory results in Life Insurance, lately established jin the University goitre, and promises much in the direction of of Vermont.",
         "THE CANADA LANCET. [SEPT. VAGINAL HYSTERECTOMY WITH larged so that a sound passed easily five inches and ABDOMINAL OVARIOTOMY.* its withdrawal was followed by free hoemorrage. Low down in the abdominal cavity a tumor was BY A. GROVES, M.D., FERGUS, ONT. easily made out, slightly to the left of the median line. It was not clear that this was separate In bringing this case before you, I do so with from the uterus, for every movement of the one the hope that it may in some degree, however caused a corresponding motion of the other ; but slight, influence others to advise or adopt operative seeing that small ovarian tumors with short treatment in the early stages of nalignant pedicles are sometimes differentiated with diffi. disease of the uterus. Whether the disease be culty from uterine tumors, I left the exact nature, hlmited to the os and cervix, or involve the of this an open question. My diagnosis was ma, body of the organ, complete ablation, to my mind, lignant disease of the uterus, with possibly a small offers the best prospect of a permanent cure. It ovarian tumor, and I advised operative treat- must be admitted that vaginal hysterectomy is a ser- ment as holding out the only chance of recoverY. ious and diflicult operation, not lightly to be under- On the 7th of May, Dr. Rogers, ny partner, taken; but one who has, and wo has not, witnessed, her with me and agreed as to the diagnosis and the terrible ravages of uterine cancer, will agree also as to the advisability of an operation. Ac- that any operation, however diflicult, is worthy of cordingly, on the morning of May 8th, I operated consideration when the only alternative is death with th assistance of Drs. Mennie, Roger and in one of its most miserable and loathsome forms. Millican. The patient having been chloroformedy It is hard to imagine any condition better calcu- the uterus was drawn down as low as possible and lated to excite pity, than that of a woman in the a ligature passed through the cervix, by means last stages of malignant uterine disease. The wlich forceps and tenacula could be dispensed nights of agony and days of pain which drugs with. The uterine cavity was thoroughl dshesed barely alleviate, the horribly offensive odor aris- win her uteme ai pas thorevnt washed ing from putrid discharges mingled, it may be, out, mn order to remove all pus and prevent the- ing ron putid iscarge migle, itmaybeescape of septic matter into the peritoneal cavit7. with urine and fæces, for perforations of the blad- at a subseqnent stage of the operation. Having der and rectum are by no means unheard-of com- inciseqen usaembrae araon tH vin plications, the burning excoriations bathed in and separated the uterus froun the bcadder, the acrid matter-ali go to for a picture too well peritoneal cavity was opened through Douglas' knars, scince for othing cu offhi, uptoent cul-de-sac, and on passing my fingers up over the years, science had nothing to offer. If, then, thi fundus an ovarian tumor was found, which it was case should tend to influence you in favor of decided to remove by abdominal incision. The attempting the radical cure of uterine cancer or abdomen was immediately opened in the ordinary sarcoma, I shasl feel that I have not wholly manner and the tumor, which was about si% wasted your time. inches in diameter and semi-solid, removed with- On the fourth of iast May I first saw the out difficulty. Placing a sponge in the abdominal patient whose case I bring before you. I found a wound, I brought down the fundus of the uterue lady 69 years of age, the mother of several chil- to the vulva, ligatured the broad ligaments and dren, and who had enjoyed good ealth up to about separated the uterus from its attachments. TherO sixteen months since, when, as she expressed it, being no oozing of blood the abdominal wound bher changes returned,\" and the discharge of was sutured, and a couple of stitches put in the blood was more or less constant until the time of vaginal wound also. A drainage-tube was left il n'y visit. Latterly it had become quite profuse vagina and a catheter in the bladder. The at times, and there waa also a considerable dis- re-action was given and she vomited only once- charge of badly smelling pus. She was quite pal- Evening temperature 991; slept considerably dur' id and was rapidly losing flesh and strength. On- ing the night, and had a temperature of 99 nets making an exainination 1 found the uterus en- morning, which in the afternoon went up to 100. Read before the Ontario Medical Asociation, June, Slight discharge fro drainage tube, little orn pain, considerable thirst. Third day: mornin",
         "and rage. dian ,rate one but hort diff1- ture ma- mall. -eat- ery. sa,« and Ac-' ,ted and ied, s of sed hed the 7ity ing vis the las, the, ha th- aal rial rue nd 1r6 he iii 'he 1e. 89.] THE CANA temperature normal; evening, 99, nothing coming through drainage-tube, which was removed. After this time the temperature never rose above the normal, and the patient progressed without an untoward symptom, to recovery. To the Editor of the CANADA LANCET. SIR,-Under the head of \" The care of the In- sane,\" in your August issue of the LANCET, You animadverted at length on \" the ponderous mecha- nism of the existing laws for the admission of an insane person into one of our asylums,\" and you say \"the difficulty seems to lie in the magisterial Supervision of those held to be insane.\" You seen either not to know, or have omitted to mention, that more than one-half of the insane are ow admitted to our asylums without coming under magisterial supervision, and a much larger number, if not the whole, might be admitted with- out it. I fear that in too many cases it is done for the purpose of being relieved of expense and ole. hIt may be said that patients who are violent have to be sent to gaol for want of room in the aslyum. This may have been true to some extent in the past, but without speaking for other aylus may say that every application made to this asylum for the past two years has received prompt attentio, and a vacancy awarded at once. I cannot therefore too strongly urge upon the pro- fedsion and Public the necessity of making appli- cation to the Asylum, instead of the magistrate, for the admission of lunatics, thus giving them the advantage of early treatment, and saving the poor unfortunates, who have already enough to bear the further reproach of being thrust into gaol to consort with common criminals. Yours, Asylun for the Insane, JAMES RUSSELL. Hamilton, Aug. 10th, 1889. FROM OUR LONDON CORRESPONDENT. LONDON, Aug. l2th, 1889. There is certainly no city in Great IBritain ffering greater opportunity for the study of dis- eaes Of chidren than Liverpool, and as far as I have seen, no hospital where the work is better or more thoroughly done. There are two resident medical officers, a surgeon and a physician, and the amount of cases these two men have to watch for their respective chiefs is very great. Of course the scrofulous diathesis is a prominent factor in the ailments of these little ones; the amount of deformities and variety is appalling, and one can- not be but thankful that such sights are indeed a rarity in Canada where food and fresh air i's so easily obtainable. This stunted growth and wiz- ened face, bent and distorted limbs has one other cause, which cause is now being prominently brought before the public by the London press- that of marriages contracted by mere boys and girls. These lower classes frequently make parties of four or six couples and go off on a sort of matri- monial picnic. The Daily Telegraph of July 19th, says, in an article entitled \" The Weeds of White- chapel,\"--\" Here is the base on which White- chapel poverty stands ; here is the difficulty which makes reformers hopeless. Troops of boys and girls marry and are parents of rickety children before they are out of their teens. They have no more forethought than rabbits, and they give to the world whole swarms of miserables, who make even a good man of philanthropic tendencies cast up in his mind the chances of civic collapse. Wher\u0026 I have seen that wholesale, unhallowed matrimony --one lot (twenty couples) were married in my presence, and I believe there was not a ring or 'a washed hand amongst them.\" The writer goes on to say that he hopes the authorities will try 'to stop these horrible early unions, but even if they did that these people are so entirely void of mo- rality, that they would live together and dispense with the nmarriage vows, as thousands do now. This factor we rarely ever have brought before us in Canada, although rickets is common enough, but I never have seen such extreme cases, and probably never will outside the great centres of England. Regarding treatment, I can say but little, as it is about the same as anywhere else, that is, the medical treatment. The surgical I will probably say something of in my next letter. As the Samaritan closes for operative work this week until October, every one has been crowding there -the operations came thick and fast. The only one of note being performed by Knowsley Thorn- ton-nephrectomy on the right side and nephro- tomy on left. The woman had symptoms for over DA LANCET.",
         "THE CANADA LANCET a year, pointing to stone in kidney. The section revealed a kidney, or rather shell, immensly dilated and full of water. No pus to be seen anywhere. The incision was made through the linea semilunaris, and the dissection and separation of capsule very simple owing to the parts being so much stretched, that when fluid was evacuated the sac could be easily brought to the surface and gradually sepa- rated with the fingers. Thornton did not tie the ureter and cut it off close, but brought it through the incision and kept the end outside by piercing with a safety pin ; his reason for so doing being that he found in his fatal cases that this ureter was buried in a deep abscess sac, which abscess probably was caused by the ureter, so that when the sac constricts this ureter is grasped tight!y in the cicatrix ; he then examined the left kidney and found a stone in the pelvis; this was taken out through an incision about one inch long-the scal- pel being plunged through the substance of the kidney with one stroke-the kidney heing pressed firmly into the loin by the left hand in the ab- dominal cavity. A drainage tube (rubber) was placed through the incision, and a careful toilet made. The woman so far, five days after, is doing extremely well. Mr. Thornton tells me he would never try to take a kidney out through the loin under any circumstance, no matter how small ; the abdominal incision being much more easily managed in every way, the command of the sac more perfect, and the drainage quite as good. The stones were of equal size, mulberry calculi and very prickly, almost like a green horse-chestnut. Mr. Thornton has done thirty-three cases with six deaths, a wonderful performance surely. Dr. Ban- tock did some four cases of section, all simple. Mr. Meredith had a number of cases, the only one of note being a double pyo-salpinx, which, on ex- amination, through incision, seemed impossible to get at, a complete roof of adhesions covering the uterus and ovaries, but the most patient dissection taking two and one-half hours completed success- fully a very difficult operation. There are a great number of Canadians here, amongst whon Dr. Thorburn, Jr., is doing good work on ýhroat and chest, and is at present assistant to Dr. Lennox Brown. NEw YORK POLCLYNIC. - Dr. H. O. Coe has been elected to the Professorship made vacant by the death of Professor James B. Hunter. CANADA MEDICAL ASSOCIATION MEETING AT BANFF. The meeting at Banff, August 13th and 14th, will be remembered by all those who attended, as one of the most pleasant outings which the medical profession have enjoyed for many a year. The C. P. R. contributed to the comfort of the mem- bers and delegates in its usual excellent style. It is not often that members of the Association have an an opportunity of spending so long a time together ; and the length of the holiday, together with the de- sire to see the far west, prompted many to accept this opportunity. We may say it was one grand ex- cursion, indeed so novel and varied were the scenic attractions, that it threatened to interfere with the regular work of the meeting, and, as it was, numerous were the groups of excursionists who could be seen accepting the warm hospitality of the trickling spring, cooled with a pinch of spiritus frumenti. Notwithstanding all this, however, the meeting was a scientific success. Dr. Adam Wright, of Toronto, contributed the first paper, which was entitled \" Hæmatoma of the Vulva and Vagina,\" and was freely discussed by Drs. Marcy, of Boston ; Ross, of Toronto, and Stewart, of Truro, N. S. \" The Climate of Alberta\" was the subject of a paper by Dr. Kennedy, of Fort MacLeod, and was full of interest to members of the Association, who showed the keenest appreciation of the sub- ject. The climate of Alberta is generally regarded as the most healthful in the Dominion, and this opinion was sustained by the paper of Dr. Ken- nedy. Pneumonia was a rare disease and phthisis was seldom met with in the territory. The cli- mate was f ree from all sudden changes, and it was urged that on account of Alberta being possessed of all the advantages and none of the disadvan- tages of Colorado, patients suffering from con- sumption would find more satisfaction in coming to the Northwest than in leaving their own country. The discussion following was extremely intereste ing and somewhat humorous, and was taken part in by Drs. McInnis, of Edmonton; Henderson, of St. Paul's; Praeger, of Nanaimo; Bentley, of Ne« Westminister; Oldright, of Toronto; Henderson, of Kingston; McLennan, of Trenton, and others. [SEPT., %rPotto of #ocictito-.",
         "THE CANADA LANCET. Dr. Gibney, of New York, followed on the sub- ger; North-West Territories, Dr. Rutledge; Mani- jet, \" The Treatment of Hip-Joint Disease.\" Drs toba, Dr. H. Higginson; Ontario, Dr. J. J. Far- Connor, Of Cincinnati; Strange, of Toronto ; Rod- ley; Quebec, Dr. John Elder; New Brunswick, dick and Shepherd, of Montreal; Cameron, of To- Dr Raymond; Nova Scotia, Dr. Muir; Prince ronto, and others continued the discussion. Edward Island, Dr. Waburton. Dr. Buller, of Montreal, presented an interest- Next place of meeting, Toronto, early in Sep- ing paper on \"Preventive Deafness,\" in which he tember. drew attention to the importance of immediate The majority of the members of the Association, attention being paid to the slightest symptom of after the meeting, took advantage of the liberal deafness in chidhood arrangements afforded them for a trip to the Dr. Stewart, of Montreal, read notes of a num- Pacific. ber of cases in which sulphonal, a new drug, used to relieve sleeplessness, had been used. Investiga- #tlttt4 grfttCt. tion as proved suiphonal to be highly useful, and the indications are that it will likely take the placo ON THE DIAGNOSIS AND TREATMENT of morphia in many cases. It bas no efficacy for 0F GASTRIC ULCER.E the relief of pain, but given in doses from 15 to 50 grains it produces sleep which is not followed by BY WILLIAM M. ORD., M.D., the unpleasant effets of the commonly used nar- Physician to, and Lecturer on Medicine at St. Thomas' cotics. There seems to be no danger of patients Hospital, London, Eng. acquiring the habit, the same as with morphia or (Continued rom Augut No.) chloral, and, besides, it is not a depressant to the (Continued from gst No.) heart's action as these latter drugs are known to We may next contrast gastric ulcer with the e. Dr. Stewart had found twenty-grain doses to graver maay, malignant disease of the stomachi. produce very Satsfactoy ets. r Whittaker Pain is, of course, a very frequent symptom of o satisfactory effect. Dr. Whittaker, this affection; pain mostly increasing in severity of Cincinnati, and others who have had experience as the disease advances, and comprehending many in the use of suphonal, endorsed all that Dr. varieties from dull to acute. It may be aggra- Stewart claedor this new remedy. vated after meals, or it may attain its greatest in- Dr. Grasett, of Toronto, presented a paper on tensity when the stomach is empty. But its ex- D. treament of olfrnturesntd an paerest-tension is usually much larger than that of gastric the treatment of Colis fracture, and an interest- ulcer. Vomiting is common, and while having a ing discussion foilowed in which Drs. Cameron of certain relation to food-taking, occurs at all sorts Toronto; Sloan, of Blyth; Stewart, of Truro; of intervals. There is very often ineffective Sith, of Seaforth, and others took part. retching when no food has been taken. In con- Dr. Whittaker, of Cincinnati, contributed an sidering the characters of the matters vomited, we cannot avoid thinking most of the symptom of iteresting paper on cVaricella,\" an extremely hSmorrhage, but in the first place we may notice coimon disease of childhood, but one to which that the vomit, whenever occui ring, is usually of this distinguished American physician gave a good a strong acid reaction, and that, besides mucus, deai of interest by his well-written essay. there is generally a considerable quantity of fluid, l Mineral evidently a secretion of the stomach. As in the Papers read by tite:-H. B. Smal , case of ulcer, the position of the new growth goes Spaings of Cana a ; Stirling, \"Vertigo, and Eye far to determine the period at which vomiting and Bar Affection,; Lapthorn Smith, \" A Coin- takes place; and I think it cannot be doubtful 1non and asily Preventable Cause of Uterine Dis- that the character of the ejecta is very much de- placement ; John Campbell, Seaforth, \" A Case termined by the position and character of the of Necrosis following Compound Fracture.\" new growth. What we see thrown up by a T a ng Cpatient having an ulcerating new growth in the e mnatng Committee reported as follows : middle of the stomach, is assuredly of a very dif- Presidentelct r. Jas. Ross, Toronto. ferent matter from what is observed in scirrhus of ViceDPresidents-Dr. D. Eberts, Dr. Brett, the pylorus. I think, though I should not like Dr. R. Spencer Dr. Bruce Smith, Dr. . P. Lacha- to be too dogmatic on the point, that the acidity pel, DJ. McLd in both cases is excessive. pelle, Dr. lie-n, Dr. L. Johnston, Dr. McLeod. The elements of this acidity have attracted a Secretaes.Brit.8 Columbia, Dr. Pre- good deal of attention of late in France and Ger-",
         "10 THE CANADA LANCET. [SEPT. many. It is asserted that the acidity, in cases of believe that the intensity is very much determined malignant disease, is due to other substances than by the position of the growth as well as by its the hydrochlorie acid which, as is generally be- nature. I believe that the ulcerative forms are the lieved, forms the main sourness of the gastric more tender, and I have certainly feit many juice, various organic acids taking the place of the pyloric tumors which were almost insensible to inorganic. And there are many who to-day be- pressure. On the whole, however, tenderness, lieve that the existence of malignant disease, as 1 when existing, is much more diffused than that of opposed to non-malignant disease, may be fairly gastric ulcer. well recognized by studying the reaction of the gas- If we review what has so far been stated in the tric juice. The test most in vogue is the tetre- point of diaganosis between malignant disease of thyl-damido-triphenyl-carbinol-oxalate, or vivid- the stomaci ad gastric ulcer, save and except the green salt, a crystalline substance of a brilliant chemical action of the gastrice juice, dothing green color, which yields, when dissolved in water, actually decisive has been put forward. The re l a blue solution. Hydrochloric acid being added to test is the presence or absence of tumor, and the such solution, effects a distinct color-change to the true method of diagnosis is to examine the epiga green. The organic acids fail to produce such a trium with the greatest care. As far as experia- change. In applying the test, a solution of hydro- ence gos, tumor, if existing, can be felt in about chloric acid, of the strength found in gastric juice, seventy per cent. of the cases. The existence of u is first applied to some of such solution in a test well- defined tu.or, in association with more or legs. tube; next, to an equal quantity of the same solu- of the symptoms enurnerated, will enable us, for tion, contained in a test-tube of equal size, an the ost part, to make a deeinite diagnosis. The, equal quantity of the fluid filtered from the vomit tumors which escape nanipulative detection are or withdrawn from the stomach is added. A com- doubtless. such as are situated on the posterio r parison of the contents of the two tubes will deter- aspect of the stomach. Though they may here mine the comparative amount ôf hydrochloric acid elude direct recognition, they still produce man present in the secretion of the stomach under in- of the symptoms described, and by pressing on, vestigation. It is strongly urged that a marked deep-seated structures wil introduce new sigon failure in the production of the green change is enablint us to recognize their position. indicative of malignant disease. In the final diagnosis, we have to remember that During the last year, I have submitted this test the simple gastric ulcer affects, for the most part,. to observation wherever it was possible, and have young women who are anemic, but not cachectic;, certainly obtained some interesting results; but that cancer affects older people of both sexes, who not uniform enough to justify me in accepting the are generally cachectic in appearance, and have reaction as decisive, and these were cases of short, pigmentation of the skin as well as anwmia. It previous duration, which got well under treat- may be noted also that, in malignant disease of ment, and went out without any other sign of the stomach, variations in the size of that orga malignant disease. One of the difficulties of color- are much more common than in ulcer. The im- tests and solutions is, that the vomit in cancer portance of such variations, however, will be be very often contains blood; when this addition ter seen when we come to the consideration of the occurs, it is usually constant, and while, of course, diffused gastric ulcer. varying in quantity, is not generally large. It is The various functional disorders of the stomach, niostly in the \" coffee-ground \" form, but some- comprehended under the term dyspepsia, ofte» times in the form of small, variously colored clots. simulate gastric ulcer. The two symptoms, pai. This, of course, stands in great contrast to the and vomiting, may, in functional disorder of the large hoemorrhages at long intervals occurring in stomach, be conspicuously present, but they ar8 gastric ulcer of the young adult feinale. To revert rarely present together. When present individ here in greater detail to an interesting point re- ually, they rarely have the same marked relatioO lating to the quantity of matters vomited : As with food-taking as is observed in gastric ulcer in ulcer, where the malignant growth is at the and if any tenderness is observed, it is not local cardiac end or middle of the stomach, the inter- I ized, and is associated with general hyperæsthesi.A. vals are short, and the amount brought up is com- There is, of course, no tumor, no hæmorrhage and paratively small ; but in growths near the pylorus 1 no fever; moreover, there are usually present or involving it, intervals as long as twenty-four associated conditions of general nervous debilitl hours, or more, are observed. The amount when or local irritations, which may favor or determin vomited is very large, and the matter consists of disordered action of the stomach. a thin fluid with a sediment of digested matters, Let us turu now to the diffuse forai of gast having a reddish-brown color. Such a vomit is ulcer, observed more particularly in middle-age generaly teeming with sarcina ventriculi. persons of both sexes. The symptonis here agaio Tenderness is mostly found in malignant disease are mainly pain, tenderuess, vomiting, ailé of the stomach. It may be acute or dul, and I hæmorrhage. But the subjects are no longe",
         "89 THE CANADA LANCET. il eimply anueunc, and, on the other hand, well-nour- whole, all his symptous suggested malignant dis- its ished; but are Ofte ca.chectic and wasted. The ease. But as I could feel no tumor, I ventured the pain s, as a rule, much less acute than in the to hope that lie had only gastric ulcer, and not the n other form Of ulcer, and the vomiting much more more serious malady. I treated him on this basis to frequent and distressing. Tenderness in the and in three weeks he had lost all his local symp- to 1 locality Of the stomach and in the whole stomach- toms and had gained flesh. It is not necessary of are a generally present. The matters vomited at this moment, to enter into the details of treat- are generaly intensely acid, and very frequently ment, inasmuch as I shall presently deal with Co tan blood either in the \" coffee-ground \" form, them ; but it may be said that lie became well- of Suc assoft prsevarousecolor from pink to black. nourished and strong, and has frequently present- of Such cases present, indeed, the strongest appear- ed himself since, in all respects fit for work. the ance of the existence of mahignant disease of the In many cases of this form of ulcer, gastric eag dtemacand tnl more favorable diagnosis can be hemorrhage presents itself as a very serious symp- eal determined only by the absence of tumor, and the tom. It goes on from day to day, in addition to as In esu t s o other symptoms and has a distinct and dangerous )r' fî l illustration, I may quote two cases. The importance of its own. The blood often has a eri first wae that of a gentleman, aged sixty-four, who bright color and a spongy consistence. The reac- u a consult me for a pain in the epigastrium which tion of the vomit is generally intensely acid. In es which hade bis 1ife miserable It came on at a some cases I have been inclined to associate, with les times, had no relation to food-taking, and whien the hæemorrhage, the idea of an erosive action ex- 'he it came it took, as lie said, \" all the life out of ercised by an intensely acid gastric juice. In two e him \" l e had no vomiting, and no other symp- cases of the kind, under my care in St. Thomas' rior toms of dyspepsia, and had no tumor or tender- Hospital, the exhibition of alkalies has been fol- rioe, ness. prescribed many remedies, calculated as I lowed, first, by cessation of the hæomorrhage; ere thougft, to relieve pain ; but he was no better for second, by the disappearance of the symptons of ny. any of them ; so I took him to Sir Thomas Wat- gastric ulcer. ogn ap W o prescribed citrate of iron, regarding, PRoGNosis.-Dr. Brinton, writing abodt thirty t iapparentyo the symptoms as neurotic. Under years ago, calculated from the statistics available the ctrate of iron lie speedily obtained relief, at the time, that perforation occurred in between hat whic asted for nearîy a year. Then a relapse 13 per cent. and 14 per cent. of the cases of gas- S occurred, and to pain was added vomiting, occur- tric ulcer. Âc; ring ot intervas, large in quantity, and with evi- There can be no doubt that his book on the sub- 7ho dences of the presence of blood. Although no ject led to a more general recognition of the dis- Ive tumor could be detected , more than one physician ease than had before existed. Whether it be, o dsaie to the conclusion that he had malignant that, instructed by his writings, I, for one, have a dsenaslis sufferings lasted several years. been more ready to recognize the symptoms of the in Etua y lie died, after an operation for stric- affection, or, that the character of the affection \u003eet- ture of the urethra and on post-mortem examina- varies in successive decades, I am bound to say t tion large, shanlow ucer presenting no signs what- that comparing the number of cases presenting the bhe4 ever of mahignant disease, was found at the pyloric symptoms of gastric ulcer and the number of end of the stomac, but not involving the pylorus. deaths recorded, the proportion of deaths is much ch,1 The case las been, for me, always most instruc- smaller than that arrived at by Dr. Brinton. i time. qoThis, perhaps, is what might have been expected. ahe a Le me quote another case. Abouttwo years ago, When Bright made his first great generaliza- bhe a mai was admitted into St. Thomas' Hospital for tion, everybody who had albuminuria was con- ar gatric h semorrage. le was a horsekeeper, and demned to death. We have learned in later years id- lad iad a severe jerk from the ground, when to make very different estimation of the symptom or Putting a bridle on a horse. The jerk was fol- of albuminuria. And I think I may safely say of S lowed by severe pain in the region of the cardiac the patients who come under our care with such S ehdmofrhe. Hec and by frequent, but amall, signs of gastric ulcer as Brinton and his contem- ,nå hessorrage. lie bad suffered from gastric dis- poraries described, very few die. n tress and occasional vomiting for some time pre- TREATMENT.-We may now turn our attention )t vious. Wben I saw him, lie lad pain after food to the subject of treatment, which seems to me to tif and subequent vomiting. Bld waa always be of the highest importauce in gastric ulcer. u present in the matters vomited, but not in large The people who die of the disease are generally quantity; there was tenderness over the whole such as have been pursuing their occupations in r stomactare, but no tumor could be felt. He spite of suffering and without precaution. Here eas sent t me with a diagnosis of cancerous dis- and there, I think very rarely, one will die of ease of the stomache le was emaciated, anxious- hmorrhage ; now, and again one will die of the lookiî. but not caciectic ; nevertheless, on the signs of perforation. But I think that if we can",
         "111E CANADA LANCET. LSEI~., once bring a patient under through hospital treat- ment, such dangers may be averted ; although in advance conditions, we can never overcomed the adverse influences of adhesion of the stomach to other parts, and deep ulceration. My experience of the treatment of gastric ulcer leads me, in the first place, to attach great im- portance to simple physical rest. A physician is commonly called upon to deal with two very dis- tinct classes of cases: first, those occupying beds in hospital; second, those consulting him at his own house, or coming as out-patients. The in- patients, kept in bed, and debarred from all move- ment that cnn Le avoided, make much better pro- gress than, the others who are moving about. I must admit that, in private practice, I have ex- perienced great difficulty in keeping patienta as completely at rest as I could wish, and that the re- sults of treatment of them are far less satisfactory than those obtained in hospital. I commend this point to general practitioners, who have much greater opportunities of following the patient's symptoms from day to day, than are open to the consulting physician. In practice, I hold it to be right that the consulting physician should always advise the patient to secure the care of a medical man near at hand, and under his guidance to carry out the first principle of treatment-physi- cal rest. Next comes physiological rest. No one can doubt that all mechanical indigestibles must be forsworn. All experience shows that, in relation to the comfort of the patient, meats, uncooked foods of all kinds, all mechanical indigestibles, and stimulants must be forbidden. After this large excision, idiosyncrasies of the patient have to be considered. Some can take milk and eggs, and soft farinaceous foods with impunity, while meat juices irritate them. Some can take the meat juices and not the milk food. Some can take nothing whatever without great suffering. Those who can take the milk and egg foods may leave us easy on the subject of their nutrition. Those who can only take the meat juices have but imperfect sources of nourishment, and in these cases, as well as in those cases wherein no aliment can be taken without pain, we are compelled to administer aliment by the rectum. Of late years a good many nutriment supposi- tories have been invented, and have been much vaunted. They have a certain advantage in being more easily retained than fluid enemata, when the rectum is irritable. But, in a general way, I be- lieve that fluid enemata are much more effective. They should consist of from four to six ounces of beef-tea and milk in equal proportions, with a drachm .of Berger's \"liquor pancreaticus,\" and should be prepared at a temperature of about 98° Fahr. Egg may be in certain cases added, and, where there is great exhaustion, a small propor- tion of brandy. In more than one case of gastric ulcer with severe symptoms, I have used such enemata for a month, allowing nothing to be taken by the mouth save water, with the result that the nurition of the patient has actually im- proved. As regards treatment by drugs, I venture to say that generally very good results may be ob- tained. The treatment must be a good deal de- termined by the proportion between the symp- toms of gastric ulcer and those symptoms supple- mented by gastric catarrh. Supposing that we have the symptoms of gastric ulcer without gas- tric catarrh, I am in the habit of giving twenty grains of carbonate of bismuth with ten grains of carbonate of soda, and ten drops of tincture of belladonna, three times a day. If there be much sign of gastric catarrh, what I am accustomed to call Brinton's mixture, viz., ten grains of bicar- bonate of potash, three grains of iodide of potas- sium, and three drops of dilute hydrocyanic acid in infusion of gentian, three times a day, is pre- scribed. The use of this mixture for a week or a fortnight will generally subdue the catarrh, and the subsequent use of the bismuth mixture rarely fails, in uncomplicated cases, to effect a cure. Complicated cases will be generally much re- lieved by this, but rarely cured. By complicated cases I mean those to which I have already alluded, in which there are signs of adhesion or of deep ulceration. We must not forget the acute com- plication of hæmorrhage and perforation. In the treatment of persistent small hæemorrhage, 1 an not inclined to the use of astringents. As a rule, I should rely on a careful examination for the symptoms of the case, and should direct treat- ment to the removal of the causes of hemorrhage, rather than use astringents in a blind way. I should use methods for the reduction of gastric7 congestion, for the neutralization of the excessive- acids of the gastric juice, for the relief of hepatic congestion. In the large hæmorrhages of the simple ulcer, the whole business is generally over before treat- ment can be instituted. But this does not mean- that treatment is unnecessary. A large quantity of blood will have generally made its way into the- intestines, where it proves a source of great irri- tation demanding instant relief. It is my practice- to administer, according to the needs of the case, sulphate of magnesia, or sulphate of soda, with dilute sulphuric acid-a hinderer of decomposi- tion-at intervals of two or three hours, until free- evacuation has been obtained. These alkaline- sulphates appear to me to be the most suitable aperients in all cases of gastric ulcer complicated by constipation. Given early in the morning, they lend effective aid to the operation of the mix tures already mentioned. In what I have said I have given from individ- THE CANADA LANCET. [SEPT.,",
         "·89.] THE CANADA LANCET. ual experience. There are some physicians who advocate the use of caustics, such as sulphate of copper and nitrate of silver. There are others who advocate the use of opium and astringents; but al I can do is to tel] what, in no inconsider- able experience, has appeared to me to be the most effective mode of treatment. I should like to add a few words on the value of iodide of potassium in the treatment of gastric catarrh, whether simple, or complicating ulcer, or complicating malignant disease. Administered with the addition of some bicarbonate of potash or soda, it is, in my experience, a drug of inesti- caable value. It speedily removes a simple catarrh. It thereby removes the primary obstacle to the treatment of ulcer; and, in malignant dis- ease, it will often, for a time, so far mitigate the svrnptoms as to niake the patient think he is being cured. L have often found it in malignant disease relieve the patient for a time, and, L think, prolong life with marked diminution of suffering. It will be observed that L have dealt with gas- tric ulcer clinically, as L undertook. The subject of the diagnosis of gastric ulcer must be constant- ly in the mind of the practitioner of medicine. Lt has been much in my mind for years. And wbat L put on record here, crude and elementary as it is, represents much careful thought and long observation- PREVENTIVE INOCULATION. GENTLEMEN,-In the year 1881, M. Pasteur laid before the mbers of the nternational Con- gress assembled in London an account of recent researches carried on in his laboratory, on the sub- ject Of preventive inoculations for chicken cholera and splenic fever. Since that time nearly eight years have elapsed, and we may ask ourselves what has become of the work then beaun: bas it fulfilled its promise, and what place have the new principles which it involved taken in the science of to-day? It was on these quetions th t M. Pasteur intended to have spoken to yeon this after- noon, but the state of bis health did not permit cf his availing himself of the hnnor done him by the President and Council of the Royal Society in ask- ing him to give the Croonian lecture this year. He therefore proposed that I should speak i bis nane, though personaly I cannot hope to speak at be whuld have done f the preventive inocula- tions which he himnself thought out and initiated. MY sole title for addressing you is that cf my being M. Pasteur's collaborator, having had, in fact, with Messrs Chamberland and Thuillier, the honor of being associated with hum frm the cein- mgnceent of his re3ear3hes upen the prevention of coitagious diseaseî, and, further, that I hve been an eye-witness of everything which I shall lay before you. Most infectious diseases never recur, and thus small-pox, measles, and typhoid fever rarely occur more than once iii a life-time. Further, a first attack of an infectious disease, even though a slight one, renders us safe f rom these diseases for a cer- tain time ; and it is this fact, coupled with the non- recurrence of infectious maladies, which has led to the discovery of preventive inoculation. Instead of waiting till we are struck down un- awares by a sudden attack of the malady, frequent- ly during an epidemic of high fatility, and under conditions very unfavorable to our power of resist- ing it, we now seek to meet it at some favorable moment, and guarded by allthoseprecautions which we know are 'apable of greatly diminishing the danger. In the place of natural, that is ordinary, infection, unforeseen and over which we have no control, we have now substituted a mode of artifi- cial infection, prepared in such a way as to en- sure exemption with as little risk as possible. It was against small-pox, that for the first time, preventive inoculations were had recourse to. An involuntary experiment, and one, unhappily, too often repeated, had shown that the liquid of the small-pox pustule is virulent, that is to say, that this small-pox lymph, introduced into the body through a wound in the skin, has the power of communicating the disease to a person who has not previously suffered from it. Inoculation with small-pox was, therefore, easy; all that was re- quired for its production being a prick from a lan- cet charged with small-pox pus. It was, there- fore, the custom to endeavor to find cases of mild small-pox, from the pustules of which a virus was taken supposed to be non-malignant, but yet capa- ble of subsequently rendering exempt against the virulent disease those who were inoculated by such a mild virus. It is well known to you how widely such inoculations spread, though far from being of an innocent character, for the inoculation which was supposed to give the disease in a mild form' often produced it very severely, and sometimes even the inoculation was the cause of death. How great, therefore, was the progress made by Jenner in replacing inoculation by vaccination, that is to say, in substituting for a severe illness one which is invariably insignificant, and yet it is efficient protection against infection by small-pox ! Although from the- beginning of this century we have enjoyed the inestimable benefit of Jen- ner's vaccination, we still have not yet completely fathomed its meaning. What is the relation be- tween vaccination and small-pox I Why does the vaccine disease of the horse and the cow, inoculated into man, render him exempt from small-pox ? Is the virus of vaccine merely that of small-pox modi- lied, or are vaccine and small-pox two different maladies.",
         "It would have seemed that these questions were easy to resolve as both small-pox and vaccine ad- mit of experimentation upon them ; yet though al- ways under discussion since Jenner's tine, they yet remain without any definite solution having been arrived at. Jenner's great discovery, which seemed to open so wide and hopeful a horizon, bas remained hitherto a solitary fact in medicine. Born of a happy observation, marvellously de- veloped by a genius as patient as it was penetrat- ing, it was at the time of its birth so far in advance of the medical science of the time that even now, after all the progress which has been made during the last seventy or eighty years, we can but sus- pect its real interpretation. Jenner thus demon- strated to us by one remarkable example that it is possible to.protect ourselves from a'mortal malady by inoculation with a trivial one ; but he gave us no general method leading to the prevention of other infectious diseases. Thediscovery of thepower of artificiallyattenuat- ing--that is, weakening--a virus does,onthecontr- ary, furnish us with a veritable method of protective inoculation, and it is one which bas given us an -ininterrupted series of good results, though this in- iention dates from but a very few years back. Like all other recent progresses in our knowledge of virulent diseases, it found its origin in M. Pas- teur's researches on ferments. In revealing to us the nature of ferments, he taught us that of the poison of infectious diseases. Like the yeast of alcoholie and the yeastof lactic fermentation, viruses are living beings-microbes, as they are now called -and, just as the development of yeast in a sugary liquid produces alcoholic fermentation, so that of microbes in the tissues of the body produces the phenomena of infectious disease. The process which bas enabled us to obtain the culture of mic- robic ferments in a state of purity is the same which bas enabled us to obtain pure cultures of microbic virus outside of the body. The indispensable condition of success in these cultivations is that of absolute purity-that is to say, the avoidance of the introduction of other foreign germs which everywhere surround us. For this purpose we have now arranged a definite technique, strict but at the saine time very simple. As the elements of the virus are living beings which can be kept in artificial cultivations, and as they are only distinguished from other lowly orga- nized beings and plants by their property of invad- ing the bodies of men and animals, the question naturally presents itself, Would it not be possi- ble to modify them by cultivation in the same way that other plants are modified i Could they not, for example, be thus robbed of those qualities which thake them formidable? To modify a virus by special modes of cultivations-such was the idea of M Pasteur ; a fruitful idea, from which have sprung those discoveries which I now propose to lay before you. SEPT It was in studyng a malady called \" chicken 1 cholera\" that M. Pasteur for the first time obtained by this means an attenuated virus. This disease is so fatal to fowls, pigeons, and birds in general that it has been given the name of cholera. It is caused by the development in the bodies of those attacked of a very small microbe, shaped like a small rod with rounded ends, and almost as wide as long. The photograph projected on the screen shows us the image of a drop of blood taken from a fowl which succumbed to the natural disease. You see between the globules of the blood the little rods which are the cause of the disease. It is, however, not the blood alone in which the mic- robe is found ; all the tissues are invaded by it. The intestines contain a great quantity, so much so that the dejecta of the sick fowls are able to spread the malady, and it is in pecking upon the contaminated ground that healthy birds are in- fected. If a minute drop of blood from a fowl which has just died of the malady be introduced under the skin of a healthy fowl, the animal inoculated soon falls ill, ceases to eat, its feathers are erected, its wings bang down, and it seems oppressed with un- conquerable somnolence. It soon dies, sometimes in less than twelve hours. The blood of the bird which bas thus died from experimental inoculation is found to be swarming with the microbe, exactly like that of the fowls which die after natural in- fection. It seems, then, that chicken cholera is a contagious disease, capable of inoculation, and in which the virus is principally contained in the blood of the animals attacked by it. The culture of the microbe which is so easily accomplished in the blood of the animals can also be carried on artificially. If with proper precautions we inoculate chicken broth slightly \" alkalised,\" and perfectly limpidy with a drop of the blood, and if we then place the bottle in a stove at 35°C, we shall find after some hours that the broth is turbid, and that this is due' to the development of the little chicken-cholera microbe. Under the microscope we shall see that each smallest drop of this bouillon contains an in- numerable swarm of motionless microbes, like. those contained in the blood which served a \" seed.\" An infinitesimally small quantity of this first culture placed in a new bottle will give a se- cond culture and by successive cultivations as many successive generations of our microbe as we wish for can be obtained. Each drop of these culture\u0026 even up to the twentieth, would kill with all the. signs of cholera quite as surely as the first, anY fowl which was inoculated by it. This experiment affords a decisive proof that the virus of the \"a* lady is without doubt the microbe found in ourt cultures, and as we now know how to prepar under absolutely certain conditions as large quant ties of virus the as we wish for, we have all t means at hand for the study of this disease. THE CANADA LANCET. (SEPT",
         "en ed is \u003ese a de en M) se. he ic- ch to he in- tas ho on its Inw- îes rd ,lyj in- he ire on en id, he ue ,ra mat in-' ke. as his se- es hao- af ~ To what cause is this gradual diminution of the malady due? *To the continued action of the Oxygen of the air. If, instead of making the cul- tivation in a botte where the renewal of the air s posible, we were to make it in a closed tube only containing a small quantity of air, the mi- robe would soon consume all the oxygen, and wou cease to grow, for oxygen is a necessity of its developmlent. In a tube deprived of air it can- not grow; it remains alive in it for a very long tire, as one can satisfy oneself by sowing in aerated boul 01the small culture formed in these sealed tubes. After being preserved for a year in this seaed tube it stias gives cultures which are as active as a re.,;ent culture f roin the blood of a fowvl just dead of chicken choiera. We see, therefore, that the diminution in viru- lence which takes place in those cultures exposed to the air is dependent on that exposure, and not on the length of time the microbe is kept. Gentlemen, what results were won, what new ideas gained by this single experiment on the cul- ture of the microbe of chicken cholera ? By it M. it will be impossible to kill them by this illness, which was formerly so formidable. The attenuated virus therefore discovered by M. Pasteur is quite as efficacious against chicken cholera as Jenner's vaccination against small-pox. But while we are ignorant of the relations between small-pox and vaccine, none of the relations be- tween the vaccine virus of fowl cholera and the virulent virus are hidden from us. This plan, moreover, is not only successful in the case of chicken cholera, but constitutes a defi- nite method of attenuation of virus, the value of which has been proved by the production through its means of the vaccine of anothor malady more interesting than fowl cholera, as it is both a scourge for cattle and can also be transmitted to man. I mean splenic fever, anthrax, or charbon, for it is by the regulated action of heat and air upon the anthrax virus that the vaccine of this malady has been obtained ; but in the case of anthrax a difficulty arose which was not present in that of chicken cholera. The anthrax virus is found in the blood of ani- mals which have just died of the disease. Celti- '89.] THE CANADA LANCET. 15 If we expose at a temperature of 33°C to the Pasteur showed us that the viruses of infectious contact of the pure air which penetrates through diseases are no more the unchangable entities they the cotton wool stopper of the culture flask one of were before iragined to be. He taught us that, these cultivations which is so active that a drop like al other living beings, the iirobie virus is Of it would kili any fowl into whom it was inocu- susceptible of modifications which hereditry per- lated and if each week we extract a small quantity petuates, that it is above al the virulent character of the contents of the flask and try its virulence whih becomes modified, and finally that this mo- upon healthy fowls, we observe the following dification can be produced artificialy and regulated changes : During the first week of the experiment accordiiV to the wishes of the experinenter. By al the fowls inoculated die, but after a longer timDe this exprinient M. Pasteur established the atten- a change sets in in the degree of virulence. Not uating influence which the air possesses; at the al the fowls now die when a certain quantity of saine time he explained how it is that the activity thir longer preserved culture is injected under of a virus, under natural conditions as sen in epi- their Ask. Some recover after having been very demics, is preserved or exausted, and how the ill. As ti.e passes the strength of the virus is same malady may be sometimes malignant, some- still more diminisied, and the number of fowls times light. which recover increases. At last, in continuing We ]ave seen how fows inoculatad with atten- the experiment, the moment comes, say, for ex- uated choera verus, suitably chosen, took the ample, after it has remained for two months in the liht form of the maady and soon recovered. If, inubator, when this virus, at first so deadly, not now, you inoculate these recovered fols with a ntY will not kili a single fowl, but causes them blood from a fowl dead of the virulent disase and the t- no inconvenience whatever; and yet at the saie tie you inoulate a number of fresh the virus is 'lot dead, for it still grows in fresh fowls you il! find that al the fresh fowls wili die nutritive substance in which it may be sown. But while those previousy inocuated with attenuated in this new culture none of the former virulence virus will resist the disease. They wilI merely returns. The daughter cultures have exactly the have a passing illness, which soon disappee r5 The sate effect uponthe fowls as the mother culture had inoculation with the attenuated virus has rendered at the tiue when it furnished the fresh seed. The thess exempt fron the fatal form of the disease; new property of the virus, therefore, that of harm- it has given them immunity; and, if in the same esness for those anituals for which it was formierly animas, you make successive inoculations of o fatal, can be perpetuated for successive genera- tin a akng such cultivations we shall ob- tory to choera to such an extent that you nay tain at their respective dates a whole series of isoc ins Of virus of diminishing activity .capable of under conditions where they would be exposed to givng to the anials either a fatal malady, a dan- the rost intense natural contagion, and they will gerous malady, a serios dalady, or one wholly in- not exeriene me te es n offensivep",
         "1fi THE CANA vated in veal broth slightly alkaline it forms a culture resembling cotton down swimming in a clear liquid. This down is formed by long and in- terwoven filaments, as you see them in the photo- graph. In the interior of these filaments, after some hours, you see bright spots beginning to ap- pear, the outline of which become more and more distinct. These brilliant spots are the germs or spores of the bacillus discovered by M. Koch ; these spores are the veritable seeds of the mi- crobes, and as grains of corn, for example, offer more resistance to heat and dryness than does the growing corn, so the pores can bear without perish- ing a temperature of 900 C., and the action of a number of agents which would kill the bacteride in its filament stage. The spore is thus the re- sistant condition of the microbe of anthrax, and whenever it finds conditions favorable to germi- nating, either in the body of an animal or in some artificial nutritive culture, it will give forth fila- ments, an:l these in their turn will produce new germs. If we expose the anthrax bacillus to a tempera- ture of 38°C and the contact of the air, as we did the microbe of fowl cholera, its virulence will not diminish. Even at the end of a long period it would still kill all the men and animals into whom it was inoculated. It consequently appears that the oxygen of the air is in this case unable to ex- ert its attenuating influence, because the spores which are formed during the first hours of the cul- ture are able to resist its action. In order, there- fore, to repeat the conditions analogous to those which were successful in the chicken cholera, we must first prevent the bacilli from producing spores. The way to do thisisby cultivating anthrax not now at a temperature of 350, but of 42° to 43°C. Under these conditions the bacilli develop, producing the filaments but no spores If we try every three days, for examplethe intensityof thevirulenceof a culture thus made at a high temperature, and in which no spores are formed, by inoculating it into sheep and rabbits, we shall find that in the first days of the ex- periment all the inoculated animals succumb; then that the virus becomes less active, and the sheep resist, while the rabbits still die, though after ill- ness more and more prolonged. After a still longer period the culture made at 42° loses its dan- ger for the rabbit, but is still fati to guinea pigs and to mice. Finally the moment arrives when it is quite harmless even to these little rodents, very sensitive to the anthrax virus as they are. We here see, as with fowl cholera, the virus passing through all the stages of decreasing virulence and finally becoming harmless. The bacilli, which at a high jemperature give off no germs, yet form them rapidly if cultivated at 30° or 350 C., and the spores which are then produced preserve the same degree of virulence as the filaments front which they were derived. It is, therefore, only DA LANCET. [SEPT., necessary to draw off each day a little of the cul- ture from the bottle at 420, and to place it in bouillon at 85° C., in order to have a series of cul- tures of graduated virulence and furnished with spores capable of fixing each of these special de- grees of intensity. The sheep and oxen which re- ceive these attenuated bacterides exhibit a passing fever, but if, later on, you inoculate them with virulent virus, it has no effect upon them. One has, therefore, only to choose among the degrees in this scale of virulence that which will give to the animal one is desirous of protecting f rom anth- rax an illness slight but sufficient to ensure the de- sired exemption. In practice the vaccinations of oxen and sheep are done twice. The virus of the first inoculation is very attenuated, and is intended to prepare the animal for the action of the second and more energetic inoculation, which is prepared twelve ,days after the first. The whole difficulty in anthrax inoculation consists in the choice of these two viruses, and in keeping the relation be- tween their degrees of virulence invariable. Every- one still has in his rememberance the striking de- monstration of the efficacy of these preventive in- oculations given at Pouilly-le-Fort in 1881. Five and-twenty sheep, chosen promiscuously from among fifty, were inoculated with attenuated virus of anthrax, and afterwards with the virulent virus at the same time that twenty-five other fresh ones were inoculated as a control experiment. The twenty-five vaccinated sheep remained healthy ; the twenty-five control sheep died of anthrax. Demonstrative as this experiment was, it did not obviate violent attacks, the first of which was against the principle of the method. The possibility of obtaining attenuation of the anthrax virus under the conditions laid down by M. Pasteur was denied. It is, however, unneces- sary to dwell upon this point, as it is admitted even by those who contested it, for example, Koch and others; and the attenuation of the bacilli cultivated at 42 C. has become a classical fact. The answer to lay criticism is to be found in these tables, which give the number of animals inocu- lated in France since 1881. TABLE I.-Anima?8 Vaccinated agai8t Anthrax. Years. 1882 1883 1884 1885 1886 1887 1888 Sheep. Oxen. Mortality among Sheep. 243,199 22,916 1.08 per cent. 193,119 20,501 0.77 - 23I,693 22,616 0.97 - 280,107 21,073 0.90 \" 202,064 22,113 0.75 \" 293,572 42,538 269,599 34,464 The mortality among sheep before the preven- tive vaccination for anthrax was ten per cent.;",
         ".'89.] THE CANADA LANCET. since that period it has fallen to less than one per cent. It shows how firmly established these inocula- tions are in agricultural practice, while the rise in their number is the most convincing proof of their efficacy. The farmer, of course, cares nothing for scientific discussions. For him, preventive vaccination is judged entirely from the standard of profit and loss; and in eight years he has had ample opportunity of coming to a definite conclu- sion on this point. The mortahty among sheep in the anthrax districts has gone down from ten per cent. to one per cent. Insurance companies insert a clause in their agreements making pre- ventive inoculations of the insured cattle obli- gatory; and in Austria, Italy and Spain the vac- cinations are beginning to be widely adopted. What better arguments could be adduced to prove the great service which the discovery has rendered tO agriculture ? But I do not desire to dwell on this point, and. will proceed, having already dis- Cussed the attenuation of the virus, to consider the fact of its return once more to the virulent condition. If in Nature we were to come across one of these attenuated bacteria which we have learnt to prepare, and which are so harmless as to be incapable even of killing a mouse, it would clearly be impossible for us to recognise in this inoffen- sive microscopical object a descendant of the terrible bacillus anthracis. To do so it would be necessary to have watched it in its stages of gradua] attenuation- t is, however, possible (always supposing that the process of attenuation bas not been carried too far) to make the bacillus rescend the steps of virulence down which it has coWe, and ve to render it once more virulent. We have stated that it was not capable even of killing adult mice; but let us inoculate with it a very young mouse, only one day old. This Young mouse will be much more sensitive to the action of the virus than the grown up one would be, and it wlll die in a few days. In developing rtself in this young mouse, the bacillus will have recovered a portion of its old fitness for life in liv- ing surrounding ; and the blood of this first mouse introduced into that of one a little older will cause its death, and thus proceeding step by step from the Youngest mouse to the oldest, it will gain power t kilt first old mice, then guinea pigs, rabbita, sheep, and last of all, oxen, which are among herbivorous animals the most callous to the action of anthrax. Thus we see that we can increase the virulence as easily as we can diminish it; and that it mani- feste itself by the increasing power of the microbes to germinate in the bodies of living animals, a power which can thus be either acquired or lost under respectively appropriate conditions. That this increase of virulence which we have thus excited is going on in Nature we can well imagine; and that a microbe, at first harmless for a particu- lar kind of animal, should afterwards become dangerous to it. Given that some fortuitous circumstance should have introduced it into an animal with but feeble power of resistance, and it will grow there. This first cultivation will adapt it to parasitic life; it will pass out ready to de- velop in an organism in which it could not pre- viously have gained a foothold, and after several such passages it will become really formidable. There is no rashness in believing that by such mneans, in the course of ages new forms of viru- lence have been evolved, and that these experi- ments on the variation of virulence throw a flood of light on that most obscure of questions, the origin of new virulent diseases. For these results also explain how one and the sane kind of microbe can produce such diverse morbid effects; how, in its active or virulent state, it causes a general disease, rapidly ending in death, and in its passive or attenuated condition produces nothing more than a special local lesion. Other viruses have also been attenuated by this method of the action of the air upon the cultures. At the Congress held in Geneva in 18382, M. Pasteur cited a whole series of f resh examples. I shall, however, only speak to you of the attenuated virus of a special forin of swine fever, a disease much dreaded by farmers, and known in France by the name of \"rouget,\"* as the sick animals are distnguished before death by red patches on the skin.-M. Roux in Br. Med. Jour. (To be continued.) CLINICAL SIGNIFICANCE OF COLORLESS STOOLS. At the recent meeting of the Royal Medical and Chirurgical Society a paper, by Dr. T. J. Walker, was readi by Dr. Andrew Clark, as to the \" Clini- cal Significance of Colorless, or Clay-colored Stools unaccompanied by Jaundice, their Connection with Disease of the Pancreas, and on the Part played by the Pancreas in eliminating Bile from the In- testines \" (Lancet, March 30th, 1889.) After re- ferring to the accepted views of the significance of clay-colored stools, the author gave particulars of two cases in which, during life, a persistent symp- tom was the absence of color in the foces, and in which the diagnosis made of obstruction of the pancreatic duct, with a healthy condition of the bile-duct, was confirmed by the necropsy. From these cases he concluded : 1: That the formation of hydrobilirubin, the coloring-matter of the fæces, depended on the mutual reaction of the bile and * This form is known in Ireland as \" red soldier,\" and s not the same disease as the pneumono-enteritis called \" swine fever \" in this country.--Tr.",
         "THE CANADA LANCET. [SEPT., pancreatic fluid, under the influences met with in the intestinal tract. 2. That in disease a deficiency of pancreatic fluid would, equally with a deficiency of bile, cause the pathological condition of color- less or clay-colored stools. 3. That since, accord- ing to the most recent physiological researches, that portion only of the colored constituents of the bile which have been converted into hydrobili- rubin was excreted in the fSces, while the un- changed bilirubin, bilifuscin, and biliverdin were absorbed, it followed that if hydrobilirubin could not be produced without the aid of the pancreas, that organ must have an important rôle in regulat- ing what proportion of the bile entering the in- testines should be absorbed and what thrown off in the fieces. Dr. Walker then pointed out that these conclusions received confirmation from the records of other published cases, that Claude Ber- nard recognized that the pancreas had a part in causing the color of the fæces, and that the state in which the bile pigments were found in the me- conium of the foetus, while the pancreatic function was in abeyance, also accorded with these conclu- sions. He further pointed out that the fact of the pancreas influencing the excretion of the bile in the fæces would, if accepted, reconcile the discrep- ancy between the clinical observation that certain drugs produced copious bilious stools, and the phy- siological observation that these drugs had little or no influence on the secretion of bile by the liver; and that the same fact would explain those hitherto inexplicable cases in which, with no evi- dence of arrest of the bile-secreting functions of the liver, or of obstruction of its ducts, the symp- tom of white or clay-colored stools was persistently present. In conclusion, Dr. Walker indicated the practical importance of the views he had endea- voured to establish in the treatment and diagnosis of pancreatic disease and of ail forms of bilious disorder. Dr. George Harley said that the paper required serious consideration, many points in it referring to matters proved, and many to others still doubt- fui. He quoted several instances which seemed to hiin to militate against the views as to the action of the pancreas which Dr. Walker had put forward. The meconium of children was only white in those cases in which the bile-duct is oc- cluded ; and in cases where a motion half black and half white was passed at the end of an attack of jaundice, the white part would be passed when the bile-duct was blocked, and the black part when it was patent, but the pancreas would be acting in both cases. White stools ought not to be so com- mon as they were if Dr. Walker's views were correct. Dr. Thudichum acknowledged the instructive- ness of the clinical cases, but thought the conclu- sions drawn were false. How was it proved that bile was eliminated from the intestine ? Had bile been found in the fæeces'? Only a very small quantity of cholic acid had been discovered in the excrement of the dog, not one-twentietlh of the whole secretion. Opium would produce colorless fæeces, and the same thing occurred previous to an attack of epilepsy in a child ; in these cases the bile-duct was not blocked. He had searched for hydrobilirubin in the fæces, and had not been able to find any. Human bile contained bilifusein, and nothing else, and there was no proof that the pan- creaticjuice converted it into hydrobilirubin. So also the idea that calomel promoted a secretion of bile was false ; calomel produced sulphide of sub- oxide of mercury, which colored the stools green. The blood never contained bile; it at once disap- peared. The formulte quoted in the paper had been aIl disproved; and, according to Henle, the average life of a modern physiological theory was four years ; therefore no data more recent than this should be quoted as authority. Dr. Pye-Smith saw facts in the paper which chemical criticism could not detract from. The two cases related were most instructive, and were far better interpreted by the explanation Dr. Walker had given than by any other. That com- plete obstruction of either of the ducts would produce white feces was a new point. Dr. Thudi- chum's criticism did not touch the matter in ques- tion, for it mattered not whether the coloring- matter were hydrobilirubin or not. It might be said that there was an a priori improbahility that pancreatic disease caused absence of the color of the fieces, because the pancreas was singularly free from disease ; stone in the duct was rare, as were also abscess or cancer in the head of the gland; the occurrence of undigested fat in the feces was likewise rare. icterus simplex was not explained by any physiological theory, and our knowledge was so incompletely established concerning the whole matter that we could not afford to put aside any explanation attempting to account for the causation of these cases. Mr. C. B. Keetley related the case of a man who died last year of cancer of the head of the pancreas, and who had obstruction of the pan- creatic duct. The gall-bladder was enormously dilated with bile, and cholecystotomy was per- formed ; notwithstanding this obstruction, at the necropsy the bile-duct was found quite patent. The fæces were always clay-colored, the man was jaun- diced, and the urine was stained with bile through- out. Dr. Walker, in reply, said he had dealt only 1 with cases without jaundice, where there were pancreatic symptoms with absolute absence of liver derangement. He did not desire to dispute the question whether the brown coloring matter in the fæces were hydrobilirubin or not, and with regard to the startling announcement that bile was never to be found in the feces or in the blood, he conl",
         "'89.] THE CANADA LANCET. fessed hinself confused, and regretted that lie 2. Wash the hair once daily with a solution of could fot look on these matters with the clear the corrosive sublimate, of the same strength, and head of the pbysioîogical chemist. The urine, in also a solution of borax, 1 to 250. botb the cases e had related, was normal in color ; 3. Disinfect the urine, feces and expectoration, normal bile was found in the gall-bladder and also the discharge from the ears and nose, if there flowed into the duodenum.--Therap. Gaz. be any. A solution of the bichloride, 1 to 1000, is --__, _best for this purpose. 4. As soon as the patient is permitted to leave PERSONAL DISINFECTION IN CONTA- the bed have the body washed with warm water GIOUS DISEASES. and soap, then sponged with the 1 to 4000 bichlo- d1 A Point which appears to us of considerable value, and which lias, doubtless, suggested itself to, wany physicians attending contagious diseases, and Wit alrnost equal certainty has seldom been acted upon, is brought again to our attention through an article Published in the Medical Record for June 22, 1889, by Dr. L. Mervin Maus, of the United States Armv. We can now scarcely deny the gerni origin of such diseases as diphtheria, scarlet fever and measles, and it is further well established that tbe spread of these diseases is due to a material contagion, which in the case of scarlet fever, is almost confined to the desquamated particles of the epidermis. It is well established that the contagiousness of scarlet fever increases with the onset of desquamation, and it is surprising, since the contagious matter is in ail probability located in these desquanated scales, that the dis- infection of the skin of the patient bas not become a routine practice in the treatment of this disease. thnfortunately, one of us is at present passing trougb an epidemic of scarlatina in his own famiîy, and there the first thought was te endeavor ti protect the other members of the family by a disinfection of the skin of the patient, employing the use of corrosive sublimate in 1 to 1000 solu- tion. In ail irobability this process was not in- auguratte sufficently soon, and did not entirely prevent the spread of the disease. It is known tbat very close approach to a scarlatina patient, or more or less direct personal contact with tbe pa- tient, is required for the spread of the disease.' If we could only thoroughly disinfect aIl the sur- roundings of the patient, we might hope, then, to do away with the spread of the disease, besides greaty reducing the necessity for.prolonged isola- tion. Dr. Maus pubishes the following rules as a Preventive measure for the extension of this dis- eaae, and States that bis practice bas been founded on personal experience, and so far bas been en- tirely satisfactory. He even states that be believes we can through the employment of this method of treatment ignore isolation, in cases of mild scarlet fever, and ordinarily permit patients to join the fanily circle in ten days or two weeks. e.vSponge the patient thoroughly morning and evening witb a tepid solution of corrosive subli- mate, 4 te 1000, as soon as the eruption miakes its appearance. re solution, wiped dry, and anointed with the following ointment: 1 Sodii biboratis, Zinci oxidi, - - - - - aa 3iv- 01. gaultherio-, ------ 3ss: Vasehini, - - - - . - - giv. The hair should be thoroughly washed with the bichloride and borax solution. 5. The patient is then to be enveloped in fresh and clean clothes throughout, and allowed to leave the sick-room if his condition otherwise admits of it. 6. The bed-linen, soiled clothes, towels, etc., should be placed in a suitable sublimate solution and boiled, and the rooms well disinfected with sulphur. The sulphur candles are very ccavenient, and the disinfection should be repeated the second day, as the germs are very tenacious of life. 7. Require the nurse or attendant to keep the hair, face and hands well disinfected during at- tendance, and to likewise make a complete change in his or her garments on date of the disinfection of the sick-room. 8. Continue the provisions of the third and, fourth rules once daily until desquamation is com- plete.-Therap. Gazette. MEDICAL NOTES. For a case of chorea in a child 13 years of age, Dr. Rex ordered 5 grs. antipyrine, t. d. In laceration of the perineum, either operate within 16 hours, or else two moths after labor. (Prof. Parvin.) For a case of facial paralysi8 (Bell's Palsy) of two nonths' duration, Prof. DaCosta directed 20 grs. potassium iodide, t. d.; the dose to be increasd gradually. As a rule, avoid stimulus in pneunonia, except in cases of drunkards, or where the process has reached the third stage, gray hepatization. (Prof. DaCosta.) As a tonic treatment for gyphilis, Prof. Gross. advised the following: R.-Hydrarg. chlorid. corrosiv., gr. Yy Tinct. ferri chlorid. . . gtt. xxv. M. Sig.-t. d.",
         "[SEPT., 20 THE CANADA LANCET. Functional czrdiac murmurs sometimes are heard at the apex, instead of their usual situation over the pulmonary area, but are not transmitted to the axilla, as organic murmurs are always. (Prof. Da Costa.) In the treatment of gastric dilatation, Prof. Da Costa advises washing out the stomach every few days, as much as possible a dry diet, the use of bitter tonics as gentian, strychnia, nux vomica and carbolic acid, or thymol after meals to prevent fermentation. Treat cervical leucorrha by applications of iodine (Churchill's tinct.), carbolic acid or a satu- rated solution of persulphate of iron, in conjunc- tion with hot water injections and tampons of boracic acid and glycerine. (Prof. Parvin.) In a case of hysterical sighing, of 12 months' duration, occurring every few minutes, but never at night, Prof. Da Costa directed 3 drops of Fowler's solution, t. d., and- .-Hyoscin. hydrobromat. . . . gr. -. Sig.-Morning and evening. In the case of a man æt. 28, a dyer in. a carpet dyeing factory, who had epileptic fits since his 17th year, and the urine containing lead, Prof. Da Costa directed 30 grains of potassium iodide, t. d., and 20 grains of potassium bromide morning and even- ing. Treat an acute ulcer by putting the patient in the recumbent position, elevate and relax the limb, paint the surrounding tissue with tinct. iodine, diluted one-half with alcohol, and apply the following solution (diluted one-half by hot water) on lint over the ulcer, t. d. : R.-Plumbi acetat., . * * 3. i Tinct. opii, f... ...fj Aquæe destillat., . . . . f vij. M. (Prof. Gross.) Coll. and Clin. Rec. RIooRs: WHAT THIEY INDICATE.-In a paper upon this subject in the London Lancet, Mr. W. Gilchrist Burnie reports three illustrative cases and points out a few diseases that rigors may indi- cate other than those that are commonly regarded as following them. The first case given was that of a man, age fifty- six years, with good family history. His health was good until within the last few years, during which he suffered from stricture of the œsophagus. When Mr. Burnie was called he found the patient suffering from hemiplegia, from which he made an apparent complete recovery at the end of two months, %n attack each of syphilis and gout having retarded the case. The patient, however,'continued to be apathetic, had no desire to get out of bed, and soon began to complain of a chilliness and pain in the region of the liver. Mr. Burnie was sum- moned, and he found the patient in a violent rigor, and with a temperature of 107° F. He con- to have one or two of these rigors daily for about six weeks, at the end of which time he died. The most interesting feature of this case is that a post mortem showed that the patient died of melanosis, and no pus was found in any part of the body. The liver was the principal organ involved, being black throughout, solid and somewhat enlarged, and on microscopical examination presenting no- thing but cancer celis and pigment granules, no liver cells being seen. Another point of interest was that although the patient had suffered from a recent attack of puru- lent catarrh of the bladder, that organ was found perfectly healthy. The second case given was that of a well-nourished young man, who after suffering for a day from general malaise, had a violent rigor, which was followed by a severe pain in the region of the gall-duct. Violent frontal headache and severe pain in the region of the liver continued for two weeks ; there was a nightly ele- vation of the temperature accompanied by violent rigors, followed by profuse sweats. At the end of this time a history of syphilis was obtained and the patient was put upon iodide of potassium and he made a rapid recovery. Four years later syphi- litie brain disease appeared, which caused his death. In this case when the rigors occurred abdominal abscess was regarded as the most probable cause of them. The third case given was that of a primipara who a week after delivery began to have one or two rigors daily. Mr. Burnie observed that when the patient remained in the second story of her house, she improved rapidly and the rigors ceased, but each time she returned to the-first floor the rigors were repeated. A decided odor of sewer- gas led to the discovery of an open connection be tween the lower room and the sewer. The patient was sent to the country, and she rapidly recovered. -Weekly Med. Rec. CARLYLE ON MEDICAL MEN.-In the recently published letters of Mrs. Carlyle there is a sen- tence in one of her husband's which it will be in- teresting to medical men to read. Coleridge, the poet, worn down by intellectual strain and the pernicious habit of indulging in opium, wellnigh penniless, neglected by friends and former patrons, was received into the family of Mr. Gilman, No. 3, The Grove, Highgate, a medical practitioner of considerable local repute, in whose family he lived for eighteen years, and was much esteemed. \"Poor Coleridge died on Friday,\" writes Carlyle; \"l he had been sick and decaying for years, was well waited on, and, one may hope, prepared to die. Carriages in long files, as I hear, were rushing all round Highgate when the old man lay near to die.",
         "'89.] TI-Ili' flAT'JAflA T.A~Tcvsvr Foolish carriages ! Not one of them would roll near hin (except to splash him with their mud) while he lived ; had it not been for the noble-mind- edness of Gilman, the Highgate Apothecary, he might have died twenty years ago in a hospital or in a ditch.\" Distracted in mind, weakened in body, and impecunious- 0f! who can tell what days, what nights he spent 0f tideless, waveless, sailless, shoreless woe !\" Estranged from former social enjoyments and ne- glected by friends, he found in Mr. Gilman's family a haven of rest, such as Cowper, the poet, had found in the family of Dr. Cotton, at St. Albans, under similar circumstances. These instances tend to rivet the attention to the beneficence of the profession, and reflect what in a minor degree may be found in every district of the country. Medical men are thought to be hardened by the suffering their daily vocation obliges them to witness, but it is not so. Authors, artists, literary men of every kind and degree, widows, and orphans, as well as the poorer portions of the community, could tell how the practice of the medical profes- sion tends, as Watson says, \" to temper the feel- ings and touch the heart.\"-Med. Age. INFANTILE DIARRHŒA.-The medical treatment is divided to meet the demands of three sets of cases. lst. Those with vomiting, colic, convulsions, frequent greenish stools and great exhaustion. At the onset give a tablespoonful of the following mixture: n.-0. ricini Glycerin . *... 01. cassi .gtt. i. After it bas operated freely, give some anti- septie combined with a small dose of opium. Sali- cylate of sodium is perhaps the best. For a child two years old the correct formula will be: n.--Sodii salicylatis..... r iv Tr. opii. deod. . . . . grs. iv. Syr. simp . - . . - . . gtts. x. M.-Sig. One tea spoonful every three hours. The result is rapid and satisfactory. 2nd. The diarrha may be tolerably frequent and of a vivid grass green color, but unattended by vomi Ling and marked prostration. This variety is rapidly cured by lactic acid. A two per cent. Solution may be given in doses of one teaspoonful every one or two hours. 3rd- This type is commonly insidious in origin; the stls being softer and more frequent than usual for a long time before the onset of alarming cYhmptoms; or it is engrafted on a pre-existing choiera infantum. Fully developed, the stools are green or pale in color, moderately thin, and con- InIng sago-lik pellets of mucous with here and and there specks and streaks of blood. Later on '89.] we find shreds and strings of mucus-like sub- stance, apparently caused by sloughing from super- ficial ulcers of the colon. Examine carefully into the sanitary surroundings of the patient, and eliminate all errors in diet. A moderate dose of castor oil will rémove all irritating matter from the intestine. Then a small dose of opium and bismuth subnitrate will quiet the nervous system and soothe the intestinal mucous membrane. As soon as the number of the stools are reduced to a moderate number, small doses of Fowler's solution of arsenic may be added, and the opium gradually discontinued. Bloody stools are frequently cor- rected by injections of nitrate of silver, one grain to the pint, at intervals of twelve to twenty hours. When convalescence is established a so- journ to the seaside is advisable.-New Eng. Med. Monthly. PsoRIAsIs AND ITs TREATMENT. - Psoriasis rarely attacks the skin of the palms of the hands or the soles of the feet, and Dr. Bulk- ley has never seen it on the tongue, although it bas formed over 43 per cent. of al cases of skin diseases which have come under his observation. The cause seems frequently due to change of temperature with much moisture. Bet ween 10. and 15 years of age the female patients were double the number of males, while between 15 and 25 years of age the reverse was true. Over 40 per cent. occur before the second decade of life, and the youngest patient was a little over a year old. Over one-third of all his patients had the disease for ten years or over. The longer the dis- ease lasts the less it is benetited by treatment. The disease is not self-limited. It is most curable in children, and less in patients between 20 and 25 years of age. Psoriasis is a constitutional disease and akin to rheumatism and gout. Meat eating increases its severity, and stimulants pre- cipitate an attack. Oils and fats favor a cure, and wool should always be worn next the skin to avoid sudden changes of temperature, and patients should live in a warm climate. Arsenic, alkalies, and sulphur water are the best medicines to use internally. Local applications are beneficial, especially if applied early, and the white precipi- tate ontment seems to act better than any other. He bas given up the use of chrysophanic acid in in private practice.-Dr. Bulkley in Med. and Surg. Rep. THE BACILLUS oF TETANU.-Tizzoni and Cat- tani ( Wiener Med. Presse) have succeeded in ob- taining pure cultures of the tetanus bacillus of Nicolaier-Rosenbach. A patient who had sus- taned a compound fracture of the arm was brought to the hospital, and developed tetanus. Amputa- tion was performed but failed to save the patient. Ris blood was repeatedly examined during life, MV1-i r A V A\" DA LA CEWmr",
         "THE CANADA LANCET. rsEPT., but no micro-organisms were found and inocula- tions with it in animals proved negative. Cultiv- tions of matter taken from the surface of the wound, however, furnished three varieties of mic- robes, from which the characteristic bristle-bacillus was separated in pure cultures. At the late Congress of the German Surgical Society, Kitasato detailed some experiments with this bacillus, and exhibited pure cultures. His method of separating it fron the other bacteria with which it is generally associated, consists in exposing it to the action of a high temperature (800 C.) This destroys the other organisms, but leaves the spores of the tetanus microbe intact, if the heat is not too long continued. The spores are cultivated in proper media and pure cultures thus obtained. Inoculations of mice produced tetanus, and reinoculations do nîot seen to diminish the virulence of the microbe.-Internat. Journal of Surgery. ŒDEMA AS A DIAGNOSTIC SIGN IN CARCINOMA OF THE STOMACH.-Dr. C. Baert, of Brussels, writing in La Clinique on cancer of the stomach, .calls attention to the frequency with which edema of the ankles is met with in this affection after it has lasted a few nonths-a diagnostic aid which is by no means new, but is, he thinks, in danger of being too much overlooked at the present day. He gives a number of cases recently occurring in the various hospitals in Brussels in which ædema was present. In one of these cases the edema came on as early as three nonths after the first symptoms of the affection made their appearance; in two other cases it was noticed after four months ; but in mo'st of the other instances it was delayed till the lapse of fron six months to a year after the onset. In one case, where there was no evi- dent cause to which to attribute the loss of appe- tite and the wasting conplained of by the patient, Professor Carpentier, noticing somne ædema of the ankle, diagnosed carcinoma of the stonach, and found his diagnosis confirmîed by the appearance a month afterward of all the usual signs of the affection. Several of the cases presented a marked increase in the nitrogen excreted in the urine. With regard to the deficiency or absence of hydro- chloric acid in the stonach in cancer of that organ, M . Baert admits that it is usual, but agrees with Wolff and Ewald in sayinig that this sign is by no means peculiar to cancer, as it is found in other gastric affec:ions.-Lancet. EFFECTS OF PROLONGED CHLOROFoRM ANÆ,s- THEIA.-Some observations made about two years ago by Dr. Ungar pointed to fatty degeneration of the heat and liver as the cause of death after re- peated prolonged administration of chloroform. Further experiments on dogs have recently been made by Dr. Strassman, which appear to confirm this view. Dr. Strassman found that the first organ to be affected was the liver, then the heart, and after that other viscera. The nature of the morbid change was not a fatty degeneration, but fatty infiltration. The actual cause of death in fatal cases appeared to be the cardiac affection, as in all such a very marked degree of change was iound in the heart. In non-fatal cases the norbid change was found to have disappeared in a few weeks' time. When morphia was given previously to the chloroformn, less of the latter was required, and consequently the changes produced were not so considerable as when the ordinary anonnt was given. Animals suffering from hunger, loss of blood, etc., were especially predisposed to the morbid changes due to chloroform.-Lancet. INFLUENCE OF THE AGE OF PARENTS UPON THE VITALITY OF THEIR OFFSPRING.-Recently before the Hungarian Academy of Sciences, this question was discussed by J. Korosi, Director of the Czech Bureau of Statistics. is conclusions, based upon 24,000 cases, may be briefly sumed up as follows: Parents of the sanie age rarely have strong off- spring ; on the contrary the weaknesses of both parents are apt to be transmitted. An aged father and youthful mother of average health and constitution, usually secure strong robust children. The mothers most likely to transmit health and strength to their offspring, are those who conceive prior to their 35th year. Mothers between 35 and 40 years give birth to children eight per cent. weaker than those whose maternal parents have not reached the former age. After 40, children are ten per cent. weaker,-and so on, in increasing ratio. Fathers under twenty years of age, invari ably procure offsprings with weak constitutions. The healthiest and strongest children are the product of fathers between 25 and 40. Any excess of age above 40 is attended with a decreas- ing ratio of health as to offspring, except where the tendency of transmission in the male parent is overborne by the female-i. e., an old father and young mother.-The Med. Age. THE LOCAL APPLICATION OF HYDRASTIS CAN- ADENSIS.-The peculiar feature of the fluid ex- tract of hydrastis canadensis of producing vascular contraction after its internal administration has led to its internal employment in cases of chronic congestion of various organs. It is strange, how ever, that as yet it does not seem to have been employed as a local application in spite of the fact that pharmacological experiments with hydras. tis have shown that this body is not only a local astringent, but also possesses local anæsthetic properties, a fact which led Dr. Felsenburg ( Veine Medizinische Blatter) to test the result of local ap [SECPr.,",
         "rt, he ut in as as .d ly ,dl ot as of he re on ch ed as th ge ng nd 35 it. ve ng ri he re is ad en ho LaB OPIUM IN THE INTEsTINAL HEMORRHAGE OF TYPHoID FEVER.-Dr. J. A. Lindsay, of Belfast, evrting on hhmorrhage from the bowel in typhoid fever, says that lie lias always been accustomed to follow Murchison's instructions, and lias given tannic acid, laudanam, and turpentine, with ice externally an ergotin by hypodermic injections. Sone good authorities prefer to omit the turpen- tine, but he cannot say that he lias ever seen any harm resuting fron its use, and its power as a eostatic is undouted. In one of his cases he gave laudaname pretty freely, in spite of the pres- ence of albumen in the urine, and with good resultsno sign of narcotism appearing. He is disposed to think that in intestinal hæmorrhage, as in ieatocele and other forms of interna bleeding, opium may le given fearlessly, and pushed eveî, to heroic doses. Stimulants are cer- tainly required in some cases, but must be regu- lated with much caution. Whilst intestinal hitorrhage in typhoid fever is a serious symp- tO it is by no means usually fatal, and prompt and decisive treatment is called for, and will often prove effectua]. -Dublin Journal of fed. -Sciences. ExERcisE AND MEDICINE. - Boerhaave, the famous physician, declared that a man was more likely to get well by climbing a tree than by drinking a decoction made of its leaves! that is, he thourht exercise better than medicine. It is on this principle that the Queen of Sweden, whose nervous condition bas given rise to much anxietv, is being treated. Shie is ordered to make lier lied and sweep lier room, besides taking a large amount of walking exercise. This methodthe house- maid treatment,\u003e' as lie calls it-has inspired a cynical journalist with sorne su-aestions which are, perhaps, wiser than lie knows g ie advises the ''office-boy treatvment,\" for the dyspeptic mil- lionaire, the \" groom treatment\" for the Crsus whose liver is too much with him, the \"country mii-nera solution. As a toilet anti- septic to use after a post-norten or similar work, Listerine, with its pleasant odor, needs only to be tried to find a permanent place there. Listerine is a very attractive looking preparation, the liquid being crystal clear, with no sediment or undissolved oils whatever. The Lambert Ph. Co. have intro- duced their product strictly through the profession, which atteststheirfaith inits efficiency.--Marttime Med. New8, Halifax. N. S. USEFUL FORMULE IN CHRONIC RHEUMATISM.- Dr. Daniel R. Brower, in a clinical lecture on a patient suffering with chronic rheumatism, fatty heart and fatty liver, published in the North American Practitioner, May, 1889, suggests the following formule to aid in the removal of uric acid from the system, and to sustain and improve the action of the heart and of the liver* I. Lithiæ citrat. . . . . . . . ij. StrychniS . . . . . . . gr. j. Tinct. Strophanthi . . . . f 3 iss. Aquæ menth. pip. . q. s. ad. f 3 iv. M. Sig. ---Teaspoonful before each meal in water. R. Aloes . . . . . . Pulv. Ipecac. .-. . Pulv. Rbei, Ferri sulph. exsiccat., Ext. Hyoseyami . . . M. Div. in capsules No. X. Sig.-One at bed-timie. PROPIIYLAXIS OF PHTHisIs.-Dr. J. C. Wilson, at the late meeting of the Medical Society of Pennsylvania, in the address on medicine, dealt with the above subject. He advanced the follow- ing propositions which lie discussed in full, viz.- 1. Tuberculosis is a specific infectious disease. 2. The constitutional manifestations are not directly due to the bacilli, but to toxic principles evolved during their growth and multiplication. 3. Tu- berculosis is directly and indirectly commnnicable . . . gr. ij. . . . gr. j. . . gr. x. '89.] THE CANADA LANCET. 23 Plication of the fluid extract of the hydrastis. postman treatment \" for the obese financier; the le states that his results have encouraged him to \"nursemaid treatment \" for the hysterical woman further experimen in this connection. His who cannot stand a child's cry, and the \"old- studies were made on a series of cases of chronic clothes women treatment \" for the fine lady who pIaryngitis compicated with enlarged tonsils. faints at the sight of powder. Probably the In al cases lie states that the results were good. \"treatments \" would be efficacious-if the pati- The local application of the fluid extract to the entwould submit.-London Hospital. diseased mucous membrane showed a marked de- rease in the contraction of the vessels and reduc- IN FERMENTATIVE DISORDERS OF THE STOMACH, tionp of swelling wit relief of the subjective and in corresponding forms of diarrhœa, we con- tYPtoms. le states that patients readily accus- sider Listerine certainly a safe, and also as a valua- tnm theselves to the bitter taste of this remedy, ble preparation. It is not at all unpleasant to and even prefer the painting of the throat with take when properly diluted ; especially, then, as the fluid extract to other forms of gargles or other i an internal antiseptic, do we recommend its use. local applications. Dr. Felsenberg thinks that It is, however, largelv used as an external anti- perhaps oa sitilar use of this remedy in the case of septic, and its oily constituents give it a more disease of other mucous membrane might lead to healing and penetrating power than is possessed equal cary results.lThera. Gaz. l p h i",
         "24 THE CANAI from the affected to the healthy individual. 4. It is not in the ordinary sense hereditary. 5. A rational scientific prophylaxis is practicable both as regards individuals and communities. HYPERIDROsIs AMoNG SOLDIER.-An official circular, addressed to Prussian army surgeons re- specting excessive sweating of the feet and other parts among the soldiers as an affection den.anding treatment, advises the use of chromic acid as an efficient and economical application, of the strength of one part in ten of water. In cases of hyperidro- sis of the feet, such a ten-per-cent. solution, applied at intervals of three, four, or six weeks, has proved sufficiently strong to remedy this source of disabi- lity. From the point of view of military hygiene, the prophylaxis of th:s affection is not merely a question of discomfort and inconvenience, but has its relations to the efficiency of the service, since all soldiers having hyperidrosis will be more or less prone to recurrent catarrhal troubles and to the evils attendant thereon. Hyperidrosis of the feet, moreover, will impair the marching capabili- ties of the men having that infirmity. \" BLACK EYE.\"-There is nothing to compare with the tincture or a strong infusion of capsicum annuum mixed with an equal bulk of mucilage of gum arabic and with the addition of a few drops of glycerin. This should be painted all over the bruised surface with a camel's-hair pencil and allowed to dry on, a second or third coating being applied as soon as the first is dry. If done as soon as the injury is inflicted, this treatment will invariably prevent the blackening of the bruised tissue. The same remedy has no equal in rheumatic sore or stiff neck.-N. Y. ilfed. Times. THE TREATMENT OF DIFFERENT FORMS OF HEMIPLEGIA.-Dr. J. Hughlings Jackson, in Brit. Medical Journal, says: The type of syphilitic hemiplegia due to a syphilitic endarteritis is not cured by drugs. After the artery is obliterated and softening occurs drugs will do nothing toward curing the paralysis. But active treat- ment should nevertheless be carried on with mer- curicals and iodides in order to prevent similar occlusion of other vessels. There is no doubt that some of these cases of hemiplegia do recover, but not from treatment. All cases of hemiplegia, from whatever cause, that get well, do so through the law of compensation by other nervous ele- ments. This compensation will depend materially upon the smallness and position of the lesion. TREATMENT OF FRACTURED PATELLA BY WIRING THE F\u0026AGMENTs.-Dr. Ceci, at the Surgical Con- gress of Bologna, reported eleven cases in which he had treated fractures of the patella by subcu- taneous wiring with buried sutures. The patients DA LANCET. [SEPT., were for the most part between fifty and seventy- eight years of age. In nearly all the cases the fracture was simple and transverse, but in one there was comminution of the lower fragment, and in another, a man, aged sixty-nine, the bone had been broken a second time two months after the first accident. Dr. Ceci uses silver sutures. All the cases had done well, hæmatoma and non-infec- tive arthritis having occurred only once.-The Brit. Med. Jour. CHRONIC ALCOIOLIsM.-In the treatment of this, Prof. Bartholow, says: For the disorders of the digestion, morning vomiting, loss of appetite, accompanied by wakefulness and nervousness, the appropriate remedies are abstinence, careful ali- mentation, and such tonics as quinine, nux vomical and the administration of bromide of potassiulo to procure quiet sleep. In the more chronic cases, where degenerative changes may be expected to have taken place, arsenic in small doses, hypo- phosphites and cod liver oil are recommended, and should be given for several months. Chloride of gold and sodium or corrosive sublimate will retard changes taking place in the connective tissue, if given early enough.-Coll. and Clin. Rec. A CURE FOR DANDRUFF.-Dr. A. J. Harrison, of Bristol, recommends the following salve for dandruf: Caustic potash ..... 8 grains. Phenic acid . . . . . . 24 grains. Lanolin -- Cocoanut oil * a3jv-M. This preparation should be scalp morning and evening. usually effected in one to three grés Med. rubbed into the Complete cure is months.-Le Pro Milk sugar in cardiac dropsy is regarded bf Germain Seé as the most reliable and least harwv ful diuretic. He attributes. the good effect of \u0026 milk diet almost exclusively to the lactose. One hundred grammes (3j oz.) lactose will produce a* enormous diuresis, increasing the daily dischargO in twenty-four hours to two and one-half liters, and daily overreaching this, until on the thirdl day, four to four and one-half liters are voided.j Milk sugar, therefore, removes cardiac dropsl surely and rapidly, and only fails if Bright's disease complicates it. It is usually well borne and may be continued for eight or ten day o longer, with intermissions. When cardiac dye pnoea co-exists, Seé resorts to iodide of potassiuV1,' -Times and Reg. MENTHOL IN ASTHMA.-Dr. Jones, Therap. %t nat8, recommends the use of a 20% solution menthol in olive oil in asthmatic attacks.",
         "'89.] THE CANADA LANCET. rity- the one and the All fec- The s of ,ite, the ical ses, î t' of ard if THE CANADA LANCET. \u0026 UonthlY Journai of Medical and Surgical Science Criticism and News. \u0026NOommunicato solicited on all Medical and Scient fic ubects, and also Reports of Cases occurring in practice. ,Addres, DR. J. L. DAvIsoN, 12 Charles St., Toronto. tdvertisement inserted on the most liberal terms. Al LetterD and Remittances to be addressed to DR. C. SHEARD, 320 Jarvis St., Toronto. AGNTS DAWSO BROS., Montreal; J. \u0026 A. MCMILLAN, St. John, N.B. 231. SRIuT \u0026 o., 30 Cornhill, London, Eng. ; M. H. MAii- LUS,. 23 Rue Richer, Paris. TORONTO SEPTEMBER, 1889. The LANCET ka8 the largest circulation of any Medical Journal in Canada. GRATUITOUS SERVICES TO THE POOR. Lord Sandhurst, in his recent address to the House of Lords, in which he urged a \" Parlia- mentary investigation into the financial and general administration of medical charities \" in England, gave the following somewhat striking account of the enormous extent of medical relief afforded in the city of London. \" The city contains one hundred and twenty-six institutions supported by private benevolence, whether funded or occasional. There are the eleven general hospitals with schools at- tached, and the eight without schools. There are the sixty-seven special hospitals. There are the twenty-six free dispensaries ; the thirty-five provi- dent dispensaries ; and the thirteen which require part payment. There are the five surgical appli- ance societies. Together they minister to the wants of more than a million and a halfVpàtients, inclusive of upwards of seventy-six thousand whom in a single year they have received as in- mates. Then there are the Poor Law establish- ments for medical relief. Eight infectious hospi- tals maintain two thousand seven hundred and sixty beds. Twenty-seven Poor Law infirmaries have eleven thousand nine hundred. Forty-four Poor Law dispensaries serve nearly a hundred and fifteen thousand out-patients.\" The London Aime of August 1st, 1889, in criticising Lord Sandhurst's address, expresses the feeling of the general public well in its admii-ation of the mag- nitude of the work represented by the medical institutions of London. These considerations are of interest to the physicians of Canada, as afford- ing a general indication of the great readiness with which medical men hasten to the relief of suffering humanity everywhere, and whilst we do not wish to infer that it is not the duty of the physician to relieve the suffering poor-a duty which no true physician ever declines-yet, in the interest of justice to all, may we not ask if such services by the medical profession are not too readily and eagerly given? Is there any profes- sion, save the clergy, where gratuitous service is expected, and, from force of habit, often expected by those far richer in this world's goods than the physician rendering such service i W e need scarcely stop to ask the reason. In large cities the dearth of clinical material is great ; too great for the able demonstrator to enquire anything about the pecuniary surroundings of the patient upon whom he bestows his benefits and advice. In private practice competition is keen, and the reputation of being good and kind is a great help to the struggling practitioner. Rich corporations do not hesitate to ask and receive the labor of the medical profession gratis. Employers of labor make the, all but gratuitous, services rendered by the medical attendant, a reason for reducing the wages of their employees, and make a direct profit out of the doctor. Sani- tary boards and organizations are only too eager to bring the best professional talent to the ser- vice of the community, who, so far from expecting remuneration for their services, are glad to escape the enmity and vengeance of ignorance. When things are changed and the doctor meets with misfortune, if he happens to lose a pauper patient by chloroform, or to have shortening or deformity after fracture, then the community cannot be too arrogant and bitter in its evidences of disfavor; the lawyer cannot be too clever in throwing aside every semblance of charity and often truth, in the prosecution of his philanthropic brother, nor the jury too ravenous to satisfy the malice of a pauper patient whom the physician merely from pity sought to serve. It is not easy to suggest a remedy for the grow- ing evil of free doctoring ; but we call attention to the fact, that so long as doctors are willing to work for nothing, it is useless to blame those who accept their services at such a rating. We would urge the profession to remember that a doctor's",
         "26 THE CANAD best friends are generally among his professional brethren ; that a spirit of unanimity existent be- tween neighboring physicians, a spirit which dis- countenances, as unprofessional and unfair such gratuities will be beneficial; and that a stern op- position to such practices, save in the cases of the absolute poor, will be to the benefit of all. CIGARETTE SMOKING BY BOYS. The practice of tobacco smoking has now be- come so general that at present few of the advo- cates of abstinence from the weed are heard. Temperance in this habit is assuredly necessary, for while in adults the moderate use of the nar- cotic seems to supply a want, apparently uni- versa], of the human race, its abuse is attended by certain more or less constant evils. This want is evinced by the use of narcotics from the earliest times, all nations, savage, semi-savage, and civilized having employed them in various forms, for that solace which the smoker of to-day finds in his pipe or cigar. Considering the large number, of persons using tobacco, and their general health, it can hardly be said that its moderate use is harmful. Good observers have come to the conclusion that in the majority of cases, tobacco, \"used in moderation and when the stomach is not empty has a beneficial effect.\" This, of course, applies to its use by adults. It has, in those ac- customed to its use, a soothing effect upon the nervous system, but, on the other hand, it often acts as a nervous stimulant to mental work, as in reading, business, etc., the student being clearer with his pipe in his mouth and the broker mentally more active while puffing his Havana. Its action as a brain stimulant is believed to be due to the irritation of the sensory ierves of the mouth and nose, which reflexly stimulates the vaso-motor centre, and dilates the vessels of the brain, thus providing for the most complote in- ternal respiration of the brain cells by a f ree sup- ply of arterial blood to them ; an effect similar to that first produced by sipping alcohol. The difficulty is, that this like other remedies of its class, it is very liable to be abused, excess fol- lowing *the moderate use of the drug, when a whole train of characteristic evils follow; such as furred tongue, irritation of the throat and hoarse- ness, dyspepsia, irritability of the heart with a A LANCET. [SEPT., characteristic rhythm and palpitation (tobacco heart) trembling, cold clammy extremities, loss of appetite, tobacco amaurosis, sndden fainting spells, etc. But it is upon young persons that its most bane- ful effects are seen. While we have above stated that its moderate use by adults is often beneficial, it cannot be too strongly urged that it is a most potent and insidious poison to the young. It is a question whether the present pernicious habit of cigarette smoking by boys is not equally of importance with the use of alcoholic liquors upon the rising generation. In this country we believe it is more harmful, inasmuch as cigarette smokers among boys outnumber spirit drinkers, largely, perhaps by twenty to one. These boys show the characteristic pallor, sickness and ner- vousness which result from the swallowing of nico- 1 tine. Anyone who has seen boys of from ten to sixteen or eighteen years of age, not only smok- ing, but inhaling the smoke of cigarettes, cannot î but have seen the effects of the poison depicted not only upon their faces, but in their listless walk, delicate frame and mental lassitude. The special evils of this form of smoking are well marked. The poorest qualities of tobacco are commonly used in their manufacture, rich in nicotine rather than in the aromatic principles of the best speci- mens of the plant. More or less stringent laws have been enactedg to restrict the sale of tobacco to children, but we all nay observe how non-effective they are. la New York a recent act by the legislature makeS it a misdemeanor to sell cigarettes or any form of tobacco to persons under sixteen years of age. Pennsylvania has a similar prohibitory law. Here it is unlawful to sell to boys under fourteen years of age, without a written order from the parents. Girls of any age may purchase. It will be easilY understood how boys of any age may, by clubbing their cents, obtain the desired cigarette through: the agency of a boy of fourteen years of age, the purchase being divided amongst them. Just how the evil is to be met is a grave question, moral suasion being of little avail among the lower clases, who are the greatest suffers from this form of die- sipation. A prohibitory law as to the manufac ture of cigarettes might meet the case, for while the use of tobacco in any form is detrimental tr the health of children, the use of cigarettes is und",
         ".1 co of ls, oe- ve en Lg. us lly ors we rs, ys I ,,r- :-0 en ok- tot ed 1k, tal ,d. []Y ier ci- we I 'In eS of re. re gh hle' Liv doubtedly at the present time the form of smok- ing which is most prejudicial to the health of the rising generation. CORROSIVE CHLORIDE IN OBSTETRICS. Great advances have been made within the last decade in every department of medicine. But to nothing are we more indebted for practical utility, or for accomplishing important results, than to antiseptics. Their utility had to a limited ex- tent been known prior to Lister's successful ex- Periments of their value in surgical practice, but since Koch's researches and discovery of specific germs of disease, antiseptics have obtained a more extended utility, and proved almost as valu- able in obstetrics as in surgery proper. The once dreaded puerperal fever or peritonitis, the terror of both hospital and private obstetrical practice, of the physician and the patient, is no longer the bete-no ig of the accoucheur, but is now clearly un- derstood, and almost wholly amenable to antisep- tic treatment. The history of the successful employment of corrosive chloride in a large lying-in hospital in Berlin, froi May, 1884, to the end of 1887, proves conclusively that, both as a preventive and re- nedial agent, it is unequalled, and that it has reduced the dangers of septicemia in obstetrics to a minimum During this period of over two and a-half years, 5,027 confinements were treated an- tiseptically with sublimate solution, with the gratifying result of reducing the number of cases of puerperal fever from 2J to 3 per cent., which ob- tained previous to 1884, to from .02 to .03 per cent. during the exhibition ef corrosive chloride. The routine treatment, after being put to bed was to wash the external genitals and syringe out the vagina with a solution, 1 to 4000, which was repeated every two or three hours. The hands of the attendants were disinfected by a 1 to 1000 solution. After delivery, the parts were again washed and syringed with 1 to 4000 solution. Subsequently vaginal injections were dispensed with unless by special order of the physician, but washing the external genitals was continued twice a day. As to the danger of such treatment, during 1884 the injections were made 1 to 1000 in strength, and no bad effects followed, but from reports from other places of poisonous effects from so strong a solution, they were reduced to 1 to 3000, and after- wards to 1 to 4000, with equally good effects; and now, for uterine injections, 1 to 5000 are used, and in po8t-partum hæmorrhages, 1 to 8000. When the stronger solutions were used a few mild cases of mercuric symptoms were observed, which soon sub- sided. Intra-uterine injections is used in 453 cases, as strong in some cases as 1 to 1000, but mostly 1 to 4000, in which but few cases evinced any symptoms of mercuric poisoning, of mixed type. In 368 cases the uterus was thoroughly syringed out, which were followed by 10 cases of intoxication, and one had a fatal termination. These records are evidence of the greater danger of intra-uterine injections, and of the ne- cessity of avoiding such injections as far as possi- ble. Yet these results should not deter us from employing them when clearly indicated. We therefore conclude from the above, and the reports from other lying-in hospitals, that corro- sive chloride not stronger than 1 to 4000, should be used in all cases of labor, and especialy where the sanitary environment is at all unfavorable. THE UsE oF PEssARiEs.-The numerous objec- tions to the use of pessaries which have recently been so strongly urged, seem to have become rooted in the minds of a majority of the profession. Per- haps the pendulum of professional fashion has swung rather too f ar in this matter. At the Soc. de Chirurg. lately, Dr. Bouilly (Jour. Am. Med. A8oc.) defended their use, endeavoring to prove that they are not dangerous. He \" would not, of course, defend the employment of those enormous pessaries that were formerly in use, but he would willingly adopt instruments, whether malleable or not, which are made to measure, and which adapt themselves to the parts to which they are applied, such, for instance, the pessaries of Hodge and of Smith. Dr. Bouilly thinks that they are clearly useful in simple, mobile, retro-deviations, and that it would be dan- gerous not to maintain the uterus in position. Between doing nothing on the one hand, or prac- ticing Alexander's operation on the other, which does not often produce satisfactory results, there is a treatment to institute, and that is of the appli- cation of a pessary. Dr. Bouilly had already col- lected 84 cases of retro-deviation in which he em- '89. THE CANADA LANCET.",
         "~- t' ployed this instrument and which always proved satisfactory. But to apply the pessary, reduction must first be effected, either by the genu-pectoral or knee-and-chest position, or by the method of Schultze. In these conditions an instrument of good dimensions re-establishes the cul de-sac of Douglas, the portion of intestine that was displaced will resume its normal position, and in directing the attention of the patient to the necessity of not ai- lowing the bladder to get full, of avoiding shocks, pregnancy may take place, or the maintenance of the uterus in proper position may be obtained in eight or nine months of treatment. The danger is nil when the pessary is well applied, and acci- dents may occur only in cases where the instrument is too large, ill-chosen and badly applied to a womb imperfectly reduced. Only once did M. Bouilly see an ulceration in the posterior cul-de-sac, and it was healed up in a few days. It is, of course, understood that the posterior adhesions are a con- tra-indication. DR. BROWN-SEQUARD's REJUVENATION Discov- ERY.-The Med. Press reports that at the last meeting of the Société de Biologie, of Paris, Dr, Brown-Séquard said that concerning the \" wonder- ful results \" he had obtained from the injection of the liquid from trituration of the testicles of young animals, hecoulid butconfirm what hehad already al- leged. Although he hadsuspended the injections, he felt himself vigorous, and he had recently made two voyages without the slightest fatigue. He sug- gested that women could have their vital forces recuperated by injection of a liquid derived from trituration of ovaries ! In any case the method of M. Brown-Séquard is not new. Horace, in one of his odes, beseeches the witch Canidia to reveal to him the secret of the draught which she pre- pared at night by crushing in a mortar pieces of flesh torn from the most fiery horses of Rome, and the patricians, says the Latin poet, used this mys- terious liquid with great confidence. Consequent- ly, M. Séquard is but an humble successor of Canidia ! SALE OF TUBERCULOUS FLESH AND MILK.-At arecent meeting of the Scottish Veterinary Society, held in Edinburgh, a motion was submitted by Prof. Williams as follows: \"That the Society, thorough- ly believing that tuberculosis is a contagious dis- rsEPT., ease, urge upon the Government-first, to stop the sale of milk from animals suspected of being infected ; secondly, to suppress the consumption of meat from tubercular animals ; and, thirdly, to give compensation for a limited number of years.\" It was held as an unanimous opinion, as shown by the discussion which followed, that all visibly dis- eased meats should be destroyed, and that milk from diseased animals is especially dangerous. OPERATIVE TREATMENT FOR PROSTATIC HY- PERTROPHY.--Prof. Kümmel, of Hamburg, in a paper lately read before the Congress of the Ger- man Society of Surgery (Med. News) stated that he had performed on six patients a partial extirpa- tion of the hypertrophied prostate gland. His cases were very grave, as they had resisted all other methods of treatment. There was fever, bronchitis, and considerable vesicular dilatation. In such cases the operation is indicated, while it is the contrary when the kidneys are seriously in- J volved, or when there is a complete paralysis of the bladder. In this last case the operation is useless, for even after the suppression of the obstacle, spontaneous micturition cannot be re- ëstablished. To extirpate the prostate gland he performs superior cystotomy ; the bladder is very carefully washed out, and he then destroys, by the aid of the thermo-cautery, not only the median lobe, but also all the parts of the gland which pro- ject into the bladder. He then sutures the bladder, and allows Nélaton's sound to remain in it. Out of six patients, one died from collapse, in another the operative result was negative, four are cured and can urinate spontaneously. In the discussion that followed, Prof, Socin, of Bâle, said lie believed the enlarged prostate was not so often accountable for the evil symptoms observed, as is the cystitis, which is so frequent a concomitant. He thought that the good results which sometimeS follow extirpation of the prostate gland, are due, probably, more to the washing out of the bladder and to the sound left in position-that is, to the treatment of the cystitis-than to the operatiol itself. The cystitis is the first enemy to combat in the treatment of prostatic enlargement. TREATMENT OF VARIoUs FoRMs oF RHEUMM TISM.-Dr, McColl, Lancet, gives the followini regarding the salicylic treatment of rheumatista THE CANADA LANCET. [SEPT.,",
         "TIRE CANADA LANCET. 1. In relieving pain and lessening fever in acute rheumatism the salicylic treatment is most un- doubtedly the most effective we know of. 2. The salicylates do not prevent the rare complications of hyperpyrexia, and are absolutely useless in its treatment. 3. It is doubtful if they prevent endocardial or pericardial troubles, the per- centage remaining about the same (50 per cent.) since the salicylic treatment as before. They seem to have no influence in curing these troubles when they do occur. 4. There is no proof that the salicylates prevent relapse. 5. It is not proved that the salicylates lessen the duration of the disease, or that they prevent anæmia. With regard to the particular form of the remedy, most writers recommend (and Dr. McColl agrees with them) salicylate of soda in twenty-grain doses, at first every hour for three or four hours according to circumstances. It should be continued in di- minished doses for at least eight or ten days after all pain and pyrexia have gone, and in most cases should be followed by iron. Salicylic acid, salicin and salol might be tried in exceptional cases where the soda salt was not well borne. In young children antipyrin might be substituted with ad- vantage. In convalescence, Sir A. Garrod's alka- line mixture, followed by iron, is advised ; and, if any jomnt remained stiff or swollen, blistering or painting with iodine is useful. SALOL IN DYSENTERY.-Dr. R. B. McCall writes to the Medical Bripf that in treating a case of dysentery in a child five years old he tried the methods of treatment whieh an experience of fif- teen years had made familiar; but, as the boy con- tinued to grow worse, he resolved to try salol, which lie administered in two-grain doses every three hours. In speaking of the marked and rapid improvement which followed, he says : \" In all my experience I never sa w the efficiency of a medicine 80 unmistakably portrayed by characteristic re- sults--the effects following close in the wake of the cause. Dose for first two days was two grains every three hours, increased to three grains, and continued at that as the maximum for three days longer; after which it was given for five days longer in diminishing quantities until left off. \"In about ten days nearly 200 grains were taken, by a child five years old and that without the least sign of oppression, disturbanoe of any kind, of stomach, heart, or kidneys, or of brain or mind. I believe salol is perfectly safe to be used in suitable doses at any age, and am persuaded from the above case and from a little experience in summer diarrheas, wherein its influence was unquestionably kind and effective, that it is des- tined to be a valuable agent.\" SIMPLE CHANCRES INDURATED BY CONTACT OF URINE.-Professor Fournier presented (Jour. of Cut. and Genito-urinary Diseases) a patient show- ing several chancres of the prepuce which have the objective aspect of simple chancres, but which to the touch are indurated ; beneath them is felt a veritable indurated nodule. In the groins there is no adenopathy, and inoculation upon the arm had a positive result. The induration which ac- companies the sores is of an irritative origin ; in fact, the patient urinates upon the lesions and bathes them in the urine, which he considers an excellent remedy. Fournier insists upon the practical importance of these cases. The simple chancre is often indurated, and this induration alone cannot be considered as demonstrative of the existence of syphilis. The agents of this in- duration are multiple, and embrace all sources of irritation, such as dirty dressings, excessive cau- tery, but especially constant contact with urine. INFANTILE CONvULsIONs.-Mr.Valentine Knaggs (Med. \u0026 Surg. Rep.) advises the use of calcium sulphide in small and repeated doses, as a remedy for infantile convulsions and other nervous diseases. He has observed the best results in convulsions from dentition, falls on the head, meningitis, and acute tuberculosis. For infants under six months of age, Dr. Ringer's prescription is recommended. It is prepared by dissolving a grain of sulphide of calcium in a half a pint of water, of which a tea- spoonful is given hourly, the dose being cautiously increased if need be. Dr. Knaggs has found it ad- vantageous to combine this treatment with the ad- ministration of antipyrine. SALICYLIC AcID IN THE TREATMENT OF SCARLA- TINA.-A writer in the Rev. de8 Malad da l'en- fance says he has administered the above drug in one hundred and twenty-five cases of scarlet fever of a severe type in children, with the happy result of a reduction of the mortality to 3J/. His me- thod has been to give doses proportienate to the -'89.]",
         "30 THE CANADA LANCÈT. [SEPT., child's age every hour during the day, and every two hours during the night. The writer believes that by this method of treatment he obviates the very serious complications of scarlatina, such as uræmia, anasarca and diphtheria. This method of treatment to be effectual should be begun early, not later than the fourth day, and should be con- tinued for some time after all trace of fever has disappeared in order to lessen the probability of a relapize. INTERNATIONAL MEDICAL CONGRESS.-We, the undersigned, do hereby give notice, that according to the resolution passed at the Washington meet- ing, September 9th, 1887, the Tenth International Medical Congress will be held in Berlin. The Congress will be opened on the 4th and closed on the 9th day of August, 1890. Detailed informa- tion as to the order of proceedings will be issued after the meeting of the delegates of the German Medical Faculties and Medical Societies, at Heidel- berg, on the 17th of September in the current year. Meanwhile, we should feel sincerely obliged, if you would kindly make this communication known among your medical circles and add in the same time our cordial invitation to the Congress. Von Bergmann. Virchow. Waldeyer. PRIVATE HOSPITAL.-We take great pleasure in calling attention to the private hospital recently opened by Dr. Rosebrugh, of Hamilton, for the treatment of medical and surgical diseases of wo- men. Especial pains have been taken in fitting up the operating rooms for abdominal surgery, com- bining all modern improvements in the way of plumbing, ventilation and other sanitary arrange- ments. We are please:I to note such careful pre- paration for this work by Dr. Rosebrugh, and as he now is one of the oldest abdominal surgeons in Canada, we heartily wish him abundant success in his new undertaking. TREATMENT OF BURNS OF THE FACE.-Chris- topher Heath recommends, Lancet, the following for superficial burns of the face: Collodion, . . 1 part. Castor oil . . 2 parts. This mixture, while it does not set as firmly as collodion, sets sufficiently to protect the part from the air, which Mr. Heath considers is the great point. A ten grain to the ounce solution of nitrate of silver, by forming a slight superficial eschar all over the burnt surface, is another good applica- tion, though rather painful at first. OBSTINATE VoMITING.-The following formulve (La France Méd.) may be useful for reference (1) R.--Tinct. of iodine . . 16 drops. Distilled water . . 60 grammes.-M. Sig.-A tablespoonful every half hour. (2) Randolph's Mixture: R.-Creasote . . . . 20 drops. Acetic acid . . . 40 n Sulph. morphine . O gr. , Distilled water . . 60 grammes.-M. Sig.-Two or three tablespoonfuls every half hour. (3) R.-Phenic acid . . . 1 drop. Chloroform . . . 3 drops. Alcohol . . . . 20 Distilled water . . 15 grammes.-M. Sig.-For one dose ; to be repeated one-half hour later, if necessary. Especially useful in Asiatic cholera. (4) Cholera Infantum: R.-Phenic acid . . . 25 drops. Alcohol . . . . 25 Peppermint water . 45 grammes. Mucilage of gum arabic, Syrup of poppy . äã 15 drops.-M. Sig.-A tablespoonful every two hours. (5) Vomiting of Pregnancy.: (a) .-Elixir of opium Brom. pot. . . . Water . . . . . Sig.-For rectal injection. (b) Dujardin Beaumetz.: R.-Hydochlor. cocaine Distilled water . . 30 drops. 1 gr. 8. 60 grammes. SOgr. 42. 300 grammes.--M. Sig.-Take a teaspoonful everyhour. To avoid the vertigo, remain in the recumbent position. (c) R.-Fl. ext. viburnum . 3 gr. 75. Sig.-To be taken at successive times. BELLADONNA WITH BRoMIDE OF POTASSIUM IN ENURESIS.-Dr. Campbell Black, in a letter to the Br. Med. Jour., states that the above combina- tion has been a favorite with him for the past fif- teen or twenty years. He believes it to be of great",
         "89.] THE CANADA LANCET. 31 eflicacy \" in all cases of preternatural excitation CILBLAINS.-The following is said (Med. Age), of the reflex arc, such as obtains in epilepsy, to be an excellent remedy for chilblains: enuresis, spermatorrhoa\" etc. Spirit camph. ; tinct. o.pii à\u0026 ij ; acid carbol HIAY FEVER.--Dr. Jacquess, writing to the Med. Brief, says of the following remedies. My wife has been a sufferer from hay fever for fifteen years, and they are the only remedies I have found to relieve her : R.-Liq. Arsenical....... 1 drachm. Tinct. Belladonne . . . . 2 ounces. M. Sig.-Five to ten drops, three or four times a day, commencing three or four weeks before the expected attack. Also : R.-Glycerini . . . . . . . 1 ounce. Acid Carbol . . . . . . . 20 drops. Apply up the nose and bathe the eye-lids, two or three times a day. For the cough, use the gly- cerine and carbolic acid internally. CONSTIPATION IN FEMALES. -The following is said (Lutand, Rev. de Thér.) to be very efficacious in the stubborn constipation of females : R.-Cit. of iron and ammon. . 31 grains. FI. ext. of cascara sagrada . 32 M. Saccharine 8 grains. Distilled water * . . ijss.-M. S.--Half teaspoonful before each meal. FOR LEUCORRHRA.-Med. Prog. gives the fol. iowing from Gaz. de Gyn .-Infusion of chamomile . . gxvij. Aluni . 3ijss. lodide of potassium * 3j. Tincture of iodine . xxxij.-M Three injections should be made daily, and, in addition, general tonics and sulphur baths are advisable. CORROSIVE SUBLIMATE FOR HYDRCELE.-Dr. Barnard, writing to the Lancet, says that a solu- ton Of corrosive sublimate, one in 1,500, gives ex- cellent results. He says that the untoward effects of iodine, such as pain, shock, consequent irrita- tation and inflammation, were eliminated by tbis treatment. PREsENTATION.-Dr. Lawton, of Harwich, was the recipient of a handsome solid silver water set, on the occasion of bis leaving Harwich with bis wife, tO reside in England. We beg to present our congratulations and best wishes for the future happiness of Dr. and Mrs. Lawton. , .,1 gr. xl ; spirit vini, 3iv ; aquæ, ;iv. BROMIDIA.-I have used the Bromidia (Battle) and the results obtained have been really excel- lent. It certainly combines all the advantages of other preparations of this nature, while at the same time it possesses none of their disadvantages. The fact that it produces no unpleasant sensation on awaking, renders it specially valuable. St. Nazaire-sur-Loire, DR. LUD. MARC. France. PERSONAL.-Dr. Bowlby, Jr., Trin. Coll., has lately succeeded in taking the L.R.C.P. Lond. and M.R.C.S. Eng., diplomas. He is one of the few Canadians who hold the double English qualifica- tion. On and after July 30th, 1889, The American Medical Digest will be merged in the Philadelphia Press and Register, both being published by The Analyst Publishing Co., 10 Park Place, New York. HIs ROYAL HIGHNESS the Prince of Wales bas sent a donation of one hundred guineas to the fund which the Lord Mayor of London, is raising in aid of the Pasteur Institute of Paris. e00o and leampdt%. A SYSTEM OF OBsTETRICS, by American authors. Edited by Barton Cook Hirst, M.D., Associate Professor of Obstetrics in the University of Pennsylvania, etc., etc. Vol. IL., illustrated with 221 engravings on wood. Philadelphia: Lea Brothers \u0026 Co. We can only again repeat our criticism on volume I. The second volume of this work bears out in every way our anticipations of what the work would be, when reviewing the role of those who had promised contributions. This work not only treats of obstetrical conditions in the ordinary set way, but being an eminently practical as well as an exhaustive treatise, deals in the fullest pos- sible manner of the hundred and one accidental complications which may arise in obstetrical cases. In volume IL. considerable attention is given to instrumental labour and to turning. The patho- logy of puerperal infection is ably and scientifi- cally discussed, and the most modern views re-",
         "32 THE CANA garding its prevention ably explained, as well a stress lain upon some older and very practica points which in this age of fine theory might b passed by or forgotten. The chapter on inflammation of the breast, and allied diseases connected with childbirth, is worth the whole price of the volume. It is practical, and so far as our judgment goes, complete. In- deed one might so speak of each succeeding chapter of this very estimable work which we apprehend when completed, will be one of the most classical works on obstetrics to be found in any language. A TREATISE ON SURGERY, its Principles and Prac- tice, by T. Holmes, M.A., Cantab, Consulting Surgeon to St. George's Hospital, Associate Member of the Chirurgical Society of Paris. With 428 illustrations. Fifth edition. Edited by T. Pickering Pick, Surgeon to and Lecturer in Surgery at St. George's Hospital, etc. Phil- adelphia: Lea Brothers \u0026 Co. Toronto : Car. veth \u0026 Co. The present edition of the above popular work is considerably enlarged and is certainly brought up by its able editor to the standard of the pre- sent knowledge of surgery. The section on Dis- eases of the Eye has been wisely, we think omitted. The reasons for such omission, in the present stage of ophthalmic surgery are obvious. Considerable changes have been made in the dis- cussion of inflammation ; wounds and their treat- ment; tumors; diseases of bones and joints; ab- dominal surgery and intestinal obstruction, and diseases of the breast. Another especial feature of the new edition is the discussion of operative treatment in reference to cerebral localization. The general plan and character of the work leave nothing to be desired, and the student will find all important matters pertaining to the subject of surgery, concisely yet plainly put. A GUIDE TO MATERIA MEDICA AND THERAPEU- TIcs, by Robert Farquharson, M.D., Edin., F. R.C.P., Lond., LL.D. Aber. Lecturer on Ma- teria Medica at St. Mary's Hospital Medical School, etc. Fourth American, from the fourth English edition, by Frank Woodbury, A.M., M. D., Professor of Materia Medica, Therapeutics and of Clinical Medicine in the Medico-Chirur- gical College of Philadelphia, etc. Philadelphia: Lea Bwthers \u0026 Co. Toronto : Carveth \u0026 Co. 1889. The size of this always popular book has been 1 LDA LANCET. [SEPT., s increased by about sixty pages. The principal I l changes made have been in leaving out certain re- medial agents which have become obsolete, and in adding a large number of others which are now looked upon as reliable and lasting. The list of omissions night, we think, have been made larger without lessening the value of the book ; but the author is hampered, as is every lecturer on the subject, by the retention in the B. P. of scores of useless articles which are never prescribed by sci- entific physicians, but which are solely and truly a burden to the student. The form of the work is i retained, the physiological and therapeutical ac- tions of the chief drugs being placed side by side. It will be found a handy book of reference in therapeutics and materia medica, both to the busy practitioner and to the medical student. DISEASES AND INJURIEs OF THE EAR; Their Pre- vention and Cure, by Charles Henry Burnett, A.M., M. D., Aural Surgeon to the Presbyterian Hospital ; one of the Consulting Aurists to the Pennsylvania Institution for 'the Deaf and Dumb, etc., etc. J. B. Lippincott Co., Phila- deiphia and London. Price $1. In this little treatise the author aims at pre- senting the subject of Diseases of the Ear \" in , form free from technical terms,\" and we think ho has eminently succeeded. In no subject in medi- cine is prevention simpler and more important than in diseases of the ear, to recognize the early symptoms is often to save a life. We think this work of Dr. Burnett is one which will give valuable information in its department, and as a plain and practical treatise on Diseases of the Ear, we can highly recommend it to both physi- cian and layman. EXPLORATION OF THE CHEST IN IIEALTH AND DIs- EASE, by Stephen Smith Burt, M.D., Professor of Clinical Medicine and Physical Diagnosis in the New York Post-Graduate Medical School, and Hospital Physician to the Out-door Depark ment, Bellevue Hospital. D. Appleton \u0026 Co., New York. This is a practical treatise of 206 pages, abund- antly illustrated. It deals in a ready way of the ordinary methods of physical examination of the thoracic viscera. Its rules are simple, easily ap plied, and it will prove a valuable little work tO students in acquiring a practical knowledge of that all-important subject. 1"
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         "Che canadian Journal of Medicine and Surgery A JOURNAL PUBLISHED MONTHLY IN THE INTEREST OF MEDICINE AND SURGERY VOL. VII. TORONTO, MARGH, 1900. No. 3. Original Contributions. ADDRESS TO THE ASSOCIATION OF EXECUTIVE HEALTH OFFICERS OF ONTARIO.* 13Y J. J. CASSIDY, M.D., PRESIDENT. Getlemen of tAiv A, Liation: LADIES AND GENTLEEN,-Of the many subjects which claim the attention of an association such as ours, some have already been discussed at former meetings and some are comparatively new. One of the more important of the latter is the regular daily medical inspection of schools. As you know, according to Schedule B of the Public Health Act, it is the duty of a medical health officer of a municipality, if thought advisable by the Board of School Trustees, to act as Medical Inspector of Schools, as well as advisory officer in inatters pertaining to school hygiene. When a contagious disease, such as scarlet fever or diphtheria, attacks a number of pupils attending a school, the services of the Medical Health Officer are called into requisition by the Board of School Trustees in order that the necessary preventive measures, such as isolation and disinfection, may be put into operation. As a matter of fact, in our own city schools at least, the services of the Medical lealth Officer are frequently required, and the -reason of this is based on a fact, which has long been known to exist, namely, that the public school is always a centre of infection towards which tie contagious diseases, incident to child-life, make their way from infected homesand-fom which these same diseases are carried to * Delivered at annual meeting in London, Ont., September 13th, 1899.",
         "THE CANADIAN JOURNAL OF other homes. The truth of this observation has been frequenutl shown in Ontario. Our present systein of placarding houses in which the infections diseases are located is only partially beneficial, even w'hen all cases arc promptly reiorted by the attending phy- sician, for the reason that in mnost cases a physician is not called to attend the patient till after it has been possible for many of the child's imates to have become infected. Tihe symptomns prescnted by nunerous cases of diphtheria or scarlet fever, in the absence of an alarming epidemic, are not regarded by parents at the onset as being of sufficient importance to warrant seeking iiiedical aid, or .even detention of the child fron school; so that for days, perhaps, the child is permitted to cough, sneeze, or expectorate the gcerms freely, while coming in close contact with other children. The like is truc of other infectious diseases to which children are especially subject. [n order to prevent the spread of the disease froin the school, .daily inedical inspection of schools lias been introduced. Work of this kind has been in operation for many years in the city of Brussels, Belgium. The city of Boston in 1894, at a time when an epidemic of diphitheria showed the authorities that a medical reform must he adopted, began a systen of daily miiedical examiniation of the schools. Dr. Durgin, Chairnan of the Board of lHealh, thus describes the mîîethods by whicl the work is carried out in that city : \"Thie Board of Health divided the city into fifty districts, giving an average of about four school-houses and fourteen bundred pupils to each district. No difficulty waw experienced in finding well-qualified and discreet plysicians who would undertake the duties prescribed; and the Board selected and appointed onv physician for each district, Ris duty was to make a visit to eaeh naster's school daily, soon after the beginning of the morning session. The master received from each of the teachers in his dis- trict early reports as to the appearance of illness in any pupil in his charge. These reports arc given to the xisiting physician, who at once examines the reported children and makes a record of his diagnosis and action in books furnished by the Board of Health for that purpose, and kept in the custody of the master. If the visit- ing physician finds the child too ill, fron any cause, to remain at school, lie advises the teacher to send the child home for the observation and care of his parents and family physician. If illness is fron a contagious disease, the child is ordered home anîid the case reported to the Board of Health. The disposition of tie sick child while at home, and the proper isolation of cases vhere contagious diseases develop in such children, as well as givig: them a warrant for returning tu school, depend principally upon the sehool inspector.\" During the first two montls 4,962 pupils were examined and 364 were found to be too ill to remain at sehool. Of these 212 suffered from contagious diseases, 43 being cases of diphtheria. 146",
         "MEDICINE A)ND SURGERY. Di;ases of the throat were found in 1,749 pupils. Diseases of the cy, ear and spine were frequent. In 1896 the number or infee- tious., discases was founid tu bc less in the Boston schouul than in 18!). New York began this systen early in 1897. O 8,960 pupils examined, 1,1\u003e6 were too ill to remain at sehool. Anong these thevre werc of Specifie infectious diseases.................. 207 cases. Oral and respiratory diseases ................ 3,934 Ear , ............. .. 66 Eye ................ 382 Skin .............. . 628 Miscollaneous ................ 3,687 i Diphtheria , ............... 26 Scarlet fever ,, ............ ... 8 M easles l ................ 59 Muips ............... 54 Chickenpox ............... 35 Croup ................ 71 Tuberculosis , ............... 3 From these figures you w'ill see the importance of daily medical inqpection in connection with public schools. Its protective value to the public, and to school children in particular, cannot be over- estinated. All know how easily the contagions diseases of children nay be and are disseminated, and how indifferent parents and guar- dians are to the protection of their own children, or others, from infectious and contagious discases in school and at home. All know how thcse diseases in children lead to after results, inipaired visinn or hearing, chronic throat difficulties, diseased nervous systeîns, by which their effectiveness as pupils .nd students is impaired, and that thereby the work of education is seriously hindered, if it is not in the case of many pupils rendered alto- gether impossible. As it would be impossible for a medical health officer in a large rity to undertake school inspection in addition to his other duties, a ';uflcient number of local physicians should be engaged by the School Toard for the purpose. In small towns and rural inunici- palities, school inspection could be donc by the medical health ,fficer of the municipality, a reasonable salary being par i1 hini for this addition to his usual duties. You will naturally expect me to say something of consumption, a dionse which, for the people of most civilized countries, lias, in tho light of recent investigation and statistics, becomue a subject of t1w greatest interest and importance. It will not be necessary to chepuqs here the current opinions held by physicians of the influence of Koch's bacillus in the causation of thbat disease. It seemus, how- ever, that while the agcncy of the bacillus as a causative factor of consumption is proved, it is equally trac that this,rmicrobe can only do harm to pprson.s whose vital resistance is low, and who thus offer a suitable soil for its growth. It is recognized to-day, more clearly 147",
         "THE CANADIAN JOURNAL OF than in the past, that the successful treatinent of consumption is largely preventive in character, and in a great number of cases it must be applied to the infant and young child. Children are in their lives much like plants, and thrive or fade according to the amount of intelligent care devoted to them. In their early years, sunshine, fresh air, warn clothing, and wholesome food are neces- sary to their very existence, and if these are generously provided, children grow up to become healthy men and women. Too often, howevcr, their early lives are passed in crowded, unclean, damp houses; their food is insufficient or unnutritious; their surround ings are most hurtful and anti-hygienic, so that it is no wonder if they become rachitic, serofulous, anemie, particularly if, as is too often the case, there is an alcoholic or other taint on the side of at least one of the parents. Their emaciated and weakened bodies, wanting in proper vitality, form a favorable and fruitful soil for the propagation of the dreaded bacillus, of which they ultimately become the victims. Any agency, private or public, that will pro- vide sunlight, pure air, wholesone food, and last, but by no means least, intelligent medical care for the children of the poor, will assist in remedying the formidable evils from which they suffer at the dawn of life, and will, therefore, lessen the number of children who now pay a large tribute to the devouring monster, consump tion. You are all aware that the success of the experiment at Nordrach, in Germany, has powerfully illuminated the sonewhat gloomy chapter of the treatment of consumption. Up to a very short time ago, climate was claimed to exercise a very important curative influence-to be, in fact, the curative influence in the succéssful treatment of this disease. Other things being equal, climate bas a good deal to do with the case. Dr. Douty, writing from Davos to the British Medical Journal, asks: \" Why bas phthisis been unknown in the Engadine and Pratigau ? The natives live on miserable food, shut up for months and months in the most insanitary of houses, yet they bave not succumbed. They have had chances of being infsYted during the last thirty years. In Sicily, again, the natives live under almost worse conditions, with a very meagre diet, and yet the percentage of deaths fromn. phthisis is one of the lowest in the world. Tlhe crofters of Scotland, the laborers of Devonshire, the peasants of Ireland, live under similar but better conditions than the nativf of the Engadine and Pratigau, but they are decimated by tuberen - losis in some form or other. How is this? It is climate that haq to answer for it, and to take then away from their damp climat\" is the first essential in making a cure. Altitude is an important factor in climatic treatment, owing largely to the diminished atmospheric pressure and increased activity of the respiratory organs. Altitude is sometimes associated with treatment of phthisis by cold air and ozone, as practised at Engadine, but it can act quite independently of cold.\" The editor of the Indian Lancet records an interesting observa- 148",
         "MEDICINE AND SURGERY. tioli mace by a French physician, Dr. Bertillon, some twenty years ag, that pulnonary phtiisis ceased iiaking progress, and that the symptoms disappeared, if the patient went to reside at a mîean altitude between the level of the sea and the line of perpetual snow; but that the symptoms would iinnediately return with increased violence if lie or she went down again to a lower level. He adds: \" This theory has been anply veritied, and the two fol- lowing cases, which have never yet been published, fully confirm it. A French gentleman of fortune, after leading a very fast life in Paris, abandoning hirmself to every kind of excess, fell ill and soun displayed the characteristic signs of lung disease-cough, with hemoptysis, nocturnal sweats, loss of appetite, general debilit-y, etc, Ie consulted Dr. Bertillon, wlho told him plainly that if lie did remain in Paris he was a lost man, and that his only chance was to take up his residence at Briancon, an important fortified town in the French Alps, which fulfils exactly the conditions of altitude above mentioned. He obeyed his physician, and in a very short tiime all the symptoms :of lis malady disappeared, lie recovered his appetcite and good spirits, and renained a whole year at Briancon in excellent healti. But in an evil hour, thinking himself cured, lie returned to Paris, and once more joined again in the pleasures of bis fi nr associates. But his old enemy was anxiously waiting for him; he began to cough as le had doue before, and to spit blood, and had to take to his bed, fron whicl le never rose again, dying after a short illness. \"The second case is that of an Irish lady who died in the city of Mexico six montls ago, aged sixty-eight, laving always to the last enjoyed the best of health, althougli wlen she went there twenty years ago she was deeply consumptive, lier left lung being alinost obliterated, and herself given up as lost. But being a sensible woman. and having heard of the altitude theory, and that the city of Mexico fulfilled the conditions of being at the mean altitude between the snow line and the sea level, she wisely remained there until she died of general debility and break up.\" In considering climate we consider cltittule, the dryness of the air, the amount of suinshine, the diathernancy of the sun's rays, the absence of fog or nist, the absence of wind, etc., and we must think what effect all these may have on the*blood pressure, and, therefore, on the secretions of skin and kidneys, the pace and depth of respiration, the secretions of the tubes and of cavities; on tle blood-making tissues, -1i the blood itself, and on the tubercle hacilli themselves. Are all these conditions and effects the same in England as they are 6,000 feet ap in the Alps ? Certainly not; and yet other things taken together have more to do with the cure of consumption than climate. As Dr. Douty says: \"Fresh air is good and desirable in every disease; but fresh air will not cure congumption. You cannot get fat, on fresl air. Overfeedingi's th-e secret of the success of Nordrach-overfeeding, conbined with the excellent judginent shown by Dr. Walther in",
         "150 THE CANADIAN JOURNAL OF the constant supervision of his patients, and the careful gradatioit of their daily exercise, whereby the heart is kept strono' and healthy, and. is able to miaintain a brisk circulation througiî the somewhat obstructed channels of the pulhunnary vessels, and the dropsical condition of the lungs induced by too much uf the recum- bent position in the Liegellle of sanatoria is avoided. Thus out only the lungs, but all the organs, including the heart and all other muscles, are brouglit into the condition of a gently but well-traimed athlete, and the patients are ready to retur to their work, if not absolutely cured, at any rate in such good condition tlat they can continue to be useful menbers of society, and if they have the sense to continue the high-feeding and careful exercise cau ev entu- ally live down their lung lesion and lose it. In too niany cases it is a weakened heart that prevents their doing so. I believe that the sane excellent principles of treatment, carried out in a totally different climate, will give even better results than those of Nord- rach, though they are, I believe, the best yet produced; but tley are produced by lte systent of treatient iib spite of aiul nut becwase of the climate. Hundreds of cases have been cured at Davos with- out any rational system of treatment wlhatever.\" There is good reason to believe, therefore, that even in countries where the winter climate is severe, as in Canada, curative results can be obtained in the treatment of consumption. For instance, the folloiving report from the Gravenhurst Sanatorium is encouraging . MEDICAL REPORT FOR TE YEAR ENDIG SETEMBEM 30TH, 1898. Nuiber of patients treated during the year ........... 116 i at Sanatoriui still under treatment.......... 33 i to be reported on..... .................... 83 Of these -83 patielits there were Discharged apparently cured ........................ 12 fi ivith disease arrested .................... 33 iiti narked improvement.... ........... 29 inimproved ............................ 11 failed.................................. 8 Of the 83 patients'64 gained in weight an average of 11 pounds. Averagu stay of each patient 98 days. The altitude of the Gravenhurst Sanatorium is only about 850 feet above sea level. In British Columbia, however, residence can be obtained at stations having a suitable elevation above the sea, and, when climatie advantages such. as they possess are made to co- operate with overfeeding, regulated exercise, and medical super- vision, the curative results to be looked for in Canadian sanatoria ought to be of the most satisfactory character. An important feature in the prevention of consumption is the isolation' of cases of the disease in sanatoria, thereby removing a considerable source of peril from healthy people, who meet them in all the vocations of life, and more particularly their families, who live in the sane homes with them. The number of cases of tuber- culosis in Ontario is, however, so large (probably 10,000, there",
         "MEDICINE AND SURGERY. h.ving been 3,154 deaths in this province in 1897) that the housing of all the cases in sanatoria, even if they were all willing to go to these resorts, cannot be realized. Disinfection of sputa, cleaning and disinfection of rooms occupied by plithisical cases, are, however, better understood and more thoroughly perforined than they were a few years ago; and intelligent people find it necessary to prac- tise these sanitary methods in order to protect theinselves when their plithisical friends are housed with them. The proposal to mnake plithisis a notifiable disease bas been received with indiffer- ence by some sanitarians and with positive objections by others. Some of the arguments used by the latter would indicate a mis- conception of the real object and scope of notificat.on in phthisis. Neither placarding nor quarantine are required in phthisis, although antagonists cf notification have imagined that they should be em- ployed in ti.at disease as well as in diphtheria. Such a view is quite erroneous. As Landouzy, of Paris, says: \" It is not the con- sumptive's body, nor his breath, nor his perspiration, nor the air of the room be inhabits which is harmful; the danger resides in the expectoration. After the departure or death of a consumptive patient, the contagion of the disease remains and survives, since his expectoration, which may have fallen in some corner of the room lie occupied, dries up, mningles with the dust, and the bacilli contained in it are ready when a favorable opportunity and a suitable culture ground are provided to renew the process of tuberculization in some other person. The use of spittoons should be enforced in the treatment of all case- of pbthisis. and further, spittoons made of some combustible material should be provided in all places private and public, and the people, young and old, should be taught to use them.\" I do not think that a tubercular patient, whose sputa are dis- infected, whose -person and clothing are kept clean, and whose room is tidy, weil ventilated, and exposed to sunlight, is a source of contagion to his neighbors. In such a case quarantine is not necessary, and to place a placard on the door would be foolish. I support notification in phthisis because it is the first and necessary step to obtain accurate knowledge of the phthisical' infective centres in a municipality. A physician attending a case of phthisis should provide for the prevention of contagion, and should consider the interest of the other members of the patient's famnily. If physicians practised prevention in cases of consumption as carefully as they do in cases of small-pox and diphtheria, the proximate and distant results of their efforts would lessen the mortality from consump- tion more than the best conceived medical treatment. If people avP careless or imprudent in dealing with tubercular cases, it is largely due to the fact that they have not been fully instructed. Sucb instruction should be given by physicians, who would then be exercising one of the noblest functions of their office-that of guardians of the -public bealth. It mnay be opportune to remind you, at this point; that the",
         "THE CANADIA:N JOURNAL OF danuer of inoculation with dust froin roois that have been occupied by consuniptives may be obviated if the windows are regularly opened. The antiseptie properties of fresh air are very great, and if consumptives are taught to open the windows they will help themselves and lessen the danger of infecting heaithy people with their disease. Probably the best way of disinfecting :apartments is by exposing then to the sun, after a thorough .cleaning; but where this nethod is impracticable formaldehyde gas disinfection or some sinmilar method may be used. It is my pleasing duty to observe that Dr. Hutchinson, Medical Health Officer for London, has referred in his last report to the duties and responsibilities resting on citizens and municipalities in opposing the spread of consumpto. His advice is tiiely, and if his recom- iendations are put into practice there will be a considerable decrease in the prevalence of consumption in this city. As )r. Hutchinson says, \"In London during 1897, out of 47,2 deaths 99 were fron consumption, and 54 froin diphtheria, scarlet fever and -typhoid fever, so that about twice as many died in this city from consumption as fromn all otier infectious diseases. Two deaths in every nine were froi consumption.\" There are several diffii-ent opinions as to the noney value of a human life. The State Legislature of Illinois places it at 85,000. Assuming that a valuation of $1,000 is correct, the loss of 99 lives per annum fromn consumption in this city ineans a direct inoney loss of .99,000, and an indirect loss of a very large sum besides. The financial inethod of appreciating the value of sanitary methods and legislation naturally appeals to every intellect, and moreover, places the loss resulting from preventable diseases in a peculiarly effective way. That ail must die at some time is a truism; but statisties show that, with proper precautions, the evil day may be deJayed. Lives now- sacrificed to contagious disease might be preserved, if not to the scriptural \"threescore and ten years,\" at -least for many years of useful and productive activity. In 1896, in .a report to the Provincial Board of Health on the hygiene of the Canadian railways, I referred at considerable length to the upholstering of seats in railway carriages, and also to the current methods of cleaning Iloors, seats, etc., in carriages. Preference was expressed for seats trimed with leather instead of the ordinary well-stuffed seat .covered writh plush, because plush is retentive of dust, and the dust of railwray carriages is rich in bacteria. Quotations were made from a report of bacteriological work done in Gerrnany by Drs. Petri, Kolb and Freidrich, who examined specimens of -dust taken froi railway carriages, and found numerous pathogenic bacteria. In nearly half the cases there was obvious evidence that the passengers lad expectorated on the floors of the carriages, and the presence of the Koch bacillus was proved. In fourth-class. carriages, which 'were unclean and rarely washed, the number of bacteria in dust swept up from one square metre of tie floor surface was estiinated at 12,624; in the 152",
         "MEDICINE AND SURGERY. third-class, 5,481; and the first-class, 2,533. On the seats and partitions there were fewer bacteria, from 2,646 to 29: and the ceiling was almost free. It was quite evident, therefore, bhat to keep the floors, seats, and partitions of a railhvay carriage clean is to practically ensure its freedom from pathogenie germs, which gravitate with the dust toward the floor of the carriage. Now leather-trimned seats can be washed with hot water and soap, and then wiped with a sterilized cloth, thus ensuring the disappearance of bacteria. Such seats are, therefore, superior for sanitary reasons to seats trimmed with plush, which have to be cleaned by coinpressed air or by brushing. For similar reasons the un- caipeted floors of carriages which are washed with hot water and soap and then wiped with. a sterilized cloth are also freed from hacteria, and conscquently that method of cleaning floors is superior ta sw'eeping. On account of its impermeability and the ease with which it can be cleaned, linoleum was recommended in my report as a floor covering for carriages and sleeping cars instead of carpet. Owing to the Clarge windbow space in railway carriages and the free penetration of sunlight into them, together with the entrance and exit of air, the destruction of the germs of disease takes place to a great extent; but as the number of consumptive persons who travel by rail is considerable, the routine disinfection of day and sleeping cariages by formaldehyde should be regularly prctised. A Iaw iaking the use of compartnent carriages by such iersoIm obligatory would reiove a source of peril from the general public, and make the work of disinfection more easy and economical for the railway company. As the cubie space in a fully-occupied railway carriage, viz., si xty cubic feet per capita, is sinall, its ventilation by any method cannot be made satisfactory. Methods of cleaning, such as have been described, will, however, remove filth and the germs of disease, while the regular opening up of the clear-story windows will assist in the escape of impure and rebreathed air. While British statistics show that the phthisis rate in aclult life bas steadily clecreased pro rata with sanitary improvements, the nuinber of deaths among young children from tabes mesenterica has increased as steadily. and that, too, proportionately with the aiount of milk consunied, particularly infants' milk. Thus tabes mesenterica shows a diminution of 8.1 per cent. for all ages, but a large increase (21. per cent.) in the case of infants under one year of age; and these statistics are only to be explained by the great and wide-spread danger arising from tuberculosis-infected milk. It is calculated that '25 per cent. of the milch cows of Great Britain are tuberculous; and it is clear that preventive measures as to milk ought to be tried in that country. The tuberculin test and the regular inspection of dairy cattle are also called for in.this country, and for the same reasons. Dairy herds in Can-ada have no better claims to imnimunity than the herds of Great Britain; and the first. step to remove suspicion from the .1-53",
         "THE CANADIAN JOURNAL OF mincis of the Canadian public with regard to the purity of the iilk supply is to prove that all the dairy cattle are free from tubercu- losis. It should also bc shown that the animals are kept in clean, well-lighted, well-aired stables; that the supply of water is abun- dant and of good quality; that their food is ample and of good quality; that the utensils of the dairy are in good order; and that the methods of handling the milk, from the act of millking itself until the output passes into the possession of the purchaser, are of the most hygienic character. In obtaining such a report as to the purity of a milk supply a Board of Iealth is acting distinctly within its right; nay, more, it is its duty to protect the infants of the municipality against poor milk. Every Board of Health in carrying into effect a by-law to secure goodi milk ought to have the co-operation of all dairymen. L lÂfortunately, instead of assisting such a good cause dairymen are sometimes a stumbling-block, fearing that inspection may leadl to loss and infringement of their rights. The riglts of a dairyman are to sell a good quality of milk at a fair price, and the riglits of the Local Board of Health are to be satisfied that the output of his dairy is pure. A dairynan should invite and encourage muni- cipal inspection, if for no other reason, because the demand for dairy milk will increase when its purity is assu-ed. Under present conditions manufacturers of condensed mili, malted milk, and other infants foods are competing with the dairymen, and a good deal of noney is paid for patent foods which, if people were satisfied of the purity of dairy milk, would naturally find its way into the farmers' pockets. In presenting this side of an important question it is to be hoped that a word to the dairymen will be sufficient for them, and that they will not be slow in taking the means to secure the confidence of the people. I must not be concluded, however,.that if lives are saved which formerly would have been allowed to perish by consumption, if mortality in child-life is diminished by isolation and disinfection, the saved lives are destined to reach old age. English vital statis- tics show that the number of individuals living to thirty-five years has increased, that of those living from thirty-five to forty-five years the number is stationary, and that there is a diminution in the number of persons living £rom forty-five to seventy-five years. In other words, if young people in England have a greater chance to reach forty years of age, those who survive to forty or sixty years of age are more in danger of death than their parents werc at the same age fifty years ago. Two hypotheses may explain this fact, the vitality of the race lias diminished, or the conditiqns of existence in aduit life are more defective than formerly. Dr. William Butler, wlho discusses this question in an article published in Public Health, thinks it is principally the first factor which must lie blamed. Turning to a second branci of the subject, lie establishes a series of tables on mortality by groups of diseases occurring during the same period, and froni the reading of these 154",
         "MEDICINE AND SURGERY. statistics the conclusion is drawn that if deaths fron consumption and zymotie diseases have become less in England the gain lias been balanced by an increase in deaths attributed to diseases of the circulatory system, the nervous systei and cancer. That there is a close relationship between tuberculosis and diseases of the n'rvous systen is a view which las already been sustained by several observers, among others Dr. Stevens, of New York, who wrote in 1897 that affections of the nerves ard disorders of tlie senses-principally alterations of vision-arc transmitted by tubercular ancestors. A child is not more tuberculizable than other children simply on account of the blemish in its ancestry, but id a candidate for all the neuropathic disorders and myopia. The undoubted increase of myopia on the one hand and insanity on the other-the number of patients in lunatie asylums having doubled during the past fifty years in England-.are closcly connected with the diminished mortality in youth and also the diminution of cases of pulmonary consumption. With bec development of sanitation in our municipalities the conviction nust grow that special and accurate knowledge of tie science and art of hygiene should be possessed by medical officers of health. So far no organized effort has been made ti train sanitary oflicers, unless we accept the lectures and instructions given by professors of hygiene in our inedical colleges. In the June number of the Sainitarian I noticed that the Council of New York University has set apart buildings near First Avenue, between Twenty-fifth and Twenty-sixth Streets, for the use of a \"School of Public Health,\" as provided by the law passed at the recent session of the New York State Legislature, and for which 325,000 was appropriated for m'aintenance for the year be.:nning October lst, 1899. It is proposed to promote public sanitation in various ways, especially to instruct properly accredited medical men and lay sanitary officers througlout the State in methods and appliances for the prevention of disease. The public will be instructed in sanitary inatters by university extension work. It is expected that a hygienic museui will be established for all forms of sanitary appliances, and inodels in plumbing, ventilation, disinfectioin, heating, clothing, and- other kindred subjects, to be open to the public. In thus drawing your attention to what has been done by our neighbors, I earnestly hope that you, and all citizens who feel interested in a similar enterprise, will bring it to te notice of your representatives in the Ontario Legislature, and will urge tlie Government of this province to make an appropriation. for the use of a \"School of Public Health \" in Ontario. The second portion of the progress of sanitary education could be carried into effect, even if a sehool vere not immediately established. Already the public are instructed in science and philosophy by university extension work, and the defivery of lectures on sanitary matters during the winter season -would easily fit in with and become a useful part of such a programme of university studies.",
         "THE CANADIAN JOURNAL OF A notion, calculated to do a great deal of harm, lias long been disseminated by porsons who are unwilling to admit the pro- tective power of vaccination, and who try to explain the relative scarcity of small-pox in civilized communities by any theory except the riglit one. They contend that sinall-pox depends on filthy local conditions, that it is a disease of the poor aud communities who neglect sanitary measures. Dr, Tebb, who lias recently pub- lished a work, entibled \" A Century of Vaccination and What it Teaches,\" supports this view, quite forgetful of the fact that in the seventeenth and eighteenth centuries snall-pox attacked the high as well as the humble. In the faiily of William III. of England, his Queen, his father, his mother, lis uncle and two cousins, children of James I., all died of small-pox, and the king hiniself barely escaped with his hfe. During the eighteenth century one Emperor and two Empresses of Austria, six arcldukes and arch- duchesses, an Elector of Saxony, an Elector of Boliemia, a Dauphin and a King of France, a King of Sweden, and a Czar of Russia were all numbered among the victins. Surely all .these dis- tinguished persons could not be consistently classed among people who suffered from the prevailing ignorance and neglect of sanitary measures. Tien again, to 'sho w that it vas an onnipresent plague in England, when Jenner began his experiments, Gilbert Blane estinated that \"'an adult person who lad not lad small-pox was scarcely met with or heard of in the United Kingdioi.\" When servants were advertised for it was common to specify \" hey nust have had small-pox in the natural way.\" In 1688,in an advertise- ment for a counterfeiter, it was noted as a means of his identifica- tion that le wa- \" without pock-holes.\" At the Institution for the Indigent Blind two-thirds of the applicants were made blind by small-pox. Thanks to the genius and bold experimentation of the immortal Jenner, small-pox las been controlled to an extraordinary extent by vaccination. In some countries it is so rare that in the opinion of German authors \"it is no longer observed in civilized countries, and nay soon be considered an infection which will possess a purely historie interest.\" So far this happy desideratum cannot be recorded of the United States, in vhich over 3,000 cases of small-pox occurred during the past year. In the Province~of Quebec no considerable epidemic lias arisen since 1885. Since that memorable year, when the Province of. Ontario vas visited by the scourge, only trifling outbreaks.have occurred among us. At present there are no cases of small-pox in Ontario. Immunity to small-pox can be procured by having the disease itself or by reliable vaccination-a statement the truth of which few will be prepared to deny. That many parents and guardians. in Ontario, while persuaded of its truth, have yet neglected to present infants and young children for vaccination, has probably been due to doubts entertained by -them as to-tie purity of the vaccine lymph in general use. The existence of a similar feeling has been noticed in England. On the occasion of a recent 156",
         "MEDICINE AND SURGERY. gathering in London the President of the Local Government Board made an interesting announcement relative to the efflect of the new Vaccination Act. He quoted from a report sent him by the head of his medical department, wlho said: \" The inspectors inform me that there is distinct evidence of a general increase in the ainount of vaccination going on, and i a number of cases the actual statistics recorded are highly satisfactory in this respect. In several such instances the increase in the nuniber of certificates of successful vaccination sent in has ranged from 25 per cent. to 100 per cent. The increase was attributed by this gentleman tc '.e systeni of domiciliary vaccination, and the provision of a bettcc and purer kind of lymph, which bas relieved the apprehensions of a great many people who were formerly opposed to vaccination.\" The lymph aIluded to by the English sanitary authority is, as you know, the new glycerinated calf lymph. The new article can be readily obtained by practitioners in this province, and it is quite likely that in a short time it vill be used extensively. Any apprehension which Ontario people inay feel .as to the purity of the lymph used can, therefore, be promptly relieved, and if the vaccinator will do his work in a clean, aseptic manner, no evil results should follow. Let us hope, therefore, that, encouraged by Local Boards of Health, vaccinators will do their work carefufly and well, and that the public will, without exception, avail themselves of their services, thus hastening the advent of that day when the people of Ontario will be placed in a position of actual immunity to smnall-pox, which for them would then possess a purely historic interest. ON THE ROLE OF PRIMARY AND SECONDARY OSTEO- PLASTIC SURGERY IN THE TREATMENT OF CO1PLICATED OR COMPOUND FRAC- TURES OF THE EXTREMITIES.* BY THOMAS B. MANLEY, M.D., visiting Surgeon to Harlem Hospital, Professor of Surgery New York School of Clinical Medicine. MODERN advances in the sciences have rendered necessary an entire recasting of our methods of dealing with various Jisorgan- izations of the bones of whole limbs or their members produced by the effects of violent force. Very much more circumspection and deliberation are demanded of the surgeon before he proceeds to sacrifice a limb, or any part of it, by amputation, than in former times; iniproved mechanical expedients, with a widened knowledge of the regenerative proper- ties of bone tissues, have enabled us to hold out hope to spare, and * Read at the Twelfth Aninual Convention, I.A.R.-S., Richnond, May 31st, 1S99.",
         "THE CANADIAN JOURNAL OF to restore, in varying degrees, many a linb, which in the near pa.st wvas unequivocally condemned to severance from the body; and more, in -trying cases, when the extent of mutilation of the soft parts lias been considerable, vhen perchance articulatious have been opened, or there hias been such extensive slattering \"f bone that all our energies are concentrated on saving the menber regardless of the degree of resulting distortions or defornity, by resorting to subsequent ostcoplastic procedures, we may at present very frequently succeed in restoring symmetry, joint action and inuscular movement. CONDITIONs ESSENTIAL FoR SUCCESS IN P1RIMARY OSTEOPLASTIC PROCEDURE AFTER SEIous FRACTURES 0F THE EXTREMITIES. I want to inake clear what is meant by this paragrapli. Wen a case is brouglt to us for treatnent, where the extent of the mutilation of the limb is great, when there co-exist serious bodily and visceral injuries, the patient in a state of shock, w'here we have not adequate provision for the proper treatnent of the case, have not ample assistance of nurses, and environnent is not such as to justify us in proceeding into putting the limb into permanent adjustment, in such -cases we are bound to concentrate all our energies on the patient after we have locally dealt with the part- in what way ? In the first place by cleansing it; and I mnean therapeutical not cheinical cleansing, because they are not the saimle, removing dirt and effecting complete hemostasis, embalming of the limb or pickling of the limb, and then setting it aside until the patient lias reacted, when lie is in a proper condition for ultimate consecutive measures. There are certain cases, particu- larly in children-restless children-wher, having sustained a frac- ture of the linb and other injuries, the adjustnent of the fracture at the timne is impossible. I will illustrate, for example, whiere one has had a compound fracture of the humerus, and at the same time a fracture of six ribs-the fracture high up, in suich a position that to fix it without inpeding the respiration, without hamperiug the lung action, is impossible, and in a case of this kind whera-the probability or expediency of putting the limb into any kind of mechanical fixture. which will immobilize it is clearly out of the question. In a case of this description, where we have a deformity, then we must resort to what is designated as \"secondary osteo- plasty,\" that is, dealing with a defornity which results from the defect of the limb, resulting after primary treatthent, that depend- ing on various causes. Ist. The condition of the patient manifestly is first out most serious concern. Is our patient in a state of grave physical shock? I se - physical shock, because one may under-estimate the degree of great collapse which follows varions serious crushes of the body, when the senses are unclouded and the unfortunate 138",
         "MEDICINE AND SURGERY. pat.ielit is sanguine of an oarly recovery, and, bosides, entertains no serious thouglits of approaching death; as this only ceases when the surgeon intinates that the traunattism is extrenely grave, and thlt. no time should be lost in adjusting his temporal affiirs and preparing for death, let it be remeinbered that the mental attitude of the patient weighs for nothing in rehing a prognosis with this class. 2nd. Has the patient been greatly exsanguinated ? Great loss of blood is always a very grave element in all exten- sive nutilating injuries. Our patient is blanched and cold; the pulse thrcady, trenulous and irregular. Our patient is thirsty; the muscles of the face twitch and the eyes are sunken. We will do well to direct all our energies toward reviving the waning powers of life before anything like a critical exanination of the tiangied parts is undertak en. :3rd. Is there any evidenca of co-existing internal hemorrhage or serious visceral injury ? In mtaany mangling wounds of the limbs from nachinery or railroad accidents the nervous systeni suffers violent shock, the wliole body violent concussion, and simultancous visceral compli- cations are not infrequent. We certainly will not examine minutely into the character of an injured limb while there are signs which point to the grave implication of an organ vital to life. From the foregoing it is therefore apparent that under ail circuistances our first attention nust be directed to the individual; Ie inust be made comfortable and composed, and, if ground for hope remain, artificial hcat must bu utilized and lie should be freely stimulated. Full reaction should be established before a tihouglit is entertained of ulterior treatment of the limb. THE PERIOD WHEN IT 18 SAFEST AND MOsT EXPEDIENT TO C1TIOALLY EXA-MINE TEE PARTS WLTII A VIEW OF DECIDING ON THE LINE 0F TREATMENT. It lias long been my conviction that very much harm has often been inflicted by the premature rough handling of limbs before the effects of shock have passed off. Iu sei-ious cases our primary effbrts should bu directed toward first, securing effective and per- mianient hemostasis; secondly, thoroughly cleansing and covering the parts; and thirdly, placing the limb in a comfortable position. Tlie word \" comfortable \" is here etephasized, because at this time theuries must give way to facts. The limb is in the proper position when a sense of case is experienced. This follows when the pressure on the nerve trunks is removed and every impediment to the free movement of the blood current is removed. To force one into full ether coma, suffering from a badly-mangled limb, and theu iake violent and repeated movements of torsion or extension, 13 to greatly imperil bis chances, and is calculated to surely circumvent nature's efforts at restitution. But when the injury is",
         "THE CANADIAN JOURNAL OF not one of great magnitude and the patient's gencral condition is good, we inay be periitted more latitude of action and more lengthy manipulation nay be permitted, although there is no doubt but in a general way the practice is - bad one of niaking any protracted exami nation or commencing any operative procedures of a protracted character at the first examination. We have done quite enough, then, at first dressing vhen we have controlled henorrhage, embalned the limb and comfortably adjusted it. How long vill we wti ? If there be no secondary hemorrhage, no fresh exacerbation of pain, and no signs of asphyxiation or gangrene in the limb, ve may delay for forty-eight hours or more, with advantage, before we reinove the primary dressings. Nowat this stage, we can sec where we are, we can accomplish wlat was impossible at the primary dressing, we eau determine the extent of osseous vitality, we can form some estimate of what the future possibilities are for the limb. The time lias now arrived vhen we may determine our course of action, though there is no good ground for haste yet in the adoption of definite therapeutic measures. As processes of repair can commence only on the subsidence of acute inflammatory engorgement, the prospects of effective osteogenesis are enhanced by this course. And, furthermore, our patient, now fully restored from the immediate depressing effects of violence, is better able to support with success further operative measures. SECONDARY OSTEOPLASTY AFTER REPARATIVE PROCESSES AiRE CORMPLETE. The above constitute a new, large and growing field for pro- gressive surgery, the scientifie foundation of which was laid by the celebrated Ollier, and its practical utilization has been con- summated by aggressive investigation in Europe and America. By judicious and skilful osteoplasty it is almost phenomenal to realize what may be accomplished in the way of osteorection and improving and restoring functions in damaged limbs; in restoring animation in parts palsied by nerve inclusion or nerve pressure Tenotomy alone, or combined with tenotomy or arthrotoriy, under proper conditions, its use in enhancing the working value of a Iiñfib cannot be overestimated. By the intelligent employment of osteo- plasty we may often not only prevent an amputation, but trans- form a wasted, twisted, anchylosed limb into a useful member, as it has several times been ny good fortune to be able to demonstrate. CONDITIONS WHICH LEAD UP TO THE NECESSITY OF SECONDARY OSTEOPLASTY. It might be supposed at first sight that if a bad fracture, or fracture-dislocation, were properly adjusted and treated immedi- ately after injury, there would be no occasion for any description of consecutive operations, that the time for interference or precise 160",
         "MEDICINE AND SURGERY. action was while the tissues were disorganized-the sooner after the accident the better. But such reasoning is fallacious, as every -qierienced surgeon well knows. Many times the question we have to solve is not, can we save the iimb vith a good prospect of recovery, but can w'e, by any means withiin our reach, preserve it in any shape ? In very many fractures of various descriptions and under various circunstance.3 no sort of fixed inechanical adjustment is possible, as, fo' example, wlen a fracture is multiple there are internal injuries or the vas- cular channels have suffered serious harn and asphyxia of the li is imnpending. On that point there is some difference of opinion, but I think all surgeons who deal with traumatisms will agree with the cele- brated French surgeon who clained that in ail serious fractures the tissues were for some tine, twenty-four lours at least, in a state of \" torpor,\" in a condition of temporary asphyxiation, that there was a complete stasis of circulation in tie parts, that the linb, as it were, lias not felt the influences of reaction.; that there lias heen no histological changes of the minute anatomical tissues, and hence the reason that there is no object in forcing equalization of permanent adjustment immediately after the injury. OPEN AND CLOSED FIRACTURES; OR THE COMPLICATED SIMPLE OR, COMPOUND FRACTURE. My own investigations and oxperimients on induced fractures in the limbs of .frogs, as well as clinical observations on miutilated limbs, have convinced me that incomplete vascular stasis of the distal end of a mangled limb is entirely compatible with its ulterior vitality, provided only thiat the damage to the great blood trunks bas not been too great. But how can we cal:ulate the extent of vascular damage, or wrhat shall be our guiding principle of action if we are assured of its existence in this class of cases ? There are no means by which an estimate of vascular damage can be primarily deternined, and often it is several days before the full vascular tide has begun to move. Our guiding principle, then, must be not to strangle or paralyze the already crippled circulation. No sort or description of splint or constricting band- age should be adjusted until the circulation lias been fully rehabilitated'. It therefore follows that,. inasmuch as aceurate mechanical adjustment is not possible or expedient here, faulty, defective, distorted limbs or u.n-union nay follow. We may also have hyperostosis or osseous fusion of continuous symmetrical shafts and other accidents. This, then, woulc constitute the second class, i.e., those cases of comnpound fractures iii vhich it is obvious enough at the primary dressing that osteoplasty is called for, but for various local and constitutional circunistances beyond our control, it is deemed 16C)1",
         "THE CANADIAN JOURNAL OF advisable and sometimes imperative that we delay until the work of union is advanced or completed. Complicated simple fracture or fracture-dislocation is not infre- quently followed by such a degree of deformity or loss of function as to seriously interfere with the future use of the limb. This is notably the case in various types of Pott's or Colles' fracture, fractures through the humerus, its shaft or proximal distal ends, intracapsular fracture at the hip-joint, fracture of the patella, etc. In many of these cases belonging to the above class osteoplastic surgery may be frequently utilized as a secondary or consecutive procedure; rarely immediately after injury except in suturing of the patella. The tendency of most fractured bones is to resume their normal position af-ter replacement, provided muscular tension can be effect- ively overcome, when satisfactory results follow; but in various :situations, especially when joints are involved and the apophyses are broken off, coinplete replacement and support at primary adjustments may be impossible, or if effective then, the fragments may later inove out of position and require operative treatment. MAKING A SIMPLE FRAdTURE COMPOUND FOR DrAGNOSIS OR TREATM\"NT.-IS IT EVER JUSTIFIABLE? It has long been taught that compound fractures require about twice as long a period of time to unite as simple fractures, and besicles that this type was always a much more serious affair than in those breaks of boue over whicl the integument remained whole. Until McEwen had demonstrated the safe and simple osteoplastic method of speedily overcoming deformed and dis- torted bone shafts, surgeons were about as charry of cutting into heelthy bone shafts as they formerly had been about opening the cavity of the peritoneum. They had the horror of making a simple fracture comp3und, and when a considerable deforinity foi- lowed a severe, simple or compound fracture they were usually contented to leave it undisturbed; or, if the deformity was con- siderable, with the joints locked, they amputated the limb. No one should ever lightly undertake an osteotomy after fractitte; but when the condition is such as will inevitably be succeeded by marked deformity of the limb with serious impediment in func- tion, we should never hesitate to open freely down over the seat of osseous disorganization and deal with the case as existing con- ditions require; provided, always, that the most vigorous asepsis is enjoined and we have a proper appreciation of the difficult task before us. It is certainly a mistake to assume that all compound fractures ar'e more protracted in uniting than all so-called simple fractures. -Many simple fractures near articulations may be treated without splinting or compression of the vesscls, uniting by primary unions. H{eretofore, when an avenue for infection was maintained by wlhat 162 ,",
         "MEDICINE AND SURGERY. was known as \" drainage,\" and when the fragments were kept in the vise-lice grip of rigid, unyielding adjustments, and thereby the vascular system nearly palsied, surely enough tardy or imper- feet union was the rule. Coinpound fracture wounds were fornerly quite invariably drained. Prophylactic drainage had indeed been regarded as a surgical dogma in open fractures, as in open wounds of nearly cvery description, whether they involved cavities or not. But we have no0w been convinced that indiscriminate drainage is a bad practice, -,nd that in an aseptic or a recent wound, in healthy tissues, \"drainage \" is worse than useless. It therefore follows that in recent compound fractures not attended with extensive laceration or contusion of the soft parts and an absence of shattering of bone, the overlying tissues may be closed in, with or without suture, and prompt primary union nay follow of the fleshy and bony issues. Incision through the overlying tissues for purposes of diagnosis ini fractures is certainly not justifiable, except in those involving the skull. By the use of the X-ray and other expedients a thera- peutic diagnosis is practicable in all fractures. Free incision, therefore, in many fractures is permissible for purposes of treatment-osteoplasty, for diagnosis only, never, except in skull fractures. THE SCOPE OF SECONDARY OSTEOPLASTY IN DEFECTIVE JOINTS OR DEFORMED LIîIBS AF'ùER FRAcTURE. Secondary osteoplasty, judiciously utilized, vill often yield remarkable results, and nay be regarded as one of its most salu- tary achievements in traumatic surgery. It deals with bones after their fragments have united, when the nerves are caught or coin- pressed; in a hyperostosis, when the shafts are greatly deflected- in fact, wlhen the limb is crooked and deformed-when a joint has been involved and its motions are either greatly iinpeded or entirely lost. It is an invaluable resource in the pseudarthroses. With the joints its great fort is at the hip, the shoulder, or, above all, at the elbow. Stimpson has utilized it with advantage after union and deformity at the ankle in Pott's fracture. Secondary osteoplasty, however, may be employed with great latitude on the bony shafts of the extremities; with the greate§t advantage on the leg. The sooner after union and the youiger the patient the better. It is almost marvellous what we may accomplish by osteoplasty in the bones of growing children, as was recently .lemonstrated by Heuter (Wiener ldinische 1wnd- schau, März 12th, 1899). In a fracture of the humerus (patient fve years old) attended with considerable loss of bone and a flail joint, lie turned to, the. skeleton of the thorax and resected ten centi- imetres of the fifth rib, inbedded it in the hiatus in the arm and",
         "THE CANADIAN JOURNAL OF closed the wound. Union -was rapid and coimplete. In nine months the full use of the arm was restored and the rib regenerated. This, indeed, would seem the climax of honologous ostcoplasty, and suggests what is expected of the surgeon in our times in the management of serious fractures. It is not recomended that recourse be had to this nuians in cases of nioderate defornity of a linb, with but slight impedi- ment in function. But there is quite a large inargin of cases where stiff and useless joints, with bowed bone shafts or useless linbs, follow union, wherein osteoplasty wvill sometiies accomplish extraordinary results. By it the muscles are liberated, and with the free division of the adhesions in the soft parts pressure on the nerves and blood trunks is reinoved, and the wasted, painful, paralyzed and useless member recovers its lost vitality. There lias been practically a resurrection; the dead or useless has again corne to life. In medico-legal cases, in the future, when serious fracture cases are to be considered, when the future working value of a limb is to be estimated, the question as to whether the full resources of osteoplasty have been exhausted inust be answered before it will be possible to make any definite calculation as to what the extent of permanent injury is. OSTEOCLASIS .AND OSTEOTOMY WlTII OSTEOCLASIS IN ANGULAR DEFORMITY OF THE THTGHI WITH SHIORTENING, FOLLOWlNG NEARER LEss PERFECT UNION. Every surgeon or practitioner having much ex-perience in the treatment of fractures of the femur will occasionally meet with cases of marked angular deformity resulting, after union, with considerable shortening of the limb. It is important to note here that it is not so muchi non-union which is at fault as imperfect or mal-union. In some of these cases there may be ground for sus- pecting unskilful treatment, but i' the najority of cases the fault is with the patient and is fur.unmentally constitutional. We know that fractured bones sometimes play strange freaks; at one time non-union lingering indefinitely, but the limb is mas- saged, or some internal remedy given. when all at once we note consolidation lias set in. Reclus recently notes how, in a few cases of tardy union, he administered thyroid extract with the most renarkable effect, while in several others it was quite useless. Again, in sone cases after a nionth or more we release the liinb fron the splints, find the limb in excellent outline, with little or no shortening. * There seems to be good union. We allow the patient to go about on crutches, later with a cane, and finally lose sight of him. But lie turns up with a deflected, distorted limb, shortened and crippled. At first siglit the aspect of such a case has a, niost disquieting effect. The patient lias had his limb again \" neasured \" and tells us, per- 164",
         "MEDICIlE AND SURGERY. chnice, that we have left hini a hopeless cripple. The prospect of having to defend one's self in civil action is not the most agree- able contemplation after such a mishap. In this class the case only reports late, after the hardening process is advanced, say, from six months to a year, then nothing probably less than a formidable operation will hold out any pros- pects of overcominig the deformity. But, happily, most of these cases are in rickety subjcets, or those in whom the callus softens and yields after the surgeon lias discharged the patient, when weight is put on the limb. However, the bowing maty occur before the patient has left the bed. In all these cases, imimediately after discovery of the deforinity, we should insist on osteorection with or without osteotomy. ln my experience this deflection of the femur has occurred in children most frequently. It occurs most conimonly in fractures near the middle of the femoral shaft. The convexity of the deflection is outward in nearly all cases. It is interesting to note that in the great majority there is little, if any, over-ridinge of the fragments, as we know froi the fact that after we refracture or press the shaft back into line there is generally no shortening. When these cases are seen early there is no class of deformities treated vith more gratifying effect, with more security and cer- tainty of results. In all these there must be complete osteoclasis, or refracture, as soon as discovered, when the deflection is ·com- pletely overcome. An adjustment should tien be applied, but should be frequently removed in order to bathe and massage the limb and freely imove the joints. In soine cases refracture of tie femur is easy, wvithout dividin' the bone, even later than a year. Such a case came under my care sonie years ago. The patient, a wonan of forty years, was injured by a defective highway. She iad a complete fracture in the middle third of the left fenur, with but very little shortening. The limb was adjusted in gypsum, and after a week she was taken home. About a year after, wlen the action for damages was tried, lier physician came to me and told me there was four and a half inches of shortening, and that walking was impossible. Sle lad then won lier suit, withi a liberal verdict. Six months after this I vas sent for to deal with the deforinity. Now, at more than eiglteen iontlhs after fracture, the femur was readily refractured and pressed into place. In three months union liad completed, without any shortening. She at present lias perfect use of the limb, without the sliglitest trace of any defect in locomotion. It is now three years siice the deformity was rectified. Osteotomy, as a preliminary step to osteoclasis, is indispensable when the uniting bond of osseous tissue lias unclergone hardening and does not yield to the application of moderate force. McEwen lias shown us that osteotony for rickety thigls or legs in children is a procedure quite devoid of danger, and is the most valuable 1615",
         "THE CANADIAN JOURNAL OF adjuvant ever placed at the command of surgeons for the correction of deformed limbs. We should not be slow to take advantage of it in those distor- tions follow'ing union of the diaphyses, wvhen it becoies necessary to cleave or partly divide the bone, thougl it should be. borne in mind that in those cases of aggravated deflection we have to deal with an excessive callous formation, besides highly vascular parts, and, moreover, that in the femur of the adalt osteotomy is always a procedure of considerable gravity. It is wiser, however, when ossification is advanced to resort to it rather than to risk great violence by force, and thereby inflict serious damage to the large blood trunks, tlie nerves and soft parts. In its performance in the adult its greatest danger may be obviated by eflective economy of blood and the most rigorous asepsis. I have here some charts roughly diagrammatic of sone tlings which will contribute in a measure to demonstrate what I have at home in the shape of drawings, but they are not in proper form to present to our seeretary. Now, imagine this to be a case of fracture of the tibia in a child, with a loss of four-fifths of its diaphysis, three fractures of the fibula, the limb so badly fractured that I was sent for to amputate it. I was prepared to take off tie limb at the hospital, but could not do so because of' soimething vhich is very essential from the standpoint of the law, and that, -was we did not have the consent of the parents. I advised the house surgeon to summon the parents by telégrapli at once. The mother arrived and said w'e miglit say what we liked, but the limb must not be amputated. We talked of tetanus, secondary hemorrhage, gangrene and all of those things,.but the woman was obdurate. The child's father was in the far West, and could not get home for four days. If, on his return, he consented to the amputation, she was satisfied, but she would not allow it to be done until lie saw his child. Tlat woman saved that child's linb and many since, because it taught me a lesson I had then to learn. The whole of the diaphysis was goie. It was fractured at about the insertion of the epiphyseal line. The shaft -of the fibula was fractured in three places, but you know the fibula is a bone deeply covered with muscles, everywhere except at the head, and -you seldom get a compound fracture of it. You will commonly find compound fractures of the tibia, but seldom of the fibula, and when there is a fracture of the fibula there is rarely displacement. We had this whole segment from this line below to the liie above (indicating) shelled out as a pea out of a pod-a pretty hopeless- looking state of affairs. After we adjusted the limb we did a little thinking. I noticed that the periosteum was very thick. As you know, in a child the periosteum is very thick and possesses great regenerative powers. To make a long story short, I put the limb in a light dressing, taking care not to hanper the circulation. The extent of recovery was so complete that when the case came up for trial-as the father, a very intelligent German, sued the railroad 166",
         "MEDICINE AND SURGERY. coiipany-the lawyer for the company asked the boy to walk up and down before the jury. The lawyer asked the foreman of the jury to say which limb had been injured, and the foreman could not tell. The extent of regeneration vas so complete that it was not possible when the boy was walking to determjine whicIh limb had been injured. That, was a case of a ehild. Remeimber, in cases of children, if the circulation is unimpeded, you can do any- thing with the bones. You cannot say immediately after the in jury whether the circulation is unimpeded or not. No living iman can say immediately after the injury-it can only be deter- miined twenty-four or forty-eight hours after, when the patient has recovered from shock-whether the circulation is intact, as in the case of a child. If an amputation is iade under such circui- stances there is ample ground for a civil action. Here is a case illustrating another factor in an adult, a nan about thirty-two years of age, who had a fracture through tie tibia, no fracture of the fibula, and who had been suffering fron rheuia- tisin iu the limb at the time lie fell down stairs, fracturing the bone shaft. Brought home and put under treatment. The ends of the bones projected througlh the tissues, took on a dark color, and enitted a foul-smelling discharge. The doctor whio had charge of the case got alarmed, and caime to me and said lie could not see anything to be done to save the man's life except to take off the limb. It certainly presented an unfavorable aspect wlen I saw it. There was a section of bone gone. Now, what are you going to do, supposing you had preserved the limb ? You are going to have a cushion joint, and you may coinpensate for that by haviag an adjustient applied to the leg which would throw the weight of the knee on the ankle, but a nuisance that must be to carry about in the hot weather. Can we hope, by any osteoplastie operation, to fill in that breach where the boue is gone, the bone shattered and detached and shelled out ? Some few years ago Prof. Plelps, of New York, employed a heretopiastie operation, remedying such a defect in the limb of a child, by producing a fracture through the leg in the animal, and leaving its vascular attachments in contact and bringing it over and fixing it in this hiatus, with the hope that the elements would fuse and the breach be avoided. The results were unsatisfactory. The parts did iot unite. It was a failure. What, then, next? In this case, as I said, the question, was, should we amputate ? I found the man in good health, a young fellow with good circulation. The ends which projected were black, snoky, sooty-colored fragments, fromi the effects of the atmosphere on the iron elements in the blood. They lad. the aspect of beinîg hopelessly necrosed, but of course the mere fact that they were black proveid nothing about the parts buried by the tissues. I found there was good circulation and put the limb in a comfortable position. In a few days the con- gestion passed avay, the linb looked well, but the breach was here. My idea wvas, after having cleansed the parts and gotten up",
         "168 TFS ' ANADIAN JOURN AL OF a heaitby action, to go on with the secondary osteoplastic treat- ment. lere is where the secondary osteoplastie treatment comnes n. Where, in Mhe first dressing you cannot take advantage of the osteogenetic process to secure repair, and resort to it as a secondary procedure, and after the patient bas recovered a fair share of health. I proceeded to cut off all the detached fragments. I then eut down to the fibula, cutting through the periosteum and taking out a segment of it which was -four and three-quarters in length, nearly five inches. That corresponded with the gap. After that I pushed the ends iup together and pushed up the leg, filling in Mie breach and putting in three hcavy wire sutures. After taking off a long section like that you might say you have an elongated set of muscles and a flail limb. What is to hold the bones in position? A inechanical appliance is only a temporary expedient, for it lias only the properties of an immobilizing agent and you will be pretty sure to have sloughs. But the fact is, iE you remove two to four inches within a week the muscles will have shortened. They vill have shortened so much that though they bang flabby and make no tension on Mie parts of all immnediately after the injury yet after a week's time the muscles will have so far shortened as to hold the fragments firily in position. The result in this case is perfect. Osteoplastie procedures often require a great deal o time. This man was down from the 5th of July, was able to get about on crutches the 1st of November, about the 1st of January he could go around witi a stick, and after another year lie did not require any support, the ankle-joint vas perfect, and two years after the accident he walked from One Hundred and Twenty-fifth Street to Coney Island and back, a distance of thirty miles, without crutch or stick of any kind, and has as perfect control of his limbs as any man, compensating for the shortening by a raised sole on his shoe. We have another kind of case involving fracture through the shaft of the tibia, and I cite the tibia because the coipound frac- tures which we see, 95 per cent. of them, are fractures through the tibia, and there is no bone in the body which we can deal with so satisfactorily with osteoplastic procedures as the tibia, and I cite it as an example. We have a fractured tibia here (indicating), with a fracture througih the fibula. In this gap between the proxinmal and decidual fragments are pieces of bones. The bones are shat- tered and some of these pieces can be picked out. There are other pieces which eau be drawn out. They have attacliments to the 1 muscles and periosteum, and to some of the connective tissue, and they have a vascular connection. In a case of this kind- I have tried it in only one-I picked out the loose fragments which remained, fixed them in the centre, closed in the breach with sutures, and these small fragments that had a vascular connection, being fitted in a breach, ultimately underwent a hyperplastic operation, which in time filled in that hiatus. This is another way in which ithe result was accomplished. This is a rough illustration of the kind of fractures where you get a sharp angular deformity.",
         "MEDICINE AND SURGERY. We dismissed the patient all right, but after a few months he turns up and there is an angular deforinity of the feinur and a shortening of five or six inches. The patient has suffered very seriously from the defect of the limb, and as we cautiously look at a case of that description we are certainly imnpressed with its serious character; but w'e must bear in iind, particularly in chil- dren, that in most cases deflection comes from the softening of the callus. The bowing of it, fortunately, alnost invariably is in an outward direction. It is in a part where there are no important blood vessels or nerves. We can, in many of these cases, restore the length of the limb conpletely, vhich is proven by measure- ment, and we know, when we restore the complete ineasureient there could have originally been no over-riding. In other cases of aduilts you vill find sometines that as the result of serious injury to a part, at the time of first injury, little can be donc in the way of treating a fracture, but yet by secondary*osteoplastic procedure you may succeed in giving the patient a good imb. Such a case I had last year, a young man who was a . vitchman and who had his thigh fractured by an accident on a train. At the same time he sustained grave bodily injuries, so that little could be donc with the injury of the thigh at the tine of the accident. There was a shortening, something more than a shortening, paralysis of the muscles of the foot, so that lie had no sensation in the foot. The muscles of the limb had wasted, and it was a question of taking off this useless limb, that was only in his way, and w'as the source of pain. He was a young fellow with a great deal of grit, and disliked to entertain the thouglit of amputation, although it seeined to be the only resort in his case. He was sent to nie, and I found a vast mass of callus. I found that the external divi- sion of the popliteal nerve was calloused. I separated the varve from the callus and found the callus was united so firnily that it was a difficult thing to do. I then made a cross-section through th( fragments and brought the linb into position, and the young fellow made a good recovery. He did not get perfect union, but the deformity was obliterated and the paralysis recovered from. He is back to his work to-day. That is an illustration of what may be accomplished in what is known as secondary osteoplasty. I saw such a case yesterday at the Soldiers' Home at Hampton. I believe the soldier could be put on his \" pins \" and be made a useful member of society. In inost cases of fractures of the femur we sometimes do not meet with the saine success, and a different condition will result; but it is unusual. This is a case in which the patient was injured on the 7.0th of March a year ago, in a head-to-head collision, in which he sus- tained serious bodily injuries, and when he ad finally recovered, among other things, the tibia bowed up, the personal group of muscles of the foot, was paralyzed and wasted. The limb -was of little or no -use. In that case, by secondary osteoplasty we were enabled by the refracture of the bone, getting the fragments into",
         "THE CANADIAN JOURNAL OF position, to get such a good result that the man could throw the whole weight of his body on one foot and walk about without a cane; no crutch or anything of that kind. He is a locomotive engineer and can go to his work now a-sound man. It struck me, Mr. President, that those who have to deal with injuries so cominonly involving the bone shafts, and froin the fact that there is so little to be found in our works on surgery dealing with the subject of osteoplasty, that a fev notes bearing on the niatter would not be lost on this Association. (To be completed in niext issue.) AN EXPERIENCE IN FORMALDEHYDE DISINFECTION.* 3Y F. MONTIZAMBERT, M.D. (EDIN.), F.R.C.S., D.C.L. Director.General of Public lealth. ON the evening of Tuesday, June 6th last, the S.S. Lacke Hrmm arrived at the quarantine station of Grosse Isle, in the River St. Lawrence below Quebec. She was twenty-five days out fron Batoum, on the Black Sea, with 2,300 Douklobor immigrants on board and a crew of sixty-nine, including the pilot. Smallpox being found on board, the vessel was ordered into quarantine. Seventeen cases of this disease, eleven of the Doukho- bors and six of the crew, were removed to the hospital between the time of the arrival of the vessel and the completion of the landing of the persons and effects they lad brouglt. All the 2,300 passengers were landed by Friday evening, the 9th. The heavy luggage from the hold was landed on Saturday and Sunday. The vessel was disinfected on Monday and Tuesday, the 12th and 13th, and she was offered to her agents for release, with a new crew, on Wednesday, the 16th, at 4 a.m. The usual methods employed in the Canadian quarantine ser- vice for the disinfection of vessels are as follows: Steam for all lospital cabins and other small apartments where it can be used; formaldehyde for saloons, stateroons and small apartments where permanent fittingà would be destroyed by steam; sulphur dioxide gas under pressure from the blast furnace for holds and steerages; and mercuric chloride solution for all free surfaces, alleyways, latrines, bilges, etc. On this occasion the sulphur dioxide blast appliance of the sta- tion was not available. Stean is not suitable for large apartments as the temperature cannot be kept up, and the steam is therefore *Rcad before the Canadian Medical Association, Toronto, August, 1899. 170",
         "MEDICINE AND STJRGERY. precipitated as simple hot water. Accordingly formaldehyde was used for the holds and steerages on this occasion. The cubie space involved was as follows: Cubic ect. Main deck ... .34,453 ....13,441 Tlirec compartrnents open n ....26 977 longitudinally. 74,871 Forchold.....17,534 Three compartments per- . .....13,461 pendicularly open by ........18,117 49,112 hatchwa's. No. 2 hold ... .17,680 Il .... 15,727 ....22,975 50,382 No. 3 hold.... 4,057 I H .... 4,264 .... 5,920 14,841 No. 4 hold. . . .13,446 Two conipartnients perpen- n .. . .19,530 dicularly open by hatch- 32,976 ways. Afterhold .... 12,734 .13,520 26,254 ToTl h casureopea.n. 254,436 Thle forinaldehyde wvas liberated from formalin, tie 40 per cent. aqueous solution of the gas. Twvelve ounces of the solution were, allowed for eachi 1,000 cubie feeb of space. The tine, of exposure wvas ciglit hours. Two instruments whre ecployed in this part of the M'ork. Although, as stated, the disinfection of the vessel wvas coin- pleted on the ]norning of Wednesday, June l4th, owring to heavy W-Cather il was not until Friday, the lOth, thab the newv crew could be sent down to receive and takze away the vessQl. During this, interva,,l an l'anchor watch'\" -vvas kept on the vessel's deck and in hierengine-roon, the officerp and crew continuing to live on shore. Whien the small steamiboat brinainag the new crew came in siglit, the last of the old crew% -xvere, brought ashore, and thie Lakce Hurn~ was lef t riding at anchior in the offing without any one on boaid. The ne'v crew that thhn boarded lier and took lier ataay were froni a sister ship, tie Lace Tw then at Quebec. After taking the Lakce 1-mr~on up to that port they hiac to leave, lier within a, day or two to rejoin their own vessel. ihey were at once replaced on the Lace R'wdonc by another, a third crew. Ilîns two ne\\v sets of men boarded, occupied, lived and slept in this vessel withiin fromn two to four daýys following lier disinfection, after toere iad just been reroved from lier seventeen cases c sniallpox scattered among nearly 2,400 people packed on board,",
         "THE CANADIAN JOURNAL OF andi having occurred both in the steerage and in the forecastles. This constituted, of course, a nuch more severe test of this inethod of disinfection than the re-emnbarkinîg of the original crew would have done. I an happy to be able to state that there has not been reported any 'subsequent case of this disease in connection with any of these persons, or traceable in any way to this vessel, during the two imonthîs and a hailf that have now elapsed since these events occurred. I ain aware that this disinfectant, formaldehyde, lias been einployed before for the purification of vessels, notably some of the United States transports after recent service at Cuba.' But I have not seen any instance recorded of its use on so large a scale in the face of actual infection with snallpox. Nor do I know of its results being put to so crucial a test as upon this occasion. In ny opinion the use of sulphur dioxide driven in from the sulphur furnace under the strong pressure of the exhaust fan miust remain our chief reliance for large apartments, such as holds and steerages; but still this instance of the successful emnploymnent of formaidehyde as an alternative is not without its value. I do not forget how careful we have to be not to hastily draw conclusions from any one case or occurrence. Still it is only by the noting of single cases that cumulative evidence can be obtained, and I have therefore thought this test of formaldehyde disinfection on a somne- w'hat extensive scale to be of sufficient interest for me to bring it before this Association. SYSTE1ATIC INTRA-UTERINE EXPLORATION AFTER EXPULSION OF PLACENTA. BY JOHIN H1UNTER, KMD., TORONTO. IN no other sphere, unless it be in the ecclesiastica.1 one, are the \" traditions of the fatiers\" more reverently or superstitiOusly followed than in sone phases of obstetri; teaching and practice. If, at any of our medical associations, one should attempt to pro- mnulgate a reform in some of the old effete methods in vogue for centuries, in order to bring then in line with modern systems.\u003e of procedure, in surgery and gynecology, he immediately confronts the sternest opposition. One after another of his colleagues rises, with a decorum commensurate with the gravity of his purpose, a visage surcharged with indignation, and with solemn wordà, indicative of the unfathomable cerebral depths in which the roots of his convictions are imbedded, ho rehearses his unfaltering faithi in the old traditions, utters his protest against the innovations, and huris his anathemas at all such unsanctified teachers and teachings. 172",
         "MEDICINE AND SURGERY. Ve witness these scenecs with some surprise and amusement, and could well affbrd to wait until time had consigned thesc traditions to the saine limbo as witchcraft andi kindred delusions, were it not for the fact that the pcrennial reiteration of themn retards the progress of obstetric art. Why should obstetrics-any more than surgery or gynecology-on the threshold of the twnitieth century, be hampered by the unscientific theories and teachings of bygone ages, although some of these had the endor- sation of the nost illustrious naines that adorn medical literature ? Tlhese great ones made the best use of the opportunities of their time. Why should we not follow their example, in this respect, rather than their teachings ? Of course, it does not follow that in order to introduce much-needed reforms we are to throw overboard the wise conservatism reared on clinical experience, the safest and firmest of all foundations. Because one man with a large experience and good technique can do certain things with impunity, is no excuse for the rank and file following blindly after his methods. A Blondin may find a tight-rope quite a safe neans of transportation across a Niagara River, but a foot-bridge is a much more suitable pathway for the crowd. The question of a systematic exploration of the uterine cavity, after the expulsion of the placenta, in every case of labor, may be discussed from two standpoints: 1. Its Necessihy 2. Its Safety. It is necessary in every case, for no mattsr 1ow carefully we may examine the expelled membranes, we cannot be sure that no fragments have been left. Two quite recent cases fully convinced me of the truth of the statement just made. In each case an experienced nurse and 1, at the special request of the patient, made a most thorough inspection of the placenta. We assured the first that the after-birth was entirely away. At my next visit [ was confronted with a fragment on a napkin. The second lady insisted on having au exanination made, althougli positively assured that all was away. The finger captured quite a piece, but for prudential reasons the patient was not made aware of it. The retained fragment, be its size what it may, is now a piece of disintegrating dead tissue, and, as such, a menace to life. It may be said that nature will take care of these fragments without our meddling. Such an excuse is only a sin of presumnption. No obstetrician, in the light of the present day, would be justified in lcaving any fragment that could be easily and safely removed. Do we not feel uneasy wlhen, with cases of abortion or adherent placenta, we are obliged to leave some portion behind. Visions of sepsis haunt us for days. A dozen similar excuses to the above may be formnulated, i.e., fragments remain aseptic, become attached to uterine wall; or, there are difficulties in making the exploration, probabilities of all the debris not being removed even then, etc. In regard to the former, they are only variations of the same sin of presumption; and as to the latter, they are simply the limitations. incident to ail operaitive work. What progress would",
         "THE CANADIAN JOURNAL OF surgeons or gynecologists make if 'they allowed themselves to be deterred by the possibility of having to contend with difficulties in operating, or by having to endure regrets for undesirable results. Why, then, should the obstetrician be discomfited by difficulties that only nerve his confreres to acquire greater skill and a more efficient technique ? There is no room in obstetric practice fori the unclean, unprogressive, unscientific, timorous or superstitious. The imperative call is for clean, intelligent, practical, scientiie, aggressive workz. 0Its Sfey.-The devotees of \" the traditions \" are so entrenched on this kopje that it is alnost impossible to hit them with the lyddite shells of criticisn. They can only be dislodged by the thrusts of steel-cold facts. It is said that to systematically iake a post-partumn, intra-uterine exploration in every case of labor would bc a very unsafe practice to follow. It mnust be frankly conceded that there nay be about this, as in every operative procedure, especially on the intra-abdominal or intra-pelvie organs, an element of danger. But.let us be consistent. Why wave the danger signal so frantically at this procedure, when we not only shut our eyes, but actually practise and endorse far more dangerous performances in the early stages of labor ? Take, for instance, the primary digital examination. The accoucheur comes in, perfunctorily washes his hands, passes one or two fingers up, more or less forcibly, through the cervix, and sweeps thein round and round the head. If there be infection on the fingers, could ingenuity devise a better method for having it effectually implanted wcl within the uterine cavity? He thon estimates the progress of the labor, and goes off, perchance to lance an abscess or dress an infectious wound, returns and repeats the examination time and agail. In the meantime- the fetal head is lacerating the soft tissues, and opening new avegues for infection, and the attrition of the head against the uterine walls rubbing in the infection very thoroughly. This process nay go on for hours. Compare these conditions with those surroundig a post-partuim examnination. Granted, that we have in the latter equally favorable conditions for infection; but what are the probabilities of its getting there ? The accoucheur has been with his patient for some time, his hands have béen washed frequently, the fingers are introduced gently, swept quickly around, and removed as the uterus is contracting. In the first stages of labor, the pressure of the fingers, the ever- widening fissures, the attrition of the fetal head, all alike con- tribute to absorption of any infection, -whereas in the post-partun, period there is a process of contraction, exfoliation, extrusion and expulsion going on. The gush of blood that follows the with- drawal of the flngers, and the outflow of the lochia tend to carry away any infectious material, so that, from the standpoint of safety, the post-part\"m examination or exploration is virgin innocence compared with the strumpet-lice procedures carried on in the first stage of labor. 174",
         "MEDICINE AND SURGERY. In conclusion wxe mnay briefly compare the two procedures as to the necessity for either of them. I think clinical zxperience fully confirms the stateiment that there is a far greater probability of finding harmful debris in the ex-gravid uterus than of finding inal-positions of the fetal head, or other abnornalities in the gravid uterus; in fact, we so rarely meet these latter conditions that the discovery of themn rather surprises us. They arc probably not found in more than four or five per cent. of all our cases, so that practically, we know that in ninety-five or ninety-six per cent. our only excuse for making an examination is merely for information regarding the progress that is being made. Now, if this procedure be justifiable for the purpose just nentioned, is it not a huadred- fold more so when in the ex-gravid uterus we expect the explora- t'on to be of great service in renoving vaste produets that miglit easily become inimical to health, or even life? i have only touched the fringe of this question, or in military parlance, a scout lias taken a snap-shot that may precipitate a battle. Well, if war be ever justifiable, it -would surely be between the vitalizing optimism, that hopes for clean, intelligent, practical, scientific, aggressive work in obstetrical art, and the palsied pessi- misn that is famishing on the traditions and teadhings of medioval ages. Is the Sealskin Sacque Unhealthy ?-And now it is the seal- skii sacque's turn to come under the ban! A New York doctor says lie verily believes that more deaths have been caused in New York from sealskin coats than from snallpox. The owners feel so proud of their possessions that they often even w'ear the coats indoors. The saine doctor says that silk underclothes are an abomination. They are too closely woven, says lie. Wool is the onily proper wear. The married men of the world should prcmote a testimonial to this medical gentleman, who is known in New York as Professor Thomas Jefferson Harris of the Post-Graduate Hospital. A Great Honor, but only Deserved.-It is not often that royalty honor nanufacturing pharmacists by a visit to their factory. Sucli renown, however, recently fell to the lot of E. lMerk, the well-known drug manufacturer at Darmstadt, Ger- many. Her Majesty's grandson, the Grand Duke of Hesse, showed lis interest in the chemical industry of his country by spending the better part of two days examining closely into the varied processes of manufacture of refined drugs at the establishment of Merck \u0026 Co. The Grand Duke was accompanied at the time of lis visit by the Grand Duchess of Hesse, the Duehess of Cobourg, the Grand Duchess Helena of Russia and Princess Beatrice of Cobourg. The party visited not only the works, but went all through the-wrareiôuses and suites of offices.",
         "T H E CANAD IAN JOURNAL OF (I1atIzo1cgy M.% Il. PcIILER, Mci C3 J. J. 3[ACKZENzll, .3.. ON THE SIGNIFICANCE OF FlIXED INFECTION IN PHTHISIS.* (.Abstiract.) TRis paper, 1'74 pages in length, is one of the inost conplete whiclh has yet appeared on this subject. It contains the result of histo- logical and bacteriological studies of twenty-six selected cases of phthisis, with clinical histories o[ the majority and with a very full discussion of the literature of the subject. The chief results of the investigation are summarized as follows: 1. The bacteria which appear in the lungs with the tubercie bacillus, in the course of,tuberculosis, settle first in the contents of cavities, Mien in the walls of cavities, and can, as a result, produce by their toxins, an efflect upon the surrounding tissues or eventu- ally upon the whole organisn. They may lead to the destruction of the cavity wall and produce a pneunonia in the neighborhood, eiMier alone or in combination with the tubercle bacillus, in the course of which also a toxemia or bacteriemia nay appear. Further, they cause by aspiration into healthy Ing tissue broncho- pneunonias, which either heal up or lead to destruction of lung tissue and eventually also to toxeina or bacteriemia. 2. The mixed infection appears, pathologico-anatomically, chiefly in the form of a pneumonia, which arises fron the combined action of the tubercle bacillus and other forms, and shows a focal, Jobular or lobar character, and there nay be demonstrated in the inflamed lung tissue, either with or without tubercle bacilli, numerous bacteria, especiailly streptococci, staphylococci and pneumococci. 3. The mixed infection plays a great role in the plithisical process, not only in its clinical course, but it alse influences the pathological findings in the lung tissue. 4. The certain demionstration of the mixed infection is possible only by histological investigation, especially by the evidence that the foreign nicro-organisnms are found iii larger numbers on and in the cavity walls, and also that they are taking part in the origin of the pneumonie changes in the neighborhood of the cavities, and that secondary broncho-pneumonic foci, arising from the aspiration of cavity contents, contain in the first stages of their formation, either with or without tubercle bacilli, other bacteria in such * Sata (3rd Suppleinent to Ziegler's Betrage). 176",
         "MEDICINE ANID SUIRGERY. numbers and with sucli distribution that pathogenic significance inust be ascribed to them. 5. Sputuin investigatiou and the cultivation of bacteria frou the lungs post mortemn alone give no safe evidence of the existence of a mixed infection. 6. Mixed infections arise mostly after the beginning of the degeneration of the purely tuberculous tissue, and may appear after a longer presence of this degeneration. 7. Only in closed cavities do the contents remain for a longer time free from foreign bacteria. Mostly, immediately after com- inunication of a cavity with the outer air, it is sown with foreign organisms, but mixed infection does not yet begin, but only when the bacteria penetrate the wall, lead to degeneration of the same, and produce pneumonie changes in the neighborhood, or when by aspiration they pass to distant portions producing there the so- called mixed pneumonia. 8. What we call phthisis is usu6lly only in its first stage a pure tuberculosis'and apparently not in all cases, even in the first stage. Pure tuberculosis which proceeds but slowly or may remain a long time dormant and may be discovered accidentally at autopsy, can neither froni its clinical course nor from its anatomical character be designated phthisis, yet there occur advanced tuberculous changes of the lungs with limited pneumonie exudation in the neighborhood of the caseous, fibrous, tuberculous foci in which a mixed infection cannot be demonstrated. Whether in such cases a mixed infection never existed, whether the secondary infection iuas healed and only the tuberculosis remained cannot be decided anatomically. 9. The majority of cases of advanced phthisis are consequently mixed infection, and a greater part of the phthisical changes are the result of the secondary infection. 10. Pure local tuberculosis of the lungs shows no fever or very slight fever, whilst inixed infections cause high fever, so that we iny from the fever conclude as to the presence of mixed infection. 11. Pathologico-anatomically there is no q.ualitative difference between pure tuberculosis and a phthisis complicated by mixed infection, but a quantitative difference exists in that in the latter the inflammatory phenomena are more marked. 12. In animal experiments, the more severe character of the mixed infection may ~be demonstrated. 18. The chief bacteria which play a role in the mixed infection are the following: Streptococcus pyogenes, staphylococcus pyogenes aureus. diplococcus pneumonio, the pneumobacillus and its varieties, and the pseudo-diphtheria bacillus pulmonalis. All the bacteria which are found in the sputum or by culture niethods do not take part in the destruction of the lungs. The changes due to secondary nfection ,nay heal up, so that after disappearance of the bacteria only tuberculosis may remain. 14. It is yery p-obable that the secondary infection does not always act.injuriously upon the phtiiisical process. It may happen 177",
         "178 JOURNAL OF1 MEDIOINE AND SURGERY. that i· niay hinder the reproduction and spread of the tubercle bacilli, and give rise to changes which nay lead to a healing of the disease. 15. The tuberculous foci usually do not enlarge from one centre, but are enlarged by the union of foci developing near one another. The individual focus tends to heal, the danger lies in the fornatiui of new foci through the escape of bacilli. 16. The wall of the cavity is often not tuberculous, but consists of a well-built granulation tissue, and this plenomenon depends apparently chiefly upon the secondary infection, in that the abov-e- named bacteria repress the tubercle bacilli. J. J. M. Ilungarian Punishment for Bigamy.--Biganists in lungary ·are compelled to submit to a queer punishnent. The mai who has been foolish enough to imarry two wives is obliged by law to live with both of themn in the same house.-N. Y. Med. .Uec. True, even in the Practice of Medicine.-It always struck me, says a writer, as very reiarkable that some people can w in success casily while others have to wage a long battle for it. Two people may engage in the same line of effort, and while one will make noney the .other will fail. Take Edward Bellamiy, for instance. He made twenty thousand dollars by \"Looking Back- w'ard.\" Lot's wife, who tried the same thing, succeeded only in miaking her salt. It's an 111 Wind Turns None to Good.-\".A. big family,\" said the old colored inhabitant, \" is sonetinies a great blessin' ter a po' man. I got nine sons-ol' en young. One got run over by a rail- road, en 1 got damages out er himiî: n'er une had a leg shot off en durin' de las' war, en de guv'ment corne up han'soine fer hin , en all de res' er dem has had de good luck ter git hutted in soine way, en ever' time dat corne I got de damages; so in ny ol' age I feelin' nighty confortably, en I rises up en calls dem -hilua blessed Attanta Constitution. Treatment of Tinnitus.--After giving an anatomical descrip- tion of the ear, with. illustration, and going over the various affections of the organ itself, and of other organs capable of causing the symptoM of buzzing, the various remedies employed are passed in review. Cimicifuga racemosa has been recommcnded by Robin and Mendel as a drug governing vascularity and a inoderator of reflex irritation. It is used as a tincture (gtt. xv.-lx.), Iluid extract (gtt. x.-xxx.), or cimicifugin (product of precipitation of the tincture by water (5-20 cgm.). These authors have found, withi the exception of cases hasting over two years, that ei'Iicifuga gives prompt and complete results.-BuUetin Génèral de T/.'ra- peutique, December Sth, 1899.",
         "ju ranadian journal of meldicIine and Surgery J. J. CASSIDY, M.D., EDITOR. 69 BLOOR STREET EAST. TORONTO. Sur.ero-itUPC1 L9 . .ttOI:DAN, 3.D..C.31.. 3cillI Univer. ty. M.D. Untversity' or Toronito: Surgeoni Tornin Il-mI flopta:n Surgen Grandt Trntk ILI ; Con. ultîin Snîr.cnî Toronlto Iloine for lucurables: len. Mon Exarniner Unlited StUtes Govennlllentt and F. e. C. STAINin. M.B.. Toronto, Lecturer nuit Demion. strator in Anatomy. Toronto University: Surgeon I. the Onît-Door DepartunentToronto ner.al lospital â-d IIâspitaI for Silck Cldllîreni. Clinieal Surqy.j-AI.Ex. PRIM\u003euRosE, Mît.. C.3I . - îinîburghi L .. rait. . Prufesour uf Anatonîy .nt Dîuretor of thie AnatomIeal Departmnent, Toronto Unlverslty: Amso. ite PIràfessor of Clinial Snrgery. T..onto iiver. sity: Secretary 316ilcal Facuilty, Toronto University. Orth.,eî. Surgery-B. E. M.cKryE.ll.A., M1.D., Torunto. Surgeon to tie Toronto Orthopedic flospital; Surgeon tl Ilit Out-latient Departinent. Toronto Ceneral Hos. .Asistant, Plrofessur of UlAîii burgery, Ontatrio . MciclCollege fur Women ;emnber of the Amîerican îrito.petlic Assoclation; and Il. Pl. Hl. GALX.OWAY, M.A).. Toronto. Surgeon tu the Toronto Ortloledic ifoepital ; Ortlhoplic Surgeon. Toronîto Westcrn lins. lItaI. 3lernber of the Aincrican Ortholedic Associa- t1-.11. Qral Suirgery-E. Il. ADAMs. Mf.D., D.D.S., Toronto. Surn.î Iathiolo'Ijy-T. Il. 31ANEY. M.D.. NeN York. Vttltsng Su.,;eon ta Iarlein Ilosital. Profesor of Nre.ry. Ye York School of Cllical Medicine, New York, etc., etc. .py and Obstelrics-GE:o. T. 3McKEoucii. M.D., 311 ..En::., Chthlam,. Ont,; and J. il. LoWE£, 31.D., NewmaLtrket,'Ont JMIeu-dl Jurlsprudence and Toricology-N. A. lOWELt. M là . Toronto. and W. A. YOUN. 31.D.. L ..P. 1and.. Toronto. W. A. YOUNG, M.D., L.R.C.P.LONO.. BUSINLss MANAGCR. 145 COL..EGE STRLET TORONTO. MedIcinle-J. J. CAssIDY. 31.D.. Toronto, fenîber OntarIo Provncial Board of ieilth: Consun.ltig Surgon. Torotînît General Ilospita a; 'ini W. J. Wusos, M.D.. Toronto, Physician Toronto Western loslital. Clinical .fcinIDIe-Ar LXANDER 31e i:AN, M.D.. P'ro. fessor of Mîcdiclnel and Clinical Medicline Toronto Univîersity PlyslIcla Toronto Ceneral Iloàpiltal. St, 31chael's Ilosltal. and Victoria Ilospital fur Slek Childrei. Mental Dses-y...zRA Il. STAFlutL. 31.1D., Toronto. Itesldent hiysiciant Toronto Asylum for the Ina.'ne. Public I[ealth and lIyg fic-t. J. CAssIDy. 'M.D., Toronto. 31einber Ontario Prvincial loard of Halth. Consuit- ling Suirgen Toronto General lospital; and E. Il. ADAM. 31.D.. Toronto. Pharmacology and Tlierapeuttîes-A. J. ItARItîNOTuS. M.D., To.t.C.S.Eng., Toronto. Phîysiotoay-A. a. Eim. 3D.. Toronto. Professor of Plhyslology Wornan's M3edical College. Toronto. P'ediatrics-AIUGUSTA STOWE GU.LSN. M.D., Toronto. Professor of Dliseas of Children Woman's 3cdlcal College. Toronto. Pathology-W Il PEiL.in, N1D. C ..TrinityV niviersity; Iathologist Hospital fotr ýlck Clilîdrenu. Toronto; Denonstrator of P'athîology Trinity Medical Collego , Physclanl to Outdoor Dilnrtmiienît Toronto Geseral lIosnpital : Surgeon Cazindlan Pacide RîIt. Toronto: and J. J. 3[AcKNF.NzE. I.A.. M.B.. Btactenologist to Ontario Provincial ioard of Itealth. Oplthalnology and Ootlogy-J. M. 3.%AcCAi.tUt. M.D.. Tornto. Asistaut Plysician Toronto GeneraI lios. pital. Octlist and AurlstVictoria lospital for Slck Children. Toronto. %ddre% n Cohnnunications, Corrspondentce. Books. Iatter Rcgardlisg Advertis- ng, 111 11malke ail Ciequîes, Drafts and Post-oIllce Orders paîyable to \"Thse :uaidlans Journ:l or NIelcine and Surgery,\" 145 College St., Toronto, Canada. nter a ftor by sending news. reports andpapcrs ut interest from any stetun of the country. Individual experlence and theories aru also soltcited. \u0026 ,eits. tu insure Insertion In the Issuc ut any month. ohuuld be sent nut liatr than the flteenîti of the pro. oin onth. VOL. VII. TORONTO, MARCH, 19oo. NO. 3. Editorials. DISINFECTION OF SHIPS BY CARBON DIOXIDE. A accident which happened about the beginning of November, 1899, on board the ship Polis Mytilini, in the harbor of Trieste, lias hed up to a discovery which may be of the greatest utility in publie and private hygiene. One of the seamen having died of buh,-nic plague, the nost rigorous sanitary precautions were iRnmtdiately takein to prevent the extension of the disease. When the disinfeetion of the ship's hold was being attended to, no dead",
         "180 THE CANADIAN JOURNAL OF rats were at first discovered, but when some casks containing ferinenting molasses had been removed, a considerable numiiber of dead rodents were found bereath them, which liad evidently perished from inhaling the fumes of carbon dioxide escaping froim the fermenting molasses. This accidental discovery bas given a hint to Dr. Apery, of Constantinople, who intends to turn it to a scientific use in disin- fecting the holds of ships. As everybody knows, carbon dioxide, which is not disagreeable to the senses, is, when respired, incapable of supporting life, aid causes asphyxia. Being one and a half times denser than atmos- pheric air it displaces the latter in the lower strata of air in a closed place, so that, if allowed to escape into a tightly closed roon, a candle placed near the floor will be extinguished; in the saie way an animal or a human being lying near the floor would perish. So that if an apparatus for producing carbon dioxide is placed in the hold of -a ship, for instance, a flask containing broken pieces uf .marble, acidulated. with muriatic acid or sulphuric acid or a generator of liquid or solid carbon anhydride, the gas, owing to its density, will displace the air at the bottom of the hold, until at last the lowest portions of this space will be filled with carbon dioxide and the rodents there vill be asphyxiated. To bring ail the rats in the ship to the desired spot some kind of bait, such as tallow or cheese, is placed there before the gas is disengaged. With a lighted candle placed at a suitable height the investigator can ascertain the level of the hold \u0026t which air lias been displaced by carbon dioxide, for the light will be extinguished as soon as the supply of oxygen becomes insufficient to support combustion. After the operation is finished the hold can be aired so that a mani can enter and remove the dead rats. This aeration inay be done with an air-pump, by heating the air in the hold, or any-other system of ventilation. To obtain certain results the operativin should be repeated two or three times on alternate days. When the rats begin to be inconvenienced by lack :f oxygen they are unable to escape, but become paralyzed and die on the spot. If any of them survive they leave the vesse). To prevent the contamination of other vessels by the rats or the carrying of infec- tion to the land, this operation should be donc wlhen the ship is two or three miles out from a port. The operation is quite inexpensive. It can be supervised and the disengageient of the gas can be observed by the lighted candle, which serves as a",
         "MEDICINE 'AND SURGERY. reag'nt and an alarin signal. Owing to its density and ditfusi- bility, carbon dioxide penetrates into the deepest holes and intorstices. If the rats are drawn to the desired spot by tlhe bait, they die there and the putrefaction of their dead bodies does not infect the other parts of the ship. Consequently, it is simply lec(sary to disinfect their dead bodies and then pitch theni into the sea. However, according to the experiments of Montefusco, of Naples, and Leone, of Munich, carbon dioxide prevents the devefop- mint of micro-organisms and causes their numbers to rapidly decrease. * When it lias been ventilated, the hold of a ship diinfected in this fashion lias no particular odor, such as is expmrienced after the use of phenol or formaldehyde. This process may be used to a certain extent in the basements of buildings and in shops. J. J. c. LNSUCCESSFUL VACCINATIONS-ARE THEY ALWAYS THE FAULT OF THE MANUFACTURER? TiiE following sentences appeared in an editorial in a recent issue of the Cleveland Journal of Medicine, and, as they contain a con- -4iderable amount of common-sense, we cannot iefrain from re- printing them. The writer says, \"A most anmusing absurdity thirefatens to occur in a town not fiar from Cleveland. The health ofippr of the town has been so unfortunate as to experience a largo proportion of unsuccessful vaccinations. He attributes this to the poor quality of the virus that lie lias employed, althougli othNr physicians in the same town, using the saine nake of virus boight fron the same drug stores, have experienced successful results. In order to show his authority, his .contempt for the opinion of his professional brothe's, and his detestation of the fraud that lie alleges lias been practised upon hini, he now asserts th' ~will sue for danages the druggists who sold the virus, and that lie will compute damages at the rate of 75 cents for every unQurcessful vaccination. Beyond naking hinself additionally ridiculous, it is difficult to see any lesult that lie nay achieve from this procedure.\" That the n1anufacturers of vaccine virus in Canada and the Tnited States have gone to very large expense indeed to secure the best plant procurable for furnishing the finest and purest lymph is fåct. 'It is but fair to give those gentlemen credit for",
         "I-THE CANADIAN JOURNAL OF their desire to give the imedical profession a lynph; the purity of which cannot bc doubted. It cannot, on the other hand, bc denied that vaccinations in many cases have given risé to quite un- necessary suffering on the part of the patient fron the inoculation of a seruin not fit for use. Such cases, however, are now rare, especially since the glycerinized virus bas become \\vhat might 'bc called fashionable. It is not fair that every time a physician has an unsuccessful vaccination, he should there and then proceed to juifip upon the manufacturer of that particular lymph. Medical men must admit that, in a large majority of cases, failure to successfully vaccinate is due to a too great routine process in the performance of this trifling surgical procedure. It is quite possible to bc too particular, in a sense, over the cleansing of the spot -about to be scarified. In nany cases, where the arm is washed with a too strong inercurial solution and the part not thoroughly dried after, the activity of the virus is entirely destroyed. Again, since the glycerinized lympli lias come into vogue, it is quite possible for the operator to forget that this lymph takes a good deal longer tine to dry than that taken from ivory points, so that by the patient being allowed to pull down his sleeve too soon, the lympli can be very easily removed from the point of application and the vaccination again prove unsuccessful. There is another point worthy of remembrance, and that is, that some physicians insist upon apply- ing a fairly strong antiseptie dressing after inoculation and before the virus bas become thoroughly dry, the dressing there and then, instead of the cutis vera, becoming the absorbing agent. These points are worthy of empliasis, and we think that there will be few who will doubt our statements in this connection. Ini vaccinating it is well to bear the following points in mind: 1. Don't prepare the site by washing with autiseptic solutions. Or if this is thought uecessary- 2. Don't fail to rinsei thor.uighly vith sterilized (boiled) water, and dry. 3. Be sure to prick the abraded surface to assure penetration of the vaccine to the cutis vera. 4. Don't draw blood if you can help it. A gentle oozing of serum gives much better results. 5. Don't fail to rub the vaccine thoroughly and persistently into the abrasion. 6. Don't replace the clothing until the vaccine is thoroughly dry. 7. Don't apply antiseptie dressings. In this connection we may add that the recent smallpox out- break in the vicinity of Toronto has brought forth strange antagonistic expressions toward compulsory vaccination froin a 182",
         "MEDICINE AND SURGERY. few in our inidst of whom we expected better judgnent. It surely cannot be fear of the impurity of vaccine lyinph at this advanced stage of serum therapy that is causing so imany protests against coimpulsory public-vaccination. From the Chief Magistrate down to certain -of those clever ones who compose the Boa.rd of Deliberators who decide in conclave solemn wvhat is best for the Young Idea, the plural of him, of course, who attends the public schools, all have something to say. A few medical men, very few indeed, hold the idea that vaccination is injurious and lias resulted to the physical injury of the subject. In some instances this may aiave been true in past years, but at the present time the great mass of the medical profession can give clear, strong evidence of the greatest good to the community at large by compulsory vaccination. Surely the opinion of the entire ethical medical profession, with a few exceptions, should be a sufficient guide to the people of this city. His Worship, for \" his credit's sake,\" should lend bis influence and encourage the vaccination of \"the Kids,\" lest the plague be not stayed and the fair face of young Canada be narred and deprived of its original comeliness. As to this latter subject all depends on th'e point of view, of course. An old Irish. wornan looking at a man who was occupying a prominent place anong his fellows, overheard a remark of syipathy expressed by a passer-by relative to the way the man's face was \".pitted \" by the ravages of the sinallpox. Sie remarked, \" Arrah, darlint, carved work 's the dearest.\" W. l. Y. ADMINISTRATION OF MEDICINES OR FOOD BY THE NASAL PASSAGES. WE notice in Le Pr'ogr'ès ledical an article by Dr. Salomon, in which lie recommends the nasal route for iedicine or food, when either the one or the other cannot be administered by the mouth without diffliculty, violence or danger. The subeutaneous and rectal routes are not always satisfactory, and we regret our inability to reacli the stomach without the assistance of the tube. The introduction of this instrument is sometimes very difficult, and is not always a harnless proceeding, even in the hands of experienced practitioners. Dr. Salomon has been in the habit, for the last twenty years, of introducing liquids into the nostrils of patients with a teaspoon. The patient is placed in the dorsal position, the head thrown back- 183",
         "THE CANADIAN J OURNAL OF wards and steadied by an assistant if the patient is excited, or sirnply held by one of the physician's hands if quiet. To facilitate the introduction of liquid, a 20 per cen',. solution of cocaine imay be applied as deeply as possible to the interior of the nasal fossa\\. Dr. Salomon continues: \" Having plugged one of the nostrils with cotton wool, you place a, teaspoonful of the liquid y.ou wish to use in front of the other nostril, and, waiting for the beginning of an inspiration, pour it into the nostril by raising the handle of the spoon.\" The 'l falls behind the glottis, and in passing over the pharynx, excites the moveinents of deglutition, which carry it on to the stonach. This nethod gives excellent results in the apoplexy of paralytic patients, in attacks of hysteria or eclampsia, when the patients are obstinate or delirious, in lunaties 'or in chil- dren. It does away with the active or passive resistance of a patient who cannot or will not open his nouth, or refuses or struggles against the introduction of the stomach tube. Death results occasionally fron suffocation during the introduction of the tube. Injections of beef-tea and milk have also occasionally been made into the bronchi by an inexperienced hand, without ien- tioning the heinateinesis caused by inopportune pressure of a stiff tube on an ulcerated stomach. A liquid introduced by the nasal fossS never causes an attack of suffocation. Dr. Salomon claims to have administered Gernian brandy, without provoking spasni or cough, all owing to the fact that, as the liquor did not touch the epiglottis, no excitation of this organ 'was caused. He also claims that disagreeable medicines imay be administered by the nasal route, as the nerves of tast:e are not disgusted, the substance used being only subjected to the scrutiny and appreciation of the olfacetory nerves. Dr. Salomon contends that it renders great service in dealing with children, and that nurses should be taught to use it. Physicians are thus relieved of the inconvenience of passing the stoinach tube for their patients, while at the saine time the latter receive all that bas been ordered for them. Physicians are familiar with the excuses given by nurses in some cases, \" We could not give the medicine because the patient would not open his mouth or spat it out of his mouth.\" The only objection which can be raised against this method is that at first sight it is slow and seems insufficient to provide proper nourishment for a patient. Certainly it would not be proper to introduce through the nostrils several quarts of beef-tea every day, but quality can be made to supplement quantity, by introducing in",
         "MEDICINE AND SURGERY. a small volume food whicla will nourish a patient sufficiently, e.g., yolks of eggs beaten. up with milk. The operation can be donc in a few minutes. Dr. Salomon, who does not claim originality in utilizing the nasal route for food and medicine, siiply desires to extend the use of his method among physicians who will often derive benefit from\u0026 its employnient. J. J. c. 1S ICE-CREAN A FOOD? lRE\u003cENTLY in a case brought before a Toronto court, a medical witness contended that ice-cream was not a food. The principal reason offered for this opinion was that the consumption of the congealed delicacy took away appetite. The judge objected to the force of this reasoning, and remarked that the eating of beef- steak was followed by similar results. If by the term \" food \" we mean animal or vegetable substances eaten for nourishrment, then ice-cream is an agreeable and nourishing food. Properly made ice- cream consists of cream, imilk (usually two parts by measure to one part o. cream), eggs, sugar, and sone flavoring extract. These ingredients are congealed in a freezer; hence the name ice-cream. As anyone will acknowledge, the nutritive value of good ice-cream is therefore very high. It is quite truc that- its chilling character may prevent dyspeptic persons from eating it, and even those blessed with a robust digestion may prefer w'armer food; but ail the same the nutritious qualities of ice-cream are not lost by corigelation. Personally, we know of a Toronto belle who, during a brief visit to Rochester, was said to have lived on ice-cream and sponge cake. Some years ago we attended a lad, one of whose fingers had been crushed in an ice-cream machine. Chiloroforni was adininistered and a portion of his finger amputated. During anesthesia the patient exhibited signs of collapse, which dis- appeared after he had vomited a large quantity of ice-cream. He subsequently explained that having no other lunch he had to depend on his employer's ice-cream for the mid-day meal. Usually, of course, people who eat it have partaken of cooked victuals and want sonething cool and sweet for dessert. - It does not on that account, however, cone under the same category as iced drinks. If by the tern \"food\" we were to understand \"an aliment, which itself is sufficient to sustain life,\" even léan ineat could not be classed as a food. Pavy's experiments prove that two rats, 185",
         "THE GANADIA1N JOURNAL OF weighing 12 oz., fed on lean meat and \\ater, reinained healthy in appearance but steadily lost weighb, and in a nontl's time veighed only 81 oz. In another experiment two rats, weighing together 12 oz. 7 drs., were kept on a meat diet exclus'vely. On the thirteenth day one of the rats died. the weight of its body being 2 oz. 8 drs., and that of the other 6 oz. 3 drs. The live one was still restricted to the sane food and died ten days later, the. weight of its body then being 5 oz. Now, no medical witness would con- tend that lean meat is not a foni. And further, it would not cease to be a food even if it were frozen. Ice-cream, however, is not in the same category as lean ineat. On the contrary, it contains not one but all the eleinents of a complete diet. We therefore cousider that it is a food, the only objection to its -use being that it is congealed and may possibly in jure the digestion of some persons. J. J C. DOMESTIC SCIENCE IN CANADA. THE Canadian girl, nowadays, bates to be a \" donestie,\" even in a mansion, and for good wages; but her renunciation of work, which is well paid for and suitable to ber sex, while indicating a desire to rise in society, often proves a detriment to her bodily strength and adds little to her stock of useful knowledge. And when she does gain the object of ber ambition, and poses as a saleslady or office clerk, so that she need not soil her fingers with the preparation of food, she does not really elevate herself in the opinion of sensible people, some of ber sisters to the contrary, of course. The abandonient of domestic service by women in Ontario has reached an acute stage, and bas already caused embarrassments in the management of niany households. Families will be placed in the awkward position -of boarding out, or ebe the ladies will have to do their own domestic work. Looked at fron the standpoint of the latter alternattive, the opening of a school of Domestic Science at Efanilton is a happy omen. The young ladies of Canadian households, with that natural cleverness and adapta- bility which belong to highly endowed natures, have already, in many instances, performed their parts in the parlor and the kitchen. There are, to-day, in Toronto, hundreds of homes wheie everything that meets the eye is \"as neat as a pin.\" and where the cooking is not to be despised, yet t1he ladies of the house, who do the work, never attended a lecture or witnessed a lenonstration at *a School of Domestic Science. 186",
         "MEDICINE AND SURGERY. till, we approve of the study of Domestic Science, and we hope that it will fill up some lacuno, the bridging of wvhich obviates domestic storms. By all means, let Canadian girls learn conprarative anatomy, physiology, cheiistry, hygiene, etc. The study of these subjects, particularly in their applied foris, will lend an air of dignity, in a display-loving age, to the very necessary, very decent, and never-to-be-despised preparation of our daily food and the cleansing of our homes. And when the \"sweet girl graduate \" becomes a wife, may she, unlike Rebecca, who served up goat's flash instead of venison to Isaae, be content with lecturing her good ian on the -vane-of -proteids, the dangers that lurk in carbohydrates, the sad results of eating the dunplings his mother used to make, and the arbistic superiority of ragoût à la Hamilton to Irish stew. J. J. c. EDITORIAL NOTES. International Congress of Hlygiene.-We notice in the Gazette Milédicale de Paris that Surgeon-General Sternberg vill represent thie Tnited States of America at the International Congress of Hygiene, which is to be held this year at Paris. We hope to be able to announce in our next issue the appointment, of a Canadian representative to this meeting of distinguished hygienists. A Fecund Cannonade.-A Boer journal of Vryheld tells a conie yarn which will bear repetition in a medical journal, as it shows the influence of terror on the animal organirn. A battery of artillery wishing to have some .practice with the guns, the offlicers bought fifty goats and had them tied on the top of a kopje. Aftr-r bombarding them for an hour or so the officers went up the hill to count the surviving goats and found fifty-one ! One of the goats had dropped a kid. Destruction of Larval Mosquitos by Coal Oil.-Dr. Laveran says that the destruction of inosquitos in the larval state is more easily accomplished than when the insects are full. grown. -The work is ecsily done by pouring a little·coal oil over the surface of the water. If equal quantities of coal oil and ordinary oil are used, the former is' the mor, effective. The larvæ are destroyed because droplets of coal oil penetrate their tracheS and asphyxiate theni.",
         "THE CANADIAN JOURNAL OF Aspirine a Succedaneum to Salicylate of Sodium.-Aspirine, which has been tried in the service of Professor Leyden, of Berlin, by Dr. J. Wolgesinith, is an acetyl-salicylic acid obtained by the action of acetic anhydride on salicylie acid. It is a crystalline sub- stance of a whitish color, which dissolves slowly in water at 98° F., in a proportion of 1 t'o 100 parts, and casily in alcohol and ether. It is scarcely at all acted on by th' gastriejuice, but in the intestinal juice it breaks up and liberates salicylic acid. Its action in rheumatism is similar to that of salicylate of sodium, but it lias an advantage over the latter in the fact that iL does not cause loss of appetite and does not disturb the stomaeh. It is given in cachets in doses of one gramme three times a day. International Congreås of Medical Electrology and Radiology. -At the request of the French Society of Electrotherapy and Radiology, the International Congress of Medical Electrology and Radiology, the initiative of which it lias taken, is connected to the International Congress of 1900. A Commission, which is composed of: Messrs. Weiss, Professor at thé University of Paris, President; A postoli and Oudin, Vice-Presidents; Doumer, Professor at the University of Lille, General Secretary; Moutier, Secretary; Boisseau di Rocher, Treasurer, and of Messrs. Bergonid, Professor at the University of Bordeaux; 'Bouchacourt and Branly, Pro- fessors at the Catholic Institute of Paris; Larat, Radiguet, and Villemin, Surgeons of the Hospitals of Paris; has been asked to assure its organization. This congress will take place in Paris, from the 27th of July to the 1st of August, 1900. All inquiries for further information inust be forwarded to Prof E. Doumer, General Secretary, 57 Rue Nicolas-Leblanc, Lille. Applications for membership are to be sent to Dr. Moutier, Il Rue de Miromesnil, Paris. Thirteenth international Congress of Medicine at Paris.- The thirteenth meeting of this congress will take place in Paris, August 2nd to 9th, 19U0. The Executive Committee makes the following announcement to the members of the medical profesbioi in the columns of the Gazette Medicale de .Paris: (1) A reduced rate of 50 per cent. will be grantd on French railways to members of the Congress on presentation of a leaflet which will be mailed directly to each member. The leaflet will be valid for one montli, from the 25th of July to the'25th of August. (2) Arrangements for lodgings have already been. made by the Committee with the 188",
         "MEDICINE AND SURGERY. chief agencies for lodgings and voyages of Paris. To become a imeimber of the Congress the admission fee, S5.00, should be sent to the oflice of the Gazette Meldicale de Paris, 93 Boulevard Saint- Germain, Paris. The chief editor of that journal, Dr. Marcel Baudouin, will attend to all such applications. The Executive Comnittee has also issued a circular to the profession in Canada through their secretary, Dr. J. F. Loranger, of Montreal, giving the terms of membership and the naines and addresses of the secretaries of sections. Dr. F. N. G. Starr is the Secretary for Ontario, and he is prepared to receive the fee and issue the membership card to any physician who may desire it. Members,-when remitting, should state the special section to which they wish to belong. Communications with regard to papers (title) should be sent to the secretary of the particular section to which they belong before the 1st of May, 1900. Salicylate of Sodium in the Treatment of Orchitis.-Dr. R. Romme, in La Presse iliedicale, writes an articlc on the use of salicylate of sodium in gonorrheal orchitis, which has been advo- cated by Dr. Picot and other physicians. He advises a preliminary purge with 40 grammes of sulphate of magnesium or sulphate of sodium. The dose which seems to be sufficient is one gramme of the salicylate of sodium four times a day. The patient is confined to bed in th- horizontal position, his scrotum being supported on a pillow or a small board covered with wadding. In simple orchi- epididymitis, in which there is no notable effusion into the tunica vaginalis testis, nor swelling with pain in the spermatie tord, the happy effects of salicylate of sodium appear very soon. The testicles become less tender, are reduced in size and become more supple, and the skin over them becoines less heated and red. If the preparation. is continued, improveiment in the patient's condition beconies still more apparent. In four or five days it becomes difficult to tell the diseased from the sound side; on palpation, Îiowever, an indurated spot eau be felt in the epididymis, which persists for a considérable time. Treatment in simple orchitis lasts eight or ten daysi and the patient suffers very little pain. When there is a large effusion into the tunica vaginalis testis, or an effusion into the spermhatic cord (funiculitis), salicylate of sodium is less efficacious. In sdch cases it is necessary to use concurrently the unguentum hydrargyri combined with belladonna, so as to promote absorption of the iniflammatoryuexudation. Relapses should be treateel by a resump- tion of the salicylate of sodium. In case-of a relapse lue to constipa- 189",
         "THE CANADIAN JOURNAL OF tion, 40 grammes of the sulphate of sodium or sulphate of magnesium will act promptly in removing the disease. Advertisements of Abortifacients.-Advertisements similar to ·the following frequently appear in Caiiaciian jour-nals of otherwisc high standing: ARRl stnigI ou arc irrogular or ED troubleid with sup) res- MAoRRIED Siod, to c \"t = N ox J81, Bridgeburg, WOMEN t., and she wll send you the formula that winl relievo the worst caso in two to flvo days. No in drTsof rccoipt ioas rought happiness to iinrd faniisu woinn. A case recently tried in England (R. vs. Win. Brown et al.) lias resulted in the conviction of five persons who had b3een the advertisers of \" female medicines.\" The remarks of the presiding judge are worthy of publicity and should be of interest to \" proprietors, editors and printers \" of newspapers in Canada who make public these advertisements, as well as the advertisers them- selves. The Britislh Medical, Journal gives the following in its report of the proceedings Mr. Justice Darling in concluding his judgment said, according to the report in the Times: \"This crime was rendered possible because newspapers accepted advertisements of this illegal business. It was desirable that it should be known that any.one who incited, by whatever means, a person to- commit crime himself committed crime. The jury bad found by their verdict that these advertise- ments were incitements which were used by the men on whom lie had passed sentence to the crime of abortion. If any advertise- ments wvhich incited to this or any other crime appeared again, the proprietors, editors, and. printers of the nevspapers which made them public, would deserve to find themselves--and if any words of his had. any influence with the treasury they would find them- selves-in that dock; and although they pointed out no parficetdar means for the commission of the crime, if the jury found that they did incite to crime, they would probably receive a more severe sentence than that passed in this case.\" Dr. J. N. E. Brown Married.-News has reached the city that Miss Alice Freeman, wrho was formerly editor of \"Woman's Empire,\" in The Empire, and known as \"Faith Fenton,\"' was married at Dawson, on New Year's Day, ·to Dr. J. N. Elliott Brown, Territorial Secretary and Clerk of the Yukon Council. John, old boy, we congratulate you. 190",
         "MEDIGINE AND SURGER1Y. Obdtuary. THE. LATE SIR JAMES PAGET. Er the death of this eminent surgeon, perhaps the leading English surgeon of his day, the medical world bas suffered what may well bc termed an ireparable loss. Although Sir James retired some years ago from active practice, and latterly had been but seldom seç.n in public, he continued to the last to take a keen interest in ail that concerned the profession. At the time of his death, the 30th of last m.onth, he was Sergeant-surgeon to Her Majesty the Queen, Surgeon to H.R.H. the Prince of Wales, and Consulting",
         "THE OANADIAN JOURNAL OF Surgeon to St. Bartholomew's Hospital. He was D.C.L. of Oxford, LL.D. of Cambridge and Edinburgh, Vice-Chancellor of the Univer- sity of London, Honorary M.D. of the University of Dublin, and Member of the Institute of France. He was a Fellow of the Royal Society. In 1871 lie accepted a baronetcy, and in 1875 he was elected President of the Royal College of Surgeons. He also enjoyed the distinction of having been president of the first medical congress held in England. Both as a man and as an eminent surgeon lie was regarded by his colleagues with unbounded reverence and admiration. Although bounteously endowed by nature with many sterling qualities and exceptional gifts of the highest order, the greatest of bis characteristics was his astounding capacity for work, a capacity which lie chiefly devoted to profes- sional subjects. From. the beginning of his career lie occupied himself almost solely with the study of inedical science, and took but comparatively little interest in questions not directly germane to his profession.-The ifedical Review, London, January. [We acknowledge with thanks. the loan from the efdical Review of Reviews, of New York, of the half-tone of the late Sir James Paget.-ED.] Dr. J. M. Corbett Dead.-The medical profession of Ontario received a terrible shock, on January 31st, on receipt of the news of the sudden death of Dr. J. H. Corbett, one of the oldest and most highly respected residents of Orillia. Dr. Corbett was the senior physician of the town, and had 'ived there from early man- hood. He was not only respected by every one, but loved by very *many. He was a staunch Conservative, and an active and devout member of the Church of England. .He leaves a widow and ten daughte'rs, four of whom are married. The Late Sir Thomas Grainger Stewart, M.D., P.R.S.E.- The death is announced at Edinburgh, on February 3rd, of Sir Thomas Grainger Stewart, M.D., at the age of sixty-one years. Sir Thomas was physician-in-ordinary to the Qneen in Scotland, professor of the practice of physie and clinical medicine in Edin- burgh University, consulting physician to the Royal Hospital for Children, and to George Hcriot's Hospital; late president of the Royal College of Physicians of Edinburgh, and an honorary president of the Tenth International Medical Congress at Berlin.- N. Y. Med. Jowtr. 192",
         "MEDICINE AND SURGERY. BOOK REVIEWS. 'ie Liternational Text-Book of Surgery. By American and British authors. Edited by J. CoLwNS WAanttuu, M.D., LL.D., Professor of Surgery in Harvard Medical School ; Surgeon to the Massachusetts General Hospital; and A. PEÀnos Goum), M.S., F.R.C.S., Surgeon to Middlesex Hospital ; Lecturer on Practical Surgery and Teacher of Operative Surgery, Middlesex Hiospital Medical Sehool ; Member of the Court of Examiners of the Royal College of Surgeons, England. Vol. I., General and Operative Surgery, with 458 illustrations in the text and nine full-page plates in colors. Philadelphia: W. B. Saunders, 925 Walnut Street. 1900. Price, $5.00.. Toronto: J. A. Carveth \u0026 Co. There is no science which, owing to the wonderful strides inade in it almost, one might say, from day to day, is in such a transitory state as that of \" The Principles and Practice of Surgery.\" There is hardly a month in which sonie considerable step forward is not made in this department, so that but a short tiime nust of necessity elapse before a work on surgery becomes more or less old, reoutiring the compiling of soinething new in order to keep up with the general a( \"ancement. It is a welcone we extend, therefore, to \" The Interna- tional Text-Book of Surgery,\" as even after a somewhat cursory perusal we feel sure that it will receive an exceedingly warm reception at the hand, as well as froin the pockets, of both American and English practitioners. Aniong the contributors to this book are such well-known men as J. Bland Sutton, W. G. Spencer, Maurice H. Richardson, Rushton Parker, Chas. McBurney, J. B. Hamilton, J. Chalmers Da Costa, and last, but by no nieans least, I. I. Caieron, of Toronto. The work, as a whole, is thorough and complete, enibracing general and operative surgery in a nianner which cannot but be endorsed by the staunchest of critics. Nir. I. H. Caneron, of Toronto, deals at sonie length with \"Surgical Tuberculosis.\" He states that all periods of life are subject to tuberculosis, but that the surgical aspect shows itself largely in childhood, the strunous glands and bone and joint affections occurring most frequently in this period. The bacillus tuberculosis nay pass froni the mother to the fetus in utero, giving rise to a peculiar susceptibility by the tissues of the body to the tuberculous irritant, thus affording a favorable nidus for the development of the germ. The writer states that the route by which the tubercle germ most frequently enters the systen is the respiratory passage, the nost likely vehicle of the contagion being lust, infected with dry sputumn. The author lays stress upon the maximum anount of sunlight and pure air as being most important in the general treat- ment of the disease. Amongst the drugs which are nost serviceable, are iron, nmanganese, quinine, strychnine, iodine, chlorine and phosphorus, vith their potash, soda and lime salts, creasote and guaiacol, cod-liver oil and ichthyol, protonuclem and methylene blue; but Mr. Cameron adds \"any or all of these in the absence of the trinity, free air, free sunshine ahd.fre nutrition, are broken reeds indeed.\" The author deals vith his subject under several headings, and takes up separately (1) tuberculosis of skin and mucous nenbrane, (2) tubercu- lous lyiphadenitis, (3) buberculosis of the serous membranes, (4) tuberculosis of tendons, tendon sheatls and muscles, (5) tuberculosis if muscles and fascio, (6) of the genito-urina'ry organs, (7) of the prostate, vesicul seminales, testis, epididytmis and vas deferens, (8) of the bladder, (9) of the kidney. 193",
         "TI-JE CANA DI AF JOURNAL OF Another of the chapters which gave us peculiar pleasure to read carefully vals that on \" Operativu and Plastic Surgery,\" by J. Ucllins Warren. In this section the author commences by discussing the iiml)ortanlt subjec; of instru- ments, advising w'hich tools had best be enployed for the perfori iiice of the best w(ork. After sliortly referring to Sutures and Ligatures, the 'teChnliqiue of Dissection and the Arrest of Bleeding, Dr. Warren goes into the ligature of hie varions arteries of ta body, from the innominate to that of the dorsalis p\"dis atnd poiterior tibial. The author devotes thirty pages to discusingthe dif- ferent amputations, illustrating his text witlh solle very clear and distinct cuts, and then takes up the vario s joint excisions. Twenty pages are given over to Osteotomlly, als' beautifully illustratecd, and the balance of the article to Plastic Surgery. This section of Dr. Warren's and the one by Mr. Ciameron on Surgical Tubierculosis \" are alone worth the snill price of the book, and we don't mean 11-o be rtereofyped in expression wlen we claim that Mr. Saundern is to be congratulated upon the we-rk, and feel sure thaù 'le will secure for it a very large sale. 'lie Ameri*aa Yc«r-Book of Medicin and Sargery. Being a yearly digest of scientific pri gress and authoritative opinion ini ail branches of Medicine and Surgery, drawn from journals, monographs and text-books of the leadîng Anerican and foreign authors and investigators, collected and .arrangel with .criticail editorial comments by- Sanuel W. Abbott, M D. Wyatt Johînston, M.D. Archibald Church, M.D. Walter Jonen, M.D. Louis A. Duhîring, M.D. David Riesman, M.D. D. L. Edsall, M.D. Louis Starr, 1t.D. Alfred Etînd, Jun., M. D. Alfred Stengel, D. Milton B. Hartzell, M. D. A. A. SteveD.s, M.. Reid Ilunt, M.D. G. N. Stewart, M.. Reynold W. Wilcox, M.]). I. M. Baldy, M.D. ftovard F. Hansol, M.]. Chas. R. Burnett, MM. Barton CooD.e lîrst, M.D. J. Chalners DaCosta, M). E. Fletcher Ingals M.. W. A. Newman Dorland, lA.D. W. W. Keen, Wl.D. V. P. Gibney, M.D. Henry G. 01db, l.D. 0. A. Hamiaun, 2M.]). Wendell ]Rober, Miý.D. I. Rlton N Daaterin de, sa. M.. un1er the general editorial charge of GEoAre M. GOULD, M.D., iii w sepaî'ate volumes, one on Medicine a Ad one on Surgery. Phiadephia W. 13. Saunders, 925 WaGiut Street. 1900. Toronto MJ. A. t\u0026. Ce. Price, 93.00 a volume in cloth ; 3.75 in half inorocco. WVe trust that wlien ive say that ive iwelcoine once more to our library shielves -'Tie Anerican Year-look of Medicine and Surgery \" we ivi1o net, under- stood as desiring te use a stereotyl)ed plîrase-iet at ail. We welcone the o . ecause of its m n t, and especially this year on account of U.D publiser dotirg the lgppy idea of dividing the ork E tOE two voluMes-,ione o Medicine, the oneer on Surgery. There are unany men whe, in the past, oild have purcased the book ad it not been for the r fact i :at te wJ. k AC as to gencral a one for theni. elysiaians arec naturally suprely uiterestelv e iedicne, w ereas surgeous on the ier and, cannot often occupy tbeir sder- book because ~ ~ ~ ~ ~ ~ ~ ,l of its, meiadepcal hsya nacu t f s th puliher tiae perusing heapter after chapter, d i i ich, thoug o two t ivumes teonen is not exactly a part of tleir days ork. We tlin , therefore, that te pub- ishing uhsed vil fi d a largely increased sale for the work i wa 100. Etoo volume this year is just the right size for easy reading, consisting of between 500 and 600 pages. In our caption we have given the list of namles of the collaborators of aci volume, the first, that of the volume on Medicine ; the second, that of Surgery. We are nucli pleased to find that our friend Wyatt Jolhnston, of Montreal, is a contributor to the volume on Medicine. His airticle consists of a chapter of nearly twenty pages on Legal Medicine. We only regret tlat it is not double, yes, triple, the length, as the subject is one vlicli 194",
         "MEDICINE AND SURGERY. tiie autho1r is vell able to treat of in its every detail. Dr. Jolhnston discusses froim a mledico-legal standpoint sucli points as the cause and varieties of rigor iortir, subpleural ec hynwses's ini death froin primnary leart failure, edem.a of tl laryngeal folds in innersed bodies, death froin tetanus, imedico-legal path- olgy of brain injuries, diflerential diagnosis of traunatic and spontaneous cerebral Ieiorrhaîge und ulcer of stomach caused by trauma. He0 closes tho chapter with a page or two on Toxicology. The section on Cutaneous Disuases and Syphilis is contributed by Louis A. Duhring and Milton B. Hartzell, of Philadelphia The plates illtustrating lichei planus, liommyoma of th le of the fice, lupus vulgaris be'foro and after treatient are excecdingly good. The ollusions made to Finseu's photo therapy and the therapeutic application of the X-lRay are exceedingly interesting. In writing of internal reinelies in the treatmnent of skin diseases, the authors refer to the use of yelliow oxide of »nercu.ry ointment, the use of pulvis cuticolor, naftalan, casein ointimenc, dry calcium sulpho-lhydrate, xeroformn, kresanin, tannoform, and egg alhu'nen. The chapter on Dermatology, as aIl the other sections are, is short, succinct and to the point, dealing abnost entirely with what is most alvameed in the dernatological world. In the volume on Medicine other chapters are contributed on Pediatrics, Pathology, Nervous and Mental Di:ases, Materia Medica, Physiology, Public Hygiene and Physiologic Chemistry. Tlîe volume on Surgery consists of sections on General Surgcry, Obltet-rics, Gynecology, Orthopedic Surgury, Ophthahnology, Otology, Diseases of the Nose and Larynx, and Anatomuy. We read with great satisfaction tHe section by I. Montgomery Baldy and W. A. Newman Dorland on Gynecology. The few pages on Perineorrhaphy are specially good, plates 3, 4 and 5, illustrating this subject splendidly. Thougli the volume on Surgery is of a more eneral character than that on Medicine, yet it icomlete and in every respect up)-to-date. The -work as a whiole is a credit to any publishinc house, and Mr. Saunders will, we trust, be amply repaid for the extra trouble and expense he has gone to iv publishing in two separate volumes, by a largely increased sale over that of 1899. W. A. Y. Chr.i;a \u0026ienc. An exposition of Mrs. Eddy's wonderful discovery, includ- ing its legal aspects. A plea for children and other helpless sick. By -W. A. PritnixeTo, Lecturer in the University and Bellevue Hospital Medical College, etc. New York : E. -B. Treat \u0026 Co. 1900. We welcomie Mr. Purrington's book as a valuable exposé of the gross alburities of Christ ian Science, and as a pretest against the theory \" that the free righit to worship according to conscience implies the right to connit any act under the pretext of religion which an evil, or erratic \"-(wre may add, or covetous)-' mind nay inspire.\" The first chapter is an answer -to the questions, \" What is Christian Science )\" and \" What are its Legal Aspects ?\" In the second the author quotes from Mrs. Eddy's books, 'to show sonething of the life, pretentions, meth'ds and literary output of this remnarkable woman, leaving the reader to jud!te, from lier own words, whether she is, as lei partizans assert, learned, modest, trutihful and generous ; or, as lier adversaries declare, ignorant, irreverent, boastful and greedy.\" The succeeding chapters treatig t f \"-Manslaughter and the Law,\" \"Christian Science before the Law,\" are very interesting and instructive. The rulings in sone of the cases cited are very curious. I one, where deceased, beyond reasonable doubt, lost his life by defendant's unskilful treat- ment, the defendant vas acquitted because of his ignorance and because it was not proved that lie had killed others by his treatment. This extraordinary ruling was, however, reversed in the case where a man who leld iinself out as a physician, killed a woman by keepinig lier for three days swatled in flannels saturated with kerosene. Here the court ruled, sub- stantially, that the standard as to what constitutes criininal recklessness, is not gauged by the actor's lbelief or idea of danger, but by comnon experience. The Jury founxd th'at the kerosene was applied as the result of foollhardy presuîmption or gross negligence.",
         "THE CANADIAN JOURXNAL OF The anthor argues that whether the treatment was positive or negative ouglit to manke no difference, as \"ib is just as much homicide to cause death by starvation as to use an active poison.\" The ruling of a Nebraska court, quoted on page 84, seoms to be good, common-sense. The defendant in this case was a Christian Scientist. Wlhen asked if lie took pay froin his patients he replied.that he expected to be remun- erated, and if the patients \" are not willing to part with the sacrifice themsolves it is not expected that they should reap the benefit.\" \" Considering that defendant described his treatment as one of prayer, this intimation that the answer to prayer would be contingent on the paym ent of the Scientist's fee, apparently seened blasphenous to the court,\" who cited froin the Bible Acts viii. 18-23, and ruled : \" The exercise of the art of healing for compensation, wictlher exacted as a fee or expected as a gratuity, cannot be classed as an act of worship, neither is it a performance of a religious duty.\" The principle underlying this question, as laid down by the Supreme Court of the United States is as follows: \" Laws are made for the governinent of actions, and while thoy cannot interfere with mere religious beliefs and opinions, in so far as they are merely beliefs, not reduced to criminal or dangerouîs practices, are not proper objects of its control.\" Ho y far the State is justified or bound to interfere in Christian Scientists' practica so as to guard the health and lives of its people, is a most important, pressing question. WVe commnend Mr. Purrington's book to the earnest con- sideration of our medical brethren, as containing valuiablo information on the subject. J. U. I. A Tex.t-Biok - of Diseases of Wonen. By COAutEs B. PENROSE, P.D., Professcer of Gynecology in the University of Pennsylvania ; Surgeo'n te the Gynecaiý Hospital, Philadelphia. Illustrated. Trird edition. Revised. Piiladelpia : W. B. Saunders, 925 Walnut Street. 1900. Toronto: J. A. Carveth \u0026 Co. Price, 83.75. This work hias been written for the medical student or the general practi- tioner, who mnay consult a treatise on gynecology for practical guidance when treating the diseuses of womien. The author has not burdened his text witi references te different therapeutic procedures, but, in mnost instances, reconi- mends but one plan of treatment for each disease, avoiding in this way a multiplicity of methods which may be confusing to the reader. This arrangement vill no doubt comnnend the work to students and is really philo- sophical, when one considers that the medical reader is not, in most cases, anxious to know all tha\\t can be written on any one subject, but rather what is essential, and particularly the safest method of treatment. So that aithougli there lias been a rather large issue of manuals of gynecology of late, we are inclined to think that for the reason just given, Dr. Penrose's book is one of the best we have seen. The author hIas also the happy faculty of expressing his ideas in clear, forcible language, probably the result of his experience as a teacher, which adds very nuch to one's villingness to accept ther as true, even when they differ froa one's own. The illustrations, which are quite numneròous, are excellent and the descriptions given of them in the text are full and complete. The caution regarding the use of the uterine Pund (page 37) is appropriate ; a physician in making well-meant efforts te mea.:ure the length of a uterus may inadvertently produce an abo:rtion. The chapters in which injuries to the perineum, the results of laceration, are described, are masterly. The accompanying illustrations in this part, ais vell as in·the chapters devoted to prolapse of the uterus, are alinost as sug- gestive as following the operati.ons de visa. Trachelorrhaphy is well described and the illustrations are nost helpful. The various diseases (benign and nialignant) of the cervix and corpus uteri, of the Fallopian tubes and ovaries, cone in for full and instructive description. One of the nost telling chapters is that devoted to gonorrhea in vomen. As phybicians know, the far-reaching effects of this disease are often followed by resuVs destructive to health and life. Dr. Penrose does not, however, hold 196",
         "MEDIC.iNE AND SURGERY. thaf the iusband is always to blamne for a pyosalpinx or endometritis in the wife, as these lesions occasionally arise fromn abortion or puerperal sepsis. 'Tie persistency with which gonorrhea sticks to the vaginal glands is strongly corroboratcd. Thei writer recalls a case of gonorrhca, which continued infective though carefally treated until cured by an operation in whicli a large part of the right gland of Bartholin and its duct had to he dissected out. The severed tissues afterwards granulated and the excavation filled in. Tho statenient that a nan cannot contract gonorrhea froni vencreal contact with a nenstruating woiman unless she lias conorrhea is probably correct ; but the opposite opinion was pretty generally beioved in, previous to the discovery of Neisser's bacillus. J. J. c. Surgical Anatoami. A treatise on Humîan Anatomny in its application to the practice ff Mediciie and Surgery. By Jors B. DEtvmt, M.D., Surgeon- in-Chief to the Gernan Eospital, Philadelphia. In 3 volumes, with 400 plates. Philadelphia : P. Blakiston's Son \u0026 Co. After twelve years of preparation a man should succe ed in producing an excellent work, and Deaver has succeeded in an cininen degree, for I have before me a beautiful production in its inaterial, in its artiîtic qualities, and in its worknanship. In this volume, on the upper extremiity, the shoulder, the back, the crainium, the scalp and the face, there .re in aP 632 pages, of which 599 are taken up with text and plates (151 in all) and 32 pages in a comprelhennive index. ''ie work, too, is strangely free from the \" Ainerican language \" tha, differs so widely fromîî the \" English language,\" though there are a few terins l, which the fo -mer is apparent. The text is clearly put and in nost instances the description is good, though in somle parts this could be inproved ; for example, that of the brachial plexus. The parts of the book devoted to landmarks, and especially of the relations these bear to subjacent structures, are most useful both to the student of anatomny and to the busy practitioner. Among these is a table giving the relations the vertebral spines bear to the internal organs. r It is unfortunate tlat in a few instances the ends of the lines in sone of the plates do not accurately corre- spond to the parts indicated. This, thougli. may easily be improved uîpon ii future editions. The plates showing the motor areas and the lines of incision for the ligation of arteries and for the stretching of nerves are nost instructive, and will prove to nany a ready reference. A unique part in the discussion of f\"actures and dislocations is the descrip- tion of the anatomical relations of the structures in their displaced position, for this is one of the difficult things for a student to think out. It is gratifying to one, too, to find such a clear and concise account of the \"muscles of the back \"-the terror of the student-for fron this book a knov- ledge of thein is grasped with comparative ease. Througlout the work one finîds considerable attention devoted to a descrip- tion of uuscular actions, and while it iay be better for the advanced student to think these out for linself, yet the average student will not do this, and lience is very naterially assisted. In fact, in the heavy work of a medical course a student somnetimes is prone to forget that lie should do any thinking for hîlimself at all. Such being the case some one else lias to think for him until lie can get time to digest his mnaterial. The publishers are to be congratulated on their production of Deaver's work. F. N. G. S. The Treatneut of Diseas-s of the Nervous System. A Manual for Practitioners. By JOSEPKI CCLLîss, M.D., Professor of Nervous and Mental Diseases in the New York Post-Graduate. Medical School; Visiting Phiysician to the New York City Hospital. Ilustrated by twenty-thiree engravings. New York : Wm. Wood \u0026 Co. 1900. There are. several good works at present on the shelves of or niedical booksellers which deal with and treat of Diseases of the Nervous Systein. Too 197",
         "198 TUE ('ANADIA.N JOURNAL OF imany, however, of the authors of those works have taken too iiuch for granted and bave given credit to the general practitioner foi knowing really more thsaii hie des about this specialty, a subject in whiclh, it must be admîitted, there i;, alas, too lit ts knowledgo amiiong imedical mon who aIe general practitioirs, and who, du not pretensd to asdopt thse uiiore modern idea anid specialize. Dr. Collins, howevoer, in presenting his book to the profession, las given special consideration to thiesù very facts, and though hie hams presmned that the average physician his suflicient knowledge to roongnize the more familiair nervosus diseases, yet lie lays stress upon the most approved current nethods of trestmg nervous diseases, and all through lias succeeded in presenting hiu \u003eubject in sni a inumner thiat we feel sure that hiis book will bu founid to be in the points llnded(- to ahead of others already publishied. A good deal of attention has1 been givenl to the causation of diseases of the nervous eystem. We like the order in which the variouts diseases have beein taken up, the author laving counnoenced hy considering Uiseases of the Brain, including the treatment of the various fsrs of leningitis, Encephalitis. Infantile Cerebral Palsies, Multiple Sclerosis, Tumors of the Brain, etc. After Diseases of the Braini, lie goes on t , Dilsieases of the Spinal Cord, including the treatiment of Acute and Compression Myelitis and Inflammsîation of the Central Gray Matter. Then he tLkes up i isea -s of the Periplheral Nerves, of Lte Symnpathetic Nervous Systeim and Funn. sial Nervous Diseases. Wlle highly approve of the discussion on that altogetiier toc couion :s - plaint, headache, and are glad that so much space has been devoted to it. We like the book very much alnd bespeak for it a very kind reception. . Maua l of .Practice of 3Medicine. By A. A. STEvENS, A.M., M.D., Instructor in Physical Diagnosis, University of Pennsylvania, and Professor of Patth- ology in the Woman's Medical College of Pennsylv'ania. Specially intended for students preparing for graduation and hospital examinations. Fifth edition. Revised and enlarged. Post 8vo, 519 pages. Numerous illus- trations and selected formole. Price, bound in flexible leather, $2.00, ist. Philadelphia: W. . Saunglers, 925 Walnut Street. Toronto: J. A. Carveth \u0026, Co. 1898. ¶iThe fact that il fifth edition of Stevens' Practice lias been produced by the puiblisher would go to show that the Anerican iedical student finds the nui!: useful. As the author says, in the preface to the lirst edition, \" There seemns to be a real need for books which present their subjects in an assimilable form.\" After perusing quite a iumber of the articles in this work we are fair]y in- clined to think that lie lias succceded in his task, and lias presented. the iarsus matters treated of, briefly, but cocgently, giving the pith of the subject without unnecessary verbiage. Perhaps this view of the merits of the work masy be more apparent to a practitioner, who is familiar witlh bulky volumes of the \"Practice of Medicine,\" thian to a student, but the latter's case is certainly more urgent, as lie has to face the inevitable examiner and must possess hTs know- ledge in a compact, but accurate fori. The chapters devoted to Diseases of the Skin and its Appendages vill be welcomed by many, who desire to bave a desk companion whicli covers the general field of practice, excepting the more important specialties. The formule under the head of treatment ae helpful, and fairly represent modern therapeuties. The work is bouind in limp covers, and when opened stays open. The text is of fair size and can be read with ease. A1 System of elledicine by Many Writers. Edited by CLIFFORD ALLBUT. Vol. VIII. New York: The Maciillan Co. 1900. Toronto : J. A. Carteth \u0026 Co., Canadian Agents. The final volume of this admirable series is devuted chiefly tu psyclhsstry ind cutaneous diseases. The suminary of mental diseases, while not exhaustive, still is comprehen- sive, and the various subjects are treated by writers of knoâwn authority in this department of niedicine.",
         "MEDICINE AND SUltGER Y. 199 'he plates iii the clr.pters on skin diseases are not, perh ps, as inerous or as elaborate as one might expect, but the text is ill that cant bu desired. In the openi'ng plges of the volume a section is devoted to Latih, a nervous disease which has oIly recently foiund a place in- vorks of the sort. (iturcli cursurily mentions it by namte, but Dr. Manson's description is the best whici wU bave sein. lI Canîiadt there wvill be a certain anount of interest afttached to this iervous pheniomtîeioi owing to the falct of its frequent occurrence here, especially atmong the Frenich of northern New Brunswick. The writer, vhile spunding the sinmier in that region, wvas made fattiliar with sevoral cases of this condition long before he liad ever heardt it scien- tiiically described, or knuw that it also existed in oriental cointries. The cohabitation of brothers and sisters, like- all consanguinCous unions, seis to tend to degenerations of bite sort amutong the ollpring, and though this practice was usuaîl amtong the ancient Egyptians, and at that tinte passed apparently without comment, the occurrence of the custom in tie locality mentioned, anong the very ignorant, would appear to have bven followed by most unfortunate results. Nearly every lumber camp, we have been told, has its \" jumping Frenchmtuan \" or victii of latah ; and it is to bc hoped that the attention wiich has been recently called to the disease, mnay prove beneficial in its subsequent suppression. E. H. s. Polk s Nedical and Surgica1 Register of the United States and Canada. A corps of mnen is now canivassing for information for the new edition cf Polk's Medical and Surgical IRegister of the United States and Canada. This publication is now so frmttly establisied, so widely known and universally used as to scarcely cal for any comment, ats it lias becotne standard in the profession and is a book of daily reference. It is a complete directory of te medical profession of North Ainerica and all that pertains tiereto. To issue suci a work is a formidable uînertaking, involving a vast amounut of labor, but the facilities of tie Messrs. Polk \u0026 Oc are exceptional. We predict for temu still greater success in the cotming edition, to be issued as early this year as possible, and we clerfully comniend Polk's Register to te profession as an invialutable work of reference. Eaci succeediLg issue has been an improvetment on its predecessor, and we are pronised that tie next nutber shall be as near perfect, as sucli a book can be made. PAJiPHLETS, REPRINTS, ETC., RECEIVED. \"A Review of tie History and Literature of Appendicitis.\" By George M. Edebois, A.M., M.D., New York. Reprint from the 3edical Record. November 25ti, 1899. New York: The Publishers' Printing Company, 32-34 Lafayette Place. 1899. \"The Fourteenth Annual Meeting of te Association of Executive Health Officers of Ontario, ield in the city of London on thie 13ti and 14ti of Septemnber, 1899.\" Toronto : Printed by WVarwick Bros. \u0026 Rutter, 68-70 Front Street West. 1899. \" Merk's Manual of te Materia Medica, togetier with a Sumamary of Therapeutie Indications and a Classification of Medicanieits.\" A Ready Reference Pocket Book for the Physician and Surgeon, containing names and chief synonyms, phtysical forn and appearance, solubilities, percentage sbrengths and phîysioloical effects, tierapeutic uses, modes of adtmin- istration and application, regular and maximum dosage, incompatibles, antidotes, precautionary requireients, etc., etc., of the cheinicals and drugs used in modern meilical practice. Publisied by E. Merck. Datrmttstadt, Gerniany. 1899. All rights reserved.",
         "THE CANADIAN JOURNAL O.F Selected cArticles. l ALKALOÎ'ETRY.* BY A. S. WA1SS, M.D., Professor ot oyiceology, West Side Clinicai school. I hAVE been asked to fill Prof. Waugh's hour, he having been called out of the city for a brief visit. I have selected Alkalonetry, and the reasons for iny conversion thereto will develop as ve go on. Years ago, when I left the University with niy precious sheepskin in my possession, lie lessons of my worthy professor of inateria medica and therapeuties still fresh in mind, I inagined I possessed an arnanentariuin tlhat nothing could circumvent. But hov sad. the awakening ! Hopes were higli, for wasn't eai drug specially studied, labeled, and tacked to a discase it was to cure? Why, disease was to fly before it, as Lie mist does before the morning sun. But did it do it in actual practice as it did theoretically ? And why not? This ' why not \" is what we will now discuss. Have you, gentlemen, ever conside-ed how muci a physician is in the power of the druggist, how much of tie piysician's reputa- tion is in the druggist's hands? Take, for instance, the brightest mnedical mind, a inan of vast learning and erudition, a good diagnostician, in fact a perfect physician, sec him at the bedside of an intensely sick person, the diagnosis at last correctly arrived at, a certain drug or drugs found necessary, correctly chosen and prescribed, what tien? Tie U is taken to a druggist, and there is where our doctor's woe begins, for our druggist happens to belong to that great class of Ph.G's, suffering from a disease known as «substitution,\" the greatest evil of our times, yet a boormerang, as you shall sec. Here I wish to add between parentheses, in all justice and fairness, that there are some wlho have not succumbed, but they are in an awful minority in this great city of ours. Ti .druggist scans the P and finds that either he doesn't keep the drug prescribed or that lie is just out of it, and it is too much bother to order a whole bottle for just one , or that it would take too much timne to get, or lie may. have something that is \"'j us, as good,\" or it may look just as the other stuff, taste like it, in fact could not by either smell or taste (our ordinary means at hand) be * A lecture delivered to the Senior Class at Harvey Medical College. 200",
         "NdEDICINE AND SURGERY. detected; or the druggist nay have a preparation of his own (this happens oftener than one imagine's) tlat he wants the physician to use, nilli ill, wlhether the doctor wants it or no; or better, whether the patient needs it or no; Dnd I will leave to your imaginations the sequel. We seo our physician with his brow furrowed, bending over his patient, watching his fleeting breath, or the patient's heartrending struggles, and wonder continually why the drug lie prescribed is not affecting this patient as he lias been taught, and knows the drug would and should act. Why does his patient show symptoms the very reverse of those he was to expect ? Why ? This is but a short review, gentlemen, of the dishonest druggist, who wilfully gives something else than was prescribed. More, a great deal more, could be said in sharper, louder, in more ringing and cutting words, for substituting is a crime. I place it atong the capital crimes, for nmany a life lias been sent into the hereafter, and the fault thereof rolled on the physician's shoulders. So let us leave him and turn to the honest druggist, vho abhors substituting, w'ho would rather lose an 1 than give soinething not called for. 'How about himi? There are some druggists who inakce all their tinctures and extracts, while others buy them already made. Now what means have these latter to verify the strength of the products they bought? None. They bouglit then on faith, they are selling thei on faith, and on faith your patients are taking them; and , ., quite often, without the desired result. Nowz' again, as to the druggists who make their own tinctures and fluid extracts, how about them ? (mind well we are speaking of the honest druggist). His pharmacopeia denands a certain quantity of a drug, finely divided let us say, a certain nenstruum, of a certain strength and quantity, to be packed in a percolator, and the menstruum permitted to pass through the drug in a certain length of time, which all wvas donc faithfully. Now how about his tinctures, or extracts--surely they are correct. Let us sec: The plarmacopeia demands that the drug shall be of certain strength, that is, that it should contain of the drug- essence, of the active principle, alkaloids in some, a certain quantity. Now what means has he to satisfy himself of the fact? None, absolutely none. He bouglit his drugs on faith, and on faith lie made his products. But faith is often lacking in scientific accuracy. We all know that drugs labeled under a. generie name are not always of a standard strength; the variations are from nit to way beyovd the standard, which is but an accepted average. A great many reasons can be given for this state of affairs. You rnay have noticed perhaps how differently the same kind of plants grow on a com- paritively small patch of ground. The land may not be as ricli in one spot or locality as in another, there may have been too much or too little moistsure during the plant's lite, the climatie conditions imay have been most excellent or the very reverse, with either too",
         "202 THE CANADIAN J OURNAL OF much or too littie sunshine, too much or too little heat, or as it often happens, too great, a variation of temperature, and all thse elements and inany more enter into the life and growth of a plant. Then the plant nay have been barvested too soon, or perinitted to get too ripe on the stem; all these aftct the active principle of the plant; so, mark me, the useful part of the plant medicinally is the active principle, the ailkaloid it contains. Now what means has our druggist to satisfy himself that his drugs contain the exact quantity of the active principle, the alkaloids denanded. May not his fluid extract or tincture be absolutely inert, having extracted only coloring matter 9l some other inert but soluble substances from the drug, and he ai all honesty dispenses an inert substance, vhen be patient's life may depend on the quantity of alkaloid prescribed ? On the other hand, let us suppose our drug is of the best quality obtainable, correctly grown, correctly garnered, dried and prepared; this drug may go to the other exfreme, and contain more active principle or alkaloid than deinaided, what means lias he to verify this ag:in so as to cut it down ? None, again. So he makes his inctures and fluid extracts that are really surcharged with altailoids, inay it ,not also happen to this druggist that bis bottles containing his surcharged preparations, stapiding on bis shelves, gradually evaporate ? Alcohol and water are volatile, and many a stopper does not fit its bottle, and it gradually diminishes in bulk but gains in strength; for alkaloids are not volatile at ordinary temperatures, and his products become twice or even three times as strong as the standard the physician lad in mind when be was prescribing. Also let us suppose that our patient being critically ill, the doutor prescribed. the maximum dose of a standard solution, and our druggist fills it out of his concentrated bottle-well, I need not dwell on the outcome, you may depict it to yourselves. So being bit times upon times in such a manner, for what 1 have recounted, I have actually experienced. I came to the con- clusion that therapy as we usually get it on our 1W is a snare and a delusion; and I turned more and more to surgery, for its results were more tangible and positive. We did not have to depend upon an intermediary person who only had his gain in view, forgetting the irretrievable daniage he was doing thereby, both to patient and physician. As I did not care to place my reputation absolutely in their hîands, I began to prescribe less and less, and only those remedies I had to. There are some large pharmaceutical firms in the U. S. who have, at least claim to have, chemical and analytical laboratories at their factories where each and every drug is tested, and if found ito contain an insufficiency of the alkaloid is rejected, that is, is not bought by them. Now wlhat becomes of this mass of drugs? (I have in my possession a pamphlet where one of these firms makes the claim of having rejected thousands upon, thousands of pounds of",
         "MEDICINE -AND SURGERY. various drugs.) What oecomes of all these drugs ? Why, they are simply niarked a shade lower than current prices and bouglit either by uiscrupulous firns, and their names are legion, or unloaded on some poor honest druggist for hin to work up. Then on the other hand our great pharmaceutical 'irms, who t'est ail their drugs first, make good products, but w'hat vitiates it is that each firm, just to be distinct, adopts a different standard, tleir products are of diflereint strengths, and how is a physician to reimember ail these various strengths ? They disregard the pharmacopeia, claiming to improve thereon, and what happens ? Doctor A- gets into the habit of using only factory X's products, so prescribes, this is to save mental wear and tear- and I don't blaine him-but Dr. B- uses factory Y's products, and so down the whole line; and the poor honest druggist, honest at first, is forced to keep his shelf loaded with the products of every factory, if he wishes to satisfy every physician, an absolute physical impossibility. What occurs then ? Why, it is but a short step to substitute, give some other product, or what is w'orse, his own decoction, and with all that follows. The fault, the crime, lies in the cupidity of every person connected with the preparing and dispensing of drugs, of drugs tliat are hidden under special formulas and trade-marks, from the big manufacturing chemist to the pettiest druggist. But dark as the picture niay look, yet none too darkly painted, we haçe the remedy at hand, and here il. is: It has been known for ages that the inedicinal value of plants lay in certain fixed principles, to get which various other products were extracted perforce from the plant, such as coloring matter and inert substances, that gave to the preparation its taste, odor, etc., but were useless. Often two or more active principles were found in one plant, often antagcnistic to -each other and at times affecting the constitution differently, one beneficiaUly and the other imayhap the reverse, and yet the methods employed of percolation, extraction, etc., did not take this under consideration, and could not separate them. Hence large firms sprang into existence w'ho undertook to put upon the market the active principles, singly as far as possible, of ail drugs, and allow you to combine them as suited to each case. This was advance indeed, as great as any made in other lines of medicine, and so was born the remedy for the abuses I have mentioned. Yet other evils will be nentioned before we are tlrough. Alkaloids and active principles bougit in bulk from the factories were not available to the busy practitioner, especially of drugs where an infinitesimal quantity was needed. Nor do they make very appetizing or sigltly draughts in that form. This gave me a great deal to think I found that homeopathy would long ago have died, been buried and forgotten, were it not for the fact that the remedies they gave were so pleasant to take. And here is the main secret why, in s eite of al the fallacies on which t iat seool 203",
         "THE CANADIAN JOURNAL OF is based, namely, such as these, the cardinol ones: \"That ail ailinents without exception from ingrowing toe-nail to a case of apoplexy were due to the 'itch'!\" \"that like cires like,\" that is, if an attenuation of a drug given to a healthy man produces colie, a greater nttenuation will cure a colic in another man; and finally \"tIat the higher the diution, that is, the more init-nitesimal the anount of dbrug, the more potent the 'renecdy,\" the potency inay h-ecome so great that it may become entirely too strong for the patient to take. This is the tripod upon which homeopathy was built, and as I have said, its survival is chiefly due to the case and pleasantness with which their remedies or lack of remedies may be taken. Having cone to this conclusion I cast about for some means to meet them on their own ground, and this I found at last in \" Dosimetry \" or \" Alkaloidal Medication,\" and further I made the discovery that we lad in our very midst a factory that prepared these drugs in so palatable a forn that conpeting with our humeopathic confreres became an easy natter, and one which at the same time elininated the druggist evil, for it enables us all at a very small outlay in money and time to be our own druggist. Now the benefits accruing nust be great to induce a physician to oive time andi money, yet let me assure you it more than repays. Tie physician's brain being his stock-in-trade, the patient lias only la right to as much of it as he pays for, that is, as nuch as will take to reheve his ailment for which lie consults his physician. . Beyond this lie is using what doesn't belong to hin, and is to that extent stealing from his doctor, as the following will illustrate: A patient came to me on account of some piles that annoyed hiim a great deal. I proposed operation; lie was not ready, lad no time, etc., so I gave hii a salve for the tine being to relieve his suffering. This salve not only relieved but actually cured hin; and so pleased was he with the effect that le had the druggist give him a copy of the prescription, which lie gave to every friend that suffered with the same ailinent. * Sone months later, meeting him on the street, lie greeted ine with this remarkable address: \" Why, doctor, that salve you gave me was a cracker-jack. It cured me entirely, and I have given a copy of it to at least two hundred of my friends, and it hasn't failed in a single instance !\" This was donc by a friend in the fulness of his heart, who did not sec that lie was robbing his physician, his benefactor. Sone years ago, when influenza was claiming its greatest number of victims, a patient vho was lef\u0026 with a cough received a prescription for a syrup. It cured him and it also made the round of friends who needed such a syrup. The same druggist, puttingI up the syrup a number of times and hearing it lauded generally, conceived the idea of putting it up wholesale, which he,-did, and simply flooded that part of the country with it, under a copy- righ ted name, using my very patients in his pamphlets and printed matter as references. 204",
         "MEDICINE AND SURGERY. Further, substitution is absolutely eliminated, and you know positively what your patient is receiving, to a fractional part of a grain; you know what you are to expect, or should expect, from your medication. In acute cases, having your medicines with you, you may begin medication at once, losing no time, time which often is valuable and which is invariably lost if the druggist's assistance is needed. This is done chiefly to impress the buyer of the difliculty the druggist meets in compounding the là, hence the price asked is \"not half what it ought to be,\" etc. You leave just suficient medicines with your patient to last him till your next visit and no more, and rest assured, your next visit will be welcome to replenish the remedies if nothing more. You raise yourself in his esteem by demonstrating to your patient the thorough mastery you have over drugs. They have more confidence in you, and your reniedies have better effect, especially when the first few doses are given by yourself. Large drug bills are saved, and this is an important item to the physiciau, for money thus saved is likely to be used in paying the doctor's bill. Then you have the satisfaction of knowing that his prescriptions are prepared just as he wishes to have them. The use of inert drugs, inistakes of compounding and giving the prescription to the wrong person, are. things of improbable occurrence. When the physician is also the dispenser, copies of his favorite prescriptions are not passed through the community and refilled for the beneit of the druggist and of the neighborhood; neither are his prescriptions scrutinized and commented upon. His daily business, represented by the number of prescriptions he writes, is not a subject for drug-store conversation. The nature of his patient's sickness is not exposed, and the family is ni) longer subjected to such questions as \"w bat is the matter ?\" or \"vho is sick 2\" delicate questions under some circumstances. In short, the doctor has the control of his practice; he shields his patients from harm, the family fron interrogation, and his prescriptions from comment. About fifty years ago Prof. Ùurggraeve, of the University of Ghent, conceived the idea of administering in disease, according to certain simple rules, the active principles of plants prepared in granules. Because the medicines were \"mathematically measured \" in small doses, the naine \"Dosimetry \" was applied to distinguish this method of prescribing from others then in vogue. It is not claimed that dosimetry is a new system or that it is a complete practice. The active principles of plants which have been used for ages in cruder forim are prepared in granules.. This is done for the purpose of convenient dispensing and of assuring accurate dosage. That granules contain accurate doses is evidenced by the fact that uniform results are always obtained, and fatal effects have never been observed. One of the precepts of dosimetry or alkaloidal iedication is: \" To acute diseases oppose acute treatment; to chronic diseases chronic treatment \" (Burggraeve). These granules represent a minimum adult dose, and in acute 205",
         "THE CANADIAN JOURNAL OF diseases they nay be administered every fifteen minutes, every half-hour, or every hour, according to the severity of be attack, uutil some inprovement, is uanifested. The medicine should thwn be given at greater intervals. By pursuing this method closely it is sinply impossible to overdose your patient. On this account the use of the alkaloids and other active principles and pow'erful drugs is perfectly free from danger. You nust know that in \"Dosimetry\" alkaloids are not the only renedies cmployed, for such reiedies as resinoids, crlucosides, acids, salts of varions imetials, extracts, and various chemical conbinations, and other substances, such as pepsin, iodoform, glonoin, camphor inono-bromate, etc., find also room as valuable remedies in the treatment of diseases. The \"materies norbi \" is never lost sight of, and every endeavor is nide to eliminate and to neutralize it. The cause of disease is always sedulously sought, with the object of applying treatment directly to it. Tiis is called the \" comáiinant treatment,\" wvhich ineans treatient directed against the cause of the disease; and if the cause is unknown, treatient mnust be directed against the most, prominent syrmptom. Thus we have what is known as cc variaat treatieint \"; this is treatmient limited to concomitant symptonis, and is discontinued as soon as relief is obtained, while the dominant treatnent is continued as long as the disease lasts. Tlie actual dispensing of granules is an easy niatter, w'hile in very young children where a solution is needed it also can be made without the slightest inconvenience. Dr. Shaller, after many experinents, found that the dosage for ebildren, of such drugs as aconitine, cicutine, gelsuminine, veratrine, and others, could safely be given as follows. One granule for ever vear of the child's age, and one more, dissolved in twcnty-four teaspoonfuls of water in a tumbler, and a teaspoonful given eveiry one-half or every bour as indicated. For a child of oae yeur two granules; wihile à child of six ionths takes one granule in twenty-four teaspoonfuls of water, and a baby of three months, one granule in forty-eight tea- spoonfuls of water. Of such purity and efficiency have these granules been found, that some have even been given hypodernically without causing any irritation whatever, acting just as tablets specially prepared for the syringe. SURGICAL MEASURES OF RELIEF IN STENOSIS OF THE UPPER AIR PASSAGES.* BY THOMiAS H. MANLEY, M.D., NEW YORK. DeRING the past ten or fifteen years the discussion of the ctiology, pathology and surgical treatment of stenosis of the aerial passages, particularly in children, has occupied an important position in medical literature, both bone and -foreign.",
         "MEDI.CNE AIND SURGERY. 20' Yet with all that lias been written on this subject, it must be athnitted that the profession is in anything but accord on the mlîost appropriate ineasures, cither prophylactie or reniedial, in those maladies which jeopardize life through inipending asphyxia or apnea. It was hoped with the application of the invaluable apparatus of Dr. O'Dwyer that, at last, the most formidable obstacles in the w'ay of treatinent had been forever removed, that the scalpel and tracheal tube night be laid aside, and that hereatter relief- measures would be as prompt and bloodless as they were efficient and permanent. But it was soon discovered that, like every other relief-measure, intubation lias its limitations; that there is a considerable pro- portion of cases in which the perforated, laryngeal plug nay, whlen introduced, destroy every possibb prospect of recovery. Our aim should be in al] cases, to occupy a middle ground-as neither too zealous partisanis of the one, nor uncompromising foes of the other. Soie would impose so far on the credulity of their brethren as to have them believe that intubation is the sovereign renedy wlhen applied early and skilfully. Others there are, w'ho have cast it aside altogether. Of this latter I saw a practical proof in the Princess Augusta's large ward for childreu in the Frierieclishal- Ros;pital in Berlin. Here their experierice with intubation had been so unfortunate that they had discarded it altogether. Hence, while we all agree that divulsion of the laryngeal chink tlirough the buccal cavity occupies an import'nt place in surgical therapy, it constitutes but one of our resources In the controversial side of the question, it is not my purpose, at this time, to enter. The conditions that give rise to a mechanical impediment to respiration in the upper air passages are dependent on inflannnation -iiifectious, specific, neoplastic and traumatic. The fundamental principle underlying every phase of treatment, of whatever description instituted, is to secure a patent air passage until nature has renoved the barriers to normal respiration. To most saiely accoiplish this purpose we must depend chiefly on thrioee agencies: First, on constitutional treatnent, which is more or less applicable ii all phases of laryngeal stenosis ; second, on local medicative measures; third, on surgical intervention. As the surgeon's aid is seldon invoked until the time is passed for internal medication, only the second and third of these agencies will be considered hure. For the first of them, there are but two substances with which I an acquainted, tlat possess such properties as will commend them im the majority of cases. I may add parenthetically. that unless the patient is on the border line of the moribund state, local illeasures should be pressed with energy for a short time before surgical intervention is resorted to. Mercury pre-eminently occnpies the first position. First, because of its well.-known power as an antiseptic agent; and, secondly,",
         "THE CANADIAN JOURNAL OF for its effects on the general systei wlhen taken up by absorption through the mucous membrane. It may be administered by fumigation-when calomel is incinerated; or through the spray- when we employ the bichloride solution of a strength varying from 1·:500 to 1:3000 according to the age of the patient, its im- pression on the system, or the urgency of the symptoms. The objections to the eiployment are Mie possibility of paralyzing the patient or salivating the nurse or attendant. Besides, thougli this agent possesses active bactericide powers, it is not a deodorizer. In nany cases of an infectious or gangrenous character extend- ing into the larynx or trachea, the ideal solution is one which is gentle and simple in its application, but energetic in action; one best tolerated and possessed of the greatest affinity for the necrotic residue of diphtheritic or other inflammatory products. To attain this end there is nothing with which I an familiar, which may be administered so continuously as the peroxide of hydrogen medicinal. An eminent medical authority* has recently warned the pro- fession not to use this agent in throat troubles, because, as lie alleges, it may cause diphtheria itself. This view is totally at var- iance with clinical experience and with our knowledge of the fundamental etiology of the disease; though we nust concede, if an inferior quality.be used, or it is employed in too strong solution, an exudate is formed, but this exudate nust be rather attributed to its injudicious employment than to any inherent power of the drug to produce such exudate. In all cases, when we employ this gaseous agent we should be assured of its purity and standard strength; hence it is my custom to employ Marchand's medicinal alone, when it can be secured. The inhaler which goes with this medicament, in my hands, in the hospital and elsewhere, has served an admirable purpose in pharyngeal or laryngeal affections. \" The immense number of unsophisticated medical men all over this country whose anxiety is for new and effective renedies, and who are stimulated by these miserable surroundings \" t may be safely trusted with the best and safest in the matter of chemical solutions, as in the selection of wines, meat juices, proprietary medicines or other pharmaceuticals. When it appears futile to persist further with local appliiations and the symptoms of approaching asphyxia are urgent, the time has arrived for prompt surgical interference. It is well known that in tracheotomies the results following depend mainly on two factors, viz., the violence of the constitutional infectiQn. and the nanner in which the operation for relief is performed. The former is beyond our control, but not so with the latter. For, with the aid that modern surgery has placed within our reach,tie technique of opening the air passages above the sternum lias been greatly *Dr. A. Jacobi, Note on Peroxido of Hydrogen, Arcivesý of Pediatrics, December, 1892. † Ibidem. 208",
         "MEDICINE AND SURGERY. siinplified. The elder Gross regarded tracheotomy as one of the most formidable operations known to surgery. 'lhe dangers immediately connected with the surgical technique ofa tracheotomy are: (1) Those which have reference to puhnonary anesthesia. (2) Henorrhage. (3) Shock. With every one who bas ever administered an anesthetic, or seen it given to one with an embarrassed respiration, it is needless to rehearse here the difficulties in the way. In the first stage of anesthesia the little -one struggles and strangles so that the anesthetizing agent must be given intermittently. As the second stage of anesthesia is reached a deep cyanosis sets in. With the accession of the third stage the corneal reflexes are paralyzed and the asphyxia deepened so that the operator is warned to hasten on or death will quickly end the scene. But our patient is a child, and it is a natter of common observation that children, pro- portionately to their age, take a large quantity of anesthetics and comni from under their influence very quickly. Hence, under the circumstances here considered, the circulation already toxemic must be further super-saturated with another lethal agent, and along with this, the fear of the patient's returning consciousness hurries the surgeon on with the procedure in whicil it is always inperative to proceed with caution and deliberation. Anesthesia is, it must be adimitted, one of the positive dangers in opening of the trachea. Without question the next difficulty in this operation is profuse hemorrhage. Here the escape of blood is dangerous in a dual capacity. First, through mortal anenia, and next through leakage into the trachea inducing fatal asphyxia, or by being sucked into the bronchial radicles and causing septie pr'ennionia. As the trachea in the child is deeply lodged beneath an immense net work of blood vessels which lie immediately under the skin, the deep cervical fascia and over the thyroid isthmus, the division of the deeply situated parts 1s not unlike the splitting of a saturated sponge. Nevertheless, if ample hemostatic precautions are observed, after the flrst gush in penetrating the deep cervical fascia, it will be slight and neither vill annoy the operator nor endanger the patient. In May, 1890, Paul Reclus, in the Gazette Hebdomadaire, pub- lished his remarkable contribution on \"'Cocaine Analgesia.\" The year preceding, Prof. W. W. Dawson had presented an able essay, en- titled \" Bloodless Tracheotomies.\"* Although Reçius reported more than two hundred cases in which lie had successfully operated under cocaine, he mentioned none for tracheal stenosis. After I had carcfully read the essays of both the Ohio and the French sutrgeons, it occurred to me that, by a conibination of both expe- dients, the ideal tracheotomy operation was at last secured. Within one nmouth of the publication of Reclus' essay I was favored, at the *Jour. Amei'. iied. Assn., July 13th, 1892. 2)09",
         "THE CANADIAN JOURNAL OF Harlen Hospital, with an opportunity of testing for the first Mime, and estimating the full value of, a surgical procedure which I have designated \" Trach2otomy by the Reclue-Dawson Method.\" I, personally, claim nothing for myself in coinection with this invaluable device, save in evolving a new operation by a coi- bination of analgesia with hemostasis, and priority in being the first to operate by this nethod and to publish its history and technique. This I did in the ovwrnal of the imnericai. Medical Association, 1891. ThougIh I have had four opportunities of employing it in the adult, up to this time I have had but one child, an infant. on which to test its merits. This was a patient of Dr. Murray's but two months of age, which was sufièring from submucous tubercular abscess of the larynx. All my patients re.covered. In a nutshell, its technique is as follows: Rigorous antisepties; a 1 per cent. solution of hydrochlorate of cocaine hypodermically administered after Reclus' plan; the drug hypodermically employed, never to exceed the maximun dose by the mouth. I always douche the surfaceL of the integument, either by a spray fron a siphon of carbonated water, or else pure cold water fron a height which accomplishes the same end, before I make the first incision. The cocaine injection serves a triad purpose in these cases: first, as an analgesic secondly, as a'cardiac stimulant; and thirdly, as a sty pic or henostatic. In these cases which we tracheotomize for infec- tious or acute iiflammatory obstruction, and in which patency of the opening is but a temporary expedient, I an confident that the best tracheal tube is none at all. In this infant of two months, by passing two sutures through the divided tracheal walls on either side an ample air vent was effected. I am confident that as the new procedure is more generally adopted, tracheotomy vill regain its lost ground. For by it, when it succeeds, deglutination is not interfered with, perfect drainage is secured and the inconvenience and, d'anger always attendant on tubation of any description, is obviated. I is unnecessary to add that by it, too, the dangers of collapse and shock will be minimized. -Publshed by The Medical and Swrgical Reporter. THE TREATMENT OF RECURRENT ATTACKS OF SPAS- 1ODIC CROUP-WITH REPORTS OF CASES. BY MILTON P. CREEL, M.D., 3urge n. c. Pilway ; Surgeon L. \u0026 N. R. R.; 31ember Natiohal Association llailway surgeons; Menber Ainerican bledical Association; Member MiEissippi Valley Medical Association. etc., etc. THERE is no affection of childhood which excites more consternation in the breast of the average mother than to awake in the night and find her infant in the throes of croup. These cases forn a large share of the physician's burdens during Q210",
         "MEDICINE AND SURGERY. the winter months, and the best means at the disposal of the pro- fession for handling these cases should be brought to bear in every instance. The treatment I have thoiglit best to consider under two heads, the treatment of paroxysms of croup, and the institution -of such means as will tend to prevent a recurrence of another .seizure. The administration of an emetie, one which. acts quickly, .affords us a safe and satisfactory means of overco-.-ing the par- oxysms of croup. Terpeth mineral, alum and honey .-ecacuanha and the other einetics, are all valuable. Often thie are slow, however, and the physician is teipted to give an anesthetic. These are safe only in those cases where the heart and respiration .are not embarrassed. A patient seen before the dyspnea is very marked, howev er, may be relieved by having him inhale cliloro- formn to the point of narcosis. The giving of the patient a warm bath has been to nie a means of overcoming the paroxysms that lias seemed of great value. it tends to relax the patient, and expedite the action of einetics, and sleep and freedom from further attack the remainder of the night generally follows. To prevent a recurrence of these attacks is a matter of h7xe greatest importance. A study of these cases, covering a large number of cases, has -convinced me that the spasmodic ,endency of the larynx is due to -existent bronchitis, and when this is removed we shall hlve no further seizures. My success in treating these cases, in bringing about a cessation of these nightly visitations of croup, has been se-ured by treatinr the accompanying bronchitis. This treatment consists of the administration of remedies which the case in hand may suggest. I have found that in these cases the patients have a bronchitis attended with copious mucous dis- -charge. When these patients vomit we are often surprised at the secretion of mucus that has gone on. If these patients are poorly nourished they must have cod liver oil, and even the hypophosphites. When, however, there is no ·trouble on this score we should not give the remedy. One agent which lias been most beneficial to me lias been the balsam of copaiba. This agent lias been depended upon by me for a number of years and lias not failed to bring me the most satis- factory results. I give it in doses of one to three drops four times daily to a âhild five years of age. I give it in an emulsion, which is sweetened and flavored and children take it without any re- luctance. This remedy is continued as long as there is any evidence of bronchitis prcsent. Conjoined with this remedy I have the mother have a vapo- cresolene lamp burn in the bedroom of the patient every night. This vapor is antiseptic and :xerts a curative action on the inflained tubes, and Ihave come to value it, and make it an essential part of m1y treatnent.",
         "THE CANADIAN JOURNAL OF The clothing of these patients should be warm, and the chest and neck must be thoroughly protecteu. One point I never fail to emphasize is that these children's feet must be adequately protected; not only during the day must this be looked after, but if there is no fire kept in the bedroom then we must have the feet covered at night. This can be done by pinning the bed-clothes, or keeping stockings on through the night. A great many mothers provide their children with long night- gowns which are heavy enough to protect the feet, and are so long that they cannot be kicked off. L. Y., aged two and one-half years, had had recurrent attacks of spasmodic croup för the past two months. Examination revealed an existing bronchitis. This patient took an cinulsion of balsan copaiba four times daily, a teaspoonful of which contained one drop of balsam copaiba. Vapo-cresolene vapor was inhaled every night, and care vas taken to have the patient provided with a long, warn nightgown to protect the child's feet. On this treatment the patient got along well and after the second week had no further attacks of croup. This was a well-nourished child, and took no cod liver oil. Beatrice I., aged 2, had attacks of croup that were very dis- tressing to her mother, and had liad an attack almost every niglit for a month. She was given the copaiba, and slept in a room where the vapo-cresolene pervaded the atmosphere. On this treatment she got along well, and was discharged cured in eighteen days, and had no more attacks during lasb winter. Willie, aged 4, had had attacks of croup for the past two. years. Examination revealed bronchitis. On the treatment given in the above case this patient made a, complete recovery in six weeks. This patient was not well nourished, however, and I Ihad him take cod liver oil for five or six weeks. These cases are briefly told, but I have striven to give results rather than unimportant, or commonplace detail. ON THE MEDICINAL USES OF HYDROGEN PEROXIDE.* BY E. R. SQUIBB, M.D., BROOKLYN. (Extract.). TiHROUGHMOUT the discussion upon diphtheria very little has been said of the use of the peroxide of hydrogen or hydrogen dioxide, yet it is perhaps the most powerful of all disinfectants and antiseptics, acting * Read before the Kings County Medical Association, February 6th, 1889, during the discussion on diphtheria, and published in Gaillard's Medical Journal for Maroh, 1889, p. 267. 212",
         "MEDICINE AND SURGERY. both chemically and mechanically upon all excretions and secretions, so as to thoroughly change their character and reactions instantly. The few physicians who have used it in such diseases as diphtlieria, scarlatina, small-pox, and upon aIl diseased surfaces, whether of skin or mucous membrane, have. uniformlv spoken well of it so far as the writer knows, and perhaps the reason why it is not more used is that it is so little known and its nature and action so little understood. Until within the last few years, except in a few manufacturing processes, it vas ciefly known as a cheinical curiosity, rarely seen because difficult to make. . . . In order to use it intelligently both the pharnacist and the physician must know something of its nature and properties. The nane hydrogen dioxide expresses its composition, and its formula, H, 0. represents this naine. Hydrogen monoxide, H. 0, or water, can under certain conditions be mnade to combine with a second molecule of oxygen, the result being a water-like liquid,,H202. This second atom of oxygen is very loosely combined, and the comnpound mnolecule is alwrays on a strain to break up into water and oxygen, and when it breaks up, cither slowly or rapidly, the oxygen separates in that nascent or most active and potent of its conditions next to the condition known as ozone. It is in the change of this breaking up into the water and active oxygen that the latter element exerts its power, and simple contact with organic matters, which are thenselves of complex nature and in condition to be changed, is sufficient to break up the dioxide and li'erate the active oxygen. For example, some albuminoids are instantly changed by contact with hydrogen dioxide, as is shown by rinsing theý mouth with dilute solution, when the albuminoid matters of -the secretions are at once coagulated. Then, as all virus is albuminoid, whether propagative or not, it is destroyed, or by coagulation rendered inert by simple contact with this agent, just as it is by contact with corrosive sublimate. This simple experiment of rinsing the mouth with a dilute solution of hydrogen dioxide and exami- ing the discharge of liquid, can hardly fail te convince one of the destructive potency of this active oxygen on some albuminoids, and of its thoroughly cleansing effects upon the inucous surfaces. Now, if diphtheria be at first a local disease, and be auto-infec- tious-that is, if it be propagated to the general organism by a con- tagious virus located about the tonsils, and if this virus be, as it readily is, an albuminoid substance, it may and will be destroyed by this agent upon a sufficient and a sufficiently repeated contact. All kinds of spray and injection apparatus can now be easily obtained with fittings of liard rubber or glass, and such only should be used. A child's nostrils, pharynx, and mouth may be flooded every two or three hours, or oftener, from a proper spray apparatus with a two-volume solution without force, and with very little discomfort; and any solution which finds its way into the larynx or stomach is beneficiaj rathei- than harmful, and thus the effect of corrosive 213",
         "THE OANADIAN JOURNAL OF sublimate is obtained withou.t its risks or dangers. Adults and children old enough to gargle the pharynx and rinse the mouth will get a better effect in this way, equally without much disconi- fort, from a three-volume solution; and this applies not only to- diphtheria, but to scarlatina and other conditions of the niouth and throat which require cleansing and disinfecting. As vaginal injections in cases of uterine cancer, etc., the strength nust bc increased until the disinfectant eflct is obtained. A copious flush- ing out with a one-volume solution will often be suflicient. When wetted cloths are laid over external sores an over-covering of oiled silk should be used. As, in passing through several hands after leaving those of the maker, a little mismanagement may spoil the solution, sone easily applicable tests of quality and strength are needed. So long as the solution will yield any active oxygen at all, it will give this off with active effervescence when poured onto a crystal or two of potassium permanganate. A solution containing only a quarter of its volume will give an efferv scence so strong as. to be nisleading, and therefore a quantitative test is needed. The following is a modification of a testing process given to the writer, with much other useful information by Mr. Charles Marchand, of New York City, one of the oldest and best makers of peroxide of hydrogen, and one who supplies it to all parts of the country. . . . If this agent is to be generally used in the treatmnent of dipli- theria, as it well deserves to be on well-established principles of action, it it very important that it be freely applied in the earliest possible bta.ges of the disease, or while it is yet local; and there- fore the agent should be easily and properly accessible in places known to physicians, and not over a mile apart throughout the city, and in hands which know the agent well, and know how to- keep it from change and to dispense it on physicians' orders. If all pharmacists should undertake to keep it-or even all the prominent ones-it would soon share the fate of many other important medicines. THE BACTERIA IN EXISTENCE. MICROBES and bacteria are the bugbear of modern life. Many people are fretting themselves to death over them. They have become reasonably reconciled to dirt, extracting solid comfort from the maximu that every nan must eat his peck of it, and there is the end of the matter. But microbes and bacteria? Is not their prolifie power simply infinite, and to secure an honest living for their billionfold offspring must not the fond parent set up promising nests in the human organism for breeding gerns of consumption, diphtheria, rabies, smallpox, and like nutritious diseases for the promotion of the health and vitality of sorne 214",
         "MEDICINE AND SURGERY. species or other specially adapted to thrive on theni ? Filters do no good against such infinitesinal creatures. They go tlough filters as easily as tlrough sieves. It is even hinted that son of theimî are actually invigorated by being boiled alive. And so people are at their wits' end to knowv wlhat to do. To increase the nervoIs panic, certain einnent mon of science are at this very hour coming forward withl tiecories that seem to cut off the last avenue of escape. For example, numbers of extra careful people have, at considerable 'expense to tlhemselves, got into the habit of drinking none but distilled wiater, wlile on ail the ocean liners and on the warships very costly apparatus lias been introduced to furnislh this exclusively for thcir passengers, officers and crews. And now, in the face and eyes of all this, and in an authoritative medical review, the Jkutsche mdicinischeJWochenschrift, comes forward one 1)r. Koppe, with an elaborate article, fIlying the flag of the astounding pronunciamento, \"Pure Water is Poison.\" By cheini- cally pure water lie means, of course, distilled water. That this is as distasteful to dri'nk as the white of Ln egg is to eat, everybody knows. But then, wlhat one lost in pleasure was supposed to be made up to hiim in licalth. On the score of this reconciling idea lie stood ready to gulp it down. Not so, says Dr. Koppe. To get back to where it was before it was distilled, what does the water at once set to work to do ? Why, to leacli out of the systen,. and espeeially out of the more delicate cells, the very salts and organie matter it previously contairied, and which really rendered it palatable. Under this process of assault and highway robbery, the cells perish, and the most destructive results are set on in the whole economy of the body. This is certainly discouraging. To pay out one's hard-earned money for making water chemically pure, only to find it taking a bee-line to inake itself chemically impure out of the very substance of one's epithelial cells, this seems as a total abstinence man converting a tippler froin his drais only to find that the tippler lias seduced him into the evil habit of indulging in ardent spirits hinself And now the very water which, througi the fiery distilling process, was for the once rendered incapable of generating bacteria, acquires fresh organic matter, enough to fecd lively colonies of them on, until, througli the ferment tley set up, it beconies sparklin'g and refreshing as Apollinaris. Every man inust eat his peck of dirt. The doctrine has long been accepted and lias led to great peace of mind. Every man must eat lis peck of bacteria. This doctrine, thougli reposing on equal authority, has not yet been quietly acquiesced in, and so found to bring no rest to the sou]. Not a pint of thei! insist too many rebellious spirits. It is all in vain. No! the true creed to embrace is not that of perturbed and anxious warfare with an invisible foc whose name is legion, but that of the brave cultiva- tion of a vigor'of health and tide of spirits that will have enough to spare for the bacteria to get a modest living out of, and still leave a su:pIus, fdr one's own requirements. Baeteria-and the 15--",
         "THE CANADIAN JOURNAL OF voods are full of them, not only in the infusorial, but in the social, moral, political, sectarian forin-will do no harm to anyone in whose veins is circulating a full flow of ruddy blood, and in whose intellect and heart is beating a strong firn will of good. Rather will they serve, as they do in yeast, to set on a needful ferment in the dough of his nature, which, through the quantity of fixed air imparted, shall enliven his vit and fancy, his love and spirits. A life in the positive, and not in the negative, this, then, is the bracing lesson taught by the psychologists of to-day. It is a poor apple-tree, they insiet, that cannot afford some sustenance to the inevitable cater- pillars and still more inevitable plant life, and still retain vigor enough to bear half-a-dozen barrels of sound russets or Baldwins. In an equally bad way is the inan who does not make blood enough to stand the suction-pipes of half-a-dozen mosquitos, and yet keep the reservoir full enough for private use. If a man is to feel hiinself drained out of ail his intellect because lie lias fallen in with a few exhausted bores, or of ail his piety because lie lias heard a few dull and lifeless sermons-a fig for his intellect or religion! Bores and dull sermons are a part of life, to be shed as a duck's back sheds water-to use an entirely original simile. It is lubricating matter the duck individually secretes for .anointing his feathers with that- keeps him warin and dry in the wet, and saves him from getting bedraggled and drawn down beneath the surface. The duck attends to the positive and simply obeys the scripture command to keep oil in his lamp. No need of his worry- ing about the negative. The oil duly provided, the water runs off of itself without ever soaking in. A leading philosopher made it his rule simply to refuse any attention to the tedious, common- place, ugly side of life. What is the use of it? he argued. It merely depresses or irritates or degrades the mind. No musician ever became a musician by dwelling on discords or false notes, but by dwelling on inelodies and harmonies. These trained his ear and attuned his soul for the production of vocal or instrumental beauty. If one loves harmony lie instinctively sheds discord. If he loves sense, charm, wit, imagination, lie instinctively sheds folly, awkwardness, stupidity, prosaic dead level. Keep the best company and all other will be repulsive. \"bon't vaste your time fighting bad company,\" said Professor William James, in one-ôf his recent admirable \"Talks to Teachers on Psychology.\" Spinoza long ago wrote in his Ethics that anything a man can avoid under the notion that it is bad lie may also avoid under the notion that some- thing else is good. He who habitually acts sub specie mali, under the negative notion, the notion of the bad, is called a slave by. Spinoza. To him who acts under the notion of good, he gives the name of freeman. See to it now, I beg you, that you make free- men of your pupils, by habituating them to acts, whenever possible, under tue iotion of good. Get them habitually to tell the truth, not so much by showing them the wickedness of lying, as by arousing their enthusiasm for honor and veracity.-Tor. Workl. .416",
         "MEDIOINE AND SURGERY. TORONTO BRANCH OF THE WALKER-GORDON LABORATORY OF BOSTON, MASS. .BY I. P. H. GALLOWAY, M.D., TORONTO. ·ON Saturday, February 17th, through the courtesy of Mr. W. E. H. Massey, a number of Toronto medical practitioners paid a visit to the Dentonia Park Farm. This celebrated model farm, covering 240 acres, is situated at East Toronto, and is an ideal agricultural -establishment, apparently as near perfection as scientifie know- ledge and unsbinted expenditure of money can inake it. Ib was the Dentonia Milk Laboratory, however, which the visitors were particularly interested in inspecting, and a couple of hours were spent most pleasantly and profitably in examining the -details of the scientific production and handling of miilk. During the past ten years sa;nitary science has made progress in regulating some of the more important supplies for hurnan life. But it is noticeable that very little improvement lias been made in the production of milk. Milk, as usually sold to-day, is about as suitable a vehicle for the transmission of disease as it was before science revealed the dangers that lurk in it. Science in the dairy lias stopped at cheapening and improving the manufacture of butter and cheese. It has not been, with rare exceptions, extended to improving the milk production either. of the farm or for the cities. The. nilk supply of Toronto comes from nobody knows where, and, very largely, is outside the control of the City Board of Health, except as to its solid contents and gross adulterations. But the general sanitary condition of barns, milk-houses, and the trans- portation of milk is still practically unregulated. Two lierds of cows are to be found in the stables-Jersey and Ayrshire-and the animals are beautiful specimens of these respec- tive breeds. The stables are model sanitary homes for the perfect care of the animals, clean and perfectly ventilated by a systen which insures a constant supply of pure air direct to eacli stall. Manure is collected as rapidly as it is voided. and is removed twice daily 300 feet from the barns by an overhead trolley system. Liquid manures are conveyed froin the stables by iron pipes with leaded joints. The cows are cared for almost like children, are fed regularly and scientifically and are kept scrupulously clean. No wonder they were so gentle and looked so contented! Eacli animal, before being accepted, is carefully tested with tuberculin, the test being repeated should the slightest suspicion inake this necessary. Should any animal appear ill it is at once isolated and ree: ,ves comp -tent yeterinary care, in fact, the herds are under the careful supervisión of a competent veterinary surgeon, who presents 217",
         "THE CANADIAN JOURNAL OP to Mr. Massey at regular intervals certificates setting forbh the condition of the cows and their surroundings. The attend- ants a.re also regularly examined by a physician, and their condition of health reported. Before each milking the cows are thoroughly groonect and cleaned, and the attendants don vhite suits táken directly fiom the steam sterilizer. The milk as it comes from the cow is received, not into open pails, but upon a fine wire gauze strainer ]et into the lid, thus absolutely preventing accidental contamination with hairs or any gross filth. The milk is at once taken to the laboratory, where it 's refrigerated and aerated, then bottled by the mnost modern scicntitic mrnethods. The milk-room, stripped of its apparatus for handling nilk, resembles nothing so inuch as the modern, aseptie, surgical operating room of a hospital. The walls are tiled, the floor is made of asphalt, kept damp; the air is filtered through gauze, and in summer is -washed witi spray-an exhaust fan, driven by elec- tricity, changing the air every few minutes. The inilkers are not allowed to enter' the mîilk-room, but pour the milk into a tilter, whence it passes through the wall to the solid white porcelain receiving vats inside the milk-roon. The presiding genius of the laboratory is Miss Lottie Shuttle- worth, a graduate of tie Agricultural Department of the Outario Agricultural College, Guelph; she has also taken the Walker- Gordon course in Boston. In her sp tless white uniform, in a place that is so nuch like an operating room, and with sterilizers at work close by, it is difficuit for a inedical man to keep from involuntarily addressing lier as \" Nurse.\" It is Mr. MasIe's ambition to piroduce ixlk that shall be pract:cally sterile without actually sterilizing it, and the bacturi- ology of the milk receives careful attention. One illustration will serve to show the care that is taken to maintain asepsis; as the delivery wagons returnx to the farm, the baskets containing the eml pty hottles are immediately transferred to a large sterilizer. They are afterwards wasled by hand in three changes of fresh sprinmg water, of which there is alundant supply, and then sterilized a seund time before being used. A special parafflin-coated dise is used as a stopper for each bottle. For those who desire it, sterilized Cr pasteurizel miilk can le procured in b-oZ. tubes. But -o the visitors the feature of greates4 iiterest was unduubtedly the ict that this layoratory is a branch of the Walkerordun Laboîrat ry Boston. and] thxat mdifid miilk f'r th scientitic substitute fenai.îîg of infants is 'w ailble to t physician in lTronto and aan a radius of one hundred miles frot the city. This method of feeding infants artincially bas been brought so prominently before the profession by Dr. T. M. Rotehi, of Boston, and others, and its value has been so well established by the ob- servation of a large number of physicians in diffirent places, that the profession in this city are to be congratulated at now having at their service facilities for securing modified milk which are 2918",
         "DEiNTONIA MILK LABORATORY showi ille solid pore1ail rcetiviii- \"ts, Coc\u003eler zid ntrater, turbille creaul sellainator, Iottie (Iller, liottie car, etc. , 'à N'à",
         "DENTONIA MILK LABORATORY showilig apparatis for 11n\u003eIldf.yitig iniilk. Trhis rooli lis tile sid.Wadlis, aspliaIl iloor, glass table' ttitd slieiçes, and solid porcelain sik.",
         "MEDICINE. AND SURGERY. second to none. The milk is modified upon physicians' prescriptions only, and is delivered in tubes of such number and containing such quantity as may be ordered. Modified mîillc is not a proprietary or manufactured food, but it is a method by which fresh cow's milk, while still reinaining a fresh mi.k, is changed as to its constituent elements of fat, milk- sugar, and albuminoids to suit the digestion of infants or invalids. Infant feeding in all its scientific forns absolutely demands a. perfect nilk for its basis, so that the saine care should be exercised in the choice of milk for modifying as ought to be employed in the selection of a raw, whole milk for the table and the nursery. This. caution is necessary because certain inisinformed or mercenary persons in the Eastern States are advocabing thu use of 4 any milk so long as it is freshly milked \" or any milk at all so long as it is \"pasteurized\" or \"sterilized.\" No nore dangerous advice can be given to mothers. No milk is suitable for modifying, or for the nursery, that is not qv ite pure and safe. \"Sterilizing \" and \"pasteurizing,\" so called, cannot make an old, impure milk valuable: but, instead, it reniains dangerous for infant feeding. It is now ascertained beyond ques- tion that the chemical poisons generated by certain bacteria are as. potent after sterilizing them as before. Heat kills some bacteria, but it does not destroy the poisons generated by them. If nilk is sterilized after the poisons have been generated, it is as dangerous as unsterilized milk may be. IL is for these reasons that the physician who know the most about infant feeding are so strongly of dhe opinion -that the selec- tion of a perfect nilk is quite as important as the form of its. modification. But this is also certain, that the form of modification is equally important. It is as foolish to say that a perfect milk can be suc- cessful if wrongly or imperfectly modified,-as to say that perfect modification will be successful with an unsafe milk, even if it be \"\u003cfresh.\" The experience of the Walker-Gordon laboratories, in feeding many thousands of infants, absofutely proves that a goodt milk aund a good nethod must go together. lu laboratory modification-modified milk--it is believed that as great a degrec of accuracy should exist as is found in the pro- duction of drugs or in the filling of prescriptions for inedicines, and the nethod is based upon two things, namnely, an accurate basis in milk and cream, and a nathematical and iechanical method that admits of no mistakes in the formula plans. Prescription-feeding, from the Walker-Gordon laboratories, lias been successful as a medicine-diet for sick infants and children, but the chief uses of the laboraories have been the regular feeding of healthy infants from birth. The process is necessarily an expensive one, the cost of feeding an infant being considerably more than by any of the patented artificial foods, but the results. prove this nethod incomparably safer and better. 219",
         "THE CANADIAN JOURNAL OF Milk containing a definite percentage of fat for home modifica- tion may also be procured upon physician's order. Nearly all medical men w'ho have mastered the subject of modified milk, as it is taught by Dr. Rotch, and vho have liad the service of a Gordon- Walker laboratory to help them in putting the modified milk theory into practicp, are unanimous in the verdict that milk so modified as to meet as nearly as possible the needs and the digestive .capacity of indi vidual babies, represents the highest point yet attained in the substitute feeding of infants. Mr. Massey's -enterprise in establishing this laboratory in connection with his farm cannot be too highly commended, and we have no hesitation in regarding it as inuch more a work of practical philanthropy ·than a commercial venture. SURGERY IN SOUTH AFRICA. Sia WILLIAM MACORMAc, the president of the Royal College of Surgeons, who volunteered his services for the South African war, .sends an interesting account to The Lacncet of his experiences with wounds inflicted by the Mauser bullet. The cases lie reports are from the Wynberg Hospital, near Cape Town: \"I saw a large number of injuries inflicted by the Mauser bullet, which is remarkable for the small external wound it pro- -duces. In three-fourths, if not even a larger proportion, it was impossible to tell the exit from the entrance wound, théy were so .similar in appearance. Some were quite healed, but most were covered with an adherent black scab slightly depressed and saucer- like. Doubtless some contraction had taken place in healing, but the size was nuch smaller than the end of a leadpencil and quite .circular. A few exit wounds were slits due to slight deflection of the bullets in their passage. These were already healed like an incised wound, and showed a linear cicatrix about half an inch long. Probably most of these injuries were inflicted at a range of 1,000 .yards, althougli the men said 500 was the distance in very nany instances in which they had been hit. One man, a Gordon High- lander, lad his elbow smashed up into small pieces. He beieved it was an explosive bullet, but it may have been a Mauser at short range, for ho was hit at a distance of 300 yards. The Boers, how- ever, use other weapons. A Martini-Henry bullet was removed from the ball of a man's thumb yesterday-an almost solitary example of a lodged bullet. They also fire hollow bullets, w'hich would have explosive effects. The Mauser bullet weighs, I believe, about 2.3 grains. Our Lee-Metford is a little heavier, about 2.7 grains, ani does not carry so far by somte hundreds of yards, while the old Martini-Henry is nearly double in weight, or some 4 grains, In the wards I noticed quite a number of perforating chest wounds, and some remarkable perforations of bone without any solution of ý2 2 0",
         "MEDICIINE AND SURGERY. continuity or complote fracture; in one instance there was a per- foration of the shaft of the tibia at the juncton of the upper with the imiddle third of the bone, an injury which my previous experi- ence would pronpunce quite impossible. \" There vere several cases in which the bullet had entered the groin and emerged through the central portion of the buttock, the direction taken making it difficult to conceive how the fenoral vessels, the sciatie nerve and artery, the femur and other important parts had escaped all injury. There were four abdominal injuries. In two cases severe hematuria followed, and the direction of the wound suggested injury to the bladder. In another the bullet. entered tie buttock and emerged in front a little below the ribs. In a third instance the abdomen was traversed in a similar direction. There were hematemesis and bloody stools for three days without any further symptoms. In another case the bullet apparently traversed the abdomen from the right linea semilunaris in front at a point a li.ttle above the level of the umbilicus to emerge two inehes to the right of the lumbar spine. There were -no symptoms. in this case of any kind. \"II will mention in the briefest way some of the cases I saw during my visit to the hospital at Wyniberg: \"i Bullet entered the chest on left side close to margin of sternum, just below the sixth rib. It must have passed between the internal niamnary artery and the bone near its division. Th- ball then tiaversed the lung and emerged at the tenth rib, about four inches from the spinal colunin; rapid convalescence-practi- cally no symptoms; wounded on October 21st. \"2. Bullet entored just below inferior angle of right scapula, between seventh and eighth ribs probably, and emerged just below centre of right clavicle; result similar to Case 1. \"3. Bullet entered opposite centre of infraspinous fossa of right scapula, emerging through rib in front three inches below middle of right clavicle. Man had hemoptysis for a week; no dyspnea. or other syiptoms. \"4. Bullet entered level of fourth dorsal vertebra, about two. inches from spine on right side, emerged two inches below centre of right clavicle. Man spat blood for a week; says lie felt no. inconvenience otherwise. , \"5. Perforating wound of surgical neck of lef t humerus with some detached fragments. Diagram shows extent of damage clearly. The fragments were removed; patient convalescent. \"6. Wound across knee; bullet entered one and a half inches behind, and on level of head of right fibula. emerged on inner side opposite niiddle of internal condyle. Wounds healed ; joint mobile. \"7. Bullet entered anterior aspect of thigh two inches above- upper border of patella and in the middle line, emerged over the- inner tuberosity of the tibia, which appeared to be grooved by it. Wounds healed, joint mobile, yet it is difficult to suppose the joint. escaped. 221",
         "THE ). ANADIAN JOURNAL OF \" S. Bullet entered middle of outer side of right knee and *emerged through centre of patella, causing a complete transverse fracture with nbout a quarter of an inch separation. The wounds had healed and the man had been able to get about, but on the previous day he had fallen and hurt the injured knee, which caused a great deal of swelling. There is no rise of temperature and he is doing well. The joint is fairly inovable. This man is a Boer field cornet, Pretorius by naine. He is a fine-looking man, with a cheery, pleasant face, and speaks Elnglish perfectly. \" 9. Bullet entered opposite centre of patella, through which it passed and energed opposite inner condyle, which was grooved by the ball. All evidence, save the scars of entrance and exit wounds, lad disappeared, and the knee was apparently as good as ever. \"\u003c10. Scar of entrance wound imediately over the right femoral artery and two inches below Poupart's ligament. The .artery can be felt pulsatiing exactly beneath it. The bullet then passed apparently inside the upper end of the femur without in- pairing the bone and energed just posterior to the great trochanter. \"11. Bullet entered in front of, and an inch below the top of the great trochanter, which it grooved and energed through the middle of the buttock. \"12. Bullet entered' anterior surface of thigh at junction of middle and upper thirds, and, passing internally to the femur, .emerged through the centre of the buttock. In none of these three last cases had any important structure been damaged, and the- wounds were either completely healed or were still covered with the small black scab already ientioned. \"13. In this case the man was wounded on October 21st, and operatec on by Col. Stevenson twenty-four days afterwards in the base hospital-viz., on November 14th. He was doing quite well when I saw hin and threc days later I heard he was practically -quite well. The bullet entered from behind two inches below the fold of the axilla and emerged in front just below the anterior axillary fold. When Col. Stevenson -aw him lie diagnosed a damaged artery from the gradually increasing tense swelling and absence of radial pulse. He made an incision, which had subse- quently to be enlarged to five inches, and after turning out nearly a pint of dark clotted blood found a large breach in the vossel where the axillary becomes brachial. When the final portions of clot were removed 1 formidable rush of artery blood occurred, bat this was immediately controlled and both ends of the vessel were securely ligatured. When I saw the man a week exactly after the operation the external wound had healed except where the drainage- tube emerged. The tenperature was normal and the general con- dition excellent. The vound was not quite aseptic from the start, but all vent well. There was when I examined hin no perceptible radial pulse. \"14. One man had four wounds in the upper extreinities caused by the same bullet. It entered the arm on the outer side· two 22*",
         "MEDICINE AND SURGERY. inches below, and thon entered the ball of the thuinb, simashed the metacarpophalangeal-joint, and finally cmerged over the first plialanx. \"1.. Bullet entered sobeutaneous surface of tibia, a little below the junction of upper wiith niddle thirds of the shaft of that bone. Tiere was a clean cut perfori tion through the tibia, but no general fracture or solution of continuity, which is very remarkable in the compact tissue. This maii says he was hit at 500 yards, but more probably it was 1,000. \"16. Bullet passed transversely across forehead about an inch above level of the orbits: the bone is deeply grooved and along the upper margin there is an elevated fracture parallel to the groove. The inan describes hinself as being 'knocked silly' for a time, and there was a teinporary diplopia, but the wounds at each side of the forehead are healed and lie claims to be perfectly well. \"17. Bullet entered right inalar bone close to its junction with zygomatic process, passed almost transversely across, and eneiged just above the centre of the left zygomatic arch, which it grooved. Ti a vas copious bleeding from the mouth and left ear, in which the patient is now deaf. He complained of loss of sinell for a tiie, but this is restored. He is going about the ward, the wound quite healed, and says he is perfectly fit and well. This inan was wounded on October 30th, the distance said to be 250 yards.\" A TUBERCULOSIS CONGRESS. A MOVEMENT begun last year in Chicago to orgranize concerted medical effort against consumption has resulted in the callirg of a tuberculosis congress to be held in that city the third Wednesday of February, and to continue through the following day. In May of last year a world congress on tuberculosis was assenbled in Berlin, Germany, and the one to be held in Chicago is in a certain sense a result of the former meeting of distinguished men of the medical profession. At the Berlin congress, attended by delegates .from Canada, the United States, Australia, New Zea- land, Persia and Japan and the leading countries of Europe the subject was discussed under four heads: 1. Disseinination. 2. Cause. 3. Prevention. 4. Treatment and Sanatoria. Under the first head it was noted that statistics show that con- sumption was more prevalent in cities and large towns than in country districts, and that of cities London, Naples and Buenos Ayres had the lowest mortality from this disease, while Vienna, Budapest, Moscow and St. Petersburg had the highest. Most liable to its attacks are those who have the care and nursing of consump- tives. those ,who. lead 'sedentary lives and workers in occupations where irritating dust is constantly inhaled. The disease also pre-",
         "THE CANADIAN JOURNAL OF vails among cattle and hogs, hence infected meat and milk are agents of dissemination. Tie t consumption is due to tubercle bacillus is without doubt, as. is also the fact that everyone having the disease becomes to a greater or less extent a centre of disseinination-hence the value of sanitariums, of which, since the crusade against consumption started, Germany has erected eighty-three. A number are also in operation in Canada, the United States and other countries. Among remedial and preventive agencies direct sunlight, putre- faction and desiccation soon destroy the crerms, and thÎese facts point the way to the treatment of the âisease. Cities, also, in Canada and in some other countries have aided in the work of pre- vention to some extent by municipal regulations or directions against expectoration in public places, such as street cars, railway stations, etc. The movement bas also shown the imperative neces- sity for better regulation of factories and other places where many human beings are crowded together at work under unsanitary conditions. Health departments have in many instances provided against the spread of consunption from articles of food by apply- ing the tuberculine test to meat and inilk. The latter should be sterilized and thorough cooking of ineat is also an aid. As to treatment the éminent specializts at Berlin congress had little new to say. The disease, of course, should be attacked in its. earlier stages. Open air, sunlight, rest, and dry soil for the home, good digestion and contentment and an abundance of strong food are recommended. It is to be hoped that the coming congress in Chicago may add at least to the general knowledge of the world in regard to the dissemination and treatment of this terrible affliction. One good effect at least will be the direction of public attention to the disease, which is one of the most destructive and also the most difficult with. which medical science has to deal.-electccl. D.R. ALEX. MOPHEDRAN expects to move into his magnificent new residence on Bloor Street West about May next. Di. E. I. STAFFORD, of the Asylum for Insane, Toronto, who. was recenty granted six months' leave of absence from the Ontario. Asylum Service by the Government in view of the havoc wrought. upon his health by the long-continued confinement of his position in the Institution, is spending the remainder of the winter at. Bocas del Toro in the West Indies, where we trust he will be much benefited by the 'climate and return to Canada completely restored to his wonted health. Colonel Bell, of Peterboro, bas. been appointed to the position vacated by Dr. Stafford. 224"
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      "label" : "[Vol. 7, no. 3 (Mar. 1900)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. w w Coloured pages I Pages de couleur Pages damaged Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Wý W: Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "TH1E SANITARY JOURNAL. DEVOTED TO PUBLIC HEALTH. VoL. II.] DECEMBER, 1876. [No. 12. EDUCATION OF OUR GIRLS. To the Editor of the SANITARY JOURNAL. SIR :-The writer not long ago, sitting in a railway car in the company of a Toronto clergyman. Among the various topies of conversation, were the subject of temperance, and the status of the average Canadian girl of the present day. We discussed the evils of intemperance, and the various remedies which have been tried and proposed, and had come to the conclusion that it remained an unsolved problem what means could be adopted to reach the root of the evil-what cure could be employed to destroy this all pervading and deep penetrating cancer which is so malignantly eating and disfiguring the social structure of our country, an evil which consumes vital forces which might be used for noble and beneficent purposes. It was after this that the writer was somewhat startled to hear his companion, with much earnestness, ask the question :-What can be done to save our young women ? He expressed his belief that in another generation, if things go on the way they are doing, we shall have no women for mothers. According to his belief Canadian girls are rapidlydeterioratinginentally andphysically, are rapidly becoming unfit for the duties of life-for usefulness at home or abroad, and that from infirmity or design she failed to accomplish the purposes of her sex. Now while we do not believe that the evil is so great as this reverend gentleman thinks; it is sufficiently so to demand prompt and earnest at- tention. It is stated on competent authority that the old families who settled the first thirteen states of the American Union are rapidly becoming extinct, that in a few generations",
         "THE SANITARY JoURNAL there will be no living descendant oi the first intrepid Ainerican pioneers. The evil producing this result has un- fortunately extended into Canada; and there is danger of its increasing and producing a most baneful effect. Therefore the enquiry of my travelling companion: can nothing be done to save our girls, is at once pressing and most important for the future prosperity of our country. It cones witbii the scope of Sanitary Science to consider tbese questions-tbe question of prevention of alcoholisn, and the question of temporal sal- vation of our women; indeed of the Canadian race. In reply to his remarks, I suggested that possibly we might find a common cause of intemperance and deterioiation of the women in a want of proper education. [e replied that such could hardly be the case when our country was well provided with educational institutions for the youth of both sexes. But, the rejoinder was :-the education referred to is of another kind; the education received at home from parents and asso- ciations, and it might have been added, the education from the pulpit and the press. How little is known of the requirements of a healthy human being. How few know or care to know the laws of hygiene. Restrictions are placed upon the young by well-meaning parents, and the pulpit declaims against evil customs and practices. But too often the cravings of nature -demands that will assert thenselves sooner or later-are ignored or regarded as the promptings of an evil nature which should be crushed out. Now it is submitted that the teacher, be he parent or preacher, who, while pointing out evil amuse- ments and recreations, fails to offer a harmless substitute, comes far short in his duty. Amusements and recreation are essential not only to the young, but at all periods of life. And if these be denied to the young, the chances are that with in- dependence of parental control, there will be reaction. Liberty will be attended with license. Parents as well as preachers often fail to distinguish between the proper use and the abuse of amusements and modes of recreation. In making this re- mark, we wish to say that we cannot, from observation and experience, allow that the use of spirituous liquors, otherwise- than as medicine, is at all permissible. Another evil in con- nection with the home, pulpit and press education'is the en- couragement given to false doctrines in science. How many persons, male and female, have to unlearn what they acquired at home both with respect to things sacred and secular. Now take the pulpit. When one hears a minister upholding false theories in science how much it impairs the influence he other- wise might have; how much less likely is one to accept his",
         "EDUCATION OF GIRLS AND BOYS. dicta on things divine. Alnost every imposture that has paraded itself before tie world during the past century has flaunted a testimonial from clergymen. These, however, are sometimes fictitious. Newspapers, religious as well as secular, give place to advertisements and often to puffs, the most false and misleading. Sometimes the purport of these advertise- ients is the inost degrading and wicked, and which is by no means concealed by their cunning and ambiguous words. The demands of society in this so-called civilized age are very trying to females. The love of idleness is a most per- nicious evil. The duties of motherhood demand the attention which is often given to other purposes. The consequence is that nany find what ought to be the joys of. matrimony irk- some ; the care of children a burden. In many cases the mother sows the evil seed in the mind of her daughter, by complaining of her lot, and the daughter grows up with the onviction that a great objection to matrimony is the danger of having cbildren. As this communication is intended to be suggestive rather than exhaustive we cannot pursue this point further. But we must glance at the evils of fashion, often encouraged by mothers, at least allowed by them to affect their daughters. The faults of dress are numerous. From the crown of the head tothe sole of the foot the dress of women is full of objections. Inadequately covered head in winter, and the feet at all tines lead to a multitude of evils. So the low neck dress, and the constriction at the waist. This last habit is one of the most fruitful causes of disease and suffering. The free action of the lungs is prevented, the heart eibarassed, the stomach, bowels and liver are pressed out of place downward; and the important organs below are made to suffer. The dragging pains, the weak back, the periodical pains in the womb, and many of the perils of child-birth, and uterine dis- placements are the result of the deformity which the vain habit of constricting the waist inflicts. The evil is much en- hanced by the general customn of wearing the underclothes suspended froin the waist instead of from the shoulders. The importance of diffusing correct knowledge upon the points referred to cannot be over-estimated. So far as individual hygiene goes, until the medical man is engaged to advise upon everything relating to private health,and his advice is implicitly followed, we can lardly expect perfectly de- veloped manhood or womanhood. And without a perfectly developed physical systein it is a question whether we shoudii expect a healthy moral nature. Yours, \u0026c., OSEnvEi.",
         "THE SANITARY JOURNAL. PRACTICAL NOTES AND EXTRACTS ON HYGIENE. VENTILATION.-This is the season of closed and double doors and closed and double windows. Too many seem to forget that they are constantly consuming oxygen and that a constant supplyof fresh air containing this element is absolutely indis- pensible to health and vigor of constitution. The want of fresh air is feit most at night, in the bed-rooms. About one-third of one's life is passed in the bed-room. Here there is no moving about fr6m room to room, or out into the fresh air, no opening of doors. According to the most reliable authority, from the most carefully made and considered estimates, every adult re- quires 3,000 cubic feet of fresh air every hour, if he is to be sur- rounded with sufficiently pure air. This would about fill a room 16 feet square of floor space, and 12 feet high. And the airinthis should be completely changed every hour. Now bearing this in mind and considering that most peoplepass the eight hours of sleep in rooms with only capacity for, at most, 2,000 cubic feet, with no provision for change or renewal, excepting the minutest cracks and crevices of doors and windows, and the pores of the walls, it should not be a matter of surprise that many awaken dull and depressed in the morning, can take only a light break- fast, instead of a good substantial one after the long fast, and prefer to take the street cars rather than walk a mile; feel a want of vigor, are easily affectediby sudden changes in the atmosphere, and are susceptible of disease. Let such try the experiment of making two openings, an inlet and an outlet, in the bed-room, on opposite sides of the room, if possible, as by lowering an upper sash or two, and after a month's experi- ence they will hardly close them. The size of the openings must be adapted to the state of the outer atmosphere, and the number of occupants of the room. Practical directions for regulating the openings to suit the temperature of the air inside and outside have been given in previous numbers of this JOURNAL. Most dwellings now have means for keeping the air a littlewarmed at night in severe weather, and it may be necessary at such times to consume a little extra fuel in order that the bed-rooms shall not get too cold; though this is a matter of comfort rather than of health, especially after becom- ing a little accustomed to the change. The bed, especially the head of it, should not be so near the inlet as to cause a draught to be perceptible. CARE OF THE SKIN.-Hufeland, a celebrated philosophic physician, and professor of medicine, long ago *rote thus, on",
         "EXTRACTS ON HYGIENE. the care of the skin : \" The more active and open the skin is, the more secure will people be against obstructions, and dis- eases of the lungs, intestines and stomach; and the less ten- dency will they have to gastric fevers, hypochondriases, gout, asthma, catarrh, and v5ricose veins. One great cause of these disorders being at present so common amongst us is, that we no longer endeavour to cleanse and strengthen the skin by bathing and other means. \"l It ought not to be forgotten, that the skin is the grand organ of crises, that is to say, the assistant of Nature in disease; that a man with open pores, and a skin sufficiently vigorous, may depend on being cured of diseases much more easily and with more certainty, and often even without the use of medicine. \" That such an organ must be a great support of health and life, no one will deny; and it is therefore incomprehensible how people in modern times, since mankind have become more enlightened, should neglect it so much. e Let me here be permitted to call the attention of my read- ers to an incongruity, which is not the only one of the kind in human life. The most ignorant person is convinced that proper care of the skin is indispensably necessary for the existence and well-being of horses and 'various animals. The groom often denies himself sleep and other gratifications, that he may curry and dress his horses sufficiently. If they be- come meagre and weak, the first reflection is, whether there may not have been some neglect or want of care in regard to combing them. Such a simple idea, however, never occurs to him in respect to his child. \"The rules which I have to propose for preserving cleanli- ness and a sound state of the skin, are remarkably easy and simple; and if observed from youth, may be considered as very powerful means for the prolongation of life. \"1st. Remove carefully everything that the body bas secreted as corrupted or prejudicial. This may be done by changing the linen often, daily if it be possible, and also the bedelothes, or at least the sheets; by using, instead of a feather bed, a mattress, which attracts less dirt; and by con- tinually renewing the air in apartments, and particularly in one's bedchamber. \"2nd. Let the whole body be washed daily with cold water, and rub th e skin strongly at the same time, by which means it will acq uire a great deal of life and vigor. \" 3rd. O ne ought to bathe once a week, the whole year through, i n tepid water; and it will be of considerable ser- 33'",
         "THE SANITARY JOURNAL. vice, to add to it three or four ounces of soap. It is much to be wished that public baths were again erected, that poor people night enjoy this benefit, and thereby be rendered strong and sound, as was the case some centuries ago.\" ADviCE To BATHER.-The Royal Humane Society, of Lon- don, Eng., has issued some excellent instructions for the guidance of bathers. They are rather intended for those who bathe in the open air during warm weather, yet they apply to all kinds of bathing, and will keep. The Lancet says they cannot be too widely circulated :- \"Avoid bathing within two hours after a meal, or when exhausted by fatigue or from any other cause, or when the body is cooling after perspiration; and avoid bathing altogether in the open air if, after having been a short time in the water there is a sense of chilliness, with a numbness of the hands and feet; but bathe when the body is warm, provided no time is lost in getting into the water. Avoid chilling the body by sitting or standing undressed on the banks or in boats after having been in the water. Leave the water immediately there is the slightest feeling of chilliness. The vigorous and strong may bathe early in the morning, on an enpty stomach, but the young and those who are weak had better bathe two or three hours after a meal ; the best time for such is from two to three hours after breakfast. Those who are subject to attacks of giddiness or faintness, and those who suffer from palpitation and other sense of discomfort at the heart, sbould not bathe without first consulting their medical adviser.\" CONSTANTINOPLE AND ITS SURROUNDINGS. INTERESTING LETTER FROM LORY MARSH, SECRETARY SANITARY INSTITUTE OF GREAT BRITAIN, TO THE SANITARY RECORD. Before leaving England to visit the East, the Committee of the Sanitary Institute of Great Britain requested me to note any facts relating to the subject of public health that might come under my observation during my travels. In Constan- tinople every facility bas been afforded me by the resident physicians and the sanitary authorities to investigate, as faras practicable, the sanitary surroundings of this interesting city. On enteri ng the harbour of Constantinople, the appearance of",
         "CONSTANTINOPLE. the city is very striking and picturesque. It is built every where on rising ground sloping down to the sea, in which there is always a strong current running, at the rate of about five miles an hour, carrying away all the refuse discharged into it. So strong is the current that the water in the harbour and along the Bosphorus, where the principal part of the houses are situated, preserves an almost crystal purity and transpar- ency. The selection of the site of Constantinople, on which to build a city, has left nothing to be desired. Built, as already observed, upon the side of two hills sloping down to the sea, which, not being subject to tidal fluctuations, deposits no filth in its course, a strong current always running, and a good ;reeze nearly always blowing froni the Black Sea to the Sea of Marmora, sweeping down the Bosphorus past Constanti- nople, there would appear to be nothing wanting, beyond an intelligent administration of public affairs, to make this a veri- tible ' City of Hygeia.' To guard the city from the introduc- tion of discase from without, a rigid system of quarantine is imposed, during the prevalence of epidemics, upon all ships entering the harbour, and excellent hospital accommodation is provided for sailors, especially British seamen. The soil upon which the city rests is everywhare dry and porous, greatly re- sembling apparently the \" Kentish rag.' As we enter the city, and note the varied nationalities of its inhabitants, the man- ners and customs of the people, the construction of the streets and houses, and inquire into the type of disease usually pre- valent, we become painfully alive to the fact that man has tried, and succeeded in a manner worthy of a better cause, to counteract in a great measure the advantage nature has al- most as it were thrust upon him. The inhabitants here re- present all nations of the East, as well as many of the Euro- pean nations. The estimated population, as far as I can leani, is about 600,000, and for the purpose of hygienic observations may be divided into two great sections, viz. the followers of Mahomet and the allied religions, and Christians of ail shades, and degrees. Each sectionoccupies separate quarters of thecity , and they hold no intercommunication with each other. One is on one side of the water and one on the other. The Maho- medan, like the Jew, appears to enjoy a greater tenacity of life than the Christian. This difference is in some measure due to race, religion-as regulating the habits and discipline of the people-and to the difference of occupations in which they are engaged. Mahomedans are more temperate in the use of stimulants than Christians ; they engage more in trade and less in manual labour; in one sense they are more moral,",
         "THE SANITARY JOURNAL. i. e. there is very little promiscuous intercourse between the sexes. Syphilis and its allies is very rare, and when met with is of a mild type. Gout is a disease almost unknown amongst them; they recover from injuries and operations in a marvel- lous manner; and I am informed that amongst the Turks, Arabs, Jews, Persians, and Armenians, pySmia and erysipelas succeeding operations are almost unknown. The Christians, especially the lower class of Greeks, do the principal part of the rough laborious work; and nearly all the carrying work about the city is done by Armenians, bearing on their backs loadsthat almost frighten you to look at. As might beexpected, they are very liable to hernia, but on the whole they are a very hard, enduring race. Like the Mahomedans, they live principaly upon bread, cheese, olives, and fruit. Stone in the bladder is a very conimon disease with all. Phthisis is very frequent, and more so amongst the Mahomedans than the Christians. I saw several cases of skin disease, and also amongst Greeks. The absence of skin disease in the Mahome- dans may be in some measure accounted for by the fact of their greater personal cleanliness, frequent washing, and use of the bath. All classes are about equally subject to fever which, I am told, is usually of a typhoid character. Diarrhea is com- mon, and more than half the children die under two years of age. Dr. Nouridjan informed me that in the upper part of the city there were a great many cases of small-pox. I saw several cases of bilious diarrhea, and learnt that all diseases of the liver of a congestive character were very common amongst all classes. There was a terrible outbreak of cholera here in 1865, and a slighter one in 1870. There is no system of registration of deaths, but the rate of mortality is stated not to be much above that of Europe. Upon this point I am ex- ceedingly sceptical. All the medical men with whom I con- sulted agreed in stating that small-pox, typhoid fever, diarrhea, cholera and phthisis, were the most common, and by far too frequent causes of sickness and death. From a care- ful survey of the city these are just the diseases we should ex- pect to find most prevalent. The streets are very irregularly constructed, badly paved; no system of sewerage; in many places the streets are so narrow and the houses so high that the atmosphere is everywhere oppressive. There is a strong urinous smell all over the city. All the streets being on a very steep gradient, nothing could be easier than the contruction of good sewers discharging direct into the sea and leaving no trace behind. For the want of sewers filth collects, and putrifies everywhere on the surface. But for the dogs, who",
         "CONSTANTINOPLE. are the great and only scavengers, the streets would become impassible. The water is principally derived from reservoirs about sixteen miles from the city, and some in different parts. Doubtless the low type of disease prevalent here is due to the regular, not intermittent, downward filtration of sewage' intob springs. Instead of 'matted organisms,' in the water, I have frequently seen actual living organisms, and there is no doubt the water used for drinking purposes in Constantinople is very impure. Fruit is very plentiful and cheap. In all cases I re- ceived the same reply to my enquiry as to the use of fruit having an effect in producing cholera and diarrhea, viz., that the fruit had nothing to do in producing these diseases. One gentleman, much engaged in the cholera in 1865, informed me that although people who eat fruit were not more liable to the disease, the fruit nevertheless during that period, however carefully gathered and stored, very rapidly decayed. The same gentleman narrated the following experiment. Two vil- lages near together showed exactly opposite results. In one case the cholera was very severe, whilst in the other there was scarcelya case. The general beliefbeing that the germsof the dis- ease were suspended in the air, a goat was killed and divided into two equal portions; one portion was taken to each vil- lage, and attached in either case to a baloon and sent a con- siderable distance into the air. In the case of the village where the disease prevailed, the meat became quite putrid, whilst in the other case it underwent no change. A great fire broke out in Constantinople in 1865 when the cholera was at its height; the death-rate, having reached its maxi- mum, rapidly declined after the fire. In 1870 the cholera broke out in the region of the Arsenal-a district principally occupied by English residents. A cordon of troops was placed round the district, and no ingress or egress permitted. Although the percentage of deaths was very great, the disease did not spread beyond the cordon. I shall reserve a few re- marks upon the pathology of cholera for my next letter from Smyrna. LORY MARSH, Secretary of the Sanitary Institute of Oct. 28, 1876. Great Britain. Dr. Lancaster, of London, lately analyzed a man weighing 154-4 pounds. He found 23.1 pounds of carbon, 2.2 pounds of lime, 22.3 ounces of phophorus, and about one ounce each of sodium, iron, potassium, magnesium and silicon, 112 pounds oxygen, 15.4 pounds hydrogen, and 52 cubic feet of nitrogen. 341",
         "THE SANITARY JOURNAL. THE RELATION OF THE MEDICAL PROFESSION TO SOCIETY. In contemplating the numbers, the education, the social posi- tion and direction of the labours of the medical profession, every thoughtful mind must become impressed with the enor- mous influence it is destined to exert in the future of the race. Its peculiar study is Man, and he has no relation to his fel- lows, to his environment, or to history, which it does not be- come imperative upon the physician to study, and this with a view to alter and direct the future. For example, we have more than once called attention to that \"natural history of crime \" which has been so ably out- lined by Professor Austin Flint, and pursued by Dr. Moritz Benedict within the last year and a half ; or we can refer to those studies in heredity and satavism which invest genealogy with a new and broad significance, and supply entirely new forms for the estimate of human motives ; or to the late re- searches in archebiosis and the differentiation of species which united with the study of mental pathology, have already re- versed the whole procedure of metaphysical reasoning and supplied a different basis for ethics. Though probably disease has not been diminished, nor yet will be in any material degree, tolerance of disease has been vastly increased, and the average duration of life has been very considerably prolonged. The sociological results of this will prove momentous. \" Time and 1,\" said Philip the Second, \"against any other two,\" and it is certain that in modern society a long life properly employed insures wealth and power toward its close. With the general increase in the duration of life, with the growing \" betterment of risks,\" to use a life- insurance expression, it will become more and more rare for young men to inherit fortunes or gain positions of power, for their fathers and uneles will continue in life. Hence, the social forces will more and more come under the control of age and experience. Fortunes will be more rarely squandered, dissipa- tion will be proportionately lessened, rash youth will more rarely hold the helm. To be sure, this is not an agreeable prospect for those who believe that the moral and iiitellectual faculties com.megmce their decay in middle life. But these may find some comfort in the undoubted fact that intellectual culture materially aids in se- curing long life, and that the most intelligent, those who ex- ercise constantly and wisely their brain power, have the best chance to outlive the others, and thus get control of the social",
         "MEDICAL PROFESSION. tendencies. Dr. William B. Neftel, in a paper on Melancholia, publisbed last year, makes the following pregnant remarks : \" That idiots do not live long is an established fact; but it is, perhaps, less known that even the physically strongest persons, the athletes, if not intellectually developed, seldom, if ever, reach an advanced age, and that the oldest persons in any country are generally also the most intelligent.\" With the growing recognition of the value of life comes the desire to defend and prolong it; and hence the profession which makes this study its avowed object must become more highly cherished as time passes. This was well put by Mr. Gladstone in an address he delivered this summer at the Med- ical College of the London Hospital. He observed, looking to the future, that in proportion as man's enjoyment increases, so will his sufferings, and the necessity for help to relieve those sufferings. It was thirty years since he delivered an address at the Middlesex Hospital, and at that time he w\u0026s impressed with the altering structure of society, the constant development that it seerned to undergo, and the effect of all this upon the physical and material, as well as upon the men- tal life. Even then he ventured to say that the importance of the medical profession, which at that time had grown so largely, would still grow in increasing proportion. Looking back across the intervening years, he could say that his an- ticipations had been fully realized. The public began to com- prehend that the medical profession laid no claim to what he inight call cabalistic methods-that was to say, it did not de- pend upon formule, but relied upon experience, endeavoured to track the truth, and followed the laws of common sense. That profession presented a future of the highest interest. And he believed it would, most probably, in that future gain increased influence, in greater proportions than other profes- sions would. The legal profession, for example, possessed now no larger social influence than they enjoyed fifty or one hun- dred years ago. But with the medical profession, as pointed out above, the development of disease and the physical habits of life tended to widen its sphere and increase its influence. This is sound reasoning, and it comes in this instance based on personal observation of society in one of its most culti- vated centres.-Med. and Sur. Rep., Phi., Oct. 28th, 1876. THE small pox is very prevalent in London, Eng., and, according to latest exchanges, is on the increase. 1343",
         "THE SANITARY JOURNAL. ON A MODE OF GENERATING SULPHUROUS ACID FOR USE AS A DISINFECTANT, \u0026c. BY THOMAS W. KEATES, CONSULTING CHEMIST TO THE METROPOLITAN BOARD OF WORKS, ETC., ETC. From the remotest time, burning sulphur bas beem em- ployed to fumigate and purify infected air, and to destroy fer- mentative and putrefactive action. There is no agent more powerful in its effects than this. Unlike chlorine, it not only acts as a dinfectant or destroyer of disease-germs and of the results of putrefaction, but it is also a powerful preservative agent, and, like carbolic acid, is a preventive of chemical changes in dead organic matter of every kind. Although the value of sulphurous acid is thoroughly under- stood, its use is necessarily limited by the difficulty which ex- ists in the way of producing it in a form in which it can be readily applied. The ordinary method of generating it by burning sulphur is cumbrous and very uncertain, owing to the difficulty of keeping up the combustion; there are also many situations in which the process cannot be carried on at all, and under the best circumstances it is inconvenient and but little nder control. Most of the readers of The Lancet are no doubt familiar, at least theoretically, with the substance called bisulphide of carbon. This is a compound of one atom of carbon with tyo atoms of sulphur (C.S.); it is a dense, mobile liquid, heavier than water, and intensely inflammable, burning in the air like spirit of wine. The bisulphide of carbon can be burned in a common spirit lamp, and in that case the products are sulphurous acid and carbonic acid only, in relative proportion to the atomic compo- sition of the bisulphide; but by a modification of the method of burning, the amount of sulphurous acid produced in a given time can be regulated to any desired extent. It is a property of the bisulphide of carbon to dissolve in fat oils and hydrocarbon liquids, such as petroleum; so by nixing it with any one of these liquids and burning the mix- ture in a properly constructed oil or petroleum lamp, sulphur- ous acid will be generated with the other usual products of the combustion # such materials, and in proportion to the quan- tity of bisulphide present in the mixture of combustible liquids: any proportionate quantity of sulphurous acid can in this way be thrown into an atmosphere, and the action may be contin- ued for any length of time.",
         "SVLPHUROUS ACID. As the sulphurous acid is generated pari passu during the com- bustion of the bisulphide, it diffuses itself in the air, which in a short time will become completely impregnated with it. In a room containing about 1300 cubic feet of air it was found that by burning 280 grains of the bisulphide the atmosphere was so far changed with sulphurous acid that it was impos- sible to remain in the room for more than a few seconds. In five minutes after the lamp was lighted litmus paper began to be reddened at some distance from it; in ten minutes the air had become very oppressive, and the litmus paper was red- dened in the extreme corners of the room; in fifteen minutes the air was so changed with the gas that it could scarcely be breathed, and in twenty minutes it was unbear - able. In that time, as I have said, 780 grains of bisulphide were consumed in a single wick lamp. Sulphurous acid generated in this manner can be applied with facility to the disinfection of any place or object. In the case of rooms in which infectious or contagious disease has pre- vailed, it is only necessary to light the lamp and allow it to burn until the atmosphere has become impregnated with the gas to any desired extent, and then to remove or entinguish it just like a common spirit-lamp. In the simple form of ap- paratus which I suggest for this purpose, the lamp is en- closed in a metal case, about three inches in diameter and eight or nine inches high, furnished with holes near the bottom for the admission of air, and others in the top for the emission of the sulphurous gas. This can be conveniently moved about, and placed, while the lamp is burning, in almost any locality. Resceptacles for infected clothing, or the clothes or linen used in connection with disease, or carriages which have conveyed fever or other patients, can be thoroughly purified without difficulty and with very little trouble. It must be observed that the bisulphide of carbon is ex- tremely volatile, having its boiling point as low 110° F. ; it is therefore necessary that the lamp in which it is burned should be furnished with a well-fitting screw-cap, to prevent the liquor from evaporating, and at the same time to keep its pe- culiar odour from escaping. This odour is often very naseous but the bisulphide is now manufactured by Messrs. C. Price \u0026 Co., of Thames street, so pure, that it possesses very little smell, and can be used without the least inconvenience.- Lancet, London, November 18, 1875. 345",
         "TVE SANITARY JOURNAL. THE REGISTRAR-GENERAL'S, (ENG i.,) ANNUAL REPORT. Year after year, for nearly half a century, these Reports, with their carefully compiled and laboriously worked out details, have been given to the public. Have the results been in equal ratio to the time and money expended on them? The answer must be emphatically in the affirmative. The weekly Table of Mortality, here arranged for the whole year, is an old London institution, improved and perfected in every manner that forethought and science can devise, and its utility is now very much increased by a publication of corresponding returns from nearly every city of importance throughout the civilised world; it follows, therefore, that, as the Registrar-General re- marks in his introduction, \"observers, like watchmen on the walls, are ever on the look-out, so that men can sec exactly what is going on, and neither plague nor cholera, nor any other great epidemic can take the nation by surprise.\" Russia is almost the only country from which no returns are received; but as statistics are beginning to be cultivated there, it is hoped that before long the capitals of that country will co- operate in carrying out the great system of hygienic observa- tion. Little by little the results of fresh sources of inquiry have been added to these returns, and only two points are now required to complete their usefulness-one of these is a record of the age at marriage in all cases, and the other is the ;ge of parents at the births of their children ; and though un- doubtedly difficult to obtain, there is no reason for supposing they will not eventually be able to be shown. The Report further explains that special inquiry bas been made into the connection which exists between great reduction in the mor- tality and genuine sanitary work; and the result is decisive. There remains no doubt that the increased salubrity of several towns and districts is entirely due to sanitary measures Where no such effects follow improvements, it may fairly be assumed the improvement is only apparent, or that the works are imperfect. What is certain is, that-thanks to the increas- ing and improved sanitary measures which are being carried out all over the country-the mortality of the whole popula- tion, though not so low as it is in some countries, is much lower than it is in large empires. That the health of the peo- ple is not stronger is partially due to the increasing density of the population, without corresponding arrangements for lodg- ing them, for supplying thein with pure water, for preventing",
         "ANNUAL REPORT. the discharge of black smoke into the air they breathe, or for carrying away impurities in the shape of sewage and other deleterious matters. It is, however, satisfactory to find that, after carefully considering the mass of information which reaches him froim all quarters, the Registrar-General is able to record that the progress of the health of England is a source of congratulation. Much, he admits, remains to be done; but with a vigilant body of health officers devoting themselves to conservative medicine, it only requires to solve efficiently the sewage and water questions, to build improved dwellings ii village, town, and city, to render the health returns as satis- factory as we can ever hope to make them. The Appendix to the Report contains an interesting statement by Dr. Farr ont the causes of death in England in 1874, considered under thu different groupings of disease.--Med. Times \u0026 Gaz. THE SANITARY CONDITION OF SWITZERLAND. The Gaz. des Hopitaux, Oct. 26, contains an abstract of an iii- teresting paper read by Dr. Lombard, of Geneva, at the recent meeting held by the Helvetie Society at Basle, in which- he stated the results of his researches as to the present distribu- tion of disease in Switzerland. Intermittent fevers, formerlv so common, ha·ve diminished in all parts of the country, and even have quite disappeared from some localities where form- erly they were very common. The mean mortality resulting fr-om phthisis pulmonalis is 77 per 1000 deaths, being a much lower proportion than that of most other countries of Europe. Thus in Belgium this varies from 168 to 198, and in England is 124. It varies much in the different cantons and cities of' Switzerland, being 104 at Zurich, from 105 to 107 at Basle, 101 at Geneva, 104 at Neufchatel, 37 at Fribourg, 49 in Valais, 50 in Thurgau, and 17 in Zug. Two influences are brought into view by this investigation-viz., the deleterious effects of industrial occupations as compared to agricultural, and the benefit of high altitudes, cases of phthisis being less frequent in proportion tô the height attained, so that it entirely disap- pears in the very high valleys. Goitre and cretinism exist in Switzerland-the first, in different degrees, in almost every part; the other in certain regions only, and tending to dimin- ish as prosperity and civilization are extended. With respect to the geographical distribution of the cretinism, the Valais occupies the first place, it being found as well in its principal",
         "THE SANITARY JOURNAL. valleys as in its numerous lateral valleys-which, with few exceptions, contain many cretins. The cantons of Vaud and Bern have cretins in only very few localities; and the same comparative immunity exists in all the cantons situated in the principal Surassic valleys-as Neufchatel, Solothurn, Ar- govia, and Basle. The grand mass of the Alps is, consequently, together with the Valais, the principal endemic seat of cretin- ism. Inflamnations of the respiratory organs are, as might be expected, amongst the most widely spread diseases in Switzerland, being found with a frequency which increases with the altitude. They are, indeed, met with in a very severe epidemic form in the higher valleys, where what is termed the \" alpenstich \" is a malignant and probably contagious pleuro-pneumonia. Scrofula and rheumatism are very pre- valent throughout the whole of Switzerland, and seem to in- crease with the altitude. Epidemic cholera has never reached the districts of the centre of the country. Alcoholism, as everywhere else, is making progress in Switzerland, and in some cantons carries off many victims. The mortality fron delirium tremens is limited in many towns and cantons to 1 or 2.per 1000 deaths; while in others it is raised to5 or 6, and in some localities to 35 per 1000. The number of blind persons in Switzerland is 76 per 100,000 inhabitants, which is a relatively very low proportion. In France there are 84 per 100,000, in Sweden 81, in Holland 100, and in Norway 184. On the other hand, in Bavaria there are only 52, in Prussia, 58, and in Belgium 68. The cantons in which most blind are found are the Grisons (130), Appenzell (109), and Tessin (103); while fewest arè found in Glarvs (42), Geneva (44), and Schwytz (46). The deaf-dumb exist in the proportion of 245 per 100,000 inhabitants, which is nearly five times larger than in France, where it is 58. The Valais occupies the foremost place (498), and after it come Lucerne (436) and Argovia (434). At the other extremity of the scale are Geneva (171), Glarvs (45), and the district of Basle (84.)-Med. Times \u0026 Gazette. IDISINFECTION WORTHY OF IMITATION.-The Health Com- mittee of the Birmingham Corporation have opened a station for the purpose of effectually disinfecting the clothes and bed- ding of patients who have suffered from infectious disease. The method of disinfection adopted is that known as Dr. Ran- some's hot-air systein. The establishment consists of several detached buildings in a large enclosed yard; it is divided into two departments-one where infected articles are received, and the other where they are placed after being disinfected.",
         "HYGIENE. The isolation of the two places is so complete that each has separate entrances, yards, out-buildings, stabling, vehicles, and attendants. Persons having need of the disinfecting apparatus have only to give notice to the sanitary inspector, and the in- fected articles will be removed in a closed van to the station, thoroughly purified and returned; this will be done in the course of a few hours, free of charge, and without any trouble to the owners of the articles. The fabrics to be disinfected are placed in an air-tight iron chamber, and exposed to heated air at a temperature of from 250° to 270°. The station ,and apparatus cost altogether about £1,000 -Sanitary Record. HYGIENE.-Whether the School Board and the teachers in our ragged and denominational schools intend to teach their little scholars the value of soap and water and to instil into their young minds the truth of the old maxim, that \" cleanli- ness is next to godliness \" we will not pretend to say. But with all reverence for what is holy and good, we shall venture to assert that to compel them to learn a short catechismn of personal hygiene in respect of its most simple and elementary rules, would even be to them of more practical benefit than that resulting from the teaching of another catechism with which the memories of too young children are frequently bur- thened. It may certainly be asked of what use would be the teaching of the elements of hygiene and the importance of thrift, industry and cleanliness to children to whom the ex- ample set them at home would more than gainsay the precept they learnt at school. There is, however, no reason why the education of parents to such habits as are conducive to health and comfort should not go hand in hand with a similar educa- tion of their offspring.-Med. Press \u0026 Circular. WHEN AND WHY WHERE MALE PHYSICIANs EMPLOYED AS. ACCOUCHEURS ?-Dr. Wm. Goodell (American Journal Ob- stetrCs, August, 1876), in a very interesting paper answers the above question. It was just subsequent to the discovery of the art of printing that male physicians began to act as ac- coucheurs, and thus destroy the monoply of midwifery by mid- wives. The reason for this change seemed to lie in the fact that the people became wiser, read more books, so that they could appreciate the ignorance of the midwives. Physicians developed with the times, the midwives did not. The former wrote elaborate works on obstetrics, which the latter, with rare exceptions, could not even read. What more natural than, that intelligent women should prefer the teacher to the inapt pupil-should place their lives in skilled hands rather than. 2",
         "THE SANITARY JOURNAL. in those which were unlettered. What more inevitable than that the male physician who -was hurriedly sent for in cases of emergency, or was kept waiting in an ante-chamber for such emergency, should, despite tradition, prejudice and re- ligion-should, in spite of himself, for it was long deemed dis- honourable for him to practice niidwifery, ultimately usurp the place of the midwife by the bedside of the woman in travail? Detroit Review of Medicine. PHYSICAL AND INTELLECTUAL QUALITIES QF MAN-THEIR MEASUREMENT.-Dr. Baxter (Med. Statistics Provost-Mar- shal's Bureau, vol. 1, p. 83,) gives as a summary of the con- clusions reached by investigators in anthropometry the follow- ing: (1.) There is a perfect form or type of man, and the tendency of the race is to attain this type. (2.) The order of growth is regular toward this type (3.) The variations from this type follow a definite law, the law of accidental causes. (4.)- The line formed by these variations, when arranged in groups receding on either side of their mean, is the curve well known to mathematicians as the binomial; it was first applied by Newton and Pascal to questions of astronomy and physics, but is applicable to all the qualities of man which can be re- presented by numbers. (5.) The more numerous the data ob- tained by actual measurement, supposing Lhem to be made with reasonable care and without bias, the more nearly ac- curate is the mean result, and the more closely does it corres- pond with that obtained by calculation.-Detroit Rev. of Med. IYGIENE IN THE RUSSIAN SCHOOLS OF MEDICINE. - The Russian Government exhibited at the Brussels Exhibition for the Saving of Life, some specimens of the models used for illustrating hygiene in Russia Schools. The composition of the human body is shown by a series of jars, which contain separately the approximate quantity of substance that go to make up the human frame. First,a large glass barrel, holding about fifty kilogrammes of water, is shown, and this forms 72 per cent. of the total ingredients. In smaller vessels are the gelatine, the albumen, the fat, the phosphate and carbonate of lime, and divers salts which help to constitute the mortal part of man. The pupils having thus learnt of what they are made, are told how to maintain the natural balance. They are shewn of what various kinds of food consist. In a glass tube is exhibited so much water, so much albumen, so much cellu- lose, sugar, starch, etc., and the outside is marked ' cabbage,' or ' cucumber.' There are jars of black bullock's blood to be 350",
         "-shaken up with air, in order to show how oxygen reddens and revives the blood in the lungs. There are also jars with lime water and a breathing tube so that the pupil can breathe in and see the water curdle at the action of the carbonie acid. Another breathing apparatus experiment shows that this car- bonic acid is fatal to the flame of a taper as it would be to human life, and as it ultimately is to the unhappy doge periodically thrust for the instruction of the traveller into the Grotto del Cane, near the Avernian lake in Southern Italy. By another of the Russian modes a striking sanitary lesson is taught. The exhibitor breathes into one side of a box, which is divided into two by a strong brick wall. The other side of box is tapped by a tube which ends just above the flame of a eandle. When the exhibitor has poured carbonic acid6from his breath into one side of the box it passes through the bricks, ,and coming through the other tube falls down (being heavier than air) upon the candle and extinguishes it. The learner is thus taught that noxious gases are not kept out by brick walls.-Sanitary Record. VAcCINIA.-The public should know that the object of being vaccinated is to have produced in the vaccinated person vac- .cinia. It is common for people to talk as if it was enough to have been vaccinated, whether vaccinia was produced by the operation or not. This is a great mistake. Security from small-pox is conferred, not by being vaccinated, but by having the system affected by the disease called vaccinia, which, like ail other eruptive diseases, should have an eruption, and pro- duce a certain amount of malaise and febrile disturbance in the system. So with revaccination. It is not enough to have the .operation performed. What is wanted is the production of the disease a second time, in a milder and modified way, but still in a way to produce certain local manifestations accompanied with a certain amount of feeling of malaise. It is people who have had vaccinia well a second time who are protected from small-pox, not people who have merely gone through the for- mal operation of vaccination which may fail from various -causes. In one case reported to us the temperature of a baby that had been well vaccinated ten days before, was found to be 102°. This was two or three days after the period when public vaccinators are required to see a child. Yet the child was still il. It had a sore arm and a high temperature. So much the better for the child ; but the case show that vac- cinated children need a little more sympathy and attention than they get, and it is very likely that they would recover all the better if vaccinia were a little more regarded than it is.-Lancet, London, November 18, 1876. 351 VACCINIA.",
         "THE SANITARY JOURNAL. SANITARY TîACHING FOR THE PEOPLE.-With a view to en- lighten the working classes on the laws of health, and follow- ing in the wake of Manchester and Birmingham, a series of twenty lectures will be given in London this winter, under the auspices of the Natural Health Society and the Trade Guild of Learning. The first lecture was given on Saturday evening before a very large and attentive audience in the large room of the Society of Arts, John Street, Adelphi, a fee of one penny per lecture only being charged to the working-classes. For other members of the community the charge is one guinea for the course. Professor W. H. Cornfield, of University Col- loge, has been selected to deliver the lectures, which are all to be in the simplest terms, that a very labouring man and woman will be able to understand, the subjects being the struetures of the body; the separate work of the bones, muscles, \u0026c.; the circulation ; brainýwork ; preventible diseases; ventilation; water supply; drainage ; foods and drinks; the arrangement of dwellings; unhealthy employments; disinfec- tion, \u0026c. The sympathies of the working classes having been appealed to and obtained, such a course of instruction cannot fail to exert a healthy influence upon the masses, and strengthen the hands of those who are engaged in an uphill hygienic war- fare.-Med. Press and Circ. FATAL GOOD-BYES.-It bas often happened that two persons in good health have bid each other good-bye, not doubting they would meet again in a few days. Within a few days one died, and they met no more. One had accompanied the other to the door to open it; a cold, raw wind was blowing; some other subject came up, and talked just a minute, but during that minute the person visited having on no extra garment, while the visitor was warmly clad, \" got chilled through and through ;\" that means, in many cases, inflamma- tion of the lungs, so often fatal within five days. If you nust stand at an open door,place yourself between the lock and the hinge, then the wind cannot blow upon you.-Ex. A NEW DANGER FROM ARSENICAL POISONING.-A rich lady, residing in the Faubourg St. Honore, Paris, found herself growing very ill, and her doctor pronounced ber to be suffer- ing from the effects of some slow poison. Finally, it was discovered that candles were kept burning all night in ber room. These candles, of a dazzling whiteness, had been strongly impregnated with arsenic during their bleaching pro- cess, and the arsenic becoming volatilised by the combustion thus poisoned the air of the bed-chamber. A white filmy powder was found in a glass of water at the bed-side, and was found to be arsenic.",
         "yANITARY wonR. PRACTICAL RESULTS OF SANITARY WORK. Within the last forty or fifty years, attention having been -strongly directed to the large comparative mortality of cities -and its connection with manifest local conditions of impurity, 'the British parliament passed laws authorizing towns to make improvements, and to raise money to pay the cost. Under this authority many towns and cities have drained their streets with sewers. They have paved streets that were bare, cleansed filthy places, opened closed courts, widened narrow lanes, removed nuisances, and introduced water from pure streams or fountains, to be used in households, instead of the corrupted water of the wells. These improvements have been followed by marked changes in the sanitary condition of the inhabitants. Sickness has diminished; some diseases that were very frequent-fevers, dysentery, cholera, etc.-have be- -come rare, and from some places they have disappeared. The rate of mortality has been reduced, and longevity has materi- ally increased.\" In Salisbury the results of such improvements was, that whereas, for nine years before, the annual mortality was 27 in 1,000 of the population, for nine years after the improve- ments were made it was only 20 in 1,000. In Liverpool the rate of mortality previous to 1847 was -3.84 per cent., or one in 26 of the population annually. An extensive system of sanitary improvement having been carried into effect, \"at once there was a change for the better in the health of the people, especially of the poor. Sickness dimin- ished, and the death-rate was reduced from 3.84 to 2.27 per eent.-nearly one-third.\" In other words, instead of one death in 26, there was only one in 37 of the population an- nually. Many other towns did a similar good work for themselves, ,and received a similar reward. The rate of mortality was reduced in London from 2.38 to 2.23 per cent.; in Manchester from 3.71 to 2.71 per cent.; in Glasgow from 3.39 to 2.78 per ,cent. by the same means. In Macclesfield \"the general rate of mortality of the whole city was reduced from 3.3 to 2.6 per cent. * * * But the worst districts, which had beén the most foul and most sickly, .and where the work of cleansing and purification had been greatest, showed the largest improvement in health and life.\" The rate of mortality was diminished in some 34, in others 40, 42, and in one 60 per cent. \" In the original state of the town .the average age of all who died was 24 years; but afterwards it was 29 years, showing a gain of 20 per cent. in longevity.\" 353",
         "THE SANITARY JOURNAL. Another writer sums up the results attained by sanitary reforms in England in the following emphatic terms: \" With- in the last half century land-draining and town-sewering have ripened into sciences. From rude beginnings, insignificant in extent, and often injurious in the first instance, the system- atie sewering of towns and draining of lands have become of the first importance. Land has thus, in not a few instances, doubled its value. Town-sewering, with other social regula- tions, has contributed to prolong human life from 5 to 50 per cent., as compared with previous rates in the same district. Agues and typhoid fevers are reduced in the frequency of their occurrence. Since 1840 an annual mortality of 44 in 1,000 in English towns has been reduced to 27; an annual mortality of 30 has been reduced to 20, and even as low as 15. Not less remarkable reductions have taken place in the mortality and loss of strength in the army and navy ; so that generally it, may be said that human life has now more value in England than in any other country in the world-a result entirely due to better sanitary arrangements.\"--(Aitken, Sci. \u0026 Prac. of Med.)-Report of Virgina State Board of Health. THE ARCTIC EXPEDITION-The Sanitary Record observes, the causes which prevented the late Arctic Expedition from pene- trating at least much nearer to their goal are now pretty clearly made out, and have a great public interest extending beyond the range of Arctic exploration, or merely retrospect tive information. The expedition failed relatively because the commanders of the sledge parties failed in the most vital mat- ters to observe the instructions given to them for the main- tainence of the health of their men. It seems incredible, but it appears to be absolutely true, that the sledge parties started without any supply of lime-juice, and that eac man was expected to drag over the rough and mountainous ice, a weight averaging upwards of 400 lbs. per man-just double the amount of exertion which could reasonably have been ex- pected of them. Under the continuous influence of want of lime-juice and excessive exertion the joints of the men began to swell, and the characteristic blood-effusions to appear with intense depression and lassitude. The swellings were rubbed with liniment as if they were bruises, and even when the pre- sence of seurvy was but too aþparent, there was not any store of lime-juice to be used as a medicine. No wonder that, when the remaining men still in health had to pull along the two sledges and the scorbutic invalids, they progressed only a. mile a day.",
         "THE SANITARY JOURNAL. Communications solicited from Medical Men and others on all subjects pertaining te Public Ilealth. VOL. II. TORONTO, DECEMBER 1ST, 1876. No. 12. A PROVINCIAL BOARD OF HEALTH. We have on several occasions suggested the advisability of having a Provincial Board of Health established in Ontario. In most civilized countries the State is taking some action in the direction of establishing Central or State Boards for look- ing after the health and life of the people. In some countries, notably England, much has been done in this way for many years, and there seems not to be in one of them two opinions regarding the usefulness and value of such bodies. It seems to be universally believed that the money and labor thus spent in the interests of public health could not be applied to better use, and the constant tendency is where action bas been taken to increased expenditure in that behalf. Eleven of the States of the 'Union' have now State Boards of Health ; Massachusetts taking the lcad, establishing a Board in 1869, The voluminous reports of this Board are becoming second only to the reports of Mr. John Simon, of the Government Board of Great Britain. Probably many of our readers have not had opportunity to learn much of the nature and objects of these State Boards, and we give below a brief notice of four of them. The Massachusetts Board, consists of seven members, appointed by the Governor, with the advice and consent of his Council. Each menber holds office for seven years, and the term of one expires every year, the Governor appointing another. The Secretary only receives a salary, though the actual expenses, travelling, etc., of the other members are paid. The Act establishing the Board provides that:",
         "THE SANITARY JOURNAL. \" The Board shall take cognizance of the interests of health and life among the citizens of this Commonwealth. They shall make sanitary investigations and inquiries in respect to the people, the causes of disease, and especially of epidemics, and the sources of mortality and the effects of localities, employments, conditions and circumstances of the public health p and they shall gather such information in respect to those matters as they may deem proper, for diffusion among the people. They shall advise the government in regard to the location of any public institutions. They shal), in the inonth of January, make report to the legislature of their doings, investigations and discoveries during the year ending December thirty-first, with such suggestions as to legislative action as they may deem necessary. \" It shall be the duty of the Board, and they are hereby instructed, to examine into, and report what, in their best judgment, is the effect of the use of intoxicating liquor as a beverage, upon the industry, prosperity, happiness, health and lives of the citizens of the State. Also what additional legislation, if any, is necessary in tho, premises.\" The Michigan Board, established in 1873, consista of six members, appointed by the Governor ; the members shall appoint a secretary, making a seventh member. The secretary only, who is the executive officer, and also Superintendent of Vital Statistics, receives a salary. The term of two members expires every two years. The duties of the board as set forth in the Act are similar to those of Massachusetts. Sections of the Act provide as follows: \" The sum of four thousand dollars per annum, or so much thereof as may be deemed necessary by the State Board of Health, is hereby appropriated to pay the salary of the secre- tary, meet the contingent expenses of the office of the secretary, and the expenses of the board, which shall not exceed the sum hereby appropriated. - \"It shal be the duty of the health physician, and also of the clerk of the local board of health in each township, city, and village in this State, at least once in each year, to report to the State Board of Health their proceedings, and such other facts required, on blanks and in accordance with instructions received from said State Board. They shall also make special reports whenever required to do so by the State Board of Health. \" In order to afford to this board better advantages for",
         "BOARD OF HEALTH. obtaining knowledge important to be incorporated with that collected through special investigations and from other sources, it shall be the duty of all officers of the State, the physicians of all mining or other incorporated companies, and the presi- dent or agent of any company chartered, organized. or trans- acting business under the laws of this State, so far as practicable, to furnish to the State Board of Health any information bearing upon public health which may be requested by said board for the purpose of enabling it better to perform its duties of collecting and distributing useful knowledge on this subject. \" The secretary of the State Board of Health shall be the Superintendent of Vital Statistics. Under the general direc- tion of the Secretary of State, he shall collect these statistics, and prepare and publish the report required by law relating to births, marriages, and deaths.\" The Virginia State Board was established in 1872, it consists of seven physicians, holding office four years. \" The board is required to place itself in communication with local boards of ltealth, hospitals, asylums, and other public institutions, and to take cognizance of the interests of ealth and life among the citizens generally. They shall make sanitary investigations and inquiries respecting the causes of disease, especially of epidemics and endemics, the sources of mortality among the whites and the blacks, and the effects of localities, employments, conditions and circumstances upon the public health; and they shall gather such information in respect to these matters as they may deem proper for diffusion among the people. The board is required to inquire into the effect of the use of intoxicating liquor as a beverage upon the industry, happiness, health, and the lives of the citizens of the State, and also what legislation, if any, is necessary in the premises, and to make an annual report to the Legislature of their doings, investigations, and discoveries, with such sugges- tions as to the legislative action required as they may deem proper.\" The Act establishing the Georgia Board, passed January 1875, provides for the appointment of nine physicians, to hold office six years, the term of three expiring every two years: \" Who shall have been practitioners of not less than ten years, one from each Congressional district in the State, who for the time being, shall be sanitary commissionersfor the said 357",
         "THE SANITARY JOURNAL. districts, and the said sanitary commissioners, together with the Comptroller-General, and Attorney-General, and State Geologist, shall constitute a board of health.g \" That said board shall take cognizance of the interests of health and life among the people of the State; they shall make inquiries in respect to the cause of diseases, and especially of epidemics, and investigate the sources of mortality, and the effects of localities, employments, and other conditions upon public health. \" Such State Board of Health is authorized to require reports and information (at such times, and of such facts, and generally of such nature and extent, relating to the safety of life, and the promotion of health, as its by-laws or rules may provide) from all public dispensaries, hospitals, asylums, prisons, and schools, and from the managers, principals, and officers thereof; and from all other publie institutions, their officers and managers, and from the proprietors, managers, lessees, and occupants of all places of public resort in the State; but such reports and information shall only be required concerning matters and particulars in respect of which it may, in its opinion, need information for the proper discharge of ita duties. Said board shall, when requested by public authorities, or when they deem it best, advise officers of the State, county, or local governments, in regard to sanitary drainage, and the location, drainage, ventilation, and sanitary provisions of any public institution, building, or public place. \" That the sum of fifteen hundred dollars is hereby appro- priated for the purposes of this Act. It can hardly be doubted that a Board of Health for Ontario, established on principles similar to the above, would be very useful. \"Slowly but surely,\" the Massachusetts Board writes, \" the value of the Board, as a powerful agent for public good, has been recognized, and the desirability of still further extending its field of usefulness lias been admitted.\" The last report of this Board is a volume of 350 pages of most valuable and instructive matter, and 10,800 copies.have been printed for distribution; being at the rate of one for every 28 families in the States. Ontario has a large surplus and spends immense sums on other and much less important things. It is to be hoped this subject will receive at least some attention, as in most other civilized couptries.",
         "THE PNEUMATIC SEWAGE SYSTEM. THE PNEUMATIC SEWAGE SYSTEM. In the pneumatic system the focal matters are drawn off by pipes connected with air-tight resorvoirs and steam-worked pumps. It has been introduced chiefly into Holland by Captain Liernur, seemingly the inventor. It was described in the SANITARY JOURNAL over two years ago, and we then stated that if the system proved to be as perfect as its advo- cates claimed, it ought to supersede the water carriage system. It appears not to have been generally very well received' how- ever, though it seems to be well adapted to low-lying cities. It no doubt has points of excellence, but any system in which the pipes for conveying the focal matter are actually trapped by the fecale itself, which trap is to prevent sewer gases getting into the houses, and which fecale might possibly be from a ty- phoid patient, and which pipes, as Captain Liernur states himself become coated inside with a moist \" schleimartig,\" must be far from perfect or desirable, and not only inelegant but disgusting and unsafe. We observe that in Montreal there is a movement to give this system a trial in a part of the city. We would advise our readers there to consider the matter well before adopting such a system. If the sewage of the city is polluting the river, can they not turn it from the river and have it conveyed out of the city by gravitation or pumping to a sewage farm. This method seems now to be very generally regarded as the most practicable one of sewage disposal. The pneumatic sydtem of Liernur we have looked into some- what and do not believe its use will become general. A Berlin commission reports that at Prague and Hanau, where it had been tried on a small scale, it had proved offensive and so un- satisfactory as not to be extended. Capt. Liernur however states that the first attempts have been improved upon. In 1867 a commission at the Hague recommended the system for that city but a year ago it had not yet been introduced there. It had a like fate at Rotterdam. Capt. Liernur is in- troducing it into a part of St. Petersburg, but that city is not to be at any of the expense. He has had an agent in London, 359",
         "THE SANITARY JOURNAL. but the system does not appear to meet with a very favourable reception in England. The Netherlands being reclaimed from the sea, and being surrounded and protected by enormous dykes, upon which the country depends for security against inundations, it is easy to see that the difficulties of drainage and sewerage are very great, and that an abundant supply of pure water is almost an impossibility. Many of the houses in the cities have common privies, discharging by nearly straight tubes into the canals. Among the wealthy class there are a few water-closets and cesspools. The poor have no accommodations, and throw into the stagnant canals the refuse which does not escape by sur- face-drainage. In Amsterdam, the odors from the canals have been for years extremely offensive, and naturally, the authorities were willing to try any system which promised a solution of their difficulty, and they adopted the Liernur system in one of the poorest quarters of the city in 1870. \" At the present time,* it bas been introduced for a popula- tion of 6,000, or one-fiftieth of the whole city. Mayor den Tex, and the present Master of Public Works, state that it has given entire satisfaction in the poorer parts of the city, where there was absolutely no accommodation before, and where the closets connected with it are out of doors. They state, also, that its first cost renders it doubtful whether it will be extend- ed even there; and that among the better classes the system is considered inferior to water-closets and cesspools. In Ley- den, a city of 40,000 inhabitants, 1,200 people in the poorest quarter have their houses furnished with Liernur's system. That it is very much better than the previous arrangement of throwing filth into the canals by hand, is universally agreed. The authorities, however, as in Prague, apparently do not con- sider that the gain is in proportion to the great expense in- curred, for no extension of the scheme has been agreed upon. Dr. C. F. Folson Sec'y of State Board of Health, Mass. says: \" By the politeness of Mr. Bergsma, Secretary of the Board of Works of Amsterdam, a friend of the system, I was able to see it in actual operation. The emptying of the tanks was complete, rapid, and as far as I could see, successful. There was no trace of odor. In the central building, where the Report of Massachusetts State Board of Ilealth, Jan. '76.",
         "THE PNEUMATIC SEWAGE SYSTEM. matter was transferred to barrels, and in its immediate vicinity, the stench was very great. \" In the houses of the poorest class, where one house is used by several families, they become soiled, and in some cases filled to overflowing, before any one takes care of them. They become clogged occasionally by coffee-grounds, ashes, etc., which will find their way into them. They are not as offensive as the milden or privy, still to be found in many large cities. They are in all cases out of doors, and the people who use them pre- fer them to the arrangements which existed before their introduction. \" In a few houses of the middle class, where they are in the yards, a few rods from the houses, they were scrupulously clean, received frequent washing, and were not offensive. In a primary school-house, where the closets were separated by only a narrow passage way from the class-rooms, they were frequently washed, and, although there was a slight disagree- able odor, there was nothing really offensive at the time of my visit. It is undoubtedly true, as the teacher said, that the closets are much more satisfactory than anything which they had ever had before. \" In the houses of the better class there is so much complaint of the bad odor that they get rid of it as best they can by flushing, with a sudden dash of a large quantity of water, after each use of the seat. Occasionally they become entirely clogged, when the odors are simply insupportable. Mr. Dyck, a resident of Amsterdam, who has also a farm in the country, states that twice in one year this intolerable stench drove him and his family entirely out of his house until the obstruction could be removed. \"Capt. Liernur proposes to meet this difficulty by automatie water-closets, using only one liter of water at each time of use; but they have not been put to the test of practice, and so small a quantity can be of no more service there than in our ordinary hopper-closets. \" A part of the original plan was to sell the excrement at a remunerative price; but people of the neater class cannot be prevented from flushing their closets liberally, and the contents of the reservoirs contain so large a proportion of water as to have the general appearance of ordinary sewage except in color. Dr. Amersfordt made a contract with the city to take the whole of it, to be delivered on his farm at 11ý cents (U. S. currency) for each one hundred liters. The contract expired January 1, * In his official report to the Oberbugermeister of Colonge, Stadtbaumeister Becker states that he found in these rooms an offensive odor.",
         "THE SANITARY JOURNAL. 1875, and has not been renewed, for two reasons. Dr. Amersfordt states that the distribution of largely-diluted manure from barrels is costly and difficult ; also that, when de- livered to him in the winter, it is'often frozen in the barrels. It is now sold for 16t cents (U. S. currency), delivered by boats on the farms, during the summer only. In winter it is carted down and thrown rnto the harbour, as it cannot be sold. \" At Dodrecht, this system is in process of introduction for 128 houses, with a population of 800 people, and Capt. Liernur is making preparations to make poydrette on a large scale, from which he hopes to obtain a considerable revenue. It should be remembered that a similar experiment failed in Amsterdam twenty years ago; that the Paris poudrette sold for one-tweutieth of the value placed upon it bythe chemists; and that an English company has become bankrupt in attempt- ing to pay two francs a cubic meter for the contents of the cesspools in Paris, leaving several hundred thousand cubie meters at Bondy, of which the authorities would be glad to rid themselves. \" The \"Liernur System\" has been very ,widely proclaimed; but, as has been seen, it has not yet met with much favor, even in Holland, to judge by the number of people now using HEALTH OF MOTHERs.-There is the health of the mother especially during pregnancy. You will have something to say concerning this. If human beings were bred with the care that is bestowed on racehorses and shorthorns, mothers would be compelled to lead very different lives from those they lead now. It is quite certain that if there is a great de- mand and drain made upon the nervous energy of a woman who has a child in utero, the nervous system of that child will suffer. There is no treatise on idiocy which you take up in which you will not find fright given as one of the causes; and in popular lan age and amongst ail classes you wil hear that a fright or a shock to a pregnant .mother is apt to bring about idiocy or some allied disorder in the child. Now, not only a sudden fright or shock, which probably is accidental or unavoidable, but long-continued emotional excitement and brain-work will have a baneful effect upon the offspring. It is another illustration of not being able to do two things at once. A woman cannot breed healthy children and devote 362",
         "ANNOTATIONS. herself to other and harassing pursuits. Dr. Seguin, an emi- nent American physician, who has specially studied such sub- jects, says that idiocy is increasing in the State of New York, and he ascribes it to the social conditions of the women in that country. \" We overburden women,\" he says, \"they over- burden themselves, and choose or accept burdens unfit for them. As soon as women assumed the anxieties pertaining to both sexes they gave birth to children whose like had hardly been met with thirty years ago-insane before their brain could have been damaged by their own exertions; insane pro- bably by a reflex action of the nervous exhaustion of their mother.' If women combine the bearing of children with the work, the anxieties, and the responsibilities of callings which, as a rule, are undertaken by that sex which does not bear children, there can be no question, in my opinion, that the children will suffer. If such vocations are to be undertaken by women, let them be left to such as are unmarried or are past child-bearing. If it does not agree with them, it will at any rate not interfere with the next generation.-(From an introductory lecture by G. F. Blandford, M.D., F.R.C.P., etc. lecturer on Psychological Medicine, at St. Geerge's Hospital Medical School, Lon., Eng.) FATALITY OF NERVOUS DIsEASE.-In a lecture on the prevalence and fatality of nervous diseases, by Julius Aithus, M.D., M.R.C.P., Physician to the hospital for nervous diseases, he shows by tables compiled from the Registrar-General's Report, in which he has collected and compared the deaths from these diseases as they occurred respectively in London, the South-Western Counties and Wales, for a quarter of a century, that the commonly received notion that diseases of the nervous systen are more prevalent and fatal in the great centres of social, professional and commercial life than in rural districts is proved to be fallacious, for it appears that the death rate is lowest in London-viz., 10-66 per cent. of. the mortality from all causes ; that in the South-Westrn Counties it is higher than in London, amounting in the average to 11-20; and that it is very much higber in Wales-viz., 15-8-that is, nearly five per cent. more t han in London. That the nervous system, he says, should be more liable to break down in the fine and wholesome atmosphere of agricultural districts than in the close and foul air of the courts and alleys which abound in great cities, seems to show that excess of manual labor is more exhaustive to the nervous system than excess of mental labour; and that the more nourishing and substantial food which is enjoyed by even the poorest classes in London, as * 363",
         "THE SANITARY JOURNAL. compared with their brethren in the country, more than com- pensates them in this respect for the advantages the country affords, as far as air and climate and the supposed wholesome- ness of rural pursuits are concerned. THE SUPERVISION OF MEDICAL SCHooLS is suggested by the London Medical Time and Gazette: \" That the Royal Col- leges should appoint a number of inspectors, chosen from the different schools much as are the present examiners. If the same care were exercised in the selection of these inspectors as in the election of examiners, and if the same spirit animated the former as seems to animate the latter, there can be no doubt that the pass-lists of the College would soon tell a dif- ferent tale. If a school inspector could reject a lecturer be- cause his lecture was below a certain stan ard, either as re- gards subject matter or adaptibility to the requirements of the students to whom it was addressed, we should soon have a decrease in the number of lecturers, and an increase in the quality of those who continued to hold their chairs. It is simply impossible for a student to tell his teachers that their lectures are not \"up to the times.\" Hence there should be some one to do it for him. VACCINATIoN.-Alderman MeCord gives (Can. Med. \u0026 Sur. Jour.) the following figures with reference to the death-rate at the Civic Small-pox Hospitals, Montreal, from Nov. 7th, 1874 to Nov. lst, 1876. Protestant Hospital.-Total num- ber received, 168. Died, 34. 20.23 per cent. There were 54 unvaccinated, and of these 25 died: = 46.29 per cent. There were 114 vaccinated, of these 9 died: = 7.89 per cent. Catholic Hospital.-Total number received, 396. Died 127 : = 32.07 per cent. There were 165 unvaccinated, of these 89 died: = 53.93 per cent. There were 231 vacciiiated, of these 38 died: = 16.45 per cent. In both Hospitals, 564 Received. Died, 161.28 = .54 per cent. Unvaccinated, received 219. Died, 117: = 53.42 per cent. Vaccinated, received 345. Died, 47 13.62 per cent. THE ANCIENTS AND DRAINAGE.-Two thousand five hundred years ago the people thought it necessary to drain the soil in order to preserve the health, and they would abandon a city rather than suffer from fevers. Vitruvius tells that 4 the city of Salabra stood originally in an unhealthy location, so that the inhabitants suffered much from fevers. This induced them to abandon the city and to remove to another location, at a distance of four Roman miles, after Hostilius had thoroughly drained the place selected for the new city.",
         "THE SANITARY JOURNAL. GOOD AND BAD wATER. In the November number of the SANITARY JOURNAL, the notes of the public analyst, Dr. Ellis, were given of the im- purities in the water of a certain well in Toronto, which he had analysed. The water was, probably, but a fair sample of that of a large proportion of the water in the city, and indeed in all other cities. Well water in populous parts of cities is rarely fit for drinking purposes. Most people seem to be in utter ignorance of the fact that a well may actually drain a large area of ground around it, and that foul organie matter from back yards, privy vaults, stables, etc., may percolate a long distance with the rain-fall into the wells; and further- more that the water may, nevertheless, appear very pure and pelucid. If it happens to taste rather bad, it is not un- frequently called \"mineral water,\" and the owner is rather proud of it. The \"city water \" so called, is now, we believe, on good authority, a very fair water, and it is a false economy to use well water, especially in the older parts of the city; while it is, Do doubt, the cause of many deaths. There should be a law to compel owners of such wells to close the wells, that they might not endanger the lives of their families and neighbors. As illustrative of the effects of bad water as compared with those of water not so bad according to the last annual report of the State Board of Health of Massachusetts, the cholera epidemie of 1853-4 showed very distinctly that in those parts of London where the filtered water taken from above the influence of the sewage of the city was used, the epidemic was very much less malignant than where the more impure was used. The General Board of Health took some pains to gather the statistics illustrative of this fact. Mr. John Simon, F. R. S., \u0026c., in his report to the board, May, 1856, selects the two water companies for comparison which were supplying the same class of houses, and as near as may be the same kind of population; the pipes of the two companies for a portion of their districts being laid in the same streets, each supplying about the saime proportion of the houses in these streets. The one, the Lambeth, was delivering in 1853-4, good water, speaking comparatively; the other, the Southwark \u0026 Vauxhall, delivering bad water. Mr. Simons report reads: \" Commonly, in attempting such inferences, the inquirer is baffled by difficulties which render exact conclusions impos-",
         "THE SANITARY JOURNAL. sible; for populations drinking different waters will often be living in diffèrent circunstances of wealth, comfort, occupa- tion, cleanliness, soi], climate.\" \" In reference to the comparison which had to be made, it is especially important to observe that the tenantries of these two great companies were not set on different parts of the South London area, each isolated from the other. On the contrary, the two populations were, so to speak, mutually interfused. Of thirty-one sub-districts into which the large space is divided, only eight were monopolized by a single water company; while of the remaining twenty-three, each was supplied sometimes in equal proportion by one company or the other.\" \" In the 24,854 houses supplied by the Lambeth Company, comprising a population of about 166,906 persons, there occurred 611 cholera deaths, being at the rate of 37 to every 10,000 living. In the 39,726 bouses supplied by the South- wark \u0026 Vauxhall Company, comprising a population of about 268,171 persons, there occurred 3,476 deaths, being at the rate of 130 to every one 10,000 living.\" \" The population drinking dirty water accordingly appears to bave suffered three and a half times as much mortality as the population drinking other water.\" \" But this evidence is only a part of the case; it admits of being greatly strengthened by a second group of facts which the statistical tables exhibit. It was thought proper to see how far any discoverable influence of foul water had been constant to both occasions; and this comparison is of singular interest for our purpose, because the Lambeth Company, which in 1854 gave the superior water, was in 1848-9 purveying even a worse supply than that of the Southwark \u0026 Vauxhall Conpany.\" \" It has already appeared that the tenantry of the Lambeth Company lost by the epidemic of 1853-4 611 persons. By the epidenic of 1848-9, in the same houses (or rather in as many of them as then existed), the deaths were 1,925.\" \" The earlier figures showed that this population suffered in 1853-4 not a third as much as its neighbors; the present figures give the further fact that it suffered also not a third as much as at the time of its unreformed water-supply.\" Now it can hardly be doubted, that the evil effects of bad water as compared with that which is better, which become so manifest in a time of epidemic, do not cease to exist when no epidemic prevails, but are continuous at all times though in a less marked degree.",
         "ANNOTATIONS. CITIZENSHIP IN SANITARY WORK. George Buchanan, M.D., F.R.C.P., \u0026c., Assistant Medical Officer, Local Government Board, Great Britain, in his recent Presidential Address to the Society of Medical Officers of Health, took for his theme \" Citizenship in Sanitary Work.\" The lecture is given at length in the British Medical Times \u0026 Gazette, which comments on it as follows:-He observed that every one who takes any real interest in sanitary work, and knows anything of its present position, will confess to himself that the science of hygiene, imperfectly understood as it is, is yet far in advance of practice; and will admit that if the community would only act up to the knowledge it has, or might have, of the laws of health, a vast amount of suffer- ing and misfortune might be avoided. It must be admitted also that our laws, such as they are, allow of incomparably more care being exercised over the sanitary welfare of the community by those who are appointed to administer the laws. What, then, he asks, can he done to make people more careful of their own health, and of the health of those depen- dent upon them ; and to make sanitary authorities more active in the performance of the tremendously responsible duties with which they are charged? Too often, he says, the only answer given to these questions is one that may be summed up in the single word \"compul- sion,\" and an incessant desire is expressed for more law, or more astringent law: for stronger powers of regulation and repression to be exercised by local governments over the people, and by the central government over local governments. But the ignorant and careless must be reduced to a minority before they can be compelled to obey sanitary Acts; and the rate at which measures of legislation will prove fruitful,. and the amount of' regulation and repression that, in the interest of health, can be exercised, will depend on the educa- tion of the people to understand the value of sanitary mea- sures to themselves and to the community, and on the trust they have in those who are to devise and execute the requi- site sanitary regulations. Certainly there are, here in England, \" many measures, the immediate adoption of which would be the saving of much disease and death, that cannot be made matter of strictly compulsory law till much sanitary education of the people has gone on. And the education that will reduce the number of people needing compulsion will give to the majority the power, as it clearly has the right, to dictate the action required for the sanitary good of the whole community.\" 367",
         "THE SANITARY JOURNAL. Dr. Buchanan in conclusion points the moral to be drawn- \"Let us do what we can towards instructing the people, as the surest way, and in the end the quickest, of getting sanitary reform that shall be real, practical and thorough. By all means let Parliament, as representing the better intelligence of the country, say from time to time, in respect of one and another sanitary condition, what is the duty of the whole community, and what particular negligence or risdoing is not to be tolerated in the country; but let the community every- where be at the same time instructed as to the significance of, and the necessity for, sanitary amendment.\" At present there is a total absence of any machinery for this purpose ; but why, he asked, \"should not every city have in it a society like the Manchester and Salford Sanitary Association, interesting the whole community in its special work, giving popular lectures, publishing sanitary papers, distributing sanitary tracts, watch- ing the doings of the sanitary authority, and proposing amend- ments in sanitary legislation ?\" The activity and energy of sanitary authorities will depend, very largely at least, on the intelligent interest shown in the matter by the communities they represent. If these are indifferent in sanitary matters, the local authorities will sooner or later become indifferent also. The intelligent and educated part of a community must not stand aside, thinking that all has been done when sanitary authorities have been appointed ; they must take a share in the work; and this they may do by means of associations like the Manchester one. An instance of the good such societies may do had been furnished, Dr. Buchanan pointed out, by Tottenham. \" There for years sanitary work had been at a standstill, the local board being composed of men who took no particular interest in their sanitary business, and who learnt no lesson from the excessive prevalence of disease in their district. A few years ago a number of the inhabitants formed themselves into a sanitary association, turned out some of the obstructives on the board, and replaced them by members anxious for sanitary amendment; leavened, not the board only, but the whole population, with a care about health; succeeded in no long time in getting the more obvious sanitary faults of the place amended; and can already show, as mea- sured by results, an amount of progress that without their exertions would not have been made.\" One such example, even, ought to have a most happy effect. The work of the Tottenham Association was purely and simply local work; and \"it is by evoking the same kind of action by the local in- telligence of the country that far surer progress will be made",
         "ANNOTATIONS. than by any compulsion applied to an unprepared and unin- telligent people.\" VALUE OF FOUNTAINS.--At a recent meeting of the Man- chester (England) Literary and Philosophical Society, Mr. Binney stated that the atmosphere of towns inay be sensibly ozonized, and improved in quality, by the action of publie fountains: \"A water fountain may be regêrded as a hydro- electric machine, the friction of the water issuing through the jets developing electric action, materially assisted by the conversion of the spray into aqueous vapor. I would sug- gest that this fact should be prominently brought before municipal bodies, to induce them to erect fountains in all available places in large cities, as sanitary agents. They might prove highly beneficial in crowded localities. An exchange remarks that the mechanical action of pure air over vegetation is productive of ozone, but still more manifestly is this subtle quality produced by the dashing of the waves and spray against the air. These lashings of air and sea mixed are in the nature of one substance rubbing on another. They evoke ozone, which, being inhaled in breathing, gives a stimulus to the constitution. Hence the benefit to health from a sea voyage, or a residence at a pleasant sea-side resort. It is to be hoped others may follow the worthy example of his Wor- ship the mayor of Toronto, and that the city may be well supplied with fountains. TREATMENT OF DRUNKARDS.-The Medical Tines \u0026 Gazette says:-Apropos of a suggestion by a speaker at a recent temperance meeting as to habitual drunk- ards, we make the following extract from a treatise on naval discipline:-\" Separate for one month every man who is found drunk from the rest of the crew, mark his clothes 'Drunkard'; give him six water-grog, or, if beer, mixed one- half water, let him dine when the crew has finished, employ him in every dirty and disgraceful work.\" In a case where this was tried the effects were so salutary, that in less than six months not a drunken man was to be found in the ship. The same system was introduced by the writer into every ship on board which he subsequently served. The culprits were heard to say that they would rather receive six dozen lashes at the gangway, and have done with it, than be put into the drunken mess-for so it was termed-for a month. A PEOPLE WITHOUT CONSUMPTION.-Dr. E. M. Wright, of Hamilton County, U.S., has published a small pamphlet with the above heading, in which he gives an interesting account 369",
         "THE SANITARY JOURNAL. of a people, about four thousand in number, who live on Walden's Ridge, a district of the Cumberland Table-land. No well authenticated death from consumption has ever occurred among them. The ridge is from 2,000 to 2,500 feet high. The mercury has never been known to be above 95 deg. F. or below 10 deg. F. The peòple, who are chiefly farmers, live mostly in log-houses, which admit plenty of fresh air, burn wood, wear no flannels, and live on corn bread, bacon, and coffee. The Cumberland Table-land is an extensive district, and comprises territory enough to form a good-sized state. . ALLOPATHY.-We have always objected to this mis-nomer, as applied to the regular school physicians, and we would like to see the following, from the proceedings of the Medical Society of the county of Kings, Brooklyn, N.Y., \" passed around: \"-\" An intelligent writer to a highly respectable English medical journal makes the great mistake of speaking of \" allopathy \" as the practice of regularly educated physi- cians. This is a badge which should not be worn for a moment. It is a nickname, the invention of Hahnemann, based on a faIse conception or misrepresentation of what honorable medicine is ; it was never a true descriptive term, and is less so now than ever before. It should he repudiated, in season and out of season, by all who consider themselves physicians; no such adjective is necessary.\" MILK Vs. ALCOHoL.-At a recent Dairy Show will serve to give encouragement to those who believe that success is likely to follow any reasonable efforts to provide other than alcoholic refreshments for the million, at moderate prices. On the third day of the show, at the request of the bystanders, the Aylesbury Diary Company began tosupply them with draughts of milk at a penny a glass. Above 1,000 gallons were sold within a few hours, and the experiment was only stopped because the refreshment contractor, finding his counters sud- denly deserted, threathened the authorittes with an action for damages, considering that such sale involved a breach of contract with him. RUSSIAN.-It is proposed among the physicians and hy- gienists of St. Petersburg to open a Hygenic Society in that city, which will be in close connection with the London San- itary Institute, and with the Paris Societe Nationale d'Hygiene. Hygiene obtains great attention among Russian physicians, and the fortnightly periodical Zdorovie, (The Health), has already published, during the first half year of its existence, some very valuable orignal papers.",
         "ANNo(TATI(NS. AT THE INTERNATIONAL MEDICAL CONGRESS, Phil., one of the best addresses was that \"On Hygiene and Preventive Medicine,\" by Dr. Bowditch, President of the State Board of Health of Massachusetts. He said that in regard to medical socialådeas, the past century divides itself into three epochs. The era of theory and dogmatism, from 1776 to 1831; of care- ful observation, from 1835 to 1869-an epoch often marked by bold and sometimes reckless scepticism-and the epoch from 1867 to 1876, distinguished for the interest that has been taken, and the progress that has been made, in state preventive medicine. VITAL STATISTICs.-From the Registrar-General's returns we learn that during the week ending Nov. 11, the mortality from all causes was at the rate of 22 deaths annually in every 1,000 persons living. The annual death-rate was 17 per 1,000 in Edinburgh, 20 in Dublin, 21 in Glasgow, and 21 in London. In the other large towns the rates of mortality were-Sunder- land 16, Birmingham 19, Hull 19, Portsmouth 19, Bristol 20, Brighton 20, Nottingham 21, Bradford, 21, Newcastle-upon- Tyne 23, Liverpool 24, Manchester 24, Norwich 24, Leicester 25, Plymouth 25, Leeds 26, Sheffield 26, Oldham 28, Wolver- hamptoa 29, and the highest rate 40 in Salford. IN Foreign Cities, the annual rates of mortality according to the most recent weekly returns of the Registrar-General, were :-In Calcutta 24, Bombay 26, Madras 35, Paris 24, Brussels 22, Amsterdam 22, Rotterdam 29, The Hague 22, 'Copenhagen 18, Stockholm 25, Christiania 16, Berlin 26, Hamburg 23, Breslau 24, Munich 36, Vienna 22, Buda-Pesth .34, Rome 19, Naples 20, Turin 18, Alexandria 46, New York 21, Brooklin, 16, Philadelphia 20, and Boston 23. The fatal cases of typhoid fever in Paris, which had been 29 and 40 in the two previous weeks, further rose to 59 last week. CARDINAL MANNING, speaking recently in support of a 4 Permissive Bill,\" said that in his opinion the publicans' business came under the law passed against \"noxious trades,\" and ought to be proceeded against as a nuisance. It is a trade directed against the health and morals of the community at large D. A. Gorton, M.D., an able homoepathist, in a work on medical philosophy, 1875, says that \"sulphur is efficacious in obstinate contumacy, and in sin original or acquired; cham- omile, in a fretful, peevish disposition; belladonna, in certain forms of temper diseases; hyoscyamus, in jealousy; nux vomica, in maliciousness, and stramonium in cowardice.\" 371",
         "THE SANITARY JOURNAL. SICKNESS AT DIFFERENT AGES.-Dr. Reginald Southey has recently been delivering a course of valuable lectures on \" In- dividual Hygiene \" in London. In one he introduced a table of \" Expectation of Sickness,\" which he had prepared and which is as folliws :-At 20 years of age, calculate on four six days yearly. At 20 to 30, 5 or 6 days. At 45, 7 days. At 50, 9 or 10 days. At 55, 12 or 13 days. At 60, 16 days. At 65, 31 days. At 70, 74 days. This refers to people of average good health, and not to those who may be afflicted with any imeranicable or chronic ailment. THE VERMONT STATE MEDICAL SocIETY-Met at Mont- pellier, Vermont, Dr. L. C. Butler in the chair. In his address lie said :-\" I would recommend that a committee be appointed by this Society to memoralize the Legislature, now in session,, for the appointment of a Sanitary Commission of three suitable persons, whose duty it shall be to examine the laws of the State now in force relative to the public health and the pre- vention of contagious and other diseases, and make a full re- port, with such legislation as they shall deem necessary, to the next session of the Legislature or meeting of this Society. THE Med. Press \u0026 Circulai, Nov. 1st, says :-The health of the country continues in a most satisfactory state; the marvel- lously low rate of mortality having been returned last week by the Registrar-General, of 12 per 1,000 in Edinburgh, 16 in Dublin, 18 in London, and 21 in Glasgow. These figures are lower than we ever remember to have seen them in Edinburgh, Dublin and Glasgow, speaking volumes for the preventive medicine of the day. COMPLIMENT To ENGLAND.-It is announced that the Reichsgesundheitsamt (State Board of Health) recently in- stalled at Berlin has been placed under the official direction of Professor Finkelberg, of Bonn, who intends to proceed to Lon- don to study the orgaization and management of the depart- ment of medical statistics in the office of the Registrar-General. Dr. Finkelberg is known as the author of a work published in 1874, entitled,' The History of Sanitary Legislation in Eng- land.' A COMMISSION of physicians, appointed by the Boston Board of Health, reports that 1,500,000 gallons of water were sold in that city in 1874 as milk, for which nearly $500,0005 was paid. In one instance thirty-four cases of typhoid fever in twenty-four families were traced so the use of milk mixed with water drawn from a well near a cesspond. 372",
         "ANNOTATIONS. DR. CARPENTER, F.R.S., Secretary to the Gilchrist Trust, has, for the benefit of the primary teachers of the metropolis, made arrangements for the delivery of a course of lectures by Dr. B. W. Richardson, F.R.S., at St. Thomas's Charterhouse Schools, on Human Physiology, and its application to daily life. The course was opened on November 3 by Dr. Carpenter, who gave an address on \" A Sound Mind in a Sound Body.\" DURING the three months ending September last, 119,909 deaths were registered in England and Wales, equal to an an- nual rate of 10-6 per 1000 of the estimated population. This death-rate was 1-4 per 1000 below the average rate in the cor- responding quarter of the ten years 1866-75, and, excepting the rate in 1873 (19-5), was lower than that which prevailed in any of those years. THE REV. MR. MATHER, of Ohio, wants quack advertise- ments kept out of the Methodist church journals. He ought to go a step further and make it a clerical misdemeanor for ministers to write quack advertisements. More men, women, and children are annually poisoned by pills and nostrums which are recommended by preachers than in any other way. Baltimore Gazette. THE deaths from small-pox rose in London from 15 in the pre- vious to 21 last week. The mortality from the same cause in Liver- pool remained stationary, namely, 1o each week. BOOKS AND PAMPHLETS RECEIVED. EPIDEMIc DISEASES AND THEIR PREVENTION in relation to the water supply in the town of Belleville. By James T. Bell, Professor of Mining and Agriculture in Albert University, and chairman of the board of health, Belleville. VICK's FLORAL GUIDE. Published quarterly by James Vick, Rochester, N. Y. Price 25 cents per annum. The number before us the first for the new year 1877. The work is published four times a year, in elegant style, finely illustrated and at a price too low even to pay for the paper alone. It is rich with articles pertaining to the garden and conservatory, and contains a complete price-list of every article kept by the seedman. A hand- some chromo precede the.whole, representing a bouquet of summer flowers. A REPORT OF THE DEATH-RATE of each sex in Michigan, and a comparison with Dr. Farr's life tables of healthy districts in England. With a statement of Infant mortality in Michigan. By H. B. Baker, M.D. Sec. State Board of Health, Mich. INDUSTRIAL CANADA, the duty of developement and how to ac- complish it. By A. Baumgarten, Ph. D. Montreal. 373",
         "THE SANITARY JOURNAL. NOTES, QUERIES AND REPLIES. CAUSE OF DEcAY OF THE TEETH-Dr. L. B. Palmer, of New York, has been led to conclude from a series of experiments, that the decay of the teeth is not, as is generally supposed, due to acids, but to alkalies, (Cosnws and British Yournal of Dental Science). With alkalies he reproduced decay of the teeth as it is seen in the mouth, but was unable to do so by acids. With the assistance of an electric current, acids simply acted on and destroyed the whole of the enainel.-Te Doctor. PHILOSOPHICAL PUZZLEs.-An American writer shows, by a per- fectly just argument, that the much-used maxim, \" All rules have their exceptions,\" is really self-contradictory. If all rules have ex- ceptions, this maxim is itself a rule, and therefore must also have its exceptions. Consequently, the proverb at the same time affirms that all rules have their exceptions, and that some rules do not,- which is an obvious case of proverbial suicide. ROMAN PHYSIcIANs visited their patients attended by all their pupils; in allusion to which Martial wrote: \"J'm ill. I send for Symmachus ; he's here, An hundred pupils following in his rear. All feel my pulse with hands as cold as snow; I had no fever then,-I have it now \" THE MORTALITY among the children of peers in England under five years of age, as quoted by the Registrar-General, is at the rate of 20-69 per ooo ; among the Society of Friends, the children's death rate is 27-87 the children of the clergy die at the rate 30-27 ; in the country districts the death-rate under five years is 40·34 ; while in town districts it reached 80-13 per ooo. PRAYER AND GooD WORK.-The inhabitants of a provincial city demanded of Lord Palmerston that the angel of pestilence should be stayed by a day of national prayer and fasting. \" I will fast with you and pray with you,\" was the statesman's answer, \" but let us also drain, scrub, wash, and be clean.\" INCORRIGIBLE.-Medical adviser: \"Now, first of all, you must not drink beer in the morning.\" Patient: \"No more I should, old fellow, but it so happens there's not a drop of brandy in the house!\" THE referred to accidents, violence, \u0026c., during the last quarter numbered 4,590 in the United Kingdom, (Great Britain and Ire- land.) There were 6,459 inquests held during the same period. DR. JAMES CURRIE said, in a letter to his friend, Dr. Bell, of Manchester, \" I get practice, but my patients seem to die out of spite.\" DRYDEN wrote:-\" He 'scapes the best, who, nature to repair, Draws physick from the fields.\"",
         "INDEX TO VOLUME II. PAE. Alopathy...... ... .. 370 Association.... 327 ApopIlexy, Prevention of ................. 307 Arctic Expedition, On . 354 Arsenic from Curtains .................. 247 Arsenical poisoning..................... 44 ,, le New Danger........ 352 Room Paper..........124, 158, 351 te le et Testing.......... 157 Asphalte Drain Pipes.................. 223 Australia Sanitary Progression......... 350 Bacteria and Septisemia................. 47 Bathu, Vapor.......... ........... 102 ,, W arm ........ ....... .......... 57 le Effects of............ 66 Beer Drinking, Effects of.............. 48 Berlin Board of Health................. 311 Book Notices...............127, 128, 193, 288 Brain Workers, Longevity of............. 104 Bread, on.. ........ ........148, 213. 251 Breathed Air...... ............ ...... 244 Brussels Sanitary Exposition ............. 319 Hygienic Conference.... .....338 Children, Diseases of Avoidable.......... 69 Cholera and Cleanliness............ 190 Cistern Water and Saliciglic Acid.... 320 Citizenship in Sanitary Work.. . . ......367 Clothing, Changing of... ............151 the Young ....... .........180 Constantinople and its Surroundings..... 338 Consumption, A People Without......... 369 Contagion and Infection........ .. 22, 51, 115 Colour and Heat......................... 29 Correspondents, to...........32, 64, 96, 128 Cost ofSickness and Death......... . ...310 Craniscopy of Criminals............. so Criminal Law and Medical Pathology.. 85 Cruelty a Characteristic of Man....... . 310 Dairy, Inspection of..... ..... ......121 Death, Failure to prevent................ 270 e from Old Age.............. ..269 Decennial Mortality, A, and Conditions of Lie ................... 184, 218 Diagnosi and Vital Siatistics.. . ........ 62 Dietary, On, Voit.... ...... ........295 Diphtheria, Early Treatmnent of. 120 from Foul Air................ 25 Origin of...... ........ .. 156 Disease Germs, On.................... 149 et te Reproduction of......... 268 Disinfectants..... ......125, 309, 344, 348 Disinfecting Powder ................ 124 Disinfection and Scarlet Fever . ... 236 Drainae and Health.............. - .. 342 Dress Reform........................... 94 Dry Earth Ciosets..................181 I System and Sewers......... 27 Dublin Sanitary Association..... ........ 286 PAGE. Dwelling Houses, Construction of ........ Il Education of our Girls.............. 333 Effects of Worry ...................320 Euthaoasia Natural... ..............81 Exercise and Labor...................... 179 Fashion sud ita Penalties.............169 Flannel Clothing........ ........... 249 Food, Amount of, Required by Man.. 249 Force and Work................... 88 Forests, Importance of..............319 Fountains, Value o! ................369 Gout, Diet for.......................... 318 Grapes as Food.... ................179 Habitual Drunkards, Danger of Operating on....... ....................18 Health Bureau....... .............113 and Longevity...............147 i of Mothers...................... 326 Hereditary Tendencies to I»isease, Con- tracting of. ..... ..............219 Heredity ........ ........................ 315 House Drainage Back and Front........ 216 Hygiene and Education..............30 et ,, Phthisis.................... 352 l in Russian Schools of Medicine.. 350 t Definition of, Parkes........... 222 l Practical Notes and Extracts on, 9, 38, 72, 97, 141, 198, 233, 65, 305 i Value 0!......................... 253 Imagination, Power of ......... ...... 17 Imperial Board of Health, Berlin. 49 India, Health o!..... ..............188 Sanitary Matters in............93 Individual ygiene................ 343 Il et Lecture on, Southy.. 164 Infant Diet...........................173, 209 t , Artificial.................... 122 i Feeding and Infant Mortality.... 87 S Mortaity.......... ..........54 Infection, Vehicles .......... 20 I Spread o!. .....2 221 Insecticide........ ................45 Kindergarten Theories.................. 241 Lead Poisoning.... ................342 Leaks in Drains, Detection of.... .....308 Life Insurance and Public Health........ 117 e Children..............285 Limit Table of Weights and Measures, Dr. Parker...... .................. 197 Longevity, Indications of ................ 242 le of Jews, Causes 0f............. 341 Lunatic Asylum, Toronto, Condition of, Dr. Workman..... ........1,33, 65 Massachusetts Board of Heaith, Objecta of 318",
         "INDEX '\u0026) VOLUME Il. PAGE. Meales Conveyed to Dog............. 320 Medical Association, Canada.......... 285 n Congress, International, Phila- delphia.... .................. 316 t Education...... .. .........312 t Schools, Supervision of .......... 364 Michigan State Board of Health........... 42, 155, 251, 349 Milk and Fever. ........................ 88 i t Contagion, and Milk Ingpection. 214 e as a Vehicle of Contagion........... 150 n Examination o .................91 n Keeping Pure....... .......... 152 , Medico-Legal Aspect of............ 108 Supply of Toronto................. 69 . versus Alcohol................ ... 370 Montrea Mortality...................96, 125 Mortality of Inkeepers....... ........178 i Toronto....................... 26 Needless Noises.......................... 222 Nervous Diseases, Fatality of ............ 363 New Buildings and Disease............. 192 Night Medical Attendance, Paris. .. .. .. .. 111 Notes, Queries and Replies,.......... 160, 192, 224, 257, 287, 321, 373 Ottawa Health Report..... .......... 61 Overwork... .....................29 i at School .................94 Ozone, by Meteorologist.............161, 193 i Produced by Plants.............. 17 Photography in Diagnosis...... ......... 156 Physician, The, and State Medicine...... 240 Plumbing Work, Conditions of.......... 201 Pneumatic Sewage System, The .......... 359 Poison, Septic, in Wells.............136 S Sleep...... ..............351 l Sources of...................... 64 Powel's Life Line-.--................... 96 Preserving Ice......................... 220 Life at Sea............... 352 Prevention and Cure................ 182 Preventive Medicine................. 46, 346 Provincial Board of Health ............. 273 Public Health and Medical Men......... 31 t What it Means. 142 Medicine, Carpenter on........... 278 Pullman Car Ventilation, Dr. Grant...... 196 Pyaenia in Hospital Practice.............. 212 Registering Diseases..................... 244 Register-General's Report.. .. .. .. .. .. 346 Registration and Sickness............ 154 Relations of Medical Profession to Society 342 Respiration by Nostrils and Mouth....... 63 Respired Air, Effecta of................. 121 Results of Sanitary Work................ 253 Roasting Meats, Temperature of......... 286 Russian Hygienic Society................ 370 nitary Bureau.. ...................... 122 PAG.. Sanitary Reform........................ 272 i Science, Importance of......... 5 School Hygiene ....... ..........62\u003e 421 Scold, History of.................. Sea Sickness....... .............. Septicemia and Bacteria............. 23 Septic Poisons In Walls, \u0026c............., 136 Sewage and Toronto Trunk Sewer........ 245 Sewer Gas Poisoning, To Prevent........ 50 Signe of Death ... .................... 310 Sleep, Hufeland on..................... 146 Small-pox Carried by Letter............. 112 i Pathology of............. 95 Smokers and Non-Smokers........... 157 State Boards of Health ............. Statistics, Foreign... .............160 , Vital................123 158 ! Sanitary and Preventable Dis ease, Dr. W. Maraden.. 129 Sucking-Bottle Poisoned.............. 351 Sulphurous Acid, Mode of Generating.... 34 Sunfiowers a Disinfectant.......**....... 18 Sunshine.......................... 342 Syphilis and Contagious Disease Act.252 Switzerland, Sanitary Condition o! .. 347 Taking Cold............ ....... .13 Temperament, Studying of \u0026c..225, 257 Temperance Question.. ....... 24 Tobacco and Augina................255 Toronto, Mortality of................26 l Trunk Sewer, Workman........ 133 \"f if and Disposal of Sewerage............... 245 Treatment of Drunkards.......-..... Trials and Triumphs of a Sanitarian...... 205 Tubercle in Food............. 148 Typhoid Attributed to Vaccination.... 86 e and Drainage, Virchow.......... 335 n and Fungus.... ........... 317 g Fever.......................19, 89 Fever, Cause of................ 286 Outbreak o!................... 59 i Specific Origin of.............. 242 t Spontaneously Generated.... .. 299 Vaccinia. .......... .................. 35 Vaccination, Inefficient.................. 222 n Bad Effects of............... 272 Venlilation.... ...-.-................... 276. Warn Bath, The........................ 75 t n Effects of................66 e i Prolonged.. ............125 Water, Good and Bad.................. 365 Water-cress, Value of................... 189 Weather, Cold, Effects of.............48, 119 Well Water, Toronto.................... 326 Wheaten Flour.......-................. 21 Will, The. as a Preventive, \u0026c........... 32 Wisconsin State Board of Health......... 337 Women, Unsexing of................. 320"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE CANADA MEDICAL RECORD. VOL. XI. MONTREAL, SEPTEMBER, 1882. No. 12 ORIGINAL COMMUNICATIONS. Motion in Children,274.-Codeia The Vital Statisties Scheme, The Practice of Medicine in China better than Morphia, 274 - 276. - Death of Dr. Major 265 -Vital Statisics 26 Treatment of the ilalcenta after Hiram Milis, 277. - Fifteenth Staistis ....... 69 Abortion, 275.-Tonga........ 275 Annual Meeting ofthe Canada Mýedical Association,27.Pr PROGRESS OF M EDICALSCIENCE. EDITORIAL. sonal, 288.-Mortality of Mon- treal for Augtst S............. 28 Infantil Diarrhea, 275Medicalo AsnsdaMeatconssociatone276 THE PRACTICE OF MEDICINE IN CHINA. Ly WM. YOUNc, C.M., M.D., late of Hong Kong, China. The practice of medicine is more or less empi- rical, that is, founded upon experience. We might, therefore, reasonably expect many substantial additions to our means of combating disease from the accumulated experiences of ages, recorded in Chinese books. To say that any one coming to China vith such expectations would be dis- appointed, is putting the case very mildly ; we would rather say, he will turn from the study with pity or contempt, if not with loathing and disgust. Did we not know it to be true, it would surpass belief, that the physicians of a nation so old, so distinguished for her literary men, and so practical in some departments, should receive with unques- tioning submission the falsehoods of their pre- decessors, and that so many ages have rolled away without the most distant approach to truth in the systems taught concerning the structure ind functions of the human body. In any- of the book stores in China, a diagram issued by the authority of the Imperial College at Peking can be bought, which gives an outline of what is known and taught in China regarding the anatomy of the human body. In this diagram the æsopha- gus is rightly made to enter the stomach. The trachea goes through the lungs into the heart, and three tubes, passing posteriorly from the heart, connect it with the spleen, the liver, and kidneys. The kidneys are shown to be connected with the spinal column, and from them originates a subtle influence, which passes upward into the brain, and downward io the spermatic cords. The kidneys have thus a place of the first importance in the animal economy, as the Chinese locate between them the Ming Mün or gate of life. These notions be it remembered are not the aberrations of irresponsible pretenders, but the undisputed teachings of the Imperial College, handed down without questioning through many generations, carrying with them the authority of deified sages, and having all the sanctity which religion and antiquity can give. In successfully dealing with a machine, the mechanic must be fami- liar with the structure of its parts, and the actiont of the whole when put together. But in China we have the human body, the most wonderful and complicated machine in existence, treated by ignorant quacks, who, taking advantage of the self-renovating powers of the human body, assume to heal its maladies, correct its irregularities, and make it work harmoniously. It is quite unneces- sary to add that surgery as an art has no existence amongst the Chinese. Nature must effect her cures unaided by science, and her efforts in",
         "THE' ANADA MEDICAL RECORD. this direction are often thwarted, or totally obstruct- ed, by the most ignorant .and unwarrantable interference with her functions, the simplest appliance in the department of surgery being quite unknown. The Chinese, however, are begin- ning to appreciate the skill of Western surgeons, as they come from all parts of the country -to the many hospitals which have been established by missionaries and by the enterprise of the physi- cians attached to the European department of the Chinese Customs service. It is one of the hopeful signs of China to see the readiness with which they consuft foreign surgeons, and to note the wonder at the result, and the respect inspired by their skill and attention. No one would ever forget the look of alarm and abject fear with which a Chinaman surveys the approach of a knife to an abscess, and how that look' changes into one of unbounded pleasure and implicit trust, as the matter wells out of the opening. These labors are doing much and will yet do more to break down the barriers of prejudice and seclusion which have been reared by centuries. That surgery was practiced amongst them at a remote period admits of no manner of doubt, as many allusions are made to thé art, in some of their old books, and according to M. Stanislaus Julien it appears as far back as the third century of our era, the Chinese were in possession of an anæsthetic agent, which they employed in the sane manner as we use chloroform and ether for pro- ducing insensibility during operations. M. Julien discovered a description of this in a work called \" Kow-King-i-tong,\" In a biographical notice of Hoa-tho, who flourished under the dynasty of Wei, between the years 220 and 230 of our era. It is stated that he gave the sick a preparation of Ma-yo, who in a few minutes became as insen- sible as one plunged in drunkenness or deprived of life. He then made incisions, etc. After a nurn- ber of days the patient found himself restored, without having experienced during the operation the slightest pain. It appears from the biography of Hoa that this Ma-yo was prepared by boiling and distillation. This, like the art of which it was the handmaid, is entirely lost, and Chinamen wondered as much as foreigners to find that in the forgotten past they possessed what is now prized by surgeons as the greatest triumphs of chemical skill, and by many a suffering patient as the greatest blessing of the healing art. At the cor- ners of the streets in-any Chinese city may be witnessed the native dentist extracting teeth by what is said to be a painless method. The patient is made to sit down, a white powder (Hg CI2) is rubbed on the gum, the patient is then directed to wait a little ; after a few -minutes the, process is repeated, and the dentist then introducing his thumb and fore-finger, with apparently very little violence the tooth is pulled out. I have never been able to trace whether any deleterious effects were produced by the action of the mercury on the jaw, or to learn what was its specific action on the gum, further than to notice that after the first rubbing it assumed a blanched appearance. The patients all winced under the operation, but it seemed harmless compared with the' anguish- inflicting forceps or key. The Chinese physician largely practices counter irritation. A favorite method which is commonly adopted in rheumatism and inflammatory pains is for the doctor to close his fist firmly, and using the index and middle fingers as forceps, to seize the skin over the part, draw it forcibly outwards, letting it free with a snap into its place. It is quite common to see coolies, that is the working classes (whose bodies are usually uncovered), with long, dark, bruised lines on their persons caused by this barbarous systen of torture. A more painful though not so common method is the application of moxa, often causing large and gangrenous wounds by the application of fire near important and sensitive organs. But the favorite application to all parts is an adhesive plaster. It is a matter of sublime indifference to a Chinese practitioner whether the patient is suffering from an abscess or a wound, an abrasion, or merely a numbness from cold, the same plaster is applied, It matters not whether the wound be recent or of long standing,. or whether it be clean or foul with corruption, the same disgusting materials are applied. If in spite of such treatment a cure is effected the praise of the remedy is vaunted abroad, but if, and what is usually the case, bad becomes worse, they assume that some evil influence has been at work to counteract the efficacy of the drug. The fact that the blood circulated through the body seems to have been known to the Chinese in- ancient times. But no true notion of arteries and veins as distributing and returning the blood has ever been developed.: They supposed that both air and blood permeated the body in tubes, which have only an imaginary existence. The study of the. pulse has been a favorite one",
         "267 THE CANADA MEDICAL RECORD. for the Chinese physician in all ages. It is mar- vellous with what eyes a Chinese doctor can look into his patient tbrough the pulse; he can not only tell the disease, the exact seat, but even decide the age and sex of the undeveloped fœtus. Western physicians are often placed at a discount among the Chinese on account of their supposed ignorance in not being able to diagnose a case from merely feeling the pulse of a patient, sometimes they are not even allowed to see the sufferer, a hand merely being thrust out between curtains, and often the most misleading answers are given to simple questions, the more certain~to test the skill or puzzle the ingenuity of the doctor. 'The Chi- nese physician sublimely soars above all such difliculties, and finds in the realms of imagination easy solutions, which, if they do not lead him to cure the patient, shamefully imposes on the inno- cent and unsuspecting. The Chinese have accom- plished this blissful and wonderful state by the invention of the theory of the Yin and Yang, which in their speculations are two principles or powers in nature, the male and female, ever active in producing the physical, chemical and vital phenomena which occur within and around us. Not only are all the obscure phenomena of inorganic change accounted for by the action and reaction of those powers, but the occult powers of living bodies in all the complicated action of their organs in health and disease are explained by calling in the aid of these imaginary principles. When these are equalized there is health ; when the male principle is in the ascendant there is disease, and it is of an inflammatory type. If the female principle predominates the disease is of a low or typhoid character. The reaction of these prin- ciples make up an amount of absurdity truly wonderful, but venerable for its antiquity. Most of the medicines in use among the Chinese are abso- lutely inert, and to some of which such virtues are attached as to be sold for many times their weight in silver. The native Gensing, though entirely rejected in western medicine, is very highly prized amongst the Chinese, so much so that it enters as an essential ingredient into numerous native prepara- tions. The high value attached to it, is because its roots bear a real or fanciful resemblance to the forim of the human body. The same fanciful relations · guide them in the application. of all medicines to the cure of disease, for medicines are never applied by them according to their known S therapeutical properties,, but according to some supposed relationship between the organs of the body on the one hand, and the elements, earth, wood, metal, water and fire, on the other. Thus they fancy that the liver is related to the element wood, and as metal has control over wood, medi- cines related to the element metal are those which for this reason are applicable to the cure of diseases of the liver; so with regard to ail thei:$ medicines and all the organs of the body. A round of imaginary relationships is established, the actual virtues of the medicines are overlookèd, active and inert substances are employed with the same confidence, thus exhibiting an amount of ignorance and absurdity in dealing with the -lives and health of men which is absolutely incon- ceivable. But one of the most melancholy chapters of Chinese medicine is the superstitious and idola- trous practices connected with guarding the sick from the destructive spirit of disease. This is accomplished by various incantations, and by the exhibition on the bed and walls of the room, of hideous pictures to frighten away the genii of evil. Sometimes the patient's face is painted in the most grotesque manner, in fantastic shapes and colors, giving the whole scene, were not the life or health of the patient at stake, a most ludicrous aspect. The choice of a physician is also decided by lot and not from any well-known skill or ability~ of the doctor, or if the patient or friends decidedupon a certain practitioner, they endeavor to find evi- dençe that their selection has been fortunate. The Chinese are, however, in all these matters thoroughly practical. The physician undertakes to cure for so much and within a certain time, and should the first dose of the medicine not produce the desired effect, the oracle is again consulted and another physician is agairi called in. The moment, however, a Chinese doctor perceives that the patient is sinking he at once abandons the case, leaving the poor sufferer to linger without aid, or\" do anything to smooth the way of the last and closing scene. This moment is the opportunity of Western Physicians, often, however, too late to be of any use to the sufferer. The Chinese have a thorough contempt for their doctors unless they are certain he is doing them good, or he succeeds in gaining their implicit confidence by bold and reckless assertion. His nostrums are. invariably looked upon with suspicion, for even in the mucli vaunted Tung Wah Hospital of Hong Kong,",
         "THE CANADA MEDICAL RECORD. which is under the management of native doctors, on a settle behind the building may be seen ranged under the name of the patient, or number of his bed duplicates of the medicine given, or the ex- hausted matrix of decoctions, so that, should the patient die with symptomns not understood, the medicine or detritus may be examined, to see that it contained no deleterious or poisonous in- gredients. Happily for the Chinese nearly all their nedi- cines are inert-as pearls, tiger's bones, rhinocerus horns, fossil bones and numerous other articles as inert are used, which are absolutely without any medicinal virtue. Were it otherwise it would re- quire no gift of prophecy to predict that the whole land would soon be a graveyard, and its teeming cities wouldbe turned into desolation. Of obstetrics as a science they are entirely ignorant, wearying and exhausting the patient by absurd and ridicu- lous positions, often risking the mother's life by giving her disgusting draughts, and at last aban- doning the case, rendering many a home desolate or marring the maternal prospects, when the most elermentary knowledge of the subject would have overcome all difficulties and saved the life of one or both. In this departmnent also prejudice is fast breaking down, and in cases of difficulty a European surgeon will be sent for. It is then, when they see how simply, and without exposure, the case is dealt with that their admiration for the foreign doctor is shown, and they make no scruple to speak of their own in termis far from complimen- tary. Incredible as it may seem, this state of matters has existed for ages, and considering the state of personal filth and the unhygienic conditions in which they live, so far as can be gathered from their own authorities or from personal observation, the rates of mortality in China will bear favorable coniparison with Western nations. This in a great measure is to be accounted for by the simple manner in which they live, their diet being chiefly vegetable combined with fats, the absence of spirituous liquors, and their places of business having only three walls, the fourth side being only a temporary structure, which can be taken away or replaced at pleasure. It bas often been remarked by European practi- tioners the absence of acute inflammatory diseases amongst the Chinese, and many profound specula- tions have been offered to account for this fact, many attributing it.to their mode of living, their abstemious habits, their vegetable diet carefull; prepared, and to their never drinking cold liquids all their drink being tea, the national beverage freshly made and carefully decanted. Perhaps th\u003c whole of these, added to their sanguine tempera ment, renders them almost free from those acut\u003c inflammatory disorders which swell the rate of mor tality in Western cities. The principal diseases fromn which they suffe are intermittent and remittent fevers, conges tions of liver and spleen, chronic rheumatism- their cities are never entirely free from small-pox Skin diseases may be studied at the corner o every street, and few homes are without'the neces sity of employing an oculist. Vesical calculi arc very common. Elephantiasis Arabum is found ii some districts, and leprosy is sometimes me with. That the minds of men whose calling is t( relieve sufferings so great and diseases so formid able should have been satisfied to grope so long in darkness is indeed wonderful. Age after age th\u003c process of the deception has gone on, one genera tion after another has followed in the abyss of men tal delusion, and never yet lias there been founc a mind among all the myriads of physicians whic could break through the trammels of venerabl\u003c ignorance, in order to strike out a new pat towards scientific and rational medicine as it ha! been developed by the labors of physicians in th( West. Why is this ? The answer is to be founc in the teaching of their religion, and in the pre judices of the literati or governing classes agains the innovations of foreigners. Their religion may b\u003c briefly defined as ancestral worship. A Chinamar can never be wiser or better than his forefathers and it is wickedness and presumption for him t( improve on their methods or alter theirdecisions and when he is asked why he does such a thing, o: does it in such a way he will not show that it i the best way in which the thing could be done,- bu will at once find refuge in their oft-repeate phrase \" old custom.\" To introduce new way! would be for him irreverence,'and new modes o thought high treason to the dead. The teachings o the literati have also engendered amongst the Chi nese an intense horror of touching a corpse anc a great reverence for the person of the dead. HEc believes as he is buried so he exists in the spiri world, and to mutilate the body, or even desecrate the 'grave, is to disturb all the sacred relation- ships that exist between the world of spirits and this mundane sphere. The body if defaced the",
         "THE CANADA MEDICAL RECORD. 269 spirit knows no rest. This doctrine has a firm hold on the minds of the people, and by it the literati maintain a cruel tyranny over the minds of their degraded fellow countryrmen. It has also been the means of excluding from the country railways and telegraphs, as the noise of the one and the wires of the other would disturb the fung shuey or repose of the dead. Two years ago, at the pro- vincial examination held in Canton, most of the candidates from a certain district of the city failed to pass ; their failure was attributed to the pre- sence of the spires of the Roman Catholic Cathe- dral, which disturbed the fung shuey. This was the cause of a serious riot, the presence of an imposing military force being necessary to save the building from destruction. Need it be wondered, then, that the study of Anatomy, which is the basis of any rational system of medicine, is altogether unknown, and the poor Chinaman continues to have his ailments treated by ignorant pretenders, who, shielding themselves behind superstitious and idolatrous customs, attribute their failures to the preponderating principle of evil. But however dark this picture may seen, rifts in the gloom are constantly appearing, clearly showing that the Chinese are beginning to- appreciate and realize the fact that a better system of medicine than their own is understood and practiced by the hated bar- barians, and many tempted by avarice and the national love of learning are travelling to other lands, attending foreign universities, even obtaining degrees, who when returning to their native land will sow precious seeds of thought, which falling *into verdant soil, will yet germinate in improved inodes of teaching, and a more just, because a nMore correct, system of niedicine, founded upon 5Xsearch and patient investigation, instead of the agaries of diseasedi maginations, thus bringing nntold blessings to that benighted and downtrodden people. Montreal, 17th August, 1882. VITAL STATISTICS.* BY W1 B. CARPENTER, M.A., .LLD., F.R.S. Owing to the peculiar circumstances of Canada, Its great extent of territory, its numerous pro- vinces and its scattered population, the problcm of ital statistics is somewhat, difficult. The best Abstract of Address delivered at Toronto before the da Medical Association, Sept. 6, 1882. results would be obtained from a uniform systenm of registering vital statistics, carried out at first in the great centres of population only. A uniforn system enforced by the authority of the Dominion Government would be far more valuable than sep- arate provincial systems carried out by local legis- lation, whose variations would seriously diminish their value. England, Scotland and Ireland possess a perfectly uniform system, thanks to the untiring efforts of Dr. Farr, whose services to vital statistics can hardly be overestimated. Although to him we owe the term zymotic, the principle of zymosis was long ago enunciated. In a work on the Dis- eases of the Army, by Sir John Pringle, published some 140 years ago, the following important prin- ciples are laid down 1. That certain diseases are due to a species of fermentation of the blood produced by ferments introduced into it. 2. That certain forms of zymotic disease nay be converted into other forms, which are usually regarded as of different type. In other words, certain zymotic diseases are convertible the one into the other. Sir John states that in £743 a number ofsoldiers, some of whom were suffering from the mild autum- nal remittent fever of the country, were shipped from the Low Countries to Scotland in little brigs at the end of the season. The voyage occupied six weeks, and the sea was so rougi that the men had to be kept under hatches the greater part of the time. The resuit of the foul air and over- crowding was that the type of fever entirely. changed, and the mild autumnal remittent became a malignant typhus, which spread rapidly through the seaport towns where the sick soldiers disem-. barked. A very striking case came under personal obser- vation. The Eclaire, a troop-ship serving on the west coast of Africa, was ordered home to England. Many of the men on board 'were suffering from the malarial fever of the country. There was a good, deal of foul bilge water in the vessel with decay- ing vegetable matter, and the result was that the simple malarial fever developed into true yellow fever. When the vessel touched at the Cape Verd Islands, the yellow fever, which had hitherto been unknown in the islands, broke out among the in- habitants, and raged with such intensity that the Portuguese Government, applied to the British Government for compensation. It is my own belief, supported by; the authofity",
         "THE CANADA MEDICAL RECORD. of Sydenham, McWilliam, Christison and many others, that the media in which germs are devel- oped have a most important effect upon the char- acter of fever produced. Germs which under ordinary circumstances would produce malarial fever, produce a more malignant type of disease when developed in blood rendered uhhealthy by bad ventilation or other causes. There is a wide range of variation in natural history quite irre- spective of Darwin's views. Sharply marked classifications and distinctions may held good for some times and some places, but not for all times and all places. A fact of great importance has been clearly de- monstrated by Dr. Farr's system of vital statistics, When different towns or different country districts are compared with each other, or when town dis- tricts are compared with country districts, it is found that the rate of mortality from non-zymotic disease is practically the same in town and coun- try. The amount of non.-zymoiic disease is a tol- erably uniform quantity all over, and the doubling or even trebling of the death rate which occurs in some of the worst town districts is entirely attri- butable to zymotic disease. When sanitary reformers got hold of this great fact, that a large or small death rate in any community practically depends upon the amount of prevent- able zymotic disease which exists in that com- munity, they impressed it strongly upon the Govern- ment to secure sanitary reforms. But the great obstacle which had to be encountered in England, and which will no doubt have to be encountered in Canada, was the want of a strong public opinion. Governments generally strive to carry out the wishes of the people as far as possible; no Gov- ernment can carry out a scheme of sanitary reform in the face of an unvilling, people, nor would the Government dare to refuse such reforms if demanded by the people. In Montreal, when compulsory vaccination was attempted to stamp out small-pox, it was found impossible to force it upon the people owing to the strong prejudice against it among certain sections of the community. Medi- cal men especially should be fully impressed with the necessity of creating a healthy public opinion on sanitary matters. In England, public opinion is now decidedly in favor of the promotion of these objects ; and I do not hesitate to say that the dread of the loss of the Prince of Wales' life has had more to do with this change of public opinion, than,any other single event. There is now com- parativeiy little difficulty in carrying forward any plan of sanitary improvement which is well con- sidered, and obviously for the public benefit. I would take this opportunity of saying some- thing about small-pox and vaccination, a subject in which I am most interested, and to which I have recently devoted considerable attention. The epidemic of small-pox which swept over Europe and America in 1871, and subsequently, was remarkable from the fact that its type (malignant purpuric) had not been seen in Europe since the middle of last century. As the result of my inves- tigations, I am led to attribute the sudden reap- pearance of this malignant form to the over- crowding of the French army in Paris during the siege, and the confinement in unhealthy quarters of the French prisoners taken by the Germans. The mild type of small-pox which existed around Paris was developed by unsanitary conditions into the malignant variety, which spread with amazing rapidity throughout Europe and America. and was very destructive of human life. It has been proved beyond doubt, that thorough vaccination and proper sanitary measures are the best possible means of protection against a malignant type of small-pox. No child that has been properly vac- cinated has ever been afflicted with anything more severe than the milder type of the disease. A matter of great importance, however, is the use of pure vaccine. Vaccine virus undoubtedly deterio- rates after long-continued transmission through the human body, and then has less protective power against small-pox. The use of animal vaccine in all cases is safer and better. In modem times no better example of the protective power of vaccina- tion can be found than the case of San Francisco. When sniall-pox broke out in the filthy over- crowded Chinese quarter, the people became thoroughly alarmed. Prompt measures were at once adopted, and all the school children, 6o,ooo in number, were vaccinated. The disease was confined to the Chinese, none of whom would submit to vaccination; in the other parts of the city the only cases vhich occurred were among adults who had neglected to be re-vaccinated, the children entirely escaped. Dr. Carpenter then referred to the cholera epi- demic of 1849. In Baltimore, the authorities took great pains to put the city in a good sanitary con- dition, and the cholera passed them by. But in the Baltimore poor-house, situated outside of the city, there was a dreadfal outbreak, 40 or 50 cases a.' 270",
         "THE, CANADA MEDICAL RECORD. Zil day out of a population of 8oo. The place had been thoroughly cleaned and whitewashed, there was no 'overcrowding, and the drainage was thought to be good. On investigation it was found that behind the walls was a marsh covered with rank grass into which the sewage was discharged. The marsh was drained and disinfected, and the cholera immediately ceased. ON INFANTILE DIARRHEA. By DOUGLAS MORTON, A.M., M.D.* * * * * * * The fact that such drugs as opium and the vegetable astringents are this day given indiscriminately, without regard to the stage of the disease or condition of the patient; and that beef tea is highly recommended by some as a food, and water given sparingly by others, constitute sufficient proof that this already much.discussed subject may yet undergo profitable discussion. Some authors have, I think, unnecessarily com- plicated the subject by discussing the different degrees of severity of the disease and its distinct stages in distinct chapters and under distinct heads. The terms summer diarrhea and chlorea infantum mean pathologically the same thing. The latter simply represents a severe type of the former, and entero-colitis is merely a stage of either. The idea of all others that should never be lost sight of in the treatment of any stage of the disease is that failure of digestion, however brought about, is an essential factor. This point I wish to make emphatic, for I do not believe that any one duly impressed with the truth of it will ever prescribe- opium or tannin in any of its forms in the early stage. In an analysis of the post-mortem appearance in eighty-two cases of intestinal inflammation in children Dr. J. Lewis Smith found the upper part of the small intestine inflamed in only twelve cases, the ilium in forty-nine cases, and the colon in eighty-one out of the eighty-two cases. The infer- ences obviously to be drawn from Dr. Smith's anal- ysis are these : That food having passed the pylorus undigested acts as an irritant on the intestinal canal, and that as it passes on it undergoes decom- position, giving rise to products more and more irritant the further it goes until it gets to the colon, which is the seat of lesion in every case which reaches the inflammatory stage. To treat this disease successfully an intelligent idea on its causation is indispensable, for in few *Read beforé the Louisville Medico-Chirurgical Soci- Y ety, September 2, 1881. diseases are their causes more susceptible bf removal, or at least of restraint, than in this. At all seasons of the year children live under bad hygienic conditions, cut teeth, and eat indi- gestible food; but it is only in the hottest part of the summer that they are peculiarly subject to diseases of the alimentary canal. In cities where these diseases prevail about one hundred times as many children die of them in July as in January. As a factor in causation heat is therefore of paramount importance. Upon the other hand it must not be forgotten that among children who do not happen to cut teeth in the hottest months,-and who get their food from their mothers' breast, the mortality is comparatively small-a fact going to show the importance also of dentition and improper food as causes. The most satisfactory explanation of the action of heat in causing infantile diarrhea is that based upon a relation existing between the skin, or rather its nerve terminals, and the vasomotor centers which control the visceral blood-supply, in accordance with which the tone of the arterioles is maintained by the tonic effect of cold air, and depressed, on the other hand, by long -ontinued heat.* This depression by heat places the vascular caliber in what may be called a state of unstable equilibrium, which is readily destroyed by the ingestion of difficultly-digested food, especi- ally soif the irritation connected with teething is superadded. The congestion following may vary from a degree sufficient simply to bring about a mild diarrhea to that severe enough to cause the garvest cholera infantum. Since heat plays so important a part in the pro- duction of infantile diarrhea, our first step in treat- ment must be to meet its effects as directly as possible. Its immediate effects are loss of tone of the muscular coats of the visceral anterioles, and their consequent dilatation. In most cases the ap- plication of cold will be our most efficient remedy, not as an antipyretic so much as a vasomotor stimulant. Cold suddenly applied to the body of a woman with postpartum hemorrhage will excite the flaccid womb and cause it to contract. We know the same effect is produced on unstriated muscle throughout the body. This idea should gaide us in our mode of application of cold. The child should be subjected to frequent bathings in water oflower temperature than that of the body. But since it is possible to produce too great a shock, the water should at first be only a few degrees lower, and gradually cooled down during the pro. gress of the bath. To prevent recurrence - of vasomotor depression the patient.should be kept comfortably cool during the intervals between the * It-is not improbable that this depression of vasomotor tone is general, and the predominant congestion which oc- curs in the internal organs, , and in the splanchnic area es- pecially, is due to the physical law necessitating the flow , of flood to the. area of least resistance. A close analogy, if not identity, thus appears to exist between the essential conditions in cholera infantum and sunstroke.",
         "THE CANADA MEDICAL RECORD. baths by sponging and fanning, and he should lie upon a cot rather than a bed or the nurse's lap. The subject of diet for infants has been so fully and satisfactorily discussed that I do not feel I have occasion to enter upon it here further than to call attention to one or two points which I con- sider of great importance. It can not be too care- fully borne in mind that the administration offood improper in kind or quantity may produce fatal injury; and it often happens that the question must important to be settled is not as to what kind of food, but whether any food at all should be given (Jacobi). If the only evil result of giving improper food were that it failed to be digested and passed through the alimentary canal without adding any material to the organism it would be a matter of slight importance; but this is far from being all. Undigested food undergoes chemical changes which bring into existence substances that act as irritant poisons upon the surface over which they pass, not only sitting up inflammation, but causing copious transudation of material which the patient can ill afford to lose. By withholding food for six or eight hours at a time not only is the patient saved from this loss, but most salutary rest is afforded to the digestive apparatus. It is very difficult to enforce this practice, for it is hard for a mother to resist the crying of her child for food, and it will be very certain to run counter to the convic- tions of the sympathetic friends who may know of the child's illness, and who watch with critical eye the doctor's whole course of procedure. The child cries rather on account of thirst, however, than for food, and it is eminently proper to give water to the fullest extent that the stomach will retain it. It will be found advantageous to give it in small quantities at short intervals. But there are cases in which the stomach will not tolerate even small quantities of cold water, and in these it will generally be found that water as hot as can be borne, in tablespoonful doses frequently given, will readily be retained. In a paper on Infantile Diarrhea by Dr. Jacobi, that appeared two years ago, attention is directed to the importance of excluding oleaginous matters from the diet as far as possible, as these are liable to undergo chemical changes, giving rise to fatty acids which are peculiarly irntant to the intestinal mucous membrane. The fact of this liability makes the question of alimentation in this disease an especially difficult one. Oil enters largely into the normal food of the child and can not be left out without serious injury. The rapid emacia- tion to be seen in intestinal diseases of children is undoubtedly due largely to the failure of assimilating oil. Fortunately we are not without a resource by which this difficulty may be met with a fair degree of success. It was long ago es- tablished by an experiment of Schreger that oil is rapidly absorbed by the skin of young animals, and we have abundant clinical evidence of the value of inunction in treating diseases of children.* *I'klnow of two instanceQ which prove distinctly that It is. peculiarly indicated in the disease under present consideration. Further on I will refer more particularly to this point. There is no disease in which the appropriate administration of drugs is followed by more definitely favorable results, and none on the other hand in which their misapplication is capable of more injury than summer diarrhea of infants. A few doses given during one day may correct some fault of digestion and materially set forward the patient toward recovery ; but a few doses, or even one, may also increase the disturbance already existing and bring down the delicately adjusted balances upon the side of death. There is therefore no disease in prescribing medicines for which greater circumspection is needed. In casting about, however, for a remedy in a given case we have, I think, a crucial test for any medicine that may occur to our mind. It is the question, Is there danger of its interfering with digestion ? Under this test tannin in all its vegetable com- binations must be condemned-certainly in every case in which there is gastric irritability and probably in the initial stage of every other case. In a large proportion of the cases of infantile diarrhea we meet, especially in those more properly termed cholera infantum, nausea and vomiting are the symptoms with which we have first to deal ; for until the patient is relieved of these little can be done in the way of administering either food or medicine. For several years it has been my practice to prescribe for these symptoms hot water to be given at short intervals. It will be found, too, an excellent plan to give it just before food and as a vehicle for medicine. It serves the double purpose of quieting gastric irritability and satisfying the great demand of the organism for water, though it may not give immediate relief to thirst. Hot water is facile .princes among the remedies I use for nausea and vomiting. I usually prescribe at the same tume from an eighth to quarter of a drop of creosote and a grain of potassium chlorate dissolved in peppermint water, to be taken in hot water as occasion requires. This also acts in a two-fold way-as a sedative on the mucous membrane of the stomach and as a destroyer of the organisms involved in fermentation. i find it rarely necessary, if I see a case from the beginning, to prescribe any thing further for these special symptoms. Occasionally I get good re- sults from small doses of calomel-a twelfth to a sixth of a grain. The cases in which this remedy has seemed to me particularly applicable are those in which dentition plays an especially important the scalp is especially capable of absorbing substances ap- plied to it. One is the case of a young lady who passed quite profoundly under the influence of alcohol applied quite thoroughly to the head (not to the hair only), and the other occurred in my own experience. At a time when I had u~sed very little quinine, and was peculiarly liable to its physiological action I used a hair-tonic containing the drug in considerable quantity. I do not know that I ever felt quinine more decidedly than on this occasion. 272",
         "TIE IFCNADA MEDICAL RECORD. ;role. There is no thebry that I know of to explain the efficacy of non-purgative doses of calomel as a :sedative except that which supposes a small -part -of the salt is changed in the stomach to the bichloride, which is also a powerful antiferment. If these remedies fail I conclude the symptoms depend on some other cause than simple hyperenia of the lining of-the stomach-that the pathological process has advanced a step further, and gastritis is present. For this I continue the use of hot water, and use in lieu of other remedies nitrate of silver-a grain dissolved in four or five ounces of distilled water, which is given in teaspoonful doses every two or three hours. The next symptom to be considered is diarrhea. I am confident that for this the routine practice of giving astringents so often carried out is thoroughly bad. I know that patients often get well under the use of kino, catechu, and krameria, and the various mixtures in which one or the other is the principle agent ; but if they are at all severe I believe the recovery would be more properly called .a survival than a cure. Of all remedies bismuth is perhaps the one most frequently prescribed, and in many cases it no doubt acts satisfactorily, but because it lias often disappointed me I rarely prescribe it. In many cases, the majority perhaps, I do not find it necessary to prescribe anything ,especially for this symptom. The proper appli- cation of cold, the use of the measures laid down bove for gastric irritability, and a suitable diet will generally be' found sufficient to accomplish a cure. But if the diarrhea persists I give hydrochlo- ric acid, to a child one year old, in one drop doses, largely diluted with sweetened water. If this does not give quite prompt relief, opium in proper doses may be added, I know of no remedy more -efficacious in a large number of cases of diarrhea, both in children andl in adults, than hydrochloric .acid. The only circumstance I am aware of that contraindicates it is the existence of nausea. This symptom must first be controlled, otherwise it will not be retained. Hydrochloric acid acts not only as an antiferment and a direct aid to digestion, but very favorably upon inflamed mucous membrane, as is shown, for instance, in- its local application in cystitis. In a considerable proportion of cases, after the severer diarrhea has been controlled a certain ,degree of looseness of the bowels continues, which keeps the patient weak and fretful. 'This state of things, particularly in one of delicate constitution -and who has passed though protracted dentition, nay last for weeks or even months, and is due to enfeeblement of digestive power and the impaired tone of the intestinal blood-vessels. This condition might be properly called subacute or chronic follicular enteritis, for the intestinal glands are especially involved. In these .cases vegetable and minerai astringents are usually pushed indefi- nitely; and though I believe these agents are ýetter adapted to this stage than any other, I Think we have a far better remedy. This is nux vomica. I give the tincture in from one to three drop doses to a child one year old, and generally, in connection with hydrochloric acid. Nux vomica being one of the very best stomachic tonics, and an excellent vasomotor tonic, also combines properties exceedingly well adapted to this state of things. Very frequently in infantile diarrhea the stools are observed to be whitish from absence of biliary coloring-matter. Yôu are all aware that this con- dition has often been explained by that extremely indefinite term, \" torpor of the liver,\" and that calomel has been given in cases innumerable \" to stimulate \" and \" stir up \" the delinquent organ. This much-abused viscus is utterly innocent of any such charge. The true explanation is this : That the mucous membrane of the duodenum is congest- ed and swollen, and that lining the common duct often partakes of the same condition, which results in obstruction to the flow of bile, and, further that the quantity which finds its way to the intestine is so greatly diluted by the large amount of fluid discharged from the bowels that very little color may be imparted to the stools. No . jaundice generally results from the obstruction in these cases, because, owing to the large amount of food assimi- lated and the great loss of material involved in the disease, secretion of bile is greatly diminished; calomel is therefore clearly not the remedy. It is a fact, however, that an increased discharge of bile may follow the administration of purgative doses of calomel under these circumstances, and it is probably explained in the following way: That the peristaltic action of the small intestine is vigorously stimulated by this drug and the anatomical relation of the bile-ducts with the duodenum is such that a strong peristaltic wave may, by pressing upon the distended ducts, force the bile through the partially obstructed common duct ; and, further, it is supposed that the stimu- lation exerted by calomel upon the muscular coat of the small intestine is felt also by that'of the bile-ducts. Under this view colorless stools present no special indications. I will close with a few remarks upon the mani- festations which arise from brain and nerve dis- turbance in this disease. The restlessness and the tendency to convulsions which appear early in infantile diarrhea are almost invariablv associated with teething, and the most efficient of all remedies is to scarify the inflamed and' swollen gums. This will often not only relieve the brain-symptoms, but put a stop to all others. If any additional sedative is needed, bromide of potassium and chloral may be given wîth advantage. But a tendency to convulsions comes on late in the disease which is of an entirely different,significance and requires entirely different treatment. To administer the bromides or chloral at this tirnie would be a blunder that' might prove fatal. Stim- ulants, when they can be given, defer nerve-storm for, a ,while, but the preeminent need of -the. organism is for food. You have - all perhaps' 27$",
         "274 TUE CANADA MEDICAL RECORD. noticed the appearance of the little sufferer in this condition. His features are emaciated to the last degree and pinched. His eyes are stretched wide open and he lies sleepless for many hours. He follows the movements of those about him with wide open eyes lit up with' a strangly premature intelligence. A little later his eyes are seen to be slightly 'crossed; a little later still there are twi*chings of the facial muscles. Then come general convulsions, then coma, then death. The child dies of starvation. The eager, wistful expres- sion of his face tells that every tissue, every cell, and, more than all the rest, those of the brain and nerves are begging to be fed. But, though it may be impossible to feed a patient in this state either by the mouth or the rectum death is not inevitable. There remains still an important resource : the patient may be fed through the skin. I have seen children who had reached the state I have described pass into a natural, tranquil sleep after the inunction of cod- liver oi or cocoa butter, and awake with renewed strength and able now to retain food taken into the stomach. This striking result is easily under- stood. From the time the tissues cease to get adequate nourishment from ingested food the brain and nerve-tissue feed upon the fat stored up throughout the body, ard no profound nervous dis- turbance occurs. This, however, at length be- cornes exhausted and nervous manifestations begin at once ; but the happy circumstance that oil is readily absorbed by the skin puts it in our power at this supreme moment to satisfy the pressing demand for the kind of food now needed above all other. As soon as this is supplied the brain and nerve return to their normal functions. It is in this con- nection a very significant truth that about two thirds of the solid organic matter of brain-substance is made up of fat.-M/ed. News. LOSS OF MOTION IN CHILDREN. This is an affection which occurs often. I will illustrate a case or two, of which -I can find no mention in any book. A child is pulled, dragged or lifted by the arm in a quick manner, for example, over a gutter. The child cries aloud, drops his arm down after it is released, and has lost completely the motion of that arm for the time being. 'The parents becoming alarmed, send for a doctor to ascertain what is the matter. He ex- amines it all around, and, like many others, con- cludes because there is a loss of motion, \" there must be a fracture, though he is not sure, because it is a child, and it is hard to tell what the real trouble is in a child.\" I have been sent for more than once under such circumstances to set a bro- ken arm, but could not find the fracture; a simple loss of motion comprehends the whole of the afflic- tion. A second case, a child falls, the nrrse jumps and runs to pick up the poor darling, in most cases by one hand, with a quick motion, a little anger probably mingled with it, \" of course it is always the nurse, mothers never commit such blunders !\" The child screams bitterly, his arm drops down, it cannot Imove it ; follows excitement in the pre- vious peaceful household. I have been sent for frequently in such cases, either by parents or by request of the family physician, to reduce a sup- posed dislocation ; but no dislocation is to be found, simply loss of motion. Fractures and dis. locations of course can and are produced in such manner, and sometimes separation of the epiphysis. But it is to the loss of motion to which I call your attention; it is fortunate, however, for the littie patient and fortunate for those concerned, that you can console them with the assurance that the limb will be restored to its proper position in time, almost without any treatment, except rest and some mild embrocation, providing you find sensa. tion unimpaired; one should carefully examine and satisfy himself of this, else the case may then assume a more grave aspect.-St. Louis M. and S. Journal. CODEIA BETTER THAN MORPHIA. Dr. Garrison (Western Med. Reporter) claims that numerous comparative therapeutic tests in this practice with morphia and codeia warrant the following conclusions : i. That codeia is a greater cardiac stimulant thah morphia, is- indicated by the greater force and volume of the pulse following the administration of the former. 2. It is a more powerful diffusible stimulant, elevating the temperature and exciting the capil- laries. Large doses produce an intense itching, with an erythematous redness of the skin, thereby indicating its use in all internal congestions, save perhaps those of cerebral or spinal origin. 3. It does not check the secretion to such an extent as morphia. It is therefore indicated when it is desired to avoid locking up the liver, con- stipating the bowels, or lessening expectoration. 4. It is greatly less dangerous than morphia, no lethal dose having been recorded, yet so potent an agent should necessarily be exhibited with due caution. Its comparative safety recommends its use in infantile therapeutics where morphia is so rarely tolerated. 5. It is never followed by the intense nausea which so often contraindicates the use of morphia, and frequently no unpleasant after-effects are noticed referable to its exhibition. 6. There is less danger frorn the induction of the opium-habit from repeated doses than is the case with morphia, which should be a matter of serious consideration in making a choice between the two. The sulphate is the form to be preferred, because of its ready solubility. The dose is about double that of the sulphate of morphia, but it may be i-",
         "THE CANADA MEDICAL RECORD. creased with safety to a much greater extent than the latter; the objection to large doses being the -excessive itching which is produced, together -with the intense erythema, both of which disappear coincident with the elimination of medicine. It is an excellent adjuvant in combination with ,other anodynes, such as chloral, the bromides, hyoscyamus and Jamaica dog-wood, adding to their efficacy and modifyiùg their action desirably. TREATMENT OF THE PLACENTA AFTER ABORTION. Dr. Stanley P. Warren, of Portland, presented a practical paper on this subject at the late meeting of the Maine Medical Association, in which he classified abortions under four heads, advocating primary extraction of the placenta without leaving the result to nature, observing, of course, all proper precautions with reference to shcok, and hemorrhage. Class i.-Sudden flooding, cervix open, severe shock, and it is unknown whether the placenta bas 1een expelled or not. Class 2.-Moderate hemorrhage; the fetus bas recently been expelled; the cervix open and the placenta within reach; general conditions ~good. Class 3.-The fetus has been expelled for some \u003clays; the secundines are retained; the lochie are fetid, and some form of septic inflammation is present in the peh-ic cavity. Class 4.-There has been more or less flooding; fetus bas been expelled; cervix is closed, and the placenta cannot be reached by the finger, gen- eral condition good. Cases were cited illustratiig each of these \u003cdivisions, and facts presented as to the subsequent condition and labors of these patients. For the first class the recommended procedures -which should relieve shock and check hemorrhage, and as soon as reaction was well established, the contents of the uterus, if any, should be re- iMoved. In the second class these seems to be no question as to the propriety of immediately evacuating the uterus, if the placenta is free and can be removed ý,uithout prelininary dilatation of the cervix. It is to be regarded as simply a foreign body. There is less danger of injury to the tissues with the finger than with the curette ; it aliso has the Âdvantage of the sense of touch. The curette, on the other hand, causes less pain, and may be used _ith or without the speculum; has not found the .vum forceps as safe as the curette, still less than the finger, and ought to be used very cautiously in the uterine cavity. in the third class, where we have present or I[npending some metritis, no good reason obtains why the uterus should not be within 24 hours, lieeved of its contents and thoroughly cleaned,; the cervix is usually patent and requires no dilation a dull curette, followed by intra-uterine, not carbolized, injections, will accomplish every desired object in the way of removal. The quicker the focus of infection is taken away, the less is reparative action delayed and septicemia to be expected. In dealing with class third, when the fetus is expelled, but the placenta shut up in the uterine cavity, obstetricians must choose whether they will \" do nothing,\" relying upon rest and opiates, or mechanically dilate the cervix, perhaps, with a sponge tent, and, as they say, \"let nature take its course,\" or they iay reiove the placenta within twenty-four hours after the expulsion of the em- bryo, using dilators for some hours before operat- ing, or dilating with the finger and immediately extracting. On these points of procedure the most distin- guished obstetricians and gynecologists in the country differ. It bas been urged in objection- i. It is unnecessary, since the vast majority of patients do well if let alone. 2. It is the finger, curette, or forceps that does the damage, rather than the retained placenta. 3. It is very difficult, perhaps 'impossible, to remove an adherent placenta, and septicemia can be caused by a placental tuft as surely as by the entire organ. To these objections the Doctor replied: i. These tonic contractions are essential to the arrest of hemorrhage; there cannot be tonic con- tractions until the placenta is expelled, and the less will be the hemorrhage existing or possible. 2. Anxiety in both patient and physician will be prevented by early completion of the abortion. 3. Time is gained in uterine involution. 4. Absorption of putrilage from retained sectin- dines is unquestionably the most frequent sequel in abortion; when the uterus is thoroughly disin- fected, septicemia is evidently imaginary. Possible accidents from manipulation are not a sufficient reason for permitting a placenta to be removed by decomposition, ignoring the fact that self-impri- sonment must be imminent ; by early removal, therefore, of the placenta, septicemia is prevented. 5. Clinically, after abortion, metritis can rarely be traced to direct mechanical violence. If lesions have occurred in the process of extraction, infec- tion in any empty uterus must be slight when compared with one in which the entire obsorbing surface is exposed and covered by a decomposing placenta.-Pzil. Med. News. TONGA. Dr. Edward C. Mann (Tier. Gazette), in speak- ing of the efficacy of tonga in an inveterate case of neuralgia appearing after sunstroke, says: \"All remedies had been tried, including hypodermics of norphia and atropia, when I happened to think of a sample of tonga sent me. I administered half a teaspoonful, and in half an hour the patient experienced a sense of general warmth diffusing 275",
         "THE CANADA MEDICAL RECORD. itself over the body, with some slight alleviation of the excruciating pain. After a second dose of half a teaspoonful a sense of drowsiness came on, and sleep with entire relief from pain ; the par- oxysms decreased in frequency, and are cut short in the manner described. I have put my patient on a constitutional treatment of cod-liver oil and arsenic, with instructions to take up tonga when needed.\" Dr. Mann adds that he has thus used tonga in this one case, but adds that it was a typical one of great severity. - American XIedicat Digest, June, 1882. THE CANADA MEDICAL RECORD, A Montbly Journal of Medicine and Pharmacy. EDITORS: FRANCIS W. CJAMPBELL, M.A., M.D.,L.R.C.P., LOND. R. A. TENNEDY, M.A., 1.D. JAMES 0. CAMERON, M.D., M.R.C.PJ, SUBSCRIPTION TWO DOLLARS PER ANNUM. Al communications and Exchanges -;iust be addres.ed o the Editors,VJrawer356, Post Ofice, Montreal. MONTREAL, SEPTEMBER, 1882. CANADA MEDICAL ASSOCIATION. The fifteenth annual meeting of the Canada Medi- cal Association was held in the City Council Cham- bers, Toronto, on the 6th, 7th and 8th September. There was an unusually large attendance of mem- bers, and great interest was manifested in the proceedings. The reports and papers read before the Association were very creditable; they were carefully prepared and well received, the discus- sions which they evoked being general and ani- mated. The chair was ably filled by Dr. Fenwick of Montreal, whose genial manner did much to promote the good feeling and harmony of the meetings. The forenoon sessions were devoted to the reception and discussion of reports and the transaction of general business ; the afternoon and evening sessions to special work in sections. Some interesting pathological specimens were on exhibi- tion, the most noteworthy were a series of Aneurisms shown by Dr. Sutherland, specimens of Echino- coccus Disease by Drs. Osler, Black and Metcalf, and microscopical demonstrations of Tubercle Bacilli and Anthrax Bacilli by Dr. Osler. Dr. O'Reilly, Medical Superintendent of the Toronto General IHospital, exhibited a new ambulance waggon, constructed for the conveyance of accidents and surgical cases to tlie Hospital; it is complete in its ai, angements, tasteful in appearance,. rides comfortably, is light enough to be drawn by one horse, and always available at a few minutes, notice. The members of the Association were- invited to visit the Hospital and were shown every courtesy by Dr. O' Reilly. The Local Committee,. with Dr. Canniff as chairman, did all in their power to make the visit to Toronto a pleasant one. An invitation was extended to the Association to be present at the forma] opening of the Toronto Provincial Exhibition on the afternoon of the 6th. On the evening of the 7th a most enjoyable con- versazione was held in Normal School buildings. The grounds were illuminated by Chinese lanterns, and the theatre, library and museum were lighted up and thrown open for promenade. During the evening addresses were given by Drs. Cannifi Workman, Fenwick and W. B. Carpenter, and an excellent musical programme rendered. While- supper was being served, the band of the 1oth Grenadiers played a selection of music. On the Sth the regular business was concluded, and the- Association adjourned to meet next year in Kings. ton under the presidency of Dr. Mullin of Hamil- ton. The members were entertained at luncheon by Dr. D. Clark, superintendent of the Toronto Asylum for the Insane, and then separated, declaring the meeting of 1882 to have been ' a grand success.\" THE VITAL STATISTICS SCHEME. At the last meeting of the Montreal Board of Health, Dr. LaRocque, the Medical Health Officer, made the following report: \" The Federal Government having voted Sio,ooo for the collection of vital statistics throughout the Dominion, and as several schemes were proposed to attain the object in view, the opinion cf a few medical men was asked in reference to the matter, and it was resolved to refer the subject to the Canada Medical Association, which held its Con- vention on the 6th, 7th and 8th instant. The committee appointed on vital statistics met and discussed the question with great earnestness, and brought a resolution before the Association, recom- mending the Government to collect vital statistics from the principal cities of the Dominion, and especially from cities in which Boards of Health were established, and also that a commission com- posed of at least ten medical men, with a legal adviser, be appointed to 'study the question of public health in all its bearings, and report to 276",
         "THE CANADA MEDICAL RECORD. Government. I have much pleasure in reporting that Montreal is recognized as the most advanced city in sanitary matters, being the only one where a regular Board of Health is organized. It would be very important that your Board should consider this question of public health, as Montreal and even the whole of the Province of Quebec are greatly interested in the matter.\" DEATH OF DR. MAJOR HIRAM MILLS. Many of our readers will recall the fact that some few years ago mention was made in these pages of the effort then being made in Montreal to establish \" The Western 7ZUospita4\" and ofthehand- some donation of $12,ooo towards the erection of a Mills' Wing by Major H. Mills. The ground was purchased and the building erected, and it is now in successful operation as the Woman's De- partment of the Western Hospital. This alone would have induced us to record the death of Major Milis, which took place on the 4th of August last at an advanced age, but the fact that he was a physician, which was known only to a few, gives him an additional claim. Dr. Mills first settled at Lennoxville, in the Eastern Townships, about the year 1867. About 1870 he reiznved to Montreal, and at once identified himself with philanthropic work, interesting himself a good deal in the Mont- real General Hospital, becoming one of its Govern- ors. It was the short-sighted policy of that Insti- tution towards the Bishop's College Faculty of Mediciue, which aroused the ire of Dr. Mills, and ied him to offer $12,ooo towards an hospital in the west end. No one in Canada knows much of the early history of Dr. Mills beyond the fact that for years he practised as a physician in one of the Southern States. He left almost his entire fortune to McGill University and to the Church of England. He was possessed of many good qualities, but was somewhat pronounced and eccentric in his views. A singular outcome of the latter being the fact that the Institution in which he seemed, so long as reason remained with him, to take a warm and anxious interest was entirely forgotten in his donations. It would be interesting to ascertain how this came about. FIFTEENTH ANNUAL MEETING OF THE CANADA MEDICAL ASSOCIATION. The Association met on the 6th; 7th and 8th Sep- tember in the City Council Chrambers, Toronto, the President, Dr. Fenwick, in the chair. The ses- sion opened at 10.3o a. m. After the transaction, of routine business, Dr. FULTON, Toronto, read the report on, Necrology; the following physicians, practising in the Dominion, have died during the past year:-Dr. Berryman, Toronto ; Dr. T. Macke St. Catharines; Hon. D. Brouse, Ottawa; Dr N. Fleming, Mildmay; Dr. H. Parsley, Thorn bury; Dr. J. A. Purney, Shelburne, N.S.; Dr. A Robertson, Liverpool, N.S.; Dr. W. G. Middle ton, Stella; Dr. N. Munro, Brucefield; Dr. Mc Michael, Gorrie; Dr. G. Cook, Norwich ; Dr J. Allen, Adolphustown; Dr. J. B. Smith, Jersey- ville; Dr. G. Lount, Norwich ; Dr. A. J. Whitehead, Toronto ; Dr. W. Philp, Manilla; Dr. H. H. Boul- ter, New Hamburg; Dr. W. Wilson, Dorchester, N.B. ; Dr. J. P. Lynn, Toronto; Dr. C. W. Heltz, Chester, N.S.; Dr. A. R. Lander, Frankville; Dr. W. Weir, Merrickville; Dr. H. Yates, Kingston ; Dr. H. Orton, Ancaster; Dr. McCay, Blairton; Dr. Munro, Montreal; Dr. F. H. Wright, Toron- to; Dr. H. Bingham, Manilla; Dr. A. McKay, Beaverton; Dr. G. W. Campbell, Montreal; Dr. Maxwell, Bear River; Dr. McIlmurray, Toronto; Dr. H. H. W. Lloyd, Coldstream; Dr. H. E. Bis- set, Hawkesbury; Dr. T. Blackwood, Paken- ham; Dr. J. Salmon, Simcoe; Dr. A. Greenlees, Toronto; Dr. R. H. Wright, St. Johns, Que. Dr. GRAHA M, Toronto, read the report on PRAc- TICE OF MEDICINE. He said that from a medical point of view the two most remarkable events dur- ing the past year were the International Medical Congress at London, and Koch's experiments on Tubercle Bacilli. He then discussed the etiology and morbid anatomy of tubercular disease, and described Koch's experiments and deductions. He supported Koch's views, and believed that a great advance had been made towards the prevention of disease. He believed that many cases of tuber- culosis were set down as typhoid fever. In adults, tubercular disease generally appears in the lungs, the germs being inhaled in the breath; in children the gerns seem to enter the stomach with the food and passing along into the intestines develop there. Dr. W. B. CARPENTER of London, England, weli",
         "THE CANADA MEDICAL RECORD. nown to the profession as the author of a stand- ýard work on physiology, was elected an honorary nember of the Association, and invited to give his -views upon Vital Statistics. His address will be found in another column. In the afternoon the Association broke up into sections. THE MEDICAL SECTION. Dr. MCDONALD of Hamilton was elected ,Chairman, and Dr. STEWART of Brucefield secre- tary. Dr. OSLER, Montreal, read a paper on Ec/ino- 4coccus Diseasc in America. The introduction into the human systei of the ova of the taenia ecihino- .coccus of the dog undoubtedly produces a disease of the most serious character. All the internal organs become disordered and hydatid cysts form in the liver, spleen, lung and kidney. Cases are reported in Iceland and some parts of Europe and America. On the whole the disease is very un- common in America. In Canada he had been able to collect notes of only 9 cases ; in the United States the disease is quite as uncommon, 52 cases being .all that he could find recorded, making 61 cases altogether in America. Only a few specimens are to be found in the museums; Cobbold says that the only specimens exhibited in the museums of Great Britain have been reared artificially. Its infrequency in the human subject in America is attributable to its infrequency among the dogs. In .Iceland fully one-sixth of the dogs suffer from it, hence the disease is very common among the Ice- landers. It is calculated that fully one-third of the cases in America have occurred among emigrants and havè probably been inported. The ova are introduced into the systen chiefly by means of \u003clrinking water, which has become contaminated with the excreta of dogs suffering from the disease. The treatment adopted in Iceland and Australia is *either tapping or incision. Sometimes the disease is cured spontaneously, either by the bursting of the cyst and discharge of its contents through the bowels or lungs, or by the hardening of the walls of the cyst and the consequent death of its inhabi- tants. Drs. GRAHAM and TEMPLE related cases of echinococcus disease which had corne under their ,observation. EVENING SESSION. At 7.30 p.m. the President, Dr. Fenwick, read his .address. He sketched the history of the Canada Medical Association, and dwelt upon the greatirn- portance of such Associations to the medical pro- fession and the public at large. He spoke of the important functions of the British Medical Asso- ciation, and pointed to it as a model of what the Canadian Association might be and do. He said that the Canadian Association might now be celebrating its jubilee as the British Medical Association had just done, had it not been for the unfortunate disagieement which had occurred among those who originally met to organize it. He wished to place the facts of this disagreement on record, as the witnesses of it were fast passing away. He hoped that harmony would now exist, and that the work of the Association would improve the status of the profession in Canada. He then dwelt at some length on the importance of sanitary legislation, a subject which is now attracting so much attention in Great Britain. He hoped that the same attention would be shewn it at Ottawa. A sum of $1o,ooo had been placed at the disposal of the Minister of Agriculture for the collection of statistics, but unless the scheme adopted met with the approval and support of the medical profession throughout the Dominion, that sum of money would do very little towards obtaining reliable information. He thought that in order to prevent failure they should commence the collection of statistics in the. large cities only, the area of work being expanded as means and opportunity permitted. He recom- mended that a committee be appointed to confer with the authorities at Ottawa, and suggested the re-appointment of the old Committee. Dr. BOTSFORD, New Brunswick, said that the subject of public health should be again pressed upon the Government. The Government looked to the Canada Medical Association to formulate some system, and he was strongly in favor of carry- ing out the President's suggestion to appoint a committee for that purpose. He noved a vote of thanks to the President. Dr. GRarT, Ottawa, said that the Ottawa Gov- ernment was willing to co-operate with the Asso- ciation in :inything that would tend to ameliorate the public health, and was prepared to give thera substantial assistance in the collection of vital statistics. He seconded the vote of thanks to the President, which was duly pult and carried. The members then divided into sections. ~eMDICAL SECTION. Dr. MACDONALb, Hiamilton, chairman of the 42 78",
         "THE CANADA MEDICAL RECORD. Section delivered his address, briefly reviewing the work done by the Association. Dr. CAMERON, Montreal, read a paper on Axis- traction. He criticised the pelvic axis as ordina- rily figured and described in text-books, and sup- ported the views advanced by Dr. Studley of New York in the American Jou-nal of the M1edical Sciences (January, 1882). He maintained that in vertex presentations the head descends in the axis of the brim till it reaches the floor of the pelvis, wtiich checks its progress and directs it forward under the pubic arch in the movement of extension. In forceps delivery traction should be made as nearly as possible in the line of zhe pelvic axis ; consequently in higli operations, the traction should be made backwards in the direction of the axis of the brim, until the head comes well down upon the floor of the pelvis; then, and not till then, should traction be commenced anteriorly. He exhibited inodels of the straight, double-curved, and Tarnier's axis-traction forceps, and discussed the relative advantages and disadvantages of these different varieties in high operations. The straiglit forceps are correct in principle, for the axis of the handie corresponds to the axis of the blades, hence traction can be made in the pelvic axis. Their great dis- advantages are difficulty of application and liability to slip. The double-curved forceps are contrived to overcome the disadvantages of the straight instrument. They give a firmer grasp of the head, are less liable to slip, are easier of application and more powerful. But their great disadvantage is that the axis of the handles does not correspond to the axis of the blades, hence traction cannot be made directly in the line of the pelvic axis. They gain in strength but lose in axis-traction, and hence require the use of extra force, which is expended upon the foetal head and maternal soft parts. The axis-traction forceps of Tarnier combine the advantages of the straight and double-curved for- ceps without their disadvantages. The instrument is powerful, and gives a firin grasp of the head, while by means of the sharp perineal curve on the trac- tion rods, the axis of the traction handle is made to coincide with the axis of the blades. Hence the line of traction can always be in the line of pelvic axis, without pressing back or injuring the peri- neum. The other advantages of the Tarnier for- ceps were described; the objections which have been urged against them were stated and criticised. Tarnier's forceps are most suitable for high opera- tions; Drs. Simpson, Thomas, Lusk, Fordyce Ba rker and others use them only to bring the head down through the brim and well into the cavity; they- then remove the Tarnier, and complete delivery vith the ordinary double-curved instrument. The method advocated by Dr. Albert Smith and taught by the Philadelphia School was described and criticised. Tarnier's latest model offorces and his cephalotribe, both exemplifying axis-traction, were exhibited and explained. Dr. ALLOWAY, Montreal, read a paper on the treatment of abortion, severely criticising the teach- ings of the ordinary text-books. He considered the tampon inefficient, ergot positively injurious, the finger insufficient, and the placental forceps; dangerous. By allowing a putrid mass to lie enclosed in uterine cavity, great risk was run of~ septic poisoning. He exhibited a uterine scoop of his own invention which he considered most effec- tual, and related a number of cases in which it had been used with success. He also exhibited a newr vaginal speculum, a modification of Neugebauer's, which he claimed to be base-expanding and self- retaining, and well adapted for minor gynecological work. Dr. HOLMES, Chatham, was accustomed to use the forceps in the way recommended by Albert Smith, namely, as a lever and tractor combined. He had no experience of Tarnier's forceps, but thought their principle a good one. He dwelt upon the necessity of guarding against cervical and perineal lacerations; for this purpose he recom- mended the use of chloroform in the latter stages. of labor, and preventing the patient from bearing down when the head is about passing through the- fully-dilated os uteri or over the distended peri- neum. DR. TEMPLE, Toronto, could not see the ad-- vantage of the Tarnier forceps over the ordinary models. He had no experience in its use, but could speak from experience in praise of other formas of forceps, particularly the straight forceps. He thought that no instrument was so suitable in occipito-posterior presentations as the straight forceps. He thought Tarnier's forceps too com- plicated, and believed that the simpler the instru- ment the greater would be the facility in using it. He also believed that the pelvic axis, as ordinarily figured in books, does not exist; such teaching is very fallacious. DR. TYE, Chatham, said he really thought that we were passing through an iron age in the matter",
         "280 THE CANADA MEDICAL RECORD. -of obstetrics and gynecology. After seeing all the forceps, scoops and other instruments which had beén exhibited .he really congratulated himself that he was not a woman. In his practice he relied chiefly on the instruments provided him by nature, and found them to be very suitable. He -wanted no better scoop than his finger. DR. CAMPBELL, Seaforth, said that he had heard Professor Simpson of Edinburgh, whose opinion is .of great weight in such matters, express himself ,decidedly in favor of Tarnier's forceps. In fact, Professor Simpson rarely uses any other form of forçeps. DR. RODGER, Montreal, said that while he dis- approved of undue multiplicity and complication .of instruments, he felt that the valuable assistance iendered by them should not be overlooked. He did not approve of the placental scoop which had been exhibited, and 'considered it dangerous and altogether unnecessary. He spoke in favor of the tampon and placental forceps in the treatment of .abortion, and held that improper application of the tampon accounted for its frequent failure. DRS. CAMERON and ALLoWAY having spoken in xeply, the Section then adjourned. SURGICAL SECTION. The Surgical Section met in the afternoon, and -elected DR. GRANT of Ottawa, chairman, and DR. Ross, Jr., of Toronto, secretary. The Section then adjourned till evening. On resuming, DR. RODDICK, Montreal, exhibited a patient who had suffered for many months from a very painful spasmodic contraction of the muscles of one side of the' neck. The man was obliged to hold his head between his hands constantly. Dr. Roddick divided the muscles, but with only tem- _porary effect; he then applied the actual cautery frequently to the back of neck with most satisfac- tory result, as the man is now perfectly well. DR. MAJOR, Montreal, read a paper on REST AND TRACHEOToMY. He urged the importance of rest in all cases of disease of the larynx and throat, ,and condemned the use of gargles. He called atten* tion to some points in the early diagnosis of laryn- geal cancer heretofore unnoticed, and suggested the use of gold instead of silver or any other metal or material for the tubes. As far as he knew he was the first to recommend its use. DR. RYERSON, Toronto, agreed with Dr. Major as to the value of rest in laryngeal troubles, and described a case in which he had performed tracheotomy successfully. DR. ELSBERG, New York, said that he held it to be the duty of those who had devoted them- selves to special subjects to give the results of their experience to their professional brethren. Some years ago his attention had been drawn to the fact that the principle of rest in cases of inflammation applied to the throat as well as to any other part of the body. Under the influence of rest inflan. matory conditions subsided, and perhaps gave way to a renewed action. The, larynx was moved in three functions, viz., in the production of voice, in breathing and in swallowing. The first is a voluntary action, consequently it is possible in this respect to secure complete rest. Breathing, though absolutely necessary for life, miglit be made easier, and by tracheotomy the larynx might be relieved from active participation in respiration. Is it advisable to practice tracheotomy for this pur- pose ? He did not share the opinion that it is a simple or harmless operation, but lie regarded it as very valuable in appropriate cases such as stenosis. With regard to the third function, swallow. ing, tracheotomy does not afford complete rest, but other means might be used to give partial rest. DR. HINGSToN, Montreal, asked Drs. Major and Elsberg to state in what cases they would or would not recommend tracheotomy. While rest might alleviate he did not believe that it could ever cure malignant disease. DR. ELSBERG, in reply, stated that he would recommend tracheotomy in all cases where stenosis called for it. With regard to the other point raised by Dr. Hingston, he wished to makê it clear that he had not enunciated the opinion that rest could: cure malignant disease, but that it might arrest it progress for a time. DR. FENWICK, Montreal, considered that rest retarded the progress of malignant disease. DR. SHEPHERD, Montreal, read a paper o Cervical Ribs, which gave rise to some discussion, He also exemplified an appliance for \"caked breast.\" DR. GRANT, Ottawa, read a paper on Cancer of the Breast in its Relation to Disease ofthe t iphes The discussion which ensued was participated by Drs. Hingston, Fenwick and Ross, jr. The Section then adjourned.",
         "THE CANADA MEDICAL RECORD. THURSDAY, SEPTEMBER 7th. .'The Association re-assembled at 10 o'clock, Dr. Fenwick in the chair. After routine business, Dr. SHEPHERD, Montreal, read the report on Surgery. He referred to the great advances made in the treatment of wounds, and said that all sur- geons are not antiseptic surgeons, and Listerism is only a phase of antisepticism. He considered that, in the treatment of wounds, cleanliness and antiseptic precautions are of the greatest impor- tance. His own experience was that the healing process goes on more satisfactorily under dry than under moist dressings. Moisture only tends to favor the putrefactive process. He described minutely his own method of dressing wounds with iodoform and boracic cotton. He then touched on the different theories as to the causes of inflamma- tion, and urged the necessity of antiseptic treat- ment. He gave an account of Dr. Hamilton's ex- periments with sponge grafting, which was found to be particularly useful in ulcers, and where the formation of new tissue was required. Dr. Mc- Ewan of Glasgow, and Dr. McManus of London, had succeeded, by means of sponge-grafting, in effecting the formation of new bone. He remarked Ihat no organ is now considered sacred by the surgeon, and spoke of the wonderful success that has recently attended the operations of Nephro- tomy and Nephrectomy. The treatment of club- foot was then glanced at, and the opinion of the members asked as to advisability of the early divi- sion of the Tendo-Achillis. Personally he believ- ed that this tendon should be spared until it had been found that the division of the other tendons was not sufficient to effect a reduction of the deformity. He thought that the great use of paring this tendon was to give a point d'appui for ianipulation. Dr. Shepherd concluded his very ble report with an account of the late improve- ments in the surgery of the joints, and discussed the question of the excision of joints for joint 4isease. Dr. BRODIE, Detroit, a delegate from the Ame- ican Medical Association, was here introduced by r. Canniff. Dr. Brodie, on behalf of the American Association, expressed good wishes for the spccess, of the Canadian Association. He said next year the American Association would meet at Cleveland, which wyas very convenient and ccessible to -Canada, and he hoped to have the ,leasue of seeing many of the members of the anadlian Association present on that occasion. Dr. CANNIFF, Toronto, moved a vote of thanks to Dr. Shepherd. Dr. GRANT, Ottawa, seconded the motion, com- plimenting Dr. Shepherd upon his admirable re- sunié. He referred to the valuable researches and discoveries of Pasteur, and emphasised the impor- tance of antisepticism in nedicine and surgery. Dr. RomabD , Montreal, while congratulating Dr. Shepherd on his admirable report, disagreed with him as to the relative value of dry and moist dressing. From his hospital experience he was not favorably impressed with dry dressings. Moist antiseptic dressings are superior to the dry in major operations where drainage is necessary. Lister's method, when properly carried out, is of the greatest importance. His own results and those of Dr. Fenwick have been remarkably improved since adopting the Listerian method, and $hey now confidently undertake operations which they would have considered impossible with the old methods. In the Montreal General Hospital they almost outlister Lister ; the more he sees of the method and its results, the more he recognizes the necessity of carrying it out faithfully in its smallest details. In the treatment of clubfoot L:e differs from Dr. Shepherd; he believes in dividing the tendo-achillis at once, and he rarely finds it necessary to divide any of the other tendons. Dr. HINGSTON, Montreal, remarked that anti- septicism and Listerisrn are not convertible terms. There is no surgeon now-a-days who does not believe in antisepticism, by which he understands complete cleanliness in the treatment of wounds. Sup- puration may be prevented by scrupulous clean- liness, without the employment of Lister's method. Some years ago he saw the late Sir James Simpson of Edinburgh amputate a breast, the most scrupulous attention was given to clean- liness, and dry dressings were applied. Simpson predicted that no suppuration would take place, and sure enough not a drop of pus formed. From his own experience he was not quite satisfied as to the safety and value' of the carbolic spray, espe cially in abdominal surgery. He does not use the spray in ovariotomy. With regard to the treat- ment of club-foot, he agreed with Dr. Shepherd in condemning the early division of the tendo-achillis; in the majority of caes he did not consider- this tendon to be at fault. Dr. MACKAY, Woodstock, had succeeded in curing club-foôt without performing tenotomy. Dr. SLOANE, Blythe, considered the introduc- 281",
         "THE CANADA MEDICAL RECORD. tion of the antiseptic method of dressing of ,wounds to be a great improvement. The country practitioner can now undertake operations he -would not formerly have dared to attempt. Dr. WORKMAN, Toronto, referred to a reported case of the successful use of whiskey dressings. . Dr. FERGUSON, Toronto, made a statement as to the strength of spray used by Dr. Keith in his later ovariotomies. He had employed a spray of i x 30, or even stronger, instead of i x 6o as recom- mended by Lister for cases of ovariotomy. Had he adhered to the weaker spray he would probably not have had evil results from it. Dr. STEWART, Brucefield, mentioned that'a well- known ýnrgeon was obliged to give up the use of spray on account of its invariably causing him to suffer from hæimaturia. Dr. HARRISON, Selkirk, did not understand the separation of antisepticism from Listerism. In a ve, y huinorous speech he described the trials and troubles of inventors. He was very thankful that in the country districts they had never invented or discovered anything. Dr. CANNIFF, Toronto, did not think that the whole credit of antiseptic surgery was due to Lis- ter. M. Pasteur, and Dr. Samson Gamgee of Bir- mingham had rendered important services in this matter. Dr. CAMPBELL, Seaforth, asked the President to define Listerism. Dr. FENwICK, the President, said that would be an arduous task. His own practice is to cleanse the wounds thoroughly, and then apply the spray. He considered the use of the spray advantageous, and meant to continue its use till something bet- ter was introduced. Even with the use of antisep- tics he had not found it possible always to prevent suppuration, and he was aware that others had a sim- ilar experience. He did not believe Gamgee's method of dry dressing to be in any way superior to the moist. Dr. SHEPHERD, Montreal, in reply said that Dr. Roddick considered moist dressings better for major operations than dry dressings, because the- moist gave better opportunity for drainage. In answer to this he would say that dry dressings did not require such elaborate provisions for drainage, as there was nothing to drain. The presence of the tube or other appliances for drainage only causes irritation, promotes suppuration, and pre- vents union; without the drainage-tube suppura- tion is less likely 'to occur, and, consequently the necessity for drainage is less. In support ofsthe utility of dressings in major operations, he quoted the statistics read before the International Medical Congress at London. Dry dressings have been used by several eminent German surgeons in a large number of amputations, excisions, etc., with great success. In the dry method antisepticism is secured by the use of iodoform. In wet dressing the stench is sometimes intolerable; in dry dressing this is almost wholly avoided. Dr. TYE, Thamesville, read the report on Tlera- /'eutics. He referred to the dangers of hasty gen. eralisations in therapeutics as well as surgery. The power of medicine is to increase or diminish the functions of tissues or organs, not to change the character of those functions. He dwelt on the use of electricity in anæsthesia, asthenia, and sup. pressed menstruation, and described the effects of the different currents, the magneto-electric, galvanic and frictional, in the treatment of different diseasr The therapeutical effects of some newly-introduced drugs were considered, nitro-glycerine among others. He remarked that although a large nui- ber of new pharmaceutical preparations had been introduced, it was questionable whether some of them were not more advantageous to the manu. facturer than the patient. Dr. CAMPBELL moved a vote of thanks to Dr. Tye, which was seconded by Dr. Stewart and carried. Dr. CANNIFF, Chairman of the Special Conmittee appointed to seek from the Dominion Government improved legislation in respect to Sanitation and Vital Statistics, submitted the report of the Comn. mittee, which contained the views of Drs. 1Hi1 and Grant, of Ottawa; Hon. Dr. Parker,of Halifax; Dr. Botsford, of St. John's ; Dr. Atherton, of Fred-, ericton ; Dr. Macdonald, of Londonderry ; Dr. Fei. wick, of Montreal; Dr. LaRocque, Health Officerof Montreal; Dr. Orton, M.P., and Dr. Oldright. A number of these views were embodied in a com. munication to the Premier. It was decided thit the Committee should meet and consider the re port, and that it should be discussed by the As sociation on Friday. The Association then adjourned. MEDICAL SECTION. Dr. HARRISON, Selkirk, read a paper on Peculiar Form of Fever, which had come underbis notice, describing minutely the symptoms, prQo* gress and treatment. The' fever wvas sometns 282",
         "THE CANADA MEDICAL RECORD. jemi.ttent, subsiding occasionally for a few days, éd then commencing again. He had prescribed quinine as he would do in intermittent fever, but vithout any beneficial result. He then changed the treatment to iodine, maltopepsin and carbolic acid. In two cases the patients died in the thir- teenth and fourteenth weeks of pure exhaustion. Inanother case recovery took place after the eighth week. The peculiarities of this fever were its tendency to change from one type of fever to another, and its long duration. D. RIDDELL, Toronto, thought these were cases of kind of malarial fever peculiar to this part of the world, partaking of the characters of cerebro- spinal meningitis. ,Dr. Ross, Montreal, thought that from the des- cription of these cases as submitted by Dr. Harrison the members were not in a position, to discuss them. There might have been suppuration of seme internal organ, such as the kidney, which coulid only have been ascertained by an examina- tion of the urine. It was not impossible that there night have been ulcerative endocarditis. Dr. TYE, Chatham, stated that some time ago a large number of cases of the kind so graphically described by Dr. Harrison had come under his observation, indeed at one time it had been almost epidemic. Dr. HOLMES, Chatham, had had similar cases under his care. He did not agree with Dr. Riddell in the view that they were of malarial origin. Dr. HARRISON, in reply, stated that he had xamined the urine, and had not discovered any. thing abnormal. He had not had an opportunity of naking a post-mortem examination; at any late there -was so little left of the patients by the tne they died, that there would have been hardly anything.to examine post-mortem. Dr. MULLIN, Hamilton, read a paper on Dibh- hria. He said that there were various forms of diphtheria, and in some cases other ailments were n as diphtheria. The severity of the attack depends greatly upon the constitution of the patient and surrounding conditions. He described a case of diphtheritic croup which he had treated. He pre- cribed an emetic of ipecac and steamed the throat. î a few days the symptoms became unfavorable, nd tracheotomyhad to be resorted to. An attack of ague supervened, but at last the patient recovered. (described a number of other cases, showing ,that the symptoms varied according to the age of h patient, and'the local and constitutional con- ditions. He said that the low forms of animal growth that invaded the fauces and tonsils of those suffering from diphtheria were extremely tenacious of life, and he considered it advisable to destroy the bacilli or bacteria, which were undoubtedly present, by cauterization or otherwise. Opinions differed widely as to the value of treatment in diphtheria. Some held that a certain proportion of cases would recover by the unaided vis medicatrix nature, and that others would not recover under any treatment, and consequently they had little faith in any treatment. Dr. HOLMES, Chatham, read a paper on Cholera Izfantunm. Since so many children die every year of this disease, its treatment is a matter of great importance. The chief causes are hot weather, damp atmosphere, defective nourishment, bad ventilation and drainage, unsuitable clothing and indigestible food. The symptoms are, elevation of temperature, abnormàl character of stools, thirst, pain, and vomiting. To prevent the disease, proper alimentation, ventilation and clothing are essential. The air should be pure, and the clothing in hot weather slight. Artificial feeding of young infants should be avoided if possible; but where resorted to, the milk or other food should be per- fectly pure and fresh. Cleanliness is a matter of great importance. The treatment must aim at reducing the temperature and restoring the normal character of the stools ; if this cannot be done the patient will surely die. To reduce the tempera- ture, cold sponging with or without spirits. He condemned the use of opiates either for their sedative or astringent effect, as he invariably found that they did harm. He recommended the use of castor oil in suitable cases, and minute doses of hydrargyrum. Dr. McDoNALD, Hamilton, said that the disease is not now as virulent as it used to be, and better modes of treatment are adopted. He advocated change of air, and was in the habit of sending his patients for a long trip upon the lake or river. Dr. Ross said that he had considerable exper- ience in the treatment of cases of cholera infan- tum. He found bromide *of potassium very useful. Dr. STEWART, Brucefield, read a paper on, Three Cases of Sciatica and one of Painful Stunp treated by stretching the Sciatic zVerve. In each case he used antiseptic precautions. Nerve stretch- ing is now recognised as an important means of curing neuralgia, but it is a practice not unaccom- 280",
         "·THE CANADA MEDICAL RECORD. panied with danger. In some cases where the operation proved fatal, death was distinctly attri- butable to the use of chloroform. Ether should always be administered in these, cases instead of chloroform. The statistics of the operation 'are very favorable: 97 per cent. of all cases so treated are either entirely cured or else greatly relieved. Dr. Ross said that they were very much in- debted to Dr. Stewart for bringing under their notice this form of treatment, which he believed Dr. Stewart was the first to use in this kind of disease. le had himself tried it unsuccessfully in a case of tetanus. Dr. STEWART, in reply to Dr. Workman, stated that the value of nerve-stretching had been acci- dentally discovered by a medical man who had cured a patient suffering intense neuralgia by acci- dentally stretching the nerve. Dr. PREVOST, Ottawa, read a paper on Tumor of Boues of Skuilt Pressing on Brain. There was an aperture in the frontal bone. The skin covering the tumor was of normal color. The patient's intellect did not appear to be much affeeted, but he seemed drowsy and dull. He walked slowly, and his memory was impaired. After entering hospital be gradually fell into a state of indifference, which was followed by coma and death. The autopsy shewed that the tumor originated in the bone. He exhibited the specimen. Dr. CAMERON, Toronto, exhibited a boy who was being treated for pseudo-hypertrophic muscular paralysis. The treatment consisted of cod liver oil, syr. fer. iodid. arsenic and galvanism. The boy shewed the peculiarity of his movements in going up-stairs, and in rising off his back. He was stripped and examined by several of the members. Dr. Ross said that such cases are rare, and are to be found chiefly among boys. Dr. CAMERoN agreed with the views of Bristowe and Charcot as to the origin and nature of the disease. Dr. SHEARD believed that in these cases the lesion originated in the anterior or motor nerves issuing from the spinal cord. Dr. BLACK submitted notes of an autopsy on a case of echinococcus disease of the liver, exhibited the preparation in alcohol, and read the notes of the case. Dr. OSLER, believed that the fatal termination in this.case was due to suppuration of the cyst, which is one of the great dangers of the'disease. He took out the specimen and demonstrated the ravages of the disease. There had been a cyst in the spleen the size of a child's head, besides an enormous' cyst in the liver. Dr. H. P. Wright, Ottawa, read a paper on Phantom Pregnancy. In the case reported the tumor was situated on the left side, and developed in such a way as to produce in the mind of the patient the idea of pregnancy. The movements of the tumor closely resembled those of a living fœtus in utero. Chloroform was administered and the tumor disappeared, and the patient is now quite well, able to attend to her ordinary duties. Such cases are found chiefly among women subject to undue exertion, spinal irritability and menstrual irregularities. Dr. SLOANE narrated a similar case. Dr. Ross stated that a case had come under his observation where a woman was convinced that she was carrying within ber a dead extra-uterine fetus, and it was with great difficulty that she was persuaded to the contrary. Dr. ELLIs described the chemical composition of milk of cows fed on distillery refuse. He had made an analysis of the milk of cows fed on differ- ent kinds of food. The mean of the solids in the milk of distillery cows he bad found to be 14.64; of other cows 12.82. The amount of fat in dis- tillery cow's milk is greater than in others, the minimum of the former being equal to the average of the latter. The caseine, sugar and ash ingre- dients are much the same in both. The principal difference is in the greater amount of fat in the milk of distillery cows. The distillery refuse on examination was found to consist of grain with the saccharine matter removed. The fat and albumen remained, together with a small quantity of alcohol, as small as distillers can make it. He could not say whether this food produced any morbid con- dition in the cows. Dr. WORKMAN bad heard that cows could not be kept long on this kind of food without degenera- tion. Dr. SLAYTER, Halifax, communicated throughl the Secretary a paper on the Advantages of Hali- fax as a Heatth Resort during th/eSum mer Months. This concluded the business of the Section. SURGICAL SECTION. Dr. HINGSTON, Montreal, read a paper on Cer- tain Obstructions in the Airpassages. This paper will be published in full in the next issue of the RECOR). 284",
         "THE CANADA MEDICAL RECORD. The paper was discussed by Drs. Major, Har- rison, Fulton, Roddick and Wright. Dr. FULTON, Toronto, read a paper on Polypoid Jibroma of the Bladder in a Child. He said that Cystotomy is the only rational mode of treating these growths, though a double-eyed catheter inight be used in the case of small polypoid growths. A lengthy discussion ensued, which was parti- cipated in by Dr. Hingston ard others. Dr. RYERsON, Toronto, read a paper on Poly- pes-Nasi. He described the various. modes of treatment, giving it as his opinion that removal by means of the snare is the most efficacious. Dr. WALKER, Detroit, spoke on Modern LitÃio- trity, describing some cases in which he had used Bigelow's instrument with success. Drs. HINGSTJN and RODDICK took part in the discussion. Dr. CAMERON, Toronto, exhibited a woman whose face was disfigured by an enormous tumor. When it first appeared, it was mistaken for an ordinary gum-boil. Her health does not seem to be much impaired. Dr. FERGUSON, Toronto, reported three cases of Eczema, which he had treated successfully with viola tricolor internally and quinine baths locally. Dr. REEVE, Toronto, read a paper on Orbital Diseases, dwelling specially upon the importance of an early recognition of such affections, and prompt operation for their removal. He exhibited speci- mens of tumors removed and photographs of cases. Dr. GOODWILLIE, New York, read a paper on a New Opjerationfor Closure of Hare-iip and the iard Palate imnediately after Birth. Ail that has been usually attempted in such cases has been to close the cleft lip only in childhood. His method is to operate immediately at birth, and close the cleft of the hard palate by forcing together the side bones of the mouth, saving ail the hard and soft tissues, thus restoring the naturai appearance. The nose, which is turned to one side in the dis- ease, is straightened and the harelip closed. When the operation is completed, the external appear- ance of the nose, lip and mouth is natural. Dr. FENWICK, Montreal, read a Report on Addi- ional Cases.of Excision of the Knee. He said that nexcision of 'the knee in children, it is desirable to preserve the growing power of the limb. If the larts from which the bone grows could be pre- served, the operation could be performed in young children with every prospect of a useful limb.,, He wished to call attention particularly to the pos- sibility of forming a good union between the epi- physes of the bones. By rounding off the bones in sawing, 'uture displacement is prevented. This method also produced the least possible amount of shortening. He shewed a specimen taken from a girl of 11 years whose knee joint he had excised, in which good bony union existed between the epiphyses of the bones. In his hospital practice he had had 26 cases ; of these 22 recovered with use- ful limbs; in only 2 cases was subsequent amputa- tion necessary. Two cases died svbsequently, one on the i8th day after operation from pyæmia, the other died eleven months after operation from heart disease following an attack of acute rheumatism. After some discussion, the Section adjourned. SEPTEMBER 8TH. The Association reassembled at 10 A. M. Dr. Fenwick in the chair. After routine business, Dr. WORTHINGTON, Clinton, read the report on Climatology and Malarial Disease. The Com- mittee sent out a series cf questions to medical men in various parts of the country, with the re- quest that the answers be returned to the, Commit- tee to form the basis of their report. Thirty-seven circulars were sent to seventeen counties, and re- plies received from twelve medical men residing in ten different counties. In four of these no malaria was reported to have existed for many years, but in the remaining six it was said to be prevalent. In the malarial districts the answer was that it prevailed to an unlimited extent, and was termed the curse of the country. In the districts referred to the country around was reported to be flat, with sluggish streams whose beds and banks consisted of alluvium. The first effect of drainage and cul- tivation was to increase the evil, but it afterwards becanie the true remedy. Malarial poisoning seemed to be more active after the month of July until the cold weather. In the Lake Scugog dis- trict malaria prevailed to such an extent as to cause the people to request the attention of the Government to the matter. He described -the different kinds of disease attributable to the malarial poison. To remedy the widespread evils of malaria he recommended thorough drainage of ail swamps and receptacles of impurities. The culti- vation of the soil does much to improve the sani- tary condition of the' country, and the growth of",
         ". THE CANADA MEDICAL RECORD. the eucalyptus globulus has been found of great advantage in the marshy districts, of the Southern States. He said that the subject deserved the con- sideration of the Provincial Board of Health, and it was a question whether the Government should not take action in cases where intervention was necessary on sanitary grounds. Dr. McDONALD spoke of the eucalyptus globu- Jus, and the merits and demerits of tree cultivation. DR. OSLER said that reports from the United States shewed malaria to be on the increase. In Montreal cases of ague have become more frequent. DR. FERGUSON referred to a case where the re- moval of a strip of woodland had been followed by the appearance of malaria where none had pre- viouslv existed. In the County of Grey a tract of 200 .acres of swampy land which had caused a great deal of malaria was cleared and put in grass. For ten years no ague was reported. The and was again broken up, and immediately after five cases of ague were reported. DR. RIDDEL said that forty or fifty years ago ague was prevalent in Toronto all along the front of the city. Wherever there were swamps, mnarshy lands, and rich grass there ague would be found. The products of decayed vegetation often ascended in the form of gas, and this created a new danger. In Toronto ague seemed to have been replaced by typhoid and other fevers. Dr. OLDRIGHT was glad to see that this impor- tant matter was receiving so much attention. The Ontario Government had requested the Board of Health to enquire into the cause of malarial dis- ease in certain districts. There was no doubt that these diseases were increasing in some districts, where dams and collections of decomposing saw- dust were common. The disease was also on the increase in certain of the States, and commissions of enquirywere being instituted. In some of even the most elevated districts the disease was very rife. Dr. WORKMAN enquired whether the malarial influences of the Don had received the considera- tion of the Board of -Health, and whether the in- crease of disease there was due to the closing of the Lying-in Hospital. Dr. OLDRIGHT said the closing of the hospital was a matter for which the Government was res- ponsible, and the -Board did no.t feel it their duty to interfere unasked. Dr. WORTHINGTON stated that malaria -: was found in high as well as in low grounds, but the cause, if traced, would ahvays be found to be the decomposition of vegetable debris. SANITARY STATISTICS. Dr. CANNIFF submitted the following resolution from the Sanitary Committee :-That for the pre. sent the collection of sanitary statistics shall be confined to the cities and large towns of the Dominion, the results to be published monthly, and the deductions drawn therefrom to be circu. lated in the various centres specified. That a' commission be appointed by the Dominion Gov- vernment in order that by consultation and co- operation of the Local Government a common basis may be arrived at for carrying out such sanitary mieasures as may be necessary for the con- sent of the Dominion Government. The commis- sion to consist of two or more medical men with a legal adviser. Dr. FENwICK said it was important that there should be a committee in communication with the Government on the subject. He had spokento Dr. Carpenter in regard to this matter, and haa asked him if there were any means of getting statistics in England. Dr. Carpenter said there was not, the health and disease tables being based upon the mortuarv returns. To get full statistics of disease was an undertaking that no Government in the world would attempt. He wished to bring out this point, and he hoped thLc the substance of the report would be sent to the Government as the official report emanating from the Association (Applause.) Dr. OLDRIGHT said the subject of the collection of statistics on disease was a new one. In their desire to get these statistics they had the strong support of the evidence of Dr. Lyon Playfair, who said that while the death statistics showed the w'recks which had been cast upon the shore the' statistics of discase served to give warning ofie pending storms. Disease statistics would 1slo_ when a certain disease was threatening a district Death statistics often gave the information too lat. He would regret any resolution of the kind recoi mended by the committee. In Ontario the medical men applied to for these statistics had noné of them made the excuse that they were-too busyt get the information. There were many diseases which stopped short of death which it was.desir': able to check. In order to put restrictive regùfr tions into force it would be necessary tO information at the time the disease was ragiP c2j ý 6",
         "THE CANADA d not when it was too late to be remedied. He moved in amendment that the statistics be not ,cofined to the towns and cities. ý'Dr. GRANT said that the Dominion Government had only granted $1o,ooo for the whole of Canada, md it would be impossible to'do more with that smi than was suggested by the committee. To pass the amendment would be to neutralize the ishole action of the committee. The Government îyere anxious to do something, and what was pro- posed was merely an initiatory step. They could do no better for the present than collect the statis- ýcs from the older towns and cities. The system could be subsequently extended if found to work rell-. -Dr. FERGUSON said that there was no reason why the rural districts should be left out when Dominion money was to be spent. The cases in the country were just as interesting as those in the cities and towns. The scheme would never be a success except by taking in the whole Dominion andsecuring the sympathy of the whole profession. Dr. FENWICK said that it would take $5,000,000 tocollect the statistics of the Dominion. If they thought the Governrment would appropriate such a sum they might pass the amendment. It was not that the country districts should be thrown out, but that they might have an opportunity of mak- ing a beginning. [ Dr. GRANT pointed out that the rural districts ,ad all towns in their midst, so that their interests vould not be neglected. No siur was thrown ulion the country practitioners. The amendment was then put and lost by twelve to seven. The motion was carried by fourteen to two. On motion of Dr. CANNIFF, it was resolved that acopy of the report be transmitted to the Premier of the Dominion. ELECTION OF OFFICERS. The nominating Committee brought in a report omnending the election of the following officers lorthe ensuing year:- President-Dr. Mullen, Hamilton. -Vice-Presidents for Ontario, Dr. Tye, Chatham; Quebec, Dr. Gibson, Cowansville ; for New flrunswick, Dr. Atherton, Fredericton; for Nova ta Dr. Jennings, Halifax; for Manitoba, Dr. , :Vinnipeg. General Secretary-Dr. Osler, Montreal. reasurer-Dr. Robillard, of Montreal. MEDICAL RECORD. 2'87 Local Secretaries--For Ontario, Dr. Saundrs,. Kingston; for Quebec, Dr. Brunelle, Montreal: for New Brunswick, Dr. Coleman; for Nova Scotia, Dr. Almon, jr. ; for Manitoba, Dr. Whiteford. Committees-On Publication, Dr. Ross, Mont- real; Dr. J. H. Cameron, Dr. Fuller, of Toronto, the general secretary and the treasurer. On The- rapeutics-Chairman, Dr. H. Punget. On Medi- cine-Chairman, Dr. Stewart, Brucefield. On Surgery-Dr. Gracett, Toronto; Dr. Brunelle, Montreal. On Obstetrics-Chairman, Dr. Ken- nedy, Montreal. On Necrology-Dr. Fulton, To- ronto; Dr. Atherton, New Brunswick ; Dr. La Chappel, Montreal. On Climatology-Dr. La- roque, Dr. Botsford, St. John ; Dr. Worthington, Clinton; Dr. Playter, Toronto. On Ethics-Drs. Gardner, Montreal; Mawsden, Quebec; Bayard, St. John; Parker, Halifax; W. J. Almon, Halifax ; Steenes, St. John; Beaudry, Montreal; Chas. Morrison, London. On Arrangements-Drs. Sullivan, Saunders, Fenvick, Metcalf, and Sweet- land. This portion of the report was adopted, and the elections confirmed by the Association. The clause fixing the NEXT PLACE OF MEETING at Kingston gave rise to considerable discussion. Dr. RoDDICK moved, in amiendnent, that the next place of meeting be Montreal. He thought there should be a larger representation from Kings- ton before a meeting should be held there. Dr. ADAM WRIGHT seconded the motion. Dr. MACDONALD, in explanation of the finding of the Committee, said that their reason for choos- ing Kington was to incite an interest in the Asso- ciation among the medical profession there. Dr. OSLER thought the place of meeting should be chosen quite independently of the number of members who happened to live there. He strong- ly approved of holding the meeting in Kingston. The finding of the Committee was sustained by a vote of 18 to 15. Resolutions were passed, tendering thanks to the Mayor and corporation of Toronto for the use of the City hall, to the medical profession of To- ronto for their generous and hospitable reception of the members of the Association, to the managers and proprietors of railroads and steamboats for favors granted, and to Dr. Canniff for his exer- tions as chairman of the Committee of Arrange- ments, On motion, the President left the chair, and Dr.",
         "288 TJIE CANADA MEvICAL RECORD. Mullen, of Hamilton, the newly-elected president, took the chair, and returned thanks for his elec- tion-an honor which he attributed rather to the desire of the Asso)ciation to give al] parts of the Dominion a fair share of the offices of the Associa- tion than to any personal merit. Dr. GRANT, of Ottawa, moved a vote of thanks to the retiring President, which was seconded by Dr. Workman, and carried amid loud applause. Dr. Fenwick made an appropriate reply. This closed a most successful meeting of the association. After the adjournment the members were entertained at the Asylum by Dr. Clark, the Medical Superintendent. EXIIIBIT OF MEDICINES AND INSTRUMENTS. During the meetings of the Association the re- presentatives of medicine manufacturers have dis- played an excellent assortment of preparations, and have shown great willingness to submit them to the tests of the profession. Mr. H. P. Gisborne, of Toronto, exhibited specimens of lactopeptine and a large number of different preparations of maltine. Maltopepsyn was exhibited by H. Morte \u0026 Co. ; and a very attractive display of surgical instruments was made by Messrs. Stevens \u0026 Sons, of Gower street, London, England. PERSONAL. Dr. William Young (C.M., M.D., Bishop's, 1878, who has been practicing in Hong Kong China, bas, owing to the climate not agreeing with him, returned to Canada and commenced practice in Montreal. Dr. J. Leslie Foley (C.M., M.D., Bishop's Col- lege, 188o), having recovered from his severe illness, has resumed practice in Montreal. Dr. Louis Ellsburg, of Nev York, who was in Montreal attending the meeting of the American Association for the Advancement of Science, favored us with a call. Dr. Balcom (C.M., M.D., Bishop's, 1882) has settled in Moncton, N.B. Dr. Morrell Mackenzie, of London, Eng., was in Montreal for a few days in August. Dr. Bowdwitch, of Boston, was in Montreal attending the Science meeting. Dr; J. G. Kitts'bn (M.D., McGill, 1876,) lately MORTALITY OF MONTREAL AUGUST. FOR Males .......................... 190 Females .......................208 Total.......................-398 Stillbirths..................... 10 Mortality under 5 years of age.........................240 Deaths from zymotic diseases were as follows Small pox...... ....... ....... o Measles ....... ............... 0 Scarlatina...................... i Diphtheria.. ............. 3 Croup................. .... 5 Pertussis............ .......... 1 Typhoid Fever............... 15 Other Fevers........ ........ i Dysentery..................... 9 Diarrhea............... .. 65 Cholera Infantum.... ... 39 Other zymotic diseases...... 8 1147 The diarrhoeal diseases have decreased , - phoid fever seems to be.on the increase. surgeon in the North West Mounted Police\"ha settled in St. Pauls, Minn., U.S. Dr. R. J. B. Howard, .A. (M.D., McGill 188o) has passed his examination for the Licein tiateship of the Royal College of Physicians, Loný- don, and the Membership of the Royal College of Surgeons, England. Dr. J. A. Grant, of Ottawa, was elected a Fellow of the Royal College of Physicians of Loo- don, on tle 27th July. Dr. Rottot, of Montreal, went to Europe the first week in September. Dr. Fenwick, of Montreal,went to Europe by th Allan S.S. Polynesian, September 17th, in charge' of one of his patients. He will return the end o October. Dr. J. Leslie Foley, C.M., M.D. Bishop's, 188o,. has been elected an Attending Physician to the Montreal Dispensary, in place of Dr. O. C: Edwards resigned. 288 THE CANADA MEuICAL RECORD."
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   "doc" : {
      "identifier" : [
         "8_05177_20"
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      "published" : [
         "[Montréal : \"Gazette\" Print. House, 1874]"
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      "title" : [
         "Canada medical \u0026 surgical journal [[Vol. 2, no. 8] (Feb. 1874)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADA MEDICAL \u0026 SURGICAL JOURNAL. ORItGINAL COMMUNICATIONS. Puerpet-al Convulsions.-Patient delivered of Twins.- Recovery. By T. G. RODDICK, M.D., House Surgeon, Montreal General Hospital. (Read before the Medico-Chirurgical Society.) The following case I have thought it well to bring before your notice, not so much on account of any special pecu- liarity in itself, as from a hope which I entertain that it may be the means of ventilating the experience of those present on so important a subject of obstetrical practice. About 9 o'clock on the morning of New Year's Day last, the subject of ihis paper, an English-woman, thirty-two years of age, two years married, and eight month's preg- nant, was seized while a\u002b ber breakfast-table with a fàint turn. Her husband Wliediately carried her to the bed, but she had \"scarcely been put there when she was seized with a severe convulsion, characterized by all the well- known sympt oms of epilepsy. She had no sooner recovered from one fit than another came on, and these continued in quick succession' fo~r some hours. At length amedical gentleman, living in St. Joseph street, was summoned, who considlgred the case as simply one of epilepsy, and not recognizing the gravid uterus as an exciting cause, ordered the ordinary bromide of potash epileptic mixture. He visited the case frequently during the next twenty-four hours, and witnessed the c6nvulsions. At the end of that time application was made for the admission of the patient Y",
         "CANADA MEDICAL AND SURGICAL JOURNAL. into the Lying-in-Hospitals of the city, failing which she was brought to the Montreal General, about 5 o'clock on the evening of the 2nd of January. The husband stated that she had about a zundred fits since nine o'clock of the morning previous, which does not require the ordinary granun salis, as the doctor himself thought the statement no exaggeration. The husband fur- ther informed me in regard to the history of the case, that his wife had often told him that whent a girl of twelve she was attacked with what was called in her neighborhood in England, the \"minute fits,\" a term new to me, and conse- quently I cannot s'ay whether it, was true epilepsy or some hysterical attack. The fact of her recovering so rapidly, as she had them only for a short time, is opposed to the former supposition. She has always enjoyed good health, but since coming to this country about a year since, owing to their reduced circumstances, she has fretted a great deal, and at times could not obtain the strong and wholesome food she had been accustomed to. As a consequence she had latterly become very thin and pale, but excepting during the first three months of her pregnancy, when she suffered from very great irritability of the stomach, she has never found her child-bearing more than an inconvenience; her husbançl never heard her complain, or make the slightest reference toit. The morning she took ill she appeared to be as well as usual, and had not been excited or disturbed mentally in any way. On admission.to the Hospital her condition was much as follows :-Countenance drawn and livid ; pupils slightly dilated ; pulse 140, thready and somewhat intermitting*; extremities cold ; no marked heat of head : was deeply insensible; swallowed with difficulty. Dr. Chipman, who received her, immediately ordered a tablespoonful ofbrandy every half hour, and on coming in myself I supplemented this with a grain of opium, and 40 grains of the bromide of pot- assium, in powders, every four hours. On examining per vaginam I found the os uteri dilated to the size of a quarter",
         "PUERPERAL CoNVULSIONS-T. o, RODDICK, M.D. 339 dollar, and dilatable in character. As she had had no con- vulsion for three or four hours, and was so thoroughly exhausted, I thought it judicious not to interfere at present. At ten o'clock she had rallied'considerably, so that now, although her pulse was still frequent. it had a much better volume, and was regular in rhythm. By this time she had taken about 4 ounces of brandy and two grains of opium. The os had dilated very slightly since the last examination, but I could now make out what I took to be a head presen- tation. The exathination brought on a slight pain, the first yet noticed, and I took advantage of the opportunity to dilate the os by introducing a pair of ordinary long-bladed lithotomy .forceps, and opening them slowly, a knuckle of the membrane with contained fluid coming down at the sane time and assisting in the process of dilatation. This expedient, which was continued a couple of minutes, proved of immense advantage. At twelve o'clock Dr. Chipman and I saw her again' together. She had no pain during the past two hours, and on examination I found no marked change in connection with the uterus. We catheterized her with the hope that the condition of the urine might throw some light on the case, but got only a very small quantity which,unfortunately, was spilt through an accident to the vessel that contained it. I left orders with the iurse to be called in three hours, or before if any change should occur. I might here men- tion that the patient had had no genuine convulsion since. her admission, nothing more than an occasional -twitching of the muscles of the face, or clonic spasms of some of the muscles of one or more extremities. 3rd January,'3 a.m.-The nurse informed me that the patient had been sleeping soundly for the past two hours, and that there was no appearance of any pain or convulsion. With such a report I thought I could remain where I waG for a time. 4.30, a.m.-Was aroused hurriedly by the nurse declaring that after three pains which quickly followed aci other,",
         "340 CANADA MEDICAL AND SURGICAL JOURNAL. the membrane had burst and the child was presenting. In ies3 than three minutes a dead child, perfectly formed but not fully developed, was delivered. On grasping the abdomen to make pressure on the uterus, I was surprised to find it still as bulky almost as before, and on examination per vaginam elicited the fact that there was a second child, the breech of which I could readily make out as it presented. With another pain, and the assistance I myself gave, this was delivered, also dead. The death of the children must have taken place some considerable time before, as the epidermis was abraded in several places, and the underlying tissues presented a dark gangrenous appearance. They were both males, and as nearas I could judge of the-same size. After dividing the cords, and at the end of about twenty minutes I went up for the placentæe, one of which I found adherent to the posterior wall of the uterus. Alto- gether, I should say there was about a cup full of blood lost during the delivery-certainly not more than that quantity. The patient now, for the first time, showed signs of returning consciousness, as evidenced by greater ease in swallowing, and an inclination to grumble when much dis- turbed, as in putting on the bandage, \u0026c. Her pulse was now 120, but fuller in volume and steadier than ever before; face more natural in appearance ; pupils still dilated but easily influenced by light ; temperature of body, and espe- cially of extremities, was natural. A large motion 'was passed from the bowels during the labour. I gave her a draught containing two drachms of the extract of ergot. 2 p.m.-During the morning and forenoon she has taken a pint of strong beef juice. and nearly a pint of champagne, and the change for the better in her condition is really marvellous. She can now be roused, and answers in monosyllables when loudly spoken to. Her pulse still remains high, i16, but quite full and regular ; temperature 99 3-50; tongue very much swollen and marked by inden- tations from her teeth ; it is also thickly coated with a white fur; complains of a pain, and when left alone falls into a",
         "PUERPERAL CONVULSINS-T. G. RODDICK, M.D. .341 sound and tranquil sleep. Dr. Howard, who now saw her for the first time in making his visit, ordered the admin- istration of a drachm of the c6ompound powder of jalap, to clear out the intestinal tract. A specimen of ber urine was obtained and examined this morning, and a trace only of albumen discovered. 1o p.m.-Is now quite conscious ; pulse 104; tempera- ture oo 1-5 ; complains bitterly of the soreness of her tongue when taking food.or stimulants; the purgative has acted once ; bas taken a large quantity of nourishment during the afternoon and evening. January 4th.-Has had a good night ; bowels once moved ; pulse 96; temperature 98 4-5; bas no complaint to make excepting of lier tongue, for which, by the way, she. bas been ordered a soothing mouth wash. January 6th.-Patient still on the mend. As there was. some fetor about the discharges, Dr. Howard prescribed the employment of an injection containing a drachm to the pint of Condy's fluid twice a day. January 9th.-To-day the patient is not so 'well; com- plains of pain in the left hypochondrium ; pulse 2o ; tem- perature 1o 1-5 ; inclination to vomit; headache, \u0026c. Dr. Howard ordered six leeches over the part, to be followed by hot fomentations, and the following mixture:- Liq. Ammon. Acet., 3ij.; Morph. Mur. 4 gr.; Acid Sul- phuros. 3 ji. Tr. Aconit. M. iij. To be given every thee hours. January roth.-Is much better to-day; pulse and tem- perature almost normal; slight tenderness only on deep pressure over any part of the abdomen : the sanie treatment to be continued. The above mixture was taken for four days, after which five grain doses of the citrate of iron and quinine were sub- stituted twice daily, and solid food allowed. T he woman is still in hospital, but with the exception of slight stiffness in the limbs in walking she is perfectly well, and will return to lier home in a day or two, or as soon as her",
         "342 CANADA MEDICAL AND SURGICAL JOURNAL husband can make certain arrangements necessary for her comfort. The case just related, I take it gentlemen, is interesting from many points of view. It undoubtedly belongs to that class of convulsions termed astheinic, and which is probably the less frequent form. The cause also of the convulsions in this patient is an 'interesting question. They are not likely to have been purely uræmic, from the fact of sO little albumen being found in the urine, although the examination of that secretion was not made until some hours after the delivery. Besides there were never any symptoms really referable t-\u003e the kidneys, nor was there at any time anasarca, the usual development of deranged renal secretion. My opinion is- I have thought that there were at least three of the recognised causes of this morbid condition combined to produce the convulsions, viz: îst the impoverished state of the woman's blood from bad food, and general unhealthy surroundings. 2nd. The presence of the dead twins. 3rd. The pressure of this more than ordinarily heavy gravid uterus on the renal veins and nerves, causing the accumu- lation in the bloodof poisonous elements. Any one of these causes would of itseif be sufficient to produce the effect; but it is very questionable whether they ever occur singly, the entire nervous system and organic functions generally, being so bound up as it were in the well-doing of the uterus during its child-bearing state. As to the treatment employed I cannot but think that the opium did marked service, both as a sedative and stimu- lant. The bromide may have also assisted in bringing about at least some of the first-named effect. The uterine injec- tions of the Condy's solution might also be mentioned as constituting an important part of the treatment, correcting as they did so effectually the fetor of the internal discharge.. Probably there is no preparation of this kind employed which will so soon and so effectually accomplish the end iii view as that used on this occasion.",
         "VACCINATION-GEORGE A. BAYNES, M.D. Vaccination-afew remarks on its efficacy. BY GEORGE A. BAYNES, M.D. I thought that at this present time, as small-pox is prevalent, a few remarks on the efficacy of vaccination, \u0026c., would not be out of place. Every one is familiar with the circumstances which led to the discovery of vaccination, which bas immortalized Jenner, who, in the pursuit of his investigations, maintained the following points: 1st. That the- essential difference between cow-pox and small-pox is the comparative virulence of the two affections, the cow pox being the milder. 2nd. That the person vaccinated with matter from the cow, resists inoculation by variolous matter. 3rd. That the preservative influence of vaccination against small pox is perpetual in the same individual. Every one coincides with Jenner on his first two points, but some doubt is entertained as to the truth of the third ; it bas caused much disputation, and there is still some dif- ference of opinion as to the necessity of re-vaccination. Those who are of opinion that Jenner was in error, base their opinion on the fact that persons who have been vac- cinated have contracted small pox, and conclude that the vaccine matter loses its efficacy, and therefore re-vaccina- tion is absolutely necessary. However this may be, one fact is beyond dispute, that small-pox is very mifid and extremely rare after vaccination. It seems to me that the necessity for re-vaccination depends on whether the vaccination was \"Genuine or Spurious ?\" If it is spurious of course it cannot be called vaccinia, it affords no protection, and therefore nothing is proved. If the vaccination were genuine, it proves that srall pox bas occurred after vaccination. But to give due weight to this last resuit it should be looked at in its proportionate light, and then deductions made. Thus what proportion 343",
         "344 CANADA MEDICAL AND SURGICAL JOURNAL. do attacks of small pox coming on after genuine vaccina- tion bear to those after no vaccination. Surely a minimum and of course a rare exception to the regular rule. And further it is possible for a person to have a second attack of small pox, although these are rare exceptions also. So that if small pox itself is incapable of protecting from a second attack, how absurd to try and prove that vaccination will secure what inoculation, or rather small-pox itself, cannot, viz: \" Perpetual Protection.\" But even if J enner were right in his third hypothesis, public opinion is in favor of re-vaccination. So the question is whether medical men are justified in pandering to popular prejudice ? The answer is simple. Public opinion like Fashion, never mind how absurd it may be, must be attended to, and besides, re-vac~- cination is not hurtful, and may be necessary where the first may have been spurious, and it also allays fears which otherwise might prove injurious. MODE OF PERFORMING THE OPERATION :-It is a matter of importance, and requires some care, the young vaccina- tor would do well to remember the following hints: In vaccinating female children do so high up on the arm just about the insertion of the deltoid muscle, as you may in after life, if you neglect this, be made to blush when the young girl who has grown to woman's estate, shows you the indelible scar, which is unprotected by the sleeve in evening dress. If the fymph is fresh it is useless and painful to.children to be scarified in more than one place ; besides the protec- tion of one genuine vesicle is equal to three or four, and the constitutional disturbance is not so great. Be very careful that the lancet you use is very clean, and keep the same one for vaccination only, for it is possible to transmit virus from one person to another by the pus, \u0026c. See that the lymph used has no blood or other.secre- tion from the person supplying it. The best manner to keep vaccine is in hermetically- sealed capillary tubes, which if it be wished may be kept",
         "VACCINATION-GEORGE A. BAYNES, M.D. for years, even in warm climates, where the ordinary scab or lymph, preserved between glass plates, or on ivory points, readily decomposes. Select the lymph before the purulent stage comes on, about.the eighth day is the'best. SIGNS OF GENUINE VAcCINATIoN.-This is the point, on which, to my min.d, the necessity of re-vaccination depends,. and the progress of the maturation of the vesicle should be watched attentively. After the operation nothing is notice- able for two or three days, but at the end of the third, or the beginning of the fourth da'y,a small red spot appears, fullowed, a few hours after'by a circumscribed redness; on the fifth day the vesicle becomes distended with serum: on the sixth day the vesicle becomes of a circular or oval form, with a- whitish umbilicated appearance; on the seventh day the vesi- cle becomes more full, and the inflammation extends to thc subcutaneous cellular tissue; on the eighth, and sometimes not until the ninth, the vesicle is at its height of perfection and is surrounded by a scarlet redness ; and then the sur- rounding glands become affected, and sometimes the febrile symptoms are very severe ; and on the tenth day the red- ness begins to fade, the inflammatory symptoms subside, the serous exudation becomes purulent, dessication com- mences, and the scab assumes a mahogany colour, which falls off about the eighteenth or twentieth day after vaccin- ation. Then is formed the cicatrix, whidh never disap- pears if genuine. In spurious vaccination, there, i.s no incubation, \u0026c., the third or fourth day a purulent secretion appears, a scab forms and exfoliates on the fifth or sixth day,. and may become reproduced again ; and even if it happens. that the scab remains on for two or three weeks, and is not followed by the peculiar cicatrix, you may put it down as a spurious case. - The next point to consider is : AT.WHAT AGE AN INFANT SHOULD BE VACCINATED.- Medical men are very positive, every one following some peculiar notions of his own, some say at ten months, others, at eight, others at six, and so on. But to mymind the ques- tion of age should not be considered at all ; for instance, if. 34\u0026",
         "346 CANADA MEDICAL AND SURGICAL JOURNAL. an epidemic should break out, or even a sporadic case appear in the neighborhood, there can be no doubt as to what is our duty, even if the infant is but a couple of weeks old. As a general rule, if the hcalth of the child will admit of the operation it is our duty to do so within six weeks at least. As to the best season, try and avoid the two extremes if possible, of heat and cold, vaccinate in spring or fall if the opportunity will allow it. IS IT PROPER TO VACCINATE DURING THE EXISTENCE OF CUTANEOUS DISEASE. - On this point there is much discrepancy of opinion, some maintain that the vaccine vesicle will modify, and even remove any cutaneous affection that may exist, while others state that an eruptive disorder, no matter of what kind, will prevent the absorption of the vaccine virus, and therefore nullify its protective influence against small pox. I have not seen any . facts, however, to sustain this latter view. If we allow our- selves to be led by circumstances it would be better not to wait for the subsidence of the eruptive disease. If small pox is prevalent, vaccinate at once; but if there is no danger to be apprehended, a little delay would be advis- able. ON THE TRANSMISSION OF SEPTIC POISON BY VACCINATION. This is the principal objection, that those who are adverse to vaccination, urge against its adoption. But if you exarnine the evidence of the \"Special Commission,\" ap- pointed for its investigation, I don't think it possible to bring in a verdict of guilty, but on the contrary there will be found an honorable acquittal. For full particulars of reports, vide Lancet, page 143 and 52, vol. IL., 1871. It may be well here to quote a few retiarks from an able paper on \"The Vaccination Question,\" by Dr. Anstie, which will be found in the third volume of '' The Practi. tioner.\" He says:-\" It is ridiculous to charge septic infec- tion, and consequent erysipelas or pyaemia to vaccination itself, because it is really the result of culpable négligence on the part of the vaccinator, for either he must have",
         "HOSPITAL REPORTS. \" taken lymph from a child actually suffering from acute \"septic disease, or else the lymph used has undergone, by \"being kept too long, or kept improperly, more or less \"of that putrefactive change which affects all animal \"matters placed in such circumstances ; or lastly, he has \"taken the lymph from a vesicle which had already become \" a pustule.\" In regard to Vaccino-Syphilis, not orily does he quote from the report of Mr. Simon to the effect that 539 medical men in answer to inquiries denied with scarcely an exception that syphilis can be conveyed as a true result of vaccination, but further the direct ex- periments of Cullerier and others, on the effect of inten- tional admixture of syphilitic matter and vaccine, and of the vaccination of large numbers of persons with vaccine matter intentionally taken from persons suffering from constitutional syphilis, added positive evidence of the most powerful kind, against the possibility of transmitting syphilis by an ordinary vaccination from a true Jennerian vesicle. Tanner says : \" Evidence such and so weighty as this ought to convince the most incredulous ; butthere is yet one other fact of crushing weight, viz: that even the poison of small pox, one of the most subtle known to physi- cians, does not affect the lymph of a true Jennerian vesicle, where a person is suffering from small pox, contracted just before vaccination, and too late therefore to profit, by its protective influence.\" HOSPITAL REPORTS. Amputations by Esmarck's Bloodless Mkfethod. Case ist.-J. B. V., a' French Canadian lad, of 1o years, was admitted under Dr. Fenwick on the i6th October, 1873, having sustained a compound comminuted fracture with extensive laceration of the soft parts in and about the left ankle-joint'; one wheel of an empty railvay car had passed",
         "348 CANADA MEDICAL AND SLRGICAL JOURNAL. over the limb and produced the injuries described. As it was thought utterly out of the question to save the foot, a consultation of the Staff was called, and the operation of amputation proceeded with. As this was the first opportunity afforded here for the employment of the \"bloodless plan,\" since it has been so highly recommended by MacCormac and others, consi- derable interest was excited when Dr. Fenwick announced his intention of trying it. The patient being chloroformed, atn ordinary cotton bandage was applied as tightly as possible from the ex- treme points of the toes upwards to the lower third of the thigh, including, of course, all the lacerated parts. A yard or so of strong rubber tubing of about the size of a pipe- stem was then wound firmly several times round the thigh exactly at the point where the bandage ceased, catching, in fact, its extreme upper edge ; the tubing was then se- curely knotted, and the bandage removed. Amputation was performed below the knee by the double (antero-posterior) flap operation. The bones were sawn and the part removed without a sponge being soiled, so complete had been. the process of strangulation. The tibials and three minor arteries were readily secured by ligatures and a smaller branch twisted, after which the band was removed. It was now interesting to see how the tissues, frdm being blanched to the last degree, suddenly blushed up, and a trifling general oozing ensued. A couple of small twigs only required twisting, and all arterial hemorrhage was at an end. The flaps were brought to- gether, and the stumps dressed in the ordinary way. He was not a strong boy, and consequently, the healing processwas slow; however he was discharged from hospital at the end of the sixth week with only a small but healthy granulating surface unhealed. The stump is now all cica- trized. Case 2nd.-A few days after the above operation, Dr. -Ross removed a toe and its corresponding metatarsal bone,",
         "HOSPITAL REPORTS. employing also the bloodless method. The patient was a man over sixty years of age, of very dissipated habits. He had been troubled for many years with a corn, situated over the metatarso-phalangeal articulation, and which at last had extended so deep as to produce caries of a considerable portion of bone -both above and below the joint. The bandage and elastic ligature were in this case carried only a short distance above the ankle joint. Not a drop of blood was lost during the operation, and certainly not more than a couple of drachmns -after the bandage had been reioved. Only one arterial ligature was required. With the exception of a slight attack of erysipelas which interfered for a few days, the healing process went on un- interruptedly, and the recovery was early and complete. Cases 3rd and 4th.-These were both accidents to the Jeft hand, caused by being caught between. the rollers of machinery. One of the sufferers was a man of thirty years,, the other a lad of fourteen-both strong and in the enjoy- ment of excellent health. The amount of injury was; not equal in both cases. The man's hand, being thick and strong, was drawn in to the metacarpo phalangeal joints only, while the boy's was more or less bruised far up the back and palm of the hand. In the former, integument enough was found to cover the metacarpal bones after the rernoval of all the fingers ; but in the latter it was neces- sary to remove the entire hand, excepting the thunb, the metacarpal bone of which also had to be excised in order to get sufficiently healthy integunient to cover the exposed parts. The bloodless method was employed in both cases, the ligature being applied about the middle of the arm. The patients are still in hospital, but progressing most favorably. In the case of the man, a large mass of the in- tegrnent sloughed, but the exposed surface is now almost covered by cicatricial tissue. The boy's hand is doing well: he has considerable motion in the thurnb. Within two weeks the.wound will have entirely healed. 349",
         "350 Tie Medical and Surgical History of the War of the Rebellion. Part i. Vol. i. Mk/edical History prepared under the direction of JOSEPH K. BARNES, SurgCon- General, United States Army. By J. J. WOODWARD, Assistant Surgeon, United States Army, with appen- dix pp. 1091. Imp. Quarto. Washington : Govern- ment Printing office, 1870. War, at all times a calamity, is occasionally inaugurated when least expected, and when nations are least prepared for the emergency. Such appears to have been the case with the American nation, when, in 1861, the South Caro- linians opened fire on Fort Surpter. America had enjoyed. a peace ofnearly fifty years,-if we except the border diffi- culties, which were not participated in by the nation at large,. nor did they in any way interfere with peaceful mercantile pursuits. At the time that Sumpter was fired into, the Southerner did not calculate the consequences with his usual astute- ness, nor did the Northerner look forward to four long years of bloody strife with his.hûstile brother of the South. War though it be hatched in hell, is very frequently follow- ed by a blessing from on high. Certainly, in the case of America it has purged that great country, with all its boast- ed freedom, of the foul stain of slavery ; so that althouglh it must be admitted that the American war of rebellion was, while it lasted, an undoubted curse, yet it has been. fol- lowed by the highest blessing that heaven can bestow on any nation-\" Equal rights to all.\" At the out break of the war so changed were the circum- stances that in due time it was found that the returns for sick and wounded then in use by the United States army were quite inadequate and very defective. William A. Hammond, M.D., the Surgeon General of that period, issued",
         "REVIEWS AND NOTICES OF BOOKS. 351 blank forms containing important changes. and modifica- tions, calculated to secure more detailed and exact reports of the sick and wounded, and in June 1862 it was announced by circular from the Surgeon General's office, that it was the intention to prepare for publication a Medical and Sur- gical History of the war. In 1863 the present able officer, Joseph K. Barnes, M.D.,acting as Surgeon General, issued a circular to Medical Directors of armies in the field, where- by they were officially instructed to forward to the Surgeon General at Washington, duplicates of their several reports to their Commanding Generals, of the killed and wounded after every engagement. The Surgeon General requested that special officers should be detailed to collate and pre- pare all attainable statistics and data in connection with- the past and future operations of the armies of the United States which may be rendered available in the accurate compilation of the Medical and Surgical History of the war. Every facility was afforded for the collection and preser- vation of important information. Medical officers serving with their regiments in the field were fully supplied with a. compact and portable register for sick and wounded. The Hospitals were likewise supplied with distinct registers, one for the sick and one for wounded soldiers, also distinct blank forms for all surgical operations. The Surgeons were instructed to enter in detail and as minutely as possible, the particulars of all Surgical operations with the results ; these were to be preserved and a duplicate copy forwarded to, the Surgeon General's office at Washington. In February 1864, we notice that separate reports were called for, of sick and wounded prisoners of war, and also of white and. coloured troops ; this was done with a view of obtaining with tolerable accuracy the sickness and mortality rates of each class. In June 1864 Medical officers in charge of Hospitais were directed to collect and preserve with diligence and care, all pathological surgical specimens, which might be met with",
         "3J52 CANADA MEDICAL AND SURGICAL JOURNAL. in the course of their hospital practice. Such for instance as fractures, compound, simple, and of the craniun ; excised portions of bonle; diseased bones and joints ; exfoliations, especially those occurring in stumps; .integumental -wounds from round and conical balls, showing the points of entrance and exit ; wounds of vessels, nerves, viscera -obliterated vessels, and where possible, photographs of cxtraordinary injuries ; plaster casts of stumps or of limbs mpon which excisions had been performed, and novel surgical appliances or new plans of dressing. It was ex- plained that all these specimens were required for the Army Medical and Surgical Museum, .and to facilitate the work officers contributing specimens were requested to remove roughly all unnecessary parts, each specimen was then to be wrapped in a cloth to which was to be attached a block of wood, on which was to be inscribed with a pencil, the name of the patient, the No. of specimen and the name of the medical officer contributing it. These then were to be immersed in a keg of dilute alcohol, and when a sufficient number had been collected, the keg was to be sent to the Surgeon-General's office in Washington. In eve-y instance wbere specimens were sent, the history cf the case with a corresponding number to that on the block of wood was required to be forwarded. We have given a slight sketch of the manner in which this work was inaugurated, and carried out, and it speaks well for all concerned. It could not have been accom- plished with anything like success without the hearty co-operation and ability of the Medical Staff belonging to. the regular and volunteer service. We must not omit to mention that the Secretary of War, the IIon. E M.' Stanton, took the deepest interest in the work, and mainly through his influence an application was made to congress, and an appropriation of money .granted, whereby 5000 copies of the first part of the Medical and Surgical History of the War was authorized to be printed at the Gçvernment -printing office.",
         "REVIEWS AND NOTICES OF BOOKS. Vol. r, of part one, consists .of a series of statistical tables, presenting a summary of facts contained in the monthly reports received by the Surgeon General referring to the sickness, deaths and ificharges frcm the service. These tables have been again subdivided into two groutps, in the first are consilered all facts referring to whiîe troops,' and in the second, what concerned coloured troops. as sonie importance is attached to this stbdivision, as shewing the influence of disease on the different races. With regard to classification it is based on that which has been in use in Enghnd bcth for rnilitary and civil purposes, and was intro- duced by Dr \\Villian Farr of London. This classification differs, however, from that of Dr. Farr, inasmuch as the fourth class or what is termed l Developmental diseases,' is omitted in consequence of its referring chiefly to children, women, and aged persons. a class of people not likely to be met with in the camp of an army in the fielh. Again parasitic diseases are assigned to a special class There are sore minor differences in the local distases, and in class V are included vounds, accidents\" and injuries. It was also recommended that in the preparation of the blank forms, the most generally adopted English dlesignations of diseasé should be used, and that the use of al Latin terms should be abolished. TI-ere is reference made to the iethod of the establishment of hospitals and of theirgovernance,-from this we learn that in due time general hospitals were looked upon and acknowledged to be independent military posts. The surgeon in charge vas the commanding officer, subject only to the Medical Director, and to the Command- ing General of the -Department. This bears a marked contrast to the systeni pursued in the British arny where all surgeons are acknowledged as bearing relative rank, but junior to all combatant officers of their rank. The Appendix to this part is full of interest ; it consists of reports of eye-witnesses of the various engagerrrnts frnm the first disaster at Bull Run, to the close of the var. These are, in many instances graphic dscriptions, and the",
         "354. CANADA MEDICAL AND SURGICAL JOURNAL. interest is kept up by well executed maps of the locality, upon which are marked the position of the contending forces. Altogether we regard this volume as of great value, not only to the student of the diseases of camp life ; but tc all who are desirous of tracing the history of this most eventful pericd in the anrals of tle Unitcd States of Anerica. 1he work is worihy of a great nation, and as a national work, it must be admitted that great credit is due not only to those who, at an early period of the struggle conceived the idea, but also to those who in the hurry and excitement of the strife, with all the extra fatigue and labor put upon them, after the actual encounter was over, when hundreds of wounded men had to be attended to, surgical operations to be performed. and ambulance arrangements or hospital necessities to be looked after, yet could find time- to record what they saw, and keep a tolerably accurato record of the day's doings. W«e shall have to leave the consideration of the surgical volume to a future issue of the JOURNAL. Lc cturcs on Discases a;d Injurics of//e Ear, dclivercd at St. Gcorge's Hospital. By W. B. DALBY, F.R C.S.; M B., Cantab; Aural Surgeon to the Hospital. With twenty-. . one illustrations. 8vo. pp 228. Philadelphia, Lindsay \u0026 Blakiston, 1873. This small work is intended, as stated by the author, to occupy a place midway between such compendious works as those of Mr. Toynbee and Mr. IHinton, which are rightly estimated as the best standard English works upon this subject. These lectures appeared in the \" Lancet \" in 1872, but'during the past year «had been revised and added to, before appearing in the present form. There is no doubt, that new books which, without being voluminous, shall give us alt the receit pathological teachings and most approved plans of treatment, are from time to time an absolute neces* sity.' More especially it might seem, is this the case, with",
         "REVIEWS AND NOTICES OF BnoKs. reference to such a branch as that of Aural Surgery, which is to such a large extent confided to specialists, and conse- quently so seidom closely studied by general practitioners Yet however willing rnost physicians in this country would be to hand over cases of ear diseases to able confreres who make a specialty of these particular affections, still from the lack of such persons every practitioner is obliged to, undertake the cure of these cases as well of every other. Mr. Daiby's work is all the more attractive from its being compiled in the furm of Lectures which makes it assume· .much more of the Clinical and less of the L\u003eidactic cha- racter, These lectures are short, practical, and at fhe saine time comprehensive, and their value is greatly enhanced by containing the, actual accounts of numbers of illustras tive cases which occurred within the authors extensive field for observation at St. George's Hospital. There are ter. lectures on discases of the ear proper, and one addi- tional lecture of considerable interest on the subject of deaf-mutisn, and the best methods of education for thes-e unfortunates. In describing the various appearances presented by the membrana tympani, as seen by the aural speculum, the author would scem to be particularly felicita ous, possessing the faculty of making such comparisons- and emplôying such words as tend'to impress upon the reader the exact character of the morbid appearance interided-to be delineated. Al vai ieties of deafness arising from various organic and -functional disorders, of course, are treated of seiiatim, and the best niethod of treatment for.each variety fully discussed. Besides these, there is also a.special Iee. turc of much interest even to the generià réader on th( subject of the terminations of Tympanic Diseasessuch as cerebral abscess, meningitis, thrombosis, pyomia; ahd there can hardly be any doubt but that the liability ofÈthat o0iL negiected ailment--chronic purulent ca'arrh-to terminate in some of these alnost necessarily fatal lesions is a matter too frequently lost sight of by the general. praztitioner-- maore especially in the case of children. We highly recon- imend Mr. Dalby's Lectures to our readers. Pé155",
         "CANADA MEDICAL AND SURGICAL JOURNAL. M EDIC IN E AND SURGERY. A Lrrtwr on the Piref ' Mithlod of Treating TapaLwo; m. De ierecd at 'the lidd/îser HIsJital, I ducsday Deermber ioth, 1873. Ur' T. SPENcER CoBnoL\u003e, M.D., F.R.S , F.L.S , Lecturn on Paitasitic Discasis at the Hiospital. GFNTLEMEN,-The trealment of thlat cemmon form of helininihiasis tu chnically callcd \" t:apoyorm \" unfortunately corstitutes one of those ecpartments of the healing art, about which people generaly Suppo.e that little or nothing need be said. Excellent plactitioners will tel] you that the administration of turpentine and cas-or oil, or the giving of half a drachm of the ehetial cxtract of male fern, suf- fices to dislodge the parasite; and, should the worm tnhappily return-which is usually the case under sucl a rough-and-ready mode of trcatment-all that you have to ,do is to repeat the rcmedy until the entozoon is finally destroyed. 'I his kird of advice has the merit of being delightfully simple ; but I have no hesitation in saying that in the majority of cases, the practical results following its adoption are cininently um.atisfactory. I am not stating that the particular drugs in questin are incfficient; on the contîary, viewed as tæniacides, I believe them to be superior to kout so, areca-nut, and other more or less well- known vermifuges. W hat I contend for is that, although in a small proportion of cases thus treated you may have. the good fortune to be successful, yet, in by far the greater number of instances, the parasite will return, because -neither the head nor even the neck of the morm will have been dislodged. If I read the moral of professional conduct correctly, it",
         "TAPEWOIIM-DR. T. SPENCER COBBOLD. should be our endeavour to effect cures as speedily as pos- sible, thereby preventing the recurrence of the disease. The ordinary mode of prescribing is, to say the least, slovenly, and it fully accounts for the very incomplete- results that are obtained If it be urged that I ought to produce evidence of the truth of what has just'been stated, I can only point to my own experiences in this connection, and assure you that nine out of eveiy ten cases in which my opinion has been solicited have been cast off or rejected ones, so to speak. I mean that they have been cases whero the patients have long previously undergone treatment, experiencing Ûnly partial relief. As observed in one of my former lectures delivered at this hospital, some persons think it fair and', honest to record al] cases as successful where 'he body of the parasite is eliminated from the bearer. Thus one practitioner, desirous of extolling the merits of turpentine, had the politeness to inforni me that this drug. with its appropriate aperient ccmbinaticn,\" rever failed to bring away the worm where it had been known to have been present.\" This statement wis based on experiences obtained by the treat- ment of thirty or forty dispensary cases. The inadequacy, Iowever, of conclusions diawn froni such a source must, I think, be obvious, for in no single instance docs it appear that the head of the parasite was obtained, or even that it was so much as sought for by the medical attendant. On grounds, therefore, of this order, 1 maintain that it is unfair to spc ak of such cases as cures, and it is, further, an entire mistake to characterise the re,ults thus obtained as success- fui. Undoubtedly, now and then, cures have been effected without finding, or without any endeavour on the part of. the practitioner to find, the head of the parasite ; but I hold that no medical man is entitled to pronoince his patient as absolutely cured, unless he has dislodged and produced the head from the matters discharged, after and in consequencé of the advice and remedies offered and administered. It 857",
         "*?58 CANADA MEDICAL AND SURGICAL JOURNAL. may be, indeed, that the head, though expelled escapes observation, however diligently sought for; and it is quite certain that much practical experience is often necessary to enable the scarcher to find the small isolated and detached hcad in the midst of dark-coloured fæcal matters, Repeatedly I have obtained it after hours of'search. Again, in proof of the statement which I have advance, respecting the comparative infrequency of cure by the ordinary methods, I may mention that not a few of the numerous cast-off cases to which I have adverted have been those of patients who had undergone more or less severe drugging at intervals extending over a period of, seveiaI years ; morcover, as ,bearing on the question of diagnosisjit is also my duty to observe that patients have ýcome to me for advice about their tapeworm disorders under far graver circumstances. I mean, that they have been subjected to the trying discipline of taking nauseous and -drastic vermifuges for the expulsion of tapeworm and other parasites which, to my certain knowledge, never had any existence, excepting either in their own imaginations or in those of their medical advisers. This is a painful statement to have to make, but it is nevertheless strictly true. One of the most remarkable cases of this description. is already recorded in my published Lecturrs on Practical .Hcninti/ology, case xxiv, p 44. Others of a similar kind .are given in the volurme referred to, where it will be seen that the majority of such purely imaginary cases of tape- worm occur either n overworked men or in hysterical .women. Certainhly bey are amongst the most painful cases that we have to deal with ; but, taken in connection with the phenomena of true parasitism, they have served to convince me that special knowledge on this subject is not without its practical value. To return to the particular point previously urged, I have further to remark that,,with more care in the exhibition of the ordinary remedies backed by a more thorough appreci- ation of the general economy and modes of development",
         "'TAPEWORM-DR. T. SPENCER COBBOLD. of the human tapeworms, a much larger professional success will be obtained. Lengthened experience justifies ne in making this statement. I can say, indecd, that, dur- ing the year now closing, it has been my good fortune to obtain unusugl success in the treatment of tapeworm. Some of these helminthiases were regarded by the patients not merely as obstinate, but incurable cases. However, to cut the matter short, let me say that, in all instances, with- out exception, where I have this year had an opportunity of actually exanining the foæces and uther matters passed by stool, as a consequence of remedies prescribed by myself, I bave succeeded in procuring the head of the worm. In every instance, therefore, I have been enabled to assure my private patients that they were permanently and absolutely cured. This success, unique, perhaps, of its kind, of course only holds good in the case of those persons who have properly placed themselves under my personal care. In the more numerous instances where my opinion has merely been sought, I cannot tell what result may have followed the advice given. Here it is only just that I shoald likewise remark thati in all the cases above referred to. I have had to deal with the very prevalent beef-tapeworm. Had it been otherwise, a similar degree of success couli not possibly have followed. It seerns to me that the pork-tapeworm (Tenia so/liw) becomes rarer and rarer, whilst that derived from beef (7. mediacane//ata) is extremely common. I - am, indeed informed by a practitioner of great experience that, of late years, the tapeworm disorder has very sensibly increased in Somersetshire, and it would not surprise me to learn that such was the case in other counties. .Be that as it nay, I can now only find time further to observe that, in the dia- gnosis and treatment of tapeworm, there are many other practical points which I should have been glad to have brought under your notice. For these. however, it must suffice me to refer you to the work already quoted. 13y way of bringing the subject to an appropriate 859",
         "860 CANADA MEDICAL AND SURGICAL JOURNAL. conclusion, I will mention one interesting case which came under ny caie last July. It was that of a gentleman who had carried the cestode entozoon about with hin fir a period of sixteen vears. Previously to my seeing hini, he had been repeatedly dosed with male fern, as much as one drathm and a half of the extract leing taken by bim at a single dose. 1i he body of Ihe tapewoim hàd several times come away ; nevertheless, hIe patient was not cured. Like some oilier ratients I have scen Ibis ycar, lie not unnaturally despaired cf my ever firding hIe head. It appeared to him absurd that I should obtain better results than others ; and the more so, since I preposed ta employ the same ding that otlers had used. However, an admir- able prepa:ation of the cxtract, prcpared by Corbyn \u0026 Co., had the desired effect. Recommending ny patient to observe certain preliminary rules, I succeeded witi much smaller doses of Ihe drug than lie had been accustomed to take. To be brief, the hcad of the worm was at once obtained ; and thbus, host and guest. after sixteen years of itimacy, were for ever separated, to hie astonishrnent of the former and o the final disccnfiture of tie latter. 13uring the residence of iis truly obstinate parasite, I reckon that my patient must have been the means of dis- tributing sonething like five hundred imii:lions of tapewarrn germs ; and yet, possibly, scarce a score of these germs have since arrived at sexual maturity. Be tlat as it may, I judge that in the course of a few more years the parasite itself would have died a natural death. It was an ill-nour- ished specinen, and evidently feeble. I-ow lcng a tape- worm, if left to itself, may be capable of living I do not know ; but I lately saw a patient who assured nie that be had played the part of tape-worm-bearer for a period of no( less than twenty years.-B, zisli Mcdical 7ourlal.",
         "STRICTURE-BERRELEY 1HILL, M.B., F.R.C.S. Current r\u003cws On treating Stricture. By BRKFLEY H i LL,. M.B., F.R.C.S , Surigeon to University College Hospitat. In the BRITISH MEDICAL JOURNAL for December 20th,- 1873, views are held up to ob!oquy by Mr. Savory which he terms \"current,\" but which I venture, nevertbeless, to believe to be \"old fashioned,\"-if not obsolete. 1\\r. Savory attacks the employment of instruments for treating urethral obstruction of all kinds, which he alleges to be still customary. Mr. Savory's conduct calls to mind that of Don Ouixote- when charging the sacks of flour in the mill, with this difference-the gallant knight-errant found his imaginary foes already erect before him, while Mr. Savory bas had t6 raise up from ihe cleac the objects of his wrath. For it is to be hoped that the treat ment of al] urethral obstructions, spasmodic, congestive, and organic alike, by inst ruments as routine practice bas been discarded by properly traincd- surgeons. To impress his readers with the terrible evil of bougie treatment, Mr. Savory informs us that a dis- tinguished surgeon once said, 'Had bougies never been invented, it would on the whole, bave been a grcat gain to humanity.\" Why not go further, and quote the anecdote of the two eminent physicians. boih now dead, who were crossing the canal-bridge at Camden Town, on their way to a consultation at Hampstead, when one asked..the other whether it vould not be, on the who'e, a benefit to humanity if ail doctors were then and there thrown into the- canal? Iis companion was, indeed, for the moment, -of opinion tbat the sacrifice of the Faculty by drowning would really be advantageous to mankind. But arguments valid against an abuse of a remedy lose much of their force when that abuse bas been subdued by more exact knowledge to a legitimate use. - At the end of his paper, Mr. Savory allges that the sum of his argument is, after al], not to suggest that instruments are never to be employed, but to affirm that '361",
         "362 CANADA MEDICAL AND SURGICAL JOURNAL. they have been and still are grossly, abused, and that in a word, instruments of any kind should never be cr.iployed in any vay except as a last resource. With much of this everyone must agree ; but the statement, that instruments should never be employed except as a last resource, needs some qualification. . In many cases, it is impossible to ascertain what is the. matter without u'sing instruments and any treatnent under such circumstances might be * routine,\" but certainly would be useless. Were the comparatively modest position at the end of the paper the only one taken up by the vrîter, it would not cali for special remark; but there is more. There is confusion, under the rerm \"'stricture,\" of conditions that are now cur. rently held to be not strictures at ail, and are expressly distinguished fron organic obstructions by all leading auathorities in this department of surgery. Mr. Savory says, \" Any advanced student or young sur- geon, if asked what he understands by the term stricture, would reply, a constriction of a porfion of the canal due to ibickening and depos't in its walls.\" And the student would be right ; it is Mr. Savory who makes the error of calling spasn and inflammatory swelling strictures. These misleading names, given at a time when the distinctions in nature and requirements of treatment were ill understood, are yet employed by some, it is truc, but without thereby intending to imply that these temporary obstructions are sim lar in nature to organic obstruction ; and the surgeon who stîll looks upon spasmodic contraction, inflammatory swelling,. and organic stricture as simple physical conditions to be treated only by physical means, had better take the advanced student, whose acquaintance with the subject is; nevertheless, second hand. for his teacher without delay. Certainly, more exact knowledge of the differences between these obstructions is current in standard treatises on urinary diseases, and the mischief that may be caused by using instruments in spasm and inflammatory swelling is carefully pointed out. So far from instrumentation being directed",
         "STRICTURE-UY BERKRLEY IIILL, M.D. as routine treatment, to the neglect of other means,even in organic stricture, such writers as Civiale and Thompson, to mention no more, warn their readers against hastily using bougies, which those masters strongly insist are evils even when mostneeded. And, whatever old-fashioned or obso- lete books may direct, in no standard treatise of the present day is the use of instruments given as the sole or most important means of treating anything but organic obstruc- tionr. Next, the reproach is made against instruments, that they do not afford a cure ; that, though the passage may be widened to the normal extent for a time, it ultimately shrinks back to its clangerous constriction,and no permanent cure is effected. This is truc, doubtless. There is no cure for stricture, if, by cure, we mean putting the urethra into such a condition that no further attention is nccessary. A system of treatment that procures such a result has yet to be found. But, if by cure be meant restoration of the canal, so that it canî be casily maintained at its full calibre through- out, the use of instruments does cure stricture, and it has yet to be proved that any other plan will do the same for organic obstructions. Apparently, one of Mr. Savory's objects ini writing was to lcad the pro!ession to suppose that organic obstructions can be dissipated by his plan of treatment-that rest in bed for an indefinite time, with warnth and other adjuvants, can cause the absorption, either wholly or in part, of organic obstructions. Un- doubtedly-and thisisalso current knowledge-the remedies on which Mr. Savory relies are efficient to remove the spasm and inflammatory swelling that often aggravate the incon- venience or suffering of an organic obstruction sufficiently to induce the possessor to seek surgical aid ; but, when this is donc, is any further progress made towards widening the canal ? To ascertain this, the canal must be gauged by the hated bougie after spasm has subsided, and again when a week or a fortnight, or any time thought requisite, has been passed by the patient in his bed, and the mea- 263",
         "364 CANADA MEDICAL AND SURGICAL JOURNAL. surerrents compared. If Mr. Savory has done this, and finds the organic thickening gone, he has made a discovery of the bighest value ; but this is not told us in bis paper. Otherwise, which patient will take ]cave of his. surgeon with the most satisfied mind-he wbo'bas learnt to pass with case along bis uretbra a bougie as large as the- natural size of bis canal, and has simply to do this, from time to time, to maintain the full potency thereof, or he who, having spent a fortnight in bed, finds he can pass. his urine comfortably now his passage is.somewhat widened by the subsidence of spasm or inflammatory swelling, but bas still a tough and narrow pait that will betightlyclosed the next time spasm sets in, or a cold is caught ? The one- man knows that, it teniporary irritation attack his urêthra, there is still recm for ie passage of bis urine while the cttack lasts ; the other knows he must be tonsant.y on bis guard against accident, and live by rule, that his narrowed urethra may suffice for his daily necds. It is useful to lift up the voice against ie rash employ- ment of insti unients in urinary discases ; there are always, too, inducenients to enploy the bougie or sourd: but this may be donc without dcprcciating ithe current teaching and knowleclge of these cliseases, and casting mischievous pre- judice on a valuable remedy.-British Alcdical 7ounal. Clinical Lccture on a Casc of Ascites from Obstruction ii d/u Portat Vin, delivercd iu University Co/uge Hospita; Ev Sîit V. JENNEI, BART., M. D., K C.B., F.R.S., Ihiysician in ordinaiuy Io tle Qucn anid the Pi ince of WVales ; Prof'ssor of Clinical ledicine in Uizzcrsity College ; Piysician to -University C ológc Hospital. To-DA, gentlemen, I propose to speak of the case of Robert A--, a man who was in the hospital recently, and whose abdomen burt. You may remember that it gave way at the umbilicus with a loud report and a quantity of fluid came out. H1e had ascites, and also a considerable",
         "ASCITES-SIR W. JE'NER, BART. amount of gas in his peritoneum., Vou know quite well, when an abdomen is resonant on percussion, and you find the resonance-ic., the air within the abdomen-move as you move the patient, that, ais a rule, the gas is not in the peritoneum, but in the intestines. In this case, however, the gas was in- the peritoneal cavity itself. That is why there was a report when the abdominal wall gave way. The man had had an artificial opening made in his belly-as I shall tell you afterwards-for the, purpose of letting out the fluid. It had hea'ed but imperfectly, ard, when the gas rapidly accumulated. the weak spot ruptured. The real causes of the man's troubles were an impedi- ment to the flow of blooci thriîugh the portal vein, and an impediment to the escale of bile frcm the hi patic duct. To these two lesions all the others which I shall describe to you were secondary. \\Vhatever permanently impedes the flow of blocd through the portal vein, must have, as its necessary results, one or more of the mechanical consequences of congestion of the part the blood from which is poured int the portal vein. The blood cannot easily escape from the portal vein ; and. of course, all the tributaries of the portal vein aie swolIen. The consequence is, that when there is impediment to the passage of blood through the portal vein, there is enlarge- ment of the organs, the blood froni which passes into the portal vein--as the spleen and the pancreas. The same impediment to the onward flow of the blucd may also cause rupture of vessels. The over-distended capillaries burst, and extravasations of blood and hemorrhages occur. Com- mon seats of hæmorrhage trom this cause are the stomach and the rectun-bleeding piles, hæmatensis. This man. whose trouble I told you was the impediment to the flowof blood through the portal vein, had repeatcd attacks of hSmatemesis. Then patients suffering frcm obstruction to the flow of blood through the portal vein have effusions of serosity from the congested vessels. There is effusi'n of scrum into the cavity of the peritoneum-ascites. This 365-",
         "3663 cANADA MEDICAL AND SURGICAL JOURNAL. man had ascites. A gain, they have 4watery fluxes,\" as they are termed-watery flow from the congested mucous mema brane. The mucous membrane of the bowels often suffers from this when it is mechanically congested. The patients. have watery diarrhœa. Then thickening of alil the con- gested textures takes place. The coats of the stomach be- come thickened ; the peritoneum becomes thickened ; the coats of the intestines become thickened. Again, inflam: mation, acute or chronic, is very apt to supervene in the congested part. It does not occur constantly, but fre- quently ; so that when there is impediment to the flow of blood through the port-l vein, it is common to have catarrhal inflammation of the stomach, catarrhal inflam- mation of the bowels, peritonitis. These are common con- sequences. A gain, ulcerat ion of the congested surface may take place, ulceration of the mucous membrane of the bowels, of the stomach, of the rectum, of all the congested parts. This man had ulceration of the bowels and of the adhesions that had formed , in his peritoncum. Then induration of all the textures occurs. Adhesions forn be- tween parts that should be fre, especially in the peritoneuni. Adhesion takes place between the coils of intestine, be- tween the omentum and the intestines, between the intes- tines, perhaps, and the parietal peritoncum (as we saw in a case the other day), between the liver and the diaphrrgm; the spleen and the diaphragm, the stomach and the adjacent parts. * As the rule, when there is a sudden impedinient to the' flow through the portal vein,a hæcmorrhage occurs. When the impediment is-more slowly developed serous effusions' occur. When hrnatemesis takes place, it generally .e- lieves greaily and at once the congested organs. You fncd a inan's spleen big to-day ; he bas bæmatemesis, and - to- morrow his spleen is greatly diminished in size ; its over- distended vessels are emptied, its thickened tissues only! remain. You know the close vascular relations between the spleen and the vasa brevia of the stomach.",
         "ASITES-SIR w. JENNER, BART. 1T When I said that-some one or more of these results ne- cessarilv follow the occurrence of obstruction, I said what was not quite true. I said it intentionally, however; be- cause I wish to fix it in your minds. It is not really neces- sary; but it occurs in the vast majority of cases ; in such a large majority that I would fix it in your minds as t/te con- scquence. It is not the rcesary conscquerce, hccause a collateral circulation suff:cient to relieve the corgested vessels may be established. You wili rcmember ihat there are anastomoses between the inferior mesenteric veins and the hypogastric veins through the inferior hoemorihoidal, and so the blood may, come bac. by the hypogastric vein. Again, the twigs of the portal vein and the veins of the serous covering of the liver open into the diaphragma'ic and oesophageal veins, and these little communications may become considerably dilated. Again, adhesions may form between the liver and the diaphragm ; new vessels be developed in those adhesions, and these new vessels may be sufficient to considerably releve the congested portal vein. They open into the diaphragiatic and æsophagcal veins. A gain, the remains of ihe unbil;cal vein which runs in the ligamentum teres sormetimes remain patent. When the portal vein is stopped the remains of the umbilical vein becomes dilated, and this little channel grows into a big 'vein, communicates with ihe nammary veins, and so returns the blood on the surface, and you see the greatly dilated veins there carrying up the blood. You will remember, therefore, when you meet with a case in which you believe that there is disease of the liver causing mechanical inpedi- ment to the flow through the portal vein, but in whirh you do not.get the ordinary consequences. what I have spoken of as the necessary consequenices, those which vou would get in the vast majority of cases-remember, I say, that you may be right in your diagnosis, alhough you have not the ascites, the diarrhœa, the hæemorrhoids, or the big spleen, because scme of the veins of whi hi I have spcken may be performing the extra duty of carrying off the blood",
         "368 CANADA MEDICAL AND SURGICAL JOURNAL from the parts which would ot'herwise be -greatly con- .gested. Whatever impedes the low of bile through the hepatic duct or through the ductus communis choledochus must impede the escape of bile from the liver ;-and whatever prevents the escape of bile from the liver will have jaundice following it, and ail the consequences of jaundice. We find that persons who are the subjects of the impedi- ment to the circulation I have described not only suffer from the mechanical consequences of the impedirnent, such as the ascites and the hæcmatemesis, which are common, and the ulceration of the bowels, which is rare, but they also suffer fron defective general nutrition? This man was greatly enaciated. What is the cause of this general mal- nutrition? First, there is the danage mechanically inflicted -on the mucous membrane of the stomach and bowels, and the consequcnt interference with the digestive process. There is diminished absorption fron that cause. Then the nechanically o.ver-distended radicles of the portal vein will be very unlikely to take up anything further. Again, there is the damage to the spleen and pancre is fron their long- continued congestion, and the consequent interference with their functioiis. Again, there is damage to ail the organs of the body froni the damaged state of the blood consequent on these lesions.and on the retained bile. These causes seeni amnply sufficient to account for the emaciation of the patient. Further, as 1 told you before, when the abdomen is greatly distended there is sufficient pressure upon the vena cava to interfere with the return of blood from the kidney ; there is congestion of the kidney. and then, if the patient survives long enough, a form of Bright's disease -and ail its consequences. Impediment to the passage of blood through the portal -vein, and of bile through lits ducts, is common .enough-. .a\"ongst the commonest diseases ; because disease of the liver which has these results is common. But impediment o the -flow of blood through the.portal vein, and to the",
         "ASCITES-SIR W. JENNER, BART. escape of bile from the hepatic duct from some condition external to the liver, is rare. It does occur, however. For example, malignant growths or hydatid cysts may press upon the portai vein and the ductus communis choledochus outside of the liver. Dr. Stokes has detailed a case of aneu- rism of the hepatic artery, where it runs, together with the portal vein, in the border of the hepatico-duodenal fold, just above the opening of the foramen of Winslow, and which interfered with the flow of blood through the portal ven. In the case I am about to narrate to you the impediment was the result of inflammation, induration, and contraction of the cellular tissue of the ligamentum hepatico-duodenale and the cellular tissue in the hilus of the liver-i. e., of the cellular tissue in which the portal vein, and the hepatic, cystic, and common bile-ducts lie. It was the trunk of the portal vein and the trunks of the bile-ducts which were injured and narrowed. The patient was a man forty years of age, admitted into the hospital on the 9th of February, 1869. As the patient was confused in mind, and could only be made to answer questions with difficulty, the following history was obtained from his sister. \" At about the age of eighteen he enlisted as a soldier and went to India. He remained in India for twelve years, and returned to England about ten years since. While in India he was frequently in the hospital, as his sister had been told, on account of disease of the liver and spleen. He was a man of intemperate habits, indulging from time to time in 'drinking bouts.'\" This is the common cause of cir- rhosis of the liver. It is not the only cause, but it is Me cause, the special cause, to which exceptions are infinitely rare. You will find it mentioned in books, that when making a diagnosis of a case of impediment to the flow through the portai vein, when considering whether it be fron cirrhosis, which has that as its great symptom, or whether it be due to some impediment external to the liver, A A 369",
         "CANADA NEDICAL AND SURGICAL JOURNAL. if the patient be a drunkard it is probable that the case is one of cirrhosis. This man was a drunkard, and there was impediment to the flow of blood through the portail vein, but he was not suffering from cirrhosis. \"About six years before admission into the hospital, after one of these debauches of drinking, he vomited a large quantity of blood.\" So that at that time he had probably- pretty certainly, indeed-impediient to the flow of blood through his portal vein, mechanically induced congestion of his stomach, and as a consequence rupture of the capil- laries and hæmatemesis. \" The hematemesis was repeated on four separate occasions, the last being about twelve months before his admission.\" No doubt he was relieved by the hæmatemesis. The congestion of the radicles of his portal vein would be relieved by the escape of blood. The loss of blood was not enough to kill him, but merely enougli to relieve considerably the congestion of his spleen and of all the radicles of the portal vein. \"After the last attack of hæcmatemesis. twelve monthsi ago, the swelling of the abdomen, which had been transient before, became permanent.\" The transient swellings of his abdomen were probably due to flatulence. The patient had congestion of his stomach and of his bowels, thickening of all the abdominal tissues, interference with digestion, and accumulation of flatus. After the last attack of hæmate- mesis the mechanically over-distended vessels relieved them- selves by letting out serosity into the cavity of the perito- neum, and permanent swelling, dropsy, ascites was produced. This increased so much that \"six months before his admis- sion he vas tapped just below the umbilicus, and five and a half gallons of fluid removed.\" The opening into the abdomen was made a great deal too near the umbilicus. A little ulceration resulted on the inner side of the opening, and obliteration of the umbilical depression ensued. It was a spot where the abdominal walls were weak, and so, when the fluid reaccumulated, the abdominal walil was distended at this spot : a very thin layer of skin 237 0",
         "ASCITES-SIR W. JENNER, BART. covered the fluid beneath, and the skin itself ultimately gave way. He was tapped where he ought not to have been ; lie should have been tapped lower down, some inches below the umbilicus, a little nearer to the umbilicus than to the symphysis pubis. \" The fluid so:n reaccumulated,\" as it was likely to do. There was a mechanical impediment to the flow of blood through the portal vein ; the effusion of serum was the me- chanical result; and removing the fluid did not reinove the impediment. \"Five weeks after the tapping he was nearly as large as he was before the operation ; subse- quently the distention diminished a little. Five weeks before he came under observation lie had a 'fit of drinking' (as his sister called it), which lasted two days. Three days before admission lie was seized, 'after tea,' with severe pain in the lower part of the right side of the abdomen. The pain was less after taking some pills; but, as he continued very ill, lie was brought to the hospital.\" The severe pain in the lower part of his abdomen was, no doubt, the result of perforation of his intestines, which we shall see he had. You will remember that perforation of the intestine is usually announced by sudden severe pain.' -not always, for now and then pain is absent. Ail persons of much experience have met with cases where, curiously enough, perforation occurs, I do not know why, without any pain at all.,,Thîe patient is not aware of having suffered any lesion. The rule, however, is that there is intense sudden pain, with symptoms of collapse, followed by those of peritonitis. The pills given were probably some opiates to relieve the pain. On the man's admission into the hospital we noted that lie was very thin, that his general nutrition was seriously interfered with. His skin was a dirty, slightly greenish- yellow colour. The greenish tint is the tint of long-con- tinued mechanical impediment to the escape of bile iromn the liver. Hence it is a common tint in cancer of the liver. A person has a gall-stone, and a sudden attack of jaundice; faE",
         "372 CANADA MEDICAL AND SURGICAL JOURNAL. the colour is a deep yellow, with no greenish tint in it. But if he bas a chronic jaundice, long-continued, his skin bas the greenish colour. The veins on the man's hands \u0026c., were small; evidently there was no impediment to the return of blood from the systemic venous system. They were pinkish, from aiæmia. The pink-ish colour of the vein is evidence of a deficiency in the red corpuscles, probably the result in this man of the interference with the nutrition in general, and perhaps also of the interference with the function of the spleen in particular. \" His abdomen was considerably distended with fluid. The umbilicus also was much distended. No scar could be seen between the umbilicus and the pubes.\" The fact was that perforation had been made at the umbilicus. \" During the night, at the lower part of the distended um- bilicus, the skin gave way with a loud noise.\" It would not have been a report had there been no air there. \"A large quantity, supposed to be about five pints, of stinking fluid escaped. A drainage-tube was introduced, and a weak solution of carbolic acid injected. The next day (Feb. Ioth) fluid continued to escape from the opening. It was very offensive, and gas escaped with the fluid.\" We bad a full explanation of this afterwards, for we found an opening in his bowel ; but remember that all collections of fluid in the vicinity of the bowel are apt to become a little offensive. \"The abdomen was very tender. ýPulse i8, very weak. Urine dark-coloured, containing one-eighth albumen. The man gradually sank, and died on the i th at 6 Ë.m.\" There vas nothing to be done for him; his mind was gone ; bis pulse excessively feeble ; there was evidênce of some injury to his bowel, of a long-continued impediment to the flow of blood through the portal vein, and of bile through the bile-ducts. After death the cavity of the abdomen contained about two pints of an opaque fluid. The external opening of the umbilicus communicated with the cavity of the abdomen. The liver, stomach, omentum, and intestines were matted",
         "ASCITES-SIR W. JENNER, BART. together and covered with a thick layer of lymph, so hard and vascular that it 'must have been of long standing. There were no adhesions between the parietal peritoneum and the intestines and omentum,:probably because the man had effusion of serum sufficient to separate the parietal peritoneuni from the other parts before adhesions formed. The parietal peritoneum was greatly thickened and red- dened, and was evidently the seat of long-continued inflam- matory action. The peritoneal. coat of the stomach was covered with lymph and thickened, and was the seat of numerous ulcers. The lymph had organised, had become part of the anterior wall of the stomach, and then the seat of ulceration. The posterior part of the bladder was adherent to the sigmoid flexure and the rectum, so that there was no cul-de-sac between the bladderand the rectum. The liver was inseparably united to the diaphragm; its lower edge was above the margin of the thorax. On separating the adhesions between two of the coils of the small intestine, situated in the right iliac fossa (where the man had felt severe pain during life),- an' opening was exposed, about the size of a sixpence, out of which fæcal matter escaped. In the interior of the bowel, a large ulcer was found at the spot. The mucous membrane around was intensely red, and coated with dirty-yellowish lymph. The situation of the ulcer was in the ileum, about a yard and a half from the cacum. The peritoneum over the ulcer was destroyed to an extent greater than that of the opening it- self, so that the muscular fibres were laid bare as well from the peritoneal as from the mucous coat. , As we looked at it in siti we thought that the opening might have been made from the peritoneum into the bowel. This is rare, but we thought it possible. Op opening the bowel, how- ever, it was clearly not so, for here the mucous membrane was consideral-1y destroyed ; it was destroyed over an area larger than the opening, and larger even than the destruction of the peritoneum. Thus there had been ulceration of the outer side and ulceration of the inner 372",
         "CANADA MEDICAL AND SURGICAL JOURNAL. side,, but from the congestion of the mucous membrane around, we knew that the perforation had occurred, as it usually does, from within outwards. Several small ulcers were subsequently found in the intestine- which had not perforated, but only destroyed the mucous mem- brane. Thus it was clear that the ulceration had begun in the bowel. It was the result of the mechanical con- gestion of the bowel. I told you that inflammation of the mucous membrane of the bowel resulted from the me- chanical congestion, but that it was catarrhal inflammation. As a consequence of this, deeper-seated inflammation with ulceration may occur, and here we had it so deep that it had perforated the bowel. The mucous membrane around the ulcers was of a deep mahogany colour. The capsule of the liver was thickened, and the liver itself was too granular, but not contracted ; the edge was thick and the tissue broke down easily under pressure. Evidently, although it was not a healthy liver, there was no such disease of the liver-substance as to scriously impede tic flow of blood through it. It was not an ordinary cirrhosed liver. The gall-bladder was covered with old lymph; and its coats were thickened; it contained four gall-stones and scarcely any bile. The cystic duct was completely closed, and the hepatic duct and the branches of the portal vein and the common duct, all the parts in the hilus of the liver, were bound together by old adhesions and a large increase of the connective tissue. This was plainly the centre of the trouble. Here the lyniph was the toughest and it was evidently the oldest. Here it was the most perfectly organised, but still greatly con- tracted, compressing the portal vein, cornpressing the cystic duct, compressing the ductus communis choledochus. All the branches of the portal vein had their coats greatly thickened. and in one branch-that to the right lobe-was an old clot firmly adherent. There were four gall-stones in the gall-bladder, but we had gooc reason to believe that they were not all the gall-",
         "ASCITES-SIR W. JENNER, PART. ' stones that had been there. I say, ' not all,\" because their sides were flattened, and they were small gall-stons, and they., did not seem to form the whole mass indicated by the peculiar flattening. We thought it probable, from the history of the man, from his having been several times in hospital with something wrong with his liver, that he had had gall-stones before, gall-stones passing down his cystic duct, or his ductus communis choledochus, which had led to inflammation, perhaps to ulceration, and to injury of the parts around. We know that such inflammation and ulceration do sonictimes result from the passage of a gall- stone, and that now and then a gall-stone is thrown out by the ulceration into the parts around. We had no evidence here that ulceration had proceeded so far, but we had evidence of inflammation which had become chronic, and had ended in exudation of lymph, the man's habits and the climate he had lived in also perhaps assisting. Lymph thus exuded contracts, and an impediment is established to the flow of blood through the portal vein. Thus, I think that the origin of the patient's trouble, the origin of the innamnation in this particular situation, where it had such a damaging effect upon his health, was the passage of a gall-stone. The liver itself was really scarcely dis- eased. It contained a good deal of bile, from the damming back of bile into it, but the ducts were scarcely, if at al, dilated, and the cellular tissue between the lobules was a ittle increased. The obstruction to the fÉow of portal blood to the liver, had no doubt, diminished the formation of bile, and hence the absence of dilatation of the ducts in the iver. The weight of the liver was 31b. 7 oz. The spleen was large and tough, the capsule thickened and adherent ; it weighed i lb. 1o oz. This was no doubt the result of the mechanically produced congestion. The nesentery was greatly thickered, coated with lymph such as covered the omentun; this lymph was due probably to the same cause which had led to the thickening of the intestines. to the enlargement of the spleen,-i. c., the 375",
         "376 CANADA MEDICAL AND SURGICAL JOURNAL. mechanical congestion, and the inflammation secondary thereto. The kidncys were enlarged ; the right weighed 6 oz., the left 7 oz. The cortical substance was broad and a little speckled with red. Probably the mechanical con- gestion of the kidneys, assisted by the habits of the man, had given rise to inflammation, and in his'cachectic condi- tion to that low form of inflammatory action which is followed by the exudation of a great quantity of protein granules which quickly experience fatty degeneration. We must see, pretty clearly, considering how little history of the man we had, the course of bis disease from its commencement to bis death, and how the one disease, the one condition, followed mechanically upon the other; how the enlargement of -his spleen, the vomiting of blood, the effusion into bis peritoneum, the ulceration of bis intes- tine, the perforation of his intestine, the distention of bis belly, and the bursting of bis umbilicus,-how all these were the mechanical results of the primary disease, the inflammation of the cellular tissue about the portal vein and the hepatic, cystic, and common bile ducts. The further result of this was changed nutrition, for he was very thin, and evidently bis nutrition was interfered with by the damage to the abdominal tissues and organs, conse- quent on their mechanical congestion, and on the damming back of bile in the blood itself.-Lancet.",
         "CANADA MONTIEAL, FEBRUARY, 1874. 'THE WEST HADDON TRAGEDY. Recent exchanges give an account of a lamentable tragedy which occurred in England, we take the account from the British Medical Yournal of the 17th ultimo. It appears that a Mrs. Gulliver,an elderly woman of 73 years, had been suffering for some ·time with symptoms referable to her heart, accompanied by attacks of fainting. Her physician who had seen her the day before her death ascertained the existence of disease of the heart by stethoscopic examination. He expressed a belief that she was in a very critical state, and advised her friends to be sent for. Her sister and a Mrs. Watts, and her niece Mrs. Waters,came to ber bouse,- Mrs. Waters and Mrs. Watts. sat up with her during the night. The following morning being, Sunday, the doctor saw her and found ber better. She ate a good breakfast, and asked Mrs. Waters to read to her, shortly afterwards the old .lady complained of feeling faint. Mrs. Waters sprinkled some eau de cologne on he: handkerchief, and about the bed, which revived ber, and she asked for and drank some sherry and water. She complained of the room being close, and the windows were opened. At her request Mrs. Waters proceeded to read a chapter out of the Bible, and the old lady was repeating after her, when she suddenly stopped and apparently fainted. Mrs. Waters called for assistance; sent for the doctor ; threw up the window sash to admit a full ciirrent of air. Some sherry was poured into her mouth, which she swallowed, but she did not",
         "CANADA 3EDICAL AND SURGICAL JOURNAL. revive. The doctor arrived shortly after and pronounced her dead. It appears that dame Rumour interfeYed in the case, giv- ing rise to the suspicion of foul play, on the plea that Mrs. Waters had a reversionary interest in the property of deceased. A month elapsed, at length· the body was ordered to be exhumed, and an inquest was held thereon. At the post mortem all the organs of thebodywere found healthy except the heart, which was in an advanced state of fatty degenera- tion, with verythin, soft walls. The contents of the stomach were examined chemically by Mr. J. D. Rodgers of London, and nothing but minute traces of morphia was found, such as would very likely be found in ordinary cough lozenges, of which deceased was in the habit of partaking. Mr. Walker, the family physician, had in his evidence said, that after death he found a high temperature of the body. This induced the chemical expert to state that in conse- quence of such high temperature after death, he was of opinion that deccased had died from some volatile noxious substance, given to her immediately prior to death, but which he was unable to detect. Upon this testimony the jary found that Mrs. Gulliver died fron poison, but by whom administercd there was no evidence to show. A warrant was made out for the apprehension of Mrs. Waters, as she was one of the persons with deceased during her last illness. Mrs. Waters on hearing the result became ve-y nuch excited, protested her innocence, aad swallowed sone poison, supposed to be strychnine, from which she died, and a second jury was summonecd. Evidence was given at this second inquest which went to prove that Mrs. Waters was of a highly excitable temperament that several of her relatives had been insane, and that on several occasions she had threatened to destroy herself, and yet a verdict offelo de se was rendered, which according to law, necessitated the burial of the body within three hours, without the benefit of clergy.",
         "THE WEST HADDON TRAGEDY. There are several points in this case which are instruc- tive and which demand a passing remark: In the first place Mr. Walker's assertion that he found a high temperature cf tIe body after death in the case of Mrs. Gulliver, does not appear to be supported by actual thermometric observation, and therefore is inadmissible; it would not be received as evidence in any well constituted court of law. It was simply absurd of Mr. Rodgers on such testimony to start a theory which could not be in any way substantiated. In death from chloroform vapour the heart is the first to cease its beatings, respiration continues for some time after all pulsation has ceased; moreover the temperature of the body docs not rise after death. Again the presence of chloroform in the blood has been proved in very minute quantity after three weeks' exposure, although the difficulty is admitted. If the death had been from Prussic acid vapour, the symptoms would have been suffi- ciently well-marked and the odour cxhaled from the b dy nmi stakable, so that the medical attendant who arrivedi at the mnioment \u003ef death could not have been deceived ; besides which the action of chloroform, alcohol, ether and prussic acid, when taken, lower the temperature of the body after death. The verdicts rendered by the coroner's jury in both cases would have disgraced a similarly constituted court amongst a people like the Ashantees. Wc in Canada, as a rule, arc badly served in this respect, yet we believe that some diffi- cuity would be experienced even in the back woods of our country to collect together twelve men so thoroughly deficient in mere common sense, as appears to have been the case with the jurors above alluded to. It proves the absurdity of continuing this court as a part of our judicial system. An enquiry in all suspicious cases of death is necessary, and could be better conducted by a magistrate, without giving him or his court the power to bring in a verdict of guilty of murder. After all the coroner's court is a mere court of enquiry. and the testimony adduced is usually 379",
         "380 CANADA MEDICAL AND SURGICAL JOURNAL. written down as it is given, and is submitted at the trial before the Court of Queen's Bench. The most harrowing part of the whole tale is the fact that the body of the unfortunate Mrs. Waters was actually buried at night, her own husband reading over her re- mains the burial service. This calls. to mind the dark and wretched doings of a past age, when thefelo de se had to be buried at nidnight in the centre of a cross road, and a stake driven through the body to prevent the spirits return to bother the living. Such things have ceased to be even thought of in this nineteenth century, and we had almost supposed that the church had removed its ban, and in such a case as the present would have\" corne to the rescue, and have donc what was right, humane, and we must add Christian. For who dare judge that this unfor- tunate woman should be held accountable for an act of frenzied madness. To such as think otherwise might apply the words of Laertes addressed to the priest at the. burial of his sister Ophelia:- \" Lay her i' the earth, \" And from her fair and unpolluted flesh \" May violets spring 1-I tell thee churbsà priest, \" A minist'ring angel shall my sister be, \".When thou liest howling.\"-HAM. Act, iv. Scene i. VACCINATION AND SMALL-POX. We publish elsewhere some very pertinent remarks by Dr. Baynes on vaccination, and as the subject is one of moment to the entire country, we cannot do better than allude to and quote from the experience obtained during the recent epidemic of small-pox, by one of the London, (England) distinct hospitals for that disease. This will be found in the last annual report of the Local Government Board, therefore there can be no doubt of its validity. It is useless to endeavour to convince anti-vaccination fanatics, if they cannot be convinccd by the testimony of the expe-",
         "TESTIMONIAL. rience given, in the early part of this century, when statis- ticians had to deal with thousands of cases of small-pox, how can the present hundreds be of any avail. T ABLE (1F THE DEATHS- AND RECOVERIES PER 1000 CASES O SMALL-FOX. begree of Vaccination. Cases under z5 years. Cases above x5 years. TtaIl Recovery Deaths. Total. Reroveries Deathr. Unvaccinated.............. 2os 131 77 122 76 46, One or more bad marks. 45 42 3 104 89 15 One or more Indifferent marksi 12 12 o 75 66 9 One good Vaccination mark.. 61 61 O o1 93 8 Two 1 29 29 O 104 99' 5 Three\" 35 35 i 39 39 O Four 17 17 O 32 32 o Five 2 0 i 1 , o Six \"2 o i 11 i O It will bc observed by this table that of the unvaccinated children the mortality was 37 per cent. The death rate of those over 15 years who were unprotected by vaccination was nearly one half. Of the children protected by vaccina- tion, arnounting in the agregate to 158 cases, there was not not a single death, and of adults those protected by three or more good vaccination marks, there was no death from smrafl-pox. TESTIMONIAL. We are happy to record that on New Year's Eve some thirty gentlemen met at Wetherell's Hotel, Bury, P.Q., and presented Dr. James McNice of that place with a testi- 'monial valued at $200, accompanied by the following address To JAMES McNicE, EsQ., M.D., C.M. SIR,-We the undersigned residents of the Township of Bury and vicinity, beg to tender you our thanks for the services rendered by you professionally during the four years you have been amongst us, and as a sliglt token of our appreciation of your services, ask you to accept this testimonial which we present to you on this occasion.",
         "82 CANADA MEDICAL AND SURGICAL JOURNAL. Hoping you may be long spared to practice your profes- sion amongst us, whose esteem you have won by your kind - ness and attention to rich and poor alike. We wish you and Mrs. McNice prosperity and healt, and a happy New Year. We remain your sincere friends, JOHN MARTIN, J.P. WILLIAM FAREWELL, J.P., And many others. To which Dr. McNice returned a suitable reply, but whici we regret space will not permit us to publish. The com- pany then sat down to a substantial supper, served in mine host's best style. THE SIAMESE TWINS. We take this account from the Medical and Surgical Repor-ter, Philadelphia':-The twins, whose death we record- ed in our last, were 63 years of age. The circumstances of their decease were as follows: On the-Thursday previous the brothers were at Chang's residence, and the evening of that day was the appointed time for a removal to Eng's dwelling. The day was cold, and Chang had been complaining for a couple of months past of being very ill. The road leading from the two houses was very rough and frozen. Early in the evening they started upon their journey in an open waggon or carryall, and in a short time arrived at Eng's. Chang became chilled by the exposure and complained of being very cold, while his partner was in apparent good health, and grumbled because he had to sit by the fire. They retired that night, and in answer to an enquiry from the sick man's wife on Friday, he stated that he was much better. On Friday evening they retired to a small room by them- selves and went to bed, but Chang was very restless. Some- 3 82 )",
         "THE SIAMESE TWINS. time between midnight and daybreak they got up and sat by the fire. Again Eng protested and said he wished to lie down, as he was sleepy. Chang stoutly refused, and replied that it hurt his breast to recline. After a while they retired to their bed, and Eng fell into a deep sleep. About four o'clock -one of the sons came into the room, and going to the bedside discovered that bis uncle was dead. Eng was awakened by the noise, and in the greatest alarm turned. and looked upon the lifeless form beside him, and was seized with violent nervous paroxysms. No physicians were at hand, and it being three miles to the town of Mount Airy,- some time necessarily elapsed before one could be sum- moned. A messenger was despatched to the village for Dr. Hollingsworth, and lie sent his brother, also a physi- cian, at once to the plantation, but before he arrived the- vital spark had fied, and the Siamese twins were dead, Dr. Hollingsworth made an examination of the bodies, and found the \"gordian knot\" or band which connect- ed them to be an extension of the sternum, about four inches in length and two in breadth. The band was convex above and in front and concave underneath. The two bodies had but one navel, which was in the centre of the band, and it is supposed that there were two umbilical cords branching from this. The connecting link was found to be the ensiform cartil- age, and was as hard as bone, and did not yield-in the least. It is also stated that for some time previous to their death no motion was observable in the band. The Doctor said he did not think they would have survived a separation, not from the fact of being afraid of separating the arteries, but from fear of producing peritonitis. No hemorrhage would have been produced, so-far as could be seen, as there were no arterial connections of any account.",
         "p MD ~. O CQ c , CL .0 .00 CD -ta p p ec m CD e Co cq oe Co O IM = .0 b.; 04 p.. Fa i 2 ;D 'r ~ D Mx a e ; 0 M C' c\u003eu mm w o -ý o L- i .i C. o r o, . A Çt -o N m 'C14 c- iz o r C) CQ Co r« - Cro .- com - ~-4?COC4 C E--ë y .0 O Q CdO 1 A cao 00 CD"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. Coloured covers/ Couverture de couleur D Covers damaged/ Couverture endommagée Covers restored and/or laminated/ Couverture restaurée et/ou pelliculée Cover title missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ L Planches et/ou illustrations en couleur Bound with other material/ Relié avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible. ces pages n'ont pas été filmées. L'Institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored andfor laminated/ Pages restaurées et/ou pelliculées W Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Continuous pagination/ Pagination continue Includes index(es)/ Comprend un (des) index Title on header taken from:/ Le titre de l'en-tête provient: Title page of issue/ Page de titre de la livraison Caption of issue/ Titre de départ de la livraison D Masthead/ Générique (périodiques) de la livraison D Additional comments:/ Commentaires supplémentaires: This item is filmed at the reduction ratio checked below/ Ce document est filmé au taux de réduction indiqué ci-dessous. loX 14X 18X 22X 26X 30X 12X 16X 20X 24X 28X 32X",
         "i UN E. CAN-AD-A HEALTH JOURNALI A MONTHLY MAGAZINE OF PREVENTIVE MEDJICINE, -EDITED BY- 1RW-Ê.MRJ2D M-JD- penbhcleir ab~aiid~rn4\u003e~n ÎieLh CO3~XT~TS: Tlicory mid Pructice as to Disinfeciun ...137.14 - Sninnary of V.ie Rcquireuicnts of the Dairies, Covslietls 21111 Milksliops Orders of 1SS5 and 1687 in Seotland ............ ...... 147.1-IS Stinienr C-tre of Inif.nts ................. 1.9l150 Teetliing- TMine ...........................1Ibo Miscilncos Stesand sclectiois.-Sunxnr Disenses-Tusts for Arsenic in Paper 1lang. ing - Arsenical1 Wall Papers - Ciacinical composition of Mani-coznptlsory Sanita. f tion of Ilonses--îlome Lite ai Longevity -Newi Factor lis tltsn-otgos mesas of Consuînsliion, \u0026c., te ............ 151-157 The Publie llealth for 3lav............... s -Mortuary Stati-stics-flcturns for May .........159 MIiere to Go and Stay ......................1260 Ordinalices of Ille IlE.%u.r Joui.%AL ...........160 EditorFs Special Corncr-1'rohsilitiots Question -Rleports of the Locil B\"ards of llcalth, . . ... .. .. ... .. . .. . .. . 161.163 Observations and AInnot-tionis............ 163-166 Notes oit Current lteraturc ........ 1 fe Subscriptîon Price, $2.Wo per year; Single Copy, 20 Cents ADDRESS ALL COMMUNICATIONS, \"IrHE4L-TH JO URNAIL, Ottatwa.»- VOL. IX. 1II~ No. 6. III- :PT",
         "HIENRY WATTERS, R OBINSON,\u0026 KENT, BARRISTERSi ETc Office: Victoria Chambers, Oheimist and.Druggist, 1 9 Victori Street, Toronto. 21,4-216 Sparks St., Ottawa. Special attention given to the Coîupolîmd- in-~ of l'l-vse-i Prescrip)tionis. N PEARSON, Dis-;forrnerly N.of Nt:wiiarket, cornier of King an-d Yonge Sîrcets, Toronto. N. G. itOISERTSOIN. N Yto ho miade Cut this out and retu ta te us. and wo ivil1 send M O E you frcc. ooithn f grcat riglit aw:iy thian.iiiytlinszt cise in this -world. ~A ny une can (lu theû work niff 'ive ut. home. Eithier sex: aIl aices. Soxnetlhinr, 10w. cIllajust coins *.oziey for-ai! workers. oV wifl startyou; capi- tl' nut nccuicd. Thius iS one1 of the gcnuine, lin- ilortant chances of a lifetinie. Those wheli are amnbitions and entcrpris:ng will notdeiay. Grand outilitfrc A ddress*fju \u0026 Ce., Aigusta, Mlaine. TUE GRA:'ND «UNiON 110TEL, Opposite tAc Grand Ccatr'al Depoi, ïVew York' City, Offers trarcliers and fimilles.irrivinig or Icaring thme city to visit Saraloga, Long Jlriach, Wite.%Mountaiins. or- otiow Sumisnerîtesori s, sulperior AUoncodtos Aimprovccncnk's, Enirope-ii p~lan. ovcr 600 cegantly furnished rooros, fitted uptmpan expcnse et a Million Dollars. $l.0Oancd upardslper day. Ililly furnished suites for famlilies. and eicgéantly furaished moinus for dinner parties for ton an\u003e]. upwarda. Culsinc' and mines or sixperior mit The itl.curs»nt, Cae.le anAe W'jnoions suppiied wvitli the best at moderato prlce. Toilct and flaggmgo Rlooras, for ladies and] gents, where coats, valises and] parcels ati bc ieft froc. WGùcsW Baggage toksa to and fro.:t :U depot fi-ce, and Q3.00 cab\u003e hire sarcdbZy stoppingat this Hole\u0026 Bcesure andtryjthe Grand Un ion, HaleZ. TORONTO $HOE COMPANY, 4 and 148 King St. Eazt, Cor. darvÎ3 St We Invite your Confidence anid Patronage. 1-48 Ol Irzrreaduarte)-s. * 146 New Ladies' -Pario)r, jEThe Grent and onJy One Price Caslh I3oot aîd Shoc flouse in Toronwu.-W IL. A. E. KENT. 0 jn",
         "THE CANADA HEALTH JOURNAL. VOL. 9. JUNE. 1887. No. 6. TIIEORY A.ND PRA\"WTICE AS TO DISINFECTION. ]3y ALPRED CARPENTER, M. D., M. R. C. P., VICE-PRESIDENT -BRITISH MEDICAL AssociATIoN, ETC., JETC. REAb) BEFORE THE ASSOCIATION 0F SAN[TARY INSPECTORS, APIL 2NI), 1887. IITRAT are the matters wvIich have to bVeodisineted? In the foremost rank ,ve have the i nfective 1)artlcleS giv- eni off fromn cases of infectivediseases. We have the exoreti and the fomnites-the latter tcrm having ref'erenco to, the xnorbid inatter wvhich rnay be contairi- cd in clothes and habitations. Then we have the socwcrs of the district, wvhich nay have, been infected by ex- ereta and by %vashingS. Ncxt 'vo have the conditions wvhich in theinscîves inay proniote the rise of infections disease, sueh as heaps of* iaxcreta, kept in the neig hbourhood of diwelIing- house.s; decollposing fishi, flesh, and vegetable_,s; the condition of the markets in wvhiclî sue] tbings are exposed for sale; the stateo f the shops and preraises of those who expose themi for sale; and also, the state oi the streets, courts, alleys, and private Pro- mises of the towri. Then there are the chances of' infec- tion fro-ii diseased animais; for their influence upon the health of main is bc- coinrg un established axiom; at last, altliough 1 recofleot the time when it 'Was limited in xnen's minds to, the cffect8 of glanders and bydrophobia. They were fain te think tbat there ivas at great guif between men and animais over which disease was not likely to pass. That day has goue by, and it :secmns now that the health of' domestic animais is as important to a country as is the health of the ma.sses themi- Selves. Thon wve have noxious trades which have to be carried on, and ivhich may be safely carried on under proper regu- lations;- but as such regulations usually involvo an cxrjense to the trader, they are, shirked if' you do flot do your pro- per duty. Lastly, thore is the condition of the water ýsupply, which mnay be -foufled by the action of' individuals or coin muni- tics. You require to izeep your oyes openf and hasten to report the possibili- ties of such to your authority as, quick- ]y as possible. With ail these duties disinfection may be more or Iess broughit into action. DEODORIZATION IS NOT DISJNFECTION- REASON, NOT ROUTINE. There is somnething mach more te be thought of than simply pouring a solu- tion of cloride of lime into a sewer, or soluation of green copperas into, a cess- pool, or putting clothes into a hot oven. If the work is to bo done pro- perly it must bo by reasoning out the grounds of tho application, and not by a biind and instinctive obodionce to somo written or verbal order. If dis- infectants are to do their work proper]y",
         "THE CANADA H-EAI JOURNAL. they must be used with a definite ob- jeet and for a definite purposc. WVhat is that objece, and what is that purpose? I recolleot in nxy student days our chemical lecturer, to whom. alone wvas dcputcd the duty of dealing wîth dis- infectants, told us that the usual objeet of sucli was to make s0 mucb stink in the bouse -that you were obliged to open thue windows and ventilate the place for the purpose of getting rid of your agent. Ho thougrht as much good miight bc donc by ventilation without the stinkc as with it, and advised ac- cord ingly. Indeed, in those days, the first and only use of disinfecting agents ivas to ged x'id of nasty smells; and in the eyes and noses of the vulgar and ig,,nor-ant that is stili thought to bo the main duty which inspectors of nui- sances have to I)crform. Lt is, how- evci, the least important part of youi duty. A very powcrflul stink is seldom. of' serions consequence beyond the fact of its being a nuisance. The very nauseousncss of it prevents iL doing nincli har-m. Somne pleasant agents may he useci to destroy smell, to wvhicb I will allude .later on;- but now 1 inay say that dis- infectingr agents, by checking putrefac- Lion, remove -the cause of* tAie smell by preventing the production of the gases upon which the sineil dcpends. These gýases may have their origin in a purcly cheniical action, or in the changes Pro- duced by living creatures, sucb as bac- teria and other kacozy mes, wvhose pro- vince appears to be to break Up) o11ranic nmaýtter into its simplerelements. These bacteria or kaeozymes are most active agentsý in the work; and if yotir disin- fectant is to bc of any use it must des- troy the life or these creatures, and of' tlheperverted protoplasmn i ii wbhich tbeir gernis or eggrs may continue to pre- serve their vitality. TIIE EGOS 0F BACTERIA. Ilcre is tlue great difficulty of correct disinfection. You may destroy tlue bac- teria, you may destroy the living crea- turcs, but they are full of eggs, as a herring May be full of roe; they arc so minute as to, be out of the field of' vision; and if you leave these germs untoucbcd you only postpone to a fu- ture day the mischief whicth is now so manifest. For, unlike the roc, of the herring, they may retain their vîtality in a dormant state for long periods of time. lndeed it has, and does daily happen that the vcry measures you are taking, for the destruction of bacterial life are at the same time preserving thcir ova frona destruction, and wrap- ping them Up in material whieh pre- vents tlucir deeay, so that iii due 'course the disease breaks out again as soon qqs your disinfècting agent isitechne and conditions arise by nicans of vh ich the vitality of the ovat is preserved, and they pass from. a dormant to an active stage, and new forcing bcds are provided for your preserved genms. This is one of tue problemns we have to solve, and it is a difficult nut to crack. For I have seen sucb ova covered by carbolic acid -,vlich bas arrested fur- ther change, and when the carbolic acid ivas pecled off, the pre3erved ova threw off their dormant nature and set to wvorIr again in the production of a newv outbreakc of' disease. NATURE 0F THE INFECTIVE GER31S. Let me sbow you your difficulties in a simple case of small-pox. First, there is your case in its feverisb stage. Lt bas been produccd always by ai germe derived, ait least in historie times, from. some previous one. . . . The genms or living protoplasm in which.this powver to infect resides are excessiveily minute. I amn accustomed",
         "TUE CANADA HBALT11 JOURNAL.19 te regard thenm as simnilar-that is, analogous-to sprouting barley in a inailt-house. If the spreuting barley is takeon out, planted ini pî'oper soi], it will groiv very rapidly; but if it be kept in a dry licat for a short time, as in the kiln, or placed in a dry p)lace, or p)ut in tlue hot sun for a short time, it loses its vitality and will flot fructify. Se the germis of living pretoplasma con- tained in the breath of a fe.verish small- 1)0x patient will take root if imme- diately transplanted to the muceus membrane of a susceptible person; but if floated about in the air for a hundred y-ards they wvill ]ose their vitality and abort, for they cannot bear the influ. ence of exposure te light and air, and cspecially te the action of ozone. Hence isolation and «ventilation es rapidly as possible is necessary for such cases, so that the gresving living gerins con- tained in the breath given off by the patient may be destroyed befere they can have the opp-rtuflity of saving their own lives by infecting some other l)e\"son. The convcyance of such cases through croiwded streets is adding te the danger of those living in the nieigh- bourhood of large snuall-pox hospitals, cspecially if such are situated in crowd. cd districts. In meoving cases, there- fèvre, the grreatest care, iust be taken te prevent the sprend of infèection by such ineans, and the air of the ambu- lance in which, they are moved should be treated in sorne -way by the produc- tion of ozone in the ambulance by ineans of jodine, carbolic acid, creasete, ýsanitas, or some other chemical which is capable Of ÛSSistin)g ina the production of that agent; and 1 should recommend that such patiçnts should, if they could bear it, use a few folds of aniseptie gauze, as a respirator, which bas been soaked with solution of carbolic acid or sanitas, or else employ a layer ef thinly-pressed cotto.7wyool, so that th~e infecting agents cont.-ined in the breath may be retained, and then des- troyed. But the germs multiplying infective disease are net limited te theso Lprouting particles. These are living, growing nt the time of the sep- aration fromn their human host, and cannot live for many seconds in isolated existence, any more than the corpuscles contained iii the human blood can re- tain their vitality under similar trans- fereuce f rom one human body te an- other; but this is net the case with the miatters thrown off during subsequent stages of the disease. It is probable th.at the growing germ is more allied to the vegetable kingdom than te the animal, and that it folloxs a iittiew~ay upen the saine lines ns the alcrIfl or sea- wveeds do, in lakes and seas. The pus- tules of small-pox whichi form. upon thie skin as the disease progresses aeds ters ef seeds 'wbich are net sprouting, which bave a vitality of their own just as the grain of barley bans which is kept in a dry and cool place--retaining xitality under sueh circumnstances for alrnest any number of years, provided. air and organie life is kept away fromn it. It r-nay be carried any distance, and when it meets mvitli its favorite nidus, or manure heap, it develops inte another plant; and se the disease spreads from case te case, froin district to district, and from generation to gen- eratien, wý,,ithout much chance of oui' being able to destroy it utterly out of the land, unless we make everybody unsusceptible of its influence by chang- in\" the character of their moist tissues by nueans of vaccination. It is proba- ble aise that the germs of small-pox, like to those of algal vegetation, coin- sist of two different kinds of spores- the growing and the resting. The growving, like te those ivhich crne fromn 139",
         "140 TE CANADA HEBALTII JOURNAL. the breath ofU~e patient, soon find a new home, or they abort, or die; but the resting spore, if kept as I have describcd, will retain its vitality foi' a very long time. I a saing some years àgo at Oban, in the Western1 Highlan ds, when I -%as informed by a medical gentleman thon resident at that place that he had several cases ofsml-o on thelIsland of Muli wvhic.h were very curious in theli' origin. 'I 1had,' lie said, ' a case of sniall-pox at the sumne place on the south-wcst coast of the Island three years before-sorne distance of course froni Tobermory. The yonng person died, and the friends of the dead per- son left the cottagice. It became untei- anted, and 'went to ruin. The roof' MèI in, and it was fully exposed to the Atlantic gales; but last :aummeri the estate passed into other hands. The ne'v landiord arranged to have some neiw cottages built at the spot formerly occupied by the ruined shanty. A gang of mon were sent from. Tober- rnory to pull down the old plate; they did so, and now seven of thcm have the sniall-pox.' It is supposed that they disturbed an old mattress upon wvhîch the former patient had died, and wvhieh had been loft in the shanty, and in it sorne of the resting spores of the ease had beeîî kept in a state oi dor'- nmant vitality for three years. There wvas no other case in the Island of'Mul , oi- upon the mainland of Scotland any.. wheî'e near to O ban, to the kinowledge of may informant, utt that time. This case was a most interesting one to me, and I placed it, on' record in the Pro- ceedings of the Royal Commission on Infections ilospitals, upon which I had the privilege of sitt.ing as a mem«ber. In detailiing this case to you, 1 arn auxious to impress upon you the neces- sity for destroyiflg ail those matters in wvhich sncb resting spores may be, hid- don, so that you, may flot be unwit. tingly the means of creating an out- break of infections diseuse even aftcr- yon may have retired from the sceuic ,)f your labouirs. THREE KINDS 0F DISEASE GER31S. I wish to împress upon your minds that, in cases of' small-pox, and from analogy, 1 'would i3ay that in ail cascs of infections disease, more or less, you have t.1îee kinds of disense germs to deal with; that the destruction of the one does not necessar-ily involve the dèstruction of the othor; that ventila- tion wvill probably bc sufficient to re- move the incidence of the evil which follows from the breathi of a single patient; 5ut that if you mnltiply these, and bring some hundreds togother, you wîll do wvhat in another way we aire doing with regard to London f'ogs- the smoke o? a great numbor of chim- neys 15 intensifying an ovii which is very smail with one chimney; or as is happening when one small sewer loses into al large rive-the, sew%,age is soon oxidised; but if many go in, after a tume oxidation is no longer possible, and the vitality of the disease gorms may be preserved for much longcer- periods, to the imminent d-anger of the neighbourhood in which such an) aggrrregation takes place; for sewagce in wvater, smoke-fog in the air, or -the excessive uggregation o? disease gernis takce up ail the available oxygen, or -%vhatover else it *may be which. causes the chemical action, and the chaÙge we wish to, promote cannot take place. Besides the growing gerni there airc the spores just ready to 1iatch, and wvhich will, and even must, hatch just as th~e spores o? algoe witl develop if they are allowed the opportunity.* If this 18 not afforded, the vitrullty o? thc germ 15 soon destroyed, and thero 140",
         "TRIE CJANADA HEALTH JOURNAL.14 would bc an end of' the race if it %vere not for the resting spores in which vitality is existing but 'ii whieh il. 18 dormant. The conditions whiclî be- long to potato-rot seemn to belong to those disoase germs which attackc the human frame, and certainly are parts of their bchuaviour in small-pox and diphtheria. Analogy also gives us the right to assumne that similar characters attach. more or less to, all infectious diseases. In some the tendency is strongest in one direction, as in the case of small- pox, in which the spores hatcbcd in the inucuous membrane of the air-passages -ire the moist virulent; whilst in others these are ail but nil, the znost danger- ous class being the spores from the alimentr.ry canal, discharged with the extreta, and wbich require some kind of foecal. fermentation to, brîng about their dangerous activity, as in the case of the exereta of a typhoid feyer p)atient. In others the greatest danger is from those wbich are thrown out by the skin, as with scarlatina germs, and se on. They ail vary in their stages of activity, but are ail mouided on the samne linos, and if thore is failure to recognise this fàculty there is danger that your efforts to stamp eut the disease rnay not bcecntireiy successful. Ventilation alone is flot enougbh, as sinali-p.ox too frequently tells us. Dis- infect.nnts ivhich arres t fermentation only act as such for a time-that is, until the disinfectants are themnseIves ,ehemnicaliy altered. They do not de- stroy the resting spore, tbeugb they may destroy or stop the production of sinell by destroying the living growing bacteria upon which the production of smell depends. Yen miust go further and go deeper than that, and sco that ne resting spore remai-ns, or 4It least that thera is no seed-bed or foreingt-box in wvhîch such spores might, bc hattlied .and brought into ac.tivity, se that the diseuse may not again be propigated in sonie, future time more or less distant. THE TIIREE DISTINCT OPEItATIONS. You wvill gather fronxi these observa- tions that no process of' disinfection wvill bc complete, which does flot pro- vide for three distinct operations. lst. Ventilation both nt the begtin- ning and at the end of 3-our work, and wvhichi is for the purpose of oxidising living, growing disease protoplasmn-a mater'al to which sunlight, fresh air and motion are conipletely antagonistie introduce, these as a matter of' course wherevor disoase is or bas beau pre- valent. 2nd. Destruction of bactoriai and fungal lifo, upon which the chemical changes producad by ferments depend. Thasa living craturas cannot incrase and multiply unless tbay have food to assist themn iu growing. Youi have, therefore, two things to, do:- first, to destroy the living creatures thenisalves, and thon by usingr up the pabulum up, on wvbich they grow, or remnoving it to soma less dangerous naighbourhood, where it may be changad to a moré satisiactory and beneficial purpose. There is, tharefore, in this second part, the destruction of parasitical. life, wbich i .nvolves a knowladge of tha natural history of~ the creatures we propose to destroy, for they have ways of tbeir own: some, cannot live -without ut- mnospheric air, and others cannot exist if free oxygen is prasent. Each kind requires a diffèrent traatment for satis- factory remnovai. 3rd. You have to destroy the resting spore upon which tha future production of the diseuse may depend. Somne years ago I cngagad myseif in studying the' effects of petato blight, and 1 found that boiling for a short time did net 141",
         "TRE HAAAIEALTII JOURNAL. destroy the resting spore-thut the haulrns of the diseused plantxnight bc plunged into boiiing water, kept there for some minutes, and thon alloived to rot, yet if tbat material was (lried 11p unci then made up into powder, and, ii the follow;ig year thrown bu'oadcast over a p\u003elot of potatoes, at ta fuvourable Limne the disease would develop itseif in the new hlirs, and apparently in con- seqiuence of the growth of' the resting spores wvhich remained in the rotten but dried powder of the old hlîrs, provided it huad been kzept out of the reuqch of sunlight during the preceding senson. This experiment tuught me muchi of the habits of such diseuses as srnull-pox and diphitheria. I learat that it wauý rot enoughi to rernove srnell anti to disinfeet the miorbid matter, but thut you must destroy the resting spores by some agent which could alter' their constituent parts. You might destroy thxe growing germ, you might destroy the hatchect or sprouting seed; but if you did flot also dostroy the unhatchcd ovum, or the undeveloped seed, you (lic flot prevent the recuri'ence of the disease. We have the analogy afforded by natural history before us, displaying numerous instances in which inseets and other living organisrns exist in many different formns, ail tendeng to corne round sooner or later to the sanie point again. I concludo frora resuits that the loxver forins of life are more multifor-m than even the better known classes of ýinsects. The- there is another way of looking at it. If wve examine a few specinieps of cell.life, such as the protoplasrn, wvhich goes to forr nervo-cell, or muscle-celi; or the ceilular tissue of any other organ, they are utterly undis- tinguishable to our finite powers in their eàrlier developrnent. It is pro- bable that many kinds of discase germs are positively sirnilLr as to forni aIs fair as we can sc, and yot are 'capable of' developing distinct diseases. It ; s ffls certain that a carefuil study doos reveal certain dlifferences, so that the expert is able to diflérentiate the (liplitheria icro-orgranismi frora that which sets up anthrax, or, frora that which pro- (laces the chickzen choiera. It niay be that some of the forras rnay be easily capable of' destruction at one tirne and not at another, because they are pass- ing tlrougrh a different kind of change. and are thon f\\ülly able to resist the action of the agent whieh is supposed to'be capable of acting as a germicide, so, that now and agrain the vaunted agrent fhils and groes out of favour. If you iae to deal sti-cessfuliy with the eradic ation of diseuse gerras ont of the land you rnust kcnow something of their life-history, unci the pertinacity with which they resist the influences of' chemical I'e-ugents and'other disinfeet- ing powvers, wvhich are sometimes thouht to bebeyond douht. This fact will explain to you why your chioride acid bas not prevented the recurrence of' disease, why ventilation lias not been enough; and, in the minds of some sanitarians, nothing remained to be done but to destroy the offending niatter by fire. Suchi is the conclasion which many sanitarians have corne to; but it is iiot a satisfactory one. It seems to me to be wickied 'vaste to destroy a commodity which may be valuable if it be transf'erred to its pr'o- per place. VEGETATION AS A DISINFECTANT. There is a means by ivhic.h s'icurity aguainst evi i consequences is provided viz. the powerful nid of vegetation. The vegetable kingdoma bas beeni placed on the earth to, colinternet the influence of animal life by taking the daily poison of CO ont of the air; the stomata, or",
         "THE CANADA HEALTII JOURNAL. l)reatbing pores, wvhich are so, abundant uipon every green loaf, havîng to, per- form tliis duty. The spongioles of a large portion of the rootiets of the G-ramiinace\u0026Ž. ait Ieast, and probably of other fiamilles besides, are able to ap- l)l'01riate the living organie matter inp- on wvhich the spread of infective discase niay clepend; to fix. the inaterial in its own tissue in a foi-i which makes it valuiable, instead of being, as is too often thought by untbinkiflg people, injurioîî, to min. If suci be washed INway z1nd conveyed to agricultural land, i hre is an end of its infeetive power, es certainly as there is anl end of the irfective power of the living g'erms wvhichi escape from, a feverish siliall-pox patient if they be exposed to sunlight and fresh air for two or tbi'ee minutes, provided the germs or resting spores are themnselves byought into contact with the spongioles of the crop. But, whilst urging this view, I am. not antagonistie to the necessity for de- stroying all the living growing gerîns of the first and second class as quickly as possible, so ns to prevent the arrest in transit, whieh may arise in any sewer, in any place, either by accident or design. We see, therefore, what wve have to do. We have to cleanse the air by acrial disinfection. We have to destroy living germs in excreta or fomites, and to rernove resting spores from places in which they niay continue to, rest until somaepower raises tlem from a dormant state into active existence. \\Ve have, therefbre, aeriai disintection for the (lestruetion of the most active forms; ive have germicides for the destruction of living germs. Lastly, wve have to, consider the best means of dealing wvith the rcsting spores, foi-, to, my mind, very few of the most vaunted disinfectants aie able to touch thern. ABRIAL DISINFECTION. The first pltice is to, bb given to, ven. tilation and sunlight. It is probable that even the resting spore cannot resist the influence of sunlighit if it be continuons l'or a sufficient length of tirne, espccially if the air itself bc fr'ee fIrom excess of carbonie acid ; I have an idea, that the vitality of the disease germi is most pronouinced in anl atmlos- pliere Nvhich contains more than four parts of CO, in ton tlîousand of ordi- nary atmospheric air. One of the ad- vantages wvhich arises from. lime.whit- ing, is the :reduction to a minimum of CO, from the air of the chaniber whichi is s0 tr 'eited; and it is probable that, this reduction is more effectuai than is the action of the lime itself upon the organie inatter wvith which it comes in contact. I need not describe to you in detail the method of' producing ehlorine or suiph urous acid, or tic measures -vhirch are to be taken if you use cither of thiose aerial disinfectants, except to, observe that if they are used at7 ail it must be an adequate use; that the ehambers treated by those, gases must be filled with an air quite irrespirable, and completely closed up for at least t-welve hours, Nvhilst at the samne time you must be careful to, avoid suffocat- ing any of the neigibors by escapes of your gas through cracks and chinks in floor or ceiling. This accident might happen very easily in thickly inhabited districts or blocks of houses. It would be rather awkward to be convicted of manslaughter because you failed to, recognise the possibility of such a result. One great advantage of aerial. disinfection of the kind named is the destruction of inseet life wvhich is also, effected by it in some kinds of habita- tion, and the fact thut the gases do, if suffcient are used for the purpose, get",
         "THE CANADA. IEALTIL JOURNAL. into tho chinks aind crevices inhabited by inseet life and into which nothing elso wili I)enetrate. Sincb a plan of treatment is always the most advan- tageous in small-pox, diphtberia, and scarlet foyer. It is pro bably un necs- sary iu any other kind of disease. But acrial disinfection alone is nover onougli; the pl1ace rnust be wvell lime- Whited after the walls have been scrap- cd, and the scrapings should be at once put into a fui-iince, and flot into the dust-bin; and it wouid be advantago- ous if the floor of the infected rooms could be afterwards washed over with a solution of bichioride of mercur. It is a rather dangerous means to use unlesa the greatest judgmnent and dcx- terity are empioyed; but carbolie acid is dangerous, and chioride of zinc is a fatal agent sometimes ;whilst xneither are anything, like so effectuai. as the use of a solution of corrosive sublimate. Pt8 greatest objection is its ox-,pense. Lt is the only known disinfectant whieh without any previous moistening des. troys thelOmost persistent micrococci in a fe'v minutes by means of a higbly dilute solution. It is rapid in its action; a solution of one part in 5,000 of water Nvili a in one quarter of a hour destroy cvery living thing or gcrm, dormant or otherwise, with which it cornes into contact. This statement bas been thoroughly proved by actual experi- ment on living organisms. The cracks in a floor shouid be always so treated in rooîrns in wvhich small-pox patients have resided. But the floor must be wvell wvashed before the mcrcuric chioride is used; otherwise so much more of the rongent wvill be nccessary to overcome the reaction înduced by the presence of albumen or of suiphu- retted hydrogon, both of which render the corrosive sublimate inert. I do not rcommend the use of mercurie chioride in any other cases, or any other places, because of its highly poisonous nature Chiorine gwas is not of much use ex- cept in the presence of rueisture. but it is easily obtaincd. The roornis re- quire to be stcauied wcll when chienine is uscd. iloorus must bc saturated with it; it should bc contînued for some heurs, and then the place well ventilat- cd. But the chiorine bas not touchied the dormant germs, though every other thing objectionable bas been destroyed wvbich depended upen oxygen for its power to lîve. Such also is the resuit with sulpburous acid. The vapers are easil$r diffuscd, but without othle menus tbey are flot sufficient. The other means being anterior to the use of the gases, -viz., scraping down and burnîng the scrapcd matter in the fire; freely lime- whiting after the gas bas been nsed, and treating the floor witb corrosive sublimnate solution if the case bas 'been one of smail-pox, scarlatina or diph- theria. Some other agents are some- times used, such as nitrons acid, bro- mine, and iodine ; but their use is ex- pensive, and more difficuit than either chiorine or So,, and it is flot necessary that 1 shouid doer*àie their action. THE BEDDING ETC., AND STEAM. But there are the contents of the house-the furniture and the bangings, the carpets,the bedding, and theclotb- ing. What 15 to 'be donc with these? The heavy ivooden furniture necd flot be removed from. the room; the bedstead sbould be treated in a manner siriila,.r to that recommended for the floor, if it bas been slept upon by a smpail-pox patient. The carpets and hangings may be exposeci te the sun- light if there should be a chance of obtaining it for some consccutivc time. If not, steam heat or hot air in a po per hot-air chamber should be uscd. The use of steam is sul)erior to, al",
         "THE CANADA flEALTH JOURNAL.15 other moins; it is ver3' !apid in its action aind ponotrating in its effects. Compiete disintbetion is obtained in a short spaceo f time, ivhilst the larger part of ordinary wvearing apparci is not damagcd by the plooe.ss. The ex- I)elimorlts of Dr. Koch, as carried on under the strictest linos, are niy sup- porters of this view; and 1 have no (toubt that this is the form wvhich dis- infèction by heat wvill obtain in the fu- ture. Hot-air apparatus is complicated and expensive if it he effectuai, espe- cially if the objeots are carpets or hiangings. Exposure to a current o? steam nt the fuit boiiing, point of 212' is certain, is simple, and is rapid, and involves very littie injury to the arti- oies which are in ordinary use; but the thinge so acted upon must be dry to be- gin witb. Those tbings which have been contamninated. with filtb, especially excreta-such as vomit or foeos-and which are not worth much, should be destroyed by fire, whilst metailic arti- cles should be covered with some greasy coating, or with vaseline, before ex- posure to the steam. The use of chiorine, as is sometinies recommended, is not satisfactory, even if it does nlot destroy the articles ex- posed to its influence; but the majority of articles of ciothir'g are irretrievably damaged by its action, so that it can only be used ivith indestructible mna- terial. It is possible tbat some genms, such as those producing potato-rot, may es- cape the action o? steam, retaining their vitality in spite o? a boat of 212%. I do not think ýthat this wiIl apply to those germs which spread in the blood o? human beinge. It does apply to some whioh may be called cold-blooded, or wbicb attack vegetable life; but the germs which produce smali-pox, dipb- theria, scarlatina, and some others, as nnth ra x, chicken choici a, etc., i e coin- pletely dostroyed by a 'steam heat of 2120; so that it is not nocessary to ap- l1Y it under pressure, or to raise tho temperature to 30O*, as lias been ro- cc, -inendod. I uadviso ail local authorities to pro- vide thernselves with a disinfecting ap. paratuls Nvhieb wvill enlable them to apply steam heat, as w'ithout it they cannot compioetely J)erform the work wvhich the law requires them, to do. I have said nothing, about carbolic acid. I wviil now explain rny reasons for omit- tîng it from the list. It will at once strike you that if the contagion parti- cles are particulate-that is, if they have a material existence-they can only be destroyed by actual contact with the disinfeoting agent, and that if one germi escapes from such contact the x'egeneration of the malady is possible. It is found by experiment that tbe quantity of vapour of carbolie aoid. must be very considerable indeed to ef- feet this contact with certainty. It has appeared to me that the effedt of car- bolie acid is to arrest oxidation, to stay the process of fermentation, to even take the life of growing germs, to, des- troy some krind of living, moving bac- teria, but to have no effeot. nt ail on unhatched or dormant spores. It is only uiseful, therefbre, in those cases in wbich the first olass of spores may be operative; it assists to, hasten the de- struction of the living germs which are given off by l'everish patients, but that is ail. This. fact was fully im- pressed upon niy mind nearly thirty year3 ago. . It is advantageous to keep an atmos- phere which is loaded with carbolie vapour, or the vapour of Sanitas or others of the same kind, in the Passages Ieading to the room in which a small- pox or scarlatina patient may be isù- 145",
         "TuB.ýý (ANADAYHIEALTII1 JOURNAL. lated. It will bcavînaeu that the roomn itself should reek ;vith stuwli va- pour. and by tliat ineans assist to arrest the imme(liate sprOli( of' mischief. But 'vhilst it does that, 4and even destroys the growing seed, it l)resve3s the dot'- niant gerni froni deeay. Yon wvill see,' therofore, that to trust to carbolic -Icid as a mens for dest.roying the progess of infectious disease is to, trust to a brokien reed. Sp)ores have been kzept for weekzs in a five per* cent, solution of carboIised oit, and have tiien been fobund capable of VIgrs gr111 (Ilowthi whenl transpiated to :L favourable soi]. The samne î'esult lias follo'ved Mieni they have been storcd in alcohiol. The use of spirituous liquors as a protec- tion -igainst the evils of impure water is no protection at ail, and the scofi' at total abstainers, thiat thiey risk their hiealtl by using water instead of' alcohol and water. is basi.ed upon aî fiction, Dot a fact. The sanie arguments app'Y to sonie oxtent to suiphmnrous acid ; thoughi in a minor degree, thiere is an hettion following the application of this gas by w~hich the cheniical composition of albumiinoid niatter is more certainly chan,, d. Oxygen is absorhed froin the gerim as well as froni the air, and the ro'vth of the gerni is to some extent inipaircd ; but So., is irre- spirable, 'xhilst an active quantity of carbolic acid niîay be borne ,vithout i nj uly.. IIOTBEDS-\" FORCING PITS.\" I thinkz I inay no'v leave the troait nient of infectious discases, so far as they corne ivithin your cognisance, and pass on to the forcing pits in whichi they find their most active develop- ment-viz., the filth collection of lIunian congrogation. Your duties have reference to the removal of these, and to their active disinfection, as well as to that connected witlh the cases of' actual disease, It lias been thongrht, that diseaso germis would lose their vitality if suspended iii w'ater; but anthrnax spores have been kopt iii solu- tion lbr niontîts a-id have not beexi destroyed. If' they airc in miotion, if* they ai-e enconrag-iced to grow-, and if wvlilst ,0 rowing they corne iii con- tact wit.1 oxygen just eseapîn)ilg froin its combîîîation witli carbon, as occurls nii thîs tlisengagenient by the vegretable lin-,dorn, tiiere is deatlî to the sp)ore; bat the3' may not grow-they rnay be laidl andi preserved. Thie niost certain death* is that wvhich arises froin its being broughit into ininiediate inter- cour.se witli the spongioles of plant life. .asl do'vn, and lot tAie spore find its way to the selvago fitrmn, and thore is ,inendt of*your trouble, provided the farmier is made to grow so nîany tons of produce for so nîany tons of sewage. But it is not always possible to 'vash away the evil; and as sewers are at pî'eson t constructed-viz., as a - stand- ing disgrao V h constructing engineer-whilst they are sewvors of deposit only, -%hilst they are flot mucli botter thun elongated cess- pools, and flot self.clearising sowers iii which deposît shal 'not takie place, it seems to be absolutely necessary that disease germs should. ho destroyed before thoy find their way into the sewers at al. Ronce al exeta from. infeetious cases should be disinfected before they enter the sewers. The best disinfeetant fbr this purpose is the sulPhate of iron-green copperas, as it is soniotimes called. it is tiseless stuggesting re-agents wbichi ia too expensive, fbr the purpose. Suîphate 0f iron is cheap, and it is effectual provided sufficient is used. Next to that ive have chîloride of lime, in wluich the deoelopment of chlorine",
         "THIE CANADA REALTU JOURNAL. ks brouglit about by decomposition of the st.,4 or of' carbolato o? lime, and various powdors which te, bo etfectui nîUSt be used very freely. Thoe quantitios wvhich are ordinarily used arc utterly insuifficient to ef1èct~ the object wvo have in vie'v. They are only pre- tences, and might just, as Weil bo oînitted froni the progu nIe altogethier. Thoso articles as app lied reniove .S11c0l1 and se utd te, comfort - they aiec deodorisers;- but flot as ordinarily used are they germnicides in any strict sense of the case... To pounds of sulphatc of iron shouki be dissolved ia nine gCallons of'%-ater, and Portions ef this thoreughly miixcd with the exeretu, aind thon the wvhole wvashed awi y ;andi if they be solid they should bc eovered vvitli at least onc-sixth the weight of carbolate or chiorido eof lime, and then wuashed away with abundance of w'ater ; but if in antherity uses cepperas in ent, street and chioride of lime in an- other they wvil be blewing hot and cold, and destroying some of their beneficial wvork befbre it is conîpleted, fer the chienine wili destroy the bene- ficial action of the iron in the sewageo whien they mix tegether. Iafected ditches should ho well wvashed eut with the iron solution, sewers should bo well lushed with cur-bolate or chioride o? lime !i suffieient quatitity te entirely fill its calibre for- many yards ef its course, se, that the invert ef the archi nîuy be washed w'ith strong solutions as ivc11 as the fleer o? the sower. 1 trust that I have said enough te show the main basis upon which disin- feedion should bc carried out. Tie peints are- 1. Ventilation. 2. Acrial disinfection by So., or chIenine, and stean. 3. Lime-whiting. 4. Washing floors and furniture with solution cf mercuric chlonîde (or- Corrosive subIinlate). 5. Steam lieut for clotliing, furni. ture,\u0026c 6. Sulphate o? ir-on or cidnide ef lime (for flushing) 7. The wonderful agency of vege. table lifé. If these meuns are effeetually ap- plied, infective diseases wvould be cern- lltoly banished frein our midst, and any local authority whicb, allows o? their continuance is doing dofective wvork.' It is difficuit, of-course, te, meot disease at ail points; but very much may be done by persuasion and exanipi e. SUMMARY OF THE .REQUIREMENTS 0F TH1E JAIRLES,- SHIEDS, ASND -MILKSHOPS ORDERS OF 1 S85 A-ND 1887, IN SCOTLAND. M B.G. A1. D.M~ackay, Sanitary La. Isl)ector, Paisley, Scotland, gives the fol lowving in the Sntry~ora 1. Evcry cowkeeper, dairyrnan, or purveyor o? nmilkc within the district o? the Local Authority must ho regristercd as such. 2. Every Local1 Authority must Izeep aogister, which is te ho rorised froni tune te time. 3. T-4ho Local Authority must regis- ter every applicant, irrespective of thç% ete o? ]lis p)romises. Buit this does net in oay wvay preclude thc local Authority from, institutiagr procedingrs a-gai nst the persün registered for an'y non-cornpliance %vith, or violation of, the provisions o? thue Order. Two classes are exenipted from regis- tration-viz., (1) Tho:s-e vhose business 00%V-",
         "THE CANADA HEALTH JOURNAL. is restricted to the rnaking and sellingr of butter or cheese; and (p) thob-e who soli milkc of their own cows in small quantities to their wvorkmien or neigh- bours for their accomnmodation. 4. The Local Authoriiy is from time. to time requircd to -ive jml;lic 72otiC( that regristration is imperative. 5. Evory person who wishes to begin to occupy any building as a dairy or cowshied miust first give onc miontki's no- tice, ini writing,, to the Local Authority of bis intention, and ho must make, pro- vision to the satisfaction of the Local Autbority for the lirhting, ventilation (including air space), cleansîng, drain- age, and water supply of the building, before it is ocenpied as such. 6. The lighting, ventilation (includ- ing air space), cleansing, drainage and water supply of ail dairies and 00w- sheds are required to be such as are necessary or proper for :-(a) The health and good condition of the cattle therein; (b\u003e tbe cleanliness of milk ves- sels used therein for containing niilk for sale, and (c) the protection of the milk therein against infection or con- tamination. 7. No one who, is suflèning from a dangerous infectious disorder, or -who bas recently been in contact with a person so suffering, is allowcd to inilk cows or to handle milk vessels, or to, take part in any way in the production, storage, or distribution of milk, until aIl danger front such disease bas ceased. S. If any water-closet., earth-closet, privy, cesspool, or urinal, Le within, communicate directly w'ith, or ventilate into any dairy, or any i-oom used as a milk store or milk shop, it shall not be lawful for any ono to occupy such dairy, room, store, or shop, after the receipt of notice of not less than one month from time Local Authority calling the attention of the occupier thereto. 9. No milkc store or milkz sbop can be used as a sleeping apartmient, or fbr aiiy purpose incompatible witli the îproi\u003eer preservation of the clean 1 mes thereof, and of the xnillc vessels and the mnill tiierein, or in any nanner likely to cause contamination of the milkz thcrein. 10. Swvine are not to bc kiept in any cowhed, mnilk store, or other place u!sed for the keeping of niilk for sale. Il. The Local Authority nuty froni time to tirne makze regulations for the. following pur-poses :-(a) The inspec- tion of cattie in dainies; (b) prescrib- ing, and regrulating the lighting, venti- lation, cleansing, drainage, and svater supply of d\u0026iries and cowsheds; (c) securing the eleanliness of milk stores, milk shops, and of mnilk vessels; (d\u003e prescribing l)reautions to be taken by purveyors of milk agaiinst infection or contamination of nilkz. Suci .Regulations must Le published by advcrtisement in a newsp2per cir- culating, in the district of the Local Autlmority, and a copy thereof must be sent to, the Board of Supervision flot less than one month befbre the date narned therein for the sarne to, corne into force. Tbe Board are exnpowered to revokie any reguhation whichi tbey deern to, be of too restrictive a charac- ter or otherwise objectionable. 13. The nilik of a diseased cow is not to Le rnixed with other milk, or sold or used for human food; but it may be used for the food of swino or other aDimals after it bas been boiled. The penalties to be imposed are not to exceed £5 for ench offence, and they may Le sued for 8ummarily under the Sumairy Jurisdiction Acts of 1864 and 1881.",
         "THE CANADA ILEALTH JOURNAL. SUMMER CARE 0F 1NFANTS. T JàE warm. weat1îer of summer, with its relaxing effects upofl the human body, and the rapid development of al sorts of diseuse germs, frein, the de- composition of organic inatter, te, which the wvarmth gives risc, is found te, be especially fatal te, infantile life; and this especialîy in cities where there is usually muc*h the larger pro: p)ortion ef orgranie exeremental Matter undergoing decompositien. Therc aie many points te consider in endeavoars to, prevent disease in the yeutig, and outranking everything else, are the air wvhieh the chuld must breathe -ind the fbod whieh it must consumne. As M~arion Harland, a %vell known wvriter on the care of' infants very sensibly ivrites, ,At this season, if ever, the mother miust resist the dis- position te fatalismn. Recognizing liie a brave, sensible woman, that suanmer is fraught ivith peculiar perils, ]et ber acquaint berseif wvith, the nature of them. and station her guards. Do flot change the child's food so, long as bis present dietary agrees îvith and nourishes hian. One of*Mr. Lineoln's homely saîvs, advising against a horse trade while crossing a creekc, is sbarply pertinent bere. Gireen fruit bas siain its thousands, but the ilerodian murderer of babes frein two years 01(1 and under 18 the niother's -iicarious hankering after variety in the nursery bill of faire. When you wvean your cbild seek eut one reahly excellent kind of food, and, baving established the fact tbat it rjuits bimn better than any other, cleave unto it while he relishes and thrives upon it, remnaining proof against temptations te depart from it until the ugly creek o? the second summer has bcen forded. The milk that enters into tbe composition of porridge, or whatever may iake up his miodest n, ýnu, must i\u003ee sweet and fresh; the cercal %vith which it i8 com.- bined the bebt of its kind and the mixture never be, ovter:5veetened. Eschew experiments ais you would Iabeled poison. Do not let him drink iced rnilk or ice water and avoid the other extreme. CoId checks diteLion and really hot drinks bave a tendency to, weaken the boîvels. Keep whvle. some respect for the \"intestinal changes\" before your eyes- and do not interfèe with them. Finally should baby ianguis.h in spite of wise regrimen, cive hini. immediate change of air.\" It is flot so much the \"1changce of~ air,\" se, often -spolzen of,. as it is \"purer air.\" If in the city take the child te, the country. If this is impos- sible, takce it eut even to, the suburbs-- eut as mueh as possible, to the parks and open spaces, away as far as vou can frein the deosely peopled part' of the toîvn. Take iLeut daily; ail day, if possible; even camp eut, with it ait night. Lookw~ell te the clothing. \"Make ebanges-notablylui flan nels-cautious- ]y. A woolen garnient, covering the chcst and abdomen, should be wvern next the skin ail summer leng, ait least until the child bas conipleted bis second yoar. It need flot be heavy or thick. .Exchange that wern in.winter for one of moderato iveigb,,t, and, ait the heat increases, this for one stili thinneir2' Keep the skin clear and active by a dauly bath 'with cuoi, but not tee cold water, witb gentie friction after it. And do not aliowv the young child to get over heated. Frequent sips of cold, not iced, pure water meet itifants like in warrn 1.49 j P' C; , 4 'i \u003eWt A~t",
         "150 TE CA1NADA HEALTH JOURNAL. wveather, and they are of immense value iii cooling, thc stomp h and bow'els, cleansiig them and cheeking fermentations. A few teaspoonfuls of' pure cold water often repeated is like -in inward bath, ft-cqtiently mucb nccded. TEETJ11NG TIllE. Ithe teething time cornes during the summer,ý it makes it much lardei on ehe, ljttle one; although, ail other things being equal, the teething child as a rule wvill suifer more in cold than in warm weatber. The following re- marks are from, Dr. Johinson's littie work on children teetbing:- D)entition is a hcalthy and natural process, and in a 'uealthy ehild is eifected %vithout trouble or suifering of any kind. The appearance of teeth is a necessary consequenc of growth, iand it is inconceivable that nature should attach pain and suifering to, this simple organic act. One Cannot underistand -%hy the cutting of a tooth should be more, painful thar. the growth of a foot or a finger. And we find, on rs-flection, tt nature is by no means guilty of this inconsistency or in3astice. To the folly. anid excesses of inan are due the suffering so, firequent. ]y attending infant dentition. Children suiTer because they inhcrit froni their parents diseased [rames, or because they are reared in disobedience to the laws of hiealth. Children wvho have been nurtured upon imnprlpe*r food, or in an unwholesome atrnos- phere, or who hav'e been dosed ivitli calomel and gray powder, are certain to, experience, a difficuit, dentition. On the other hand, the clIdren of Nature, as the ofl'spring of the jNorth American Indians, wilI pass through this ordeal witbout Cause for complaint. Denti- tion is commonly :more severe in winter than in summer. It is more severe in the City than in the Country, and the badly nourished cliiîdren of the poor pass throughi it witli more pain than do the well.nourished children of the ricli. The treatment, should be mostly preventive. Freslh air, not medicine, is needed. If the child*lives in the City it should be taken to the parks or squares very rnuch of the time, when the weather 1)ermits. The rooms in whic-h it lives should be so well ventilated as to be always supplied with as pure air as possible. Pure food is equally essential. The habit of stuffingr a child with fbod, salted and sea-soned, is almost sure to, derange the w'hole digestive canal, :tnd tbroughi this medium so affect the child's health as to make teething a serions afihir. If not wveaned. and the mother's or nurse's mnilk is abundant and good, this should constitute ils sole food. if cov's miikz is uscd, care should bc takien to sec that the cow is healthy and properly icd. If the child is weancd, bread and xnillk. good pot.atoes, boiled rne. oat- mcal gruel or barley gruel and a little ripe fr-uit ivili aIl be excellent. Fed regularly, but not ofîener than once in four hours, wiîli pure air and whole- some food, equal, circulation and a pro- per distribution of the nervous energies are insured. The bowels must be free, not by physic, but by the right food, and, if necessary, an injection. Con. stipated chuldren always suifer more from tcething than those whose bowels are free. 150",
         "THE CANADA HEALTU JOURNAL. MISCELLANEOUS N~OTES AND SELECTIONS. SMMRx'~~ DisEASES.-The advent of summer says the Amcericaît Iancet, brings to the front a special class of diseases. In somne wvay these are re- lated to hieat. This in some cases aets directly upon the organisrn, produeing a clasa of aflfections kinown as hient diseases, sura-stroke, etc. In varying degrrees it is possible that this cause is more commion tlîan iS generally suI)- posed. But the beat of summer is in- directly the means of causing niany diseases, as choiera infantum, choiera, mnorbus, diarrhoea, dysentry, etc. This is due to the influence of lient in p)romoting, decomposition, eithor by actingr to break uI) organicecoml)ouinds, or by causing. the infinito, inulti.ulic- tion of the organic germs whiich i nduco sncb;I decomposition. The wvays by whieh the human body may be damaged Or* destroyed through the activities of this agent are siînply infinite. Great light lias of bite yeurs been cast upon this snbject, but'stili our knowlodge romains very mieas.r. We alro:îdy have outiinod the antiseptie treatnment of sunimer diarroea. More or Iess the idea of preventi ns paitreficti ro- cesses enters iargeiy ino our i(lens of' tic management of nmany kinds of* ca.-ses. It is along this lino that lies tUecniost hopeful siudy of suminr diseases. TESV, FOR ARSENIC IN ]PAPERRANG- IYGs.-A feiw months ao0 we gave, fýrià. the Brtis,1Adical Journal, what 'vas said te be reliable tests for arsenic ini papers. Wni. Woollans \u0026 Co. (paperstainers) have since written te that journal for publication the followv- ing: Having made the subject of .arsenic iin paperhangings a matter of close study for many years, %vc read with grent interest the description of the test devihsed by Mr. G;renstted, as published in the I3.itishb 3Medical Journal of Saturday, IDeceruber lltli. %Vc hioped sonie roug\"h, ready, and r-eliabie test for arsenic had been at last dis- covered, but in the resuit ive wore dis- appointcd. The method proposed wvould answor in most cases whoe \"considera,-blo quantitieq\" of arsenic are present, so fitr as Tests 1 and 2 are concerned ; but there are stili a large nuînber of papers made and coloured with arsenical pigments whieh would exhibit no recognisable i eactiens of the kind described; and there are mnany others highly lirseIÀical, but fi-ce frorn copl)er, which wouid yield no sueli re- actions as those described as --Tests 3 aînd 4.\" 0f the Ibirmei-, the red and the liit coloured papers enclosed are examples, while sampie A, B anÂd C (eontaining arsenic) are quite froc fircm, copper, the bine C being highly arsen icai. AN EXPERIENCE Of over a qua«rter' o? a cen tur3' in tho nmanuf.-ctu-e of non- arsenîcal papers, and a knoiedge of' many miethods, botli enipirical and scientiflo, of ,,seritaiiniiig the prescuce, or -%viiit is sometinmes nmore difficuit, determining the absence o? arsenic in a suspectod paper or other fabric., cmi- bolden us [ Vooi1ans \u0026t Co., I)iIIer- stainers] te zisk your permission to p)oint ont te your miedical renders that it wvould be -essentially in~jidicious, where the health o? a patient is aut stakie, for any of* them te rely uI)of any test, such as that nowv retbrrod to, te determine the absýence o? zirbenic; and thant the only %vay in which sucia a conclusion can be safely arrivcd ut, is to, submuit a sampte, of the paper to a competent analytical authority fbr careful examination. A superflcial, or",
         "TIIE CANADA HEALTH JOURNAL. even an exhaustive examination of the visible paper is oftcn deeeptive, since it is frequently found that a pcrfectly harmless paper is hune over an old arsenical one, and where it is suspected that illness arises from, Ürsenical poisoning, the medical adviser should not bc content %vith anything Iess thian a saniple of the piaper or papers strip- ped off clean to the plaster. This can generally be donc without disfiguring the roomn by taking it lrom behiind the bcd or somo other he-avy piece of furni- ture. %Ve liave seeu as many as twelve coats stripped off in one mass, of -%vhieh perhars haif would be arsenical. THE first Anierican contribution to niiedical literature 'vas \"A 13rief' Rule to Guide the Conimon People in SmaII- pox and Measels, 1374,\" by the Rev. Thonmas Tliacher, first minister at the old South Churceh in Boston. Su says Dr. Francis Bacon, in \"Sorne Accouint of' the Medical Profession in NLew Ha,.ven.\" Tu E CHEMICAL COMP IOSITION OF 31Aa.-Frorn a elhemic-al point of viewv, says Le Pîcicticicu, man is com- ])osed of thirteen elemnents, of wvhieh live are [ordinar-ily] gases and eight are soîids.. If w'e consider the cheni ical composition of a main of the average ,%vight of 154 pounds, 've will find that hoe is composed iii large part of o.cygen, which is in a suite of extreme coin- pr1ession~. In fact, a main weighing 154 poutids con tains n inety-seve n ])ounds of oxygen, 'the volume of ivhich, nt ordinary temporatuire, would exceed 980 cubie feet. The ltydrogeb is mucb less in quantity, tbere being less thari fifteen pounds, but which, in a free state, would occupy a volume of 2800 eubie feet. The three otber gases are nutrogen, neariy four pounds; cidorine, about twenty-six ounces, and 7?oîurikc, tbree and a quarter ounces. 0f tho solids, carbon stands at the head of the mctalloids, there being forty- eight pounds. Nextcornes pao spltorius, twenty-six ounces, and sulphur, three and a quarter ounces. The most abundaht metal is calcium, more than three pounds; next potassiium, twvo and a haif ounces; sodium, two and a quar-ter ounces; and, last«Sy, iron, one and a quarter ounces. Lt is neediessa to say that the varions combinations madle by these thirteen elements are alniost innumnerable. TiaE COMPULSORY SANITATION OF HorrsEs.-According to the Lon don Tizes, INIr. Dixon)-Har-tlanâ's bill pro- po.sing a nev Sanitary Board for London, now before .Parliament, provides, in effeet, for the corn- l)ulsory sanîtary in-pection and re- gistration of ail buildings of wvhateveî- natuire. The metropolis is, accordiing to the schenie, to bo divided into seventy districts, each of '%vhiehi is to be \"-under the control\" or~ a sanitary surveyor. On giving a 'veeki's notice this officer and his assistants-the pre- sent sanitary inspectors-may enter a buildingr and inspeet adi sanitary ap- pliances, fittings, and drains; and should hie find the building not in a sanitary condition lie ivili point out the defeets, and require thern to be amnended within three months. But should the building be f'ound to be in a .sanitary condition the surveyor will, if desired, certify tbis for a fee of a guinea. And without such a cerfificate no house is in future te be lot. Ap- parently, bowever, the certificate would be valid fur this purpose for as mauy as six years. A further provision is, that no sanitary work is te be cern- menced until the plans have been ap- proved by the surveyor; nor le any drainage work to be covered up pntil it has been examined, testcd, and",
         "THE CANADA BALTH1 JOURNAL. passcd by hlm. Aýs to new buildings none are to ho beglun until complote plans of the drainage have been de- posited -%vith the sanitary surveyor of the district. These plans, and aiso copies of sanitary certificates, are to be accessible to the public nt his offee on payment of a Ibo ofone shilling. HOME LIFE AND LoNiGEVITY.-The influnonce of the donîestic circle is mnost potent for good in ait that mnakes life ývorth the living. This is wvell portr.ayed by a wvriter lu tho Philadel- 1)hia Timnes who says : .1ban CoLlft u l my flugers more than a score .of mon, brilli,-nt wvriters and earnest wvorkers, wbo, died ail too ,soon. Erratie as many of them were-wayward even some of themn-they were alniost with- ont exception mcn of deep sympathies and tender friendships. Bobemians in fuiet as Wveil as in naine, their lives be- came a saerifi*ee not to dissipation, as the world'is apt to, suppose, but to the homelessness thaît is inherent in Bohe- mnianistn. These young men, over wvhose graves 1 stood, one after the other, as the ycars roiled by, should be living 8tili, in the prime et'fllfe and enjoying the bealth and happiness of a vigorous manhood. The world bas lost of its best ln Iosing themn. They are dcad, flot because th(\u003e world wSîs careless of their taleints, not because the ternpter'8 wreathed and flowing bowl alured them. Death sought them ont and came to, tbem ail too early because for them tbcre were no hearthstones-because their lexicons of youth were robbed of the 'worcts home, love, 8isterly syrnp4tby, mother- ly tendernesand care. OXtGUrN.ATjcD Wi\u0026mm6-Dr. Willian 8ays, .The Brin freres -ofParia.have bought o\u0026aa hL3oe6for pro- quartiauestronttatncgihere. *Thçy have mado available to ail Europe an oxygouated watcr wvhicli' bids fair to eclipbse, in good resuits and popularity, evory table wvater in tho market. It lias received the qualified sanction of the Frenchli cientists anîd doctors, and it is cIaimed that it is a certain pro- tection fiom cholera, d iphtheri, dysentery and ail infections and zymotic diseases. It also relieveq gout, rheumatism, and dyspepsia«,, as Weil as various kidney diseuse.s. A patent bas receutly been ibsued in this country for a \"1coînpound oxygen\" wvater which, ks said to be even botter than the Freneh preparation. Roence we shall soon bo enablcd to renew our' youth without leaving oui' own soil! Strangest and pcrhazps niost important of ail,? it is said to miaterially diminish the appetite for aleoholîc stimulants. If the clainis set up for it aire one-haif truc, the race ought to be on the ove of a benefit beside wbich ail ordinary blessing will seem trivial enomgh. A NEWFACTQR IN ATHLETISM- WONDERS OP OXYGEN.-Dr. Willian, Of New York, writes in the .4Annals of Ily.iene on some wonderful effeets of Oxygen :Given, any two athietes, with ail conditions essçutiaiy the same, except that one shali be thus scienti- ficaiiy and thoroughly oxygen-fortfi.îed, the other not, the one thus prepared;is as sure to win in the conteet before them, no matter what its *nature, whether wrestling, rowing, batting, running or .swimnming, whetber in.the .field or on the loram,.as the morroW'a eun to sbine. J4t is easy.to compus practical tet. lAt the skptic apply to.sonme on.e of -the now njnu deglers .who advertiso vpte o.ýj\u0026n gas, for mediciînaI p.urpcwqý,\" ,oari.win fin3ou~cd: s orqe toýo p.uM, iand",
         "THE CANADA HEALTII JOURNAL. normal ability to hold bis briatb, then proced to inhale the gas, properly diluted, for the space of~ flîteen or twenty minutes. While thus per- meated, or so to speak, saturated, with oygen, let hirn agrain test his augmien- ted ability in the samne direction. If the test bo thirly miade hie will find that in this induced state of~ super- oxygenation hie cani abstain from, breathing, or hold the breatb, three times as long as lie could do prior to its use. In tbe direction of scjentifie research wve are far behind the East. In France, Pasteur has demonstrated that the hog choiera and sonie other forais of grerm, diseases are possible only wben thore is a lack of oxygçn (anierobîsni). The treatment of' slough- ing ulcers bas undergone a revolution. Poisoning by opium, belladonna and other deadly narcotics, is beitig success- fully met by the free use of the gas; the drowned are resuscitated; choiera and epîdemie dysentery arle combatted; and Russian physicians assert that hydrophobia itself, otherwise admitted- ly incurable, bas been made to yield to this searching antidote. CONTAoIouJSNESS OF CoN-SU3PuION AND CLIMATE.-M1edical Inspector A. A. Hoehling's r~eport upon the Flag-ship Pensacola, Nlediterranean Statien, states (in Santitariaii) that \"Among the native poor of M1adeira consutrption is on the increase. This is attributed to, the use of the cast-of clotbing of patients wbo corne bore to die, and to the mode of living of the natives. \"1As the bacillus of tubercle requires a high tniperature, for culti. vation in the laboratory-at least 9Oo\u003e- niay ùot a continuously warm cliniate favôr its liability at IMadeira, where it ils beinig added'to almost daily by fresh importations. The spreading of the disease imong the natives,- and the fact that the climate does not beem to arrest the diseaso in patients wbo corne frorn abroad, wem to furnish sonie grounds for an affirmative answer. If this bypothesis is ever proven it ivili give us good reason for sending con sumptives to a cold climate, Jike Min- nesota affords, wliere the bacillus is flot favored with a high ten-perature to increcase and multiply. Experience ai- ready appears to furnish good argu- ments to sustain this viewv aiso, for patients who are flot toc. far advanced do better in Minnesota than in Madeira and like climates. 0f course the ad- vanced stages of the disease do badly everywhere, and suifer less in a mild climiate; so for euthaï)«.sia wo may continue to recommend the latter.\" AGAINST WET.NURSINO AGAIN.-The N. 1. MIedical Times says that, in a paper read before the New York Academy of Medicine, (in Med. Rec.) Dr. Winters argues with rnuch clear- ness and force, that every attempt to depart from maternaI suckling, even wvhen a hired breast is resorted te, in- crosses infant mortality. His conclud- ing paragraphs are as follows: The lives of nine-tentbs of the wet-nursed eildren are ptirchaÈod at the expensc of the lives of other children. The practice, thorefore, of placing childreuî to dry-nurse, oither in familles or in institutions, in order that thé mother may go as wet-nurse, is iniquitous. It is mef ccusable and indefensible under atny c lcunstances. It is the deliberate starvation of one child tbat another may live. It is lamentable that a system, s0 pernicious and -injurions to the best interests of society- sbould ho tolerated, and-even en couraged., by the most eminent and honorable members o£ -the medical profession. Briefly, thon, we usually select a bireling* to perform, the mother's, most saéred.",
         "THE CAN\\ADA HEALTIU JOURNAL. duty; one wvho ecupies the lowest place in the social scale, and iii whom there is an abscence of the moral quali. ties. SoeM of the most sueessful and popular patent nostrums, says Good Healt\u0026, are, upon analysis, found to be wholly inort, except as they are made potent by an attractive naine or reputed efficîency. A recent analysis of ene of the most popular of Russian patent niedicines, to which most remarkable virtues bave been ascribed, showed the only constituent te be water from the river Nova. AN elaborate system of experiments, says the N. Y. Medicat lines, lias established the fact tînt no mulk below 10929 specifie gravity cati corne from cows in a state of health. Any mulk which falis below this standard is eitherdiluted orunhealtby, or~ is the pradnct of cows in an advauced state of pregnancy, in which condition the milk is unfit for luman consumption. INî A SIKETCHI contributed te the .New York .Jkdicat Journai by Dr. Wylie. on the life and works of the late Dr. J. Mai-ion Sims, many interesting facts and inci- dents are given. Rie was traly master of bimseIl Vices fie bail none, net evon of the smallest kind. The animai in him was completely under centrel. ie habits and lis appetites were al- ways guuded by bis reason. I have known him day after day and month after mentb, rise at seven, take a simple breakfast, consisting of a glass of milk andl Soutbern bominy, bread and butter, andl semetimes an egg. At eight enter bis carrnage, and niako a -few morning cails on severe cases. At nine .return te lis office and see patients tilI one or one-tbirty,. and take-.a;8imple. lunch..of steak, potatees,. etc. At.two enter bis cal Tige, \"ViS'it patients, eperate, etc., retutrning home usuallyabout five or six, write lottors, and at seven take a plain dinner of one kcind of meat and vegetables. Rie nover took wine, nor coffee, nor ton, nor condiments of any kind. At the table ho NVas usually taikative and playful, talking about the topies of the day and the thentre, of wvhich he was very fond. Al ter dinner lie usually wrote letters and did liglit work, reading jcurnals, etc., or passed hIs time with lis family or friends in the drawing.room. About nine-thirty lie wvuld usually go te lis bed-room, where he rend or wrote, sometimes ly- ing in bed, until midnight, when he wvould retire for the night. It was always marvelous te see bim s0 con- tinuously and per8istent.ly intent upon his work. Ho lad a habit of writing down ideas 2t night, by means of a pamphlet, the edge being placed on paper so as to guide his pencil without a liglit. When one was familiar with bis capacity for endurance, lis pow.'Ir of concentration, lis un bounded enthu- siasni, bis deliberate, persistent, pains. taking work, backed up by lis unseif- isbness and undaunted moral courage,. it was not surprising te witness his success. Ris mette as a boy was: \"Duty bef'ore pleasure.\" Later in life lie needed ne mette; it bail bocome a habit for bim te do what lie thouglit was riglit. Difficulties, obstacles and trouble were as nothing to him when once lie had made up his mind to act. Rie went direetly at a thing, and ho kept atit untilit was mastered. IL was this great painstaking and persistent work that made tbings se clear andl so definite to him, andl enabled hiai te express lislideas go lucidly. It was al1.go this power that developed: lis self- reliiiice and ]bis moral courage, and made«his inistrumnents and bis mtid of o eratingsu nearly perfect.*",
         "56THE CA.NADA ILEALTH JOURNAL. Dr. W. O. Dawvson, i1» Knozv- ledge, lias discuisscd the siibject of diet in relation to, aga with a good deal of' skill, and Mr. De Lacy Rvans, as Nwell as otheî' writers, in re- cent i nvee tigations, havo established some very initeiîesting and valu.ablefaeits. It appeirs that the Principal character- istic ofold tige is a (leposition offibrous, gelatinous and carthy deposits in the systeni. The s3lov bat steady deposi tion of calcareous inatter throughout the system is the change which pro- duCes old age, seen in the l'ailure of the beart's action, the stiffened lirnbs, im- paired digestion, and wasting mentai and physical powvers. The calcareous deposits, in the heart, and arteries, capls- ing partial ossification of the heart valves and arterial tissue, impede the circulation, and by shutting off the supply of blood necessary to, nutrition, produce mental and physical starvation and senile decay. The fibrinous and gelatinous accumulations of old age, the former being an oxîde of albumen, and the latter an oxide of fibrine, de- posited by the blood in the blood vessels and tissues, lessening the calibre of the vessels and diminisbing their Btrength, leading to induration, are, it sooms, cbiefly traceable, to the chemical action of atmospberic oiygen. GOOD IHEALTH gives the following on tea: Theine, the toxie principle of the common beverage, tea, is'not less than two hundred tines more powerfal as a poison than is alcohol; 'that is, a few grains 6f theine will produce as deadly éffèts as two, hundréed times as munch alcohol. A stron'g cup of tea'has more int4ô:iicatink\"properties in ite than an equal quantity of'beer. Éôft4'ithàttind- ingk the «poéet êeuo ' \"ýthe cup that chersad nt iet*ate.'~iLn EDg- limb 'Writér téils ôf a ýirt f ïiÔùn newopàpêr \"correspodénta Who mieet regular]y on Saturdny night4, and hava a reula slroeon ea.Somo of thiei are genorally found uinder the table in the niorning. The London Lancct tolls ot a yonng lady who recently suffered with de\u003c.lirium tr-emens froni chewinrý, tea leaves. llowv nîuehl more evidet.c is needed to convince our skceptical, tea-loving friendÀ. \"MAN AN[) HIts SIIOES,\" a1S given in rhynie belowv, is wvorth passing arouind. WVe get it from Technics: Eow niucl a mian is like bis shoes! For instance, bath a souil may lose; Both hiave been tanned; both are mnade tiglit By eobblers, both get le! t and right. Botli need a mnate ta be coniplete; And both are miade to go on feet. They bath need hîeeling; oit are 8old, Atid bathi ini tiine wvill turn to znould. WVitli shoce die Iast is first ; with me» The first shail be the hast; and when The shoes wvear ont they're niended new; Wlîen men wear out they're men dead toa f They both are tread upon, and botii IVill tread on others, notliing loth. Bath have their ties, and both incline, When polished, in the world to @hine; And both peg out. Now, would you ehoose, To be a mnan or be his slîoes ? MICROBES IN WA\u0026TCE.-In an article from Zeitschrqet fü~r llygieine (in Sani- tarq Record), on the conditions of the existence of the dîfferent kînds of bacteria in. drinking water, is the. fol- lowing. Microbes are found in every kind of waters, iu the water from pnmps, from artesian wells, in spring water, \u0026c. After having draiwna con- -siderable quantity of waterifrom. a'welI, a perceptible decrease of bacteria may be observed. This diminutibu jo5tifies ýtii conclusion -that -the. eubterranean water which-feods -thewelle-is up-to a -certain distance -froc of -bcteria,- and -tut the. layers of aoil-frÔiùýwhich-the water4 p ttbIates :ir~iripr 'alppciït'this vie'w. 'the \u003eprîéÙical con- 156",
         "T1UE CANADA B.EALTII JOURNAL.15 clusions arrivcd at from these facts are:. in order that the wvater of a well may contain the lcast possible quantity of bacteria, the walls of the wve11 must be of absolutely inipermeable inaterial; the well ought to be fol by deep suLb- soul water, and be continually and rcgularly use(I. IN the same article it is stated: ln recaptulating, the resuits of his invest- igattionsP, Bolton arrives at the follow- ing practical conclusions: The infec- tion of drinking-watcr by pathogenous bacteria originates more frequen tly during its percolation tbrough the deeper strata and in 3ubsoil water than from and at the Surface of the grotind. The bacteria do not infest and render dangerous the well for a long perîod, as they themselves perish afier a few weeks. The spores of longer vitality can be eliminated by continuons empty- ing of the wells The chemîcal, condi- tion of the water possessses no ether importance than that of raisiog suspi- cion of the presence of pathogenous bacteria. The determination of' the kind of bacterium is of higher import- ance in bacteriological. analysis than the enumeration of the total quantity of bacteria contained ini the -vater under examination. The bacteriological in- vestigation of ivater submitted to aualysis ought te be made immediately on account of the probable increaseband the ultimate destruction 'of the baeteria. A vERY bail and serions habit, which .aýppears te bc sprcading, is arsenic eat- ing by yonng wonten. The attention of the New Yurk B3oard of HlealtIi bas repeatedly been called to the promiscu- ous use'by young ivemen of arsenic wafers. Dr. J. T. Nagle recently x'e- ccived a letter frorn a lady in Ha! lem, Who. writes, My daughters for some time past have been eating arsenic wafers. I understand that tliousands of women are cating those' wvafers, and that as many more are rcsorting to other less expenisive although more powerfal poisons. This practice is not unknewn in Canada, and a loud note of warning should be sounded by the press. NOSTRU31 VENDORS Will have a hard tinie in Russia. A Est of patent medicines, drawn up it appears bjy a committce of physicians, the import- ation of which the Ilussian Government, lias decided to prohibit, has recently been published. It consista of about cigbt hundred preparations of English, American, French and German origin. Pilla, plasters, hair resterers, cough drops, medicated foods, eintments, and many niiscellaneous preparations for a great variety of ailments, are ail clas- sed together in one \"llong, medical index expurgaterius.\" A OREAT number of micro-organismb inhabit the mouth in the normal state ; a still greater number may be found there accidentally intreduced eithier by the fond or by the inhaled air, and froni want of cleanlineas. M. \"lignai (.1rch. de Plu.ys) fbnnd in the buccal coating and in the dental tartar eighteen differ- cnt species et micro-oirganisms, and from these be succeded in isolating seventeen. Hence the importatnce of cleaning the mouth ib obvions. IT is claimed that the popular drink ef the future, says the NJ Y. .Mdical Tines, wvill bc milk charged vvith car- bonic acid. It is said that millk tlhus carbonated will keep an indefinite lengtb, of time. DR. MARY WALKER earnestly reom.- mends that measures be taken to in- duce people. te leave money when they die te go into a fund for the suppres- Sion of the use of tebacco. 157",
         "THIE PUBLIC H1EALTH FOR MAY. MORTUARY RETURNS FROM THE TWENTY-SIX CANADIAN CITIES AND 'rOWVNS. IN the death rate in May in the twen- ty.six principal cities and towns making monthly returns to the De- partnient of Agriculture in Ottawa, thiere was a slight declino as compareat with April. This fiait in thec mortality in May is usual in this climate, and is usually followed by a rise in June or JnIy. The total 'number of deaths recordcd for the month in the twenty- six cities and tow'ns, coniprising an assurned population o? 680,000, -vas 1,323, the number in A1,ril being 1,377. This shows a mortality of about 24 per 1,000 for the month-oit 1 per 1,000 lower than in April. Wliilc ini nearly ail other cities the niortality was below the total average of 24 per 1,000, in Montreul, Quebec and Hlll it was considcrably abovo the averatge. In the total mortality from zymotie dîseases there was a slight decline dur- ing the month; although in Montreal, Toronto and Quebec there was an increase in this class. Meses, which caused 32 deatha in the twenty-six centres in April, caused only 14 in May. Only one death was recordcd from, scarlet fever. Erom diphtheria there were 80 deaths-an increase from 75 in April. 0f these 80 deaths, 32 were in Mon- treal, 21 in Toronto and 12 in Quebec -making in these three eitip.s 65 of the total of 80 deaths fi n this cause. From diarrhoeal, disenses and fevei's the niortality' in May was about the samie as in April, wbile from rheuma- tisim there was an increase. From, local diseases there wvas a mnarkied decline in the mortaility, wvhilo frorn consti tutional and developinental (liseases there wvas an increase. Withal there ivas but littie notable change in the public health in Mlay as compared with April. Il' iS said that the~ raw onion briiised and applied to the recent wound is «t sp)cCific in the bite o? venomous ser- pents and for the sting of becs, etc. THE Michigcan State Board o? 1{ealth says the A111ais of flygicne bas under- talzen un important saniti.iy enterprise, which is noth;ng bass than a house-to- bouse inspection of cvery city and in- corporated village in the Stute. The work will be earried on througb the local boards acting jointly with the State orgra nization, and the results ivili be compiled and published in a single report. The mnagnitude o? this under- taking and the vital importance o? its purposes are such as must niake its successful conipletion a highly valuable contribution to sanitary science. THREE GREAT PHYSIcIANS.-If you require any medicines, says the Collee of Salern, let chcm. be these three, which are always at hand: \"A bright and peaceful mind, a plain diet., and moderato exorcise.\" Dumoulin also, held the same opinion. This celebra- ted physician in bis last hours, being surrounded by niany physicians o? Paris, who deplored bis3 approaching end, said to them: \"Gentleman, I leave behind me threegreatphiysicians.\"' Eacb one in attendance, believing him- self to be one o? the tbree urged Dumoulin to name them, whereupon lie repliod. \"WaYter, Exercise, and diet.Ir -Jour. D'Ely.qiene.",
         "TRE CANADA EEBALTII JOUR~NAL. :5 'im, l'aa isîc 2ýu 4~. . . . I.,, c..t Zý .1 cq pui a §ipHdo - -1 - X~C\u003eO neO.Iq saquas JUDr Ju o!n l e ; - . Z'4 CC \u0026n.\" *Ci *.-ý :* v .,........... p, fld2ÇjqT~ C\u003ceiag . I H0 el. .S4;vap jo I jaqtuflu pjoJl 1 ' 1~~ PR o *0. 159",
         "160 TE CANAJ3A H1EALTJI JOURNAL WHERE TO GO AND STAY. THE ST. LÂWREDNCE AND) THE SA70UENAY. Wliither shall the weary fiee? 'ras asked in the Mlay nuniber of the JOURNAL. Hundreds of our Canadian readers and friends wmll within the next month or two seek rest and recreation, and change frdm the daily routine of work and worry which s0 largely makze up the life of too, many. For a large number in Western Ontarjo, a trip down the St. Lawrence to the Sagu- enay and Up thîs wild and rugged river would afford a most delightful change and recreation-literally, a re-creation, in mental clearnesa and physical vigour. There is flot probabiy ini the world a route presenting soi many attractions to the tourist or excursionist and affording at the same time such comfortable, indeed, luxurious accommodations, as this one, from the head of Lake Ontario, down the, gt. Lawrence te Tadousac and thence up to Ha!1 Ha!1 Bay, 60 miles up the Saguenay. l he trip, to and fro, is almost equal toa \" sea voyage\" as te time, and although net affording the pure sea air, this te many is more than compensated for by the con- stant anid delightful changes of scenery, te say nothing of the freedom, from the turmoil and sickness s0 common on the ocean. To most people it proves to be a far nicer and more pleasing trip than one on the Northeru Lakes. The Thousand Islands, the many*\"rapids,\" writh the in- numerable other points of natural interest, especially below Quebec, the rnany cities and tewns and handsome villa résidences, with the far famed Victoria Bridge, make this trip, for the majority of recreation seekers, the most desirabie and charming on this continent. On the luxurious boats of the Richelieu and Ontario Navigation Coin- pany-the -Royal Mail Line,\" and only daily one, the tourist finds every accom- modation which anyone van desire ;-the best of wholesome, substantial. food aud most coinfortable beds. Anyone taking this trip should endeavoui% to remain for a turne at one or other of the \"1sea side\" resorts, such as -Murray Bay or Tadousac. Altogether too this is comparatively an in- expensive trip. THE season at the ever popular \"1health resort,\" the Caledonia Springs, is now, fully opened. Thiis is largely visited by those seeking rest and recreation or teno- vation as well as by rheumatics and dyspeptics. The liotel accommodations are hardly second to any on the continent. The waters for drinking and bathing are probably equal to ar.y in America or eveu in Europe, as virtually proved indeed by the niany who hav'e experienced the bene- fitsofthesesprings. The Springs are easy of access, by way of either Ottawa or lion- treal, by the Ottawa river boats, the Emapress and Prince of Wales, wliich afford every accommodation and coinfort that anyone could desire, and are under excellent management. The Queens Royal Hotel, at Niagara-on- the-lake, at the mouth of the Niagara River, about ten miles from the fails, is a branch of the \"Queens,\" Toronto, and bas the reputation of being a very attractive summer resort. There are Tennis and Croquet Lawns, as well as good fishing, bathing and boating. It ia situated in a private park and is a most refined home- lihe family hotel. ORDINý,ANCES 0F\"TEE CANADA HEALTH JOURNAL Pure Air: The complete destruction of ail waste organie matter, by fire or other- -wise ; no collections any where of bodily excrement-perfect sewerage or daily dis- infection or deodorization with frequent reinoval; through ventilation of aIl build- ings, public and private; complete isola- tion and disinfection in ail cases of in- fections disease. Pure Water: Strict prohibition of the pollution of ail inland wvaters-rivera, lakes, streanis-by sewage or other waste sub- stances; thorougli filtration of ail public water supplies; closing of suspected ivelIs. Pure Wholesome Food: Prompt and severe punishment of aIl adulterators of food, with frequent and repcated analyses; thorougli inspection of foods-meat, ailk, flour, bread, fruits, \u0026c., with punishment of ail offeringimpure or bad food; improved methods of preparation and cooking food. Education cf the Public in all Matters Pertaining to Healtb. . 160",
         "Canada T-ealth Jollrnacl. A ilONV7IL Y XA G'.-ZINE 0P PREVENTIVE MEDICINE. THRTENTE YEAR of Publocation,...................NINTR VOLUME. Spee-iall% deeigla'd for anedical and mter healta Ofi. cers, lctaor fatuilies andti1 aIl Iateran4ti l in rol otilig thte pubiea liealthi. l'ie only llaqaith Joura:al anIlite En)gtula langatage litibli4hed in Canada. lraut Aixs.. -Toà lr. vent si.liaaess and proinote public aud Iladividual lanaltil. Commuannic.ations solaclted on all sanlt-try snibjects. Loc l hemltit olficers would confer a fiuvor iay sendlng to the EttIitor copies of their repoirt.a. briet notices of their sanitary condition, improvemteutts, or eveuts lu any way conuecteti with bealtt. See Club Rates to Healtia Boardls and others on ativer tlslng page. Ail communicatins, wlth remaittances or othierwise, ahoulti bit addruaed, Il teaith jourrnal,\"Ottawa, cari. A blie croc,% oltî.o.iit tlhts inic Ies titat te qnltç(ritler ta wvlaoin it is atltree.-wil le iatdé.lbt.d for ihis weacr's suit- .crtjition \u003cfrot Jt. t4. 11cr ), antd aoh sothi cilI confer favor iay kiiully reaaitting, foi- wlaielt we.-ilahl feel obliged. '\u003cle antit ttlertke to ttttake oatit lieouats andi Senti tîtetu ly mailu or otiterwi-;t ant iiiy cag lil Ail tant rvanitting ulaarisig thte eanlr liant of Ilit year- thet tiret taantt or two-ttat exîmeet t0 p:ay $2.00 -,we altttt itastst tait titis lin cotatatloi fotiresi l'hyaatciatts liay S3.00 for tîteir Maturail Journtal, coaatsiaittig ato tatore rvaating niatter thian titis ne. $1.50 now ta wortla tatre to us f han $0-00 tnany tatontila heiiee, witla cost oft itie, btills and postage. WiiI ail friends plea-se thir.k of titis, anti bell. us lu the work by an early reatittance. An3vzRTiIau.çs of unexceptinnable ciaaracter taken to a litaiteti extent and at reasonable raies . advealis- mente of\" patent melicines.\" flot acceate-Âl. EDITORS' SPECIAL CORNER. O.n the temperance question we are very desirous of flot being misunderstood. We have bestowed a good deal of thouglit and some study upon the effeets and value of alcoholie beverages, and aise, on the other band, upon the effeets and alleged benefits of prohibition. An esteemed friend sonie monthe ago placed in our bands a number of copies of the Médical Teinperance Joutrnal, of London, England, ini which are the strongest arguments against the value of alcohol- as a food, yet we still think the weight of evidence is decidedlY in favour of this substance possetisiîîg valuable food properties, and that it is a valuable natural product for which no other substance can welI be substîtuted. As regards prohibition, if it could be suc- cessfully sustained, in order to break ulp the intemperate habits, inherited or acquired, of a large number of our fellow creatures weho cannot use alcolîolic bever- ages in safe moderation, wve should certain- ly be disposed to vote for prohibition ; but being convinced tîtat; it cannot be success- fully cax-ried out, and that these unfor- tunate beinga whose powers of self-control in relation te alcohiol are se defective thtat they will break alniost any law, divine or huinan, ini order te obtain their wouted stimulant, or a worse one, and cannot be restrained by Act of Parliamient, but must have aremedy that will penetrate to greater depths, and as laws flot fully approved ot and sustained by almost thîeentire body cf the people concerned, ivili be incessantly broken and are worse than ne law, we cannot conscientiously support the measure as heretofore proposed. We would favour prohibition in the manufac- ture and sale, for other than mechanical and medicinal purposes, of ardent spirits, and encourage the substitution cf Canadian wines and beer. And we would favour great changes in the retail traffic in ail alcohelie beverages -.-impose a heavy license, make strict laws in relation to seil- ing te minors and habituai arunkards, with, heavy penalties, and easy facilities for sustaining actions for damages, in case of infraction of the law, and grant; ienses only te persuns of good moral standing, who liad neyer transgressed the law. These measures, with religious, moral, mental and physical culture te strengthien the powers cf self-control, Nvould do much- indeed aIl than can be done, te proinote the cause temperance. THE, valuable contribution on disinfec- tien in this nuniber «cf the JouRNÀL, by. Dr. Alfred Carpenter, one of the nîost emincuat cf English sanitarians, should be read, by every one who tak-es an interest in the preventien cf disease. It contains a great deal that must prove cf interest te others besides physicians and health officers. A WVR.PPERt should be ready te, put on the body in cold summer evenigs; asum-* mer chili after the heat is sometîmes fol- lowed ;'y serions consequences.",
         "TRE CANAOA HEALTIL JOURNAL TuE REPORTS 0F TIIE LOCAL BOARDS 0F In thie animual reports for last year of the Local Boards of Heaitlî iii Ontario, pub-. iislied by the Provincial Board, theré are inany useful luixts and .sug-estions, wvhich '«ve purpose giving- froiii tinie to tinie for the beziefit of other hieaith 1boards and health officers. Dr. Tracy, I.efdical Healtlî Ollicer of Belleville, states thiat. -duî-ing October I Ixeard tîxat a case of sinailpox occurred in Trenton. 1 at onice wrote to the -Medicai Heaitli Oirier at Treziito4i for particulars and askiîug liiiî w~hat precautions wvere takien. He wvrote nie thiat one% case, thiat of a, child. liad broken uut, ami that it hiad beeîu reuucved to the island, togetiier wvitiu its uîuotlier aîud ail tiiose wvho liad been in contact witli it. I w\u003c)uId suiggest that the Council place a sinall sumn to tic credit of the Board te uxeet aîîy case cf tiîis kind. Proniptniess iii dealing wîti the first case wouid be the ineans of saving tiicusaînds of dollars to the city.\"* This last is a iost useful suggestion and shouid be univcrsailv acted uipon. -A great deal is lest by liialt bodies not being pre- pared for the isolation of first cases. A piîysiciaiî no% ini this city. a memnber of panliainent froin an eastern province, lias just informed us of the difficulties lie laboured under and tue ioss sustained in tie village in which lie practices, frein there beiug no provision of this kind on an outbreak of sunailpox in the village iast year. During the session of the House lastyear. Dr. Jeiukins. MN. P. from Char- iettetowîii. P. E. I., aiso toid us of like difficulties experieîîced, iii that city ini the early part of last year. Tiiere, a very severe epidenuic de.stroved nuauuy lites: al- thoiig Nvlien tiiey were once or- ganized and prepared for it tluey. quickiy stauped out tue outbreak, as wve have before noted- Dr. Griffin, M1edicai Healtli Officer of Brantford, -%vrites tlîat, several tinues dtuing the year tiiere liad been outbreaks of ineasies. scarlet fever and dipflitheria in that city, but their extension lie thought l'had been in a good degree prevented by the rigid measures to exelude from the public schoois aIl chldren coming fromi any lieuse\" containing a case of infections disease until ail danger hiad passed. The nuîuuber of deathis frein typuoid fever, Dr. Griffin 'rites, to date, '«as four exclusive cf any that lîad occurred outside, cf the city iinits. He \"'regrets lîowever, thiat tîjis conveys ne idea cf the amount cf sickness frein tliat disease, '«hidi lias been unusually large since about the mîiddle cf Auguist.\" In the John H. Stratford Hospital alene tliere lîad heeîî tweîîty-five cases during the tlîree Iast înontlîs, and tiiere were then ten cases tiiere eut cf a total cf 27 cases iii the luespital. The uîwortaiity liad been low. altiiougli the sickxîess rate wvas iîiglî. Thîe cause of tluis state cf tlîings we refer te elsewliere. Tiq report states tlîat tlîe dairies, nearly ail situated in the tow«nship, were ail -visited and tiîorougiîly examined by tue Sanitary Inspecter, and full reports entered iiian l Inspection bock. -~The imnpor- tance cf nîilk inspection is mucli greater in thc 'vinter menths than in tIc sunîner ; aiîd it is intendcd te enforce the iaw witu great strictncss, net cnly as te tIe adulter- ation cf niilk, but as te the unclcaness cf the byres, unhealtiîiness cf the cattie, and as te the use cf putrescent and other im- proper fcods, and cf impure watcr.\" A great nuany buildings liad been erected during the ycar, in ncarly ail cf which the dry eartiîsystcnu Iiad been adopted. It had aise been further extcndcd in the public sdhools, connected witiî which it is intend- cd next year, te, abclisi the lust cf the oid closets whicli reinain.\" -A sert cf ccss-pocl had cxisted at the neat nuankét, the only tree exit fer the foui gases cf wlîicli -%vas inte the meat stalis. Thîis pit witiî its drain wvas abulislied and dry earth introduoed. lThe violent opposition made te, this most dangercus nuisance,\" tiuedoctorsays, \",4well illustrates the dcsirability of a ivider diffusion cf knowledge on sanitary nuatters.\" Dr. Keating, 'Medicai Officer cf Guelphu, states that, \"For pronuoting the cleanliness and hcalth cf the city, as weil as for the great ccnveniece and comfcrt cf ail, one cf the niost urgent needs at present is an efficient nucans for the frequent removal of garbage.... .The disposai of garbage in every '«cil reguiated hcusehold is a matter",
         "TUIE CANADA IL1EALTH JOURNAL. 6 of no simili importance. From the in- spector's rep)ort, I note with pleasure that the laudable practice of burning ail solid kitchen refuse is being carried eut bv niany. The reiuoval of objectionabie inatter front the yards or outbuildings wvas enforced in ail cases.\" The Medical Heaitlî Oficer of Kingston, Dr. Fee, states tlîat, in that; city dry earth eiosets hiad been instituted in many places, especially in sinall yards. 6,000 feet of sewvers and drains liad been erected during the year. Dr. Fee writes that, \"thie ini- petus given by sanitar7y reforin lias been utarked iii our city by the steady and con- stant attenîtion paid by individuais to keeping tijeir places ciean. The nuînber of cellars cieaned out, the inn wells (eml)tied, reîîîedeiled anîd put iii better con- dition tiîan tlîey have been for niany years Il go to prove tlîat by constant at- tention to matters of cieanliness, etc., iii the course cf a short tinie tue people vill be educated in sucli a mnîner tiiat wve shall not have te w-ait until an epideinic appears ameongst us te cause our citizens te awake to the n-cee-sity cf a strict observance of the laws relating te ijeaiti.\", In London, Dr. Hutchinson, Medical Healtli Officer, states that, ' inuch lias been \u003clone te improve the condition cf the city. .Many unheaithy places have been visited by the Sanitary Inspecter and inyself , and inany nuisances abated. Foui wells have been cieaned or filied up, and city water is graduaily taking the place of impure wvell- water .... .Tle Board lias now under con- sideratien the subject of divising ineans for the disposai of sewage, eitlîer by a process of destruction by chenîicals or fil- tering. Severai cities in tlîe United States and one in Canada, have adopted the latter process, and use the Hyatt; Filter, miade in Newa-k, New Jersey. This filter se far lias answered the purpose wvell;-two or tliree of these filters put down at tue inter- section cf the trunk uines, would be suffi- cient; for the city.\" In Chatiham, Dr. Ruthierford, Medical Officer, states, there were reported during the year ninety-three cases cf con- tagious diseases by the town physicians, 'wlie report %viffingly and clîeerfully te tlîe Inspecter direct.\" The Docter in lus report, urges, at considerable length, the desirability of the town proyiding fora pure public water supply. He concludes as fol- 1owvs: \"I 1 Tenture te, say that, -%ithout burdening the people beyond tlieir ability and villingness, the saine could be muade seif-sustaîining, and the -people would be l\u003eenefited at the expense cf sickness, deatli and tlîe doctors, and w-ould have ail the iinnunity from contagious diseases thuat sucli a systein cf good and pure 'vater sup)p)y couid alone give them,. Just tlîink of 200 tons of extreta and sewage, -%vortli $'e30 per tont, if uised for fertiiizing purposes, being allon-ed te percolate tue porous soil cf Cliathai every year, te containinate our welis and our prescrit drinking water supph-.\" Dit. Sylvester, Medical Healtli Officer cf Gait, iii lus report, reg-rets4 tiîat the tow-vn is net in a position te adopt systerus cf water works and dra inaige, and urges the ,_ouncil te î)rovide a liospital for infectious diseases in order te be prepared in case cf an outbreak cf an epidenic. Vaccination hiad beeîî very general during the previous year. Dr. Burrovs. -Medical, He-althi Officer of Lindsay, in a iengtliy and interesting re- port, regrets, as înany do, that the Public Heaitlî Acts de not provide for that inde- pendence cf action cf the Local Boards wvhich is necessary fer theni te carry eut their wishes. -The Local Boards. cf Health slîould lie as entirely independent in every particular as are Boards cf Educa- tion.- It is te be lîoped, the time is net far .distant -%vlen they wvill lie se. The doctor w-rites strongiy for a systern cf niedical inspection cf sciiocis, ene cf our nxost im- portant sainitary essentials. These notes on the reports cf tue Local Boards wviil lie centinued in our ne-xt issue. OBSIERVATIRNS AND ANNOTATIONS. Japanese paper napkins, Techniés thinks thiat, in viewv cf tlîe fact tlîat; disease nray be, and doubtiess eften is, transnîitted di- rectly býy linen used in tue sick recru, it is advisable wlienever possible te use paper napk-ins for absorbing offensive discharges; iii place cf sponges, liandkerchiefs, linen napkzins and towels. Thuese are clean and attractive and can lie burned as soon as 163",
         "THE CANADA HE1,ALTUl JOURINAL. used, thus avoiding ail danger of conta- gion. As an iniproveinent on tàie linen, napkin used in hotels and restaurants, pre- suinably freshly laundered, but often miere- ly darnpened and inangled, tiiese paper flalkins would be %velcoine. Tliere is a possibility, however reniote that diseasç luay be acquired, by the use, iii rotation, of linen and otlier articles. Ruîxdislikes bicycles. He says: 1 flot only object, but ain quite prepared to spend ail îny best ' bad language' in repro- bation of bi-tri-and-4-5-6 or 7-cycles, and every otiier contrivance and invention for superseding human feet 'on God's ground. To walk, to run, to leap and to dance are vîrtues of the hurnan body, and neither to stride on stilts, Nvriggle on wlîeels, or dan- gle on ropes, and nothing in the training of the huinan mind with the body will ever supersede the appointed God's ways of slow walking and liard working.\" EZAMPLEs of abortive treatment, by germicidal remedies, of scarlet fever and diphtheria, by the administration of the biniodide of inercury, are given by Dr. Illingsworth in tha London Medical Pr-ess. IlThose germis wluich have found an en- trance to the circulation, and whose pre- sence there is indicated by the scarlatinal rash and enlerged cervical and subniaxil- lary glands, are rapidly followed and des- troyed, with the g-rand resuit of rapid res- toration te lieaith and the lirevention of those fearful sequeloe to which miultitudes have fallen victims.\" A VILE HABIT whiclî one sees indulged in on street cars by p)eop)le wlio certainly ought to know better, as an exohiange strengly puts it, is that of putting coins in the nxouth. \"14It is quite coinmon among woinen, who under suchi circunistances neyer seeni to have quite hands enougli, and so thîey press tlîeir moutlis into service to do whîat is flot oniy a vulgar thing, but absolutely filtliy.*\" he coin niay carry infectious disease. TE3E fly season is upon'us again. Do not be too severe on the flues. Thîey doubtless do sonie good if they are a tornent and sometinies convey contagion. Thieir par- ticular office appears to be Ilthe consunîp- tien of those dead minute animaIs wlîose decaying myriads would otherwise poison the air.\" It was a renîark of Linnaeus thiat three flies would consume a dead hiorse tioonier than a lion could. He, of course, included the fauxilies of the tliree flies. LiEBEIIT reports (Deiit. Mced. W1och., iii Newv Y-ode !\u0026Jdic«l Tiies) thiree cases of epilepsy, %vhicli ail showed a remark-able aura : ouie beginning witi a crauip or invo- luntary motions of tîme ton gue, ai tlîree of whii wvere promptly and perrnanently cured. by the extraction of a decayed tooth, which, in every instance, hiad been tlue source of irritation. BismioP FoSTER, considering, on the one hand, the destitution that prevails, botli at home, and especially in some of the coun- tries \\vhere missionary effort is put forth s0 vigorously, and, on the other, the inti- mate dependance of nians inteilectual and spiritual development upon bis physical condition, urges that we nîay hope for the best culture of the christian graces in the hearts of men only in proportion as adequate nourishunent of their bodies is provided for. TEE Calcutta Health Society is doing good work in drawing public attention te insanitrry conditions (BriU. Mled. Journal- XApril 23rd, 1887.) In a little publication issued by the Society it is pointed eut that, during the last six years, choiera alone, had claimed 24,000 victinîs in the city and its suburbs, and that thmis result is directly traceable te the flltliy condition of certain plague-spots, te defeets in the drainage system, te the want of proper control over the zniik supply, and te thme deficiency of tme water-supply. Attention is drawvn te, the enorunous infant-mertality, which, is mainly due te the ignorant and snpersti- tîous practices of the native lying-in rooui. A meeting was lately held under the aus- pices of the Society, wlien the Lieutenantz. Governer, wlio presided, urged the Muni- cipality te, spare ne pains te, reunove the causes whien rendered Calcutta, the home of choiera and a standing menace te, the hîealth of the world. As Chicago is proposing to, construct a canal te avert; its sewage toward, the Mis- issippii, the Sanitary Era, in refering te the report of a commission upen it, says : -Il Its upahet is the decided recoxnmenda- tien of an artificial water way te conneet",
         "THE CANADA IIEALTII JOURNAL~.16 lake 'Micliigan w'ithi the 'Mississippi valkey by way of the Des Plaines aiid Illinois rivers, tlius draining the rity aud suburbs of Clicaàgo to the Gulf of Mexýico instead of the Gulf of St. Lawrence. Il It reinains to be seen wliether the world. lias iliov d on- wvard enougli as yet to lead or drive Clii- cago te undertake the disposai of lier own filtlJi ilistea(l of pouriîig àt down the tliroats of the sinîller coîimuiinities wvitliin reacli. Prob:ibly the latter %vill liave to submiit, .uîd if the resuit slîould be conîpulsory pîî- rification of the water supplies of the towns, frein Joliet to Peoria, the sceie now dreaided wvil1 ierhiaps be a blessing iii dlisguise.* A SINGLTLAR suggestion in tlîe Zyiiotech- nie Magazine, is that a newv industry luiglît be created ini the raising of poultry and various doniestic animiais uI)of certain kinds of food wliici wvill imipart to tlîeir flesh new and palitable flavors. It is wel known thiat tlîe excellent flavor of the can- vas-back duck is due to thie wild cclery it feeds upon in the Soutliern niarshes, and the delicious Congo clîickens owe their su- perior excellence to tlîe pineapples they eat. The grouse of the Western plains is aromatic with the wild sage; wild ducks and other sea-fowl have a fishy flavor; and the fish fed to swine may be alniost said to be eaten over again by the consumer of the pork. IN ZUMCu, Swîtzerland, arrangements have been mnade for a great temperance meeting of an international character, in September. The main topics of discussion will be the regulation of the drink traffie, the alleged nutritive properties of alcoholie liquors, asylums for inebriates, and statis- tics of coffee houses, refreshinent rooms and other places for the sale of non-alco- holic drinks. IN relation to the infectiousness of tub- ercolosis 'and its conununicabiity frorn cows to mani, it is stated (Dr. Wyss cf Ge- neya, i Denî Fortschritt) that -this dise is unknown or very rare ini those countries the people of which do uot breed cattle, as in the pola regioswand tropics. Accord- ing-to tieevidence:of competent trust- worthy Norwegianmedioal meni,the south- weetetn distrcte\u003eof.-Norway ad, reaaed freefrom tubeculesi until the introdue- tion of Englisiî cattie. Siîîce tlien this dis- case lias beeil rapidly sprc1 adiîîg. Dui. *WYSS states tlîat it is not sufficient to boil niilk at 158' F. iii order to destroy tlîe tubercular bocillus wlîicli the milk nuay contain. Hlupppe stat.5 tlîat tlîe steriliza- tion of milk is extreniely difficult. WHAT seeniis te be a clear case of the infectionî of scarlet fever being convcyed, with tlîe rcsult of cominiunicatiîîg the dis- ease, by mneans of a book from a free library, is reportcd in the Sanitary Record of June, inst. HERE is a lesson for landiords :- In the Superier Civil Court at Boston a inother and lier four chldren have individually sued the landiord to recever daniages for sickncss, contracted because of tlîe poor sanitary condition of tlîe lieuse, and for the care cf the fainily during thîeir sickness froni diplîtlieria. Damnages in each case wvere awarded, the iother receiving $1,600, and the chîildren $700, $300, $250 and $200 respectively. THE average weekly circulation cf the British Médical Journal hias risen to 14,000, a nuniber which the Journal asserts is flot only enorniously in excess of that cf any othier medical journal in the country, but will be found on investigation to be consid- erably ini excess of the combined circula- tion of the whole cf the other medical journals in Great Britain. THE Utica Observer states that a com- mercial traveller offered to sell, at 4 cts. per pound, but did flot recommend, \"11cur- rent jelly,\" which consisted of water, tar- tarie acid, glucose, gelatine, dried cores and skins cf apples, aniline red for côlor- ing and a variety cf other things., IN- the canton cf Berne, Switzerland, the advertising cf prcprietary medicines ,'has been forbidden, -unless the article has been apprcved by the samitary authorities. AI- though the newspapers have protested, stepe -have been taken to make the order applicable to, aïl, cantons. CoFirs-m\u0026- is the namne of -a .new -bever- *geprepared - 'f -rorcsted - eaves -of ýthe cocfee tree. -The-Malaye: prefer thàso te o coffee. The, leaves contain. 0.5 toe0.7 per cent. cf cafeine, with more of ,ie' b.iter ..principle than the berx-y. 165",
         "166 TE, (JANA'DA IIEALTH JOURNAL. TnE important subjects, niostly original, which have been treated of in this, journal during the past tlîree or four mionthas are, anîongst others, as follows : Science of Health and its Popularization; 1%ilk Sup- ply anLd how it iuay be containinated; Catching Cold ; Tellnperance and Prohib- ition ; Adulteration of Foods ; Recent Ex- perinments with Dîsenfectants ;Healtli Officers and the Water Supply; Isolation in Infectious Diseases ; WVhat to do witli House Slops; The 2atent Medieine Evil ; Open Air for Consuinption ; The Publie and the M4edical Profession, The Progress of Sanitation during the Reign of Queen Victoria; On the HihDeath Rate in Can- ada, and its Prevention ; What Rags niay do; Overwork and worry ; Consunîption, is it Contagious? its Prevention ; Poison- ous Wall Papers; Diet and Dining ; Dis- posai of Sewage; Downward Filteration; Holidays, Wlîither shaîl we go? Camnping N~OTES ON CURRENýT LITERATURE. Ix the June Cen tury is a striking portrait of Count Leo Tolstoi, the Russian novelist. presefltiiig a persoriality of a unique and homnely yet fascinating type, the impression of %vhicli upon an Anierican is recorded by Mr. George Kennan in a paper entitled \"A visit to Counit Tolstoi.\" This account is the forerunner of what will doubtless be an at- tractive series of papers wvhich is proum- ised later in the magazine, making record of a hazardous trip to Siberia iii 1885 and 1886 by M4r. Kennan, in the interest of the Cenituryi, for the purpose of investigat- ing the Russian exile systein. Mnf. Ken- nan's present paper gives a graphie descrip- tion of Tolstoi and his bomle, and sets forth sonie of the novelest*s peculiar religlous and social opinions. An illustrated paper of the wvidest popular bearing is the second of Prof. Atwaten's articles on food. \"- \"1How Food Nourishes the Body,\" present- ing in compact fonîn a large amount of the latest deductions of chemical analysis and other scientific.investigation. The Lincoln History makes good progress, and there is thue full cornplement of ententaining light reading, in story and poetry. HARPERS MO'NTHLY for June is hardly Up to the good average of this magazine. \"lSocial Studies \" are interesting and sug- gestive. Mrs. O'Meara's \"Norka, a Story of Russian Life,\" contains nxuch that is of înterest. The editonial departinents, contain inuch that is useful and attractive. A .NEw illustrated paper lias reached our table-\" The Illustrated Foreign News, Printed fromi Duplicate Plates of the Illus- trated London X%'ws and other Foreign Periodicals,\" and promises to be an excel- lent weekly whîich will probably take at once a good position. Ia appearance it is niuch like the well known. London News; only $4 a year-The Illustrated News Co., Potter Buildings, Park Row, New York. ST. NICHOLAS for July lias just reached us. Frank R. Stockton follows his last month's paper on \"R ing London\" with an equally interesting description of life \"llu Englishi country,\" characteristie scenes of which Alfred Parsons and Hfarry Fenu show in, several delightful drawings. Il. H. Boysen commences a new \"lTale of Two Continents. Alexander Black, an amateur with a professional'a expenience, gives, in IlThe Amateur Camera,\" some useful hints to his fellow-arnateurs, the sort of advice that is not found ini the books. The Brownies celebrate the IlGlo- nious Fourth.\" Do flot shut out too closely with sîjut- ters or b]inds, the sunshine from your rooms. NEITHiER roonîs non the huinan body can be long in good condition without abund- ance of sun light. DRiNx not freely of iced or very cold wvater, especially when mnucli heated or after a meal, but sil. it sloivly. So much space is given in tîjis nunîber to the valuable article by Dr. Carpenter, on disinfection, from a late issue of the Sani- tary Record, that the usual variety of topics cannot be diseussed. We thoughit it best not to divide it. \"IlA VALUABLE SERIAL, which ought to, be in the hands of eveny Mtayor, Alderman, Town Councillor and Health Omeier ini the Dominion.\" Sn it is stated of the CANADA. HEALTU JOURNAL in a Report on Epidemie Diseases, \u0026c. By J. T. Bell, Esq., irite Chairman Board of Health, Belleville. 166"
      ],
      "title" : [
         "The Canada health journal [Vol. 9, no. 6 (June 1887)]"
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      "label" : "[Tome 2 (janv. 1827)]",
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      "title" : [
         "Quebec medical journalJournal de médecine de Québec = The Quebec medical journal [Tome 2 (janv. 1827)]"
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated I Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps / Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) I Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'Institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. El Ei Coloured pages I Pages de couleur Pages damaged I Pages endommagées El Pages restored and/or laminated / Pages restaurées et/ou pelliculées El Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached / Pages détachées Showthrough / Transparence Quality of print varies / Qualité inégale de l'impression E Includes supplementary materials / Comprend du matériel supplémentaire E Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Texte en français et en anglais. Text in French and English.",
         "THE ldlz t b v MEDIGAL JOURNAL. c0ul4.qIlyl\u003cG A CIUTIC.L ANALYSIS 0F RECENT PUBLICAT.-ONS, WITI A 1DET.ALE1\u003e AND CC»I!LETC MIST0ICT 0F TUE NZEW DISCOVE- RiKss AxtU IIPKOVE.XTS OF TUE 31OST £KE PMa.C- TI?10'.ERS ON TUE VIR10U-. ESANZCIIS OF M.NDJCAL 8CIWNCE, VIZ: ANATOMY, PUYSIOLOGY, 3MEDî- CASE, SIJRGERY, CUE-,ISTay, rUAguic-V, eOTANY, NATURAL JMISTOIS, MEDIC.L JURISPRUDE~NCE AXUD MNEICAL POLICE, AXU% TUE DRatXCUZS OF fGiX. X\u003eALL TUE OnsTETUirlC ARTS. AND OR[GINAL ESSAVS, CASE:'-' \u0026c. \u0026c. EDITED -BY XAVIER TESSIEPI, VOLUME Il woxsa4, *-DAx irirE, MARKET-SQAE, LOWE\u0026-TrOW., QUssELO. 1 827.",
         "THE uebet *Itbitat 5ouvrng. JANUARY, 1827. CRITICAL ANALISIS. Elements of-Iedical Jurisprudence.-By TUEODOR ic BEciC, M. D. Professor of the Institutes of Medicine, and Lecturer on Medical Jurisprudence in the College of the Western District of tlhe State of New-York, \u0026c. \u0026c. Second Edition, with Notes, and an Appendix of original cases and the latest discoveries.-By WILLI. DUNLOP, M. R. C. S. L. Meinber of the Medico-Chirurgical, and of the 'Wer- nerian Society of Natural History, Edinburgh ; Lecturer on Medical Jurisprudence, \u0026c. \u0026c. pp. 640 London, 1825. From the immense number of works, which have, of late years, swelled the medical library of the public, with ail the information which men could ever be expected to obtain, it had almost become a question, whether any thing more re- mained to be added to the vast stock of knowledge it already possessed. Hence that overflow of writings and books whuich would make reading a mere amusement, instead of proving a plentiful source of useful instruction. But the work now before us, the contents of which we shall attempt to present to nur readers, is one of the few which have powerfully con- tributëd to place this question beyond doubt ; nay, its authoi",
         "CrTICAL .NALYSI3. has carried the science of Medical Jurisprudence to a dezree which leaves hardly any thing to desire, in the various depart- inents which it embraces. The Editor himself does not fear to challenge a comparison with any of the English works, in scientific accuracy, philosophical plainn-s and precision of style, extent ?f research, genuine scholarship and erudition, pointedness if illustration, and copiousness of detail and refe- rence to original documents. Dr. Andrew Duncan Junr. also asserts that, under the unassuming title.of Medical Jurispru- dence, Dr. Beck has presented us with a comprehensive sys- tem, the diversîfied departments of which have been so mi- nutely investigated, that few cases can ever occur in practice on wvhich it will be found necessary t. seek elsewhere for far- ther information. Indecd we may say that it contains wich- in its comparatively sniall bulk, the choicest Medico-legal li- brary for the practitioner. Dr. Male also, the father of En- glish Medical Jurisprudence, expresses his opinion in the fol- lowing wvords: \"Dr. Beck has recently published one of the best works on Juridical Medicine vhich has been conpiled cither in this or any other country.\" In our last number, we took occasion to dwell on the im- portance of this science, and on its necessity in the cause of justice and humanity, vhen speaking of M. Bertrand's Ma- nuel, but more particularly in the notice we gave of a trial for rape which lately took place in this city ; and alough the convict was then under sentence of death, we did nothe- sitate to express our conviction of his innocence, and we feel no little gratification, from hearing that some circumstances have since appeared which corroborate our assertion, and in consequence of which our equitable Governor lias set the captive at liberty. Such are the happy results which would invariablv follow a careful enquiry of all the circumstances necessary to the be- neficial administration ofjustice. But, however satisieud we",
         "BEcK oM 5EDIGAL JURISPRUDENCE. may be of having discharged our duty in the protection of in- nocence, we cannot but regret that these investigations should not be made during the trial, which would in niany casessave to an horest and useful citizèn, the disgrace of an unmerited sentence which stamps his caracter with an ignominious and lasting reprobation ; whilst they would, on the contrary, tend to the detection of crimes, vhich can only be truly delineated by the means which Medical Science affords of giving to at- tested facts, a just appreciation of the confidence to be placed in the assertion of ignorant or corrupt witnesses. We are however bound to acknowledge, that in the particular ins- tance to which we just alluded, the life of the accused could not bc entrusted into abler hands than those of the eminent Counsel w\"ho stood in his defence, but who, unfortunately, placed too inuch confidence in the judgiment tf an unen- lightened jury. This reflexion we are led to introduce on the present occasion, as it proceeds from a thorough conviction that the practice hitherto observed in this country, cf select- ed Jurors among the lower class of citizens, who are gene- rally without any education, does not contribute so ably to the ends of justice, particularly when the life of a man is at stake, as if that important body were taken from the more enlightened classes, such as the Grand Jurors are: the latter being, in our opinion, a more competent tribunal than the former, for the discharge of this very serious and sonetimes difficult function ; still we are happy to observe this precau- tion taken in mnatters of a civil jurisdiction, when the honor or property of the citizen is in jeopardy, and we sincerely hope it may be extended to the protection oflifeé, the dearest of all propeities. We heg pardon for this suggestion ; and we feel confident it would not be doing justice to the good sense of our coun- trymen, if we were to expatiate longer on a subject which it is Our intention, in the following pages, tg place in its true",
         "CAITICAL ANALYSIS light. Our readers will shortly be convinîced, that we could not bave a better opportunity of laying before them a com- plete and faithful view of the present improved state of Juri- dical Medicine, in all its departments, than by unfolding the pages of Dr. BEcKS volume, which he has Óffered to the pub- lie with that diffidence and modesty, the true criterion of su- perior merit. In the Preface, instead of meeting with the u- sual apology of author's pretensions to priority of opinion or improvement, or the display of vain hÙmility, wc find an acknowledgment of the various sources fron which lie bas collected his principal materials, leaving the reader to ap- preciate his own personal merit. In the Introduction, which is a comprehensive retrospect of the progress of medical juris- prudence in Germany, France, England, and the United-Sta- tes, we also observe tvith much pleasure, a spirit of liberality which is above those national prejudices, not unfrequentlv to be met with in the more ordinary class of authors. Thus af- ter acknowledging that American litterature bas been in a great degree derived fromin Great-Britain, Dr. Beck attributes the little interest which this science has excited on this Con- tinent, to the want of its deserved attention in that country. We are also endebted to Dr. Beck for the revival of the memory of the late Dr. Stringharm of Nev-York, wlo was the first that ever delivered a course of lectures on1 this science, before an American audience, at nearly the same period that they were commencetd in Engiand; and since that time, Medical Jurisprudence lias been cultivated with such ardour and success in both countries, as to inake it impossible to determine which of the two bas more ably contributed to its present improved state. The first chapter is on Feigned Discases. The Apthor very judiciously observes that, the police of every well-regu- lated country should direct its energies agaiast such impositi- ons ; for a very severm injury may not only be inflicted on in-",
         "BeCK ON MEDICa.L JURISPRUDENCE. dividuals through them, but the public morals may be dete- riorateil. The following diseases have at various times been feigned. i Alferation.of the pulse ; altered state of the urine ; hSmatu- ri-1 ; iicontinenlice of urine ; suppression of urine ; naiming.and defornity ; dropsy and tunours of varions kinds ; excretion of calculi and various foreign matters ; ulcers; homnoptysis; hSma- temesis ; jaundice and cachexia ; fever ; pain in various parts ; Syncope and hysteria ; discases of the heart; apoplexy ; paralysis ; epilepsy ; convilsiois; catalepsy ; nostaigia ; near sightedness ; ophhalliiia ; blindnes and deafness, with or withont dmnbnes.\" The state of the pulse may be weakened or even rendered imperceptible by a pressure along the course of the artery, but this vill be easilv detected. In the case of incontinence of urine, Fodére recommends applying a Ii.gature round the penis, which will thereby beconie so enlargcd as to render its removal necessary in a short time, if it be real, and not when it is feigncd. The urine is also altered in its colour by various means. The Indian fig (cactus opuntia) and cantharides taken internally, will make it as red as blood. Maiming or defor- mity cai bealso ascertained by a careful exarnination. Artifi- cial dropsy and other tumous, have been produced by inflating the cellular texture under the skin in various parts of the body, thereby giving the appearance of disease ; but as the mere existence of a tumour is not a sufficiently conclusive symp- tom, it wili be the duty of the Physician to attend to the other concomiutant circunstances. A feigned excretion of calculi will be ascertained by chemical processes. Calculi pretended to have come from the bladder vere found in the vagina, and in the pockets of the impostor. Ai tificial ulcers may be distinguished by their border being less callous, their surface more superficial, and less painful than real ones ; and by their promptly yeilding to the use of lukewarm water, and being covered with lint. Cancers have been feigned by the application of a part of spleen, glued on",
         "k CRITICAL NALYSIS. its smooth side to the skin. -A false eruption of petechiaæ or pustules may be detected by examining the person perfectly naked. Ail the species of hemorrhage are marked with symp- tônis which need not be enumerated. Jaundice may also be feigned by a daily use of muriatic acid in small doses, and other neans ; but it must be recollected that real jaundice is fre- quently accompanied with vomiting, pain, and sleeplessness, and always with a yellov colour of the adnata. Real cache- xia or great weakness, is marked by a loss of appetite, or of strength, or swelling of the legs. Pain is difficult of detection, to a dezree that Fodére him- self relates instances in which he bas mistaken feigned pain for real and real for Ieigned. But pain in any one part is ge- nerally accompanied with an alteration of some of the natural functions of the part affLcted. Real pain is also frequently accompanied with wiant of sleep, of appetite and with some fever. Feigned syncope or hysteria cannot resist the appli- cation of sternutatories to the nostrils. In the fo ner it is dificult to dissemble a smail, feeble, and languishing pulse, an almost suppressed respiration, cold sweats, coldness of the extremities, and great paleness of the contenance. Persons haye succeeded in inoderating, others in increasing, the ac- tion of the heart. Apoplexy cannot be long dissembled, and according to Zacchias, will not resist sternutatories, and in paralysis a powerful shock from an electric jar may develope the deceit. Feigned epilepsy is however of common occurrence. In the-real disease, the person falls suddenly to the ground, the face is livid, the pupil fixed and does not contract nor relax in the light or in the dark, lips pale, mouth distortedi and frothy, and the pulse altered ; there is a total loss of feeling, and insensibility even to actual cautery, the eyes open with a wink and not in the natural manner. A true epileptie is ge- nerally cshamed of his situation. Convulsions and catalepsy,",
         "BECK ON 3MEDICAL JURISPRUDENCE.. if suspected to be assuied, may be recognized by tie actual cautery. A soldier, naned Drake, had resisted ali applica- lions, but on hearing of the hot iron, rose up and acknow- ledged the fraud. Another, Phineas Adams, remained fron the 26L. April to the Sti. July 1811, in astate of ftigned in- sensibility, resisting all violent and powerful meaus, and even the operation of scalping ; and having in consequence obtain- ed his discharge, lie vas seen, tvo days after, carrving a hea- vy load on his back to his fiather's house. Extacies and pos- sessions are now considered impossible. Nostalgii, or Maladie du pays, frequently occurs in the mi- litary, from an ardent desire of returning horne. Though an imaginarydisease, it may occasion by its long duration a real disease; and should therefore be attended to. But false myo- pia, or near-sightedness, vhich is sometimes induced by ivear- ing convex glasses, may according to Fodéré, be ascertained by presenting an open book, close to the nose, even with the aid of glasses used by near-sighted persons, and the impostor vill not be able to read. Artificial ophthalmiia arrives at its acimè withina fe;w hours after the application ofan acrid subs- tance. Feigned blindness is diflicult of detection In amau- rosis, a dilated and fixed state of the pupil, docs not always attend. Deafness may also be ascertained by a carefal exa- mination. The celebrated Sicard discovered the fraud of a pre- tended deaf and dumb, who said he had been instructed at his school, and who had always escaped the minutest researcli, on reading a letter written vith his ovn hand. The folloving is a specinen : \"Jejur de vandieux ima mer et né en Nau- triche, quhonduit (pour condutd) essepoise (pour espoir) torre (pour tort) ; ru S. flonoret, jai tas present (pourj'Utais pré. sent) ; jean porte en core les marque (pour fen porte encore les marques). This man wrote from sound, white the deaf and dumb write only as they see, and be knew that thesound of the gutturtds q and c was similar.",
         "10 CXITICAL ANALTSIS. Abstinence lias also been used to excite cominiseration and charitv. A most remarkable instance is that of the well known Ann Moore. In the 3lst year of Edward III, a woman, Ci- cely De Rydgeway, from a record in the tower of London, indicted and condemned for the murder of hér husband, fasted in prison forty days. The record adds : \"Nos etl de causà, pietate moti ad laudem Dei, et gloriosa\u003e Virginis Maria,, mna- tris sum, undè dictum miraculum processit, ut creditur.\" She was of course pardonned. The second Chapter treats of disqualifying diseases. In all cases vhere a Phsician is consulted as to the ritness of persons servmig as jury, witness, or in any other office requir- ed by law, or as to the condition of a crirninal for hard la- bour or other severe punish ment, he must study the peculiar symptoms and indications with great attention, and, while he leans on the side of mercy, avoid being deceived by feigned representations of imaginary diseases ; for, it is impossible to suggest specifdc rules, applicable to every instance that may occur. The rest of this chapter chiefly relates to mili- tarv laws and duties, we therefore refer those of our readers who might wish to devote their attention to that particular objIect, to the work itself, to the Code de la conscription, of Napoléon, or to a report of Dr. S. L. Mitchill, to the Legis- lature of New-York, in 1819. From the fourth Chapter we select the following paragraph in the author's own words, which appears to place the long disputed question of doubiful sex in its true liglit. \" It will readily beobserved, froni the above illustrations, that all the cases ofsupposed hermnaplrodites are referabic to the cla.: ses now describeJ. They are eilier males, vi(lh sone tinusual or. ganisation or position of the uirinary or digestive organs ; or fia- leswith:r, cularged clitoris, or prolapsed uterus; or itdividnals ki wYhom the generative organs have not produced their usual ef'ect in inlusncing lthe developement of the body. Thus it is evidenft,",
         "BECK ON MEDICAL JURISPRioDcNCE. thuai, inistead of combininig the powers of both sexes, they arc for the niost part incapable of exerting aiiy sexual finiction. \" Dr. Anidrew Duiscan Juir.'says: Ii the two sexes, there are organs whicl correspond to each other, and which nay be called asalogou\u003e orgis, the penis to the clitoris, the scrotum to the labia, the testes to ihe ovaria, and the prostate to the uterus; and it fur- ther appears, that of these analogous organs, no two were ever founid on the saine individual. No monter bas been described, having both a.peniis and a clitoris, nor with a testis and ovarium of hie saie side, we may ventura to say, vith testes and ovaria, nor one having a prostate and utel us.\" We now coie to the ifth Chapter, concerning rape, and cannot butter introduce this subject than by giving the judi- cious oîinion of Sir Mathew Hale, quoted by the author.- \"It is an accusation,\" said he, \"easy to be made and harder to be provcd, but liarder to be defended by the party accused, though innocent.\" The hvmeni lias been wanting in chaste females, and e.xisting in other cases in the opposite circuns- tance, practitioners having even been called to perforate it in cases of actual labour. Hence a great variety of opinion has been entertalned by the most distinguislhed Physicians, but Dr. Beck retains its existence among the signs of virginity, provided it be con- nected with other physical proofs. The caruncu!œ mjrti. formes have sonetiues been found in the place of the hymen. Zachias says that they are indicative of chastity when red, tu- mid, and connected together by corde carnee ; whilst it is the contrary, ,when they are found pale, fla.:cid, and their con- nexion destroyed. They are, however, generally consideredi as the remains of the hymen, \"'et corruptm adeo pudicitiz in, dicia,\" but disappear after sone time. lhien a rape has been committed, there will be, besides an absence of the signs of virginity, others indicative of the em- ploynent of force, such as contusions on various parts of the extremities aud body. -Dr. Beck is so far from considering",
         "CRITICAL. ANALSIS. these as unnccessary, that lie believes thei compatible vith a final consent on the part of the female. One case amrîong nany of the saine nature, is related, where, in consequence of an infiamed state of the genitals in a young girl, which ternii- nated in death, and who complained of havirrgbeen mu·c.huîrt by a young man with whoin she had slept, Mr. Ward, Sur- geon, then attending the Manchester Infirmary, gave C ver- dict of murder against the young man. From the subsequent admission into the Infirmary of several youths siiflarly af- fected, and in which it was absolutely certain that no injury or violence whatever had been inflicted, M. Ward hastened to rescue from an impending fate, the victim of a scientific er- ror. Capuron has observed similar cases which hie ascribed to an epideniie cataral affection then prevalent in Paris. But, as Dr. Duncan says, we must take care not Io run into the opposite error, \"for il is cxtremele improbable thai di- seases :hcm occur so rarely, should hapen to apear in a child to whom riocIncc reas offered, unless that violcnce had some efect in producing il.\" Marks of external injury, how- ever, continues Dr. Beck, are only corroboraiing, and cannot operate as certain proofs, except wlien the age, strength, ai state of mir d of the respective parties are properly considered. On the question of the possibility of a wouman beinr invo- luntarily deprived of her chastity, Mahon says: \"D'après l'impossibilité presqu'entière où est un homme seul de forcer une femme,-on doit rarement ajouter foi à l'existence du viol ; je crois même qu'il serait prudent de ne l'admettre que lorsque plusieurs hommes armés se sont réunis pour commet- tre ce crime.\" Farr is also of opinion that if is impossible, for a vonian always possesses sufficient power to resist the attempt. Fodéré, Capuron and Brandelius rassert, the same, Metzger only allows of three cases in which the crime can lie consumated : whiere narcotics have bcar administered, where many are enracd against the female-andi where a strong",
         "BECK ON alEDICAL JURISrRU)EN\u003cCE. ian attacks one who is not arrived at the age of puberty. The following answer of the Medical Faculty of Leipsie is here given, which we believe worthy of being copied:- * \" Si circuîmstantias qiuve in actu coeundi concurrunt, considera- mus, non credibile, nec possibile videtur, quod unuis masculus nu. bilen virginiem, (txcipe impubem, tencram, delicatan, aut sinul ebriamn puelliiu) absque ipsius consensu, permissione, atque voluin- tate vitiare, aut violento niodo stuprare possit; dùm fmiendu\u003e cui- libet facilins est, si velit, penis Irimissionlemi recusare, vel miultis alis modis im)edtire, quam viro eidemn invito plauè intrudent.\" Menstruatiin has been mistaken for defloration, as well as other appearances of momentary inflammations produced by the introduction of irritating substances or bodies. From this reuark of our author, we are led to ask this question with regard to the case to which wealluded at the commencementof this article ; was not the state of the parts as reported by the women, the consequence of the first menstruation ? This would seeni not to be altogether impossible from the fact of her not having menstruated before the period complained of, and from the assertion on the part of the accuser of the he- morrhage havingcontinued during the three subsequent days. Here the author gives a sketch of the laws of different na- tions against rape ; those of England and. Scotland make it a felony without benefit of clergy, as well as some of the Provinces of the .United States, but in the generality of these and in France, from the Napoléon code, it is punished by im- prisonement or fiñe, or by both. The remiainder of this chap- ter isdevoted to sone megdico-lega1questions, connected with this subject. To the question whetber the presence of syphi- lis in the female is a proof in favour or against her accusation, the author remarks that the infection generally taking place not before three days, the examination should be made within %hat time. We must observe that this is not frequently the 'Mse in our climate, as it mostly occurs after 48 and sometimes",
         "CRITICAL ANALYSIS. 36 or even 24 hours, and this miglit operate as a reason for us to require an examination somewhat sooner. The author denies the possibility of a woman being violated duringsleep, without ber knowledge, except when she is under the influ- ence of powerfuli marcotics. He also oposes the opinion of Dr Bartley and Farrwho maintain that pregnancy following rape is to be considered as a proof of acquiescence, and that in order to ascertain this, the punishment of the criminal should bedclayed till the requisite tine. In concluding, we give the following opinion of Dr. Beck as one which should alwayr be kept in mind, that, \"No man ought. to be con- demned on medical proof solely. The Physician should only deliver his opinion, for or against an accusation already prefer- red.' We will for the moment pass over the Chapters which treat of Impotence and-Sterility, Pregnancy andDelivery, and various others equally interesting, in order to arrive to that concerning personsfound dead, which, as it includes a variety of useful instructions te the Coroner and the Physician, will therefore occupy our attention in preference ; and in our se- lections, weshallgiveas we bave hitherto done, the ideasofthe author in other words, in order to be more concise; as we shall bave little occasion for our own remarks, on any of the subjects the work embriaces, and which, as we have al, ready said, are so completely investigated by Dî. Beck, that it would be alnostimpossible for us to enlarge anany ofthem. Our regret, on the contiary, is that our limits do not permit us to give them in his own words. We paSs over some minute directions for the dissection of persons found lifeless, and proceed to extract what it mostne, cessary to be attended to, in the examinations of the several ac, cidents and appearances which may tend to the discovery Of the cicumstances attendiig a sudden death. The following' distinction between sugillution, which is a spontaneous effusion of blood, originating fçorn malignant feycrs, scurvy, or a",
         "1ECK ON MEDICAL JURISPRUDF.NCE. 15 .Commencement of putrefaction, and ecchymosis the result of violence, deserves notice. \" Sagillation is inarked by ivid, dark-coloured spots.-Thus, on a person lu.ng, an ecchymosis marking the course of a rope, nt the neck o on the extremities, is a certain proor that the iijury lias not been inflicted on a dead body.\" '\"It should also be remembered that blooci is sometimes found extravasated in one or more of the large cavities, and is to be considered as a natural appearance, unless we rind some of the blood vessels injured.\" \"Wounds received before death are marked by red, bloody, and separatei edges. Those inflicted afterwards are livii, and their cdges close to each other. Simiiarappearances cha- racterise contusions or blows, in which there bas becn no so- lution of continuity ; and, on dissection, they are, if indaicted on the living, found to be sub-cutaneous wvounds : vessels are seen torn and fluids extravasated, and the whole exhibits the marks of tumour, in its X'stic and circumscribed shape. Violence to the dead body can only produce livid flaccid spots, unattended with engorgement or tumour. Gangrene also is marked bv its being surroundedi with a red edge : putrefac- tion is not, and the spots causedl by the latter are of various colours. Dry gangrene cannot take place on the dead bodv, since therc is no heat, or action of vessels to produce it, but the disorganization observed is of a humid nature.\" It is here remarked that extravasated blood is sometimues found on the body of persons dying in a state ofintoxication, and which mav not be the result of violence or blows. Carbonie acid gaz, which is so pernicious to life, may be generated in narrow and unventilated places crowded with peaple. It arises from burning charcoal, lime-kilns, and celfars, vhere beer, wine, or other liquors are in a state of fermentation. It is also frequently prodnced in wells, mar- shes, and mines. The fumes of a candle, according to. the",
         "1b CRITICAL ANALYSIS. Faculty of LeipsiC, are idcentical with the vapours from char- coal and lime, and will produce the sanie deleterious effects. \" If they are discovered,\" say Struve and Belloc, \"after lie gaz has bad its fuil oparation, their bodies present the following ap- pearances: the head, face and neck are swollen ; the eyes are pro, pelled froni tleir sockels, but preserve their brilliancy often for tvo or three hours after death ; the tongue is protruded, swrollen, and inclined to one side of the mouth, the jaws are firmîly closed; the face is livid ; the lips are ofa dark blite colour; the abdomen is iniflated; the body preserves ils warmîh ior-a Jength of hanie, and soneimues indeed is warner tlan natural, while the 1iinbs remain flexible for soie hours.\" To these marks, Dr. Beck adds that, effusion of serum, tinged vith blood, are found, particularly in the ventricles of the brain, and in the bronchi-, while th muscles are so soft as to be tora by thesligltest exertion, and that the epi- glottis is ahivays elevated. Of Personsfound hung. Dr. Beck continues, the circums- tance that actually takes place, in consequence of hanging, is a deep sleep, arising from the cerebral compression, unac- companied with the symptoms that attend apoplexy, and in no case of recovery, folowed by the ordinary termination fo that disease, viz: paralysis. On enquiring of the persons Vhohave survived hanging, they allagree in stating that they feel no pain, but immediately fall into a profound slcep. If the person lias been suspended after death, the impression of the cord is of a livid colour, instead of being red and accom- panied witl a suffused countenance. An attentive dissection is, however, essentially necessary in these cases. In cases ofstrangulations the external marks will be evi- dent, and those of the cord bear some difference witi re-ard to the absence of weight of the body as in hanging. It is extremely difficult for a person to strangle himsself with his own hands, since they lose their strength the moment com- pression begins.",
         "BECK ON MEDICAL JIRISPRUDCNCE. The numierous sign which are ascribei by authors.. as indicating death from drowning, are all eluivoeal, and ac- cording to Dr. Beck, the pre'ence of frothy Mucus, is un- doubtedly the most important one. No water will be found in the stomacli of persons dead before drowning. In the first case, the blood is generally fluid, and particular attention is to be paid to external injuries, and the circumstances at- tending submersion ; and it is to bu reiembered that crery instance is mlrked with peculiarities which render it impos- sible to lay down gencral rules applicable to all cases. The Physician, therefore, must be passessed of an accurate know- ledge of physiology antd pathology, to enable him to give a correct opinion. \" In death by smothering, circunistantial evidenre rust be the principal, if not the only means of ascertaininig wIe:tlhcr the event has been produced by crime or accident. Tumours pressing on the organs of respiration, or foreignt bodics fountd in ihe trachea or esophagus, are of course indications of accideutal death,' In the cases of death from wounds, we find a great nunber of interesting narrations and trials, as vell as valuable ins- tructions to the Surgeor, which are long and do not admit of being given in a saaller compass, than in the author's own words, without proving in a great degrec useless. The ar- ticle on spontazeuus combustions is also very imaportant, and the number of cases which are related of this extraordinary accident, amounting to eighteen, seen suliicientilv authenti- cated as to leave no very reasonable doubt of the possibility Of its taking place, at least in individuals who indulge in bard drinking. The concluding paragraph in this chapter is on persons dead from hunger, and we copy the following indications of this accident \"The body is much emnaciated, and a fetid, acrid odour exhales from it, althouh death mnay have bcen recent. The eycs are red",
         "18 tITICAL A .ALYSrS. and open. This appearance is uncommon from ollier causes bi death. The tongue and throat are dry, even to aridity, und the stonach and intestines are contracted and empty. This last mark bas bea repeatedly aoticed. Haller dissected the bo- dy ofa person who destroyed himIclby honger, anid found the or- gans in question entirely empty. Not the leasi vestige of fieces w-as to be seen in the intestines. The galt-bladder is pufTed ivith bile, and this fluid is round scattered over the stomach and intes- tines, so as to tinge them extensively. The îungs are witlered, but ail the other organs are genuerally in a he'althv state. The blood- vessels are usuaily empty.\" Our limits compel us, thnugh reluctantly, to conclude for the moment, the analysis of this highly useful and justlv ce- kebrated work, and it is our flattering expectation that what we extract from it, inay prove sufficient to convey to our countrymen an idea of its excellence. Let us, therefore, be permitted to indulge the hope, that such a scientific auxiliary andt useful companion, may become the constant adviser of the Jurist, as i. will prove a safe guide to the Physician who' may be called upon to deliver an opinion, on vhich may de- pend the honor or even the life of a fellow creature. Dr. Ece'is work aIso posseses another advantage over a number of oChers of the same nature, as its subjects are particularlv applied to the constitutional laws, which, in the criminn departmnact, are generally those of Great-Britain, prevailing in this country. The former Editions are now entire1y consumed, and we understand the author is superintending another, which lie will enlarge and illustrate with new and interesting docu- ments. As soon as it is issued from the press, w-e vill make it a duty to give tinely notice, hat all may have an opportu- nity of being provided vith such a valuable acquisition ; and as our present analysis has been limited to a few chapters, we will only resume our labour, when this new Edition is com- pleted.",
         "PEMflERTON ON TUE ABnOMINAL VISCERA. 19 . practieil treatise on various discases of the Abdomina( Vis. cera, by CHICISTOPHER RoBERT PEMBERTON, M.D., F. R. S. Fellow of the College of Piysicians, Physician extraordi- nary to His Royal Highness the Prince Regent, Physician to Hi Royal Highness the Duke of Cumberland, and-late one cf the Physicians to St. George's Hospital.-Fourth Edition, revised and corrected. London. G. \u0026 W. Nicol, pp. 201, 1S20. The title of this handsone little voIunie would alone de- serve our attention, if the high credit of its author, as a Pro- fessional man, did not sulliciently warant mnr notice; but when wC coie to examine its contents, the comparative exi. quity of the book vanishes under the conviction of its extensi. ve usefulness. In delivering ourgeneral opinion of this work, we cannot but rccall to nind a reilexion which we took occa, sion to niake sonetime ago, when speaking of M. Brodie; treatise, originating in the conviction that the healing art is in a great degrce endebted of its present ilourishing state, to the taste which our conteriporaries have shown for researches on particular and separate subjects. The difficulty of inclu. ding most of the diseases under the same physiological and theoretical themes, had compelled the ancients to have recour- se to principles derived fron the philosophical opinions of the day, and in this manner, the science of maedicine has inevita, bly experienced the vicissitudes of ages and the variety oi the opinions prevailing in different nations. But in the prescrit century, a new direction has been imparted to genius, which by obeying its natural propensities, has been directed to in, vestigations which had previously been mere objects of anu, aement or speculation. Thus the study of Pathology lias opened Aie path to subsequent and repeated discoveries, in the knowhlLge of diseas;ed organization, :nd hence again the at, ,ention has become dirceted to their numberless variete",
         "CRITICAL ANALYSIS. thereby giving rise to a clacification founded on the nature of these alterations themselves. The spirit of inquiry resulting from this unrestricted li- berty o reasouing, has been directed to the study of particu- lar organs ; but it must be acknowledged that the study of the viscera is yet the least cultivated, if wé compare their importance in the organization, the obscurity which enve- lopes anurimber of the aflections to which they ar. liable, and the consequent di flicuhies attending their treatment. It is to bc hoped, hower.er, that this sub.ject will meet with that con- sideration to which itis -o justly entitled, and in the mean timc, we must feel -atiled that the work hefore us, is one w hici from its minute researches and the illustrative docu- ments which it contains, is a valuable acquisition to the practitioner. In the preface, tie.\\uthor announces that Lis bcook will b found to contain his on% observations and reflexions, and -the re ader iust not expect te find in this vork a regular his:cry of the abdominal diseases as they are recorded by the authors, who have coller:ted the opinions of others, on this ampl- and i-nportant theme.\" This mode of instruction is not altogeth:r so undcserving- as inight at tirst appear, whîen veconsider how advanta-cous it is for the interest ofscience, that the opinions and experience of ob:ervers slcud s u. il the test oz nthers enuazed in the saine pursuits ; but we fear that this exc'iusion of other writer's opinion may becone, in less hoeori hauds, the cause of idle attempts to draw false conclusions fron isolatdfacts and ex piale experinents, be- si'es the necessity 'vhith timposes on the practitioner, re- sidin ;t a distance fromi th1 e Aletropolis, of collecting-.ù anim- ber of works on one subject which miglt sometinies te en. compjjasscd :in less volowiious and expensive sizes. The buok w% hich we lave perused in the preceding article, isa verv satisIhetorv evidence of this truth, as it contains a l",
         "PEM3B.RTON ON 'rME ABDOMINAL VISCERt.. the information which it would be possible to seek for in other more voluininous works ; we sincerley hope, however., the reader may say, with Dr. Penb'rtii, \"that this little volu- me will be found to contain some remarks, not altogether un-- worthy of attention, even to the experienced practitioner, upon aluiost every disorder of the abdominal viscera : and he vill, I trust, not faiR to discover a vein of enquirý into certain di- seases, ivhich others have but slightly recorded, or inade- quately conceived.\" It i, divided into eleven chapters, which comprehend as nany dis.eases of the clylopoëtic viscera. Tie description of their svmptoms, the varieties of the complaints, and their course, a-egiven in a minute but accurate manner whici we have seldom met with, and which alone convey as complete an idea of the disease, as if the patient hinself was under view. Did not the work possess other merits, these are more thn suflicient to render its perusal indispensable to the prac- titioner, and we fear not to say that in this respect, it is inferior to none of those we have yet had occasion to read. We now proceed to examine its contents, and on opening the fi rst chapter, vhich speaks of Peritonitis, we find the au- thors opinion on the long disputed question, wvhether this is idiopatically the same as puerperal fever, which lie delivers in the negative, considering peritonitis only as a symptoni of the latter complaint. lis observation, however, that is is nuch -more frequent among women than men, deserves to be recorded, as it may tend to an enquiry on the causes of this preference, vhich night throw some lighit on its identity with puerperal fever. Again, Dr. Pemberton has rermarked that in the acute form, alvine discharges whether spontaneous or induced by art, do nut diminish the pain and tension and if this be strictly true, it would seem to differ in a su- perior degree with puerperal fever; as it is now pruved that extensive evacuations are so benelicial in this disea-",
         "9.1 CRITICL ANALYSIS. se, that turpentine itself is at this day freely administere4 in order to induce them. It need hardly be mentioned that he depends chiefly on bleeding, general and topical, immedi- ately folowed by blisters. It is suficient to mention the name of Broussais, in justifi. cation of our astonishment on beholding the following sen- tence, \"The Chronic Inflammation of the Penitonzeum, is a disease which, though cursorily introduced by writers, yet has not, as far I know, been hitherto considered in any sepa- rate discussion. I the more wcnder at this circumstance, sir.- cel do not regard it asa complaintof very uncommon occur- rence.\" The gencral division of the work is as follows : Ist The PeritonSum, 2nd the liver, 3d the gall-bladder, 4th the pancreas, 5th the spleen, 6th the kidnevs, 'th the stomach, Sth the intestines, 9th ihflammatidn of the peritonSal coat of the intestines, 10th inflammation of the mucous membrane of the intestines, 11th disease of the mesenteric glands. When speaking of the difliculty of discerning inflammation of the liver from that within the ehest, the author g-ives the following ldirection, which appears extremely plausible \"That in the former case, a gradual inspiration docs not pra- duce cough, although it increases the pain ; that the pain is increased by pressure underthe margin of the ribs, and that the cough (if it is present») is found to have succeeded the pain several days, and not tohavepreceded it, or to have been. coeral with it, as in Pleurisv.\" \" i:tlammation of the liver may be distinguish.ed frcm spasm on Ilhe gall ducts, by there being no nausea-io profuse sweating-.-- by flc pain bein; permanent-b% fite pulse being upvards of one bundred in a rinuatr. aud by the patient always preferring to keep Ihe body in a straighl, quiescent posture; whereas tle greatest Case is obtained by bending the body forwyard on the knees,'wlen tie:e is spasm on the gail ducts.\"",
         "PEMBERTON ON TUE ABDOMINAfL VISCER. U Dr. Pemberton also remarks that since this treatise was writ- ten, his observation leads hii to believe that very little prac- tical advantage is to be derived from the nature of the pulse, taken by itself, in acute inilammatory diseases ; \"for, says lie, \"I have knotvn the pulse remain perfectly unaccelerated, and in every respect natural, in inflanmatory disorders of the most alarming magnitude ; where venæsection has proved the buf- fy condition of the blood, and unequivocal relief has justified the operation.\" This proposition, in its general sense, is a great truth, and fron the opportunities we have had of witnessing this circums- tance, we are led to ascribe it rather to a peculiar condition uf the system, than to a variety in the disease itself. Butit does not appear to us altogether consistent to admit it in all its bearings, for it is aliso practically true, that an acceleration in the pulse is not a more essential condition of the inflammatory diathesis, than the existence of the buffy coat of the blood can alonejustify depletion. On the other hand, we have the au- thority of Rush hinself and the test of experience, for assert- ing that the state of the pulse which indicates venesection is altogether independant of its frequency, viz : that peculiar feel of ten.zion in the arrery, whithout which it is doubtful wlhether bleeding vill not prove prejudicial. Medical men are everv dav called to patients indulging in ardent spirits, vho e:thibit all the ordinarv indications of inflammation, which would seem to urge the necessity of bleeding, and still that operation will prove injurious and sometinies fatal, al- tlough the pulse is accelerated, large and full, but not pos- sessing that peculiar condition which we have just noticed ; wlilst it is needless to say that the bufy coat will frequently be seen in cases which do not call for the use of the lancet: for this evacuation may also afford temporarv relief, even in cases where it vould appear contra-indicated, or at least use- more I)arlicularly if the strength and constitution of the",
         "CRITICIL ANALISIS. patient is such as notto be materially affected by vhat niiglit prove injurious under more alarming circumstances. We are unwilling to carry farther our observations on this isolated question, although we should feel inclined to draw the attention of the practitioner to the importance of consul- ting the state of the pulse, in all cases where an inflammation is suspected to be present ; and it will be found that, while o- ther symptoms may by their varieties and anomalies with res- pect to the nature or the seat of the complaint, create some dillieulties in his mind, the pulse vill faiitlifullv indic:ate the condition of the circulating system, which can undergo no deviation from its naturai functions that will uot be co'mmu- nicated to the arteries. It may not be unnecesssary to add that in the cure of acute hepatitis, the author greatly relies on the use of purgatives, even with calomel, which he justly condeins in an alterative fornm before the symptors have disappeared. In the chronic affection, and even in incipient schirrus of the Liver, Dr. Pem- berton bas derived much beneit from the use of a pint of the infusion of Taraxacum taken daily, in divided doses. He preparzs it, by adding a quart of boiling water to ten freslh plants, root and1 leaf, straining off the liquor as soon as it is cold. Our author acknowledges that he is acquainted with no symptoms by which an abscess occasioned by hydatids, cau be distinguished from one arising from common inflamma- tion. The gall-bLcdder may, by inflammation, be thickened in its coats, so as to lay the foundation for an incurable jaundice, which will then be known, \"if the jaundice is intense and permanent, and when the patient sufFers little or no pain in~ the region of the stomach ; for the intensity of thejaundice will prove that the liver is itself not interrupted in its natural function ; and the patient being free from pain, will prove that the duct is not stopped by a gall-stone. But thejaundice",
         "PrMBERTON 0N TILE AoM1NAL VliCERA. 25 from spasm, or from gall-stones, may be knwvn by a sudden acute pain at the pit of the stoniach, attended with iausea, and retchings--and diffusing over the whole of the epigastric region, the riglt-side and the back-with irregular and spas- modie twitcels, in various parts of the body.\" \" Thougli the patient, during the passage or a gall stone, is never free from some pain, yet it increases, by paroxysais, to a degree of acute sufferisig, and subsides again into one of conipar.tive case; and ihese paroxysis occur several timies in an hour. The great est relief from pain is experienced by bending the bodcly forward upon the knees. The nrine is ofa dark brown coliur, from an admixture of bile; the stools are, from a deficiency of it, clay.colonred The state of the bowcls is very irregular ; they are ab often rela!:ed as constipated.\" In the cure ofthis disease, the author seems to place much confidence in opium, and says that, \"'the quantity of opium ought to have nolimit but the absolute abatement of the pain, and till that object is obtained, the patient should take a grain of solid opium, or twenty, five drops of tinct : opii eve- ry hour.' He is not. much inclined to recommend emetics, but, as soon as the pain is relieved, lie prescribes \"a pill of five grains of calomel, and about four hours afterwards a so- lution of neutral salts in peppermint water ; and these should be repeated every third day till the discase disappears.\"- Wlhen the colour of the stools indicates a removal of the obs- truction, he directs two ounces of some slight bitter, such as the Infus : Gentian : comp : or the Infus: Cascarillaæ, three times a day. It isalo mentioned that a variation in the yel- lowness of the eves and skin may occur, while the obstruc- tion reniains the same. What is said in the third chapter corcerning the knowledge ofthe diseases to which the Pancreas is liable, amounts to a positive proof that we know noihing of their existence in the living subject, altbough the author would attempt to ascer- D",
         "cRITIcAL ANALYsTS. taid them, by the absence of other diseases. This negative mode, however, may perhaps prove as.ineffectual, as it is for the most part difficult, if not altogether impossible to arrive to that conclusion. The sane obscurity envelopes the affections of the spleen, We must, however, mention the symptoms given by Dr. Pem- berton, indicating the indolent smiling, or engorgement, of this vircus. These are : difficultv of lying on the right side, comuple.xion cf a lenden colour, and verv sallov, though with- outjaundice. It is a very singularcircurmwince, indecd, that a !ong continuation of intermittent fevers, cspecially of quar- tans, give a tendency in the spleen to swell. On the whole, ve may acknowledge that the diseases of the spleen are not much better understoed that its natural functions. Among the symptoms enumerated in the sixth chapter, indicating a dis:se of die kidneys, ve notice the followi.g : \"a torbid urine, with a seulement of purulent matter, ex- tremely offensive to the sniell and stre-iked with blod; also a dul pain in the buttock of the side affected, extending down the thigh, and offten (though not always) a retraction of the tesiicles, or a mere soreness,\" But when a stone is in the ureter, \"the pain is more acute, the pulse less frequent, and a sympathetic pain on the skin of the abdomen, inidway Uztwen the os ilium andnavel whilst in inflammation of the cellular membrane under the psom muscles, the pain is in- creased bv rotating the thigh, the flesh becomes wasted, and the nausea attending a disease of the kidneys is wanting.- Large stones have sometinies been found without having ever been suspected during life.\" On noticing the striking occurrence that diseases of the kicdneys produce no emaciation, Dr. Pe mberton takes an op- portunity of suggestingan ingenious distinction between the organs whose diseases occasion a wasting of the body, and",
         "PEMuKttTON ON TIIX ASDOOfI12, VISCERA. those ini which it is not so ; and this is apparently so plausi- ble that we cannot pass it unnoticed. lie proposes to divide the glands of the body, into thoie which secrete a fluid from the blood, for the use of the body, and those which secrete a fluid to be discharged from it. The former nay be terraed glands of supply, and the latter, glahds of waste. The lirst are the Liver, the Pancreas, tie 3Mesenteric glands, perhaps the stonach, and the sinll intestines ; the Spleen is also iicluded in their number. The second, viz theglands of vaste, are tie Kidnoys. Breasts, exhalant Ar- teries, and the large Intestines. In the former class of or- gans, the diseases are invariably accompanied with a wasting of the bodv, whilst in the grlands of vaste, emaciation dues not take place. There is botli truth and ingenuity in this di- ývision, but whether it can be strictly applied to practice, and in that case, how far it miglt nut be extended to a greater number ef diseases and of organs, are qaeries which, in our opinion, deserve investigation. We therefore leave them to more experieniced and competent judges. In the next cliapter, the diseases of the stomach are enu- merated. \"A pain in the stomch,\" says the author, \" not arising froni an organie disease of that viscus, does not affect the pulse, for although it may be frequent from irritability of habit, yet it is not more so when the patient is suffering fron pain, than when lie is without it, and in this case the tongue is moist and without fur.\" Pyrosis or Water Brash he has also frequently observed in Scotlancd and Ireland, more con- nonly anong women than men, and, attributes it to the use of potatoes, \"«because,'\" says he, \"their living chiefly upon potatoes, eeems to be the only peculiarity in their mode of life.\" Buthe does not believe it arises froin the use of ardent Spirits ; he is, on the cnntrary, led to eonsider that drunkards are less liable to it than others. Dr. Pemberton adopts the 0\u003eilion of Dr. Rollo;r'especting the affinity and resemòlanco",
         "CaITCIL ANALsis o pyrosis with diabetes. in the treatment, he places great reliance on Opium combined with Rino in pills. Alum, and Rhubarb are also prescribed, but enietics are reprobated. The other .specfs fp:,ün in the stomach, which the au- thor attributes to the muscular fibres of the stomach par- taking of the general irritability of all other muscular parts in an irritable habit, also deserves great attention. \"In this complaint, the pain is most felt when the stomach is full- the tongue, towards the root, is covered with whiite mucus, the food will rernain down perhaps half an hour ( or more ) before any uneasy sensations are produced. The pain conti- nually increases till the foodl is returned agnin, Try litile changed by the operation of digestfi. The disease is also attended with symLnpathetic headache, and seenismore particu- larly to attack hliorotie ivomen, and hypochondriacal men.- It may be distinguished from that pain 'which is produced in a stricture of the Cardia, by the pain not being perceivcd the instant the food is swallowed-by the seat of the pain not being confiied to one spot, (both of which circumstances at- tend a stricture of the Cardia)-.nd -by there havin- existed constitutional derangementprcricus to the stomnach affection; whereas in stricture of the cardia the constitution is subse- yuetl3 affected.\" The niedicine which is here prescribed, is an ounce and ahalf three times a day of the Mistura ferri comvonsita. The author adds that be bas known the recur- rence of the pain prevented, by the taking of a tea spoonful of brandy before each mneai, although fermented liquors shouid in general be avoided. There is also another state of disease of the stomacli which as it has neyer been properly describeds we cannot pass n- moticcd. It is represented by Dr. Pemberton to be a vomit- ing, in consequence of nausèa unattcnded by pain. \"It at- tacks the patient in paroxysms, after considerable intervals of perfect health, and what is thrown up is usually small in",
         "PzUBERTON ON THE ABDOMINAL vISCZal. [uantity, and often sour : there is also frequently a sensation. at the root of the tongue, and sometimes through the ivhole lengtli of the esophagus, which 'constitutes what is caled. Heart-burn. There are eructations, and usually great head- ache, and the pain-is often confined to the ball of one eye.- The tongue is moist and white; the pulse natural, and there is no thirst. A predisposition to it appears hereditary, and its i..turns are much influenced by the inagination.\" In order to remove the parosysi, the author prescribes an enietic or a purge; but to prevent its recurrence, the patient is directed to abetain fbom hot soups, animal broths, fish, the fat of meat, miilk and all ferrmented liquors. On the coutrary, he is advised plain ments in moderation, with dressed vegeta- bles, exercise to a degree as to occasion some perspiration, and Seillitz water as an evacuant. In that species of heart- burn caused by the formation ofan acid in the stomach, there- by giving rise to a sensation of hent about the cardia. and of rawness along the internal surface of the oesnphagus, our au- thor recommeads five drops of the -nitrie acid every three or four hours in cold water ; and when the cisease is checked, this is to be dimînished to three, two, and at length one drop every three or four hours. We now proceed to sorne organic diseases of the stomach, 'vhich, although well understood, are still beyond ourmeans of cure, and therefore worthy of our most serious attention. The frst is a stricture of the cardia, which, according to Dr. Pernberton, is indicated by a peculiar sensation on any at- tenpt to swallow solid food \"This is a £ort of tensive cir- cumscribed sensation about the pit of the stomach, striking through to the back, producing a feeling of incipient suffo- cation. This continues till the food is rejected, whichils done by an effort more resembling hiccup than vomiting.\" A stricture of the pylorus, savs the author, may be confounded with that state of stomach attending chlorotic wumcn ; but",
         "CRITICAL ANALTSIS. in this latter case, a constitutional derangement lias preceded the stomach atTection, whilst in the former, it is the reverse, and the food having passed to the stomach without pain, as in stricture of the cardia, is thrown up by vomiting, and not by that peculiar effort above mentioned. * The author knows of no symptom indicating a schirrhus of the stomach, but when it is formed into un open cancer, \"there is generally an eructation of very fætid air, and also a vomiting of dark coloured mucus, whiéh is also verv offen- sive. The pain is constant, though varying in degree, and is increased by taking any acrid substance, and not by taking mild fluids such as milk, \u0026c.\" la the treatment he relies chiefly on milk diet, and on cicuta and c.lomel, the latter not to a degrce to affect the system. The last accident mentioned in this chapter is the Vomit- ing in old peopie. This malady does not proceed from any known cause, and is to be relieved by salis, opit:m and a spare regimen. A total abstinence fron every thing for si.xc or eighthours, has sometimes restored the patient. With respect to the diseases of the intestines which are the subject of the eighth chapter, we find nothing particular whe- re the author speaks of cholera-morbus ; but in Dvsentery, which he does not consider by any means infectious, he di- rects purgatives, untill the conplete evacuation of the scy- bala, and when the griping pain has in some degree subsided, he has obtainci the greatest relief from twelve drops of Balsamum Copaiboe, every four or six hours, with cinnamon watcr and the yoke of an erg. \"A constant pain round the navel, vith a retraction of the integuments towards the spi- ne ; a costiveness, an absence of fever, an accelerated pulse, and a preference to a bent position, will distinguish colica pictonurm from any other disease of the abderen.\" The au- thor considering the costiveness as spasmodic, recommeinds npium as a cathartie, wivth salts or castor cil, or if no fluid",
         "iMBRz'ToN ON TiR ABDOMINAL VISCERtA. ýan be taken, with calomel in the form of pills. \"The oily draught, or half an ounce of neutral salts, should be taken every morning, in broth containirig a large proportion of fat and suet as prescribed by De Haen.\" Dr. Pemberton has succeeded in curifig a paralysis of the wrist, the conse quence of this affection, by supporting the arnm with asplint made fast tinder the arm, to the extremities of the fingers, the hand being laid flat upon it ; and a cure was effected by hlm in four or six wceks, the splint being kept night and day.- le acknowledges, however, that this trial in cases of para- lysis not proceediig from the absorption of lead, has not suc- ceeded. Our Author dwells somewhat at length on the distinction between the Fcbris infantzwn remi!!en., the seat of which he allows to be ii the intestines, and Hydrocephalus. In the former, he veryjudiciously insists on the propriety of admi- nistering full purgative doses, if the costiveness is obstinate; although he fears that by producing a great discharge, the intestines may become distended viti air, and thereby occa- sion a fatal Tympinitis. In a case of this kind, which occur- red lately in ourpractice, we gave half an ounce of turpen- tine, after the failure of the strongestcathartics, and the child being about five vears ofage, speedily recovered, and is now doing perfectly well. We niust, however, add as an uncom- mon occurrence, tfiat during the convalescence of this child, large abscesses broke out, on the forehead, behind the neck, under the chin, along the spine and the extreinities, all at the same time, and of about the size of an egg. Ia the inflammation of the peritonmal coat of the intestines, our author recommends, besides general bleeding, the appli- cation of cupping on the abdomen, but particuirly opposite !o the ca:cum, and purgatives are to be continued during the whole progrcss of the disease. He also directs, when the dis- asie runs on to Lhe sixth, seventh, or eighth day, whout a",
         "ORITICAL ANALYSIs. sensible abatement of the symptoms, the throwing up the rec- tum the smoke of tobacco, or its infusion in the proportion of one drachm of tobacco to ten ounces of boiling water, for an enema, which may be repeated every six or eight hours. An inflammation of the mucous membrane of the intestines is marked by the pain being \" conflned to some one part of the abdomen, and not acute though constant, and by the ab- sence of tension of the abdomen. The pulse is about 112 in a minute, and the bowels are costive.--This inflammation ze- nerally terminates by a throwing out of coagulable lvmph, whic' maybe disco'ered in the evacuations, resembling shreds of boiled macaroni, and which announce that the patient will soon recover. But if the evacuations are particularly offensive, and appear curdled, with here and there specks of blond ; and especially if these continue for any length of time, there will be gond reason to apprehend, that the inflammation lias ter- minated in ulceration. The disease, in this state, is extre- melv dangerous ; though a steady adherence to a milk diet will frequently restore the patient, when it is assisted by small doses of some astringent bitter, such as the Decoctum Cin- chonoe, or a weak infusion of the Cortex Granatorum.- When ulceration appears to be low d.îwn in the rectum, an injection of the expressed juice of carrots has appeared to re- move the offensive smeU of the fæces, and to give the 1lcers a tendency to heal.\" The concluding ciapter is devoted to the disease of the me- senterie glands called by the French (le Carrcau). The symptomsof this afflicting malady, and the means of distin- guishing it from others with which it has a reEemblance, are ably and accurately described. But the conclusion amounts to a corroboration of this painful truth, that it is like many others, an incurable disease. In parting with this excellent work, we must again ex- press our conviction, that, in a practical point of view, it will",
         "PEbiMBERTON ON THE ABDOMINAL VIScERA. 33 be found one of the niost useful books of reference to the practitioner ; and although it is only devoted to a limited number of diseases, yet the importance of those to which Dr. Pemberton has difected hi rescarches, as vell as the limited means of cure which we possess against ni:ny of thmin, it is yet entitled to rank among the niost valuable productions in the science of Medicine ; and we do not hesitate to say that it will contribute .in no little degree, to maintain the es:del Professional reputation and eminence which its distinguisihed author deservedly enjoys in the opinion of his contempora- ies both at home and abroad.",
         "QUARTERLY RETROSPECT OF IMPROVEMENTS IN MZEDIcAIL SCIECE. The C(anadian Rcrie= zn Maganc. Gcologicai and MinerIlogcaZcharacters ofthe''Black Rock\" of Cape Diumond.-The rock of CapeDia.mond, cornmonly cal- led the \"Black bock, has been sometimes denorninated a Li- mestone. With the vicw to expose its claims to tha:t distinction, we shallgive, to the best ofourability, its Geologicaland Mine- ralogical characters. The Strata, as they lie naturally and artificially exposed, on the northern shore of the St. Lawrcn- ce, betwcen Cape Rouge and Sillery Cove, areof thatvariety of argillaccous schist, called Grey Wacke, assdciated, in con- formable order, with that finer variety denominated Clay Slate or Argilite. Tlie dip of the Strata is to the S. E., at about an angle of 353, iLs consequent bearing N. E. and S. W., with a slight inclination of its upper edge below the ho- rizon, towards the N. E. It is probably owinz to this incli- nation, that the Grey Wacke is lost before it reaches Quebec, bv descending below the level of the St. Lawrence: indeed tue last of it is seen at Siilery Cove, very near that level, and five miles from Quebec. Ilere the Clay Siate, which bas been running in parallel strata at the back of the Grey Wacke, is alone visible. It forms n lw ridge, but continues to rise tnwards Quebec vith the interruption of a valley or two, un- til at Cape Diamond it forms a precipice about 320 feet above",
         "QUARTERLY RETROsPECT. the level of the river. All this distance, it pîresrves mach the saine dip and uearing as the Grey Wacke, with wlicl, fi some places on the opposite shore, it may be seen alternating. Althougli no Geological difference, tlius far, appears between the Clay Siate at Sillery Ceve and the \"Black Rock\" :at Cape Diamonid, a very evident chemical one exists. At tie latter place the rock has become oftern of a stooty blackness-exhal- ing a bituininous odor when struck or seratched, and some- tie; soiling the fingers. The cause of this is the preseiice of Carbon, which lias baen four.d in the roek in the propor- tion of 20 per cent. There appears also to ba a dhierence in the eIfect of weather, or otier destructive ager.ts. On the Clav Slate, betwcen Siliery Cove and Cape Diamond, tlcy exert their influence hy covering the base of the rock witi a erumnbling dleposit of small wvedge slaped fragmîIents, So- metimes higlly ferruginous. At Cape Diaionl they act by displaving a continuous schistose structure oflittle tenuity pa- rallel vith the plane of stratification. The eneral bearing of the \"Black Rock,\" is to the N. E. However, in sone places the strata may be seen running North, the dip being reversed to the N. W. In some cases the strata are vertual, or nearly so. All this mav be occa- sioned by the bending or waving of the strata. The thickness of the strata varies fron three feet to three inches. The former are often, to all appearance of a very compact structure, breaking with concnoidal surfaces and sharp edges. In mîost of these, however, weather effects what the hammer fails of doinz, and displavs its really schistose structure. It is on account of this, and its absorbent charac- ter, tlat the \"Black Rock\" is not a good building stone.- The thin strata are generally very schistose, apparent to the eye. ' hey are soinetimes compact and break into long pris- matic pieces, which yield a ringing, metallic, sound when struck : these separate the thicker strata at certain intervals",
         "'36 QUARTERLY RETROSPECT. and often determine the planes of stratification vhen they might otherwise be doubtful, from the resemblance which the whitened and even surfaces of the natural joints some- times bear to them. The latter are never continuous-ano- ther useful test. Among the peculiar appearances cormon to the \"Black Rock,\" and displayed by fracture, is a ribbed aspect : another is a glossy convexity, a surface ressemblingpolished shoelea- ther. The effect of weather is also sometimes remarkable.- In most cases it exhibits the schistose nature of the rock; in others more compact, it shows a roundecd and whitencd sur- face forming a striking contrast with its sooty interior.- *While again in others, by the rounding of successive laminoe, a series of concentric irregular ovals are foried, much re- sembling the grain of fir ; and when the surface is browned or reddeied, a singular imitation of wood is produced. In excavating, strata are met with, the colour of which is a lively green : these have, for the most part, undergone a considerable degree of induration and reembile flint in frac- turc, translucency, hardness and effect of the blowpipe (query siliceous schist 1) spheroidal concretionary lumps of the saine, and of a dark grey varicty, are common, Sone of the strata are decidedly more calcarcous than others : and two instarces of an unquestionable Limestone have met our observation. The first is fetid and somewhat Chrystaline: the other compact. Both are situated on the same plateau, and bordering on the local and conformable congloierate, which characterizes the precipice to the N. and N. W. of the town. The last mentioned stone is of-an excel- lent quality, and dissolves in acid almost totaily, with violent effervescence, and burns to a white caustic lime. Unfortun- ately for the inhabitants of Quebee, w0ho procure their lime at Beauport, a distance of five miles, on the other side of the St. Charles, it does sot prescrve these characters for any",
         "QUARTERLY rETROSPECT* 37' considerable distance, but becomingsuddently impure, it is lost by abruptly dipping under the « Black Rock\" in the di- rection of its bearing. The fragment of one solitarv bivaloc vas observet.it. The minerals found in the \" Black Rock\" are 1st. Iron as an oside and as a sulphuret : the former, in a state of solution, often bestows a red or yellow stain on the surface of tie rock. The latter is not so common and is ge- nerally found With a soft greenish varicty of the rock. 2nd. Quartz sometimes in fine aucular ervstals of considera- ble transparency, as are also others approaching the form of the double pyramid, applied base to base more frequently in ill formed semii-transparent prisns. They vary in size from drusy, to crystals as large as the tli-mb. The latter are ne- ver transparent throughout ; and often appear in the progress of formation. 3rd. Calcarcous Spar, in white and brown aucular crystals, finer than spun glass, radiating from a white calcareous base, often enclosing ill formied crystals of quartz ; also in perfect rhombs. B1ut its most common appearance is in veins of a lainiar structure, traversing the rock in all directions ; these in sone places become so numerous as to give the rock the aspect of a congloierate ; they often traverse cach other, andin this case, onevein appears to have dizlodged that por- tion of the other it met with in its progress.* 4th. Petroleum, in soft translucent pieces of a green and yellow colour, sometimes surrounding the soot, more rarelv insinuating itself into the interior, of a crystal of quartz. 5th. Coail-dust or soot, often investing the surface of quartz. Crystals, in drusy cavities. The same thing has been observed of veins of granite in gneiss-the former is owing to the infiltration of calcareous spar, through the agency of-wa ir, ito fractures ne the rock across old- er veins of that mineral. The latter docs not probably admit of so satisfactorv an explantationî.",
         "QUARTERLY RETROSTECT. Gth. Fluor Spar. As far as we can learn, this is by no means common. One specimen of an imperfect crystal we have met with. Its colour is a deep purple, so intense as to render the crystal scarcely transparent. Its forn is that of half a curve di- ided diagonally. It was found associated with caix spar in a crevice of the\" Black Rock.\" The earthly minerals above nared, occur for the most part, in crevices and small fissures in the rock. 0f rtwo specimens of rock, one procured from Wolf's Cove, betveen Sillery Cove and Cape Diamond-the other fron Cape Diamond, the following is a comparative mineralogi- cal d.scription. fldf's Cov.-Colour, dark ash grey, opaque--st-ucture compact, fracture uneven, somîewhat conchoidal with sharp edges-easily scratched by the knife-reccives a trace from copper-colour of powder, reddixh-streak duil light grey. Sp. Gr. 2,57. Moderate effervcscence inii acid with or without being powdered, which soon subsides, leaving considerable sediment. Before the blow-pipe it formis a yellowish or brownishi enanal; the part furthest from the flame is whiten- ed. Cape Diumond.-Colour brownish black-opaque- struc- ture compact paclure uneven conchoidal, vith sharp edges, scratched by the knife, but not quite so easily as the forego- ing-colour of powder, reddish ash grey- streak reddish grey--e£hales the bituminous odor when struck-effect in and the same as the last, with the addition of the solution being discoloured. Sp. gr. 2,54. Effect of the blowpipe pre- cisely the sane as in the last instance. Such is a very imperfect sketch of the Geological associa- tions and Mineralogical characters of the \" Black Rock\" of Cape Dianiond ; froin which it appears to be an argellite and not a L. stone. The only characters it possesses in common any of the varieties of the latter, arc a Elight efferves-",
         "QUARTERLY RETROSPECT. cence in acid, and its bituminous odor. But as the clay, slates, sand stones, and shelis, in this neighbourhood, pos- sess one or botli of these characters, as they often do else- where, they are liable to be confounded with the L. stones, if the \" Black Rock' be considered one. A. B. London Medical and Physical Journal. Case of small¡pox afler inoculation with smallpox.-A case of smnll poc occu1rrinr after small pox froni inoculation is rcported by Mr. Richards. It appeared to have been modi- fied and mat eriallr intluenced by the previous inoculation. Effect if Ergot.-It ivill be recollected that in our second No. cases vere published by Drs. Morrin \u0026 Painchaud of this city, as also a valuable communication fron Dr. Taché of St. Thoinas, illustrative of the efficacy of crgot in promoting uterine action. We have the pleasure to announce semilar successful results in three cases published by Mr. Clark, Sur- geon, Bristol. In other publications, we observe that this remedy has also been given in uterine hemorrhage with a de- cided benefit, as was suggested by Dr. Taché some time since. Wound of the abdomen.-Mr. Wm. Dix, of Northampton.. sbire, was called to a young man who had received from the horn of a bull, a wound of the abdomen of about three inches in length. Nearly three feet of intestines protruded, with a portion of the mesentery and omentum. He was called twenty minutes after the accident, returned the protruded parts, and kept the wound closed by means of a suture and sticking plaster. The patient recovered in less than a fort- niglit.",
         "40 QUARTERLY RETRoSPECT. OssIf::ation of the uterus.-In a lady 69 years of age, who had died of a strangulated hernia, Mr. FowL:s found a large spherical mass of bone, of the size of a pullets egg, irmbedded in the uterus, behind the triangular cavity ; part of the substance of the uterus being distinctly to be traced over its upper part. Ucrine Ilemorrhage cured by transfusion.-We mentio,ý ed in our last the case of a young woxnan into iviiom r. Blundell had injectedfour ounces of blood with success, and we have the pleasure to announce a second succesful trial in a similar case which occurred to Dr. Doubleday, who injcct- edfourtcen ounces cf blood taken from the husband's arm. The operation vas perforied in the same manner as that of Dr. Blundell, and the recovery was also speedy and complete. The subject in this case vas much stouter and oi a larger size than the other, which may account for the greater quan- tity of blood required. Two equally succesful cases are also related by C. Waller, Esq. Comparison of Indian and European Skulls.-Dr. Patter- son, of Culcutta, from a comparison of numerous skulls of Indians with those of Europeans, has deduced that the head of the former is to that of the latter race as two to three. Or otherwise, that the head of an European fifteen years of age, is of the same size as the head of an Indian thirty years of age, Erperimcnts on Poùoning.-M. Segalas communicated to the Academy of Medicine the result of soine experiments made by him, tending to prove that poisons rather produce their effects through the medium of the vessels than of the nerves. The fullowing is the result of his researches 1st. Having cut the spinal marrow of an animal, so as to Tender it paralytic, and having placed some alcoholic extract of nux vomica in the paralysed parts, he percëived that teta- nus came on just as quickly and powerfully as if the nervous system had been entire.",
         "QUARTERLY RETRoSPECT, 2d. Having, on the contrary, left the spin:d marrow un- touched, but prevented the blo;îd whiclh returned froni the part where the poison had been lndged, fron being carried to the lcart, lie observed that the poisoning did not take place. 3d. Tetanu. .ppeared to come on equally quickly vhen lie injected the poison into the bronchi:,, although the eighth pair of nerves were divided. 4th. The nux vomica place: in the thigli of an animal ren- dared paralytic lly the division of the spi:mlnmarrow, produ- ced telanus not only in the trunk and upper extrenities, but also in the paralysed parts. 5th. The sa:ne result takes place in wla-tever part the poi- son has been placed ; only the contraetion of the paralysed muscles is slower, and seems only to occur in proportion as the blood conveys the poisonous matter to the nerves which animate them. Gth. H1aving injected the poison into the crural artcry of a paraphlec animal, its effE:cts were manifested in the like man- ner : the convulsions coinenced in the thighs, and only became general after the lapse of time judge 1 to be necessary for the ronveyance of the poison to the spinal marrow. M. Segalas concludes frou his experiments, that the vo- luntary muscles can contract themselves, in certain cases, in- dependently of the action of the spino-cerebral system. In these experiments, M. Segalas has often designedly made the division of the spinal narrow at differcnt points, but nost commonly on a level with the last vertebroe of the neck, or the first of the lumbar vertebrm; and this has produced no modification of the phenomena. Re-union of a Nose, which h ad been compltclýy separated.-.- The follo\u003ewing abstract.of an instance in point we take from one of the best German Journals of the day :- An unfortunate tailor, by the name of Gruzlewski, seated himself in a window, one wing of which lie had opened. A",
         "QUARTERLY RETROSPECT, sudden and violent gust of wind shut it with considerable force, and a part of the glass which was broken carried off a great portion of the man's nose. The separated piece was about the length of a finger, and the whole breadth of the- nose. It fcll from the second storv of the house into the street. The circumstance occurred about seven o'clock in the evening. A surgeon was immediately sent for, and he was satisfied with merely applying a plaster. Another surgeon, iowever, was consulted two hours after the accident. He sought for the nose vith a candle in the street, and placed it in its natural situation. In a few days it had united, and re- gained its warm th and sensibility. 'fhe only mark of the ac- cident whi.ch rernains perceptible is a small, narrow, red scnr. It is observed, dhat the magistrates would testify the truth of this relation, if it were considered necessary. A similar case is also recorded in the same Journal, in which complete union took plate, where the nose had been en- tircìy scparated. (Journc! der Chirurgie und Augen-Ici- kandc. von GnR FE und W.\\LTuER; band -, heft 4.) For much interesting information upon the subject of the re-union of divided parts, we refer our readers to a publica- tion of W1îsaxx, \"De Coalitu partium a reliquo Corpore prorsus disjunctarum.\" Gangrena Senilis.-DrurTREN recommends the applica- tion of leeches in this '.:rm of complaint. By their frequent application, he cured an old ivoniai, of sixty years of age, in the Hotel Dieu. The usual sedative, antispasmodic, tonic, and antiseptic means, had been tried in vain. The authority of this eminent surgeon is doubtless·to be received with much attention; yet we may be allowed to doubt, not from any abs- tract opinions upon the subject, but from attentive observa- tion, whether there.are many cases of true gangrena senilis in which we can venture upon debilitating means of any kind.",
         "QUA'R*CERLY RETRO.iPFUT. 43 New M»Iontkfjj Gaze lle of lcaftz. CarefGrFj;d .sy -Dr. CUE§OLMl. of Canturberry, lias cured several caseq of Epilepsy, some of Mlsich were o? manv year, standing-, Iy the folli ing- nethod : lie ordt.,rs the tartar crnetie noinmet to be rulibed, on the upper part of the arin, the bowels to hc freiy ope-ned by croton seuoil eVery second morain!r, cnd a piE composeti of one ei-hlh. o? a grain of lu- x.à-tr caustîc with il-ri.- grains of the extract of he:u1luelK, to bu tkntivice a day. Gurfu-Crup -D~ X LiELaOof Prtisîs-a, r-coi-meris the VOIiing tr--.tiaient, W~ha rnXL1Irc ci' Ant1iIflofial, wine., IIpec.icu-.n, ni o.vDiuel or qls cuhut unil a membru- neus sub-,tt.ice, andi afterardi a tough, plhle-m arc thraivn Lecchcs.- vcry inter-,stingi article on the use of lecehecs, ni tli-irjLuiicious cnip)lovm-ient iii the vanscases ani consti- tutions, is given by the Editor, l'he practical utility of whieh woV(Uid w.-rant, our i:iserting iL at fil ieng-th, dit i Uct our li- mits preclude it. IVe illili erefore presezît ii.s prominent fe:aturesý. A leech ivill draw about its own %weiht ot bloond, .nid the:e proporti-iii will ooze ont of the openin; aft r izs r-.aovztl, larovidadz warm funxax Csh continueti for soine tine -,fter. Thus a ieech wei-hio twvo drachnis vri!I dr-ai about twc drachmus o? blond, andi the quantity wvhieh wiIl esc-.peo afzervards will ho very littie more tlhan that quan- tity. Thus the qnnivt eae ah setie ythe wveaght -ofe the afnmal. itself. Trhe blood taken uphy tueleeh itself scenis to, be venons, whilst thiat wvhich escapes aftee iLs remcwval isatra.This is essentiai to bc known particularly inl typhus lever where the ]oss of arterjal blood, may be detri- Mental, whil3t, the vennus may bc abstracted, with benefit. It 18 àlso desirable to knoiv the quaintity oe blond whichi may be, taken from, the body of a chilti or of a iveak uerson.",
         "-QUARTERLY RETROSPECT. ilercurial Ointment.-iM. Hlernandez ias ,communicated to the Society of Pharnacy of Paris, a new mode 'if making the mercurial ointment. It consists in heating the mortar in whîich the ointmentis to bermade so as toliquily thelard. As the lard cools, the quicksilver becomes divided or incorporat- ed, during the triturature. By this plan, niuch time and la- bour are saved ; an addition of a few drops of turpentine, which evaporates during the triturature, greatly accelerates the division of the quicksilver. Laudanun.-It appears, by the verdict of a coroner's in- quest, that two infants, ziged only a few nonths, were poi- soned by the dose of seven drops of laudanum. In many ir- ritative complaints of infants, particularlv during teething, laudanum is unquestionably a nost valuable inedicine ; but in such cases, practitioners seldom order a grcater quaptity than a drop for a dose, and generally only half a drop. The basis ofGodfrey's cordial being laucainun, its indiscrininate use lias no doubt destrcved the lives of nanv thousand chil- dren. Of late ycars, this quack mcedicinc lias nearlv fallen into disue. Edinglurg 3!edical and Surgical Journal. Cs fCí Rccorcr3ifrcm Dupfurc oJ the LUerus.-B»y Lewis Fr..eu, Phyivci::n nr.d Comrzei!or to the Dutchess of Parma. (.:nnali U::i=ersli di 31ediina, Fchbr. 125.)-A woman, 4 vears old, in lier sixth prciancy, was taken with labour pains at te usual time. Whilest::ndinz, vith the assistance of the miduife, ::- wae s suddenlv seizd with faintness and vomitin; andi whlile her itu::band ;and the nidwife were as- sisting her into her lied, sle canplained of a sense of tearinîg in the belly, and a feeling as if there were two foetuses. The",
         "QUARTERLY RETROSPEeT. 45 belly soon began to swell, the vomiting recurred frequently, and the breathing became interrupted. Professor Rossi beiné calleid to sec ber, recognised a rupture of the uterus, and af- ter consul ting wiitbsone of his fricnds, proceeded to extract the ehild by the operation of gastrotomy. The incision was made on the left side cf the hvwoastrium where the feet could be felt, and in no long tine the foetus and secundites were extracted, The child gave sorne signs of life, but soon expired. Fort. klter the uperation, tie woman was res- tored to a state of perfec.t health, except that she liad a her- nial tunour of the size of a large apple in the scat oF t icie- sion. Three years afterwardsshe became again pregnant, and brought forth a sevea-month's fetu-s, which lived fourteen days. Edinburgh Journal of tie dlIcical Sciences. Protruion and Wuund of tlie Stonach.--Mr. TRAvERs re- lates, thit a fenmale, ag-ed 53, and the mother of ninc:ccn chil- drn, in.icted on herself a vound in the ablomei, ilrce in- ches in length, andi in a transverse direction. Wbea admit- ted into St. Thou:s' Hospital, at the expirmtion ofsix hours, the greater part of the large curvature of the stomnach, the arch of the colon, and the entire large onentuni, were pro- truded ar.d mtran=ula!ed in the wounil. The orentun as partiall detached from the stomach, which organ vas vound- ed il two places ; one, halian inch long through the perito- neal cout; the other, a perforation of all the conts, admitting the hxead ofa lare probe, and giving issue to a considlerable quantity of mucus. Patient faint ; pain sliglt; pulse 102, and irregulir ; some hiccup. A silk ligature vas placed round the sinl puncture in the stomuach, and the displaced",
         "QUARTERLY RETRosrECT. viscera returned, after enlarging the external wound. This last was £losed by the guili suture. Warm fomentations, and abstinence from food and drink enjoined. £nd day, some re- action; had been sick in the night from some drink given ; is frce from pain ; pulse 120; pain on pt-essure : an enema ordered. Er-ening, a dose of eastor oil, and twentv leeches to the abdomen. Sd, much fever ; V. S. zxviij. and 20 leeches to the abdomen ;. bowels not opened. 4th day, two stools ; pulse 98; tension of the abdomén ; three more stools during the day. 5th, sutures rernoved ; wound united, ex- cept at its right extremity, where a serous fluid is discharged in considerable quantities. On the Gi day, was allowed food, and on the 23d of Dec. about two months after the ac- cident, was discharged cured. The NÇe=-York Medical and Pliysical Journal. Dr. FosTAIs on Ieadachc and Tic Dculoureux.--Many people, especiaUy sanguincous and delicate females vith flushed countennnces, are occnsic-nally affected In the afternoon -with pain in the head, which increases until they have slept a sufficient length of time, when they awake free from dis- tress, and in good health. This continues uninterrupted un- til mid-day, when the same action commences, and runs the saine course. This affection, which is truly pcriodical, ari- ses unquestionably from an increased action of the capillaries of the brain, and conscquently would te aggravatcd by sti- muli or irritants. The nervous, or periodical headache cf authors, however, is quitethe reverse of this. It affects the feeble and nervous with emaciated habits and pale countenances. It commen- ces early in the morning, sometimes a few minutes after a-",
         "CZIARTERLY RETIKOSPECT\u003c waking, and continues untiljust after mid-day,. when it be- gins to decline, and in the evenfing ceases entirely. It arises, most probably, from a perturbed state of the faculties of the brain, favoured7by debility both cerebral and vascular. That pure debility or atony wili not produce this affection, is evi- dent froi the fact, that excessive hæmorrhages and other di- rectly depletory means, how far soever they may be carried, will not of necessity induce the disease, Gure.--The indication of cure in nervous irritative diseases in general, that of elevating vascular action, will not always overcoine the morbid process constituting this disease ; al- though it frequently will, especially when supported by to- nics, effect that end. This affectioa more readily admits of relief froim counter-irritants, inducing a new action in the parts concerned capable of naintaining its ascendency. For this purpose no article possesses lialf the efficacy of arsenic. This herculean agent, administered ini doses of one fourth or one halfa grain twice in twenty four hours, with the interpo- sition of a laxative every 4th or 5th day, will seldom, I iuay venture to say alnost never, disappoint the practîtioner. Of Tic Douloureux.-The extreme remoteness of the affec- tion froim the centre of circulation, must render blood-letting either nugatory or utterly abortive, and purging promises but little more ; but emetics give a general impulse to every liv- ing fibre, break old associated habits, give mobility to new laws, increasing the action of the veins and lymphatics, and yet diminishing that of the arteries. They indeed scem to debilitate, but the debility they induce approaches the nature of a languor, readily admitting relief from the action of to- nics to whose remediate powers theygive a degree of conge- niality and facility of operation otherwise unattainable. They should not only precede a tonie course, but should be fre- quently interposed during its continuance. Iaving cleared the vay by an emetie, our next stcp is to",
         "QUARTERLY RETROSPECT. restore the action of the digestive organs, and through their instrumentality, the vigour of the whole system. This ob- ject is most effectually accomplished by chalybeates, especial- .y the carbonas ferri, emplvcd so successfully by Drs. Hut- chinson, Ritchmond, and Carter, as reported in the London Journals. This article, so celebrated, admits however of au- xiliarv means : a careful attention to diet, bitter infusions, exercise in the cpen air, change nf scene, in short every mea- sure c:den!ated to envirorate thec dïigestive powers. Cont'buitions on ledical Juzrispruidence, by T. R. Bcr, M. D. Thi1s article contains an elaborate investigation of two cases of murder which lately took place in New-York. The irst is for the murder of Mr. Lambert, who was knocked down de.d by a blow in the stomach. On examining the bo:Iy, Dr. Post found on the internal surface of the stoinach, some sm:dl red spots of a stellated form, apparently cWTusiors of blood proceeding froni some of the smaller vessels, and extending in different directions. It was contended that this might be a case of sudden death, as there were no other tra- ces of somcthing like morbid appearance, but those spots just mentioned. Drs. Post, Stevens and Chessman, being asked whether, if these appearances had been found in a case of sudden death, without any knowledge of the attendant cir- cumstances, they would necessarily attribute them to an act of external violence\u003e answered in the negative. \"'Circums- tancial evidence must guide-but it was strongly intimated by several, that. Che marks could hardly bcproduced without some act of violence. and the idea would hencesuggestitself. Dr. Stevens did not suppose that the same marks could be produced by a fall, for in such case, the muscles are in some degree contracted and ready to receive the blow.\" Verdict: Manslaughter. Dr. Beck, whose work we have perused with se much satisfaction at the beginning of this number, and whose au-",
         "QUARTERLY RETROSPEcT. thority, therefore, must stand very high in the Medico-Juri- dical science, here remarks, that the inference pretended to be drawn in this case, from the absence ofsome positive de- rageeicnt equivalent to a common cause of death, is unte- nable ; for it is well known that very slight injuries in the regior of the stomach will frequeLtly prove fatal, without Icaving theslightest symptom of injury. Sir Astley Cooper and other equally erninent Surgeons relate similar instances. Malformation ofthe urinary andgenital organs. Dr. Cuan- LEs DRaK., Physician t? the New-Y \"kzState 'isun, relates the following extraordinary malformation observed on a pri- soner named Robinson. Description. The first part that ar- tracted attention in this remarkable malformation was a fleshy mass, situated over the region of the symphisis pubis. It was not unlike, in its general appearance, to the adhering surface of a placenta, and, at the time of the patient's death, measured in circumference at its base, nine inches and three fourths ; its highest elevation was about an inch. The ure- ters having first crossed cach other, terrninated rather below the centre of this tumour and about half an inch apart. .The urine, continuahv dribbling from these openings, hept the surrounding parts o the tumour in an abradcd and infiained state. The.vasa defe:-entia terminated with patulous raouths at the lower verge of the fleshy mass, where the sulcus, re- presenting tie uretlira-, comm-ences. These openings were as near together as in the natural state of these orgaris, and had between them a narrow granular elevation, which miglit be considered a crista galli. Fromi the rami of the ischia pro- ceeded the crura cavernosa penis, on which were directly placed, half an inch below the openings of the vasa deferen- tia, a glans of ordinary size and form. This glans was placed reverted, with its lower part uppermost, possessing an ample fold of skin below it-the vestige of a prepuce, but devoid of any trace of frenum, and the upper part of the parietes of the G",
         "QUARTERLY RETROSPECT. urethra deficient, so as to constitute *the urethra a mere sul- cus, which extended between the risings of ihe crura up to the verge of the fleshy mass before described. Directly be- neath this urethral sulcus, extending back beyond it, lay the prostate gland. A short distance below the cipénings of the vasa deferentia, in thesulcus, were three -or four minute fo- ramina-these were thought to be the excretory ducts of the prostate. Between the peritoneum and the inner surface of the os pubis, where this bone joins its fellow to form the sym- phisis, lay on each side a yellow condensed cellular substan- ce, resenbling, in some degree, in structure, the vescicule seminales, the rudiments of which bodies I have no doubt they were. The vasa deferentia .passed under them, and might have communicated with them, but the parts were so altered and condensed by previous attacks of inflammation, that 1 despaired oftracing the connexion. -The testicles were large and apparently well formed, the scrotum without rnpha., and the anus situated more anteriorly than under ordinary circumstances, In each groin where the spermatie cord passes over the brim of the pelvis, there vas a fulness and projection vhich gave the appearance of hernie, but which, on examination, proved to arise from the unna- tural size of the angles of the ossa pubis, which, instead of -forming the symphisis, terminated at this place, leaving a space between the two bones of nearly four inches. As the body exhibited no trace of an umbilicus, the first object on openinginto the abdominal cavity was, to ascertain how the fotus had been nourished in utero. The round ligament was founi passingfrom the fissure of the liver, between the peri- toneum and the abdominal parietes, directly into the fleshy mass. Fron which it appears probable, that the fo:tus hnd not possessed a funis, but had been attached to the uterus by means of this substance, whicb, in its general aspect, as bas been before observed, was notunlike the adhering surface of a placenta.",
         "QUARTERLY RETROSP.CT. Thekidneys were in their natural situation, and the ureters took their usual course across the pelvis, terminating as pointed out above, without the intervent'on of any sac or blauder. The left kidney and ureter appeared to be healthy in every respect. Not so those of the riglt side : the natural structure of the kidney was almost entirely obliterated, pre- sentin- a tuberculous appearance, witli internal ulcerations and purulent deposits. The surrounding parts were greatly thickeuned and ahtered in texture, showing thu traces of former inflammations. 'he ureter of this side quite to its termina- tion, was also mueh discased, its coats tickened and of a cartilaginous fruiness. Robinson acknowledged that his ve- nereal desires had remained througl life undir.ùiislcd. Maifurmation of thc osophagus and !rachca.-A case in which the superior portion of the esophagus terminated in a cul-de-sac, at about one inch and a lialf froni the pharynx, whilst the ascending portion terminated in the trachea, is re- lated by Dr. A. P. HOLrES, as hlving occurred in the prac- tice of Dr. ARuotoi, both of Montreal. We have been led to notice this case, both fre m its coming from some of our countrymen, ai from its containing an un- common species of malformation ; and as ive cannot suppose that the reporters would altogether dread the eye of their countrymen, as it is given in a plain and intelligible langua- ge, we thus take the liberty of bringin;g it back to the place from whence it came, and wlere it should have been first made publie. Whether the conduct of these Gentlemen in this instance, has been intended as a sort of bravade offered to this publication or its supporters, we are totally unaware but we cannot be made to believe that they could have been actuated bysuch motives, when it is considered that the Que- bec Medical Journal is honored vith the support of all those who are truly respectable and enlightened in the country, and because they would then prove at variance with all tho",
         "52 QUARTERLY RETRoSPECT. friends of science, and the most respctable and learned part of the Profession in their own city. On the contrary, it ap- pears probable, and no consideration can prevent our convic- tion, that they had in view to pay a muerited honage to the talents and learning which are displaye4 in the New-York Medical and Physical Journal, by courting a place among the correspondents of that eminent publication, or at least that it bas been unintentional on their part. We cannot, bowever, allow the opporturnity to pass, with- out giving a friendly advice to these gentlemen, and to sone of the younger part of the Profession, which is, never to for- get that new and authentic cases have become so rare of our days, that they seem to require something more than an ordi- nary notice, to entitle theni to public confidence, more par- ticularly when they come from a foreign country, or from any considerable distance. They should nottherefore,go so far froin home, that their veracitv may be questioned, or otherwise ex- posed to ridicule. A very striking example of this truth can be found in a case related by Dr. Otto, of Copenhagen ; and although bis character as a Physician, stands high in the Pro- fe.cion, yet his veracity bas been called in question by some, with regard to the extraction of 273 needles from the body. We do not intend to give the sanie interpretation to Dr. Ar- noldi's case ; on the contrary, we have some pleasure in de- claring our conviction, that there appears no reasonable ground for suspecting, we do not say his veracity, but the correctness and accuracv of detail. We are still more happy in having this opportuoity of proving our strict adherence to the pledge we made, of devoting our undertaking to the interest of the Me- dical Profession in this country- and to the protection of its niembers. This duty, we hope, shall never fail to be exer- cised wih impartiality to individuals, and justice to the inte- rest of science. We expect to neet the co-operation of the enlig-htened class of our countrymen in this particular.",
         "QUARTERLY KETROSPECT. 53 Thc North American Medicaland Surgical Journal. Lunar Caustic on Wounds and Ulcers.-The practice of healing wounds and ulcers by natural or artificial scabs, to whicli the attention of the profession was first directed by Mr. J. HUTESR, bas been too much neglected, and the circum- stances under which it is useful, have not been accurately, stated. In a small ivork published by Mr. HIGGINOTTOM, in Januarylast, at London, the practice of forming an eschar by the lunar caustie over small ulcers and recent wounds, has been strongly recommended ý.s saving the patient much pain, trouble, aud danger. Thc whole surfhce is to be pencilled with the solid caustic so as to form an eschar, and where this remains adlierent, the wound or ulcer invariably heals with comparatively little inconvenience. When effusion occurs under the eschar, whether of seru m or of pus, there is more dilliculty ; but if this fluid be evacuated by a puncture, and the caustie applied to the orifice, the eschar willoften re- main adherent. Sonictimes the fluid iust be frequently eva- cuated. If the eschar does not separate favourably, a cold poultice may be applied, which not only removes the eschar, but lessens the irritation and intlammation. Should the sore not be healed, Mr. H. recomnends the reapplication of the caustic. To prevent effusion under the eschar, and to preserve it adhering, lie advises the whole to be covered with a piece of gold-beater's skin ; but we may add, that as this effusion arises from too much inflammation, more powerful meansmay occasionally be enployed, especially a solution of acetate of lead. LÂtxRy recommiends with the same view, after the ap- plication of moxa, the use of the aq. ammonim. Indeed any evaporating, cold, astringent lotion will be advantageous. The application of the caustic, of course, produces some pain, but this soon subsides, and the patient experiences more tase than under any other mode of treatment.",
         "54 QUA.TRLaT METaoltECT. Fisûla Lachrymalis.-At the session of the Royal Acade. my, on the 15th of December, Mr. J. CiLoQUET related the case of a female, who, three years previously, had'submitted to the operation for fistul. Iachrym. according to the method of M. FOcUT. The canula which had been allowed to re- main in the nasal canal, had ulcerated through the foor of the nase, and presented its inferior extremity on the inside- of the. Mouth. A practical commentary on this mode of onerating, whiclh is still recomnended by able surgeons ! Presence of Mercury in Sanples of medicinal Prussic Acid. Mr. REGutBE!AJ, apothcecary at Montpellier, has detected this impurity in some prussie acid, prepared in Paris. Its presence wae first suspected, fron a portion of the acid, ac- cidentaily dropped, leaving a white stain on the copper disli of a balance. It is probable, that the impure acid, spoken of, had been made by passing sulphuretted hydrogen through a solution of cyanide of mercury, according to VAuQUELIN'S process ; and that an insufficiency of the decoSmposing gas. had been employed. May not this accidental impurity explain the occasional sa. livating effects of prussic acid. Boston Medical Intelligencer. The Cure for Worms.-As considerable excitement has been created in several sections of tlie Union, from the pub- lication made in this paper of the 13th -ult. relative to the important discovery made by Mr. Anaox Huxciu, for the expulsion of worms, and ia consequence of which we have been solicited to give more particulars through the medium",
         "QUARTERLY RETRoSPECT. 5 of the above letter as well as by public journals, we shall en- deavour to satisfy the publie excitement not only from verbal information, but from ocular demonstration, as to the power- ful efficacy of the Cedar Apple upon those within our know- ledge who have taken it, as well as the impossibility of its doing any injury to those who may eat the apple. 1st.-The Apple or Knot is to be found upon the red cedar, the white cedar tree is not to be found, we believe in this country. £nd.-The apple bears no resemblance in shape, size, or -any similarity, to the Cenar berry. The apple is a sort of excrescence, and which is to be found at all seasons of the year, on the small boughs or twings of the cedar tree, \"va- rving in size from the hazel to that of the black walnut, bearing a strong resemblance to a nitted potatoe. The apple which is of last year's growth, and perfectly dricù, docs not look like the orchard- apple, and is not so bitter as those of this year's growth, but as a medicine, they possess the same virtue as those that are green, .and can be grated or pounded file, and taken in molasses. 3d.- The apple, which contains some moisture, can be eaten like.any other fruit. Tic quantity Ir. l.recommends,just as they come fromt the tree, is one for every year that the child is old, and to be taken nine mornings in succession, fasting- From our own experience of the efficacy of the cedar apple, we should say that a much less quantity ivould do. lowever, the apple is perfectly innocent, and any quantity may be eaten without being attended vith any bad effects. To.prove that a small portion will answer, we will cite a case. A lad 13 years of age, belonging to this omRce, eat a piece of last year's apple about the size of a pea, and in 24 hours after- wards, no less than twrenty-four wormsi were expelled-and another case in the neighbourhood, of a child 17 months old, who eat about half an apple, and one hundred werc expelled,",
         "QUARTERLT RETROSPECT. and we are happy to say, that in no instance bave we heard as yet, that the remedy has failed in having the desired effect. Uerine H.emorrhagc.--M. GOinRrt., in aletter addressed te the Editor of the G:ee deSanti, states a simple method, which be bas employed succesfully, for arresting uterine h:emorrhage. He applies on the back, between the shoulders, a dry oxal cupping glass, the -vertical diameter of which is four or five inches, and the transverse diameter from two to three inches. He lets .t remain for half an hour ; in general the h:morrhage stops, or i:; very considerably diminished in the space of a few minutes. The application of cupping glas- ses, he observes, has also been founid successful in diininish- ing immoderate mentrual discharge.*1 Journal Universel. Coqueuch.-M. C déduit les conelusions suivan- tes pour ce qui regarde le traitement de cette maladie. I. Que dans les tempéramens sanguins, elle exige les saignées et un rétrime débilitant. 2. Que la nème chose doit s'ob- server dans t\u0026js les tempéramens, lorsque la maladie est chro- nique. 3. Que les antispasmodiques conviennent aux tem- péramens nerveux. 4. Mais que la saignée et les débilitans doivent être rejetés pour les tempéramens lymphatiques ; et cette vérité s'applique plus particulièrement à l'enfance, parce que la lymphe domine sur la partie rouge du sang, et que les fluides sont moins épais que chez l'adulte, Cepen- dant l'auteur recommande la faignée modérée, quand il y a métastase inknammatoire sur quelque viscère. * The application of a large cupping glass to the breast, with a viev of checking the menstrual disch.brge, is recommended in one of the Aphorisns of Flippocrates.",
         "GUAItTEraLY RETROSPECT. Archives GénéLr'ules. Dothinientcria. Pustules des petits intestins.-Ce nom vient d'être donné à une maladie dont M., BREroxeou, de Tours, et après-lui, SEnaZs, Brocssits, AxonAL et autres personnages distingués, nous ont donné une description sa- tisfaisante, et qui consiste dans des pustules qui se trouvent ordinairement à 'extrémité inférieure de l'ileum. Suivant eux, cette malaIie est aussi commune et aussi destructive que la ite-vér.le, la rougeole oula scarlatinc ; il y a mnme peu de p,:rsonnes qui n'en aient été aUcites durant le±ur vie; ils soutiennent que cett mitadie parait catagieuse, mauis qu'elle n'attaque qu'une fois dans la vie. Elle parait avoir son sièe dans les glandes de Psyna et de nuxnan, dont Haller nous a donné une description dans son traité de Phy- siologie. Nous nous abatindrons d'entrer dans de plus longs détails pour le moment; niais nous y reviendrons aussitôt que nous aurons appris le résultat d'une discussion qui a maintenant lieu à P.tris sur ce sujet, et dans laquelle des médecins du plus grand mérite sont engagés. Huile extr:ite de I'Euphorbi:1 Lathris.-A r te séance de 'Acadlémi Ravale de Mé:iecine, M. Ballv a lu an mé:noire contenant le résultat de plusieurs expériences cliniques, faites à Plopital de la Pitié, sur l'eIret de ce remède. Celle dont il a fait usage, et qui parait avcir en effet plus d'activité que les autres préparations, était extraite par expression et au moyen de Plalcohol. Administrée à quinze individus de difé. rens âges, elle n'a pas produit d'effets bien variés, outre qu'elle n'a pas paru être un purgatif bien actif. Au contraire, il considère que lhuile de pignon d'Inde (croton tiglium) lui est préférable sous ce dernier rapport, sans parler de l'effet qu'elle a d'exciter le vomissement, vu qu'il faut en.donner six ou dix gouttes pour qu'elle ait un effet purgatif. Cepen-",
         "0* QUARTERLT ITRoSPECTe dant, comme elle ne provoque pas la salivation, M. Bally la préfère sous ce rapport au pignon dInde, surtout quand elle est fraiche, comme un purgatif utile pour les enfans. Calcuds urinairer guéris par le sous-carbonate de Soude.- M. RoiQrrr a présenté à la même Académie un rnémoire dans lequel il rapporte qu'il aguéri d'un calcul composé d'aci- de urique, une personne agée de *74 ans, au moyen du sous- carbonate de soude, à la dose de 10 grains dans le cours de la journée; et au bout d'un mois il retira le noyau d'an calcul dont les couches extérieures paraissaient avoir été dissoutee ou usées. Bulletin MédicaT. Division singuière de l'Aorie.- -M. Z.AGoWE I de St. e-' tersburgh, a trouvé en 1so, Parche de l'aorte divisée en deux branches pour admettre la trachée entr'elles, et se re- joignant aussitdt en un seul tronc, en sorte que la trachée se trouvait complètement embrassée. La compression qui a da s'exercer durant la vie sur la trachée, a sans doute produit une difi-culté de respirer. En ISOS, on découvrit que la sous- clavière droite prenaitson origine a la gauche de la crosse de l'aorte, et passaitderrière la trachée qui se trouvait alors com- prise entre ces deux: artères. Les Francais ont donné à l'ar- tere innominée, le nom de brachio-cephalic, qui renferme lidée de son office et de sa distribution. Distribution conre-nalure des artères.--MM. BaittiE, L.IN.GsTJFF, et FÀARE, OUt chacun vu unl cas, et M. lzDs- uaxs, dans son Journ\" de Physiologie, en rapporteun qua- trième, où l'aorte et l'artère pulmonaire, ont changé de pla- ce. Dans ce dernier cas, les deux circulations étaient bien distinctes ; le §ang du corps passant des veines caves danà",
         "-QUAUTERLY RETRoSPECT. 39 loreillette droite, ensuite dans le ventricule droit, et de lâ .dans l'aorte pour se répandre dans tout le corps ; tandis que le sang pulmonaire ne parcourait qu'un petit espace, car après être passé par les veines pulmonaires dans l'oreillette gauche, et de Il dans le ventricule gauche, il retournait dans l'artère pulmonaire. Les seules communications que Mr. TIEDEM.us ait apperçues entre les deux circulations étaient- par le foramen ovale, le ductus artcriosus, et probablement une anastomose entre les branches des artères puim'naires et bron chiales. Lenf.mt n'offrit aucune apparence partictulière avant le nea- vièiejour; mais à cette époque il fut saisi de suff)ar. 'ns, avec une couleur bleue noirâtre de la peau, et mourut le dou- zèiee jour. Le Propagaleur des Scienccs Médicales. Digiltle.--Le Dr. NErns de Berlin donne ce qui suit tomme le résultat de ses ob:iervations sur l'emploi de la digi- tale dans les maladies des poumons. Elle est inutile lorsque les poumons sont en suppuration, à la suite Ce tubercules, ou d'une hémoptysie inflammatoire, ainsi que dans les phleg. morrlgie locales de ce viscère ; mais elle guérit presque toujours ces catarrhes chroniques qui résultent d'un état d'é- réthisme de la muqueuse qui tapisse les bronches. Cette ma- ladie a été aussi nommée bronchitis chronique, consomption muqueuse, catarrhe pulmonaire, ou ce que les Anglais appellent galloping conumption. Lorsque le diagnostic dans cette af- fection est bien établi, on peut toujours espérer une guérison, pourvu que les conditions suivantes se trouvent reunies le. Le malade doit être susceptible de l'action stimulante du renède, quoique cela ne se rencontre pas toujours. La",
         "QUARTERLY RETROSPECT digitale ne sera non plus d'aucun servce, si après en avoir fait usage pendant quelques jours, le pouls demeure toujours unif'ormae et fréquent ; alors le remède ne convient pas. 2e. Il faut bien s'assurer que les feuilles, quoique sèches, so;en± entièrement vertes, sans aucune appjarence de taches brunes. On en fait infuser deux onces, dans six onces d'eau bouillante. Le malade prendra une cuillièrée à table de ce:te infusion, toutes les heures, jusqu'à ce qu'il éprouve des nausees, ou un resserrement dans la gorge, un étincelkment dars les yeux, ou une irrégularité du pouls. Alors on dis- co.tinue le remède pendant sept ou huit jours, et durant cet intervalle, il développe toute son action, le pculs devenant irrégulier, et la sécretion nuqucuse diminuant par degrés. Si la première tentative ne réu-ssit pas entièrement, on peut essayer de nouveau après quelques jours. Cpération pcur le Phkymnosis.--MJ. T. CLCQUET a perfec- tionné cette opération, dle manière a ne laisser aucune diffor- ndté. Il reccmmande de faire l'incision à la surface inférieu- re. près du, et parallèle au, froenun prxputii. L'ineision Ion- fgitudinale ainsi faite, devient transverse, aussitôt que le pré- .ace est rauienè derrière le gland, et la cicatrice s'opère clans une ligne à peine visible ; en sorte que le prépuce acquiert ainsi en largeur ce qu'il a perdu en longueur. 1. C.cot.ET a guéri par ce moyen un grand nombre de personr.es, sans que le prépuce ait paru dévier en rien de sa conformation na- tu-elle. l étenti:n cr Ci ine, causéc par une Sricture det UL-rc.- 31. Aces.rr raconte le cas suivant : Un homme âgé de 70 ans, d'une constitution pléthorique, avait eu, 30 ans aupara- vant, trois attaques de gonorrhée, et depuis ce teins avait éprouvé une difficulté considerable à décharger ses urines, dont il ne pouvait rejeter qu'une ou deux onces à la fois.- A huit r. ,z. il essaya d'uriner, mais en vain. Il éprouvait de grandeis douleurs. Le pouls était agité, le visage coloré ; le",
         "PVAaTERLY RETROSrECT. ventre enflé et globuleux à sa partie inférieure; les veines sous-cutanées abdominales distendues ; et un demi priaspis- me. Les efforts pour uriner étaient douloureux et infruc- tueux. Le jour suivant à 10 heures A. mx. M. Aisessr passa une bougie, qui s'arrêta près de la bulbe de l'urètre, et ame- na un peu de sang. Les urines étaient retenues depuis 14 .ures, quoiqu'il eût coutume de les faire 12 ou 16 fois par nuit. L'obstruction était telle qu'il ne restait plus d'autre alternative à employer, que l'introduction forcée du cathètre, ou la ponction dela ves:ie. M. Amusstr eut recours au pro- .cèdé suivant, qui réussit complètement. Il injecta avec for- ce, uais par dégrès, dans l'urètre, de l'eau chaude, qui, en dilatant lorifice de la stricture, repoussa les mucosités é- paissies qui l'obstruaient. Aussitôt que le liquide injecté eut atteint l'urine, le malade s'écria qu'il était guéri, et en efflet ses urines revinrent comme auparavant. A deux reprises, il rendit près de deuxchopines d'urine épaissie. La rétention n'a pas eu lieu depuis, et le malade continue en bonne santé. Cette manière, si l'expérience la confirme, est la plus avan. tageuse que l'on puisse désirer. Opiration pour une oblitiration de l'urètre.-Un homme agé de e'i ans, fut, le 16 Juin, 1815, blessé par une balle qui divisa l'urètre à sa partie moyenne, sans intéresserles corps caverneux. A mesure que la blessure guérissait; l'urètre s'oblitérait tellement, qu'en May 1819, le malade ne pouvait uriner que guttatim, avec douleur et dilicultée, et il était menacé d'une inflammation du périnée. Les bougies ne donnant aucun soulageruent, M. VANIER de Cherbourgh, pratiqua une incision dans la direction de l'urètre, sur toute l'étendue de la cicatrice, de manière qu'une sonde pouvait être conduite tout le long du canal. Il ramena les'ièvres de laplaie par dessus la sonde, et vers le cinquième jour les bords étaient réunis et cicatrisés. On enle'va alors la sonde, et on introduisit à sa place une bougie qui s'étendait seulement au",
         "QIIA2TERLY RETROSPECT. delà de la cicatrice, et que le malade portait par intervalles. La guérison fut si parfaite que trois ans après, il pouvait uri- ner aussi facilement qu'avant sa blessure. Anîvrismefaux consécutif, guiri par la méthode de Val- salka.--Nous allons rapporter ce cas tout au long afin de don- ner surtout à nos lecteurs Canadiens, une idée parfaite de cette méthode que les modernes ont perfectionnée. L'exemple que nous allons citer est presque toutà fait semblable à celui dont parle Sabatier dans s'on traité de Médecine opératoire, qu'il dit avoir guéri par le même moyen. Mademoiselle Antouard, agée de 18 ans, jouissant d'une bonne santé, reçut, le 18 Juin 1825, un coup de poignard, qui intéressa la carotide gauche, au 'dessous de l'extrémité supérieure lu sternum, l'instrument ayant été dirigé en de:. dans et en bas. Le sang se répandit aussitdt en abondance dans le tissu cellulaire de la partie latérale et antérieure du cou, et la défaillance eut lieu sur le champ. Le quatriè-ne jour après, cette masse de sang était presqu'entièrement ab- sorbée, mais une tumeur anévrismale se fit appercevoir au bord du sternum. Le Dr. SouciEzz vit la malade un mois après l accident, et la tumeur était de la grosseur des deux poings de la Demoiselle. Les pulsations étaient presqu'égales dans toute son étendue, mais surtout vis-à-vis l'orifice de l'artère. La tumeur ne causait point d'autre douleur que celle qui résultait de sca poids, ce qni donnait lieu à un mal de tête continuel. Le Dr. Soucuzia ne trouvant pas prudent d'avoir recours à une opération vu la chaleur de la saison, et sur une tumeur située aussi profondément sous le sternum, se détermina à mettre en pratique les principes suivans : 1. Diminuer la masse du sang, et par là son action stimulante sur le cœur, qui, perdant ainsi de sa force projectile, ralentirait aussi la rapidité avec laquelle le sang s'échappait par Pouverture de Partère, et imprimait aux parois de la tumeur une secousse",
         "QUARTERLY RETROSPECT, qui mettait obstacle à la coagulation du sang. 2. Seconde; l'effet des saignées générales et. locales, par l'usage dufroid, dela pression, et surtout de la digitale ; et la force de la cir- culation étant ainsi diminuée, on peut obtenir une coagula- tion du sang, et peut-être une guérison complète. Mademoiselle Antouard se soumit de- bon gré à ce traite- ment, et il lui fut prescrit, 1. de l'eau de riz, acidulé avec le. jus de citron, et une infusion de mauve pour tout breuvage et toute nourriture. 2. Des frictions sur l'abdomen et le dedans des cuisses, soir et matin, avec huit grains de feuilles de digi- tale, réduites en poudre, et préalablement macérées pendant 24 heures dans une suffisante quantité de salive. 3. L'ap- plication de. 12 sangsues tous les jours, près de la tumeur - et après avo'r favorisé l'issue du sang occasionnée par leurs piqures au moyen de fomentations émollientes, il était en- joint de couvrir la tumeur avec des compresses imbibées d'une solution froide de sucre de saturne, renouvellée souvent, de manière qu'elle fût toujours d'une température plus froide que la peau elle-même. 4. D'augmenter la pression sur la tumeur avec le fond d'un gobelet (tumbler), assujetti par les mains d'un assistant. 5. Enrin un repos et un silence abso- lus. Aout, 2, 1825, quatrièmejour du traitement. Les pulsa- tions de la tumeur sont plus centrales ; la tumeur elle-même sensiblement diminuée ; le pouls moins fort et réduit de SG à 74 par minute; les menstrues, qui avaient été supprimées de- puis deux mois, sont reparues le 31 lu mois dernier, et con- tinuent encore. Prescription: saignée .'viij -le landemain, 12 sangsues sur les parties latér-ales de la tumeur ; Digitale xiv grs. en trois frictions pour la journée. Continue ut su- pr. Aout, S. La malade est tranquille ; le pouls à 60, plein, sans vigueur ; isage décoloré, mais conservant une légère teinte rouge ; mal de tête diminué ; point de nausées ; les",
         "QUAnTERLT RETXOSPECT. menstrues ont cessé le 6. Prescription : saignée 3xij.- quinze sangsues demain ; la digitale augmentée pour tous les jours suivaus à xxviij grs. La tumeur diminuée d'un quart, Continue ut supri. Aout, 12. Le volume de la tumeur réduit aux 3-5 ; le pouls 56; nuits tranquilles ; un peu le mal de tète, et d'esto- mac ; li malade se plaint de la faim et de faiblesse, ainsi que de la fatigue de ses assistans : ce qui oblige d'avoir recours à un bandage pour exercer la compression, malgré que ce moyen ne soit pas aussi eflicace qu'avec la main ; mais on accorde cette faveur, vu que les pulsations sont diminuées, et devien- nent de plus en plus centrales, tandis que l'élévation de la tu- meur est elle.menl peu considérable, De crainte d'altérer trop sa santé, on lui permet de se lever un peu de son lit, et d'ajouter à sa diète ordinaire un peu de crême de riz bien lé- gère. Prescription : saignée :x tous les deux jours, et huit sangsues autour de la tumeur ; la digitale est portée à 3\u003c2 grs. par jour ; bain de pied pendant une heure, matin et soir ; si- lence absolu. Aout, 19. La tumeur n'est plus visible ; les pulsations ce- pendant un peu sensibles ; la pean est épaissie ; le pouls 50. Prescription saignée =viij. six sangsues tous les quatre jours jusqu'au retour des menstrues ; la digitale réduite à xx grains mais appliquée comme auparavant ; la compression est con- tinuée ; on permet un peu de gelée de riz, une soupe à la ver- micelle, et un léger exercice ; on persévère dans le silence et les bains de pied, et on permet un clystère pour diminuer la constipation. Le Dr. SOCC\u003cIxER revit sa malade 15 jours après. IL faillait une hIain habile pour découvrir en quel endroit l'artère était cicatrisée, vu qu'on n'y pouvait appercevoir qu'une petite élé- vation au dessns du reste de l'artère. Le pouls est à 48 ; la faim est extrême, et les remèdes sont devenus désagréables. On en suspendit quelques-uns, et on. permit à la malade quel-",
         "QvRTEItLY RETROSPECT. U\u0026 ques fruits et le blanc d'un poulet, de plus que sa diète ordi- naire. La digitale est réduite à 1.Z grains par jour ; la coni- pression, le silence, et l'exercice modéré sont prescrits ;.les menstrues ont reparu au bout de,20 jours, et en plus grande abondance que la première fois. Au bout d'unmois, on ne pouvait découvrir tucune trac.- de la tumeur. La jeune Demoiselle prit par dé5res un peu plus de nourriture et d'exercice, sans en éprouser d'inconvé- nient, et on cessa enfin tous les remèdes. Dans les mois de Décembre et Janvier dernier, elle n'éprouvait aucun malaise ni inconvénient de la part de la tumeur, et l'union des parois de l'artère fut regardée comme complète. Le Dr. SoucimE, se propose de publier ses commentaires sur ce cas important. Revue M1édicale. Naissance.-D'apres les régistres de Paris pour 1825, Mr. DuGEs publie le tableau suivant des naissances dans cette ville. Sur 37, 441 accouchemens, il y en a eu 36,902 duu. seul enfant ; 444 de deux, et 5 de trois. Des sexes.-Entre cinquante quatre cas de jumeaux, pris au liazard, cinq ont donné un garçon et une fille ; treize, deux filles., vingt-six, deux garçons. Ce dernier nombre, qui est la moitié du tout, parait être la proportion ordinaire. Dans deux cas de trois enfans, M. La Chapelle a vu dans lun, trois filles, et dans J'autre deux filles et un garçon. Poids et volume.-Lesjumeaux sont en général plus petits que les enfans uniques, mais rarement plus gros que ceux qui vienne-it par trois ; en sorte que dans les deux premiers cas, le poid total liffère peu. Dùpositions des enveloppes.-Quelquefois les jumeaux sont, contenus dans une seule enveloppe membraneuse, et -nagent",
         "bti QUIRTERLY RETROSPECT. dans les mêmes eaux, mais ces circonstances arrivent trs r- rement. Madame La Chapelle, célèbre accoucheuse, assure qu'elle nel'a jamais vu ainsi;) au contraire, soit qu'il y eut deux ou trois enfans, elle a toujours observé que chacun était contenu dans un sac séparé par l'union des. deux chorions et des deux amnilos. Quelquefois il n'y a qu'un chorion pour les deux fotus, malgré que M. Duges avaue n'avoir jamais vu cette disposition. Le placenta est le plus souvent unique, du moins dans trois cas contre deux. Quoiqu'il en soit, on ren- contre une variété infinie dans cette espèce de réunion, de- puis le simple contact jusqu'à l'union la plus parfaite, sans (ue la ligne de séparation soit même visible ; en sorte que les vaisseaux de l'un s'anastomosent quelquefois avec ceux de l'au- tre. Quand cette anastomose existe, ce n'est jamais au moy- en des vaisseaux capillaires, mais par les gros vaisseaux, tels que ceux qui se ramifient sur la surface intérieure du placen- ta ; car on observe que.dans le même placenta, les capillaires d'un colylédon ne communiquent pas avec ceux de l'autre. Pt humati,me guéri par le camphre enfunigation.-M . Du- paquier rapporte plusieurs guérisons de rhumatisme, au moy- en du camphre en fumigation. Il place le malade dans une chaise et le recouvre jusqu'au cou d'une couverte, tandis qu'il fait brûler du camphre sur une platine placée au dessous du malade, en jetant une petite cuillerée de camphre tous les cinq minutee, jusqu'à ce qu'il en soit consommé une demi- once. Cette épreuve dure environ une heure ; le malade est remis au lit et continue de transpirer pendant quelques heures. La fumüration peut être renouvelée plusieurs fois le jour sui- vaàt l'urgence du cas. Dans un cas de rbumatisme à l'épau- le, le même Monsieura réussi à opérer une guérison, en fe- sant porter sous l'aisselle un petit sac rempli de camphre. Rhumatisme du cour guiri par l'Acupundure.-M. Pe, gros dans un cas de cette nature, introduisit trois aiguilles successivement, entre la cinquième et la sixième côte, vers le,",
         "QUAITExLY ETROSPECT. 67 nilieu du cartilage de cette dernière. La première était lon- gue de 13 lignes, et aussitôt après son introduction, qui fut sans douleur, la malade étendit les bras, qu'elle contracta ensuite, et enan tomba (dans unesorte de délire, dont z1le s'éveilla com- me d'un songe aubout de di- minutes; mais la douleur conti- nuant, on introduisit au même endroit une seconde aiguille lon- gue de 15 lignes, et enfin une de 13. M. Pegros ne doute pas que celle-ci n'ait pénétré le péricarde et atteint le coeur même. La malade fut guérie. Cancers guér-is par les Anutiphlogistiques.-Dans la vue de donner une idée de cette nouvelle manière de guérir le cancer, nous rapportons ici un cas consigné dans le Journal ci-dessus, pour Février IS26, et traité par M. Lisfranc, à l'Hopital de la Pitié. La malade était âgée de 36 ans, d'un tempérament vigau- reux, et avait souffert lPablation d'un cancer au sein, 18 mois avant son entrée à l'Hopital, le 10 Octobre 1825. La partie avait les apparences suivantes : sur toute l'étendue de la cicatrice, on sentait un grand nombre de ganglions engor- gés, et une induration le long des muscles pectoraux, *grand et petit, qui s'étendait de la clavicule à toutes les parties ex- ternes et supérieures du thorax, jusqu'au pli de l'aisselle, oà on appercevait un certain nombre de ganglions. La surface de la cicatrice était élevée d'environ un demi-pouce au dessus du niveau le la poitrine. La malade 'éprouvait à de courts in- tervalles, des douleurs vives et lancinantes, qui se renouvel- laient sans cause apparente, et devenaient plus sévère au moindre attouchement de la tumeur. On employa des saignées de bras fréquentes et abondantes, les sangsues appliquées sur la tumeur, ainsi qu'à la partie su- périeure et intérieure des cuisses, afin de provoquer les mens- trues-la digitale pour calmer les palpitations-les émollients, et une diète sévère. Le 10 Janvier, la tumeur et les dou- leurs étaient disparues, les menstrues continuaient avec ré.",
         "o0i QUARTERLY RETIOSPECT gularité, et la malade avait recouvré l'usage de son bras, que l'enflure de Paisselle avait rendu presque nul. Cette manière de traiter les cancers est maintenant en grand usage en France, et vientde s'introduireen Angleterre et aux Etats-Unis. Elle mérite toute l'attention des.Médecins. Magnétisme Animal-LAcadémie Royale de Médecine de Paris, vient de nommer une còmmission composée de MIM. LEaoux, BOURDOIS, DoUBLE, MÂGuNorx, IÂAENNEc, TuILLTEA Ma.RC, ITan, FoUQUIER et GUENEAU DE Mussy, pour s'enquérir des effets miraculeux que l'on prétena opérer par cet agent. On avait jusqu'à présent regardé cette prati- que comme une manouvre dejongleur et de charlatan, mais rattention que vient d'y donner le corps savant dont nous ve- nons de parler, et la considération dont les membres appoin- tés pour faire rapport sur de sujet, jouissent dans le monde, nous font croire qu'il y alà quelque chose de plus qu'ordinai- re. Nous nous ferons un plaisir d'informer nos lecteurs du résultat de leurs recherches, aussitôt qu'il sera renda public. Bulletin des Sciences Médicaes, Serophule.-M. Wr:z recommande l'emploi de la potasse caustique dans cette maladie. Il fait dissoudre x grs. de po- tasse caustique dans une once d'eau d'écorce d'orange, et en donne de xii à xx gtt. quatre fois le jour, dans un peu de bouillon. Il employe aussi une solution de potasse causti- que dans six onces d'eau distillée, pour guérir les ulcères. Ver Solitaire.-Dans plusieurs cas de cette espèce qui a- vaient résisté à tous les plus puissans remèdes, M. BOUGARD a ré'-.ssi au moyen de pilules composées de calomel et d'ex- trait d'aloës, trois grains de chaque divisés en trois pilules, qu'il donne tous es soirs pendant huit jours, en augmentant ou diminuant la dose, de manière à produire trois selles par jour. Il ordonne aussi une diète sévère.",
         "FOltEIGNi AND DOMESTIC INTELLIGENCE AND CORRESPONDENCE. An attempt ta ascertain the value of the VAccINAt VInUs, as a means of lessiening the susceptibilits to varioIous diseases, with -cnarks on the most probable origin and nature of the smal-por. Itead before the County Medical Society of New-York, April 11, 1825.; by FEL.3: PASCALIS, M. D., Fellow of the College of Physicians and Surgeons, \u0026e. [Continued froin page 232, Vol. 1.] No. 6. Ts -1 distressing combination of symptoms incident to the disease, and not eclusively marked by'any kind of pustules : it is marked by the formation of swellings ofthe legs, of glands and joints, of inposthumes in different parts Of the body, even of caries of bones, and of severe ophthal- mias. These were observed aùd accurately described by Doctor Lewis Valentin, in the epidemic small-pox, which broke out in Norfolk, Portsmouth, and Princess Ann Coun.- tics in Virginia, in the year 1'795. This excellent physician adds, that the inoculations which were resorted to li order to check the alarming progress of the calanity, participated in these malignant operâtions of the variolous poison, though chiefly anong the blacks, and that he even saw infants with the collar bone projecting through the skin. The mortality was great, owing to the complication of abscesses, ulcerg and tunodrs, which could not alway5 be successfully mariaged bythe gýneral treatment of the small-pox ; a similar coni-",
         "PAsCALIS ON VAMIOLOUS DIsEASES. plication of malignant symptoms took place in this city during lae last. epidemic, under the care of Dr. Samuel Akerly, in a pupil of the Deaf and Dumb Institution. The Doctor was obliged to open two large abscesses in both shoulder joints ; another took place, which' aftervards vas discussed, and the boy recovered. This statem2nt of causes and effects, much abridged froa what bas been collected by the best judges in ancient and modern times, may satisfactorily denionstrate the greater ma- lignity and virulence of the epidemic small-pox over the re- gular and ordinary course of the sanie disease, when es :ed by inoculation. It also evidently shows that the influence of the vaccine virus iii the humai system, rendering it unsus- ceptible to the latter, is not adequate to the repulsion of the former, when arrayed with all its nost deadly symptoms. It can, hiowever, modify the intensity of its operation ; it divests it of its particular fotor, of its secondary fever, of its dange- rous pustules and inflammations,-and transforms it into a per- fect varib.id. This secondury attack is not altogether mys- terious or incomprehensible, if we would reflect for a mo- ment, and campare it with wçhat takes place in a body la- bouring under a full and well muarked attack of natural small- pox, it is, that when safely conducted to the last eruptive stagc,. and when all critical efforts seem to have been com- pleted ; still by the presence, and from the unavoidable ab- sorption of agreat nuuber of pustules, the patient is subject to a secondary fever, to a secondary eruption and formation of pustules, which equally prolong bis sufferings, and require the care and attention of bis physician. It may be expected that in concluding this investigation, we should acquaint our readers weith te history of our late epidemic sniall-pox and varioloid, as they occurred during the years 18.3 and 1SI4, in the cities of PhiladeIphia, New- York, and others, giving the results of mortality by the one,",
         "P\u0026SCALIS O: VAUtOLOUS DsEASEa. and the vaccinal failures by the other. Our present limits will not admit of these intcresting details, already authentically recorded in our Medical Journals- I shall selert for the pre- sent purpose, the subjoined cases frnm my own observation, and that of others, sucli as will suRiciently illustrate the first and principal subject of investigition expresse- in the title of this paper. Cases which occurred il Ner\u003eYork dirng the epidcmic smali-por of 1S2 A. Professor WNeven nfors h yr his pupil, caught the diease at a source which had aiTected a great marv students of the college. le had been vaccinated in his infancy by the bte Dr. Kissam ; nevertheless lie sick- cned with considerable violent.,: his case was, however, con- sidered as the varioloid, with brisk red spots. and then pus- tules all over the body. Three more in the family whohad been vaccinated by the sane piyîsichn took the disease. On the sixth day, Dr. M. used a little of the lymph from a pus- tule on his student to ineculate a healthv boy with, in the familv, who hadi neither heen vaccinatei nor inoculatei, and this progressed regularly intonfine distinct anti benign small- pox ; in fine: the mother of the pupil, aged 40 vears, who had been inoculated in lier childhood and had the disease re- gularly, took it again on this occasion. It appears by this remark-able occurrence, that four cases of epidemie snall-pox were all renderei mild and without danger by the influence of vaccination, and the other by that of the smnall-pox, which demonstrates that both possess the same desree of constitu- ional influence in relation to the epidemie small-pox. A medical gentleman of this city experienceti a violent at- tack of pneumonia, with a great determination to the head, and it bccame necessary to take repeatcdlv from him, a large",
         "7%. PASC.LIS ON VrRIOLUS DISLISz. quantity of blood. With this and other means, the patient's disorder was subdued, but he was leftin a very reduced state, from which he was scarcely recovering, when yieliding to an urgent professional call, he iwas carried to a house where the snall-pox yet existed. Re was shortly after laid up again with an alarming feser, until a considerable eruption broke out on bis face and breast, which proved to be variolous pus- tules of a distinct and tubercular kind, and clustered together ;.n very red spots, creatingan intolerable degree of pain. This varioloid, which progressed tediously, wvas in this subject a secondary attack, hr having hAd the inoculated small-pox at the age of ten yçars. Two sisters, Germans, aged 18 and 20, born in Wesphalia, and inoculated with the smnall-pox during their childhood, still bearing good scars on their arms, lived in the samIe fanily, industriously engaged iii their capacity of house-servants, and ihere tihey experienced mo other indisposition than that inci- dent to a change of climate. They separated before the cpi- demic took place, and shortly after, at no grent distance of time, sickened with the variola, cach in their respective pla- ces of residence, in wbich not anv such case had occurred. The oldest experienced a somewhat confluent Tarioloid ; the second, had a violent fever which required venesection, ac- eompanied with a mixed.tubercular eruption. Tiey both re- covered on the 18th. or 20th. day ofthe disease. These cases are instances of the actiî iry of the epidemic, equaIl in stran- gers as in natives, and in ellier kind of protection, by the in- oculation or by the process of inoculation. IV. We see in the following, a reciprocal and simulta- neous Influence of the two diseases upon each other ; the one by exciting the operation of the -vaccine virus, which was dormant in the subject, and the other by changing the epide- mic variolous matter, into simple varioloid. From which it results, that both the vaccine disease and the arteîcialsmal-",
         "PASCALIS ON VARIOLOUS DISEASES. pox, are equally capable of controuling the epidemic -sariola. I was desired to vaccinate a little girl of 6 or 7 years of age.,lately arrived from Louisiana, and I attempted to do it three times withourthe least effect, always at 6 or 7 days in- terval between each operation. Apprehending that ny daily attendar ce upon several cases of small-pox, might be the means at least of ex.posing the child to an attack of the ex- isting epoidemic, I xequested the parents to permit her to be inoculated, as all circumstances rendered this measure per- fectlvjustifiable. I used fresh lyrnph, from a lad of IS years of age, just labouring under a heavy confluent small-por, yet a very hopeful case. At the usual time, the little girl sickened, and at the same time, a fine vaccine pustule with an areola, arose on the spot where the virus had been inserted. A few days after which, a second eruptive fever brought on a gradual varioloid eruption j the pustules were rather small, not nuinerous, and were generally of the dry and tubercular kinds : her recovery was rapid and perfect. It must now be confessed that the march of the human mind towards the knowledge of the natural laws vhich govern one of the most formidable diseases, has been to this day re- strained or retarded by an opinion, which, without any foun- dation, lias obtained the belief and assent of al nations ; to wit: that the small-pox is specifically unique undsuigeneris; the same which 1ung ago was imported from Arabia. From this it was afterwards inferred, that by the universal adop- tion of the Jeanerian process, the small-poi must be even- tually eradicated from the surface of the earth. That this philanthropie and benevolent desire has not and cannot be realized, twenty-five years of experience bas already shova us. This disease has not disappeared from a single popu- lous district or nation, and uninterrytedly exists in all the largest cities of the world. Should it'be granted, however, that by the vaccine process, millions of infecting sources of",
         "74 PASCALIS ON VRIoLOUS DiSEESu. that virus have ben suppressed, mortality by the smail-poi greatly diminished, and that vcry few sweeping epidemics have occurred, it nevertheless appears certain th:it there re- mains soine other sources of the disease, which the Jenneriin prophylactic cannot reach, nor effectually control: or else there could.not have been any epidemic small-pox in the midst of large populations, arnong whomi the practice of vac- cination is most rigidly enforced, nor such a number of vac- cinal failures amountinz even to thousands, been reported in a single populous city* Such exisiting sources it is our duty to investigate : The following short attempt, I confess, may be deemed-preposterous ; but I inform my readers, that I cannot produce better arguments or proofs, than those that are furnished by logical unalogy and analysis. To those to whom they may not appear satisfactory, I apologise, by hold- inz the vaccine virus as an invaluable discovery, not only by its influence against the small-pox, as it bas been explained and represented, but because it is a precious key to unlock the bidden and mysterious source of the small-pox, and which may also guard the humnaù race against its epidemical visi- tations. Nothing is found in the science of therapeutics that could, by analogy, be compared to the power or influence of the vaccine virus, except it be that of the small-pox itself, of whîicii it nay be the prophylactic. But as it has been proved a complete preservative against the artificial disease, and an incomplete one against the epidemic, ther4% may be inferred from this unexpected resulit, a very conclusive analogy, vhich w'ould hold good, if epizotie diseases vhen existing in epide- mie form, could affect-or endanger the human constitution ; for then a bovine or ccineepdemie, might at once, by pri- ority, iuplantin our sysieman absoluteinsusceptibility to the Vide Dr. Chapnau's Journal or Medicine,'\u0026e. No.14.",
         "PASCALIS Ox VARIOLOUS DIsEASFS. 75 bhamran pustular pestilence. Now if analogy is in all specu- lative sciences, and especially in tht of inatiematics and al- gebra, the very rationale by which we nmay progress from the kuown to unknown proportions or quantities, the above al- ledged hypothesis is admissible by way of comlparison, fromn that law which limits the power of the vaccine -virus to a pre- servation against the artificial small-pox. Furthermore, as there arc no thrceor four diseases that present more striking analogies tian we find between cowpox, the varic2l'Z:, and variola, it is next ta a theorem, that by the one which is per- fectly known to us, we should come at the truc nature of the allier ; then to its source, and perhaps ta the periods or cir- cuistances of its formation. Proceeding from this analogy to another series of attribu. tes appertaining to the cow-pox, we find that this virus is a diseased matter secreted from the body of a cov, or froin the hoof of a horse, on the authority of Jenner himself, of the celebrated Dr. De Carra of Vienna, and of the Dr. Chevalier Valentin. Their .researches on the subject should not be passed unnoticed, in treating of a contagious matter which has not only been traced fron one animal to another, but lias been also transferred to ditTerent species and froin then again to the huiian sulject, in wlon the equine virus has shown the same efects and eiicacy : nay, it, has been so much con- founded with the vaccinal matter in certain countries, that Dr. De Caro did not know but equine matter bad the!re su- perseded the vaccine! This fact being particularly interest\u002b ing, we refer the reader for further details to the notes 6, 7, and 8 in the \" Notice Historique sur le Docteur Jenner, \u0026c.L 1ancy 1S24. Second Edition, by Lewis Valentin, M. D. Knight, \u0026c-\" 2. This virus bein- absorbed by the human body, after several days, a small quantity of lymph is assimilated to it,",
         "PASCALIS ON VARioLoUS DiSEASES. whiclh forms one or more pustules, retaining the saine powers as that which originally came from the cow. 3. And when the evolution of this .virus is completed in the human constitution, it is, in every respect, as far altered or infduenced by. the operation, as it would bave been by the inoculated or artidcial small-pox.; although both diseases mnay be diversified in point of duration, of nature, for m, and quantity of pustules, it is also true that one only symptom is required for the efflciency of both, that ie, erupti.e fever ; vith this difference, that in the small-pox it takes place at the commencement, until the eruption is formed, while in the vaccine diseases, fever is manifested :. a later period only, If now, we consider that no mineral nor vegetable poison is known to be absorbed by the human body, and that the pover of absorption and reproduction are confined to animal matter and animal poisons, such as give rise to hydrophobia, syphilis plica-polonica, herpes, psora, lepra, variola, kine- pox, and other contagious diseases ; and that there is no kind of analogy hetween any two of those diseases, the two last excepted ; it is not only justly inferred, but demonstrated, that the small-pox is an animal virus. The next question Nwould be to ascertain from what animal being it proceeds, whether froin the brute creation, or from the humanrace, or indiscriminately from both. The double origin of the vaccine %irus, to which we have alreadv ad:- verted as possibly of an equine nature, and also the singular pustular disease of the sheep kind, callcd the rot,* (in-French le Claveau) might promise a cluc, especially as the latter bears some imperfect reseniblance to the human variola ; but let us drop any such conjecture, and by attending only to the fact of extensive epidemics having taken place ie almost every populous nation and citv, wNe may learn the * Med Repos. N. S. vol Il. p.28,",
         "PASCALIS ON VARIOLOUS DISEASES. general circumstances urider which epideinc diseases are formed. One is the atmosplieric constitution of seasons, of heat, and of moisture ; the second, ve designate as the miasmatic exhalations from the soil or other localities, such as marshy grounds, stagnant waters, and dried ponds, \u0026c. ; and lastly, the accidental conditions of dense assemblages of hunan beings. The extensive inhabited regions which have sometimes been ravaged by pestilential fevers, as happened in the vhole Roman empire under the two Justinians, in the ·!th and Sth centuries, were certainly excitetd by an um-. ersaIllv deleterious state of the atmosphere. The sanie cause presided and pre- vailed no doubt, in the 16th century, w hen all possible forms of influenza, catarrhs, and fatal angine ravaged all Europe, by the sweating sickness in England, by the sneezing sick-ness on the continent, and by the croup in Itaiy. -But such uni- versal causes have never been applicable to the epidemie small-pox; it never was simultaneous oî er extensive regions; it docs not invade many populous ton ns or districts at the sa- me time : it has always been successivelv and at diffèrent da- tes in vinter, in summer, in frozen regions, and under the torrid zone, in dry and hunid situations, and fron pole to pole, a scourge to mankind, parcelling out its attacks amidst the joys and comforts ofprevious health, suddenly and unexpec- tedly diffusing its powers throughout all ages and classes of society. The miasmatie exhalations of the earth have long been known to be the ordinary or accidental sources ofa catalogue of endemie or epidenic diseases and plagues. The Hebrews had their Leprosis, the Greeks their Elephantiasis, the Polan- ders have their Plica Polonica, the Savoyards their Goitre, and the Italians their Malaria, \u0026c.; and vhat a variety of fevers of a bad character are endenial in the vicinilies of our Ereat lakes and rivers ! But not one defined or bad quality",
         "78 nSCALS O VIRaOLOUS DISEASES. ofland or soil has ever been observed to pronote epidemics of small-pox more than another ; no one race nor tribe of.men, nor one climate, nor season, nor one latitude more than an- other ; nor is there any exception in society or in the savage life, in their ailments or occupations, in the toils or hardships of the labouring classes, or amidst the refined luxuries and comforts of the rich, in the humble huts of tfie poor to the gorgeous of the great. And no age, in fine, can be said to be more congenial to or productive of this disease than an- other. Louis XV. king of France, after the daily fatigues of hunting, experienced an attack of varicella, when 28 vears of-age, and 36 years after, lie diei of the mîost horrid and malignant attack of the small-pox. The third condition or circunstance productive of general epidemics, and tlat only which has attendei those of the sinall-pox, is unquesionably that of large and dense popula- tions. Hence it has always been hovering in camps, in fleets, and prisons ; it is frequent in all commercial cities, and is nev- cr extinct in London, Paris, Lisbon, and Constantinople ; this specific matter, it appears, is formed or aggravated by an ani- mal or deleterious effluviun, Vhich, passing from inan to man, from breath to breath, graduially acquires its elenen- tary intensity, by which a single particle or atoni of it, sim- ilar to leaven, excites a general ferment of the wholc lympli in the human fabrie; but this terrible operation, which can so-readilybeaverted or modifled by the slight constitutional action of another animal virus, suggests to us that two con- currinz elements or causes, one remote in the living body, and- which lias not been eliminatedl from it, the other proxi- mate, catn, by the fortuitous accession and junction of im- pure animal effluvia, créate the variolous poison with all its own attributes. This phenomenon appears neither so in- comprehensible, nor so singular nor dreaIful as that of phtly- riasis. WVhen the direalating lyImph in the morbid state,",
         "FASCALIS O VARIOLOUS DISEASES. 79 and under some accessory influence of external heat, or filth, is brought to the last term of animal decomposition, and forns or creates a most horrid kind of vermin, which is ra- pidly increased by continually succeeding generations, issu- Ing from all the hairy surfaces, froin mucous membranes and Trom purulent pustules. If that trivial adage might be in- dulged in i here, \"(To see is to believe,\" I might add, Quoe- que ipse miserrimna vidi. History informs us, that the divine Plato, Herodes king of the Jevs, the dictator Sçlla, and .Philip ofSpain, all died of that shocking malady. There cannot be much doubt that the small-pox is an ani- mal poison, exclusively procceding from human beings, and that when prevailing as an epidlemic, it is of a recent and fresh for tion ; and since it could not be traced to atmos- pherie ca... Ltution, as ve have already demonstrated, nor to miasinatie exhalations, or other deleterious qualities of the soil, we must conclude from a series of striking circumstan- ces, that itis a conpound and morbid formation from human efiluvia; it must then be reasonable to suppose that exten- sive infecting and invisible currents of the kind, cannot have a long existence under tie vicissitudes of seasons, and the variableness of winds and temaperature, although they may be often renewed in camps, jails, ships, hospitals, and burying places, as well as in all dense assemblages of human beings. Another and last remark in conclusion, relates to the con- tagion of the smnll-pox, which proves to be so much more active, dilrusible, and transportable by intermediary vehicles, such as the efiluvia fromn clothes and other materials, than any other. Epidemie fevers of a bad or nialignant character continue still to excite great controversy among the lcarned, and the heads of government, respecting their contagious power. I would only propose a final question, which has been illustrated by the above investigation ; whethe the con. tagious property of any disease incident to mankind, cannot",
         "PASCILIS ON VARIOLOtUS DISEASES. be peremptorily decided ; first, by its nature as an animal virus ; secondly, by its being absorbed into the human sys- tem ; and finally, by the conversion or assimilation of human lymph into a virus of the same nature, and capable of re- producing the sarme disease? We beg Dr. Pascalis will accept our most grateful thanks for this highly scientific essay, and other very valuable pa- pers. After the respectful mention made of it in the annual report of the Linnnan Society of Paris for IS3, and in the New-York Medical and Phvsical Journal, it is impossible that ve can with propricty dwell on its nierits, which are so strikingly evident on its perusal. Our readers will nL doubt hail with pleasure the opportu- nitv which is now afforded them, of appreciating the value of the different doctrines to which our anxiety in exploring an af.ectual mode of arresting the progress of a most desolating calamitv, has naturally given rise ; and as we feel confident that we could not apply to a more respectable source for in- formation on this very important topic of scientific inquiry, we must be allowel to submit an idea which this paper has created in our mind, and which, we hope, shall be received with the sameindulgence as it is presented with diffidence and respect. Dr. Pascalis has very satisfactorily proved someuseful points which had lately given rise to much agitated questions, but we are sory that after such plausible arguments, both for and against vaccination and inoculation, we shoufld be still left without the-means of obviating the failures of these.two pro- phylacties. It is, however, admitted that in case of the small- pox occurring after vaccination, it only appears under a benign form called varioloid. It is also granted that artificial small- pox is seldoi attended with serious consequences. Would it not be worthy of trial, to ascertain to what degree of niildness the inoculated variola can be reduced by previous-vaccination? We are mot -aware that it has ever been proved how far this previous vaccination may influence variola when inoculated, as it does when epidemically engendered. Should this suggestion be not considered an idle proposi- tion, it mighr become the means of satifying the partisans of either party, and- of ascertaining whether both inoculations are a more effectual preventive of variola than one alone. (Note of the Editor.)",
         "MEILLETIR ON SCROFULA. Dissertation on Scrof la, by J. B. MErLLEUa, M. D. \u0026c.\u0026r. of lAssomption. (Coûtirnxed from page 240, Vo'. I.) Is it reasonable to believe that the uniorn of living parts cat be effected mechanically, as pieces of wood and other subs- tances are made to adhere, by gluing theni together? And, besides, how can inorganic matter possibly be the agent of the creation of any thing whatever, and be the author of a new life? Is it not, on the contrary, mueli more likely to act as an e.traneous and irritating substance, vhich, as long as it renmains in the way, must unavoidably prevent the parts froni reuniting together ? Is this not the natural corrollary ? la truth, the precise operation of nature in effecting the \u003c:ure or reunion of parts which have been, either with design or accidentally, divided, is not as yet, and perhaps never will be fully understood by any one; but from analogy, and from the knowlviedge we have of the myriads of effects vhich result from» the well known laws of attraction and of affinity inherent in all physical bodies, we may safely conjecture, if not assert, and this without in the least degree going out of the strict bonds of true philosophy, that the adhesion and reunion of such divided parts are the natural effects of an animal aflinity, in and between the parts divided, the whole depending mure or less on the degree of vital action, and nothing else; and that an increase of the nervous action must produce an augmentation in the degree of the same attrac- tion and afdinity ; and, although the novelty of such an idea might excite the superficial to laughter, yet, to establish it, we might adduce here many plausible and logical arguments. We might, indeed, amuse ourselves much longer, and travel with ease, ôver a much wider field, while on this subject ; but, as it is here incidental and somewhat forcign to our pre-",
         "4 unEI.rLEUa ON SCIOVULk. sent purpose, and as no one, I trust, will, after a delibei-ate investigation, be likely to indulge himself in such wild and unfounded notions, we wil now conclude this digression, and return to the further pursuit of our main object, that of provirg that scrofula is decidedly an inflammatory discase. Those who deny that scrofula is of an infiammatory na- ture, generally assert that it is a disease of mere debility, and th, most powerful arguments which they bring forvard to support their doctrine, are, that the greatest share of rene- dies recommended and used by most practitioners for the cure of scrofula, consists in such as produce inflammation inr the parts affected, which- inflammation is believed to be ne- cessarv to effect its healing; also, that, as to the general treatment, bark, bitters, and other tonics and stimulants, are recomrmended and used\u003e with a happy success ; and that, if these do no good, they at least do no harim. That such in- flammation, thas purposely induced in the system, may tend ta effect the cure of scrofula, we are not' disposed to- deny ; but it should be recollected. that it is nothing but a substitute for that which already existed previous, and which is exchanged for a more commendable one ; serofula being analogaus in this respect t- syphilis, which an person denies to be an inffammatory disorder, in the treatment of whichy mercury, which is a powerful stimulant, is administered frcely, in-order to change the specific intiammation-into a' more manageable one. But even in this, mercury proves' hurtful, if the patient is not well prepared by asuitable de- pletion prior to its administration. Here it should be remembered that inflammation may, and in fact does take place, in the system or any of its parts, when labouring under a state of positive debility, a truth recognizect bv some of the first medical authors, as Broussais, Armstrong, Thcmson, \u0026c., and that whea this is the tas, it is always slow in it progress, and chronic in its nature. Such inflam-",
         "MEILLEUR ON SCROPULA. mation therefore may, with propriety, be called passive or indolent, as there is no very perceptible increased action of the beart and arteries, nor auy very evident febriîe commo. tion. Such is the case in that inflammation which precedes and attends schirrus, cancer, scurvy and scrofula. Now, I bave no doubt but in the treatment of a discase of such a character, the nioclerate and well conducted administration of mild tonics and stimulants can cifect a cure, and this would not militate against it being of an inflaninatory nature : are :hey not admuinistered, vith success, in chronic hcpatitis and other chronic inflamnatory disorders ? The principal object in view in these instances, is to give sullicient tone to the systen, to enable it to shake off as it were, the ruorbid diathe- sis, and to assure a more healthy amid more vigorous one ca- pable of resisting the noxions influence of those adventitious causes which are calculated to keep up, if not to augment, he diseased action in the vhole animal body, thus rendered more and more susceptible of morbilic impression. There are three other arguments, but of very little or no value,vhich are generally brought against the inflammatory nature of scrofula. These are, that the pulse is but little or not at all altered ; and that there is scarcely any pain expe- rienced in the parts affected, nor redness of the interuments covering them. It'should be recollected that the disorder is a chronic one, arnd that i onseqnently, the degree of inflam- mation is not so high as it would be, were it an acute one ; .hat in chronic or passive diseases, as a gencral rule, the de- gree of alteration in the pulse is slight, and of course, of little consequence ; finally, that the glands, parts which are usually the principal seat of the complaint, are generally re- mote from the heart, and comparatively, but very imper- fcÇtly supplied with nerves ; hence little or no pain is ex- periencet in them by the patient, in the same degree of disease. Besides, as to the redness, before the skin partici,",
         "MEILLEUX ON ScR0FULA. pates of the inflammation of the scrofulous glands which it corers, it is merely elevated by their preternaral enlarge- ment, in consequence of which its blood-vessels are put upon the stretch, their .size .is diminished, and a less quantity of blood circalates through them, in a given time ; but when itpartakes of the inflammation, ils nerves have an increased action, the circulation is carried on with much more force and rapidity, and the cutis or epidermis assumes some degree of preternaturalredness and warmth, the well known cha- racters cf inflammation. CL:sses and Pathologg.-Had scrofula been generally con- sidered as a constitutional, instead of a local disease, we would not still remain so much in the dark with regard to its true pathology. But, as in every discurcive investigation one cannot. reason or argue without starting from some fixed and well 1anown principles, I will avail myself of the following, which should ever be present in the mind of every medical man. The animal system is one and a whole, everywhere endued with a nervous power, whose seat, says Le Gallois, \"cons- titutes in itself the individnal as a living being ;\" all the rest of the organization of an animal serving only to establish a relation between the said nervous power and external objects, or to prepare and supply it with materials neceýsary for its support and nourishment. Far from being particular to, and concentratcd into any point, thi3 nervous power has an im- nied:ate connexion end perfect harmony with all the cons- tituent parts of the animal machine. Le Gallois illustrates ti ; assertion by a familiar, but well adapted comparaison: let us uppose,\" says that able writer, \"a number of vheels all connected tegether by their cag2, they wil form one sye- tem only ; no one can perform any motion unless they all don the snane' Now if tbese positions are true and founded, as every one who has ever so littile knowledge of physiology",
         "MEILLEUR oN SCROFULA 85 must admit, it follows that when any one part ofthat whole is affected, depressed, excited, or disordered, the others must necessarily have a share in, and be synchronous participants of the same action; whether it is regular or irregular, healthy or diseased. The affection of any one part therefore becomes instanta- neously that of the whole system. As a musical string put upon the stretch cannot bc 'vibrated any ,here between its two poles, or points of atachment, without ,.ne vibration being inimediatelv communicated throughout, so the living sys- tem cannot be affected in any one part, without all the others participating of the saine affection, the morbid action travel- ling, through the medium of the nerves, from one organ or subdivision of thegeneral system to another, and foi -ing an unintcrrupted chain, which ultimately involves the whole body. If one receive a wouncd any where on his body, ac- cording to Bicbat, the part to which the cause is applied re- ceives, the nerves transmit, and the sensorium perceives the injury ; and we may add that the nervous action being re- ilected back from the sensorium equally to every living part, the whole system becoines universally affected. - But the painful sensation is referred to the place where the caus.e has miade its morbific impression, on account of the nervous re- action which is added to the local excitement in consequence o.f which thepain is there so nuch greater ihan elsewhere, that the general uneasiness is neutralized, as it -ere, and the patient is scarcely able to feel it, though its bad effects are, to him still more than to oti-rs, very notable and palpable. A great, a very great number of familiar examples rnight be specified here, were it necessary, to establish tbis doctrine. Indeed, if a disease can be s!i',tly cal, and exisL without affecting the whole system, wzy are its effects general, und its consequencesso unlimitted Why, foir example, in cases of extensive lesions, lacerrtions and bruises, do we not direc4",
         "Dou MILLEUa ON SCROFUL. our medication exclusively to the parts injured ? But, te state things as we have reason to believelthey are, aild not as they may appear to a superficial observer, we must assert that strictly speaking, there never was, nor éver can be, any sucl thing as a disease absolutely local ; for it is diametrically opposed tç the laws of the nervous system and animal eco- nomy, as well as to those of nature, who never made any kind allowance for such strange anomaly ; and the contrary idea entertained by some, is absolutely without any founda- tion, and tends to lead the practitioner into an error whose results must be the grossest blunders, and the nost unpar- donable mistakes ; for, under the impression that the disor- der-which cals his skill and knowledge into operation is a lo- cal one, he is induced -to direct his attention, in the treat- ment thereof, exclusively to the part or organ which -p: pears to be its principal seat, and to neglect the systern at large, which however generally speaking, should be in the very onset, strictly and faithfully attended to. Ail the medir cal, and many of the surgical disorders, which are considered Jby authors are local, ar local concentrations of general or cons- titutional disease. Having premised these brief remarks, and attempted to prove in a short way the unity of the nervous system, which bave~been thought necessary in this place, for the better un- derstanding of the causes and pathology of the disease under consideration, we will now proceed to the investigation 6f these conjointly. Bedingfield under-the bead, Bydrocephusr inferxrt, n4 in a degression to his main subject, suggests that indigestion or dyspepsia is the cause ofscrofula, and Abernethy, Alibert, and Thomson seem to have entertained the ame idea, and -Dr. Lloyd is decidedly of that opinion. (0) Dr. Caldwell, (*) Since this dissertation-his been writien, i had ihe plensure. while attending, lectures, as a medical graduate, at Darmoutha College, to see.the able Prof Olivier iuculcate ie same doctrine.",
         "tILLEUa ON OCROrULÂ. the commentator of Cullen's pratice of Physic, says, \"tscro- fula appears to be, in no small degree, assimilated to rickets. Like that disease, it arises no doübt, from a want of vigour, accompanied by a pectiliar vitiated action in the organs of digestion, a\"similation and nutrition.\" And although Dr. Thomas in his modern practice of Physic, censures Mr. l- chard Carmicheal for considering scrofula as arising from a. disordered state of the digestive organs, yet, the Dr. himself, in the treatmentof the disease, seems to direct his attention, principally to the digestive functions. Such is the opinion- which several learned authors seem to have entertained coq- cerning the complaint under consideration ; and as I never saw it discussed, but muerely advanced, it is the one which I vill endeavour to establish here as tenable, although I may fail in the attempt. la fact, indigestion or dyspepsia, is ne \u003chubt the remote cause of that mysterious disorder, scrofula, which ivriters in gencral appear to know only from its bane- fil effects on the constitution ; for, nothing can agree better than indigestion, with.its well known character that of being genemnlly accompanied with a remarkable degree of debility, throughout its course. It is well known that the stomach performs the most im- portant office in the corporeal system, andthat when for some cause or other, its functions are debilitated, impaired, or di- seased, it is unable to convert into a nutritious ch-me the food received into it. The aliments thus imperfectly digested, prove to be, in their passage from that organ into the duode- urnm, irritants capable of producing an inflammation of the pylorus and of the first intestine, which inflammation fre- quently extends directly to the liver and pancreas, the lining membraneof their ducts being a continuation of that of the duodenum into which they empty themselves of their con- tents. This explains satisfactorily the apparentlyso myste, rions sympathy of many. Accordirgly the ingesta present",
         "MX[LLEUR ON SCROFULA. themselves to the mrouths of the lacteals in a state of imper- fect digestion, and sometimes perhaps in a crude state.- Bendingfield, therefore, persuaded that such may be the case after having suggested in a few words, that indigestion is the cause ofscrofula, concludes by speaking as follows: \"lalthough the absorbents of the intestines, in all probability, possess to a certain extent, the power to receive or to refuse what may be presented to their mouths, yet, if oniy imperfect chyme be formed, they will be necessitated to take it up. The imper. fect chyme (or rather chyle) thus taken up acts upon the in- ner surface as an extraneous body. They, as well as the glands atached to them, beconie inflamed, and thus is pro- duced the disease terned Iabcs mesenicrica.\" Dr. Thomson, also has made very judicious remarks to the saie end, and nearly in the saie !anguage. That the mesenterie glands are commoniv found much discased in both young and old scrofulous subjects, has long ago been known to be the fact; but it never was, I believe, generally considered to Le the consequence of indigestion or dyspepsia. This however appears to be the most plausible rationale of the disorder, particularly when we know that all which is taken up by the lacteals, has to pass through them before it can arrive in the circulation. Now, if the ingesta are imper- fectly or but little digested, we have good reason to believe that the mesenteric glands must take on a norbid action be- fore any other part of the body, except the lacteas- which first take it up, and which of couse must be first affected.-- Thus, we are justified in asserting with pesitve confidence, that tabes mesenterica is noi the cause. cf scrofula, as a certain class of writers say it is, no more so than that the tubercles, : qund in the lungs, are the cause of phthisis pulmonalis, but merely the conscquences of a serofulous or pbthisical dia- thesis. (To be continued in ournext.)",
         "VALLER SUR LE CANCER DE L'UTERUS. Dissertation sur le cancer de l'Utérus. Par GUILLU:E J. L. VALLEE, M. D. \u0026c. \u0026c. de Montréal. (Continuée de la page 243. VoL 1.) Pendant un tems plus ou moins long, le cancer de Putérus ne se présente quesousla forme d'fection locale; mais, à une époque plus ou môins tardive, il commence à exercer son influ- ence sur l'économie animale, et à se compliquer des symptô- mes de la cachexie cancéreuse. Cette époque se manifeste par les signes suivans 3 Amaigrissement progressif, tristesse, dégouts, désordres continuel, dans l'appareil digestif; la peau acquiert cette teinte livide, jaune-paille, avec des taches bleu- âtres, signe non-éqivoque des désorganisations profondes. Ce caractère n'avait pas échappé à Hippocrate, ce qui prou- ve que cet habile médecin portait ses recherches jusqu'aux plus petits détails qu'il ne croyait pas indifférens pour Phom- me de l'art. Quelquefois on remarque des syncopes, des convulsions. La malade a depuis long-tems oublié les douceurs du repos; une fièvre d'abord peu apparente, sensible seulement le soir et durant la nuit, s'allume, et, acquérant chaque jour plus de force, consume la malade que la diarrhée achève de précipiter vers le terme fatal. Souvent même elle a succombé, avant ces grandes destructions, aux suites d'une hémorragie exces- sive, ou de quelque inflammation aiguë. Telle est la marche la plus ordinaire du cancer de l'utérus; mais qui pourrait décrire les variétés presque innombrables qu'offre cette maladie, soit dans son ensemble, soit dans cha- cun de ses symptômes, considérés sous le rapport de leur in- tensité, de leur durée, de Pépoque où ils se manifestent, de l'ordre dans lequel ils se succèdent. Marche et durée.-On voit que dans le tableau rapide que M",
         "993 VALLEE sUR LU CACER DE L'UTERUs. j'ai fait des syrptômes, j'ai supposé la maladie attaquant l'o- rifice utérin. En effet, elle commence presque toujours par le col deluterus, et c'est ordinairement ra lèvre postériedre du museau de tanche qu'elle envahit d'abord. Le cancer dé- bute sou: deax fortes principales : quelquefois c'est un en- gorgement chronique qui passe à 'état squirrheux, puis à la dégénération carcinomateuse ; le plus sowivent dest uni véri- tableulcère cancéreux qui répose immédiatement sur le tissu même de l'utérus. La durée de cette affection varie àT'infinie, depuis quelques moisjuzqu'à plusieurs années. Lorsque le mal a commencé sur le corps de l'utérus, celui- ci peut être entièrement squirreux, sans que le col paraisse y participer. C'est ici qre le diagnostic est beaucoup plus dif- ficile, et que on' rie reconnait la maladie qu'à la présence des douleurs lancinantes, et quand elle a fait (les progrès tels que le mal est au-dessus des ressoiírces de l'art. Quand le corps est affecté, 'utérus peut. acqdérir un volume considé- rable. Ambroise Paré le vit égaler celui de la tête. M., profèsseur Fizeau l'a vu acquérir une grossear plus énorme. Prognostie -Le prognostie que l'on peut porter sur cette maladie est des plus fachenx. Cependant, quand elle n'oc- cupe que la partie superficielle du col de lutérus, quoique très-gr.ve, on peut concevoir l'espérance d'en arrAter les pro- grès; mais de tous teins le cancer, une fois bien développé, a Ïté Tegardé comme incurable par tous les auteurs. Lors- qu'il est ancien et qu'il occupe la totalité de ratérus, il con- duit certai'nement le malade au tonbeair. Diagnostic.-ll est des circonstances qui rendient le dia- gnostic très-difficile ; c'est surtout au' début du cancer que l'on court risque de se méprendre. Disons quelques mots- des maladies avec lesquelles on pourrait le eonfondre.- La métrite chronique pourrait peut-être en imposer à l'observateur ; mais cette dernière est plutdt aecompagnée",
         "VALLES SUR LE CANCER DZ Ù'UTERUs. 91 d'une rétention de menstrues, que de pertes copieuses et fréquentes. Pour ne pas confondre avec le cancer de Putérus les maladies que je viens d'énunérer, il faut apporter la plus grande attention dans la recherche des symp:ômes qui lui ap- partiennent. Mai ilsuffira de se rappeler la nature desdou- leurs, les altérations particulières que ce mai imprime à la peau, son influence sur la santé générale, pour établir, dans la plupart des cas, un diagnostic sûr et certain. Dans ces cas, rien ne nous semble plus efficace pour pro- curer un soulagement momentané qlue la solution d'opium, cdministrée sous forme de lavemens. On conseille dans les mêmes vues les injections émollientes et narcotiques dans le .vagin et l'utérus, avec des décoctions de mace, de têtes de pavots, de ciguê ; des bains de siège, ,c. M. Fearon rejette Pemploi de tous les remèdes internes ; et il dit que les succès que l'on prétend avoir obtenus à l'aide de ces moyens ne peuvent s'appliquer au cancer confirmée- Quand le mal est borné au col de l'utérus, l'opération pa- rait offrir plus de probabilité de r.éussir. On peut employer deux méthodes pour le détruite ; soit que la maladie soit assez peu avancée pour qu'on puisse trancher sur des parties saines, .t que le col soit assez ferme pour être fixé, soit qu'il soit tel- lement ramolli qu'on ne puisse le saisir. De ces deux cas, Yun admet la resdision, et l'autre la cautérisation. Le der- nier de ces pocédés, la cautérisation, est dû à M. le baron Dupuytren, chirurgien en chef de l'Hôtel-Dieu.-- (f. le Dr. Vallée donne ici une description des diverses manières d'opérer des plus habiles chirurgiens de Paris ; mais .comme nous croyons avoir suffisamment donné une idée de son mpérite par les extraits qui sont maintenant devant nous, nous allons maintenant passer aux conclusions de Pauteur.] Conclusions--D'après tput ce que nous avons dit, il nous semble qu'il nous est permis \u003cle tirer les conclusions suivan- tes :. Toutes les fois que le cancer a porté ses rat'ages sup",
         "92 VALLEE SUR LE CANCER DE .UTERUS. le corps de l'utérus, et que celui-ci est dans un état complet ou presque complet de chute, l'utérus cancéreux peut être emporté 1 l'aide de la ligature. 2. Quand la maladie est bornée au col de Putérus, si elle est superficielle, sous forme d'ulcère reposant sur des tissus sains,.fermes, la rescision doit être employée. 3. Dans les cas de trop grande friabilité des tissus du col, si celui ci est trop peu ferme pour être fixé, s'il est ramolli, ou si le cancer est plus profondément situé, et occupe une plus grande partie du museau de tanche, la cauté- risation nous semble préférable. 4. Quand la dégénération a envahi la presque totalité du corps, (celui-ci n'étant pas dans un état de chute), à plus forte raison quand les parois du va- g*n et les parties environnantes sont prises, lopération est tout-a-fait impraticable. Que faire dans cette circonstance malheureuse? User de palliatifs, entourer la femme de presti- ges d'espoir qu'on est si loin de partager ; et, s'il est possible encore, par des consolations adroitement ménagées, semer dc quelqes fleurs le chemin qu'il lui reste à parcourir ; voilà, hélas! à quoi se borne le triste ministère du médecin. Essai sur la nécessité d'établir à Québec, Capitale du Canada, un Ilopital Général, consiéré con.ne le noyn le plus ef'- cace d'être utile à l'humanité, et à la Science tUédicale ci Canada. Par unMédecin de Québec. Dans un teins où la Législature va s'occuper de Pérection d'un édiice qui doit fournir au Médecin les moyens d'exercecr son art en faveur des malheureuses victimes de la maladie, on doit s'attendre que ceux qui sont par état yvoués à l'exercice d'un devoir aussi important, ne voyent pas avec indifférence approcher l'époque où ils pourront travailler avec plus",
         "SSAr SUI UN LÔPITA. GENERAL' 93 d'avantage pour les souffirans. Mais comme ce sujet embrus- se nécessairement deux questions, l'une d'économie politique, l'autre de police médicale, je ne m'attacherai qu'à-cette der- nière la seule qui soit de mon ressort ; elle me conduira à rechercher, pourquoi les établissemens de ce genre que nous po3sédons non seulement ne sont pas suffisans pour produire les heureux effets qu'on en devrait attendre, mais mème inca- pables de jamais le devenir, d'où je concluerai à la nécessité d'y pourvoir d'une autre manière qu'on ne l'a fait jusqu'à pré- sent ; enfin je chercherai les moyens qu'il est nécessaire d'a- dopter pour rendre un semblable établissement avantageux à la société, et utile à la science médicale. Je ne puis mieux entrer en matière, qu'en introduisant ici l'idée noble et sublime que nous donne d'un hôpital un illustre contemporain, M. Fodéré, dans les termes suivans : \"Ce fut une belle pensée de nos pères, que celle qui créa ces lieux où les pauvres atteints de maladies ou d'inf.ités sont accueillis pour y recevoir les secours que ler état exige, et d'avoir appelé ces asiles IJotel-Dieu, maison le Dieu, père icommun des hommes. Gloire en soit au christianisme; car c'est à cette secte, vrai et unique refuge des malheureux, qu'on doit ces institutions bienfaisantes (lui manquaient aux Grecs et aux Romains, quelque haut point de civilisation que ces peuples eussent déjà atteint lors de la chute du polythéis- me. La charité, premier élément de la religion du Christ, avait déjà échauff tous les cours dès l'aurore de son établis- sement, et nous usons, dans les lettres que Pline le jeune écrivait à Trajan en faveur de ces nouveaux religionaires, qu'il les recommandait à sa clémence: quia ablucre solent pedes sanctorum, et egentibus cibum, polunque iurgiri. Les premiers évêques tenaient leur maison épiscopale ouverte aux passans et aux malades ; ils les couchaient, les nourris- saent, et employaient tous leurs revepus à ces actes de bien- faisance, qui furent le fondement des donations immenses",
         "94 raSi sua \"n riA8FiL GENErXAL. dont on gratifia PEglise. Julien, dit l'Apostat, parait être le premier Empéreur qui ait destiné à ce sujet des maisons et des revenus particuliers, par les soins d'Oribase, son médecin et son confident, en 36 de l'ère chrétienne. Les branches de cette secte imitèrent leur mère comme, et adoucirent sur ce point la férocité des Turcs; Mahomet Il, et Bajazet son successeur établirent de grands et magnifiques hôpitaux à Constantinople; ils en firent même pour les bêtes, au rap- port de Lovicerus dans son histoire des Turcs; tant la pre:- mière institution du christianisme avait donné l'essort au plus sublime des semimens sociaux, celui de l'humanité.\" Pour rechercher si nos établissemens actuels répondent à une fin aussi noble, je vais envisager séparément chacun de nos hôpitaux. Le premier qui doit nous occuper d'abord est l'Hôtel-Dieu de Qnébec ; et comme son défaut de suffisance à nos besoins, parait tenir à des régles qui font partie de leur organisation, et dont les maitresses hôspitalières paraissent disposées de ne jamais se départir, il me sera inutile de n'ar- rêter sur celui de Montréal, dont la fondation et P'organisation oont les mêmes 1 tous égards, et auquel ce que je dirai sur celui-ci, devra par conséquent s'appliqueren grande partie. L'Hôtel-Dieu tient son existence de l'autorité des Rois de Trance, en considération des soins que les Dames l eligieuses voulaient bien vouer aux pauvres malades. Mais de même que dans la plupart des maisons de cette nature en France, et partout ailleurs où elles existent, ou a perdu de vue par di- grès l'objet principal, en rendant ces asiles le réfuge despau- vres plutôt que des malades ; et c'est ainsi qu'en assurant à ceux là un moyen de subsister sans ttavail, on a favorisé i'oi- siveté et la fainéantise. Vëtablissement dont je parle, est peut-êtreun de ceux qui ontle moins donné dans cet e:tcès, nalgré qu'on ne puisse nier qu'il n'ait un peu favorisé l'abus. Le-malheureux qui souffre dans sa çabane, exposé aux, inju- res de l'air, et manquant mnme du premier besoin de l'hom7",
         "xSsAr sui V14 11orxTAL GENERAL. 95 me malade, la propreté, se trouve exclus d'un hospice que ses charitables ayeux lui avaient destiné ; tandis qu'on y ap- perçoit quelques imaginaires qu'une.funeste manie et un besoin factice de prendre des remèdes, conduit à rechercher leséjour d'un hôpital, comme un autre plus sensé va prendre l'air de la campagne. Il est vrai de dire qu'on y est bien nourri et bien traité, mais qu'en rapporte-t-on ? Pour peu qu'ne personne soit af- faiblie par quelqute cause que ce soit, ne fût-ce qpe par un trop long exercice, l'air infecté d'un hôpital suffit pour entrainer des maladies lentes dont les suites sont quelquefois funestes, mais qui ne laissent jamais d'être très préjudiciables au tem- pérament surtout des jeunes personnes. Mais, dira-t-on, ne voit-on pas-à l'Hôtel-Dieu quelquea malades qui y sont tra âtés avec assez dle soin, pour qne l'on doive considérer cet établissement comme très utile aupublic ? C'est une verité que j'admets dans toute son étendue: et telle est la haute idée que j'ai du zèle et des attentions que les re- ligieuses portent aux malades qui leur sont confiés, que mon plus grand regret sera toujours de les voir s'obstiner à repous- ser les veux de tout le pays, qui désire.ardamment qu'elles veuillent bien accepter les moyens qui leur sont offerts de rem- plir leur pieux ministère d'une manière elicace, et pour Pavan- tage même des sòuffrans. Mais il n'est que trop évident que, surtout dans un lieu où il n'y a pas une variété d'hospices pour différus genres de maladies, tant que cet établissement con- tinuera son système d'exclusion, il ne pourra jamais rencou- trer nos baoins. On avait enjoint à Montpellier, que personne n'entràt dans rHôpital sans qu'il eut la fièvre, pour désigner que ces sortes d'asiles sont établis moins pour les maladies dont la guérison dépend d'un bon régime et d'un soin longtems continué, que pour celles qui demandent un prompt secours, et qui cont de nature à entrainer des accidens grues : en un mot.pour fes",
         "ES$A SCU UN DéPtTAL 'GEhERAL. maladies aigues. Qu'on ne dise pas que l'admission de toute espèce de maladie soit incompatible avec ce que Pon doit en- tendre par la maùon de Dieu. * L'H-4iel-Dieu de )Paris, pour s'être relaché de la sévérité de i5ancien régime qui est si stric- tement observa Ici, a-t-il dérogé à sa destination primitive? Croit-on quesi les protectrices des malheureux qui y exercent leur généreux zXle, avaient plutôt consulté lèurýropre intérêt, en interdisant Pentrée de leur Hospice- i des malades, que la crainte chimérique, et qui est beaucoup moins qu'imaginaire de nos hospitalières, condamnent à devenir les victimes d'un coupable égoisme, et de notre indifférence; peut-on raison- nablement croire, dis-je, que cet asile contiendratit aujourd'hui des milliers de malades de toute espèce, que la certitude d'y voir adoucir leurs maux, y amènent de toutes les parties du royaume. J'ai dit de plus, et je dois prouver, que cet établisserneut n'est point propre à encourager la science médicale. En effet, pour s'assurer que le Médecin s'attache d'une manière infati- gable à l'avancement de son art, il est seulement nécessaire que son crédit s'y trouve intéressé. Ce puissant mobile qui a condnit au- plus.hauts faits, et qui est le premier mo- teur de toutes les actions des hommes, est cause que l'homme dans quelqu'état qu'il soit, éprouvé toujours le besoin même de redoubler d'efforts pour acquérir les connaissances qui lui manquent, et de perfectioner celles qu'il possède. Malheureuse- ment pour nons, le pays est peut-ètre trop jeune ericore, pour qu'il soit prudent de confier aux Médecins la prrogative de décider du mérite de chacun de leurs membres. Comme ils sont cependant plus compétens encore que tont autre tribu- nal, on ne doit pas s'étonner si les personnes appelées à reni- plir des situations importantes dans les établissemens, soit aux hopitaux, soit ailleurs, n'ont gagné pur ) aucun crédit auprès de leurs. concitoyens. Mais si d'un coté je vois l'émulation assoupie dans un ordre",
         "ESSAI SUR UN nIôPITAL GENERAL. de choses auquel il n'est pas en notre pouvoir de remédier, je me réjouis cependant dans la pensée que l'on ne pouvait faire un meilleur choix, que de ceux que je vois préposés à tous nos établissemens en Canada. La voiK publique et l'as- sentiment de toute la Profession, ont confirmé ce qui avait d'abord pari ne tenir qu'à des considérations étrangères au mérite personel. Si je ne craignais de blesser leur modestie, il nie suffirait de les nommer pour rendre homage à leur mé- rite. Mais comme je me suis proposé dus cet écrit, le faire voir ce que l'on doit éviter dans une nou 'elle organisation, en montrant ce qui est pour le moins susceptible d'amélioration dans nos établissemens actuels, on mne pardonnera sans doute de i'appesantir sur un objet que je considère comme l'unique moyen de paver la voie aux taleus, et par conséquent à l'a- vancement de la science. Je dirai donc, avec toute la franchise que m'inîspire la bonne foi de mes lecteurs, qu'il est possible que par la suite, on con- sulte moins le mérite, pour remplacer ceux qui remplissent aujourd'hui ces situations avec tant d'ava:tage, que le désir de favoriser des individus qui n'apporteraient d'autres qualifica- tions que la naissance et la fortune : ce qui serait aussi préju- diciable aux intérèts de Thumanité que j'invoque, qu'à ceux de la science que je désire voir prospérer parmi nous. Pour nous en convaincre, il sufnit de tourner nos regards vers ceux qui font aujourd'hui l'admiration. de-l'univers. Si a faveur elt présidé aux offices dans les hôpitaux de Londres ou le Paris, on ne verrait pas de nos jours deux simples gen- tilshomies, MM. Cooper et Dupuytren, élevés aux premiè- res dignités, celles de Chirurgiens des deux pr-hmiers Monar- ques de l'univers, et de tarons les deux plus fameux Empi- res du monde. Je pourrais peüt-ètre même ôser dire, qu'en Canada, comimé partout ailleu's, les talens se trouvent rare.. inent alliés à la foeturie et-lua- asañee. Je me suis lhissé tntraincr plus )oin que je n'aurais désiré, X",
         "ESSAI SUR UN BOPIfAL GEXERAL. pour faire sentir combien ces situations sont importantes pour l'avancement de notre art ; et je me flatte d'avoir prouvé que loin d'être dûes à la fortune ou à la faveur, elles devraient plutôt être le moyen de les acquérir, en les rendant la récom- pense du vrai mérite. Mais comme cette règle me parait a- voir été fidèlement suivie jusqu'à présent à l'Hôtel-Dieu, j'au- rai occasion d'en parler plus au long, lorsqu'il sera question de l'Hôpital des Emigrés dont l'exemple devra nous donner une leçon salutaire. Je terminerai ce que' j'ai à dire sur ce sujet, en considérant comment et pourquoi l'Hôtel-Dieu est vraiment utile à l'humanité. Dans tout ce que j'ai ditjusqu'à présent, je me suis attaché a mettre sous les yeux les écueils que l'on doit éviter dans IL nouvel établisement dont notre Législature ajustement senti la nécessité, en accordant une somme d'argent pour s'en pro- curer des plans. J'ai cru aussi découvrir qu'on avait maf di- rigé le système d'exclusion observé à rlHôtel-Dieu. Malgré ces inconvéniens, qui ne sont tels 1 la vérité que par l'absence d'un autrc établissement plus général, je regarde l'Hôtel- Dieu comme très utile. Outre ce plan que l'on se propose d'exécuter, il se trouve des maladies qui demandent des soins que les mains seules de celles auxquelles un zèle évangélique fait nième trouver arréable le plus pénible de tous les devoirs, celui d'être le témoin continuel des souffrances de ses sem- blables, sont capables d'adoucir. Dans quelle classe de la So- ciété trouverez-vous ces soins assidus, ces complaisances que la sympathie fait sortir d'un caeur tendre et sensible, ce cou- rage et cette sévérité dans l'exercice d'un ministère que lana- ture même n'est pas toujours capable d'inspirer dans l'ame du plus proche parent, onu du plus chéri des amis ? C'est sous ce point de vue, que l'on doit envisager l'Hôtel- Dieu comme un établissement utile, je dirai même indispen- sable, pour ces sortes de maladies dont la guérison dépend plutôt d'un régime bien ordonné, que de Pemploi des remè-",
         "ESSAI SWtR UN IIÔPITA. GENER.L. 99 des. Mais comme il n'est pas possible d'y mèler aussi toutes les maladies acconpagnées de fièv:r:, les ulcères ou les plaies en suppuration, sans exposer les premiers à contracter d'au- tres maladies, ou du moins à rendre plus graves celles qui existent déjà, ce sera une raison de plus pour nous faire voir la néressité d'un autre établisenent. Je dois pourtant dire encore avant que de prendre congé de liétel-Dieu, qu'il me parait étonnant qu'avec une somme de près de 36000 piastres, que la Législature a accordée à cet établissenentà titre d'aide, on n'ait pas réussi à donner plus qu'une salle pour les hommes et une pour les femmes. Le nombre total même des malades n'est pas aujourd'hui plus considérable qu'il nel'était avant ce don. Mais ceci est du ressort du po- litique, et je ne ferai que citer le fait, seulement pour faire sentir combien cet établissement est peu proportioné à nos besoins, même depuis les immenses sacrifices que l'on a faits pour le rendre tel. (*) Depuis que PEmigration est devenue considérable, la crainte de l'introduction parmi les citoyens de lièvres impor- tées, fut cause que la Législature appropria une somme de 3000 piastres par an, pour le soutient d'un asile temporaire pour les étrangers malades. L'opinion public est tellement prononcée contre cet établissement, qu'il est de mon devoir de développer les vraies causes qui ont contribué à faire nai- tre contre cet Hospice, des préjugés que rien mois que son anéantissement n'est capable de dissiper. Le Bill qui lui donnait existence ayant été, depuis 83, changé et amîenél tous les ans, a été cause que cet Hôpital n'a jamais acquis de stabilité et d'uniformuité dans ses opéra- tions. Les difficultés que l'on avait éprouvées dlans la pre- mière année de son existence, se sont naturellement renou- vellées aussi souvent que ces clangremens ont eu lieu. Le (O) Le dernier ranport nous apprencd qu'au ler. d'Octobre der- Bier, le uoiubre ittai de mal;uks dams l'llòtel-Dieu était de 1,5 t",
         "ESSAI sCR UN HoPITAL GENERAL. premier Bill qui donnait libre accès à tous les Médecins de la ville, était sans doute ce qu'il y avait de plus sage, parce que chacun pouvait y exercer son art en faveur des malades avec plus ou moins de succès, suivant les talens et l'habileté (le chacun. Mais, par une fatalité qui s'est développée depuis dans un plus grand jour, la réunion de plusieurs pouvoirs sur les mêmes têtes, fournît à quelques-uns le moyen de contre- balancer sinon d'anéantir ce que d'autres pouvaient acquérir de crédit par le seul mérite. Pour obvier à cet inconvénient, on a depuis conféré le droit d'assister à cet Hôpital aux quatre ou six plus anciens \\léde- cins de la ville qui voudraient l'accepter. C'est ainsi que Von a foulé aux pieds les exemples que nous donnaient tous les établissemens qui ont donné naissance à des hommes distin- gués dans leur art. On doit à Pge le respect et la con:idé- ration, mais le prix lu mérite appartient à tous. Que 'ne puis-je citer iciles belles paroles du Lord Chatham sur le Hlus- tings, lorsqu'cn lui reprochait sa jeunesse pour lui refuser une place dans le Parlement. Que l'on ccmp:are les dccunens que nous a laissés le Dispensaire de Québec, avec ceux de l'Hôpital des Emigrés, on sera étonné de trouver tant de dis- parité dans deux établissemens de la u;ème ville. C'est que dans le premier il ne fallait que du mérite, et on avait tout le publie pour e tandis que dans celui-ci, Iàge seul est la première et lunique qualification requise. C'est ainsi qu'en fermant la porte à l'émulation, on a étouffé dans sa naissance ce puissant mobile des actions humaines. .Nous avons pour- tant lieu d'être satisfait, en voyant que le zèle et l'attention de ceux que la loi a déSi-néb pour remplir ces cflices, ont en grande partie supplée à ce qu'il y avait de vicieux dans son organisation. Dans un tel désordre, que pouvait-on ecpérer ? Il n'y a pas même jusqu'à ilintérêt individuel qui u'ait été mis en jeu. Une clause du Bill de cette année est venu mettre le comble 100",
         "ESSIS SUit UN uoP1TAL E£NERAL. à l'ignominie, et couvrir d'opprobre le caractère de tous ceux que l'on a supposés assez peu délicats pour souscrire àson exó- cution. Il est enjoint que six Magistrats formeront les Di- recteurs (le l'Etabli'ssemient, avec le pouvoir de faire telles rè- gles qu'ils jugeront à propos. Quatre Médecins, choisis par- mi les plus anciens, donneront leurs soins gratis aux malades; mais avaut que d'entrer en oilice, chacun d'eux revêtira de sa signature un instriuient par lequel il promet et s'oblige de se tenir toujours prê't à donner ses soins aux malades, au.si sou- vent qu'il cri sera requis, le jour et de nuit. et qu'il sera au pouvoir (les six Magistrats su5dlits, de s'enquérir de la con- duite des lédecins dans l'Ibipital, et dans le cas où ils seront convaineus que tl Médecin a manqué à quelques-unes des rè- gles qu'ils ont le droit de faire conjointement avec les Magis- trats, tel Médecin sera honteusement chassé de l'établissement pour tel temns que les dits Mlagistrats jugeront à propos de fixer. Le respect que je lois à nos loix, et les sentimers doulou- reux qu'une telle injure à ma profession éveille dans mon anie, me ferment la bouche à la seule lecture le cet opprcbre non mérité de notre part ; etje n'oserai pas même en appeler au sentiment le plus obtus de nos Législateurs, pour leur deman- der s'il est un seul d'entr'eux qui voulût ainsi, avec connais- sance (le cause, et de propos délibéré, mettre son caractère et son honneur entre les mains et à la merci de six individus, quelques respectables qu'ils soient, qui décideront sommaire- ment, sans appel, et sans autre forme de procès que leur sa- tisfaction : et cela pour avoir fait un acte qui devrait mériter, je ne dis pas un salaire, niais Pestime et la reconnaissance du public entier. L'honneur, a dit un sage, est l'élément nécessaire aux gran- des actions ; et tandis que toutes les classes de la société re- clament à l'ènvie cette prérogative de tout sujet libre, n'y a- t-il donc que les Mëdceins qui ne participeraient pas à un tel",
         "ESSA; sUR UN lOPITAL oENERAL. bienfait, sans se montrer insensibles aux cris de l'humanité ? O vous qui vous êtes si souvent montrés jaloux de défendre les justes droits du citoyen, avez-vous cru consulter l'intérêt des pauvres sruffrans, en exigeant de ceux dont vous implo- riez un secours que vous les connaissiez incapables de vous refuser, le honteux sacrifice de leur caractère et de leur hon- neur, pour prix de leurs services ? Le zèle infat'gable d'une classe d'hommes, auquel les nations les mieux politées se sont empressées de rendre homage, et qe vous avez si injustement outragé, ne vous donnait-il pas une aufiisante garantie 'e votre confiance ne serait pas frustrée ? Je détourne mes regards de ce pénible tableau, puisqu'en le parcourant, je ne ferais que mettre en jeu les sensations déchirantes qu'on ne peut s'empêcher d'éprouver, en voyant amoncelés une foule de ses semblables, dont la ma ladie n'est peut-être pas la seule souffrance. L'humanité outragée par une défiance injurieuse pour ceux qui sont seuls capables d'a- doucir ses maux, me ferait dévoiler plus qu'il ne serait né- cessaire pour justifier en quelque sorte les préjugés qu'un tel désordre a fait naitre contre l'établissement dont je parle. Mais si des sentimens que je respecte, et une méfiance que je réprouve, ont fait que l'Hôtel-Dieu et l'Hôpital des Emi- grés, les deux seuls hospices que nous avons à Québec pour recevoir les pauvres malades, sont incapables de suflire aux besoins de la population actuelle, les efforts que font les Mé- decins, surtout depuis quelque tems, me présagent un avenir plus heureux. Cette espérance se ranime davamage, lors- que je vois l'intérèt que prend notre Gouvernement dans tout ce qui est capable de mettre en activité les ressources du pays. En effet, la Législature a donné dans maintes circonstances des preuves de son zèle à contribuer à cette fin Jouable ; et si par faute d'information suflisante, elle a pu commet tre quel- que erreur sur ce qui paraissait n'être pas de son ressort de mieux connaitre, nous avons tout lieu de nous féliciter qu'elle",
         "ESSAI sUit U PIHPIT.ib oENERAL. ne tardera pas à apporter nn remède salutaire à un nal qui n'est pas encore sans ressource. Aprés avoir démontré la nécessité d'un Hôpital Général à Québec,je nie suis proposé de faire voir les avantages de l'é- tendre à toute la Province ; c'est ce qui m'engagera à dire quelque chose des établissemens à Montréal. Il y a dans cette ville comme à Québec, des Hôpitaux con- fiés au- soins des bames Religieuses mais comme j'ai déjà eu lieu de m'étendre sur les vices que j'apperçois dans leur organisation, en parlant de l'Hòtel-Dieu, je passerai a un au- tre établissement plus récent, et qui, en même tems qu'il est un ornement pour la ville (lui le contient, promet aussi les plus grands avantages, tant pour ce qui regarde le soulage- ment des malades, que pour l'intérêt (le la Profession. Je dois pourtant regretter que cet éloge ne puisse maintenant s'appliquer qu'à sa régie intérieure, etje vais dlire pourquoi. Je me suis permis de dire, en parlant de l'Hôpital des Emi- grés, etje ne crains pas d'être contredit, que l'on avait perdu de vue le plus grand intérêt de la science, et par conséquent des malades, en fermant la porte à certaine partie de la Pro- fession. sans égards au mérite et aux talens, et que l'on avait parlà empêché de se développer cette émulation louable qui cherche à acquérir du crédit en se rendant utile aux souffran- ces de l'humanité. Le système d'exclusion que j'ai aussi re- gretté dans l'organisation de l'Hôtel-Dieu, je suis encore plus fàehé de le rencontrer dans le Montreal General Hospital qui, à cela près, doit être rangé au nombre de ceux qui pour- raient un jour donner naissance à des hommes distingués dans leur art. Par (article 3, chapitre VIII, des règles \u003cle cet Fôpital, il est ordonné que la situation de Médecin ou Chirurgien ne pourra être donnée qn'à ceux qui tiendront un Diplôme de quelque Université ou Cellège dans les limites de l'Empire Britannique. Le Canada ne possède ni Université ni Collège, 10311",
         "104 ESSAI SUa UN hôPITAL GENERiAL. et l'époque de leur création est peut-être encore bien éloi- gnée. La langue francaise étant aussi la langue des sept huitièmes de la population en Canada, les élèves en Médecine Canadiens qui sortent du pays pour perfectioner leur éduca- tion, trouvent par conséquent beaucoup plus d'avantage à étudier en France; tandis qu'une grande partie de l'autre huitième de la population qui parle'la langue anglaise, passe aux Etats-Unis. Il est done très probable que les situations à cet Hôpital ne seront que rarement accessibles aux habi- tans du pays, et jamais à ceux qui ont acquis leur éducation médicale en Canada. Je ne me permettrai pas de prêter aucune intention aux fondateurs de cet établissement, mais je lois dire que si 'on avait eu en vue d'exclure de cet établissement tous ceux qui sont nés et él'vés en Canada, il n'aurait pas été possible de le faire d'une manière plus efficace et plus directe que par cette résolution mème. Personne n'admire et ne respecte plus qu-. moi les qualités et les connaissances que l'on ren- contre si fréquemment dans ceux qui ont succé le lait au her- ceau même de lalittérature anglaise ; je voudrais même qu'il fût possible que tous mes concitoyens allassent y puiser les premiers élémens de leurs connaissances; mais, à l'exemple de ceux qui se montrent dignes d'ètre nommés les enfans de leur patrie, personne n'est plus jaloux que moi de voir mes concitoyens se montrer les émules de ceux à qui une meil- leure fortune a donné tant d'occasions de s'instruire dont nous manquons parmi nons. Que dis-je \u003e Je me glorifie d'appartenir à un peuple qui a donné des hommes capables, sans avoir eu d'autres occasions que celles que notre pays seul peut fournir, de devenir les rivaux heureux de tant d'au- tres élevés dans tout le luxe littéraire, et chez qui l'art a pres- que dévancé la nature la plus précoce. Je ne sortirai pas de Montréal, et je demande quel est celui qui osera disputer la palme, comme chirurgien, à cet illustre",
         "ESSAI SUR UN i0îrrY G::1:n.iL. 105 conitoyen dont les succès étonnans dans les opérations les plus formidables de son art, ont déjà pour le moins ögal tout ce que l'on rapporte des haut -faits des plus grands mai- tres sur l'ancien et le nouveau continent. Que 112 peut-on pas attendre de ses travaux, lor::que l'ge et l'cxpériece a::- ront achevé 'ouvrage de la nature dans cet estimablejeune homme. Voilà pourtant ce qu'un pays, manquant d'Institu- tion, d'Ecoles, d'Universités et de Colleges, a produit. Mais pour avoir pris naissance en Canada, et n'en atre jamais sorti, un homme si utile à Ihumnanité, si àcessa:re lle nos hpitaux, se trouve par là exclus d'un étabis:emnt auquel ilserait un ornemîent, autant qu'il y serait une acqui::tion pour les malades, et pour l'intérêt de la Chirurgie. Ma tàche est maintenant remplie. En paccourant nos lô- pitaux, j'ai apperçu da:.- tous des abus plus ou moins grands, et dont plusieurs sont peut-être hors le ressources. L'insuf- fisance de la plupart d'entr'eux m'a fait désirer que l'on prit les moyens pour y surpléer d'une manière plus avantageuse pour l'intérèt de l'huainnité. Le système d'exclusion dans les uns, celui de monopole dans les autres ; l'émulation fou- lée aux pieds, et les talens mconmnus ; tels sont les maux qui pésent encore sur nous, et donc les secours d'une Légis- lature éclairée vont bientôt nous affranchir, en accordant aux veux et aux véritables besoins du pays, un établissement où tous ces obstacles feront place à un meilleur'ordre de choses. Tel est le but que je me suis proposé dans cet écrit, et je me flatte que ies efforts ne seront pas sans effet. Si j'ai été sévère dans la critique, on ne me refusera pas au moins d'avoir été juste ; car il m'était facile., sans déroger à. la vérité, (le porter plus loin mes remarques, de même que je pouvais dire beaucoup plus en témoignages d'approbation ; Mais mon dessein était moins de donner un apperçu complet de l'état de nos hôpitaux, que de désigner ce que l'on pou% ait regarder comme àéFectueux. Je n'ai donc fait que m'acquit- ter d'une partie de mon devoir comme mcdecin et citoyen. 0",
         "TUE QUEBEC MEDICAL SOCIETT., THE QUEBEC MEDICAL SOCIETY. The yearn hich has just elapsed will form a memorable Sra in the scientitic history of Canada, as it has given birth to the flrst attempts which have been made with the view of open- ing a free intercourse vith the litterrary world, and of pro- moting the interest and cultivation of Medical science within the limits of our country. It is indeed a happy circumrstance which makes it our lot to announce to all our countrymen and to the medical world, the formation of a MEDICAL SOCIETY in Quebec, whilst we can bear evidence to the spirit of concord and unanimity vhich presided to its organization. A perusal of its bye-laws and regulations will no doubt be read with satisfaction, and we beg leave ta call the earnest attention of al the Profession in Canada, to the advantages which are now opened to theni of culitivating, through that mcdium, a friendly intelligence with all its members, which cannot fail ioprove ser-iceable in mnany instances. Every branch ofScientific ir.quiry is yet unesplored in Ca- nada, and an ample harvest will reard the exertions of the attentive observe2r ; and we believe that nothing could prove a more powerfuland em-cious excitement towards the further cuitivation and :imrovcmcnt of the various branches of the si;enice ofrz.ure and of art, than thespirit of liberality which isso prominrient throughout all the rules of the Society. No. distinction wf person or country, no favorite school or gra- duazion, in fine no particular prerogative of age, birth, lan- guage or education, which might be made the tools for per- secuting talents, can be expected togive any consideration in the Profession whish will not exclusively be the reward of true merit. Uuder such favourable auspices, iWe must hail the forma- tion of the QUEnEC MEmCAL SOCIETY, US one of the nost",
         "TI QUEnFC MEDICAL -SOCIETY. 107 rernarkable events in the scientific history of Canada, which will ever be remembered with plensure by all those who from a true and pure love of Canadian litterature, mav in vears to come, experience the beneficial influence of a Society intend- ed for the further progress of the natural sciences, the funda- mental and only basis of the science of the Physician. At a general vmeeting of the Medical Practitioners of Que- bec, helh! on the ; ist of November lasc, Dr. Joseph Morrin in the chair, the folloving resolueions wcre proposed, and adopted: That of all the various classes of society which have a di- rect influence on the prosperity of the State, thc Medical Profession having for its object to ensure confort and hap- piness to every individual, must be considered as the most beneficial to mnankind. That it becomes the duty of every member of that Profes- sion, to unite all their efforts in promoting the science by vhich such a laudable object can be attained. That the improvemnents which have lately taken place in the Profession of Mediciie in this country, enforce on its memibers the necessity of adopting such measures as may ensure the further support and protection which the interest of Medical Science imperiousiy require. That it is the opinion of this meeting, that this desideratum can be effectually obtained by an Association of Medical Gen- tlenen zealous to promote the cause of Medical Science in this part of His Majesty's doininions. That the nienbers here prescnt do nowjointly form them- selves into that As.ioc'ation, for the purposes above mentioned, under the nane and denomination of Tie Qucbec 3ledical SocietY. That the following resolutions be adopted as the standing rules, bye-laws, and constitution of the Society, which shall remain permuanent, immutable, and irrevocable for the space",
         "THE QUEBFEC MEDICAL SOCIETY. of five years, and to which all niembers present, and those who may li future be added to their number, shall be bound to conform themeclves as members or officers of this Society. RESOLVED unanimously :- I.--That the members present do liereby constitute them- selves into a permanent association to be hereafter designated inder the nane and denomination of TiE QucinEc M:DIc.AL SociE-rv, the sole object of which is, and shall always be, the disseiination and improvement of the various branches of Medical Science viz : Natural History, Botany, Chen istry, Pharmacy, Nateria \\Jedica, Physic, Surgery, Anatomy, Physiology;, \\dical Jurisprudence, Nedical Police, and thefi Obstetric Arts. Il.-That this Scciety shall hold its sittings on the first Monday of everv month, to which ail members shall dulv and reularly ttcnil, except on urgnt business ; and in case it be a1 holyday the sitting vili bc had the next day. III.- That no person, cxcept the muemubers and Honorary iembers, -hall, under any pretence whatever, attend anv of the sitting, unless especially introduced by tie President or the Vice- Pre:ident, the Secretary, and one of the members ; but such person thus introduced shall not bc allowed to take any part in the procedings of the Society. IJ.--That one President and one Vice-President he ap- pointed annually, at every annual sitting, whieh shall bc heid on the ßirzt monday of Decemberof every year, which appoint- nent. shl be made by a majority of the votes present. .-l hat the . o the Prcsiient hall bc, to preside at everv sitti1!, ar.d to miain::a crder and decortim ; he will be allowed to talc a part in the diebates like aill other memibcrs, and at the expiration of his oflice, shall deliver to the Society an address on sone medical subject, which shall become the 1ir: t order of the day, :dther tl inutes of tie last meeting",
         "-IrE QUIEC MEDICAL, SOCIETY. shall have been read ; and all suchi addresses shall be kept as records of the Society, to be publiýhed by its order. VI.-That the.duty of the Vice-President shall be, to pre- side in the absence of the President, subject to the sane oh- servance, and endowed with the sane privileges as the Presi- dent hiriself ; thxe same rule to be observed, whenever, in the absence of both, any other member shall take the chair ; but when the Presidênt shall attend, the Vice-President shall then take his seat with the other members of the Society. VII.-That a Secretarv be naned whose appointmîent shadl be perpetual, and in case of his resignation or death, his suc- cessor shall be appointed: by a majority of three fourths af al, the nienbers of the Society. Hils duty shall be, to preserve all records, documents, and transactions of the Society ; to correspond on the part of the Society, with ail Medical Socie. tics, Universities, Academies, Colleges, or other Medical or Scientific Associations oi bodies in any country, or with any individual out of the Society, whenever such correspondence or connexion may appear convenientand practicable, orother- wise uiseftul to the objects of the Society. VI I.-That all communications, documents, papers, pre- sents, or other objects which may be forwarded or presented to the Societv, by or in behalf of any 3Medical or other Scien- tific Association, body, or individual, or by any person whether a permanent or honorary niember, who shall not communicate it personalv, shall be addressed to the Secretary who vill sub- mit thein to the Societv in a due forni ; or such mnay be pre- sented by any one of the menbers, in behalf of such Associa- tion, body or individual ; except where the object shall be a regular or essentiail document of the Society, in which case it shall be delivered into the hands of the Secretary, ns the pro- per channel through which the Society should reccive it in an oflicial manner. IX.-That no person shall become a permanent member 109",
         "THE QUJEBEC MEDICAL SOCIETY. of this Society, unless he shall have been proposed by one of the members at a monthlv sitting, to be balloted at the ensuing- meeting ; and if two thirds of the votes be affirmative, such person shall becone a member, and if less than that number, he shall be rejected. Provided always that the Emember pro- posing him, shall shew to the satisfaction of the Society, that such person is a qualified practitioner accordin- of the in- tent and meaning of the laws of this province, andi that he is actually in practise or residia in, or within a distauce of twelve miles of, the citv of Quebec. X.-Thuiat no person shall become an H'Ionorary meinber, unless he shall have been pro;oucd at a monthly sitting-, to be balloted at the ensuing meeting, and a majority of the votes present shall be suilicient to admit him, otherwise he shall be rejected. XI.-That whenever a person shall have been rejected after having been balloted, he shaHl not be again proposed vithin the space of one %car, but if such person shoul have been rejected for the want of any of the above qualifc.uions, lie shal never be proposei a second time. unless it be satis- f.ctorhy proved that he has since acquired such qualilcation. XtI.-That whenever the Pre=zident, or the V:ce-lresiident shall not attend, the senior member present shall preside atd miterim. XIII.-That it shahl be the duty of every mn.raber to pre- sent alternaitely a paper on some MIedical subject. The se- nior miuiber shall bega, and at everv sub-equent mecting, each other member shail follow his example fron his senio- ritv, and thus in rotation. The President, Vice-President and 5ecretarv, or all other'oflicers of the Society shall also be included in ttis performance. Anti it sh.ill be the duty of the Secretary to give notice, at every mieeting, to the member whose duty it shall bc to present his paper, and in case of such persmn bein; absent at the mecting whnczî his paier is",
         "TH1E QUEBEC MEDICAL SOCIETY. M1 to be presented to the Society, he shall cause the saine to be delivered in time to the Secretary who will then rend it in his place ; and ail such papers shall B.ecome the first order of the .Àay after the minutes of the last meeting shall have been read. They shailfalso be kept as records of the Society, to be publishcd by its order. XIV.-That the modes of voting at any resolution shall be the signal voting and the balloting. The signal voting sha!I be dictated by the President, and it shall be competent for the Society to use that mode of voting with the unanimous consent of all mneibers present ; and the balloting shall be had! recourse to on the cali of one ni the imembers lho ihall not be bound to give any explanation for so doing. The bal- lo!ing 5hall be in such a nianner as every one maygive his vote in secrecv and wlien the votes are ail given, the Secre- tary shall then collect and report thein in the presence of all the menibers, and enter the saine accordingly in the minutes. Providcdatways, that in ail cases where the nanie of one 31± dical or other Gentleman may have been mentioned, who Inay be at al interested in the event of the resolution, no. other mode of votin- shall be adopted on al such occasions, than the ballating. Except when it shah ibe necessary to ap- point a President, Vice-1resident, or any ofiicer which the Society ny think proper to appoint in future, in which case every niember shall give his vote separately in writing to the Seeretary, wIo will then declarethe person orpersons named or appointed. XV.-Tlat four members, including a President and the Seeretary, shall constitute a Quorum, competent for transact- ng ail affairs and business of the Society. XVL-That it shall be competent for the Society to de- termine, at any future period and by a majority of the votes preseit, the propriety of raisingla subscription fee from ail the memabers, in order to procure plates, prin tings, stationary,",
         "THE QUEDEC 31EDICAL SOCIETY. books, pamplaies, or any other article required for its use. or for the further and proper execution of its object. XVII.-That no conversation, discussion or motion, bear- ing on any political or other subject foreign to any of the object of the Societv, as nentioneà in the above resolutions, shall, at anv future period of ils existence, be allowed during anv of its ittings; and in case of the person thus proposing such conver-=a, dcussion ormotion, refusinig to obey the call afordr by theiersden, lheshalliuiediately be disiisscd fron Le Sxiztv, and declared incapable and untit to be a i:n )nped as one of its meulers. Xvil.-Tat 1no other right or privilege than those pro- vded for in thcse resoluîtions, shall ever be understood to be invet.1 on nv ofthe incnbers and officers of this Society, whether thev relate to any ririit or imnnuunity appertaining to any one, in whatever capacity lie nay be acting ; or whether thev refer to any species of control of opinion or person over any one nf the members, who are all to be considered as per- fectly inde::endent of onc another, but one is to be dependent on the whole, in as mich only as will be essential to the main- tainance oi order, decencv, and decoruim. XXL-That it shail be competent for the Society to appoint at discretion, Committees for inquiring and reporting on any subject which the Society might, at anv ine, think pro- per to investigate ; which Commitees shall be appointed in the same mianner as provided for with regard to all other offi- cers of the :oc:ety ; thev shall in ail their proceedingsstrict- lv conforn them-selves to all the rules and regulations of the Society, subject to the saime observance and endowed with the same privileges as the Society itself, in as much as may be necessary to good order and decorum, or to the prosecu- tion of their labour. Provided always that, wheueNer any question shal crise which nay relate to any prerogath e or to the interpretation of any of these rules and bye--laws, they",
         "TIHE QUEBEC MEDICAL SOCIETY. shall proceed no further but call an extraordinary meeting of the Society, and lay before it the question or difficulties at issue, unon which the Society shall proceed and determine according to the litteral and true meaning of these rules and bye-laws. XX.-That it shall be coapetent for any two menmbers to call an extraordinary meeting of the Society, by applying and submitting their reasons to the Secretary, who shall then make then kiown to the President, whose duty it shall be to give inimediate order to the Secretary to calil such extraordi- nary mieutin9g, dictating also the time when it shal be held. XXI.--That it shall be in the powier of any one of the membecs, to introduce anv Of his friends and acquaintances at all annual sittings of the Society, but such person thus in- troduced shahl not be allowedh to take any part in the procced- ings or transactions of the Society. XXI.-That no proposal or motion tendiog to alter, des- troy or amend any of these rules and bye-laws, either in their tenure, meaning, or effect, shall be proposed to this Society, before the expiration of five years from this date ; and any such proposal or motion then made, shall be delivered in writing, and deposited with the Society for the inspection of the nenhers, during the space of three months, before the Soci- ety shall proceed upon it : and all such proposal or motion shall beadopted by a majority of three fourths of all the memi- bers of thc Society, mniembers absent being allowed to vote by proxy, or by sending ther vote in writing to the Secretary; and should it be once rejected by the want of such majority, it shall not be again proposed. XXIII.-That it shall be competent for the Society to make and adopt, at any future period, such rules and regulations, or appoint such additional officers, as ray be considered use- ful ; and all resolutions once adopted, shall not be liable to be al tered or repealed before the lapse of twelve months from P",
         "114 RAPPORT DES MALADIES A QUEBEC. the date of their adoption. Provided always, that all such proposed motions or regulations shall be consonant with the true spirit and meaning of these-rules and by.e-lavs. Monday, 41k. December, IS26. RESOLED, That Dr. JOSEPiR MORRIN be elected President, and Dr. CuArEs NORBERT FERRaULT Vicc-President, of the Society, for the present year ; and that Dr. XAVIER TEsSIER Le ap- pointed Secretary, according to the 'th. article of the bye- laws of the Society. That Dr. XAvIER TEssIER be requested to announce in the next number of the QuEBFC MEDICAL JOURNAI,, the existence of this Society, and give publicity to the rules and constitution by which it is to be governed ; and that the thanks of the Society be presented to him for this favour. Jos. MO FRIN, President. C. N. PERRAULT, Vice-Presi dent. Xav. TESSIER, Secretary. Rapport ie ltat de la Santi Publique durant la dernière, Saison. Nous avons dèjà en si Eouvent occasion d'implorer lesecours de nos Corfrères Praticiens de Québec, pour rendre satisfai- sant un apperçu des maladies qui Krvalent dans chaque saison, et nous croyons en avoir auEs isuffisamment montré les avan- tages, dans tout le cours de notre volume précéder.., qu'au risque de paraitre importun, nous èsons renouveler notre ap- plication, sans nous lasser de le faire, jusqu'à ce que nous ayons obtenu quelque favcur i notre demande. Dansle Jour-",
         "lAPPORT DES MALADIES A. QUESEC. Yal du Dr. Duncan pour 1810, ce grand Médecin nous ap- prend, qu'ayant ésolu de donner-un semblable apperçu des maladies de chaque saison à Edinbourg, il s'était adressé pour cet obetL aux Mécins en pratique, pour en obtenir les infor- mations nécesraires à son travail. Il avoue cependant que ses peines ont été inutiles, et nous regrettons de voir qu'il ait été par là contraint d'abando:rer cette belle partie de son ouvrage. Quoique nous nayon: pas lieu de faire les mêmes plaintes que le 'édecin Ecossais, vu Passistance que nous avons plu- sieurs fois reçue de nos confrères les pius zèlh-3, nous croyons devoir avertir que nous comptons encore sur l'assistance de toute la Profession dans nos rapports à P venir. La Table Métroloique que nous avons continué de don- ner, est sins contredit l. jarti la plus imîportante de notre ta. bleau, cnnsidérée sous un point de vue philosophique. Ce précieux ouvr.:ge. dont nous sommues redevable à notre esti- mable ami le Dr. C. N. Perrault, fait le plus grand honneur au zèle et auc taiens qui ont si éminemment distingué la fa- mille de ce savant Médecin ; et nous nous réjuissans de cette occasion d'offrir à un membre aussi justement respecté parmi ses confrères, le tribut de reconnaissance que nous devons à son zèle, et que partageront sans doute avec nous cette classe éclairée dl- nos concitoyens qui aiment à honorer le mérite, et à rendre homage au, talens utiles. En comarant l'état de la dernière saison avec celui \u003cle !'au- tomne dernier, on appercoit autant dle variété dans les épidé- mies, que dans la constitution atmuosplhérique. La Rougeole et la Coqueluche qui avaient prévalu rautomne dernier, n'ont point para dans cette saison, mais le Croup (La Grippc), a fait des ravages alarmans, et a inoissoné un grand nombre de victimes parmi les enf.ins. Le nombre des mortalités est ce- pendant moins dù à la malignité de la maladie, qu'à l'appa- rence trompeuse du Catarrhe sous laquelle elle a souvent dé- buté ; ce qui a quelque fois été cause qu'on n'a reconnu la 115",
         "110 MEDICAL LECTURES. maladie que trop tard. Nous devons dire encore une fois \u003cple le vitriol bleu a réussi par dessus tout autre moyeu, et nous apprenons avec plaisir de notre ami le Dr. Ans. Fraser, le St. Vallier, qu'il en a aussi obtenu les succès les plis prononcés. De même que dans les saisons précédentes, la petite-vérole n'a pas cessé ses ravages, au contraire, elle parait avoir été plus séi ére cet automne que dans toute autre saison de l'année. L'automne dernier on avait remarqué qu'elle était plus fré- quente que dans les saisons précédentes, ce qui porterait à croi- re que l'automne est la saison convenable à son invasion. En conséqence d'informations reçues des Institutions Royales de Londres, nous sommes autorisé à dire qlue la Société de 'Mé- decine de Québec, dont nous venons d'annoncer la formation, se propose de donner à ce sujet toute l'attentien qu'il mérite, et nous espérons que tout le public Canadien donnera à cette entreprise l'appui qu'elle exige. Medical Lectures. We are not a little gratified to witness the spirit for impro- vement which is rapidly spreading among the menbers of the Profession. Within a period of twelve months, Quebec has to reckon the commencement of a Medical Journal, the es- tablishment of a Museum of Natural History by our active and intelligent countryman, 'Mr. Chasseur ; the formation fa Medical ociety, and Lectures are now given for the instruction of those who, in a few years, mav contribute their share towards the perfection of aill these important objects. Our friends at Montreal, although wanting some of Ihe above Institutions, have also felt the impuhe imparted to genius, for the cultivation of îcience, as ve have the pleasure to witness the efforts which are making to render the Pro-",
         "WEDICAL LECTURIES. 'IT fession respectable and truly useful to mankind. Four Me- dical Gentlemen, viz : Drs. Caldwell, Robertson, Stephen. son and Holmes, have, since a few years, been engaged ir; giving lectures on various departments of Medical Science, and the success which they have encountered, is a flattering testimony of their qualifications to the task. We must, how- ever, deplore that soie defect complained of by the great najority of the Profession in Montreal, should have given rise to a spirit of division, which we fear is to be referred to political dissentions kept up by national prejudices. Situated at such a distance, we are not sufficiently conver- sant vith the rrounds of complaint, to give an opinion; but we flatter ourself, and we carntestly entreat our Professional brethren of Montreal, to endeavour to make up by mutual concessions, and revive that friendly understanding vithout vhich the Profession must be degraded in its members, and obstacles to their own improvement, dayly and constantly rencw ed. Suc is the high opinion which we entertain of their good sense, that ive have nohesitationin expressing our hope that these unfortunate failures vill soon give way to concord and unanimity. Fortunately for the Profession, we are not similarlI situated in Quebec, and not a dissenting voice lins been raised, whenever.the interest of the science was at ail concerned. \"The Lectures vhich are nov deliver- ing in the presence of the most distinguished characters both in and put of the Profession, are a striking and gratifiying evi- dence of the liberal dispositions of the Medical Practitioners in this city. There are at present in Quebec two Ge..tlemen delivering lectures on Chemistry, and one on Anatomy and Physiology. Dr. T'rs. Blanchet is lecturing at the Emigrant 1ofspital, and Dr. J. Whitelaw at the old Theatre. To Dr. Blanchet, the Profession is much endebted for his indefatigable exertions, both as a Member of the Legislature",
         "118 METEOROLOGICAL TABLE FOR QUEBEC. and as a Medical man. In the former capacity, however, we must regret to say that his principles have sometimes differed from the majority of his brethren, but as a Medical man, we are confident we express the opinion of all the Profession in saying, that his unremitting efforts have not a litt.le contri- buted to raise the Profession to its present improved state anong us. Dr. Blanchet also has the credit of being the first Cana- dian Medical Author. His work on the applicatiQn of Che- mistry to the science of Medicine, was promising a very use- ful member to his profession ; and we acknowledre with plea- sure that an unrernitting study of Chenistry since that period, must re.nder his lectures highly scientific and interesting to the hearer, should his age and unwearied occupations per- mit him to prosecute still furthe his exertions in cultivating a science in which he has rendered himself so proficient. METEOROLOGICAL TABLE FOR THE AUTU31NAL SEA3ON OF 1S26, AT QUEBEC. SEPTEMBER. E 1TUER IO3îETER. -*1. TtsPEE ... .~'3 pi8 S -4x 3 pt ,3.\u003c. A.M 8 W 23( 44 5,2 i 46 NE N EN E.cloudy clear cloudy 24. 44 52 46 N E N E. E«clear clear clear 25' 44 54 48 N E- EN E'clear .clear clear 261 50 54 52 S WIS E;S E clear rain rain 27 54 60 54 tS E.S EN El rain rain rain 28 .56 64 54 '-N Ej wS W cloudy cloudy rai'n 29 54 58 52 S W WS W cloudy' show.I cloudy 30 52 56 48 S Wi S WiS Wicloudv rain cloudy",
         "METEOROLOoIC.AL tABLE FOR MONTREAL. The other Lecturer on Chemistry is Dr. Whitelaw. Had not the advantage of a personal acquaintance with this Gentle- man, afforded us an opportunity of being convinced of his ex- tensive knowledge as a Medical man ànd as a Chemist, the un- exampled satisfaction vhich bis Sirst lectures have created in the minds of all competent judges, give an ample testimony of his superior merits as a Lecturer. The plan of his intend- ed course, and his unfastidious delivery, will greatly contri- bute to render it highly profitable uder so able a master. The Anatonicaliectures delivered by Dr. Douglass, equal, in our opinion, what is to be expectedl even in the most an- cient Colleges, and the best regulated schools. We do not hesitate to pronounce his Introductory Lccture the niost claborate history of comparative Anatomy which we have ever heard or read. We must then regret that the students of Me- dicine do notsuffliciently avail tlcnselves of this precious token. METEOROLOGICAL TABLE FOR TIIE AUTUMNAL SEASON or 1826, AT MONTREAL, SEPTEMBER. THLERMOMETERt. a7 A. M. SP. x. 2341 X 55 X 24 40 ,, 59 r, 25 39 ,, 69 ,, 26 48,, 57 ,, 27 57 ,, 72. ,, 2s 63 ,, 61 ,, 291 5Q ,, 5o ,, 301,51 ,, 65 ,, B.R0oMETEU. 7 Ai. SP. M. 30 23 30 27 30 31 30 37 30 33 30 25 30 21 30 13 29 91 29 87 29 72 99 71 29 74 29 70 £.9 Es 29 91 ATMOSPHERE. --Fair. -Fair. -Fair. -Rain. -Rain. -Rain. --Showers. -Fair, 11L\u003e",
         "METEOROLIole.\\L TABLE FOI QUEBEC. OCTOBER. I ru E iETrER. WIS. MoENDSERE. .3 î'.X 3 P..i S A.M- j P. P.m. S.r.x. 3 P.x. $ r.ar. 40 54 46N E1S WiS W. rairn clouiy clear 1 44 5S 50 S W S W W cloudy clear cloudy 44 50 -14 S WS WS W cloucdy clear cloudy 4 40 4: 4 S VI' S W'N W c!oudy cloudyvclear 5 3S 5-2 46 j N W N WV N W clear clcar clear 6 -P 7U 54 S WS W;N E clear clear clear y 4-1 54 51 N ES iS W: cloudv thund. cloudIy 8» 40 50 -14 N W N WIN W c1lud' clear clear 9 44 .50 4 S W WiS co rain rain 10 3S 4S 40 N. W: clear clear clear il 3G 5'; 50 N VS WiS Wi clear c ecar cloudy 12 44'53 50 S ES E;S E: cloudy cloudy cloudy 13 4$ GO 46 S W . - .N E' clear ,clear clear 14, 44 50 46 fN E N E'N E cloudy'clear cloudy 15'. 42 51 44 N E N E'N E foggy Icloudy cloudy 16 -18 54 56 N E S E. S , rain rain cloudy 17 - 48 56 46 S Wl S W.S W, clear j clear clear 16 44 54. 52 S W N EIN Ejclouy clear cloudy 19 j50 50 44 S E NW N W; rin clear clear 20 41 52 46 N W.S WV S W cloudy. clear cloudy 21 48 5i 50 S W S W ,N E, rain cloudy cloudy 22 45 4S ' 44 N EN N W N XXjrain clear clear 23- 34 44 40 'N WN IN l clear cloud% cloudy 24 40 42 ,o W N W cloudy cloudy clear 25 I 32 36 34 ,i WN W N I clear clear suow 26 1 36 38 34 lN E N W N XWI sleet cloudy clear 27 32 35 3-2 !N VN WI N WV cloudy clear clear .s , 34 4Il 410 'N WV N1 E N E, clear cloudy rain. 191 48 54 50 !S ES E S F cloudy cloudy rain 300' 44 40 35 N WN 1V N W rain cloudy cloudy 31j I 32 38 34 N W.N WiN W clear clear clear 120",
         "METrEOROLOGICAL tIABLE FOR MONTREAL. OCTOBER: HERMOMETER. M%.T g P. M. T 7.. 1 43 2 42 3 38 4 43 51 41 61 49 7 6'2 8i 38S 9. 40 10 37 l1 32 12 43 13 41 14 42 15i 44 16 41 17, 46 18! 45 19ý 4S 20i 44 21j 46 2c 43 23 312 24 33 25 29 26 29 27 26 28 33 29 46 30 42 311 29 BAROM ETLR. iî. 3t'. M. 7 A0 29 30 29 29 30 30 29 29 30 30 33 30 30 30 30 29 29 30 29 29 29 39 30 29 39 29 30 30 2-9 29 30 29 29 30 30 30 98 13 71 99 26 S9 15 36 47 44 35 22 07 75 96 17 73 87 79 S7 11 99 27 83 21 21 79 63 07 03 91 94 15 21 95 78 93 27 41 49 27 23 15 95 79 i'2 06 85 86 76 93 07 17 14 91 33 11 67 81 03 ATMOSPILERE. -Fa ir. --Flir. -F a ir. -Fair. -Fair. -Rain. --Fair. --Fair. -Fair. --Fair. --Fair. -Fair. -Fair. --Fair. -Rai. -Fair. -Fair, -Fair. -Fair. -Rain. -Fair. -Fair. -Fair. -Fair. -Fair. -Fair,",
         "N=TOlRtolGCà% IABLE Toit QUIEBC, NOVEMBER. .9 A.M 3 P.)f8 S- 4 A.,%. 3 P.31. 8 P.1 P . 31~ . . 383 40 44 NEI EIS It hi1 rain cloudy 2 .36 42 3S S WVýS IN E- clear clear cloudy 3 36 d36 28 S WvN W 1 WÏ rain cloudy clear 4 26 34 32 N WN I N Wl cleaîr dandy cloudy Zî- 22 .3 4 3-1 N M\u003e-lN W(N W 1 chear ecar cloudy G 3eS 2N \u003e EN E dar cloudy snlow 7 34 42 40 S EýS W S WV rain cloud'v rait 8 32 36 4 3 S «W4S Wý N W cloud;. cloudy cloudy 9 28 36 36 S IWVS w N E cle-r cloudy eloudy 10 36' 36 !4o N E'N EN Ermin s1cet -,'rain il j36 42 38 S IVjS w (S W I cloudy cicear !cloîidy 1-2 39 34£2 E' -? Z (VN W rain cloudv ecar 131 20 23 Qo0 N XVNý\\ WIN W1 clear ciear 'clear 14!918I 22 24 N IV N El-N Lt'clotudv snov lsnow 15 L8 30 34 S ES MIs M\",Sno i bnow jcloudy 16 35 42 1.36 S IVý7 ES WV cloudv!diloudy' rain 17 35 Os 39 N EN E -. E rain mian mi~n 42 41. Mq W VIN W. eloudy. cloudvj cle.ar 191 212 26 22 N W (1 MI COdycea ear 20 0 28 N E N !N E cloudv* cloud-v snow 121 27 30 28 '.4 EN'ý\\ E èN\\ E clou#vicloudv'cloudy 22\u003c 28 29 t 2G JN E N E~N E eloudy(l;. elear' jdoudy 231 2,2 21-, 26 S NV S WVS Wl c1oudy. cloudI, cIouly 241 2(; 25 S -% S w!S Il snw snw cloudy 2( 23 f29 06 ' WSWsnow ciondi clear 26; 2 32 .SS S W N E' N E cloudy cloudy cloudy o-I 3 42 \u003e ~S IN E. S w ramn P(c1u eïou- 36 38 S' ~ ES W S W cloudy! clouth cloudy 0.9.0D 38 23 ' W S iv cloudN-Isnotvsntiw '301 I 3,5 38136 WS Iv iS l W; 1O(I oiddo",
         "METEGROLOGICAL TABLE FOR MONrREAL. NOVEMBER. THEit3[0ETElt, ' BAUOM3ETEt. il7 . 3r.__I.i. . A. 3M.3 P. 3M. 1. 54 X 29 81 29 87 -Rain. 2' 3 , 48. , 29 76 29 79 -Fair. 5 , , 47 30 58 -Fair. 4 2G ,, 5 30 26 30 29 -Fair. 5 2 ,, 40 ,, 30 38 30 4L -Fair, 6 30 ,, 4 ,, 30 41 , P 33 -Rir, 7 3.5 ,, 50 ,, 29 71 29 67 8 33 ., , 29 69 I 29 93 -Fair. 4 1, 30 13 30 07 -Fair. 101 35 ,, 41 ,, 30 00 29 93 -Rain, 11 38 ,, 42 ,, 29 74 I29 9:. -Fair. 12 27 ,, 39 ,, 29 87 29 95 -Fair. 13 24 , 30 ,, 30 16 30 37 -Fair. 14 23 22 ,, 3) 38 30 13 -snow, 15 30 ,, -40 ,, 29 65 29 67 -Rain, 16 36 , 45 , 29 91 29 92 -Fair, 17 38 ,, 155 ,, 29 85 29 83 -Rain. 18 33 ,, 30 , 29 38 29 56 -Fair. 10 18 ,, 30 ,, 30 25 30 37 -Fair. 2) -28 ,, 36 ,, 30 43 30 48 --Fair. 01 24 ,, 31 ,, 30 57 30 33 -Fair. 22 27 » 34 ,, 30 27 30 15 -Fair. 23 25 ,, 26 ,, 29 91 29 89 -Fair. 24 22 ,, 25 ,, 29 92 29 96 -Fair. 25 23 , 32 , 29 96 2999 -Fair. 26 25 ,, 30 ,, 30 00 29 63 -Rain. 27 32 ,, 40 , 29 45 29 83 -Fair, 28 32 ,, 35 ,, 30 01 29 91 -Snow, 29 31 , 35 ,, 29 71 29 73 -Fair. 30 33 , 42 ,, 129 73 Q9 69 -Fair,",
         "miVUSO\u0026OiOa 1ADIA y\" M DE~E3IDEL pTKNOSZ. 3 INDS. 8 A ? eSE. i34 le 30 LIS w~ qeS 16 'x wiI âqr ' .36 ~ws W l - 40 - N IVN -W 14 !s 4Y swN 113N t--\\ s 'w àu 0e Jx w'- w 12XNW' E I idmi , ies, Ickéar râ iciemr iN £fchrd cloudclody doïtèoudy cicud lr*jW cmd)m- d ekdy Ywidebrf dear dear Y E w jW uodka durd S Il Iur.d.,clcar tirai Udeai' ~turm.nd NOTICE« TO ATôLPIL~P1R raLl.iýg4oïkeha..4ad. thse amsIee rl h uvi ,~ .'-~ jrScEntemeiyail th ego 1e )er, vI:VI t j\u003cIyud- pam.\u003cemlly meived-bv te Ediiorcf ~ ~ nsihs bd~-o\u003c'e £o.mupy uji bis ~ wl r cesrrnid ia'bs a enùspWée secf icAurtïients fer ike puToie, uS dlhzo elable eliremiues and fo.rniua by suI1ih tbis labour usai Secouie a \"cri istructive auseent, witbout accasioing oeula@r tumblee me e-ipeace. N~ihins in ibis deluUaemt Winl Se-\" etii iiet for thse \u003ekde\" Jtmuds, wu i n u tise l saet muooro\u003cherwuge. - 1 34 i10 ,34 134 -34 14 ,30 34 3c\u003c 1 s\u003ci 1- gi; .",
         "MET.OR21LOGICAL TABLE FOR MONTREAL. DECEMBER. 7 A. as. I s. ar. 29 X 32 X 25 , 17,, 10 , Y15 ,, 14 ,, 3,, 20,, 4 ,, 34 ,, 40 , 40 ,, j45 , 32 ,, 35 30 , 33 31 35 25 ,, 7 ., 9 ,, 7I 2R ,, 37 ,, 32 , 3,, 35 ,, -43 ,,I 33 ,, 35 , 14 , 16, OS ,1 13 10 , 11 7 A. 31. r. i q9 96 29 SQ 29 S9 29 98 10 21 30 29 3 43 30 45 30 4S 30 43 i30 3G i 0 27 .30 25 30 23 30 03 29 74 2) 75 .'9 73 j29 GG 29 39 29 59 29 98 30 Os 29 56 '29 f9I 2 9 S7* 30 09 30 02 30 01 29 99 29 92 29 69 29 81 29 S6 29 7 , 29 77 30 01 30 15 30 21 I29 83 A'UX CORRESPOND.NS. En conséquence de notre invitation à toute la Profession, désirant leur avis sur tous nos établissemens en Canada, donr il nous était imlportant de connaître les rapports avec le bien public, les écrits reçus s'accordant à tous égards avec les principes invoqués par l'auteur de liPEsai sur un Hôpital Géneral, uons avons cru devoir les supprimer. Notre correspondant nous autorise de plus à \u003clire, que s'il se rencontrait qu'elqu'un hors de la Profession, qui serait dis- pose a diviser d'opinion avec lui sur aucun de ses avancés, il Ser.a toujours prèt à soutenir une discussion ionnête et dé- Cente, plcrvd qu'il ait le public pour juge. HERE. AT3Z0SPI -Snow. -Fair. -Fair. -Fair. -F'air. -Rain. -Fair. -F'air. --Fair. -Sleet. -Snow. -Snow. -Fair. -Fair. -Fair. --Fair. -.Rain. -Fair. -Fair. -rair. 1-Snow.",
         "126UORAWMCAL UO=S BIOGRAPICAL IqOTICE3. f I Méca Recordcr of Origiaal -Pdpmr and Iatellgeaoeta ZL.D; Eleuber of dSe Amercas Pwtk».pbient Society, Comrspontlio; Jtaber of the 3Iodiecal Socewy \u003efL,.doo, ac. AisistedtyU Oao of Pbysiçiaus in Phitadeiphia. 'Webster, -Ne. L'i, Seil Eit Street, Pimlacp. l\u003egice 5 \"uIZs per strnuu. À_cÉ\u0026LjQes, tr rno Our NviUberwes ùeartycouplted wheu werc favrâoureil wih xo. 3.(; et hme 1 eeb'a. pridi work. AI- thoug-h we cerer hi bavna lfeein\"s Journa before e ?VUtIC beard it . of -i. 'vcry h*gh- .telnm:. Tbtlao:e-uw\"OUty, bmowevzr. froè \"Ma WC a ba timic to rezd- as 5@iL pans of it, couintamd eue -r- païfel wh:at ive- c=C-ýiCàr of its i.mpou¶ance, ad we use conviaccd È~ i1. veut- v;azicttbe io uauch agiWedaed 1y every well-Lber 6o.ite-caet-? 0f icience. ansd thaits cous- tant iueru!al wUbe fcuu au a:)uadut, s«oume-ê ukil in- formiation. ' 1. wIl peoeercsronkfrofn mumber. 2'k Xe-1,k JdWo aad Ï1'\u0026gaiàtf -OMme. Nus. 1. \u0026 g;di k i b.jà'.aL Bè\u0026, M.. x Mda i LU. l'ieoto, MD. and John likU, M. P. FrJlAut andl Sepim!er, 16t'G. Pri 4 dollarsperm au\u003e. la exeauge. pp. G iechum r.QMauerly. ,wé bue cmurezal uieeae me4 urimmloar \"ubiso Ume, 49ad l Ic:kae te3qiiitb due u et-me je cour. boswhife Lasdt~eeeuees.t thaL~o.Aut h C..vita au",
         "BIOGRAPIIICA1L NOTICES. Roche M. D. No. III, July, 1826. Philadelphia. In exchange. pp. 216 in each Number. Price 5 dollars per annum. Quarterly. There being also no Agent in this country for this Journal, application is to be niade to M. J. Dobson, No. 103, Ches- nut-Street, Philadelphia. To those of oursubscribers who night be prevented from subscribing to any of these Journals froin the difficulty of procuring them, we readiily offer our services in transnitting their request to any of the above aecreditted Agents. Examination of a vork entitled, Recherches pra(iques sur la Fiivre Jaunc.-Par A. J. Dariste, M. D. of the Roval Academies of Paris, \u0026c. Respectfully prescnted to the Director, Sr. Dr. Da. Jose Maria Varo, to the President, Vice-President, Secretaries and Members of the Academy of Practicl Medicine of Mexico, by their most obedient and much hononred Pellow-corresponding Member,Felix Pas- calis, M. D. Renmarks on the Thcorv af Pain.-By the same author. The former of these being ess interestingr to the Canadian readers, we will insert the latter in our next number. Paris, 16 Aout, 1S2G.-On assure que la Police a fait sai- sir un ouvrage intitulé :(lgraphi des 3é1decins Francais. Un Médecin estimable et écleiré, M. R. Th. H. Laennec, est mort le 13 de ce mois, à Kerlouarncc, près Donarnené, dans le Finistère. Il était né à Quimper en 17S1. Ce grand homme est bien connu dans tout le monde, et sa perte est vi- vement ressentie par tous les amis des sciences. TO AUTIIORS AND PUBLISIIERS. The Editor respectfullv sollicits an exchange with all Edi- tars and Publishers of Medical or other scientific and litte- rary perioxlical publications, whatever bc their shape or size, or their distance froni Quebec. They may be sent by Pos, with this address, \"Dr. Tessier, Quebec.\" Authors are earnestly requested to send their work for no- tke and analysis itthis Journal.",
         "CONTENT. CUSTiciL JAÂTSM. pace E!e.aMots of(medaC2l Jmipuero. T. R.Beek, M. .D., Froe.:ot ofldie Insttutee Medicine. and Lonsdon EikItion, by Wm., Dunlnp, Fl.c. S. ký \u0026C_ \u0026 APr.aeticzd U=e3ie on imiuwas \u003clisem«c of the abdomimal rizcer.-Cv C. it Petubefto;li,% 1).. è£. oiou. 19 Chicters -of zUic flîk ok-.Upxafter unoeu- I~-Et: ~ 2ît.-W of the-abi\u003coÀ.- Ite--uaiui of -.-a!raenl.EIqs.Cop ture cd tue [Itr.-Wouod of bW Çommbh.H«\u0026d Luw au- -LktLi 3chnlli.Mewry in. Divir4*W des-oua~droehmnmae-o taire. 16 Atiteèmpt-l 2o ascrt'àin the '-aliéeof the raMcndîriru, ms eoi~. .c.c.-vE1~'jvaa,,33 D. $\u0026c.,.New.yo\u0026L 6 A r~uiion '4c.iehla, by . Meilk:ur, Ji.»D. lhe QmbeMdîoelSoigv Rapoi là là-i~pbiue .ec Medial lctuvm1. ~.adlis1 tewlgica T.LIe*1w d~olls-t\"4 de. 4. 1wM\u003cieL 11-SU 0 t. ýw uafml.sue l T* j_ Z #Mwbe115"
      ]
   }
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   "doc" : {
      "contributor" : "oocihm",
      "media" : [
         "text"
      ],
      "note" : [
         "Monthly"
      ],
      "lang" : [
         "eng"
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.8_05183_21",
      "pkey" : "oocihm.8_05183",
      "label" : "[no. 9] (Sept. 1861)]",
      "source" : [
         "Scanned from a microfiche held by the Hannah Institute for the History of Medicine."
      ],
      "key" : "oocihm.8_05183_21",
      "identifier" : [
         "8_05183_21"
      ],
      "published" : [
         "Montreal : [J. Lovell, 1861]"
      ],
      "title" : [
         "The British American journal [Vol. 2, [no. 9] (Sept. 1861)]"
      ],
      "type" : "document",
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "THE BRITISH AMERICAN JOURNAL, ORIGINAL COMMUNICATIONS. MEDICAL DEPARTMENT. ART. XLVI-On the identity of Cowpoz and Sma1lpox. By .ANTONY VON IFFLAND, M.D., M.R..S.Eng. \u0026c \u0026c. Sonie years since, (I believe in 1845) I submitted to the medical profession, through the \"Journal of Medical Science\" so ably conducted by you for many years, and other medical periodicals, my conviction, that the vaccine virus, in consequence of the many and various systeims through which it had been trans- mitted for a long period of time, without any renewal from the cow, had in a great nieasure lost its protective power. Of late years I have had many oppor- tunities of being, with you, also convinced, that it afforded only temporary secu- rity against the ravages of snall-pox. To remedy this evil, I had, with others, suggested the desirableness of freshi matter being taken from the cow, when practicable; but, as has already been ob- served, \"it is one thing to speculate and advise upon the matter, and another practically te proceed with it.' It has been generally admitted that the cow-pox is only a modification of small-pox by the nature of the animal in which it is gene- rated, and although I have not gone se far as personally te inoculate a cow with the natural small-pox virus, I can bear testimony to the fact, that the small-pox matter will, if introduced into the cow's teat, produce at all times the same sore, or as it is now universally called, the vaccine pustule; there may, in some re- spects be dissimilarity, but they are the saie ; and that the cow-pox is small-pox passing through the constitution of the cow, and which, having lest its infectious quality, will retain its protective power in the human system, at least for a cer- tain period of time there can be no doubt of. About six weeks since, we had.in the hospital a large number of cases of Small-pox among the Germans and Poles, with many of a confluent characterbutin consequence of the salubrity ofthe island and the excellent ventilation which ýthe locality of the Small-Pox Hospital affords, nearly all recovered, (the four deaths having occurred ainong young children), while the patients, from time te time, -were allowed, at an early convalescence te walk about and sit within the prescribed limits of the hospital. -fewof these 26 VOL. .Il",
         "BRITISH AMERICAN JOURNAL. patients having, however, wandered as far as the grounds in which the cows some- times grazed, my cow, being one of the number, was milked by some of the patients whose fingers were still covered with small-pox crust, and as lier teats had already suffered from the stings of musquitoes or sinall black flies, the small-pox virus was readily communicated, and in a few days produced all the characteristic pus- tues. The girl who milked ber had neither been vaccinated, nor had had the natural small-pox, and in a few days ber hands were covered with pustules bearing great similarity to those of natural small-pox, but otherwise with no constitutional disturbance. The teats of other cows on the island were also similarly affected, My servant girl, although much exposed to contract small-pox from lier frequent intercourse with the patients, in distributing comforts to the children in hospital. had up to this period, (15th August) borne perfect immunity from any attack. The others, who also milked the cows with pustules on their teats, had merely small sores on their hands ; they were very young girls, and had been vacciuated at a very early age. Among the great number of patients admitted into hospital with small-pox, nearly one third had been vaccinated at a very early age, and bore the saine depressed cicatrix on their arms as is usually seen on those who have been regu- larly vaccinated; but whether they had had the constitutional fever during the progress of vaccination, or whether the pustule was of a spurious character, (which bears the saine cicatrix as the genuine) it was impossible to learn. Among this number, however, it may be remarked, that with few exceptions, the disease ex- hibited itself in a very mild form, having but few distinct pustules, and the con- stitutional disturbance so partial as scarcely to necessitate their confinement to bed. Grosse Isle, 20th Aug, 1861. ART. XLVII.-The Mfedical Statistics of the City of Montreal. By GEORGE E. FENWICK, M. D., Physician to the Montreal Dispensary and Infirmary for Diseases of Women and Children. ln publishing the accompanying tables compiled from the cemetery returns, my object is to draw attention to the great need of an uniform system of registra- tion, and to endeavour to prove that however faulty our drainage, however over- crowded in some localities are our buildings, yet the mortality of Montreal is not quite so high as has been represented. That the death-rate is high, when com- pared with some others cities in Canada is truc, but that there has been any in- crease in that rate during the last sten years, is doubtful. There being but two burial places for the city and environs, an opportunity of arriving with positive certainty at the number of deaths within the city limits is by no means an easy task. A critical examination of the tables proves that a large number of the deaths recorded are from surrounding country parishes. In the Mount Royal Cemetery it is well known that there are interred annually a large number who do not be- long to the city proper. The same may be said of the Roman Catholie Cemetery, the number of burials from the villages in the immediate neighborhood of the city is quite an item; these will be found in a separate column under the heading 390",
         "I G. E. 'FENWICK. ON MEDICAL STATISTICS. « Prom the Country,\" In estimating the rate per thousand of deaths in the city these will have to be discarded. Infant Mortality.-By reference te *these tables it will be found that the mortality among children is particularly high. They are chiefiy among the children of the poor, in numerous instances the fatal result may be attributable to improper care, an indifference on thec part of parents to seek medical aid, if not the inability (through povei-ty) of obtaining it. By this I would not have it infered that medical relief would not be given, and given cheerfully if sought, as the marked benevolence of the medical staff of our city, as of all the world over, is proverbial. But parents too often, pro- bably through delicacy or a disinclination of ineurring obligations which, through, straightened circuinstances, they feel they cannot discharge, are induced to res- ort to a host of domestic reiedies, and we are called in when our services are of no avail. Of the 3173 deaths recorded during the past year 2182 are of children under 8 years of age. The cause of this sacrifice of infant life is not alone to be attributed te neglect on the part of their guardians ; it is readily traceable to impro- per food, badly constructed habitations, over-crowded courts, back alleys, without drainage or ventilation, surrounded by filth, foul air, and deadly emanations, is it a wonder so large a mortality lias to be chronicled. The remedy for all this is a proper system of drainage and a thorough cleansing of these purlieus of disease; and as a means te relieve the present necessity, the establishment of an hospi- tal or infirmary for the children of the destitute is actually indispensable. A hospital with the above objects exists, but in name; I trust however that before many months have passed, a flourishing institution for the relief of the children of the poor, will be in active operation. If this benevolent charity is properly carried out it will afford the means at least of removing sick children of the destitute, from these nurseries, se to speak, of disease and death, to a place of refuge, where they can have wholesome air, proper food, and medical relief. The necessity of a general system, of statistical registration should occupy the earnest attention of our city authorities. Through the kindness of Mr. J. Desturnell I am enabled te quote from the laws and ordinances relative to the preservation of the publie health in the City of New York, under the heading, \"Article second,\" page 35, section 10, we find: \" It shall be the duty of each and every physician in the City of New York, to report to '* the City Inspector, when required by the Board of Health, the death of any of his pa- \"tients who shall have died of disease within 24 hours thereafter and to state in such \"report the specific nane and type of such disease.\" A little further on we find that: \" Every practising physician who shall refuse or zieglect to perforn the duties enjoined \"on him by the 10th section of this article shall be considered guilty of a misdemeanor \"and shall also forfeit for each offence the sim of $250, to be sued for and recovered by the Board of Health.\" A little further on we find at page 135, section 10: \",No sexton or other person having charge of any place of intermnent in the City of \"New York, shall, under a penalty of two hundred and fifty dollars, inter or permit to 891",
         "BRITISH AMERICAW JOURNAL \" be interred, any dead body therein, without having first received a certificate, stating \" the name, apparent age, birth place, date and place of death, and the disease of whicb \"he or she shall have died, signed by the attending physician; or in case no physician \"shall have attended such deceased person, then by some (member) of the family of the \"deceased ; or in case of an inquest having been held, by the coroner; which certificate \"shall be deposited with the return in the office of the City Inspector.\" I believe the Bye-Laws of our Corporation have a similar provision as the above. It is, however, not carried out. No attempt has been made to collect relia- ble information on this important subject, except, during the existence of epi- demie cholera. As at present collected the returns are useless, as touching the causes of death, inasmuch as the information is obtained alone from the friends of the deceased. I think there eau be little doubt, but, that the profession generally would cheerfully comply with a sanatory regulation which would ultimately tend to so muli good; however, if not, the Corporation have the power of legislation, and enforcing, under a heavy penalty, compliance on their part. In England a most accurate system of registration bas been carried out for many years, and correct and reliable returns are published annually. These have been ofthe greatest use to sanatory reformers, as they are enabled thereby to advance facts borne out by the average of a long series of years. Is it too much to, ask a similar enaetment for the United Canadas ? Let us in our infancy as a country, profit by the experience of our respected and venerable parent. But in the absence of a gencral law, it becomes the duty of our city authorities to insist on a fair, and reliable system of registration of these matters, and follow in the footsteps of all the first cities in the civilized world. lu the subjoined tables the returns froin the Protestant and Roman Catholic Cemeteries are given separately. This has been done to render them more com- plete when compared with the return of the Census Commission of our city. The months of greatest mortality among the Protestants were July and August. Among Catholics, June and July; there were fewest deaths among Protestants in November and December; among Catholics in February and November. A special column lias been devoted to the Sours Grises, or Grey Nun Found- ling Hospital. During the year there were 454 deaths of infants, returned from that institution. It can hardly be supposed that Montreal offers so large a number of illegitimate births annually. I will refer again to this subject in the course of this paper. Smnall Pox.-Deaths from this cause occurred in 154 cases. Of these 23 were Protestants; 131 Catholies: of the former 18 werc under 8 years of age, the greatest mortality occurring in the St. Ann's and St. Mary's Wards. Of the latter 121 vere uider 8 years, the largest:number of deaths being in the St. Antoine, St. James's and St. Mary's Wards. 'We may presume that the rate of mortaiity under this heading has not been great. In the Montreal General Hospital, 62 cases of Small Pox are reported for the year 1860, amongst whomwere two deaths; If we take the rate at 4 per cent. we would have 3850. casesof the disease-the largest% proportion- being among infants- or young children. I- speak froi personal observation,-as, for every",
         "DR. G. E. FENWICK ON MEDICAL ST'tISTICS. 893 case I saw of the disease in an adult, there were 20 among children. However here is evidence, if evidence were needed, to prove the necessity of effectually carrying out the Vaccination Act recently passed by the legislature. It is much to be regretted that this act is confined in its operation to the larger cities in Canada. I am at a loss to conceive why the country parishes and smaller towns shonld be overlooked. Small Pox is well known to prevail occasionally to ah alarming extent in whole districts, more especially among French Canadians, as may be evidenced by the fact that in some parishes almost the entire popula tion present the deep pits and scars which remain after a severe attack of this malady. Referring again to these returns it will be found that the great pro- portion of these deaths are among the children of the poor, and from the locality of the Roman Catholics we may infer the largest proportion to have been French Canadians, as nearly three-fourths of the population of those wards are of French extraction. The necessity of early vaccination cannot be too urgently enforced, and for the poorer class there are two hospitals and the Montreal Dispensary, public institutions, with constant supplies of fresh vaccine lymph, where their children will be vaccinated gratis, if they will be at the trouble of taking ther there. Abundant evidence can be brought in proof of the beieficial effects of vacci- nation, the most strildng facts are given by Dr. Casper, of Berlin. During the ten years from 1782 to 1791, 4453 deaths are recorded as having occurred from small pox in the city of Berlin. In the year 1800 vaccination was introduced and practised extensively. In the ten years from 1802 to 1811 there were 2955 deaths from small pox, and in the 11 succeeding years the cases of deaths from that disease had diminished to 555. It had been observed that an epidemie of small pox occurred about every third year. In 1803 its recurrence was first checked by the prevalence of vaccination. A popular notion that other maladies peculiar to infant life became more fatal after the introduction of vaccination was combatted by Casper. He found on comparing the two periods from 1786 to 1789, and 1819 te 1822, that in the former period 39 out of 100 children died of other maladies, whereas during the latter the. death rate was reduced to 34 out of every 100. On the same point we may notice the official return of deaths in Sweden: In 1779 small pox destroyed 15,000 persons. 1784 \" \" 12,000 \" 1800 \" \" 12,800 \" 1801 \" \" 6,000 \" 1822 \" \"1 \" 1823 37 \" Here, also, as in other continental countries, vaccination was introduced about the year 1800. It may not be deemed irrelevant to mention re-vacciatii. Müch difference of opinion obtains on this subject. The great Jenner was of opinion that re-vaccina- tion was necessary, thatthe protectiveinfhienee fvieiine graduallyiminished as the patient advanced in:age. Without e is engaging the attention of eminent observers at thepresentday,'I *ill m erely",
         ": BRITISH -AMERICAN JOURNAL; say that a trifling scratch on thearm, and a few days of discomfort will amply repay an individual if it preserves him from an attack of so loathsome and dan- gerous a disease as Small Pox. Measles.-This disease proved fatal in 32 cases. All were children under 8 years of age; of these 7 were Protestants, and 25 Roman Catholics. The St. Antoine, St. Mary, and St. James' wards having the largest number of deaths. Scarlet Fever.-Sixty-five cases of death are recorded from this cause; 34 were Protestants, and 31 Roman Catholics. This fact will not fail to strike the reader. I must refer him, however, to the next disease in the column, Fever, under which beading I have included all other fevers, however named. It will be observed that 82 cases are recorded as occurring amongst Roman Catholics, 53 of whom are children. Again, under the heading Dropsy, we have 11 cases among Roman Catholics, all children. As fever on the one hand is not by any means a common disease of early childhood, and dropsy is seldom, if ever seen, except as a sequelæ., we may reasonably infer that the majority, if not the whole of these cases, were either scarlet fever, or in the latter instance the sequeln of that malady. The largest proportion of deaths from scarlet fever, occurred in the St. Antoine and St. Ann's wards. . Fever.-UJnder this heading if we subtract the 53 deaths which are recorded as having occurred among children, there will remain a total of 37. The largest proportion of deaths being in the St. Antoine, St. Ann's, and St. James' wards. I have entered thus minutely into the details of the above class of discases as shewing a bearing on the unhealthy localities of our city. Al who have made this subject one of ordinary observation, will allow that the line from Mignonne Street to the foot of Cote à Barron, and from St. Law- rence Main Street east, is exceedingly unhealthy from the existence of a con- tinuous swamp, which in summer pours forth its noxious emanations with deadly effect on the inhabitants of that district. The same may be said of the St. Antoine ward, between St. Antoine and Bonaventure Streets, and across in an open lumber yard in the latter street, may be observed an open drain, which after heavy rains is swelled into the proportions of a small river. This drain is one terminal extremity of the Craig Street tunnel, which carries of more than half the sewerage of the city. Again, another source of the of mortality in the St. Ann's ward, may be traced in the open drain which runs across McCord Street, beneath William and down through the college property, to empty its waters into the St. Lawrence, somewhere in the neighbourhood of the Custom House. But this is not alone the source in the St. Ann's and St. Mary's wards; there is an absence of effi- cient'drainage in both these wards; the.upper end of Griffintown lies very low, and the passer-by willnotice in the spring, after the melting of the winter snow, vacant building lots, some of considerable extent, lying beneath water. These, as the heat of summer advances, become covered with vegetable mould, and ulti- mately dry. up. If the season is wet they remain more or less covered withwater the entire summer. The same may be said of the lower part of the St. Mary's ward, though not to so great a degree. Montreal, 70 Craig Street. (To be continued.) 394",
         "LYIàONýS' TREATISE ON PEVER. * REVIEW DEPARTMENT. ART. XLVIII.-A treatise on Fever, or selectionsfrom a course of Lectures on Fever. By ROBERT D. LyoNS, KC.C., M.B.T.O.D., Professor of Practical Medicine and Pathology, \u0026c. Philadelphia: Blanchard and Lea; Montreal: B. Dawson \u0026 Son, 1861. The author of this treatise not only received his professional education in Ire- Iand where the common forms of continued fever have long prevailed both spora- dically and epidemically, but also had an opportunity of investigating their pathology and pathological anatomy minutely and extensively in his capacity of Pathologist-in-chief to the British army in the Crimea. Froin such a man, no mere compilation would be tolerable, and it is but fair to acknowledge at once that his treatise contains not only his confirmation or denial of previous opinions upon many topics, but numerous original observations, the results of his own labours and the proofs of his ability and earnestness in the cause of science. The first chapter embodies some \" general observations \" upon fever, anmongst which Prof. Virchow's late opinions upon the essence of fever are glanced at~ind approved of by the author. Galen's definition of fever-\" calor proeter naturam\" -is admitted to constitute the one essential and pathognomonic symptom of fever; and to be present and appreciable by the thermometer even during the rigors that precede the hot skin; and it is contended that while frequency of pulse, thirst, scanty urine, \u0026c. are frequently absent in fever, præternatural heat never is. The source of the elevation of temperature in fever, it is alleged by Virchow, is tha in- creased consumption of tissue over that average normal quantity whose metamor- phosis maintains the physiological temperature of the body. Although our author adopts this opinion of Prof. Virchow, the German Pathologist, we are surprised that be makes no allusion to the facts adduced'by Dr. Parke sin support'of it. Why is this ? The eminent pathologistjust nanmed ha. shown that in fever tie excreta are more abundant than in bealth, the amount of food taken being the same in both that the termperature and the amount of the exeretions are closely related to each other; and tiat the patient's loss of weightis in lf cases proportionaté to the am- out of the excretions and to the temperature; a series of facts establishing the correct- ness of Prof. Virchow's thesis. The almost fatal objection to this view, viz., that in some fevers the excreta are lessened not increased, has been ably met by Dr. Parkes, who bas shown tbat ln such cases tbe prducts of metamorphosis are not dimin- ished, but instead of being eliminated as excreta, are retained. And further he has rendered it probable, not to say demnostrated, that this retention in the system of the products of the increased metamorphosis of tissue is a common cause of the secondary inflýiniations that arise ii fever ; and to him belongs the merit of at last affording an explanation of the nature of crisis, and sozcalled cetica evacuations-these being nothing more than sudden eliminations from the system of retained excretions through the skin,or kidneys,or bowels;with coincidënt improvement in' the other symptoms. No allusion to these important results of Dr. Parkes' investigationsis made by ourauthor. is name is not even mentioned in connection with the subject under discussion. 895ý",
         "BRITISH AMERICAN JOURNAL. In Chap.II. on the \"general pathology of fever,\" Virchow's and Parkes' opin- ion that the increased consumption of organic material whieh evolves the aug- mented temperature in fever, has its immediate cause in alterations of the nervous system, is accepted. Physiologists admit that the nervous system regulates the metamorphosis.of tissue and the production of heat; and Virchow holds that it exerts a moderating power over the waste of the tissues, and that in fever this power is restrained, paralysed, and in the sane proportion the waste is increased and the temperature of the body augmented; and thus the starting point of fever is attained. This view derives much support, amongst other things, from the results of division of the sympathetic nerve in the neck or of the vagus, which brings about increased temperature, acceleration of pulse and other febrile pheno- mena; from the characters of many of the phenomena of fever, such as the early prostration, exhaustion, and apathy; from the rigors; from the periodicity of many of the symptoms, etc., and from the influence of bark on periodic fevers: but we do not think these arguments establish the opinion of Virchow that'the ex- citing cause of fever, having entered the blood, exerts its first influence on the moderating nervous centres. Did our space permit, many arguments might be adduced to show that the blood suffersfirst and that it participates largely with the nervous system in the determination of the phenomena of fever; that in fact the starting point offever is the entrance into or generation in the blood of some morbific agent. By the way, we conceive that our author has misapprehended Virchow's meaning when lie attributes to him the idea that \" the fever poison first invades the animal system through the channel of the nerves\" (p. 40.) That pathologist admits that the fever making cause enters the blood, although he holds that it exerts its first influence on the nervous system. Chapter 1II gives the following classification of fevers, which, though not free from grave scientific objections, may be convenient for the memory. 1. Primary Fevers, comprising the several forms of continued, intermittent, and remittent fever: 2. Irritative Fevers, comprising gastric, gastro-intestinal, remittent, and hectic fever; and 3. Eruptive Fevers, comprising small-pox, measles, \u0026c. Chapters IV to VIII inclusive are devoted to a consideration of the several forms of continued fever, and as these are of most interest and importance to Canadians, we will confine our remarks to the topics they may suggest, and pass by for the present, the subject of yellow fever, which has received a large share of the author's attention, and the personal study of which he made the object of a special visit to Portugal during an epidemic which prevailed there. No other forms of fever are discussed by our author. Continued fever may be divided according to Dr. Lyons into- Synocha or Inflammatory Fever. Synochus or Mixed or Nervous Fever. Typhus or Adynamie Fever. Typhoid or Enterie Fever. The Synocha of this writer is not the mere inflammatory fever of Cullen, nor alone relapsing fever as Christison cousidered it, but it includes these as varieties together with the \" seven day \" fever or \" febricula \" of Jenner, and those fevers which though running on to 14 or 21 days are unattended by the prostration of 896",
         "LYONS' TREATISE ' ON FEVER. 9 typhus, the enteric lesions of typhoid or the cutaneous eruptions of either, and which are now often styled \" simple continued fever.\" While giving Synocha this \"large and liberal interpretation,\" our author contends for the -occasional occurence in the present day of the true Synocha of Cullen in opposition to those who doubt its existence altogether. He admits, however, that Synochal types of fever appear to have certainly become less frequent in Great Britain of late years than formerly if we accept the accounts given us by former writers; and in this econnexion he propounds the notion, \" that the sthenic or synochal types of fever are in the present day, and perhaps always have been, most remark- ably developed amongst the gramenivorous and herbivorous races of men, while the putrid or typhus types of febrile action more readily develop themselves in the races amongst which animal food constitutes a large part of their ordinary aliment.\" (p. 87.) He also entertains an idea we have met with elsewhere, that the characters of fever are influenced by the general constitution of races, i. e. that different types of fever prevail in different races. A short account is given of relapsing fever which the author admits to be of frequent occurrence in Ireland, but the name of Jenner is not even mentioned in connexion with it, although the lectures were originally addressed to students, and that pathologist was one of the first to demonstrate the distinctions existing between relapsing and other, forms of fever. During convalescence from relapsing fever Drs. Heslop and Lyons have noticed a \"soft systolic murmur pro. pagated up the aorta, heard loudest in the recumbent position, in most instances becoming all but imperceptible when the patient assumed the erect posture, finally disappearing as convalescence progressed, and manifestly not of organic nature.\" (p. 91). An interesting circaimstance which will no doubt be adduced as antagonistic to the non-identity view of the specifie nature of relapsing, typhus, and typhoid fevers, was noted by the author in the Criinea. A patient would present the well-marked symptoms of relapsing fever, with its decided temporary convalescence, but the type of fever would change in the relapse, so that it would assume the characters of typhus or typhoid feyer ? Dr. Bnenett mentions a somewhat similar case.* It may be that in such cases two distinct poisons, the poison of relapsing and the poison of typhus or typhoid fever co-existed as has been suggested by Dr. Murchison. Our author does not venture upon any elaborate discussion of the very inte- resting and after all still moot question, the identity or non-identity of typhus and typhoid fevers, but the tendency of his observations and descriptions is very much towards the side of non-identity. He thinks it \" not improbable that typhus and typhoid fevers recognise a different exciting cause ; he aflirMs that their natural history differs \" in many essential respects; and he recognizes a practi- cal clinical difference in the course, duration, symptoMs, and secondary: lësions of the two morbid proceses.\" On- the subject of the lesions of the alimentary canal in typhus, some valuable 'information, the results of his own investigation, is given, which we would like to transcribe, but cannot for want of space. Suffice it to say that lie admits with Stokes the greater preponderance of lesions of the intestines in some epidemics-of'pure typhus than in others, These lèsionis are Clinical Lectures, 3rd:Edition, p. S07. 397'",
         "BRITISH AMERICAN JOURNAL. mainly, various degrees of vascular turgescence of the mucous membrane of the small intestines, and now and then in a few .isolated cases, three or four small irregular superficial ulcerations engaging the mucous membrane only; and he states it as his conviction \" that any true follicular lesion of the intestine is as rare in typhus fever, as it is common in typhoid.\" We confess to a feeling, somewhat akin to shame, when we reflect upon the various and opposed representations of what are mere matters of correct observation that emanate from men who assume the responsibility of publishing their opinions. Notwithstanding the labours of Bretonneau, Louis, Chomel, Bright, Armstrong, Gerhard, A. P. Stewart, Jenner, and a host of others, pathologists are not yet in accord respecting the condition of the intestines in typhus fever. Thus in direct contradiction of the statement of our author above quoted, we find the late Dr. Perry of Glasgow, in summing up the result of three hundred necroscopic examin- ations, affirming that dothion-enteritis or enlargement of the mucous follicles of the smaller intestines and enlargement and ulceration of the aggregated glands of the lower third of the ileum, occur in combination with contagious typhus and are to be met with in about one in six who die from typhus. Dr. Stokes, too, alleges that he has occasionally found follicular ulcerations of the intestine in cases of the \" best marked maculated typhus.\" On the other hand, Dr. Anderson, in his little monograph on fever, just published, speaks thus positively; \"In pure typhus Iknow (the italics are his) that ulceration of the bowels does not occur.\"* A similar diversity of statement exists touching the cutaneous erup- tions of typhus and enterie fever. Our author describes very fully the \" maculS or petechiS \" of typhus and the lenticular rose spots of enteric fever ; and with Jenner, Anderson, and others, appears to regard them as severally distinctive of those fevers; but Dr. H. Kennedy, of Dublin, one of the first British writers to describe the peculiarities of typhoid fever, has quite lately maintained that petechiS may exist in typhoid fever, and bright lenticular spots without this fever; and still later, Dr. Joseph Bell, of Glasgow, asserts that he has seen \" a patient labouring under a well-marked attack of typhoid, after a severe epistaxis, have the rose-coloured elevated spots converted into dark-coloured non-elevated macule, at the same time a large additional number making their appearance, so that in the course of a few hours a case of undoubted typhoid eruption became converted into an unmistakeable one of typhus.\" We should like to be assured that both observers were aware that the maculS of typhus in their first stage resemble very closély indeed the lenticular spots of typhoid fever, but that in the third stage according to Dr. Jenner, they become dark purple in their centre and flat, and may be changed into true petechie. It may be after all that Dr. Bell's cases were cases of typhus instead of typhoid L Our author's account of the symptoms of typhus is full enough, more especially when dealing with the secondary lesions incidental to the disease: we would especia]ly commend to the student his observations upon the phenomena pre- sented by the brain and circulating organs; he will there find, amongst other things, what a student of Stokes. las to say about the heart in fever. The same may be said of his symptoinatology of typhoid, or as it has been last styled Ed. Med. and Surg. Jour. Jauuary, 1836.",
         "LYONS' TIEATISE ON FEVER. pyt7hogenic fever. He has established a very valuable distinction amongst the examples of this fever, viz., those in which the symptoms of intestinal disorder progress pari passu with the primary fever, and these are the most frequent, and those in which the entire symptomis do not declare themuselves until after the primary fever has run its course of two, three or four weeks and a true conval- escence appears to have been established but proves delusive. The latter cases are fortunatcly the least frequent, as they are certainly the most serions, the intestimal symptoms, not only assuming a marked severity but often issuing fatally. The author dwells upontwo symptoms as indicative of the existence of morbid action in the abdominal viscera in typhoid fever; one, an elevation of temperature in the abdominal parieties, sensible to the thermometer as well as the hand, and ranging above that of other parts for days in succession; the other an inordinate action of the abdominal aorta, or the iliac arteries, or both, ivith but moderate force and volume of the heart and radial arteries. These symptoms may be unaccompanied by pain, tenderness, or uneasiness of the abdomen, yet by themselves indicate the pro- priety of at once attempting to combat the intestinal lesion they represent. The intestinal lesions of typhoid fever are described with much minuteness by, Dr. Lyons, and although his description of them agrees in almost all important par- ticulars with Rokitansky's, it is even more full and proves the author to be an accomplislied and painstaking morbid anatomist. The reader is not to infer, as he may readily do, from the author's way of putting it, that Rokitansky has not described the processes of slougbing and cicatrization that occur in the glands of Peyer in this fever, he has done so, though not as distinct stages of the morbid process. To Dr. Lyons, however, belongs the merit, if we mistake not, of first describing the slow atrophie process that now and then invades the intestinal mucous membrane, especially the tubes of Lieberkühn, in protracted cases of enter- ic fever, a process strictly similar to -that announced in 1854 by Dr. Handfield Jones, as of frequent occurrence in tile stomach. Unlike the great German patholo- gist, the Dublin professer has found the heart \" flabby and soft, and its texture friable \" in typhoid fever, \" but never the same extent of degeneration and of the fishy condition that obtains in extreme cases of typhus.\" The discussion of the intestinal lesion met with in the secondary fever of cholera, and known as Il cholera typhoid,\", may seem ont of place in a work on fever, but this contre- place may be excused, not only because the author gives the result of his own observations and researches on this interesting subject, but because of the impor- tant bearing of cholera typhoid upon the pathology of typhoid fever; the constL tutional symptoms and the intestinal lesion being very mnuch alike in both, and the pyrexia of both bearing intimate relations to; if they are not positively dependent upon the enteric lesion. Chapter viii contains a notice of typhoid fever as ob- served by, the author in the 'Crimea, with a summary of the history of the cases and of their chief post-mortem appearances. This review has already attained proportions that prohibit any adequate notice of the treatment of feverreccommended-by Dr. Lyons. His remarks upon the measures suitable to combat the cerebral symptoms of typhus,upon the employment of tartar emetie and opium, and the administration of wineand;stimulantsri that disease, and upon the general management of the patient are worthy of 899",
         "BRITISH AMERICAN JOURNAL attentive study. He attaches great value to the use of turpentine in the advanced stages of the bronchitis and pneumonia of typhus. He regards wine and other spirituous stimulants of doubtful propriety in typhoid fever, approves of quinine in all stages of the latter fever, and in the former, \" when there is no secondary complication and when no positive indication for specific treatment exists ;\" no very positive opinion is expressed as to the potency of einetics given in the early stage of fever, although a very careful observer, Dr. Brinton, has quite recently asserted their power, in some cases, to cut short typhoid fever, and in many others to reduce the fever to something which, though it \" can't be cured, may be endured.\" We have said enough we think to convince the reader that Dr. Lyons' work on fever is well deserving of a careful perusal, and contains the results of the personal experience of a capable and industrious student. There are grave faults in the order and arrangement of the author's observations, as though nany of them were made at long intervals, and then put together without being recast, as also some important omissions witness the entire subject of the etiology of fever, but these are not to be mentioned in view of the gencral inerits of the work. The careful personal investigation of a few points in the pathology of a dis- ease, excuse, in our opinion, the omission of other points which may not have received the author's confirmation. ART. XLIX.-A Treatise on Human Physiology, designed for the use of Stu- dents and Practitioners of ferlicine. By JOHN C. DALTON, Jr., M. D., formerly Professor of Physiology and Microscopie Anatoniy in the College of Physicians and Surgeons, New York, \u0026c. 2nd edition, revised and enlarged, with two hundred and seventy-onc illustrations. Philadelphia: Blanchard \u0026 Lea. Montreal: Dawson \u0026 Sons. 1861, royal 8vo., pp. 690. The demand for this valuable work has now exhausted one edition, and ne- thing more clearly demonstrates the estimation in which it is held by the pro- fession than this fact. With very few exceptions indeed, the volume before us may be viewed as containing a condensation of the latest views of physiologists generally, on the important subjects comprised within this branch of medical knowledge, written in a most flowing style, and so utterly devoid of the dryness which usually attaches to works of this nature, that there is no wonder that it has become such a favourite. In several essential respects, this edition differs materially from its pre- decessor. Thus there is devoted an entire chapter to the consideration of the specialsenses, which were only partially alluded to in the first edition; a re-ar- rangement of the chapter on the cranial nerves, with the introduction of the latest views and facts in reference to their physiology, has been made; an ec- count of some original experiments with. regard to the functions of the cerebellum has been rendered, with the conclusions to which they tend; certain considera- tions in regard to the properties of sensation and motion,,have been introduced; t Ten Lectures, Introductory to the study of Fever, London, 1861. 400",
         "TUE PHYSICIAN'S VISITING LIST. and lastly, there has been added a new chapter \"l on imbibition and exhalation, and the functions of the lymphatie systen, including the study of endosmose and exosmose, and their mode of action in the animal frame; the experiments of Dutrochet, Chevrueil, Gosselin, Matteucci and others, on this subject, the con- stitution and circulation of the lymph and chyle, and finally a quantitative esti- mate of the entire processes of exudation and re-absorption, as taking place in the human body,\" Additions have also been made, in various parts, to the chapters on secretion, excretion, the circulation, and the functions of the digestive apparatus, and twenty-two new and original illustrations have been introduced. After a most careful perusal of the work, and this is our excuse for the delay in noticing it, although there exist a few points of unimportant character, to which exception might be taken, on the whole, however, we cannot but consider it Une of the best exponents of this branch of medical scieie in our language, beautifully, nay, enticingly written, and giving expression to the very latest views. We cannot but most cordially recommend this volume to medical men, and students of medicine. Its style is so different from that in whieh works of this character are usually couched, as to render it peculiarly attractive, so much so, in fact, that on repeated occasions, when fatigued by professional duty, we have taken it up to beguile the passing moment, pleasure and profit, in its perusal, going hand in hand. It ought to be on the shelf of every physician, because we feel assured that he could take up on such an occasion, no more interesting work, whether to refresh his memory, or to put him in possession of the latest knowledge on the various subjects. The work, it is almost needless to say, comes out of the establishment (we were almost going to call it an \" atelier,\") of Messrs. Blanchard \u0026 Lea, in their highest style of art, beautifully printed and bound, with the engravings well designed and executed, the work a credit to both author and publisher. ART. L.-The Physician's Visiting List, Diary, and Book of Engagements for 1862. Philadelphia: Lindsay \u0026 Blakiston. Montreal: Dawson \u0026 Sons. We are happy to perceive that the enterprising firm of Lindsay \u0026 Blakiston are thus early in the field, and attending to the necessities of the profession dur- ing the forthcoming year. If we are not mistaken, this firm is the first that suggested this decided iniprovem'ent upon the old routine of the practising phy- sician. From the beginning until the present period, we can testify to the immense saving in time by the adoption of the plan indicated in these little pocket books, and we know that, this is the idea universally entertained of their value. They can be obtained for the daily 'treatment of from 25 to 100 patients, the price, as a matter of course, varying with the required lines for any number of patients ,over 25, and the style in which the work is got up We cordially commend them to our co-labourers. The price of one for25 patients or-entries, is $1.15. 401",
         "402 BRITISH AMERICAN JOURNAL, PERISCOPIC DEPARTMENT MIDWIFERY. A DYNAMOMETRICAL ADAPTATION TO THE FORCEPS. By Dr. KRISTELLER. (Monatsschr. f. Geburtsk.) , Dr. Kristeller has submitted to the Berlin Obstetrical Society a contrivance by means of which the exact degree of extractile force employed in using the forceps may be measured. He observes, that the obstetrist, in seeking to describe the extent of the ob- stacle to delivery, is compelled to draw upon his imagination, and to use vague terms, as \" easy, feeble, moderate, difficult, \u0026c.\" For these expressions bis instruments enables us to substitute the figures of a scale. His instrument is somewhat complicated, and not easy to describe without the help of drawings. The dynamometrical apparatus is is adapted to the handles. Each handle consists of two parts, one moveable, and the other fixed. The fixed part is a strong steel-plate, which forms the con- tinuation of the fenestra. The moveable part is a half-cylinder of brass, which is so adapted by its plane surface to the steel-plate that it can ride frcely up and down, but in no other direction. Above, the brass half-cylinder is closed by a projection forming a notch in which the fingers of the olierator are hooked for power of traction; below, the cylinder ends in the ordinary dilation for the hand to rest upon. Within the half cylinder lies a strong steel spiral spring, which presses above against the prominences which support the operator's fingers, and to which the chief part of the extractile force is applied, and below is fixed immoveably to a projection from the steel-1pate. When the operator pulls with his right hand upon the upper prominence, and with bis left up- on the shafts of the handles, he draws the moveable half-cylinders down, compressing the spiral springs, the elasticity of which serves to measure the strength employed. This is indicated by a graduated index adapted to the handle below the lock. Dr. Kristeller enters with some minuteness into the applications and uses of this in- strument. He especially insists upon the advantage it offiers as a measure of the hind- rance to delivery, enabling us to determine the time when the forceps must be abandon- ed for the cepbalotryptor.-Brit. 4ê For. fed. Chir. Review. A SUCCESSFUL CASE OF TRANSFUSION. By Professor MARTIN. Professor Martin bas related to the Berlin Obstetrical Society a successful case of transfusion. A primipara aged twenty suffered a fright in her eighth month; aymptoms of inflammation the uterus followed ; pains set in with considerable external bleeding, but marked anæma, with prostration. The os uteri being rigid and undilated, plunging was resorted to. Next morning, a pointing swelling appeared in the scrobiculum, of the pulse could hardly be felt, syncope was frequent, the temperature falling, and death seemed imminent. The median :vein of the right arm was exposed by an incision of the skia four or five inches long, a flat trocar was used to perforate the vein, and six to seven, ounces of freshly-drawn blood was injected through a warmed glass syringe. The patient com- plained of no pain, but immediately showed a blush on the cheeks. The plug now re- moved, the os was found dilated ; the fœtus (dead) was extracted by forceps. The uterus being compressed, the placenta was expelled with^more than two pounds of black clot. The maternal surface of the placenta showed a compressed part occupying two- thirds, around which the cotyledons rose in a border like a wall. There was some",
         "CHlLOROF'ORiM il; MIDWIFERY. after-hoemorrhage, which was stilled by injecting a solution of sesquichloride of iron. Such a degree of anSmia remained, that a second transfusion was resorted to. About thrce ounces of fresh blood were thrown into the right basilic vein. The patient gradually rallied. She bad othereal spirit of chlorated iron and laudanum alternately, and warm milk. She ultimately recovered.-Brit. 4y For. Med. Chir. Review. CHLOROFORM IN MIDWIFERY. By CARLES KIDOD, M. D., of London. It is a subject of interest from time to time to take note of the progress that certain discoveries, such as chloroform, are making in the world of practice. Some doubt has been recently expressed by Dr. Robert Lee and Dr. Barnes as to the propriety of using chloroform in special cases of midwifery. Drs. Sinclair and Johnston published 313 cases of this kind, where it was perfectly successful. Dr. Kidd has been furnished with a letter from one of the ablest obstetricians, Professor Doherty, Queen's University, Gal- way, in which the subject has been as clearly handled as by any of our chief authorities. Dr. Doherty has given chloroform in about 150 cases of various kinds, 130 in the County Galway Infirmary, and in about 30 puerperal case in private practice. The fol- lowing is Dr. Doherty's letter, which Dr. Kidd esteems of the highest value \"As far as natural labour is concerned,\" lie says, \" I don't thiuk it justifiable, under such circumstance, to add the risk, slight as it may be, which chloroform produces to the ordinary risks of labour; but there are many cases, usually termed natural, in which its administration is of great benefit to the patient-stly, wben the dilatation of the os is very painful; and, 2ndly, when the latter portion of the second stage is attended with great suffering and excessive uterine action. In the painful dilatation of the os uteri, I consider it invaluable. I don't allude to those short, muscular, thick figured women in whom we often fEnd the neck of the uterus thick, rigid and undilatable. In such persons tartar emetic with or without V.S. is more beneficial ; but vhen the neck is thin and di- lating at probably a reasonable degree of speed, but attended with great anguish, such is the case in which chloroform acts as the greatest boon of modern science. Under these circumstances, it is by no means necessary to produce stupor ; in fact, I have been astonished at the small dose which has been sufficient to render the pain bearable. The woman is never deprived of lier senses, her breathing and the action of the heart are never disturbed by it, and yet she expresses the greatest comfort and most important relief. My mode of administration in these instances is by means of an ordinary Snow's inhaler; but I take the precaution of removing the valve or fiap of leather which is immediafely adjacent to the mouth-piece, not that over the chamber where the paper or sponge is. I am sure, then, that the patient will draw a large quantity of atmospheric air in along with the chloroform vapour. Once I perceive, by watching her for a little time, that she can imbibe it with impunity, I trust the apparatus to the patient herself, directing her to put it to her mouth the moment she feels a pain coming on, and to remove it when the pain is over. I find she very quickly gets into the habit of obeying these in- structions accurately; but I keep my eye on lier that she does not continue to inhale after the pain has ceased. With comparatively slight and transient effects I feel convinced I have brought many women over what would otherwise have been more painful and tedious labours from delay in the first stage with little suffering, and they have consequently been afterwards in a far more favourable condition, and their recovery bas been more speedy than it otherwise, in ail probability, would have been. The latter' observation holds good also where the expulsive stage is attended with agonizing and powerful efforts. Chiloroform allays the intense excitement, abates unnecessary force, causes the soft parts to yield, and if it does delay laboura little by suspending-the volun- tary actions, it does so with advantage to the patient both at the time and afterwards. In these cases, however, I find it necessary to carry its effects further than the former, and 40à",
         "BRITISH AMERICAN JOURNAL. I do not trust it to the patient. I avoid, if I can, causing any degree of insensibility, If I can render the process endurable, I consider I have gone quite far cnough. Admi- nistered to this extent, I have not found it interrupt labour so as to require artificial de- livery, and cannot in any case in which I have been obliged to resort to instruments lay the necessity at its door; on the contrary, I am sure some cases would ultiniately have become instrumental from exhaustion if the pain of the first stage had not been assuag- ed by its use. When using an instrument I never give chlioroform if my patient is cou- rageous. By explaining to the patient her exact condition, and the step I am obliged to adopt, I find in nine cases out of ten she subnuits patiently without a struggle. If this be the case, I think it would be better to refrain from giving chlioroform ; but if she is of a different disposition, I give it and carry it to a stage of stupor. The same observation is applicable, but not to the sane extent, in turning. If the waters have been long dis- charged, or from narrow brim it bas become necessary to proceed very leisurely in turn- ing, I always administer chloroforn before beginning the operation. It facilitates it by keeping the woman quiet, and by relaxing the uterus. As to wbether hoemorrhage follows from its use, I cannot speak positively. I have been present when in two or three instances I thought a disposition to hbmorrhage, which manifested itself after la- bour, might be due to the chloroform ; but in my own practice I take such exceeding great care to follow down with the band on the abdomen the uterus as it is expelling the child, and to maintain it in a contracted condition by firm and unrelaxing pressure. coutinued till the placevta is away and binder on, that neither where chloroform has been given, nor in other cases, have I for years past had a single case of homorrhage which caused me anxiety. In both, after the expulsion of the placenta, if there be any sign of hSemorrhage coming on, I invariably give ergot witb the best results. I have not found the separation of the placenta arrested by chloroform. In some instances where it has been carried to the state of stupor there may be some delay, but according as the stupor passes off the uterus comes again into action. I have never seen any permanent ill effects from its use. Transient headache, and some nervous excitement have in two or three instances followed, but I rather think they were due to the drug not having been pure. Mania bas not occurred in any of my cases. I have not bad an opportunity of using chloroform in puerperal mania, but I have no doubt it will prove of use, particularly when the person obstinately refuses to take food. By placing ber under its soporific effects nutrient enemata, containing a fit dose of opium, will I am convinced, be found most serviceable. In convulsions which are not of the sthenic character, chloroformn is of use, particularly the form attended with or arising from toxenia.-Dublin Medical Press. AMENORRHRA CONNECTED WITH AN UNDERSIZED UTERUS. Dr. Simpson, in a \"Lecture on Amenorrhœa ; its Local Treatment,\" publisbed in the Medical Tines and Gazette, gives the history of a case and its trentment as follows: \" The patient was the siàter of a doctor, and had been under the care of various medical men at different times, bad from puberty suffered from amenorrha and its atten- dant evils, more especially fron asthma, recurring every month, and lasting for several days, and interfering sadly with ber healthand happiness. Sbe had never once menstruat- ed regularly, the uterus being slightly undersized. She had taken quantities of medicine of every possible kind; had been repeatedly leeched, and had been subjected to many different local applications, sometimes with some little relief to ber symptoms, but never with any result at all approaching to cure. Believing that in such a case all hope .of radical relief was vain, except through measures directed towards the uterus itself, I persevered for a time in the application of nitrate of silver to the lining mem- brane of its cavity, in the manner I have described to you; and the operation was al- ways attended with more complete and lasting relief than the patient had ever before experienced. This treatment was for several months persevered in; but both she and",
         "QUININE AS A PARTURIFACIENT. 405 I having become tired at last of imperfect and transient results, I had recourse to the introduction of a small metallic pessary into the uterine cavity. In the case of the lady of whom I now speak, the introduction of this instrument was followed by the speedy relief of all her more urgent symptoms, and particularly of her monthly fit of asthma, and after she had worn it for some weeks, she was equally astonished and deligbted to find, at the recurrence of ber next period, a free menstrual discharge, instead of the dreaded apnSa with which she had been so long afflicted. She continued to wear it for ten or twelve months, until her lealth became so far restored that she was able to go to a ball,-a kind of amusement in which she had never before been qualified to in- dulge. When the discharge appeared to have become fairly established, the instrument was at last removed ; and for some months the patient continued to menstruate regu- iarly and to enjoy good general health. On the recurrence of cold weather, however, the uterus again failed to performs its function, and instead of having the proper men- strual discharge, she was attacked with one of her old fits of asthma. At her own suggestion and urgent solicitation I again introduced the galvanie pessaryi and she wore it for about three years altogether, without ever experiencing from it any kind of inconvenience. The uterus during that time performed its functions painlessly and regularly ; the secondary symptoms were all kept in abeyance, and it was only at length finally removed, wlen the uterus was found to be equal to the performance of its functions without the presence of any irritant in its interior. The same good effects, which were here produced, I hare scen resulting fromn the use of the intra-uterine bougie or pessary in various similar cases. PLACENTA PREVIA; TREATMENT BY THE CAOUTCHOUC WATER PESSARY. By E. J. FoUNTAIN, M. D., Davenport, Iowa. Mrs. P., aged twenty, at seven and a half months of her pregnancy, began to have hemorrhage, but without labour pains or dilatation of the os. This ceased partly under the use of rest, cold water enemata, opium, and acetate of lead. At the end of two -weeks, it recurred with greater violence and some pain. Dilatation was sufiicienttoallow the finger to enter, and the placenta was ascertained to be in front. To check the alarming discharge a caoutchouc bag was introduced, and filled full of cold water, which at once arrested the flow. In half an hour it again commenced moderately; the water, now quite warm,.was allowed to escape, and the bag refilled. By the continuance of this process through the day and night, the patient was kept safe. When the contents were changed, an examination could be made without removing the instrument. After twenty-four hours, as the os was becoming well dilated, and the pains more regular, turning was thought of, but finally rejected, and the former plan continued. Finally the head pressed dowa on the placenta, thus perfectly controlling the hemorrhage, and the child was soon bora in good condition, aboit thirty hours after the commencement of the treatment.. The placenta was found loose in the vagina.-./m. Med. Times, (March 9, 1861.) QUININE AS A PARTURIPACIENT. The Cincinnatti Lancet and Observer for July, contains the proceedings of the Union Medical Society, at Knightstown, Ind. Dr. Cochran reported an obstetrical case, in which the patient was exhausted, and the, pains had ceased for some time. le gave ten grains of. quinine atone dose,;which was speedily followed by strong pains, and the birth. of the chile. It should be observed that the parturient properties, of quinine have several times been under ,discussion previously,before this society. We, abstract an opinion or two of other members elicited in the discussion. Dr. Canadasaid, !'It»could 27 VOL. I.",
         "BRITISH AMERICAN JOURNAL. not always be relied on; but he viewed it as the most reliable parturient remedy we have.\" Dr. Cronse thought that \" when quinine was given in proper doses, it rarely disappoints.\" On a former occasion, Dr. John Lewis said: \" When I find a patient in labor, with a rigid os uteri, a tense pulse, and dry skin, I always give quinine freely, use dry cips over the sacrum, and the warm foot-bath, and expect the os uteri to relax, the pulse and skin to soften, the uterine contractions to increase in frequency and force, as sur- ely and as certainly as I would nausea to follow the exhibition ofipecacuanha, or purg- ing from jalap. Bearing upon this subject we may mention that Dr. J. S. Rich, of Georgia, in the Charleston Medical Journal and Review for March, 1860, reports several cases of uterine hemorrhage of alarming character that were speedily relieved by the use of quinine, after the failure of all other known means. Prof. Edward Warren, now of Baltimore, says, e we have found nothing more likely to produce abortion in pregnancy than the, administration of large doses of quinine.\" Several others have ascribed to it abortive powers, when administered in full doses. It is quite possible that it may be found to be a valuable parturient remedy, thougli in any ordinary doses we do not believe, as an abortive agent, it. is at all to be feared.-Med. and Surg. Reporter. SURGERY. OPERATION FOR THE REMOVAL OF THE HEAD AND NECK OF THE OS FEMORIS, IN A CASE OF MORBUS COXARIUS-CURE OF PATIENT. By E. S. Cooper, A.M., M.D., Professor of Anatomy and Surgery in the Medical Depart- ment of the University of the Pacific, San Francisco. Master M. H., St. thirteen, afflicted with hip-joint disease for four years, was brought to me in March, 1857. Six sinuses leading towards the joint were found; two terminat- ing external to the trochanter major, and four considerably above, one near the crest of the ieum. But a probe could not be introduced so as to touch any portion of the dis- eased structures constituting the joint, though small portions of exfoliated bone had been tbrown off through these sinuses at different times. The leg of the diseased side measured about two inches less in length than its fellow, and was only about one-half its size. The leg was flexed and fixed in that condition. Operation.-The patient was placed upon the right side (the left being the seat of dis- ease), an incision was made nine inches long, extending fromt the orifice of the upper, to that of the lower sinus. The lower part of the incision was made directly in front of the trochanter major. The upper extremity was made to pass through parts of the gluteus maximus and medius muscles. Having exposed a portion of the trochanter major, a bone chisel was taken, and the soft parts removed from the bone, following it along from the greater trochanter to the inner extremity of the cervix of the femur and the margins of the acetabulum. The capsular ligament was nearly destroyed but an adventitious formation, corresponding slightly to that tissue, was found connecting the internal extremity of the cervix of the femur to the margins of the cotyloid cavity. On pressing upon this structure, purulent matter was forced out through the openings made by the process of ulceration. After finding this state of the parts the joint was opened at once, and the true condition of the articulating faces revealed. The entire head of the os femoris was ulcerating, as was also the articulating face of the acetabulum. The head of the bone was therefore taken away, and likewise a small amount of the cervix The major portion of the acetabulum was then removed with a bone chisel. The liga- mentum'teres had been destroyed by the process of ulceration. 406",
         "(OERATIOlt FOR' FISTUTLk. 407 T'he bony tissue beingremoved as mentioned, the wound was fully opened and the parts examined, to sec if any more discased bone tissue requiring renoval remained. :None being found, the wound was dressed by applying a piece of lint, wet with an eva- porating lotion, in the wound, one end of whiclh ivas introduced into the acetabulum, fil- ing the space previously occupied by'bone. A roller was then applied, commencing at the toes of the limb of that side and continuing up and around the hips as tightly as the patient could conveniently bear it. This was wet with an evaporating lotion every two hours for ten days, when an aqueous solution of permanganate of potass (four grains to the ounce) was applied instead for a week longer, when the dressing was changed for the first time, a major portion of the lint being permitted to remain still in the wound. At the end of four weeks after the operation, the lint was removed from the wound, soap suds injepted into the cavity, and the surfaces, whence the diseased bone was taken, examind. These were found covered with healthy granulations. A second piece of lint w1s losely introduced into the wound, and the roller still applied as before. The amount of pain experienced by the patient on taking off and reapplying the roller was not very great, but sufficient to afford an objection to the frequent repetition of the change, and the roller was permitted to remain over two weeks at first without any change, partly for this reason, and partly because the proper adjustment of the roller is one of the most important features in the after treatmnent in this and similar cases. It is to the tightly adjusted roller that we owe the consolidation of the tissue -and freedom against the burroving of purulent matter, a condition su much to be dread.. ed; the bane in. fact of this class of operations. The opening into the joint was made to heal by granulation entirely, but at nu time was the granulating surface painful, or otherwis2 in an unhealthy condition. The patient had not an untoward symptoma du- .ing convalescence, and at the end of six months fron the period of the operation, was able to walk considerably, and constantly improved for five months more, when he was able to walk four miles a day with no other aid than a cane, the wound being at this time entircly cicatrized.-Jmerican Medical Times. ON OPERATING FOR FISTULA IN ANO IN PHTHISICAL SUBJECTS. By Professor Tmair. (Presse Médicale Belge, No. 21.) These observations are intended by their author as a sort of protest against the doc- trine maintained by M. Jobert-viz., that the objection usually held by surgeons to operate for fistula in patients suffering under phthisis is a mere prejudice, to be entirely -discountenanced ;'the fistula, in fact, beingjust like any other emunctory, a cause of de- bility in this disease, and as such to be suppressed as soon as possible. If the action of a fistulat resembled that of a prolonged blister or an issue, as stated to do by M. Jobert, Professer Thiry would agree with him in regarding it as an unfortunate complication to be -got rid of as soon as possible. But this is only afaulty interpretation for he has found in all the cases that has come under his care, that fistulae and abscesses occurring about the anus in the subjects of pulmonary tubercle, are the result of tuberculur de- posit at the margin of the anus, constituting only an additional manifestation of the general diathesis. The discharge fronm such is not an evacuation of matter enfeebling the patient, but a discharge of tubercular matter mingled with pus, and benefiting the patient thus far by removing tubercle which might otherwise have been deposited in the lungs and aggravated bis condition. The matter contained in the discharge from these anal abscesses of fistule, is shown by microscopical examination to be in part tubercular, and unsoftened tubercular matter also lines the botton of the cavity whence it proceeds. Soon after the estalishment of the fistula the'cbest symptoms often un- dergo a notable amelioration, while the patient exbibits many other signs of returning health. If this trace be taken advantage of by thie idmihistrationof suitable renedies, complete recovery'even may ensue, the fistula iteclf, the last trace of the tubercular diathesis, disappearing spontaneously. Such a result is 'byino means so rare-as isgen",
         "408 BRITISH AMERICAN JOURNAL. erally supposed, and it would be of yetemore frequent occurrence if fistulS were more frequent than they are, and if proper perseverance were observed in the application of remedies and the observance of an azotized diet. Under the influence of fistulS and of the treatment which they allow of being put into force, the author bas known cavaties to have become cicatrized; and so far from regarding them with Jobert as aggravating complications which should be at once removed, he regards them as highly salutary, and would recommed their provocation by every possible means when nature does not produce them spontaneously. The success which M. Jobert states that he bas obtained in operating in these cases can only be explained by the supposition that he bas bad to do only with fistulous tracts proceeding from mere phlegmonous abscesses. A phlegmon- ous abscess, quite independently of tubercle, may become developed at the margin of the anus, and the resulting fistula may be operated upon with even advantage to the pat- ient; but the difficulty is to distinguish such a case from a fistula acting as a means of elimination of tubercular matter, to the great advantage of the puimonary affection and the general constitution. The decision is sometimes difficult, and always import- ant, as the very life of the patient may be dependent upon it. However, the general conclusion at which M. Thiry arrives is, that the operation for fistula performed at any stage of pbthisis only precipitates its fatal termination. He selects two of the cases which have come under bis own notice, as ilustrative of the advantage derived from re- specting the fistula, at both an early and a late stage of the affection, and lie adverts to others in which a contrary practice bas been followed by the worst results.-Brit. For. Med. Surg. Review. ON THE EMPLOYMENT OF THE DRY SUTURE. The foregoing is the rather singular appellation of an interesting paper by Dr. Baelen, in the \" Journal de Medecine de Bordeaux,\" who states it as due to the inven- tive talents of Dr. Vesigné of Abbeville, at which place Dr. Baelen saw the procedure adopted. We extract the most important part of this paper from our valuable exchange alluded to, merely observing in linine that Dr. Vesigné is a distinguished physician of Abbeville, and surgeon in chief to its principal hospital. Dr. Baelen thinks it may prove a useful expedient in military surgery, and considered it bis duty to take public notice of it, as a highly ingenious and most satisfactory method of securing the re- union of the severed surfaces of wounds. Some stout and strong linen strips or ribands, a few pins, some waxed thread and collodion, are all that is required. The wound should be thoroughly cleaned, and every foreign body removed, the ad- jacent parts sbould be also washed, dried, and if necessary, shaven. Everything being ready, the surgeon takes a number of these linen ribands, observing that their length is proportionate to the depth of the wound. It depends on circum- stances whether their number should correspond with the extent of the wound. One or more of the pins is to be fastened into the end of the riband next the edge of the wound, taking care that it bas a firm hold, and is in a direction of right angles to the eut surface. This done, the operator by means of the collodion, fastens on eacb side of the wound, and opposite the direction as indicated, the ribands thus armed with the sole precau- tion that the pins placed nearest the wound should be directly opposite each other, and therefore parallel. That part of the riband to which the pin is attached, need not be glued to the skin, but left free if expedient, to the distance of about a 4 inch from the edge of the wound. The adoption of this precaution permits us to protect the skia from the action of the pin, by inserting pieces of lint or other soft materiai, between it and the skin. There is another precaution equally indispensable, and it consists in the observation of this maxim, that the ribands and pins must be placed exactly opposite each other on each side of the wound, so that when submitted to traction the edges should come exactly into place.",
         "TRRATMENT OF DELIRIUM TREMENS. 409 After the attachment of the riband to the skin by means of the collodion bas been per. fected by the evaporation of the ether, and after an assistant bas brought the lips of the wound accurately together by bis bands, the surgeon takes bis waxed thread and passes it round the pins, in the usual figure of eight manner. Dr. Avigné thinks that the su- tures should be independent of each other, as it permits us to augment or diminish at pleasure, the traction on the lips of the wound, without deranging the whole of the dressing. The modus operandi of such a procedure is obvious. A most powerful and sustained traction is effected on the skin, drawing together the cut edges of the wound with the most precise accuracy. The autbor of the paper enumerates in addition the following advantages :-complete absence of pain-freedom from cicatrices at the points where the old pins passed-great solidity of the wound, proportional to the tractive power employed, which may be maintained as long as we desire-great facility in undressing and redressing the wound-avoidance of all foreign bodies in the wound-freedom from erysipelas in consequence of non-employment of any adhesive plaster-and finally, the ease with which the cause of a secondary homorrhage can be discovered, by throwing open the wound to its bottom, without the infliction of the least pain, as nothing more requires to be done under such a condition of matters, than to sever the ligatures to the extent it may be deemed necessary.-Translated and abridged from the UJournal de .Aedecine de Bordeaux,\" by Editor B. .4. G. TREATMENT OF DELIRIUM TREMENS BY LARGE DOSES OF DIGITALIS. By T. B. PEAcocK, M.D., F.R.C.P., Physician to St. Thomas's Hospital, London. CAsa 1.-J. T., aged 30, formerly a soldier who bad served in North America, the Crimea, and India, and had just returned from Calcutta, was admitted into St. Thomas's Hospital, under my care, on October 14, 1860. He was received, labouring under symp- toms of delirium tremens, at half-past two, p.m., and was reported to bave taken a a quart of spirits daily for several days. At half-past six, when he was in a very rest- less and excited state, suffering from retching and sickness, and bis pulse 103 in the minute, he was directed to bave half an ounce of the tincture of digitalir, and the dose was given in a quarter of an hour. At a quarter to eight the pulse h.d fallen to 72, and was of good volume, and he was much quieter, free from sickness, and disposed to sleep. At eleven, p.m., he was much in the same state; pulse 76 and regular; he bad not slept, but was quiet, and still seemed disposed to sleep. At ten, a.m., on the 15th he was seen by myself: he was reported not to have slept ten minutes during the night, and bad been restless and trying to get out of bed, but not violent. The tongue was dry and a little red, the pulse 80, somewbat sharp, and decidedly resistant. The sounds of the heart were natural, except the second, which was somewbat indistinct. The pupils were large, and not apparently affected by light. The urine deficient in quantity, and high coloured. His manner was basty, but he spoke quite rationally, and he took bis food well. During the evening and night of the same day he slept for a considerable period, and the following morning he was much botter. He was quite intelligent, but still he bad a somewbat agitated manner. The pulse was 80 to 84 in the minute and feeble, and the second sound of the heart was very indistinctly audible. He was directed to have five grains of the sesquicarbonate of ammonia in an ounce and a half of decoction of bark every three hours. On the 17th he continued to improve, and on the 18th bis appearance and manner were much more tranquil, the tongue somewhat dry and slightly furred; the bowels regular; pulse 80. He had made water freely, but said that the quantity was less than usual. He was directed to have the quinine and iron mixture three times daily and the mixed diet. To be allowed to leave bis bed. When up there was a considerable increase in the frequency of the pulse-greater than was perhaps explained by bis",
         "410 BRITISH AMERICAN JOURNAL, general state-in the bed it beat steadily 80 in the minute, when sitting up it was 100, and was more irritable and feeble, and when standing it became 120, very sharp and feeble. He was presented and went out cured on the 20th. During the period of his residence in the hospital he was not allowed any stimulus. Case 2.-S. S., aged 44, a waterman, admitted into St. Thomas's Hospital on October 15, 1860, under the care of Mr. McMurdo, after baving sustained a fracture of the thigh from a fall. On the 18th he began to have nymptoms of delirium tremens, and bad become very violent, when, at 4.45 p.m., a dose of 40 minims of tincture opii was given to him. At 10.30 p.m., the laudanum was found not to bave bad any soothing effect, and bis pulse was 120, and 5 ss. of tincture of digitalis was given. At 11.15 p.m. the pulse was still 120. 19th : At 9 a.m. he was reported to have been violent during the night, but less after taking the dose of digitalis till 4 a.m., when lie again became more excited. He had no sleep during the night, but was then quieter. Pulse 98, quiet and feeble. 4 p.m.: He had still had no sleep. The pulse was 98, full and regular. To repeat the dose of tincture of digitalis. 10 p.m.: las still not slept. Pulse 82, full and regular. Pupils natural and contractile. He bas passed a small quantity of water. He appears dis- posed to sleep. 20th, 4.30 a.m.: Has still not slept. Pulse 80, regular. He bas passed some water, which smells of digitalis. To have a glass of gin. 11.25 a.m. : Still no sleep. Pulse 80, irregular and interr.ittent. '4.45 p.m.: I saw him with Mr. Whitfield. He had still had no sleep. The pulse was 80 and irregular, and lie was much depressed. To have six grains of the sesquicarbonate of ammonia in an ounce of deciction of bark every four bours. Two pints of porter in twenty-four hours. 9 p.m.: Pulse 70, irre- gular, and intermittent. Bowels bave been acted upon. To have four ounces of gin and half a dram of the solution of hydrochlorate of morphia and a drachm of aromatic spirit of ammonia directly. 11 p.m.: Pulse 88, regular. 21st, 10 a.m.: Did not sleep till five o'clock this morning. The pulse is now 84, full, soft, regular. The tongue is dry, and lie complains of thirst. He lias passed water naturally. 9 p.m.: Has slept at intervals and taken bis meals naturally, is otherwise going on well. 22nd, 10 a.m.: Has slept during the night. Pulse 80, soft, slightly intermittent. The sesquicarbonate of ammonia every six hours. Full diet. From this time he progressed favourably.- Medical Times. TREATMENT OF WHOOPING-COUGH. By C. S. SHELTON, M.D., of Springfield, Illinois. The prevalence of whooping-cough in this city during the past winter and spring, furnished an occasion for testing the value of the extr. belladonna and sulph. zinc, con- jointly used in the treatment of this disease, as suggested by Dr. Fuller in the October number of the Lancet. His experience in its use, as there reported, was so successful as to encourage the hope that a remedy was found possessed of the power to lessen the severity and cut short the course of a disease which so often gives rise to years, if not of life-long mischief. The use of these remedies, as administered by myself in sixteen cases, goes to confirm the testinony of Dr. Fuller. In every case the effect was bene- ficial, and in the greater number quite satisfactory, cutting short the cough, in some cases, to ten days, with a palliation of all the symptoms. The ages of the children ranged from six months to ten years. I began with those under three years of age with one-sixth of a grain of the extract and half a grain of zinc four times daily, dissolved in water and gum mucilage. To those above that age, a quarter of a grain of the extract and a grain of the zinc, increasing the dose, in some cases to double the quantity, according as the child could bear it, but never beyond, as the speedy modifi- cation of the symptoms rendered it unnecessary in some cases, while in others the sys- tom would not bear it. The following effect would be manifest within an hour after taking the medicine, and continue from one to thiee hours: deep red or scarlet colour.",
         "QUASSIA IN THE TREATMENT OF CHOLERA. of the whole surface, particularly of the face and neck; dilatation of the pupil, arterial excitement, dry warm skin, aud general excitability of the whole system, which would gradually pass off, lcaving no unfavourable effects. A marked impression upon the disease was the result of the treatment. The par- oxysms of the cough were less frequent and less protracted, the whoop not as loud, the spasmodic synptoms greatly subdued, bronchial irritation less, a secretion of the bronchia established at an early stage, and the stomach less disposed to reject food. In the case of my own little girl of two years, an impression was produced in twenty-four hours after taking the first dose. She had coughed severely for ten days, and was cured in ten days from the tirst administration of the mixture. After three weeks she caught cold, and the cough and whoop returned. She was put again upon its use, with a like happy result. A boy of seven years had coughed a week, and the cough, with all its attendant symptoms, was increasing in violence. Gave a quarter of a grain of the extract and a grain of the zinc four times daily. The poisonous effects (if I may so call it) of the medicine daily followed its administration. Cured in ten days. Another lad of six years, who had coughed for two months, was cured in two weeks. The cases mostly occurred during the months of March and April, at a time of general prevalence of coughs and colds and sudden atmospheric changes. No remedies were given in conjunction with the belladonna and zinc ; but in three instances a mixture of syrup of ipecac. and gum mucilage was ordered. From my experience in the use of the extr. of belladonna and sulph. zinc, though limited, I am led to the conviction that they possess peculiar power in reaching the seat of the discase, and that the whooping- cough need not \" run its course.\"-./iner. Med. Times. BREEDING OF. TAPEWORM. By a recent experiment made on the human subject, Mr. Kuchenmeister has again succeeded in demonstrating that the cysticercus cellulosa becomes metamorphosed into the tænia solium of man. A man, under sentence of death, was induced to eat some pork containing cysticerci. The culprit was executed on March 31, 1860 ; and on post mortem examination, one-half of the cysticerci swallowed were found to have become converted into flat worms. Eleven tapeworms, with perfectly developed joints, were found in the intestines, the largest measuring five feet.-Medical and Surgical Reporter. QUASSIA IN THE TREATMENT OF CHOLERA. We noticed some time ago the stoppage of the works on the Jumna Bridge in conse- quence of the sudden appearance of, and subsequent mortality from, cholera among the workmen. When all other remedies seemed to fail and the number of deaths to be daily on the increase, it was determined to try the effect of Dr. Honigberger's specific quassia. Mr. Honigberger, a merchant of this place, who is a nephew to the doctor, and who has used the remedy with great success, was invited to the bridge to try the quassia remedy. From the night of the 10th instant, the date of the breaking out of the disease, the total deaths up to the 22d were 144. The first day there were 29 deaths, and for the next few days the average was about 15. On the 16th, the superintendent of the works tried quassia, and he attributes the rapid diminution of fatal cases entirely to it. Not only was this effect visible on this side of the river, but the same effect was visible on the other side where the quassia was also used. The medicine not only acted as an almost certain cure but also a preventive. Twenty-four cases (bad ones) which were inoculated after the patients had been attacked, got well again, and to prevent the dis- case spreading, more than 600 healthy coolies were inoculated ; this had the desired effect as there was not a single death from cholera for nearly a week after. 411",
         "412 BRITISH AMERICAN JOURNAL. A native doctor bas since been appointed, and an bospital established, where quassia is now the only remedy used and found most efficacious. Dr. De Cruze bas treated eleven cases of cbolera in all its stages with tincture of quassia and only lost one patient, a child a year old. The rest gM over the malady in less time than if they had been otherwise treated. The plan of treatment is very simple, make an incision in the left arm until the ap- pearance of blood, drop into the cut three to five drops of the tincture. So soon as the blood coagulates bind up the vound with a strip of cloth and keep it moist. For cramps in the legs the incisions are made in the calves. The patients were allowed only cold water and sherbet to drink, sometimes a mussuck of cold water was thrown over the body and bead, for the medicine is found to cause extraordinaay heat in the body. Tbis refreshed the patients very much. Seven cases out of the eleven noticed were in a state of collapse when taken in hand. Mr. Honigberger bas treated ten cases of cholera, some of whom were in a state of collapse in Kutra and Colonel-gunge, all of whom have recovered. We think it our duty to make known the effect of this extraordinary medicine in curing one of the most dreadful scourges of India. The remedy is so simple that the most ignorant may be taught how to administer it. No one at this time of year, when sickness is so prevalent, should be without a lancet and a phial of the quassia tincture. And the government should at once adopt measures for the introduction of the medicine into their European and native hospitals, and distribute it to every thannah and chokey in the station. Many thousand lives might thus be saved by its means.-.dllahabad Gazette. We are glad to say the sickness bas considerably abated on the Jumna Bridge. Dr. Honigberger's cholera remedy, tincture of quassia, bas been tried with success on even bad cases, and we only hear one or two deaths take place now, about 100 deatbs before the inoculation , we think this medicine ought to be in the hands of all government surgeons, for the use of the hospitals. Mr. Bell and other Europeans have done much in alleviating the sufferers.-Nord West Gazette. TREATMENT OF ASPHYXIA. In the Berkshire Medical Journal for April, Prof. W. H. Thayer bas an article upon the treatment of asphyxia, the main point in which we consider worthy of redevelop- ment here. In cases of suspended respiration, from whatever cause, it is usually directed that the heat of the body be kept up by artificial means during the period of the asphyxia; after the respiration is establisbed, it is usually supposed that the requisite warmth of the body will be provided for by the natural forces. Prof. Thayer takes issue on this point, and says the body should be kept considerably below the natural temperature until respiration is restored or established ; then the heat of the body should be provided for-in other words, the enfeebled heat-developing forces shonld be aided by warm clothing, etc. In proof of his positions, he refers to experiments by Buffon and Le Gal- lois, also by Sir Astley Cooper, in which it was found that animals died much sooner in water at or above blood-heat, than in water thirty or more degrees below it. Dr. Thayer quotes also two or three authorities in support of his views. We make one or two short extracts : \" The surface of the body should be kept cool until respiration is re-establisbed, in order that as little as possible of the oxygen that remains in the system may be con- sumed.\"-Braithwaite's Retrospect, Part V., p. 48. \" To elevate the temperature, or to accelerate the circulation, without baving first secured the return of respiration is therefore not to save, but, in reality, to destroy life.-Ibid, Part XXXIII., p. 88. We believe -Dr. Thayer's views to be correct, and we have certainly put them, or",
         "TREATMENT OF ASPHYXIA. 413 rather, similar opinions, in practice in certain cases, for several years past. In the first three or four years of our practice we were in the habit of placing ail still-born chil- dren, that gave any promise of restoration, in a warm bath, and we do not now remem- ber having seen one such restored, that was not actually breathing more or less dis- tinctly at the time. Since those first years our practice bas been different. If there be pulsation in the cord, we do not separate the child from the mother until respiration is establisbed or the pulsation ceases. Artificial 'respiration is attempted by the very easy method of elevation and depression of the shoulders. At each elevation, (we mean carrying the shoulders towards the head,) a dash of cold water is poured upon the chest or head. The elevation and depression are made with regularity, and at about the usual intervals of natural respiration. The cold dash is equally regular, and is simultaneous with the elevation movement. If there is no pulsation in the cord, we give the child a few dashes with cold water, and if the respiratory effort is not com- menced at once, we separate the child, place it upon a table, and commence artificial respiration, either as above, or by Marshall Hall's method, accompanied still with the cold dash as before. As soon as breathing is established, a well-warmed flannel blanket is in readiness to receive the child, and we consider a few drops of warm sling no detriment at this time, and before commencing with the washing and dressing, which is a severe and fatiguing ordeal for a feeble child. By such means we are confident we have seen a goodly number of children saved, that, by the warm bath, would have been surely lost. We have bad the happiness of seeing the maternal eye-wet with weeping-kindle with joy and gratitude at the sound of the first faint gaspings and still feebler cry. When the mother bas given up in despair, supposing. that she has suffered all the pains of parturition and is still childless, and bas taken a sorrowing look at tbe dead product of ber labour, it is no mean joy to be able to make her sud- denly happy by handing her a living child-blood of ber blood-that she can·regard in no other light than as a resurrection from the dead. A case in point occurred to us only last week. After a rather tedious labor, during the last six hours of which we were in attendance, a male child was born. There was no signs of life, and we did not remember having noticed the least evidence of motion- during any period of the labor. The cord was wound around the neck, also around the leg. Liberating the child from these entanglements, there was still found to be no signs of pulsation-in fact the cord was as flaccid as though it never had carried blood. The child gave no unnatural appearances at birth, and we commenced with our efforts as hinted above. Gradually, slowly, and almost imperceptibly, the surface of the bodyr grew faintly dark, darker, and still darker, until the hands, feet, lips, neck, and face were almost black. The mother watched all this, and now she and ber friends gave up all hope, and the mother was in the agonies of one bereft of ber child and her hope. This change of colour was our encouragement, for it gave us the evidence that the child had not been long dead at least. True, the encouragement was but faint, for the chariga of color, besides the above, only gave evidence of the continuance of a chemical change. The oxygen was being exhausted, and the arterial blood converted into venous. When the very dark color was reached, a new discouragement was upon us, for it showed that the oxygen was nearly or quite exhausted, and if we were not quite too late, there was at least but a few moments left to us. Those moments we presumed upon, and tried to improve to the best advantage. Soon a faint gasp brought to our eyes tears of joy, andi in less tban half an hour we had the satisfaction of handing over to the nurse a living, breathing, crying baby. Such results are not novelties in the hands of good pbysicians-the idea we would, urge is, that, had the child been put in a warm bath, it is more than probable the result would have been different. In the experiments of Sir Astley Cooper, a puppy immersed in warm water died in less than twelve minutes ; another, of the same age, immersed in, cold water, lived thirty-four minutes. In the case we have given above; the child was virtually immersed in a cold bath, and yet the colour of the skin, before the first respi.",
         "BRITISH AMERICAN JOURNAL. ratory effort was made, showed that the oxygen of the blood was nearly or quite ex- hausted; a few seconds more, without a respiratory gasp, and death would have been' complete. Had thé warm bath been used, this condition of deoxygenation would have occurred two-thirds sooner, or in one-third the time, and before the lapse of the remain- ing time, death would have been complete, and the child beyond all human powers of restoration.-Med. 4- Surg. Reporter. BLOODLETTING IN PNEUMONIA. In regard to the propriety and utility of bloodletting in inflammations in general, and in pneumonia in particular, there is a great diversity of opinions held by different mem- bers of the profession. There are, first, those who believe that bloodletting is judicious in nearly all cases of inflammation, not actually of a decided typhoid type. They be- lieve that disease has not changed its type, and that bloodletting is as much demanded now as at any former time. They are willing to admit that bloodletting may have been formerly too much employed, but, at the same time, they are confident it is now by far too little used as a .herapeutic measure. There are, second, those who believe that the fathers in the profession were right- that free and repeated bleedings were actually demanded to subdue inflammation, but that now, because of a change of the type of diseased action, bloodletting is seldom or never necessary. In their opinions, physicians were right fifty years ago, and are right now upon this subject. There is a thIrd class, who believe that bloodletting is seldom necessary now ; they believe that diseased action is the same now that it was fifty years ago, and that the free and repeated bloodlettings then employed were uncalled for and injurious, as well as based upon incorrect observations and false notions of pathology. It is interesting to listen to the teachings of those who, for the last fifty years, have closely observed the condition and tendency of diseased action. Before the Berkshire Medical Society, as per report in the April number of the Berkshire Medical Journal, the learned and venerable Dr. Alexander H-. Stevens made a few remarks upon the treatment of pneumonia, and the change of type in diseased action. Dr. Stevens belongs to the second class of physicians as given above; he believes that the type of disease is ma- terially changed. Formerly lie was in the habit of bleeding, and, he thinks, with benefit in diseases that now do not tolerate bloodletting at all. In regard to the time of change we make the following extracts: \" I am, and ever have been, of spare habit of body; my weight is about 130 pounds, and vas about that in the winter of 1814, when I had an attack of pneumonia. I lost about sixty ounces of blood, and felt that each of the three bleedings I underwent did me good. In the year 1815 I had charge of a military hos- pital, in which were received twenty or more cases of pneumonia. In these cases the serum of the blood was tinged with bile. The disease was new, and afterwards called bilious pneumonia, was well described by Dr. Gallup. It î ould not bear more than one bleeding. This was the first I saw of the change which has been gradually taking place since that time from a sthenic to an asthenic disease. I no longer, or very rarely find, at the present time, the indications for bleeding as laid down by John Hunter and other observers.\" Formerly, he says, they were present in nearly all acute diseases.\" In regard to the treatment of pneumonia, we stand committed to the opinion that bloodletting is seldom or never necessary. We have uot bled a case of pneumonia in the last eight years, nor seen occasion to regret the omission. For nearly four years past, we have not only omitted bleeding, but we have placed nearly all our cases of in- flammation of the lungs at once upon quinine and opium. To those who are in the habit of relying, in such cases, upon the lancet, antimony, calomel, etc., this will, doubt- less, seem. hazardous treatment; but, in the four years, we have not lost a patient with pneuaonia, under seventy years of age, and we have seen several recoveries in persons considerably older, as well as in very young children-cases that, under our former methods of treatment, we.think, would have died. 414",
         "PRESENCE OF SUGAR IN HEALTHY URINE. 415 Ten or twelve years ago, under bloodletting, antimonials, calomels, etc., our patients were seldom discharged before the end of the third week, and often not until the fourth. Now, it is an exception if he is not discharged by the tenth day. Usually, under from three to five grains of quinine, with five of Dover's powders, with the addition of a little morphine, so as to bring the dose of the opiate up to an equivalent to from one to two grains, repeated every three or four hours, the pulse will come down from 110, 120, or 130, to 80 or 90, in the first twenty four hours ; the cough will become less frequent and less tight, and the patient will break out in a profuse sweat. Formerly, we were in the habit of using small doses of antimony and Dover's powder, until the skin became a little moist before using the quinine. Now, we think there is no surer or quicker way to get a cool and moist skin than to give quinine and opium in combination as above, and repeat at rather frequent intervals. This spring we treated quite a num- ber of cases thus, with such uniform results that we often surprised the friends by pre- dicting the exact daily decrease of the pulse, the day of commencing convalescence, and the probab'd day of discharge. During last winter, we treated a very severe case of double pn imonia, and another in May last. Both recovered. When the symptoms were alarmi.ng, and death seemed imminent, the influence of the remedies was positive. In these cases, the chlorate of potash and veratrum viride were additions to the medi- cines alluded to above. In the winter of 1857 and '58, we commenced treating pnenmonia with quinine, etc., omitting bleeding. We were not aware that such treatment had been employed or advised, except in cases of malarial or typhoid pneumonia. Dr. Cartwright, of New Orleans, claims to have been the first to recommend quinine in pneumonia, which he says he did in the Medical Recorder for April, 1826. Dr. W. H Howard, of North Carolina, in an able paper upon walarial pneunonia, denies this claim, and avers that the quinine treatment was practised in some instances, both at home and abroad, an- terior to that time. Dr. T. J. Cogley, of Madison, Ind., in 1857, recommended the use of quinine and capsicun in pneumonia. Several others have done the same, in papers. which we have not the time now to hunt up and specify. We have carefully examined all the papers within our reach bearing upon this point, published anterior to 1858, and if we rightly remember, in all cases where quinine lias been recommended in pneumonia, the cases have been regarded as typhoid or malarùil. We have just been making an observation which, we think, bas a bearing upon the idea under consideration. We saw a case last night of diphtheria, in a patient aged about thirty-five years, a man, and a hard laborer. The patient had been sick about a week : there was considerable fever. present, pain in the head, etc. The throat pre- sented the peculiar appearance of diptheria ; the tongue was heavily coated, and as black as charcoal, and the pulse at 100. Twelve miles from our residence, we were urged to stay with the patient over night, who was greatly alarmed, and did so. . We gave three grains of quinine, and one-sixth of a grain of morphine, and repeated every three hours during the night; also, a tablespoonful of a saturated solution of the chlo- rate of potash every three hours. This morning the pulse was at 80, and the patient said he had sweat profusely ail night. We ordered the medicines to be given at intervals of four hours instead of three, with the addition of fresh meat, broths, and egg-nogg. We shall expect the patient to be fairly convalescent in three days. This case, and we might cite hundreds similar, goes to show that quinine is a sedative of no mean impor- tance.-Med. and Surg. Reporter. PRESENCE OF SUGAR IN HEALTHY URINE. Dr. Bence Jones bas confirmed the statement of Brücke that sugar exists in this secre- tion in its normal state. With the assistance of Drs. Ulrick and Valentine, he bas sub- mitted the different processes for detecting and estimating sugar to a close examination. Mehmann's method-according to wbich the urine is evaporated to dryness, the residue,",
         "416 BRITISH AMERICAN JOURNAL. extracted with alcohol, the sugar precipitated by alcholic solution of potash, then re-dis- solved in water, and the copper test applied-was not found to be sufficiently delicate, much sugar being lost during the evaporation. The fermentation test (production of carbonic acid and alcohol by yeast)was stopped when much urea or oxalate of urea was present : half a grain of sugar in water could be detected by the alcohol produced, and could be approximately determined by the carbonic acid given off; but in concentrated urine much larger quantities may be entirely overlooped. In decolorizing the urine previous to using Soleil's saccharimeter sugar is always lost, whether animal charcoal or basic acetate of lead and ammonia be employed an :e decolorizing agent. Petten- kofer's test is pronounced the most delicate known. The urine is mixed with a few drops of a concentrated solution of glychocholic acid* in soda or cholacic acid: three or four drops of concentrated sulphuric acid are then added, and the whole gently heated without boiling. If sugar is present a purple colour is seen at the edge of the watch glass, whicb is more evident on a white ground. The reaction is not hindered by a little colouring matter, but if the urine contains much it must be removed. Trom- mer's test failed with y, of a grain of sugar with 1 grain of hydrochlorate of ammonia; and -r of a grain of sugar with 1 grain of urea stopped reduction. The best way of applying Trommer's test is the following, recommended by Lehmann :-Two or three cubic centimetres of the urine are mixed with a few drops of solution of potasb, and filtered ; then an equal quantity of strong potash is added, with about three drops of solution of sulphate of copper; the whole is well shaken, and the clear liquor poured off from the hydrated oxide of copper which has not dissolved. If the blue solution when heated becomes colourless without depositing suboxide of copper, then two drops more of the sulphate of copper should be added, and the experiment repeated. A sep- aration of suboxide is often thus obtained, but long boiling must be avoided, as sugar is thereby decomposed. But the best results were obtained by Brücke's ïead process, according to which the urine is precipitated with neutral acetate of lead, and then with basic acetate of lead, and after filtering off the precipitate ammonia is added; in this last precipitate the chief part of the sugar is found. The authors were able by this process to detect - of a grain of sugar in 200 cubic centimetres of urine, and 1 of all the sugar added was recovered ; moreover, when sulphuretted hydrogen was used to de- compose the ammonia precipitate the sugar could be obtained in a state fit for fermen- tation, and free from colour, so that the saccharimeter could be employed. For the quantitative estimation of the sugar Fehling's standard copper solution was employed as the most useful and most accurate. This solution is thus prepared :-Dissolve 69 grains of crystallized sulphate of copper in five times their weight of distilled water, and add to it, first, a concentrated solution of 268 grains of tartarate of potash, and then a solution of 80 grains of hydrate of soda in one ounce of distilled water. Put the solution into an alkalimeter tube, and add distilled water so as to make 1,000 grain measures of the liquor. Every 100 grain measures of the solution are equivalent to one grain of grape sugar. ETHER EMPLOYED IN THE FORM. 0F AFFUSION IN NEURALGIA. From two drachms to an ounce and a half of ether are to be poured upon the most painful spot, and to be kept there by means of a small square of linen previously placed on and held in exact apposition to the skin so that no wrinkling of the linen may allow of the escape of the fluid. In this way all the ether is brought into contact with the surface. The ether should be poured upon the linen in srnall quantities, according to M. Bet- beder, who originated this method of treatment. A brief pause should be made for the purpose of allowing it to evaporate, then some more of the fluid should be poured upon the linen compress, and this process should be continuously repeated. Similar appli- cations should be made to the other points where the pain is most decidedly manifested.",
         "CASTOR-Olt IN TRE VOLATILE OILS. In recent cases cf neuralgia, M. Betbeder says that he bas always obtained a notable cessation of pain, often instantaneous, and frequently, also, d'efinitive, without any sub- sequent relapse of the pain. In old standing cases of neuralgia the effect was much less marked, but even then the relief from the suffering was very satisfactory.-Annuaire de Thérapeutique, 1861.-London .Medical Review. MATERIA MEDICA. CHLOROFORM SOLUTION OF GUTTA PERCHA, Take of Gutta Percha, in small slices, an ounce and a half. Chloroform, twelve fluid-ounces. Carbonate of Lead, in fine powder, two-ounces. To eight fluid ounces of chloroform contained in a bottle, add the gutta percha and shake occasionally till it is dissolved; then add the carbonate of lead, previously mixed smoothly with the remainder of the chloroform, and baving shaken the whole thorough- ly together, several times at intervals of half an hour, set the mixture aside and let it stand for ten days, or until the insoluble matter has subsided and the solution bas become limpid, and either colorless or of a slight straw colour. Lastly, decant, and keep the so- lution in a glass stoppered bottle.- nerican Journal of Pharmacy. A MEANS OF DETECTING THE PRESENCE OF CASTOR-OIL IN TEE VOLATILE OILS. BY HARRY NAPIER DRAPER, F.c.s.L. As a general rule, the volatile oils which are employed in pharmacy and perfumery are, at least in our markets, to be obtained pure; but it doces occasionally happen that they are sophisticated with sorne fluid of low price. Turpentine of wood, alcohol, and the fixed cils are the most common adulterants. It is a very simple matter to detect alcohol, and the admixture of turpentine so much deteriorates the propor odour of the oil that but slight experience is required for its recognition. The insolubility of nearly all the fixed cils in alcohol, and the consequent facility of ascertaining- their presence by simple treatment, of the suspected sample, with this reagent ii so well known, that this mo:le of adulteration is seldom attempted. Castor-oil forms however, an ex- ception to the general behaviour of this class of bodies in this respect. Soluble not only -in alcohol, but in all menstrua which dissolve the volatile cils, its recognition by the means just pointed out would be impracticable, and its miscibility with alcohol can even be taken advantage of to introduce the latter into the volatile oil in such propor- tion as to imitate the natural fluidity of a pure specimen. laving recently had occa- sion to examine an oil which was suspected to be adulterated in this manner, it occurred to me that the reaction, by which ricinus cil when treated with nitric acid gives rise to onanthylic acid (C1 HI OS'\u002bHO), might be taken advantage of for its detection. This body is a product of the oxidation of the castor oil,,and is formed when the warm oil is treated with an excess of nitric acid. -A violent. action ensues, during which much nitrous acid is disengaged, and there is found filoating in the acid liquid, when the residue is mixed with water, a soft unctuous mass, which is, I believe, the palmine of Boudet, accompanied by fatty acids. If the acid liqnid be now neutralized with carbonate of soda, so as to entirely remove the odour of nitrous acid, the smell of the onanthylic acid can bè most clearly recognised. It is upon this lct that I have based the method of detecting the presence of castor-oil which is now to be des- cribed. The modus operandi is as follows :-Twenty drops of the suspected cil are 417",
         "BRITISIH AMERICAN JOURNAL placed in a small porcelain capsule, and heated on the sand-batb until the odour of the oil is no longer perceived. To the residue--if there be any-add five or six drops of nitrkc acid, and as soon as the action has subsided dilute with a solution of carbonate of soda. If castor-oil be present the odour of the cnanthylic acid will now be at once perceived, and when once smelled, is not likely to be mistaken for any other. As, however, it can hardly be compared to any other familiar odour, any one who bas occasion to use this test will do well to make the experiment with castor-oil alone, and to acquaint himself with the peculiar smell. In this way I bave been able to detect the admixture of five per cent. of castor oil in volatile oils, and bave no doubt even a much smaller proportion could be recognised.- Dublin Medical Press. GLYCEROLE OF CHLOROFORM FOR INTERNAL USES. By Dr. DEBONT. p, Glycerine fi 3 viii. Chloroform fl 3 ij. Each teaspoonful will be found ta contain 6 minims of the chloroform, the dose may be therefore regulated in accordance with desire.-Journal de M1edecive de Bordeaux. FERRI CARBONAS EFFERVESCENS: A NEW FORM OF CHALYBEATE. Dr. T. Skinner, in a communication to the Dublin Medical Press, recommends the following formula for preparing effervescing carbonate of iron- If Acidi Tart., 'Ziij. Sodn Bicarbonatis, v. Ferri Sulph., 3 x. Pulv. Sacchari, -j. 3 vj. Acidi Citrici, 3 ij. 1. Mix the sulphate ofiron with the sugar and part of the tartaric acid. 2. Mix the citric acid with the remainder of the tartaric acid and the bicarbonate of soda. 3 Add the mixtures, and thoroughly incorporate them by sifting. 4. The whole is now ta be thrown into a metallic pan set in a water-bath ; in a few minutes it will separate, when it should be rapidly stirred until granules are formed. If preferred, it may then be flavoured withi oil of lemon ; bitherto, however, the preparation bas been without it. When the above is carefully prepared, it bas all the appearance of the puplar and well known granular effervescent citrate of magnesia, with the addition of a slight yel- lowish green tint. Every drachm and a half contains ten grains of sulphate of iron, whicI, with a complement of bicarbonate of soda, is certain ta produce, in a state of so- lution, four grains of nascent protocarbonate of iron. MISCELLANEOUS. ON BUNSEN AND KIRCHHOFF'S SPECTRUM OBSERVATIONS. BY EENRY ENFIELD RoSCoE, EsQ., Professor of Chemistry in Owens College, Manchester. (Delivered at the Royal Institution, MZiarch 1, 1851.) TuE speaker commenced by stating that the researches of Bunsen and Kirchhoff which he had the honour of bringing before his audience, mnarked a new era in the science of Analytical Chemistry ; that by means of these discoveries the composition of terrestrial",
         "SPECTRUM OBSERVATIONS. matter becomes revealed to us with a degree of accuracy and delicacy as yet unheard of, so that chemical elements supposed to be of rare and singular occurrence, are shown to be most commonly and widely distributed, and on the first practical application of this new method of analysis two new and hitherto undetected alkaline metals have been discovered. The importance of these researches becomes still more strikingly apparent when we hear that the conclusions derived from them outstep the bounds of our planet, enabling us to determine with all the certainty of definite experiment the actual presence of a number of elementary bodies in the sun. The colours which certain bodies impart to fame, have long been used by chemists as a test for the presence of such bodies. Thus soda brought into a colourless flame pro- duces a bright yellow light, and substances containing soda in any form give this yel- low colour. Potash gives a violet aname, lithia and strontia impart to 'ame a crimson colour, whilst salts of barium tinge it green. These colors are produced by the incandescence or luminocity of the heated vapour of the various bodies placed in the flame. It is only because these substances are volatile, or become gases at the tempera- turc of the flame, that we observe the peculiar colour. If any substance, such as plati- num, which is not volatile at the temperature of the flame,.be placed in it, no coloration is observed. The higiher the temperature of the flame into which the same substance is placed the greater will be the luminocity; and the more volatile the salt of the same metal, the more intense is the ligit produced. Heated to the point of incandescence in any other manner, the vapours of these metaits and their salts give out the same coloured light. Thus, if we burn gun-cotton, or gu'n- paper, steeped in solutions of tiese various salts, we get the characteristie colours. The well-known coloured fires owe their peculiar effects to the ignition of the vapour of some particular substance. Thus, in red lire we have strontium, in green fire we have barium salts present in the state of luminous vapour. Tiese facts have long been known and applied, but it was reserved for Bunsen and Kirchhoff to place these beautiful phenomena in their truc position, to apply to them the modern methods of exact research, and thus to open out a new and rici field for most important investigations. This they accomplisied in a most simple and beautiful man- ner, by examining these coloured flames, not by the naked eye, but by means of a prism or an apparatus for separating, decomposing, or splitting up the ligit produced by the incandescent vapour into its different constituent parts. If we pass white sun-light througi a prism, we get the well-known solar spectrum discovered by Newton. The red, or least refrangible rays appear at one end, and we pass througi all gradations ofeolour-noticing on our way certain dark Unes or spaces shewing lie absence in solar light of some particular rays, lines with which we shall have much to do-until we arrive at the violet, or nost refrangible end of the spectrum. If instead of using white sun-light, we pass the rays from the yelolw soda flame through the prism, we get the soda spectrum, and ve find that instead of a continuousspectrum, all we sec is one brigit yellow line, showing that every kind of light except that bright yellow ray, is absent in the soda fdame; or that the soda flame gives out only one kind of ligit. And as each metal, sodium, potassium, lithium, calcium, strontium, barium, \u0026c., communicates a distinct tint to flame, so each gives a distinct and characteristie spec- trum, consisting of certain bright coloured lines, or bands of light of the most peculiar form and tint. The actual spectra of these metals can be beautifully secn in the simple apparatus de- signed by Bunsen and Kirchhoff. In each spectrum of these metals, the form, number, position, colour, and tone of the bright lines reinain perfectly constant and unvarying, so that from the presence or ab- sence of one of these Unes, we may with absolute certainty draw conclusions respecting the presence or absence of the particular metal, as we know of no two substances which .419",
         "420 BRITISH AMERICAN JOURNAL. produce the same bright lines. None of the bright lines produced by any one metal in- terfere in the least with those of any other, and in a mixture of all these metallic salts -together,,each ingrediant can thus be easily detected. As an example of the exactitude with which a very small quantity of a most compli- cated mixture can thus be analyzed, the speaker quoted Bunsen'à words. \"I took,\" says Bunsen, \"a mixture of chloride of sodium, chloride of potassium, chloride of lithium, chloride of calcium, chloride of strontium, chloride of barium, containing at most yub-y part of a grain of each substance. This mixture I put into the flame, and observed the result. First, tbe intense yellow sodium line appeared, on a background of a pale continuons spectrum ; as this began to be less distinct, the pale potassium lines were seen, and then the red lithium line came out, whilst the barium lines appeared in all their vividness. The sodium, lithium, potassium, and barium salts were now almost all vola- tilized, and after a few moments the strontium and calcium lines came out, as from a dissolving view, gradually attainingtheir characteristic brightness and form.\" We can thus detect the most minute traces of any of these bodies, if mixed with the largest qnantities of any other substance. The delicacy and accuracy of these reactions is without parallel, as is seen fro:n the following statements .- 1. Soda r bapart of a milligramme, or r part of a grain of soda can be de- tected. Soda is always in the air. All bodies exposed to air show the yellow sodium line. If a book be dusted near the flame the soda light can be seen. 1.. Lithia -rfo- part of a milligramme, or r part of a grain of lithia can be easily detected. Lithium was only known to occur in four minerals. It is now found by spectrum analysis to be one of the most widely distributed elements. It exists in almost all rocks ; it bas been found in 3 cubie inches of sea, river, and Thames water; in the ashes of tobacco, and most plants; in milk ,human blood, and muscular tissue. 3. Strontia -,,5-r\u003cor of a milligramme, or h part of a grain of strontia can be easily detected. 4. Lime mjôre of a milligramme, or TF-jr-a, of a grain may be easily detected. In examining the spectra of the alkalies obtained from certain mineral vaters, Bun- sen observed the occurrence of two bright blue lines which lie had not seen before, when he examined alkalies from other sources. Hence lie concluded that these bright lines must be produced by a new, hitherto undetected, alkaline metal. Subsequent search proved the validity of the supposition. The new,metal was found and isolated. The analogy between this discovery and a celebrated one in another branch of physical science, will be at once understood. As Adams and Leverrier discovered Neptune, so Bunsen discovered \" Cosium\" by the perturbations produced in the spectra of the other alkaline metals. This is, however not all. A few days ago the speaker received a letter from Bunsen, which contains the folloWing most interesting information:-\" The substance which I sent you as impure tartrate of CSsium contains a second new alkaline metal. I am at present engaged in preparing its compounds. I hope soon-to be able to give you more de- tailed information concerning it. The spectrum of the new metal consists of two splendid red lines situated beyond the red line K a in the ultra red portion of the solar spectrum. Hence I propose to call the new metal 'Rubidium. \" That this same method of investigation can be extended to all the metallic elements is more than probable, for Kirchhoff writes-I have assured myself that even the metals of the rarest earths, as yttrium, erbium, and terbium, can be most quickly and certainly determined by help of the spectrum analytical method.\" Experiments are being carried on with a view of making this mode of examination practically applicable to all metals. To turn, now to the second, and, if possible, to the more interesting part of the sub- ject, namely, theconclusions drawn from these observations respecting the composition of the sun's atmosphere. The solar spectrum invariably contains, a large number of dark lines, or spaces, or shadows. These have been called Fraunhofer's Lines from the",
         "SPECTÉUM O3SERVATIONSO 4 uiame of their discoverer. They show us that in the sun's light certain kind of rays aié wanting; and as these Unes are always present, exactly in the same position, we see that certain kinds of rays are always absent in solar light. There are many thousands bf these lines in the whole length of the spectrum. Only a few have been as yet map- ped and named. What is the cause of these constant darklines? And we must remember that it is in sunlight alone that these particular lines occur; in the light of the fixed stars, as well as in artificial lights, other lines are found. It is the discovery of this cause by Kirchhoff which gives the subject such peculiar interest, as it enables us to draw conclusions re- specting the composition of the sun's atmosphere. The points of the case are put as ·concisely as possible under the following beads:- 1. The solar spectrum invariably contains certain fixed dark lines, called Fraunhofer's Lines. 2. The spectra produced by the luminous vapour of all metals contains certain fixed bright lines, invariable, and distinct for each metal. 3. All and each of the bright lines thus produced by certain metals-viz. sodium, po- tassium, magnesium, and iron, are found to coincide exactly with certain of the dark Unes of the solar spectrum. 4. Hence there must be some connexion between the bright lnes of the metal and the dark solar lines. 5. The connexion is as follows :-Each of the dark fixed lines in the solar spectrum is caused by the presence in the sun's atmosphere of the luminous vapour of that metal which gives the coincident bright line. By taking a special case we may more easily understand the matter. Let us examine the question why it is to be concluded that Sodium occurs in the sun's atmosphere ? In the following sentences the reasoning on this subject is rendered clear:- 1. The light emitted by luminous sodium vapour is homogeneous. The sodium spec- trum consists of one double bright yellow line. 2. This bright double sodium line is exactly coincident with Fraunhofer's dark double line D. 3. The spectrum of a Drummond's Light (like that of all incandescent solids) is con- tinuous. It contains no dark lines or spaces. 4. If between the prism and the Drummond's Light a soda flame be placed, a dark double line identical with Fraunhofer's dark double line D is produced. 5. If instead of using Drummond's Light we pass sunlight through the soda flame, we see that the Rune D becomes much more distinct than when sunlight alone is em- ployed. 6. The sodium fiame bas, therefore, the power of absorbing the same kind of rays as it emits. It is opaque for the yellow \" D \" rays. 7. Hence we conclude that luminous sodium vapour in the sun's atmosphere causes Fraunhofer's dark double line D. The light given off from the sun's solid body produ- cing a continuous spectrum. 8. In similar manner the presence in the solar atmosphere of potassium, iron, magne- sium, nickel, and chromium has been proved. Kirchhoff's own words may perhaps render this matter still more plain. \" The sun,\" says Kirchhoff, \" consists of a glowing gaseons atmosphere, surrounding a solid nucleus which possesses a still higher temperature. If we could see the spectrum of the solar àimosphere without that of the solid nucleus we should notice in it the bright Unes *hich are charadteristic of the metals it containS. The more intense luminosity of the internal nucleus doeë not, however, permit the spectrum of the solar atmosphere to be- come apparent; it is'reverâed according to my newly discovered proposition; so that, iistead of the bright Unes which- the lminous atmosphere by itself would bave shown, dark ones appear. We do not sec the spéctruni of'thè solar atmosphere itself, but a ne- gative image of it. This casé howver, with an ¥4ual degree* of certainty, serves to de- 28 vol. Il. 42Î",
         "I3RITISIT ÂMEIZiCA11 iouTz\"LAL. tect the metals present in the sun's atmosphere. All that we require for this purpose ig a very accurate knowledge of the solar spectrum, and of the spectra of the individual metals.\" Kirchhoff is at present engaged in continuing these observations - and although only eighteen months have elapsed since the first discovery was made, he las already mapped more than seventy lines in the solar spectrum, between D and E, which are produced by iron. He has shown that the well-known group in the green known as b, is caused by magnesium, whilst other coincident lines prove the presence of nickel, chromium, potassium, and sodium in the solar atmosphere. The speaker regretted that he was unable to show even a drawing of the coincident lines, as no representation of them has yet been completed. The lines produced by many metals possessing very distinctly marked spectra are seen to coincide with none of the dark solar lines ; and hence the conclusion is drawn that these metals-for instance, silver, copper, zinc, aluminium, cobalt, lead, and antimo- ny-do not occur at al], or at any rate occur only in very small quantities in the sun's atmosphere. The speaker said that lie should not soon forget the impression produced on his mind when visiting his friends in Heidelberg last autumn, by seeing the splendid spectacle of the coincidence of the bright lines of the iron spectrum with the dark solar lines. In the lower half of the field of the telescope were at least seventy brilliant iron lines of varions colours, and of all degrees of intensity and of breadth; whilst in the upper half of the field, the solar spectrum, cut up as it were, by hundreds of dark lines, exhibited its steady light. Situated exactly above each of the seventy brigh t iron lines was a dark solar line. These lines did not only coincide with a degree of sharpness and precision perfectly marvellous, but the intensity and breadth of each bright line was so accurately preserved in its dark representative, that the truth of the assertion that iron was contained in the sun, flashed upon the mind at once. The speaker concluded by remarking that these researches are still in their earliest in- fancy; that the dawn of a new stellar and terrestrial chemistry has been announced, thus opening out for investigation a bright prospect of vast fields of unexplored truth. CONCEALMENT OF A BURGLAR'S INSTRUMENT IN THE RECTUM. The Paris correspondent of the Lancet relates the following remarkable e ffair : \" A curions case recently brought before the Society of Surgery throws some liglit upon the mysteries of the Bagnio, and illustrates the desperate nature of the expedients to which the galley-slaves are in the habit of resorting, in order to elude the vigilance of their gaolers. A convict at the prison of Vannes, in Normandy, condemned to fif- teen years of hard labor for robbery, was suddenly seized with colic, vomiting, and fever, accompanied by obstinate constipation. In the presence of these symptoms of intestinal obstruction, search was made for a hernia, but none was found. The prisoner, aware of the gravity of his state, and hard-pressed for some explanation as to the origin and cause of the disorder by the attendant physician, confessed to having been in the habit of secreting within the cavity of the rectum the money lie happened to possess. An examination of the lower bowel, first by the finger, and then by a long pair of for- ceps, threw no light upon the case ; the intestine was empty. The peritonitis daily gained ground, and the patient, evidently sinking, was again urged to give some more satisfactory clue as to the source of the disease. He now somewhat modified his pre- vious statement, and said that lie had introduced into his rectum, a few days previously, a cieft stick, which lie used as a porte-monnaie, and that in the hurry of a sudden alarm, the pointed end had been inserted foremost, in lieu of the blunt extremity. The* left hypochondriac region was then carefully explored, and towards the upper part of the descending colon, a voluminous tumor was discovered; this corresponding with the point of the obstruction. Towards the end of the seventh day the man died, and the",
         "DANGEROUS COSMETICS. 423 44topsy revealed the following; The usual post-mortem signe of acute peritonitis- serons effusion, false membranes, enormous distension of the intestines by flatus, ad noreover, the existence of a foreign body of considerable size and weight, occupy- 'hg the transverse colon. This body, on its withdrawal from the intestine, proved to be substantial metallic case, of cylindrical form, enveloped in a piece of bladder, and Possessing a conical extremity, which pointed upwards, i. e., towards the cScum. hzen stripped of its covering, the cylinder, which weighed one pound five ounces, was fol3nd to be a case or tube, in hammered iron, closed at one end, and provided with a eover at the other, six inches and a quarter in length, and two in diameter. Within Were found an iron tube; part of a gun-barrel four inches long; an iron screw and ; a turn-screw; two small saws, one for wood, the other for eutting metal; the ill of a centre-bit; a file; a piece of two francs, and four pieces of one franc, together a. lump of grease-a complete thieves' arsenal. On a closer examination, it was acertained that these instruments, united by means of the nut and screw, could be 41de to forn a powerful lever, capable of wrenching asunder the bars of a window- natlRg, and thus affording the means of escape. Thanks, no doubt, to tke possession of this portable \" jimmy,\" this very convict had, on a former occasion, and when im- Prisoned in the gaol at Brest, been enabled to regain bis liberty. The medical interest *the case lieu, of course, entirely in the acquired tolerance of the rectum for so enor- e1os asuppository, and in the manner in which this capacious iron cylinder had tra- 'Oued along the intestine, upstream, and against the peristaltic current, and roupded corner of the transverse colon, in spite of gaseous distension and muscular opposi- A11. .ccording to the experience of the turnkeys of Vannes, the concealment of con- %hnd articles, by insertion into the rectum, is almost universal amongst the convicts, 4 the little conical boxes, carried for the purpose by the galley-slaves, are commonly 4 p amongst themselves as ' nécessaires.',\" DANGEROUS COSMETIOS. t a recent sitting of the French Academy of Medicine, Dr. Réveil read a paper \"On Rt ecessity of Preventing Perfumers from Belling Poisonous or Dangerous Articles,\" ch should be exclusively left to the responsibility of regular chemists, and not sold ehtot a physician's prescription. \"To show the danger there is in allowing the un- eked sale of certain compounds,\" he said, \"I need but state that arsenic, the acid ate Of mercury, tartar emetic, cantharides, colchicum, and potassa caustica, form tf their ingredients. The kind of soap called lettuce-soap, which is sold with the ol»40tncement that it bas been acknowledged by the Academy, does not contain the thtest trace of lettuce. This and other soaps are all colored green by the sesqui- o of chromium, or of a rose color by the bi-sulphuret of mercury, known as ver- 0n. Some, which are cheaper, contain 30 per cent. of insoluble matter, such as lime plaster ; while others contain animal nitrogenous matter, which, having escaped the rCsu of saponification, emit a bad Smell when its solution is left exposed to the The varions toilet vinegars are so far noxious that, being applied to the skin still pregnated with soap and water, they give rise to a decomposition, in consequence of the fatty acide of soape, being insoluble in water, are not removed by washing, e rancid, and cause a chronic infiamnmation of the skia. The preparations em- Ca for hair-dye under the pompous name Of 'African water,' 'Florida water,' \u0026c., cOntain nitrate of silver, sulphur, oxide and acetate of lead, sulphate of copper, and ee Oxious substances. All cosmetics for removing hairs or freckles are dangerous; e lit antéphéligue, for instance, contains corrosive sublimate and oxyd of lead. Were 5nisut to deliver sncb a remedy to a customer without a regular prescription, he d be liable to a fine of 6000f.\" L Réveil concluded by expressing hie regret that certain physicisas hou4 o far their own dignity as to lend thq5upPott of their ames tO #9Pw *oio029j I P- -Galignani's Messenger.",
         "THE MONTREAL, SEPTEMBER, 1861. AN ANNUITY FUND FOR DISABLED MEMBERS OF THE PROFESSION, OR FOR THEIR WIDOWS AND FAMILIES. It will be fresh in the memory of our readers, that at the last semi-annual meeting of the Board of Governors of the College of Physicians and Surgeons of Lower Canada, notice was given by Drs. Smallwood and Gilbert, that a mo- tion for the formation of a \" College Medical Benevolent Fund,\" would be sub- mitted to the consideration of the ensuing triennial meeting of the College. A professional engagement prevented our presence at that period of the session of the Board when that notice was given, and we are therefore ignorant of the intentions of the mover and seconder-whether the object in fact be the relief of disabled members of the profession, or 'the relief of their widows and off- spring. We have little doubt that this motion originated out of a distressing case which was presented to the meeting of the Board. It appears that a Dr. Boudreau, a provincial licentiate, left this country, when the Californian gold fever was at its height, for California. Having arrived there, he became at- tacked, as we have understood, with one of the endemic fevers, the result of which, from its severe influence on the brain, was amaurosis. le is now, and has been for years, perfectly blind. So far as we have understood he is a gen- tleman whose morality in every respect is unimpeachable. Despite of this severe dispensation he has continued to practice his profession as best he could, by the aid of an amanuensis to write the prescriptions which he dictated, but in surgical cases or operatic procedures, he was indebted to the kind heart and hand of one, who has placed his services at his disposal, who we know has frequently operated for him, and who, we also know, would be displeased if his name was mentioned openly. It was presumed that this was a case deserving of a temporary alleviation by.the Board. A petition was accordingly presented, and its fate is recorded in the following lines:-\" that the Board had no power so to dispose of the funds of the College, and moreover, because the peti- tioner was not a member of the College.\" In this denial of assistance under such peculiar circumstances, ugly as it is, we cannot but concur. The Board of Governors has received no authority from",
         "ANNUITY FUND. the College to disburse the funds of the College otherwise than has been directed by the By-laws. The Board is but the executor of the College, and may not transgress with impunity its acknowledged instructions as contained in the By- laws. But the presentation of a petition, and the denegation of the prayer, have awakened a most important reflection, whether it would .not be better to devote, as under the circumstances indicated, a trifling amount to an object of charity from time to time, as necessity may arise, or at once to adopt the more noble and legitimate (in our opinion) system of rendering the annual contributions of the members of the College subservient to a certain extent, to the relief of the wants of their families when they themselves have gone to their narrow homes; and their near and dear ones left, as occurs in ninety-nine out of a hundred cases, almost penuiless in the world. Of the three professions, Divinity, Law and Physic, it may be said, that the representatives of the first class scarcely do more, from the scantiness of their annual salaries,-which is barely sufficient in the large majority of instances,- than support their families, and maintain their external appearance as gentlemen. Hence in most of the churches provision has been wisely made, in the event of their demise, for the support to a certain extent of their widows and families. The members of the second profession,-whether by the industrious pursuit of their calling, or their preferment to offices of place and power, which seems, however absurdly to be considered as centred in it,-continue in the majority of instances not only to possess an abundance of this world's goods, but are enabled also to leave fortunes to their families. With the third class, whom we repre- sent, and than whom none toil more severely, whether by mind or body, through heat or cold, through wet and dry, by night and by day, how many let us ask, how many by their own fruitful toil, unaided by extrinsie circumstances, are enabled to leave even an adequacy for the support of their families ? Very pro- bably not one per cent. and we have little hestation in stating, that the labour in the profession of medicine is immeasurably more severe than in either of the two sister professions. And usually with so poor a prospect those who pro- pose entering its pale, there must be something beyond the mere love of lucre which tempts and attracts. What that is which can thus inspire men to devote their lives to the relief of a suffering humanity beyond an influence so powerfully operative in ordinary minds, any one who bas once imbibed its limpid streams can tell. We do not arrogate for our profession a preeminence over the others. Far be this from us; for as much human salvation transcends in the sublimity of its object everything of a sublunary character, so must the palm in this respect beà awarded to the profession of Divinity. But if our profession has to suc- cumb in such a respect to the nobler one alluded to, it yet as much transcends that of law, as. the salvation of human life is not to be measured by pounds, shillings, and pence, That there is something peculiarly attractive in the study of medicine consists in the fact, that independently of its high and almost holy mission, there is no subject connected with natural science of which it does not, may not, take cognizance. Hence there is none, with the exception mentioned, which induces its student to search more narrowly, and recognize a \"nature's God; \" and therefore none which eau induce a man for that sake, who 425",
         "BRITISH AMERICAN JOURNAL is thoroughly imbued with the true feelings or principle of bis profession, to de- vote his time, which is his means, to works of benevolence and charity. How much of a physician's time might have been devoted to profitable pursuits which might have enriched bis purse, let the history of every physician pronounce, no matter what his present status. ilence there must exist little wonder why physicians generally die poor, leaving nothing for their families but a naine, it may be possibly among the honoured ones of the earth, but a vox et pretere nihil. Hence we regard the motion of Drs. Smallwood and Gilbert as a step in the right direction, and sensibly alive to the animus which prompted it, we take it up and most cordially endorse it. But the subject as it now stands is, we cannot but acknowledge, fraught with diffleulties. The amount at the disposal of the College at present, after its so many years of existence, is but a small one, scarcely exceeding, we believe, some £250. And the annual subscription of the members, is entirely insufficient to warrant such an appropriation of the interest of that sum: and although the fees from candi- dates are sufficient to meet the ordinary travelling expenses of the distant mem- bers of the Board of Governors who feel disposed to do their duty, it would yet take a long time before sueh an inerease could be effected in it, as to make it a fund worthy of such an object. Some additional means must be resorted to among those who look forward to so desirable a result--and we sec none other likely to serve its purpose, than a special fund destined to that object. Most assuredly the funds of the College could not by any possibility be appropriated in a more desirable manner, and we look with some earnestness to the seheme which the proposer and seconder of the motion have in view. We think that in antici- pation of the Triennial meeting, when it is intended that the subject will be brought before the College, the subject should be discussed fairly and openly, and we will with pleasure open these pages to any communications on the subject. It is thus by rendering the college a useful institution, in the truest acceptation of the word, rendering it, in fact, something more than a Board of Examination for candidates desirous of entering the profession, that it will be enabled to fulfil an object to which it may with the greatest propriety be devoted. J. J. E. LINTON, EsQ., CLERK OF THE PEACE FOR THE COUNTY OF PERTH, C. W. (Ecce iterum Crispinus!) Just twelve months have elapsed since we had occasion to expose and denounce Mr. Linton's feelings towards McGill College and Lower Canada Licenses, and the fact that lie had circulated throughout the length and breadth of the land an infinite number of copies of a lucubration of bis which lie contrived to get published both in the \" Pilot\" of this city, and the \" Examiner \" of Stratford. One would have imagined that the matter had died out-but it appears that Mr. Linton, our most particular friend, bas been \" nourishing his wrath to keep it warm.\" We have a right to question bis taste in promoting discord while pro- fessing to be a \" Clerk of the Peace.\" It appears that lie bas been reissuing these celebrated manifestoes, but if they are productive of no greater injury to our University, and the value of our licenses, than was effected last year, we trust 426",
         "EfDITORIAL SUMIARY. he'will continue bis kindly work year by year, and prove himself, as far as MeGiI College and Lower Canada are concerned, possessed of the very milk of human kindness, as we feel convinced he could do us no greater favour. People, however, will naturally ask, what is the cause of this fresh proceeding of J. J. E. Linton, Esq., Clerk of the Peace for the County of Perth. An un- kindly disposition on the part of a great number of our people might attribute it to malice, vindictiveness, or some other equally reprehensible motive; the more charitably disposed of the community however will we have no doubt be diPposed to attribute it to some mental infirmity at the utmost, if indeed they do not regard it as a decided attempt to advance or promnote Lower Canada interests, for which we cannot but feel too grateful. Possibly the learned, and wise ex- pounder of the law bas a Gacocthes scibendi, and seeks an opportunity of smug- gling bimself into print again. Time, which tells all things, will doubtless disclose the effects of this twelve months' incubation, as long a period as a jenny-ass requires. GEORGE McLEAN, EsQ. We must say, albeit in a merry mood, that \"it never rains but it pours.\" Mightily pleased with Mr. Lincoln's efforts in pronoting the best interests of our Lower Canadian Institutions, we have to thank Mr. MeLean of Bay Street, (it should-have been Baa Street, a more appropriate name,) Toronto, for a letter of thanks for the notice of his \" very valuable \" nostrums in our last number. As we think that that was notice enough, we decline to insert his self-Laudatory epistle. He can see no difference between a letter of ours, rccomnendatory of the Plantagenet water, a mineral spring in certain complaints, and those of the medical gentle- men in fâvour of his nostrums. Will he permit us to inform him that the composi- tion of the one is known, that of the other unknown ; that the one is a natural production, the other artificial; and that like I{amlet's father and his uncle, the one is an \"Il Hyperion \" the other a \" Satyr.\" If Mr. MeLean desires to receive the Journal, we should like in all humility to receive his request for it \" in less questionable shape,\" and we will be most happy to comply with it. Tte Bifalo Mfedical and Surgical Journal and Reporter. Edited by Julius F. Mines, M.D., Surgeon to the Buffalo General Hospital. We acknowledge the reception of No. 1, Vol. I., of the aforenamed periodical, and will with great pleasure place it on our exchange list. It opens with an interesting address by Dr. Austin Flint, before the Erie County Medical Society. The Journal is well and vigorously edited. The political troubles in the United States, however, render it a question of doubt whether a newly started periodical can sustain itself at present. We certainly wish it the utmost amount of suceess. EDITORIAL SUMMARY. Bayonetting the Wounded.-After the late fight at Bull Run, Surgeon Barnes of the 28th Regiment New York voluateers, reports that \"he selected a retired spot, under a 427",
         "428 BRITISH AMERICAN JOURNAL. large tree, as a temporary place wherein to dress the wounded; and to signalize it, hung his green sash on the limb of a tree. It was soon recognized by the enemy, and after about thirty wounded soldiers had bcen brought to him, after baving performed tb required dressings and operations, the cannon-balls of the enemy began to play upon the party. As his assistants and servant had left, he bad to leave to seek the assist- ance of ambulances to remove the wounded, and on bis return, ho found \"every one of the wounded bayonetted or sabred.\" Independent of this evidence of the fact, an officer of the Massachusetts 5th Regiment, lying wounded on the field, heard the order given by a rebel officer to \" bayonet the sons of - red shirts,\" and cannon were frequently made to bear on ambulances carrying off the wounded. Dr. Barnes lost bis sash, coat, sword, watch, and all lis medical instruments. In the 19th century a tale of the above kind is scarcely credible, but we believe that in a civil war, far more than in any other kind, in which the passions are roused to a higher pitch, sncb scenes are more apt to occur. It is a disgrace to the Christianity of the present time, and a lasting shame to the cowardly perpetrators of the deeds, for they are cowards indeed who would raise offensive weapons against unarmed or disarmed persons, and use them. The symbolized spot, near a field of battle, where the surgeon is performing bis office of humanity, should be a sacred one, around which every sentiment of Christian feeling and true honor and generosity should throw their protecting ogis. .A Substitute for Silver.-Messrs. De Ruolz and Dr. Fontenay bave, after years' work, discovered a new alloy, which may be used for small coin and industrial uses. It is composed of j silver, 25 to 30 per cent nickel, and from 37 to 52 per cent copper. The inventors propose to call it trisilver or tiers-argent; and its perfection is said to be a triumph of metallurgical science. It is stated to be ductile, malleable, easily fused, and emits a fine sound when struck, is not affected by exposure to the atmosphere, and not attacked by any but the strongest of acids. It resembles platinum in colour, and possesses extreme hardness and tenacity; has no odour, and a sp. gr. a little les than that of silver. Army Medical School at Chatham.-We understand that the varions professors at this recently established institution have now ample leisure for their scientific experiments, as the whole of the last batch of successful candidates have been summarily placed on half-pay. No eleve of any of the great medical schools now dreams of exposing himself to a curriculum, bis success in which can only lead to disappointment. The fact we believe to be, is that the school is virtually \" to let \" there being neither candidates nor pupils.-United Service Gazette. Stringent Resolutions Against Homoopathy, 4Sc.-At a meeting of the Council of the Royal College of Surgeons in Ireland on Aug. 2nd, the following ordinance and reso- lution were finally adopted:- \" No fellow or licentiate of the College shall pretend or profess to cure diseases by the deception called homceopathy or the practices called mesmerism, or by any other form of quackery ; neither shall they or any of them seek for business through the medium of advertisements, or by any other disreputable method. It is also hereby ordained that no fellow or licentiate of the college shall consult, meet, advise, direct, or assist any person engaged in such deceptions or practices, or in any system or prac- tice considered derogatory or dishonourable by physicians and surgeons.\" The College of Physicians bas adopted the following form of declaration to be taken by licentiates on admission: \" I engage not to practise any system or method (so-called) for the cure or alleviation of disease, of which the College bas disapproved; nor to endeavour to obtain practice or to attract public notice, by advertising, or by any other unworthy means. I also engage that I willneither permit nor sanction the use of my name by any other person for such purposes, nor in connection with any secret or other remedy; and in case of gay doubt relative to the true meaning or application of this engagement, I promise to",
         "EDITORIAL SUMMARY. submit to the judgment of the College. And I solemnly and sincerely declare, that should I violate any of the conditions specified in this declaration; so long as I shall be eitber a licentiate or fellow of the College, I thereby render myself liable, and shall submit to censure of the College, pecuniary fine (not exceeding twenty pounds), or expulsion and surrendering of the diploma, whichever the President and Fellows of the College, or the majority of them, shall think proper to inflict.\"-Dublin .MedicalPress. Military Hospitals in Washington and Neighbourhood.-The first is the Washington Infirmary, established several years ago for strangers and homeless persons. It can accommodate 180 patients and is full. It is attended by Drs. White, Gouley and Butler, with assistants. The Sisters of Mercy attend to the nursing. 2nd. The Columbian Hospital, capable of accommodating 250 patients. Chief physician, Dr. Abadie, assist- ed by Drs. Asch, Brainard, Adolphus and Knickerbocker. 3rd. The C. Street Hospital for regulars, consisting of a couple of dwelling-houses, rear of the National Hotel, bas 78 beds. Name of Physician not given. 4th. Union Hotel Hospital, Georgetown, is an old tumbledown hotel, which bas been devoted to hospital purposes. It has 24 beds, and is attended by Dr. Gainselan and assistants. 5th. Seminary Hospital, Georgetown, \" is an old barrack-like structure, long used as a boarding school.\" It bas 162 beds, and is nnder the professional charge of Dr. J. R. Smith and four assistants, Wolverton, Riley, Norward and Kennedy. \".Small rooms, tortuous passages, and an insufficient water supply are the defects of the Hospital. And 6tb, the Military Hospital at Alexan- dria, \"formerly an old seminary,\" contains 104 patients. Dr. - of the navy is in charge, with two assistants, and eight lady nurse. In all the hospitals the nursing is done by \"ladies.\" Whether these are ladies of the Florence Nightingale stamp, or females of an inferior social standing, we are unable to say. With regard to the char- acter of the diseases, it is \"remarked that about 500 of the patients are suffering from wounds, a few from dysentery, a considerable number from articular rheumatism, and the remainder from typhoid fever, diarrhea,\u0026c.\" Surgeon-general Finley proposes to establish a Sanitarium for the convalescents at the naval academy, at Annapolis, and about 200 patients had been removed there.-Extracled and abridged from a letter of a corres- pondent to the .dmerican Medical Times, Aug. 24. \" AXTRAMANKAZ.\" In the course of a trial on a will case, in the Court of Probate and Divorce, before Sir C. Creswell, \"Jones versus Her ïMajesty's Proctor,\" the following curious evidence was elicited :- The plaintiff, Dr. David Griffiths Jones, when cross-examined by the Queen's Advocate, said-\"I bave practised homSopathy and also hydropathyfor nine or ten years. I combine the two systems. By hydropathy I mean hot and cold water treatment, diet, and exer- cise. I was originally bred an allopathist. I know a medicine called, not the 1 astra- mancax,' but the ' axtramankaz.' (Laughter.) I don't know at all what the word means. I bought the receipt froin which I make the axtramankaz from an old Dutchman in Lon- don, whose name I forget. It is a farinaceous substance, a substitute for cod-liver oil. It may be made of cereals, rice, and other compounds. There is a common vegetable produce in it. What it is, is my secret. I had an establishment for its sale at 449, New Oxford Street. I had an assistant there, Mr. George, who brought an action against me. The sale went on in New Oxford Street until 1857, when the establishment closed. The commodity is still sold at any wholesale chemists. I took ont a patent for it, butI forget when. I took my degree at Aberdeen in April 1853. The Dutchman's receipt was not written in Latin or in Dutch but in English. I have lectured on hydropathy and homoeopathy at varions halls in London and in the country.\" It was proved that the plaintif bad never been to Aberdeen, but there had been an understanding between hini and a man named Reeves, who had represented Jones at tho examination, and had obtained a degree of M.D. of laMarishal College, Aberdeen, by pas- sing the exanination, and signing the paper \" D.G. Jones.\"-Pharmacevtical Journal.",
         "BRITISH AMERICAN JOURNAL. The Debusscope.-This name bas been given to a recent French invention, wbich con- sists of two silvered plates, highly polished and of great reflective power, placed together in a frame-work of card board or wood, at an angle of seventy degrees. On being placed before a small picture, a design of any kind, no matter how rough, or whether good or bad, the debusscope will reflect the portion immediately under the eye, on all sides, forming the most beautiful designs ; and, by being slowly moved over the picture, will form new designs to any extent. The instrument gives the design in such a manner that it can be made stationary at pleasure until copied. It is, therefore, an inexhaustible treasure to draughtsmen and others. Setting aside the utility of the debusscope alto- gether, it can be made the means of gratification in the drawing-room, and, doubtless, will soon assume its proper place along with the microscope and stereoscope as a source of amusement.-Chemist and Druggist. New York Medical College.-Dr. E. Noeggerath bas been appointed to the chair of clinical midwifery, and diseases of females in the above institution, and a new chair of opthrmic and aural surgery bas been created, to which Dr. W. F. Holcomb bas been noruinated.-American Medical Times. BOTANICAL SOCIETY OF CANADA. REGULATIONS FOR THE EXCHANGE OF SPEcIMENS. The laws of the Society provide for the formation of a public herbarium and the extension and improvement of private herbaria. In order to accomplish these important objects, arrangements have been made for receiving from members contributions of dried specimens of plants, and for supplying in return the desiderata of such members. The following regulations have been framed for regulating the exchange of specimens: 1. The distribution of specimens shall be conducted by the Curators, and shall com- mence on the 15th November annually, before which time all contributions of specimens must be sent in by members who desire to participate in the distribution. 2. To entitle a Fellow or Subscriber to a share of the Society's duplicate specimens at any of the annual distributions, he shall have transmitted to the Society before the 1st November, not less than 50 species of plants, with as many duplicate specimens of the rarer ones as possible. 3. All specimens contributed to the Society must be carefully prepared, by being pressed between sheets of paper in the usual way, but not fastened down to paper in any way. Each specimen is to be accompanied by a label containing the name of the plant, together with the locality where collected, the date of collection, and the col- lector's name. 4. Universities and societies forming herbaria and corresponding with the Society will be permitted to take precedence of the members in the annual distributions. The Society's public herbarium will be invariably supplied with such specimens as may be required before any distributions take place. 5. Members are required to send, along with annual contributions of specimens, a list of those species which they desire to receive in return, or otherwise to specify in suffi- ciently explicit terms the nature of the plants wisbed for. The above rules will be strictly observed. Foreign botanists, in various parts of the world, have expressed a desire to contribute to the Society's collections. There are spontaneous and liberal offers from Tuscany, Sicily, France, Australia, and other distant parts. It remains for the botanists of Canada to say, by their contributions this autumn, whether the Society will be able to enter upon such advantageous ex- changes. Al) communications for the Botanical Society of Canada are to be addressed to Prof. Lawson, Kingston, C. W. 430",
         "MORTALITY IN MONTREAL. 431 STATISTIOS OF MORTALITY IN THE CITY OF MONTREAL. Fron Returns of Interments in the Mount Royal Cemetery, May and June, 1860. By G. E. FuNwicX, M.D. MAY. Disease. Stillborn ............. Small Pox............. Measles ............... Scarlet Fever.......... Convulsions........... Hydrocephalus......... Congestion of Brain Inflammation of Brain... Apoplexy ............. Disease of Spine........ Booping Cough......... Croup ................ Inflammation of Lungs.. Consumption.......... Disease of Heart........ Liver Compilaint........ Inflammation of Kidney.. Rupture................ Accidentail ............ Senile Debility......... General Debility.......i Infantile Debility ...... Unknown............. Total........ 1 1 i.. 1 .. 3.. i .. 3 .. 2 .. 2.. 2 .. 2 .. 2 .. 2.. 1i.. . 4f.. il.. i..l 3i.. 2.. 23.. 3f.. 43f 1 CI U I a~ 0. 0. c\u003e C . . . 1 !1 1 12..I 1 2i .. ..4 2.. .1. Of the above 23 were Males and 20 Fernales. JUNE. 1.... I.. .. .... . .. .. . .. ..I 1 .. . ..1.. .. 2.. .. 1.. ..1.. 1 .. ..o .. Stillborn .............. 2 Small Pox ............ 2 Measles ............... 2 Scarlet Fever.......... 5 Convulsions........... 3 Hydrocephalus......... 3 Apoplexy ............. 1 Delirium Tremens...... 1 Disease of the Spine.... 2 Hooping Cough........ 2 Croup ................ 1 Inflammation of Lungs.. 4 Consumption .......... 7 Disease of Heart ........ 1 *ApthS............... 1 Infantile Cholera....... 12 Dropsy ............... 1 Senile Debility......... 3 Infantile Debility....... 4 Accidental ............ 1 Not known............ 1 Total........ 59 2 .. .. ... .. 2 .1.... 2 1.. . . 1.... . 1. i.. r.. 1. . .12,.... 231 91.. .. .... 1.. 3 2 ...... 1. . . . . . . . ... .. . ... . . .. 1.. . . Of the above 28 were Males and 31 Females. .. ..1 .1. 1 . 1.. ..34.. :..1 .. . 1 2 .. 2.. 1.. il 1.. 1.. 1.. 21T81 6r 4 1 2 2 1 3 6 5 r, 1 2ý-8 i i Fi 10 8 31..,3 l 4| 2 21 1",
         "BRITISH AMERICAN JOURNAL. STATISTICS OF MORTALITY IN THE CITY OF MONTREAL. From Returns of Interments in the Mount Royal Cemetery, July and August, 1860. JULY. Disease. Stillborn .............. Small Pox............. Measles ............... Scarlet Fever.......... Fever................. Convulsions ........... Hydrocephains......... Croup ................ Inflammation of Lungs... Censumption .......... Dentition ............. Diarrhea ............. Dysentery............. Inflammation of Bowels.. Canadian Cholera...... Infantile Cholera....... Disease of the Liver.... Dropsy ............... Tumour............... Senile Debility......... Infantile \" ......... Accidental............ Not known............ .. .......... .. .. .. .. ....... ......................... ..........i1........ .................. .... ......1..4 2 3.. .. 12 Total......65 33 .1..l 1| 4| 3| 2ý Il 3..0 11110 1314 5r.5 71 5 Of the above 30 were Males and 32 Females. AUGUST. Stillborn .............. 4 4 .............................2.. .. 1 1.. Small Pox............. 1.. .. .......................... i.... .... .... Scarlet Fever.......... 3.. 2 1.. ........................3.......... Fever.................1.. .....................................1.. Convulsions ........... 4.. 4........................1 2.... 1. Hydrocephalus......... 6.. 5 1....................1.... 4 1.......... Epilepsy............... .. .. ...... .. .. .. .. .. .. 1.. .. .. ...... Apoplexy ............. 2 .. .. .............2.. .. .. ........ . Hooping Cough........1.. 1.............................i.......... Croup................. 1......................................1 Inflammation of Lungs.. 4.. 1 3..........................1.... 2.. 1 Consumption..........13.. 2 2 2.. 1 2 3 1.. ....1.... 1 3.. 3 2 1 2 Disease of the Heart... 2 .. .. .. .. ..1.... 1..................1.. .. Dentition.............. 1.. 1.. .. ................................... ApthS ................ 1.. I...................................1.... Asthma..............1............. ................1........ Inflammation of Bowels.. 1..........i..............i.............. Diarrhoea........ .....2 ...... .... ...1 .... 1i.... .... .. ...... i1... Infantile Cholera....... 3.. 3.........................,,.1.. i.......i Disease of Liver........ 2.............1.......i........... 1. Senile Debility ........ 4.. ................2 2.............1.... 2 1 Infantile Debility....... 5.. 5.. .........................2 1 1 Accidental............ 6 .. 1.... 3.. 1.... .. . .. ... I.. .. 4 Not.known,...........1 ..................................i. Total . 704289 2.. 5 56 33 1 2.. 21411 6112 0 611 Of the above 43 wereKiales and 27 Females.",
         "MORTALITY IN MONTREAL. STATISTIOS OF MORTALITY IN THE CITY OF MONTREAL. From Returns of Jnterments in the Roman Catholic Cemetery, May and June, 1860. MÂ.\u0026y Disease. Small Pox .......... Measles ............ Scarlet Fever......, Fever.............. Convulsions... Congestion of I:rain.. Tetanus.......... Paralysis........... Rooping Cough..... Croup ............. Inflammation ofLungs Consumption........ Disease of the Heart. Dentition .......... Worms ............ Disease of Liver..... Dropsy ............ Childbirth.......... Gravel............. Cancer ............ R1heumatism........ Abscess ............ Suicide ............. Senile Debility...... Infantile Debility. ... 1 2 2 1 10 126 - eq g. . .~ *U .. 1 2 J..3 . 86 ..7..9 c o O ~ Cc t~ O .. . .. .. .... 2i 2 5! 2 21.. .. . ..- 1.- 3 .. 1 -. ..2. 3... 2.. 1.. ,.....1 ..... 1 ..1 .. .. .... . 111.. 1 2 2 4 2. 2 ...] ... 1.. ..............................1 I.. 1.. il 6 5111 ~j3~ ____________________ I. - . - Total..... 22167ý75!23 3 1 81011 8 8 7..10 .. 1301312!242116631 Ofthe above 102 were Males and 119 Females. JuNs. Small Pox......... Measles ........... Scarlet Fever....... Fever.............. Convulsions .........* Inflammation of Brain Apoplexy .......... Paralysis........... Hooping Cough ..... Croup ............. Inflammation Lungs. Consumption ....... Disease of Heart .... Dentition .......... Diarrhœa .......... Disease of Liver..... Dropsy ............ Childbirth ......... Inflammation ....... Cancer ............ Charbon ........... Homorrhage ....... Accidental ......... Senile Debility...... Infantile Debility.... Total...... 13.. 1 .. 72.. 21 2 .. .............. .... .. ...... .-. ..: ..:*1··.. ..1 .... .. .... ..... 1 1 2. 1i.. .. . .. .. ... . ..1 .. . . .. . .1 .. 1 2 . ....... ... 1.. .. .. ... .. .. 1 ...... .. .. .. ....1.. .. .. .. ................... ..... .. 1 .. . .... .. 1 4 17.. 6.... 1 2 1 121 1.. .. 2026 9 ..,.6.. ..3 1-. 2 .. 1 .. 1.. -.1 ..1' 131 3.5 0f tqe above 138 were-Males and 151 Females. 433 1- -;- - 1 1 , .- .",
         "BRITISH AMERICAN JOURNAL. STATISTICS OF MORTALITY IN THE CITY OF MONTREAL. From Returns of Interments su the Roman Catholic Cemetery, July and .August, 1860. JULY. Small Pox........ Scarlet Fever.... Fever........... Convulsions...... Hydrocephalus...... Apoplexy ........ Paralysis ......... Delirium Tremens... Hooping Cough..... Inflammation Lungs. Consumption ....... Asthma............ Disease of Heart .... Dentition........... Diarrhea .......... Cholera ............ Dropsy ............. Childbirth.,....... Cancer.......... Charbon ........... Gangrene .......... Abcess............. Rheumatism........ Sudden Death ...... After an Operation.. Accidental....... Suicide ............ Senile Debility....... Infantile Debility .... Total...... .( Small Pox.......... Measles.......... Fever........... Convulsions ........ Hydrocephalus...... Paralysis........... Hooping Cough..... Croup.............. Inflammation Lungs . Consumption....... Asthma............ Disease Heart....... Dentition .......... Diarrhoa .......... Dysentery.......... Disease of Liver.... Childbirth.......... Cancer ............. Erysipelas........ Sudden Death ...... After an Operation.. -Accidental........ Senile Dèbility...... Infantile Debility.... *Total...... 18.. 2.. 7.. 2.. 2.. 1.. 1.. 3.. 6.. 19.. 1. 2.. .20 5.. 1.. 1 .. 2.. . 2.. 1.. 1.. 1 .. .5 .. 5 .. 15756 26516 Of the above 131 were Males and 134 Females. P cq Go M r.. \u003ejCiU1 JJ 2,U 2 U.2eic~ - 17. 611.. .. ...... .. ......1 4 10.... 9 1.......... ...... 342.. 11.... 4 2 2111.........3 11..-. ...-..........*.. .. .......... 2;.. 1 1J.......-...........1. ..... .... 3.......11....1l.. 1......... 3.. ... .......2.. 1.. .1... 1 .i. 1............1........... . . . 2 2 1 4.. 1 2. 4. .... . . . . 1 1 ..... 18 ... . 2 9 2 1.... 4 3......2.... 1. . . .. .j1.... 30'..30...........-.............5221. 10.. 5 1...... 1.. 2 1.... 1 3212 1.............1...*.....*.1. ......... 3..............1 1.... 2.. 2............ 2............2 ... .... .. *.. . .... . . 1 2 1 2-................... ....*......... i1....~...........................I 1...................1.....1............ 2.......... 1....................... 1..........-...1............. .... ..... 12.................1 110.. 1. 121. 2121i 21083126 1.. 2231814 19 261957 31 P '41 413115, 9 Il 8Î41.122 2 54. 34 23747133 58 C fh a..1 er3;.. 2 .. 1 .. ýf ~ ~ ~ ~ . ..e ..ov 1.. ..r ..le ..d -.4 ..a AUGUST., . .. 1 .. .. 3.1.. il1 1l.... .. 1,1.. 1.. 1 5 4 3 2 . 2.... . 81 1.. .. ... . 1.. 8 8j 91 8 7 ... 1.. 22 .... 1.. .... 6 19 ....91 1 4 1.. 3 2 2 6 ... ..I I161 2 ....0 2 ..1. 3.... 1 ..... ........ 2 2.. . 5 2.... 2 1.... 1.... 21.... .. .... .. 18155413 4212855 26 ý 1 , , 434",
         "BIRTHS, MARRIAGES, AND DEATHS. 435 BOOKS, \u0026c., RECEIVED. REPORT OF THE MEDICAL SUPERIN'fENDENT OF THE PRovINcIAL LUNATIC ASlLuM, Toronto, for the year 1860. Quebec, pp. 13. REPORT OF THE 3oARD O1 INsPECTORs OF AsYLUMS, PRISONS, \u0026c., for the year 1860. Quebec, pp. 176. THE PHYsIOIANS' PocKET, DosE, AND SYMPTOM BooK, containing the doses, and uSes of the principal articles of the Materia Medica, \u0026c., by Joseph H. Wythes, A. M., M. D. 3rd edition. Philadelphia: Lindsay \u0026 Blakiston. Montreal: Dawson \u0026 Son. 12mo., pp. 244. Price THE PnrsiciANs' VISITING LIsT, DAŸ BooK, AND MEMORANDA. Philadelphia: Lindsay \u0026 Blakiston. Montreal : Dawson \u0026 Son. Price from 50 cents to $1.25. THE NEw SYDENHAM SOCIETY's YEAR BoOK OF MEDICINE, SURGERY, AND THE ALLIED SCI- ENCES FoR 1860. London, 1861, pp. 578. A TREATISE oN DIsEAsEs oP THE JOINTS, by Richard Barwell, F.R.C.S., \u0026c. Philadel- phia: Blanchard \u0026 Lea. Montreal: Dawson \u0026 Son. 8vo., pp. 463. Price $3.00. THE MoRBID EFFECTS OF THE RETENTION IN THE BLOOD OP THE ELEMENTS OF THE URINARY SEcRETIN.-Fiske Fund Prize Essay, by William Wallace Morland, M.D. Phila- delphia: Blanchard \u0026 Lea. Montreal: Dawson \u0026 Son. Svo., pp. 83. Price 75 cents. TEE PATHOLOGY AND TREATMENT or VENEREAL DisEAsEs, including the results of recent investigations upon the subject, by Freenan G. Bumstead, M.D., \u0026c., with illus- trations on wood. Philadelphia: Blanchard \u0026 Lea. Montreal: Dawson \u0026 Son. 8vo., pp. 686. Price $3.75. BIRTHS, MARRIAGES, AND DEATAS. BmTHs. On the 24th August, in the village of Napier, the wife of W. Henderson, M.D., of a daughter. At Stratford, county of Perth, on the. 20th August, the wife of P. Shaver, M.D., of a son. At Orillia, on the 14th August, the wife of G. H. Corbett, M.D., of a daughter. In Montreal, on the 3rd instant, the wife of G. E. Fenuwick, M.D., of a daughter. In Almonte, Ramsay, on th 4th instant, the wife of Dr. Robert Howden, of a daughter. MARRIAQE. On the 4th instant, at the Parish Church of this city, by the VeryRev. Bishop Taché, assisted by the Rev. Mr. Papin, Curate, C. B. DeBoucherville, Esq., M.D., M.P.P., of Boucherville, to Susanne Elizabeth, youngest daughter of the late Robert Lester Morrogh, Esq., formerly Prothonotary of this city. At Rivière du Loup (en haut), on the 26th ult., by the Rev. Mr. Bouclier, Rector of the Parish, Antoine Lemaitre Augé, Esq., merchand, to Maria Anna, only daughter of the late L. H. Gauvreau, M.D. and M.P.P. DEATHS. At St. Michael's Cottage, Quebec, on Thursday, 29th August, Joseph Morrin, M.D., in the 67th year of his age. The late Dr. Morrin's faithful services to the profession of which he was one of the most distinguished ornaments, demand more than this mere passing notice as a tribute to bis memory, and we will endeavour to discharge this almost filial duty in our next. At Nicolet, on the 4th August, Emma, infant daughter of Dr. E. D. Fontaine, aged 4j months. On the 28th August, Dr. Delinelle, of St. Urbain, county of Chateauguay. Dr. D. was out shooting with a friend. The branches of some shrubs caught the trigger of bis gun, the barrel'of which was carelessly held under his arm. It became discharged, its contents lodging in the chest, causing his death in one hour. He leaves a wife and three young children to mourn bis loss. e was much esteemed-bythose acquainted with him. In Montreal, on the 23rd August, aged 73 years, Rebecca Ferguson, relict of the late Jacob Hall, Esq., and mother of Archibald Hall, M.D., of this city.",
         "ABSTRACT OF METEOROLOGICAL OBSERVATIONS AT MONTREAL -IN AUGUST, 1861. By Archtibald Hall, M.D. DAILY MEANS or THE THERÉME- WIND. BAIN AND SNOW. CLOUDS. 'u n. P. - . n GENERALOBSERVATIONS. Iuc's. o 0 0.100 0.10 0.10 0 * 0 10 Inch. Inch. Inch. 1 29.852 72.3 66.5 .87 5.0 3.3 Cu1. St. 79.2 61.0 N. i.0 0.32 ....... 0.32 FaintAurorallight at10 p.m. 2 29.782 76.5 66.3 .72 8.5 8.0 Cu. St. 82.2 65.3 S. 1.0 ...... ....-... ......... [4.50 p.m. 3 29.85876.0 62.9 .69 5.5 0.0 0.0 81.6 70.2W.N.W. 1.3 0.01......... 0.01 Thuunderstorm from S.W.at 4 29.76 76.2 67.8 .80 8.5 9.0 CU St. 82.0 65.0 S. 1.6...............ThundcrstormW.ai5.30p.m. 4 29.688 75.4 65.9 .76 7.5 4.6Cir. St. 82.4 67.2 N.W. 20 0.08......... 0.08 6 29.847 66.5 52.6 .63 5.5 6.0 Ou 70.7 60.6 W.N.W. 1.3 0.15 ......... 0.15 7 30.005 67.6 55.1 .GS 4.5 1.0Strat. 75.0 56.9 S.W. 1.3.................... ! 29.993 66.9 55.6 .69 3.5 1. 0 Cir. Cu. 75.0 62.5 N.N.E. 0.6 .......... ..... ... Faint Auroral streamers. 9 2U.4 68.4 56.0 .67 2.5 2.3 Cu. 75.0 56.9 E. 2.0 ......... ......... ... [at 2.30 p. m. 10 29 615 71.0 60.8 .74 5.5 5.0 Ou. St. 78.5 62.8 S.W. 3.0 .................. ..... Thunderstorm from W.S.W. il 29:870 66.3 55.6 .73 3.0 2.3 Cu. 72.8 56.6W.N.W. 1.3 0.57 ......... 0.57 Fait Auroral light. 12 29.975 63.1 52.4 .72 7.5 9.3 Cu. St. 68.2 55.5 N.E. 2.6 ...... ......... Urcles round sun 11 a.m. 13 30. 03 64.0 52.9 .71 6.5 8.0Cir.Cu.St. 71.5 55.8 N.E. 3.3...............Solar Haloa.m. 14 30.147 62.4 51.1 .70 4.0 5.3 Cir. Cu. St. 70.9 53.8 N.N.E. 2.0 ..... ......... 15 30.165 69.1 57.7 .71 3.0 0.3Cu. 76.6 56.0 S.W. 1.6....................... 16 30.116 70.2 58.4 .69 2.5 4.0 Cr. Cu. St. 78.2 56.0 S.W. 1.3 ......... ......... ......... 17 30.012 72.1 61.5 .74 5.0 9. 6 Ou. St. 78.6 63.4 W.S.W. 2. 3 Inap. ......... Inap. Distant Lightning. 18 30.054 70.7 61.0 .75 5.5 7.0 Cu. St. 77.0 64.2 W.S.W. 2.0 Inap. ......... Inap. 19 30.182 63.7 56.8 .80 5.5 2.3Cir.St. 70.8 50.5 N.E. 1.6....................... 20 30.246 63.6 56.5 .80 4.5 2.6Cu.St 71.8 52.2 E.S.E. 1.0........................... 21 30.044 67.2 60.8 .84 S.5 10.0 Ou. St 71.8 59.0 S.S.W. 1.0 ......... ................. 22 29.752 64.9 59.0 .86 7.0 6.3 Nimb. 70.6 61.4 S.W. 2.0 0.92......... 0.92 23 29.90 65.1 56.3 .77 4.0 0.6 Cu. 72.0 54.5 S.W. 2.3 0.52......... 0.52 2 30.02- 67.9 59.6 .77 5.0 4.3 Ou. St. 77.2 54.9 S.W. 2.0 ......... ......... ....... Distant Thunder. 26 30.106 69.6 61.5 .80 5.5 3.3Cu.St 77.5 60.0 W.S.W. 1.0 0.35......... (.35 Imperfect Lunar Halo. 26 30.081 69.7 64.3 .90 8.5 8.6 Nimb. 78.6 61.8 S.W. 1.0 ......... ......... ......... 27 30.002 70.4 65.4 .88 8.5 9.6 Ou. St. 75.0 05.2 S.W. 1.0 0.24 ......... 0.24 Thuuderstorm 7.15 p.m. 23 29.949 72.2 66.2 .S7 7.2 6.6Cu.St. 78.5 61.8 S.W. 1.3Inap. .........Inap. Lightning S. at evenng. 29 29.849 72.1 67.7 .0 6.5 4.0 Cu. 79.4 64.9 W. 1.6 0.17 ......... 0.17 Thiunderstorm from S.W.at 30 29.850 66.1 61.0 .88 8.0 8.3 eu. St. 73.3 57.2 W.N.W, 1.6 ......... ......... ......... 1.30 a.m. 31 30.010 60.8 55.5 .89 5.5 1.6 Ou. 66.7 53.8 W. 2.0 0.03......... 0.03 S's....... ...... ...--.... ........ ............. ............ ...... 3.36 I's 29.957 68.78 59.72 .775 ..... ............i7.43 59.6-. Ars~~~A G T .... .......... ABSTRACT OF METEOROLOGlCAL OBSERVATIONS AT TORONTO IN Conpiledfrom thte Records of thel Magnetic Observatory. THEEMOME- DAILY IEANS OP THE TER. Inches. 1\u003e 0-100 -l 29.5525 71.63 83 2 7826. .4735 72.05 82 4 1186. 6030 7.20 78 1 ............ Sun day ... .4840 73.17 78 8206. .5520 68.92 78 2 78 61.4 .6232 62.65 90 1 526. .6117 65.18 77 1 956. .4885 66.57 89 8 81.8 62.0 .30 69.15 72 7 80.0 57.2 ............ Sun day .. 8.2 66.2 .5900 57.92 84 1 6.8 57.8 .6892 60.77 80 109.55.0 .8545 59.40 ' 72 7 8 53.2 .8415 61.35 72 0 72.0 47.0 .7272 64.70 74 6 74.2 53.4 .7213 66.18 78 6 77.0 54.0 ............ Sun day .. 7.3 53.0 .7905 64.13 78 6 70.6 57.2 .8545 64.23 71 7 70.2 58.4 .6202- 70.48 83 10 80.0 58.5 .5710 61.70 - 81 A 70,8 60.5 .7407 63.15 66 1 75.4 51.2 .7882 .65.18 74 2 75.5 52.4 .......... Sun day'. . 75.5' 54.5 .6987 67.92 82 9 76.6 62.0 .6312 68.03 81 7 75.8 63.8 .6312 66.07 85 6 74Î8 58.4 .60-7 63.27 81 4 74.2 59-8 .6592 60.45 67 2 70.0 51. .7M40 59.40 63 4 69.8 49. 8 .65. 6..8 8 .. 7.. 4..... .0 5 29.,53165.8 ý, 8 '71. .30 O 63.5 66.5 67.0 67.5 64.0 61.0 61.0 66.0 68.0 55.0 59.5 57.0 56.0 61.0 67.0 58.0 55.0 70.0 60.8 53.0 63:5 61.5 66.5 68.0 65.0 54.0 52.0 WIND. ~ ej~2. .~ .~3 l'o 2.23 4.37 6.07 5.80 3.26 1.84 4.95 4.47 3.29 6.87 2.58 10.01 5.09 1.39 1.02 3.21 1.88 2.58 2.60 3.24 7.08 9.92 5.21 1.85 1.60 1.98 7.00 2.33 2:38 10.92 3.54 S. 5 E. N. 72 E. N. 84E. S. 37 W. N. 84 W. S. 80 E. N. 56 E.. N. 74 E. N. 68 E. N. 29 W. N. 88 E. N. 43 E., N. 54 E. S. 7 W. S. 25 E. S. 60E. S. 85 W. S. 80 W. N. 78 E. S. 89 E. S.,,49 W. N.ý \"W. N. 75 W. S. 41 W. 8. 50 E. ~S. 21 W. S. 29 W. S. 23 W. N. 75 W. N. 49 W. N. 31 W. Inch. .005 .465 .115 .015 .760 [nap. Inap. .575 [nap. ......... . E... . 4....2 2.953 N61.75. N.8 E. 4.21'4 1 Inch.1 0. 1e- GE1\u003cERAL IZEMAlIES. Dense fog during everng. Lightning in horizon. Nos.of Shoot'g Stars obser'd. Incessant lightni'g at night. Sultry dense fog at sunset. {Large Meteor at 9.21 p. m in S. W. burst throwing out sparks. {Auroral light and faint streamers. Solar Halo at 2 p.m. Thunder Storm, Solar Halo. Faint Auroral light. Lunar Corona. Solar Halo during foôréxnon. Showers duringýafternoon. Thunder Storm duri'g even. {Thunder Storm duris afternoon. I I I \"2 S's W'a 1 : AUGUST, 1861."
      ]
   },
   "version" : "0.4",
   "request" : "http://eco.canadiana.ca/view/oocihm.8_05183_21/1?r=0\u0026s=1\u0026fmt=json\u0026api_text=1"
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{
   "doc" : {
      "published" : [
         "Toronto : Bryant Press, [1894]"
      ],
      "identifier" : [
         "8_05187_191"
      ],
      "type" : "document",
      "title" : [
         "The Canadian practitioner [Vol. 19, no. 11 (Nov. 1894)]"
      ],
      "text" : [
         "Technical and Bibliographic Notes / Notes techniques et bibliographiques The Institute has attempted to obtain the best original copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. Coloured covers / Couverture de couleur D Covers damaged / Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin / La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: L'institut a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. Ei Coloured pages / Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées VIJ Showthrough / Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials I Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning /1 Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "CANADIAN PRACTITIONER EDITOR: ADAM H. WRIGHT, B.A., M.D. Tor. ASSOCIATE EDITORS: JAMES F. W. ROSS, M.D. Tor. JOHN CAVEN, B.A., M.D. Tor. EDMUND E. KING, M.D. Tor. PUBLISHERS: THE BRYANT PRESS, 20 BAY STREET. VOL. XIX.] NOVEMBER, 1894. [No. i i Original Conmunications. THE PÉAN-SEGOND OPERATION (VAGINAL TOTAL EXTIR- PATION OF THE UTERUS AND ADNEXA) IN SUPPURATIVE DISEASES OF THE FEMALE PELVIS. B% GEORGE H. ROHÉ, M.D., President of the American Association of Obstetricians and GynScologists. T HE proposition first made by Péan, that the uterus should be removed together with the appendages in case of suppurative disease in the pelvis, came like a shock to surgeons, even to those who are considered radical in their opinions regarding operation in inflammatory diseases of the uterine appendages. Operators who performed abdominal section and ablation of the ovaries upon indications considered totally unjustifi- able by many were taken aback by a proposition so revolutionary. And yet the foremost advocate of total extirpation in the United States is one",
         "ROHÉ: THE PÉAN-SEGOND OPERATION. who is known ds a leade: Zmong the conservative operators. There seems, then, something in this operation that appeals to those of conservative tendencies. At first thought this would appear somewhat paradoxical, but upon further consideration it becones evident that the operation is really conservative; for true conservatism does not consist, as some seem to think, in incompletely doing a large number of unnecessary operations. but in thorougly doing those operations that are necessary. More care- ful diagnosis, more judicious consideration of the pathology and causation, and greater familiarity with the clinical history of diseases of the female pelvic organs, iill result naturally in limiting the sphere of operative inter- vention in the course of these diseases. There is at the present day little doubt that the large majority of cases of tubal and ovarian suppuration depend primarily upon gonorrhœal infec- tion of the vaginal and uterine mucosa, and these cases are generally found associated with suppurative endometrial inflammation, no matter how remote the date of the original infection. It is, perhaps, possible that a gonorrhœal endometritis may be cured by properly directed local treatnent, but few mill be willing to admit that this is a common occur- rence, even in cases where the specifnc inflammation is limited to the endometrium. In cases, on the other hand, where the tubes and ovaries and the pelvic peritoneum are involved, the restoration of the ute-rin mucosa alone is not considered probablc. Hence advanced g) næcolo- gists have rightly abandoned topical treatment of the interior of the uterus in cases where the adnexa are the seat of suppurative inflammation. Manyof you know likewise, fromexperience,thebarrenness of results of such intra-uterine therapy after the removal of the appendages. How many cases can you not recali where dilatation, curetting, and antiseptic applica- tions, even destructive cauterizations, failed to change permanently the purulent character of the discharges and arrest the hSmorrhages from the uterus after ablation of the adnexa. In these cases the uÏerus itself must be regarded as a corpus delicti; not only troublesome to the medical attendant, but a source of anxiety, of coinplaint, and even of danger, to the patient, for there can be no doubt of the greater liability of a womb in such a morbid condition to septic or tubercular infection and cancerous degeneration. In cases of puerperal endometritis where there is a tubal involvement, the removal of all the affected organs would seem to be indicated. Indeed, in these cases the uterus is the source of greater danger from the large sur- face infected. From some personal experience, not altogether of a con- soling character, I arn led to the opinion that the removal of suppurating tubes and ovaries in a puerperal cas% is of little avail unless the uterus be removed at the same time. 800",
         "ROHÉ: THE PÈAN-SEGOND OPERATION. The objection has been made that this operation is a serious one ; that,.when successful, it deprives the woman of organs which characterize her sexually ; that, in short, while a woman may lose her ovaries and still remain a woian,ýyet, when the uterus is also removed, she is entirely unsexed and unnecessarily mutilated. Much of this sort of argument seems to me purely theoretical and unwarranted by facts, but its pre- sumptively authoritative character and constant asservation give it some dignity and standing. It would seem, however, that a living mother and housewife, even though deprived of uterus, ovaries, and tubes, is more desirable than a dead woman with these organs in her pelvis. It may be said that the alternative here suggested is exaggerated, hut those who have practised much obstetrics, and have verified causes of death in the puerperium by p7.rsonal autopsies, know well that the conditions are not overdrawn. In cases of dense adhesions of displaced uterus, tubes, and ovaries without pus formation, in which severe pain is one of the prominent symptoms, simple ablation of the adnexa, with release of the uterine adhesions, is usually insufficient to give relief. The attachment of the uterus anteriorly by hysteropexy or other method of antefixation, in con- junction with iremoval of the append2ge, is sometimes effective, but the entire extirpation of the uterus with the appendages is more successful. The complete extirpation of the uterus and appendages by the vaginal nethod for pelvic suppuration was donc for the first time by Péan on December 12th, 1886. The case was one of endometritis, complicated with salpingitis, pelvic peritonitis, and suppurating cysts of the ovaries. The uterus was large, inflamed, painful, and fixed in the masses of exuda- tion surroùnding it. The same operation was done on the 2oth of the saie month. In 1888, Péan did the operation four times. He described it, with its results, in a communication to the Paris Société de Chirurgie on July 2nd, 1890, and again before the International Medical Congress in Berlin in the saie year. When first performed, the operation found few supporters, but Segond, having performed it a number of times, became enthusiastic over the results obtained. Doyen, of Rheims, began operating by the vaginal method in 1887, and, at the Brussels Congress of Gynæcology in 1892, was able to report upon 77 cases. At the same congress, Segond reported 1o cases, Péan 150, and Jacobs, of Brussels, 58. The mortality in Segond's cases was a fraction over 10 per cent.; in Péan's, 6.75 per cent.; and in JacoIs', 2 per cent. In a later statistical report (July, 1893), the latter operator reports 140 operations, with a mortality of 1.42 per cent. At the semi-centennial meeting of the Berlin Obstetrical and Gynæco- logical Society in May, 1894, L. Landau reported 38 operations, with no",
         "ROHÉ: THE PÉAN-SEGOND OPERATION. deaths. It will be seen from these statistics that the mortality of what is now generally known as the Péan-Segond operation compares very favor- ably with ablation of the adnexa by abdominal section. But the mere statistical comparison of the immediate results of an operation is insufficient to enable one to form a judgment upon the desira- bility of this or that procedure in a given case. The claim is made that the ultimate results are better when both uterus and appendages are extir- pated than when the latter are alone removed. This claim finds strong support among American operators, who have, however, generally given preference to the removal of these organs by abdominal section. Those cases of extensive pelvic suppuration in which manyloperators (Mundé, Kelly, Pozzi, Landau, Laroyenne, and others) puncture or incise the purulent collections per vaginam, and drain, are, as pointed out by Péan, Segond, and Jacobs, espëcially suitable for vaginal total extirpation. In these cases it is often extremely difficult, as well as hazardous, to do a complete operation by the abdomen. Pus sacs are liable to rupture and infect the peritoneum, and when the pus is thick and adhesive thorough cleansing of the abdominal viscera smeared with this material is exceed- ingly difficult. The uterus and intestines are covered with thick masses of lympli so densely adherent as to make separation and thorough cleans- ing sometimes impossible. In these cases some American operators (Baldy, Krug, Polk, and others) remove the uterus with the appendages, and as much of the inflammatory new formation as practicable, by the abdominal incision. By the vaginal method the work of removal is ren- dered inuch easier and less dangerous, and a large opening is left, which, if packed with gauze, makes the best possible drain. To my mind, the operation of Péan-Segond finds in this class of cases its chiefest indication. Surgeons who have often done the adominal operation for total removal claim that by this method it is easier to deal with intestinal and omental adhesions, that everything is open to the eye, and that any injury to the intestines can be immediately and readily repaired. At first thought this seems a very plausible contention, but practically adhesions do not often materially interfere with the performance of the vaginal extirpation. If an intestinal fistula resuits, it usually closes readily in a fev weeks under gauze-packing and cleanliness. The objection so often made, that by the vaginal operation one is com- pelled to \" work in the dark,\" has been refuted by those having much experience with this method. My own observation and experience enable me to pronounce the objection untenable. Even where one has to deal with a narrow vagina, and a uterus high up in the pelvis, every step of the operation can be guided by the eye. Péan, Segond, Jacobs, Landau, and Doyen have generally found it 802",
         "ROHÉ: THE PÉAN-SEGOND OPERATION. possible to remove the uterus and appendages entirely. In the cases in which this is not practicable without exposing the patient too long to the depressing effects of prolonged anesthesia, the \"open treatment,\" with perfect drainage. gives the patient a much better chance for recovery than does the operation by abdominal section. The objection bas 'been made that the shock of extirpation of the uterus with the appendages is much greater than when the latter ire alone removed. Krug, Baldy, and Polk have denied that this is true of the abdominal method. My own experience teaches that in vaginal total extirpation the shock is not any greater than in simple abdominal section with ablation of the adnexa. The pain following vaginal extirpation when clamps are used is, undoubtedly, more severe than abdominal section. It only lasts, however, while the clamps are in position, and generally moderates considerably after the first twenty-four hours. 1 am inclined to believe that pain is greater when clamps are employed than when ligatures are used, but I regard the former as preferable, not only because the operation can be done in less time, an advantage not to be belittled, but also because hernostasis is more perfect. The forceps must, however, be tested for elasticity before use, must be trustworthy, and must be securely locked. When properly applied and the vagina firmly packed with gauze, protect- ing the mucous membrane against direct pressure of the forcep-handles, there is usually very little complaint on account of their presence. The after treatment is no more troublesome than after a simple abdominal section. A soft rubber catheter, with a button end (Pezzer's), is introduced into the bladder and allowed to remain until the first dress- ing is removed. After removal of the clamps and first dressing (in forty- eight hours), the urine is usually voided without assistance. Unless the patient is very weak, she may be allowed to sit up in eight to ten days. After the first dressing is removed the vagina should be cleansed once or twice daily with a douche of warm water. The bowels should be moved on the third or fourth day. Without desiring to be considered a partisan of the Péan-Segond operation in suppurative and other inflammatory diseases of the pelvis, I am convinced of its great superiority over simple ablation of the adnexa in all those cases in which the uterus is the seat of gonorrhoal, septic, or tubercular infection. 803",
         "THE ANTITOXINE TREATMENT OF DIPHTHERIA. By DR. J. J. MACKENZIE, B.A., Bacteriologist to the Provincial Board of Health, TORONTO. POSSIBLY no better example has yet been given us of practical resuits proceeding directly from careful scientific experimentation than the new blood-serum therapy in diphtheria and tetanus. The foundations of this work were laid in the careful study of the bacilli which cause these diseases, and the toxines which they produce, in cultures and in the animal body. It was noticed very soon that an animal which had received less than the minimum fatal dose of the diphtheria toxine had, upon its recovery from the effects of the dose, acquired a tolerance of larger doses, and that this tolerance could be greatly increased by carefully graduated doses until a considerable degree of immunity had been acquired against infection with the diphtheria germ. The next step of importance was the discovery that the blood 'serum of an animal thus immunized had the power of neutralizing, either in a test tube or in a second animal, a certain quantity of the diphtheria toxine. The introduction of the serum of the immune animal into a second animal conferred on the latter an immunity directly proportional to the degree of immunity of the first and the amount of serum introduced. It was naturally concluded that this immunizing action of the serum of an immune animal was due to a substance present in it, antagonistic to the toxine of diphtheria, or as it was called, for want of a better name, an antitoxine. The possibility of rendering animais immune to diphtheria by the introduction of an antitoxine led at once to the trial of the antitoxine on animals already infected, and, as one would naturally expect, it was found that much larger doses of serum were neces- sary to heal an established infection than to immunize against infection. Various methods of immunization have been tried with the object of producing the greatest possible immunity in larger animais, such .as sheep, goats, and horses, in order to obtain large quantities of a powerful serum for use on human patients. Behring, the pioneer in this work, uses the following method in sheep : a sufficient dose of a weak- ened diphtheria toxine is injected subcutaneously, so as to produce a slight febrile reaction ; this is repeated until no further rise in temperature takes",
         "MACKENZIE: ANTITOXINE TREATMENT OF DIPHTHERIA. 805 place ; the dose is then increased slôwly until large doses (50-100 c.c.m.) produce no reaction, when he proceeds further with doses of unweakened cultures. In this manner he has immunized some forty sheep in about six months, from which, by monthly bleeding, he can obtain a large con- tinuous supply of serum. Roun, in a paper before the International Con- gress of Hygiene and Demography at Buda-Pesth (Lancet, Sept. 22nd, 1894), gives an account of the methods used in Paris. The animals employed are horses, and, from the resuits, it seems a serum of much higher potency has been obtained than by any of the other methods. A preliminary report upon the results of the treatment on human sub- jects appeared in 1893, but it is only within the past few months that we are beginning to get detailed statistics. Of these some of the most interesting are those of Kossel (Zeitschrift fiir Hygiene und Infections krankheiten, Bd. xvii.). These relate to cases treated in the hospitals of Berlin extending over a considerable period, viz., from September, 1893, to May, 1894. His results are as follows; Number of cases treated, 233 ; deaths, 54, or a mortality of 23 per cent. of these 72 were tracheotomies ; deaths, 31, a mortality of 43 per cent. These figures speak very favorably for the treatment, especially when it is remembered that, being hospital cases, they are more likely to be of a severer type than those in general practice. But the best idea of the results of the treatment is obtained when we take into consideration the num ber of days after the commencement of the disease that the injections of serum were begun. This is shown in the following table: Day of illness. Treated.l Recovered. Died. Recoveries in percentage. I. 7 7 O 100 IL. 71 (9) 69 (7) 2 (2) 97 III. 30(7) 26(6) 4(l) 87 IV. 39 (14) 30 (10) 9 (4) 77 V. 25 (11) 15 (5) ro (6) 6o VI. 17 (7) 9 (2) 8(5) 47 VII-XIV. 41 (23) 21 (10) 20 (13) 51 Unknown 3 (1) 2 (1) 1 - Totals...... 233 (72) 179 (41) 54 (3) 77 The tracheotomies are in brackets. In the course of this series of cases it became apparent that much larger doses of serum should be used, and in the last 55 cases this was done. Of these 55 so treated, 25 of which were tracheotomies, only eight died (all tracheotomies), and of these three died of pure mechanical hindrance to respiration. There is no immediate reaction as a result of the injection of the serum, but within twenty-four hours the temperature drops, followed more slowly by the pulse. The membrane ceases to spread, and soon comes",
         "8o6 MACKENZIE: ANTITOX[NE TREATMENT OF DIPHTHERIA. off, and the diphtheria bacilli rapidlv disappear from the throat. An urticaria-like rash appears usually within two weeks of the injection ; this is apparently due to the action of the foreign blood serum, and not to the antitoxine. In the Berlin report there are records of three relapses, which makes it probable that the immunity produced by the serum injections only lasts for a few weeks. The Paris results given in Roun's paper before the International Congress are equally as favorable as those given above. Of 3oo cases where the diagnosis was confirmed by bacteriological examina- tion there were 78 deaths, a mortality of 26 per cent. Roun also gives a careful analysis of his statistics, and compares them with the results in the same hospitals under other methods of treatment, but it is not necessary to repeat them here. Suffice it to say that his results agree throughout with those obtained in Germany, not only in the lessened mortality, but also in the curtailment of the duration of the disease, and the rarity of complications following. It would seem, then, that we have in the blood-serum treatment of diphtheria something much more efficacious than anything that has yet been discovered. But we must not look for progress to stop here, because we have every reason to expect that, in the near future, a method will be found by means of which the antitoxine may be isolated fron the serum, and so concentrated that smaller doses will be required, and still better results produced. This has been done, to a certain extent, for the tetanus antitoxine, and it will surely be done for diphtheria also. [Since writing the above a method has been published (Zeitschriftfür Hygiene und Infections krankheiten, Bd. xviii.), which is briefly as follows : The goats are strongly immunized, when it is found that a certain quantity of antitoxine passes over into the milk ; this milk is collected, and, after separation of the fat and casein, the antitoxine is precipitated and dried. In this manner a continuous supply of the antitoxine is obtained without the serious drain upon the animal's health which the monthly bleeding necessitates.]",
         "THE POSITION OF THE SCIENCE OF MEDICINE IN THESE LATTER DAYS.* Bv GEo. A. PETERS, M.B., F.R.C.S., Associate Professor of Surgery and Clinical Surgery, University of Toronto; Surgeon to the Victoria Hospital for Sick Children, Toronto; Surgeon, Extern Dept., Toronto General Hospital. N opening this meeting, as president of the Toronto Medical Society, my first pleasing duty is to thank its members nost cordially for the very real honor they have done me in electing me to the highest office in their gift. In accepting the office, I can assure them that I do not lightly enter upon the duties appertaining thereto. On the contrary, I am pain- fully conscious of the responsibility which attaches to the chief executive officer of such a society; the more so when I recall the able and energetic manner in which my predecessors have fulfilled the duties of the position. \"May blessings be upon the head of Cadmus, the Phœnicians, or whoever it was that invented books,\" says the sage Carlyle, in a moment of somewhat rare eupepsia, and, when we recall the advances which medi- cal science has made through the labors of medical societies, we may, not inaptly, beatify their originator, whoever he was, in somewhat similar terms. The advantages which we may look to reap from thus associating ourselves together as a medical society are many and far-reaching, embrac- ing benefits to ourselves and our patients, and enabling us to contribute, to some extent, to the advance of medical science. In these latter days we are disposed- to plume ourselves upon the advanced position which our profession has attained, and to look back with self-complacent indulgence upon the crude pathology and empirical practice of our progenitors. In many respects, it may be admitted, we have cause ; but, if we reflect that, fifty years hence, those who succeed us may look back upon us as well-meaning, but clumsy and benighted bar- barians, we may be able to retain our becoming modesty. THE CUMULATIVE NATURE OF SCIENCE. Learning, in all sciences, is cumulative in its nature, and the science of medicine is a striking example of this law. * The present proud position of medicine is ours largely by heredity. We are, -in fact, the resultant of a *President's address before the Toronto Medical Society.",
         "PETERS: THE SCIENCE OF MEDICINE. long, tedious, and laborious process of evolution, in the various steps of which each generation of medical men-one might almost say each indi- vidual-has borne a brave and honorable part. It behooves us of this generation, therefore, to look to our laurels, to see that we contribute our full quota to the progress at present going on, so that posterity may not be able to charge to our account the \"sin of emptiness.\" The oppor- tunities enjoyed by the practitioner of miedicine of to-day are infinitely greater than ever before, but these opportunities carry with them correspond- ing responsibilities, which, in accordance with common equity, it is incum- bent upon us to assume. It is a startling as well as an inspiring thought that the medical embryo of to-day can, with a few years of earnest study, place himself, in relation to his profession, almost at the exact point at which even the leaders of a previous generation were obliged to leave ofn after a lifetime of unremitting toil and anxious research. Much of their labor was barren and unproductive, but the gernis of truth survived, and were incorporated into the compendious text-books which are placed in the hands of the modern medical student. By thus utilizing the work done by our predecessors, we are undoubt- edly making progress in rapid strides, but it must be confessed that the ultimate-the limit of all possibilities as regards the development of the healing art-is not yet in sight ; in fact, it is so remote that we need not seriously consider its existence, nor fear to be shocked by suddenly find- ing ourselves upon its dizzy edge. THE GERM THEORY. If there be any inhabitants upon the planet Mars, if they be observing us, as some speculative scientists claim, and if they could be supposed to take any interest in what we know as the practice of medicine, what would be the most striking characteristic of the problem which would confront them ? Would it not be the extraordinary phenomenon of a remorseless hand- to-hand battle, waged without quarter being asked or granted on either sI,-between a race claiming to occupy the very pinnacle of perfection of all animal life upon this earth-the self-styled lords of creation-and the meanest, the most ignoble, and the most helpless little vegetables in existence, variously known as gerns, or microbes-so contemptible in size that one of the principal weapons that must be employed against them is a frightful yawning microscope ? We can well imagine that a good fight is dear to the heart of the inhabitants of the war-god's own planet, but we blush to surmise what they must think of such a cowardly and ill-matched combat as this ! But perhaps the combat is not so unequal as at first sight appears. Let us investigate. Bacteriologists assure us that each germ has the power, under favorable circumstances, 808",
         "PETERS: THE SCIENCE OF MEDICINE. to reproduce itself in about twenty minutes. By a repetition of this pro- cess a single germ may, in fdrty-eight hours, become the proud parent of some 280 times as many little disease-producers like itself as there are human beings on the face of the earth. So that, as regards the mere question of bulk and numbers, the advantage is not where it would, to a superficial observer, seem to be. Then as regards effective fighting qualities. Thousands upon thou- sands of our race succumb annually to the prowess of the germ of tuber- culosis alone; the cholera bacillus brings to the dust from thirty to eighty per 'ent. of all it engages in conflict, and it has been estimated that in the fourteenth century the Black Plague-presumably a germ disease- carried off not less than twenty millions of people. iMoreover, the germ is invariably the aggressor. Unfortunately, we are not in a position to deny having furnished a very remote provocation. Indeed, it is recorded against us .that our very first parents took an un- warrantable liberty with the vegetable kingdom, and ever since the days of Sir Walter Raleigh we must abjectly plead guilty to repeated and pre- meditated onslaughts upon the potato ; but these too tempting edibles are very distant relatives of the germs which have taken up the quarrel and are waging such a formidable vendetta; and, since their immediate family was not molested, it certainly seenis a trifle officious on their part to take a hand in wreaking such a terrible vengeance. And we may further submit, in vindication of our own self-respect, that the methods of warfare pursued by these microbes is such as to alienate from them every vestige of the sympathy which their seeming helplessness and innocence might otherwise invite. They have no taste for the pomp and circumstance of war-the formal challenge and the brave advance in battle array. On the contrary, their tactics are treach- erous and traitorous to the last degree. Witness, for example, the plan of campaign followed by the bacillus tuberculosis. This germ hesitates not to subvert to 'ts own evil purposes the holiest affections of husband and wife; it flom ishes through the clinging tenderness of sister to sister, and it lurks in thîe kiss which the fond mother bestows upon her trusting child. By thus taking advantage of the most admirable and beautiful touches of human nature, this fell foe to our race often sweeps whole fami- lies into premature graves in a few short years. Again, \" a cup of cold water \" is one of the blessings for the donation of which a sure reward has been promised, yet the cholera bacillus chooses this apparently harmless medium more often than any other as the means of entering the domain of its victim. We dignify the weapons of these germs as \" ptomaines,\" \"leucomains,\" \" toxines,\" \"albumoses,\" or \" the metabolic products of their vital activity,\" mainly because it is too disgusting to think what they 809)",
         "PETERS: THE SCIENCE OF MEDICINE really are. Suffice it to say, that the arms of such germs as the bacillus foetidus and bacterium termo are of such malodorous character that the stink-pots of mediæval warfare were delicate perfumery in comparison. There are, it is true, important side issues in the practice of medicine with which, so far as we know at present, germs have no connection what- ever; but, in these days, the gern theory of disease so colors the whole field of view as to practically obscure every other question. Now, this cause of disease has, doubtless, existed since the beginning of time. We know, for example, that all the firstborn of Egypt died in a single night, and we may fairly assume, without questioning for a moment the miracu- lous character of the epidemic, that the cause was some virulent germ, which, in this instance, was compelled to manifest a peculiar selective action. The children of Israel, very early in their career as a natton, passed stringent laws for the segregation of their lepers, though the bacil- lus lepræe was discovered so recently as A.D. 1874 by Hansen, of Bergen. We read also that Satan \"smote Job with sore boils, from the sole of his foot unto his crowi,\" though it is certain that the patient patriarch was blissfully ignorant of the fact that the immediate cause of his sad affliction was the staphylococcus pyogenes aureus. In view of these facts, then, it is doubtful if any of us fully realize the importance of the stupendous discovery that bas burst upon us during the last five and twenty years. ANTISEPSIS AND ASEPSIS. The discovery having been made, however, the leaders in our pro- fession--among whom our own English Lister, the French Pasteur, and the German Koch tower head and shoulders above the rest of their genera- tion-were not slow to act upon it, with the result that, for a few spasmodic years, it was even thought that, by the aid of carbolic acid, corrosive sub- limate, iodoform, and other chemical ammunition, the strongholds of our at-last-revealed adversaries were to be speedily laid low. This was the brief and not too brilliant dynasty of antiseptics. Soon recognizing, however, that to destroy germs in a test-tube is a very different thing from dislodging theni from their entrenchments in the human body, and that substances which are poison to the microbe are not always innocuous to its host, it early became clear that to avoid a conflict with such a subtle enemy is even better than victory. Thus, again, was the truth of the old aphorism exemplified, that \"discretion is the better part of valor,\" and thus, also, was established the era of \"asep- sis\" and \"preventive medicine.\" Accordingly, the wary physician of to-day, upon the first signal of danger,,,proceeds at once to place himself in an attitude of defence, and endeavors to keep the foe at bay by atten- tion to the hygienic environment of his patient, by strengthening the resist- 8IO",
         "PETERS: THE SCIENCE OF MEDICINE. ing power of his constitution, and by embarrassing the commissariat department of the microbes by a chemical disinfection of the whole area of the prospective battle-ground. Nowhere, perhaps, is the idea of \"prevention \" more apparent than in the field of surgery. In fact, it may be admitted that almost all the recent advances in surgery are owing to our newly-acquired ability to prevent suppuration and inflammation with some degree of certainty, and to bring about the healing of wounds by first intention. CONTRAST OF SURGERY ONE HUNDRED VEARS A.GO WITH THAT OF TO-DAY. To give an idea of the condition of surgery as it existed about one hundred years ago, I quote from Pilcher's interesting work on \" The Treatment of Wounds.\" John Bell, in his delightful discourses on \"The Nature and Cure of Wounds \"(Edinburgh, 1795), claims that the surgeon \" does all his services by observing and managing the properties of the living body, where the living principle is so strong and active in every part that by that energy alone it regenerates the lost substances, or unites in a more immediate way the more simple wounds.\" \" Thirty years ago,\" he says, \" surgeons had no settled notions that cut surfaces might be made to adhere ; they had no motive for saving the skin, or where they had saved it they did not know how it should be used, nor how much it mnight contribute to, a speedy cure ; if thev extirpated a tumor, they cut away along with it all the surrounding skin ; if they performed the trepan, they performed in a most regular manner that preliminary operation which they chose to call scalping ; or, in plain terms, they cut away six or eight inches of that skin which should have saved the fractured skull fro.n enfoliation, and should have immediately covered and defended the brain ; in performing amputation, they cut by one stroke down to the bone, and even when they performed the 'fiap amputation they dressed their stump and flap as distinct sores.\" The subject upon which discus- sion ran high in Bell's time was that of procuring the repair of wounds by immediate adhesion. The French surgeons had declared, not only that their flap operation procured an easy and perfect cure, but they affirmed that often in three days the flesh of such a stump had adhered. To this a contemporary of Bell's, O'Halloran, whom Bell characterizes as an excellent and most judicious surgeon, whose doctrine and practice were followed by all the best sur- geons of that day, had replied: \"I would ask the most ignorant tyro in our profession whether he ever saw or heard even of a wound, though no more than one inch long, united in so short a time ?\" adding, \" These tales are told with more confidence thanveracity; healing by inosculation, by the first intention, by immediate coalescence without suppuration, is nerely chimerical, and opposite to the rules of nature.\"",
         "PETERS: THE SCIENCE OF MEDICINE. Is it not an astounding fact that the very thing which, scarcely more than a century ago, was regarded as \" chimerical, and opposite to the rules of nature,\" viz., healing of wounds by primary adhesion, has, to-day, become the universally acknowledged standard of proficiency in the art of surgery? This should warn us that we must not allow our egotism to prescribe limits to the possibilities of the development of medical science in the future. Yet, notwithstanding this, I will venture the opinion that in attaining the healing of wounds by first intention we have arrived at an ultimate fact in surgery. In a word, to achieve that result realizes our highest ideal in regard to wound treatment. In his endeavors to reach this ideal, the surgeon has discovered that be must surround the wound with precautions to prevent the entrance of all possible sources of disturbance, so as to allow the reparative processes of nature to have full sway without let or hindrance. Neglecting, for the moment, all thought of mechanical irritants, we may say, in brief, that the problem he sets himself is to prevent the access of those vegetable germs which research and experience have shown to have the baneful power of destroying and consuming the lymph and leucocytes which constitute the building material employed by nature to repair the breaches in living tissues. It is a hopeful sign of the times that, should a surgeon find that lie has failed in this, and that suppuration has occurred in an operative wound the environments of which have been under his control, he not only feels chagrined, but has a vague and uncomfortable feeling that a certain stigma has fallen upon him because he has failed to reach his ideal. While such a failure should put him on his mettle and lead him to closely scrutinize the technique of his operation, I submit that he may often reproach hiniself unjustly for such a result. I have once or twice been shocked to see rash statements in works * aspiring to be standard text- books of advanced ideas, to the effect that any surgeon who acknowledged to having suppuration in his practice convicted himself thereby of culp- able negligence, and rendered himself amenable to action for malpractice. Watson Cheyne, Tubby, and many others have shown that, if septic mat- ter be injected into the veins of a rabbit, and a subcutaneous or even suhperiosteal fracture of a bone be produced at the same time, suppura- tion will probably occur at the seat of fracture ; and, surely, so long as there continue to occur, without obvious external wound, such instances of suppuration as thecal abscess, empyema, and acute osteomyelitis, those who are addicted to the habit of committing themselves to paper without adequate preparation and study might at least restrain themselves from making such sweeping and damaging assertions. We have much yet to learn about \" blood antisepsis \" and \"intestinal antisepsis.\"",
         "PETERS: THE SCIENCE OF MEDICINE. Now, while I have been exalting the value of asepsis in surgery, I desire to avoid leaving the impression that, in my opinion, the days of antisepsis are numbered. On the contrary, we still find, and no doubt shall always find, antiseptic measures indispensable in preparing the field for our operations; in the disinfection of foul and sloughing ulcers and abscesses, in cleansing recent wounds of infective material, and in purifying wounds which have been infected before coming under ôur care. Manual dex- terity, ingenuity in designing operations, and mechanical skill in carrying out these designs, we can scarcely expect will ever be greater than in the days of Syme and Liston. These qualities are not hereditary in the same sense that the term applies to the scientific aspect of surgery. The edu- cation of the hand and eye, familiarity with mechanical principles, and dexterity in the use of instruments, are attributes that each surgeon must acquire for himself, and it must be acknowledged that the facilities which we place in the hands of our students for this object are all too small. PREVENTIVL MEDICINE. In the practice of medicine, as distinguished from surgery, the ques- tion of prevention of disease assumes a more comprehensive and cosmic aspect. The physician, in his capacity as a hygienist, shapes his measures so as to prevent outbreaks of disease in communities. The surgeon con- cerns himself with the limited area of a wound and its environments, but the physician has the larger task of surrounding a locality with the safeguards of good drainage, clean lanes and streets, pure water for drinking and cleansing purposes, and prompt and complete removal of sewage and garbage. The importance of the work of Boards of Health and of Medical Health Officers is becomi.ng, year by year, more apparent. In olden times, epidemics and plagues were looked upon as visitations of a retributive Providence, exasperated by the sins and shortcomings of the people; but, in these enlightened days, the advent of an epidemic of smallpox, cholera, scarlet fever, diphtheria, or typhoid fever is greeted with a feeling bordering closely on indignation, and the omniscient people immediately proceed to make a pretty careful canvass of the sins and short- comings of the unfortunate Medical Health Officer, or Board of Health. In short, the profession has \"educated the people up\" to the belief that, when such a calamity happens, \"someone has blundered,\" and hence the feeling. Is it too much, then, to hope that in a few decades some, at least, of the preventable diseases may follow the plague, or Black Death, to oblivion ? Typhus fever is well on the way, and smallpox might, in a few years, be relegated to the realms of tradition were it not for the sense- less opposition of a few addle-pated obstructionists. THE FIELD OF THERAPEUTIcS. But, while great advances have been made in the prevention of dis- ease, it must be acknowledged that the list of our efective therapeutic S13",
         "PETERS: THE SCIENCE OF MEDICINE. agents is increasing with discouraging slowness. I lay stress on the word \" effective,\" for the very obvious reason that our waste-baskets are literally flooded with new preparations for which extravagant merits are claimed, but which do not stand the test of time and experience. It is a somewhat remarkable fact that almost the only real specific we have is a vegetable alkaloid-quinine-which appears to have a destructive action upon the only animal parasite which infects man constitutionally. It is almost to be regretted that the more attractive field of lymphs, animal extracts, and antitoxines has enticed many investigators away from' the minerai and vegetable kingdoms, which have, somewhat unwillingly, yielded us mercury, iron, quinine, opium, digitalis, and chloroform. Our curative drugs are few, indeed, but the most pronounced pessimist will scarcely deny that we have many agents which greatly palliate the distressing symptoms of dis- ease, and not a few which have a decidedly favorable influence upon the course of a malady. As some person has wisely said : \" The pilot at the helm of a tempest-tossed ship cannot curb the storm, but he may guide the distressed barque safely to her haven of rest \"; and so with us, though we can seldom cure the disease, we can frequently so modify its course as to turn the wavering halance in favor of the scale of life. ANIMAL EXTRACTS. The bearing of advances in our knowledge of physiology is shown by the attention that is being devoted to the therapeutie value of the animal extracts. Brown-Séquard and D'Arsonval, the originators of the move- ment, base their expectations upon the theory that each gland, in addition to its secretion into its duct, gives something also to the blood, which may be called its internal secretion, and which is useful or necessary in main- taining the normal heaithy state of the organism. For example, the thyroid gland-which, by the way, however, is a ductless gland-is now known to have a certain function in the elaboration of the fluids of the body. It is further known that ablation of that organ, or failure in its function from disease, produces that peculiar malady, myxodema. With a correspondence of theory with fact, which is the more gratifying because of its rarity, it is found that the administration of a properly prepared extract of the thyroid of other animals has a distinctly curative effect upon this disease. As an isolated fact, this may not be considered a very important matter, owing to the comparative infrequency with which the disease is encountered, but as an example of a new departure in therapeu- tics it is of absorbing interest. It is now in order for some investigator to come forward with an extract of the suprarenals for the cure of Addi- son's disease, or with an extract of the lymphatic glands for the cure of leucocythemia. There is a vast deal yet to learn of the physiology of many organs of the body, and when the physiologists know more of these",
         "PETERS: THE SCIENCE OF MEDICINE. the experimental therapeutists may furnish us with useful extracts of the spleen, prostate, pineal gland, pituitary body, and other structures which are at present adjudged functionless. There is a large and imposing monument awaiting the genius whose happy lot it may be to isolate a useful extract of the vermiform appendix of the wombat, one of the very few quadrupeds, I understand, which are decorated with this intestinal frill. Seriously, however, if these extracts are ever to be such as to merit the confidence of the profession, it is apparent that they must be prepared with care and skill by a competent physiological chemist. There must be some attempt to realize in the extract that part of the organ which shall, when injected into the blood or tissues of the patient, be able to represent, to some degree, the frinction of his disabled organ. To mince up the brain, the heart, or the liver of an ox, and dignify the filtrate obtained therefrom by such pretentious names as cerebrine, cardine, or hepatine, is surely the acme of quackery. It would certainly be an excel- lent thing to have an examining institution, under the control of the State or some properly qualified and responsible authority, under whose judicial scrutiny all such alleged cure-alls should be required to pass before they could lawfully be placed within reach of a too-confiding public. IMMUNITY. A very much more hopeful outlook, however, is afforded by the work which is now being done by clever men in rendering animals \"immune \" or \" refractory \" to certain diseases. The behavior of bacteria in presence of their own excreta, and in feeding grounds that have been browsed over, as it were, by an allied tribe, or by an adroitly attenuated generation of their own species, suggested to Pasteur, Koch, and other savants, the idea of establishing such artificial conditions within the body as would render it hostile to the germs of disease, and so prevent their development. It falls not within the scope of this paper to discuss the theories of immunity. From a practical point of view, it matters little which is cor- rect-the theory of exhaustion of the soi] as believed in by Pasteur and Cliff; the theory of adaptation as expounded by Grawitz and Flint, who believe that acquired immunity consists in the transformation of the biological function of the organism; or the theory of retention of Chau- veau, who explains immunity by supposing that the bacteria first intro- duced secrete a material that remains in the body, and prevents a later development of the same organism. It is curious to note that variolation or inoculation of smallpox was practised from time imnemorial in China and Persia. The practice was imported into Turkey, and thence intro- duced into Great Britain by Lady Mary Montague in 1721. Vaccination was not discovered by Jenner until 1798. Recent investigations by Eternod, Haccius, Copeman, Klein, and others, whose results were freely 815",
         "PETERS: THE SCIENCE OF MEDICINE. discÙissed at the last meeting of the British Medical Association, seem to point to the fact that variola and vaccinia are really the same disease. So that probably what Jenner actually used was a virus which had been acci- dentally attenuated by passing through the comparatively refractory tissues of the cow. In this view of the case, then, the attenuation would be called upon to account for the fact that the vaccinia was not infectious, as the varioloid unfortunately was. At all events, these early inoculations, made, it must be admitted, in a somewhat empirical manner, were the pioneer instances of this plan of treatment, which is to-day, perhaps, the most promising feature of curative and preventive medicine. As it is only reasonable to expect, opinions differ as to the theory of action of the immunizing agents. Welch says : \" We now know the protective influence of the blood serum of immune animals consists quite as much in the power to destroy the poisons produced by the bacteria as in the power to destroy the bacteria directly \"; and he deduces from this fact the idea that \"the antidotal capacity of the blood and animal fluids may be one of the means employed by nature to dispose of the pyogenic cocci.\" Pasteur, in speaking of the action of the infusions prepared from the desiccated cords of animals affected with rabies, considers \" that, together with the modified virus enclosed in the desiccated cords, there exists special chemical products elaborated by the microbe of rabies which play a part in the production of immunity.\" Kitasato showed \" that in animais, at least, by the inoculation of certain chemicals, immunity against tetanus infection may be secured; and, further, that the blood of these animals made immune against the disease may have the effect, when injected into other animals, not only of preventing infection, but of curing the disease when it is definitely estab- lished.\" Gamaleia considers that immunity to certain diseases enjoyed by various animais is due to the presence in their tissues of certain \" defensive pro- teids,\" which he thinks are also developed in the processes of vaccination. Having thus merely grazed the subject of the causes of immunity, let us turn for a moment to the results which may be placed to the credit of the theory. The results which have been obtained through vaccination against smalipox are too widely known to require more than a mere mention. Dr. Haffkine's method of inoculation against cholera is still on its trial, but as one instance of its success the following may be mentioned : \" Of 200 inhabitants of a native bustee (hamlet) 116 were inoculated with the protective vaccine. Not long afterwards an outbreak of the disease occurred in the hamlet; ten persogs were affected, none' of whom had been inoculated, and seven died. All those who had been inoculated remained free.\" At all events, Haffkine's work has made so great an",
         "PETERS: THE SCIENCE OF MEDICINE. impression in India that the municipality of Calcutta voted unanimously to devote a sum of money to thoroughly test the system for two years. Smallpox and cholera are the only two diseases which have so far been proceeded against systematically by vaccination. The use of \"lymphs,\" \"antitoxins,\" and \"defensive proteids\" in other diseases partakes more of the nature of curative than of peventive measures, but the results which have been obtained are scarcely less encouraging. Pasteur has been able to reduce the mortality in rabies from 80-90 per cent. to less than i per cent. In the Children's Hospital, in Paris, the mortality from diphtheria has been reduced from 50 per cent. tO 26 per cent. by Roux's antitoxin, system. Tizzoni and Cattani have had gratifying results in a number of cases of tetanus. Among the lower animals it appears that experimenters can, with the greatest ease, produce immunization against almost any dis- ease. Millions of sheep in various parts of thé world are absolutely pro- tected fron antbrax by inoculation. Mice, rats, guinea pigs, rabbits, cows, horses, and other animals, have been immunized from septicæemia, cholera, tetanus, glanders, anthrax, and diphtheria, and it is surely only a question of time when these desirable exemptions may be extended to man. - But while we are encouraged to hope that, in the near future, we may learn to prevernt many diseases and to cure others, there stilr remains a vast ndmber of diseases upon the prevention of which we have as yet had little light thrown. The whole class of tumors, malignant and non- malignant ; the congenital deformities, such as club-foot, harelip, and monsters of all kinds, are generally agreed to have a cause which exerts its malevolent influence before birth, and of the nature and prevention of which we are practically in total ignorance. We also have to lament our impotence in the prevention and cure of the slow and insidious inflammatory diseases, such as locomotor ataxia and other scleroses of the nervous system, atheroma, rheumatoid arthritis, Bright's disease in its chronic form, cirrhosis of the liver, etc. THE NEUROSES AND INSANITIES. Preventive medicine finds ample scope for the exercise of its mission in the field of the nervous and mental diseases. That pitiable class of our fellow-men who are the subjects of disturbed mental equilibrium seens to be doomed to perpetual despair, so far as benefit from treatment is concerned. The figures of Tuke and Bucknill, Thurman and Pliny Earle, have shown that, \" out of eleven persons who become insane, nine ultimately die insane, and, of the remaining two, but one entirely recov- ers.\" One of the saddest features of this subject is the fact that, so far from our being able to prevent insanity, that maladv is distinctlv on the",
         "PETERS: TE SCIENCE OF MEDICINE. increase. In the Milroy Lectures, 1894, Dr. John Berry Haycraft showed, in a very interesting manner, that, in a chart compiled from the Registrar- General's Reports (Great Britain), the curves representing the prevalence ,of the neuroses and insanities are almost the exact reverse of those show- ing the fluctuations of the zymotic and infectious diseases. While the growth and development of hygienic and preventive medicine are slowly overcoming the virulence and spread of the zymotic diseases, the insani- ties and neuroses are on the increase, owing, as explained by Mercier, to the increase of their factors, viz., heredity, on the one hand, and, on the other, the increase in the complexity and severity of the stresses of social and civilized life. In the discussion on \" The Prevention of Insanity,\" at the late meeting of the British Medical Association, the general feeling seemed to be that the time is not yet ripe for legislation on the subject, but that the way must be slowly prepared by the education of public opinion. The president of the section of Psychology expresses himself as being \"convinced that the only way to really diminish and stamp out insanity is by so educating public opinion that those who have been insane or are threatened with insanity shall, in the face of such public opinion, abstain from bringing into the world children who must certainly contain in them the potentiality of insanity, who will some of them de- velop it if others escape, and so will hand on the heritage from generation to generation, till the race dies out.\" OUR INTERFERENCE WITH NATURAL SELECTION. As a race, it cannot be denied that in these latter days we are deliber- ately interfering to a very appreciable extent with the processes of natural selection. How many rickety, syphilitic, scrofulous, tubercular, and im- becile children are kept alive through the agency of our hospitals, and raised by excessive care and pampering through a sickly and unhappy childhood ! Such objects are exultingly pointed out as triumphs of the healing art ; they struggle on past puberty, rnarry early, generally seeming to prefer consorts a little worse than themselves, and, since they seem to retain the power of reproduction withl great pertinacity, frequently have large families, who partake of the vicious physical and mental qualities of both parents. In this connection I cannot do better than again quote from Haycraft, who puts the case very strongly: \"I do not see how we can shirk the fact,\" he says, \" that preventive medicine and civilization, between them, have alreadly deteriorated in a very marked degree the healthy vigor of our race. If things continue in their present course, it is fair to assume that in a hundred years or so the wretched products of our race-embodiments of every constitutional disorder transmitted by ances- try from whose ranks the diseased have not been weeded out, before the child-bearing period was over, by those natural agencies hitherto free to 818",
         "PETERS: THE SCIENCE OF MEDICINE. act-will drag out their lives, martyrs to surroundings which they have tried to mould; they who, as a race, should have been moulded by their surroundings. Preventive medicine is trying a unique experiment, and the effect is already discernible-race decay. But the experiment has gone quite far enough, and it should be modified to produce a different result. Why should the microbe select ? Why not public humanity and public reason, since selection there must be ? This appears to be the only possible solution of the difficulty, for it is not to be desired that pre- ventive medicine should cease from making war upon the microbe, pro- vided other selective agencies are used to replace them. Is it not our duty, by boldly facing facts and publicly stating them, to endeavor to bring about such strong public opinion as will force people to look upon the act of giving birth to a diseased child as one of the most cruel sins ?\" Powerfully and ably as these sentences place the subject before us, it seems to me that the question of the destination of the race is too large for us. Its solution must be left to the omniscience and omnipotence of Him who determines the destinies of man and microbe. We have been largely endowed with the instinct of self-preservation, and with intellect to guide that instinct. Our instinct is unselfish, in so far as it extends to our fellows ; it is tender and sympathetic inasmuch as it embraces the preservation and welfare of those weaker and more helpless than our- selves; and it is merciful in that it drives us not to the wanton destruc- tion of other forms of created life, though we grant that no scruple restrains our destructiveness, when necessary in self-defence, or when required for our subsistence and the continuation of our species. 'Certain it is that, individually, we need not.let the responsibility for the deterioration of the race rest heavily upon us. The circle which each of us has to fill in the economy of creation'is an extremely narrow one. The standard which we try to live up to in our profession has been slowly evolved through the long ages, and we believe that we are realizing our highest ideal when we do our utmost to preserve and prolong human life. whether that life is manifested in the glorious body of a stalwart, godlike man, or in the shrunken frame of a feeble, wailing infant. 8IQ",
         "HiEMATOCELE DUE TO EXTRA-UTERINE GESTATION.* By DR. T. P. KENNEDY, WINGHAM, ONT. Mr.~President and Gentlemen: O N the 9th day of June last, I was called to see Mrs. B., æt. 33, mother of three children, the youngest six years of age. Had had several miscarriages, the last one occurring about three years ago. Said she had had womb trouble the last five or six years, and had been treated for it by several physicians. She now complained of menorrhagia. Said she had been flowing off and on for the last four weeks, and also had at intervals during that time slight crampy pains on the right side. Once or twice these pains had been so severe that she had resorted to a morphine pellet for relief. Her tenperature was normal, her pulse good, and she was up and around attending to her household duties. I advised rest, and prescribed potass. brom., tinct. hyoscy., and some 3 grs. ergotine pills. I saw her again two or three times during the week, and as the flow still persisted advised an examination. At the time I suspected the possi- bility of extra-uterine pregnancy, but as I could find no swelling, nor bulging, nor apparent enlargement of the tube, I dismissed the idea from niy mind. , There is no doubt now, judging from the subsequent history of the case, that there was enlargement of the tube at that uie, and I should feel chagrined, indeed, at not having discovered it if I did not know of men of eminence who have made similar mistakes. Amongst others, I have personal knowledge of a case that went to Lawson Tait desiring operation. Upon examination he dismissed her, telling her that she had no tubal trouble requiring operation. In the course of a month or six weeks she returned, and insisted upon operation to relieve her sufferings. Upon abdominal section Tait encountered the most for- midable adhesions. In speaking of these cases Tait says, in his \" Lectures on Ectopic Pregnancy \": \" Absolute accuracy of diagnosis in the abdomen' is very far from being possible; only the ignorant assert that it is, and only fools wait for it.\" Failing to discover any enlargement of the tube, as I have said, I dismissed the notion of'tubal pregnancy. As the uterus was * Read at the meeting of the Huron Medical Association.",
         "KENNEDY: H.EMATOCELE. 821 somewhat enlarged and tender on bimanual examination, I considered my case one of endometritis, and advised curetting. This I accordingly did on the 18th day of June, scraping out about two teaspoonfuls of fungous material. I washed out the uterus with a carbolic solution, and applied Churchill's tincture of iodine to the endometrium. There was no re- turn of the hæmorrhage, no fever, and the patient did well for a week. s On the 25th of June, just one week later, I was called up suddenly, and told, by the messenger, that Mrs. B. was dying. I hurried over, and found her almost in a state of collapse, pale and faint, vomiting, and suf- fering the most agonizing pain in pelvis. I gave her sufficient morphine hypodermically to control pain, and applied hot stupes to the abdomen, ordered vaginal douches of carbolized solution (1 in 4o) as hot as could be borne, a gallon every four hours. Next morning when I saw her the pain was comparativelyeasy; temperature, io3¾° ; pulse, 1o8. Prescribed quin. sulph., grs. iv., every four hours, and Rochelle salts, 3i., every three hours till bowels moved. I was at a loss to account for this sudden attack of what I considered pelvic cellulitis-couldn't believe it was septic, as the instruments had been sterilized thoroughly, and I had taken the usual pre- cautions in preparing my patient for the curetting. I now know from the subsequent history of the case that rupture of the sac had taken place, and this accounted for the hæmatocele found subsequently. Upon vaginal exam- ination soon found bulging and fullness behind, and to the right went in Douglas' cul de sac, and rather inclined to the opinion that I had an abscess forming. In three or four days the temperature was down to normal, and remained normal for four days, when she had another acute attack, although not so severe as the former. At this time Dr. Towler saw her with me. He, and Dr. Chisholm, who saw her a few days before, believed it to be a case of pelvic abscess. Fron this time forward temperature ran from 1oo° to 1o1½°, and once to 102°; pulse from 92 to 1o8. Patient suffered no pain, excepting a soreness and constant ache, with occasional sharp shooting pains in the right side. Swelling was gradually increasing in size, but as there were no urgent symptoms, and as I could never satisfy myself that there was fluctuation, I believed I was not justified in adopting any radical measure, and hoped to see the mass subside, in time, under palliative treatment. I may say that only twice during her illness did she complain of chills, and they were very slight. July 2oth. Dr. Macdonald, jr., saw her with me, and considered it a case of pelvic abscess. From the 28th to 29th of July swelling increased very rapidly in size, and now reached the umbilicus, and I concluded that the time had come to take some active operative procedure. Dr. Macdonald, sr., now kindly saw her with me, diagnosing pelvic abscess, and strongly advised opening",
         "KENNEDY: HEMATOCELE. from the vagina. I was rather of the opinion that the swelling could be better got at, and more satisfactorily dealt with, by abdominal section. I accordingly wired Dr. Meek, from London, to come up and see the case. Dr. Meek came the following morning, and putting patient under chloro- form, assisted by Drs. Macdonald, sr., and Towler, I aspirated from the vagina, and drew off nothing but blood, proving the swelling to be a hæematocele. From the history of the case Dr. Meek now diagnosed hæmatocele, due to extra-uterine pregnancy, and advised abdominal sec- tion ; but, as surroundings were not favorable for immediate operation, advised that she be sent to the hospital. On the way down she suffered some pain, requiring morphine, gr. f4/, to ease. 7 p.m., temperature, 103'; pulse, îoo, weak. July 31st. Morning: Temperature, rooj'; pulse, ioo, weak. Did not rest very well during the night. 4 p.m. While nurse was not in room, got out of bed, on chamber, to have motion of bowels. HIad severe abdominal pain and faintness. Was assisted back to bed. Soon after this temperature ran up to 1050; pulse, 120, weak. It was intended to wait a few days before operating, to see if acute,§ymptoms would not subside, but, after this rise of temperature and pulse, decided to operate on following day. Examination of urine showed albumen pus and casts, so that patient was not in most favorable condi- tion for operation. Aug. 1st. Temperature went down gradually during the night, till it reached 101° this morning. Pulse, above roo. Considerable abdominal pain during night. Operation at 2 p.m., by Dr. Meek, assisted by Dr. Eccles and myself. Incision to right of linea alba, over the most prominent part of tumor, thinking possibly peritoneal cavity might be shut off at this point, and that the sac could be emptied without entering general cavity. It was found, however, that peritoneal cavity was not shut off. Over surface of tumor which presented in the wound omentum was spread out and adherent. Adherent omentum was separated, and under it was found some sero-purulent fluid. Thinking the sac might contain pus at this point, a small aspirating needle was introduced, but no pus found. The opening in the sac was enlarged, and it was found to contain thick blood- clot and some syrupy, liquid blood. The clots were partly scooped out with the fingers, and then an effort was made to enucleate the sac, but it was found that the posterior wall, low down, was formed by adherent coils of intestine and omentum. In separating these, the blood sac was broken into. More than a quart of blood-clot was rapidly scooped out with the fingers from behind the right broad ligament, Douglas'. pouch, and behind the left broad ligament. On the right side, the right",
         "KENNEDY: HEMATOCELE. ovary was found down on posterior surface of broad ligament, embedded in the mass of blood-clot. On the left side, tube and ovary were above and in front of blood tumor. Right tube was found extending out from right cornua of uterus, in the upper and back part of roof of tumor on right. Towards outer extremity it was dilated to about the size of a small orange. Broad ligament on this side was transfixed close to uterus, and the tube, with its corresponding ovary, ligated and cut away. On left side, broad ligament was considerably shortened, and the ovary and tube boùnd down from peritonitis, and it was deemed advisable to remove them. Patient being in Trendelenburg posture, the walls of the hoemato- cele could be easily made out, and it could be seen that the anterior wall was formed by the posterior surface of right broad ligament, posterior surface of uterus, and posterior surface of left broad ligament. The posterior wall was formed by rectum, low down, and, above this, the sig- moid flexure of colon, adherent coils of small intestine, appendix vermi- formis, and omentum. Roof on right side by arching broad ligament, and right tube covered over by adherent omentum; in median line, by adherent coils of intestine and omentum. The greater bulk of tumor was on the right side, and the mass sloped off to the left down behind left broad ligament, with its ovary and tube, and betweern it and the sigmoid flexure of the colon. The floor of the mass was low down behind cervix, in Douglas' pouch. It could be seen, therefore, that it was an intra- peritoneal hæmatocele, caused by rupture of the right Fallopian tube. After scooping out all organized blood-clot, etc., from pelvic cavity, and removal of appendages, the peritoneal and pelvic cavity was thoroughly flushed out with hot water, and drainage by iodoform gauze, and glass drainage tube introduced to bottom of Douglas' pouch. There was not much active bleeding during operation, and very little oozing after. The abdominal wound was closed by interrupted silkworm gut sutures. Exam- ination of right tube after removal; dilated part cut open, and sac, about the size of a hen's egg, found, with smooth lining, and, at one point, a thick, fleshy mass about the size of a fifty-cent piece. No foetus was found. The following history of case after operation and result of post mortem was kindly furnished to me by Dr. Meek: Patient rallied very well after operation, with pulse of 86, and tempera- ture roo°. During night she vomited a few times. August 2nd., Morning : Temperature, 1 oo° r; pulse, 11o. Very little pain or distension ; looks well; some vomiting still ; quantity of urine sufficient. Afternoon: Teinperature, 103°; pulse, 120. Tympanites; quantity of urine less. Ox-gall enema brought away gas and lowered temperature some, and gave relier. 82.3",
         "KENNEDY: HEMATOCELE. August 3rd. Morning : Did not rest well during night. Temperature, 103°; pulse, 140, weak. Quantity of urine deficient. Bowels have moved with enema, showing no obstruction. Gradually got weaker, and died at 2 p.m. Post mortem. No hæmorrhage. Pelvis well drained. Rectum and a portion of small intestine very dark and congested, but very little perito- nitis. Both kidneys were found enlarged, and unhealthy in appearance. (Have not yet received microscopic report.) The urine examined after operation was found to contain albumen, pus, and casts. This case was, without doubt, a case of tubal pregnancy, which rup- tured into peritoneal cavity about the second rnonth. Why the hinor- rhage was not fatal at the time of rupture can be explained, I think, by the fact that the rupture, in all probability, took place between the layers of the mesosalpinx primarily and subsequently into the peritoneum after inflammatory exudations had formed adhesions, shutting off the pelvis from the general cavity. The gradual increase of tumor was evidently due partly to inflammatory exudation and partly to gradual recurrence of hemorrhage. There is little doubt that there would have been suppuration in a short time if the case had been left to nature, and I think from the dirty, grayish, necrotic appearance of upper part of sac there would likely have been general peritoneal infection and death. Death was, no doubt, due to septicæmia, complicated by nephritis. If one could always recognize the nature of these things, the sooner after primary rupture such cases are operated on the better. If not operated on soon after rupture, acute symptoms of inflammation set in. Then, if symptoms are not urgent, it is usually safer to delay operation till acute symptoms have subsided. If there are symptoms, however, pointing to probable suppuration, there should be no delay. Pus should not be permitted to form if possible. To have attempted to empty this kind of hæmatocele through pouch of Douglas from vagina would, in all probability, have been disastrous. The posterior wall of sac being made up of adherent coils of intestine and omentum, it is likely that in attempting to scoop out the blood-clots this wall would have been broken, and general peritoneal infec- tion result ; or, if wall was not broken, the tube with its foetal sac and placenta could not have been removed in this way, and there would have been primary risk from hæmorrhage into sac, and secondary, almost cer- tain, risk from decomposition and suppuration at site of placental attach- ment. Dr. Meek, in his note to me giving result of post mortem, adds: \"Though result in this case was fatal, I am none the less convinced, from my own personal experience in such cases, that by abdominal section we can save a larger percentage of these wormen than by any other form of 824",
         "KENNEDY: HAMATOCELE. 825 treatment. The introduction of the aspirating needle into the mass in this case was a mistake, and, I am satisfied, did harm. In another such case I should prefer confirming my diagnosis from the abdominal side by opening into the peritoneal cavity, rather than by aspirating per vaginam. In a case of large suppurating hærmatocele recently operated on,\" he adds, \"I made my diagnosis from abdominal side by attacking the tumor by abdominal section, and, from the smooth after-progress of the case, I have not had reason to regret it.\" In conclusion, allow me to say that prob- ably the largest number of cases of hæmatocele is due to rupture of an extra-uterine gestation sac, but cases of ectopic pregnancy in any form are, as we all know, comparatively rare. Is it not possible, however, that they may occur in the practice of the general practitioner occasionally, without being recognized ? This very case I am speaking of would never have been known as a case of extra-uterine gestation had it not been for operation on a subsequent post mortem. If the operation had not been done the case would have, in all probability, succumbed, as I have already said, in a few days, from generalperitoneal infection,,and the cause of death would have been given as pelvic abscess or peritonitis.",
         "Clinical notes. SPINA BIFIDA. BY DR. BARNHARDT, Asiistant Surgeon to St. Michael's Hospital, ToRoNTo. Mr. President and Gentlemen: T HE specimen I present this evening is from an infant with the follow- ing history : Female, born at full term on February 27, 1893. Gen- eral appearance of child quite natural and healthy. A soft, glistening, fluctuating tumor, about the size of a hen's egg, was observed in the lumbar sacral region of the spine. When the child cried the tumor became quite tense, and though by gentle pressure it was possible to displace the fluid it returned immediately the pressure was removed. The anterior fontanelle. was large; the posterior one with the sagittal and lambdoidal sutures was open; the parietal bones were easily movable, showing, in all, a considerable delay in the development of the cranial bones. There was almost complete lumbar paraplegia. The calf muscles of the leg were absent; the hamstring muscles of the thigh could be distinguished on the left, but not on the right side. There was contracture of flexor muscles of thigh, most marked on right side; there was talipes varus of right foot. Defæcation and urination were performed naturally. The spine was short, as shown in the accompanying sketch; the anus was prominent, and displaced an inch backwards and upwards. At eighteen days the patient succumbed to an attack of cerebro-spinal meningitis, origi- nating in the tumor. An autopsy was made twelve hours after death, at which nothing was done except to excise the tumor, with the lower half of the spinal cord, and examine the vertebræ. The accompanying figure illustrates roughly the appearance of the spine. There was right lateral curvature in the lower dorsal and lumbar region; the laminæ of the vertebre were undeveloped below the ninth dorsal, excepting a partial development of the tenth dor- sal. The inferior half of the spine was abnormally short. The cord was *Read before the Pathological Society, Toronto.",
         "BARNHARDT: SPINA BIFIDA. 827 found to terminate in the tumor at the tenth dorsal vertebra. The location of the fibres of the cauda equina has not yet been made out, owing to the specimen being still incompletely hardened, but from the distribution of the paralysis it is quite evident that some of the trunks which go to form the sacral plexus have been implicated in the deformity. The specimen is now in a two per cent. solution of pot. bichromate, and when properly prepared the results of further investigation with the aid of a microscope will be made known to the society.",
         "A CASE OF LOCOMOTOR ATAXIA GREATLY IMPROVED BY SUSPENSION. By DR. HUGH A. CUTHBERTSON, CHICAGO. R. M., a man aged 36 years, vas engaged in office work, and conse- quently not exposed to inclement weather or great fatigue. He never had syphilis, but had gonorrhea five or six times, and he indulged in sexual intercourse to excess. He both chewed and smoked tobacco. Symptoms. In 1888 the nail of the great toe blackened, and, after inflammation of the matrix, with suppuration, was cast off. Soon after this the patient had slight lightning pains at long intervals Then there was loss of knee-jerk. There were no eye symptoms of any kind, and the arms were never affected. At this time the patient's rectum was very sensitive, so much so that, when riding in the street cars, he had to stand up when the car bumped over tracks. Later he had difficulty in passing urine, and he was constipatQd for two years, having to use cascara sagrada during that time. There was anSsthesia of the legs, and, when he crossed his legs with his eyes shut, he could not tell which leg was upper- most. When his legs were pricked with a pin he did not feel the pain for some time. When the patient stood with his eyes shut he swayed frorn side to side, and when washing his face he had to steady himself. He had to keep his eyes on the ground when walking, and he had the characteristic gait of lifting his feet high and bringing them down, striking the ground with the heel first. He never had the cushion feeling on the soles of his feet. In the fall of 1889 he lost the use of his legs, and had to resort to a wheel chair as a means of locomotion. He consulted Dr. N. S. Davis and others in Chicago, who recommended electricity and no attempt at exercise. He was also told that suspension would do him no good. In the spring of 189o he was taken to the Home for Incurables on 55th street, and on June 1st bought a suspension apparatus, and had his room-mate suspend him for from six 4o nine minutes every other day, being completely lifted off his feet. He kept up the electrical treatment",
         "CUTHBERTSON : CASE OF LOCOMOTOR ATAXIA. for a time, and then gave it up, basing his hope on suspension and exer- cise as a means of cure. He at once wheeled himself out on the balcony, and, taking hold of the railing, walked from one end to the otber, increas- ing the distance each day. In from fifteen to eighteen months he was able to abandon the wheel- chair and get about with the aid of two canes. In six months more he was able to get about with one cane, and he was now able to walk to Washington Park, a distance of four blocks, but he had to rest frequently in the journey, and when he came home he felt perfectly exhausted. When he came into the hospital he could not sleep well at night, but was very restless, tossing from side to side; but now he sleeps well all night, and wakens up in the morning greatly refreshed. He kept gradually increasing the ler-gth of his walks. For the last six or eight months he has been going without the aid of a cane, walks up four flights of stairs three or four times after breakfast, and then six or seven miles in the streets. He spends the afternoon playing croquet. The bladder and rectal symptoms have almost entirely disappeared. When walking he still staggers a little, but his feet are not lifted so high as formerly, and he says he is regaining power in the front part of the foot and toes. When he shuts his eyes he still sways to and fro. He thinks that in those cases where suspension has been used and failed, it was not kept up long enough. He has used it continually, every other day, since he entered the hospital. Of the dozen cases that have been in the hospital since this man entered, but two have been caused by syphilis. It is a noticeable fact that none of these patients are able to use crutches. They all use canes. 829",
         "Progress of MIedicineo THERAPEUTICS IN CHARGE OF GRAHAM CHAMBERS, B.A., M.B. Tor., Professor of Analytical Chemistry and Toxicology, Ontario College of Pharmacy; Lecturer in Organic Chemistry and Toxicology, Woman's Medical College; AND WILLIAM LEHMANN, M.B. Tor., Physician to the Home for Incurables and House of Providence. TREATMENT OF NOCTURNAL ENURESIS. Dr. D. MacAlister (The .Practitioner), having first examined the patient to see that no surgical aid is required, gives atropine and strychnine in doses gradually increased. Eserine salicylate, instilled into the eyes, may be used to counteract the action of atropine on the iris. The patient is awakened in the middle of the night, and at early morning, for the pur- pose of emptying the bladder. The medicine is administered at 9 p.m., and no liquids are allowed after 6 p.m. The secret of success in this method of treatment lies in giving the drugs, especially the atropine, to the full limit of tolerance. THE BEST FORM OF GLVCERINE-JELLY Dr. M. Hodara, of Constantinople, after some investigations into the properties of Unna's glycerire-jelly for the treatment of eczema, concludes that it should melt at a low temperature, and set at a comparatively high temperature. He gives the following formulæ, which fulfil the above requisites : For a soft jelly, melting point 1oo° F., setting point 82° F., the follow- ing formula is best R.-Zinci oxidi...... 20 parts. Glycerini........ 12.5 \" Gelatinæ *...... 12.5 \" Aquæ .......... 55 \"",
         "THERAPEUTICS. If a hard, contractile jelly is required: e.-Zinci oxidi...... 25 parts. Glycerine....... 10 \" Gelatine........ 15 Aquæ.......... 50 This melts at 102' F., and sets at 870 F. THIOFORM. Thioform, a chemical combination of bismuth, sulphur, and salicylic acid, has been brought forward as a substitute for iodoform. It is a taste- less and odorless powder of a greenish-yellow color. When used as a dressing for ulcers, wounds, burns, etc., thioform has shown itself to be equal, if not superior, to iodoform. However, the specific action of iodoform in tuberculous affections could not be expected from the use of thioform, as the latter does not contain iodine. Finally, thioform has been used internally in doses of fifteen grains. Its action was similar, but superior, to bismuth salicylate. PRURITUs ANI SUCCESSFULLY TREATED WITH CHLORINATED LIME. N. K. Berger (Zemsky Vratch) inserts into the anus, about one inch deep, a pledget of cotton soaked in liquor calcis chlorinate, and left there until smarting'occurs, when it is withdrawn, and the anus bathed with the same solution. The operation is to be repeated. Swelling of the parts, concomitant dermatitis, or eczema, are said to be cured by a few applica- tions.-The American Journal of the Medical Sciences. BONE MARROW IN THE TREATMENT OF PERNIcIous ANEMIA. The usefulness of this substance in pernicious anærmia was shown by Prof. Thomas R. Fraser in a valuable paper read before the International Medical Congress at Rome. He gave a very complete clinical history of a case in which no benefit occurred during the prolonged administration of both medium and large doses of iron and arsenic, but that rapid improvement resulted from the administration of ox bone marrow, both with and without iron and arsenic. The bone marrow was given by the mouth, uncooked, and in a quantity of three ounces daily. THE ELECTRICAL TREATMENT OF UTERINE FiEROIDS AND SUBIN- VOLUTION. Dr. F. W. N. Haultain (Edinburgh MedicalJournal) contributes a valu- able paper on this subject. He sums up his article with the following conclusions : 83I",
         "PROGRESS OF MEDICINE. (i) The constant current is of the greatest value as a uterine hoemo- static when due to small fibroids and subinvolutions. (2) It is curative in most cases of endometritis. (3) That it reduces measurably the size of a certain proportion of fibroid tumors, while upon the majority it has a salutary though less decided action. (4) That its action on fibroids larger than a seven months' pregnancy is not curative, but temporarily palliative. (5) That it reduces the size of subinvoluted uterus. (6) That beneficial constitutional effects are rapidly promoted. (7) That its method of hemostatic action is both local and interpolar, the latter being, probably, the most potent. TREATMENT OF URTICARIA. In the fournal of Mlédicine de Paris for April, 1894, is an article upon this disease, from which we make the following abstracts: The indications which are to be met in its treatment are the removal of the cause and of the symptoms. It is to be remembered that among the causal factors are a large number of vegetable substances and para- sites, and that, in addition, fish, shell-fish, and similar articles of food may produce these symptoms. Among the important drugs which produce urticaria are antipyrin, arsenic, copaiba, chloral, salicylic acid, santonin, the iodides, bromides, and turpentine. Often these eruptions can be relieved by external applications, and of course the causative factor in the eruption should be removed. For the urticarial diathesis a severe alimentary régime should be insti- tuted. Red meats and similar substances should be avoided, and only white meats taken. Heavy rich foods are also to be avoided. Should an arthritic diathesis be present, alkalies, such as bicarbonate of sodium or Vichy water, should be used, or one of the mild purgative alkaline waters resorted to. Should the urticaria be due to dyspepsia with constipation, the fol- lowing prescription may be given: ]ý.-Benzonaphthol, Powdered rhubarb, Calcined magnesia, of each, gr. v. Make into one cachet, and administer such a cachet half an hour before each meal. Should diarrhœa be present, order: I.-Betanaphthol,, Salicylate of bismuth, Prepared chalk, of each, gr. v.",
         "THERAPEUTICS. 833 To be put into one cachet, which is to be taken after each meal. Should nervous irritation be sufficient to prevent sleep, some mild hypnotic may be given-such, for example, as a small dose of opium, or sulphonal in the dose of 8 grains. Should the nervous irritation be very great, as much as 30 grains may be given in a day ; or, in other cases, cachets containing as much as 4 grains of chloralose may be given four times a day. Often, too, bromide of potassium, in moderate dose, with extract of valerian, is useful. For the local treatment, lotions and powders are chiefly indicated. Baths are also useful. The patient is directed to take a bath of moderate temperature for a quarter of an hour. The bath contains one litre of vinegar, one litre of glycerin, and two drachms of corrosive sublimate. It should be taken in a porcelain or wooden tub. In relation to lotions there is rnuch room for choice. Some recommend ether in the proportion of one-third, others vinegar one-third, or, again, Cologne water in the proportion of one-third,-or the following prescription may be used as a lotion P.-Corrosive sublimate, Chloride of ammonium, of each, gr. ii.; Aqua lauro cerasi, -iiss. Distilled water, àviii. Of the powders to be enployed after the bath, we may use simple powdered sta-ch, one-fourth of oxide of zinc, one-tenth of salicylate of bis- muth, or one-fiftieth part of cam-iphor. Of the salves, those which contain menthol or phenol are of most value, as, for example, the following pre- scription .-Vaseline, si.; Oxide of zinc, gr. xlv. to gr. lxxv.; Menthol or phenol, gr. v. CHRONIC ULCER OF STOMACH. W.-Chloroform.......... 3i. Bismuth subnitrate. .. . 3iii. Distilled water........ 'xvi. Sig.-Shake, and take one or two teaspoonfuls every hour. FISSURE OF THE NIPPLES. e.- Aristol.............. 3iss. Liquid vaseline..... .. i. Sig.-Apply after each nursing.",
         "PROGRESS OF MEDICINE. .GoNORRHAL OPHTHALMIA AND OPHTHALMIA NEONATORUM. Px.-Sulphate of quinine.... 2. Dilute muriatic acid.. .75 Distilled water... ... . .8g. 'Sig.-Shake well, and use as an eye-wash every hour. TRIKRESOL: A NEW ANTISEPTIC. Trikresol is a mixture of the three isomerides, ortho-, meta-, and para- kresol. They are homologues of phenol CHOH, and differ from it by having one atom of hydrogen replaced by the radical methyl CH3. The existence of the three isomeric compounds is explained by the different positions occupied by the methyl group in the benzine nucleus. C- -OH (1) HC cH (2) PHENOL: : C6 H5 0H HCH (3) H (4) C 4-OH C OH OH 1 C -CH3,2 CH4- CH3,3 C H4 - CH3 4 Ortho-kresol. Meta-kresol. Para-kresol. Trikresol forms an important constituent of a number of germicides- creolin, tysol, aseptol, etc.-which have, of late years, come extensively into use. However, it is only recently that a mixture of the kresols in the pure state has been obtained from coal tar. It is a clear, colorless liquid, soluble in water to the extent of about i in 40. It is, at least, three times more active than carbolic acid, and, moreover, is less poisonous, and does not numb the fingers and hands of theoperator. One per cent. solutions of trikresol kills the pyogenic cocci in half a minute. The presence of albuminous substances do not materially retard its action. Finally, trikresol is cheap, which is an important factor to be considered with respect to an antiseptic.",
         "OBSTETRICS IN CHARGE OP ADAM H. WRIGHT, B.A., M.D. Tor., Professor of Obstetrics in the University of Toronto; Obstetrician to the Toronto General Hospital. ASSISTED BY H. CRAWFORD SCADDING, M.D., Physician to Victoria Hospital for Sick Children. SEPSIS PUERPERALIS. A CLINICAL AND BACTERIOLOGICAL CONTRIBUTION. (Goldscheider, A., Charité Annalen, Band xviii.). The basis of this essay are sixty-eight cases of puerperal fever observed during the last three years. The cases are divided into the following classes, according to the classificatiop of Kehrer: (i) Sapremia (resorptive fever)-sixteen cases. (2) Peritonitis--twenty-one cases. (3) Pymia, thrombo-phlebitis, and mixed forms-twenty-four cases. (4) Septicæmia-three cases. (i) Sajrmia. Under sapræemia is understood a febrile condition caused by the resorption of putrid masses from the cavum uteri. This fever subsides after thorough local antiseptic treatment. The 'author reports twelve cases (five confinements at term and seven abortions) with- out a death, and concludes that the prognosis of saprîemia is favorable, especially if a timely and energetic local therapy is carried out. The fever shows peculiar characteristics. It is intermittent or mark- edly remittent ; initial chills are the rule. The pulse , full and of mod- erate tension, in contrast to the small, rapid pulse of t Pz. septic forms of puerperal fever. Respiration is rapid-about sixty perg mwte. Herpes labialis is sometimes observed. Stinking lochia are thé.rnule. Local symptoms are generally absent. In the beginning sapræmia may resemble the gravest forms of puer- peral fever. The results of the local treatment aid in making the differ- ential diagnosis, and enable us to give a favorable prognosis. Under the same heading he also reports four cases of temperature rise",
         "PROGRESS OF MEDICINE. due to infected lacerations of the perineum. These did well under appropriate local treatment. (2) Peritonitis pierperalis (eight abortions, twelve deliveries at term, all terminating fatally). When these patients tñrst came under observation the tympanitis was moderate ; it increased with approaching death. Exudations could only be denionstrated in four cases. Abdominal ten- derness is characteristic of peritonitis ; it may be absent if the sensorium is not free. Although vomiting is generally thought to be a constant symp- tom of peritonitis, it was not present in four cases. The pulse is small and frequent. The character of the fever is variable. The temperature ranged from 38.50 to 420 Celsius. In three cases the temperature was subfebrile ; in these cases there was collapse. The lochia were stinking in five cases. The fully described cases and accompanying post-mortem reports give no uniform picture. (3) Puerperai pySmi?, thzromboph1ebitis, sepi/co-pySmia. The author groups these cases into nine subdivisions. In some cases there was thrombo-phlebitis and embolism ; in others pus or pyogenic products were circulating in the blood. He also describes cases in which, besides the pyæmia, there existed a diphtheritic endometritis and diphtheritic puer- peral abscesses. The prognosis in these cases is undoubtedly better than in the septic form ; out of twenty-four cases nine recoveries are noted. The differen- tial diagnosis between pyæmia and septic peritonitis is only possible after prolonged observation. Repeated chilils are characteristic of pyæemia. In septic peritonitis we have chills in the beginning of the disease. The character of the pulse is of great importance in the diagnosis and prog- nosis. In cases of pure pyæDmia we find a fever pulse, full and bounding. Stinking lochia are less frequent in pyornia than in septicrnia. Swelling of the spleen could not be demonstrated intra vitam. A purulent peri- tonitis is not of a pyæemic nature. (4) Septicïemia (three cases-one abortion, death after four days; two deliveries at term, fatal after nine and seventeen days respectively). The varying picture of the disease is probably due to differing biological conditions and the malignancy and number of the invading streptococci. The malignancy of the streptococci is apparently not caused by any spe- cial virulence of the secreted poisonous substances, but is due to an enor- mous power of propagation. It is doubtful whether the streptococci acquire the malignant character only after they have invaded the system. More probably their greater development-is aided by the presence of bac- teria of putrefaction in the cavum uteri. The therapeutic rules laid down gre, in brief, the following: Local therapy in saprSrmia.",
         "OBSTETRICS. Avoidance of all and every local treatment in the peritoneal forms of puerperal fever, also in thrombo-phlebitis and pyoemia. Intra-uterine irrigation in endometritis purulenta, without disturbing the patient much. Abundant nourishment. The author has used the stomach tube with much success in the feeding of the patients. Alcohol. , Absolute rest and sleep. Active stimulation. Tincture strophanthus in cardiac weakness. -American Jouernal of the Medical Sciences. ASEPTIC MIDWIFERY WITHOUT INTERNAL DISINFECTION. Mermann (Centraibl.f. Gynak., No. 33, 1894) discusses aseptic as dis- tinguished from antiseptic delivery. He brings forward statistics of 300 labors in the Mannheim Lying-in Hospital, from December, 1892, to February, 1894. In no case, not even before or after operative inter- ference, were antiseptics introduced into the internal organs. Unless the labor was far advanced, each patient was examined internally. Not one mother was lost ; one, it is true, had phthisis, and was transferred to a general hospital, where she died. In no case did aiy severe infectious disorder occur. Mermann, adding the above to previous statistics, can show a series of 1,200 labors without one instance of fatal infection. Two deaths are included, but in one-the case of phthisis just noted-death was not due to the labor ; the second was a case of rupture of the uterus. Mermann shows that antiseptic midwifery cannot claim such favorable results.-Britisk vfedcaifournal. SUDDEN DEATH DURING LABOR. Mrs. C., aged 25, had had two previous confinements, which were rapid and normal. There was a history of rheumatic fever when a girl. Cardiac disease (mitral stenosis) had resulted, but was not suspected till five months before ber third confinement, when she suffered fron acute bronchitis with hæmoptysis. There was some ædema at the latter end of pregnancy, and for a week before labor. She was kept in bed ; there was then no bronchitis. Labor began on April 1st. The os was well dilated when the mem- branes ruptured, and a fourth facial presentation was made out. Progress was slow and pains severe and rapid before the face and cranium swept over the perinæum, which remained intact. She rested some minutes after the expulsion of the child, and spoke about ber labor being more severe and different from the others. Friction and gentle compression of the uterus was tried to expel the placenta ; whilst doing so she began to cough, and suddenly threw back her head, gasping for breath, with wild, 837",
         "838 PROGRESS OF MEDICINE. staring eyes. She rapidly became unconscious, and died in about two minutes. The heart continued beating for about half a minute after the beginning of the attack. The placenta was hurriedly expelled, and ether and artificial respiration tried, but without avail. There was no post- partum hemorrhage. No post-mortem examination was allowed. This was probably a case of pulmonary embolism occluding the main trunk, the blood clot forming in the right ventricle or auricle during the pains of labor, and getting dislodged by the coughing.-James Dunloq, M.B., C.M., Glasgow, in British Medicalfournal. INDUCTION OF PREMATURE LABOR IN A CASE OF CONTRACTED PELVIS. (Ballantyne, Edin. Afed. jour., July, 1894.) The patient, æt. 42, pregnant for the eighth time, was 5 ft. 13/2 in. in height, and had no apparent deformity. The abdominal enlargement suggested that full term had almost been reached. The obstetrical history showed gradually increasing difficulty in labors, beginning with the third and culminating with the seventh, in which the child had to be broken up. Pelvic measurements : Interspinous diameter, 9 inches ; intercrestal, io inches ; external conjugate, rather over 7 inches ; intertrochanteric, 124 inches; diagonal conjugate, 3 inches. The true conjugate was judged to be about 23/ inches, and all the other diameters were slightly less than normal. The patient stated that she last menstruated in May, 1893, but there was a profuse discharge of blood on July 9th following. Quickening occurred in the beginning of November. Induction of premature labor was begun on February 15th, when it was calculated that the pregnancy was 220 days old. Pelzer's method of injecting two ounces of glycerine through the cervical canal into the lower uterine segment was employed four times on the 15th, but nothing resulted. Next day the cervix was dilated with Hegar's dilators up to No. 12, still without result; so, at 7 p.m., Champetier de Ribes' dilator was introduced well within the inter- nal os. Uterine action began at 7.30. As the head would not engage in the brim, version was performed under anæsthesia. The lateral parts of the pelvis were found roomy, and no spinal deformity was felt. After much difficulty the child was born alive 6Y4 hours after the introduction of de Ribes' bag, but it died seven hours later. Its bi-parietal diameter measured 3X/ inches; bi-temporal, 234: inches. The mother made a good recovery. Ballantyne is inclined to attribute the narrowing of the conjugate to an osseous or cartilagipous tumor growing forward from the first sacral or last lumbar vertebræ.--Medical Chronicle.",
         "OBSTETRICS. PUERPERAL INFECTION FROM THE INTESTINE. Dumont (Archives de Tocol. et de Gynéc., July, 1894), in a paper on \"Puerperal Pseudo-Infection of Intestinal Origin, due to the Bacterium Coli Commune,\" says this form of infection arises from changes in the intestinal mucous membrane, inflamed through compression by the gravid uterus, or through retention of fæces irritating the coats of the bowel. These changes allow the bacterium coli to pass into the peritoneum, setting up infection, which is intestinal and not, strictly speaking, puer- peral in origin. The symptoms usually appear about a week after deliv- ery, the patient doing well at first, but being troubled with obstinate con- stipation. The temperature and pulse rise very high, the face looks pinched, the tongue is rough, the breath foetid. The mental condition remains normal, and even the appetite may be good. There is tender- ness over the cæcum, transverse colon, and sigmoid flexure. Sometimes a flabby mass can be felt touching the uterus, but separable from that organ. The uterus and fornices feel free on palpation, as in many cases of true puerperal infection. The result is very uncertain. At least the course of the disease is different from that of enteric fever. In mild cases the symptoms disappear after the action of a purge ; in other instances the patient dies within a fortnight ; in others, again, she may remain ill for over six weeks, and yet recover. The usual sequele of infections have been known t.o follow, such as phlegmasia dolens, arthritis, ulcerative en- docarditis, and salpingitis. An important complication, observed by two obstetricians, is paralysis, caused by central myelitis ; this explains the great frequency of paralysis of the intestine, which involves further reten- tion of the irritating scybala and greatly aggravates the disease. Dumont believes in the prophylactic treatment of this kind of infection. The bowels should not be allowed to become constipated during pregnancy. Laxatives and enemata during childbed are imperative from the first. Seven cases of intestinal infection are described.--Epitome, British MAedi- cal Journal. THE TEMPERATURE AFTER DELIVERY IN RELATION TO THE DURATION OF LABOR. Dr.* Arthur E. Giles gave an analysis of 6oo cases of normal labor from the point of view of the relation of the temperature immediately after delivery to the characters of the labor. The results were summarized as follows: (1) The average rise of temperature due to labor was slight, the average of the 6o cases being 98.7 F. (2) The length of the labor bore but a slight relation to the subsequent temperature. (3) The length of the second stage, however, had a direct influence on the temperature,",
         "PROGRESS OF MEDICINE. which rose in proportion to the length of this stage. (4) The time -of day at which delivery took place had very little influence on the temperature, which, however, was highest in the groups of cases where delivery took place between 12 p.m. and 4 a.m., and between 4 p.m and 8 p.m. (5) When chloroform was given during the second stage of labor the temperature was commonly lower immediately after delivery, even if the second stage lasted longer. The average temperature in fifteen cases with a second stage averaging two hours and forty minutes was 98.7. (6) A similar result followed the application of forceps under chloroform ; in twenty-six cases with a second stage lasting on an average three and a half hours the average temperature was 98.8. (7) In twelve cases of natural delivery in which the second stage lasted on an average thirty-five minutes, but where an intra-uterine douche was given, the average tem- perature afterwards was 99.4 F. PREGNANcY AND LABOR WITH BRIGHT'S DISEASE. Dr. Herman presented to the I ondon Obstetrical Society six more cases of pregnancy and labor with Bright's disease. He concludes there are at least two kinds of renal disease to which the pregnant woman is specially liable. One of these is a very acute disease, in which premoni- tory symptoms are either absent or of duration measurable by hours or days. It attacks chiefly primigravidie. It often causes intra-uterine death of the child. It is attended with extreme diminution of the quantity of urine, and the small quantity of urine that is passed is greatly deficient in urea, but contains enough albumin to rake it solid on boiling. This disease 's accompanied with rapidly recurring fits. If it run a favorable course, the fits cease, then the urine increases in amount, and the per- centage of urea in it rises. If the excretion of urea be not re-established, the case quickly ends fatally. Such cases seldom, if ever, pass into chronic Bright's disease. The other is a disease which attacks older subjects, chiefly those who have had children before. Its premonitory symptoms extend over a period measurable by weeks or months. It often leads to intra-uterine death of the child. It is accompanied generally by increase in the quantity of urine, with copious loss of albumin, but not so much in proportion to the urine as in the more acute disease, and with diminution in the elimination of urea, but not nearly so great a diminution as in the more acute disease. Delivery is followed by temporarily increased diuresis and increase in the urea elimination. When this increase is considerable the albuminuria usually diminishes and disappears, and the patient gets well. When the increase is only slight the albuminuria persists, and the case becomes one",
         "OBSTETRICS. of chronic Bright's disease. This form of disease is sometimes attended with fits, but generally not. The presence of albuminuric retinitis affects the prognosis unfavorably. When the pressure within the abdo- men is greater than usual the amount of urine may be diminished, but in such cases the diuresis and the augmentation of the urea elimination after delivery are proportionately greater. In the acute disease which causes eclanpsia, and in the chronic disease when it is associated with excessive intra-abdominal pressure, much of the albumin is paraglobulin. The cases in which the albumin is mainly serum-albumin gencrally either die or pass into chronic Bright's disease.-Abstract fromn the Amneri-can Gynecoiugical and Obstetrica/Jot- ,ai, October, 1894. THE CARE OF PREGNANT WOMEN. At the annual meeting of the American Association of Obstetricians and Gynocologists held in this city on September I9th, 2oth, 21st, Dr. Dewees, of Salina, Kansas, read a paper entitiled \"The Care of Pregnant Women,\" a report ofwhich appeared in our last issue, page 779. He con- cludes that civilization, with its fixed habits of excesses-through ignorance as well as carelessness-is the true source of wornan's present suffering during gestation and childbearing. It follows, then, that the prevention of their sufferings lies in the education and training of these women so that they vill cultivate the self-discipline requisite to enable then to prevent the continuous irritation from excesses in their habits of life. The next great advance in our special branch of medical science will be through convincing the general practitioner that the diseases peculiar to women in pregnancy and parturition are largely preventable. When this obtains, his moral obligation will impel himu to give adequate instruc- tions concerning the ill-effects of improper posture, dress, food and drink, and erroneous habits of living, including the non-forbearance of indis- criminate excesses and impure sensual indulgences. As yet we are compelled to meet the situation as we find it, and it becomes the duty of the obstetrician : (i) To discover if the patient be actually pregnant. (2) To determine positively whether the pregnancy be uterine and normal, or tubal, abdominal, and abnormal. (3) To carefully note the history, age, primiparity or multiparity, environments, station in life, general condition of health, period of gesta- tion, dress, food, drink, habits of life; to make repeated examinations of the urine, and to ascertain the temperature from the time pregnancy is established to the termination of gestation.",
         "PROGRESS OF MEDICIE, (4) To make a physical examination for the purpose of accurately determining the pelvic diameters; the symmetry and size of the bony out- let; the integrity, condition, and position of the vagina, uterus, and other intra-pelvic viscera and adjacent structures ; the state of abdominal muscles ; the presence or absence of hernia, varicose veins, tumors, etc.; the shape, size, and condition of the breasts and nipples; the condition of heart, lungs, mind, stomach, bowels, etc. (5) To observe the state of the foetus, its strength and viability, as well as the implantation of the placenta. The thoughtful obstetrician will advise the patient as to the requisite régime. The consciousness of his full duty will impel him to insist upon: (i) Absolute regular hours and wholesome environments. (2) Plain, but nutritious diet. (3) A proper amount of exercise by walking or light labor on foot, and maintaining the correct erect posture, with not less than ten hours' sleep out of every twenty-four. (4) The open condition of the bowels and skin, which is to be chiefly maintained by proper diet, exercise, and bathing, the wearing of flannel, warm, low-heeled shoes and loose garments, and, in rare cases, the proper use of laxatives and hot water enemata. Uranalysis and thermometry are very important from beginning to end of pregnancy. They are simple in detail, yet how prolific of averting the culmination of conditions very hazardous to mother and child-conditions which otherwise are frequently discerned only by the appearance of anas- arca of the lower extremities, œdema of the face, or an eclaniptic seizure. Dr. Deweeswould replace the term \" puerperal fever \" by \" parturial sepsis.\" He thinks the first misleading, and failing in the expression of the condition it is intended to imply. Parturial sepsis is a surgical sepsis, arising from the conditions in which women are found during the extension of the uterine contents, similar to those during surgical procedures. When the pelvis is abnormally distorted or contracted, pelvimetry furnishes the chief guid- ance. In the present light of science, premature delivery and enibryalcia have no place in the obstetric art in connection with a viable foetus. We are thus left to choose between two procedures whenever we find the pel- vis so distorted or contracted that it precludes all probabilify of delivering the living child, namely, symphysiotomy and Cesarian section. At term symphysiotomy is available only in cases where the conjugat measures are sixty-seven millimetres, while if the conjugat is found to be sixty-seven millimetres or under the only recourse is Cesarian section. The distinction of the embryo is, however, requisite under certain cir- cumstances or conditions, such as,the presence of large fibroids in the body of the uterus, or large tumors involving both the ovary and uterus, also cancer of the uterus, and, in certain cases, placenta prævia. 842",
         "OBSTETRICS. In the discussion which followed, Dr. J. Henry Carstens, of Detroit ; Dr. Joseph Hoffman, of Philadelphia; Dr. H. W. Longyear, of Detroit; Dr, C. A. L. Reed, of Cincinnati; Dr. Duff, of Pittsburg; Dr. Joseph Price, of Philadelphia; Dr. W. B. Jones, of Rochester; and Dr. E. W. Cushing, of Boston, took part. Regarding the subject of albuminuria of pregnancy, Dr. Longyear said he knew of nothing that would do much good except emptying the uterus. The more he had seen of the fatal results of albuminuria of pregnancy, the more he had been convinced that the only safety to the mother is to deliver her just as soon as he found albuminuria present. He believed it to be justifiable practice if, after repeated examinations of the woman, he found the system to be surcharged with urea to deliver. He would say that the majority of deaths he had seen from albuminuria incidental to labor had not been attended with eclampsia, and that women oftener die from urærnic poisoning without convulsions. Dr. Reed said that if it be true that the condition were not a remedi- able one, then the position which Dr. Longyear assumed would be ten- able. But these cases are curable, and he could see no reason for enter- ing upon a murderous line of tactics simply because the baby was little. When the fact has been demonstrated that the case is not curable, then the proposition relative to the induction of premature labor could be taken into consideration, but the idea that delivery should be brought about the monient the diagnosis of albuminuria had been made is one he could not permit to go without a challenge. Dr. Duff said, in reference to the question of albuminuria, that he regretted to hear Dr. Longyear say that we should bring on labor when- ever albuminuria was detected. About twenty per cent. of pregnant women have more or less albuminuria, and there are not more than two per cent. of pregnant women with albuminuria who have eclampsia. He thought it seldom, indeed, that death occurred from albuminuria of preg- nancy without eclampsia. It had not been discovered how the different poisons were eliminated from the kidneys, and it had not been positively demonstrated that it is albuminuriaper se, or uroemic poisoning, that kills women.",
         "SURGERY IN CHARGE OF L. M. SWEETNAM, M.D. Tor., Lecturer on Therapeutics in the Woman's Medical College; Surgeon to the Outdoor Clinic, Toronto General Hospital; Surgeon to St. Michael's Hospital; AND A. PRIMROSE, M.B., C.M. Edin., Associate Proressor and Demonstrator of Anatomy, University of Toronto; Surgeon outdoor Department, Toronto General Hospital ; Surgeon, Victoria Hcspital for Sick Children. CHOLECYST-DUoDENoSTOMY AND GASTRO-ENTEROSTOMIES BY AID 'OF MURPHY'S BUTTON. While operations on the gall-bladder have been performed as long ago as in the middle of last century, it is first during the last ten or fifteen years that improved methods have been devised, by aid of which a moder- ately favorable prognosis could be obtained. We owe this progress, as to many other advances in surgery, to Ameri- can surgeons; in this case to Dr. John B. Murphy, of Chicago, whose anastomosis button, by its simplicity and .mechanical perfection, and the ease and celerity with which it may be applied, seems to fulfil all indica- tions for a safe and reliable removal of gallstones from the gall-bladder itself. The question arises, When ought we to operate in cases of jaundice ? It is impossible to give a distinct diagnosis in each case. Jaundice may be the result of gallstone impaction in the common duct, or of cancer of the pancreas or liver, invol£ing the duct, or simply of a gastro-duodenal catarrh. In many cases, of course,. the symptoms will be sufficiently prominent to give a differential diagnosis ; in others the diagnosis will be obscure, unless we open the abdomen. I need scarcely mention that an impacted gallstone, if sufficiently large, in the common duct gives jaundice, and, secondarily, swelling of the gall- bladder, while an impaction in the cystic duct is not followed by jaundice, and may not be followed by swelling* of the gall-bladder, unless cholecy- stitis supervenes. On the other hand, swclling of the gall-bladder, with or without jaundice, may be the result of a carcinoma of the gall-bladder itself, or neoplasms in the pancreas and liver, involving the common duct, or of an empyema, the result of cholecystitis with or without gallstones.",
         "SURGERY. When ought we, therefore, to discard medical treatment, and have recourse to the only means which can clear up the diagnosis-laparotomy ? I believe that jaundice ought to be treated by laparotomy after a course of medical treatment of several weeks has demonstrated the improbability of relieving the trouble by this means. The abdomen having been opened by a vertical incision at the outer edge of the rectus muscle, we may examine the gall-bladder for stones in the common, cystic, or hepatic ducts, and if found, particularly in the gall- bladder, remove them with scarcely any danger to the patient. If carci- noma of the gall-bladder should be found, it is entirely feasible to remove the gall-bladder by cholecystectomy. If the common duct should be found obstructed by a neoplasm, we may, at least, relieve the jaundice by a cholecystenterostomy, with any more danger to the patient than accom- panies an explorative antiseptic laparotómy, and that is nihil. The older operations for gallstones consisted i. . (i) Suture of the gall-bladder to the parietal peritorieum with secondary incision, .e., cholecystotomy in two sittings; (2) suture with immediate incision, ie., cholecystotorny in one sitting; (3) incision of gall-bladder followed by immediate suture and reposition in abdominal cavity, i.e., ideal cholecy- stotomy. 0f these three operations, the first has given the most favorable results, the mortality being ten per cent., six deaths in fifty-nine cases. The second operation has given a mortality of 19 per cent. in 201 cases, but both the first and second operations have the great disadvan- tage that a biliary fistula is left in a large number of cases, estimated at 31 per cent., so that perfect recovery has only been obtained by these operations in about 50 per cent. The third operation, ideal cholecy- stotomy, has given a mortality of 23 per cent. Compare the results of these operations with the most modern operation, scarcely as yet known to physicians, cholecystenterostomy, or cholecyst-duodenostomy, by aid of Murphy's button, with a mortality of nihil and a complete recovery of oo per cent. in seventeen cases, or, if I add one of rny own, eighteen cases, and you will probably agree with me that the problem of removing gall- stones by operation has been most ably and brilliantly solved by this new device. The operation is performed in the following way: After the abdomen has been opened and the gall-bladder isolated and drawn out of the wound, a running thread is inserted around a line one-third longer than the incision to be made, and going through aIl the layers of the organ. The incision is thereafter made and the gallstones removed. It is not necessary to remove ail the gallstones, as they will pass away after the button has been passed. One-half of the button is now inserted with a forceps and the running thread tied around the cup. A similar thread and incision is 845",
         "PROGR'\u0026SS OF MEDICINE. made in the duodenum, opposite the mesentery and below the head of the pancreas, the button inserted and the two halves firmly pressed together. The spring in one of the cups maintains pressure till the button sloughs off, and it is voided by rectum in from seven to twenty or twenty-five days. The gall-bladder shrinks thereafter, forming a canal of the size of the common duct. This operation is, according to Murphy, indicated : (i) In all cases in which it is desired to drain the gall-bladder; (2) in all cases of cholelithiasis with obstruction of the common duct; (3) in all cases of cholecystitis, with or without gallstones ; (4) in all profusely discharging biliary fistulas. It is contraindicated : (i) When the gall-bladder is too small for insertion of the button ; (2) where adhesions are so extensive that the bladder and duodenum cannot be approximated; (3) where the ductus cysticus is obliterated, in which cases cholecystectomy is indícated. When a stone is impacted in the common duct, attempts have occa- sionally been made of removing it either by crushing it through the walls with instruments protected by a rubber covering, or by dividing it by a needle introduced through the wall, or, lastly, by incising the duct, remov- ing the stone, and closing the wound by suture. This last operation is very difficult, on account of the deep position of the duct, and the mortality is about 40 per cent. The Murphy button may be used to advantage on other organs than the gall-bladder. In a recent case, operated seven weeks ago, I made an anastomosis betveen the stomach and the duodenum, on account of cancerous stricture of the pylorus. The case was entirely successful, all vomiting stopped, and the patient left the hospital in three weeks greatly improved, able to eat and retain his food. His life will, probably, be lengthened a good many months by this operation. In another case of cancer of the pylorus, in which the patient was extremely exhausted from starvation from vomiting, death occurred twelve hours after the operation. The operation was performed in less than fifteen minutes, and she died simply from exhaustion. In a third case of cancer of pylorus, in which the patient was in a state of extreme inanition, I made a gastro-duodenos- torny a fev weeks ago, using the smallest of Murphy's buttons, as the others of my set were all in use. For seven days everything went well, vomiting had ceased; and the patient was improving and feeling well, when she suddenly complained of severe burning pain in the abdomen, as if \"melted lead was being poured down among the bowels.\" She collapsed and died in two hours. The post-mortem showed that the button had slipped oùt of the stomach, leaving a large opening, through which the contents had entered the, abdominal cavity. Tht small diameter of the button necessarily allowed only a small brim of the hypertrophied wall of the stomach to be compressed between the cups, and the accident occurred 846",
         "SURGERY. partly on this account, partly from muscular contractions of the stomach. I consider it of the utmost importance to publish this case, and shall, in al] future gastro-enterostomies, use a running suture around the button as a means of safety. I do not believe it would have occurred in a cholecyst- enterostomy, where the muscular force, probably, is lacking.-Herman Mynter, M.D., in the Bufalo Medical and Surgicaljournal. FEEDING OF INTUBATED CHILDREN. Paine (Albany Medical Annals) refers to the paroxysms of choking and coughing liable to be excited by efforts at swallowing, the danger of the expulsion of a tube when no one is at hand able to replace it, the dis- comfort of getting fluids into the air passages, and the deterioration of vital force and blood from lack of nourishing food. He has resorted to feeding through the nose by a stomach tube ; the nares and fauces are first sprayed with a two per cent. solution of cocaine, and a new soft rubber catheter (No. 6 or smaller) is well oiled and slowly and carefully passed through the least obstructed nostril. A rapid movement will carry it below the highly reflex area of the larynx, and the remainder can be introduced slowly. The No. 6 catheter will not enter any of the O'Dwyer tubes, except possibly the largest. The entrance of a small tube into the larynx will be immediately revealed by the current of air forced through it, while in the esophagus it will excite the act of swallowing. It should be introduced tÉirteen or fourteen inches and the desired nutriment slowly passed into the stomach by a fountain syringe or simple catheter and funnel, after which the tube can be slowly withdrawn. This procedure offers the.advantages of the easy introduction at regular intervals of sufficient concentrated nutriment, stimulants, and medicines, the removal of aggravated thirst, and ability to feed the patient while in any position. -Philadelphia Polyclnic. 847",
         "PifÆDIATRICS AND ORTHOPÆEDICS IN CHARGE OP W. B. THISTLE, M.D., L.R.C.P. Lond., Assistant Denonstrator of Anatomy, University of Toronto; Physician to Victoria Hospital for Sick Children; Clinical Lecturer on Diseases of Children in the Wonan's Medical College; AND B. E. McKENZIE, B.A., M.D., Lecturer on Orthopaedics and on Surgical Anatorny in the Woman's Medical College, and Surgeon to the Victoria Hospital for Sick Children, Toronto. METHYLENE BLUE IN NoeMA. G. F. Kostuerin (Vratci, No. 32, 1894, p. 893) relates two cases of noma, in which, after all the usual measures (actual cautery, perchloride of iron, thymol, iodoform, etc.) had failed, he resorted to hourly painting the parts with a twenty-five or thirty per cent. aqueous solution of rmethy- lene blue. In a few hours fetor disappeared and sloughs began to fall off, while, later on, cicatrization set in. One of the patients ultimately died from exhaustion, but the other recovered. GASTROTOMY FOR TUE REMOVAL OF FOREIGN BODIES. In the British Medicalfourna, November 3rd, '1894, Mr. Mayo Rob- son gave an account of a case in which he had successfully removed, by gastrotomy, the following articles: 47 cast-iron garden nails, 1/ inch long; 93 brass and tin tacks, Y inch to 1 inch long ; 12 large nails, some brass-headed ; 3 collar studs; 1 safety pin; i sewing needle. They had been swallowed by a child aged 1o, during the course of the previous eight months. The wound healed by first intention, and the patient nade a complete recovery. The symptoms were obscure until a clue was obtained by the vomiting of a nail. Mr. Robson dwelt on the marked effect of transfusion of saline solution in combating shock. ADENOID GROWTHS IN THE DOME OF THE NASO-PHARYNGEAL SPACE. Ray J. Morrison, Lousville, Kentucky (Med and Surg. Rep., Phila., 1894, lxx., 74), summarizes as follows:",
         "PEDIATRICS. (1) The majority of cases of chronic nasal obstruction in children are due to the presence of adenoids in the naso-pharynx. (2) Mouth breathing, snoring, wakefulness, defective mental develop- ment, bad teeth, deformed chests, and deafness result from this obstruc- tion. (3) The recurring earaches and pus discharges from the ear, per- sistently resisting treatment directed to the ear, are the result of the pres- ence of adenoids, and, in a majority, prompt relief follows surgical removal of the growths. (4) Many of the ear diseases of adults and so-called post-nasal catarrhs are the result of adenoids that had not been recognized or treated in early life. (5) That, while adenoids will apparently disappear as adolescence is, attained, they never entirely atropby, but leave fibrous stumps and adhe- sions to the Eustachian tube. (6) Operation for their removal'should be undertaken under an anos- thetic, and thorough removal accomplished. (7) The operation is reasonably safe, and, besides giving decided relief to the local symptoms in the throat and ear often shows wonderful improvefnent in the general physical condition. ANTITOXIN TREATMENT OF DIPHTHERIA. In the last number of T/ie Britisi Medical lournai (November 3rd, 1894), three cases of diphtheria are reported in full, in which injections of Aronson's antitoxin serum were used. CASE I. At. i1 years. Taken ill Oct. 19th. Next day tonsils and uvula covered with membrane ; from portions of this cultures of Klebs- Leoffler bacillus were obtained. Oct 21st : 19.5 c.c. injected. That evening temperature fell to normal. This was followed by rapid detach- ment of the membrane and reduction of glandular enlargement, which had previously been marked. Oct. 23rd : Tonsils and palate almost free from membrane. CASE 2 (Dr. Fowler). .Ét. 13 years. Began to, feel ill on Oct. 12th. Admitted to hospital Oct. 14th. Right tonsil covered with thick mem- brane, while over left was a thin film. Slight glandular swelling. Tem- perature, 102.50 ; pulse, 1oo; respiration normal ; 2 c.c. Aronson's anti- toxin sérum injected into left arm. A chlorine mixture to be sprayed on throat every two hours. At ro p.m. temperature was 102°; at 6 a.m. it was 99.4°, and, on the evening of the 16th, 98.8°. The membrane had not increased, and patient felt better. Oct. 17th: Morning, temperature, 99° ; pulse, 56 ; tongue moist ; left tonsil clean; and membrane on right 849",
         "PROGRESS OF MEDICINE- was separating. Oct. 1 8th : Temperature normal. Improvement. Oct. ith : Throat quite clean. Albumin in urine. CASE 3 (Dr. Makeling). At. 6Y/ years. Taken ill first on Oct. 1st. Had headache and chills. Oct 6th: Throat became sore. There was earache, with slight offensive discharge from the ears. First seen Oct. 7th. Membrane on both tonsils, uvula, and palate. Glands at angles of jaws swollen and painful. Temperature, 100.6° ; pulse, 130. Urine scanty and highly albuminous. Mixture of tr. ferri mur., quin. sulph., and pot. chlor. given, and throat sprayed with carbolic acid (i in 60). Oct. 8th : No improvement. Pulse, 132 ; temperature, 102°. Marked whistling stridor and falling of intercostal spaces. 5 c.c. Aronson's anti- toxin serum injected. One and a half (12.30) hours after injection, tem- perature 99°; no change in pulse. At i p.m. child expectorated large piece of membrane. At 2.30 pulse 120, stronger; temperature, 98.8*. Second injection of 3 c.c. antitoxin given. Oct. xoth: Temperature, 97.8; pulse, 1o8. Improvement continued. Large quantity of mem- brane expectorated during afternoon. Oct. 11th : Child still improved during early part of the day, but breathing became difficult, and trache- otomy was done. This gave marked relief, but after a time the pulse began to fail. Green, foul-smelling stools were voided. Child'died at 11 p.m. PLEURITIS WITH PURULENT EFFUSION CURED BY ASPIRATION. A case of pleuritic effusion cured by aspiration is related by James Carmical (Edinburgh Medicalfournal, September, 1894). The patient, a little girl of one year and nine months, had been ill for five weeks before admission with slight cough, and was becoming feeble and anæmic, Physical signs of effusion on right side. The pleura was aspirated and twelve ounces of pus removed. Two days afterwards aspiration was again done, and three ounces of pus withdrawn. Five days later the process was repeated, and four ounces removed. Again, three days later, three ounces were removed. It was now'decided to drain, but, on incision, no pus escaped, and the wound was at once closed, and healing by first intention insured. Five days after incision aspiration was again tried, this time bringing two and one-half ounces of pus. No further aspirations required, the child making a complete recovery. Discharged well two months after admission. In all, five aspirations were done. Six months afterleaving the hospital no difference could be detected in the physical signs on the two sides of the chest.",
         "PATHOLOGY IN CHARGE OF JOHN CAVEN, B.A., M.D., L.R.C.P. Lond., Professor of Pathology, University of Toronto and Ontario Veterinary College ; Pathologist to Toronto General Hospital and Home for incurables. ASSISTED BY JOHN A. AMYOT, M.B. Tor., Demonstrator of Pathology, University of Toronto; Assistant Surgeon to St. Michael's Hospital; Physician to House of Providence. THE HISTOLOGY OF CHRONIc GASTRITIS. (Ubrik. Quensel, Nordisht MLedicinskt Arkiv., xxv. 5, Mèmotre, pp. 24-34.) In the first part of his thesis the author takes up the atrophy of the gastric mucosa. He examined the stonachs of three cases of pernicious (progressive) anoemia. The first was that of a man of thirty-seven years who had suffered since his eighteenth year from a progressive gastric catarrh. Six months before death he developed all the signs of pernicious anæemia. On examining the gastric juice, neither hydrochloric acid, pepsin, nor rennet was found, but a small quantity of lactic acid. At the autopsy the following modifications were found : Ecchymoses of the skin and endocardium, fatty degeneration of the myocardium, lobular pneu- monia, follicular enteritis, bone marrow red and embryonic. The stomach wall was of the usual thickness, the mucosa pale; a few polypi were found at the cardiac end. The second case was that of a man thirty-two years of age, who, four years before his death, had commenced to suffer from acid and glairy regurgitations, and sometimes vomiting; six months later symptoms of pernicious anæmia came on. These symptoms improved after some time in the hospital, but again became worse, and finally brought on death. The examination of the gastric juice showed the pres- ence of lactic acid, but the absence of hydrochioric acid, pepsin, or rennet. At the autopsy the following conditions vere found : Anasarca, ascites, ecchymoses of- the skin and peritoním; follicular enteritis, marrow red and embryonic, the gastric mucosa vey much thinned in all the cardiac region, and particularly in the middle third of the organ. The third case was that of a man fifty-eight years of age, who had, during six months, become quite pale and weak. On entering the hospital, it was diagnosed",
         ". PROGRESS OF MEDICINE. permicious anoemia. At the autopsy were found ecchymoses of the skin and pleural pulmonary œdenia, fatty degeneration of the ryocardium, no change in the marrow; in the stomach the submucous tissue was thickly cedematous, the mucosa vas covered with a thick, pale, tenacious mucus. On microscopic examination, M. Quensel found in the three cases a very much advanced interstitial gastritis, with much atrophy of the glands. These changes were found almost entirely in the cardiac end, only very slight alterations being found at the pyloric. After a review of the work already done on this subject, the author goes on to the question of the bearing of these changes as an etiological factor in pernicious anæmia. He does not think that the ston-ach change can be the only cause of this blood disease. At the same time he does not but admit that progressive pernicious anSnia and gastric atrophy usually go hand in hand ; so far nothing more definite can be said. In the second part of his thesis M. Quensel gives a résumé of the histological changes in chronic gastritis. Ie bases his observations on the three cases above mentioned, and on nineteen others, a more detailed account of which he gives in the third part of his paper. In reference to the etiology of these cases, gastritis in four cases accompanied cancer of the stomach ; in five, pulmonary tuber- culosis ; in one, pseudoleucemia ; fa one, organe heart disease ; in two, chronic nephritis ; in three, alcoholics ; in one, senile (man eighty-five years old). In spite of the different etiologic factors the author has found that in all the cases the changes were of the same nature, with the one exception that they were in different stages of development. The author contends that a histological division of chronic gastritis should be made into interstitial and parenchymatous chronic gastritis. M. Quensel did not have at his disposal material illustrative of this last division, and trusts to the literature on the subject. In this paper he adheres particularly to the interstitial form. The author has shown that the neoformation of connective tissue, which constitutes the chief alteration and the essential one, commences always at the inner surface of the mucous membrane, whence it gradually spreads more deeply, thus forming a type to which he gives the name descending interstitial gastritis. As the neoformation of connective tissue goes on the glands disappear more and more, until finally there is a com- plete atrophy of the gastric mucosa. In the early stages of the process the author has not been able to make out any change in the epithelial cells. In the more advanced stage, he has often found a granular degeneration of the chief cells, but has never found any in which there was fatty degener- ation. The border cells were made out in nearly every case, even when hydrochloric acid was absent clinically. In two cases only, when the gastric juice was shown to be free of hydrochloric acid, were these cell s",
         "PATHOLOGY. absent, but their disappearance may have been correlative to cadaveric changes, which could not be excluded in these two cases. M. Quensel specially mentions a case where all the glands of the cardiac region were of the simple tube forni, lined even to the bottom of the glands with cells resembling the surface epithelium. Quite a number of these cells showed mucous degeneration. The author has found in a certain number of other cases the same changes in the glands in circu mscribed spots, as welli at the Pyloric as at the cardiac end of the stornach. He also mentions a diffuse fibrosis of the stomach in a woman aged thirty-seven years. The submucosa was con- siderably thickened with sarcomatoid tissue. The mucosa, on the con- trary, showed no considerable changes, and from this he has been led to admit the probability that the process might start in the submucosa. M. Quensel makes an exhaustive observation on certain homogeneous concretions formerly observed in chronic gastritis by Sachi and various other authors. They are from 4 to 30 mi in diameter, and he has been able to observe how the large ones are formed froi a fusion of smaller ones. The number varies in each case ; sometirnes they are very numer- ous, and are found chiefly in the superficial parts of the mucosa. They are always situated in the connective-tissue spaces, and not in the blood vessels. In the unstained state they are yellowish, and slightly glistening ; they ire deeply colored with cosin, acid fuchsin, and prussic acid. Wei- gert's method of staining fibrin has a specific reaction on these. Con- cerning the histogenesis, M. Quensel attributes their origin to the hya- line degeneration of the red blood corpuscles ; a degeneration which does not take place in the blood vessels, but only when the red corpuscles, after diapedesis or rupture of a vessel along with an inflammatory process, have gotten out of the blood vessels into the lymph spaces. Hyaline transfor- mation of the red blood corpuscles is much more common in chronic gastritis than is pigmentary transformation, which M. Quensel has, only on two occasions, and then in an insignificant degree, been able to observe. -Rev. Internat. de Bibliog. Méd. THE INFLUENCE OF BLEEDING ON THE ABSORPTION AND ToxICITY OF DRUGS. (F. A. Fodera, Archivio difarmacol. e Terapeut., 1894.) Bleeding, as Magendie, hastens absorption very much, and diminishes the resistance of the organism to poisons, at least to nerve poisons (stychnine), which is easily explained. Anærmia, whatever be its cause, renders the central and peripheral nervous system more excitable.-Rev. Internat. de Bibliog. Méd.",
         "PROGRESS OF MEDICINE. THREE SPECIMENS OF CARDIAC TUMORS. (Ludvig Hektoen, iledical News, 1893.) Neoplasms of the heart are amongst the rarest ; there are actually only 11o or thereabout on record. These three cases are particularly interesting. The first was in a woman fifty years of age, suffering frorn uterine cancer. The autopsy revealed a cancerous nodule in the wall of the right ventricle. The second was in a boy of twelve years, having an osteo-sarcoma of the tibia, for which dis- articulation at the knee had been done, and afterwards the same at the hip. After death a large sarcomatous nodule, nearly filling the right ventricle, was found. The third was in an Indian woman of about fifty years of age. There were no clinical observations. At the post-mortem examination a primary, small round cell sarcoma was found in the heart.-Rev. Internat. de Bibliog. Méd. ON THE PATHOLOGY OF INFECTION IN THE EMBRYO. (Pr. Maffuca, I. Polidinica, Jan. 15, 1894.) The author has endea- vored, not so much to observe how infection takes place in the embryo, as to how the infected embryonic tissue itself reacted. With this object he has studied the action of anthrax, hen cholera, Friedlander's pneumo- coccous of aviary and human tuberculosis, and of their toxic properties on the embryo chick, and on the embryos of rabbits. The following are some of the general conclusions he has come to fron these researches : The living embryo does not allow of the growth of pathogenic microbes in its tissues, except under very exceptional conditions; it is capable of destroy- ing, attenuating, or storing then up to allow of their growth after the embryo has escaped from the egg. Some microbes, non-pathogenic for the adult chicken, are pathogenic for the embryo. This one conclusion refers more to the chick than to the rabbit foetus. These conclusions are drawn from observations made on nearly one thousand embryo-chicks and one hundred and fifty rabbit fotuses. The author proposes to follow out these researches.-Rev. Intern. de Bib!iog. Yéd.",
         "HYGIENE AND PUBLIC HEALTH IN CHARGE OF WILLIAM OLDRIGHT, M.A., M.D. Tor., Professor of Hygiene in the University of Toronto; Surgeon to St. MichaeVs Hospital; AND E. HERBERT ADAMS, M.D., D.D.S. COMPULSORY VACCINATION. Dr. W. E. Quine, of Chicago, before the Illinois State Medical Society, said that vaccination was introduced to the attention of the medi- cal profession by Edward Jenner, in 1798, as the result of investigations which extended over a period of twenty years. During the century pre- ceding, according to the estiniates of our rnost authoritative writers and statisticians, smallpox, \" the rnost terrible of all the ministers of death,\" destroyed in Europe alone 5o,oooooo human lives. Think of it! Five hundred thotisand deaths every year from the most loathsome pestilence known to man ; thirteen hundred deaths every day, nearly a death every minute for a hundred years. If it be true, as is believed by enlightened people, that universal vaccination and revaccination, efficiently done, will put an end to ail this desolation and horror from epidemics of smallpox, and finally eradicate the disease altogether, it would appear that the discoverer of vaccination is the greatest benefactor that mankind has known. Alexander was great. Caesar was great. Hannibal was great. Napoleon was great. They were ail great-as destroyers. What have they done ? What have all the kings and potentates and warriors of earth done, in comparison with one mnember of the medical profession in the direction of adding to the sum total of human happiness and human life? Are such conceptions of the possibilities of vaccination an idle dream? As proof of the protective influence of vaccination, many examples were cited by the speaker, and but one will suffice here: A village in Leicestershire of thirteen hundred inhabitants was visited in 1872 with smallpox. All but two of the inhabitants were vaccinated, and they escaped the disease. The two unvaccinated persons contracted the dis- ease and died of it.",
         "PROGRESS OF MEDICINE. Age for vaccination. Children are more liable to smallpox than adults, and more liable to die when attacked. The younger the child, the greater the danger ; hence vaccinate during the first year of life.-The journal of the American fedicai Association. NATIONAL LIvE STOCK SANITARY ASSOCIATION. A National Live Stock Sanitary Association has be-en recently organized in Washington, D.C. In view of the proninence which has recently been given to diseases of live stock in Canada, the establishm1ent of such an association would obviously be of great benefit to the financial and sani- tary interests of this country. THE VALLEY OF MEXICO. The drainage of the valley of Mexico has been undertaken again. The estimnated cost is $3,5oo,ooo. The contract was made by the authorities of the city of Mexico on June 4th. The work is to be finished by May ist, 1896. INSOMNIA. It is pointed out by Mr. Huxley that nature's plan for curing insomnia is to limit the supply of oxygen to the blood, as the cat and dog bury their noses in some soft hollow in their hair or fur ; birds put their heads under their wings and soon fall asleep. Mr. Huxley suggests that those suffering from insomnia should cover their heads with the bedclothes and breathe and rebreathe only the respired air ; when drowsiness is produced it is easy to go on sleeping, and the bed coverings can be pushed aside and as much fresh air obtained as is needed.--American Practitioner and News. INSANE, ASYLUMS THAT ARE SIMPLY PRISONS. The address of Dr. S. Weir Mitchell before the American Medico- Psychological Association in Philadelphia was in the nature of a broadside aimed at the management of insane asylums in this country. The doctor finds little in the present system to commend. In the appointment of asylum superintendents, physicians, and nurses, nothing is as influential as a political pull. Asylums are simply prisons, and not hospitals conducted in an intelligent and scientific manner. They are not provided with modern medical advantages, such as masseurs, an electrical room, and hydro- therapeutic treatment. The nurses are not properly educated and exam- ined. A far better system than the,huge asylur would be separate srnall houses, with caretakers and appliances for work and recreation. The insane 856",
         "HYGIENE AND PUBLIC HEALTH. should have work, when able to perform it, and they would prefer it to listless idleness. If the )bject of the insane asylum is to restore the patient to usefulness in society, the present methods of procedure, according to Dr. Mitchell, are deserving of nothing but denunciation. As the address was delivered in the presence of many asylum superintendents, it is likely to be productive of some pretty vigorous thinking, at all events.-Paric Record. A SEWERAGE SYSTEM FOR NEW ORLEANS. The Cresent City is to be congratulated upon the prospect of having constructed in the near future a complete and extensive sewerage system. If there is a spot on earth that needs sewers worse than New Orleans, the Texas Sanitarian has forgotten its geographical whereabouts. Twenty- eight deaths to every thousand inhabitants is a sufficient basis for the indictnent and trial for manslaughter of every administration since the days of Ben. Butler.-Texas Sanitarian. THE SANITARY INSTITUTE. The fourteenth congress and exhibition of the Sanitary Institute was held in Liverpool, commencing September 24th. The Lady Mayoress of Liverpool presided in the conference on \"Domestic Hygiene.\" The various sections were : J. Sanitary Science and Preventive Medicine, under the presidency of Dr. Klein. II. Engineering and Architecture. III. Chemistry, Meteorology, and Geology. MORTALITY oF TuBERCULoSIS. Dr. Lagneau said that his investigation into the relationship existing between occupations and the development of tuberculosis showed that the greatest number of deaths from phthisis occurred in workers exposed to irritating substances in the respired air. In Switzerland 10 out of oo stone-cutters die from phthisis. In England, of 1,ooo deaths occurring ir these workers, 340 were from phthisis. Tuberculosis makes cruel on- slaught likewise in those individuals who habitually occupy a bent posture at their occupations, and in those who live sedentary and intellectual lives. Of 1,ooo deaths in Italy among students and seminarians, 45o died of phthisis-that is, nearly one-half. In England, of a similar number of deaths in printers, 43o died of phthisis. On the other hand, statistics show that it is quite exceptional for this disease to be the cause of death of those who live in open air. In Switz- erland, of 1,ooo deaths occurring in outdoor laborers and farmers, not more than one or two die froni phthisis. A similar number of deaths in",
         "PROGRESS OF MEDICINE. Italy among shepherds and farmers shows only from forty-four to fifty-five deaths. In France the sanitary statistics gathered from 665 towns show that the more the population is conglomerated, so in proportion are the inhabit- ants gravely infected with tuberculosis.-Medical Record. A STATISTICAL STUDY OF SMALLPOX. Welch, in a paper read before the Pan-American Medicai Congress, has placed upon record the statistics of 5,ooo cases of smallpox that have been under his care at the Municipal Hospital for infectious diseases in Philadelphia. Of these 2,831 were cases of unmodified variola, of which 54.-8 per cent. died; and 2,169 of varioloid, modified by vaccination, of which 1.29 per cent. died. Nearly two-thirds of the cases were males, the death rate being about the same for both sexes. Nearly one-sixth of the patients were of negro blood, and among these the proportion of deaths was larger than among the whites. But Welch points out that the proportion of the unvaccinated was correspondingly larger amorig patients of negro blood, and that comparing the unvaccinated of both races the mortality was alniost exactly the same, viz., 58.5 for white and 58.54 for black. The statistics but feebly indicate the value of vaccination, however, since they give no sign of the disfigurement of the unvaccinated who recovered and the comparative freedom from scars of those who had been vaccinated. On admission, the presence and character (as good, fair, or poor) of vaccination scars was noted in each case, and the subsequent course of the disease seems to indicate that the quality of the marks has more signifi- cance, as indicating protection, than their number, although this also seemed to have some influence. With reference to vaccination after exposure and prior to the appear- ance of the eruption, it was found that of seventy-four cases vaccinated longer than seven days before the appearance of the eruption but fifteen died. As to revaccination, his experience leads him to place implicit confidence in its efficacy. The proportion of deaths among the vaccinated increases with the length of time that has elapsed ; after fourteen years the deaths being about 9 per cent. of those who showed a good mark. After revaccination, deathi occurred in a smaller proportion of cases than after a previous attack of smallpox, and not at all in those who showed good scars. 858",
         "HYGIENE AND PUBLIC HEALTH. As to second attacks, he has never seen an unmodified or severe case of smallpox in a person who was deeply and characteristically pitted from a previous attack, and during a service of over twenty years no person was admitted a second time for any forn of the disease.-Plladephia oy- clinic. DENTAL EXAMINATIONS OF ScOoOL CHILDREN. The Berlin Society of Dentists has vritten to the magistrates of Berlin, proposing to establish dental examinations of school children at regular intervals, a sanitary measure which is already in practice in many schools of England and France, as well as in the Prussian Military College.- Popular Health Magazine. VACCINATION. Before the introduction of vaccination, the mortality in Austria from smallpox was 62 per 0oo,ooo; in Prussia, 49. Since the introduction of vaccination the mortality has been two cases in 700,000. In Germany, where revaccination is compulsory, the death rate is one patient in every 1,200,000. CHILDREN OF TUBERCULAR PARENTS. The hygienic treatment of children born of tuberculous parents should begin at birth. If the mother is tuberculous she nust not nurse the child. If possible, the child should be brought up in the country, or better still, if practicable, near the sea, or at least make long stays in the country, as the dangers of contagion are less frequent there than in the cities. Any sign of feebleness, such as rickets, anæcmia, enlarged glands, etc., should receive due attention. Diseases of the respiratory tract, should be most carefully attended to, as they may directly prepare the soil preferred by the 859",
         "ELECTION PROTEST. W E understand that a protest has been entered against the election of Dr. Spankie, of Wolfe Island, in Division 15. After a very exciting election, the votes were counted hy the returning officer, Dr. A. S. Oliver, in the presence of scrutineers representing the candidates. The result was declared a tie, and Dr. Oliver gave his casting vote in favor of Dr. Spankie. The scrutineer of his opponent, Dr. Dickson, of Pembroke, had objected to several of the votes recorded for Dr. Spankie, on the ground that they were tendered by proxy. In former times such piotests were settled by the council. It will be remembered that, after the elec- tion in 1889, Dr. Shaw, of Hamilton, was unseated by the council at the following session, and Dr. Miller was declared the representative of the division. Other cases of a similar kind had occurred before that time, and sometimes a considerable amount of ill-feeling was aroused, Such trials by the whole body of the council became so unsatisfactory in various respects that a change was thought desirable by many, including a ma- jority of the members of the council. The recent amendments to the Medical Act provided that in future any such election trial shall be held by a county judge. In this instance the protest will be tried by His Honor Tudge Price. METHODS OF WARFARE. F any one cognizant of events were to ask, in all seriousness, whether the recent council elections were conducted in accordance with methods that reflected credit on a body of educated gentlemen, he would probably be regarded as a very innocent simpleton, who scarcely deserved a reply; or he might possibly be told that there was no tangible evidence of the existence of any very large nutnber of educated gentlemen among the medical profession of Ontario. The contest between the \" Old Editorials.",
         "EDITORIALS. Guard \" in the council and the \"Defence Association \" has been intensely bitter-far beyond anything this province has ever seen before, in matters pertaining to medicine. Letters \"by the ream\" appeared in the lay press, telling the public of Ontario that the members of the Medical Council were guilty of \"extravagance,\" \" wastefulness,\" \"transgressions of the law,\" \" dishonesty,\" \" untruthfulness,\" \" fraud,\" and a few other some- what objectionable peculiarities and idiosyncrasies. It is only fair to add that the charges referred to were brought against men, not as private individuals, but as servants of the general profession, honored in having committed to their care a public medical trust. Criti- cisms oftheir acts were quite pertinent, but violent language such as that used by many of the critics was, to say the least, quite unnecessary and undignified. Unfortunately, many of the replies on behalf of the council were quite as violent as the attacks, while, at the same time, son-e of them were almost babyish in their weakness. At the last meeting of the coun- cil the retiring president delivered an address, able in character, but not altogether wise. Immediately thereafter the \"Defence \" champions rushed to the newspapers, and some of their letters were not simply violent-they were vicious. The ex-president was so seriously affected that he appar- entlv lost his head, and published a letter which made no pretence of an- swering any arguments, but simply contained a coarse and vulgar personal attack on a leading member of the Defence Association. We have no desire to discuss this unfortunate businèss in detail, but we feel compelled to enter a very decided protest against such conduct, involving, as it does, a gross violation of all the decencies connected with journalistic contro- versies. If the warfare be continued, we hope that better methods will prevail on both sides. THE NEW COUNCIL. A LIST of the successful candidates will be found in this issue. We cannot say that the results of the elections have furnished any great surprises. It will be noticed that three of the most able and most promi- nent members of the Defence Association, Drs. McLaughlin, Sangster. and Armour, have been elected. Dr. McLaughlin was a member of the coun- cil many years ago, and is generally acknowledged to be an able and con- scientious man. His election by acclamation is a popular one. Dr. Sangster distinguished himself in the recent battles as a fighter of ability, and we believe the majority of physicians in Oritario will be glad to see him in the new parliament. Personally, we regret the defeat of Dr. Cotton, whose character and ability fully qualify him for a seat in the",
         "EDITORIALS. Council; but, considering the strength of the forces combined against him, his defeat by the leader of the Defence Association, in a division where the influence of that body was overwhelmingly strong, will create no surprise, and will leave no cloud of any sort hanging over him. The contest between the president, Dr. Philip, and Dr. Armour was conducted with great vigor on both sides. Dr. Armour was, so far as we know, the originator of the Defence Association. At all events, he has been from the first one of the most active workers in its ranks. Dr. Philip was, on the whole, an excellent member of the council, and was highly respected by his colleagues, as shown by his unanimous election to the presidency during the last session. All things considered, however, it is probably well that these three Defence men have been elected. They certainly represent a large portion of the electorate, and it seems a matter of justice that this trio should assume the responsibilities of office. Dr. Vardon, of Galt, another very active member of the Defence Association, was defeated by Dr. Brock, of Guelph. Of the twelve territorial representatives in the last council only four remain-Drs. Bray, Williams, Henry, and Rogers. The election of Dr. Rogers is remarkable from the fact that it means the defeat of the able and well-known veteran, Dr. Bergin. The four mentioned will be fully able to represent the \"Old Guard,\" and their election will be con- sidered by a large proportion of the profession as a legitimate matter for -congratulation. Drs. McLaughlin and Shaw, having been representatives before, should not be placed in thefreshnan class. There will be an unusually large number of new men, from whom we will expect much. They are, as a rule, endowed with ability and good judgrnent. They are, speaking in a general way, no party men, and are not likely to go to extremes, either in the direction of radicalism or fos- silism. We hope that partyism, if it be continued on the present lines of Defence and anti-Defence ideas, will be kept within the bounds of decency and order; and that any discussions of the -burning medical questions of the times, though they may be animated, will not degenerate into unseemly wrangling. Upon the whole, we think the various electors have chosen wisely and well, and, as a consequence, we will have in the new council a body of medical legislators who will do credit to themselves and their constituents. SUBSTITUTION. BY INSTRUMENT MAKERS. IN our report of the proceedings of the American Association of Obste- tricians and Gynæcologists (pP. 794-5), our readers have probably noticed that Dr. Murphy, of Chicago, called the attention of the members to a defective button that was purported to be a Murphy 862",
         "EDITORIALS. button. He pointed out the defects, and showed the particular danger that would arise fron these defects. A man's reputation, earned by hard and conscientious work, can easily be harmed by his friends. Men devise new operations and invent new instruments to aid their being properly carried out, report their progress, and, by every legitimate means, endeavor to aid others in repeating these operations. The only fair means of judging whether that particular pro- cedure is a good one, and that the reports of the results attained are abso- lute, is by test repetitions of the operation ; but these should be done with the same. precaution, the saie careful technique, and wvith instruments sinilar to.those used by the inventor. Very few men inves'.igate far enough the technique of an operation before proceeding to perform it, and some, by failure, bring discredit on the originator, or elsc rush into print with a modification, which is no modification except in adding a new naine. Instrument makers purchase an instrument in the open market, for a sample, which may be defective in itself, and, in a great number of cases, never submit an instrument to the inventor for his opinion, but proceed to manufacture and cheapen the instrument, while still calling it by the original name. Bad resuits cannot help following, and the operation is blamed. It was a very striking instance of this that brought the inatter to the writer's attention. Dr. Murphy, of Chicago, was requested to dou n anastomosis at St. Michael's Hospital, Toronto, and he was handed a button, recently purchased by one of the staff, to use. He at once detected its faults, and pointed them out, and showed a button that was properly made that lie had in his pocket ; yet several of us had seen the button, but did not detect these very dangerous defects. We cannot be too careful, in purchasing instruments, to get proper quality, and to do so we often have to pay a little more than supposedly similar goods could be purchased fron other dealers. It is best always to buy from reliable dealers, and those who guarantee their goods vith their reputation. Medical ethics does not permit of instruments being patented, but there are instances where it might save lives. We remember that Dr. Otis, when he devised his urethratome, thought of these impositions of instrument makers, and wanted to patent it and hand the patent to the Academy of Medicine, but they would not consent. Yet that instrument has been badly curved and twisted, so that it was impossible to do Otis' operation as done by him; yet it was called and sold as Otis' urethra- tome. We could give other instances, but that would be superfluous. The only moral that can be drawn from the above is to always familiarize oneself with the details of an operation, and any new device that is to be used in the procedure, and purchase the latter from a reliable source.",
         "Correspondence. THE RESULT AWAITED AND THE RESULT ANTICIPATED. DEAR EDITOR,-\"If I had appendicitis, I would lie in bed, take salines, apply poultices, and await the result.\"-M.D. (possibly a reincar- nation of B.C. 710), in a recent medical journal. Who among us, even in a most iimited sphere. cannot recall cases of this affection where the attendant did await he resilt, which result was occasionally of greater interest to the undertaker than to the physician ? This subject has been so thoroughly threshed out that repetition should be unnecessary, but still, with all the light that has been thrown upon this region of the abdomen, the slaughter continues, encouraged by such statements as the one I have quoted. By way of illustration of the \" await the result\" nethod, I give notes of a case that came under my observation while practising in Bruce county, Ont., previous to the ushering in of the appendicitic era, and also, by way of comparison, notes of a case very silar in a rural district forty miles from town, but happily happening after the commodious and convenient \"inflammation of the bowels\" had been resolved into its component parts : CASE I. J. P., æt. 39, farmer, overheated and chilled, presented symp- toms now recognized as indicative of appendicitis. Received the orthodox poultice, etc. In a few days I was comforted with the thought that \" the inflammation of the bowe!s was under'control,\" temperature fell to normal, pain ceased, and all that remained was a distended abdomen with increased dullness towards the right side. Believing my patient convalescing, I discontinued regular daily attendance. A few days later I was called to explain a sharp pain in right fossa occurring after a motion of the bowels. Neuralgia, muscular rheumatism, and a few other convenient terms were used, to the apparent satisfaction of the friends. Next day found the patient comatose. The result awaited was rupture of abscess into the peritoneal cavity, septic inflammation, and ù2ath. CASE 2. J.E., æt. 31. First attack, course of disease similar to that of Case r. Had received well-directed treatment for upwardslof a week,",
         "CORRESPONDENCE. when attendant concluded that something other than poultices and salines were required. When seen, pulse was 8o, temperature normal, and pa- tient comfortable, abdomen tympanitic, no dullness perceptible per rec- tum, Douglas' sac distended and tense. Upon opening the abdomen (Dr. Jones), the deeply congested and inflated intestines filled the open- ing, and proved troublesome by obstructing thë field. In the right fossa was an abscess containing two ounces of pus ; appendix gangrenous, except base, which was ligated. A second abscess, completely distinct from the former, was found occupying the pouch, and containing about six ounces of pus. The abdomen was thoroughly irrigated with boiled water, adhesions separated, and drainage applied. Recovery was some- what retarded by defective after-dressings, but the ultimate result left nothing to be desired. With such cases not infrequent in our experience, and with many reported in the journals, it seems to be possible that the definite teaching of surgery is still meaningless to some ofour worthy members. If the resuits of surgical interference in this disease were disastrous, we could excuse such expressions; but with a mortality almost nil there is no excuse for such a statement as, \" If I had appendicitis, I would lie in bed, take salines, and await the resuit.\" ERNEST HALL. Victoria, B.C. 865",
         "Qok Revi emxs. Books received: INEBRIETY AND NARCOMANIA: Its Etiology, Pathology, Treatment, and Jurisprudence. By Norman Kerr, M.D., F.L.S., Fellow Med. Soc., Lon- don ; President Society for Study of Inebriety, etc. Third edition. Svo., 780 pages ; $5. London : H. K. Lewis, i36 Gower street, W.C. MEDICAL NURSERY. Notes of a lecture given to the probltioners at Lon- don Hospital by the late James Anderson, M.D., F.R.C.P. Edited by Ethel F. Lampori, Associate of the Sanitary Institute, etc., etc. With an introductory biographical notice by Sir Andrew Clark, Bart. Crown octavo. London : H. K. Lewis, 156 Gower street. A MANUAL OF SURGERY, GENERAL AND OPERATIVE. By John Chalmers DaCosta, M.D., Demonstrator of Surgery, Jefferson Medical College, Philadelphia ; Chief Assistant Surgeon, Jeferson Medical College Hos- pital ; Surgical Registrar, Philadelphia Hospital, etc. One very hand- some volume of over 700 pages, with a large number of illustrations. (Double number.) Price, cloth, $2.5o net. TEXT-BOOK OF NERVOUS DISEASES. Being a compendium for the use of students and practitioners of medicine. By Charles L. Dana, A.M., MD., Professor of Nervous and Mental Diseases in the New York Post-gradu- ate Medical School and in Datmouth Medical College, etc. One volume post octavo, 525 pages. Illustrated by 204 wood engravings, over half original. One plate. Bound in red parchment cloth. Price, $3.25. William Wood \u0026 Company, New York. PRACTICAL URANALYSIS AND URINARY DIAGNOSiS : A Manual for the Use of Physicians, Surgeons, and Students. By Charles W. Purdy, M.D., Queen's University; Fellow of the Royal College of Physicians and Sur- geons, Kingston ; Professor of Urology and Urinary Diagnosis at the Chicago Post-graduate Medical School. Auhor of \"3right's Disease and Allied Affections of the. Kidneys\"»; also of \" Diabetes : Its Causes,",
         "BOOK REVIEWS. Symptoms, and Treatment.\" With numerous illustrations, including photo-engravings and colored plates. In one crown octavo volume, 360 pages, in extra cloth, $2.50 net. Philadelphia : The F, A. Davis Co., Pub- lishers, 1914 and 1916 Cherry street. TEXT-BOOK OF HYGIENE: A Comprehensive Treatise on the Principles and Practice of Preventive Medicine from an American standpoint. By George H. Robé, M.D., Professor of Therapeutics, Hygiene, and Mental Diseases in the College of Physicians and Surgeons, Baltimore; Super- intendent of the Maryland Hospital for the Insane ; Member of the American Public Health Association ; Foreign Associate of the Société Française d'Hygiène, etc. Third edition, thoroughly revised and largely rewritten, with inany illustrations and valuable tables. Royal octavo, 553 pages. Cloth, $3 net. Philadelphia: The F. A. Davis Co., Publish- ers, 1914 and 1916 Cherry street. A MANUAL OF THERAPEUTICS. By A. A. Steven, A.M., M.D., Lecturer on Terminology and Instructor in Physical Diagnosis in the University of Pennsylvania; Demonstratorof Pathology in the Woman's Medical Col- lege, Philadelphia ; Physician to St. Mary's Hospital and to the South- eastern Dispensary ; Pathologist to St. Agnes' Hospital. Philadelphia: W. B. Saunders, 1894. This work is intended to place before the student a practical outline of modern therapeutics, and, considered as a whole, is deserving of high commend- ation. The book may, for the purpose of reviewing, be divided into five parts. Part I. is devoted to a classification of drugs under their pharmacological heads, and, if fault may be found, we are of the opinion that the author has erred on the side of brevity. A description of drugs, alphabetically arranged, occu- pe t n More attention is paid to therapeutics and admin- es th sucedn pai therap£uics .admin istration than to physiological action. The student will find described in this division a1 the recently discovered preparations. Then follows a short discus- sion on remiedial measures other than drugs, such as electricity, massage lavage, disinfection, etc. The latter part of the work is principally devoted to applied therapeutics, probably the most valuable portion of the work. The application of the particular drugs which have been found most useful in the treatment of each disease is here discussed. The volume closes with tables of doses, sof discases and remedies, and a short chapter on incompa-% tirt The volume contains 450 pages, and is a very creditable specimen of printing and binding. DISEASES OF THE SKIN: AN OUTLINE OF THE PRINCIPLES AND PRAC- TICE OF DERMATOLOGY. By Malcolm Morris, F.R.C.S., Surgeon to the Skin Department, St. Mary's Hospital, London, etc. In one 12mo. vol- ume Of 572 pages, with 19 chromo-lithographic figures and 17 engravings. Cloth, $3.50. Philadelphia : Lea Brothers \u0026 Co., 1894. We have. read, with a great deal of pleasure, the above work, and can thoroughly recommend it both to the practitioner and studetL. it is particu- 867",
         "BOOK REVIEWS. larly adapted to the use of students. It is concise, complete, and up to date, and, at the same time, no space is wasted in useless words. Mr. Morris is one of the foremost English dermatologists, and bas the happy faculty of imparting his knowledge in a pleasing manner. The arrangement of the work is one to be commended, and the first three chapters, on \" Pathology of the Skin,\" \" Classification,\" and \" Principles of Diagnosis,\" will lead many an erring student into the right road if their precepts are followed. The pathology throughout the whole work is right up to date, and treatment is fully consid- ered. We do not appreciate the colored drawings as we would like, from the too high colorincig. It is a fault with most colored plates in skin diseases. The drawings are admirable, but the coloring too bigh. It is the fault of the lithographer, not the artist. The Germans are the only ones who appear to color correctly. The typography, presswork, and binding are in the very best style of Lea Brothers \u0026 Co. A TEXT-BOOK OF PRACTICAL THERAPEUTICS. With especial reference to the application of remedial measures to disease, and their employment on a rational basis. By Hobart Armory Hare, M.D., B.Sc., Professor of Therapeutics and Materia Medica in the Jefferson Medical College of Philadelphia; Physician to the Jefferson Medical Hospital ; Consulting Physician to the Franklin Reformatory Home; Laureate of the Royal Academy of Medicine in Belgium, of the Medicai Society of London, etc. Fourth edition, enlarged and thoroughly revised. Philadelphia: Lea Brothers \u0026 Co., 1894. The value of this excellent work to the medical profession is well evidenced by the fact that no less than four editions have been issued in as many years. The volume is divided into four parts devoted respecively to genleral thera- peutical considerations, drugs, remedial measures other than drugs, and diseases with their special treatment. Part . deals with rmodes of administra- tion, dosage, absorptioni, strength, incompatibles, and a classificatiôn of drugs under their various therapeutic beads. In Part IL. all the drugs in general use, including those more recently added to the list, such as methylene blue, der- matol, condurango, convallaria, chloralose, piental, piporazine, trional, etc., are dealt upon. Such drugs are arranged alphabetically, and each drug is described as to sources or preparation, physiological action, therapeutics, to.ic properties, and method of use. Such remedial measures as acupuncture antiseptics, heat, cold, climate, foods for the sick, - enteroclysis, intravenons injection, rest cure, etc., are extensively dealt with in Part IIL The conclud- ing portion of the book is occupied with methods of treatment in the different diseases classified alphabetically. Not only bas the author indicated the drugs best adapted to particular diseases, but bas entered carefully into the question as to the best treatment at particular stages and conditions. Throughout the work all weights and measures are given both in the metric and English system, so as to render it uniform with the new United States Pharmacopœia. In conclusion, we may say that we know of no work more suited to the needs of the student and the general practitioner who desires to have a greater knowledge of modern therapeutics. 868",
         "BOOK REVIEWS. 869 A SYSTEM OF GENITO-URINARY à'ISEASE, SYPHILOLOGY, AND DERMA- TOLOGY. By various authors. Edited by Prince A. Morrow, A.M., M.D. In three volumes. Published by D. Appleton \u0026 Co., New York. Toronto agency, Geo. N. Morany, 63 Yonge street. Subscription only. Volume III., \" Dermatology.\" We have before us the last volume of the above system-\" Dermatology.\" It, like its predecessors, is a most complete collection of the good works of the many authors. It is impossible to pass each chapter in review before us, and almost as difficult to choose which to speak of in particular. All are good, up to date, and complete. What the general practitioner most requires is to be found here-aid to diagnosis and treatment. He is not overburdened with historical facts and obsolete pseudonyms. History and titles are referred to, but no space is wasted. The index of this work is a valuable acquisition in itself. It is very thoroughly arranged, and is a great aid to the busy practi- tioner in his hunt for reference material. Possibly the most complete and really new material in the volume is the chapters on \" Leprosy,\" by Dr. Prince A. Morrow. These embrace the researches made by Dr. Morrow during his trip to Hawaii, and include a most interestng series of photographs made by him at the same time. Every phase of the disease is beautiftily pictured in all its hideous manifestations. It is unnecessary to say that the chapter reads like a serial story, so beautifully is it woven together. This is the day of bacteriology, and that particular exciting cause of many forms of skin lesion has received a very thorough examination. We can recommend this system to every practitioner, and feel sure that it will be of most practical value to him. The binding, typography, presswork, etc., are of the highest order, as all of the works of D. Appleton \u0026 Co. are. A SYSTEM OF LEGAL MEDICINE. By Allan McLane Hamilton, Consulting Physician to the Insane Asylums of New York City, and Lawrence Godkin, Esq., of the New York Bar. With the collaboration of Prof. Bahcock, etc. Illustrated. VolumeI. New York : E. B. Treat, Cooper Union, 1894. This encyclopedia of medical Jurisprudence will be published in two volumes. The first volume, which is a handsome book of nearly 700 pages contains contiibutions on the following subjects ; \" Medico-legal Post-mortem Examinations\"; \"Death in its Medico-legal Aspects\"; \"Blood, and Other Stains \" ; \" Identity of the Living\"; \" Identity and Survivorship \" ; \" Homi- cide and Wounds \"; \" Poisoning\"; \"Toxicological Importance of Ptomaines and Other Putrefactive Products\"; \" Life Insurance\"; \" Accident Insurance \" ; \"The Obligation of the Insured and the Insurer \" ; \"Legal Relations of Physi- cians and Surgeons to Their Patients and One Another\"; \"Indecent Assault upon Children.\" The contributors, býih legal and medical, are men of high standing in the U.-ted States, aiid have sufficient weight to spek with undoubted authoritv on the various subjects connected with medical jurisprudence. Mr. Lawrence",
         "BOOK REVIEWS. Godkin tells us that the science of forensic medicine had its beginning in 1553, when the Emperor Charles V. of Germany directed that the opinions of medical men should be taken in cases of death by violence with a suspicion of a criminal agency, and goes on to give a very interesting account of its pro- gress up to the present time. Some contributions by eminent lawyers give much valuable information on subjects which frequently arise in court, but are not, as a rule, fully treated in our ordinary text-books on medical jurisprudence. Much new material in the way of experimental worr is presented in this volume, especially with respect to gunshot wounds and blooc stains. The report of -the investigations of Dr. Victor C. Vaughan in regard to ptomaine poisoning is exceedingly interest- ing, and, in some respects, rather startling. The chapter on life insurance deserves special mention, being the best we have seen on the subject. It is very difficult, in a brief review, to give anything like an adequate idea of the merits of this work. As to the first volume, we find nothing that deserves adverse criticism. All the chapters are admirable, and the matter all fully up to the times. We believe every medical practitioner should have this \"System of Legal Medicine.\" CHOREA AND CHOREIFORM AFFECTIONS. By Wm. Osler, M.D., F.R.C.P., London ; Professor of Medicine Johns Hopkins University, Baltimore, etc. London: H. K. Lewis, 136 Gower St., W.C. In this latest work Professor Osler deals exhaustively with the interesting affection chorea, and the not less interesting, if rarer, affections closely allied to it. The author draws largely upon the records of his own cases and those of his colleagues in the Infirmary for Diseases of the Nervous System, Philadel- phia. The list taken from this source includes 554 cases. In addition to this wide experience, medical literature, current and remote, has been utilized to place before the reader whatever may be of interest, whether in the way of historical views as to nature and pathology, or peculiar phases of the disease. The author deals at length with the heart inflammation so commonly met with in chorea. The records cited indicate in what proportion of cases is endocarditis likely to occur, and also in what proportion is this endocarditis followed by permanent heart derangement. Of 554 cases 170 presented heart murmurs, and in fatal cases the frequenicy of endocarditis is so great as to make the statement true, \" that there is no known disease in which endocarditis is so constantly found, post mortem, as chorea.\" Of 140 cases examined by the author and his colleagues two or more years after thè attack of chorea, there were signs of organic heart disease in 72. With reference to the pathology of the disease there is still much that is obscure, and what had been written early in the century would still apply. Regarding the relation of chorea to acute rheumatism, the writer puts the ques- tion : \" Are its symptoms merely manifestations of the rheumatic poison, or does the arthritis bear the sanie relatjon to chorea as the joint inflan.,nation to gonorrhcea or to cerebro-spinal fever?\"",
         "BOOK REVIEWS. 871 Coming to choreiform affections, chapters are devoted to the various forms of tic, habit spasms, etc., and cases are related to illustrate the peculiar phases of these choreiform movements and their association with peculiar mental states and special sense derangements. A chapter is devoted to chronic progressive chorea in chronic hereditary chorea, sometimes termed Huntington's disease. Histories of two families in whom this condition passed from one generation to another are included in this chapter. Altogether, the book contains within its 125 pages a wealth of information on the subject, and represerts a vast amount of work on the part of its author. We are glad to have bad an opportunity of reading the book, and can confi- dently recommend it to our subscribers as a work calculated to broaden one's ideas as to the true nature and scope of chorea.",
         "jIvedieal Items. CORRECTION.-In the report of a case of Primary Diphtheritic Laryngitis in our last number a misprint occurred. The quantity of calomel sublimed was thirty \" grains, not \" three \" grains as stated. DR. MAY, of Chicago, was in town in October to attend bis brother's funeral. DR. H. E. BUCHAN, who bas been on the staff of the asylum in Kingston, bas been transferred to London. DR. THOS. S. CULLEN (Tor., '90) bas been appointed assistant in gyno- cology in Johns Hopkins Hospital. DR. BRUCE L. RIORDAN, of this city, was elected third vice-president of the National Association of Railway Surgeons. DR. J. H. AUSTIN, of Brampton, bas just returned from England. He is recovering from pneumonia, contracted in London. DR. JAMES M. FORSTER, late of \" Orchard House,\" Hamilton, bas been pronoted to be assistant superintendent of Kingston Asylum. DR. BRUCE SMITH, who received an appointment in the Hamilton staff some months ago, bas left Seaforth, and is now in charge of \"Orchard House.\" DR. N. H. BEEMER, who bas been appointed superintendent of the Asy- lum for Insane, Mimico, was instructed,to take charge of the institution No- vember i5th. DR. OLIVER WENDELL HOLMES, the distinguished ex-professor of Har- vard, and well-known author, died at bis home in Beverley, Mass., October 7, at the age of 85. DR. T. P. MCCULLOUGH bas sold bis practice at Everett, Ont., to Dr. Kingston, of Stirling. Dr. McCullough is leaving for New York, where he will study diseases of the eye, ear, etc. DR. C. R. DIcKsoN was elected second vice-president of the American Electro-Therapeutic Association, and appointed chairman of the Standing Committee on Electrodes. The association will hold its 1895 meeting in Toronto, most likely in September.",
         "MEDICAL ITEMS. 873 DR. HUNTER ROBB, late assistant in gynæcology at the Johns Hopkins Hospital, has been elected to the chair of gynæcology in the medical depart- ment of the Western Reserve University. DR. W. OSLER, of -Baltimore, spent the greater part of the summer in England. After attending the meeting of the British Medical Association at Bristol be spent some time in London and Oxford. He paid a short visit to Toronto, September 24-28, on his return, after which he went to Baltimore. DR. ARCHIBALD H.- MACKINNON died in Everton, September 27, 1894, after a long illness. He took his course in the Toronto School of Medicine, graduating in 1877. He practised in Hillsburg for several years, and was highly successful as a medical practitioner, and greatly respected as a high- minded citizen. He removed to Toronto in 1892, but failing health prevented him from doing much professional work. PHILADELPHIA AS A MEDICAL CENTRE.-According to the Philadelphia newspapers, that city is again asserting its right to special prominence as a medical centre. The census of the medical schools is as follows : University of Pennsylvania, 875 ; Jefferson, 700 ; Hahnemann, 325 ; Medico-Chirurgical, 300; Woman's, 200; total, 2,4oo. The following candidates have passed the primary examination :-j. Beeket, Thamesville; W. L. Coulthard, Toronto ; B. F. Churchill, Toronto ; P. G. Goldsmith, Peterborough ; J. Gibbs, Bayview; D. Jamieson, Barrie ; J. M. Jory, Norwood; J. Jardine, Toronto ; Eleanor Lennox, Toronto ; J. A. Marquis, Brantford; W. G. MacKechnie, Brighton; T. Sneath, Midhurst; H. H. Sinclair, Walkerton; Thos. Wilso)n, Elm; F. A. White, Aylmer. FOR THE LUBRICATION OF CATHETERS.-To facilitate the exploration of the urethra and bladder in his wards in the Necker Hospital, Professor Guyon (according to the Paris correspondent of the Lancet) is in the habit of using the following formula: Powdered soap, 4 drams ; glycerine and water, of each 2 drams ; mercuric chloride, i grain. This ointment is said not to be irritat- ing to the urethra, and to be endowed with much greater lubricating powers than either oil or glycerine. THE TREATMENT OF APPENDICITIS. -At the last meeting of the Board of Managers of. the University Hospital the director was authorized to set aside certain beds to be used by Professors William Pepper and J. William White for cases of appendicitis, those gentlemen being engaged in a special investiga- tion of the symptoms, treatment, and patbology of that disease. Each case admitted to these beds will thus be studied from the outset with reference to both its medical and surgical features. It is hoped that the results may aid in clearing up the prevalent differences of opinion as to this malady.-Mdical News. FIRST AID.-She had attended the ambulance classes and obtained the certificate. The street accident she had earnestly prayed for took place. A marrhad broken his leg. She confiscated the walking-stick of a passer-by and broke it into three pieces for splints. She tore up her skirt for bandages.",
         "MEDICAL ITEMS. When all was completed she summoned a cab, and took her patient to the hospital. \"Who bandaged this leg so creditably?\" inquired the surgeon. \"I did,\" she blushingly replied. \"Well, it is most beautifully-most beautifully done ; but you have made, I find, one little mistake. You have bandaged the wrong leg.\"-Tid-Bits. SUPPLEMENTAL EXAMINATIONS, ONTARIO MEDICAL COUNCIL.-The following candidates have passed the final examination, held in September, and are therefore admitted as members of the College of Physicians and Surgeons of Ontario :- W. Arrell, Caledonia ; W. A. Ball, Toronto ; Ellen A. A. Burt, Toronto; W. L. Coulthard, Toronto ; G. M. Ferris, Campbellford; J. Jardine, Toronto ; J. M. Jory, Norwood ; Thos. Kerr, Toronto ; K. C. Mcllwraith, Hamilton ; E. J. O'Connor, Ottawa; W. H. Scott, Toronto ; J. S. Shurrie, Trenton ; H. H. Sinclair, Walkerton ; A. T. Shillington, Kemptville ; J. T. Somerville, Clifford, Mich., U.S.A.; J. Stenhouse, Toronto ; F. W. Stockton, Richwood; Thos. Wilson, Elm; D. Thomson, Woodbridge; F. A. White, Aylmer. DOCTORS AS COMPANIONs.-The following passage from Mr. James Payn's \" Gleams of Mernory,\" now appearing in the Cornhill Mfagazine, will be interesting to members of the medical profession : \" Upon the whole, and for a 'scratch' companion, I prefer a doctor to a man of any other calling. He may not be very good as a conversationalist, but he is rarely very bad, like a cheroot. He bas bad a genuine experience of life, and bas seen down to the depths of it ; a sick man does not attempt to deceive his doctor, or put the best face on his character, as he does with a priest. Moreover, what is very unusual; your doctor knaws more about you, professionally at all events, than you know about yourself. He does not tell you about it, it is truc ; not a word of that aneurism you carry about with you, and which will soine day kill you in half a minute, but your consciousness that he may possess such knowledge makes him interesting. The best suggestions I have had made to me for plots for my novels have coine to me from doctors, to whom I bave also had cause to be grateful for many things.\"-N. Y. Med. Record. SCARLET RASH AFTER ENEMATA.-The occasional occurrence of a bright scarlet rash after injections of warm water into the bowel should be borne in mind. The rash appears in about two hours after the injection, and lasts about twenty-four hours. It covers the whole of the body and limbs, and is especially marked on the face. In rare cases it is accompanied with sore throat and slight fever. The rash is almost exactly like that of scarlet fever, and may easily be diagnosed as such, especially if a sore throat is also present. It occurs more commonly in children than in adults, and is occasionally distinctly urt carial. It is due to toxoemia caused by absorption of fæcal matter liquefied by the injection of a 4arge quantity of warm fluid into the rectum. In all cases of supposed scarlet fever it will be well to exclude.the possibility of the rash being due to an aperient enema.",
         "MEDICAL ITEMS. 875 I have lately met with two well-marked illustrations of this toxæmic rash. Case i was that of my own son, aged 1I. I was told that a scarlet rash had come out on him. I found that he was covered with a bright scarlet rash, but there was no sore throat, no fever, and no increase im the pulse rate. A soap and water enema had been used about two hours before the rash was noticed. I could not diagnose the case until, thinking it over, I remembered making a note on rashes after enemata. On reference.I fdnd the note was made from a very interesting paper by Dr. Burford, \" On a Mild Form of Septic ToxSmia Occurring after Enemata.\"* The rash disappeared in about twenty-four hours, and the boy was quite well. Case 2 I met with at the Queen's Hospital. A little girl was to be operated upon, but just before the operation a scarlet rash was observed on the child, and I was asked to see ber. On en'quiry I found that a soap and water enema bad been used that morning. There was no sore throat or fever, and the rash shortly disappeared.-C. W. SUCKLING, M.D., in Briisht Medical Journal. A MODEL SURGICAL CLINIC.-Scene, a spacious room. At a large table in the centre is seated the surgeon ; his secretary is opposite, an enor- mous folio register open before him. A group of students is clustered about the table. Benches filled with waiting patients occupy the sides of the room. The secretary calls No. 120,736. A man aided by crutch and cane limps forward. The surgeon's examination into the biography and genealogy of the patient (four folio pages carefully written -out by the secretary) being ended, the attendant removes the multiple wrappings of the right foot, exposing an inflanied great toe with ulceration upon one side of the nail. The surgeon gives it a hasty glance, and, turning, addresses the students as follows : \" Gentlemen, a few years ago a case of this kind-evidently an ingrowing nail-would have been at once submitted to local treatient, and, I admit, with fair prospects ofa good result. But now that we have learned the general interdependence of the different organs of the body, we feel that a thoroughly scientific treatrnent demands the examination by specialists of these different organs, in order to detect any condition, likely to be etiological factors in the case. The attendant will therefore take him and a copy of his history to the different rooms in succession, and return here with their respective offciai reports.\" [Some Hours Later.] Surgeon (loquitur).-\" Gentlemen, the patient has now returned to us, and I ask your attention while I read the reports of the various specialists.\" Ophthalmological Dep5ar/nent.--Case No. 120,736. This patient is myopic. As I recall a case where a similar visual defect was the cause of injury to the great toe in a person who \" stubbed \" it against the curbstone, I have ordered appropriate lenses to correct the difficulty, as a prophylactic against the recurrence of the disease. It is essential, however, that this treat- ment should be supplemented by wearing a loosely-fitting shoe. Otological Department.-Case No. 120,736. I find no defect of audition. As the patient's trouble may have arisen from want of suitable support to the foot, I have thought it best to shorten the stapes leather two holes. *Lancet, December x5th, z888.",
         "MEDICAL ITEMS. Rlzinological Department.-Case No. 120,736. A case of nasal tone ail. Wisbing to bring about a radical change in the parts, I have removed with the curette all adenoid growths, together with the adherent mucous membrane, from the cavities, and packed them all with aseptic gauze-which should be removed if the patient wishes to sneeze. Depariment Abdominal Surgery.-Case No. 120,736. Drs. A., B., and C., in consultation. The history showing that the patient's mother during life lost a set of false teeth, Dr. A., reasoning that \"tooth and nail\" are generally associated in action, is inclined to think the set may have been swallowed unconsciously and remained in the patient's stomach. Of course, he advises an operation. Dr. B., iù view of the accepted belief that \"Gallia est omnis divisa in partes tres,\" thinks it possible that one of them may have wandered down to the great toe, and advises an exploratory incision of the gall-bladder to ascertain if either part be missing. The \"Gallic boot of love,\" cited by Dr. 0. W. Holmes, seems to indicate a tendency of the gall to the foot. Dr. C. concurs entirely with b of these opinions, but on general grounds advises the removal of the appendix. The patient, however, avers that this has been already done, and that he bas it in a bottle at home, which he will fetch if required. It is therefore deemed advisable to await further develop- ment. Gyncological Department.-Case No. 120,736. Palpation reveals no abnormal condition of uterus or appendages. A medical student calling our attention to the fact that the patient wears pants and has well-developed male generative organs, we doubt if this is a proper case for this department. Department Genito-Urinary Diseases.-Case No. 120,736. Organs appar- ently healthy. It, however, is not impossible that the patient may have had a stone (vesical) which was passed naturally and impinged upon and injured the great toe. Department ofNeuroses, etc.-Case No. 120,736. The result of a careful examination of this case indicates a deficient innervation of bis lower extremi- ties. Two well-marked areas of impaired sensibility or partial anæsthesia are located in the gluteal regions beneath the tuberosities of the ischia. His history not mentioning this, we questioned him as to how long the condition had existed. His replies were unsatisfactory-merely to this effect, that he had \" sat so long upon those d-d hard benches that his -- got numb.\" A rubber cushion with two holes is recommended, and the case should be kept under observation. \"There, gentlemen,\" continued the surgeon, as he finished reading to them the reports, \"you have the result of a careful scientific inquiry into this case. \"I shall now send the patient to the chiropodist around the corner, with instructions to have the toe cleansed and a piece of sheet lead inserted under the roughened edge of the nail. I counsel you all not to lose the opportunity of witnessing the operation. Good morning, gentlemen !\"-Boston Medical and Surg-icalfJournal.- The Quarterly MedicalJournal. 876",
         "MEDICAL ITEMS. THE MEDICAL COUNCIL ELECTIONS. The results of the recent elections are as follows: TERRITORIAL REPRESENTATIVES. Division No. i-Dr. J. L. Bray, Chatham; acclamation. \" 2-Dr. J. A. Williams, Ingersoll; acclamation. 3-Dr. W. F. Roome, London; acclamation. ' 4-Dr. W. Graham, Brussels ; acclamation. \"9 5-Dr. Brock, Guelph, elected; opposed by Dr. Vardon, Galt. 6-Dr. Henry, Orangeville, elected ; opposed by Dr. Smith, Orangeville. \" 7-Dr. G. M. Shaw, Hamilton, elected; opposed by Dr. D. Heg.. gie, Brampton. ' 8-Dr. J. P. Armour, St. Catharines, elected ; opposed by Dr. D. L. Philp, Brantford. -\" 9-Dr. John Hanley, Waubaushene, elected ; opposed by Dr. W. D. C. Law, Beeton. \" o-Dr. J. E. Barrick, Toronto ; acclamation. i-Dr. H. T. Machell, Toronto; acclamation. \" 12-Dr. J. H. Sangster, Port Perry, elected ; opposed by Dr. J. M. Cotton, Lambton Mills. 13-Dr. J. A. McLaughlin, Bowmanville ; acclamation. 14-Dr. Thornton, Consecon, elected; opposed by Dr. Ruttan, Napanee. 15-Dr. W. Spankie, Kingston, elected by the casting vote of the returning officer; opposed by Dr. W. W. Dickson, Pem- broke. 16-Dr. R. Reddick, Winchester, elected ; opposed by Dr. R. F Preston, Newboro. 17-Dr. A. F. Rogers, Ottawa, elected; opposed by Dr. D. Ber- gin, Cornwall. COLLEGIATE REPRESENTATIVES. Dr. W. Britton, Toronto, University of Toronto. Dr. J. W. Rosebrugh, Hamilton, University of Victoria College. Dr. V. H. Moore, Brockville, University of Queen's College. Dr. W. T. Harris, Brantford, University of Trinity College. Sir James Grant, Ottawa, University of Ottawa. Dr. J. Thorburn, Toronto, Toronto School of Medicine. Dr. F. Fowler, Kingston, Royal College of Physicians and Surgeons, Kingston. Dr. W. B. Geikie, Toronto, Trinity Medical College. Dr. W. H. Moorehouse, London, Western University, London. HOMoeOPATHIC REPRESENTATIVES. Dr. George Logan, Ottawa. Dr. G. Henderson, Strathroy. Dr. C. T. Campbell, London. Dr. L. Luton, St. Thomas. .Dr. W. J. H. Emory, Toronto. 877",
         "878 MEDICAL ITEMS. OBITUARY. DR. WILLIAM GOODELL, the distinguished obstetrician and gynæcologist, of Philadelphia, died October 27th, in the sixty-fifth year of bis age. HENRY RICHARDSON, M.B.-Dr. Richardson, of Ancaster,' received his medical education in the Toronto School of Medicine, and graduated in the University of Toronto in 1867. He at once commenced practice in Ancaster, where, he remained until the time of his death, which took place suddenly on Sunday, October 28. HUGEL C. GUELPH, M.B.-The members of this year's graduating class of the University of Toronto were much shocked when they heard that one of their number, Dr. Guelph, had died in London, England, on October 24 from meningitis. He lost his parents in early childhood, and lived thereafter with his aunt, Miss Kent, of Toronto. After securing his degree in June he took a holiday of a few weeks, after which he went to England in August. His illness was short in duration, but otherwise we have not full details at the time of writing. His career as a student was in all respects satisfactory. He left bis home apparently in good health, and full of hopeful anticipations of pleasure to be derived from post-graduate work. Death suddenly seized him, and in doing so cruelly crushed very fond hopes of many loving friends. ROBERT WILLIAM HILLARY, M.B.-Dr. Hillary, of Aurora, died at bis late residence on Sunday, October 21, 1894. His health had been poor for sone years, but apoplexy was the immediate cause of death. He was born in Dublin, Ireland, in 1832, and was educated at Trinity College in that city. He came to Canada in 1856, and received his license from the Provincial Medical Board in 1857. Affer this he practised one year at Laskey, King township, and one year at King Station, after which he removed to Aurora, where he soon acquired a large practice, which he retained until his physical powers failed. He was a bright, clever, witty, large-hearted Irishman, generally popular with all classes, and much beloved by bis intimate friends and relatives. He was surgeon to the 12th Battalion for twenty-five years, a member of the Ontario Medical Council from 1872 to 1875, president of the Ontario Medical Association 1892-3, and held many prorminent offices in Masonic and other orders. His son, Dr. R. M. Hillary (Trin., '90), was associated with him in practice for some years, and will continue bis residence and professional work in Aurora."
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         "Technical and Bibliographic Notes / Notes techniques et bibliographiques Canadiana.org has attempted to obtain the best copy available for scanning. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of scanning are checked below. D Coloured covers / Couverture de couleur D Covers damaged I Couverture endommagée D Covers restored and/or laminated / Couverture restaurée et/ou pelliculée D Cover title missing / Le titre de couverture manque D Coloured maps I Cartes géographiques en couleur D Coloured ink (i.e. other than blue or black) / Encre de couleur (i.e. autre que bleue ou noire) D Coloured plates and/or illustrations / Planches et/ou illustrations en couleur D Bound with other material / Relié avec d'autres documents Only edition available / Seule édition disponible Tight binding may cause shadows or distortion along interior margin I La reliure serrée peut causer de l'ombre ou de la distorsion le long de la marge intérieure. Additional comments / Commentaires supplémentaires: Canadiana.org a numérisé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de numérisation sont indiqués ci-dessous. W W W W z' Coloured pages I Pages de couleur Pages damaged I Pages endommagées Pages restored and/or laminated / Pages restaurées et/ou pelliculées Pages discoloured, stained or foxed/ Pages décolorées, tachetées ou piquées Pages detached I Pages détachées Showthrough I Transparence Quality of print varies I Qualité inégale de l'impression D Includes supplementary materials / Comprend du matériel supplémentaire D Blank leaves added during restorations may appear within the text. Whenever possible, these have been omitted from scanning / Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le texte, mais, lorsque cela était possible, ces pages n'ont pas été numérisées. Continuous pagination.",
         "1HE CANADA LANCET VoL. xxxiv. TORONTO, MAY, 1901. No. 8. ORIGINAL ARTICLES. FILARIAE AND FILARIASIS.* Ey J. H. ELLIOT, M.B. (Tor.) Medical Supt. Muskoka College Sanitarium. The subject of filariæ and filariasis is of great interest, as wel as of mpor tance to a practitioner in the tropics. li the more temperate lands ot therhaps of oniy passing interest a. cases are rarely seen, and then ilonlv in those who have iived for some years in an endenjie area. Athoug of so frequent occurrence in the tropics, our knowledge of the human fiiarioe is stili rather fragmentary, and much work stili re- mains to be done. With the exception of one species, F. nocturna, the pathological siguificance of those inhabiting the blood and lymph chan- nels is quite unknown. ? Under the term Filaria sanguinis hominis are included three. possibly four or five, species of nematode worms. 1. Filaria Bancrofti-the embryos of which are known as Filaria nocturna. 2. Filaria perstans. 3. Filaria Ozzardi (provisional) Manson. Others which have been described are known only in the adult or embryo condition. Their life history in the human being still remains to be worked out. These inelude F. diurna and F. Demarquein. Filaria Bancrofti bas a very wide distribution, being found in almost aIl tropical countries. In America it is found as far north as Charleston It is found in Southern Europe, Tropical Africa, India, China and Australia. The embryo form, filaria nocturna, was discovered by Demarqua at Paris in 1863, in the fluid from a case of chylous dropsy of the tuynica vaginalis. Later it was found in chylous urine by Wucherer at Bahia in 1866. Lewis in India first described them in the circulating blood. The parent filaria are hair-like,opalescent nematodes, about three to four inches long. They are usually found male and female together. Their habitat is some part of the lymph system, either in the distal iym- phatics, a lymphatic varix, or the larger vessels between the glands. If *Read before the Toronto Medical Societv March 2st, 1901 [ 451 ]",
         "ELLIOT: FILARIAE AND FILARIASIS. in a varix they are free to move abogt, but when in the distal lymphatics it is more usual to find them coiled up in small cyst-like dilatations. When set free, and placed in water or salt solution they move about very freely, coiling and uncoiling themselves very rapidly, often apparently getting themselves into an inextricable tangle. The adult male is about 70 m.m. long, very slender, and shows a greater tendency that the female to curl when in water or salt solution. The oral end is slightly tapered and club shaped. The tail etd also tapers, the tip being rounded off abruptly. The female filaria is the larger, both in diameter and length. The anterior and posterior extremities are similar to the male. The two uterine tubes occu'py the greater part of the whole length of the body, and are seen to contain nuiiberless ova in various stages of development while near the external opening the embryos can be seen in the fresh con- dition, actually moving about. The embryos which are found in the circulating blood are minute, colorless, snake-like worms, about 1-80 inch in length, 1-3200 inch in diameter. Each is enclosed in an exceedingly delicate sheath consider- ably longer than the worm it encloses. It moves freely backwards and forwards in this, the part not occupied collapsing, and trailing about after the head or tail as the case may be. The head end is abruptly rounded; under a high power there can be seen, when the movements of the animal have about ceased, a six lipped, prepuce-like structure which is constantly covering and uncovering the end of the worm. Occas- ionally a short, sharp, fang-like projection is momentarily shot out, and quickly retracted. In fresh drawn blood the movements of the worm are very rapid, and it is impossible to make out any structure beyond the sheath. The little animal is constantly moving backwards and forwards within its sheath, and violently lashing about. The corpuscles near it are much agitated by the continual movements of the embryo. Wriggling about so actively the enbryo does not as a rule move very far from the one place, and soon has a place about it quite clear of corpuscles; but occa- sionally it will insinuate itself anongst the corpuscles and move away from the field. All that are seen are of the same size; they undergo no further de- velopment until they are taken up by their intermediate host, the mos- quito. The number of embryos found in a drop of blood will vary accord- ing to the time of day the examination is made. As a rule a preparation made during the day will give a negative result, or not more than an occasional specimen. As evening approaches the embryos begin to enter the peripheral circulation, and their numbers gradually increase until midnight, after which they gradually decrease until seven or eight o'clock, after which none are to be found until evening again. The number found in each drop at midnight will vary from ten to twelve to as many as five or six hundred, depending no doubt on the number of females, and upon whether they are reproducing at that time. Assuming that the parasites are equally distributed throughout the cir- culation there may be as many as forty or fifty millions circulating at one time. [ MAY 452",
         "ELLIOT: FILARIAE AND FILARIASIS. 453 This phenomenon of diurnal periodicity is maintained for years with the utmost regularity. It may be disturbed by causing the patient to sleep during the day, and reinain awake during the night, when the em- bryos will be found in the peripheral circulation during the day, and absent during the night. When absent from the peripheral circulation tley are to be found principally mn the lungs and larger arteries At a post mortem examina- tion made by Manson on a case dying suddenly in the morning from poisnn, and in which the filariae were always absent from the peripheral circulation during the day, he found that while blood from the liver and spleen showed an average of only one embryo to each drop, preparations from the lung and carotid artery showed over six hundred to each. No satisfactory explanation of this phenomenon of \" periodicity \" is as yet forthcomng; possibly it is an adaptation to the nocturnal habits of the mosquito, but even if so why should they retire into the larger vessels and lungs during the day ? What the average length of life of each embryo in the blood stream may be, or what finally becomes of the millions which are constantly being produced we do not know. Only a very small portion of them are taken up by suctorial insects, the rest must necessarily be disposed of within the human host. The internediate host of the Filaria Bancrofti is the mosquito; both Culex and Anopheles have bcn shown to be favorable to the fuither development of the enbryos. It cannot yet be said t] at all mosquitos may act as iitermediate hosts although inembers of each genus have been used in experimental work with successful results. If the stomach contents of a mosquito be examined after feeding on a filaria infested patient, the embryo wili be found in greater numbers than an examinriation of the patient's hlood would lead one to expect. Apparently the nosquito or the embryo has a selective action-there is an affinity sonewlere, possib!y exerted by the filaria on the proboseis of the insect within the vessels. Within the insect's stomach the movements of the young filaria be- come very active. I t soon leaves the stonlach, and finds its way ami ngst the thoracic muscles where it moves about slowly, If one mosquito be dissected dailv from a hatch which were fed simultaneously on a patient the further development can be satisfactorily studied. The metamorphosis is completed in a period varying from fif- teen to thirty or more days. At the end of this time a mouth is formed, the alimentary canal may be distinguished, and the young parasite has grown from 1-80 inch to 1-16 or even 1-4 inch in length. At this stage they may be found crowded forward at the base of the prcboscis, and underneath the cephalic ganglia. From here they push forward along the proboscis, and nay be found lying free amongst the 8tilets. How the parasite regains its human host is again undecided. From the fact that at the completion of its metamorphosis in the mosquito it passes out along the proboscis, is strongly suggestive that it is carried to\u003e the human being when the insect next takes a feed of blood, but this is only conjecture. Manson's first theory was that the parasites are set free in water upon the death of the mosquito, and that they reach the stom- 1901.]",
         "ELLIOT: FILARIAE AND FILARIASIS. ach in drinking water, and nothing has yet been adduced to prove that this may not be so. However the filariae may be introduced into man, they finally reach the lymphatics, attain sexual maturity, and after fecundation a new generation of embryos is set free, which again appear in the circulation. The degree of prevalence of filariasis varies a great deal in the different endemie areas. In British Guiana and some of the islands of the West Indies from tive to twenty-five per cent. of the native popula- tion show filario in the blood. In some of the islands of the South Pacific nearly 40 per cent. show infection, while in parts of West Africa, twenty-five to fifty per cent. of the adult male population carry the parasites, though here F. diurna and F. perstans are also found, and account for a large proportion of these cases. By far the greater portion of those who harbor the parasites do so without any inconvenience, and without any symptoms arising from their presence. The young filariæ circulating in the blood apparently set up no trouble whatever, any pathological conditions which develop are always traceable to either the parent worm, or to the ova premature- ly discharged. The ova are much larger in diameter than the free embryos, and if set free in large numbers will very effectually block the lymphatics. Broadly speaking there are two varieties of disease brought about by the filaria-the one in which there is a marked varicosity of the lymphatics, the other characterized by an œdematous condition w iich tends to become to a certain extent organized and solid resulting in elephantiasis. As a result of a lymphatic vessel becoming blocked by one or more worms or a number of ova, a thrombus may be formed, or an inflam- mation set up in the walls of the vessel with subsequent thickening. From this occlusion, partial or complete, there is a resulting varicosity of the vessels towards the area drained with or without edema. With inflammation recurring in this area of lymphatic congestion there is pro- duced a thickening of the tissues, and sooner or later a condition of elephantiasis results. When the thoracic duct is the seat of obstruction there is as a consequeice an enormous dilatation of the abdominal, and pelvic lymphatics, and a huge varix from 8 to 10 inches in diameter, and several inches thick may be found, behind which the kidneys and bladder are effectually concealed. If the lynphatics of the bladder or kidney rupture, chyluria supervenes. If the lymphatics of the scrotum are involved lymph scrotum results. Acute attacks of lymphangitis are very common in filarial disease. There is a painful swelling of the vessels or glands affected, with as a rule a red line on the skin over the affected area, this inflammation spreads, may become erysipelatoid in character, and a rigor followed by a high fever supervenes. The attack may continue for two or three days with headache, vomiting and even delirium. Finally a general diaphoresis sets in, and the swelling gradually subsides, leaving some [ MAY 454",
         "ELLIOT: FILARIAE AND FILARIASIS. 455 permanent thickening. These attacks may recur at varying intervals of weeks, months or years, and are often mistaken for malarial fever, occuring as they do in districts where malaria is almost always prevalent. Elephantiasis is perhaps the most frequent pathological condition set up by filarial infection. In Sanoa over 50 per cent. of the adult male population is affected. In most tropical countries it is not of so frequent occurrence, but is fairly common in all parts where the filaria Bancrofti is found. In over 90 per cent. of the cases the lower limbs are involved, either one or both, or in conjunction with some other portion of the body. The scrotum is frequently involved, less often the mammae, vulva or local- ized portions of the arms, body or neck. Chyluria, the result of the rupture of a varix on the walls of the bladder or about the kidneys is not a very serious condition, though it as a rule causes the patient a great deal of mental worry. It very fre- quently appears without any warning, though it may have been preceded by pain or aching in the loins and pelvis from the distension of the varix. The urine may be white, pink or even red, during a part of the day it may be quite normal; it coagulates or standing. The general health of the patient is not affected, and about the only inconvenience is the pain attendant upon the passage of clots which may form in the bladder. Occasionally these may cause retention. Other forms of disease associated with this filaria are varicose glands of the groin and axilla, lymph scrotum, orchitis, chylous ascites, and chylous diarrhoea. F. perstans.-This parasite has so far been found principally on the West Coast of Africa from Lagos to the Congo, and in Demerara. As the name indicates it has not a periodicity as has F. nocturna, but may be found in the blood at any time. The infection is not as great as in F. nocturna, the average drop of blood not showing more than perhaps one to ten embryos. Indeed in some cases several drops may be examined before one is found. The embryos are much smaller than F. nocturna, measuring only 1/12\"5 inch in length. The worm narrows gradually from the anterior third to the tail, ending abruptly in a rounded, not pointed, extremity. It is devoid of a sheath. The head end, too, is distinctive; there is no hooked cephalic prepuce to be seen, but a retractile fang is easily observ- able, and is shot out and retracted at shorter intervals than the corres- ponding structure in F. nocturna. The movements of the embryo on the slide are very active, moving very rapidly across the field with a quick, snake-like movement, and travelling freely all through the preparation. The parental forms were discovered by Daniels. They are slightly shorter than F. Bancrofti. The tail is distinctive, being incurvated with a slight notch in the chitinous covered tip. Only a few adults have as yet been found. Their habitat has been the connective tissues at the root of the mesentery, behind the abdominal aorta, and beneath the pericardium. No definite pathological lesions have been found associated with this parasite. Manson has conjectured it is the cause of the sleeping sickness 190 1.]",
         "ELLIOT : FILARIAE AND FILARIASIS. of the Congo natives, partly from its presence in three cases of the dis- ease, which he has seen in England, and the fact that the geographical dis- tribution of the parasite and the disease are somewhat similar. Against this is the epidemic character of the disease, and the fact that F. perstans is present in a large percentage of the population in dis tricts-e. g., the Niger Delta and the Oil Rivers-where the sleeping sickness is unknowrn. F. Ozzwrdi.-This is the name given provisionailv by Manson to a filaria occurring in the aboriginal Carib Indians of the hinterland of British Guiana, it is often associated with F. perstans. The embryos are similar to F. perstans in size and movement, but possess a pointed tail. The adult worns in size and structure closely resemble F. Bancrofti except as regards the tail which is bulhous. F. diurina.-The parental forim of t his species has not as yet been described. The embryos to which this name has been given are not to be distinguished morphologically either in fresh or permanent prepara- tions from F. nocturna. The distinction is in their.periodicity. Instead of at night, it is dur- ing the day with a maximum about eleven to one o'clock that they are found in the peripheral blood. Their distribution is limited to certain parts of the West Coast of Africa. Whether they are identical with F. nocturna, and the variation in periodicity is due to some influence acting on the embryo, can only be satisfactorily settled by the diseovery of the parent worm. We know from the experimuents of Stephen Mackenzie that the periodicity of F. nocturna may be changed by causing the patient to be up at night, and to sleep in the day timue The, average West African native is so prone to sleep durmg the hot part of the day, and to be up doing his canoeing during the night or to be dancing until the morning, especially at the full of the moon, that it would l'e very easy to reconcile the facts and explain thei on this basis. The observations made by \"The Liverpool Malaria Expedition to Nigeria\" upon an extensive series of cases will soon be published. As a newber of that expedition I had the opportunity of seeing a great many cases of F. nocturna, F. diurna and F. perstans. In many of the natives there was double infection, and in a few cases the three forms were present' The table of periodicity of F. nocturna and F: diurna does not show the restriction to the fixed hours which is usually supposed to exist. In some cases it was difficult to say whether the emubryos found should be called diurna or noctuina. Froin clinical observation we were much in- clined to regard them as identical but on attempting to study their meta- morphosis in Anopheles claviger we were unable on two different occa- sions to find any of the F. diurna within the body of the mosquito; all were apparently excreted with the undigested food, while F. nocturna underwent the usual changes, and was found in the proboscis on the 15th day. On account of our work on malaria we were conpelled to drop the subject at this interesting point and were unable to return to it. Unfertunately we had no opportunity of a post mortem examination [ MAY 456",
         "ELLIOT: FILARIAE AND FILARIASIS. 457 on any of the cases, and consequently were unable to compare the parent forms. F. Maglhäesi.-This name has been applied to two adult worms, male and female, described by Prof. Magalhaes, found in the left ventricle of the heart of a child that died in Rio de Janeiro. The female measured'155 m.m. in length by 0.7 m.m. in diameter; both were cylindrical, and of uniform thickness with exception of the club shaped anterior extremity, and the tapering tail. No other similar worms have been described, and nothing is known of the life history, or of the pathology. Filariae inhabiting the connective tissue. F. Medinensis, the guinea worm, plays a rather important part in tropical pathology. It occurs in Persia. Arabia, parts of India, and in tropical Africa. In certain parts of the West Coast it is very prevalent, especially so among the Yoruba tribes, where nearly half the inhabitants in many of their villages are afflicted with the parasite. It is not un- usual to find several guinea worms in the same individual. I have seen a boy of ten, the son of a Yoruba soldier, with two in each foot, and another patient with two in each foot and one in the buttock. As many as thirty have been reported in one person Only the female is known. The length varies from one to four feet, the average being .30 to 36 inches. The diameter is about 1-10 inch. The body is opalescent, almost milky white, devoid of markings, ending abruptly in a sharp pointed tail which is bent at an angle to the body. The mouth is surrounded by six papille, two large and four small. There is no opening at the posterior end of the alimentary canal. The enor- mously distended uterus with its millions of ova and embryos is also ce- cal, the vagina being entirely obliterated, probably from pressure. This immense worm inhabits the subcutaneous and intermuscular conànective tissues. When mature she moves towards the lower extrem- ities, pushing forward until she is underneath the epidermis; soon atter she reaches here a small bulla forms over her head, and on the rupture of this, an ulcer is seen, in the centre of which is a small opening. On the first occasion that the ulcer comes in contact with water, either by the patient wading a stream, or by the application of water to the ulcer, the uterus is ,prolapsed through the mouth, is extended beyond the ulcer, and ruptures setting free a milky fluid which is found to contain myriads of embryos. The embryos are about 1-30 inch in length. The head is somewhat tapered, and abruptly rounded; the tail is long and pointed; the body is striated transversely. They will live in clear water for a week, and in the water of a wayside pool two or three weeks. The fact that the worm when ready to discharge her young travels as a rule to the leg, or foot, and that the embryos are expelled the moment there is contact with water, required for some time an explanation. This was afforded by the observations of Fedschenko in Turkestan, who found that the intermediate host was a small crustacean, Cyclops quadricornis, and we now see that the appearance of the worm in the foot and leg is but instinct for the preservation of her species, it being necessary that 1901.]",
         "ELLIOT: FILARIAE AND FILARIASIS. she deposit ber young in some pool which is the habitat of the cyc- lops, as ber host is walking through it. No doubt the parasite is again conveyed to the human body through drinking the water containing the wected cyclops. The treatment consists in tying a small piece of wood to the worm nhen extended, and winding out one to three or four inches daily. Care must be taken, as the breaking of the worm within the body is usually followed by inflammation, a cellulitis, and at times abcess and sloughing. By frequent douching all the embryos will be extended in from 15 to 20 days, and then the worm may be more easily extracted, or is at times absorbed. More recently a 1 in 1,000 solution of perchloride of mercury bas been injected into the worm causing its death. Filaria Loa.-This parasite is only known on the West Coast of Africa where in certain parts it is very common. It wanders about the connective tissues of the body. When in the subeutaneous tissue it causes itching and pricking sensations. Its course can be followed readily as it traverses the tissues near the surface. It is seen more often in the con- junctival tissues, and in the neighborhood of the eyes than elsewhere. Its length of life must be great as it bas been seen in patients who have heen at least ten years away from the West Coast. The maie is about 28 m. m. in length, by 0.3 m. m. in breadth ; the female about 35 m. m in length by 0.5 m. mn. in breadth. Both are cy- lindrical, tapering at both ends, more marked at the tail. The embryos have not been found in the body, unless, as has been thought, F. diurna is the embryo of this species. Those studied in utero,or which have been expelled after the removal of a loa from the eye are sheathed, and very similar in size to F. diurna. However this may be decided in the future the fact remains that the great majority of cases of F. Loa, though occuring in the same district in which F. diurna is found, do not show the latter in the blood. In Southern Nigeria where we found 20 to 25 per cent. of the adults infected with F. diurna we saw but one case of F. Loa. The treatment i' removal when the worm is seen under the skin. It must be grasped by a pair of forceps, and held until an incision is made over it. The negroes usually place a small pinch of salt into the eye which successfully drives the parasite away or remove it with a sharp thorn. [ M AY 458",
         "GORDON: DYSMENORRHOEA. 459 DYSMENORRJOEA.* By D. GILBERT GORDON, M.D., L.R.C.P. and S. (Edin.), Physician Outdoor Department, Toronto General Hospital. Some of the most satisfactory moments that come to a physician in his professional life are those in which he has been able to relieve great pain; and on the other hand few bring to him more disappointment than when, after repeated effort, he fails so to do. The suffering endured by woman during the performance of the func- tion of menstruation is so general that we are all constantly meeting it. The temptation to prescribe such remedies as whiskey or morphine for this particular kind of pain is so strong that against our better judgment, we allow their continued use. I do not desire to treat dysmenorrhea as if it were a disease, for it is not; it is a symptom, and the causes of this symptom and its relief are the points to which I wish to direct the atten- tion of this society. There has been much discussion both in the journals and in medical associations as to the classification of dysmenorrhœa. In speaking of the classification of a symptom it must almost necessarily mean the classifying the causes of the symptom, and on this account therefore there has been so much disagreement. Dr. Johnston, for example, claims that the classification should be entirely etiological, and in this while he is quite logical he is lead into an evident error in his classification. He would divide dysmenorrhoea into two classes, viz., one due to infection (inflammatory) and one due to structural changes. He distinctly states, and is supported by many, that there is no such thing as neurotic or neuralgie dysmenorrhoea, no such conditions as obstructive or membran- ous dysmenorrhœa. Now in this he has gone too far, for I am sure you will all agrce with me that there are cases where there is no infection and no structural change and yet where there is intense dysmenorrhea. There is such a condition as neuralgic dysmenorrhea. We have all seen patients in whom the pain would completely disappear on an entire change of environment, perhaps to recur on a return to the old surroundings. What seems to me the most satisfactory classification is the old one taught by Thomas and Goodell and still adhered to by most of the Ameri- can gynæcologists and obstetricians, viz.: (a) Neuralgic, (b) Inflamma- tory, (c) Obstructive, (d) Membranous. It is not to be expected that these can be clearly defined, in fact, they run together and overlap. For example a neuralgic condition will lead to menstrual disorders, and in time structural changes in the endom- etrium will take place when we have inflammatory or congestive causes of pain. While my experience leads me to believe that dysmenorrhoa due to mechanical causes, yet these causes may produce congestive changes certainly occurs. Just as an obstruction in the larynx would be followed by an inflammatory condition and the production of pain, so might obstruction in the cervix produce similar results. The * Read before Toronto Medical Society. 1901.]",
         "GORDON: DYSMENORRHOEA. etiology therefore is very complex. The treatment to be successful must be the treatment of the cause. 1. Neuralgic dysmenorrhœa.-While it is true that neuralgia is often a cloak to hide ignorance, and while it is easy to make this class a dumping ground for those cases which we are unable to explain, yet there are some that belong here. A woman may men- struate painlessly for a number of years, until perhaps she is over- worked or over-worried, may not be able to get her usual amount of outdoor exercise, and she begins to have pains during her periods, which gets worse and worse as time goes by. The pain comes on shortly before the flow and probably lasts for about twenty-four hours. If this woman is sent away for a holiday, she will probably be free from pain and remain free while she is away, and if she stays away a few months she will likely be free for some periods after her return. The results are diffèrent in the inflammatory variety. In this neuralgic type tonic treatment, good fresh air with exercise and good food will probably effect a cure. I wish to recommend in these cases, and in fact in most women's diseases, the wise use of the bicycle. I think the bicycle has done more to lessen the amount of fees paid to gynæcologists than all drugs on the market put together. I would like to deprecate most strongly in these and similar cases of dysmenorrhœa the use of alcohol and sedatives, also the making vaginal examinations in the unmarried. It would be a most unfortunate thing if any patient suffering simply from neuralgic dysmenorrhoea were subjected to local treatment. Inlammatory dy8menorrhœa.-Here as a rule a most careful physi- cal examination will have to be made to ascertain exactly the condition of the parts. The inflammatory condition of diseased parts, those con- cerned in menstruation is the cause of the pain and the treatment must be directed to such. These cases are for the most part infective. The inflammatory condition may be secondary even though causing the pain. The removal of a submucous fibroid may completely cure the pain. The rectifying of a utero-displacement may produce a like effect. The treat- ment that will in most cases be required and which if carefully and thor- oughly done will give most satisfactory results is a dilatation of the cervix, preferably under an anesthetic, then a curettage followed by a packing with iodoform gauze. The packing should not be repeated but should be allowed to remain in place for three days. If it is not considered advisable to do an operation, the use of the warm douche, the boroglyceride tampon, and the application to the endometrium of Churchhill's iodine or carbolic acid will often pro- duce a cure although longer in bringing it about. My experience has been that dilatation as practised by Goodell or splitting or nicking the cervix as recommended by Marion Sims are very unsatisfactory by them- selves, they furnish only a temporary relief. The real cause of the pain may be in the ovary; here the results are much more unsatisfactory. The application of blisters or paint- ing the vaginal vault with iodine or the use of hot douches may give relief. Of these I have found the hot douche used twice daily for half [ MAY 460",
         "GORDON : DYSMENORRHOEA. an hour by far the most satisfactory. The water should not be used so warm as to be uncomfortable. These cases are generally sterile. If so and if it can be ascertained that one ovary is healthy, I would recommend the removal of the diseased ovary. This will probably cure both condi- tions. Should pregnancy occur in these conditions with or without a partial oophoretomy it will probably result in cure. I would not, how- ever, recommend marriage as a means of curing a patient a martyr to dysmenorrhoea of the inflammatory type, for I have found that the pain is much greater after marriage and often results in sorrow to both con- tracting parties. Obstructive dysmenorrhoe.-I am inclined to think that the pain in menstruation due to this cause must exist very seldom. A deformed uterus may, however, produce inflammatory changes and this condition produce pain. Membranous dysmenorrhœa.-This most interesting and rare con- dition I know nothing of personally for I have never seen a case. During the function of menstruation the mucous membrane of the uterus is stimu- lated and prepared to receive the fertilized ovum which is thrown upon its surface. Should, however, the ovum remain unfertilized the mucous membrane degenerates and is thrown off in shreds causing little or no pain. If this degeneration does not take place as is claimed by Dr. Williams, of London, then probably a degeneration takes place in the deeper tissues and the membrane in toto is exfoliated and the expulsion causes extreme pain. It seems to me likely that in this case too the pain is partly of inflammatory origin and not due entirely to the expulsion. That a great part of the pain is mechanical is made clear by the fact that the pain ends abruptly when the membrane is expelled. The picture of the membrane cast off as pointed out by Dr. Cook, of Washington, shows the whole membrane to have undergone certain charges, e. g., multiplica- tion of the glandular structure, a large increase of polynuclear leuco- cytes, in fact signs of greatly increased inflammatory reaction. This entire exfoliation of the membrane as claimed by Dr. Williams is due to an excess of fibrous tissue in the wall of the uterus. This excess being due to a failure in evolution at the time of puberty, or a failure of invo- lution after child birth or abortion. The theory held by many, viz., that it is due to an acute inflammation of the deeper tissues at each period seems to me to be the most reasonable one. The treatment of these cases on the whole is most unsatisfactory. Dr. Johnstone claims to cure 9 out of 10 of bis cases by thorough curettage and packing, putting them through an artificial labor, as lie styles it. If bis claim is true, it is really most remarkable and furnishes better results than most men can. Many claim to have effected cures by the application to the endometrium, some davs before the expected period, of iodine or carbolic acid. Galvanization is also extolled by some, but on the whole the treatment is unsatisfactory as far as a permanent cure is concerned. Allow me to give very shortly the histories of a few illustrative cases which have come under my notice. Miss A., aged 21, had been suffering for some years with dysmenorrhœa of a rather peculiar type, inasniuch as severe pain was experienced only at every alternate period. For the first two or three years of her men- 1901.] 461",
         "GORDON: DYSMENORRHOEA. strual life she suffered but little. The best of care and tonic treatment had no beneficial effect. A trip to the continent was advised, and during her first period after leaving home, which took place on board ship, she- suffered none, and during a stay of three months on the continent she was free from pain though travelling considerably. She remained free like- wise for some months after her return. A summer in Muskoka had a like beneficial effect, and the trouble has not returned in anything like its original severity for now more than a year. Mrs. P., aged 34, had two children and one miscarriage. Suffered greatly during menstruation, also had dragging and bearing down pains, menorrhagia, etc. A dilatation with curettage and packing completely relieved the symptom. Mrs. J., aged 27, suffered greatly, more since marriage. Examination revealed a latero-anteverted, undeveloped uterus. Marked tenderness on examination. Left ovary tender to touch. A thorough dilatation with currettage and packing relieved somewhat the pain for about three months. A year afterward I removed the lef t ovary. This resulted in a partial cure of the pain. The woman is still sterile. Mrs. G., aged 22. Suffered from dysmenorrhoea. Was sterile. Had a retro displacement. Right ovary tender, enlarged and displaced. Two years ago J removed this ovary, pain was relieved. She has now a son eight months old. 462 [ MA\u0026Y",
         "PARSONS AND LUSK: MULTIPLE NEURITIS. 463 A CASE OF MULTIPLE NEURITIS SUCCEEDING TYPHOID FEVER WITH PERMANENT PARALYSIS. Reported by MESSRS. R. PARSONS and CHAS. P. LUSK, Final year students at Trinity Medical College. The writers venture to present this paper for publication because of the exceedingly interesting clinical history which it reveals, rather than from any wish to discuss the subject of Multiple Neuritis. The patient came under the care of Dr. Allan Baines at the Toronto General Hospital and through his kindness and that of Dr. Bingham who. operated at a later date performing a radical cure for a condition of floating kidney, we are enabled to place the history before you. Clinical History.-Mrs. O., aged 26, married 6 years. Family History.-Mother died at 38 of consumption and heart disease. Her mother's three sisters and one brother also died of consump- tion and a fourth sister living at the present time has the same disease. Paternal history, is negative. Personal Eist\u003crry.-Had measles when sixteen ; no other children's diseases. She was married in 1894. One year later when in Toronto she was taken sick with what she calls dysentery, after a period of general malaise. After being sick for three weeks, during which time the motions of the bowel numbered eight to twelve a day, she sought med- ical advice, A day or two afterwards, after a sleep of a couple of hours' duration. she awoke to find both lower limbs comp'letely paralyzed. The next day she was taken to the Burnside Lying-in Hospital and was deliver- ed of an eight months foetus Oct. 17th, 1895. The same day she practically lost the use of arms and hands. There was an intense pain in both temples which radiated backwards to the occiput, and thence down the back of the trunk and legs to the feet. During November, she was transferred to the medical wards of the hospital. There the paralysis of the hands and arms began to improve, although generally before going to sleep there was severe twitching of the muscles of the extremities, and also great pain in the supra-scapular fossae, and thickened speech existed for some time. Her vision was dimmed for a while and the muscles of the left hip, thigh and calf, and of the left thenar eminence were markedly shrunken. She went home and about June 30th, '96, was sufficiently improved to attempt standing on her feet, but could not walk and had to be wheeled in a wheel chair for the rest of the year. Then for some months she was able to get about with the aid of crutches. Her condition gradually improved until she was able to do light house work, and could walk as much as half a mile. The left leg and foot would swell at times as far as the knee, and when tired her legs would give way under her completely letting her fall to the ground. During '96 she had herself noticed that the left kidney was movable, and would descend as far as the left iliac region. She has been a continual sufferer from indigestion, and also cdmplains of having had occassional attacks of suppression of 1901.]",
         "PARSONS AND LUSK: MULTIPLE NEURITIS. urin, more especially in, the winter time. On using the sitz bath a few teaspoonfuls of urine would pass away and sometimes,what seemed to be. pure blood. At times three days would pass without voiding urine During this time there would be a constant, agonizing pain which she re- ferred to the neck of the bladder, and a more or less constant desire to evacuate the bowel. Present Ilness.-During September, 1900, while in the city, she over-exerted herself and has not been well since. She suffered from pal- pitation of the heart to such a degree that she was unable to keep the recumbent position. On returning to her home in the country she had occassional attacks or a sensation of distention about the stomach and heart, also she complains of severe pain extending from the ensiform cart- ilage to the umbilicus, and a constant craving for food which would be relieved by the taking of the smallest quantity. She was admitted to the hospital Oct. 25th. EXAMINATION. Temperature, normal. Pulse, 90, normal in character. Respirations, 18, normal in character. Stools, constipation unless using laxatives. Urine. Color, pale straw; odor, faintly urinous; sp. gr., 10.30; al- bumen, none; sugar, none; urea, 10 grains to, the ounce; microscopically, oxalate of lime crystals; epithelial cells ; many pus cells. Digestion is poor; tongue, deep red and slight central fissure. General symptoms. Palpitation of the heart, constipation, dryness of mouth and throat. SPECIAL EXAMINATION. Skin. Moist and cool, but patient complains of cold feet and hands. Chest and neck. Thyroid gland is enlarged, more marked in right half. This has occurred two or three times previously, but has yielded to applications of tincture of iodine. The chest on inspection shews the right sub-clavicular fossa more flattened than the left. Other signs normal. Beart. Slight increase of lateral dulness extending 1.25 c.m. to left of nipple line ; apex beat, fifth intercostal space, nipple line ; auscultation reveals nothing abnormal. Abdomen. Somewhat distended; soreness in epigastrium; on left side we find a movable kidney, which descends as far as the level of iliac crest. GENITO URINARY SYSTEM, Right ovary, slightly tender ; neither enlarged. Body of uterus is nor- mal. Ceruix. Cleft on right side to vaginal vault; slightly cleft on lett side; external os, everted and admits finger; the endometrium is eroded; a mucous discharge which is foul, but the menstrual period j ust two days past; menstruation is regular, but the flow is profuse. Bones, Joints, Muscles, etc. Partial paralysis of the left lower limb and of left shoulder, also of right lower limb, but not nearly so marked. The muscles of the calf of left leg are shrunken and flaccid. Anterior muscles seem normal. The museles of left thigh are atrophied somewhat 464 [ MAY",
         "PARSONS AND LUSK: MULTIPLE NEURITIS. and are soft even when the leg is flexed. This limit is 2.5 c.m. less in circumference at lower and middle thirds than the right. The glutei are markedly atrophied on this side. Knee jerk is present, and ankle clonus is absent The left arm cannot be lifted above a right angle with the body. The thenar muscles of left hand are flattened and she experiences some difficulty in making the finer movements. The muscles of the right side are but little impaired. In walking, however, the right foot is not lifted so readily as the left nor can the right leg be extended as readily. On attempting to sit up in bed she first turns upon her side, supports herself upon the elbow and then with the aid of the other arm lifts the trunk into the erect position. When prone upon the floor, in order to rise she elevates the hips until the legs are extended, then with the hands she lifts herself into the standing position. In November Dr. Bingham, with the assistance of Drs. Baines and Powell, performed a nephrorraphy for the relief of the floating kidney. He used the operation which is recommended by Jacob- son, in which after making the initial incision and removing the intervening perinephric fat, he incised the capsule of the kidney along the upper and outer border, stripping it fromn the lateral surfaces, and then suturing the flaps to the edges of the muscular wound. The opera- tion was markedly successful and the patient at the time of writing (three weeks later) has had a good recovery, is experiencing no discom- fort whatever, and is ready to return t-o her home. DIAGNosIs. The atrophy with the absence of all sensory symptoms suggests a condition of muscular dystrophy, though the sudden paralysis with complete absence of hereditary history will hardly bear this out. The history of the so-called attack of dysentery, which appears rather to have been an attack of enteric fe-er, and the succeeding paralysis, with pain,etc.,suggest a multiple neuritis complicating typhoid. If this be so, the case is worthy of remembrance, in that multiple neuritis complicating typhoid fever according to Osler and other authors is generally recovered from, but in this the paralysis and atrophy of the muscles have been permanent 1901.] 465",
         "ELLIOTT: PREVENTION OF TUBERCULOSIS. THE PREVENTION OF TUBERCULOSIS.* By J. E. ELLIOTT, M.D., Toronto. In calling this meeting uo order, I feel that it is unnecessary to ex- plain its purpose, but I think I should make some explanation why it is under the auspices of the Young Men's Liberal Club. One of the objects of the Club is to discuss questions for the good of the people, and as president I felt that there was no question of so much importance to the people at the present time as how to prevent consumption. I gave notice of motion some two weeks ago, which 1 shall pres- ently read, to be discussed at the next regular meeting, but the Executive Committee thought that the question was of such public importance that the discussion should not be confined to the members of the Club; so to lift it as far as possible from the ·realm of politics, this special open meeting was called, and I am glad to know our efforts to bring the important question before the public has not been in vain. The notice of motion is as follows: \"In view of the fact that one-fifth of all deaths is due to tuberculo- sis, and that tuberculosis is a contagious and infectious disease, conse- quently preventible; resolved, that in the opinion of this meeting the present is an opportune time for all legislative bodies to at once enact laws for the prevention of this dread disease.\" I should, I feel, explain that the statistics given in the preamble do not refer to our country but to general statistics. The death rate froma tuberculosis in Canada is probably nearer 1 in 7 or 8 than 1 in 5. It may also be of interest to you to know that one-fourth of the deaths between the ages of 15 and 55 are due to tuberculosis. When you begin to real- ize the magnitude of this fact you can well understand the necessity of every one assisting to improve the conditions which are responsible for these facts. It is now accepted by everybody that tuberculosis is contagious or infectious, and not hereditary as was believed until recently, in fact, is still tle belief of many. I shall not say that it is not hereditary in some isolated cases, but the number of hereditary cases is so few as to not re- quire much notice. A good soil for the germ to grow in, is where the hereditary tendency comes in. If the disease is infectious, how is it so ? Tapiner succeeded in in- fecting all his experimental animals shut up in a chamber into which large quantities of tuberculous sputa were discharged in the form of spray, and his servant, a robust man, in perfect health, persisted in a spirit of bravado in entering the inhalation chamber and acquired an acute attack of tuberculosis which proved fatal in 14 weeks. You all know that the lungs are the organs most frequently affected and that the germs are carried from the lungs in the expectoration in great numbers. One expectoration may have as many as two million * Read before the Young Men a Liberal Club, Toronto. 466 [ MATr",
         "ELLIOTT: PREVENTION OF TUBERCULOSIS. 467 germs and a person with acute tuberculosis of the lungs may expectorate as many as two or three billion bacilli in 24 hours. These germs are de- posited in every place where consuinptives go-on the street, in the bed- room, in the street car, in the railroad train. The expectoration soon dries up and the germs are blown into the air and inhaled into the lungs. All the germs do not produce the disease when inhaled into the lungs. This depends upon the susceptibility of the individual who inhales them. Some are inhaled by individuals who are able to resist the attack of the germs and they \" fall by the wayside.\" Others are inhaled by persons who have not the same resistance and the germs get a lodging, \" fall in stony places,\" remain dormant for a long time and when the system is run down from an attack of bronchitis, pneumonia, or pleurisy, or any debilitating cause, they then get their work in and the person becomes a consumptive. Statisties from post mortem examinations show that 25 to 50 per cent. of people who die from other causes than tuberculosis have the disease in a dormant state. Again, there is another class of individuals who inhale the germs- into the lungs, where they find a good soil to start in and they develop consumption which runs a rapid course. Another common source of infection is from taking into the stomach foods containing the tubercular germs. The most common foods contain- ing tuberculous germs are meat and milk. Meat, I may say, is not nearly so dangerous as milk, and as children are the ones who mostly drink milk, they are the most frequently infected with tuberculosis from this source. The fact that milk carries tuberculosis has been proved over and over again. Many instances might be cited in proof of the fact if titue per- mitted. Prof. Kanthack, in 1898, in examining milk from the 16 different dairies supplying the University of Cambridge, found that nine of the samples infected guinea pigs with tuberculosis. Owing to improved sanitary conditions in the larger European cities, the death rate from tuberculosis has been gradually diminishing, but the mortality of children suffering from intestinal tuberculosis has not dimin- ished owing to the increased consumption of cow's milk. Another strong proof that tuberculosis may be traced to milk, is the fact that calves are free from tuberculosis at birth, and that before the end of two years 50 per cent. of some herds are tuberculous. Statistics collected from abroad of the post mortem examination of 610,000 calves showed that only 12 of them had tuberculosis. This shows conclusively that consumption is not a hereditary diseasebut an acquired one. It is not necessary to use any further examples to convince you that the germs of consumption are carried into the system through the lungs and stomach by inhaling the germ-laden dust and the eating of contaminated foods. Our duty in future is how to prevent this. I may here quote from the British Medical Journal of Mav 20th, 1899, over two years ago, the opinion of its Ontario correspondent at that time, of the state of the work of preventing tuberculosis. He says: \" We are making some progress in the right direction in Canada, but our municipal bodies are moving somewhat slowly. The Council of Toronto has been urged by the profession of the city to take certain steps towards the 1901.]",
         "ELLIOTT: PREVENTION OF TUBERCULOSIS. establishment of a sanitorium for our sick poor, but is slow in responding in a satisfactory manner.\" What was true of Toronto two years ago is true to-day, in fact I regret to say that the sick poor consumptive is in a worse condition to day in Toronto than he was in 1899. To-day we have not a hospital or institution where the consumptive can go for treatment, with the possible exception of a small ward in the Home for Incurables, where only the incurable in the last stages of the disease may go to be cared for. The question of sanitariums has been discussed in the city fi om time to time, but it has not been taken up by the Council, who, I consider, are the responsible body to provide for the care of the poor consumptive. Heretofore those interested in the question of the prevention of consump- tion have taken the broom by the wrong end-only the question of sani- tariums has been discussed. This is ail very well for those infected, tut what is being done to prevent fresh infection ? The greatest source of infection, as we have said before, is the expectoration. This should be prohibited in all public places. If consumptives are allowed about, they should be compelled to carry some receptacle to expectorate in and afterwards destroyed. Notification of all consumptives should be required, not necessarily that they should be confined in sanitariums, like smallpox or diphtheria patients, but those in the acute stages should at least be isolated. This may appear a very string- ent rule but the time has arrived when public opinion isripe for it. You will remember when first the law was formed to placard diphtheria, scarlet fever, etc.. there was a great hue and cry; it was not long until the few objectors accepted the situation and now all quietly submit to the regula- tions. The same would be the case with compulsory notification of tuberculosis. At first we would no doubt have a few objectors, but in time I believe all would willingly submit to the law for the public good. Another source of danger which might be prevented and guarded against is the milk supply. Statistics show that very few herds of cattle are free from tuberculosis. I am glad to say that the action of both the Dominion and Ontario Governments, has done much to reduce tubercul- osis among the cattle of this country. But until we are able to get milk without being contaminated with tuberculosis, it will be necessary to take most stringent means to prevent infection of our children. The only way that I can see in which we can guard the health of the people from infection by milk is to make it compulsory that ail milk should be sterilized. We have ample Iproof that by the sterilizing or boiling of milk, the death rate of children is greatly reduced. In Fecamp in Normandy, the infant mortality was reduced 50 per cent. by the use of sterilized milk, and the deaths froin enteritis reduced from 30 per cent. to 16. In another town the moitality fron intestinal troubles during the months of July, August and September was on an average 69 per cent., but when fed on sterilized milk the death rate fell to 27 per cent. It has been estimated that 30,000 infants could be saved annually if sterilized milk were used in Great Britain alone. I fully be- lieve much bas been done by our City Health Department to improve the sanitary condition of our dairies, but there is much still to be done. 468 [ MAY",
         "1901.] ELLIOTT: PREVENTION OF TUBERCULOSIS. 469 The question of sanitariums is a very important subject; from my point of view I believe we require two kinds. One for the acute cases, and the other for the incipient and curable cases. It should be impressed on the public, that at least 75 per cent. of consumptives are curable if taken in the incipient stage. The Provincial Legislature has made ample provision in its Act re- specting the municipal Sanatoria for consumptives to permit all munici- palities to erect and equip sanatoria to which they will contribute the sum of $4,000 to a building, $1.50 a week for each patient. I am strongly of the opinion that all municipalities should control their own sanatariums for the poor consumptive. They should be con- ducted under the supervision of the Medical Health Officer of the mungå- pality as the Isolation Hospital in Toronto is.",
         "ANDERSON: A CASE OF AINHUM. A CASE OF AINHUM By H. B. ANDERSON, M.D., Toronto. The specimen which I present to you was sent me by Dr. Barry Johnston, of Balaclava, Jamaica. It is the little toe of a Negro that was only attached by a thin pedicle which Dr. Johnston snipped off. The term Ainhum-derived from the Nagos word meaning to saw-is applied to a peculiar disease, which is found among certain dark-skinned races on the Pacific islands, in North and South America, and according to Manson, in India. Dr. Johnston tells me that it is quite-common among the Negroes of Jamaica. The condition begins by the formation of a constriction at the base of the toes,especially the little toe-which continues to deepen until the digit is attached only by a narrow stalk. The toe then either falls off or is snipped off. The process is usually a very slow one, sometimes taking years to produce amputation. It does not affect the general health, and little discomfort is caused except when the freely moveable toe gets in the way or when ulceration occurs, which is rare. The disease is more frequent in males than in females, and usually occurs in adults, but has been present in infants a few weeks old. It tends to run in certain families, many inembers sometimes being affected. As the constriction at the base of the toe deepens, the distal end of the toe becomes enlarged and bulbous. The various tissues atrophy. In the toe which I show you the bone is soft and cuts with little resistance. The constricting band appears to be thickened structures of the derma. According to Unna the disease is a kind of ring-formed sclerodermia. This constticting band really causes strangulation of the structures distal to the band like the snaring of a tumor. Manson thinks the condition is due to the ulceration beginning at the digito-plantar fold from irritation, with contraction of the hyperplastic tissues. The lodgement of dirt, etc., in this region would keep up the process until final amputation occurs. Some have described the condition as a trophoneurosis, something of the nature of Raynaud's disease, but on no good reason, which may also be said of the idea that the disease is a form of leprosy. 470 [ MAY",
         "1901.] SELECTED ARTICLES. ASTHMA. By R. ALEXANDER BATE, A. B., M. D., of Louisville, Ky. Assistant to the Chair of the Principles and Practice of Medicine and Clinical Medicine, Hospital College of Medicine, Louisville, Kentucky. Asthma is a disorder of nutrition, dependent upon the arthritic dia- thesis, and is characterized by paroxysmal dyspnoea due to spasmodic contraction of the bronchial tubes. The spasmodic contractions, according to Loomis, are due to a neuro- sis, which depends upon the existence of a peculiar diathesis. Trousseau, Salter and others, likewise speak of asthma as a diathetic neurosis. Haig attributes asthma to the effect of uric acid upon the circula- tion in the thorax, and shows that the paroxysms correspond to the nat- ural fluctuations in the excretion of uric acid Modern opinion seems to consider asthma a neurosis of the branches of the pulmonary plexus due to arthritism. In nasal or hay asthma, it is believed, uric-acidæmia so alters the nutrition of the spheno-palatine branches as to cause temporary parai- ysis, thus inducing hyperæsthesia and turgescence of the nasal mucosa. In bronchial asthma, uric acid in the blood so alters nutrition as to cause a neurosis of the branches of the pulmonary plexus, thus inducing hyperæsthesia and engorgement of the bronchial mucosa, the spasmodic contraction of the muscular fibers, and various manifestations of de- ranged katabolism. The manifestations of functional derangements are the diminished quantity of oxygen and water, excreted by the lungs, also the fatty acids, the octahedral crystals of Leyden, and the spirals of Curschmann found in the expectoration. Loomis found the oxygen of the expired air was almost entirely re- placed by carbonic acid. The exact pathology of the gravel-like bodies and mucous pearls of the sputum is not clear. Asthma frequently alternates with neuralgia, migraine, angina and - cardialgia-all diseases due to uric-acidmia. The famous case of Peter the Great, and many others, have been cited where the asthmatic manifestations gave place to gout. The asthma became relieved as the blood was freed of urie acid. Gout de- veloped because the urie acid was precipitated from the blood into the tissues. The protean manifestations of arthritism can be understood if w regard the entire vascular system as one organ, upon which the perfecb nutrition of every other tissue in the body is dependent. If the blood when most alkaline becomes loaded with uric acid, the size and relative nutritional capacity of this vascular organ is greatly diminished. Thus the nutrition of every structure in the body may be modified. ASTaxA. 471",
         "However, some tissue, either by inheritance or acquisition, is weaker than the rest, and first makes manifest the deranged nutrition. Molecu- lar starvation causes loss of function of the cells in ail diseases of uric- acidæmia. The other class of arthritic disorders occur when, from lessened alka- linity of the blood, uric acid is precipitated into any of the numerous adjacent tissues. Heredity, anatomical and physical causes especially determine the site of the precipitation. This second class of diseases are characterized by the manifestations of an actual irritant instead of being inerely func- tional disturbances, as in the first class. Asthna belongs to the first class. Pulmonary weakness being the predisposing cause, any age may be afflicted ; but the greater proportion of cases occur during adult life. Males are affected twice as often as fe- males, and the disease is transmitted along the male line. Heredity can be traced in 50 per cent. of the cases. Arthritism in some form, perhaps, could be traced in every instance. Attacks come on most frequently at the beginning of the alkaline tide, which is from two to four o'clock in the morning, when the blood is surcharged with uric acid. Bronchitis is present in eighty per cent. of the cases; intestinal indigestion, characterized by flatus,.and skin diseases also occur. The causes of asthma may be divided into two classes: First.-The systemic or essential cause, the arthritic diathesis. Second.-The local or exciting cause of the attack. The first of these is, perhaps, present in every case. Loomis says: \" Unquestionably, the primary cause of asthma is some constitutional idiosyncrasy.\" Aneurisms of the aorta and other mediastinal tumors, in certain in- stances, have produced asthma. These tumors press constantly upon the pneumogastric nerve, yet the asthmatic paroxysms agree with the aika- line tide. Instances of this kind seem to emphasize the necessity of both diathesis and neurosis. The pressure explains the neurosis, and the paroxysms occurring only during the alkaline tides show the arthritism. The second class of causes-the local or exciting causes-can only act when the first exists. That is, the condition essential to the par- oxysm, as turgescence, hyperæsthesia and spasmodic contractions of the muscles, can only occur when the nutritional disorder has resulted in a neurosis of the pulmonary plexus. Among the exciting causes may be mentioned: irritating inhalations -dust, smoke, chemical vapors, fumes of sulphur, burning sealing-wax; vegetable irritants, odors of ipecacuanha, roses, hay, rag weed, and ema- nations from animals. Also emotional disturbances, sudden chilling, and climatic influences, all of which affect the relative alkalinity of the blood. Among bhe reflex causes may be mentioned an overloaded stomach or rectum, and uterine disturbances. Chronic inflammations and diseases of the nasal mucous membrane, cardiac disease, and emphysema may likewise produce asthma. Too sudden arrest of chronic discharges, retrocedent gout, syphilis, skin dis- eases, and renal diseases are classed as excitante. [ MAY 472 AsTHMA.",
         "1901.] ASTHMA. 47- The relation of phthisis to asthma seemi an unsettled question Some regard pulmnary tuberculosis as \"an antecedent disease having a casual rejation to asthma.\" Others regard asthrng as antaaonistic to phthisis, and believe an arrest of the tubercular trouble occurs with the onset of asthma. The anatomical changes observale in asthna ofly occur when the disease has become chronic. They are aroducts of inHla mation incident to chronic bronchitis, and the emphysematous condition resulting froin habitual overdistention of the air celms. The asthnatic syndronie is a classical portrayal of uric-acidamia As observed in most uric acid disorders, a prodroma buoyance gives place to corresponding languor and depression of spirits. n Ingestion of any of tht- xanthin group clears the blood of causes this exhilaration only Io be followed by an increasedf uric acid and when the alkaline tide begins. . Sleeplessness, pruritus, and headache are marked At tirst there is voided large quantities of limpid urine, in which the uric acid is diminished. This soon gives place to scanty high-colore urine loaded with urates. The paroxysm comes on usually during the alkaline tide, in the smiall hours of the morning; after a meal that raises alkalinity, or during the afternoon alkaline tide-from three to six o clock. The capillaries are obstructed, the veins distended, the surface temperature below normal, and the extreneties cold, blue and shrunken. The pulse is \"-mall and thready.' The sufferer rushes to the window for oxygen, regardless of the oitside temperature. The high arterial tension thus manifested explains the frequent presence of bronchitis, acid dyspepsia, renal and skin diseases. The physical signs. together with the history, inake it impossible to confuse asthma with any other disease. The attacks may last from a few hours to several daYs, and have a great tendency to become chronie. Emphysema and dilatation of the right heart usually are found in those having suffered for years. Modern treatment has not only been able to cut short the attacks in most instances, but to prevent a return, as well. A cure, in the sense of inmunity, as results when cured of certain microbic diseases, of course never occurs in a disorder of nutrition. The same nutritional disturbance, which primarily existed, will cLuse a re- turn of the disease. Since arthritism is the essential cause of asthma, prophylactic treat- ment should be begun in the children of all lithemic individuals, espe- cially the sons of asthinatics. Prophylactic treatment embraces proper hygiene and diet. The environment should be changed where several generations have been reared upon the same soi under identical conditions. Oxidation should be promoted by an out-of-door life, mountain- climbing, sea voyages, bathing, massage, or other means. Warm, dry climates are to be preferred, and flannel should be continuously worn. The diet should be as nutritious as possible, and free of the uric acid group. No tea, coffee, chocolate, alcohol, red meats, bananas, strawberries or tomatoes should be used.",
         "The lentils and articles of diet c9ntaining salicylates and phosphates in other than nuclenie form) are serviceable. Since a deficiency of oxygenation is the cause of the products of in- complete metabolisin, that class of food that carries with it most oxygen, the carbohydrates, should constitute the greater part of the diet. As expressed by Stewart: \"Wit'i a diet containing les, proteid and fat and more carbohydrate the oxygen deficit would be less.\" The niedicinal treatnent em.braces the management of the attack and the limitation of the diathesis. For the control of the attack the exciting cause must be removed and the urie-acidæmiamust be overcome. The exciting cause should be ascertained, and if it be irritatng inhalation, reflex or mechanical, atmospheric or emotional, auto-intoxicant or ex- traneous cause, it should, if possible, be removed. Freeing the.blood of mic acid re-establishes the circulation, opens the obstructed capillaries, empties the engorged veins, overcomes the cyanosis, and permits relaxation. The therapeutic measures overcoming uric-acidæmia are the hypoder- mic injection of morphine and atropine sulphates, hydrochlorate of apio- morphine, bisulphate of quinine and acid salts of similar alkaloids. Oxygen and the nitrites may be used by inhalation. The nitrites both free the blood of uric acid and dilate the capil- laries. The drugs most popular for internal administration--the iodides, the acid phosphates, the coal-tar derivatives and such depressants as lobelia and tobacco-have also been shown by Haig to raise the acidity of the blood. The diathetic or curative treatment (to be administered during the interval) consists in removing the uric acid from the sy stem and in per- manently keeping down arterial tension by a diet free of the xanthin group. The mendicaments elimininating urie acid froim the systen are the salts of lithia, the salicylates, piperazine, and other urie acid solvents. Acid salts of arsenic and quinine are supposed to lessen its production in the system. The suprarenal extract is indicated for its tonic action on the cardio- vascular apparatus, aside froin any action it may have upon retrograde metamorphosis. Cholagogues and laxatives to unload the liver and intestines are both necessary during the attack and the inter al. Holding in view the principles laid down by the school regarding asthma as a diathetie neurosis, together with the treatment elucidated by Alexander Haig, has undouht, dly been the most satisfactory in my haz.ds.-Interstate Medical Journal. [ MAY 474 ASTHMA.",
         "OVARIAN GRAFTING. OVARIAN GRAFTING. Dr. Robert T. Morris in an interesting article in the Medical Record reviews a number of his own cases of ovarian grafting together with a résumé of the literature up to date. His first notes upon cases treated in this manner appeared in 1895 and it would seem that to him belongs the credit of the idea, subsequently developed by others at considerable length, particularly in experiments upon animals. The two facts that led to the writer 's own experiments were the continuance of function desplayed by thyroid glands grafted upon cases of thyroidectomy and the occurrence of menstruation and even pregnancy in cases of double ovariotoin ; the reason for the latter he thinks is explained by a case in which he had occasion to open the abdomen somie months after a double pyosalpinx operation and found that a small portion of the ovary, distal to the ligatu e and of course deprived of its original circulation by way of the broad ligament, hai retained its vitality, instead of being absorbed as is usually supposed in such cases. It therefore occurred to him that a piece of ovary night be deliberately transplanted with as good results as when accidentally done : that thus the menopause might be averted and pregnancy become a possibility; also that such experiments if successful woulil afford an argument against the reioval of supposedly useless uteri n cases whose adnexa had been extirpated. His first, case was a woman, two years married but never pregnant, from whom both tubes and ovaries were removed for septic trouble of long standing. A small piece of une ovary was transferred to the interior of the stump of the right oviduct. The patient became pregnant soon after leaving the hosrpital but aborted at three months, probably on account of persistent adhesions; she continued to mentruate for about four years. The second case was a girl of twenty years with infantile uterus and rudimentary adnexa, who had never menstruated. A portion of ovary frot* a womari thirty years old was grafted into the fundus of lier uterus. Beginning eight weeks later she has continued to menstru- ate with some irregularity but in a fairly normal way, has improved much in personal appearance and is relieved of the symptoms of sup- pressed menstruation from which she formerly suffered. In the interests of science, no effort should be spared to induce this young woman to marry. Of the writer's remaining cases, six have been lost sight of too soon to allow conclusions to be formned, though they continued to menstruate so long as they were under observation. Four other cases are reported, though two of these are of recent date. Case III, twenty-two years old, had ovarian cysts removed successively from both sides, and at the second Operation A portion of another patient's ovary was gratted into the left broad ligament. She was heard from a year later and during that time had menstruated regularly and easily. Case IV., thiity years old, had suffered from very painful menstruaticn accompanied by much reflex 1901.] 475",
         "disturbance. A diagnosis of ovarian sclerosis (afterwards contirimied) was made and both ovaries were removed. With the exception ot two months sone time later, when she appeared to bave a pelvic thrombo- phlehitis, she has menstruated regularly and painlessly, the freedom from pain being due doubtless to the removal of the ovaries but the continu- ance of menstruation to the grafting operation. Case V., similar to the preceding, had an apparently normal portion of one ovary transferred to the lef t broal ligament ; menstruation wvas deferred for some months but bas now returned and is less painful than formerly. In Case VI., a similar operation was performed ; for four years she bas menstruated regularly, i hough sometimes scantily and, while she has some pain due probably to the refoimation of adhesions, she sufleis much less than before. This case is a married woman but has not become pregnant. The writer now chooses a point of the broad ligament as near as possible to the norinal site of the ovary, slitting the ligament and sutur- ing to the raw surface thus formed the raw surface of the ovarian frag- ment, leaving the latter uncut surface to project into the peritoneal cavity. As untoward results he nentions the case of supposed thronbo-phlebitis, a case (V.?) in which the patient's own ovary, already degenerate, con- tinued to undergo degeneration, and a third, that was thought to have an extra-uterine pregnancy but disappeaied from observation. Such a pregnancv is liable to occur unless the oviducts with their fimbri-e be lett (as is often possible) intact. Fron these cases and from experiments upon animals it is evident that ovarian tissue nay be transplanted with continuance of its function and even with the possibility of future pregnancy. Even more interest- ing is the ca-e of the young woman with undeveloped uterus and adnexa who after the introduction of notrmîal ovarian tissue begarn to nenstruate. As the writer suggests it is important now to learn what would be the eflct of ovarian grafting upon patients whose ovaries have been removed some tiie previously. Doubtless nmany of these cases might have been spared a premature menopause and its various accompaning disurbances, could ovarian grafting have been done originally. But would the opera- tion, even now, prevent further degeneration or undo such as has already occurred ? At aill events the experiments are sufficient to show the pos- sibilities of work along these lines and, as the author insist-, con-titute a reasonable argument for leaving the uterus whenever possibe. Should some of these experiments result in pregnancy we should fancy certain not uninteresting medico-legal questions might arise but we suppose this is one of the objections that Pr. Morris classities as \" fanciful and when at Iast a real oaby is pioduced firom such a dual league it will be tinie enough to decide whether the infant belongs to the woman whose ti-sues, though cast upon a foreign shore, realiy sent it foith or to the woian whose uterus took the wanderer in and harbored it for nine weary months; and whether the second woman would be justitied in a suit to recover rental ; or, failing in that, in e :icting the tenant before the lease should have expired.-Aner. (Gyv. and Obs. Jour.-A. D. C. 476 [ M1 iYý OVARIAN GRAFflNG.",
         "ROUTINE DeUCHING IN OBSTETRICS. ROUTINE DOUCHING IN OBSTETRICS. Since Semmelweis showed how greatly the mortality from puer- peral infection inght be reduced by simLply washing the operator's hands before delivery, much attention has been devoted to methods for still further diminishing the number of infected cases. With this object in view routine vaginal douching before labor bas been advocated by many obstetricians. In the year 1887 Ginner announced that the vaginal sec- retion of pregnant women examined by himi did not contain the path- ogenic bacteria which were usually found in puerperal infections, and that for this reason the use of vaginal douches before labor for the prevention of auto-infection was unnecessary. Since that time the advisability of routine douching before and after delivery has been frequently discussed. The statistics advanced by those in favor of routine douching, as weil as those presented by the opponents of this procedure, are of uncer- tain value. This is due Jargely to the diminution of the number of cases of infection in the maternity hospitals, by icason of the many improve- ments in aseptie technic, such as the restriction of frequent internal ex- aminations, and careful disinfection of the hands. This small proportion of infected cases affords poor grounds for estimation of the results of antepartum douching, as some of the cases infected are doubtless due to individual errors in technic and \u003eo prove nothing in regard to the value of douches. Certain observers have discovered pathogenic mi icro-organ ism s in the normal va2ina and for this reason advocate prophylactic douching. Others hold that the vaginal secretion possesses bactericidal qualities. These are attributed by Döderlein to its acid reaction produced by the vaginal bacillus which bears his name. The experiments of KröSpig show that the vagina takes longer to eliminate pathogenie bacteria artificially intro- duced, when douches are employed ; and other investigators have found that douching, with or without antiseptie solutions, usually Mails to re- move such organi-ins. The recent bactei iological researches of A. Wadsworth (Amerieca n Journal of Obstetrics, April) have led him to condemn routine antepartum or postpartum douching. His technic was such as to exclude all possi- bility of contamination of the uterine and vaginal secretions, and both cultures and staining methods were einployed. He found that it was exceptional that pathological bacteria persisted in the vaginal secretion through pregnancy and labor, but that if they were present the lochia favored their growth, and energetie antisepsis after labor was necessary. Cultures from several cases in one of the best of New York's maternity hospitals demonstrated the persistence of streptococci in the vagina after repeated douching with a 1-5,000 solution of bichloride. He considers as requisite points that the disinfecting solution be brought into contact with all bacteria by distending the folds of the vagina, and that it be of sufflcient strength to kill the micro-organisms without, however, injuring 190)1.] 477",
         "ROUTINE DOUCHING IN OBSTETRICS. the vaginal wall. The douche, as ordinarily given, merely removes the protective resources of the vagina. Wadsworth's cultures confirmed the statement that the uterine cavity is usually germ-free. He emphasizes the necessity of differential diagnosis between sapremia and septie con- ditions, since intra-uterine douching after labor is strongly indicated for the removal of the abnormal contents of the uterus in the former class, while in septic conditions it is likely to aid in disseminating the process unless the uterine sinuses have been closed by granulation tissue. The rule which he lays down is that bacteriological examination of the cavity of the uterus should always precede an intra-uterine douche and such an examination shoild be made early, since, if a radical operation is required, an early determination of this point is of great importance in regard to is prognosis. Reviewing the results of Wadsworth's observations as well as those of others, one cannot fail to note that antepartum douches frequently fail to remove pathogenic bacteria when they are present: but they de- stroy the natural protection öf the vagina, whether this be its secretion as a whole or the vaginal bacillus ; that they are liable to cause slight injuries to the vaginal wall and so furnish points for the entrance of infection, or at least by removing the lubricant of the vagina to make labor more difficult and thus favor such vaginal traumatism ; and, fiially, that pathogenic bacteria may be introduced by these manipulations. For these reasons, and on account of the danger of dissemination of sep- sis by intra-uterine douching while the uterine sinuses are closed only by infected blood-clots, one must in general agree with Wadsworth's con- clusion ; that \" the routine management of cases should be freed as far as possible from all procedures which interfere with the natural re- sources of the body ; for these, in the vast majority of cases, are sufficient protection against the invasion of pathogenic bacteria. In the few ex- ceptionial cases requiring interference this should be determined and directed by the bacterial examination.\" This statement seems open, however, to siight modification. No one will leny that after manipulations which require the intimate contact of the hand with the interior surface of the uterus, as in manual extraction of retained secudines, it is wise to give immediately a bichloride douche for the purpose of flushing out any pathogenic bacteria which may have been introduced, before they have an opportunity to become attoched to the uterine wall. Such a bacteriological examination as Wadsworth ad- vises is obviously beyond the reach of the attending physician in a large proportion of cases in private practice, and in these the indication for for douching must necessarily be derived from careful exclusion of all other causes of fever, with the presence of local symptoms. Whether the uterine condition is one of sapremia or of sepsis must, in such a case be determined by the judgment of the physician. aided by the history of the labor and the probability of the infection before or during labor as opposed to retention of secundines. As a general rule avoid douching in obstetrics unless it is particularly indicated.-Med. News. 478",
         "SOCIETY REPORTS. SOCIETY REPORTS. TORONTO CLINICAL SOCIETY. Stated Meeting April 3rd, 1901. The president, Dr. W. H. B. Aikins, in the chair. Notice of Motion-Dr. Meyers--To amend Sec. 2, Article IX, of the constitution that the nomination of officers shall be held at the April meeting of each year. Papillot of Larynx.-Dr. G. Poyd read clinical notes of this case, occurring in a child 6k years of age. First came under his notice in November, 1898, with loss of voice. Measles at 4 years and history of several attacks of croup. In spring after measles became hoarse ; since that time voice gradually lost. Physical exanination showed respiration etc., normal. Papillomatous patches on both cords; tonsils hypertrophied. Three weeks after operation symptoms of whooping cough set in. Membrane appeared and antitoxiii and calomel fumigations employed. Intubation performed, tube for a four year old child being used. The tube was expelled in a few days but as there was no dyspnoea present it was not replaced. Two days after a severe laryneieal spasm occurred and the tube was reinserted. Post mortei examiration showed usual signs of asphyxia. Dr. Ryerson and Anderson discussed the case. Multiple Neuriti.s-Dr. D. C. Meyers exhibited patient and de-cribed the conditions present in this case. This inan during the latter part of January was exposed to a severe cold and following that paralysis ser in in both hands and feet, beginning simultaneously in all four extreimities. Dr. Meyers had been unable to trace the cause to any other source than a severe cold. Drs. Anderson and Rudolf discussed the case, the latter stating he had seen the patient in the hospital and thought he had had from him a history of using white arsenic in connection with his work. Internal Hydrocephalu.s.-Dr. H. C. Parons Jescribed this case which bai occurred in a child of 12 years. At the age of seven the child was quite well, going to school and quite bright. A full description of the case has alreadyv been reported. Stated meeting, May 1st, 1901. The president, Dr W. H. B. Aikins, in the chair. Visitors present :-Drs. D. M. Anderson and Howland. Tempero - Sphnoidal Abscess, Operation, Recovery -Exhibition of Patient. Dr. Herbert A. Bruce presented this patient and recited history of the condition. It occurred in a young man of twenty-four years. When 1901.] 479",
         "SOCIETY REPORTS. he was a sinall boy about five or six years of age he had ear trouble,- otitis media in the right ear and was treated in Toronto by two or three ear , pecialists for a peiod of five or six months. He was taken home then apparently cured, continuing to have a little boracie acid dusted in to his ear, and the discharge ceased in a few months. Up to the 1st of March of this present year had no trouble apparently at all except occasionally a little discharge at times when he got a cold ; but it was nothing to speak of at any tinie,-only a few drops and then it would cease. He was on the ice playiiig a wind instrument, a trom- bore in the band of a country town, and the next day he was taken ser- iously ill He said le f lt as though he had blown a hole through his ear. lis temperature was 101 and pulse increased to 100. Headache, pain in the side of the head and sickness of the stomach were present. The local doctor was called in and prescribed for him and he lay in bed for two weeks. He had very few symptomis when seen by Dr. Bruce. He was lying in bed, quite rational, with a temperature of 97 4-5 and a pulse rate of 66, with pain in the side of his head and sickness at times. The history was that he was sick every day three or four times without any apparent cause. which lad no relationship to the ingestion of food. He had not been out of bed then for two weeks and inquiry about dizziness or giddiness showed that none had been present. Dr. Bruce got him up to walk a little through the room when he felt a little light headed, but not more than one would expect after lying in bed that length of time, so that was not looked upon as a symptom of importance. He had much exaggerated knee jerks and ankle clonus on both sides, particularly well marked on the right side. Drowsiness was another condition present. He slept a great deal and seemed drowsy and willing to go to sleep almost any time. He took nourishment fairly well. These were the only symptoms present. There were no eye symptoms. Dr. Bruce found a slight discharge on examination of the ear very slight, with per- foration of the drum. Over the mastoid there was a slight amount of swelling. He came to the conclusion that there was certainly mastoid disease and probably also cerebral abscess. He advised his removal to Toronto General Hospital, where he was taken immediatedly and after two days in bed he was operated on. The condition found was briefly as follows :-An incision was made in the usual position down over the mastoid from the base to the tip, one half inch behind the ear and the antrum was opened. Pus was found here and then on passing a probe down into the cells, these were found filled with cholesteatomatous material. A portion of the aquamous bone was then chiselled away thus exposing the temporo-sphnoidal lobe of the brain. A grooved trocar was passed in and pus was seen oozing along the groove. A considerable quantity of pus was then evacuated, between three and four ounces and there was a cavity as large as a. tangarine orange. The ossicles were then removed from the ear and a portion of the posterior wall of the meatus removed. A drainage tube was placed in the cavity and dressings applied, the whole wound being left open. This operation was performed on the 14th of March last, about seven weeks ago; and the result is very satisfactory. The cavity drained nice- 480 [ MAY",
         "ly and Dr. Bruce thinks it entirely filled in, but a little opening remains and syringing is still done through the opening and out at the external auditory meatus. During the first week after the operation there was considerable delirium, the patient being noisy and restless, but that dis- appeared and he made a satisfactory recovery. One peculiar feature of the pus was the extreine offensiveness of the odor. The roof of the middle ear had been completely destroyed. Dr. Hamilton asked Dr. Bruce the condition of the reflexes, which were much increased before the operation. Dr. Bruce then exainined these and found them still slightly exaggerated. Ankle clonus was also still slightly pr\u003csent. Dr. Orr thought that chronic suppuration had been going on in the middle ear for many years and that it was extraordinary that there should be such extensive lesion of the bone with so few symptoms. Dr. Ross referred to the case of a boy who was shot in the temporo- sphenoid al region. A probe demonstrated that the bullet had gone through the bone. He was perfectly conseious ; no syniptois at all, until grad- ually and slowly he began to get weaker and weaker until he finally died and on post-nortem, examination one half of the brain was a great amount of pus. Tumor of Thigh,-Clinical Notes. Duodenal Ulcer,-Specimens. Dr. F. LeM. Grasett reported these cases and presented the speci- mens. The second was a case of ulcer of the duodenum with rupture in- to the peritoneal cavity, and death following somewhere within forty- eighlit hours. It occurred in a doiestic servant.. The case was first seen by Dr. A. A. SmaIl and when seen by Dr. Small indicated that there was some trouble in the neighborhooI of the appendix. There was dullness in the right flank. and the diagnosis was contirmed a few hours later by Dr. Nevitt. The woman was rapidly approaching a moribund condition, and if somethiing were niot done inmediately death would intervene. Dr. Grasett then operated and found everything in the right region normil. There was. hov, ver, a collection of fluid hke thin green mucilage, the li ke of which Dr. Grasett had never seen before. He considered there must be a rupture somnewhere and if he had prolonged the incision upwards lie thinks he would have found the rupture without any difficùlty ; but the anesthetist said the patient was collapsing, so Dr. Grasett desisted. The patient died one to one and a half hours afterwards. It was found post nortem that rupture had taken place in the duodenum from an old ulcer, probably the day before. Everything she had been taking the way of food went into the stomach and then into the peritoneal cavity. By ex- ternal palpation nothing could be felt she was in such a tympanic state. The tumor of the thigh was a fatty tumor The specimen shows that it is broken down forning a large cyst in the centre and a number of smaller cysts. It produced a large tumor in the back of a woman's *thigh a little above the popliteal region. It had existed there for eight 481 1901.] SOCIETY REPORTS.",
         "SOCIETY REPORTS. years. Six nonths before she was seen hy Dr. Grasett, a doctor attend- ed her in continement and during the confinement he noticed this tumor. Six months after this the tumor had grown enormously and there was great pain in the sciatic nerve and the woman was rapidly becoming a cripple. Dr. Grasett then operated and had no trouble in enucleating it. A large part of the tumor had lifted up the sciatic nerve and it took considerable time separating the nelve and tumor. The wound healed by tirst intention froin end to end. Gradually power came back into the limb and the wonan got perfectly well. She sat up in the hospital and got an attack of the grippe followed by tr uble in the middle ear. From this she recovered. Examination of the tunor was made by Dr. Ander- son and pronounced a lipomia. An interesting feature of the case was the manner in wbich the tumor was hugged by the sciatic nerve. Dr. A. A. Smail enla'ging on the case of duodenal ulcer said the patient, a very healthy looking young girl of seventeen years, caime to him complaining of nausea and only nausea, for which he prescribed a mild stomachie. He was called to see her early the following norning, when he found her complaining of very severe abdominal pain, which pain was confined to the right inguinal region. She was sent at once to the hospital ; and it was thought that it might be coprostasis, a high enema was given with very slight result. Section was then advised, and the results found as given by Dr. Grasett. Dr. George A. Bingham spoke in reference to the lipomatous mass. There is danger in connection with these tumors and mentioned a case of a woman of 60 years, who had had for twenty years a snall mass situat- ed over the anterior crural nerve. Ulceration occurred from irritation of underclothing and there was general breaking down of the whole mass. The temperature rose to 101 or 102 and there was a slight cardiac murniur, also prior to operation. The growth was removed and for sone time after the operation this cardiac inurmur persisted. It was probably due to septic endocarditis a, a result of absorption owing to broken down tissue, from a simple fatty tumor. This gradually got well and the pat- ient left the hospital recovered. Dr. Ross referred to a case of duodenal ulcer occurring in his prac- tiee. Patient was taken sudd-nly with pain, with severe hemorrhage from the stomach and died. Post nortem showed old duodenal ulcer, which had suddenly perforated into a vessel resulting in death. Also spoke of a.case in consultation, a man, who for years, had very severe hemorrhage from the intestine at long intervals. This case was.jocularly referred to as \" onionitis \" fron pieces of green onion being found in stomach when operated on. From this the man made a good recovery, but some months after came back to the hospital. He died and on post mortem found old ulcer. 6 Operations for Deformities With Photographs. Dr. George A. Bingham presented photographs and recited the his- tory of this case. A cripple, a young lad of 14 years, alhhough he looked 17, caine to the Childien's Hospital, having heard of the wonderful sur- a 482 [ MAY",
         "gical operations done atthis institution. From his head tohis kneeshisphy- sical condition was normal, but from his knees down he was not so. This lad had a dog and sleigh, to which he harnessed the dog and drove down in winter time to the Children's Hospital, not having other means of getting there and being bound to get there somehow. The right leg below the knee was rudimentary, eight inches in length. There was but one bone in the leg-the tibia. There were only four metatarsal bones and four toes. The foot was turned looking directly upward in the direction of the knee. The toes were also webbed. Dr. Bingham amputated at once and procured an excellent stump. The bones of the left leg were twisted inward. The internal malleolus was lower than the external ; as a mat- ter of fact he walked on the internal malleolus. The metatarsal bones were turned inward toward the toe This leg was perfectly useless and the problem was what to do with it. Dr. Bingham chiselled the bones and broke them down in order to bring the foot back into proper relation with the leg. There was great difficulty in getting the bones to co-apt properly. Dr. Meyers motion to elucidate the meaning of clause 2, Article IX of the constitution fixing the April meeting of each year for the nomina- tion of officers was carried. Dr. Pepler as treasurer was authorized to remit $25 to Dr. Conerty, of Smith's Falls, and also to open a subscription list towards a fund for Dr. Conerty froin members of the Clinical Society. GEORGE ELLIOTT, Recording Secretary. 1901.] 483 SOCIETY REPORTS.",
         "MISCELLANEOUS. MISCELLANEOUS. Gonorrhea and its Treatment from the Present Standpoint. Henry J. Scherck, of St. Louis, after briefly considering the anatomie features of the urethra enters into an account of his routine treatment. In acute specific anterior urethritis, the canal is first washed with luke- warm water, then injected by means of three-ounce, blunt-pointed syringe with a solution of either 2 per cent. mercurol, 5 per cent protargol, or 1 per cent Crede's silver. The solution is retained for five minutes after which lîrigation froin a two-gallon vessel filled with 1-10 per cent solu- tion of potassium permanganate at 120 degrees F., is practiced at a pres- sure sufficient to distend the urethra without overcoming the sphincter muscle. This local treatment is practiced every day or twice a day, the strength of the permanganate solution being gradually increased to twice the original. Internally, diluents and capsules containing cystogen (ammonio-formaldehyde) gr. v. with ten mimins of santal oil, are admin- istered. The same treatment is likewise pursued in chronie urethritis, except that the glands must first be emptied by stretching with straight or curved Oberlaender dilators. In case of prostatic gonorrhea, the gland is emptied by rectal massage and the solutions of mercury salts injected directly into the prostatic portion by means of a deep urethral syringe. -St. Louis M\u003cd. Review. The Treatment of Chronic Rheumatism by Spinal Counter Irritation. In a paper on the treatment of chronic rheumatisn, Dr. A. C. Lat- ham calls attention to the benefit to be derived in certain cases of chronic articular rheumatism from counter-irritation applied over the spine. He relates two cases in which the greatest relief followed the application of blisters over the cervico-dorsal and dorso-lumbar regions of the spinal column. Not only did the joints recover more or less mobility, but the structural changes in the eflected joints also underwent improveinent. This method would seeni to be equally applicable to advanced cases of chronic arthritis with eburnation of the articular surfaces, by checking the evolution of the painful manifestations, even arresting the further progress of the disease.-The Medical Press aind Circulætr. Bronchitis (s.ubacute) I4. Strych. sulphat.....................gr. ss Codein .................. . gr.ss Jerpin. hydrat. ..................... gr. xxiv. Guaiacol carbon .................... gr. xl. M. ft. caps. No. xii. S. One everv three hours. 484 [ NMA4Y",
         "Fetid Breath. 13. Thymol .................... ....... gr. viij. Spir. vini rect .................... G lycerini ........................... ss. Formol...........................gtt. viîj. Aquæ ....... - .... ......... q. s. ad ý viij. M. S. Use as mouth wash, especially when fetor is due to decay- ing teeth.--Med¡cal\" Tunes and Hospi'al Gazette. Ichthyol in Erythema Nodosum. In a letter from London, by Dr. Raymond Crawfurd, published in the Theraipeu te Gazette for March, Dr. Brownlie is cited as recommend- ing the following formula: u Ichthyol ........................ 2 drachms; Alcohol, Ether, each.................... 3 M. The alcohol and ether are first mixed, and then the ichthyol added ; else an insoluble deposit is formed. Painted on, it is said to relieve the burning pain speedily. Dr. Crawfurd himself recommends a paint consisting of a drachin of ichthyol in an ounce of collodion. An Ointment for Intertrigo. We find the following formula in Reed's Textbook of Gyncecology: R. Zinc oxide, Bismuth subcarbonate, j each ...... 30 grains; Carbolie acid ................... ..10 drops; Vaseline .. ........................ 1 ounce. M. To be smeared on the affected surf ace.-Philadelphia Med. Jour. Treatment of Obesity. A treatment which has of late found much favour on the Continent for the purpose of reducing obesity without the production of any incon- venience or inju]ry to health, consists in giving very smnall doses of thyroid extract on an empty stomach, followed by Marienbad water and the administration of quinine and theobromin. If all the favourable results ascribed to this procedure are truly reported, then it would appear that the difficult problem of the treatment of obesity had been satisfactorily solved-but this remains to be seen.-lhe Medical Press. Instant Relief of Pains. According to Winterburn, in the Journal of Obstetric8, in many cases a nice warm imeal is butter than any medicine; \" still, where the pains are exhaustive and severe, I turn to amyl nitrite. This potent drug is a very effective controller of after-pains, and used cautiously I see no rea- son to apprehend harm fron it. A neat way of using it is to saturate a 1901.] MISCELLANEOUS. 485",
         "486 MISCELLANEOUS. [ MAY small piece of tissue paper with five or six drops, stuff this into a 2- drachm vial and request the patient to draw the cork and inhale the odor when she feels the pains coming on. It acts with magical celerity. -Med. Progress. Manganese dioxide, combined with ferrous carbonate, is eflective in amenorrhea with anemia.-Med. Summary. Chronic Bronchitis. Eucalyptol ............................ 1 dr. Camph. tinct. opium .................... 4 dr. Syrup tolu ............................ 1 oz. Simple syrup ....................to make 4 oz. Teaspoonful every four hours. Oil turpentine............ ........... Tar ..............................aa 20 m in. Oil eucalyptus.... .................,. 50 min. Balsam tolu................... ...... i dr. Benzosol......... ........ ........ 4 dr. Make into 60 capsules. One four or five times a day.-Merck'8 Ar- chive8.",
         "The Canada Lancet A MONTHLY JOURNAL OF MEDICAL AND SURGICAL SCIENCE, CRITICISM AND NEWS. The Oldest Medical Journal in the Dominion: Established 1867. Editor :-H. B. ANDERSON, M.D. ASSOCIATE EDITORS: W. B. Geikie, M.D. F. Le M. Grasett, M.D. G. Sterling Ryerson, M.D. John L. Davison, M.D. Geo. A. Bingham, M.D. N. A. Powell, M.D. D. Gilbert Gordon, M.D. Allan Baines, M.D. D. J. G. Wishart, M.D. J. T. Fotheringham, M.D. D. C. Meyers, M.D. C. A. Temple, M.D. F. Fenton, M.D. H. C. Parsons, M.D. Chas. Trow, M.D. Chas. B. Shuttleworth. COLLABORATORS: A. H. Ferguson, M.D., Chicago. Ernest Hall, M.D., Victoria, B.C. ladley Williams, London. J. Coplin Stinson, San Francisco. All Communications in reference to the Literary part of the Journal, articles for publica- tion, etc., address The Editor, 241 Wellesley Street, Toronto. Articles on subjects of Medi- cal, Surgical or general interest to the profession solicited for publication. Correspondence in reference to Advertising, Subscriptions, Publishers Department, etc., address Dr. G. P Sylvester, Business Manager. Make Cheques and Drafts payable to the Business Manager. EDITORIAL. EAR COMPLICATIONS OF LA GRIPPE. The late severe epidemic of la grippe bas been attended by an un- usual number of cases of inflammation of the ear,'in most instances fortunately of one ear only, but in a good percentage, of inflammation of both ears. These have been divided again into at least three classes, viz.,- catarrhal, suppurative, and those accompanied by nastoidal inflamma- tion more or less severe. The first of these classes bas yielded to applications of ear drops containing 10 per cent. of cocaine, with 1 per cent. of atropine and morphia, combined with carbolic acid and glycerine, warmed and used very fre- quently according to the persistence of the pain. When these have proven insufficient to allay the inflammnation, the use of two or more leeches in front ol the ear has relieved the congestion and allowed Nature to have her way. In the second group the cases which have given most trouble have been those where the perforation of the drum membrane bas been too small, or situated too high up to allow of free drainage. Here we have (487]",
         "found that a slight enlargeient of the perforation, made by a blunc pointed Graefe knife, under cocaine anaesthesia, and followed up by measures designed to evacuate the middle ear, have been niost u-eful, The evacuation may be secured by the use of the Valsalvan or Politzer methods of inflation through the nose, or what is simple and less apt to produce passive congestion, by means of suction through a flexible rubber tube which will fit the external meatus, or by Seigel's suction specuilun. This evacuation requires to be made frequently enough to prevent the collection causing pain, and gently en\u003eugh to avoid passive congestion, or the forcing of pus into the antrum. In many cases also the perforation has required to be enlarged more than once. In the third class of cases, leeches vigorously applied ani followed by heat to stinulate the flow of blood fron the leech wounds, and to iro- mote the discharge of pus, have proved useful. In many cases. however the mastoid has requirerl to be opened and thoroughly evacuat-d. It is unfortunate that so many mastoidal cases have beeti permitted to go so far without surgical interference, and that a number of deaths have resulted fron meningitis and blood poisoning which mnight have been saved perhaps, had early incision been made Where the invasion of the mastoid was marked at the visit by redness behind the ear and puffiness of the coverings of the bone, the indications were decided, but it often occurred that pain was the prominent symptom, and time was lost in relieving this without operation,when in fact the strength of the inflamma- tory process tended inwards and upwards rather than outwards. When an opening was finally made in these cases, the whole of the mastoid cells were found invaded, and the sigmoid sinus laid bare, while the poisoning process had invaded the blood stream through one of the avenues with which the ear abouids. The whole course of these cases has given a fresh denonstration, which should not be needed in these days, of the absolute necessity for thorough and watchful care in the disinfection of the naso pharynx in all cases of la grippe to prevent the closure of the Eustachian tube, and the spread of the inlammatory process to a mucous membrane which is as vulnerable in the tue as in the nose and its accessory sinuses. If the physician would accustom himself to observe the condition of the drum membrane with the saine care as he takes the pulse and the tenperature, early congestion would be noted and precautionary measures taken, but unfortunately the physician neglects the ear clinie in his student days, and in the press of his work thereafter has few opportunities to acquire the needful technique. D. J. G. W. 488 EDITORIAL. [ \\MAY",
         "1901.] FILTHY BANK BILLS. The present outbreak of smallpox has caused some of our lay con- temporaries to speculate on the chances of infection being carried by means of bank bills that are continually passing from hand to hand. That the danger is a very real one requires no argument to convince any one who bas even the most limited knowledge of the spread of infection, though there is no means of estimating how often infectious diseases are actually disseminated in this way. The occurrence of isolated cases of smallpox in districts where the patient can trace no other means of exposure, often suggests infected buils as the means of infection. These bills remain in circulation until they are often in a most filthy condition, a fact that is more quickly noticed by visitors from countries where a paper currency is not in use. While it is no doubt in the interests of the banks to use a paper currency still it is only right that they should take all reasonable precautions to minimize the dangers froin such a system. The matter should receive the attention of the health authorities, who have now a very opportune time on account of the pre- valence of small-pox to arouse the public to a proper appreciation of the dangers to which they are exposed. ASEPSIS IN BARBER SHOPS. Is it not about time the crusade in favor of ordinary cleanliness, not to mention asepsis, was carried into the barber shops ? True, in some centres an agitation in the matter bas taken place and some mnedical journals have called attention to the necessity for a change, but in most places there has been absolutely no improvement in the methods employed to prevent infections that are well known to be carried through cirelessness in these places. The sane brushes, combs, and various solutions are used indiscrimately ; and often the same razors, straps, shaving brushes anil soap, with the least pretence at disinfection. The ordinary barber probably never dreams of the necessity of sterilizing his hands after attending each customer. It is interesting while in the barber's chair to speculate on one's chances of escaping sycosis, seborrhoea or tinea, though, of course, those who are aware of the dangers expose themselves to them as seldom as possible. In these days of public interest in microbic diseases and knowledge of the dangers of infection it would be to the advantage of their trade if barbers learned something of aseptic methods and could iiake their customers feel assured that they carried them out. EDITORIAL. 489",
         "EDITORIAL. THE SPITTING NUISANCE. At a recent meeting of the Young Men's Liberal Club of Toronto, called by the President, Dr. J. E. Elliott, to discuss the subject of the Prevention of Tuberculosis, among other resolutions, one was intro- duced to ask the civie authorities to introduce regulations in order to attempt to control this disgusting habit. The great American Republic bas gained the unenviable notoriety of being a nation of \" spitters,\" so much so that in New York, Boston, and other cities, placards are posted in prominent places warning the people of the penalties for indulging in the habit. Large fines, from $10 to $500, and even imprison- ment may be meted out to offenders, and police officers in plain clothes go out to watch for violation of the law in this matter. Unfortunately a proportion of the Canadian populace appears some- what given to the same filthy practice which the resolution wishes con- trolled by law. That the habit is odious, disgusting, and at times dangerous to the public health, no one will deny. and as such should be discouraged in every way possible. It is quite probable at the same time, that the danger of the spread of infection by spitting on the streets has been overrated, as the drying and exposure to the sunlight of the organisms expectorated readily destroy them in most cases. The wisdom of the provision of such severe penalties as mentioned above is a questionable interference with the personal liberty of the subject and one can readily conceive of instances where it might be a genuine hardship. The spitting nuisance is one of those things better deait with by educating the public than by attempting to enforce abstinence by legal enactment. PRACTICAL SYMPATHY FOR DR. CONERTY. We have on several former occasions referred to the hardship inflicted upon Dr. J. M. Conerty, of Smiths Falls, in the prolonged defence of a suit for malpractice in which his brother practitioners best acquainted with the case consider him innocent of blame. We learn that a com- promise bas been made in the matter, the doctor paying $600 in settle- ment of the claim. This is a most regrettable feature of the case but no blame can be attached to Dr. Conerty as he has defended his reputation and honor and that of the profession to the full limit of his resources. It merely illustrates the well known fact that, considering the financial loss, the injury to one's reputation and the annoyance connected with the 490 [ M AY",
         "defence of actions of this sort, it is much cheaper to compromise, regard- less of the merits of the case than to defend. Unfortunately every case thus settled is an incentive to further litigation, for there are always ungrateful and unscrupulous patients, usually paupers, urged on by even more unscrupulous and rapacious lawyers, of the shyster variety, who are anxious to extort blackmail. A Medical Defence Union that would ensure evety action of this kind being fought to a fair finish would do more than anything else to discourage such litigation. We hope that some of our large medical associations will take the matter up at an early date, as a Medical Defence Union is one of the urgent needs of the profession in this country. We are pleasedto state that at the last meeting of the Toronto Clinical Society, Dr. Conerty's case was brought before the notice of the Fellows by Dr. Wm. Britton, President of the College of Physicians and Surgeons of Ontario. The members were unanimous in their expressions of regret and sympathy and on motion of Drs. Hamilton and Anderson, a sum of $25.00 was voted from the funds of the society and the treasurer was instructed to open a list to receive individual subscriptions to assist the doctor in defraying the expenses in connection with the defense of his case. It is to be hoped that the appeal in Dr. Conerty's behalf will meet with a hearty response from the profession in all parts of Canada. NOTE.-Since the above was written we are gratified to learn from Dr. Conerty that no compromise has been made. fHe is determined to continue the fight and it remains to be seen if his professional brethren will stand by him. The question is one involving the interests of the pro- fession at large, and as such is deserving of their serious consideration. 1901.] EDITORIAL. 49) 1",
         "EDITORIAL NOTES. EDITORIAL NOTES. Canadian Red Cross Representative in South Africa- The following appreciative letters refer to Col. Ryerson's services in South Africa as Red Cross Commissioner. LOCKINGE HOUSE, WANTAGE BERKS, March 7th, 1901. Dear COLONEL RYERSON, I am very much pleased with the very ample and interesting report that you have furnished to the Red Cross Society. I look forward with great pleasure to the time when, owing to your successful operations on the staff of Lord Roberts and representing the British Red Cross Society, great harmony will exist between England and the Dominion. Lord Roberts speaks in the highest terms of your services and 1, as chairman of the Red Cross Society, desire to add my testimony to that of the Com- mander in Chief. I must also add my thanks for the deeply interesting pamphlet of your \" experiences \" during the war, kindly sent to me. With kind regards, believe nie Youîrs very truly, (Signed) WANTAGE. P.S.-I am about to send you a proof copy of a photogravure of my- seli which bas been reproduced at the wish of some of my friends froin a portrait by Sir William Richmond. I shall be very pleased if you will accept it with my best wishes as a \"souvenir \". Copy. PRETORIA, 27th February, 1901. My dear COLONEL RYERSON, I trust you will pardon me for not writing and thanking you long before this for your very great assistance to us in our difficulties. I have often intended to write but I could never secure a time when I could quietly sit down and say to you what was in my mind. To others who have assisted me I could write appropriate letters of thanks, but you seemned to have placed on me a debt so large that I am unable to repay. I do, however, acknowledge it and I thank you sincere- Iy in the name of the service to which I belong. You came to this country with most useful stores. You placed them at the disposai of the sick and wounded when and where most needed. Your work was most 492 [ MAY",
         "EDITORIAL NOTES. untiring and unselfish and I fear will never be appreciated as it should be. I doubt, however. if this last will trouble you much, .... * If I ever visit Canada I will avail myself of the honour and pleasure of calling on you and I will I trust then have a talli over past events. Believe me, yours sincerely, (Signed) W. D. WILSON, Surgeon Gen'l., Principal Medical Officer of the Army in South Africa. American Academy of Medicine. The 26th annual meeting of the American Academy of Medicine will be held at the Hotel Aberdeen, St. Paul, Minn., on Saturday, June 1st, 19C1, at 11 arm. (Executive session : the open session beginning at 12 a.m.), and continuing through Monday, June 3rd. The principal features of the meeting will be a symposium on \"Institutionalism ;\" and another on \" Reciprocity in Medical Licensure.\" Series of valuable papers on both topics have been promised, as well as interesting papers on some other subjects. The president's address (Dr. S. D. Risley, of Philadelphia) will be delivered on Saturday evening, June I st, and the annual social session held on Monday evening, June 3rd. Members of the profession are always welcomed to the open sessions of the Academy. The secretary (Dr. Charles Mclntire, Easton, Pa.) will be pleased to send the programme, when issued, blank applications for fellowship, etc., when requested to do so. A Substantial Medical Fee. The daily press is authority for the statement that Dr. Walter C. Browning, of Philadelphia, rendered a bill for $190,000 to the estate of Senator Magee of 1Pittsburg for medical services during the latter's illness. It is gratifying to note that our medical brethren in the great Republie are attempting to keep up the pace in the financial transactions in their country that are attracting so much attention of late. Toronto Clinical Society Dinner. About forty members of the Toronto Clinical Society dined at the Albany Club on Tuesday evening, April 22nd. Dr. W. H. B. Aikins occupied the chair and a most enjoyable evening was spent. Article on Smallpox. The article on Smallpox published in the last number of THE LANCET was kindly furnished us by Dr. W. B. Geikie, who should have been credited with the same. 1901.] 493",
         "The New York State Pathological Institute. The State Lunacy Commission, it is said, has asked for th- resig- nation of Dr. Ira Van Gieson, the well-known pathologist and head of the Institute. The commission claim that while research work of much scientific value has been carried on by Dr. Van Gieson and his associates, it has been of little practical value to the State hospitals. It will strike most sensible men that the Lunacy Commission is somewhat impat;ent in the matter of the results of scientific research, which certainly cannot be weighed out or measured off in definite quantities each year. The Cause of Cancer. According to statements appearing in the lay press, Dr H. R. Gaylord, of the University of Buffalo, claims to have discovered the cause of cancer. At variance with the opinions of the Italian school, that cancer is due to vegetable parasites, blastomycetes, Dr. Gaylord says the parasite is a minute form of animal life-a protozoon. It is stated that his observations and experiments prove beyond doubt the reliability of the discovery. The profession would have received the news with more confidence had it appeared in a less sensational way; nevertheless the appearance of an account of Dr. Gaylord's investigations in the medical press will be awaited with much interest. The Peterboro Grave Robbing Case. The case of William Patterson, a third year student of medicine in Queen's University, charged with opening the grave of a Mrs. Sheehan in the Peterboro cemetery and unlawfully, wilfully and indecently inter- fering with the dead body, in having it packed in a trunk and forwarded to Kingston for dissecting purpose, was disposed of by bis Honor Judge Weller on April 22nd. The prosecution failed to prove that Patterson opened the grave, on which charge he was consequently discharged. On the other charge of indecently interfering with the dead body, Patterson was fined $200, or in default, one year in gaol. The judge, in passing sentence, stated the law provided a sentence of five years in the peniten- tiary or a fine, at the discretion of the judge. Considering Patterson's previous good character and antecedents, he inflicted the lighter sentence. The case is interesting as being the first of the kind to come before the courts of Ontario. Counter Prescribing Druggists. The appeal of the druggists fined at the Toronto Police Court for violation of the Ontario Medical Act by counter prescribing,was allowed by Judge Macdougall on purely technical grounds. The decision in no way establishes the right of druggists however, to practice in future. 494 [ M'AY EDITORIAL NOTES.",
         "EDITORIAL NOTES. 495 Christian Scientists and Smallpox. A person in Berlin, Ont., suffering from smallpox, according to recent statements in the public press, was for some ten davs under the care of Christian Scientists before the health authorities were aware of the case. No doubt the disciples of Mrs. Eddy will consider absent treatment sufficiently efficacious henceforth with this patient. Toronto Pathological Society. At the last meeting of the Toronto Pathological Society the following officers were elected for the coming year:- President, R. D. Rudolf; Vice-President, H. C. Parsons: council J. T. Fotheringham, W. H. Pepler and Wm. Goldie. Toronto Clinical Society. This society closed a very satisfactory year's work at the regular meeting on May 2nd, when the election of officers for the coming year took place, as follows:- President, J. F. W. Ross; Vice-President, E. E. King; Corresponding Secretary, Arthur Small; Recording Secretary, Geo. Elliott; Treasurer, W. H. Pepler; Executive Committee, H. J. Hamilton, H. B. Anderson, H. A. Bruce, Geo. A. Bingham and W. B Thistle. Defaulting Practitioners. Some 700 practitioners resident in different parts of Ontario who have neglected or refused to pay the $2 annual fees levied on all Provin- cial licentiates, were recently notified by the Council of the College of Physicians and Surgeons that if they failed to pay up before April 19th their licenses would be suspended and they would then be proceeded against for continuing to practice without the proper qualification. A considerable number settled in order to avoid further trouble, but many who refused to do so have sent a deputation to wait on the Provincial Government. Precisely what they are after is not known. It is stated that the Government will ask the Medical Council to dfer action until the misunderstanding is settled. The Ontario Medical Association. We would again direct the attention of our readers to the coming meeting of our Provincial Medical Association in the Normal School building, Toronto, on June 19th and 20th next. Dr. Charles P. Noble of Philadelphia will read a paper on Compli- cations and Degenerations. of Fibroid Tumors with reference to Treat- ment. 1901.]",
         "EDITORIAL NOTES. [ MAY There will be a discussion on Gastrie Ulcer introduced hy Dr. J. W. Edgar of Hamilton; a discussion on Empyema, introduced by Dr. Turnbull of Goderich and Dr. Ferguson of London; and a discussioii on Extra uterine Pregnancy, introduced by Dr. Garratt of Kingston. Dr. J. H. Elliott, of the Muskoka Sanitariun will read a paper on the treatment of Tuberculosis; Dr. Prevost of Ottawa one on Intraspinal Cocainization, and Dr. Osborne of Hamilto'n will speak of Field Service during the South African war. The Committee on Papers will be glad to receive at an early date the titles of short papers on subjects of interest to the profession. British Columbia Medical Association. The next meeting of the above naned Association will be held in Victoria during the second week in August and a cordial invitation is extended to any niedical brethren from the east who may be visiting the Coast at that time to attend the meeting. PERSONAL. Dr. W. T. Yeo, Trin. '98, has opened an oflice in Parkdale, Toronto. Dr. J. O. Orr sails for England short ly, where he wili spend three or four nonths. Dr. A. McPhedran attended the meeting of the Association of Anierican Physicians last week. Dr. J. J. Mackenzie has sailed for Europe where he will spend the sumnier doing pathological work. Dr. Jas. Third, of Kingston, who has been ill for some time, we are pleased to learn, is gradually recovering. We are pleased to report that Dr. E. E. King, who has been confined to the house for sone time has quite recovered. Dr. H. J. Way, of Chicago, a member of the resident medical staff, Toronto General Hospital 1892-3, was in Toronto, recently, attending his father's funeral. Dr. Lelia Davis, Deionstrator in Histology, Wonan's Medical Col- lege, leaves shortly to spend a few months in medical research work in Boston and Baltimore. 496",
         "1901.1 L' . 497 Dr. J. A. Couch (Trinity '87) who practiced for several years at Warsaw, Peterborough County, has taken up his residence in Toronto, opening an office on Sheroourne St. Dr. J. A. McWillie and Dr. E. H. Stafford, of Toronto, who accom- panied a sealing fleet to Newfoundland, have safely returned. They report a great catch and an exciting time. Dr. Chas. M.. Stewart, Trin. '99, a former member of the resident medical staff of the Toronto General Hospital, has been appointed Medi- cal Superintendent of the Ottawa Protestant Hospital. We are glad to learn that Dr. J. A. Temple, of Simcoe street, and Mrs. Temple, who received a severe shaking up from their horse running away, are both able to be about agairr Dr. H. A. Bruce's nany fri.ends' in the profession wili be pleased to know that he has quite recovered from his recent infection in the finger, received while operating on a case of appendicitis. Dr. Leonard Vaux 'Trinity '97) has acconhpanied the Canadian con- tingent to the South African ConstabuWi.y as surgeon. Dr. Vaux was surgeon to the Royal Canadian Àrtillery in South Africa a year ago. We are pleased to note that Dr. H. E. M. Douglas, A.M.C., a graduate of Queen's University, Kingston, has been awarded the Victoria Cross for conspicuous courage in attending the wounded at the battle of Magers- fontein. Dr. McNicholl of Cobourg has been appointed medical superintendent of the new asylum for the insane in Cobourg, with Dr. Harriet Cockburn of Toronto as assistant physician. Dr. Cockburn is to be congratulated on being the first lady graduate in medicine to receive such an appoint- ment in Ontario. Among the recipients of honors for services in South Africa· we notice the naine of Lieut. L. E. W. Irving, son of Amelius Irving Esq., K.C., of Toronto. Dr. Irving is a graduate in medicine of Trinity College, and on the outbreak of the war volunteered his services and accompanied the Royal Canadian Artillery. His conspicuous fitness as an officer and his excellent record were brought to the notice of the authorities with the result that he has received the Distinguished Service Order. PE s",
         "OBITUARY. OBITUARY. Dr. T. H. Little. The peculiarly sad circumstances connected with the death of Dr. T. H. Little, of Spadina Ave., from smallpox, acquired while in the dis- charge of his professional duties, bas called forth expressions of the deepest regret from all classes of the community. The doctor, who had not been successfully vaccinated, contracted the disease .from a patient whom lie was attending, and the attack developed into one of the con- fluent hæmorrhagic type, ending fatally in a week's time on April 24th. Dr. Lit tle was born in Owen Sound thirty-nine years ago, where he received bis early education. He was a graduate in arts of Victoria University and in inedicine of the University of Toronto, graduatino in 1887. Some years ago he was married to Miss Cooper, of Port Hope, who survives him. After graduation Dr. Little opened an office in Toronto, where he succeeded in establishing a large practice. He possessed in a high degree the confidence of bis clients and the esteem of bis brother practitioners. Dr. Little was an Anglican in religion, and a prominent member of the Masonic fraternity. Dr. Charles William Covernton. One of the last of the physicians of the old school, men whose careers have reflected so much honor on the profession of this Province, and whose lives have been examples worthy in all respects of the emulation of future generations of physicians, passed away on April 17th in the person of Dr. Charles William Covernton. Dr. Covernton was born in England in 1813, being the son of James Covernton, Esq., of Seven Oaks, Kent Co. He began the study of medicine in London, afterwards continuing it in Edinburgh University and St. Andrews, where he received bis M.D. in 1835. In 1836 Dr. Covernton came to Canada and shortly alter took up the practice of his profession in the town of Simcoe. The Mackenzie Rebellion breaking out soon after bis arrival, he offered bis services as surgeon with the Loyalists In 1869 Dr. Covernton was elected terri- torial representative of the Gore and Thames Division of the Council of the College of Physicians and Surgeons of Ontario, and in 1870 he became vice-president and in 1871 president of the same body. 498 [ MAY",
         "He removed to Toronto about this time and was appointed to the professorship of Medical Jurisprudence in Trinity Medical College on its re-organization, which position he retained until a few years ago, when, owing to advancing years, he retired fron active work, remaining, how- ever, Emeritus Professor until the time of his death. Dr. Covernton took a keen interest in ail matters pertaining to his profession, especially to public health. He held the position of president of the Provincial Board of Heakh and at various times represented the profession of the Province at foreign congresses. In 1840 he married Frances Elizabeth, daughter of Hutchins W. Williams, banker, of Dublin, by whom he had nine children. Three sons, William Hutchins, Charles McKenzie and Theodore Selby, all deceased, entered the inedical profession, the latter at one time being professor of Sanitary Science in Trinity College. The funeral was largely attended by prominent members of the, Toronto profession by whom he was held in the highest esteem. Among Dr. Covernton's students in Simcoe was Dr. Charles O'Reilly, Superintendent of th'e Toronto General Hospital, who pays the kindliest tribute to the nemory of his old preceptor. A gentleman of the higliest honor, courtlv in bearing, of polished manners, free f rom envy and petty jealousy and devoted to his calling, his career has shed lustre on the profession of Ontario and his memory will long be cherished. Dr. John Wanless. Dr. John Wanless, one of the oldest phymicians in Toronto, died at his residence, 594 1 uron street, on Sunday, in his 88th year. Deceased was born in Dundee, Scotland, and came to Canada in 1813, settling on a farm in Huron county. He practised in London, Montreal and Toronto. Two sons and two daughters survive him. Dr. J. Archer Watson. The lamentable accidental death of Dr. J. Archer Watson of Toronto on April 11th, came as a great shock to his many friends and acquaint- ances in the medical profession. He was riding out to Islington on a restive young horse that was just being brokeri, and on reaching the C. P. R. crossing at Dundas St., the animal became frightened and ran in front of a passing engine, throwing the rider to the ground. The base of the skull was fractured, producing instantaneous death. Dr. Watson was born at Emery, Ontario, in 1856, his father being the late William Watson, Esq., superintendent of schools for west York. 499 1901.] OBITUARy.",
         "500 OBITUARY. [ MAY He received his early education at Weston High School and afterwards at Jarvis street Collegiate Institute, Toronto. The deceased entered Trinity Medical College in 1881, graduating in 1885, after which he opened an office on Sherbourne St., where he resided at the time of his death. In 1889 he was appointed a demonstrator of anatony in Trinity Medical College, a position which he held for some years. Dr. Watson was also one of the pronioters and a member of the staff of the Toronto Western Hospital. He was an enthusiastie lover of sports being a member of the Toronto Athletic Club, Ontario Jockey Club, Hunt Club etc. The deceased was an Independent Conservative in politics, a Metho- dist in religion and a prominent menber of the Sons of England and the Orange Order. The funeral to Riverside cemetery, Weston, was largely attended by his friends and professional brethren, evincing the high esteem in which. he was held and the deep sympathy felt in his sad taking off.",
         "1901.] BOOK REVIEWS. 501 BOOK REVIEWS. THE AMERICAN YEAR-BOOK OF MEDICINE AND SURGERY. Being a yearly digest of scientific progress and authoritative opinion in all branches of Medicine and Surgery, drawn from Journals, Monographs and Text-Books of the leading American and Foreign Authors and Investigators, collected and arranged with critical editorial comments by a staff of eminent American Specialists and under the general editorial charge of George M. Gould M. D. In two volumes treating of Medicine and Surgery respectively. Price $6.00 cloth. Philadeiphia and London. W. B. Sanders \u0026 Co 1901. Canadian Agents J. A. Carveth \u0026 Co., Toronto, Ont. The preface of this work states that the innovation introduced last year of issuing the publication in two volumes, one treating of Surgery, the other of Medicine, was so generally regarded as an improveinent, that the same plan has been adopted this year;. the staff of editors of Depart- ments remains the same, with the exception of the Association of Dr. Aloysius O. J. Kelly, (the well-known Philadelphia Pathologist,) with Dr. Riesman. The profession accordingly is offered as the 1901 issue, two handsome volumes of excellent typographical work, in good binding and of convenient size, the volume on Medicine containing 681 pages, and that on Surgery 610, with a comprehensive and convenient index, appended to each, while in foot-note reference is given the short title of the publication in which may be found the particular article reviewed. The reception accorded the Year-Book in the past is sufficient proof of the value of such a collaboration, giving as it does a selection by com, petent authorities of subjects of importance, both to the general practioner and to the specialist. Every year the profession is provided with an en- ormous array of medical literature in the form of text-þook, monograph, journal and advertisement, much of which is merely speculative or know- lege ill-digested and statements unsupported and misleading, but much too is valuable were not the ordinary practitioner, either too busy or in- sufficiently equipped in scientifie training to sift the good from the bad. This services the editor of the Year-Book undertake and they have done their work on the whole ably, choosing what is useful and practical on matters of general import and including too, much that is suggestive and interesting from the stand-point of scientific research. The work is necessarily largely an index for reference, giving the subject and particular phase treated but on topics of general interest and importance the treatment is fuller. W-iere views not generally accepted or in the experimental or controversial stage are mentioned, the editor guards the reader by appending a critical note. The ordinary reader is thus kept in touch with the wealth of information which is constantly",
         "accumulating from the labors of students in all parts of the world, but guarded from adopting immature suggestions as facts. 5 In the volume on Surgery, mention must be made of the references to articles treating of bullet wounds and of cocaine anaesthesia-subjects of special interest at present. The departments of obstetries and gyne- cology are possibly the most valuable in this volume, especially the articles on the Pathology of Pregnancy. The volume on Medicine under the heading of typhoid contains a great deal of value on the Widal re- action, but readers in this country would like to have heard something with regard to the South African epidemie. The chapter on Pathology contains many new suggestions on neoplasms and that on therapeutics will be carefully read by the physicians bewildered by the claims of manu- facturers of new preparations and specifics. The great majority of the references on Surgical subjects are to American Journals while on Med- icine those of foreign extraction preponderate. Canadian Journals furnish but half a dozen references, a fact explainable partly by the com- paratively insignificant amount of research work done here; but one cannot help suggesting that a better system of Hospital Records would assist in making the work done here available to our students and prac- titioners. A.J.M. A SYSTEM OF PRACTICAL THERAPEUTICS. Edited by Hobart Amory Hare M.D. Professor of Therapeutics and Ma- teria Medica in The Jefferson Medical College, Philadelphia. Physi- cian to The Jefferson Medical College Hospital. Second edition-re- vised and largely rewritten, Volume III, with illustrations. Lea Bros. \u0026 Co., Philadelphia and New York, 1901. This volume deals especially with surgical Therapeutics. The first chapter-on Anaesthesia and Anaesthetics, is contributed by Dr. Charles Lester Leonard. The article is a full and thoroughly practical guide to the administration of anaesthetics and should be of great value to the practitioner. Dr. Charles H. Frazier writes a most complete chapter on Surgical Technique, dealing with surgical bacteriology, sterilization and disinfection, preparation for operation, preparation of ligatures, sutures, dressings, and the details of operative technique. H1e also takes up the treatment of aseptic and septic wounds. Fractures and dislocations are dealt with by Dr. Henry R. Wharton in an exhaustive article in which the latest and most approved methods are described. This article is very fully illustrated. A very practical chapter and one that will appeal particularly to the general practitioner is that devoted to minor surgery and bandaging by Dr. Geo. W. Spencer. Cerebral concussion and shock are discussed by Joseph Ransohoff F. R. C.S. Surgical treatment in diseases of the respiratory organs is dealt with by Dr. A. J. McCosh, while Dr. Geo. Ryerson Fowler contributes a beauti- fully illustrated article on the surgical treatment of appendicitis, also other forins of peritonitis and strangulated hernia. As an illustration of [ MAY BOOK REVIEWS. 502",
         "female development or of the nude in art, plate V may be very excellent but most observers will be puzzled at the necessity for so much display, and of the particular pose of a handsome figure to illustrate the site of the primary incision in appendicitis. The treatment of obstruction of the intestines from various causes haemorrhoids, fistula in ano etc., are fully discussed by Dr. Edward Martin. Most useful and complete articles are those by Dr. Wm. T. belfield on therapeutics of the male genito-urinary tract and by Ed. E. Mont- gomery on therapeutics of the genito-urinary diseases of women. Diseases of the eye, ear, nose and throat and their treatment by the general practitioner will prove particularly valuable articles to those for whom they are specially written. These are dealt with by Drs. Casey Wood, S. MacCuen Smith, E. Fletcher Ingals, and A. Braden Kyle. The large number of formulae given in connection with these articles will prove especially helpful. Altogether we take pleasure in repeating the high commendation of this volume which we have previously expressed in reference to former ones. The work cannot fail to prove of great use and is worthy of the most cordial reception by the profession. H. B. A. OBSTETRIC CLINIC. By Denslow Lewis, Ph. C., M.D., Professor of Gynecology in the Chicago Policlinic; President of the Attending Stafi of Cook County Hospital, Chicago; President of the Chicago Medical Examiners' Association; Vice-President of the Illinois State Medical Society ; Ex-President Of the Physicians' Club of Chicago; Consulting Obstetrician to the Florence Nightingale Home ; Senior Gynecologist and Obstetrician to the Lakeside Hospital, Chicago; Late Special Commissioner from the Illinois State Board of Health and the Health Department of Chicago for the Investigation of Municipal Sanitation in European Cities. A series of thirty-nine Clinical Lectures on Practical Obstetrics de- livered to students and practitioners in Cook County Hospital, Chi- cago. Together with remarks on criminal abortion, infanticide, ille- gitimacy, the restriction of venereal diseases, the regulation of prostitu- tion and other medico-sociologic topics. Octavo, 640 pages. Price, $3.00. Chicago: E. H. Colegrove, 65 Randolph Street. These lectures make extreiely interesting and profitble reading. They are essentially practical, and though lectures delivered by the bed- side or in the operatng room to a class, upon material much of which must have come to hand simply in the ordinai y course of hospi t al work, and without any possibility of arrangement, the author has succeeded in covering very thoroighly the vast majority of those accidents and conditions met with in the course of obstetrie practice. He might be properly classed as a Liberal-Conservative, who, while he is progressive and ever ready to avail himself of all that science and art may provide, does not allow himself to be carried away by fads.- F. F. 503 1901.] BOOK REVIEWS.",
         "Text Book of Histology, including Microscopic Technique, by A. A Bohm, M.D., and M. Von Davidoff, M.D., of the Anatomical Institute in Munich. Edited by G Carl Huber, M.D., Junior Professor of An- atomy and Director of the Histological Laboratory, University of Michigan. Authorized translation from Second German Edition by Herbert H. Cushing, M.D. Jefferson Medical College, Philadelphia. W B. Saunders \u0026 Co., Philadelphia and London. A. J. Carveth \u0026 Co., Canadian Agents. The volume opens with a chapter devoted to histological technique, the more useful and modern methods are emphasized, formulæ for stains and solutions are complete, directions for fixing, sectioniig, cutting and staining are clear and concise. The structure of the cell in wlhich the subject of Karyokinesis is embodied is set forth in a manner very pleasing to read and is followed by a description of the various elementary tissues with special methods of preparation applicable to each. The nervous system usually demands considerable space in a work of this character. Here, however, the space is surprisingly sinall, but equally surprising is the effective manner in which the subject is handled and the clearness with which it is set before us. Professor Mall's observations on the splenic lobule constitute some- thing new in the histology of this organ. Following the section on the blood and blood forming organs, valu- able hints are given in the way of technique in their study. The sections on the alimentary canal and genito-urinary tract are clearly put and well illustrated, the description of the supra renal cap- sules is perhaps particularly worthy of mention. The work closes with extensive references to literature. The essen- tials of a work on histology are clearness of description and illustration, with well directed instructions to the students as to how to proceed in his investigations, and equally clear directions as to what to use, exact formule, and how to use them. This volume etibodies these points and should render much assist- ance to those engaged in the study of histology.-H. C. P. DAVIS'S OBSTETRIC AND GYNECOLOGIC NURSING. By E. P. Davis, A.M., M.D., Professor of Obstetrics in Jefferson Medical College and Philadelphia Polyclinic. 12mo. volume of 402 pages, fully illustrated. Philadelphia and London: W. B. Saunders \u0026 Co., 1901. Canadian agents: J. A. Carveth \u0026 Co., Toronto. Price $1.75 net. As a text book for nurses this work is admirable, giving all that a nurse should know, at the same time avoiding those things which con- cern the physician alone, and in connection with which a little know- ledge is more apt to be dangerous than useful. 504 [ MIAY BOOK REVIEWS.",
         "BOOK REVIEWS. 505 The first half of the work is devoted to obstetrics, and its perusal cannot fail to be of interest and value to anyone assisting at a confinement or having the care of a pregnant or puerperal woman. The cuts are mostly found in this part of the work, and have been carefully chosen and well executed. The second division of the book is devoted to gynaecology, and is in no way inferior to the first. The publishers' work is throughout excellent. F. F. * A TEXT BOOK OF GYNAECOLOGY. Edited by Charles A. L. Reed, A.M., M.D., Gynaecologist and Clinical Lecturer on Surgical Diseases of Women at the Cincinnati Hospital, President American Medical Association, Etc., Etc. Illustrated by R. J. Hopkins. New York: D. Appleton \u0026 Co. 1901. This work is a strictly up-to-date volume, and reflects much credit upon the author. In its preparation the efforts of some thirty contributors, comprising many of the best known writers and teachers of the subject in Great Britain, United States and Canada, have been utilized in such a way as to produce a complete text book, and not simply a collection of monographs. There are three hundred and fifty-six illustrations which, with very rare exceptions, are new. The paper is good and print clear; in fact, the whole work is creditable alike to contributors, editor and publisher.-- F. F. Surgical Pathology and Therapeutics, by John Collins Warren, M.D., LL.D., Professor of Surgery in the Massachusetts General Hospital. The second edition with an appendix, containing an enumeration of the scientific aids to surgical diagnosis, with a series of sections on Regional Bacteriology. Published by W. B. Saunders \u0026 Co., Phila- delphia. Canadian Agents, J. A. Carveth \u0026 Co., Toronto. The second edition is indeed welcome, as it brings up to the present all new facts and many suggestions on the pathology and therapeutics of surgery. Every one should possess a work so carefully prepared as the one by the eminent author. The association of the pathological conditions present in each case, with the symptoms and the indications for treat- mient must of necessity be of great value to the student of surgery. The opening chapter onBacteriology, with the excellent plates prepared by Wm. J. Kaula is to a good introduction to the chapters on inflammation and its sequelae, tuberculosis, diseases of bone, tumors, nialignant and benign, and each receives its due share of attention. The appendix is most valuable, as it deals with the scientific examinations of the blood and the various excretions and secretions of the body and other methods of precision which give exact data to arrive at diagnosis, prognosis and rational treatment. Such a work is especially valuable to the practi- tioner.-C. A. T. 1901.]",
         "FISCHER - INFANT-FEEDING IN HEALTH AND DISEASE. A Modern Book on all Methods of Feeding. For Students, Practitioners, and Nurses. By Louis Fischer, M.D.. Attending Physician to the Children's Service of the New York German Poliklinik ; Bacteriolo- gist to St. Mark's Hospital; Professor of Diseases of Children in the New York School of Clinical Medicine; Attending Physician to the Children's Department of the West-side German Dispensary; Fellow of the New York Academy of Medicine, etc. Containing 52 Illus- trations, with 16 Charts and Tables, mostly Original. 368 pages, 534 x 8 inches. Neatly Bound in Extra Cloth. . Price, $1.50, net. Delivered. F. A. Davis Company, Publishers, 1914-16 Cherry St., Philadelphia, Pa. This little book devotes the first few chapters to a consideration of the anatomy and physiology of the digestive organs in the infant and to the various constituents of foods. A useful chapter on the bacteria associ- ated with diseases due to digestive troubles in the infant comes next. The subjects of mothers' milk, wet nursing, weaning the infant, cow's milk and its modification, management of the nipples and breast, substi- tute foods for milk, sterilization and pasteurization of inilk, etc., are fully discussed. Dietetic management of colic, constipation, rickets, etc., is also considered, with directions for preparation, suited to different conditions, is furnished. Altogether, the book contains a vast amount of exceedingly valuable information in a concise form that will be very readable. PUBLISHERS' DEPARTMENT. Ptomaines. One of the leading specialists of the South, Dr. W. L. Bullard of Columbus, Ga., concludes a highly interesting and instructive article on Ptomaines in the following manner :-\" In all my twenty years' exper- ience at special work, where the quick and safe relief of pain is the object of treatment, I have found nothing to equal five-grain antikamnia tablets. This remedy is not only a foe to ptomaines and their absorption, but is also a corrective in cases of poisoning by food-decomposition. As purely pain relievers, the§e tablets of course are recognized the world over as non-cardiac depressants, and free fromn any tendency to produce habit. I would also call the attention of the profession to those instances where- in it is strongly advisable to rid the system of the offending materies morbi as well as to correct their harnful influences whether it be in the poisons of food decomposition or the absorption of ptomaines. In such cases I know of nothing better than Laxative Antikaninia Tablets. These tablets judiciously administered, rid the system in a perfectly natural manner of the offending material and lessen therefore, the quan- tity of medicine necessary to be taken by the patient, and produce no disturbing influences on the delicate inolecular interplay of the nervous structure.\" * 506 BOOK REVIEWs. [ MÍAY"
      ],
      "title" : [
         "The Canada lancet [Vol. 34, no. 8 [i.e. 9] (May 1901)]"
      ],
      "type" : "document",
      "identifier" : [
         "8_05199_369"
      ],
      "published" : [
         "Toronto : [Ontario Pub. Co., 1900]"
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{
   "doc" : {
      "published" : [
         "[Montreal? : s.n.], 1890 (Montreal : J. Lovell)"
      ],
      "identifier" : [
         "09677"
      ],
      "type" : "document",
      "title" : [
         "Reminiscences of old Quebec : subterranean passages under the citadel ; account of the old convent of the Congregation of Notre Dame that does not now exist ; prominent old Quebecers, \u0026c., \u0026c."
      ],
      "text" : [
         "Technical and Bibliographic Notes/Notes techniques et bibliographiques The institute has attempted to obtain the best orlginal copy avallable for filming. Features of this copy which may be bibliographically unique, whIch may a any of the Images in the - reproductionW which may significantly change the usual method offlming, are checked below. Coloured covers/ Couverture de couleur Covers damaged/ - Couverture endommagée Cdvers restored a «taminated/ Couveture restauEat/ou pelliculée Cover titie missing/ Le titre de couverture manque Coloured maps/ Cartes géographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bleue ou noire) Coloured plates and/or illustrations/ Planches et/ou illustrations en couleur - Bound with other material/ Relié avec d'autres documents n Tight binding may cause shadows or distortion aong interior margin/ La reliure serrée peut causer de l'ombre ou de la distortion le long de la marge intérieure Blank leaves added during restoration may appe r within the text. Whenever possible, thes have been omitted from flming/ Il se peut que certaines pages blanches ajoutées lors d'une restauration apparaissent dans le text mais, lorsque cela était possible, ces pages n'or pas été fumées. Additional commente:/ Commentaires supplémentaires: This item il fimed et the reduction ratio checked bel Ce document est filmé au taux'de réduction indiqué \u003c lOX 14X 18X L'institut a microfilmé le meilleur exemplaire qu'il lui a été possible de se procurer. Les détails de cet exemplaire qui sont peut-être uniques du point de vue bibliographique, qui peuvent modifier une image reproduite, ou qui peuvent exiger une modification dans la méthode normale de filmage sont indiqués ci-dessous. Coloured pages/ Pages de couleur Pages damaged/ Pages endommagées Pages restored and/or laminated/ Pages restaurées et/o'u pelliculées \\Pages discoloured, stained or foxed/ 'Pages décolorées, tachetées'ou piquées Pages detached/ Pages détachées Showthrough/ Transparence Quality of print varies/ Qualité inégale de l'impression Includes supplementary, material/ L., Comprend du matériel supplémentaire E Only edition available/ Seule édition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been refilmed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, - etc., ont été filmées à nouveau de façon à obtenir la meilleure image possible. 22X 26X 3 X Mx X*",
         "fe 44",
         "'11 rr",
         "REMINISCENCES OF OLDQIEBEC. SUBTERRANEAN PAS4GrES UNDER THE ,CITADEL ACCOUNT OF THE OLD CONVENT OF THE CONCREGATION 0O NOlE 'DAME. Til %T DONS NOT NOW KIMST. PROMINENT. OLD QUEBE€ERS, \u0026c., \u0026c. BT MRS: DANIEL MACPHERSON. MONTREAL PXINTED BY JOHN LOVELL \u0026 SON, 1890.",
         "(73) * ° Entered according to Act of Parliament of Canada, in the year one thousand eight hundered and ninety, by Ma5s. DANIEL MACPHERSON, in the pffice of the Minister of Agriculture and Statistics at Ottawa. LLO1ýý4 1V .. N 0 1",
         "33'EDIcATIo35-. TO JAMES MACPHERSON LÉMOINE, EsQ., AUTHOR OF QUEBEC PAST AND PRESENT, MAPLE LEAVES,. ETrC.,, MYDEAR HUSBAND'S COUSIN AN!) TRIED FRIEND., I DF.DICA' E TIJTS VOLUME AS A SLIGHT MARK OF ESTEEM. CHARLI'TE HOLT GETHINGO MACPH1ESON. q4",
         "$11 (76 jA",
         "1 CONTENTS. CHAPTER. PAGE I. Reminiscences f Quebec Fifty Years Ago...: II. Reminiscences Q uebec- Coninad..22 III. Charlesbourg.... ........................23 IV. Murray Bay........ . ........27 V. St. Helen's Island, Montreal................1 VI. Little River St. Charles..........0..........e.. VII. Jeune Lorette........4....................2 VIII.- Lake St. Charles.... ................... IX. St. Leon Springs....... .......... 46 X\\. Two Great Fires ofQuebec4.................8 XI. The Ruins of the Suspénsion Bridge over Mont. morency Falls.... ...... ..........\u0026 . . .52 XII. The Ursuline Convent; Robervi, Lake St. John.58 XIII. The Old Convent of La Congregation de Notre Dame ............................ XIV. La Tire Parties..........................68 XV. Two Stories Founded on Facts...........7...0 XVI.. My Godmother's Story ..........7.......... XVII. Mount Hermon Cemetery..................84 XVIII. Prominent Characters of Quebec ..............88 XIX. Spencer Grange, Qoebec's Special Author's Home sco XX. Montreal Generaa Hospitdal.................103 XXL Notes on Nursg.... . ..... -107 c",
         "f s i N. eore 1e",
         "QUEBEC AND ITS VICINITY. CHAPTER I. ON stepping into Ye Olde Curiositie Shoppe, 2116 St. Catherine street, I saw exposed for sale an old 'oil painting of Place d'Armes, Que- bec, in 1828. The proprietoJr, knowing that I had lived in Quebec, asked me if I recognized it. Know it-why, every house is rich in per- sonal recollections. First, the grand old English Cathedral, that does not seem a day older than when .first I saw it. On the lower side, the house for, years occupied by P. J. O. Chauveau, Esq, late sheriff of Montreal; then Dr. Mars- den's late residence; then that of Daniel Mac- pherson, and adjoining that then occupied by Hon. P. Casgrain ; and, next to that, old Payne's hotel. Ah! what 'memores cluster raround that old building. I have çnjoyed many delightful reunions at Hon. Mr. Chauveau's, but pleant as they were, theyareelipsed by",
         "1o QUEBLC AND ITS VICINITY. the glorious times we had in old Payne's hotel, where Quebec's renowned dancing mistress, Miss Aspinall, held royal sway, a very exact- ing queen in her own domain, with an eccentric horror of peppermints. Here we had the assemblies, and well do I recall the handsome couple, Mr. and Mrs. Hart's first appearance after their marriage-she who is now Lady Shea. In this building were also exhibited the famous Siamese twins, Chang and Eng. In CatherineCrowe's \"Night Side of Nature,\" she says, \"I never saw them myself;\" and, for the benefit of those similarly circumstanced, I quote the following particulars from Dr. Pas- savant: They were united by a membrane which extended from the breast-bone to the navel; but, in other respects, were not different from their countrymen in general. They were ex- ceedingly -alike, only that Eng was the more robust of the two. Their pulsations were not always coincident. They were active and agile and fond of bodily -exercises. Their intellects were well developed,-and- their tones of voice and accent were precisely the same.",
         "QUEBEC ANO T17'S VICINITY. 11 \"As they never conversed together, they had nearly forgotten their native tongue. If one was addressed, they both answered-(that may be, but I am positive I saw them speak to two different persons separately)-and a gentleman who is in this city told me only last evening he had seen them do so also.\" I continue Dr. Pas- savant's narrative:- \" They played some games of skill, but never with each other, 'as that, they said, would be like the right hand playing with the left. They read the same book at the same time, and sang together in unison. \"\u003cIn America they had a fever which ran precisely the same course. Their hunger, thirst, sleeping and waking, were always coinci- dent, and their tastes and inclinations were identical. \" Their movements were so simultaneous that it was impossible to distinguish with which the impulse originated, they appeared to have but one will. The idea of being separated by an operation was repugnant to them; and they consider themselves happier in their duâlity than are the individuals that look on them with pity. This admirable sympathy, although",
         "*1 12 QUEBEC AND ITS VICINITY. necessarily in an inferior degree, is generally manifested, more or less, betwixt all persons twin-born.\" I (the writer) can vouch for this sym- pathy myself. I have twin sons, men now living, who were always ill together. I remember on one occasion calling in Dr. Sewelt-io see my twin babies, about two years of ggS.,\"If one was ill,\" said Dr. Sewell, \"I would say it was this bad influenza, prevalent, with tendency to inflammation; as both are ill, it may be sometlying infectious.\" \"Oh! no,\" I said, \"both are always ill together.\" .The dear old gentleman laughed at me and said, \"did you ever see such a worian, she wants her boys ill in pairs.\" The next morning proved I was right, both were ill with inflammation of the lungs from bad influenza. To return to t-he Siamese, a lady resident of this city told me only yesterday that she saw the Siamese Twins in New York, and had heard they had married sisters. Onehad two children the other three. They died about ten years ago, I think one twenty-four hours before the other./ What caused the death of the other, I don't know, perhaps the separation, cutting of",
         "the ligature. I wish the Medical Raculty would tell us more about it. We cross the road to the then residence of the Hon. Judge Black, now occupied by his nephew, J. G. Clapham, notary, adjoining which, in the pictu-re, is a building (not now in existence) formerly used for some military service, in rear of whicwas the ill-fated theatre, the burning of which caused more grief than any one calamity that ever occurred in Quebec. It is with feelings of mingled awe and gratitude I allude to this, for only by a providential interposition were my father's family and myself saved from being there that night. It was a lovely evening and we were going, when my dear father said: \"It is too fine a nightto spend closed up in a theatre ; let us drive to the MacPherson's and go some -rainy night.\" Thank God, we took that drive ; shall I ever forget our return to the city ? We were living .almost ten minutes walk from Place d'Armes, and the sky was one glare of light. ' I begged to go and see the fire. We got just opposite to Dr. Marsden's house I have described, when with outstretched hands we saw the Rev. Mr. O'Rielly approach, a much loved priest of QUEBEC AND iTS VICINITY. 13",
         "14 QUEBEC AND ITS VICINITY. the parish church. \"Back, for God's sake,\" were his words. Shall I ever forget the agony of look and utterane' \" not a step further;\" I thought in my\u003e ministration I was used to the sigiht oýsfçrng, but I have never seen any- thing like this. I had just spoken- to and given a drink water to your dear' friend Jane Scott and he father, and yet had to leave them to burn, crushed down under a load of staircase a eople. The theatre had caught th fire fro dr ery, a rush was made for the door, the doo pened inward, and when the staircase fell th who were near were buried in a mass with o ossible means of ex ication. Had panic vailed all might have been rescued, as was proved by one-quite a young fellow, George Shaw, brother of the present port- warden of.Montreal, who held down his sister by force till another way was opened, and they were saved. Amongst other acts of heroism was that of Miss, Ray, daughter of Am. Con. Genl. Ray, who, at the theatre with her sister and her intended, insisted her sister should be saved first, and when her betrothed returned it was too late, all retreat as cut off, and the last seen of them was he flames",
         "encircling them'as they perished in each other's arms. So deep a gloom was',cast over the city that the theatre was never rebuilt, and the rear of the present post office stands on its site. Let us turn to a brighter picture, th'e remembrance is too painful for continuance ; and as in life the sad and the gay perpetually jostle each other, so it is here, with only the platform intervening but not shown in the picture, is all that remains of the ancient Castle of St. Lewis, now the Normal School. It was formerly used as the Governor Geheral's residence, and my earliest recollections of it are a ball given there; by Lady Aylmer to the young children. I-remem- ber going there, but tha.t' is all I remember about it, as I was then of the mature age of five years; but I do remember some years after an aunt ih a pink silk turban going to another ball at the same castle, and as the guests were to promenade in the Governor's garden attached, we child4n were to go and look at them over the fence, but, alas, we had hardly got there when it commenced to rain, and we had to retreat. How many Quebecers are alive now that attended that ball ? Opposite to this is the garden where is the monument erected in honor 1 QUEBEC AND ITS VICINITY. 1 5",
         "i6 QUEBEC AND ITS VICINITY. of Wolfe and Montcalm. Facing the river, only a few paces off, is the house wh e, in my day, resided the Hon. George Primrse, uncle of the present Earl of Roseberry. An aged relative, then seventy-five years of age, who hed 'been absent from Quebec for fifty years, twenty years ago took me to this place and pointed out the house where my grandfather first lived. He was a Capt. James G.-of the old iooth Regiment. She told me at the time it was almost the only house, except one else I think between the road facing the river and. the present residence of Mrs. White (Sir Hugh Allan's daughter). We now climb the hill and face the Citadel, and what a host of recollections are evoked here. I perfectly remember my nursery in one of the now Hunt houses, and breaking in the back of 'my doll's head to give it medicine, also my delight at seeing the Archery Club, the ladies held then. l don't think I have ever seen any more graceful pastime. Col. Gore, father of' the present Countess of Errol, resided in one of these houses opposite to the Citadel, \u003cf which so much has been written. I will onl recall a personal experience that will surprise",
         "4. 1 QUEBEC AND I7S VICINITY. 17 even sorme old Quebecers. * In the year 18- my beautiful cousin Lizzie Henshaw, the love- liest woman to my -fancy inc ~ as in person I have ever mef, accorrV ed her husband to Quebec, the late' laoeited Edward Fayrer, of the Ordnance Department, on a duty of inspection as to stores needed. As he was starting for the Citadel, he said to his wife and us ladies, \"I think you may corne with me, and I will show you what yod will never have again the chance to see probably, the underground rooms and passages with fire- proof quarters for women and children, in case of siege.\" Can I forget the 'astonish- ment of the soldiers, when an official at the Citadel took out a heavy bunch of keys, and accompanied by a few soldiers, as a favor eagerly sought for, allowed to accompany us, opened double iron doors, co'nducted us down long steps till we reached a long passage only lighted by the holes for muskets, then pýtch dark passages and large rooms suggestive of crawling insects. I remember the fear I had of being left behind, and said one might have to cry aloud to be heard if forgotten. The answer was no sound could be heard, and a",
         "QUEBEC AND ITS VICINITY. soilier so left gave himself up to die, when he remembered he might be thought of when missed at .evening roll call; such was the case, and when he did not answer, it struck the parties he had been with it was possible he might be found where he was, and so saved from a living tomb. I worider if the Princess Louise or any of thé Governor's ladies ever went through them.- And. now, my friends, Ill give you a treat, from Mr. James Macpherson Le Moine's pen, of a letter I found in the Montreal Star in answer to the inquiry of an old Quebecer, Mrs. Daniel Macpherson. OLD QUEBEC. THE PLACE D'ARMES IN THE YEAR 822. To the Editor of the \" Star ':- SIR,-In a recent issue, an \"Old Quebecer,\" now a resident of Montreal, has appealed to 'me for infor- mation as to the occupants of h0t\u003cses round the Place d'Armes, at Quebec, in 1822, in order to fully realize the objects shown in a curious old picture, of that period, owned in Montreal. It is not always easy after a lapse of close on seventy 'years to re-people a locality with all its",
         "former tenants, even with thehelp of that eminently respectable authority-the \"oldest inhabitant.\" I should have (ailed had I not had récourse to an ancient directory of the city, published at Quebec in 1322, at the printing office, 3 Mountain street, of Messrs. Wilson \u0026 Cowan, by one Thomas Henry Gleason, a very rare book at present. Beginning then with Mr. Morgan's emporium fashionable tailor- ing, I find that this large edifice, No. i Ste. Anne street, of which thé corner-stone had been laid with grand Masonic honors on the 15th August, 1805, by the Hon. Thos. Dunn, then administrator of the pro- vince, was kept in 1822 as an hotel by one George Wilson, and known as the Union Hotel. The con- struction of*the Union Hotel seems to have been quite a social event among our festive grandfathers. Chief Justice Sewell and other dignitaries were present in regalia. The American prisoners of war, taken in -1812, at Detroit, were installed for a short period in this hostelry, prior to their removal to the Chateau de Bonne, at Beauport. For years,.those attractive social gatherings, the assembly balls; took pjace in the Union Hotel, then known as Payne's Hotel. It had originally been built on the site occupied about i8oo by the surgery of Dr. Longmore, staff-surgeon to the Forces, the ancestor of our respected fellow-townsman, Major Elton-Prower. At No. 2 an eminent barrister, member of Parliament, and finally chief justice, Vallières de Saint Real, had his law study and residence in 1822. No. 3 was occupied, later on, by the well- remembered president of the Literary and Historical Society, Dr. John Charlton Fisher. LL.D. Here was entertained by him, in 1842, on his visit to Quebec, the \u003cy 1 1 QUEBEC AND ITS VICINITY. 19",
         "20 QUEBECAND ITS VICINIT ). great English novelist, Charles Dickens. The house subsequently 'belonged-to-the Hon. Louis Massue, L. C. The corner dwelling, No. 4, was occupied by a noted builder, Mr. Fortier, was leased for years for Government offices, and subsequently owned by a noted and regretted Quebec physician, Dr. William Marsden. On the corner opposite to Treasury Lane, facing-the Anglican Cathedral, there resided in 1822 a Mr. Joseph Roy, an uncle, I think, of the late Hon. P. J. O. Chauveau, who held out there more than half a century, in a roomy, old-fashioned house. To the west of the Place d'Armes stood the English Cathedral, erected in 1804, and a few yards north the old Court House, built in 1814 and destroyed by fire in 1871. Facing thé west end of the Cert House stood, and still stands, the Kent House, Prince Edward's winter- quarters in :1791-3, whilst, immediately to the east, there stood in 1822 the Commissariat office, purchased 'by the Ordnance Department from the heirs Brebant, about 1815. There was a gap, in 1822, wheré the Union Savings Bank now stands, and across it to the east was the house and office of the late Hon. Louis Panet, senator and N. P. The corner dwelling and law office, now owned by James Dunbar, Q.C., was~ -probably tenanted in 1822 by its late owner, Barthelot D'Artigny, Barrister and Member of Parliament. To the eMt; loomed out in 1822 the lofty wing of the old chateaun. burnt on 23rd January, 1834, now tenant'ed' by the Laval Normal school, then known as Chateau Haldimand, built by him in 1779. A high wall an4ia guard room adjoined, with the old building usèd for years, first asa riding school, and in 1846 as a theatre, whose destruction by fire, on",
         "QUEBEÇ AND ITS VICINI7 Y. 21 the i2t June of that year, was attended with a great loss of life. The corner house, in 1822, was owned by James Black, the father of Judge Henry Black, now the-p erty of John Greaves Clapham, N.P. Until 1863 the Place d'Ar.rmes was an open space on which the militia roli was called each year on the 29th June, St. Peter and St. Paul's day. Possibly the regulars, the 7oth, may have drilled there in 1822, and the spot may have also been familiar to Pay- master Thomas Scott, the gifted brother of Sir Walter. In 1823 his remains rested in the St. Matthew Ceme- tery. J. M LEMOINE. QUÉBEC, July, 1890. -p 4 4\u003e",
         "CHAPTER II. I sAW in the paper a short time since that in the walls of Duquet's jewellery store, Fabrique street, had been found cannon balls or bullets. This is the very house old Mrs. L-- pointed out as the one in which she had been married. It was then occupied as officers' quarters. In fact, during fifty years absence, so little change had old Quebec seen that she pointed out the house, still standing, where her fatherhad died, about four doors abovè Hope hill, left side going up. She could find lier way everywhere till she came to the top of Abraham's hfll-when she was completely lost. Why, this used to be all green fields. I used to walk out straight to the blue house and only another house, called the red house, for some miles. The red house is gone to give place to Tozer's rigidence. The blue house still existed a few years ago, and may still exist. The green fields are replaced by St. Roch's, the most thriving part of the city of Quebec. wu 22, QUEBEC AND 17S VICINITY.",
         "QUEBEC AND ITS VICINITY. 23 CHAPTBR III. CHARLESBOURG. THE old gros habitant is a race very nearly extinct, at least in its distinctive features, for rick4anadians of that class have adopted the dress and ways of the present generation, whereas, in myday, however well-to-do a rich French-Canadian countryman was, he always wore the étoft dupays, which was a pretty grey cloth, made amongst themselves, and superseded now þy what is called Upper Canada tweed. I was at two weddings of the olden time, and as such are now extinct, I describe them for the benefit of those who can never have the oppor- tunity of enjoying the fun of such long past days. If there are any of the people I speak of existant nowthey will still be found, I think, only about the vicinity I now describe. After passing the Pay bridge, St. Roch's, and turning to the left, we get on to the road lead- ing to Lake St. Charles. At the foot of Charlesbourg hill, a roaS turns to the right, which brings us toc- the smait vil-",
         "QUEBECAND ITS VIÇ7Ñee'Y. lage of Ste. Angèle. A road so little noticed, that I am sure hundreds- of Quebecers pass it every day without ever driving on it. The road lies low ; alffthe houses are on an elevation, and side by side. About sixty years ago or more, the- first ldGie, a lovely residence, belonged to the -family -of the Hon. Jonathan Sewell, chief justice.. In my young days it was unoccupied. Some legend of a man having hanged himself on a tree, in front of the house, caused the family to refuse to live there, and we childrekx had the lovely grounds to ourselves; and many 4 delightful walks and picnics we held there. This is now the residence of Mr. Alford, heir to Mr. Pozer (our almost sole Quebec millionaire then). He had bought up the. ground on which St. Roch's now stands, and thus made a for- tune. Next to this was Mr. Giroux, gros habitant, then the Bourrets, then Villeneuves, thenP- Le Claires, and so on, for about a dozen farms, all thoroughly respectable, truly pious, with old French politeness, hoiisés exquisitely clean. The wonxen dressed on week days in flaw¶Fl petticoats, and mantilettes of ,tuff spun by themselves. Well, old Bourret had only two",
         "daughters, and we had been in the habit of pass- ing the summer there for many years, and we were of course asked to the wedding, for which grand preparations were in progress, and to celebrate which at least four houses were laid under contribution. The LeClaires were the violinists for all the country around,.and their brilliant touch electrified all into motion. One house was used alone for dancing, and for three days-and three nights the sound of quick moving feet was heard as they worked energetically in reel, jig and cotillion. Onehouse was reserved for sleeping\\ where eaéh, š~hiey could get a chance of a bed, took a rest, and then again joined the dancers and gave place to -others One house only for cooking and eating, and the long tables, filling three sides of a room, were literally loaded down with provisions, _replenished as fast as eaten. With genuine admiration, I viewed thé array of ham, fowl, mutton, pork, beef, meat pies, with mountains of chrochinolles, or what they now call doughnuts or crullers. Miss Bourret (now Madame Paquet) still lives, and these houses are still occupied by the younger branches of their 'families; but the QUEBEC AND JTS VICINITY. 25",
         "26 QEBEC AND 17S VICINI.TY. gravestones in the churchyard of Charlesbourg church alone now record the abiding place of her parents. Near this church is Mr. Huot's well-known country inn for picnics, travellers, etc. :Driving beyond this about ten miles on a lovely turnpike road, you come to Lake St. Charles, where ýthe Verrets have a country hotel. The Verrets themselves are perfect specimens of the old rich habitant modern- ized, for the young ladies quite understand and follow the fashions as well as town ladies.",
         "CHAPTER IV. MURRAY BAY. I THINK it is about fifty years ago that I went down on, I think, the first steamboat that ever ent to Murray Bay. , At that time it was nly known to the friends of the seigneurs, Mr. Nairne and the Hon. John Malcolm Fraser. The steamer I think was called the \"Pocohontas,\" and was styled by us clever young people as an old tub, because she had a good deal of motion and we were seasick. In fact, so great a storm arose, and we were so ill, that Mr. L. T. McP-- brother of the seigneur of Crane Island, offered the captain and all the passengers dinner and shelter if he would stop over for the night.. I was so desperately ill I can remember little of it then, except the nice d.own beds and well spread meals for which the M-- ladies. were so famous. This is the island to which' Mrs. Moody, authoress of \" Roughing it in the Bush,\" etc. etc., alludes, i her work \"Flora Lyndsay.\" \"Thus, on the\u003c9th of August, they passed Crane 1 QUEBEC AND ITS VICINITY. 27",
         "f 28 QUEBEC AND ITS VICINITY. Island, the beautiful domaine of Mr. Macpherson, on the north side of the river, and early on the morning of the 3oth, the ' Annie ' cast her anchor opposite Grosse Isle.\" This Mr. D. Macpherson, grandfather of James Macpherson Le Moine, and my dear late husband, gave the island to his son John, and his daughters devised it by will to a nephew, on condition that he took the name of Macpherson. He has not done so, but still has possession of the island notwithstanding. I suppose lawyers can arrange anything. And now on to Murray Bay, where some of the happiest years of my life have been spent; but so full of sad as well as delightful remin- *iscences. I cannot linger over them, but will only say, that with the exception of one or two families besides ourselves, no one then went to Murray Bay but sportsmen and the friends and relatives of the seigneurs. Even ten years later our bread wgs sent from Quebec weekly, with vegetables, butter, meat, etc.; and at the post office, such a primitive institution, on receipt of the mail bag it was emptied on the floor,. and every one helped themselves. Now it is crowded with hotels, fashionable visitors, and",
         "QUEBEC AND ITS VICINITY. possesses a convalescent home,-a great boon to persons of limited or no means. When we though.t of going summer sea bathing, and we all of us had plenty-of means then, our first visit was to the garret or old clothes cupboard, 'and everything shabby' gathered together, and the purchase made of a good broad plaited and broad brimmed habitant hat, for which we paid about twenty-five cents (now sold for'five), a large coarse red flannet nightgown for bathing dress, the very sight of which would cause any modern young lady to swoon away; but then we ladies went together, and for safety (instead of relying on beaux to protect us,-a horrid modern practice, I think) we joined hands and went in sometimes eight or ten together, and I am sure we enjoyed it more than the young people do now. Such drives in hay carts, almost jolted to death over rough roads. Archibald Campbell, Esq., and John Burrows, Esq., of the Prothonotary's - Office, Quebec, and Henry Austin, Esq., I am sure still ~retain a pleasant recollection of these times. Previous to the trip I speak of in the -d'Pocohontas,\" Murray Bay was only reached by schooner. It was then renowned 29",
         "I I t., 30 QUEBEC AND ITS VICINIT. for its salmon and other fishing, s Crane Island was for its game. I don't know ho t is now contemplated, when they tell me there is a railroad almost if not all the way to Mur y Bay.",
         "CHAPTER V. ST. HELEN'S ISLAND, MONTREAL. AT the period I write of was a military station only, occupied by soldiers and their officers and friends. I was sitting on the grass, with my dear cousin, Lizzie Fayrer, and her sister, Fanny Henshaw, also the army surgeon (I forget his name, but he was a splendid fellow), and a couple of young officers, when a loud detonation was heard. Some one turried laugh- ingly to Fa iy and said, \"Yoû are done for; that is the Grand Trunk blown up!\" This was in allusion to the then secretary of the Grand Trunk, to whom she was engaged to be married. A circumstance I feel no delicacy in entioning, as she has been his happy wife for e last thirty years, and is now living in Eng- nd with her husband and a large family of hildren, all well and prosperous. We little hought how little fun there was about the matter. The surgeon was the first to perceive that there was - something wrong, and said, TOh! if I only had a boat, I would go and see; QUEBEC AND ITS VICINITY. 31",
         "32 QUEBE C A ND IYS VICINI 7 Y. they must want medical assistance.\" Having his case of instruments in his hand, he had been cleaning them. As he sat chatting with us, he said: \"I'il risk taking a boat without per- mission, In a matter of life and death, surely red tapeism can be put aside. Will any of you. ladies come?\" We went. On nearing the shore, I caught sight of a figurelunder a she.et, and looked no more. Poor Lizzie insisted on going through the sheds and looking at every corpse, terrified that she might recognize her dearly loved brother George, who, though ex- pected, had not come into.Montreal that day, and I am happy to say is well and alive now, one of the few living links binding me to the happy past. The noise we had heard was the explosion of the boiler of the Grand Trunk steamer, which I caused many a warm heart to thrill with anguish. I don't ever remember seeing such green grass as then on St. Helen's Island, and the butter was something wonderful, the grazing was so rich. Now St. Helen's Island is covered with refreshment booths, wooden horses, and is",
         "QUEBEC AND ITS VICINITY. 33 crowded with excursionists every day in the summer. I doubt if there I could possibly recall the\u003cpot where I have had so much happi- ness. Mr. F- lived there in the old barracks, and a little child of his lies buried, I think, in the churchyard there. All mementos left of one of the most genial homes I ever visited.",
         "34 QUEBEC AND ITS VICINITY. CHAPTER VI. LITTLE RIVER ST. CHARLES. AFTER leaving St. Rochs we pass out through what is the populous suburb of St. Sauveur 30 years ago. It was a pretty rural road sprinkled with cottages here and there. One still stand- ing now belongs to the Robertsons, a little further out, three belonged to the late Major Tempfe, whose wife, a sister of Dr. Sewell's, was renowned, as so many of.the Sewell family are, for her extreme amiability and gentle manners. I remember an anecdote she told me of herself. At the time she married, so little correct was the English· idea of what Canada.was', that even people well informed considered any one Can- adian born very inferior to any one of English descent. Perhaps there are some who do so now ? I only ask for information, not sarcastical, as Artemus Ward would say. Well, when the tenantry of Major Temple's brother heard that the major was going to marry in Canada, I fancy they pictured her as a sort of squaw, and their",
         "master, something of a farceur, rather encouraged the idea, at the same ltime insisting that, as his brother's wife and the daughter of theHon. the chief justice of Quebec, she should be received with all the honors. Of course Mrs. Temple knew nothing of all this ' after; and was thoroughly astonished to \\hear on every side: « Why, she is white.\" \"Did they think I was a black ?\" she asked. \"Something very near it, my, dear, I think,\" was her husband's reply. She was a handsome woman in her middle age; if as fair in her youth as her daughter Mary was, they might -well say she is white. The next house then standing is that of Mr. Weir, where I lived myself until it was acci- dentally burnt down. Mr. Weir was, I think, a civil engineer. I heard a few days since~that his sons have rea- lized large fortunes in the same line; and all met in Quebec a month ago. Such is the love we bear our dear old city, all those who can return to it when we can. Now 30 years ago a queer old house greets our view, then occupied by Mr. Langlois, a retired country gentleman, living on his means in this pretty little house with his wife and large QUEBEC AND ITS VICINITY. 35",
         "36 QUEBEC AND ITS VICINIT. family. The original house had never been altered with the love our ancestors had for their homesteads, but a, wing added on here and there as more roorn was required. If you do not meet Madame Langlois in one of the garden paths with large garden scissors in hand, you will catch sight of her bland hospitable face at the house door, you» must come and partake of cake and wine (de rigueur) in those days, and then into the green house for a bunch of flowers., Very few of that large family survive, but I hear that Mrs. Buller (Dr.) and Mrs. Peterson, now living in Montreal, are her granddaughters. We step here across the road to the residence of the late Judge Panet, father or grandfather of the present Minister of Militia. When first I knew it, it was occupied by a military surgeon, Dr. Reed and his family. The house interior ar- rangements were most picturesque and uncom- mon. You entered a hall whose ceiling was the vaulted roof. I have never seen anything like it elsewhere. It had long been the desire of the Roman Catholic priesthood imQuebec to purchase a site for a cemetery. Application had been made repeatedly to purchase ground for that purpose ni",
         "to various people-on the little river road, as it was called, but ineffectually; every person had lived half a century on their property, had plenty of means, and did not want a churchyard in the vicinity. Finallyon the death of Judge Panet, it was found, that persuaded of how much this burial ground was needed, he de- vised his property to the church for that pur- pose, and here adjoining the old house is the pretty St. Charles Cemetery. The next property belonged then to the Hon. Louis Panet, senator, now owned and occupied, by Hon. Jean Thomas Taschereau, ex-judge of the Superior Court, brother of the Cardinal, and his lady, sister of Sir Edouard Caron. The Hon.' Louis Panet's daughter, Madame Wilbrod Larue, then lived next door, and I have many delightful reminiscences of balls and fêtes of every kind, for then one danced'asthey took their tea-a matter of course. But it appears to me that ours were really the days of enjoyment. We understood the word fun I fear few young people understand now. Near at hand now is the present.residence of Judge Andrews, and oppositç the pretty littie QUEREC AND 17S VICINIT' 7 37",
         "8 .8 QUEBEC AND ITS VICINITY. cot age.where not long since died his father and mother. We now retrace our steps and corne upon what is called Scott's bridge, om the right hand of which is the old King farm, and on the left a short distance up the Hunt farn, then Con- nolly's. And now, my children, I ani going to- take you to Poplar Grove, and intrçduce you to your dear father's early home and the dear grandnother you have never seen, Entering the grounds by an-0ol-fashioned wooden gate through a road of French poplars, come upon a green circular grass plot on which we have danced riiany ,quadrilles. A gallery fronts a very large, low, neat-looking, unpretending building, and you enter a square, spacious passage, its furniture, a grandmother's clock, a comfortable sofa and same armchairs, r-on the left a pretty parlor and dining room in the rear. Straight on through the passage a dôor opens into a very large parlor, where a sweet-faced lady sits netting (not knitting). Net- ting, is an almost forgotten style of female hand- work. You ask what she is doing, and she answers : \"I am not strong enough to go about much, so am amusing myself making a sett of",
         "QUE BEC AN49 ITS VICINITY 39 curtains to be given to the one of the family to be married first. My dear husband was the first to be married and I got the curtains, unfortu- nately to be consumed in the fire that burnt the house.\" And now, children, with all love and re- verence will I describe your dear grandmother, who from the day she extended her kindness to . the\"' motherleis girl of nine years till the day of -her deah, almost a score of years after,- was the object of my warmest affection and gratitude. I see her before me now as she sits in that old-fashioned armchair, in her invariable dress of plain black silk, her snowy cap, collar and cuffs, with the dark hair with scarcely a silver thread, although she wasSeventy or mpre when she died, and that hair could reach to her knees. A-handsome face, the expression that of perfect goodness and resignation, for she had known much grief. The death of two sons grown to nianhood had clouded her declining years, and: your father was the only male of the name:j of Macpherson belonging to the family. The advent here of my twin boys was consoling, but here again sorrow steps in.",
         "40 QUEBEC AND ITS VICINITY. In this dear old house died of scarlet fever my golden-haired little Kate, wlose coffin rests on my mother's in old St. Matthew chapel ceme- tery, Quebec. The side of this fine old room is half taken up by a bow window, spacious enough to con- tain a table and two chairs, and looking out upon a garden of tulips such as I have never seen elsewhere, gorgeous in all their purple crimson and gold, and,- at the other end, a glass- door leads into a porch with seats, and whose roof is hidden beneath morning glories and honeysuckles. A few steps takes you into the garden, where, under an immense walnut tree, we find seats and a table built around the trunk of the tree, so large that we'-sit down, per- haps, sixteen persons, every fine evening, to tea here, to enjoy the evening coolness and get rid of the flies. This tree was planted by your dear grandmother when a child, and under its shade she sat in her old age, for the property had been for generations in their family. But one night-a fierce winter one, in a raging storm-the family had to escape in theg night. dresses and bare feet to a neighbor's house the former property of Mrs. H -, an army",
         "QUEBEC A ND 17S VICINZ7 Y. 41 surgeon's widow, who occasionally pàid it a summer's visit, and were frequent visitors. Miss H- still lives in Montreal; her sister, Lady M-. , resides in Quebec; but Mr. P- who housed them then, and continued a familiar visitor for years, has passed away. Of your grandfather I need not speak. You remember him well, and the fine new residence built by him, but for which I would not give the old house. Now comes another Sewell-for no one could write the history of Quebec without speaking of them. Montague, son of the late chief justice, whose widow, daughter of old Colonel Wolfe, still lives at Portneuf with her two sons, her daughter married not long ago to Rev. Mr. , all these residences were bounded by the little River St. Charles, where the young people had boating to their heart's content. f3 3 f \u003e",
         "42 QUEBEC AND ITS VICINIT Y. CHAPTER VII. JEUNE LORETTE. IN my early days there were really numbers of Indians, though the chiefs baby was laid in a cradle and wore a lace cap. Now the relics of these times can there be seen, and not far off the house remains of old Madane Falardeau. 'A spacious, old-fashioned habitant house, very clean, with fine floors for dancing, and an im- mense supply of dinner equipage of the simplest style. We used to make up parties of thirty or forty, drive out and have real picnics, and Ma. dame Falardeau made it a boast that she never forgot a face, and we never could catch her make a mistake. After an absence of many years a party went out, and one gentleman said, \" Do you know me?\" Madame Falardeau, after looking at him attentively, -said, \"You are Lord William Paulett, if he is in this country; but I heard he had gone to England.\" It was he; he had returned for a visit. And another lady went out with us one day, who Pli,",
         "43 had been absent thirty years. \" Do you know me, Madame Falardeau?\" \"Yes; I am sure you are the little girl who always came out with your father, with a black boy in livery, a little black servant they brought to wait at table.\" QUEBEC AND 17S VICINZ7Y. t11~t. _ [i t",
         "44 QUEAEC AND ITS VICIN1T. CHAPTER VIII. LAKE ST. CHARLES. I HAVE a picture of Lake St. Charles before me, painted for and presented to my father by the late Sheriff Sewell; and it contains a picture of my father's yacht and another boat,-a picture suggestive of such happy hours and sombre memories ; and one fact rises up -before me,-the singular fulfil- ment of a dream. I was at Lake St. Charles at the time and vouch for the truth, and also that four of the parties are 'still living. A party, consisting of a entleman and two ladies, went out, and wishing to go boating, asked a young friend to take them out. He said it was too rough, as the wind was rising. They so persisted, and fearing they would go alone, he went to a young gentleman's house, a near neighbor, and asked him to come and help him to manage the boat. \"Oh!\" said Mrs. S-, \"I don't want you to go, A- it 'looks windy, and I am so anxious when",
         "QUEBEC AND ITS VICINITY. 45 you go on''the water with a party.\" A positively refused to go, and wlhen later it got quite windy, Mrs. S- said, \"I am so glad I persuaded you not to go.\" A- answered, \"You did notpersuade me, mother; but I had one of my dreams last night. I thought I was in J. G--'s boat, with several persons, I did not see their faces, but the sail swung around and knocked over one person, who was lost overboard, so I took it as a warMning.\" Before half an hour was passed, one of the party had been drowned in the manner described, despite the most gallant efforts of the gentleman who had tried to prevent their going, and had only yielded to the fear that they would go alone if he refused to accompany them.",
         "46 QUEBEC AND 17S VICINITY. CHAPTER IX. ST. LEON SPRINGS. IT is fully fifty years ago since my father took me to Three Rivers en route for St. Leon Springs. We were most hospitably received by Mr. Lajoie, of Three Rivers (father of the present dry goods mercha,nt of Three Rivers), and his good lady, and Mr. Faucher de St. Maurice, father of the present gentleman of the same name. Of the party were, I think, Mr. Gingras, whose son, bro- ther-in-law of Mr. Dorion, recently deceased, was the first, I think, to establish the reputation of these waters. After a sumptuous repast at Mr* Lajoie's, we were driven to St. Leon Springs, and this is what I remember of it then, a steep sandy hill' up which was walking a pale, thin young lady, whom my father pointed out to me as Miss G--; that lady has been in bed seven years, you see ber walking now, whether the cure was permanent or not I have no means of ascertaining, but Mr. Campbell, late proprietor of, St. Leon Springs, told me only two weeks",
         "QUEBEC AND ITS VICINITY. 47 since that he remembered Miss G-- perfectly. Mr. Campbell further ·told me since that his father had noticed the cattle drinking at this spring, and finding it had a peculiar taste, had it analysed, and gave to the public this boon for the afflicted and health-preserving drink for the sick. We had tea that day at the Springs on a deal table without table-cloth, seated on wooden benches, while carpenters were putting the roof on a large building we sat in. I presurne this was the first hotel, rather a contrast to that of the present day, which is yearly crowded with an increased number of fashionable visitors from all parts of the Dominion, in search of health or amusement. This hotel has been very lately enlarged and fitted up with every modern con- venience. Parties leaving Montreal by the Canadian Pacific Railroad, and getting off at Louiseville, will find vehicles waiting to take them to St. Leon Springs. Xi",
         "48 QUEBEC AND ITS VICJNITY. CHAPTER X. TWO GREAT FIRES OF QUEBEC. THE great fire of commenced near the site of the present Frères' school, on Gallow's hill, as it was formerly suggestively called. It was supposed to have originated from hot ashes carelessly left in a back porch. We who knew the family living there scouted the. idea, as they did; they were too methodical and good house- keepers to permit any careleàsness. Only ten years ago, one of the daughters, now living, told me that a miscreant on his death-bed had con- fessed he had set fire to Mr. T-'s house, out of revenge for some fancied injury, and had led a life of torture, fearing discovery and grief at the widespread desolation he had created. But good results have followed, like the fire of St. Roch's; good substantial buildings have replaced, old wooden structures. Have you ever heard the old-fashioned tocsin, \"ding; dong, ding! \" a fearful summons that seems~to sound the knell of doom. We wîre in the play-",
         "QUEBEC AND ITS VICZNITY 49 ground, in our dear old Ursuline convent, when its first knell reached our ears. As usual, the good ladies sent out to ascertain the locality of the fire, and the report continued to come in- \"ten, twenty, thirty, forty houses gone!\" At ast the Superioress appeared. \"Young ladies, you hear how whole streets are going. We do not knov where this will end. Take your choice now at once. I permit you to go home now, to be with your relatives. Later you may be unable i to find them. So, if you desire to stay, you can do so, but will not be permitted to leave until to-morrow, unless sent for. This fire was finally stopped through the heroic devotion of my dear husband's old friend, Archibald Camphell, Esq., advocate, of the Prothonotary's office. He was standing near General Hope when he heard him say, \"If I could only get them to hear the order to blow up that house, we might stop the fire and save itfrom extending to the banks.\" \"You would like to have that house blown up ?\" asked Mr. C-. \"Yes,\" was the general's reply. \"But no one could reach with the order in time.\" \"I wil,\" was young Archie's ieply, and with the unreasoning disregard of self and\u0026 courage he",
         "50 QUEBEC AND ITS VICINITY. displayed on many other occasions, he leaped the rampart near the Hotel Dieu, flew down the cliff, and almost miraculously escaped to give directions and save further destruction. General Hope loaded him with praise. I wonder if any of those banks whose property was saved from destruction ever gave any sub- stantial token of gratitude. The Lewis suburb fire occurred a month ear4ier. It is a fact, but onby came to our knowledge in a funny fashion. My dear old father was very particular about the get up of his linen, and had a special laundress. , One morning he told the servant boy to go for his washing. On his returning without it, Mr. G-, whose old acquaintances will fully appre- ciate this, as he was known to be slightly quick- tempered, asked the reason, the boy answered, \"Please, sir, I could not find Mrs. --'s house.\" \" Why not?\" \"She was burnt out.\" \" Well, did you find out where she moved to?\" \"'No, sir.\" \"The next neighbors could have told you.\" \" Please, sir, there are no neighbors.\" \"Well, some one in the street.\" \"There are no streets.\" \"What does the fellow mean Have you gone crazy?\" \"No, sir; please, all q",
         "the streets are burnt up for ever so far.\" And such was indeed the case. We were living in a thickly walled brick house, opposite the Pr ent Morrin college (then the jail), now occupied by - Chouinard, Esq. Ah! the many memories that cluster around that house.- There my mother died! There I first heard the word \"mesmerism!\" My father saidAto Dr. Morrin, in my presence, \"W*hat is this stuff I hear about some power called 'mesmerism' possessed by some woman in the jail, I don't believe in it, do you?\" \"No,\" said Dr. M -, \"I don't want to; but I have to against my own belief-as many must say, even in the present day. QUEBEC AND ITS VICINITY. 51",
         "52 QUEBEC AND ITS VICINIT J. CHAPTER XI. THE RUINS OF THE SUSPENSION BRIGE OVER MONTMORENCY FALLS, QUEBEC. ABOUT 30 years ago or more, the members of the Quebec road trust had decided on building a suspension bridge over the falls, to be used instead of one similar to that near Bureau's hotel, Montmorency. It was completed to the delight of the trustees, but the habitants would not use it. They were unaccustomed to such a style of thing and con- sidered it unsafe, and despite all reasoning would break off the bars nailed up to prevent passage over the other, and cross over. To give them confidence, a0organi- sed by the trustees, and a lunch prepared for a party consisting of perhaps thirty persons of the -,#ost prominent families in Quebec, who all drove over, had a delightful time, and exultingly pointed to the fact of its safety in contrast to the fears of the rural population. The next day a",
         "QUEBEC AND 17S VICINIZ Y. 53 koman and her son in a light cart crossed over, and the supports, strained by weight of vehicles of the previous day androst I think, gave way, and horse, cart, woman and boy were plunged in the seething waters. Had the catastrophe only occurred the day before, a dozen families instead of one would have been plunged into mourning. It was useless to dream of re- building it, it would never have been used by the people, and the stone supports can be seen to-day.",
         "i 1~ il f 54 QUEBE C A ND 1TS VICINZ7 Y. CHAPTER XII. THE URSULINE CONVENT, QUEBEC. I LEAVE to my learned friend, James Macpher- son LeMoine, Esq. (brother of the recently deceased chaplain of this Institution), all histo- rical details and mention of it. I pretend only to personal reminiscences, and as every orne in life has his use, I humbly creep in with my experience to fill the gap. I ought to know something of the dear old Ursulines, for from ther age of nine years tili a few months before my marriage, nine years after, I spent every day there, except summer holidays, from eight in the morning till five in the afternoon, taking çinner and lunch there, and so happy was I that I quite remembeç running into school, not away from it. The way was this, at eight precisely the heavy iron gates were opened by the Lady Superioress and another nun, and we filed in two and two between them; then once closed, no more to be opened till our exit,",
         "QUEBEC AND ITS VICINITY. 55 for the Ursulines is one of the strictest order in Canada. I was passionately fond of my school, my lessons and te chers, in fact, it was ny home, for I was mothe less, and the kindest of fathers cannot supply t e mother's place, particularly when absent during eday on business. So terribly distressed at finding myself shut out, and too late, I was going away down-hearted, when I saw that the yard door was -open, and old Louis, one of the factotums of the establish- ment, was sawing wood there. I remermbered that passage led to the refectory windows, which w re generally open at that hour. I made a dash past old Louis, j.umped on the window with the celerity of lightning, doffed my bonnet, and quietly walked to class. Old Louis report- ed, but all was as usual when the Superioress-came in to ascertain, and though I was niot found out, I don't think even the good sisters would think it an unpardonable offence tò run into school, though they might to run out. This great estabrishment was then par cxcel- lence the educational seminary for ladies in Que- bec, and even now when so many schools and new convents have been established, it still holds i wn, for all the head nuns are ladies of",
         "56 QUEBEC ANDITS' VICINITY. liberal education, and their pupils come from north, south, east and west. To an outsider the grim iron bars and the strict rules seem very distasteful, but if they only knew the happy placid life the inmates lead. Many(of them are women of great talent. As I am wr g of the past, I must refer to dear Mère de l'Incarnation, a South American lady, who seemed to me a walking encyclopedia, so va- rious was her knowledge. Convent tradition says that a gentleman having inherited some pro- perty from Cuba, the lawyers were in a sad case, as no one understood Spanish sufficieritly to deci- pher the deeds, when some one thought of this old lady, and the lawyers were then permitted to meet her in the parlor (the iron grafings inter- secting however), while she translated the deeds. Another remarkable lady was the çleceased Mère St. Henri, so beloved that she was cons- tantly elected superioress; she was a relative of the seigneur of Murray Bay. I could go on for ever if I wanted to be discussive on the subject of these ladies. I will confine myself to the niention of only two more-one, Miss Georgiana Van Felson, now superioress, daughter of the late Judge Van Felson, an old schoolfellow; one",
         "QUpBEC AND I7S VICINITY. 57 of our companions on our first visit to Murray Bay. And last but not least, I must speak of my dear teacher and friend, Mère Ste. Croix, as smart when I saw her a few months ago as when I first knew her, some forty years since. She was a sister of that famous Abbé Hjojes, whose work, \"Conférance de Notre Dame,\".obtained a world-wide reputation. His eloquence was so great, that it was impossible to get through the crowd when he was to preach. My friends, no matter of what creed, if you can- obtain a copy of Conférances de Notre Dame, they are published in English-though copies are very rare-you will enjoy a treat. The first chaplain I remember there was the Venerable Father Maguire, who nearly choked, himself, or was nearly choked, by bending too close over some chemical preparations at one of our examinations, for the young ladies even then in an advanced institution like the Ursu- lines of Quebec studied chemistry, botany, etc. Happily he recovered breath, but I have often - since thought with horror how near we were to a tragedy. His successor was the Rev. Mr. Le- Moine, one of those excellent men who live but for others. When curé of Beauport, his house- 5 yd",
         "58 QU BEC AND ITS VICIN17 Y. keeper used to complain that she dare not leave a sparc blanket or second great coat in sight, for Mr. LeMoine would cert(nly give it away, saying, \" why should I have a second article I do not need, when some one wants it ?\" I saw him a few weeks before his de- cease, his benevolent countenance all smiles as he said, \" I am getting weak but do-not suffer, and oh, eve-y one is so good to me.\" H , so self-sacrificing for others, magnified everytiing done for hiri elf. Once a nun of the Ursuline Convent tak s the final vows after some years probation it i for life, and many of my readers· will say this ijestraint is terrible, though volun- tary. So far \\from it, by special permission of the Bishop, se eral of these ladies have left their convent to fou d institutions elsewhere, but in- variably ask to be sent back to their Mother House. One o these, the Very Rev. Mère Ste, Croix, I entioned, having gone to Texas (I think), r urned a few years ago, and within ten years a most others returned from founding a convent f their order at ROBERVAL, L E ST. JOHN; and à propos of Roberval, let me say that",
         "QUEBEC AND ITS VICINITY. 59 tlia-trgh I. -visited it under the rnost unfavor- able auspices and in the bitter cold of% an i exceptionally severe winter, I was delighted with it;f here the wild, wild country life with all the comforts of civilization. You leave Quebec - on the train about 8 a.m., I think, and arrive the same evening. Just at the station are comfortable boarding houses. .Even if the Grand Hotel is not open you have your daily post, your telegrains, even in the depth, of winter. A few pleasant associates, good medi- cal men, and'a primitive existence most delight- ful to the town worn, and I cannot forbear mentioning 1with deepest gratitude the name of Mr. B. A. Scott, manager of large mills here. During the fearful e demic of la grnppe, that evenTo~ïd~utt~hils secluded part of the world, one of my sons was sç ill with inflammation of the lungs from it that his life was despaired of. \"There is no hope,\" said the doctors. \"While there is life there is hope,\" answered Mr. Scott, and he recalled the doctors and stayed all night with ny boy till pronounced out of danger. As he has done to mine, may others repay to him the debt in overflowing measure. His father had just the same kind nature, for I",
         "60 QUEBEC AND ITS VICINITY. remember once in coming over frop Crane Island (we were frequent visitors at the Misses Macpherson's hospitable home), a terrible storm arose. In a frail skiff we were almost lost. I was terribly ill and could not bear the wine and stuff offered me'on landing, and he a stranger sent up a couple of bottles of bitter ale. I was able to retain a portion of that, and never forgot this instance of sponta- neous kindness. Roberval is destined, I am sure, to a grand future. Sensible people who want a change of air and- scene get so thoroughly tired of the routine of fashionable life existent even at the well-worn sea-side places, that here, hile enjoy- ing all the comforts of civilization, you are really without its pale, and the air for many is much more beneficial than that of salt water. In fact, to many of those who are troubled with throat or chest affections the sea-side is de- cide#y inimical. Here you have the bracing, pu mountain air, which brings healing with eve draft. Landing unexpectedly last winter I cam ddenly to Mr. Thomas, and Madame Trembl , though a stranger, with great courtesy, gave me up her own bedroom to make me com-",
         "QUEBEC AND ITS VICINITY. 61 fortable. She is a nice musician. Her little daughter has a complexion of milk and roses, as also Mr. Treqiblay's brother's wife, inherited rom old country blood. This very Mr. Tremblay, now living, told me he came here twelve years ago a dying man. Hi: physician in California told him he had no hope, and, unwilling to leave a young wife in a strange city (they had come from St. Ann's, near Montreal), he made his last arrangements and came home to die, but instead inhaled new strengti anc health in the life-giving atmosphere of Lake St. John, and is living there now. I now leave it to Mr. Miller to describe with an abler pen than mine this beautiful region. The extract , is from his 'Doomof the Mamelons with a description of Lakè St. John and Saguenay region\": \"And las, but not least, be it remembered by my readers, that from Quebec roll the trains of the Que- bec and Lake St. John RaÀlway, which for two hundred miles will take you through the least in- habited stretch of country crossed by steel rails on the continent ; a country without houses or mills,.or huts or cabins or wigwams, a stretch of real wood- land, where on either side of the track stands a forest unmarked\\by axe, rivers on which are no boats, lakes",
         "62 QUDBEC AND ITS VICIVITY. numberless where no camp fire was ever lighted, and scarce an Indian's canoe has been, and where the beaver dams, on which the beavers were working but yesterday, are within forty feet of your window as you whirl past. Through this tangle of rivers, lakes, forests, swamps, hills, mountains, you are whirled onward until suddenl y the train breaks, like a chased buck, out of the thicket, into an opening, and Io, the wide, bright waters of Lake St. John lie spre4d out in broad expanse before you. Veriry it is worth a day's ride to see the loríeliest lake in the loneliest woods in the wide world, is it not ? And that, too, seen from the window of a Palace Car! Its enough to take an old trailsman's breath away to think of such a conjunction ! \" The climate of the Lake St. John region, as I foundc it to be last summer, was a surprise to me. As it is two hundred miles direètly north of Quebec, I naturally expected that it would be m uih colder. Instead of this being the case, I found the reverse to be true. Frost was much slower in coming than it was sixty leagues farther south. The water retained its summer warmth for nearly a full month beyond the date I had set for it to freeze. It was comfortable bàthing at Lake St. John up to October ro, at which time the air was warm and genial. The prevalent winds were from the south-west, and they seemed to have blown from southern atmospheres, for even on stormy days they did not chill one. The cold east winds which blow straight up the St. Lawrence channel from Labrador, and which make one feel so uncomfortable at Quebeë^.and even at Montreal, seem not to get north of the Laurentian móuntain -line, for during all",
         "QUEBEC AND ITS VICINITY. 63 the autumn there was but one northeast storm, and that was not a cold one. I never lived in a more equable and genial autumnal climate than I found to be the normal one in this inland region, and for pur- poses of pleasure and health I can cordially commend camp life on these northern lakes until snow drives one out. \"Of wild fowl there is an abundance. Along the tributaries of the lake ducks and geese of many varieties nest and raise their young. The sportsman can'find good sport both on the lake and on all the lakes around and in the rivers and streams flowing into it. In point of accessibility this region is now most convenient to all sportsmen and tourists from the States. \"The Lake St. John Railroad now runs io the very shore of the lake, and before reaching it, it dasses scores of lesser lakes full of fish and beautiful to the eye. No angler need go to Lake St. John to com- mand as good angling as a disciple of the rod ever found. But if he is ambitious to try his skill and test his tackle on a wan-na-nish, that peer of the salmon, he must visit the great lake, for in no other body of water in the woods can he find this noble fish. The angler leaving Boston Monday morning will reach Lake St. John Tuesday afternoon, and cover the entire distance in a Pullman car. This makes an excursion even of a week's duration practicable to any angler from New England. I know of no other opportunity fer prime sport to be found on the continent eilual to this. The opening up of this wonderful country to the public by the construction of this railroad is a positive boon to",
         "64 QUEBkC AND S VICINITY. sportsman and tourist alike. It makes a high order of pleasure and healthy recréation pgssi1e and con- venient to thousands that could iqot otherwise en- joy it. \"It should be remembered in this connection that all this country is yet in a wilderness condition. and, therefore, most charming to those who love seclusion, and from education in camp life and woodcraft know how to guide and take care of themselves and those dependent -on them for needed protection and com- fort. But there are a few hotels and but few settlements or clearings, and \" guiding\" is not a practice or a habit of life with the Indians and half- breeds resident there. These needed facilities of safety aid happiness will, undoubtedly, be speedily evolved from the rude conditions now existing in answer to public demand, but at present they do not exist to any such extent as to be adequate for any great multitude of vititors. I don't doubt that the natives, both red and white, will speedily develope into excellent guides, for many of them are experts in canoe service and at trailmg and their trapping life has made them familiar with the country,- within certain fixed limits.\" 1 0",
         "QUEBEC AND ITS VICINITY. '65 CHAPTER XIII. THE OLD CONVENT OF LA CONGRE- GAT.ON DE NOTRF DAME I WAS born in the old Quebec Bank, Quebec. I don't remember the circumstance myself; but I do remember being drawn in a basket- carriage by old Germain, the messenger of the bank, to the Convent, situated on the site occupied by the Gibb stores and those of Messrs. McCall \u0026 McShene. The Convent was so near the water that, as an inmate of- the Convent of the order told me to-day, the sailors, not being very back- ward, used to land ther boats so close that the sails used to flap on the Convent windows. The present Convent of the Sisters of the Congrégation de Notre Dame has been forty- seven years on its present site opposite St. Roch's church, on St. Joseph street. So it is quite fifty-six years since I learnt ny letters in the old building on St. Peter street, and since L2~. su",
         "66 QUEBEC AND 17S VICIN17 Y. my father used to call at the Convent for me and take me out boating on the St. Lawrence river, then the ordinary place of boating for lovers of the water; but how I hated it, it made me so ill, and poor father would always persist in saying it was the fat soup I got for dinner at the Convent. The effect of the soup. must have lasted many years, for I was always ili on the water, etil about twenty years ago. I went down in the autumn to Charlottetown, P.E.I., and the weatlrer being very rough I bribed the stewardegs to put-a mattress on the floor of the cabin and bring me my meals there. I never gos. up till we arrived at Char- lottetown, and though both stewardesses were ill, and all the other ladies, I was not so at all. I attributed it to lying down from the first moment a hint for others suffering with mal-de mer. I ope it may prove equally successful. he Convent at Ville Marie, Montreal, is maison mère, or head convent of the Con- gr ation de Notre Darne. y next 'recollection of the Quebec Bank tv when Mr. Noah Freer was manager. I pa icularlygetall a parcel of biscuits he shared wi h me at lunch tine; and many years after,",
         "f QUEBEC AND ITS VIClNI7Y. 67 about the last time i saw the old gentleman, I asked him if he still kept his biscuits there, and he showed them to me in their accustomed nook. Il L'1~ t, d t',If",
         "68 QUEBE C AND 17 S VICIN17 Y. ut Lt -v -J ~gL '4 E. CHAPTER XIV. LA TIRE PARTIES. I THINK I hear my old country and American readers say: \"What is La Tire ? \" Now, don't be hoqified, your own fair hands work up flour in buns and pastries, and you eat the latter made by you know not whom, when pur ased. Well, la tire is a candy made by boilin molasses to a certain consistency-only the experienced can say when exactly cooked enough. The general plan is to put a spoonful now and then into ed hen it snaps itis-dune A lump is then taken up in flour powdered fingers and pulled until white. An amateur wilt do this without scarcely touching it, and so neatly she could do it with a velvet dress on and not leave a speck. It isundoubtedly the healthiest and the very nicest candy I think ever made. A kind of imitation of it is sold in the confectioiers, but inférior, I think, ·to the .genuine article. Well, fifty years ago St. Catherine's day was always looked forward to",
         "QUEBEC AND ITS VIC1NITY. 69 as a great time for the young folks, and we always hoped by thàt day to have some sleigh. ing and also la tire parties. Fancy twenty or thirty even grown people making la tire, each one vying with the other as to whose was the whitest. Such fun, such threats from some one tht unless some request for a dance or some- thing were promised you would be surrounded by a string of la tire and be stuck all over. 4 These parties were gradually dropped for more fashionable assemblies, but some French Cana- dian families still make it for their young people every now and then.",
         "70' QUEBE C AND 17S VICJNI7 Y. CHAPTER XV. TWO STORIES FOUNDED ON FACTS, WRITTEN FOR MY DEAR LITTLE FRIEND BELL HOLT, DAUGHTER OF STANLEY HOLT, ESQ., TREASURY DE- PARTMENT, QUEBEC. IN a second hand hotel in the lower town of Quebec lay dying -a poor lady, widow of an officer in the army, whose demise had only occurred a year before. Like many military men, this gentleman, whom we will call Mr. Smith (for I will not give his real name), had been most anxious to purchase.a farm and work it, and because he had thought littl'e of the discomforts he enjoyed out sporting, imagining life in the country was to be a per- fect paradise. It is comparatively easy to gather the crop when ripe, but what of the planting and hand-work to be gone through before arriving at that end. However, he was not destined to face these trials, for he caught a cold in carelessly exposing himself when on a",
         "QUEBEC AND 17S VICIN17 . 71 shooting excursion and also one of investigation, looking opt for.a suitable purchase in the then wilds of Valcartier. He died of rapid decline after a short illness, and left his wife and children o do as best they could with the few hundred pounds left. Mrs. S., like most officers' wives, knew littie of household management, accus- tomed to have their rations regularly sent in, wood and light provided, and an orderly always at their service. Even a military man himself, once he leaves the army, generally finds he is helpless in these matters, and quite dependent on the honesty of those about him. Hence poor Mrs. S. was in a sad plight, for they had not been many years in this country, and their principal? friends had been the members of the regiment to which Mr. S. had belonged; they had -gradually slipped out of sight and memory of their few remaining acquaintances in Quebec. All alone, with only 'a grasping, coarse- minded boarding house mistress standing be- side her bed, she .passed away, begging of the woman to go to a clergyman and ask him to take what money was left, and seeing who her relatives were from papers in a box she gave her, try and send her",
         "72 QUEBEC AND ITS VICINITY. children to them. It was most unfortunate hat this poor lady should not have seen to hese important matters herself while able; but he had been so completely prostrated by her hisband's sudden death that she had deferred he matter until too late, and she found herself unexpectedly face to face with the grim con queror, and so these poor children had to suf- fer alone for the procrastinating sin of their parents, for though the wornan promised she did not perform. On the contrary, she indeed ot the little girl into an orphan asylum, but he boys beingMlder, one was sent to Valcartier o help on a farm, and the other, though still ery young, was apprenticed to a boot maker. The clergyman who came to the funeral se ice did enquire if there'were no friends or m s, but the woman said only enoughZwas left for funeral expenses, and hardly enough to y what was due for the board of the family during the father's and mother's illness. This of ,course was untrue, but she as soon as possiS6e disposed of the children in the afore- said manner, hid away or destroyed the papers and took possesion of money, trinkets and everything the poor lady had left.",
         "QUEBEC AND ITS VICINlTY. 73 A year pasked when - another officer's widow (Mrs. S.) asked her daughter if she could not get her a little servant to thread her needle and sit beside- her to þerform any little offices needed, for she felt herself growing very infirm. Accordingly a visit was made to the orpha-n asylum, and struck'by the pleas- ant, refined face of this little Miss Smith she was selected. Some time after Mrs. S. was going to receive some company, and extra silver dishes and pretty china articles were brought out for use. The little girl helped in doing so, but displayed no astonishment at the sight of what Mrs. S. thought must be a wonderful sight to the child. At length Mrs. S., curious at the child's display of indifference, said: \"You may look at this silver basket, child. I don't think you have ever seen anything so pretty before.\" \"Oh, * yes, I have,\" promptly answered the little one. \" Mamma had things like you.\" Fancying this was only the outc e of childish pride, Mrs. S. said sharply: \"My hild, you are not speaking the truth, these things cost a great deal of money. ,' But;\" persisted the. little one, \"mamma did have things like that;- and she hadaold watch and a piano-my mother was 1 lady.\" 6 '*5 4' 1, 4, r",
         "74 QUEBEC AND ITS VICINITY. Mrs. S. growing interested gradually drew from Miss Smith her whole history. \"Child,\" she said, \"-what was your father's naine?\" \"He was Captain Smith.\" Growing quite excited, the old lady called her daughter. \"My dear, you have often heard your father speak of his old com- rade Captain S. Well, if what this child states is true, this must be his poor little neglected child.\" A responsible party at once went with the little girl to the Lower Town Hotel, and the land- lady's confusiòn at the sight of the child was so great that it was evident she feared detection, and by threats of sending herto jail, she was at last induced to confess the whole thing, and re- turn the mother's effects and part of the ill- gotten money. Can you faricy the meeting between these long-parted -little children, for old acquaintances of their father's came forward to claim them, and they were tended by loving' hands until their relatives in England could be. communicated with, and as then there were neither steamships nor telegraphs, it took many months. Once more enjoying the comforts of life together the time flew quickly, till at last came kind letters- from grandmother and uncles, urgently asking that they be sent home to 'k",
         "QUEBEC AND 17S VICIiVZTY. 75 them at once, and there we leave them. The mother's long deferred prayer for her little ones was at last' heard, and the Father of the father- less had had thern in His'keeping as He has us all; only when- bowed down with grief and trials we cannot realize that the discipline is needed. Perhaps the very privations' these poor children had suffered might prove the means of greater happiness later by teaching them to appreciate our daily comforts taken as a matter of course, and for which are so little grateful. This true story vas told me by an old blind Scotch lady, Miss O., who, having outlived all her relatives, was supported by her friends and the Presbyterian church of Quebec. Speaking of hei- changed position, though residing a few doors from us in a pretty farm house at Little River, she said\"that vhen showing kindness to the little girl, how little her mother thought hy own daughter would be dependent on strangers in later life, for she had only an officer's daugh- ter's pension. And now, young ladies, shall I tell you to what she attributed her blindness,-ai almost criminal neglect of her eyes. Exceed- ingly fond of fancy-work, she occupied herself t~'i ? 1v G",
         "76 QUEBEC AND 17S VlCINITY. with it unceasingly, and as her sight grew weaker, she used stronger light. One evening she said she was just finishing a bit of work, and twilight coming on, she strained her eyes by going to the window, exerting herself to finish her work, when all became dark and was dark forever.",
         "f QUEBEC AND ITS VICINITY. 77 CHAPTER XVI. MY GODMOTHER'S STORY, TOLD BY HER TO ME SOME TWENTY- FIVE YEARS AGO. SHE came on a visit to Quebec after an absence -ofany long years; an.d seeing me in great trouble then, though up to that time my life had been an exceptionally prosperous and happy one, said, \"Don't loose heart. To all there comes a period in life when individuals seem singled out for tnisfortune, death enters and claims not one, but successive victims, till it seems as if our troubles were greater than we. can bear. Yet, at last, there is a rift in the cloud, the darkness rolls away, and the sun of prosperity shirfes again, doubly appreciated after the period of gloom. I remember well this lady's home, her daughter was niy companion, but a few years old, 'and it was with keen admiration, and I fear a little pang of envy, I contemplated her 4",
         "78 QUEBEC AND ITS VICINITY. numerous and expensive toys sent for her form New Yorkf--quite a journey then, fifty years ago; but Mrs. W. was very rich, gnd had an elegantly furnished house opposite the wall of the old Jesuit barracks in St. Ann street, in rear of the old Ursuline convent. And now'permit me to digress a little while I tell you a funny inci- dent that occurred to some young ladies in the same convent. The Ursuline convent forms a square, the front facing.,St. Lewis street, the back bounded their own, property on St. Anne street, and their garden extending from opposite the English Cathedral to the rear of the Sewell property on St. Anne street. Well, some old gentleman lived in onè of these Sewell houses, and in his yard was an apple tree, whose branches loaded with fruit hung over the 'gar- den -wall, too tempting for modern Eves to resist. We were given plenty of apples for dessert at our convent dinners, but these forbidden fruit were supposed to be sweeter, and some of the young ladies found means of getting at and appropriating the fruit. This coming to the ears of the good sisters, punishment swift and severe for the delinquents was to be meted out. These good ladies considered the offence enor-",
         "QUEBEC AND ITS VICINITY. 79 mous. What, convent girls so well brought up to be guilty of such dishonest, unlady-likecon- duct! So it was decided the girls should go and ask the old gentleman's pardon, acknow- ledging the offence, and word was sent to Mr. A. (we will call him), who said he would be glad to see them. An hour was appointed for the recep- tion, as he did think they should arrange the mat- ter personally. They were sent under the charge of some head servant of the establishment (for the Ursulines never leave their convent, except to found other convents by order of the Bishop), and very shamefully and rather nervously entered a parlor which contained a table loaded with sweets and confections. An old gentle. ,ran with a very benevolent and smiling·faée greeted them thus: \"I Young ladies, I am very glad that the anger of the good sisters has procured me the pleasure of this visit and of you a holiday. You will not refuse to partake of this slight lunch I havé had prepared for- you, and take home to your young companions this basket of apples and sweets. And now, one ail I make you a free-gift of all the fruit of my trees. I cannot use it myself, and shall be glad if you young ladies will have it.\" Such was the punish- ma",
         "80 QUEREC AND ITS VICINIT.ý ,qjent meted out and the ineffectual attempt of the convent authorities to impress onSf'nm the difference between mine and thine ; and now I must return to my dear godmother. Her father, a wealthy American, had brought her., a. motherless onlyh ild and settled in Quebec. So elicately was shCbrought up, that she had even a littletack boy in livery to carry her books to school. Yet with evéIy wish gratified, so noble was her nature, she did not become selfish, for she told rme herself that the greatest comfort she had had in her adversity was that she had so frequently sent letters with money arlorlo- mously to other friends who needed it, 'but to whom the giving of it personally would have given pain. At, the time Qf her marriage she told me she had no idea of how, to sew, had never indeed even herfimed a handkerchief. She continued living with her father for ye rs after her marriage, and a nurse who had lied with them, and served me after, said she hearçi old Mr. F. say -one day exultingly of1his darling daighter's fate and happiness: \"Thank God, my child can never want.\" No doubt a thoughtless but a terrible speech to make- almost enough to invoke misfortune. Many a K",
         "PI\" QUERIC AND ITS 1CINITY. 8 'kirng and queen has want-ed for bread, and any eflecting person must know there can be no possibility of security from trouble,\u003cmuch less from money loss. Even when all yrecautions are taken, cafiany one say that their wealth is secure? Money invested in buildings may be Ilost by large fires, causing the insolvency of insurance corifpanies; banks may fail; and busi- ness speculations nay turn out ill. And such was the case here. Mr.-F. lost moncy, and the disaster so preyed upon him, that he fell ill of brain fever, and the first news his wife got was that he was dying at Lake George, U. S. She hurried on there, but traveling was so slow that .she qnly arrived in time to receive his dying breath. The news so prostrated her aged father, that he became paralysed and could not help her, and she who had been bred up in the la of luxury found herself almost penniless in strange part of the coun- try with a father whQ required a masculine atendant, he had become so helpless, two sons and a little daughter. Happily for her then, as at- all times ,she was a sincere chris- tian, and she committed her cause to Him who doeth all things well. Thinking over the future",
         "82 QUEBEC AND ITS VICINITY. she said to a friend, \"I have had a good educa- tion. I can at any rate educate my chil'dren, why not educate others also ? \"So the idea was acted on. She opened a school at Glen's Falls.- She told me that when she knelt down- for the evening prayer, the. first time she was there she thought her heart would break as she caught sight of the carpetless floor, the bare wooden tables and benches. Her eldest son, seeing her emotion, came up, and putting his arm aroufd her said :«\"Mother, dear, do not fret, good fimes will come again,\" but to her good times seemed impossible. Yet some years after when my father and myself on a trip to Saratoga triedi to see her, *we were told that some wild landq, belonging to her father,, considered worth nothing, had become valuable, and that she had gone to Chicago. Later, on the occasion of her visit to us in Quebec, she 'said to me, \"My dear child,' I do not say this out of ostentation, but to show you how the wheel of fortune turns, and bright times come again, as my on said. I 'was present at his wedding in Chicago, where there were three hundred invited guests, for ieh married the daughter of a very rich man nd",
         "QVEBEC AND TS VICINITY. was doing well himself. As I gazed at the bril- liant party crowding dining-room, hall, parlor, and conservatories, .I did indeed realize that - good times had come again.\" 83",
         "84 QUEBEC AND ITS VICINIT.-* CHAPTER XVII. MOUNT HERMON CEMETERY. THE sun was shining and the birds were sending forth theirjoyous peals, as James Macpherson LeMoipe moàt k jdiy drove me to my husband's grave. I hadý'-een too ill to ,go there at the time of his funeral, and even now, my son said, \"You should not go, mother; you cannot stand it.\" * How thankful I am I did go.* The peacefulness of Mount Hermon seems to have passed into my heart. I have visited 'the grand cemetery of Mount Auburn. I have often seen Mount Royal and Cote de Neiges. But the quiet peacefulness of Mount Hermon excelle4g them all. I only saw a couple of mourners at the graves, and my darling's resting place pleased me rnuch. A good sized nicely kept plot,' not gra'nd with bright colored flowers, but nicely kept green mounds indicating each resting place;.,a plain granite ,to his father's",
         "QUEIEC AND ITS VICIVITY. memory, beside whom and his mother and his little child he sleeps. \"Adieu, my darling. I go forth with ny bitter grief much assuaged to leave you in such a quiet resting place, afar from the jar of a city where crowds do not congregate with their hamp.ers, as is done elsewhere.\" I do not think our dear departed wish us to so*row iselessly, but there certainly appears to mn a want of reverence to the dead when the cemeteries are turned into picnic grounds. \"'The long, long dreary day is past and gone, And still I am weeping, my lone watch keeping.\" TO MY DEAR HUSBAND, WHO DIED 15TH AUGUST, 1889. As I sit in the gloaning and ponder, And grieve for the dear one no more, Lilke a wind-toss'd bark on the ocean, I long for a sight of the shore Where storms are unknown and safe 4helter Awaits those who faithfully strive His heavenly footsteps to follow, Our Saviour, who, dead and alive, A loving example has set'us, And beckons us onward to share The heavenly mansion he promised .And weht on before to prepare.",
         "86 QUEBEC AND ITS VICINIl Y. On the banks of Death's lonely river, Extending I see your dear hand ; Tho' long be the years intervening, You'll wait for me there on the strand, And be the first spirit to greet me, On the shores of that heavenly land. So Ill shoulder my cross with submission, And patiently wait for my call, Content that in death's silent slumber, That you should be spared grief and all That a life's separation implies. Whose lives have been twined so together, Full forty-five years, aye and more, The wrench is so great, it seems almost The cord is so strained it must break; But now, husband darling, I leave you, In peace in Mount Hermon to sleep, While 1, better fitted by nature To struggle with grief and to weep, Await here that blessed to-morrow Will take me to meet you again. For love that is true love will ever Spare the loved one ail pain aid all grief, And gladly itself bear the burden To give that loved other relief. Then sleep on in peace, my dear husband, Beside father, mother and child, While I in submission abj1e, Till on death's call I hasten g Once more to your loved side. An4 have I qot also our children W$ose love apd whose duty comb'ine T replace ail 've lost in you, darling.",
         "9. QUEBEC AND ITS VICINJITY. Yet, in death, as in life, you are mine. And the words that you said on your death bed Are ever before me, my dear, \"You cannot stay very long after, The end of your life is so near.\"",
         "88 QUEBEC AND 17S VICIN]7Y. CHAPTER XVIII. PROMINENT HARACTERS QUEBEC. IIIS LORDSHIP THE LATE BISHOP- MOUNTAIN. I cannot revisit the old English Cathedral in Quebec without seeing in the glass of memory the venerable figure of Bishop Mountain, in his lawn sleeves, seated in his place of dignity near the altar railing. So many are living who can recall his kindly face, I do not need to give him, an elaborate notice. He was universally respected and be- loved, and with wise and cautious policy held his own at a difficult crisis in the Anglican church's history in Quebec. His deacon or curate (I am not sure of the title), also much liked, was decidedly low church, as were most of his congregation; butthiis vas the time of the Puseyite movement, 1and hs son, the Rev. -Armeyn, just returnedfrom Oxford, decidedly high church in his views,Á ut the dear old",
         "QUEBEC AND ITSVICINITY. 89 bishop, by his moderation and personal force of character, abated the storm, and there was no split in the Cathedral con- gregation. I will not dilate on his good qualities, but I will only relate one circum- stance that will, I think, serve to illustrate his character. The seigneur of Crai4e Island, John Macpherson, died there, and his body was taken to the south shore to be buried. Re.' mark, at that time thei e were neither telephones, railroads nor telegraphš. A man in a sleigh breasting the-heavy country roads, crossing the rivèr from Levis in a canoe,-amidst shoafs of ice, brought the intelligence, and also the request for a clergyman to perform the funeral service. What was- to be done ? Any clergyman con- senting would have to face the dangerous 'crossing and then drive about 25 miles in intense cold and storm. Mr. L. T. Macpherson saw but one plan of action, to lay the matter before the Bishop, this being the only way lie could think of to accomplish his duty to his dead brother and his nieces. An appeal was made to the Hiishop, and what do you suppose was his answer, thoroughly characteristic of the man, '\" It will be such a disagreeable journey that I",
         "90 QUEBEC AND ITS VICIAhI7Y. should not like to request any of the clergy to go, they ght construe it into a command ; but I wilV go myself.. I am an old nissionary, you k$Cw, and used to hardships.\" And he did go. Nobtotdgentteman that he was. This nar- -ative alhie embalms his meniory. THIE REV. FATHER NIcMAHON. One of the most celebrated priests of the Irish parish church -of Quebec, a prototype of the Rev. Father Dowd, here beloved by Protestants as by Catholics. Well, the Rev. Mr. McMahon was one of those men. without. fear and without regard, who could always hold his own, and on one occasion, when there was some little sign of a rupture between Protestànts and Roman Catho- liés, he quietly turned round and asked his own congregation if they would remember that St. Patrick's church was mostly built with Protes- tant money. They acknowledged the fact, and. harmony was restored. On another occasion he heard giggling in the gallery, and turning his eyes upon the delinquents-two or three mem- bers of the most respectable families of his congregation, he said: \"Young ladies, if this dis-. turbance continues I shall have to ask the beadle S1",
         "QUEBEC AND ITS VICINITY. 91 to call you out by name and request you to leave the church.\" Need I say the lesson was most effectual, and was it not justly given? Even apart from irreverence, can there be worse manners than for any two or three persons to disturb a whole congregation, either in church or other assembly ?' Perhaps some of our mod- ern young people will think of this when they talk loud in theatres and public places when the performance does not suit them, regardless of the rights of others. JEFFREY HALE, ESQ. The name of the venerated Jeffrey Hale is a household word in Quebec. \"If by your works ye shall know them,\" he will be well judged. A practical christian embodies all we have to say. A man of aristocratic lineage and amp!e means, he showed his blue blood by his truly refined, unostentatious life.- His thin, spare figure, his benevolent face, that of his sister, a refined lady of the~old s* l, will not readily be forgotten by Quebecers. His Sunday School Jeffrey Hale's hospital and St. Mätthew's",
         "92 QUEBEC AND ITS VICIN17 Y. chapel bear witness/ to his liberal disposi- tion of money for charitable purposes.. St. Matthew's chapel was the first place of worship in Quebec where the pews were free. It was intended for poor people, but is now the most, fashionable church in the city. Adjoining is the- old English burying-ground peopled, by our fathers and grandfathers, and containing the last remains of many an English officer. A dy- ing sister said she would rather have Mr. Hale talk and read to hejr than any clergyman. COLONEL ANTROBUS. Col. Antrobus, the then one military aide- de-camp, and just the right man in the right place,' handsome, digpified, overflowing with .bonhomie, a favorite with all, fell a victim to cholera, I think, and died after a few days ill- -ness, deeply regretted. THE HON. R. E. CARON, -afterwards Sir R. E. Caron, mayor,, judge, lieut.-governor, who for good looks and gra- .ciousness. contested the palm with our dear old Dr. Sewell. We use the ttrm here as a mark - of affection for Dr..Sewell never grew old,",
         "QUEBEC AVD ITS VICINI7Y. always suave and cheerful, and attended his patients till a.shorttime before his death. So great a favorite was the Hon. R. E. Caron, that quite a numbef years was he mayor of Quebec. He was constantly re-elected, his fel-, low-citizens recognizing the fact of his peculiar eligibility for the office. Generous in entertain- ing, with ample means, his handsome house irr St. Louis street (where somè members of his. family still reside) was the house of gracious hospitality, and when raised to the position of lieut.-governor, it * was generally conceded a wiser 'choice could not have been made. He' retained his'popularity until bis death. His successor was, I think, Hon. Mr. LeTellier, who, being a widower, and his daughters young, prevailed on Lady Stuàrt to receive his guests on reception nights. This lady, member of one of the oldest and most respected French families of the olden time, was well fitted by habit and position for the office. The DeGaspé family belong to the annals of Quebec from Mons. DeGaspé, senior, 4ath\u003ce of-that very rare- and:interE\u003eting old book, \"Les Anciens Cana- diens.\" Like the Philips family, they were ail very handsome. I only remember a few of them,",
         "r 94 QUEBEC AND ITS JICINI7 Y. Mad. DeBeaujeu, Mad. Alleyn, Madame Pover, the Abbé DeGaspé, Madame Fraser and Madame Hudon. Is itreally the case that the past generation were ha'ndsomer than their pre- decessors:r is there truth-in what-an English officer, Capt. Warberton, wrote on Stada- cona, Quebec, that whereas he had never seen in Canada such·real beauty as he occasionally met in England, still hé had never met so many pretty girls as in Quebec. But I remember the gentlemen as well as the ladies, ,'nd a sight to -be admired was that of Mr. Philips with his son and. daughters, as they walked to church, eath and every one beautiful. ,Several of them have pasised away. One I know lives in Montreal, Mad. B--, wife of the Q.C. of that name. She was very han me, and one of Miss As.- pinall's most proficient scholars. I wonder whether the young people now are ever taught the graceful scarf dance, or stately minuet. Lt is 41ot twenty years since I'went into society; so can only write of the past not the present. Leaving the Caron's reidence, we see on the right hand side a comfortable·stone house where Iived the Hgh Constable Downs. I think his I",
         "QUEBEC AND l1S VICIVITY. 95 daughter, Mrs. B , still lives there. The old.gentleman, I remember; was very stout andk rather tenacious of the dign his office; and Was a little quick-tempered, qui ough to * make him the subject of a practical joke which created a great sensation in my time. Some gtaceless young fellow (lawyer they ay) stole a nuniber ofsummonses signed by the High Constable, and ready for filling up, commanding the-receiver under any amount of penalties not 'te fail to appear on the petty jury. These were sent to people of the highest Position in the cityexempt from any such service, and the very sending of which implied gross ignorance on the part of the sender. Fancy then the scene that appeared in Mr. Down's office, when a gentle- man, a judge I think, who lrnew it was a mistake, showing the document to Mr. --, said, \"Is there notalittle error here?\" \"A little error! No, *sir, there is a great error here, and the dolt who sent out that paper shall certainly be dismissed for not knowing his business better.\" But in comes another and still another dignity.of the law with the same wêrk, until it dawned upon these ' gentlemen that they had been all hoaxed. They laughed, but not so Mr. D--. This was",
         "96 QUEBEC AND 17S VIC/Ni Y. touch ing the majesty of the law and his 'office, and lie swore dire vengeance on the delinquent for stealing his papers, when he should discover the offender; but despite all efforts, the secret was well kept, only some, who knew our incor- rigiblefarceur suspected. PADDY McGUIRE, AN HONEST HORSE DEALER. \"Well, Miss Charlotte,\" I think I hear him say, \"sure I'm glad to meet ye. I've been lookin'g fôr ye this week past. I've just the loveliest little pony, canters beautiful-just the thing youi want for your own pretty self. I'm keepin' it for ye. You'll 'ust s e to Pa about it, won't you? \" \"I could have sold it over and over again, but you see I wanted you to have it,\" \" But Mr. Mc\\Sçath, you know, we have a nice horse already, and my father only keeps ·one.\" \"A nice horse, faith, and who knows better than myseILf. Sure *N3idn't I sell it to the old gentleman ; but'because2 you have a good one, can't ye have a better?\" I don't think I got the pony ; but, wherever procured, I had plenty of riding,.and with my darling husband used to think nothing of a ride: out.pas\u003e the-Suède, and home to Little River.. 4",
         "QUEBEC AND ITS VICINI7 Y. 97 HOT-ROLLS. Is there any one in Quebec that remembers .Hot-Rolls. A soubriquet for a poor unfortunate gentleman whom drink and disaster had brought so low, that his only means of living was bring- ing around hot rolls for some baker. I have reason to remember him, for, on ne- occasion, when all alone in the English Cathedral, he walked ii, drew ýut a big long knife, and sat down ati theentrance end of the pew, depositing the knife on the shelf before him. I was when young very nervous. I was terrified beyond ex- pression, and sat in agony till the gentleman canie around for the collection in my father's pew, when he induced him to leave, and once lmore I breathed freely. MRS. IEUSTON. I do not think that there could be a better illustration of the thoughtlessness regarding lu- natics some fifty yearsago, than-tratjelstrated in the case of Mrs. Heuston. It was said she had seen better days.. I was too young to re- member much about her, but I do remember a wild creature dressed in old ftnery-her",
         "98 QUEBEC AND 17S VICINTY. head decked with flowers, low necked and short sleevés, then evening dress, wearing white satin slippers, and so dressed coming for contribu- tions to Mrs.·Hammond's school in the depth of Winter. How could \"our ancesters have permitted such a thing for a day ? The answer is perhaps due to the fact that lunatic asylums then were abodes of horror ; that freedom to this poor ceature, though she would not wear warm cothing, was doubly precious, as I have it from my dear father's authority, that ofice on a jury he had visited the-primitive asyum, and there had.seen bad patients: one, a sister of a niedical man in high position then, was given her food through a trough like pigs. And anent promi- nent personages, I may méntion Dr. Douglas. I hardly think he can be living now. He, in con- junction with others, opened an asylum on the Beauport road. I remember my father saying to him': \" Well, Doctor I have just been talking to one of your patients who is as saneàs you are, perhaps more so, as you wrongly judge him a - lunatic.» \"Well,\" said the D'ctor, \"go and ask him what countryman be is.\" 'My father-did so, and in a state of grçat excité ment (he'ad touched hispeculiarrnonomania),he ansered ~ -141",
         "QUEBEC AND ITS VICINITY.. 99 \u003c'I arn father of the Moon and cousin tathe Suir, and all bow down to me.\" Dr. Douglas was a man of intellectual taste, and had a lovely resi- dence then on Beauport road replete with articles of virtu. I do not know who occupies it now. I r 1 *(w",
         "100 QUEBEC AND -ITS VICINITY. CHAPTER XIX. SPENCER GRANGE, QUEBEC'S SPE- CIAL AUTHOR'S HOME. RARE OBJECTS STILL AT SPENCEfk GRANGE.. THE first I remember of Spencer wood was as a visitor at the then residence of Mr. Atkinson, a rich merchant of artistic taste, and who in his travels had collected many curiosities. The next time I went there was at a reception of the governor's ladies, for Mr. Atkinson had ceded it to the govrnment asa vice-regal resi- dence, and. removed to a smaller dwelling. Spencer Grange, I remember, was a tho- roughly respectable, comfortable house, nicely furnished, but4hough-presided over by a hiece, yet emphatically the residence of awold bache- lor. Last week I visited Spencer Grange, and I am happy to say the feminine element predom.. inates, and he (Mr. A.) only plays second best. What can a man do against three of the higher) sçx? It is true he has his library as overflow-",
         ".m ý- ing with books as his- own brain with knowledge. *We leave him there guarded by an animal Miss Jeannette calls a beauty. As I am far from the indignant flash of her dark.eyes, I will express my opinion and say if her pet is -good-looking, I ,nevertheless mistrust him. \"Oh! I can assure you,\" says Miss J., \"he is so kind an sych a good breed, andis only cross to tresp gsers.\" And have I not reason to be uneasy ? He knew I was a trespasser when he came and looked me over, and discerned I was going to devour his master's substance. After a preliminary sniff, which expressed, \"I'll take you on trial,\" he left me to wend my way into the pleasant parlor, I have known so many long years undeï such different circumstances. But I must not moralize here ; the cup of grief is full, and if I permitted myself to be a moment off guard it would overflow. So I will put all . painful thoughts aside, and ask you to look out -on the pretty lawn skirted with forest trees, - then folloW me into the dining room, adjoining- which is a passage adorned with marble buâts, leading to'the grapery-a sight worth driving miles to seewhen the grapes are in bloom. I do not think I noticed one article which would tempt you to ask the price, unless it be a curious - s-: - 101 h 1- h 1, QUEBEC AND ITS VICINITY.",
         "102 QUEBEC AND 17S VJCINITY. mosaic marble, brought, I think, from Italy by Mrs. LeMoine's uncle, Henry Atkinson.. When I was young it *as c(nsidered that the* mingling of colors in a lady's ress should be so blended you could not think of detail but of the harmonious whole; and such is the effect of the interior of the Grange.. Harmony, comfort, elegance without pretension, specially notice- able is the bedroom far excelence, the ladies\" department. The grounds about Spencer Grange are not extensive, but the house is so situated that wher- ever you look you see a miniature wood, you could fancy yourself a dozen miles from the city instead of three. Mr.LeMoipe has added a new front, which gives extra room and takes off from the plainnesé of the old building. The architect deserves credit for the skill he has employed in its construction. Such a cosy little sewing room, ftanked by the most comfortable of bed-, rooms, where good taste prevails in the color- ing and orfiaments. One hing specially noticed was the heads of rare wild animals, and in every corner trophies of the chase. A pretty aviary also adjoins the dining room. I bope it May be Mny yrs ere death or sorrow invade its presence",
         ") CHAPTER XX. THE MONTREAL GENERAL HOS- PITAL. Permitted by the kindness of the officials th sit for many hours a day for several weeks be- side the bed of a young Englishman, who had no relatives in this country, and who required constant watching, I had an opportunity, given to few outsiders, of seeing thoroughly the work ing of this institution, and, though the old pre- judice against hospitals hàs died away, and I had come to recognise the nursing as'far supe- rior to that possible in a private house, I had no' conception of the perfection to which the arrangements have been brought in this establish- ment.- In fact, had I to choose between leaving a !ck friend at a well regulated hcspital (even as ia non-paying patient) or at a fine hotel, I should choose the former, knowing they would be better cáred for than in any outside institution wanting hospitat appliances. When all is so well conducted, it is hard to discriminate. From .1 *~ -~ 4-¶~.~ mn QUEBEC AND 17S VICIWI7Y. s: -7. 103",
         "04 QUEBEC AND ITS VIClNITY. the dignified matron, Miss Livingston, to the under-nurses and assistants, all work thoroughly and cheerfully; but, as it was in Ward i i, where I had my part of observation, I must be excused if I mention specially the refined head nurse, Miss Chapman, and her assistants, Miss Hobson and Miss Priam. The two former are English ladies, and the latter a clergymari's daughter from Ùpper Canada. The extreme delicacy with which they discharge often disagreeable and painful duties is beyond all praise, and Miss Chapman, being an educated lady with considerable medical, know- ledge, I would rather take my- report of my friends conditià from her than from that of the attend- ing physician, because while he sees the patients at certain.hours,she sees them at all times and can note things he cannot. \"An I righ , Dr. McRee- ves?\" I sec the doctor's beamin face and cour- teous bow as lie says. \" You are right, madame.\" And now permit me to say, in rny humble opinion, that he Montreal General Hospital still wants two things to i{ake it perfect. As this article is written without any one's knowledge, I alone am responsible for the suggestions that may possibly bear kood fruit, but cannot do any harm, so I will venture to iemark, I think the two things most '7' - * * * - '*'*~--~",
         "QUEBEC AND 17S VICIN17 Y. 105 I w needed in connection with this institution are- a convalescent home attached to or near to the city, conducted exactly as the hospital itself, with intelligent nurses to take care of patients well enough to leave their beds,butsyet requiring weeks of care, a change from the sick ward eŠn sleep is not liable to be disturbed Ify sicker patients, cheerful surroundings and pleasant companion- ship, instead of the sight of others' suifer- ing, must surely be an aid to recovery ; and two separate wards for ladies and gentlemen of refinement but small means who cannot afford a private room. .I fully recognise the fact that. the non-paying patient has all the care and luxuries ordered for his case as much as the one who pays $6o per month; but how much more comfortable a lady with moderate income, or clerk on small salary, would feel if he could get to the ward set apart for such cases, and pay a moderate sum as he would in a boarding-house, and in the end I think it would pay, for so many would pay some pounds per month who give nothing now. Think of this al ye in high places, let the grand corpo- ration of the Canadian Pacific and Grand Trunk with its hundreds of employees, some of tel'-",
         "1o6 QUEBEC AND ITS VICJNITY. whom are always in this institution, ponder seriously on these facts, and may God lead them. to think to purpose and bring into action with good result. Are -we not all interested in this matter ? What may fnot a day bring forth ? Who is to say but to-rnorrow we ourselves, our sons, daughters or brethren, may not find ourselves at the mercy of this or. some similar health-- restoring home. If the Canadian Pacific Railway and Grand Trunk Railway were to donate a sumthey could easily spare r a few wards I have spok n of, they could be kept up by contributiofs and rxoney received for boarding patients o4 tter class, who in the time of illness would be spe- cially sensitive to surroundings.",
         "QUEBEC AND 17S VICNJ7Y. 107 CHAPTFR XXI. NOTES ON NURSING. THIS part of my book must necessarily be egotistical, if I arn to help others by my advice and experiece. I can only do so by saying what I did myself and howI came to, do it. Well, in the year - , a young son of mine was sitting on the Esplanade, Quebec, watching some exhibition, when he found the party seated beside him was a young girl covered with small- pox. He left quickly, but the harm was done. I forget how many days after he took ill. The late lamented Dr. LaFleur, of Levis, attended him, and from him Ilearnt the treatment, which enabled me, alone, without nurse or pNsician, to treat another son. Both Wvere very bad cases, and neither bear the slightest mark of ever having had the disease. I wished to go to the General Hospital .in Quebec with my boy. \"What is your object?\" Dr. LaFleur inquired. \"To prevent giving it to others,\" I answered. \"Well,\" he said, \"as fil.~",
         "108 QUEBEC AND ITS VICINITY. you would have to get a carriage, cross in the steamer, aÉd drive some dlistance, youwould probably do yourson great harm and risk in- fection to dozens' of people before you get there.\" So I remained wheré I was. We occupied a very large double house; one side- parlor and bedroom was tightly closed off from the rest. All food was carried to me by an old man, hired to sit on a grass-plot and bring what was re e -taking it from the servants' hands and ositing it on the gallery. Every article of rniture was taken and, with carpet, put in th h ngard, and theie kept three months. I only r tai ed a· bed, and I had a small stove4 in which burnt alH remains of food, and the plates were th' roughly soaked in disinfectants before bein(returned to the cook. All linen and bits of tton used as pocket handkerchiefs were burnt, d the sheets thrown into tubs of cold watjwth disinfectants, and the old man, with a stick, shaking them around several times, before changing the water, and put them out on the grass, in the hot sun, to dry; thus I could change the bed every day or two, and yet not risk infection to others by having them washed. Dr. LaFleur only came into the house for about a",
         "QUEBEC 4NfD ITS VICINITY. week, he looked at his patient through an open window. I attend alone for six weeks, and then two t\u0026tsere erected, in one of which he and I sat n alked to other members of the faalily in another tent. This was the one solitary case in South Quebec. Thank God no one took it from us. And now for my second case and the treatmerrt: I must premise I pretend to no nedical know- e. Inever gave a pulse or temperament to a doctor, for my days were the days of Dickens' Sarey Gamp, and to give a drink, or rather not give a drink, of cold water to a fever-stricken and thirst-consuming patient was the utmost we aimed at in nursing; so that in acting the parf of sole physician, I was driven by stern neces- sity by no desire of my own. When first the small-pox epidemic appeared iri Montreal, there was a regular panic, there was not rgoéi in the Civic Hospital, and the doctors feared to attend small-pox cases on account of the fears of their other patients. This was the poâtion of affairs when i went one morning to my dressmaker, and asked her to make some small repairs to a pair of pants belonging tq my . When I went back for them and for some dresses (fortunately they log y \u0026,~",
         "110 'QUEBEC AND ITS VICINI7Y. were calico and so washed), I noticed a very peculiar and disgusting - odor. I remtrked, \"You can never ,e healthy in such an atmos- phere as this. . Why don't you open your win- dows?\" \"They have been open.\" The room was in semi-darkness, and a child's cot was in the óeeorner. I believe now the sick child was in that cot. I took my effects and departed. The next day. Mrs. G--, a.-kind neighbor from that house, saih: \"You get your sewing done there ? I want some done; but little Jeff, wh6 went to get some milk there, says he is sure that he saw a child ill with small-pox, and refused to take the' milk.\" ''lCan it be possible '\" It flashed upon me instantly fhat was reallye peculiar disgusting odor. of small-pox i had smelt. I said sd. A doctor was sent Ito investigate, and it was found to be the case ; and the criminal neglect of that family gave it to ten parties kn that street-one of themÂmy son. A brother of little Jeff took it also. My patient had started on business and reached Toronto, feeling very ill; went to a physician there, who told him there was a good deal, of low fever about, and he had better lay up in some hospital there. He said, no, he would come home,; but, just on arrival, wanted to go to an hospital-",
         "QUEBE AND 1.TS VICINITY. III beginning, to fear it was small-pox. But as -it was late, and he very much eychausted, I- per- suaded him to stay with us night, as he had had -no food and could eté none. I gave him some hot bitter ale (an old Englishman had told me it was a good thing to cause an eruption to come Ôut). He- slept the sleep of exhaustion tha, night, and the next morning he was covered with a rash. We had been such a healthy family. We knew no doctor in Mont- real; knew none to whom to apply. So (and now the personal pronoun must- be used very often if I am to obtain the d'esired result from these memories) that by helping -any one unexpectedly placed in, my position, unable to procure medical help, I was enabled to take care of and preserve the life and prevent dis- figurement of a patient, and destroy all danger of infection. . I called to Mr. G--, a neighbor, from an upper window,-and asked him to send me a doctor. \"'What for?\" \"I don't know.\" \"Can it be small.-pox ?\" \"It may be.\" So he sent. Dr. Laberge arrived, glanced from a distance, said \"4I'll send the doctor of the Civic hospital to. mnorrow. We'l1 judge betterthea.\" There was i it",
         "r '. 112 QUEBEC AND ITS VICINIT. chloride -of lime on a .saucer in the passage, through which passed a through draft of air. There was'no one in the housé except.my hus- . band, my son and myseilf. My servant had gone home some days previously. My dear husband would not leave; but I never spoke to him, except from a distance, for six long weeks. He occu- pied a room in the lower story, and spent his days walking in the country, and took his meals out. The next day the civic doctor arrived- he pronounced it an unmistakable case of small- pox. \"Will you have him taken to the Civic hospital ?\" was the next query? \"Can I hire af room to go with him, and nurse him, if I stay inside all the time?\" \"No ; there is no roon to hire. The hospital is crowded. It will be as much as I can do to get your son a bed; then he will remain.\" The two next houses were unoccupied--parties were in the country. Mine was on a corner, net a large vacant lot, opposite a large green, field, with an empty school-house. I decided to ask permission to remain. I again sent for Dr. Laberge; he ' took in the - sur- roundings, and said I could, ashe saw I was to be trusted. I asked him to attend my patient ; he said he could not, in his public situation he",
         "r,1 QUEBEC AND ITS VICIITY. I 13 would risk too much infection to others. \"lWell, then,\" I asked, \"can you tell me how to make the salve Dr. Lafleur, of Levis (now deceased)ý put on the patient's face to prevent disfigure- ment ? Was it black?I\" \"No, grey.\" \"This I can- not tell you; but I know.in England they use something with charcoal in it.\" And that was all the medical advice I had in the course of this long, and very serious illness, for it was a very bad case, and the doctor who had seen my son in Toronto said, from the weakness of my patient at the time he saw him, he thought that there were no hopes of recovery. I also sent for Dr. P- , of Bleury street. He looked in from the door, and said his duty to patients he was then attending would 'prevent his com- ing, unless in case of inflammation of the lungs or other serious complication. So I prepartd for a seige in earnest. I talked from an upper window,'and ordered that essence of beef and a bag of ship (not cabin) biscuits, be sent to me. Some canned things for myself, cheese, other crackers, honey,-preserved fruit, lemons, oranges, gelatine.and wine for jelly, etc.; and as medical stores an ounce of flour of-sulphir, a bottle of iodine (srall one), a jar of mineral water, a few k ~",
         "114 ' QUEBEC AND ITS VICINITY. ounces best cream of tartar, a small quantity of powdered charcoal, a box of pure fresh lard, a small new paint brush, a bottle of sweet oi, and a few seidlitz powders. This was all my medical paraphernalia, more preventive than curative, for I pretend to no medical knowledge. OTHER PREPARATIONS. In the outbuildings was a table, with drawers, containing silver money over-a cup of chloride of lime, paper, and pen and ink. I arranged with a man to place on that table every day, a pouncf of any kiÉd of fresh meat, some boxes of -strawberries, half a gallon of milk, a few fresh eggs, and the daily papers. My friends were requeste after ringing the bell to look to the parlor window, from whence I said how we were getting on, and to place between the doors amusing books, papers and letters. Well, with profuse apologies came the men. \" So sorry, but we are obliged -to placard you.\" \"So much obliged,\" said I. \"Put it on the outer door where it can.be well seen, and then I shall have perfect quiefiid-not be bothered by visitors.\"",
         "QUEBEC AND ITS VICINITY. 115 Now I think it is time to go back to my patient, whom I have left quietly dosing in the very top story on the bath room flat. For the first few days he was very weak, his long travel and anxiety to reach home had told upon him, so occasionally I gave him hot ale as nutritive and stimulating, and sailors' biscuits and strawberries. He was delighted with the biscuit. \"How did you corne to think of it. I could not have eaten bread.\" I know by experience that a person ill can eat sailors or soda biscuit when they cannot eat anything else; besides, the baker ceased to corne, and if the man I had hired to bring me provisions failed me, I was insured against starvation, for none of my family wòuld have been permitted to corne near me. I have since learned, that when a house is placarded, you can insist on a policeman calling with eatables every day. As soon as the eruption was fully out, I made a salve of charcoal erfectly black, with which the patient's face was thickly covered, he ,only looked like a negro, and as the oldest of everything was brought into use and burnt in a small stove on the same flat, it did not matter much. Old shirts shared the same fate, and for pocket handkerchiefs I used old squares of cotton,",
         "116 QUEBEC AND ITS VICINITY. and burned them. M I put into practice what Dr. LaFleur taught e. It sounds disgusting, but is not everything about small-pox disgusting, and a few days patience and perseverance protects from disfigurement for life. So I must tell you that every single justule as soen as it reacker - maturity, must be picked with'a clean fine nudle, and not suffered to eat holes in the skin, for this is what causes disf;gurement, by small-pox. Then mix equal parts of cream nd iodine, and with a small cl n paint brus touch every pustule, don't neglect one, or there will be mark. This must be done every day f a few days ; if it smarts put more -r am, and then every day for about a week, put on all over the face a mixture of cream and glycerine. - That is the whole process, very simple in practice, and which not only saves the looks, but gives great relief, by taking away the intolerable itching which-.-mall-pox patients s.iffer from; for sore throat and inability to swallow, gargle with flour of sulphur, and put a little on the tongue. Now for diet. As soon as the eruption was fully out, I gave all fruit and milk he asked. I stopped the ale, and never gave a drop of wine or stimulant of any kind during the wh six",
         "QUEBEC AND ITS V/CINITY. 11y weekš he was in my charge. I may state here that from what 'I hav heard, I attribute the great disfigurement amongst the French Canadians, particularly of the lower class (intelligent people know better), to the great quantity of whiskey and'g'n given at that time. In fact, heard a man say in the cars one day, ere is o ly one remedy for smiiall-pox, this a 't a you g child-du gin à force-meaning gin any q antity, and now mind ask a doctor what t s uld be, as I had no doctor. I gave my pat ýwhat he asked for, tea, coffee, broma, le and when the fever was high lemonade with ple of cream of tartar, for which this receipt Takean ouce oofcreamn of tartar, put it in a goodsi jug, cut up a lemon and put it on the cream of tartar with me white sugar, pour on it MoMe boi f water to extract the , then fill up with cold water, when well settled, veasthe patient is tbirtty. After the anxiety of the first ten ays was oueg, and my patient began to mend, we had some very pleasant though quiet days. I read aloud amusing books and papers, at the nd-of about six weeks I thought iny patient well enough to go free, .,and so called out of",
         "l is QUEBEC AND ITS VICINITY# the Window to send for a city doctor to pro- 'hounce my patient cured. We went into the hangard, where a nice dinner was cooling on a coal oil stove, passed the day there while the house was being disinfected, and returned next day'to freedom, with grateful hearts to rejoice over past danger. If I have been so minute in these details, it is that in times of publie- calamity, when doctors are overworked and hard' to procure, most parties.lose their wits, and do not-exercise the calm judgment that might otherwise help to save their friends and themselves. I must note as, a singular fact that both the gentlemen I have spoken of as patients had been vaccina9ed as children, which shows the necessity of revaccination, while ' , who attended them, had not been revaccinated, and, after a lapse of fifty years 4accination, never took it, though I attended them both. An extraordinary exception, not to be relied upon. The question was asked me, what would you ve done if your patients became delirious, as ou were alone ? They were both, t times sligltly delirious, but not annoyingly so. Had they sho th ls1ightest symptom of becoming",
         "s- k QUEBEC AND ITS VICINITY. 1I\"9 uncontrollable, I should have rolled them in sheets, tied them, and called for help. I had reasoned out- all my plans in my own mind. So I give this as t hint to others, and I advise any one else to bathe the feet constantly in sweet oil, as one patient suffered most from his feet. In cases of yellow fever, I have heard that in the'South they apply a salt erring to thp sole of the foot, it draws out the fever, becomes black, is burnt, and another put on. I would now try the,.same on small-pox, taking ç care the brine d.d not touch the skin, the herring to be -well covered. CHOLERA. The first case of cholera I remember of was the case of a servant who was pronounced by two doctors almost in the stàte of collapse. A man-I never- knew ,his name-asked to be allowed to try what he could do, as there was pronounced no hope. He tried .brandy in good greén tea, after a dose of castor oil,-I think a Ytea-spoonful of best brandy in a small cup of hot green tea. The women recovered, and,ilike wildfire, the news spread, and old Mr. Tibbits, recently deceased, and - Horatio Patton, Esq., r'",
         "120 QUEBEC AND ITS VICINITY. both lumber merchants, employing hundreds of hands, used to start out in the morning, on their rounds, each.carrying a bottle of brandy and pail of hot tea in hands, waiting on and saving the lives of hundreds of men, women and children. The late Brian O'Hara, Esq., a very old friend of my dear father's, told me that when a merchant in Porto Rico (he was English con- sul there), so miany of bis blacks died of cholera, that he was obliged to have a large dining. room® in his house prepared as an hospital, and thé ladies of his family to look after them. Cold water was supposed at that time, in nearly all çliseases, especially cholera, to be so, much poison, and the men were, some of -them, strapped down to prevent their getting at it. One powerful fellow, on seeing the m* place water on the verandah, broke his nds, and before he could be stopped, drank re than a quart ; all expected to see hi die, instead, he 'began to mend from moment, and then the othes were allow to use it. None died after. ' I had a very young c ild ill with country cholera. My lather ad my trying cold",
         "QUEBEC AND JTS VICINZTY.* 12T water and giving the child ice to suck. My boy is living now. And a young doctor, living near us at Lake St. Charles, refused to try it, think- ing it too hazardous a remedy. His child dièd. Water poured on chopped raw heef, allowed to soak to extract strength, is also good in cholera for a young child. Now, cholera is much better understood ; then its treatment was guess work. A physician, now deceased, who had a great deal to do with it (late Dr. Michaud, of Kamouraska), told me, 'from the first moment of an attack, if possible, o1he attacked should remain perfectly quiescent. The movement of a hand even being unwise. PREVENTION. Mrs. MacDonald, wife of a sergeant in the army (one of Quebec's noted nurses), told me that on the outbreak of the cholera in India, the doctor of'the regiment ordered that every man, woman and child put on and keep on a flannel band, reaching from the waist to the hips, and not one of their regiment died of it.. Apropos of cholera, the late Dr. James Sewell told me that when in England, staying with two old lady friends, one betame ill. He said. 9 B i t' * ,*-,i~.",
         "122 QUEBEC AND ITS VICINITY. he had seen so much of it in Quebec he knew it was cholera by the peculiar look in the eye, and advised thpm to send for their own doctor at ôhce. The learned. man' came and, after examining the lady, said it was nothing seriou and wanted to see this young prodigy fr America who kftew so much. The lady as dead before night of Asiatic cholera. The on- .don physician knew it in theory, D e' Il by practice. . But· even Dr. Sewell's we tried knowledge failed to save his cher'ied wife, who died of it after a few hours. il ess. The first symptoms must be attende4 to at ·once ; whereas this lady, seeing her husband so over- worked, failed to acquaint him how ill she felt, and fell a victim in part to her own unselfish. ness., How great was the universal sorrow I need not say. CANCER. The late Dr. Anderson told me he had seen bis father, I think it was, cure a woman. by the application of pure lemon-juice. He said the lemon-juice killed the cancer, the bad fiesh fell off, and the woman's slgulder remained per- fectly cured without.aid of the knife.",
         "QUEBEC AND ITS VICINIT. 12 SPRAINS. An Indian remedy for sprains is to take salted parsley and bind it on the sprained part, chang. ing it occasionally till'it is cured. This I know, to be perfectly successful, having seen a party treated. Hot carpomile infusive is also good for a sprain. INDIAN REMEDY FOR DROPSY. 1 was told that a woman who had lived near us some years ago, a farmer's wife, had been ured by a squaw, by covering the whole body ith slices of cucumber which drew out the water through the pores; I do not know whether this is true or not, but it was told to me for a fact. For sting of a wasp or bee, wet earth, and put it on, it will take away the pain at once.",
         "k Y 6",
         ". QUEBEC AND ITS VICINITY. TO MY SUBSCRIBERS. A word of thanks. Nearly all personal friends of half a century standing I have desired that a record may be kept of your ,names, a pleasing remembrançe of the past. At th.e time I pen- ned .these old mernories I had no' idea of publishing themr; having done so I thank you, and on the success I achieve will depend whe- ther or not I ever come before you again. CHARLOTTE MACPHERSONd MONTREAL. E. Arnoldi. LM T L W. S. Taylor, treasurer C.P.R. W. E. Suckling, assistant treasurer C.P.R. S. E. Taprell, cashier C.P.R. - )Dr. Kirkpatrick, Montreal General Hospital, W. Grant Stewart, M. D. G. W . Swettý Windsor Hotel, 2 copies. J. Penfold, Bank B.N.A. M. Michaels, Windsor Hotel, 1 copies. E Macauley, Insurance. J. W. McCallum, advocate. Joseph Ringfield, 54 Victoria Street. Mrs. E. Urquhart, do Mr. R. Hall, do Andrer Baille. E. B. Meyer (Morgans). J. C. Johnston, Courville Street. Miss Duggan, do. J. H. Michaud, g3 Mackay. ~ Lewis J. Trotter. F. Meredith, Esq., barrister. 44% L 125",
         "QUEBEC AND ITS VICINITY. Chas. Austin, ii Hospital Street. H. Lindsay, Art Gallery. Mrs. Kingston, Dorchester Street. H. Girard, C.P.R. Dr. LaBerge. Provincial Board of Health. Dr. Lachapelle, Board of Health. G. A. Bowen, 53 Victoria Street. W. D. Dawson St. Lawrence Street. Rev. G. Osborne Troop, 577 Sherbrooke. Miss F. D. Joseph,'i9 Milton Street. Miss M. Milne. R. G. Kelly, 21 Laval av. E. 13. Greenshields, 2 copies. A. B. Chaffee, C.P.R. Jno. W. Molson. Dr. McKechnie, Montreal General Hospital. Walter Paul. W. D. Dupont. Rev. Bd. Wood, St John the Evangelist Chugh. A. Joyce, Cathcart Street. W. Denoon, Peel Street. J. H. Bouchette, i Drummond Street. L. Barbeau. Chs. Ho11and. Ernest Stuart. J. P. P. Casgrain. J. Cradock Simpson. Chs. Alexander. Wm. S1harpley. Theo. Robincon. Geo. McKay, 1871 Notre Dame Street. J. Alex. Strathy, 73 St. Frs. Xavier Street. A. Bishop Stewart. W. F. Smardon. D. Walker, 2347 St. Cateie Street. R. T. Takahashi, a367.St. Catherine Street. SamL. S. Grant. *j Beaver Hall Geo. E. Drummond 1fer; 126",
         "QUEB'C AND 17S VICINIT Y. Strachan Bethune. J. F. Gibsone. Henry McKay, 233 Commissioners Street. W. J. Anderson, 99 Commissioners Street Jas. G''Shaw, 37 ter Street. Mrs. F. A. Fuhrer. -C. Meredith, 87 St. Frs. Xavier Street. A. Macnider, Bank of Montreal. J. H. Pipon, Bank of Montreal. U. Garand, Banque Ville Marie. J. A. MacPhail, Mansfield Street. Somerville Weir. John Palmer. C. F. J. Phillips, 1755 Notre Dame Street. H. C. Scott. L. J. R. Hubert. M. Authier. David Denne. Gerald E. Hart. David R. McCord. Wm. McLennan. Henry Fry. W. Drysdale. Forbes Torrance. Miss Coleman, 54 Victoria. Dr. Fenwick. Alfred Monk, ;80 St. James. QUEBEC. St. Iuis Hotel. W. G. Lemesurier. HonI.Tos. McGreevy. Hon. Pierre Garnea.- Lady Stuart. Madame J. T. Taschereau. Hon. M. Stearns, Legislative Assembly. Archlibald Campbell, Esq., Prothonotary. John Barroughs, Esq., Prothoeotary. Ilmis Fiset, Esq., Prothonotary. C. P. Angers, Lie1it-Govr. 1 21",
         "5z8 QUEBEC AND ITS VICINITY. The Ursuline Convent. J. J. Foote, Chronicle. Mercury office. George Van Felsan. E. Chinic. Hon. David Ross. Ernest Hamel. H. Hope Sewell. Henry Austin, notary. M. Cook, advocate. J. D. Dawson. Robert Mitchell. H. W. Wright. James Carrell, Telegraph Co. St. Leon Mineral Water Co., 5 copies. J. H. Philips, St. Leon Water Co. Rev. J. H. Petry. C. E. Holiwell, bookseller. Auger \u0026 CampbelI, notaries. Arthur Hunt. Daniel McGee. Jas. A. Macnider. J.'Stevenson, Quebec Bank. E. G. Meredith, notary. H. M. G. McMiîchaell, manager Bank t. N. A.è J. C. Moore, Merchants B. of Çanada- -- P. G. LaFrance, Banque Nationale. P. B. Dumoulin, Banque du Peuple. Mittbew Miller. W. Lidsay Creighton,Bank of Montreal. A. Thopson, president Union Bank. E. G. Price, vice-president Uj'on Bank. E. J. Hale, director Union ank. D. C. Thompoon,.Uinion Bank. E.E.. Webb, cashier Union Bank. D. indby. -. -a B ber. TroN~ITO. ............ .",
         "li- - 4 - - 7 e - fk"
      ],
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         "text"
      ],
      "contributor" : "oocihm",
      "collection" : [
         "wmh"
      ],
      "note" : [
         "Half title : Quebec and its vicinity.",
         "Title from title screen.",
         "128 p. ; 19 cm."
      ],
      "lang" : [
         "eng"
      ],
      "subject" : [
         "Quebec (Province) -- Description and travel.",
         "Québec (Province) -- Descriptions et voyages."
      ],
      "location" : "http://eco.canadiana.ca/view/oocihm.09677",
      "creator" : [
         "MacPherson, Daniel, Mrs., ca. 1828-1892."
      ],
      "key" : "oocihm.09677",
      "label" : "Reminiscences of old Quebec : subterranean passages under the citadel ; account of the old convent of the Congregation of Notre Dame that does not now exist ; prominent old Quebecers, \u0026c., \u0026c. / by Mrs. Daniel MacPherson."
   },
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   "version" : "0.4"
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